PMID- 8460533
TI  - Giant collagen plaques in Creutzfeld-Jakob disease. Report of two cases with
      ultrastructural studies.
AB  - We report two cases of Creutzfeld-Jakob disease with clusters of giant collagen
      fibers. To our knowledge, these abnormally large collagen fibers have never been
      described in patients with degenerative diseases of the central nervous system.
      The significance of the formation of such plaque-like large collagen fibers has
      as yet not been elucidated. It is felt that these represent a product of the
      degenerative process.

PMID- 8460532
TI  - Alzheimer neuropathology in mentally retarded adults: statistical independence of
      regional amyloid plaque and neurofibrillary tangle densities.
AB  - The densities of neurofibrillary tangles (NFT) and neuritic plaques (NP) were
      assessed quantitatively in the brains of 303 mentally retarded adults 23 to 90
      years of age at the time of their deaths (mean = 59.5 years). Cases with Down's
      syndrome, hydrocephalus and metabolic disorders were excluded from the study.
      Examinations of frontal, temporal, parietal, and occipital cortex, as well as
      hippocampus and parahippocampal gyrus were made in every case. NPs and/or NFTs
      were observed within the brains of 163 cases (53.8%). Detailed analyses indicated
      that NP density within all brain regions examined was positively related to age,
      with the largest age associated increases in density seen in frontal and temporal
      regions. In contrast, NFT density increased with age only within hippocampus and
      parahippocampal gyrus, but not neocortex. In addition, NP lesions within
      neocortex were more diffusely distributed across regions for older compared to
      younger cases, while no similar age-associated change in the topography of NFTs
      was observed. Finally, factor analyses of the combined NP and NFT data indicated
      that, while strong correlations existed across the various brain regions for
      measures of NP and NFT densities, considered separately, there was virtually no
      indication of regional associations between these two types of lesions. While
      these data, from cases with mental retardation, cannot be generalized directly to
      the nonretarded population, they provide strong evidence that models of Alzheimer
      pathogenesis must take into account the fact that regional densities of NPs and
      NFTs, and, therefore, the underlying processes associated with formation of these
      lesions, can be largely independent.

PMID- 8460534
TI  - The heterogeneous temporal evolution of focal ischemic neuronal damage in the
      rat.
AB  - Male Fisher rats (n = 61) underwent permanent focal cerebral ischemia induced by
      left middle cerebral artery (MCA) occlusion, in conjunction with ipsilateral
      common carotid artery ligation. The experiments were terminated at time points
      ranging from immediately following occlusion to 30 days post MCA occlusion. A
      coronal histological section, in close proximity to the site of the arterial
      occlusion, was taken from each brain and divided into six areas encompassing the
      affected cortex and caudate putamen. Each area was analyzed for ischemic damage
      according to a grading scale that reflects changes in neuronal morphology.
      Differential neuronal counts were also made on a 0.5-mm2 field in each of the six
      areas. The areas closest to the occluded vessel showed accelerated ischemic
      damage between 8 and 12 h after occlusion, leaving open the possibility that
      before 8 h, therapeutic intervention may be effective. After 12 h, changes in
      these areas progressed to complete necrosis and eventual cavitation with a
      complete loss of neurons after 10 days. The areas more peripheral to the occluded
      vessel exhibited mild ischemic damage, with an apparent reversal of damage
      grading at later time points and no loss of neurons. This reversal of ischemic
      damage in the peripheral areas is suggestive of a histological equivalent of the
      penumbra.

PMID- 8460535
TI  - The topographic distribution of brain atrophy in frontal lobe dementia.
AB  - The topographic distribution of brain atrophy was quantified by image analysis of
      fixed brain slices from ten patients dying with dementia of frontal type (DFT)
      and from six other patients dying with dementia of frontal type with motor
      neurone disease (DFT + MND). In both groups the atrophy was maximal within
      frontal, anterior temporal and anterior parietal regions of cortex, although
      other structures such as the amygdala, caudate nucleus, thalamus and hippocampus
      were also affected. The magnitude of the atrophy was much greater, in all
      affected regions, in DFT alone than in DFT + MND. Grey and white matter were
      affected equally in DFT alone although in DFT + MND a preferential white matter
      involvement was noted. No differences in the topographic distribution of the
      atrophy was observed in cases of DFT showing a spongiform degeneration of the
      cortex compared to those showing a gliotic degeneration with, or without, Pick
      cells and Pick bodies.

PMID- 8460536
TI  - Type C Niemann-Pick disease in a boxer dog.
AB  - Pathological and biochemical studies were performed on a 9-month-old boxer dog
      with progressive neurological abnormality. Histological examination revealed
      marked neuronal storage throughout the central nervous system and histiocytic
      storage in the reticuloendothelial system. Ultrastructurally, the neuronal
      storage consisted of accumulation of concentric membranous inclusions and
      clusters of dense bodies. The biochemically unesterified cholesterol content was
      high in the liver and spleen. The brain showed increased levels of
      lactosylceramide and two gangliosides, GM3 and GM2. These findings indicate that
      this dog was affected with a heterogeneous lipid storage disease similar to the
      human Niemann-Pick type C disease.

PMID- 8460537
TI  - Recent advances in breast feeding.
AB  - Increasingly, epidemiological studies are showing the benefits of exclusive
      breast-feeding to infants in industrialized countries, as they have previously
      for those in developing countries. In this review we have focused on several
      recent developments, in particular on the interplay between infant behaviour and
      maternal physiology in regulating breast milk supply. This will illustrate that
      many past and current clinical problems concerning breast-feeding are likely to
      be of iatrogenic origin, the products of imposing arbitrary rules for breast
      feeding management. In order for the protective benefits to be fully realized it
      is necessary to ensure that breast-feeding is free from prescriptive practices.
      We will illustrate the key role played by the infants' control of appetite in the
      hope of encouraging clinicians to empower infants to exercise more control over
      the feeding process.

PMID- 8460538
TI  - Two color flow cytometric analysis of lymphocytes in HTLV-I carrier children.
AB  - Phenotypic changes in lymphocytes from healthy children with antibody for human T
      lymphotrophic virus type I (HTLV-I) were studied using two color flow cytometry.
      The subjects were high school students within a small district of Kyushu, Japan.
      In the carrier group, a subset of lymphocytes which expressed CD8+CD57+ was
      significantly lower in percentage (P < 0.01) and in number (P < 0.05). There was
      no significant difference between carriers and non-carriers in the percentage and
      number of CD4+Leu8+ cells or CD4+HLA-DR+ cells. The IgG levels were slightly
      higher in carriers than in non-carriers (P < 0.05). These findings suggest that
      HTLV-I-infected cells may affect the immune system in healthy carrier children.

PMID- 8460539
TI  - The in vivo and in vitro postantibiotic effect of aminoglycosides using a
      clinically isolated micro-organism.
AB  - We reported a case of abscess in which Serratia marcescens was isolated as the
      causative organism. We measured the postantibiotic effect (PAE) of dibekacin
      (DKB) and gentamicin (GM) against S. marcescens and studied the relationship
      between the clinical effect and the PAE. The minimal inhibitory concentration
      (MIC) of DKB against S. marcescens was 6.25 micrograms/mL and the serum
      concentration 30 min after infusion of 100 mg DKB was 5.99 micrograms/mL. The
      abscess was cured by the administration of DKB every 12 h. The PAE in vivo was
      2.5, 2.9 and 3.3 h when DKB was administered at 50 mg/kg, 100 mg/kg and 200
      mg/kg, respectively. This PAE is one of the reasons that infection can be
      effectively treated with intermittent administration, even if the serum
      concentration is below the MIC.

PMID- 8460540
TI  - Growth and growth hormone secretion in children after bone marrow
      transplantation.
AB  - Long-term sequelae of bone marrow transplantation (BMT) are a major concern among
      long-term survivors since the procedure has been considerably developed over the
      past decade. In this study, linear growth and growth hormone (GH) secretion were
      evaluated in 25 children (14 males and 11 females) with various neoplastic or non
      neoplastic hematological disorders who had survived for more than 3 years after
      BMT. Impaired linear growth after BMT, as defined by a change in height standard
      deviation score (SDS) by more than -1.0 SD, was observed in 14 patients (56%).
      Four children showed severe growth suppression with a decrease in SD score by
      more than 2.0, and 10 exhibited a moderate reduction by between 1.0 and 2.0 SD. A
      recovery of normal height velocity was observed in those who had received BMT at
      a younger age. The type of disease, a difference in preconditioning regimen, the
      presence of chronic graft-versus-host disease or a GH secretory capacity 1 year
      after BMT were not contributing factors for impaired growth. A serial examination
      of GH secretion with insulin-induced hypoglycemia demonstrated that poor GH
      secretion was not necessarily a prerequisite for impaired growth. These results
      indicate that the secretory status of GH does not predict the future growth
      pattern of children who received BMT.

PMID- 8460541
TI  - Role of vagotony in sinus node dysfunction in children with symptomatic
      congenital long QT syndrome.
AB  - The present study examined chronotropic dysfunction and the role of vagotony in
      congenital long QT syndrome, sinus node function and the effects of
      parasympathetic blockade. Six patients with congenital long QT syndrome were
      studied. The four males and two females, aged 1-15 years, had episodes of syncope
      and malignant ventricular arrhythmias. Congenital long QT syndrome was defined as
      a corrected QT interval greater than 0.45 s, T wave alternans and the age at
      diagnosis. The sinus heart rate measured from a 24 h electrocardiograph was
      abnormally low (< 50 min) in three patients (1, 4 and 5 years old) and did not
      increase sufficiently with the administration of atropine in five of the six
      patients with congenital long QT syndrome. From intracardiac electrophysiological
      studies, the corrected sinus node recovery time was prolonged in three patients
      and the total sinoatrial conduction time was prolonged in two patients. In most
      patients who had an abnormally long sinoatrial conduction time and corrected
      sinus node recovery time, these values returned to normal following atropine
      administration. In one patient, the corrected sinus node recovery time was
      prolonged paradoxically by atropine. Sinus node dysfunction in congenital long QT
      syndrome was affected by vagotony associated with a right sympathetic nerve
      system abnormality.

PMID- 8460542
TI  - Management of colorectal polyps in children.
AB  - Forty-two patients each with a colorectal polyp have been treated in our hospital
      over the past 10 years. In twenty-two cases the polyps were noted in the rectum,
      nine in the sigmoid colon, seven in the descending colon and four in the
      transverse colon. Each patient had only one polyp. Hematochezia was the main
      symptom in 29 patients, prolapse of the polyp from the anus in 10, abdominal pain
      due to intussusception in two and no symptoms were observed in one. Auto
      amputation of the polyp was considered to have occurred in five patients. Twelve
      rectal polyps were resected from a transanal operation, and another 25 polyps
      were removed endoscopically with electric cautery. We have had no experience of
      endoscopic complications such as bleeding or perforation. A histological
      examination revealed an adenoma in one patient. Other polyps were non-neoplastic
      and were classified as juvenile, inflammatory and hyperplastic in 30, two and
      four patients, respectively. There have been no recurrences of polyps to date.

PMID- 8460543
TI  - Irradiated fetal thymus transplantation in a patient with combined
      immunodeficiency with predominant T cell defect.
AB  - A 6 month old boy was diagnosed as a case of combined immunodeficiency (with
      predominant T cell defect by previous classification). His T cell count was
      decreased, his B cell count in peripheral blood was increased, his serum IgG
      level was decreased, his serum IgM level was normal and the thymus was not
      evident on CT scans and magnetic resonance imaging. Administration of the thymus
      hormone, thymosin, led to a partial recovery of T cell function without
      normalization of the T cell count. At age 26 months the patient received an
      irradiated thymus transplantation from a 16 week old female fetus. After the
      transplantation, the T cell count (mainly CD4+ cells) increased by 50-70%. A mild
      graft-versus-host reaction (GVHR) occurred and several immunosuppressants were
      prescribed. Chromosome analysis showed that the T cells have both 46 XY and 46 XX
      karyotypes while the B cells have the 46 XY karyotype alone. His cellular
      immunity (skin tests, DNA synthesis, mixed lymphocyte reaction, cytotoxic
      activity and natural killer cell function) and his serum IgG level remained low.
      However, being on regular r-globulin therapy and oral anti-fungal drugs, he is
      now living normally with almost no trouble at age 6 years and 3 months. This case
      showed that irradiated thymus transplantation might be a useful method when an
      adequate donor for bone marrow transplantation is not available. The unexpected
      observation that the increased T cells were mainly CD4 may be related to the mild
      GVHR and the clinical improvement.

PMID- 8460544
TI  - Peripheral expansion of gamma delta T cell receptor-positive cells in a patient
      with Crohn's disease.
AB  - A 13 year old boy with Crohn's disease had a prominent expansion (over 40%) of
      gamma delta T cell receptor-positive cells (gamma delta T cells) in the
      peripheral blood. The gamma delta T cells were gradually decreased from 48 to 22%
      in 18 months. Anti-gamma delta T cell receptor-triggered cytotoxicity was evident
      at onset and after 1 year. The significance of peripheral expansion of gamma
      delta T cells in a patient with Crohn's disease is discussed.

PMID- 8460545
TI  - Treatment of an infant with congenital sodium diarrhea by oral rehydration.
AB  - We have been following a male case of congenital sodium diarrhea (CNaD), who had
      a distended abdomen, passed watery stools with high sodium concentration, and
      showed metabolic acidosis in the first week of life. He also showed hyponatremia,
      low urine sodium, high serum aldosterone and high renin activity. Other possible
      causes of secretory diarrhea were ruled out. The initial effective treatment was
      oral supplements of water and electrolytes lost in the fecal fluid: with this he
      gained weight, and hyponatremia and metabolic acidosis were corrected. Loperamide
      hydrochloride was administered to increase intestinal absorption of sodium, as
      the serum prostaglandin was high. Watery diarrhea then improved, but as he passed
      acholic stools, we stopped and postponed the treatment for a while; the stools
      then became watery again. Although diarrhea has persisted, he has not shown any
      abnormalities in growth or psychomotor development for the first two years of
      life.

PMID- 8460546
TI  - Inflammatory esophagogastric polyp and fold in an adolescent.
AB  - The case of a 13 year old boy with an inflammatory esophagogastric polyp and
      ulcerative colitis is described. Endoscopy revealed a typical polyp and gastric
      fold complex at the esophagogastric junction and a hiatal hernia. Histology of a
      biopsy specimen confirmed an inflammatory polyp covered by hyperplastic squamous
      and gastric foveolar epithelium. Continuous 24 hour esophageal manometry
      suggested gastroesophageal reflux, which may be related to the pathogenesis of
      the lesion. Follow-up endoscopy showed marked regression of the polyp with
      medication for reflux esophagitis. This clinical entity is rare in childhood and
      adolescence, and the manifestations may not be readily recognized. Therefore,
      endoscopic biopsy is important in children with esophageal polyps. However,
      polypectomy is unnecessary except when malignancy is suspected or when symptoms
      persist.

PMID- 8460547
TI  - Transient scoliosis in a child with juvenile rheumatoid arthritis.
AB  - An 8 year old girl was admitted to hospital complaining of arthralgia in a few
      large joints. According to the clinical course and serological tests, a diagnosis
      of a polyarticular type of juvenile rheumatoid arthritis was made. About 6 weeks
      after the onset, scoliosis was observed. The curvature regressed spontaneously
      over the following 6 months. Generally, scoliosis associated with juvenile
      rheumatoid arthritis has been noted a few years after the onset. A transient
      scoliosis in the early phase of this disease is rare.

PMID- 8460548
TI  - An autopsied case of Williams syndrome complicated by moyamoya disease.
AB  - An 18 year old girl with typical clinical features of Williams syndrome suddenly
      died of intracerebral hemorrhage due to moyamoya disease. Autopsy revealed
      vascular abnormalities, such as supravalvular aortic stenosis (SAS) and an
      abnormal complicated cerebrovascular network in the cerebral arteries. The
      arterial wall of the SAS lesion consisted of thickened medial tissue showing
      elastic disorganization with prominence of the smooth muscle cells. The narrowed
      vessels of the circle of Willis showed intimal thickening with an extremely wavy
      internal elastic lamina and marked thinning of the media. To our knowledge, this
      is the first report of moyamoya disease associated with Williams syndrome.

PMID- 8460549
TI  - Ultrasonographic evaluation of abdominal vessels in Kawasaki disease.

PMID- 8460550
TI  - Abnormal findings in the signal-averaged electrocardiogram in patients with
      Ebstein's anomaly.

PMID- 8460551
TI  - Distribution of lectin receptors in the human hyperplastic tonsil: histochemical
      and flow cytometric analyses.
AB  - The distribution of lectin receptors in the human tonsil was studied using 16
      biotinylated lectins. The avidin-biotin-peroxidase complex (ABC) method was used
      on frozen and paraffin-embedded tissue sections. Cell suspensions were also
      analysed by dual flow cytometry using respective fluorescein isothiocyanate
      conjugated lectins and phycoerythrin-labeled anti-CD3 and anti-human
      immunoglobulin. Frozen sections fixed with acetone and paraffin-embedded
      materials fixed in three solutions were compared for lectin affinity; ethanol
      fixed sections gave best results followed by frozen and buffered formalin-fixed
      ones, then nonbuffered formalin. Con-A, RCA-1, LcH, WGA, MPA, PHA, PSA, PNA, SJA
      and GSA-1 reacted with all tissue components of the tonsil in immunohistochemical
      studies, but binding intensity was fixative dependent. Binding of Lotus and BPA
      to lymphocytes was limited to germinal center lymphocytes. Other tissue
      components were also reactive but staining intensity was weaker in Lotus compared
      with BPA. SBA and DBA did not react with lymphocytes, but reacted with
      macrophages/histiocytes, vascular endothelia, and epithelial cells. LBA and LPA
      were constantly negative with all tissue components irrespective of fixatives.
      Flow cytometric analyses showed that all but three (DBA, LBA and LPA) partially
      or totally stained lymphocyte surfaces. Lotus receptors were expressed
      exclusively on B-lymphocytes.

PMID- 8460552
TI  - Inhibition of liver regeneration in mice following extended hepatectomy by
      transfusion of lymphokine activated killer cells.
AB  - Lymphokine activated killer (LAK) cells can destroy not only tumor cells but also
      syngeneic liver cells. In this study, the effects of passive transfer of LAK
      cells on liver regeneration were examined by the 3H-thymidine uptake and
      bromodeoxyuridine (BrdU) labeling methods after resection of 70% of the volume of
      the liver. LAK cells were infused 12h after hepatectomy and the effects on
      regeneration of liver cells were examined 36 h later. The transfusion of LAK
      cells induced significant inhibition of liver regeneration at a dose of 5-10 x
      10(7) cells. Neuraminidase treatment of lymphocytes is desirable to enhance the
      selective entrapment of LAK cells into the liver. When LAK cells were treated
      with neuraminidase (0.5 units/ml), and transfused into hepatectomized mice, more
      potent suppression of liver regeneration was induced in comparison with the same
      dose of LAK cells. The intraperitoneal injection of recombinant interleukin 2
      (rIL-2) after partial hepatectomy also inhibited the regeneration of remnant
      liver. From these results, lymphocytes such as LAK cells appear to regulate liver
      regeneration.

PMID- 8460553
TI  - Hemostasis of gastric variceal hemorrhage by transileocoecal and transhepatic
      obliteration.
AB  - Obliteration for gastric or duodenal variceal hemorrhage was performed via
      transileocoecal or transhepatic portal catheterization in 8 patients with portal
      hypertension. The patients were 6 men and 2 women, whose average age was 59
      years. All of the patients had cirrhosis of the liver. The obliteration was
      performed as an emergency procedure in 6 cases, and 2 patients were electively
      treated. Transileocoecal obliteration (TIO) and transhepatic obliteration (PTO)
      were selected for 6, and 2 patients, respectively. Variceal bleeding was
      successfully controlled in all patients after completion of the therapy. One
      patient died after 3 months when duodenal variceal bleeding recurred. Elective
      surgical operations were performed on 2 patients after the initial therapy,
      because the vein feeding toward the varices remained. Six of the patients have
      survived to date without bleeding. Transient oliguria and jaundice after the
      therapy were noticed in 2 patients. Histological examination revealed cast
      formation of polymerized cyanoacrylate in the obliterated gastric varices of 2
      patients. TIO and PTO seem to be safe, effective procedures to stop bleeding from
      ectopic varices, gastric or duodenal. This therapy is useful either to obtain
      accurate information about the varices or to obliterate the collateral veins in
      patients with ruptured ectopic varices.

PMID- 8460554
TI  - Efficacy of percutaneous transluminal coronary recannalization for preservation
      of the post-infarct left ventricular regional wall motion: a trial of the
      evaluation by weighting coronary artery segments.
AB  - Efficacy of the percutaneous transluminal coronary recannalization (PTCR) therapy
      was evaluated by weighting infarct-related coronary artery segments in 28
      consecutive patients with acute myocardial infarction. The study focused on the
      influences of the time interval from the onset of chest pain to PTCR (PTCR-Time)
      and on the post-infarct left ventricular regional wall motion in conjunction with
      the serum levels of GOT, LDH and CPK and with PTCR-Time. PTCR success rate was
      84.0%, and re-occlusion rate was 4.0%. The thrombolysis in myocardial infarction
      grade 2, however, was observed in 7 (33.3%) of 21 cases with successful PTCR.
      There was no significant difference in PTCR-Time between the PTCR success and
      nonsuccess groups. Significant correlations were observed between the PTCR-Time
      and each peak value of standardized serum levels of LDH and CPK, and between the
      PTCR-Time and the post-infarct regional wall motion abnormality. There were also
      significant correlations between the standardized serum level of each of these
      three enzymes and the post-infarct regional wall motion abnormality. It was
      clearly demonstrated that the earlier the recannalization of the infarcted artery
      was achieved, the less extensive the myocardial damage in quantitative and
      qualitative aspects.

PMID- 8460555
TI  - Evaluation of radiograph signs for the diagnosis of solitary peripheral pulmonary
      nodules less than 3 cm.
AB  - Ten radiograph signs were assessed by two experts for their usefulness in the
      diagnosis of small solitary peripheral pulmonary nodules less than 3 cm. The ten
      categories included notching, spicula formation, pleural indentation, vascular
      convergence, contour, paleness, homogeneity, cavitation, air bronchogram, and
      calcification. The cases included 134 lung cancers and 44 benign lung lesions
      resected between 1972 and 1988 at the Second Department of Surgery, Okayama
      University Medical School. Notching, spicula formation, pleural indentation,
      vascular convergence, contour, and air bronchogram were useful signs in
      differentiating lung cancer from benign lung lesions. However, since the
      radiograph signs exhibited great variation in both lung cancer and benign lung
      lesions, a diagnostic operation is sometimes inevitable.

PMID- 8460556
TI  - A case of chronic pancreatitis with pseudoaneurysm rupturing into a pseudocyst.
AB  - A 44-year-old man with alcohol-induced chronic pancreatitis was referred to our
      institute for evaluation of severe anemia. The hemoglobin was 2.6g/dl. The
      results of upper gastrointestinal and colonic examination were negative. Computed
      tomography and ultrasound examination revealed a pseudocyst in the head of the
      pancreas. A pseudoaneurysm of the anterior superior pancreaticoduodenal artery
      shown by angiography appeared to have caused gastrointestinal bleeding by
      rupturing into the pancreatic cyst connected to the main pancreatic duct. A
      pyrorus-preserving pancreaticoduodenectomy was performed successfully.

PMID- 8460557
TI  - Solitary pancreatic metastasis from renal cell carcinoma.
AB  - A rare case of resectable solitary pancreatic metastasis from a renal cell
      carcinoma is reported. The patient was a 57-year-old man who presented with
      epigastralgia. He had undergone a radical nephrectomy of the right side 30 months
      previously. The diagnosis of pancreatic metastasis was based on the patient's
      past history and angiographic demonstration of typical hypervascular tumor
      staining. Histological examination was confirmatory. The patient was successfully
      treated by pancreaticoduodenectomy followed by alpha-interferon administration.
      As of 6 months after surgery, he remains well.

PMID- 8460558
TI  - Effective preoperative and postoperative respiratory training in a lung cancer
      patient with chronic respiratory failure.
AB  - A case illustrating the value of aggressive respiratory training in improving the
      prognosis of lung cancer complicated by low pulmonary function is reported.
      Preoperative and postoperative respiratory training enabled the patient with
      chronic respiratory failure to survive a lengthy operation and eventually breathe
      without assistance. The patient has survived more than 71 months, and experiences
      only exertional dyspnea at the time of publication. Aggressive preoperative and
      postoperative respiratory management may make more of the growing number of lung
      cancer patients eligible for standard surgical procedures.

PMID- 8460559
TI  - Rat liver epidermal growth factor receptors in intrauterine growth retarded and
      heavy-for-date fetuses.
AB  - We recently reported that epidermal growth factor (EGF) levels in the first urine
      to be voided by intrauterine growth retardation (IUGR) and heavy-for-dates (HFD)
      infants were lower than control infants (8). In this study, we analyzed EGF
      receptors to reveal the mechanisms controlling EGF levels. EGF binding to fetal
      rat liver increased markedly from day 19-21 of gestation. Fetal rats were divided
      into IUGR, control and HFD groups. EGF binding to the liver in each group was as
      follows, IUGR; 380 +/- 57 fmol/mg protein, control; 258 +/- 47, and HFD; 545 +/-
      112. The binding to IUGR and HFD rat liver was significantly greater than in the
      control group (p < 0.05). These data suggest that IUGR rats compensate for a lack
      of EGF by increased receptor expression and that HFD rats consume more EGF and
      have decreased urinary EGF excretion. These data also suggest that EGF is closely
      related to fetal growth and may play some important roles in fetal growth.

PMID- 8460560
TI  - Surgical management of haemangioblastoma of the posterior fossa.
AB  - Fifty-one cases of posterior fossa haemangioblastoma have been seen in our
      department over a period of 23 years. Seven cases were associated with spinal
      cord lesions and one with a supratentorial lesion. There were 22 cases of
      Lindau's disease (43%). The onset was earlier and recurrences commoner than in
      isolated cases. In 10 cases the development of new tumours in different parts of
      the central nervous system (CNS) required re-operation, demonstrating the
      multicentric nature of this disease. The majority of the tumours occupying the
      fourth ventricle or medulla oblongata (8 cases) were macroscopically solid and
      had higher post-operative morbidity than the cystic tumours in the cerebellum.
      The recent development of magnetic resonance imaging (MRI) provides accurate
      anatomical information of the lesions (especially those of the brain stem and
      spinal cord) even while asymptomatic. The brilliant enhancement of these tumours
      on MRI with Gadolinium-diethyline-triamine-pentaacetic acid (Gd-DTPA) has proved
      to be particularly useful.

PMID- 8460561
TI  - Pituitary apoplexy: endocrine, surgical and oncological emergency. Incidence,
      clinical course and treatment with reference to 799 cases of pituitary adenomas.
AB  - Authors analyzed retrospectively the incidence of pituitary apoplexy in a series
      of 799 pituitary adenomas with respect to the long term follow-up of the
      patients. Focal vascular abnormalities in histological specimens of tumours,
      regarded as morphological suggestion of past apoplexy (haemorrhage, ischaemic
      infarction or necrosis), were established in 113 out of 783 surgical cases
      (14.4%). Acute clinical onset, justifying the clinical diagnosis of pituitary
      apoplexy, occurred in 39 patients only (5% of the whole series), 19 of them were
      subjected to urgent surgical decompression due to severe neurological deficit.
      The haemorrhagic character of apoplexy was established in most cases requiring
      immediate surgery. The detailed clinical picture of this condition and its
      management are discussed with respect to the long term prognosis. On this basis
      the authors suggest the necessity of surgical treatment in every case of
      pituitary apoplexy, taking into account not only neurological recovery, but also
      endocrine and oncological aspects of the disease. The observation that pituitary
      apoplexy may be a "marker" of tumour invasiveness (even in small, "enclosed"
      adenomas) is highlighted.

PMID- 8460562
TI  - Neuropsychological evaluation in a series of 17 cases operated on for
      craniosynostosis.
AB  - In a study of patients suffering from craniosynostosis various pre- and post
      operative parameters were identified that may affect subsequent intellectual
      capacity. In particular, facial malformations appeared to be closely correlated
      with impaired intellectual development. Other parameters included measurement of
      cranial circumference and volume; their subaverage values correlated with slight
      mental insufficiency. However, in the pre-operative period they cannot be used as
      prognostic indices because these relations were statistically not significant.
      The remaining parameters (neurological and electroencephalographic findings, post
      operative re-ossification of the skull, pre-operative digital impressions, CT
      findings) did not seem to be related to intellectual development.

PMID- 8460563
TI  - T-bone plastique for treatment of brachy-turricephaly.
AB  - The "T-Bone Plastique", which is presented in this paper, allows a surgical
      correction even of extreme cases of brachy-turricephaly together with
      malformations of the occipital region in one operative session. Brachy
      turricephaly is characterized by abnormal vertical height of the skull and a
      shortening of its anterior-posterior length, frequently combined with
      malformations of the occipital region. Resection of the prematurely closed
      coronal suture, bi-parietal trepanations with 90 degrees rotation and side
      exchange of the parietal bone flaps, double transverse trepanation of the
      occipital bone and outward bending and shifting of the bone fragments enable a
      bony remodeling and normalization of the deformed skull. Using this operative
      technique in three children we achieved a significant improvement of the skull
      form with an aesthetically pleasing result, without any neurologic sequelae and
      with normal development of the children during follow-up.

PMID- 8460564
TI  - The Glasgow Coma Scale: a mathematical critique.
AB  - The Glasgow Coma Scale permits 120 possible mathematical combinations of eye,
      verbal and motor scores. Out of these only about 15 are clinically valid and
      useful in the assessment of altered consciousness. A mathematical analysis of
      this pruned scale shows a predominant skew towards the motor response. Without
      clinically altering the scale. The numerical values can be modified to produce a
      more equitable dominance by each of the factors and greater precision. This is
      also necessary as the value of a unit is the same in the sum score, whether
      contributed by the eye, verbal or motor elements.

PMID- 8460565
TI  - Surgical management of neurogenic claudication in 100 patients with lumbar spinal
      stenosis due to degenerative spondylolisthesis.
AB  - 100 consecutive patients with neurogenic claudication due to segmental spinal
      stenosis in degenerative spondylolisthesis have been analyzed prospectively with
      respect to their clinical presentation, radiological and intra-operative
      findings, operative techniques and surgical results. By including 6 patients who
      had to be operated upon again overall results were excellent in 91, good in 4,
      satisfactory and moderate in 2, respectively, and poor in 1 patient (mean period
      of postoperative observation: 2.9 years). Three different techniques of spinal
      instrumentation are evaluated with respect to the surgical results. After
      microsurgical decompression of the neural elements 38 patients were fixed using
      the translaminar screw fixation method according to Magerl (re-operation
      necessary in 5), in 9 patients spondylodesis was achieved by the plate fixation
      method according to Louis (re-operation necessary in 1) and in 53 patients (as
      well as in the 6 patients who had to be re-operated on) primary Cotrel-Dubousset
      instrumentation was used. The best surgical results were obtained by laminectomy
      and Cotrel-Dubousset fixation. Instrumentation of more than 1 motion segment was
      restricted to patients with additional scoliosis or severe degenerative changes
      of the lumbar spine.

PMID- 8460566
TI  - Microsurgical treatment of lumbar disc herniation: follow-up of 237 patients.
AB  - We have reviewed retrospectively the results of 237 consecutive patients who
      underwent microsurgical discectomy for a virgin lumbar disc herniation. Included
      were 128 (54%) mean and 109 (46%) women, with the mean age of 42 years. Intra
      operatively, protrusion was found in 60 (25%) patients, prolapse in 127 (54%)
      patients and sequestration in 50 (21%) patients. The median post-operative follow
      up time was 2 years. During the observation period, sciatic pain had completely
      recovered or markedly diminished in 218 (92%) patients, and 187 (79%) patients
      had returned to work. The mean duration of preoperative sciatica was 3.8 months
      in those patients who finally returned to work. In contrast, it was as long as
      6.3 months in those patients who lost their working capacity as a consequence of
      low back pain. The patients operated on for a prolapse or a sequestrum recovered
      better than those who underwent surgery for a protrusion. Of the patients
      operated on for a protrusion, 68% returned to work, while 76% of those operated
      on for a sequestrum and 85% of those operated on for a prolapse returned to work
      during the follow-up. Difference was seen also in the occupational outcome: only
      37% of the patients operated on for a protrusion reported to manage their work
      well, while 47% of those with a prolapse and 58% of those with a sequestrum
      managed well. Surgical complications were infrequent in this study. Dural tear
      appeared in 10 (4%) patients and post-operative discitis in 4 (1.7%) patients. Of
      all patients, 9 (4%) required re-operation for a true recurrent disc.

PMID- 8460567
TI  - Peri-operative elastase-alpha-1 proteinase inhibitor in patients with
      postoperative intervertebral discitis.
AB  - In a prospective study of 251 patients operated upon for lumbar disc herniation
      it has been investigated whether the preoperative and early postoperative values
      of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory
      processes-and C-reactive Protein (CRP)-a well known predictor of some
      postoperative complications-were correlated to the later development of discitis.
      Postoperatively discitis developed in 14 patients. A randomly chosen group of 15
      complication-free patients out of the total of 251 cases was used as control
      group. Elevated EPI plasma values, especially in the pre-operative and first
      postoperative days, turned out to be significantly related to the likelihood of
      later discitis development, but no such relation for the CRP plasma values could
      be established. Thus and early prediction of patients at risk for this
      complication seems to be possible by pre- and postoperative measurement of EPI.
      It could be justified-but its usefulness has yet to be proven-to give antibiotics
      prophylactically and other anti-inflammatory medication in patients with elevated
      pre- and postoperative EPI values.

PMID- 8460568
TI  - Conjoined lumbosacral nerve roots.
AB  - Conjoined lumbosacral nerve roots is a congenital anomaly that may produce
      lumbosciatic pain. When symptomatic and undiagnosed, it may be one of the causes
      of failed back syndrome. Diagnosis with water-soluble contrast myelography has a
      frequency of 4%. Anatomical studies have shown to have an incidence of 14%. High
      quality Magnetic Resonance Imaging (MRI) with coronal views may reveal this
      condition without recurring to computed tomography (CT)-myelography. In this
      paper we describe our recent experience with five consecutive cases observed
      during a one year period.

PMID- 8460569
TI  - Effect of fibrin glue on postlaminectomy scar formation.
AB  - An experimental study in rats has been carried out with the aim of studying the
      scar formation over the spinal dura in the presence of fibrin glue. Although the
      main action of fibrin glue is the enhancement of wound healing by increasing the
      fibrous tissue, our present data suggest that this re-absorbable biomaterial
      diminishes the epidural scar formation, at least the first two weeks after
      laminectomy. This finding leads us to consider the use of fibrin glue over spinal
      duramater when it is likely that reoperation may become necessary in a short
      period of time after a laminectomy.

PMID- 8460570
TI  - Neuropathological and neurophysiological effects of interstitial white matter
      autologous and non-autologous protein containing solutions: further evidence for
      a glioma derived permeability factor.
AB  - The feline infusion model of brain edema was used to evaluate the
      pathophysiological effects of 0.6 ml infusions of autologous serum protein (66%),
      human serum protein (66%), human glioma cyst fluid and a tissue culture medium
      (TCM) on the structure and function of the forebrain white matter. These
      infusions increased local white matter water content by between 10.8 and 12.5
      ml/100 g brain and were associated with moderate increases in ICP and CSF outflow
      resistance and a significant decrease in lumped craniospinal compliance. Cortical
      somatosensory potentials, motor evoked potentials, EEG and local cerebral blood
      flow (rCBF) at normocapnia were generally unchanged by the various infusions. All
      infusates except the 66% autologous serum protein infusion impaired rCBF CO2
      reactivity. Histologically all infusates caused marked extracellular edema. The
      autologous serum protein infusion caused no additional histological changes
      whereas the glioma cyst infusates caused profound endothelial and astrocytic
      swelling, focal endothelial necrosis, basement membrane disruption, perivascular
      microglial reaction and pavementation and perivascular migration of
      polymorphonuclear leukocytes. Similar but less marked changes were seen after
      infusion of human serum protein whilst the TCM produced only minimal changes. The
      intensity and extent of Evans Blue extravasation into the forebrain white matter
      was greatest with glioma cyst infusates and with all infusions reflected the
      extent to microvascular changes. These studies show that products derived from
      gliomas cause additional damage to the blood-brain-barrier than that caused by
      non-autologous serum proteins. These results add further support for the
      existence of glioma derived permeability factors (GDPF), but suggest neither
      serum proteins nor glioma derived compounds in the white matter interstitium
      significantly influence local electrophysiological function. Some limitations of
      the infusion edema model when using non-autologous infusions and difficulties
      quantitating brain dysfunction are emphasised.

PMID- 8460571
TI  - Topical effect of bromocriptine on rat-transplanted human prolactinomas.
AB  - In prolactinoma surgery, especially in macro-adenomas, it is not always possible
      to remove the tumour totally. Cell remnants may cause a regrowth and continue
      hypersecretion. In order to find out whether tumour remnants could be destroyed
      by local application of bromocriptine, a research model has been designed. First,
      prolactin secreting pituitary tumours, removed during surgery, were implanted
      bilaterally into the brain tissue of rats. In eight rats, the viability of tumour
      transplants was proven histopathologically and their prolactin secretion was
      shown immunocytochemically. In a second step, on eight rats, sterile
      bromocriptine solution was applied topically to the tumour transplants on one
      side. The other side served as control. Histopathological examination of these
      treated tissues revealed fibrosis. Immunocytochemical analysis showed no
      secretory activity. Ultrastructural investigations also revealed evidence of
      degeneration of the treated cells. The natural course of the transplanted tumour
      tissues of the other side, as a control group, was also observed during the same
      55-day period.

PMID- 8460572
TI  - Effect of superoxide dismutase on acute reperfusion injury of the rabbit brain.
AB  - To study the involvement of free oxygen radicals of the blood-brain barrier (BBB)
      disruption during early reperfusion, we isolated the distal internal carotid
      artery, and the middle and anterior cerebral arteries via the transorbital
      approach in anesthetized rabbits. Using radiolabeled microspheres, regional
      cerebral blood flow (rCBF) was measured before, during and after 1-hour
      unilateral occlusion of these vessels. Fifty-five minutes after ischemia, animals
      received intravenous saline placebo (control), superoxide dismutase (SOD) at 8
      mg/kg = 30,000 U/kg, or weakened superoxide dismutase (wSOD) at 8 mg/kg = 30,000
      U/kg. Integrity of the BBB was assessed by leakage of Evan's Blue-albumin dye (EB
      albumin dye), which was given at 15 minutes of reperfusion and allowed to
      circulate for an additional hour. In the control and wSOD-treated groups, rCBF
      decreased (26% and 40% of control, respectively) within the blue-tinted tissue of
      the occluded hemisphere during ischemia; hyperemia was observed during early
      reperfusion. In the control and wSOD-treated groups, EB-albumin dye leakage
      across the BBB increased 49% within the occluded hemisphere. However, within the
      SOD-treated group, the BBB showed minimal dye leakage even though rCBF of the
      occluded hemisphere (so-called blue-tinted tissue) decreased by 38% during
      ischemia. We conclude that 1-hour focal cerebral ischemia and reperfusion produce
      a vascular endothelial injury at the BBB. Since SOD administration showed
      significant protection, free-oxygen-radical production during early reperfusion
      is associated with breakdown of the BBB to large molecules.

PMID- 8460573
TI  - Serial regional blood flow and visual evoked responses in transient cortical
      blindness.
AB  - Normal regional blood flow was documented by Single Photon Emission Computed
      Tomograms 5 and 20 hours before the full recovery of cortical blindness in two
      patients, lending itself to the possibility of being a prognostic factor. Rubbing
      of the posterior cerebral arteries against the tentorial edges during trauma
      instead of traction was believed to cause blindness in one patient and
      embolization due to hammering bone grafts home during cervical spinal fusion, in
      the other. Pattern reversal visual evoked responses (PRVERs) were absent during
      blindness; upon recovery P 100 with full amplitude and normal latency appeared
      despite the presence of tunnel vision. These are consistent with the fact that
      the central 8-10 degrees of visual field represented in the posterior occipital
      poles being the main sources of P 100 in association with the x-cells in the
      centre of the retina.

PMID- 8460574
TI  - Poikilothermia in a female patient with a germinoma in the basal ganglia.
AB  - An unusual association of poikilothermia and a germinoma originating in the left
      basal ganglia is described in a 17-year-old female. The tumour was found
      extending into the hypothalamic structures. Following irradiation therapy, the
      patient gradually regained her regulation of body temperature.

PMID- 8460575
TI  - Artificial intelligence and the supervision of bioprocesses (real-time knowledge
      based systems and neural networks).
AB  - The ability to supervise and control a highly non-linear and time variant
      bioprocess is of considerable importance to the biotechnological industries which
      are continually striving to obtain higher yields and improved uniformity of
      production. Two AI methodologies aimed at contributing to the overall intelligent
      monitoring and control of bioprocess operations are discussed. The development
      and application of a real-time knowledge-based system to provide supervisory
      control of fed-batch bioprocesses is reviewed. The system performs sensor
      validation, fault detection and diagnosis and incorporates relevant expertise and
      experience drawn from both bioprocess engineering and control engineering
      domains. A complementary approach, that of artificial neural networks is also
      addressed. The development of neural network modelling tools for use in
      bioprocess state estimation and inferential control are reviewed. An attractive
      characteristic of neural networks is that with the appropriate topology any non
      linear functional relationship can be modelled, hence significantly reducing
      model-process mismatch. Results from industrial applications are presented.

PMID- 8460576
TI  - Host-vector interactions in Escherichia coli.
AB  - Introduction of a DNA vector into E. coli for the purposes of cloned gene
      expression can perturb native cell functions at many levels. The presence of
      foreign DNA can alter regulation of chromosomal DNA replication, regulation of
      transcription of chromosomal genes, ribosome functions and RNA turnover,
      activities of regulatory proteins, chaperone and protease levels, membrane
      energetics and protein post-translational processing, as well as energy and
      intermediary metabolism of the cell. The combined effects of these interactions
      on the metabolic characteristics of the host-vector system have major
      implications for yields of cloned biotechnological products and interactions of
      genetically engineered organisms with their environment.

PMID- 8460577
TI  - Parameters influencing the productivity of recombinant E. coli cultivations.
AB  - In the past 10 to 15 years, many of the promises of microbial genetic engineering
      have been realized: the use of recombinant Escherichia coli has moved from the
      laboratory to the production facility, and the manufacture of therapeutic
      recombinant proteins such as human growth hormone and interleukins is a rapidly
      growing industry. Along with this progress, however, have come new problems to
      solve: bioreactor operators have discovered that large-scale cultivations of
      plasmid-containing bacteria do not behave in exactly the same way as those of
      plasmid-free cells, plasmid stability has been recognized as a major hurdle, and
      the protein product might not be present in a soluble form but rather as
      intracellular granules that resist solubilization. These and other difficulties
      represent a new generation of challenges for genetic engineering. However,
      genetic engineering can do more than solve these problems. Molecular biological
      techniques also have the ability to create new opportunities: to produce new
      compounds, to use cheaper substrates, to facilitate downstream processing, and to
      optimize production in new ways. The productivity of a cultivation can generally
      be expressed as the product of the cell density and the specific biological
      activity. Both of these parameters are influenced by a variety of factors. For
      recombinant cultivations, though, the level of biological activity, a reflection
      of the plasmid copy number and expression efficiency, is the more interesting and
      important consideration and will therefore be given more attention in our review.
      In this contribution, our general goal is to discuss the factors that influence
      the productivity of recombinant E. coli cultivations, covering parameters
      relating to DNA; parameters relating to protein synthesis; parameters relating to
      proteins; and parameters relating to downstream processing. The object is not to
      tell the reader how to choose the perfect plasmid, host, and cultivation
      conditions, but to make known the many variables involved in designing a
      recombinant process and to point out recent and potential advances made possible
      by genetic engineering. The discussion focuses on the production of a protein,
      but many of the same concepts apply to other cultivations of recombinant E. coli,
      including cases in which the desired product is not a protein or the cells have
      been designed for a special metabolic capability such as pollutant
      biodegradation.

PMID- 8460578
TI  - [Dementia, daily activities and micturition of the elderly living in a nursing
      home].
AB  - This report shows the relation between daily activities, dementia and urinary
      disturbance. The subjects consisted of 44 males and 110 females with an average
      age of 80 years (ranged from 57 to 102). We evaluated the daily activities,
      underlying diseases, state of urination and the intelligence by the scale of
      Hasegawa. The persons with diapers had a higher degree of dementia than those who
      could go to the lavatory. As the degree of dementia aggravated, the incidence of
      urinary incontinence significantly increased. Urodynamic studies were performed
      on 49 persons who had urinary disturbance. There were 25 persons with normal
      vesical function, 16 with overactive vesical function, and 8 with underactive
      vesical function. Since all of the incontinent persons without dementia had
      abnormal vesical function, pharmacologic therapy was expected to be effective for
      them to improve incontinence. Half of the incontinent persons with dementia had
      normal vesical function. Mental and physical disabilities seemed to be the main
      factors causing incontinence in these persons. The multidisciplinary approach
      including medication, behavior treatment and awareness of the nursing staff is
      important and effective to reduce urinary incontinence.

PMID- 8460579
TI  - [Macrophage colony-stimulating factor for treatment of prostatic cancer with bone
      metastases].
AB  - Macrophage colony-stimulating factor (MCSF) was used in the treatment of
      pancytopenia for a 64-year old man with prostatic cancer with bone metastases.
      Pancytopenia was improved and tumor markers (PA, PAP, gamma-Sm) were normalized
      rapidly after castration. The alkali phosphatase (A1P) concentration decreased to
      the normal range and bone metastases were improved markedly after two courses of
      chemotherapy. To determine the clinical efficacy of M-CSF against tumor markers
      and A1P, we used M-CSF on two other patients with prostatic cancer with bone
      metastases. In one of them, the levels of the tumor markers decreased from the
      initiation of the injection of M-CSF, but gradually increased to the initial
      levels after the last injection. The total A1P concentration was not changed by M
      CSF, but the A1P-3 concentration decreased and continued to decline. These
      findings suggest that M-CSF has an antitumor effect and that it can be effective
      in the treatment of prostatic cancer with bone metastases.

PMID- 8460580
TI  - [Adherence of bacteria to various urethral catheters and occurrence of catheter
      induced urethritis].
AB  - To prevent the occurrence of nosocomial urinary tract infections among patients
      with indwelling urinary catheters, we compared commercially available catheters
      for the degree of irritation to surrounding mucosa and bacterial adherence. The
      hydrogel-coated catheter was found to be superior to the teflon-coated or
      silicone-coated catheters, since it had the lowest degree of bacterial adherence
      and mucosal irritation among these products. These findings suggest that the
      incidence of catheter-induced urinary tract infection would be lowered by the use
      of hydrogel-coated catheter, and recommend their use for patients requiring long
      term urinary catheterization.

PMID- 8460581
TI  - [Side effects of estrogen administration to prostatic cancer patients: clinical
      and statistical survey of 109 prostatic cancer cases of Kyoto University
      Hospital].
AB  - Since the introduction of hormonal treatment for prostatic cancer by Huggins and
      Hodges in 1941, severe side effects of synthetic estrogen, which have overcome
      its benefit, have been reported in the U.S.A. and in European countries. However,
      in Japan the adverse effects of estrogen have been reported to be milder than in
      western countries, and estrogen still has an important role in the treatment of
      prostatic cancer in Japan. In this communication, the side-effects of synthetic
      estrogen administered to 109 prostatic cancer patients, who were admitted to
      Kyoto University Hospital between 1980-1990 are reported. Fifty-three (48.6%) of
      the 109 patients suffered adverse side effects of the estrogen, specifically
      cardiac disease (20.2%), fluid retention (14.7%) and hypertension (13.8%). Five
      of these patients died. Among the risk factors analyzed, daily dose, past history
      of cardio-vascular disease and ECG abnormalities were significantly correlated
      with the appearance of adverse effects. The reasons why the frequency of lethal
      side-effects is lower in our cases compared to findings reported by the Veterans
      Administration group may be the lower daily dose and cessation of estrogen
      administration when mild adverse effects appear and some other unknown factors,
      although the background of the patients and method of analysis are not comparable
      among them. The overall frequency of side-effects in prostatic cancer patients
      administered estrogen in our cases is not necessarily lower than in western
      countries, but the severity of the side effects was milder in our cases. We must
      be a ware of the potential adverse effects of estrogen.

PMID- 8460582
TI  - [A case of adrenal myelolipoma associated with renal cell carcinoma].
AB  - A 41-year-old male patient was admitted to Maebashi Red Cross Hospital with a
      complaint of a left flank mass. Left renal tumor and contralateral adrenal mass
      were revealed by ultrasonography, computed tomography and magnetic resonance
      imaging. Endocrinological examinations were unremarkable. Left nephrectomy and
      right adrenalectomy were performed simultaneously. Histological findings of the
      left renal tumor confirmed clear cell carcinoma, and those of the right adrenal
      tumor revealed myelolipoma with mature adipose tissue and hematopoietic elements.

PMID- 8460583
TI  - [A case of adrenal myelolipoma incidentally discovered on abdominal
      ultrasonography].
AB  - We report a case of adrenal myelolipoma occurring in a 58-year-old-woman. A tumor
      was incidentally detected in the right adrenal region by ultrasonography during
      admission to our hospital due to gastric ulcer. Ultrasonography revealed punctate
      calcification within the tumor. No endocrinologic abnormalities were
      demonstrated. CT revealed a nonhomogenous mass 5 cm in diameter that consisted of
      tissue with a fatty density and areas of calcifications. Retrograde femoral
      angiography demonstrated that the tumor was relatively hypervascular. Large blood
      vessels resembled sinusoids that were demonstrated by pooling of the contrast
      medium. Right adrenalectomy was performed. The histological diagnosis was adrenal
      myelolipoma.

PMID- 8460584
TI  - [A case of myelolipoma arising from accessory adrenal gland].
AB  - A case of adrenal myelolipoma is reported. The patient was a 74-year-old female
      who was admitted to our hospital. Ultrasonography and CT scan incidentally showed
      a left retroperitoneal tumor, located between the left kidney and the spleen. At
      the operation, we observed that the tumor separated from the normal left adrenal
      gland, and confirmed that the tumor had developed from the accessory adrenal
      gland. The resected tumor measured 61 x 42 x 40 mm in size and 60 g in weight.
      Histological findings were compatible with myelolipoma. We reviewed 104 cases of
      adrenal myelolipoma reported in the Japanese literature.

PMID- 8460585
TI  - [Argyrosis of the urinary tract after silver nitrate instillation: report of a
      case].
AB  - A 69-year-old woman was referred to our hospital for evaluation of pyuria and
      renal dysfunction. Twenty days earlier, the patient had undergone silver nitrate
      retrograde instillations for essential renal bleeding. Routine laboratory
      findings showed renal dysfunction with a serum creatinine concentration of 7.2
      mg/dl and blood urea nitrogen concentration of 68 mg/dl. The urine contained
      numerous red cells and white cells. The plain X-ray film of the abdomen revealed
      right renal calcification. Computed tomographic scan confirmed the calcifications
      in the right renal collecting systems and parenchyma. The most likely diagnosis
      was argyrosis of the upper urinary tract. The patient underwent a right
      nephrectomy. Histopathological examination of the specimen showed that the renal
      pelvis was filled with blood clots. Laboratory evaluation including serum
      creatinine concentration and urinalysis revealed normal parameters
      postoperatively. We conclude that this patient developed argyrosis of the urinary
      tract, and review previously published papers concerning complications of silver
      nitrate instillation.

PMID- 8460586
TI  - [Multilocular cystic renal cell carcinoma: a report of two cases].
AB  - Two cases of multilocular cystic renal cell carcinomas in a 48-year-old man and
      in a 41-year-old woman are reported. Radical nephrectomy was performed in both
      cases. Both histologic diagnoses were multilocular cystic renal cell carcinoma,
      clear cell subtype, grade 1. We had some difficulty in diagnosing the latter case
      with multilocular cystic mass which had smooth, glistening lining and contained
      clear-yellow fluid. Microscopical examination of the permanent sections revealed
      that the cysts were lined by a cuboidal or flattened epithelium, but no tumor
      cells. However, laminar growth of renal cell carcinoma of the clear cell type was
      present in several areas in the septa, and a few residual tumor cells were found
      in the hyalinized septa. When renal cell carcinoma is present in only a part of
      the multilocular cystic renal mass, it should be diagnosed as multilocular cystic
      renal cell carcinoma. The literature was surveyed.

PMID- 8460587
TI  - [Two cases of urinary tract abnormalities (ectopic ureterocele and VUR)
      associated with complete duplex kidney].
AB  - Two patients with complete duplex kidney accompanied by ectopic ureterocele and
      vesicoureteral reflux (VUR) had repeated episodes of refractory urinary tract
      infection. One patient was a 11-year-old girl who showed VUR into the cele
      ureter. The other patient was a 17-year-old female who showed VUR into the mate
      ureter. Satisfactory results could be obtained by twin ureteroneocystomy with
      cele wall resection in both cases. Complete duplex kidney is often complicated by
      urinary tract abnormalities such as ectopic ureterocele, VUR, and renal
      dysplasia, and these complications complicate its diagnosis. The treatment of
      complete duplex kidney with urinary tract abnormalities are discussed.

PMID- 8460588
TI  - [A case of bilateral ectopic ureter in a male].
AB  - A 7-year-old boy was admitted for recurrent pyelonephritis. Intravenous
      pyelography IVP showed right hydronephrosis and normal left kidney and ureter.
      Cystourethroscopy revealed no ureteral orifices in the bladder but bilateral
      ureteral openings adjacent to the seminal colliculus. Right retrograde
      pyelography showed severe hydroureter and hydronephrosis. The diagnosis was
      bilateral ectopic ureteral opening into proximal urethra. His abnormality of
      ureteral opening was classified as type II in Thom's classification. Bilateral
      ureterocystoneostomy was performed. Only 3 cases of bilateral ectopic ureter in
      males have been reported in the Japanese literature.

PMID- 8460589
TI  - [A case of retrocaval ureter treated in childhood].
AB  - A case of retrocaval ureter in a 10-year-old boy is reported. His chief complaint
      was asymptomatic total macrohematuria. Physical examination and all laboratory
      findings were within normal limits, but drip infusion pyelography revealed a
      right hydronephrosis with "S shaped" ureter. The diagnosis was confirmed by
      enhanced CT scan. After follow-up for 1 year and a half, right uretero 
      ureterostomy was performed because the severity of the hydronephrosis had
      increased. We review 25 cases of retrocaval ureter in childhood reported in the
      Japanese literature and compare the clinical characteristics between infant cases
      and adult cases.

PMID- 8460590
TI  - [Removal of migrated ureteral stent with a Fogarty catheter].
AB  - A 64-year-old woman had undergone right percutaneous nephrolithotomy and
      transurethral ureteroscopy elsewhere. Stenosis of uretero-pelvic junction had
      occurred. Against the stenosis a double-J ureteral stent was placed within the
      right ureter and migration of the stent out of the bladder into the more proximal
      ureter was found after the stent exchange. The patient was referred to us for
      endoscopic removal and treatment of stenosis. A 4F Fogarty catheter was inserted
      into the right ureter endoscopically and manipulated up alongside the double-J
      stent. After the balloon was inflated with 0.8 ml of diluted contrast medium, the
      stent was removed into the urinary bladder. We have found our method to be
      convenient and safe in the removal of migrated ureteral stent.

PMID- 8460591
TI  - [A mullerian duct cyst treated by injection of minocycline: a case report].
AB  - A 29-year-old male was admitted for the examination of left flank pain. Abdominal
      ultrasonography revealed a cystic mass beneath the urinary bladder. Computed
      tomographic scan, magnetic resonance imaging and transrectal ultrasonography
      showed that this cystic mass was located between the bladder and the prostate.
      DIP, urethrocystography and seminal vesiculography demonstrated no communication
      between this mass and the urinary and the seminal tract. From these findings it
      was diagnosed a mullerian duct cyst. We obtained 15 ml of clear yellowish fluid
      which contained no sperm by fine needle aspiration under ultrasound guidance and
      injected minocycline for sclerotherapy. Left flank pain had disappeared and
      repeated ultrasonography showed a small cystic lesion. However, the size of the
      cyst was unchanged for six months after discharge. Twenty-five mullerian duct
      cysts reported in the Japanese literature were reviewed.

PMID- 8460592
TI  - [Quality of life of the patients with continent urinary reservoir].
AB  - To improve the quality of life (QOL) of patients requiring urinary diversion,
      various surgical techniques including those employing a continent urinary
      reservoir (CUR), such as Kock pouch or Indiana pouch, and those using the
      conventional ileal conduit have been advocated. In this study we asked patients
      who had undergone a CUR operation to complete a questionnaire, consisting of 106
      questions relating to the QOL during the disease-free period. A total of 81
      questionnaires were sent out, and 60 (74.1%) CUR patients responded. The average
      age was 61 and the male to female ratio was 49 to 11. The time elapsed from the
      operation was 42 months. Twenty-nine questions addressed the patients physical
      condition and on the whole it was kept in good quality. Because they were
      unwilling to show their stoma, they were reluctant to bathe together with family
      members. However, 59% of them went to a public bathhouse (common in Japan). Other
      physical abilities related to exercise were not significantly hampered by this
      operation. Eighty per-cent of them were not bothered by having a stoma. Twenty
      four questions were related to social life. The operation had a bad influence in
      20-30% of them concerning their interaction with friends and hobbies. Twenty two
      percent of the patients who had a job prior to the operation stopped working.
      Only a few patients abandoned travelling. Concerning their sex life (7
      questions), males suffered impotence at a very high rate, but only 26% of the
      patients lost interest in sex. Symptoms related to the operation (41 questions)
      were mild. Overall, 94% of the patients would choose the same operation again if
      it were required.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460593
TI  - Adenomyosis of the seminal vesicle with hematospermia.
AB  - A 62-year-old man presented in 1987 with hematospermia. No abnormal findings were
      observed by cystourethroscopy. Ultrasound showed the enlargement of the right
      seminal vesicle. The right seminal vesicle could not be visualized by seminal
      vesiculography. Computed tomographic scan revealed a homogeneous mass at the
      right dorsolateral aspect of the prostate. Surgical exploration was performed.
      The prostate and bilateral seminal vesicle were resected. Pathological diagnosis
      was adenomyosis of the right seminal vesicle.

PMID- 8460594
TI  - [Primary squamous cell carcinoma of the prostate: a case report].
AB  - Primary squamous cell carcinoma of the prostate is so rare that only 6 cases have
      been reported in the Japanese literature. This type of cancer is independent of
      androgen, and its prognosis seems to be generally poor. The patient was a 76-year
      old male who was admitted to our hospital with a chief complaint of dysuria.
      Although the markers for prostatic tumor were within normal ranges, findings in
      digital examination and imaging suggested prostatic cancer. Because of the marked
      dysuria, transurethral resection of prostate serving as a biopsy was carried out,
      and histopathological examination led to a diagnosis of squamous cell carcinoma.
      Despite 2 courses of chemotherapy with pepleomycin and cis-platinum (CDDP),
      followed by radiotherapy, the patient died from cancerous cachexia about 9 months
      after the initial examination.

PMID- 8460595
TI  - [A case of urinary retention due to ovarian dermoid cyst in a female infant].
AB  - The patient was a 20-month-old girl. She visited some pediatric clinic with the
      chief complaint of voiding difficulty and miction pain from October 5, 1991.
      Excretory urogram, abdominal ultrasound and computed tomographic scan revealed a
      retrovesical mass which compressed the urinary bladder antero-superiorly. She was
      referred to our hospital for further evaluation. Physical examination disclosed a
      fist-sized tumor in her lower abdomen, which persisted after bladder emptying.
      Cystoscopy revealed elongation of the urethra and elevation of the bladder base.
      Tumor markers and endocrine examination were normal. Magnetic resonance imaging
      at 2 weeks after admission revealed that the retrovesical tumor had been
      translocated cranial to the bladder. Operation was done on October 29, 1991. The
      tumor originated from the right ovary and was 6.2 x 5.0 x 5.0cm in size and 60g
      in weight. The cut surface of the surgical specimen included the fatty tissue and
      hair, and the pathological diagnosis was an ovarian dermoid cyst. This is the
      youngest case of ovarian dermoid cyst presenting as urinary retention in the
      Japanese literature. The mechanism of urinary retention due to infantile
      gynecological disease is discussed.

PMID- 8460596
TI  - [A case of benign mesothelioma of the tunica vaginalis testis].
AB  - A case of benign mesothelioma of the tunica vaginalis testis is described. A 56
      year-old man with no history of asbestos exposure presented with a swelling of
      the left scrotal content. A physical examination revealed a hydrocele and an
      induration on the left epididymal head. A cytological examination of the
      hydrocele fluid demonstrated clusters of mesothelial cells without evidence of
      malignancy (class III). Left inguinal orchiectomy was performed because a 15 mm
      papillary pedunculated tumor was seen on the surface of the tunica vaginalis. A
      microscopic examination showed the papillary and glandular structures composed of
      cuboidal cells with no cytologic atypia, which were consistent with benign
      mesothelioma. The patient remains well and free of recurrent disease 10 years
      after operation.

PMID- 8460597
TI  - [A case of 46XX male].
AB  - A 24-year-old man consulted our hospital with a complaint of male infertility.
      Semen analysis revealed azoospermia. Endocrinological examination showed elevated
      serum luteinizing hormone and follicle stimulating hormone levels, and low normal
      level of serum testosterone. Testicular biopsy disclosed atrophic seminiferous
      tubules. Abdominal computed tomography revealed no ovaries or uterus. The
      chromosomal analysis revealed a karyotype of 46XX. This cases was diagnosed as a
      case of 46XX male. Forty six cases of this syndrome have been cited in the
      Japanese literature. We discussed the genesis of this syndrome.

PMID- 8460598
TI  - Biennial survey of physician clinical-nutrition training programs.
AB  - This is the fourth survey of physician clinical-nutrition training programs. As
      in previous reports, current fellowship training programs were identified,
      descriptive information obtained, and program content surveyed. In addition, a
      questionnaire developed by the American Board of Nutrition Committee on
      Fellowship Training Programs was used to determine the degree of emphasis given
      to content in the areas of basic nutrition science, clinical applications, and
      research training. Among the 38 programs identified, uniform ratings of
      importance were found in all major topic areas. There was also uniformity in most
      subtopics, with minor exceptions. As expected, in the area of nutrition in the
      life cycle, pediatric training programs emphasized infancy and childhood whereas
      medical-surgical programs emphasized adulthood and aging. Alcoholism was
      emphasized in medical-surgical training programs whereas cystic fibrosis and
      inborn errors of metabolism were emphasized in pediatric programs. Nutrition in
      burn patients received minor emphasis in all programs. The overall uniformity of
      curricular content in training programs confirms the contention that clinical
      nutrition has a defined clinical scope and should be considered for establishment
      as a recognized subspecialty in American medicine.

PMID- 8460599
TI  - Adipose tissue distribution measured by magnetic resonance imaging in obese
      women.
AB  - This study had two objectives: 1) to establish magnetic resonance imaging (MRI)
      as a tool for measuring subcutaneous and visceral adipose tissue (AT)
      distribution in obese women, and 2) to assess the relationship between selected
      anthropometric variables and MRI-measured AT. Fifteen healthy obese women aged
      35.0 +/- 9.8 y (mean +/- SD) with a body mass index of 36.4 +/- 7.1 and a waist
      to-hip ratio of 0.91 +/- 0.05 participated in the study. The mean difference for
      repeated measures of subcutaneous and visceral AT area at L4-L5 was 1.1% (P =
      0.15) and 5.5% (P = 0.14), respectively. Large interindividual differences were
      observed for total (30.2-81.7 L), subcutaneous (27.1-76.8 L), and visceral AT
      volume (0.9-5.5 L). Subcutaneous and visceral AT represented 92.3% and 6.3% of
      the total AT volume, respectively. Hip (r2 = 0.96) and waist (r2 = 0.88)
      circumferences were significant predictors of subcutaneous AT volume. The
      combination of body weight, age, and height explained 89% of the variance in
      visceral AT volume. These results demonstrate that MRI provides reliable measures
      of subcutaneous and visceral AT distribution in obese women.

PMID- 8460600
TI  - Circadian variation of diet-induced thermogenesis.
AB  - The objective of this study was to assess a circadian variation of diet-induced
      thermogenesis (DIT) that could favor weight gain among night workers used to
      eating a night time snack. Nine young men were given the same mean at 0900, 1700,
      or 0100. Energy expenditure was measured by indirect calorimetry 1 h before and
      during the 6 h after the snack. DIT was calculated as the 3 h of energy
      expenditure above basal metabolic rate. Morning DIT was significantly higher than
      afternoon DIT (P = 0.04) and night DIT (P = 0.002). Afternoon DIT was higher than
      night DIT (P = 0.06). We conclude that the time when a meal is consumed affects
      the thermogenic response and must be considered in the energy balance.

PMID- 8460601
TI  - Meal-induced thermogenesis in lean and obese prepubertal children.
AB  - The resting metabolic rate (RMR) and the thermic effect of a meal (TEM) were
      measured in a group of 16 prepubertal (8.8 +/- 0.3 y) obese children (43.6 +/-
      9.2 kg) and compared with a group of 10 age-matched (8.6 +/- 0.4 y), normal
      weight children (31.0 +/- 6.0 kg). The RMR was higher in the obese than in the
      control children (4971 +/- 485 vs 4519 +/- 326 kJ/d, P < 0.05); after the RMR was
      adjusted for the effect of fat-free mass (FFM) the values were not significantly
      different (4887 +/- 389 vs 4686 +/- 389 kJ/d). The thermic response to a liquid
      mixed meal, expressed as a percentage of the energy content of the meal, was
      significantly lower in obese than in control children (4.4 +/- 1.2% vs 5.9 +/-
      1.7%, P < 0.05). The blunted TEM shown by the obese children could favor weight
      gain and suggests that the defect in thermogenesis reported in certain obese
      adults may have already originated early in life.

PMID- 8460602
TI  - Food preferences, body weight, and platelet-poor plasma serotonin and
      catecholamines.
AB  - The possible relationship between body weight, food preferences, and plasma
      neurotransmitters was investigated in 96 healthy volunteers. The volunteers were
      divided into groups according to sex, body mass index, and food preferences. In
      all groups fasting platelet-poor plasma (PPP) norepinephrine and serotonin (5-HT)
      were examined. PPP-5-HT was low in obese individuals (mean +/- SD: 51.7 +/- 34.6
      nmol/L) in comparison with lean individuals (94.31 +/- 85.2 nmol/L; P < 0.01), in
      lean male carbohydrate cravers (22.7 +/- 16.4 nmol/L) in comparison with protein
      cravers (132.9 +/- 80.6 nmol/L; P < 0.005) and noncravers (64.7 +/- 51.7 nmol/L;
      P < 0.05), and in obese male carbohydrate cravers (34 +/- 22.7 nmol/L) in
      comparison with obese male protein cravers (98.8 +/- 28.4 nmol/L; P < 0.001). In
      conclusion, PPP-5-HT might be seen as a peripheral indicator of processes linked
      with food consumption and food preferences.

PMID- 8460603
TI  - Long-term effects of weight reduction on serum lipids and plasma insulin in obese
      children.
AB  - The long-term metabolic effects of weight reduction on serum lipids and plasma
      insulin were evaluated in 32 obese children with a mean (+/- SD) relative weight
      of 160.9 +/- 20.1% before and after active treatment for 1 y and after
      observation for another 4 y. The obese subjects had higher serum triglyceride and
      plasma insulin concentrations initially but lower high-density-lipoprotein (HDL)
      cholesterol concentrations and a lower ratio of HDL cholesterol to total
      cholesterol (TC) than 29 normal-weight children. There was a decrease of 15.8% in
      relative weight over the first year with a parallel decrease in serum
      triglyceride and plasma insulin, whereas HDL cholesterol and the ratio of HDL
      cholesterol to TC increased (P < 0.001). These changes remained stable over the
      second year. At 5 y the obese subjects still had a reduced weight (12.8% lower
      than initially) and higher HDL cholesterol. These results indicate that weight
      reduction in obese children is associated with a change in serum lipids toward
      normal and reduced peripheral hyperinsulinemia.

PMID- 8460604
TI  - Longitudinal assessment of energy expenditure in pregnancy by the doubly labeled
      water method.
AB  - Twelve women were studied before pregnancy and at 6-wk intervals from 6 to 36 wk
      gestation. Total energy expenditure (TEE) by the doubly labeled water method,
      basal metabolic rate (BMR), energy intake, and body composition were assessed on
      each occasion. There was substantial interindividual variation in the response to
      pregnancy. Mean total energy costs were as follows: delta BMR 112 +/- 104 MJ
      (range -53 to 273), delta TEE 243 +/- 279 MJ (range -61 to 869 MJ), and fat
      deposition 132 +/- 127 MJ (range -99 to 280 MJ). The mean total cost of pregnancy
      (cumulative TEE above baseline+energy deposited as fat and as products of
      conception) was 418 +/- 348 MJ (range 34-1192 MJ). This was much higher than
      current recommendations for incremental energy intakes. Self-recorded incremental
      intakes (208 +/- 272 MJ) seriously underestimated the additional costs. The
      variability in response emphasizes the problems in making prescriptive
      recommendations for individual women, because there is no way of predicting
      metabolic or behavioral responses to pregnancy.

PMID- 8460606
TI  - Energy expenditure in lactating women: a comparison of doubly labeled water and
      heart-rate-monitoring methods.
AB  - Estimates of total daily energy expenditure (TDEE) by heart-rate (HR) monitoring
      were compared with those made by the doubly labeled water (DLW) method in nine
      exclusively breast-feeding women. Subjects recorded HR and dietary intake daily
      during the 8-d, isotope-measurement period. Milk energy output was determined by
      3-d test weighing and analysis of 24-h milk samples. Total energy output (milk
      energy and TDEE) averaged 12.36 +/- 1.03 MJ/d with DLW compared with 11.74 +/-
      1.3 MJ/d with HR monitoring, a 5.8% difference (NS). Individual differences
      ranged from -27.1% to +17.6%. The high water turnover and relatively low level of
      activity during lactation made the slopes of deuterium and 18O disappearance more
      similar, resulting in increased error in estimates of TDEE by DLW. Therefore, the
      DLW method may not be appropriate for use in lactating women. There are
      considerable individual deviations in estimating TDEE by HR monitoring, but it is
      satisfactory for estimating TDEE of groups.

PMID- 8460605
TI  - Nutritional efficacy of a fortified weaning rusk in a rural area near Beijing.
AB  - A micronutrient-fortified rusk for weanling children was tested in a rural area
      near Beijing. Two hundred twenty-six children aged 6-13 mo were randomly assigned
      by village to either a micronutrient-fortified or an unfortified rusk, daily for
      3 mo. The fortified rusk contained extra zinc; iron; calcium; vitamins A, D, and
      B-12; thiamin, riboflavin, niacin, and folic acid. Infants receiving the
      fortified rusk exhibited no decline in hemoglobin concentrations during the study
      whereas those receiving the unfortified rusk exhibited a significant decline.
      Improvements were also seen in erythrocyte porphyrin, plasma vitamin A, and
      riboflavin status, but these improvements were seen in both of the groups.
      Micronutrient fortification was probably beneficial for iron status and the
      fortified rusk promises to be an effective vehicle for supplementation.

PMID- 8460607
TI  - Breast milk chromium and its association with chromium intake, chromium
      excretion, and serum chromium.
AB  - Chromium metabolism of lactating women was evaluated by measuring diet, breast
      milk, urine, and serum chromium in 17 subjects 60 d postpartum. Breast milk
      chromium concentration was similar for the 3 d of collection with a mean +/- SE
      concentration of 3.54 +/- 0.40 nmol/L (0.18 ng/mL). Dietary intake and urinary
      chromium values were also similar for each of the 3 collection days. Total
      chromium intake of lactating mothers (0.79 +/- 0.08 mumol/d) was greater than
      that of reference female subjects (0.48 +/- 0.02). There was a significant
      correlation (r = 0.84) between serum chromium and urinary chromium excretion. If
      a breast milk volume of 715 mL is assumed, chromium intake of exclusively breast
      fed infants is < 2% of the estimated safe and adequate daily intake of 10
      micrograms. In summary, breast milk chromium content is independent of dietary
      chromium intake and serum or urinary chromium values. Chromium intake also did
      not correlate with serum or urine chromium but there was a significant
      relationship between serum and urinary chromium concentrations.

PMID- 8460608
TI  - Different clearance of intravenously administered olive oil and soybean-oil
      emulsions: role of hepatic lipase.
AB  - The elimination of two intravenously administered fat emulsions consisting of
      either 20% (wt:vol) soybean oil or 17% olive oil plus 3% soybean oil was studied
      in six normolipidemic young men according to a randomized crossover protocol.
      Slower elimination was found with the olive oil emulsion. A significantly lower
      maximal removal capacity (K1) and fractional catabolic rate (K2) were measured
      with olive oil emulsion (P < 0.05). Removal of olive oil emulsion was inversely
      related to hepatic lipase activity (r = -0.85; P < 0.05). Removal of soybean-oil
      emulsion was related to the initial plasma triglyceride concentration (r = -0.84;
      P < 0.05) but not to lipolytic activity. In vivo apolipoprotein C-II binding was
      similar for both emulsions. Therefore, hepatic lipase activity is more important
      in the elimination of olive oil emulsions than soybean-oil emulsions. The faster
      elimination of soybean-oil emulsions suggests an additional elimination pathway,
      such as the reticuloendothelial system.

PMID- 8460609
TI  - Validation of an in vitro assay for predicting the amount of starch that escapes
      digestion in the small intestine of humans.
AB  - The aim of the present study was to validate an in vitro assay for quantifying
      resistant starch (RS) in foods against an in vivo model. The amount of starch
      escaping digestion in the small intestine of ileostomates was compared with that
      observed by using the in vitro assay. Subjects with ileostomies were fed five
      foods containing different types and amounts of RS (baked beans, pearl barley,
      cornflakes, and whole and ground rice). The total amount of starch escaping
      digestion and recovered in the effluent (ranging from 5.7% in baked beans to 0.7%
      in ground rice) was compared with results obtained by using the in vitro assay
      with an incubation time of 6 h. The assay was found to be a good qualitative
      predictor (r = 0.90, P < 0.05), but a poor quantitative predictor of RS amounts.
      Increasing the duration of incubation with alpha-amylase and amyloglucosidase to
      15 h resulted in a very close agreement between results from the in vitro
      technique and the in vivo model. These data indicate that for a variety of foods
      the in vitro assay produced an excellent estimate of starch escaping digestion in
      the small intestine of humans.

PMID- 8460610
TI  - Problems with estimating vitamin C intakes.
AB  - The vitamin C content of foods was examined from two national databases and new
      values were obtained by HPLC. HPLC values were lower in four of the five highest
      vitamin C contributors to the US diet (orange juice, grapefruit, tomatoes and
      tomato juice, and potatoes), as well as in broccoli, red peppers, and cooked
      collard and mustard greens, compared with values from the other databases. When
      HPLC values were substituted in the Health Habits and History Questionnaire, the
      resulting estimates of dietary intake of vitamin C in two studies were lower.
      Despite these lower estimates of absolute intake, in one study the correlation
      between dietary vitamin C and plasma ascorbic acid was similar. In conclusion,
      the accuracy of the vitamin C content of foods is important for estimating the
      absolute amount of vitamin C intake in the population but may not change the
      ranking of people in epidemiological studies.

PMID- 8460611
TI  - Seasonal variation of serum concentrations of beta-carotene and alpha-tocopherol.
AB  - We studied the seasonal variation in serum concentrations of beta-carotene and
      alpha-tocopherol (HPLC) in 17,247 Finnish men who smoked. Month of blood sampling
      was a statistically significant determinant of serum concentration of beta
      carotene in a regression model including age, body mass index, alcohol and fat
      intakes, total serum cholesterol, and daily cigarettes as covariates. The serum
      concentrations were lowest in April-June and highest in October-November. The 1.5
      fold increase in the serum concentration of beta-carotene during the fall
      reflects the seasonality of dietary sources of carotenoids in Finland. The serum
      concentrations of alpha-tocopherol demonstrated no seasonal variation but
      remained close to 27.6 mumol/L throughout the year. The results indicate that the
      seasonal variation of serum concentrations of beta-carotene should be taken into
      account in long-term studies in which comparison of groups or individuals is
      based on serum concentrations.

PMID- 8460612
TI  - Homeostatic control of zinc metabolism in men: zinc excretion and balance in men
      fed diets low in zinc.
AB  - Zinc metabolism was studied in 11 men. The study began with 28-d equilibration
      when dietary zinc was 159 mumol/d (X), followed by 35-d periods when the diet
      contained 21.9 (I), 37.5 (II), 51.6 (III), or 67.8 (IV) mumol Zn/d in random
      order, and ended with 35 d with X. The diet was conventional foods and egg white
      protein. Zinc balance, including surface and semen losses, was zero only during
      I. Semen zinc was unaffected by diet. Plasma zinc dropped to 0.44 and 0.49
      mumol/L in two subjects during I and was significantly decreased during I
      compared with X (P < 0.0002). Urinary zinc declined with decreasing zinc intake.
      A combination of urinary and plasma zinc criteria from Baer and King (Am J Clin
      Nutr 1984; 39:556-70) could be used to distinguish stages of zinc deficiency. By
      these criteria, no subjects were deficient during IV, one was marginally
      deficient during III, three were marginally deficient during II, and seven were
      deficient during I.

PMID- 8460613
TI  - A physiological amount of zinc supplementation: effects on nutritional, lipid,
      and thymic status in an elderly population.
AB  - Forty-four institutionalized elderly subjects with body mass indexes (BMI) of
      either > or = 24 or < or = 21 participated in a 16-wk crossover study designed to
      determine the effects of low-dose zinc supplementation [306 mumol (20 mg)/d] on
      food intake, anthropometry, and biochemical and immunological indexes. Initial
      serum zinc concentrations were low in both groups and increased by approximately
      20% after zinc supplementation. Zinc supplementation allowed a partial but
      significant restoration of serum thymulin activity and improved nutritional
      status (food intake and serum albumin and transthyretin concentrations) but had
      no effect on anthropometric indexes or serum apolipoproteins, except
      apolipoprotein CII and apolipoprotein CIII. After zinc supplementation, serum
      copper concentration decreased but there was no change in the ratio of low
      density-lipoprotein cholesterol to high-density-lipoprotein cholesterol. Low-dose
      zinc supplementation allows restoration, at least partially, of nutritional and
      thymic status without the known disadvantages of high doses of zinc.

PMID- 8460614
TI  - Lipoprotein abnormalities associated with cholesteryl ester transfer activity in
      cystic fibrosis patients: the role of essential fatty acid deficiency.
AB  - The purpose of this study was to elucidate the roles of lecithin:cholesterol
      acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) in the
      lipoprotein derangement of cystic fibrosis (CF) patients with respect to their
      essential fatty acid (EFA) status. Triglyceride enrichment and cholesteryl ester
      (CE) depletion were observed in the lipoproteins of 22 CF patients. The abnormal
      chemical composition was more severe in 12 EFA-deficient (EFAD) than in 10 EFA
      sufficient (EFAS) patients. Expressed in nmol.L-1.h-1, LCAT activity was higher
      (P < 0.05) in both EFAS (mean +/- SE, 92.7 +/- 1.9) and EFAD (108.8 +/- 3.0)
      patients than in control subjects (65.2 +/- 0.9). An equal CE transfer was
      recorded in the lipoprotein-deficient serum, as a source of CETP activity, in all
      groups studied by using normal exogenous low-density lipoprotein (LDL) and high
      density lipoprotein (HDL). However, in contrast to the maximal amount of CE
      transferred from endogenous HDL to endogenous apolipoprotein B (apo B) in control
      subjects, a reduction in CETP activity was seen in CF patients and more
      pronounced in the EFAD group. These findings indicate that impaired lipoprotein
      composition may have marked effects on the transfer of CE between HDL and apo B
      in EFAD CF patients.

PMID- 8460615
TI  - Relationships among nutritional status and skeletal and respiratory muscle
      function in cystic fibrosis: does early dietary supplementation make a
      difference?
AB  - Relationships among nutritional status and skeletal and respiratory muscle
      function were examined in 16 children with cystic fibrosis (CF) and mild lung
      disease (FEV1 95 +/- 16% predicted). Subjects were randomly assigned to receive
      (or not) noninvasive nutritional supplementation at 25% of normal energy
      recommendations for 6 mo. Skeletal muscle strength and power were similar to
      those of healthy children as were respiratory muscle strength and endurance.
      Stepwise-regression analysis indicated that changes in skeletal muscle strength
      and energy intake correlated significantly with growth [weight (kg) = 1.90 - 0.60
      (Tanner Stage) + 0.49 (maximum voluntary strength (Nm) + 0.03 (energy intake, %
      RNI), r = 0.76, P < 0.05], though body composition, protein biochemistry, muscle
      power, respiratory muscle strength, and use of dietary supplements did not. Thus,
      changes in skeletal muscle strength may be a functional index of changes in
      nutritional status in CF. Dietary supplementation per se was not associated with
      functional improvement.

PMID- 8460616
TI  - Growth and body composition in children infected with the human immunodeficiency
      virus-1.
AB  - Anthropometric data were collected on 89 children born to human immunodeficiency
      virus (HIV)-infected women (37 who seroreverted and 52 who were HIV-infected).
      The main outcomes included birth weight, gestational age, weight, height, arm
      muscle circumference (AMC), and triceps skinfold thickness (TSF). Gestational age
      and birth weight were not different between the two groups. The earliest
      anthropometric evaluation on seroreverted children (age 19 mo) when compared with
      HIV-infected children (age 21 mo) revealed that weight and weight-for-height
      percentiles were significantly different (51% vs 33% and 66% vs 48%,
      respectively). Height and TSF percentiles were not different, although AMC
      percentiles were lower in infected children (64% vs 43%). In follow-up
      evaluations, the weight differences between infected and control children did not
      change. We conclude that HIV does not affect birth weight, but postnatal events
      result in altered weight gain in HIV-infected children. Lean body mass is lower
      than in an HIV-negative comparison group at early stages of HIV infection.

PMID- 8460617
TI  - Classification of Peruvian infants by using reference growth data.

PMID- 8460618
TI  - Diabetes and energy intake.

PMID- 8460619
TI  - Vitamin C inhibition of N-nitroso compound formation.

PMID- 8460620
TI  - Perimenopausal increase in serum cholesterol: a 10-year longitudinal study.
AB  - The relative contribution of menopause to the age-related increase in serum total
      cholesterol concentration in women is not exactly known. Cross-sectional studies
      suggest a considerable contribution of menopause, whereas in short-term
      longitudinal studies, only a small increase was observed around menopause. In a
      10-year follow-up study (1979-1989), serum total cholesterol concentration and
      dietary intake were measured annually in 167 healthy perimenopausal women
      (initially aged 49-56 years) who lived in the mixed rural/industrial community of
      Ede, the Netherlands. The longitudinal design enabled us to study the "natural
      course" of serum total cholesterol concentration and the influence of dietary fat
      intake during and after cessation of ovulation. For data analysis, three
      menopausal cohorts were created based on years relative to menopause: 2 years
      before ("perimenopausal"), 2 years after ("early postmenopausal"), and 6 years
      after ("late postmenopausal"). In each cohort, the analysis was conducted on data
      from 4 years of follow-up. The results show that from 2 years before to 6 years
      after menopause, serum total cholesterol concentration increased on average by at
      least 1.1 mmol/liter (19%). Thereafter, only a minor increase was observed. The
      rise was significantly lower in women who increased their intake of
      polyunsaturated fatty acids as compared with women who reduced their intake
      during that period. It is concluded that cessation of ovulation appears to be
      associated with a major increase of 19% in serum total cholesterol concentration
      during an 8-year period around menopause. This increase may be reduced by
      increasing the intake of polyunsaturated fatty acids.

PMID- 8460621
TI  - Diet and endometrial cancer: a case-control study.
AB  - A case-control study of 168 cases with endometrial cancer and 334 controls was
      conducted in Birmingham, Alabama, between June 1985 and December 1988. Cases were
      identified at the University of Alabama Hospital and in a private practice;
      controls were selected from among women who attended the University optometry
      clinic. A food frequency questionnaire that evaluated the intake of 55 nutrients
      and 116 foods was obtained for 103 cases and 236 controls. Logistic regression
      was used to evaluate the effect of diet on endometrial cancer after adjustment
      for total calories, age, race, education, obesity, smoking status, age at
      menarche, number of pregnancies, age at menopause, diabetes, hypertension, and
      use of exogenous estrogens. High intake of certain micronutrients was associated
      with a decreased risk of endometrial cancer: the odds ratio for subjects in the
      upper tertile versus those in the lower tertile was 0.4 for both carotene and
      nitrate (95% confidence interval (CI) 0.2-0.8 and 0.2-0.9, respectively). There
      also was an inverse association between endometrial cancer and protein
      consumption (trend test; p = 0.002), and a moderate direct association with
      cholesterol intake (OR = 1.9, 95% CI 0.9-3.7) when terms for both these
      macronutrients were included in a logistic model. Total intake of animal and
      vegetable fat were not associated with endometrial cancer. More frequent
      consumption of several vegetables and certain dairy products was associated with
      a statistically significant decreased risk of endometrial cancer. These results
      suggest that diet plays an important role in the etiology of endometrial cancer.

PMID- 8460622
TI  - Calcium, magnesium, and free fatty acids in the formation of gallstones: a nested
      case-control study.
AB  - In a nested case-control study, calcium status was assessed by measurements of
      serum total calcium, magnesium, phosphate, ionized calcium, parathyroid hormone,
      albumin, total CO2 (bicarbonate), and free fatty acids in relation to gallstone
      formation. The subjects were recruited from a cohort study (n = 4,581) on the
      epidemiology of gallstones in Denmark. The cohort was examined with
      ultrasonography twice, in 1983 and 1988; 63 subjects developed gallstones, and
      among those who did not, 122 were randomly selected as controls. Subjects with
      gallstones had significantly increased serum concentrations of total calcium,
      magnesium, and bicarbonate as compared with normal subjects. The difference was
      only observed in women. Age, body mass index, alcohol consumption, and smoking
      did not influence the results when included as covariables in a logistic
      regression analysis. Multivariate analysis showed increased concentrations of
      magnesium, bicarbonate, and parathyroid hormone to be significantly associated
      with gallstone disease in women. No significant association was observed between
      gallstone disease and serum variables in men.

PMID- 8460623
TI  - Copper in human mammary carcinogenesis: a case-cohort study.
AB  - In 1968-1975, a cohort of 5,100 ostensibly healthy women was established on the
      island of Guernsey, England, for investigation of the influence of hormonal
      factors on breast cancer. At the women's entry into the study, blood samples were
      drawn from each participant, and each woman completed a questionnaire that
      provided information on established risk indicators in human mammary
      carcinogenesis. Plasma copper levels were measured in 46 breast cancer cases
      diagnosed an average of 11 years (standard deviation (SD), 4) after entry into
      the study cohort and in an age-stratified random sample of 138 women drawn from
      the total initial cohort at risk. Plasma copper levels were 1.31 mg/liter (SD,
      0.37) in the cases and 1.26 mg/liter (SD, 0.36) in the controls; the 95%
      confidence interval for the overall difference was -0.07 to 0.17. A U-shaped
      relation between premorbid plasma copper levels and the risk of developing breast
      cancer was seen. Adjusted odds ratios for breast cancer were 1.8, 1.0, 1.6, and
      3.2, respectively, in the four quartiles of the copper distribution. No major
      changes in the risk estimates were observed when statistical evaluation was
      restricted to cases diagnosed more than 10 years after collection of blood
      samples.

PMID- 8460624
TI  - Maternal risk factors for congenital syphilis: a case-control study.
AB  - This study estimated the strength of association between maternal cocaine use and
      congenital syphilis after adjustment for other factors, especially the use of
      prenatal care. The authors reviewed medical chart and laboratory data for 75
      liveborn infants treated for congenital syphilis at Harlem Hospital Center (New
      York City) in 1987, 150 matched control infants, and their mothers. Cocaine use
      was determined from universal maternal medical histories and infant toxicology
      screenings, and the sensitivity of each method of ascertainment was evaluated.
      With the use of either maternal history or positive infant urine toxicology as
      evidence of cocaine use, 66.2% (49/74) of case infants versus 16.1% (24/149) of
      control infants were judged to have been exposed to cocaine in utero (odds ratio
      (OR) = 9.1, 95% confidence interval (Cl) 4.7-29.2). However, in multiple logistic
      regression, lack of prenatal care was the single variable with the highest
      adjusted odds ratio (adjusted OR = 11.0, 95% Cl 1.3-93.1); maternal cocaine use
      had the second-highest adjusted odds ratio (adjusted OR = 4.9, 95% Cl 1.8-13.0).
      Thus, despite the emergence of maternal cocaine use as a new risk factor,
      underutilization of prenatal care remains the strongest predictor of congenital
      syphilis.

PMID- 8460625
TI  - Assessment of blood lead levels in children living in a historic mining and
      smelting community.
AB  - Lead poisoning in childhood is an important public health problem, and thus, it
      is important to determine how children are exposed to lead. In 1987, the authors
      conducted an exposure assessment and blood lead screening for children aged 6-71
      months living in Leadville, Colorado. High levels of lead had been found in the
      soil as a result of both past mining and smelting activities and natural
      mineralization. Blood was collected from each child for lead analysis, and
      behavioral characteristics were identified through an interview with a parent or
      guardian. Three sources of exposure to lead were associated with blood lead
      levels: lead in a core sample taken from the backyard of the family's home, lead
      brought home on the clothes of a miner, and lead from soldering in the home. Two
      pathways of exposure were associated with blood lead levels: the child swallowing
      things other than food, and taking food or a bottle outside to play. Multivariate
      regression using these variables found effect modification by age. For children
      aged 6-36 months, only sources of exposure were independent predictors of blood
      lead levels, while in children aged 37-71 months, a pathway of exposure in
      addition to sources of exposure independently predicted blood lead levels.

PMID- 8460626
TI  - Association of education with reported age of onset and severity of Alzheimer's
      disease at presentation: implications for the use of clinical samples.
AB  - Clinical samples are commonly used to attempt to infer factors that are
      etiologically important in Alzheimer's disease. Use of clinical samples for these
      purposes is valid if and only if detection of Alzheimer's disease is unbiased
      with respect to the factors being studied. The issue of how education influences
      detection of Alzheimer's disease is controversial. The purpose of the present
      investigation was to shed light on the role of education in the detection of
      symptoms of Alzheimer's disease. To do so, we examined the association of
      education with age of symptom onset, severity of disease at diagnosis, and time
      from symptom onset until diagnosis in a large clinical sample of Alzheimer's
      disease patients from throughout California. The diagnoses of the 1,658 cases in
      the sample were made in 1985-1990. Age of onset was defined as the age at which
      symptoms first appeared, according to family members. Severity of dementia was
      measured with Blessed-Roth Dementia Rating Scale scores. The reported age at
      symptom onset was later in those with less education (p < 0.0001). However,
      decreasing education was associated with greater severity of disease at
      presentation (p < 0.008), suggesting that a lower educational level may lead to
      later detection of Alzheimer's disease and referral to clinical centers at a
      later stage of disease. This implies that using clinical samples of Alzheimer's
      disease patients to study factors correlated with age at onset may lead to biased
      conclusions, if these factors are also associated with education.

PMID- 8460627
TI  - A novel approach to the characterization of cumulative exposure for the study of
      chronic occupational disease.
AB  - Inappropriate parameterization of an exposure metric for the study of
      occupational and environmental hazards may lead to significant misclassification
      and biased results. A model for identification of an optimal expression for
      cumulative exposure that includes exponentiated terms for concentration and time
      was developed. When the values of the exponents are allowed to vary, an optimal
      expression for cumulative exposure may be identified. The approach has advantages
      for the study of chronic hazards, in that it is flexible, limits the number of
      assumptions, and incorporates many of the models generally suggested in the
      literature. In addition, the model results may be interpreted to suggest
      particular pathophysiologic mechanisms. The model was implemented with data from
      a previously studied cohort of underground coal miners, and the associations
      between the exposure metric and measures of obstructive lung disease were
      identified. The results demonstrated that the exposure metric can improve the
      association of dust exposure histories with various outcomes over the usual
      measure of cumulative exposure. However, in the particular data set used, the
      overall predictive power of alternative models was similar and the
      interpretability of the results was limited.

PMID- 8460628
TI  - Comparison of three methods of estimating odds ratios from a job exposure matrix
      in occupational case-control studies.
AB  - A job exposure matrix consists of jobs on one axis and substances on the other,
      with the matrix elements describing the likelihood of an individual's exposure to
      a substance in a given job. This can be used in case-control studies to infer
      exposures of subjects whose jobs are known. The simplest form of job exposure
      matrix contains binary entries, but it is also possible to envisage continuous
      variables describing the probability of exposure in the job (probabilistic
      matrix). In such a case, the user has various options for transforming and
      analyzing the data, including the following: 1) transform to binary variables and
      analyze as conventional binary exposure variables; 2) leave as continuous
      variables and analyze using logistic regression; 3) leave as continuous variables
      and analyze using a linear model. Simulations were carried out to compare the
      ability of the three methods to estimate odds ratios under 36 experimental
      conditions. The linear model produced unbiased estimates, the logistic model
      produced somewhat biased estimates at high odds ratios, and the transformation to
      a binary variable produced systematically low estimates in most experimental
      circumstances. With the linear and logistic models, the odds ratio estimators had
      similar precision when the bias of the latter was not too great. The authors
      conclude that the linear model permits optimal use of a probabilistic matrix in
      an epidemiologic study and hope that these results will encourage the development
      of job exposure matrices containing probabilities rather than dichotomies.

PMID- 8460629
TI  - Re: "Risk factors for mortality from all causes and from coronary heart disease
      among persons with diabetes: findings from the National Health and Nutrition
      Survey I Epidemiologic Follow-up Study".

PMID- 8460630
TI  - Re: "A simple, valid step test for estimating maximal oxygen uptake in
      epidemiologic studies".

PMID- 8460631
TI  - Aging, healing, and the metabolism of telomeres.

PMID- 8460632
TI  - Loss of telomeric DNA during aging of normal and trisomy 21 human lymphocytes.
AB  - The telomere hypothesis of cellular aging proposes that loss of telomeric DNA
      (TTAGGG) from human chromosomes may ultimately cause cell-cycle exit during
      replicative senescence. Since lymphocytes have a limited replicative capacity and
      since blood cells were previously shown to lose telomeric DNA during aging in
      vivo, we wished to determine: (a) whether accelerated telomere loss is associated
      with the premature immunosenescence of lymphocytes in individuals with Down
      syndrome (DS) and (b) whether telomeric DNA is also lost during aging of
      lymphocytes in vitro. To investigate the effects of aging and trisomy 21 on
      telomere loss in vivo, genomic DNA was isolated from peripheral blood lymphocytes
      of 140 individuals (age 0-107 years), including 21 DS patients (age 0-45 years).
      Digestion with restriction enzymes HinfI and RsaI generated terminal restriction
      fragments (TRFs), which were detected by Southern analysis using a telomere
      specific probe (32P-(C3TA2)3). The rate of telomere loss was calculated from the
      decrease in mean TRF length, as a function of donor age. DS patients showed a
      significantly higher rate of telomere loss with donor age (133 +/- 15 bp/year)
      compared with age-matched controls (41 +/- 7.7 bp/year) (P < .0005), suggesting
      that accelerated telomere loss is a biomarker of premature immunosenescence of DS
      patients and that it may play a role in this process. Telomere loss during aging
      in vitro was calculated for lymphocytes from four normal individuals, grown in
      culture for 10-30 population doublings. The rate of telomere loss was
      approximately 120 bp/cell doubling, comparable to that seen in other somatic
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460633
TI  - De novo truncation of chromosome 16p and healing with (TTAGGG)n in the alpha
      thalassemia/mental retardation syndrome (ATR-16).
AB  - We have previously described a series of patients in whom the deletion of 1-2
      megabases (Mb) of DNA from the tip of the short arm of chromosome 16 (band
      16p13.3) is associated with alpha-thalassemia/mental retardation syndrome (ATR
      16). We now show that one of these patients has a de novo truncation of the
      terminal 2 Mb of chromosome 16p and that telomeric sequence (TTAGGG)n has been
      added at the site of breakage. This suggests that the chromosomal break, which is
      paternal in origin and which probably arose at meiosis, has been stabilized in
      vivo by the direct addition of the telomeric sequence. Sequence comparisons of
      this breakpoint with that of a previously described chromosomal truncation (alpha
      alpha)TI do not reveal extensive sequence homology. However, both breakpoints
      show minimal complementarity (3-4 bp) to the proposed RNA template of human
      telomerase at the site at which telomere repeats have been added. Unlike
      previously characterized individuals with ATR-16, the clinical features of this
      patient appear to be solely due to monosomy for the terminal portion of 16p13.3.
      The identification of further patients with "pure" monosomy for the tip of
      chromosome 16p will be important for defining the loci contributing to the
      phenotype of this syndrome.

PMID- 8460634
TI  - Genetic linkage analysis in familial breast and ovarian cancer: results from 214
      families. The Breast Cancer Linkage Consortium.
AB  - Breast cancer is known to have an inherited component, consistent in some
      families with autosomal dominant inheritance; in such families the disease often
      occurs in association with ovarian cancer. Previous genetic linkage studies have
      established that in some such families disease occurrence is linked to markers on
      chromosome 17q. This paper reports the results of a collaborative linkage study
      involving 214 breast cancer families, including 57 breast-ovarian cancer
      families; this represents almost all the known families with 17q linkage data.
      Six markers on 17q, spanning approximately 30 cM, were typed in the families. The
      aims of the study were to define more precisely the localization of the disease
      gene, the extent of genetic heterogeneity and the characteristics of linked
      families and to estimate the penetrance of the 17q gene. Under the assumption of
      no genetic heterogeneity, the strongest linkage evidence was obtained with
      D17S588 (maximum LOD score [Zmax] = 21.68 at female recombination fraction [theta
      f] = .13) and D17S579 (Zmax = 13.02 at theta f = .16). Multipoint linkage
      analysis allowing for genetic heterogeneity provided evidence that the
      predisposing gene lies between the markers D17S588 and D17S250, an interval whose
      genetic length is estimated to be 8.3 cM in males and 18.0 cM in females. This
      position was supported over other intervals by odds of 66:1. The location of the
      gene with respect to D17S579 could not be determined unequivocally. Under the
      genetic model used in the analysis, the best estimate of the proportion of linked
      breast-ovarian cancer families was 1.0 (lower LOD-1 limit 0.79). In contrast,
      there was significant evidence of genetic heterogeneity among the families
      without ovarian cancer, with an estimated 45% being linked. These results suggest
      that a gene(s) on chromosome 17q accounts for the majority of families in which
      both early-onset breast cancer and ovarian cancer occur but that other genes
      predisposing to breast cancer exist. By examining the fit of the linkage data to
      different penetrance functions, the cumulative risk associated with the 17q gene
      was estimated to be 59% by age 50 years and 82% by age 70 years. The
      corresponding estimates for the breast-ovary families were 67% and 76%, and those
      for the families without ovarian cancer were 49% and 90%; these penetrance
      functions did not differ significantly from one another.

PMID- 8460635
TI  - A somatic cell hybrid map of the long arm of human chromosome 17, containing the
      familial breast cancer locus (BRCA1).
AB  - We describe a detailed somatic cell hybrid map of human chromosome 17q11.2-q23,
      containing the familial breast and ovarian cancer locus (BRCA1) and highly
      informative closely linked markers. An X-irradiation panel of 38 hamster/human
      and mouse/human hybrids with fragments of chromosome 17 was generated and
      characterized with 22 STS markers from this chromosome. A detailed map of 61
      probes onto chromosome 17q, subdividing the chromosome arm into 25 regions, was
      done by using a panel of hybrids with well-defined breakpoints and nine
      chromosome-mediated gene transfectants. Our localization of RARA, TOP2, EDH17B1
      and 2, and possibly WNT3, between THRA1 and D17S181, two markers known to flank
      BRCA1, suggests that any of these is a potential candidate for the BRCA1 locus.
      The marker D17S579 (Mfd188), which is believed to be very close to BRCA1, maps
      closest to the EDH17B genes.

PMID- 8460636
TI  - Linkage analysis of chromosome 17q markers and breast-ovarian cancer in Icelandic
      families, and possible relationship to prostatic cancer.
AB  - Seven families, selected for breast cancer segregation, have been analyzed for
      chromosome 17q12-q23 linkage to breast and ovarian cancer. In two of them,
      linkage is seen with most markers tested, increasing toward the most proximal
      region, but without informative recombinations above NM23. In the remaining
      families, no linkage is observed. Families with 17q linkage are not easily
      distinguished by clinical characteristics such as early onset (mean age at
      diagnosis < or = 45 years) or organs involved. In fact, the family with the
      highest lod scores (> or = 2.3) belongs to the "later onset" (> 45 years)
      category of families. Interestingly, prostatic cancer is the most frequent
      malignancy, after breast cancer, in the families that we studied (13 cases total,
      all metastasizing) and is especially prevalent in males presumed to carry the
      trait. Of 16 paternal carriers, 7 (44%) had developed prostatic cancer. Haplotype
      analysis in families with 17q linkage reveals two further prostatic cases as
      potential carriers. We propose that breast cancer genes may predispose to
      prostatic cancer in male carriers.

PMID- 8460637
TI  - THRA1 and D17S183 flank an interval of < 4 cM for the breast-ovarian cancer gene
      (BRCA1) on chromosome 17q21.
AB  - In order to pinpoint the locale of the gene for early-onset familial breast and
      ovarian cancer (BRCA1), polymorphisms were developed within the locus for thyroid
      hormone receptor alpha (THRA1) and for several anonymous sequences at chromosome
      17q12-q21. The THRA1 polymorphism is a dinucleotide repeat with 10 alleles and
      heterozygosity.79. Gene mapping in extended families with inherited, early-onset
      breast and ovarian cancer indicates that BRCA1 is distal to THRA1 and proximal to
      D17S183 (SCG43), an interval of < 4 cM. This locale excludes HER2, THRA1, WNT3,
      HOX2, NGFR, PHB, COLIA1, NME1, and NME2 as candidates for BRCA1 but does not
      exclude RARA or EDH17B. Resolving the remaining recombination events in these
      families by new polymorphisms in the THRA1-D17S183 interval will facilitate
      positional cloning of the breast-ovarian cancer gene on chromosome 17q12-q21.

PMID- 8460638
TI  - Linkage of a major breast cancer gene to chromosome 17q12-21: results from 15
      Edinburgh families.
AB  - DNA from members of 15 pedigrees each containing between three and eight cases of
      breast cancer have been collected from southeastern Scotland. Polymorphic markers
      on chromosome 17q were screened to locate a putative breast cancer gene by using
      DNA from relevant individuals within these families. Pairwise LOD scores were
      calculated for markers D17S74, NM23, D17S588, and D17S579. The maximal summated
      LOD for the 15 families was 5.44 at theta = .034, when D17S588 (42D6) was used.
      In these breast cancer families, a subset which did not give evidence for linkage
      to this region could be identified.

PMID- 8460639
TI  - A breast-ovarian cancer susceptibility gene maps to chromosome 17q21.
AB  - Nineteen North American Caucasian families that contain a minimum of four
      confirmed cases of breast or ovarian cancer have been studied. Four polymorphisms
      (cLB17.1, D17S579, D17S588, and D17S74), which span a region of approximately 15
      cM on chromosome 17q12, were typed. Our data confirm the location of a dominant
      gene conferring susceptibility to breast and ovarian cancer (maximum lod = 9.78)
      and suggest that the breast-ovarian cancer syndrome is genetically heterogeneous.
      Two recombinants in one large family suggest that the breast-ovarian cancer locus
      lies between D17S588 and D17S579.

PMID- 8460640
TI  - Chromosome 17q linkage studies of 18 Utah breast cancer kindreds.
AB  - In this paper we present linkage results from the analysis of 18 Utah breast
      cancer kindreds, for three 17q markers. Four kindreds had LOD scores greater than
      1.0 for at least one of the marker loci. One of these kindreds has a LOD score of
      6.07 with D17S579, and we believe it to be the most informative 17q family
      reported to date. Among the kindreds which appear unlinked to 17q were an early
      onset breast cancer family, a large breast-ovarian family, and a kindred with
      mixed age at onset. Analysis of individual recombinants in the linked families
      localizes the BRCA1 gene between THRA1 and D17S579 (Mfd188). A comparison of the
      Cancer and Steroid Hormone Study (CASH) model and a model which assumes a rare
      dominant susceptibility locus with low penetrance and no phenocopies stresses the
      difficulties in assessing linkage if the assumptions of the CASH model in terms
      of age at onset of breast cancer are not appropriate for the BRCA1 locus. A
      hypothetical breast cancer pedigree is used to calculate gene carrier
      probabilities under the CASH model, thereby illustrating some of our concerns
      regarding the use of this model to detect and exclude 17q linkage in breast
      cancer families.

PMID- 8460641
TI  - Linkage analysis with markers on 17q in 29 Swedish breast cancer families.
AB  - Recently, a putative breast cancer gene was localized to the long arm of
      chromosome 17. A collaboration study was undertaken to confirm linkage, to
      further map the gene, and to determine to what extent breast cancer families are
      linked to this locus. The Swedish material consisted of 29 breast cancer families
      in which 68 affected members were studied. Linkage analysis of breast cancer
      susceptibility was performed with a number of markers on 17q. In this material a
      weakly positive LOD score in favor of linkage was observed in a subgroup of
      families with early onset, while no such linkage was observed in a subgroup of
      families with late onset.

PMID- 8460642
TI  - Genetic heterogeneity and localization of a familial breast-ovarian cancer gene
      on chromosome 17q12-q21.
AB  - In a study of 31 breast cancer families and 12 breast-ovarian cancer families, we
      have obtained clear evidence of linkage to markers on chromosome 17q in the
      families with ovarian cancer (maximum lod score 3.34 at theta = .04) but only
      weak evidence in those without ovarian cancer. Recombinant events indicate that
      the gene lies between D17S588 and D17S250.

PMID- 8460643
TI  - Linkage analysis of early-onset breast and ovarian cancer families, with markers
      on the long arm of chromosome 17.
AB  - We have conducted linkage analysis in 16 breast cancer families, 13 of which are
      classified as site-specific breast cancer families and 3 of which are classified
      as breast-ovary families. Linkage analysis has largely focused on a single
      extended breast-ovary family. Analysis of all families combined shows significant
      evidence for linkage to 17q (LOD = 3.63 at theta = .0, for linkage to NME1),
      confirming the observations of Hall et al. and Narod et al. Many families were
      consistent with linkage, but their limited size and informativeness precluded
      confirmation of linkage. A putative recombinant in a breast-ovary family suggests
      that BRCA1 is distal to D17S250.

PMID- 8460644
TI  - A linkage study in seven breast cancer families.
AB  - Seven breast cancer families are examined for evidence of linkage to a site in
      the region of 17q12-q21, by using five markers. The families constitute a subset
      of a larger series of familial breast cancer; the seven families were selected
      because constitutional DNA was available on informative members, either from
      clinical samples or extracted from paraffin blocks. Two-point lod scores are
      reported. The maximum lod score, 0.8824, is obtained with marker NM23 at theta =
      0. This is clearly not significant in itself; however, when taken in context with
      evidence from existing reports, it provides support for linkage to this region.

PMID- 8460645
TI  - Linkage analysis in German breast cancer families with early onset of the
      disease, using highly polymorphic markers from the chromosome 17q11-q24 region.
AB  - Linkage analysis in German breast cancer families with early onset of the disease
      by using six markers on chromosome 17q11-q24 has been carried out. In the region
      between markers D17S250 and GH, three markers showed positive LOD scores at an
      estimated distance of zero. Evidence for linkage is greatest for D17S250, with a
      LOD score of 2.42.

PMID- 8460646
TI  - BRCA1 maps proximal to D17S579 on chromosome 17q21 by genetic analysis.
AB  - Previous studies have demonstrated linkage between early-onset breast cancer and
      ovarian cancer and genetic markers on chromosome 17q21. These markers define the
      location of a gene (BRCA1) which appears to be inherited as an autosomal dominant
      susceptibility allele. We analyzed five families with multiple affected
      individuals for evidence of linkage to the BRCA1 region. Two of the five families
      appear to be linked to BRCA1. One apparently linked family contains critical
      recombinants, suggesting that the gene is proximal to the marker D17S579
      (Mfd188). These findings are consistent with the maximum-likelihood position
      estimated by the Breast Cancer Linkage Consortium and with recombination events
      detected in other linked families. Linkage analysis was greatly aided by PCR
      based analysis of paraffin-embedded normal breast tissue from deceased family
      members, demonstrating the feasibility and importance of this approach. One of
      the two families with evidence of linkage between breast cancer and genetic
      markers flanking BRCA1 represents the first such family of African-American
      descent to be reported in detail.

PMID- 8460647
TI  - Detection of aneuploid human sperm by fluorescence in situ hybridization:
      evidence for a donor difference in frequency of sperm disomic for chromosomes 1
      and Y.
AB  - Fluorescence in situ hybridization with repetitive-sequence DNA probes was used
      to detect human sperm disomic for chromosomes 1 and Y in three healthy men. Data
      on these same men had been obtained previously, using the human-sperm/hamster-egg
      cytogenetic technique, providing a cytogenetic reference for validating sperm
      hybridization measurements. Air-dried smears were prepared from semen samples and
      treated with DTT and lithium diiodosalicylate to expand sperm chromatin.
      Hybridization with fluorescently tagged DNA probes for chromosomes 1 (pUC177) or
      Y (pY3.4) yielded average frequencies of sperm with two fluorescent domains of
      14.2 +/- 2.4/10,000 and 5.6 +/- 1.6/10,000 sperm, respectively. These frequencies
      did not differ statistically from frequencies of hyperploidy observed for these
      chromosomes with the hamster technique. In addition, frequencies of disomic sperm
      from one donor were elevated approximately 2.5-fold above those of other donors,
      for both chromosomes 1 (P = .045) and Y (P = .01), consistent with a trend found
      with the hamster technique. We conclude that fluorescence in situ hybridization
      to sperm chromosomes provides a valid and promising measure of the frequency of
      disomic human sperm.

PMID- 8460648
TI  - Slow acetylator mutations in the human polymorphic N-acetyltransferase gene in
      786 Asians, blacks, Hispanics, and whites: application to metabolic epidemiology.
AB  - Our aim was to determine the population frequencies of the major slow acetylator
      alleles of the polymorphic N-acetyltransferase (NAT2) gene, whose locus maps to
      chromosome 8. We used allele-specific PCR amplification on 786 dried blood spots
      obtained from Hong Kong Chinese, U.S. Koreans, U.S. blacks, U.S. Hispanics,
      Germans, and U.S. whites. Our results show that four slow acetylator alleles can
      be detected as mutations at positions 481, 590, and 857 in the NAT2 gene.
      Recognized base substitutions at positions 341 and 803 need not be determined,
      because they were almost always associated with the 481T mutation. The known
      mutation at position 282 was strongly associated with the 590A mutation. The
      481T, 590A, and 857A mutations accounted for virtually all of the slow acetylator
      alleles in Asian and white populations. The 857A mutation proved to be an Asiatic
      allele. The results will be useful in large-scale epidemiologic studies of cancer
      and other conditions potentially associated with the acetylator polymorphism.

PMID- 8460649
TI  - Pseudoautosomal marker DXYS20 and manic depression.

PMID- 8460650
TI  - Incorrect genetic counseling of a couple with beta-thalassemia, due to incomplete
      testing.

PMID- 8460651
TI  - Age differences in stable carbon and nitrogen isotope ratios in a population of
      prehistoric maize horticulturists.
AB  - Stable carbon isotope ratios in prehistoric human bone collagen have been used
      extensively to document the introduction and intensification of maize
      horticulture in notheastern North America. Most previous studies are based on
      small samples of adults who are assumed to characterize the diet of the
      population. In this study, all 29 individuals buried within an Ontario Iroquoian
      village site dated A.D. 1530-1580 were analysed for stable isotopes of carbon and
      nitrogen. Age distribution of the sample ranges from preterm to elderly.
      Significant negative correlations between age and delta 13C, and age and delta
      15N values were found. High delta 13C values in infants and young children (delta
      13C = -6.8 to -12.3) suggest a weaning diet high in maize. High delta 15N values
      in infants relative to adults suggest a trophic level effect during breast
      feeding which has been reported in a modern sample by Tuross et al. (Am. J. Phys.
      Anthropol., 1993). In addition to the isotopic evidence for extremely high
      carbohydrate (maize) intake, the MacPherson sample includes two juveniles aged 3
      4 years, exhibiting circular caries. No other cases of this condition are known
      in the extensively studied southern Ontario skeletal collections. Together the
      evidence from dentition and stable carbon isotopes indicates a very high
      carbohydrate diet in subadults. Circular caries result from developmental stress
      during enamel formation with subsequent caries formation in areas of thinner
      enamel. These findings are relevant to studies of infant and early childhood
      morbidity and mortality among prehistoric maize horticulturists.

PMID- 8460652
TI  - Occipital lesions: a possible cost of cradleboards.
AB  - This examination of a Mimbres-Mogollon pueblo skeletal sample reveals a
      surprising percentage of individuals with occipital lesions. Each lesion is
      located in the approximate center of the squama immediately superior to the
      external occipital protuberance. Notably, no child over the age of 1 year
      exhibits a lesion that would have been active at the time of death, but a number
      of older children and adults exhibit evidence of healed lesions in this same area
      on the occipital. The restricted nature of these lesions, in terms of both their
      locations and ages of those actively affected, suggests that the use of
      cradleboards may have been at least a contributing, if not initiatory, factor in
      their creation. Specifically, this study suggests that the pressure and friction
      of an infant's head against a cradleboard may have 1) produced ischemic ulcers,
      2) produced the conditions favorable for bacterial infections such as impetigo or
      carbuncles, or 3) complicated the treatment of other infections appearing on the
      back of the scalp.

PMID- 8460653
TI  - Elastic properties of human supraorbital and mandibular bone.
AB  - Elastic constants, including the elastic modulus, the shear modulus, and
      Poisson's ratio, were measured on human craniofacial bone specimens obtained from
      the supraorbital region and the buccal surfaces of the mandibles of unembalmed
      cadavers. Constants were determined using an ultrasonic wave technique in three
      directions relative to the surface of each sample: 1) normal, 2) tangential, and
      3) longitudinal. Statistical analysis of these elastic constants indicated that
      significant differences in the relative proportions of elastic properties existed
      between the regions. Bone from the mandible along its longitudinal axis was
      stiffer than bone from the supraorbital region. Directional differences in both
      locations demonstrated that cranial bone was not elastically isotropic. It is
      suggested that differences in elastic properties correspond to regional
      differences in function.

PMID- 8460654
TI  - Increasing human tooth length between birth and 5.4 years.
AB  - Most previous studies of tooth development have used fractional stages of tooth
      formation to construct growth standards suitable for aging juvenile skeletal
      material. A simple alternative for determining dental age is to measure tooth
      length throughout development. In this study, data on tooth length development
      are presented from 63 individuals of known age at death, between birth and 5.4
      years, from an archeological population recovered from the crypt of Christ
      Church, Spitalfields, London. Isolated developing teeth (304 deciduous, 269
      permanent) were measured in millimeters and plotted against individual age.
      Regression equations to estimate age from a given tooth length, are presented for
      each deciduous maxillary and mandibular tooth type and for permanent maxillary
      and mandibular incisors, canines, and first permanent molars. Data on the
      earliest age of root completion of deciduous teeth and initial mineralization and
      crown completion of some permanent teeth in this sample are given, as well as the
      average crown height and total tooth length from a small number of unworn teeth.
      This method provides an easy, quantitative and objective measure of dental
      formation appropriate for use by archeologists and anthropologists.

PMID- 8460655
TI  - Sexual dimorphism in large-bodied primates: the case of the subfossil lemurs.
AB  - Large body size has evolved repeatedly in the order Primates, not merely among
      anthropoids but also among prosimians. Whereas high degrees of sexual size
      dimorphism characterize many of the large-bodied anthropoids, this is not the
      case for extinct large-bodied lemurs. This paper uses finite mixture analysis and
      other techniques to ascertain just how much skull length dimorphism might be
      embedded in the generally unimodal distributions of skull lengths of giant
      extinct lemurs from single localities, and then compares these results with known
      skull length dimorphisms in extant lemurs and large-bodied catarrhines. We show
      that low levels of skull length sexual dimorphism (or none at all) characterize
      subfossil lemurs, and we explore several possible explanations for this
      phenomenon. Traditional explanations of sexual size dimorphism generally focus on
      body size or mating systems. These are not sufficient to explain the variation in
      sexual dimorphism that can be observed in the order Primates.

PMID- 8460656
TI  - Inbreeding avoidance in rhesus macaques: whose choice?
AB  - Whether nonhuman primates avoid copulating with close kin living in their social
      group is controversial. If sexual aversion to relatives occurs, it should be
      stronger in females than in males because of females' greater investment in each
      offspring and hence greater costs resulting from less viable offspring. Data
      presented here show that adult male rhesus macaques breeding in their natal
      groups at Cayo Santiago experienced high copulatory success, but copulated less
      with females of their own matrilineages than with females of other matrilineages.
      Adult females were never observed to copulate with males of their own
      matrilineage during their fertile periods. Although natal males sometimes courted
      their relatives, examination of two measures of female mate choice showed that
      females chose unrelated natal males over male kin. Female aversion to male kin
      was specific to the sexual context; during the birth season, females did not
      discriminate against their male relatives in distributing grooming. Evolved
      inbreeding avoidance mechanisms probably produce different outcomes at Cayo
      Santiago than in wild rhesus macaque populations. Gender differences in sexual
      aversion to relatives may be partly responsible for differences between studies
      in reported frequency of copulations by related pairs.

PMID- 8460657
TI  - Divergence between biochemical and cytogenetic differences in three species of
      the Callicebus moloch group.
AB  - Specimens from three species of the Callicebus moloch group--C. moloch (N = 80),
      C. brunneus (N = 166), and C. cupreus (N = 23)--were studied. Twenty genetic loci
      were investigated through electrophoresis, genetic distances were estimated, and
      the results compared with the available cytogenetic data. Low values of genetic
      distance were encountered, contrasting with relatively large chromosome
      differences. We propose that recent karyotypic rearrangements, rather than other
      Pleistocene events, were the major evolutionary mechanisms determining speciation
      in these three taxa.

PMID- 8460658
TI  - Stature reconstruction from long bones in ancient population samples: an approach
      to the problem of its reliability.
AB  - Stature estimates provided by the application of the anatomical method of Fully
      and Pineau (1960) to well preserved Neolithic skeletons (39 males and 27 females)
      from seven different European countries are compared with those drawn from lower
      extremity components by means of regression equations commonly used to predict
      stature of earlier European populations. The analysis of data, carried out with
      reference both to the sample of origin of the skeletons and to stature classes,
      suggests that the equations of Pearson (1899) and of Trotter and Gleser for
      Negroes (1952, 1977) yield very good estimates in female samples, leading to
      errors below 2 cm in most of the cases. These equations, and those of Olivier et
      al. (1978), prove useful for stature reconstruction in males too, with the
      exception of very low (below 154 cm) and very tall (over 179 cm) individuals.
      Formulae of Breitinger (1938) yield values consistent with those resulting from
      the anatomical method only within a range including medium-high statures, while
      the corresponding Bach (1965) formulae for females provide poor approximations.
      The Trotter and Gleser formulae for Whites (1952) yield very unsatisfactory
      evaluations, except in specimens taller than 180 cm, and usually overestimate
      stature both in male and in female skeletons. The results obtained from the long
      bones by means of alternative approaches to the least-squares regression formulae
      (Model II regression, and femur/stature ratio) and their efficacy in predicting
      stature of the samples under study is discussed in the final part of the paper.

PMID- 8460659
TI  - Periodontal health in free-ranging baboons of Ethiopia and Kenya.
AB  - Frontal and lateral intraoral photographs of 19 baboons from the Awash National
      Park, Ethiopia and 37 baboons from Amboseli National Park, Kenya, were used to
      assess periodontal health. The Awash baboons, and two groups (Alto's and Hook's)
      at Amboseli, fed entirely from natural sources, but baboons from the third
      Amboseli group (Lodge) fed largely on food refuse from one of the park's lodges.
      Juveniles and adults were evaluated separately. Intraoral photographs were
      seriated based on visual appraisals of periodontal health. In both age groups,
      the best periodontal health was seen in Awash animals; Alto's and Hook's animals
      were intermediate, and the poorest health was seen in the Lodge sample. The
      periodontal health decreased with age in adult baboons, as reported in humans.
      Geochemistry, genetics, age, and diet (particularly variations in bacterial
      flora) were considered as factors contributing to the intergroup differences.
      Although it is not possible at present to exclude any of these as a contributing
      cause, we consider that diet in the broad sense (including food, water, and
      contamination by oral bacteria of human origin) probably plays a major role.

PMID- 8460660
TI  - Technical note: an electronic caliper designed for measuring bone breadths in
      living subjects.

PMID- 8460661
TI  - Human cranial variability: a methodological comment.

PMID- 8460662
TI  - Role of polyamines in the regulation of proliferation and hormone production by
      insulin-secreting cells.
AB  - This paper focuses on the mechanisms regulating proliferation and insulin
      production by normal and tumoral pancreatic beta-cells. In particular, the
      evidence for involvement of polyamines is reviewed. Pancreatic islet cells
      contain high levels of polyamines, and based on findings obtained using enzyme
      directed inhibitors, it appears that putrescine and spermidine are necessary for
      proinsulin biosynthesis, whereas spermine may exert a stimulatory or permissive
      role in RNA transcription-stabilization and long-term insulin release. Islet
      polyamine content is not altered by short-term secretory stimulation, nor is the
      acute secretory response impeded by polyamine synthesis inhibitors, making it
      unlikely that these amines play any major role in short-term insulin release.
      Various mitogens increase islet polyamine contents and DNA synthesis, but
      increases in cytosolic polyamines do not seem to mediate their mitogenicity.
      Nuclear polyamine content is not altered by the inhibitors, suggesting that
      maintenance of polyamines within this organelle may be sufficient to sustain
      elevated DNA synthesis. In tumoral RINm5F cells, polyamine depletion results in
      decreased proliferation and increased cellular content of insulin and insulin
      secretory granules without affecting insulin mRNA levels or translation.
      Moreover, polyamine-depleted RINm5F cells display improved substrate metabolism
      and sensitivity of the stimulus-secretion coupling. Possible levels of polyamine
      interaction with Ca2+ metabolism are discussed.

PMID- 8460663
TI  - Staurosporine induced Ca2+ increase in DDT1MF-2 smooth muscle cells.
AB  - The free calcium concentrations in nucleus ([Ca2+]n) and cytoplasm ([Ca2+]c) of
      cultured DDT1MF-2 smooth muscle cells were estimated using the fluorescent dye
      indo-1 and laser confocal microscopy. The alkaloid staurosporine mainly increased
      [Ca2+]c during the initial minutes of stimulation and the nucleocytoplasmic
      gradient was maintained. Thereafter [Ca2+]n increased further while [Ca2+]c
      decreased, resulting after 10 min in a reversion of the nucleocytoplasmic
      gradient. Staurosporine increased the Ca2+ influx but also released intracellular
      Ca2+. In Ca(2+)-free solution no inversion of the nucleocytoplasmic gradient was
      seen in most cells. Ca2+ increased more rapidly in the area of the perinuclear
      sarcoplasmic reticulum (SR) than in the central cytoplasm. This is suggestive of
      the release of Ca2+ from this region. Ca2+ concentration remained also enhanced
      near the plasmalemma during this time period. This might indicate that the efflux
      mechanism is also affected. It is unlikely that these changes are due to
      inhibition of protein kinase C, since phorbol esters are ineffective and since
      downregulation by prolonged incubation with phorbol 12-myristate 13-acetate only
      affected the time periods required to attain the described [Ca2+]c and [Ca2+]n
      peaks. The slow time course of the staurosporine effects allowed demonstration of
      the spatiotemporal Ca2+ gradients between the nucleus and the cytoplasm and also
      inside the cytosol. The different time course of the increases in [Ca2+]c and
      [Ca2+]n suggests that two different Ca2+ mobilization events are present. The
      occurrence of an inversion of the nucleocytoplasmic gradient whereby [Ca2+]n
      increased while [Ca2+]c values decreased indicates that the increase in [Ca2+]n
      might result partially from release sites inside the nucleus.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8460664
TI  - Low-affinity mixed acetylcholine-responsive receptors at the apical membrane of
      frog tadpole skin.
AB  - The larval frog skin has a very high electrical resistance and a corresponding
      low rate of transepithelial ion transport. Amiloride, a blocker of sodium
      transport in adult skin, transiently stimulates rather than inhibits short
      circuit current (Isc) across larval skin through nonselective cation channels.
      Acetylcholine (ACh) stimulates Isc like amiloride, although the response is more
      prolonged. Pretreatment with ACh markedly suppressed amiloride stimulation of
      Isc; amiloride pretreatment also suppressed ACh stimulation. Half-maximal
      stimulation of Isc by ACh occurred at 347 microM. Stimulation by ACh was
      inhibited by both d-tubocurarine [dissociation constant (Kd) = 57 microM] and
      atropine (Kd = 49 microM). The specific nicotinic agonist 1,1-dimethyl-4
      phenylpiperazinium and the specific muscarinic agonist oxotremorine-M both
      stimulated Isc and were blocked by either atropine or d-tubocurarine. Reciprocal
      desensitization and blocker cross-reactivity suggest that ACh activates the same
      population of receptors as amiloride. This ACh-responsive receptor has
      characteristics of both nicotinic and muscarinic receptors found in other
      tissues.

PMID- 8460665
TI  - Intracellular tetanic calcium signals are reduced in fatigue of whole skeletal
      muscle.
AB  - Force and intracellular calcium signals were monitored in whole bullfrog
      semitendinosus muscles during fatigue produced by intermittent tetanic
      stimulation. Intracellular calcium signals were monitored using the fluorescent
      calcium-sensitive indicator indo-1 from the ratio of fluorescence intensities (R)
      at 400 and 470 nm. Fatiguing stimulation caused 1) proportional decreases of
      tetanic force and R, suggesting a component of the decreased force during fatigue
      of whole muscle may be due to insufficient calcium to activate contraction; 2) a
      progressive slowing of the relaxation of both force and R, suggesting slowed
      force relaxation may be mediated by slowed calcium removal from the myoplasm; 3)
      an increase of resting level R, suggesting impaired calcium removal from, or
      increased leakage to the cytosol; 4) prolongation of the twitch contraction,
      which was paralleled by changes in R. These findings are consistent with previous
      single fiber studies and suggest that changes in whole muscle contractility with
      fatigue may be partially mediated by changes in calcium handling by the cell.

PMID- 8460666
TI  - Effects of arginine vasopressin and atriopeptin on glial cell volume measured as
      3-MG space.
AB  - This study evaluates the hypothesis that arginine vasopressin (AVP) and
      atriopeptin, peptide hormones synthesized and released within the brain, are
      regulators of brain cell volume using cultured astroglial cells derived from
      newborn rats. Cell water content, regarded as volume, was measured in defined,
      serum-free medium as the 3-O-methylglucose (3-MG) space. Initial experiments
      established conditions such that glucose, which competes with 3-MG for the
      glucose carrier, would not interfere with the measurement of the 3-MG space. AVP
      increased the 3-MG space of glial cells by an average of 25% between 30 and 120
      min of exposure, whereas atriopeptin decreased it by 32%. The 3-MG space remained
      close to normal after coadministration of both peptides. The AVP-dependent
      increase in 3-MG space was blocked both by the V1 antagonist d(CH2)5Tyr(Me)AVP
      (Manning compound) and by the cotransport inhibitor, bumetanide. Results are
      consistent with a role for AVP and atriopeptin in the homeostasis of atroglial
      cell volume.

PMID- 8460667
TI  - Stimulation of phospholipase D activity and phosphatidic acid production by
      norepinephrine in rat aorta.
AB  - We sought to relate norepinephrine (NE) stimulation of phosphatidic acid (PA)
      production to functional responses of rat aorta and pathways for PA production.
      The time course for changes in PA was closely related to Ca-dependent tonic
      responses in 42K efflux and contraction. NE (30 microM for 1 min) increased PA
      and reduced phosphatidylcholine (PC) and phosphatidylinositol (PI) based on Pi
      analyses and 32P labeling of phospholipids. The 32P-to-Pi ratio in PA (0.8 +/-
      0.2, n = 13) was similar to PC (0.8 +/- 0.1, n = 14) but was significantly lower
      (P < 0.001) than PI (4.6 +/- 0.5, n = 14). The 32P-to-Pi ratio in PA was also
      lower (P < 0.02) than phosphatidylinositol phosphate and phosphatidylinositol
      bisphosphate. NE also increased [3H]PA twofold (P < 0.05) when PC was selectively
      labeled with [3H]myristic acid. These observations are more consistent with PA
      being formed from the hydrolysis of PC by phospholipase D (PLD) than by the
      phosphorylation of diacylglycerol produced by the action of phospholipase C. PLD
      was assayed by the formation of phosphatidylethanol (PEt) via a
      transphosphatidylation reaction with ethanol (half-maximal stimulation at 0.4
      0.5% vol/vol). The time course for PLD stimulation by NE was similar to PA, with
      significant increases (P < 0.002) during 10 s to 30 min exposure. Once formed,
      PEt was degraded slowly, with a half time > 3 h. It is concluded that NE
      stimulates PLD in rat aorta, which forms a significant amount of PA from the
      hydrolysis of PC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460668
TI  - Inhibition of slow-wave repolarization and Ca(2+)-activated K+ channels by
      quaternary ammonium ions.
AB  - We studied the effects of the K+ channel blocker tetrapentylammonium (TPeA) on
      the electrical activity of intact circular smooth muscle from canine colon. TPeA
      (10 and 20 microM) increased slow-wave duration and "locked" the membrane
      potential around -30 mV plateau potential after several minutes of application,
      suggesting that K+ channels are essential for termination of colonic slow waves.
      Repolarization and normal slow-wave activity resumed after 20-30 min of washout.
      The patch-clamp technique was used to study the block of large-conductance Ca(2+)
      activated K+ channels (BK channels) by TPeA and tetraethylammonium (TEA) in
      excised and cell-attached patches from isolated colonic smooth muscle cells.
      Channel block was characterized by a voltage-dependent dissociation constant
      [Kd(V)] for the binding of TEA and TPeA to a blocking site located a fraction of
      the distance across the membrane field (delta). The extracellular TEA binding
      site had a Kd(0) of 0.33 mM and a delta of 0.23. The extracellular TPeA binding
      site had a Kd(0) of 2.2 mM but showed significantly less voltage dependence
      (delta = 0.02). The intracellular binding site for TEA was of low affinity [Kd(0)
      = 76 mM]. Intracellular TPeA was the most potent blocker of BK channel current
      [Kd(0) = 11.7 microM]. The voltage dependence of block by intracellular TPeA
      (delta = -0.21) was not significantly different from that of intracellular TEA
      (delta = -0.3). Internal TPeA (10 microM) also blocked a 70-pS K+ channel and a
      23-pS K+ channel.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460669
TI  - Refilling the inositol 1,4,5-trisphosphate-sensitive Ca2+ store in neuroblastoma
      x glioma hybrid NG108-15 cells.
AB  - Bradykinin-induced increases in the intracellular free Ca2+ concentration
      ([Ca2+]i) were recorded in single NG108-15 cells with indo-1-based dual-emission
      microfluorimetry (50% effective concentration, 16 nM). A 1-min exposure to 30 nM
      bradykinin completely depleted the inositol 1,4,5-trisphosphate (IP3)-sensitive
      Ca2+ store; refilling the store required extracellular Ca2+ (half time, 2 min).
      Refilling the IP3-sensitive store was completely blocked by 1 microM La3+ and 10
      microM nitrendipine, but not 10 microM verapamil, 10 microM flunarizine, 1 microM
      nitrendipine, or 0.1 microM La3+. Thapsigargin irreversibly depleted the Ca2+
      store and prevented its refilling (half-maximal inhibitory concentration, 3 nM).
      Influx of Ca2+ across the plasma membrane did not increase after depletion of the
      IP3-sensitive store by exposure to bradykinin, although maintained presence of
      the agonist produced significant Ca2+ influx. Similarly, Mn2+ and Ba2+ influx, as
      measured by indo-1 quenching and spectral shifts, did not increase following
      depletion of IP3-sensitive store. In contrast to depletion of the IP3-sensitive
      Ca2+ store by bradykinin, thapsigargin (10 nM) treatment produced Ca2+ and Ba2+
      influx. We conclude that after Ca2+ mobilization, the IP3-sensitive Ca2+ store in
      NG108-15 cells is refilled with cytoplasmic Ca2+ via a thapsigargin-sensitive
      Ca(2+)-Mg(2+)-ATPase. Cytoplasmic Ca2+ is replenished by a persistent leak of
      Ca2+ across the plasma membrane. This leak is not modulated by the status of the
      intracellular Ca2+ store. In NG108-15 cells, agonist and thapsigargin-evoked Ca2+
      entry are mediated by activation of plasmalemmal Ca2+ channels independent of the
      status of the IP3-sensitive intracellular Ca2+ store.

PMID- 8460670
TI  - Regulation of the mitochondrial ATP-Mg/Pi carrier in isolated hepatocytes.
AB  - This study investigated the cellular regulation of net adenine nucleotide
      movements between the cytoplasm and mitochondria in intact cells. Such movements
      are presumed to occur primarily by ATP-Mg exchange with Pi via the mitochondrial
      ATP-Mg/Pi carrier. Vasopressin, A23187, and thapsigargin all elevate
      intracellular free [Ca2+] and all caused dose-dependent increases in the
      mitochondrial adenine nucleotide content (29, 63, and 39%, respectively). Phorbol
      12-myristate 13-acetate had no effect. The effect of vasopressin was abolished
      when cytoplasmic [ATP] was decreased (by 43%) and [Pi] was increased (3-fold) by
      addition of carboxyatractyloside. The effect of thapsigargin was abolished by
      addition of xylulose to deplete cytoplasmic [ATP] (by 50%) and [Pi] (> 4-fold).
      The results indicate that in intact cells Ca2+ activates the mitochondrial ATP
      Mg/Pi carrier to enable changes in the subcellular distribution of adenine
      nucleotides and that the relative [ATP] and [Pi] gradients govern the direction
      and magnitude of net adenine nucleotide movements between the cytoplasm and
      mitochondria.

PMID- 8460671
TI  - Elevation of inositol tetrakisphosphate parallels inhibition of Ca(2+)-dependent
      Cl- secretion in T84 cells.
AB  - Carbachol and histamine both stimulate calcium-dependent chloride secretion in
      the colonic epithelial cell line, T84. However, pretreatment of cell monolayers
      with carbachol blocks subsequent chloride secretion induced by thapsigargin but
      not the calcium elevation stimulated by this agent, whereas histamine
      pretreatment blocks neither thapsigargin-induced chloride secretion nor calcium
      elevation. To examine whether inositol phosphate metabolism might account for
      this difference, we measured levels of radiolabeled inositol phosphates:
      Ins(1,3,4)P3, Ins(1,4,5)P3, Ins(1,3,4,5)P4, Ins-(1,3,4,6)P4, Ins(3,4,5,6)P4,
      InsP5, and InsP6 after cell stimulation. Although both carbachol and histamine
      increase Ins (1,4,5)P3 at 5 s, there is a greater and more persistent increase in
      the levels of Ins(1,3,4)P3 and InsP4 at later time points after carbachol than
      histamine, which corresponded to the suppression of the chloride secretory
      response.

PMID- 8460672
TI  - Acid and base effects on avian osteoclast activity.
AB  - Osteoclasts generate a massive acid flux to mobilize bone calcium. Local
      extracellular acidification by polarized vacuolar-type H(+)-ATPase, balanced by
      contralateral HCO3-(-)Cl- exchange to maintain physiological intracellular pH, is
      theorized to drive this process. It follows that extracellular pH, PCO2, or HCO3-
      concentration ([HCO3-]) should impact bone matrix dissolution. However, the
      effects on bone resorption of the concentrations of these ions or their
      transmembrane gradients are unknown. Furthermore, because bone management is a
      vital process, regulatory feedback may minimize such effects. Thus a complex
      relationship between bone resorption and pH, PCO2, and [HCO3-] is expected but
      requires experimental determination. We measured bone resorption by isolated
      avian osteoclasts while varying these parameters across the physiological range.
      Bone degradation increased 50% from pH 7.3 to 6.7, whether achieved by changing
      [HCO3-] (2.3-38 mM) at constant HCO3- or PCO2 (15-190 mmHg) at constant [HCO3-].
      However, at constant pH, changing PCO2 and [HCO3-] within physiological limits
      did not affect bone resorption. In contrast, total HCO3- removal at pH 7.4
      reduced bone degradation by rat or avian osteoclasts substantially, confirming
      that normal acid secretion requires HCO3-. These observations support a model
      coupling osteoclastic bone resorption to proton and HCO3- transport but indicate
      that [HCO3-] is not rate limiting under physiological conditions. Extracellular
      pH changes affect osteoclastic bone resorption measurably, but not dramatically,
      at physiological [HCO3-].

PMID- 8460673
TI  - ATP synthase activity is required for fructose to protect cultured hepatocytes
      from the toxicity of cyanide.
AB  - The contributions of the loss of the mitochondrial membrane potential (MMP) and a
      depletion of ATP to the genesis of lethal injury were evaluated in the killing of
      cultured hepatocytes by cyanide (CN). The glycolytic production of ATP from
      fructose (Fru) maintained the MMP and prevented the killing by CN. Inhibition of
      the mitochondrial ATP synthase by 0.1 micrograms/ml oligomycin (Oligo) reduced
      ATP stores at the same rate and to the same extent as did 1 mM CN. With Oligo
      there was no loss of the MMP, and the hepatocytes maintained viability over the 6
      h during which CN killed all of the cells. Oligo had no effect on the rate of
      killing by CN. However, Oligo reversed the protective effect of Fru on CN-induced
      killing, a result that correlated with the loss of MMP but not with the depletion
      of ATP. Neither Fru nor Oligo affected the intracellular acidosis achieved with
      CN alone. Fru also prevented toxicity of the uncoupler carbonyl cyanide m
      chlorophenylhydrazone (CCCP), a result that correlated with the preservation of
      MMP. Oligo potentiated the toxicity of CCCP. It is concluded that a functioning
      mitochondrial ATP synthase is required for the production of ATP from Fru to
      prevent the killing of hepatocytes by CN. The extent of killing correlated
      closely with changes in the MMP but not with changes in the content of ATP.

PMID- 8460674
TI  - Molecular adaptation of vascular endothelial cells to oxidative stress.
AB  - Cellular organisms respond at the cellular and molecular level when confronted
      with sudden changes in environment, and molecular adaptation represents the
      ability of the cells to acclimate themselves to their new environment. In this
      study we examined the response of bovine vascular endothelial cells (VEC) to the
      oxidative stress by exposing the cultured cells to two different concentrations
      of H2O2, 0.04 or 0.08 mM, for 18-24 h. H2O2-exposed VEC displayed good viability
      (85-90% for 0.04 mM H2O2; 75-80% for 0.08 mM H2O2) and exhibited normal
      morphology. H2O2 treatment of the VEC was associated with the expression of a
      number of new proteins, as demonstrated by two-dimensional gel electrophoresis of
      total cell lysate. Cells exposed to 0.04 mM H2O2 expressed 25 new proteins,
      whereas 19 newly expressed proteins were detected when the cells were exposed to
      0.08 mM H2O2. Western blot analysis of H2O2-treated VEC using specific antibodies
      to heat-shock proteins (HSP) identified one of these proteins as a member of the
      HSP 70 family. In addition, H2O2 induced an increase in antioxidative enzyme
      activities in the VEC, including superoxide dismutase, catalase, and glutathione
      peroxidase. Moreover, these changes were a truly adaptive phenomenon because
      challenging the VEC with brief exposure to toxic levels of H2O2 (1 mM for 30 min)
      showed increased viability (by Trypan blue exclusion test) and decreased injury
      (by lactate dehydrogenase supernatant-to-cellular ratio determination) in adapted
      cells (preexposed to 0.04 or 0.08 mM H2O2) compared with control cells.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8460675
TI  - Modulation of cytokines and myocardial lesions by vitamin E and chloroquine in a
      Mg-deficient rat model.
AB  - Antioxidant treatment with alpha-tocopherol did not affect the level of the
      "inflammatory cytokines" in Mg-deficient animals, although it diminished the
      extent of the myocardial lesions. In another group of Mg-deficient animals
      chloroquine treatment diminished significantly the levels of circulating
      cytokines (interleukin-1, interleukin-6, and tumor necrosis factor-alpha) and
      also resulted in a major decrease in myocardial lesions. These results raise the
      question of the role of these inflammatory cytokines in the formation of lesions
      in Mg-deficient myocardium. Because these cytokines are able to stimulate free
      radical production in various cell types, we postulate that Mg deficiency
      involves free radical mechanisms that can be amplified by inflammatory cytokines;
      whether these cytokines initiate lesion formation is unclear. Although our data
      do not confirm either possibility, we submit that these results implicate a role
      for the inflammatory cytokines in the cardiac pathology of Mg deficiency.

PMID- 8460676
TI  - Effects of exercise training on skeletal muscle glucose uptake and transport.
AB  - Exercise training increases the concentration of GLUT-4 protein in skeletal
      muscle that is associated with an increase in maximal insulin-stimulated glucose
      transport. The purpose of this study was to determine whether exercise training
      results in a long-lasting increase in insulin-stimulated glucose transport in rat
      skeletal muscle. Glucose uptake and skeletal muscle 3-O-methyl-D-glucose (3-MG)
      transport were determined during hindlimb perfusion in the presence of a
      maximally stimulating concentration of insulin (10 mU/ml). Hindlimb glucose
      uptake was approximately 29% above sedentary (Sed) levels in rats examined within
      24 h (24H) of their last exercise session. However, when rats were examined 48 h
      (48H) after their last exercise session, hindlimb glucose uptake was not
      different from Sed levels. Maximal 3-MG transport was enhanced, above Sed levels,
      in red (RG; 72% increase) and white (WG; 44% increase) gastrocnemius and
      plantaris (Plan; 67% increase) muscles, but not soleus (Sol), of 24H rats. GLUT-4
      protein content was significantly elevated in those muscles that exhibited
      enhanced 3-MG transport in 24H rats. GLUT-4 protein content was also elevated in
      RG, WG, and Plan of 48H rats and was not different from 24H rats. Despite the
      elevated GLUT-4 protein content, 3-MG transport in 48H rats was only slightly,
      although statistically not significantly, higher than in Sed rats. These results
      provide evidence that exercise training does not result in a persistent increase
      in skeletal muscle glucose uptake or transport, despite an increase in GLUT-4
      protein content.

PMID- 8460677
TI  - Deoxygenation-induced cation fluxes in sickle cells. III. Cation selectivity and
      response to pH and membrane potential.
AB  - Deoxygenation of sickle cells increases membrane permeability to Na, K, and Ca
      and contributes to cellular cation depletion. This study examines the
      physiological nature of the pathway that mediates deoxygenation-induced movements
      of monovalent cations. Deoxygenation-induced Rb influx was a linear function of
      external Rb concentration, with no evidence of saturation. Activation of the
      deoxygenation-induced pathway was fostered by alkaline pH (7.5), whereas ion
      movements via the activated pathway were optimal between pH 6.9 and 7.0 in cells
      incubated in media in which NO3 replaced Cl to eliminate KCl cotransport. The
      deoxygenation-induced pathway exhibited no selectivity among the alkali metal
      cations Li, Na, K, Rb, or Cs, but the monovalent organic cations
      tetramethylammonium, tetraethylammonium, and N-methylglucamine were excluded.
      Sickle cells incubated in low-Cl media (external Cl, 40 mM) to depolarize the
      membrane exhibited increased deoxygenation-induced K efflux and reduced Na
      influx. Cells treated with valinomycin to hyperpolarize the membrane showed
      increased deoxygenation-induced Na influx. These characteristics of the
      deoxygenation-induced transport pathway, linear concentration dependence, lack of
      cation selectivity, and response to membrane potential, argue against a carrier
      mediated mechanism in favor of a diffusional process. The exclusion of small
      organic cations, however, suggests that factors other than ion size influence
      deoxygenation-induced permeability.

PMID- 8460678
TI  - Intracellular pH determination by 13C-NMR spectroscopy.
AB  - A noninvasive method for the determination of pH by the 13C-nuclear magnetic
      resonance (NMR) chemical shift of the C-3 carbon of sn-glycerol 3-phosphate is
      described. Nonlinear least-squares analysis of the chemical shift variation of
      the C-3 resonance of sn-glycerol 3-phosphate with pH at 37 degrees C in solutions
      and in perchloric acid extracts of tissue yielded a pKa of 6.2, making it a very
      sensitive indicator of pH in the approximate range of 5-7. Intracellular pH
      determined by the present 13C-NMR method correlated well with simultaneous
      measurements of pH by 31P-NMR spectroscopy over a wide range during normal
      perfusion and ischemic conditions in intact rat hearts. These findings indicate
      that this approach is particularly suited for quantification of intracellular pH
      over the physiological range in intact tissues and that observed in ischemic
      myocardium.

PMID- 8460679
TI  - Glucose transporters and glucose transport in skeletal muscles of 1- to 25-mo-old
      rats.
AB  - It is widely thought that aging results in development of insulin resistance in
      skeletal muscle. In this study, we examined the effects of growth and aging on
      the concentration of the GLUT-4 glucose transporter and on glucose transport
      activity in skeletal muscles of female Long-Evans rats. Relative amounts of
      immunoreactive GLUT-4 protein were measured in muscle homogenates of 1-, 10-, and
      25-mo-old rats by immunoblotting with a polyclonal antibody directed against GLUT
      4. In the epitrochlearis, plantaris, and the red and white regions of the
      quadriceps muscles, GLUT-4 immunoreactivity decreased by 14-33% between 1 and 10
      mo of age and thereafter remained constant. In flexor digitorum brevis (FDB) and
      soleus muscles, GLUT-4 concentration was similar at all three ages studied.
      Glucose transport activity was assessed in epitrochlearis and FDB muscles by
      incubation with 2-deoxyglucose under the following conditions: basal, submaximal
      insulin, and either maximal insulin or maximal insulin combined with contractile
      activity. Glucose transport in the epitrochlearis muscle decreased by
      approximately 60% between 1 and 4 mo of age and then did not decline further
      between 4 and 25 mo of age. Transport activity in the FDB assessed with a
      maximally effective insulin concentration decreased only slightly (< 20%) between
      1 and 7 mo of age. Aging, i.e., the transition from young adulthood to old age,
      was not associated with a decrease in glucose transport activity in either the
      epitrochlearis or the FDB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460680
TI  - Glucose uptake and glycogen synthesis in normal and chronically active muscles.
AB  - The hindlimb muscles of the C57Bl6J dy2J/dy2J (dy2J) mouse suffer from a chronic
      neural stimulation (pseudomyotonia), resulting in increased contractile activity.
      In response to the increased contractile activity, these muscles store increased
      amounts of glycogen. In this study, glucose uptake and glycogenesis (glycogen
      synthesis from glucose) were analyzed in chronically active and normal muscles.
      In vivo experiments demonstrate increased 3-O-methylglucose (3-MG) uptake rates
      and glycogenesis by chronically active dy2J gastrocnemius muscles (Gast) vs.
      normal control Gast. The chronically active diaphragm muscle (Dia) showed the
      highest rates of 3-MG uptake, as well as glycogenesis in vivo when compared with
      other skeletal muscles. No differences were observed between dy2J and control
      Dia. The levels of blood glucose were similar between dy2J and control animals.
      In vitro experiments demonstrated an increased sensitivity and responsiveness to
      insulin for glucose uptake in the dy2J soleus muscle (Sol). Glycogenesis by dy2J
      Sol was elevated only at the highest insulin concentration tested (10,000
      microU/ml). In contrast, the dy2J extensor digitorum longus muscle had an
      increased sensitivity and responsiveness to insulin for both glucose uptake and
      glycogenesis. This study demonstrates that chronically active muscles have
      elevated capacities for glucose uptake and glycogenesis and may help to explain
      the elevated glycogen levels in the dy2J hindlimb muscles.

PMID- 8460681
TI  - Effects of subbasal insulin infusion on resting and exercise-induced glucose
      turnover in depancreatized dogs.
AB  - beta-Adrenergic blockade suppressed lipolysis and normalized the exercise-induced
      increments in glucose uptake (GlcU) and metabolic clearance rate (MCR) in alloxan
      diabetic dogs with residual insulin, but not in insulin-deprived depancreatized
      dogs even when combined with methylpalmoxirate (MP), which suppresses fatty acid
      oxidation. The effects of a minimal amount of insulin (as in the alloxan-diabetic
      dog), were studied in depancreatized, 24-h insulin-deprived dogs during rest and
      treadmill exercise (6 km/h, 10% slope) using a 1/4 basal insulin infusion (50
      microU.kg-1.min-1, insulin, n = 6) alone, or with MP (20 mg.kg-1.day orally, 2.5
      days, MP+insulin, n = 6). At rest, insulin decreased circulating fatty acids
      (31%) and Glc (13%) and increased GlcU and MCR (86 and 72%). Glc production was
      unaffected. MP plus insulin markedly suppressed hepatic fatty acid oxidation,
      decreased Glc (44%) and Glc production (50%), and markedly increased MCR (128%).
      The exercise-induced increments in MCR were markedly improved only by MP plus
      insulin but were still lower than in the propranolol-treated alloxan-diabetic
      dogs. Plasma Glc inversely correlated with the exercise-induced increase in MCR
      (r = -0.86). We conclude that 1) acute infusion of subbasal insulin improved GlcU
      in depancreatized dogs at rest but not during exercise; 2) inhibition of fatty
      acid oxidation combined with subbasal insulin improved the exercise-induced
      increase in MCR; and 3) the difference in GlcU and MCR between the MP plus
      insulin-treated depancreatized dogs and the beta-blockade-treated alloxan
      diabetic dogs suggests a difference between acute and chronic effects of insulin.

PMID- 8460682
TI  - Female sex hormones, perinatal, and peripubertal androgenization on hepatocyte
      insulin dynamics in rats.
AB  - The effects of female sex hormones on insulin binding and receptor-mediated
      insulin degradation were investigated in hepatocytes from ovariectomized rats.
      The influences of perinatal and peripubertal androgenization on these events were
      examined. Estradiol treatment increased insulin binding and receptor-mediated
      insulin degradation by increasing cell surface insulin receptor number.
      Progesterone also increased both binding and degradation, but the increase in
      degradation exceeded the increase in binding. Perinatal exposure to testosterone
      blunted the estradiol-induced increase in insulin binding and decreased
      degradation, whereas the progesterone-mediated increases were completely
      suppressed. Peripubertal testosterone decreased binding, with a much greater
      reduction in insulin degradation. Perinatal androgenization did not influence the
      peripubertal testosterone effects. Thus peripubertal female sex hormones exert
      regulatory influences on both hepatic cell surface insulin receptor number and
      postreceptor events mediating insulin degradation. These events are modulated by
      perinatal and peripubertal exposure to androgens. Abnormalities in sex hormone
      levels and/or hepatic androgenization could therefore contribute to altered
      insulin metabolism and hyperinsulinemia in some hyperandrogenized women with
      abdominal obesity and increased androgenic activity.

PMID- 8460683
TI  - Effects of cell density on in vitro glucose metabolism by isolated adipocytes.
AB  - We studied the effect of variable isolated fat cell concentrations (from 0.17 to
      1.25 x 10(6) cells/ml) on rate and pattern of basal and insulin-stimulated
      glucose metabolism by rat epididymal fat cells. Cell concentration did not affect
      total glucose utilization, but high cell concentrations increased the absolute
      and relative conversion of glucose to CO2 and glyceride-fatty acids by two- to
      threefold and decreased the conversion to lactate, pyruvate, and glyceride
      glycerol when compared with values observed at low cell concentration. When
      effects of adenosine deaminase (ADA) and N-6(2-phenylisopropyl)adenosine (PIA)
      were examined, addition of ADA to incubated cells produced no significant changes
      in the rate or pattern of adipocyte glucose metabolism; PIA had a slight and
      uniform effect on the conversion of glucose to its metabolic products and minimal
      effect on insulin-stimulated glucose metabolism. Medium free fatty acid
      concentration did not change during the incubation at various cell density, but
      intracellular free fatty acids were found to be inversely related to fat cell
      density in the medium. Thus a variable fat cell density influences the pattern of
      adipocyte glucose metabolism in vitro. This effect may be due to variable rates
      of lipolysis and resulting changes in intracellular fatty acid concentration
      rather than to adenosine per se. This work has practical implications in the need
      to define cell density when carrying out in vitro measurements of adipocyte
      glucose conversion to products.

PMID- 8460684
TI  - Characterization and ontogeny of endothelin receptors in human placenta.
AB  - Because of the potent mitogenic and vasoactive properties of endothelin-1 (ET-1)
      and the presence of its receptor in third trimester placenta, we postulated that
      ET-1 might be involved in human placental growth and vascularization during
      development. As an initial approach to test this hypothesis, placental ET
      receptors were characterized and quantified in each trimester of pregnancy.
      Membrane-rich particulates were prepared from first-, second-, and third
      trimester villous human placenta obtained immediately after pregnancy termination
      or delivery. ET receptors were characterized by radioligand saturation analysis,
      ligand competition, and reverse transcription-polymerase chain reaction (RT-PCR)
      to determine the concentration, affinity, and specificity of ET binding sites,
      and to document the presence of specific ET-receptor subtype mRNA transcripts in
      placentas from each trimester. Kinetic determinations of 125I-labeled ET-1
      binding yielded a Kd = 61 pM, consistent with the equilibrium determinations of
      34 +/- 6 pM (n = 11). The concentration of ET receptors decreased significantly
      from 682 +/- 94 fmol/mg protein (n = 4) in the first trimester to 266 +/- 89
      fmol/mg protein (n = 4) in the third trimester. Competition studies with
      unlabeled ET-1 indicated a single class of binding sites with a Ki = 49 +/- 5 pM
      (n = 9), whereas competition with ET-3 demonstrated binding sites with two
      affinities. The predominant sites had a Ki = 84 +/- 14 pM, similar to that for ET
      1. The RT-PCR data confirmed that both ETA and ETB receptors mRNA transcripts are
      expressed in human placenta.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460685
TI  - Hepatic glucose production and insulin sensitivity and responsiveness in iron
      deficient anemic rats.
AB  - We performed euglycemic hyperinsulinemic glucose clamps at insulin infusion rates
      of 1.9, 4.0, 9.3, and 19.3 mU.kg-1 x min-1 in rats with varying severities of
      iron deficiency anemia (IDA; mean hemoglobin concentrations of 59, 79, 107, and
      137 g/l) to assess the effect of IDA on insulin sensitivity and responsiveness.
      Glucose appearance and disappearance (Rd) rates were determined using a primed
      continuous infusion of [3-3H]glucose. Basal plasma glucose and insulin
      concentrations were similar between the IDA and control rats. Basal hepatic
      glucose production was significantly (P = 0.0001) elevated in the two most anemic
      groups (13.6 +/- 2.4 and 12.6 +/- 3.1 vs. 10.6 +/- 2.2 and 10.2 +/- 2.0 mg.kg-1 x
      min-1). A significant upward shift in the insulin dose-response curves for Rd
      indicated an increase in peripheral insulin responsiveness in the two most anemic
      groups while a slight leftward shift was suggestive of an increase in insulin
      sensitivity in all three anemic groups. Hepatic insulin sensitivity and
      responsiveness were unaffected by IDA. We conclude that increased glucose
      utilization rates in IDA rats are due primarily to an increase in peripheral
      insulin responsiveness.

PMID- 8460686
TI  - Local bone injections of LPS and M-CSF increase bone resorption by different
      pathways in vivo in rats.
AB  - We investigated the local in vivo action of lipopolysaccharide (LPS), a potent
      monocyte activator, and of macrophage colony-stimulating factor (M-CSF), a
      hemopoietic growth factor influencing monocyte differentiation, on bone
      resorption in normal female 8-wk-old rats. LPS (2 injections of 0.5 microgram), M
      CSF (2 injections of either 12.5, 25, 100, or 500 ng), or vehicle was injected
      into bone marrow space through a thin catheter implanted, under hydrochloride
      anesthesia, in the distal end of the right femur. Histomorphometry was performed
      after staining of the tartrate-resistant acid phosphatase (TRAP). The number of
      osteoclasts and of TRAP-positive marrow cells (considered as osteoclast
      precursors) were counted in the secondary spongiosa. LPS caused a 3-fold increase
      in osteoclast surface, a 4.5-fold increase in the number of osteoclasts, but no
      change in the number of TRAP-positive marrow cells. M-CSF induced a striking dose
      dependent biphasic effect on the number of TRAP-positive marrow cells and on bone
      resorption (no change with the lowest or with the highest concentrations,
      although the two intermediate doses significantly increased resorption surfaces
      and the number of osteoclasts). Our results demonstrate a local in vivo effect of
      LPS and of M-CSF on bone resorption and suggest that these substances act at
      different stages of osteoclast development and function.

PMID- 8460687
TI  - Thyroidal vascular responsiveness to parasympathetic stimulation is increased in
      hyperthyroidism.
AB  - It has been suggested that thyroid blood flow (TBF) is regulated by both
      parasympathetic and sympathetic nerves. Because thyroxine (T4) pretreatment
      increases the sensitivity of the thyroid to the effects of thyrotropin, the
      present study was conducted to determine whether T4 pretreatment can also
      sensitize the thyroid to the effect of parasympathetic stimulation on TBF.
      Untreated or T4-pretreated rats were anesthetized, and both superior laryngeal
      nerves (SLN) were transected. TBF was continuously monitored by laser Doppler
      flowmetry (LDF), and thyroid vascular conductance (TVC) was also determined by
      the microsphere technique. Stimulation of the SLN had no effect on TBF or TVC in
      untreated rats when measured by LDF or microspheres. In contrast, stimulation of
      the SLN after T4 pretreatment increased TBF by 65 +/- 21% over prestimulus levels
      as measured by LDF. TVC was also increased significantly (P < 0.05) in these rats
      compared with TVC in a nonstimulated T4-pretreated group. To examine the role of
      muscarinic receptor activation in the mediation of these increases in TVC, T4
      pretreated rats were given saline or atropine prior to SLN transection.
      Stimulation of the SLN in T4-pretreated rats given saline increased TVC
      significantly (P < 0.05) compared with TVC in the nonstimulated saline-treated or
      atropine-treated group. In contrast, TVC in the stimulated group given saline was
      not significantly different from the group that was stimulated after atropine
      injection. Our results suggest that the thyroidal vascular responsiveness to
      parasympathetic stimulation is increased in the hyperthyroid condition.

PMID- 8460688
TI  - Ouabain is secreted by the adrenal gland in awake dogs.
AB  - Ouabain has been identified in the plasma and adrenal glands of several mammals,
      including humans. To investigate possible adrenal secretion of ouabain in vivo,
      at rest, and in response to acute blood volume changes, we prepared trained adult
      dogs (n = 10) with splenectomy and unilateral adrenal venous (AV) cannulation.
      Two days later, after an overnight fast, dogs had either 1) 20% hemorrhage (hem)
      or 2) 20% blood volume expansion (exp; 6% Dextran 70, 0.9% NaCl) in random order.
      In AV and arterial plasma (ART), ouabain was measured by a ouabain-specific
      immunoassay, and cortisol and aldosterone were measured by radioimmunoassay. ART
      and AV ouabain concentration did not change after hem or exp [P = not significant
      (NS)]. In 94 of 97 paired samples, the concentration of ouabain in AV was greater
      than that in ART (Wilcoxon, P < 0.001), and the mean ouabain concentration was
      greater in AV (756.4 +/- 85.7 pmol/l) than ART (235.4 +/- 18.5 pmol/l; P <
      0.001). The mean AV-to-ART ouabain concentration ratio was 5.7 +/- 1.29. Adrenal
      secretion of ouabain was not influenced by hem or exp (analysis of variance, P =
      NS). Adrenal secretion of cortisol and aldosterone increased after hem (P < 0.05)
      and was unaltered by exp (P = NS). This study demonstrates that ouabain is
      secreted by the adrenal gland in the awake dog. However, adrenal ouabain
      secretion and arterial blood ouabain are not altered by acute hem or exp.

PMID- 8460689
TI  - Acute effects of ethanol on hepatic endocytosis and processing of insulin in
      perfused rat liver.
AB  - This study utilizes the perfused rat liver combined with subcellular
      fractionation and compartmental analysis to investigate the effects of ethanol on
      hepatic uptake, endocytosis, and processing of insulin. At 4 min after the start
      of a 2-min pulse of radiolabeled insulin, increasing ethanol concentrations
      progressively inhibited insulin uptake by the liver (57% at 50 mM ethanol).
      Subcellular fractionation of the perfused livers showed a progressive shift in
      distribution from a predominantly endosomal location (control) to a bimodal
      distribution between endosomes and plasma membrane. This could be largely
      accounted for by a specific reduction in the endosome-associated insulin. Binding
      studies showed no changes in the binding properties of the plasma membrane
      insulin receptor. Compartmental analysis of the perfusate efflux curves confirmed
      the lack of effect of ethanol on the binding constants but showed a significant
      decrease in the endocytic rate constant (50%) together with an increase in the
      retroendocytic rate constant (33%). Simulation studies with the compartmental
      model showed that these changes could account for the observed decrease in uptake
      by the liver. No changes were found in the subsequent endocytic degradation of
      insulin.

PMID- 8460690
TI  - Respiratory, ionic, and functional effects of succinate esters in pancreatic
      islets.
AB  - The methyl esters of succinic acid were introduced a few years ago as new potent
      insulin secretagogues. In the present study, they were found to increase O2
      uptake by rat islets incubated in the absence or presence of D-glucose; to
      decrease 86Rb outflow from prelabeled islets; to stimulate biosynthetic activity
      in the islets, with a preferential effect on the synthesis of proinsulin; to
      inhibit 45Ca efflux from prelabeled islets perifused in the absence of
      extracellular Ca2+ but to augment 45Ca net uptake and to cause a biphasic
      stimulation of 45Ca outflow in islets incubated or perifused in the presence of
      extracellular Ca2+; and to evoke a biphasic stimulation of insulin release. The
      insulinotropic action of these methyl esters coincided with a shift to the left
      of the sigmoidal relationship between insulin output and D-glucose concentration,
      was concentration related in the 2-10 mM range, failed to be duplicated by
      succinic acid, displayed both Ca2+ dependency and resistance to a lowering of
      extracellular pH, and was operative in the absence of D-glucose whether or not
      the islets were stimulated by non-nutrient secretagogues. It is concluded that
      the respiratory, cationic, biosynthetic, and secretory responses of the islets to
      succinate methyl esters display the characteristic features usually encountered
      in the process of nutrient-stimulated insulin release.

PMID- 8460691
TI  - Metabolic effects and fate of succinate esters in pancreatic islets.
AB  - The metabolic effects and the catabolism of succinate methyl esters were examined
      in rat pancreatic islets. The esters augmented 14CO2 production from islets
      prelabeled with L-[U-14C]-glutamine but inhibited NH4+ output, suggesting that
      they do not activate glutamate dehydrogenase. They decreased 14CO2 output from
      islets prelabeled with [U-14C]palmitate. They had little effect on the oxidation
      of exogenous D-[3,4-14C]glucose, D-[2-14C]glucose, D-[6-14C]glucose, or D-[1
      14C]glucose, suggesting unaltered ratio between the input of acetyl residues and
      four- or five-carbon metabolites, such as succinate, into the Krebs cycle. By
      following the fate of both [1,4-14C]succinate dimethyl ester and [2,3
      14C]succinate dimethyl ester, data were obtained to indicate that succinate is
      efficiently formed from the ester and further metabolized, leading to the
      generation of 14C-labeled acidic metabolites including pyruvate and L-lactic
      acid, CO2, and amino acids. It is proposed that a concerted increase of both
      succinate and acetyl residue influx into the Krebs cycle accounts for the
      increase in O2 uptake caused by the succinate methyl esters and, hence, for
      stimulation of both pro-insulin biosynthesis and insulin release.

PMID- 8460692
TI  - Pancreatic beta-cell function and glucose metabolism in human segmental pancreas
      and kidney transplantation.
AB  - beta-Cell function and glucose metabolism were studied in eight insulin-dependent
      diabetic recipients of combined segmental pancreas and kidney transplant with
      peripheral insulin delivery (Px), in eight nondiabetic kidney-transplant
      individuals (Kx), and in eight normal subjects (Ns) after three consecutive mixed
      meals. All subjects had normal fasting plasma glucose, but increased basal levels
      of C-peptide were demonstrated in the transplant groups (P < 0.05 relative to
      Ns). Postprandial hyperglycemia was increased 14% in Kx and 32% in Px (P < 0.05),
      whereas compared with Ns postprandial C-peptide levels were increased three- and
      twofold, respectively, in Kx and Px (P < 0.05). Compared with Ns basal insulin
      secretion rate (combined model) was increased 2-fold in Kx and 1.4-fold in Px (P
      < 0.05). Maximal insulin secretion rate was reduced 25% in Px compared with Kx (P
      < 0.05) but not different from that of Ns (P NS). Also, maximal insulin secretion
      rate occurred later in Px than in controls (Tmax: Px 50 min, Kx 30 min, and Ns 32
      min; P < 0.05). The total integrated insulin secretion was increased 1.4-fold in
      Px compared with Ns (P < 0.05) but decreased 1.4-fold compared with Kx (P <
      0.05). Fasting and postprandial proinsulin-to-C-peptide molar ratios were
      inappropriately increased in Px compared with Kx and Ns. Basal hepatic glucose
      production was increased 43% in Px and 33% in Kx compared with Ns (P < 0.05).
      Postprandial total systemic glucose appearance was similar in all three groups,
      whereas peripheral glucose disposal was 15% reduced in Px (P < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8460693
TI  - Determinants of decline in resting metabolic rate in aging females.
AB  - We considered the association of several metabolic and lifestyle variables as
      modulators of the decline in resting metabolic rate (RMR) and fat-free weight
      (FFW) in 183 healthy females (18-81 yr). RMR showed a curvilinear decline with
      age, which was significant in women aged 51-81 yr but not in women aged 18-50 yr.
      FFW showed a curvilinear decline with age, which was significant (P < 0.01) in
      women 48-81 yr but not in women 18-47 yr. The decline in RMR was primarily
      associated with the loss of FFW (r2 = 72%), whereas the decline in FFW was
      explained primarily by differences in maximal O2 consumption (VO2max), age,
      leisure time physical activity, and dietary protein intake (total r2 = 46%). We
      conclude that RMR and FFW showed a curvilinear decline with age which was
      accelerated beyond the middle-age years. Second, the age-related decline in RMR
      was primarily associated with the loss of FFW. Third, the loss of FFW was
      partially related to a decrement in VO2max and nutritional factors. Therapeutic
      interventions designed to increase VO2max by elevating physical activity may
      preserve fat-free weight and thus offset the decline of RMR in aging women.

PMID- 8460694
TI  - Two-compartment model of acute stimulation of aldosterone secretion in vivo by
      angiotensin II.
AB  - Sheep with a cervical adrenal autotransplant were used to establish the
      relationship between acute change in angiotensin II (ANG II) concentration and
      acute change in aldosterone secretion rate (ASR). The kinetics of 131I-labeled
      ANG II and unlabeled ANG II across the adrenal were consistent with distribution
      within a two-compartment model. ASR was found to be a linear function of the ANG
      II concentration predicted to occur in the second compartment, indicating that
      acute change in ASR is determined to a large degree by the rate of exchange of
      ANG II between the first and second compartments. The time required for ANG II
      concentration to reach 50 and 95% of steady state was estimated to be
      approximately 5 and 45 min, respectively. The time course for agonist
      distribution within the adrenal may be an important factor to consider in both
      the design and interpretation of experimental studies that involve the
      stimulation (or inhibition) of adrenocortical cells.

PMID- 8460695
TI  - Remote and chronic access to the third cerebral ventricle of the unrestrained
      prepubertal rhesus monkey.
AB  - One channel of a commercially available standard-size three-channel fluid swivel
      was modified to permit continuous access to the brain of unrestrained prepubertal
      rhesus monkeys via a continuous length of small-bore Teflon tube originating from
      a swivel device on top of the animal's cage and terminating in the third cerebral
      ventricle. This system was employed to achieve continuous access to the third
      cerebroventricle in four monkeys for periods of up to 12 mo. The value of the
      system for studies of the neurochemical control of hypothalamic-releasing factor
      secretion was established by monitoring adenohypophysial responses to
      neurotransmitter receptor agonists infused into the third ventricle.
      Specifically, repetitive infusions of morphine (30 micrograms/infusion) elicited
      a robust train of prolactin discharges, and third ventricular administration of N
      methyl-DL-aspartic acid (NMA; 20 micrograms) resulted in striking discharges of
      LH.

PMID- 8460696
TI  - Determinants of intrabolus pressure during esophageal peristaltic bolus
      transport.
AB  - Previous manometric studies of esophageal fluid bolus transport in humans have
      generally ignored the hydrodynamic distinction between intrabolus pressure and
      pressure within the lumen-occluded, contracting esophageal segment. In this study
      we obtained concurrent esophageal videofluoroscopic and intraluminal manometric
      recordings in supine normal volunteers using different bolus volumes and
      viscosities and abdominal compression. Intrabolus pressure increased with bolus
      volume, viscosity, and abdominal compression. Esophageal diameter increased with
      larger bolus volumes, and this increase was correlated with increases in
      intrabolus pressure. Intrabolus pressure was highest in the bolus tail. Peak
      intraluminal pressures > 20 mmHg above basal intrabolus pressure almost
      invariably were associated with effective peristalsis, whereas values of this
      pressure differential < 20 mmHg frequently were associated with ineffective
      peristalsis and retrograde bolus escape. Intrabolus pressure can serve as an
      important indicator of the forces resisting peristaltic transport and the
      occurrence of ineffective bolus transport.

PMID- 8460697
TI  - Protective action of oral N-acetylcysteine against gastric injury: role of
      hypertonic sodium.
AB  - N-acetylcysteine (NAC), when administered orally as a 20% solution, is a potent
      protective agent against gastric injury in the rat stomach induced by absolute
      ethanol. The present study was undertaken to define the means by which this
      protection is mediated. The notion that NAC acts as a glutathione precursor was
      excluded when N-acetylserine (NAS) was noted to be equally protective against
      alcohol injury. The NAS molecule contains a hydroxyl moiety at the site where NAC
      contains a sulfhydryl. To orally administer 20% NAC at a neutral pH, NaOH is
      added to the free acid form to keep NAC in solution. We determined by titration
      that a sodium concentration of 1.2 M results. Thus it became apparent that the
      protective effect of NAC might be mediated through the sodium employed to titrate
      NAC. Accordingly, we examined various sodium salts and assessed their relative
      protective effects against alcohol injury. Both sodium acetate and sodium
      chloride in 1 M solutions were found to be equally effective in preventing
      alcohol injury with the same efficiency as 1 M sodium solutions of NAC and NAS,
      excluding the acetate portion of NAC and NAS as being of primary importance for
      protection to occur. Further study, using different concentrations of sodium
      chloride (i.e., 150-1,000 mM) revealed that the 1 M solution was most optimal in
      preventing alcohol injury. One molar sodium by itself and when administered as
      part of the NAC solution also prevented gastric injury by concentrated acid and
      base.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460698
TI  - Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter
      motor function.
AB  - Effect of aging, bolus volume, temperature, and consistency on the pharyngeal
      peristalsis, as well as the effect of aging on the upper esophageal sphincter
      (UES) resting pressure and its response to esophageal distension by air and
      balloon, were studied in 14 young and 12 healthy elderly volunteers. In both age
      groups there was no significant volume or temperature effect on amplitude,
      duration, or velocity of the pharyngeal peristalsis. Compared with water
      swallows, mashed potato swallows resulted in a significant increase in the
      amplitude and duration of the hypopharyngeal peristaltic pressure wave (P <
      0.05). For water swallows, the amplitude and duration of the peristaltic pressure
      wave in the hypopharynx were significantly increased in the elderly compared with
      the young group (P < 0.01). UES resting pressure in the elderly measured 43 +/- 5
      (SE) mmHg and was significantly less than that of the young (71 +/- 8 mmHg; P <
      0.01). Magnitude of the UES pressure decrease because of esophageal distension by
      air, as well as magnitude of its pressure increase because of esophageal balloon
      distension, was similar among young and elderly. 1) Contrary to common
      expectations, the parameters of the pharyngeal peristaltic pressure wave do not
      deteriorate in the elderly in their seventh and eighth decade. 2) Compared with
      the young, hypopharyngeal pressure wave amplitude and duration are significantly
      increased in the elderly. This increase could be caused by an adaptation response
      to a pharyngeal outflow compromise. 3) Pharyngeal peristaltic pressure wave
      amplitude and duration, but not its velocity, are modulated by the bolus
      consistency. This modulatory mechanism is preserved in the elderly. 4) Although
      UES resting pressure is significantly decreased in the elderly, its pressure
      response to esophageal distension by air and balloon is preserved.

PMID- 8460699
TI  - Age-related differences in intestinal microvascular responses to low-flow states
      in adult and suckling rats.
AB  - We used in vivo videomicroscopic techniques to compare the intestinal
      microvascular responses of 8- to 12-wk-old adult rats with those observed in 8-
      to 12-day-old suckling rats. Changes in intestinal microarteriolar diameters and
      blood flow were measured during hemorrhage (5 and 10 ml/kg), hypoxia (10% O2
      breathing environment), and hypothermia (surface cooling to 34 degrees C and 31
      degrees C). Intestinal blood flow (as measured by optical Doppler velocimetry)
      was decreased by a similar amount in both adult and suckling rats during all
      three periods of stress. Large arteriolar diameter changes were also similar in
      adult and suckling rats. In contrast, there were substantial differences in the
      responses of the small premucosal arterioles. These premucosal arterioles
      selectively dilated in adult rats, suggesting a redistribution of blood flow
      toward the mucosa during each of the three periods of stress. These same
      microvessels failed to dilate in the suckling rats during each of the three
      periods of stress, suggesting that the intestinal microvasculature in the
      immature rat lacks vasodilator mechanisms that are active in the adult rat. We
      propose that altered microvascular control could make the developing intestine
      prone to mucosal damage during periods of decreased perfusion.

PMID- 8460700
TI  - Mechanism of bile acid-induced biliary lipid secretion in the rat: effect of
      conjugated bilirubin.
AB  - We have compared the effects of bilirubin and bilirubin ditaurate (BDT) on
      biliary phospholipid and cholesterol secretion in unanesthetized normal Wistar
      (NW) and Groningen Yellow (GY) Wistar rats under various experimental conditions.
      GY rats express a genetic defect in biliary secretion, but not in hepatic uptake,
      of various organic anions. Under physiological conditions, NW and GY rats showed
      similar biliary secretion rates of bile acids and of bilirubin, despite the fact
      that bilirubin concentrations in GY plasma were 25 times as high and in GY livers
      three times as high as in NW plasma and livers, respectively. Secretion of
      cholesterol and phospholipids was not impaired in GY rats under these conditions.
      Biliary secretion of intravenously injected BDT (3 mumol/100 g body wt) was
      delayed in eight-day bile-diverted GY rats and showed lower peak values when
      compared with NW rats. The inhibitory effects of BDT on phospholipid and
      cholesterol secretion paralleled these differences, being delayed and much less
      pronounced in GY rats. No overshoot in phospholipid or cholesterol secretion was
      observed when bilirubin output returned to preinjection values. Stimulation of
      [14C]choline-labeled phospholipid secretion after a bolus injection of
      taurochenodeoxycholic acid (1 mumol/100 g body wt) closely followed biliary bile
      acid concentration. Similarly, inhibition of labeled phospholipid secretion by
      BDT closely paralleled the biliary bilirubin concentration. Gel filtration
      studies (Sepharose 4B-CL) under micelle-preserving conditions demonstrated a
      specific interaction of BDT with biliary bile acids. The presented data indicate
      that conjugated bilirubin does not inhibit biliary lipid secretion via
      interaction with bile acids inside the hepatocyte.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8460701
TI  - Hepatic taurocholate uptake is electrogenic and influenced by transmembrane
      potential difference.
AB  - Uptake of the bile acid taurocholate by hepatocytes is coupled to Na+ influx. The
      stoichiometry of uptake, however, is uncertain, as is the influence of the
      transmembrane electrical potential difference (PD) on this process. In this
      study, we examined the relationship between taurocholate extraction and PD
      (measured using intracellular microelectrodes) in perfused liver, and we measured
      taurocholate-induced transport current in cultured hepatocytes using patch-clamp
      recording techniques. In the perfused liver under basal conditions, PD averaged 
      28.4 +/- 0.6 (SE) mV, and extraction of 1, 50, and 300 microM taurocholate was
      0.95 +/- 0.02, 0.98 +/- 0.01, and 0.41 +/- 0.03, respectively. When the Na+
      chemical gradient was decreased by replacing perfusate Na+ with choline, the
      membrane depolarized to -17.2 +/- 1.1 mV, and taurocholate extraction markedly
      decreased at all taurocholate concentrations (P < 0.01). When perfusate Na+
      concentration was held constant at 137 mM, membrane depolarization induced by
      substitution of gluconate for perfusate Cl- (-17.9 +/- 0.6 mV) or Cl- for nitrate
      (-10.3 +/- 2.1 mV) significantly decreased extraction of 300 microM taurocholate.
      Abrupt exposure to taurocholate produced a concentration-dependent membrane
      depolarization in the presence of Na+, but not in its absence (P < 0.001). In
      cultured hepatocytes, exposure to 100 microM taurocholate produced an inward
      current of -0.056 +/- 0.016 pA/pF at a holding potential of -40 mV. This current
      was Na+ dependent, and it increased twofold as holding potential was changed from
      -20 to -50 mV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460702
TI  - Cerebral-evoked potential responses following direct vagal and esophageal
      electrical stimulation in humans.
AB  - Cerebral evoked responses following direct electrical stimulation of the vagus
      and esophagus were compared in 8 epileptic subjects and with those recorded after
      esophageal stimulation in 12 healthy nonepileptic controls. Direct vagal
      stimulation was performed using a left cervical vagal pacemaker, which is used in
      the treatment of epilepsy. Esophageal stimulation was obtained with the use of an
      esophageal assembly incorporating two electrodes positioned 5 and 20 cm orad to
      the lower esophageal sphincter. Evoked potential responses were recorded with the
      use of 20 scalp electrodes. The evoked potential responses consisted of three
      distinct negative peaks and were similar with the use of either vagal or
      esophageal stimulation. The measured conduction velocity of the afferent response
      was 7.5 m/s in epileptic subjects and 10 m/s in healthy controls, suggesting that
      afferent conduction is through A delta-fibers rather than slower C afferent
      fibers. We conclude that the cortical-evoked potential responses following
      esophageal electrical stimulation are comparable to direct electrical stimulation
      of the vagus nerve and involve mostly A delta-fibers. This approach provides a
      method for the assessment of vagal afferent gastrointestinal sensory pathways in
      health and disease.

PMID- 8460703
TI  - Distribution and abundance of neutral endopeptidase (EC 3.4.24.11) in the
      alimentary tract of the rat.
AB  - The distribution of neutral endopeptidase (NEP; EC 3.4.24.11) was examined in the
      alimentary tract of the rat. Immunoreactive NEP and NEP mRNA were localized to
      epithelial cells of the small intestine and to muscle cells in the stomach, small
      intestine, and colon by immunohistochemistry and in situ hybridization
      histochemistry. NEP antisera recognized a protein on Western blots of membranes
      from gastric, jejunal, and colonic mucosa and gastric muscle with an
      electrophoretic mobility identical to that of recombinant human NEP
      (approximately 95 kDa). An antisense cRNA probe to NEP hybridized to RNA of
      approximately 3.5 kb and approximately 6.5 kb, corresponding to the primary
      transcripts of rat NEP, on Northern blots of total RNA from the jejunal mucosa.
      NEP message was detected in mRNA from jejunal and colonic mucosa and gastric,
      jejunal, and colonic muscle using a ribonuclease protection assay. NEP enzymatic
      activity, assessed by DL-thiorphan-inhibitable degradation of glutaryl-Ala-Ala
      Phe-4-methoxy-2-naphthylamine, was highest in homogenates of jejunal mucosa (868
      +/- 98 pmol.h-1 x micrograms protein-1) and was between 49- and 413-fold lower in
      other gastrointestinal tissues. The cellular origin of NEP in the gastric and
      colonic mucosa could not be determined.

PMID- 8460704
TI  - Vitamin A metabolism in rat liver: a kinetic model.
AB  - Vitamin A metabolism in the liver involves both hepatocytes and the
      nonparenchymal perisinusoidal stellate cells. To describe and quantitate the
      dynamic relationships between retinol in these cells and in plasma, we
      administered either chylomicrons labeled with [3H]retinyl esters or plasma
      containing [3H]retinol-retinol-binding protein-transthyretin to rats.
      Radioactivity and retinol masses were measured in plasma, liver, and isolated
      hepatocytes for 15 days; data were analyzed by model-based compartmental
      analysis. The resulting model predicts that: 1) approximately 20% of the total
      plasma turnover of retinol goes to the liver (vs. nonhepatic tissues) and
      approximately 20% of plasma retinol input is from liver (vs. nonhepatic tissues),
      2) about one-half of the retinol recycling from plasma to liver is taken up by
      hepatocytes and about one-half by nonparenchymal cells, 3) retinyl esters in both
      cell types are derived preferentially from newly taken up retinol rather than
      from the main intracellular retinol pools, and 4) at least one-half of the
      retinol secreted by hepatocytes of rats consuming low levels of vitamin A is
      directly transferred to nonparenchymal cells. In addition, the data are
      compatible with the hypothesis that retinol-binding protein is the vehicle for
      transfer of retinol from hepatocytes to nonparenchymal stellate cells and between
      plasma and liver cells.

PMID- 8460705
TI  - Na(+)-dependent bile acid transport by hepatocytes is mediated by a protein
      similar to microsomal epoxide hydrolase.
AB  - A protein mediating hepatocyte sodium-dependent bile acid transport across the
      sinusoidal plasma membrane has been purified by immunoprecipitation with
      monoclonal antibody (MAb) 25D-1, which specifically recognizes this protein on
      the surface of intact hepatocytes (Ananthanarayanan et al. J. Biol. Chem. 263:
      8338-8343, 1988). The function of this protein was further established by
      proteoliposome reconstitution (von Dippe et al. J. Biol. Chem. 265: 14812-14816,
      1990). NH2-terminal amino acid sequence analysis and amino acid composition
      revealed this protein to be closely related to the enzyme microsomal epoxide
      hydrolase (mEH). Both proteins exhibited the same elution times on a reverse
      phase high-pressure liquid chromatography column, comigrated with an apparent
      molecular weight of 49,000 as measured by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis, and possessed identical isoelectric points of 8.2. The MAb
      was capable of immunoprecipitating chromatographically purified mEH, as well as a
      protein derived from the sinusoidal plasma membrane that exhibited mEH activity
      comparable to that of the protein isolated from the endoplasmic reticulum. The
      subtilisin fragmentation patterns derived from chromatographically purified mEH
      and the MAb-precipitated plasma membrane protein were also identical. Hydropathy
      profile analysis of the amino acid sequence of mEH suggested the presence of four
      transmembrane domains. The results of these studies indicate that a protein that
      is involved in mediating sodium-dependent bile acid transport is closely related
      to mEH.

PMID- 8460706
TI  - Kinetic analysis of rat parotid gland muscarinic receptors in vivo: comparison
      with brain and heart.
AB  - (RR)- and (SS)-quinuclidinyl iodobenzilate enantiomers [(RR)- and (SS)-IQNB,
      active and inert, respectively] have been synthesized for quantitative evaluation
      of muscarinic acetylcholine receptor (mAChR) binding. Pharmacokinetic approaches
      have not been used previously to assess in vivo IQNB binding in nonexcitable
      tissues. We have applied this method to examine mAChRs in rat parotid gland in
      comparison to those in brain and heart. Short-term infusion studies in vivo
      showed that the "instantaneous" reversible binding of (RR)- and (SS)-IQNB was
      high in the parotid (greater nonspecific binding potential), intermediate in the
      heart, and lowest in cortex and cerebellum. Long-term bolus injection experiments
      showed that the parotid gland mAChRs possessed a binding potential for receptor
      specific sites (380), which was intermediate between that of parietal cortex
      (930) and cerebellum (10) and greater than that of heart (165). In vitro binding
      to plasma membranes was generally consistent with the in vivo findings. In
      aggregate, these studies show that mAChRs can be evaluated in vivo in a
      nonexcitable tissue with the use of stereospecific ligands and a pharmacokinetic
      approach. The data suggest that IQNB, a mAChR antagonist, can identify
      characteristics of specific binding sites, which may reflect tissue differences.

PMID- 8460707
TI  - Effect of dietary lipid peroxides on metabolism of serum chylomicrons in rats.
AB  - We have found that in rats the peroxide content of chylomicrons (CM) is
      determined by the lipid peroxide concentration in the diet, indicating that
      dietary lipid peroxides are incorporated into the lymph CM. Moreover, these
      incorporated lipid peroxides influence the normal CM metabolism. When
      radiolabeled CM were injected into rats, there was no difference in the initial
      plasma removal between CM prepared from oil with low peroxide content (control
      CM) and CM prepared from oil with high peroxide content (oxidized CM). However,
      the tissue distribution of the labels indicated that the hepatic uptake of CM
      decreased with increasing lipid peroxide content of CM. At 10 min after injection
      of CM, liver uptake of cholesterol label was 48.39 +/- 3.08% for control CM and
      31.41 +/- 10.73% for oxidized CM. Vitamin E enrichment of control CM increased
      their hepatic uptake to 61.07 +/- 0.83%. Additionally, binding of oxidized CM to
      the heart endothelium increased from 2.55 to 3.60% compared with binding of
      control CM. When the hydrolysis of control and oxidized CM by endothelial
      lipoprotein lipase (LPL) was tested in a heart perfusion system, we found that
      after 30 min, 56.51 +/- 5.81% of control and 76.82 +/- 1.75% of oxidized CM were
      not hydrolyzed and remained in the perfusate. Thus our results indicate that the
      altered metabolism of oxidized CM may be related to a reduced hydrolysis rate by
      endothelial LPL.

PMID- 8460708
TI  - Oleic acid-induced mucosal injury in developing piglet intestine.
AB  - A role for luminal nutrients, in particular products of lipid digestion, in the
      pathogenesis of mucosal injury to developing intestine has been postulated. We
      evaluated changes in mucosal permeability and light and electron microscopic
      histology induced by luminal perfusion with the long-chain fatty acid oleate in
      developing piglet intestine as a function of age and concentration of the fatty
      acid. 51Cr-labeled EDTA plasma-to-lumen clearance was measured in jejunum and
      ileum of 1-day-, 3-day-, 2-wk-, and 1-mo-old piglets during sequential perfusion
      with saline control (20 min); 0, 1, 5, and 10 mM oleic acid/10 mM taurocholate in
      saline (20 min); and normal saline (60 min). The jejunum of piglets < or = 2 wk
      showed significantly greater increases in mucosal permeability compared with 1-mo
      old animals after perfusion with oleic acid. This effect was dependent on the
      luminal concentration of the fatty acid and was associated with mucosal injury
      evident under light and electron microscopy. In contrast, the overall response in
      ileum was more attenuated compared with jejunum. Thus oleic acid, a common
      dietary fatty acid, induces dose- and age-dependent injury in developing piglet
      intestine. Investigation of the mechanisms of this injury may provide the basis
      for dietary modifications directed at decreasing the risk of mucosal injury
      during enteral feeding in neonatal intestine.

PMID- 8460709
TI  - Control of gastric corpus chromogranin A messenger RNA abundance in the rat.
AB  - Enterochromaffin-like cells in the corpus mucosa of the stomach produce histamine
      in response to gastrin; chromogranin A (CGA) is often used as a morphological
      marker for these cells, but its functional significance in the gastric mucosa is
      largely unknown. We have examined whether CGA mRNA abundance in the rat corpus is
      controlled by endogenous gastrin. In rats fasted for up to 48 h, there was a
      progressive decline in plasma gastrin and CGA mRNA; refeeding of fasted rats
      produced a prompt increase in plasma gastrin and an increase in CGA mRNA that was
      significant after 4 h. Treatment of fasted rats with omeprazole to inhibit acid
      secretion increased plasma gastrin and CGA mRNA levels. The increased CGA mRNA
      associated with omeprazole or refeeding was reversed by treatment of rats with
      the gastrin/cholecystokinin B antagonist CI-988 and gastrin antibody,
      respectively. The results suggest that CGA production in enterochromaffin-like
      cells of the rat stomach is part of the functional response of these cells to
      circulating gastrin.

PMID- 8460710
TI  - Pertussis toxin attenuates platelet-activating factor-induced pulmonary
      hemodynamic alterations in pigs.
AB  - To determine whether platelet-activating factor (PAF)-induced release of
      cyclooxygenase products might be dependent on G proteins in vivo, we administered
      pertussis toxin (PTX) (9.7-10.0 micrograms/kg iv) to conscious pigs approximately
      48 h before bolus infusions of PAF (10 ng/kg). Autoradiography of ADP-ribosylated
      lung cell membrane proteins from PTX-treated pigs demonstrated marked reduction
      in the amount of radiolabel ([32P]NAD) incorporated, indicating that PTX induced
      ADP-ribosylation of G proteins in vivo. PAF, infused at hourly intervals from 0-4
      h, caused increases in plasma concentrations of thromboxane B2 (TxB2) concomitant
      with pulmonary hypertension and vasoconstriction in anesthetized pigs. These
      physiological changes were blocked or markedly attenuated by indomethacin,
      indicating they were dependent on cyclooxygenase products. In PTX-treated pigs,
      the PAF-induced pulmonary hypertension and vasoconstriction were modestly
      attenuated, whereas the increases in plasma TxB2 were markedly attenuated. PTX
      prevented PAF-induced aggregation of platelets in vivo as evidenced by blockade
      of thrombocytopenia. However, in vitro, PAF-induced aggregation of platelets was
      independent of PTX. Moreover, incubation of platelet-rich plasma with 50 microM
      PAF failed to increase TxB2 levels. These findings suggested that a PTX-sensitive
      cell other than the platelet was responsible for triggering release of TxA2 and
      thrombocytopenia in vivo. We conclude that PAF-induced release of TxA2, pulmonary
      vasoconstriction, and thrombocytopenia in anesthetized pigs are dependent on a
      PTX-sensitive G protein; however, the residual hemodynamic effects indicate
      involvement of a PTX-insensitive G protein, or alternatively, G protein
      independent pathways.

PMID- 8460711
TI  - Activation of tracheal smooth muscle responsiveness by fMLP-treated HL-60 cells
      and neutrophils.
AB  - We assessed the effects of cultured human promyelocytic leukemia (HL-60) cells
      and polymorphonuclear leukocytes (neutrophils) isolated from peripheral human
      blood on tracheal smooth muscle responsiveness in 40 male Hartley guinea pigs.
      Undifferentiated HL-60 cells (16-25 passages) were activated in vitro by
      incubation with 1 microM f-Met-Leu-Phe (fMLP), and force of contraction was
      measured isometrically using an in situ preparation of tracheal smooth muscle.
      Increasing concentrations of acetylcholine (ACh; 10(-10) to 10(-6) mol/cm2
      tracheal surface) were applied topically to the epithelial surface pretreated
      with 4 x 10(6) fMLP-activated HL-60 cells, 4 x 10(6) fMLP-activated neutrophils,
      4 x 10(6) sham-activated HL-60 cells, fMLP+vehicle, or vehicle control. Topical
      application of fMLP-activated HL-60 cells caused a maximum active tension (AT) of
      1.13 +/- 0.2 g/cm after 5 min; fMLP-activated neutrophils, sham-activated HL-60
      cells, or fMLP+vehicle had no effect. The fMLP-activated HL-60 cells also caused
      substantial augmentation of tracheal contraction to ACh (P < 0.05 vs. sham
      activated cells for all concentrations > 10(-9) mol/cm2). Although fMLP treatment
      caused 247 +/- 28% increase from baseline level in O2-. production, neither
      direct contraction nor augmentation of muscarinic stimulation was demonstrated
      after topical application of 4 x 10(6) neutrophils. In 12 other preparations,
      fMLP-activated HL-60 cells were pretreated with either 10 microM indomethacin
      (Indo) or 100 microM A63162, a 5-lipoxygenase inhibitor. Pretreatment with Indo
      caused complete blockade of direct tracheal contraction and 88 +/- 13% blockade
      of muscarinic augmentation; there was no effect after A63162.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8460712
TI  - Biphasic glucocorticoid regulation of pulmonary SP-A: characterization of
      inhibitory process.
AB  - Pulmonary surfactant, which is necessary for normal lung function, is under both
      developmental and hormonal regulation. Glucocorticoids induce all components of
      surfactant and have a unique biphasic effect on surfactant protein A (SP-A),
      either stimulating or inhibiting accumulation in cultured fetal lung depending on
      dose and time of exposure. In this study we further characterized glucocorticoid
      inhibition of SP-A in cultured explants of human fetal lung. Decreased content of
      SP-A mRNA was the dominant response to dexamethasone added either early or later
      during culture. Inhibition occurred at < or = 1 nM dexamethasone on prolonged
      exposure, was blocked by RU 486, and was observed with other glucocorticoids but
      not sex steroids. When cortisol was removed from the culture medium, inhibition
      was rapidly reversed. The immediate inhibitory effect of 100 nM dexamethasone on
      SP-A mRNA content was completely blocked in the presence of cycloheximide. SP-A
      gene transcription, measured by nuclear elongation assay, was decreased by 60%
      after 4- to 8-h exposure to 100 nM dexamethasone. Stability of SP-A mRNA,
      determined both by addition of actinomycin D and by label-chase experiments, was
      transiently decreased immediately after adding dexamethasone (t1/2 approximately
      3 h). In tissue treated with dexamethasone for > or = 8 h the stability of SP-A
      mRNA in control and treated explants was not different (t1/2 approximately 8 h).
      Our findings indicate that inhibition of SP-A is the dominant response to
      glucocorticoid. This effect is receptor mediated and apparently involves
      induction of a labile protein(s) that decreases gene transcription and
      transiently reduces mRNA stability.

PMID- 8460713
TI  - Increased pulmonary vascular permeability in rats with biliary cirrhosis: role of
      thromboxane A2.
AB  - Rats with liver cirrhosis exhibit arterial hypoxemia and loss of hypoxic
      pulmonary vasoconstriction similar to some patients with end-stage liver disease.
      We hypothesized that the pulmonary circulatory dysfunction in cirrhosis results
      from vascular endothelial cell injury and interstitial lung edema. To investigate
      this hypothesis, we compared the extravascular lung albumin leak, lung
      ultrastructural changes, and tissue eicosanoid levels in control and cirrhotic
      rats. In comparison to sham-operated controls, rats with biliary cirrhosis, 6 wk
      after ligation of the common bile duct, had increased lung albumin leak index
      (1.46 +/- 0.12 vs. 0.80 +/- 0.04, P < 0.001) and bloodless lung wet-to-dry weight
      ratio (4.94 +/- 0.05 vs. 4.78 +/- 0.03, P < 0.05). Electron-microscopic sections
      of lungs from cirrhotic rats demonstrated infiltration with intravascular
      macrophage-like cells, endothelial cell injury, and interstitial edema. In
      addition, lung tissue thromboxane B2 was significantly increased in cirrhotic
      rats, and pretreatment with a thromboxane synthase inhibitor, dazoxiben, reduced
      lung thromboxane B2 level and attenuated extravascular lung albumin leak (control
      1.03 +/- 0.07, cirrhotic 2.29 +/- 0.06, cirrhotic plus dazoxiben, 1.57 +/- 0.17).
      In contrast, WEB 2086, a platelet-activating factor antagonist, had no effect on
      lung albumin leak. We conclude that pulmonary vascular permeability is increased
      in rats with biliary cirrhosis and that thromboxane A2 contributes to the
      pulmonary circulatory abnormalities in cirrhosis.

PMID- 8460714
TI  - Phospholipase A2 in alveolar type II epithelial cells: biochemical and
      immunologic characterization.
AB  - The enzyme phospholipase A2 (PLA2) catalyzes phospholipid hydrolysis and is
      thought to play important roles in surfactant synthesis and in the generation of
      lipid mediators, including eicosanoids and platelet-activating factor. This study
      sought to characterize PLA2 in rat type II pneumocytes by biochemical and
      immunologic means. Type II cells were found to contain an alkaline-active, Ca(2+)
      dependent PLA2 activity predominantly localized to cytosol fraction. This
      activity preferred phospholipids containing arachidonate in the sn-2 position and
      phosphatidylethanolamine (PE) over phosphatidylcholine (PC); it was active at
      physiologically relevant Ca2+ concentrations and was resistant to dithiothreitol.
      These biochemical features were suggestive of a high-molecular-weight form of
      PLA2, and immunoblot analysis of type II cell extracts indeed detected a 97-kDa
      protein corresponding to a high-molecular-weight PLA2, but no low-molecular
      weight pancreatic-type enzyme. Human A549 cells, which share certain features
      with type II cells, contained a similar PLA2 activity and immunoreactive protein.
      By contrast, whole rat lung cytosol contained both a 97-kDa PLA2 and a 14-kDa
      pancreatic-type PLA2, but its activity was typical of the latter in that it
      lacked sn-2 specificity for arachidonate and was inhibited by dithiothreitol.
      These results indicate that rat type II as well as human A549 epithelial cells
      contain a high-molecular-weight PLA2, for which mounting evidence suggests an
      important role in physiological and pathophysiological situations.

PMID- 8460715
TI  - ACh release from horse airway cholinergic nerves: effects of stimulation
      intensity and muscle preload.
AB  - This study was conducted to determine the effects of stimulation parameters and
      muscle preload on acetylcholine (ACh) release induced by electrical field
      stimulation (EFS) of horse airway cholinergic nerves. Trachealis strip bundles
      were prepared and suspended in 2-ml tissue baths. The tissues were stimulated
      three to five times for 30 min each. Increasing frequency (0.5-16 Hz) and voltage
      (5-20 V) increased ACh release; increasing pulse duration (0.5-3 ms) had only a
      minor effect. Alterations in muscle preload (2-20 g) had no effect on ACh
      release. ACh release was fairly constant for up to five repeated stimulation
      periods with the same EFS parameters. Stimulation of the tissues for 15 min
      released the same amount of ACh as 30 min if the amount was expressed as
      picomoles per gram per minute, suggesting that ACh release rate was constant
      during the 30-min period of stimulation. Atropine (10(-6) M) potentiated the
      release of ACh four- to fivefold, presumably by removing the autoinhibitory
      effect of ACh on the cholinergic nerves. Tetrodotoxin (10(-6) M) abolished the
      EFS-induced ACh release.

PMID- 8460716
TI  - Asbestos exposure increases human bronchial epithelial cell fibrinolytic
      activity.
AB  - Chronic exposure to asbestos fibers results in fibrotic lung disease. The distal
      pulmonary epithelium is an early target of asbestos-mediated injury. Local
      plasmin activity may be important in modulating endoluminal inflammatory
      responses in the lung. We studied the effects of asbestos exposure on cell
      mediated plasma clot lysis as a marker of pericellular plasminogen activation.
      Exposing human bronchial epithelial (HBE) cells to 100 micrograms/ml of asbestos
      fibers for 24 h resulted in increased plasma clot lysis. Fibrinolytic activity
      was augmented in a dose-dependent fashion, was not due to secreted protease, and
      occurred only when there was direct contact between the plasma clot and the
      epithelial monolayer. Further analysis showed that asbestos exposure increased
      HBE cell-associated urokinase-type plasminogen activator (uPA) activity in a time
      dependent manner. The increased cell-associated PA activity could be removed by
      acid washing. The increase in PA activity following asbestos exposure required
      new protein synthesis because it was abrogated by treatment with either
      cycloheximide or actinomycin D. Therefore, asbestos exposure increases epithelial
      mediated fibrinolysis by augmenting expression of uPA activity at the cell
      surface by mechanisms that require new RNA and protein synthesis. These
      observations suggest a novel mechanism whereby exposure of the distal epithelium
      to inhaled particulates may result in a chronic inflammatory response that
      culminates in the development of fibrotic lung disease.

PMID- 8460717
TI  - Role of Ca2+ entry in the modulation of airway tone by hypoxia.
AB  - To evaluate the cellular mechanisms involved in hypoxic relaxation of airway
      smooth muscle, we investigated the effects of hypoxia on the behavior of third-
      and fourth-order porcine bronchial rings contracted with either carbachol or KCl.
      In one series of experiments, hypoxia (95% N2-5% CO2) was imposed and rings were
      then exposed to increasing concentrations of carbachol or KCl. In separate
      experiments, rings were first contracted with carbachol (10(-6) M) or KCl (40 mM)
      and were then exposed to solutions bubbled with decreasing concentrations of O2.
      The CO2 concentration was maintained constant at 5% in all experiments. The
      initial magnitude of KCl-induced but not carbachol-induced contractions was
      profoundly reduced by 95% N2-5% CO2. The sensitivity of the airway to carbachol
      was unchanged. In rings precontracted with either carbachol or KCl, hypoxia
      caused similar losses of airway smooth muscle tone in a reversible and
      concentration-dependent manner. The effects of hypoxia were independent of the
      presence of an intact epithelium and were not inhibited by the cyclooxygenase
      inhibitor indomethacin (5 microM), the soluble guanylate cyclase inhibitor
      methylene blue (50 microM), or the beta-adrenoceptor antagonist propranolol (1
      microM). The impairment by hypoxia of the initiation phase of KCl-induced
      contractions and of the maintenance phase of both KCl- and carbachol-induced
      contractions, but not the initiation phase of carbachol-induced contractions,
      suggests that changes in O2 tension modulate airway tone by altering the entry of
      extracellular calcium into the airway smooth muscle.

PMID- 8460718
TI  - Cell-specific posttranslational processing of the surfactant-associated protein
      SP-B.
AB  - Pulmonary surfactant-associated protein B (SP-B) is a 9-kDa lung-specific protein
      expressed in alveolar epithelial type II cells and Clara cells. The protein
      markedly increases the surface activity of phospholipids and is an active
      component in some surfactants in clinical use. SP-B is produced from a 43-kDa
      precursor protein by proteolytic cleavage of flanking regions from both the NH2-
      and COOH-terminal ends of the active protein. In this study we have compared the
      nature of the posttranslational processing of the SP-B precursor in type II cells
      and in a heterologous cell line transfected with the SP-B precursor. We found
      that isolated type II cells produce the 9-kDa form of SP-B from the precursor
      through a series of intermediates detectable in the cell lysates. In contrast
      Chinese hamster ovary cells stably transfected with the full-length human SP-B
      precursor produce the precursor and a 26-kDa intermediate but not the 9-kDa
      protein. The precursor protein in both cell types is glycosylated with NH2-linked
      sugars. Our results suggest there is cell specificity in the posttranslational
      processing of the SP-B precursor.

PMID- 8460719
TI  - Asymmetric effects of H2O2 on alveolar epithelial barrier properties.
AB  - The effects of H2O2 on active ion transport and resistance to passive solute flow
      were studied utilizing rat alveolar epithelial cell monolayers cultured on
      permeable supports. Type II alveolar epithelial cells were plated onto tissue
      culture-treated polycarbonate membrane filters. The resulting confluent
      monolayers on days 3 and 4 were mounted in a modified Ussing chamber and bathed
      on both sides with N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid-buffered
      Ringer solution. These monolayers have a high transepithelial resistance (> 2,000
      omega.cm2) and actively transport Na+ from apical fluid. H2O2 (0-100 mM) was then
      delivered to either apical or basolateral fluid. The changes in short-circuit
      current (Isc) and monolayer resistance (R) in response to the exogenous
      hydroperoxide were measured. To determine the degree of cellular catalase
      participation in protection against H2O2 injury to the barrier, experiments were
      repeated in the presence of 20 mM aminotriazole (ATAZ; an inhibitor of catalase)
      in the same bathing fluid as the hydroperoxide. Results indicated that H2O2
      decreased Isc and R gradually in a dose-dependent manner. The effective
      concentration of apical H2O2 at which Isc (or R) was decreased by 50% at 1 h
      (ED50) was approximately 4 mM. However, basolateral H2O2 exposure led to ED50 for
      Isc (and R) of approximately 0.04 mM. Inhibition of cellular catalase yielded
      ED50 for Isc (and R) of approximately 0.4 mM when H2O2 was given apically, while
      ED50 for basolateral exposure to H2O2 did not change in the presence of ATAZ. The
      rate of H2O2 consumption in apical and basolateral bathing fluids was the same,
      while cellular catalase activity rose gradually with time in culture.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8460720
TI  - Peptidase inhibitors reverse steroid-induced suppression of neutrophil adhesion
      in rat tracheal blood vessels.
AB  - Exposure of the tracheal mucosa of rats to capsaicin evokes neurogenic
      inflammation, one manifestation of which is the adherence of neutrophils to the
      endothelium of venules. In the present experiments, with the use of aerosolized
      capsaicin, we determined whether this neutrophil adhesion is inhibited by
      dexamethasone and whether the effect of dexamethasone can be reversed by
      inhibiting endopeptidase 24.11 (neutral endopeptidase, NEP) and kininase II
      (angiotensin-converting enzyme, ACE), which degrade the neuropeptides that
      mediate neurogenic inflammation. Adult male pathogen-free F344 rats were treated
      for 2 days with dexamethasone or with vehicle (controls) and were then exposed
      for 2 min to aerosolized capsaicin. Neutrophils adhering to the endothelium of
      venules in tracheal whole mounts were stained histochemically for myeloperoxidase
      and then counted. Sites of increased vascular permeability were localized with
      Monastral blue. In the control rats, aerosolized capsaicin (10(-8)-10(-3) M)
      increased in a concentration-dependent fashion the number of adherent neutrophils
      and the amount of Monastral blue labeling of blood vessels. Dexamethasone in
      doses of 0.5, 1, 2, or 4 mg.kg-1.day-1 reduced by 49 63, 80, and 93%,
      respectively, the number of adherent neutrophils in capsaicin-exposed rats and
      caused similar reductions in the amount of Monastral blue labeling. When given
      alone, neither phosphoramidon, an inhibitor of NEP, nor captopril, an inhibitor
      of ACE, completely reversed this effect of dexamethasone, but when the two drugs
      were administered together, adherent neutrophils were as numerous in the
      dexamethasone-pretreated rats (112 +/- 9 neutrophils/mm2) as in controls (109 +/-
      10 neutrophils/mm2). The amount of Monastral blue labeling was also similar in
      these two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460721
TI  - "Getting real" about HIV in adolescents.

PMID- 8460722
TI  - The control of iodine deficiency.

PMID- 8460723
TI  - The ethics of blinded HIV surveillance testing.

PMID- 8460724
TI  - Commentary: the new female condom--item 1 on a women's AIDS prevention agenda.
AB  - A US Food and Drug Administration (FDA) advisory panel has recommended that the
      female condom Reality be approved for contraception and acquired immunodeficiency
      syndrome (AIDS) prevention. Final FDA approval will mark the first official
      recognition of a woman-controlled method for protection against sexually
      transmitted disease. A female condom allows women to use just one method to
      respond to the twin anxieties of AIDS and unwanted pregnancy. In those couples in
      which the man refuses to wear a male condom, the availability of a female condom
      makes protection possible for the first time. Although the female condom has some
      advantages over the male condom--greater comfort for some women and men and
      nonreliance on male arousal--general population experience with the device is
      needed to achieve regular widespread use and hence effectiveness at population
      levels. The FDA still lags behind in responding to women's needs for information
      on AIDS and sexually transmitted disease.

PMID- 8460725
TI  - Commentary: condoms and HIV/STD prevention--clarifying the message.
AB  - In the United States and throughout the world, the majority of human
      immunodeficiency virus (HIV) infections are sexually transmitted. an estimated 12
      million other sexually transmitted diseases occur annually in the United States.
      Avoiding sexual intercourse altogether or restricting sex to partners known to be
      uninfected will prevent infection; this needs to be promoted as the most
      effective strategy. Studies show that correct and consistent use of latex condoms
      is highly effective in preventing sexually transmitted HIV infection and other
      sexually transmitted diseases. The effectiveness of condoms depends on individual
      behavior leading to correct and consistent use. Further studies are needed to
      maximize the use and effectiveness of condoms for those who choose to be sexually
      active as well as to develop and evaluate other methods, particularly those more
      under the control of women. In the interim, our prevention message should be
      clear: When used correctly and consistently, condoms are highly effective; when
      used otherwise, they are not.

PMID- 8460726
TI  - Sentinel surveillance for HIV-2 infection in high-risk US populations.
AB  - OBJECTIVES: We conducted sentinel surveillance in persons practicing behaviors
      known to transmit retroviruses to determine the US presence and extent of human
      immunodeficiency virus type 2 (HIV-2). METHODS: Sentinel surveillance for HIV-2
      was conducted by testing 31,533 anonymous blood specimens from patients at
      sexually transmitted disease clinics, injecting drug users at treatment centers,
      and clients at HIV counseling and testing sites in 14 US cities where West
      African immigrants often settle. Specimens were tested by HIV-1 and HIV-2 whole
      virus and synthetic peptide enzyme immunoassay and confirmed by HIV-1 and HIV-2
      Western blots. RESULTS: Nearly 10% of 31,533 sera were positive for HIV-1. Two
      heterosexual Black male sexually transmitted disease patients were infected with
      HIV-2. One of the HIV-2 positive specimens did not cross-react on HIV-1 enzyme
      immunoassay screening. One client had antibodies consistent with malarial
      infection in West Africa; the other, who had syphilis, did not have antibodies to
      malaria or to any of 20 arboviruses present in Africa. CONCLUSIONS: Clinics
      serving clients from HIV-2 endemic areas should test persons practicing risk
      behaviors for both HIV-1 and HIV-2. Sentinel surveillance for HIV-2 serves as an
      early warning system for the possible spread of this virus in the United States.

PMID- 8460727
TI  - A method for identifying persons at high risk for sexually transmitted
      infections: opportunity for targeting intervention.
AB  - OBJECTIVES: The purpose of this study was to develop a method to identify persons
      at high risk for acquiring new sexually transmitted infections. METHODS:
      Computerized medical records from sexually transmitted disease clinics in Dade
      County, Florida, were used to conduct a retrospective cohort study. For all
      patients who visited in 1987, risk factors were identified for returning to the
      clinics within a year with a new sexually transmitted infection. Predictor
      variables were derived from the index visit and any visits in the year prior to
      the index visit. Logistic regression was used to develop a model that was applied
      to all patients who attended in 1989. RESULTS: Of 24,439 patients attending in
      1987, 18.5% returned within a year with a new infection. Return rates were
      highest for 15- to 19-year-old Black males (31.8%). The highest odds ratios for
      returning were a diagnosis or treatment for an infection in the previous year and
      a diagnosis or treatment for infection at the index visit. The patients predicted
      to be at highest risk had a 39% return rate. There were as many new infections
      among the 2893 patients at highest risk as there were among the 13,326 patients
      at lowest risk. CONCLUSIONS: We developed a model that identifies persons at very
      high risk for sexually transmitted infection. These persons should be targeted
      for intensive intervention to reduce their risk.

PMID- 8460728
TI  - American adults' knowledge of HIV testing availability.
AB  - OBJECTIVES: Understanding client needs, knowledge, and preferences about services
      is necessary to ensure that human immunodeficiency virus (HIV) counseling and
      testing programs are accessible. This study addressed knowledge of HIV testing
      availability. METHODS: To study American adults' knowledge of HIV testing
      availability, we collected data during 1990 by random digit-dialing telephone
      surveys of adults residing in 44 states and the District of Columbia. RESULTS: Of
      the 81,557 persons who responded, almost two thirds identified medical doctors as
      a source of HIV testing. Fourteen percent identified public sites, and 12% said
      they didn't know where to go for HIV testing. Persons who were older, less
      educated, and had lower incomes were less likely to know where they could go for
      testing. Persons identifying public sites shared some characteristics with others
      who lacked adequate health care coverage. CONCLUSIONS: Physicians will be
      increasingly called upon to provide HIV counseling and testing to their patients.
      This may require additional training to provide effective, individualized, risk
      reduction messages about sexual and drug use behaviors. Even when persons have
      adequate information about availability, sociodemographic characteristics are
      likely to influence preferences for HIV counseling and testing.

PMID- 8460729
TI  - Changes in sexually transmitted disease rates after HIV testing and posttest
      counseling, Miami, 1988 to 1989.
AB  - OBJECTIVES: The effects of posttest counseling on acquisition of sexually
      transmitted diseases in patients at a large urban sexually transmitted disease
      clinic were studied. METHODS: Comparisons were made of the percentage of patients
      who had a positive gonorrhea culture (or any sexually transmitted disease) in the
      6 months before and after human immunodeficiency virus (HIV) counseling and
      testing. RESULTS: For 331 patients counseled about a positive HIV test, the
      percentage with gonorrhea was 6.3 before and 4.5 after posttest counseling (29%
      decrease). For 666 patients counseled about a negative test, the percentage with
      gonorrhea was 2.4 before and 5.0 after posttest counseling (106% increase). With
      any sexually transmitted disease as the outcome, patients who tested positive for
      HIV had a 12% decrease and patients who tested negative had a 103% increase after
      counseling. CONCLUSIONS: HIV counseling and testing was associated with a
      moderate decrease in sexually transmitted diseases among patients who tested
      positive for the virus, but risk increased for patients who tested negative. This
      suggests a need to improve posttest counseling in this clinic and to assess the
      effects of counseling and testing in other clinics.

PMID- 8460731
TI  - A new approach to combatting iodine deficiency in developing countries: the
      controlled release of iodine in water by a silicone elastomer.
AB  - OBJECTIVES: Four hundred million people or more may be exposed to iodine
      deficiency worldwide, in developing countries in particular. Because of the
      practical problems with existing methods for the large-scale prevention of iodine
      deficiency, the authors developed a new approach to collective prophylaxis.
      METHODS: This approach relies on the controlled diffusion of iodine into water
      from a silicone elastomer. Silicone matrices installed in a bore well released
      iodine at a rate sufficient to permit the daily per capita intake of at least 100
      micrograms of iodine, the amount recommended by the World Health Organization.
      The matrices were tested over 1 year in a village in Mali, West Africa, an area
      in which goiter was highly endemic. The effects on the well water and population
      were compared with those of a placebo system in a control village. RESULTS: An
      increase in urinary iodine levels was observed in the treated population, and
      after 12 months the incidence of goiter had fallen from 53.2% to 29.2%.
      CONCLUSIONS: This new concept, adaptable to all sources of water supply, may
      contribute to the eradication of iodine deficiency.

PMID- 8460730
TI  - Depressive symptoms in blood donors notified of HIV infection.
AB  - OBJECTIVES: Understanding more about the psychological state of persons notified
      of human immunodeficiency virus (HIV) infection is critical for designing
      notification and counseling programs that will have the most positive effect.
      METHODS: The subjects were blood donors who had been notified of HIV infection by
      the New York Blood Center. A nurse elicited a medical history, performed a
      limited medical examination, and asked the subjects to complete a questionnaire
      that included questions about drug use, sexual behavior, and psychological
      characteristics. The subjects completed another questionnaire approximately 2
      weeks later. RESULTS: The average depressive symptom scores for both men and
      women were substantially higher than scores typically found in representative
      population samples. More than a quarter of the men and more than a third of the
      women reported seeking psychological or psychiatric services in the first few
      weeks following notification. CONCLUSIONS: Anticipating and meeting individuals'
      psychological needs may be necessary if HIV screening programs are to address
      effectively the needs of persons infected with HIV.

PMID- 8460732
TI  - Vitamin and mineral supplement use and mortality in a US cohort.
AB  - OBJECTIVES: Vitamin and mineral supplementation is a common practice in the
      United States, yet little is known about the long-term health effects of regular
      supplement use. METHODS: To examine the relationship between reported use of
      supplements and mortality, we analyzed data from US adults 25 to 74 years of age
      who were examined in the First National Health and Nutrition Examination Survey
      (1971 to 1975), with vital status determined through 1987. RESULTS: At baseline,
      22.5% of the cohort reported using supplements regularly and 10.0% reported
      irregular use. The risk of mortality for regular supplement users was similar to
      that for nonusers. No consistent mortality benefits or risks of supplement use
      were found across a number of population subgroups. The risk for those who
      reported supplement use at both the baseline and a follow-up interview
      approximately 10 years later was similar to the risk for those who reported not
      using supplements at either interview. CONCLUSIONS: We found no evidence of
      increased longevity among vitamin and mineral supplement users in the United
      States. Considering the wide use of supplements in the general population, the
      cost-effectiveness and the safety of supplement use need to be better defined.

PMID- 8460733
TI  - Chlamydial cervical infection in jailed women.
AB  - OBJECTIVES: The prevalence of Chlamydia trachomatis cervical infection in
      incarcerated adult women has not been reported. To develop a policy for testing
      and treatment, we determined the prevalence of and risk factors for chlamydial
      infection in women in a New York City jail. METHODS: Interviews and cervical
      cultures for C trachomatis were obtained from 101 consenting female inmates.
      RESULTS: Positive cultures for C trachomatis were found in 27% of the
      participants. Mucopurulent cervical discharge and education of 8 years or less
      were two independent risk factors for infection, but only 63% of the infected
      women had one or both of these factors. If pelvic tenderness were considered as a
      third factor, an additional 7% of the infected women would have been identified.
      CONCLUSIONS: The prevalence of chlamydial infection in this population was as
      high as that in populations for which presumptive treatment is recommended.
      Although the optimal policy for detection and treatment of chlamydial infection
      may vary depending on practical considerations, we suggest that women entering
      correctional facilities should be screened or offered presumptive therapy for C
      trachomatis infection.

PMID- 8460734
TI  - Using a passive alcohol sensor to detect legally intoxicated drivers.
AB  - OBJECTIVES: We examined whether a passive alcohol sensor could be used for mass
      screening of motorists to accurately and quickly detect drivers whose blood
      alcohol concentration exceeded a variety of levels often established as per se
      evidence of legal intoxication. METHODS: In a voluntary roadside survey, 1181
      late-night drivers in Minnesota were interviewed. Breath measurements were taken
      with both a passive alcohol sensor and an evidentiary quality portable breath
      test device. RESULTS: Measurements could be taken much more easily and quickly
      with the passive sensor, whose readings correlated very strongly (r = .87) with
      the evidentiary device. Moreover, for criterion blood alcohol concentration
      levels ranging from 100 mg/dL to 20 mg/dL, a large proportion of motorists could
      be accurately identified as being above or below the criterion, with relatively
      few false-negative or false-positive identifications. CONCLUSIONS: The use of
      passive alcohol sensors at sobriety checkpoints should allow motorists to be
      processed very quickly with minimal inconvenience. At the same time, detection of
      legally intoxicated motorists will probably be substantially increased and the
      general deterrent value of per se alcohol-impaired driving laws enhanced.

PMID- 8460735
TI  - Activating communities for health promotion: a process evaluation method.
AB  - OBJECTIVES: To date, evaluations of community-based prevention programs have
      focused on assessing outcomes, not the process of organizing communities for
      health promotion. An approach was developed to analyze community organization
      efforts aimed at advancing community health objectives. These organizational
      processes are referred to as community activation. METHODS: Information was
      gathered from 762 informants through a key informant survey conducted in 28
      western communities. The data collected included informant ratings of community
      activation and information about interorganizational activities analyzed through
      network analytic techniques. RESULTS: Activation levels, as measured by informant
      ratings, varied across communities. Program coordination, as measured by network
      analysis, occurred, on average, approximately 30% of the time. Higher income
      communities tended to be more activated than lower income communities.
      CONCLUSIONS: There is a widely recognized need for improved information about
      health-related community organization activities. It appears possible to gather
      such information through key informant surveys and to develop measures of
      community organization status that can be used in the evaluation of community
      health promotion programs.

PMID- 8460736
TI  - Prevalence of HIV infection among psychiatric patients in a New York City men's
      shelter.
AB  - We report on the prevalence of human immunodeficiency virus (HIV) infection among
      psychiatric patients in a New York City shelter for homeless men. We reviewed the
      records of all 90 men discharged from the shelter psychiatry program to community
      housing over a 2-year period. HIV serostatus was recorded for 62 of the 90 men.
      Of these 62, 12 (19.4%) were positive. There were 28 men whose serostatus was not
      recorded. Data on the HIV risk behaviors of these 28 men suggested that
      seroprevalence could have been similarly high among them. The results indicate an
      urgent need to develop and apply preventive interventions for HIV in this
      population.

PMID- 8460737
TI  - Increasing frequency of heterosexually transmitted AIDS in southern Florida:
      artifact or reality?
AB  - Acquired immunodeficiency syndrome (AIDS) cases reported as the result of
      heterosexual contact have been increasing in the United States, with Florida
      reporting a disproportionate number. We investigated 168 such AIDS cases from
      southern Florida. After follow-up, 50 (30%) patients were reclassified into other
      transmission categories. The data suggest that the increased rate of
      heterosexually acquired AIDS cases reported from southern Florida was partially
      related to misclassification of risk.

PMID- 8460738
TI  - Public reactions to AIDS in the United States: a second decade of stigma.
AB  - The pervasiveness of stigma in the United States related to the acquired
      immunodeficiency syndrome (AIDS) was assessed in telephone interviews with a
      general adult sample (n = 538) and an African-American sample (n = 607). Most
      respondents manifested at least some stigma. African Americans expressed greater
      support for policies separating persons with AIDS from others and a stronger
      desire to avoid these persons, whereas Whites expressed more negative feelings
      toward them and a greater willingness to blame them for their illness. Regardless
      of race, men were more likely than women to support policies such as quarantine
      and to say that they would avoid persons with AIDS.

PMID- 8460739
TI  - Changes in HIV rates and sexual behavior among homosexual men, 1984 to 1988/92.
AB  - Data were collected from 1614 homosexual and bisexual men in 1984 through 1985
      and from 1988 to 1992 in Pittsburgh. Of the men entering the study since 1988,
      16% reported engaging in unprotected anal receptive intercourse with more than
      one partner during the 6 months before their visit. Approximately 7% of the
      younger men and 18% of the men over 22 years of age in the recent cohort were
      already infected with the human immunodeficiency virus, the same rates as those
      described 8 years ago. Aggressive risk-reduction programs are needed in high
      schools and existing networks in the gay community.

PMID- 8460740
TI  - Reported asthma among Puerto Rican, Mexican-American, and Cuban children, 1982
      through 1984.
AB  - Data from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982
      through 1984) and the National Health and Nutrition Examination Survey (NHANES)
      II (1976 through 1980) were used to examine reported physician-diagnosed asthma
      among 6-month-old through 11-year-old children. The highest prevalence of active
      asthma was reported for Puerto Ricans: 11.2% compared with 3.3% for non-Hispanic
      Whites, 5.9% for non-Hispanic Blacks, 2.7% for Mexican Americans, and 5.2% for
      Cubans. Health services utilization and severity do not appear to explain the
      differences between Puerto Ricans and Mexican Americans. Educational programs on
      asthma should consider focusing on Puerto Ricans.

PMID- 8460741
TI  - Complications of BCG vaccinations in rural Haiti.
AB  - This study investigated an outbreak of axillary lymphadenitis and abscesses after
      Bacillus Calmette-Guerin vaccination among rural Haitian children treated at the
      Hospital Albert Schweitzer from January 1986 through March 1991. Seventy-seven
      cases of vaccine-related complications were identified, all among children
      immunized before the age of 1 year. The proportions of children with
      complications were 0.017% for 1986 through 1989, 0.91% for 1990, and 2.2% for
      January through March 1991.

PMID- 8460742
TI  - The alcohol warning label and adolescents: the first year.
AB  - Awareness of the alcohol labeling law and exposure to, beliefs about, and memory
      for the government-mandated alcohol warning label were measured in a sample of
      adolescents immediately before the label was required to appear (in the fall of
      1989) and 1 year after the label was required. After the label was required,
      there were increases in awareness, exposure, and recognition memory, but there
      were not substantial changes in alcohol use or beliefs about the risks written on
      the warning.

PMID- 8460743
TI  - Diagnostic x-ray exposure and lens opacities: the Beaver Dam Eye Study.
AB  - The Beaver Dam Eye Study is a population-based study of common age-related eye
      diseases. During the standardized medical history, the 4926 subjects were asked
      whether they had ever had a chest x-ray, computerized axial tomography (CAT) scan
      of the head, other x-rays of the head, x-rays of the abdomen, or other diagnostic
      x-rays. The eye examination included photographs of the lenses of the eyes, which
      were subsequently graded according to protocol. Nuclear sclerosis and posterior
      subcapsular opacity were significantly associated with CAT scans. If these
      relationships are causal, it would highlight the importance of minimizing such
      exposure to the lens of the eye.

PMID- 8460744
TI  - Cardiovascular disease risk factors: improvements in knowledge and behavior in
      the 1980s.
AB  - This study surveyed 4158 adults residing in two control cities of the Stanford
      Five-City Project. Analysis of five cross-sectional surveys (conducted in 1979
      through 1990) demonstrated improvements in respondents' general cardiovascular
      disease risk factor knowledge and behaviors. Cholesterol-related knowledge and
      behavior showed particularly marked improvements.

PMID- 8460745
TI  - Groundwater surveying and management: an interagency effort in Michigan.

PMID- 8460746
TI  - Management issues in a major typhoid fever outbreak.

PMID- 8460747
TI  - HIV surveillance testing: taking advantage of the disadvantaged.

PMID- 8460748
TI  - Colorado's HIV partner notification program.

PMID- 8460749
TI  - Non-Hodgkin's lymphoma and occupational exposure to hair dyes among people with
      AIDS.

PMID- 8460750
TI  - Study of hypertension in urban bus drivers questioned. 1. Hypoglycemic agents,
      intrinsic stress may be factors.

PMID- 8460751
TI  - Study of hypertension in urban bus drivers questioned. Study design as source of
      bias.

PMID- 8460752
TI  - Percutaneous dilational tracheostomy. Completing the anaesthetist's range of
      airway techniques.

PMID- 8460753
TI  - Neuromuscular effects of rocuronium bromide (Org 9426) during fentanyl and
      halothane anaesthesia.
AB  - The neuromuscular effects of intravenous rocuronium bromide, 0.6 mg.kg-1 or 0.9
      mg.kg-1, were studied in four groups of 10 patients during anaesthesia with or
      without halothane (0.5-0.75% inspired concentration). Neuromuscular block was
      monitored using mechanomyography and train-of-four stimulation. The mean times to
      onset of complete neuromuscular block were 58 and 59 s using the 0.6 mg.kg-1 dose
      in patients anaesthetised with fentanyl and halothane respectively. The times of
      34 min and 33 min for 25% recovery of T1 (first response in the train of four),
      54 min and 52 min for 90% recovery of T1, 55 min and 60 min for a train of four
      ratio of 0.7, and 13 and 13 min respectively for the recovery index (25-75%
      recovery of T1) were not significantly different in these groups. Complete block
      with the 0.9 mg.kg-1 dose occurred in 47 s and 44 s respectively in the fentanyl
      and halothane groups. T1 recovered to 25% in 51 min and 58 min, and to 90% in 77
      min and 86 min respectively in the two groups. The recovery indices and the times
      to spontaneous recovery of the train of four ratio to 0.7 were 17 min and 19 min,
      and 83 min and 93 min respectively. All the parameters were significantly
      different between the 0.6 mg.kg-1 and 0.9 mg.kg-1 doses. Halothane in the
      concentrations used did not influence the neuromuscular effects. It is concluded
      that rocuronium is a rapidly acting non-depolarising muscle relaxant with a
      duration of action similar to that of vecuronium and may be a useful alternative
      to suxamethonium for rapid tracheal intubation.

PMID- 8460754
TI  - A review of 2000 consecutive ICU admissions.
AB  - The working practices and outcomes from UK intensive care units are poorly
      documented to date. We have reviewed 2000 consecutive admissions to one intensive
      care unit in a tertiary referral centre with initially six, then eight beds. The
      study was a retrospective review of contemporaneous data collection within the
      period 1986-1990. Demographic details, referral source, admission time, admission
      diagnosis, APACHE II score, therapeutic interventions, and outcome were recorded.
      A high overall mortality in the intensive care unit (23%), proportional to APACHE
      II scoring on admission, was demonstrated. This reflects the referral of many
      patients who have, or who develop, multiple organ failure. Mortality was
      significantly higher in patients over the age of 40 years. A total of 69.5% of
      patients were admitted outside the hours 0800-1800 h on Monday to Friday and
      admissions peaked between 1200 and 2100 h, demonstrating the need for senior out
      of-hours cover. These figures may be used to compare future mortality and work
      practices in this and other units. The report illustrates some of the advantages
      and disadvantages of one method of data collection. As it represents one unit
      only, care must be taken in extrapolating results to others. The timing of
      admissions suggests that a review of medical staffing practices would be useful.

PMID- 8460755
TI  - Propofol and fentanyl act additively for induction of anaesthesia.
AB  - The induction dose-response of propofol was compared with the dose-response of
      its combination with fentanyl and with that of fentanyl alone in three groups of
      60 women undergoing minor gynaecological surgery. Dose-response curves were
      determined for each group using bootstrap and isobolographic analyses. Propofol
      was found to act additively with fentanyl for induction of anaesthesia. Twenty
      three percent of the ED50 of fentanyl was required in combination with 75% of the
      ED50 for propofol to achieve the ED50 of the combination. This indicates that,
      for induction of anaesthesia, propofol and fentanyl are not synergistic.

PMID- 8460756
TI  - Effects of omeprazole, with and without metoclopramide, in elective obstetric
      anaesthesia.
AB  - We report the results of a study comparing two dose regimens of the gastric
      antisecretory agent, omeprazole, used as prophylaxis against pulmonary aspiration
      of gastric contents during general anaesthesia for elective Caesarean section.
      Since antisecretory agents do not clear stomach contents already present at the
      start of treatment, two groups of patients who had received both omeprazole and a
      prokinetic drug, metoclopramide, were also studied. Thirty patients received oral
      omeprazole 40 mg on the evening before and on the morning of the operation (group
      1), 33 received oral omeprazole 80 mg on the morning of the operation (group 2),
      and 15 (group 3) and 16 (group 4) patients respectively received the oral
      omeprazole doses stated above and in addition metoclopramide 10 mg given
      intramuscularly at least 20 min before induction of anaesthesia. Gastric aspirate
      pH and volume were measured at induction of anaesthesia and on completion of
      surgery. At induction of anaesthesia, treatment was judged successful (pH > or =
      2.5 and volume < 25 ml) in 87%, 73%, 100% and 81% of patients in groups 1-4
      respectively. The corresponding results on completion of surgery were 100%, 88%,
      100% and 100%. While omeprazole is useful as prophylaxis against pulmonary
      aspiration during general anaesthesia for elective Caesarean section, the
      addition of a prokinetic agent seems to be necessary to maximise its effects.

PMID- 8460757
TI  - Can pre-emptive lumbar epidural blockade reduce postoperative pain following
      lower abdominal surgery?
AB  - In a double-blind study, 36 patients who received a standard general anaesthetic
      for abdominal hysterectomy or myomectomy, received either 15 ml of bupivacaine
      0.5% with adrenaline by lumbar epidural injection 15 min before surgery (group A)
      or the same dose at the end of surgery but before waking (group B). Pain was
      assessed for 24 h by cumulative morphine dose (self-administered by patient
      controlled analgesia), visual analogue scale and verbal rating score. Patients
      were included for analysis if they were pain free on waking and for at least 2 h
      after. There was no significant difference (p > 0.05) between the two groups in
      morphine dose, visual analogue scale or verbal rating score at 6 and 24 h after
      waking. As expected, there was a significant difference in the mean time of first
      use of patient-controlled analgesia (4.26 h in group A vs 5.06 h in group B, p <
      0.05). Consequently, we compared the morphine dose, visual analogue scale and
      verbal rating score at 23 h in group A with those at 24 h in group B. Again there
      were no significant differences between the two groups. We were unable to
      demonstrate that epidural blockade had a significantly better effect on
      postoperative pain when administered before, rather than after, surgery.

PMID- 8460758
TI  - Combined infusions of morphine and ketamine for postoperative pain in elderly
      patients.
AB  - The value of using a combined infusion of morphine with a variable dose of
      ketamine for postoperative analgesia following upper abdominal surgery was
      assessed in a double-blind randomised study of 40 elderly patients. Four groups
      of 10 patients received an infusion of morphine at 1 mg.h-1, either alone, or
      combined with ketamine at a rate of 5, 10 or 20 mg.h-1. The addition of ketamine
      to a continuous infusion of morphine did not significantly improve either
      analgesia or postoperative lung function. Increasing the dose of ketamine
      resulted in an increased incidence of postoperative dreaming (p < 0.01).

PMID- 8460759
TI  - Epidural anaesthesia through caudal catheters for inguinal herniotomies in awake
      ex-premature babies.
AB  - Ex-premature babies are at risk of apnoea after surgery. Regional anaesthesia has
      been used as an alternative to general anaesthesia for some surgical procedures
      in the belief that it may be safer. However, single dose caudal epidural and
      subarachnoid anaesthetics have a duration of action which may be insufficient for
      some operations. The level and duration of anaesthesia can be extended if local
      anaesthetic is given through an epidural catheter. In addition, the dose needed
      to provide adequate anaesthesia may be lower because the local anaesthetic is
      given at an appropriate segmental level. We report our experience of caudal
      epidural anaesthesia in nine, awake ex-premature babies who were having inguinal
      herniotomies. The anaesthesia was excellent in six babies. Two babies cried
      briefly with peritoneal or spermatic cord traction. One other baby needed
      supplementation with nitrous oxide in oxygen in order to complete the surgery.
      The majority of babies slept throughout surgery. There were no reported
      postoperative complications.

PMID- 8460760
TI  - Blood loss following tonsillectomy in children. A blind comparison of diclofenac
      and papaveretum.
AB  - One hundred and ninety-eight children, aged 3 to 12 years, who were scheduled for
      tonsillectomy were randomly allocated to receive either diclofenac 1.0 mg.kg-1 or
      papaveretum 0.2 mg.kg-1 by intramuscular injection after induction of
      anaesthesia. There were no significant differences between the treatment groups
      in operating theatre blood loss, the frequency of bleeding on the ward, or the
      need for operative haemostasis. However, the incidence of above average bleeding
      in the recovery room was significantly higher in the diclofenac group (p < 0.05).
      Similarly, marked restlessness in the recovery room was more frequent in the
      diclofenac group (p < 0.01). In both treatment groups there was an association
      between bleeding and restlessness during recovery so the increased bleeding in
      the diclofenac group may not be a direct effect.

PMID- 8460761
TI  - Subcutaneous emphysema in labour.
AB  - Spontaneous subcutaneous and mediastinal emphysema is a rare but potentially
      dangerous complication of labour. The condition was observed in an 18-year-old
      primigravida in the first stage of labour, who subsequently required Caesarean
      section which was performed under epidural anaesthesia.

PMID- 8460762
TI  - A case of acute poisoning due to organophosphate insecticide.
AB  - A case of acute severe organophosphate poisoning by deliberate self
      administration is reported. The patient required intensive therapy for 30 days.
      Unusual features of the case were the avoidance of atropine, because of the high
      risk of ventricular fibrillation, and the ineffectiveness of pralidoxime.

PMID- 8460763
TI  - Skin necrosis following continuous positive airway pressure with a face mask.
AB  - A 60-year-old woman with respiratory failure required ventilatory support using a
      continuous positive airway pressure face mask. She developed extensive necrosis
      of the skin of the bridge of the nose. A number of precipitating factors are
      discussed and suggestions made to minimise the risk of this complication.

PMID- 8460764
TI  - Association of anaesthetist's checklist for anaesthetic machines. Problem with
      detection of significant leaks.
AB  - Eight experienced anaesthetists performed a 'cockpit drill', following
      instructions in the Association of Anaesthetist's checklist, on an anaesthetic
      machine that had a significant leak (3 l.min-1 at a pressure of 16 kPa). Only one
      anaesthetist detected the leak and this was by audible means rather than by any
      of the protocol's set manoeuvres. We demonstrated that a leak of 3 l.min-1 from
      the flowmeter block resulted in an inspired oxygen concentration of 6% when the
      anaesthetic machine was used with a minute volume divider ventilator.

PMID- 8460765
TI  - Pleural drainage systems.
AB  - The physics and the physiological principles of pleural or chest drainage systems
      are reviewed. The clinical management and complications of pleural drainage are
      summarised.

PMID- 8460766
TI  - Coeliac plexus block with bupivacaine reduces intestinal dysfunction in
      neurosurgical ICU patients.
AB  - Coeliac plexus block, an established method of treatment for pain associated with
      pancreatitis and cancer, was used in neurosurgical patients with gastrointestinal
      dysfunction. The study was performed in 16 patients whose gastric reflux volume
      exceeded 600 ml per day for 3 consecutive days. Patients were allocated to a
      block group (n = 8) or a control group (n = 8). Coeliac plexus block was
      accomplished with a modified Moore technique using 50 ml bupivacaine 0.25%. In
      the block group, gastric reflux volumes for 3 days preceding coeliac plexus block
      and 3 consecutive days following coeliac plexus block were analysed. In the
      control group, gastric reflux volumes were observed over a period of 6 days. Mean
      (SEM) gastric reflux volume decreased significantly following coeliac plexus
      block from 770 (50) ml to 60 (30) ml (p < 0.01). In the control group, gastric
      reflux remained unchanged over the corresponding periods (730 (60) ml c.f. 670
      (50) ml). The response of gastric reflux volume to coeliac plexus block suggests
      that the mechanism is related to inhibition of sympathetic activity in patients
      whose sympathetic drive is increased due to the underlying neurological disease,
      and possibly due to sedation withdrawal symptoms.

PMID- 8460768
TI  - Functionally crossed pipelines.

PMID- 8460767
TI  - Audit of pre-operative starvation.
AB  - An audit of pre-operative starvation at Huddersfield Royal Infirmary has been
      undertaken. It shows that both adults and children are starved for significantly
      longer than the hospital's official starvation policy requires. The mean
      starvation time for children was almost 10 h, which is longer than the 8 h
      required before hypoglycaemia becomes a risk. A review of the literature suggests
      that only 3 h of fluid withdrawal is necessary. Possible ways to improve pre
      operative starvation regimens are discussed.

PMID- 8460769
TI  - Hoarseness after tracheal intubation.

PMID- 8460770
TI  - Delayed profound respiratory depression after premedication with trimeprazine.

PMID- 8460772
TI  - Reservoir requirements of the PAC portable anaesthesia system.

PMID- 8460771
TI  - Delayed profound respiratory depression after premedication with trimeprazine.

PMID- 8460773
TI  - Combined spinal/epidural anaesthesia for caesarean section.

PMID- 8460774
TI  - Eldor combined spinal/epidural needle.

PMID- 8460775
TI  - Foreign bodies in the larynx.

PMID- 8460776
TI  - A simple and cheap aid to blind nasal intubation.

PMID- 8460777
TI  - An introducer for the flexible laryngeal mask airway.

PMID- 8460778
TI  - Not another high block.

PMID- 8460779
TI  - When to remove the laryngeal mask airway.

PMID- 8460780
TI  - Misuse of a Bodok seal.

PMID- 8460781
TI  - Transdermal hyoscine--timing of patch.

PMID- 8460782
TI  - Phaeochromocytoma without raised pre-operative catecholamine levels.

PMID- 8460783
TI  - Delayed diagnosis of contralateral tension pneumothorax during thoracotomy--an
      example of fixation error.

PMID- 8460784
TI  - Broken needle complicating arterial cannulation.

PMID- 8460785
TI  - Nil by mouth after midnight.

PMID- 8460786
TI  - The pre-operative anaesthetic visit.

PMID- 8460787
TI  - Problems with a new spray.

PMID- 8460788
TI  - The importance of checking ampoule labels.

PMID- 8460789
TI  - Tracheal intubation of children in intensive care.

PMID- 8460790
TI  - Learning fibreoptic intubation: fundamental problems.

PMID- 8460791
TI  - Learning fibreoptic intubation: fundamental problems.

PMID- 8460792
TI  - Checking anaesthetic machines--checklists or visual aids?

PMID- 8460793
TI  - Pharmacokinetic model-controlled infusion of midazolam. A prospective evaluation
      during general anaesthesia.
AB  - The accuracy of a computer-controlled infusion of midazolam, based on previously
      published pharmacokinetic parameters, was tested prospectively in 12 adult female
      patients undergoing general anaesthesia. Anaesthesia consisted of an initial
      bolus followed by an exponentially decreasing infusion of midazolam given
      according to body weight, fentanyl, nitrous oxide and vecuronium. Venous blood
      samples were taken at 15 min-intervals throughout the procedures and for 1-2 h
      postoperatively. The bias of the model was -5.1% (95% CI -11.3 to 1.2%) and
      precision 24.8% (95% CI 20.9 to 28.6%). Least squares regression analysis
      decreased the bias to -2.8% but did not alter precision. Retrospective fitting of
      an alternative set of published parameters for midazolam resulted in significant
      deterioration of the model. The precision was similar to that found in past
      studies of intravenous anaesthetic agents. Further improvement in the accuracy of
      midazolam infusion awaits improved understanding of the causes of pharmacokinetic
      variability.

PMID- 8460794
TI  - Brainstem auditory evoked response during propofol anaesthesia in children.
AB  - The effect of propofol on the brainstem auditory response was studied in 10
      healthy children presenting for elective general surgery. A computer-controlled
      infusion of propofol was used to induce and maintain anaesthesia. Basal brainstem
      auditory evoked responses were recorded in the awake child and at different
      infusion rates of propofol. Significant increases in the latencies of the
      brainstem waves III and V and the interpeak intervals I-V and III-V were seen and
      were dose dependent. The changes were small and would not preclude the use of
      propofol anaesthesia for brainstem auditory evoked response testing in children.

PMID- 8460795
TI  - Closed loop control of arterial hypertension following intracranial surgery using
      sodium nitroprusside. A comparison of intra-operative halothane or isoflurane.
AB  - Forty patients were chosen at random to receive halothane or isoflurane
      anaesthesia during craniotomy and a comparison of the postoperative hypertensive
      response was made using a microcomputer-based closed-loop arterial pressure
      control system with sodium nitroprusside to control and assess arterial pressure
      during the first 6 postoperative hours. A desired target systolic pressure was
      chosen for each patient and the frequency of hypertension, sodium nitroprusside
      requirements and quality of arterial pressure control were compared between the
      two groups. Thirty-five patients required sodium nitroprusside. The halothane
      group required a median dose of 15.2 mg (range 0-72) compared to 3.4 mg (range 0
      87) in the isoflurane group. This difference is not statistically significant.
      Quality of arterial pressure control was satisfactory in both groups. In
      conclusion, arterial hypertension occurs frequently following intracranial
      surgery and is uninfluenced by the choice of halothane or isoflurane intra
      operatively. This closed-loop arterial pressure control system functioned safely
      and effectively in this context.

PMID- 8460796
TI  - Effect of extradural anaesthesia on the ventilatory response to hypoxaemia.
AB  - The effect of lumbar or thoracic extradural anaesthesia on the ventilatory
      response to progressive isocapnic hypoxaemia was studied in two groups of 10
      unpremedicated patients. The ventilatory measurements were taken twice, before
      and 20 min after the administration of 10 ml of lignocaine 2%. Lumbar extradural
      anaesthesia did not change the slope of the hypoxic response curve, but it
      significantly increased minute ventilation by 27% at an arterial oxygen
      saturation of 90%. Thoracic extradural anaesthesia was not associated with any
      changes in either index. We conclude that neither lumbar nor thoracic extradural
      anaesthesia impairs the ventilatory response to progressive isocapnic hypoxaemia.

PMID- 8460797
TI  - Sedation with propofol during surgery under local blockade. Assessment of a
      target-controlled infusion system.
AB  - The ability of a target-controlled propofol infusion system to provide sedation
      for 40 patients undergoing surgery under regional blockade was assessed. Eighty
      eight per cent of the total infusion time was at the desired sedation level with
      little oversedation. This was achieved with a median blood propofol concentration
      of 0.93 micrograms.ml-1. The pharmacokinetic algorithm performed as well when
      used for sedation as for total intravenous anaesthesia. The predicted and
      measured blood propofol concentrations showed a bias of -12% and a precision of
      34%.

PMID- 8460798
TI  - The effect of oral ondansetron in the prevention of postoperative nausea and
      vomiting after major gynaecological surgery performed under general anaesthesia.
AB  - The efficacy and safety of ondansetron in preventing postoperative nausea and
      vomiting following major gynaecological surgery was evaluated in this
      multicentre, double-blind study. A total of 243 patients were randomised to
      receive three doses of oral ondansetron 8 mg or matching placebo at 8-hourly
      intervals, with the first dose being given an hour before surgery. A standard
      general anaesthetic technique was employed throughout. Nausea, vomiting and
      safety assessments were performed continuously during the 24 h postrecovery
      period. Of the 237 patients evaluated for efficacy, significantly fewer
      ondansetron 8 mg treated patients (65/117; 56%) experienced postoperative nausea
      and/or vomiting compared with placebo-treated patients (94/120; 78%) during the
      study period (p < 0.001). In addition, ondansetron 8 mg reduced the severity of
      nausea (p < 0.001) and the total number of vomiting episodes experienced (p <
      0.001). Overall, ondansetron 8 mg was well tolerated and effective in preventing
      postoperative nausea and vomiting in this surgical setting.

PMID- 8460800
TI  - The management of tracheal rupture using bilateral bronchial intubation.
AB  - The management of a patient who required positive pressure ventilation following
      pharyngolaryngo-oesophagectomy during which tracheal injury was sustained is
      described. Ventilation with a tracheal tube resulted in a massive
      pneumoperitoneum. Bilateral bronchial intubation was employed with success.

PMID- 8460799
TI  - The effect of the anaesthetist's attire on patient attitudes. The influence of
      dress on patient perception of the anaesthetist's prestige.
AB  - Two groups of adult patients (55 each) were visited pre-operatively by an
      anaesthetist who was dressed either formally or casually. Their response to this
      visit, their opinions regarding anaesthetists and their knowledge of anaesthetic
      work were elicited afterwards by means of a questionnaire. Patients' satisfaction
      with the anaesthetist and his/her visit was not influenced by dress. The
      anaesthetist was awarded a high level of prestige and the length of his/her
      training was recognised to be comparable to that of other professionals; 81.8% of
      patients thought that anaesthetists held a medical degree but only 35.4% thought
      that they worked in the intensive care unit. Patients expressed a preference for
      doctors to wear name tags, white coats and short hair but disapproved of clogs,
      jeans, trainers and earrings.

PMID- 8460801
TI  - Continuous spinal anaesthesia in acute respiratory failure.
AB  - A patient with an obstructed femoral hernia and intercurrent respiratory failure
      was successfully anaesthetised with a continuous spinal technique. The technique
      provided excellent intra-operative anaesthesia and early postoperative analgesia,
      whilst avoiding further respiratory compromise. Disconnection of the catheter hub
      from the catheter prevented prolonged provision of postoperative analgesia by
      this route. Fixing of both the catheter and the hub to the patient are advocated
      to avoid this problem.

PMID- 8460802
TI  - A very small dose of suxamethonium relieves laryngospasm.
AB  - Intravenous suxamethonium, in a dose as small as 0.1 mg.kg-1, has been found to
      be reliable in the treatment of laryngeal spasm. Three episodes of vocal cord
      spasm observed during direct laryngoscopy were relieved by this dose of
      suxamethonium.

PMID- 8460803
TI  - A comparison of the laryngeal mask airway and Guedel airway, bag and facemask for
      manual ventilation following formal training.
AB  - Ten volunteers, with no previous experience of resuscitation, were formally
      trained in the use of the laryngeal mask airway and the oropharyngeal airway
      (Guedel), bag and facemask for manual ventilation of the lungs in 104 fit,
      anaesthetised adults. They then used both airways in turn. The order of insertion
      was randomly allocated, and the times taken for insertion were also recorded.
      Ventilation for each airway was deemed to be successful if an increase in end
      tidal carbon dioxide partial pressure did not occur and arterial oxygen
      saturation remained greater than 90%. Success rates for the laryngeal mask airway
      and the Guedel airway, bag and facemask were 87% and 43% respectively (p < 0.001)
      and the average insertion times were 27.4 s (SEM 1.5) and 15.8 s (SEM 0.50) (no
      significant difference), respectively. The laryngeal mask airway proved to be
      easier to use for manual ventilation than the Guedel airway, bag and mask for
      inexperienced personnel who had received a period of formal training in both
      techniques.

PMID- 8460804
TI  - The minilink breathing system: resistance and suitability for spontaneous
      ventilation.
AB  - The Portex infant breathing/ventilation systems with 8.5 mm and 15 mm internal
      diameter connectors were compared with a standard T-piece which had a 15 mm
      connector and 22 mm internal diameter tubing. The differential pressures across
      each system were measured at constant fresh gas flows up to 30 l.min-1 dry air.
      Resistance was calculated at flows compatible with quiet respiration and peak
      inspiratory flow. Flow resistance of the 3.0 mm internal diameter tracheal tube
      in conjunction with the minilink breathing systems were similar to those
      previously reported for tracheal tubes alone. However, the minilink breathing
      system assumed a greater influence on resistance when tracheal tubes of larger
      internal diameter were used. It added considerably more resistance than the
      standard tubing. This may have a deleterious effect during spontaneous
      ventilation in older children.

PMID- 8460805
TI  - The rebreathing characteristics of the Hudson oxygen mask.
AB  - A lung model was used to study the effect of varying minute ventilation, oxygen
      flow and inspiratory : expiratory ratio on the rebreathing characteristics of the
      Hudson oxygen mask. The onset of rebreathing was detected using two different
      sets of criteria; those defined by Kain et al. and Humphrey. The onset of
      rebreathing was also quantified in terms of the inspired volume of carbon dioxide
      and increases in deadspace. The magnitude of rebreathing was increased by
      reducing oxygen inflow and increasing minute ventilation. Variation in I : E
      ratio between 1 : 1 and 1 : 4 had little effect on rebreathing. Using the
      clinical criteria of Kain et al, the onset of rebreathing was detected when
      oxygen inflow/minute ventilation ratio was reduced below 0.78 on average. With
      the other criterion, rebreathing occurred when the ratio was 0.46.

PMID- 8460806
TI  - Laboratory assessment of the Baxter disposable patient-controlled analgesia
      system.
AB  - The performance of the Baxter patient-controlled analgesia infusor system was
      assessed in the laboratory. The flow of the 5 ml.h-1 infusor was measured
      gravimetrically with the flow restrictor maintained at 31 degrees C and the
      reservoir at either 20 degrees C or 25 degrees C. At 25 degrees C the mean flow
      was 4.98 (SEM 0.06) ml.h-1 and at 20 degrees C the mean flow was 4.32 (0.05) ml.h
      1. The patient-control module performed reliably, delivering a mean of 0.42
      (0.001) ml following depression of the button, slightly less than the
      manufacturer's quoted value of 0.5 ml.

PMID- 8460807
TI  - Dural taps revisited. A 20-year survey from Birmingham Maternity Hospital.
AB  - The records from 34,819 obstetric epidurals performed at Birmingham Maternity
      Hospital over the period 1969-1988 were examined. During that time there were 460
      dural taps (overall incidence 1.3%). Of the methods used to detect the epidural
      space, loss of resistance to injection of saline was associated with the lowest
      incidence of dural tap (0.6%). The incidence of typical postdural puncture
      headache when managed conservatively was 86%. Provision of an epidural drip after
      delivery reduced the incidence of headache to 70%. Elective forceps delivery
      conferred no additional benefit, and tended to delay the onset of headache. Blood
      patches were performed on 135 patients and provided complete relief of headache
      in 93 (68%). A further 23 patients (16%) obtained partial relief.

PMID- 8460808
TI  - Patient-controlled analgesia with and without background infusion. Analgesia
      assessed using the demand: delivery ratio.
AB  - Sixty adult patients following general surgical operation were treated with
      patient-controlled analgesia using morphine. Patients were allocated into three
      groups to receive: no background infusion, a 1 mg.h-1 or a 2 mg.h-1 background
      infusion. The other controls on the patient-controlled analgesia machine were set
      to allow a maximum dose of morphine of 6 mg.h-1 to each group. Analgesia was
      assessed after 4 and 24 h using a 100 mm horizontal visual analogue scale. The
      number of analgesic requests made by the patient and the number of those requests
      which resulted in successful deliveries was recorded. Patients who received a
      regimen including a background infusion had improved pain relief, particularly in
      the first 4 h of treatment (p < 0.05). Patients who received a background
      infusion of 2 mg.h-1 had an increased incidence of nausea (p < 0.05). A
      background infusion of 1 mg.h-1, with a 1 mg bolus dose and a 12 min lockout
      interval provided acceptable pain relief without excessive nausea. In all three
      groups the ratio of analgesic requests to successful deliveries correlated with
      the degree of pain reported by visual analogue score (p = 0.0001).

PMID- 8460809
TI  - A comparison of propofol and methohexitone for dental chair anaesthesia in
      children.
AB  - Fifty healthy children presenting for outpatient exodontia received either
      propofol or methohexitone for induction. Anaesthesia was maintained in both
      groups using 50% oxygen in nitrous oxide and 1-2% halothane. Those receiving
      methohexitone maintained a significantly higher mean arterial pressure and heart
      rate than the propofol group. Nine percent of patients in the propofol group
      developed ventricular arrhythmias, compared to 32% in the methohexitone group.

PMID- 8460810
TI  - Anaesthesia for procedures on the larynx and pharynx. The use of the Bullard
      laryngoscope in conjunction with high frequency jet ventilation.
AB  - Twenty patients undergoing elective procedures on the larynx and pharynx were
      anaesthetised using a propofol infusion and a bolus of vecuronium. High frequency
      jet ventilation was employed via a 7 French gauge catheter, with a second
      catheter being used to measure expired carbon dioxide levels. The Bullard
      laryngoscope was compared with the Macintosh instrument both for visualising the
      larynx and subsequently inserting a catheter. One catheter was left in place
      until the patient was fully awake, and in one case this enabled gas exchange to
      be maintained in the presence of laryngospasm. Using the Bullard laryngoscope,
      intubation was possible in all 20 patients, in a mean time of 22 (6.8) s. Using
      the Macintosh laryngoscope only 16 patients could be intubated and this took
      significantly longer at 34 (18.3) s (p < 0.05). The Bullard laryngoscope and high
      frequency jet ventilation offer a reliable method of intubating and
      anaesthetising patients with upper airways pathology and further benefits may
      accrue in the recovery period.

PMID- 8460811
TI  - Anaesthetic machine checking practices.

PMID- 8460812
TI  - Inhalational agents and the Servo ventilator.

PMID- 8460813
TI  - Anaesthesia and upper respiratory tract infections.

PMID- 8460814
TI  - Whatever happened to the premedication?

PMID- 8460815
TI  - The influence of methane on the infrared measurement of anaesthetic vapour
      concentration.

PMID- 8460816
TI  - A perforated diaphragm--enough to raise anyone's blood pressure!

PMID- 8460817
TI  - Unexpectedly high spinal anaesthesia following failed extradural anaesthesia for
      caesarean section.

PMID- 8460818
TI  - Pathogenesis of post-immersion collapse.

PMID- 8460819
TI  - 'Vocalaid' and surgical emphysema.

PMID- 8460820
TI  - Cocaine dosage in rhinosurgery.

PMID- 8460821
TI  - Bite guard for laryngeal mask airway.

PMID- 8460822
TI  - Catecholamine response to laryngoscopy and intubation after thiamylal or ketamine
      induction of anaesthesia.

PMID- 8460824
TI  - The oesophageal detector device in the asthmatic patient.

PMID- 8460823
TI  - Information processing under anaesthesia.

PMID- 8460825
TI  - Support for the Waters' canister.

PMID- 8460826
TI  - Intrathecal pethidine: a word of caution.

PMID- 8460827
TI  - A brief history of nuclear magnetic resonance.

PMID- 8460828
TI  - Design of a glucose minisensor based on streptavidin-glucose oxidase complex
      coupling with self-assembled biotinylated phospholipid membrane on solid support.
AB  - A simple and fast procedure to prepare a glucose-sensitive minielectrode is
      presented. It is based on a biotin-modified phospholipid bilayer to which a
      streptavidin-glucose oxidase complex is coupled. The assay is based on the
      electrochemical detection of enzymatically generated hydrogen peroxide at the
      potential +670 mV. In the case of an air-saturated buffering solution the
      response to glucose was measured up to 50 mmol.L-1, with a linear portion up to 7
      mmol.L-1. The influence of oxygen tension, pH, and temperature as well as
      possibly interfering substances was investigated. The prospect usage for the
      measurement of blood and urine was tested.

PMID- 8460829
TI  - Detection and evaluation of fragrances by human reactions using a chemical sensor
      based on adsorbate detection.
AB  - Human reactions and sensor responses to 37 typical fragrances are investigated in
      order to develop a chemical sensor which can detect fragrances and evaluate them
      in subjective terms of human reactions. Eight female test subjects recorded their
      reactions to these fragrances by grading them on a seven-point scale in terms of
      55 descriptive characteristics. Their reactions fell into two general categories,
      "pleasantness" and "freshness (elegance)", dependent on the characteristic
      chemical structure of the fragrances. The women evaluate the fragrances mainly by
      the degree of pleasantness and freshness (elegance). A set of eight plezoelectric
      sensors incorporating different hydrophobic polymer materials is fabricated to
      predict such human reactions because their adsorbate detection and pattern
      recognition are similar to those in humans. The sensors were effective in
      detecting hydrophobic fragrances in the gas phase, and their fragrance
      classifications were similar to human ones. The sensor responses to the adsorbate
      correlate significantly with two of the human responses with multiple correlation
      coefficients of more than 0.6 (p < 0.02). Namely, the sensor can predict two
      different human reactions to fragrances simultaneously, suggesting the
      possibility of developing an artificial olfactory sensor based on adsorbate
      detection.

PMID- 8460830
TI  - Determination of total polyamines in tumor cells by high-performance capillary
      zone electrophoresis with indirect photometric detection.
AB  - Tumor cells contain much higher levels of common polyamines such as putrescine,
      spermidine, and spermine than normal cells. Our previous work demonstrated that
      high-performance capillary zone electrophoresis with indirect photometric
      detection was suitable for the determination of underivatized free polyamines in
      tumor cells. We now report improved sensitivity (7-fold), greater quantitative
      reproducibility, and quantitation of both bound and free, underivatized
      polyamines in PC 12 tumor cells. 1,7-Diaminoheptane was used as an internal
      standard for quantification. Femtomoles of three polyamines and simple cations
      such as K+ and Na+ were easily separated in less than 10 min. The quantitations
      for total spermidine and spermine (bound and free) were found to be 2-fold higher
      than the quantitation for free, unbound polyamines using our previous method. The
      signal response was linear over 2 orders of magnitude. The method described here
      provides a fast and simple technique for quantitation of bound, unbound, and
      total polyamines for use in the study of the biological role of polyamines.

PMID- 8460831
TI  - Determination of methylmercury in fish samples using GC/AA and sodium
      tetraethylborate derivatization.
AB  - A simple technique is described for the rapid determination of methylmercury in
      fish tissue. Following simple dissolution in methanolic KOH solution, aqueous
      phase ethylation by derivatization with NaB(C2H5)4, cryogenic trapping on a
      packed chromatographic column, and GC separation, volatile mercury species are
      detected by atomic absorption spectrometry. Absolute detection limits are 4 pg of
      Hg for CH3Hg+ and 75 pg of Hg for labile Hg2+. Concentration detection limits for
      this optimized procedure are 4 ng of Hg for CH3Hg+ and 75 ng of Hg for labile
      Hg2+ per gram of pulverized dried fish tissue. Analysis of standard reference
      materials demonstrates the accuracy, precision, and reproducibility of the
      analytical method.

PMID- 8460832
TI  - Investigation of a "screened" electrostatic ion trap for analysis of high mass
      molecules by fourier transform mass spectrometry.
AB  - With the recent adaptation of matrix-assisted laser desorption/ionization (MALDI)
      of large biomolecules and polymers to Fourier transform mass spectrometric
      analysis, it is of interest to explore the possible advantages of using a
      "screened" electrostatic ion trapping technique. It is demonstrated that the
      observed rate of change of ion cyclotron resonance frequency with trapping
      potential is in excellent agreement with theory, being independent of mass and
      charge, in the mass range from 1185 to just under 17,000 Da. When a screened
      cubic trap is used in a ca. 7-T magnetic field, the electrical potential within
      the trap is effectively reduced, and ion cyclotron resonance frequency shifts as
      a function of trapping potential are decreased by a factor of 25. There is no
      evidence of significant improvement in mass resolution with this trap design,
      except when higher trapping potentials are compared. In a 9.7-V screened trap
      measurement, a bovine insulin spectrum with an average resolution of 10,000 is
      obtained. Comparable mass resolution under conventional trapping conditions could
      not be obtained for trapping potentials greater than 1.2 V. It is evident from
      this study that use of the screened trap technique could offer advantages for
      MALDI-Fourier transform mass spectrometry.

PMID- 8460833
TI  - Dual microcolumn immunoaffinity liquid chromatography: an analytical application
      to human plasma proteins.
AB  - Dual-column microcolumn immunoaffinity chromatography was accomplished by
      coupling immunoaffinity (IAC) and reversed-phase high-performance liquid
      chromatography (RP-HPLC) analysis columns. The IAC support was prepared by
      hydrophobically adsorbing the appropriate antibody onto an octyl silica-based
      stationary phase contained in a 250-microns-l.d. fused-silica microcolumn. Once
      the antigen was captured, the antigen-subtracted human plasma could be sent to
      the RP-HPLC microcolumn for plasma profiling. The antigen was quantitated by
      desorbing it from the IAC column and transferring it to the RP-HPLC system. Human
      plasma profiles were generated after removal of albumin, and transferrin and
      alpha 1-antitrypsin were quantitated with nanogram sensitivity. All analyses were
      accomplished with less than 1 microL of human plasma.

PMID- 8460834
TI  - [Methodologic aspects of the determination of growth hormone in urine].

PMID- 8460835
TI  - [The Navarra study (PECNA). Hyperlipidemia III. Variations in the median HDL
      levels and lipid risk quotient in children and adolescents based on age and
      gender].
AB  - As part of an epidemiological study on cardiovascular risk factors among children
      and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829
      children of both sexes. The subjects were between 4 and 17 years of age and were
      selected at random from the school population in our community. In this article
      we analyze the variations in HDL-cholesterol and cholesterol/HDL and LDL/HDL risk
      quotients according to age and sex. Beginning at the age of 10, the HDL decreases
      in both sexes, although this decrease is more evident among males and they obtain
      levels lower than those during early childhood. Among females older than 14 there
      is a slight increase. Apparently the decrease in HDL among male adolescents is
      due to an increase in the production of testosterone during this stage of life.
      Both risk quotients decrease until the children are 10 years of age, after which
      they increase among males and stabilize or slightly decrease among females. For
      this reason, scores are higher for males during the last years of adolescence.
      The cardiovascular lipid risk increases with age and during adolescence in higher
      among males and depends more on the variations in HDL than on variations in
      cholesterol or LDL. We believe that the best definition for cardiovascular lipid
      risk during the infancy or adolescents is one which is based on the risk
      quotients.

PMID- 8460836
TI  - [The Navarra study (PECNA). Hyperlipidemia IV. Prevalence of hyperlipidemia in
      the infant- and juvenile population of Navarra. Variations based on age, gender
      and health care accessibility].
AB  - As part of an epidemiological study on cardiovascular risk factors among children
      and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829
      children of both sexes. These children were between 4 and 17 years of age and
      were randomly selected from the school population of our community. In this
      article, we analyze the prevalence of lipid risk, according to its different
      definitions, among children and adolescents in Navarra, and its variations
      related to age, sex and sanitary area. The prevalence of hypercholesterolemia (C
      > 200 mg/dl) among children and adolescents, aged 4 to 17 years, is very high:
      21.07% +/- 0.54%. In spite of having high serum levels of HDL, the lipid risk
      measured by the risk quotient LDL/HDL > 2.2 is still very high: 15-70% +/- 0.49%.
      If we define the lipid risk during childhood and adolescence by the quotient
      LDL/HDL > 2.2, male adolescents turn out to be the group with the highest risk.
      This phenomenon coincides with the results of the epidemiological studies made
      among adults. Nevertheless, they do not coincide with these results if the lipid
      risk is defined by C > 200 mg/dl. In our opinion, during infancy and adolescence,
      the lipid risk is better defined by the quotient LDL/HDL > 2.2.

PMID- 8460837
TI  - [Long-term results of surgical management of congenital aortic stenosis].
AB  - This retrospective study and review of the literature was undertaken to assess
      the long term results of valvotomy in congenital aortic stenosis (AS). One
      hundred and seven patients, aged between 14 days and 15 years (mean: 6.2 years),
      were operated on between 1966 and 1989. Thirty-three cases had valvular AS, 48
      discrete subvalvular AS, 10 supravalvular AS and 16 combined AS. Thirty-three
      patients had associated cardiac anomalies. The surgical mortality was 6.5% (3.5%
      in children over 2 years of age). Three patients were lost. Ninety-seven patients
      had a follow-up period between 6 months and 16 years (mean: 5.4 years) with an
      actuarial survival of 95% at the age of 15 years. There were adverse events in 39
      patients: AS, aortic regurgitation, bacterial endocarditis, third-degree heart
      block. Thirteen patients required re-operation and 4 balloon valvuloplasty; the
      late mortality was 5%. We conclude that this surgery has a low surgical
      mortality, but must be considered as palliative in most cases.

PMID- 8460838
TI  - [Congenital familial cardiopathies. Prenatal diagnosis].
AB  - The diagnosis of congenital heart disease by means of echocardiography is already
      a real fact. The use of this technique for diagnosis in utero currently allows
      the detection of these malformations during the early stages of pregnancy and to
      determine the prognosis of the fetal cardiopathies, as well as to establish a
      medical or surgical treatment of the neonate. The prenatal echocardiographic
      study of 126 pregnant women, previously having had children with heart disease,
      has allowed s to prove the greater incidence of cardiopathy in this population
      (6.4%), compared to the results obtained from a group of pregnant women
      previously having normal children and without a high risk pregnancy (0.8%). These
      findings support the theory that genetic factors are the primary cause of
      congenital cardiac malformations, although the existence of teratogen factors
      (rubella, diabetes, etc.) in some cases cannot be excluded.

PMID- 8460839
TI  - [Study of the growth and final body height in a young adult population].
AB  - To know the final height of young adults in our environment, we obtained a
      control group with 340 students of medical and professional training and compared
      them with the patterns of Hernandez et al. Medium values of weight, height,
      weight/height rate, and tricipital and subscapular skinfolds are similar in both
      groups. If we separate them by birth year (1965-1966 and 1970-71), we find
      significant differences, on behalf of the younger group, in women for weight and
      weight/height rate (p < 0.05), and in both sexes for skinfolds (p < 0.001). If we
      separate them by oriing (medicine-professional training), we find significant
      differences, on behalf of male university students in weight and weight/height
      rate (p < 0.05) and of female professional students in skinfolds (p < 0.001). We
      verify the suitability of the tables of Hernandez et al. for the final growth of
      young people around us and justify their use in the daily practise.

PMID- 8460840
TI  - [Thyroid cancer in childhood: review of 7 cases].
AB  - Thyroid carcinoma in childhood is a rare, but nevertheless malignant disease,
      with a high incidence of nodal metastasis. Seven children, 6 boys and 1 girl,
      aged 4 to 9 years with thyroid carcinoma were treated at the Hospital Infantil
      Valle de Hebron of Barcelona between 1965 and 1990. The diagnosis was established
      by cervical nodal biopsy in all cases except one. Papillary carcinoma was found
      in 4 cases, follicular type in 2 cases and one case of mixed carcinoma was
      diagnosed. Surgical treatment consisted in lobectomy on the affected side,
      followed by total thyroidectomy on the opposite side and bilateral resection of
      involved nodes one or more times. In two patients, treatment with sodium-iodine
      I131 showed active tissue in the thorax and wound. Both were treated effectively.
      All patients are alive without recurrences during a follow-up period of 1 to 23
      years. Main complications were: temporary recurrence of the nerve injury in two
      patients and a controlled hypoparathyroidism in another two cases. In all cases,
      treatment with L-thyroxine was required. Thyroid carcinoma in children carries a
      considerably better prognosis than in adult patients. We must suspect thyroid
      carcinoma and indicate biopsy in all cases of cervical nodes resistant to
      antibiotic treatment. Early diagnosis, total thyroidectomy, radioiodine treatment
      and hormone administration permit radical cure even in the case of metastatic
      disease.

PMID- 8460841
TI  - [Gastroesophageal reflux in pediatric neurologic patients].
AB  - With the aim of evaluating the incidence of gastroesophageal reflux (GER) in
      neurologic pediatric patients with severe motor and/or psychiatric involvement, a
      retrospective study of 140 infants followed at the Neuropediatric Unit was
      realized. Forty-five patients (32.1%) had moderate to severe mental retardation
      (ms RR), 21 of these patients had associated tetraparetic cerebral palsy (T-CP).
      The rest of the infants presented variable degrees of neurologic involvement: 25
      diplegic (D-CP), 27 hemiparetic (H-CP), 22 with slight mental retardation or
      borderline IQ without motor deficit (SMR), and 21 had attention deficit disorder
      with hyperactivity (ADD-H). The diagnosis of GER was based on clinical
      symptomatology and barium ingestion with fluoroscopy and/or esophagoscopy. GER
      was confirmed in 27 patients: 19 (90.5%) with T-CP, 6 (25%) with ms-MR and 2 (8%)
      with D-CP. The rest of the infants did not have GER. There was a very significant
      difference in the frequency of GER in the T-CP group with respect to the other
      groups (p < 0.001) and a significant difference in the ms-MR patients with
      respect to the other groups (p < 0.05). The treatment of GER was surgical in ten
      patients (37%), after failure of medical treatment in 8; exclusively medical
      treatment in 10 cases (37%) and postural and dietetic treatment in 7 (26%)
      patients. Good control of GER, resulting in an improvement in the quality of
      life, occurred in 90% of the patients treated surgically and only in 55% of the
      patients treated medically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460842
TI  - [Smoking habits among Bierzo adolescents].
AB  - The results of a smoking survey, carried out in the Bierzo area, are reported
      here. The study group included 403 youngsters, 245 males and 158 females, between
      the ages of 11 and 20 years. One hundred and sixty-three of the 265 youngsters
      that had smoked sometimes, continued to smoke, with 93 (23.0%) smoking
      occasionally and 70 (17.3%) smoking habitually. The proportion of females and
      males was similar. The mean age of males for their first experience with smoking
      was 12.6 years and was earlier than that for females (13.7 years). There were
      less smokers among youngsters from families in a high economic situation (18%),
      but they formed the group with the highest consumption of tobacco. The smoking
      habit of the youths was related to the tobacco use of their siblings, but not to
      that of their parents. A negative relationship was found between efficacy at
      school and smoking. The was also a high frequency of smokers among habitual
      drinkers.

PMID- 8460843
TI  - [Acute lymphoblastic leukemia: comparison of traditional treatment with intensive
      therapy methods].
AB  - In this study we compare two different therapies for the treatment of non-B acute
      lymphoblastic leukemia (ALL). Forty-four children diagnosed as having non-B ALL
      were treated by one of two methods: 20 children were treated from 1981 to 1984
      according to the PETHEMA 7/78 protocol and 24 children were treated from 1984 to
      1987 following the BFM 83 protocol. These treatments differ in that BFM 83
      includes a higher number of cytostatics, uses intravenous methotrexate at
      moderate doses as "reservoirs" treatment and a lower dose of holocranial
      radiotherapy. The BFM 83 treatment resulted in a significant improvement in
      survival (48% versus 92% p < 0.05), as well as in the absence of further events
      (45% versus 88%, p < 0.01).

PMID- 8460844
TI  - [Sexual and biological maturation].
AB  - We have studied the physical characteristics of strength and the
      electrocardiographs of 291 boys, between 9 and 15 years of age, and 284 girls
      from 8 to 14 years old, divided into groups according to their sexual maturation
      stage (SMS). During this age period, children pass from SMS 1 to SMS 5. We have
      used the Ruffier-Dickson test as a test of strength and have also obtained an
      electrocardiographic index. Analysis of variance (ANOVA) showed that in girls,
      the number of hours of sport activity/week, systolic blood pressure (SBP) and
      diastolic blood pressure (DBP) both during rest and post-effort (SBPe and DBPe),
      Ruffier-Dickson index (RDI), pressure frequency product (PFP), increase of
      diastolic blood pressure (Inc DB) and the indices of Lewis and Sokolow right show
      a statistically significant dependence on the SMS. In boys, the number of hours
      of sport activity/week, SBP, DBP, heart frequency post-exercise, SBPe, RDI, PFP,
      increase in systolic blood pressure and the index of Sokolow right and left are
      dependent on the SMS. The objective of this paper is to draw the pediatrician's
      attention to the need to use the SMS for evaluating biological functions, not the
      chronological age.

PMID- 8460845
TI  - [Central venous access in pediatric patients. A 6-year experience].
AB  - The need for an access to the venous system, in order to infuse chemotherapeutic
      treatments or parenteral nutrition, has increased the number of central venous
      access systems (CVAS) implanted in the past years. Between February 1985 and
      December 1990, 87 devices were implanted in 76 patients (from 11 months to 15
      years of age), with a median function time of 349 days (range: 7 to 1887 days).
      The overall incidence of complications was 0.10 per 10 days of catheterization,
      with complication rates for infection and thrombosis of 0.02 and 0.03,
      respectively. Nineteen systems were removed because of complications and 11
      because of completion of the treatment. Of the cases, 97.7% included a follow-up
      period. The present study confirms the advantages of these devices, with a long
      working life and a low complication rate, being a good alternative for
      chronically ill children requiring long-term and/or cyclic intravenous therapy.

PMID- 8460846
TI  - [Anomalous origin of the left coronary artery from the pulmonary artery:
      echocardiographic diagnosis in an asymptomatic infant].

PMID- 8460847
TI  - [Spontaneous reactivation of chronic hepatitis due to hepatitis B infection in a
      child].

PMID- 8460848
TI  - [Value of echography in the early detection of osteomyelitis in childhood.
      Apropos of a case].

PMID- 8460849
TI  - [Panniculitis associated with alpha 1-atitrypsin deficiency].

PMID- 8460850
TI  - [Neonatal multifocal osteomyelitis caused by Serratia marcescens. 10-year
      evolution of a case].

PMID- 8460851
TI  - [A case of neonatal Pallister-Killian syndrome (tetrasomy 12p)].

PMID- 8460852
TI  - [Spondylodiscitis in childhood: study of 7 patients].

PMID- 8460853
TI  - Factors associated with appendicular bone mass in older women. The Study of
      Osteoporotic Fractures Research Group.
AB  - OBJECTIVE: To determine the factors associated with appendicular bone mass in
      older women. DESIGN: Cross-sectional analysis of baseline data collected for a
      multicenter, prospective study of osteoporotic fractures. SETTING: Four clinical
      centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the
      Monongahela valley, Pennsylvania. PATIENTS: A total of 9704 ambulatory, nonblack
      women, ages 65 years or older, recruited from population-based listings.
      MEASUREMENTS: Demographic and historical information and anthropometric
      measurements were obtained from a baseline questionnaire, interview, and
      examination. Single-photon absorptiometry scans were obtained at three sites: the
      distal radius, midradius, and calcaneus. Multivariate associations with bone mass
      were first examined in a randomly selected half of the cohort (training group)
      and were then tested on the other half of the cohort (validation group). RESULTS:
      In order of decreasing strength of association, estrogen use, non-insulin
      dependent diabetes, thiazide use, increased weight, greater muscle strength,
      later age at menopause, and greater height were independently associated with
      higher bone mass. Gastric surgery, age, history of maternal fracture, smoking,
      and caffeine intake were associated with lower bone mass (all P < 0.05). For
      example, we found that 2 or more years of estrogen use was associated with a 7.2%
      increase in distal radius bone mass, whereas gastrectomy was associated with an
      8.2% decrease in bone mass. The associations between bone mass and dietary
      calcium intake and rheumatoid arthritis were inconsistent. Alcohol use, physical
      activity, use of calcium supplements, pregnancy, breast-feeding, parental
      nationality, and hair color were among the many variables not associated with
      bone mass. Multivariate models accounted for 20% to 35% of the total variance of
      bone mass. CONCLUSIONS: A large number of factors influence the bone mass of
      elderly women; however, age, weight, muscle strength, and estrogen use are the
      most important factors.

PMID- 8460854
TI  - Prediction of cardiovascular death in men undergoing noninvasive evaluation for
      coronary artery disease.
AB  - OBJECTIVE: To develop prediction rules from clinical and exercise test data
      identifying patients at high and low risk for cardiovascular events among a group
      of male veterans. DESIGN: Prognostic study with prospective gathering of data and
      routine follow-up of consecutive patients referred for exercise testing. Patients
      only underwent noninvasive evaluation for coronary artery disease. No validation
      cohort is yet available. SETTING: A 1200-bed Veterans Affairs Medical Center.
      PATIENTS: Of 3609 men referred for exercise testing between 1984 and 1990, 2546
      patients remained evaluable after exclusion of those who underwent subsequent
      cardiac catheterization, those with significant valvular heart disease, and those
      who had previous coronary artery bypass surgery. MEASUREMENTS: Evaluation
      included recording of clinical data on a standardized form and a standard
      treadmill test followed by assessment of cardiovascular events. RESULTS: During a
      mean follow-up period (+/- SD) of 2.75 (+/- 18) years, 119 cardiovascular deaths
      and 44 nonfatal myocardial infarctions occurred in 2546 patients. The Cox
      proportional hazards model showed the following characteristics to be
      statistically independent predictors of time until cardiovascular death: history
      of congestive heart failure or digoxin use, exercise-induced ST depression,
      change in systolic blood pressure during exercise, and exercise capacity. Using a
      simple score based on one item of clinical information (history of congestive
      heart failure or digoxin use) and three exercise test responses (ST depression,
      exercise capacity, and change in systolic blood pressure), 77% of patients were
      categorized as low risk (annual cardiac mortality rate, less than 2%), 18% as
      moderate risk (annual cardiac mortality rate, 7%), and 6% as high risk (annual
      cardiac mortality rate, 15%; hazard ratio, 10; 95% confidence interval, 6 to 17).
      This model has not yet been validated. CONCLUSIONS: Variables available from the
      usual non-invasive work-up of patients with known or suspected coronary artery
      disease can be used to predict future risk for cardiovascular death.

PMID- 8460855
TI  - Radiation pneumonitis: a possible lymphocyte-mediated hypersensitivity reaction.
AB  - OBJECTIVE: To determine if unilateral thoracic irradiation results in a lymphoid
      alveolitis in both irradiated and unirradiated lung fields. DESIGN: A
      prospective, nonrandomized study. PATIENTS: Women receiving postoperative
      radiotherapy for carcinoma of the breast were evaluated both before and 4 to 6
      weeks after radiotherapy. Findings after radiotherapy in 15 asymptomatic patients
      were compared with findings in a group of patients with clinical radiation
      pneumonitis. MEASUREMENTS: History, physical examination, chest radiograph,
      quantitative gallium lung scanning, respiratory function tests, bronchoalveolar
      lavage, and lavage lymphocyte subset analysis. RESULTS: After irradiation, lavage
      lymphocytes increased significantly (34.5% versus 46.8%; P = 0.01) in the 17
      patients studied prospectively. There was an associated reduction in vital
      capacity (102.5% versus 95.5%; P = 0.04). Comparison of results in patients
      before treatment, after treatment without clinical pneumonitis, and after
      treatment with clinical pneumonitis showed a dramatic increase in total
      lymphocytes after irradiation (6.3 versus 9.4 versus 35.2 million, respectively;
      P = 0.005), particularly in those with clinical pneumonitis. Only in those with
      clinical pneumonitis was this accompanied by an increase in the gallium index
      (3.7 versus 3.4 versus 9.0, respectively; P < 0.001). Vital capacity was also
      progressively reduced (102.5% versus 96.9% versus 76.7%, respectively; P = 0.04),
      as was diffusing capacity (98.6% versus 91.4% versus 72.6%, respectively; P =
      0.003). No statistical differences existed between irradiated and unirradiated
      sides of the chest in either lavage or gallium lung scan studies. CONCLUSION: In
      most patients, a lymphocytic alveolitis develops in both lung fields after
      strictly unilateral thoracic irradiation; this is more pronounced in patients
      developing clinical pneumonitis. These findings suggest that radiotherapy may
      cause a generalized lymphocyte-mediated hypersensitivity reaction.

PMID- 8460856
TI  - Hypopituitarism after tuberculous meningitis in childhood.
AB  - OBJECTIVE: To study the prevalence and pathogenesis of hypopituitarism following
      tuberculous meningitis in childhood. DESIGN: A retrospective cross-sectional
      study. SETTING: A university teaching hospital and a tuberculosis referral
      center. PATIENTS: Forty-nine patients, aged 23.4 +/- 6.0 years (mean +/- SD), who
      had tuberculous meningitis in childhood (age at diagnosis, 5.9 +/- 5.0 years)
      were studied. MEASUREMENTS: A detailed assessment of hypothalamic-pituitary
      function, including conventional stimulation tests and responses to four
      hypothalamic releasing hormones, was done. Magnetic resonance imaging of the
      hypothalamic-pituitary region was performed in patients with abnormal endocrine
      function. RESULTS: Ten patients were found to have abnormal pituitary function:
      Seven had growth hormone deficiency, four of whom also had gonadotropin
      deficiency; the other three had gonadotropin deficiency, corticotropin
      deficiency, and mild hyperprolactinemia, respectively; none had diabetes
      insipidus. Among those with growth hormone deficiency, a significant correlation
      (r = 0.749, P < 0.05) was found between the height standard deviation score and
      the age at diagnosis of tuberculous meningitis. Growth hormone, corticotropin,
      and gonadotropin responses to growth hormone releasing hormone, corticotropin
      releasing hormone, and gonadotropin releasing hormone, respectively, suggested a
      hypothalamic defect in five patients. Magnetic resonance imaging scans of the
      hypothalamic-pituitary region were abnormal in five patients. CONCLUSIONS:
      Hypopituitarism was documented in 20% of a small subset of patients years after
      recovery from tuberculous meningitis in childhood. The cause appears to be
      tuberculous lesions affecting the hypothalamus, pituitary stalk and, directly or
      indirectly, the pituitary itself. Early recognition and treatment can be
      beneficial.

PMID- 8460857
TI  - Spontaneous pneumothorax in patients with leukemia: first sign of invasive
      mycosis?

PMID- 8460858
TI  - Isolated right ventricular myocardial infarction.

PMID- 8460859
TI  - Atherosclerotic renovascular disease and progressive renal failure.
AB  - PURPOSE: To evaluate information on the prevalence and rate of progression of
      atherosclerotic renovascular disease and the effect of angiotensin-converting
      enzyme inhibition on this process, with the goal of developing a rational
      approach to the diagnosis and management of this disorder. DATA SOURCES: Relevant
      articles were identified from the authors' files and from MEDLINE searches.
      Additional references were obtained from the bibliographies of identified
      articles. STUDY SELECTION: Virtually no controlled prospective studies have been
      reported. The articles presented are primarily retrospective analyses and include
      those that provide sufficient information about the incidence or progression of
      renovascular disease and about the outcome and mortality rate associated with
      various treatments, to allow evaluation. DATA EXTRACTION: For the outcomes of
      interest, data from individual reports are presented in tabular form, the results
      summed, and averages obtained. RESULTS: Atherosclerotic renovascular disease, in
      many cases involving both renal arteries, is a common finding in patients older
      than 50 years, particularly those with diffuse atherosclerotic vascular disease.
      Hypertension is not a particularly sensitive indicator of this disease (almost
      one half are not hypertensive). The disease progresses and may account for 5% to
      15% of all patients developing end-stage renal disease each year. Angiotensin
      converting enzyme inhibition may damage ischemic renal tissue, but this is
      counterbalanced by beneficial effects of this therapy. Once end-stage renal
      disease is present, mortality rates are high despite dialysis support (> 50% over
      3 years). Both surgery and angioplasty can preserve or improve renal function and
      may delay or prevent the need for dialysis therapy. These invasive procedures may
      have lower rates of morbidity and mortality than the so-called "conservative"
      approach of dialysis therapy when renal failure develops. CONCLUSIONS: Given
      available information, diagnosis and intervention should be considered seriously
      in patients at high risk for renovascular disease who have clearly progressing
      renal insufficiency. Prospective trials are needed, however, to determine the
      costs and benefits of each approach to treatment in all patients with
      renovascular disease and renal insufficiency.

PMID- 8460860
TI  - NIH conference. New insights into common variable immunodeficiency.
AB  - Common variable immunodeficiency (CVI) is a heterogenous immunodeficiency
      syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections,
      and various immunologic abnormalities. In addition to recurrent infections,
      patients with this syndrome also have an increased incidence of autoimmune
      disease and malignancy. Because the spectrum of associated diseases is broad,
      patients with CVI are seen by various medical specialists. This review discusses
      the pathogenesis, clinical manifestations, diagnosis, and treatment of CVI.

PMID- 8460861
TI  - More informative abstracts of articles describing clinical practice guidelines.
AB  - Recommendations are proposed for preparing more informative abstracts of articles
      describing clinical practice guidelines. Information about the development and
      content of guidelines should be summarized with the following structure.
      OBJECTIVE: a succinct statement of the objective of the guideline, including the
      targeted health problem, the targeted patients and providers, and the main reason
      for developing recommendations concerning this problem for this population.
      OPTIONS: principal practice options that were considered in formulating the
      guideline. OUTCOMES: significant health and economic outcomes identified as
      potential consequences of the practice options. EVIDENCE: Methods used to gather,
      select, and synthesize evidence, and the date of the most recent evidence
      obtained. VALUES: persons and methods used to assign values (relative importance)
      to potential outcomes of alternative practice options. BENEFITS, HARMS, AND
      COSTS: the type and magnitude of the main benefits, harms, and costs that are
      expected to result from guideline implementation. RECOMMENDATIONS: a brief and
      specific list of key recommendations. VALIDATION: the results of any external
      review, comparison with guidelines developed by other groups, or clinical testing
      of guideline use. SPONSORS: key persons or groups that developed, funded, or
      endorsed the guideline. Abstracts adhering to these recommendations could enhance
      readers' ability to appraise the applicability, importance, and validity of
      guidelines for specific providers, patients, and settings. More informative
      abstracts could also promote the use of more explicit methods of guideline
      development, more consistent reporting of guideline documents, and the more
      appropriate use of guidelines by clinicians.

PMID- 8460862
TI  - A birth in Tedda.

PMID- 8460863
TI  - Risk factors for low bone mass: clinical implications.

PMID- 8460864
TI  - The breast cancer screening controversy continues.

PMID- 8460865
TI  - The breast cancer screening controversy continues.

PMID- 8460866
TI  - The breast cancer screening controversy continues.

PMID- 8460867
TI  - The breast cancer screening controversy continues.

PMID- 8460868
TI  - Carcinoma of the male breast.

PMID- 8460869
TI  - Tamoxifen for carcinoma of the male breast.

PMID- 8460870
TI  - Minocycline-induced pneumonia.

PMID- 8460872
TI  - Perceptions of chief medical residency.

PMID- 8460871
TI  - Minocycline-induced pneumonia.

PMID- 8460873
TI  - Medical informatics and the need for general internists.

PMID- 8460874
TI  - Positive views of retirement communities.

PMID- 8460875
TI  - A national cross-sectional study of the working environment in the Danish wood
      and furniture industry--air pollution and noise.
AB  - A cross-sectional survey was carried out in the Danish wood and furniture
      industry at 200 factories. In this paper, representative estimates of employees'
      full-shift exposures to wood dust, vapours from organic solvents, formaldehyde
      and noise dose were calculated using a model for two-stage cluster designs.
      Exposures to air pollutants were generally below the occupational exposure limits
      (OELs), while noise doses were at the same level as OEL. The overall exposure to
      wood dust was 0.90 mg m-3, exposure to vapours from organic solvents was 0.13
      C/OEL and noise dose, Leq (8 h), was 90.5 dB(A).

PMID- 8460876
TI  - The evaluation of exposure of printing trade employees to polycyclic aromatic
      hydrocarbons.
AB  - Epidemiological studies of the lung cancer experience of workers in the printing
      industry have been inconclusive. Where there have been positive findings, the
      effect has generally been attributed to polycyclic aromatic hydrocarbon (PAH)
      exposure, although no exposure measurements were made. This study was undertaken
      to determine the exposures of printing press operators to PAH and total
      particulate (TP), and to evaluate the factors contributing to exposure. Personal
      time-weighted average exposures of press room workers were determined on two
      consecutive days at nine sites, including two newspaper operations. The average
      PAH exposure was 16.5 micrograms m-3 (including naphthalene). The average TP
      exposure was 0.63 mg m-3. Examination of the data revealed that there were
      significant differences between sites for exposure both to TP and to PAH.
      Newspaper plants had significantly lower exposures than commercial printing
      operations. There were no significant differences in exposure between the various
      job classifications of workers in the press rooms. Factors identified as
      contributing to exposure to TP were: the effectiveness of the ventilation
      systems, the method of feeding the press, the type of paper and the print
      impression area.

PMID- 8460877
TI  - The effect of seat suspension on exposure to whole-body vibration of professional
      drivers.
AB  - In this study the effectiveness of the seat suspension on the transmission of
      whole-body vibration through the driver's seat has been determined. Eleven types
      of seat frequently used in lorries, agricultural tractors and fork-lift trucks
      were selected. The transmissibility coefficient of each seat was measured by the
      ratio of the acceleration (weighted root-mean-square in the vertical axis) at the
      interface between the seat surface and the human body to the vibration at the
      attachment points of the seat on the vehicle floor. Measurements in the
      laboratory, using standardized representative vehicle vibration spectra and two
      volunteers of different weights, showed transmissibility coefficients of 0.34
      1.28. Attenuation of the vibration input spectrum was obtained in 20 out of 24
      (83%) measurements. Measurements in the field, conducted in vehicles under
      representative working conditions, showed transmissibility coefficients of 0.60
      1.45. Attenuation of the vibration spectrum was obtained in 17 out of 24 (71%)
      vehicle-seat combinations. No significant differences were observed between seats
      with conventional suspension and those with air suspension. Laboratory
      measurements of the dynamic response of the seat suspension did not provide an
      adequate basis for predicting its performance in the field. In most work
      situations the magnitude and duration of vibration-exceeded the 8 h fatigue
      decreased proficiency boundary of 0.32 m s-2 in the vertical axis, which
      indicates that in many working situations with a daily exposure of 8 h or more
      suspended seats will not protect professional drivers from harmful exposure to
      whole-body vibration.

PMID- 8460878
TI  - Lung cancer in the Schneeberg mines: a reappraisal of the data reported by
      Harting and Hesse in 1879.
AB  - The first description of occupational lung cancer, by Harting and Hesse in 1879,
      unfortunately is not readily accessible. Its account of the vicissitudes of the
      Schneeberg miners merits study and is therefore presented in summary and set in a
      historical and geological context. The authors attempted to discover the cause of
      the disease and made recommendations for improving the health of miners. In the
      course of their programme of investigations, they developed methods for measuring
      airborne dust and inhaled dust by personal monitoring. It was left to subsequent
      discovery for radon and its daughter products to be identified as the causal
      agents. Later generations were to discover the impact of radioactive spoils from
      mines situated in the mountain range in which Schneeberg was located.

PMID- 8460879
TI  - Bronchial reactivity among cotton workers in relation to dust and endotoxin
      exposure.
AB  - Bronchial reactivity was measured before work among non-smoking female and male
      workers from carding, spinning, warping and weaving areas in a cotton mill.
      Airport baggage loaders were used as controls. The amount of dust and endotoxin
      was measured at the different workplaces. Statistically significant decreases in
      FEV1 were found between groups of cotton workers at different work sites after
      administration of the highest accumulated methacholine dose used (1.25 mg). A
      relationship was found between decreases in FEV1 after methacholine challenge and
      airborne endotoxin levels but not for dust.

PMID- 8460880
TI  - The setting of an occupational exposure limit for phosphamidon in the workplace-
      a Chinese approach.
AB  - This paper describes the approach of setting an occupational exposure limit for
      phosphamidon, an organophosphorus pesticide, in the workplace in China. Apart
      from a general review of the literature relating to various toxicological
      studies, special emphasis has been placed on the results of a systematic
      occupational health survey on the workers exposed to phosphamidon. As a result of
      the survey, together with the literature review, a 'maximum allowable
      concentration' (MAC) for phosphamidon in the air of workplace is suggested as
      0.02 mg m-3 but on the condition that the route of skin entry be blocked
      effectively. In addition, based on the description of the standard-setting
      process in China, a comparison has been made to the current U.K. approach.

PMID- 8460881
TI  - Renal cell carcinoma metastatic to the orbit: a clinicopathologic report.
AB  - Renal cell carcinoma (RCC) is a tumor of middle-aged men that metastasizes to the
      lung, liver, and bone. Few cases of RCC metastatic to the orbit have been
      reported. When this tumor spreads to the orbit, the orbital metastasis is likely
      to be the first indication of the cancer. We report the case of a 53-year-old man
      with widespread metastatic RCC whose first sign of disease was a metastatic
      orbital tumor. External and ocular examination and computed tomographic and
      histopathologic findings are described. The clinical characteristics, treatment,
      and prognosis of metastatic RCC are discussed.

PMID- 8460882
TI  - Hemicentral retinal vein occlusion associated with ocular hypertension and
      clotting abnormality.
AB  - Hemicentral retinal vein occlusion in a young adult man occurred after a high
      corticosteroid-induced increase in intraocular pressure (IOP), supporting the
      accepted association between raised IOP and retinal vein occlusion. However,
      detection of a plasminogen activator deficiency in this patient indicated a
      particular susceptibility to intravascular clotting episodes.

PMID- 8460883
TI  - The correction of diplopia after cataract extraction.
AB  - The records of 12 patients with persistent diplopia after cataract extraction
      were reviewed. All patients were corrected surgically using an adjustable-suture
      technique. After strabismus surgery, the diplopia in nine of the 12 patients
      resolved without adjunctive therapy. Three patients had occasional diplopia
      postoperatively. Prismatic correction postoperatively was unwarranted in two
      patients because diplopia occurred on rare occasions, but the third required
      postsurgical prismatic correction with improvement.

PMID- 8460884
TI  - Isolated ocular involvement in non-Hodgkin's lymphoma with immunocytochemical
      evaluation.
AB  - We report the case of a patient with isolated ocular involvement and non
      Hodgkin's lymphoma (also known as reticulum cell sarcoma). Most non-Hodgkin's
      central nervous system lymphomas are large cell lymphomas derived from B-cells.
      The patient initially had iritis OD and vitreous cells OS. Eventually, rubeosis
      and vitritis developed OD. A systemic workup showed no extraocular lymphoma.
      Immunocytochemical analysis was done on the vitreous OD and detected a monoclonal
      B-cell population of large lymphoid cells. This case shows the frequent delay in
      making the diagnosis of this condition. This diagnosis must be remembered when a
      patient has vitreous opacities.

PMID- 8460885
TI  - Computed tomography and magnetic resonance imaging in the diagnosis of posterior
      scleritis.
AB  - The clinical records of 14 patients with posterior scleritis were reviewed to
      compare the diagnostic potential of computed tomography (CT) and magnetic
      resonance imaging (MRI) in this condition. None of these patients had evidence of
      collagen vascular or other systemic diseases. Done 13 times on 11 patients, CT
      was diagnostic for posterior scleritis in six patients on seven occasions. We
      used MRI six times in five patients, and it was not diagnostic for posterior
      scleritis in any patient. Thus, CT appeared to be more sensitive than MRI in the
      diagnosis of posterior scleritis. The CT results appeared comparable to
      ultrasonographic findings (obtained eight times in six patients) in the diagnosis
      of posterior scleritis. Both CT and MRI, however, detected signs of orbital
      pseudotumor in six and three patients, respectively. These findings support the
      concept that posterior scleritis and orbital pseudotumor may represent a
      continuum of the same disease process.

PMID- 8460887
TI  - Integrative systems research on the brain: resurgence and new opportunities.

PMID- 8460886
TI  - Endogenous endophthalmitis caused by Escherichia coli.
AB  - Endophthalmitis is a rare complication of Escherichia coli-induced septicemia.
      Nine cases of endogenous endophthalmitis caused by E. coli have been reported
      previously, all except one in patients with diabetes. The most common primary
      site of infection is the urinary tract. The course of illness is rapidly
      progressive with a poor visual prognosis. Concurrent systemic morbidity,
      including body abscesses and endocarditis, is high. We report an additional case
      of endogenous endophthalmitis from E. coli in a diabetic woman. Enucleation was
      required despite aggressive topical and systemic treatment. The pertinent
      literature is reviewed.

PMID- 8460888
TI  - Molecular control of cell fate in the neural crest: the sympathoadrenal lineage.
AB  - Over the past five years, new insights have been gained into the biology of the
      SA lineage. These advances have been powered by the development of immunologic
      methods to isolate embryonic SA progenitors from fetal adrenal glands and
      sympathetic ganglia. Analysis of these embryonic progenitors has confirmed many
      of the ideas derived from earlier studies of postnatal cells, but has
      necessitated several revisions in our thinking, as well. First, embryonic SA
      progenitors appear to be distinct from mature SIF cells, a cell type initially
      postulated to be the central intermediate in the SA lineage. Second, FGF, not
      NGF, appears to be an important early influence on neuronal fate; NGF
      responsiveness appears relatively late in differentiation. Third, the development
      of both sympathetic neurons and adrenal chromaffin cells is not a one-step
      process, but rather involves a series of events, in which the cells change their
      responsiveness to growth factors and glucocorticoids. Fourth, emerging
      circumstantial evidence suggests that SA progenitors may have additional
      developmental potentials. Finally, new insights have been gained into the
      molecular mechanisms that underlie both the differentiation of SA progenitors and
      their determination from earlier multipotent neural crest cells. These advances
      have made the SA progenitor a well-defined system for studying the molecular
      control of cell fate in a vertebrate neurogenic precursor cell. The analysis of
      the SA lineage at the cell biological level has raised several interesting
      molecular questions for future investigation. In the neuronal branch of the SA
      lineage, how is the acquisition of NGF-responsiveness and NGF-dependence
      controlled, and what is the relationship of these events to the expression of
      p140trk and p75? In the chromaffin branch of the pathway, which molecules control
      the timing of PNMT expression? In the uncommitted SA progenitor, what is the
      molecular basis of the antagonism between the competing neuronal and chromaffin
      pathways of differentiation, and how does commitment to neuronal differentiation
      occur? Can SA progenitors differentiate to enteric neurons in vitro, and which
      differentiation and survival factors control this phenotype, as well as the other
      classical neurotransmitter and neuropeptide phenotypes expressed by SA
      derivatives? What are the roles of MASH1 and other regulatory genes in
      controlling early stages in neural crest cell determination, and how is the
      expression of these molecules in turn controlled? How much of the genetic
      regulatory network controlling neuronal differentiation in Drosophila has been
      conserved in vertebrates?(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8460889
TI  - Implicit memory: a selective review.

PMID- 8460890
TI  - The neurofibromatosis type 1 gene.

PMID- 8460891
TI  - The role of NMDA receptors in information processing.
AB  - In this review, we have concentrated on the parallels between the cellular
      properties of the NMDA receptor and a variety of functional properties within
      sensory and motor systems. Of course, the NMDA channel exists within the cell in
      conjunction with a variety of other channels, including non-NMDA channels.
      Although the NMDA receptor is unique in a cellular sense--it is the only ligand
      gated channel that is also voltage dependent and calcium permeable--it is not
      unique in a functional sense. A cell that has non-NMDA receptors and voltage
      sensitive channels will also exhibit nonlinear behavior. Moreover, Buhrle &
      Sonnhof (1983) demonstrated some time ago that calcium flows into frog motor
      neurons through more than one type of calcium channel. The contribution to the
      inflow of calcium from NMDA channels may vary from cell to cell and could easily
      be a minor proportion of the total. Many authors have pointed out that the NMDA
      channel has a low conductance at a resting potential of -70 mV. However, many
      cells in the nervous system are depolarized from -70 mV by excitatory input.
      Thus, as pointed out above. NMDA receptors make a contribution to the tonic or
      spontaneous activity of cells in both visual cortex and spinal cord. In practice,
      many cells are probably working in a range of membrane potentials where the NMDA
      channels are always open to some extent. Even in the hippocampal slice where a
      substantial amount of afferent input is removed, NMDA receptors contribute to
      spontaneous activity (Sah et al 1989). Does the NMDA receptor act as a switch?
      Does it act as an AND gate? The suggestion that it may act as a switch comes from
      work on LTP in the hippocampus, which is readily produced by high-frequency
      stimulation and is abolished by APV. However, activation of the NMDA receptor is
      only the first in a sequence of reactions leading to LTP: In theory, switch-like
      behavior could also be produced by calcium-buffering systems within dendritic
      spines, or by enzymatic processes (Lisman 1985; Zador et al 1990). Fox & Daw
      (1992) have modeled the action of NMDA and non-NMDA receptors that are activated
      in parallel with each other, and shown that the occurrence of switch-like
      behavior depends on the relative density of NMDA versus non-NMDA receptors.
      Switch-like behavior is not seen in the visual cortex, but might be seen in the
      hippocampus if the relative density of NMDA receptors there was higher than in
      the visual cortex.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8460892
TI  - Processing of temporal information in the brain.

PMID- 8460893
TI  - Inferior temporal cortex: where visual perception meets memory.

PMID- 8460894
TI  - Common principles of motor control in vertebrates and invertebrates.

PMID- 8460895
TI  - Recent advances in the molecular biology of dopamine receptors.

PMID- 8460896
TI  - Molecular mechanisms of developmental neuronal death.
AB  - Data derived from several experimental approaches demonstrate that naturally
      occurring neuronal death during development has many parallels with the
      physiologically appropriate death seen in nonneuronal cells. Physiologically
      appropriate death in different cell types may share some common mechanisms. These
      general notions must remain vague and tentative, because details of the
      mechanisms by which cells die in response to physiological positive or negative
      signals are poorly understood in any cell type. Current thinking focuses on the
      idea that cells possess a mechanism, which involves specific gene products, that
      are designed to kill the cell in response to appropriate physiological signals.
      Genetic studies of cell death in C. elegans and the demonstrations of increased
      expression of specific genes temporally associated with death in nonneuronal
      cells are consistent with this view. However, in the latter studies, there is no
      direct evidence that such temporally related genes are critical to the process of
      cell death or whether such gene expression may be related to somE other aspect of
      the response to the hormonal manipulations that produce the death of the cell
      under study. Therefore, the mechanism of death of any cell type is not
      understood, and whether neuronal death during development or after experimental
      manipulation results from the same mechanism is unknown. Several approaches are
      currently being pursued in a number of laboratories to address this general
      problem. These include pharmacological studies, such as described above, and
      studies aimed at analyzing biochemical and morphological changes associated with
      death. Attempts to find mRNAs or proteins whose increased expression is
      associated with neuronal death can be addressed by subtractive and differential
      hybridization strategies, by two-dimensional protein gel electrophoresis, and by
      examining genes whose increased expression is temporally correlated with cell
      death. Success in these various strategies will provide an understanding of
      neuronal death and relate to it cell death in other cell types. If future work
      provides direct evidence for a genetic program acting physiologically to produce
      death in the developing nervous system, an obvious question becomes the possible
      role that loss of transcriptional control of such a program plays in the adult in
      responses to mechanical or chemical trauma, neurodegenerative disease, or
      neuronal attrition associated with aging. Studies addressing the basic
      developmental process of trophic factor deprivation-induced death should provide
      molecular markers of and pharmacological approaches to these pathological
      processes in the adult.

PMID- 8460898
TI  - How parallel are the primate visual pathways?

PMID- 8460897
TI  - Molecular basis of neural-specific gene expression.

PMID- 8460899
TI  - Glial boundaries in the developing nervous system.

PMID- 8460900
TI  - Genetic and cellular analysis of behavior in C. elegans.

PMID- 8460901
TI  - The processing of single words studied with positron emission tomography.

PMID- 8460902
TI  - Modeling of neural circuits: what have we learned?

PMID- 8460903
TI  - Neuroanatomy of memory.

PMID- 8460904
TI  - Behaviorally based modeling and computational approaches to neuroscience.
AB  - The almost incredible advances that have recently occurred in the power of
      computers available to scientists in all disciplines have encouraged an explosion
      of neural network and behavioral models. Some of these have been constrained more
      by the imagination of the programmer than by rude biological facts. Their
      relevance for the experimental neuroscientist thus varies from case to case. Some
      models (e.g. Grillner's model of lamprey swimming movements) are so closely based
      on known neuroanatomy and neurophysiology that it becomes possible to generate
      and test precise experimental predictions. Other models (such as MURPHY and
      NOMAD) use neurobiological principles in their architectures, but do not portray
      any particular organism. Although it is harder to relate the study of these
      models of the study of real animals, they fulfill an important explanatory role.
      They make possible insights into how behavior is controlled by neuronal activity
      that would be unobtainable in real animals using present methods. Thus, even the
      excesses of neural modeling have provided a useful impetus to what is undoubtedly
      a most promising approach to integrating data from the various disciplines
      concerned with behavior and the mind. The problems have been pointed out by many
      authors (see citations in our introduction), and a phase of more critical
      evaluation appears to have begun. We hope that our brief survey of models based
      on widely different theoretical approaches, but all aimed at explaining behavior,
      will encourage critical comparisons to be made. As in more mature fields, such as
      thermodynamics, we can expect that more complete models will force an evaluation
      of theoretical hypotheses against the entire body of available evidence, rather
      than just a few pertinent test cases. Such evaluation will make possible a much
      more rigorous exclusion of invalid or inconsistent theoretical ideas. From such
      studies, a much smaller, but more robust, set of basic principles can be expected
      to emerge. From the perspective afforded by our own modeling studies, it appears
      essential that modeling be informed by a general theory of brain function. In
      this work, the theory of neuronal group selection provides a useful basis for
      further work by virtue of its consistency with basic evolutionary and
      physiological principles and the power of the selection paradigm to shape neural
      networks in behaviorally adaptive directions.

PMID- 8460905
TI  - Computational models of the neural bases of learning and memory.

PMID- 8460906
TI  - Patterning the brain of the zebrafish embryo.

PMID- 8460907
TI  - Protein targeting in the neuron.

PMID- 8460908
TI  - Discovery and development of new antibiotics: the problem of antibiotic
      resistance.

PMID- 8460909
TI  - In vitro and in vivo antibacterial activities of T-3761, a new quinolone
      derivative.
AB  - T-3761, a new quinolone derivative, showed broad and potent antibacterial
      activity. Its MICs for 90% of the strains tested were 0.20 to 100 micrograms/ml
      against gram-positive bacteria, including members of the genera Staphylococcus,
      Streptococcus, and Enterococcus; 0.025 to 3.13 micrograms/ml against gram
      negative bacteria, including members of the family Enterobacteriaceae and the
      genus Haemophilus; 0.05 to 50 micrograms/ml against glucose nonfermenters,
      including members of the genera Pseudomonas, Xanthomonas, Acinetobacter,
      Alcaligenes, and Moraxella; 0.025 micrograms/ml against Legionella spp.; and 6.25
      to 25 micrograms/ml against anaerobes, including Bacteroides fragilis,
      Clostridium difficile, and Peptostreptococcus spp. The in vitro activity of T
      3761 against these clinical isolates was comparable to or 2- to 32-fold greater
      than those of ofloxacin and norfloxacin and 2- to 16-fold less and 1- to 8-fold
      greater than those of ciprofloxacin and tosulfoxacin, respectively. When
      administered orally, T-3761 showed good efficacy in mice against systemic,
      pulmonary, and urinary tract infections with gram-positive and gram-negative
      bacteria, including quinolone-resistant Serratia marcescens and Pseudomonas
      aeruginosa. The in vivo activity of T-3761 was comparable to or greater than
      those of ofloxacin, ciprofloxacin, norfloxacin, and tosufloxacin against most
      infection models in mice. The activities of T-3761 were lower than those of
      tosufloxacin against gram-positive bacterial systemic and pulmonary infections in
      mice but not against infections with methicillin-resistant Staphylococcus aureus.
      The activities of T-3761 against systemic quinolone-resistant Serratia marcescens
      and Pseudomonas aeruginosa infections in mice were 2- to 14-fold greater than
      those of the reference agents.

PMID- 8460910
TI  - Effects of two magainin peptides on eicosanoid release from rat peritoneal
      macrophages.
AB  - Magainins are novel polycationic peptides with broad-spectrum antimicrobial
      activity, including activity against gram-negative bacteria. Gram-negative
      bacteremia can elicit endotoxic shock that is associated with the increased
      formation of eicosanoids. Inhibition of eicosanoid synthesis has been shown to
      improve the outcome of experimental endotoxic shock. The aim of the present study
      was to test the in vitro effects of two magainin peptides, MSI-97 (M1) and MSI-98
      (M2), on eicosanoid synthesis by rat peritoneal macrophages (M phi) stimulated by
      Salmonella enteritidis lipopolysaccharide (LPS; 50 micrograms/ml) and Salmonella
      minnesota lipid A (5 micrograms/ml) and to compare their effects on LPS
      reactivity with a metachromatic dye. M1 (100 micrograms/ml) significantly (P <
      0.05) reduced LPS-stimulated synthesis of thromboxane B2 (TXB2), without changing
      6-keto-prostaglandin F1 alpha in M phi. Similarly, M2 (10 micrograms/ml)
      significantly attenuated M phi synthesis of TXB2 stimulated by either LPS or
      lipid A. However, at a higher concentration (100 micrograms/ml), M2 but not M1
      significantly augmented LPS-induced increases in TXB2 and 6-keto-prostaglandin F1
      alpha. Polymyxin B (40 micrograms/ml) inhibited LPS production and lipid A
      stimulated TXB2 production. M1 (100 micrograms/ml) and polymyxin B (10 and 40
      micrograms/ml) also inhibited calcium ionophore A23187 (10 microM)-induced
      synthesis of TXB2. The lipid A moiety of LPS reacts with dimethylmethylene blue
      dye, providing a metachromatic assay of LPS. This metachromatic reaction with
      lipid A was significantly reduced by polymyxin B and M2 at all concentrations. M1
      was effective only at the highest M1:lipid A concentration ratio (2:1). Thus, M1
      and M2 share some similarities with polymyxin B in inhibiting lipid A reactivity
      with the dye, which suggests that these magainins may also bind to lipid A.
      However, M1 was devoid of any inhibitory effects on dye reactivity with S.
      enteritidis LPS and M2 was inhibitory at only one concentration ratio (1:5). In
      conclusion, the varied effects of the magainin peptides on LPS, lipid A, and M
      phi eicosanoid synthesis appear to depend on the type of peptide used and on its
      concentration.

PMID- 8460911
TI  - Molecular basis of rifampin resistance in Mycobacterium leprae.
AB  - Rifampin is currently the most potent drug used in leprosy control programs. We
      show that the rifampin resistance which emerged in nine patients with lepromatous
      leprosy, who had received rifampin monotherapy, stemmed from mutations in the
      rpoB gene, which encodes the beta subunit of RNA polymerase of Mycobacterium
      leprae. In eight cases missense mutations were found to affect a serine residue,
      Ser-425, while in the remaining mutant a small insertion was found close to this
      site. These findings will be of use for the development of a rapid screening
      procedure, involving the polymerase chain reaction, for monitoring the emergence
      of rifampin-resistant M. leprae strains.

PMID- 8460912
TI  - Effect of obesity on vancomycin pharmacokinetic parameters as determined by using
      a Bayesian forecasting technique.
AB  - Few data exist concerning the effect of obesity on the pharmacokinetic parameters
      of vancomycin. The purpose of this investigation was to assess the effect of
      obesity on vancomycin pharmacokinetic parameters in 95 nonobese and 135 obese
      adult patients (age range, 18 to 92 years) receiving vancomycin. All subjects had
      normal renal function as defined by a creatinine concentration in serum of < or =
      1.5 mg/dl (mean estimated creatinine clearance +/- 1 standard deviation, 76 +/-
      34; range, 23 to 215 ml/min). Vancomycin concentrations in serum were determined
      by the fluorescence polarization immunoassay. All data for vancomycin
      concentration in serum versus time for each course of therapy were fitted by
      using a two-compartment Bayesian forecasting program. Subjects were stratified
      into nine groups on the basis of the percent difference between actual body
      weight (ABW) and lean body weight (LBW) (> -10%, -10 to 0%, > 0 to 10%, > 10 to
      20%, > 20 to 30%, > 30 to 40%, > 40 to 50%, > 50 to 60%, > 60%). Analysis of
      variance with post hoc Scheffe's testing revealed that statistically significant
      differences occurred in terminal disposition half-life (t1/2 beta) between the
      extremes of modestly obese (group 4) and morbidly obese (group 9, P < 0.05)
      patients. Similar analysis with distribution volume (V) identified significant
      differences in patients at or near their LBW (groups 2 to 4) and patients who
      were morbidly obese (groups 8 and 9, P < 0.05). Multiple regression models for
      the pharmacokinetic parameters V, t1/2beta, and vancomycin total body clearance
      were developed to assess the joint predictive power of LBW, ABW, and percent over
      LBW, controlling for the effects of age, initial creatinine concentration in
      serum, initial creatinine clearance, and gender. In the final model for V, both
      ABW and percent over LBW were independent and significant predictors. For total
      body clearance, only ABW was significant and predictive. Percent over LBW was a
      significant and independent predictor of t1/2beta. LBW is not predictive of these
      pharmacokinetic parameters and should not be used for initial dosing. On the
      basis of these data, ABW appears to be superior to LBW for calculating initial
      dose requirements for vancomycin.

PMID- 8460913
TI  - Multiple-dose pharmacokinetics of 12 milligrams of trimethoprim and 60 milligrams
      of sulfamethoxazole per kilogram of body weight per day in healthy volunteers.
AB  - The disposition of 12 mg of trimethoprim and 60 mg of sulfamethoxazole per kg of
      body weight in six healthy male volunteers is described. The daily dose was
      evenly divided and administered orally every 6 h for 13 consecutive doses.
      Individual drug components were assayed by high-performance liquid
      chromatography. Steady-state concentrations in serum for trimethoprim and
      sulfamethoxazole were within the purported therapeutic ranges for treating
      Pneumocystis carinii pneumonia. Co-trimoxazole was well tolerated, and no subject
      withdrew from the study because of toxicity. Comparison of the pharmacokinetic
      parameters in this study with those of our previous findings indicates that the
      elimination of trimethoprim-sulfamethoxazole follows a first-order process within
      the dose ranges assessed. Administration of 15- to 20-mg/kg trimethoprim and 75-
      to 100-mg/kg sulfamethoxazole in four evenly divided doses for the first 24 h
      followed by 12 and 60 mg/kg/day, respectively, for the remainder of therapy
      rapidly attains concentrations in serum within the proposed P. carinii pneumonia
      therapeutic range. Clinical trials are indicated to evaluate this dosing scheme,
      which may decrease exposure to potentially excessive concentrations of
      trimethoprim and sulfamethoxazole.

PMID- 8460914
TI  - Mechanism of uptake of deglucoteicoplanin amide derivatives across outer
      membranes of Escherichia coli and Pseudomonas aeruginosa.
AB  - Teicoplanin is a glycopeptide antibiotic which is ineffective against gram
      negative bacteria because of its inability to penetrate the outer membrane.
      Removal of the sugar residues and attachment of polyamines to carbon 63 yielded
      two dibasic deglucoteicoplanin amides, MDL 62,766 (766) and MDL 62,934 (934),
      with moderate MICs for Escherichia coli (2 to 4 micrograms/ml) and Pseudomonas
      aeruginosa (8 to 32 micrograms/ml) compared with those of the monobasic
      teicoplanin aglycone (16 and > 1,024 micrograms/ml, respectively). MICs were
      increased 16- to 32-fold by Mg2+ supplementation of Luria broth but not by Na+
      supplementation at an equivalent ionic strength. Both 766 and 934 were capable of
      binding to P. aeruginosa lipopolysaccharide (LPS) at Mg(2+)-binding sites, as
      assessed by dansyl polymyxin displacement experiments. Furthermore, both
      compounds increased E. coli and P. aeruginosa outer membrane permeability to the
      hydrophobic fluorescent probe 1-N-phenylnaphthylamine (NPN), whereas the parent
      compounds teicoplanin aglycone and teicoplanin and the beta-lactam ceftazidime
      were totally ineffective. Addition of 1 mM Mg2+ blocked the increase in outer
      membrane permeability. Compound 766 had a lower MIC than 934 for both bacteria
      tested, bound to LPS with a higher affinity, and permeabilized outer membranes to
      NPN at lower concentrations. We propose that both deglucoteicoplanin amides
      exhibit increased gram-negative activity by virtue of their ability to access the
      self-promoted uptake pathway across the outer membrane.

PMID- 8460915
TI  - Multiple-dose pharmacokinetics of amikacin and ceftazidime in critically ill
      patients with septic multiple-organ failure during intermittent hemofiltration.
AB  - The pharmacokinetic parameters of amikacin and ceftazidime were assessed in four
      patients undergoing hemofiltration for septic shock. The parameters were assessed
      during hemofiltration and in the interim period. The concentration-time profiles
      of these two drugs in plasma, urine, and ultrafiltrate were investigated after
      intravenous perfusion (30 min). In all cases a 1-g dose of ceftazidime was
      administered; for amikacin, the dosage regimen was adjusted according to the
      patient's amikacin levels (250 to 750 mg). Concentrations of drug in all samples
      were assayed by high-performance liquid chromatography with UV detection for
      ceftazidime and by enzyme multiplied immunoassay for amikacin. The elimination
      half-life (t1/2) and the total clearance of amikacin ranged from 31.1 to 138.2 h
      and from 5.4 to 8.9 ml/min, respectively, during the interhemofiltration period
      in anuric patients. Hemofiltration substantially decreased the t1/2 (3.5 +/- 0.49
      h) and increased the total clearance (89.5 +/- 11.8 ml/min). The hemofiltration
      clearance of amikacin represented 71% of the total clearance, and the
      hemofiltration process removed, on average, 60% of the dose. During
      hemofiltration, the elimination t1/2 of ceftazidime (2.8 +/- 0.69 h) was greatly
      reduced and the total clearance increased (74.2 +/- 11.2 ml/min) compared with
      those in the interhemofiltration period (9 to 43.7 h and 7.4 to 16.8 ml/min,
      respectively). About 55% of the administered dose was recovered in the filtrate,
      and the hemofiltration clearance of ceftazidime was 46 +/- 14.3 ml/min. A
      redistribution phenomenon (rebound) in the amikacin and ceftazidime
      concentrations in plasma (35 and 28%, respectively) was reported after
      hemofiltration in two patients. The MICs for 90% of the most important pathogens
      were exceeded by the concentrations of the two drugs in plasma during the whole
      treatment of these patients.

PMID- 8460917
TI  - In vitro activities of ceftriaxone and fusidic acid against 13 isolates of
      Coxiella burnetii, determined using the shell vial assay.
AB  - The susceptibilities of 13 isolates of Coxiella burnetii to fusidic acid and
      ceftriaxone were determined by use of the recently described shell vial assay (D.
      Raoult, H. Torres, and M. Drancourt, Antimicrob. Agents Chemother, 35:2070-2077,
      1991). At a concentration of 4 micrograms/ml, ceftriaxone was bacteriostatic for
      four isolates and slowed the multiplication of the other nine. Fusidic acid at a
      concentration of 2 micrograms/ml was bacteriostatic for six isolates and slowed
      the multiplication of three others. These results show that these compounds could
      be effective in the phagolysosome of C. burnetii-infected cells.

PMID- 8460916
TI  - Oral enoxacin for infection prevention in adults with acute nonlymphocytic
      leukemia. The Enoxacin Prophylaxis Study Group.
AB  - A randomized, double-blind, placebo-controlled trial was conducted in eight
      hematologic units to determine the efficacy and safety of oral enoxacin for
      infection prevention in adult patients with acute nonlymphocytic leukemia. One
      hundred nineteen patients undergoing remission induction or consolidation
      chemotherapy were enrolled; 62 of them received enoxacin (400 mg orally every 12
      h). Patients received antifungal prophylaxis with oral mycostatin (1,000,000 U
      four times daily) or clotrimazole (1 troche five times daily). Analysis was
      performed on an intent-to-treat basis. There was no significant difference
      between groups in race, age, or type and stage of leukemia, but there were more
      males in the placebo group (P = 0.073 [Fisher's exact test]). Fewer enoxacin
      patients had gram-negative bacteremia (1 versus 14 [P < 0.001]), gram-negative
      infection at any site (2 versus 19 [P < 0.001]), or bacterial and/or fungal
      infection (17 versus 26 [P = 0.056]). There was no significant difference in the
      number of patients with gram-positive infection at any site (12 versus 16), gram
      positive bacteremia (9 versus 10), deep fungal infection (6 versus 2), death (2
      versus 3), other antimicrobial therapy required (48 versus 48), therapy with
      amphotericin B (15 versus 7 [P = 0.105]), any adverse event (45 versus 36), or
      any study drug-associated adverse events (13 versus 6). Logistic regression
      confirmed (odds ratios and 95% confidence intervals are given in parentheses)
      that enoxacin reduced the risk of gram-negative infection (0.07; 0.01 to 0.30),
      especially gram-negative bacillary bacteremia (0.05; 0.01 to 0.37), without
      altering the risk of gram-positive bacterial (0.63; 0.26 to 1.5), deep fungal
      (2.57; 0.47 to 13.9), or Clostridium difficile (1.16; 0.3 to 4.56) infection. The
      median time to the onset of fever of more than or equal 102.8 F (39.3 degree C)
      was 32 days for the enoxacin group versus 15 days for patients receiving placebo
      (P=0.0007 [Wilcoxon test]). In patients with acute nonlymphocytic leukemia, oral
      enoxacin prevents gram-negative infections, delays the onset of fever, does not
      alter the incidence of gram-positive or proven deep fungal infections, and is
      well tolerated.

PMID- 8460919
TI  - Activity of ampicillin-sulbactam and oxacillin in experimental endocarditis
      caused by beta-lactamase-hyperproducing Staphylococcus aureus.
AB  - Using a rat model of aortic valve infective endocarditis, we previously found
      that oxacillin was equally effective against an oxacillin-susceptible strain of
      Staphylococcus aureus and a beta-lactamase-hyperproducing borderline oxacillin
      susceptible strain of S. aureus; also, ampicillin-sulbactam was less effective
      than oxacillin against both isolates and at low doses was less effective against
      the borderline-susceptible strain than against the fully oxacillin-susceptible
      strain (C. Thauvin-Eliopoulos, L. B. Rice, G. M. Eliopoulos, and R. C.
      Moellering, Jr., Antimicrob. Agents Chemother. 34:728-732, 1990). In the present
      study, we extended this work, using alternative treatment schedules and
      additional bacterial strains. Extending treatment with low doses of ampicillin
      sulbactam (500 and 250 mg/kg of body weight per day, respectively) to 6.5 days
      resulted in equalization of effectiveness against the previously studied strains
      BOSSA-1 and OSSA-1 (3.75 +/- 1.61 log10 and 4.71 +/- 1.79 log10 CFU of residual
      viable bacteria per g, respectively). Against the borderline oxacillin
      susceptible strain BOSSA-1, increasing the sulbactam dosage from 500 to 2,000
      mg/kg/day while maintaining a fixed dose of ampicillin (1,000 mg/kg/day) by
      continuous infusion resulted in lower bacterial counts (4.93 +/- 1.84 log10
      versus 3.65 +/- 1.26 log10 CFU of residual viable bacteria per g, respectively),
      but this difference was of only borderline significance; differences in efficacy
      between the low-dose and high-dose sulbactam regimens were exaggerated when
      intermittent intravenous administration was used (6.19 +/- 1.90 log10 versus 3.37
      +/- 1.41 log10 CFU/g, respectively; P < 0.001). However, for any individual
      sulbactam dosage, the model of administration (continuous versus intermittent
      infusion) did not affect the activity of the regimen. When additional strains
      were used in the model, oxacillin and ampicillin-sulbactam (1,000 plus 2,000
      mg/kg/day) were equally effective against both oxacillin-susceptible and
      borderline oxacillin-resistant strains of S. aureus. These results support the
      predictions that oxacillin would be clinically effective in the treatment of
      infections caused by borderline oxacillin-susceptible strains of S. aureus and
      that, except at very low doses, ampicillin-sulbactam would also be as effective
      against borderline-susceptible strains as against fully oxacillin-susceptible
      strains of S. aureus.

PMID- 8460918
TI  - Pharmacokinetics of intravenous fusidic acid in patients with cholestasis.
AB  - The pharmacokinetics of fusidic acid and 3-ketofusidic acid were investigated in
      cholestatic and noncholestatic patients after intravenous administration of
      single and multiple doses of 500 mg of sodium fusidate. The patients, all with
      low serum albumin levels, were divided into three groups. Group I consisted of
      six noncholestatic patients; group II consisted of nine mildly cholestatic
      patients with mild hepatic impairment (conjugated bilirubin, 47 mumol liter-1;
      alkaline phosphatase, 280 IU liter-1; gamma-glutamyltranspeptidase, 190 IU liter
      1); group III consisted of six benign intrahepatic cholestatic patients with high
      isolated conjugated hyperbilirubinemia (98.1 mumol liter-1). Assays were
      performed by high-pressure liquid chromatography. At steady state, the mean peak
      concentrations in serum were 63.7, 44.9, and 92.2 micrograms ml-1 in groups I,
      II, and III, respectively; over a dosage interval, areas under the concentration
      time curve were 411.1, 238.7, and 603.4 micrograms.h ml-1 and the mean body
      clearances were 0.34, 0.53, and 0.25 ml min kg-1 in groups I, II, and III,
      respectively. The accumulation ratio of fusidic acid increased from 2.8 and 2.4
      in groups I and II to 4.2 in group III. At steady state, the ratios of the areas
      under the concentration-time curve from 0 to 8 h for 3-ketofusidic acid/fusidic
      acid were 0.11, 0.09, and 0.10 in the three groups, respectively. Only very small
      amounts of fusidic acid and 3-ketofusidic acid were found in urine. These results
      substantiate the following hypotheses. In group I and II patients the clearance
      is higher than that in healthy volunteers because of the increased free, unbound
      fraction of fusidic acid, a consequence of lower serum albumin concentrations,
      resulting in increased distribution in tissue and hepatic metabolism. In group
      III patients, the higher bilirubinemia results in competition with fusidic acid
      for the limited glucuronidation, thus compensating for the increased elimination
      with fusidic acid because of the low serum albumin concentration. These results
      suggest that fusidic acid can be administered normally even to patients with high
      bilirubinemia because the postoperative serum albumin concentration is usually
      low.

PMID- 8460920
TI  - Pharmacokinetics and pharmacodynamics of granulocyte-macrophage colony
      stimulating factor and zidovudine in patients with AIDS and severe AIDS-related
      complex.
AB  - Granulocytopenia is a complication of human immunodeficiency virus disease, as
      well as a toxic manifestation of zidovudine therapy. To evaluate pharmacokinetic
      and pharmacodynamic relationships, 11 AIDS-AIDS-related complex patients who had
      developed zidovudine-associated granulocytopenia (mean absolute neutrophil count,
      1,077/mm3) were examined after addition of granulocyte-macrophage colony
      stimulating factor (GM-CSF) to zidovudine. GM-CSF was administered as a daily
      (1.0 or 0.3 micrograms/kg) or every-other-day (0.3 micrograms/kg) subcutaneous
      dose over a 28-day period. Zidovudine was continued at the same daily dosage as
      was previously being administered. Of 11 patients, 7 (1.0 micrograms/kg, n = 5;
      0.3 micrograms/kg, n = 2) had a pharmacologic response to GM-CSF with an increase
      to a mean absolute neutrophil count of 3,189 cells per mm3 at 4 weeks (P < 0.05).
      The peak concentration of GM-CSF in plasma ranged from 11.5 to 84.4 pg/ml, and
      the time to peak ranged from 1 to 3 h. No correlation between GM-CSF disposition
      and hematologic response was noted. A decreased plasma zidovudine
      glucuronide/zidovudine ratio was noted after 1 week of GM-CSF, and an increase in
      the area under the plasma concentration-versus-time curve for zidovudine was
      found in three patients after 4 weeks. Low doses of GM-CSF can raise the
      granulocyte count in patients with zidovudine-induced neutropenia. The use of GM
      CSF and zidovudine may represent a viable treatment option for persons with human
      immunodeficiency virus infection who develop neutropenia while receiving
      zidovudine but do not tolerate alternative nucleoside analogs. Further studies
      are needed to assess the complex interaction between these two agents.

PMID- 8460921
TI  - The fractional maximal effect method: a new way to characterize the effect of
      antibiotic combinations and other nonlinear pharmacodynamic interactions.
AB  - The checkerboard technique leading to the fractional inhibitory concentration
      indexes and the killing curve method are currently the most widely used methods
      to study antibiotic combinations. For both methods, experimental conditions and
      interpretation criteria are somewhat arbitrary. The relevance of the fractional
      inhibitory concentration index computation, in the classic case of additivity [P
      = d1/(D1)p + d2/(D2)p, where d1 and d2 are the doses of drugs 1 and 2 in
      combination to produce an effect at a percent level (P) and (D1)p and (D2)p are
      the doses required for the two respective drugs alone to produce the same effect]
      relies on the assumption of a linear relationship between the MIC and the
      concentration of the test antibiotics. In addition, there is no consensus as to
      the definition of synergy in killing curve interpretation. The fractional maximal
      effect (FME) method is a new approach which was developed to handle the nonlinear
      pharmacodynamics exhibited by antibiotics and other drugs. This method relies on
      the mathematical linearization of the nonlinear concentration-effect scales and
      eventual construction of an isobologram-type data plot. The FME method was
      applied to study interactions between several antibiotic combinations:
      amoxicillin and tetracycline, ciprofloxacin and erythromycin, and ticarcillin and
      tobramycin. These combinations were selected because the pharmacologic basis for
      their interactions has been previously described. The FME method correctly
      identified antagonism for the first two combinations and synergism for the last
      combination. Conclusions were reproducible across the range of concentrations
      studied. Besides providing information on the nature of the interaction, the
      method can rapidly explore the effect of changing concentration ratios of two
      antimicrobial agents on the degrees of interaction. The FME method may be applied
      to interactions between drugs or agents with either a linear or nonlinear
      endpoint measurement. Methods frequently used for drug combination testing are
      also discussed in the paper.

PMID- 8460922
TI  - Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with
      human immunodeficiency virus infection.
AB  - Eleven pediatric patients, aged 1 to 10 years and with symptomatic human
      immunodeficiency virus infection, were treated with 6 or 10 mg of oral ribavirin
      per kg of body weight daily for 60 days. Safety and pharmacokinetic parameters
      were monitored; five children had comprehensive pharmacokinetic evaluations. The
      children tolerated the drug well, and treatment was not associated with any
      clinically significant adverse effects. Peak concentrations in plasma of 2.5 and
      3.0 microM were reached at 90 min after single oral doses of 6 and 10 mg/kg,
      respectively. The mean systemic availability of oral ribavirin was 42.3%. After
      60 days of ribavirin administration, mean trough concentrations in plasma of 2.6
      and 4.1 microM were obtained. Ribavirin penetrated well into the cerebrospinal
      fluid, achieving 70% of the concentration in plasma at steady state.

PMID- 8460923
TI  - Thrombin-induced rabbit platelet microbicidal protein is fungicidal in vitro.
AB  - Platelet microbicidal protein (PMP) is released from platelets in response to
      thrombin stimulation. PMP is known to possess in vitro bactericidal activity
      against Staphylococcus aureus and viridans group streptococci. To determine
      whether PMP is active against other intravascular pathogens, we evaluated its
      potential fungicidal activity against strains of Candida species and Cryptococcus
      neoformans. Anionic resin adsorption and gel electrophoresis confirmed that the
      fungicidal activity of PMP resided in a small (approximately 8.5-kDa), cationic
      protein, identical to previous studies of PMP-induced bacterial killing (M.R.
      Yeaman, S.M. Puentes, D.C. Norman, and A.S. Bayer, Infect. Immun. 60:1202-1209,
      1992). When assayed over a 180-min period in vitro, the susceptibilities of these
      fungi to PMP varied considerably. Generally, Candida albicans strains (mean
      survival, 33.5% +/- 6.9% [n = 6]) as well as isolates of Candida glabrata (mean
      survival, 50.8% +/- 2.9% [n = 2]) were the most susceptible to killing by PMP,
      while Candida guillermondii and Candida parapsilosis were relatively resistant to
      PMP-induced killing. Compared with C. albicans, C. neoformans was relatively
      resistant to the fungicidal activity of PMP, with a mean survival among the
      isolates studied of 77.4% +/- 12.4% (n = 6). Against C. albicans, PMP-induced
      fungicidal activity was time dependent (range, 0 to 180 min), PMP concentration
      dependent (range, 10 to 150 U/ml), and inversely related to the fungal inoculum
      (range, 5 x 10(3) to 1 x 10(5) CFU/ml). Scanning electron microscopy of PMP
      exposed C. albicans and C. neoformans cells revealed extensive surface damage and
      collapse, suggesting that the site of PMP fungicidal action may directly or
      indirectly involve the fungal cell envelope.

PMID- 8460924
TI  - Relative efficacies of broad-spectrum cephalosporins for treatment of methicillin
      susceptible Staphylococcus aureus experimental infective endocarditis.
AB  - The effects of treatment with broad-spectrum parenterally administered
      cephalosporins and cefuroxime, cefazolin, or nafcillin were compared in an
      experimental model of Staphylococcus aureus infective endocarditis, and the
      results in vivo were compared with the activities of the study drugs in vitro.
      After 3 days of treatment, all antimicrobial agents tested were more effective
      than no treatment in reducing the number of surviving bacteria in cardiac valve
      vegetations. Nafcillin was the most effective agent studied and was significantly
      more active than was ceftizoxime, ceftriaxone, cefotaxime, cefoperazone,
      cefuroxime, or cefazolin (P < or = 0.05). Cefpirome and ceftazidime were the most
      effective broad-spectrum cephalosporins. The outcome of treatment with cefpirome
      or ceftazidime was similar to that of treatment with nafcillin and significantly
      better than that of treatment with ceftizoxime or cefotaxime (P < or = 0.05).
      Treatment outcome correlated closely with the MICs of the antimicrobial agents
      for the study strain with the exception of ceftazidime, which was significantly
      more active in vivo in comparison with other agents than predicted by its MIC (P
      < or = 0.0003). When ceftazidime was excluded as an outlier, treatment outcome
      correlated with the MICs of the remaining study drugs (Spearman's correlation
      coefficient, 0.95; P < or = 0.0004), as well as with the estimated percentage of
      time during which the concentration of total drug (correlation coefficient, 
      0.85; P < or = 0.007) or free drug (correlation coefficient, -0.90; P < or =
      0.003) exceeded the MIC. A consideration of total or free drug concentrations in
      relation to MICs did not significantly improve the correlation with outcome
      observed with the MICs alone.

PMID- 8460925
TI  - In vitro activity and beta-lactamase stability of FK-037, a parenteral
      cephalosporin.
AB  - The in vitro activity of FK-037, 5-amino-2-[[(6R, 7R)-7-[[(Z)-2-(2-amino-4
      thiazolyl)-2- methoxyimino) acetyl] amino]-2-carboxy-8-oxo-5-thia-1-
      azabicyclo[4.2.0]oct-2-en-3-yl]methyl]-1-(2-hydroxyethyl)-1H-pyrazoli um
      hydroxide, inner salt, sulfate (1:1), a new parenteral cephem, was compared with
      those of cefepime, ceftazidime, imipenem, and ciprofloxacin. FK-037 inhibited
      methicillin-susceptible staphylocci at < or = 4 micrograms/ml. Of 98 isolates of
      homogenous methicillin-resistant Staphylococcus aureus, 55 (56.1%) were inhibited
      by 8 micrograms of FK-037 per ml, compared to 3.1% for cefepime. Imipenem was the
      most active beta-lactam tested against staphylococci. The MIC of FK-037 for 90%
      of the strains tested (MIC90) was 0.06 micrograms/ml for hemolytic streptococci,
      Streptococcus pneumoniae, viridans group streptococci, and Streptococcus bovis.
      The MIC90 for many of the members of the family Enterobacteriaceae was 1
      microgram/ml, similar to that of cefepime and lower than those of ceftazidime and
      imipenem. The MIC90 for Klebsiella pneumoniae and Enterobacter cloacae was 8
      micrograms/ml, similar to that for cefepime, but all isolates were inhibited by 2
      micrograms of imipenem per ml. K. pneumoniae isolates with cefotaxime and
      ceftazidime MICs of > 32 micrograms/ml with Bush type 2b' beta-lactamases were
      inhibited by 4 micrograms of FK-037 per ml. E. cloacae, Citrobacter freundii, and
      S. aureus stably resistant to FK-037 could be selected by repeated transfer in
      the presence of FK-037. The FK-037 MIC90 for Pseudomonas aeruginosa was 4
      microgram/ml, compared to 32 microgram/ml for cefepime and ceftazidime and 8
      microgram/ml for imipenem. Xanthomonas maltophilia, Pseudomonas cepacia,
      Acinetobacter anitratus, and Bacteroides species were resistant to FK-037 (MIC,
      more than or equal 32 microgram/ml). MBCs were identical to or within twofold of
      the MICs except for a 32-fold greater MBC for P. aeruginosa. Inoculum size and
      acid environment did not lower the activity of FK-037. FK-037 was not appreciably
      hydrolyzed by Bush group 1, 2a, 2b, and 2e beta-lactamases but was hydrolyzed by
      2b' and 2d enzymes at rates comparable to that of ceftazidime. Nonetheless, FK
      037 inhibited bacteria possessing TEM-3, -5, and -7 and SHV -5 at less than or
      equal 8 microgram/ml. Overall, FK-037 has lower MICs against staphylococci and P.
      aeruginosa than the currently available iminomethoxy aminothiazolyl
      cephalosporins and has activity against members of the family Enterobacteriaceae
      comparable to that of cefepime.

PMID- 8460926
TI  - Mevinolin (lovastatin) potentiates the antiproliferative effects of ketoconazole
      and terbinafine against Trypanosoma (Schizotrypanum) cruzi: in vitro and in vivo
      studies.
AB  - We have studied the antiproliferative effects of mevinolin (lovastatin), an
      inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, on the protozoan
      parasite Trypanosoma (Schizotrypanum) cruzi and its ability to potentiate the
      action of specific ergosterol biosynthesis inhibitors, such as ketoconazole and
      terbinafine, both in vitro and in vivo. Against the epimastigote form in vitro,
      mevinolin produced a dose-dependent reduction of the growth rate up to 25 microM,
      but at 50 and 75 microM, complete growth arrest and cell lysis took place after
      144 and 96 h, respectively. A systematic study of the effects of mevinolin
      combined with ketoconazole and terbinafine, which act at different points in the
      ergosterol biosynthesis pathway, on the proliferation of epimastigotes indicated
      a synergic action, as shown by concave isobolograms and fractional inhibitory
      concentration indexes ranging from 0.17 to 0.54. Analysis of the sterol
      composition and de novo sterol synthesis in control and treated cells by thin
      layer and gas-liquid chromatographies showed that the antiproliferative effects
      of the drug alone and in combination were correlated with the depletion of the
      endogenous ergosterol pool and particularly with a critical (exogenous)
      cholesterol/endogenous 4-desmethyl sterol ratio in the cells. When we studied the
      effects of mevinolin on the amastigote form proliferating inside Vero cells in
      vitro, only very modest effects on the parasites were observed up to 0.75 microM;
      above this concentration, significant deleterious effects on the host cells were
      found. However, when the same concentration of the drug was combined with
      ketoconazole, it was able to reduce by a factor of 10 the concentration of the
      azole required to eradicate the parasite (from 10 to 1 nM), again indicating a
      synergic action. On the other hand, a combination of mevinolin and terbinafine
      had only additive effects on amastigotes, but a ternary combination of mevinolin,
      ketoconazole, and terbinafine was again clearly synergistic. In vivo studies with
      a murine model of Chagas' disease showed that mevinolin can also potentiate the
      therapeutic effects of ketoconazole in this system; combined treatment with the
      two drugs at doses that alone offered only limited protection against the
      parasite was able to essentially eliminate circulating parasites and produce
      complete protection against death. These results confirm the synergic action
      against the proliferative stages of T. cruzi both in vitro and in vivo and in
      vivo of combined ergosterol biosynthesis inhibitors that act at different points
      in the pathway and suggest that mevinolin combined with azoles, such as
      ketoconazole, can be used in the treatment of human Chagas' disease.

PMID- 8460927
TI  - In vitro activity of RP59500, an injectable streptogramin antibiotic, against
      vancomycin-resistant gram-positive organisms.
AB  - The in vitro activity of RP59500, a streptogramin antibiotic, against 146
      clinical isolates of vancomycin-resistant gram-positive bacteria was examined.
      Five strains of the species Enterococcus casseliflavus and Enterococcus
      gallinarum, for which the MIC of vancomycin was 8 micrograms/ml, were also
      studied. Twenty-eight vancomycin-susceptible strains of Enterococcus faecalis and
      Enterococcus faecium were included for comparison. The drug was highly active
      against Leuconostoc spp., Lactobacillus spp., and Pediococcus spp. (MICs, < or =
      2 micrograms/ml). RP59500 was more active against vancomycin-susceptible strains
      of E. faecium than E. faecalis (MICs for 90% of the strains [MIC90s], 1.0 versus
      32 micrograms/ml). Vancomycin-resistant strains of E. faecalis were as resistant
      to RP59500 as vancomycin-susceptible strains (MIC90, 32 micrograms/ml), but some
      vancomycin-resistant E. faecium strains were relatively more resistant to the new
      agent (MIC90, 16; MIC range, 0.5 to 32 micrograms/ml) than were vancomycin
      susceptible organisms of this species.

PMID- 8460928
TI  - Efficacy of ampicillin-sulbactam versus that of cefoxitin for treatment of
      Escherichia coli infections in a rat intra-abdominal abscess model.
AB  - We examined the efficacy of ampicillin-sulbactam (2:1) and cefoxitin in the
      treatment of infections caused by Escherichia coli strains exhibiting increasing
      levels of beta-lactamase-mediated resistance to ampicillin-sulbactam in the rat
      intra-abdominal abscess model. Cefoxitin was superior to ampicillin-sulbactam in
      the treatment of infections caused by all strains. Treatment with ampicillin
      sulbactam resulted in a statistically significant decrease in CFU per gram of
      abscess in comparison with treatment with ampicillin alone for both the
      moderately resistant and the resistant strains, with an inverse correlation
      between the MIC and the absolute decrease in CFU per gram of abscess.

PMID- 8460929
TI  - Reproducibility of the microdilution checkerboard method for antibiotic synergy.
AB  - We assessed the reproducibility of the microdilution checkerboard method for
      measuring antibiotic synergy. Five strains of Pseudomonas aeruginosa were tested
      with four antibiotic combinations by using 10 replicates each. Twenty-five
      percent of replicate sets gave discordant classification results (i.e., a 7:3 or
      worse split in categorization). Determination of the individual MICs of each
      antibiotic alone was excellent; all 10 replicates were within 1 twofold dilution
      for 95% of the 80 sets of 10 replicates. The microdilution checkerboard method
      either should not be used or should be used with at least five replicates per
      determination, with > or = 80% agreement among the replicates required for
      classification.

PMID- 8460930
TI  - Cefotaxime breakpoint for Streptococcus pneumoniae.

PMID- 8460931
TI  - Activity of several S-adenosylhomocysteine hydrolase inhibitors against African
      swine fever virus replication in Vero cells.
AB  - Several inhibitors of S-adenosylhomocysteine (AdoHcy) hydrolase have been found
      to selectively suppress the replication of African swine fever virus (ASFV) in
      Vero cells. Of the compounds tested, 3-deazaneplanocin A proved to be the most
      potent and selective inhibitor of ASFV replication. Its selectivity index (SI)
      was 3000. Then followed 9-(trans-2',trans-3'-dihydroxycyclopentyl)-3-
      deazaadenine (SI = 2500), the 4'beta-vinyl derivative of 9-(trans-2',trans-3'
      dihydroxycyclopentyl)adenine (SI = 2000), 6'beta-fluoroaristeromycin (SI = 1250),
      4',5'-unsaturated 5'-fluoroadenosine (MDL 28842) and 9-(trans-2',trans-3'
      dihydroxycyclopentyl)adenine (SI = 667), 9-(trans-2',trans-3'-dihydroxycyclopent
      4'-enyl)adenine and the 4 beta-methyl derivative of 9-(trans-2',trans-3'-
      dihydroxycyclopentyl)adenine (SI = 400), 9-(trans-2',trans-3'-dihydroxycyclopent
      4'-enyl)-3-deazaadenine (SI = 200). We postulate that the mechanism of anti-ASFV
      action of these compounds is based on the inhibition of AdoHcy hydrolase, thus
      resulting in the accumulation of AdoHcy and suppression of methylation reactions
      needed for viral mRNA maturation.

PMID- 8460932
TI  - Characterization of murine Caraparu Bunyavirus liver infection and
      immunomodulator-mediated antiviral protection.
AB  - A rapid, peripheral disease model utilizing the Bunyavirus, Caraparu, was
      established in mice for the evaluation of antiviral therapy with
      immunomodulators. 4-6-week-old B6C3F1 female mice, inoculated intraperitoneally
      with virus, developed coagulative liver necrosis and died between 4-6 days after
      infection. This Caraparu disease model was relatively resistant to treatment with
      immunomodulators, such as ABMP, Ampligen, alpha-interferon (IFN-alpha) or beta
      interferon (IFN-beta). However, a significant increase in median survival time
      (MST) was consistently observed upon treatment with gamma-interferon (IFN-gamma).
      The nucleoside analog--ribavirin--was highly effective against Caraparu virus in
      repeated treatment schedules begun on either day -1, day 0, or day +1 of
      infection. Ribavirin gave little protection when initiation of treatment was
      delayed until day +2. However, combined treatment with IFN-gamma, starting on day
      0 and ribavirin starting on day +2, significantly reduced mortality.

PMID- 8460933
TI  - The importance of light in the anti-HIV effect of hypericin.
AB  - The requirement for light in the anti-HIV-1 activity of hypericin was
      investigated. The hypericin concentration-dependence and light dosage-dependence
      of the reaction were measured. Under conditions in which hypericin caused
      substantial inactivation of HIV-1, there was a strict requirement for visible
      light. Only when the concentration of hypericin approached the cytotoxic level
      was there an apparent light-independent antiviral effect. This strict light
      requirement for the antiviral effect could explain some of the apparently
      discrepant results reported by other workers. Furthermore if hypericin is
      contemplated for use in humans, the importance of light must be considered.

PMID- 8460934
TI  - The physical basis of the genetic code: the choice between speed and precision.

PMID- 8460935
TI  - Differential prenylation of proteins as a function of mevalonate concentration in
      CHO cells.
AB  - The incorporation of [5-3H]mevalonate into prenylated proteins and polyisoprenoid
      lipids has been determined as a function of mevalonate concentration in Chinese
      hamster ovary (CHO) cells that are inhibited in mevalonate synthesis. The
      relative incorporation of mevalonate into the different end products of
      isoprenoid metabolism was markedly dependent upon the concentration of mevalonate
      in the medium. The synthesis of cholesterol was dominant at higher concentrations
      of mevalonate while higher molecular weight isoprenoids were favored at the lower
      concentrations. The relative incorporation of mevalonate into the different
      prenylcysteines of prenylated proteins was dependent upon mevalonate
      concentration with geranylgeranylcysteine being the principal product at higher
      concentrations. At low levels of mevalonate farnesylcysteine synthesis
      predominated and geranylcysteine was detected. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis of proteins from CHO cells that had been
      radiolabeled at different concentrations of [3H]mevalonate had different patterns
      on fluorography with relatively few proteins labeled at low concentrations. A
      study of this effect on the prenylcysteines of a specific protein, Ras, showed
      considerably less sensitivity to mevalonate concentration than bulk protein.
      These results indicate that the specific proteins that are prenylated depend upon
      the availability of the isoprenyl diphosphate substrates.

PMID- 8460936
TI  - Regulation of hepatic lecithin: retinol acyltransferase activity by retinoic
      acid.
AB  - The activity of the hepatic enzyme lecithin: retinol acyltransferase (LRAT),
      thought to catalyze the esterification of retinol for storage, was previously
      shown to vary directly with the vitamin A (retinol) status of the rat [Randolph,
      R. K., and Ross, A. C. (1991) J. Biol. Chem. 266, 16453-16457]. The present
      studies were designed to determine whether liver LRAT activity is regulated in
      vivo by retinoic acid, a principal active metabolite of retinol. LRAT activity
      was negligible in the livers of vitamin A-deficient rats. Following treatment
      with a single 2-micrograms dose of retinoic acid, LRAT activity increased
      significantly while, following treatment with a single 20-micrograms dose, liver
      LRAT activity equalled that of vitamin A-sufficient adult rats. Retinoic acid was
      more effective than an equimolar quantity of retinol in restoring LRAT activity
      in the vitamin A-deficient rat liver. The increase in hepatic LRAT activity after
      administration of retinoic acid occurred rapidly, reaching a maximum within 12-16
      h but declining again after 48-72 h. Studies were conducted in vivo to gain
      insight into the level of regulation of LRAT by retinoic acid. The increase in
      LRAT activity by retinoic acid in the vitamin A-deficient rat was blocked
      completely by both actinomycin D and cycloheximide. The ability of liver to
      esterify retinol in vivo was correlated with the in vitro activity of LRAT after
      retinoic acid induction. We conclude that retinoic acid, an important end product
      of retinol metabolism, regulates a key aspect of hepatic retinol metabolism
      through its regulatory activity on liver LRAT.

PMID- 8460937
TI  - Coordinate induction of the urea cycle enzymes by glucagon and dexamethasone is
      accomplished by three different mechanisms.
AB  - Induction of the mRNAs of the five urea cycle enzymes by glucagon and
      dexamethasone was studied in cultured rat hepatocytes to define mechanisms which
      coordinate the increases in the enzyme activities by these hormones. The
      transcription rate for arginase mRNA increased 9-fold in 7 h, the mRNA level 90
      fold in 28 h, and the arginase activity 1.5-fold at 48 h, suggesting that
      induction is due primarily to stabilization of mRNA. Arginase mRNA induction was
      minimal with either hormone alone, combined hormones were synergistic, and
      cycloheximide pretreatment did not prevent the rise in mRNA levels. Carbamyl
      phosphate synthetase mRNA levels responded synergistically to the combined
      hormones and peaked 240-fold above controls at 24 h although activity only
      increased 1.4-fold at 48 h. Argininosuccinate lyase and synthetase mRNAs were
      induced by an increased transcriptional rate, were not induced by single
      hormones, responded synergistically to combined hormones, and showed a partial
      blockage of mRNA induction by cycloheximide. The ornithine transcarbamylase mRNA
      level was not increased by these hormones although activity increased 1.3-fold,
      suggesting stabilization of the enzyme. Thus glucagon and dexamethasone induce
      the urea cycle enzymes by three different mechanisms: transcriptional control of
      mRNA in argininosuccinate synthetase and lyase, stabilization of mRNA in carbamyl
      phosphate synthetase and arginase, and protein stabilization of ornithine
      transcarbamylase.

PMID- 8460938
TI  - Purification of multiple forms of cytochrome P450 from a human brain and
      reconstitution of catalytic activities.
AB  - The present study demonstrates the presence of multiple forms of cytochrome P450
      (P450) in human brain obtained at autopsy, the purification of various isoforms
      to apparent homogeneity, and the monooxygenase activities in reconstituted
      systems. Sequential chromatography on octylamino-Sepharose 4B, DEAE-Sephacel, and
      DEAE-cellulose yielded four isoforms of P450 (A, B, C, and D) with specific
      contents of 11.0, 9.4, 12.5, and 8.3 nmol of P450/mg protein, respectively. While
      the forms A, B, and C were apparently homogeneous as examined by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis; the P450D was not homogeneous. The
      apparent molecular masses of the four forms of P450 were 60,200 Da (P450A),
      60,900 Da (P450B), 60,200 Da (P450C), and 61,000 Da (P450D), respectively. NADPH
      cytochrome P450 reductase (reductase) was also partially purified from the brain
      microsomes. Immunoblot analysis of the four forms of human purified P450, using
      antisera to purified rat liver P450 (IIB1 + IIB2), rat liver P450 (1A1 + 1A2),
      phenobarbital-inducible rat brain P450, human liver P450 IIE1, P450 1A2, P450
      IIC, and P450 IIIA4, indicated differential immunological cross-reactivity. The
      monooxygenase activities of the purified human brain P450s were demonstrated with
      various substrates (aminopyrine, morphine, aniline, 7-ethoxycoumarin, and
      nifedipine) as examined in reconstituted systems consisting of purified human
      brain P450, purified rat brain NADPH cytochrome P450 reductase, deoxycholate,
      phospholipid, and NADPH.

PMID- 8460939
TI  - Characterization of rat plasma esterase ES-1A concerning its molecular and
      catalytic properties.
AB  - To characterize esterase ES-1A from rat plasma with regard to its molecular and
      catalytic properties, the enzyme was purified. The degree of purification, as
      measured by a densitometric gel scanning assay for ES-1 activity, was about 142
      fold with a recovery of 9%. The ES-1A preparation was free of other plasma
      esterases but not of other plasma proteins. The enzyme shows microheterogeneity
      after staining for esterase activity in gradient polyacrylamide gel
      electrophoresis and isoelectric focusing. The native ES-1A protein is a
      carboxylesterase (EC 3.1.1.1) with a molecular mass of about 59 kDa as determined
      by gel filtration and gradient polyacrylamide gel electrophoresis. ES-1A exhibits
      a pI of 4.73 and optimum pH of 8.6 for p-nitrophenylbutyrate hydrolysis. With
      various p-nitrophenyl esters as substrate for ES-1A, it was found that the
      Michaelis constant decreased with increasing number of C atoms of the unbranched
      fatty acid moiety, whereas the maximum reaction velocity peaked with p
      nitrophenylvalerate. The high degree of similarity of the properties of rat ES-1A
      with those reported earlier for mouse ES-2B, rabbit EST-2F, and human ESB2
      suggests that these four esterases have a common evolutionary origin.

PMID- 8460940
TI  - Secretion of platelet-activating factor acetylhydrolase following phorbol ester
      stimulated differentiation of HL-60 cells.
AB  - Platelet-activating factor (PAF) plays an important role in a number of
      biological processes ranging from inflammation to reproductive biology. We have
      reported that the enzyme that inactivates this potent autacoid, PAF
      acetylhydrolase (PAF-AH), is decreased in maternal plasma during the latter
      stages of pregnancy. This enzyme is associated with the plasma lipoprotein
      fraction and therefore its tissue origin was thought to be the liver. Prescott
      and colleagues (J. Biol. Chem. 265, 17381, 1990) have reported that both a rat
      liver cell line (HepG2 cells) and human peripheral macrophages secrete PAF-AH of
      the plasma type. We have shown previously that the injection of rats with
      dexamethasone or medroxyprogesterone causes an increase and estrogen a decrease
      in the plasma PAF-AH activity. To clarify the mechanism of hormonal regulation of
      PAF-AH production, we employed a monocyte-macrophage model system to investigate
      the secretion of PAF-AH during differentiation. In the present study, we have
      demonstrated that a myelocytic leukemic cell line (HL-60) produces and secretes
      PAF-AH into a defined medium when the cells are differentiated into macrophages
      following stimulation by 12-O-tetradecanoylphorbol-13-acetate (TPA). The medium
      obtained from unstimulated HL-60 cells did not contain detectable amounts of PAF
      AH activity. Stimulation with TPA caused a dose- and time-dependent increase in
      PAF-AH activity in the media. No increase in cell number was observed in the HL
      60 cells during the culture period after the cells were treated with TPA. Cell
      lysis was excluded by the demonstration that the TPA-induced adherent cells
      excluded trypan blue and did not release lactate dehydrogenase activity into the
      medium. The increase in PAF-AH activity was inhibited by actinomycin D and
      cycloheximide. Dexamethasone and medroxyprogesterone markedly increased the
      secretion of PAF-AH by these cells, while estrogen was without effect. Bacterial
      endotoxin (lipopolysaccharide, LPS) inhibited the production of PAF-AH by these
      cells in a dose-dependent manner. The stimulation of PAF-AH secretion during
      differentiation of HL-60 cells and its modulation by LPS and steroid hormones may
      provide a useful model system for studying PAF metabolism during the inflammatory
      response and pregnancy.

PMID- 8460941
TI  - Time-dependent uncoupling between myosin phosphorylation and contractile force
      induced by Ca(2+)-depletion in smooth muscle.
AB  - Phosphorylation of the 20,000-Da myosin light chain is an important regulatory
      mechanism of smooth muscle contraction. In this study, we investigated the
      uncoupling between carbachol-activated myosin phosphorylation and isometric
      stress in Ca(2+)-depleted bovine tracheal smooth muscle at low [Ca2+]. In control
      tissues, lowering extracellular [CaCl2] from 1.6 to 0.1 mM had insignificant
      effects on carbachol-activated steady-state isometric stress and myosin
      phosphorylation. In contrast, in Ca(2+)-depleted tissues, lowering [CaCl2]0 from
      1.6 to 0.1 mM significantly reduced steady-state isometric stress without
      significantly changing steady-state myosin phosphorylation, thus uncoupling
      contractile force from myosin phosphorylation. Time-course data of myosin
      phosphorylation and isometric stress revealed that isometric stress and myosin
      phosphorylation were coupled at the beginning of contractions, but then gradually
      became uncoupled at steady state. We attempted to stabilize the cell membrane and
      contractile filaments using high [Mg2+]. However, 25 mM [MgSO4] further reduced
      steady-state isometric stress development at 0.1 mM [CaCl2]0 without
      significantly changing steady-state myosin phosphorylation. These results
      indicated that Ca(2+)-depletion induced a time-dependent cellular process which
      gradually uncouples contractile force from myosin phosphorylation. Furthermore,
      steady-state isometric stress appeared to be not limited by myosin
      phosphorylation, but sensitive to the [Ca2+]/[Mg2+] ratio near the cell membrane.

PMID- 8460942
TI  - Further biochemical characterization of rabbit reticulocyte eIF-4B.
AB  - In this report, it is shown that eIF-4B exhibits ATP hydrolysis activity in a
      ribosome-dependent fashion. This activity is significantly enhanced by the
      addition of eIF-4A and eIF-4F, although neither of these factors, alone or
      together, display a significant ribosome-dependent ATPase activity. Sepharose-6B
      gel filtration experiments with combinations of nonlabeled and 14C reductively
      methylated initiation factors (eIF-4A, eIF-4B, eIF-4F, and eIF-3) provide
      evidence that both eIF-4B and eIF-4F, but not eIF-4A, interact with ribosomes in
      the presence of specific factors and ATP. It is not known with which ribosomal
      subunit(s) these factors interact. In ultraviolet radiation-induced crosslinking
      studies, an eIF-4A and/or eIF-4F and ATP-dependent crosslinking of eIF-4B to
      radiolabeled oligo(A)12-18 was observed. Past studies with oxidized-cap mRNA
      achieved cross-linking of all three of these factors, driven by the specific
      interaction of eIF-4F p24 with the m7GTP cap structure; this is the first
      reported instance of only eIF-4B cross-linking to RNA.

PMID- 8460943
TI  - Thermodynamic elucidation of structural stability of deuterated biological
      molecules: deuterated phospholipid vesicles in H2O.
AB  - Thermodynamic studies of deuterated phospholipids in H2O were conducted using
      deuterated lipid bilayer vesicles prepared from aqueous dispersions of 1,2
      dimyristoyl-d54-, 1,2-dipalmitoyl-d62-, and 1,2-distearoyl-d70
      phosphatidylcholines. The results obtained in combination with those previously
      reported in D2O made possible the evaluation of deuterium solvent and deuterium
      alkyl-chain substitution effects in deuterated phospholipids. These effects
      included the temperature (delta tm), the enthalpy (delta delta H), the free
      energy (delta delta G), the entropy (delta delta S), and the cooperative melting
      unit (delta n) of the main lipid phase transition from the gel to the liquid
      crystalline phase. To supplement thermodynamic observations, fluorescence steady
      state polarization measurements were also performed. The results were examined to
      elucidate the nature of interactions in deuterated compounds. The deuterium
      solvent effect increases the structural stability of deuterated lipid vesicles,
      due to an enhancement of hydrophobic interaction in D2O. This observation is
      contrary to that previously reported for deuterated proteins, phycocyanins, where
      structural stability is reduced in D2O solvent. These findings therefore support
      the proposal that an alteration in hydrophobic interactions in deuterated
      proteins due to deuterium substitution is not likely to play a significant role
      in contributing to the structural instability of proteins.

PMID- 8460944
TI  - Hydride shifts in the biosynthesis of the p-menthane monoterpenes alpha
      terpinene, gamma-terpinene, and beta-phellandrene.
AB  - The biosynthesis of several monoterpenes from the acyclic precursor geranyl
      pyrophosphate requires the migration of positive charge from the isopropyl side
      chain into the cyclohexenoid ring of the universal alpha-terpinyl cation
      intermediate of the reaction. The hydride shifts responsible for charge migration
      in the formation of three p-menthane olefin isomers were examined in a range of
      plant species: alpha-terpinene in American wormseed, gamma-terpinene in thyme,
      and (-)-beta-phellandrene in lodgepole pine. The experimental approach utilized
      soluble cell-free enzyme systems and specifically labeled geranyl substrates,
      with the determination of the labeling patterns in the resulting cyclic products.
      The results were consistent with stereoelectronic features of the cyclization and
      support the general model for monoterpene formation.

PMID- 8460945
TI  - Structures of mucin-type sugar chains on human erythropoietins purified from
      urine and the culture medium of recombinant Chinese hamster ovary cells.
AB  - Less is known about the mucin-type sugar chains attached to human erythropoietin
      as compared with N-linked sugar chains which structures and function have been
      well studied. In this study, we purified urinary human erythropoietin from three
      independent groups of aplastic anemia patients, and analyzed the structures of
      mucin-type sugar chains as well as that obtained from recombinant human
      erythropoietin produced by Chinese hamster ovary cells. Unlike the N-linked sugar
      chains, the mucin-type sugar chains are totally different between the urinary and
      the recombinant erythropoietins. All of the three independent samples of urinary
      erythropoietin contained oligosaccharides with the structures of +/- Neu5Ac alpha
      2-->6GalNAc, while recombinant human erythropoietin contained those with the
      structures of Neu5Ac alpha 2-->3Gal beta 1-->3(Neu5Ac alpha 2-->6)GalNAc, Neu5Ac
      alpha 2-->3Gal beta 1-->3GalNAc, and Gal beta 1-->3(Neu5Ac alpha 2-->6)GalNAc.

PMID- 8460946
TI  - Modulation of the fumarases of Escherichia coli in response to oxidative stress.
AB  - The [4Fe-4S]-containing fumarases A + B of Escherichia coli are susceptible to
      oxidative inactivation, while fumarase C, which is not an iron-sulfur protein, is
      induced under oxidative conditions. Thus, imposition of oxidative stress, whether
      by addition of paraquat or by mutational deletion of superoxide dismutases,
      diminished fumarases A + B while elevating fumarase C. H2O2 appeared to be one
      cause of the inactivation of fumarases A + B, but was not involved in the
      induction of fumarase C. Thus lack of hydroperoxidases I and II did increase the
      paraquat-elicited inactivation of fumarases A + B without affecting the induction
      of fumarase C by paraquat. The importance of Fe(II) for the unstable fumarases
      was exposed by alpha,alpha'-dipyridyl, which decreased fumarases A + B without
      affecting fumarase C or the inductive effect thereon of paraquat. The oxidative
      inactivation and the subsequent reactivation of fumarase A was examined in
      extracts. Under air there was a first-order inactivation of fumarase A, which was
      rapidly reversed when O2 was excluded. The role of iron loss and restitution, in
      this inactivation and reactivation, was clarified by EDTA, which was without
      effect on the aerobic inactivation, but blocked the anaerobic reactivation. These
      results are consistent with a predominantly ferric state of the available iron in
      the presence of O2 and of the ferrous state in the absence of O2.

PMID- 8460947
TI  - Redox potential and electrostatic effects in competitive inhibition of dual-path
      electron transfer reactions of spinach plastocyanin.
AB  - Redox inactive ions with high positive charges lower the rate constant for
      oxidation of several plant plastocyanins (PC) by small positively charged
      inorganic reaction partners. The rate constant decrease is commonly attributed to
      competitive inhibition where the redox inactive ions are bound to the negatively
      charged remote electron transfer (ET) site of PC and block this site sterically.
      We have investigated the effects of the inhibitor [NH3)5Co(NH2)Co(NH3)5]5+ on the
      ET reactions of spinach PC with [Co(phen)3]3+ (phen = 1,10-phenanthroline) and
      the electrically neutral analogue [Co(phen-SO3)3] (phen-SO3 = 5-sulfonato-1,10
      phenanthroline) at the ionic strengths mu = 0.1 M and 0.03 M. Inhibition of the
      [Co(phen)3]3+ reactions is notably smaller for PC(II) reduction than for PC(I)
      oxidation. This is indicative of a redox potential increase of PC(II)/PC(I) on
      inhibitor attachment. The effect amounts to 16 mV at mu = 0.1 M and 31 mV at mu =
      0.03 M. These data, and analysis in terms of ET theory show that inhibition
      cannot be caused solely by steric blocking. Driving force and interreactant
      electrostatic work terms are equally important. The PC(I)/[Co(phen-SO3)3]
      reaction exhibits a more entangled pattern. The rate constant first increases
      slightly with increasing inhibitor concentration, then drops, and approaches a
      constant value not far from the original value. This pattern is in line with
      association between the negatively charged -SO3- groups of the Co(III) complex
      and the inhibitor, and ET of the associate at both ET sites of PC.

PMID- 8460948
TI  - Oxidative modification of glucose-6-phosphate dehydrogenase from Leuconostoc
      mesenteroides by an iron(II)-citrate complex.
AB  - Incubation of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides
      with Fe2+ and citrate results in rapid O2-dependent inactivation of the enzyme.
      Maximal rate of inactivation occurred at equimolar concentrations of Fe2+ and
      citrate. Loss of enzyme activity appears to be the result of selective oxidative
      modification, as evidenced by a corresponding increase in protein carbonyl
      content. Partially inactivated enzyme remained predominantly in the dimeric form
      with no change in the apparent affinity of the remaining active subunits for
      substrate. Modified Glu-6-PDH was, however, more susceptible to heat
      denaturation. Our results suggest that the Fe(2+)-citrate complex binds to the
      glucose 6-phosphate binding site and then undergoes reaction with H2O2 formed in
      solution leading to the oxidative modification of amino acids essential for
      enzyme activity.

PMID- 8460949
TI  - Purification and characterization of class mu glutathione S-transferase isozymes
      from rabbit hepatic tissue.
AB  - Class mu glutathione S-transferases (GSTs) are important in the detoxication of
      epoxides generated by oxidative metabolism. Phenobarbital, 3-methylcholanthrene,
      and pyridine have failed to enhance the expression of class mu GST isozymes in
      rabbit hepatic tissue (T. Primiano, S. G. Kim, and R. F. Novak, Toxicol. Appl.
      Pharmacol., 113, 64-73, 1992). Two class mu GST isozymes have been isolated from
      rabbit hepatic cytosol and purified to homogeneity using S-hexylglutathione
      agarose, CM-Sepharose, and PBE94 chromatofocusing chromatography. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis and immunoblot analyses showed that
      both isozymes possessed M(r) values of approximately 25,500 and cross-reacted
      with class mu-specific GST IgG. Gel filtration analysis revealed that these
      isozymes were dimers with molecular weights of approximately 45 kDa. The class mu
      GST isozymes had pIs of 7.8 and 7.2 as determined by nonequilibrium pH gel
      electrophoresis. The class mu GST 7.8 and 7.2 isozymes exhibited different
      metabolic activities toward the substrates 1-chloro-2,4-dinitrobenzene,
      bromosulfophthalein, 1,2-epoxy-3-(p-nitrophenoxy)propane, trans-4-phenyl-3-buten
      2-one, p-nitrobenzyl chloride, and 3,4-dichloronitrobenzene. Metabolic activity
      of the two GSTs toward the substrate 1-chloro-2,4-dinitrobenzene was inhibited by
      Cibacron blue, triethyltin bromide, S-hexylglutathione, bromosulfophthalein, and
      indomethacin. The amino acid composition of GST mu 7.8 and 7.2 was determined and
      found to be very similar to those of purified rat class mu GST isozymes. N
      terminal analysis of the first 21 residues of the pI 7.8 class mu GST isozyme
      revealed that it had 71 and 81% sequence identity with the Yb1 and Yb2 subunits,
      respectively. Similarly, N-terminal analysis of the first 21 residues of the pI
      7.2 class mu GST isozyme revealed a 75% sequence identity with either the rat Yb1
      or Yb2 subunit. Examination of class mu GST expression in rabbit hepatic cytosol
      following treatment with a series of known inducers including phenobarbital, 3
      methylcholanthrene, isosafrole, pyrazine, trans-stilbene oxide, butylated
      hydroxyanisole, and tert-butylhydroquinone was accomplished. The data show that
      these agents not only failed to enhance class mu GST expression, but that 3
      methylcholanthrene and isosafrole caused suppression of class mu GSTs. These
      results provide evidence for the existence of two closely related class mu GST
      isozymes in rabbit hepatic tissue and suggest that the molecular mechanisms
      regulating GST expression differ between rat and rabbit in response to these
      xenobiotics.

PMID- 8460950
TI  - Lithium restores glycogen synthesis from glucose in hepatocytes from diabetic
      rats.
AB  - In hepatocytes incubated in the presence of 20 mM glucose, strong stimulation of
      glycogen synthesis by LiCl was observed in cells from both normal and
      streptozotocin-induced diabetic rats. This stimulation was concentration- and
      time-dependent, and it was related to an increase in the glycogen synthase
      activity ratio. No effects of LiCl on glycogen phosphorylase activity were
      detected under these conditions. When hepatocytes were incubated with LiCl and
      insulin together, an additive effect on glycogen synthesis from glucose was
      observed. However, when hepatocytes were incubated in the presence of
      gluconeogenic precursors, such as lactate and pyruvate, and then with LiCl, no
      effect on glycogen accumulation was observed. Under these conditions,
      simultaneous activation of glycogen synthase and glycogen phosphorylase occurred.
      These results indicate that lithium ions, like insulin, are able to stimulate
      glycogen synthesis from glucose in diabetic rat hepatocytes, although the
      mechanisms of action of the two effectors on hepatic glycogen metabolism are
      probably different.

PMID- 8460951
TI  - Homoserine dehydrogenase-I (Escherichia coli): action of monovalent ions on
      catalysis and substrate association-dissociation.
AB  - Changes in the kinetic properties of homoserine dehydrogenase-I (HD-I) from
      Escherichia coli, caused by substitution of Na+ for the normal activating
      monovalent ion, K+, has been investigated by equilibrium isotope exchange
      kinetics (EIEK). HD-I, part of the aspartokinase/homoserine dehydrogenase-I
      complex, is one of the few dehydrogenases to exhibit allosteric feedback
      regulation and cation activation. EIEK methods are especially useful for
      definitively identifying which rate constants are altered by bound modifiers.
      Saturation curves for the [14C]Hse<-->ASA and [3H]NADP+<-->NADPH exchanges were
      compared in the presence of K+ vs Na+, varying different combinations of
      substrate pairs in constant ratio at equilibrium. Kinetic differences between the
      K+ and Na+ enzymes were analyzed systematically by simulations with the ISOBI
      program. This analysis clearly demonstrates that substituting Na+ for K+ shifts
      the kinetic mechanism from preferred order random to a nearly random order
      scheme, along with causing significant rate limitation at catalysis between the
      central complexes. Initial velocity kinetics demonstrate that HD-I has a 10-fold
      higher affinity for Na+ than K+, but that the Na(+)-enzyme is 10-fold less active
      and exhibits higher substrate Km values, especially for L-Hse.

PMID- 8460952
TI  - Subcellular localization of prostaglandin endoperoxide synthase-2 in murine 3T3
      cells.
AB  - Polyclonal antisera specific for prostaglandin endoperoxide (PGH) synthases-1 and
      -2 were used to determine the subcellular locations of each PGH synthase isozyme
      in detergent-permeabilized mouse 3T3 fibroblasts by indirect
      immunocytofluorescence. Antiserum to PGH synthase-1 demonstrated a mottled
      pattern of cytoplasmic and perinuclear staining of both serum-starved and serum
      stimulated 3T3 cells. This pattern of staining is consistent with the results of
      earlier studies which demonstrated that PGH synthase-1 is associated with the
      endoplasmic reticulum and nuclear envelope of these cells. As expected,
      antibodies directed against a peptide unique to PGH synthase-2 failed to stain
      serum-starved cells, which lack appreciable levels of this second form of the
      enzyme. However, serum-stimulated 3T3 cells, which do express PGH synthase-2,
      showed the same pattern of staining with PGH synthase-2 antibodies as was
      observed with anti-PGH synthase-1 serum--mottled cytoplasmic staining and
      perinuclear staining. We conclude that the subcellular location of PGH synthase-2
      is the same as PGH synthase-1 in murine 3T3 cells. Thus, the notable differences
      in the primary amino acid sequence--the signal peptide and the additional 18
      amino acid C-terminal segment in PGH synthase-2--do not cause a change in
      localization. Colocalization of PGH synthases-1 and -2 implies that the source of
      arachidonate substrate, the site of PGH2 and prostanoid formation, and the
      mechanism of product transport from the inside to the outside of the cell are the
      same for these isozymes.

PMID- 8460953
TI  - Bias, ignorance, and gun control: a plea for education.

PMID- 8460954
TI  - A deceptive contrivance.

PMID- 8460955
TI  - Albendazole therapy for giant subarachnoid cysticerci.

PMID- 8460956
TI  - Neuropathological indexes of Alzheimer's disease in demented and nondemented
      persons aged 80 years and older.
AB  - Subjects with clinically diagnosed senile dementia of the Alzheimer type (n = 37)
      and healthy controls (n = 5) were assessed clinically until death. Postmortem
      examination of the brain was performed at age 80 years or older. The brains of
      all of the group with dementia (except one that was found to have a non-Alzheimer
      dementia) had substantial densities of neocortical senile plaques regardless of
      dementia severity; the control brains had very few senile plaques. In those
      subjects with Alzheimer's disease, moderate correlations were found between
      dementia duration and severity (cognitive portion of the Blessed Dementia Scale
      and the Sum of Boxes from the Clinical Dementia Rating) and certain
      neuropathological lesions, both gross and microscopic. Densities of neocortical
      neurofibrillary tangles were related to degree of dementia; densities of
      neocortical senile plaques were unrelated. We conclude that (1) neocortical
      senile plaque densities differentiate very old subjects with Alzheimer's disease
      from nondemented controls, but there is a need for more postmortem studies of
      older persons who are free of dementia; and (2) among the microscopic lesions
      studied, densities of neocortical neurofibrillary tangles were most closely
      related to the degree and duration of dementia.

PMID- 8460957
TI  - Greater abnormalities of brain cerebrospinal fluid volumes in younger than in
      older patients with Alzheimer's disease.
AB  - OBJECTIVE: This study used a semiautomated analysis technique to quantify
      differences in regional brain cerebrospinal fluid volumes observed with computed
      tomography between healthy adults and patients with Alzheimer's disease (AD).
      DESIGN: Cross-sectional, between-subject design, using an age-regression model.
      SETTING: Palo Alto (Calif) Department of Veterans Affairs Medical Center.
      PATIENTS AND OTHER PARTICIPANTS: The 117 patients with probable or definite AD
      were recruited from the Geriatric Psychiatry Research Unit and National Institute
      of Mental Health Clinical Research Center of the Palo Alto Department of Veterans
      Affairs Medical Center. The 114 healthy volunteers were recruited from the local
      community. MAIN OUTCOME MEASURES: Cerebrospinal fluid volumes estimated from
      computed tomographic scans and neuropsychological test scores. RESULTS: The
      computed tomographic estimates of ventricular and sulcal cerebrospinal fluid
      volumes increased significantly in all sampled brain regions in normal aging and
      were vastly larger in AD than in normal aging. Furthermore, younger patients with
      AD had significantly greater cerebrospinal fluid volume enlargement than did
      older patients with AD compared with healthy controls of their age. When the AD
      group was divided on the basis of reported age at symptom onset, patients in the
      early-onset group (onset before age 65 years) were quantitatively more abnormal
      than and showed a different pattern of abnormality from the patients in the late
      onset group. This onset difference was also evident in neuropsychological test
      performance. CONCLUSIONS: This cross-sectional study revealed a number of
      converging findings that suggested greater abnormality in the early-onset than in
      the late-onset group of patients with AD. The possibility remains, however, that
      the two onset groups represent different stages along a continuum of pathologic
      changes.

PMID- 8460958
TI  - Explicit memory in Alzheimer's, Huntington's, and Parkinson's diseases.
AB  - OBJECTIVE--Comparing the pattern of spared and impaired memory functions in
      neurodegenerative diseases known to affect different brain structures. DESIGN-
      Various situations of acquisition (free encoding or controlled encoding) and
      retrieval (immediate and delayed free and cued recall, recognition) were used.
      SETTING--Referral center. PATIENTS--Fifteen for each disease (ie, senile dementia
      of the Alzheimer type [SDAT], Parkinson's and Huntington's), matched for
      education, severity of dementia, and depression. MAIN OUTCOME MEASURES-
      Comparison of free and controlled encoding situations, relationships between
      memory, executive, and linguistic functions test scores. RESULTS--In the free
      encoding situation: no difference among the three groups, but higher numbers of
      intrusions and false recognitions in SDAT. In the controlled situation: cued
      recall and recognition scores significantly higher in Parkinson's disease and
      Huntington's disease than in SDAT. Memory performances correlated with executive
      functions test scores in Huntington's disease and Parkinson's disease, but not in
      SDAT. All results significant at P < .01. CONCLUSIONS--Clear distinction between
      the true amnesic syndrome of SDAT, compatible with lesions of hippocampus and
      temporal cortex, and the inefficient planning of memory processes of Huntington's
      disease and Parkinson's disease, which might result from a striatofrontal
      dysfunction.

PMID- 8460959
TI  - Influence of age on clinical and psychometric assessment of subjects with very
      mild or mild dementia of the Alzheimer type.
AB  - OBJECTIVE: The influence of age on performance on clinical and psychometric
      assessments is examined in groups of nondemented persons and individuals with
      either very mild or mild dementia of the Alzheimer type (DAT). DESIGN: Initial
      clinical and psychometric assessments of persons enrolled in longitudinal studies
      of DAT and nondemented control subjects. SETTING: Alzheimer's Disease Research
      Center at Washington University, St Louis, Mo. PARTICIPANTS: Volunteer samples of
      108 people (44 men, 64 women) with mild DAT, 61 people (30 men, 31 women) with
      very mild DAT, and 122 healthy nondemented people (45 men, 77 women) were
      recruited between 1979 and 1991. Age ranged from 54 to 87 years. Persons with
      confounding medical, neurologic, or psychiatric disorders were excluded. Dementia
      severity was staged using the Clinical Dementia Rating scale. MAIN OUTCOME
      MEASURES: Five brief quantitative clinical tests included in the 90-minute
      clinician administered protocol, as well as 14 tests included in a 2-hour
      psychometric test battery. RESULTS: Dementia severity affected performance on all
      measurements. Age did not influence performance on clinical assessments. There
      was a significant interaction between age and dementia severity on 10 of 14
      psychometric measures. In general, older nondemented individuals performed less
      well than younger nondemented individuals while older mildly demented persons
      performed about the same as, or slightly better than, their younger counterparts.
      CONCLUSIONS: Age does not affect performance on brief clinical assessment
      instruments. However, age affects psychometric performance differently in
      cognitively intact persons when compared with persons with DAT. As a result,
      psychometric differentiation between cognitively normal and demented individuals
      is more difficult in older populations.

PMID- 8460960
TI  - Altered brain energy metabolism in demented patients with multiple subcortical
      ischemic lesions. Working hypotheses.
AB  - We report the results of brain metabolic studies (using magnetic resonance
      spectroscopy) in three groups of individuals: (1) demented patients with multiple
      subcortical ischemic lesions (n = 18); (2) nondemented, age-matched controls (n =
      21); and (3) demented patients with neurodegenerative disease, probably of the
      Alzheimer type (n = 19). Patients with dementia with subcortical vascular
      lesions, as demonstrated by appropriate imaging studies, had an increase of
      phosphate energy charge in areas of the cerebral cortex (especially prominent in
      the frontal regions) superficial to and excluded from the subcortical lesions. We
      hypothesize that this increased energy charge might be caused by reduced
      metabolic activity of disconnected brain tissue or by astrocytic hypertrophy and
      hyperplasia that accompanies subtle ischemic, cortical alterations.

PMID- 8460961
TI  - Hippocampal sclerosis and human memory.
AB  - OBJECTIVE: To study the effects of hippocampal sclerosis on preoperative
      neuropsychological memory tests. DESIGN: Analyses of variance and chi 2 tests
      were used to compare patient groups (divided retrospectively) with a control
      group. SETTING: Hospital epilepsy unit. PATIENTS AND OTHER PARTICIPANTS: All
      patients who underwent a temporal lobectomy for intractable seizure relief during
      the preceding 18 months were included if the following criteria were met: (1) age
      was between 15 and 55 years; (2) IQ was 80 or greater; (3) the left hemisphere
      was dominant for speech; (4) there had been no previous brain surgery; (5)
      sufficient hippocampal tissue had been supplied for pathologic study; and (6)
      there was no hippocampal abnormality other than sclerosis. The 40 patients who
      met all of these criteria were divided into groups based on pathological
      classification (presence or absence of hippocampal sclerosis) and side of
      excision. Ten normal control subjects, matched to the patients based on age and
      education, were also asked to perform the memory tests. All subjects approached
      gave their informed consent to participate in the study. INTERVENTIONS: None.
      MAIN OUTCOME MEASURES: None. RESULTS: No group demonstrated impairments on
      measures of attention or recognition memory. A deficit in learning paired-word
      associates was found for the left hippocampal sclerosis, right hippocampal
      sclerosis, and left no-hippocampal sclerosis groups, but on tests requiring the
      delayed recall of information, only patients with hippocampal sclerosis were
      impaired. For verbal tasks, the delayed recall deficit was limited to patients
      with left-sided sclerosis. CONCLUSIONS: Hippocampal sclerosis impairs the ability
      to learn associations and to retain information over a delay interval. For the
      learning and retention of verbal material, the left hippocampus is more important
      than the right.

PMID- 8460962
TI  - Cranial magnetic resonance imaging in severe preeclampsia vs eclampsia.
AB  - OBJECTIVE: This study was undertaken to evaluate the hypothesis that severe
      preeclampsia and eclampsia are associated with unique cranial magnetic resonance
      images. DESIGN: Case series of women with severe preeclampsia and eclampsia.
      SETTING: Referral center. PATIENTS: Sixteen women with severe preeclampsia and 10
      women with eclampsia. RESULTS: Half of the women with severe preeclampsia had
      abnormal scans with nonspecific foci of increased signal in the deep cerebral
      white matter on T2-weighted images. However, women with eclampsia had either a
      multifocal area of increased signal at the gray-white matter junction on T2
      weighted images or cortical edema and hemorrhage. These findings are consistent
      with necropsy descriptions of cortical edema and petechial hemorrhage. Basal
      ganglion lesions were also common. CONCLUSIONS: These findings appear to be
      unique to eclamptic women and should be considered of diagnostic significance in
      contrast to the nonspecific changes in patients with severe preeclampsia. Cranial
      magnetic resonance imaging may, thus, be of value in cases with diagnostic
      uncertainty, atypical presentation, or focal neurologic deficit.

PMID- 8460963
TI  - Dyslexia, left-handedness, and immune disorders.
AB  - OBJECTIVE: To illuminate a possible three-way association between dyslexia,
      immune disorders, and left-handedness. Geschwind's, Behan's, and Galaburda's
      hypotheses have been of special interest in this connection. DESIGN: Statistical
      analysis based on general assessment of the prevalence of the three
      aforementioned conditions. PARTICIPANTS: There were 734 children included from a
      total of 1165 in grade 6 (about 12 years of age) in the municipality of
      Stavanger, Norway. SETTING: Educational and demographic statistics indicate that
      the municipality of Stavanger is representative of the national population at
      large regarding the three conditions examined. MAIN OUTCOME MEASURES: A screening
      test with high reliability and validity was used to assess reading ability. It
      measured word recognition and phonological decoding. The questionnaires that
      recorded the students' handedness and immune disorders were filled in by the
      parents. Handedness was assessed by a Norwegian version of the Oldfield
      Inventory. A questionnaire concerning allergies and asthma was used to assess the
      prevalence of immune disorders. RESULTS: The bivariate analyses disclosed a
      significant association between handedness and dyslexia and a significant but
      weak association between handedness and immune disorders. No significant
      association was found between dyslexia and immune disorders. A triadic analysis
      yielded the following: 66.7% of the left-handed dyslexic children had immune
      disorders (P > .05); 42.1% of the left-handed children with immune disorders had
      dyslexia (P < .01); and 32% of the dyslexic children with immune disorders were
      left-handed (P < .05). CONCLUSIONS: There seems to be some association between
      dyslexia, left-handedness, and immune disorders. Of the three factors, handedness
      seems to be the most important association. The findings lend some support to the
      one interpretation of the hypotheses of Geschwind, Behan, and Galaburda.

PMID- 8460965
TI  - Sympathetic skin response in patients with cerebellar degeneration.
AB  - Sudomotor function was studied based on sympathetic skin responses (SSRs) in 87
      patients with various types of cerebellar degeneration. Evaluations of
      orthostatic hypotension and the R-R interval variation were also performed in
      these patients. The respective incidences of SSR abnormality and orthostatic
      hypotension were 44 (50.6%) of 87 and 39 (44.8%) of 87. Fourteen percent of the
      patients with abnormal SSRs did not have orthostatic hypotension, but 8% of the
      patients with normal SSRs did have orthostatic hypotension. Sympathetic skin
      responses were abnormal in most patients with Shy-Drager syndrome, sporadic
      olivopontocerebellar atrophy (OPCA), and striatonigral degeneration, whereas SSRs
      were normal in patients with familial OPCA, sporadic cerebellar atrophy, and
      familial cerebellar atrophy. We demonstrated that SSR can be used to evaluate
      sudomotor function in degenerative disorders of the central nervous system as
      well as in peripheral neuropathies. The vasomotor and sudomotor functions usually
      are both disturbed in patients with cerebellar degeneration, and the SSR can
      detect autonomic dysfunction as sensitively as does the head-up tilt test. We
      also concluded that sporadic OPCA differs from familial OPCA in that it has a
      much higher incidence of autonomic dysfunction and that degeneration of the
      cerebellar cortex did not affect the autonomic regulation.

PMID- 8460964
TI  - Immunoglobulin G immunosuppression of multiple sclerosis. Suppression of all
      three major lymphocyte subsets.
AB  - Six patients with relapsing chronic progressive multiple sclerosis were treated
      on 2 consecutive days with large amounts of IgG to induce immunosuppression.
      Peripheral blood lymphocyte subsets were monitored for 5 weeks after IgG
      treatment to determine immunosuppression. Decreased numbers of B, T, and natural
      killer lymphocytes were detected after treatment. Lymphocyte numbers were at a
      nadir 1 week after treatment, but an immunosuppressive effect continued to be
      present after 5 weeks. Although clinical efficacy was not evident in this brief
      open trial, the decrease of peripheral lymphocyte numbers and the apparent safety
      of the procedure warrant further study.

PMID- 8460966
TI  - Opportunistic cerebral vasculopathy and stroke in patients with the acquired
      immunodeficiency syndrome.
AB  - OBJECTIVE: To describe an unusual cause of stroke in patients with the acquired
      immunodeficiency syndrome. DESIGN: An observational case series of hospitalized
      patients with subsequent autopsy. MEASURES: Clinical, radiological, and
      pathological examinations were performed. RESULTS: In three of 14 patients with
      stroke, the infarctions were secondary to an opportunistic vasculopathy caused by
      Candida albicans, cytomegalovirus, or lymphoma. CONCLUSION: Opportunistic
      conditions may lead to vascular abnormalities and subsequent stroke in patients
      with the acquired immunodeficiency syndrome.

PMID- 8460967
TI  - Medical care and case fatality from myocardial infarction and coronary death in
      Newcastle and Perth.
AB  - Coronary mortality rates are significantly higher in Newcastle than Perth. In
      this paper we examine the extent to which this might be due to differences in
      medical treatment and case fatality. Population-based disease registers were used
      to identify all cases of non-fatal definite myocardial infarction (MI) and
      coronary death in people aged 25-64 years in the study populations between July
      1988 and June 1990. Case fatality (at 28 days from onset of symptoms) was not
      significantly different between the centres. Thrombolytic therapy was used for
      one third of all hospitalised events in both centres. Other drugs of proven
      benefit were, however, used more often in Perth than in Newcastle. For example,
      during hospitalisation 74% of patients in Perth received beta-blockers compared
      with 41% in Newcastle (difference = 33%, 95% confidence interval (CI): 28%, 37%)
      and 85% of patients in Perth compared with 72% in Newcastle received aspirin
      (difference = 13%, 95% CI: 9%, 17%). Median lengths of stay in a coronary care
      unit (CCU) and total hospital stay were one day shorter in Perth. As case
      fatality was similar, the differences in mortality rates can be attributed mainly
      to differences in attack rates. Greater use of cardio-active drugs in Perth
      apparently did not result in improved short-term outcome although potential long
      term benefits cannot be judged yet.

PMID- 8460968
TI  - Clinical aspects of malignant mesothelioma in Australia.
AB  - Australia is currently experiencing an epidemic of malignant mesothelioma. The
      clinical aspects of malignant mesothelioma were investigated in 295 Australian
      patients as part of a national study of the disease. Most patients were male
      (91%), with the mean age at diagnosis being 64 years. The predominant cell type
      was epithelial (38%) and the majority of primary tumours arose from the pleura
      (94%). Mean survival was poor (17.6 months from first symptom; 11.8 months from
      diagnosis). Patients with a pleural primary tumour were more likely to present
      with dyspnoea, chest pain and cough; to have a pleural effusion diagnosed
      radiologically; and to have metastatic spread. Patients with a peritoneal primary
      tumour were more likely to present with weight loss, loss of appetite, abdominal
      pain and ascites; to have radiologic evidence of asbestos exposure; and to have
      spread along a needle track created during a diagnostic tap. A minority of
      patients had past thoracic conditions, or radiologic findings, specifically
      related to previous asbestos exposure. About one fifth of patients had no known
      asbestos exposure. Forty-one per cent of subjects received some form of
      chemotherapy, radiotherapy and/or surgery, but no formal disease staging had been
      documented for any patient. Proper controlled trials of secondary and tertiary
      treatments in malignant mesothelioma are now needed.

PMID- 8460969
TI  - Sheehan's syndrome: clinical profile, pituitary hormone responses and computed
      sellar tomography.
AB  - Twenty patients with the typical clinical presentation of Sheehan's syndrome were
      studied. All had a severe degree of hypopituitarism. The circulating mean basal
      levels of thyroid hormones, cortisol and prolactin were significantly lower (p <
      0.05 to < 0.02) compared to those in 50 age matched controls. The provoked
      pituitary responses to combined pituitary stimulation in 13 patients were
      markedly lower (p < 0.02 to < 0.001) than those in ten age matched control
      subjects. Sellar computed tomography revealed an empty sella in all the patients;
      partial in five and complete in the remaining. A secondary empty sella is
      considered a characteristic finding in the classical form of Sheehan's syndrome.

PMID- 8460970
TI  - Ethics and clinical medicine.

PMID- 8460971
TI  - Continuous hepatic artery infusion of 5-fluorouracil for metastatic colorectal
      cancer localised to the liver.
AB  - Continuous regional delivery of chemotherapeutic agents offers the prospect of
      maximising dose intensity at the site of localised disease, while minimising
      systemic toxicity. This prospective phase II study evaluates the efficacy and
      toxicity of hepatic arterial infusion of 5-Fluorouracil (5-FU) via an implantable
      Infusaid pump in previously untreated patients with localised but unresectable
      hepatic metastases from colorectal cancer. In 25 patients the response rate was
      56% and median survival was 15 months, comparable to previous reports utilising
      fluorodeoxyuridine (FUDR). Twenty per cent of patients (all responders) survived
      longer than three years. Systemic toxicity was trivial, and the practice of
      reducing the intensity of therapy when nausea or a rise in alkaline phosphatase
      occurred avoided the previously described local toxicity of biliary sclerosis
      seen frequently with FUDR. In selected patients, particularly those with more
      limited disease, this form of therapy is effective and well tolerated and
      warrants further evaluation as an alternative to FUDR.

PMID- 8460972
TI  - Autosomal dominant polycystic kidney disease (ADPKD)--mechanisms of cyst
      formation and renal failure.
AB  - None of the hypotheses proposed so far to explain cyst formation in autosomal
      dominant polycystic kidney disease (ADPKD) is entirely satisfactory, e.g. the
      theory of tubular obstruction by intraluminal polyps or dilatation of nephron
      segments as a consequence of abnormal compliance of the basement membrane. Recent
      in vitro studies show that (i) synthesis of basement membrane material is
      abnormal and that (ii) the direction of transepithelial resorptive flux into a
      secretory mode is reversed as a consequence of faulty insertion of Na, K-ATP'ase
      into the luminal membrane. It remains unclear why cystic transformation of a few
      percent of nephrons should cause endstage renal failure. Our clinical and
      experimental studies do not provide evidence to support some hypotheses proposed
      in the past, i.e. that renal parenchyma is compressed by expanding cysts and that
      glomeruli are overperfused. Our histological studies show that progression to
      endstage renal failure is associated with (i) progressive arteriolar lesions (out
      of proportion to the vascular lesions seen in extrarenal vascular beds; and (ii)
      progressive interstitial fibrosis. It appears that fibroblasts in ADPKD are
      particularly sensitive to platelet derived growth factor (PDGF) which is secreted
      by epithelial cells of the cyst wall in a paracrine fashion. In contrast to
      previous opinion, which was presumably skewed by ascertainment bias, it appears
      that not all, and perhaps not even a majority, of ADPKD patients progress to
      endstage renal failure. Factors related to progression are gender, family history
      and hypertension. Both abnormal sodium excretion and inappropriate renin
      secretion play a role in the genesis of hypertension. Elevated blood pressure,
      albeit within the normotensive range, is demonstrable even in prepubertal
      children. The involvement of renin in renal vasoconstriction of normotensive
      ADPKD patients suggests a particular role of ACE inhibitors in the management of
      these patients.

PMID- 8460973
TI  - The chronic B-cell leukaemias.

PMID- 8460974
TI  - Absence of amyloid deposition in gastroduodenal mucosa of uraemic patients
      undergoing dialysis treatment.

PMID- 8460975
TI  - Silent myocardial ischaemia is uncommon after uncomplicated acute myocardial
      infarction.

PMID- 8460976
TI  - Failure to detect measles virus sequences in lymphocytes of patients with
      multiple sclerosis.

PMID- 8460977
TI  - Caution in using wages to assess community savings.

PMID- 8460978
TI  - Tubulo-interstitial nephritis and uveitis (TINU) syndrome in an adult.

PMID- 8460979
TI  - The Arthur E. Mills oration--the right to live and the right to die.

PMID- 8460980
TI  - Culture-positive tuberculosis at St Vincent's Hospital, Melbourne, 1962-1989.
AB  - The disease type and demography of patients with culture confirmed tuberculosis
      (TB) diagnosed at St Vincent's Hospital, Melbourne between the years 1962 to 1989
      were reviewed. Four hundred and eighty-two patients with culture-positive TB were
      identified whose origins were as follows: Australia 194; Northern Europe 38; The
      Mediterranean 98; Asia 60 and other or unknown 92. Patients whose country of
      birth was in Asia or the Mediterranean area accounted for 57% of patients in the
      1980s; they presented at a younger age, with a higher proportion of
      extrapulmonary disease and a more equal sex distribution than did Australian born
      patients. The main types of extrapulmonary disease also differed for the various
      ethnic groups. The overall proportion of patients with an isolate resistant to at
      least one of the anti-TB drugs was 10.0% but in the Asian born was 21.7%. This
      survey, the longest series of bacteriologically confirmed cases of TB reported
      from a single institution in Australasia, has identified several changes in how
      TB is presenting for diagnosis.

PMID- 8460981
TI  - A survey of the efficacy of sustained-release monensin capsules in the control of
      bloat in dairy cattle.
AB  - Thirty-four farms in the Macalister Irrigation District in Gippsland, Victoria,
      using sustained-release monensin capsules in 5102 cattle in the 1990 bloat season
      were surveyed. Questions were asked about the prevention and incidence of bloat
      in 1989 and 1990. Eight farms not using the capsules were selected to act as
      controls. Relatively low rates of broken capsules (0.6%), injury to animals at
      administration (0.06%) and regurgitation (1.02%) were reported. A variety of
      preventive techniques were used. There was a significant decrease in the use of
      pasture spraying, drinking water administration and flank spraying of anti-bloat
      substances on the farms using the capsules in the 1990 season, with no
      compensatory rise in the use of other techniques. There was no significant change
      in bloat prevention techniques used on the control farms over the same period.
      Significantly fewer cattle on the farms using capsules were treated for, and
      fewer died of clinical bloat in 1990 than in 1989. There was no significant
      change in the incidence of bloat on the control farms over the same period. It
      was considered that the anti-bloat capsules were effective in reducing the
      incidence of clinical bloat in pasture-fed dairy cattle.

PMID- 8460982
TI  - Relationship between milk production and somatic cell count in dairy cows in East
      Gippsland.
AB  - The analysis of records for 75,821 herd tests on 23,700 cows in the Macalister
      Irrigation District of East Gippsland, using a model that also included stage of
      lactation, herd and cow effects, found a strong relationship between somatic cell
      count and milk production. Unit increases in the natural logarithm of the somatic
      cell count were associated with decreases in production of up to 2.6% in the
      range 54,598 to 403,429 cells per mL. This is equivalent to a decrease of 1.9%
      for a doubling of cell count from 100,000 to 200,000 cells per mL. Subclinical
      mastitis was assessed to be a significant source of loss in milk production in
      the study area.

PMID- 8460983
TI  - Experiences with a vaccine being developed for the control of swine dysentery.
AB  - A prototype vaccine that is being developed for the control of swine dysentery
      (SD) was tested in two groups of experimental pigs. Vaccination induced high
      circulating antibody titres against the aetiological agent, Serpulina (Treponema)
      hyodysenteriae. Pigs in the first trial were vaccinated twice before being
      challenged orally with the bacteria. Five of 6 unvaccinated animals developed
      dysentery within a fortnight of challenge, but only 1 of 6 vaccinated pigs showed
      signs of disease at this time. Unexpectedly, 1 mo after challenge, the surviving
      unvaccinated pig and 2 remaining healthy vaccinated animals succumbed to the
      disease. The reason for the development of this late-onset form of dysentery was
      not clear. In the second trial, 8 pigs were vaccinated 3 times. Only 2 of these
      animals (25%) developed severe dysentery after being mixed with infected pigs,
      whereas 7 of 8 (88%) unvaccinated control pigs in the same pen became diseased.
      The late-onset form of dysentery was not observed. The prototype vaccine for SD
      provided a useful level of protection, and could be used in programs to control
      the disease in Australia.

PMID- 8460984
TI  - A survey for mycoplasmas in bulk-tank milk of dairy herds in Western Australia.

PMID- 8460985
TI  - Detection of Libyostrongylus douglassi in ostriches in Australia.

PMID- 8460986
TI  - A case of giardiasis in a dog in Tasmania--a cause of disease or incidental
      finding?

PMID- 8460987
TI  - An attempt to prevent acute toxoplasmosis in macropods by vaccination with
      Hammondia hammondi.

PMID- 8460988
TI  - Assessment of tetracycline and Babesia culture supernatant as prophylactics for
      moderating reactions in cattle to live Babesia and Anaplasma vaccines.

PMID- 8460989
TI  - Strains of parasites.

PMID- 8460990
TI  - Pathology of experimentally-induced, acute toxoplasmosis in macropods.
AB  - Thirteen Tammar wallabies (Macropus eugenii) were dosed orally with 500, 1000 or
      10,000 oocysts of Toxoplasma gondii, as part of a vaccination trial. Eleven
      animals died of acute toxoplasmosis 9 to 15 days after challenge. The lesions
      were similar in all animals, consisting of foci of necrosis and inflammation in
      the intestines, lymphoid tissue, adrenal cortex, heart, skeletal muscle and
      brain, and severe generalised pulmonary congestion and oedema. Free and
      intracellular tachyzoites of Toxoplasma were associated with the lesions. The
      remaining 2 animals had shown no signs of disease when euthanased four months
      after challenge. Small, focal, non-suppurative inflammatory lesions were seen in
      brain, heart and skeletal muscle of these animals and chronic Toxoplasma
      infection was confirmed by mouse inoculation.

PMID- 8460991
TI  - Benign footrot--an epidemiological investigation into the occurrence, effects on
      production, response to treatment and influence of environmental factors.
AB  - Benign footrot was studied in 1 1/2-years-old Merinos on 2 farms in central
      Victoria from September 1987 to August 1990, inclusive. Treatment groups of 100
      sheep grazed together with the remaining untreated sheep. Inspections were
      carried out every 3 weeks during the spring transmission period until the number
      of lesions greater than score 2 dropped below 3%. At each inspection, each sheep
      was weighed and lesion scores for each foot and digit were recorded, the treated
      group of sheep was treated by standing in 20% (w/v) zinc sulphate-sodium lauryl
      sulphate for 1 hour, and bacteriological samples were randomly collected from 5
      sheep with and 5 without lesions. Dichelobacter nodosus organisms were obtained
      from sheep in both groups. Laboratory tests indicated benign organisms in flock A
      and low virulence, intermediate organisms in flock B. During the first 2 years,
      the number and severity of lesions were greater in flock A than in flock B.
      However, in the third year, with an early 'autumn break', there was a rapid and
      severe outbreak of footrot in flock B; 98% of the flock had lesions at the first
      inspection in July 1989. Flock A had a less dramatic increase in lesions of
      footrot. Both treated and untreated groups in flock B recovered rapidly between
      the third and fourth inspections. A later increase in lesions for both flocks
      coincided with damage caused by barely grass seeds. During this period there was
      a significant difference (P < 0.001) in body weight between the treated and
      untreated sheep on farm B.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8460992
TI  - The recombinant catalytic domain of human neutrophil collagenase lacks type I
      collagen substrate specificity.
AB  - The coding region for human neutrophil short form procollagenase lacking the
      hemopexin like domain coding region was amplified by polymerase chain reaction.
      Recombinant short form procollagenase was expressed in E. coli and purified in a
      three step procedure. Renaturation of this proenzyme was carried out by an
      effective new method using Q-Sepharose chromatography. Treatment of short form
      procollagenase with mercurials resulted in active short form collagenase M(r)
      21,000 and an intermediate product of M(r) 23,000. These two products were
      separated by hydroxamate affinity chromatography. The active, short form
      collagenase M(r) 21,000 is stable. Despite full proteolytic activity, it lacks
      type I collagen substrate specificity and forms the basis for crystallisation
      experiments.

PMID- 8460993
TI  - Cloning and sequencing of a cDNA coding for bovine conglutinin.
AB  - A 912 bp bovine cDNA fragment encoding bovine conglutinin was amplified by the RT
      PCR technique. cDNA clones encoding the bovine conglutinin were isolated from a
      bovine liver cDNA library using a specific probe obtained from the PCR product.
      These cDNAs carry an insert of 1113 bp coding for a protein of 371 amino acid
      residues with a signal peptide of 20 residues. The deduced amino acid sequence of
      cDNA agrees with that determined by conventional amino acid sequence analysis.
      Two polyadenylation signal sequences were detected in the DNA sequence downstream
      of the 3' end of the gene. Southern blot analysis of total bovine genomic DNA
      indicated that there is only one copy of the gene encoding bovine conglutinin.
      Northern blot analysis of bovine tissues showed that conglutinin mRNA of about
      1.5 kb is expressed in the liver and also slightly in the lung.

PMID- 8460994
TI  - ATP induces an intracellular calcium pulse in osteoclasts.
AB  - Adenosine triphosphate (ATP; 50 microM) induces a large, fast, transient increase
      in intracellular calcium ([Ca2+]i) in rabbit osteoclasts, as measured with fluo-3
      on a confocal laser scanning system. The [Ca2+]i increase is most intense in the
      nuclei of these multinuclear cells, indicating that Ca2+ release is occurring
      just outside the nuclei. ATP produces a much larger effect than adenosine,
      indicating that these cells have P2 purinergic receptors. Ca(2+)-free bathing
      medium and the Ca2+ channel blocker Cd2+ both inhibit but do not block the
      effect, showing that internal Ca2+ release is involved, but that either the
      steady state Ca2+ influx or a change in influx is important in modulating the
      effect. Thapsigargin also inhibits the effect. The ATP effect is repeatable with
      no change in bathing medium, implying that this signalling pathway has a
      mechanism for adaptation to progressively higher levels of ATP.

PMID- 8460995
TI  - Structural studies on synthetic peptides from the principal neutralizing domain
      of HIV-1 gp120 that bind to CD4 and enhance HIV-1 infection.
AB  - In previous studies we have demonstrated that synthetic peptides, corresponding
      to sequences in the (307-330) region of the gp120 principal neutralizing domain
      of different HIV-1 isolates are specifically recognized by a site distinct from
      the high affinity gp120-binding site of CD4. Interestingly, a peptide designed
      from the HIV-1 MN strain is able to enhance viral infection, while a HTLV-IIIB
      derived analogue is at least ten-fold less efficient and no effect is shown by
      other tested peptides. This enhancing effect occurs in the early step of
      infection and it is not strain restricted. A correlation between structure and
      biological functions evidenced by CD, FT-IR, and preliminary mono and
      bidimensional NMR is presented in this paper. The experimental data are compared
      to the predictions obtained by theoretical calculations.

PMID- 8460996
TI  - Constitutive expression and production of tumor necrosis factor-beta in T-cell
      lines infected with HTLV-I and HTLV-II.
AB  - A highly sensitive enzyme-linked immunoassay was developed to detect soluble
      levels of TNF-beta. Analysis of TNF-beta in culture supernatants from long-term T
      cell lines infected with human T-cell lymphotropic virus (HTLV) types I and II
      demonstrated elevated levels of TNF-beta when compared with uninfected T-cell
      lines. Presence of interleukin-2 in the culture medium showed a synergistic
      effect upon TNF-beta production. Further, constitutive expression of TNF-beta
      mRNA was observed in most cell lines infected with HTLV-I or HTLV-II. These
      results demonstrate that infections with HTLV-I/II can alter production of TNF
      beta, presumably via the transactivation of TNF-beta promoter by the tax protein
      of HTLV-I and HTLV-II.

PMID- 8460997
TI  - Biphasic effect of extracellular ATP on the membrane potential of mouse
      thymocytes.
AB  - Extracellular ATP induced changes in the membrane potential of thymocytes from
      BALB/c mice were analyzed. At concentrations below 0.1 mM, ATP hyperpolarizes the
      cell membrane on the time scale of development of the Ca(2+)-signal. After a
      longer time hyperpolarization turns to depolarization. ATP concentrations higher
      than 0.5 mM caused rapid depolarization without previous hyperpolarization.
      Verapamil, quinine or the absence of extracellular Ca2+ blocked the
      hyperpolarization by ATP. In Na(+)-free medium the magnitude of depolarization
      decreased. Our data suggest a contribution of Ca(2+)-activated K+ channels to the
      hyperpolarizing effect of ATP at lower concentrations. The direction of membrane
      potential changes is determined presumably by a sensitive balance of ATP-receptor
      mediated Ca(2+)- and Na(+)-influx and the Ca(2+)-activated K(+)-channel activity.

PMID- 8460998
TI  - P2 purinergic agonists and 12-O-tetradecanoylphorbol-13-acetate, as well as
      protein kinase A activators, stimulate thyroglobulin secretion in FRTL-5 cells.
AB  - We studied the role of various intracellular pathways in thyroglobulin secretion.
      The P2 agonists (ATP, ADP, GTP), 12-O-tetradecanoylphorbol-13-acetate (TPA), and
      protein kinase A activators stimulate thyroglobulin secretion in cells grown
      without TSH. The effects of these agents are additive. Pertussis toxin partially
      inhibits the effect of ATP but has no effect on the action of GTP. ATP and GTP
      increase cytosolic calcium (279 +/- 16% and 302 +/- 22%, respectively) while TPA
      and TSH (1 mU/ml) do not. Thus, both the protein kinase A and kinase C pathways
      regulate thyroglobulin secretion in FRTL-5 cells.

PMID- 8460999
TI  - Secretory form of Alzheimer amyloid precursor protein 695 in human brain lacks
      beta/A4 amyloid immunoreactivity.
AB  - It is not clear how Alzheimer amyloid precursor proteins (APP) are metabolized in
      the brain itself. Secretory forms of APP in a phosphate buffer-soluble fraction
      were purified from post-mortem human brain by heparin-affinity and ion-exchange
      chromatography and analyzed by N-terminal amino acid sequencing and SDS
      polyacrylamide gel electrophoresis/immunoblotting. We found apparently similar
      multi-isoforms of secretory APP (at 93-97, 105-112 and 123 KDa) to those that we
      have described recently in cerebrospinal fluid. Antisera to the initial part of
      the beta/A4 sequence labelled only those bands that were found to react with
      antiserum to the Kunitz-type inhibitor insert of APP, suggesting that beta/A4
      amyloid may be generated specifically from APP-695.

PMID- 8461000
TI  - Expression of GLUT4 glucose transporter mRNA and protein in skeletal muscle and
      adipose tissue from rats in late pregnancy.
AB  - We investigated the influence of pregnancy on the expression of insulin-regulated
      glucose transporter (GLUT4) mRNA and protein in skeletal muscle and adipose
      tissue. GLUT4 mRNA expression in quadriceps muscle from control and pregnant rats
      was similar in the fasted and fed states. When the level of expression was
      determined as the immunoreactive GLUT4 content per gram of tissue, the relative
      GLUT4 protein content of red quadriceps from pregnant rats was significantly
      higher than that for control rats in both the fed and fasted states. GLUT4
      protein expression in white quadriceps from pregnant rats was significantly
      increased in the fed state compared to control rats, but there was no significant
      difference in the fasted state. In adipose tissue, the relative GLUT4 protein
      content was significantly lower in pregnant rats than control rats in the fasted
      state, but there was no significant decrease in the fed state. Although the
      expression of GLUT4 protein showed these variations in late pregnancy, there was
      no significant difference of GLUT4 mRNA expression between control and pregnant
      rats. These findings suggest that GLUT4 kinetics may differ between late
      pregnancy and the normal state, and these changes may be related to insulin
      resistance in pregnancy.

PMID- 8461001
TI  - Purification and characterization of reversible sperm motility inhibitors from
      porcine seminal plasma.
AB  - Two sperm motility inhibitors (SMI1 and SMI2) were purified from porcine seminal
      plasma with high performance liquid chromatography (HPLC). Their molecular
      weights are about 15,000 as estimated by SDS-polyacrylamide gel electrophoresis
      (SDS-PAGE). Both of them decreased the percentage of motile spermatozoa in a dose
      dependent manner. The inhibitory effect can be abolished by addition of the
      porcine follicular fluid. Both SMI1 and SMI2 have similar amino acid composition,
      suggesting that they may be structurally related. They also have inhibitory
      effect on chymotrypsin.

PMID- 8461003
TI  - A novel method for glass micropipette polishing for electropatch clamp recording
      using oxygen plasma.
AB  - We have applied discharge plasma to the polishing of micropipettes for patch
      clamp experiments instead of the conventional heat-polishing method. Using the
      micropipettes given the treatment with O2 plasma, we succeeded in the formation
      of giga-seals on human Jurkat cells with 70% of trials. Ellipsometrical
      measurement of the effect of O2 plasma to etch thin films of SiO2 suggested that
      O2 plasma has virtually no effect on the etching of glass surface. Multiple
      advantages of this novel method for polishing are noted relative to the
      conventional method. In particular, this method makes the micropipette polishing
      remarkably convenient. The polishing effect of O2 plasma on micropipettes without
      effect on the physical etching provides a novel insight into the mechanism of
      polishing.

PMID- 8461002
TI  - Role of nitric oxide pathway in the protection against lethal endotoxemia
      afforded by low doses of lipopolysaccharide.
AB  - Survival after lipopolysaccharide challenge (LD80, 20 mg.kg-1, i.p.) was
      significantly enhanced by previous treatment with a microdose of LPS (50
      micrograms.kg-1, i.v.). When NG-monomethyl-L-arginine, a specific inhibitor of
      the formation of nitric oxide from L-arginine, was given 30 minutes before
      microdose, survival was significantly reduced. When we monitored the serum Tumor
      Necrosis Factor (TNF) levels in both groups a significant reduction of TNF level
      after the microdose was observed in mice previously treated with L-NMMA. The
      ability of L-NNMA to reduce TNF release was dose dependent.

PMID- 8461004
TI  - Functionally distinct endothelin B receptors in vascular endothelium and smooth
      muscle.
AB  - IRL 1620 (Suc-[Glu9,Ala11,15]-ET-1 (8-21)) (0.1 nM - 1 microM), a novel ETB
      selective endothelin (ET) agonist, produced endothelium-dependent relaxations in
      precontracted rabbit mesenteric artery (2 nM, EC50) and endothelium-independent
      contractions in porcine coronary artery (18 nM, EC50). ET-3 (0.1 nM-10 nM)
      produced qualitatively similar responses in the two tissues. The maximal
      contractions induced by IRL 1620 or ET-3 were substantially smaller (< 20%) than
      that produced by ET-1. BQ-123 (1 microM), an ETA receptor antagonist, inhibited
      responses to ET-1 without affecting IRL 1620- or ET-3-induced responses in either
      tissue. Thus functionally distinct ETB receptors mediating vasodilator and
      vasoconstrictor effects are located on the vascular endothelium and smooth
      muscle, respectively. The overall effect of ETB receptor activation on vascular
      tone is tissue-specific and presumably reflects differing receptor distribution
      at the two sites.

PMID- 8461005
TI  - Protein kinase C-alpha but not protein kinase C-epsilon is differentially down
      regulated by bryostatin 1 and tetradecanoyl phorbol 13-acetate in SH-SY5Y human
      neuroblastoma cells.
AB  - SH-SY5Y human neuroblastoma cells can be induced to differentiate by phorbol
      esters but not by bryostatins although both agents increase protein kinase C
      (PKC) activity in these cells to a similar extent. We examined whether this
      difference could be explained by differences in the responses of specific PKC
      isoenzymes. Both TPA and bryostatin 1 at 10 nM induced a rapid increase in
      membrane-associated PKC-alpha immunoreactivity which was sustained for 72 hours
      in TPA-treated cells, but was down-regulated within 24 hours in bryostatin
      treated cells. TPA likewise induced a sustained phosphorylation of an 80 kDa PKC
      substrate whereas in bryostatin-treated cells the 80 kDa substrate was rapidly
      phosphorylated reaching a maximum at 6 hours followed by a decline to basal level
      within 48 hours. A higher concentration of TPA (300 nM), which results in a less
      differentiated phenotype, induced down-regulation of PKC-alpha within 24 hours.
      In contrast, both TPA and bryostatin 1 stimulated translocation and a partial
      down-regulation of PKC-epsilon with similar kinetics. These results suggest that
      the divergent actions of bryostatin 1 and TPA in SH-SY5Y cells are at least
      partially due to differential modulation of PKC-alpha but not PKC-epsilon by
      these two agents.

PMID- 8461006
TI  - Estrogen stimulates the elaboration of cell/matrix surface-associated inhibitory
      factor of osteoclastic bone resorption from osteoblastic cells.
AB  - Osteoblast-like UMR106 cells secreted bone resorption-stimulating activity (BRSA)
      under stimulation by human parathyroid hormone 1-34. Most of BRSA was associated
      with cell/matrix surface and could be extracted by 2 M NaCl. Pretreatment with 17
      beta-estradiol (E2) reduced BRSA by enhancing the elaboration of an inhibitory
      factor of BRSA in a dose-dependent manner, and 10(-9) M 17 beta-E2 showed a
      significant effect. Neither 17 alpha-E2 nor dihydrotestosterone showed a similar
      effect. The inhibitory factor of BRSA was also bound to cell/matrix surface,
      showed affinity for heparin, and was trypsin- and heat-sensitive. Furthermore,
      this factor could also inhibit resorption pit formation stimulated by 1,25
      dihydroxyvitamin D3, interleukin (IL)-1 alpha and IL-6. Elaboration of such an
      inhibitory factor of bone resorption from osteoblasts may play an important role
      in the protective effect of estrogen against bone resorption.

PMID- 8461007
TI  - NO- and NO2-carrying molecules potentiate photorelaxation in rat trachea and
      aorta.
AB  - Photorelaxation elicited by ultraviolet light (366 nm) was investigated on
      isolated rat thoracic aorta and trachealis. Rat tracheal smooth muscle but not
      aorta did not show UV-induced photorelaxation. Both streptozotocin, NO-carrying
      molecule and N omega-nitro-L-arginine, NO2-carrying molecule significantly
      enhanced photorelaxation, concentration-dependently, in rat trachealis and aorta.
      Methylene blue (10 microM) inhibited the potentiation action of streptozotocin
      and N omega-nitro-L-arginine in both tissues. Superoxide dismutase (300 U/ml)
      enhanced streptozotocin- and N omega-nitro-L-arginine-potentiated photorelaxation
      in rat trachealis, while pyrogallol (0.1 mM), a potent O2- generating agent,
      inhibited streptozotocin-potentiated photorelaxation in trachealis.
      Streptozotocin was much more effective than N omega-nitro-L-Arginine in
      potentiating of photorelaxation elicited by UV light in both tissues. From these
      findings, we conclude that streptozotocin and N omega-nitro-L-arginine produce
      EDRF like labile substance(s) by UV irradiation.

PMID- 8461008
TI  - Interleukin 1 beta regulates glycogen metabolism in primary cultured rat
      hepatocytes.
AB  - We examined the effects of human recombinant IL-1 beta on glycogen metabolism in
      cultured rat hepatocytes. When IL-1 beta was present at 8 nM in the culture
      medium for 15 hours prior to cell harvest, glycogen storage in hepatocytes was
      lowered approximately by 60% of the control. The enzymatic activity of glycogen
      synthase I in the IL-1 beta-treated cells (8 nM) was decreased by 70%; however,
      the activity ratio of the synthases I to D was not different from the untreated.
      In addition, the activity of glycogen phosphorylase a, the active form of
      phosphorylase involved in glycogenolysis, was increased by approximately 27%
      while the total phosphorylase activity was not changed. The data demonstrate for
      the first time that IL-1 beta lowers the intracellular glycogen contents in
      primary cultured rat hepatocytes.

PMID- 8461009
TI  - Cloning and sequencing of cDNA encoding mouse GTP cyclohydrolase I.
AB  - A full-length cDNA clone for GTP cyclohydrolase I (EC 3.5.4.16) was isolated from
      a mouse brain cDNA library by plaque hybridization. The nucleotide sequence
      determination revealed that the length of the cDNA insert was 994 base pairs. The
      coding region encoded a protein of 241 amino acid residues with a calculated
      molecular mass of 27,014 daltons. The deduced amino acid sequence of mouse GTP
      cyclohydrolase I was found to be highly homologous to rat (96%) and human type 1
      (89%) enzymes.

PMID- 8461010
TI  - Hepatocyte growth factor induces mitogenic reaction to the rabbit gastric
      epithelial cells in primary culture.
AB  - Hepatocyte Growth Factor (HGF) was originally identified as hepatotrophic factor
      for liver regeneration. More recently, HGF was revealed to stimulate
      proliferation of various epithelial cells. At present study, we have investigated
      the mitogenic effect of HGF on gastric epithelial cells in the primary culture
      system. HGF remarkably stimulated proliferation of these cells dose dependently
      and synergistically with EGF and insulin. Mitogenic action of HGF might be
      mediated not by intracellular Ca2+ but by tyrosine kinase pathway. Conditioned
      medium of cultured fibroblast-like cells showed proliferative effects on cultured
      gastric epithelial cells in a similar way as exogenous HGF. These results suggest
      that HGF might be involved in the repair process of gastric mucosa.

PMID- 8461011
TI  - Human monocyte chemotactic protein-3 (MCP-3): molecular cloning of the cDNA and
      comparison with other chemokines.
AB  - When human MG-63 osteosarcoma cells are triggered with IL-1 beta, they produce,
      among various other cytokines, also monocyte chemotactic proteins (MCPs).
      Homogeneous MCP-1, MCP-2 and MCP-3 were found to induce production of gelatinase
      B and chemotaxis of monocytes. Based on the almost complete amino acid sequence
      of natural MCP-3, two sets of degenerated oligonucleotides were used for the
      amplification of MCP-3 cDNA. Total RNA from stimulated MG-63 cells was reverse
      transcribed and PCRs done on the mRNA:cDNA duplex. Using the PCR-product, several
      cDNAs were isolated from a cDNA library of IL-1-stimulated MG-63 cells. From the
      cDNA sequence the complete primary structure of the protein was deduced: MCP-3
      shows 71% and 58% amino acid homology with MCP-1 and MCP-2, respectively. Our
      study establishes MCP-3 as an inflammatory cytokine that regulates macrophage
      functions. Because MCP-3 is often produced by tumor cell lines and regulates
      protease secretion by macrophages, its production might also contribute to
      invasion and metastasis of cancer cells.

PMID- 8461012
TI  - Cytokinin-specific binding protein in etiolated mung bean seedlings.
AB  - We have found that a synthetic urea derivative, N-(2-chloro-4-pyridyl)-N'
      phenylurea (4PU30, forchlorfenuron), has even higher cytokinin activity than N6
      benzyladenine (BA). Using [3H]4PU30 (2.83 TBq/mmol) as a probe, we confirmed
      chromatographically the presence of a high-affinity cytokinin-specific binding
      protein (CSBP) in whole-cell extract from etiolated mung bean seedlings. The
      apparent molecular weight of CSBP was estimated to be 21 kDa. The association
      constants (Ka's) of CSBP for 4PU30 and BA were calculated to be 4 x 10(10) M-1
      and 3 x 10(9) M-1, respectively. Various active cytokinins showed mutually
      competitive binding to CSBP, and their affinities for CSBP corresponded well to
      their cytokinin activities at the tissue level.

PMID- 8461014
TI  - Impaired glycosylation of glycosylphosphatidylinositol-anchor synthesis in
      paroxysmal nocturnal hemoglobinuria leucocytes.
AB  - Metabolic labeling with [3H]sugars in vivo or [3H]sugar nucleotides in vitro of
      glycosylphosphatidylinositol (GPI)-anchor precursors in peripheral blood
      granulocytes and cultured T lymphocytes of paroxysmal nocturnal hemoglobinuria
      (PNH) patients showed a synthetic defect in the GPI-anchor. Among the GPI-anchor
      precursors, phosphatidylinositol (PI) was normally synthesized, while the
      synthesis of glucosaminylphosphatidylinositol (GlcN-PI) and subsequent
      mannosylation of GlcN-PI were inhibited in affected cells. The defect in the GPI
      anchor synthesis in PNH is thus attributed to interrupted glycosylation at plural
      sites in the synthesis of the common carbohydrate structure of the anchor.

PMID- 8461013
TI  - The Dictyostelium discoideum 5S rDNA is organized in the same transcriptional
      orientation as the other rDNAs.
AB  - In eukaryotes 5S rRNA genes are transcribed by RNA polymerase III. These genes
      occur in D. discoideum on the ca. 90 copies of an extrachromosomal palindrom
      together with the other ribosomal RNAs, which are generally transcribed by RNA
      polymerase I. A 5S rRNA gene has been isolated and its nucleotide sequence as
      well as the organization of the gene relative to the RNA polymerase I operon has
      been determined. The sequence of the coding region corresponds exactly to an
      earlier published 5S rRNA sequence. The genes are located just downstream from
      the 26S RNA and transcription orientations of the pol I genes and the pol III
      gene point into the same direction, away from the centromer of the palindrom. The
      isolated gene appears to be functional since it serves as a specific target for a
      nuclear protein, most likely TFIIIA. A genomic copy of a 5S rRNA pseudogene has
      been isolated from the D. discoideum strain V12. This pseudocopy contains
      nucleotides 52 to 82 of a bona fide 5S rRNA gene with only three mismatches. It
      resides 78 nucleotides downstream from the glu13(UUC) tRNA gene which in the D.
      discoideum strain V12 is associated with the retrotransposable element DRE.

PMID- 8461015
TI  - Separate regulation of heme oxygenase and heat shock protein 70 mRNA expression
      in the rat heart by hemodynamic stress.
AB  - To elucidate the role of heat shock proteins in hearts, we examined the
      expression of heme oxygenase (HO) and heat shock protein 70 (HSP70) mRNAs in
      hearts of rats subjected to hypoxia or pulmonary artery banding, both of which
      produce pressure overload to the right ventricle. At 3 d of hypoxia, HO mRNA
      levels were elevated about fourfold compared to the basal levels in both right
      and left ventricles, while HSP70 mRNA was not induced at all. Pulmonary artery
      banding markedly and immediately (within 6 h) increased HO mRNA levels in both
      ventricles, but induced HSP70 mRNA only in the right ventricle. This is the first
      in vivo evidence showing the separate regulation of HO and HSP70 gene expression
      in hearts by hemodynamic stress.

PMID- 8461016
TI  - Cytofluorimetric identification of two populations of double positive (CD4+,CD8+)
      T lymphocytes in human peripheral blood.
AB  - Two different subsets of CD4+,CD8+ T lymphocytes have been identified in
      peripheral blood collected from normal subjects and from patients with different
      diseases. The subpopulations differed in the degree of CD4 and CD8 antigen
      expression. Hence, it was possible to distinguish by cytofluorimetric analysis
      cells with a low (dim) or with a high (bright) fluorescence intensity after the
      staining with anti-CD4 or anti-CD8 mAbs. CD4+dim,CD8+bright lymphocytes were
      found in patients with EBV-infectious mononucleosis and were present for less
      than a month. CD4+bright,CD8+dim T cells were observed in neoplastic patients as
      well as in healthy subjects and were continuously present in similar percentages
      over a long period of time (at the moment, about 3 years). Both the
      subpopulations expressed CD2, CD3, CD5 antigens and had an alpha beta-TCR, but
      did not express CD1a or CD7. Only CD4+dim,CD8+bright cells expressed HLA-DR
      antigen and the activation marker CD38, while only CD4+bright,CD8+dim lymphocytes
      expressed CD56 and CD57 molecules. The hypothesis may be put forward that these
      two subsets represent an effort of the immune system to cope with different
      requirements, i.e., of viral or neoplastic origin, while it is not clear the
      meaning of these cells in healthy subjects.

PMID- 8461017
TI  - Lipoproteins upregulate high affinity Fc receptors in human monocytes.
AB  - Plasma lipoproteins have been implicated in immunoregulation. Here we report that
      LDL and VLDL up-regulate high affinity Fc receptors (Fc gamma RI) in normal human
      monocytes. Adherent monocytes were cultured for 4 days in media containing fetal
      calf serum or delipidated serum. Immunofluorescence analysis showed a significant
      decrease in percentage of Fc gamma RI-positive cells from 85 +/- 3 in medium
      containing normal serum to 54 +/- 9 in medium containing delipidated serum. The
      decrease in the fraction of cells expressing Fc gamma RI was parallel to a
      decrease in the average number of receptor molecules per cell as indicated by a
      decrease in the mean value fluorescence intensity from 234 +/- 20 to 112 +/- 14.
      The inhibition of Fc gamma RI expression was overcome by addition to the culture
      medium of LDL or VLDL. Since pure cholesterol is ineffective, it is proposed that
      these lipoproteins deliver a component(s) such as apolipoprotein B-100 which
      triggers a signal leading to up-regulation of Fc gamma RI in monocytes and
      macrophages.

PMID- 8461018
TI  - Expression of human endothelin receptor ETB by Escherichia coli transformants.
AB  - Membrane fractions from Escherichia coli transformed with an expression vector
      for the human endothelin receptor ETB were found to exhibit specific and
      saturable binding sites for labeled ET-1. Binding properties were similar to
      those observed in eukaryotic cells: KD was 110 pM and the three endothelin
      isoforms were equipotent in competition experiments. The importance of the
      cysteines located in each of the three extracellular loops was assessed by
      replacing them individually with alanine residues. Impaired binding was observed
      in each case but the effect was far more pronounced for the cysteine mutants of
      the first and second loop pointing to their critical importance for active ETB
      expression.

PMID- 8461019
TI  - Production and hydrolysis of cyclic ADP-ribose at the outer surface of human
      erythrocytes.
AB  - Hemoglobin-free membranes from human erythrocytes are able to convert beta-NAD+
      to cyclic ADP-ribose, a calcium mobilizer as potent as inositol 1,4,5
      trisphosphate. Identification of cyclic ADP-ribose was based on HPLC analyses and
      its Ca(2+)-mobilizing activity on sea urchin egg microsomes. Erythrocyte
      membranes also hydrolyze cyclic ADP-ribose to ADP-ribose. By comparing the cyclic
      ADP-ribose-synthesizing and -hydrolyzing activities on unsealed and right-side
      out resealed ghosts, it can be concluded that both are localized at the
      extracellular side of the membrane. This is confirmed by the demonstration of
      both enzyme activities on the surface of intact human red cells. Identification
      of the two enzymes involved in cyclic ADP-ribose metabolism might suggest some
      physiological role of this nucleotide in red cells.

PMID- 8461020
TI  - Arginine-vasopressin increases the release of ET-1 into perfusate of rat
      mesenteric artery.
AB  - The regulatory systems of endogenous endothelin-1 (ET-1) production from intact
      tissues and the effects of produced ET-1 on vascular tonus by a closed circuit
      perfusion system of rat mesenteric artery were investigated. It was demonstrated
      that ET-1 is released from intact mesenteric arterial beds from Wistar rats both
      under basal conditions and after stimulation with arginine-vasopressin (AVP) (10(
      10)-10(-9) M). Furthermore, AVP (10(-10)-10(-9) M) markedly and dose-dependently
      induced the expression of prepro ET-1 mRNA in the mesenteric arterial beds.
      Increased release of ET-1 by AVP may contribute to maintaining vascular tonus.
      Concomitant addition of actinomycin D inhibited the increased expression of
      prepro ET-1 mRNA and reduced the amount of immunoreactive ET-1 found during the 6
      hour perfusate from AVP (10(-10) M)-stimulated and -unstimulated tissues.

PMID- 8461021
TI  - Retinoic acid inhibits DNA and albumin synthesis stimulated by growth factor in
      adult rat hepatocytes in primary culture.
AB  - Retinoic acid inhibits proliferation as a result of inducing differentiation in
      various cells. Isolated hepatocytes have quiescent cell function and seldom
      proliferate in culture. It is of interest whether such function changes in
      proliferation induced by growth factors and the proliferation is inhibited by
      retinoic acid. In adult rat hepatocytes in primary culture, retinoic acid reduced
      DNA synthesis stimulated by epidermal growth factor or hepatocyte growth factor
      in a dose-related manner. Albumin synthesis was increased with EGF stimulation.
      Retinoic acid attenuated this increase, but affected neither albumin synthesis in
      the absence of EGF nor EGF binding to the cells. Adult rat hepatocytes in primary
      culture may proliferate with quiescent cell function. Retinoic acid inhibits such
      proliferation and cell function.

PMID- 8461022
TI  - Intronic androgen response elements of prostatic binding protein genes.
AB  - Transcription of the genes that code for the different components of Prostatic
      Binding Protein is dependent on androgens. DNA-cellulose competition assays have
      demonstrated the presence of regions with affinity for the androgen receptor
      located immediately upstream and in the first intron of these genes. DNase I
      footprinting in vitro now reveals the exact binding site of a receptor dimer in
      the first intron of the C3(1), C3(2) and C1 genes. Gene transfer experiments
      resulted in the description of functional androgen response elements in the C3
      genes. The C1 intronic binding site, however, has a much weaker affinity for the
      DNA-binding domain of the androgen receptor, a characteristic that might explain
      its inability to function as an androgen response element in chimeric gene
      constructs.

PMID- 8461023
TI  - Novel missense variants of prion protein in Creutzfeldt-Jakob disease or
      Gerstmann-Straussler syndrome.
AB  - We found 3 novel missense variants in the open reading frame of the prion protein
      (PrP) gene. The codon 105 point mutation (proline to leucine) was found on a
      codon 129 (Valine) PrP allele in 4 patients from 3 different Japanese families
      with Gerstmann-Straussler syndrome. The codon 180 variant PrP (valine to
      isoleucine) was found in Creutzfeldt-Jakob disease (CJD) patients with a similar
      clinical course to that of codon 178 mutation. The codon 232 variant PrP
      (methionine to arginine) was documented in the CJD patients with typical clinical
      and pathological findings. These variant PrP molecules were not detected in 200
      normal Japanese PrP alleles. PrP has a large repertoire of variant forms, and
      each primary structure of PrP corresponds to the distinct phenotype of prion
      diseases.

PMID- 8461024
TI  - Fluoride causes suppression of neurite outgrowth in human neuroblastoma via an
      influx of extracellular calcium.
AB  - We have used human neuroblastoma NB-OK1 cells to investigate the regulatory
      mechanism of neurite outgrowth. Sodium fluoride suppressed forskolin-stimulated
      neurite outgrowth in a dose-dependent manner. Sodium fluoride increased
      intracellular free calcium concentrations ([Ca2+]i), but had no effect on the
      cAMP level, arachidonic acid (AA) release or phosphoinositide (PI) hydrolysis in
      NB-OK1 cells. The calcium response of sodium fluoride was dependent on the
      extracellular Ca2+. The dose-response curve for stimulation of [Ca2+]i elicited
      by sodium fluoride was similar to that for suppression of neurite outgrowth. The
      suppressive effect of sodium fluoride on neurite outgrowth was inhibited by
      nonspecific Ca2+ entry blocker Mn2+ but not by L-, N- and T-type Ca2+ channel
      blockers. Hence we describe for the first time a possible role for calcium
      signaling in the regulation of neurite outgrowth by a G protein activator in the
      human neuron-derived cell line.

PMID- 8461025
TI  - Application of chemical cytochrome P-450 model systems to studies on drug
      metabolism. VI. N,N-coupling reaction of N-methylaniline catalyzed by polypeptide
      bound porphyrinatoiron(III) and cytochrome P-450.
AB  - Polypeptide-bound porphyrinatoiron(III) effectively catalyzed the N,N-coupling
      reaction of N-methylaniline in the presence of NaBH4/O2/tetramethyl-ammonium
      hydroxide or cumenehydroperoxide, whereas the corresponding non-bound monomer
      porphyrinatoiron(III) had little catalytic activity. Rat liver microsomes also
      catalyzed the N,N-coupling which was inhibited by cytochrome P-450 specific
      inhibitors, SKF-525A and metyrapone. The polypeptide-bound porphinatoiron(III)
      appears to be an excellent cytochrome P-450 model for drug metabolism studies.

PMID- 8461026
TI  - Breeding experiments to combine the X-linked sparse-fur (spf) mutation with the
      autosomal recessive BALB/cByJ strain: testing the biochemical phenotype of double
      mutant mice as a model for ammonia: fatty acyl CoA synergism.
AB  - Breeding experiments were conducted to combine the X-linked sparse-fur (spf)
      mutation with ornithine transcarbamylase deficiency and the autosomal recessive
      deficiency of short-chain acyl CoA dehydrogenase (SCAD) in BALB/cByJ mice. We
      obtained spf/Y (scad/scad), spf/+ (scad/scad) and spf/spf (scad/scad) double
      mutants amongst the F2 progeny, which were tested and separated on the basis of
      urinary orotate and the GC/MS analysis of urinary butyrylglycine, methylsuccinate
      and ethylmalonate. The testing of the biochemical type was feasible both on the
      basis of a 24-h urine collection form adult mice kept in metabolic cages and on
      the basis of urine spots collected on filter paper from younger progeny. It is
      postulated that the spf/Y (scad/scad) double-mutant may serve as a useful animal
      model to study the ammonia: fatty acyl CoA synergism.

PMID- 8461027
TI  - Characterization of DNA binding properties of Yp20: an abundant nuclear protein
      isolated from Saccharomyces cerevisiae.
AB  - The aim of this study was to elucidate the function of Yp20 (yeast 20 kDa
      protein) which is an abundant basic DNA-binding protein copurified with yeast
      chromatin. The work presented here shows that Yp20 is a sequence specific DNA
      binding protein. DNA binding activity was extremely thermostable. The affinity of
      binding to TRP1 was higher than the affinity of binding to the B domain of ARS1.
      The dissociation half time of Yp20-DNA complexes was less than 1 min. Yp20 showed
      no homology to a similar abundant 21 kDa ARS binding factor II (ABFII),
      previously described. Competitive gel retardation assays revealed two different
      regions that were protected by Yp20. One was overlapping the ABF1 binding site on
      ARS1 and another protected region was found upstream to the translational start
      codon of the TRP1 gene. It thus appears that Yp20 may have a role in DNA
      replication and/or transcription.

PMID- 8461028
TI  - Taurine prevents glucose-induced lipid peroxidation and increased collagen
      production in cultured rat mesangial cells.
AB  - Hyperglycemia is directly involved in the development of diabetic nephropathy. A
      high glucose concentration promotes membrane lipid peroxidation and stimulates
      collagen production in a variety of cultured cells. Taurine, a sulfur amino acid,
      is an endogenous antioxidant and antifibrotic agent. We tested whether taurine
      ameliorates the above effects of elevated ambient glucose on renal cells in
      vitro. Raising glucose concentration from 5.6 to 33.3 mM enhanced lipid
      peroxidation in rat mesangial cells, as assessed by malondialdehyde and
      conjugated diene content, and increased collagen production by 59%. Taurine
      prevented both glucose-induced effects in mesangial cells. In contrast, neither
      high glucose nor taurine, alone or in combination, affected lipid peroxidation or
      collagen production in MDCK or LLC-PK1 cells, derived from renal tubular
      epithelium. These results indicate that taurine may be a useful therapeutic agent
      to attenuate diabetic glomerulosclerosis.

PMID- 8461029
TI  - Characterization of recombinant human serotonin 5HT1A receptors expressed in
      Chinese hamster ovary cells. [3H]spiperone discriminates between the G-protein
      coupled and -uncoupled forms.
AB  - 5HT1A serotonin (5-hydroxytryptamine) receptors have been characterized by ligand
      binding in a recombinant Chinese Hamster Ovary cell line expressing the human
      receptor gene. The agonist ligand [3H]2-(N,N-dipropylamino)-8-hydroxy-1,2,3,4
      tetrahydronaphthalene ([3H]8-OH-DPAT) and the antagonist [3H]spiperone were used.
      For both radioligands the binding sites labelled have the properties of 5HT1A
      receptors and most antagonists show roughly equal affinities for the receptors
      labelled by either [3H]8-OH-DPAT or [3H]spiperone. Agonists, however, show higher
      affinities for the sites labelled by [3H]8-OH-DPAT and the antagonist spiperone
      conversely shows a higher affinity for the sites labelled by [3H]spiperone.
      Whereas [3H]8-OH-DPAT binding is inhibited by guanosine triphosphate (GTP) the
      binding of [3H]spiperone is increased by GTP. A model is proposed for the results
      whereby [3H]8-OH-DPAT labels a form of the receptor coupled to a G-protein and
      [3H]spiperone labels a form of the receptor uncoupled from G-proteins (or
      possibly coupled to a different G-protein).

PMID- 8461030
TI  - Protection of erythrocytes against hemolytic agents by cyclodextrin polysulfate.
AB  - Cyclodextrins generally exhibit hemolytic activity, some at concentrations as low
      as 1-10 mg/mL or lower. However, we found previously that a highly polysulfated
      cyclodextrin has no demonstrable hemolytic activity (Macarak et al., Biochem
      Pharmacol 42: 1502-1503, 1991). In the present study, we determined that, in
      fact, cyclodextrin polysulfate (CDS) actively protected erythrocytes against
      hemolysis induced by a wide spectrum of hemolytically active substances, ranging
      from pharmaceuticals, such as chlorpromazine, to solid suspensions of siliceous
      particles. The protective action was also effective against the hemolytic action
      of non-sulfated cyclodextrins. The similar kinetic responses of the erythrocytes
      to CDS protection against such chemically and structurally diverse hemolytic
      agents suggest a common mechanism involving the cell. Addition of the sulfated
      cyclodextrins to other cyclodextrin compounds used to solubilize poorly soluble
      pharmaceutical agents can extend the allowable maximum dosage without deleterious
      hemolytic action.

PMID- 8461031
TI  - Binding of suprofen to human serum albumin. Role of the suprofen carboxyl group.
AB  - The binding of suprofen (SP), a non-steroidal anti-inflammatory drug of the
      arylpropionic acid class, and its methyl ester derivative (SPM) to human serum
      albumin (HSA) was studied by dialysis and spectroscopic techniques. In spite of
      the remarkable differences in the physicochemical properties of SP and SPM, the
      binding of each molecule to HSA was quantitatively very similar. Thermodynamic
      analysis suggests that the interaction of SP with HSA may be caused by
      electrostatic as well as hydrophobic forces, whereas the interactions with SPM
      may be explained by hydrophobic and van der Waals forces. Similarities in the
      difference UV absorption spectra between ligand-detergent micelle and -HSA
      systems indicate that the SP and SPM molecules are inserted into a hydrophobic
      crevice on HSA. The same studies suggest that the carboxyl group of SP interacts
      with a cationic sub-site which is closely associated with the SP binding site.
      Proton relaxation rate measurements indicate that the thiophen ring and
      propanoate portion of the SP molecule is the major binding site for HSA. The
      locations of SP and SPM binding sites were identified by using fluorescence
      probes which bind to a known site on HSA. The displacement data implied that SP
      primarily binds to Site II, while the high affinity site of SPM as well as low
      affinity site of SP are at the warfarin binding site in the Site I area. From
      binding data with chemically modified HSA derivatives, it is likely that highly
      reactive tyrosine (Tyr) and lysine (Lys) residues, which may be Tyr-411 and Lys
      195, are specifically involved in SP binding. In contrast, these two residues are
      clearly separated from the SPM binding site. The binding of SP and SPM is
      independent of conformational changes on HSA that accompany N-B transition. There
      is evidence that the carboxyl group may play a crucial role in the high affinity
      binding processes of SP to HSA.

PMID- 8461032
TI  - Reduction of dapsone hydroxylamine to dapsone during methaemoglobin formation in
      human erythrocytes in vitro.
AB  - The fate of the toxic metabolite of dapsone, dapsone hydroxylamine, has been
      studied in the human red cell. Twice-washed red cells were incubated at 37
      degrees with dapsone hydroxylamine: at 3 and 5 min, 27.0 +/- 2.2 and 33.2 +/-
      2.7% of the haemoglobin had been converted to methaemoglobin, leading to a
      maximum at 45 min (45 +/- 1.8%). HPLC analysis revealed that parent amine was
      produced from dapsone hydroxylamine during methaemoglobin formation in the red
      cells. At 3 min, conversion of dapsone hydroxylamine to dapsone reached 7.0 +/-
      3.9% leading to a maximum at 30 min (18.1 +/- 3.7%). There was a linear
      relationship between hydroxylamine-dependent methaemoglobin formation and
      conversion of hydroxylamine to dapsone (r = 0.97). At 4 degrees, methaemoglobin
      and dapsone formation was greatly retarded, and did not exceed 10%. Co-incubation
      of diethyl dithiocarbamate (DDC) with dapsone hydroxylamine and red cells led to
      a marked increase in methaemoglobin formation (61.4 +/- 3.4%) compared with
      hydroxylamine and red cells alone (45.0 +/- 1.8%, P < 0.001) at 45 min, and
      conversion of dapsone hydroxylamine to dapsone was almost doubled at 45 min (35.7
      +/- 5.3%) compared with hydroxylamine and red cells (18.1 +/- 2.5%). A linear
      relationship between methaemoglobin formation and dapsone formation (r = 0.96)
      was also shown to occur in the presence of DDC. Incubation of red cells with DDC
      and dapsone hydroxylamine caused a significantly greater reduction in glutathione
      levels (98.3 +/- 1.6%) compared with red cells and dapsone hydroxylamine alone
      (84.8 +/- 2.7%) at 5 min (P < 0.001), although there was no significant
      difference between the groups at 15 min (96.9 +/- 2.6 vs 98.1 +/- 2.2%). Intra
      erythrocytic glutathione was then depleted by 75 +/- 3.4%, by pretreatment with
      diethyl maleate (6 mM), and these cells in the presence of the hydroxylamine
      showed a significant fall in both methaemoglobin generation (29.7 +/- 1.2 vs 35.0
      +/- 1.7%) and parent amine formation (11.1 +/- 0.2 vs 16.5 +/- 1.1%) compared
      with untreated red cells at 45 min. It is possible that a cycle exists between
      hepatic oxidation of dapsone to its hydroxylamine and reduction to the amine
      within the red cell, which may lead to re-oxidation by hepatic cytochrome P450.
      This process may contribute to the persistence of the drug in vivo.

PMID- 8461033
TI  - Differential inhibition of coumarin 7-hydroxylase activity in mouse and human
      liver microsomes.
AB  - Coumarin is 7-hydroxylated by the P450 isoform Cyp2a-5 in mice and CYP2A6 in
      humans. Various drugs, endogenous substances, plant substances and carcinogens,
      altogether about 90 chemicals, were evaluated as possible inhibitors of coumarin
      7-hydroxylase (COH) activity in mouse microsomes. The effects of selected
      compounds on COH activity in human liver microsomes were also tested. The
      furanocoumarin derivatives methoxsalen (8-methoxypsoralen) and psoralen proved to
      be the most potent inhibitors of mouse COH activity (IC50 values 1.0 and 3.1
      microM, respectively). The furanocoumarins bergapten (5-methoxypsoralen),
      isopimpinellin (5,8-dimethoxypsoralen), imperatorin and sphondin also effectively
      inhibited mouse COH activity (IC50 values 19-40 microM). Methoxsalen,
      isopimpinellin and metyrapone were also inhibitors in mice in vivo. Methoxsalen
      was a potent inhibitor of COH activity also in human liver microsomes, (IC50
      value 5.4 microM), whereas bergapten, isopimpinellin and imperatorin had no
      effect. The imidazole antimycotic miconazole was a potent but non-specific
      inhibitor of COH activity. Several known substrates and inhibitors of members in
      the CYP1A, CYP2B, CYP2C, CYP2D and CYP3A subfamilies were poor inhibitors of COH
      activity. These results suggest that (i) the coumarin-type compounds in
      particular interact with the active sites of Cyp2a-5 and CYP2A6, and (ii) the
      active sites of Cyp2a-5 and CYP2A6 are structurally different, since a number of
      compounds inhibited mouse, but not human COH activity.

PMID- 8461034
TI  - Studies on the reactivity of acyl glucuronides--IV. Covalent binding of
      diflunisal to tissues of the rat.
AB  - Acyl glucuronides have been shown to be reactive electrophilic metabolites
      capable of undergoing hydrolysis, rearrangement (isomerization via acyl
      migration) and covalent binding reactions to plasma protein. The present study
      was undertaken to explore the occurrence and extent of in vivo formation of
      covalent adducts of diflunisal (DF), a salicylate derivative which forms a
      reactive acyl glucuronide, with tissues and plasma protein of rats. Groups of
      rats were given 50 mg DF/kg i.v. twice daily for periods of up to 7 days. Steady
      state plasma concentrations of reversibly bound DF and its conjugates (as
      measured 6 hr after a dose) were achieved by the third day of dosing. T 1/2
      values after cessation of dosing were about 5-10 hr. By contrast, covalent DF
      tissue adducts steadily accumulated over the 7-day dosing period. Maximum
      concentrations, measured 6 hr after the last dose, were 4.8 (liver), 1.0
      (kidney), 0.74 (plasma), 0.26 (small intestine minus contents), 0.27 (large
      intestine minus contents) and 0.20 (skeletal muscle) microgram DF/g tissue or/mL
      plasma. T 1/2 values of about 50, 67, 18, 38 and 43 hr were obtained for liver,
      kidney, plasma and small and large intestine (respectively) after cessation of
      dosing. Thus, the study of acyl glucuronide reactivity and the question of any
      derived toxicity or immune responses should consider the formation of long-lived
      adducts in tissues as well as in plasma.

PMID- 8461035
TI  - Inhibitory action of chloramine on formate-metabolizing system. Studies suggested
      by an unusual case record.
AB  - We previously reported on a patient exposed simultaneously to methyl chloride and
      chloramine gas who developed metabolic acidosis and permanent blindness [M.
      Minami et al., Hum Exp Toxicol 11: 27-34, 1992]. The case report suggested the
      possibility of potentiation of methyl chloride toxicity by chloramine. The
      potentiating mechanism was investigated by exposing mice to methyl chloride
      followed by ammonia chloramine, and then the level of formate in urine samples
      was measured with an enzyme coupling method to detect disturbance of formate
      metabolism. Mice dosed with 0.05 mL 1.0 mM chloramine after methyl chloride
      exposure excreted a significantly larger amount of urinary formate than mice
      treated with only methyl chloride. There was no difference in urinary formate
      levels between mice treated with only 0.05 mL 1.0 mM chloramine and those given
      only the vehicle (0.1 M phosphate buffer pH 6.0) for chloramine. The underlying
      biochemical mechanism of deterioration of formate metabolism was found to be the
      inhibition of the enzyme, N10-formyl tetrahydrofolate (N10-f-THF) dehydrogenase
      by 0.56-3.35 microM chloramine in the in vitro experiment using the purified
      enzyme. Positive control mice, given orally 0.1 mL 10% methanol in 0.1 M
      phosphate buffer (pH 6.0) excreted the same amount of urinary formate as those
      receiving 0.05 mL 1.0 mM chloramine after methanol administration. This was
      ascribed to the inhibitory effect of chloramine on formaldehyde dehydrogenase and
      depletion of substrate for further metabolism. The inhibition of the enzyme by
      chloramine (2.7-100.8 microM) was confirmed by in vitro experiments, using the
      purified enzyme, formaldehyde dehydrogenase.

PMID- 8461036
TI  - Initial characterization of the major mouse cytochrome P450 enzymes involved in
      the reductive metabolism of the hypoxic cytotoxin 3-amino-1,2,4-benzotriazine-1,4
      di-N-oxide (tirapazamine, SR 4233, WIN 59075).
AB  - The benzotriazine di-N-oxide SR 4233 (tirapazamine, WIN 59075) is currently in
      phase I clinical trials as the lead compound in a series of novel and highly
      selective antitumour hypoxic cytotoxins. Reductive bioactivation is thought to
      proceed via a one-electron reduced, oxidizing nitroxide radical and also forms
      the inactive single N-oxide SR 4317 via radical disproportionation or a second
      one-electron reduction. In mouse liver microsomes reductive metabolism is
      catalysed predominantly by cytochrome P450 (70%) and cytochrome P450 reductase
      (30%). The aim of the present study was to examine which cytochrome P450 isozymes
      may be involved. Reduction of SR 4233 to SR 4317 was monitored by HPLC analysis.
      Metabolism by microsomes from both control and dexamethasone-induced BALB/c male
      mice was 70% inhibited by carbon monoxide. The cytochrome P450 inhibitor SKF
      525A, following aerobic preincubation, also inhibited SR 4233 reduction by 58%.
      Reduction was induced 2-3-fold by dexamethasone and was not accountable by
      increases in cytochrome P450 reductase or DT-diaphorase. The induction data and
      the greater degree of inhibition of SR 4233 reduction by metyrapone compared to
      alpha-naphthoflavone suggested a possible involvement of Cyp2b, Cyp2c and Cyp3a
      cytochrome P450 subfamilies. Both Cyp3a (7.4-fold) and Cyp2b (1.8-fold) type
      enzymes were shown by western immunoblot analysis to be induced by dexamethasone,
      the latter correlating more closely with increased SR 4233 reductase activity and
      also with the 2-fold induction of benzphetamine N-demethylase, a Cyp2b-type
      enzyme. No inhibition of SR 4233 reduction was seen with erythromycin or
      cyclosporin A which act as substrates/inhibitors for Cyp3a-type enzymes, but
      inhibition was seen with p-nitrophenol and tolbutamide which are substrates for
      Cyp2el- and Cyp2c-type enzymes, respectively (11% and 25% inhibition in induced
      microsomes). SR 4233 itself inhibited benzphetamine N-demethylase, which is
      catalysed by Cyp2b-type enzymes but not erythromycin N-demethylase which is
      catalysed by Cyp3a-type isoforms. Immunoinhibition studies with epitope specific
      monoclonal antibodies were consistent with the major involvement of
      phenobarbitone- and steroid-inducible products of the Cyp2b and Cyp2c
      subfamilies. These forms contributed at least 53% and 26%, respectively, of the
      cytochrome P450-associated SR 4233 reductase activity in the induced microsomes.
      The findings support our earlier conclusion that cytochrome P450 is the major SR
      4233 reductase in mouse liver and provides leads as to the possible involvement
      of specific isoforms in human tumours and normal tissues.

PMID- 8461037
TI  - Cytochrome P450-related differences between rats and mice in the metabolism of
      benzene, toluene and trichloroethylene in liver microsomes.
AB  - In evaluating the risks to humans of exposure to chemicals, the results of
      studies in rodents are sometimes used as a basis for extrapolation. It is
      therefore important to elucidate differences in metabolism among species.
      Differences in cytochrome P450-catalysed oxidation of benzene, toluene and
      trichloroethylene (TRI) between male Wistar rats and male B6C3F1 mice were
      investigated by immunoblot and immunoinhibition assays using monoclonal
      antibodies (MAbs) to cytochrome P450 (CYP1A1/2, CYP2B1/2, CYP2E1 and CYP2C11/6).
      Immunoblot analysis showed that anti-CYP2B1/2 did not detect any protein in
      either untreated rat or mouse liver microsomes, whereas with anti-CYP2E1 and/or
      anti-CYP1A1/2 a clear-cut band was seen more in liver microsomes from mice than
      from rats. Mouse liver microsomes had a greater monooxidation activity for
      benzene and TRI than rat liver microsomes; mice also had a higher rate of
      aromatic hydroxylation of toluene at low substrate concentration, but a low rate
      of side-chain oxidation when a high concentration of toluene was used. The
      metabolism of benzene was saturated in mice at around 0.23 mM, but the metabolism
      of the other two solvents was not saturated in either rats or mice at the low
      concentrations used. Anti-CYP2E1 inhibited the metabolism of benzene, toluene and
      TRI in microsomes from mice to a greater extent than in rats, while anti
      CYP2C11/6 inhibited their metabolism in rats to a greater extent than in mice;
      anti-CYP1A1/2 inhibited the metabolism of TRI only in microsomes from mice. These
      results indicate that (i) male B6C3F1 mice have more CYP2E1 and 1A1/2 than male
      Wistar rats, whereas rats have more CYP2C11/6 than mice; (ii) rats and mice
      express CYP2B1/2 but they are not immunochemically detectable; (iii) CYP2E1 and
      2C11/6 in both species are responsible for the metabolism of benzene, toluene and
      TRI, whereas CYP1A1/2 in mice catalyses the oxidation of TRI. The differences in
      the metabolism of benzene, toluene and TRI in rats and in mice may therefore
      depend, at least in part, on differences in the distribution of P450 isozymes
      between the two species.

PMID- 8461038
TI  - Phase I and phase II xenobiotic reactions and metabolism of the food-borne
      carcinogen 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline in aggregating liver
      cell cultures.
AB  - Aggregating fetal liver cell cultures were tested for their ability to metabolize
      xenobiotics using ethoxycoumarin-O-deethylase (ECOD), as marker of phase I
      metabolism, and glutathione S-transferase (GST), as marker for phase II
      reactions. Significant basal activities, stable over 14 days in culture were
      measured for both ECOD and GST activities. The prototype cytochrome P450
      inducers, 3-methylcholanthrene (3-MC) and phenobarbital (PB), increased ECOD and
      GST activities reaching an optimum 7 days after culturing, followed by a decline
      in activity. This decline was partially prevented by 1% dimethyl sulfoxide (DMSO)
      added chronically to the culture medium. DMSO was also found to induce ECOD
      activity and to a lesser extent GST activity. Furthermore, it potentiated in a
      dose-dependent manner the induction of ECOD by PB. The food-borne carcinogen 2
      amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) is metabolically transformed
      through a number of pathways in vivo. It was therefore used to examine the
      metabolic capacity in fetal and adult liver cell aggregates. Metabolism of MeIQx
      was mainly through N2-conjugation, resulting in formation of the N2-glucuronide
      and sulfamate conjugates for non-induced fetal liver cells. These metabolites
      were also found in large amounts in non-induced adult liver cells. Low levels of
      cytochrome P450-mediated ring-hydroxylated metabolites were detected in both non
      induced fetal and adult liver cells. After induction with arochlor (PCB) or 3-MC,
      the major pathway was ring-hydroxylation (cytochrome P450 dependent), followed by
      conjugation to beta-glucuronic or sulfuric acid. The presence of the glucuronide
      conjugate of N-hydroxy-MeIQx, a mutagenic metabolite, suggested an induction of
      P450 CYP1A2. The metabolism of MeIQx by liver cell aggregates is very similar to
      that observed in vivo and suggests that aggregating liver cell cultures are a
      useful model for in vitro metabolic studies in toxicology.

PMID- 8461039
TI  - Effect of rociverine on P450-dependent monooxygenases and its N-deethylation
      metabolism in rat liver microsomes.
AB  - Rociverine [2-(diethylamino)-1-methylethyl cis-1-hydroxy [bicyclohexyl]-2
      carboxylate] citrate (ROC) is an antispasmodic agent therapeutically active in
      humans at doses of 0.5-1 mg/kg. This study investigated the effect of acute
      administration of the drug on hepatic microsomal cytochrome P450 (P450)-catalysed
      drug metabolism. Only high doses (> or = 100 mg/kg) of ROC were able to induce in
      rats the hepatic microsomal pentoxyresorufin O-depenthylase (PROD) and 16 beta
      testosterone hydroxylase activities both associated with P4502B1/2 and the
      erythromycin N-dimethylase (ErD) and 2 beta-testosterone hydroxylase activities
      both dependent on P4503A1/2. However, at 100 and 200 mg/kg of ROC, the 16 beta
      testosterone hydroxylase and PROD were the most induced activities, suggesting
      that P4502B1/2 are the isoforms most sensitive to ROC induction. Accordingly, ROC
      treatment enhanced, in a dose-dependent manner, the amount of P4502B1/2 and 3A1/2
      in microsomes as assayed by western blotting. The northern blot analysis of ROC
      treated rat liver showed that the P4502B1/2 induction appears to be regulated at
      the mRNA level as in the induction by phenobarbital (PB). The oxidative
      metabolism of ROC with hepatic microsomes from control or PB- and ROC-induced
      rats resulted in a N-deethyl ROC derivative (major metabolite) and an unknown
      minor ROC derivative. The kinetic parameters for the N-deethylation of ROC were
      studied with purified P4502B1 and with microsomes from control or rats treated
      with various inducers (phenobarbital, ethanol, beta-naphthoflavone, dexamethasone
      and rociverine). It was found that phenobarbital-, dexamethasone- and rociverine
      induced microsomes deethylated ROC with a Vmax about five times higher than that
      (0.9 nmol/min/mg protein) of control microsomes, although with a similar affinity
      (Km approximately 0.3 mM). In a reconstituted system, the purified P4502B1
      metabolized ROC with a high deethylation rate (22 nmol/min/nmol P450). Moreover,
      the ROC deethylation was inhibited by compounds such as hexobarbital, metyrapone
      and triacetyloleandomicin, selective inhibitors for P4502B and/or P4503A enzymes.
      On the other hand ROC, when added in vitro, inhibited the 16 beta- and 2 beta
      testosterone hydroxylases and the PROD and ErD activities. Taken together, these
      results indicate that the ROC-inducible P4502B and P4503A are involved in ROC
      deethylation. In conclusion, it has been demonstrated that ROC is a weak
      phenobarbital-like inducer of P450, probably able at high and reiterated doses to
      alter its own metabolism, at least in the rat liver.

PMID- 8461040
TI  - Effects of chronic low-level lead exposure on mRNA expression, ADP-ribosylation
      and photoaffinity labeling with [alpha-32P]guanine triphosphate-gamma
      azidoanilide of GTP-binding proteins in neurons isolated from the brain of
      neonatal and adult rats.
AB  - The effects of chronic lead exposure on mRNA expression, ADP-ribosylation and
      photoaffinity labeling with [alpha-32P]guanine triphosphate-gamma-azidoanilide
      ([32P]GTP-A) of alpha i or alpha s subunit of G protein were investigated in
      neurons isolated from the brain of neonatal and adult rats exposed to lead
      acetate or sodium acetate (for control). Rats were exposed by oral feeding for 10
      days or 20 weeks to a low level of lead acetate or sodium acetate. The exposure
      started either prenatally or at an adult age. The expression of alpha i-mRNA in
      neurons obtained from the brain of control neonatal rats was significantly higher
      than that of the expression in samples obtained from the brain of control adult
      rats or the brain of rats exposed to lead at an adult age. The expression of
      alpha i-mRNA in neurons obtained from the brain of control neonatal rats, lead
      exposed neonatal rats and adult rats prenatally exposed to lead did not differ
      significantly. Chronic lead exposure did not affect the expression of alpha s
      mRNA in neurons obtained from the brain of neonatal and adult rats. The ADP
      ribosylation or the photoaffinity labeling with [32P]GTP-A of alpha i or alpha s
      subunits reflected the developmental pattern of the expression of alpha i or
      alpha s-mRNA. The incorporation of radioactivity in alpha i-subunit obtained from
      the brain of control neonatal rats, lead-exposed neonatal rats and rats
      prenatally exposed to lead was greater than the incorporation in alpha i-subunit
      obtained from the brain of control adult rats or rats exposed to lead at an adult
      age. The incorporation of radioactivity did not differ significantly in alpha s
      subunits obtained from control or lead-exposed neonatal and adult rats. These
      observations indicate that (1) the mRNA expression, ADP-ribosylation and
      photoaffinity labeling with [32P]GTP-A of alpha i-subunit decrease, whereas the
      mRNA expression, ADP-ribosylation and photoaffinity labeling with [32P]GTP-A of
      alpha s-subunit do not change as animals age after postnatal day 10, (2) chronic
      prenatal lead exposure delays the age-dependent decrease in mRNA expression, ADP
      ribosylation and photoaffinity labeling of alpha i subunit, and (3) chronic adult
      exposure does not cause these changes.

PMID- 8461041
TI  - Circadian rhythm of rat spleen cytoplasmic thymidine kinase.
AB  - The activity of thymidine kinase (TK, EC 2.7.1.21), the first enzyme of the
      thymidine phosphorylation pathway, was measured at various times over a 24-hr
      period in the spleens of Sprague-Dawley rats that had been housed under
      standardized conditions of light and dark for at least 4 weeks before the study.
      Spleen cytoplasmic TK activity was assayed with [2-14C]thymidine as substrate.
      Under "normal" light conditions (lights on 6:00 a.m.-6:00 p.m. and lights off
      6:00 p.m.-6:00 a.m.), a circadian variation of TK activity was observed (P <
      0.0001), Cosinor analysis) with peak activity (1.98 nmol product/hr/mg protein)
      at 1:00 a.m. (19 hr after light onset, HALO) and trough activity (0.40 nmol
      product/hr/mg protein) at 1:00 p.m. (7 HALO). Maximum enzyme activity exceeded
      minimum activity by approximately 5-fold. Reversing the light-dark cycle resulted
      in a corresponding shift in TK activity. Under these "reverse" conditions (lights
      on 6:00 p.m.-6:00 a.m. and lights off 6:00 a.m.-6:00 p.m.), a circadian variation
      in TK activity was also observed (P < 0.0001, Cosinor analysis) with peak
      activity (1.14 nmol product/hr/mg protein) at 12:00 noon (18 HALO) and trough
      activity (0.32 nmol/hr/mg protein) at 12:00 a.m. (6 HALO). Maximum enzyme
      activity exceeded minimum activity by approximately 4-fold. In summary, this
      study demonstrated for the first time that TK activity varies over a 24-hr period
      in association with the light-dark cycle.

PMID- 8461042
TI  - Alteration of calcium mobilization in endothelial cells by volatile anesthetics.
AB  - Halothane and isoflurane have different effects on the peripheral vasculature.
      Halothane decreases blood pressure primarily by decreasing cardiac contractility,
      whereas isoflurane acts primarily as a peripheral vasodilator. These peripheral
      vascular actions may result from different effects of the anesthetics on
      endothelial cell function and the release of endothelium-derived vasoactive
      mediators. The ability of these agents at clinically relevant concentrations to
      alter agonist-induced calcium mobilization in single cultured bovine aortic
      endothelial cells was tested using the fluorescent indicator fura-2. Neither
      halothane (0.3, 0.5, and 2 mM) or isoflurane (0.5 and 2 mM) altered basal calcium
      ([Ca]i = 49 +/- 5 nM); however, the calcium transient normally elicited by 10 nM
      bradykinin (peak [Ca]i = 307 +/- 22 nM) was inhibited significantly by halothane
      but not isoflurane. Neither anesthetic altered the calcium response to ATP (10
      microM). These findings suggest that anesthetics may have specific effects on
      receptor-mediated endothelial cell functions that could influence hemodynamics.

PMID- 8461043
TI  - Protection of a rat tracheal epithelial cell line from paraquat toxicity by
      inhibition of glucose-6-phosphate dehydrogenase.
AB  - Transformed rat tracheal epithelial cells (U2) were found to be 3.6-fold more
      sensitive than lung fibroblasts (RLF) to paraquat. Although the toxic effects of
      paraquat are associated with the generation of very active superoxides, U2 cells
      contained higher levels of superoxide dismutase and catalase than RLF cells. On
      the other hand, the specific activities of both NADPH-cytochrome c reductase and
      glucose-6-phosphate dehydrogenase (G6DP) were 3- to 4-fold higher in U2 cells
      than in RLF cells. Treatment with dehydroepiandrosterone (DHEA) and
      epiandrosterone (EPI), G6PD inhibitors, significantly decreased the intracellular
      NADPH and protected U2 cells from paraquat toxicity. Since DHEA and EPI treatment
      did not affect the uptake of paraquat, our results suggest that paraquat
      sensitivity may depend on the redox cycling-associated activities of paraquat.

PMID- 8461044
TI  - Degradation of membrane phospholipids in the cultured human astroglial cell line
      UC-11MG during ATP depletion.
AB  - The exposure of brain cells to adverse conditions, such as ATP depletion, induces
      the degradation of membrane phospholipids and the accumulation of free fatty
      acids. We have investigated the mechanism of membrane breakdown in an in vitro
      cell injury model. Confluent cells from the human astroglial cell line UC-11MG
      were treated with sodium iodoacetate to deplete their intracellular ATP. Large
      amounts of saturated (palmitic acid) and unsaturated (oleic, linoleic and
      arachidonic acid) free fatty acids as well as diacylglycerols containing
      prelabeled fatty acids were released from the cells prior to the loss of plasma
      membrane integrity. The capacity of the cells to reincorporate free fatty acid
      into membrane phospholipids decreased in parallel with the loss of intracellular
      ATP, indicating the failure of the acyltransferase pathway. The addition of the
      phospholipase A2 inhibitors manoalide, mepacrine, or U-26384, or the
      phospholipase C inhibitor U-73122, reduced the severity of cell injury, but did
      not maintain cell viability. The addition of a battery of protease inhibitors
      with or without the phospholipase inhibitors had no protective effect. These
      results suggest that the activation of phospholipases A2 and C coupled with the
      loss of the reacylation process lead to the breakdown of membrane components
      during lethal cell injury.

PMID- 8461045
TI  - Isolation and characterization of a human ileocecal carcinoma cell line (HCT-8)
      subclone resistant to fluorodeoxyuridine.
AB  - A 5-fluoro-2'-deoxyuridine (FdUrd)-resistant subclone (Fd9XR) of HCT-8 (human
      ileocecal carcinoma) cells was established by two schedules of drug exposure.
      Initially, cells were exposed to short-term (3 hr) 100 nM FdUrd repeatedly (9
      cycles over 8 months), and cells were then exposed to 10 nM FdUrd continuously.
      During this latter stage, a colony (Fd9XR) with fast growth rate was isolated,
      expanded, and characterized with respect to mechanisms of resistance to FdUrd and
      cross-resistance to other chemotherapeutic agents. Fd9XR cells were 1000-fold
      resistant to FdURD, but 3-fold more sensitive to 5-fluorouracil (FUra) than HCT-8
      cells. After a 3-hr treatment with FdUrd, Fd9XR cells accumulated 6630-, 69-, and
      3.7-fold less fluorodeoxyuridylate (FdUMP), fluorouridine triphosphate (FUTP) and
      acid-insoluble materials, respectively, than HCT-8 cells. However, when FUra was
      substituted for FdUrd, Fd9XR cells accumulated 9.2-, 3.1-, and 2.3-fold more
      FdUMP, FUTP and acid-insoluble materials, respectively, than HCT-8 cells. Fd9XR
      and HCT-8 were similar in their growth rates, combined pools of 5,10
      methylenetetrahydrofolates (5,10-CH2H4PteGlun) and tetrahydrofolates (H4PTeGlun),
      thymidine phosphorylase (TP) activity, and level and activity of thymidylate
      synthase (TS). In contrast, thymidine kinase (TK) activity of Fd9XR was 0.23 and
      0.35% of that of HCT-8, for thymidine (dThd) and FdUrd as substrates,
      respectively. Furthermore, Fd9XR cells exhibited greater sensitivity to the
      antifolate TS inhibitor ICI D1694 and to methotrexate (MTX) than HCT-8 cells. In
      addition, dThd alone and in combination with hypoxanthine did not offer any
      protection against the cytotoxic effect of ICI D1694 in Fd9XR cells. These
      results indicate that in Fd9XR cells (1) TK deficiency is the primary mechanism
      of resistance to FdUrd; (2) the greater sensitivity to FUra was associated with
      higher pools of FdUMP and FUTP with a subsequently higher level of incorporation
      into cellular RNA; and (3) antifolate compounds, e.g. ICI D1694 and MTX, could be
      useful agents in the treatment of FdUrd-resistant tumors associated with
      decreased TK activity and decreased capacity of utilizing dThd.

PMID- 8461046
TI  - Plasmodium falciparum: effects of amantadine, an antiviral, on chloroquine
      resistant and -sensitive parasites in vitro and its influence on chloroquine
      activity.
AB  - The lysosomotropic nature of amantadine suggested potential as an antimalarial.
      Sensitivity tests to amantadine hydrochloride alone and in combination with
      chloroquine were carried out in 96-well microtitre plates using the tritiated
      hypoxanthine uptake method to measure parasite growth. Amantadine alone has
      antimalarial activity. Amantadine is more potent against chloroquine-resistant
      strains. Combinations of amantadine and chloroquine result in slight synergy in
      both resistant and sensitive strains.

PMID- 8461048
TI  - Stabilization of S-adenosylmethionine decarboxylase by aminoguanidine.
AB  - Aminoguanidine, an inhibitor of copper-containing amine oxidases, is often used
      in cell culture studies to prevent the oxidation of added polyamines or their
      derivatives by the amine oxidase present in bovine serum. However, in the present
      study, we demonstrate that aminoguanidine, besides affecting the degradation of
      polyamines, may affect one of the important regulatory enzymes in the
      biosynthesis of polyamines, namely S-adenosylmethionine decarboxylase (AdoMetDC).
      Aminoguanidine was shown to induce a 2-3-fold increase in the AdoMetDC levels in
      L1210 cells. This increase was fully explained by a stabilization of the enzyme,
      probably caused by the binding of aminoguanidine to the active site of AdoMetDC.

PMID- 8461047
TI  - Metabolism of phenacetin in V79 Chinese hamster cell cultures expressing rat
      liver cytochrome P4501A2 compared to isolated rat hepatocytes.
AB  - In a genetically engineered V79 cell line (XEMd-MZ) expressing rat cytochrome
      P4501A2 the activity of phenacetin-O-deethylase was determined and compared with
      freshly isolated rat hepatocytes. In the V79 cells the apparent Km was 0.99
      microM (N = 4), compared to the high affinity Km (0.23 microM, N = 4) found in
      freshly isolated rat hepatocytes, where as the Vmax found in the XEMd-MZ cells
      (14.90 pmol/min/10(6) cells) corresponded to the Vmax for the high affinity site
      of the hepatocytes (18.2 pmol/min/10(-6) cells). The metabolic capacity of
      phenacetin was quantitatively comparable to that of freshly isolated hepatocytes
      on a cell to cell basis.

PMID- 8461049
TI  - Effect of folate diastereoisomers on the binding of 5-fluoro-2'-deoxyuridine-5'
      monophosphate to thymidylate synthase.
AB  - A series of natural and unnatural stereoisomers of reduced folate coenzymes have
      been studied for their capacity to facilitate binding of 5-fluoro-2'-dUMP (FdUMP)
      to bacterial thymidylate synthase (TS). The natural cosubstrate for the enzyme,
      (6R)-5,10-methylene-tetrahydrofolate (CH2-H4-folate), was 4-fold more potent than
      the unnatural 6S-form in promoting FdUMP binding to TS, but in a racemic mixture
      the effect of the 6R-form was not affected by the 6S-form. FdUMP binding to TS
      was also stimulated by tetrahydrofolate and dihydrofolate (85% and 30% as
      compared to (6RS)-CH2-H4-folate, respectively), but not by the stereoisomers of 5
      methyl-tetrahydrofolate and 5-formyl-tetrahydrofolate (leucovorin). These results
      suggest that folates, which are not a natural cosubstrate for TS, have an
      additional role in facilitating FdUMP binding to TS.

PMID- 8461050
TI  - Sulphate conjugation of minoxidil in rat skin.
AB  - Minoxidil sulphotransferase (MST) activity was determined in the cytosolic
      fraction of rat skin and liver. MST of rat skin is similar to the P (phenol)-form
      of phenosulphotransferase (PST) of human tissues with respect to thermostability
      and inhibition by 2,6-dichloro-4-nitrophenol (DCNP). p-Nitrophenol, a prototype
      substrate of human P-PST form, inhibits MST at micromolar concentration while
      millimolar concentrations of dopamine and tyramine, substrates of human M
      (monoamine)-PST, are required to elicit a similar degree of inhibition. The
      enzymatic transfer of 35S from sodium 35sulphate to minoxidil was also
      demonstrated suggesting that the rat skin is potentially capable of synthesizing
      3'-phosphoadenosine-5'-phosphosulphate (PAPS) from inorganic sulphate and
      utilizing it for the biosynthesis of minoxidil sulphate, its active metabolite.
      Thus, it is conceivable that the pharmacological action of minoxidil as a
      promoter of hair growth could be carried out by the cutaneous tissues without the
      contribution of hepatic or other extrahepatic organs.

PMID- 8461051
TI  - Clearance of N-nitrosodimethylamine and N-nitrosodiethylamine by the perfused rat
      liver. Relationship to the Km and Vmax for nitrosamine metabolism.
AB  - The first-pass clearance of dietary N-nitrosodimethylamine (NDMA) by the liver is
      the most important factor in the pharmacokinetics of this carcinogen in the rat,
      but is less important in the pharmacokinetics of N-nitrosodiethylamine (NDEA).
      The reason for the difference in clearance of these two nitrosamines is not
      known. These experiments were carried out to see whether the general
      characteristics of the clearance of these two carcinogens in vivo could be
      reproduced in the perfused liver, and whether the clearance could be correlated
      with the Michaelis-Menten parameters Km and Vmax for their metabolism. If this
      could be done one would be able to predict the possible extent of first-pass
      clearance of nitrosamines in man from measurement of Km and Vmax for nitrosamine
      metabolism by the human liver. The Km (22 microM) and Vmax (10.2 and 13.4 nmol/g
      liver/min) for the metabolism of NDMA by slices from two human livers, the
      inhibition of that metabolism by ethanol (Ki 0.5 microM), and the rate of N-7
      methylation of DNA when slices are incubated with NDMA, were measured. These
      results are similar to those reported previously with rat liver. The Km (27
      microM) for the metabolism of NDEA by rat liver slices and the inhibition of that
      metabolism by ethanol (Ki 1 microM) were estimated from the rate of ethylation of
      the DNA of the slices. The clearance of both these nitrosamines by the perfused
      rat liver was measured, and the results appeared to parallel those in vivo with a
      striking difference between the clearance of NDMA and NDEA. The maximal rate of
      clearance of NDMA was 11.2 nmol/g liver/min and of NDEA 8.9 nmol/g liver/min,
      similar to the Vmax for metabolism of NDMA by liver slices and to the estimated
      maximal rate of liver metabolism of both nitrosamines in the living rat. However,
      although the Km for metabolism of these two nitrosamines by liver slices is
      similar (about 25 microM), the logarithmic mean sinusoidal concentration [see
      Bass and Keiding, Biochem Pharmacol 37: 1425-1431, 1988] giving half maximal
      clearance during perfusion (the equivalent to Km) was 2.3 microM for NDMA and
      10.6 microM for NDEA. The almost 5-fold difference between these two values is
      the basis for the difference between the clearance of the two
      nitrosamines.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8461052
TI  - Purification and immunological characterization of pigeon serum
      butyrylcholinesterase. Implications on environmental monitoring and toxicological
      testing of birds.
AB  - Butyrylcholinesterase (EC 3.1.1.8) (BChE) was purified from pigeon serum to
      electrophoretic homogeneity by a four-step procedure involving blue sepharose CL
      6B chromatography, ion exchange chromatography, procainamide affinity
      chromatography and gel filtration. An overall 2789-fold purification was
      achieved, with a final specific activity of 61.35 mumol/min/mg. The purified
      enzyme separated into two peaks when filtered through a column of Sephacryl S
      300, a smaller peak containing the tetrameric form of BChE (C4) and a larger peak
      containing the monomeric form of BChE (C1). Native polyacrylamide gel
      electrophoresis (PAGE) of both peaks revealed single protein bands which
      coincided with esterase activity, with approximate M(r) values of 84,000 and
      340,000, respectively. The C1 monomer represented 85-90% of the activity found in
      the pigeon serum. It is not clear whether this polymorphism of BChE in
      vertebrates contributes to the wider inter-individual variations observed in
      xenobiotics elimination kinetics and in the response to the pharmacological and
      toxic effects of pesticides. PAGE of the monomeric form of the enzyme in the
      presence of sodium dodecyl sulphate showed only one protein band with a M(r) of
      84,000, while that of the tetrameric form revealed two bands, a major protein
      band (84,000) and a minor band (170,000), representing the monomer and the dimer
      of the dissociated tetrameric BChE enzyme under reducing conditions. Highly
      specific polyclonal antibodies were raised in rabbits against the purified
      enzyme. These antibodies cross-reacted with other avian BChEs, a criterion which
      make them useful for the immunopurification of other BChEs from different species
      as well as for biomonitoring and toxicological studies on the role of esterases
      as an indicator of avian exposure to organophosphorous pesticides.

PMID- 8461053
TI  - Effects of the synthetic anti-oxidant, probucol, on the U937 monoblastoid cell
      line.
AB  - Probucol is a clinically important drug that decreases plasma cholesterol in
      humans and has a marked anti-atherogenic effect in hyperlipidaemic Watanabe
      rabbits. The action of probucol in this animal model has been partly attributed
      to its anti-oxidant abilities. Probucol can decrease the oxidative modification
      of low-density lipoprotein and hence diminish its uptake by macrophages. In this
      paper, we have examined the effect of probucol on the monoblastic cell line U937
      and on U937 cells induced to differentiate towards a macrophage phenotype by 1,25
      dihydroxycholecalciferol (DHCC), tumour necrosis factor-alpha (TNF-alpha) or
      phorbol myristate acetate (PMA). We found that probucol enhanced the
      proliferation of undifferentiated U937 cells. Probucol also enhanced
      proliferation in cultures that had been pre-treated with DHCC or TNF-alpha, but
      had no effect on cultures that had been pre-treated with PMA. In contrast, when
      U937 cells were treated simultaneously with probucol and DHCC or TNF-alpha, there
      was a more marked decrease in proliferation than was induced by these agents in
      the absence of probucol. Probucol had little effect on the phenotype of resultant
      cells. The surface expression of CD13 (aminopeptidase N), CD4, CD35 (C3b
      receptor), CD64 (Fc gamma RI), CD71 (transferrin receptor) and HLA Class II was
      not affected by probucol. Probucol treatment led to a small increase in the
      surface expression of CD16 (Fc gamma RIII) in TNF-alpha treated cells and to a
      small decrease in the expression of CD14 (a monocyte marker) in PMA-treated
      cells. The induction of c-fgr mRNA and TNF-alpha mRNA by DHCC or PMA or TNF-alpha
      was not significantly altered in the presence of probucol. The affect of probucol
      on U937 cells does not appear to be due to its anti-oxidant abilities because
      butylated hydroxytoluene (BHT), an equally powerful anti-oxidant, did not have
      the same effect on the cell proliferation as probucol and because no changes were
      detected in the levels of lipid peroxidation in U937 cell culture supernatants.

PMID- 8461054
TI  - The distribution of fibro-fatty atherosclerotic lesions in the aortae of casein-
      and cholesterol-fed rabbits.
AB  - Atherosclerotic lesions were induced in the aortas of 50 rabbits by feeding a
      semi-purified cholesterol-free casein diet or normal rabbit chow with a low level
      of added cholesterol for 6 or 10 months. Following perfusion fixation, the aortae
      from these animals were opened along their length, stained with oil red O and
      photographed en face. Orifice associated lesions were mapped by measuring radial
      lesion length at 10 degrees intervals circumferentially around ostia. Histology
      of these lesions revealed abundant smooth muscle cells surrounded by collagen and
      elastin in the extracellular matrix, typical of fibrous plaques, as well as oil
      red O staining lipid and some macrophage derived foam cells. These fibro-fatty
      lesions were found distal and lateral to ostia, at the same locations as fatty
      streaks seen in rabbits fed a 2% cholesterol diet for 1 week to 2 months in
      previous studies. The results of this study show that in moderately
      hypercholesterolemic rabbits fed an atherogenic diet for 6 to 10 months, advanced
      atherosclerotic plaques develop in the same location as the fatty streaks seen in
      short term experiments.

PMID- 8461055
TI  - Aortic esterified cholesterol is not superior to total cholesterol as a measure
      of atherosclerosis severity in cholesterol-fed rabbits.

PMID- 8461056
TI  - Can lipoprotein lipase be the culprit in cholesteryl ester accretion in smooth
      muscle cells in atheroma?
AB  - Bovine aortic smooth muscle cells and human skin fibroblasts were incubated with
      beta-very low density lipoprotein (beta VLDL) isolated from cholesterol-fed
      rabbits and labeled with [3H]cholesteryl oleate. Addition of lipoprotein lipase
      resulted in a 3.2-4.8-fold increase in cell associated radioactivity of which 45
      61% was in free cholesterol, i.e., derived after intracellular hydrolysis. After
      exposure of smooth muscle cells to beta VLDL for up to 9 days and 60 min sodium
      heparin wash at 4 degrees C to remove extracellular surface bound lipoprotein,
      cellular cholesterol increase was 2 micrograms in controls and in the presence of
      lipoprotein lipase (LPL) it was tenfold higher. Addition of [3H]cholesteryl ester
      labeled beta VLDL during the last 48 h of incubation showed that 30-40% of total
      cellular label was in free cholesterol. This value represents the minimal
      cellular uptake of the added lipoprotein cholesteryl ester. Addition of
      recombinant apolipoprotein (apo) E to smooth muscle cells incubated with beta
      VLDL and [3H]oleate induced no further increase in [3H]cholesteryl oleate. We
      propose that following LPL-mediated binding of beta VLDL to heparan sulphate,
      this complex either undergoes endocytosis, or translocation of cholesteryl ester
      into the smooth muscle cells (SMC) occurs without endocytosis of the entire
      particle. The present results indicate that in the aortic wall macrophage-derived
      lipoprotein lipase could play a role in cholesteryl ester accretion in smooth
      muscle cells during atherogenesis.

PMID- 8461057
TI  - Lipoprotein(a): relation to other risk factors and genetic heritability. Results
      from a Dutch parent-twin study.
AB  - We measured plasma levels of lipoprotein(a) (Lp(a)) in a sample of 152 Dutch
      adolescent mono- and dizygotic twin pairs and their parents. The distribution of
      Lp(a) levels was skewed, with the highest frequencies at low levels and was
      similar for adult men and women and their children. The relationship of Lp(a)
      concentrations with other lipoprotein and apolipoprotein risk factors for
      coronary heart disease and with lathosterol, an indicator of whole-body
      cholesterol synthesis, was studied dependent on sex and generation. In mothers
      and children there was a small positive correlation between Lp(a) levels and
      plasma cholesterol and apolipoprotein (apo) B. In mothers and daughters there
      also was a correlation between Lp(a) and LDL cholesterol levels. No correlation
      was found between Lp(a) levels and plasma lathosterol, suggesting that there is
      no relationship between Lp(a) levels and cholesterol synthesis. Associations
      among family members, i.e. between monozygotic and dizygotic twins and between
      parents and offspring were used to study familial transmission of Lp(a) levels.
      Results showed that almost all of the variance in Lp(a) concentrations was
      accounted for by genetic heritability. A small, but significant, sex difference
      in heritability was observed, but heritabilities were the same in parents and
      offspring. Heritability estimates were 93% for females and 98% for males. No
      evidence was found for assortative mating or for the influence of a shared family
      environment. These results indicate that nearly all variance in Lp(a)
      concentrations that is not accounted for by the apo(a) size polymorphism, is also
      under genetic control.

PMID- 8461058
TI  - Effect of low density lipoprotein on monocyte adhesiveness to endothelial cells
      in vitro.
AB  - Adhesion of monocytes to the endothelium is an early event in the development of
      atherosclerosis. The possibility that low density lipoproteins enhance this
      process by activating monocytes was investigated using an in vitro adhesion test
      on endothelial cell monolayer cultures. Preincubation of monocytes with low
      density lipoprotein (LDL) (100 micrograms LDL protein/l x 10(6) cells/ml) for 15
      min induced a 70% increase in adhesion to endothelial cells with a maximal effect
      at 100 micrograms LDL protein/ml and a short latency of effect (2 min). Anti-LDL
      receptor antibody, which inhibited LDL binding, blocked this activation. The LDL
      effect appeared to depend on receptor binding of LDL rather than on receptor
      mediated endocytosis, since preincubation of monocytes with LDL at either 4
      degrees C or 37 degrees C resulted in the same stimulation of adhesion. A
      cytofluorimetric study using integrin monoclonal antibodies (MAbs) against CD18
      and CD11b did not reveal any increase in expression of the integrins on the
      surface of LDL-activated monocytes. However, a 30-min preincubation of monocytes
      with anti-CD18 abolished the LDL-activated adhesion. These results indicate that
      LDL induces a rapid activation of monocyte adhesiveness to endothelial cells.
      This effect appears to be mediated by interaction of LDL with its receptor rather
      than LDL-receptor complex internalization or integrin membrane mobilization from
      intracellular pools. The integrin system nevertheless appears to be involved.

PMID- 8461060
TI  - Levels of plasma factor VII and factor VII activated forms as a function of
      plasma triglyceride levels.
AB  - It has been shown that triglyceride levels are one of the determinants of factor
      VII levels. In this study we have simultaneously evaluated, in a group of 102
      healthy individuals, the different forms of factor VII, namely factor VII mass,
      factor VII coagulant activity, activated factor VII double-chain form and factor
      VII-phospholipid complex, in relation to triglyceridaemia. The data showed a
      highly significant correlation of factor VII mass, factor VII coagulant activity
      and factor VII-phospholipid complex with triglycerides. No correlation was
      observed between the activated factor VII double-chain form and triglycerides.
      These data, together with analysis of the linear and orthogonal regression
      slopes, suggest that increase of plasma factor VII coagulant activity as a
      function of plasma triglyceride levels is attributable to an increase in both
      mass and activity of factor VII and that the increase in activity is dependent on
      an increase of factor VII-phospholipid complex rather than activated factor VII
      double-chain form. The ratio between the slopes of the regression straight line
      of factor VII mass and factor VII-phospholipid complex in relation to
      triglycerides was 2.23 (95% confidence limits 1.74-2.50), thus indicating that
      the contribution of factor VII mass is prevalent over that of the factor VII
      phospholipid complex.

PMID- 8461059
TI  - Hypercholesterolemia in non-insulin-dependent diabetes mellitus: different effect
      of simvastatin on VLDL and LDL cholesterol levels.
AB  - Non-insulin-dependent diabetes mellitus (NIDDM) is often characterized by an
      increase in VLDL-triglyceride, VLDL-cholesterol, LDL-cholesterol and a reduction
      in HDL-cholesterol. HMG-CoA reductase inhibitors significantly lower cholesterol
      rates and have an indirect effect on the LDL receptor. We measured the effect of
      simvastatin in 28 hypercholesterolemic subjects, including 14 with NIDDM in good
      metabolic control (HbAIc 7.8% +/- 1.3%). A 24-week treatment with 10 mg/day
      (weeks 1-4), 20 mg/day (weeks 5-8) and 40 mg/day (weeks 9-24) simvastatin
      revealed different responses in diabetic and non-diabetic patients. Total
      cholesterol, LDL-cholesterol and apo B decreased significantly in both groups
      (less in the diabetics), whereas only NIDDM patients displayed a significant
      reduction in VLDL-cholesterol and VLDL-apo B. In the non-diabetics, the reduction
      in plasma cholesterol was mainly confined to the LDL fraction (276 +/- 65 vs. 132
      +/- 28 mg/dl), whereas a significant fall in VLDL-cholesterol (45 +/- 19 vs. 21
      +/- 10 mg/dl) was more evident in the NIDDM patients. Simvastatin also influenced
      plasma apo B levels (221 +/- 33 vs 134 +/- 23 mg/dl in non-diabetics and 182 +/-
      44 vs. 134 +/- 30 mg/dl in diabetics). Significant reduction of apo B, LDL-apo B
      (205 +/- 39 vs. 128 +/- 23 mg/dl) in the non-diabetics and VLDL-apo B (16 +/- 5
      vs. 9 +/- 2 mg/dl) in the diabetics, indicates that the VLDL are primarily
      concerned when statins are administered in NIDDM.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8461061
TI  - Predisposition to LDL oxidation in patients with and without angiographically
      established coronary artery disease.
AB  - Oxidative modification of low density lipoprotein (LDL) may play an important
      role in the mechanism of atherosclerotic damage to blood vessels. In the present
      study the LDL isolated from the plasmas of 73 coronary artery disease (CAD)
      patients, 28 valvular heart disease (VHD) patients, 59 subjects affected by type
      IIa hyperlipoproteinemia and 71 controls was oxidatively modified by incubation
      with copper ions. In 15 CAD and 15 Type IIa patients and 15 controls the LDL
      chemical composition and polyunsaturated fatty acid (PUFA) content were also
      measured. Differences in the LDL susceptibilities to lipid peroxidation were
      studied by measuring the changes of fluorescence intensity. The lag phase in the
      CAD patients was found to be significantly lower than in the VHD and controls (P
      < 0.001). The lag phase in the type IIa patients was significantly higher than in
      the CAD patients (P < 0.01), and significantly lower than the VHD and controls (P
      < 0.01). The LDL isolated from the type IIa patients had an increase in the
      relative content of free and esterified cholesterol (P < 0.05), while the CAD
      patients had a decrease in the relative content of free cholesterol (P < 0.05),
      and an increase in the relative content of protein (P < 0.05). The lowest value
      of the LDL cholesterol to protein ratio and LDL size, was found in the CAD
      patients (P < 0.05). When expressed in micrograms/mg LDL cholesterol, the
      concentration of the LDL PUFAs was significantly higher in the CAD group than in
      the others (P < 0.05). The LDL alpha-tocopherol concentration was quite similar
      in the different groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461062
TI  - Effect of interleukin-1 receptor antagonist on vascular smooth muscle cell
      proliferation.
AB  - The development of the atheromatous plaque is largely dependent on vascular
      smooth muscle cell proliferation and production of biologically active compounds
      such as cytokines and growth factors. Cytokines such as IL-1 derived from blood
      vessel wall may contribute to regional defense or pathology. Neutralization of
      the effects mediated by IL-1 by a receptor antagonist specific for IL-1 alpha and
      IL-1 beta has been shown to reduce the possible pathologic consequences induced
      by IL-1 in the regional environment. The effect of human recombinant interleukin
      1 receptor antagonist (hrIL-1ra), a new member of the IL-1 family, has been
      assessed on modulating vascular smooth muscle cell (VSMC) proliferation in the
      rat. A significant dose- and time-dependent reduction of DNA synthesis was
      observed when hrIL-1ra was added to the cell cultures. The maximum inhibitory
      effect was seen using IL-1ra at a concentration of 250 ng/ml and after 48 h
      incubation with cultured vascular smooth muscle cells. Furthermore, hrIL-1ra
      inhibited VSMC growth in the presence of exogenous mitogenic doses of IL-1 alpha.
      The addition of indomethacin to the cultures did not modify the inhibitory
      events. These data suggest a possible pharmacologic role for IL-1ra in inhibiting
      VSMC proliferation by possibly interfering with the autocrine regulatory pathway
      of IL-1.

PMID- 8461063
TI  - Effect of testosterone on atherogenesis in cholesterol-fed rabbits with similar
      plasma cholesterol levels.
AB  - The aim was to examine the effect of testosterone on atherogenesis in cholesterol
      fed, castrated male rabbits not mediated via different plasma cholesterol levels.
      The rabbits in the testosterone group (n = 19) and in the placebo group (n = 17)
      were injected intramuscularly twice weekly for 17 weeks with 25 mg testosterone
      enantate and placebo, respectively, reaching plasma testosterone levels of 50-150
      nmol/l in the testosterone group. No effect of testosterone on liver function or
      body weight was detected, but at week 15 mean blood pressure was 75 +/- 2 mmHg
      (mean +/- S.E.) in the testosterone group compared with 69 +/- 2 mmHg in the
      placebo group (P < 0.05). To reduce variation in plasma cholesterol between the
      two groups, the amount of cholesterol fed to each rabbit was adjusted on the
      basis of weekly determinations of plasma cholesterol; the mean plasma cholesterol
      levels during the 17 weeks were 20.9 +/- 1.0 and 20.4 +/- 0.9 mmol/l for the
      placebo and testosterone groups. In the intima-inner medias of the aortic arch,
      the thoracic and the abdominal aorta there were no consistent significant
      differences in aortic cholesterol content, expressed either as nmol/cm2 or
      nmol/mg protein, between the two groups. However, the aortic cholesterol content
      tended to be lower in the testosterone group than in the placebo group. These
      findings suggest that in cholesterol-fed, castrated male rabbits, testosterone
      does not promote atherogenesis by an effect directly on the arterial wall.

PMID- 8461064
TI  - Lipoprotein(a) is not associated with coronary heart disease in the elderly:
      cross-sectional data from the Dubbo study.
AB  - Lipoprotein(a) (Lp(a)) may be an independent risk factor for cardiovascular
      disease. We have examined Lp(a) concentration in 1202 males and 1512 females,
      aged 60 years and older, who were participants in an ongoing prospective study of
      cardiovascular disease in the elderly. This report relates to cross-sectional
      data at study entry. Median Lp(a) concentration was significantly higher in
      females than in males (P < 0.001), but did not vary with age. Lp(a) concentration
      rank was significantly correlated with total (r = 0.16, P < 0.001) and LDL
      cholesterol (r = 0.19, P < 0.001), but this relationship disappeared after
      adjustment of LDL cholesterol for Lp(a) cholesterol content. Twenty-four percent
      of males and 17% of females had prevalent coronary heart disease (CHD) at study
      entry based on non-invasive criteria. Median Lp(a) concentration was slightly
      higher in those subjects with CHD, compared with those without CHD, but the
      difference was not statistically significant (P > 0.20). In a multiple logistic
      model, the following variables were independent predictors of CHD in this elderly
      population: age, hypertension (males only), family history of CHD, HDL
      cholesterol and triglycerides (females only), but not total cholesterol or Lp(a).
      These relationships were similar whether or not the model included Lp(a)
      concentration. The findings do require confirmation in the prospective study now
      in progress.

PMID- 8461065
TI  - Effect of dietary hydrogenated corn oil (trans-octadecenoate rich oil) on plasma
      and hepatic cholesterol metabolism in the hamster.
AB  - The effect of dietary hydrogenated corn oil (trans-octadecenoate-rich oil) on
      plasma cholesterol and triglyceride concentrations was compared with dietary
      palmitic acid in hamsters given a cholesterol-rich diet. The addition of dietary
      palmitic acid and hydrogenated corn oil accelerated the increase in plasma VLDL-
      and LDL-cholesterol levels and plasma triglyceride level induced by dietary
      cholesterol loading. Dietary cholesterol, palmitic acid and hydrogenated corn oil
      showed no effect on plasma HDL-cholesterol concentration. A decrease in hepatic
      LDL receptor activity was seen in animals fed a diet supplemented with
      cholesterol in combination with palmitic acid or hydrogenated corn oil in
      comparison with animals fed a diet supplemented with cholesterol alone.
      Hydrogenated corn oil (trans-octadecenoate-rich oil) appears to potentiate the
      effect of dietary cholesterol in elevating the plasma VLDL- and LDL-cholesterol
      levels through the suppression of hepatic LDL receptor activity. trans
      Octadecenoate in dietary hydrogenated corn oil may be as atherogenic as dietary
      palmitic acid due to a suppression of hepatic LDL receptors in the presence of
      dietary cholesterol loading.

PMID- 8461066
TI  - Conflict of interest.

PMID- 8461067
TI  - [4 sources to knowledge].

PMID- 8461068
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 14-1993. A 74-year-old woman with hyperparathyroidism and an
      osteolytic lesion in the humerus.

PMID- 8461069
TI  - The outcome of a free autogenous semitendinosus tendon graft in human anterior
      cruciate reconstructive surgery: a histological study.
AB  - This report illustrates the outcome of a free human autogenous semitendinosus
      tendon graft placed in the knee under arthroscopic control for anterior cruciate
      ligament reconstruction. The tendon graft showed signs of injury by localized
      loss of normal histochemical staining properties. The cellularity was not
      diminished in an early (3-week) specimen. The resultant composite anterior
      cruciate ligament consisted of two distinct areas: tendon graft and surrounding
      fibrous tissue. The tendon maintained gross and microscopic characteristics of
      the original tendon. The tissue surrounding the tendon graft had a disorganized
      cellular pattern and hypervascularity. The tendon graft in this study did not
      show gross or microscopic evidence of death and reorganization. Previous reports
      have led to erroneous conclusions concerning the outcome of a free tendon graft
      due to inaccurate biopsy site of the reorganizing fibrous tissue surrounding the
      tendon graft.

PMID- 8461070
TI  - A comparison of the doubled semitendinosus/gracilis and central third of the
      patellar tendon autografts in arthroscopic anterior cruciate ligament
      reconstruction.
AB  - The purpose of this study was to compare the postoperative success and stability
      of two different autografts used to reconstruct the anterior cruciate ligament
      (ACL): doubled semitendinosus/gracilis (DST&G) and bone-patellar tendon-bone
      (PAT). Ninety-one young (x = 25.4 years), active patients were available for an
      average follow-up of 36.4 months and included 55 patients in the PAT group and 36
      in the DST&G group. No patients had previously undergone ACL reconstruction. Knee
      stability data were obtained yearly and included scores from the Lysholm
      questionnaire, Lachman exam, and KT-1000 arthrometer at 30 pounds (KT30) and
      maximum pull (KTMAX). Both autografts were of comparable size, tension, and
      isometricity. Two separate factorial multivariate analyses of variance (MANOVA)
      were used to compare the two series for 3 follow-up years in the categories acute
      and chronic (A versus C) and meniscectomy and no meniscectomy (M versus NM).
      Results indicated that in all categories and follow-up years, PAT patients had
      consistently greater knee stability compared with the DST&G group. Overall MANOVA
      results showed significantly lower (p < 0.01) Lachman scores in PAT versus DST&G
      in each of the 3 follow-up years. Significantly lower (p < 0.05) KT30 and KTMAX
      values were also observed for PAT compared with DST&G in year 1. MANOVA results
      also showed lower (p < 0.01) Lachman scores in PAT-A versus DST&G-A for 3 follow
      up years. Lachman scores in PAT-NM patients were lower (p < 0.01) for postop
      years 1 and 2 compared with DST&G-NM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461071
TI  - The ligamentization process: a 4 year case study following ACL reconstruction
      with a semitendinosis graft.
AB  - This study evaluates the histological and biochemical changes that occurred in a
      semitendinosis autograft 4 years after intraarticular placement as an anterior
      cruciate ligament (ACL) substitute in a human patient. The graft was harvested
      during total knee replacement. Comparison to harvested ACL and hamstring tendon
      was made. Changes in collagen crimp pattern, cell type, glycosaminoglycan
      composition, and collagen crosslinking were present between the ACL autograft and
      the hamstring tendon. The appearance and biochemical properties of the
      semitendinosis autograft and the native ACL were similar 4 years following
      intraarticular placement. These observed phenomena could be attributed to
      functional adaptation, supporting the concept of ligamentization.

PMID- 8461072
TI  - Radiographic analysis of femoral interference screw placement during ACL
      reconstruction: endoscopic versus open technique.
AB  - Fifty patients with anterior cruciate ligament reconstruction using a bone
      patellar tendon-bone autograft performed by two techniques were evaluated
      roentgenographically to compare the position of the femoral interference screws.
      Group I consisted of 25 patients in whom the screw was placed using a distal
      lateral femoral incision (the two-incision technique). Group II patients
      underwent arthroscopically assisted intraarticular placement of the screw. These
      patients were then evaluated with anterior-posterior (AP) and lateral
      roentgenograms. We observed that the AP and lateral screw angles were
      significantly different with the two techniques. In addition, the endoscopic
      placement of the femoral screw had an associated divergence of the screw relative
      to the bone plug in nine of 25 patients compared with zero of 25 in the open
      group. In conclusion, radiographic differences do exist between femoral
      interference screws placed for fixation of an ACL graft using the open approach
      and those placed endoscopically. Although the clinical significance of these
      differences is not known, we raise the question of greater divergence in femoral
      interference screw placement with the newer intraarticular femoral interference
      screw placement techniques.

PMID- 8461073
TI  - Scoring of patellofemoral disorders.
AB  - A new questionnaire was used to evaluate subjective symptoms and functional
      limitations in patellofemoral disorders. The questionnaire was completed
      independently by four groups of female subjects: controls (N = 17), and subjects
      with anterior knee pain (N = 16), patellar subluxation (N = 16), and patellar
      dislocation (N = 19). The questionnaire mean scores for the groups were 100, 83,
      68, and 62 points, respectively (p < 0.0001). The items dealing with abnormal
      painful patellar movements (subluxations) (p < 0.0001), limp (p < 0.0001), pain
      (p < 0.0001), running (p < 0.0001), climbing stairs (p < 0.0001), and prolonged
      sitting with the knees flexed (p < 0.0001) differentiated the study groups most
      clearly. We recommend that these questions be asked when taking a standardized
      clinical history of an anterior knee pain patient. We also analyzed lateral
      patellar tilt and displacement by magnetic resonance imaging (MRI) in 28 subjects
      with patellar subluxation or dislocation. Low questionnaire sum score correlated
      best with increased lateral patellar tilt measured during quadriceps contraction
      in 0 degree knee flexion. It seems that a tendency to lateral patellar tilt
      during quadriceps contraction causes anterior knee pain and can be imaged in knee
      extension when the patella is not fully supported by femoral condyles.

PMID- 8461074
TI  - Two cases of dorsal defect of the patella with arthroscopically visible cartilage
      surface perforations.
AB  - Dorsal defect of the patella is an approximately 1-cm, circular, radiolucent,
      well-marginated benign lesion invariably located in the superlateral aspect of
      the patella. Only approximately 50 cases have been described in the world
      literature, of which < 10 cases have been studied histologically. We report two
      patients with bilateral, virtually symmetrical, dorsal defects of the patella and
      describe the arthroscopic and histologic findings. Case 1 was a 14-year-old girl
      and case 2 was a 35-year-old man. Cartilage perforations were seen via
      arthroscopy on the cartilage surface of both knees. The pathophysiology of this
      disorder remains to be clarified, although van Holsbeeck et al. proposed that
      vastus lateralis traction injury in the ossification process of the patella may
      be involved, as in the case of bipartite patella. The present arthroscopic and
      histological findings support this hypothesis.

PMID- 8461075
TI  - The efficacy of Na-naproxen after diagnostic and therapeutic arthroscopy of the
      knee joint.
AB  - The purpose of the study was to evaluate the effect of na-naproxen after
      diagnostic arthroscopy and arthroscopic surgery of the knee joint. In a double
      blind trial, 41 patients were randomized to treatment with na-naproxen, and 46
      patients were given placebo after surgery. For additional analgesia, patients got
      acetaminophen if necessary. In patients who underwent arthroscopic surgery, there
      were no differences between those treated with na-naproxen and those who received
      placebo in pain levels, but patients receiving na-naproxen had significantly less
      need for additional analgesia and returned significantly more quickly to work
      than patients receiving placebo (median 10 versus 30 days). In patients who had
      only diagnostic arthroscopy, there were no differences between the na-naproxen
      and placebo groups.

PMID- 8461076
TI  - Acute traumatic knee hemarthrosis.
AB  - A rapidly developing hemarthrosis in an acutely injured knee is reported to be
      associated with "surgically significant" lesions, such as anterior cruciate
      ligament tears, meniscus tears, and osteochondral fractures, in < or = 90% of
      cases. We report two cases of adult men who showed signs of such acute
      hemarthroses in stable knees after significant trauma. Neither had significant
      intraarticular pathology, such as meniscal, articular, or ligamentous injury, at
      arthroscopy. Persistent postarthroscopic bleeding led to additional diagnostic
      testing that found mild factor VIII deficiency. Hemophilia A and other clotting
      disorders should be considered by arthroscopic surgeons as a possible cause of a
      posttraumatic hemarthrosis.

PMID- 8461077
TI  - Pain relief after arthroscopic surgery of the knee: a prospective, randomized,
      and blinded assessment of bupivacaine and bupivacaine with adrenaline.
AB  - A prospective, randomized, and double-blind study was conducted to compare the
      influence on postoperative pain of equal volumes of saline, bupivacaine, or
      bupivacaine with adrenaline, injected both intraarticularly and into the wound
      puncture site, for 118 day case patients undergoing elective knee arthroscopy.
      Marginal analyses of postoperative visual analogue pain scores and postoperative
      fentanyl doses showed that the group given bupivacaine with adrenaline had less
      postoperative pain when compared with the saline group. However, when multifactor
      analyses were performed, preoperative visual analogue pain scores, operation type
      and length, and the sex of the patient were all shown to be significant
      predictors of postoperative pain, but the use of bupivacaine was not. We conclude
      that the observed differences in postoperative pain were due to differences
      between the groups in these predictive factors, especially preoperative pain
      scores, and that the use of bupivacaine was less important and not statistically
      significant in influencing postoperative pain.

PMID- 8461078
TI  - Arthroscopic observations before and after manipulation of frozen shoulder.
AB  - The purpose of this article is to report the arthroscopic findings before and
      immediately after manipulation for frozen shoulder. Twenty patients were selected
      for manipulation under general anesthesia after failing to improve with
      conservative measures in 6 months. The findings showed the joint capsule was
      difficult to penetrate with the arthroscope cannula and obturator because of the
      thickness of the capsular tissue. The glenohumeral joint accepted less than the
      normal amount of fluid. The humeral head was tight against the glenoid even in
      the suspended position. The main intraarticular finding was vascular synovitis.
      There were no intraarticular adhesions or degenerative changes. An immediate
      postmanipulation second-look arthroscopy showed there was synovial and capsular
      hemorrhage indicative of tearing from the manipulation. After glenohumeral
      manipulation, the joint accepted more fluid, and the humerus was easily
      distracted away from the glenoid with intraarticular distention.

PMID- 8461079
TI  - Full-thickness supraspinatus tendon tears with intact superior glenohumeral
      capsule.
AB  - Fourteen of 318 consecutive shoulder arthroscopies performed over 5 years were
      found to have a complete tear of the supraspinatus tendon with an intact superior
      glenohumeral joint capsule. All tears were surgically repaired into a bony trough
      in the greater tuberosity. All of these tears were found in the past 2 years,
      representing the last 155 arthroscopies performed. This would indicate that there
      were probably similar lesions that were missed in earlier cases. This represents
      a significant pitfall injury that may yield a negative arthrogram and may be
      overlooked in arthroscopic shoulder surgery unless close inspection of the bursal
      side of the rotator cuff is accomplished.

PMID- 8461080
TI  - Arthroscopic staple capsulorrhaphy: a long-term follow-up.
AB  - Fifty-four shoulders with recurrent anterior shoulder instability were evaluated
      following arthroscopic staple capsulorrhaphy. Average follow-up for those with
      only the index surgery was 39 months. Eighteen patients (33%) experienced at
      least one episode of postoperative instability. Ten underwent an open
      reconstructive procedure. Routine radiographs at time of follow-up demonstrated
      loose staples in 15% of asymptomatic patients. Range of motion was preserved
      following surgery. There was no loss of forward elevation. An average of 5
      degrees of external rotation and one spinal segment in internal rotation were
      lost following surgery. Forty-three percent of overhead athletes were able to
      return to their preinjury level of activity. Caution should be taken when
      considering arthroscopic staple capsulorrhaphy as recurrence rates are higher
      than those following open reconstruction. However, range of motion and functional
      level are well-maintained. When capsulorrhaphy is performed, consideration should
      be given to routine staple removal following adequate capsular healing.

PMID- 8461081
TI  - Arthroscopic treatment of full-thickness rotator cuff tears: 2- to 7-year follow
      up study.
AB  - This study analyzes the midterm follow-up results of 40 full-thickness rotator
      cuff tears treated by arthroscopic subacromial decompression and debridement.
      Patients were selected for this prospective study based on a variety of factors,
      including physiologic age, handedness, activity level in occupation or avocation,
      and preoperative estimate of repairability. Patients were divided into three
      groups based on the size of the tear as measured during surgery; results were
      evaluated on the UCLA shoulder rating scale. This study emphasizes the importance
      of patient selection when applying arthroscopic treatment for full-thickness
      rotator cuff tears. Small (0-2 cm) tears (n = 10) in older individuals not
      involved in strenuous activities did well (90% satisfactory). Patients with
      larger (2-4 cm) repairable tears (n = 8) did poorly (50% satisfactory) in
      comparison with our previous study of the results of open repair (84%
      satisfactory). Arthroscopic treatment in patients with massive, irreparable tears
      (n = 22) did not restore lost strength or range of motion, but there was
      significant pain relief, and 86% were satisfied with the results on a limited
      goals basis. The study concludes that with proper patient selection, arthroscopic
      treatment has a valuable, but limited, role in the treatment of full-thickness
      rotator cuff tears.

PMID- 8461082
TI  - Bony anatomy of coracoacromial arch: implications for arthroscopic portal
      placement in the shoulder.
AB  - Ease of access and occasional iatrogenic damage to the shoulder during
      arthroscopic procedures is dependent in part on bony landmarks that are not
      constant in their positions. Coracoacromial arch morphology of 280 scapulae was
      examined to study bony variations that influence portal placement posteriorly,
      superiorly, anteriorly, and laterally.

PMID- 8461083
TI  - Endoscopic carpal tunnel release: a cadaveric study.
AB  - Endoscopic carpal tunnel release was performed on 13 fresh-frozen cadavers using
      the Agee 3-M "Inside Job" Endoscopic Carpal Tunnel Release System, by a surgeon
      specifically trained in the technique and with a large clinical experience.
      Independent dissections showed no inadvertent lacerations to nerves, vessels, or
      tendons. The superficial palmar arch, the communicating branch between the ulnar
      and median nerves at the palm, and the common digital nerves to the third and
      fourth web spaces were the structures most at risk. Measurements of the distances
      between external landmarks were not helpful in accurately predicting the depth of
      blade insertion. In five of 13 cases there was complete release of the transverse
      carpal ligament. In four of the remaining eight cases fine fibers of the
      transverse carpal ligament or fascia connecting the thenar and hypothenar muscles
      were left over. In the other four cases there was an incomplete release of the
      transverse carpal ligament. The palmar fascia and more volar structures were
      preserved in the majority of cases.

PMID- 8461084
TI  - Arthroscopic Herbert screw fixation of patellar osteochondritis dissecans.
AB  - Osteochondritis dissecans of the patella is a rare cause of anterior knee pain.
      The lesion is thought to arise from chronic shear stress across the patella
      articular surface, producing a fragment of cartilage and subchondral bone that
      may remain in situ or become detached. When attempts at conservative treatment
      fail to provide satisfactory results, operative intervention is indicated. We
      present the case of a symptomatic lesion of the patella treated successfully with
      arthroscopic internal fixation using a retrogradely directed Herbert screw. The
      literature is reviewed with an emphasis on pathophysiology, diagnosis, and
      surgical treatment.

PMID- 8461085
TI  - Bilaterally painful anomalous insertion of the medial meniscus in a volleyball
      player with Marfanoid features.
AB  - A female volleyball player with a Marfanoid habitus had bilateral symptomatic
      anomalous insertions of the medial meniscus. Arthroscopic resection of the
      anomalous portions of the medial menisci as they attached to the anterior
      cruciate ligament successfully eliminated her symptoms.

PMID- 8461086
TI  - Foreign body arthroscopically retrieved from the elbow.
AB  - A patient was found to have a tea-cup-handle fragment in her elbow joint. The
      fragment was removed arthroscopically. Interestingly, the patient was unaware of
      its presence and was asymptomatic for > 29 years.

PMID- 8461087
TI  - Transligamentous motor branch of the median nerve discovered during
      endoscopically assisted carpal tunnel release.
AB  - The endoscopically assisted carpal tunnel release is an alternative to open
      procedures. A case is presented in which a transligamentous motor branch of the
      median nerve exits from the main trunk in a proximal and ulnar location. It is
      discovered from within the carpal canal during an endoscopically assisted
      procedure. The authors suggest adherence to strict principles to minimize
      potential complications in the rare event of an anatomic anomaly.

PMID- 8461088
TI  - Arthroscopic assisted PCL reconstruction: a technical note on potential
      neurovascular injury related to drill bit configuration.
AB  - Neurovascular injury is a potential complication during arthroscopic assisted or
      open posterior cruciate ligament (PCL) reconstruction. The anatomical
      configuration of the posterior tibia and the square configuration of the end of
      commonly used drill bits require special attention. One portion of the drill bit
      may cut out of the tibia < or = 20 mm distal to the exit point of the guide wire.
      The sharp square edges of these drill bits have a greater potential to traumatize
      adjacent soft tissue and to increase the risk of neurovascular damage. This risk
      may be decreased by using a tapered drill bit, an oscillating drill, and careful
      elevation and retraction of the overlying soft tissue.

PMID- 8461090
TI  - Arthroscopic meniscus repair: the easy way.
AB  - A new suturing system that offers the arthroscopist the ability to perform both
      inside-out and outside-in techniques for repairing meniscus tears with the same
      instrumentation is introduced here. Depending on the location of the tears, the
      surgeon can use either technique; in all the cases, meniscus repair can be
      performed in the easiest way.

PMID- 8461089
TI  - Endoscopic ACL reconstruction: a technical note on tunnel length for interference
      fixation.
AB  - The total length of bone-patella tendon-bone autografts can vary significantly
      between individuals. Grafts that are "too long" may protrude from the tibial
      tunnel site, precluding interference screw fixation. A simple calculation can be
      used to estimate the length of the tibial tunnel required to accommodate the
      graft. An intraoperative final check can be made with a calibrated drill. This
      distance should accommodate the total graft length. If necessary, minor
      adjustments that include trimming the bone plugs or deepening the femoral osseous
      tunnel can be made to prevent graft protrusion.

PMID- 8461091
TI  - Surgical technique of meniscal replacement.
AB  - Meniscal replacement by allograft and prosthesis is under laboratory and
      investigational clinical practice. In order to succeed, a replacement must
      duplicate the exact mechanical function of the original meniscal cartilage. The
      technique of replacement described in this article permits minimal disruption of
      the joint tissues, accurate placement of the meniscal horns, and secure fixation
      of the meniscal synovial junction.

PMID- 8461092
TI  - Osteochondritis dissecans of the talus: a new technique for arthroscopic
      drilling.
AB  - Ankle arthroscopy is an effective procedure for the evaluation and management of
      osteochondritis dissecans of the talus. For active individuals with detached
      lesions, excision, curettage, and drilling are an effective treatment. The
      ability to drill arthroscopically significantly reduces the morbidity associated
      with open procedures. The use of an anterior cruciate ligament guide and the
      transmalleolar approach are techniques that have been advocated for the drilling
      of defects on the posteromedial aspect of the talar dome. However, we describe a
      new technique using the meniscal repair instrumentation that permits accurate
      arthroscopic localization and drilling of osteochondral lesions; no
      transmalleolar portal is required.

PMID- 8461093
TI  - Arthroscopic suturing of TFCC lesions.
AB  - Different types of triangular fibrocartilage complex (TFCC) lesions have been
      described. We propose an arthroscopic repair of the peripheral tear, as it is a
      tear in the vascular portion of the TFCC. The technique is based on one used for
      meniscal repairs of the knee, and it is quite easy to perform.

PMID- 8461094
TI  - Complications associated with the use of an infusion pump during knee
      arthroscopy.

PMID- 8461095
TI  - [Perioperative preventive use of antibiotics in large ENT tumor operations].

PMID- 8461096
TI  - [A forehead light for the coat pocket].

PMID- 8461097
TI  - [Difficulties in recognition and treatment of lethal midline granuloma and
      otolaryngologic and radiotherapeutic practice].
AB  - The authors report on two cases of a "lethal midline granuloma". The first
      patient was treated by irradiation and chemotherapy. He lives for the last three
      and a half years in complete remission. The established diabetes did not affect
      the healing process. In the second case only a palliative irradiation was
      practicable because of the extreme tumour propagation, but the result was
      nevertheless good.

PMID- 8461098
TI  - [Radical parotid surgery of metastatic malignant melanoma].
AB  - With an increasing incidence of the malignant melanoma we also have to expect an
      increasing number of metastases of the parotid lymph nodes. Up to now there are
      no definite guidelines concerning the surgical treatment of these metastases.
      What is important is the question whether the facial nerve should be resected or
      retained. Between 1987 and 1991 in the ENT-clinic of the University Hamburg
      Eppendorf eight patients were treated for metastases of a malignant melanoma in
      the parotid gland. The clinical course demonstrates that there is no indication
      for a radical surgical treatment of these patients. It neither leads to a delayed
      appearance of distant metastases, nor does it improve the life expectancy.

PMID- 8461099
TI  - [Anthracycline derivatives as photosensitizing agents in photodynamic laser
      therapy: an in vitro study with squamous epithelial cancer cells of the mouth
      cavity].
AB  - Photodynamic laser therapy performed with hematoporphyrin derivatives has become
      increasingly important in the treatment of well-defined tumors in superficial
      sites. Limitations of this procedure result from the side effects of
      hematoporphyrin derivatives. In searching for possible alternatives to the usual
      photosensitizing agents, we studied the cytostatic drugs adriamycin and
      epirubicin. In order to evaluate the photodynamic effects of these agents we
      conducted in vitro studies on isolated cells from a squamous cell carcinoma of
      the oral cavity. The light source employed was an argon laser with wavelengths at
      488/514 nm. Comparison of the cytostatic effect achieved by these anthracycline
      derivatives with and without laser light treatment showed a pronounced
      photodynamic effect. These results may herald new photodynamic therapeutic
      modalities.

PMID- 8461100
TI  - [Computerized manometry and deglutition after pharyngolaryngeal tumor
      resections].
AB  - 33 patients were examined after laryngopharyngeal surgery by means of computer
      manometry using 4-channel-pressure probes. After local tumour resection in the
      region of tonsils and lateral oropharyngeal wall a slight cranial decrease in
      pressure results. Resections of the soft palate, glossotonsillar groove, base of
      the tongue, and of the vallecula lead to a cranial release of pressure reducing
      the driving force of the tongue. The swallowing action is therefore delayed and
      completely uncoordinated resulting in dyskinesia of the PE segment. Stenosis in
      the PE segment after hypopharyngeal resections increases the resistance to bolus
      transfer. If the base of the tongue is intact the obstruction can be compensated.
      After laryngectomy the sphincter pressure is decreased reducing the
      hypopharyngeal suction pump and prolonging bolus transfer. The tongue driving
      force, however, is increased. As long as the base of the tongue region is intact,
      pressure is not released and bolus transfer not severely impaired despite missing
      contraction of the pharyngeal constrictor muscle. Thus, reconstructive procedures
      after ablative pharyngeal surgery have to provide more "high-volume-tissue" in
      the base of the tongue (i.e. myocutaneous pectoral flap) in order to initiate
      swallowing and avoid cranial release of pressure whereas in the PE-segment more
      "low-volume-tissue" is necessary (i.e. myofascial pectoral flap) to facilitate
      bolus transfer.

PMID- 8461101
TI  - [Lymph node metastases of the neck in unknown primary tumor: is there a
      differential imaging diagnosis?].
AB  - In 32 patients suffering from cervical lymph node metastases with an unknown
      primary tumour the pretherapeutic findings via sonography, CT and MR were
      compared and the post-therapy findings of tumour aftercare assessed. After an
      average follow-up period of 38 months the group of branchiogenic cervical cysts
      had no recurrence. In the group of 18 patients with more than one cervical lymph
      node metastasis without primary tumour, either the primary tumour or further
      lymph node metastases became manifest in 11 patients after an average follow-up
      period of 36 months. Imaging of the number of lymph node metastases and
      differentiation between malignant degenerated branchiogenic cysts and lymph node
      metastases without primary tumour is important for prognosis. A combination of
      findings from sonography, CT and MR enables performance of such differential
      diagnosis due to morphological aspects and aspects that are conditioned by the
      contrast medium.

PMID- 8461102
TI  - [The emergency: traumatic aneurysm in the area of the head-neck].
AB  - Bleeding of aneurysm of cervical arteries is an emergency situation in ENT
      surgery. Compression of trachea and big cervical veins together with blood loss
      needs immediate treatment. Three cases are demonstrated presenting diagnostic and
      therapeutic management of one spontaneous respectively posttraumatic aneurysm of
      the inferior thyroid artery, and two aneurysms of lingual respectively facial
      artery after tonsillectomy. Interventional angiography plays an important role in
      overcoming such problems. Intravasal application of a platinum coil stops
      bleeding of the aneurysm and surgical revision of the neck can be avoided.

PMID- 8461103
TI  - [Subcutaneous emphysema of the neck and pneumomediastinum after arthroscopy of
      the knee joint. A case report ].

PMID- 8461104
TI  - [Short-term changes in the larynx and voice after intubation].
AB  - The endoscopic and stroboscopic picture of the larynx as well as the voice were
      examined pre-operatively and on the first or second post-operative day in 75
      patients who had been anaesthesized with intubation. The stroboscopic findings
      were evaluated according to the criteria suggested by Schurenberg (1990). The
      quality of the voice was estimated with a voice purity index (Moser 1984) and the
      dynamic and frequency range of the voice was measured. After intubation, we found
      alterations of the mucous membrane in 73% of the patients: increased amount of
      visible blood vessels, bleeding into the vocal cords or the trachea, bruises at
      the processus vocals or the arytenoid cartilages. The stroboscopic picture showed
      deterioration: pre-operatively large amplitudes and/or mucosal waves became even
      larger postoperatively, small amplitudes and mucosal waves decreased even
      further. The timing and the spatial symmetry of the vocal cord movements also
      deteriorated. On the average, the dynamic range and the frequency range of the
      voice did not change. However, in individual cases the changes were considerable.
      The same was true for the parameters of the voice purity index. There was no
      statistically significant dependency on sex or age of the patients, the duration
      of the intubation or the diameter of the intubation tube.

PMID- 8461105
TI  - [Jatho stoma reconstruction--cannula-free, self-anchored tracheostomy in
      laryngectomy patients].
AB  - Since 1987 we are using a tracheostoma construction technique proposed by Jatho
      in 1976. A vertical incision is made in the anterior wall of the trachea. A
      triangular skin flap is interdigitated into the slit. The slit is additionally
      held open by a thread on each side of the trachea which leads through the periods
      of the subclavial bone and from there through the skin. 34 patients, who were
      operated on according to this technique were followed up during a period between
      3 and 43 months. None of them needed a cannula to keep the stoma open. Four of
      these patients underwent a revision procedure analogue to that one described
      above. These results are compared to the results from conventional stomal
      construction and various stoma plasty techniques found in literature.

PMID- 8461106
TI  - How we spent our vacation: collaborative storytelling by young and old adults.
AB  - Young and old dyads collaborated in describing a mutually experienced event.
      Three general aspects of the vacation descriptions of 10 younger (M = 28.5 years)
      and 10 older (M = 70.7 years) married couples were examined. First, regarding the
      structure of the stories, the older adults' speech contained longer clauses, and
      they were less likely to situate an event in absolute time than were the younger
      adults. Second, regarding the content of the stories, older couples' discourse
      was more subjective, with more descriptions of places and people and fewer
      descriptions of itineraries than younger couples'. Third, regarding the
      interactions of the collaborators, the older couples produced fewer words of
      support for their spouse and more monologues than did the younger couples. This
      pattern of findings may result from a strategy by the elderly storytellers to
      decrease the memory demands of the task and the cognitive demands of the
      collaboration.

PMID- 8461107
TI  - Relaxation for insomnia and hypnotic medication use in older women.
AB  - Relaxation therapy was given to 3 groups of older women (N = 57): (a)
      hypnotically medicated insomniacs, (b) nonhypnotically medicated insomniacs, and
      (c) noninsomniacs. Groups b and c were receiving antihypertensives. Self-reported
      sleep and medication data were collected for 1 week at pretreatment (except
      relaxation), posttreatment, and 6-weeks follow-up. Three relaxation sessions, a
      nondemanding, hybrid method, were administered with the rationale of helping
      insomnia or high blood pressure. Substantial sleep improvement occurred only for
      nonhypnotically medicated insomniacs. Substantial sleep medication reduction
      (47%) occurred only for hypnotically medicated insomniacs. This relaxation
      approach proved valuable, but the nature of the treatment effect was dependent on
      the medication status of the insomniac.

PMID- 8461108
TI  - The impact of differences in subordinate and supervisor age on attitudes and
      performance.
AB  - In a study of the influence of differences in employee age and the age of the
      employee's immediate supervisor, an age-difference variable was created and used
      to test 4 competing sets of predictions for performance and attitudinal outcomes
      within a sample of 292 high school teachers. Analyses revealed that employees who
      were older than their supervisors (a) reported better working relations with
      their supervisors, (b) evaluated their supervisors more favorably, and (c)
      received ratings from their supervisors that were not less favorable than other
      employees. The results suggest that bias does not necessarily operate against
      employees who are older than their supervisors and that a relational approach
      that is based on attribute similarity-dissimilarity offers an additional source
      of systematic variance that can aid in explaining individual responses.

PMID- 8461109
TI  - Event-related potentials as indicators of repetition priming in young and older
      adults: amplitude, duration, and scalp distribution.
AB  - Event-related brain potentials (ERPs) were recorded in young and older adults in
      an indirect repetition priming paradigm. Compared with the young adults, the
      older adults' ERP repetition effect was larger and of longer duration, due
      entirely to greater amplitude elicited by the repeated item. These data suggest
      that, although indirect memory (as indexed by a robust ERP repetition effect)
      appeared to be intact in the older adult, the possibility exists for qualitative
      age-related differences consistent with inefficient and/or additional processing
      of the repeated item.

PMID- 8461110
TI  - Caring for an institutionalized parent: the role of coping strategies.
AB  - This study extends knowledge about the stresses of caregiving by considering
      relationships between adult children and their institutionalized parents.
      Although previous studies have indicated that emotional strains experienced by
      adult children with institutionalized parents are of similar magnitude to those
      experienced by caregivers in the community, little attention has been paid to
      effects that may mediate the stressor-mental health relationship. Coping
      strategies were hypothesized as mediators of the stressor-mental health
      relationship. Data from 424 adult children with a parent living in a nursing home
      revealed that emotion-focused coping strategies mediate the relationship between
      stressors and mental health, whereas problem-focused coping strategies do not
      mediate this relationship. Findings emphasize the importance of examining coping
      strategies as multidimensional entities having differential effects on mental
      health.

PMID- 8461111
TI  - Blocks in choice responding as a function of age and physical fitness.
AB  - Although both physical fitness and aspects of cognitive functioning are known to
      be poorer among older people, there is conflicting evidence about the interaction
      between age and fitness. Is greater age more strongly associated with impaired
      cognition among less fit people than it is among more fit people? In a sample of
      employed men aged 17-63 years, it is shown that this interaction is significant
      with respect to the occurrence of exceptionally slow responses but is not
      significant for mean reaction time. Multiple regression analyses suggest that the
      former measure may be interpreted as an inability to maintain concentration over
      time rather than as an index of response speed.

PMID- 8461112
TI  - Age differences in hostility among middle-aged and older adults.
AB  - Multiple measures of hostility were administered to middle-aged and older
      volunteers. There was a positive association between age and self-report measures
      reflecting hostile beliefs about others, including cynicism and suspiciousness.
      There was a weak inverse relationship between age and self-report measures of the
      overt expression of anger and aggression, but no association between age and
      measures of covert hostility was found. There was a positive relationship between
      age and an assessment of hostile behavior that was based on the respondent's
      interaction style during an interview. The magnitude of these age trends did not
      differ between men (n = 50) and women (n = 75). These findings illustrate the
      multidimensional nature of hostility. They also have practical implications for
      older people because hostility is associated with psychological well-being and
      has been shown to have consequences for health and longevity.

PMID- 8461113
TI  - Why do semantic priming effects increase in old age? A meta-analysis.
AB  - This study reports a meta-analysis comparing the size of semantic priming effects
      on young and older adults' lexical decision and pronunciation latency. The
      analysis included 15 studies with 49 conditions varying the semantic relatedness
      of a prime stimulus (single word or whole sentence) and a target word. An effect
      size analysis on the difference between young and older adults' semantic priming
      effect (unrelated minus related latency) indicated that semantic priming effects
      are reliably larger for older than for young adults. There was no evidence for
      nonhomogeneity in this age difference across the different conditions. The
      relationship between young and older adults' semantic priming effects was
      described by a function with a positive intercept and a slope of 1.0. This
      pattern of findings favors aging models postulating process-specific slowing
      rather than general cognitive slowing.

PMID- 8461114
TI  - Age difference patterns of psychometric intelligence in adulthood:
      generalizability within and across ability domains.
AB  - Cross-sectional data from the 5th (1984) wave of the Seattle Longitudinal Study
      are reported with regard to the generalizability of age differences in
      psychometric intelligence within and across ability domains. Ss were 1,628
      community-dwelling individuals drawn from a Pacific Northwest health maintenance
      organization. Age difference patterns of 9 groups with mean ages from 29 to 88
      years are examined for the ability domains of verbal ability, spatial
      orientation, inductive reasoning, numeric ability, verbal memory, and perceptual
      speed. Each ability is marked by 3 or 4 observed variables.

PMID- 8461115
TI  - Orienting tasks as moderators of narrative and expository text recall in
      adulthood.
AB  - Incidental narrative and expository prose memory of 60 older adults (M = 72
      years) and 60 younger adults (M = 24 years) was assessed following orienting
      tasks that emphasized either relational (sentence scrambling) or individual
      proposition (letter deletion) information or following a control condition.
      Orienting tasks were done capably, but older adults took longer and made more
      errors on the letter-deletion task than did younger adults. Age differences in
      recall were observed consistently for expository texts, but for narrative texts,
      age differences in recall were observed only when letters were deleted. If
      orienting tasks overtax older adults' processing resources or emphasize shallow
      information, recall gains may be minimal.

PMID- 8461116
TI  - Age differences in the performance of computer-based work.
AB  - This study investigated the extent to which age had an impact on the performance
      of computer-based work. Three simulated real-world computer-interactive tasks
      that varied in complexity and pacing requirements were evaluated. Ss included 65
      women, ranging in age from 25 years to 70 years. The methodology encompassed
      physiological, subjective, and objective performance measures. The data indicated
      that previous computer experience and age had a significant impact on the
      performance of the 3 tasks. Increased age was associated with longer response
      times and a greater number of errors for all 3 tasks. Age also influenced
      perceptions of fatigue and task difficulty. The findings are discussed in terms
      of the implications for training and job design.

PMID- 8461117
TI  - Do men show more rapid age-associated decline in simulated everyday verbal memory
      than do women?
AB  - Recent magnetic resonance imaging data suggest that men show more rapid age
      associated atrophy of the left hemisphere than do women. To investigate whether a
      similar pattern occurs for functional decline, the authors tested 417 male-female
      pairs, ages 17-79 years and matched perfectly on age and education, on 3 computer
      simulated everyday verbal memory tests: Name-Face Association, First-Last Name
      Associate Learning, and Grocery List Selective Reminding. Age and gender
      significantly predicted performance on all 3 tests. By contrast, only 1 of 15 Age
      x Gender interactions was significant, accounting for merely 1% of the test
      variance. These data suggest that although gender-based differences in rate of
      left-hemisphere structural decline may occur with normal aging, these apparently
      do not translate into differential functional decline in simulated everyday
      verbal memory.

PMID- 8461118
TI  - Age and the self-perception of ability: a twin study analysis.
AB  - Two thousand nine hundred seventy-four adults, including 678 monozygotic and 547
      dizygotic twin pairs, aged 27-86 years, self-rated ability on 6 factors:
      Interpersonal Competence, Workplace Skills, Trade Skills, Intellectual and
      Cultural, Domestic Skills, and Athletic Competition. Age accounted for no more
      than 2% of the variance on any factor, and, although there were significant
      gender effects, no significant Age X Gender interactions were observed. Twin
      similarity did not vary significantly with age, and biometrical variance
      component estimates were statistically homogeneous across age with talent factor
      variance being apportioned approximately equally to genetic and nonshared
      environmental factors. Consistent failure to find age effects as well as
      consistent observation of significant heritability support the conclusion that
      self-concept crystallizes early in adulthood and reflects genetically influenced
      psychological characteristics.

PMID- 8461119
TI  - Activity memory and aging: the role of motor retrieval and strategic processing.
AB  - This study examined the role of retrieval and encoding mechanisms in the
      magnitude of age differences in the recall of subject-performed tasks (SPTs).
      Eighty older (60-79 years old) and 80 younger adults (18-26 years old) were
      tested in 1 of 4 conditions by varying modality at both encoding and retrieval.
      The role of list organization in reducing age differences in SPT recall was also
      examined. The results suggested that older adults' SPT recall improves when motor
      processing is enhanced by list organization. Age differences in recall were
      reduced for an organized list when motor processing occurred during retrieval or
      encoding, but age differences in recall of an unorganized list remained under
      most conditions. Discrepant results in the literature concerning the magnitude of
      age differences in SPT recall could be due in part to differences in list
      characteristics, such as organization, that have not been fully explored.

PMID- 8461120
TI  - Age-related differences in the motoric aspects of transcription typing skill.
AB  - Eighty typists ranging in age from 21-71 years and in skill from 24-110 net words
      per minute participated in 2 experiments examining age-related differences in the
      motoric aspects of transcription typing skill. Age- and skill-related differences
      were examined for 2 simplified typing tasks: letter reaction time, which assessed
      latency to type a single keystroke, and digraph typing, which assessed the
      latencies to type 2 consecutive keystrokes. A finger tapping and choice reaction
      time task were also included. The results indicated that low-skill, older typists
      exhibited a deficit in both the translation and the execution components of motor
      performance, whereas high-skill, older typists exhibited a deficit in translation
      only. An additional task that manipulated preview of the text to be typed
      replicated the findings of Salthouse (1984), suggesting that older typists
      compensate for age-related slowing by beginning keystroke preparation sooner.

PMID- 8461121
TI  - Adults with Down syndrome and their aging mothers: diagnostic group differences.
AB  - Adults with Down syndrome (n = 160) and their aging mothers were compared with
      adults who have mental retardation due to other causes (n = 253) and their
      mothers in order to determine the nature and direction of diagnostic group
      differences at the middle and later stages of the family life course. Consistent
      with research on young families with a child who has Down syndrome, aging mothers
      of adults with Down syndrome reported less conflicted family environments, more
      satisfaction with their social supports, and less stress and burden associated
      with caregiving than did mothers whose adult child's mental retardation was due
      to other causes. Factors associated with patterns of stability and change in
      diagnostic group differences were discussed.

PMID- 8461122
TI  - Maternal reports of behavior of siblings of children with Down syndrome.
AB  - Mothers of children, ages 6 to 13 years, representing two target groups were
      interviewed: siblings of children with Down syndrome and a comparison group of
      siblings of children without Down syndrome. Mothers were interviewed regarding
      their expectations of typical child behavior, their perceptions of conduct
      problems of their child, and the extent to which that child shared household
      responsibilities. There were no significant differences between the groups
      regarding expectations of "typical" children, but the mothers of girls who had a
      sibling with Down syndrome reported significantly more conduct problems than did
      either mothers of children without Down syndrome or mothers of boys with a
      sibling who had Down syndrome. Groups did not differ with regard to the number of
      household tasks, but reports of conduct problems in the girls who had a sibling
      with Down syndrome were inversely related to the number of tasks undertaken.

PMID- 8461123
TI  - Type and frequency of social interaction among workers with and without mental
      retardation.
AB  - The social/verbal interactions of 6 employees with moderate or severe mental
      retardation and 6 workers without mental retardation were observed in six
      restaurants. Results showed that target workers without mental retardation gave
      more directions, asked more work-related questions, initiated more jokes, and had
      more general work-related comments than did target workers with mental
      retardation. The latter received more greetings and social amenities.
      Interactions between workers with mental retardation and the job coach correlated
      negatively with the workers' initiation of interactions with co-workers who did
      not have mental retardation. Implications for job placement and training as well
      as future research needs were discussed.

PMID- 8461124
TI  - Relation between mental age and vocabulary development among children with mild
      mental retardation.
AB  - An investigation of the relation between lexical knowledge and mental age (MA) in
      elementary school-age children with mild mental retardation was conducted.
      Lexical knowledge was assessed using the Peabody Picture Vocabulary Test-Revised
      (PPVT-R) and the Boehm Test of Basic Concepts. Items on the PPVT-R focus on
      labels for objects and events; items on the Boehm focus on relational terms.
      Mental age was measured via the Columbia Mental Maturity Scale. Results indicated
      that the relation between lexical knowledge and MA depended upon the nature of
      the vocabulary test: The correlation between the Boehm and MA was significantly
      higher than that between the PPVT-R and MA, suggesting that for this population,
      MA is more strongly related to knowledge of abstract relational terms than to
      knowledge of labels for objects and events. The latter may be more open to the
      influence of differential language experience.

PMID- 8461125
TI  - Dynamic contextual variables and the directives of persons with mental
      retardation.
AB  - We examined the ability of 14 persons with mental retardation and of 14 children
      without mental retardation to adjust the linguistic form of their directives as a
      function of their listener's affective state (happy or sad) and activity level
      (busy or idle). Directives were elicited by requiring the subjects to obtain toys
      from an adult listener. We found that both groups of subjects were sensitive to
      these dimensions of the communicative context. However, the directive forms used
      by the subjects with mental retardation were more imposing overall.

PMID- 8461126
TI  - Reliability of psychiatric and psychological diagnoses of mental retardation
      severity: judgments under naturally occurring conditions.
AB  - The reliability of diagnoses of mental retardation severity was examined through
      the comparison of psychiatric and psychological case reports found in client
      records. For a sample of 126 dually diagnosed clients, overall chance-corrected
      agreement was .47, ranging from .38 (for diagnoses of moderate mental
      retardation) to .55 (for diagnoses of borderline mental retardation). Results
      showed that the analysis of naturally occurring variation in diagnostic practices
      (including variability in professional judgment and assessment methods) may offer
      a more realistic appraisal of the reliability of diagnostic decisions in
      professional practice situations than do studies in which important sources of
      diagnostic error are controlled.

PMID- 8461127
TI  - Incidence of excessive/impacted cerumen in individuals with mental retardation: a
      longitudinal investigation.
AB  - A major sequelae of impacted cerumen (earwax) is conductive hearing loss, which
      can be deleterious to linguistic, social, and intellectual development,
      particularly for individuals with mental retardation. The longitudinal incidence
      (12-year period) of excessive/impacted cerumen and related conductive hearing
      loss of 117 adults with mental retardation was examined. Results indicated a
      considerably higher incidence of excessive cerumen and cerumen impaction with
      associated conductive hearing loss in adults with mental retardation (28%) than
      in the general adult population (2% to 6%). Moreover, a strong propensity for
      recurrent cerumen impaction in the mentally retarded population was found. These
      findings were discussed in view of the management of cerumen impaction among
      individuals with mental retardation.

PMID- 8461128
TI  - Impact of community-based instruction on the development of adaptive behavior of
      secondary-level students with mental retardation.
AB  - The impact of community-based instruction on the development of adaptive behavior
      in 34 high school students with moderate to profound mental retardation was
      examined. Results were: (a) Students made statistically significant gains in
      three of four domains of the Scales of Independent Behavior; (b) student IQ,
      level of student ambulation, and presence of behavior problems were not
      significant predictors of the amount of community-based instruction students
      received; and (c) the amount of community-based instruction was a more powerful
      predictor of gains in these domains than were IQ, level of student ambulation,
      and the presence of behavior problems. Results were discussed in terms of
      implications for the design and implementation of secondary programs for students
      with mental retardation.

PMID- 8461129
TI  - Determining the prevalence of human immunodeficiency virus (HIV) within a
      residential facility for persons with mental retardation.
AB  - Administrators of residential facilities for persons with mental retardation must
      take a proactive stance in determining the prevalence of HIV in the population.
      Administrators of the Stockley Center, a 345-bed ICF/MR, approached the issue
      utilizing a double-blinded seroprevalence study. Their aim was to use results
      from this testing to identify settings of high to moderate prevalence for
      purposes of reducing the further spread of infection.

PMID- 8461130
TI  - The neurofibromatosis type 1 gene and its protein product, neurofibromin.

PMID- 8461131
TI  - Guidance and topographic stabilization of nasal chick retinal axons on target
      derived components in vitro.
AB  - We studied mechanisms underlying the generation of topographic order within the
      developing chick retinotectal connection by combining the recently introduced
      stripe assay with a novel membrane protein fractionation technique. Our
      experiments show a preference of temporal and nasal retinal fibers for growing on
      cell membranes prepared from their proper target area. In addition, membrane
      preparations from posterior tectum were found to prolong substantially the
      survival of nasal neurites in vitro. We conclude that tropic as well as trophic
      interactions contribute to the generation of topographic maps during
      embryogenesis, in our case to the homing of nasal axons within the posterior
      tectum.

PMID- 8461133
TI  - hikaru genki, a CNS-specific gene identified by abnormal locomotion in
      Drosophila, encodes a novel type of protein.
AB  - We have identified a gene, hikaru genki (hig), whose mutant phenotype includes
      abnormal locomotor behavior. Mutant first instar larvae have uncoordinated
      movements, and both larvae and adults have reduced locomotion. Sequence analyses
      revealed that this gene encodes a novel type of protein with a signal sequence,
      but without transmembrane regions. One of its domains has similarities with
      immunoglobulin domains; three or four regions are similar to a complement-binding
      domain found in complement-related proteins and selectins. In situ hybridization
      to embryos revealed that accumulation of the hig transcripts is restricted to
      subsets of cells in the CNS. Our data suggest that hig has a role in the
      development of CNS functions involved in locomotor activity.

PMID- 8461132
TI  - Evidence that fibroblast growth factor 5 is a major muscle-derived survival
      factor for cultured spinal motoneurons.
AB  - We examined the potential role of fibroblast growth factor 5 (FGF-5) as a target
      derived trophic factor for spinal motoneurons. Northern analysis of total RNA
      from rat skeletal muscle revealed an FGF-5 mRNA transcript both during the period
      of embryonic motoneuron death and in the adult. Recombinant human FGF-5 supported
      the survival of highly enriched cultures of embryonic chick motoneurons.
      Significant proportions of the motoneuron survival activity of rat skeletal
      muscle extracts could be immunoprecipitated using an antiserum to FGF-5. The
      immunoprecipitable activity was present in soluble and matrix-bound forms in
      embryonic muscle, but bound exclusively to the extracellular matrix in adult
      muscle. These results, along with the secretory nature of FGF-5, suggest that FGF
      5 may act as a target-derived trophic factor for motoneurons.

PMID- 8461134
TI  - Mutations affecting growth cone guidance in Drosophila: genes necessary for
      guidance toward or away from the midline.
AB  - We performed a large-scale screen for mutations that affect the development of
      CNS axon pathways in the Drosophila embryo. We screened embryos from over 13,500
      balanced lines and saved over 250 mutant lines whose phenotypes suggest possible
      defects in growth cone guidance. Here we focus on two new genes: commissureless
      (comm) and roundabout (robo). Mutations in comm lead to an absence of nearly all
      CNS axon commissures, such that growth cones that normally project across the
      midline instead now extend only on their own side. Mutations in robo lead to the
      opposite misrouting, such that some growth cones that normally extend only on
      their own side instead now project across the midline. The phenotypes of these
      two genes suggest that they may encode components of attractive and repulsive
      signaling systems at the midline that either guide growth cones across the
      midline or keep them on their own side.

PMID- 8461135
TI  - Neurons assemble acetylcholine receptors with as many as three kinds of subunits
      while maintaining subunit segregation among receptor subtypes.
AB  - A family of genes encoding neuronal acetylcholine receptor (AChR) subunits has
      been identified and cloned from vertebrates. Expression studies have implied that
      as few as one or two kinds of subunits may be sufficient to construct neuronal
      AChRs and that multiple pair-wise combinations of the gene products are capable
      of generating functional receptors. We show here that a class of AChRs with a
      predominantly synaptic location on neurons contains receptors having at least
      three types of subunits and that the subunits are encoded by the alpha 3, beta 4,
      and alpha 5 AChR genes. In addition, we show that a class of extrasynaptic AChRs
      on the same neurons contains the alpha 7 subunits but lacks the alpha 3, beta 4,
      and alpha 5 subunits. The results demonstrate that native AChRs on neurons are
      more complex in composition than previously appreciated and suggest that
      constraints on subunit interactions limit the kinds of receptor species produced.

PMID- 8461136
TI  - Release of LHRH is linearly related to the time integral of presynaptic Ca2+
      elevation above a threshold level in bullfrog sympathetic ganglia.
AB  - To study the Ca2+ dependency of luteinizing hormone-releasing hormone (LHRH)
      release in the bullfrog sympathetic ganglia, a method was developed to fill the
      preganglionic nerve terminal boutons with membrane-impermeant fura-2. We found
      that as stimulation frequency increased from 0.5 to 40 Hz, the peak [Ca2+]i
      ([Ca2+]p) and the rate of rise in [Ca2+]i increased, the decay of [Ca2+]i
      transients followed up to three exponentials, and release of LHRH was linearly
      related to integral of ([Ca2+]i--[Ca2+]t)dt. The threshold level of [Ca2+]i for
      LHRH release for a given set of boutons on a C cell, [Ca2+]t, was estimated by
      the [Ca2+]p evoked by 0.5 Hz stimulation that does not induce LHRH release.

PMID- 8461137
TI  - Multiple promoters direct tissue-specific expression of the rat BDNF gene.
AB  - Brain-derived neurotrophic factor (BDNF) supports the survival of a specific set
      of neurons in the vertebrate nervous system. Here we show that the rat BDNF gene
      consists of four short 5' exons and one 3' exon encoding the mature BDNF protein.
      Eight different BDNF mRNAs with four different 5' ends and two alternative
      polyadenylation sites are transcribed from this gene. BDNF mRNAs containing exons
      I, II, and III are expressed predominantly in the brain, whereas exon IV
      transcripts predominate in the lung and heart. mRNAs containing exons I, II, and
      III increase markedly in the brain after kainic acid-induced seizures, whereas
      exon IV mRNA increases only slightly. Several transcription initiation sites were
      mapped upstream of the four 5' exons, and transfection of promoter-reporter gene
      constructs confirmed that these sequences act as promoters. Combined, the data
      demonstrate that alternative usage of four promoters within the BDNF gene and
      differential splicing control tissue-specific and seizure-induced expression of
      BDNF mRNA.

PMID- 8461139
TI  - The effect of recoverin-like calcium-binding proteins on the photoresponse of
      retinal rods.
AB  - The rod photoresponse is triggered by an enzyme cascade that stimulates cGMP
      hydrolysis. The resulting fall in cGMP leads to a decrease in Ca2+, which
      promotes photoresponse recovery by activating guanylate cyclase, causing cGMP
      resynthesis. In vitro biochemical studies suggest that Ca2+ activation of
      guanylate cyclase is medicated by recoverin, a 26 kd Ca(2+)-binding protein. To
      evaluate this, exogenous bovine recoverin and two other homologous Ca(2+)-binding
      proteins from chicken and Gecko retina were dialyzed into functionally intact
      Gecko rods using whole-cell recording. All three proteins prolonged the rising
      phase of the photoresponse without affecting the kinetics of response recovery.
      These results suggest that recoverin-like proteins affect termination of the
      transduction cascade, rather than mediate Ca(2+)-sensitive activation of
      guanylate cyclase.

PMID- 8461138
TI  - The 87K postsynaptic membrane protein from Torpedo is a protein-tyrosine kinase
      substrate homologous to dystrophin.
AB  - Postsynaptic peripheral membrane proteins at the neuromuscular junction have been
      proposed to participate in the immobilization of the nicotinic acetylcholine
      receptor at the synapse. An 87 kd cytoplasmic peripheral membrane protein has
      been demonstrated to colocalize with the nicotinic acetylcholine receptor in the
      Torpedo electric organ and at the mammalian neuromuscular junction. We have
      cloned the cDNA encoding the 87K protein from Torpedo electric organ, and the
      predicted protein sequence is homologous to the C-terminal domains of dystrophin,
      the protein product of the Duchenne muscular dystrophy gene. The 87K protein
      displays a restricted pattern of expression detected only in electric organ,
      brain, and skeletal muscle. Analysis of the in vitro and in vivo phosphorylation
      of the 87K protein indicates that it is multiply phosphorylated on serine,
      threonine, and tyrosine residues. The 87K protein is in a complex with other
      proteins associated with the postsynaptic membrane, including dystrophin and a 58
      kd protein. These results suggest that the 87K protein is involved in the
      formation and stability of synapses and is regulated by protein phosphorylation.

PMID- 8461141
TI  - A novel tetrodotoxin-insensitive, slow sodium current in striatal and hippocampal
      neurons.
AB  - Slow inward currents modulate neuronal firing patterns and may generate
      depolarizing afterpotentials (DAPs). We report a novel, slow Na+ current (INaS)
      in striatal and hippocampal neurons that can generate DAPs. INaS activated at
      depolarizations greater than -40 mV, was tetrodotoxin insensitive, and activated
      and deactivated slowly over hundreds of milliseconds. INaS was dependent upon
      extracellular Na+, but was not affected by 0 mM extracellular Ca2+ or by Ca2+
      channel blockers (Mn2+, Cd2+, or Co2+). A tetrodotoxin-insensitive, Na(+)
      dependent plateau potential that was likely generated by INaS was shown to
      underlie DAPs during intracellular recordings from hippocampal CA1 pyramidal
      neurons. Membrane depolarizations and DAPs generated by INaS may contribute to
      alterations in neuronal firing and epileptiform bursting.

PMID- 8461140
TI  - The internal quaternary ammonium receptor site of Shaker potassium channels.
AB  - Quaternary ammonium (QA) compounds inhibit K+ conductance by entering and
      occluding the open pore of voltage-activated K+ channels. We characterized the
      effects of a series of alkyl-triethylammonium blockers on the Shaker K+ channel
      and tested them on a series of site-directed mutants of the channel protein in
      order to define the structural features of the binding sites. We found that
      mutations in two regions of the channel protein, the pore (P) region and the last
      transmembrane sequence (S6), appear to alter QA binding, not through their
      effects on gating but perhaps through direct effects on the binding site. Several
      mutations in the P region affect tetraethylammonium binding but have minimal
      effects on longer blockers, suggesting that the hydrophobic tail contributes to
      binding in a nonadditive fashion. Binding of the longer blockers can be affected
      by varying the hydrophobicity of 1 residue within S6 by site-specific
      substitution, in a manner consistent with a direct hydrophobic interaction
      between the side chain at this site and the alkyl chains of the blocker.

PMID- 8461142
TI  - Long-term potentiation in the hippocampus induced by platelet-activating factor.
AB  - Platelet-activating factor (PAF) is an ether phospholipid that serves as an
      autacoid in a wide range of biological processes. We found that when PAF was
      added to hippocampal slices, it induced a stable and concentration-dependent
      increase in excitatory postsynaptic potential and population spike recordings
      (long-term potentiation [LTP]). The PAF effect was blocked by the PAF receptor
      antagonists BN 52021 and WEB 2086 and the N-methyl-D-aspartate receptor
      antagonists MK 801 and 2-amino-5-phosphonovalerate. However, these PAF receptor
      antagonists did not block LTP induced by high frequency stimulation. The
      facilitation induced by PAF could not be reversed by PAF receptor antagonists.
      Induction of either PAF-or tetanus-triggered facilitation occluded the subsequent
      expression of the other, suggesting a common pathway. LTP is a type of synaptic
      plasticity associated with the formation of memory, and PAF may play an important
      modulatory role in this process.

PMID- 8461143
TI  - Surgical treatment of congenital bronchopulmonary disease in children.
AB  - From 1987 to 1992, 22 children (age 0 days-14 years) were operated for congenital
      bronchopulmonary disease. One patient had a hamartoma. Four children had a
      bronchogenic cyst, in 1 patient combined with an esophageal duplication.
      Intrapulmonary sequestration was diagnosed in 3 children; one of whom had an
      esophageal duplication as well. Four children had localized emphysema. In 1
      patient histology showed rhabdomyosarcoma. A lobectomy was performed following
      chemotherapy but recurrence was not resectable at a third thoracotomy. Ten
      patients had cystic adenomatoid malformation, 6 were dependent on artificial
      ventilation before surgery. Three patients with cystic adenomatoid malformation
      died in hospital: 2 after pneumonectomy who were shown to have bilateral disease
      and 1 died after bilobectomy and was shown to have a hypoplastic contralateral
      lung. Hospital morbidity involved 1 patient with recurrent pneumothorax, 2 with
      atelectasis of the operated lung and 3 with prolonged artificial ventilation.
      Late mortality involved 1 patient due to pulmonary rhabdomyosarcoma. After 1-26
      months of follow-up there were no late complications. Adequate multidisciplinary
      treatment allows acceptable mortality and low morbidity in surgery for congenital
      bronchopulmonary disease in children.

PMID- 8461145
TI  - Diffuse subaortic stenosis: modified Konno procedures with aortic valve
      preservation.
AB  - The Konno procedure provides adequate relief of diffuse subaortic stenosis but
      requires aortic valve replacement. This may be questionable in patients without
      aortic valve lesions. Eleven patients had diffuse subaortic stenosis and normal
      aortic orifice: tunnel subaortic stenosis (6 patients) or diffuse hypertrophic
      obstructive cardiomyopathy (5 patients). The mean age was 16 +/- 14 years (range:
      3 months to 45 years). The mean subaortic gradient was 95 +/- 24 mmHg (range: 60
      to 150 mmHg). Two patients had previously undergone resection of discrete
      subaortic stenosis. Modified Konno procedures were used: aortoseptal approach
      with aortic annulus division in 5 patients, conal enlargement without aortic
      annulus division in 6 patients. There was one early death (9%, 70% CL = 1%-27%)
      and no late deaths. Reoperation was required in two patients: one early for
      iatrogenic aortic regurgitation and one late for residual ventricular septal
      defect and mitral regurgitation. The mean follow-up was 3.8 +/- 4.2 years (range:
      2 months to 10 years). The survivors were in functional class I (8/10), had a
      normal left ventricular function (9/10), were in sinus rhythm (10/10) and had
      left ventricular outflow tract gradients ranging up to 25 mmHg (mean = 6 +/- 10
      mmHg). Residual surgery-related defects included ventricular septal defect (one)
      and aortic regurgitation (one). In patients with diffuse subaortic stenosis and
      normal aortic orifice, modified Konno procedures with aortic valve preservation
      are preferable, effective and can be safely performed in infants and children.

PMID- 8461150
TI  - Mediastinal cystic hygroma: report of a case with review of the literature.
AB  - Cystic hygroma is a developmental malformation of the lymphatic system. It is
      very uncommon for this type of tumor to arise from and grow exclusively in the
      mediastinum. Enlargement of such a lesion within this region often produces
      alarming respiratory symptoms requiring immediate medical attention.

PMID- 8461149
TI  - Unusual variant of pulmonary arteriovenous communication.
AB  - We report a case of direct communication of right pulmonary artery to left atrium
      , a very rare congenital anomaly treated surgically with complete success at our
      centre.

PMID- 8461147
TI  - Retrograde ascending aortic dissection: a diagnostic and therapeutic challenge.
AB  - Aortic dissection with an entrance tear in the transverse aorta is generally
      considered to have the highest acute fatality rate of any type of dissection and
      the direction of its extension is the most difficult to predict. In a prospective
      study, we evaluated 61 consecutive patients (mean age 56.7 years, ranging from 21
      to 75 years), presenting with ascending aortic dissection during a 36-month
      period and tried to clarify the incidence of retrograde ascending aortic
      dissection. In 49 patients (80.3%), the intimal tear was located in the ascending
      aorta, whereas the dissection originated in the transverse aorta in 12 patients
      (19.7%); in this latter group, extension was strictly retrograde in 5 patients
      and in both directions in 7 patients. Three patients died before operation; 58
      patients underwent aortic replacement/repair under moderate hypothermia; if the
      primary tear extended into the transverse aorta or was not found in the ascending
      aorta, the aortic arch was explored during a brief period of deep hypothermic
      circulatory arrest. The overall operative mortality was 12.1% (7/58); it was
      10.4% (5/48) in ascending aortic dissection and 20% (2/10) in dissection of the
      transverse aorta. Age (P < 0.005), concomitant coronary artery disease (P < 0.01)
      and the site of intimal tear (P < 0.01) were significant predictive factors of
      operative risk. A tear in the transverse aorta is almost always associated with
      retrograde dissection and may simulate dissection with the entrance tear in the
      ascending aorta. Localization of the entrance tear remains a diagnostic challenge
      in aortic dissection but Doppler-echocardiography had a high sensitivity in this
      series (96.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461148
TI  - Risk factors of septicemia and perioperative myocardial infarction in a cohort of
      patients supported with intra-aortic balloon pump (IABP) in the course of open
      heart surgery.
AB  - In 1325 open heart operated (OHO) patients with a perioperative mortality of 5.8%
      the incidence of septicemia and perioperative myocardial infarction (PMI) were
      much higher in a cohort of 110 patients given intra-aortic balloon pump (IABP)
      support during the operative course. Analysis of this cohort showed that
      peri/postoperative insertion of the pump, the presence of disease in the
      descending branch of left coronary artery (LAD) and the need of more than one
      saphenous vein graft were risk factors for PMI. The presence of LAD disease was
      the only independent risk factor for PMI with an odds ratio (OR) of 4.62. Well
      known risk factors such as NYHA functional class, emergency, low left ventricular
      ejection fraction (EF) or elevated end diastolic pressure (EDP) were not
      prognostic of PMI. Thus, the intraoperative seemed to be more important than the
      preoperative risk profile for the development of PMI. Independent risk factors
      for the development of septicemia were the duration of IABP with an OR of 1.5 for
      each pump day and implantation of a valve prosthesis with an OR of 6.3. To avoid
      septic complications, this study suggests pump removal as soon as possible.

PMID- 8461146
TI  - Contractile and vascular consequences of blood versus crystalloid cardioplegia in
      the isolated blood-perfused rat heart.
AB  - The protective effects of sanguineous and asanguineous St. Thomas' cardioplegia
      (SCP and ACP) on post-ischemic vasodilator responsiveness, left ventricular
      developed pressure and end-diastolic pressure (LVDP and LVEDP), tissue adenosine
      triphosphate (ATP) and creatine phosphate (CP) contents were compared in the
      isolated blood-perfused rat heart. Five groups of hearts were studied: the
      controls (n = 8) perfused with blood (from a support rat) for 50 min (37 degrees
      C), versus hearts (n = 14/group) arrested by a single infusion of either
      cardioplegic solution (15 degrees C) prior to global ischemia (15 degrees C) and
      blood reperfusion (37 degrees C). After 2 or 4 h of ischemia and 50 min of
      reperfusion, endothelium-dependent vasodilator acetylcholine (1 microgram)
      induced a 10 +/- 0.5 and 8.5 +/- 0.5% reduction, respectively, in coronary
      resistance, in the SCP groups, but only a 6.5 +/- 0.6 and 4.5 +/- 0.5% reduction
      (P < 0.05), respectively, in the ACP groups. However, there were no significant
      differences in LVDP, LVEDP, tissue ATP and CP contents, and endothelium
      independent vasodilator response to nitroglycerin between the two cardioplegic
      groups. In a further study, rat hearts (n = 8/group) were arrested with SCP
      (magnesium concentration < 0.5, 5.0 or 16.0 mmol/l, in groups 1, 2 and 3) and
      subjected to 4 h of global ischemia (15 degrees C) followed by 50 min of blood
      reperfusion (37 degrees C). At the end of reperfusion, LVDP (at a ventricular
      volume of 180 microliters) was 60 +/- 3.4, 72 +/- 3.5 and 70 +/- 3.2 in groups 1,
      2 and 3, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461151
TI  - Mitral balloon valvotomy eight years later.

PMID- 8461144
TI  - Adenocarcinoma and Barrett's oesophagus. A clinico-pathological study.
AB  - A clinico-pathological study was carried out in two series of patients in order
      to determine: the prevalence of adenocarcinoma in Barrett's oesophagus in
      patients undergoing surgical resection for columnar cancer of the oesophagus, the
      incidence of Barrett's oesophagus in patients with complications of gastro
      oesophageal reflux, and the subsequent cancer development in 3-20 years follow-up
      of such patients, compared with others who had no Barrett's oesophagus. Group 1
      consisted of 264 patients with adenocarcinoma of the oesophagus undergoing
      resection and reconstruction; 18 (6.8%) had concomitant carcinoma and Barrett's
      oesophagus. These were predominantly male (male/female ratio 8/1) and had worse
      long-term survival than the other adenocarcinomas. Group 2 consisted of 782
      patients with complications of gastro-oesophageal reflux, 26 (3.3%) of whom were
      found to have Barrett's oesophagus. When followed up for a period of up to 20
      years, 4 (15.4%) of these developed cancer in the mean period of 11.5 years (1
      case per 74 person-years). This is highly significant compared with 4 others
      (0.5%) who developed cancer amongst the 756 remaining patients in group 2 with no
      Barrett's oesophagus, in the mean interval of 8 years 2 months (1 case per over
      1500 person-years). Of the 18 patients with Barrett's stricture, 4 (22%)
      developed cancer at a mean interval of 11.5 years representing one case per 51.7
      person-years indicating a higher risk of cancer development in patients with
      Barrett's stricture compared with other patients with complications of gastro
      oesophageal reflux with/without columnar epithelial-lined oesophagus and no
      stricture. Anti-reflux operation has not protected our patients with Barrett's
      oesophagus against cancer development.

PMID- 8461152
TI  - [Prognosis in unstable angina as a function of the clinical presentation].
AB  - OBJECTIVE: To assess the prognosis of Unstable Angina according to its clinical
      presentation using Braunwald's Classification. DESIGN: Retrospective study of
      hospital admissions from January 1982 to September 1990. SETTING: Coronary Care
      Unit and a Cardiology Department of a Central Hospital. PATIENTS: There were 132
      patients, 109 men and 23 women, with a mean age of 56 +/- 9 years, all submitted
      to cardiac catheterization at least 90 days after hospital admission followed up
      during 34.2 +/- 24.2 months. MATERIAL AND METHODS: Patients were divided in three
      groups according to the clinical presentation of Unstable Angina: Group A-
      Aggravated Chronic Angina and/or "De Novo" Angina; Group B--Angina at Rest but
      not in the last 48 hours, and Group C--Angina at Rest in the last 48 hours. Group
      A was also sub-divided, and the patients with Unstable Angina after myocardial
      infarction were excluded. The previous clinical profile was evaluated as well as
      the circumstances in which Unstable Angina occurred, need of Coronary Care Unit,
      angiographic findings and follow-up. RESULTS: Within the 132 patients, 86 were in
      the group A, (59 with Aggravated Angina and 27 with "De Novo" Angina), 11 in
      group B, and 35 in group C. The group with Aggravated Angina had higher incidence
      of previous myocardial infarction and bypass surgery (p < 0.01 and p = 0.05),
      compared to group with "De Novo" Angina and B, and also three vessels disease
      associated to ventricular dysfunction. "Culprit Lesion" appeared more frequently
      as eccentric type I in group A, and as concentric in group C. Revascularization
      procedures were performed in 95 patients (CABG in 66 and PTCA in 29) being
      respectively: 21 and 6 were urgent, 19 and 18 were elective and 26 and 5 were
      late procedures. CABG were more frequent in group A. There were 73 major cardiac
      events in 44 patients (8 deaths, 12 myocardial infarction and 53 new episodes of
      Unstable Angina), which were more frequent in group with Aggravated Angina and
      group C. The chance of patients with major cardiac events was in a 78 months
      follow-up, about 25% for group with "De Novo" Angina, 50% for patients with
      Aggravated Chronic Angina, and was greater than 75% in patients with Angina at
      Rest and episodes in the last 48 hours (p < 0.05)--Log-rank Test. The worse
      prognosis was seen in patients with Aggravated Chronic Angina, when a gathering
      of clinic patterns of Braunwald's classification were present. CONCLUSIONS: In
      summary, the group with Aggravated Angina and group C had more severe disease,
      required more urgent CABG and PTCA, and had also a higher incidence of cardiac
      events. The group with better prognosis was the group with "De Novo" Angina,
      which should be distinguished of the group with Aggravated Angina who was the
      worst prognosis.

PMID- 8461153
TI  - [Automatic measurement of arterial pressure].
AB  - Whenever we have a new technique for the measurement of Blood Pressure (BP),
      variations to standard devices should be expected. Recent guidelines for
      measurement and validation of automatic devices by Scientific Societies should be
      followed if doctors want to improve the accuracy of readings, avoiding mistakes
      in the diagnosis and monitoring of hypertension. To characterize the variability
      and reproducibility of the DINAMAP (Dynamic Automatic Mean Arterial Pressure), a
      random comparison with two observers (A; B) between this device and the
      sphygmomanometer was performed in a group of 80 patients with different
      pathologies. To evaluate the variability and reproducibility in the same person
      we analysed as well the mean variation in a setting of successive readings in 3
      persons. The global correlation was good for both systolic (r = 0.9) and
      diastolic pressures. The behaviour of the DINAMAP for different pressure levels
      was obtained by the regression analyses of the pressures differences between both
      devices. The best correlation is found around the 140 mmHg measurements,
      pressures above or under this level are respectively underestimated and
      undervalued. We discuss the needs of a standard statistical methodology with
      physiological meaning for the analysis which enables to understand the multiple
      variations that doctors can find when performing the comparison tests.

PMID- 8461154
TI  - [Echocardiographic evaluation of pulmonary valve stenosis for valvuloplasty in
      children and adults].
AB  - OBJECTIVES: 1--To determine the accuracy of the echocardiographic selection and
      characterization of the pulmonary stenosis (PS) for balloon valvuloplasty; 2--To
      analyze the differences between children and adults in obtaining the
      echocardiographic parameters used for pulmonary stenosis characterization.
      MATERIAL AND METHODS: We studied 53 consecutive patients with PS and a peak
      Doppler gradient > or = 40 mmHg, submitted to cardiac catheterization to perform
      balloon valvuloplasty if the right ventricle to pulmonary artery peak-to-peak
      systolic pressure gradient was > or = 40 mmHg. The patients were divided into 3
      groups on the basis of age: < or = 5 years (group 1; n = 18), 6-16 years (group
      2; n = 17) and > 16 years (group 3; n = 18). A complete echocardiographic study
      was performed including identification of valvular morphology (commissural
      fusion, dysplasia or mixed), determination of right ventricle to pulmonary artery
      peak Doppler gradient and the transducer position that yielded the highest
      transvalvular flow velocity (V), evaluation of the right ventricular outflow
      tract morphology and measurement of the valvular annulus diameter. RESULTS:
      Technically adequate recordings were obtained in all patients. Fifty patients
      (94%) were submitted to pulmonary valvuloplasty. The echo-Doppler recording of V
      was obtained from the parasternal position in 27 patients (51%), suprasternal in
      14 (26%), subcostal in 10 (19%) and apical in 2. In group 1, the V was obtained
      from the suprasternal position in 8 patients (44%), subcostal in 5 (28%),
      parasternal in 4 (22%) and apical in 1. In group 2, it was the parasternal
      position in 8 patients (47%), suprasternal in 6 (35%), subcostal in 2 (12%) and
      apical in 1. In group 3, it was the parasternal position in 15 patients (83%) and
      subcostal in 3. The peak Doppler gradient ranged from 40 to 215 mmHg (mean +/- SD
      = 78 +/- 37) and the peak-to-peak gradient at cardiac catheterization from 32 to
      220 mmHg (mean +/- SD = 81 +/- 41). The correlation between eco-Doppler peak
      gradient and peak-to-peak gradient at cardiac catheterization was r = 0.95 (SEE =
      12 mmHg) being, for group 1, r = 0.89 (SEE = 14 mmHg), for group 2, r = 0.97 (SEE
      = 8 mmHg) and, for group 3, r = 0.98 (SEE = 10 mmHg). The right ventricular
      outflow tract shows dynamic reaction 48 patients. Two patients had an
      infundibular gradient > 25 mmHg, significantly underestimated by echo-Doppler in
      one. All 5 patients (9%) but one with angiographic criteria for valvular
      dysplasia, were identified by echocardiography. One patient had a mixed form. The
      remaining 47 patients had valvular commissural fusion. The annulus size measured
      by echocardiography ranged from 10 to 28 mm (mean +/- SD = 17.7 +/- 4.3) and by
      angiography from 10 to 28 mm (mean +/- SD = 17.6 +/- 4.4). Close correlations
      were found between echocardiographic and angiographic measurements: r = 0.97 (SEE
      = 1.1 mm) being, for group 1, r = 0.90 (SEE = 1.1 mm), for group 2, r = 0.94 (SEE
      = 0.8 mm) and, for group 3, r = 0.87 (SEE = 1.3 mm). CONCLUSION: The
      echocardiographic examination allows an accurate selection and characterization
      of the PS for balloon valvuloplasty. The most significant difference in the study
      of PS in children and adults, was the lack in the ability of the eco-Doppler to
      record the V from the suprasternal position in adults. 2D echocardiography can
      reliably measure the annulus diameter in children and adults, providing precise
      information for balloon diameter selection before valvuloplasty.

PMID- 8461155
TI  - [Diagnostic value of transesophageal echocardiography in the study of mitral
      prosthesis dysfunctions].
AB  - The aim of this study are to establish the value of transesophageal
      echocardiography (TEE) in the diagnosis of mitral prostheses dysfunctions and to
      compare the performance of TEE and the transthoracic approach (TTE) in this
      context. From October 1990, the data when we started transesophageal ultrasound,
      till January 1992, we performed 218 TEE's. In 61 patients (pts) there was
      clinical suspicion of mitral prostheses dysfunction and TEE detected abnormal
      prostheses function in 22 pts (36%), 12 of which have been reoperated. In this
      group of 12 pts who underwent surgery, the basis for this study, the results of
      ETT and TEE were compared with surgeon's information. TEE confirmed the surgical
      findings in 11 patients (97%) with only one falsely positive (3%). On the other
      hand, TTE confirmed the surgical findings in only 6 pts (50%), confirmed
      partially in 3 (25%) and was falsely negative in 3 pts (25%). From these results
      the authors conclude: in the group of patients with mitral prostheses device
      dysfunction, that have been submitted to surgical treatment, there is great
      concordance between surgeon's findings and TEE information. TEE seems to be more
      accurate than TTE in the diagnosis of mitral prostheses dysfunction. Finally, TEE
      in conjunction with TTE is highly reliable in the diagnosis of mitral prostheses
      dysfunctions and spares patients from catheterism.

PMID- 8461156
TI  - [Torsades de pointes: analysis of 105 episodes].
AB  - PURPOSE: To analyze episodes of Torsades de Pointes (TP), in search of its
      electrocardiographic characteristics. PATIENTS AND METHODS: We analyzed 105
      episodes of TP, in 4 patients using quinidine and diuretics, recorded by 24-hour
      Holter monitoring. The following parameters were studied; ventricular
      repolarization out of TP, rhythm disturbances before TP; ECG characteristics of
      the onset, the bouts and the end of the TP. RESULTS: Ventricular repolarization,
      out of the TP, was abnormal, with the presence of U-waves at the end of the T
      waves, resulting in prolongation of the QT (QU) interval. The U-wave voltage was
      noted to be cycle-length dependent. Ventricular bigeminy preceded TP in 100
      episodes (95%) and the mean interval between both parameters was 18 +/- 16 min.
      The onset of the TP episodes showed the "short/long/short cycle rule", hereby
      called "pre-pause cycle", "preparing cycle" and "trigger cycle" respectively. The
      rotatory QRS-T morphology around the baseline, was seen in 75% of episodes, at
      the beginning or throughout the bout. Monomorphic ventricular tachycardia pattern
      was seen in the other 25% of episodes. Termination of bouts was sudden in all
      cases, and persistent ventricular bigeminy led to another bout in 90 episodes
      (85%). CONCLUSION: In TP patients, there is enlargement of QT intervals mostly
      due to U-waves appearance. The U-waves seen in these cases, probably have an
      important role in the genesis of TP and are probably related to ventricular after
      potentials (triggered activity). Ventricular bigeminy is a premonitory sign of TP
      in patients using class 1A antiarrhythmic drugs. Persistent ventricular bigeminy
      post-TP episodes is a strong indicator of another bout of TP. The onset of TP is
      more important than its morphology for the correct diagnosis of this arrhythmia.

PMID- 8461157
TI  - [Diastolic intraventricular gradient detected with Doppler echocardiography in
      hypertrophic cardiomyopathy. Report of a case].
AB  - It has recently been reported the rare existence of intraventricular diastolic
      gradients in patients with hypertrophic cardiomyopathy. This proves the great
      disturbance of diastolic function that exists in these patients. We report the
      case of a patient with this disease, in whom a significant diastolic
      intraventricular gradient was detected with color Doppler echocardiography. In
      the end we make a summing up of its most probable physiopathology.

PMID- 8461158
TI  - [Contribution of Holter monitoring in the diagnosis of a case of Prinzmetal's
      angina].
AB  - Prinzmetal angina is a peculiar kind of angina pectoris, in which Holter
      monitoring has been particularly useful for diagnosis. In this paper it is
      reported a 56 years old male patient with coronary artery spasm induced during
      coronary arteriography in which the Holter electrocardiography was of most
      importance for decision making.

PMID- 8461159
TI  - [Localization of immunoglobulins in the central nervous system].
AB  - The affinity of IgG to the central nervous system has been demonstrated by
      several authorities. The present study revealed the physiological localization of
      immunoglobulins. Developing human brains were obtained from autopsies, and the
      regional localization of IgG, IgA and IgM was examined as a function of age.
      Thirteen brains from children, aged 3 months to 13 years, were evaluated for IgG
      localization. Four other cases, aged 3 to 7 months, were stained for IgG
      subclasses, IgA and IgM. Positive IgG staining was observed in neurons and glial
      cells of the cerebrum and Purkinje cells of the cerebellum in 5 cases, aged 3 to
      7 months. It was decreased in 4 cases aged 1 year (3/4 in the nerve cells of the
      hippocampus and Purkinje cells, 2/4 in those of the amygdala and parietal cortex,
      and 1/4 in other regions). IgG was absent except in the Purkinje cells of four
      cases, aged 3 to 13 years. Every IgG subclass and IgA existed in neurons and
      glial cells of the cerebrum and Purkinje cells of the cerebellum in all cases.
      IgM staining, however, was negative in the nerve cells of the cerebral cortex
      although it was positive in Purkinje cells of the cerebellum and basal ganglia.
      These findings suggest that the immunoglobulins possibly passed through the
      premature blood-brain barrier in infants, were taken up by the nerve and glial
      cells in the cerebral cortex and other deep structures of the central nervous
      system, and may exert some effects on the developing process of the brain.

PMID- 8461160
TI  - [Common viral infections and pediatric neurological disorders: introductory
      remarks].
AB  - The analytical methods of nucleic acids are excellent tools to find virus
      antigens in various tissues, such as CSF, blood and brain; polymerase chain
      reaction (PCR), restriction fragment length polymorphisms (RFLP) and
      hybridization techniques. Antigens can be isolated from cellular and/or
      supernatant fractions of the CSF of patients with common viral infections. The
      latter means the possible infection of virus in the nervous system, however, the
      former depends on the species of isolated cells. If the infected cells are the
      brain cells and/or endothelial cells of the ventricular system, viral infection
      in the nervous system is inferred. On the contrary, if they are blood cells,
      macrophages or monocytes, further studies of EGG, cytokine assay and other
      clinical and laboratory tests are necessary for the diagnosis of the nervous
      system infections.

PMID- 8461161
TI  - [Herpes simplex encephalitis].
AB  - Herpes simplex encephalitis (HSE) is a severe disease with high mortality and
      morbidity. As effective antiviral therapy improves the outcome of younger
      patients, the early diagnosis of the disease has become important, especially in
      children. The annual incidence of HSE in Japan among children is estimated to be
      about 100-200 cases, and the mortality is 10-20%. Instead of brain biopsy, we
      applied the polymerase chain reaction (PCR) assay to the early diagnosis. The DNA
      of herpes simplex virus was detectable in CSF of all HSE patients in the acute
      phase. Serial quantitation of viral genome by PCR also revealed that the amount
      of DNA decreased gradually corresponding to antiviral therapy, and it turned to
      be negative 3 to 18 days after the onset of neurological signs and symptoms (mean
      10.1 days). These results show the PCR assay is a useful diagnostic tool for the
      early and non-invasive diagnosis of HSE.

PMID- 8461162
TI  - [Neurological complications of varicella-zoster virus (VZV) infection].
AB  - Sixty cases with varicella-associated neurological disorders from Japanese
      literature during recent 11 years were analyzed and compared with previous
      reports. Chief diseases were encephalitis (encephalopathy) (23.3%), cerebellar
      ataxia (21.7%), meningitis (18.3%), cerebral infarction (13.3%) and facial palsy
      (8.3%). Cerebellar ataxia, meningitis and cerebral infarction were found in young
      children under 9 years, and other disorders were seen also in older children and
      adults. Some cases had neurological symptoms before the appearance of skin rash.
      The number of cells in cerebrospinal fluid was increased in meningitis,
      encephalitis and myelitis. Though neurological complications due to varicella
      were rare, prognosis was not necessarily good, including several cases with death
      or severe sequelae. In our 4 cases of herpes zoster meningitis, marked
      intrathecal VZV-specific antibody production was found and they showed high
      antibody index. Oligoclonal band was found in one case. The pathogenesis of
      neurological complications of VZV infection was considered to be caused by direct
      viral invasion in herpes zoster and at least in some cases of varicella. Therapy
      with antiviral agents is necessary and vaccination is recommended for prevention.

PMID- 8461163
TI  - [Enterovirus infections].
AB  - Non-polio enteroviruses are currently the most common agents of the central
      nervous system viral infection, and are the major causes especially in patients
      with aseptic meningitis. The practical problems with enterovirus meningitis
      revealed from the investigation of our patients are as follows. (1) The triad of
      symptoms of meningitis (fever, headache, vomiting) were seen only in 50% of the
      older children affected. The only manifestation of neonates with aseptic
      meningitis was fever. (2) In more than half of the patients, the cerebrospinal
      fluid showed polymorphonuclear predominance within 3 days from the onset. (3) The
      causal viruses were isolated frequently (70%) from the cerebrospinal fluid of the
      children with aseptic meningitis. (4) The patients more than 1 year of age had no
      sequela clinically. Among neonates and early infants, transient abnormalities of
      brain CT findings were seen in 40% and delayed speech in 30%. Their prognosis
      should be investigated more precisely.

PMID- 8461164
TI  - [AIDS virus].
AB  - A Japanese child case of subacute progressive encephalopathy was presented. Not
      only the pathological findings of HIV growth in microglias, astrocytes and
      macrophages in the central nervous system, but also the pathobiological findings
      of neuronal apoptosis were shown as etiologies of HIV encephalopathy.
      Epidemiology, diagnosis, prophylaxis, fetomaternal transmission and embryopathy
      were discussed briefly.

PMID- 8461165
TI  - [Brain imaging in a case of early-onset acute disseminated encephalomyelitis].
AB  - A case of early-onset acute disseminated encephalomyelitis was presented with her
      brain imaging. Two weeks after a nonspecific upper respiratory infection, a 14
      month-old girl developed spastic paraplegia, difficulty in using left upper
      extremity and mental deterioration with aphasia. Steroid improved her clinical
      symptoms. However, 9 weeks later, when steroid was almost withdrawn, relapse with
      meningeal signs appeared. Reinstitution of steroid was started and 8 weeks later
      when meningeal signs disappeared, rehabilitation by physical therapist was
      started. Eighteen months later she recovered into normal intelligence and slight
      gait difficulty walking with left lower extremity weakness. CT showed extensive
      symmetric low density lesions in bilateral cerebral white matters and they almost
      resolved 8 months later. MRI showed extensive symmetric high signal lesions in
      bilateral cerebral white matters which were demonstrable in the sagittal image.
      Abnormalities in MRI were much improved 4 months later when she began to speak
      several words again.

PMID- 8461166
TI  - [A case with severe neurological involvement due to vitamin B1 deficiency
      associated with megaduodenum].
AB  - We reported a case of 4-year-old boy with multiple vitamin deficiencies,
      especially vitamin B1 deficiency. He had megaduodenum associated with membranous
      stenosis on upper jejunum. He showed recurrent vomiting at his infantile period,
      and recently intermittent neurological symptoms. When he was admitted to our
      hospital, he could not walk and showed masked face, absent deep tendon reflexes,
      horizontal and vertical nystagmus, proximally dominant muscle weakness and
      multiple vitamin deficiencies. Oral administration of small doses of vitamin B1
      (20 mg/day) could make remarkable clinical improvements. At three weeks after the
      treatment he could walk and run. Before the admission he had febrile convulsions
      and showed transiently striatal low density on CT image. We concluded that his
      neurological symptoms were due to vitamin B1 deficiency associated with
      megaduodenum. When a patient with intestinal anomaly shows neurological symptoms,
      we should think of vitamin deficiency.

PMID- 8461167
TI  - [A case report of arthrogryposis multiplex congenita with abnormal distribution
      of fiber type].

PMID- 8461169
TI  - [Usefulness of 123I-amphetamine SPECT in evaluation of cerebral circulation by
      the acetazolamide test in patients with moyamoya disease].

PMID- 8461168
TI  - [Effect of ethyl loflazepate on age-dependent epileptic encephalopathy].

PMID- 8461170
TI  - Determining the accuracy and relevance of mortality rates for extremely low
      birthweight infants.

PMID- 8461171
TI  - Priorities and practice in tropical paediatrics.
AB  - More than 14 million children under 5 years of age die annually in the Third
      World, mainly due to diarrhoea, pneumonia, malaria and immunizable diseases. The
      problems of poverty, malnutrition, poor sanitation, illiteracy and high fertility
      that traditionally are associated with underdevelopment are now being compounded
      by social disruption due to rapid changes in lifestyle, new diseases such as AIDS
      and Third World debt. A vital part of the solution is provision of basic medical
      and education services to all, with emphasis on female literacy and improving the
      status of women. Key elements in providing basic medical services are delegation
      and empowerment. Doctors must delegate the delivery of essential child health
      services to appropriately trained and adequately supported auxiliaries. Parents,
      especially mothers, need to be empowered with the knowledge and resources to
      recognize and manage, or assist in the management of, their children's health
      problems.

PMID- 8461172
TI  - Screening for cryptantigen exposure and polyagglutination in neonates with
      suspected necrotizing enterocolitis.

PMID- 8461174
TI  - Infant botulism: a review in South Australia (1980-89).
AB  - Between March 1980 and March 1989 there were six identified cases of infant
      botulism. The presenting symptoms were predominantly poor feeding, lethargy and
      constipation, and the presenting signs were predominantly hypotonia, weak gag
      reflex and respiratory difficulty. All required intensive care and prolonged
      hospital stays. Recovery was eventually complete in all cases. Infant botulism is
      an uncommon condition but early recognition with adequate intensive care usually
      results in complete recovery.

PMID- 8461175
TI  - Paediatric management practices in Down syndrome: a follow-up survey.
AB  - In a follow-up survey to a 1984 study, 339 paediatricians in Australia were
      invited to complete a brief questionnaire in 1990, in which they indicated their
      usual recommendations, practices and advice when managing children with Down
      syndrome. The response rate was 67%. The results indicated that the most frequent
      paediatrician-initiated referrals were for early intervention and for discussion
      with other parents; these options were selected more frequently in 1990 than in
      1984. While referral to a social worker was the next most frequent choice, it
      occurred less in 1990 than in 1984. Other increases in referrals were for
      physiotherapy and speech therapy. Paediatricians were more likely to support
      referral to a geneticist, speech therapist or cosmetic surgeon in response to a
      specific parental enquiry, and less likely to support referral to a social worker
      or to full-time care. There had been significant increases since 1984 in the
      likelihood that paediatricians would order audiology and investigation of thyroid
      and cardiac function. There was less opposition to the use of sedatives, and
      virtual cessation of the use of tryptophan. Paediatricians were more optimistic
      about the likelihood of persons with Down syndrome living independently, caring
      for their own finances, and marrying, but not about other developmental areas.

PMID- 8461173
TI  - Insulin dependent diabetes in pregnancy: impact of maternal blood glucose control
      on the offspring.
AB  - Definition of optimal glycaemic control in diabetic pregnancy may still be
      debated. Measures of glucose control (based on 4-6 daily glucose and frequent
      HbA1c values) were recorded in two series of diabetic pregnancies; one
      multicentre study (n = 92, 1979-82), and one study from our own institution (n =
      113, 1983-85). The average pregnancy glucose levels were 5.9 mmol/L (third
      trimester only) and 6.5 mmol/L (all trimesters), respectively. Discriminant
      analysis (including pregnancy glucose, HbA1c, gestational age, diabetes duration
      and hypertension) revealed that gestational age only (first series) and
      gestational age and HbA1c independently of each other (second series) were
      significantly associated with the occurrence of severe neonatal morbidity present
      among 30 and 16.8% of the infants, respectively. The overall outcome was
      favourable. The findings of no perinatal mortality, normal premature delivery
      rate (8.9%) and a very low rate of severe maternal hypoglycaemia (4.4%) in series
      two support the feasibility of a strict but individualized management programme.

PMID- 8461176
TI  - What do health care professionals know about childhood asthma?
AB  - The aim of this study was to examine the level of knowledge about childhood
      asthma in paediatric nurses, pharmacists and general practitioners to assess
      their potential value as sources of accurate information for patients with
      asthma. The main outcome measure was the score obtained on an asthma knowledge
      questionnaire which had been validated previously. The maximum possible score was
      31. Eighty-three general practitioners had a mean score of 28.1 (range 14-31); 82
      pharmacists scored a mean of 24.2 (range 15-30) and 30 paediatric nurses had a
      mean score of 25.5 (range 16-30). General practitioners scored well in most
      questions but had some worrying deficiencies, particularly in distinguishing
      preventive therapy from symptom relieving medication. Pharmacists and paediatric
      nurses had a number of problems in certain important areas. In particular
      pharmacists as a group were unaware of many of the clinical features of asthma,
      had misconceptions, such as the need to avoid cow's milk, and recorded incorrect
      responses to clinical scenarios of acute treatment. Paediatric nurses tended to
      overestimate the side effects of inhaled medications, and also the value of
      auscultation. They had poor knowledge of exercise-induced asthma. The data
      overall suggest that specific educational strategies should be devised for
      different groups of health professionals who manage children with asthma and
      suggest that poor knowledge on the part of health care providers may contribute
      to morbidity.

PMID- 8461177
TI  - Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic
      areas.
AB  - Data are presented for 2382 children investigated for fever in a Malaysian
      hospital between 1984 and 1987 when Widal tests and blood cultures were a routine
      part of every fever screen. There were 145 children who were culture positive
      (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed
      as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of
      combinations of initial Widal titres in predicting a positive S. typhi culture in
      a febrile child (culture positive vs the rest) showed the best model to be an O-
      and/or H-titre of > or = 1 in 40 (sensitivity 89%; specificity 89%). While the
      negative predictive value of the model was high (99.2%) the positive predictive
      value remained below 50% even for very high titres of O and H (> 1 in 640), at
      which point the specificity was 98.5%, supporting the clinical view that a high
      proportion of the TYP-CN patients really were typhoid but were missed by culture.
      The TYP-CN patients showed a very similar clinical and age profile to TYP-CP
      patients. The length of history of fever did not affect the initial Widal titre
      in culture positive cases. The Widal test in children remains a sensitive and
      specific 'fever screen' for typhoid although it will not identify all cases. In
      children, lower cut-off points for O- and H-titres should be used than are
      generally recommended.

PMID- 8461178
TI  - Evolution of asthma.

PMID- 8461180
TI  - Stillbirths, neonatal and post-neonatal mortality by race, birthweight and
      gestational age.
AB  - The birthweight and gestational age specific mortality of singleton Aboriginal
      and White infants born in Western Australia during the period 1980-86 is
      described. The analyses are based on the approximately 8000 Aboriginal and
      143,000 White births notified through the Western Australia Midwives' system,
      which were linked to perinatal and infant death records. Overall, stillbirth,
      neonatal and post-neonatal mortality risks were significantly higher (P < 0.01)
      for Aboriginals than Whites. However, for specific birthweights and gestational
      ages, particularly for infants of lower birthweight and shorter gestations,
      Aboriginals had lower mortality risks than Whites. The ratio of Aboriginal to
      White mortality risks tended to increase with advancing age of death, suggesting
      that longer exposure to the well-documented poorer social and environmental
      conditions of Aboriginal infants increased the mortality risk.

PMID- 8461181
TI  - Essential fatty acid deficiency in parenterally fed preterm infants.
AB  - To determine the incidence of essential fatty acid (EFA) deficiency during short
      term fat-free parenteral nutrition, the authors investigated prospectively the
      EFA status of nine low birthweight (1145 +/- 343 g) preterm (28.2 +/- 1.9 weeks)
      infants, in whom delivery of dietary fat was delayed postnatally for 2-9 days.
      Serial determinations of plasma fatty acids showed that during fat-free
      alimentation, the major EFA, linoleic acid (LA), decreased rapidly (-0.75% total
      fatty acids per day), accompanied by a rise in endogenously produced non
      essential fatty acid, eicosatrienoic acid (Mead acid). Essential fatty acid
      deficiency was confirmed biochemically by an elevation in the triene-tetraene
      ratio in six of the infants, only one of whom developed clinical symptoms.
      Abnormal fatty acid profiles were corrected within a few days of fat delivery by
      either intravenous or enteral routes. Essential fatty acids and their metabolites
      are involved in a wide range of physiological functions vital to postnatal growth
      and development. Depletion of these nutrients can be corrected by providing a
      minimum of 0.25 g LA/kg per day (equivalent to 0.50 g/kg per day of 20%
      intralipid or 30-50 mL/kg per day of breast milk).

PMID- 8461179
TI  - Combined therapy with growth hormone and oxandrolone in adolescent girls with
      Turner syndrome.
AB  - Five adolescent girls with Turner syndrome (mean age 13.9 years, mean bone age
      12.0 years) were treated with both recombinant human growth hormone (rhGH) and
      oxandrolone for 2 years with an average increment in height of 13.4 cm. The mean
      bone age advanced by only 1.2 years, providing an increase in the mean estimated
      mature height of 9.2 cm. We conclude that rhGH and oxandrolone benefit older
      teenagers with Turner syndrome because of an increased growth rate with slow
      progression of skeletal maturation.

PMID- 8461182
TI  - The cost of improving the outcome for infants of birthweight 500-999 g in
      Victoria. The Victorian Infant Collaborative Study Group.
AB  - The aim of this study was to conduct an economic evaluation of neonatal intensive
      care for extremely low birthweight (ELBW) infants born in the state of Victoria.
      Two distinct eras (1979-80 and 1985-87) were compared. Follow-up data at 2 years
      of age were available for all 89 survivors from the 351 live births in 1979-80,
      and for 211 of 212 survivors from the 560 live births in 1985-87. The overall
      cost-effectiveness for ELBW infants during 1985-87 compared with 1979-80 was
      $104,990 ($A 1987) per additional survivor, or $5390 ($A 1987) per additional
      life year gained. Cost-effectiveness improved with increasing birthweight. If the
      quality of life of the survivors was considered, the economic outlook was more
      favourable. The cost per quality-adjusted life year gained was $5090 ($A 1987),
      approximately one-tenth of that obtained from the only previous full economic
      evaluation of neonatal intensive care. Although neonatal intensive care is
      expensive, it compares favourably with some other health care programmes,
      particularly as the outcome for ELBW infants continues to improve.

PMID- 8461183
TI  - Insulin deficiency: effects on fetal growth and development.
AB  - Insulin deficiency in either the mother or foetus has significant effects on
      fetal growth and development. In the human, maternal insulin deficiency, or
      diabetes mellitus, leads to macrosomia and increased adiposity of the foetus,
      while specific fetal hypo-insulinaemia is associated with intra-uterine growth
      retardation. When maternal diabetes is induced in experimental animals, no
      consistent increases in fetal bodyweight are observed although the body fat
      content of the foetus is increased in the majority of species studied. The
      magnitude of the fetal weight gain during maternal diabetes appears to be
      determined by the body fat content of the foetus, the severity and duration of
      the diabetes and by the temporal pattern of maternal hyperglycaemia observed
      during pregnancy. The latter factors, in particular, influence the level of
      insulin in the foetus which, in turn, regulates the rate of intra-uterine growth.
      By contrast, fetal insulin deficiency has a more uniform effect on fetal growth
      and leads to impaired growth in both experimental and naturally occurring hypo
      insulinaemic conditions. Fetal insulin deficiency reduces fetal growth by
      decreasing nutrient uptake and utilization of the fetal tissues and by altering
      the circulating concentrations of the insulin-like growth factors. Consequently,
      deficiencies in either fetal or maternal insulin secretion during pregnancy can
      alter fetal growth and have important consequences for perinatal survival and
      postnatal morbidity.

PMID- 8461184
TI  - A fatal case of necrotizing enterocolitis in a neonate with polyagglutination of
      red blood cells.
AB  - An infant of 30 weeks gestation developed necrotizing enterocolitis (NEC) 8 days
      after birth and died 2 days later after a fulminating course. During her illness
      she received two blood transfusions, both of which produced sub-optimal rises in
      her haemoglobin and were associated with evidence of haemolysis. Retrospective
      analysis demonstrated T antigen (Tk) polyagglutination of the infant's red blood
      cells and donor plasma. Although bacterial cultures were negative throughout the
      course of the illness in this case, T antigen exposure is associated with certain
      anaerobic infections and with severity of NEC. Infants with NEC should be
      regularly screened for T antigen exposure and if this test is positive, plasma
      (immunoglobulin) containing infusions should be avoided.

PMID- 8461185
TI  - Chronic diaphragmatic pacing in a quadriplegic boy.
AB  - Diaphragmatic pacing is a method of long-term artificial ventilation that is
      preferable to other forms of ventilation in suitable patients. Its use is
      described in a 14 year old quadriplegic boy who was previously hospital dependent
      and required continuous positive pressure ventilation.

PMID- 8461187
TI  - New Zealand Cot Death study and missing data.

PMID- 8461186
TI  - Flunitrazepam in terminal care.
AB  - Flunitrazepam is a benzodiazepine of long half-life with sedative, anxiolytic,
      muscle relaxant and anticonvulsant properties. It has proved effective in
      controlling terminal agitation, confusion, restlessness, dystonia and fitting in
      adults and can be given by subcutaneous infusion in combination with other drugs.
      Its use in children during their terminal illness is described. Good symptom
      control without excessive sedation was achieved over the 24 h prior to death.

PMID- 8461188
TI  - Day care in Victoria.

PMID- 8461189
TI  - Non-ketotic hyperglycinaemia.

PMID- 8461191
TI  - Fringe benefits.

PMID- 8461190
TI  - Severe choanal stenosis complicating nasopharyngeal CPAP.

PMID- 8461192
TI  - The definition of oral health.

PMID- 8461193
TI  - The need for involvement--an interview with David Lloyd. Interview by Sharon
      Beesley.

PMID- 8461194
TI  - 'Emergency dental services'.

PMID- 8461195
TI  - 'The future of vocational training'.

PMID- 8461196
TI  - 'Temporomandibular joint and orofacial pain: clinical and medicolegal management
      problems'.

PMID- 8461197
TI  - 'A survey of patients seen in consultant clinics in conservative dentistry at
      Edinburgh Dental Hospital in 1990'.

PMID- 8461198
TI  - 'Profession in turmoil'.

PMID- 8461199
TI  - BDJ re-design.

PMID- 8461200
TI  - Duplication of maxillary molars.

PMID- 8461201
TI  - Latex allergies.

PMID- 8461202
TI  - pH changes in plaque after eating snacks and meals, and their modification by
      chewing sugared- or sugar-free gum.
AB  - Previous studies have suggested that if either sugar-free or sucrose-containing
      chewing gum is chewed after acidogenic meals or snacks, the plaque pH response to
      the latter is reduced and the potential for remineralisation of experimental
      white spot caries lesions is enhanced. This study has compared the effects of
      both gums on plaque pH (measured by the sampling technique) in 10 subjects who
      chewed the gums after standard acidogenic challenges (sucrose rinse, cupcake, and
      fried chicken dinner). The results showed that while both gums can significantly
      reduce the acid response, sugar-free gum appears more effective.

PMID- 8461203
TI  - The use of a caries detector dye during cavity preparation: a microbiological
      assessment.
AB  - During cavity preparation conventional tactile and optical criteria are used to
      assess the caries status of the enamel-dentine junction, cavity preparation being
      considered complete when this area is hard to a sharp probe and stain free. In
      the present study 201 cavities were prepared under rubber dam. When caries
      removal was considered complete using the conventional tactile and optical
      criteria, a caries detector dye (1% acid red in propylene glycol), which is
      claimed to stain 'infected' tissue red, was applied. Fifty-two per cent of
      cavities showed caries dye stain in some part of the enamel-dentine junction.
      Subsequent microbiological sampling of dye-stained and dye-unstained sites
      resulted in the recovery of low numbers of bacteria and revealed no difference in
      the level of infection of the two sites. It is concluded that the conventional
      tactile and optical criteria are satisfactory assessments of the caries status of
      tissue during cavity preparation and that subsequent use of a caries detector dye
      on hard and stain-free dentine will result in unnecessary tissue removal.

PMID- 8461205
TI  - Mercy mission to Guatemala.
AB  - The author joined an American team on one of their regular 'Mercy Missions' to
      Third World countries to treat underprivileged children. The patients' gratitude,
      the absence of complaining, operating conditions and quality of life were in
      stark contrast to that often seen in the UK. It was a heart warming experience
      for all members of the team.

PMID- 8461204
TI  - Controversies in cross-infection control.
AB  - The following article is intended to question certain procedures designed to
      prevent cross-infection. It is the first of a series of occasional articles
      describing new techniques, research, and new products, which it is hoped, may
      enable dental practitioners to update their knowledge of this rapidly changing
      subject.

PMID- 8461206
TI  - Temporary dressings.

PMID- 8461207
TI  - A different kind of cancer pain: the issue of family pain.

PMID- 8461208
TI  - Midazolam in terminal care.

PMID- 8461209
TI  - Controlling cancer and its symptoms.

PMID- 8461210
TI  - What is a non-profit hospice?

PMID- 8461211
TI  - Regulations vs. ideals: a case history of a hospice closure.

PMID- 8461212
TI  - Whole person care: beyond psychosocial and physical needs.

PMID- 8461214
TI  - A consensus statement by radiation oncologists regarding radiotherapy for bone
      metastases.

PMID- 8461213
TI  - A consensus statement by radiation oncologists regarding radiotherapy for bone
      metastases.

PMID- 8461215
TI  - Fetal origins of coronary heart disease.

PMID- 8461216
TI  - Mechanisms of ethanol-induced cardiac damage.

PMID- 8461217
TI  - Non-invasive three-dimensional localisation of arrhythmogenic foci in Wolff
      Parkinson-White syndrome and in ventricular tachycardia by radionuclide
      ventriculography: phase analysis of double-angulated integrated single photon
      emission computed tomography (SPECT).
AB  - A new tomographic technique combined with phase analysis was used to detect
      premature and ectopic ventricular contraction patterns in 15 patients with Wolff
      Parkinson-White syndrome and during ventricular tachycardia in seven patients.
      Data generated by gated single-photon emission computed tomography (SPECT) were
      analysed by backprojection of the Fourier coefficients, double-angulation, and
      integration to thick slices containing the ventricles, thus allowing
      visualisation of the contraction patterns in three perpendicular views. The
      results were compared with those of catheter mapping. In nine patients with Wolff
      Parkinson-White syndrome the site of initial contraction detected was identical
      with the site of the accessory pathway found by catheter mapping. The sites of
      origin of the ventricular tachycardias determined by catheter mapping were within
      3 cm of the sites detected by the new technique. This new technique seems to be a
      promising non-invasive method for localising ectopic ventricular activity that
      will considerably shorten the time required for subsequent invasive procedures.

PMID- 8461218
TI  - Significance of reciprocal ST depression in acute myocardial infarction: a study
      of 258 patients treated by thrombolysis.
AB  - OBJECTIVE: To investigate the clinical significance of reciprocal ST depression
      on the presenting electrocardiogram in patients with acute myocardial infarction
      treated by thrombolysis. DESIGN: A prospective cohort analytical study. SETTING:
      A London district general hospital. SUBJECTS: Two hundred and fifty eight
      consecutive patients with acute myocardial infarction treated with thrombolysis.
      INTERVENTIONS: All patients underwent treadmill stress testing after a mean (SEM)
      of 10 (3) days; 200 patients (78%) were referred for coronary arteriography at 30
      (16) days. MAIN OUTCOME MEASURES: Relation between reciprocal ST depression at
      presentation and several endpoints: time from start of chest pain to hospital
      presentation, electrocardiographic changes during early treadmill stress testing,
      presence of multivessel coronary disease, and clinical outcome in terms of
      recurrent ischaemic events (death, reinfarction, and unstable angina) during a 10
      (range six to 12) month follow up. RESULTS: Presentation was generally early, but
      in this group of patients reciprocal ST depression was significantly related to
      the time from the start of symptoms, those with reciprocal change presenting on
      average one hour earlier than those without. Although reciprocal change on the
      presenting electrocardiogram was weakly associated with ST depression on
      treadmill stress testing, it was not indicative of remote ischaemia as a result
      of multivessel coronary disease or high grade collateralisation of the infarct
      related artery. There was no association between reciprocal change and the
      incidence of recurrent ischaemic events. CONCLUSION: Reciprocal ST depression on
      the presenting electrocardiogram seems to be a benign electrical phenomenon
      related to the time from the start of symptoms. It does not necessarily predict
      an adverse prognosis in patients treated by thrombolysis.

PMID- 8461219
TI  - Early treatment with captopril after acute myocardial infarction.
AB  - OBJECTIVES: To determine the effects of early treatment with captopril on
      haemodynamic function, neuroendocrine biochemistry, left ventricular structure,
      clinical outcome, and exercise capacity over one year from acute myocardial
      infarction. DESIGN: Randomised, double blind, placebo controlled comparison of
      captopril and placebo. SETTING: Coronary care units and cardiology departments of
      two university teaching hospitals in Glasgow. PATIENTS: 99 haemodynamically
      stable patients with acute myocardial infarction, selected on clinical grounds as
      being at risk of late ventricular dilatation. INTERVENTION: Captopril or
      identical placebo started between six and 24 hours after start of symptoms and
      continued for 12 months. Target maintenance dose was 25 mg three times a day.
      MAIN OUTCOME MEASURES: (a) Acute haemodynamic effects of treatment; (b)
      neuroendocrine biochemistry from admission to two months; and (c) change in
      echocardiographic measures of left ventricular size, clinical outcome, and
      exercise capacity after 12 months of treatment with a separate analysis of the
      effects of one month of treatment withdrawal on left ventricular volumes.
      RESULTS: Captopril caused acute reductions in mean (SEM) pulmonary artery
      pressure (2.48 (0.69) mm Hg) and systemic vascular resistance (260 (103))
      dyn.s.cm-5). Over the first 10 hours captopril reduced mean arterial pressure by
      12.1 (2.4) mm Hg compared with 3.8 (1.9) mm Hg in the placebo group. No patient
      had to be withdrawn from the captopril group because of hypotension. From day 1
      onwards systolic and diastolic arterial pressures in the captopril treated group
      were slightly but not significantly lower than on placebo. There was no
      difference in the incidence of ventricular or supraventricular arrhythmia with
      treatment. Captopril prevented the day 3 peak in angiotensin II that occurred in
      the placebo group (peak concentration (interquartile range): 10.1 (4.8-19.4)
      pg/ml v 16.8 (4.3-46.3) pg/ml)) but had no effect on atrial natriuretic factor,
      arginine vasopressin, or catecholamines. Plasma atrial natriuretic factor
      remained above normal in both groups at two months after infarction. After one
      year left ventricular volume indices had increased less on captopril than on
      placebo: left ventricular end systolic volume index 5.4 ml/m2 v 14.7 ml/m2 (95%
      confidence interval (95% CI) of difference -14.6 to -3.9; p = 0.0011); left
      ventricular end diastolic volume index 8.4 ml/m2 v 19.0 ml/m2 (95% CI of
      difference, -17.0 to -4.2; p = 0.0016). Withdrawal of captopril for one month did
      not affect ventricular volumes. There was no difference in exercise capacity.
      CONCLUSIONS: Captopril started between six and 24 hours after acute myocardial
      infarction is not associated with significant hypotension. It suppresses
      activation of the renin angiotensin system but has no effect on plasma
      concentrations of other neurohormones. Atrial natriuretic factor remains raised
      at two months after myocardial infarction. Captopril significantly decreases left
      ventricular dilatation. This effect is not lost after one month of treatment
      withdrawal and is thus due to an alteration of left ventricular structure and not
      to a short lived haemodynamic action of captopril. Long-term treatment with
      captopril does not result in improved aerobic exercise capacity after acute
      myocardial infarction.

PMID- 8461220
TI  - Plasminogen activator inhibitor: a risk factor for myocardial infarction in
      diabetic patients.
AB  - OBJECTIVE: To determine whether diabetic patients admitted with acute myocardial
      infarction have impaired fibrinolytic activity due to raised plasminogen
      activator inhibitor compared with non-diabetic patients. SETTING: A district
      general hospital. PATIENTS: 90 non-diabetic and 38 diabetic patients admitted
      with acute myocardial infarction. RESULTS: Both plasminogen activator inhibitor
      activity and antigen were significantly higher in diabetic than in non-diabetic
      patients (24.7 (6.8) v 18.5 (6.8) AU/ml; p = 0.0001 and 64.2 (range 13.1 to
      328.8) v 38.5 (range 10.9 to 173.7 ng/ml; z = 3.3; p = 0.0008) with a positive
      correlation between activity and antigen (rs = 0.51; p = 0.0001). In both groups,
      activity and antigen concentrations were significantly higher than in diabetic
      and non-diabetic subjects without coronary artery disease (p = 0.002 to 0.0001
      for each comparison). Plasminogen activator inhibitor activity correlated
      significantly with admission plasma glucose (r = 0.32; p = 0.0001), glycated
      haemoglobin (r = 0.32; p = 0.0001), admission plasma insulin (rs = 0.48; p =
      0.001), and Killip grade of heart failure both on admission (rs = 0.27; p =
      0.001) and on discharge (rs = 0.22; p = 0.006), but not with cumulative creatine
      kinase MB isoenzyme release (rs = -0.08). There were similar but weaker
      correlations between tissue plasminogen activator antigen and admission plasma
      glucose, glycated haemoglobin, and insulin. In 18 patients (12 non-diabetic and
      six diabetic) plasminogen activator inhibitor activity was measured between six
      and 12 months (8.3 (1.6)) after the acute infarct and remained similar to
      activity on admission (24.8 (1.9) AU/ml (NS) for diabetic and 17.9 (6.9) AU/ml
      (NS) for non-diabetic patients) and was still significantly higher in diabetic
      than in non-diabetic patients (p = 0.007). CONCLUSION: These results show that
      diabetic patients have higher plasminogen activator inhibitor activity than non
      diabetic patients both on admission with acute myocardial infarction and at
      follow up six to 12 months later. Raised plasminogen activator inhibitor activity
      may predispose diabetic patients to myocardial infarction and may also impair
      pharmacological and spontaneous reperfusion after acute myocardial infarction
      thus contributing to the poor outcome in these subjects.

PMID- 8461229
TI  - Unruptured aneurysm of the sinus of Valsalva: a potential source of
      cerebrovascular embolism.
AB  - An unruptured aneurysm of the right sinus of Valsalva with intraluminal thrombus
      that displaced the right coronary artery ostium was diagnosed in a 30 year old
      Omani man who was investigated for uncontrolled grand mal epilepsy and residual
      left hemiparesis caused by occlusion of the right middle cerebral artery.
      Surgical intra-aortic closure of the aneurysm, which necessitated a saphenous
      vein graft to the right coronary artery, was successful. An aneurysm of the sinus
      of Valsalva is an unusual cause of a thromboembolic cerebrovascular accident.

PMID- 8461223
TI  - A loss of taurine and other amino acids from ventricles of patients undergoing
      bypass surgery.
AB  - OBJECTIVE: To study the changes in amino acid content of left ventricles of
      patients during cardiac surgery that involves cardiopulmonary bypass and cold
      cardioplegia. DESIGN: Biopsy specimens (up to 10 mg wet weight) from the left
      ventricle of 30 patients undergoing coronary artery bypass graft and valve
      replacement surgery on cardiopulmonary bypass (protected by cold cardioplegia
      with St Thomas' solution) were taken immediately before the infusion of the
      cardioplegic solution and just before the removal of the cross clamp, and were
      analysed for their amino acid content. RESULTS: Of the most abundant cellular
      amino acids in the left ventricle taurine, glutamine, glutamate, and aspartate,
      but not alanine, showed a significant fall during the period of cross clamping. A
      rise in intracellular sodium (Na) is known to occur during cold cardioplegic
      arrest so that an activation of an amino acid/Na efflux, similar to that seen in
      animal experiments, seems a likely mechanism. The anomalous behaviour of alanine
      suggests some recovery of metabolism. CONCLUSIONS: The loss of alpha amino acids
      (by contrast with the loss of taurine) will depress protein synthesis and reduce
      energy reserves after cardiac surgery. Attempts to preserve the concentrations of
      intracellular alpha amino acids must be balanced against the need to regulate
      intracellular Na concentration and hence intracellular pH and calcium ions. The
      presence of alpha amino acids in the cardioplegic solution (or in a resuscitation
      solution) should maintain the intracellular concentrations and favour activation
      of the taurine/Na symport to oppose the rise in intracellular Na concentration.
      Because the reservoir of tissue taurine is limited, the potential benefits of
      increasing the concentration of taurine in the heart by diet before surgery and
      addition of alpha amino acids to the cardioplegic solution merits further
      assessment.

PMID- 8461222
TI  - Progression of aortic valve dysfunction in 51 adult patients with congenital
      bicuspid aortic valve: assessment and follow up by Doppler echocardiography.
AB  - OBJECTIVE: To assess the pattern and progression of aortic valve dysfunction by
      serial Doppler echocardiographic examinations in ambulatory adult patients with
      congenital bicuspid aortic valve. DESIGN AND SETTING: Retrospective analysis of
      patients referred for Doppler echocardiography over a four year period. SUBJECTS:
      Fifty one adult patients with echocardiographic diagnosis of congenital bicuspid
      aortic valve had serial Doppler echocardiographic studies at least six months
      apart. There were 40 men and 11 women with a mean age of 36 years. MAIN OUTCOME
      MEASURE: Doppler echocardiographic values of aortic valve dysfunction. Cardiac
      events including endocarditis and aortic valve replacement were also evaluated.
      RESULT: Coarctation was present in five patients. 31 (61%) patients had a
      functionally normal bicuspid aortic valve defined as a mean gradient < 25 mm Hg
      and mild regurgitation. Significant aortic regurgitation was present in 15
      patients (moderate in 12 and severe in three). Three patients had isolated aortic
      stenosis and two patients had combined aortic valve dysfunction. At a median
      follow up of 21 months (range six to 46 months), six patients had aortic valve
      surgery (one for aortic stenosis, three for aortic regurgitation, and two for
      endocarditis). Only 22 patients (43%) continued to have a functionally normal
      aortic valve. CONCLUSION: In this cohort of fairly young patients, aortic
      regurgitation is more common than aortic stenosis. Progression of aortic valve
      dysfunction occurs in patients with pre-existing valve dysfunction and even in
      those with normal aortic valve function at the initial echocardiographic
      examination.

PMID- 8461224
TI  - Ultrastructural quantification of collagen in human chordae tendineae.
AB  - OBJECTIVE: To determine collagen fibril diameter distributions in the chordae
      tendineae and to see whether there are any differences between right and left
      sides of the human heart. DESIGN: Collagen fibril diameters and the percentage
      volume occupied by collagen fibrils (as opposed to ground substance) were
      determined by means of a planimeter with a digitising tablet from electron
      micrographs printed at a magnification of 136; 000. MATERIAL: Human chordae
      tendineae were obtained at postmortem examination from seven subjects aged 50-75
      years. MEASUREMENTS AND MAIN RESULTS: Histograms of collagen fibril diameter
      distributions showed a sharp, unimodal distribution. The mean collagen fibril
      diameters associated with the tricuspid and mitral valves were 41.1 nm and 40.5
      nm respectively. The percentage volume occupied by collagen was about 39% for
      each valve. There were no significant differences for any of these values between
      the right and left sides of the heart. CONCLUSIONS: The greater pressures present
      on the left side of the heart are not reflected in any difference in collagen
      fibril diameters within the chordae tendineae compared with the right side.

PMID- 8461226
TI  - Initial experience with excimer laser angioplasty for coronary ostial stenoses.
AB  - The excimer laser has several potential advantages over conventional balloon
      angioplasty in the management of stenoses of the native coronary arteries and of
      the ostia of saphenous vein grafts. Its use in nine patients, eight of whom were
      classed as high risk, is described. Four lesions involved the ostia of saphenous
      vein grafts, three of protected left main stems, and two of native right coronary
      arteries. Stand alone laser was used in seven cases and laser with additional
      balloon angioplasty was used in two vein graft stenoses. Acute laser success was
      achieved in all cases, with a mean reduction of stenosis from 82% to 34% after
      laser alone and to 28% when balloon angioplasty was used as well. One patient
      died during laser angioplasty to a non-ostial lesion (procedural success rate
      89%) and a second died ten weeks after the procedure. In one patient recurrent
      angina developed (clinical recurrence rate 25%) and restenosis was confirmed on
      angiography. Follow up angiography was also performed on the other six surviving
      patients, all of whom were symptom free and none of whom showed evidence of
      significant restenosis (restenosis rate 14%). With a mean follow up of 19.7
      months the overall success rate was 67%.

PMID- 8461221
TI  - Circulating endothelin in children with congenital heart disease.
AB  - OBJECTIVE: To evaluate whether circulating endothelin, a peptide that is thought
      to play a part in mediating vascular tone, might be high in pulmonary
      hypertensive congenital heart disease. DESIGN: A prospective study with a
      radioimmunoassay technique to estimate urinary and plasma endothelin
      concentrations. SETTING: A supraregional referral centre for patients with
      congenital heart disease. PATIENTS: The 12 hour urinary endothelin concentration
      in young children with an increased pulmonary blood flow (n = 24, median age
      eight months) were compared with those in children with right ventricular outflow
      tract obstruction (n = 14, median age 1.5 years) and with those in healthy
      controls (n = 16, median age 1.8 years). The concentrations were also measured in
      adolescents with irreversible pulmonary vascular disease (n = 17, median age 18
      years) and compared with those in controls of similar age (n = 19, median age
      18.5 years). Also the plasma concentrations in the left atrium and pulmonary
      artery were measured in young children with either high (n = 11, median age 10.8
      months) or low (n = 5, median age 1.0 year) pulmonary blood flow, in the
      peripheral arterial and venous blood of young children with either high (n = 13,
      median age 10.8 months) or low (n = 6 median age 1.9 years) pulmonary blood flow,
      and in the peripheral venous blood of seven healthy young children (median age
      1.7 years). RESULTS: The urinary excretion of endothelin was similar in young
      children of a similar age, whether they had high, low, or normal pulmonary blood
      flow. Also, urinary endothelin excretion in older patients with irreversible
      pulmonary vascular disease was similar to that in normal subjects of similar age.
      Urinary endothelin excretion in normal young children, however, was significantly
      greater than that in normal older subjects (p = 0.0001). There was no
      transpulmonary or arteriovenous difference detected in either children with high
      or low pulmonary blood flow, and plasma concentrations sampled from the left
      atrium, pulmonary artery, and systemic artery and vein were similar in both
      groups. CONCLUSION: There was no evidence to implicate circulating endothelin in
      the pathogenesis of pulmonary vascular disease.

PMID- 8461225
TI  - Long-term follow up of patients treated with a software based antitachycardia
      pacemaker.
AB  - INTRODUCTION: Over the past decade, several advances have been made in the
      management of tachycardias by pacing techniques, but limited data are available
      on the long-term outcome of patients treated with antitachycardia pacemakers.
      PATIENTS AND METHODS: An antitachycardia pacemaker, the Intermedics Intertach,
      was implanted in 22 (17 female) patients with supraventricular tachycardia over a
      five year period. All were selected after detailed evaluation and testing of a
      temporary antitachycardia pacemaker system showed that their arrhythmia could be
      stopped promptly, reliably, and under different physiological conditions.
      RESULTS: The 22 patients have been followed up for a mean period of 57.3 (range
      19-76) months. All except one of the patients has had frequent episodes of
      tachycardia reliably ended by the pacemaker. Complications have occurred in seven
      patients, necessitating removal of the pacing system in four. Of the 18 patients
      who continue to have pacemakers, seven are being treated with beta blockers or
      verapamil; no other antiarrhythmic drugs are being taken. CONCLUSIONS:
      Antitachycardia pacing is an acceptable long-term option for carefully selected
      patients with supraventricular tachycardia, but even after extensive testing a
      substantial number of the patients may continue to require drug treatment.
      Furthermore, the widespread use of curative techniques for supraventricular
      arrhythmias (catheter ablation and surgery) has decreased the need for this
      palliative treatment.

PMID- 8461227
TI  - Arterial duct angioplasty as an adjunct to dilatation of the valve for critical
      pulmonary stenosis.
AB  - OBJECTIVE: To assess the efficacy of arterial duct angioplasty in maintaining
      adequate ductal patency in neonates with critical pulmonary valve stenosis.
      PATIENTS: Two neonates presenting with cyanosis due to critical pulmonary valve
      stenosis with severe right ventricular hypoplasia underwent percutaneous balloon
      dilatation of the pulmonary valve. Despite successful dilatation, both remained
      cyanosed while receiving prostaglandin E2 infusions. RESULTS: Angioplasty of the
      arterial duct resulted in increased arterial oxygen saturations. Adequate
      arterial duct patency was maintained for three months during which time right
      ventricular dimensions increased enough to allow sufficient pulmonary circulation
      without the duct. CONCLUSIONS: Arterial duct angioplasty is an effective
      additional treatment for patients with critical pulmonary valve stenosis whose
      right ventricle is too small to provide adequate forward flow after balloon
      dilatation of the valve. Arterial duct angioplasty sustains adequate patency of
      the duct while the right ventricle grows sufficiently to undertake the pulmonary
      circulation.

PMID- 8461228
TI  - Acceleration of ventricular response to atrial flutter after intravenous
      adenosine.
AB  - Adenosine may be of therapeutic and diagnostic value in the emergency management
      of arrhythmias. It causes transient atrioventricular nodal block and thus ends
      paroxysmal supraventricular tachycardias that involve the atrioventricular node.
      Also, it may uncover underlying atrial arrhythmias by slowing the ventricular
      response. Its duration of action is brief and serious adverse effects have not
      been reported. A 12 year old patient with atrial flutter is presented, in whom
      intravenous adenosine was followed by acceleration of the heart rate to a
      potentially dangerous arrhythmia.

PMID- 8461234
TI  - Cardiac surgery: moving away from intensive care.

PMID- 8461233
TI  - Answers to complex questions cannot be derived from 'simple' trials.

PMID- 8461231
TI  - Correction of myocardial ischaemia after transcatheter embolisation of a small
      left coronary artery venous fistula.
AB  - A 50 year old woman presented with a history of angina and palpitation. She had a
      positive exercise test and thallium scintigraphy showed reversible ischaemia in
      the territory of the left anterior descending coronary artery. Coronary
      angiography showed a small coronary arteriovenous fistula arising from the
      bifurcation of the left main stem--that is, the origin of the left anterior
      descending and circumflex coronary arteries--with no evidence of coronary
      stenosis. The aberrant coronary artery was embolised with platinum microcoils
      delivered by a percutaneous, transcatheter, coaxial technique. The patient was
      subsequently symptom free with no evidence of ischaemia on exercise testing or
      thallium scintigraphy. This case suggests that when there is clear evidence of
      myocardial ischaemia even small coronary arteriovenous fistulas should be treated
      by embolisation.

PMID- 8461230
TI  - Pulmonary artery dissection in a patient with idiopathic dilatation of the
      pulmonary artery: a rare cause of sudden cardiac death.
AB  - A 31 year old man presented with a left hilar mass. Thoracic tomography showed
      this mass to be the pulmonary artery, and subsequently idiopathic dilatation of
      the pulmonary artery was diagnosed. He remained well until 11 years later when he
      died suddenly. Postmortem examination confirmed idiopathic dilatation of the
      pulmonary artery with death due to pulmonary artery dissection and cardiac
      tamponade. It seems likely that idiopathic dilatation of the pulmonary artery
      predisposed to fatal pulmonary artery dissection.

PMID- 8461235
TI  - The role of SPECT in the evaluation of skeletal trauma.
AB  - Single photon emission computed tomography (SPECT) has, in the last decade,
      established a critical role in routine diagnosis. Skeletal scintigraphy
      exemplifies the impact in improving detection of lesions by delineation of their
      site and size. The advantage of minimizing the superimposed radioactivity from
      overlying and underlying structures is typified by the readiness with which
      avascular necrosis of the femoral head can be identified by removal of the
      surrounding hyperaemia which masks the classical photopaenia. However, the
      ability to achieve an accurate image at a plane at a prescribed depth is most
      characteristically shown by the study of a vertebra, a bone of irregular contour
      and subject to a variety of pathological disorders at different sites within it.
      The various focal abnormalities resulting from these can be localized exactly,
      readily distinguishing, for example, those in the body from those in the natural
      arch. In particular, the alterations resulting from trauma, such as pars
      interarticularis stress fracture, are readily seen. Consequently SPECT has an
      indispensable role in the investigation and management of low back pain. However,
      the ability of SPECT to delineate abnormal accumulation has provided a new
      approach to the evaluation of knee pain, especially when acute such as that
      resulting from athletic injury, since the identification of the presence or
      absence of focal abnormalities can be critical to patient management. The
      frequency of these various disorders in which SPECT is so useful explains why the
      procedure has become such a routine high-volume examination is so many
      departments.

PMID- 8461232
TI  - Financial audit of antitachycardia pacing for the control of recurrent
      supraventricular tachycardia.
AB  - OBJECTIVE: To assess the financial implications of antitachycardia pacing in
      patients with frequent supraventricular tachycardia. PATIENTS: Intertach
      pacemakers were implanted in 25 patients (mean age 47 years, five men): 22 had
      atrioventricular nodal reentry tachycardia. The patients had failed a mean of 4.9
      (range zero to eight) drugs and had been admitted to hospital 3.7 (zero to 31)
      times over a symptomatic period of 13.9 years (two months to 54 years). RESULTS:
      The mean admission time for implantation was 2.8 (two to seven) days. One patient
      with Wolff-Parkinson-White syndrome subsequently underwent surgery. Infection
      occurred in two patients, and pain over the pacemaker required its resiting in
      two. Two patients have had one admission each for tachycardia. Six patients
      remain on anti-arrhythmic drugs. Costs were calculated including value added tax,
      capital charges, and allocated overheads. The cost a year before pacing was 1174
      pounds including drug costs, clinic visits, and hospital admissions. The mean
      cost of pacemaker implantation was 3364.22 pounds, including the pacemaker and
      lead, admission and procedure, readmissions and first pacing check. Subsequent
      annual follow up cost was 73.72 pounds including annual clinic visits and drug
      costs. The cost of pacing is 4241 pounds whereas medical management costs 7044
      pounds assuming pacemaker life of six years: with a 10 year life the cost is 4537
      pounds compared with 11,740 pounds: with a 12 year life the cost is 4685 pounds
      compared with 14,088 pounds. CONCLUSION: The excess cost of implantation of an
      antitachycardia pacemaker is minimal in patients with frequent supraventricular
      tachycardia despite drug treatment and is justified by excellent control of
      symptoms and reduction of drug use and hospital admissions.

PMID- 8461236
TI  - Factors causing prolonged hypoperfusion after transient ischemic attack.
AB  - Even during the symptom-free stages, patients with a TIA often experience
      cerebral blood flow disturbances. In order to evaluate the factors which cause
      this abnormality, we studied the cerebral blood flow disturbance, anatomy and
      clinical status in 21 patients after TIAs. The results of 99mTc-hexamethyl
      propylene-amine oxime SPECT were compared with CT, cerebral angiogram,
      cerebrovascular risk factors and clinical findings to determine which factor is
      most responsible for the hypoperfusion of brain after TIA. The overall
      sensitivity rates in detecting a lesion were 67% in SPECT and 19% in CT. The
      hypoperfused area tended to be large in patients who had intracranial, severe
      stenotic, multiple, or hemodynamically significant arterial lesions on the
      ipsilateral side. No such relationships were found between other examinations. We
      conclude that hypoperfusion after TIA essentially reflects a continuous cerebral
      blood flow disturbance that can be attributed to atherosclerosis of the cerebral
      arteries, with subsequent embolic and/or hemodynamic cerebral ischemia, although
      there may be a variety of processes.

PMID- 8461238
TI  - Cerebrocerebellar relationships in normal subjects and patients with dementia of
      the Alzheimer type: a SPECT study.
AB  - The relationships between blood flow in the cerebrum and the cerebellum was
      investigated in 21 normal subjects and 21 patients with dementia of the Alzheimer
      type (DAT). In normal subjects, only asymmetry in the frontal cortical blood flow
      was significantly correlated with asymmetry in the contralateral cerebellar blood
      flow. However, a significant correlation between asymmetry in the cerebral
      cortical blood flow in many areas and the blood flow in the contralateral
      cerebellum in DAT patients was observed. These results suggest the existence of a
      functional relationship between the cerebrum and the cerebellum in both normal
      and DAT groups, mediated by neuronal mechanisms through crossed fiber pathways.
      However, there are regional differences in the cerebrocerebellar relationship in
      normal resting and pathological states.

PMID- 8461242
TI  - Variant angina in thyrotoxicosis.
AB  - Thyrotoxicosis may exacerbate angina pectoris in patients with coronary artery
      disease but angina also occurs in thyrotoxic patients with normal coronary
      arteries. Four female severely thyrotoxic patients presented with apparent angina
      pectoris as a manifestation of their thyrotoxicosis. Two of them had transiently
      abnormal ECGs during pain. Treatment for thyrotoxicosis immediately stopped the
      chest pain, which did not recur. All patients had negative exercise ECGs, and one
      had a normal coronary angiogram. The possible mechanisms to explain this
      phenomenon are discussed. Coronary artery spasm has been demonstrated in
      thyrotoxic patients previously and may explain the features in these patients. An
      alternative hypothesis is that myocardial metabolism is fundamentally changed by
      thyrotoxicosis. We would recommend that thyroid function assessment should be
      considered in young female patients with atypical angina.

PMID- 8461241
TI  - Sydenham's chorea: a new look at an old disease.
AB  - Eight children with Sydenham's chorea were studied to illustrate the clinical
      characteristics and the outcome of the disease. Their ages ranged from 8 to 13
      years and the male to female ratio was 1.7:1. Most of them had hemichorea, which
      frequently affected the right side of the body. The common presenting
      manifestations were involuntary movements, facial grimacing, clumsiness, and
      emotional instability. The duration of chorea ranged from one week to three
      years, with a median of 11 weeks. One half of the patients had associated mild
      carditis. Recurrences of chorea occurred only among patients who were not
      maintained on continuous penicillin prophylaxis. Haloperidol seemed to be an
      effective and tolerable agent in controlling the motor manifestations of the
      disease.

PMID- 8461239
TI  - Accumulation of thallium-201 in medullary thyroid cancer with negative serum
      calcitonin and carcinoembryonic antigens: a case report.
AB  - Thallium-201 (201Tl) scintigraphy has been used in the evaluation of thyroid
      neoplasm. Even though several authors have shown the usefulness of 201Tl
      scintigraphy in evaluating recurrent tumor of medullary thyroid cancer, the
      number of reports on primary thyroid cancer is limited. We presented a case of
      medullary thyroid cancer which showed 201Tl uptake in both early and delayed
      scans. This case had normal serum levels of calcitonin and carcinoembryonic
      antigen.

PMID- 8461240
TI  - A novel sustained-release formulation of ibuprofen provides effective once-daily
      therapy in the treatment of rheumatoid arthritis and osteoarthritis.
AB  - The efficacy and safety of a novel sustained-release formulation of ibuprofen
      given once-daily was compared with conventional-release ibuprofen tablets 400 mg
      given four times daily, in a single-blind, parallel-group study. This study was
      conducted at 84 general practice centres throughout the UK among patients with
      osteoarthritis or rheumatoid arthritis. An unequal randomisation in the ratio of
      4:1 was carried out, with 463 patients who received sustained-release and 115 who
      received conventional-release ibuprofen providing evaluable data. In this study
      sustained-release ibuprofen was shown to be a more effective alternative to
      conventional ibuprofen therapy for the treatment of arthritic diseases in general
      practice, offering the convenience of once-daily dosing and the associated
      potential benefit of improved patient compliance.

PMID- 8461237
TI  - Dopamine D2 receptor SPECT imaging: basic in vivo characteristics and clinical
      applications of 123I-IBZM in humans.
AB  - The purposes of this study are to evaluate the utility of kit formulation, the
      basic in vivo characteristics, and clinical usefulness of dopamine D2 receptor
      imaging with 123I-(S)-(-)-3-iodo-2-hydroxy-6-methoxy-N-[(1-ethyl-2-pyrrodinyl)m
      ethyl]- benzamide (123I-IBZM). We studied 22 normal controls, 3 early symptomatic
      Huntington's disease patients, and 1 patient with visual hallucination on and off
      neuroleptics. 123I-IBZM could be conveniently prepared with a high degree of
      purity from a kit, but with relatively low radiochemical yield. We demonstrated
      123I-IBZM receptor binding equilibrium by performing serial SPECT scanning in a
      normal volunteer. The basal ganglia/frontal cortex (BG/FC) ratios plateaued after
      the specific binding reached equilibrium approximately 60 minutes after
      injection. The BG/FC ratio declined significantly with age. The ratios for the
      Huntington's disease patients were significantly lower than those for normal
      controls. The images of the patient off neuroleptic therapy showed dramatically
      increased BG activity compared with those obtained while on therapy. The BG/FC
      ratio provides an estimate of Bmax/Kd and hence the receptor density. It appears
      important to perform SPECT early in the equilibrium phase and at a fixed time
      after injection to obtain significantly high signal to noise ratios. 123I-IBZM is
      an ideal tracer for SPECT including a rotating gamma camera type which can
      provide estimates of the receptor density objectively by calculating the BG/FC
      ratio, and is a promising agent for the investigation of dopamine D2 receptors in
      clinical conditions.

PMID- 8461243
TI  - The prevalence of Chlamydia trachomatis infection among gynaecological patients.
AB  - The prevalence of chlamydia trachomatis infection in the population screened, at
      All Saints Hospital in Chatham between 1988 and 1990, was 6.3%. The main risk
      factors for cervical chlamydia infections in gynaecological patients were found
      to be an age less than 25, low socioeconomic status, and exposure to other
      sexually transmitted diseases. More research is needed to elucidate the factors
      that contribute to the differences in sociodemographic characteristics of this
      disease. Meanwhile it is clear that public health intervention is crucial to its
      control. The disease is frequently asymptomatic and occurs often in a population
      that is not seen routinely in standard STD outreach efforts. Furthermore, the
      chlamydia prone population is only moderately successful at referring sexual
      partners.

PMID- 8461244
TI  - Assessment of patients' knowledge about their illness and treatment.
AB  - One hundred and twenty two patients over the age of 65 were questioned about
      their knowledge of their illness and treatment. They were unaware of a quarter of
      both their illnesses and medications. There was a considerable lack of knowledge
      about certain groups of diseases and medications, while patients were much better
      informed about others. The possible reasons for this discrepancy are briefly
      discussed and some practical suggestions are put forward.

PMID- 8461245
TI  - How sound are recommendations for lowering cholesterol for the primary prevention
      of coronary heart disease?

PMID- 8461246
TI  - ACE inhibition in the 1990s.
AB  - Angiotensin-converting enzyme (ACE) inhibitors are now widely prescribed for the
      treatment of hypertension and heart failure. Their increasing popularity is based
      on impressive results from studies of efficacy in clinical situations and the
      realisation that they may have advantages over conventional treatment. This
      review will highlight some of the recent advances in our knowledge of the role of
      ACE inhibitors and will develop a rational approach to prescribing.

PMID- 8461248
TI  - An uncommon benign breast tumour--hamartoma.
AB  - Two patients who presented with mobile breast lumps which were later diagnosed to
      be hamartomas are presented, along with a brief review of current literature.
      These benign lesions are likely to be increasingly diagnosed because of routine
      mammographic screening and hence clinical awareness is paramount to prevent these
      lesions from being overtreated. Hamartoma of the breast is a rare benign breast
      lesion which is unfamiliar to most clinicians. We herein report two examples of
      such a lesion and review the recent literature. The hamartoma presents as a soft
      well-defined lump, causing considerable asymmetry of the breasts.

PMID- 8461247
TI  - The acute porphyrias.
AB  - The porphyrias are a heterogeneous group of rare inborn errors of metabolism
      caused by inherited enzyme defects in the haem biosynthetic pathway, resulting in
      overproduction of porphyrins. The porphyrias can be distinguished biochemically
      but may be difficult to differentiate clinically. Considerable advances have been
      made in the understanding of the enzymology and molecular biology of the
      porphyrias. The acute attack of porphyria may be a life-threatening condition,
      and an understanding of its many precipitating factors, clinical features and
      management is of importance in a disease with a significant mortality.

PMID- 8461250
TI  - An unusual cause for respiratory difficulty after thyroidectomy.
AB  - Problems with breathing immediately after extubation following thyroidectomy are
      rare, but can usually be attributed to a surgical error such as damage to one or
      both recurrent laryngeal nerves. Tracheomalacia may also cause respiratory
      distress following extubation. We present an unusual cause of failure to resume
      spontaneous respiration after thyroidectomy.

PMID- 8461254
TI  - Sex hormones and dexamethasone modulate interleukin-5 gene expression in T
      lymphocytes.
AB  - The ability of the sex hormones progesterone, testosterone and estradiol-17 beta
      and the glucocorticoid dexamethasone to modulate expression of the interleukin-5
      (IL-5) gene in T cell lines has been investigated. The T cell lines used show
      analogous regulation of IL-5 gene expression to that occurring in T-lymphocytes,
      in that IL-5 mRNA levels are undetectable unless the cells are induced with
      phorbol myristate acetate (PMA). Progesterone and testosterone were as effective
      as PMA in inducing IL-5 mRNA levels in the T cell hybrid NIMP-TH1 and induced IL
      5, -3 and -2 mRNA accumulation in the T cell lymphoma EL-4. Estradiol-17 beta
      also induced IL-5 mRNA accumulation but less effectively than testosterone.
      Nuclear run-on experiments suggested that the effects of progesterone,
      testosterone and PMA on IL-5 gene expression were mediated at the level of
      transcription. The presence of the protein synthesis inhibitor cycloheximide
      completely prevented PMA-induced synthesis of IL-5 mRNA by both NIMP-TH1 and EL-4
      cells, indicating that induction of IL-5 mRNA via PMA stimulation requires de
      novo synthesis of a presumptive trans-acting factor(s). PMA-, testosterone- and
      progesterone-induced expression of the IL-5 gene was completely blocked by the
      anti-inflammatory steroid dexamethasone. Stimulation of IL-5 expression by PMA
      was relatively resistant to the immuno- suppressive drug cyclosporin A although
      inhibition did occur at very high levels. Testosterone- and progesterone-induced
      IL-5 gene expression was not inhibited by cyclosporin A. The in vivo significance
      of these findings are not yet clear but the results show that sex hormones have
      the potential to regulate cytokine gene expression in cells possessing the
      appropriate steroid receptors.

PMID- 8461252
TI  - Food induced anaphylaxis--death can and must be avoided.

PMID- 8461251
TI  - Isolated subglottic lymphoma: an interesting cause of dysphonia.
AB  - Isolated laryngeal lymphomas are exceedingly rare tumours: they tend to be
      greyish submucosal swellings and to respond well to radiotherapy. A case of
      subglottic lymphoma is presented, along with a review of previously reported
      cases of subglottic lymphomas.

PMID- 8461253
TI  - Cholesterol levels and coronary risks.

PMID- 8461249
TI  - Paradoxical cerebral embolism originating from thrombus in tumour veins as
      presenting manifestation of retroperitoneal liposarcoma.
AB  - The coincidence of pulmonary and systemic emboli suggests paradoxical embolism.
      We present the case of a young man in whom a blood clot travelled from the veins
      in a retroperitoneal liposarcoma via a patent foramen ovalis to the systemic
      arterial circulation. Young patients with embolic disease but no obvious source
      of thrombus may have underlying neoplastic disease. Venous thrombosis is a
      frequent complication of neoplastic disease. Arterial embolism associated with
      neoplasm is, however, not widely recognised.

PMID- 8461258
TI  - Vitellogenin synthesis in cultured hepatocytes; an in vitro test for the
      estrogenic potency of chemicals.
AB  - We describe here an in vitro technique to assess the estrogenic activity of
      chemicals. This technique is based on rainbow trout hepatocytes incubated in a
      basic medium free of any additional growth factors or estrogenic chemicals and
      uses the production of vitellogenin (VTG) as a marker for the estrogenic potency
      of the compounds tested. The system allows at least some of the metabolic
      transformations which are undertaken by the liver cells in vivo and could
      therefore be used for xenobiotic compounds which exhibit estrogenic activities
      after liver metabolic transformation. A dose-response curve was always
      consistently obtained using estradiol-17 beta (E2), with a mid point at around
      100 nM E2 and a maximum response at around 1000 nM. Established estrogens such as
      17 a 1 ethynylestradiol (EE2) or diethylstilboestrol (DES) were also tested. EE2
      appeared to be equipotent with E2 and DES slightly less potent. E2 conjugates
      were, perhaps surprisingly, also very potent. Estradiol-3-sulfate was equipotent
      with E2 and estradiol-17 beta-glucuronide approx. 10% as potent. Other steroids
      such as androgens and progesterone, though active in the bioassay, were 3 orders
      of magnitude less potent than E2. Of the various steroids tested, only cortisol,
      at concentrations up to 50 microM, was completely inactive. Six different
      phytoestrogens were tested in the assay. All were weakly estrogenic, possessing
      approximately one thousandth the potency of E2 (they were as potent as the
      androgens and progesterone). All six phytoestrogens, as well as the androgens and
      progesterone, were tested in the presence of tamoxifen. In all cases tamoxifen
      reduced the production of VTG significantly, demonstrating that the estrogenic
      action of all of these compounds was most likely mediated by the E2 receptor. The
      potencies determined here may not reflect the situation in vivo but can provide
      complementary results about the activity of chemicals which need an hepatic
      metabolization to be estrogenic. Hepatocyte cultures would profitably be
      developed in other species to sustain these results.

PMID- 8461255
TI  - Binding of RU486 and deacylcortivazol to the glucocorticoid receptor is
      insensitive to sulfhydryl-modifying agents.
AB  - The differential sensitivity of the rat liver glucocorticoid receptor (GR) to
      sulfhydryl group modifying agents when bound to various agonist and antagonist
      ligands was studied. [3H]Triamcinolone acetonide (TA) binding was completely
      abolished by previous treatment of the unbound receptor with various N
      alkylmaleimides. On the contrary, [3H]RU486 binding was only slightly affected by
      treatment with N-ethylmaleimide (NEM) and more significantly decreased with
      maleimides bearing bulky substituents. Ligand exchange experiments demonstrated
      that, unlike the agonist TA, the antiglucocorticoid RU486 was unable to protect
      the GR binding site from the effect of NEM. This lack of protection would seem to
      be due to the presence of the bulky 11 beta-substituent in RU486 since RU26988
      and RU28362, two 11 beta hydroxylated glucocorticoids bearing the same 17 alpha
      propynyl side chain as RU486 but lacking the 11 beta-substituent could protect GR
      against NEM. The ability of a GR ligand to prevent NEM inactivation of TA binding
      appeared unrelated to its agonist or antagonist nature: deacylcortivazol, a
      potent agonist, afforded no protection whereas antagonists of the 17 beta
      carboxamide series did. These data strongly suggest that compounds bearing bulky
      substituents on the steroid A and/or C rings, like deacylcortivazol and RU486,
      are positioned differently from canonical glucocorticoids in the steroid binding
      groove of the GR.

PMID- 8461256
TI  - Altered patterns of proteins released in vitro from oviductal and uterine tissue
      from adult female mice treated neonatally with diethylstilbestrol.
AB  - Proteins released during incubation in vitro of oviductal and uterine tissues
      from 8-week-old female NMRI mice treated neonatally with diethylstilbestrol (DES)
      or vehicle were studied. The objective was to study if neonatal DES treatment
      altered the patterns of proteins released from the oviduct and uterus, as earlier
      studies had shown a detrimental effect of the oviductal environment in DES
      exposed females on early embryo development. In separate experiments nonlabeled
      and 35S-labeled proteins released from oviductal/uterine tissues during organ
      incubations were characterized with 1 and 2D gel electrophoresis. The incubation
      media of both oviducts and uteri from DES females had increased levels of a serum
      derived nonlabeled protein, identified as apolipoprotein A1. The amount of this
      protein in the incubation medium was not influenced by previous ovariectomy but
      increased by in vivo treatment with estradiol, in both ovariectomized controls
      and DES treated females. Three other unlabeled proteins were consistently found
      in higher amounts in the incubation media from DES exposed oviduct/uterine
      tissue, than in incubates of control tissue. In tissue incubates of oviducts from
      DES females, three synthesized proteins (35 kDa-pl 6.2, 112 and 143 kDa) were
      released in lower amounts and two in higher amounts (53 kDa-pl 6.6 and 53 kDa-pl
      6.8) than in controls. In uterus from DES treated females one labeled protein was
      released in increased amounts (80 kDa-pl 6.7) and one in decreased amounts (43
      kDa-pl 6.6), when compared with controls. In estrogen induced uterine luminal
      fluid from 8-week-old DES treated females the levels of four proteins (26, 42, 53
      and 97 kDa) were increased and two (24 and 32 kDa) were decreased. These results
      show permanent alterations in levels of secreted proteins in both the oviduct and
      uterus of adult but neonatally DES treated females, which could be of importance
      for their poor reproductive performance.

PMID- 8461257
TI  - Relative involvement of protein kinase C and of the estrogen receptor in the
      cytotoxic action of a population of triphenylethylenes on MCF7 cells as revealed
      by correspondence factorial (CF) analysis.
AB  - A multivariate statistical method, correspondence factorial (CF) analysis, was
      used to examine the correlations among the protein binding and cell proliferation
      effects of a series of 36 di- and triphenylethylenes (DPEs and TPEs). The
      analysis was applied to a study which measured their competition for estradiol
      binding to cytosol estrogen receptor (ER), their influence on protein kinase C
      (PKC) activity under different conditions of enzyme activation, their ability to
      promote the growth of a breast cancer cell line and to inhibit growth at high
      concentrations (cytotoxicity). The CF analysis revealed several levels of
      correlation. First, it distinguished those molecules within the population that
      stimulated rather than inhibited PKC activity. Second, it made apparent a strong
      correlation between cytotoxicity and inhibition of Ca++ and phosphatidylserine
      dependent PKC activity, which was most marked when the enzyme had been activated
      by diacylglycerol indicating that PKC inhibition under physiological conditions
      might contribute to the overall cytotoxicity of these compounds. Third, a lower
      level of correlation was established between competition for ER binding and
      cytotoxicity. Taken together, the results suggest that MCF7 cells might be most
      sensitive to a cytotoxic effect of TPEs (via PKC and other targets) when they at
      the same time decrease estrogen-stimulated proliferation via an ER-mediated
      antiestrogenic effect.

PMID- 8461260
TI  - Characterization of rat uterine estrogen receptors in vivo.
AB  - In vivo binding of [3H]estradiol ([3H]E2) in the rat uterus was performed by an
      intraluminal perfusion of the ligand for different time periods. In this way the
      binding takes place in the intact organ before processing the tissue. In 10 min,
      with 10 nM [3H]E2 apparent saturation or steady state incorporation of the [3H]E2
      was achieved with a similar distribution of the label between cytosol and nuclear
      fractions. In vitro, the subcellular localization of the estrogen receptor (ER)
      is influenced by the extent of tissue damage. With the intact organ the ER
      subcellular distribution approaches that of the in vivo perfusion. With
      increasing [3H]E2 in the perfusate it was possible to obtain a "saturation" curve
      and to derive the kinetic parameters. For cytosol: Kd 16 nM; Bmax 235 fmol/mg
      prot. For nucleus: Kd 2.7 nM; Bmax 103 fmol/mg prot. To follow the time course of
      the ER movement in vivo, "pulse and wait" experiments were designed. Both uterine
      horns were perfused for 1 min. One of the horns was immediately processed (0
      time) and the other was left in place after the perfusion for different periods.
      At 0 time 90% of the bound label appeared in the cytosol. At 5, 15 and 30 min,
      the label in the cytosol decreased and that of the nucleus increased approx. to
      50%. Thus, translocation of the bound label from cytosol to nucleus was apparent.
      The role of the cytoplasm-nucleus ER traffic in the regulation of gene
      transcription by estrogens is discussed.

PMID- 8461265
TI  - The Kallmann's syndrome variant (KSV) model of the schizophrenias.
AB  - The KSV model of the schizophrenias proposes that up to 70% of schizophrenics
      have a pathogenic allele, or abnormal expression, of the KALIG-1 gene which is
      located at Xp22.3. This gene encodes a nerve-cell adhesion molecule (N-CAM) like
      protein, and is deleted in 66% of patients with Kallmann's syndrome, anosmia with
      secondary hypogonadism. Although superficially distinct, the schizophrenias and
      Kallmann's syndrome show numerous parallel trait defects which occur with a
      similar sex distribution. These defects are usually more profound in Kallmann's
      syndrome. Occasionally, Kallmann's patients exhibit additional defects, such as
      ichthyosis, which are due to the further deletion or translocation of adjacent
      genes. Since schizophrenics exhibit virtually all known trait defects in
      Kallmann's except these, it suggests that the aberrant genes are defective, but
      not deleted in schizophrenia. It also appears that compensatory mechanisms,
      involving serine proteases, are active in schizophrenia, which largely preserve
      fertility, but at the expense of an increased vulnerability to develop a
      psychosis by an episodic disruption of the blood-CSF barrier. Consequently,
      schizophrenia is rare in Kallmann's patients, while most schizophrenics are
      capable of reproduction.

PMID- 8461259
TI  - Sex hormone binding globulin and non-protein-bound oestradiol in postmenopausal
      patients with primary biliary cirrhosis and normal controls.
AB  - Several studies have suggested that patients with primary biliary cirrhosis (PBC)
      have an increased risk of a number of medical conditions related to their
      oestrogen levels. This study has measured sex hormone binding globulin (SHBG)
      binding capacity, total oestradiol levels and percentage non-protein-bound (NPB)
      oestradiol and calculated the concentration of NPB oestradiol, in postmenopausal
      subjects in the following groups; normal controls, early PBC, advanced PBC and
      advanced PBC who were receiving therapy. Mean SHBG levels were higher in all
      groups of patients with PBC than in controls. No significant difference was
      observed in total or biologically active oestradiol between the four groups.

PMID- 8461261
TI  - Generation of estradiol within the pregnant guinea pig uterine compartment with
      special reference to the myometrium.
AB  - Between about 50 and 58 days of gestation, the guinea pig chorion becomes
      attached in its entirety to the uterine wall, suggesting a facilitation of
      transfer of agents such as steroids between these tissues. At a time between 59
      and 64 days, relaxation of the pubic symphysis starts, and anywhere from 5 to 8
      days after that event delivery takes place. The present in vitro study was
      undertaken to evaluate estrone sulfate as a substrate for local production of
      estradiol, via the action of estrogen sulfatase and 17-hydroxysteroid
      dehydrogenase, in chorion, endometrium and myometrium taken at four distinct
      stages of gestation, as follows: 50 days, representing pre-chorion attachment to
      the uterus (stage 50); 1 or 2 days before pubic symphysis relaxation (minus 1
      day, or -1 day); 1 day following relaxation (+1 day); and 1-2 days before
      delivery (late, or L). At these same stages, the metabolite patterns formed from
      estradiol were evaluated for endometrium and myometrium. Each of the tissues
      behaved somewhat differently. Overall hydrolysis of estrone sulfate by
      endometrium and myometrium exceeded that by chorion. Generation of free steroid
      from estrone sulfate increased 3-fold in chorion between stages 50 and -1 and
      during this period estradiol production from estrone sulfate increased 9-fold and
      continued to rise until delivery. Cytosolic estrogen sulfotransferase activity of
      chorion decreased 7-fold between stages 50 and -1. This suggested a tissue
      environment geared to producing potentially active estradiol. However, myometrium
      converted very little estrone into estradiol until just before delivery despite
      the facile formation of estrone from estradiol at stages -1, +1 and L. The
      control of estrogen metabolism by interaction of tissues in the uterus and by
      some form of enzyme regulation in these tissues suggests a possible role for
      locally produced estrogen in the stages leading up to parturition.

PMID- 8461268
TI  - Training novice raters on the Negative Symptom Assessment Scale.
AB  - The Negative Symptom Assessment (NSA), a scale for rating negative symptoms of
      schizophrenia, has been shown to have high interrater and test-retest
      reliabilities as well as high concurrent validity with similar instruments. In
      this study, the facility of clinicians unfamiliar with the NSA to learn this
      scale was evaluated. After attending a 30-min training lecture, 27 experienced
      researchers, who had never previously used the NSA, viewed and rated a
      videotaped, semi-structured NSA interview of a schizophrenic patient. These
      ratings were compared with those of an experienced rater. Scores for most items
      met our criteria for learning with this level of training. These data demonstrate
      that high levels of agreement with experienced raters can be achieved on the NSA
      after brief periods of training.

PMID- 8461266
TI  - Positive and negative symptoms in the psychoses. Re-analysis of published SAPS
      and SANS global ratings.
AB  - The validity of the simple dichotomy between positive and negative symptoms was
      examined by reanalysing the results of published studies using global ratings
      from Andreasen's SAPS and SANS. Global ratings from our own sample of 114
      diagnostically heterogenous psychotic patients were also analysed. In none of the
      studies was a simple positive-negative dichotomy an adequate representation of
      symptom structure. The most commonly occurring structure consisted of three
      independent groups: Hallucinations/Delusions, Positive Thought Disorder and
      Negative Symptoms. These findings applied to both manic and schizophrenic groups
      of patients. An important implication of these results for future studies is that
      combining positive symptoms into a single scale is inappropriate because possibly
      differential relationships between Hallucinations/Delusions and Thought Disorder
      and a variety of external measures may be obscured by such a means of data
      reduction.

PMID- 8461264
TI  - Pathway and kinetics of prednisolone metabolism in the human placenta.
AB  - Prednisolone is metabolized in the perfused human placental lobule to prednisone,
      20 alpha-dihydroprednisone, 20 beta-dihydroprednisone and 20 beta
      dihydroprednisolone. The pathway of metabolite formation was defined in
      perfusions of placental lobules using prednisone and 20 beta-dihydroprednisone
      separately as substrates and with prednisolone co-perfused with glycyrrhetinic
      acid, a potent inhibitor of the 11-oxidase component of the 11 beta
      hydroxysteroid dehydrogenase enzyme system. The pattern of metabolites identified
      from 6 h samples indicated a reversible formation of prednisone from
      prednisolone, the production of the 20 alpha- and 20 beta-dihydro metabolites of
      prednisone from prednisone, the formation of 20 beta-dihydroprednisolone from 20
      beta-dihydroprednisone only and no direct formation of 20 beta
      dihydroprednisolone from prednisolone. Kinetic analysis at two substrate
      concentrations confirmed that the formation of three of the four steroid
      metabolites followed first order kinetics. In perfusions with an initial
      prednisolone concentration of 1 microgram/ml (n = 4) or 100 ng/ml (n = 3), the
      rate constants obtained were (mean +/- SD, maternal compartment, h-1):
      prednisone, 1.97 +/- 0.49 and 2.25 +/- 0.15, P > 0.1; 20 alpha-dihydroprednisone,
      0.0006 +/- 0.0004 and 0.0017 +/- 0.0006, P < 0.1; 20 beta-dihydroprednisone, 0.15
      +/- 0.022 and 0.15 +/- 0.0077, P > 0.1. In contrast, the rate constant for
      formation of 20 beta-dihydroprednisolone at an initial prednisolone concentration
      of 100 ng/ml (0.083 +/- 0.0095 h-1) was significantly (P < 0.01) greater than the
      corresponding rate constant at the higher initial prednisolone concentration
      (0.039 +/- 0.015 h-1). A significant increase (P < 0.05) was observed for the
      formation of 20 beta-dihydroprednisolone at the end of 6 h perfusions at the
      lower initial substrate concentration (11.2 +/- 1.9%) compared with the 1
      microgram/ml concentration (6.0 +/- 2.5%).

PMID- 8461262
TI  - Changes in pituitary, hypothalamic and brain progestin-metabolizing enzyme
      activities during lactation.
AB  - Progesterone 5 alpha-reductase activity and 5 alpha-dihydroprogesterone 3 alpha
      hydroxysteroid oxidoreductase (3 alpha-HSOR) activities (NADH- and NADPH-linked)
      were measured in anterior pituitaries, hypothalami and brains from lactating rats
      (8 and 21 days postpartum) and non-lactating (60-day-old cycling) rats. Tissue
      levels of these three enzyme activities varied significantly among the three
      groups examined. In terms of pituitary, mean levels of both of its 3 alpha-HSOR
      activities were 40-140% higher in actively lactating rats (8 days postpartum)
      relative to mean levels in lactating rats at weaning (21 days postpartum) or in
      non-lactating rats. There were no differences in pituitary progesterone 5 alpha
      reductase activity among the three experimental groups. In the hypothalamus, the
      NADPH-linked 3 alpha-HSOR was elevated (50%) at 8 days of lactation compared to
      the group at 21 days. Hypothalamic NADH-linked 3 alpha-HSOR levels did not vary
      among the 3 groups. Hypothalamic progesterone 5 alpha-reductase levels in the
      actively lactating and weaning groups were 30% lower than those of the non
      lactating group. Brain levels of progesterone 5 alpha-reductase were also lower
      in these two lactating groups (35-55%) as compared to the non-lactating control
      group. In brain, NADPH 3 alpha-HSOR activity did not vary among the three groups,
      but levels of NADH 3 alpha-HSOR activity were lower (40-50%) in the weaning group
      as compared to the actively lactating and control groups. These findings suggest
      the possibility that tissue changes in these progesterone-metabolizing enzyme
      activities during lactation and at weaning are influencing the in situ supply of
      3 alpha,5 alpha-tetrahydroprogesterone and 5 alpha-dihydroprogesterone and their
      derivative effects on GABAA receptor activity and prolactin and gonadotropin
      release. The decreased activity of progesterone 5 alpha-reductase in hypothalamus
      and brain would presumably reduce in situ 5 alpha-dihydroprogesterone formation
      while increases in 3 alpha-HSOR activity would suggest higher in situ 3 alpha,5
      alpha-tetrahydroprogesterone formation, especially in the pituitary.

PMID- 8461263
TI  - Corticosteroid side chain oxidations--3. Evidence for isomerization and direct
      oxidation reactions in the formation of steroid 21-oic acids by rabbit liver
      cytosol.
AB  - Isomerase complexes that oxidize the alpha-ketol side chain of
      deoxycorticosterone (DOC) to pregnolic and pregnenoic acids without the addition
      of cofactors have been purified from rabbit and hamster liver cytosols. The
      isomerase complex in rabbit liver cytosol was partially resolved from a NAD
      dependent dehydrogenase that oxidized the glycol side chain of 20 beta-dihydro
      DOC to the 20 beta-hydroxy-21-oic acid. Corticosterone (B) and 20 beta-dihydro B
      were less active substrates than DOC or 20 beta-dihydro DOC with the
      corresponding preparations. The rabbit resembles other rodent and human species
      in that isomerization and oxidation at C21 is the major pathway of acid formation
      whereas direct oxidation at C21 may only be of significance with metabolites that
      have the glycol side chain.

PMID- 8461270
TI  - Prolonged haloperidol and reduced haloperidol plasma concentrations after
      decanoate withdrawal.
AB  - Haloperidol and reduced haloperidol plasma concentrations were measured in twelve
      schizophrenic patients upon cessation of haloperidol decanoate (HLD) treatment.
      Each patient received HLD 100 mg every 4 weeks for five injections. After the
      fifth injection, HLD was discontinued. Haloperidol and reduced haloperidol plasma
      concentrations were obtained prior to cessation and at weeks 1, 3, 4, 5, 7, 9,
      11, and 13 post-injection. Haloperidol and reduced haloperidol plasma
      concentrations were assayed by HPLC. Both haloperidol and reduced haloperidol
      plasma concentrations were detectable 13 weeks post HLD discontinuation. Maximal
      haloperidol plasma concentrations were observed at one week post cessation and
      gradually declined. The mean elimination half-life for haloperidol was 27.4 +/-
      8.6 days (range 19.0-47.0 days). Reduced haloperidol plasma concentrations
      declined very slowly. Our results show that both haloperidol and reduced
      haloperidol plasma concentrations can remain for extended time periods after HLD
      is discontinued.

PMID- 8461267
TI  - Cholinergic hyperactivity and negative symptoms: behavioral effects of
      physostigmine in normal controls.
AB  - Intravenous infusion of physostigmine (a centrally active anticholinesterase
      agent) in normal subjects leads to a syndrome of psychomotor inhibition; this has
      been proposed as a model for selected symptoms of depression. In view of its
      similarity to the negative schizophrenic syndrome, we compared the 'physostigmine
      syndrome' to the negative symptom profile by evaluating the behavioral effects of
      intravenous physostigmine infusion in seven normal volunteers. Observer ratings
      and self description revealed significant withdrawal, apathy, alogia, lethargy,
      decreased energy, slowed thoughts, diminished affective responsivity, and reduced
      hedonic capacity. Subjects did not report sadness, ideas of hopelessness,
      worthlessness, or guilt. These findings support the implication of cholinergic
      hyperactivity as one mechanism in the pathophysiology of negative schizophrenic
      symptoms.

PMID- 8461269
TI  - Differential effects of haloperidol on negative symptoms in drug-naive
      schizophrenic patients: effects on plasma homovanillic acid.
AB  - After 5 weeks of haloperidol, positive symptoms in drug-naive schizophrenic
      patients substantially subsided. Negative symptoms, although with a different
      temporal pattern, decreased after the fifth week of haloperidol treatment;
      specifically, a decrease was seen in anhedonia and affective flattening, whereas
      avolition-apathy and attentional impairment presented no changes. Alogia showed a
      decrease during the third week and a trend to return to placebo scores during
      weeks 4 and 5. Changes in affective flattening, alogia and attentional impairment
      correlated with changes in positive symptoms. During placebo, plasma homovanillic
      acid (HVA) correlated with negative symptoms and with changes presented by
      negative symptoms between the first and the fifth treatment week. These data show
      that negative symptoms respond differentially to neuroleptics and suggest that
      avolition-apathy may represent a different behavioral component of the
      schizophrenia process.

PMID- 8461271
TI  - Visual controlled information processing resources and formal thought disorder in
      schizophrenia and mania.
AB  - Visual selective attentional performance under low and high processing load
      conditions was examined in patients with schizophrenia (n = 20), or bipolar
      affective disorder-manic type (n = 21) and a group of normal control subjects (n
      = 18). Although schizophrenic patients demonstrated significantly more impaired
      cognitive performance than normal controls, bipolar patients were found to be as
      deviant as the schizophrenic patients on almost all of the performance variables.
      Positive thought disorder under high processing load demands was moderately
      correlated with schizophrenic patients' response processing ability. In contrast,
      negative thought disorder ratings were found to be moderately associated with
      reaction time performance during high processing demands for both patient groups.
      These findings are discussed with regard to the relationship between selective
      attention, visual-motor controlled information processing deficits, and thought
      disorder in psychosis.

PMID- 8461273
TI  - Concordance for gender in sib pairs affected with schizophrenia and related
      disorders.
AB  - An excess concordance by sex among siblings affected with schizophrenia has been
      proposed by some previous and recent investigators. However, this hypothesis has
      not been supported by some recent studies having complete ascertainment of
      probands and relatives. The present report is based on sibships with multiple
      affected members derived from a family study of systematically recruited
      inpatients (146 probands with schizophrenia and 132 probands with other psychotic
      disorders). Evidence for an excess concordance rate for gender among proband
      sibling pairs with both members affected is suggested under a broad definition of
      illness.

PMID- 8461272
TI  - A comparative study of obstetric history in schizophrenics, bipolar patients and
      normal subjects.
AB  - Information on pregnancy and birth complications was collected for 46 patients
      with DSM-IIIR schizophrenia or bipolar disorder and for 23 normal controls.
      Pregnancy complications were more frequent and birth complications more frequent
      and more severe in schizophrenics than in bipolar patients or in normal controls.
      In contrast with other findings in the literature, more obstetric complications
      (OCs) were found in female than male schizophrenic patients.

PMID- 8461274
TI  - Handedness in twins with schizophrenia: was Boklage correct?
AB  - Boklage's report of increased non-right handedness among monozygotic twins with
      schizophrenia has been cited as evidence to support an association of abnormal
      brain lateralization with the development of schizophrenia. The present study
      found no such association. Two previous attempts to replicate Boklage's findings
      (Luchins et al. 1980; Lewis et al. 1989) also reported little support. Studies of
      twin handedness do not appear to support an association of brain lateralization
      and schizophrenia.

PMID- 8461276
TI  - Premorbid functioning, cognitive functioning, symptoms and outcome in
      schizophrenia.
AB  - In this study we examined the relationship between premorbid functioning,
      outcome, cognitive functioning and positive and negative symptoms of
      schizophrenia. Cognitive functioning and symptoms were examined longitudinally in
      a sample of 39 subjects with schizophrenia (according to the DSM-III criteria).
      Subjects were assessed at admission to hospital and six months later during a
      period of relative remission. Premorbid functioning was significantly associated
      with negative symptoms but not with positive symptoms at both the acute phase and
      the remitted phase of the illness. Outcome was also associated with negative
      symptoms at admission and with both positive and negative symptoms at follow-up.
      Deficits on cognitive tests of verbal reasoning and concept formation were
      significantly associated with poor premorbid functioning and outcome.

PMID- 8461275
TI  - Cholesterol, heart disease and the brain: an opportunity in research and a
      disaster in public health education?

PMID- 8461278
TI  - Thalamic radiodensity and cognitive performance in mild and moderate dementia of
      the Alzheimer type.
AB  - Eighteen patients with mild to moderate dementia of the Alzheimer type underwent
      cranial computed tomography (CT) and tests of visual attention, recognition and
      learning. Two subgroups emerged. Subgroup 1 was made up of ten patients who
      showed impaired visual recognition learning and memory, but intact attention in
      marked contrast to subgroup 2, which was made up of eight patients, in whom all
      of these functions were impaired. Planimetric and densitometric CT measurements
      yielded one significant difference between the two subgroups: a decreased
      radiodensity in the dorsomedial thalamus of the patients from subgroup 2. Lower
      radiodensity in the right dorsomedial thalamic area was significantly correlated
      with impaired performance on the test of attentional set shifting, more
      specifically, with deficits at the reversal learning stage. These results are
      interpreted in the context of recent evidence linking reversal learning to a
      neural network comprising the cholinergic basal forebrain, the amygdala and the
      orbitofrontal cortex, as well as the mediodorsal nucleus, and recent evidence of
      cholinergic deficits in this structure in patients with Alzheimer's disease.

PMID- 8461277
TI  - Structure and promoter organization of the human monoamine oxidase A and B genes.
AB  - Monoamine oxidase (MAO) A and B play an important role in regulating levels of
      biogenic amines. MAO A and B cDNAs have been cloned and the deduced amino acids
      share 73% sequence identity. The genes for MAOA and B are comprised of 15 exons
      interspersed by 14 introns, span at least 60 kb and exhibit identical exon-intron
      organization. These findings suggest that the MAOA and MAOB genes are derived
      from the duplication of a common ancestral gene. The core promoter region of MAOA
      is comprised of two 90 bp repeats, each of which contains two Spl elements and
      lacks a TATA box. The MAOB core promoter region contains two sets of overlapping
      Spl sites which flank a CACCC element all upstream of a TATA box. The different
      organization of the MAOA and MAOB promoters may underlie their different cell and
      tissue specific expression.

PMID- 8461279
TI  - Emotional-aversive nature of the behavioral response induced by carbachol in
      cats.
AB  - Intrahypothalamic-preoptic application of carbachol induces a characteristic,
      emotional-aversive response in cats similar to their natural defensive behavior.
      This study was undertaken to provide quantitative evidence that the magnitude of
      the carbachol-induced, emotional-aversive response follows the same rules as
      natural responses to threat. An aversive emotional response can be described in
      terms of a spatiotemporal relationship between the animal and the relevant threat
      stimulus (potential danger). The physical distance to the threat stimulus and its
      movements should be predictive of the magnitude of the emotional response. The
      goal of the study was to test the relationship for the carbachol-induced
      response. The presentation of a threat stimulus (a human hand) to cats injected
      with carbachol caused a significant increase in vocalization. The magnitude of
      the response was inversely proportional to the physical distance between the cat
      and the threat stimulus. The hand in motion caused significantly longer
      vocalization than the immobile hand and cats not familiar with the experimental
      situation vocalized significantly more than those that had been exposed to the
      hand before. The spatiotemporal relationship between the animal and the threat
      stimulus strongly suggests that the carbachol-induced response is emotional and
      aversive in nature and does not differ from the relevant natural responses.

PMID- 8461281
TI  - Absence seizures associated with panic attacks initially misdiagnosed as temporal
      lobe epilepsy: the importance of prolonged EEG monitoring in diagnosis.
AB  - While temporal lobe epilepsy is often considered in the differential diagnosis of
      patients with anxiety or panic disorders, other types of epilepsy can confound
      the presentation or treatment of adults with panic disorders. The cases of two
      patients are presented who were initially thought to have temporal lobe epilepsy
      producing panic attacks, but who were subsequently found to have primary
      generalized seizures. The clinical implications are discussed.

PMID- 8461282
TI  - Tranylcypromine withdrawal phenomena.
AB  - The gradual or abrupt withdrawal of tranylcypromine can result in syndromes
      ranging in severity from mild discomfort to incapacitation. Five patients were
      subjected to the withdrawal of tranylcypromine. Vignettes describing the
      withdrawal syndrome experienced by these patients are presented. These patients
      suffered from severe depression or impairment of cognition in association with a
      reduction in their daily dose of tranylcypromine. The authors conclude that
      reductions in a patient's dose or the discontinuation of tranylcypromine warrant
      the careful supervision of a physician.

PMID- 8461280
TI  - Effects of adrenal cortex hormones on limbic structures: some experimental and
      clinical correlations related to depression.
AB  - Cushing's disorder and depression present overlapping although not identical
      psychological symptomatology. In turn, a subset of patients with affective
      disorders present with hypercortisolemia and disturbances, specifically
      disinhibition, of the hypothalamic hypophysio adrenal axis (HHAA). Memory
      disturbances, in particular, biasing toward negative contents, overlapping sleep
      abnormalities (marked reduction of stages 3 and 4) increased fatigue and loss of
      energy, attentional deficits and irritability, are just part of the common
      symptomatology presented by patients with both Cushing's disorder and depression.
      All of these behavioral manifestations are known to be affected by adrenal
      steroid hormones. There is consensus that hippocampal structures are a main
      target for adrenal steroid hormones; hence, these neural regions are some of the
      most likely mediators of the effects of corticoadrenal steroids on behavior. This
      paper proposes that an imbalance of adrenal steroids and their metabolites may
      play a fundamental role in the psychophysiopathology of Cushing's and depressive
      disorders. The imbalance of these hormones, especially at limbic sites, could
      distort mood and memory content affecting cognition based on recollection and
      present experiences. Reestablishing an adrenal balance could therefore be
      considered as a therapeutic aid in a subset of depressive disorders.

PMID- 8461284
TI  - Anxiety disorder in a case of Arnold-Chiari malformation.
AB  - This report describes a patient who suffered concurrently from panic disorder
      with agoraphobia and Arnold-Chiari malformation. Surgical correction of the
      neuroanatomical anomaly altered the patient's symptom pattern, enabling a more
      clear delineation of her anxiety disorder.

PMID- 8461283
TI  - The manic syndrome: factors which may predict a patient's response to lithium,
      carbamazepine and valproate.
AB  - Studies suggest that 80% to 90% of all patients in the manic state respond to
      lithium provided that they are relatively free of dysphoria ("pure mania"). In
      contrast, less than 40% of individuals in the manic state who cycle rapidly or
      are substantially dysphoric ("dysphoric mania") respond to lithium. These
      patients appear to be more responsive to carbamazepine and valproate. The authors
      conclude that carbamazepine and valproate are the drugs of choice if one desires
      to treat a rapidly cycling individual or patient with dysphoric mania with just
      one agent. However, they emphasize that a prospective study designed to identify
      the predictors of response of primary mania to lithium, carbamazepine and
      valproate is required. Studies assessing the relative value of lithium,
      carbamazepine or valproate as prophylactic agents in the care of patients with
      specific subtypes of mania are also needed. These studies would address the most
      important issues confronting researchers interested in the drug treatment of
      mania.

PMID- 8461285
TI  - Is the routine CT head scan justified for psychiatric patients? A prospective
      study.
AB  - Thirty-four psychiatric patients, assessed for a physical illness that was missed
      during diagnosis, underwent a CT scan. After investigation, the diagnosis of 14
      patients changed from a functional to an organic illness. In nine patients, the
      CT scan was reported to be abnormal, and yet only two were diagnosed as having an
      organic syndrome. In seven patients, the CT scan was normal but the patients had
      an undisputed organic brain syndrome. These findings indicate that the use of CT
      scans should be restricted to cases in which the diagnosis is seriously in
      question. The clinical findings should dictate the use of CT scans either to
      clarify or to complement them.

PMID- 8461287
TI  - Depression and attachment problems.
AB  - This study investigated the characteristics related to attachment of 42 depressed
      psychiatric patients and 42 non-depressed psychiatric controls. The depressed
      subjects demonstrated an anxious pattern of attachment, characterized by either
      intense care-seeking in relation to their attachment figure or angry withdrawal
      from their attachment figure when their desire for security was frustrated. The
      results are discussed in terms of Bowlby's attachment construct.

PMID- 8461286
TI  - Early onset of lithium-associated hypothyroidism.
AB  - In general practice, psychiatrists are confronted with the difficulty of
      structuring a rational design for the early detection of hypothyroidism. To
      determine the period during which a patient receiving lithium is most at risk of
      developing hypothyroidism, a retrospective study was conducted on the records of
      154 patients at two general hospital lithium clinics from January 1980 to August
      1991. Forty-two cases of hypothyroidism (clinical hypothyroidism and/or
      abnormally elevated levels of TSH) were detected. A significant difference was
      found between the onset of hypothyroidism and age (older patients developed more
      thyroid dysfunction), but no significant differences were found between thyroid
      abnormality and sex or diagnostic category and menopausal status, although trends
      were observed for the two former variables. This longitudinal study is the first
      to describe an outline of thyroid functioning in terms of the duration of
      treatment. Lithium-associated hypothyroidism develops most often during the first
      two years. Of the 42 cases of hypothyroidism, 16 were diagnosed within six months
      (38%), 23 within the first year (55%), and 31 two years (74%). Since thyroid
      functioning is an important parameter in the course of affective disorders, its
      close and frequent monitoring is mandatory during the first two years of
      treatment.

PMID- 8461288
TI  - Distribution of the chlorophyll spectral forms in the chlorophyll-protein
      complexes of photosystem II antenna.
AB  - The chlorophyll-protein complexes that form the antenna system of photosystem II
      have been purified and analyzed in terms of the commonly observed chlorophyll
      spectral forms. With the exception of chlorophyll b, which is known to be
      associated with the complexes comprising the outer antenna (LHCII, CP24, CP26,
      CP29), the spectral forms occur with similar absorption maxima and are present in
      rather similar amounts in each of the antenna complexes. On the basis of the
      published chlorophyll stoichiometries for the complexes in photosystem II
      antenna, the distribution of the spectral forms in a "reconstituted" antenna has
      been determined. These data were used to calculate the equilibrium population of
      excited states within the various chlorophyll-protein complexes within
      photosystem II. This was compared with the light absorption capacity of each of
      the complexes in the "reconstituted" antenna. The ratio of these two parameters
      (excited-state equilibrium distribution/absorption capacity) was determined to be
      1.21 for the inner (core) antenna and 0.88 for LHCII. The standard free energy
      change for exciton transfer from the outer to the inner antenna was calculated to
      be -0.17 kcal mol-1. It is concluded that the photosystem II antenna is arranged
      as a very shallow funnel.

PMID- 8461289
TI  - DNA double-crossover molecules.
AB  - DNA molecules containing two crossover sites between helical domains have been
      suggested as intermediates in recombination processes involving double-strand
      breaks. We have modeled these double-crossover structures in an oligonucleotide
      system. Whereas the relative orientations of the helical domains must be
      specified in designing these molecules, there are two broad classes of the
      molecules, the parallel, DP, and antiparallel, DA, molecules. The distance
      between crossover points must be specified as multiples of half-turns, in order
      to avoid torsional stress in this system; hence, there are two further
      subdivisions, those double-crossover molecules separated by odd, O, and even, E,
      numbers of half-turns. In addition, the parallel molecules with odd numbers of
      half-turns between crossovers must be divided into those with an excess major or
      wide-groove separation, W, or those with an excess minor- or narrow-groove
      separation, N. We have constructed models of all five of these classes, DAE, DAO,
      DPE, DPOW, and DPON. DPE molecules containing 1 and 2 helical turns between
      crossovers have been constructed; the DAE molecule contains 1 turn between
      crossovers, and the DAO, DPOW, and DPON molecules contain 1.5 helical turns
      between crossovers. None of the parallel molecules is well-behaved; the molecules
      either dissociate or form multimers when visualized on native polyacrylamide
      gels. In contrast, antiparallel molecules form single bands when assayed in this
      fashion. Hydroxyl radical autofootprinting analysis of these molecules reveals
      protection at expected sites of crossover and of occlusion, suggesting that all
      the complexes contain linear helix axes that are roughly coplanar between
      crossovers. However, the DPOW molecule and the DPE molecule with 2 turns between
      crossovers show decreased protection in the portion between crossovers,
      suggesting that their helices may bow in response to charge repulsion. We
      conclude that the helices between parallel double crossovers must be shielded
      from each other or distorted from linearity if they are to participate in
      recombination. We have analyzed the possibilities of branch migration and
      crossover isomerization in double-crossover molecules. Parallel molecules need no
      sequence symmetry beyond homology to branch migrate, but the sequence symmetry
      requirements for antiparallel molecules restrict migration to directly repetitive
      segments that iterate the sequence between crossovers. Crossover isomerization
      appears to be a very complex process in parallel double-crossover molecules,
      suggesting that it may be catalyzed by topoisomerases if it occurs within the
      cell.

PMID- 8461290
TI  - The specific interactions of HMG 1 and 2 with negatively supercoiled DNA are
      modulated by their acidic C-terminal domains and involve cysteine residues in
      their HMG 1/2 boxes.
AB  - Sedimentation and gel retardation studies show a stronger interaction of HMG 1
      and 2 with negatively supercoiled DNA than with linear, nicked-circular, or
      positively supercoiled ds-DNA. An apparent unwinding angle of 58 degrees was
      obtained for HMG 1 and 2 when assayed by protection of negatively supercoiled DNA
      from topoisomerase I relaxation or when assayed by the supercoiling of nicked
      circular DNA with T4 DNA ligase. The protection of negatively supercoiled DNA was
      linear up to molar ratios of about 250:1. There was little change in binding
      reactions or in the protection of supercoiled DNA at ratios above 250:1,
      indicating that both activities saturate and that HMG 1 and 2 have binding site
      sizes of about 20 bp. P1, the major tryptic fragment of HMG 1 or 2 which retains
      the two DNA binding HMG 1/2 boxes, displays a 2-fold increase in binding to all
      types of ds-DNA compared to intact HMG 1 or 2. However P1 protects negatively
      supercoiled DNA from topoisomerase I relaxation about 5-fold less than intact HMG
      1 or 2. Complete protection with P1 occurs at a molar ratio 1040:1, indicating a
      DNA binding site size of about 4 bp and an apparent unwinding angle of 10
      degrees. P1 binding to closed-circular ss-DNA also involves a binding site of
      about 4 bp. Adding the acidic C-terminal fragment to P1 reversed its binding and
      allowed topoisomerase I to relax supercoiled DNA. These findings highlight the
      importance of the acidic C-terminal domains of HMG 1 and 2 in limiting
      electrostatic interactions of the HMG 1/2 boxes with ds- or ss-DNA. N
      Ethylmaleimide inhibited the binding of intact HMG 1 or 2 to negatively
      supercoiled DNA, but did not inhibit the electrostatic binding of HMG 1 or 2 to
      ss-DNA, or of P1 to any form of DNA (ds or ss). These results suggest that
      cysteine residues are involved in the specific interaction of HMG 1 or 2 with
      negatively supercoiled DNA and that the acidic C-terminal domains modulate an
      intramolecular conformational change involving sulfhydryls within the HMG 1/2
      boxes.

PMID- 8461291
TI  - 7,8-Dihydro-8-oxoadenine as a replacement for cytosine in the third strand of
      triple helices. Triplex formation without hypochromicity.
AB  - Oligonucleotides containing thymine and cytosine (or 5-methylcytosine) bases are
      known to bind to specific homopurine sequences in double-stranded DNA by means of
      T.AT and C+.GC base triplets. Cytosine in the third strand of such triple helices
      can be completely replaced by 7,8-dihydro-8-oxoadenine a base which should not
      require protonation to form base triplets. Experiments using native PAGE and
      inhibition of triplex-directed photo-cross-linking demonstrate that triplexes
      with 7,8-dihydro-8-oxoadenine in the third strand are as stable at pH 6.0 as
      triplexes with 5-methylcytosine. The stability of triplexes with 7,8-dihydro-8
      oxoadenine, unlike those with 5-methylcytosine, is not substantially diminished
      upon raising the pH to 7.4. Surprisingly, triplex formation with an
      oligonucleotide containing only thymine and 7,8-dihydro-8-oxoadenine was not
      associated with significant hypochromicity and could not be detected in
      conventional thermal denaturation experiments.

PMID- 8461292
TI  - Effects of site-specific acetylation on omega-conotoxin GVIA binding and
      function.
AB  - Chemical modification of omega-conotoxin GVIA (omega-CgTXGVIA) was performed
      using nonsaturating concentrations of acetic anhydride to generate seven distinct
      derivatives. Following separation of these peptides using reverse-phase HPLC (RP
      HPLC), their individual molecular weights were determined using fast bombardment
      mass spectrometry (FAB-MS). Three peptides contained a single acetylated amino
      group, three possessed two acetylated amino groups, and the last contained three
      acetylations. For each peptide, the specific site of acetylation was confirmed
      using a scheme of tryptic digestion, under nonreducing conditions, followed by RP
      HPLC and FAB-MS. Biological profiles for each peptide were obtained by analyzing
      their capacity to displace native 125I-omega-CgTx GVIA binding to rat hippocampal
      membranes and to block K(+)-stimulated 45Ca2+ influx into chick brain
      synaptosomes. The data indicate that successive additions of acetyl moieties to
      omega-CgTx GVIA lead to a loss of both binding affinity and Ca2+ influx
      inhibitory potency. Within the monoacetylated series, acetylation of the amino
      terminal of Cys-1, as compared to the epsilon-amino group of either Lys-2 or Lys
      24, leads to the greatest shift in potency. In summary, these results indicate
      that basic (i.e., primary amino) groups, which are brought into close proximity
      as a result of disulfide bridging, are important in the functional blockade of
      neuronal Ca2+ channels by omega-CgTx GVIA.

PMID- 8461293
TI  - Similarities and differences between yeast and vertebrate calmodulin: an
      examination of the calcium-binding and structural properties of calmodulin from
      the yeast Saccharomyces cerevisiae.
AB  - The Ca(2+)-binding and structural properties of calmodulin (CaM) from the yeast
      Saccharomyces cerevisiae (yCaM) were analyzed by flow dialysis and NMR
      spectroscopy. Full-length yCaM and two truncated versions of yCaM were expressed
      in Escherichia coli and purified. yTR1 (residues 1-76) and yTR2 (residues 75-147)
      are similar to the vertebrate CaM fragments TR1 and TR2, which are generated by
      limited proteolysis with trypsin. As was found for the fragments of vertebrate
      CaM, the yCaM fragments retain native conformation and are useful for examining
      structure and metal-binding properties by NMR. Evidence for a short beta-sheet in
      each domain, as well as characteristic NOEs to aromatic residues, suggests that
      yCaM folds similarly to vertebrate CaM. Furthermore, although the previously
      considered "invariant" glycine at position 6 is replaced by a histidine in site
      II of yCaM, the far downfield chemical shift of His-61's amide proton suggests
      that this site adopts a conformation similar to that found in other EF-hand
      sites. Macroscopic Ca(2+)-binding constants were determined for yCaM by flow
      dialysis, revealing three high-affinity sites (dissociation constants were 5.2,
      3.3, and 2.3 microM in the presence of 1 mM MgCl2 and 100 mM KCl). Positive
      cooperativity was observed among all sites. Ca2+ binding was also monitored
      indirectly by one-dimensional NMR. Titrations of the fragment molecules reveal
      that two binding sites reside in the N-terminal domain (sites I and II) and one
      in the C-terminal domain (site III). All three sites exhibit slow-exchange
      behavior in the intact protein, but site III exhibits fast-exchange behavior in
      the isolated C-terminal domain fragment (yTR2). Thus, an interaction between the
      two domains of intact yCaM affects the behavior of site III. These results with
      yCaM differ from those of vertebrate CaM in terms of Ca(2+)-binding
      stoichiometry, affinity of sites I and II, relative affinity of sites in the N-
      and C-terminal domains, and the exchange behaviors observed.

PMID- 8461294
TI  - Divalent cation-induced lipid mixing between phosphatidylserine liposomes studied
      by stopped-flow fluorescence measurements: effects of temperature, comparison of
      barium and calcium, and perturbation by DPX.
AB  - To understand the mechanism of membrane fusion, it is important to study the
      processes that mix the lipids of two apposed membranes. We measured the rates of
      divalent cation-induced aggregation and lipid mixing of bovine brain
      phosphatidylserine (BBPS) LUV, using light scattering and a resonance energy
      transfer assay. The lipid and divalent cation solutions were combined by stopped
      flow mixing, which permitted measuring the half-times of aggregation and lipid
      mixing between pairs of liposomes. The collisional quencher DPX [p-xylene
      bis(pyridinium bromide)], used in a liposome contents-mixing assay, lowered the
      main transition temperature (Tm) of BBPS by about 10 degrees C and decreased the
      temperature threshold for lipid mixing. Since DPX was inside the liposomes for
      the latter measurements, this implies that perturbations to the inner monolayer
      affect the reactivity of the liposome. When palmitoyl-oleoyl-PS (POPS) was
      substituted for BBPS, little or no lipid mixing occurred. Ca(2+)- and Ba(2+)
      induced BBPS aggregation and lipid mixing were compared as a function of
      temperature and divalent cation concentration. Aggregation rates were nearly
      insensitive to temperature and correlated with the percent of PS bound to either
      Ba2+ or Ca2+. Above Tm, lipid-mixing rates increased with the Ba2+ and Ca2+
      concentrations and temperature, even above the Tm of the Ba2+/PS complex.
      Arrhenius plots were linear for both ions. The temperature dependence was greater
      for Ca(2+)- than Ba(2+)-induced reactions, and the slopes were independent of
      divalent cation concentration. When equivalent fractions of PS were bound with
      divalent cation at, and above, 20 degrees C, the lipid-mixing rate was greater
      with Ca2+ than with Ba2+. The faster rate may reflect greater activation
      entropies and/or greater attempt frequencies at one or more steps in the Ca(2+)
      induced process. We conclude that stopped-flow mixing permits better
      characterization of initial interaction between liposomes, that small changes in
      the acyl chain region of the PS bilayer or the inner monolayer can have large
      effects on lipid-mixing rates, and that the differences between Ba(2+)- and
      Ca(2+)-induced interactions may be related to qualitative differences in the
      destabilization step.

PMID- 8461295
TI  - pH- and ionic strength-dependent fusion of phospholipid vesicles induced by
      pardaxin analogues or by mixtures of charge-reversed peptides.
AB  - The fusogenic properties of the neurotoxin paradaxin and eight of its analogues
      with small unilamellar vesicles (SUV), composed of egg phosphatidylcholine and
      phosphatidylserine (PC/PS), were investigated. Fusion was demonstrated by a lipid
      mixing assay and by an increase in vesicle size as revealed by electron
      microscopy. The lipid-mixing assay was performed at either neutral (pH 6.8) or
      acidic (pH 4.5) conditions, in solutions containing either high or low salt
      concentrations. A low level of fusion could be induced at neutral pH only by
      pardaxin derivatives with amino groups at both the peptide's backbone and N
      terminus. However, a marked enhancement in the fusogenic activity occurred when
      amino groups were present also in the C-terminus. Pardaxin analogues in which
      amino groups were substituted by carboxylic groups induced elevated levels of
      fusion only at high salt concentrations where enhancement of aggregation occurs,
      and acidic pH, which increased alpha-helicity. The influence of mutual
      interactions between pardaxin's analogues possessing complementary charges on the
      lipid-mixing process was also studied. At neutral pH and high salt, an inactive
      acidic analogue increased the fusogenic activity of a complementary-charged basic
      peptide. However, such mutual interactions at low salt concentrations reduced the
      fusogenic activity of the pardaxin analogues. Analogues containing D-amino acids
      were not fusogenic, thus demonstrating the structural specificity of these
      observations. The results indicate that the charge, alpha-helical structure, and
      aggregation of peptide monomers play an important role in the fusogenic ability
      of polypeptides.

PMID- 8461296
TI  - Two structurally related diaziridinylbenzoquinones preferentially cross-link DNA
      at different sites upon reduction with DT-diaphorase.
AB  - The nucleotide sequence preferences for the formation of interstrand cross-links
      induced in DNA by 2,5-diaziridinyl-1,4-benzoquinone (DZQ) and 3,6-dimethyl-2,5
      diaziridinyl-1,4-benzoquinone (MeDZQ) were studied using synthetic duplex
      oligonucleotides and denaturing polyacrylamide gel electrophoresis (PAGE).
      Reaction of these bifunctional alkylating agents with a DNA duplex containing
      several potential cross-linking sites resulted in the formation of cross-linked
      DNAs with different electrophoretic mobilities. Analysis of the principal cross
      linked products by piperidine fragmentation revealed that the preferential site
      of cross-linking was altered from a 5'-GNC to a 5'-GC sequence upon reduction of
      DZQ to the hydroquinone form by the enzyme DT-diaphorase. In contrast, the
      reduced form of MeDZQ was found to preferentially cross-link at 5'-GNC sites
      within the same sequence. These preferences were confirmed in duplex
      oligonucleotides containing single potential cross-linking sites. Additional
      minor cross-linked products were characterized and revealed that DZQ and MeDZQ
      are both capable of cross-linking across four base pairs in a 5'-GNNC sequence.

PMID- 8461297
TI  - A quantum mechanical study of the active site of aspartic proteinases.
AB  - We have performed ab initio self-consistent field (SCF) and configuration
      interaction (CI) calculations on the active site of the aspartic proteinases
      pepsin and endothiapepsin. The active site, which carries a formal negative
      charge to effect hydrolysis, was modeled as a formic acid/formate anion moiety
      and a water molecule, and the nearest hydrogen bonding residues (Gly34, Ser35,
      Gly217, and Thr218, with respect to the residue numbering in endothiapepsin) were
      modeled as formamide and methanol molecules. Four possible binding modes for the
      active-site water molecule were considered. In contrast to previous theoretical
      studies, we predict that the most stable form has the water molecule forming a
      bifurcated hydrogen bond to the inner oxygens of Asp32 and -215, with Asp32 being
      ionized. The calculations suggest that the water molecule prefers to bind across
      the shortest OD32 ... OD215 diagonal of the active-site carboxyl groups and
      therefore the binding mode of the water molecule for all the native aspartic
      proteinases can be readily predicted by measuring these distances.

PMID- 8461298
TI  - Site-specific mutagenesis of Drosophila alcohol dehydrogenase: evidence for
      involvement of tyrosine-152 and lysine-156 in catalysis.
AB  - Amino acid sequence comparisons reveal that tyrosine-152 and lysine-156 of
      Drosophila alcohol dehydrogenase (ADH) are conserved in homologous
      dehydrogenases, suggesting that these residues are important in catalysis. To
      test this hypothesis, we used site-directed mutagenesis to substitute tyrosine
      152 with phenylalanine, histidine, or glutamic acid or to substitute lysine-156
      with isoleucine. All of these mutants are catalytically inactive. Two mutants
      were active: A cysteine mutation of tyrosine-152 has 0.25% of wild-type ADH
      activity, while an arginine substitution of lysine-156 retains 2.2% of wild-type
      ADH activity. Kinetic analysis shows that the cysteine mutant increases
      Km(ethanol) 56-fold and Km(propan-2-ol) 100-fold, while Km(NAD) values are
      essentially unaltered. The arginine mutant also shows the significant enlargement
      of Km(ethanol), but not of Km(NAD). Furthermore, the cysteine mutant and arginine
      mutant have different substrate specificity and behave differently on competitive
      inhibition than wild-type ADH. These results suggest that both tyrosine-152 and
      lysine-156 have essential roles in catalysis by Drosophila ADH.

PMID- 8461299
TI  - Novel ion specificity of a carboxylate cluster Mg(II) binding site: strong charge
      selectivity and weak size selectivity.
AB  - Carboxylate cluster Mg(II) binding sites consist of a cluster of side-chain
      carboxylates, typically 3-4 in number, partially buried in a shallow cleft on the
      surface of a Mg(II) binding protein. Such clusters are often found in the active
      sites of enzymes catalyzing phosphochemistry. An example is the phospho-signaling
      protein CheY of the Escherichia coli chemotaxis pathway, which binds Mg(II) via a
      cluster of three carboxylates at its phosphorylation site. The present study
      quantitates both the ion charge and size specificity of the CheY site by
      measuring the dissociation constants of metal ions from groups Ia, IIa, IIIa, and
      the lanthanides; these spherical cations provide a range of substrates with
      incrementally varying charge and radius. The site binds divalent and trivalent
      cations, but it effectively excludes monovalent cations, including the
      physiological ions Na(I) and K(I). This charge specificity is in contrast to the
      site's remarkable lack of size specificity: divalent and trivalent cations
      exhibit affinities which are essentially independent of radius. It is revealing
      to compare the ion specificity of the Mg(II) site with the previously
      characterized specificity of the EF-hand class of Ca(II) sites commonly found in
      Ca(II) signaling proteins. The Mg(II) and Ca(II) sites exhibit similar charge
      selectivity, but the Ca(II) site is highly size-selective, preferring divalent
      and trivalent ions with radii similar to that of Ca(II).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8461300
TI  - Thioltransferase is a specific glutathionyl mixed disulfide oxidoreductase.
AB  - To study the substrate specificity and mechanism of thioltransferase (TTase)
      catalysis, we have used 14C- and 35S-radiolabeled mixed disulfides of cysteine
      and glutathione (GSH) with various cysteine-containing proteins. These protein
      mixed disulfide substrates were incubated with glutathione, glutathione disulfide
      (GSSG) reductase, and NADPH in the presence or absence of thioltransferase.
      Glutathione-dependent reduction of protein mixed disulfides was monitored both by
      release of trichloroacetic acid soluble radiolabel and by formation of GSSG in an
      NADPH-linked spectrophotometric assay. GSH-dependent dethiolation of
      [35S]glutathione-papain mixed disulfide (papain-SSG) and the corresponding bovine
      serum albumin mixed disulfide (BSA-SSG) were catalyzed by thioltransferase (from
      human red blood cells) as shown by the radiolabel assay, and equivalent rates
      were measured by the spectrophotometric assay. Dethiolation of [35S]hemoglobin
      glutathione mixed disulfide (Hb-SSG) was also catalyzed by TTase. In contrast,
      TTase did not catalyze GSH-dependent dethiolation of [14C]papain-SScysteine or
      [14C]BSA-SScysteine as measured by the radiolabel assay. [14C]Hb-SScysteine and
      Hb-SScysteamine also did not serve as substrates. In separate experiments, TTase
      from rat liver displayed analogous selectivity. Thus, thioltransferase
      (glutaredoxin) appears to be specific for glutathione-containing mixed
      disulfides. Apparent TTase catalysis of GSSG formation from the papain- and BSA
      SScysteine mixed disulfides was observed by the spectrophotometric assay, but a
      lag phase occurred consistent with preenzymatic formation of GSScysteine which
      could serve as the actual TTase substrate. Two-substrate kinetic studies of TTase
      with GSH and GSScysteine gave patterns of parallel lines on double-reciprocal
      plots (1/V vs 1/[S]), consistent with a simple ping-pong mechanism involving a
      TTase-SSG intermediate.

PMID- 8461301
TI  - Proton nuclear magnetic resonance sequential assignments and secondary structure
      of an immunoglobulin light chain-binding domain of protein L.
AB  - The 1H NMR assignments have been made for the immunoglobulin (Ig) light chain
      binding B1 domain of protein L from Peptostreptococcus magnus. The secondary
      structure elements and the global folding pattern were determined from nuclear
      Overhauser effects, backbone coupling constants, and slowly exchanging amide
      protons. The B1 domain was found to be folded into a globular unit of 61 amino
      acid residues, preceded by a 15 amino acid long disordered N-terminus. The folded
      portion of the molecule contains a four-stranded beta-sheet spanned by a central
      alpha-helix. The fold is similar to the IgG-binding domains of streptococcal
      protein G, despite the fact that the binding sites on immunoglobulins for the two
      proteins are different; protein G binds IgG through the constant (Fc) part of the
      heavy chain, whereas protein L has affinity for the variable domain of Ig light
      chains.

PMID- 8461302
TI  - Oxalate- and Ga(3+)-induced structural changes in human serum transferrin and its
      recombinant N-lobe. 1H NMR detection of preferential C-lobe Ga3+ binding.
AB  - (1) The binding of the synergistic anion oxalate and Ga3+ to human serum
      transferrin (HTF, 80 kDa) and its recombinant N-lobe (HTF/2N, 40 kDa) has been
      studied by one- and two-dimensional 1H NMR spectroscopy, at 310 K, pH*7.25. (2)
      Specific protein resonances are sensitive to oxalate binding (fast exchange on
      the NMR time scale) and allowed determination of the apparent binding constant
      for oxalate binding to the N-lobe (log K 4.04). (3) Slow exchange between apo-HTF
      and Ga-loaded HTF or HTF/2N was observed. Binding of Ga3+ appeared to be
      accompanied by small changes in the orientations of residues in hydrophobic
      pockets in the interdomain hinge region close to the metal binding site. (4)
      Under the conditions used, preferential binding of Ga3+ (added as Ga(NTA)2) to
      the C-lobe of HTF was observed. Binding to the C-lobe markedly perturbed
      resonances in the glycan N-acetyl region of the spectrum, suggesting that metal
      binding is communicated to the surface of the protein. This could be important in
      receptor recognition of metallotransferrins. (5) The displacement of Ga3+ from Ga
      ox-HTF with Fe3+ was studied, and the paramagnetic broadening effects allowed
      identification of resonances from groups close to Fe3+. The passage of Fe3+ from
      the exterior to the interior of the protein was followed by 1H NMR spectroscopy,
      and the half-life for Ga(3+)-Fe3+ exchange was determined to be 4.3 h (310 K).

PMID- 8461303
TI  - Design of a linker for trivalent thrombin inhibitors: interaction of the main
      chain of the linker with thrombin.
AB  - N alpha-Acetyl[D-Phe45,Arg47]hirudin45-65 (P53) is a bivalent thrombin inhibitor
      (Ki = 5.6 nM) that consists of an active site inhibitor segment, [N alpha-acetyl
      (dF)PRP]; a fibrinogen recognition exo site inhibitor segment, hirudin55-65
      (DFEEIPEEYLQ-OH); and a linker, hirudin49-54 (QSHNDG), connecting these inhibitor
      segments (DiMaio et al., 1990). The structure-function relationships of the
      linker were studied using a combination of various omega-amino acids, which
      modified the length of the linker as well as the number and the locations of
      peptide bonds. Linkers with 14-18 atoms (counting only the atoms contributing to
      the length of the linker) showed a competitive inhibition with Ki = 1.7-3.4 nM.
      The potency of the inhibitors with 12-13-atom linkers was sensitive to the
      chemical structure of the linker. The high-potency inhibitors showed a
      competitive inhibition, while the low-potency inhibitors showed a hyperbolic
      inhibition. Among them, an inhibitor with a 13-atom linker showed the highest
      potency (Ki = 0.51 nM, an 11-fold improvement from that of P53 above), indicating
      that this is an optimal linker length. Since linkers with 6-10 atoms failed to
      bridge the active site and exo site inhibitor segments, a minimum of 11 atoms was
      required to bridge them, even though the potency of the inhibitor with an 11-atom
      linker was weak (Ki = 26 nM). Molecular dynamics simulation of the inhibitors
      with 13-atom linkers suggested that some linkers serve as a functional domain
      with the amide bond of the linker interacting with thrombin through hydrogen
      bonds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461304
TI  - Thermodynamics of tubulin polymerization into zinc sheets: assembly is not
      regulated by GTP hydrolysis.
AB  - The thermodynamics of tubulin assembly into Zn sheets have been studied, with
      special emphasis on the role of bound nucleotide and of GTP hydrolysis in
      polymerization. In contrast to microtubules, Zn sheets could be assembled from
      GDP-tubulin as well as from GTP-tubulin. Accordingly, no appreciable
      destabilization of the Zn sheets was observed following GTP hydrolysis and P(i)
      release, indicating that the binding of Zn2+ to tubulin has abolished the
      regulatory switch role played by GTP hydrolysis in tubulin assembly. As a
      consequence, the critical concentration for assembly of Zn sheets did not
      increase with tubulin concentration, a feature characteristic of microtubule
      assembly. Zn sheets do not bind P(i) analogs, indicating that the gamma-phosphate
      binding locus of the E-site of tubulin is occluded following GTP hydrolysis in
      these GDP-tubulin polymers. Nonlinear van't Hoff plots were obtained for assembly
      of Zn sheets in the presence of either GTP or GDP, consistent with a change in
      heat capacity. Enthalpy, entropy, and heat capacity changes had values similar to
      those reported for assembly of microtubules or polymerization of tubulin
      colchicine, indicating that hydrophobic tubulin-tubulin interactions are of
      comparable size in these different polymers.

PMID- 8461305
TI  - Structure and dynamics of sialic acid at the surface of a magnetically oriented
      membrane system.
AB  - A structural analysis of a sialic acid containing glycolipid alpha-dodecyl-N
      acetylneuraminic acid anchored to the surface of a phospholipid-based membrane
      like fragment is presented. The analysis is based on measurement of dipolar
      interactions between 13C-13C and 13C-1H spin pairs in a magnetically oriented
      membrane phase and the interpretation of data using an order matrix formalism.
      Structural analysis in this medium allows an assessment of properties in an
      environment approximating the environment where similar molecules function as
      cell surface receptors. The results indicate an extended headgroup conformation
      with the carboxyl group of the sialic acid near the membrane interface.
      Anisotropic motion of the sialic acid headgroup occurs with the most restriction
      along an axis which is significantly out of the plane of the sialic acid ring
      suggesting an important role for the carboxylate group in membrane surface
      interaction. The effect of calcium on the headgroup orientation was also
      investigated, but the results showed no significant change in the preferred
      conformation, possibly due to a weak binding under the conditions of the
      experiment.

PMID- 8461306
TI  - Purification and further characterization of macrophage 70-kDa protein, a calcium
      regulated, actin-binding protein identical to L-plastin.
AB  - We have previously identified a macrophage 70-kDa, actin-bundling protein as a
      constituent of actin-based cytoplasmic gel and showed that its association with
      or dissociation from cytoplasmic gels was remarkably affected by submicromolar
      calcium. In this study, we purified the 70-kDa protein from soluble cytosolic
      extracts and carried out a more detailed characterization. The amino acid
      sequences of four peptidic fragments, obtained from the purified protein by
      enzymatic or chemical cleavage, were completely or nearly identical to those of L
      plastin, a protein initially identified in transformed cells from solid tumors
      (Goldstein & Leavitt, 1985). By Western blot analysis of normal cells and tissues
      using specific anti-70-kDa protein antibodies, the 70-kDa molecule was detected
      only in hematopoietic cells. The 70-kDa protein bound to actin with apparent Kd
      values of 1.8 and 5.5 microM in the absence and presence of 20 microM free
      calcium, respectively. Cross-linking activity measured by falling-ball
      viscosimetry was optimal at free calcium lower than 0.15 microM but was
      progressively inhibited at higher calcium concentrations, within the
      physiological range. Half-maximal inhibition occurred at 1.6 microM free calcium.
      No severing of actin filaments by the 70-kDa protein was observed in any of these
      assays or previously (Pacaud & Harricane, 1987). Major conformational changes of
      the protein, as measured by the fluorescence emission intensity of tyrosine
      residues, occurred at free calcium concentration ranging between 0.15 and 1.5
      microM. Magnesium did not mimic the calcium effect. The results suggest that the
      70-kDa protein possesses both high-affinity sites and selectivity for
      calcium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461307
TI  - 1H-NMR resonance assignments, secondary structure, and global fold of the TR1C
      fragment of turkey skeletal troponin C in the calcium-free state.
AB  - The TR1C fragment of turkey skeletal muscle TnC (residues 12-87) comprises the
      two regulatory calcium binding sites of the protein. Complete assignments of the
      1H-NMR resonances of the backbone and amino acid side chains of this domain in
      the absence of metal ions have been obtained using 2D 1H-NMR techniques.
      Sequential (i,i+1) and short-range (i,i+3) NOE connectivities define two helix
      loop-helix calcium binding motifs, and long-range NOE connectivities indicate a
      short two-stranded beta-sheet formed between the two calcium binding loops. The
      two calcium binding sites are different in secondary structure. In terms of helix
      length, site II conforms to a standard "EF-hand" motif with the first helix
      ending one residue before the first calcium ligand and the second helix starting
      one residue after the beta-sheet. In site I, the first helix ends three residues
      before the first calcium ligand, and the second helix starts three residues after
      the beta-sheet. A number of long-range NOE connectivities between the helices
      define their relative orientation and indicate formation of a hydrophobic core
      between helices A, B, and D. The secondary structure and global fold of the TR1C
      fragment in solution in the calcium-free state are therefore very similar to
      those of the corresponding region in the crystal structure of turkey skeletal TnC
      [Herzberg, O., & James, M.N.G. (1988) J. Mol. Biol. 203, 761-779].

PMID- 8461308
TI  - 1H NMR spectroscopic studies of selenosubtilisin.
AB  - Anomalously low-field signals in 1H NMR spectra of serine proteases provide
      valuable information on the protonation state of the catalytic histidine residue.
      We have examined the pH dependence of the deshielded protons of three different
      oxidation states of selenosubtilisin, a semisynthetic selenoenzyme with
      significant peroxidase activity, in order to evaluate the influence of the
      selenium prosthetic group on the hydrogen-bonding network in the modified active
      site. In the spectra of the anionic seleninate and selenolate derivatives, two
      resonances were observed at 18.0 and 15.5/14.0 ppm, assigned respectively to the
      N delta 1 and N epsilon 2 protons of protonated His64. These signals were
      apparent from pH 4 to above pH 10, indicating that the negatively charged
      prosthetic group increases the stability of the imidazolium dramatically, raising
      its pKa by at least 3-4 pH units. In contrast, a neutral selenenyl sulfide
      species exhibits no deshielded proton signals at 18 ppm at any pH but has a weak
      signal at 14.1 ppm above pH 7 which was assigned to the N delta 1 imidazole
      proton of neutral His64. While the pKa of His64 appears normal (approximately 7)
      in this derivative, the selenenyl sulfide substitution may alter the orientation
      of the imidazole ring within the active site for steric reasons. Together with
      data on the influence of pH on peroxidase activity, these results suggest that
      selenosubtilisin's His64 acts as a general acid facilitating the reduction of the
      selenenyl sulfide to selenolate by thiols.

PMID- 8461309
TI  - How do mutations at phenylalanine-153 and isoleucine-155 partially suppress the
      effects of the aspartate-27-->serine mutation in Escherichia coli dihydrofolate
      reductase?
AB  - Several second-site suppressors of the D27S lesion in Escherichia coli
      dihydrofolate reductase (DHFR) have been identified. The activity of the primary
      mutant, D27S DHRF, was found to be greatly decreased at pH 7.0, consistent with
      aspartic acid-27 being critically involved in proton donation during catalysis.
      Partial suppressors of the D27S mutation have been selected by their ability to
      confer an increased resistance to trimethoprim upon host E. coli; the suppressors
      have been identified as F153S or I155N substitutions. D27S+F153S and D27S+I155N
      DHFRs display 2-3-fold increases in kcat over D27S DHFR values, but only the
      F153S mutation decreases the Km for dihydrofolate by a factor of 2. Neither
      double mutant approaches wild-type DHFR activity. Unexpectedly, Phe153 and Ile155
      occur on the surface of the protein and are approximately 8 and 14 A distant from
      the active site. Ile155 is a member of a beta-bulge. A previously identified
      suppressing mutation, F137S, occurs nearby and is also a member of the same beta
      bulge [Howell et al. (1990) Biochemistry 29, 8561-8569]. Clustering of these
      three second-site mutations indicates this area of the structure may be important
      in protein function. Conformational changes due to the presence of these
      suppressing mutations are likely as the F153S and I155N mutations do not affect
      hydride-transfer rates upon introduction in wild-type DHFR and alterations in
      circular dichroism spectra are associated with the double-mutant DHFRs.

PMID- 8461311
TI  - Mutations designed to modify the environment of the primary electron donor of the
      reaction center from Rhodobacter sphaeroides: phenylalanine to leucine at L167
      and histidine to phenylalanine at L168.
AB  - Two mutations, L168 His to Phe and L167 Phe to Leu, were made in residues near
      the primary electron donor, a bacteriochlorophyll dimer, of the reaction center
      from Rhodobacter sphaeroides. Blue shifts of 10-15 nm in the 865-nm band of the
      donor were observed in the optical absorption spectra of both of the mutant
      reaction centers. The rate of initial electron transfer was determined by
      measurement of the kinetics of the decay of the excited state of the donor, and
      the rate of charge recombination was determined by measurement of the recovery of
      the bleaching of the donor. The initial electron transfer time constant and the
      charge recombination time constant were determined to be 3.6 ps and 220 ms,
      respectively, in the L168 His to Phe mutant and 5.0 ps and 85 ms in the L167 Phe
      to Leu mutant, compared to 3.8 ps and 100 ms measured for the wild type. The
      oxidation potential of the donor measured by oxidation-reduction titrations was
      found to decrease by 80 mV in the L168 His to Phe mutant and increase by 25 mV in
      the L167 Phe to Leu mutant. Time-resolved fluorescence decay measurements
      indicated that the change in the oxidation potential of the donor in the L168 His
      to Phe mutant resulted in a change in the energies of the charge-separated
      states. The results show that an increase in the driving force does not increase
      the rate of the initial electron transfer reaction.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8461310
TI  - A transforming growth factor-alpha-Pseudomonas exotoxin hybrid protein undergoes
      pH-dependent conformational changes conducive to membrane interaction.
AB  - TP40 is a chimeric protein containing transforming growth factor alpha (TGF
      alpha) at the N-terminus and a derivative of a 40,000-Da segment (PE40 delta cys)
      of Pseudomonas exotoxin (PE). PE40 delta cys contains domains Ib, II, and III of
      PE in which the cysteines are mutated to alanines. The rationale for inclusion of
      TGF-alpha is to provide TP40 with selective targeting toward cells expressing the
      epidermal growth factor receptor (EGFr) on their surface [Pastan, I., &
      FitzGerald, D. (1989) J. Biol. Chem. 264, 15157-15160]. Translocation across
      endosomal membranes is thought to be a required step for cytotoxic activity of
      PE. This step is presumably facilitated by the low pH in endosomes which induces
      exposure of a hydrophobic surface of the protein, which in turn becomes available
      to interact with and translocate across the membrane. We have employed the
      hydrophobic fluorescence probe 2-p-toludinylnaphthalene-6-sulfonate (TNS) and the
      intrinsic tryptophan fluorophores of TP40 to investigate pH-induced changes in
      the tertiary structure of this protein. The pH dependence of TP40 interaction
      with liposomes also provided a model for studying protein-membrane interactions.
      TNS fluorescence was markedly enhanced in the presence of TP40 below pH 4 and to
      a lesser degree between pH 7 and 5. A progressive red shift of tryptophan
      fluorescence with decreasing pH was also seen with the approximate midpoint for
      this transition occurring around pH 3. Both observations suggest that acidic pH
      induces exposure of hydrophobic regions of TP40, making them accessible to
      solvent and TNS. No major alteration of the secondary structure was manifested in
      the far-UV CD spectrum of TP40 upon a reduction in pH from 7 to 2. Thus, the low
      pH-induced structural change of TP40 appears to involve a subtle exposure of one
      or more hydrophobic surfaces without an extensive unfolding of the protein's
      secondary structure. In the presence of anionic liposomes, a low-pH-induced blue
      shift of the TP40 tryptophan fluorescence was observed, suggesting that
      interaction with liposomes also required the low-pH conformation of the protein.
      However, the midpoint of this fluorescence blue shift occurred at approximately
      pH 5, which is presumably closer to the physiological pH within endosomes.
      Neutral liposomes failed to induce these spectral changes in TP40, implying a
      lack of interaction with these lipids. At acidic pH values between 2 and 4, self
      association of TP40 in solution was detected by equilibrium sedimentation and
      quasielastic light scattering measurements. This probably results from
      intermolecular interaction between exposed hydrophobic surfaces.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8461312
TI  - Dietary vitamin E reverses the effects of ultraviolet light irradiation on rat
      skin glycosaminoglycans.
AB  - Chondroitin 4-sulfate (Ch 4-S), three dermatan sulfates (DS18, DS45a, DS45b) and
      hyaluronic acid (HA) were the major glycosaminoglycans (GAG) isolated from the
      skin of 4 groups of albino rats. The yields from Group 1 (control) were: Ch 4-S,
      0.015%; HA, 0.028% and DS (total), 0.098% (w/w). Traces of heparin were detected
      only in rats irradiated with ultraviolet (UV) light (Group II), in the GAG pool
      isolated with 45% ethanol. Yields increased by at least 28% (w/w) in Group II,
      but decreased, except HA's, also by at least 28%, below the level of the control,
      in irradiated rats that also ingested vitamin E (Group III). The sulfate
      composition of these GAG determined by infrared spectroscopy was as follows:
      approx. 17% (w/w) for DS18, 21-30% for DS45a, 21-35% for DS45b and 26-44% for Ch
      4-S. A 60-70% (mol/mol) N-acetylation of hexosamine in DS45 was estimated by
      Fourier transform 1H-NMR spectroscopy; the IdUA composition of this DS was 30-46%
      (mol/mol), and the uronic acid/hexosamine ratio ranged from 2.50:1 to 1.6:1. The
      data show UV light irradiation of rat skin to result in an abnormally elevated
      production of the major GAG and oversulfation of Ch 4-S and DS. These effects are
      reversed, except for the sulfation of DS45b, when the irradiated animals also
      ingest vitamin E.

PMID- 8461313
TI  - The acute phase reactant serum amyloid A (SAA3) is a novel substrate for
      degradation by the metalloproteinases collagenase and stromelysin.
AB  - We found that the matrix metalloproteinases collagenase (MMP-1) and stromelysin
      (MMP-3) each has the ability to degrade a novel substrate, serum amyloid A
      (SAA3). SAA3 is a product of rabbit synovial fibroblasts stimulated with phorbol
      esters or interleukin-1, and it acts in an autocrine or paracrine manner to
      induce collagenase in both rabbit and human fibroblasts. Recombinant rabbit
      fibroblast procollagenase and human fibroblast prostromelysin were produced by
      baby hamster kidney (BHK) cells stably transfected with these genes, and latent
      enzyme was activated with aminophenylmercuric acetate (APMA). The Km for both
      enzymes was approximately 10 microM, and the Vmax for collagenase was
      approximately 6 pmol/minute/100 ng enzyme, while that for stromelysin was about 3
      fold faster. Treatment of SAA3 with either enzyme generated a fragment of approx.
      6 kDa that has the same amino terminus as the parent molecule, but this fragment
      was rapidly degraded. We have been unable to isolate C-terminal fragments,
      suggesting that the mature protein is cleaved at multiple sites and/or that the
      initial cleavage fragment is readily digested. The amino acid composition of the
      6 kDa fragment suggests that the 14 kDa protein is cleaved at residues 50-57, a
      hydrophobic region that is conserved between rabbit SAA3 and human SAA1. We
      conclude that the ability of collagenase and stromelysin to degrade SAA3 broadens
      the repertoire of substrates for these matrix degrading enzymes, and we speculate
      that the presence of a feedback mechanism that can subvert the
      autocrine/paracrine stimulation of matrix-degrading enzymes may play a role in
      limiting matrix degradation during inflammatory conditions.

PMID- 8461314
TI  - Isolation and characterization of a sialic acid-specific binding lectin from the
      hemolymph of Asian horseshoe crab, Tachypleus tridentatus.
AB  - A lectin was isolated from the hemolymph of Asian horseshoe crab Tachypleus
      tridentatus by using glycophorin HA affinity chromatography and Sephacryl S-300
      gel filtration. The lectin's molecular weight was approx. 533 kDa; being a simple
      protein comprised of two non-identical subunits with molecular weights of 30 and
      32 kDa. The hemagglutinating activity of the lectin against equine erythrocytes
      was strongly inhibited by several sialoglycoproteins and weakly inhibited by
      sialic acid, although not inhibited by neutral sugars, hexosamines, N
      acetylhexosamines, glucuronic acid, or several asialoglycoproteins. In addition,
      glycophorin HA was more effective than glycophorin HA digested with trypsin in
      inhibiting hemagglutination of the lectin. These results suggest that the
      purified lectin specifically reacts with sialic acids containing glycoprotein.

PMID- 8461315
TI  - Role of the trehalose carrier in dehydration resistance of Saccharomyces
      cerevisiae.
AB  - Yeast cells are well known for their ability to survive complete dehydration, a
      phenomenon that is directly linked to the presence of the sugar trehalose in
      these cells. This sugar apparently endows the cells with the capacity to survive
      dehydration. Previous studies on in vitro models showed that trehalose must be
      present on both sides of the bilayer to stabilize dry membranes. The present
      report demonstrates that a specific trehalose carrier seems to enable the sugar
      to protect the yeast cell membrane by translocating trehalose from the cytosol to
      the extracellular environment. Saccharomyces cerevisiae mutant strains which lack
      the trehalose carrier did not survive after dehydration although they accumulated
      endogenous trehalose. Furthermore, when carrier mutants were dehydrated in the
      presence of exogenous trehalose the cells became more resistant showing increased
      survival.

PMID- 8461316
TI  - Irreversible inactivation of 3-hydroxy-3-methylglutaryl-CoA reductase by H2O2.
AB  - A concentration-dependent inactivation of 3-hydroxy-3-methyl-glutaryl-CoA (HMG
      CoA) reductase was found on preincubation of rat liver microsomal preparations
      with H2O2 and at lower concentrations in the presence of KCN which inhibited the
      contaminating catalase. The inactivation was not affected in the presence
      quenchers of hydroxyl radicals and singlet oxygen and was also obtained when H2O2
      was added during the reaction. HMG-CoA, but not NADPH, partially protected the
      enzyme from H2O2-inactivation. Even at high concentration DTT was unable to
      reverse this inactivation. The soluble 50 kDa-enzyme was similarly inactivated by
      H2O2, and the tryptic-digest of the inactivated protein indicated the presence of
      a disulfide-containing peptide. The results support the view that H2O2 by
      directly acting on the catalytic domain possibly converts an active thiol group
      to an inaccessible disulfide and irreversibly inactivates HMG-CoA reductase.

PMID- 8461317
TI  - Does lung NAD(P)H:quinone reductase (DT-diaphorase) play an antioxidant enzyme
      role in protection from hyperoxia?
AB  - NAD(P)H:quinone reductase, or DT-diaphorase, has been studied primarily in the
      liver where it appears to function as an antioxidant-like enzyme in the 2
      electron reduction of some quinones to less toxic hydroquinones. This property
      together with new molecular biology evidence that oxidants such as H2O2 can
      induce gene transcription of DT-diaphorase provide especially intriguing reasons
      to examine the possibility that lung DT-diaphorase could have an important
      antioxidant enzyme role versus pulmonary O2 toxicity during exposure to
      hyperoxia. We found that similar to the 'classical' lung antioxidant enzymes
      (superoxide dismutase, catalase and glutathione peroxidase) DT-diaphorase
      activity increased significantly in the late gestational fetal lung; also its
      activity was altered in the same way as the antioxidant enzymes by prenatal
      hormonal treatment. Another similarity is that DT-diaphorase activity was induced
      in the neonatal animal lung during hyperoxia, but not in the adult animal lung.
      However, using various drug treatments which markedly increased lung DT
      diaphorase activity (e.g., 3-methylcholanthrene, butylated hydroxyanisole,
      methimazole) we found no improved hyperoxic survival in the treated adult rats.
      Also, dicumarol treatment, which markedly depressed DT-diaphorase activity, did
      not diminish the hyperoxic survival rate in an O2-tolerant adult rat model. Thus,
      we conclude that unlike the classical antioxidant enzymes, increased pulmonary DT
      diaphorase activity is probably neither necessary nor sufficient to protect
      against pulmonary O2 toxicity during hyperoxia.

PMID- 8461318
TI  - The glycosides of hydroxylysine are final products of collagen degradation in
      humans.
AB  - Glucosyl-galactosyl-hydroxylysine (GGHYL) and galactosyl-hydroxylysine (GHYL) are
      metabolites derived from collagen degradation. They are useful biochemical
      markers provided they are not further processed. Experiments were run to test the
      activity of alpha- and beta-glycosidases in human kidney cortex preparations.
      Results allow to exclude the presence of the specific enzymes, in contrast with
      what is reported for the rat kidney tissue.

PMID- 8461319
TI  - Persistent decrease in spermidine/spermine N1-acetyltransferase activity in 'post
      regeneration' rat liver.
AB  - The activity of cytosolic spermidine/spermine N1-acetyltransferase and polyamine
      levels were measured in livers of rats killed at different times after partial
      hepatectomy. The enzyme activity, which showed an early increase a few hours
      after the operation, had significantly and persistently decreased by the time the
      liver mass had been regained (10 days) compared to intact rats or sham-operated
      rats, and up to 30 days after partial hepatectomy, compared to intact rats of the
      same age. The early induction of spermidine/spermine N1-acetyltransferase
      activity was also confirmed by the high level of N1-acetylspermidine, which
      normally is undetectable, and by a dramatic increase in putrescine content.
      Spermidine levels were increased during the first 10 days after partial
      hepatectomy, i.e., when the liver had regained its mass, and progressively
      decreased after this time until 30 days after the operation. The changes in
      spermine content were similar but not as marked as the changes in spermidine
      content at the different observation times.

PMID- 8461320
TI  - Interaction between neutrophil-derived elastase and reactive oxygen species in
      cartilage degradation.
AB  - The role of proteases and reactive oxygen species (ROS) in polymorphonuclear
      neutrophil (PMN) induced cartilage degradation in vitro were studied. ONO-5046, a
      novel synthetic elastase inhibitor, significantly and dose dependently protected
      cartilage from degradation induced by PMNs stimulated with phorbol myristate
      acetate (PMA), opsonized zymosan, N-formyl-methionyl-leucyl-phenylalanine plus
      cytochalasin-B, or A-23187. The degradation by PMA-stimulated PMNs was unaffected
      by protease inhibitors which lack anti-elastase activity. However, the hydrogen
      peroxide (H2O2) reducing agent catalase afforded significant protection.
      Measurement of elastase activity following PMN activation by PMA showed that
      antioxidants which reduce H2O2 and/or hypochlorous acid decreased elastase
      activity. Thus, it is suggested that an indirect interaction between ROS and
      elastase activity may exist in PMN induced cartilage degradation. Furthermore,
      the possible implication of an endogenous elastase inhibitor(s) is discussed.

PMID- 8461321
TI  - Effects of seven months' exposure to a static 0.2 T magnetic field on growth and
      glycolytic activity of human gingival fibroblasts.
AB  - Human gingival fibroblasts in confluent cultures were continuously exposed to a
      static 0.2 T magnetic field for 6 or 8 months. Culture flasks were not changed
      during the exposure, but culture medium was renewed. After dilution and mixing of
      the cultures surviving intact, field-exposed and sham-exposed cultures received
      further field- or sham-exposure on Sm-Co blocks. Rate of cell proliferation,
      histogram of the nuclear DNA content, rates of lactate production and glucose
      consumption and the ATP content were determined and cell morphology was
      investigated by both light- and electron-microscopy. Results show no marked
      differences between exposed and control cells.

PMID- 8461322
TI  - In vitro and ex vivo xanthine oxidoreductase activity in rat and guinea-pig
      hearts using hypoxanthine or xanthine as substrate.
AB  - Through oxyradical formation xanthine oxidoreductase (XOD) could play a role in
      the etiology of cardiac damage. Its measurement poses problems, due to little
      substrate specificity, self-inactivation and endogenous inhibitors. Perfusion of
      guinea-pig hearts with hypoxanthine gave rise to only little xanthine release; in
      contrast rat hearts showed vivid xanthine production. Therefore, xanthine
      breakdown was hypothesized to exceed its formation in guinea-pig hearts. The
      kinetics of both substrates for XOD in cardiac homogenates were therefore
      compared with those obtained in perfused hearts. Oxypurine contents and effluent
      catabolites were determined by HPLC. Regardless of substrate, Vmax values in
      homogenates were about 38 and 13 mU/g for rat and guinea-pig heart, respectively.
      Km values were in the 3-5 microM range; therefore the hypothesis concerning the
      low xanthine release in guinea-pig hearts must be rejected. Activities in hearts
      perfused with hypoxanthine (50 microM) were 40 and 18 mU/g for rat and guinea
      pig, respectively; perfusion with xanthine produced < 50% of the activities
      observed with hypoxanthine (p < 0.002). Intracellular xanthine concentration,
      estimated from sorbitol distribution space and myocardial xanthine content was
      negative in both species, contrasting intracellular hypoxanthine levels, which
      approached extracellular concentrations. This disparate distribution indicates
      that hypoxanthine transport across the cell membrane far exceeds that of
      xanthine. Consequently, hypoxanthine is preferable to xanthine as substrate in
      perfused hearts to estimate XOD activity in situ.

PMID- 8461323
TI  - Alpha-1,4-glucan lyase, a new class of starch/glycogen degrading enzyme. I.
      Efficient purification and characterization from red seaweeds.
AB  - This study presents the first purification and characterization of an alpha-1,4
      glucan lyase. The enzyme degraded alpha-1,4-glucan to produce 1,5
      anhydrofructose. A simple and efficient purification procedure has been developed
      and the enzyme has been purified to homogeneity from two red seaweeds
      Gracilariopsis lemaneiformis and Gracilaria verrucosa. alpha-1,4-Glucan lyase was
      apparently a single polypeptide as a molecular weight of 111,000 was observed in
      SDS-gel electrophoresis, and 98,000 by gel filtration chromatography on Sephacryl
      S-200. Amino acid composition analysis of the enzyme showed high amounts of
      Asp/Asn, Gly and Glu/Gln. The isoelectric point of the enzyme was 3.9, as
      revealed by isoelectrofocusing. The concentrations of maltotriose, maltose and
      amylopectin that yield half of the maximum activity were 798 micrograms ml-1
      (1.58 mM), 1,418 micrograms ml-1 (4.14 mM) and 1,600 micrograms ml-1,
      respectively. alpha-1,4-Glucan lyase exhibited a wide pH optimum range from pH
      2.5 to 7.0 for maltose and from pH 3.5 to 7.5 for amylopectin. The optimal
      temperature for activity of the algal lyase was 50 degrees C when maltose or
      amylopectin was used as a substrate under the assay conditions. The Arrhenius
      activation energies were 45.8 and 44.0 kJ mol-1 for maltose and amylopectin as
      substrate, respectively. Only one form of alpha-1,4-glucan lyase was found in
      cell-free extracts of the two red seaweeds.

PMID- 8461324
TI  - Characterization and biological activity of 8-substituted analogues of 2',5'
      oligoadenylates.
AB  - Analogues of the 2',5'-linked adenylate trimer 5'-monophosphates
      (p5'A2'p5'A2'p5'A) containing 8-hydroxyadenosine and 8-mercaptoadenosine in the
      first, second, and third nucleotide positions were tested for their ability to
      bind to and activate RNase L of mouse L cells. The ability of
      p5'ASH2'p5'ASH2'p5'ASH (pASH3) (1c) to bind 2-5A dependent endonuclease was
      markedly decreased. On the other hand, an analogue of the 2',5'-linked adenylate
      trimer monophosphate substituted by 8-hydroxyadenosine in the first, second, and
      third nucleotide positions bound almost as well as parent 2-5A [pppA(2'p5'A)2]
      (p3A3) (1d) to RNase L. The 8-substituted analogues of 2-5A were more resistant
      to the degradation by the (2',5') phosphodiesterase. Of particular interest is
      monophosphate, pASH3 (1c) which possessed higher anti-HIV activity than pA3 (1a)
      or pAOH3 (1b).

PMID- 8461325
TI  - The interaction of sodium nitroprusside with peripheral white blood cells in
      vitro: a rationale for cyanide release in vivo.
AB  - Isolated monocytes and polymorphonuclear leukocytes release the cyanide anion
      from the hypotensive agent, sodium nitroprusside. The proposed mechanism involves
      the production of hydrogen peroxide which oxidizes the substitution inert d6
      iron(II) transition metal complex to a labile d5 iron(III) complex. Consequently,
      the release of cyanide becomes more favoured. This mechanism is supported by the
      chemical release of the cyanide anion from sodium nitroprusside in vitro by
      hydrogen peroxide and the demonstrated ability of monocytes and polymorphonuclear
      leukocytes to generate hydrogen peroxide ex vivo when chemically stimulated by
      the nitroprusside anion. The results suggest that within a clinical environment
      white cell counts and cell activation induced as a consequence of disease
      processes may be important for predicting the toxicity of sodium nitroprusside.

PMID- 8461326
TI  - Calculating three-dimensional molecular structure of paliurine B from atom-atom
      distance and restrained energy minimization.
AB  - The conformation of paliurine B, a 13-membered cyclopeptide alkaloid isolated
      from Paliurus ramosissimus, has been determined from 2D NMR and distance
      geometry, followed by the restrained energy minimization calculation. The
      conformation of the 13-membered ring is well-defined but that of the acyclic
      dipeptide tail region is relatively disordered. In addition, the cavity in the 13
      membered ring is just large enough to insert a magnesium ion but is a little
      small for calcium or sodium ions.

PMID- 8461327
TI  - Structure determination of glycosphingolipids of cultured human keratinocytes.
AB  - From cultured human keratinocytes, seven glycolipid fractions were isolated by
      DEAE and silica-gel column chromatographies, and further by HPLC on a silica-gel
      column. By means of 1H-NMR spectroscopy, fast atom bombardment mass spectrometry
      and GLC-mass spectrometry, one fraction was determined to contain
      acylglucosylceramides, which consist of amide linked omega-hydroxy fatty acids
      (C30:0, C30:1, C32:1 and C34:1), fatty acids linked to the omega-hydroxy fatty
      acids through ester linkages (C14:1, C16:1, C18:1 and C18:2), a long-chain base
      (d18-sphingenine), and beta-glucose. Five of the other fractions contained
      glucosylceramides, and the seventh fraction contained a mixture of
      glucosylceramides and galactosylceramides. Glucosylceramides containing long
      chain omega-hydroxy fatty acids, which are assumed to be immediate precursors of
      the acylglucosylceramides, were hardly detected in these glycolipid fractions.
      Six glucosylceramide fractions were separated due to differences in their fatty
      acids and sphingosines. On comparison with the results reported in our previous
      paper, the acylglucosylceramide content of the cultured human keratinocytes was
      about half that of human epidermis. Under the culture conditions used, the human
      keratinocytes did not differentiate into granular or horny cells. Taken together,
      the results suggest that the synthesis of acylglucosylceramides is not activated
      much in the cultured keratinocytes, but would be more activated in differentiated
      cells.

PMID- 8461328
TI  - Phosphatidylethanolamine derived from phosphatidylserine is deacylated and
      reacylated in rat hepatocytes.
AB  - The metabolism of phosphatidylserine (PS), phosphatidylethanolamine (PE) and
      phosphatidylcholine (PC), derived from [3H]serine, has been studied in rat
      hepatocytes. After an initial pulse with radioactivity for 10 min and a chase for
      up to 240 min, cells were harvested and PS, PE and PC isolated. At the end of the
      pulse, greater than 90% of [3H]serine derived phospholipid radioactivity was
      associated with PS. In the subsequent chase, newly-made PS was degraded rapidly
      with less than 25% of the label lost from PS appearing in the PE and PC pools. In
      contrast, [3H]serine-labeled PE turnover was not detectable. Very little newly
      made PS was converted to PC. PE and PC were further fractionated into molecular
      species by high-performance liquid chromatography. We report that [3H]serine
      labeled PE is deacylated/reacylated with the major product of remodeling being
      18:0-20:4 PE. In contrast, [3H]serine-labeled PC is not significantly remodeled.

PMID- 8461329
TI  - Lipoprotein and apoprotein profile of Japanese quail.
AB  - The present study delineated the lipoprotein and apoprotein distribution in
      Japanese quail. Quail lipoprotein was composed of three fractions: VLDL, d <
      1.020; LDL, 1.020 < d < 1.081; HDL, 1.081 < d < 1.210. When animals were fed the
      cholesterol-free diet, HDL was the predominant form, LDL intermediate, VLDL and
      chylomicron were smallest in amount. Feeding of cholesterol induced a marked
      change in the lipoprotein profile: VLDL or chylomicron predominated over HDL and
      LDL. An apoprotein of 26 kD (molecular weight) was the major protein moiety
      comprising more than 50% of total apoprotein in the entire density range of
      lipoprotein class. Amino acid composition of 26 kD protein was similar to hen,
      rat and human apo A-I. N-Terminal 36 amino acid sequence of 26 kD protein showed
      92% homology to chicken apo A-I and 11% homology to human apo A-1. The 26 kD
      protein did not react with the antibody raised against human apo A-I. These
      observation showed that the 26 kD protein was partially identical to apo A-I.

PMID- 8461330
TI  - Regulation of hepatic and non-hepatic apolipoprotein A-I and E gene expression
      during liver regeneration.
AB  - In this study, we have determined what tissues other than liver express
      apolipoprotein (apo) A-I and apo E genes during liver regeneration at the level
      of the specific mRNAs, and have compared these findings with the serum values of
      high-density lipoprotein (HDL), low-density lipoprotein (LDL) and very-low
      density lipoprotein (VLDL). Our results show that liver and intestine express
      most of the apo A-I mRNA during liver regeneration. Although apo E mRNA is
      expressed principally by the liver, its expression is reduced in liver during
      regeneration but is increased markedly in non-hepatic tissues, such as in
      intestine, kidney, lung and brain. These results suggest that humoral or
      circulating factors released during liver regeneration influence apolipoprotein E
      gene expression, not only in hepatic but also in non-hepatic tissue.

PMID- 8461331
TI  - Kinetic analysis and substrate specificity of a lysophospholipase from the
      macrophage-like cell line P388D1.
AB  - The kinetics of the lysophospholipase purified from the P388D1 macrophage-like
      cell line (Zhang and Dennis (1988) J. Biol Chem. 263, 9965-9972) have been
      explored. Three different lysophospholipids were used in these studies: 1
      hexadecanoyllysophosphatidylcholine, 1-tetradecanoyllysophosphatidylcholine, and
      1-hexadecanoyllysophosphatidylglycerol. Since all of the substrate dependence
      data for these substrates fit a Hill model, the enzyme's activity appears to be
      cooperative requiring at least two lipid molecules for full enzymatic activity.
      The enzyme did not show a preference for any of these substrates since their kcat
      ranged from 1.2 to 1.5 mumol min-1 mg-1 and their half-maximal activities
      ([S]0.5) were achieved at substrate concentrations between 15 and 33 microM.
      Enzymatic activity also appeared to be independent of the aggregation state of
      the substrate. No dramatic changes in rate could be associated with substrate
      aggregation at the critical micelle concentration. This is in marked contrast to
      some phospholipases A2 that exhibit dramatic activations when their substrates
      aggregate. In very dilute solutions, less than 0.5 micrograms/ml protein, the
      lysophospholipase loses activity irreversibly within minutes. This effect of low
      protein concentrations can be overcome by maintaining the enzyme in the presence
      of greater than 10 microM lysophospholipid. This inactivation can affect kinetic
      studies, since the [S]0.5s for this enzyme are usually in this range. We have
      found that increasing the protein concentration with a 'non-specific protein',
      e.g., cytochrome c, can protect the enzyme without affecting activity and, thus,
      allow valid kinetic data to be obtained over the full substrate concentration
      range.

PMID- 8461332
TI  - The effect of surface charge on the hydrolysis kinetics of partially hydrogenated
      egg phosphatidylcholine and egg phosphatidylglycerol in aqueous liposome
      dispersions.
AB  - The hydrolysis kinetics of partially hydrogenated egg phosphatidylcholine (PHEPC)
      and egg phosphatidylglycerol (EPG) were investigated as a function of surface pH
      at 60 degrees C. The bulk pH of the liposome dispersions was varied from pH 3.0
      to 8.0. Charge was introduced to the liposomal bilayers by addition of EPG.
      Different electrostatic profiles were obtained at the bilayer-water interface by
      varying the surface charge density and the ionic strength of the buffer
      solutions. With the Gouy-Chapman equation the surface potential and with the
      Boltzmann equation the resulting shift in the surface pH compared to the bulk pH
      was estimated. The hydrolysis rate of both phospholipids increased with surface
      charge density in acidic medium; in alkaline medium the opposite was true. The
      hydrolysis rate constants, however, plotted as a function of surface pH agreed
      reasonably well with the results found with neutral liposomes.

PMID- 8461333
TI  - A phospholipase A2 inhibitor decreases generation of thiobarbituric acid reactive
      substance during lung ischemia-reperfusion.
AB  - A novel active-site directed specific inhibitor of phospholipase A2 (PLA2), 1
      hexadecyl-3-trifluoroethylglycero-sn-2-phosphomethanol (MJ33), administered
      endotracheally co-dispersed in liposomes, significantly reduced the formation of
      thiobarbituric acid reactive substances (TBARS) in isolated rat lungs subjected
      to ischemia-reperfusion. Elevated conjugated dienes were unaffected. This
      contrasts with the effects of the cyclo-/lipoxygenase inhibitor 5,8,11,14
      eicosatetraynoic acid (ETYA), which decreased formation of both TBARS and
      conjugated dienes (CD). The effects of MJ33 plus ETYA were additive for TBARS but
      results for CD were similar to ETYA alone. A similar dissociation of inhibition
      of TBARS and CD formation by MJ33 was observed with t-butyl hydroperoxide induced
      lipid peroxidation of isolated lung microsomes. Assay of lung homogenate with
      phosphatidylcholine as substrate showed that MJ33 selectively inhibited the
      Ca(2+)-independent acidic PLA2. MJ33 had no effect on thromboxane B2 release by
      the isolated lung, indicating the effects of acidic PLA2 inhibition do not
      involve the arachidonate cascade. MJ33 also partially prevented lung edema and
      lactate dehydrogenase release associated with ischemia-reperfusion. The
      observations show that this PLA2 inhibitor can be delivered to oxidant-sensitive
      lung sites by its co-dispersal in liposomes, and that oxidant-induced lipid
      peroxidation in this model of lung injury occurs in a complex lipid prior to PLA2
      activity.

PMID- 8461334
TI  - Different effects of the hypolipidemic drugs pravastatin and lovastatin on the
      cholesterol biosynthesis of the human ocular lens in organ culture and on the
      cholesterol content of the rat lens in vivo.
AB  - This study aimed to investigate the influence of the hypocholesterolemic drugs
      pravastatin and lovastatin on the cholesterol biosynthesis in the ocular lens.
      Two model systems were used: a human lens organ culture system and an in vivo rat
      lens system. For measurements of cholesterol and fatty acid synthesis rates,
      human lenses were incubated for 20 h in the presence of [14C]acetate. Pravastatin
      and lovastatin were added 1 h prior to the addition of the radioactive label. In
      order to avoid the influence of differences relating to individual donors, one
      lens from each donor was incubated without drug (control) and the other lens was
      incubated in the presence of the drug. Statistical analysis showed that the fatty
      acid synthesis rate was not influenced by the drug. For each lens pair the
      percentage inhibition of the cholesterol synthesis caused by the drug was
      calculated. Using various concentrations of the drugs, a dose-response curve was
      composed for the inhibition of the cholesterol synthesis. The experiments showed
      that in the human lens organ culture system, lovastatin was 100-fold more potent
      than pravastatin in inhibiting the cholesterol biosynthesis. To study the in vivo
      influence of vastatins on the cholesterol content of the developing lens, Wistar
      rats were weaned at day 21 of age and subsequently the pups were fed a control
      diet or drug-containing diet (10, 50 or 100 mg lovastatin/kg chow) for a 3-week
      period. At the end of diet intervention, doses of 50 or 100 mg lovastatin/kg chow
      had caused a reduction of about 20% of the lenticular cholesterol content
      compared with controls. No effect on the lens cholesterol content by pravastatin
      was observed. Both human ex vivo and rat in vivo experiments show that lovastatin
      much more strongly inhibits the lenticular cholesterol synthesis than does
      pravastatin.

PMID- 8461335
TI  - Different hydrolytic efficiencies of adipose tissue lipoprotein lipase on very
      low-density lipoprotein subfractions separated by heparin-Sepharose
      chromatography.
AB  - Human very-low-density lipoproteins (VLDL) were subfractionated by heparin
      Sepharose chromatography into an unbound (A) and three bound (B, C and D)
      populations at increasing ionic strengths. Subfractions were characterized
      regarding their chemical composition and efficiency of triacylglycerol hydrolysis
      by rat adipose tissue LPL. The triacylglycerol content decreased, whereas the
      cholesterol and protein contents increased from subfractions A and B to
      subfraction D. VLDL-D showed the highest apo E/apo C ratio, though all the
      subfractions contained appreciable apo E. Appearance of VLDL-A resulted from
      exceeding the binding capacity of the column, since practically all its particles
      eluted at positions of bound VLDL under re-chromatography. Subfractions B, C and
      D stimulated LPL activity on emulsified tri[14C]oleoylglycerol to a similar
      extent, indicating that their apo C-II content was equally effective activating
      LPL. Incubation of tri[14C]oleoylglycerol labeled VLDL subfractions with fat pad
      pieces in the presence or absence of heparin resulted in greater hydrolysis and
      fatty acid uptake for VLDL-B and -C than for VLDL-D, a pattern observed over a
      wide range of LPL activities in the media. We conclude: (1) any VLDL particle can
      interact with heparin, which is consistent with the presence of apo E in all the
      subfractions, and (2) triacylglycerols in apo E-rich VLDL are less efficiently
      hydrolyzed by LPL than those in apo E-poor particles. We propose that richness in
      apo E impairs LPL action upon VLDL and decreases the rate of delivery of fatty
      acids to peripheral tissues.

PMID- 8461336
TI  - The effects of probucol on the levels, structure, composition and metabolism of
      plasma lipoprotein in rats.
AB  - The effects of probucol administration on the levels, structure, composition and
      metabolism of plasma lipoproteins were determined in male rats. Probucol caused a
      25% decrease of plasma cholesterol and a 20% decrease of plasma triacylglycerols.
      The effect was more pronounced on lipoproteins of density less than 1.063 g/ml (
      35%) than on density greater than 1.063 g/ml (-21%). The density of LDL, HDL-1
      and HDL-2 separated by ultracentrifugation on a zonal rotor was shifted towards a
      higher density. The content of cholesteryl esters increased in VLDL and LDL and
      decreased in HDL-1 and HDL-2. LDL, HDL-1 and HDL-2 were relatively enriched with
      proteins. The intravascular metabolism of 125I-labeled apo A-I was identical in
      control and probucol-treated rats with a circulating half-lifetime of 9.5 h. The
      circulating half-lifetime of LDL labeled biosynthetically with [3H]cholesteryl
      esters was also identical, 6.5 h. The circulating half-lifetime of
      [3H]cholesteryl esters in HDL-2, in contrast, was 9.5 h in control rats and 7.5 h
      in probucol-treated animals. Plasma cholesterol ester transfer activity was
      almost undetectable in either control or probucol treated animals. The
      investigation demonstrates a pronounced effect of probucol on plasma lipid and
      lipoprotein levels in rats, on cholesterol ester distribution between
      lipoproteins and on lipoprotein transport rates in the plasma. These effects may
      contribute to the anti-atherogenetic action of probucol.

PMID- 8461337
TI  - Signal-transduction mechanisms of ATP-stimulated phosphatidylcholine secretion in
      rat type II pneumocytes: interactions between ATP and other surfactant
      secretagogues.
AB  - ATP stimulates phosphatidylcholine secretion in type II cells, an effect that is
      mediated by both adenosine A2 receptors coupled to adenylate cyclase and P2
      receptors coupled to phosphoinositide-specific phospholipase C. Activation of
      these effector enzymes leads to formation of cAMP, diacylglycerols and inositol
      trisphosphate (IP3). cAMP in turn activates cAMP-dependent protein kinase,
      diacylglycerols activate protein kinase C and IP3 promotes Ca2+ mobilization. To
      further investigate the signal-transduction mechanisms mediating the ATP effect,
      we examined its action in combination with that of other surfactant
      secretagogues: 5'(N-ethylcarboxyamido)adenosine (NECA), a A2 agonist that
      activates adenylate cyclase; TPA (12-O-tetradecanoylphorbol-13-acetate), a direct
      activator of protein kinase C; and ionomycin, an ionophore that increases
      intracellular Ca2+. The effects of NECA, TPA and ionomycin were additive and thus
      consistent with independent signaling mechanisms. However, the effects of all
      combinations of three or four secretagogues that contained ATP were 10-20% less
      than additive. This suggested that ATP and other secretagogues act via common
      mechanisms. Calmodulin antagonists decreased the effects of ionomycin and ATP by
      approx. 60% and 30%, respectively, but did not decrease the effects of NECA,
      terbutaline or TPA. Complete inhibition of the effect of ATP was achieved with a
      combination of a calmodulin antagonist, an A2 antagonist and a protein kinase C
      inhibitor. These and previous data suggest that the stimulatory effect of ATP on
      phosphatidylcholine secretion in type II cells is mediated by three signal
      transduction mechanisms: activation of cAMP-dependent protein kinase; activation
      of protein kinase C; and a calmodulin-dependent mechanism.

PMID- 8461338
TI  - The effect of the HMG-CoA reductase inhibitor simvastatin and of cholestyramine
      on hepatic apolipoprotein mRNA levels in the rat.
AB  - We have administered the hypolipaemic drugs simvastatin and cholestyramine to
      rats, both separately and together, to determine whether drug-induced changes in
      plasma apo lipoprotein levels occur through regulation of hepatic genes coding
      for apolipoproteins (apos) AI, AIV, E and B. Cholestyramine alone had little
      effect on either the plasma levels of the apolipoproteins studied or their
      hepatic mRNA levels. However, simvastatin, either alone or in combination with
      cholestyramine, produced marked changes in both of these parameters. While
      simvastatin plus cholestyramine lowered mRNAs for apo AIV, apo E and apo B by
      50%, 37%, and 55%, respectively, the treatment resulted in an increase of 150% in
      apo AI mRNA. This combined drug treatment caused a lowering in plasma
      concentration of all four apolipoproteins which failed to reach significance with
      apo E. Relative to controls, the values decreased to 83 +/- 14% for apo AI, 67 +/
      8% for apo AIV and 73 +/- 15 for apo B. An important novel finding of the
      present study, was that hypolipaemic drugs caused the apo B mRNA levels in rat
      liver to decrease. Previous reports have shown that although dietary fat or
      hormones caused marked changes in the concentration of circulating lipoproteins,
      they failed to alter apo B mRNA content. We suggest that the synthesis of apo B
      is subject to both pre- and post-translational regulation.

PMID- 8461339
TI  - Integration of mass spectrometry into strategies for peptide synthesis.

PMID- 8461340
TI  - Charge-remote fragmentation in a disulfide-containing peptide, [Pen]-enkephalin,
      under fast atom bombardment collisionally activated dissociation conditions.
AB  - Fast atom bombardment collisionally activated dissociation tandem mass
      spectrometry (FAB CAD MS/MS) of a disulfide-containing peptide, [2-D
      penicillamine, 5-D-penicillamine]- enkephalin ([Pen]-enkephalin), is described.
      Unlike those of most other disulfide-containing peptides investigated, CAD of the
      native, unreduced protonated molecule of [Pen]-enkephalin yields a relatively
      large number of fragment ions. Most of the peaks in the CAD spectrum represent
      fragmentations of the peptide backbone with 'unsymmetric' cleavage of the
      disulfide bond with charge retention on the N-terminus; the fragment ions
      generally do not contain a sulfur atom or a disulfide group. The CAD spectrum of
      the N-terminal ethyl-triphenylphosphonium derivative, on the other hand, shows
      few fragment ions and is dominated by the single peak at m/z 523. This dominant
      ion also results from 'unsymmetric' cleavage and corresponds to the analogous
      protonated species (m/z 235) in the spectrum of the underivatized peptide. The
      chemical method of charge localization by triphenylphosphonium derivative
      formation at one end of the peptide is shown to be useful for investigating
      fragmentation mechanisms in FAB CAD MS/MS. Comparison of the CAD spectra of
      derivatized and underivatized [Pen]-enkephalin suggests that charge-remote
      fragmentation plays a significant role in the high-energy dissociation of this
      disulfide-bonded peptide.

PMID- 8461341
TI  - Direct observation of a DNA quadruplex by electrospray ionization mass
      spectrometry.
AB  - In 10 mM sodium phosphate, pH 7.6, containing 0.1 mM ethylenediaminetetraacetic
      acid, ions correspondings to the non-calent, four-stranded oligonucleotide,
      d(CGCG4GCG)4, were detected by negative ion electrospray ionization (ESI) mass
      spectrometry at a low nozzle-skimmer (delta NS) bias (-150 V), but not at a
      higher delta NS bias (> -250 V). In contrast, when the sample was desalted and
      analyzed by ESI mass spectrometry at a low delta NS bias only ions for the single
      stranded d(CGCG4GCG) species were observed. These data agree with spectroscopic
      evidence which showed that oligonucleotides with the sequence motif
      5'd(CGCGnGCG)3', where n = 2-5, formed stable four-stranded complexes in the
      presence of monatomic cations, like K+, Ca2+, Na+ and Li+, but not in their
      absence.

PMID- 8461342
TI  - Particle beam liquid chromatography/mass spectrometry with negative ion chemical
      ionization for the confirmation of ivermectin residue in bovine milk and liver.
AB  - Particle beam liquid chromatography/mass spectrometry (LC/MS) using negative ion
      chemical ionization was applied to the analysis of ivermectin residue in bovine
      milk and liver. Samples were prepared by liquid/liquid extraction followed by
      alumina B solid-phase extraction clean-up. On-line LC/MS of extracts was carried
      out on a C-18 bonded silica column. Signals were observed from on-column
      injections of 4 ng dihydro-avermectin B1a (H2B1a) in extracts equivalent to 2 ml
      milk or 0.3 g liver. The specificity required for a regulatory confirmation
      procedure was achieved by monitoring the H2B1a molecular ion and four fragment
      ions. Ion chromatogram peak areas were at least three times greater than control
      samples integrated over the same time window. Coeluting matrix compounds enhanced
      the response and altered the abundance pattern of H2B1a. To compensate for this
      matrix effect, control milk extracts were spiked with H2B1a standard and used for
      the abundance matching for the abundance matching requirement of regulatory
      confirmation.

PMID- 8461343
TI  - The role of vertebral and internal carotid artery disease in the pathogenesis of
      vertebrobasilar transient ischemic attacks.
AB  - Color-coded duplex sonography has improved the evaluation of the hemodynamics of
      the vertebral arteries (VA). A reliable differentiation between a normal vessel,
      hypoplasia, stenosis and occlusion of VA can now be made. We studied two groups
      of patients in a prospective study with isolated carotid artery disease (n = 48),
      and with a combination of carotid and vertebral artery disease (n = 14), to
      determine the role of VA in the pathogenesis of transient ischemic attacks (TIAs)
      in the vertebrobasilar system. Apart from the existing arteriosclerotic changes
      of the internal carotid arteries, the condition of the VA was of importance for
      the occurrence of TIAs in the vertebrobasilar territory. We found that 8% of the
      patients with isolated hemodynamically relevant stenosis or occlusion of one or
      both internal carotid arteries had a TIA in the vertebrobasilar territory.
      Patients with combined carotid and vertebral artery disease had an increase of
      TIAs in the same region in 71%. The high rate of TIAs in this group might be
      attributed to the combined effect of carotid and vertebral artery disease, as a
      third group (n = 30) with isolated vertebral artery disease showed TIAs in only
      13%.

PMID- 8461344
TI  - Long-term stability of subtypes in schizophrenic disorders: a comparison of four
      diagnostic systems.
AB  - The long-term stability of subtypes of schizophrenic disorders in 148 narrowly
      defined schizophrenic patients according to four diagnostic systems was compared.
      The patients were investigated longitudinally for 23 years on average (range 10
      50 years). Patients who experienced only one episode and those who were
      permanently hospitalised were excluded on methodological grounds. Of the
      remaining 100 patients, a total of 461 episodes were classified into various
      subtypes according to the criteria of DSM-III-R, ICD-10, the positive/negative
      dichotomy, and Schneider's first-rank symptoms. It was found that long-term
      stability of subtype in schizophrenic disorder was not the rule but the
      exception. The frequency of stable course was found to be depend on the type of
      the initial episode. In most cases a subtype change occurred within the first few
      years of the illness with no clear direction. In later stages of the illness the
      relative frequency of episodes predominated by negative symptomatology increased.
      The findings were similar for DSM-III-R, ICD-10 and positive/negative dichotomy.
      Only in patients beginning without first-rank symptoms were more stable than non
      stable courses found. The results of this study do not support the assumption
      that stable subtypes are nosological or etiopathogenetic subentities of
      schizophrenic disorders.

PMID- 8461345
TI  - Estimation of the dimensionality of sleep-EEG data in schizophrenics.
AB  - Deterministic chaos could be regarded as a healthy flexibility of the human brain
      necessary for correct neuronal operations. Several investigations have
      demonstrated that in healthy subjects the dimensionality of REM sleep is much
      higher than that of slow wave sleep (SWS). We investigated the sleep-EEG of
      schizophrenic patients with methods from nonlinear system theory in order to
      estimate the dynamic properties of CNS. We hypothesized that schizophrenics would
      reveal alterations of their dynamic EEG features indicating impaired information
      processing. In 11 schizophrenic patients, the EEG's dimensionality during sleep
      stages II and REM was reduced. We suggest that such lower dimensional chaotic
      processes might be associated with an overloading of neuronal networks during
      sleep and therefore the psychopathology of schizophrenics might be due to
      impaired complexity of their EEG's dynamics.

PMID- 8461346
TI  - Incidence of cycloid psychosis. A clinical study of first-admission psychotic
      patients.
AB  - The concept of cycloid psychosis has gained increasing acceptance during recent
      decades. Using the diagnostic criteria of Perris and Brockington, an intelligible
      delineation of a group of patients has been obtained. Few epidemiological data on
      cycloid psychosis have been reported so far. The objective of the present study
      was to describe the one-year incidence of cycloid psychosis in a clinical sample.
      The diagnostic registers of all patients hospitalized for a functional or an
      organic psychosis and discharged in the year 1983, in Lund, Sweden were
      investigated. 514 patients were identified of whom 83 were admitted to hospital
      for the first time. 29 of these patients had a functional psychosis and were
      below the age of 50. In this age group 7 cases (4 women, 3 men) fulfilled the
      diagnostic criteria of cycloid psychosis and thus constituted almost one fourth
      of all first admissions of functional psychoses that year. The one-year incidence
      for first admission in cycloid psychosis was 5.0 per 100,000 inhabitants in women
      and 3.6 per 100,000 inhabitants in men within the age group 15-50 years in the
      catchment area of 163,175 persons. We conclude that cycloid psychosis constitutes
      a considerable proportion of functional psychoses in both sexes.

PMID- 8461347
TI  - An empirical comparison of diagnoses and reliabilities in ICD-10 and DSM-III-R.
AB  - The psychiatric classification systems ICD-10 and DSM-III-R were compared by
      applying both sets of diagnostic criteria to the same sample of patients
      suffering from affective and psychotic disorders. Four independent raters
      assessed diagnoses according to both systems to 100 written case records which
      had been prepared in a traditional, standard format. The International Diagnostic
      Checklists (IDCL) were employed to rate relevant psychopathological signs and
      symptoms and to apply diagnostic decision rules. The results showed that ICD-10
      yielded a generally higher reliability for all main disorders except for bipolar
      disorder. Overall reliability was kappa = 0.53 for diagnoses according to DSM-III
      R and 0.59 for diagnoses according to ICD-10. Agreement was best for affective
      disorders, moderate for schizophrenia and inacceptable for schizoaffective
      disorder. Insufficient boundaries were found in both systems between
      schizoaffective disorder on one side and schizophrenia and bipolar disorder on
      the other side. The different duration criteria for schizophrenia of six months
      in DSM-III-R and one month in ICD-10 tend to have considerable consequences for
      frequency rates of schizophrenia in a typical clinical setting.

PMID- 8461348
TI  - Routine psychiatric examinations guided by ICD-10 diagnostic checklists
      (International Diagnostic Checklists).
AB  - A systematic assessment of psychiatric diagnoses according to the new
      classification system ICD-10 can be guided and enhanced by the International
      Diagnostic Checklists (IDCL). This instrument was developed and evaluated
      primarily for use in routine clinical care. It consists of 30 separate lists in
      pocket form, each assigned to a specific disorder and allowing immediate and
      operationalized diagnostic decisions (without the need of computer assistance).
      Personality disorders are covered by a separate 12-page booklet (IDCL-P).
      Examples of the checklists are given together with possible areas of application.
      First studies have indicated good clinical practicability and satisfactory to
      excellent diagnostic reliability.

PMID- 8461349
TI  - Partners in adversity: I. Study design and context.
AB  - This paper presents results from a longitudinal study of three groups of married
      women undertaken in Edinburgh. Each study group was identified through their
      common experience of a particular stressful situation. Recruitment to the two
      principal study groups required that a marital partner had either recently died
      or had recently experienced a myocardial infarction (MI). The third group
      consisted of those women recently entering a Women's Aid refuge. Interviews were
      completed with 64 bereaved women, 143 women shortly following their partner's MI
      and 32 women entering a refuge. Where possible, follow-up interviews were
      undertaken about three months following the first interview. Detailed assessments
      were made of the 'target' stressful experiences, of any others that had occurred,
      and of the course and nature of the respondent's mental health during the study
      period. Additional assessments included measures of style of coping and of the
      support resources available and utilized. This report presents details of the
      design and methodology of the study and of the respondents' experiences of the
      specific stressors that recruited them to the study. It also provides the
      background to an examination and analysis of the sequencing of adverse
      experiences reported in the companion paper.

PMID- 8461350
TI  - Partners in adversity: II. Measurement and description of stressful event
      sequences ('complexes').
AB  - Three groups of married women were studied with each defined by their experience
      of a different stressful incident (the target event). In the first (the Coronary
      Group), the husband had suffered a non-fatal myocardial infarction whilst in the
      second (the Bereaved Group), he had recently died. In the third (the Refuge
      Group) the subject had just entered a refuge run by Women's Aid in order to flee
      from her husband. This paper concentrates on the description and measurement of
      the sequence of these experiences and of others occurring within the same study
      time. The Bedford College core rating scheme together with other ratings were
      applied. In the Coronary group, the target event was rated as a severe threat in
      46.9% of cases, and also rated as being of uncertain outcome and hopeless. Over
      one quarter of the sample received other ratings such as subject-focused and
      choice of action. Virtually all the bereavements were rated severe threat, loss,
      hopeless and subject-focused. The refuge target events were mostly rated of only
      moderate threat but differed widely on other characteristics. In the 6 months
      prior to the target event, other severe events tended to occur most frequently to
      the Refuge group and least frequently to the Coronary group. However, these other
      severe events were mostly connected with the target event and what had lead up to
      it. Issues concerning the measurement of the principal study events and the other
      stressors experienced are discussed.

PMID- 8461351
TI  - Is schizophrenia really on the decrease?
AB  - Directly age standardized rates of first admission schizophrenia in Denmark
      (1991: 5.1 million inhabitants) decreased significantly with a slope of -0.16 and
      -0.13/100,000 inhabitants fifteen years and above for males and females
      respectively from 1971 to 1991 when examined by help of the Danish nation-wide
      psychiatric case register in the Institute of Psychiatric Demography, Aarhus. A
      control for changes in diagnostic delay/changing diagnostic patterns does not
      affect the findings. Various nosological factors might cause the decrease, e.g.
      changing structure in organization of treatment facilities, decreasing number of
      beds (50% in Denmark during the period investigated) and correlated with this:
      increasing suicide rates among pretreatment schizophrenics, increasing rates of
      schizophrenics not yet diagnosed in shelters for homeless and in institutions for
      criminals. The decrease might be genuine. In connection with this the theories
      about damage to the fetus during the gestation period are briefly discussed.

PMID- 8461352
TI  - The effect of war on suicide rates. A study of France from 1826 to 1913.
AB  - An analysis of suicide rates in France from 1826 to 1913 indicated that suicide
      rates were lower during years of war than during years of peace. This effect was
      stronger for female suicide rates than for male suicide rates and seemed to hold
      both for major and minor wars.

PMID- 8461354
TI  - Special issue: The family and HIV disease.

PMID- 8461353
TI  - A test-retest study of cerebral blood flow during somatosensory stimulation in
      depressed patients with schizophrenia and major depression.
AB  - Six depressed patients with schizophrenia and 6 depressed patients with major
      depression were investigated before and during somatosensory stimulation (SS)
      with Tc-99m HMPAO SPECT. 8 controls were investigated only under resting
      conditions. The results can be summarized as follows: 1. Both psychiatric patient
      groups were hypofrontal (dorsolateral prefrontal cortex) compared to controls. 2.
      Hypofrontality was further enhanced by SS, significantly only in affective
      psychoses in the right inferior frontal lobe and in the right frontal hemisphere
      in total, in schizophrenia in the left dorsolateral prefrontal cortex. 3. Within
      the frontal lobes different regions were affected by SS in the two diagnostic
      groups. 4. In the right inferior parietal lobe SS response was significantly
      different in the two illnesses with schizophrenia showing a relative decrease,
      affective psychoses showing a relative increase of activity. 5. SS produced an
      increase of cerebral blood flow in subcortical regions (statistically significant
      contralateral to SS in thalamus and basal ganglia, ipsilateral to SS in
      cerebellum), a pattern which was common to all psychiatric patients. 6.
      Somatosensory cortex flow was not changed by SS. In conclusion, we could not
      fully confirm our hypotheses that similar blood flow abnormalities in different
      illnesses during SS are only caused by similarities in depressive
      psychopathology. Instead, depressed patients with schizophrenia were different
      from depressed patients with major depression in showing decreased activity in
      interrelating brain regions participating in an attentional network.

PMID- 8461355
TI  - The extended family and support for people with AIDS in a rural population in
      south west Uganda: a safety net with holes?
AB  - It is commonly assumed that the extended family in Africa provides a safety net
      for individuals in times of need. This paper examines this assumption using data
      on the care of people with AIDS in a rural population in South West Uganda. Over
      a six month period data were collected by counsellors on the care given to 30 (17
      women, 13 men) AIDS patients by their families. In 27 of the 30 cases there was
      evidence of limited care. Various reasons were given for this by the carers,
      including lack of food and money for medications and the carer's other family
      responsibilities. For 17 clients who died during the study period, records of
      seven cases show that other relatives were asked to help with care but refused on
      the grounds of poverty or other commitments. However, in all but one of these
      cases extended families did provide assistance for the funeral. The findings
      suggest that there is a need to question the assumption that the extended family,
      in the culture under study, is able to provide adequate support for AIDS
      patients.

PMID- 8461356
TI  - World Health Organization Global AIDS Statistics.

PMID- 8461357
TI  - Significant relationships and social supports of injecting drug users and their
      implications for HIV/AIDS services.
AB  - Strong social support networks have been associated with positive outcomes for
      health and well-being throughout the life-cycle. This paper investigates the
      structural and functional nature of social support networks of 100 injecting drug
      users (IDUs) in Sydney and the implications for HIV/AIDS services. Using a
      modified ISEL respondents saw support in terms of its tangibility of people and
      support, in terms of an appraisal of having friends, and as a self-esteem
      measure. We found the majority of respondents 'hung around' with other IDUs,
      lived with other IDUs, and were satisfied with the support they received from
      their friends. Friends appeared to be a more important source of social support
      than biological families and if respondents were to become HIV infected they
      would be more open about their status with friends than family. Where family was
      involved in support it was likely to be provided by mothers and siblings who were
      also the family members who knew about the respondent's drug use. There was no
      relationship between numbers of supports and satisfaction of support, suggesting
      quality and quantity of support were independent. Non-social supports were
      conceptualized primarily in terms of medical services.

PMID- 8461358
TI  - The family and HIV disease.

PMID- 8461359
TI  - The child in the family--responding to AIDS and HIV.
AB  - This study examines the psychosocial needs of children with AIDS and HIV
      infection based on a cohort of 18 infected children. Fifteen of the children live
      with their mothers, nine of whom are single mothers. For 14 children the mother
      is HIV +ve and for a further 8 the father is also HIV +ve. Many children have
      siblings (10), but only one of these is infected. Close family and grandparents
      are rarely involved in care and only one child, the oldest, is aware of parental
      and personal HIV status. Where children attend school or preschool centres none
      have been informed of the child's HIV infection. Cultural issues are prevalent,
      especially marked when English is not the first language (n = 10) which renders
      obstacles for counselling and developmental appraisal. Children in this group are
      hospitalized more frequently than the parents. Child and parental hospitalization
      is problematic. Three case situations arising in this group are described in some
      detail to highlight the nature of the emotional challenges facing carers and
      service providers.

PMID- 8461360
TI  - Psychological distress and the role of significant others in a population of
      gay/bisexual men in the era of HIV.
AB  - This study, based on The Conservation of Resources Theory (COR), explores the
      relationship between social resources and psychological distress, as reported by
      gay/bisexual men who are at varying degrees of risk for HIV. This study involves
      theory-based stress research, and adds to the body of literature that addresses
      social support and gay men. Specific emphasis was placed on the process of social
      support by significant others in relationship to the devastating impact HIV has
      on the gay/bisexual community. The investigators employed an ex-post facto design
      that was guided by past and present theoretical and empirical data, and by
      specific research hypotheses. The findings suggest that facets of social support
      appear to be interactively related to the perceived threat of HIV in predicting
      distress. In general, this study supports COR theory in that resources were
      related to the experience of psychological distress, yet it emphasizes that the
      relationship between support and gay men is complex, and thus generalizations
      from findings based on research with the majority culture may not apply to a
      population of gay/bisexual men. Implications for future research are also
      provided.

PMID- 8461361
TI  - The impact of HIV/AIDS on the family and other significant relationships: the
      African clan revisited.
AB  - Although changing in size, structure and function, the African family has
      persistently maintained its place as the central human social unit. Beyond the
      traditional African family--whether in the nuclear or the extended form--is a
      network of people, most of whom are connected by kin or blood relationships,
      termed the clanship system. Patterns of family treatment and care are deeply
      embedded in this wider kinship system. The AIDS epidemic has caused adverse
      psychosocial and economic consequences leading to change in the family structure,
      and thus disturbed the capacity of the nuclear and extended family to respond to
      the needs of members afflicted by HIV and AIDS. Hence, the clanship system could
      become the locus of AIDS activity designed to ensure the well-being and
      continuity of the family where its leadership undertakes to sustain, to
      reorganize, or to create wholly new families or structures among populations
      being devastated by AIDS. New associations based on common emotional bonds of
      caring beyond kinship ties will be necessary to support some vulnerable members.
      However, for such to prove durable in the troubled socio-economic context of Sub
      Saharan Africa, these will need strong links to or derive their legitimacy from
      the resilient traditional social network, the African kinship system.

PMID- 8461363
TI  - AIDS and the family: implications for counselling.
AB  - The presence of HIV spectrum illness stimulates a powerful emotional reaction
      from a patient's family and friends. Grief and shock over the infection, and its
      implications are frequent observations. Sadness, anxiety, helplessness and anger
      are also common. Health care staff should address these responses in order to
      strengthen coping skills and maximize interpersonal comfort. Stigmatization and
      isolation are major stressors. Bereavement is complicated by fear, shame,
      dependency and hopelessness. Therefore, a task in counselling is to maintain the
      integrity and supportiveness of the patient's social unit by encouraging open
      communications between those involved and by educating about AIDS. Information
      should be provided on HIV transmission, self-protection, and illness progression
      as well as the safety of causal contacts and the practices of 'safer sex'. The
      significant others should retain outside interests and be encouraged to seek help
      for patients from supportive social agencies. Instillation of hope lends benefit
      to patient, family and friends. Kind, non-judgmental counselling and good quality
      medical care should be made available, especially since HIV-related disorders are
      increasingly becoming a chronic disease. Advocacy for the significant others
      translates into better adjustment and it enhances the patient's medical
      prognosis.

PMID- 8461362
TI  - AIDS and the urban family: its impact in Kampala, Uganda.
AB  - Twenty-two families with one or more adult members with AIDS were extensively
      interviewed about sociodemographic variables, knowledge of AIDS, responses to
      AIDS, material needs, psychological state and perception of stigma. A total of 24
      individuals were enrolled. Seven subjects did not permit contact with family
      members. Of the 24 subjects, four denied that they have AIDS, four informed
      everyone in the household of the AIDS diagnosis, eight told no one at all, and
      eight told some of their family. Subjects reportedly did not tell their family
      because the family would worry, they feared rejection, it is none of their
      business or they wouldn't understand. Family members expressed fear of loss,
      shock and disbelief at the diagnosis, but did not reject the subject or fear
      infection. Persons with AIDS and their families expressed fear of rejection from
      those outside the household due to the perceived stigma associated with AIDS. The
      labelling of someone as having AIDS relates to their physical condition, so with
      declining health, subjects and their families may avoid outside contacts. A
      direct impact of AIDS is to diminish mobility, decreasing available economic
      resources. These data indicate the importance of assisting families responsible
      for caring for AIDS patients.

PMID- 8461364
TI  - A family with HIV and haemophilia.
AB  - An Indian Sikh family affected with both HIV and haemophilia is described. The
      use of interpreters; the regular follow-up in the Concorde trial; family therapy
      and help with practical problems have been approaches used to help the family
      despite language and cultural differences.

PMID- 8461366
TI  - [Another look at serum bactericidal activity].

PMID- 8461365
TI  - Social support and HIV.
AB  - This paper reviews research about the relationship between social support and
      health for people with HIV. Current studies linking social support and HIV are
      described and the major findings summarized in order to identify gaps in the
      literature. It is argued that, to date, research in this area has focused
      primarily upon gay white men in the USA at a symptomatic stage of the illness.
      There are few studies which have considered the impact of social position on the
      relationship between social support and health, and few which have included HIV
      negative controls. Whilst there is evidence of a link between social support and
      the psychological well-being of people with HIV, research is still in its
      infancy. Much information is required about which particular aspects of social
      support and health are associated, how this association changes over time
      according to the stage of the disease, and with the socio-economic and cultural
      characteristics of those with HIV.

PMID- 8461367
TI  - [Utilization of an emergency service by patients with HIV infection].
AB  - BACKGROUND AND METHODS: To know the impact of HIV infection in a hospital
      emergency department the health care episodes of seropositive individuals are
      reviewed in a retrospective study from the January 1 to March 31, 1992. Cases
      have been identified comparing the list of those infected by HIV with the users
      of the department during the period studied. RESULTS: 430 episodes in 288
      patients (1.5 episodes/patient) have been included constituting 2.3% of the
      total. 76.4% were males, with a mean age of 29.2 years (range, 18-59) and 60.2%
      were evaluated the medical area. Hospital admission was indicated on 147
      occasions (34.2% versus 19% of seronegatives; p < 0.001). The most frequent
      diagnoses were infections which were or were not associated to alteration of
      cellular immunity (32.8%) and complications related with the abuse of opioid
      substances (23.7%). CONCLUSIONS: The pathology associated to HIV infection and to
      the abuse of intravenous drugs constitutes a frequent problem in the emergency
      departments. The infectious diseases which are or are not associated to
      alteration in cellular immunity, complications related with the consumption of
      opioids and the high index of admissions are of note. Professionals carrying out
      health care work in this medium must be familiarized with the diagnosis and
      treatment of these processes.

PMID- 8461368
TI  - [Resistance in Haemophilus influenzae in Spain. 2d study (1990)].
AB  - AIM: To study the resistance to strains of H. influenzae simultaneously isolated
      during 1990 in 10 Spanish cities with this being the second multicentric study
      carried out in Spain. METHODS: Three hundred eight strains of H. influenzae were
      consecutively isolated with less than 50% being from the respiratory tract. The
      sensitivity by microdilution in supplement Isosensitest was studied. RESULTS:
      Thirty-five percent of the strains were producers of beta-lactamase which
      predominate among those isolated in systemic infections and specially among those
      from Madrid (58.78%) and Barcelona (61.8%). The strains producing beta-lactamase
      were more resistant to all the antimicrobials than the non producers. Five point
      two percent of the strains were resistant to ampicillin by non enzymatic
      mechanisms. Resistance to chloramphenicol is frequent (28.6%) especially among
      strains producing beta-lactamase, strains of ocular origin and ORL (46%) and
      systemic infections (74.3%). The distribution is irregular, being more frequent
      in Seville (66.7%) and not detectable in Barcelona. Resistance to tetracycline is
      also usually linked to the production of beta-lactamase and not necessarily to
      that of chloramphenicol. Resistance to cotrimoxazole is the most frequent (67.5%)
      specially in Valladolid (87.5%). Resistance to cefaclor is of 60.7% being the
      most frequent among those isolated from ocular processes and ORL. Only 28 strains
      (9.1%) were sensitive to all the antimicrobials tested. Thirty-nine percent were
      multiresistant. CONCLUSIONS: The authors found a slight increase in the high
      resistance detected in 1986. This increase was not uniform in all of Spain being
      significant in Madrid with producers of beta-lactamase, in Seville to
      chloramphenicol, to tetracycline in Bilbao and cotrimoxazole in Valencia.

PMID- 8461369
TI  - [Prevalence of serotype 0:12 among strains of P. aeruginosa causing nosocomial
      infection in Spain (1980-1991)].
AB  - BACKGROUND: The aim of the present study was to characterize P. aeruginosa
      strains causing nosocomial infection in Spain between 1980-1990 with special
      emphasis on the incidence of serotype 0:12 strains. METHODS: 11,411 strains of P.
      aeruginosa from hospital-acquired infections were studied and epidemiologically
      characterized by phage-typing, serotyping and sensitivity to antimicrobial
      agents. The strains of the 0:12 serotype were analyzed by isoenzyme analysis.
      RESULTS: Although the major serotypes throughout the period studied were: 0:1,
      0:6 and 0:11, the existence of serotype 0:12 strains (6%) were detected which had
      produced nosocomial outbreaks in surrounding countries. This serotype is
      homogeneous in that the epidemiologic markers and patterns of sensitivity to
      antibiotics and the multienzyme analysis demonstrate uniformity in the
      electrophoretic patterns of all the strains studied. CONCLUSIONS: The 0:12
      serotype is in Spain indistinguishable by phage typing and studies of antibiotic
      sensitivity. It may be considered as being of clonal origin and is probably equal
      to that existing elsewhere in Europe.

PMID- 8461370
TI  - [Follow-up of the quantitative serological response to the treatment of
      Helicobacter pylori infection in children].
AB  - BACKGROUND: The aim of the present study was to know the usefulness of a enzyme
      immunoanalysis (EIA) technique for the monitorization of the serologic to
      treatment of infection by Helicobacter pylori in Spanish children. METHODS: 17
      children with digestive symptomatology in whom the diagnosis of infection by
      Helicobacter pylori was confirmed and eradication was objectified following a
      month of treatment with amoxycillin, metronidazole and Bismuth subcitrate were
      studied. In each patient a biopsy of the gastric mucosa was performed and a
      sample of serum was withdrawn for initial diagnosis and for control of
      eradication once treatment had finished (mean time between diagnosis and
      confirmation of eradication was 79.6 +/- 33.5 days). The samples of gastric
      mucosa were processed by standard methodology (histologic and/or culture).
      Serologic determinations (IgG and IgA) were carried out using a EIA technique
      (Pyloriset EIA-G and EIA-A; Orion Diagnostica). RESULTS: In 12 of the 17 patients
      resolution of the clinical symptomatology was produced. A decrease in the levels
      of IgG was observed in 15 (88.2%) and of IgA in 14 (82.3%) of all the children
      studied. A significant difference was found between the mean values of the levels
      of IgG (p < 0.01) and IgA (p < 0.05) in the 17 patients at the time of diagnosis
      and following eradication. CONCLUSIONS: In agreement with the present results the
      series study of the quantitative level of antibodies IgG and IgA versus
      Helicobacter pylori is shown as an adequate instrument for evaluating the
      response to treatment in pediatric patients.

PMID- 8461371
TI  - [Oro-esophageal candidiasis resistant to fluconazole in patients with AIDS].
AB  - BACKGROUND: Fluconazole-resistant Candida albicans has been seldom reported in
      the literature. in this study, two clinical cases of oro-esophageal candidosis
      resistant to this antifungal drug are described. METHOD: Infection was confirmed
      by isolation of yeasts (culture of mouth swabs, oesophagoscopy and histology of
      biopsy specimens). In vitro antifungal susceptibility tests were performed with
      standard methods (NCCLS). RESULTS: Clinical and microbiological fluconazole
      resistant Candida albicans was isolated. CONCLUSIONS: Causes of development of
      resistances are commented, and the role of immunodeficiency and the possibility
      of a Candida strain selection is discussed.

PMID- 8461372
TI  - [Acute toxoplasmosis. Laboratory diagnosis].
AB  - BACKGROUND: The microbiological diagnosis of acute toxoplasmosis in
      immunosuppressed patients, cannot, usually, be done through serological
      techniques. The methods for isolation or direct detection of parasite are the
      only ones that might be helpful to determine an earlier diagnosis, on these
      patients. METHODS AND RESULTS: The use of urine in 3 patients with acute
      toxoplasmosis, allowed us to isolate the parasite after inoculation of the sample
      in human embryonic fibroblast cell line (MRC-5). CONCLUSION: In our opinion urine
      could be an adequate sample for isolation or detection of Toxoplasma gondii in
      immunosuppressed patients, and an alternative to serological methods, as well.

PMID- 8461373
TI  - [Problems in studying sensitivity in Haemophilus influenzae].

PMID- 8461374
TI  - [Bacterial keratitis. Report of a case].

PMID- 8461375
TI  - [Isolation of Leclercia adecarboxylata in a cirrhotic patient].

PMID- 8461376
TI  - [Spontaneous splenic rupture secondary to Salmonella typhi infection].

PMID- 8461377
TI  - [Evaluation of the cut-off point in the serological diagnosis of Helicobacter
      pylori infection in children using an enzyme immunoassay technique].

PMID- 8461378
TI  - [Bacteremia caused by Campylobacter jejuni resistant to nalidixic acid and
      fluoroquinolones].

PMID- 8461379
TI  - What about those monkeys that got T-cell lymphoma?

PMID- 8461380
TI  - Direct in vivo gene transfer to airway epithelium employing adenovirus-polylysine
      DNA complexes.
AB  - Adenovirus-polylysine-DNA complexes were evaluated for their capacity to
      accomplish direct in vivo gene transfer to airway epithelium employing a rodent
      model. Binary complexes containing transferrin or adenovirus, or combination
      complexes containing both transferrin and adenovirus, were evaluated. The highest
      in vitro gene transfer efficiency in primary cultures of airway epithelial cells
      was accomplished by the combination complexes. This result was paralleled in
      vivo. Transient gene expression of up to 1 week was observed with localization of
      the transduced cells to the region of the small airways. These results establish
      the feasibility of this type of approach for gene therapy applications.

PMID- 8461381
TI  - High-level human adenosine deaminase expression in dog skin fibroblasts is not
      sustained following transplantation.
AB  - Primary skin fibroblasts are an attractive target tissue for retroviral-mediated
      gene therapy; however, transient expression of therapeutic genes has been a
      recurrent problem in several rodent models. The gradual decrease in gene
      expression could be tissue or species specific. To investigate the phenomenon
      further, human adenosine deaminase (ADA) expression was monitored in genetically
      modified skin fibroblasts transplanted in beagle dogs. In culture, transduced
      canine fibroblasts expressed high levels of human ADA activity (33.6 mumoles
      adenosine metabolized per hour per milligram of soluble protein) in comparison to
      canine ADA in untreated control cells (1.3 mumol/hr.mg protein) and for 2 weeks
      following transplantation, the graft contained up to four-fold more enzyme
      activity from human ADA than the endogenous canine enzyme. However, by 10 weeks,
      human ADA expression was undetectable. At the time when human ADA expression was
      greatly reduced, DNA analysis showed the presence of vector sequences. These
      results directly parallel those observed in rodent models and suggest retroviral
      vector inactivation is a tissue-specific rather than species-specific mechanism.

PMID- 8461382
TI  - Position paper on human germ line manipulation presented by Council for
      Responsible Genetics, Human Genetics Committee Fall, 1992.

PMID- 8461383
TI  - Use of two retroviral markers to test relative contribution of marrow and
      peripheral blood autologous cells to recovery after preparative therapy. The
      University of Texas M.D. Anderson Cancer Center. Division of Medicine.

PMID- 8461384
TI  - Long-term expression of retroviral-transduced adenosine deaminase in human
      primitive hematopoietic progenitors.
AB  - Adenosine deaminase (ADA) deficiency, a rare autosomal recessive disorder, is an
      ideal candidate for gene replacement therapy. By means of co-cultivation with a
      retroviral vector-producing cell line, we have demonstrated efficient transfer
      and expression of the human ADA gene into human primitive hematopoietic
      progenitors. At 6 weeks post-transduction in myeloid long-term bone marrow
      culture, approximately 50% of the clonogenic progenitors were transduced by the
      provirus, with ADA expression detected in 30% of transduced colonies. The ADA
      activity increased by 3.7-fold in the nonadherent fraction of transduced bone
      marrow after 9 weeks. We have also achieved efficient transduction by retroviral
      supernatant of normal and ADA-deficient bone marrow cells that were allowed to
      establish a stromal layer in long-term culture, indicating the feasibility of
      proceeding with attempts to perform stem cell gene therapy on patients with ADA
      deficiency.

PMID- 8461385
TI  - T-cell receptors in autoimmune disease.

PMID- 8461386
TI  - MHC and autoimmune diseases.

PMID- 8461387
TI  - Anti-CD3 antibodies.

PMID- 8461388
TI  - Anti-T-cell receptor V beta antibodies in autoimmunity.

PMID- 8461389
TI  - Vaccination with T-cell receptor peptides.

PMID- 8461390
TI  - From treatment of experimental allergic encephalomyelitis to clinical trials in
      multiple sclerosis.

PMID- 8461391
TI  - Human-murine chimeric CD4 monoclonal antibodies. A modern panacea for autoimmune
      disease?

PMID- 8461392
TI  - CD4 antibody therapy in chronic inflammatory dermatological diseases.

PMID- 8461393
TI  - Anti-class II antibody treatment in autoimmune diseases.

PMID- 8461394
TI  - Molecular dissection of the T-cell receptor/CD3 complex.

PMID- 8461395
TI  - Interleukin-2 receptor-targeted immune therapy.

PMID- 8461396
TI  - Anti-gamma interferon (IFN-gamma) monoclonal antibodies.

PMID- 8461397
TI  - Suppression of T-cell activation by administration of MHC class II-binding
      peptides.

PMID- 8461398
TI  - Thyroglobulin as autoantigen and tolerogen.

PMID- 8461399
TI  - Prevention of myosin-induced autoimmune myocarditis with competitor peptides.

PMID- 8461400
TI  - CD4, CD8, and other surface molecules regulating T-cell activation.

PMID- 8461401
TI  - MHC proteins and MHC peptide interactions.

PMID- 8461402
TI  - Monoclonal antibodies for the therapeutic induction of tolerance.

PMID- 8461404
TI  - Detection of muscle larvae of Trichinella spiralis by enzyme-linked immunosorbent
      assay.
AB  - ELISA was applied to the detection of Trichinella spiralis larvae in infected rat
      muscles. Anti-muscle larva serum was prepared by inoculating crude extract of
      muscle larvae to rabbits. Limb muscles of infected rats were emulsified with
      carbonate buffer and the supernatant was used for ELISA. ELISA values of positive
      muscular samples were clearly higher than those of negative ones to prove that
      ELISA can be applied to the detection of muscle larvae. The present method showed
      positive values to muscles infected with 10 or more larvae per gram of muscle
      (LPGM).

PMID- 8461403
TI  - Fine structure of the septal olfactory organ of Masera and its associated gland
      in the golden hamster.
AB  - Fine structures of the septal olfactory organ of Masera (MO) and its associated
      gland, a kind of olfactory glands, were examined in the golden hamster in
      comparison with those of the olfactory epithelium (OE) and vomeronasal organ
      (VNO) and their associated olfactory glands. Bipolar neurons of the MO were
      divided into two types according to their apical morphology, one similar to the
      receptors of the OE and the other to those of the vomeronasal sensory epithelium
      (VSE). The former was dominant and interpreted as main receptors of the MO. The
      other was less in number, but also regarded as a kind of olfactory receptors. The
      ultrastructural features of supporting cells of the MO were similar to those of
      the OE rather than to those of the VSE, while those of basal cells were almost in
      common in the OE, VSE and MO. The associated gland of the MO was positive to both
      PAS and alcian blue as the Bowman's gland of the OE. The fine structure of the
      associated gland of the MO was also similar to that of Bowman's gland. The
      present findings on the fine structure of the MO and its associated gland
      strongly suggest that the MO fulfills an olfactory function similar to that of
      the OE.

PMID- 8461405
TI  - Identification and characterization of the major carbohydrate-binding proteins in
      chicken serum as immunoglobulins.
AB  - To isolate the major carbohydrate-binding proteins in pooled normal chicken sera,
      affinity chromatographies on different affinity gels were carried out. From the
      results obtained, normal chicken sera were found to contain serum proteins which
      were Ca(2+)-dependently and -independently reactive with mannose, N
      acetylglucosamine, N-acetylgalactosamine, L-fucose, melibiose, lactose,
      unsubstituted Sepharose 4B, and SeaKem HE agarose. They were electrophoretically
      and antigenically found to be mainly IgM and IgG.

PMID- 8461406
TI  - Polyacrylamide gel electrophoretic mobility of alkaline proteinase produced by
      Aspergillus flavus isolated from a penguin.
AB  - The electrophoretic mobility of alkaline proteinase produced by four isolates
      from a penguin (Spheniscus magellanicus) was same in all of them and was
      consistent with that of Aspergillus (A.) flavus NRRL 1957 used as a reference
      strain, but not consistent with that of A. parasiticus NRRL 2999. Therefore, four
      isolates were confirmed as A. flavus.

PMID- 8461407
TI  - Hypersensitivity of LEC strain rats in radiation-induced acute bone-marrow death.
AB  - LEC strain rats, which have been known to develop hereditarily spontaneous
      fulminant hepatitis 4 to 5 months after birth, were highly sensitive to whole
      body X ray-irradiation as compared to WKAH strain rats. Radiation-induced acute
      bone-marrow death occurred at doses higher than 2.0 Gy in LEC rats, and at doses
      higher than 7.4 Gy in WKAH rats, respectively. By probit analysis of survival
      data, it was shown that the LD50/30 value for LEC rats was 3.0 Gy which was
      significantly lower than that (7.8 Gy) of WKAH rats. Histopathological
      examinations of the bone marrows from both strains after irradiation at a dose of
      4.0 Gy revealed that a number of hemopoietic cells were recovered in WKAH rats on
      day 8 after irradiation, but not in LEC rats. These results suggested the
      hypersensitivity of LEC rats to ionizing radiation in connection with acute bone
      marrow death.

PMID- 8461408
TI  - Superovulation of Japanese black heifers treated with FSH-P and FSH-R.
AB  - The effects on superovulation in beef heifers of two kinds of porcine FSH
      preparations with different LH content, FSH-P and FSH-R, were compared. Forty-two
      heifers of the Japanese Black Breed received a total dose of 28AU of FSH-P
      containing 6.5% LH or FSH-R containing 0.58% LH intramuscularly, in a descending
      manner for four days. The mean numbers (+/- SD) of obtained ova/embryos and
      transferable embryos were 4.9 +/- 2.3, 1.5 +/- 0.9 and 11.2 +/- 2.4, 4.8 +/- 1.4,
      respectively. FSH-R treatment yielded a significantly greater number of
      ova/embryos and transferable embryos than FSH-P treatment (P < 0.05).

PMID- 8461409
TI  - The ability of Salmonella enteritidis isolated from chicks imported from England
      to cause transovarian infection.
AB  - S. Enteritidis HY-1 isolated during quarantine from chicks imported from England
      was used. Laying hens at the age of 34 weeks were inoculated orally with 10(10)
      organisms (10 birds), intramuscularly with 10(9) (5 birds), and intravenously
      with 10(9) (5 birds). Egg production did not change in hens infected orally,
      although it was reduced in hens infected intramuscularly for 2-3 weeks post
      inoculation. For one month, internally infected eggs of which the shells were not
      contaminated were found: one out of 65 eggs in hens infected orally and three out
      of 36 eggs in hens infected intramuscularly. This experiment demonstrated the
      ability of S. Enteritidis isolated from chicks imported from England to cause
      transovarian infection.

PMID- 8461410
TI  - A case of neonatal calf with meningitis associated with Klebsiella oxytoca
      infection.
AB  - A 16-days-old calf exhibited pyrexia, difficulty to stand and walk, cloudiness of
      the ocular aqueous humor, and swelling of the shoulder joints. The primary
      pathological lesion was fibrinopurulent meningitis with Gram-negative small
      bacilli, and which was concurrently accompanied with endophthalmitis,
      polyarthritis, and purulent inflammation in several visceral organs. Klebsiella
      oxytoca was isolated from the brain and spinal cord. These results suggest that
      this is a rare case of meningitis with septicemic K. oxytoca infection in
      neonatal calf.

PMID- 8461411
TI  - Comparative study on cross-reaction of leptospiral antibodies in several
      serological tests to detect antibodies to Borrelia burgdorferi in dogs.
AB  - The effects by the leptospiral antibody are described at several serological
      tests for the detection of the antibody to B. burgdorferi in dogs. The titers at
      ELISA used with the ultrasonicated bacterial antigen (US-ELISA) were related with
      IFA. But cross reaction with the leptospiral antibody were shown in an
      agglutination test. Non-specific and cross-reactions were observed in ELISA used
      with formalin-killed bacterial antigen. This indicates that US-ELISA is a
      reliable serodiagnosis method for Lyme disease in dogs in eliminating the cross
      reaction with leptospiral antibody.

PMID- 8461412
TI  - Clinostomum complanatum (Trematoda) infection in freshwater fish from fish
      dealers in Tottori, Japan.
AB  - During the period January 1989 through February 1991, 327 freshwater fish of 3
      different species (Carassius cuvieri, Cobitis anguillicaudatus and Hypomesus
      transpacificus) purchased from 7 fish dealers in Tottori City were investigated
      for the metacercarial infection of Clinostomum complanatum. Among them, 20.5%
      (16/78) of C. cuvieri were infected with this fluke. Each infected fish harbored
      1 to 30 metacercariae. The sites and rates of parasitization of metacercariae in
      the infected fish were 42.4% in the body muscles, 30.3% in the muscles at the
      pectoral fin, 21.2% in the tissues around the gills and 6.1% in the cheek
      muscles.

PMID- 8461413
TI  - Ovarian response to hCG in the postweaning sow.
AB  - Five non-cyclic postweaning sows were given intramuscularly 1,000 IU of hCG on
      day 2 (4 sows) and day 36 (1 sow) after weaning. Single or multiple follicular
      cysts were developed in ovaries in all cases. Plasma E2 fluctuated at low levels
      in 4 of 5 sows resulting in silent heat. The sows which exhibited neither estrus
      nor ovulation after hCG administration did not display any preovulatory LH surge,
      and plasma progesterone levels remained low (< or = 1 ng/ml). These results
      suggest that abnormal follicular growth or impairment of the ovulation process as
      a consequence of unsatisfactory LH release after hCG treatment in swine with
      ovarian inactivity may promote the formation of ovarian cysts.

PMID- 8461414
TI  - An electron microscopic study on follicular formation and TSH sensitivity of the
      fetal rat thyroid gland in organ culture.
AB  - Thyroids of 15-day rat fetuses prior to culture had no follicles. After 2 days in
      culture, regardless of added TSH in the medium, thyroids had small, colloid
      storing follicles. In the follicular cells, the rER and Golgi apparatus were
      somewhat well developed as compared with the thyroids prior to culture. Thyroids
      of 17-day fetuses prior to culture were first inlaid with follicles. With TSH, 2
      day cultures of 17-day thyroids showed a more marked dilation of rER and a
      further development of Golgi apparatus than those without TSH. These results
      indicate electron microscopically that TSH has no effect on the first formation
      of follicles as well as on the initial development of follicular cells, but that
      TSH can promote the further development of follicular cells themselves of once
      developed follicles.

PMID- 8461415
TI  - Three cases of bovine extreme tetralogy of Fallot.
AB  - Three female Holstein calves having cyanosis of the visible mucous membrane,
      exercise intolerance and systolic murmur were examined. Extreme Tetralogy of
      Fallot with ventricular septal defect was confirmed at autopsy. All of the
      intrapericardial pulmonary arteries were completely absent in two cases. In the
      other case, the atretic pulmonary trunk, with a bicuspid valve, rose from a very
      small chamber which was located on the blind-ending muscular infundibulum. There
      was no connection between the atretic pulmonary trunk and the right ventricle.

PMID- 8461416
TI  - Platelet abnormalities in a dog suffering from gangrenous mastitis by
      Staphylococcus aureus infection.
AB  - Severe gangrenous mastitis due to Staphylococcus aureus infection was diagnosed
      in a 7 year-old intact female beagle which was presented with swelling of mammary
      glands after dystocia. Leukocytosis (25,200-48,600/microliters), decreased
      platelets (107,000-179,000/microliters), and abnormal platelet pattern continued
      during the critical condition. Consistent with platelet pattern, large platelets
      were observed in the blood smear. The number of leukocytes and platelets rapidly
      returned to normal during treatment, and the platelet pattern was also restored.
      The number and pattern of platelet may provide a clue for the evaluation of the
      clinical condition and/or severity of the lesions in the dog with mastitis.

PMID- 8461417
TI  - A cryptic DNA sequence, isolated from Actinobacillus pleuropneumoniae, confers a
      hemolytic activity upon Escherichia coli K12 strains.
AB  - A hemolytic recombinant clone on Escherichia coli was obtained from a genomic
      library of Actinobacillus pleuropneumoniae. The clone possessed a recombinant
      plasmid, pHLY1, carrying an insert DNA of 1 kilobases. A 21 kilodaltons protein,
      which is assumed to be a fusion protein with a tetracycline resistant protein of
      pBR322, was encoded by pHLY1. The nucleotide sequence and its deduced amino acid
      sequence were different from those of the previously reported hemolysin genes of
      A. pleuropneumoniae. Furthermore, the amino acid sequence did not show a
      significant homology with other published sequences in the SWISS-PROT Protein
      Sequence Data Bank.

PMID- 8461418
TI  - Epidemiologic analyses of spatial clustering of bovine ephemeral fever outbreaks.
      I. Application of the negative binomial distribution.
AB  - An epidemic that propagates through a population results in a contagious spatial
      pattern. The incidence per farm of bovine ephemeral fever (BEF) outbreaks in the
      22 areas of Fukuoka Prefecture in 1988 was well explained by the negative
      binomial distribution, which is generally considered, as the clustering of the
      outbreaks. Furthermore, the clustering was analyzed with three categories of
      vaccination rate (No. 1-40%, and 40-80%). As a result, the no vaccination and
      high vaccination rate (41-80%) groups tended to shift to similarly the Poisson
      distribution. It may be speculated that an insufficient vaccination control of
      the BEF was influenced with the clustering.

PMID- 8461419
TI  - Pathological analysis of bone fractures in race horses.
AB  - Pathomorphological analysis was performed on fractured bones of 470 race horses.
      The most common fracture site was the limb (98% of cases), and the majority of
      fractures were intra-articular. Focal osteochondral lesions consisting of
      osteochondrosis, osteonecrosis and osteosclerosis were observed frequently in
      fractured and non-fractured bones. In the fractured bones, the lesions frequently
      appeared in the vicinity of the fractured site. Under the influence of antecedent
      osteochondrosis from the young stage, osteosclerotic and osteonecrotic lesions
      may have been induced by immoderate exercise and localized ischemia. These morbid
      conditions may be important as local predisposing factors for bone fracture
      because the osteosclerotic and osteonecrotic lesions may contribute to diminished
      resistance to torsion and shearing forces.

PMID- 8461420
TI  - An ultrastructural study of cutaneous hemangioma in two chickens.
AB  - Cutaneous hemangioma in two laying hens was examined by light and electron
      microscopy. In close association with capillary and cavernous hemangioma there
      was a solid cell mass. Ultrastructurally, the cell mass consisted of
      undifferentiated mesenchymal cells and had an alveolar structure. There were
      transitional cell types from the alveolar structure to the capillary and
      cavernous hemangiomas. Hemangiomatous structure may develop from the
      undifferentiated mesenchymal cells in the solid cell mass.

PMID- 8461421
TI  - Suppressed antibody response to sheep erythrocytes in experimentally Babesia
      rodhaini-infected mice.
AB  - Mice experimentally infected with Babesia rodhaini were immunized with sheep red
      blood cells (SRBC), and the splenic plaque forming cell (PFC) response to SRBC
      was investigated. Suppressed splenic antibody response to SRBC accompanied with
      the elevated parasitemia was recognized. This evidence suggests that an
      immunosuppression in B. rodhaini infection may be involved in the multiplication
      of parasites contributing to high mortality of mice infected with B. rodhaini.

PMID- 8461422
TI  - Turbidimetric-kinetic assay of endotoxin in rumen fluid or serum of cattle fed
      rations containing various levels of rolled barley.
AB  - A new, automated turbidimetric-kinetic (ATK) assay was used to quantitate
      bacterial endotoxin in rumen fluid or in serum of Holstein steers. The ATK method
      used Limulus amebocyte lysate (LAL) reagent with added beta-glucan (LAL-ES) which
      improved specific sensitivity to endotoxin. Design of the feeding trial permitted
      comparison of endotoxin levels found during consumption of a basal ration with
      those higher levels detected at various times following the introduction of
      increasing percentages of rolled barley to that basal ration. Both serum and
      ruminal endotoxin levels were significantly higher in steers on the higher
      concentrate rations. Peak endotoxin levels were detected 20 days following the
      change to the highest concentrate ration which contained 60% barley. Endotoxin
      levels from both sources subsequently decreased. Ruminal endotoxin stabilized at
      about 10 times the level, and serum endotoxin stabilized at 2 to 4 times the
      level, of that previously found during feeding of the basal ration. Test protocol
      included sample dilution and heating in order to avoid the effects of endotoxin
      inhibitors. Recovery rates for added endotoxin to either serum or rumen fluid
      supernates ranged from 120 to 136%. Coefficient of variation for endotoxin
      concentration in serum was lower than 10%, and in rumen fluid only slightly
      higher. There was significant correlation between ruminal concentration as
      measured by the ATK method and an alternative chromogenic substrate assay
      procedure. Changes in endotoxin level in experimental steers were those
      predictable from experience with naturally occurring incidents of grain
      engorgement. The ATK assay appears to be an accurate and rather simple technique
      which will prove useful for experimental and clinical studies in the future.

PMID- 8461423
TI  - Purification and identification of a serum protein increased by anthelmintic
      drugs for Dirofilaria immitis in dogs.
AB  - Polyacrylamide gel electrophoretic analysis of canine serum protein has revealed
      that the administration of anthelmintics elicits an increase in a certain serum
      protein. This protein, named PT60, was partially purified by ammonium sulfate
      fractionation and preparative electrophoresis. The purified PT60 gave a single
      band with the molecular size of 53 kDa in sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis under non-reducing conditions. After reduction with 2
      mercaptoethanol, two bands appeared at 35 kDa and 17 kDa, indicating that PT60
      consists of two subunits which are linked with each other by disulfide bonds.
      PT60 had the capacity to bind to hemoglobin. In an immunodiffusion test, an
      antiserum against PT60 cross-reacted with canine haptoglobin (Hp). N-terminal
      amino acid sequences of two PT60 subunits were identical to those of alpha and
      beta subunits of canine Hp, respectively. Thus, PT60 was identified as Hp.

PMID- 8461424
TI  - Antibody responses of Japanese horses to influenza viruses in the past few years.
AB  - A total of 305 horse sera collected in the Hidaka district of Hokkaido in the
      years 1988-90 were tested for the presence of hemagglutination-inhibition (HI)
      antibodies to A/equine/Newmarket/1/77 (H7N7), A/equine/Tokyo/2/71 (H3N8) and
      A/equine/Kentucky/1/81 (H3N8, Kentucky) strains of equine influenza (EI) virus.
      Antibodies to the 3 strains were detected in hardly of the 45 sera from 2-years
      old horses which were collected before vaccination. Many of the 51 horses, after
      vaccination with inactivated EI virus, had HI antibodies to the 3 strains in 37
      to 88 per cent. However, the number of positive reactors among the horses aged 3
      to 23 years gradually decreased with the advance in age. In particular, no
      antibody response was found in the 60 horses over 9 years of age, except for 3
      cases with HI antibody of low titer, with the Kentucky strain which has recently
      been prevalent among the horse populations in many countries. In a complement
      fixing test, antibodies to the soluble antigen of type A influenza virus were
      detected in the sera collected from the horses which were exposed to an outbreak
      of EI virus infection, but not in the sera from the vaccinated horses examined.

PMID- 8461425
TI  - Referential derivation of epidural electroencephalogram in El mice.
AB  - Epidural EEG of 20 El mice is recorded under ketamine and xylazine anesthesia
      with epoxy coated silver balls as exploring electrodes. A stainless steel needle
      is placed subcutaneously near the nose as a reference electrode. Reproducibility
      of recording is remarkable. Multiple spike complex synchronizing on both frontal
      lobes is observed in 8 mice. Among them, small spikes preceding the multiple
      spike complex are also observed on the left frontal lead in 7 mice and on the
      right in 1 mouse. These spikes do not spread to occipital recordings. The
      discriminative ability of the recording is due to the coated electrode commonly
      employed with much larger animals and to suitable placement of the reference
      electrode. This simple and well known method permits the analysis of not yet
      satisfactorily explored the EEG of El mouse.

PMID- 8461426
TI  - Inhibitory effects of horse serum on immunoassay of horse ferritin.
AB  - The effects of horse serum on the immunoassay of horse ferritin were investigated
      using two sandwich enzyme-linked immunosorbent assay (ELISA) systems. In System
      A, affinity-purified antibody to horse spleen ferritin and its conjugate with
      alkaline phosphatase were used as the first and second antibodies, respectively.
      In System B, whole antiserum and its conjugate with the enzyme were used. The
      recoveries of horse spleen ferritin added to horse sera were very low in either
      system (50-71% in System A; 42-79% in System B). However, heat treatment of the
      sera at 75 degrees C for 15 min improved the recoveries (90-96%) in System A,
      whereas the recoveries in System B were not sufficiently improved by the same
      treatment (75-83%). The apparent concentrations of ferritin in adult and newborn
      horse sera increased after heat treatment of the samples. From these results, it
      is concluded that horse serum contains the heat-unstable substance(s) which
      inhibits the immunoassay of horse ferritin.

PMID- 8461427
TI  - Evaluation of phlebotomy-induced erythropoietin production in the dog.
AB  - Erythropoietin (EPO) production in dogs was studied by reducing red blood cells
      with phlebotomy. In this study, the hemoglobin reduction rate (delta %Hb) was
      newly taken into account as the regulating factor for EPO production, and its
      usefulness to estimate the stimulating intensity to EPO production was examined.
      As the result, plasma EPO was highly correlated with delta %Hb showing the
      importance related to regulation of EPO production, in the increasing plasma EPO
      by different degrees of phlebotomy, in the change of plasma EPO through the
      anemia progress and recovery period after severe phlebotomy, and in the initial
      variation of plasma EPO induced by chronic mild phlebotomy. On the other hand,
      increasing EPO production appeared at least within 6 hr after acute severe
      phlebotomy, which revealed significantly higher plasma level compared with the
      mild chronic phlebotomy, suggesting the effect of time leading to red blood cell
      reduction on EPO production response. Simultaneously, considering an in vivo EPO
      half life of 8.4 hr calculated from plasma EPO disappearance after bilateral
      nephrectomy, endogenous plasma EPO accumulation should be taken into
      consideration in rapidly increasing of delta %Hb.

PMID- 8461428
TI  - Distribution of T cell subsets in chicken lymphoid tissues.
AB  - The distributions of T cell subsets in chicken lymphoid tissues were investigated
      immunohistochemically using monoclonal antibodies (Lc-6, Lc-4) with specificity
      for chicken CD4 and CD8, respectively. In thymic tissues, CD8+ cells were found
      only in the cortex, while CD4+ cells were detected not only in the cortex but
      also in the medulla. The cortex just below the capsule demonstrated no
      immunoreactivity to either antibody. In the cecal tonsile, CD8+ cells were found
      restrictly in the subepithelial lamina propria. It was noted that the germinal
      centers were clearly surrounded with many CD4+ cells in the mid and deep portions
      of the lamina propria. In the spleen, clusters of CD8+ cells were observed only
      in the red pulp. Most lymphocytes in the periarteriolar lymphatic tissue and
      perivenous lymphatic tissue showed a CD4-positive reaction. No lymphocyte in the
      germinal centers reacted with these two monoclonal antibodies. No
      immunoreactivity for either CD8 or CD4 was detected anywhere else in the bone
      marrow or bursa of Fabricius. In the case of exposure to the protein antigen
      (alum-precipitated bovine serum albumin), CD4+ cells were demonstrated in some
      germinal centers, which were increased in size, while the areas expressing CD8 in
      the red pulp were decreased in size. These results suggest that the preferential
      distributions of T cell subsets are inherent in chicken lymphoid tissues.

PMID- 8461429
TI  - Endometriosis in cynomolgus monkeys retired from breeding.
AB  - Twenty-seven cases of endometriosis were found in 94 female cynomolgus monkeys
      retired from breeding. The ages of the affected monkeys (28.7% of all the
      monkeys) ranged from 11 years to 23 years of age with an average of 15.3 years.
      There was no significant difference in the incidence of endometriosis between
      groups which had or had not undergone a cesarean section. Time after the last
      pregnancy was significantly longer in the affected monkeys than in the non
      affected ones. These cases were histopathologically classified into four types:
      1) pelvic endometriosis with formation of endometrial cysts (51.8% of the
      affected monkeys), 2) pelvic endometriosis invading other organs without
      formation of endometrial cysts (3.7%), 3) uterine adenomyosis (22.2%), 4)
      combined pelvic endometriosis and uterine adenomyosis (22.2%).

PMID- 8461430
TI  - Effects of surgical orthodontic treatment for malalignment due to the prolonged
      retention of deciduous canines in young dogs.
AB  - This study was conducted to clarify the effects of surgical orthodontic treatment
      for malalignment caused by the prolonged retention of deciduous canines in young
      dogs. Fifty-five dogs with malocclusion or pre-malocclusion were divided into two
      groups. Group 1 received surgical orthodontic treatment (32 dogs) using
      modification of Ross and Yamane's method of treating for malalignment due to
      prolonged retention of deciduous canine teeth; Group 2 received no treatment (23
      dogs). Occurrence of malocclusion 1-3 weeks after treatment of the group
      receiving surgery was only 3.8%. However, malocclusion was seen in 73.4% of the
      non-treatment group approximately 2 years after the first examination. Surgical
      orthodontic treatment was very useful in treating malalignment due to prolonged
      retention of deciduous canines in young dogs.

PMID- 8461431
TI  - Pharmacokinetics of sulfadimethoxine in skin of broiler-chicken after single and
      multiple intravenous injections.
AB  - Pharmacokinetics of sulfadimethoxine (SDMX) in skin of broiler chicken after
      intravenous and in-drinking-water administrations were investigated to examine
      the reason for a longer residue of SDMX in the skin which was observed in the
      residue study after administration via drinking water at a concentration of 1,000
      ppm. The decay curve of SDMX in the skin after single intravenous injection of
      200 mg/kg, the highest dose, was fitted to the two compartment model with T1/2 of
      4.4 hrs in the first elimination phase and 173 hrs in the second one. The
      extrapolated concentrations in the skin at 24 hrs after the injection were
      calculated to be 69.0 micrograms/g for the 1st phase and 0.11 micrograms/g for
      the 2nd phase. The decay curves in the skin after single injection of 30 and 100
      mg/kg were fitted to the one compartment model with T1/2 of 3.2 and 5.7 hrs,
      respectively. Dividing a high dose into 3 to 5 doses and injecting sequentially
      with intervals of the previously measured T1/2, SDMX concentrations in the skin
      were about half of those in the plasma and ran parallel. The plasma concentration
      time curves after single intravenous injection of SDMX more than 100 mg/kg showed
      nonlinear kinetics with concentrations over 100 micrograms/ml for 12-30 hrs after
      the injection. By administration of SDMX via drinking water, a sustained residue
      curve of SDMX in the skin at 1,000 ppm reported previously was not observed at
      500 ppm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461433
TI  - Rumen ciliates of Ezo deer (Cervus nippon yesoensis) with the morphological
      comparison with those of cattle.
AB  - The composition of rumen ciliate protozoa was surveyed in 13 Ezo deer, Cervus
      nippon yesoensis, inhabiting Hokkaido, Japan. As a result, two species of the
      genus Entodinium, E. simplex and E. dubardi, were detected. Each Ezo deer had
      only a single species of protozoa, E. simplex or E. dubardi. Since E. simplex in
      Ezo deer had a wide variation in body size and shape, its measurements were
      compared with those of E. simplex, E. nanellum and E. exiguum obtained from
      Holstein-Friesian cattle feeding in the same area. The ciliate density ranged
      widely from 3.1 to 5882.4 x 10(3) with an average of 567.4 x 10(3) per 1 ml of
      rumen fluid.

PMID- 8461432
TI  - Evaluation of extravascular thermal volume in the lung in dogs with endotoxin
      induced shock by double indicator dilution method using heat and sodium ions.
AB  - Accuracy assessment was undertaken under varying hemodynamic conditions for a
      lung water volume measurement device which is based on the principle of a double
      indicator dilution method using heat and sodium ions. Changes in extravascular
      thermal volume were investigated in dogs with endotoxin-induced shock. The
      isoproterenol- or propranolol-induced changes in hemodynamics had no effect on
      the measurement. This confirmed the high accuracy of this measuring method. The
      measurement revealed a tendency for the extravascular thermal volume to gradually
      increase (p < 0.05) during endotoxin shock. This confirmed the gradual
      progression of pulmonary edema during endotoxin shock.

PMID- 8461434
TI  - Controlled release of proteins from 2-hydroxyethyl methacrylate copolymer gels.
AB  - A series of hydrogels with large pores was synthesized by the precipitation
      polymerization of 2-hydroxyethyl methacrylate (HEMA) with crosslinking agent in
      aqueous solution. Such gels are potentially useful for the controlled release of
      large-molecular-weight species such as proteins. In this study, the release
      behavior of lysozyme and alpha-amylase from hydrogels formed from HEMA or HEMA
      with a comonomer was studied. It was found that the polymer composition affected
      the total amount of lysozyme released and its activity. Effects were smaller with
      alpha-amylase. Charged gels, containing a phosphate moiety, released larger
      amounts of lysozyme at a reduced rate as a result of charge-charge interactions.

PMID- 8461435
TI  - Release of chemicals from polyurethane foam in the Meme breast implant.
AB  - Samples of polyurethane (PU) foam from the Meme breast implant were incubated at
      37 degrees C in either 0.3-3.0 N sodium hydroxide (NaOH) solutions, normal
      saline, or methanol. The chemicals released were analyzed by gas chromatography
      (GC), gas chromatography/mass spectrometry (GC/MS), and Fourier-transform infra
      red (FT-IR) spectroscopy. The surfaces of the treated and untreated foam samples
      were studied by scanning electron microscopy (SEM). The NaOH solutions hydrolysed
      the foam, releasing toluene diamine (TDA). Incubating the foam in methanol washed
      out trace quantities of anti-oxidant, 2,4-dimethyl-6-t-butylphenol (DBP). When
      the foam was incubated in normal saline at 37 degrees C no TDA was detectable but
      another compound with a mass ion of 173 was detected. Further GC/MS studies
      confirmed that this compound was polyol, one of the reagents used to manufacture
      the PU foam. Repeatedly incubating or washing the foam in normal saline or
      methanol eliminated the release of polyol. SEM studies of the foam samples before
      and after incubation experiments, showed no evidence of polymer degradation.
      These findings indicated that polyol was present in the PU foam only as an
      impurity or residue and did not originate from the breakdown of the foam itself.

PMID- 8461437
TI  - In vitro toxicity of biomaterials determined with cell density, total protein,
      cell cycle distribution and adenine nucleotides.
AB  - Inhibition of cell growth is the most commonly used endpoint for in vitro
      toxicity of biomaterials. The use of several different endpoints might however
      generate more information concerning the nature of the toxicity. Thus, we
      examined the toxicity of two biomaterials, Polyvinylchloride (PVC) and
      Polyoximethene (POM), with different selected endpoints. The influence of cell
      growth on these endpoints was also investigated. Water extracts from the
      polymeric materials were tested on the continuous cell line L-929. Cell density,
      total protein, total protein per cell, fraction of cells in G0/G1- or S-phase,
      the concentration of ATP, ADP and AMP were used as endpoints. The PVC material
      did not significantly influence any of these endpoints until after 72 hours of
      exposure and the main part of the toxicity at 72 hours was related to higher
      proliferation rate in control cultures. After the cells had been incubated for 8
      hour with POM the main toxic effect was on the energy parameters. In conclusion
      the PVC material was less toxic than the POM material. Our results also implies
      that the choice of endpoint will influence the evaluation of cytotoxicity.

PMID- 8461436
TI  - Preservation of regional and global left ventricular function by intracoronary
      infusion with oxygenated fluorocarbon emulsion Therox in dogs.
AB  - We tested the oxygen transport and delivery capacity of the novel perfluorocarbon
      emulsion, Therox (F44E, 1,2-bis-perfluorobutyl-ethylene) by comparing left
      ventricular regional and global function in dogs during perfusion of the left
      anterior descending coronary artery (LAD) with oxygenated Krebs buffer and
      oxygenated Therox emulsion (20% w/v) at 20 ml/min for two separate 3 min periods.
      During LAD perfusion with oxygenated Krebs buffer, complete loss of systolic wall
      thickening in the LAD perfusion area was observed, dP/dt was significantly
      reduced and left ventricular end-diastolic pressure (LVEDP) was increased. In
      contrast, LAD perfusion with oxygenated Therox maintained regional wall
      thickening at 60-70% of control and completely preserved global function as
      measured by dP/dt and LVEDP. Thus, Therox is an effective oxygen carrier in this
      animal model.

PMID- 8461438
TI  - Preparation and evaluation in vitro and vivo of copoly (lactic/glycolic) acid
      microspheres containing norethisterone.
AB  - Poly (lactic/glycolic) acid (PLGA) microspheres containing 20% norethisterone
      (NET) were prepared and the preparation methodology was optimised. The
      microspheres showed a slow and steady release pattern up to more than 96 hours in
      27.5 wt% ethanol solution. In vivo performance of the microspheres indicated that
      a single intramuscular injection of 80 mg of microspheres could significantly
      prolong the duration of estrus suppression up to 45 days in rats. In addition,
      the studies on the stability of microspheres showed that there was no significant
      change both in the NET content of microspheres and the NET release rate in vitro
      after storage for one year.

PMID- 8461439
TI  - The long-term observation of the transplantation of encapsulated rat islets to
      the diabetic mice.
AB  - Rat islets encapsulated in the immuno-isolated membrane were transplanted
      intraperitoneally into 11 streptozotocin induced diabetic mice. The effective
      rate was 91% while all rejected in the 11 nonencapsulated xenograft group. 4 mice
      showed complete remission and longest normoglycemic period in those mice was 360
      days. The pathological changes of islets of the long-term successful xenograft
      group were studied and showed atrophy. It proved that the immuno-isolated
      membrane can protect rejection during xeno-transplantation.

PMID- 8461440
TI  - Skin sensitization study of a new BIS-GMA based dental restorative material.
AB  - One of the criteria for the Dental Restorative Material is to not to evoke
      sensitization reaction when used clinically. The newly synthesized BIS-GMA based
      Chitra's Dental Material intended for such application was tested for skin
      sensitization as per the international protocol of test i.e. skin Maximization
      test in G.Pig. Result of this test showed conclusively that the material is
      devoid of sensitization potential and fit for clinical application.

PMID- 8461441
TI  - [Mechanics of damage and biomechanical tensile strength of the femur].
AB  - The properties of the femur are represented by the micromechanics of composites
      and the mechanics of damage. A consideration of the femur as a composite the
      Young's modul is dependent on the density. The biomechanical behavior of the
      femur can be simulated by a one-dimensional model of the mechanics of damage. It
      is shown that the maximal tolerable stress and the yield stress are not direct
      material properties. Material behavior is determined by a damage variable that is
      dependent on the current strain. The results of this investigation are in good
      agreement with experimental results.

PMID- 8461442
TI  - [Rotational bending test of hydroxylapatite plasma-coated models of TiAl6V4].
AB  - Plasma spraying of hydroxyapatite coatings onto hip joint and knee endoprosthesis
      implants and dental implants is state of the art. Nevertheless, there is still a
      lack of data on the long-term behavior of such coatings. Using the rotating
      bending test DIN 50,113 it is shown that parts plasma-sprayed with 200 microns
      OSPROVIT exhibit delamination only after fracture of the metallic component. At a
      load of 400 MPa more than 1.10(9) loading cycles were achieved.

PMID- 8461443
TI  - [Eye heating caused by microwave ovens].
AB  - To clarify the question as to whether microwave ovens represent a risk for the
      eyes, a worst-case situation was investigated in which it was assumed that a
      child observes the internal heating process with its eyes as close to the door of
      a microwave oven as it is possible to get. As expected, heating of the eyes was
      observed, which, however, was caused mainly by the conventional heating process
      rather than by microwave radiation. Significant microwave heating was observed
      only when increased scattered radiation was simulated by inactivating the safety
      contacts and opening the door of the microwave oven. When the door is opened to a
      clearly visible gap width (2.3 cm), the contribution of the microwave component
      to the overall temperature increase of 5 degrees C after one hour of continuous
      exposure did not exceed 16%. Even at the maximum possible door gap width which
      just did not cause the oven to switch off automatically (2.6 cm), 15 minutes of
      continuous exposure contributed only 50% to the 2 degrees C temperature increase.
      On the basis of these results, damage to the eye through the use of microwave
      ovens can be excluded.

PMID- 8461444
TI  - [Expert system for automatic, subjective determination of refraction].
AB  - An automatic system for determining a patient's subjective refraction for the
      fitting of glasses or contact lenses, is described. The system works without any
      intervention on the part of the ophthalmologist or optometrist. Directions are
      provided and questions asked of the patient via a loudspeaker or headphones with
      the aid of a computer. This computer also controls the positioning of different
      lenses before the patient's eyes using a phoropter, and the projection of the
      chart figures for visual acuity testing. The patient responds via a dedicated
      graphic tactile answering unit. The principles involved are described, and the
      experience so far gained with the method discussed.

PMID- 8461445
TI  - [Suture surface and suture strength of polypropylene monofilaments].
AB  - Knots form the weakest sections in suture materials. The addition of forces in
      the knot caused by bend and tension exceed the strength of the suture material
      and lead to rupture in the knot. Furthermore the most pronounced tissue reactions
      occur in the surrounding of knots because of their relatively large surface as
      compared to the linear filament. With a higher knot holding capacity a secure
      fixation can be achieved with less knots. As a reduced number of knots leads to a
      smaller surface a reduced tissue reaction can be expected. Because of high
      rigidity and a low coefficient of friction synthetic monofilaments achieve only a
      low knot holding capacity. To improve the knot holding capacity a usually large
      number of knots is being used. With increasing surface of exogenous materials the
      extent of foreign-body reactions increases, e.g. formation of granuloma. Results
      of in-vitro experiments are reported that were conducted to identify the smallest
      secure knot in polypropylene filaments of various diameters.

PMID- 8461446
TI  - [Safety testing of high frequency surgery neutral electrodes (measuring
      instrument for impedance and temperature increase with AAMI-HF18 standard load)].
AB  - A new safety tester device for surgical grounding plates is described. This
      device can measure impedance distribution and temperature increase under a
      standard load in accordance with the AA-MI-HF18 standard. Apart from relevant
      information about the grounding plates under test, possible risks for the patient
      can also be demonstrated.

PMID- 8461447
TI  - Exhaustive conformational search and simulated annealing for models of lattice
      peptides.
AB  - We consider simple lattice models for short peptide chains whose states can be
      exhaustively enumerated to find the lowest energy conformation. Using these exact
      results and numerical simulations, we compute the distributions for the mean time
      tN, required to find the global minimum energy state by simulated annealing (SA),
      as a function of N, the number of units in the chain. On the basis of scaling
      arguments, the time tN, to find the global minimum energy of longer chains,
      beyond the range covered by exhaustive enumeration, can be estimated. On the
      basis of the observed exponential increase in folding time of the standard SA
      algorithms, it is imperative that better algorithms be found for minimizing
      longer chains.

PMID- 8461449
TI  - A model for the dynemicin-A cleavage of DNA using molecular dynamics simulation.
AB  - Molecular dynamics (MD) simulations to model possible reaction pathways of the
      dynemicin-A-DNA cleavage mechanism were performed. Two base-pairs sequences,
      ApCpTpApCpTp-3'/TpGpApTpGpAp-5' and CpApCpGpGpGp-3'/GpTpGpCpCpCp-5', were
      considered in the calculations. A model based on a prior study of intercalation
      of dynemicin-A and posterior activation of the drug was assumed in this study.
      The minimum energy minor groove intercalation complexes for dynemicin-A were used
      as starting structures in the MD simulations for the reactive intermediate
      species involved in the postulated action mechanism. The dynemicin-A diol
      derivative product of the opening of the epoxy ring was used as a "steric mimic"
      ligand for the DNA-reactive diaryl intermediate. The calculated changes in the
      geometry of the intercalation complex, due to the opening of the epoxy ring,
      correspond to the approach of the postulated intermolecular reaction centers in
      the intercalation states that are responsible for the highest observed DNA
      cleavage frequency observed. Conversely, unfavorable reaction geometries were
      found for the intercalation modes corresponding to the lowest observed DNA
      cutting frequencies.

PMID- 8461448
TI  - Persistence analysis of the static and dynamical helix deformations of DNA
      oligonucleotides: application to the crystal structure and molecular dynamics
      simulation of d(CGCGAATTCGCG)2.
AB  - A theory and graphical presentation for the analysis of helix structure and
      deformations in oligonucleotides is presented. The parameters "persistence" and
      "flexibility" as defined in the configurational statistics of polymers of
      infinite length are reformulated at the oligonucleotide level in an extension of
      J. A. Schellman's method [(1974) Biopolymers, Vol. 17, pp. 217-226], and used as
      a basis for a systematic "Persistence Analysis" of the helix deformation
      properties for all possible subsequences in the structure. The basis for the
      analysis is a set of link vectors referenced to individual base pairs, and is
      limited to sequences exhibiting only perturbed rod-like behavior, i.e., below the
      threshold for supercoiling. The present application of the method is concerned
      with a physical model for the angular component of bending, so the link vectors
      are defined as the unit components of a global helix axis obtained by the
      procedure "Curves" of R. Lavery and H. Sklenar [(1988) J. Biomol. Struct. Dynam.,
      Vol. 6, pp. 63-91; (1989) ibid., Vol. 6, pp. 655-667]. A discussion of the
      relationship between global bending and relative orientation of base pairs is
      provided. Our approach is illustrated by analysis of some model oligonucleotide
      structures with intrinsic kinks, the crystal structure of the dodecamer
      d(CGCGAATTCGCG)2, and the results of two molecular dynamics simulations on this
      dodecamer using two variations of the GROMOS force field. The results indicate
      that essentially all aspects of curvature in short oligonucleotides can be
      determined, such as the position and orientation of each bend, the sharpness or
      smoothness, and the location and linearity of subsequences. In the case of
      molecular dynamics simulations, where a Boltzmann ensemble of structures is
      analyzed, the spatial extent of the deformations (flexibility) is also
      considered.

PMID- 8461450
TI  - Synthetic peptide and template-assembled synthetic protein models of the hen egg
      white lysozyme 87-97 helix: importance of a protein-like framework for
      conformational stability in a short peptide sequence.
AB  - In the native structure of hen egg white lysozyme (HEL), the amino acid sequence
      87-97 (HEL 87-97) forms an amphiphilic helix, with hydrophilic residues in the
      sequence directed toward the solvent. A synthetic version of the HEL 87-97
      sequence (with the cysteine corresponding to position 94 of HEL replaced by
      alanine) displays conformational features in solution typical of an unordered
      structure as judged by CD. However, various modifications in the sequence result
      in increased helix-forming potential of the HEL 87-97 analogues. Further
      stabilization of the helical conformation in the most helical analogue of the HEL
      87-97 sequence is obtained when 4 copies of this peptide sequence are coupled on
      a peptide carrier molecule following the template-assembled synthetic protein
      (TASP) approach [M. Mutter and S. Vuilleumier (1989) Angew. Chem. Int. Ed. Engl.,
      Vol. 28, pp. 535-554 "A Chemical Approach to Protein Design-Template-Assembled
      Synthetic Proteins (TASP)." This suggests that long-range interactions of the
      peptide with its environment contribute to conformational stability in short
      peptide sequences. TASP molecules may prove useful for the study of the factors
      that determine secondary structure formation in short peptides by providing a
      protein-like framework.

PMID- 8461451
TI  - Accommodation of a D-Phe residue into a right-handed 3(10)-helix: structure of
      Boc-D-Phe-(Aib)4-Gly-L-Leu-(Aib)2-OMe, an analogue of the amino terminal segment
      of antiamoebins and emerimicins.
AB  - The crystal structure of the nonapeptide Boc-D-Phe-Aib-Aib-Aib-Aib-Gly-Leu-Aib
      Aib-OMe (I), which is an analogue of the N-terminal sequence of antiamoebins and
      emerimicins, establishes a completely 3(10)-helical conformation with seven
      successive intramolecular 4-->1 hydrogen bonds. The average, phi,psi values for
      residues 1-8 are -59 degrees and -32 degrees, respectively. Crystal parameters
      are C47H77N9O12, space group P1, a = 10.636 (4) A, b = 11.239 (4) A, c = 12.227
      (6) A, alpha = 101.17 (4) degrees, beta = 97.22 (4) degrees, gamma = 89.80 (3)
      degrees, Z = 1, R = 5.95% for 3018 data with magnitude of F0 > 3 sigma(F),
      resolution 0.93 A. The use of the torsion angle kappa = C(i-1)N(i)C alpha(i)C
      beta(i), where kappa = 68 degrees for D-Phe and kappa = 164 degrees for L-Leu,
      confirms the opposite configurations of these residues. The phi,psi values of -62
      degrees and -32 degrees at D-Phe are unusual, since this region is characteristic
      of residues with L configurations. Peptide I possesses only two chiral residues
      of opposing configuration. The observed right-handed 3(10)-helical structure
      suggests that helix sense has probably been determined by the stereochemical
      preferences of the Leu residue.

PMID- 8461452
TI  - Synthesis, conformation, and activity of HCO-Met-delta Z Leu-Phe-OMe, an active
      analogue of chemotactic N-formyltripeptides.
AB  - In order to induce a beta-turn conformation into the chemotactic linear
      tripeptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP), the new analogue
      N-formyl-L-methionyl-delta Z leucyl-L-phenylalanine methyl ester [delta Z
      Leu]2fMLP-OMe (1) has been synthesized. The conformational and biochemical
      consequences of this chemical modification have been determined. Analogue 1 has
      been synthesized by using N-carboxy-(Z)-alpha,beta-didehydroleucine anhydride as
      key compound to introduce the unsaturated residue at the central position of the
      tripeptide 1. The x-ray analysis shows that 1 adopts in the crystal a type II
      beta-turn conformation in which the new residue occupies the (i + 2) position,
      and an intramolecular H bond is formed between the formylic oxygen and the Phe
      NH. 1H-nmr analysis based on nuclear Overhauser effect measurements suggests that
      the same folded conformation is preferred in CDCl3 solution; this finding is also
      supported by molecular dynamics simulation. The biological activity of 1 has been
      determined on human neutrophils (polymorphonuclear leukocytes) and compared to
      that shown by fMLP-OMe. Chemotactic activity, granule enzyme release, and
      superoxide anion production have been determined. Analogue 1 is practically
      inactive as chemoattractant, highly active in the superoxide generation, and
      similar to the parent in the lysozyme release. The conformational restriction
      imposed on the backbone by the presence of the unsaturated residue is discussed
      in relation with the observed bioselectivity.

PMID- 8461453
TI  - Molecular dynamics simulations of B-DNA: an analysis of the role of initial
      molecular configuration, randomly assigned velocity distribution, long
      integration times, and nonconstrained termini.
AB  - Molecular dynamics simulations of three DNA sequences using the AMBER 3.0 force
      field were performed with implicit inclusion of water through a distance
      dependent dielectric constant and solvated counterions. Simulations of the self
      complementary DNA dodecamer d(CGCGAATTCGCG) were started from a regular B-DNA
      structure and the x-ray single crystal B-DNA structure. Although mean convergence
      during the 89-ps calculation was confirmed, localized differences in backbone
      torsionals and base-pair helicoidals were observed. A nanosecond simulation of
      the nonself-complementary 14 base-pair DNA d(GGCGGAATTGGCGG) indicates that most
      structural parameters stabilize within the first 100-200 ps, while isolated
      features show low-frequency oscillations throughout the calculation. The lack of
      harmonic constraints on the ends of the molecules was shown not to perturb the
      structural dynamics of the internal oligonucleotide beyond the external 2 base
      pairs. Comparison of three simulations of the nonself-complementary 14 base-pair
      DNA d(GGCGAAATTCGCGG), identical in all respects other than the assignment of
      initial Maxwellian atomic velocity distributions, revealed the inherent
      systematic variability. The three calculations result in nearly superimposable
      global structures, with localized variations in torsionals and helicoidals. Our
      results provide a basis for performing a comparative analysis of the effect of
      DNA sequence on localized structure.

PMID- 8461454
TI  - Calcium-dependence of laminin binding to phospholipid membranes.
AB  - Laminin is the most abundant noncollagenous protein in basement membranes. Its
      self-assembly has been studied in solution, and it has been established that
      calcium ions induce partially reversible aggregation. The behavior at a lipid
      membrane surface is of greater biological significance, but it is difficult to
      study quantitatively binding kinetics at a surface. The present work uses a
      powerful new integrated optics technique to measure the absorption and
      aggregation of the laminin-nidogen at a bilayer lipid membrane surface. It is
      found that the binding of a single layer of laminin at the lipid membrane is
      independent of the presence of calcium, but that the building up of multilayer
      laminin membranes requires calcium, and that these may not be destroyed by a
      calcium-complexing agent.

PMID- 8461455
TI  - Looking into the grooves of DNA.
AB  - The present study is aimed at understanding the effects of DNA sequence, local
      conformation, and curvature on groove geometry. Energy-optimized structures are
      obtained by Jumna methodology; groove geometry is analyzed by a recently
      developed technique that allows an accurate and continuous measurement of width
      and depth. The mechanics of groove deformations is also studied and analyzed in
      terms of helicoidal parameters.

PMID- 8461456
TI  - Helix promotion in polypeptides by polyols.
AB  - The helix content of [L-Lys(Me3)]n.ClO4 and [L-Lys(Me3)50,L-Ala50]n.ClO4 in water
      is markedly increased by the presence of sucrose and glycerol. For [L
      Lys(Me3)]n.ClO4 the ellipticity at 222 nm changes from +2 x 10(3) deg cm2 dmole-1
      in water to -44 x 10(3) in 50% glycerol. Sucrose does not promote helix formation
      in melittin at pH 7.2, but glycerol does. At pH 5.5 sucrose and, more so,
      glycerol, induce helix in melittin. Glycerol induces some helix in methylated
      melittin, but less than in melittin. The results are discussed in relation to
      excluded volume effects, delta G of transfer of peptide and hydrophobic groups
      from water to mixed solvents, electrostatic effects, and preferential hydration.

PMID- 8461457
TI  - Ca(2+)-induced conformational transitions of phosphorylated peptides.
AB  - CD spectroscopic studies on protected peptides containing lysine and serine, or
      phosphoserine, and on serine-containing fragments of the neurofilament protein
      midsized subunit, both in the unphosphorylated and phosphorylated form, are
      reported. The introduction of the phosphoryl group was not found to have a
      significant spectral effect in aqueous solution. In trifluoroethanol (TFE),
      spectral shifts toward unordered (type U) spectra or the appearance of distorted
      spectra likely reflect the adoption of aperiodic polypeptide conformations due to
      salt bridge(s) between negatively charged phosphoserine and positive lysine side
      chain groups. A turn-stabilizing effect of phosphorylation was also observed. CD
      monitored titration experiments in TFE revealed a high conformational sensitivity
      of phosphopeptides toward Ca2+ ions. The appearance of the unordered spectra or
      spectral shifts were the sign of a bulk disordering effect of Ca2+ ions. Spectra
      with specific spectroscopic features reflect the formation of Ca2+ complexes and
      the adoption of ordered unique backbone conformations. When ordered structures
      were obtained on addition of Ca2+ ions, the observed CD curves showed a
      resemblance to the spectrum of beta-pleated sheets. This may originate from chain
      extension and the formation of beta-pleated sheet segments fixed by Ca2+ bridges
      between PO3H-1 groups of adjacent peptide chains. The data clearly show that the
      effect of the Ca2+ ions is highly specific: the sequence, chain length, presence
      and distribution of charged side-chain groups, degree and site of
      phosphorylation, and environmental factors appear to be determining in the
      process of chain extension or beta-sheet formation.

PMID- 8461458
TI  - Cytokine treatment of inherited bone marrow failure syndromes.

PMID- 8461459
TI  - Effects of interleukin-3 and granulocyte-macrophage colony-stimulating factor on
      thrombopoiesis in congenital amegakaryocytic thrombocytopenia.
AB  - Amegakaryocytic thrombocytopenia (AMT) is a rare and often fatal disorder of
      infancy and childhood presenting with isolated thrombocytopenia that progresses
      to marrow failure. The defect in thrombopoiesis is not well understood nor is the
      etiology of the progressive marrow failure. No standard modality of treatment
      exists. Here, we evaluated the capacity of marrow cells isolated from five
      patients with AMT and progressive marrow failure to generate megakaryocyte
      progenitor cells (CFU-MK). These in vitro studies demonstrated assayable numbers
      of CFU-MK from all patient bone marrows that responded in vitro to the addition
      of interleukin-3 (IL-3), granulocyte-macrophage colony-stimulating factor (GM
      CSF), or the combination of both. These findings suggest that the defect in AMT
      might be partially correctable by the administration of these cytokines. A Phase
      I/II trial of in vivo administration of these same hematopoietins in the
      identical patients was conducted in which no significant toxicity was observed.
      IL-3 but not GM-CSF administration resulted in improved platelet counts in two
      patients and decreased bleeding and transfusion requirement in the remaining
      three. No clinical benefit was observed when GM-CSF was administered after IL-3
      pretreatment. Prolonged IL-3 administration has resulted in platelet increases in
      an additional two patients. In vitro responsiveness of CFU-MK to either cytokine
      did not predict the degree of clinical response. Although the optimal dose and
      schedule of IL-3 either alone or in combination remains to be established, this
      study suggests that IL-3 may contribute to the treatment of patients with AMT.

PMID- 8461460
TI  - Subunit structure of the erythropoietin receptor analyzed by 125I-Epo cross
      linking in cells expressing wild-type or mutant receptors.
AB  - To analyze the structure of the murine erythropoietin receptor (EpoR), wild-type
      or mutant EpoR cDNAs were expressed in cell lines, and the proteins that cross
      linked with 125I-labeled erythropoietin (Epo) were analyzed by
      immunoprecipitation using an antibody against the intracellular region of the
      cloned EpoR. COS-7 cell transfectants expressing the wild-type EpoR showed two
      major cross-linked species of 145 and 110 Kd, both of which were recognized by
      the antibody against the cloned EpoR after denaturation under reducing
      conditions. Furthermore, a reduction in sizes of both cross-linked bands was
      observed in COS-7 transfectants expressing a mutant receptor with an internal
      deletion, thus indicating that both species contain the cloned EpoR. COS-7 cells
      expressing mutant receptors with carboxy-terminal deletions showed cross-linked
      bands corresponding to the smaller species of the two observed in cells
      expressing the wild-type receptor. In contrast to COS-7 cell transfectants, DA3
      cells expressing wild-type or mutant EpoR cDNAs showed an additional cross-like
      species of 130 Kd. The size of this species was not altered by deletions in EpoR,
      showing that it did not contain EpoR. The 130-Kd cross-linked band, which would
      contain a 95-Kd protein, was also observed in a murine erythroleukemia cell line,
      D1B. These results suggest that Epo associates with a second component of 95 Kd,
      which is specifically expressed in hematopoietic cells.

PMID- 8461461
TI  - Pre-CFU-S quiescence and stem cell exhaustion after cytostatic drug treatment:
      protective effects of the inhibitory peptide pGlu-Glu-Asp-Cys-Lys (pEEDCK).
AB  - Pre--CFU-S are characterized by their ability to generate spleen colony-forming
      cells (CFU-S) and by their ability to repopulate the hematopoietic system after
      damage. We have investigated their response to three consecutive injections of
      cytosine arabinoside (ara-C), given at t = 0, 12, and 20 hours. Nine hours after
      treatment, the number of CFU-S and pre--CFU-S was reduced to 10% or 30%,
      respectively. No pre--CFU-S were in S-phase at this time, indicating that the pre
      -CFU-S losses were not caused by direct drug killing. Up to 1 year after
      treatment, pre--CFU-S were still depleted to 10% of normal, indicating that their
      proliferative quiescence was permanent. We have previously shown that inhibition
      of CFU-S recruitment with pGlu-Glu-Asp-Cys-Lys (pEEDCK) makes them ara-C
      resistant and prevents their decimation. We now found that this also prevented
      the excessive drainage of the pre--CFU-S pool, suggesting that pre--CFU-S
      allocation into active hematopoiesis is triggered by the CFU-S deficit. pEEDCK
      may thus be applicable as a protector of the hematopoietic repopulation potential
      against cytostatic drug-induced aplasia. Postchemotherapeutic stimulator
      treatment with (pEEDCK)2-dimer did not ameliorate pre--CFU-S losses. Long-term
      culture-initiating cells (LTC-ICs) showed a similar pattern of irreversible
      reduction after cytostatic drug treatment, which could be prevented by pEEDCK.
      Our results suggest, that certain subclasses of hematopoietic stem cells (pre-
      CFU-S) are permanently quiescent and exhaustible and that the capacity for self
      renewal is not a necessary property of all stem cell-like cells.

PMID- 8461462
TI  - Lasting safe interruption of endarterectomy thrombosis by transiently infused
      antithrombin peptide D-Phe-Pro-ArgCH2Cl in baboons.
AB  - To evaluate the relative antithrombotic efficacy and hemostatic safety of
      antithrombin therapy for vascular thrombus formation at sites of mechanical
      vascular injury, we administered the potent and specific irreversible synthetic
      antithrombin D-PHE-PRO-ARG chloromethyl ketone (D-FPRCH2Cl) after performing
      carotid endarterectomies in baboons. The continuous intravenous infusion of D
      FPRCH2Cl, 100 nmol/kg per minute for 1 hour, abolished acute carotid
      endarterectomy thrombosis for at least 48 hours. The plasma level of D-FPRCH2Cl
      during the infusion was maintained steady at 7.2 +/- 0.9 mumol/L, but decreased
      rapidly after discontinuing its infusion (T50 17 minutes). Platelet deposition,
      measured in real time using autologous 111In-platelet scintillation camera
      imaging, was 1.51 +/- 0.40 x 10(8) platelet/cm in the 14 treated animals 90
      minutes postoperatively, compared with 11.7 +/- 1.16 x 10(8) platelet/cm in 14
      heparin-treated controls (P < .002). The antithrombotic benefit was equivalent
      for treatment begun either 5 minutes before (nine animals) or 15 minutes after
      (five animals) reestablishing flow in the operated vessel, ie, 1.59 +/- 0.36 x
      10(8) platelet/cm versus 1.35 +/- 0.51 x 10(8) platelet/min, respectively; P >
      .5. Endarterectomy thrombosis remained decreased for at least 48 hours
      postoperatively, as determined by the ratio between net 111In-platelet
      radioactivity at the endarterectomized site versus whole blood (ratio 0.82 +/-
      0.25 in the treatment group v 3.03 +/- 0.51 in heparin controls at 90 minutes, P
      < .005; and 0.85 +/- 0.23 v 3.25 +/- 0.48 at 48 hours, P < .002). The marked
      reduction in endarterectomy thrombosis in treated animals at 48 hours was
      confirmed by scanning electron microscopy. Thrombin activity formed rapidly and
      became immediately bound to thrombus on thrombogenic segments in untreated
      control studies; treatment with D-FPRCH2Cl irreversibly inactivated the thrombus
      bound thrombin. Hemostatic function, as measured by bleeding time (BT), activated
      partial thromboplastin time (APTT), and prothrombin time (PT) was impaired
      throughout the intravenous administration of D-FPRCH2Cl (BT > 30 minutes, APTT >
      150 seconds, PT > 50 seconds); BT, APTT, and PT values were normal 30 minutes
      after discontinuing the infusions. As expected, blood loss into the surgical
      wound was substantial in nine animals receiving therapy initiated before
      restoring flow in the operated vessel (mean 95 mL, range 45 to 130 mL). By
      contrast, beginning D-FPRCH2Cl therapy in five animals 15 minutes after restoring
      arterial flow, a time when surgical hemostasis had been achieved, prevented
      excessive blood loss (mean 15 mL, range 10 to 35 mL; P < .01 compared with
      earlier treatment) without compromising the antithrombotic effects.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8461463
TI  - Antithrombotic properties of a dermatan sulfate hexadecasaccharide fractionated
      by affinity for heparin cofactor II.
AB  - The relationship between the antithrombotic activity of dermatan sulfate (DS) in
      vivo and its catalytic effect on the inhibition of thrombin by heparin cofactor
      II (HC II) in vitro was investigated. DS was depolymerized by Smith degradation
      and the fragments obtained were separated by gel filtration. The fragment of
      minimal size with full catalytic activity was a hexadecasaccharide, which was
      further fractionated by affinity for immobilized HC II. Only a small proportion
      by weight (6.7%) was recovered in the high-affinity fraction, which had about 10
      times more catalytic activity than the unfractionated oligosaccharide; the change
      in activity was primarily caused by the removal of inert materials, recovered in
      the low-affinity fraction. 1H-NMR spectra indicated strengthening of the signal
      given by Ido A (2S04) in the high-affinity fraction compared with that of the low
      affinity fraction. The anticoagulant activity of the high-affinity fraction was
      exclusively HC II-dependent. The antithrombotic potency was evaluated in rabbits
      using the Wessler-thromboplastin model. Half-maximal prevention of thrombosis was
      obtained after injection of 250 micrograms/kg DS, of 500 micrograms/kg
      hexadecasaccharide, or of 60 micrograms/kg of its high-affinity fraction. The low
      affinity fraction was ineffective at the highest dose tested (1,200
      micrograms/kg) and did not potentiate the effect of the high-affinity fraction.
      These results show that the antithrombotic effect of DS is essentially dependent
      on HC II binding and activation and that HC II is therefore a suitable target for
      antithrombotic drugs.

PMID- 8461464
TI  - Platelet interactions with fibronectin: divalent cation-independent platelet
      adhesion to the gelatin-binding domain of fibronectin.
AB  - Divalent cation-dependent platelet adhesion to fibronectin (FN) is mediated by
      the integrin receptors alpha 5 beta 1 (GP Ic-IIa) and alpha IIb beta 3 (GP IIb
      IIIa), which recognize the RGD (Arg-Gly-Asp) sequence in the cell-binding domain.
      However, FN can also support divalent cation-independent platelet adhesion. To
      determine which domain of FN mediates divalent cation-independent adhesion,
      proteolysis with thermolysin and affinity chromatography were used to isolate the
      cell-binding, gelatin-binding, and heparin-binding domains of FN. Unactivated and
      thrombin-activated platelets adhered to intact FN and the 45-Kd gelatin-binding
      domain in the presence of either Ca2+ or EDTA. Platelet spreading was mediated
      only by the 105-Kd cell-binding domain and required divalent cations. The heparin
      binding domains did not support platelet adhesion. Reduction of intrachain
      disulfide bonds or removal of carbohydrate side chains on the gelatin-binding
      domain did not alter the ability to support platelet adhesion. Divalent cation
      independent adhesion to the 45-Kd gelatin-binding domain was not inhibited by
      RGDS (Arg-Gly-Asp-Ser) synthetic peptides or monoclonal antibodies (MoAbs)
      directed against known platelet receptors. We conclude that platelets can adhere
      but not spread on the gelatin-binding domain of FN by a novel divalent cation
      independent mechanism.

PMID- 8461465
TI  - Human platelet aggregation by murine monoclonal antiplatelet antibodies is
      subtype-dependent.
AB  - Twenty murine monoclonal antibodies (MoAbs) generated against different human
      platelet antigens induced clumping of human platelets in plasma and buffer.
      Whereas one MoAb could agglutinate platelets, clumping for 19 MoAbs was blocked
      by metabolic inhibitors, indicating that these induce platelet activation.
      Fifteen MoAbs were of IgG1, two of IgG2a, and two of IgG2b subtype. F(ab')2
      fragments of these did not evoke an aggregatory response, but specifically
      inhibited aggregations by and binding of their respective intact MoAbs to
      platelets. Single-platelet counting technology indicated that the MoAbs bind
      through their antigen-binding and Fc domains mainly to the surface of the same
      platelet, rather than cause interplatelet-binding. Despite these similarities,
      the mechanism of action was nevertheless subtype-dependent. Aggregation induced
      by all IgG1 antibodies could consistently be prevented by blocking the Fc gamma
      II-receptor, whereas aggregations induced by all IgG2 antibodies still occurred
      with blocked Fc-receptor, provided functional complement was present. We
      therefore conclude that platelet activation by MoAb-binding is initiated by
      antigen recognition followed by an Fc domain-dependent step, which involves the
      Fc gamma II-receptor for IgG1-type MoAbs and complement-binding for IgG2-type
      MoAbs. Thus, antibodies of different subtypes can aggregate platelets via
      different pathways.

PMID- 8461466
TI  - Protein S deficiency in men with long-term human immunodeficiency virus
      infection.
AB  - Decreases in protein S levels have recently been reported in some human
      immunodeficiency virus (HIV)-infected patients. To examine predisposing factors,
      25 men randomly selected from a long-term study of HIV-infected patients were
      studied. The minimum mean duration of HIV seropositivity in this group was 106.6
      months (range 15 to 143 months). No patients were anticoagulated at the time of
      the study. Three of the 25 randomly selected patients gave a history of
      thrombosis, in each instance occurring after the onset of HIV positivity. Two of
      the 3 patients with thrombosis had more than one episode. Coagulation studies
      showed that 3 of 3 (100%) of the patients with thrombosis and 16 of 22 (72.7%) of
      those without previous thrombosis had decreased free protein S. Mean-free and
      total protein S levels were statistically lower for HIV-infected patients with
      and without previous thrombosis compared with healthy male controls. C4b-binding
      protein was not increased in study patients with decreased protein S levels.
      Decreases in protein S levels did not correlate with CD4+ cell levels, CDC class,
      p24 antigen positivity, zidovudine (AZT) use, or Pneumocystis carinii
      prophylaxis. The duration of disease statistically correlated with decreases in
      protein S levels (r = .37, P < .05). A linear correlation existed between
      increasing IgG anticardiolipin antibody levels and decreasing free protein S
      antigen (r = .67, P < .005). This study shows that protein S deficiency is common
      in long-term HIV-infected patients and is caused by a decrease in the free
      protein, rather than by changes in the bound complex. The data suggest that
      protein S deficiency is not correlated with HIV disease severity but may
      predispose patients to thromboembolic complications.

PMID- 8461467
TI  - Complement and virus-specific antibody-dependent infection of normal B
      lymphocytes by human immunodeficiency virus type 1.
AB  - We tested the susceptibility of human purified, normal B lymphocytes to human
      immunodeficiency virus type 1 (HIV-1) infection, in the presence or absence of
      complement-sufficient serum and of virus-specific antibodies. Virus replication
      was detected when cells were infected in the presence of both complement and anti
      HIV antibodies (C'-ADE conditions), by day 2 postinfection. Similar results were
      obtained when B lymphocytes were purified either from peripheral blood (three
      healthy donors) or from tonsils (four individuals with chronic tonsillitis). HIV
      infection was shown by polymerase chain reaction (PCR) detection of proviral
      sequences (gag and pol genes), by p24 antigen synthesis, and by cocultivation
      assay with MT2 cells. The higher p24 production was obtained when B cells were
      preactivated for 2 days by phorbol 12-myristate 13-acetate (PMA) before infection
      and then cultured in the presence of low-molecular weight B-cell growth factor
      (LMW-BCGF). Expression of virus envelope glycoprotein (gp) 120 could also be
      detected on a subpopulation of B cells (CD19+, CD22+) by flow cytometry. Blocking
      experiments with monoclonal antibodies (MoAbs) against CD4, CD21 (complement
      receptor 2 [CR2]), CD35 (CR1), CD19, and CD5 surface molecules indicated that
      infection of B cells involves CD4, CD21, and CD35 antigens. Indeed, blocking of
      CD4 receptor inhibited 10% of p24 production, and blocking of both CD21 and CD35
      led to extinction of p24 signal. CR-dependent pathway is thus a major route for
      C'-ADE of HIV infection in normal B cells. Our results emphasize the importance
      of studying interactions between HIV and the complement system for better
      understanding infection mechanisms and the major dysfunctions of B cells in HIV
      infected individuals.

PMID- 8461468
TI  - Enrichment of interleukin-2-responsive natural killer progenitors in human bone
      marrow.
AB  - Natural killer (NK) cells can be cultured in interleukin-2 (IL-2)-containing
      medium from selected human bone marrow (BM) cells obtained after the elimination
      of mature T and NK cells. To isolate and characterize IL-2-responsive NK
      progenitors in the selected BM cells, we investigated the expression of IL-2
      receptors (IL-2R) on these cells. Neither CD25 (IL-2R alpha) nor IL-2R beta
      antigen was observed on the selected BM cells before culture. However, CD25+
      cells without detectable levels of IL-2R beta antigen appeared 24 hours after
      culture in IL-2-containing medium. Cells were sorted from each fraction of the
      selected BM cells 24 hours after culture after staining with anti-CD33, anti
      CD34, and anti-CD25 monoclonal antibodies. The generation of NK cells (CD3- CD56+
      cells) and NK activity were observed only from the CD33-/CD34-/CD25+ cell
      fraction after culture in IL-2-containing medium. The frequency of IL-2
      responsive NK progenitors relative to the fraction was 1/231 (95% confidence
      range, 1/156 to 1/289), which corresponded to the frequency relative to the total
      number of selected BM cells when the frequency relative to the CD33-/CD34-/CD25+
      cell-fraction was converted according to the percentage of these cells in the
      total number of selected BM cells. These results indicated that IL-2-responsive
      NK progenitors were enriched in the CD33-/CD34-/CD25+ cell fraction.

PMID- 8461469
TI  - Mechanism of the chromosomal translocation t(14;18) in lymphoma: detection of a
      45-Kd breakpoint binding protein.
AB  - The translocation t(14;18) between the BCL-2 oncogene and the Ig heavy chain
      (IgH) gene provides the molecular basis for the development of follicular
      lymphomas. The illegitimate recombination occurs in early B cells. While V(D)J
      recombinase is most likely involved on the chromosome 14 part, little is known
      about the mechanism of breakage on chromosome 18. We investigated the BCL-2
      breakpoint regions for their structural vulnerability and protein binding
      capacity. We found that the major breakpoint region (mbr) contains an S1 nuclease
      sensitive site and is the target of an endogenous nuclease present in early B
      cells. A 45 Kd nuclear protein (bp45) from early B cell extracts binds to a
      homopurine-homopyrimidine stretch (GGGAGGACGGGAGGAAGGCG) in the mbr, which is
      homologous to a recombinatorial element in Escherichia coli (CHI). The protein
      also binds to homologous sequences in the minor breakpoint cluster region (mcr)
      and in the IgH locus. The localization of the binding sites on both chromosomes
      as well as the tissue distribution of bp45 suggest that this protein-DNA
      interaction is involved in the translocation t(14;18). The DNA binding motif is
      also present at other translocation breakpoints indicating a more general role
      for this mechanism.

PMID- 8461470
TI  - Induction of monocytic differentiation and tumorigenicity by v-Ha-ras in
      differentiation arrested hematopoietic cells.
AB  - Activated ras genes are often associated with human myeloid leukemias with a
      monocytic differentiated phenotype. To investigate the role of the activated ras
      gene in leukemogenesis, a myeloid nontumorigenic cell line (FDC-P1) was infected
      with a selectable retroviral vector carrying the v-Ha-ras gene (H1neo). Infected
      FDC-P1 cells were not only tumorigenic, but also showed increased monocytic
      differentiation in vitro. Monocytic differentiation and tumorigenicity in vivo
      were correlated with several-fold increased levels of activated ras gene
      expression. Tumorigenic cells were arrested with respect to monocytic marker
      expression at a much later stage of macrophage differentiation than the parental
      noninfected FDC-P1 cells. These data thus suggest a model of how activated ras
      genes could be involved in the preferential induction of hematopoietic
      malignancies with a myelomonocytic phenotype.

PMID- 8461471
TI  - Myeloid but not lymphoid cells carry the 5q deletion: polymerase chain reaction
      analysis of loss of heterozygosity using mini-repeat sequences on highly purified
      cell fractions.
AB  - Interstitial deletions of the long arm of chromosome 5 are among the most
      characteristic abnormalities observed in myeloid disorders. To assess the lineage
      involvement of peripheral blood cells from patients with a 5q--anomaly, purified
      neutrophils, monocytes, T lymphocytes, and B lymphocytes were analyzed for loss
      of heterozygosity using six different highly polymorphic mininucleotide and
      dinucleotide (CA) repeat sequences from the 5q31 to 5q33 region. Ten patients
      were screened by polymerase chain reaction (PCR) amplification and proved to be
      informative for at least one marker. Six patients showed a complete or partial
      disappearance of an allele in myeloid cells, whereas cells of lymphoid lineages
      exhibited full heterozygosity. The other patients displayed no allelic loss,
      indicating that the informative markers were located outside the deleted
      chromosomal segments. In addition, three female patients who were also
      polymorphic for the BstXI site in the PGK-1 gene were analyzed for the
      methylation status of this gene. Clonality of hematopoiesis, as determined by non
      random X-chromosome inactivation, followed the same cell pattern as the 5q
      specific allelic losses. In conclusion, using tumor-specific and clonal markers,
      we have demonstrated that the 5q- anomaly is restricted to cells of myeloid
      origin, leaving lymphoid cells unaffected.

PMID- 8461472
TI  - Dietary omega-3 fatty acids lower levels of platelet-derived growth factor mRNA
      in human mononuclear cells.
AB  - Platelet-derived growth factor (PDGF) is a potent mitogen thought to propagate
      atherosclerosis and other proliferative or inflammatory diseases. Some of these
      diseases are ameliorated in humans by ingestion of omega-3 fatty acids. We
      investigated mRNA expression of both PDGF-A and PDGF-B in quiescent peripheral
      blood mononuclear cells from healthy male volunteers. For this, a highly
      sensitive, quantitative polymerase chain reaction strategy (3n-PCR) was
      developed. In contrast to granulocytes, both PDGF-A and PDGF-B mRNAs are
      expressed in mononuclear cells. This expression occurs at a remarkably constant
      rate. Moreover, effects of 7 g/d of a 85% omega-3 fatty acid fish oil concentrate
      were investigated in a 6-week controlled, randomized, observer-blind study in 14
      human volunteers, 7 of whom served as controls. omega-3 Fatty acids increased in
      mononuclear cell phospholipids. We demonstrate for the first time that diet
      affects human gene regulation. Dietary omega-3 fatty acids downregulate gene
      expression of both PDGF-A (-66%), and PDGF-B (-70%). This may represent a novel
      mechanism for the antifibrotic and antiatherosclerotic action of omega-3 fatty
      acids.

PMID- 8461473
TI  - Allogeneic blood transfusion-induced enhancement of tumor growth: two animal
      models showing amelioration by leukodepletion and passive transfer using spleen
      cells.
AB  - Allogeneic blood transfusions have been reported to induce immunomodulation in
      recipients of blood products. While the mechanism(s) of this immunomodulatory
      effect is unknown, it has been suggested that this effect of allogeneic blood
      transfusions could adversely affect patients with a malignant disorder. These
      concerns have been supported by a number of nonrandomized, mainly retrospective,
      clinical studies which indicate that allogeneic blood transfusions can adversely
      affect prognosis following the surgical treatment of oncology patients. Recently,
      we have shown that allogeneic blood transfusions enhance primary tumor growth and
      increase metastatic pulmonary nodule formation in inbred mice. The tumor growth
      promoting activity of allogeneic blood transfusions was studied also using
      outbred rabbits. In this present study, we demonstrate that the tumor growth
      promoting effect of allogeneic blood transfusions is mediated by donor leukocytes
      and that this effect can be abolished by their removal before transfusion. We
      show also that the allogeneic blood transfusion tumor growth-promoting effect can
      be passively transferred to naive animals (both mice and rabbits) using spleen
      cells from allogeneically transfused animals. In these experiments, numbers of
      metastatic pulmonary nodules were significantly increased in both mice and
      rabbits that had received spleen cells from allogeneically transfused animals
      compared with those that had received spleen cells from syngeneically transfused
      animals, or from animals that had been transfused with leukodepleted allogeneic
      blood.

PMID- 8461474
TI  - Acquired immunodeficiency syndrome-associated non-Hodgkin's lymphomas and other
      malignancies in patients with hemophilia.
AB  - Non-Hodgkin's lymphoma (NHL) is the most common human immunodeficiency virus
      (HIV)-associated malignancy in hemophiliacs. We studied the incidence and
      clinicopathologic features of NHL in 3,041 hemophiliacs followed at 18 US
      Hemophilia Centers between 1978 and 1989. Of the 1,295 (56.6%) who were HIV(+),
      253 (19.5%) developed acquired immunodeficiency syndrome (AIDS), of whom 14
      (5.5%) developed NHL. Three NHL occurred in HIV(-) hemophiliacs, for a 36.5-fold
      greater risk in HIV(+) than HIV(-) hemophiliacs (P < .001). The NHL incidence
      rate was 29-fold greater than in the US population by Surveillance, Epidemiology,
      and End Results (SEER) estimates (P < .001). Between 0 and 4 lymphomas have been
      observed per year between 1978 and 1989. At presentation 13 (92.9%) of the HIV(+)
      NHL were extranodal. Ten were stage IV, 1 stage II, and 3 stage IE. Ten (71.4%)
      were high-grade, 3 (21.4%) intermediate-grade, and 1 (7.1%) was a low-grade B
      cell lymphoma. Epstein-Barr virus (EBV) DNA was detected in 36% by in situ
      hybridization, including one central nervous system (CNS) lymphoma. The mean CD4
      cell count at NHL diagnosis was 64/mm3, the mean latency from initial HIV
      infection was estimated to be 59 months, and the median survival was 7 months.
      The incidence of basal cell carcinoma in HIV(+) hemophiliacs was 18.3-fold
      greater than in HIV(-) hemophiliacs (P < .001) and 11.4-fold greater than in the
      US population (P < .001). In conclusion, incidence rates of NHL and basal cell
      carcinoma in HIV(+) hemophiliacs are significantly increased over rates in HIV(-)
      hemophiliacs and over rates in the US population. Clinicopathologic presentation
      of NHL in HIV(+) hemophiliacs is similar to that in HIV(+) homosexual men.

PMID- 8461475
TI  - Long-term follow-up of a phase III study of recombinant human granulocyte
      macrophage colony-stimulating factor after autologous bone marrow transplantation
      for lymphoid malignancies.
AB  - One hundred and twenty-eight patients with non-Hodgkin's lymphoma (NHL),
      Hodgkin's disease (HD), and acute lymphoblastic leukemia (ALL) previously
      reported from a phase III trial of rhGM-CSF or placebo following autologous bone
      marrow transplantation (ABMT) were investigated for the development of late
      toxicities. Median follow-up is 36 months. No apparent long-term deleterious
      effects on BM function were observed. Moreover, disease-free survival and overall
      survival were similar for patients on both treatment arms, arguing for the long
      term safety of recombinant human granulocyte macrophage-colony-stimulating factor
      (rhGM-CSF). The only factors predictive for both a high risk of relapse over time
      and mortality were having the diagnosis of ALL and/or undergoing ABMT in
      resistant relapse. We attempted to identify clinical variables before BM harvest,
      at the time of marrow infusion, or events within the first 100 days
      posttransplant, which might predict speed of neutrophil recovery in the setting
      of placebo or rhGM-CSF administration after ABMT. Only previous exposure to
      agents that deplete stem cells led to a significant delay in neutrophil recovery,
      suggesting their avoidance in patients who may undergo ABMT. Nevertheless, even
      those patients benefited from rhGM-CSF. For all patients, rhGM-CSF and agents
      that deplete stem cells were the strongest independent predictors for neutrophil
      engraftment. With the increasing use of newer hematopoietic growth factors both
      alone and in combination, long-term follow-up is essential to confirm the same
      safety that we report with rhGM-CSF.

PMID- 8461476
TI  - The role of HLA-DPB1 disparity in the development of acute graft-versus-host
      disease following unrelated donor marrow transplantation.
AB  - The role of HLA-DPB1 disparity in the development of acute graft-versus-host
      disease (GVHD) following unrelated donor (URD) marrow transplantation is unknown.
      We studied 129 patients who underwent marrow transplantation from HLA-A, -B, 
      DRB, and -DQB matched URDs to determine whether matching for HLA-DPB1 alleles
      significantly decreased the risk of developing acute GVHD. HLA-DPB1 alleles were
      determined by sequence-specific oligonucleotide hybridization and by the number
      of patient DPB1 alleles not shared by the donor scored. The Kaplan-Meier
      probability of developing grades II to IV acute GVHD was determined for patients
      incompatible for zero (group A), one (group B), or two (group C) DPB1 alleles. Of
      the 129 pairs, there was no recipient DPB1 incompatibility in 28 (22%), one DPB1
      mismatch in 72 (56%), and two DPB1 mismatches in 29 (22%). The probability of
      grades II to IV acute GVHD was 0.69 (0.50, 0.86) for group A, 0.83 (0.73, 0.91)
      for group B, and 0.72 (0.56, 0.87) for group C (P = .63). These results indicate
      that matching patients and unrelated donors for HLA-A, -B, -DRB, and -DQB does
      not predict for matching at DPB1. However, recipient incompatibility for DPB1
      alleles does not detectably influence the risk of acute GVHD. Therefore, HLA-DP
      disparity should not be used as an exclusion criterion for donor selection in
      unrelated marrow transplantation.

PMID- 8461477
TI  - Interleukin-1 administration before lethal irradiation and allogeneic bone marrow
      transplantation: early transient increase of peripheral granulocytes and
      successful engraftment with accelerated leukocyte, erythrocyte, and platelet
      recovery.
AB  - Administration of interleukin-1 beta (IL-1 beta) before a lethal irradiation with
      or without allogeneic bone marrow transplantation (BMT) protects greater than 90%
      of the irradiated mice. To approach the mechanisms responsible for the
      radioprotective effect of IL-1, we examined the effects of IL-1 pretreatment on
      engraftment and kinetics of peripheral blood, spleen, and marrow cell
      reconstitution after irradiation and BMT. Although the BMT was not necessary for
      the survival of the IL-1-pretreated lethally irradiated mice, allogeneic marrow
      did engraft in these mice as evaluated in the spleen and marrow 2 months after
      BMT. IL-1 pretreatment significantly accelerated hematopoietic recovery versus
      transplanted saline-treated controls with a pronounced enhancement of peripheral
      leukocyte, platelet, and erythrocyte recovery. Leukocyte recovery in IL-1
      pretreated mice was unique in that IL-1 first induced an early transient (maximum
      at day 7) increase of peripheral granulocytes before accelerating leukocyte
      recovery after day 11. IL-1 pretreatment also significantly enhanced marrow cell
      recovery after allogeneic BMT with an eightfold increase in marrow cellularity
      from day 4 to 11 versus control transplanted mice. When lethal irradiation was
      not followed by allogeneic BMT. IL-1 pretreatment also affected the peripheral
      reconstitution of leukocytes, platelets, and erythrocytes. Interestingly, in the
      absence of BMT, IL-1 also induced an early circulation of peripheral
      granulocytes. Overall, our data demonstrate that a single administration of IL-1
      before lethal irradiation and allogeneic BMT can induce an early transient
      increase of circulating granulocytes, followed by an accelerated multilineage
      recovery and long-term allogeneic engraftment.

PMID- 8461478
TI  - Experiences of the first 493 unrelated marrow donors in the National Marrow Donor
      Program.
AB  - More than 410,000 people participated in the National Marrow Donor Program (NMDP)
      as of October 1, 1991, and more than 850 volunteers had donated marrow. While the
      incidence of serious morbidity as a result of bone marrow donation is rare, the
      incidence of lesser complications and the long-term consequences of marrow
      donation are not known. To determine the incidence of donor complications and
      measure the recovery time of volunteer, unrelated marrow donors, we analyzed the
      results of surveys of the first 493 persons who donated marrow through the NMDP.
      The marrows were collected at 42 centers. The median age of the donors was 37.9
      years (range 19.1 to 55.6 years). The median volume of marrow collected was 1,050
      mL (range 180 to 2,983 mL). Autologous red blood cells were transfused to 89.8%
      (439) of donors but only 0.6% (3) of donors received allogeneic blood. Acute
      complications related to the collection procedure occurred in 5.9% of donors; but
      a serious complication, apnea during anesthesia, occurred in only one donor. When
      donors were questioned approximately 2 days following discharge from their
      hospitalization, most donors described symptoms related to the collection; 74.8%
      experienced tiredness, 67.8% experienced pain at the marrow collection site, and
      51.6% of the donors experienced low back pain. Donors were surveyed repeatedly
      until they felt that they had recovered completely. Mean recovery time was 15.8
      days; however, 42 (10%) donors felt that it took them > or = 30 days to recover
      fully. The duration of the marrow collection procedure and duration of anesthesia
      both positively correlated with donor pain and/or fatigue following the
      collection; but the duration of the collection procedure had the highest
      correlation with post-collection pain and fatigue. The volume of marrow collected
      per unit of donor weight was more weakly correlated with donor pain and/or
      fatigue than the anesthesia and collection times. When multivariate analysis was
      used to analyze the correlation between donor recovery time and these variables,
      only the duration of the collection was found to correlate significantly with
      donor recovery time (P = .001). This analysis demonstrates that marrow donation
      is well tolerated with few complications. To decrease further the incidence of
      donor discomfort and recovery time following donation, the duration of the
      collection procedure, and probably the duration of anesthesia, and the volume of
      marrow collected, should be kept to a minimum.

PMID- 8461479
TI  - Psychosocial effects of unrelated bone marrow donation: experiences of the
      National Marrow Donor Program.
AB  - In this study, we investigated the psychosocial effects of unrelated marrow
      donation. Survey questionnaires were administered pre-donation, shortly post
      donation, and 1 year post-donation to all donors through the National Marrow
      Donor Program over a 3-year period. Univariate, bivariate, and multivariate
      analyses were then performed. Donors were generally quite positive about the
      donation 1 year post-donation: 87% felt it was "very worthwhile" and 91% would be
      willing to donate again in the future. Marrow donors were more likely than kidney
      donors to feel better about themselves as a result of the donation (P < .001).
      Donors with longer collection times, in general, had less positive psychosocial
      outcomes from the donation. Donors who experienced lower back pain or difficulty
      walking as a result of the donation were more likely to experience the donation
      as more stressful and painful than expected, but no more likely to experience it
      as less positive emotionally than donors who did not experience these side
      effects.

PMID- 8461480
TI  - Autologous bone marrow transplantation for non-Hodgkin's lymphoma in first
      remission.

PMID- 8461481
TI  - Selection of patients with aggressive lymphoma in remission candidates to
      autologous bone marrow transplantation.

PMID- 8461482
TI  - Oral iron chelator L1 and autoimmunity.

PMID- 8461483
TI  - The repeated sequence (AT)x(T)y upstream to the beta-globin gene is a simple
      polymorphism.

PMID- 8461484
TI  - Immunophenotypic features of t(8;21) (q22;q22) acute myeloid leukemia in adults.

PMID- 8461485
TI  - Interleukin-3 enhances the endogenous leukotriene production.

PMID- 8461486
TI  - Chronic stress from the Goiania 137Cs radiation accident.
AB  - At the invitation of the Brazilian government, the authors conducted a
      multidisciplinary field study in Goiania, Brazil, 3 1/2 years after an accident
      involving 137Cs, a radioactive cesium isotope. They compared subjects exposed to
      low levels of ionizing radiation, subjects who experienced anticipatory stress
      from fear of radiation exposure, and a nonirradiated control group. Results
      indicated the presence of chronic stress, as measured by psychological,
      behavioral, and neuroendocrine indices, in subjects who were exposed as well as
      in subjects fearful of potential radiation exposure. Anticipatory stress
      associated with potential exposure to ionizing radiation resulted in a level of
      stress similar to that from actual exposure to ionizing radiation. These findings
      have implications for past and future radiation accidents.

PMID- 8461487
TI  - Coping with recent life events: the interplay of personal and collective
      resources.
AB  - The importance of personal and collective resources in coping with recent life
      events was studied among 230 kibbutz members. The sense of coherence, a global
      life orientation that detects the ability to avoid stressors and to choose
      appropriate coping strategies and resources, represented personal resources.
      Collective resources, embedded in the social system to which one belongs, were
      measured by membership in a religious kibbutz, the kibbutz being viewed as a
      powerful, collective-coping resource by itself. Physical well-being,
      psychological distress, and functional limitations were used as outcome measures.
      Both types of resources have a salutogenic effect, but sense of coherence appears
      to be a better resource for avoiding the effect of recent life events and for
      moderating psychological distress and functional limitation after experiencing
      such events. The two types of resources have no additive effect, nor do they
      compensate for each other. Only one significant interaction was found, suggesting
      that the combination of the two resources is useful in avoiding functional
      limitation. It is also suggested that collective resources have a slight positive
      effect on personal resources, which, in turn, take over and become most valuable
      in coping with recent life events. When stress affects social functioning, these
      same personal resources facilitate the mobilization of whatever collective
      resources are available.

PMID- 8461488
TI  - The effect of psychiatric disorders on weight loss in obesity clinic patients.
AB  - Research on psychiatric disorders in obesity has indicated that obese people are
      not psychiatrically different from nonobese people. Few studies, however, have
      addressed the potential impact of psychopathology on weight control. In the
      present study, a consecutive sample of 37 patients presenting to a major
      metropolitan weight control unit were given structured diagnostic interviews
      (Structured Clinical Interviews for Diagnosis I and II). These patients completed
      one of two 12-week diet programs involving either behavior modification or liquid
      protein diets. After 12 weeks of a liquid protein formula diet, patients with no
      personality disorder lost significantly more weight than personality disordered
      patients; personality disordered patients on a behavioral diet tended (p < .15)
      to lose more weight during a 12-week diet than the patients without personality
      disorders. These data suggest that there are differential responses to liquid
      protein and behavioral diets, depending on the presence or absence of a
      personality disorder.

PMID- 8461489
TI  - Medical students' differential use of coping strategies as a function of stressor
      type, year of training, and gender.
AB  - The cognitive-transactional model of stress was used to study the process by
      which medical students cope with stress. The study examined the coping responses
      employed by male and female first- and fourth-year medical students as a function
      of those situations they appraised as most stressful. Multivariate analyses of
      variance (MANOVAs) revealed that preferred coping strategies varied by stressor
      type and year of training. In dealing with medical-school-related stressors,
      first-year students used self-blame and problem-solving styles of coping more
      than did fourth-year students. When dealing with interpersonal stressors,
      however, fourth-year students tended to use confrontive coping more than did
      first-year students. Surprisingly, whether the student was a man or a woman had
      no impact on coping responses. The findings underscored the importance of the
      moderating impact of the appraisal process on the coping strategies employed to
      manage stressful situations. Implications for medical education, as well as for
      future research on coping with stress, are discussed.

PMID- 8461490
TI  - The effects of task demand and decision latitude on cardiovascular reactivity to
      stress.
AB  - This study investigated the effects of task demand (absence or presence of time
      pressure) and decision latitude (choice or no choice over a task) on
      cardiovascular and affective responses to stressful tasks among 70 college
      students. Subjects also rated whether they felt under pressure and the extent to
      which they felt in control. Time pressure was related to elevated systolic blood
      pressure (SBP) responses among men and increased negative affect for both sexes.
      Lack of choice over the task also resulted in increased negative affect in both
      sexes. The least stressful condition--having a choice in the absence of time
      pressure--resulted in reduced negative affect. In addition to the effects of
      manipulated decision latitude and demand, perceptions of being in control were
      associated with reduced SBP among women who had a choice. Perceived control also
      contributed to reduced negative affect among men. These results suggest that the
      postulated negative effects of high demand and low decision latitude (ie, job
      strain) on cardiovascular health may be mediated in part by increased
      cardiovascular reactivity and negative affect.

PMID- 8461491
TI  - The challenge of calcific aortitis.
AB  - Coronary bypass and valvular operations have become more prevalent as the
      nation's elderly population grew 21% within the last decade. Ascending aortic
      calcification was a manifestation of this aging process. Aortic cannulation
      appeared impossible. Postoperatively, the stroke rate reached 14%, and the number
      of unexpected deaths rose sharply. Embolization of calcific and arteriosclerotic
      debris to cerebral and coronary vessels is believed to be the cause. The sharp,
      beveled, and narrowed jet-forming tips assaulted the delicate and soft intima of
      the artery. Nineteen cases of severely calcified aorta with increased predictable
      risk factors were operated on within the past 5 years. There were 12 coronary
      bypass grafts, 4 ventricular aneurysmectomies, and 3 valve replacements. Five of
      these cases were redo operations. The average age for these patients was 73.7
      years. With the availability of the cannula introducer, we were able to find a
      small soft spot inside the arch or ascending aorta and cannulate these patients.
      We began to cool the patients down immediately and chose one of the three
      available methods for cardiac arrest. By changing the angle of application and
      direction of the axis of the clamp, we could cross-clamp the aorta loosely in 11
      patients and administer cardioplegia. Intraluminal balloon occlusion of the
      ascending aorta was used once. The remainder of the cases had fibrillatory
      arrest. All proximal anastomoses in the coronary patients were done while on
      cross-clamp, intraluminal balloon occlusion, or brief periods of circulatory
      arrest. All sutures were passed from inside the aorta to avoid displacing or
      dissecting calcified plaques.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461492
TI  - Surgical treatment of Wolff-Parkinson-White syndrome: epicardial approach without
      the use of cardiopulmonary bypass.
AB  - Epicardial dissection without the use of cardiopulmonary bypass (CPB) was
      performed in 88 patients (56 males and 32 females, mean age 31.9 years). With
      intraoperative epicardial mapping, 101 accessory pathways were detected, with
      multiple pathways in 11 patients. CPB was avoided in all but one patient due to
      frequent onset of atrial fibrillation with rapid ventricular rate. Surgical
      ablation was successful in 86 patients (97.6%). Three patients required multiple
      surgical procedures because of persistence of conduction along a component of the
      original pathway. All but two patients were discharged without antiarrhythmic
      medication; these two patients were given quinidine therapy because of atrial
      fibrillation, but had normal early and late electrophysiological studies.
      Surgical ablation of Kent bundles by the epicardial approach for the treatment of
      Wolff-Parkinson-White syndrome can be achieved without the use of CPB. Optimal
      and steady exposure of the area are mandatory for the procedure, and dissection
      is eased by avoidance of heparin required for CPB.

PMID- 8461493
TI  - Mitral valve replacement in the presence of severe valvular and annular
      calcification.
AB  - Degenerative and rheumatic mitral valve disease are associated with calcification
      of the annulus, leaflets, and subvalvular mechanism. Surgical treatment is
      greatly affected by the presence of such calcification, which frequently
      precludes successful repair, mandating valve replacement. Dense calcification of
      the posterior leaflet, annulus, and chordae can cause great difficulty in the
      insertion of a prosthetic device, and is associated with a high frequency of
      technical complications. We have devised a technique of replacing the mitral
      valve in the face of such severe calcification, which allows the surgeon to
      safely insert a single disc mechanical prosthetic valve, avoiding the
      calcification completely. A large Teflon felt collar precludes the need to place
      any sutures through the posterior valve leaflet. Successful early experience with
      five patients, exhibiting both degenerative and rheumatic disease, is described.

PMID- 8461494
TI  - Intra-arterial aortoinfundibuloplasty: hemodynamic and anatomical study of a new
      method for the enlargement of a small aortic annulus.
AB  - A new method for prosthetic valve replacement in a small aortic annulus is
      described. An anatomical examination showed that the intra-arterial approach via
      the main pulmonary artery made it feasible to incise the aortopulmonary septum at
      the middle point of both coronary ostia and also to relieve left ventricular
      outflow tract obstruction with a two-dimensional patch. The pressure study in
      three mongrel dogs demonstrated that 6-mm augmentation of the host aortic annulus
      with this procedure made no significant difference in the pressure gradient
      between the right ventricle and the main pulmonary artery before and after
      operation. The right ventricular end-diastolic pressure did not show any
      significant change with respect to hemodynamics. It is expected from these
      results that our procedure could be used for the treatment of various types of
      left ventricular outflow tract stenosis without affecting the hemodynamics and,
      especially, right ventricular function.

PMID- 8461495
TI  - The surgical anatomy of ventricular septal defects associated with overriding
      valvar orifices.
AB  - This is the second review in a three-part series concerned with the description
      and categorization of ventricular septal defects. By viewing the defects from the
      right ventricular aspect, they can be placed into one of three classes:
      perimembranous, muscular, or doubly committed and juxta-arterial. According to
      the posteroinferior margin of the third group, these could extend to become
      perimembranous or muscular. In this review, the complications produced by
      malalignment of the septal structures associated with overriding of an arterial
      or atrioventricular valve are described in detail. It shows that although there
      are problems in defining the extent of any interventricular communication, these
      ventricular septal defects can be classified with the same categorization as
      developed for those not associated with overriding. The nosology developed is
      able to serve as a guide to the surgeon to the site of the specialized axis for
      atrioventricular conduction.

PMID- 8461496
TI  - Resection of infected ventricular aneurysm (Salmonella) following septic saddle
      embolus.
AB  - Bacterial infection (Salmonella enteritidis) of left ventricular true and false
      aneurysm in a 62-year-old man was followed by septic saddle embolus. The septic
      saddle embolus was removed and the aneurysm was later resected with coronary
      bypass grafting. The patient is alive with satisfactory function over 5 years
      postoperatively.

PMID- 8461497
TI  - Management of absent pulmonary valve syndrome with patent ductus arteriosus.
AB  - The etiology of absent pulmonary valve syndrome is unknown. Several theories have
      been advanced to explain the associated findings of a rudimentary pulmonary
      valve, ventricular septal defect, aneurysmal pulmonary arteries, and absence of
      the ductus arteriosus. The patient presented here would contradict these
      currently held theories. A review of the literature follows the case report.

PMID- 8461498
TI  - Electrophysiological consequences of hypothermic hyperkalemic elective cardiac
      arrest.
AB  - While the development of pharmacological cardioplegic solutions for myocardial
      protection during cardiopulmonary bypass (CPB) have significantly lengthened the
      safe operating time for cardiac surgical procedures, the introduction of
      hypothermic hyperkalemic cardioplegia (CPG) has markedly increased the incidence
      of postoperative arrhythmias and conduction abnormalities. Using a customized
      modification of a computerized mapping system, we have developed a large animal
      porcine model of CPB that is exquisitely sensitive to the electrophysiological
      (EP) derangements imposed by ischemia and cardiac arrest. This model is able to
      measure spatial and temporal parameters of ventricular activation with high
      resolution, using an array of up to 84 epicardial electrodes that can be
      reproducibly placed on the surface of the heart utilizing known epicardial
      anatomical markers (e.g., coronary arteries). With this system we have measured
      the spectrum of clinically observed EP disturbances caused by CPG, from slowed
      intraventricular conduction to complete heart block. Compared to the control
      group of hypothermia alone, 2 hours of crystalloid CPG arrest had a significant
      slowing effect on ventricular activation (p < 0.05). CPG was accompanied, in each
      animal, by profound changes in the spatial distribution of ventricular activation
      and persistent slowing of ventricular activation. Traditional EP parameters of
      effective refractory period and pacing threshold were unchanged by CPG. Smaller
      temporal and spatial changes were observed in the control group, but were always
      reversed by 90 minutes of warm reperfusion. We conclude that CPG induces injury
      of the specialized conducting system and, to a lesser degree, the myocardium.
      This model will afford us the opportunity to test new methods of CPG to further
      improve myocardial preservation during CPB.

PMID- 8461499
TI  - Warm heart surgery: concept, concerns, and future course.
AB  - Hypothermia has been considered a prerequisite for decreasing oxygen consumption
      and providing myocardial protection. The decrease in myocardial oxygen
      consumption however, is more closely related to the state of electromechanical
      arrest than to hypothermia. The rationale for warm blood cardioplegia is based
      not only on electromechanical quiescence but equally on facilitation of O2
      delivery. This report outlines the basis for the concepts, the various concerns
      and the possible future directions of warm blood cardioplegia.

PMID- 8461500
TI  - Myocardial antioxidant defenses during cardiopulmonary bypass.
AB  - In 31 male patients undergoing coronary bypass surgery who underwent different
      periods of cardioplegic hypothermic arrest, the activities of glutathione
      peroxidase, glutathione reductase, glutathione transferase, copper/zinc
      containing and manganese-containing superoxide dismutases, and catalase were
      studied in the right atrial myocardium, before and 5 minutes after aortic cross
      clamping. The levels of thiobarbituric acid reactive substances (TBARS) and
      nonproteic thiol compounds (NP-SH) were also assessed. Prolonged ischemia
      followed by reperfusion induced activation of the major myocardial antioxidant
      enzymes with marked NP-SH depression and TBARS increase, despite cold crystalloid
      cardioplegic protection. These changes were significantly related to the duration
      of the ischemic arrest, suggesting: (1) that reperfusion free radical generation
      is dependent on the severity of the previous ischemic period; and (2) the
      occurrence of myocardial oxidative stress during cardiopulmonary bypass.

PMID- 8461501
TI  - Optimal electrical stimulation for latissimus dorsi muscle after cardiomyoplasty.
AB  - The aim of this study was to evaluate the functional state of latissimus dorsi
      muscle (LDM) during electrical stimulation following cardiomyoplasty. Both single
      pulses and bursts of impulses were used for electrical stimulation. In 15 dogs,
      studies were carried out for 2 months, while in 19 patients, the follow-up period
      after cardiomyoplasty was 10 +/- 3.1 months. The LDM was punctured by needle
      electrodes at various intervals following cardiomyoplasty, and the changes of the
      rheomyosignal (RMS) curve were registered on the "Reostim-06." During the follow
      up study, it was found that: (1) signal amplitude decreased 30%; (2) the
      contraction duration of LDM increased 38%; (3) the contraction velocity decreased
      43%; and (4) relaxation velocity decreased 61%. There is a correlation between
      LDM mechanical contractile force and RMS indices (r = 0.8). The RMS index was a
      function of the electrical burst duration and the number of impulses in the
      bursts. Thus, RMS parameters can characterize the functional state of LDM, and
      they may be used in designing a new generation of electromyostimulators for
      optimal LDM stimulation at different periods after cardiomyoplasty.

PMID- 8461502
TI  - Dynamic cardiomyoplasty as an effective therapy for dilated cardiomyopathy.
AB  - Nine male patients with dilated cardiomyopathy unresponsive to maximal medical
      therapy were submitted to dynamic cardiomyoplasty according to the technique
      described by Carpentier and Chachques, and preliminary postoperative results are
      reported. Seven patients were in New York Heart Association (NYHA) Class III and
      two were in intermittent Class IV. The mean age was 56 years (range 51 to 61
      years). Preoperative ejection fraction (EF) by multiple gated acquisition ranged
      from 14% to 28% (mean 20.7%). No additional surgery was performed.
      Transesophageal echocardiographic monitoring was used during surgery to guide the
      wrapping procedure. There was no operative mortality. There was one early death
      (1 month). One late death (sudden death) occurred 7 months after surgery despite
      significant clinical improvement. Follow-up ranges from 2 to 16 months. Six
      patients were submitted to hemodynamic evaluation from 4 to 6 months after
      surgery by transthoracic and transesophageal echo-Doppler assessment. Effective
      latissimus dorsi support was clearly documented in all patients by comparing
      postoperative basal hemodynamic values (Cardiomyostimulator [Medtronic, Inc.]
      switched off) and data obtained during assisted beats (EF increased from 19.4% +/
      8.6% to 32.6% +/- 13.8%, p = 0.043; and stroke volume increased from 51.6 +/-
      20.6 mL to 63.0 +/- 22.0 mL, p = 0.014). All patients who completed the
      latissimus dorsi training protocol were in NYHA Class I or II. A significant
      reduction in postoperative medical therapy was achieved in all patients. Our
      preliminary results confirm that the cardiomyoplasty procedure is to be
      considered a safe and valuable mean for treating selected patients with dilated
      cardiomyopathy refractory to maximal pharmacological treatment.

PMID- 8461503
TI  - Skeletal muscle ventricles with efferent valved homograft.
AB  - Skeletal muscle ventricles (SMVs) were constructed from the latissimus dorsi
      muscle in seven beagles. Following 3 weeks of vascular delay and 6 weeks of
      electrical conditioning, the SMVs were connected in series with the thoracic
      aorta using a valved aortic homograft for the efferent limb. The SMVs were
      stimulated to contract synchronously during diastole. Effective aortic diastolic
      counterpulsation was achieved in all dogs, with an average 24.2% +/- 15.3%
      improvement in diastolic pressure. In two animals surviving beyond 3 months,
      increase in SMV function was noted over time. Appropriate aortic homograft valve
      function was documented by echocardiogram. Acute reversible heart failure was
      induced with propranolol in one dog alive after 126 days. A 61.3% reduction in
      cardiac output and a 37.6% reduction in mean arterial blood pressure were
      achieved. During profound low cardiac output, SMV stimulation with 33 Hz and 50
      Hz improved cardiac output by 16.9% and 17.8%, improved the tension time index by
      14.9% and 16.1%, and improved the endocardial viability ratio by 34.1% and 34.1%,
      respectively. These results again demonstrate the long-term effectiveness of SMVs
      as aortic counterpulsators. A valve in the efferent limb of the SMV system
      functions appropriately over time and may improve the efficiency of the system.

PMID- 8461504
TI  - Myocardial stunning: an overview.
AB  - Over the past two decades, we have challenged the belief that transient ischemia
      is benign with little functional sequelae following resolution of ischemia. The
      phenomenon of prolonged postischemic contractile dysfunction, or of myocardial
      stunning, has been developed and is under investigation using multiple
      experimental and clinical models. Classifications of myocardial stunning have
      been suggested and include single and multiple reversible ischemic episodes,
      partially reversible episodes, and global ischemia. More challenging is the
      understanding of the mechanisms of myocardial stunning, including free radical
      protection, excitation-contraction uncoupling, altered calcium flux,
      microvascular dysfunction, and impaired energy production and use. Finally,
      advances have been made in the clinical arena, including development of new more
      sensitive technologies to detect dysfunction, and development of potentially
      important therapies, including free radical scavengers, adenosine-regulating
      agents, and calcium channel blockers. In this brief overview, we focus on
      myocardial stunning, including a historical perspective of coronary occlusion,
      and definition, classification, and clinical implications of myocardial stunning.

PMID- 8461505
TI  - Protean causes of myocardial stunning in infants and adults.
AB  - Myocardial stunning can follow regional or global ischemia in the adult or
      immature heart. This report reviews some of our studies of the protean causes of
      stunning including energy and substrate depletion, inefficient oxygen
      utilization, calcium loading, acidosis, oxyradical damage, and summarizes studies
      and strategies to limit its occurrence. Data showing that reintroduction of
      molecular oxygen during reoxygenation of immature cyanotic hearts can cause
      stunning via a newly described biochemical pathway involving superoxide anion and
      nitric oxide are also included.

PMID- 8461506
TI  - Clinical evidence of myocardial stunning in patients undergoing CABG surgery.
AB  - Although patients who have undergone coronary artery bypass graft (CABG) surgery
      frequently present with symptoms suggesting that myocardial stunning has
      occurred, measurements of regional myocardial function and perfusion are
      difficult in clinical settings. Several studies have used left ventricular
      function indices (i.e., cardiac index, left ventricular stroke work index,
      ejection fraction) to assess myocardial stunning immediately following CABG
      surgery. These changes in ventricular function have been found to be reversible
      and the clinical data are consistent with the occurrence of myocardial stunning.
      Myocardial metabolism is also reportedly depressed following CABG surgery.
      Decreases in myocardial oxygen extraction, consumption, and lactate utilization
      all point to the presence of myocardial stunning, as do abnormalities in regional
      wall-motion and electrocardiographic changes (i.e., transient Q waves) described
      in patients who have undergone CABG surgery. New approaches to differentiating
      viable from nonviable myocardial tissue will likely include stress
      echocardiography using new stress agents, ultrasound contrast agents, and high
      frequency ultrasound.

PMID- 8461507
TI  - Identifying stunned myocardium during cardiac surgery: the role of myocardial
      contrast echocardiography.
AB  - Differentiation of reversibly stunned myocardium from irreversibly damaged
      (infarcted) myocardium is critically important in patient management. Current
      methods for monitoring myocardial function yield only nonspecific assessments of
      myocardial viability. On the other hand, myocardial contrast echocardiography
      (MCE) can be used to evaluate the extent of myocardial perfusion as well as the
      efficacy of myocardial protection in patients undergoing coronary artery bypass
      graft (CABG). This system includes an external ultrasound unit and an internal
      tracer, usually gaseous microbubbles, which reflect the ultrasonic beam. Previous
      studies have shown that myocardial risk areas identified with MCE correlate with
      areas defined by technetium autoradiography and infarction size. We have used MCE
      to evaluate coronary artery bypass patients (N = 21) with regard to myocardial
      function and cardioplegia perfusion patterns. A significant correlation (p <
      0.01) was found between abnormal contrast enhanced cardioplegia patterns and
      depression of left ventricular function. Refinements to ultrasound technology and
      contrast agents will further enhance the diagnostic power of MCE for the
      quantification of myocardial blood flow.

PMID- 8461508
TI  - The effect of prophylactic nitroglycerin infusion on the incidence of regional
      wall-motion abnormalities and ST segment changes in patients undergoing coronary
      artery bypass surgery.
AB  - The effects of nitroglycerin (NTG) on regional wall-motion abnormalities, ST
      segment changes, and the incidence of myocardial infarction (MI), cardiac
      failure, and mortality were studied in 30 patients undergoing coronary artery
      bypass. Patients received continuous infusions of either normal saline or NTG (1
      microgram/kg per min [low dose] or 2 micrograms/kg per min [high dose]) beginning
      at anesthesia and continuing for 4 hours postoperatively. The occurrence of wall
      motion abnormalities as detected by transesophageal echocardiography was 38
      events in the normal saline group (N = 10). Significantly fewer events (p < 0.05)
      were recorded in the low dose and high dose NTG groups (20 events and 15 events,
      respectively) compared to controls. There were no significant differences between
      the control and NTG groups with regard to the incidence of Holter ST segment
      events or the incidence of MI, cardiac failure, or cardiac death. NTG reduced the
      incidence of echocardiographic wall-motion abnormalities in a dose dependent
      manner while having no significant effect on other parameters examined.

PMID- 8461509
TI  - Clinical markers and clinical consequences of stunned myocardium.
AB  - Clinical markers must be identified to distinguish between stunned and acutely
      ischemic myocardial tissue, as well as to assess the viability of myocardium.
      Evaluation of electrocardiographic ST segment abnormalities can distinguish
      transmural oxygen deprivation from subendocardial oxygen declines, but stunned
      myocardium may have normal ST segments. Myocardial contrast echocardiography can
      estimate regional myocardial blood flow but ultrasound measurement of blood flow
      is not always able to discern stunned from nonviable myocardium. Change in
      extracellular pH has been used to study ischemia, but has not yet been shown to
      reflect differences between stunned and ischemic myocardium. A combination of
      clinical markers of flow, delivery, and oxygen consumption may be necessary in
      order to differentiate between stunned and ischemic regions. This distinction can
      have important therapeutic consequences because patients with acutely ischemic
      but viable myocardium may be ultimately harmed by inotropic drugs that increase
      myocardial oxygen demand. In contrast, inotropes may be indicated for stunned
      myocardial tissue. The determination of the reversibility of myocardial
      dysfunction can also impact on decisions to use mechanical cardiocirculatory
      support. Differentiation of stunned and ischemic myocardium might also streamline
      ICU assignments and lead to more effective use of high technology resources.

PMID- 8461510
TI  - Is post cardiopulmonary bypass dysfunction a special form of stunning?
AB  - It has been suggested that cardioplegic arrest during cardiopulmonary bypass
      (CPB) produces global myocardial ischemia with a risk of myocardial stunning. It
      has also been postulated that anesthetic technique may affect the course of post
      CPB myocardial stunning via exaggerated myocardial depression. However, we have
      previously found that global ventricular and regional myocardial responses to
      halothane do not differ in post-CPB and pre-CPB dogs. Our examination of the
      effects of CPB on the beta-adrenergic function revealed that beta-adrenergic
      receptor function is only slightly decreased immediately following (i.e., 1 min)
      and 30 minutes post-CPB. A dose-response relationship was established for
      dobutamine, with decreased responsiveness noted at both times. Since other data
      show normal inotropic stimulation of stunned myocardium, decreases in dobutamine
      responsiveness cannot be explained by beta-receptor desensitization. Overall,
      these data indicate that CPB does not result in myocardial stunning. The
      differences between these data and others showing myocardial stunning following
      CPB may be due to several factors, such as anesthetic regimen, lack of coronary
      blood flow abnormalities, and a reduction in sarcoplasmic reticular damage due to
      the hypothermic conditions used.

PMID- 8461511
TI  - Can myocardial stunning contribute to myocardial infarction during coronary
      artery bypass surgery?
AB  - Myocardial stunning commonly occurs after cardiopulmonary bypass (CPB).
      Myocardial stunning can be cardioprotective under some conditions, but in other
      situations may actually contribute to myocardial infarction (MI). Vascular
      endothelial stunning may be one of the mechanisms by which myocardial stunning
      can cause MI. It has been found that 15 minutes of reversible ischemia is enough
      to cause elevations in vascular resistance and impairment of vasodilator
      responsiveness. However, no correlation between contractile dysfunction and
      microvascular stunning has been observed. Transduction defects (increased oxygen
      extraction and consumption despite normal regional oxygen blood flow and
      delivery) may be another mechanism by which stunning predisposes to MI,
      indicating uncoupling of substrate utilization from energy production. In
      addition, abnormalities in wall motion, oxygen free radical toxicity,
      hypotension, use of inotropic agents (leading to increased oxygen consumption,
      high heart rates, and arrhythmias) increase the risk of cellular necrosis.
      Following CPB, flow limitations due to diffuse atherosclerosis in some areas may
      result in poor contractility, and newly grafted areas have a high probability of
      becoming ischemic and stunned. These areas are likely to contribute to MI.

PMID- 8461512
TI  - Myocardial stunning after coronary bypass surgery.
AB  - At the Toronto Hospital, 2,510 patients received isolated coronary bypass grafts
      (CABG). Overall mortality was 2.3%, the incidence of low output syndrome (as
      defined by need for inotropic agents or intraaortic balloon pump) was 9.2%, and
      mortality among low output syndrome patients was 16%. We have attempted to
      identify factors that minimize cardiac injury. We have previously shown that free
      radical injury occurs during CABG: coronary blood contains increased levels of
      conjugated dienes after cross-clamp release; and, there is a reduction in the
      antioxidant, alpha-tocopherol. In vitro studies revealed that ascorbic acid and
      alpha-tocopherol protect cardiac myocytes, while endothelial cells are protected
      from free radical injury by superoxide dismutase and catalase. To test the former
      two antioxidants in vivo, we used left anterior descending artery (LAD) occlusion
      in the dog followed by 2 to 4 hours of reperfusion. When administered in
      deoxygenated saline at 30 seconds prior to reperfusion and 4 minutes after
      release of LAD occlusion, both agents significantly reduced the infarction area
      compared to simple reperfusion or deoxygenated saline alone. Antioxidants
      therefore have the potential to reduce the ischemic injury and myocardial
      stunning that accompany CABG.

PMID- 8461513
TI  - Does ventricular fibrillation cause myocardial stunning during defibrillator
      implantation?
AB  - Induction of ventricular fibrillation (VF) is an important part of the process of
      inserting implantable cardioverter defibrillators (ICDs), allowing the
      measurement of defibrillation thresholds. However, animal studies have revealed
      that repeated cycles of VF and defibrillation result in depressed left
      ventricular (LV) function and reduced cardiac output. Short intervals of VF do
      not affect myocardial contractility but longer periods produce heart failure.
      Induced VF was used in a canine model to study profound myocardial stunning
      leading to heart failure, as well as the therapeutic potential of the
      phosphodiesterase inhibitor, amrinone (combined with epinephrine and
      norepinephrine). Amrinone was found to significantly (p < 0.05) increase
      contractility when added to a stable preparation supported by epinephrine and
      norepinephrine infusion; amrinone or catecholamines alone had no effect. In the
      clinical setting, the following factors may affect LV contractility during ICD
      surgery: catecholamines released as a result of hypotension; negative VF;
      ischemia; antiarrhythmic drugs; anesthetics; and bradycardia after device
      testing. Patients (n = 125) have tolerated ICD insertion well. Early data reveals
      no significant changes in ejection fraction. Though rare, death due to myocardial
      stunning and LV power failure can occur during ICD insertion. It may be possible
      to use arterial pressure monitoring to predict this event in vulnerable patients.

PMID- 8461514
TI  - Myocardial stunning and preconditioning: age, species, and model related
      differences: role of AMP-5'-nucleotidase in myocardial injury and protection.
AB  - Mechanisms of myocardial stunning include myocardial adenosine triphosphate (ATP)
      depletion, catecholamine release, and oxygen free radical formation. Although the
      latter is the most widely supported mechanism, levels of 5'-nucleotidase (directs
      AMP dephosphorylation) are inversely related to functional recovery following
      ischemia and may also have a role in ischemic injury. Previous studies reveal
      that 5'-nucleotidase levels increase with age and also vary with species. An
      inhibitor of this enzyme (alpha, beta methylene adenosine 5'-diphosphate) was
      effective in maintaining AMP levels in vitro but was ineffective in dogs due to
      limited permeability. Observed species-specific differences in recovery from
      myocardial stunning may be related to differences in AMP accumulation and
      subsequent metabolism. Species showing improved recovery from stunning may
      accumulate AMP as a result of feedback inhibition of 5'-nucleotidase. Using a
      model of extreme experimentally-induced ischemia, we found that adenosine
      treatment allowed full recovery of ventricular function within 30 minutes,
      probably by entrapping ATP catabolites. Similarly, enhancement of adenosine
      production by N-diarylalkylpeprazine derivatives has also been shown to be
      cardioprotective in the setting of global normothermic ischemia. Novel strategies
      for pharmacological intervention in the ATP catabolic pathway should use animal
      models involving species that are tolerant to myocardial stunning.

PMID- 8461515
TI  - Metabolic correlates of myocardial stunning and the effect of cardiopulmonary
      bypass.
AB  - In order to study the metabolic consequences of myocardial stunning, repeated
      coronary occlusions were performed in dogs. The production of CO2, adenosine
      triphosphate (ATP), phosphocreatine (PCr), and inorganic phosphate (Pi) by
      myocardial cells was assessed, along with extracellular and intracellular pH. Our
      results indicate that regional coronary artery occlusion reduces the ability of
      the myocardium to produce H+ and CO2 and to replenish ATP post ischemia. These
      alterations, then, represent the hallmark of metabolic viability during periods
      of ischemic insult. Decreases in PCr and Pi were completely eliminated during
      reperfusion and, therefore, are ot reflective of myocardial stunning. When
      normothermic cardiopulmonary bypass (CPB) is instituted and the coronary artery
      is occluded three times with reperfusion between each occlusion, alterations in
      myocardial H+ and high energy phosphates are identical to those observed using
      only repetitive coronary occlusion. Systemic hypothermia during CPB does not
      protect against myocardial stunning; however, it is anticipated that
      interventions that prevent the reduction in H+ and ATP levels may overcome the
      effects of myocardial stunning that occur during cardiac surgery.

PMID- 8461516
TI  - Reversible postischemic ventricular dysfunction: biochemical insights.
AB  - Myocardial stunning, or reversible postischemic ventricular dysfunction, occurs
      clinically much more frequently than was originally assumed when this phenomenon
      was first described in experimental studies. Despite the fact that stunned
      myocardium may appear histologically normal and have a normal metabolic profile,
      ventricular contractility is severely impaired. In a number of studies using both
      global and regional stunning models, we have demonstrated impaired oxygen
      extraction and abnormal patterns of oxygen consumption. In addition, impaired
      calcium transport or uptake by the sarcoplasmic reticulum occurs and there is
      sarcolemmal disruption during stunning despite reversibility of the ischemic
      injury. Although oxygen free radical production is thought to occur only early
      during postischemic reflow, the use of oxygen radical scavengers in a model of
      regional stunning was shown to attenuate the ventricular dysfunction.

PMID- 8461517
TI  - Relationship of severity of myocardial stunning to ATP dependent potassium
      channel modulation.
AB  - Pharmacological modulation of ATP sensitive potassium channels (K+ATP channels)
      in vivo may influence ischemia and reperfusion injury of myocardium. The purpose
      of this investigation was to ascertain the actions of multiple K+ATP channel
      openers and interactions with a K+ATP channel antagonist in a model of stunned
      myocardium in anesthetized and conscious dogs. The results indicate that the
      K+ATP channel openers, aprikalim and nicorandil, enhance recovery of regional
      contractile function of stunned myocardium. This action was blocked by the
      selective K+ATP antagonist, glyburide. The beneficial effects of K+ATP channel
      openers were not related to changes in systemic hemodynamics or coronary
      collateral perfusion, but instead may be a manifestation of direct
      cardioprotective actions of these compounds.

PMID- 8461518
TI  - Cellular and subcellular aspects of myocardial stunning.
AB  - Possible mechanisms of myocardial stunning at the cellular level include oxygen
      free radical production, neutrophil-induced damage, accelerated degradation of
      adenosine triphosphate (ATP), ischemia-induced myofibrillar damage, and calcium
      overload due to abnormal sodium/calcium exchange. Although the role of free
      radicals is generally accepted, their source(s) and clinical importance remain
      controversial. Similarly, an association of a declining ATP pool with myocardial
      stunning is well established but may not have clinical relevance as treatments
      that result in functional recovery do not always increase ATP levels. Little
      evidence exists for a strong link between myofibril damage and myocardial
      stunning. In contrast to these mechanisms, altered calcium homeostasis is an
      attractive hypothesis because: normal hearts perfused with high levels of calcium
      develop contractile dysfunctions similar to stunning; stunned hearts perfused
      with low calcium have increased function; calcium overload inhibition attenuates
      stunning; and reduced calcium ATPase activities have been found in sarcoplasmic
      reticulum from stunned hearts. Future research efforts should strive to
      simultaneously evaluate flow, function, and metabolic changes that occur in the
      stunned heart. Changes in the latter may eventually be studied using the
      techniques of molecular biology, integrating knowledge at the molecular level
      with clinical needs.

PMID- 8461519
TI  - Models of myocardial stunning.
AB  - The use of animal models is a valuable approach to the elucidation of the
      pathophysiology of myocardial stunning. Coronary occlusion followed by
      reperfusion produces stunning experimentally, mimicking a myocardial infarction
      followed by thrombolysis, angioplasty, or coronary bypass. Timing of occlusion
      and duration to avoid necrosis is critically dependent on the animal species
      used. For example, 10 minutes of occlusion is required in pigs, 20 minutes in
      canine models, and sheep or rabbits may require ischemic times somewhere in
      between. Alternatively, two to six cycles of occlusion followed by reperfusion
      (repetitive occlusion) may be used. In addition, global ischemia with the heart
      vented and on cardiopulmonary bypass may simulate myocardial stunning. In this
      case, 30 minutes produces 50% reductions in myocardial contractility in dogs
      while 10 minutes is needed in pigs. Animal models have also included the study of
      a stunned heart in an in vitro apparatus. In these models, discontinuation of
      perfusion for 10 to 15 minutes is needed to produce stunning in rats, 20 minutes
      in rabbits, and probably longer periods in dogs and pigs. Myocyte cell cultures
      may also be valuable for studying responses to ischemia and reperfusion at the
      cellular level. It is generally agreed that cardioplegic protection,
      antioxidants, metabolic enhancements, and blockade of calcium overload are some
      of the strategies that can minimize or eliminate myocardial stunning.

PMID- 8461520
TI  - Coronary pressure-flow regulation in the stunned myocardium.
AB  - In this study, we used a swine model to study coronary autoregulation in the
      stunned myocardium. In 18 domestic swine, the left anterior descending coronary
      artery was cannulated and flow to this artery controlled via an extracorporeal
      perfusion circuit. Stunning was induced by reducing pump flow to approximately
      25% of the baseline value for 15 minutes followed by 1 hour of reperfusion. This
      ischemia/reperfusion protocol reduced systolic shortening to approximately 50% of
      control, at 1 hour of reperfusion. Neither the slope of the coronary pressure
      flow relation (0.41 +/- 0.19 vs 0.48 +/- 0.26 mL/100 g per min per mmHg) nor an
      autoregulation index (0.43 +/- 0.16 vs 0.30 +/- 0.32) was significantly changed
      at 1 hour reperfusion (p > 0.05) compared to baseline. These findings argue
      against the hypothesis that the mechanical dysfunction of the stunned myocardium
      is due to suboptimal perfusion caused by poor coronary autoregulation.

PMID- 8461522
TI  - Cytokines and reperfusion injury.
AB  - Myocardial dysfunction following prolonged ischemia and reperfusion is at least
      partially dependent upon adhesion of neutrophils to myocardial and endothelial
      cells. Neutrophils are thought to contribute to reperfusion injury by two
      mechanisms: impairment of the microvasculature by physical obstruction, and
      secretion of products that damage microvasculature and myocardium. Cytokines have
      been shown to play several roles in neutrophil aggregation. Interleukin-6 (IL-6),
      along with IL-1 and tumor necrosis factor-alpha (TNF-alpha), induces the
      expression of intracellular adhesion molecule-1 (ICAM-1) in myocytes and
      endothelial cells, respectively. These cytokines also inhibit contractility and
      nitric oxide release (a vasodilator), and IL-1 and TNF-alpha have been found to
      reduce adrenergic stimulation of myocardial contractility by reducing
      intracellular cyclic AMP levels and uncoupling adenylate cyclase from beta
      receptors. The transforming growth factors, TGF-alpha and TGF-beta, also have a
      role in reperfusion injury. TGF-alpha reduces endothelial cell release of nitric
      oxide, while TGF-beta appears to protect against reperfusion injury by reducing
      plasma TGF-alpha levels, blocking neutrophil adherence, and promoting nitric
      oxide release. Although cytokines are likely to have important roles in
      reperfusion injury, their involvement in myocardial stunning is unclear.

PMID- 8461521
TI  - Sarcoplasmic reticulum in globally stunned adult and newborn myocardium.
AB  - Dysfunctional sarcoplasmic reticulum (SR) is thought to be involved in the
      phenomenon of myocardial stunning. Adult (3 to 4 kg) and neonatal (5 to 7 day
      old) rabbit hearts were examined for structural SR alterations following ischemic
      damage and myocardial stunning induced by incubation in Ringer's lactate at 39
      degrees C. SR protein yield in neonate hearts (but not adult hearts)
      significantly decreased (p = 0.01) following 30 minutes of ischemia. In addition,
      calcium ATPase activity was reduced in both adult p = 0.006) and neonatal (p =
      0.02) ischemic hearts. Examination of SR proteins by gel electrophoresis
      indicated that the levels of several proteins were altered by ischemia. In adult
      hearts, decreased levels of proteins of 22.5, 31.5, 33, and 83 kilodaltons (kd)
      were observed. In newborn ischemic hearts, decreases in 29, 37.5, 82, and 83 kd
      proteins were detected. The quantitative changes in calcium ATPase levels and SR
      protein content may adversely affect myocardial excitation-contraction coupling
      and relaxation, contributing to dysfunction in myocardial stunning.

PMID- 8461523
TI  - Potential role of neutrophil anti-adhesion therapy in myocardial stunning,
      myocardial infarction, and organ dysfunction after cardiopulmonary bypass.
AB  - When activated neutrophils are recruited and bind to endothelial tissues, they
      release leukotrienes, proteolytic enzymes, and free radicals. The latter has been
      implicated in myocardial stunning following periods of ischemia and reperfusion,
      as may occur following cardiopulmonary bypass (CPB). The neutrophil surface
      complex CD11/CD18 promotes the neutrophil-endothelial adhesion process.
      Monoclonal antibodies have been developed that can block neutrophil adhesion to
      the endothelium by preventing CD11/CD18 binding to adhesion molecules (ICAM-1 or
      ELAM-1) located on endothelial cells. We used monoclonal IgG antibody 60.3 to
      block neutrophil adherence and thereby potentially reduce myocardial stunning.
      Pretreatment of rabbits subjected to myocardial ischemia/reperfusion with either
      monoclonal 60.3 or saline resulted in only a small increase in the rate of
      recovery of preload recruitable stroke work index during reperfusion. More severe
      occlusion may have been needed to see significant results. We also evaluated the
      effects of anti-neutrophil therapy in animal models of CPB. Rhesus monkeys were
      subjected to deep hypothermia and CPB, followed by 24 hours of fluid
      resuscitation. Animals receiving monoclonal 60.3 (N = 3) showed less weight gain,
      less infused resuscitative fluid, and higher terminal hematocrit and PaO2 than
      controls (N = 3). Antineutrophil therapy may prevent multiorgan system failure in
      certain high risk patients.

PMID- 8461524
TI  - Myocardial stunning and reperfusion injury in cardiac surgery.
AB  - This article reviews the evidence that myocardial stunning during surgical
      reperfusion after coronary revascularization or heart transplantation is not
      strictly due to myocardial injury sustained during ischemia, but results from
      pathophysiological events triggered by reperfusion (reperfusion injury). In
      sheep, left ventricular (LV) dP/dt and stroke work were reduced up to 50%, and
      60% to 70% necrosis was observed in the area at risk during 3 hours reperfusion
      following coronary occlusion and cardioplegic arrest on bypass. Reperfusion with
      leukocyte depleted blood, or pharmacological blockade of either thromboxane or
      leukotriene receptors, provided significant improvements in LV function and
      myocardial blood flow, with a 40% to 50% reduction in necrosis. Similar results
      have been obtained using animal heart subjected to 2 to 3 hours arrest at either
      4 degrees C or 15 degrees C, simulating cardiac preservation and reperfusion
      after transplantation. Diastolic pressure was significantly elevated, and
      increases in the time constant for relaxation of LV pressure and coronary
      vascular resistance were noted. These indices of myocardial stunning were
      reversed after blocking neutrophil-endothelial cell interaction with monoclonal
      antibodies against CD18 or ICAM-1 receptors, and significant improvements were
      also obtained after either thromboxane or leukotriene receptor blockade. We
      conclude that immediate postoperative myocardial stunning results largely from
      reperfusion injury that occurs due to an acute inflammatory response to ischemia
      and reperfusion, and that stunning can be largely reversed with appropriate
      pharmacological intervention.

PMID- 8461525
TI  - Do deficiencies of endothelial derived relaxing factor contribute to myocardial
      stunning?
AB  - Myocardial stunning is a phenomenon in which ventricular function is depressed by
      prior ischemia and remains suboptimal when blood flow is resumed. It is also
      characterized by coronary vascular endothelial dysfunction that is related to the
      duration of ischemia and can result in protein leakage, myocardial hemorrhage, or
      increased coronary vascular resistance. It is thought that local vascular tone is
      regulated by endothelium derived relaxing factor (EDRF), a compound commonly
      believed to be identical to nitric oxide (NO). EDRF increases the effects of
      other vasodilators through the formation of cyclic guanosine monophosphate (cGMP)
      by guanylate cyclase. Patients with various cardiovascular disorders have been
      found to have dysfunction in the EDRF system, and EDRF paradoxically produces
      vasoconstriction in atherosclerotic arteries. Similarly, EDRF stimulation of
      vasodilation due to acetylcholine, calcium ionophores, or platelets appears to be
      reduced in coronary arteries that have been damaged by ischemia and reperfusion.
      By increasing EDRF production or inhibiting its breakdown, EDRF precursors such
      as L-arginine, the superoxide radical scavenger superoxide dismutase,
      nitroglycerin, and nitroprusside all cause vasodilation by increasing NO levels
      in the setting of myocardial ischemia. These therapies may also improve local
      "microvascular" function, thereby improving ventricular function.

PMID- 8461526
TI  - Calcium and stunned myocardium.
AB  - Calcium administration during ischemia or at the onset of reperfusion is
      generally considered to be deleterious because cytosolic calcium is elevated at
      this time. In contrast, the administration of calcium antagonists before or
      during ischemia is protective. While calcium antagonists may not be beneficial
      when given after reperfusion, calcium administration during this period has been
      found to enhance the recovery of systolic and diastolic function of stunned
      myocardium.

PMID- 8461527
TI  - Adenosine and the stunned heart.
AB  - Adenosine is one agent under investigation as a therapeutic intervention of
      myocardial stunning. Adenosine caused numerous effects on the cardiovascular
      system through its interaction with A1 and A2 receptors. We investigated
      adenosine A1 receptor mediated mechanisms of cardiac protection in the stunned
      rat myocardium. Previous studies showed that both adenosine and R
      phenylisopropyladenosine (PIA), an A1 receptor agonist, prolonged the time to
      onset of ischemic contracture in ischemic isolated rat hearts.
      Phenylaminoadenosine, an A2 receptor agonist, did not have any effect, while
      receptor antagonists blocked adenosine and PIA action. Direct attenuation of the
      effects of myocardial stunning was observed by altering levels of interstitial
      fluid adenosine. Our laboratory has shown that administration of erythro-9(2
      hydroxy-3-nonyl) adenine (EHNA; an adenosine deaminase inhibitor) to dogs
      subjected to left anterior descending coronary artery (LAD) occlusion followed by
      reperfusion results in dramatic increases in ischemic levels of interstitial
      fluid adenosine and postischemic myocardial function. Using a similar model in
      dogs, we have shown that exogenous intracoronary adenosine (50 micrograms/kg per
      min) augmented postischemic recovery of function, as assessed by significant
      enhancement (p < 0.01) of systolic wall thickness (7.0 +/- 3.0 pretreatment vs 
      5.7 +/- 1.7 controls). These data support the role for an adenosine A1 receptor
      mediated mechanism for protection against myocardial stunning.

PMID- 8461528
TI  - Effects of triiodothyronine on stunned myocardium.
AB  - Administration of thyroid hormone, triiodothyronine (T3), causes numerous
      cardiovascular effects such as increases in stroke volume, cardiac output, heart
      rate, and myocardial contractility, and decreases in systemic vascular
      resistance. Along with other stressors, cardiopulmonary bypass (CPB) has been
      associated with reduced levels of T3. We examined the effects of T3 on early
      postischemic myocardial recovery in rabbit hearts subjected to crystalloid
      perfusion to simulate a low T3 state, and in pig hearts following global ischemia
      due to CPB. Studies using the former system showed that T3 administration results
      in significantly improved developed pressure after reperfusion of mildly ischemic
      hearts compared to controls, without producing inotropic effects. In more
      severely stunned rabbit hearts, physiologic and 10 times physiologic doses of T3
      produced significantly improved (p < 0.05) stroke work end-diastolic length
      compared to placebo treatment. T3 treated pigs undergoing CPB and subjected to 30
      minutes of global normothermic ischemia experienced significantly enhanced
      recovery of left ventricular contractility compared to controls at 90 and 120
      minutes post reperfusion. Neither placebo nor T3 affected myocardial adenosine
      triphosphate levels. These data show that T3 enhances recovery from myocardial
      stunning without producing acute inotropic effects.

PMID- 8461529
TI  - Bone mass, bone loss, bone density and fractures.

PMID- 8461530
TI  - The incidence of hip fracture in Europe.
AB  - Fragility fractures are now recognized as a major public health problem. Although
      the prevalence of all fractures is similar among men and women, the vast majority
      of osteoporotic fractures occur in elderly women. These comprise vertebral
      compression fractures, Colles' fracture at the wrist and hip fracture, and to a
      lesser extent fractures at other sites. The fracture of greatest socioeconomic
      consequence in Europe is hip fracture, which increases exponentially in incidence
      with age. The reasons for differences in age- and sex-specific incidence relate
      in part to the lower bone density of women at the time of maturity (peak bone
      density) and the accelerated bone loss that occurs after the menopause. Women
      live significantly longer than men, so that the prevalence of osteoporosis
      amongst elderly women is six-fold that of men. The age-specific incidence of hip
      fracture is rising in men and women in many countries, and if the current trends
      in the United Kingdom continue then the number of hip fractures occurring each
      year will more than double over the next 20 years. There is a marked geographic
      distribution in the incidence of hip fractures, even in Europe. Indeed the
      differences in incidence between communities is greater than the differences in
      incidence between sexes within communities. This suggests that the importance of
      gonadal insufficiency in women has been overemphasized and that other factors,
      probably relating to genetic or lifestyle factors affecting peak bone density,
      account for ecological differences in incidence of hip fracture between
      communities.

PMID- 8461531
TI  - The effect of age on bone collagen turnover as assessed by pyridinium crosslinks
      and procollagen I C-terminal peptide.

PMID- 8461532
TI  - Different characteristics of cervical and trochanteric hip fractures.

PMID- 8461533
TI  - The effect of natural and surgical menopause on the secretion of cytokines from
      human blood monocytes.

PMID- 8461534
TI  - The role of macrophage stimulating factor M-CSF in bone resorption.

PMID- 8461535
TI  - Macrophage colon-stimulating factor (M-CSF) is essential for differentiation
      rather than proliferation of osteoclast progenitors.

PMID- 8461536
TI  - Estrogen, cytokines, and the control of osteoclast formation and bone resorption
      in vitro and in vivo.

PMID- 8461537
TI  - Hormones in the coupling of bone resorption and formation.

PMID- 8461538
TI  - Local control of osteoclast function.

PMID- 8461539
TI  - A new model of osteopenia using ectopically induced bone: effects of parathyroid
      hormone and estradiol on bone turnover in induced bone.

PMID- 8461540
TI  - Binding of osteopontin to the osteoclast integrin alpha v beta 3.
AB  - Occupancy of the chicken osteoclast alpha v beta 3 integrin stimulates immediate
      cell signals. Peptides from osteopontin containing Arg-Gly-Asp and peptides from
      the osteopontin and bone sialoprotein sequences containing Arg-Gly-Asp stimulated
      immediate reductions in osteoclast cytosolic Ca2+. The changes in cytosolic Ca2+
      required the Arg-Gly-Asp sequence, and were blocked by LM609, a monoclonal
      antibody to the alpha v beta 3 integrin. Osteoclast stimulation by the proteins
      through the integrin did not require immobilization since soluble peptides
      produced changes in cytosolic Ca2+ and inhibited osteoclast binding to bone
      particles and bone resorption. The decrease in cytosolic Ca2+ stimulated by
      osteopontin and related peptides was due to activation of a plasma membrane
      Ca(2+)-ATPase. Thus, the data suggest that ligand binding to the osteoclast alpha
      v beta 3 integrin results in a reduction in cytosolic Ca2+ which participates in
      regulation of osteoclast function.

PMID- 8461541
TI  - Prostaglandins: mechanisms of action and regulation of production in bone.
AB  - Prostaglandins (PGs), particularly PGE2, are produced by bone and have powerful
      effects on bone metabolism. PGs have an initial, transient, direct inhibitory
      effect on osteoclast function. However, the major long-term effect in bone organ
      culture is to stimulate bone resorption by increasing the replication and
      differentiation of new osteoclasts. PGs also stimulate osteoclast formation in
      cell culture systems. Stimulation of osteoclastic bone resorption may be
      important in mediating bone loss in response to mechanical forces and
      inflammation. PGs have a biphasic effect on bone formation. At relatively low
      concentrations or in the presence of glucocorticoids, the replication and
      differentiation of osteoblasts is stimulated and bone formation is increased.
      This increase is associated with an increase in production of insulin-like growth
      factor-I (IGF-I). However, at high concentrations or in the presence of IGF-I,
      PGE2 inhibits collagen synthesis. In osteoblastic cell lines this inhibition can
      be shown to occur at the level of transcription of the collagen gene. The
      stimulatory effect on bone formation has been demonstrated when PGs are
      administered exogenously, but it is not clear how endogenous PG production
      affects bone formation in physiological or pathologic circumstances. The
      production of PGs in bone is highly regulated. The major source appears to be
      cells of the osteoblast lineage. A major site of regulation is at the level of
      the enzyme PG endoperoxide synthase (cyclooxygenase or PGH synthase). PGE2
      production and PGH synthase mRNA are increased by PTH and interleukin-1 and
      decreased by estrogen. Glucocorticoids probably act by a different mechanism,
      decreasing either arachidonic acid or PGH synthase activity.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8461542
TI  - Prevention of corticosteroid bone loss.
AB  - Prolonged corticosteroid therapy is known to result in an increased risk of
      osteoporotic fracture, probably as a consequence of enhanced bone resorption and
      depressed bone formation. We examined the effects of prophylactic treatment with
      1,25-dihydroxyvitamin D3 (calcitonin) and nasal salmon calcitonin on
      corticosteroid-induced bone loss in 103 patients being treated with long-term
      corticosteroids for the first time in a randomized, double-masked prospective
      study. Patients were randomly allocated to one of three groups receiving either
      calcium supplementation alone, calcium plus calcitriol, or calcium plus
      calcitriol and nasal salmon calcitonin. Treatment was given for 12 months. Bone
      mineral density (BMD) was measured every 4 months by dual-photon absorptiometry
      in the lumbar spine and femoral neck. Calcium supplementation alone did not
      prevent bone loss at either site. In the lumbar spine calcitriol, with or without
      nasal calcitonin, significantly reduced bone loss (p < 0.0001). Neither
      calcitriol alone nor calcitriol with calcitonin prevented bone loss at the
      femoral neck. These data suggest that treatment with calcium and calcitriol, or
      with calcium and intranasal calcitonin, greatly reduced or prevented
      corticosteroid-induced bone loss in the lumbar spine.

PMID- 8461543
TI  - Steroid osteoporosis.

PMID- 8461544
TI  - Systemic mastocytosis and osteoporosis.

PMID- 8461545
TI  - Estrogen: effects and actions in osteoporosis.

PMID- 8461546
TI  - Estrogen and bone.

PMID- 8461547
TI  - Calcium enhances the bone-sparing effects of low-dosage estrogen in
      postmenopausal women.

PMID- 8461548
TI  - Calcium supplementation in osteoporosis.
AB  - Although calcium is the most abundant inorganic constituent of the bone,
      indispensable for the maintenance of its physical strength, the role of calcium
      nutrition in the development of osteoporosis and the preventive and therapeutic
      significance of calcium supplementation in osteoporosis have been matters of
      intense controversy. The wide difference in the baseline nutritional intake of
      calcium among different groups and the variation in age of the patients studied
      may have been contributory factors. Emphasis has so far been placed on the rapid
      bone loss in the immediate postmenopausal period predominantly influenced by
      estrogen deficiency which has overshadowed the effect of calcium. The strong
      dependence of the effect of calcium preparation used tends to be forgotten. In
      the present study employing oyster shell electrolysate as the calcium source in
      patients with a mean age of approximately 80 years, bone mineral density was kept
      significantly higher than in age-matched, non-supplemented patients over a period
      of 2 years. In separate experimental studies, rats maintained on 2% calcium
      showed higher bone mineral content and lived longer than did controls maintained
      on 1% calcium. Age-associated deterioration of renal function and hyperlipidemia
      were also prevented by calcium supplementation.

PMID- 8461549
TI  - Epidemiology of hip fractures in the elderly: a cross-national analysis of
      mortality rates for femoral neck fractures.

PMID- 8461550
TI  - Prevention of osteoporosis: calcium nutrition.
AB  - Calcium is a threshold nutrient which means that a nutritional response in terms
      of calcium balance or bone mass will be present at intakes below the threshold
      and not above. The analogy can be made with the case of iron nutrition and
      anemia. Estimates of the threshold intake levels can be made for all stages of
      life based on available calcium balance data. They range between 1.3 g/day for
      infants to 1.5 g/day for women past menopause. Calcium nutrition is most
      important during growth and development in achieving genetically programmed peak
      skeletal mass. It is also important in maintaining bone mass in the elderly
      years. Calcium needs are supplied by the breakdown of the skeleton during the
      first few years after menopause, and thus calcium nutrition is less important
      until about 5 or 6 years after cessation of menses. Optimum calcium intake is
      best obtained from food sources; however, the lower food intake of modern humans
      compared with the food intake of humans during involution has resulted in
      difficulty in gaining an adequate intake of calcium. Calcium supplements are
      destined to become and important source of dietary calcium and thus some
      attention must be paid to their nutritional value. Solubility of a calcium salt
      is not a major determinant of absorbability over a range of 5 orders of magnitude
      of solubility. However, there is a well-defined enhancing effect of the co
      ingestion of a meal with calcium supplements. It would seem prudent to recommend
      that any calcium supplement be given at meal times.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8461551
TI  - Exercise therapy for osteoporosis.
AB  - Our experimental and clinical studies lead to the following conclusions: 1. The
      amount of exercise that has a favorable effect on bone tissue differs between
      males and females among individuals. 2. An appropriate amount of exercise has a
      favorable influence not only on weight-bearing bone but also on non-weight
      bearing bone, provided there is a sufficient intake of calcium. 3. Exercise may
      prevent the bone loss in osteoporosis, but an increase in bone mass cannot be
      expected. The major aim is to increase bone mass before the achievement of peak
      bone mass in order to prevent osteoporosis. However, suitable weight-bearing
      exercise in osteoporosis is useful for the prevention of falls which may result
      in fractures, to increase muscle strength, to improve walking balance and
      coordination, and to prevent orthostatic hypotension.

PMID- 8461552
TI  - Exercise in the prevention of osteoporosis.

PMID- 8461553
TI  - Prevention of bone loss in postmenopausal and senile osteoporosis with vitamin D
      analogues.

PMID- 8461554
TI  - Total body absorptiometry in postmenopausal osteoporosis patients treated with 1
      alpha-hydroxylated vitamin D metabolites.

PMID- 8461555
TI  - 24R,25-dihydroxyvitamin D3 increases bone mass in vivo.

PMID- 8461556
TI  - The development of vitamin D3 analogues for the treatment of osteoporosis.

PMID- 8461557
TI  - Treatment of postmenopausal osteoporosis with 1,25-dihydroxyvitamin D3.

PMID- 8461558
TI  - Vitamin D in bone formation.

PMID- 8461559
TI  - Human parathyroid peptide treatment of vertebral osteoporosis.
AB  - Previous studies have shown that treatment with daily injections of human
      parathyroid peptide (hPTH) 1-34 increase axial cancellous bone mass partially at
      the expense of peripheral cortical bone. In the present work the same hPTH 1-34
      regime given for 12 months has been combined with oestrogen or nandrolone therapy
      to control peripheral bone resorption. Spinal and iliac cancellous (but not
      cortical) bone increased by 40%-50% above initial values while no perceptible
      changes occurred in radial cortical or cancellous bone. The evidence of
      radiokinetic and histomorphometric studies performed before and in the last
      months of treatment suggested that bone remodeling had proceeded through a
      transient anabolic phase with increased activation, but that activation had
      become normal after 11-12 months in the cancellous bone of the ilium whereas it
      continued to be raised elsewhere in the skeleton. It is concluded that in
      combination with oestrogens, hPTH peptides given daily injections hold great
      promise for the treatment of patients with osteoporosis who have already lost
      substantial amounts of spinal cancellous bone.

PMID- 8461560
TI  - Influence of age, sex and diet on bone mass and fracture rate.

PMID- 8461561
TI  - Treatment of postmenopausal osteoporosis with daily parathyroid hormone plus
      calcitriol.

PMID- 8461562
TI  - Calcitonin in the prevention and treatment of osteoporosis.

PMID- 8461563
TI  - Effect of salmon calcitonin nasal spray on bone mass in patients with high
      turnover osteoporosis.

PMID- 8461564
TI  - Fluoride salts for vertebral osteoporosis: the benefit-to-risk ratio depends on
      the cumulative dose reaching bone.

PMID- 8461566
TI  - Double-blind placebo-controlled trial of treatment of osteoporosis with the
      anabolic nandrolone decanoate.

PMID- 8461565
TI  - Fluoride treatment of osteoporosis: cyclical non-blinded or continuous blinded
      studies?
AB  - The future of sodium fluoride (NaF), the most potent osteoblast stimulator known
      to man, is in the balance. Of three recent randomized trials of continuous NaF
      only one found a significant in vertebral fractures in the NaF group. When data
      from the first year were excluded, two of the studies (those with the largest
      numbers) showed a significantly reduced risk of vertebral fracture on NaF. The
      effect of NaF on cortical bone is poorly documented. Two studies have shown
      reduced forearm cortical bone density with continuous NaF. A further two
      (histomorphometric) studies have shown the development of increased cortical
      porosity on continuous NaF treatment. In one, this was selectively at the
      external cortex and was linearly correlated with cancellous volume increase. Our
      pilot study using NaF administered cyclically has shown an encouraging (though
      non-significant) reduction in vertebral fracture rates (excluding year 1) and no
      fall in forearm cortical density. Another (US) cyclical study has shown no
      increase in cortical porosity. A current W. Australian randomized study of 50
      patients is described where NaF dosage is varied proportional to the osteoblast
      response, and duration is dependent on densitometric and radiographic response.
      The future of NaF should involve cyclical administration, in cautious initial
      dosage (50-60 mg/day) of enteric-coated NaF, in conjunction with a potent
      inhibitor of resorption such as hormone replacement, bisphosphonates or
      calcitonin.

PMID- 8461567
TI  - Bisphosphonates and osteoporosis.

PMID- 8461568
TI  - Ipriflavone influences the osteoblastic phenotype in vitro.

PMID- 8461569
TI  - Epidemiology and prevention of osteoporosis in urbanized Asian populations.
AB  - The incidence rate of hip fracture in Hong Kong in 1989 was calculated from
      hospital admission data and the census population. The incidence rate has
      increased 3-fold since 1966 to reach 9 per 1000 in men and 13 per 1000 in women
      80 years and over. The age-adjusted rate was comparable to that in Singapore but
      higher than that in Japan. A case-control study was conducted on 280 women and
      120 men with hip fracture and 800 controls. The relative risk for hip fracture
      increased with a low calcium intake, being 2.9 (95% confidence interval 1.9 to
      4.6) in the lowest quartile. The relative risk for hip fracture was also
      significantly increased in subjects who did not perform load-bearing activity
      every day. Osteoporosis may be prevented by an adequate calcium intake and load
      bearing activity in urbanized Asian populations.

PMID- 8461570
TI  - Bisphosphonates in osteoporosis?

PMID- 8461571
TI  - Risk factors for bone loss in healthy postmenopausal women.

PMID- 8461572
TI  - Determinants of peak bone mass in young adult women: a review.

PMID- 8461573
TI  - An integrated view of the role of the endocrine system in the genesis of the
      osteoporosis associated with aging.
AB  - Estrogen deficiency is the major determinant of increased bone resorption and
      bone loss occurring in early menopause (first 5-6 years). The increased bone
      resorption is probably caused by the release of immune system cytokines such as
      IL-1, IL-6 and TNF by osteoblasts, the biosynthesis of which is no longer
      suppressed by estrogen. PTH secretion, although decreased in early menopause, may
      also contribute to increased bone destruction because of the presence of
      cytokines such as IL-1 and TNF which increase the sensitivity of bone to the
      resorptive effects of PTH. For the same reasons, the bone-destructive effects of
      increased serum levels of PTH occurring in the late menopause may be exaggerated.

PMID- 8461575
TI  - Effect of pregnancy and lactation on maternal bone mass and calcium metabolism.

PMID- 8461574
TI  - Risk factors for osteoporosis.

PMID- 8461576
TI  - Risk factors for hip fracture in elderly Japanese women in Tottori Prefecture,
      Japan.

PMID- 8461577
TI  - The relationship between femoral neck strength, bone mineral content and fracture
      fixation strength: an in vitro study.

PMID- 8461578
TI  - Determinants of peak bone mass.

PMID- 8461579
TI  - Influence of body parameters on female peak bone mass and bone loss.

PMID- 8461581
TI  - Age- and gender-related changes of body composition in Japanese.

PMID- 8461580
TI  - Variation in spinal and femoral bone mass gain, energy and calcium intake during
      adolescence.

PMID- 8461582
TI  - Selection of postmenopausal women for pharmacologic osteoporosis intervention.

PMID- 8461583
TI  - Use of a rapid decrease in trabecular bone density in the early diagnosis of
      senile osteoporosis.

PMID- 8461584
TI  - Screening for osteoporosis by bone densitometry: a stratified intervention
      approach.
AB  - We have performed computer modelling of the relationship between bone mass, age
      and hip fracture in a conditional probability model using a national population
      of 100,000 postmenopausal women aged 50 who have their bone density measured
      once. The computer model very closely reproduced the actual number of fractures
      in a Western Australian population. Intervention to bone loss completely in
      subjects with the lowest bone density (below 1 SD below the mean) would prevent
      0.42 of a hip fracture per patient treated if the whole population were treated.
      Halving the rate of bone loss in the whole population would reduce hip fracture
      by two-thirds. These data suggest that hormone replacement therapy, which is the
      most effective therapy for preventing bone loss but which has the most side
      effects, should be focused on subjects with bone mass below 1 SD below the mean.
      The remainder of the population could be targeted with a public health campaign
      based on the lifestyle factors of increased dietary calcium and exercise which
      have been shown to slow but not stop bone loss.

PMID- 8461585
TI  - Diagnosis of osteoporosis and assessment of bone mass by radiography: the most
      convenient procedure to reduce the risk of fracture.

PMID- 8461586
TI  - Incidence of hip fracture: an Italian survey.

PMID- 8461588
TI  - Some problems of dual-energy X-ray absorptiometry in the clinical use.

PMID- 8461587
TI  - Biochemical markers of bone turnover for the clinical investigation of
      osteoporosis.
AB  - The non-invasive assessment of bone turnover has received increasing attention
      over the past few years because of the need for sensitive markers in the clinical
      investigation of osteoporosis. Markers of bone formation include the serum
      measurement of total and bone-specific alkaline phosphatase, osteocalcin, and
      type I collagen extension peptides. Assessment of bone resorption can be achieved
      by measurement of urinary hydroxyproline, urinary excretion of the pyridinium
      crosslinks (pyridinoline and deoxypyridinoline), and by measurement of plasma
      tartrate-resistant acid phosphatase activity. For the screening of bone turnover
      in women at the menopause, and for the assessment of the level of bone turnover
      in elderly women with vertebral osteoporosis, serum osteocalcin and urinary
      pyridinoline appear to be the most sensitive markers, so far. Programs combining
      bone mass measurement and assessment of bone turnover by several markers in women
      at the time of menopause are being developed in an attempt to improve the
      assessment of the risk for osteoporosis. Efforts are made to develop more
      convenient assays and to identify other markers of bone turnover. In future a
      battery of various specific markers is likely to improve the assessment of the
      complex and subtle abnormalities of bone metabolism that characterize the various
      aspects of osteoporosis.

PMID- 8461590
TI  - Bone histomorphometry.

PMID- 8461589
TI  - Bone densitometry: current assessment.

PMID- 8461591
TI  - [Results on the status of the organizational structures in hospital hygiene in
      Germany--I. Overall evaluation with special reference to acute hospitals].
AB  - The results of an inquiry about the hospital hygiene in 2034 German hospitals
      demonstrate, that 35% of all hospitals have a hospital epidemiologist, 66% have
      infection control nurses and 86% infection control physicians. Infection control
      committees are present in 81% of German hospitals. 88% of all 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- 8461592
TI  - [Genotoxicity--causes and sequelae].
AB  - Genotoxicity is being increasingly focussed in both scientific and public
      discussions. This paper tries to point out the connections with mutagenicity and
      carcinogenicity and to show up several important medical aspects of DNA damage.

PMID- 8461593
TI  - [Information system on cancer mortality and district characteristics of the
      Rhineland TUV].
AB  - On account of the lack of a comprehensive cancer registry with national coverage
      for the Federal Republic of Germany, the long-term and interregional evaluation
      of cancer mortality data is of particular relevance. Therefore, the TUV Rheinland
      instructed by the Federal Ministry for the Environment, Nature Protection, and
      Reactor Safety maintains an "Information System on Cancer Mortality and District
      Characteristics (IKK)" using official cause of death and resident population
      statistics. Mortality data for a variety of different cancer sites are documented
      with local and temporal separation for the area of the Federal Republic of
      Germany (before the German unification) and for a period of 20 years. The IKK
      data can be employed as a meaningful tool for epidemiological investigations
      relating to the correlation of cancer mortality and environmental agents. In the
      present paper the principles of the IKK are described and some examples of
      results are presented.

PMID- 8461594
TI  - [Results of studies from the AIDS counseling center of the Frankfurt/M. city
      health office January 1990 to December 1991].
AB  - Between January 1990 and December 1991 5854 clients entered the AIDS-Counselling
      Service of the Municipal Health Department in Frankfurt/M; 1997 (34%) of them
      were female and 3857 (66%) male. In 5228 cases blood samples were examined for
      HIV-antibodies and the prevalence of positive tests was 84 (1.6%). Among the
      subjects who were seropositive for HIV, 51 (61%) were homosexual, 9 (11%)
      bisexual and 11 (13%) heterosexual men, furthermore 5 (6%) heterosexual women. 8
      (9%) seropositive persons were intravenous drug abusers (5 male, 3 female). With
      the aid of an anonymous questionnaire that was filled in voluntarily by the
      clients, information about the sexual anamnesis, reasons for wanting the test,
      and whether they had been already tested for HIV in the past, could be gained.
      During the examined period, safer sex has been practiced by 414 (58%) of 712
      homosexual men and by 1183 (24%) of 4867 heterosexuals (2923 male, 1944 female).
      By reason of a new partner 141 (19%) homosexuals and 1261 (26%) heterosexuals
      wanted to be tested for HIV; 529 (74%) homosexuals and 1806 (37%) heterosexuals
      had been already tested for HIV in the past. Summing up we can state, that the
      large attendance of the AIDS-Counselling Service, now as before, could be traced
      back to great acceptance and trust placed the population in the Municipal Health
      Department. HIV-testing is accepted by heterosexual and homosexual couples as
      well, and often performed at the beginning or at the end of a partnership. Safer
      sex plays, now as before, a subordinate role among heterosexuals in comparison to
      homosexuals.

PMID- 8461595
TI  - [Participation in the 1992 World Diabetes Day in the Ammerland district--a
      contribution to health promotion].
AB  - Departments of Health can function as important initiators of health promotion on
      community level. This includes the support of efforts for cooperation ("corporate
      identity"). A one-day-project for the World Diabetes Day (June 27, 1992) in the
      Ammerland county (Lower Saxony) gives an insight on possible activities, results
      and conclusions.

PMID- 8461596
TI  - [100 years ago: the first school doctors in Leipzig--a contribution to the
      history of school health in Germany].
AB  - One hundred years ago, in May 1892, the first school doctors began their work.
      The medical and organizational conditions for activities in school hygiene in
      Germany, their problematic linkage to "racial hygiene" and the military, and the
      favourable conditions for school medicine at the national and local levels and
      among members of the profession in Leipzig and Saxonia are presented. A
      description of the doctors' hygiene-oriented tasks in the schools completes the
      picture of the development of school hygiene in imperial Germany and in one of
      its richest cities.

PMID- 8461597
TI  - [A model project for geriatric rehabilitation in Rhineland-Pfalz].

PMID- 8461598
TI  - [Discussion on implementation of a pilot project "Social medicine consultation"
      in the Mecklenburg-Vorpommern MDK (Medical Service of Health Insurance)].

PMID- 8461600
TI  - [Proposal of the Society of German AIDS Foundations for singular support from the
      organization].

PMID- 8461599
TI  - [Report of the status of HIV and AIDS in Germany].

PMID- 8461601
TI  - The possible use of spleen cells for the adoptive immunotherapy of cancer
      patients.
AB  - The possible use of spleen-derived mononuclear cells (SPMC) for the intentional
      and economical adoptive immunotherapy of cancer patients was studied. SPMC were
      obtained from spleens resected surgically from patients with gastric cancer or
      idiopathic thrombocytopenic purpura (ITP). When SPMC were cultured in recombinant
      interleukin 2 (rIL2), SPMC, in the form of interleukin-activated killer spleen
      cells (IL-SP) proliferated in six of eight cases. CD8+ lymphocytes were the major
      expanding cell population in most SPMC cultures and IL-SP showed a significant
      cytolytic activity against cultured tumor cells during cell proliferation. When
      cultured with a streptococcal preparation, OK-432, for 24 to 48 h, SPMC showed
      cytotoxic activity against tumor cells and were expressed as OK-432 activated
      killer spleen cells (OK-SP). The effects of supernatants from IL-SP and OK-SP on
      tumor cell growth were also examined. The supernatants from IL-SP and OK-SP
      significantly inhibited cell growth in 3 and 10 out of 11 cases, respectively,
      while those from OK-SP showed higher growth inhibitory activity than those from
      IL-SP. The results of this study indicate the potential of SPMC as effector cells
      for the adoptive immunotherapy of cancer patients.

PMID- 8461602
TI  - Survival and recurrence after low anterior resection and abdominoperineal
      resection for rectal cancer: the results of a long-term study with a review of
      the literature.
AB  - Morbidity, survival, and recurrence in 203 patients treated with curative low
      anterior resection (LAR) were compared with those in 100 patients treated with
      curative abdominoperineal resection (APR). The overall 5-year survival figures
      for the total number of, LAR and APR patients were 75.6 +/- 5.7%, 79.8 +/- 6.4%
      and 67.7 +/- 9.6%, respectively. The prognosis for cancers situated low enough in
      the rectum to involve the anal canal was poor even when managed by APR, as
      evidenced by a low survival at 5 years of 59.0 +/- 9.6% and a high pelvic
      recurrence rate of 34%. For all except these tumors, LAR proved at least equal
      to, or better than APR as a curative surgical method for middle and low rectal
      cancers, on the basis of 5-year survival being 79.8 +/- 6.4% vs 78.7 +/- 5.2%,
      operative mortality being 1.5% vs 1.0%, morbidity being 39.4% vs 59.0%, and the
      incidence of pelvic recurrence being 8.9% vs 13.5%. When deciding upon the most
      appropriate surgical procedure for rectal cancer, especially for middle or low
      rectal lesions, the patient should not simply be condemned to a permanent
      colostomy. Thus, we first attempt LAR for every lesion except those which are
      very advanced or those with anal canal involvement, if technically feasible and
      suitable for the individual patient.

PMID- 8461603
TI  - Management of gallstones in cirrhotic patients.
AB  - 34 cirrhotic patients who underwent either cholecystectomy alone or in
      conjunction with common duct exploration were retrospectively reviewed. In Child
      A and B patients morbidity was low and there were no postoperative deaths.
      However, all patients who underwent additional cholecystectomy during the non
      shunting operation for esophageal varices required blood transfusion.
      Cholecystectomy in Child C patients is frequently associated with considerable
      intraoperative bleeding and subsequent postoperative complications. In the 23
      patients who were not operated upon for gallstones, no patients developed
      symptomatic biliary disease. Ultrasonographically, most of these gallstones were
      strongly suspected to be black stones. Elective surgical intervention for
      symptomatic Child A and B patients would normally be warranted, but hemorrhage
      and resulting complications due to additional cholecystectomy for asymptomatic
      gallstones during the non-shunting operation should be minimized. An additional
      cholecystectomy should be considered, provided such a cholecystectomy is thought
      to be easily performed judging from the degree of development of collateral
      circulation around the hepatoduodenal ligament and unless black stones are
      suspected ultrasonographically. For symptomatic gallstones in Child C patients
      every type of medical treatment should be attempted. After considering the
      bleeding tendency or ascites, percutaneous transhepatic gallbladder drainage is
      considered to be one of the safest treatments.

PMID- 8461604
TI  - A study on postoperative enteritis caused by methicillin-resistant Staphylococcus
      aureus.
AB  - We investigated the production of staphylococcal enterotoxin (SE) with respect to
      coagulase types by methicillin-resistant Staphylococcus aureus (MRSA). A total of
      138 strains of MRSA, which were isolated from clinical materials in the surgical
      ward between 1983 and 1990, were studied. Coagulase type IV strains produced SE A
      only, whereas coagulase type II strains were classified into four groups by SE
      production: SE B producing strains (32.7%), SE C producing strains (29.8%), SE B
      and C coproducing strains (12.5%), and SE A and C coproducing strains (25.0%).
      Almost all of the organisms (nine of ten) which were isolated from the feces of
      patients with MRSA enteritis were SE A and C coproducing strains. The coincidence
      in time of the prevalence of MRSA enteritis and the isolation SE A and C
      coproducing strains also demonstrated that these strains caused MRSA enteritis.
      Although SE C producing strains and SE A and C coproducing strains were
      simultaneously prevalent in 1990, the former tended to be sensitive while the
      latter tended to be resistant to minocycline. Considering the variety of
      antibiotic sensitivity in coagulase type II strains, it is thus considered to be
      of critical importance for epidemiologic purposes to further characterize
      isolates by SE typing.

PMID- 8461605
TI  - The effect of supplementing hypothermic crystalloid cardioplegia with catalase
      plus allopurinol in the isolated rabbit heart.
AB  - The effect of adding allopurinol and catalase to hypothermic cardioplegia for
      ischemic-reperfusion injury was investigated in the isolated rabbit heart. Hearts
      were divided into two groups, namely: Group C (n = 7), which received a
      hypothermic crystalloid cardioplegic solution alone (4 degrees C), and group T (n
      = 7), which received the hypothermic cardioplegic solution with allopurinol (148
      mumol/L)13 and catalase (37 nmol/L).12 The cardioplegic solution was infused
      continuously into the isolated hearts, which had been placed in ice-cold saline,
      during a 12 h preservation. Subsequently, the hearts were mounted on a
      noncirculating, nonpulsatile perfusion circuit using Krebs-Henseleit buffer
      solution at 37 degrees C for 1 h at a constant perfusion pressure of 75 mm Hg.
      The left ventricular developed pressure (LVDP), maximum rate of pressure change
      (max dp/dt), and percent recovery of coronary flow were higher, while the
      creatine phosphokinase concentration and left ventricular end diastolic pressure
      (LVEDP) were lower in group T. The tissue malondialdehyde concentration and water
      content were similar in both groups. Thus, cardiac function after a 12 h
      preservation was enhanced by the added combination of allopurinol and catalase to
      the cardioplegic solution, supporting its role in the prevention of free radical
      reperfusion injury in cardiac preservation.

PMID- 8461606
TI  - Fibrinogen Osaka IV: a congenital dysfibrinogenemia found in a patient originally
      reported in relation to surgery, now defined to have an A alpha arginine-16 to
      histidine substitution.
AB  - We discovered a congenital heterozygous dysfibrinogen in a patient and reported
      this case in relation to surgery some time ago (Jpn J Surg (1988) 18:43-46).
      Further studies on the isolated abnormal population of fibrinogen derived from
      this patient have revealed that fibrinopeptide A was not cleaved by ancrod, a
      snake venom-derived thrombin-like enzyme, but by thrombin, slowly but completely.
      The released fibrinopeptide A components, being the A, AY, and AP peptides, were
      all found to be abnormal, as evidenced by slightly earlier elution positions on
      high-performance liquid chromatography, compared with the normal counterparts. By
      analyzing their amino acid sequence, we have identified an arginine to histidine
      substitution at position 16 of the A alpha chain, the thrombin cleavage site.
      Utilizing insolubilized abnormal fibrinogen, we confirmed that the polymerization
      site assigned to the central E domain, the "A" site, was exposed by thrombin, but
      not by ancrod. This dysfibrinogen, designated as fibrinogen Osaka IV, is the
      second abnormal molecule with an A alpha arginine-16 to histidine substitution
      identified among Japanese families.

PMID- 8461607
TI  - Modes of biliobiliary anastomosis in relation to the healing process and
      occurrence of postoperative stricture.
AB  - The inverting and everting methods of biliobiliary anastomoses were compared
      histopathologically and electron microscopically. Epithelialization started on
      the 3rd postoperative day and occurred within 8 mm of the anastomosis with an
      earlier and more active epithelialization being seen in the proximal area than in
      the distal. A rapid decrease of the mucosal defect was seen for 3-5 days which
      slowed down thereafter, and closure was achieved by 30 days after the anastomosis
      in both groups. The everted group showed a smoother and more rapid healing
      process, quicker epithelialization, and less mucosal defects than the inverted
      group. In the chronic phase, the inverted group showed more papillary hyperplasia
      and more pronounced fibrosis of the wall. The stricture index, being the internal
      circumference of the common bile duct: proximal x 2/anastomosis site + duodenal x
      100, of the everted group was 123.7% compared to 146.7% for the inverted group,
      but there was no statistical difference. There was no difference in the total
      area of crypts, representing the epithelialization, between the two groups.
      Anastomoses with proximal dilatation therefore healed more slowly than those
      without dilatation. These findings show everted anastomosis to be superior to
      inverted anastomosis and thus support the usefulness of T-tube drainage to
      prevent postoperative dilatation of the bile duct.

PMID- 8461608
TI  - Extracorporeal cisplatin removal using direct hemoperfusion under hepatic venous
      isolation for hepatic arterial chemotherapy: an experimental study on
      pharmacokinetics.
AB  - This study was undertaken to pharmacokinetically evaluate the efficacy of direct
      hemoperfusion under hepatic venous isolation (HVI-DHP) to cisplatin (CDDP)
      removal during hepatic arterial infusion. CDDP (2-4 mg/kg) was administered
      continuously to mongrel dogs through the hepatic artery for 10 min. Plasma levels
      and tissue concentrations were then compared between animals receiving CDDP alone
      (group 1, n = 4) and those treated with additional HVI-DHP for 20 min (group 2, n
      = 6). The peak CDDP levels in the right external jugular vein (systemic level)
      were 6.10 +/- 1.31 (mean +/- SD) and 1.41 +/- 0.12 micrograms/ml in groups 1 and
      2 at a dosage of 2 mg/kg, respectively (P < 0.01). The estimated drug removal
      rates in group 2 animals at dosages of 2 and 4 mg/kg were 45.7 (mean, n = 5) and
      46.9% (n = 1), respectively. The tissue concentrations of CDDP of the liver 30
      min after the initiation of infusions were similar in both groups. The values of
      the liver, the heart, and the kidney were 1.90 +/- 0.55, 0.50 +/- 0.16, and 3.90
      +/- 2.50 micrograms/g of wet tissue weight, respectively, in group 1. In
      contrast, tissue levels of the heart and the kidney in group 2 animals were
      significantly reduced, with the values at a dosage of 2 mg/kg being 0.21 +/- 0.03
      micrograms/g (P < 0.01) and 0.86 +/- 0.53 micrograms/g (P < 0.05), respectively.
      This study demonstrated that the extrahepatic distribution of CDDP during hepatic
      arterial infusion can be reduced significantly by the concomitant use of HVI-DHP.

PMID- 8461609
TI  - Superior mesenteric arteriovenous fistula: report of a case and review of the
      literature.
AB  - Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with
      only 22 cases being documented. We report herein a case of a 63-year-old man with
      an iatrogenic arteriovenous fistula which developed after a small bowel resection
      for intestinal tuberculosis. The patient was admitted to our hospital for a
      gastric ulcer, at which time an ultrasonogram demonstrated cystic dilatation of
      the superior mesenteric vein, proving to be an arteriovenous fistula of the
      mesenteric vessels. An angiogram of the superior mesenteric vessels subsequently
      confirmed this diagnosis and resection of the fistula was performed, followed by
      an uneventful recovery. Iatrogenic mesenteric arteriovenous fistula with no
      presenting symptoms, as in our case, is uncommon and surgery performed before the
      development of associated portal hypertension should achieve good results. A
      review of the literature follows the report of this case.

PMID- 8461610
TI  - Right common iliac arterio-intestinal fistula caused by tubercular peritonitis:
      report of a case.
AB  - A 59-year-old female was admitted with massive hematemesis and melena. A
      hematological examination revealed that the red blood cell count was 1.31 x
      10(6)/mm3, Hb 3.4 g/dl, and Hct 12%. No source of bleeding was found by an
      emergency endoscopic examination of the esophagus, stomach and duodenum, or by
      superior mesenteric angiography. At laparotomy a right common iliac arterio
      intestinal fistula was found. The microscopic examination of this part of the
      ileum, including the fistula, revealed the presence of tubercular peritonitis. An
      extra-anatomic bypass graft using a prosthetic graft was performed between the
      left and right femoral arteries because reconstruction of the right common iliac
      artery was impossible.

PMID- 8461611
TI  - Primary squamous cell carcinoma of the breast after cured Hodgkin's disease.
AB  - An unusual case of primary squamous cell carcinoma of the breast occurring after
      cured Hodgkin's disease is reported herein. A 27-year-old woman developed a left
      breast mass 2 years after chemotherapy and radiation for nodular sclerosing stage
      IIB Hodgkin's disease. Excisional biopsy revealed squamous cell carcinoma of the
      breast and a modified radical mastectomy was performed, however, no metastasis
      was found in the axillary nodes. She received etoposide, mitomycin-C, and
      doxifluoridine as adjuvant chemotherapy, and remains well without any evidence of
      recurrent Hodgkin's disease or breast cancer. To our knowledge, this is the first
      reported case of primary squamous cell carcinoma of the breast associated with
      Hodgkin's disease. The risk of patients treated for Hodgkin's disease developing
      breast cancer as a second malignant neoplasm is discussed following the report of
      this case.

PMID- 8461612
TI  - DNA ploidy, c-myc oncoprotein p62 and v-H-ras oncoprotein p21 in colorectal
      carcinoma.
AB  - DNA ploidy and expression of the c-myc oncoprotein p62 and the v-H-ras
      oncoprotein p21 were examined in 54 colorectal carcinomas. DNA ploidy, determined
      by DNA flow cytometry, was diploid in 19 samples and aneuploid in 35. Expression
      of the p62 oncoprotein, determined by immunohistochemical staining, was intensely
      positive in 18 samples while that of the p21 oncoprotein, also determined by
      immunohistochemical staining, was positive in 29. There was no correlation
      between DNA ploidy and expression of the p62 oncoprotein, and DNA ploidy did not
      correlate with expression of the p21 oncoprotein. There was, however, a close
      correlation between expression of the p62 oncoprotein and that of the p21
      oncoprotein being P < 0.01 according to Peason's chi-square test.

PMID- 8461613
TI  - The outcome of patients with thyroid carcinoma and Graves' disease.
AB  - A total 847 consecutive patients with Graves' disease who underwent thyroidectomy
      between 1965 and 1990 were found to have a 4.3% incidence of coincident carcinoma
      of the thyroid. In 68.2% of these cases the tumors were less than 1 cm in
      diameter and were detected in only 7 patients (19.4%) prior to surgery.
      Dissection of the regional lymph nodes was necessary in only 11 patients. A
      review of the patients in 1990 revealed no carcinoma-related deaths with
      metastases occurring most commonly in the patients with larger tumors and in
      those whose cancer had been detected prior to thyroidectomy. Although the
      detection of potential tumors occurring with Graves' disease using preoperative
      echogram may be of interest, our results suggest that occult microcarcinoma
      occurring coincidentally with Graves' disease is not clinically significant as it
      did not cause any recurrence in this study. Moreover, there was no evidence to
      suggest that Graves' disease was associated with the increased or rapid growth of
      these tumors.

PMID- 8461614
TI  - Building choice opportunities within occupational programmes for persons with
      profound developmental disabilities.
AB  - Choice opportunities were arranged within the occupational programmes of two
      subjects with profound developmental disabilities. The subject participating in
      Experiment 1 was already familiar with a computer-aided programme aimed at
      promoting independent occupation. That programme was now extended to allow him to
      choose activities and reinforcers. He was also exposed to a control programme
      involving the use of folders with drawings. The subject participating in
      Experiment 2 had no previous experience with special programmes. For this
      subject, two versions of a computer-aided programme were used: one to teach
      occupational engagement without choice; and the other occupational engagement
      with choice. The results have shown that the first subject was very successful in
      combining choice behaviour and constructive activity with the computer-aided
      programme, but not with the control programme. The second subject learned very
      rapidly independent activity engagement, but required relatively long time to
      develop 'meaningful' choice behaviour. General implications of the findings are
      discussed.

PMID- 8461615
TI  - Effects of a community-based service on adaptive and maladaptive behaviours: a
      longitudinal study.
AB  - Changes in skill acquisition and problem behaviour, contingent upon the
      introduction of a new community-based service, were compared for subjects in
      three different residential settings: supported accommodation; hospital; and
      private family homes. Results over a 5-year period indicate links between service
      contact and increases in skill level, together with an increase in problem
      behaviour for subjects who moved from hospital to supported accommodation. The
      interpretation of client income in the context of service process is discussed.

PMID- 8461616
TI  - Service use among school leavers with severe learning difficulties: the views of
      carers.
AB  - School leaving is a time when difficult decisions have to be taken. Difficulties
      are likely to be particularly complex when the school leaver has severe learning
      difficulties. Carers of 61 young people living in one East London Health District
      were interviewed about their child's experience of service use at around the time
      of school leaving. The timing of school leaving appears to have been well
      handled, and the experience of those who went on to further education was
      positive. The school social work service was greatly appreciated. On the debit
      side, many informants were critical of the quality of short-term residential
      care. The commonest concern was for the prompt availability of day care. As in
      the few other studies of this subject, the impression that services appeared
      uncoordinated was given by carers.

PMID- 8461617
TI  - Factor structure of the Motivation Assessment Scale.
AB  - The Motivation Assessment Scale (MAS) was developed to provide clinical
      information on four hypothesized functions that may control problem behaviour in
      persons with developmental disabilities. The original four-factor structure of
      the MAS was based on face validity, with the items being grouped in terms of each
      of the hypothesized functions. Validation of the scale was provided in terms of
      correlations between teacher ratings of eight children on the MAS and ranking of
      the controlling variables from functional analogue tests. In this study, staff in
      residential facilities rated 60 residents and teachers in schools rated 96
      students on the MAS. The target behaviour rated for both samples was self-injury,
      with the institutional sample engaging in the behaviour more than 15 times an
      hour and the school sample, less than 15 times an hour. The results of factor
      analyses, with varimax rotation, provided a conceptually meaningful factor
      structure with the institutional sample, but not with the school sample. The 16
      MAS items resolved into four factors that were conceptually related to four
      conditions that may maintain problem behaviour (i.e. sensory, escape, attention
      and tangible). The results suggested that the original MAS has a robust factor
      structure and may be clinically useful in predicting the controlling functions of
      problem behaviours, if the target behaviours occur at a rate no less than 15
      responses per hour.

PMID- 8461618
TI  - A scale of attitudes toward the application of eugenics to the treatment of
      people with mental retardation.
AB  - As part of a larger study of the attitudes of diverse samples towards the
      application of eugenics to the treatment of people with mental retardation, a 32
      item summated rating scale was developed as a contemporary, brief, easy to
      administer and score, and psychometrically sound instrument. Data were collected
      and analysed that indicated satisfactory item characteristics and reliability,
      and initial support for the content and construct validities of the scale.
      Analyses of social desirability data revealed that scale scores were not
      influenced by the subjects' desire to adhere to socially desirable expectations.
      The scale should be useful for the investigation of questions concerning the
      formation, structure and correlates of attitudes toward the application of
      eugenics to the treatment of people with mental retardation, and the relationship
      of these attitudes to contemporary mental retardation policies and practices.

PMID- 8461619
TI  - Asperger's syndrome: three cases and a discussion.
AB  - The recently revived academic interest in and controversy over the subject of
      Asperger's syndrome is briefly discussed. Gillberg & Gillberg's operational
      criteria for its definition are used to isolate three cases of the syndrome
      presenting over a single year to a mental handicap service. The cases are
      described in detail. Common themes and associations with the available literature
      are discussed. In all three cases, the struggle for clarity in the syndrome's
      nature or specificity in the literature is also reflected in aspects of their
      clinical management.

PMID- 8461620
TI  - An analogue assessment of hand stereotypies in two cases of Rett syndrome.
AB  - Stereotype hand movements are one behavioural manifestation of Rett syndrome, a
      neurodegenerative disorder resulting in severe mental retardation. They are
      neuropathological in origin, and constitute a barrier to the acquisition and
      exhibition of more developmentally appropriate behaviours, as well as posing a
      health risk for some individuals. The present study used an analogue assessment
      procedure, in which experimental conditions were constructed varying in the
      consequences delivered contingent upon the exhibition behaviour, to examine
      environmental correlates to the moment-to-moment expression of these behaviours.
      Results are discussed regarding their implications for intervention and research
      into the aetiology of stereotypic behaviours.

PMID- 8461621
TI  - Children of alcoholic parents: health, growth, mental development and
      psychopathology until school age. Results from a prospective longitudinal study
      of children from the general population.
AB  - Of 640 women who paid their first visit to the two maternal welfare centres in a
      new Stockholm suburb during one prospective year, 532 (85%) were interviewed with
      regard to 41 stress factors forming a "life stress score" (LSS). The interviews
      were supplemented with data from hospital, social welfare and police records
      concerning the expectant mother and the father. The 532 mothers were divided into
      three groups according to the degree of psychosocial stress (group 1 (n = 194)
      without psychosocial stress; group 2 (n = 171) with severe psychosocial stress;
      and group 3 (n = 167) in an intermediate group). In group 2, there were 23
      mothers and 51 fathers in 64 families known to suffer from alcoholism/heavy
      drinking at the time of the first interview and these comprised our study group.
      The pregnancies and deliveries in the families were investigated with prospective
      methods. There were 497 liveborn children of whom 54 were born into families
      known for alcoholism/heavy drinking. The physical health and development of the
      children was followed by prospective data from the child welfare centers. Data
      concerning psychological development and psychiatric health of the child were
      obtained by interviewing the mother and evaluating the child during visits at
      home at one and four years of age. At one year of age, 452 of the children (226
      boys, 226 girls) and at four to five years of age, 412 of the children (202 boys,
      210 girls), were evaluated using the Griffiths' Development Scales. Findings from
      these evaluations form the basis for comparison of development of children from
      alcoholic/heavy drinking parents with all other children. For 388 children, data
      were available from all examinations up to the end of the fourth year, including
      38 children (12 boys, 26 girls) in the study group and 350 other children (183
      boys, 167 girls). The present findings indicate that children of alcoholic
      parents in the general population who were followed from pregnancy up to the end
      of their fourth year have a higher risk of pre- and postnatal death, and have
      poorer mental development and more symptoms of a psychopathological child
      psychiatric nature (DSM-III) than other children. Differences related to physical
      development during infant years disappeared during the observation time. With
      regard to mental development over a longer period, it appears that factors
      related to the parent's addictions and the child's sex (i.e. male child) are more
      important than pediatric risk factors in the form of a score of reduced
      optimality.

PMID- 8461623
TI  - Screening for thyroid disorders in a working population.
AB  - Subclinical thyroid disorders have received increasing attention in recent years
      due to refined laboratory methods and a stronger emphasis on the role of
      preventive medicine. We performed a screening for thyroid-stimulating hormone
      (TSH) on 6884 persons in a working population. In cases in which TSH was not
      within the normal range we also measured the levels of triiodothyronine (T3),
      thyroxine (T4), and thyroxine-binding globulin (TBG). All persons who did not
      present with exclusion criteria or other nonthyroidal illnesses (n = 59) and the
      controls (n = 39) were submitted to thyrotropin-releasing hormone (TRH)-testing.
      Additionally, sonography of the thyroid was performed on 120 persons (59 subjects
      with abnormal hormone levels and 61 controls) to determine thyroid size and rule
      out morphological abnormalities. Based on the TRH test and T3, T4, and TBG
      measurements we found a prevalence of 0.03% (2/6884) for overt hyperthyroidism,
      0.33% (23/6884) for subclinical hypothyroidism, 0.09% (6/6884) for subclinical
      hypothyroidism, and 0.015% (1/6884) for overt hypothyroidism in the healthy
      population. In subjects with overt or subclinical hyperthyroidism the prevalence
      of goiters (thyroid volume > 18 ml in women, > 25 ml in men) was 28%. Of this
      group 48% had structural abnormalities. All persons with goiters and/or
      structural abnormalities were over 35 years of age. Among the euthyroid, 20% had
      thyroid enlargement, and the same proportion presented with structural
      abnormalities. There were no differences between the two age groups. In the group
      with overt/subclinical hypothyroidism 47% presented with structural abnormalities
      of the thyroid; however, none presented with thyroid enlargement. Thyroid nodules
      were found only in older persons (> 35 years) with euthyroidism or
      hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461622
TI  - Granulocyte-macrophage colony-stimulating factor in the sera of patients with
      aplastic anemia.
AB  - To clarify the role of growth factors in the pathophysiology of aplastic anemia
      we measured serum granulocyte-macrophage colony-stimulating factor (GM-CSF)
      levels in 33 aplastic anemia patients by a specific and sensitive enzyme-linked
      immunosorbent assay. GM-CSF serum levels of patients with aplastic anemia were
      significantly higher than in healthy volunteers. GM-CSF levels were correlated
      with the severity of aplastic anemia but not with the absolute neutrophil count.
      Since T lymphocytes are one of the main sources of GM-CSF, our data provide
      further evidence for in vivo T lymphocyte activation in aplastic anemia. GM-CSF
      serum levels are higher in patients responding to immunosuppressive treatment
      than in nonresponders. Elevated serum GM-CSF might be predictive of a good
      response to immuno-suppressive therapy. GM-CSF serum levels are lower immediately
      after treatment with antilymphocyte globulin/antithymocyte globulin (ALG/ATG)
      than corresponding pretreatment values. Thus we cannot confirm the hypothesis
      that ALG/ATG effects in vivo are mediated by stimulating the release of growth
      factors. We conclude that in aplastic anemia the primary defect is a failure in
      GM-CSF response rather than in GM-CSF supply.

PMID- 8461624
TI  - Primary and secondary microcirculatory disorders in essential hypertension.
AB  - In this prospective cross-sectional study blood fluidity and peripheral
      microcirculation were measured in patients suffering from essential hypertension
      with and without macroangiopathy. The cutaneous microcirculation was evaluated by
      intravital microscopy and the intramuscular by pO2 needle electrode. Disorders in
      the microcirculation without macroangiopathy in the system of the feeding
      arteries are defined as primary microangiopathy. Disturbed microcirculation with
      macroangiopathy in the feeding arteries in one area but no detectable
      microcirculatory disorder in another region is defined as a secondary
      microcirculatory disorder. Of the 57 patients in this study 27 had a primary
      microcirculatory disorder. It was remarkable that all 27 hypertension patients
      had a microcirculatory disorder in the area of the skin. Intramuscular
      microcirculatory disorder on its own without affection of the skin was not
      detected in any case. An exclusively secondary microcirculatory disorder occurred
      in 16 patients. This study shows that 93% of the patients with long-term
      essential arterial hypertension have microcirculatory disorders. It is most
      interesting that about one-half of these hypertension patients had a primary
      microcirculatory disorder, i.e., no indication of a hemodynamically active
      stenosis was found in the large vessels.

PMID- 8461625
TI  - Stepwise development of a clinical expert system in rheumatology.
AB  - The evaluation of computer expert systems, a promising diagnostic tool for future
      application in clinical medicine, is of great importance. We present here the
      evaluation of our expert system, "RHEUMA". It is stressed, that repeated
      retrospective testing and updating of an expert system and its subsequent
      repeated assessment in clinical use and surroundings is mandatory. This increases
      the diagnostic accuracy of the system. For our system this is demonstrated under
      three separate conditions. In the first study the information available for the
      computer system (mainframe) came from medical histories only. Here an error rate
      of about 25%--similar to that of physicians themselves using the same information
      -was observed in 358 outpatients, compared to the final diagnoses of physicians
      also relying solely on information from medical histories. In a second step a
      completely new system on a personal computer was developed with all relevant
      diagnostic information. The error rate of this system (0.4%) was much too
      optimistic because the knowledge base was changed during the study, affecting
      about 30% of the 282 prospectively recruited outpatients. In a third step the
      efficacy of the expert system was tested in an additional hospital without the
      diagnostic involvement of the first testing clinic. The error rate of the system
      without changing the knowledge base reached 11% in 51 outpatients in this
      rheumatology clinic. This result reflects the diagnostic accuracy of the system
      today. Its ability to specify the same diagnoses which clinical experts reached
      approached 90%. Considerable time is needed for such prospective testing, with
      repeated updating of the knowledge base--in our case for both the two systems and
      field studies of 2 years each.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461626
TI  - Lipoprotein (a), low-density, intermediate-density lipoprotein, and blood
      pressure in a young male population.
AB  - Both hypercholesterolemia and hypertension are risk factors for atherosclerotic
      vascular disease, and elevated cholesterol levels occur more frequently than
      expected in patients with hypertension. Elevated levels of intermediate-density
      lipoproteins (IDL) and low-density lipoproteins (LDL) were shown to be
      atherogenic, and LDL, comprising the major cholesterol-carrying fraction in human
      plasma, are structurally related to lipoprotein (a)[Lp(a)], a further risk factor
      for atherosclerosis. In the present study we investigated 200 male employees
      (mean age 26 +/- 7 years) to determine whether the relationship of IDL and Lp(a)
      to systemic blood pressure is similar to the reported correlations between total
      and LDL cholesterol and systemic blood pressure. To this end blood pressure was
      measured several times in each individual, and lipids, lipoprotein-cholesterol,
      apolipoprotein B (apo B), and Lp(a) were determined in fasting serum. IDL
      cholesterol and apo B, the main protein component of IDL and LDL correlated with
      blood pressure. However, levels of Lp(a) correlated neither with systolic or
      diastolic blood pressure nor with lipoprotein cholesterol, body weight, or age.
      Although IDL and Lp(a) are considered lipoprotein risk factors for
      atherosclerosis, levels of Lp(a), unlike IDL, are not related to blood pressure,
      body weight, or age. Our data suggest different metabolic and pathophysiological
      mechanisms of the risk factors, IDL, LDL, and Lp(a).

PMID- 8461627
TI  - Aneurysms of coronary arteries in a patient with adult polycystic kidney disease:
      arteriosclerosis or involvement by the primary disease?
AB  - Adult polycystic kidney disease is frequently associated with gastrointestinal
      and cardiovascular abnormalities. These include hypertension, mitral valve
      prolapse, mild dilation of the aortic root, abdominal aneurysms, and
      predisposition to aortic, mitral, and tricuspidal valve regurgitation reminiscent
      of Marfan's syndrome. Although the exact molecular mechanisms of adult polycystic
      kidney disease are not well established, a generalized defect of collagen
      structure is hypothesized. The most severe vascular problems, however, are
      typical intracranial aneurysms with a high incidence of subarachnoid hemorrhage
      and a high mortality rate. We report a case of dilated coronary arteries found
      incidentally in a patient with adult polycystic kidney disease and stress-induced
      angina pectoris. The typical angina pectoris of the patient is explained by left
      ventricular hypertrophy and coronary heart disease. Multiple liver cysts, mitral
      valve prolapse, and the coronary aneurysms in this patient with adult polycystic
      kidney disease appear to reflect the manifestation of a generalized connective
      tissue disorder in this syndrome.

PMID- 8461629
TI  - Allopurinol and oxypurinol in human breast milk.
AB  - To pregnant or breast feeding women drugs should be given with caution. We report
      the case of a 5-week-old breast-fed infant whose mother was taking 300mg
      allopurinol/day for 4 weeks. Allopurinol and oxypurinol were detected by HPLC in
      maternal plasma and breast milk with a method first described here. In infant's
      plasma taken 2 h after breast feeding oxypurinol was found; allopurinol was below
      the limit of detection. The milk/plasma ratio in the mother 2 h (4 h) after drug
      ingestion was 0.9 (1.4) for allopurinol and 3.9 (2.4) for oxypurinol. The average
      daily dose for the baby of allopurinol was 0.14-0.20 mg/kg and that of oxypurinol
      7.2-8.0 mg/kg by ingestion of breast milk after oral intake of allopurinol by the
      mother.

PMID- 8461628
TI  - Cellular signaling by cyclosporine A in contractile cells: interactions with
      atrial natriuretic peptide.
AB  - Immunosuppressive therapy with cyclosporine A (CyA) may be associated with severe
      side effects such as nephrotoxicity and arterial hypertension. The partial
      reversibility of these effects suggests that they are at least in part
      functional. The present study examined the effects of CyA on cellular signaling
      in vascular smooth muscle cells and in glomerular mesangial cells and the
      interactions with the endogenous vasodilator atrial natriuretic peptide (ANP).
      Intracellular free calcium concentrations ([Ca2+]i) were measured using Fura-2.
      45Ca2+ was used to measure Ca2+ efflux and cellular Ca2+ influx. In the presence
      of cyclosporine (10 micrograms/ml), the Ca(2+)-mobilizing effects of angiotensin
      II (10(-8)M) in smooth muscle cells and of arginine vasopressin (AVP) in
      mesangial cells were significantly enhanced. CyA significantly stimulated
      cellular Ca2+ uptake in both cell types. ANP blocked the Ca2+ mobilization by
      angiotensin II and AVP and also completely inhibited the potentiating effect of
      CyA on angiotensin II- and AVP-induced Ca2+ mobilization. ANP also completely
      blocked the CyA-stimulated Ca2+ uptake. These findings suggest that CyA
      stimulates transmembrane Ca2+ influx, thereby increasing vasopressor-sensitive
      intracellular Ca2+ stores and augmenting vasopressor-induced Ca2+ mobilization.
      This cellular effect of CyA in vitro was markedly diminished by ANP. The effects
      of CyA on intracellular signaling may directly enhance the contractile response
      of smooth muscle and the glomerular mesangium to vasopressor stimuli and may also
      contribute to other disturbances of cell metabolism associated with CyA.

PMID- 8461630
TI  - Cefotaxime desensitization.
AB  - We report the successful desensitization to cefotaxime in a patient with severe
      lumbar osteomyelitis of unknown bacteriology and hypersensitivity to the drug.
      Desensitization was carried out because of the unknown bacteriology, the
      favorable response to cefotaxime at that time, and hypersensitivity to other
      antibiotics. On the first day the patient received 1 mg cefotaxime intravenously.
      The dose was increased for 13 successive days to 4 g cefotaxime intravenously per
      day. No allergic reaction occurred during desensitization or within 4 weeks of
      observation under this therapy. Patients with severe infections of unknown
      bacteriology might benefit from desensitization if therapy with a second-choice
      antibiotic is impossible.

PMID- 8461631
TI  - Laudatio to Professor Dr. N. Zollner on the occasion of his 70th birthday.

PMID- 8461632
TI  - New clues to the pathophysiology of hepatorenal failure.
AB  - In patients with advanced liver disease, decreases in renal blood flow,
      glomerular filtration rate, and urinary output are frequently observed. The
      deterioration in renal function is usually not due to a unique cause but is the
      result of the concerted action of several mechanisms operating in parallel;
      decreased plasma protein formation and increased intrahepatic vascular resistance
      lead to sequestration of blood volume, favoring hypovolemia and reduction in
      cardiac output. At the same time enhanced formation of nitroxide leads to
      peripheral vasodilation; bacterial endotoxin escaping clearance by the diseased
      liver stimulates the expression of a long-acting nitroxide synthase. Furthermore,
      vasodilating intestinal mediators such as substance P escape inactivation by the
      liver. In the face of peripheral vasodilation the maintenance of blood pressure
      requires an increase in cardiac output, which is achieved by activation of
      sympathetic nervous tone, renal vasoconstriction, enhanced release of renin,
      angiotensin, aldosterone, and antidiuretic hormone, leading to renal retention of
      sodium and water. Renal vasoconstriction is opposed by vasodilatatory
      prostaglandins, and renal failure may be triggered by inhibition of prostaglandin
      formation. On the other hand, vasoconstrictive eicosanoids, such as thromboxane
      B2 and leukotriene E2, which escape hepatic inactivation, may contribute to renal
      vasoconstriction. Beyond these mechanisms disturbed hepatic regulation of renal
      function may participate in the generation of hepatorenal syndrome. The liver
      regulates renal function via both a hepatorenal reflex decreasing renal blood
      flow and a hypothetical liver-borne diuretic factor increasing renal blood flow.
      Both enhanced hepatorenal reflex activity and decreased formation of the liver
      borne diuretic factor could participate in the pathogenesis of hepatorenal
      syndrome.

PMID- 8461634
TI  - The past of the future of medicine.

PMID- 8461633
TI  - Lung transplantation.
AB  - The indications and results of single and double lung transplantation are
      described on the basis of 66 operations performed by the authors and on the
      background of the world literature. Lung transplantation is considered a new and
      promising therapeutic mode for treating patients with end-stage pulmonary failure
      related to fibrosis, emphysema, infective conditions, and pulmonary hypertension
      yielding satisfactory early results. The long-term prognosis of patients
      undergoing lung transplantation, like that of any other organ transfer, remains
      guarded.

PMID- 8461635
TI  - Called by God, led by men: women face the masculinization of American medicine at
      the College of Medical Evangelists, 1909-1922.

PMID- 8461636
TI  - Bodies of the past. Essay review.

PMID- 8461637
TI  - The beginnings of the tobacco controversy: puritanism, James I, and the royal
      physicians.

PMID- 8461638
TI  - "Helps for Suddain accidents": Stephen Bradwell and the origin of the first aid
      guide.

PMID- 8461639
TI  - The conceptualization of influenza in eighteenth-century Britain: specificity and
      contagion.

PMID- 8461640
TI  - Early nutrition and diabetes mellitus.

PMID- 8461641
TI  - Improving medical education.

PMID- 8461642
TI  - Pre-emptive analgesia.

PMID- 8461643
TI  - Selective decontamination of the gut.

PMID- 8461644
TI  - The language of health.

PMID- 8461645
TI  - Use of tumour marker immunoreactivity to identify primary site of metastatic
      cancer.
AB  - OBJECTIVES: To determine whether variations in the expression of tumour related
      antigens can predict the origin of tumours. DESIGN: Immunohistological study of
      tumour marker expression in primary adenocarcinomas and respective metastatic
      deposits. Antibodies to the following tumour markers were used: polymorphic
      epithelial mucin (NCRC-11 and SM3), carcinoembryonic antigen, carcinoembryonic
      antigen with non-specific antigen co-specificity, CA125, CA19.9, prostate
      specific antigens, and thyroglobulin. SETTING: Histopathology department of
      teaching hospital. SUBJECTS: 100 pathology sections of metastatic adenocarcinoma
      and their related primary tumours. MAIN OUTCOME MEASURES: Concordance of
      reactivity between primary and metastatic tumours. Reactivity profiles of tumour
      sites. RESULTS: The correct primary site of origin was predicted in 70% (33/47)
      of tumours in men and 54% (27/43) tumours in women with antibodies SM3, 288,
      CA19.9, CA125, and PSA (men only). Specificities ranged from 68% for breast
      tumour to 98% for prostate tumour. CONCLUSION: Use of tumour markers in patients
      presenting with metastatic adenocarcinoma of unknown origin can help localise the
      probable primary sites and reduce the need for extensive and expensive imaging
      techniques.

PMID- 8461646
TI  - Who's afraid of informed consent?
AB  - OBJECTIVE: To test the assumption that patients will become unduly anxious if
      they are given detailed information about the risks of surgery in an attempt to
      obtain fully informed consent. DESIGN: Preoperative anxiety assessed before and
      after patients were randomly allocated an information sheet containing either
      simple or detailed descriptions of possible postoperative complications. SETTING:
      Four surgical wards at two Sheffield hospitals. SUBJECTS: 96 men undergoing
      elective inguinal hernia repair under general anaesthesia. MAIN OUTCOME MEASURE:
      Change in anxiety level observed after receiving information about potential
      complications. RESULTS: Detailed information did not increase patient anxiety
      (mean Spielberger score at baseline 33.7 (95% confidence interval 31.3 to 36.2),
      after information 34.8 (32.1 to 37.5); p = 0.20, paired t test). A simple
      explanation of the facts provided a statistically significant degree of
      reassurance (mean score at baseline 34.6 (31.5 to 37.6), after information 32.3
      (29.8 to 34.9); p = 0.012), although this small effect is likely to be clinically
      important only in those whose baseline anxiety was high (r = 0.27, p = 0.05).
      CONCLUSIONS: In men undergoing elective inguinal hernia repair a very detailed
      account of what might go wrong does not increase patient anxiety significantly
      and has the advantage of allowing patients a fully informed choice before they
      consent to surgery, thus reducing the potential for subsequent litigation.

PMID- 8461647
TI  - Inherited prion disease (PrP lysine 200) in Britain: two case reports.
AB  - OBJECTIVE: To identify cases of inherited prion diseases in Britain and to assess
      their phenotypic features. DESIGN: Screening study of patients suspected
      clinically to have Creutzfeldt-Jakob disease and other neurodegenerative diseases
      by prion protein gene analysis. SETTING: Biochemical research department.
      SUBJECTS: Patients suspected to have Creutzfeldt-Jakob disease and other
      neurodegenerative diseases. RESULTS: Two patients with symptoms characteristic of
      sporadic Creutzfeldt-Jakob disease were found to have inherited prion protein
      disease (PrP lysine 200), with a mutation at codon 200 of the prion protein gene.
      Both were homozygous at codon 129 of the gene. One patient was a man aged 58 of
      British descent while the other was of Libyan Jewish origin. CONCLUSION: Two foci
      of inherited prion disease are known, among Libyan Jews and in Slovakia. A
      separate British focus of the disease may also exist. Heterozygosity at codon 129
      may lead to reduced penetrance of the mutation.

PMID- 8461648
TI  - Association of low birth weight with beta cell function in the adult first degree
      relatives of non-insulin dependent diabetic subjects.
AB  - OBJECTIVE: To examine the relation between birth weight and beta cell function in
      the first degree relatives of non-insulin dependent diabetic subjects. DESIGN:
      Cross sectional study of 101 adults of known birth weight from 47 families which
      had at least one member with non-insulin dependent diabetes. SUBJECTS: 101 white
      adults aged mean 43 (SD 7) years. SETTING: Oxfordshire, England. MAIN OUTCOME
      MEASURES: Glucose tolerance was measured by continuous infusion glucose tolerance
      test. beta cell function and insulin sensitivity were calculated from the fasting
      plasma glucose and insulin concentrations with homeostasis model assessment. beta
      cell function was standardised to allow for the confounding effects of age and
      obesity. RESULTS: Twenty seven subjects had non-insulin dependent diabetes, 32
      had impaired glucose tolerance, and 42 were normoglycaemic. Birth weight
      correlated with the beta cell function of the complete cohort (rs = 0.29, p =
      0.005), the non-insulin dependent diabetic subjects (rs = 0.50, p = 0.023), and
      the non-diabetic subjects (rs = 0.29, p = 0.013). The non-insulin dependent
      diabetic (n = 27) and the non-diabetic (n = 74) subjects had similar mean (inter
      quartile range) centile birth weight 50% (19%-91%), and 53% (30%-75%)
      respectively. Non-insulin dependent diabetic subjects had significantly lower
      beta function than the non-diabetic subjects: 69% (48%-83%) v 97% (86%-120%), p <
      0.001. CONCLUSIONS: The cause of the association between low birth weight and
      reduced beta cell function in adult life is uncertain. Impaired beta cell
      function in non-insulin dependent diabetic subjects was not accounted for by low
      birth weight, and genetic or environmental factors are likely to be necessary for
      development of diabetes.

PMID- 8461649
TI  - Effect of using safer blood products on prevalence of HIV infection in
      haemophilic Canadians. Canadian Hemophilia Clinic Directors Group.

PMID- 8461650
TI  - Time of presentation, time of operation, and unnecessary appendicectomy.

PMID- 8461651
TI  - General practitioners in partnership with management: an organisational model for
      debate.
AB  - The role of general practitioners is changing and expanding. Doctors have more
      control over the treatment received by their patients but remain largely
      unaccountable to the public and management. This article proposes an
      organisational model for integrating primary and secondary care which retains the
      advantages of fund-holding while giving management control over overall strategy.
      It proposes that general practitioners control funds for all primary and
      secondary care. Secondary care will be contracted through a joint team of
      managers and an elected general practice executive committee. A new health care
      purchasing authority will contract for primary services with individual practices
      or primary care provider units. General practitioners will have local contracts
      reflecting their desire to provide an expanded range of services and the needs of
      the community.

PMID- 8461652
TI  - FHSAs and prescribing.

PMID- 8461653
TI  - Making change happen.

PMID- 8461654
TI  - Primary care development zones.
AB  - Most commentators on the Tomlinson report have agreed with its emphasis on
      improving primary and community care. The three elements of such a strategy are a
      remedial programme to bring primary care up to national standards, a programme to
      provide such services to people with non-standard needs such as mobile Londoners,
      ethnic minorities, and homeless people, and the development of an expanded model
      of primary care. No one model will be appropriate across all of London. The
      process should start with an audit of existing resources and services within each
      community, together with an analysis of needs. From this would develop a local
      programme with specific plans for investment in premises, staffing, training, and
      management. New contractual mechanisms may be needed to attract practitioners,
      improve their premises, secure out of hours services, and provide medical cover
      for community beds. There should also be incentives for closer working between
      primary and secondary services. No developments on the scale needed for London
      have been carried out in primary care within the lifetime of the NHS--but their
      success will be critical to the calibre of health services for Londoners into the
      next century.

PMID- 8461655
TI  - Alternative allergy and the GMC.

PMID- 8461656
TI  - Alternative allergy and the GMC.

PMID- 8461657
TI  - Alternative allergy and the GMC.

PMID- 8461658
TI  - Alternative allergy and the GMC.

PMID- 8461659
TI  - Alternative allergy and the GMC.

PMID- 8461660
TI  - Alternative allergy and the GMC.

PMID- 8461661
TI  - Alternative allergy and the GMC.

PMID- 8461662
TI  - Alternative allergy and the GMC.

PMID- 8461663
TI  - Alternative allergy and the GMC.

PMID- 8461664
TI  - Self monitoring of blood glucose.

PMID- 8461665
TI  - Paget's disease of bone.

PMID- 8461666
TI  - Architecture of cancer.

PMID- 8461667
TI  - Avoiding exposure to HIV and hepatitis.

PMID- 8461668
TI  - Avoiding exposure to HIV and hepatitis.

PMID- 8461669
TI  - Avoiding exposure to HIV and hepatitis.

PMID- 8461670
TI  - Irish vote against abortion.

PMID- 8461671
TI  - Tomlinson report.

PMID- 8461672
TI  - Looking through a bubble.

PMID- 8461673
TI  - The politics of poverty and health.

PMID- 8461674
TI  - Tomlinson report.

PMID- 8461675
TI  - Tomlinson report.

PMID- 8461676
TI  - Cardiotocography during labour.

PMID- 8461677
TI  - Mothering skills of women with mental illness.

PMID- 8461678
TI  - Screening newborn infants for Duchenne muscular dystrophy.

PMID- 8461679
TI  - The Clintons go to Washington: a healthy move?

PMID- 8461680
TI  - Experience with screening newborns for Duchenne muscular dystrophy in Wales.
AB  - OBJECTIVES: To assess the acceptability of screening newborn boys for Duchenne
      muscular dystrophy. DESIGN: Screening is offered on the basis of informed consent
      in response to an information sheet entitled "A new test for baby boys--Do you
      want it?" The programme includes a prospective long term evaluation of family
      responses to early diagnosis and a comparison of their experiences and
      perceptions with those families who have undergone the later traditional clinical
      diagnosis. SETTING: All maternity units throughout Wales. Samples obtained
      through screening programme for phenylketonuria and congenital hypothyroidism.
      SUBJECTS: Those families whose son had a positive screening test. MAIN OUTCOME
      MEASURES: Creatine kinase activity. Venous blood test to confirm positive result.
      Molecular genetic mutation analysis. Muscle biopsy and dystrophin analysis.
      Qualitative measure of satisfaction among affected families. RESULTS: 34,219 Boys
      have been screened and nine affected families have been identified. Eight
      families were very positive about the programme. Three chose not to complete the
      diagnostic process. CONCLUSION: The programme should continue to permit a full
      evaluation of the issues involved and should serve as a model for other
      initiatives within the community for genetic disease.

PMID- 8461681
TI  - Explaining socioeconomic differences in sickness absence: the Whitehall II Study.
AB  - OBJECTIVE: To describe and explain the socioeconomic gradient in sickness
      absence. DESIGN: Analysis of questionnaire and sickness absence data collected
      from the first phase of the Whitehall II study. Grade of employment was used as a
      measure of socioeconomic status. SETTING: 20 civil service departments in London.
      SUBJECTS: 6900 male and 3414 female civil servants aged 35-55 years. MAIN OUTCOME
      MEASURES: Rates of short spells (< or = 7 days) and long spells (> 7 days) of
      sickness absence. RESULTS: A strong inverse relation between grade of employment
      and sickness absence was evident. Men in the lowest grade had rates of short and
      long spells of absence 6.1 (95% confidence interval 5.3 to 6.9) and 6.1 (4.8 to
      7.9) times higher than those in the highest grade. For women the corresponding
      rate ratios were 3.0 (2.3 to 3.9) and 4.2 (2.5 to 6.8) respectively. Several risk
      factors were identified, including health related behaviours (smoking and
      frequent alcohol consumption), work characteristics (low levels of control,
      variety and use of skills, work pace, and support at work), low levels of job
      satisfaction, and adverse social circumstances outside work (financial
      difficulties and negative support). These risk factors accounted for about one
      third of the grade differences in sickness absence. CONCLUSION: Large grade
      differences in sickness absence parallel socioeconomic differences in morbidity
      and mortality found in other studies. Identified risk factors accounted for a
      small proportion of the grade differences in sickness absence. More accurate
      measurement of the risk factors may explain some of the remaining differences in
      sickness absence but other factors, as yet unrecognised, are likely to be
      important.

PMID- 8461683
TI  - Clinical symptoms associated with seroconversion for HIV-1 among misusers of
      intravenous drugs: comparison with homosexual seroconverters and infected and non
      infected intravenous drug misusers.
AB  - OBJECTIVE: To study the clinical symptoms associated with seroconversion for HIV
      1 among misusers of intravenous drugs. DESIGN: Case-control study in cohorts of
      drug misusers and homosexual men. SETTING: Outpatient clinic, Municipal Health
      Service, Amsterdam. SUBJECTS: Misusers of intravenous drugs from our prospective
      cohort who seroconverted for HIV. Controls were drug users positive for HIV, drug
      users negative for HIV, and homosexual men who had seroconverted. RESULTS: Five
      out of 18 (28%) drug users were admitted to hospital with bacterial pneumonia in
      the four to six months between their last visit at which they were HIV negative
      and their first visit when they were HIV positive. For comparison none of the 27
      homosexual men who seroconverted for HIV, three out of 177 (2%) drug users
      negative for HIV, and 10 out of 112 (9%) drug users positive for HIV reported
      bacterial pneumonia. One out of the 18 drug users who seroconverted suffered from
      oesophageal candidiasis at the time of seroconversion. Other clinical symptoms
      did not differ between drug users who seroconverted and those who remained
      negative for HIV, probably due to the high background morbidity among the drug
      users. CONCLUSIONS: Seroconversion to HIV-1 among intravenous drug misusers is
      associated with bacterial pneumonia. Those drug users with previously negative
      test results for HIV who are admitted to hospital for bacterial pneumonia should
      be tested to detect primary infection with HIV-1.

PMID- 8461682
TI  - Vitamin A supplementation in infectious diseases: a meta-analysis.
AB  - OBJECTIVE: To study the effect of vitamin A supplementation on morbidity and
      mortality from infectious disease. DESIGN: A meta-analysis aimed at identifying
      and combining mortality and morbidity data from all randomised controlled trials
      of vitamin A. RESULTS: Of 20 controlled trials identified, 12 trials were
      randomised trials and provided "intention to treat" data: six community trials in
      developing countries, three in children admitted to hospital with measles, and
      three in very low birth weight infants. Combined results for community studies
      suggest a reduction of 30% (95% confidence interval 21% to 38%; two tailed p <
      0.0000001) in all cause mortality. Analysis of cause specific mortality showed a
      reduction in deaths from diarrhoeal disease (in community studies) by 39% (24% to
      50%; two tailed p < 0.00001); from respiratory disease (in measles studies) by
      70% (15% to 90%; two tailed p = 0.02); and from other causes of death (in
      community studies) by 34% (15% to 48%; two tailed p = 0.001). Reductions in
      morbidity were consistent with the findings for mortality, but fewer data were
      available. CONCLUSIONS: Adequate supply of vitamin A, either through
      supplementation or adequate diet, has a major role in preventing morbidity and
      mortality in children in developing countries. In developed countries vitamin A
      may also have a role in those with life threatening infections such as measles
      and those who may have a relative deficiency, such as premature infants.

PMID- 8461684
TI  - Alcohol and cor pulmonale in chronic bronchitis and emphysema.

PMID- 8461685
TI  - Fundholding in northern region: the first year.
AB  - OBJECTIVE: To describe the experiences of 10 fundholding practices in the
      Northern region during 1991-2 and to elicit subjective assessments of the impact
      of their change in status on practice management and patient care. DESIGN:
      Semistructured interviews were conducted with clinicians and practice managers;
      other staff in the practices were asked to fill in questionnaires. Questions were
      asked about the preparatory year, the impact of fundholding on clinical practice
      and practice management, perceptions of the costs and benefits of fundholding,
      and views about the future of the scheme. SETTING: 10 of the 28 first wave
      fundholding practices in the Northern region, March-July 1992. RESULTS: Two
      interviews were conducted in nine practices and one interview in the tenth
      practice. Replies to the questionnaire were received from 35 general
      practitioners (73%) and 89 (58%) nonmedical staff. Practices sought independence
      in applying for fundholding status and found the preparatory year challenging and
      time consuming. General practitioners thought that the greatest change had
      occurred in relationships with consultants and the least change in relationships
      with patients. Most respondents thought that fundholding had changed the way they
      worked. The perceived benefits of fundholding were mentioned more often than the
      perceived costs. CONCLUSIONS: The results offer some encouragement to the
      proponents of fundholding, but more longitudinal studies are needed to evaluate
      the misgivings of critics of the scheme. Fundholders are uncertain about their
      ability to make savings year after year, particularly in an increasingly cost
      contained environment.

PMID- 8461686
TI  - "Not clinically indicated": patients' interests or resource allocation?
AB  - The decision that a particular intervention is not clinically indicated may
      conceal two quite different ethical assumptions. The first assumption is that the
      intervention is not of overall benefit to this patient. The second is that
      limited resources should not be used for this patient. These issues are discussed
      with reference to cardiac surgery in elderly patients with reference to the main
      theories of allocation: QALYs, needs theories, the sanctity of life theory, the
      lottery theory, and market forces.

PMID- 8461687
TI  - Public health medicine and purchasing health care.

PMID- 8461688
TI  - ABC of sleep disorders. Function of sleep.

PMID- 8461689
TI  - Toxic shock syndrome after elective minor dermatological surgery.

PMID- 8461690
TI  - Counselling in general practice.

PMID- 8461691
TI  - Counselling in general practice.

PMID- 8461692
TI  - Monitoring treatment with aminoglycoside antibiotics.

PMID- 8461693
TI  - Monitoring treatment with aminoglycoside antibiotics.

PMID- 8461694
TI  - Monitoring treatment with aminoglycoside antibiotics.

PMID- 8461695
TI  - Monitoring treatment with aminoglycoside antibiotics.

PMID- 8461696
TI  - Another African disaster.

PMID- 8461697
TI  - Another African disaster.

PMID- 8461698
TI  - Electroacupuncture in fibromyalgia.

PMID- 8461699
TI  - HIV transmission, travel, and Thailand.

PMID- 8461700
TI  - National standard for entry into general practice.

PMID- 8461701
TI  - Risk stratification for open heart surgery.

PMID- 8461702
TI  - Laser treatment of port wine stains.

PMID- 8461703
TI  - Cardiovascular disease in developing countries.

PMID- 8461704
TI  - Rationing.

PMID- 8461705
TI  - Working with adult survivors of child sexual abuse.

PMID- 8461706
TI  - Bronchospasm during disulfiram-ethanol test reaction.

PMID- 8461707
TI  - Monitoring cyclosporin treatment.

PMID- 8461708
TI  - Working with adult survivors of child sexual abuse.

PMID- 8461709
TI  - Community care.

PMID- 8461710
TI  - Condyloma acuminatum and squamous papilloma of the palate.

PMID- 8461711
TI  - Contracting arrangements.

PMID- 8461712
TI  - Community care.

PMID- 8461713
TI  - Consultant episodes.

PMID- 8461714
TI  - Junior doctors' hours.

PMID- 8461715
TI  - Junior doctors' hours.

PMID- 8461716
TI  - Waiting times for outpatient appointments.

PMID- 8461717
TI  - Screening for hypertrophic cardiomyopathy.

PMID- 8461718
TI  - On not listening to patients.

PMID- 8461719
TI  - Antibiotic prophylaxis of neonatal group B streptococcal infections.

PMID- 8461720
TI  - Richard Doll at 80.

PMID- 8461721
TI  - Trends in incidence of anal cancer in Denmark.
AB  - OBJECTIVE: To study long term trends in incidence of anal cancer in a well
      monitored, unselected population. DESIGN: Descriptive epidemiological study based
      on data from the Danish Cancer Registry. SETTING: Denmark, 1943-87. MAIN OUTCOME
      MEASURES: Time related changes in anal cancer incidence according to sex, age,
      birth cohort, urban or rural residence, and marital status. RESULTS: The
      incidence of anal cancer remained fairly constant in the period 1943-57 and was
      similar for men and women, but it increased 1.5-fold among men and nearly tripled
      among women thereafter. Among men the incidence increased from 0.25 per 100,000
      population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among
      women from 0.28 to 0.74 (p < 0.01). The greatest increase was among residents of
      the capital (Copenhagen). During 1943-87 age specific trends increased in young
      and middle aged men and in all age groups among women. Men with anal cancer were
      significantly more likely throughout the study period to be unmarried than were
      patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence
      interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with
      marital status was found among women. CONCLUSIONS: The distribution and incidence
      of anal cancer have changed appreciably since around 1960, especially among
      women, which indicates important aetiological changes. Changes in sexual
      behaviour may have facilitated the spread of a transmittable agent of
      aetiological importance. It has recently been suggested that cigarette smoking
      promotes anal cancer, and this finds indirect support in the synchronism between
      changes in anal cancer incidence and heavy smoking behaviour. Factors associated
      with homosexuality are likely to explain some of the cases among men.

PMID- 8461722
TI  - The relation of small head circumference and thinness at birth to death from
      cardiovascular disease in adult life.
AB  - OBJECTIVE: To determine how fetal growth is related to death from cardiovascular
      disease in adult life. DESIGN: A follow up study of men born during 1907-24 whose
      birth weights, head circumferences, and other body measurements were recorded at
      birth. SETTING: Sheffield, England. SUBJECTS: 1586 Men born in the Jessop
      Hospital. MAIN OUTCOME MEASURE: Death from cardiovascular disease. RESULTS:
      Standardised mortality ratios for cardiovascular disease fell from 119 in men who
      weighed 5.5 pounds (2495 g) or less at birth to 74 in men who weighed more than
      8.5 pounds (3856 g). The fall was significant for premature cardiovascular deaths
      up to 65 years of age (chi 2 = 5.0, p = 0.02). Standardised mortality ratios also
      fell with increasing head circumference (chi 2 = 4.6, p = 0.03) and increasing
      ponderal index (weight/length3) (chi 2 = 3.8, p = 0.05; for premature deaths chi
      2 = 6.0, p = 0.01). They were not related to the duration of gestation. Among men
      for whom the ratio of placental weight to birth weight was in the highest fifths
      the standardised mortality ratio was 137. CONCLUSION: These findings show that
      reduced fetal growth is followed by increased mortality from cardiovascular
      disease. They suggest that reduction in growth begins early in gestation. They
      are further evidence that cardiovascular disease originates through programming
      of the body's structure, physiology, and metabolism by the environment during
      fetal life. Maternal nutrition may have an important influence on programming.

PMID- 8461723
TI  - Sexually transmitted diseases and HIV-1 infection among homosexual men in England
      and Wales.
AB  - OBJECTIVE: To examine surveillance data for evidence of changing sexual behaviour
      and continuing transmission of HIV-1 among men who have sex with men. DESIGN:
      Analytic study of surveillance data on sexually transmitted diseases. SETTING:
      England and Wales. MAIN OUTCOME MEASURES: Number of cases of rectal gonorrhoea
      and newly diagnosed HIV infection in homosexual men. RESULTS: New cases of
      gonorrhoea among men attending genitourinary medicine clinics increased by 7.7%
      in 1989 and by 4.2% in 1990. Reports of rectal isolates of Neisseria gonorrhoeae
      also rose and the male to female ratio for patients with rectal gonorrhoea
      changed from 0.3:1 during 1988-9 to 2.6:1 in 1990-1. Although the overall number
      of cases of acute hepatitis B fell during 1988-91, 81 and 82 homosexual men were
      infected in 1990 and 1991 respectively compared with 50 and 42 in 1988 and 1989.
      1526 men had HIV-1 infection diagnosed in 1991, the largest number since 1987.
      Twenty eight of the 97 (29%) men who seroconverted between January 1989 and
      December 1991 were aged less than 25. The proportion of men aged 15-19 who were
      found to be infected with HIV-1 at their first test increased from an average of
      2.4% up to 1990 to 4.7% in the first nine months of 1991. The prevalence of HIV
      infection in men under 25 attending genitourinary medicine clinics in London was
      17% compared with 7.8% outside London. CONCLUSION: Unsafe sexual behaviour and
      HIV transmissions have increased among homosexual men after a period of decline.
      Recent HIV transmissions may disproportionately affect younger men.

PMID- 8461724
TI  - Dangers of long waiting times for outpatient appointments at a urology clinic.

PMID- 8461725
TI  - Effect of long term tamoxifen treatment on bone turnover in women with breast
      cancer.

PMID- 8461726
TI  - Prevalence of symptoms in patients with simple renal cysts.

PMID- 8461727
TI  - Analysis of national register of Down's syndrome in England and Wales: trends in
      prenatal diagnosis, 1989-91.

PMID- 8461728
TI  - Effect of NHS reforms on general practitioners' referral patterns.
AB  - OBJECTIVE: To compare outpatient referral patterns in fundholding and non
      fundholding practices before and after the implementation of the NHS reforms in
      April 1991. DESIGN: Prospective collection of data on general practitioners'
      referrals to specialist outpatient clinics between June 1990 and March 1992 and
      detailed comparison of two time periods: October 1990 to March 1991 (phase 1) and
      October 1991 to March 1992 (phase 2). SETTING: 10 fundholding practices and six
      non-fundholding practices in the Oxford region. SUBJECTS: Patients referred to
      consultant outpatient clinics. RESULTS: After implementation of the NHS reforms
      there was no change in the proportion of referrals from the two groups of
      practices which crossed district boundaries. Both groups of practices increased
      their referral rates in phase 2 of the study, the fundholders from 107.3 per 1000
      patients per annum (95% confidence interval 106 to 109) to 111.4 (110 to 113) and
      the non-fundholders from 95.0 (93 to 97) to 112.0 (110 to 114). In phase 2 there
      was no difference in overall standardised referral rates between fundholders and
      non-fundholders. Just over 20% of referrals went to private clinics in phase 1.
      By phase 2 this proportion had reduced by 2.2% (1.0% to 3.4%) among the
      fundholders and by 2.7% (1.2% to 4.2%) among the non-fundholders. CONCLUSIONS:
      Referral patterns among fundholders and non-fundholders were strikingly similar
      after the implementation of the NHS reforms. There was no evidence that
      fundholding was encouraging a shift from specialist to general practice care or
      that budgetary pressures were affecting general practitioners' referral
      behaviour.

PMID- 8461730
TI  - Letter from Albania. A country in transition.

PMID- 8461729
TI  - Screen detected high blood pressure under 40: a general practice population
      followed up for 21 years.
AB  - OBJECTIVE: To assess hypertension detected under 40 in a general practice
      population. DESIGN: Prospective case-control study. SETTING AND SUBJECTS: Former
      coal mining community in south Wales. Systematic case finding for hypertension
      and associated risk factors applied to a mean total population of 1945 from age
      20 on a five year cycle through 21 years. Mean population aged 20-39, 227 men and
      213 women. Case criteria: age < 40 and mean systolic pressure > or = 160 mm Hg or
      diastolic pressure > or = 100 mm Hg. Age and sex matched controls randomly
      sampled from the same population. MAIN OUTCOME MEASURES: Mean initial pressures
      and pressures at follow up in 1989 or preceding death, and all cardiovascular
      events. RESULTS: 25 men and 16 women met criteria. Estimated five yearly
      inceptions were 26/1000 for men and 18/1000 for women. Male group mean initial
      blood pressure was 164/110 mm Hg for cases, falling to 148/89 mm Hg at follow up.
      Five male cases died at mean age 47.8, compared with two controls at 49.5. Female
      group mean initial pressure was 172/107 mm Hg for cases, falling to 145/86 mm Hg
      at follow up. One female case died aged 50, no controls. 10 male cases had non
      fatal cardiovascular events at mean age 40.2, compared with two controls at mean
      age 50.5. Four female cases had non-fatal events at mean age 47.2, compared with
      one control aged 58. Male differences were statistically significant.
      CONCLUSIONS: Hypertension under 40 is dangerous, commoner in men than women,
      rarely secondary to classic causes, and may be controlled in general practice on
      a whole community basis.

PMID- 8461731
TI  - ABC of sleep disorders. Circadian rhythms.

PMID- 8461732
TI  - Persistent glue ear in children.

PMID- 8461733
TI  - Persistent glue ear in children.

PMID- 8461734
TI  - Persistent glue ear in children.

PMID- 8461735
TI  - Persistent glue ear in children.

PMID- 8461736
TI  - Medical education.

PMID- 8461737
TI  - Medical education.

PMID- 8461738
TI  - Persistent glue ear in children.

PMID- 8461739
TI  - Medical education.

PMID- 8461740
TI  - Monitoring theophylline treatment.

PMID- 8461741
TI  - Liver failure induced by paracetamol.

PMID- 8461742
TI  - Monitoring theophylline treatment.

PMID- 8461743
TI  - Treating mentally ill people in the community.

PMID- 8461744
TI  - Treating mentally ill people in the community.

PMID- 8461745
TI  - Treating mentally ill people in the community.

PMID- 8461746
TI  - Treating mentally ill people in the community.

PMID- 8461747
TI  - Preoperative autologous blood transfusion programme.

PMID- 8461748
TI  - Consensus statements.

PMID- 8461749
TI  - Misuse of anabolic drugs.

PMID- 8461750
TI  - Oral cancer in Scotland.

PMID- 8461751
TI  - Saving the normal foreskin.

PMID- 8461752
TI  - Child resistant containers for liquid medications.

PMID- 8461753
TI  - Child resistant containers for liquid medications.

PMID- 8461754
TI  - Computer generated protocols.

PMID- 8461755
TI  - Managing urinary tract infection.

PMID- 8461756
TI  - Decreasing quality of semen.

PMID- 8461757
TI  - Screening for abdominal aortic aneurysms.

PMID- 8461759
TI  - Dentists and the NHS.

PMID- 8461758
TI  - Nurse practitioners in accident and emergency departments.

PMID- 8461760
TI  - Malignant melanomas in general practice.

PMID- 8461761
TI  - New clinics for HIV testing: a waste of money.

PMID- 8461762
TI  - ACE inhibitors after myocardial infarction.

PMID- 8461763
TI  - Deprivation payments.

PMID- 8461764
TI  - Improving London's health service.

PMID- 8461765
TI  - Treating bed wetting.

PMID- 8461766
TI  - Mycobacterium tuberculosis DNA in tissue affected by sarcoidosis.
AB  - OBJECTIVE: To investigate the prevalence of Mycobacterium tuberculosis DNA in
      granulomatous tissues from patients with sarcoidosis and from controls matched
      for age, sex, and tissue by using the polymerase chain reaction. DESIGN: Single
      blind control trial. SUBJECTS: 16 patients with sarcoidosis who had undergone
      diagnostic biopsy of lung, skin, or lymph node and 16 patients with squamous cell
      carcinoma or Hodgkin's disease to act as controls. In addition, four lung
      specimens infected with M tuberculosis were included as positive controls.
      RESULTS: M tuberculosis DNA was present in sarcoid tissues containing granulomas
      from seven of the 16 patients and one of the 16 matched controls. Two of the four
      specimens known to be infected with M tuberculosis were positive in the
      controlled experiment. CONCLUSION: These figures suggest that M tuberculosis DNA
      is detected as readily in patients with sarcoidosis as in patients with frankly
      tuberculous tissues and imply that M tuberculosis may be linked to the cause of
      sarcoidosis.

PMID- 8461767
TI  - Demographic and social characteristics of adults with cystic fibrosis in the
      United Kingdom.
AB  - OBJECTIVE: To obtain information about social and demographic characteristics and
      lifestyle of adult patients with cystic fibrosis, including those who do not
      attend major specialist clinics. DESIGN: Confidential self completion postal
      questionnaire to adult patients with cystic fibrosis, asking about social and
      demographic characteristics, social class and occupation, employment, education,
      insurance and social security benefits, symptom severity, and medical care.
      SETTING: National association for adults with cystic fibrosis. SUBJECTS: 1052
      adult members of the Association of Cystic Fibrosis Adults UK, accounting for 68%
      of those with cystic fibrosis in the United Kingdom population over 16 years of
      age and over 80% of those over 25 in June 1990. RESULTS: The response rate was
      82% (397 women, 423 men). Most adults with cystic fibrosis were found to be
      living fulfilling lives into adulthood. Significantly fewer men were married or
      cohabiting than women (110 (26%) men, 175 (44%) women). 420 (55%) responders were
      working, and of these 235 (56%) had less than two weeks' sick leave a year. Half
      of those not employed gave ill health as the reason. Revealing that they had
      cystic fibrosis at job interviews reduced likelihood of being employed for those
      with mild to moderate disease. People with cystic fibrosis had been less
      successful than the general population in achieving O level or equivalent
      qualifications, but more successful in achieving A level or higher
      qualifications. Achievement of any qualifications enhanced employment prospects
      irrespective of disease severity. CONCLUSION: Contrary to an image of chronic ill
      health and disability, a high proportion of adults with cystic fibrosis are
      living full and productive lives.

PMID- 8461768
TI  - Clinical diagnosis of pyloric stenosis: a declining art.
AB  - OBJECTIVE: To assess whether diagnostic imaging of pyloric stenosis has made a
      difference in rapidity of diagnosis, duration of pre-operative hydration, and
      length of stay in hospital. DESIGN: Chart review of infants with confirmed
      diagnosis of pyloric stenosis. SETTING: Paediatric teaching hospital. SUBJECTS:
      215 infants with a confirmed diagnosis of pyloric stenosis seen during 1974-7 and
      187 infants with pyloric stenosis seen during 1988-91. MAIN OUTCOME MEASURES:
      State of hydration on admission, time between presentation to hospital and a
      definite diagnosis, techniques used to make the diagnosis, whether a pyloric mass
      was felt before or after an imaging procedure, time between presentation and
      surgery, and length of stay in hospital. RESULTS: The average age at presentation
      was 40 days in both groups. A pyloric mass was palpated either without or before
      an imaging study in 87% (187/215) of cases during 1974-7 but in only 49% (91/187)
      during 1988-91. The use of barium meal examination and ultrasonography increased
      from 20% (42/215) of cases during 1974-7 to 61% (114/187) during 1988-91. There
      were no significant differences between the two groups in the time taken to
      establish a diagnosis, the mean duration of preoperative treatment, or the length
      of stay in hospital (after allowance for the decline in average length of stay of
      all hospital patients between the two periods). CONCLUSIONS: An increased use of
      diagnostic imaging for pyloric stenosis did not lead to earlier diagnosis or
      better management. While imaging is important in identifying pyloric stenosis in
      difficult cases, increasing reliance on imaging has reduced doctors' skills in
      diagnosing pyloric stenosis clinically.

PMID- 8461769
TI  - Antibiotic resistant propionibacteria in acne: need for policies to modify
      antibiotic usage.

PMID- 8461771
TI  - Weak link in vaccine cold chain.

PMID- 8461770
TI  - Knowledge and use of secondary contraception among patients requesting
      termination of pregnancy.

PMID- 8461772
TI  - Risk of vertebral fracture in women with rheumatoid arthritis.

PMID- 8461773
TI  - National asthma attack audit 1991-2. General Practitioners in Asthma Group.
AB  - OBJECTIVE: To describe the frequency and characteristics of asthma attacks in the
      United Kingdom and to compare actual management with recommended guidelines for
      the management of attacks. DESIGN: Correspondence survey. SETTING: 218 general
      practices in the United Kingdom. SUBJECTS: 1775 patients of all ages who had a
      total of 1805 asthma attacks over three months. MAIN OUTCOME MEASURES: Patient
      characteristics, place of management of attacks, comparison of actual management
      with recommended guidelines. RESULTS: Of the 1805 attacks, 300 occurred in boys
      aged 0-9, 144 in girls aged 0-9, and 118 in women aged 20-29. The estimated
      frequency of attacks in the community was 14.3 per 1000 patients per year. 1546
      (86%) patients with attacks were managed within general practice, 225 (12%) were
      admitted to hospital, and 34 (2%) were discharged from an accident and emergency
      department. Two patients died. On initial presentation, 248 (14%) patients were
      "not breathless," 900 (50%) were "moderately breathless," 535 (30%) were
      "breathless and distressed," 68 (4%) were "too breathless to talk," and 2 were
      "moribund." Recording of clinical data was variable. Underuse of nebulised
      bronchodilators and systemic steroid was apparent in all grades of clinical
      severity. Contrary to current guidelines for asthma management, "step up" in
      maintenance therapy after an attack was often not practised. CONCLUSION: Reported
      management was at variance with recommended guidelines. This has major
      implications for the design and distribution of future guidelines.

PMID- 8461774
TI  - Ethical issues in randomised prevention trials.

PMID- 8461775
TI  - Newcastle: "if it doesn't work here, it can't work anywhere".

PMID- 8461776
TI  - Some guidelines on the use of cost effectiveness league tables.
AB  - Decisions to allocate resources in health care are increasingly influenced by
      relative cost effectiveness. To warn decision makers of some of the pitfalls
      currently found in cost effectiveness league tables and to suggest how meaningful
      comparisons may be made between health care technologies a published league table
      was scrutinised by examining its sources. This showed some of the methodological
      problems surrounding such tables and how such difficulties could be reduced in
      future. The source studies in the table featured different years of origin,
      discount rates, health state evaluations, settings, and types of comparison
      programmes; all of these differences may raise problems for meaningful
      comparison. Decision makers need to assess the relative value for money of
      competing health care interventions. In the absence of systematic comparisons
      such assessments are likely to take place informally. This will probably have a
      worse risk-benefit trade off than the formalized use of league tables.

PMID- 8461777
TI  - ABC of sleep disorders. Recreational drugs and sleep.

PMID- 8461778
TI  - Foreign body aspiration: a hazard of metered dose inhalers.

PMID- 8461779
TI  - Umbilical cord clamping in preterm infants.

PMID- 8461780
TI  - Umbilical cord clamping in preterm infants.

PMID- 8461781
TI  - Problem lists in letters.

PMID- 8461782
TI  - Problem lists in letters.

PMID- 8461783
TI  - Problem lists in letters.

PMID- 8461784
TI  - Problem lists in letters.

PMID- 8461785
TI  - The laryngeal mask.

PMID- 8461786
TI  - The laryngeal mask.

PMID- 8461787
TI  - The laryngeal mask.

PMID- 8461788
TI  - Gestational diabetes mellitus.

PMID- 8461789
TI  - Gestational diabetes mellitus.

PMID- 8461790
TI  - Alternative allergy and the GMC.

PMID- 8461791
TI  - Sexual behaviour.

PMID- 8461792
TI  - Poor growth in children.

PMID- 8461793
TI  - Sexual behaviour.

PMID- 8461794
TI  - Circumcision.

PMID- 8461795
TI  - Initiation of hypertension in utero.

PMID- 8461796
TI  - Epidemiology of endometriosis.

PMID- 8461797
TI  - Hypersensitivity to dexamethasone.

PMID- 8461798
TI  - Business travel and sexually transmitted diseases.

PMID- 8461799
TI  - Community dermatology.

PMID- 8461800
TI  - General practitioners in partnership with management.

PMID- 8461801
TI  - BMA's evidence on specialist training.

PMID- 8461802
TI  - Piscatorial epistles.

PMID- 8461803
TI  - Shanghai declaration on non-communicable diseases. WHO Directors of Non
      Communicable Disease Collaborating Centres and Key Officials.

PMID- 8461804
TI  - Paracelsus, and 500 years of encouraging scientific inquiry.

PMID- 8461805
TI  - Hypertension and cancer.

PMID- 8461806
TI  - Diabetic care in general practice.

PMID- 8461807
TI  - Treating hypoglycaemia in general practice.

PMID- 8461808
TI  - Non-medical use of ketamine.

PMID- 8461809
TI  - Meeting local needs.

PMID- 8461810
TI  - Incidence of and mortality from cancer in hypertensive patients.
AB  - OBJECTIVES: To assess incidence of and mortality from cancer in hypertensive
      patients taking atenolol, comparing the findings with two control populations and
      with hypertensive patients taking other drugs. DESIGN: Retrospective analysis of
      patients first seen in the Glasgow Blood Pressure Clinic between 1972 and 1990.
      Patients' records were linked with the registrar general's data for information
      on mortality and with the West of Scotland Cancer Registry for information on
      incident and fatal cancers. Cancers were compared in patients and controls and in
      patients taking atenolol, beta blockers other than atenolol, and hypotensive
      drugs other than beta blockers. SUBJECTS: 6528 male and female patients providing
      54,355 years of follow up. SETTING: Hypertension clinic in Glasgow. MAIN OUTCOME
      MEASURES: Observed numbers of cancers in clinic patients were compared with
      expected numbers derived from cancer rates in two control populations adjusted
      for age, sex, and time period of data collection. RESULTS: Cancer mortality was
      not significantly different in clinic patients as a whole and controls. Incident
      and fatal cancers were not significantly increased in male or female patients
      taking atenolol. Cancer incidence did not rise in the clinic after a large
      increase in prescriptions for atenolol after 1976. CONCLUSION: This analysis does
      not suggest a link between atenolol and cancer.

PMID- 8461811
TI  - Case-control study of leukaemia and non-Hodgkin's lymphoma among children aged 0
      4 years living in west Berkshire and north Hampshire health districts.
AB  - OBJECTIVE: To investigate the relation between parental employment in the nuclear
      industry and childhood leukaemia and non-Hodgkin's lymphoma. DESIGN: Case-control
      study. SETTING-West Berkshire and Basingstoke and North Hampshire District Health
      Authorities. SUBJECTS: 54 children aged 0-4 years who had leukaemia or non
      Hodgkin's lymphoma diagnosed during 1972-89, who were born in the study area and
      were resident there when cancer was diagnosed. Six controls were selected for
      each case: four from hospital delivery registers and two from livebirth registers
      maintained by the NHS central register. Controls were matched for sex, date of
      birth (within six months), and area of residence at birth and time of diagnosis.
      MAIN OUTCOME MEASURES: Parents' employment by the nuclear industry and exposure
      to ionising radiation at work. RESULTS: Five (9%) of the 54 cases and 14 (4%) of
      the 324 controls had fathers or mothers, or both, who had been employed by the
      nuclear industry (relative risk 2.2, 95% confidence interval 0.6 to 6.9). Nuclear
      industry employees who work in areas where exposure to radiation is possible are
      given film badges to monitor their exposure to external penetrating ionising
      radiation. Three fathers of cases and two fathers of controls (and no mothers of
      either) had been monitored in this way before their child was conceived (relative
      risk 9.0, 95% confidence interval 1.0 to 107.8). No father (of a case or control)
      had accumulated a recorded dose of more than 5 mSv before his child was
      conceived, and no father had been monitored at any time in the four years before
      his child was conceived. A dose-response relation was not evident among fathers
      who had been monitored. CONCLUSIONS: These results suggest that the children of
      fathers who had been monitored for exposure to external penetrating ionising
      radiation in the nuclear industry may be at increased risk of developing
      leukaemia before their fifth birthday. The finding is based on small numbers and
      could be due to chance. If the relationship is real the mechanisms are far from
      clear, except that the effect is unlikely to be due to external radiation; the
      possibility that it could be due to internal contamination by radioactive
      substances or some other exposure at work should be pursued. The above average
      rates of leukaemia in the study area cannot be accounted for by these findings.

PMID- 8461812
TI  - Comparison of nifedipine and propranolol as second line agent for hypertension in
      black Kenyans.

PMID- 8461813
TI  - Cancer mortality and atenolol treatment.

PMID- 8461814
TI  - Does awareness of rates of obstetric interventions change practice?

PMID- 8461815
TI  - Prompting the clinical care of non-insulin dependent (type II) diabetic patients
      in an inner city area: one model of community care.
AB  - OBJECTIVE: To evaluate the effectiveness and acceptability of centrally organised
      prompting for coordinating community care of non-insulin dependent diabetic
      patients. DESIGN: Randomised single centre trial. Patients allocated to prompted
      care in the community or to continued attendance at hospital diabetic clinic
      (controls). Median follow up two years. SETTING: Two hospital outpatient clinics,
      38 general practices, and 11 optometrists in the catchment area of a district
      general hospital in Islington. PATIENTS: 181 patients attending hospital
      outpatient clinics. NULL HYPOTHESIS: There is no difference in process of medical
      care measures and medical outcome between prompted community care and hospital
      clinic care. RESULTS: 14 hospital patients failed to receive a single review in
      the clinic as compared with three patients in the prompted group (chi 2 = 6.1, df
      = 1; p = 0.013). Follow up for retinal screening was better in prompted patients
      than in controls; two prompted patients defaulted as against 12 controls (chi 2 =
      6.9, df = 1; p = 0.008). Three measures per patient yearly were more frequent in
      prompted patients: tests for albuminuria (median 3.0 v 2.3; p = 0.03), plasma
      glucose estimations (3.1 v 2.5; p = 0.003), and glycated haemoglobin estimations
      (2.4 v 0.9; p < 0.001). Continuity of care was better in the prompted group (3.2
      v 2.2 reviews by each doctor seen; p < 0.001). The study ended with no
      significant differences between the groups in last recorded random plasma glucose
      concentration, glycated haemoglobin value, numbers admitted to hospital for a
      diabetes related reason, and number of deaths. Questionnaires revealed a high
      level of patient, general practitioner, and optometrist satisfaction.
      CONCLUSIONS: Six monthly prompting of non-insulin treated diabetic patients for
      care by inner city general practitioners and by optometrists is effective and
      acceptable.

PMID- 8461817
TI  - Community care and the fundholder.
AB  - According to the government, clearly agreed local arrangements should enable
      individual general practitioners to make their full contribution to the new
      system of community care without getting involved in extra bureaucracy. From 1
      April the main part of that contribution will be to refer to social services
      those patients who seem to need social care. Many general practitioners are
      worried that such referrals will be complex and time consuming and will generate
      too much extra work. Moreover, general practitioners may also be asked to see
      patients specifically to help social workers' assessment procedures, and many
      fear that such consultations will overwork and underpay them. General
      practitioner fundholders already use contracts to spell out what they expect from
      hospital services. From 1 April they will be able to set up contracts for
      community health services such as district nursing and chiropody, and possibly
      this might be extended to social aspects of community care. Over the past 14
      months Dr Rhidian Morris and his partners in a fundholding practice in Devon have
      piloted contracts for all aspects of community care. In this article Dr Morris
      explains how the most radical part of the pilot project--the contract for social
      care--was set up. He argues that the lessons on communication that came from what
      was essentially a fundholding project could apply also to non-fundholding
      practices.

PMID- 8461818
TI  - The fortysomething barrier: medicine and age discrimination.
AB  - Agism in the medical profession is mainly covert but it is not uncommon. It is
      widely believed that people become less productive as they get older. However,
      research has shown that older people have less absenteeism, more job stability,
      and greater output than younger workers. Job losses, which until recently were
      unheard of in the NHS, usually affect older people first, resulting in the loss
      of those with the most skill and experience. With an aging population it is
      important that the government takes steps to discourage age discrimination in the
      NHS and Britain as a whole.

PMID- 8461816
TI  - Influences on control in diabetes mellitus: patient, doctor, practice, or
      delivery of care?
AB  - OBJECTIVE: To assess patient, doctor, practice, and process of care variables for
      their effect on glycaemic control in diabetes mellitus, and to quantify their
      relative effects. DESIGN: Search of general practice medical records, patient
      questionnaires and examination, doctor questionnaire, videotaping and analysis of
      consultations, and practice questionnaire. SETTING: 12 practices with 32
      participating general practitioners in Nottinghamshire. SUBJECTS: 318 patients
      randomly selected from those with diabetes in each practice, 10 for each
      participating doctor. MAIN OUTCOME MEASURE: Glycaemic control as measured by
      random glycated haemoglobin A1c estimation (random haemoglobin A1 measurement).
      RESULTS: Glycaemic control was significantly related to the disease process as
      measured by years since diagnosis, treatment group, and number of diabetes
      related clinical events. Females had significantly worse control than males.
      Other patient factors, such as age, social class, lifestyle, attitudes,
      satisfaction, and knowledge, had no association with glycaemic control. Of all
      the doctor factors examined, only doctors who professed a special interest in
      diabetes achieved significantly better glycaemic control. Bigger and better
      equipped practices and those with a diabetic miniclinic had patients with
      significantly better glycaemic control, as did those with access to dietetic
      advice. Patients attending hospital clinics had worse glycaemic control, but this
      seemed to be attributable to the case mix and practice characteristics. Shared
      care did not contribute to the multiple linear regression model. CONCLUSION:
      Glycaemic control among diabetic patients in the community is related to such
      factors as treatment group, sex, and years since diagnosis; it is also related to
      the organisation and process of care. The findings support concentrating diabetic
      care on partners with special interests in diabetes in well equipped practices
      with adequate dietetic support.

PMID- 8461819
TI  - ABC of sleep disorders. Sleep disorders in children.

PMID- 8461820
TI  - Late presentation of traumatic rupture of the diaphragm in a child.

PMID- 8461821
TI  - How many doctors does Britain need?

PMID- 8461822
TI  - How many doctors does Britain need?

PMID- 8461823
TI  - Unlicensed nicotine skin patches.

PMID- 8461824
TI  - How many doctors does Britain need?

PMID- 8461825
TI  - Medical education.

PMID- 8461826
TI  - Death from cancer at home.

PMID- 8461827
TI  - Death from cancer at home.

PMID- 8461828
TI  - Long term care of elderly people in the NHS.

PMID- 8461829
TI  - Respite care.

PMID- 8461830
TI  - Children of parents infected with HIV in Lothian.

PMID- 8461831
TI  - Retinoblastoma in children of former residents of Seascale.

PMID- 8461832
TI  - Persistent glue ear in children.

PMID- 8461833
TI  - Inheritance of chronic inflammatory bowel disease.

PMID- 8461834
TI  - Pre-emptive analgesia.

PMID- 8461835
TI  - BCG vaccination and health care workers.

PMID- 8461836
TI  - Selective decontamination of the gut.

PMID- 8461837
TI  - Toxic shock syndrome after minor surgery.

PMID- 8461838
TI  - Risks to surgeons and patients from HIV and hepatitis.

PMID- 8461839
TI  - Gloves for venepuncture.

PMID- 8461840
TI  - Microalbuminuria, height, and sex.

PMID- 8461841
TI  - Police surgeons.

PMID- 8461842
TI  - Low blood pressure and wellbeing.

PMID- 8461843
TI  - The cervical spine in rheumatoid arthritis.

PMID- 8461844
TI  - Gangliosides in neurological diseases.

PMID- 8461845
TI  - Patients' interests or resource allocation?

PMID- 8461846
TI  - NHS reforms.

PMID- 8461847
TI  - Tipping the balance.

PMID- 8461848
TI  - Waiting times for outpatient appointments.

PMID- 8461849
TI  - Volatile substances and the law.

PMID- 8461850
TI  - Brief interventions for alcohol problems: a review.
AB  - Relatively brief interventions have consistently been found to be effective in
      reducing alcohol consumption or achieving treatment referral of problem drinkers.
      To date, the literature includes at least a dozen randomized trials of brief
      referral or retention procedures, and 32 controlled studies of brief
      interventions targeting drinking behavior, enrolling over 6000 problem drinkers
      in both health care and treatment settings across 14 nations. These studies
      indicate that brief interventions are more effective than no counseling, and
      often as effective as more extensive treatment. The outcome literature is
      reviewed, and common motivational elements of effective brief interventions are
      described. There is encouraging evidence that the course of harmful alcohol use
      can be effectively altered by well-designed intervention strategies which are
      feasible within relatively brief-contact contexts such as primary health care
      settings and employee assistance programs. Implications for future research and
      practice are considered.

PMID- 8461851
TI  - Cross system agreement for substance use disorders: DSM-III-R, DSM-IV and ICD-10.
AB  - This report presents results of a field trial of Substance Use Disorders as
      defined by DSM-III-R, DSM-IV (proposed) and ICD-10. Diagnoses based on the three
      systems were derived from interviews using the Composite International Diagnostic
      Interview (CIDI) in a heterogeneous sample of 521 adults drawn from clinical and
      community settings. Two issues are addressed: (1) cross system agreement; and (2)
      syndrome coherence of proposed criterion sets for Substance Dependence in each of
      the three systems. Findings were as follows: (1) Cross system agreement for
      Dependence was generally high, especially between DSM-III-R and DSM-IV. (2) Cross
      system agreement was lower for DSM-III-R and DSM-IV Abuse and very low for DSM-IV
      Abuse and ICD-10 Harmful Use. (3) Agreement varied across drug categories with
      lowest DSM-III-R/DSM-IV agreement for alcohol abuse and DSM-IV/ICD-10 agreement
      for marijuana use disorders. (4) Overall prevalence differed for the three
      systems with DSM-IV yielding highest rates followed by DSM-III-R and ICD-10 in
      that order. (5) Factor analysis of Dependence criteria showed high loadings of
      all items on a single factor across the three diagnostic systems and for all
      categories of drugs. Implications for validity of the dependence syndrome
      construct and for revisions in DSM-IV are discussed.

PMID- 8461852
TI  - Alcohol consumption and related problems among primary health care patients: WHO
      collaborative project on early detection of persons with harmful alcohol
      consumption--I.
AB  - This WHO collaborative project is the first phase of a programme of work aimed at
      developing techniques for early identification and treatment of persons with
      hazardous and harmful alcohol consumption. The aim of the present study was to
      determine the prevalence of hazardous and harmful alcohol use among patients
      attending primary health care facilities in several countries, and to examine the
      correlates of drinking behaviour and alcohol-related problems in these culturally
      diverse populations. The broader purpose was to determine whether there was
      justification for developing alcohol screening instruments for cross-national
      use. One thousand, eight hundred and eighty-eight subjects in Australia,
      Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment
      of their medical history, alcohol intake, drinking practices, and any physical or
      psychosocial problems related to alcohol. After non-drinkers and known alcoholics
      had been excluded, 18% of subjects had a hazardous level of alcohol intake and
      23% had experienced at least one alcohol-related problem in the previous year.
      Intrascale reliability coefficients were uniformly high for the drinking
      behaviour (dependence) and adverse psychological reactions scales, and moderately
      high for the alcohol-related problems scales. There were strong correlations
      between the various alcohol-specific scales, and between these scales and
      measures of alcohol intake. Although the prevalence of hazardous and harmful
      alcohol consumption varied from country to country, there was a high degree of
      commonality in the structure and correlates of drinking behaviour and alcohol
      related problems. These findings strengthen the case for developing international
      screening instruments for hazardous and harmful alcohol consumption.

PMID- 8461853
TI  - The Alcohol Use Disorders Identification Test (AUDIT) in a routine health
      examination of long-term unemployed.
AB  - A representative sample of 310 long-term unemployed in Norway was followed for 2
      years with clinical examinations and the AUDIT questionnaire. 30% of the men and
      8% of the women scored over the cut-off point for an alcohol use disorder. This
      gives a probable prevalence of 16%. The test predicted return to employment in
      this sample. The AUDIT answers were also used as a basis for dividing into three
      groups: 'normal', 'hazardous' and 'harmful'. At 2 year follow-up, 27% had changed
      group, 32 respondents to the worse and 24 to the better. This 'unstable' group
      was characterized by weaker social network and more frequent drinking. The AUDIT
      was judged as a useful instrument both in a routine health examination and as an
      epidemiological tool.

PMID- 8461854
TI  - Alcohol consumption and sickness absence: from the Whitehall II study.
AB  - Previous studies suggest that problem drinkers have markedly increased sickness
      absence. However, it is not clear how more moderate alcohol consumption and
      abstinence relate to sickness absence. As part of the Whitehall II study the
      relationship between different drinking patterns and sickness absence is
      examined. A total of 10,314 male and female civil servants completed a baseline
      questionnaire about their drinking habits--the amount of alcohol consumed over
      the past 7 days and the frequency of drinking over the past 12 months. All
      sickness absence has been recorded prospectively. Drinking patterns and sickness
      absence are examined for short spells (< or = 7 days) and long spells (> 7 days)
      adjusting for other causes of sickness absence: age, grade of employment,
      smoking, work characteristics and baseline health. Alcohol consumption was
      strongly related to employment grade, the lower the grade the higher proportion
      of men and women reporting no alcohol consumption. For men the relation of
      alcohol intake to short spells of sickness absence (< or = 7 days) appeared to be
      U-shaped, for long spells (> 7 days) increased rates of absence were found only
      in frequent drinkers. There was no clear relationship for women, however higher
      rates of sickness absence were found in non-drinkers.

PMID- 8461855
TI  - ADH and ALDH genotype profiles in Caucasians with alcohol-related problems and
      controls.
AB  - Eighty-two Caucasian patients receiving treatment for alcohol-related problems
      and eighty four controls were DNA typed for variants in the alcohol dehydrogenase
      (ADH2 and ADH3) and mitochondrial aldehyde dehydrogenase (ALDH2) gene loci. No
      association was observed between individual, or combined gene frequencies and the
      presence of alcohol-related problems.

PMID- 8461856
TI  - Reduced alcohol use in pregnancy and changed attitudes in the population.
AB  - The objectives of this study were to investigate (1) changes in consumption of
      alcohol among pregnant women over a period of 5 years (1984/85-1990), (2) changes
      of attitudes towards drinking during pregnancy in the general population over the
      same period of time, and (3) possible connections between (1) and (2). The
      investigation was designed as a cross-sectional study. Our subjects were two
      representative samples of pregnant women in Oslo, n = 377 and 425, and two
      representative samples of the Norwegian population, n = 1004 and 1204. The main
      outcome measures were a self-completed questionnaire for the pregnant women and a
      personal interview for the general population sample. There was a significant
      reduction (50% decrease) in alcohol consumption among the second cohort of
      pregnant women compared with the first. Furthermore, we found an increase during
      the 5-year period in the number of persons with a restrictive attitude towards
      alcohol use during pregnancy. There seems to be a connection between these two
      phenomena, but with our present state of knowledge it is hard to say anything
      about the causal relationship between them.

PMID- 8461857
TI  - Criminal involvement of cocaine users enrolled in a methadone treatment program.
AB  - This was a study of criminal activities of cocaine users versus non-users
      enrolled in a methadone treatment program in New York City. Of those 140
      methadone clients studied, 100 (71%) were cocaine users. There were no
      demographic differences between the two groups except marital status. Married
      clients (including common-law married) were more likely than never-married single
      clients to be non-users. Cocaine users were significantly more depressed, using
      the subscale of the Symptom Checklist-90. Although numbers of lifetime arrests
      and criminal involvement (in the year immediately preceding the research
      interview) of cocaine non-users were distinctively lower than those of users, the
      differences were not significant. In a multiple regression analysis, length of
      stay in the methadone program was the strongest predictor of criminal
      involvement. Those who were retained longer in the treatment were significantly
      less likely to be involved in criminal activities, regardless of cocaine use.

PMID- 8461858
TI  - ICD-10 harmful use of alcohol and the alcohol dependence syndrome: prevalence and
      implications.
AB  - Data from a 1988 survey on United States drinking practices and related problems
      was used to derive the prevalence and population estimates of harmful use of
      alcohol and the alcohol dependence syndrome as defined in the ICD-10 Clinical
      Descriptions and Diagnostic Guidelines Version (ICD-10-CDDG). Corresponding
      estimates were also presented for ICD-10-CDDG diagnoses that incorporated the
      duration criterion of the ICD-10-Diagnostic Criteria for Research Version (ICD-10
      DCR). The prevalence of ICD-10 harmful use and dependence combined, with and
      without the duration criterion, were 5.2% and 7.1%, respectively. Corresponding
      harmful use rates were negligible (0.27%). Implications of the extremely low
      prevalence of harmful use in the US population and the impact of the duration
      criterion on the rates are discussed in terms of the fundamental nature of
      alcohol use disorders as syndromes and the viability of the harmful use of
      alcohol category as originally conceptualized.

PMID- 8461859
TI  - Liaison services for pregnant drug users.

PMID- 8461860
TI  - Temazepam abuse.

PMID- 8461861
TI  - Gender and colorectal cancer.
AB  - Studies of gender differences in colorectal cancer have shown temporal shifts in
      incidence and site distribution which can be attributed, in part, to
      environmental and behavioural factors. In high-risk populations, rectal cancer
      and left-sided colon cancer have been more frequent in older men, whereas right
      sided colon cancer has been more commonly found in older women. Among known
      associations with reduced colorectal cancer risk, women appear to ingest more
      dietary fibre, seem to benefit more from physical activity and body mass, and
      consume less alcohol. Although these differences may contribute to the risk
      differential, hormonal events during reproductive years also appear to affect
      women's risk at older age. The interactions of sex hormone metabolism and
      nutrition, including dietary fibre, in colorectal carcinogenesis provide a
      rewarding field for investigation.

PMID- 8461862
TI  - Action plan for a tobacco-free Europe: implementation in central and eastern
      Europe, 1993-94. WHO Regional Office for Europe.
AB  - Major political and social changes in central and eastern European (CEE)
      countries offer new opportunities and challenges in tobacco control. Action
      against tobacco in CEE countries is part of an overall European strategy, the
      action plan for a tobacco-free Europe. Several CEE countries have voiced their
      concern about the deterioration of tobacco control and about the entry of the
      international tobacco industry. In response, the Regional Office has set up a
      framework for an international task force. The core of the task force consists of
      the EURO staff and a special consultant. Several European countries and
      organizations have already expressed their willingness to joint the task force by
      seconding an expert to participate in the country missions and consensus
      conferences. This paper describes particular steps to implement the action plan
      in central and eastern Europe. It outlines priority action to be carried out by
      the CEE countries themselves and describes possibilities for assistance by all
      European countries. A key role is assigned to a European alliance on tobacco or
      health to create psychological and material prerequisites for action as well as
      act in an advisory role. Some of the projects are already underway, but they can
      be considerably strengthened by extra resources and support. Some of the projects
      are possible only with new resources. The project proposals are classified
      according to the six areas of the new action plan but presented in a different
      order. This paper sets out a range of activities.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8461863
TI  - Adult mortality from leading sites of cancer in Italy and a note on European
      data.
AB  - An overview is given of recent patterns of trends in cancer mortality in various
      age groups in Italy and, for comparative purposes, in other European countries.
      Important changes in mortality for several major cancer sites have been observed
      over the last two decades, such as the declines in gastric cancer or the
      increases in lung cancer mortality. These are difficult to understand and justify
      from an epidemiological and public health viewpoint, since the main cause of lung
      cancer (cigarette smoking) has long been known, while the determinants of stomach
      cancer are still largely undefined. Changes were minor, and inconsistent across
      countries, for other major cancers, such as intestines or breast. Furthermore,
      trends were systematically more favourable in young adults (and, to a less extent
      middle age), as compared to the elderly. The decline in young adults reflects
      more favourable exposure to risk factors (eg declined smoking prevalence, better
      diet), but also improvements in diagnostic and therapeutic procedures for some
      cancers. Due caution is required in any extrapolation, particularly since the
      distribution of the most common types of cancer changes in subsequent age groups.
      These favourable trends in young adults offer, none the less, important (and
      positive) indications as to the likely future trends when the same generations
      will reach middle and older age.

PMID- 8461864
TI  - Dietary and other environmental risk factors in acute leukaemias: a case-control
      study of 119 patients.
AB  - Selected dietary risk factors and other environmental factors were studied in 119
      adult patients (60 males and 59 females of the Cracow region) with acute
      leukaemia (91 acute myeloid leukaemia and 28 acute lymphoblastic leukaemia), by a
      case-control study method and logistic regression modelling of the risk of
      leukaemia. It was shown that the diet of patients with acute leukaemias before
      the onset of the disease differed qualitatively and quantitatively from that of
      healthy subjects of control groups. The risk of acute leukaemia was elevated in
      the subjects characterized by rare consumption of raw vegetables, frequent
      drinking of milk, frequent consumption of poultry, and drinking of soft water.
      Other environmental conditions connected with the dietary risk were: frequent
      viral infections, vaccination with the vaccinia virus, frequent use of
      aminophenazone, presence of fungi in the house, drinking of milk supplied from
      own's own cows, and frequent deaths of reared poultry.

PMID- 8461865
TI  - Oral contraceptive use and risk of benign breast disease in a French case-control
      study of young women.
AB  - We report the results of a French hospital-based case-control study designed to
      analyse the relation between the use of oral contraceptives (OC) and the risk of
      benign breast disease (BBD). The cases were 286 women, each less than 46 years
      old, with BBD histologically verified between 1982 and 1985. Controls were 382
      patients, matched to cases on year of birth and month of interview, and who were
      hospitalized for a non-malignant disease other than BBD. Odds ratios were
      estimated by multivariate regression, taking into account level of education,
      place of residence, family history of breast cancer, age at menarche, number of
      children, age at first full-term pregnancy and Quetelet index. The risk of BBD
      was found to decrease significantly with a longer use of OC before the first full
      term pregnancy (FFTP), but there was no association between the risk of BBD and
      the duration of OC use after FFTP. OC use before FFTP reduced the risk of non
      proliferative disease, but did not significantly affect the risk of proliferative
      disease. These results did not depend on the amount of oestrogen (0.05 mg or more
      vs < 0.05 mg) contained in OC.

PMID- 8461866
TI  - Biliary bile acids in cholelithiasis and carcinoma of the gall bladder.
AB  - The role of biliary deoxycholate as an endogenous carcinogen and the possible
      association between cholelithiasis and the subsequent development of carcinoma of
      the gall bladder is unclear. This paper describes biliary bile acid analysis
      performed on three groups of patients, 10 with cholelithiasis, 10 with carcinoma
      of the gall bladder and 10 control patients. This is the first report of bile
      acid changes in carcinoma of the gall bladder. In these 30 patients the total
      bile acids concentration was highly variable (11.44-53.68 mg/ml). The mean ratio
      of primary to secondary bile acids was 3.5:1. This ratio was, however,
      significantly higher in cholelithiasis than in the control group (5.34:1; P <
      0.001); patients with carcinoma of the gall bladder had significantly higher
      secondary bile acids (1:1; P < 0.001). This is due to a marked increase in the
      secondary bile acids and indicates that raised biliary deoxycholate
      concentrations are present in patients with carcinoma of the gall bladder and
      therefore may well be a factor in carcinogenesis.

PMID- 8461867
TI  - Sulphated bile acid per se inhibits colonic carcinogenesis in mice.
AB  - Peroral sulpholithocholic acid (SLC) promoted colonic tumorigenesis in
      conventional rats. We then tested this compound in the mouse, a species with
      different bile acid metabolism from the rat. Female conventional ICR mice
      received 0.5 mg of N-methyl-N-nitrosourea (MNU) three times in one week
      intrarectally or 16 mg/kg body weight of 1,2-dimethylhydrazine (DMH)
      subcutaneously once a week for 10 weeks, followed by a basal diet (CE-2), or CE-2
      containing SLC or lithocholic acid (LC) (both at 0.5 mmol/100 g CE-2) for 40
      weeks. At autopsy, numbers of mice bearing colonic neoplasms were 4/26 (15%) in
      the MNU + CE-2, 4/23 (17%) in the MNU + SLC, 5/28 (18%) in the MNU + LC, 12/24
      (50%) in the DMH + CE-2, 6/23 (26%) in the DMH + SLC and 11/27 (41%) in the DMH +
      LC group. The DMH + SLC group had less adenocarcinomas than did the DMH + CE-2
      and the DMH + LC group (P < 0.05). Total faecal bile acids in the mice fed on
      bile salts showed threefold increases compared with those on the basal diet.
      Sulphates constituted an average 7% and 19% of faecal bile acids in the MNU + SLC
      and DMH + SLC group, respectively. These results indicated that effects of
      peroral SLC on colonic carcinogenesis correlated with the degree of desulphation
      of SLC in the intestine and sulphates per se inhibited colonic carcinogenesis.

PMID- 8461868
TI  - A medico-legal enquiry and its consequences: labels to remind women to have
      cervical smears.

PMID- 8461869
TI  - Mortality trends of different localizations of cancer in Spain (1951-87).

PMID- 8461870
TI  - Colorectal cancer and dietary calcium: a word of hope.

PMID- 8461871
TI  - Primary prevention: knowledge and action.

PMID- 8461872
TI  - Dietary non-nutritive cancer protective factors.
AB  - It has been widely believed that the majority of cancers in humans were caused by
      exposure to environmental carcinogens. The pronounced variation in incidence
      rates of specific cancers from one country to another was explained by a
      variation in the load of carcinogens to which people were exposed from the sea of
      carcinogens in which they lived. This native and simple point of view can no
      longer be upheld. It is becoming evident that this theory cannot quantitatively
      explain the observed occurrence of cancer. Variations in the intake of compounds
      with anticarcinogenic effects might just as well be made responsible for a major
      part of the variation in cancer incidence. A review is given of this emerging
      field and it is argued that the study of anticarcinogens may allow us to reach a
      more balanced concept of the causative network in human cancer. It should also
      equip us with better means for more effective cancer prevention.

PMID- 8461873
TI  - A technique to prepare boronated B72.3 monoclonal antibody for boron neutron
      capture therapy.
AB  - B72.3 monoclonal antibody has been successfully boronated using
      mercaptoundecahydro-closo-dodecaborate (boron cage compound). The reagent was
      incorporated by first reacting the lysine residues of the antibody with m
      maleimidobenzoyl succinimide ester (MBS), followed by Michael addition to the
      maleimido group by the mercapto boron cage compound to form a physiologically
      stable thioether linkage. Boron content of the antibody was determined by atomic
      absorption spectroscopy. For biodistribution studies, boronated antibody was
      radioiodinated with idogen. 125I-labeled and boronated B72.3 monoclonal antibody
      demonstrated clear tumor localization when administered via tail vein injections
      to athymic nude mice bearing LS174-T tumor xenografts. Boronated antibody was
      calculated to deliver 10(6) boron atoms per tumor cell. Although this falls short
      of the specific boron content originally proposed as necessary for boron neutron
      capture therapy (BNCT), recent calculations suggest that far fewer atoms of 10B
      per tumor cell would be necessary to effect successful BNCT when the boron is
      targeted to the tumor cell membrane.

PMID- 8461874
TI  - Correlation of lipophilicity to biodistribution of 99mTc-labelled aminothiols.
AB  - A series of 99mTc-DADT complexes substituted with heterocyclic amines were
      synthesized and tested for their ability to cross the BBB. Each 99mTc-DADT
      complex analysed by HPLC was found to consist of two epimers. The more lipophilic
      epimers were biodistributed in mice. The data demonstrated a significant brain
      uptake (3-12% dose/g whole brain) and a high lung accumulation (11-85% dose/g) at
      2 min p.i. Between the partition coefficients of the technetium complexes, a
      linear correlation for lung accumulation was observed, while a parabolic curve
      for brain uptake was found.

PMID- 8461875
TI  - 99mTc-DADT complexes substituted with heterocyclic amines: effect of substitution
      on in vivo reactivity.
AB  - Alkylpiperidinyl and alkylpyrrolidinyl 99mTc-DADT complexes were synthesized and
      tested for their ability to cross the BBB. Each complex was a mixture of two
      epimers separated by HPLC. More lipophilic epimers were biologically evaluated in
      mice, at various time intervals. Similar biodistribution patterns were obtained
      for both piperidinyl and pyrrolidinyl DADT-complexes. Brain uptake or retention
      was influenced by the heterocyclic amine introduced into the DADT backbone.
      Subcellular concentration of selected 99mTc-DADT complexes was more profound in
      crude nuclear and post-microsomal fractions. Moreover, interaction of 99mTc
      2,2,6,6,9,9-hexamethyl-4,7-diaza-4-(3-methylpyrroli dinyl)-ethyl-1,10-
      decanedithiol with either lipids or microsomes of whole brain was almost
      unaffected by time. This may suggest that a possible selective site of
      interaction and metabolism for DADT complexes occurs in brain.

PMID- 8461876
TI  - [35S]cysteamine: facile synthesis, in vivo biokinetics, and subcellular
      distribution.
AB  - Whereas chemical radioprotection against external beams of ionizing radiation is
      well studied in radiobiology, the aspects relating to tissue incorporated
      radionuclides have received little attention. The increased use of radionuclides
      in diagnostic and therapeutic nuclear medicine, as well as the presence of both
      manmade and natural radioactivity in the environment, indeed call for such
      investigations. Our ongoing work on a variety of radioprotectors has revealed
      that cysteamine (MEA), S-2-aminoethylisothio uroniumbromide hydrobromide (AET),
      and others (e.g. ascorbic acid), protect spermatogonial cells in mouse testis
      from the effects of chronic irradiation with intratesticularly localized
      radionuclides. In these experiments, dose modification factors ranging from 2 to
      4 and 10 to 14 were obtained using spermhead survival and induction of spermhead
      abnormalities, respectively, as the biological end points. Similar experiments
      were carried out by changing the mode of administration of cysteamine to oral
      intubation. In these studies a dose modification factor of approximately 3 was
      observed in the spermhead survival assay. In an effort to understand the
      protection offered by MEA, the present work describes a one-pot synthesis of high
      specific activity [35S]cysteamine from elemental [35S]sulphur and its use in
      determining the biokinetics and biodistribution of MEA following intratesticular
      (i.t.) or oral administration in mice.

PMID- 8461877
TI  - Investigation of two new [99mTc]Tc-HEDP preparations that can be expected to give
      a better lesion-to-normal-bone uptake ratio when used as bone scanning agents.
AB  - Two new potential bone scanning agents have been prepared and characterized. One
      of the agents, Tc(Sn,pH 12)-HEDP, is prepared at pH 12 (and subsequently
      neutralized). The other agent, Tc(Fe)-HEDP, is prepared by reducing [99mTc]TcO4-
      by a mixture of Fe(II) and Sn(II). From ion exchange chromatography on Aminex A
      28 it appeared that the proportion of early eluting components of the two new
      agents is larger than that of the usual agent, Tc(Sn,pH 7.4)-HEDP. The
      stabilities on storage, and in serum, of the three agents appeared to be equally
      good. The adsorption on tri-calciumphosphate of Tc(Fe)-HEDP and Tc(Sn,pH 7.4)
      HEDP was determined at several values of concentrations of Sn(II) and HEDP.
      Further, the influence of the pH (1-12) during reduction of [99mTc]TcO4- by
      Sn(II) on the adsorption of the agent on tri-calciumphosphate (at a fixed pH of
      7.4) was investigated. It appeared that the adsorption of Tc(Sn,pH 12)-HEDP and
      Tc(Fe)-HEDP is less than that of Tc(Sn,pH 7.4)-HEDP. It is argued that this
      result points to a better efficiency in lesion detection of the two new agents,
      compared to the usual one.

PMID- 8461878
TI  - Synthesis, radiolabeling and tissue distribution of 11 beta-fluoroalkyl- and 11
      beta-fluoroalkoxy-substituted estrogens: target tissue uptake selectivity and
      defluorination of a homologous series of fluorine-18-labeled estrogens.
AB  - We have synthesized six estrogens substituted at the 11 beta-position with a
      fluoroalkyl or fluoroalkoxy substituent. These compounds bind to the estrogen
      receptor with moderate to high affinity, with the fluoroalkyl analogs being
      higher affinity binders than the fluoroalkoxy ones. All of these fluorine
      substituted estrogens were prepared in fluorine-18-labeled form, with high
      radiochemical purity and at effective specific activities (15.4-50.4 TBq/mmol;
      415-1362 Ci/mmol) adequate for biodistribution studies. In immature female rats,
      five of the six fluoroestrogens showed selective uptake by the uterus, with
      uterine uptake as a percent of the injected dose per gram being 4-9% at 1 h, and
      uterus-to-blood or uterus-to-muscle ratios being 10-40. Selective uterine uptake
      was eliminated by co-administration of a blocking dose of unlabeled estradiol.
      The only compound that did not show selective uterine uptake was 11 beta
      fluoropropoxyl estradiol; its rapid metabolism and its low affinity for the
      estrogen receptor, particularly at 25 degrees C, may account for its lack of
      specific uptake. The level of bone activity, an index of metabolic
      defluorination, shows that the defluorination rates of these six estrogens are a
      complex function of structure and functionality. Least prone to defluorination is
      11 beta-(2-fluoroethoxy)estradiol and most prone is 11 beta-(2
      fluoroethyl)estradiol. The extent of defluorination of the remaining compounds
      shows weak evidence for the protective effect of a heteroatom-substituted beta to
      the site of metabolism (the CH bonds on the fluorine-bearing carbon atom). The
      binding affinity, tissue distribution and metabolism of these 11 beta-fluoroalkyl
      and fluoroalkoxy-substituted estrogens further our understanding of the behavior
      of fluorine-18-labeled estrogens as potential imaging agents for estrogen
      receptor-positive breast cancer.

PMID- 8461879
TI  - Metabolism in vitro of radioiodinated N-isopropyl-p-iodoamphetamine by isolated
      hepatocytes.
AB  - An in vitro technique for the determination of radiopharmaceutical metabolism has
      been developed using isolated hepatocytes. Radioiodinated N-isopropyl-p
      iodoamphetamine (IMP; iofetamine, USP) was employed a model tracer in these
      studies because its labeled metabolites are well-characterized. Hepatocytes
      isolated from the rat and human produced labeled metabolites in vitro for up to 4
      h in a manner similar to that reported for humans in vivo. Identical metabolites
      were generated by all cell types investigated, but the rate of metabolism
      differed (rat >> human; female > male; fresh > frozen). The utility of this
      methodology for the preclinical evaluation of potential radiopharmaceuticals is
      described.

PMID- 8461880
TI  - Compartmental analysis of the pharmacokinetics of radioiodinated monoclonal
      antibody B72.3 in colon cancer patients.
AB  - Sixteen patients with colorectal cancer were administered 37-74 MBq (1 mg) of
      radioiodinated B72.3 monoclonal antibody. Pharmacokinetic analysis was carried
      out on plasma and urine samples. Elimination from the plasma was biexponential
      with a mean T1/2 alpha of 3.7 h and T1/2 beta of 62.4 h. The plasma clearance was
      fit to a two-compartmental model. This was combined with a previously reported
      model for radioiodine to construct a composite model. There was a good
      correlation (r = 0.952) between the model-predicted and observed excretion of
      radioiodine suggesting that the composite model is compatible with the
      pharmacokinetics of the radiolabelled antibody.

PMID- 8461881
TI  - The stability in liver homogenates of indium-111 and yttrium-90 attached to
      antibody via two popular chelators.
AB  - To investigate the influence of chelator on the stability in liver homogenates of
      111In and 90Y-labeled antibodies, the C110 antibody was conjugated with the
      cyclic anhydride of DTPA (cDTPA) and with isocyanatobenzyl-DTPA (SCN-Bz-DTPA) and
      labeled with both radionuclides. After incubation in fresh liver homogenates at
      37 degrees C for 1-2 days, the soluble fraction was analyzed by filtration, HPLC
      and TLC to determine the nature and extent of transchelation of the label and
      catabolism of the antibody. The loss of activity from antibody, as shown by
      passage through a low molecular weight (10 kDa cut-off) filter, was 3-5 times
      more pronounced for 90Y (51 and 68% at 1 and 2 days) than 111In (11 and 29%,
      respectively). No significant difference was observed between chelators.
      Furthermore, analysis of these low molecular weight species showed that even at 1
      day, 90Y in contrast to 111In was present as one or more weak complexes and
      therefore no longer chelated to either DTPA or Bz-DTPA. Little evidence was
      observed for instability in liver of the thiourea bond whereby SCN-Bz-DTPA is
      attached to the antibody. By contrast the identification of 111In-DTPA in the
      homogenates demonstrates the instability of the amide bond generated by cDTPA
      conjugation. In conclusion, as expected, 90Y was shown to form less stable
      chelates than 111In, however, in this investigation the greater denticity of Bz
      DTPA over DTPA did not improve stability with either radiolabel.

PMID- 8461882
TI  - An improved synthesis of [125I]N-(diethylaminoethyl)-4-iodobenzamide: a potential
      ligand for imaging malignant melanoma.
AB  - To improve the radiolabeling yield and the specific activity of [125I]N-(2
      diethylaminoethyl)-4-iodobenzamide (DAB), the aryltributyltin precursor was
      synthesized from the N-(2-diethylaminoethyl)-4-bromobenzamide derivative by
      palladium catalyzed stannylation using bis(tributyltin). The radiolabeled
      product, [125I]DAB, was obtained by an iododestannylation reaction in high
      radiochemical yields (85-94%, radiochemical purity, > 98%) using chloramine-T as
      an oxidizing agent. The specific activity was greater than 1600 Ci/mmol. The
      biodistribution studies in nude mice implanted with human malignant melanoma
      xenograft showed a good tumor uptake (6.14% ID/g at 1 h, 2.81% ID/g at 6 h and
      0.42% ID/g at 24 h) of [125I]DAB. Unfortunately, a high uptake in the non-target
      organs, such as liver and lung, was found. At 1 h post-injection the activity
      level in liver and lung was 11.76 and 7.58% ID/g, respectively. A slow clearance
      of activity from liver and lung was observed at 6 h (3.43 and 0.49% ID/g). These
      results demonstrate that iodinated IDAB is a potential radiopharmaceutical for
      the management of patients with malignant melanoma.

PMID- 8461883
TI  - Synthesis and biodistribution of 18F-labeled fleroxacin.
AB  - [18F]Fleroxacin (6,8-difluoro-1,4-dihydro-1-(2-[18F]fluoroethyl)-4- oxo-7-(4
      methyl-1-piperazinyl)-3-quinolinecarboxylic acid) was synthesized from its
      methylsulfonyl ester precursor. 6,7,8-Trifluoro-4-hydroxyquinoline-3-carboxylic
      acid ethyl ester (Ro 19-7423) was alkylated with 2-bromoethanol to produce 6,7,8
      trifluoro-1,4-dihydro-1-(2-hydroxyethyl)-4-oxo-3-quinolinecarboxyl ic acid ethyl
      ester in 76% yield which was then condensed with 1-methyl-piperazine to produce
      6,8-difluoro-1,4-dihydro-1-(2-hydroxyethyl)-7-(4-methyl-1-piperazinyl)4- oxo-3-
      quinolinecarboxylic acid ethyl ester in 67% yield. This product was reacted with
      methanesulfonyl chloride to produce the mesylate precursor of fleroxacin in 66%
      yield. Nucleophilic substitution of the mesylate with 18F- in the presence of
      Kryptofix 2.2.2 followed by basic hydrolysis produced [18F]fleroxacin with a
      radiochemical yield of 5-8% [EOS] within 90 min. The pattern of biodistribution
      of [18F]fleroxacin was similar to the 14C-labeled drug.

PMID- 8461884
TI  - Clearance and distribution parameters of 99mTc-EHIDA, -DTPA and -MAG-3 by dynamic
      liver/kidney scintigraphy.
AB  - The radiopharmaceuticals (RF) EHIDA, DTPA and MAG-3 (labeled by 99mTc), commonly
      used in dynamic liver/kidney scintigraphy, are distributed in intravascular
      (i.v.) and extravascular (e.v.) spaces, as they are simultaneously cleared from
      the blood passing through their target organ (liver/kidney). The drop in
      concentration of these RF in blood is therefore determined by distribution as
      well as by clearance up to the time of equilibrium. From that time only the rate
      of decrease of RF in blood expresses the "true" (liver/kidney) clearance and this
      clearance parameter is a clinically reliable index of the function of the target
      organ. (A) The method of analysis of the clearance curve obtained from the heart
      region has been reported; the method is based on a physiological approach with
      respect to the distribution processes of the RF in the organism. Apart from the
      main important parameter, T (clear) (half-time of the "pure" clearance of the
      resp. RF from its distribution space), two further parameters are obtained: T
      (distr.) (half-time of the e.v. distribution of the RF) and END (distr.) (end of
      this distribution). (B) The results of 218 patients examined using 99mTc-EHIDA,
      192 using DTPA and 65 using MAG-3 have been statistically processed. The mutual
      correlation of all parameters [T (distr.), END (distr.), T (clear)] within each
      group of patients as well as the differences of corresponding parameters between
      the groups of patients are studied. The main purpose of the work was to obtain
      the reliable clearance parameters of the RF with extravascular distribution for
      routine clinical practice.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461885
TI  - L-[2-18F]fluorophenylalanine and L-[U-14C]phenylalanine: a comparative study of
      their transport to rat brain.
AB  - The transport rates of L-[2-18F]fluorophenylalanine ([18F]Phe) and L-[U
      14C]phenylalanine ([14C]Phe) across the blood-brain barrier were compared in
      saline, large neutral amino acids (NAA) and large basic amino acids (BAA) loaded
      rats. The fraction of transported tracer (FTT) was expressed as the ratio of
      brain radioactivity to integrated plasma radioactivity at 5 min after injection
      of the tracers. Cerebral FTTs of [18F]Phe and [14C]Phe in the control group were
      0.042 and 0.045, respectively, and decreased to 0.016 and 0.019 in the NAA loaded
      group. The ratios of FTT of [18F]Phe and that of [14C]Phe were approx. 0.90, and
      did not differ among the three groups. These results indicate that the transport
      of [18F]Phe from the blood to the brain can be considered to be mediated by the
      NAA transport system and that its transport rate is almost the same as that of
      [14C]Phe.

PMID- 8461886
TI  - DNA fingerprinting of Trypanosoma vivax isolates rapidly identifies intraspecific
      relationships.
AB  - Using the polymerase chain reaction and arbitrarily selected oligonucleotide
      primers of 10 or 11 bases, we have amplified DNA sequences from Trypanosoma vivax
      parasites isolated from South America and Africa. On the basis of polymorphisms
      in the DNA fingerprints generated by three of the primers, the parasites could be
      separated into two major groups, one comprising T. vivax isolates from Kenya and
      the second including all the other T. vivax parasites (from Colombia, The Gambia,
      Nigeria and Uganda). One of these three primers (ILo 525) also gave isolate
      specific DNA fingerprints for the parasites tested, which will allow the use of
      this technique both in the species identification and discrimination of T. vivax
      parasites.

PMID- 8461887
TI  - Effect of low temperature on the in vitro growth of Plasmodium falciparum.
AB  - The effect of low incubation temperature on synchronized cultures of Plasmodium
      falciparum was studied. Young trophozoites that were maintained at 28 degrees C
      matured slowly and invaded poorly. Growth seemed to arrest when parasites reached
      a maturation equivalent to 30 h, although they reestablished their growth
      normally when returned to 37 degrees C. On the other hand, 36-h synchronized
      parasites that were transferred to 28 degrees C completed their cell cycle with a
      12-16 h delay, but without changes in the parasite as seen by light microscopy
      and without a diminution in the efficiency of the invasion or in the
      incorporation of 35S-methionine. These results might be useful for obtaining
      parasites at defined stages of development at the desired time.

PMID- 8461888
TI  - An improved medium for Plasmodium chabaudi in vitro erythrocyte invasion assays.
AB  - RPMI-1640 is routinely used as the basal medium for the in vitro maintenance of
      malaria parasites. In this study we tested several commercially available
      nutritional media in a Plasmodium chabaudi chabaudi erythrocyte invasion assay
      and showed that three media, BME Basal Medium--modified, Dulbecco's Modified
      Eagle Medium, and William's Medium E, improved the level of merozoite invasion
      when compared with RPMI-1640. These media improve the rate of maturation of newly
      invaded rings to young trophozoites. Radioisotope incorporation by trophozoites
      maintained in these three media was also improved when compared to trophozoites
      maintained in RPMI-1640. BME Basal Medium--modified, or a combination of three
      parts BME Basal Medium--modified with one part William's Medium E, supported
      higher levels of erythrocyte invasion by merozoites. We suggest that either of
      these media replace the currently used RPMI-1640 for in vitro studies on P. c.
      chabaudi.

PMID- 8461889
TI  - Ultrastructural and cytochemical identification of peroxisomes in the ciliate
      Ichthyophthirius multifiliis.
AB  - The peroxisomes of the parasitic ciliate Ichthyophthirius multifiliis were
      studied, using ultrastructural and cytochemical techniques. In this ciliate most
      peroxisomes possess a circular or oval section less than 0.6 micron in diameter.
      However, some dumbbell-shaped and elongated peroxisomes could also be observed.
      These organelles were frequently associated with the mitochondria and were more
      abundant in the cell cortex than in the center of the ciliate. Small vesicles and
      dense nucleoids were usually present in the ultrathin sections of these
      peroxisomes. Peroxisomal vesicles and tubular structures were selectively
      impregnated with osmium tetroxide. Catalase was detected by cytochemical
      techniques in I. multifiliis peroxisomes.

PMID- 8461890
TI  - Reclinomonas americana N. G., N. Sp., a new freshwater heterotrophic flagellate.
AB  - A new heterotrophic flagellate has been discovered from sites in Maryland,
      Michigan and Wyoming. The flagellate resides within a lorica constructed of a
      meshwork of intertwined fibrils with the outer surface invested with nail-shaped
      spines. The organism "reclines" within the lorica with its ventral aspect
      directed upward, and has two heterodynamic flagella, neither of which bears
      mastigonemes. One flagellum is directed upward and the other is arched over the
      ventral aspect of the body. Ingestion of bacteria takes place at the left
      posterior half of the cell. The organism is anchored to the lorica on the right
      posterior side by a series of regularly spaced cytoplasmic bridges and at the
      left anterior of the cell by a cytoplasmic appendage similar to the "languette
      cytoplasmique" found in some bicosoecids. The right side of the cell is raised
      into a flattened lip with the outer margin reinforced by a ribbon of
      microtubules. The new flagellate has mitochondria with tubular cristae and lacks
      a Golgi. A new genus is created to accommodate both the new flagellate described
      herein and Histiona campanula Penard. A new family is proposed to include the new
      genus and Histiona.

PMID- 8461891
TI  - A group I intron in the SSUrDNA of some Naegleria spp. demonstrated by polymerase
      chain reaction amplification.
AB  - The small subunit ribosomal DNA (SSUrDNA) of all described Naegleria spp. was
      amplified by polymerase chain reaction with universal primers. In all strains of
      N. andersoni andersoni, N. andersoni jamiesoni, N. australiensis italica and two
      related strains, and one out of four clusters of N. gruberi, a band of
      approximately 3.3 kb was obtained. All other strains displayed a band with the
      expected DNA length of 2.0 kb. This means the former have a 1.3 kb intron in the
      SSUrDNA. Restriction analysis demonstrated that the intron is between two
      conserved Pst I sites at the 5' end of the SSUrDNA. It also suggested the introns
      might not be identical in each species or subspecies. The Pst I fragment of
      SSUrDNA containing the 1.3 kb insert in N. andersoni andersoni was cloned and
      sequenced. The 1,296-nucleotide insert is situated in helix 19 of the SSUrDNA,
      which is an area of conserved primary and secondary structure. Sequence and
      secondary structure analyses of the insert revealed it it is a group I intron.
      This group I intron is very large and contains an open reading frame that could
      serve to encode a polypeptide of 139 amino acids in size.

PMID- 8461892
TI  - The challenge of Pneumocystis carinii culture.
AB  - Published and unpublished data on the cultivation of P. carinii were reviewed by
      a panel of investigators convened by the National Institutes of Health. Although
      several cell culture systems allow propagation of P. carinii for a limited time
      with modest rates of replication, these have not proved adequate for isolation of
      P. carinii in sufficient quantity to explore important basic biological
      investigation. Attempts at cell-free culture have yielded only transient
      proliferation. Because much of the unsuccessful work on cultivation of the
      organism has been unpublished, the panel agreed that these data may be useful to
      other investigators in designing experimental strategies for cultivation.
      Therefore, the purpose of this report is to make available this information to
      researchers, lest others unknowingly repeat unsuccessful methods. It is hoped
      that by documenting the history and the complexities of Pneumocystis culture,
      renewed interest and efforts will be directed toward this fundamental scientific
      challenge.

PMID- 8461893
TI  - Leishmania differentiation in natural and unnatural sand fly hosts.
AB  - Leishmania differentiation in the gut of phlebotomine sand flies was evaluated
      based on five light and electron microscopic studies of natural (Leishmania
      panamensis/Lutzomyia gomezi, Leishmania chagasi/Lutzomyia longipalpis) and
      unnatural (Leishmania mexicana/Lutzomyia abonnenci, Leishmania
      panamensis/Phlebotomus papatasi, Leishmania major/Lutzomyia longipalpis) life
      cycles. In the bloodmeal, transformation of amastigotes into stumpy promastigotes
      occurred before or during division. Further division in pairs or rosettes
      resulted in the development of spatulate and/or elongate nectomonad (free
      swimming) promastigotes. Elongate, short, and metacyclic nectomonad
      promastigotes, and nectomonad paramastigotes were present in the midgut lumen.
      Dividing short promastigotes predominated in the cardia, and appeared to generate
      metacyclic forms which were observed in three life cycles. Haptomonad (attached)
      forms of Leishmania panamensis in the hindgut were primarily spatulate
      promastigotes (natural host) or pear-shaped promastigotes (unnatural host);
      paramastigotes and dividing forms were rare. At the stomodeal valve, short
      haptomonad promastigotes predominated in unnatural hosts, while both short and
      pear-shaped haptomonads were abundant, along with paramastigotes in natural
      hosts. Haptomonad paramastigotes and pear-shaped promastigotes colonized the
      esophagus, while paramastigotes predominated in the pharynx. Metacyclics were
      free-swimming in the lumen of the foregut.

PMID- 8461894
TI  - Developmentally-regulated virulence factors of Trypanosoma cruzi and their
      relationship to evasion of host defences.
AB  - Developmental preadaptation of virulent stages of Trypanosoma cruzi correlates
      with their ability to survive and establish infection in mammalian hosts.
      Infective trypomastigote stages must first preadapt to survival in the
      extracellular milieu and then to the rigors of establishing an intracellular
      infection. Selected phenotypic variations in evading host defences have been
      correlated with expression of stage-specific proteins or functions. Resistance of
      trypomastigotes to complement-mediated killing correlates with the presence of a
      stage-specific molecule that exhibits an analogous function to mammalian decay
      accelerating factor, and with the presence of a neuraminidase/trans-sialidase
      that transfers sialic acid moieties to the parasite surface, thereby enabling it
      to avoid complement activation. Trypomastigotes enter cells by a mechanism that
      involves sorting of cell surface receptors and avoids eliciting a respiratory
      burst. Once within a membrane-bound vacuole, which undergoes acidification, the
      neuraminidase/trans-sialidase and an acid-active, transmembrane pore-forming
      protein are released by the parasite and are capable of acting together to
      accelerate rupture of the vacuolar membrane and the parasite's escape into the
      cytoplasm of the host cell. Escape from the parasitophorous vacuole allows
      virulent stages of T. cruzi to avoid compartmental, non-oxidative killing
      mechanisms such as degradation by lysosomal hydrolases.

PMID- 8461896
TI  - Absence of transitory [Ca2+]i flux during early in vitro metacyclogenesis of
      Trypanosoma cruzi.
AB  - The phorbol ester TPA (phorbol 12-myristate 13-acetate) substitutes for CO2 as an
      agonist for transforming Trypanosoma cruzi epimastigotes to the metacyclic
      trypomastigote stage in a starvation medium consisting of phosphate buffered
      saline + 10 mM proline, 10 mM sodium acetate and 0.035% NaHCO3. Since TPA is
      thought to stimulate protein kinase C by mimicking the activity of the secondary
      messenger diacylglycerol, the above result suggested that T. cruzi
      metacyclogenesis could be activated by a Ca(2+)-dependent protein kinase C signal
      induction pathway. Accordingly, cytosolic calcium flux ([Ca2+]i) in
      epimastigotes, activated with 5% CO2 or TPA (10(-7) M), was measured with the
      Ca2+ molecular probe, fluo-3AM. In addition, [Ca2+]i was measured in cells
      incubated with putative metacyclogenic agonists (e.g. proline, glutamate,
      bioamines, ionophores and catecholamines). None of the compounds studies, except
      for EGTA, affected cytosolic Ca2+ levels. Control assays with 11 microM
      thapsigargin, which mobilizes noncytoplasmic Ca2+ stores by inhibiting
      endoplasmic reticulum Ca(2+)-ATPase, validated our fluorometric assay procedure.
      Although thapsigargin significantly increases cytoplasmic Ca2+ fluorescence, it
      has no effect on transformation. The protein kinase C inhibitors staurosporine, H
      7 and HA 1004 were tested for their effect on T. cruzi metacyclogenesis. Low
      concentrations of staurosporine and HA 1004 significantly elevated Peru strain
      transformation while H-7 had no effect on Peru strain metacyclogenesis. Inhibitor
      H-7 did significantly depress CL transformation. The results indicate that
      induction of T. cruzi metacyclic trypomastigote formation by CO2 and TPA is not
      accompanied by changes in cytosolic Ca2+ and do not provide supporting evidence
      for participation of a protein kinase C-mediated phosphoinositide cascade in
      metacyclogenesis.

PMID- 8461895
TI  - Developmental life cycle of Leishmania--cultivation and characterization of
      cultured extracellular amastigotes.
AB  - The biochemistry and immunology of Leishmania promastigotes has been extensively
      studied; this is due primarily to the facility with which this stage, in contrast
      to the amastigotes stage, can be maintained in axenic culture. Several attempts
      to axenically culture lines of Leishmania amastigotes have been reported in the
      literature. This paper summarizes methods of adaptation (low pH, elevated
      temperature and culture medium) and characterization of several axenic lines of
      Leishmania amastigotes. Based on morphological, biological, immunological and
      biochemical evidence, these organisms appear to resemble amastigotes from
      infected macrophages or tissue. The axenically cultured amastigotes appear to be
      distinct from shocked (heat, serum deprivation, stressed) Leishmania
      promastigotes in the plethora of proteins synthesized, growth (multiplication) in
      culture, and developmental regulation observed. These data suggest that
      Leishmania organisms have a significant developmental response to certain signals
      (pH, temperature) mimicking their in vivo macrophage milieu. The response to
      other environmental parameters characteristic of the host-macrophage remain to be
      determined. These axenically cultured amastigotes should be of interest for
      further immunological, biochemical and developmental investigations of the
      disease-maintaining stage of this parasite.

PMID- 8461897
TI  - Introduction of loop sutures in microsurgical telescoping anastomosis.
AB  - We have designed a loop suture technique for use in microsurgical telescoping
      (sleeve) anastomosis to prevent problems from the free floating inserted vessel
      stump. The patency rate of rat femoral arteries repaired with this technique was
      95% and that of interpositional vein grafts, in which both the proximal and
      distal anastomoses were completed with the same sleeve technique, was 81.0%.

PMID- 8461898
TI  - Healing of microvenous PTFE prostheses implanted into the rat femoral vein.
AB  - 44 PTFE prostheses (Gore-Tex; ID 1 mm) were implanted into rats' femoral veins by
      means of the sleeve anastomotic technique and were evaluated at regular intervals
      from 1 h up till 24 weeks after implantation by means of light and electron
      microscopy to study in detail their healing process. All prostheses, except one
      at 1 week and one at 24 weeks after implantation, were patent at the time of
      removal. Upon implantation, the luminal surface of the prostheses became covered
      with a thin clot layer. From 1 week onwards, endothelial cells originating from
      the anastomotic sides grew in across the anastomoses. In addition, small
      capillary-like orifices were present at the anastomotic sites, from which
      endothelial cells also seemed to originate. At 2 weeks, in several areas in the
      mid-region of the prostheses, the fronts of regenerating endothelial cells had
      reached each other, and about 80% of the luminal surface was covered by
      endothelium and at 3 weeks, the prostheses were completely covered by an
      endothelial layer. These results demonstrate that PTFE microvenous prostheses
      heal exclusively by means of rapid ingrowth of endothelial cells originating from
      both sides at the anastomoses.

PMID- 8461899
TI  - Non-radioactive coloured microsphere measurement of regional tissue blood flow
      for axial pattern flaps in rabbits.
AB  - We administered non-radioactive coloured microspheres (NRACM) to measure the
      regional tissue blood flow (RTBF) of eight axial pattern flaps and four kidneys
      in four rabbits using four repeated injections into each animal. As a control, we
      used radioactive microspheres (RAM) for six kidneys in three rabbits. There were
      no significant differences for RTBF values between NRACM and RAM, between the
      numbers of microspheres used (2 x 10(6) and 4 x 10(6)), or between the number of
      injections. These results showed that NRACM is a useful and safe laboratory
      method.

PMID- 8461900
TI  - A comparison of newborn versus old skin fibroblasts, their potential for tissue
      repair.
AB  - An assessment was made of the ability of human skin fibroblasts from newborn and
      old subjects to produce intracellular urokinase inhibitor and urokinase
      plasminogen activator when exposed to phorbol myristate acetate. Urokinase
      inhibitor produced by human skin fibroblasts may be essential for cell growth
      regulation. The expression of urokinase inhibitor and/or urokinase-plasminogen
      activator may possibly be age-related. The principal observation that newborn
      skin fibroblasts show a low level and poorly sustained production of
      intracellular inhibitors of urokinase could help to explain the flexibility of
      the wound healing process in the foetus.

PMID- 8461901
TI  - Role and innocuity of Tisseel, a tissue glue, in the grafting process and in vivo
      evolution of human cultured epidermis.
AB  - Cultured epidermal sheets are currently used for burn wound treatment but
      reported results on graft take are variable. This study was designed to evaluate
      the role and influence of Tisseel, a fibrin glue, in the take of cultured human
      epidermal sheets in an athymic mouse model. On days 4, 10 and 21 post-grafting,
      histology, electron microscopy and immunofluorescence staining confirmed the
      presence of a human epithelium and the development of a basement membrane.
      Tisseel was detectable on day 4 only, but overall treated and untreated grafts
      were similar. The use of Tisseel enhanced the mechanical stability of these
      fragile grafts, increased the percentage of graft take, and its innocuity on the
      in vivo evolution of cultured epidermal sheets was demonstrated. For these
      reasons, we think that Tisseel may be advantageous in a clinical setting.

PMID- 8461902
TI  - Epiphora in facial paralysis. 1950-1.

PMID- 8461903
TI  - Epiphora in facial paralysis.
AB  - Current management concepts of epiphora in established facial palsy are reviewed
      and compared with those advocated by McLaughlin and criticized by Stallard in
      1949.

PMID- 8461904
TI  - The supramalleolar flap based on septocutaneous perforators from the peroneal
      vessels for intraoral soft tissue replacement.
AB  - In cadavers the septocutaneous perforating vessels branching off the distal
      segment of the peroneal artery were studied. An area of skin approximately 7 x 12
      cm above the ankle was noted to be perfused by these and intraoral defects in 8
      patients have been repaired using the supramalleolar flap as a variation of the
      peroneal flap developed by Yoshimura. Owing to its thinness and the long and wide
      vascular pedicle, the flap is particularly suitable for reconstructing mobile
      parts of the oral cavity, and in selected cases may be considered as an
      alternative to a radial flap.

PMID- 8461905
TI  - Perineural infiltration in basal cell carcinomas.
AB  - 4376 basal and squamous cell carcinomas were dealt with over a period of 100
      months. 76.6% of these were basal cell carcinomas. Perineural spread was noted in
      0.178% of basal cell lesions and in all examples was found in recurrent tumours,
      which were predominantly in the preauricular and malar areas in this series.

PMID- 8461906
TI  - Non-medical implications of malignant melanoma.
AB  - Insurance and mortgage companies continue to regard melanoma in a rigid and
      perhaps flawed way, with detrimental effect to patients' financial standing. We
      questioned 100 consecutive patients coming to our clinic between the ages of 20
      and 50, and asked if they had had problems obtaining life insurance, mortgages
      etc, since they were diagnosed. A substantial proportion of patients in the
      younger age groups had problems with mortgage and insurance applications.

PMID- 8461907
TI  - Anatomical investigations of the cutaneous branches of the circumflex scapular
      artery and their communications.
AB  - The vascular anatomy of the cutaneous branches of the circumflex scapular artery
      and their communications with perforators supplying adjacent territories are
      described, based on dissections of 20 scapular regions. The cutaneous branches of
      the circumflex scapular artery are distributed in three areas by the ascending,
      horizontal and descending branches. The existence of the ascending branch was
      constant, confirming the reliability of the ascending scapular flap.

PMID- 8461908
TI  - T flap hypospadias repair in circumcised patients.
AB  - Single stage repair of distal penile hypospadias with chordee in circumcised
      patients is described. A ventral 'T' flap is used, the horizontal part of the T
      flap forming the complete circumference of the new urethra and lying in the
      defect created due to chordee release. The vertical part of the T flap, in
      conjunction with the grooved glans, forms the neourethra like the flip flap
      procedure. Of 22 patients repaired in this way, 2 (9.0%) developed fistula and
      one (4.5%) had meatal stenosis, thus in 86.5% successful repair was achieved.

PMID- 8461909
TI  - Use of the inferiorly based rectus abdominis flap for inguinal and perineal
      coverage--low venous pressure zone concept.
AB  - The authors report 8 cases of coverage of the inguinal and perineal areas with
      the inferiorly based rectus abdominis myocutaneous flap. This flap seems to be
      the technique of choice for coverage of such defects. The design of the flap can
      be explained by the low venous pressure zone concept.

PMID- 8461910
TI  - A simple device for nasal tube fixation in facial burns patients.
AB  - In acute facial burns, it is sometimes necessary to insert tubes down one or both
      nostrils. We describe a simple secure method of fixation.

PMID- 8461911
TI  - Thromboembolic prophylaxis in plastic surgery.

PMID- 8461912
TI  - Angelman syndrome.

PMID- 8461913
TI  - Necrotising fasciitis in the head and neck region.

PMID- 8461914
TI  - Extravasation injuries.
AB  - The leakage of cytotoxic drugs, intravenous nutrition, solutions of calcium,
      potassium, bicarbonate and even 10% dextrose outside the vein into which they are
      delivered is known not only to cause skin necrosis but also to precipitate
      significant scarring around tendons, nerves and joints. In this review of 96
      patients with extravasation injuries seen between 1987 and 1992 at St Thomas'
      Hospital, Mount Vernon Hospital and The Hospital for Sick Children, Great Ormond
      Street, several patients required extensive reconstruction and in some, despite
      this, extravasation injury has rendered a limb virtually useless. Two techniques,
      liposuction and saline flushout, are described to remove extravasated material
      while conserving the overlying skin. Analysis of flushout material confirmed that
      the extravasated material was actually being removed. Forty four of the study
      group in whom noxious materials were known to have extravasated underwent such
      early treatment. The results in this group were quite striking--the majority
      (86%) healed without any soft tissue loss at all. The early referral and
      treatment of extravasation injuries is, therefore, recommended.

PMID- 8461915
TI  - A new design of the cross-finger flap: the C-ring flap.
AB  - A new cross-finger flap, the C-ring flap, is described for repair of degloved
      amputation stumps and dorsal and volar defects of the fingers. The C-ring flap is
      an axial pattern cross-finger flap based on one digital vascular bundle either
      distally or proximally. We used this flap in 12 cases with different types of
      finger defects. The results were satisfactory. We conclude that the C-ring cross
      finger flap had distinct advantages over standard cross-finger flaps. These
      advantages are discussed.

PMID- 8461916
TI  - Insulin-like growth factor-1 and biochemical markers of osteoarthritis.

PMID- 8461917
TI  - Central nervous system involvement in systemic lupus erythematosus. Are we any
      further forward?

PMID- 8461918
TI  - The Roche Rheumatology Prize Lecture. Complement deficiency and disease.

PMID- 8461919
TI  - Insulin-like growth factor-1: a prognostic factor of knee osteoarthritis.
AB  - During a population survey in 1975-1978 persons with radiological osteoarthritis
      (ROA) of the knee were identified. After 12 years a follow-up study was conducted
      to study the effect of circulating insulin-like growth factor-1 (IGF-1) on
      cartilage loss, osteophyte growth and overall progression in 141 persons with
      confirmed ROA of the knee. The outcome measures were scored by comparing the
      radiographs taken at baseline and at follow-up. Insulin-like growth factor-1 was
      measured by radioimmunoassay in serum taken at follow-up and in 79% of the
      baseline sera. After adjusting for age, gender and body mass index at baseline,
      IGF-1 concentration at follow-up was related to osteophyte growth and overall
      progression. The adjusted odds ratio of the highest vs the lowest tertile was
      2.96 (95% CI: 1.15-7.60) for osteophyte growth and 2.58 (1.01-6.60) for overall
      progression. No clear relationship was found with cartilage loss. These results
      were confirmed when baseline IGF-1 was studied. We conclude that the circulating
      IGF-1 concentration has an effect on the course of knee OA by influencing
      osteophyte formation but a preventive effect on cartilage loss could not be
      shown.

PMID- 8461920
TI  - Osteoarthritic human cartilage is more sensitive to transforming growth factor
      beta than is normal cartilage.
AB  - Osteoarthritis is a degenerative joint disease, characterized by the destruction
      of the articular cartilage. One of the first changes in the osteoarthritic
      articular cartilage is a reduction in proteoglycan content. In this study we
      demonstrate that transforming growth factor beta (TGF beta), a multi-functional
      growth factor, stimulates the proteoglycan synthesis of explants from human
      articular knee cartilage dose-dependently in vitro. Osteoarthritic cartilage
      proved to be much more sensitive to stimulation by TGF beta than normal healthy
      cartilage. This may indicate that TGF beta plays an important role in the repair
      of osteoarthritic cartilage.

PMID- 8461921
TI  - Anti-P antibodies are associated with psychiatric and focal cerebral disorders in
      patients with systemic lupus erythematosus.
AB  - In a cross-sectional study, 62 patients with systemic lupus erythematosus were
      assessed using standardized psychiatric and psychological methods; systemic
      disease activity was scored using the British Isles Lupus Assessment Group and
      the Lupus Activity Criteria Count indices. IgG and IgM anti-P antibodies were
      measured by ELISA using a synthetic 22 amino acid peptide as the relevant
      antigen. IgG and IgM anti-P antibodies were significantly associated with
      neuropsychiatric disorders (psychiatric and neurological) but failed to
      distinguish patients with psychiatric disorders from those with neurological
      disorders. These antibodies were not associated with cognitive impairment or
      systemic disease activity.

PMID- 8461922
TI  - Cognitive impairment and autoantibodies in systemic lupus erythematosus.
AB  - Nervous system involvement in systemic lupus erythematosus (SLE) includes a wide
      array of manifestations some of which have been associated with specific
      autoantibodies. These include reactivity to surface neuronal and lymphocyte
      antigens, ribosomal P and cardiolipin. The aim of the present study was to
      examine the association between cognitive abnormalities and these autoantibodies
      in an unselected female population of SLE patients. Using a battery of
      standardized neuropsychological tests, cognitive impairment was identified in
      15/70 (21%) SLE patients compared to 1/25 (4%) patients with rheumatoid arthritis
      and 1/23 (4%) healthy subjects (P = 0.04). Circulating antineuronal antibodies
      were measured by indirect immunofluorescence using human neuroblastoma cell lines
      IMR-6 and SK-N-SH. Lymphocytotoxic antibodies were measured by microcytotoxicity.
      Antibodies to ribosomal P and cardiolipin were measured by ELISA. Antineuronal
      antibodies were detected in 34%, lymphocytotoxic antibodies in 47%, anti-P
      antibodies in 17% and anticardiolipin antibodies in 24% of patients. In the
      cognitively impaired and unimpaired SLE patients there was no significant
      difference in the prevalence of antineuronal antibodies (33 vs 35%),
      lymphocytotoxic antibodies (40 vs 50%), anti-P antibodies (20 vs 17%) or
      anticardiolipin antibodies (7 vs 29%). The titre and isotype of autoantibodies
      were also similar in both groups. These results suggest that autoantibodies which
      have previously been associated with nervous system manifestations of SLE are not
      likely to be directly involved in the pathogenesis of cognitive dysfunction.

PMID- 8461923
TI  - Patients with anticentromere antibodies, clinical features, diagnoses and
      evolution.
AB  - The sera of 1373 patients derived from a random population of 2627 individuals
      examined in a rheumatology outpatient clinic were found to be positive for
      antinuclear antibodies (ANA). Forty-seven of 1373 ANA positive patients (3.42%)
      presented a pattern of anticentromere antibodies (ACA), and of these 41 were
      followed-up. The predominant clinical features among ACA positive patients were
      Raynaud's phenomenon, arthralgias, scleroderma affecting the hands, feet, face
      and forearms, telangiectases and pulmonary involvement. There were 26 patients
      (64%) with limited cutaneous systemic sclerosis (lSSc), seven with primary
      Sjogren's syndrome (Ss) (17%), five with idiopathic Raynaud's phenomenon (IRPh)
      (12%) and three (7%) with other diseases. The lSSc subset was characterized by a
      significantly younger age for disease onset than for the IRPh patients. The
      Raynaud's phenomenon of lSSc patients lasted for many years before the onset of
      scleroderma, while their pulmonary involvement was mild and subclinical. The Ss
      patients with ACA were characterized by a lower incidence of parotid gland
      enlargement and anti-La (SSB) antibodies than described in the literature.
      Finally, the presence of ACA correlates with the clinical criteria proposed for
      the diagnosis of lSSc.

PMID- 8461924
TI  - Physiological variations in the urinary excretion of pyridinium crosslinks of
      collagen.
AB  - To further validate measurements of the pyridinium crosslinks of collagen as
      indices primarily of bone resorption in arthritis and other diseases, the effects
      of day-to-day and nyctohemeral parallel variations, and of renal impairment have
      been studied. Day-to-day variations measured over 3 weeks were between 16 and 24%
      for a group of post-menopausal women. Nyctohemeral variations in crosslink
      excretion of 10-15% were recorded. Although crosslink excretion relative to
      creatinine was generally higher in the morning than in the evening, no consistent
      pattern was observed between healthy male and female volunteers and a group of
      patients with OA or RA. For patients with impaired renal function, with or
      without arthritis, there was no correlation between crosslink excretion and
      either creatinine clearance rates or urinary N-acetyl glucosaminidase activity.
      These results suggested that there was no direct relationship between renal
      function, at the glomerular or tubular level, and crosslink excretion.

PMID- 8461925
TI  - Pelvic insufficiency fractures in rheumatoid arthritis.
AB  - The occurrence of pelvic insufficiency fractures in patients with rheumatoid
      arthritis has not previously been well emphasized. These fractures are difficult
      to detect clinically and appropriate radiological investigation is necessary for
      diagnosis. We describe five patients with a spectrum of radiological features and
      discuss the approach to diagnosis and treatment of these lesions.

PMID- 8461926
TI  - A complicated case of systemic lupus erythematosus.

PMID- 8461927
TI  - Autoantibodies in central nervous system lupus.
AB  - Central nervous system (CNS) involvement in patients with lupus remains both a
      diagnostic and a therapeutic challenge. The role of autoantibodies in the
      pathogenesis of CNS lupus and/or as markers for disease activity is reviewed.
      Doubt is cast on the value of measuring anti-neuronal antibodies. Those
      antibodies binding ribosomal-P protein antigens or certain phospholipids appear
      to have greater utility, although even in these cases there is no uniform
      agreement as to their precise role in CNS disease induction, or how well antibody
      levels reflect disease activity.

PMID- 8461928
TI  - Antibodies to type II collagen in early rheumatoid arthritis.
AB  - Antibodies to native and denatured type II collagen were investigated in a group
      of 79 patients with rheumatoid arthritis (RA) of disease duration less than 12
      months (median 8 months; range 3-12 months). Using a solid-phase ELISA to measure
      these antibodies, the incidence of patients with levels above the upper limit of
      normal (mean of normal plus 3 SD) was low as compared to previous findings in
      patients with established disease. The majority of positive sera contained small
      amounts of IgM antibodies to denatured type II collagen whilst a few had IgG
      antibodies to native and denatured type II collagen. These findings suggest that
      the production of high levels of serum anti-type II collagen antibodies in
      patients with RA is a secondary phenomenon, which may exacerbate the disease
      rather than be a primary cause of disease.

PMID- 8461929
TI  - Familial scleroderma: HLA antigens and autoantibodies.
AB  - We report clinical and serological findings as well as the results of extended
      (HLA-A, B, C, DR and complotype) haplotype determinations of a family with two
      cases of systemic scleroderma and one case of primary biliary cirrhosis and
      incomplete CREST syndrome in a sibship of eight. In addition, one of these eight
      siblings has showed immunological findings of autoimmune disease for years but
      has not developed clinical symptoms. This family was studied by Soppi et al. in
      1982; one member of the family has since then developed primary biliary cirrhosis
      and incomplete CREST type scleroderma. All family members with scleroderma or
      related disease as well as their sister with immunological abnormalities share
      the A2; B8; DR3 haplotype. Also some members of the family share the same
      haplotype but have remained healthy. This haplotype seems to be a predisposing
      factor but additional genetic or environmental factors are probably necessary for
      expression of autoimmune disease.

PMID- 8461930
TI  - Vertebral osteomyelitis due to Staphylococcus epidermidis.
AB  - Vertebral osteomyelitis due to Staphylococcus epidermidis is extremely rare and
      usually occurs in the context of immunosuppression in association with an
      adequate portal of entry for infection. This paper reports a case of vertebral
      osteomyelitis due to S. epidermidis in a man with no evidence of
      immunosuppression or obvious portal of entry. The patient presented with severe
      back pain but there were no clinical signs of infection. Radiographs and
      computerized tomographs showed destruction of thoracic vertebral bodies and an
      adjacent soft tissue mass. S. epidermidis was grown from multiple blood cultures.
      All isolates had identical antibiograms and biochemical profiles. There was
      evidence of healing of the vertebral bodies and resolution of the soft tissue
      mass after appropriate antistaphylococcal treatment.

PMID- 8461931
TI  - Group G streptococcal osteomyelitis of the spine.
AB  - Two elderly men, one with definite and one with probable malignancy, presented
      with severe back pain. Both had osteomyelitis of the lumbar spine due to Group G
      streptococci which responded to chemotherapy.

PMID- 8461932
TI  - Q-fever polyarthritis.

PMID- 8461933
TI  - Differential therapeutic response in AIDS-associated polyarthritis.

PMID- 8461934
TI  - HLA-DR antigens in rheumatic fever and rheumatic heart disease patients.

PMID- 8461935
TI  - Mixed connective tissue disease--a farewell?

PMID- 8461936
TI  - UCTD or U1 RNP-associated connective tissue syndrome.

PMID- 8461937
TI  - Cytokine inter-relationships and their association with disease activity in
      arthritis.

PMID- 8461938
TI  - Sensorineural hearing loss in juvenile chronic arthritis.

PMID- 8461939
TI  - Pseudogout mimicking meningitis.

PMID- 8461941
TI  - The use of monoclonal antibodies for the diagnosis and therapy of bladder cancer.

PMID- 8461940
TI  - Cyclosporin A in the treatment of relapsing polychondritis with severe recurrent
      eye involvement.

PMID- 8461942
TI  - Validation of a non-invasive radioisotope method of imaging ureteric urine
      transport.
AB  - Measurement of ureteric function has hitherto involved the use of invasive
      techniques. A non-invasive, radioisotope method of imaging and displaying
      individual ureteric boluses has been described, a refinement of which is used in
      this department. Each "spindle" displayed using this technique theoretically
      represents an individual ureteric bolus of urine, but the technique has never
      been validated in the normal ureter in either the experimental model or man. A
      porcine model was set up to allow simultaneous measurement of ureteric bolus
      transmission using the radioisotope (compressed image) method and by the accepted
      techniques of electromyography (EMG) and urine drop counting. The timing of each
      urinary bolus, as recorded by the different modalities was then compared. The
      results from 11 studies showed a significant correlation between the radioisotope
      and EMG methods (mean r = 1.00, P = 0.0003). There was a constant relationship
      between the part of the radioisotopic image representing the rear end of the
      bolus and the EMG complex (mean time difference = 5.32 +/- 1.067s), thus defining
      that part of the image representing the peristaltic contraction wave. There was a
      variable relationship between the EMG and the part of the image representing the
      leading edge of the bolus (mean time difference = 13.36 +/- 5.23s), emphasising
      that bolus length is variable, being dependent on bolus volume. The radioisotope
      "spindle" concurs with EMG activity in the porcine ureter. The compressed image
      technique is thus validated as a non-invasive method of demonstrating ureteric
      urine transport.

PMID- 8461943
TI  - New method for discriminating between calcium stone formers and healthy
      individuals.
AB  - A new method for discriminating between the urine of potential calcium stone
      formers and healthy persons has been proposed, based on determination of the
      calcium binding capacity of urine (CBC) by titration of early morning urine with
      a calcium chloride solution. For this purpose a new PVC matrix calcium ion
      selectrode for measuring calcium ion concentration in whole urine was used. The
      selectrode has a disposable membrane which can easily be prepared and replaced in
      the laboratory. Plots of the calcium ion concentration versus the concentration
      of total added calcium were linear up to a point where precipitation of calcium
      salts commenced. The slopes of these titration lines were used as criteria for
      discrimination. Statistical evaluation showed good separation between the urine
      of healthy and stone forming donors. A 2-sample t test with unequal variances
      gave mean values of 0.31 for healthy urine (13 samples) and 0.64 for stone
      forming urine (26 samples). Individual 99% confidence intervals were 0.21-0.40
      for the controls and 0.54-0.73 for the patients respectively. Discriminant
      analysis showed that from a group of treated patients with low Dl (13 samples), 3
      were classified as stone formers and 10 were non-formers. Thus there was good
      correlation with the clinical situation and with the previously proposed Dl test.

PMID- 8461944
TI  - Effect of Desmodium styracifolium-triterpenoid on calcium oxalate renal stones.
AB  - We have studied the inhibitory effects of Desmodium styracifolium-triterpenoid
      (Ds-t) (extracted from Desmodium styracifolium (Osbeck) Merr, a herbal medicine)
      on the formation of calcium oxalate renal stones induced experimentally by
      ethylene glycol (EG) and 1 alpha(OH)D3 (1 alpha D3) in rats. The incidence of
      urinary stone formation was 81% in the control group, which received EG and 1
      alpha D3, and 29% in the Ds-t group, which received EG and 1 alpha D3
      supplemented by Ds-t. The serum calcium (Ca) concentration in the Ds-t group was
      significantly elevated and urinary Ca excretion was markedly reduced. Urinary
      excretion of citrate (Cit), a factor that prevents stone formation, was
      significantly increased in the Ds-t group. Excretion of urinary phosphorus (P),
      which was elevated to a significantly greater extent in the controls than in the
      Ds-t group, was increased in both groups. The increase in urine volume in the Ds
      t group was significantly greater than in the control group. The 24-h creatinine
      clearance rate (Ccr) was significantly lower in the controls. These findings
      suggest that Ds-t inhibits the formation of Ca oxalate stones in rat kidneys by
      increasing the output of urine, decreasing the excretion of calcium and
      increasing the urinary excretion of citrate. Ds-t may be useful in preventing the
      recurrence of urinary Ca oxalate stones in the clinical setting.

PMID- 8461945
TI  - Is retrograde ureterography indicated in pelviureteric junction obstruction?
AB  - The role of retrograde ureterography in the management of pelviureteric junction
      (PUJ) obstruction remains controversial and it has recently been reiterated that
      visualisation of the entire ureter on the affected side is mandatory owing to the
      high incidence of other ureteric abnormalities. In a review of 119 consecutive
      adult pyeloplasties carried out over a 9-year period, only 2 ureteric
      abnormalities were found in association with PUJ obstruction (duplex ureter/3-cm
      proximal stricture). Other anatomical abnormalities included aberrant vessels,
      fascial bands and renal anomalies. Most secondary abnormalities were undiagnosed
      prior to surgery and all were easily dealt with per-operatively.

PMID- 8461946
TI  - Retrograde balloon dilatation for pelviureteric junction obstruction.
AB  - A total of 49 retrograde balloon dilatations for pelviureteric junction (PUJ)
      obstruction were carried out on 43 pelviureteric junctions in 42 patients from
      1986 to 1991. The majority (34/43) were performed as primary treatment for PUJ
      obstruction, with 9 patients having a history of previous open pyeloplasty.
      Follow-up ranged from 3 months to 4 years (mean 18 months). Clinical improvement,
      as assessed by absence of symptoms, was seen in 34 cases (80%). There was either
      no change or an improvement in renographic findings (t1/2 time and/or split
      function) in 40 patients (93%). Of the 9 patients who were undergoing secondary
      treatment, 5 showed clinical improvement and 8 showed no change or renographic
      improvement. Nine patients required 12 further procedures, of which 5 were
      interval nephrectomy. Balloon pyelolysis is a simple procedure with good results
      over a 4-year follow-up period. It is less effective for the treatment of
      secondary pelviureteric junction obstruction. It has a low morbidity and no
      mortality, involves a short hospital stay and allows an immediate return to full
      activity. It is therefore an attractive alternative to open pyeloplasty as first
      line treatment for PUJ obstruction.

PMID- 8461947
TI  - Non-invasive investigation of normal individual ureteric activity in man.
AB  - This study was designed to investigate non-invasively human ureteric function
      between individuals and with increasing diuresis, using the radioisotope
      compressed image technique. Five normal males underwent fast frame renography
      with ureteric spindle imaging in dehydrated and hydrated states, urine production
      being measured in each individual for each scan. Urine flow rates and renographic
      parameters demonstrated that each ureter carried more urine in the hydrated
      state. The velocity at which individual boluses passed down the ureter was
      constant for each ureter and did not change with diuresis. The ureteric
      peristaltic rate showed wide individual variation between ureters in the same
      subject, but fell within what is becoming accepted as the "normal range" of < 4
      urine boluses per minute. Some ureters accommodated an increase in urine flow by
      an increased peristaltic frequency, some showed no change and others showed a
      decreased frequency. In those ureters in which there was no change, or a decrease
      in peristaltic frequency with diuresis, the increased urine flow must have been
      handled by increases in bolus volume. Thus increases in ureteric urine flow in
      man are accommodated by changes in both peristaltic frequency and bolus size. The
      results are discussed in relation to previous studies which used invasive
      techniques.

PMID- 8461948
TI  - A combined urodynamic and continence unit--a review of the first 19 years.
AB  - We have completed a 19-year audit of all patients referred to the
      urodynamic/continence unit since its inception in 1972 and their subsequent
      clinical management; a total of 20,437 patients were referred, increasing from 51
      in the first year to 1564 in 1990. Although the annual number of referrals has
      remained constant for the last 8 years, the need for more complex urodynamic
      assessment such as video-cystourethrography has increased from 5% (56/1164) in
      1981 to 25% (385/1564) in 1990. The number of out-patient attendances to medical,
      physiotherapy and continence clinics has also increased over that period. We
      conclude that the number of referrals represents increasing recognition of the
      value of urodynamic assessment. Accurate diagnosis leads to more effective
      treatment, whether surgical, medical or conservative. Some methods of diagnosis
      are complex and suitable only for a tertiary referral centre.

PMID- 8461949
TI  - Bladder neck mobility evaluated by vaginal ultrasonography.
AB  - Factors involved in monitoring bladder neck mobility were studied by means of
      vaginal ultrasonography. Thirty-three continent, 28 incontinent and 39 patients
      who had undergone surgery for incontinence were examined in the supine and
      sitting positions during rest, the Valsalva manoeuvre and withholding urine.
      Bladder neck mobility can be described as a semicircular movement with the tip of
      the symphysis pubis as the centre and a line from the tip to the bladder neck as
      the radius (BS). Movement can be measured by 2 independent factors: BS distance
      and size of the angle between the BS line and the midline of the symphysis, at
      rest, during the Valsalva manoeuvre and withholding urine. The continent controls
      were characterised by a 90 degrees angle at rest, a long BS (2.4 cm) and a fixed
      bladder neck. The incontinent patients had a shorter BS (2.1 cm), angles at rest
      of approximately 100 degrees--the angle increased with the grade of incontinence-
      and a mobile bladder neck. If 2 of the 3 criteria (angle at rest > or = 95
      degrees, BS < or = 2.3 cm and mobility > or = 20 degrees) are regarded as
      diagnostic of incontinence, diagnostic sensitivity was 84% and specificity 82%.
      In the surgical group, patients who failed to respond to treatment had a shorter
      BS, larger angles and greater bladder neck mobility than their successfully
      treated counterparts.

PMID- 8461950
TI  - Iatrogenic urogenital fistulae.
AB  - Nineteen patients with iatrogenic urogenital fistulae were treated between 1985
      and 1989. All resulted from obstetric and gynaecological surgery. Major symptoms
      were leakage of urine through the vagina, menouria and perineal dermatitis. The
      fistulae formed after treatment for benign conditions in 18 patients. Fistulae
      complicating cancer surgery were uncommon. All patients with uretero-vaginal
      fistulae underwent preliminary percutaneous nephrostomy. Twelve patients
      underwent reconstruction using either the Boari-Ockerblad flap (5), uretero
      neocystostomy (4) or other techniques (3), all with excellent results. Most of
      the remaining patients had treatment elsewhere. We consider that preliminary
      diversion, followed by delayed reconstruction, is a valuable option in the
      management of uretero-vaginal fistulae.

PMID- 8461951
TI  - Peripheral blood lymphocyte response in patients with superficial transitional
      cell carcinoma of the bladder treated with intravesical Bacillus Calmette-Guerin-
      a useful marker of response?
AB  - Intravesical instillation of Bacillus Calmette-Guerin (BCG) offers safe and
      effective short-term/long-term treatment for superficial transitional cell
      carcinoma (TCC) and TCC in situ of the bladder. However, 17 to 42% of patients
      may experience recurrence in spite of this therapy and a marker of effective
      treatment is of paramount importance. In this study the in vitro response of
      peripheral blood lymphocytes (PBL) to BCG was analysed in 10 patients with
      superficial TCC and TCC in situ before and during BCG instillations. The in vitro
      response of PBL to BCG, expressed as a stimulatory index (SI), revealed that 6
      patients had a SI > 5 and 4 patients had a SI < 5. None of the former patients
      had recurrence of TCC during a mean follow-up of 17 months, while all of the
      latter patients experienced recurrence of TCC within 9 months. It was concluded
      that the in vitro response of PBL to BCG may be used as a marker of response to
      intravesical BCG treatment.

PMID- 8461952
TI  - Mitomycin-C in superficial bladder cancer. Is long-term maintenance therapy
      worthwhile after initial treatment?
AB  - A total of 72 patients with recurrent superficial transitional cell carcinoma of
      the bladder (TCC) were treated with 40 mg intravesical instillations of mitomycin
      C (MMC) weekly for 10 weeks, followed by monthly maintenance doses. With a mean
      follow-up period of 41 months, 30 patients (42%) had a complete and sustained
      response after the initial treatment course, and a further 14 (19%) achieved a
      complete response on maintenance therapy. Sixteen patients (22%) continued to
      have recurrent tumours and the remaining 12 (17%) developed recurrent tumours
      after an initial complete response. Of these, 4 patients with carcinoma in situ
      (CIS) showed symptomatic improvement, but the histological changes persisted and
      all of those with tumours > 2 cm in size did not respond. We conclude that
      maintenance treatment with MMC is beneficial in superficial bladder cancer but is
      of limited value in the presence of bulky tumours or CIS.

PMID- 8461953
TI  - Two years' experience with photodynamic therapy of bladder carcinoma.
AB  - Eleven patients with intractable bladder carcinoma who were either unfit for
      radical surgery, or had refused it, were treated with whole bladder photodynamic
      therapy. Seven patients had carcinoma in situ and 4 had papillary tumours. Four
      of the 11 patients had recurrent tumours after a full course of radiotherapy for
      invasive bladder cancer. A complete local response was initially achieved in 9
      patients with a mean follow-up of 12 months. The patients previously treated with
      radiotherapy had a remarkable response, with local control in all cases, but they
      had severe local side effects and a pronounced reduction in bladder capacity. In
      the non-irradiated group, bladder capacity was reduced permanently in only 1 of 7
      patients.

PMID- 8461954
TI  - Expression of C-50 antigen as a prognostic variable in transitional cell bladder
      tumours.
AB  - The immunohistochemical expression of C-50 antigen was quantitated in paraffin
      embedded biopsy specimens of 218 transitional cell bladder tumours. The patients
      were treated according to standard practice in one institution and followed up
      for over 10 years. The expression of C-50 antigen was inversely correlated to T
      category, papillary status and WHO grade. Aneuploid tumours with a high S phase
      fraction (SPF) showed low expression of C-50 antigen. Progression in T, N and M
      categories was inversely correlated to CA-50 expression. Low expression of C-50
      antigen predicted progression in Ta-T1 tumours. Expression of C-50 antigen was
      related to a favourable prognosis in the whole series, in papillary tumours, in
      diploid tumours, in WHO grade 2 tumours and in Ta-T1 tumours. The combination of
      DNA ploidy and expression of C-50 antigen was a highly significant predictor of
      survival. In Cox's analysis, expression of CA-50 had an independent predictive
      value in Ta-T1 tumours, whereas in the whole cohort the T category and
      papillarity were independent predictors.

PMID- 8461955
TI  - Cardiovascular reflexes in the neurological evaluation of impotence.
AB  - Testing of the autonomic cardiovascular reflexes (single breath beat-to-beat
      variation and orthostatic blood pressure change) was performed in 542 patients
      with erectile dysfunction who were grouped according to aetiological factors and
      their response to visual sexual stimulation and the papaverine test. Age-related
      normal values for autonomic tests were determined in the group of 124 patients
      with psychogenic impotence. Abnormal cardiovascular reflexes were associated with
      ageing and organic impotence, indicating autonomic dysfunction as a major
      contribution to impotence. Single breath beat-to-beat variation, as a simple non
      invasive test, is useful in the clinical evaluation of impotence, especially in
      patients with diabetes and a history of alcohol abuse.

PMID- 8461956
TI  - Extensive condylomata acuminata of male urethra: management by ventral
      urethrotomy.
AB  - Between 1982 and 1990, 4 males with extensive intraurethral warts presented with
      marked inflammation of the external genitalia. When sepsis had settled all
      patients underwent ventral urethrotomy, in which the urethra was divided median
      as far back as was necessary to expose all of the warts. Surgical and electro
      excision were the preferred methods of removal. Of 3 patients who developed
      recurrences 2 were lost to follow-up. A third remained without treatment for 1
      year and when next seen the warts had spontaneously resolved and his urethra was
      closed. A fourth patient was lost to follow-up for 4 years before returning with
      destruction of his external genitalia by a verrucous carcinoma. The human
      immunodeficiency virus (HIV) did not appear to be a factor in the natural history
      of intraurethral warts in 2 patients who were negative for serum antibodies 2 and
      8 years after presentation.

PMID- 8461957
TI  - The failed exstrophy closure: strategy for management.
AB  - In the last 7 years, 29 boys and 11 girls have been referred with failure of
      their exstrophy closure; 38 patients had classic bladder exstrophy and 2 had
      cloacal exstrophy. Reclosure was performed for complete bladder dehiscence in 28
      cases and for significant bladder prolapse in 10. Two patients underwent revision
      of the posterior urethra after primary closure due to a severe urethral stricture
      secondary to the use of para-exstrophy skin flaps. Six patients underwent
      posterior iliac osteotomy at the time of initial bladder closure and in 34 no
      osteotomy was performed. Thirty-seven patients underwent either posterior iliac
      osteotomy (15) or anterior innominate osteotomy (22). Epispadias repair together
      with reclosure of bladder exstrophy was done in 20 boys. The upper tract has
      remained normal in all patients. Fourteen have undergone subsequent bladder neck
      reconstruction. Seven patients have undergone simultaneous bladder neck
      reconstruction and augmentation cystoplasty and 1 has undergone augmentation
      cystoplasty and Mitrofanoff procedure; all are dry on intermittent self
      catheterisation. The failed exstrophy reconstruction represents a formidable
      dilemma. However, a well planned reconstruction including osteotomy (even if
      previously performed), reclosure with or without epispadias repair or revision of
      the urethra can be performed with an excellent chance of proceeding with staged
      reconstruction.

PMID- 8461958
TI  - Efficacy and causes of failure of endoscopic subureteric injection of Teflon in
      the treatment of primary vesicoureteric reflux.
AB  - A total of 135 consecutive patients with primary vesicoureteric reflux (VUR) were
      treated as day cases using submucosal Teflon injection (STING) between 1984 and
      1988. Up to 3 repeat procedures were performed in the event of failure; 89% of
      patients and 92% of ureters were cured. None was obstructed and 2 recurred. Eight
      patients continue to have asymptomatic reflux Grade 2 or less, while 7 have had
      open surgery to correct the reflux. Most of the failures had a satisfactory
      appearance at STING but this deteriorated with time and appears to have been
      caused by leakage of Teflon from the injection site post-operatively. There were
      no signs or symptoms of embolisation or migration of the implant material.

PMID- 8461959
TI  - GRAP repair: single-stage reconstruction of hypospadias as an out-patient
      procedure.
AB  - A novel repair of the distal urethra with glanular and preputial reconstruction
      is described for distal penile hypospadias; 52 consecutive patients underwent
      this procedure without catheter splintage or urinary diversion. All voided
      without problems on the day of operation; 44 (85%) were treated as day cases,
      while the remaining 8 boys stayed in hospital for at least 1 night post
      operatively for reasons not associated with the operation. Follow-up was complete
      and ranged from 15 to 30 months (mean 18). There was no evidence of meatal
      stenosis, phimosis or urethral stricture; 26 boys (50%) had associated chordee
      pre-operatively which was incompletely corrected in 2 (8%). These have a minor
      degree of chordee of glans on penile shaft and neither has required further
      treatment. Four boys (8%) developed partial wound breakdown which necessitated
      reconstruction in 2 and both of these have now been treated successfully.
      Functional and cosmetic results are excellent.

PMID- 8461960
TI  - Ileal conduit-enteric fistula.

PMID- 8461961
TI  - Reflex renal shutdown.

PMID- 8461962
TI  - Primary osteogenic sarcoma of the kidney presenting as staghorn calculus.

PMID- 8461963
TI  - Transitional cell carcinoma of the bladder in a young woman with the polycystic
      ovarian syndrome.

PMID- 8461964
TI  - Detrusor myopathy: a cause of detrusor weakness with retention.

PMID- 8461965
TI  - Colovesical fistula complicating unsuspected bladder outflow obstruction.

PMID- 8461966
TI  - Two cases of haemangiopericytoma.

PMID- 8461967
TI  - Re: Effect of vaginal ultrasound probe on lower urinary tract function.

PMID- 8461968
TI  - Familial Alzheimer's disease. A pedigree with a mis-sense mutation in the amyloid
      precursor protein gene (amyloid precursor protein 717 valine-->glycine).
AB  - Ten affected individuals are described from a kindred with autosomal dominant
      familial Alzheimer's disease in which a mutation in the amyloid precursor protein
      gene results in a valine to glycine substitution at amyloid precursor protein 717
      which co-segregates with the disease. The mean age at onset of symptoms was 52
      years with a range from 40 years to 67 years. The median duration of the disease
      was 11 years, with a range of 7-16 years. All individuals fulfilled the National
      Institute for Neurological and Communicative Disorders and Stroke criteria for
      probable Alzheimer's disease. A homogeneous clinical and neuropsychological
      pattern was evident within the family. Myoclonic jerks, seizures, depression and
      a lack of insight were common features. Positron emission tomography demonstrated
      biparietal bitemporal hypometabolism in the one affected individual who was
      studied. The diagnosis was confirmed histopathologically in one individual.

PMID- 8461969
TI  - Normal and pathological saccadic dysmetria.
AB  - Initial saccades to visual targets are generally not precise in either normal
      subjects or patients with saccadic dysmetria. Quantitative criteria have to be
      applied to clearly distinguish between normal and pathological saccadic
      dysmetria, which is often found in patients with cerebellar lesions. To establish
      these criteria, the accuracy of visually guided horizontal saccades (10 degrees
      and 20 degrees target steps) was studied in a group of 24 patients with lesions
      affecting the cerebellum or its connections, and compared with data from 17
      normal subjects. Eye movements were recorded with infrared oculography. Saccades
      of normal subjects had an average gain of 0.92-0.95 depending on the stimulus
      condition. Centripetal saccades were significantly larger than centrifugal
      saccades, for 20 degrees target steps. Most patients (n = 15) had significantly
      larger saccadic amplitudes than normal subjects (hypermetria), at least in one
      direction. Saccades in the opposite direction could be either hypometric,
      hypermetric or normal. Two patients had hypometric saccades in both directions.
      For one of the patients with hypermetria, in addition, the amplitude difference
      between centrifugal and centripetal saccades was significantly larger than in the
      normal subjects. Five patients had no significant pathology of the initial
      (primary) saccade, but a pathological pattern of corrective saccades. Two
      patients had normal saccades under all conditions. The quantitative comparison
      with normal subjects allows the detection even of mild pathology. According to
      our results, a pathology can be assumed when the average gain of saccades in at
      least one direction is 1.0 or more, or when more than two out of 20 saccades are
      followed by two corrective saccades of which the last is in the direction
      opposite to the initial saccade (pathological pattern of corrective saccades).
      Target steps of 20 degrees reveal a pathological condition more often than 10
      degrees target steps. The application of quantitative criteria might be useful to
      establish a diagnosis of pathologic saccadic dysmetria even in instances in which
      it is clinically not obvious.

PMID- 8461970
TI  - Some saccadic eye movements can be delayed by transcranial magnetic stimulation
      of the cerebral cortex in man.
AB  - In 15 normal subjects we investigated the effect on visually guided saccadic eye
      movements of giving a single transcranial magnetic stimulus through a circular
      coil centered at the vertex. In the normal paradigm, subjects fixated a target
      which moved randomly to the left or right by 11 degrees. The mean saccadic
      reaction time of 189 ms was increased by 40-50 ms if a magnetic stimulus was
      given in random trials some 60 ms prior to the expected onset time of control
      saccades. The duration and amplitude of the saccades was unchanged. The delay was
      smaller if the stimulus was given earlier in the reaction period, or if the coil
      was moved anterior or posterior to the vertex. Larger stimulus intensities
      produced longer delays. Three subjects were trained to produce express saccades
      (mean saccadic reaction times of 107-141 ms) in a 'gap' paradigm. The latency of
      these saccades, which are thought to be mediated by collicular mechanisms without
      involvement of the cortex, was not affected by magnetic stimulation. This
      suggests that magnetic stimulation delays normal visually guided saccades by an
      action on the cerebral cortex, rather than on the oculomotor centres of the
      brainstem. Five subjects made non-targeted saccades in darkness in response to an
      auditory stimulus. These saccades, like visually guided saccades, could be
      delayed by magnetic brain stimulation. We conclude that saccadic delay is
      produced by interference with cortical areas involved in the execution of
      saccades rather than by interfering with the perception of the visual or auditory
      'go' stimulus. These probably include supplementary and frontal eye field and
      posterior parietal cortex. The fact that visually guided saccades emerged intact
      after the delay indicates that the instructions for amplitude and direction were
      stored separately from those involved in timing when the movement was to occur.

PMID- 8461971
TI  - Motor recovery following capsular stroke. Role of descending pathways from
      multiple motor areas.
AB  - The functional anatomy of motor recovery was studied by assessing motor function
      quantitatively in 23 patients following capsular or striatocapsular stroke. While
      selective basal ganglia lesions (caudate and/or putamen exclusively) did not
      affect voluntary movements of the extremities, lesions of the anterior (plus
      caudate/putamen) or posterior limb of the internal capsule led to an initially
      severe motor impairment followed by excellent recovery, hand function included.
      In contrast, lesions of the posterior limb of the internal capsule in combination
      with damage to lateral thalamus compromised motor outcome. In experimental
      tracing of the topography of the internal capsule in macaque monkeys, we found
      axons of primary motor cortex passing through the middle third of the posterior
      limb of the internal capsule. Axons of premotor cortex (dorsolateral and post
      arcuate area 6) passed through the capsular genu, and those of supplementary
      motor area (mesial area 6) through the anterior limb. Small capsular lesion can
      therefore disrupt the output of functionally and anatomically distinct motor
      areas selectively. The clinically similar motor deficits with a similar course of
      functional restitution following disruption of these different descending motor
      pathways indicate a parallel operation of cortical motor areas. They may have the
      further capability of substituting each other functionally in the process of
      recovery from hemiparesis.

PMID- 8461972
TI  - Decrease of contralateral neglect by neck muscle vibration and spatial
      orientation of trunk midline.
AB  - Three patients with a right hemisphere lesion and marked left-sided neglect
      without visual field defects were asked to detect and identify stimuli which were
      tachistoscopically presented in the left or right visual half-field. Neglect of
      stimuli presented in the contralesional left visual field, which was observed
      when the patient's body was in a normal upright position with trunk, head and
      gaze oriented straight ahead to the middle of the projection screen, could be
      reduced by vibrating the left posterior neck muscles as well as by turning the
      trunk 15 degrees to the left. In contrast, unspecific stimulation on the left
      side of the patient's body, produced by vibrating the left hand muscles or the
      proprioceptive signal induced by turning the head 15 degrees to the left, had no
      compensatory effects. The results showed that the afferent information about real
      lengthening of the left posterior neck muscles (produced by turning the trunk) as
      apparent lengthening of these muscles (produced by their vibration), leads to a
      remission of contralateral neglect. Thus, the proprioceptive input from the neck
      muscles, i.e. the head-on-trunk signal, appears to influence the extension of the
      neglected part of space in patients with neglect. The signal seems to contribute
      substantially to the neural generation of the egocentric frame of reference that
      allows the determination of body position with respect to visual space. We
      hypothesize that the reduction of neglect by vibration of the contralateral
      posterior neck muscles is based on a shift of the subjective spatial localization
      of the sagittal midplane in the contralesional direction and a corresponding
      alteration of the egocentric coordinate system necessary for visuomotor
      coordination and exploration of space.

PMID- 8461973
TI  - Clinical responses to electrical brain stimulation of the temporal and frontal
      lobes in patients with epilepsy. Pathophysiological implications.
AB  - The clinical responses elicited by electrical stimulation of discrete cerebral
      structures in the temporal and frontal lobes were studied in 75 patients
      undergoing pre-surgical evaluation using chronic intracerebral
      electroencephalographic recordings. Responses without after-discharge spreading
      beyond the site of stimulation included somatosensory, autonomic,
      thermoregulatory and viscerosensory phenomena, simple motor responses, some
      simple automatisms, changes in facial expression or voice tone, vocalizations,
      conscious confusion and experiential phenomena. Except for oro-alimentary
      automatisms, these responses were similar to the initial responses elicited by
      stimulations followed by a spreading after-discharge. Responses were most often
      obtained from limbic structures, sometimes from the temporal isocortex, and
      rarely from frontal sites (except for simple motor activity and some simple
      automatisms). Specific clinical responses could often be elicited from more than
      one site (74 out of 147), frequently even from non-contiguous areas in the same
      or both hemispheres. This suggests that the neuronal substrates responsible for
      the production of some of these phenomena are widespread neuronal matrices linked
      through connections which have become strengthened through repeated use as
      hypothesized by one of us [Gloor (1990), Brain, 113, 1673-1694]. Such a
      hypothesis could also account for the individually idiosyncratic nature of many
      of these responses.

PMID- 8461974
TI  - Time course of action potentials recorded from single human afferents.
AB  - It was the object of this study to measure the time course of the action
      potential in individual human sensory nerve fibres in relation to conduction
      properties of the axons. For this purpose, the technique of percutaneous
      microneurography was combined with intradermal electrical stimulation of distal
      portions of the axons. Recordings were made at the wrist level from 57 type
      identified mechanoreceptive median nerve afferents [mainly rapidly adapting (RA)
      and slowly adapting type I (SAI)] innervating the glabrous skin of the hand.
      Measurements were made of the duration and time-to-peak of the positive peak of
      the diphasic (large positive phase followed by smaller, slower negative phase)
      action potential typically recorded using microneurography. Durations ranged from
      0.31 to 0.75 ms (mean 0.50 ms) and times-to-peak from 0.12 to 0.45 ms (mean 0.21
      ms), with no difference between afferent categories (RA, SAI). Time-to-peak was
      strongly positively correlated with duration (linear r = 0.81). Conduction
      velocity was measured over the distance extending from the point of intradermal
      stimulation (typically in the fingertips) to the point of recording at the wrist
      (distal conduction velocity). Absolute refractory period was measured using
      paired stimuli applied at the point of intradermal stimulation, within the
      receptive field of the afferent (distal absolute refractory period). Distal
      conduction velocities ranged from 15 to 60 m/s (mean 33 m/s), and distal
      refractory periods from 0.7 to 4.5 ms (mean 2.1 ms), with no difference between
      afferent types (RA, SAI). Distal absolute refractory period was inversely
      correlated with distal conduction velocity. The data were slightly better
      described assuming a non-linear (exponential) relationship; the non-linear
      correlation coefficient was -0.77. The time course of the action potential varied
      inversely with distal conduction velocity and directly with distal absolute
      refractory period. The time-to-peak versus conduction velocity data were slightly
      better described by a power than a linear relationship. Coefficients of
      correlation were: duration versus conduction velocity, linear r = -0.76; time-to
      peak versus conduction velocity, non-linear r = -0.64; duration versus absolute
      refractory period, r = 0.70; time-to-peak versus absolute refractory period, r =
      0.76. Extensive intercorrelation between the variables duration, distal
      conduction velocity and absolute refractory period was revealed by multiple
      correlation techniques. Inter- and intra-subject skin temperature variation was
      within 5 degrees C. Correcting the time course, conduction velocity and absolute
      refractory period values for temperature variation within this limited range did
      not affect the results.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8461975
TI  - Immunological associations of acquired neuromyotonia (Isaacs' syndrome). Report
      of five cases and literature review.
AB  - Neuromyotonia is a syndrome of spontaneously occurring muscle activity of
      peripheral nerve origin, which can be triggered by voluntary or induced muscle
      contraction. It is one among several causes of visible myokymia. Although
      neuromyotonia may sometimes accompany hereditary neuropathies, most cases are
      acquired. The abnormal activity is characterized electromyographically by
      doublet, triplet or multiplet single unit discharges that have a high intraburst
      frequency, the frequency of the bursts themselves being irregular. Fibrillation
      potentials and fasciculations are often also present. We report five patients
      meeting these criteria. Clinical evidence suggesting a possible autoimmune
      aetiology included the presence of oligoclonal bands in the spinal fluid of the
      three patients examined and improvement following plasma exchange in two of three
      patients treated. Other supporting evidence from an English language literature
      review of approximately 40 patients reported in the last 20 years includes an
      associated thymoma in five cases, myasthenia gravis (two cases), raised anti
      acetylcholine receptor antibody titres (two cases) and induction by penicillamine
      (one case). Finally, two further patients have recently been reported to benefit
      from plasma exchange. These clinical data, taken together with the physiological
      changes observed in mice injected with patients' immunoglobulin G (reported
      separately), suggest that antibody-mediated autoimmune mechanisms, possibly
      directed to peripheral nerve K+ channels, may be important in the aetiology of
      acquired neuromyotonia.

PMID- 8461976
TI  - Vagolytic effect of diabetes mellitus.
AB  - The amplitude of respiratory sinus arrhythmia was quantified as the ratio of the
      longest to the shortest R-R intervals in electrocardiograms recorded during deep
      inspirations and forced expirations in the supine position. The mean of the
      absolute differences between consecutive R-R intervals recorded during normal
      quiet breathing in a supine position was also calculated. Since these two tests
      measure only cardiac parasympathetic function, they were used to assess the
      resting vagal tone in 165 patients with diabetes mellitus and 116 healthy
      volunteers (controls). The frequency distribution curve of resting vagal tone was
      Gaussian in the controls and was also negatively correlated with age and height.
      The frequency distribution curve of resting vagal tone was skewed in the diabetic
      population where a majority of patients had low vagal tone. The correlation of
      vagal tone with age was stronger than in controls, but there was no correlation
      of vagal tone with height in diabetic patients. The mean resting vagal tone in
      diabetic patients was reduced by 40%, and the whole frequency distribution curve
      was also shifted to the left by 40% relative to the control curve. It is
      concluded that there is a substantial impairment of cardiac vagal function in
      most diabetic patients, contrary to current belief. Clinical tests which include
      measurement of vagal tone may give a bias towards low values in diabetic patients
      because of the shift to the left in the distribution curve of vagal tone in the
      diabetic population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8461977
TI  - Effect of locus coeruleus lesion on c-fos expression in the cerebral cortex
      caused by yohimbine injection or stress.
AB  - The injection of the alpha-2 adrenoceptor antagonist, yohimbine, has been shown
      to increase c-fos immunoreactivity in the rat cerebral cortex. To determine the
      extent to which this response is mediated by the central noradrenergic system,
      the present studies examined it in rats previously given unilateral 6-OHDA
      lesions of the locus coeruleus. The lesions were found to produce a significant
      attenuation of the response. A similar effect on the c-fos immunoreactive
      response to restraint stress was found. It is concluded that the noradrenergic
      system plays a necessary role in the above c-fos responses in the cortex to
      yohimbine and to stress. The c-fos protein therefore appears to be involved in
      the effects of noradrenergic neurotransmission in the CNS.

PMID- 8461978
TI  - HIV envelope protein-induced neuronal damage and retardation of behavioral
      development in rat neonates.
AB  - Cognitive and motor impairment are common symptoms among patients infected with
      the human immunodeficiency virus (HIV), including children who suffer
      neurological deficits and are frequently developmentally impaired. The HIV
      envelope protein, gp120, which has been shown to be toxic to neurons in culture,
      is shed in abundance by infected cells, and thus may play a significant role in
      the neuropathology of AIDS. To test this possible mechanism, neonatal rats were
      injected systemically with purified gp120 and the following consequences were
      observed: (1) radiolabeled gp120 and toxic fragments thereof were recovered in
      brain homogenates; (2) dystrophic changes were produced in pyramidal neurons of
      cerebral cortex; (3) retardation was evident in developmental milestones
      associated with complex motor behaviors. In parallel studies, co-treatment with
      peptide T, a gp120-derived peptide having a pentapeptide sequence homologous with
      vasoactive intestinal peptide, prevented or attenuated the morphological damage
      and behavioral delays associated with gp120 treatment. These studies suggest that
      gp120 and gp120-derived toxic fragments may contribute to the neurological and
      neuropsychiatric impairment related to HIV infection, and that peptide T appears
      to be effective in preventing gp120-associated neurotoxicity in developing
      rodents.

PMID- 8461979
TI  - Improving effect of acetylcholine receptor agonists on a deficit of 2
      deoxyglucose uptake in cerebral cortical and hippocampal slices in aged and AF64A
      treated rats.
AB  - The aim of the present study was to determine whether the facilitation of 2
      deoxyglucose (2-DG) uptake in the cerebral and hippocampal slices by nicotinic
      and muscarinic receptor agonists is compromised in the aged rat brain. For this,
      the effects of the nicotinic receptor agonist nicotine, the muscarinic receptor
      agonists oxotremorine and McN-A-343, and the ACh esterase inhibitors
      physostigmine and NK247 on 2-DG uptake in the brain slices of young (2-month-old)
      and aged (24-26-month-old) rats were tested. The decrements of 2-DG uptake in the
      cortical slices of aged rats were significantly attenuated by treatment with
      oxotremorine, nicotine and amiridine. In contrast, the metabolic responsivity of
      hippocampal slices to these drugs was reduced. To assess whether age-related
      changes in 2-DG uptake may be due to deficits in cholinergic function, we tested
      these drugs on the decrements of 2-DG uptake in ethylcholine aziridinium (a
      neurotoxic analog of choline) injected rats. The reductions of 2-DG uptake by
      injection of ethylcholine aziridinium was attenuated by oxotremorine but not by
      physostigmine. The present results reveal that metabolic decrements in the
      cerebral cortex from aged or ethylcholine aziridinium-injected rats were
      attenuated by muscarinic and nicotinic receptor agonists, suggesting that the
      muscarinic and nicotinic receptor mechanism in the cerebral cortex may be
      involved in cholinergic drug-induced functional recovery in aged rats.

PMID- 8461980
TI  - Immunocytochemical staining of neuropeptide Y (NPY) in the insular lobe of the
      monkey: a light microscopic study.
AB  - Neuropeptide Y (NPY) has been detected immunocytochemically in cerebral cortex
      and subcortical white matter of the primate frontal, parietal, temporal, and
      occipital lobes. Because little is known about NPY in the primate insular lobe
      and because peptides play an important role in normal neuronal functioning and
      alterations in brain peptides are associated with certain neurological diseases,
      we studied the presence, distribution, and structural characteristics of NPY
      immunostained elements at the light microscopic level in the insula of Macaca
      fascicularis. We used free-floating sections, rabbit anti-porcine NPY serum, and
      the avidin and biotinylated peroxidase complex technique. Neuropeptide Y
      immunostained neurons were demonstrated in layers II, III, and V/VI, and in the
      adjoining subcortical white matter. Immunostaining was localized to neuronal
      somata, neuronal processes, and a delicate plexus in the neuropil. The majority
      of NPY-immunostained neurons were non-pyramidal, had round somata 10-20 microns
      in major transverse diameter, and two or three neuronal processes. Computer-aided
      quantitative analysis of the length, breadth, and area of NPY-stained neurons was
      performed. Our findings are consistent with observations by others on the
      presence, laminar distribution, and structural characteristics of NPY
      immunostained elements at the light microscopic level in other cerebral lobes of
      non-human primates.

PMID- 8461981
TI  - A new method to study motoneuron regeneration using electromyograms shows that
      regeneration slows with age in rat sciatic nerve.
AB  - We developed a novel method for measuring motoneuron regeneration using
      transcutaneous electrical nerve stimulation to evoke electromyograms (EMGs).
      Using this technique we found that functional regeneration of the motoneurons of
      the rat sciatic nerve was significantly slower in 9-10-month-old rats (10 mo)
      than in 10-12 week old rats (3 mo). All rats received crush injuries of the
      sciatic nerve and were analyzed for reinnervation of the muscles in the foot by
      the novel EMG method on days 25, 29 and 33 post-surgery. There were significantly
      fewer test sites reinnervated in the foot of the older group. Fifty percent of
      the sites in the foot were reinnervated 27.2 days post-surgery in the 3 mo group
      in contrast to 33.7 days post-surgery in the 10 mo group, indicative of a 24%
      longer recovery period in the older animals. Rats were also assessed
      behaviourally with a behavioural test score (BTS). The BTS results correlated
      with the EMG findings demonstrating that our novel method measuring rate of
      recovery of EMGs is behaviourally relevant. We discuss the need to use animals
      older than 3 months for the study of 'adult' regeneration phenomena since 3-month
      old rats may be somewhat immature. We applied this age principle and the novel
      EMG method in our accompanying paper which shows the acceleration of nerve
      regeneration by weak DC electric fields.

PMID- 8461982
TI  - Weak electric current accelerates motoneuron regeneration in the sciatic nerve of
      ten-month-old rats.
AB  - When a weak direct current (DC) of 10 microA driven by an implantable device was
      applied to a crushed sciatic nerve in 9-10-month-old rats, regeneration was
      accelerated as assessed electrophysiologically. Rats underwent a sciatic nerve
      crush of the right leg and were randomly assigned to one of three groups: (i)
      Cathode Distal (CD); (ii) Sham Implant (SI); or (iii) No Implant (NI). On post
      operative days 25-39 each rat received a measurement of evoked electromyograms
      (EMG) in the foot. In addition each rat received a behavioural test score (BTS).
      This BTS correlated well with the evoked EMG results showing the behavioural
      relevance of the EMG results. NI rats performed the same as SI in the evoked EMG
      procedure, but CD rats performed significantly better than both the control
      groups. The recovery period in the CD rats was 21% shorter than in either the
      sham-treated or untreated controls showing that weak DC can greatly enhance nerve
      regeneration in adult rats. This result was in contrast to previous work in
      younger rats where DC treatments had no effects. The discrepancy is discussed in
      relation to the slowing of regeneration in older rats.

PMID- 8461983
TI  - Astrocytic and synaptic response to kindling in hippocampal subfield CA1. I.
      Synaptogenesis in response to kindling in vitro.
AB  - Early morphological events associated with the genesis of epileptiform activity
      are essentially unknown, despite significant progress on morphological correlates
      of potentially related plastic neural phenomena. Hippocampal area CA1 shows the
      capacity to generate epileptiform bursting activity after certain patterns of
      electrical stimulation. Using an in vitro slice kindling preparation, we found
      increases in the numbers (areal densities) of shaft and sessile spine synapses in
      hippocampal subfield CA1 within minutes following the establishment of stable
      afterdischarges. These data strongly suggest that synaptogenesis is associated
      with the early stages of epilepsy formation.

PMID- 8461984
TI  - Astrocytic and synaptic response to kindling in hippocampal subfield CA1. II.
      Synaptogenesis and astrocytic process increases to in vivo kindling.
AB  - Astrocytic glia are important for maintaining synaptic function during
      physiological activity. Recent hypotheses concerning epilepsy suggest a role for
      astrocytes in the control of neuronal excitability and in pathogenesis. This
      report provides morphological evidence that the periodic electrical stimulation
      used in the kindling model of epilepsy induces astrocytic hypertrophy and an
      increase in shaft synapse density in the CA1 region of the hippocampus. The
      Schaffer collateral pathway in the stratum radiatum of CA1 of five pairs of rats
      was kindled in vivo. Control animals received the same number of stimulations at
      a lower intensity and frequency. The animals were killed 24-48 h after reaching
      the criterion of five generalized seizures, and the brains were examined by
      electron microscopy. Kindling produced a 37% and 33% increase in the volume
      fraction of astrocytic processes in the middle and distal portions, respectively,
      of the s. radiatum in CA1. In the same tissue, the number (areal density) of
      shaft synapses was increased 25% in the s. radiatum of animals exhibiting
      generalized seizures. On the other hand, the areal density of degenerating
      synapses in both kindled and control animals was low and not significantly
      different. These results suggest that both synaptogenesis and hypertrophy of
      astrocytes contribute to an early stage of epileptogenesis when degenerative
      changes of the sort that might induce gliosis were not prominent in the tissue
      under study.

PMID- 8461985
TI  - Relationship between resting cytosolic Ca2+ and responses induced by N-methyl-D
      aspartate in hippocampal neurons.
AB  - Cytosolic calcium concentrations ([Ca2+]i) in cultured hippocampal neurons from
      rat embryos were measured using fura-2. Neurons with higher resting [Ca2+]i
      showed greater [Ca2+]i responses to N-methyl-D-aspartate (NMDA) and K+
      depolarization. There was a strong relationship between resting [Ca2+]i and the
      maximal changes in [Ca2+]i (delta[Ca2+]i), which fit the our proposed equation to
      describe this relationship.

PMID- 8461986
TI  - Urinary 6-sulphatoxymelatonin excretory rhythms in laboratory rats: effects of
      photoperiod and light.
AB  - The excretion rhythm of the melatonin metabolite, 6-sulphatoxymelatonin, was
      determined in rats maintained on contrasting 14 h L:10 h D and 10 h L:14 h D
      photoperiods. The novel use of a high protein liquid diet together with an
      automatic urine collection system facilitated the monitoring of the onset, offset
      and total production of metabolite before, during and after a 57.5% reduction in
      the dark period (5.75 h and 8 h delay in lights off). In 14 L:10 D, melatonin
      metabolite excretion increased 2.7 +/- 0.2 h after lights off, whereas in 10 L:14
      D, the onset occurred 5.1 +/- 0.2 h after lights off. Duration of melatonin
      metabolite excretion was not different between the two photoperiods. Reduction of
      the dark period by 57.5% delayed the appearance of melatonin metabolite excretion
      until 2.15 +/- 0.4h and 2.9 +/- 0.4h after darkness in both long and short
      photoperiods. Upon restoration of the original photoperiod on the third day, the
      onset of metabolite excretion was significantly delayed by 1.4 +/- 0.4 h (P <
      0.05) in long day animals and 2.2 +/- 0.2 h (P < 0.05) in short day-length
      compared to the first day. This study highlights the utility of urinary 6
      sulphatoxymelatonin determinations in rats and provides new information on the
      acute effects of extended evening light on pineal melatonin secretion.

PMID- 8461987
TI  - Rimmed vacuoles of inclusion body myositis and oculopharyngeal muscular dystrophy
      contain amyloid precursor protein and lysosomal markers.
AB  - Rimmed vacuoles are small areas of focal destruction of muscle fibres, found in
      inclusion body myositis, oculopharyngeal muscular dystrophy and other muscle
      disorders. They are known to contain amyloid proteins, probably of beta-amyloid
      type. We examined rimmed vacuoles immunohistochemically in 12 patients with
      inclusion body myositis and two patients with oculopharyngeal muscular dystrophy
      with antibodies to beta-amyloid precursor protein and cathepsin B and D. We found
      evidence for the presence of all these markers in rimmed vacuoles. These results
      confirm the presence of beta-amyloid in rimmed vacuoles, and provide additional
      support for the hypotheses that rimmed vacuoles are of lysosomal origin and that
      lysosomes are probably important in the metabolism of amyloid precursor protein.

PMID- 8461988
TI  - Involvement of amyloid precursor protein in memory formation in the rat: an
      indirect antibody approach.
AB  - The potential role of different isoforms of amyloid precursor proteins (APPs) in
      memory and learning processes was investigated in rats using antibodies
      differentiating between APP isoforms containing or lacking the Kunitz protease
      inhibitor (KPI) domain. Rats received intracerebroventricular injection of
      control immunoglobulins (IgGs), anti-KPI-APP (= anti-P3) or anti-N-terminus-APP
      (= anti-P4). No immediate effects on learning of a passive avoidance task were
      observed; however, performance evaluated 1 day later was somewhat impaired by the
      anti-P3 antibody (reacting with APPKPI) and even more markedly impaired by the
      anti-P4 antibody (reacting with both APP695 and APPKPI) relative to control
      antibody. The antibodies did not affect performance of an active avoidance task
      acquired prior to the experimental treatment or active avoidance learning 8 days
      post-treatment. These results suggest that blockade of APP by an antibody
      injected intracerebroventricularly impairs the consolidation and/or retrieval of
      memory in rats.

PMID- 8461989
TI  - The effect of dietary protein on thyrotropin-releasing hormone and thyrotropin
      gene expression.
AB  - In the rat, 48 h of food deprivation significantly reduces hypothalamic
      paraventricular nucleus (PVN) thyrotropin-releasing hormone (TRH) gene
      expression, anterior pituitary thyrotropin (TSH) gene expression and circulating
      triiodothyronine (T3). Using in situ hybridization histochemistry, we have now
      assessed the effect of selective nutritional deprivation, by comparing protein
      free and protein and fat-free diets with a normal diet matched for total energy
      content. As previously demonstrated, fasting markedly reduced PVN TRH
      transcripts, pituitary TSB beta transcripts, circulating T3 and body weight.
      Compared to rats fed a control diet, rats fed a protein-free or a protein and fat
      free diet of similar energy content showed a highly significant decrease in PVN
      TRH transcripts, pituitary TSB beta transcripts and circulating T3 levels. The
      exclusion of fat from the protein-free diet did not produce any further decline
      in the parameters measured. This indicates that variations in the protein
      composition alone of the diet are sufficient to reduce hypothalamic TRH mRNA,
      pituitary TSB beta mRNA and plasma T3, and are the predominant factors in the TRH
      response to starvation.

PMID- 8461990
TI  - Involvement of superoxide dismutase and glutathione peroxidase in attenuation of
      radiation-induced hyperthermia by interleukin-1 alpha in rats.
AB  - Pretreatment with recombinant human interleukin-1 alpha (rhIL-1 alpha) 20 h
      before irradiation attenuates radiation-induced hyperthermia. Experiments were
      conducted to determine the role of antioxidant enzymes such as superoxide
      dismutase (SOD) and glutathione peroxidase (GSHPx) in rhIL-1 alpha-induced
      attenuation of radiation-induced hyperthermia. Radiation exposure increased SOD
      and decreased GSHPx levels in the hypothalamus, while treatment with rhIL-1 alpha
      increased GSHPx levels and had no effect on SOD levels. However, rhIL-1 alpha and
      irradiation together increased hypothalamic SOD level but prevented the fall in
      GSHPx level. Our results suggest that attenuation of radiation-induced
      hyperthermia by rhIL-1 alpha may involve stimulation of SOD and GSHPx because
      rhIL-1 alpha treatment and irradiation together increased hypothalamic GSHPx and
      SOD levels, and intracerebroventricular administration of SOD and GSHPx
      attenuated the radiation-induced hyperthermia.

PMID- 8461991
TI  - Calcium currents in pyramidal neurons acutely dissociated from the rat frontal
      cortex: a study by the nystatin perforated patch technique.
AB  - We studied electrical and pharmacological properties of voltage-activated Ca2+
      currents (ICa) in freshly dissociated rat frontal cortical pyramidal neurons by
      using nystatin perforated patch and conventional patch-clamp techniques. With
      either nystatin perforated patch technique or conventional patch-clamp technique,
      low voltage-activated ICa (LVA ICa) and high voltage-activated ICa (HVA ICa) were
      recorded. However, in conventional whole-cell recording, HVA ICa ran down within
      5-20 min, whereas the current remained stable for 50 min at least in nystatin
      perforated patch recording. The HVA ICa recorded by nystatin perforated patch
      technique was further classified to L-type, N-type and a current component
      resistant to both nicardipine and omega-conotoxin by their current kinetics,
      voltage- and drug-sensitivities. Present results suggest that the perforated
      patch technique is a useful method for studying the properties of high voltage
      activated Ca2+ channels.

PMID- 8461992
TI  - Effects of estrogen upon dopamine release from the corpus striatum of young and
      aged female rats.
AB  - In vitro superfusion was used to examine the effects of estrogen administration
      upon striatal dopamine release in ovariectomized young and aged female Fischer
      344 rats in response to 10 microM amphetamine or 30 mM potassium stimulation.
      Estrogen treatment increased basal dopamine and decreased DOPAC release in young
      and aged females (10 micrograms estradiol benzoate given subcutaneously 24 and 48
      h prior to superfusion). Amphetamine-stimulated dopamine release was
      significantly decreased in aged estrogen-treated females, but did not differ in
      young females as a function of estrogen treatment. Conversely, young females
      treated with estrogen showed significantly decreased striatal dopamine release in
      response to potassium stimulation, while aged females showed no differences as a
      function of hormone treatment. Striatal dopamine content was significantly
      decreased in all estrogen-treated young and aged females. It appears that
      estrogen is altering dopamine uptake mechanisms in both age groups, since basal
      DOPAC release is decreased and dopamine is increased. This estrogen effect
      depletes the readily releasable dopamine storage pool to a greater extent in the
      aged female as evidenced by reduced amphetamine-stimulated dopamine release. By
      contrast, estrogen does not alter vesicular dopamine storage pools in aged
      females, which are mobilized by potassium. These results may have important
      implications regarding sex differences in expression and treatment of age-related
      movement disorders.

PMID- 8461993
TI  - Gene delivery to spinal motor neurons.
AB  - This study demonstrates the direct delivery of plasmid gene constructs into
      spinal motor neurons utilizing retrograde axoplasmic transport. The plasmid
      vectors contained the Lac Z gene under the control of both the Rous sarcoma virus
      (RSV) and Simian virus (SV)40 promoters. beta-Galactosidase expression was
      observed in alpha and gamma motor neurons by histochemical staining following
      direct injection into the sciatic nerve or gastrocnemius muscle. The presence of
      LacZ gene constructs was confirmed by the polymerase chain reaction (PCR). The
      ability to introduce gene constructs into motor neurons allows for the study of
      gene regulation and permits the development of gene therapy strategies for motor
      neuron diseases including the spinal muscular atrophies (SMA) and amyotrophic
      lateral sclerosis (ALS).

PMID- 8461994
TI  - Neuroprotective activity of dimer of 16,16'-dimethyl-15-dehydroprostaglandin B1
      (di-Calciphor) in cerebral ischemia.
AB  - Post-ischemic treatment of di-Calciphor (16,16'-dimethyl-15- dehydroprostaglandin
      B1) significantly improves animal survival and prevents ischemia-induced
      neurodegeneration of vulnerable forebrain regions assessed with histochemical and
      biochemical techniques in gerbils. Neuronal degeneration seen by Cresyl violet
      staining and silver impregnation in the CA1 sector of the hippocampus and the
      dorso-lateral sector of the striatum was significantly reduced in animals treated
      with di-Calciphor. In addition, the early onset of selective degradation of
      calpain I substrates spectrin and microtubule-associated protein (MAP2) in these
      same vulnerable regions was prevented. The lack of adverse side effects may
      facilitate the potential therapeutic use of this drug in preventing neuronal
      damage caused by stroke.

PMID- 8461995
TI  - Calcium-mediated metabolic stimulation of neuroendocrine structures by
      intraventricular endothelin-1 in conscious rats.
AB  - We examined the hypothesis that the vascular- and brain-derived peptide,
      endothelin-1 (ET), would affect cerebral neuroendocrine structures when
      administered via the peripheral circulation or via a lateral cerebral ventricle
      (i.c.v.). ET was infused intravenously (14 nmol/min) or injected i.c.v. (9 pmol)
      in conscious rats in which local cerebral glucose metabolism was assessed by the
      quantitative autoradiographic [14C]deoxyglucose technique. Whereas intravenously
      infused ET was previously demonstrated to selectively stimulate metabolic
      activity in the pituitary intermediate and anterior lobes of conscious rats, it
      was without effect in 20 individual structures or subnuclei involved in
      neuroendocrine functions, including several circumventricular organs.
      Intraventricular ET, however, caused hypermetabolic responses in 9 neuroendocrine
      structures, including the pineal gland, subfornical organ, median eminence, the
      hypothalamic paraventricular and supraoptic nuclei, and other hypothalamic and
      preoptic structures. The metabolic stimulation resulting from central ET was
      abolished or attenuated regionally by i.c.v. pretreatment with the calcium L
      channel inhibitor, nimodipine. The findings indicate that i.c.v. ET elicits a
      calcium-mediated hypermetabolic effect on several neuroendocrine structures in
      the forebrain involved in the regulation of fluid homeostasis, the cardiovascular
      system, and body temperature.

PMID- 8461997
TI  - Contribution of caudal ventrolateral medulla to the cardiovascular responses
      elicited by activation of bed nucleus of the stria terminalis.
AB  - The contribution of caudal ventrolateral medulla (cVLM) to the mean arterial
      pressure (MAP) and heart rate (HR) responses elicited by microinjections of L
      glutamate (GLU) into the cardiovascular responsive region of bed nucleus of the
      stria terminalis (BST) was investigated in the chloralose-anesthetized, paralysed
      and artificially ventilated rat. Unilateral injections of GLU into BST elicited
      decreases in MAP of -25 +/- 3 mmHg (n = 10) and HR of -13 +/- 3 bpm (n = 10).
      These cardiovascular responses were not altered after a 100 nl microinjection of
      0.9% NaCl into cVLM. However, the magnitudes of the decreases in MAP and HR were
      attenuated (-11 +/- 3 mmHg and HR, -4 +/- 1 bpm, respectively) 5 min after a 100
      nl microinjection of the reversible synaptic blocker cobalt chloride (CoCl2) into
      cVLM. Restimulation of BST 40 min after the 100 nl microinjection of CoCl2 in
      cVLM elicited cardiovascular responses that were not significantly different in
      magnitude from those evoked before the microinjection of CoCl2 (MAP, -23 +/- 4
      mmHg; HR, -12 +/- 5 bpm). In an additional series of experiments (n = 3),
      restimulation of BST 1 h after an ipsilateral electrolytic lesion in cVLM
      elicited decreases in MAP (-11 +/- 2 mmHg) and HR (-8 +/- 4 bpm) that were
      significantly smaller than those elicited prior to cVLM lesion. These data
      suggest that a component of the pathways originating in BST involved in mediating
      depressor responses and cardiac slowing relays in cVLM.

PMID- 8461996
TI  - Evaluation of role of upper cervical inspiratory neurons in respiration, emesis
      and cough.
AB  - Upper cervical (C1-3) inspiratory (UCI) propriospinal neurons project to spinal
      segments containing respiratory motoneurons, but their functional significance is
      unknown. Bilateral kainic acid injections into this cell column in 12 decerebrate
      cats (11 paralyzed and artificially ventilated) had no major effect on phrenic,
      intercostal, and abdominal nerve discharge or EMG activity during (fictive)
      respiration, vomiting and coughing. Thus, UCI neurons are unessential for
      activation of major respiratory muscles during these behaviors.

PMID- 8461998
TI  - Microdialysis analysis of norepinephrine levels in the paraventricular nucleus in
      association with food intake at dark onset.
AB  - It has been proposed that norepinephrine (NE) in the paraventricular nucleus
      (PVN) acts to stimulate carbohydrate feeding specifically at the start of the
      active (dark) cycle in rats. This study used microdialysis to examine the
      relationship between endogenous levels of NE in the PVN at dark onset and the
      amount of food consumed at this time. The results indicated that: (1) in satiated
      rats on a lab chow diet, NE levels in the PVN, as opposed to sites anterior or
      lateral to this nucleus, were significantly higher during large meals around dark
      onset then they were during small meals or during intervals that preceded the
      large meals, and (2) in food-deprived animals given a pure carbohydrate diet at
      dark onset, PVN levels of NE just before the initiation of the meal were
      significantly higher in animals that consumed a relatively large carbohydrate
      meal (> 2.0 g) during the first dark hour, and they were significantly correlated
      across animals with the size of their carbohydrate meal. These findings are
      consistent with other evidence linking endogenous PVN NE to food intake at the
      beginning of the natural feeding cycle.

PMID- 8461999
TI  - Antidromic activation of a peptidergic pathway in the limbic system of the male
      rat.
AB  - Stimulation of the medial amygdaloid nucleus (AME) produces a long-latency and
      long-lasting inhibition of pyramidal cells in both the dorsal and the ventral
      hippocampus. The inhibition is blocked by a specific antagonist to vasopressin,
      which is a candidate neurotransmitter in the system. Antidromic activation of the
      AME from the hippocampus occurs with a latency suggestive of the conduction
      velocity of small diameter unmyelinated fibers. Immunocytochemistry for
      vasopressin reveals small diameter, unmyelinated immunoreactive fibers in the
      vicinity of the stimulating electrode in the hippocampus, and immunoreactive cell
      bodies in the vicinity of the recording electrode in the AME.

PMID- 8462000
TI  - Synaptic connections of a periodontal primary afferent neuron within the
      subnucleus oralis of the cat.
AB  - The central axon of a primary afferent neuron that responded to light mechanical
      stimulation of the lower premolar teeth in a fast adapting fashion was intra
      axonally injected with horseradish peroxidase in the cat. The labeled terminals
      within the rostrodorsomedial (Vo.r) and dorsomedial (Vo.dm) parts of subnucleus
      oralis were examined electron microscopically. The labeled ending had pale
      axoplasm, contained clear spherical synaptic vesicles, and formed multiple
      synapses with dendrites and/or unlabeled axonal endings with pleomorphic vesicles
      (P-endings). In these synaptic contacts, the labeled primary ending was
      presynaptic to dendrites and postsynaptic to P-endings. Labeled endings
      simultaneously synapsing with both dendrites and P-endings were more frequent in
      Vo.dm (28%) than in Vo.r (8.3%).

PMID- 8462001
TI  - A new soluble brain-specific protein: identification and partial purification.
AB  - A new soluble 170-kDa protein (BP170) was found to be present exclusively in the
      brain of all the vertebrates that we studied by Western immunoblotting. It was
      not detected in peripheral rat tissues, including heart, kidney, liver, spleen,
      lung, muscle, adrenal, intestinal mucosa, sciatic nerve, or pituitary. In rat
      brain, its regional distribution was found to be heterogeneous, with its highest
      concentration in the cerebrum and its lowest in the hypothalamus, and 89% of it
      was in the post-microsomal fraction. BP170 constitutes at least 0.05% of the
      total brain cytosol proteins. Its level increases during development, being the
      lowest at 5 days and the highest at 90 days postnatal. BP170 is a single-chain
      polypeptide. It could be partially purified by precipitation with polyethylene
      glycol followed by column chromatography on Q Sepharose. Although BP170 was
      identified by an antiserum against puromycin-sensitive aminopeptidase (PSA), the
      two proteins differ in molecular weight, chromatographic properties, regional and
      subcellular distribution, developmental changes, immunoreactivity, and enzyme
      activity. Self-incubation or trypsin treatment of the partially purified BP170
      generates no PSA activity, indicating that BP170 is not a PSA precursor.
      Furthermore, BP170 is neither an inhibitor nor an activator of PSA. Our data
      suggest that BP170 is a novel brain-specific protein not previously described.

PMID- 8462002
TI  - Angiotensin II decreases the rate of production of cerebrospinal fluid.
AB  - The choroid plexus, which produces cerebrospinal fluid (CSF), contains receptors
      for angiotensin II and a very high concentration of angiotensin-converting
      enzyme. Circulating angiotensin II decreases blood flow to the choroid plexus.
      The first goal of this study was to examine the hypothesis that angiotensin II
      decreases the production of CSF. The second goal was to determine whether effects
      of angiotensin II on the production of CSF were receptor-mediated. Production of
      CSF was measured in chloralose-anesthetized rabbits using ventriculocisternal
      perfusion of artificial CSF containing blue dextran. Rabbits received either
      vehicle, angiotensin II, angiotensin II in the presence of an angiotensin II
      antagonist (saralasin), or saralasin intravenously. Increases in blood pressure,
      during administration of angiotensin II, were prevented by withdrawal of blood.
      Under control conditions, CSF production averaged 7.2 +/- 0.2 microliters/min
      (mean +/- S.E.). Angiotensin II (100 ng/kg/min i.v.) decreased CSF production by
      24 +/- 3% (P < 0.05, n = 8). In the presence of saralasin (1 microgram/kg/min
      i.v.), angiotensin II had no significant effect on CSF production (-4 +/- 6%, P >
      0.05, n = 7). Vehicle did not affect CSF production significantly (-2 +/- 6%, P >
      0.05, n = 7). Saralasin alone decreased production of CSF (-21 +/- 5%, P < 0.05,
      n = 7). To test the specificity of saralasin in blocking effects of angiotensin
      II receptor stimulation on CSF production, the carbonic anhydrase inhibitor
      acetazolamide was administered in the presence and absence of saralasin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8462003
TI  - Increased sensitivity of the hippocampus in ethanol-dependent rats to toxic
      effect of N-methyl-D-aspartic acid in vivo.
AB  - Chronic administration of ethanol in animals leads to CNS tolerance and physical
      dependence. Subsequent withdrawal of ethanol causes hyperexcitability which is
      thought to be related to increased sensitivity of N-methyl-D-aspartic acid (NMDA)
      receptors. The purpose of this study was to investigate sensitivity to NMDA in
      ethanol-treated animals by detecting damage after intrahippocampal injection of
      NMDA. Choline acetyltransferase (ChAT) and glutamate decarboxylase (GAD) specific
      activity was used as markers of cholinergic and gamma-aminobutyric acid neurons,
      respectively. Ethanol-dependent animals were more liable to die following
      intrahippocampal injection of either 120 or 240 nmol of NMDA. There was a
      significantly greater decrease in hippocampal GAD but not ChAT specific activity
      in the surviving animals. These data support the hypothesis that ethanol
      dependence is associated with increased sensitivity to NMDA which may be
      responsible for excitotoxic brain damage and death.

PMID- 8462005
TI  - Electrophysiological characterization of the projection from the nucleus raphe
      magnus to the lateral reticular nucleus: possible role of an excitatory amino
      acid in synaptic activation.
AB  - Numerous studies have shown that the lateral reticular nucleus (LRN), located in
      the caudal ventrolateral medulla, is an important nuclear region in the
      descending analgesia system. Activation of this brainstem region, either
      electrically or chemically, results in a reduction in nociceptive threshold. In
      addition, destruction of LRN abolishes the tonic descending inhibition present on
      dorsal horn neurons. Recent neuroanatomical tracing studies have shown that the
      nucleus raphe magnus (NRM), long implicated in nociception, sends direct
      projections to LRN; however, no information exists regarding the physiological
      characteristics of this pathway, nor its role in the endogenous descending
      analgesia system. The purpose of this study was to physiologically characterize
      the synaptic influence(s) of projections from the NRM to the LRN using
      electrophysiological recording, electrical and chemical stimulation, and
      iontophoretic techniques. Sixty-one percent of LRN neurons responded to single
      pulse stimulation of NRM; 52% of the responsive cells were excited and 48% were
      inhibited. The mean latency to onset of excitation was 4.9 +/- 1.2 ms. High
      frequency (100 Hz) electrical stimulation of NRM influenced 69/102 neurons; 52%
      (36/69) were excited, while 48% (33/69) were inhibited. Microinjection of
      glutamate into NRM significantly modified the discharge of 83% (93/112) of LRN
      cells tested; of these, 71% were inhibited, while 29% were excited. In 35 cells
      the effects of the excitatory amino acid antagonist kynurenic acid (KYN) were
      studied. In 75% of the cells excited by glutamate administration into the NRM
      (18/24), KYN partially antagonized this response. In 11 LRN cells inhibited by
      NRM chemical stimulation, KYN had no effect on this inhibition. Overall, 95% of
      the LRN cells responsive to NRM stimulation were also responsive to noxious
      peripheral stimulation, indicating that these cells are receiving ascending
      information from the spinal cord regarding somatosensory stimulation as well as
      receiving descending input from the NRM. It is concluded that LRN neurons are
      highly responsive to both noxious peripheral stimulation and NRM efferent
      activation, and that this region plays a significant role as an integrator for
      both ascending and descending information.

PMID- 8462004
TI  - Cerebral amino acid, norepinephrine and nitric oxide metabolism in CNS oxygen
      toxicity.
AB  - CNS oxygen (O2) toxicity is complex, and the etiology of its most severe
      manifestation, O2 convulsions, is yet to be determined. A role for depletion of
      the brain GABA pool has been proposed, although recent data have implicated
      production of reactive O2 species, e.g. H2O2, in this process. We hypothesized
      that the production of H2O2 and NH3 produced by monoamine oxidase (MAO) would
      lead to depletion of GABA and production of nitric oxide (NO.) respectively, and
      thereby enhance CNS O2 toxicity. In this study, rats treated with an MAO
      inhibitor (pargyline) or a nitric oxide synthase inhibitor (LNNA) were protected
      against O2-induced convulsions. Selected cerebral amino acids including arginine
      were measured in control and O2 treated rats (6 ATA, 20 min) with or without drug
      pretreatment. After O2 exposure, the cerebral pools of glutamate, aspartate, and
      GABA decreased significantly while glutamine content increased relative to
      control (P < 0.05). After treatment with either enzyme inhibitor, glutamine,
      glutamate and aspartate concentrations were maintained near control levels.
      Remarkably, GABA depletion by O2 was not prevented despite protection from
      seizures by both pargyline and LNNA. The NO. precursor, arginine, was increased
      significantly in the brain by toxic O2 exposure, but both pargyline and LNNA
      inhibited this effect. Simultaneous norepinephrine measurements indicated that
      its storage substantially decreased during hyperoxia (P < 0.05), but this effect
      too was blocked by either pargyline or LNNA. These data indicate that protection
      against O2 by these inhibitors is not related to preservation of the GABA pool.
      More importantly, O2 dependent norepinephrine metabolism and NO. synthesis appear
      to be interactive during CNS O2 toxicity.

PMID- 8462006
TI  - Distribution of fibroblast growth factor 5 mRNA in the rat brain: an in situ
      hybridization study.
AB  - Fibroblast growth factors (FGFs) are potent growth factors with roles in the
      brain ranging from development to adult plasticity. FGF-5 is a newly described
      member of the fibroblast growth factor family. In order to evaluate a possible
      role of FGF-5, we have examined the locus of synthesis of FGF-5 in the rat brain.
      We have used in situ hybridization of 35S-labelled RNA probe complementary to FGF
      5 mRNA. FGF-5 mRNA was present in neurons in select regions of the rat brain. FGF
      5 mRNA expression was particularly intense in the olfactory bulb within
      periglomerular elements and the mitral cell layer. The primary olfactory cortex
      also showed a robust expression of FGF-5 mRNA mostly within layer II. In the
      hippocampal formation, the greatest labelling of FGF-5 mRNA occurred in
      hippocampal pyramidal cells within subfields CA3 and secondarily within subfields
      CA1, CA2 and CA4. The dentate gyrus granule cells displayed a modest
      hybridization signal. The cerebral cortex (neocortex) showed a light labelling
      throughout its rostro-caudal extent mostly within external layers. The entorhinal
      cortex showed a higher FGF-5 mRNA expression as compared to the neocortex and
      signal appeared more intense in layer II. In general, FGF-5 mRNA was shown to be
      localized mostly in limbic structures, suggesting that FGF-5 may play a role in
      limbic system function or dysfunction.

PMID- 8462007
TI  - Long-term potentiation of perforant path synapses in hippocampal CA1 in vitro.
AB  - This paper reports a study of long-term potentiation (LTP) of perforant path
      synapses in CA1. Using rat hippocampal slices with CA3 and the dentate gyrus
      removed, stimulation of the perforant path evoked a population excitatory
      postsynaptic potential (pEPSP) that was negative-going in s. lacunosum-moleculare
      of CA1. High-frequency conditioning stimulation of the perforant pathway induced
      LTP of the perforant path pEPSP in slices disinhibited by the GABAA receptor
      antagonist bicuculline methiodide (20 microM). Conditioning of the perforant
      pathway in normal medium, however, failed to induce LTP. Potentiation of the
      perforant path pEPSP in the presence of bicuculline lasted at least 1 h, was
      specific to the tetanized pathway, and based on a threshold property, appeared
      associative in nature.

PMID- 8462008
TI  - Serotonergic influence from nucleus raphe obscurus on neurones in the
      periaqueductal grey matter in the rat.
AB  - In rats anaesthetised with urethane, iontophoretic application of 5
      hydroxytryptamine (5-HT, 5-70 nA) produced changes in ongoing activity of 41/44
      neurones in the periaqueductal grey matter (PAG). The majority (85%) of
      responsive cells were inhibited and 15% were excited. The inhibitions were
      mimicked in 5/7 cells by iontophoresis of the 5-HT1A agonist 8-hydroxy-2-(di-n
      propylamino) tetralin (8-OH-DPAT, 10-30 nA) whilst excitation was produced in 3/5
      cells by iontophoresis of the 5-HT2 agonist alpha-methyl-5-HT (10-30 nA).
      Selective activation of neuronal perikarya in nucleus raphe obscurus (NRO) by
      microinjection of 50-100 nl D,L-homocysteic acid (DLH) inhibited ongoing activity
      of 25/31 neurones tested in the PAG for periods of 30-580 s, mean 183.5 s. The
      duration of the inhibition was potentiated by between 36 and 300% during
      iontophoresis of the 5-HT re-uptake blocker paroxetine (1-25 nA, 6/6 cells). The
      results indicate that there is an extensive inhibitory serotonergic input to the
      PAG which originates, at least in part, from NRO.

PMID- 8462009
TI  - Dopamine release from canine striatum following global cerebral
      ischemia/reperfusion.
AB  - The elevation of extracellular dopamine (DA) levels in the striatum of
      experimental animals subjected to ischemic insult has been well documented. The
      contribution of excessive DA to neuronal damage can be inferred from the ability
      of DA antagonists, as well as selective destruction of dopaminergic tracts, to
      confer neuroprotection in models of ischemia. In the current study, we report an
      enhanced releasability of preloaded [3H]DA in response to either elevated
      potassium or N-methyl-D-aspartate (NMDA) from striatal slices of beagles that had
      experienced 10 min of ischemia induced by cardiac arrest. The elevation in
      sensitivity to potassium stimulation was transient, approaching control levels
      after 30 min of reperfusion. In contrast, release stimulated by NMDA was elevated
      immediately after cardiac arrest and remained elevated for as long as 24 h of
      reperfusion. Release stimulated by NMDA was enhanced by glycine (Gly) and
      inhibited by MK801, consistent with mediation through the NMDA receptor/channel
      complex. The increased sensitivity of DA release, coupled with the high levels of
      excitatory amino acids (EAAs), including glutamate (Glu), aspartate (Asp) and Gly
      in ischemic brain, probably contribute to the extensive neuronal cell damage.

PMID- 8462010
TI  - Conventional versus high-dose epidoxorubicin as single agent in advanced breast
      cancer.
AB  - Between March 1986 and December 1987, two groups of consecutive patients with
      advanced breast cancer underwent epidoxorubicin (Epidx) monochemotherapy. Twenty
      three patients (group A) received Epidx at a dose of 60 mg/m2 and 27 (group B) at
      a dose of 120 mg/m2 (i.v. every 3 weeks). No patient had undergone anthracycline
      treatment before entering the study. Age ranged from 39 to 70 years (mean 52) in
      group A and from 35 to 69 (mean 50 in group B). The main sites of involvement
      were liver (5 patients in group A and 10 in group B), lung (4 and 5 patients,
      respectively), bone (7 and 8 patients, respectively), and soft tissue (6 and 5
      patients, respectively). The number of courses of therapy ranged from 4 to 10
      (mean 7.4) in group A and from 3 to 10 (mean 6.6) in group B. Tumor response and
      toxic effects were graded according to World Health Organization criteria. CR +
      PR were 35% in group A and 67% in group B (chi square = 3.862, p < 0.05). Results
      were analyzed at 130 weeks from the beginning of the therapy. At this time,
      survival was 9% in group A and 15% in group B, with a median survival time of 61
      weeks (range 18-130) and 77 weeks (range 24-130), respectively. No patient in
      group A showed cardiac toxicity higher than grade 2 during or after the
      treatment, whereas in group B, 2 patients developed congestive heart failure
      after a cumulative Epidx dose of 1080 and 1200 mg/m2. Treatment delays, to allow
      recovery of white blood cells, were infrequent and occurred only in patients
      previously subjected to chemotherapy. No patient required hospitalization for
      sepsis, and alopecia was reversible in all patients. Our data demonstrate that
      there is a relationship between Epidx dose and response rate in advanced breast
      cancer.

PMID- 8462011
TI  - Colonic epithelial proliferation indices before and after colon cancer removal.
AB  - Rectal mucosal (epithelial) proliferation labeling indices (LI) have been widely
      used as a risk marker for colorectal cancer and as an intermediate end-point in
      chemoprevention studies. The purpose of this study was to determine whether the
      presence of cancer preoperatively altered the LI and whether these LI could be
      used over the long term as a marker for colon cancer. We studied 25 patients (18
      with colorectal cancer and 7 with benign colonic diseases) who were admitted for
      colonic resection. Biopsies for thymidine LI were taken before, during, and 4 and
      7 months after the operation. The preoperative LI of cancer patients was higher,
      but not significantly, than that of noncancer patients (5.22 +/- 3.54 and 4.11 +/
      1.34%, respectively, p = 0.28). The intraoperative LI was significantly higher
      than the preoperative LI (8.08 +/- 4.00 and 4.90 +/- 3.07%, respectively; p =
      0.004). After 4 and 7 months, the LI was not significantly different from the
      preoperative LI (p = 0.60 and 0.89, respectively). Resection of a colonic segment
      did not affect the level of proliferation over time. Therefore, it is unlikely
      that LI can be used as a marker to predict local recurrence after curative
      resection of colorectal cancer.

PMID- 8462012
TI  - Effect of blood-brain barrier and blood-tumor barrier modification on central
      nervous system liposomal uptake.
AB  - In this study of 25 central nervous system (CNS) tumor-bearing rats, the CNS
      biodistribution of intravenously administered, indium-labeled liposomes was
      investigated. In 16 animals, the blood-brain barrier and blood-tumor barrier were
      modified using intracarotid administration of etoposide. In control animals,
      analysis by autoradiography and well-counting experiments demonstrated uptake of
      liposomes in the tumor-bearing hemisphere (% injected dose/g tissue = 0.135) with
      minimal uptake in the non-tumor-bearing hemisphere (% injected dose/g tissue =
      0.007), p < 0.01. Unilateral intracarotid etoposide administration enhanced
      liposome uptake in both hemispheres-0.215 and 0.023 (tumor-bearing and nontumor
      bearing), respectively. The presence of meningeal tumor involvement in nontumor
      implanted hemispheres increased liposomal uptake 10-fold. These findings may have
      clinical applicability in designing therapeutic protocols for the treatment of
      CNS tumors.

PMID- 8462013
TI  - Radioimmunodetection of colorectal cancer metastases with 131I-labeled monoclonal
      antibody B72.3: a pilot study to determine efficacy of detection and
      pharmacokinetics.
AB  - We performed radioimmunoscintigraphy (RIS) and/or pharmacokinetic (PCK) studies
      in 12 patients with primary or metastatic colorectal carcinoma, utilizing an
      intravenous administration of 1-4 mCi (1 mg) of 131I-B72.3 monoclonal antibody.
      Metastatic lesions were correctly identified in 4/8 patients by RIS. Two patients
      with small lesions (> 2 cm diameter) had a false-negative RIS scan. Two patients
      had a true-negative RIS scan. Optimal images were obtained at 1 week
      postinjection. PCK studies showed that the plasma clearance of 131I-B72.3 was
      biexponential with an alpha-phase half-life ranging from 0.5 to 7.1 hr and a beta
      phase half-life ranging from 47.5 to 85.3 hr. Systemic and renal clearance data
      indicated that 131I-B72.3 was cleared very slowly and almost entirely by
      deiodination. This pilot study was conducted to gain an understanding of the
      pharmacokinetics of this radiolabeled antibody. On the basis of these data, we
      are now studying second-generation antibodies as part of our long-range
      objectives to incorporate them in early detection and treatment protocols.

PMID- 8462014
TI  - Epirubicin and ifosfamide in advanced soft tissue sarcoma: a phase II study.
AB  - Thirty patients with previously untreated and measurable or evaluable advanced
      soft tissue sarcoma entered this phase II study. Median age was 53 years (range:
      24-71 years). Starting dose of Epirubicin was 100 mg/m2 IV bolus on day 1
      combined with Ifosfamide, 2.5 g/m2, as a 6-hr IV infusion on day 1 and day 2 with
      uroprotection with Uromitexan, 1.6 g/m2, on day 1 and day 2. This schedule was
      repeated every 3 weeks. In case of minimal myelosuppression, the dose of
      Epirubicin was increased by 10 mg/m2 up to 130 mg/m2. Ifosfamide dosage was not
      increased. Mean cumulative dose of Epirubicin received was 477 +/- 272 mg/m2
      (range: 200-1200 mg/m2). Of 27 evaluable patients (WHO criteria), 13 had a
      partial response (48%), 4 showed no change (15%), and 10 had progressive disease
      (37%). Median time to progression was 27 weeks. Of 27 patients evaluable for
      toxicity, hematological toxicity at day 21 was mild. Nonhematological toxicities
      consisted of nausea and vomiting in 82% of patients (WHO grade 3-4 = 19%),
      stomatitis in 44.5% (WHO grade 3 = 7.5%), and alopecia in 96% (WHO grade 2-3 =
      89%). Appearance of cardiac dysfunction without heart failure during the
      treatment led to discontinuation of this chemotherapy in 3 patients. The results
      of this study show that the combination of Epirubicin and Ifosfamide is effective
      in advanced soft tissue sarcoma with an acceptable toxicity. However, we cannot
      conclude from this trial whether combination Epirubicin and Ifosfamide is
      superior to Epirubicin alone.

PMID- 8462015
TI  - Strategies to improve continuity of care and decrease rehospitalization of cancer
      patients: a review.

PMID- 8462016
TI  - Pap smears, elderly women, and Medicare.

PMID- 8462017
TI  - Continuous intravenous narcotic infusions for cancer pain.

PMID- 8462019
TI  - Patient awareness under general anesthesia.

PMID- 8462018
TI  - Concepts of antibody-mediated cancer therapy.

PMID- 8462020
TI  - Functional significance of c-myb expression in normal and leukemic hematopoiesis.

PMID- 8462022
TI  - Clinical results with recombinant human interleukin-3.

PMID- 8462021
TI  - Modulation of cytotoxicity and differentiation-inducing potential of
      arabinofuranosylcytosine in myeloid leukemia cells by hematopoietic cytokines.
AB  - Hematopoietic growth factors may be useful in improving the clinical
      effectiveness of arabinofuranosylcytosine (ara-C). In vitro studies have
      indicated that interleukin 3(IL-3) and, to a lesser extent, granulocyte
      macrophage colony-stimulating factor (GM-CSF), but not G-CSF or M-CSF, may be
      capable of specifically augmenting the ability of ara-C to kill leukemic myeloid
      cells by pharmacological and cytokinetic mechanisms including increase of
      intracellular ara-CTP/dCTP pool ratios and enhanced ara-C DNA incorporation in
      leukemic blast cells, decrease of IC 90 of ara-C for leukemic colony-forming
      cells (CFC) as compared with normal CFC growth, and recruitment of quiescent
      leukemic cells into the cell cycle. In contrast, the combination of ara-C with M
      CSF or with the leukemia inhibitory factor (LIF) appears to be useful in
      overcoming the block in differentiation of leukemic blast, while the effects of
      GM-CSF and IL-3 on ara-C-induced differentiation appear limited. The combined
      treatment of human myeloid leukemia cells by ara-C and LIF is associated with
      down-regulation of c-myc gene expression, transcriptional activation of jun/fos
      gene expression, and features of functional differentiation (e.g., the capability
      to reduce nitroblue tetrazolium, to express lysozyme, or to display
      differentiation-related surface receptors including C3bi and the c-fms protein).
      On the basis of these in vitro studies first clinical trials are underway that
      are examining the efficacy of ara-C combinations with these molecules for the
      treatment of myeloid disorders.

PMID- 8462023
TI  - The use of recombinant human granulocyte macrophage colony-stimulating factor in
      autologous and allogeneic bone marrow transplantation.
AB  - In order to determine the effect of recombinant human granulocyte macrophage
      colony-stimulating factor (rhGM-CSF), it has been administered to patients
      undergoing autologous or allogeneic bone marrow transplant (BMT). Results in
      patients undergoing autologous or allogeneic BMT indicate that rhGM-CSF is
      minimally toxic and is associated with reduced morbidity. Trials also indicate
      that rhGM-CSF may be an acceptable therapy for patients with marrow graft failure
      since survival appears to improve substantially in patients who received rhGM-CSF
      compared with historical control patients.

PMID- 8462024
TI  - Combination treatment of acute myeloblastic leukemia with rhGM-CSF and standard
      induction chemotherapy.

PMID- 8462025
TI  - A model for others: a strategy for improving diagnosis and therapy of human
      malignancies using monoclonal antibodies targeting TAG-72 oncofetal antigen.

PMID- 8462026
TI  - Severe 5-fluorouracil toxicity in a patient with decreased dihydropyrimidine
      dehydrogenase activity.

PMID- 8462028
TI  - Body composition and bone mineral distribution during growth in females.
AB  - The total mass of lean tissue, fat and bone mineral was measured in a cross
      sectional study by dual-photon absorptiometry in 76 normal, ambulatory females
      aged 8 to 26 years. These measurements allowed quantification of average total
      body bone mineral density and assessment of the mass and the average density of
      bone mineral in different regions of the body, specifically the head and the
      legs. Both total-body and regional results are presented as logistic functions of
      age; the functions were derived by nonlinear regression analysis. Normal ranges,
      defined as twice the root mean square deviation about the fitted equation, are
      also expressed as functions of age. As well as providing normal reference values,
      these data suggest that muscle mass is an important determinant of total-body
      bone mineral mass and that peak bone mass is achieved at different ages in
      different regions of the skeleton.

PMID- 8462027
TI  - Long-term follow-up of neoadjuvant chemotherapy with 5-fluorouracil and cisplatin
      with surgical resection and possible postoperative radiotherapy and/or
      chemotherapy in squamous cell carcinoma of the esophagus.
AB  - Seventy patients with local squamous cell carcinoma of the esophagus were treated
      between 1981 and 1990 with preoperative chemotherapy, surgical resection, and
      possible postoperative radiation therapy and/or chemotherapy. Chemotherapy
      included two cycles of 5-fluorouracil (1000 mg/m2) by continuous intravenous
      infusion on days 1-4 and cisplatin (100 mg/m2) on day 4. Complete clinical
      response (CCR) was achieved in 28 (41%) patients, partial clinical response (PCR)
      in 17 (25%), and no response in 23 (34%). Fifty-five (81%) patients were
      resected, 6 (9%) were explored, and 7 (10%) were unable to have surgery.
      Microscopic analysis of 55 resected patients showed 50 (91%) with active tumor, 1
      (2%) with necrotic tumor, and 4 (7%) with a pathological complete response to
      chemotherapy. Twenty-six of the 55 resected patients (47%) had no gross evidence
      of disease at the time of surgical inspection. Median overall survival was 21.86
      months (range 2-107 months) for all patients and 26.71 months (range 2-107
      months) for resected patients. Actuarial 5-year survival rate was 31% for all
      patients and 39% for resected patients. Prolonged survival correlates with
      complete clinical response to chemotherapy, low pathological stage of disease,
      and successful resection of the lesion.

PMID- 8462029
TI  - Computed tomography during arterial portography in malignant carcinoid syndrome:
      a report of two patients.
AB  - Computed tomography during arterial portography (CTAP) and delayed high-dose
      iodine computed tomography (CT) have improved the preoperative localization of
      hepatic metastases from colon cancer. Nearly all patients presenting with
      malignant carcinoid syndrome have liver metastases, and removal of tumour bulk is
      considered the most effective means of management. To determine suitability for
      hepatic resection, CTAP and delayed high-dose iodine CT were used to evaluate the
      distribution of hepatic disease in two patients with malignant carcinoid
      syndrome. In both patients CTAP showed lesions not seen during recent dynamic
      incremented CT; the location of the lesions precluded resection. CTAP also
      demonstrated metastases less than 1 cm in diameter in one patient. Facial
      flushing (both patients) and hypotension (one) occurred during infusion of the
      contrast agent into the superior mesenteric artery. Because CTAP can demonstrate
      small hepatic metastases (less than 1 cm in diameter), it is recommended for
      patients with malignant carcinoid syndrome who are being considered for hepatic
      resection. The infusion of contrast media through the superior mesenteric artery
      may induce a carcinoid crisis, and prophylaxis with a somatostatin analogue is
      suggested.

PMID- 8462030
TI  - Leaking Baker's cyst detected by magnetic resonance imaging.
AB  - Popliteal or Baker's cysts, often found incidentally during examination of the
      knee, are common. The authors report the magnetic resonance imaging (MRI)
      manifestations of a leaking Baker's cyst that initially presented as
      thrombophlebitis in a patient who had undergone reconstruction of the anterior
      cruciate ligament 4 months before; no cyst was present at the time of the
      surgery. Marked inflammatory changes apparent in the surrounding muscle and
      subcutaneous tissues were best appreciated in T2-weighted and fat-suppressed
      inversion recovery images. Although the results of ultrasonography suggested the
      diagnosis, they were not conclusive; MRI was a useful noninvasive adjunct in
      making the definitive diagnosis.

PMID- 8462031
TI  - Anterolateral dislocation of the lumbosacral junction.
AB  - An unusual case of anterolateral fracture-dislocation of the lumbosacral junction
      is reported, and seven additional cases from the literature are discussed. The
      mechanism of injury is forced hyperflexion and shear. The prevalence of
      neurologic involvement is high, as is the number of fractures of the adjacent
      spinal elements and the occurrence of disk fragments in the spinal canal. The
      value of plain radiography and computed tomography in diagnosis and planning
      treatment is illustrated.

PMID- 8462032
TI  - Venous thrombosis of the middle lobe after upper lobectomy.
AB  - The author reports a case of venous thrombosis of the middle lobe occurring after
      upper lobectomy. Rapid lobar opacification without loss of volume is
      characteristic of this uncommon postoperative complication. Correct
      interpretation of the postoperative radiographs and early reoperation are
      essential.

PMID- 8462033
TI  - Atypical sperm granuloma of the epididymis mimicking a testicular mass.
AB  - Ultrasonography (US) plays a crucial role in the evaluation of scrotal masses and
      is highly accurate in distinguishing extratesticular from intratesticular
      lesions. Occasionally, however, it may be difficult to distinguish an
      extratesticular process adherent to the testis from an intratesticular mass on
      the basis of US findings. The authors present one such unusual case, in which an
      epididymal sperm granuloma mimicked a testicular mass.

PMID- 8462034
TI  - Residents' Corner. Answer to case of the month #18. Cervical spinal meningioma.

PMID- 8462035
TI  - The Canadian radiologist and informed consent.

PMID- 8462036
TI  - The trachea: normal anatomic features, imaging and causes of displacement.
AB  - Radiologists have long regarded the trachea as one of their "blind spots," even
      though this structure can be visualized as well as, if not better than, any other
      intrathoracic component because of the excellent intrinsic contrast provided by
      air within the trachea and by the tracheal interfaces with the mediastinum and
      the lung. Despite this ease of visualization, radiologists may overlook tracheal
      abnormalities in their diligence in examining the pulmonary parenchyma and the
      heart. The trachea can be imaged by a variety of techniques, including plain
      radiography, computed tomography (CT) and magnetic resonance imaging. Important
      tracheal interfaces include the right and left paratracheal stripes and the
      tracheoesophageal stripe. The right posterolateral tracheal band is best seen
      with CT. The trachea is generally a midline structure displaced slightly to the
      right by the aortic arch. Various conditions, including mediastinal masses and
      vascular anomalies, may bow, displace or indent the trachea. Such appearances are
      most commonly seen in patients with thyroid masses or a right-sided aortic arch.
      Enlarged nodes do not usually narrow the trachea unless they are much harder than
      the cartilaginous rings, as occurs in nodular sclerosing Hodgkin's disease, or
      the rings are soft, as is the case in children.

PMID- 8462037
TI  - Consent: radiologists' dilemma about contrast media.
AB  - In February 1990 the Conseil d'evaluation des technologies de la sante du Quebec
      released a report advocating the use of high-osmolar contrast media for "low
      risk" patients. The authors of the report justified not mentioning to these
      patients, in the course of obtaining informed consent for examinations requiring
      intravascular contrast media, that there are two classes of contrast agent.
      Furthermore, they advocated concealing this policy from the public. In contrast,
      the authors of this article suggest that informed consent is the product of a
      dialogue between the consenting person (the patient) and the one requesting
      consent (the radiologist). Such a dialogue can exist only if the doctor gives the
      patient sufficient information so that the two are at the same level of
      understanding; the patient can then make an informed decision. These discussions
      are held in the name of equity. Three criteria that can be used to test for
      ethical equity--impartiality, reciprocity and "examplarity"--are discussed. The
      authors of this paper argue that a policy limiting access to low-osmolar contrast
      media is justifiable. However, concealing from the patient and the public the
      existence of a choice of contrast media is considered ethically indefensible.

PMID- 8462038
TI  - Nonrenal cystic masses in neonates and children.
AB  - With the increasing use of ultrasonography (US) in children, abdominal cystic
      masses, many of them nonrenal, are being detected more frequently both before and
      after birth. Between 1986 and 1991, 20 predominantly cystic abdominal or pelvic
      masses of nonrenal origin were detected by US in patients less than 10 years of
      age. Ten of the 20 patients were neonates; in 5 of these the masses were detected
      antenatally. Pathological correlation was obtained for 16 of the patients. Six of
      the cysts were ovarian; two represented cystic teratoma, two exhibited torsion
      and hemorrhage, one was a giant simple cyst and one was a simple cyst with
      herniation. Six of the lesions were duplication cysts; two were found in the
      antral region, of which one was ulcerated and had perforated. In the remaining
      group of eight cysts, three were found in newborns; one represented colonic
      atresia and another was a choledochal cyst. Several of these nonrenal cystic
      masses were detected incidentally or in patients with nonspecific abdominal pain.
      US correctly predicted the location of the cyst and the diagnosis in most
      patients. In many of the patients the masses were complicated by other problems
      that required diagnosis and treatment.

PMID- 8462040
TI  - About that fee increase...

PMID- 8462039
TI  - Intravenous administration of gadolinium in the evaluation of rheumatoid
      arthritis of the shoulder.
AB  - The authors sought to determine the utility of intravenously administered
      gadolinium chelates in magnetic resonance imaging (MRI) of patients with
      rheumatoid arthritis of the shoulder. One shoulder was examined for each of 12
      patients--6 men and 6 women, ranging in age from 48 to 71 (average 63) years-
      with well-established disease. The patients had had the disease for 1 to 25
      (average 13) years. Static MRI was performed before and after infusion of
      gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) (0.1 mmol/kg body
      weight); T1-weighted or proton-density images (repetition time [TR] 600 to 1000
      ms, echo time [TE] 15 to 30 ms) were obtained. Images obtained after enhancement
      were particularly useful in the differentiation of pannus from fluid and also
      allowed improved delineation of tears of the supraspinatus tendon. In addition,
      contrast-enhanced dynamic gradient-echo spoiled GRASS sequences (TR 50 ms, TE 11
      ms, flip angle 70 degrees) were obtained for all patients; for these sequences
      the same slice was imaged repeatedly at 20-second intervals. The rate of increase
      of signal intensity in abnormal synovium varied from 0.64 to 5.83 (average 2.30,
      standard deviation [SD] 1.67) units/second; the enhancement factor ranged from
      1.55 to 4.64 (average 2.63, SD 0.98). The authors conclude that for imaging the
      shoulder enhancement with Gd-DTPA allows improved distinction between synovial
      thickening and joint effusion and may improve assessment of the rotator cuff. The
      wide range in the rate of signal increase and total enhancement during dynamic
      imaging probably reflected heterogeneity in the study population.

PMID- 8462041
TI  - Toronto clinic's new approach.

PMID- 8462042
TI  - Toronto clinic's new approach.

PMID- 8462043
TI  - Toronto clinic's new approach.

PMID- 8462044
TI  - Toronto clinic's new approach.

PMID- 8462045
TI  - Physicians and abortion.

PMID- 8462046
TI  - Physicians and abortion.

PMID- 8462047
TI  - Nasogastric tube placement.

PMID- 8462048
TI  - Four decades of glucocorticosteroid immunosuppression.

PMID- 8462049
TI  - Coordination of guidelines development.

PMID- 8462050
TI  - Canadian physicians and euthanasia: 1. An approach to the issues.

PMID- 8462051
TI  - Do physicians locate as spatial competition models predict? Evidence from
      Alberta.
AB  - This article analyses how physicians choose locations of practice in response to
      spatial competition forces and considers the implications of such choices for
      public policy to alleviate shortages of practitioners in rural areas. The
      predicted geographic distribution of physicians, as determined through spatial
      competition modelling, was compared with the actual distribution of physicians in
      1990 among Alberta's 19 census divisions. Physicians were found to respond to
      spatial competition forces in choosing where to practise, with the qualification
      that 1 urban patient had a demand weight equal to 2.32 rural patients. A policy
      to attract more physicians to rural areas by means of income subsidies is
      technically feasible but expensive. The high cost means that alternative policies
      such as a bigger and more effective ambulance network to transport patients to
      medical centres should become the focus of public policies to improve health care
      in rural areas.

PMID- 8462052
TI  - Learning the secrets of human chromosomes: Canada's role in an international
      project.

PMID- 8462053
TI  - Cesarean section: analysis of the experience before and after the National
      Consensus Conference on Aspects of Cesarean Birth.
AB  - OBJECTIVE: To examine the effect of recommendations to reduce the cesarean
      section rate issued by the National Consensus Conference on Aspects of Cesarean
      Birth in 1986 on obstetric practices and to identify current patient factors that
      predict cesarean section. DESIGN: Descriptive retrospective cross-sectional
      study. SETTING: A tertiary care perinatal referral centre and a general teaching
      hospital with a level 2 nursery in Hamilton, Ont. PATIENTS: All patients who gave
      birth at the two hospitals in 1982 (4121 women) and 1990 (4431). MAIN OUTCOME
      MEASURES: Cesarean section rates and indications and predictors of cesarean
      section. RESULTS: Although a trial of vaginal delivery after cesarean section was
      offered 93% more often in 1990 than in 1982 (p = 0.0002), the rate of vaginal
      delivery increased only 2.6%, for a reduction of 8.7% in the total cesarean
      section rate and of 15% in the repeat cesarean section rate. The incidence rate
      and treatment of dystocia did not change. The rate of cesarean section for breech
      presentation remained unchanged, and fetal distress was rarely confirmed with pH
      measurement in scalp blood before cesarean section. The most important predictors
      of cesarean section in 1990 were previous cesarean section and labour induction.
      For the nulliparous women and the multiparous women with no previous cesarean
      section labour induction was the most important predictor. CONCLUSIONS: The rate
      at which patients with previous cesarean section are offered a trial of vaginal
      delivery has increased significantly since 1982; however, the total and repeat
      cesarean section rates have not decreased proportionally. Induction of labour is
      currently the most important correctable predictor of cesarean section. The
      active management of dystocia, efforts to increase the rate of vaginal breech
      delivery and appropriate methods to diagnose fetal distress need to be improved;
      such improvements should reduce the cesarean section rate further.

PMID- 8462054
TI  - Contamination of human ovarian follicular fluid and serum by chlorinated organic
      compounds in three Canadian cities.
AB  - OBJECTIVES: To determine the extent of contamination of ovarian follicular fluid
      and serum samples in women undergoing in-vitro fertilization and to study the
      effect of the contaminants on reproductive outcome. DESIGN: Inception cohort
      study. PATIENTS: Seventy-four women undergoing in-vitro fertilization at three
      regional clinics in Halifax, Hamilton, Ont., and Vancouver. MAIN OUTCOME
      MEASURES: Follicular fluid and serum levels of contaminants, cleavage rates and
      time to cleavage of first egg. RESULTS: Five chlorinated organic chemicals were
      frequently found in the two types of samples: alpha-chlordane (ALCH),
      dichlorochlorophenylethylene (DDE), heptachloroepoxide-oxychlordane (OXCH),
      hexachlorobenzene (HCB) and polychlorinated biphenyl (PCB). The levels were
      generally low. Regional differences between the three clinics were present.
      Samples from the Halifax clinic had the lowest frequency and level of
      contamination. The source of drinking water (well, bottled or municipal) was an
      important confounder. The concentrations of the five contaminants did not affect
      the cleavage rate or the time to cleavage of the first egg. CONCLUSION: Trace
      amounts of toxic and persistent chlorinated organic chemicals found in the
      follicular fluid of Canadian women undergoing in-vitro fertilization did not seem
      to have any adverse biologic effect on the rate of fertilization and the time to
      cleavage. Reasons for regional differences in the concentrations of contaminants
      require further study.

PMID- 8462055
TI  - Advance directives: the views of health care professionals.
AB  - OBJECTIVES: This study examined the views and experiences of 20 physicians and 20
      nurses at a major Canadian teaching hospital regarding the use of advance
      directives in clinical care. DESIGN: The participants were purposively drawn from
      four clinical specialties: family and community medicine, oncology, intensive
      care and geriatrics. Detailed interviews were conducted in person. Content
      analysis was used to code the data, which were further analysed with both
      quantitative and qualitative techniques. MAIN RESULTS: Thirty-nine of the 40
      participants favoured the use of advance directives in clinical care; physicians
      had somewhat less positive attitudes than nurses toward such directives. Advance
      directives were thought by participants to be helpful in resolving disagreements
      between patients and their families about treatment options; in making patients
      more comfortable, both physically and psychologically, during the process of
      dying; and in opening up communication and trust among patients, their families
      and health care professionals. Concerns about the use of advance directives
      focused on the lack of clarity in some patients' instructions, the absence of
      legal status for directives, the possible interference with a practitioner's
      clinical judgement, the adequacy and appropriateness of patients' information
      about their circumstances, and the type of intervention (passive or active)
      requested by patients. CONCLUSIONS: New regulations and legislation are making
      the use of advance directives more widespread. Health care professionals should
      participate in the development and implementation of these directives. Continuing
      professional education is essential in this regard.

PMID- 8462056
TI  - The insulin resistance-dyslipidemia syndrome: the most prevalent cause of
      coronary artery disease?

PMID- 8462057
TI  - Ottawa announces hike in funding for AIDS research, education.

PMID- 8462058
TI  - Researchers, animal rights activists fight public relations war at Western.

PMID- 8462059
TI  - Society must lead in determining Canadian position on euthanasia, doctors say.

PMID- 8462060
TI  - In the US, AIDS has become a "marginal" disease that affects thousands.

PMID- 8462061
TI  - Calgary hospital's cooperative care program: "the care went from good to
      excellent".

PMID- 8462062
TI  - Testing program an attempt to help managers cope with growing stress in civil
      service.

PMID- 8462063
TI  - Seek funding from provinces or private sector, not Ottawa, researchers told.

PMID- 8462064
TI  - London's Gordon Museum provides insight into some remarkable medical history.

PMID- 8462065
TI  - Comparative morphology of sulfur mustard effects in the hairless guinea pig and a
      human skin equivalent.
AB  - A commercially available human skin equivalent (HSE) was used as an in vitro
      organotypic skin model to study temporal morphological effects of sulfur mustard
      gas (HD). Light and electron microscopic analyses of the HD-human skin equivalent
      model (HD-HSE) were compared to the HD-hairless guinea pig model (HD-HGP). HSE
      samples were exposed to 10 microliters HD vapor for 8 min and harvested at
      selected times up to 24 h. Skin sites of HGP were exposed to the same vapor dose
      or to 2.0 microliters liquid HD for 30 min and collected at 12 and 24 h. In both
      models, basal cells of the stratum germinativum were selectively affected. The HD
      HSE study revealed that basal cell changes began 3 to 6 h following exposure.
      These early cellular changes included an acantholysis of some basal cells with
      widening of intercellular spaces, disruption of desmosomal attachments, nuclear
      pyknosis, perinuclear blebbing and repositioning of cytoplasmic tonofilaments to
      a perinuclear position. At 12 to 24 h, basal cell pathology progressed to diffuse
      swelling of endoplasmic reticula, cytoplasmic vacuolations and necrosis which now
      extended to supra basal cell layers. Comparing basement membrane zone effects, HD
      HGP consistently developed characteristic microblisters at the dermal-epidermal
      junction; however, HD-HSE with its absence of a morphologically distinguishable
      basement membrane did not. Instead, cellular fragments, granules and debris
      accumulated early in this area to thicken regions usually assigned to the lamina
      lucida and lamina densa of a true basement membrane leading to complete
      separation of dermis from epidermis at later time periods.

PMID- 8462066
TI  - Ultrastructural and morphometric changes in somatotropic cells following
      intraventricular administration of Met-enkephalin to rats.
AB  - An ultrastructural and morphometric study of Kurosumi et al. (1986) on type 1 GH
      cells in adult Sprague-Dawley rats, after the intraventricular administration of
      Met-enkephalin, with or without prior intraperitoneal administration of naloxone,
      was carried out and then compared to the same cellular type of untreated animals
      and of animals intraventricularly treated with distilled water, used as controls.
      The study demonstrated an increase of cellular (p < 0.05) and nuclear (p < 0.05)
      areas, an enlargement and dilation of the cisternae of the Golgi complex, with an
      increase in the Golgi area (p < 0.01) and the immature granules (p < 0.01); a
      greater development of the rough endoplasmic reticulum and an increase in the
      number of exocytosis (p < 0.01) and, only in male rats, an increase in the mature
      secretory granules (p < 0.01). The prior administration of naloxone prevented the
      appearance of these changes and also produced an increase (p < 0.01) of the
      organelles involved in the crinophagic phenomenon. These results suggest that the
      opioids play a modulating role, stimulating the synthesis and secretion of GH,
      which affects the ultrastructural features of the hypophyseal GH cells.

PMID- 8462067
TI  - Chronic lead exposure induces ultrastructural alterations in the monkey seminal
      vesicle.
AB  - Lead is a toxic and carcinogenic metal that has been extensively associated with
      male reproductive abnormalities. The purpose of this study was to establish the
      effects of lead on the primate seminal vesicle. Sixteen cynomolgus monkeys
      maintained in environmentally controlled conditions were orally administered
      gelatin capsules containing 1500 micrograms lead acetate/kg bw/day. Monkeys were
      randomly assigned to the following groups: control (n = 3) which received 95%
      glycerol and 5% distilled water (vehicle) over their lifetime, infancy (limited
      to the first 400 days of life; n = 4), post-infancy (dosed following 300 days of
      life to 9 years of age; n = 5) and lifetime exposure (9 years; n = 4). At
      necropsy, the seminal vesicles from each animal were removed, fixed in
      glutaraldehyde, and processed for ultrastructural analysis by conventional
      methods. The glands from animals in the control group consisted of acini lined by
      two cell types, viz., tall columnar secretory cells, and round basal cells.
      Secretory cells possessed microvilli, basally located nuclei surrounded by much
      rough endoplasmic reticulum, a few lipid droplets, and supra-nuclear regions
      dominated by pleomorphic membrane-limited secretory granules. All the treated
      groups exhibited an augmentation in the number of lipid droplets within the
      secretory cells. In both the infancy and post-infancy groups, a marked reduction
      in electron-dense cores of the secretory droplets was observed in severely
      affected regions of the glands. These findings support the evidence that lead is
      a potent reproductive toxicant, however, further research is needed to determine
      the consequences of this damage on reproductive performance.

PMID- 8462068
TI  - Studies on varicocele. II. The inhibin secretion.
AB  - In this paper a previous interpretation given by the authors concerning one of
      the ways varicocele can affect fertility is confirmed. Moreover, it is definitely
      demonstrated that the high temperature stimulates inhibin secretion (and probably
      the testosterone-estradiol conversion) in the Sertoli cells, while the
      somatomedin secretion in vitro seems to be unaffected. It means that the action
      of the temperature on the germinal cells seems to be mediated by the pathway:
      inhibin (plus estradiol)-->pituitary-->FSH. Inhibin in the Golgi complex of
      Sertoli and germinal cells has been detected by electron microscopical
      immunocytochemical techniques.

PMID- 8462069
TI  - The role of RCA-binding sites in the adhesion of trypanosoma cruzi to heart
      muscle cells, as revealed by electron spectroscopic imaging.
AB  - The involvement of host-cell surface membrane components during T. cruzi-heart
      muscle cell (HMC) interaction was investigated. We used the lectin RCA I (Ricinus
      communis), which binds to residues of D-galactose, conjugated with ferritin as a
      tool to reveal the role played by lectin-binding sites during adhesion of T.
      cruzi to HMC. With electron spectroscopic imaging (ESI) it was possible to
      observe a concentration of RCA I-ferritin particles on the surface membrane of
      HMC at the site of parasite attachment. This suggested that migration of
      galactosyl residues was occurring during the cellular recognition process,
      particularly since these particles were absent in the immediate vicinity of the
      attachment site, while being present in other regions of HMC membrane not related
      to the attachment sites. No region of the parasite's cell body was observed to
      have preferential status for the purposes of adhesion to HMC.

PMID- 8462070
TI  - Tracheal epithelium of bonnet monkey (Macaca radiaca) and its response to ambient
      levels of ozone. A cytochemical study.
AB  - The effect of 6 or 90 days exposure to 0.15 or 0.30 ppm of ozone on the
      morphology or carbohydrate cytochemistry of bonnet monkey tracheal epithelium was
      studied. Ozone treatment induced damages and necrotic phenomena of ciliated
      cells, as well as a significant increase in the population density of small
      mucous granule (SMG) cells compared to controls. In addition, the appearance of
      'intermediate' cells, a type of nonciliated cells which was not observed in
      controls, was noticed. Characterization of the secretory cell carbohydrates with
      the PA-TCH-SP, HID-TCH-SP and LID-TCH-SP sequences indicated the existence of
      periodate-reactive sulfated and carboxylated polysaccharides in both treated and
      control monkeys. The luminal surface of the affected tracheal cells, however,
      exhibited a glycocalyx more rich in mucosubstances than the control animals. The
      possible role of 'intermediate' and SMG cells in repairing the injured epithelial
      regions, as well as the significance of the ozone concentrations used in relation
      to the ozone range measured in photochemical smog are discussed.

PMID- 8462071
TI  - Immunocytochemical localization of surface and intracellular antigens recognized
      by human sera in microfilariae of Wuchereria bancrofti.
AB  - Sera from patients with various clinical pictures of lymphatic filariasis,
      including tropical pulmonary eosinophilia (TPE), were used for the localization
      of surface and intracellular antigens in microfilariae of Wuchereria bancrofti
      embedded in Lowicryl K4M. Very few or no antigenic sites were located on the
      outer face of the sheath. The most inner layer, as well as the space between the
      cuticle and the sheath, was intensely labeled. Sera from TPE patients intensely
      labeled the cuticle and the cytoplasm of muscle cells.

PMID- 8462072
TI  - Ultrastructural evidences of a distinct axial domain within native rat tail
      tendon collagen fibrils.
AB  - The structure of collagen fibrils of tail tendon in young and mature rats was
      investigated by transmission (TEM) electron microscopy after cytochemical methods
      associated with special procedures of dehydration and fixation. All the collagen
      fibrils show a central condensed material of 4 nm in diameter which remains
      preserved even when fibrils have been swollen and partly disorganized by the
      ethyl glycol dehydration. A cytochemical characterization using PTA and TCH
      treatments strongly suggests the glycoprotein nature of this central compact
      material and reveals the heterogeneous structure of each fibril. The first
      morphological evidence that the construction of the collagen fibrils must take
      place around a condensed material which serves as a scaffolding is obtained.
      These observations are in agreement with the now well established existence of
      heterotypic collagen fibrils in many extracellular matrices.

PMID- 8462073
TI  - Infiltration of hypertrophic esophageal smooth muscle by mast cells and
      basophils.
AB  - Partial obstruction leads to chronic distension and muscular hypertrophy of the
      opossum esophagus. The smooth muscle cells of the circular muscle layer enlarge,
      become pleomorphic and are surrounded by an amorphous ground substance in the
      extracellular space. Here we describe the histological and ultrastructural
      features of a peculiar cellular infiltrate in the hypertrophic smooth muscle. The
      infiltrate consisted uniquely of mast cells and basophils. In per unit area, the
      number of mast cells increased from 0.9 +/- 0.1 cells in controls to 3.7 +/- 0.2
      in hypertrophic smooth muscle; the corresponding numbers for basophils were 2.5
      +/- 0.2 and 7.2 +/- 0.3 cells. Cells were seen primarily in the septal spaces of
      the circular muscle layer and at the interface of the circular and longitudinal
      muscle layer. The cytoplasm of basophils is normally packed with round and oval
      granules. The granules stain metachromatically and with varying intensity on
      Wright-Giemsa stains. On transmission electronmicroscopy, granules display a
      membrane and a great diversity in the structure of their luminal contents. In
      hypertrophic muscle, most granules were discharging their contents into the
      cytoplasm or extracellular space. The membranes of adjacent empty granules then
      fused to form a chain of vacuoles. Similar changes occurred also in the mast
      cells which differed from the basophil by their lack of nuclear lobulation and by
      the greater homogeneity of their cytoplasmic granules. It is possible that these
      inflammatory cells are involved in the reconstruction of the smooth muscle and
      its connective tissue which occur during esophageal distension and hypertrophy.

PMID- 8462074
TI  - Successful excimer laser angioplasty following unsuccessful primary balloon
      angioplasty.
AB  - We report five patients where excimer laser coronary angioplasty facilitated
      successful balloon dilatation of heavily calcified lesions that could not be
      dilated by conventional angioplasty techniques alone. In each case, the lesion
      was crossed successfully with a guide wire. Conventional angioplasty failed
      because of inability to cross the lesion with a balloon (four lesions) or
      inability to dilate the lesion with balloon inflation (two lesions). These cases
      illustrate an indication for excimer laser coronary angioplasty as an adjunctive
      procedure in heavily calcified coronary stenoses.

PMID- 8462075
TI  - Is aggressive heparinization necessary for elective PTCA?
AB  - The optimal level of heparin anticoagulation for elective PTCA is unknown. To
      determine if PTCA complications are related to the level of anticoagulation,
      serial ACT values were prospectively measured in 189 patients undergoing 201
      elective PTCA procedures. The mean heparin dose before balloon inflation (pre
      inflation) was 10,100 units, and the mean dose per procedure was 13,200 units.
      The mean pre-inflation ACT was 295 sec, but was < 300 sec in more than 50% of
      patients. Acute complications were not related to any ACT parameter and the
      development of new intracoronary thrombus was not observed. In elective PTCA
      procedures, the routine monitoring of ACT values is unnecessary when standard
      heparin doses are used.

PMID- 8462076
TI  - Digital geometric measurements in comparison to cinefilm analysis of coronary
      artery dimensions.
AB  - Six months follow-up post-PTCA angiograms from 31 patients were acquired
      digitally and on cinefilm and used for a comparison of geometric coronary
      measurements at the site of the previous dilatation. On 70 images of 34 coronary
      segments quantitative analysis was performed both on-line, using the Automated
      Coronary Analysis package of the Philips Digital Cardiac Imaging System (DCI,
      pixel matrix 512 x 512) and off-line, using the Cardiovascular Angiography
      Analysis System (CAAS). With the CAAS a cine-video conversion is performed and a
      6.9 x 6.9 mm region of interest from the 18 x 24 mm cineframe is digitized into a
      512 x 512 pixel matrix. In both systems the vascular contours are assessed by
      means of operator-independent edge detection algorithms. The angiographic
      catheter was used for calibration. Best agreement between DCI and CAAS was found
      for obstruction diameter and minimal luminal diameter, respectively (r = 0.82; y
      = 0.12 + 0.97x; SEE = 0.29). The reconstructed reference diameter related to a
      computed reference contour yields lower correlation (r = 0.76; y = 0.27 + 0.91x;
      SEE = 0.37). Worst results were obtained from the relative measure of percent
      diameter stenosis as well as from the derived parameter of plaque area. The on
      line digital approach of geometric coronary assessments provides good agreement
      with cinefilm analysis when direct measurements of coronary dimensions are
      applied.

PMID- 8462077
TI  - Superior accuracy of anatomic positioning with echocardiographic- over
      fluoroscopic-guided endomyocardial biopsy.
AB  - To assess the superior anatomic positioning of echocardiographic-guided
      endomyocardial biopsy compared to traditional fluoroscopic-guided technique,
      these two modalities were compared in a blinded fashion during femoral sheath
      endomyocardial biopsy in 21 patients, 19 being evaluated after orthotopic cardiac
      transplantation. The simultaneous fluoroscopic and echocardiographic imaging
      indicated that traditional fluoroscopic positioning of the bioptome against the
      septum is inaccurate in over half of patients undergoing biopsy. This finding
      should be considered in cardiomyopathy patients or those at high risk for biopsy
      related complications.

PMID- 8462078
TI  - Quantitative evaluation of left ventricular shape in anterior aneurysm.
AB  - The purpose of the study was to analyze left ventricular (LV) shape in post
      infarction anterior aneurysm by utilizing quantitative analysis of wall
      curvature. Forty-one patients (39 men, 2 women; mean age 56 years) subjected to
      surgical intervention for LV aneurysm complicating an anterior myocardial infarct
      were retrospectively evaluated. In all patients the presence of resectable
      aneurysmal tissue had been confirmed by direct surgical examination. Patients
      with inferior myocardial infarction and patients who had undergone percutaneous
      transluminal coronary angioplasty (PTCA) or bypass surgery were excluded. Pre
      intervention ventriculograms (RAO projection) were analyzed. LV wall excluded.
      Pre-intervention ventriculograms (RAO projection) were analyzed. LV wall motion
      was studied by applying the centerline method. Regional curvature of end
      diastolic and end-systolic outlines was calculated at 90 equidistant points from
      aortic corner (point 1) to mitral plane (point 90). Patients with LV anterior
      aneurysm show a typical pattern of alterations in wall curvature, which is
      characterized by a shifting of the angiographic apex (the point with the greatest
      curvature) towards the mitral plane, and by a sharp shift of curvature values at
      the antero-basal and infero-apical regions, marking the borders of the sac. These
      hinge points closely correspond to the external limits of wall motion
      abnormalities. Significant correlations were found between degree of regional
      curvature alterations and severity of global LV dysfunction, as indicated by
      decrease of ejection fraction and increase of end-systolic volume. In conclusion,
      quantitative evaluation of LV shape by means of wall curvature analysis allows
      recognition of the characteristic morphologic changes of the aneurysm, i.e., wall
      expansion and deformation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462079
TI  - A prospective, randomized, and double-blind trial on the effect of fish oil on
      the incidence of restenosis following PTCA.
AB  - Restenosis after successful coronary angioplasty (PTCA) occurs in 25-35% of all
      procedures. To date, most pharmacologic strategies have failed to reduce the
      restenosis rate significantly. However, recent studies have suggested a potential
      benefit of dietary supplementation with omega-3 fatty acids (fish oil) on
      restenosis following PTCA. The benefit of omega-3 polyunsaturated fatty acids on
      the incidence of coronary artery restenosis following elective PTCA was assessed
      in 212 consecutive patients (41 female, 171 male). Following a successful
      angioplasty, 204 patients received a dietary supplementation with either nine
      capsules containing fish oil (3.15 g omega-3 fatty acids) or nine placebo
      capsules containing olive oil. Treatment was started immediately after PTCA and
      maintained over 4 mon. Compliance was assessed by analysis of lipid fatty acids
      prior to angioplasty and at 4 mon follow-up. The angiographically determined
      incidence of restenosis (stenosis diameter > 50%) was 31.2% per lesion in
      patients receiving fish oil and 33.7% in patients receiving olive oil. Gross
      progression of coronary artery disease in vessels not subjected to angioplasty
      was 17% and 16%, respectively. In conclusion, low dose fish oil supplementation
      begun on the day of a successful coronary angioplasty failed to demonstrate any
      effect on coronary artery restenosis.

PMID- 8462080
TI  - Intracoronary blood flow velocity and transstenotic pressure gradient using
      sensor-tip pressure and Doppler guidewires: a new technology for the assessment
      of stenosis severity in the catheterization laboratory.
AB  - In a patient undergoing percutaneous balloon angioplasty of a stenotic proximal
      right coronary artery the transstenotic pressure gradient was measured using a
      0.018" guidewire with a distal optical microsensor. Blood flow velocity was
      measured proximal to the stenosis using a 0.018" Doppler guidewire. Transstenotic
      pressure gradient and blood flow velocity were measured in baseline conditions
      and after intracoronary injection of 12.5 mg of papaverine. Coronary blood flow
      was calculated from the measured blood flow velocity and the corresponding cross
      sectional area. The measured pressure gradients were compared with the values
      derived from the stenosis geometry assessed with quantitative coronary
      angiography (automated edge detection measurements in two orthogonal views,
      assuming an elliptical cross-sectional area). The measured transstenotic pressure
      gradient was 15 mm Hg in baseline conditions and 42 mm Hg at the peak effect of
      the papaverine injection. A 50% flow velocity increase was observed at peak
      hyperemia (time-averaged maximal flow velocity = 30 cm/s before and 45 cm/s after
      papaverine). The transstenotic pressure gradient calculated from the measured
      stenosis geometry was 20 mm Hg and 42 mm Hg in baseline and hyperemic conditions,
      respectively. The combined use of a pressure and a Doppler guidewire provides a
      complete assessment of the transstenotic pressure/coronary flow velocity relation
      at rest and after pharmacologically induced hyperemia and allows the
      characterization of stenosis hemodynamics and functional severity.

PMID- 8462081
TI  - The use of transesophageal echocardiography to avoid left atrial thrombus during
      percutaneous mitral valvuloplasty.
AB  - During mitral balloon valvuloplasty, transesophageal echocardiography (TEE) has
      been employed for the accurate placement of the transseptal needle, guide wires,
      and balloon catheters and to provide an immediate evaluation of the results of
      the procedure. We describe a case demonstrating that TEE can be used to avoid a
      left atrial appendage thrombus during the placement of wires and catheters. With
      TEE guidance, we feel left atrial appendage thrombi are no longer an absolute
      contraindication to percutaneous mitral valvuloplasty.

PMID- 8462082
TI  - Epicardial and subselective transcoronary chemical ablation of incessant
      ventricular tachycardia.
AB  - Incessant ventricular tachycardia in patients with severely depressed ventricular
      function remains a major therapeutic challenge. Although alcohol ablation via the
      tachycardia related vessel has been shown to be an effective alternative, it
      might not be applicable in some cases due to anatomic limitations. In three
      patients with ischemic cardiomyopathy and incessant ventricular tachycardia no
      effective antiarrhythmic therapy could be found. Alcohol ablation was then
      attempted but the tachycardia related vessel could not be intubated. A
      subselective injection of alcohol into a more proximal segment of the coronary
      artery was then performed in two cases. In one patient as subselective injection
      was also not possible, the injection was performed epicardially after
      thoracotomy. Ablation was successful in all cases. In very selected cases of
      incessant ventricular tachycardia that have failed all other therapeutic
      interventions, alcohol ablation of the tachycardia can be performed using an
      epicardial or subselective transcoronary injection of alcohol.

PMID- 8462083
TI  - Characterization of a saphenous vein graft aneurysm by intravascular ultrasound
      and computerized three-dimensional reconstruction.
AB  - Aneurysmal dilatations in saphenous vein grafts are rare complications of
      coronary artery bypass surgery that mostly represent thin-wall pseudoaneurysms at
      anastomotic sites. We describe a case of an enlarging distal saphenous vein graft
      aneurysm in which intravascular ultrasound (IVUS) and computerized three
      dimensional reconstruction (3DR) of the IVUS images was performed to conclusively
      demonstrate true aneurysm morphology. Although both atherosclerotic and
      nonatherosclerotic mechanisms for vein graft aneurysm formation have been
      previously suggested, IVUS images and 3DR of the aneurysm in this case did not
      reveal any of the features typical for atherosclerotic lesions. Further, the IVUS
      images and 3DR suggest that progressive atherosclerosis is not the likely cause
      of aneurysm formation in this case. This application of IVUS and 3DR provides
      detailed information about saphenous vein graft aneurysm structure, clues to
      aneurysm formation, and suggests a natural history that may differ from that of
      pseudoaneurysms.

PMID- 8462084
TI  - Percutaneous retrieval of a deformed guidewire by a modified snaring technique.
AB  - An attempt to percutaneously remove a guidewire from the inferior vena cava was
      hampered by kinks developing in the wire during snaring. A modified technique was
      adopted that permitted its retrieval, obviating the need for a formal venotomy.

PMID- 8462085
TI  - Percutaneous embolization of an arteriovenous fistula of the internal mammary
      pedicle following sternal wire insertion.
AB  - A case of traumatic arteriovenous fistula and false aneurysm of the internal
      mammary artery was encountered following sternal wire insertion during cardiac
      surgery. The diagnosis was suspected by echo-doppler and confirmed by
      arteriography allowing percutaneous embolization using cyanoacrylate in the same
      setting.

PMID- 8462086
TI  - High flow coronary fistula closure by percutaneous coil packing.
AB  - Few cases of transcatheter coronary fistula closure have been reported. High flow
      coronary fistulae are usually treated by surgery. This case report presents a 5.4
      liters/min flow coronary fistula percutaneously closed by steel coils. This large
      flow needed the packing of 25 coils, 10-15 cm long, for its total occlusion.

PMID- 8462087
TI  - Transcatheter coil occlusion for treatment of left internal mammary-anterior
      descending artery steal phenomenon.
AB  - A 60-yr-old female with previous bypass surgery including LIMA-LAD graft
      presented with unstable angina due to steal phenomenon caused by a large pectoral
      branch of LIMA. Transcatheter coil occlusion of the pectoral branch was
      successfully performed. This procedure should be considered in similar cases.

PMID- 8462088
TI  - Retrieval of a lost coronary stent from the descending aorta using a PTCA balloon
      and biopsy forceps.
AB  - We report a case of unsuccessful stenting of a right coronary artery after acute
      dissection during percutaneous transluminal coronary angioplasty (PTCA). The
      stent was lost in the descending aorta and we used an original technique to
      remove it from the arterial bed by using both a very low profile balloon and a 6F
      bioptome.

PMID- 8462089
TI  - Rescue transcatheter embolectomy following complicated transluminal extraction
      atherectomy of a coronary vein graft.
AB  - Transluminal extraction catheter atherectomy of a saphenous vein graft to the
      right coronary artery was performed in a 72-year-old female and was complicated
      by distal embolization. A successful transcatheter aspiration of the embolic
      plaque was achieved. The usefulness of this technique as a coronary intervention
      is discussed.

PMID- 8462090
TI  - Kissing balloon technique in complex PTCA: single guiding catheter and dual wire
      rapid exchange system.
AB  - This report is a description, based on four cases, of a variation from previously
      described approaches for accomplishing the "kissing balloon" technique for
      complex PTCA. We describe a case in which a single guiding catheter is utilized
      in combination with two over-the-wire monorail type balloon catheters allowing
      use of standard length (175 cm) guidewires. Various combinations of balloon
      diameters are described. We believe this approach has significant advantages over
      other techniques, principally in its rapid and easy usage.

PMID- 8462091
TI  - Reference level for pressure measurements.

PMID- 8462092
TI  - Low profile catheter use.

PMID- 8462093
TI  - Motor neurons and neurofilaments in sickness and in health.

PMID- 8462094
TI  - High resolution cosmid and P1 maps spanning the 14 Mb genome of the fission yeast
      S. pombe.
AB  - Gridded on high density filters, a P1 genomic library of 17-fold coverage and a
      cosmid library of 8 genome equivalents, both made from S. pombe strain 972h-,
      were ordered by hybridizing genetic markers and individual clones from the two
      libraries. Yeast artificial chromosome (YAC) clones covering the entire genome
      were used to subdivide the libraries, and hybridization of short oligonucleotides
      and DNA pools made from randomly selected cosmids provided further mapping
      information. Restriction digests were generated as an independent confirmation of
      the clone order. The high resolution clone map was aligned to the genetic map and
      the physical Notl and YAC maps. The usefulness of the various mapping techniques
      and cloning procedures could be assessed upon the different data sets.

PMID- 8462095
TI  - A 13 kb resolution cosmid map of the 14 Mb fission yeast genome by nonrandom
      sequence-tagged site mapping.
AB  - We present the application of a nonrandom sequence-tagged site (STS) content
      detection method in mapping an entire genome, that of fission yeast. The novelty
      of our strategy is in the use of STS probes made from both ends of cosmid clones,
      selected on the basis of "sample without replacement" (only library clones that
      show no previous positive hybridization are selected and made into probes). We
      developed powerful techniques, based on consistency analysis, for error detection
      and contig assembly. In addition, we probed our library with genetically mapped
      markers and Notl or Sfil linking clones, thereby anchoring contigs onto
      chromosomes. Our map contains more than 1000 sites, including genes (most were
      previously unmapped), occurrences of known repetitive elements, and Notl-Sfil
      restriction sites.

PMID- 8462096
TI  - Interleukin-2 receptor gamma chain mutation results in X-linked severe combined
      immunodeficiency in humans.
AB  - The interleukin-2 (IL-2) receptor gamma chain (IL-2R gamma) is a component of
      high and intermediate affinity IL-2 receptors that is required to achieve full
      ligand binding affinity and internalization. We have localized the IL-2R gamma
      gene to human chromosome Xq13. Genetic linkage analysis indicates that the IL-2R
      gamma gene and the locus for X-linked severe combined immunodeficiency (XSCID)
      appear to be at the same position. Moreover, we demonstrate that each of three
      unrelated patients with XSCID has a different mutation in his IL-2R gamma gene
      resulting in a different premature stop codon and predicted C-terminal
      truncation. These data establish that XSCID is associated with mutations of the
      IL-2R gamma gene product. Since XSCID is characterized by absent or markedly
      reduced numbers of T cells, our findings imply that IL-2R gamma plays a vital
      role in thymic maturation of T cells. These results also have important
      implications for prenatal and postnatal diagnosis, carrier female detection, and
      gene therapy for XSCID.

PMID- 8462097
TI  - An SH3-SH2-SH3 protein is required for p21Ras1 activation and binds to sevenless
      and Sos proteins in vitro.
AB  - Activation of the sevenless protein-tyrosine kinase is required for the proper
      specification of R7 photoreceptors in the Drosophila eye. The activation of a Ras
      protein, p21Ras1, is a crucial early event in the signaling pathway, and
      constitutive activation of p21Ras1 is sufficient to induce all of the effects of
      sevenless action. Here we report that another gene, E(sev)2B, required for proper
      signaling by sevenless encodes a protein of the structure SH3-SH2-SH3. We further
      provide evidence that the E(sev)2B protein is required for activation of p21Ras1
      but not for any subsequent events, and that this protein can bind in vitro to
      sevenless and to Son of sevenless (Sos), a putative guanine nucleotide exchange
      factor for p21Ras1. These results suggest that the E(sev)2B protein may act to
      stimulate the ability of Sos to catalyze p21Ras1 activation by linking sevenless
      and Sos in a signaling complex. We have renamed the E(sev)2B locus downstream of
      receptor kinases (drk).

PMID- 8462098
TI  - A Drosophila SH2-SH3 adaptor protein implicated in coupling the sevenless
      tyrosine kinase to an activator of Ras guanine nucleotide exchange, Sos.
AB  - A Drosophila gene (drk) encodes a widely expressed protein with a single SH2
      domain and two flanking SH3 domains, which is homologous to the Sem-5 protein of
      C. elegans and mammalian GRB2. Genetic analysis suggests that drk function is
      essential for signaling by the sevenless receptor tyrosine kinase. Drk biological
      activity correlates with binding of its SH2 domain to activated receptor tyrosine
      kinases and concomitant localization of drk to the plasma membrane. In vitro, drk
      also binds directly to the C-terminal tail of Sos, a Ras guanine nucleotide
      releasing protein (GNRP), which, like Ras1 and drk, is required for sevenless
      signaling. These results suggest that drk binds autophosphorylated receptor
      tyrosine kinases with its SH2 domain and the Sos GNRP through its SH3 domains,
      thereby coupling receptor tyrosine kinases to Ras activation. The conservation of
      these signaling proteins during evolution indicates that this is a general
      mechanism for linking tyrosine kinases to Ras.

PMID- 8462099
TI  - The solution structure of the Oct-1 POU-specific domain reveals a striking
      similarity to the bacteriophage lambda repressor DNA-binding domain.
AB  - The POU-specific (POUs) domain, in association with a POU-type homeodomain, forms
      the bipartite DNA-binding POU domain. The solution structure of the Oct-1 POUs
      domain has been determined by multidimensional nuclear magnetic resonance
      spectroscopy and consists of four alpha helices surrounding a conserved
      hydrophobic core. The POUs domain is structurally similar to the DNA-binding
      domains of the bacteriophage lambda and 434 repressors and 434 Cro. These domains
      exhibit superimposable helix-turn-helix (HTH) motifs, except that in the POUs
      domain, the first helix and the linker to the second helix of the motif are
      extended. The conserved structural features have been used to propose a plausible
      model for DNA binding by the POUs domain. A human dwarfism mutation that affects
      positive control in the related POU domain protein Pit-1 maps to the same region
      of the HTH motif as do positive control mutations in lambda repressor.

PMID- 8462100
TI  - Increased expression of neurofilament subunit NF-L produces morphological
      alterations that resemble the pathology of human motor neuron disease.
AB  - Excessive accumulation of neurofilaments in the cell bodies and proximal axons of
      motor neurons is a major pathological hallmark during the early stages of many
      human motor neuron diseases. To test directly the consequence of overexpression
      of the major neurofilament subunit NF-L, we produced transgenic mice that
      accumulate NF-L to approximately 4-fold the normal level in the sciatic nerve. In
      young animals, the motor neurons of the ventral horn of the spinal cord have
      massive accumulations of neurofilaments, swollen perikarya, and eccentrically
      localized nuclei. NF-L accumulation is accompanied by an increased frequency of
      axonal degeneration, proximal axon swelling, and severe skeletal muscle atrophy.
      These data indicate that extensive accumulation of neurofilaments in motor
      neurons can trigger the neurodegenerative process.

PMID- 8462101
TI  - Progressive neuronopathy in transgenic mice expressing the human neurofilament
      heavy gene: a mouse model of amyotrophic lateral sclerosis.
AB  - We generated four transgenic mice with a 34 kb genomic fragment including the
      complete human neurofilament heavy (NF-H) gene. This human NF-H fragment
      contained all regulatory elements for tissue-specific expression, and in two
      transgenic lines, human NF-H proteins were produced at levels up to 2-fold the
      levels of endogenous mouse NF-H protein. By 3-4 months of age, these NF-H
      transgenics progressively develop neurological defects and abnormal
      neurofilamentous swellings that are highly reminiscent of those found in
      amyotrophic lateral sclerosis (ALS). We propose that a modest up-regulation of NF
      H cross-linkers can result in an impairment of neurofilament transport, causing
      neuronal swellings with ensuing axonopathy and muscle atrophy, a mechanism of
      pathogenesis pertinent to the possible etiology of ALS.

PMID- 8462102
TI  - In vivo evidence that transcription and splicing are coordinated by a recruiting
      mechanism.
AB  - We describe the nuclear organization of pre-mRNA processing components in HeLa
      cells upon adenovirus 2 infection and their relationship to the localization of
      viral RNA sequences. We observe a redistribution of cellular splicing factors as
      well as RNA polymerase II and heterogeneous nuclear ribonucleoprotein particle
      proteins to sites of viral RNA transcription. Similar results were obtained in
      cells transiently transfected with a plasmid containing a portion of the beta
      tropomyosin gene. Our findings demonstrate a very close association between RNA
      transcripts and transcription and pre-mRNA splicing factors, suggesting that
      these processes are both temporally and spatially linked in the cell nucleus.
      Furthermore, these data suggest a recruiting mechanism that regulates the
      localization of transcription and splicing factors in response to the initiation
      of active transcription.

PMID- 8462103
TI  - The IL-2/IL-2 receptor system: a current overview.

PMID- 8462104
TI  - Maternal-specific methylation of the imprinted mouse Igf2r locus identifies the
      expressed locus as carrying the imprinting signal.
AB  - The mouse insulin-like growth factor type 2 receptor (Igf2r) is imprinted and
      expressed exclusively from the maternally inherited chromosome. To investigate
      whether methylation could function as the imprinting signal, we have cloned 130
      kb from the Igf2r locus and searched for sequences methylated in a parental
      specific manner. Two regions have been identified: region 1 contains the start of
      transcription and is methylated only on the silent paternal chromosome; region 2
      is contained in an intron and is methylated only on the expressed maternal
      chromosome. Methylation of region 1 is acquired after fertilization, in contrast
      with the methylation of region 2, which is inherited from the female gamete.
      Methylation of region 2 may mark the maternal Igf2r locus in a manner that could
      act as an imprinting signal. These data suggest that the expressed locus carries
      a potential imprinting signal and imply that methylation is necessary for
      expression of the Igf2r gene.

PMID- 8462105
TI  - Bacterial sex pheromone-induced plasmid transfer.

PMID- 8462106
TI  - Identification of a natural killer enhancing factor (NKEF) from human erythroid
      cells.
AB  - We have previously shown that RBC significantly augment NK cell-mediated
      cytotoxicity when added at the initiation of cytotoxicity assays. We now report
      that RBC cytosol contains a soluble factor that mediates a similar enhancement of
      NK activity when the factor is precoated on a plastic surface. We have purified
      this NKEF by ammonium sulfate precipitation, ion exchange chromatography, and gel
      filtration HPLC. While gel filtration HPLC shows that NKEF has an apparent
      molecular mass of between 300 and 400 kDa, SDS-PAGE analysis indicates an
      apparent molecular weight of 48 and 24 kDa under nonreducing and reducing
      conditions, respectively. Immune serum obtained from a rabbit immunized with
      purified NKEF blocks NKEF augmentation of NK activity. In contrast, preimmune
      serum fails to inhibit NKEF activity. Anti-NKEF antibody reacts with the cytosol
      of NK-sensitive erythroleukemic target cell K562. Western blot analysis indicates
      that this antibody recognizes a 24-kDa protein both in RBC and in K562. We have
      generated tryptic peptides from NKEF and obtained partial amino acid sequences
      from three of the peptides. Two of the sequences show no significant homology
      with any known sequences. The third sequence shows partial identity with a
      deduced sequence from a murine erythroleukemia-related gene. Thus, NKEF is a
      novel protein with unique amino acid sequence. Our results of NKEF in RBC suggest
      that RBC could play an important role in regulating NK function.

PMID- 8462107
TI  - The influence of DNA structure on the in vitro stimulation of murine lymphocytes
      by natural and synthetic polynucleotide antigens.
AB  - Although DNA is generally considered to be a poor immunogen, recent evidence
      suggests that DNA from various species differ in their immunological activity and
      that bacterial DNA can induce the in vitro proliferation of normal murine B
      cells. To delineate structural features of DNA associated with mitogenic
      activity, the response of murine lymphocytes to various natural and synthetic
      polynucleotides was determined. Both ss and dsDNA from two different bacterial
      strains were equally effective in inducing proliferation. This response was
      independent of adenosine methylation, since DNA from dam- Escherichia coli
      stimulated proliferation. Among the synthetic polymers tested, only the duplexes
      poly(dG).poly(dC), and poly(dG.dC) were mitogenic, while polymers containing dA,
      dT, or dI alone or in combination with dG and dC were inactive. The mitogenic
      activity of poly(dG.dC) was eliminated, however, upon substitution of rG for dG
      or 5medC for dC. The mitogenic activity did not require high molecular weight DNA
      since active polymers ranged in size from approximately 260 to 800 base pairs. In
      addition, E. coli DNA fragments of 50-300 and 125-600 bases were mitogenic.
      Together, these data suggest that the mitogenic activity of DNA is dependent on
      sequence-specific determinants that can be presented by synthetic DNA duplexes as
      well as bacterial ss and dsDNA.

PMID- 8462108
TI  - Negative selection of thymus-dependent CD4+8+ intestinal intraepithelial
      lymphocytes by internal superantigens.
AB  - CD4 and CD8 double-positive (DP) T cells were transiently found in the Peyer's
      patch of mice 2 to 3 weeks after birth and preceded the appearance of DP
      intestinal intraepithelial lymphocytes (iIEL). DP iIEL were detected in euthymic
      specific pathogen-free mice, but not in athymic and germ-free mice. The pattern
      of V beta genes expressed on these DP iIEL was similar to that of CD4 single
      positive peripheral T cells, which reflected the negative selection by internal
      superantigens, M1s, and I-E. CD8 SP T cells did not receive such a strict
      negative selection with these antigens. DP iIEL expressed a high density of T
      cell receptor alpha beta and CD3 and responded to immobilized anti-CD3 to undergo
      blastogenesis and de novo IL2 receptor expression. These results indicate that DP
      iIEL are mature thymus-dependent T cells immigrated to intraepithelial space via
      the Peyer's patch in response to intestinal antigenic stimulation.

PMID- 8462109
TI  - Characterization of lymphokine-activated killing by human peripheral blood
      mononuclear cells stimulated with interleukin 2 (IL-2) analogs specific for the
      intermediate affinity IL-2 receptor.
AB  - Interleukin 2-stimulated human peripheral blood mononuclear cells (PBMC) generate
      lymphokine-activated killing (LAK). Using the IL-2 analogs R38A and F42K, which
      interact primarily with the beta and gamma subunits of the IL-2 receptor, we
      assessed the roles of IL-2R beta gamma and the high-affinity IL-2 receptor
      complex in LAK activation. Although the kinetics of LAK activation were
      identical, lytic activity was approximately 30% lower and proliferation was up to
      55% lower in those PBMC stimulated by R38A or F42K than in those exposed to wild
      type IL-2. The percentage of cells expressing cell-surface markers such as CD3,
      CD4, CD8, and CD16 was not significantly different after treatment with wild-type
      IL-2, R38A, or F42K; however, the proportion of cells expressing IL-2R alpha
      increased dramatically in response to stimulation by F42K (30%) compared to
      stimulation by either rIL-2 or R38A (15%). In addition, by Day 7 the
      concentration of soluble IL-2R alpha in analog-stimulated LAK culture
      supernatants was 50-75% less than that from wild-type IL-2-cultured cells. These
      findings suggest that interaction of IL-2 with IL-2R beta gamma alone is
      sufficient for both proliferation and the generation of LAK, and that stimulation
      with subunit-specific IL-2 analogs results in differential regulation of the IL
      2R alpha on human LAK cells.

PMID- 8462110
TI  - Protection against apoptosis in chicken bursa cells by phorbol ester in vitro.
AB  - Like the thymus, the bursa of Fabricius is a site of massive lymphopoiesis
      accompanied by cell death in vivo. In the present study we have, therefore,
      examined whether chicken bursa and thymus cells exhibit apoptosis. Bursa and
      thymus cells from SC chickens, 4-10 weeks of age, were incubated for 8-24 hr with
      various reagents. Genomic DNA was isolated, electrophoresed in 3% Nusieve agarose
      gels, and examined for patterns of DNA fragmentation. A laddering of DNA in
      multiples of 200 base pairs, indicative of apoptosis, was observed particularly
      with bursa and, to a much smaller extent, with thymus or spleen cells. These
      patterns of DNA fragmentation from bursa cells could be prevented by adding
      phorbol myristate acetate (PMA) but not by its inactive analogue 4 alpha-PMA
      during culture. Ionomycin is not required for this effect and, alone, appears to
      be slightly toxic for bursa cells, although it does not inhibit the effect of
      PMA. PMA did not affect the degree of DNA fragmentation in spleen or thymus
      cells. The addition of the protein kinase C (PKC) inhibitor staurosporine
      abolished both the preventive effect of PMA on apoptosis and its protective
      effect on bursa cells, as assayed by [3H]thymidine incorporation 24-48 hr after
      the initiation of cultures. PKC inhibitors also prevented the proliferation
      inducing effect of PMA + ionomycin on spleen cells. It is concluded that the
      activation of protein kinase C and perhaps other kinases protects against
      apoptosis in cultured bursa cells.

PMID- 8462111
TI  - Detachment and lysis of adherent target cells by CD4+ T cell clones involve
      multiple effector mechanisms.
AB  - Detachment of adherent targets from their substratum is a unique activity of both
      CD8+ and CD4+ T cells. Recently, we have demonstrated that with mixed,
      alloreactive populations, CD4+ T-cell-mediated detachment is kinetically distinct
      from lysis and requires protein synthesis. Heterogeneity of effector phenotypes
      precluded further elucidation of the mechanism of detachment at the mixed
      population level. Here, we examine further the mechanism of target cell
      detachment by CD4+ cells using clones which differ in lytic efficiency and
      demonstrate that detachment of adherent targets from their substratum (1) may
      result from either protein synthesis-dependent or independent pathways, which can
      be correlated with differences in clonal lytic phenotype, (2) is contact
      dependent and does not involve soluble factors, (3) can be pharmacologically
      uncoupled from IL4 production, as a measure of cytokine release, and (4) fails to
      correlate with perforin expression by immunocytochemistry. Finally, isolated
      granule preparations are unable to mediate detachment independent from lysis.

PMID- 8462112
TI  - Immunization with recombinant Escherichia coli expressing retinal S-antigen
      induced experimental autoimmune uveitis (EAU) in Lewis rats.
AB  - Previously we have reported that microbial proteins having sequence homology with
      uveito-pathogenic peptide (peptide M) of retinal S-antigen (S-Ag) induced
      experimental autoimmune uveitis (EAU) in Lewis rats and subhuman primates. In
      order to evaluate the role of natural microbial infections in causing autoimmune
      diseases we have constructed a recombinant Escherichia coli expressing retinal S
      Ag when injected it into Lewis rats which developed EAU. Control animals
      immunized with E. coli JM105 transfected with only plasmid DNA did not induce
      EAU. Similarly, baker's yeast (Saccharomyces cerevisiae), which has six amino
      acid residues in histone H3 identical with peptide M of S-Ag, induced EAU when
      injected into rats. Lymph node cells of rats immunized with recombinant E. coli
      or with the yeast show significant proliferative responses against peptide G and
      peptide M of S-Ag, respectively. The animals immunized with recombinant E. coli
      also produced antibody to S-Ag.

PMID- 8462113
TI  - Differential requirement for humoral factors for IL-2R expression of murine T
      cell subsets, Th1, Th2, and CD8Th clones.
AB  - Three types of alloreactive T helper (Th) cell clones, Th1, Th2, and CD8Th, were
      examined for the requirement of costimulatory factors for IL-2 receptor (IL-2R)
      expression and proliferation. When stimulated with allogeneic spleen adherent
      cells, these Th cell clones all expressed IL-2R strongly, whereas they expressed
      the receptor only weakly when subjected to allogeneic B cell stimulation. The
      addition of partially purified IL-2RIF to Th1, Th2, or CD8Th cell clones
      stimulated with B cell antigen-presenting cells increased the IL-2R expression of
      Th1 and CD8Th cell clones but not of the Th2 cell clone. Conversely, IL-1 up
      regulated IL-2R expression of Th2 cell clones stimulated with B cell APC but not
      of Th1 and CD8Th cell clones. Neither IL-2RIF nor IL-1 induced IL-2R expression
      of unstimulated Th cell clones. IL-2R expressed in the presence of these
      costimulators contributed to IL-2-dependent proliferation of these cells. Thus,
      the expression of IL-2R was indicated to be regulated differently in three types
      of Th cell subsets through different cytokines.

PMID- 8462114
TI  - TNF production and hypertrophic scarring.
AB  - The percentage of TNF alpha- and beta-positive cells was analyzed in hypertrophic
      scar (N = 13), normotrophic scar (N = 7), and normal skin (N = 6) biopsies using
      monoclonal antibodies and immunoperoxidase staining of cryostat tissue sections.
      Samples were first characterized for infiltrating cells. In hypertrophic samples
      there was a significant increase in activated infiltrating cells, capable of
      producing TNF beta and IL-1 beta. In contrast, the percentage of TNF alpha
      positive cells was significantly lower than that detected in normotrophic scars.
      In fact, in hypertrophic scar samples a positive staining with anti-TNF alpha mAb
      was restricted to 8% of tissue-infiltrating cells compared to 35.4% of the cells
      present in normotrophic scars; 12% of infiltrating cells were stained in normal
      skin sections. These results suggest that TNF alpha may be important for normal
      wound healing and that hypertrophic scarring might be partially a consequence of
      a low amount of TNF alpha.

PMID- 8462115
TI  - Delineation of the role of a Na+/Ca2+ exchanger in regulating intracellular Ca2+
      in T cells.
AB  - One of the metabolic events that results from ligation of the CD3-TCR is an
      increase in [Ca2+]i. The mechanisms that generate this rise in [Ca2+]i are poorly
      understood, but involve mobilization of intracellular Ca2+ stores and the
      movement of extracellular Ca2+ into the cell. To examine the role of Na+/Ca2+
      exchange in the increase in [Ca2+]i after CD3-TCR engagement, the effects of
      specific inhibitors of Na+/Ca2+ exchange, DCB, CBDMB, and bepridil, were
      examined. Inhibitors of Na+/Ca2+ exchange suppressed IL2 production and the rise
      in [Ca2+]i in Jurkat cells stimulated by anti-CD3 mAb. Mobilization of
      intracellular Ca2+ stores and mitogen-stimulated inositol phosphate production
      were not inhibited by these agents. Inhibitors of Na+/Ca2+ exchange also
      inhibited mitogen responses of normal T cells and the sustained increase in
      [Ca2+]i resulting from cross-linking class I MHC molecules, addition of PHA, or
      anti-CD3 mAb. Additional evidence for an important role of a Na+/Ca2+ exchanger
      in generating increases in [Ca2+]i after CD3 ligation was the finding that
      replacing extracellular Na+ with Li+, that cannot be transported by the Na+/Ca2+
      exchanger, nearly abrogated the rise in [Ca2+]i induced by cross-linking CD3.
      These results are consistent with the conclusion that a Na+/Ca2+ exchanger is
      important in regulating changes in [Ca2+]i that are critical for T cell
      activation.

PMID- 8462116
TI  - An ultrastructural study of mitotic chondrocytes in the Swarm rat chondrosarcoma.
AB  - The Swarm rat chondrosarcoma is a well established model system for the
      biochemical studies of cartilage proteoglycans. In this study, we observed the
      ultrastructure of mitotic chondrocytes in this tumor to confirm whether it is
      also useful as a morphological model system to examine the mitosis of
      chondrocytes. As a result, the mitotic chondrocytes in this tumor contained
      fairly prominent cell organelles, and the endoplasmic reticulum was mainly
      vacuolized and the Golgi stacks were replaced by the cluster of small vesicles
      during the later stage of the mitotic cycle. Although the cytoplasmic division
      began at the telophase, the cytoplasmic cleavage furrow was so narrow that
      dividing chondrocytes looked as if they were partitioned by a slit. These
      findings are almost consistent with the changes that occurred in the mitotic
      chondrocytes of the tibial growth plate, although the degree of disorganization
      in the Golgi apparatus is slightly different. Therefore, this tumor is useful as
      a convenient morphological model system to examine the mitosis of chondrocytes
      because of the facility for taking specimens.

PMID- 8462117
TI  - Mechanical properties of artificial teeth.
AB  - In selecting the teeth for fabrication of complete or partial dentures, each
      patient's anatomic and physiologic requirements and the properties of the
      artificial teeth themselves should be taken into consideration. The purpose of
      this study was to evaluate the mechanical properties of the artificial teeth by
      the static compression test and the impact test. Specimens were the lower first
      molar porcelain and resin teeth (Livdent FB-20 teeth by G. C. Co., Tokyo, Japan).
      All were of the same shape. In the static compression test, the fracture load and
      deformation of the artificial teeth were measured with an Instron-type universal
      testing machine at a cross-head speed of 1.0 mm/min. Elastic modulus, ultimate
      strength and absorbed energy were calculated. In the impact test, the
      acceleration of a falling impactor was measured with a drop impact apparatus. The
      load applied to the specimen was equivalent to 300N. Absorbed energy and
      deformation were calculated. The resin teeth showed a lower elastic modulus,
      higher fracture toughness and shock-absorbing ability than the porcelain teeth.
      Resin teeth should be selected when the first requisite is high shock-absorbing
      ability, and porcelain teeth should be selected when the first requisite is high
      masticating efficiency.

PMID- 8462118
TI  - Study on morphology of mandibular corpus and ramus influencing the eruption of
      mandibular first permanent molar.
AB  - The mandibular first permanent molar has been reported to be the first permanent
      tooth to erupt. However, according to the recent reports, a considerable increase
      in the number of children has been observed with the eruption of the mandibular
      first permanent molar after the eruption of the mandibular central incisor. The
      purpose of this study is to investigate whether there is any morphological
      difference in the mandible including the mandibular corpus and the ramus between
      the subjects with the mandibular first permanent molar erupting prior to the
      mandibular central incisor (Group A) and the subjects with the mandibular central
      incisor erupting prior to the mandibular first permanent molar (Group B).
      Lateral, posteroanterior, 45-degree oblique cephalometric radiographs and dental
      plaster models were used as the materials. Based on the data statistically
      analyzed, the results are summarized as follows: 1. No significant differences
      were found in the conventional angular lateral cephalometric measurements between
      the two groups. 2. No significant difference was found in the mandibular length
      between the two groups. 3. Significant differences were found in the mandibular
      corpus and the ramus between the two groups. In other words, the children in
      Group A have a narrower ramus, longer corpus and a larger eruption space for the
      mandibular first permanent molar than the children in Group B. These results
      indicate that even though there was no significant difference in the
      anteroposterior dimension of the mandible between the two groups, the internal
      proportion of the mandible represented as the ratio between the corpus and ramus
      was significantly different. This may suggest that the different proportional
      constituents of the mandible have a close relationship with the eruption timing
      of the mandibular first permanent molar.

PMID- 8462119
TI  - Joint epidemiological longitudinal dental survey in Nigeria, especially in
      comparison with that of Japanese.
AB  - Since 1980 we carried out a longitudinal dental survey in Ile-Ife, as a joint
      study with the dental school of Ife University, Nigeria, being supported by A
      Grant under The Monbusho International Scientific Research Program for ten years.
      One thousand one hundred seventy-one children and adults were examined in the
      1991 survey. The data were compared with the data in the previous survey and
      Japanese survey. Results were as follows: 1) Caries prevalence rate and the
      average number of DMFT were still very low, especially showing that both the
      caries prevalence and the average number of DMFT decreased in the rural areas
      because the attrition proceeded faster than the caries, 2) Nigerian deciduous and
      permanent dentition were larger than in the Japanese in all items measured, 3)
      the condylar head was transformed from the round shape to the ultra-flat shape
      with age, 4) there was a fewer incidence of severe periodontal diseases despite
      of the marked deposition of calculus, 5) with respect to Nigerian foods, there
      was no difference between the rainy and dry seasons in both the urban and rural
      communities, 6) the weaning period of the baby is decided by their mother, taking
      care of the health of the baby, almost all babies at one year to two years and a
      few at three years and 7) the menu for the breakfast, lunch and supper of the
      baby was made considering the nutritional aspect of the baby.

PMID- 8462120
TI  - Reversal of multidrug resistance in Friend leukemia cells by dexniguldipine-HCl.
AB  - Dexniguldipine-HCl (DNIG)--a prospective clinical modulator of p170-glycoprotein
      (pgp170)-mediated multidrug resistance (MDR)--was evaluated in a drug
      accumulation assay in MDR murine leukemia cell strain F4-6RADR expressing pgp170.
      The compound elevated low accumulation of either doxorubicin (DOX), daunorubicin
      (DNR), or mitoxantrone (MITO) in resistant F4-6RADR cells to the very levels
      observed in drug-sensitive F4-6 precursor cells. In parallel with the increase in
      DNR content (F4-6RADR, solvent: 303 +/- 27 pmol/mg protein; DNIG (3.3 mumol/l):
      1,067 +/- 174 pmol/mg protein; F4-6P, solvent: 948 +/- 110 pmol/mg protein; n = 8
      9, SEM), the amount of DNR tightly bound to the acid precipitate pellet obtained
      from F4-6RADR (i.e., protein, DNA, RNA) increased 3.9-times to the levels
      observed in sensitive F4-6 cells. The main pyridine metabolite of DNIG displayed
      similar activity. Concentration-response analysis revealed that DNIG and R,S
      verapamil (VER) induced 100% reversal of the DNR accumulation shortage associated
      with the MDR phenotype but DNIG was 8 times more potent than VER (50% inhibitory
      concentration (IC50), 0.73 vs 5.4 mumol/l). In keeping with the accumulation
      assay, DNIG was about 10 times more potent than VER in sensitizing F4-6RADR cells
      to the cytostatic and cytotoxic effects of DNR in proliferation assays. In
      conclusion, DNIG is a potent in vitro modulator, improving (a) the accumulation
      of anthracycline-like cytostatics, (b) drug access to cellular binding sites, and
      (c) the cytostatic action of DNR in F4-6RADR leukemia cells of the MDR phenotype.

PMID- 8462121
TI  - Effect of tumor presence on cisplatin and carboplatin: disposition in the
      isolated, perfused tumor and skin flap.
AB  - The purpose of this study was to evaluate the disposition of elemental platinum
      (Pt) derived from cisplatin (CDDP) or carboplatin (CBDCA) in the isolated,
      perfused tumor and skin flap (IPTSF). Flaps were perfused with either 3.0
      micrograms CDDP/ml perfusion medium (n = 4 tumor, n = 4 control) or 15 micrograms
      CBDCA/ml (n = 4 tumor, n = 3 control) at a rate of 1 ml/min for 3 h. A 2-h (CDDP
      experiments) or 3-h (CBDCA experiments) washout phase using undosed medium was
      then performed. The disposition kinetics of free (ultrafilterable) Pt were
      characterized using a four-compartment physiologically relevant pharmacokinetic
      model. A tumor effect on the disposition of Pt was noted in that the Pt mass from
      CDDP in the central and mobile tissue compartments was greater in tumor flaps
      than in control flaps (P < 0.05). Similar trends were noted in CBDCA-treated
      flaps, but these were not significant. The Pt mass in the fixed tumor and non
      tumor tissue compartments was significantly greater when Pt was derived from CDDP
      than when it was derived from CBDCA (P < 0.05). A linear relationship existed
      between the estimated micrograms of Pt in the flaps from both CDDP and CBDCA and
      the cross-sectional vascular resistance of the flaps at 30 (CDDP, r = 0.78;
      CBDCA, r = 0.89) and 60 min (CDDP, r = 0.65; CBDCA, r = 0.85) of perfusion. We
      conclude that the IPTSF is a useful model for evaluating the disposition of Pt
      drugs in tumor and non-tumor tissue and that tumor presence alters the
      disposition of CDDP.

PMID- 8462123
TI  - Phase I pharmacokinetics study of high-dose fotemustine and its metabolite 2
      chloroethanol in patients with high-grade gliomas.
AB  - The pharmacokinetics of high-dose fotemustine followed by autologous bone-marrow
      transplantation during a phase I-II clinical trial in 24 patients with
      glioblastoma or astrocytoma (grade III-IV) was investigated. Plasma levels of
      fotemustine were determined by high-performance liquid chromatography (HPLC) and
      UV detection. The metabolite, 2-chloroethanol, was simultaneously followed in six
      patients by gag liquid chromatography and electron capture detection (GLC-ECD)
      assay. The drug was given as a 1-h infusion on 2 consecutive days. In all, 40
      pharmacokinetic determinations of fotemustine were made at dose levels ranging
      from 2 x 300 to 2 x 500 mg/m2. Plasma drug elimination was best described by a bi
      exponential model, with short distribution and elimination half-lives of 4.15 +/-
      2.57 and 28.8 +/- 12.1 min being observed, respectively. No significant
      difference in half-lives or clearance was seen between the first and the second
      administration. During dose escalation, the mean area under the concentrationtime
      curve (AUC) increased from 5.96 +/- 2.89 to 12.22 +/- 3.95 mg l-1 h. Drug
      clearance was independent of the dose given and equal to 109 +/- 65 l/h,
      indicating no possible saturation of metabolism and elimination mechanisms at
      these high-dose levels. The metabolite 2-chloroethanol appeared very early in
      plasma samples. Its elimination was rapid and rate-limited by the kinetics of the
      parent compound, giving the same apparent terminal half-life. A close
      relationship between AUC and C45 values was evidenced (r = 0.890). Associated
      with the stability of fotemustine kinetic parameters, this could be used in
      future studies for individual dose adjustment, particularly for high-dose
      fractionated regimens.

PMID- 8462122
TI  - Pharmacological properties of the ornithine decarboxylase inhibitor 3-aminooxy-1
      propanamine and several structural analogues.
AB  - Analogues of 3-aminooxy-1-propanamine proved to be highly potent and selective
      inhibitors of ornithine decarboxylase (ODC). The compounds competed with
      ornithine for the substrate binding site of ODC, but resulted in progressive and
      apparently irreversible inactivation of the enzyme. Diamine oxidase was inhibited
      by these compounds to a lesser extent than ODC; the compounds were not
      metabolized by this enzyme. Several derivatives were growth-inhibitory for human
      T24 cells and for other mammalian cells, the most active compound being 3
      aminooxy-2-fluoro-1-propanamine (AFPA). Growth-arrested cells were largely
      depleted of putrescine and spermidine. Cellular growth arrest could be
      antagonized by supplementation with spermidine. Selection for resistance against
      AFPA led to cells with amplified ODC genes and overexpression of the message.
      Some of the derivatives were tumoristatic at well-tolerated doses in mice bearing
      solid T24 tumours. The antiproliferative activity of these compounds appears to
      be mediated by polyamine depletion.

PMID- 8462124
TI  - Doxorubicin and doxorubicinol pharmacokinetics and tissue concentrations
      following bolus injection and continuous infusion of doxorubicin in the rabbit.
AB  - Cumulative dose-related, chronic cardiotoxicity is a serious clinical
      complication of anthracycline therapy. Clinical and animal studies have
      demonstrated that continuous infusion, compared to bolus injection of
      doxorubicin, decreases the risk of cardiotoxicity. Continuous infusion of
      doxorubicin may result in decreased cardiac tissue concentrations of
      anthracyclines, including the primary metabolite doxorubicinol, which may also be
      an important contributor to cardiotoxicity. In this study, doxorubicin and
      doxorubicinol plasma pharmacokinetics and tissue concentrations were compared in
      New Zealand white rabbits following intravenous administration of doxorubicin (5
      mg.kg-1) by bolus and continuous infusion. Blood samples were obtained over a 72
      h period after doxorubicin administration to determine plasma doxorubicin and
      doxorubicinol concentrations. Rabbits were killed 7 days after the completion of
      doxorubicin administration and tissue concentrations of doxorubicin and
      doxorubicinol in heart, kidney, liver, and skeletal muscle were measured. In
      further experiments, rabbits were killed 1 h after bolus injection of doxorubicin
      and at the completion of a 24-h doxorubicin infusion (anticipated times of
      maximum heart anthracycline concentrations) to compare cardiac concentrations of
      doxorubicin and doxorubicinol following both methods of administration. Peak
      plasma concentrations of doxorubicin (1739 +/- 265 vs 100 +/- 10 ng.ml-1) and
      doxorubicinol (78 +/- 3 vs 16 +/- 3 ng.ml-1) were significantly higher following
      bolus than infusion dosing. In addition, elimination half-life of doxorubicinol
      was increased following infusion. However, other plasma pharmacokinetic
      parameters for doxorubicin and doxorubicinol, including AUC infinity, were
      similar following both methods of doxorubicin administration. Peak left
      ventricular tissue concentrations of doxorubicin (16.92 +/- 0.9 vs 3.59 +/- 0.72
      micrograms.g-1 tissue; P < 0.001) and doxorubicinol (0.24 +/- 0.02 vs 0.09 +/-
      0.01 micrograms.g-1 tissue; P < 0.01) following bolus injection of doxorubicin
      were significantly higher than those following infusion administration. Tissue
      concentrations of parent drug and metabolite in bolus and infusion groups were
      similar 7 days after dosing. The results suggest that cardioprotection following
      doxorubicin infusion may be related to attenuation of the peak plasma or cardiac
      concentrations of doxorubicin and/or doxorubicinol.

PMID- 8462125
TI  - Effect of temozolomide and dacarbazine on O6-alkylguanine-DNA alkyltransferase
      activity and sensitivity of human tumor cells and xenografts to 1,3-bis(2
      chloroethyl)-1-nitrosourea.
AB  - We investigated the ability of 5-(dimethyltriazeno)imidazole-4-carboxamide (DTIC,
      decarbazine) and an analogue, temozolomide, to deplete cells or tumors of O6
      alkylguanine-DNA alkyltransferase (AGT) and to enhance the antitumor effects of
      1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU). Human colon cancer (HT29) cell
      survival was decreased by almost 1 log when treated with 500 microM temozolomide
      prior to 150 microM BCNU. Administration of the maximal tolerated dose of DTIC
      (300 mg/kg) to nude mice carrying HT29 xenografts resulted in complete depletion
      of AGT activity in tumors at 4 h and 16 h. Administration of 150 mg/kg DTIC
      caused a 76% reduction in AGT activity at 4 h, but only a 28% reduction at 16 h.
      The maximally tolerated doses of DTIC and BCNU, alone and in combination, were
      used to treat nude mice bearing HT29 xenografts. No difference in tumor growth
      occurred when animals were treated with either BCNU alone (50 mg/kg), DTIC alone
      (300 mg/kg), DTIC (150 mg/kg) followed by BCNU (12.5 mg/kg), or BCNU (25 mg/kg)
      followed by DTIC (150 mg/kg). These data suggest that methylating agents such as
      DTIC may be too toxic to be used in combination with BCNU to deplete tumor
      alkyltransferase levels effectively and increase the therapeutic index of BCNU.

PMID- 8462126
TI  - Pharmacokinetics of BW12C and mitomycin C, given in combination in a phase 1
      study in patients with advanced gastrointestinal cancer.
AB  - The effect of combining the oxygen-transport-modifying drug BW12C with mitomycin
      C was investigated in a phase 1 study of 26 patients with advanced
      gastrointestinal cancer. The dose of BW12C was increased from 20 mg/kg to 60
      mg/kg. Dose-limiting toxicity of vomiting was experienced at doses greater than
      50 mg/kg. This corresponded to whole blood levels > or = 700 micrograms/ml and to
      > 50% haemoglobin modification. Whole blood concentrations of BW12C and
      modification of the haemoglobin oxygen saturation curve were linearly dependent
      on dose. BW12C whole blood pharmacokinetics were best described by a one
      compartment model and were clearly dose-dependent. The half-life increased from
      2.1 h at a dose of 20 mg/kg to 7.2 h at a dose of 60 mg/kg. The AUC increased in
      a similar non-linear fashion with increasing dose. Mitomycin C was given at a
      fixed dose of 20 mg/m2 at the end of the BW12C infusion. Mitomycin C plasma
      pharmacokinetics fitted a two-compartment model, giving a mean beta half-life of
      50 +/- 7 min and AUC of 1.1 +/- 0.08 micrograms/ml h, and were unaffected by the
      combined treatment. There was no evidence of increased mitomycin C toxicity.

PMID- 8462127
TI  - Glutathione depletion increases the cytotoxicity of melphalan to PC-3, an
      androgen-insensitive prostate cancer cell line.
AB  - Prostate cancer that is androgen-insensitive is unresponsive to a wide spectrum
      of cytotoxic agents, including all of the alkylating agents. Since a major
      pathway for the detoxification of the alkylating agents is conjugation with
      glutathione (GSH), GSH depletion has proved to be effective as a technique to
      restore melphalan sensitivity in melphalan-resistant cancer cell lines. However,
      the effect of GSH depletion has not been widely studied in tumor cell lines that
      have not developed resistance due to previous exposure to alkylating agents.
      Thus, we decided to investigate GSH depletion as a technique to increase
      melphalan cytotoxicity to PC-3 cells, an androgen-insensitive prostate cancer
      line. After 2 and 6 h incubation with 0.25-5 microM melphalan, virtually no
      effect was observed on either clonogenic lethality or MTT viability until 5
      microM exposures. A 24-h incubation of the cells with 100 microM buthionine
      sulfoximine (BSO), an inhibitor of GSH synthesis, reduced the GSH content by 70%
      75%. Following GSH depletion, an increase in clonogenic lethality and a decrease
      in MTT viability occurred after exposure to concentrations as low as 0.25 microM.
      The dose modification factor ranged from 2.9 after 2 h incubation to 4.5 at 6 h.
      These results provide support for additional studies in prostate cancer for
      further investigation of GSH depletion as a technique to induce sensitivity to
      alkylating agents in this chemotherapy-resistant tumor.

PMID- 8462128
TI  - Oral bioavailability of mesna tablets.
AB  - To test the feasibility of uroprotection with sodium 2-mercaptoethane-sulfonate
      (mesna) in tablet form the bioavailability of mesna tablets was determined in
      healthy volunteers by HPLC. The area under the plasma concentration-time curve
      (AUC) of free mesna was significantly lower following oral (110 mumol.l-1 x h-1;
      95% CI 98-122) than following i.v. administration of 1.2 g of mesna (201 mumol.l
      1 x h-1; 95% CI 158-244). The AUC for total mesna, i.e. dimesna and mixed
      disulfides, however, were comparable in the two groups, with 628 (539-717) and
      772 (713-831) mumol.l-1 x h-1, respectively. The mean residence time was
      significantly longer following oral mesna, at 79 (76-83) min vs 239 (229-250)
      min. Following oral mesna 51.1% (46.2-56.0%) of the administered dose was
      recovered in the urine in 24 h, compared with 60.6 (53.6-67.6)% in 4 h following
      i.v. mesna, and the average concentration of mesna in the urine exceeded 3 mmol.l
      1 for 8 h. The data indicate that mesna in tablet form has an adequate
      bioavailability for uroprotection and therefore may be preferable to liquid
      mesna, which has an unpleasant taste. Oral mesna has a longer mean residence time
      than i.v. mesna, which means that uroprotection can be achieved with longer
      dosing intervals.

PMID- 8462129
TI  - Gastrooesophageal reflux in children with cerebral palsy.
AB  - Feeding difficulties, vomiting and recurrent chest infections associated with
      poor growth and nutrition are common in children with cerebral palsy (CP).
      However, the role of gastrooesophageal reflux as a possible cause has been little
      studied. We therefore investigated 23 children with cerebral palsy (median age
      2.3 years, range 0.6-11.8) whose symptoms were consistent with gastrooesophageal
      reflux (severe feeding difficulties 70%, failure to thrive 52%, anaemia 31% and
      recurrent chest infections 31%). Using 24-hour ambulatory oesophageal pH
      monitoring, we determined the relationship between gastrooesophageal reflux and:
      (a) developmental age (Griffith's scales); (b) feeding behaviour skills score;
      (c) nutritional status and (d) clinical assessment of cerebral palsy (type and
      severity). Abnormal gastrooesophageal reflux (i.e. reflux index > 5%) was
      detected in 16 (70%) patients (median reflux index 11.4%; range 5.4-59%). Reflux
      was unrelated to chronological or developmental age, but there was a significant,
      unexplained association with male gender (P < 0.01). No correlation was found
      with feeding behaviour skills score, malnutrition (which was commonly severe) and
      type and severity of cerebral palsy. We conclude that gastrooesophageal reflux is
      common and should be sought in symptomatic, neurologically handicapped children
      as effective treatment is likely to improve quality of life.

PMID- 8462130
TI  - Annotation: care of children in hospital. The European Association for Children
      in Hospitals.
AB  - The Charter for Children in Hospitals, drawn up by professional and women's
      groups from a number of European countries at the First Conference for the Care
      of Children in Hospital (Netherlands 1988) presents many fine guidelines for
      protecting the rights of children and their parents before, during and after
      hospitalization. The development of these guidelines, their current acceptance in
      Europe and the psychological principles underlying them, are outlined here.

PMID- 8462131
TI  - Handedness in children at school entry: does the 'Mesker test' provide a valid
      method for testing writing handedness?
AB  - The 'Mesker test', an experiment devised after the psycho-motor dominance test
      described by the Dutch paediatrician Mesker, was evaluated as a method for
      testing writing handedness in 145 children at school entry in Crewe Health
      Authority. Also included in the assessment was if, and how these children know
      their laterality. Positive outcome was measured as Mesker test result
      corresponding to spontaneous hand-preference in symbol copying. The correct
      indication of right arm or leg was evaluated in relation to the outcome by
      chance. The Mesker test could not confirm hand-preference in children at school
      entry. There was no significant relation to the child's maturity and no
      significant consistency in test performance. The sub-group of right-handed
      writers who confirmed their handedness showed an almost significant level of
      consistency. No more children who thought they knew the right side indicated the
      correct limb then could have been arrived at by chance. This was not
      significantly related to having been taught, writing handedness or maturity. It
      is concluded therefore, that at school entry age children don't have a good
      knowledge of their body's laterality. Although the Mesker test does not confirm
      writing handedness at school entry, it may be useful in older children with
      inconsistent laterality.

PMID- 8462132
TI  - Prevention of childhood disability in the People's Republic of China.
AB  - With a dramatic decrease in infant mortality, an emerging challenge facing modern
      medicine in China is chronic disabling conditions in infants and young children.
      According to the results of a national sampling survey in 1987, it is estimated
      that there are over 51 million people of all ages with disabilities, which
      accounts for 4.9% of the total population. One out every five families in China
      has a member who is disabled. For children under 14 years of age, the overall
      prevalence rate of disability is 2.66%. The prevalence rate of mental retardation
      is 1.8% which accounts for 66% of all disabled children. Mental retardation is
      the most frequent childhood disability. Research on factors contributing to
      disability indicates the complexity of the problem. The etiology of 47% of cases
      is unknown, 21% of cases result from damage prenatally, 3% are due to perinatal
      factors, 29% are acquired during infancy and early childhood. Efforts to prevent
      developmental disabilities among children can be classified in terms of primary,
      secondary and tertiary activities. The most important primary prevention
      activities consist of genetic counselling, immunization programmes, improved
      prenatal, perinatal and postnatal health care, and legislation. On the secondary
      preventive level, focus is primarily on prenatal diagnosis and newborn screening.
      Tertiary preventive efforts include special education and comprehensive
      rehabilitation services. While these prevention efforts have been established,
      they are insufficient to meet the needs of disabled children and their families.
      In the context of the one child per family policy in China, much more is needed,
      much more can be done to reduce childhood disability. In addition to
      strengthening prevention efforts at all 3 levels, special emphasis should be
      placed on (a) integration of existing primary health care systems with early
      intervention programmes, (b) public education and information, (c) personnel
      preparation, and (d) research and evaluation.

PMID- 8462133
TI  - Reliability and validity of the Portage assessment scale for clinical studies of
      mentally handicapped populations.
AB  - The Finnish version of the Portage Assessment Scale was used with 114
      aspartylglucosaminuria (AGU) persons aged between 1 and 56 years. Ninety-three
      persons with AGU were also given psychological tests, mainly SB (Finnish), WISC-R
      and WPPSI, but also Merrill-Palmer, Bayley, Leiter and WAIS tests. The data also
      include for the reliability assessment a sample of 30 normal pre-school children.
      The internal consistency reliability was calculated for the areas of
      socialization 0.80, language 0.81, self-help 0.73, cognitive 0.70, motor 0.75 and
      for the whole scale 0.80. The factor analysis produced one very strong factor.
      The results of the Portage assessment were compared to the developmental levels
      provided by the tests. Both methods gave almost identical cross-sectional
      descriptions of the skills of patients with AGU, which was interpreted as
      providing a cross-validation for Portage in clinical use and to mean that Portage
      can be used as a reasonable assessment method. The advantages of Portage include
      easy use by non-psychologists, concrete descriptions of the skills, the 5 areas,
      and the close relation to rehabilitation.

PMID- 8462134
TI  - Are primary school children gaining heart health benefits from their journeys to
      school?
AB  - Information was collected in relation to 1133 children, aged 4-11 years,
      regarding methods of travel to and from school, together with distances involved.
      Ninety-seven per cent of the children walked, travelled by car or alternated
      between these 2 methods of travel. Some 584 children (51.5%) walked to school
      every day with an average one-way-distance of less than half a mile. It would
      seem therefore that few primary school children are walking far enough to gain
      heart health benefits from their journeys to school. Reasons are given, however,
      as to why it is important for young children to be encouraged to walk to school
      providing adequate safety considerations are taken into account.

PMID- 8462135
TI  - Coronary artery size and dilating capacity in ultradistance runners.
AB  - BACKGROUND: Increases in coronary artery size and dilating capacity have been
      observed in some animals after endurance training, and at autopsy, active men
      appear to have enlarged epicardial coronary arteries. This cross-sectional study
      was designed to test the hypothesis that highly trained endurance runners have
      larger epicardial coronary arteries and greater dilating capacity than inactive
      men. METHODS AND RESULTS: The subjects, ages 39-66 years, included 11 male
      volunteers who had participated in ultradistance running during the past 2 years
      and 11 physically inactive men who had been referred for arteriography but had no
      visible coronary artery disease. The internal diameter of the proximal segments
      of each major epicardial coronary artery was measured before and after
      nitroglycerin administration using a computer-based quantitative arteriographic
      analysis system. Measurements also included maximal oxygen uptake, plasma
      lipoprotein concentrations, body composition, and cardiac mass by
      echocardiography. Before nitroglycerin, the sum of the cross-sectional areas for
      the proximal right, left anterior descending, and circumflex arteries was not
      different for the runners and the inactive men: 22.7 +/- 4.79 versus 21.0 +/-
      7.97 mm2 (p = 0.57), respectively. However, the increase in the sum of the cross
      sectional area for the proximal right, left anterior descending, and circumflex
      arteries in response to nitroglycerin was greater for the runners (13.20 +/- 4.76
      versus 6.00 +/- 3.02 mm2; p = 0.002). Left ventricular mass index (152 +/- 21
      versus 116 +/- 41 g/m2; p < 0.05) but not left ventricular mass (284 +/- 40
      versus 246 +/- 91 g; p = 0.22) was significantly greater for the runners. Among
      the runners, dilating capacity was positively correlated with aerobic capacity
      and negatively related to adiposity, resting heart rate, and plasma lipoprotein
      concentrations. CONCLUSIONS: Highly trained, middle-aged endurance runners
      demonstrated a significantly greater dilating capacity of their epicardial
      coronary arteries in response to nitroglycerin compared with inactive men. The
      causes of this greater dilating capacity and its clinical significance need to be
      determined.

PMID- 8462136
TI  - Prognostic value of an abnormal signal-averaged electrocardiogram in patients
      with nonischemic congestive cardiomyopathy.
AB  - BACKGROUND: An abnormal signal-averaged ECG (SAECG) has predictive value for
      arrhythmic events in patients with coronary artery disease. The purpose of this
      study was to investigate whether an abnormal SAECG could provide prognostic
      information in patients with nonischemic dilated cardiomyopathy. METHODS AND
      RESULTS: We prospectively obtained SAECGs in 114 patients with dilated
      nonischemic cardiomyopathy. Twelve-lead ECGs, left ventricular ejection
      fractions, hemodynamic measurements, and peak exercise oxygen consumption (VO2)
      also were measured. An SAECG was defined as abnormal by any one of the three
      following criteria: filtered QRS duration > 120 msec, root-mean-square voltage in
      the last 40 msec < 20 microV, or duration < 40 microV > 38 msec at 40 Hz. Sixty
      six patients had a normal SAECG, 20 patients had an abnormal SAECG, and 28
      patients had bundle branch block (BBB). Mean follow-up was 10 +/- 5 months. Age,
      ejection fraction, peak VO2, pulmonary capillary wedge pressure, and cardiac
      index were not statistically different among the three groups. Use of
      antiarrhythmic drugs was similar among the three groups, although patients with
      BBB had more implantable defibrillators (p < 0.05). The incidence of previous
      atrial arrhythmias was similar for the three groups. Patients with abnormal SAECG
      or BBB had more past episodes of sustained ventricular tachycardia and/or sudden
      death episodes (n = 9) than patients with normal SAECG (n = 1) (p < 0.01).
      Prospectively, none of the 66 patients with normal SAECG died suddenly or had
      sustained ventricular arrhythmias. Two deaths occurred from progressive heart
      failure, and three patients required urgent transplant. In the 20 patients with
      an abnormal SAECG, four patients had sustained ventricular tachycardia, five
      patients died suddenly, two patients died from progressive heart failure, and one
      patient required urgent transplant. In the patients with BBB, four patients had
      sustained ventricular tachycardia, and four patients required urgent transplant.
      One-year event-free survival, i.e., absence of ventricular tachycardia and/or
      death, was 95% in patients with normal SAECG, 88% in patients with BBB, and only
      39% in patients with an abnormal SAECG (p < 0.001). Multivariate analysis
      demonstrated that SAECG and New York Heart Association classification were
      independent predictors of survival. CONCLUSIONS: Patients with an abnormal SAECG
      had a statistically significant increase in sustained ventricular arrhythmias
      and/or death than did patients with a normal SAECG or BBB. This study
      demonstrates that an abnormal SAECG is a marker of past and future arrhythmic
      events in patients with nonischemic dilated cardiomyopathy. In contrast, patients
      with a dilated cardiomyopathy with a normal SAECG have an excellent prognosis
      with adverse outcome only from progressive heart failure.

PMID- 8462137
TI  - Effects of captopril on ischemia and dysfunction of the left ventricle after
      myocardial infarction.
AB  - BACKGROUND: Treatment with angiotensin converting enzyme inhibitors has been
      shown to be beneficial in patients with heart failure and myocardial infarction.
      Experimental studies have shown beneficial effects on the ischemic myocardium.
      METHODS AND RESULTS: The effects of captopril were evaluated in 64 patients with
      left ventricular dysfunction after myocardial infarction. The patients were
      randomized at day 7 to either placebo or captopril (50 mg daily) in a double
      blind parallel study over a period of 6 months. The patients were followed up by
      means of ambulatory ECG monitoring, bicycle ergometer testing, and
      echocardiographic examination. The duration of ST segment depression detected
      during ambulatory ECG monitoring was lower in the captopril group (87 minutes)
      than in the placebo group (638 minutes) (p < 0.001), and the number of patients
      in the captopril group with exercise-induced ST segment depression (p < 0.01) was
      lower at the completion of the study. The working capacity increased during the
      study period from 540 +/- 47 seconds to 738 +/- 41 seconds (p < 0.01) in the
      captopril group and was higher than that in the placebo group (530 +/- 43
      seconds, p < 0.01) at the end of the study. Furthermore, a significant dilation
      of the left ventricular end-diastolic and end-systolic volumes was observed in
      the placebo group (p < 0.05); this was prevented in the captopril group where, in
      addition, a reduction in end-systolic volume was observed (p < 0.05).
      CONCLUSIONS: Captopril has a favorable effect on the dysfunctioning myocardium
      after myocardial infarction inasmuch as the ischemic burden is reduced, the
      working capacity is increased, dilation of the left ventricle is prevented, and
      systolic function is improved.

PMID- 8462138
TI  - Hemodynamic characteristics of the early phase of primary hypertension. The Dutch
      Hypertension and Offspring Study.
AB  - BACKGROUND: The hemodynamic characteristics of the early phase of primary
      hypertension are subject to debate. In particular, it remains unclear whether an
      increased vascular peripheral resistance or a raised cardiac output is involved
      as the primary hemodynamic alteration in hypertension. METHODS AND RESULTS: We
      studied hemodynamic characteristics and oxygen consumption in relation to 24-hour
      ambulatory blood pressure measurements in three groups of normotensive children
      with a different familial predisposition for hypertension. Selection of
      participants was based on parental blood pressure levels. Mean 24-hour blood
      pressure was higher in the offspring of two hypertensive parents compared with
      the offspring of two normotensive parents; there was a difference of 4.7 mm Hg
      (95% confidence interval [CI], 1.8-7.6) for systolic blood pressure and a
      difference of 4.8 mm Hg (CI, 2.3-7.3) for diastolic blood pressure. The 24-hour
      blood pressure pattern was consistently at a higher level for both systolic and
      diastolic blood pressures in the offspring of two hypertensive parents compared
      with the offspring of two normotensive parents. The smallest differences in blood
      pressure were seen at night, and the largest differences in blood pressure
      between the groups of offspring were seen during periods of physical activity.
      Echocardiographic examination combined with registration of oxygen consumption
      did not show a difference in cardiac index and arteriovenous oxygen difference
      between the study groups. However, differences in cardiac dimensions were
      apparent, with an increased left ventricular mass index (8.7 g/m2; CI, 2.4-15.0)
      in the offspring of two hypertensive parents. CONCLUSIONS: These findings do not
      support the existence of a hyperkinetic circulatory phase but may indicate the
      presence of an increased left ventricular mass in early primary hypertension.

PMID- 8462139
TI  - Carotid artery intimal-medial wall thickening and plasma homocyst(e)ine in
      asymptomatic adults. The Atherosclerosis Risk in Communities Study.
AB  - BACKGROUND: Plasma levels of homocyst(e)ine are elevated in certain patients with
      occlusive arterial diseases. We extended these findings to asymptomatic adults.
      METHODS AND RESULTS: We determined plasma homocyst(e)ine levels in 287 pairs of
      asymptomatic adults. Cases and controls were defined on the basis of intimal
      medial thickness of the carotid wall as measured by B-mode ultrasound. Study
      subjects had no history of atherosclerotic disease and were selected from a
      probability sample of 15,800 men and women between 45 and 64 years old. Subjects
      with thickened intimal-medial carotid walls (cases) had higher plasma
      homocyst(e)ine levels than controls (p < 0.001). The odds ratio for having a
      thickened carotid artery wall was 3.15 (p < 0.001) for subjects in the top
      quintile of plasma homocyst(e)ine levels (> 10.5 mumol/L) compared with those in
      the bottom quintile (< 5.88 mumol/L). CONCLUSIONS: The present study as well as
      observations on the common occurrence of elevated plasma homocyst(e)ine levels in
      patients with occlusive arterial diseases suggest that clinical trials should be
      conducted to determine whether normalization of hyperhomocyst(e)inemia may
      prevent progression of atherosclerosis.

PMID- 8462140
TI  - Spontaneous occurrence of symptomatic paroxysmal atrial fibrillation and
      paroxysmal supraventricular tachycardia in untreated patients.
AB  - BACKGROUND: Ambulatory outpatients (n = 150) with a history of paroxysmal
      supraventricular arrhythmia were studied to establish the characteristics of the
      first recurrence of symptomatic tachycardia (time to first recurrence, heart rate
      during tachycardia, and observed rhythm that was regular versus irregular) when
      no antiarrhythmic drug was being taken. Baseline variables were examined to
      assess their impact on time to first recurrence: index arrhythmia (paroxysmal
      atrial fibrillation [n = 37] versus paroxysmal supraventricular tachycardia [n =
      113]), age (mean +/- SD, 43.3 +/- 16.1 years), female sex (n = 71), or presence
      of other heart or lung disease (n = 53). METHODS AND RESULTS: Transtelephonic
      monitoring of the ECG was used to document the rhythm during recurrences of
      symptomatic tachycardia. Time to first recurrence of symptomatic tachycardia and
      heart rate during tachycardia were measured, the observed rhythm was classified
      as irregular (consistent with paroxysmal atrial fibrillation) or regular
      (consistent with paroxysmal supraventricular tachycardia), and the hour of
      recurrence was recorded. Advancing age was significantly associated with a
      decreasing time to first recurrence (p < 0.001); the estimated increase in the
      hazard function was 25% with each 10 years of advancing age. After the effect of
      age was adjusted for, neither the classification of arrhythmia (p > 0.2),
      presence of other heart or lung disease (p > 0.8), nor sex (p > 0.9) was
      significantly associated with time to first recurrence. Among patients with
      paroxysmal supraventricular tachycardia, 6.5% had atrial fibrillation recorded at
      the next symptomatic arrhythmia; among patients with paroxysmal atrial
      fibrillation, 11.8% had a regular tachycardia recorded at the next symptomatic
      arrhythmia. There was a circadian pattern to the hour of occurrence of paroxysmal
      supraventricular tachycardia but not paroxysmal atrial fibrillation. CONCLUSIONS:
      Age is more important than other clinical variables, including the ECG
      classification of a paroxysmal supraventricular arrhythmia in predicting the
      occurrence of symptomatic arrhythmias. Arrhythmias documented by ECG during
      symptoms are often different from the arrhythmia documented at the time of
      referral, which may confound interpretation of antiarrhythmic drug effects.

PMID- 8462141
TI  - Lesion-to-lesion independence of restenosis after treatment by conventional
      angioplasty, stenting, or directional atherectomy. Validation of lesion-based
      restenosis analysis.
AB  - BACKGROUND: Since many restenosis trials include patients in whom more than one
      lesion is treated, analysis of the angiographic data on a "per lesion" basis
      might be confounded by potential correlations of restenosis among multiple
      treated lesions within each patient. The goals of this study were: 1) to
      determine whether there was any correlation in the rate of restenosis among
      multiple lesions that underwent conventional angioplasty, stenting, or
      directional atherectomy within the same patient and 2) to determine whether
      lesions treated in a multilesion intervention experience a different magnitude of
      restenosis than lesions undergoing single-lesion procedures. METHODS AND RESULTS:
      Of 441 patients treated by Palmaz-Schatz stenting (n = 114), directional
      atherectomy (n = 100), or conventional balloon angioplasty (n = 227), 67
      underwent multilesion procedures involving treatment of 146 lesions. A general
      linear model with intraclass correlation (GLIMIC) was used to calculate the
      coefficient of correlation (rho) of the change in the measured minimum luminal
      diameter (late loss) from the time of the initial procedure to 6-month angiogram
      among the multiple lesions within the same patient for all 441 patients. This
      showed no correlation among multiple lesions within the same patient for the late
      loss in minimum luminal diameter (rho = -0.12 [95% CI: -0.40, 0.12]), among
      lesions in the same vessel (rho = 0.14 [95% CI: -0.34, 0.62]), or among different
      vessels (rho = -0.18 [95% CI: -0.52, 0.16]), suggesting that the magnitude of
      late loss is independent among multiple lesions within the same patient. There
      was no difference (p = 0.96) between the observed incidence of zero-, one-, and
      two-vessel restenosis (> or = 50% diameter stenosis at follow-up) for patients
      with multiple-lesion treatment and that predicted assuming lesion-to-lesion
      independence. Similarly, there was no difference in late loss or in the overall
      binary restenosis rate when single-lesion procedures were compared with
      multilesion procedures. Multivariable analysis of the late loss in lumen diameter
      (which adjusted for the effects of the acute result and the device used)
      demonstrated no independent effect (p = 0.20) of single-lesion versus multilesion
      status. CONCLUSIONS: Luminal encroachment appears to occur at independent rates
      among multiple lesions treated in a single patient. The observed incidence of
      restenosis for patients with multiple treated lesions is accurately predicted
      assuming independent probabilities of restenosis. Lesion-based analysis, even
      when including multiple treated lesions within the same patient, is thus valid
      for evaluating conventional angioplasty, stenting, or directional atherectomy.

PMID- 8462142
TI  - Effects of age, sex, and menopausal status on plasma lipoprotein(a) levels. The
      Framingham Offspring Study.
AB  - BACKGROUND: Lipoprotein(a) [Lp(a)] is an atherogenic particle that structurally
      resembles a low density lipoprotein (LDL) particle but contains a molecule of
      apolipoprotein(a) attached to apolipoprotein B-100 by a disulfide bond. Because
      elevated plasma levels of Lp(a) have been shown to be an independent risk factor
      for coronary artery disease, it is important to define normal ranges for this
      lipoprotein. METHODS AND RESULTS: We have measured Lp(a) in 1,284 men (mean age,
      48 +/- 10 years) and 1,394 women (mean age, 48 +/- 10 years) free of
      cardiovascular and cerebrovascular disease and not on medications known to affect
      lipids who were seen at the third examination cycle of the Framingham Offspring
      Study. Plasma Lp(a) levels were measured by an enzyme-linked immunosorbent assay,
      which uses a "capture" monoclonal anti-apo(a) antibody that does not cross-react
      with plasminogen, and a polyclonal anti-apo(a) antibody conjugated to horseradish
      peroxidase. The assay was calibrated to total Lp(a) mass. The Lp(a) frequency
      distribution was highly skewed to the right, with 56% of the values in the 0-10
      mg/dL range. Mean plasma Lp(a) concentrations were 14 +/- 17 mg/dL in men and 15
      +/- 17 mg/dL in women. Values of more than 38 mg/dL were above the 90th
      percentile and values of more than 22 mg/dL were above the 75th percentile in
      both men and women. CONCLUSIONS: We have determined mean Lp(a) levels for men and
      women participating in the Framingham Offspring Study. In this population, there
      was an inverse association between plasma levels of Lp(a) and triglycerides for
      both sexes (p < 0.006), but triglycerides accounted for only approximately 0.5%
      of the variation in Lp(a) levels. Associations of Lp(a) levels with total and LDL
      cholesterol levels were not significant after correction for the estimated
      contribution of Lp(a) cholesterol to total and LDL cholesterol. After controlling
      for age, Lp(a) values were 8% greater in postmenopausal women than in
      premenopausal women, but this difference was not statistically significant. Body
      mass index, alcohol consumption, cigarette smoking, use of beta-blockers or
      cholesterol-lowering medications, and use of drugs for the treatment of diabetes
      and hypertension were not correlated with Lp(a) levels.

PMID- 8462143
TI  - Assessment of the human splanchnic venous volume-pressure relation using
      radionuclide plethysmography. Effect of nitroglycerin.
AB  - BACKGROUND: No method exists to assess human splanchnic venous function, the most
      important region in terms of vascular capacity. METHODS AND RESULTS: We studied
      25 stable patients without heart failure or hypertension to develop a method to
      assess the splanchnic venous volume-pressure (V-P) relation and to determine the
      effect of nitroglycerin (GTN). We used blood pool scintigraphy to assess changes
      in regional splanchnic vascular volume (SVV) and low levels of continuous
      positive airway pressure (CPAP) to passively alter venous pressure and thus, SVV.
      We postulated that the relation between SVV and the CPAP used would reflect the
      capacitance of the splanchnic venous bed and that changes in the position of this
      relation would provide a relative measurement of any change in capacitance. In 12
      patients (group 1), the splanchnic vascular V-P curves were recorded before and
      2, 9, and 20 minutes after 0.6 mg sublingual GTN; in eight patients (group 2),
      recordings were made at similar times before and after sublingual administration
      of placebo; in five patients (group 3), the hemodynamic effects of CPAP were
      assessed by means of right and left cardiac catheterization. Right atrial and
      femoral venous pressures increased (p < 0.001) and cardiac output fell (p < 0.05)
      during CPAP. There was an apparently linear relation between CPAP and SVV (r =
      0.74-0.98); SVV increased an average of 7.4 +/- 2.2% (p < 0.001) by 12 cm H2O
      CPAP: The splanchnic vascular V-P curves were reproducible with minimal
      variability in SVV (+/- 2%, p > 0.2) in group 2. After administration of GTN, the
      splanchnic vascular V-P curve shifted away from the pressure axis in a parallel
      fashion by an average of 9.4 +/- 5.4% (p < 0.001). CONCLUSIONS: We have developed
      a reproducible noninvasive technique that may be used to assess human splanchnic
      venous V-P relations. We have demonstrated for the first time in humans that GTN
      exerts its dilatory effect by increasing the unstressed splanchnic venous volume.

PMID- 8462144
TI  - Implantable transvenous cardioverter-defibrillators.
AB  - BACKGROUND: Implantable transvenous cardioverter-defibrillators offer a
      significant opportunity to decrease procedural morbidity and medical costs in the
      care of patients with life-threatening ventricular arrhythmias who otherwise
      would have required a sternotomy or thoracotomy for device insertion. The purpose
      of this study was to examine prospectively the safety, efficacy, and limitations
      associated with the use of a transvenously implanted, tiered-therapy cardioverter
      defibrillator with antitachycardia pacing function in a consecutive population of
      84 ventricular fibrillation (VF) and sustained ventricular tachycardia (VT)
      survivors. METHODS AND RESULTS: The index arrhythmia promoting transvenous
      cardioverter-defibrillator implantation was VF in 41 patients, VT in 27, and both
      VF and VT in 16. In each patient, transvenous defibrillation via a coronary
      sinus, a right ventricular, a superior vena caval, and/or a subcutaneous chest
      patch lead system was attempted. The pulsing methods used include two-electrode
      single-pathway pulsing or three-electrode dual-pathway simultaneous or sequential
      pulsing. A transvenous cardioverter-defibrillator was inserted if the
      defibrillation threshold (DFT) was < or = 20 J. Successful implantation of a
      transvenous cardioverter-defibrillator was possible in 80 of 84 (95%) patients.
      The mean implant DFT was 10.9 +/- 4.8 J. After cardioverter-defibrillator
      implantation, all patients were extubated in the operating room and sent to a
      standard telemetry ward for monitoring. No patient suffered a postoperative
      pulmonary complication or perioperative flurry of cardiac arrhythmias.
      Postoperative complications included lead dislodgments in eight, transient long
      thoracic nerve injury in one, asymptomatic left subclavian vein occlusion in two,
      asymptomatic small pericardial effusion in one, subcutaneous patch pocket
      hematomas in four, pulse generator pocket infection in one, and lead fracture in
      one. As experience was gained with the procedure, it was routine to discharge
      patients 3 days after surgery. The mean hospital stay was 6.0 +/- 2.4 days. Upon
      discharge, all patients returned to their prehospital activities including those
      with complications except for the patient with a pocket infection, who required
      intravenous antibiotic therapy. Patient survival using an intention-to-treat
      analysis was 98% over an 11 +/- 7-month follow-up period. During this time
      period, 31 of the 80 patients (39%) with transvenous lead systems were
      successfully treated by their device for sustained VT or VF. Antitachycardia
      pacing was used in 424 episodes of monomorphic VT and was successful in 371
      (88%). All episodes of VF were aborted by the device. Antiarrhythmic drugs were
      used after device implantation in only eight of 80 patients (10%). CONCLUSIONS:
      Transvenous cardioverter-defibrillator implantation is practical in most
      candidates. Implant DFTs are usually low, surgical morbidity and postoperative
      complications are modest, therapy of VT and VF is efficient, and survival is
      excellent.

PMID- 8462145
TI  - Distribution of circumferential stress in ruptured and stable atherosclerotic
      lesions. A structural analysis with histopathological correlation.
AB  - BACKGROUND: Although rupture of an atherosclerotic plaque is considered to be the
      cause of most acute coronary syndromes, the mechanism of plaque rupture is
      controversial. METHODS AND RESULTS: To test the hypothesis that plaque rupture
      occurs at sites of high circumferential stress in the diseased vessel, the
      distribution of stress was analyzed in 24 coronary artery lesions. Histological
      specimens from 12 coronary artery lesions that caused lethal myocardial
      infarction were compared with those from 12 stable control lesions. A finite
      element model was used to calculate the stress distributions at a mean
      intraluminal pressure of 110 mm Hg. The maximum circumferential stress in plaques
      that ruptured was significantly higher than maximum stress in stable specimens
      (4,091 +/- 1,199 versus 1,444 +/- 485 mm Hg, p < 0.0001). Twelve of 12 ruptured
      lesions had a total of 31 regions of stress concentration of more than 2,250 mm
      Hg (mean, 2.6 +/- 1.4 high stress regions per lesion); only one of 12 control
      lesions had a single stress concentration region of more than 2,250 mm Hg. In
      seven of 12 lethal lesions (58%), rupture occurred in the region of maximum
      circumferential stress; in 10 of the 12 lethal lesions (83%), rupture occurred in
      a region where computed stress was more than 2,250 mm Hg. CONCLUSIONS: These data
      suggest that concentrations of circumferential tensile stress in the
      atherosclerotic plaque may play an important role in plaque rupture and
      myocardial infarction. However, plaque rupture may not always occur at the region
      of highest stress, suggesting that local variations in plaque material properties
      contribute to plaque rupture.

PMID- 8462146
TI  - Quantitative adenosine 201Tl single-photon emission computed tomography for the
      early assessment of patients surviving acute myocardial infarction.
AB  - BACKGROUND: We prospectively investigated whether adenosine 201Tl tomography
      (SPECT) could determine the extent of coronary artery disease, the presence of
      jeopardized myocardium, and the risk for in-hospital cardiac events in 120
      clinically stable patients early (5 +/- 3 days) after myocardial infarction.
      METHODS AND RESULTS: All patients had coronary angiography and SPECT in close
      proximity. Adenosine SPECT identified 99% of infarct-related arteries and 82% of
      severely stenosed (> or = 70%) noninfarct arteries. Multivessel disease was
      accurately predicted in 69% of patients. Sixty-five percent of stenosed
      noninfarct arteries had matching thallium perfusion defects, and 92% of these
      were reversible. The specificity of adenosine SPECT was > 90%. Thallium
      redistribution occurred often within infarct (59%) and noninfarct (92%) zones.
      The patency status of the arteries, however, did not predict the presence or
      extent of jeopardized myocardium. The perfusion defect size was larger (p =
      0.0001) in patients with (45 +/- 18%) than in those without (22 +/- 15%) in
      hospital cardiac events. Furthermore, 90% of patients with events had a > or =
      20% perfusion defect compared with only 38% of those without events (p = 0.0001).
      The positive-predictive accuracy for developing a cardiac event was 70% when the
      perfusion defect size was > 30%. The ischemic defect also was larger in patients
      with (19 +/- 14%) than in those without (10 +/- 10%) events (p = 0.001). The
      positive- and negative-predictive values for developing early postinfarction
      angina were 43% and 91%, respectively, when the ischemic defect was > 12%.
      CONCLUSIONS: In selected low-risk survivors of myocardial infarction, early
      quantitative adenosine SPECT is safe and accurate in detecting and localizing
      coronary stenoses, assessing the extent of jeopardized myocardium, and
      determining subsequent risk for in-hospital cardiac events.

PMID- 8462147
TI  - Angiographic and hemodynamic determinants of myocardial ischemia during adenosine
      thallium-201 scintigraphy in coronary artery disease.
AB  - BACKGROUND: Myocardial ischemia attributed to coronary steal may occur in some
      patients receiving pharmacological coronary vasodilation. ECG ST-segment
      depression is a marker of myocardial ischemia in these patients, but the factors
      determining the presence or absence of ischemia are not well known. METHODS AND
      RESULTS: To examine the angiographic, hemodynamic, and scintigraphic determinants
      of adenosine-induced ischemic ST-segment depression in patients with coronary
      artery disease, we studied 65 consecutive patients (45 men and 20 women; mean
      age, 65 +/- 12 years) who showed reversible perfusion defects during adenosine
      (140 micrograms.kg-1.min-1 for 6 minutes) 201Tl single-photon emission computed
      tomography. Patients with prior myocardial infarction were excluded. Ischemic ST
      depression occurred in one third of the whole cohort (22 of 65 patients). The
      presence of coronary collateral vessels (p = 0.001), systolic blood pressure at
      baseline (p = 0.006), and adenosine-induced anginal chest pain (p = 0.011) were
      the only significant independent predictors of ischemic ST-segment depression by
      stepwise logistic regression analysis. Rate-pressure product at baseline,
      systolic blood pressure, heart rate, rate-pressure product, increase in heart
      rate, and rate-pressure product during adenosine infusion and maximal percent
      stenosis were variables also significantly related to ischemic ST depression by
      univariate analysis but were not predictive after the three primary variables
      were included in the regression model. Perfusion defect size, number of diseased
      vessels, and age did not correlate with ST-segment depression. CONCLUSIONS: The
      presence of collaterals, which may predispose to coronary collateral steal, is
      the most significant correlate of ischemic ST-segment depression during adenosine
      infusion. Systolic blood pressure at baseline, which may affect the myocardial
      oxygen supply/demand ratio and anginal chest pain induced by adenosine, are
      additional variables related to ischemic ST-segment depression during adenosine
      infusion.

PMID- 8462149
TI  - Comparison of resetting and entrainment of uniform sustained ventricular
      tachycardia. Further insights into the characteristics of the excitable gap.
AB  - BACKGROUND: Resetting and entrainment have both been used to characterize the
      electrophysiological properties of the reentrant circuit in ventricular
      tachycardia. Several entrainment studies have suggested that the circuit has
      decremental properties, because the return cycle increases at faster pacing
      rates. Resetting, however, demonstrates a fully excitable gap in the majority of
      tachycardias. METHODS AND RESULTS: The response to resetting and overdrive pacing
      was analyzed in 18 ventricular tachycardias. Resetting demonstrated some duration
      of a fully excitable gap in 14 of 18 tachycardias. Overdrive pacing was performed
      at several cycle lengths with an incremental number of stimuli (1-15 beats) such
      that the first beat that interacted with the tachycardia (the nth beat) could be
      identified. The return cycles measured during resetting and the nth beat of
      pacing were identical (r = 0.99). At relatively long paced cycle lengths, paced
      beats after the nth beat resulted in a constant return cycle in most tachycardias
      with a fully excitable gap. At rapid paced cycle lengths, an increase in the
      return cycle from the nth to the nth + 1 beat was associated with progressive
      prolongation in the return cycle with each incremental paced beat until a longer
      equilibrium return cycle was reached or the tachycardia terminated in response to
      pacing. CONCLUSIONS: We propose that the responses to resetting and overdrive
      pacing with or without entrainment appear to provide conflicting information
      about the characteristics of the circuit because they in fact measure entirely
      different electrophysiological parameters. The nth beat of pacing foreshortens
      the excitable gap to the extent that it arrives prematurely. Subsequent paced
      beats interact with an altered tachycardia circuit that has had less time to
      recover excitability. Resetting is the interaction of a single paced beat with
      the tachycardia and, as such, provides a more accurate assessment of the
      characteristics of the unaltered tachycardia circuit.

PMID- 8462148
TI  - Frequency domain measures of heart rate variability before the onset of
      nonsustained and sustained ventricular tachycardia in patients with coronary
      artery disease.
AB  - BACKGROUND: Low heart rate variability (HRV) is associated with an increased risk
      of arrhythmic death and ventricular tachycardia (VT). The purpose of this study
      was to examine whether there is a temporal relation between changes in HRV and
      the onset of spontaneous episodes of VT in patients at high risk of life
      threatening arrhythmias. METHODS AND RESULTS: Components of HRV in the frequency
      domain were analyzed before the onset of 28 episodes of nonsustained VT (more
      than four impulses; duration < 30 seconds) and 12 episodes of sustained VT (> 30
      seconds or requiring defibrillation) in 18 patients with coronary artery disease.
      Seven patients had survived cardiac arrest not associated with acute myocardial
      infarction, and 11 had a history of sustained VT. All frequency domain measures
      of HRV, i.e., total power (p < 0.001), high-frequency power (p < 0.05), low
      frequency power (p < 0.01), very-low-frequency power (p < 0.01), and ultralow
      frequency power (p < 0.05), were significantly lower before the onset of
      sustained VT than before nonsustained VT. Total power of HRV was also lower
      during the 1-hour period before the onset of sustained VT than the average 24
      hour HRV (p < 0.05). An indirect correlation existed between the length of VT and
      the total power of HRV analyzed during the 15 minutes before the onset of VT (r =
      0.54, p < 0.01). HRV had a trend toward increasing values before the onset of
      nonsustained VT (p < 0.01) but not before the sustained VT episodes. The ratio
      between low-frequency and high-frequency powers increased substantially before
      both nonsustained and sustained VT episodes (p = 0.06 and p = 0.05,
      respectively). The rate of VT or the coupling interval initiating the VT did not
      differ significantly between the nonsustained and sustained VT. CONCLUSIONS:
      Spontaneous episodes of VT are preceded by changes in HRV in the frequency
      domain. Divergent dynamics of HRV before the onset of nonsustained and sustained
      VT episodes may reflect differences in factors that can facilitate the
      perpetuation of these arrhythmias.

PMID- 8462150
TI  - Magnetic resonance jet velocity mapping in mitral and aortic valve stenosis.
AB  - BACKGROUND: Magnetic resonance (MR) phase-shift velocity mapping is an
      established method for measurement of nonturbulent intravascular flow. Shortening
      the echo time of the MR sequence to 3.6 msec allowed application of the technique
      to turbulent jet flow. The objective of this study was validation of MR jet
      velocity mapping in patients with cardiac valve stenosis. METHODS AND RESULTS: We
      used a 0.5-T Picker MR machine to measure peak poststenotic jet velocity in 15
      consecutive patients recruited with known valve disease (six mitral stenosis,
      three of these restudied after valvoplasty, and 11 aortic stenosis). On the same
      day as the MR study, these patients underwent independent Doppler
      echocardiographic measurement of peak jet velocity. The results of 10 further MR
      investigations of aortic stenosis are also reported and compared with Doppler
      studies performed within 6 months. Of the 29 MR studies, 28 (97%) produced
      interpretable velocity maps, the one failure being attributed to misplacement of
      the imaging slice in a case of severe aortic stenosis. Agreement between MR and
      Doppler measurements of peak jet velocity in the recruited group was as follows:
      n = 18; range, 1.4-6.1 m/sec; mean, 3 m/sec; mean of differences (MR-Doppler),
      0.23 m/sec; standard deviation of differences, 0.49 m/sec. CONCLUSIONS: In vivo
      MR peak jet velocity measurements agree well with those made by Doppler
      ultrasound. The technique, which is not subject to restricted windows of access
      and has potential for further refinements, could contribute to improved
      evaluation of stenoses, especially at locations where ultrasonic access is
      limited.

PMID- 8462151
TI  - Suppression of protein degradation in progressive cardiac hypertrophy of chronic
      aortic regurgitation.
AB  - BACKGROUND: The heart adapts to the volume overload of aortic regurgitation with
      dilation and hypertrophy. The development of left ventricular hypertrophy at the
      protein level is a dynamic process resulting from an imbalance between cardiac
      protein synthesis and degradation. The objective of the present study was to
      determine in vivo the relative contributions of cardiac protein synthesis and
      degradation to the progressive hypertrophy that occurs in response to chronic
      aortic regurgitation and to compare these with responses earlier in the course of
      this stress. METHODS AND RESULTS: Continuous intravenous infusions of [3H]
      leucine were administered 3 days and 1 month after surgical induction of aortic
      regurgitation and sham operation in rabbits. Total cardiac protein and myosin
      heavy chain fractional synthesis rates were obtained by analysis of plasma and
      protein hydrolysate data using [14C]-dansyl chloride assays. Left ventricular
      growth rates were determined from serial echocardiographic and postmortem left
      ventricular weight and protein concentration measurements; protein degradation
      rates were determined by subtraction of growth rates from synthesis rates.
      CONCLUSIONS: In comparison with sham-operated control rabbits, protein fractional
      synthesis rates were increased at 3 days but not at 1 month after induction of
      aortic regurgitation Progressive cardiac hypertrophy occurring at 1 month was
      caused by a decrease in protein fractional degradation rates. An increase in
      protein synthesis contributes only to the early phase of hypertrophy caused by
      acute aortic regurgitation, whereas progressive eccentric hypertrophy in chronic
      volume overload is due to suppression of protein degradation.

PMID- 8462152
TI  - Intraluminal vapor bubble induced by excimer laser pulse causes microsecond
      arterial dilation and invagination leading to extensive wall damage in the
      rabbit.
AB  - BACKGROUND: Previous in vitro studies demonstrated that during excimer laser
      ablation of aortic tissue in saline, a fast-expanding and imploding vapor bubble
      is formed. The present in vivo study was designed to demonstrate the formation of
      a fast-expanding intraluminal bubble in flowing blood and to assess any damage to
      the adjacent arterial wall. METHODS AND RESULTS: Excimer laser pulses (one to 10,
      at 55 mJ/mm2 per pulse) were delivered coaxially in the femoral and iliac
      arteries of nine normal rabbits. Time-resolved flash photography of dissected
      arteries in situ demonstrated a 50% diameter increase within 75 microseconds
      after the laser pulse and a subsequent invagination (150-500 microseconds) that
      corresponded with the temporal course of the bubble expansion (up to 3.2 mm in
      diameter) and implosion observed in a hemoglobin solution. One day after laser
      light delivery, light microscopy (47 arterial segments) showed abrasion of the
      internal elastic lamina, medial necrosis, and extensive dissection planes filled
      with red blood cells. The degree (up to 100% medial necrosis) and extent of
      damage (up to 1.9 mm in length) increased with the number of delivered laser
      pulses. CONCLUSIONS: In blood, each excimer laser pulse generated a fast
      expanding and imploding vapor bubble. In vivo, the intraluminal vapor bubble
      produced microsecond dilation and invagination of the adjacent arterial segment,
      which induced dissections and extensive wall damage far beyond the penetration
      depth of 308-nm laser light (< 100 microns). This unique pattern of extensive
      wall damage observed in the rabbit might explain the mechanism of dissection
      observed in humans and might have an impact on the acute and chronic outcome
      after excimer laser coronary angioplasty.

PMID- 8462154
TI  - Development of the pharyngeal arch system related to the pulmonary and bronchial
      vessels in the avian embryo. With a concept on systemic-pulmonary collateral
      artery formation.
AB  - BACKGROUND: The literature is ambiguous as to the question of the developmental
      background of systemic-pulmonary collateral arteries. These are found in
      combination with various congenital heart malformations such as pulmonary
      atresia. From a clinical point of view, it is of interest to know whether we are
      dealing with the persistence of transient embryological vessels such as ventral
      segmental arteries or parts of pharyngeal arch arteries or with the prenatal or
      postnatal recruitment of the bronchial vasculature that normally supplies the
      lung. This study of the embryology of the extrapulmonary and intrapulmonary
      vasculature aims at a better understanding of the variations in origin, course,
      branching pattern, and histology of collateral arteries. METHODS AND RESULTS:
      Serial sections of quail embryos ranging between stage HH11 and stage HH28 were
      incubated with a monoclonal antibody (alpha MB1) against endothelial cells and
      their precursors. Additional series of chick embryos were injected with india ink
      to study the lumenized vascular patterns. A splanchnic plexus consisting of
      endothelial cells and precursors is present around the foregut before the lung
      buds develop. This plexus expands and gives rise to the pharyngeal arch arteries,
      the ventral pharyngeal veins, the pulmonary vessels, and the bronchial vessels,
      including the intrapulmonary vessel network. During two subsequent periods, the
      splanchnic plexus is transiently connected to the systemic arteries and veins.
      The bronchial arteries and veins develop in the second period from these
      transient vessels. The expansion and extension of the splanchnic plexus to many
      organs during the formation of the bronchial vessels explains the varying course
      and branching pattern of the bronchial vasculature. CONCLUSIONS: These results
      show that we are not dealing with two or more individual vascular systems that
      contribute to the developing vessels of the lungs but with one vascular plexus
      that normally gives rise to the pulmonary and bronchial vasculature but has the
      potential to give rise to other systemic-pulmonary connections.

PMID- 8462153
TI  - Overdrive stimulation of functional reentrant circuits causing ventricular
      tachycardia in the infarcted canine heart. Resetting and entrainment.
AB  - BACKGROUND: Clinical electrophysiology studies have used, for the most part,
      models of anatomic reentrant circuits to explain entrainment of ventricular
      tachycardia. Our studies use activation maps to directly determine mechanisms of
      entrainment of functional circuits that cause tachycardia. METHODS AND RESULTS:
      Electrograms were recorded from 192 sites on reentrant circuits in the epicardial
      border zone of canine myocardial infarcts during sustained ventricular
      tachycardia. Overdrive stimulation from different sites and at different cycle
      lengths was investigated. The reentrant circuits were shown to be functional, yet
      stimulated impulses could enter and repetitively reset the circuits
      (entrainment), demonstrating the presence of an excitable gap. Entrainment could
      occur from different stimulation sites with the stimulated impulses from each
      site activating the circuit with a different pattern. Entrainment, however, did
      not occur when the stimulated wave fronts obliterated the lines of functional
      block in the circuit. Fusion on the ECG occurred during entrainment when the
      stimulated impulses activated the ventricles concurrently with a previous
      stimulated impulse leaving the reentrant circuit at a different site. The first
      postpacing QRS was captured but not fused because it was caused by the last
      stimulated impulse emerging from the circuit. The first postpacing cycle length
      on the ECG was either equal to or longer than the overdrive cycle length
      depending on whether there was a fusion QRS during overdrive. The first
      postpacing cycle length at sites in the reentrant circuit equaled the pacing
      cycle length. At an appropriately short overdrive cycle length, stimulated
      impulses blocked in the circuit to terminate reentry. CONCLUSIONS: Functional
      reentrant circuits causing ventricular tachycardia can be reset and entrained.
      Activation maps directly show the mechanisms.

PMID- 8462155
TI  - Effect of prosthetic valve malfunction on the Doppler-catheter gradient relation
      for bileaflet aortic valve prostheses.
AB  - BACKGROUND: Considerable discrepancies between Doppler and catheter gradients
      caused by localized gradients and pressure recovery have been reported for normal
      bileaflet aortic valve prostheses. METHODS AND RESULTS: To examine whether this
      Doppler-catheter gradient relation is affected by prosthetic valve malfunction, a
      19-mm CarboMedics aortic valve was simultaneously studied with continuous-wave
      Doppler and catheter technique in normal function and in various states of
      malfunction ranging from slightly restricted opening to total occlusion of one
      leaflet. For each functional status, peak and mean gradients were measured at
      eight different flow rates (cardiac output, 2.0-6.0 L/min). Excellent correlation
      between Doppler and catheter gradients was found regardless of the valve function
      (r = 0.99, SEE = 1.0-3.3 mm Hg). However, the relation between Doppler and
      catheter gradient was highly dependent on the function of the valve as shown by a
      variation of slopes from 1.08 to 2.08. For the normally functioning valve (angle
      between flow axis and leaflet 5 degrees), peak and mean Doppler gradients were
      approximately twice the catheter gradients (slope, 2.08 and 2.03 for peak and
      mean gradients, respectively). Slightly restricted opening of one leaflet (22
      degrees) significantly altered the Doppler-catheter gradient relation, and slopes
      decreased to 1.69 (p < 0.01) and 1.52 (p < 0.001) for peak and mean gradients,
      respectively. The differences between Doppler and catheter gradients
      significantly decreased with further restriction of valve opening, and slopes
      ranged from 1.25 to 1.41 for angles between 34 degrees and 52 degrees. When one
      leaflet was totally occluded, the slope finally dropped to 1.08 for both peak and
      mean gradients, and Doppler gradients were only slightly greater than catheter
      gradients. Gradients increased with malfunction of the valve caused by reduction
      of the effective orifice area. However, the increase of Doppler gradients was
      considerably smaller than the increase of simultaneous catheter gradients.
      CONCLUSIONS: The discrepancies between Doppler and catheter gradients that have
      been reported for normally functioning bileaflet aortic valve prostheses may be
      reduced or even disappear in patients with malfunctioning valves. Furthermore,
      the increase of Doppler gradients caused by malfunction of the valve may
      underestimate the true hemodynamic changes.

PMID- 8462156
TI  - Cardiotoxicity of human recombinant interleukin-2 in rats. A morphological study.
AB  - BACKGROUND: One of the side effects of interleukin 2 (IL-2) cancer immunotherapy
      in humans is the vascular leak syndrome, which is frequently associated with
      depression of myocardial function, myocarditis, and myocardial necrosis. METHODS
      AND RESULTS: To investigate this cardiotoxicity, IL-2 (three doses of 5 x 10(5)
      Cetus units/day i.p.) was given to rats for 2, 3, or 5 days. Heart, lung, liver,
      spleen, and kidney tissues were studied by light and electron microscopy and with
      immunoperoxidase techniques. Cardiac changes consisted of focal lymphocytic and
      eosinophilic infiltration, myocyte vacuolization, myofibrillar loss, and
      necrosis. Ultrastructural alterations included swelling of endothelial cells,
      with dissociation of intercellular junctions, migration of lymphocytes into the
      interstitium, and interstitial hemorrhage and edema. Close contact between
      infiltrating lymphocytes, particularly large granular lymphocytes, and cardiac
      myocytes was often observed in areas of tissue damage. All lesions were more
      severe on day 5 than on days 2 and 3. Immunoperoxidase stains demonstrated asialo
      GM1 ganglioside antibody-positive, granular lymphocytes to be much more frequent
      in myocardium of IL-2-treated rats than in that of control rats. CONCLUSIONS:
      Although we cannot exclude the possibility of a direct toxic effect of IL-2 on
      myocytes, our observations suggest that the myocardial damage produced by this
      agent is triggered by IL-2-activated lymphocytes that exert cytolytic effects,
      first on endothelial cells and then on cardiac myocytes, thus producing lesions
      that involve both the cardiac microcirculation and the muscle cells.

PMID- 8462157
TI  - Experimental basis of determining maximum coronary, myocardial, and collateral
      blood flow by pressure measurements for assessing functional stenosis severity
      before and after percutaneous transluminal coronary angioplasty.
AB  - BACKGROUND: Severity of coronary artery stenosis has been defined in terms of
      geometric dimensions, pressure gradient-flow relations, resistance to flow and
      coronary flow reserve, or maximum flow capacity after maximum arteriolar
      vasodilation. A direct relation between coronary pressure and flow, however, may
      only be presumed if the resistances in the coronary circulation are constant (and
      minimal) as theoretically is the case during maximum arteriolar vasodilation. In
      that case, pressure measurements theoretically can be used to predict maximum
      flow and assess functional stenosis severity. METHODS AND RESULTS: A theoretical
      model was developed for the different components of the coronary circulation, and
      a set of equations was derived by which the relative maximum flow or fractional
      flow reserve in both the stenotic epicardial artery and the myocardial vascular
      bed and the proportional contribution of coronary arterial and collateral flow to
      myocardial blood flow are calculated from measurements of arterial, distal
      coronary, and central venous pressures during maximum arteriolar vasodilation. To
      test this model, five dogs were acutely instrumented with an epicardial, coronary
      Doppler flow velocity transducer. Distal coronary pressures were measured by an
      ultrathin pressure-monitoring guide wire (0.015 in.) with minimal influence on
      transstenotic pressure gradient. Fractional flow reserve was calculated from the
      pressure measurements and compared with relative maximum coronary artery flow
      measured directly by the Doppler flowmeter at three different levels of arterial
      pressure for each of 12 different severities of stenosis at each pressure level.
      Relative maximum blood flow through the stenotic artery (Qs) measured directly by
      the Doppler flowmeter showed an excellent correlation with the pressure-derived
      values of Qs (r = 0.98 +/- 0.01, intercept = 0.02 +/- 0.03, slope = 0.98 +/-
      0.04), of the relative maximum myocardial flow (r = 0.98 +/- 0.02, intercept =
      0.26 +/- 0.07, slope = 0.73 +/- 0.08), and of the collateral blood flow (r = 0.96
      +/- 0.04, intercept = 0.24 +/- 0.07, slope = -0.24 +/- 0.06). Moreover, the
      theoretically predicted constant relation between mean arterial pressure and
      coronary wedge pressure, both corrected for venous pressure, was confirmed
      experimentally (r = 0.97 +/- 0.03, intercept = 9.5 +/- 13.3, slope = 4.4 +/-
      1.2). CONCLUSIONS: These results provide the experimental basis for determining
      relative maximum flow or fractional flow reserve of both the epicardial coronary
      artery and the myocardium, including collateral flow, from pressure measurements
      during maximum arteriolar vasodilation. With a suitable guide wire for reliably
      measuring distal coronary pressure clinically, this method may have potential
      applications during percutaneous transluminal coronary angioplasty for assessing
      changes in the functional severity of coronary artery stenoses and for estimating
      collateral flow achievable during occlusion of the coronary artery.

PMID- 8462158
TI  - Cyclosporine A has no direct effect on collagen metabolism by cardiac fibroblasts
      in vitro.
AB  - BACKGROUND: Cyclosporine A has been implicated in the pathogenesis of myocardial
      interstitial fibrosis observed in heart transplant recipients. However, other
      confounding variables such as posttransplantation hypertension and rejection
      episodes may also be responsible for interstitial fibrosis development and
      associated abnormalities in ventricular diastolic function. Therefore, we
      examined whether cyclosporine A directly or indirectly affects fibrillar collagen
      metabolism by cardiac fibroblasts in vitro. METHODS AND RESULTS: Rat cardiac
      fibroblasts were isolated by collagenase digestion. Subconfluent cultures were
      then maintained (24 hours) in serum-containing or serum-free medium before
      addition of cyclosporine A (50-1,000 ng/mL). After an additional 24 hours, total
      procollagen synthesis, accumulation, and degradation were analyzed by measuring
      hydroxyproline content in the cell monolayer and in the ethanol-soluble and
      ethanol-precipitable fractions of the culture medium. mRNA levels for alpha 1(I)
      and alpha 1(III) procollagen polypeptides were assessed 2, 6, 12, and 24 hours
      after cyclosporine A treatment using Northern blot analysis. The results were
      compared with control cultures maintained in the absence of cyclosporine A. There
      were no differences in procollagen gene expression, total procollagen synthesis,
      accumulation, or degradation in cardiac fibroblasts treated directly with
      cyclosporine A, in concentrations up to 1,000 ng/mL, compared with untreated
      cells. In additional experiments, we examined whether cyclosporine A might
      stimulate the production of collagen regulatory substances by cardiac myocytes in
      culture. However, addition of conditioned media from neonatal myocytes maintained
      in the presence and absence of cyclosporine A (1,000 ng/mL) also had no effect on
      collagen deposition by cardiac fibroblasts. CONCLUSIONS: We conclude that
      cyclosporine A has no direct effect on collagen metabolism by cultured cardiac
      fibroblasts in vitro. In addition, we have excluded a paracrine effect of
      ventricular myocytes on collagen production in the presence of cyclosporine A.
      These results suggest that factors other than cyclosporine A are responsible for
      the interstitial fibrosis observed in cardiac allografts.

PMID- 8462159
TI  - Changes in diastolic function during development and correction of chronic LV
      volume overload produced by mitral regurgitation.
AB  - BACKGROUND: Mitral regurgitation (MR) causes an augmentation in left ventricular
      (LV) diastolic function, increasing early diastolic filling rate and decreasing
      LV stiffness. Whether these changes in diastolic function persist, return to
      normal, or become abnormal after mitral valve replacement (MVR) is unknown.
      METHODS AND RESULTS: Simultaneous LV echocardiography and catheterization studies
      were performed in six dogs in the baseline state (baseline), 3 months after
      creation of MR (chronic MR), and 3 months after MVR. Chronic MR caused LV
      dilation (end-diastolic dimension increased from 4.5 +/- 0.1 cm in baseline to
      5.8 +/- 0.1 cm in chronic MR, p < 0.05) and eccentric LV hypertrophy (LV-to-body
      weight ratio increased from 3.6 +/- 0.2 g/kg in baseline to 4.9 +/- 0.4 g/kg in
      chronic MR, p < 0.05). Chronic MR caused an increase in LV early diastolic
      filling rate (peak rate of increase in minor-axis dimension increased from 11 +/-
      1 cm/sec in baseline to 18 +/- 1 cm/sec in chronic MR, p < 0.05), did not change
      the time constant of myocardial relaxation (tau was 31 +/- 4 msec in baseline and
      30 +/- 2 msec in chronic MR), and caused a decrease in the modulus of regional
      chamber stiffness from 7.7 +/- 1.2 in baseline to 2.4 +/- 0.03 in chronic MR, p <
      0.05. MVR caused the resolution of LV dilation (end-diastolic dimension returned
      to normal [4.8 +/- 0.2 cm]), but three months after MVR, regression of LV
      hypertrophy was incomplete (LV-to-body weight ratio remained elevated [4.4 +/-
      0.5 g/kg]). After MVR, LV early diastolic filling rate (8 +/- 1 cm/sec), the
      relaxation time constant (31 +/- 2 msec), chamber stiffness (7.1 +/- 1.8),
      myocardial stiffness (11.2 +/- 3.1), and LV end-diastolic pressure (8 +/- 1 mm
      Hg) returned to normal. CONCLUSIONS: The enhanced diastolic function seen in
      chronic MR returned to normal after correction of the chronic volume overload by
      MVR.

PMID- 8462160
TI  - Functional dissociation of cellular activation as a mechanism of Mobitz type II
      atrioventricular block.
AB  - BACKGROUND: Several mechanisms have been advanced to explain Mobitz type II
      atrioventricular block in the ischemically damaged His-Purkinje system. Only
      recently, however, has an animal model been developed to study this form of
      conduction defect in vivo and in vitro. METHODS AND RESULTS: Conduction defects
      were induced in anesthetized dogs by ischemic damage to the proximal His-Purkinje
      system after anterior septal artery ligation. Stable 2:1 atrioventricular block,
      localized within the His bundle or in the proximal bundle branches, was obtained
      in each dog by atrial pacing at an average rate of 239 +/- 20 beats per minute (n
      = 12). In vitro studies were then performed from the same hearts. Action
      potentials and electrograms were simultaneously recorded from the His bundle and
      the proximal right bundle branch at the site of damage. At slow rates of pacing
      (40-60 beats per minute), the action potential amplitude was 85 +/- 4 mV, and
      some cells (10 +/- 3%) showed dissociation from the electrical activity in the
      bundle. At fast rates (149 +/- 11 beats per minute), during 1:1 conduction, the
      frequency of cellular dissociation increased to 57 +/- 6% (p < 0.001), and the
      action potential amplitude decreased (-31 +/- 4%, p < 0.001). The frequency of
      dissociation closely correlated with the reduction in action potential amplitude
      (r = 0.87, p < 0.001). These changes were markedly attenuated once 2:1 block
      developed. The site of block was not constant but rather showed a dynamic
      behavior with spatial shifting in response to changes in pacing rate or the
      introduction of extrastimuli. CONCLUSIONS: These results indicate that in the
      ischemically damaged proximal His-Purkinje system, an increase in rate leads to
      reduced and asynchronous cellular activation before 2:1 block. The latter
      provides a more stable activation pattern, because the frequency of dissociation
      is markedly reduced.

PMID- 8462161
TI  - Coronary angiography: more than meets the eye.

PMID- 8462162
TI  - 'Ultra' coronary arteries: bigger and better?

PMID- 8462163
TI  - Prognostic impact of late potentials in nonischemic dilated cardiomyopathy.
      Potential signals for the future.

PMID- 8462164
TI  - Nonthoracotomy defibrillator lead systems. A welcomed addition but still a lot to
      learn.

PMID- 8462165
TI  - Myocardial ischemia during pharmacological stress testing.

PMID- 8462166
TI  - Hemodynamic overload and the regulation of myofibrillar protein degradation.

PMID- 8462167
TI  - In search of the optimized excimer laser angioplasty system.

PMID- 8462168
TI  - Transient entrainment of tachycardias.

PMID- 8462169
TI  - High stored iron levels and the risk of myocardial infarction.

PMID- 8462170
TI  - Infective endocarditis after transesophageal echocardiography.

PMID- 8462171
TI  - Transesophageal echocardiography and bacterial endocarditis.

PMID- 8462172
TI  - Smoking and acute myocardial infarction.

PMID- 8462173
TI  - Stability of plasma atrial natriuretic peptide.

PMID- 8462174
TI  - Prevention: the key to progress.

PMID- 8462176
TI  - Genetics of lipoprotein disorders.
AB  - Lipoproteins are circulating complexes of lipids and proteins, the transport and
      metabolism of which are directly controlled by apolipoproteins A-I, A-II, A-IV,
      B, C-I, C-II, C-III, D, E, and (a); lipoprotein-processing proteins lipoprotein
      lipase, hepatic lipase, lecithin-cholesterol acyltransferase, and cholesteryl
      ester-transfer protein; and lipoprotein receptors, low density lipoprotein (LDL)
      receptor, chylomicron remnant receptor, and scavenger receptors. Studies have
      shown a close association between lipoprotein abnormalities and coronary artery
      disease susceptibility. Four types of abnormalities are frequently seen:
      increased LDL cholesterol levels; decreased high density lipoprotein cholesterol
      levels, usually accompanied by increased triglyceride or very low density
      lipoprotein levels; increased concentrations of chylomicron remnants and
      intermediate density lipoproteins; and increased concentrations of an abnormal
      lipoprotein, lipoprotein (a). One or more of these abnormalities is present in 50
      80% of myocardial infarction survivors. The exact pathogenic process whereby each
      of these abnormalities causes coronary artery disease is a subject of active
      investigation but beyond the scope of this brief presentation. However, the
      genetic contribution to each of these abnormal lipoprotein phenotypes is coming
      into focus and is discussed.

PMID- 8462175
TI  - Phenotyping. On reaching base camp (1950-1975).
AB  - The search for plasma lipoproteins began at the turn of the century. It was not
      until 1949 that a meeting of the Faraday Society celebrated the separation of the
      alpha and beta lipoproteins. At that moment, ultracentrifugists in Berkeley were
      already busily converting "alpha" to high density lipoprotein and "beta" to low
      density lipoprotein; the modern era of lipoproteins had begun. Over the
      succeeding 10 years, a quarrel over whether the level of Sf 0-20 or cholesterol
      was the more powerful risk factor ended with an eclipse of the analytical
      ultracentrifuge and a surge of interest in the biological side of lipoproteins.
      The postheparin clearing factor became lipoprotein lipase, and free fatty acids
      were discovered. In 1960, abetalipoproteinemia and Tangier disease suggested that
      the apolipoproteins must be specific and spurred a hunt for their number and
      nature. The first amino acid sequences aroused speculation of "amphipathic
      helices." By 1970, conversion of hyperlipidemia to five types of
      hyperlipoproteinemia led to worldwide fascination with electrophoretic patterns,
      "floating beta," and "the Friedewald formula" as codes for genetic abnormalities
      leading to early coronary artery disease. A few years later, the appearance of
      "familial combined hyperlipidemia" confounded the phenotyping, and the discovery
      of the low density lipoprotein receptor heralded the coming of true genotypes.
      This is a Bethesda-based story of the "climb to base camp" preceding the joining
      of molecular biology with the research on lipoproteins, dyslipoproteinemia, and
      atherosclerosis.

PMID- 8462177
TI  - Heterogeneity of high density lipoprotein particles.
AB  - Human high density lipoprotein (HDL) contains at least two types of lipoprotein
      containing A-I particles: one contains both apolipoproteins (apo) A-I and A-II
      (Lp A-I:A-II) as main protein components, whereas in the other, apo A-II is
      absent (Lp A-I). The two subpopulations have different metabolisms and
      physiological roles. Studies indicate that apo A-II is an antagonist of
      cholesterol efflux. Lp A-I but not Lp A-I:A-II is increased in women compared
      with men. The lower apo A-I levels in patients with coronary artery disease
      reflect a decrease in Lp A-I. Lp A-I also is decreased in children with a family
      history of coronary artery disease, and increased in elderly subjects. Despite
      cholesterol intake remaining constant, a high polyunsaturated:saturated fat diet
      leads to a decrease in Lp A-I but not Lp A-I:A-II. Chronic alcohol consumption
      induces an increase in Lp A-I:A-II and a decrease in Lp A-I, although short bouts
      of drinking produce increases in both Lp A-I and Lp A-I:A-II. Hypolipidemic drugs
      have specific effects on discrete apo A-I particles.

PMID- 8462178
TI  - High density lipoproteins, reverse transport of cholesterol, and coronary artery
      disease. Insights from mutations.
AB  - BACKGROUND: The reverse cholesterol transport model is most widely used to
      explain both the role of high density lipoproteins (HDL) in lipid metabolism and
      the inverse association between HDL cholesterol plasma concentration and the risk
      for coronary artery disease (CAD). As familial HDL cholesterol deficiency is
      frequently paralleled with a family history of premature CAD, much interest has
      been directed toward the molecular defects in apolipoproteins and lipid-transfer
      enzymes involved in the formation and metabolism of HDL. Knowledge of the basic
      defects in rare HDL-deficiency syndromes and apolipoprotein variants provides
      genetic markers of whether the presence of these molecular defects accounts for
      low HDL cholesterol levels and the accompanying coronary risk. METHODS AND
      RESULTS: Sequence analysis of proteins or DNA from patients with HDL deficiency
      or hyperalphalipoproteinemia as well as from randomly screened probands has
      helped to identify a series of molecular defects in the genes of apolipoprotein
      (apo) A-I, apo A-II, apo A-IV, apo C-III, lecithin cholesterol acyltransferase,
      and cholesterol ester-transfer protein. Some of these mutations were associated
      with absent and low levels of HDL cholesterol in homozygous and heterozygous
      carries, respectively, but only a few homozygotes were at an increased risk of
      CAD. These mutations were invaluable for gaining insight into structural
      functional relations in HDL metabolism. CONCLUSIONS: Mutations in the genes of
      apo A-I, apo A-II, apo A-IV, apo C-III, lecithin cholesterol acyltransferase, and
      cholesterol ester-transfer protein can influence HDL cholesterol plasma
      concentrations but do not account for the coronary risk associated with low HDL
      cholesterol levels. In general, these observations suggest that the low HDL
      concentrations in CAD patients are not a reflection of impaired reverse
      cholesterol transport but rather of some other metabolic disturbances, such as
      catabolism of triglyceride-rich particles.

PMID- 8462179
TI  - Genetic determinants of responsiveness to the HMG-CoA reductase inhibitor
      fluvastatin in patients with molecularly defined heterozygous familial
      hypercholesterolemia.
AB  - BACKGROUND: In familial hypercholesterolemia, plasma lipoproteins can be
      modulated by 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase
      inhibitors, although the underlying response mechanisms are still unknown.
      METHODS AND RESULTS: A single-blind study with fluvastatin, an HMG-CoA reductase
      inhibitor, was conducted in 64 familial hypercholesterolemia patients who had
      defined apolipoprotein E (apo E) and apolipoprotein(a) [apo(a)] isoforms. Plasma
      lipids and lipoproteins were analyzed throughout the study. The patients were
      grouped according to low density lipoprotein (LDL) receptor genotype. After 4
      weeks of treatment with 40 mg of fluvastatin, the mean decrease in plasma LDL
      cholesterol (LDL-C) in patients with the genetically characterized "Sephardic"
      and "Lithuanian" mutations was 16-18%, whereas in the other three groups, it was
      25-30% (p < 0.005). High density lipoprotein cholesterol (HDL-C) levels increased
      in all groups. Multivariate analyses suggested that 41% of the LDL-C response can
      be explained by the LDL receptor mutation, body mass index, apo E3/E4 phenotype,
      apo(a) isoform LpS2, and baseline LDL-C levels, and 46% of the change in HDL-C is
      associated with age, sex, body mass index, baseline HDL-C, and the Sephardic
      mutation. CONCLUSIONS: Fluvastatin exhibits diverse and independent effects on
      plasma lipoproteins related to several constitutional, genetic, and familial
      factors. Information regarding these factors may provide better prediction of
      patients' clinical responses to fluvastatin.

PMID- 8462180
TI  - A quarter century of drug treatment of dyslipoproteinemia, with a focus on the
      new HMG-CoA reductase inhibitor fluvastatin.
AB  - Disorders associated with the overproduction or delayed clearance of beta-very
      low density lipoprotein and low density lipoprotein (LDL) are strikingly related
      to premature coronary artery disease. There are five recognized classes of LDL
      lowering drugs, each acting through different basic mechanisms. The increased
      predictability, safety, and efficacy of newer lipid-lowering agents have allowed
      controlled clinical trials to demonstrate conclusively that reducing LDL leads to
      a reduction in coronary artery disease. Fluvastatin, a 3-hydroxy-3-methylglutaryl
      coenzyme A (HMG-CoA) reductase inhibitor, is almost completely absorbed, actively
      targeted to the liver, and secreted in the bile. It has no active circulating
      metabolites. The safety and efficacy of fluvastatin have been demonstrated in
      more than 2,500 subjects treated in the United States, Canada, and Europe, and
      more than 1,000 have been treated for more than 1 year. Combination of
      fluvastatin with cholestyramine results in additional cholesterol lowering. The
      Lipoprotein and Coronary Atherosclerosis Study, a randomized, double-blind trial
      of fluvastatin using quantitative coronary angiography to measure atherosclerotic
      plaque change and positron emission tomography to evaluate myocardial perfusion
      (myocardial flow reserve), illustrates the further exploration of lipoproteins
      and atherogenesis made possible by the availability of this new generation of
      cholesterol-lowering agents.

PMID- 8462181
TI  - Dyslipidemia and atherosclerosis. A forecast of pharmaceutical approaches.
AB  - Five classes of lipid-lowering drugs are approved by the Food and Drug
      Administration (FDA) for use in the United States: nicotinic acid, bile acid
      sequestrants, fibric acid derivatives, reductase inhibitors, and probucol. None
      of the agents has an antiatherosclerotic indication. Cholestyramine and
      gemfibrozil have received indications for preventing complications of
      atherosclerosis, namely, myocardial infarction and coronary artery disease death.
      Foreseeable pharmacological strategies to reduce lipid-related cardiovascular
      risk might be divided into three categories. First, the present approach of
      lowering lipid and lipoprotein concentrations might be extended through
      modification of available agents (e.g., a more potent or soluble bile acid resin)
      or development of agents of novel mechanism (e.g., acyl-CoA:cholesterol
      acyltransferase [ACAT] inhibition or inhibition of cholesterol biosynthesis at a
      step other than HMG-CoA reductase). Second, blood lipids could be directly
      addressed outside of lipid-lowering strategies. Raising high density lipoprotein
      (HDL) cholesterol levels has not been fully explored, or the target might be
      modification of the lipoproteins themselves rather than their concentrations.
      Areas of particular interest in the latter regard are hepatic lipase activity,
      cholesteryl ester transfer protein activity, and differences between oxidized or
      otherwise modified low density lipoprotein (LDL) particles and normal LDL. Third,
      it may be possible to directly lessen the atherosclerotic potential of the vessel
      wall (e.g., through protecting it from the effects of certain growth factors or
      altering its state of relaxation.

PMID- 8462182
TI  - Norcolut with immune modulators in the complex treatment for hyperplastic uterine
      processes.
AB  - The results are presented of the treatment of 55 patients for hyperplastic
      endometrial processes with the preparation norcolut combined with the immune
      modulators thymalinum and myelopidum. It was found that the application of the
      suggested schemes of the introduction of the medicines mentioned increase the
      treatment effectiveness and enlarges its possibilities.

PMID- 8462183
TI  - The significance of the relationship between serum levels of cobalamin and MCHC
      during pregnancy.
AB  - Cobalamin concentration and mean corpuscular haemoglobin concentration (MCHC)
      were found to have highly significant inverse correlation with the weeks of
      pregnancy (respectively -.278 P < .0001 and .342 P < .00001) in 205 pregnant
      women. Among all haematometric parameters cobalamin concentrations during
      pregnancy only correlates with MCHC (P < .01). This datum seems to indicate an
      influence of B12 on erythropoiesis which adequate the concentration of
      haemoglobin to circulatory modifications of pregnant women.

PMID- 8462184
TI  - Infectious morbidity in gynecologic oncologic surgery. A clinical and economic
      evaluation.
AB  - In the Department of Obstetrics and Gynecology, Faculty of Medicine, Varese,
      between March 1991 and February 1992, 70 consecutive patients undergoing elective
      oncologic surgery were evaluated for rationalizing the use of antibiotics in
      order to reduce the cost of infectious complications. We divided our patients
      into two groups: a high infection risk group and a low infection risk group. Our
      findings show that: the HIR group shows a higher antibiotic cost than LIR one;
      our selection criteria for HIR patients are probably correct; in the LIR group
      46.6% of patients were not submitted to any antibiotic therapy.

PMID- 8462185
TI  - Immunoglobulins IgG, IgA, IgM, complement C3, C4 and ferritin and transferrin
      levels in serum and follicular fluid in IVF patients.
AB  - Serum and follicular fluid immunoglobulin (IgG, IgA, IgM) and complement (C3,
      C4), as well as transferrin and ferritin concentrations were measured in 82
      consecutive IVF patients (Pregnant: Group A, and non pregnant: Group B). Higher
      serum concentrations were observed in complement in all Immunoglobulins but IgM
      which was found to be significantly lower in follicular fluid in both groups.
      Also there were no statistically significant differences observed for transferrin
      and ferritin levels in either compartment or among the groups. No correlation was
      found for the above parameters and the in vitro fertilization outcome in terms of
      oocytes retrieved, fertilized and embryos implanted.

PMID- 8462186
TI  - The prevalence of the precancerous lesions in breasts contralateral to clinical
      cancer. A morphological comparison with breasts containing a benign lump.
AB  - Two small series (nine cases each) of human female breasts were collected to
      compare the morphological changes of mammary glandular trees contralateral to
      primary breast cancer and those collateral to symptomatic benign lump. Each whole
      mammary gland was analysed by a submacroscopic scrutiny method using a
      stereomicroscope. Interesting and suspicious samples were removed for routine
      histology. Benign subclinical lesions were indifferently present in both series:
      Spheric cysts (5:5), sclerosing adenosis (3:3), intraductal papillomas (1:1),
      fibroadenomas (3:1). On the contrary proliferative epithelial lobular lesions
      with various degree of atypia i.e. atypical lobules (Grades IV-V according to
      Wellings), were detected only in the first series (p < 0.01). These data agree
      completely with the hypothesis of a systemic nature of breast cancer and support
      indirectly the possible predictive value of atypical lobules in bioptic specimens
      for the subsequent development of cancer in collateral and/or contralateral
      breasts.

PMID- 8462187
TI  - Sperm dysfunction in partners of infertile patients with minimal or mild
      endometriosis.
AB  - A review of the literature does not show that minimal or mild endometriosis
      unquestionably causes infertility although its association is known; the cause
      only becomes apparent as the disease progresses. In these patients therefore,
      prolonged infertility for other reasons may have exacerbated or predisposed a
      tendency in them to develop the disease. Sperm dysfunction in their partners may
      have been one factor. Sperm penetration assays using mid-cycle (estrus) bovine
      cervical mucus were studied in 22 men whose wives were confirmed to have minimal
      or mild endometriosis. All men had normal semen analyses. For controls, 16 men of
      proved fertility were used. Whilst all but one (94%) of the fertile men showed
      adequate penetration (> 30 mm), only 59% of the men in the study group achieved
      this penetration (p < 0.05). These findings provide evidence that minimal or mild
      endometriosis may not be the primary cause of infertility in patients in whom the
      diagnosis is made.

PMID- 8462188
TI  - Salivary ferning and the menstrual cycle in women.
AB  - The Authors report the data relative to the monitoring of menstrual cycle carried
      out by the observation of salivary ferning. They compared the usual physical and
      hormonal parameters of four groups of women with the aspect of the
      crystallisation of the saliva observed both by normal optical microscope and by a
      special type of pocket microscope which can be used by women themselves. In
      conclusion the Authors report a careful examination of the biochemical
      correlation relating the women's hormonal climate and its salivary constituents.

PMID- 8462189
TI  - Resuscitating fresh stillbirths.
AB  - Guidelines for duration of resuscitation of freshly-stillborn term infants and
      their long term outcome are unclear. The predictive factors of both cerebral
      palsy and early neonatal demise include Apgar scores of 3 or less at 10 minutes,
      perinatal acidaemia and neonatal seizures. We describe the case of severe
      perinatal asphyxia (umbilical artery pH at birth of 6.75, Apgar scores of 0.1 and
      5 0.1 5 at 1.5 and 10 minutes and neonatal hypertonia) in a term pregnancy, where
      the infant made an uneventful recovery and was discharged home well. Guidelines
      for neonatal resuscitation are discussed.

PMID- 8462190
TI  - Treatment of idiopathic infertility with testosterone undecanoate. A double blind
      study.
AB  - This study refers to 50 couples treated for subfertility. Twenty five of these
      patients were treated with TU (Testosterone Ur econoate), the remaining 25
      received placebo. Sperm characteristics, including ejaculate volume, pH, sperm
      density, morphology, motility, total testosterone, FSH, LH, DHT and E2 were
      evaluated both before and after treatment. A statistically significant increase
      of DHT levels was noticed after TU administration, whereas a marginally
      significant improvement of sperm morphology was present. Serum FSH
      concentrations, decreased significantly in the TU group whereas serum LH
      presented a slight but not statistically significant decrease; 4 pregnancies were
      achieved by the TU group whereas none were achieved by the patients belonging to
      the placebo group. The administration of TU per os to patients with idiopathic
      oligospermia presents a demonstrably positive effect.

PMID- 8462191
TI  - Characterization of a deleted Y chromosome in a male with Turner stigmata.
AB  - A 46,X,+mar karyotype was detected in an 11-year-old male with a clinical picture
      characterized by obesity, short stature, bilateral cryptorchidism and coarctation
      of the aorta. The presence of ZFY and SRY genes was demonstrated by PCR
      amplification, and the origin of the marker chromosome from a deleted Y
      chromosome was analyzed by in situ hybridization. The proximal limits of a
      deletion in Yq were defined by the absence of Southern blot hybridization signals
      upon probing with Yq11 markers. Cytogenetics and molecular methods taken together
      indicate a deletion in q11.21. In addition, the loss of Yp subtelomeric sequences
      was suggested by the analysis of Southern blots hybridized with a 29A24 (DXYS14)
      probe and by the presence of coarctation of the aorta tentatively localized in
      Yp. The karyotype of the patient was suggested to be: 46,X,del (Y) (p11.3
      q11.21).

PMID- 8462192
TI  - Familial occurrence of hereditary renal adysplasia with mullerian anomalies.
AB  - We report on a family with unilateral or bilateral renal agenesis and Mullerian
      anomalies (vaginal atresia or minor anomalies). This family provides support for
      an autosomal dominant pattern of inheritance with incomplete penetrance and
      variable expressivity in hereditary renal adysplasia (HRA) associated with
      Mullerian defects.

PMID- 8462193
TI  - Infant mortality in myotonic dystrophy in Saguenay-Lac-St-Jean: a historical
      perspective.
AB  - Infant mortality among children born to 373 individuals with myotonic dystrophy
      (MD) who lived in Saguenay-Lac-St-Jean during the period 1838 to the present time
      was analyzed using a case-control approach based on a population register. A
      statistically significant increase was found in the rate of deaths during the
      first week of life among children born to MD mothers (57.5%) compared to control
      mothers (34.8%) and MD fathers (39.1%) (p < 0.01). The stillbirth rate was not
      increased. The rate of mortality after the first week fell significantly in both
      MD and control groups during the period of observation. There was evidence of a
      slight selective disadvantage among this MD population.

PMID- 8462194
TI  - Heritable unstable DNA sequences and hypermethylation associated with fragile X
      syndrome in Japanese families.
AB  - Fragile X syndrome, associated with the fragile site at Xq27.3 (FRAXA), is the
      most common form of familial mental retardation. The fragile X mutation has
      recently been characterized as a heritable unstable DNA sequence,
      p(CCG)n/p(CGG)n, in the FRAXA locus. In the present study, a correlation between
      fragile X-genotypes in the FRAXA locus and hypermethylation of an adjacent CpG
      island was examined in four Japanese families with fragile X syndrome. We show
      here that the heritable unstable DNA sequences in the fragile X chromosome
      usually increase in size when transmitted by female carriers, and that the degree
      of methylation in the CpG island correlated with the increased sizes of the
      unstable DNA sequences. When a hypermethylated full mutation was transmitted by a
      male to his daughters, both the size of the unstable DNA sequence and the degree
      of the methylation reduced to the premutation range. Our observations suggest
      that female meiosis has a greater potential for amplifying unstable DNA sequences
      and that amplified DNA sequences can be transmitted through germ cells, while
      male germ cells seem not to be able to tolerate highly amplified unstable DNA
      sequences.

PMID- 8462195
TI  - A balanced autosomal translocation (3;9) associated with primary hypogonadism and
      dorsal spine stenosis.
AB  - A man with a balanced translocation between chromosomes 3 and 9 associated with
      primary hypogonadism and dorsal spine stenosis is reported. The possible
      significance of this chromosomal abnormality is discussed.

PMID- 8462196
TI  - Trisomy 13 (Patau syndrome) with an 11-year survival.
AB  - Trisomy 13 is very rare in live-born children. Only a small number of these
      children survive the first year and very few cases are reported to live longer.
      Survival time depends partly on the cytogenetic findings--full trisomy 13 or
      trisomy 13 mosaicism--and partly on the existence of serious somatic
      malformations. We report on a 11-year-old girl with full trisomy 13. In this
      case, missing cerebral and cardiovascular malformations probably allowed the long
      survival.

PMID- 8462197
TI  - Fluorescence in-situ hybridisation and molecular studies used in the
      characterisation of a Robertsonian translocation (13q15q) in Prader-Willi
      syndrome.
AB  - A patient with classical Prader-Willi syndrome was found to have a Robertsonian
      translocation 45,XY,t(13q15q)mat. On CBG banding, the translocation chromosome
      had a large centromere with one primary constriction. Using fluorescence in situ
      hybridisation, positive signals were obtained with chromosome 13 and chromosome
      15 centromere probes, proving that the translocation was dicentric. NOR banding
      was negative in this chromosome, suggesting that the breakpoints were at 13p11
      and 15p11. DNA studies showed that, while there was no deletion involving 15(q11
      13), maternal uniparental disomy for chromosome 15 was present. We compare our
      findings with the five other cases of familial Robertsonian translocation PWS
      that have been reported.

PMID- 8462198
TI  - Kallmann syndrome in two sisters with other developmental anomalies also
      affecting their father.
AB  - The classical features of Kallmann syndrome with anosmia and hypogonadotropic
      hypogonadism were observed in two sisters aged 13 and 19. They had additional
      malformations including anosmia, bilateral vesico-ureteral reflux and unilateral
      hearing loss. One of the girls had unilateral coloboma of the optic nerve. The
      father had unilateral hearing loss and duplication of the left ureter; he died of
      an unrecognized coarctation of the aorta. He had no clinical signs of
      hypogonadism or anosmia. It is suggested that the malformations observed in these
      patients may be due to a dominant inherited defect of embryonic cell migration,
      resulting in different phenotypic expressions within the same family, including
      the Kallmann syndrome.

PMID- 8462199
TI  - Interstitial deletion del(17) (q21.3q23 or 24.2) syndrome.

PMID- 8462200
TI  - Hereditary complete deficiency of the fourth component of complement: effects on
      the kidney.
AB  - Hereditary complete C4 deficiency has until now been detected in 18 patients. A
      disturbed clearance of immune complexes probably predisposes these individuals to
      systemic lupus erythematosus and other immune complex diseases. Renal involvement
      of hereditary complete C4 deficiency is described in seven patients from three
      families. Three patients of one family suffered from SLE and a severe mesangial
      and endocapillary proliferative glomerulonephritis which required
      immunosuppressive treatment. In two patients from a second family a mild focal
      and segmental mesangioproliferative glomerulonephritis was present which, except
      for an episode of acute renal failure in one patient, did not cause serious
      clinical problems. One additional child died without renal involvement. The
      patient from a third family developed Henoch-Schoenlein purpura,
      mesangioproliferative glomerulonephritis with segmental scarring and terminal
      renal failure. Immunofluorescence studies showed deposition of immunoglobulins
      and complement C3 in the glomeruli. Severity of renal disease is probably
      determined by activation of the alternative pathway of complement in the kidney.

PMID- 8462201
TI  - Effects of topical instillation of minocycline hydrochloride on cyst size and
      renal function in polycystic kidney disease.
AB  - To reduce renal cyst size in autosomal dominant polycystic kidney disease
      (ADPKD), minocycline hydrochloride solution was instilled into the enlarged cysts
      in three ADPKD patients. In one patient with reduced renal function, such
      sclerotherapy apparently diminished cyst size, but without apparent improving
      effect on renal function at 7 months of follow-up. The second patient, who needed
      the replacement therapy on admission, had been free from hemodialysis over 4
      months after the therapy. Persistent flank pain disappeared in both patients. In
      the third patient with normal renal function, sclerotherapy was done to get a
      better control of hypertension. Initially blood pressure decreased, but it
      returned up to the pre-therapy level irrespective of definite reduction of the
      enlarged cysts at 8 months of follow-up. The therapy with minocycline
      hydrochloride did not appear harmful, and may be helpful in the management of
      ADPKD.

PMID- 8462202
TI  - Renal functional reserve in elderly patients.
AB  - The concept of renal functional reserve (RFR) is used in the evaluation of renal
      function in health and disease. RFR is defined as the difference between
      glomerular filtration rate (GFR) at rest and the maximum GFR for example under
      stimulation by an amino acid infusion or a protein rich meal. GFR decreases
      normally with age by about 1 ml/min per year. The purpose of this study was to
      establish the effect of the GFR decrease with age on absolute and relative values
      of RFR. We investigated 12 hospitalized patients 60 to 85 years of age (mean 74
      +/- 2.0 SEM) recovering from nonrenal disease. On two consecutive days, inulin
      and paraaminohippuric acid (PAH) clearance was performed over a period of 4
      hours. On day A patients received 1 liter of a 5% glucose solution i.v. On day B
      an equal volume of an amino acid solution (2 mg/kg/min) was given. In these
      elderly patients baseline GFR without stimulation measured 73.2 +/- 7.9 ml/min
      per 1.73 m2 and stimulated GFR was 99.1 +/- 8.5 ml/min, a 35.3% increase (p <
      0.025). Thus, renal functional reserve measured 25.9 +/- 8.7 ml/min. PAH
      clearance increased from 329.0 +/- 41.9 ml/min per 1.73 m2 to 438.8 +/- 50.3
      ml/min (p < 0.025). These data confirm that baseline GFR is lower in the elderly
      compared to young adults. However, renal functional reserve is well maintained in
      elderly human subjects. This suggests that glomerulosclerosis of aging may not be
      the only explanation for the low baseline GFR in the elderly.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8462203
TI  - Myocardial functions of children with acute poststreptococcal glomerulonephritis.
AB  - Left ventricular function was investigated by two-dimensional and M-mode
      echocardiography in 35 patients with acute poststreptococcal glomerulonephritis
      and in 25 healthy controls. Six of these patients were found to have myocardial
      dysfunction during the acute congestive phase and convalescent phases of APSGN.
      One of these 6 patients, later, died. No correlations were determined between
      myocardial dysfunction and hypertension, cardiac failure, pericardial and pleural
      effusion. As a result, left ventricular function may be impaired in acute
      congestive phase of APSGN and this may affect the course and prognosis of the
      disease.

PMID- 8462204
TI  - Acute renal failure associated with non-fulminant hepatitis A.
AB  - A 49-year-old man developed acute renal failure as a complication of non
      fulminant hepatitis A. This is a rare association of uncertain etiology.

PMID- 8462205
TI  - Clinical experience with a new antithrombotic (dermatan sulfate) in chronic
      hemodialysis patients.
AB  - Dose finding studies with a new antithrombotic (dermatan sulfate) for the
      prevention of clot formation in the extracorporeal circuit were performed in
      chronic hemodialysis patients in comparison with standard heparin treatment.
      Dermatan sulfate (DS), which inhibits the coagulation via the heparin cofactor II
      pathway, was given in single predialysis injections, immediately before
      commencement of the dialysis procedures, in dosages ranging from 2 mg/kg to 6
      mg/kg body weight. In our pilot study, an open non comparative study in patients
      using plate type dialyzers, we observed moderate clot formation in the
      extracorporeal circuit. In our second study, with a randomized heparin-controlled
      design in patients with plate type dialyzers, still significant clot formation
      occurred in the extracorporeal circuit. In the third study, in chronic
      hemodialysis patients using a cuprophane hollow fiber dialyzer, we also
      investigated the addition of a small bolus of standard heparin (20 I.U./kg body
      weight) to the injection of DS. A single bolus injection of 6 mg/kg, with or
      without the addition of a bolus of standard heparin, had a comparable efficacy as
      standard heparin treatment. No major bleeding events were encountered in the
      studies and DS had a reduced effect on the activated partial thromboplastin time
      as compared to standard heparin. In conclusion, these results suggest that DS in
      a dose of 6 mg/kg, with or without a small dose of standard heparin, given as
      single predialysis bolus injections, appears to be an effective alternative to
      standard heparin and, in addition, it may simplify the anticoagulant
      administration protocol.

PMID- 8462206
TI  - Bioelectrical impedance in the evaluation of the nutritional status of
      hemodialyzed diabetic patients.
AB  - Bioelectrical impedance is a technique allowing a quick, repeatable and reliable
      assessment of body composition. This method was applied to detect total body
      water (TBW), fat (FAT) and fat-free mass (FFM) in 80 normal subjects, 65 diabetic
      (45 insulin-dependent [IDD], 20 non insulin-dependent [NIDD]) and 34 uremic
      diabetic patients (20 IDD, 14 NIDD) submitted to hemodialysis three times a week.
      Uremic patients were tested at the end of the dialytic session. Multivariated
      analysis adjusted for age, sex and disease showed the following results: body
      mass index (BMI) increased with age (p < 0.005) and in the presence of NIDD (p <
      .001); TBW was lower in nephropathic patients (p < 0.05) and in the female sex (p
      < 0.0001); FFM decreased with age (p < 0.005), female sex (p < 0.0001) and in
      nonuremic NIDD (p < 0.001). Correspondingly FAT increased with age (p < 0.005),
      female sex (p < 0.0001) and in nonuremic NIDD (p < 0.001). Sixteen uremic
      subjects, randomly selected from both IDD and NIDD groups, tested at the
      beginning and at the end of the same hemodialytic session, showed a significant
      decrease of TBW which corresponded to the correction of their overhydratation. In
      our patients uremia does not seem to influence the nutritional status and the
      bioelectrical analysis could be applied to determine the real dry weight in
      hemodialyzed diabetic patients.

PMID- 8462207
TI  - Evaluation of maxillofacial vascular abnormalities with Tc-99m RBC.
AB  - Three-phase scintigraphy using Tc-99m RBC was performed in seven patients with
      vascular abnormalities of the maxillofacial region. Scintigraphy was able to
      distinguish whether the lesions had increased perfusion (three patients) or only
      a large venous component (four patients), and thus helped in assessing the best
      route for contrast angiography. In four patients a recurrence was suspected. In
      one, a follow-up Tc-99m RBC study showed successful embolization therapy and no
      recurrence, and in three patients it showed early recurrence of the lesion. The
      results of this report indicate the value of Tc-99m RBC scintigraphy in the
      management of patients with vascular abnormalities of the maxillofacial region.

PMID- 8462209
TI  - Bone scintigraphy in blastomycotic osteomyelitis.
AB  - A case of disseminated North American blastomycosis is described in which the
      full extent of the multifocal osteomyelitis was depicted by Tc-99m MDP
      scintigraphy. Skeletal involvement by this disease is not uncommon, yet the
      utility of bone scintigraphy has not been reported. The efficacy with which the
      whole body may be examined makes this technique especially appropriate for a
      hematogenously disseminated and often multifocal form of osteomyelitis where
      radiographically occult and asymptomatic lesions may be present.

PMID- 8462208
TI  - Evaluation of postoperative osteomyelitis of the sternum comparing CT and dual Tc
      99m MDP bone and In-111 WBC SPECT.
AB  - This article reports on a retrospective study of 32 patients who underwent CT and
      combined Tc-99m MDP and in-111 WBC SPECT between 1988 and 1991 for post-operative
      sternal osteomyelitis. Of these 32 patients, 7 patients (Group 1) underwent
      evaluation for possible sternal osteomyelitis due to persistent fevers,
      leukocytosis, or changes in the sternal incision; 12 patients (Group 2) had
      surgically proven osteomyelitis, and in 13 patients (Group 3) there was definite
      clinical evidence of sternal wound infection (however, surgical specimens of the
      sternum were not submitted). There was considerable overlap between the CT
      findings in the soft tissues adjacent to the sternum in Group 1 and Group 2
      patients. Severe demineralization was seen in two patients, and erosion of the
      sternum was seen in five patients with proven osteomyelitis. Combined Tc-99m MDP
      bone and in-111 WBC SPECT was positive for osteomyelitis in 11 of 12 patients in
      Group 2. One patient with osteomyelitis had negative scintigraphy; however, this
      patient had a four-week course of IV antibiotic therapy prior to the study. All
      seven patients in Group 1 had negative SPECT scans and were treated successfully
      with oral antibiotics and minimal soft tissue debridement. Three patients in
      Group 3 had negative SPECT scans and were treated successfully with antibiotics
      and limited debridement. Ten patients with positive SPECT scans were treated with
      a combination of antibiotics and aggressive surgical intervention. In conclusion,
      CT findings in the soft tissues offer little specificity in distinguishing soft
      tissue inflammation from osteomyelitis of the sternum.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8462210
TI  - Incidental lymph node visualization on bone scan due to subcutaneous infiltration
      of Tc-99m MDP. A potential for false positive interpretation.
AB  - Soft tissue localization of radiotracer on bone scintigraphy may result in false
      positive interpretations, if the activity overlies a bony structure. A case is
      presented in which special views and follow-up clarified the soft tissue nature
      of focal uptake in arm and axilla.

PMID- 8462211
TI  - Diuresis renography. The need for an additional view after gravity-assisted
      drainage.
AB  - The role of diuresis renography (DR) in the evaluation of pelvi-ureteric junction
      obstruction is well established. However, problems may be encountered when
      applying this technique to patients after pyeloplasty because of the role of
      gravity-assisted drainage (GAD) in this post-operative group. Twenty-three
      radionuclide studies that were performed in 21 children were reviewed. All
      children underwent standard DR and all then had an additional view performed
      after GAD. In 12 children evaluated in a preoperative assessment for possible
      obstruction, 5 were obstructed on both DR and after GAD, 1 was equivocal on DR
      but drained after GAD, and 6 were not obstructed in either part of the study. In
      11 children assessed after pyeloplasty, 5 were obstructed on DR but not
      obstructed on GAD, 3 were not obstructed in both studies, 1 was obstructed in
      both, and 2 were equivocal on DR but not obstructed after GAD. It can be
      concluded that when assessing patients, particularly those who have undergone
      pyeloplasty, DR should be supplemented with an additional view acquired after
      gravity-assisted drainage.

PMID- 8462212
TI  - Preoperative localization of parathyroid carcinoma using Tc-99m MIBI.
AB  - A patient with parathyroid cancer is presented who underwent Tc-99m MIBI
      scintigraphy. The Tc-99m MIBI image demonstrated increased accumulation of
      activity at the lower pole of the left thyroid lobe which was later confirmed as
      a parathyroid cancer. Uptake by parathyroid cancer must be kept in mind as a
      cause of increased Tc-99m MIBI accumulation when a disease is in question in the
      thyroid or parathyroid gland.

PMID- 8462213
TI  - Primary adrenocortical nodular dysplasia presented as adrenal adenoma by
      functional scintigraphy.
AB  - This is a report of a case of a 12-year-old boy with Cushing's syndrome in which
      high doses of dexamethasone failed to suppress glucocorticoid secretion. Neither
      CT nor MRI (morphologic studies) revealed any adrenal abnormality. Functional
      images with NP-59 (I-131 beta-iodomethyl-norcholesterol) clearly revealed intense
      unilateral uptake in the right adrenal gland. A right adrenalectomy was
      performed, and the pathologic diagnosis was primary adrenocortical nodular
      dysplasia. One year later, the cushingoid signs had virtually disappeared and
      urinary steroid excretion and serum cortisol levels were within the normal range.
      Nevertheless, primary adrenocortical nodular dysplasia is essentially a bilateral
      disease. In this case, a remission in the adrenocortical hyperfunction was
      observed. Although there was confusion in the etiological diagnosis, functional
      scintigraphy correctly indicated the status of adrenal function.

PMID- 8462215
TI  - Macrovascular pulmonary arteriovenous malformations demonstrated by radionuclide
      method.
AB  - Pulmonary arteriovenous malformations (AVMs) are abnormal vascular communications
      that allow unoxygenated blood to pass from the venous to the arterial
      circulation. Usually congenital in origin and twice as likely in women,
      hemoptysis, dyspnea, and chest pain are the common presenting complaints in AVM.
      A case of pulmonary AVMs that were demonstrated on a radionuclide angiogram is
      presented. Pulmonary AVMs were suspected after finding radioactivity in both
      kidneys on a perfusion lung scan.

PMID- 8462214
TI  - Lung uptake of Tc-99m HMPAO in cigarette smokers expressed by lung/liver activity
      ratio.
AB  - Tc-99m HMPAO, a lipophilic radiopharmaceutical used for brain imaging, has been
      reported to localize in smokers' lungs. To quantitate this uptake in the lung, 55
      patients, who were referred for brain imaging for dementias or strokes, also
      underwent lung imaging (anterior lung imaging includes a large part of the liver)
      after IV injection of the radiopharmaceutical. Regions of interest over the liver
      and the lung were calculated. Of the 55 patients (ages 13-79), 30 were smokers
      and 25 were nonsmokers. The smokers had been smoking from 6-59 years, and daily
      cigarette consumption ranged from 8-50 cigarettes. The mean lung/liver ratio for
      smoking patients were 0.792 +/- 0.042 (SE); the mean lung/liver ratio for
      nonsmoking patients was 0.408 +/- 0.019 (SE). Lung/liver ratio uptake was
      significantly higher in the smoking patients (P < 0.01) than in the nonsmokers.
      Thus, lung/liver uptake of Tc-99m HMPAO may be used as an indicator of cigarette
      smoking.

PMID- 8462216
TI  - Tc-99m HMPAO brain SPECT findings in Creutzfeldt-Jakob disease.
AB  - A Tc-99m HMPAO brain single photon emission computed tomography (SPECT) study of
      a patient with biopsy-proven Creutzfeldt-Jakob disease (CJD) demonstrated
      decreased perfusion in the right frontal and temporal areas. Brain CT findings
      were normal, and electroencephalographic results were nonspecific. The clinical
      potential of Tc-99m HMPAO brain SPECT in the evaluation of CJD is described, and
      its use encouraged.

PMID- 8462217
TI  - Diagnosis of abdominal cerebrospinal fluid pseudocyst by scintigraphy.

PMID- 8462218
TI  - Vicarious excretion of technetium-99m MAG3 in a patient with polycystic renal
      disease.

PMID- 8462219
TI  - Periodontal disease detected by Tc-99m albumin colloid leukocyte imaging.

PMID- 8462220
TI  - Diagnosis of horseshoe kidney on technetium-99m hepatobiliary scintigraphy.

PMID- 8462221
TI  - Tc-99m HMPAO brain SPECT in dementia due to transitory obstructive hydrocephalus.

PMID- 8462222
TI  - Unintentional intraluminal small bowel catheter placement detected by Tc-99m SC
      scan obtained before planned intraperitoneal phosphorus-32 therapy.

PMID- 8462223
TI  - Radioiodine scanning of the thyroid. Searching for the other lobe.

PMID- 8462224
TI  - Detection of inguinal hematoma during a gastrointestinal bleeding study.

PMID- 8462225
TI  - Tc-99m HMPAO SPECT brain imaging of Gilles de la Tourette's syndrome.

PMID- 8462226
TI  - Localization of Tc-99m DTPA in a chordoma.

PMID- 8462227
TI  - Drug concentration monitoring. An approach to rational use.

PMID- 8462228
TI  - Intravenous infusion conditions. Implications for pharmacokinetic monitoring.
AB  - Drugs are often given intravenously with an expectation that the predicted serum
      concentrations will be achieved rapidly. Routine pharmacokinetic monitoring of
      some drugs may be of limited value, unless the effect of intravenous drug
      delivery systems on serum concentrations is known. In vitro studies have
      demonstrated that the actual time for complete drug delivery can be markedly
      longer than predicted and is dependent inter alia on factors including the
      delivery device, flow rate, injection site, drug volume and tubing diameter.
      Studies in paediatric patients have shown that the serum concentrations of drugs,
      including aminoglycosides and chloramphenicol, are strongly influenced by
      intravenous drug delivery systems. Similarly, data from adult patients have
      indicated that a drug delivery system can affect serum concentrations of
      aminoglycosides. Some data are available about the pharmacokinetics of drugs
      delivered by newer devices, e.g. controlled release infusion systems, membrane
      devices and implanted pumps, but additional research is needed to determine their
      predictability of delivery and pharmacokinetics of commonly used drugs. To
      achieve optimal therapeutic outcomes in patients, it is crucial to understand the
      impact of an intravenous drug delivery system on serum concentrations and to
      develop guidelines for pharmacokinetic monitoring.

PMID- 8462230
TI  - Famotidine and theophylline pharmacokinetics. An unexpected cimetidine-like
      interaction in patients with chronic obstructive pulmonary disease.
AB  - The results of research studies conducted to date in vitro and in healthy
      volunteers are practically all concordant in demonstrating the lack of any kind
      of interference between famotidine and microsomal oxidative metabolism. The
      pharmacokinetics (elimination half-life, area under the plasma concentration-time
      curve, clearance and volume of distribution) of theophylline 3.4 mg/kg as an
      intravenous infusion over 5 min (a dosage previously used to test drug
      interactions with cimetidine and ranitidine) were evaluated in 7 patients with
      chronic obstructive pulmonary disease (COPD) and peptic ulcer disease before and
      after 8 days' treatment with famotidine 40mg at night. The results indicate that
      famotidine can induce substantial and statistically significant slowing of
      theophylline elimination with a cimetidine-like interaction profile.

PMID- 8462231
TI  - Stereoselective pharmacokinetic properties of chloroquine and de-ethyl
      chloroquine in humans.
AB  - Stereoselective pharmacokinetic properties of chloroquine were investigated in
      humans after a single oral dose of the separate enantiomers. The study was
      carried out according to a crossover experimental design with a washout period
      between the administration of each enantiomer. Total blood chloroquine
      concentrations were measured using an achiral high performance liquid
      chromatography method. Terminal half-life (t1/2 lambda z) and mean residence time
      (MRT) were longer for (R)-chloroquine (294h and 388h, respectively) than for (S)
      chloroquine (236h and 272h, respectively). The total body clearance was lower for
      the (R)-enantiomer [136 +/- 38 ml/min (8.16 +/- 2.28 L/h)] than for the (S)
      enantiomer [237 +/- 71 ml/min (14.22 +/- 4.26 L/h)]. Although the (R)
      stereoisomer remained longer in the body, its volume of distribution (3410 +/-
      720L) was lower than than that of (S)-chloroquine (4830 +/- 1490L). Protein
      binding was different for both chloroquine stereoisomers, with opposite
      preferential binding to human albumin and alpha 1-acid glycoprotein. Binding to
      total human plasma amounted to 66.6 +/- 3.3% for (S)-chloroquine and to 42.7 +/-
      2.1% for the (R)-enantiomer. De-ethyl-chloroquine concentrations were also
      different for both enantiomers, resulting in a statistically significant increase
      in the AUC of (S)-de-ethyl-chloroquine (12.9 +/- 7.4 mg/L.h) compared with (R)-de
      ethyl-chloroquine (6.29 +/- 2.18 mg/L.h). With a daily dosage regimen, the
      divergent pharmacokinetic behaviour of chloroquine enantiomers generates a
      calculated R:S ratio of blood concentrations amounting to 1:0.7 at steady-state.
      Insufficient information about stereoselective activity and toxicity of
      chloroquine stereoisomers prevent further conclusions about the clinical
      consequences of these pharmacokinetic differences.

PMID- 8462229
TI  - Clinical pharmacokinetics of angiotensin converting enzyme (ACE) inhibitors in
      renal failure.
AB  - Arterial hypertension occurs frequently in patients with chronic renal failure.
      Antihypertensive treatment of arterial hypertension with angiotensin converting
      enzyme (ACE) inhibitors has been shown to be effective with a low incidence of
      adverse effects compared with other drug classes. Furthermore, treatment with ACE
      inhibitors may slow the progression of renal function impairment in certain
      groups of patients, such as those with diabetes. Most ACE inhibitors are prodrugs
      which are converted by hepatic esterolysis to an active diacid metabolite. Only
      captopril and lisinopril have sufficient oral bioavailability and are given as
      active drugs. ACE inhibitors can be subdivided into 3 classes with regard to the
      active group: the majority of ACE inhibitors are carboxyl-containing drugs, a new
      class of ACE inhibitors possess a phosphoryl-group and captopril and related
      compounds are sulfhydryl-containing drugs. The predominant elimination pathway of
      ACE inhibitors is excretion via the kidneys. Therefore, renal insufficiency is
      associated with reduced elimination of most ACE inhibitors and, thus, altered
      pharmacokinetic properties. This is most evident in chronic renal failure when
      glomerular filtration rates (GFR) are < 30 to 40 ml/min (1.8 to 2.4 L/h). As
      renal clearance decreases, the peak plasma concentration and area under the
      plasma concentration-time curve of the active drugs or diacids are increased and
      time to peak concentrations and half-life are prolonged. However, there are large
      between-drug differences in the changes in pharmacokinetic parameters, resulting
      in different degrees of drug accumulation after consecutive administration. This
      leads, for example, to high accumulation rates for drugs such as lisinopril, or
      cilazaprilat. In contrast, fosinopril, which is also excreted to a large extent
      by the hepatobiliary pathway, does not seem to accumulate in renal failure. In
      general, pharmacokinetics and conversion of prodrugs seem to be slightly affected
      in chronic renal failure; however, these changes do not appear to be clinically
      relevant. Efficiency of clearance for prodrugs or active drugs and their
      respective metabolites by haemodialysis or peritoneal dialysis varies
      considerably. For some ACE inhibitors, such as captopril or enalapril, the high
      elimination fraction by haemodialysis necessitates a supplemental dose after
      dialysis. Other ACE inhibitors, such as quinapril or cilazapril, are only poorly
      eliminated by haemodialysis or peritoneal dialysis. Dosage recommendations for
      treatment with ACE inhibitors in chronic renal failure depend on the specific
      pharmacokinetic properties of the various agents. For most ACE inhibitors, dosage
      adjustment is recommended in moderate and severe impairment of renal function,
      with resultant dosages being 25 to 50% of those recommended for patients with
      normal renal function.

PMID- 8462232
TI  - Cadaver renal transplantation in children. Incidence, immunosuppression, outcome,
      and risk factors.
AB  - In North America, about 50% of all renal transplants done in children are from a
      living-related donor source--a figure two and a half times greater than the
      comparative figure for Europe. Graft survival in children is lower for cadaveric
      donor (CD) than for living-related donor (LRD) kidneys. Four of 10 children with
      a CD kidney lose their graft within four years. Since it is unlikely that the
      availability of LRD kidneys will increase, attention must be focused on improving
      outcome of cadaver renal transplants in children. This review analyzes factors
      that affect graft outcome. Young recipient age, utilization of kidneys from very
      young donors, and cold ischemia time are detrimental to prolonged graft survival.
      Additional factors that impact adversely on cadaver graft survival are a history
      of previous transplantation, absence of a DR match, and black ethnic origin of
      the recipient. An understanding of risk factors to graft survival should enable
      physicians to optimize cadaver renal transplantation in children.

PMID- 8462233
TI  - Difficult parents. From adversaries to partners.
AB  - The pediatrician's job becomes frustrating when it is necessary to deal with
      difficult parents. Some physicians may not have the training or inclination to
      engage such parents in a therapeutic partnership. This paper discusses tools
      available to physicians which will help them develop an effective partnership
      that includes uncovering the hidden meaning behind a child's illness;
      understanding the reciprocal nature of partnerships; and the importance of
      determining each party's goals, roles, and expectations. Negotiating these steps
      enables physicians to develop a productive relationship with difficult parents of
      sick children. This strategy can facilitate the child's medical care and improve
      the parents' and physician's satisfaction with the services rendered. This paper
      also discusses steps to take when these attempts are not sufficient to handle the
      situation.

PMID- 8462234
TI  - Exercise-induced bronchospasm in nonasthmatic obese children.
AB  - The frequency, degree, and pattern of bronchial reactivity to exercise were
      compared in 13 obese and 14 control children, ages 6 to 10 years, with no history
      of asthma. Spirometry was performed before and every three minutes after a seven
      minute exercise challenge on a treadmill. There were 11 obese children and 6
      controls who had at least a 15% fall in at least one of three monitored pulmonary
      function parameters (P < .05). The group mean percentage falls in FEV1 and FEF25%
      75% were significantly greater in the obese group than in the controls. The
      pattern of bronchospasm, occurring soon after the exercise challenge, is
      consistent with that found in the known asthmatic population. A significant
      correlation was found between triceps skin-fold thickness and degree of fall in
      FEF25%-75% (r = .55, P < .005). This study demonstrated that significantly
      greater frequency and degree of bronchospasm of the smaller airways occur in
      obese children, partially related to the amount of subcutaneous fat. Whether
      exercise-induced bronchospasm leads to exercise avoidance and obesity or whether
      obesity causes or enhances bronchial hyperreactivity to exercise requires further
      study.

PMID- 8462235
TI  - A survey of Quebec pediatricians' attitudes toward donor insemination.
AB  - Inspired by a study done in France, Quebec pediatricians were surveyed regarding
      their knowledge of children conceived by donor insemination (DI) and their
      families, as well as their attitudes and opinions about DI. A two-part
      questionnaire was mailed to all 487 members of the Quebec Association of
      Pediatricians. One hundred and ninety-seven (40%) responded. Findings indicate
      that Quebec pediatricians have treated few children conceived by DI and know
      little about how their families are handling the issue of DI. Most pediatricians
      favored telling DI offspring about their mode of conception, and almost half
      stated that such children, at maturity, should have the right to know their
      biological fathers. Their opinions reflect the growing trend toward openness in
      adoption and DI.

PMID- 8462237
TI  - Childhood masturbation.

PMID- 8462236
TI  - High-dose urokinase therapy in newborn infants with major vessel thrombosis.
AB  - The effectiveness of urokinase therapy for thrombosis in children, particularly
      in newborn infants, has not been established. We report our experience with the
      local administration of high-dose intrathrombus urokinase in two newborn infants.
      One infant had aortic thrombosis and the other, thrombosis of the right femoral
      artery. The known abnormalities in the newborn's fibrinolytic mechanism provide
      the rational basis for the therapeutic use of high doses of plasminogen
      activators. No significant abnormalities of our patients' fibrinolytic systems
      were found, and effective thrombolysis was achieved. A literature review of the
      use of urokinase therapy for thrombosis in children reveals great disparities in
      dosage and outcome. We believe that fixed-dose regimens should be replaced by
      individually adjusted thrombolytic therapy and that the need for higher doses of
      urokinase in newborns should be studied further.

PMID- 8462238
TI  - Computed tomography in diagnosing retropharyngeal abscess in children.

PMID- 8462239
TI  - The role of the male caretaker in Munchausen syndrome by proxy.

PMID- 8462240
TI  - Discordant monozygotic twins with markedly different grades of anterior lens
      capsule vascularity.

PMID- 8462241
TI  - Child abuse by poisoning. Why is alprazolam difficult to detect?

PMID- 8462242
TI  - Reflections of a grandparent.

PMID- 8462244
TI  - Evaluation and management of solitary and multiple pulmonary nodules.
AB  - Solitary pulmonary nodules are malignant in 50% of cases. The 5-year cure rate
      after resection of a malignant nodule averages 50% and is even higher if the
      nodule is small. Stability for 2 years suggests benignity, and the presence of
      calcification in certain patterns indicates that the nodule is probably benign.
      Biopsy of the nodule may establish benignity. The "wait and watch" strategy may
      be advisable under certain circumstances. Multiple pulmonary nodules are usually
      due to metastatic spread from an extrapulmonary primary tumor. Biopsy is usually
      advisable because the nodules may be due to a curable benign process.

PMID- 8462243
TI  - Epidemiology and etiology of lung cancer.
AB  - Lung cancer incidence and mortality have increased sharply during this century,
      making it a common cause of death and the most frequent fatal cancer in men and
      women. The known behavioral and environmental causes--cigarette smoking, asbestos
      and other occupational carcinogens, radon, and environmental tobacco smoke--are
      responsible for the majority of cases. Although the proportion of adults who
      smoke in the United States has dropped since the mid-1960s, the incidence of lung
      cancer in the United States is expected to continue to rise through the 1990s
      because of the long latency between initiation of smoking and the occurrence of
      the disease. Efforts to alter lung cancer mortality by early detection and better
      therapy have not yet succeeded in reversing this trend. The modification of risk
      factors is currently the most effective approach to reducing future lung cancer
      deaths.

PMID- 8462245
TI  - Role of phototherapy, laser therapy, brachytherapy, and prosthetic stents in the
      management of lung cancer.

PMID- 8462246
TI  - Oncogenes and growth factors in human lung cancer.
AB  - We are only beginning to understand the importance of lung cancer tumor biology
      in relation to prognosis and response to therapy. Many of the biologic and
      genetic changes we have described are preliminary observations and require
      further confirmation before clinical use. However, information concerning three
      oncogenes may soon prove to be helpful in the clinical arena: the myc genes in
      SCLC, and the ras genes and c-erbB-2 in NSCLC. In general their presence
      identifies poor patient response to therapy and poor survival. These markers are
      currently being used in a clinical setting at some research centers, but are not
      recommended for general diagnostic or prognostic use without further confirmation
      of their utility. Incorporation of this information with that learned by standard
      staging procedures may result in improved understanding of patient prognosis and
      challenge current concepts of lung cancer treatment. For example, surgically
      resected stage I NSCLC patients may benefit from adjuvant therapy if found to
      have these adverse biologic factors, and require more stringent follow-up after
      therapy. Finally the understanding of the pathogenesis of lung cancer may enable
      the development of novel therapy directed against these growth pathways. Our
      ultimate goal is to derive a therapeutic and prognostic paradigm involving both
      molecular-genetic and clinical factors to arrive at an optimal staging model and
      treatment plan.

PMID- 8462247
TI  - Lung cancer staging classification.
AB  - In presenting the staging system, I recognize that in a given patient the total
      tumor burden cannot be precisely quantitated, and the balance between host
      defenses and the heterogeneity of the malignancy is not measurable. These and
      other complex interacting biological variables will influence the subsequent
      course of the disease. However, our data support the premise that the
      straightforward indices of disease extent in the TNM system permit a simple yet
      valid classification that best reflects prognosis. Patients can be grouped
      together according to certain measurable common features of their disease so that
      within each stage group treatment options and survival expectations will be
      generally similar. In this manner reliable and valid comparisons of the results
      of different modalities of therapy can be made. Survival data according to
      staging criteria are a measure of the efficacy of available therapy for lung
      cancer; thus, the staging information serves as a valuable guide for treatment
      planning.

PMID- 8462248
TI  - Radiologic manifestations of bronchogenic cancer.
AB  - Radiologic imaging provides crucial information about bronchogenic cancer and is
      complementary to more invasive diagnostic techniques. The diagnosis is often
      suspected initially from the chest radiograph. The CT scan permits the most
      complete analysis of the extent of the tumor, nodal metastasis, and distant
      metastasis and serves as a guide to further evaluation and surgery. MRI, at the
      current stage of development, is generally reserved for cases in which CT
      findings are inconclusive. Rapid technologic advances have the potential for
      altering this imaging hierarchy in the near future.

PMID- 8462249
TI  - Sputum cytology.
AB  - Examination of sputum is the least invasive method of obtaining a cytologic
      diagnosis in a patient suspected of harboring lung cancer. Cytologic diagnosis
      has advanced to a point where it is of comparable value to histology. The authors
      discuss the sensitivity, specificity, reliability, and pitfalls of sputum
      cytology as well as the role it plays in screening of early lung cancer. The
      advantages and shortcomings of sampling and cytopreparatory techniques are also
      reviewed. Concluding remarks outline future developments in sputum cytology.

PMID- 8462250
TI  - The role of bronchoscopy in lung cancer.
AB  - Flexible fiberoptic bronchoscopy is the most useful invasive technique for
      diagnosing lung cancer. This article details the use and efficacy of bronchoscopy
      with such established techniques as forceps biopsy, brush biopsy, and bronchial
      washing in the diagnosis and staging of bronchoscopically visible central lung
      cancer and peripheral lung cancer. The efficacy of such newer techniques as
      transbronchial needle aspiration, transbronchial curettage, ultrathin fiberoptic
      bronchoscopy, and quantitation of tumor markers in bronchoalveolar lavage fluid
      is also discussed, along with the complications of bronchoscopy and new
      techniques for detecting early lung cancer.

PMID- 8462251
TI  - The role of transthoracic needle biopsy for the diagnosis and staging of lung
      cancer.
AB  - Percutaneous transthoracic needle biopsy (TNB) is a simple and safe procedure
      with high diagnostic accuracy for the diagnosis and staging of cancer in the
      lung, hilum, and mediastinum. The complication rate is low and consists primarily
      of pneumothorax, with only a small percentage of these requiring chest tube
      reexpansion. Major complications are rare. Computed tomographically guided biopsy
      is a powerful adjunct to fluoroscopic biopsy and expands the application of TNB
      to include most thoracic lesions. TNB is the initial diagnostic procedure of
      choice in peripheral lung lesions, suspected focal metastases, and most hilar and
      mediastinal masses. Its proper role in the diagnosis and staging of lung cancer
      requires the close collaboration of the radiologist, cytopathologist, and the
      patient's primary physician.

PMID- 8462252
TI  - Basics of renal anatomy and physiology.
AB  - A kidney contains over 1 million functioning units called nephrons. Each nephron
      is composed of a glomerulus and tubule. The glomerulus acts to filter the blood
      free of cells and large proteins, producing an ultrafiltrate composed of the
      other smaller circulating elements. The ultrafiltrate enters the tubule, which is
      highly specialized at various segments, to produce the final urine by removing
      substances from the tubular fluid (reabsorption) or adding substances to the
      tubular fluid (secretion). Filtration, reabsorption, and secretion keep the
      organism in balance in terms of water, minerals, electrolytes, and hydrogen ion
      concentration and eliminate the toxic substances produced by the body. The major
      known hormonal functions of the kidney influence blood pressure, calcium
      metabolism, and red blood cell production.

PMID- 8462253
TI  - Fundamentals of clinical acid-base evaluation.
AB  - The final diagnosis of acid-base perturbations relies on laboratory analyses. The
      major direct tools of assessment are arterial pH and PCO2 and serum electrolytes.
      From these values, a diagnosis of metabolic acidosis, respiratory acidosis,
      metabolic alkalosis, and respiratory alkalosis with or without an excess anionic
      gap and with or without a proper compensatory response is made.

PMID- 8462254
TI  - Laboratory evaluation of renal tubular acidosis.
AB  - In this article, the renal tubular acidoses are briefly described, individual
      laboratory tests of urinary acidification are reviewed, and the administration
      and interpretation of these tests are discussed. A systematic approach to the
      laboratory evaluation of hyperchloremic metabolic acidosis is included.

PMID- 8462255
TI  - Urinalysis and urinary sediment in patients with renal disease.
AB  - Examination of the urine plays a vital role in the diagnosis of kidney diseases.
      Proteinuria is an important indicator of renal disease and the types of proteins
      found in the urine help distinguish glomerular and tubular disorders. The
      findings of casts and blood cells in the urine provide valuable clues about the
      causes of the underlying renal pathology. Crystals may be found in the urine of
      healthy individuals and in patients with urolithiasis, toxic damage, and chronic
      renal failure.

PMID- 8462256
TI  - Evaluation of renal concentrating and diluting ability.
AB  - Evaluating the diluting and concentrating capacity of the kidney can be
      accomplished with three basic laboratory tests, urine and plasma osmolalities,
      and circulating levels of antidiuretic hormone. When used with simple techniques
      to stimulate dilution and concentration, these tests will provide critical
      clinical information in patients with defects in either dilution or concentration
      of the urine.

PMID- 8462257
TI  - Perturbations in sodium balance. Hyponatremia and hypernatremia.
AB  - Perturbations of serum sodium concentration are the most common electrolyte
      abnormalities seen in clinical medicine. Patients may exhibit profound
      alterations in mental status or be asymptomatic. Appropriate diagnosis and
      treatment is essential to reducing morbidity from serum sodium abnormalities.
      This article reviews the etiology, symptoms, and treatment of hyponatremic and
      hypernatremic syndromes.

PMID- 8462258
TI  - Perturbations in potassium balance.
AB  - Hyperkalemia and hypokalemia are commonly encountered in medical practice.
      Differential diagnosis and therapeutic approaches have been presented to provide
      an informed choice for the practicing physician.

PMID- 8462259
TI  - Assessment of hypocalcemia and hypercalcemia.
AB  - Methodologic aspects including causes of factitious hypocalcemia and
      hypercalcemia are summarized. The differential diagnosis of hypocalcemia is
      reviewed under three main headings: hypoalbuminemia, hypocalcemia with decreased
      parathyroid hormone (PTH) action or activity, and hypocalcemia with normal PTH
      action and activity. The differential diagnosis of hypercalcemia is subdivided
      into three broad categories: hyperproteinemia, PTH-mediated hypercalcemia, and
      non-PTH-mediated hypercalcemia. The causes of hypocalcemia and hypercalcemia are
      outlined with a focus on pathophysiology and clinicochemical sequelae. A
      laboratory perspective is emphasized in outlining management strategies.

PMID- 8462260
TI  - Assessment of hyperphosphatemia and hypophosphatemia.
AB  - Methodologic aspects including causes of factitious hyperphosphatemia and
      hypophosphatemia are summarized. The differential diagnosis of hyperphosphatemia
      is reviewed under its three broad causes: decreased glomerular filtration rate,
      increased exogenous or endogenous phosphate load, and increased renal tubular
      phosphate reabsorption. The differential diagnosis of hypophosphatemia is
      reviewed under its three broad causes: inadequate gastrointestinal input, excess
      phosphate losses, and transcellular shifts. The consequences of hyperphosphatemia
      and hypophosphatemia are outlined with a focus on pathophysiologic and
      clinicochemical sequelae. A laboratory perspective is emphasized in outlining
      management strategies.

PMID- 8462261
TI  - Laboratory evaluation of magnesium status. Renal function and free intracellular
      magnesium concentration.
AB  - In summary, magnesium plays an essential role in both extracellular and
      intracellular metabolism. Even though biologists recognize the importance of
      magnesium, clinicians often are unaware of the frequency and significance of
      magnesium disturbances. Some clinicians recommend routine measurement of
      magnesium when other electrolyte analyses are required for the care of patients.
      Others have reported a high frequency of hypomagnesemia in hospitalized patients,
      but the clinical significance of this observation was not evident. Patients with
      coexisting hypokalemia of any cause require particular attention however, and it
      is important to assess magnesium status in that setting. The assessment of
      magnesium status is difficult because of the distribution of magnesium within the
      intracellular compartment. The majority of body magnesium is located within soft
      and hard tissues and most intracellular magnesium is complexed and not available
      for measurement. Accordingly, no single determination is available to accurately
      assess magnesium status. The simplest and most useful approach is the
      determination of serum magnesium and renal magnesium clearance and interpretation
      of these parameters in light of complete history and clinical evaluation of the
      patient. Accordingly, one combines the laboratory assessment with the clinical
      evaluation. Other tests, such as determination of serum and intracellular free
      Mg2+ activity by either fluorescent or 31P-NMR techniques, are not particularly
      useful in the routine laboratory. These approaches currently are being used on an
      experimental basis to assess the role of magnesium in health and disease, which
      may lead to better indices of clinical evaluation in the future.

PMID- 8462262
TI  - Proteinuria.
AB  - Proteinuria is an important finding in patients because it may signify either a
      benign disorder or renal disease. A systematic approach to evaluation, which
      incorporates a careful clinical evaluation coupled with a few simple laboratory
      tests, is required to determine whether the patient can be followed, or whether a
      more invasive study, such as renal biopsy, is indicated. Although the causes of
      proteinuria are diverse, a structured approach to the patient with proteinuria
      provides maximal information with minimal expense and risk.

PMID- 8462263
TI  - Laboratory investigation of renal stone disease.
AB  - Renal stone disease is a chronic disease associated with a high rate of
      recurrences and hospitalizations. Over the past three decades, the incidence of
      nephrolithiasis has increased by 60% to 75%. Because there is a significant
      amount of morbidity associated with development of stone disease, a comprehensive
      yet simple evaluation to determine the cause of the problem is warranted.

PMID- 8462264
TI  - Important aspects concerning evaluation of renal function and blood pressure.
      Kinins, prostaglandins, lead.
AB  - The kallikrein-kinin and prostaglandin-thromboxane-leukotriene systems and the
      body lead burden all influence renal function and systemic blood pressure to some
      extent. Because these systems may become generally accepted as more important in
      assessing renal function and blood pressure in the future, a brief overview of
      each has been given.

PMID- 8462265
TI  - Assessment of renal function in the young. Special considerations.
AB  - Infants are born in a state of renal insufficiency and have varying degrees of
      maturity of tubular processes. This is even more striking in premature infants.
      This article presents a review of glomerular and tubular function assessment with
      particular attention to factors that impact these developmental and maturational
      factors.

PMID- 8462266
TI  - Assessment of renal function in the old. Special considerations.
AB  - The most important clinical renal function to monitor with age is glomerular
      filtration rate (GFR), as all other changes in renal function tend to parallel
      changes in GFR. The serum creatinine and creatinine clearance have become the
      clinical tests most frequently used to measure GFR. The creatinine clearance
      decreases at a rate approximately 1% per year after age 40 years. Mean serum
      creatinine values, however, fail to increase with age because creatinine
      production, which is dependent on muscle mass, falls at nearly the same rate as
      the renal clearance of creatinine. Serum creatinine concentrations must be
      interpreted with this in mind when used to determine or modify dosages of drugs
      cleared totally, for example, the aminoglycoside antibiotics, or partially, for
      example, digoxin, by the kidney.

PMID- 8462267
TI  - Evaluation of elevated blood pressure.
AB  - The clinical laboratory is essential to the successful and complete evaluation of
      the patient with hypertension. A reasonably thorough knowledge of the important
      physiologic components of blood pressure regulation, in conjunction with a good
      history and physical examination and a simple panel of screening tests serve to
      detect or rule out the presence of secondary forms of hypertension in the
      majority of patients.

PMID- 8462268
TI  - Assessment of renal function--glomerular and tubular.
AB  - The tests most commonly used to estimate the status of renal function via
      alterations in glomerular filtration rate (GFR) are plasma creatinine
      concentration (PCr), blood, urea, nitrogen (BUN), and creatinine clearance (CCr).
      Unfortunately, these tests have some drawbacks. Nevertheless, they are quite
      useful to clinicians aware of their limitations, especially in many instances
      when it may be unnecessary or impractical to have precise measurements.
      Accordingly, serial measurements of PCr, especially when related to simultaneous
      BUN determinations, or CCr, may suffice. However, the functional status of the
      kidneys often needs to be corroborated by more precise methods when subtle
      changes in renal function are detected or when clinically indicated.

PMID- 8462269
TI  - Quantitation of renal function using radioisotopic techniques.
AB  - Radioisotopic methods are practical for clinical use because they do not require
      continuous intravenous infusion or urine collection. This obviously is of great
      advantage in infants and small children, in whom accurate urine collection is
      difficult, but the techniques apply to adults as well. The ability to determine
      individual kidney function is a major benefit. Accuracies of the radioisotopic
      techniques vary but generally are within clinically acceptable ranges. The need
      for accuracy and reproducibility can be balanced with the desire for speed and
      convenience when choosing among the different techniques. Methods that use plasma
      sampling provide greater accuracy and are recommended in cases of severe
      dysfunction, whereas methods such as Gates' camera method, which eliminates
      plasma samples, can be completed in minutes. Radioisotopic techniques are most
      useful in the ranges of mild to moderately decreased function, in which serum
      creatinine concentration is nondiagnostic, and although they are much less
      accurate at markedly low renal function levels, so is 24-hour creatinine
      clearance. In conclusion, radiopharmaceutical agents offer a wide array of
      possible techniques for simple, accurate, and noninvasive measurement of global
      as well as individual GFR and ERPF.

PMID- 8462270
TI  - Serologic evaluation of renal status.
AB  - Mechanisms of immunologic injury causing glomerulonephritis are based on immune
      complex or autoantibody deposition with activation of complement. Circulating
      immune complex disease can be diagnosed and monitored with improved assays for
      immune complexes, DNA antibodies, complement levels, and complement activation
      products. Etiologic auto-antibodies for the Goodpasture antigen, neutrophil
      enzymes, and ones directly promoting complement activation are now quantitated
      for more accurate serologic diagnosis. The spectrum of postinfectious
      glomerulonephritis also presents several new measurements for assessing clinical
      status. Diagnosis and monitoring of glomerulonephritis now entails panel testing
      for these humoral abnormalities that are useful to establish the etiology and
      treatment regimens.

PMID- 8462271
TI  - Diagnosis of acute and chronic renal failure.
AB  - This article presents a systematic approach--through history, physical
      examination, and laboratory findings--for the pursuit of the diagnosis of acute
      and chronic renal failure. These guidelines are based on the pathophysiology of
      the syndromes. In management, they serve the goal of staying the failure and
      regaining renal function.

PMID- 8462272
TI  - An on-line method in studying music parsing.
AB  - Listening to music entails the construction of a mental representation based on
      partial and ambiguous information. This study examines an experimental method
      that reflects such parsing decisions on-line by detecting the cognitive load
      resulting from temporary parsing failures. The method investigated was a divided
      attention paradigm in which listening to music was the primary task and click
      detection was a concurrent secondary task. It was hypothesized that increasing
      the complexity of the primary task by introducing an unprepared chromatic
      modulation results in an increase in response latencies to a click presented
      immediately after the modulatory shift. The support of this prediction by
      musicians' data provides evidence for the sensitivity of the paradigm. The
      failure of non-musicians to reflect the expected load is attributed to their
      attention-allocation strategy. These results are discussed in terms of their
      implications on the view of the musical parser as deterministic.

PMID- 8462273
TI  - Frames of reference in vision and language: where is above?
AB  - Spatial terms such as "above" must be used and interpreted with respect to some
      frame of reference. Perceptual cues for verticality were varied in four
      experiments to investigate whether the comprehension and production of "above" is
      based on a viewer-centered (deictic) frame, an environment-centered (extrinsic)
      frame, or an object-centered (intrinsic) frame of reference. "Above" was usually
      interpreted with respect to an environment-centered reference frame, but there
      was a significant contribution from object-centered reference frames as well; the
      viewer-centered reference frame made no independent contribution to "above". The
      meaning of "above" appears not to specify a particular reference frame; rather,
      selection of a reference frame during spatial assignment determines how spatial
      terms such as "above" and "below" will be used and interpreted.

PMID- 8462274
TI  - A perceptually-based model of children's earliest productions.
AB  - A model is proposed to account for processes underlying the initial extraction
      and representation of words. The model incorporates perceptual salience into a
      framework provided by autosegmental phonology. In one study, predictions of the
      model were tested in a corpus of utterances obtained from three children in the
      one-word speech period. Analyses of the corpus supported the predictions,
      suggesting that salience of elements such as stressed and final syllables may
      contribute to the form of early productions and, specifically, to the form of
      utterances containing filler syllables and full or partial reduplications.
      Because the data for this study were children's productions, and the model
      concerns children's representations, a second study was carried out to
      investigate representations somewhat more directly. That study also explored the
      possible influence of an additional prosodic factor on the form of early words. A
      word-learning task with 2-year-olds, 3-year-olds and adults assessed whether
      children would attend to stress pattern or segmental sequence in identifying the
      referent for a word. As expected, children did rely on prosody in their word
      choices far more frequently than did adults, suggesting that one prosodic
      component, stress pattern, may in some cases be prominent in a child's
      representation for a word. The results of the two studies provide support for the
      utility of the autosegmental framework, as well as additional evidence for the
      perceptual salience of stressed and final syllables and of stress pattern.

PMID- 8462275
TI  - Variations in genome mass.
AB  - 1. Genome size varies considerably among vertebrates, ranging from less than 1 pg
      to more than 200 pg; the amount of DNA differing among individuals in a
      population can equal the amount in the entire structural gene complement. 2.
      Recent technological advances permit evaluation of genome size variation at
      several levels including sub-chromosomal, chromosomal and cellular. 3. Genome
      size variation may also be viewed from taxonomic levels, and across evolutionary
      time frames. 4. As sources of genome size variation are identified and studied,
      the conundrum of the C-value paradox (lack of correlations among genome size,
      genomic complexity and phylogenetic status of organisms) may prove to be more
      apparent than real. 5. For example, the limited and relatively constant genome
      size of avians may be related to the physiological constraints of flight.

PMID- 8462276
TI  - DNA fingerprinting of the roe deer, Capreolus capreolus L.
AB  - 1. After digestion of roe deer DNA with the restriction enzyme HaeIII,
      microsatellite sequences cross-hybridize with the digoxigenin-labeled multilocus
      probe (GTG)5 yielding non-radioactive DNA fingerprints. 2. Since different organs
      of the same individual exhibit identical fingerprints, somatic stability is
      confirmed. 3. The method discloses a high potential of individualization. The
      probability that two unrelated roe deer have identical fingerprints was found to
      be 10(-7). 4. It is shown that band-similarity indices can be used to estimate
      the degree of relationship within groups of individuals.

PMID- 8462277
TI  - Isolation of Antho-RFamide related peptides from the eyestalks of blue crab.
AB  - 1. Two carboxyl-terminally amidated peptides (CP1 and CP2) were isolated from the
      blue crab (Callinectes sapidus) eyestalks by a method of carboxyl-terminal
      analysis. 2. The peptides were sequenced as pGlu-Gly-Arg-Phe-amide (CP1) and pGlu
      Leu-Gly-Arg-Phe-amide (CP2). 3. Each carboxyl-terminus of the peptides was
      precisely determined by amino acid analysis utilizing phenylisothiocyanate
      derivatives. 4. CP1 was identical to the sea anemone neuropeptide, Antho-RFamide.

PMID- 8462278
TI  - Fatty acid-binding protein in bovine longissimus dorsi muscle.
AB  - Experiments were conducted to purify and obtain amino acid sequence data for
      fatty acid-binding protein from bovine longissimus dorsi muscle. 1. Separation of
      sarcoplasmic proteins by fractionation on Sephadex and DEAE cellulose columns
      indicated that a low abundance fatty acid-binding protein exists in bovine l.
      dorsi muscle. 2. Fatty acid-binding protein in bovine l. dorsi muscle cannot be
      separated from myoglobin by standard protein purification procedures. However,
      partial sequencing of a partially purified protein fraction indicated the
      presence of an NH2-terminally blocked protein. 3. Myoglobin bound palmitate under
      the in vitro conditions of these experiments.

PMID- 8462279
TI  - Purification and characterization of metallothionein and its activation of
      pyridoxal phosphokinase in trout (Salmo gairdneri) brain.
AB  - 1. Brain metallothionein was isolated and purified for the first time from
      rainbow trout. 2. Brain metallothionein exhibited an elution volume (Ve/Vo) of
      2.0, had a molecular weight of 6762 Daltons, and contained a zinc content of 9
      micrograms/mg protein. 3. Brain pyridoxal phosphokinase was isolated and assayed
      for the first time in rainbow trout. 4. Zinc (0.20 microM) or zinc
      metallothionein (6-30 microM) stimulated the activity of brain pyridoxal kinase
      in a linear fashion. 5. The results of these studies are interpreted to suggest
      that in trout brain zinc metallothionein may participate in metabolism of vitamin
      B6 and formation of pyridoxal phosphate, the active coenzyme.

PMID- 8462280
TI  - Inhibition of human and murine cytosolic epoxide hydrolase by group-selective
      reagents.
AB  - 1. Human and murine cytosolic epoxide hydrolase were inhibited by thiol-,
      imidazole- and carboxyl-selective reagents. They were not inhibited by amino-,
      guanido- or activated serine-selective reagents. 2. Murine, but not human,
      cytosolic epoxide hydrolase was inhibited by N-bromosuccinimide, a tryptophan
      selective reagent. 3. Based on sequence data from peptides isolated from CNBr
      digests, human and murine CEH share areas of sequence homology. Of the five
      unique human CEH CNBr peptides sequenced, three shared common sequences with one
      of the unique murine CEH CNBr peptides. The human and murine CEH peptides with
      common sequences had between 64 and 78% sequence identity. 4. A cysteine
      important for the activity of murine CEH appears not to be in the active site as
      judged by N-phenylmaleimide inhibition in the presence and absence of either
      (2S,3S)-2,3-epoxy-3-(4-nitrophenyl)glycidol, a competitive inhibitor, or trans
      stilbene oxide, a substrate.

PMID- 8462281
TI  - Inhibition of epoxide hydrolase from human, monkey, bovine, rabbit and murine
      liver by trans-3-phenylglycidols.
AB  - 1. trans-3-Phenylglycidols were potent inhibitors of cytosolic epoxide hydrolases
      in all species tested. 2. The order of inhibitor potency varied from species to
      species but trans-3-(4-nitrophenyl)glycidols were always the most potent
      inhibitors tested for cytosolic epoxide hydrolase. 3. The S,S-enantiomer was a
      more potent cytosolic epoxide hydrolase inhibitor than the R,R-enantiomer when a
      free hydroxyl group was present. However, (2R,3R)-1-benzoyloxy-2,3-epoxy-3-(4
      nitrophenyl)propane was always a better inhibitor than the (2S,3S)-enantiomer. 4.
      All microsomal epoxide hydrolases were poorly inhibited by the trans-3
      phenylglycidols, and related compounds, tested. The best new microsomal epoxide
      hydrolase inhibitor tested was (1S,2S)-1-phenylpropylene oxide which gave 18-63%
      inhibition, at 2 mM, depending on the species tested.

PMID- 8462282
TI  - Comparison of the mucus glycoproteins present in the different layers of rat
      gastric mucosa.
AB  - 1. Applying a newly developed separation method, mucus glycoproteins (mucins)
      present in the different layers of gastric mucosa in rats were studied. 2.
      Distributions of mucin in the four layers of gastric mucosa expressed as mg mucin
      hexose per animal are: deep mucosa of corpus, 705; deep mucosa of antrum, 163;
      surface mucus, 421; mucus gel, 30; and soluble mucus, 173. 3. Relatively low
      molecular sugar chains, having a small amount of neutral sugars, are rich in the
      deep corpus and deep antral mucin. 4. Higher molecular size carbohydrate chains,
      rich in fucose and galactose, are abundant in the surface mucus and mucus gel
      derived mucin.

PMID- 8462283
TI  - Glycogen hyperaccumulation in white muscle fibres of RN- carrier pigs. A
      biochemical and ultrastructural study.
AB  - 1. The dominant RN- gene affects meat quality of pigs by increasing the glycogen
      content of muscle. Glycogen localization was studied in Longissimus dorsi muscle
      from RN- carrier pigs (RN- pigs) and rn+ rn+ homozygous pigs (rn+ pigs). 2.
      Ultrastructural study showed an excess of glycogen in the sarcoplasm of white
      fibres from RN- pigs as compared to rn+ pigs. 3. Lysosome-enriched fractions
      extracted from muscles contained 6% of the tissue glycogen content in both types
      of pigs. The distribution of the glycogen particles between sarcoplasm and
      lysosomes appeared to be similar in both RN- and rn+ pig tissues. 4. White fibres
      from RN- pigs with an increased glycogen level showed two ultrastructural
      alterations: the sarcoplasmic compartment was abnormally enlarged and a large
      proportion of mitochondria was morphologically modified. 5. The RN- gene seems,
      therefore, to be associated with alterations in the glycolytic metabolism, in the
      distribution of proteic compartments and in the oxidative metabolism of white
      muscle fibres.

PMID- 8462284
TI  - Insulin induction of c-Ki-ras in rat liver and in cultured normal rat
      hepatocytes.
AB  - 1. Insulin administration in neonatal rats causes a dramatic accumulation of the
      major c-Ki-ras transcript. 2. The level of c-Ki-ras transcript is greatly reduced
      in alloxan-induced diabetic rats. 3. Injection of insulin in alloxan-induced
      diabetic rats is able to restore almost completely the level of c-Ki-ras
      transcript found in insulin-induced normal rats. 4. Results from nuclear run-off
      experiments reveal that the inductive effect of insulin is at the level of
      transcription of the c-Ki-ras gene. 5. As in whole animals, insulin is also able
      to induce the expression of c-Ki-ras in cultured normal hepatocytes. 6. This
      inductive effect of insulin is markedly reduced in hepatocytes which have been
      previously treated with the tumour promoter, 12-O-tetradecanoylphorbol-13 acetate
      for 24 hr, a result suggesting that at least part of the effect of insulin is
      mediated via protein kinase C.

PMID- 8462285
TI  - Comparative studies of synthesis, phosphorylation, DNA binding and proteolytic
      characteristics of a novel protein during phases of the mouse spleen cell cycle.
AB  - 1. Cultured mouse spleen cells were exposed to the mitogen Concanavalin A
      followed by isoproterenol, and nuclei were electronically sorted from seven
      partitions of the cell cycle. 2. Several nuclear proteins, including stress
      proteins, which were cell-cycle-stage specific, were elicited by isoproterenol as
      determined by micro-electrophoresis and fluorography. 3. Two novel S-phase
      proteins (X0 and X') demonstrated differing synthesis and phosphorylation
      patterns during the cell-cycle phases. 4. X' showed DNA binding characteristics
      and proteolytic properties (hydrolyzing X0 or beta-galactosidase); both proteins
      were cell-cycle regulated.

PMID- 8462286
TI  - An arm immersion model of compromised skin (II). Influence on minimal eliciting
      patch test concentrations of nickel.
AB  - The transition metal nickel is a very common cause of allergic contact dermatitis
      (ACD). In the general population, adults with hand eczema have a high incidence
      of allergy to nickel, and nickel allergy is high in occupational dermatoses and
      is often linked to wet work. Nickel may be found as a trace contaminant in some
      consumer products, e.g., household cleaning agents. It has therefore been debated
      whether these levels, whilst not a primary cause, might be sufficient to maintain
      ACD. The minimal concentration of nickel in patch tests on normal skin that will
      elicit an allergic reaction in highly sensitised subjects is 1-10 ppm. This trial
      assessed whether reactivity to nickel was altered on compromised dorsal forearm
      skin and compared this to normal skin on the contralateral dorsal forearm and on
      the back. Skin damage consequent upon arm immersion in sodium dodecyl sulphate
      (SDS) greatly enhanced reactivity to nickel on the forearm, with the dorsal
      aspect reacting most both in number of reactions at each concentration and in the
      minimal eliciting concentration, which was 0.5 ppm in 2/20 under the conditions
      of a 48 h occluded patch.

PMID- 8462287
TI  - Contact dermatitis from dielectric fluids in electrodischarge machining.
AB  - We report an outbreak of irritant contact dermatitis in the aerospace industry
      from electrodischarge machining (EDM). 20 workers doing EDM developed irritant
      contact dermatitis from the dielectric fluid used in EDM, a form of precision
      metal machining that is widely used in mould making and precision engineering.
      Dielectric fluid contains hydrocarbons that are aromatic, paraffinic or
      naphthenic and are skin irritants. Irritant contact dermatitis from dielectric
      fluid has not been reported previously. EDM will become more widespread and
      occupational dermatitis from dielectric fluid is likely to become more prevalent
      in the future. Our experience was that irritant contact dermatitis from
      dielectric fluid can be prevented by simple preventive measures such as personal
      hygiene and health education.

PMID- 8462288
TI  - Frequency of false-negative reactions to the fragrance mix.
AB  - To estimate the frequency of false-negative reactions to the fragrance mix, the 8
      constituents of the mix in concentrations of 5% (2% for cinnamic aldehyde) were
      added to the European standard series for routine testing. Patients with positive
      reactions to individual ingredients in the absence of a reaction to the mix were
      retested with serial dilutions. In a 4-month period, 677 patients were tested. 61
      (9%) reacted to the mix and to 1 or more of the ingredients. 4 patients (0.6% of
      all patients tested and 6.2% of the patients allergic to fragrances) had false
      negative reactions to the mix. They were allergic to cinnamic alcohol, geraniol,
      isoeugenol and oak moss (1 reaction each), in the absence of a reaction to the
      fragrance mix. It is concluded that the currently used concentration of the mix
      (8 x 1%) not infrequently results in false-negative reactions, and that further
      research should be done to overcome this problem.

PMID- 8462289
TI  - Measurement of skin-fold thickness in the guinea pig. Assessment of edema
      inducing capacity of cutting fluids, acids, alkalis, formalin and dimethyl
      sulfoxide.
AB  - The rabbit has been used for decades for predictive testing of skin irritancy,
      but in recent years, the guinea pig has been suggested as an alternative,
      especially for assessment of one of the components of the irritant reaction:
      edema (fluid accumulation). A method based on skin-fold measurements with
      Harpenden calipers has been developed and modified. In previous papers,
      experience with sodium lauryl sulphate, nonanoic acid and industrial solvents was
      reported. The present results concern the use of cutting fluids, buffered and
      unbuffered acid and alkaline solutions, formalin and dimethyl sulfoxide. This
      inexpensive and comparatively unsophisticated method afforded clear dose-response
      relationships and good discriminating power. The only exception was the acid and
      alkaline solutions, where no changes in skin-fold thickness were observed despite
      their documented irritant potential. The appearance of erythema (visual scoring)
      and the increase in skin-fold thickness, and their relationship, are discussed
      with some illustrative examples. The method described is now well standardized
      and is suited for predictive testing of the edema-inducing capacity of chemicals
      and products.

PMID- 8462290
TI  - Allergic contact dermatitis of the lip margins from para-tertiary-butylphenol in
      a lip liner.
AB  - We describe the use of gas chromatography with mass spectrometry (GC-MS) in the
      investigation of a case of allergic contact dermatitis of the lip margins caused
      by a lip liner. Patch testing identified sensitization to para-tertiary
      butylphenol-formaldehyde resin (PTBP-FR), a resin glue frequently used in leather
      work but rarely found in cosmetics. Investigation specified the para-tertiary
      butylphenol (PTBP) component of the resin as the hapten responsible for the
      allergic contact dermatitis, as well as for associated depigmentation.

PMID- 8462291
TI  - The sensitizing potency of Euxyl K 400 and its components 1,2-dibromo-2,4
      dicyanobutane and 2-phenoxyethanol.
AB  - Using a modified FCA (Freund's complete adjuvant) procedure, the sensitizing
      capacity of Euxyl K 400 and its ingredients, 1,2-dibromo-2,4-dicyanobutane and 2
      phenoxyethanol, has been studied in guinea pigs. The experiments demonstrate that
      a distinct but weak sensitizing potency exists for Euxyl K 400 and
      dibromodicyanobutane. Phenoxyethanol remained almost negative. These results are
      in good accordance with the low number of cases of allergic contact dermatitis
      due to Euxyl K 400 and dibromodicyanobutane described since their introduction on
      the market. Cases of phenoxyethanol contact allergy have been published hitherto
      only 4x in the medical literature.

PMID- 8462292
TI  - Allergic contact dermatitis from natural latex without contact urticaria.
AB  - During the last decade, there have been many reports of immediate-type
      hypersensitivity to natural latex, resulting in contact urticaria, generalized
      allergic reactions such as urticaria and Quincke's edema, and asthmatic or
      anaphylactic reactions. Moreover, delayed-type hypersensitivity to rubber
      additives such as thiuram and carbamate derivatives is acknowledged to be the
      main cause of dermatitis in patients working with rubber gloves. We here report
      on a patient who developed severe dermatitis on his hands and forearms 3 months
      after he had started working with rubber gloves. Patch tests with rubber
      additives, skin prick tests and RAST to natural latex were negative. However, a
      delayed type of hypersensitivity to latex could be shown by a positive patch
      test. To our knowledge this is the 1st case reported of an isolated contact
      dermatitis from natural latex without contact urticaria to latex or
      hypersensitivity to rubber additives. We therefore propose that not only patch
      tests with rubber additives, but also skin prick and patch tests with latex
      should be performed in contact dermatitis patients working with rubber gloves.

PMID- 8462293
TI  - Contact dermatitis from beryllium in dental alloys.
AB  - An increasing number of metals with the potential to cause allergic contact
      dermatitis have found their way into dental alloys for economic and practical
      reasons. 2 patients are reported who developed gingivitis adjacent to the
      Rexillium III alloy in their dental prostheses. Patch testing demonstrated
      positive reactions to beryllium sulfate, a component of the alloy. Components of
      dental alloys and the mechanism of the contact dermatitis are discussed.

PMID- 8462294
TI  - Palladium in dental alloys--the dermatologists' responsibility to warn?
AB  - Palladium is increasingly used in industry, but also in fine jewelry and in
      dentistry. Thus, palladium-silver alloys comprise a substantial part of the noble
      metal ceramic alloy sales in Western countries. The increased use of this metal
      seems, however, to be paralleled by a rise in the number of reports of palladium
      allergy. Recently a European study reported a sensitization rate of 2.8%. In
      Austria, where palladium has started to displace amalgam in dental fillings
      because of concerns about mercury toxicity, and gold due to price factors, we
      have found a sensitization rate of 8.3% in unselected eczema patients. Despite
      the current lack of clear clinical relevance of this finding, these numbers
      should motivate us to question this substance as "the alloy of the future".

PMID- 8462295
TI  - Lichenoid dermatitis in 3 professional footballers.
AB  - We describe 3 professional footballers who developed lichenoid dermatitis over a
      short period of time. Clinically, the eruption in all 3 of them can be classified
      as lichenoid photodermatitis. We suggest an influence of possible contact
      allergens or photo-active substances. Histologic evidence points to features of
      classical lichen planus with purpura, typical of lichen aureus (purpuricus), but
      showing some clinical and morphological differences.

PMID- 8462296
TI  - Contact allergy to disperse blue 106 and blue 124 in black "velvet" clothes.
AB  - 9 cases of allergic contact dermatitis due to black "velvet" fabrics, mostly
      leggings, are reported. In all cases, the 2 disperse dyes Blue 106 and 124 were
      shown to be the responsible contact sensitizers. Preparation of a chloroform
      extract and separation of the different disperse dyes by analytical and
      preparative thin-layer chromatography showed that 8 of the 9 black "velvet"
      clothes contained the same composition, namely Disperse Blue 1, 106, and 124,
      Disperse Red 1 and Disperse Yellow 3. In experimental studies performed
      previously, Disperse Blue 124 has been demonstrated to be a moderate sensitizer
      while Disperse Blue 106 proved to be the strongest sensitizer found so far among
      the azo disperse dyes.

PMID- 8462297
TI  - Contact allergies to topical corticosteroids.
AB  - The patient, a 34-year-old Japanese woman who noticed worsening of her rash after
      using topical corticosteroid preparations on her neck, was patch tested for both
      commercial preparations and corticosteroids themselves. The patch test results
      revealed that she had a contact allergy to gold, oxytetracycline, and 2 types of
      corticosteroid (acetonides and esters) in 7 compounds (betamethasone valerate and
      dipropionate, hydrocortisone butyrate and hydrocortisone butyrate propionate,
      amcinonide, budesonide, and fluocinonide).

PMID- 8462298
TI  - Allergic reactions to a hairdressers' series: results from 9 European centres.
      The European Environmental and Contact Dermatitis Research Group (EECDRG).
AB  - To obtain data on the frequency of sensitization among European hairdressers, the
      patch test results from 9 centres were evaluated. 8 allergens recommended by the
      ICDRG and EECDRG in the hairdressing series and PPD from the standard series were
      used to patch test 809 hairdressers and 104 clients suspected of contact
      sensitization. Among hairdressers, the mean frequencies of sensitization ranked
      as follows: GMT 19%, PPD 15%, APS 8%, PTD 8%, ONPPD 4% and PADH 4%. In contrast
      to GMT in acid permanent waves, the frequency of sensitization to AMT in alkaline
      permanent waves was only 4%. Frequencies of sensitization to pyrogallol and
      resorcinol were 0.8% and 0.6%, respectively. The frequencies of sensitization
      showed marked regional variations, particularly that to GMT, which was highest in
      Germany (51%), followed by Spain (22%) and London (19%). Clients of hairdressers
      showed a similar rank order of sensitization frequency, with the exception of
      APS, which was completely negative in this (small) series.

PMID- 8462299
TI  - Contact urticaria from watermelon in a patient with pollen allergy.

PMID- 8462300
TI  - Allergic contact dermatitis due to plant extracts in a multisensitized patient.

PMID- 8462301
TI  - Contact allergy to benzyl alcohol and benzyl paraben.

PMID- 8462302
TI  - Repeated patch testing in delayed hypersensitivity to beta-lactam antibiotics.

PMID- 8462303
TI  - Reaction to topical lignocaine in a patient with contact dermatitis.

PMID- 8462304
TI  - Allergic contact dermatitis due to lanolin in an adhesive plaster.

PMID- 8462305
TI  - Allergic contact dermatitis from ethylbutylthiourea in neoprene.

PMID- 8462306
TI  - Contact dermatitis in a cast technician.

PMID- 8462307
TI  - Frequency of HLA antigens in persons sensitive to N-isopropyl-N'-phenyl-p
      phenylenediamine (IPPD).

PMID- 8462308
TI  - Airborne allergic contact dermatitis from benzalkonium chloride.

PMID- 8462309
TI  - Delayed prolonged contact urticaria from the elm tree.

PMID- 8462310
TI  - Allergic contact dermatitis due to para-tertiary-butylphenol-formaldehyde resin
      in a hearing aid.

PMID- 8462311
TI  - Antagonism in concentrated surfactant systems.

PMID- 8462312
TI  - Systemically aggravated contact dermatitis caused by aluminium in toothpaste.

PMID- 8462313
TI  - A strange manifestation of occupational contact urticaria due to mouse hair.

PMID- 8462314
TI  - Contraception in older woman.
AB  - Oral contraception (OC) in the premenopause has been recently proposed as
      treatment for control and prevention of the putative symptoms typical of this
      period of life. Indeed, menstrual cycle disturbances and climacteric symptoms
      frequently occur at this age. The major aim of normal contraception is resultant
      maintenance of normal sexual activity. The effects of one OC containing 20 mcg
      ethinylestradiol and 150 mcg desogestrel (EE/DOG) were studied. Treatment did not
      significantly modify both lipid metabolism (triglycerides, total cholesterol,
      HDL, LDL, Apo A, Apo B) and clotting system (fibrinogen, PT, PTT, antithrombin
      III, fibrinopeptide A). No significant modifications of oral glucose tolerance
      test (OGGT) occurred after EE/DOG treatment. Also, bone density was not modified
      during estro-progestinic administration. From our experience, if there are no
      risk factors such as smoking, obesity or hypertension, the OCs could be used
      until menopause for absolute contraceptive efficacy, good tolerance and lack of
      side effects.

PMID- 8462315
TI  - Oral contraceptive use and breast cancer in Indonesia.
AB  - A hospital-based case-control study was conducted in Ujungpandang, Indonesia, to
      determine the association of breast cancer and current and former oral
      contraceptive (OC) use. This study included 119 newly diagnosed, histologically
      confirmed, breast cancer cases who were admitted to the four largest referral
      hospitals in Ujungpandang from 1990-1991. Controls were 258 women admitted to
      these same four hospitals with diagnoses unrelated to breast cancer or OC use.
      Thirty cases (32%) and 55 (19%) controls reported having ever used OCs. The odds
      ratio for ever using OCs and breast cancer was 1.8 (95% confidence interval 1.2
      3.0) after adjustment for age, age at first pregnancy, and family history of
      breast cancer. Increasing duration of OC use did not increase risk of breast
      cancer. No latency trend of increasing years since first OC use among cases was
      observed; however, a younger age at first OC use was associated with increasing
      breast cancer risk. A significant recency effect was observed; women last using
      OCs within five years of study enrollment were at greatest risk of breast cancer
      (OR = 4.9, 95% CI: 2.1-11.4). This first study of breast cancer and OC use in
      Indonesia does not provide consistent data to indicate an increased risk of
      breast cancer associated with OC use. Although breast cancer cases were 80% more
      likely to have ever used OCs, neither duration nor latency of OC use were
      associated with cancer risk. The significant recency effect suggests that a
      detection bias might explain the observed relationship between ever OC use and
      breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462316
TI  - Release characteristics, ovarian activity and menstrual bleeding pattern with a
      single contraceptive implant releasing 3-ketodesogestrel.
AB  - The properties of a single contraceptive subdermal implant releasing 3
      ketodesogestrel were assessed in fifteen women over twelve months. Serum levels
      of 3-ketodesogestrel were monitored regularly following insertion and after
      removal. The mean serum level of 3-ketodesogestrel was 245 pg/ml after 72 h
      (steady state) and 176 pg/ml after twelve months. All volunteers demonstrated
      ovulation inhibition throughout the study. Transient oestradiol peaks occurred
      during the study. No luteal activity was noted. The cervical mucus was rapidly
      rendered hostile to sperm migration. Two women withdrew from the study during the
      first six months for medical reasons. Both volunteers cited bleeding irregularity
      as the main cause, one complaining of oligomenorrhoea, the other of prolonged
      bleeding/spotting episodes. A small but significant increase in weight was noted
      during the study period.

PMID- 8462317
TI  - Influence of gestodene and desogestrel as components of low-dose oral
      contraceptives on the pharmacokinetics of ethinyl estradiol (EE2), on serum CBG
      and on urinary cortisol and 6 beta-hydroxycortisol.
AB  - A randomized controlled clinical trial was undertaken over a 6-month treatment
      period with two low-dose combined oral contraceptives (OC) to investigate whether
      the metabolism and elimination of ethinyl estradiol (EE2) is differently
      influenced by the two progestational components gestodene (G) and desogestrel
      (D), an issue which has been very controversial recently. The two formulations
      contained 30 micrograms EE2 each, together with either 75 micrograms G or 150
      micrograms D. Of the 40 young women recruited for each formulation, 31 of each
      group were available for statistical evaluation. The pharmacokinetics of serum
      EE2 were studied on day 1, 10 and 21 of cycle 1, 3 and 6. There were no
      significant differences between the two groups in any cycle with respect to
      parameters measured. This was true for the distinct intracyclical rise in the
      mean EE2 serum levels from day 1 to day 10 and the smaller further increase
      between day 10 and day 21, with no change in this respect between the cycles
      studied. Respective changes were seen with regard to the area under the EE2 serum
      concentration curve up to 4 and 24 hours (AUC0-4 and AUC0-24), cmax and tmax of
      serum EE2. The estrogen-dependent corticoid-binding globulin (CBG) increased
      similarly in the two groups intracyclically and slightly also intercyclically at
      all times tested. Except for the first treatment cycle, urinary excretion of
      cortisol and 6 beta-hydroxycortisol displayed a tendency to lower values
      intracyclically as well as intercyclically, again with no differences between the
      two groups. Also, the 6 beta-hydroxycortisol-to-cortisol ratio was not different
      between the groups, showing a slight tendency to rise from about 4 at the
      beginning of the medication to around 5.5 at the end of the 6th treatment cycle
      in both groups. It is concluded that G and D as components of low-dose OCs exert
      comparable effects on the metabolism and elimination of EE2.

PMID- 8462318
TI  - Effect of antiprogestin, hCG and a prostaglandin analogue on human uterine
      contractility.
AB  - In the present study, the effect of hCG and RU 486 on non-pregnant uterine
      contractility and the sensitivity of the myometrium to the prostaglandin analogue
      misoprostol (GD Searle, Chicago, IL, USA) was evaluated. Seven healthy female
      volunteers participated in the study. Uterine contractility was recorded on cycle
      day LH+13 in two cycles. After recording the spontaneous contractility, 200
      micrograms and 400 micrograms of misoprostol were administered orally at an
      interval of 45-60 minutes. In the second month, 5,000 IU hCG was administered on
      cycle day LH+8 and 10,000 hCG on cycle days LH+10 and LH+12, and 200 mg RU 486 on
      cycle day LH+11, 48 hours prior to the recording. In three women, a third month
      was included in which the same treatment, except for RU 486, was given. Treatment
      with hCG delayed menstrual bleeding and resulted in a significant increase in the
      concentration of plasma progesterone. Following hCG, the degree of uterine
      contractility was reduced, while after hCG and RU 486 the uterus was
      significantly more active. In the control cycle and following hCG alone,
      misoprostol had a slight stimulatory effect. When RU 486 was added, the degree of
      contractility following misoprostol was 4 to 9 times greater than that found if
      RU 486 was not given. Late luteal administration of RU 486 is not an effective
      method of fertility regulation. The results of the present study indicate that a
      combination of RU 486 and misoprostol will be more suitable for this purpose.

PMID- 8462319
TI  - Intravasal application of BCG (Bacille Calmette Guerin) is not an effective
      method for control of fertility in the male: a preliminary report.
AB  - Bacille Calmette Guerin (BCG) was applied intravasally in male rats with the hope
      of developing a method for control of fertility in the male. Our results,
      however, suggest that this approach is not feasible for control of male
      fertility.

PMID- 8462320
TI  - Tamoxifen as an antifertility agent in the long-tailed macaque (Macaca
      fascicularis).
AB  - The potential use of tamoxifen, a nonsteroidal antiestrogen, as an antifertility
      agent was studied in the long-tailed macaque (Macaca fascicularis). Twenty-six
      cycling females were bred, then treated with a single oral dose of tamoxifen (5
      mg/kg) (N = 13) or vehicle (N = 13) on day 4 post-ovulation. Serum progesterone
      (P4) and tamoxifen concentrations were evaluated on post-ovulation days 4, 8, 12,
      16, and 18. No effects of treatment were observed on P4 concentrations or on the
      fertility rate--pregnancy was achieved in 4/13 controls (31%) and 6/13 treated
      females (46%). Analysis for serum tamoxifen concentrations in samples collected
      during the fertility and a supplemental pharmacokinetic study (N = 3; single oral
      dose of 10 mg/kg; urine and serum evaluated) failed to reveal any detectable
      tamoxifen levels. It was concluded that (1) absorption of tamoxifen may be
      negligible under the described treatment regimens or (2) tamoxifen
      metabolism/clearance occurs at a rapid rate.

PMID- 8462321
TI  - Additive effect of RU 486 and anordrin on pregnancy interruption in the mouse.
AB  - The effect of various doses of anordrin and RU 486, alone or combined, on serum
      progesterone (P) levels, fetal resorption, and recovery of ovulation was studied
      in mice. Each drug was given as a single sc injection on day 7 of pregnancy and
      autopsy was performed on days 8, 9, or 11. Serum P was normal at 24 h but fell
      significantly 48 h after treatment with anordrin (0.05 mg). Doses of 0.05 or 0.2
      mg anordrin were effective in interrupting pregnancy in 30% and 70% of pregnant
      mice, respectively. RU 486, 0.01 mg per mouse, induced a pronounced decrease of P
      levels 24 h after treatment and interrupted pregnancy in 50% of pregnant mice.
      The combined treatment with submaximal doses of anordrin plus RU 486 did not
      further decrease P levels, but increased the proportion of mice with fetal
      resorptions to 90%. The combination of small doses of anordrin with RU 486 had an
      additive effect on pregnancy termination. The additive effect required a dose of
      RU 486 above the threshold level. Direct observation of aborted fetuses indicated
      that the resorptive process occurred earlier with RU 486 than with anordrin.
      Recovery of ovulation was associated with pregnancy termination in a high
      proportion of mice treated with either drug or their combination.

PMID- 8462322
TI  - Commentary: ethics, ethics everywhere--ascertainment bias in new disorders.

PMID- 8462323
TI  - Approach to the diagnosis and staging of mediastinal masses.
AB  - Improvements in cytologic techniques have made needle biopsy much more helpful in
      diagnosing mediastinal masses. We have added thoracoscopy to the surgical
      armamentarium. Tumor markers facilitate accurate diagnosis. In the field of
      imaging, cysts can now be identified almost certainly and aspirated. Magnetic
      resonance imaging has changed the workup of patients with posterior mediastinal
      masses. Staging investigations should be based on the type of tumor and the
      likelihood of spread.

PMID- 8462324
TI  - Current therapy for thymoma.
AB  - Thymomas are the most frequently encountered neoplasm of the anterior
      mediastinum. Thymic neoplasms can be divided into 3 broad categories based on
      histologic appearance and behavior. Thymomas are tumors with benign-appearing
      cellular features. If there is no gross or microscopic invasion beyond the
      capsule, the tumor is considered benign. Any tumor with gross or microscopic
      invasion through the capsule is considered malignant. In a third category, thymic
      tumors which have histologically malignant epithelial features, are considered
      thymic carcinomas and generally have an adverse prognosis. Microscopically,
      thymomas consist of a variable component of lymphocytic, epithelial, and fusiform
      (spindle) cell elements. The tumors may be classified according to the
      predominant cell type or are considered mixed if no cell type predominates.
      Prognosis is most strongly linked to clinical stage. The role of adjuvant
      radiotherapy or chemotherapy in the treatment of such tumors is controversial,
      but malignant thymomas are generally responsive to radiotherapy. Associated
      myasthenia gravis does not adversely affect the prognosis of thymoma, and medical
      attention to the myasthenia may contribute to earlier diagnosis of the thymoma.
      Cisplatin-based chemotherapy may be used to treat advanced disease with a modest
      response rate.

PMID- 8462325
TI  - Preoperative assessment of patients undergoing pulmonary resection.
AB  - A careful preoperative assessment of patients with lung cancer is essential for
      identifying those at high risk for morbidity and mortality related to the
      surgical procedure. The clinician must assess the risk associated with such
      treatment, decide whether the risk is prohibitive, and institute therapy to
      reduce such risk. Testing modalities used in the preoperative evaluation include
      spirometry, full pulmonary function tests, measurement of arterial blood gases,
      radionuclide lung scanning, exercise testing, invasive measurement of pulmonary
      artery pressure, and a variety of studies involving lobar occlusion or lateral
      position testing. Studies evaluating the utility of these procedures are
      reviewed. Additionally, the impact of advanced age on postsurgical outcome is
      evaluated, as are the possibility of operating on high-risk patients and the use
      of preoperative interventions.

PMID- 8462326
TI  - New approaches to Pancoast and chest wall tumors.
AB  - Superior pulmonary sulcus carcinoma, or Pancoast's tumor, was first identified in
      1932 by H. K. Pancoast, who described a small tumor at the apex of the lung
      producing a characteristic pain pattern and rapid, universal mortality. Despite
      early indications that this type of carcinoma was amenable to neither radiation
      nor surgery, the current treatment approach calls for irradiation therapy (3,000
      rad over 2 to 3 weeks) followed by surgical resection of the chest wall, lower
      brachial plexus, and en bloc resection of the lung. In selected patients with
      negative mediastinal nodes, this approach has been associated with a 34% 5-year
      and a 29% 10-year survival.

PMID- 8462327
TI  - Solitary brain metastases. Radiation, resection, or radiosurgery?
AB  - Three treatment options are available for management of the patient with a known
      thoracic mass and a solitary brain metastasis: external beam radiation, surgical
      resection, and stereotactic radiosurgery. Traditional external beam radiation may
      still represent the most appropriate choice in the management of patients with
      radiosensitive lesions who are in poor health or who have significant risk
      factors that prohibit other treatment choices. Surgery is recommended in the
      presence of significant edema, a large intracranial mass, significant symptoms
      requiring immediate attention, associated hemorrhage, and for superficial
      lesions. Finally, stereotactic radiosurgery, an important new technique whereby
      high doses of radiation are targeted directly to the mass, is recommended
      particularly for deep lesions that are difficult to reach surgically and for
      treatment of patients for whom surgery is contraindicated. Stereotactic
      radiosurgery has the added benefits of being noninvasive, effective, and
      repeatable in the presence of recurrence or other metastatic disease.

PMID- 8462328
TI  - Natural history and epidemiology of malignant mesothelioma.
AB  - Asbestos exposure constitutes the primary cause of pleural and peritoneal
      mesothelioma in humans. Risk relates to the duration and intensity of exposure.
      Thus, those exposed at younger ages are at higher lifetime risk. Families of
      asbestos workers exposed to asbestos on hair and clothing as well as to asbestos
      items brought home from the workplace are also at risk, as are employees working
      in the same vicinity as asbestos workers. The public health significance of
      exposure from asbestos in public and private buildings remains controversial.
      Malignant mesothelioma is difficult to diagnose and carries a poor prognosis.
      Chemotherapy with single or multiple agents has thus far been disappointing, but
      doxorubicin and cisplatin or mitomycin and cisplatin are probably most active
      with response rates in measurable disease of 25%. Palliative radiotherapy is also
      problematic since differences between tumor cytotoxicity and pulmonary tolerance
      are small and radiation pneumonitis may significantly impair quality of life.

PMID- 8462329
TI  - Extrapleural pneumonectomy in the setting of a multimodality approach to
      malignant mesothelioma.
AB  - The use of extrapleural pneumonectomy in a multimodality treatment setting for
      malignant pleural mesothelioma is described, presenting first the right-sided
      approach and then the left-sided. This technique used in a multimodality approach
      with CAP chemotherapy (cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2,
      cisplatin 75 mg/m2) 5 cycles at 3-week intervals, and radiotherapy (55 Gy
      radiation to sites of previous bulky disease or residual disease) to treat 44
      patients with malignant pleural mesothelioma resulted in improved operative
      mortality and decreased length of hospital stay.

PMID- 8462330
TI  - Pleurectomy/decortication and adjuvant therapy for malignant mesothelioma.
AB  - Malignant mesothelioma is an uncommon and usually fatal cancer, for which there
      is no standard treatment. However, surgical resection remains the mainstay of
      treatment because of the inability to treat the entire hemithorax effectively
      with radiation and the lack of effective chemotherapy drugs. Extrapleural
      pneumonectomy is the only technically feasible operation for patients who have
      bulky local tumor and chronic entrapment of the lung, but
      pleurectomy/decortication is associated with a lower operative morbidity and
      mortality, and seems to lead to an equally good survival in patients who have
      early-stage disease. Because of the high risk of local recurrence after surgical
      resection by either extrapleural pneumonectomy or pleurectomy/decortication,
      efforts have been directed at developing effective adjuvant treatment. Radiation
      given postoperatively after pleurectomy/decortication has led to a minimal
      improvement in survival and to significant side effects. Adjuvant chemotherapy is
      considered investigational but is currently being evaluated in a clinical trial
      using high-dose intrapleural and systemic chemotherapy after
      pleurectomy/decortication. Additional well-designed prospective trials are needed
      to alter the dismal outcome of this disease.

PMID- 8462331
TI  - Video thoracoscopic management of benign and malignant pericardial effusions.
AB  - Surgical management of symptomatic benign and malignant effusive pericarditis is
      often required. Twenty-two patients with medically recalcitrant effusive,
      nonconstrictive pericarditis underwent pericardial resection by a video-assisted
      thoracoscopic surgical (VATS) technique (9 malignant, 13 benign).
      Pericardiectomy, resulting in complete drainage of the pericardial space and
      control of patient symptoms was accomplished routinely. Ipsilateral pleural
      effusions, originally present in 11 patients, were also managed. The VATS
      pericardiectomy was well tolerated even by gravely ill patients. This approach
      should be considered as an alternative to lateral thoracotomy or subxiphoid
      pericardial window for the surgical management of patients with symptomatic
      benign and malignant pericardial effusions.

PMID- 8462332
TI  - Approach to the patient who presents with superior vena cava obstruction.
AB  - Obstruction of the superior vena cava (SVC), a thin-walled vessel that carries
      blood at low pressure, may result from compression by tumor or intraluminal
      thrombus formation. The SVC syndrome that ensures may be the cause of significant
      morbidity. This article reviews the pathogenesis of SVC syndrome, appropriate
      radiologic imaging procedures, and the issue of obtaining a tissue diagnosis. The
      management of SVC syndrome with chemotherapy, radiotherapy, and surgery is also
      discussed.

PMID- 8462333
TI  - Synchronous primary lung cancers.
AB  - Synchronous primary lung cancers (SPLCs) occur in up to 0.5% of patients with
      lung cancer. They are first diagnosed intraoperatively or upon pathologic
      examination of resected tissue in up to 40% of patients with SPLCs. Complete
      surgical resection is possible in over 90% of patients, with an operative
      mortality of 2.1%. Despite a high frequency of early stage disease (two thirds of
      patients have either stage I or II tumors), surgical therapy yields an overall 5
      year survival of only 20%, far lower than expected. These findings suggest that
      the biology of SPLCs is different from that of ordinary lung cancers, or that the
      diagnosis of SPLCs is being made too often, and that in some patients the second
      cancer focus actually represents metastatic disease. The use of newer techniques
      of identifying the molecular and biologic characteristics of these cancers,
      including analysis of DNA ploidy patterns, may more accurately define SPLC
      patients. Optimal interventional and preventive therapies remain to be
      determined.

PMID- 8462334
TI  - Pulmonary metastectomy. Current indications for removing lung metastases.
AB  - Despite a great deal of literature on pulmonary metastectomy, the treatment of
      pulmonary metastases remains somewhat controversial. However, review of the
      literature does allow the development of certain algorithms to approach this
      problem, and these are discussed.

PMID- 8462335
TI  - Overview: the changing nature of esophageal cancer.
AB  - Squamous cell carcinomas of the esophagus, while still frequent in many locations
      throughout the world, now comprise a smaller percentage of esophageal cancers in
      the United States than was previously believed. Such tumors occur most often in
      black men and in association with tobacco and alcohol abuse. Adenocarcinomas of
      the distal esophagus represent an increasing proportion of esophageal tumors.
      These neoplasms arise in columnar epithelium (ie, Barrett's esophagus) or extend
      into the esophagus from their site of origin in the proximal stomach. Esophageal
      adenocarcinomas appear more often in white than black subjects and in men more
      than women. The clinical features and diagnostic approaches to squamous cell
      tumors and adenocarcinomas of the esophagus are similar.

PMID- 8462336
TI  - Multimodality therapy for esophageal carcinoma--update.
AB  - Transhiatal esophagectomy with mobilization of the stomach to replace the
      esophagus has been used to provide palliation of dysphagia at the University of
      Michigan for more than 15 years. The subtotal esophageal resection is believed to
      be preferable to the transthoracic approach that has been considered the standard
      for this surgery. As experience with the technique has increased, complications
      have decreased. Most patients are discharged, able to swallow, by the 10th or
      11th postoperative day. Survival in these patients is no worse than that reported
      after more traditional transthoracic esophagectomy, and the transhiatal route has
      reduced postoperative pulmonary complications and the incidence of mediastinitis
      from anastomotic leak, which is fatal in 50% of patients. In a phase II trial of
      preoperative combined radiation therapy and chemotherapy with cisplatin,
      vinblastine, and continuous-infusion 5-fluorouracil in 45 patients, survival
      after esophagectomy seemed considerably better than in our historical control
      subjects treated with transhiatal esophagectomy alone. The 3-year survival of the
      43 patients was 46% compared with 23% of those who received only surgery.
      Considering only the 27% of those patients who had no cancer in their resected
      specimens, ie, the complete responders, the 5-year survival is 70%. A phase III
      trial is now accruing patients in an attempt to confirm these results.

PMID- 8462337
TI  - Selecting the surgical approach to cancer of the esophagus.
AB  - Surgical treatment of cancer of the esophagus is influenced by two issues: use of
      surgical resection within a multimodality treatment approach and selection of the
      correct surgical approach. Selecting the correct surgical approach should be
      individualized and determined by the intent of surgery (curative or palliative),
      the anatomic location of the tumor (cervical or thoracic), the preferred method
      of reconstruction (colonic interposition or gastric pull-up), and whether surgery
      is the only therapeutic modality to be used or will be combined with neoadjuvant
      chemotherapy and/or radiotherapy. A discussion of the efficacy of treatment
      within a multimodality setting and a description of the surgical approach follow.

PMID- 8462338
TI  - Sleeve lobectomy, segmentectomy, and thoracoscopy in the management of carcinoma
      of the lung.
AB  - In patients with lung cancer, the goals of limited resection procedures of the
      lung and major airways are to provide an adequate cancer operation while
      preserving functioning lung tissue. Discussed in this article are sleeve
      lobectomy, an alternative to pneumonectomy in patients with cancer in a lobar
      orifice; segmentectomy or wedge resection, an alternative to lobectomy in those
      with a peripheral lung cancer; and thoracoscopy, an alternative to open
      thoracotomy for various chest malignancies.

PMID- 8462339
TI  - The molecular biology of lung cancer pathogenesis.
AB  - Lung cancers exhibit multiple genetic lesions including mutations activating the
      dominant cellular proto-oncogenes as well as those inactivating the recessive or
      "tumor suppressor" genes. Candidate tumor suppressor genes include those on
      chromosomes 1p, 1q, 3p14, 3p21.3, 3p25 (VHL gene), 5q21 (APC/MCC gene cluster),
      9p21-22 (interferon gene cluster), 11p, 13q (rb gene), 16p24, and 17p (p53 gene).
      Mutations in p53 inactivate its transcriptional activity, while replacement of a
      wild-type p53 in lung cancer cells inhibits growth and tumorigenicity suggesting
      that p53 acts as a master growth regulatory switch. Lung cancer cells exhibit
      several positive autocrine growth factor loops and express nicotine receptors
      which could function as tumor promoting systems. In addition, they express a
      negative autocrine loop involving opioids and their receptors which is reversed
      by nicotine acting through nicotinic acetylcholine receptors. The presence of
      nicotine receptors suggests nicotine or its metabolites may play a direct role in
      lung cancer pathogenesis.

PMID- 8462341
TI  - [Open letter of the chief physician of a university surgical clinic for revision
      of the public health structure regulation--reduction in compensation for
      physicians entitled to liquidation].

PMID- 8462340
TI  - [Work disability: economic effects of ambulatory surgery].

PMID- 8462342
TI  - [Prevention of infection in endoscopic surgery (minimal invasive surgery)].

PMID- 8462344
TI  - [Clinic administrator as manager--management in clinic administrations. Thoughts
      on seminars of the German Society of Surgery].

PMID- 8462343
TI  - [Routine bed disinfection is unnecessary. In Freiburg a new model was developed].

PMID- 8462345
TI  - [Sale of the practice and patient records. Federal court: leaving patient records
      is only allowed with patient consent].

PMID- 8462346
TI  - [Drainage in surgery of infections].

PMID- 8462347
TI  - [Pyogenic liver abscess. Analysis and follow-up examination of a personal patient
      sample 1981-1992].
AB  - From January 1, 1981 to January 1, 1992 a total of 30 liver abscesses were
      treated in the University Clinic for Surgery in Cologne. 23 patients underwent an
      primary operative treatment and seven patients received a controlled guided
      percutaneous drainage. During the observation period four patients (13.3%) died
      by the effect of the liver abscess. 20 patients (66.7%) were subjected to
      clinical, laboratorical and computertomographical post examinations. The primary
      rate of operation success amounted to 47.8%, that of controlled guided
      percutaneous drainage of 42.8% (NS). The secondary success rate (that means after
      successful operative reintervention) amounted to 86.9% by the operative and to
      85.7% by the percutaneous drainaged cases. During the post examination no relapse
      was determinated. Larger or chambered liver abscesses as well as extrahepatic
      spreading required operative drainage and, in cases of multifocal spreading, a
      resection with concomitant antibiotics. In case of solitary abscesses the
      controlled guided percutaneous drainage is the least harmful and low-prices
      method.

PMID- 8462348
TI  - [Parathyroid gland cancer. Problems in diagnosis and therapy].
AB  - Parathyroid carcinoma occurs in 0.1 to 5% as the cause of primary
      hyperparathyroidism (HPT). It is difficult to determine the true incidence,
      because parathyroid carcinoma is diagnosed too often due to unreliable histologic
      criteria. It is only justified to make the diagnosis, when a local recurrence or
      metastases with the clinical picture of a recurrent or persistent HPT occurred.
      Treatment of choice is the initial en-bloc resection, which may result in long
      disease-free intervals. Pharmacological treatment, chemotherapy, and radiation
      are mostly ineffective in the treatment of parathyroid carcinoma. A satisfactory
      long-term palliation can only be achieved with repeated resections of the local
      recurrences and metastases. Diagnostic efforts should be made to localize the
      recurrent tumor before every reoperation, whereby ultrasonography of the neck is
      the most sensitive procedure. Occasionally the parathyroid tissue cannot be
      identified in spite of preoperative diagnostic studies or hypercalcemia persists
      after surgery. In these cases forced diuresis and medical treatment with
      calcitonin, diphosphonates or mithramycine can briefly control hypercalcemia. The
      clinical courses of 3 patients with metastasizing parathyroid carcinoma are
      presented and discussed. In these patients 3 to 11 surgical interventions were
      performed in combination with an intermittent medical treatment. By this regimen
      we achieved long-term palliations up to 13 years.

PMID- 8462349
TI  - [Endosonography of the anal canal in functional disorders of the pelvic flow.
      Initial experiences].
AB  - Nine patients were examined by anal endosonography for pelvic floor disorder.
      Internal anal sphincter thickness was correlated with sphincter function. Six
      patients with idiopathic incontinence showed a reduction of internal anal
      sphincter thickness, one patient with outlet obstruction due to chronic anal
      fissure showed an increase of thickness. Traumatic lesions could be precisely
      localized because of defects in both internal and external anal sphincter. Anal
      endosonography can be recommended in the evaluation of pelvic floor disorders.

PMID- 8462351
TI  - [Laparoscopic dissection of the Ladd band in adulthood].

PMID- 8462350
TI  - [Surgical treatment and regional chemotherapy in melanoma of the extremities].
AB  - Since 1979, our treatment protocol for extremity melanoma includes wide local
      excision, regional lymph node dissection and hyperthermic limb perfusion. We
      report on the results of a follow-up of the patients treated in the first decade
      (n = 451). According to the UICC Classification of 1987, 4% of our patients were
      in stage I, 36% in stage II, 50% in stage III and 9% in stage IV. The respective
      5-year survival rates were 93%, 91%, 49%, and 20%. We conclude that regional
      chemotherapy appears to be beneficial even for stage II patients, as 5-year
      survival rates of more than 90% can be achieved.

PMID- 8462352
TI  - [Congenital post-papillary, membraneous duodenal stenosis as a rare cause of
      jaundice in adulthood].

PMID- 8462353
TI  - [Immunoglobulin administration in preparation for splenectomy in autoimmune
      thrombocytopenia in childhood].

PMID- 8462354
TI  - [A new instrument for extirpation of PTFE vascular prostheses. Initial clinical
      experiences].
AB  - In seven patients in whom a PTFE prosthesis had to be removed (six arteriovenous
      dialysis shunts in the arm and one femoro-popliteal by-pass), surgery was
      performed with the aid of a newly developed prosthesis removal device. This
      device consists of a guide rod that is inserted in the prosthesis while a second,
      chisel-like extension with a sharp cutting edge is advanced along the exterior of
      the prosthesis to separate it from the tissue. With this technique, up to 17-cm
      long segments were extirpated subcutaneously. The only complication was a lesion
      of an radial artery in an atypically situated AV shunt. The advantages of the new
      instrument are that it saves time and conserves tissue and skin.

PMID- 8462355
TI  - [Surgical procedure in Crohn disease].

PMID- 8462356
TI  - [Drainage--materials and physical principles].

PMID- 8462357
TI  - [Drainage in hepatobiliary surgery].

PMID- 8462358
TI  - [Drainage techniques and drainage principles in visceral surgery].

PMID- 8462359
TI  - [Drainage in accident and reconstructive surgery].

PMID- 8462361
TI  - Concentrating missense mutations in core gene of hepatitis B virus. Evidence for
      adaptive mutation in chronic hepatitis B virus infection.
AB  - To elucidate the temporal relationship between liver damage and mutation(s) in
      hepatitis B virus core gene, serial sera from a progressive liver disease patient
      and an asymptomatic carrier were studied. By direct sequencing, missense
      mutations in the core gene were only found in serum from the progressive liver
      disease patient during the period with frequent exacerbation. Using methods of
      cloning and sequencing, missense mutations were also found in clones derived from
      the progressive liver disease patient at a relatively early phase, but strains
      with a missense mutation from earlier sera did not exist in sera of a later
      period. Furthermore, there was a tendency of concentrating missense mutations in
      clones derived from the progressive liver disease patient. These data suggested
      that missense mutations in the core gene that occurred at an earlier phase might
      evoke an immune response to eliminate mutated virus and that concentrating
      missense mutations during a phase of exacerbation might be a result of adaptive
      mutation.

PMID- 8462360
TI  - Interferon in the management of chronic hepatitis B.
AB  - Many drugs have been used in the treatment of chronic hepatitis B, but with the
      exception of interferon, none have proved to be effective. Several studies have
      found that a sustained loss of viral replication occurs in approximately 40% of
      patients who started with a 16-week course of recombinant interferon alfa-2b
      given in a dose of 5 million units daily or 10 million units three times weekly.
      Moreover, disappearance of hepatitis B surface antigen in serum has been observed
      in 10-15% of treated patients. Based on these results, the Food and Drug
      Administration approved the use of this form of interferon in chronic hepatitis B
      in July 1992. This article reviews the importance of chronic hepatitis B as a
      health problem as well as the mechanisms of action, benefits, and adverse effects
      associated with interferon. Particular emphasis is given to the safety and
      efficacy data for recombinant interferon alfa-2b.

PMID- 8462363
TI  - Controlled trial of high-dose octreotide in treatment of acute pancreatitis.
      Evidence of improvement in disease severity.
AB  - Nineteen consecutive patients with acute pancreatitis were sequentially allocated
      to treatment with high-dose octreotide (N = 9) or to act as controls (N = 10).
      All other aspects of treatment were similar and were according to a strict
      treatment protocol. There was no significant difference between the two groups on
      admission with regard to recognized criteria of poor prognosis. The octreotide
      treated group required significantly less analgesia and after 48 hr developed
      significantly fewer poor prognostic indicators, including falls in hematocrit of
      > 10%, in serum albumin to < 32 g/liter, and in serum calcium to < 2.00
      mmol/liter. Falls in arterial PO2 to < 10 kPa, in serum albumin of > 20%, and in
      hemoglobin of > 2 g/dl were also significantly less frequent. There was a trend
      towards improvement in the octreotide-treated group in every other physiological
      and radiological indicator of disease severity. High-dose octreotide may reduce
      the severity of acute pancreatitis.

PMID- 8462362
TI  - Effect of cyclosporine on distribution of macrophage subpopulations in rat
      hepatic allograft.
AB  - Macrophage subpopulations infiltrating the grafts of ACI(RT1a) to LEW(RT1(1))
      orthotopic rat liver transplants treated with or without immunosuppressive
      therapy were studied using immunohistochemical staining. LEW recipients of ACI
      liver transplants experienced severe acute graft rejection, with a mean survival
      of only 10.2 +/- 0.7 days. An indirect immunoperoxidase technique on cryostat
      sections of the liver grafts was used to determine the localization of macrophage
      subpopulations infiltrating the grafts, as defined by specific anti-rat
      macrophage monoclonal antibodies, designated TRPM-1 (pan-macrophage), TRPM-3
      (activated macrophage) and Ki-M2R (tissue macrophage). TRPM-1+ or TRPM-3+ cells
      gradually increased on days 5 and 7 in the untreated hepatic allografts, whereas
      no significant changes in the number of these cells were observed in the
      isografts. Treatment with cyclosporine (CsA) greatly decreased the number of
      these two different types of cells infiltrating the hepatic allografts, compared
      to the untreated hepatic allografts or the isografts. The time course of the
      accumulation of these cells in the allografts treated with CsA showed a similar
      pattern; the cells increased gradually by day 5 and thereafter decreased. This
      pattern is different from that observed in the untreated allografts or in the
      isografts. There was no significant difference in the number of Ki-M2R+ cells
      between the untreated hepatic allografts and the isografts. However, the number
      of the Ki-M2R+ cells in the hepatic allografts treated with CsA was much less
      than that of either the untreated allografts or the isografts. These findings
      suggest that a progressive relative increase in host TRPM-3+ macrophage is a
      characteristic feature of ongoing first-set rejection in the rat hepatic
      allograft.2+ allograft, even when compared with the isografts.

PMID- 8462364
TI  - Morphological changes of small pancreatic cysts in response to secretin
      stimulation. Observation by endoscopic ultrasonography.
AB  - It is difficult to discriminate clinically the etiology of small pancreatic cysts
      using conventional methods. Endoscopic ultrasonography can delineate small
      lesions. In order to help differentiate the etiology of cystic lesions of the
      pancreas by endoscopic ultrasonography, we investigated morphological changes
      following stimulation of the pancreatic secretion with secretin. After an
      intravenous injection of secretin (50 CU), the size, shape, and echogenicity of a
      cyst smaller than 2 cm were recorded for 15 min. Of 17 cases examined, 10
      patients showed an alteration of these factors. These cases were thought to be
      nonneoplastic cysts, which included all six cases where communication to the main
      pancreatic duct was demonstrated by ERCP. Five cases of neoplastic cyst did not
      show the change in shape and size. These results indicate that secretin
      stimulation provides useful information in the diagnosis of the etiology of
      pancreatic cyst by endoscopic ultrasonography.

PMID- 8462365
TI  - Truncated GLP-1 (proglucagon 78-107-amide) inhibits gastric and pancreatic
      functions in man.
AB  - We studied the effect of intravenous infusion of synthetic truncated GLP-1
      (proglucagon 78-107-amide) on fasting and postprandial gastric acid secretion,
      gastric emptying, and pancreatic secretion of trypsin and lipase in eight normal
      volunteers using marker dilution and aspiration technique. The infusion resulted
      in a plasma concentration of 110 +/- 14 pmol/liter (mean +/- SEM). Truncated GLP
      1 significantly inhibited postprandial acid secretion by 43 +/- 11% in spite of
      unchanged plasma gastrin concentration. Gastric emptying rate decreased
      significantly; 50% emptying time increased from 16 +/- 2 min to 30 +/- 5 min.
      Postprandial trypsin and lipase outputs were significantly inhibited by 47 +/-
      17% and 40 +/- 9% during truncated GLP-1 infusion. Pancreatic enzyme output was
      linearly correlated to gastric emptying, and truncated GLP-1 did not affect this
      relationship, suggesting that the effect on pancreatic secretion was secondary to
      the effect on gastric emptying. Postprandial insulin and glucagon concentrations
      were similar with and without truncated GLP-1 infusion in spite of significantly
      lower blood glucose levels (5.2 +/- 0.2 versus 3.7 +/- 0.3), indicating that GLP
      1 stimulated insulin secretion and inhibited glucagon secretion. In conclusion,
      our results suggest that truncated GLP-1 act as a physiological inhibitor of
      gastric and pancreatic functions in man.

PMID- 8462366
TI  - Regulation of intestinal concentration of cholecystokinin by bile and/or
      pancreatic juice.
AB  - Pancreatic exocrine secretion in conscious rats is regulated by intraluminal bile
      and/or pancreatic juice. Exclusion of bile and/or pancreatic juice from the
      intestinal lumen caused cholecystokinin (CCK) release and stimulated pancreatic
      secretion. CCK in the plasma is mainly derived from endocrine cells in the
      proximal small intestinal mucosa. We examined the changes in CCK concentrations
      in the intestinal mucosa and compared them to those of plasma CCK concentrations
      and the changes of luminal trypsin activities after bile and/or pancreatic juice
      diversion in conscious rats. Rats with bile and pancreatic fistulae were used.
      Each treatment of bile, pancreatic juice, and bile-pancreatic juice diversion
      decreased luminal trypsin activity and increased plasma and intestinal CCK
      concentrations. The potency of the stimulatory effect on plasma and intestinal
      CCK concentrations was bile-pancreatic juice diversion > pancreatic juice
      diversion > or = bile diversion. Neither plasma CCK concentration nor intestinal
      CCK concentration was in inverse proportion to trypsin activity. The plasma CCK
      concentration did not parallel intestinal CCK concentration. Intravenous infusion
      of CCK-8 (300 pmol/kg/hr) did not increase CCK concentration in the intestinal
      mucosa. It was proposed that bile and/or pancreatic juice in the intestinal lumen
      regulated CCK concentrations not only in the plasma but also in the intestinal
      mucosa.

PMID- 8462367
TI  - Prevalence of gallstone disease in Mexico. A necropsy study.
AB  - The prevalence of gallstone disease in Mexico was investigated by studying a
      sample of 21,446 necropsies performed at the Department of Pathology of the
      General Hospital of Mexico City during a 35-year period (1953-1988). For each
      decade, 1000 necropsy cases were randomly selected. The crude prevalence of
      gallstone disease was 14.3%, 8.5% for males and 20.4% for females. The age groups
      ranged from 20 to more than 80 years old; the age-standardized prevalence for
      males was 5.6% and for females 16.2%. These rates are intermediate between those
      found in Chile and some African countries, comparable to some European studies,
      and less than those found in Mexican-Americans. No significant trend in the
      prevalence of gallstone disease was found when the different decades were
      compared.

PMID- 8462368
TI  - Stabilization of biliary lipid particles by ursodeoxycholic acid. Prolonged
      nucleation time in human gallbladder bile.
AB  - We evaluated the effect of ursodeoxycholic acid on the metastability of human
      bile as reflected by nucleation time and also assessed the mechanism of its
      action in an ultrastructural study. Ursodeoxycholic acid significantly prolonged
      the nucleation time of gallbladder bile from cholesterol gallstone patients
      without causing either drastic changes in the distribution of cholesterol between
      the nonmicellar and micellar fractions of bile or biliary cholesterol
      desaturation. Gel permeation chromatography resolved two distinct components of
      the nonmicellar fraction: vesicles and phospholipid lamellae (identified by
      electron microscopy). Nonmicellar cholesterol was predominantly carried by
      vesicles in the bile of untreated gallstone patients, whereas it was chiefly
      carried by phospholipid lamellae in patients treated with ursodeoxycholic acid.
      Furthermore, phospholipid lamellae from untreated gallstone patients showed rapid
      transformation and cholesterol microcrystal formation within seven days, whereas
      the lamellae from ursodeoxycholic acid-treated patients were stabilized and
      showed little change. On the other hand, biliary mucin concentration was reduced
      by the treatment with ursodeoxycholic acid. These findings suggest that
      ursodeoxycholic acid stabilizes phospholipid lamellae and consequently prolongs
      nucleation time. It is also possible that the reduction of biliary mucin plays a
      role in this process.

PMID- 8462369
TI  - Neuropeptides in pig sphincter of Oddi, bile duct, gallbladder, and duodenum.
AB  - To better understand the complex structure and function of the sphincter of Oddi
      (SO), the occurrence and localization of nine neuropeptides, including vasoactive
      intestinal polypeptide (VIP), bombesin, neuropeptide Y, peptide histidine
      isoleucine (PHI), calcitonin gene-related peptide (CGRP), galanin, substance P,
      serotonin, and somatostatin, were studied by immunohistochemical methods in the
      pig SO. The SO innervation was compared to gallbladder, common bile duct, and
      duodenal innervation. Specimens from the SO, gallbladder, common bile duct, and
      duodenum demonstrated a rich network of nerves, as suggested by light microscopy
      and confirmed by a myelin marker S-100. SO demonstrated very strong
      immunoreactivity for VIP, strong immunoreactivity for neuropeptide Y and galanin,
      moderate immunoreactivity for PHI and CGRP, and borderline immunoreactivity for
      bombesin and substance P. Serotonin and somatostatin immunoreactivity was also
      observed, not in the nerves, but in some of the epithelial cells. The gallbladder
      innervation was virtually identical to the SO innervation, whereas common bile
      duct and duodenal innervation were slightly different. To our knowledge this is
      the first time that galanin- and PHI-like immunoreactivities have been observed
      in the SO. Our observations suggest that these peptides, along with VIP,
      neuropeptide Y, and CGRP, might play a role in the neural control of biliary
      motility.

PMID- 8462370
TI  - Mechanism of intragastric tetramethylammonium protection against 40% ethanol
      injury in rat stomach.
AB  - The effect of tetramethylammonium (TMA), a ganglionic stimulant, on gastric
      mucosal injury induced by 40% ethanol was examined. In studies I-III, rats were
      treated with intragastric vehicle or TMA (1 or 10 mg/kg). In study I, 1 hr after
      the treatment, 40% ethanol was given intragastrically. The length of the linear
      corpus mucosal lesions was measured unbiasedly with a caliper after another hour.
      In study II, mean blood pressure was assessed before and after the treatment. In
      study III, 1 hr after the treatment, gastric mucus and juice volumes, and
      titratable acid were measured. In study IV, 40% ethanol (10 ml/kg) was
      administered intragastrically immediately after 0.2 or 1.4 ml of intragastric
      vehicle treatment. One hour later, gastric lesions score was assessed as in study
      I. Results show that (1) intragastric TMA dose-dependently protected against 40%
      ethanol-induced gastric injury; (2) neither dose of intragastric TMA increased
      mean blood pressure; (3) there was a dose-related increase in gastric mucus
      secretion for TMA 1 and 10 mg/kg, and a significant increase in gastric juice
      volume only for TMA 10 mg/kg; and (4) the rats treated with 1.4 ml of vehicle
      plus 40% ethanol had significantly less injury than those treated with 0.2 ml of
      vehicle plus 40% ethanol. We conclude that the protective effect of intragastric
      TMA can be explained by its dose-related effect in enhancing gastric mucus
      secretion for TMA 1 and 10 mg/kg and the significantly greater increase in
      gastric juice volume for TMA 10 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462371
TI  - Effects of compound U74500A in animal models of gastric and duodenal ulceration.
AB  - Pretreatment with U74500A (up to 0.65 mg/100 g) failed to affect gastric lesions
      induced by 100% EtOH gavage in Sprague-Dawley rats. Topical application of
      U74500A did not reduce lesions induced by 40% EtOH in ex vivo gastric chamber
      preparations. However, pretreatment of rats with U74500A (0.65 g/100 g per os)
      reduced the incidence and severity of experimental duodenal ulcer induced by
      cysteamine HCl, and duodenal ulcer induced by cysteamine-HCl plus GABA. These
      results show U74500A to have powerful and specific antiduodenal ulcer actions.
      Pharmacologic analysis of organ-bath preparations of the small intestine show
      this compound to reduce intestinal contractility to applied cholinergic and
      serotonergic agonists. However, relaxations induced by electrical or nicotinic
      ganglionic stimulation were unaffected. U74500A itself caused concentration
      dependent contractions.

PMID- 8462372
TI  - Gastroprotective effect of zinc acexamate against damage induced by nonsteroidal
      antiinflammatory drugs. A morphological study.
AB  - The gastroprotective effect of zinc acexamate against gastric damage induced by
      different nonsteroidal antiinflammatory drugs (indomethacin, diclofenac, and
      piroxicam) was morphologically assessed in the rat glandular stomach by light and
      scanning electron microscopy. In addition, the capability of these
      antiinflammatory drugs to inhibit gastric prostaglandin E2 production was
      compared with their ability to induce gastric lesions. Microscopically,
      disappearance of mucus glycoprotein and exfoliation of the mucosal surface were
      the most common findings. Surface ultrastructural lesions varied from minimal
      lesions of the surface epithelial cells to deep erosions of the gastric mucosa
      with release of associated cellular elements and sloughing of the denuded lamina
      propria. Diclofenac elicited the most powerful inhibitory activity on mucosal
      prostaglandin E2 (98% inhibition vs control), closely followed by piroxicam
      (97.8%) and indomethacin (91.05%). Pretreatment of animals with zinc acexamate
      significantly increased the presence of mucus glycoprotein, maintained the
      continuity of the surface epithelial cells, and decreased the depth of the
      mucosal erosions. The degree of protection exerted by zinc acexamate varied with
      the antiinflammatory, but was always evident.

PMID- 8462373
TI  - Phenytoin-induced chronic hepatitis.
AB  - Phenytoin has been associated with acute hepatotoxicity. Chronic liver enzyme
      abnormalities associated with phenytoin have been attributed to enzyme induction.
      There have been no reports of phenytoin-induced chronic hepatitis. We describe an
      asymptomatic 52-year-old woman who received phenytoin sodium for 11 years and was
      found to have elevated serum aminotransferases. Assays for hepatitis A, B, and C
      were negative. Liver biopsy was performed and showed chronic persistent
      hepatitis. This documentation of phenytoin-induced chronic persistent hepatitis
      was proven by histology and its etiology confirmed by drug withdrawal and by
      rechallenge. Although uncommon, this entity is important to recognize in the
      differential diagnosis of asymptomatic chronic hepatic enzyme dysfunction.

PMID- 8462374
TI  - Diclofenac induced hepatitis. 3 cases with features of autoimmune chronic active
      hepatitis.
AB  - Diclofenac is a frequently prescribed nonsteroidal antiinflammatory drug (NSAID).
      Significant hepatotoxicity related to diclofenac may be more common than
      previously recognized, as three patients with diclofenac-associated hepatitis
      were seen by one clinician in a single year. All patients were ANA positive
      during the hepatitis and had histologic features of chronic active hepatitis. Two
      had been inappropriately treated with corticosteroids. The third patient
      presented more acutely with jaundice and symptoms of hepatitis. Two of the
      patients developed the same hepatic reaction when rechallenged with diclofenac.
      The third patient was changed to tiaprofenic acid, a NSAID of the same family,
      and redeveloped evidence of hepatotoxicity. All three were subsequently able to
      take naproxen without liver dysfunction. Diclofenac-induced liver disease may be
      misdiagnosed. Twenty-six cases of significant hepatic reactions to diclofenac
      have been previously reported in the literature and are reviewed. Such hepatic
      reactions to diclofenac and related NSAIDs may be commoner than realized.
      Introduction of a NSAID of another class appears to be safe.

PMID- 8462375
TI  - Severe hepatic failure occurring with T61 ingestion in an attempted suicide.
      Early recovery with the use of intravenous infusion of reduced glutathione.
AB  - A case of acute hepatic failure following ingestion of the veterinary euthanasia
      drug T61 is described. Presenting symptoms were drowsiness, disorientation,
      muscle hypertonia, and upper limb myoclonus, which faded within a few hours. Two
      days later, acute liver failure occurred, manifested as encephalopathy, jaundice,
      and a severe coagulopathy. The hepatic damage was thought to be due to the
      solvent dimethylformamide, which is the only known hepatotoxin included in the
      preparation utilized in the suicide attempt. High-dose (1.2 g/day) intravenous
      reduced glutathione was administered, with a rapid improvement of liver function.
      The patient was discharged after 17 days. Normalization of all liver function
      tests was achieved within two months. The favorable outcome in this case stands
      in contrast to the report of a previous case of lethal T61-induced hepatic
      failure. Although a different amount of dimethylformamide was ingested in each
      case (0.45 vs 0.60 ml/kg body wt) and individual differences in susceptibility to
      the effects of the hepatotoxic agent may have played a major role in these two
      cases, it is not unlikely that the infusion of high doses of glutathione to our
      patient contributed to her survival and hepatic recovery.

PMID- 8462376
TI  - Endoscopic incision of intraluminal duodenal diverticulum. Case report of a new
      technique.

PMID- 8462377
TI  - Effects of benfluorex on insulin resistance and lipid metabolism in obese type II
      diabetic patients.
AB  - OBJECTIVE: To evaluate the change in lipids and insulin sensitivity in 10 obese
      type II diabetic patients after treatment with benfluorex or placebo for 2 wk.
      RESEARCH DESIGN AND METHODS: The study had a double-blind, cross-over design.
      Insulin sensitivity was measured with the euglycemic hyperinsulinemic glucose
      clamp technique at two different insulin infusion rates: 0.05 (clamp 1) and 0.10
      U.kg-1.h-1 (clamp 2). RESULTS: Subanalysis of the glucose infusion rate under
      steady-state conditions in the last 30 min of clamp 2 yielded a glucose infusion
      rate of 5.36 and 3.87 mmol.kg-1.min-1 after benfluorex and placebo, respectively
      (P = 0.018). CONCLUSIONS: Benfluorex increases insulin sensitivity in obese type
      II diabetic patients.

PMID- 8462378
TI  - Skin surface pH in intertriginous areas in NIDDM patients. Possible correlation
      to candidal intertrigo.
AB  - OBJECTIVE: To compare skin surface pH and moisture in intertriginous areas in
      diabetic patients and healthy control subjects and to study the relationship
      between these parameters and candidal infection. RESEARCH DESIGN AND METHODS: We
      measured the skin surface pH and moisture in the axillary, inframammary,
      inguinal, and forearm skin with a pH meter with a flat-glass electrode and skin
      corneometer. The subjects were 50 NIDDM patients from the diabetic outpatient
      clinic at Beilinson Medical Center, Petah Tiqva, Israel, and 40 healthy control
      subjects from hospital personnel. The main outcome measures were skin surface pH,
      skin moisture, and skin culture for Candida. RESULTS: Skin pH in the inguinal and
      axillary regions was significantly higher in diabetic patients compared with
      healthy control subjects (P < 0.0001), whereas no difference was noted in the
      forearm. In the inframammary region, diabetic women had significantly higher pH
      than nondiabetic women (P < 0.01). No difference was noted in men in this region.
      Six patients (12%) had candidal infection in intertriginous areas. CONCLUSIONS:
      Our study indicates that in intertriginous regions, skin surface pH of diabetic
      patients is significantly higher than in normal control subjects and implies the
      significance of skin pH as a possible factor promoting host susceptibility to
      skin candidal infection.

PMID- 8462379
TI  - Apolipoprotein E polymorphism is associated with plasma cholesterol response in a
      7-day hospitalization study for metabolic and dietary control in NIDDM.
AB  - OBJECTIVE: To investigate the effects of apolipoprotein E phenotype, which is an
      important genetic factor determining plasma cholesterol level, on plasma
      lipoprotein metabolism during a 7-day diet therapy of diabetes. RESEARCH DESIGN
      AND METHODS: Diet therapy was performed in 242 subjects with NIDDM. Plasma lipid
      levels and apolipoprotein A-I, B, and E levels on hospital days 2 and 9 were
      compared in three phenotype groups, epsilon 2 (E2/2, and E2/3), epsilon 3 (E3/3),
      and epsilon 4 (E3/4 and E4/4). RESULTS: No differences were observed in fasting
      blood glucose level, body mass index, age, duration of NIDDM, or medication among
      the three phenotype groups. Before starting the treatment, total plasma
      cholesterol did not vary by apolipoprotein E phenotype, although the mean plasma
      low-density lipoprotein cholesterol level in epsilon 4 patients was higher than
      in either epsilon 3 or epsilon 2 patients (epsilon 4, 145 +/- 42; epsilon 3, 131
      +/- 34; epsilon 2, 128 +/- 36 mg/dl; P < 0.05). Changes in fasting blood
      glucose/body mass index after the 7-day treatment were not different among the
      apolipoprotein E phenotype groups, whereas the decrease in plasma cholesterol
      level after the treatment was significantly greater in epsilon 2 patients than in
      either epsilon 3 or epsilon 4 patients (epsilon 2, 10.3 +/- 14.2; epsilon 3, 6.1
      +/- 11.0; epsilon 4, 3.8 +/- 9.6%; P < 0.05). CONCLUSIONS: Total plasma
      cholesterol response to in-hospital diet therapy varies by apolipoprotein E
      phenotypes, with subjects with apolipoprotein E2 showing the greatest response,
      whereas those with apolipoprotein E4 show the least. We suggest that subjects
      with apolipoprotein E4 should be controlled more strictly than other subjects
      from a viewpoint of reducing plasma cholesterol levels.

PMID- 8462380
TI  - Prevalence of diabetes and impaired glucose tolerance in Funagata area, Japan.
AB  - OBJECTIVE: To determine the prevalence of diabetes mellitus and IGT in the
      Funagata area of Japan. RESEARCH DESIGN AND METHODS: The total eligible subjects
      was 1163, all were > or = 45 yr of age, and 52 were known diabetic patients. Data
      collected included body height, weight, and answers to medical questionnaires. A
      75-g OGTT was done in the morning. WHO criteria were used to classify the current
      diabetes status of study participants. RESULTS: Of the 1111 scheduled for the
      OGTT, 868 took the test; the participation rate was 77.8%. The prevalence of
      diabetes was 10.5 and 12.9%, and the prevalence of IGT was 14.7 and 18.0% for men
      and women, respectively. The prevalence of undiagnosed diabetes (4.9%) was almost
      equal to that of previously diagnosed diabetes (4.5%). CONCLUSIONS: The
      prevalence of diabetes in the Funagata area was two to four times higher than
      that of previous reports in Japan, in which many investigators used a urinary
      glucose test as a preliminary test. This difference is attributed to the method
      of determining the prevalence of diabetes.

PMID- 8462381
TI  - Glucose tolerance during and after pregnancy in nondiabetic women in an urban
      population in Tanzania.
AB  - OBJECTIVE: It is generally accepted that glucose tolerance deteriorates during
      pregnancy in the developed world. Several small studies have suggested that this
      may not be the case in sub-Saharan Africa. This study was designed to investigate
      changes in glucose tolerance in nondiabetic African women during pregnancy in Dar
      es Salaam, Tanzania. RESEARCH DESIGN AND METHODS: Women (n = 89) seen before the
      14th wk of pregnancy without known diabetes were recruited: 58 had a 75-g OGTT in
      the 1st, 2nd, and 3rd trimesters and postpartum. RESULTS: Mean FBG levels were
      3.9, 3.5, 3.6, and 3.7 mM in the 1st, 2nd, and 3rd trimesters and postpartum
      period, respectively. Values were significantly lower in the 2nd and 3rd
      trimesters than in the 1st and 2nd trimesters compared with postpartum. Mean 2-h
      blood glucoses were 4.7, 4.4, 4.3, and 4.2 mM, respectively. The 1st trimester
      value was significantly higher than in the 3rd trimester and postpartum. Fifteen
      (26%) of the 58 women showed a decreased or unchanged 2-h blood glucose during
      the course of pregnancy, 5 (9%) showed an increase, and no clear pattern was seen
      in 38 (67%). Values for fasting glucose showed similar trends. CONCLUSIONS: We
      conclude that women during pregnancy in an urban African setting show little
      change in glucose tolerance. This contrasts with women in both the developed
      world, where glucose tolerance worsens, and in a rural African environment, where
      glucose tends to improve.

PMID- 8462382
TI  - Exaggerated hyperglycemia after a pizza meal in well-controlled diabetes.
AB  - OBJECTIVE: To examine whether the postprandial hyperglycemic effect of pizza in
      well-controlled IDDM patients is related to overeating or to unique properties of
      this popular food. RESEARCH DESIGN AND METHODS: On two evenings, each patient (n
      = 8) consumed a meal that was similar in macronutrient composition except that
      one consisted of pizza and the other was a control meal that included high
      glycemic index foods. The insulin regimen was held constant. RESULTS:
      Postprandial glucose levels were within the target range (< or = 10 mM) after the
      control meal. Although the initial glucose increase was similar for the two
      meals, plasma glucose continued to rise and was significantly increased from 4 to
      9 h after ingestion of pizza compared with the control meal (P < 0.05). This
      increase occurred even though free insulin, glucagon, and free fatty acid levels
      did not differ significantly. CONCLUSIONS: Our data suggest that pizza has
      properties that accentuate and sustain postprandial hyperglycemia.

PMID- 8462384
TI  - Effects of gemfibrozil on low-density lipoprotein particle size, density
      distribution, and composition in patients with type II diabetes.
AB  - OBJECTIVE: To study the effects of gemfibrozil treatment on LDL particle size,
      density distribution, and composition in NIDDM patients. RESEARCH DESIGN AND
      METHODS: We performed LDL analyses on 16 NIDDM patients with stable glycemic
      control. They were randomly allocated to receive either gemfibrozil (n = 8) or a
      placebo (n = 8) for 3 mo in a double-blind study. The LDL particle size
      distribution and the particle diameter of the major LDL peak were measured with
      nondenaturing polyacrylamide gradient gel electrophoresis. The density
      distribution and composition of LDL were determined with the density gradient
      ultracentrifugation method. RESULTS: In the gemfibrozil group the mean serum TG
      concentration decreased by 38%, HDL cholesterol concentration increased by 10%,
      and LDL cholesterol concentration by 17% (P < 0.05). During gemfibrozil therapy
      the mean particle diameter of the major LDL peak increased from 244 to 251 A (P <
      0.05), whereas in the placebo group the mean LDL particle diameter remained
      unchanged. We found an inverse correlation between the changes of serum TG and
      the particle diameters of the major LDL peak (r = 0.85, P < 0.01). Gemfibrozil
      produced a shift in the LDL density distribution toward lower density. The mean
      peak density decreased from 1.0371 to 1.0345 g/ml because of a significant rise
      in the light LDL concentration from 141.0 to 183.2 mg/dl (P < 0.05), whereas the
      concentration of dense LDL had a tendency to decrease. In the placebo group the
      LDL density distribution did not change. Gemfibrozil increased the CE-to-TG ratio
      in LDL core lipids by 27% (P < 0.05); otherwise, the LDL composition was only
      slightly affected. CONCLUSIONS: The results indicate gemfibrozil-induced changes
      in LDL properties in NIDDM patients are similar to those previously reported in
      nondiabetic individuals and are related to changes in serum TG level.

PMID- 8462383
TI  - Sporting activity and hyperglycemia in middle-aged men.
AB  - OBJECTIVE: To assess the relationship between self-reported frequency of
      participation in sporting activity and the prevalence of hyperglycemia
      (nonfasting glucose level > or = 7.8 mM) in middle-aged men. RESEARCH DESIGN AND
      METHODS: We used a cross-sectional study of 7617 British middle-aged men, drawn
      from 24 general practices in England, Wales, and Scotland, who were participants
      in the British Regional Heart Study. The response rate was 78%. Patients with
      diabetes (physician-diagnosed) were excluded from our analysis. Frequency of
      participation in sporting activity was determined by the respondents and reported
      as none (61%), occasionally (12%), or frequently (27%). RESULTS: The age-adjusted
      prevalence odds ratio for hyperglycemia was 0.86 (95% confidence interval, 0.6
      1.2) in those reporting occasional, and 0.62 (95% confidence interval, 0.4-0.85)
      in those reporting frequent sporting activity, compared with those reporting
      none. This effect of frequent sporting activity on the prevalence of
      hyperglycemia was independent of body mass index, occupational status, smoking
      status, systolic blood pressure, use of antihypertensive therapy, and time of
      sampling. CONCLUSIONS: Frequent sporting activity in middle-aged men is
      associated with a reduced prevalence of hyperglycemia and may reduce the risk of
      NIDDM.

PMID- 8462385
TI  - Development of impaired glucose tolerance with or without weight gain.
AB  - OBJECTIVE: To evaluate whether risk factors and changes in insulin concentrations
      differ in subjects who develop impaired glucose tolerance with or without weight
      gain. Hyperinsulinemia is a risk factor for impaired glucose tolerance, and
      insulin concentrations increase further with the development of impaired glucose
      tolerance. Its development, however, often is accompanied by weight gain, which,
      by itself, is associated with high insulin concentrations. RESEARCH DESIGN AND
      METHODS: Participants for this study were adult Pima Indians involved in an
      ongoing epidemiological study. Initially, all had normal glucose tolerance.
      During follow-up, 80 of 387 who did not gain weight developed impaired glucose
      tolerance, as did 295 of 1026 who gained weight. Risk factors for impaired
      glucose tolerance and the relationships between changes in weight and glucose and
      changes in insulin were evaluated by multivariate analyses. RESULTS: High
      baseline fasting insulin predicted impaired glucose tolerance regardless of
      weight after adjustment for age, sex, body mass index, and glucose. The
      development of impaired glucose tolerance was accompanied by a further increase
      in fasting and 2-h insulin, whether or not subjects gained weight. In both weight
      change groups, impaired glucose tolerance was associated with more centralized
      fat distribution. CONCLUSIONS: Fasting hyperinsulinemia, a reflection of insulin
      resistance, is associated with the risk of developing impaired glucose tolerance
      whether or not weight is gained. Impaired glucose tolerance occurs when insulin
      resistance increases further. Weight gain is the most common precipitating
      factor. Aging and physical inactivity are other possible precipitating factors.

PMID- 8462386
TI  - Renal function changes in microalbuminuric normotensive type II diabetic patients
      treated with angiotensin-converting enzyme inhibitors.
AB  - OBJECTIVE: To determine the effects of captopril on microalbuminuria and renal
      function in normotensive type II diabetic patients. RESEARCH DESIGN AND METHODS:
      A total of 26 patients were randomized in two homogeneous groups for clinical and
      analytical data in a 6-mo follow-up study. Group A received captopril (initial
      dose: 12.5 mg daily, increased according to tolerance); group B was untreated.
      RESULTS: Microalbuminuria decreased only in the treated group at 6 mo (P = 0.044)
      and a significant (P = 0.027) mean percentage change on microalbuminuria
      excretion between the groups was observed. Filtration fraction decreased in group
      A (baseline: 0.23 +/- 0.03; 6 mo: 0.22 +/- 0.04) and increased in group B
      (baseline: 0.22 +/- 0.04; 6 mo: 0.25 +/- 0.04) with a significant mean percentage
      change between the groups at 6 mo (P = 0.032). The mean percentage change in
      microalbuminuria was significantly correlated with a mean percentage change in
      diastolic blood pressure throughout the trial. Neither metabolic control nor
      sodium or protein intake changed in either group during the trial. CONCLUSIONS:
      These results suggest that captopril can help arrest microalbuminuria in
      normotensive type II diabetic patients, with a decrease in diastolic blood
      pressure and filtration fraction after a 6-mo treatment.

PMID- 8462387
TI  - The prevalence and identification of risk factors for NIDDM in urban Africans in
      Cape Town, South Africa.
AB  - OBJECTIVE: To determine the prevalence of NIDDM and associated risk factors in
      urban Africans in Cape Town, South Africa. RESEARCH DESIGN AND METHODS: With a
      three-stage, proportional, stratified, random cluster method, we sampled 1000
      Africans, > 30 yr of age, living in African residential areas in Cape Town. We
      assessed glucose tolerance with a 75-g oral glucose tolerance test, according to
      World Health Organization criteria, and obtained anthropometric and demographic
      data. RESULTS: The response rate was 79%. The prevalence of NIDDM was 8.0%
      (confidence interval 5.8-10.3%), age-adjusted to world population figures and
      that of impaired glucose tolerance, 7.0% (confidence interval 4.9-9.1%).
      Multivariate analysis indicated that increased age (odds ratio 4.18), upper
      segment fat distribution (odds ratio 2.94), proportion of life spent in an urban
      area (odds ratio 2.32), and obesity (odds ratio 2.31) were significant
      independent risk factors for NIDDM. In contrast, sex, family history, alcohol
      intake, and physical activity were not independent risk factors. Only increased
      age (odds ratio 4.06) was a significant risk factor for impaired glucose
      tolerance. CONCLUSIONS: The prevalence of NIDDM in urban Africans in Cape Town,
      South Africa, is moderately high, and considerably higher than previous reports
      from Africa. The association of NIDDM with urbanization has important
      implications in view of the large-scale urbanization occurring in southern
      Africa.

PMID- 8462388
TI  - Insulinemia in children at low and high risk of NIDDM.
AB  - OBJECTIVE: Fasting hyperinsulinemia in the presence of normoglycemia usually
      indicates insulin resistance and is characteristic of populations at high risk
      for developing NIDDM. Hyperinsulinemia predicts the development of impaired
      glucose tolerance and NIDDM in Pima Indians, a population with a high incidence
      of NIDDM. Insulin concentrations in population-based samples of children who have
      different risks of developing NIDDM later in life have not been reported
      previously. RESEARCH DESIGN AND METHODS: We compared fasting insulin
      concentrations in two populations of nondiabetic children, 6-19 yr of age: Pima
      Indians from southern Arizona and Caucasians from Minnesota. RESULTS: Insulin
      concentration varied with age, sex, glucose concentration, and relative weight.
      Mean fasting insulin concentration was 140.3 pM in Pima Indian males, 94.4 pM in
      Caucasian males, 171.5 pM in Pima Indian females, and 107.1 pM in Caucasian
      females. For each sex, the mean fasting insulin concentration, controlled for
      age, glucose, and relative weight, was significantly higher in the Pima Indians
      than in the Caucasians (P < 0.001). CONCLUSIONS: From a young age, Pima Indian
      children have higher fasting insulin concentrations than Caucasian children. As
      hyperinsulinemia predicts subsequent NIDDM, these data suggest that the
      susceptibility to NIDDM is manifest at a young age as fasting hyperinsulinemia.

PMID- 8462389
TI  - Comparison of six commercial techniques in the measurement of microalbuminuria in
      diabetic patients.
AB  - OBJECTIVE: To evaluate the advantages and drawbacks of six commercially available
      techniques in the measurement of microalbuminuria in diabetic patients. RESEARCH
      DESIGN AND METHODS: Timed overnight urine samples from 75 patients in our
      diabetic clinic were tested with 2 qualitative tests (Micral-Test and
      Microbumintest) and assayed with 4 quantitative tests, which used different
      methodologies: double-antibody RIA, RID, IT, and NEPH. All tests were
      commercially available. The double-antibody RIA was taken as the golden standard.
      All urine samples were either negative or trace by Albustix (Ames, Elkhart, IN).
      Interobserver variation for the 2 qualitative tests was assessed by asking 12
      experienced nurses to read the color changes on the dipsticks and the tablets
      simultaneously, using test solutions with albumin concentrations of 16, 32, and
      64 mg/L. RESULTS: The 75 urine samples contained 0-154.2 mg/L of albumin.
      Correlation coefficients of RID, NEPH, and IT with RIA were 0.970, 0.975, and
      0.974, respectively. Intra-assay and interassay CVs ranged from 1.36-11.5%.
      Microbumintest had a higher sensitivity (100 vs. 75%), but lower specificity
      (82.5 vs. 87.3%) than Micral-Test. Considerable interobserver variation existed
      in the matching of colors for both tests. Discrepancies were especially
      significant with Microbumintest, with 8 of 12 nurses misreading the 32 mg/L
      level. CONCLUSIONS: Correlations of the 3 quantitative methods with RIA were all
      > 0.970. Choice of test may depend more on considerations such as time, space,
      number of specimens to be handled, and availability of instruments. Both
      qualitative tests showed a relatively low specificity. Positive tests must be
      confirmed with quantitative assays before microalbuminuria is diagnosed.
      Microbumintest had a higher sensitivity, but its unacceptably high interobserver
      variation and lower specificity were serious drawbacks.

PMID- 8462390
TI  - Effects of metformin on insulin resistance, risk factors for cardiovascular
      disease, and plasminogen activator inhibitor in NIDDM subjects. A study of two
      ethnic groups.
AB  - OBJECTIVE: To investigate the effects of metformin on glycemic control, insulin
      resistance, and risk factors for cardiovascular disease in NIDDM subjects from
      two ethnic groups (Caucasian and Asian) with different risks of cardiovascular
      disease. RESEARCH DESIGN AND METHODS: A total of 27 subjects with NIDDM (17
      Caucasian, 10 Asian) were given metformin and placebo each for a 12-wk period in
      a randomized, double-blind, placebo-controlled crossover study, and the dose was
      increased after 1 and 6 wk, up to a maximum of 850 mg three times a day. Insulin
      resistance, glycemic control, and cardiovascular risk factors were assessed
      before and after each treatment phase. The end of 12 wk of metformin treatment
      was compared with the end of 12 wk of placebo treatment. RESULTS: Metformin
      treatment was associated with significant improvement in FPG at 6 and 12 wk (mean
      difference at 12 wk, -3.08 mM, 95% CI -4.12 to -2.04 mM, P < 0.0001) and MCR of
      glucose (median difference 0.40 ml.kg-1.min-1, interquartile range -0.10 to 1.30
      ml.kg-1.min-1, P = 0.036). beta-cell function calculated by HOMA also improved
      significantly (median difference 14%, interquartile range 7 to 23%, P < 0.001).
      Total triglyceride (median difference -0.2 mM, interquartile range -0.6 to 0.1
      mM, P = 0.034), total cholesterol (mean difference -0.52 mM, 95% CI -0.83 to 
      0.22 mM, P = 0.002), and LDL cholesterol (mean difference -0.40 mM, 95% CI -0.64
      to -0.16 mM, P = 0.002) fell significantly on metformin treatment, whereas no
      significant changes were observed in HDL cholesterol. PAI-1 activity fell
      significantly (mean difference -5.3 AU/ml, 95% CI -8.2 to -2.4 AU/ml, P = 0.001),
      but plasma fibrinogen concentrations and platelet function, spontaneous or
      agonist induced, were unaffected. UAE was lower on metformin treatment (median
      difference -2.4 micrograms/min, interquartile range -4.4 to -0.2 micrograms/min,
      P = 0.004), but metformin had no significant effect on BP. The effects of
      metformin on glycemic control and cardiovascular risk factors were generally
      similar in the two ethnic groups. CONCLUSIONS: These findings indicate that
      metformin treatment improves glycemic control, and lowers insulin resistance and
      risk factors for cardiovascular disease, including PAI-1, and may therefore be
      useful in the long-term management of NIDDM subjects who have a high risk of
      cardiovascular disease.

PMID- 8462391
TI  - Pupillary abnormalities in type I diabetes occurring during adolescence.
      Comparisons with cardiovascular reflexes.
AB  - OBJECTIVE: To evaluate computerized infrared pupillometry for the assessment of
      autonomic neuropathy in adolescents with type I diabetes. RESEARCH DESIGN AND
      METHODS: We measured resting pupil diameters and pupillary light reflexes in 142
      adolescents with type I diabetes (72 boys and 70 girls, 10.4-19.8 yr of age,
      duration of diabetes 0.7-18.3 yr) and in 75 nondiabetic control subjects (29
      boys, 46 girls, 11.3-19.8 yr of age). All study participants were assessed using
      four standard cardiovascular tests: maximum-minimum heart rate during deep
      breathing (mean of three cycles); heart-rate change during a Valsalva maneuver
      (Valsalva ratio, mean of three maneuvers); lying-to-standing heart-rate change
      (30:15 ratio); and lying-to-standing BP change. RESULTS: Mean resting pupil
      diameters were significantly smaller in the diabetic group: 6.28 +/- 0.06 vs.
      6.77 +/- 0.11 mm, P < 0.0001); and significantly smaller with greater duration of
      diabetes (r = -0.29, P = 0.0006) and higher levels of GHb (r = -0.24, P = 0.004).
      Patients with retinopathy grade 30 or more (Wisconsin 191 grading) had
      significantly smaller resting pupil diameters: 5.9 +/- 0.16 vs. 6.4 +/- 0.12 mm,
      P = 0.008). The phasic light reflex as determined by reflex amplitude and maximum
      constriction velocity was significantly reduced in the diabetic group: 2.27 +/-
      0.03 vs. 2.44 +/- 0.04 mm, P = 0.0009; and 6.68 +/- 0.12 vs. 7.24 +/- 0.16 mm/s,
      P = 0.007). Reduced reflex amplitude was related to a longer postpubertal
      duration of diabetes (r = -0.18, P = 0.04). We found no association between
      pupillary and cardiovascular tests. CONCLUSIONS: Infrared computerized
      pupillometry demonstrates subclinical diabetic autonomic neuropathy as early as
      adolescence. Its presence seems to be related to longer duration of diabetes and
      unfavorable metabolic control.

PMID- 8462392
TI  - Microalbuminuria in NIDDM.
AB  - OBJECTIVE: To determine an effective screening procedure for microalbuminuria.
      RESEARCH DESIGN AND METHODS: The prevalence of microalbuminuria in NIDDM patients
      whose urine was negative on routine Albustix testing was studied.
      Microalbuminuria was measured in overnight urine samples from 128 NIDDM patients
      on at least two of three occasions over a 6-mo period. Patients were tested with
      Micro-Bumintest or Micral-Test. RESULTS: Ten of 128 patients had albumin
      concentrations > or = 20 mg/L on two or more occasions, 14 patients had A-C
      ratios > or = 3 mg/M on two or more occasions, and 9 patients had both.
      CONCLUSIONS: Neither Micro-Bumintest nor Micral-Test is a useful or feasible
      screening procedure for microalbuminuria.

PMID- 8462393
TI  - Maternal age and birth order of young IDDM patients. A study from southern India.
AB  - OBJECTIVE: To assess the effects of maternal age and birth order on the risk of
      IDDM in Asian Indians. RESEARCH DESIGN AND METHODS: Data from a diabetes registry
      in Madras, India, was used to find IDDM patients diagnosed before 20 yr of age. A
      questionnaire was used to elicit clinical details of subjects. RESULTS: Children
      with mothers < or = 24 yr of age had a higher percentage of IDDM. Children with
      lower birth orders had a higher prevalence of IDDM. CONCLUSIONS: The risk of IDDM
      in children is increased in children with lower birth orders, born of younger
      mothers.

PMID- 8462394
TI  - Oral health in patients with type II diabetes and impaired glucose tolerance.
AB  - OBJECTIVE: To assess the influence of type II diabetes and impaired glucose
      tolerance on dental, periodontal, and oral mucosal tissues. RESEARCH DESIGN AND
      METHODS: We examined 11 subjects with type II diabetes, 32 with impaired glucose
      tolerance, and 43 control subjects from the oral physiology component of the
      Baltimore Longitudinal Study of Aging. At the time of the study, none of the
      participants was taking medication nor being treated for any medical problems
      other than diabetes. RESULTS: Only a few statistically significant dental and
      periodontal changes were apparent in the group with type II diabetes, and no oral
      mucosal differences existed between the diabetes and control groups. Dental,
      periodontal, and oral mucosal parameters in patients with impaired glucose
      tolerance were essentially indistinguishable from the other two groups.
      CONCLUSIONS: These findings suggest that among well-controlled individuals with
      type II diabetes and impaired glucose tolerance, few appreciable differences are
      evident in oral health.

PMID- 8462395
TI  - Undiagnosed NIDDM: clinical and public health issues.

PMID- 8462396
TI  - Is it time to introduce metformin in the U.S.?

PMID- 8462397
TI  - Patient outcomes research and type II diabetes. The Agency for Health Care Policy
      and Research focuses on improving patient outcomes.

PMID- 8462398
TI  - Sensory threshold testing.

PMID- 8462399
TI  - Diabetes in the east African islands of Zanzibar.

PMID- 8462400
TI  - Micral-test. A new semiquantitative test for urinary albumin.

PMID- 8462401
TI  - Time for a change.

PMID- 8462402
TI  - Diabetic ketoacidosis in pregnancy. Another atypical case.

PMID- 8462403
TI  - Renal failure in Wolfram's syndrome.

PMID- 8462404
TI  - Lipid and lipoprotein levels in young IDDM patients.

PMID- 8462405
TI  - Stability of mailed and couriered capillary HbA1c samples.

PMID- 8462406
TI  - Comment on consistency.

PMID- 8462407
TI  - With federal funding ban lifted, fetal tissue research will continue in earnest.

PMID- 8462408
TI  - Proposed FHWA regulations for insulin-using commercial motor vehicle operators.

PMID- 8462409
TI  - Hodgkin's disease and the malignant lymphomas.
AB  - The unanticipated finding of a subcutaneous swelling, typically an enlarged lymph
      node in the neck, is legitimate cause for concern. After excluding benign or
      reactive conditions, this sign should initiate a series of investigations to
      characterize the neoplasm and, in the case of a lymphoma, lead to prompt
      treatment aimed at cure. The classic description of such cervical adenopathy is
      that by Thomas Hodgkin, who clearly recorded both the clinical behavior and the
      macroscopic findings evident at dissection. Subsequent histologic study revealed
      the multinucleate giant cells that characterize the tumor that now bears his name
      and linked it to those of Greenfield, Sternberg, and Reed. Initial debate
      centered on whether this entity was inflammatory or malignant, with the issue
      further clouded by the frequent coexistence of tuberculosis. Although a number of
      features exist in favor of both concepts, current consensus places it among the
      neoplastic processes. Hodgkin's disease was separated from other malignant
      lymphomas as agreement on diagnostic criteria emerged. The next major step
      forward was the demonstration, first by Vera Peters and then by Henry Kaplan,
      that adequate doses of radiotherapy were curative when delivered to treatment
      fields that encompassed the tumor. A further milestone was the introduction by
      Vincent DeVita, Jr., and his colleagues of combination chemotherapy that was
      effective in late stage of disseminated disease. The established cornerstones of
      managing these patients are accurate diagnosis; precise anatomic staging,
      modified as appropriate by associated factors known to have prognostic value; and
      selection of irradiation, chemotherapy, or whatever combination will result in
      the best possible patient survival. However, success is not universal, and death
      due to resistant or relapsing disease is encountered all too frequently. It is
      here that the benefits of a multidisciplinary approach are evident, because a
      substantial level of expertise coupled with sound judgment is needed to salvage
      these individuals, often by means of investigational programs. Some of the latter
      are limited by profound myelosuppression, and safety may center on the use of
      cytokines in the form of interleukins and growth factors, with or without bone
      marrow transplantation. In such situations, benefit must be balanced against
      risks in well-structured clinical trials that embody informed consent. Herein
      lies one of the major goals for the next decade. The non-Hodgkin's lymphomas can
      conveniently be considered in two broad categories. Some follow an indolent
      clinical course, in which the lymph node retains a follicular pattern with small
      component cells, and others are aggressive tumors, in which primitive blasts have
      diffusely effaced the glandular architecture.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8462410
TI  - Punishing pregnant drug users: enhancing the flight from care.
AB  - One hundred forty-two low income women were interviewed postpartum to determine
      their attitudes regarding the potential effects of a punitive law on the behavior
      of substance-using pregnant women. The convenience sample was primarily black
      (85.2%) and single (81%) and 14.8% admitted use of illicit drugs during
      pregnancy. A goodness-of-fit chi-square analysis revealed that subjects believed
      a punitive law would be a significant deterrent to substance-using gravida
      seeking prenatal care, drug testing or drug treatment (P < 0.01). Comments
      indicated that substance-using pregnant women would 'go underground' to avoid
      detection and treatment for fear of incarceration and loss of their children.

PMID- 8462411
TI  - Restricting the availability of alcohol and rates of personal violence (suicide
      and homicide).

PMID- 8462412
TI  - International Cannabis Research Society meeting summary, Keystone, CO (June 19
      20, 1992).

PMID- 8462413
TI  - Buprenorphine and cocaine effects on social behavior of monkeys.
AB  - We administered for 2 weeks intramuscular buprenorphine 0.3 mg/kg per day (and in
      a separate series, its vehicle) to each of 7 male, group-living Macaca fuscata
      (Japanese Snow Monkeys). Animals received one injection of cocaine 0.75 mg/kg and
      one of saline (about Days 9 and 14) in each series; after each of these doses
      ethologic observers recorded for 3 h the frequency of occurrence of 64 separate
      social, self-care, position and other behaviors. Cocaine alone changed the
      frequency of many behaviors. Buprenorphine alone only reduced the frequency of
      eating, yawning and ejaculation. The drugs had no interactive effects on
      behavior. In a dose reported to suppress monkeys' heroin and cocaine self
      administration, buprenorphine showed remarkably few disruptions of normal group
      behavior. But it neither reversed nor enhanced cocaine's behavioral effects.

PMID- 8462414
TI  - Enhancement of cocaine-induced hepatotoxicity by ethanol.
AB  - The contribution of moderate ethanol consumption on cocaine induced
      hepatotoxicity and the role lipid peroxidation plays as a possible mechanism of
      such increased hepatotoxicity were evaluated. Male C57BL/6 mice were injected
      interperitoneally (i.p.) with increasing doses of cocaine, from 10 to 50 mg/kg
      body weight daily and simultaneously fed a liquid diet containing 28% of the
      calories as ethanol for 5 or 9 weeks. Control mice received saline (i.p.) and an
      isocaloric carbohydrate diet. Lipid fluorescence and conjugated dienes of
      extracted lipids and amounts of malondialdehyde (MDA) were evaluated as indices
      of lipoperoxidation. In addition, serum alanine aminotransferase and aspartate
      transaminase were measured as indicators of liver injury and cellular death.
      After 9 weeks, ethanol consumption during cocaine treatment increased hepatic
      lipid fluorescence, conjugated dienes and MDA about twofold over mice-treated
      with cocaine alone. Similarly, serum transaminases were 2.8-6-fold greater in
      mice consuming alcohol and treated with cocaine than in mice treated with cocaine
      only. Histological examination of livers from mice fed ethanol during treatment
      with cocaine exhibited increased hepatic injuries and necrosis. The data suggest
      that ethanol exacerbates cocaine-induced hepatotoxicity via increases in free
      radical activity and hepatic lipid peroxidation.

PMID- 8462415
TI  - Reinforcing effects of extended inhalation of nitrous oxide in humans.
AB  - The subjective, psychomotor and reinforcing effects of nitrous oxide at
      subanesthetic doses (30% and 40% in oxygen) were determined in normal healthy
      volunteers using a choice paradigm. Thirty percent nitrous oxide was chosen no
      more often than oxygen (41.6% choice rate), indicating that, for most of the
      subjects tested, extended inhalation of this nitrous oxide concentration was no
      more reinforcing than oxygen inhalation. Forty percent nitrous oxide was chosen
      significantly less often than oxygen (22% choice rate), indicating that, for most
      of the subjects tested, extended inhalation of this nitrous oxide concentration
      was less reinforcing than oxygen. Nitrous oxide produced robust subjective
      effects (e.g., increased ratings of 'high,' 'tingling,' and 'dizzy'). Subjects
      who chose nitrous oxide reported pleasant subjective effects and liked it, while
      those who chose placebo reported unpleasant subjective effects and disliked it.
      Both concentrations of nitrous oxide impaired psychomotor performance in all
      subjects. The lack of reinforcing effects noted in the present study, given
      nitrous oxide's known abuse potential, is discussed.

PMID- 8462416
TI  - Cocaine use and other suspected risk factors for obsessive-compulsive disorder: a
      prospective study with data from the Epidemiologic Catchment Area surveys.
AB  - Using prospectively gathered epidemiologic data, we sought to estimate the degree
      to which the risk of obsessive-compulsive disorder might be elevated among adults
      actively using cocaine, with and without illicit use of marijuana or other
      controlled substances. Study subjects were selected in 1980-84 by taking
      probability samples of adult household residents at five sites of the
      Epidemiologic Catchment Area (ECA) Program: New Haven, Connecticut; Baltimore,
      Maryland; St. Louis, Missouri; Durham-Piedmont, North Carolina; Los Angeles,
      California. Soon after sampling at baseline, a total of 18,572 participants
      completed standardized interviews to measure suspected risk factors (including
      illicit drug use) and to evaluate whether they had met diagnostic criteria for
      currently or formerly active obsessive-compulsive disorder (OCD), as well as
      other mental disorders. The interviews were re-administered 1 year later to
      identify incident cases among 13,306 at-risk participants, 414 being active
      cocaine users. After sorting these participants into strata defined by age and
      census tract of household residence and after excluding persons found at baseline
      to have active or prior OCD, we found 105 incident cases of OCD within 103 of the
      age-matched and residence-matched strata, which also contained a total of 514
      subjects who had not developed OCD. Applying standard epidemiologic strategies
      presented in prior ECA research reports, we performed conditional multiple
      logistic regression to estimate the risk of OCD for active cocaine users versus
      non-users. We also performed unconditional multiple logistic regression to
      estimate OCD risk for the 414 active cocaine users versus the 12,892 participants
      not using cocaine. Both of these epidemiologic strategies yielded consistent
      results: subjects actively using cocaine and also marijuana were found to be at
      increased risk for OCD. Under the conditional model, the estimated relative risk
      was 7.2 (P = 0.03), while the value from unconditional regression was 4.1 (P =
      0.01). Active users of cocaine almost always were active users of marijuana or
      some other controlled substance, so it was not possible to estimate a relative
      risk value for subjects using cocaine only. Nonetheless, if replicated, this
      epidemiologic test of the cocaine-OCD hypothesis warrants attention in laboratory
      and clinical research, as do other suspected risk factors identified in the
      study, including sex (being female), employment status (not working for pay) and
      a prior history of distinct psychiatric disorders such as alcohol dependence,
      affective disorders and phobic disorders.

PMID- 8462417
TI  - [Origin and development of the animal welfare law].
AB  - At July 2, 1969, the Deutsche Bundestag has invited the Bundesregierung to submit
      a new and comprehensive law for animal welfare. After having removed difficulties
      with the constitution by completion of the constitution (at 18. March 1971) with
      animal welfare an outline of a new animal welfare law was presented to the
      Deutsche Bundestag in September 1971, and at July 24., 1972, the new law came
      into force. The leading idea of the former right, to protect the animal against
      pain and suffering has been promoted and extended to the protection of life of
      the animal simply. The animals protection-position is only allowed to restrict,
      if there is a reasonable proof coming out from very important common interests.
      The law prescribes for those, who are holders of animal more duties than in
      former time; species and needs of animal are to be laid down. To avoid the
      excavation of prohibition of experiments with animal by many exceptions the
      principle is introduced to approve respectively to notify experiments with
      animals before beginning. The amendment of the animal welfare law of August 12,
      1986, concerns especially the regulations about experiments with animals, among
      many other new instructions a commission for ethics has been introduced. New is
      also, that the importance of animals as fellow-creature is mentioned in the law.
      The social process of learning in animal welfare is not yet finished, the new
      animal welfare law has given a contribution for arising a responsibility for
      ethics in a capable of bearing.

PMID- 8462418
TI  - [Are amendments to the German animal welfare law necessary?].
AB  - The author gives a survey on the actual discussions and negotiations to amend the
      German Animal Welfare Act. Additionally, he reports about preparations to amend
      existing and to implement new animal welfare regulations.

PMID- 8462419
TI  - [Limits of infinite animal welfare in the internal market of the European
      community].
AB  - The European Communities are, above all, economically oriented. Thus, as animal
      protection is concerned, EC legislation is only realized to an amount that
      ensures a smooth functioning of the internal market. In this sense, animal
      protection with in EC finds its limits in the Treaty of Rome rather than could be
      called "borderless". Nevertheless, a deterioration of the now existing level of
      animal protection in the Federal Republic of Germany should not be feared due to
      increasing European integration. Every member state still has the prerogative to
      issue more strict regulations than the minimum requirements of the EC.

PMID- 8462420
TI  - [Duties of the Central Office for Documentation and Evaluation of Alternative and
      Supplementary Methods for Animal Experimentation at the Institute for Veterinary
      Medicine of the Federal Health Office, Berlin].
AB  - A National Center for Documentation and Evaluation of Alternative Methods to
      Animal Experiments (ZEBET) was established at the Department of Veterinary
      Medicine of the German Federal Health Office (BGA) in 1989. It is supporting
      wherever possible the basic principles of animal protection: to replace animal
      experiments, to reduce the number of laboratory animals in experiments, and to
      reduce the suffering of those animals used in experiments. ZEBET is responsible
      for documentation of and information on alternative methods to animal
      experiments. ZEBET is also the national center for planning, funding and
      coordinating validation programs for alternative test methods and has laboratory
      facilities for developing new experimental approaches.

PMID- 8462421
TI  - [The use of the organs of slaughtered animals for the testing of drugs:
      suitability of the bovine udder for the study of substances active through the
      skin].
AB  - Various in vitro models are used to study the transdermal penetration and
      absorption of test compounds. The isolated perfused bovine udder is described as
      a new in vitro model. Using bovine udders from slaughtered healthy cows, the
      percutaneous absorption of dexamethasone, benzoyl peroxide and isosorbide
      dinitrate was measured. For further validation of the described model, additional
      studies are necessary.

PMID- 8462422
TI  - [Handling of animals for slaughter according to animal welfare regulations].
AB  - According to animal protection the transport and proceeding of slaughtering are a
      difficult topic to cope with. The section of people is often restricted to
      distrust and rejection. In order to achieve improvement we need laws which
      prescribe the transport standards in particular with regard to the duration of
      driving and resting periods and the feeding. Transports which exceed 12 h enlarge
      the risk of disregarding laws and prescriptions and should on principle be
      prohibited. At least the important coherence between protection of slaughter
      animals on the one hand and the meat quality on the other hand requires a careful
      treatment of the animals from the producer to the slaughtering. The only
      successful options are strict control and high penalties. To get the method of
      narcosis of pigs out of common criticism we should lead our minds into a new
      direction: In this case animal protection should be more reflected to than meat
      hygiene problems and therefore the possibility of a provoked heart failure before
      the bleeding out should be realized.

PMID- 8462423
TI  - [Experiences with the supervision of electric stunning of slaughter swine and the
      technical evaluation of stunning equipment in the government district of Weser
      Ems].
AB  - The performance of electrical stunning in abattoirs is being investigated with
      regard to animal welfare. The results emphasize the necessity of appropriate
      training for all persons involved with the stunning and slaughter of livestock.
      The discussion includes problems associated with stunning. References are made to
      technical equipment used for monitoring electrical stunning and personal safety
      precautions.

PMID- 8462424
TI  - [Raising dogs and cats in compliance with animal welfare using advice on behavior
      and behavior therapy].
AB  - Housing conditions of companion animals are often not adequate to animal welfare.
      This is caused by a generally negative attitude towards animals in the public,
      combined with a lack of knowledge about the normal behaviour and the animals
      demands towards their environment. In the interest of animal welfare, measures
      are needed which could help to improve the attitude towards animals by the
      general public. A further aim should be to provide a better knowledge about the
      needs of animals in the group of persons owning animals as well as persons
      planning to buy one in the future. Essential improvements in the housing
      conditions of dogs and cats can be expected by a more intense engagement of
      veterinarians in behaviour therapy. Individual points of this thematic will be
      discussed, suggestions as well as advice for the improvement of work will be
      introduced.

PMID- 8462425
TI  - [Pain and fear in animals].
AB  - Pain and fear are feelings of reluctance, which result in a behaviour of
      avoidance. They are protective mechanisms and are only partly approachable to the
      quantification with natural scientific methods. It will pointed to the central
      role of the diencephalon, limbic system and the cerebral cortex concerning the
      processing and valuation of mental state. The recognition of clinical symptoms
      and precise behavioural observations are an essential aid to assess the state of
      pain and fear in animals.

PMID- 8462426
TI  - [Animal welfare standards in ecological animal husbandry and the possibilities of
      their regulation].
AB  - There is an ethic claim to an increasing consideration of animal welfare in
      agricultural husbandry. To put this in practise requires the consumer's
      willingness to pay higher prices for food, produced according to animal's needs.
      A growing number of consumers is willing to do that. For the higher price the
      consumer expects a product-security, which guarantees processing standards by
      transparent criteria and inspection. Guidelines in organic agriculture regulate
      standards of animal welfare and environmental friendly production. Standards of
      animal welfare are far beyond those in protection of animals legislation.
      Nevertheless, they don't allow a general judgement about animal welfare in
      husbandry systems on organic ruled farms. A practicable and conclusive valuation
      concept is necessary. It is referred to the animal needs index as a concept for
      valuation, which is already tested in practice.

PMID- 8462427
TI  - [The problems of making birds unable to fly and questions of raising waterfowl in
      ponds from the viewpoint of animal welfare].
AB  - From the viewpoint of the current law on animal welfare, the methods of rendering
      birds flightless are described and evaluated. Besides the animal welfare, other
      law statutes are to be paid attention to obligatory when waterfowl is kept on
      ponds. The raising and fattening of ducks and geese without water to swim on, can
      also be advocated from the angle of animal welfare.

PMID- 8462428
TI  - [Problems relevant to animal welfare in the control of pet shops from the
      viewpoint of official veterinarians].
AB  - Results of an inquiry of all official veterinarians in Berlin are presented,
      concerning the situation of animal welfare in pet shops. Typical problems of
      keeping animals in pet shops are revealed. Many of the official veterinarians
      make complaints about the lack of practical guidelines, manuals or expert
      opinions when they are asked to give legal assessments. Existing recommendations,
      e.g. for cage sizes, are of a broad variety, which is underlined by some
      demonstrative pictures.

PMID- 8462429
TI  - [Legal protection of industry and animal welfare--legal and ethical problems].
AB  - The first animal patent for the so called "Harvard-onco-mouse" has been widely
      discussed in the media and in public respectively. The opinion of veterinarians
      on animal patents should be based as far as possible on objective information,
      such as the legal situation and consideration of ethical discussion. The paper
      contains information on the following subjects: definition, aim and purpose of
      patents, patentability of microorganisms and genes, animal patents, animal rights
      and patents, ethics and animal patents.

PMID- 8462430
TI  - A multicenter randomized trial of high frequency oscillatory ventilation as
      compared with conventional mechanical ventilation in preterm infants with
      respiratory failure.
AB  - A multicenter randomised trial was conducted in nine neonatal centers in Japan to
      re-evaluate the safety and the efficacy of high frequency oscillatory ventilation
      using the piston type oscillator (Hummingbird) in the treatment of respiratory
      failure in preterm infants weighing between 750 and 2000 g at birth. A total of
      92 infants were enrolled in the study. Forty-six infants were allocated to high
      frequency oscillatory ventilation and 46 infants to conventional mechanical
      ventilation. There were no differences in sex, birth weight, gestation and Apgar
      score between groups. The study was begun 2.0 +/- 1.6 h (mean +/- S.D.) after
      birth in the high frequency oscillation group and 1.7 +/- 1.5 h after birth in
      the conventional mechanical ventilation group. The absence of intraventricular
      hemorrhage was confirmed by echography in all cases before beginning ventilation.
      Mortality was similar in high frequency oscillatory ventilation and conventional
      mechanical ventilation (0 and 2%). The incidence of intraventricular hemorrhage
      was also similar in the high frequency and conventional mechanical ventilation
      groups (15 and 13% overall; 4 and 2% in grades III and IV, respectively). Nine
      percent of the infants in high frequency oscillatory ventilation and 13% in
      conventional mechanical ventilation developed bronchopulmonary dysplasia, but the
      difference was not significant. The frequency of air leaks was also equal in both
      groups. Periventricular leukomalacia was detected in 9% of infants on
      conventional mechanical ventilation and 2% on high frequency oscillation, but the
      difference was not significant. Mean airway pressure was significantly higher in
      the high frequency oscillatory ventilation group and the infants on high
      frequency oscillation showed a significantly higher arterial to alveolar oxygen
      tension ratio after 6 h of treatment. These results suggest that high frequency
      oscillatory ventilation does not increase the risk of severe complications such
      as air leaks, intraventricular hemorrhage or periventricular leukomalacia when it
      is used by experienced neonatologists. Indeed high frequency oscillatory
      ventilation helps provide better oxygenation with higher mean airway pressure
      without increasing the risk of bronchopulmonary dysplasia and severe
      complications such as air leaks and intraventricular hemorrhage.

PMID- 8462431
TI  - Development of ultradian rhythm of EEG activities in premature babies.
AB  - Ultradian rhythms in electroencephalogram (EEG) activity in premature neonates
      were studied. The values of square roots of total power (SQP) of EEG showed a
      normal Gaussian distribution. We analyzed the smoothed time series of SQP by
      autoregressive analysis and component analysis. Ultradian rhythm was divided into
      four groups by period length (group I: 5-30 min, group II: 30-60 min, group III:
      60-100 min, group IV: longer than 100 min). Group IV rhythms were not detected
      before 32 weeks of gestation. Changes in the characteristic values of ultradian
      components in group II showed that there were critical periods in the development
      of central nervous activity at 29 and 33 weeks of gestation. This method allowed
      detection of ultradian rhythms, even at very early gestation, directly from the
      neonatal central nervous system. This method may be applicable to ill infants.

PMID- 8462432
TI  - Patterns of development in fetal breathing activity in the latter third of
      gestation of the baboon.
AB  - Patterns of fetal breathing activity were examined in a longitudinal study of the
      fetal baboon over the latter third of gestation. More than 1400 h of recorded
      tracheal fluid pressure in 16 or 24 h records from seven fetuses over a range in
      gestation from 121 to 172 days (term, 175-180 days) were analyzed. In these 81
      records, there was a high degree of variability in the percent of time spent
      breathing by the fetuses (range, 14-83%) with no apparent influence of
      gestational age (mean +/- S.D., 45.6 +/- 17.6%). Nonetheless, the mean amplitude
      of fetal breaths increased with gestation from absolute values of about 5-10 mmHg
      (r = 0.73, P < 0.001) and the mean inspiratory time interval increased from about
      0.45-0.55 s (r = 0.40, P < 0.001). During epochs of breathing, the mean rate
      decreased from about 42-36 breaths per min (r = -0.54, P < 0.001) and the indices
      of both short term (r = -0.54, P < 0.001) and long term (r = -0.73, P < 0.001)
      variability in rate decreased. These results demonstrate a clearly defined
      pattern of development in the breathing activity of the fetal baboon which is
      comparable to the pattern described for the human fetus in the third trimester of
      gestation. These similarities suggest that the progressive functional maturation
      of the mechanisms generating respiratory patterns are comparable among primate
      species.

PMID- 8462433
TI  - Characterization of the neonatal heart rate baroreflex during and after ECMO.
AB  - Prolonged continuous blood pressure (BP) and heart rate (HR) recordings from
      neonates of 35 to 42 weeks gestation were studied during and after ECMO. Data
      segments with significant deviation of BP were extracted for further analysis.
      The simultaneous changes in BP and HR were compared and the slope of the
      regression determined baroreflex sensitivity (BRS). Of 464 BP deviations, 98%
      produced curves with a negative slope consistent with the presence of a
      baroreflex. The average BRS was -1.0 +/- 0.8 bpm/mmHg (mean +/- S.D.) and curves
      were steeper during rising BP than falling BP (-1.1 +/- 0.9 beats/min per mmHg
      versus -0.9 +/- 0.6, P = 0.001). The baroreflex was more sensitive during ECMO
      than after ECMO to both rising BP (-1.0 +/- 0.5 beats/min per mmHg versus -0.7 +/
      0.5, P = 0.004) and falling BP (-1.0 +/- 0.6 beats/min/mmHg versus -0.7 +/- 0.5,
      P = 0.04). HR response curves obtained during different BP fluctuations on the
      same recording had varying threshold, consistent with acute resetting. One infant
      demonstrated chronic baroreceptor resetting over 3 days to a rise in resting BP.
      The near-term, critically ill neonate has an active baroreflex which is capable
      of resetting. ECMO was associated with accentuation of the baroreflex response.

PMID- 8462434
TI  - Qualitative abnormal fetal breathing movements, associated with tracheal atresia.
AB  - A case is reported in which qualitatively, grossly abnormal fetal breathing
      movements turned out to be indicative of complete tracheal atresia. Fetal
      breathing movements were vigorous and jerky and of large amplitude; similarly
      abnormal movements were observed after birth. At postmortem tracheal atresia was
      diagnosed, in combination with other congenital abnormalities, which pointed to a
      VATER-association. The combination of a VATER-association with tracheal atresia
      has only been reported once before. An absence of the normal Hering-Breuer reflex
      in this case of complete tracheal atresia, probably explains the abnormal fetal
      breathing pattern. This case is in line with a growing number of reports in
      literature in which qualitatively abnormal fetal movements were indicative of
      congenital malformations.

PMID- 8462435
TI  - Plasma amino acid profiles in preterm infants receiving Vamin 9 glucose or Vamin
      infant.
AB  - Amino acid profiles were measured in 29 low-birth-weight infants receiving either
      Vamin 9 glucose (n = 18, group A) or Vamin Infant (n = 11, group B) as the amino
      acid source in parenteral nutrition; intake was otherwise identical. Infants were
      sampled when receiving 430 mgN/kg per day (3.2 g/kg per day amino acids) and 90
      non-protein kcal/kg per day. There was no difference between groups in birth
      weight, gestational or postnatal age. The percentage N retention was similar in
      both (68 and 60%, groups A and B respectively). Phenylalanine and tyrosine levels
      were higher in those who received Vamin 9 glucose but 55% of infants given Vamin
      Infant had tyrosine levels below the lower limit of the target range. Cysteine
      levels were low in both groups. Further modification of the amino acid
      composition of parenteral solutions for the newborn is necessary. If sufficient
      non-protein energy can be provided the risk of abnormally high amino acid levels
      is reduced.

PMID- 8462436
TI  - [Colombia: evaluation of the masters degree in nursing, Universidad del Valle
      1988-1990].

PMID- 8462437
TI  - [Peru: health promotion/pesticide use. Reflections on an instructional course for
      farmers].

PMID- 8462438
TI  - [Development of human resources for the local health systems: Brazil].

PMID- 8462439
TI  - [Health personnel and work: a glance at the institutions].

PMID- 8462440
TI  - [Participation and partnership in health].

PMID- 8462441
TI  - [Proposal for a model for the study and development of intersectorial action in
      health].

PMID- 8462442
TI  - [Strategic administration of the development of human resources in health
      systems].

PMID- 8462443
TI  - [Venezuela: health concepts and practices among inhabitants of suburban
      communities and their health agents].

PMID- 8462444
TI  - Insulin and insulin-like growth factor I receptors: are there functional
      distinctions?

PMID- 8462445
TI  - Differential posttranslational processing of proenkephalin in rat bone marrow and
      spleen mononuclear cells: evidence for synenkephalin cleavage.
AB  - Proenkephalin (PENK) messenger RNA was reported to be present in bone marrow
      mononuclear cells (BMMC) and spleen mononuclear cells (SMC). Nevertheless, the
      pattern of PENK products in normal cells of the rat immune system, which is
      important for defining the physiological role of PENK gene expression, has not
      been well established. In this work we have characterized the processing of the
      opioid portion (met-enkephalin-containing peptides) and nonopioid portion
      (synenkephalin-derived peptides) of PENK in rat BMMC and SMC. Met-enkephalin
      containing peptides were detected in mononuclear cells of both hematopoietic
      tissues. In BMMC, free immunoreactive (IR)-met-enkephalin corresponded only to
      the 15% of total met-enkephalin-IR, whereas in SMC it represented the 66.5%. Gel
      filtration chromatography showed that BMMC contained partially processed PENK
      derived peptides of high and intermediate molecular weight, whereas SMC displayed
      fully processed products containing met-enkephalin and/or the carboxyterminal
      portion of synenkephalin. HPLC purification of low molecular weight products
      showed that free IR-met-enkephalin in SMC mainly corresponded to met-enkephalin
      and oxidized met-enkephalin. In addition we have characterized in SMC three
      peptides lower than 3.0 kilodalton containing the C-terminal sequence of
      synenkephalin. These peptides were purified by gel filtration, affinity
      chromatography, ion exchange chromatography, and HPLC. These results show that
      PENK was processed in mononuclear cells of the primary (bone marrow) and
      secondary (spleen) organs of the rat hematopoietic system, as occurs in neural
      and endocrine tissues. Nevertheless, the precursor was cleaved only in the latter
      tissue to low molecular weight peptides. Furthermore we demonstrated that
      synenkephalin (proenkephalin 1-70) in SMC was processed to low molecular weight
      peptides containing the C-terminus free. This last result suggests that a dibasic
      Lys-Lys and monobasic (Lys) sites were cleaved.

PMID- 8462446
TI  - A truncated human insulin receptor missing the COOH-terminal 365 amino acid
      residues does not undergo insulin-mediated receptor migration or aggregation.
AB  - A previous study of tyrosine kinase-defective insulin receptors demonstrated that
      receptor autophosphorylation or tyrosine kinase activity was required for
      concentrating insulin receptors in coated pits, but not for their migration or
      aggregation on the cell surface. Furthermore, receptor migration and aggregation
      on the cell surface were not sufficient to cause internalization of the occupied
      receptors in coated pits. In the present study, biochemical and ultrastructural
      techniques were used to compare insulin receptor mobility and internalization in
      Rat 1 fibroblasts expressing wild-type human insulin receptors (HIRc) with those
      in cells expressing receptors truncated at residues 978 (HIR delta 978) or 1301
      of the carboxyl-terminus (HIR delta CT). There were no significant differences in
      the mobility or internalization of insulin receptors on HIR delta CT cells
      compared to those of insulin receptors on HIRc cells. Ultrastructural analysis
      revealed that truncated insulin receptors on HIR delta 978 cells failed to
      migrate from their initial location on the microvilli, move to the plasma
      membrane, and aggregate in coated pits. Receptor-mediated insulin internalization
      in HIR delta 978 cells was markedly decreased due entirely to a decrease in ATP
      dependent, coated pit-mediated internalization. ATP-independent endocytosis in
      non-coated pinocytotic invaginations was not affected by receptor truncations.
      These results provide evidence of the roles that regions of the beta-subunit play
      in the processing of occupied insulin receptors. 1) The carboxyl-terminus of the
      insulin receptor is not involved in the events leading to receptor
      internalization, i.e. migration, aggregation, and concentration in coated pits.
      2) Internalization of insulin receptors by the ATP-independent noncoated
      invagination pathway is not regulated by residues in the insulin receptor beta
      subunit distal to 978. 3) Sequences in the beta-subunit between 978-1300, but not
      the autophosphorylation and kinase domains, are involved in insulin-induced
      receptor migration and aggregation.

PMID- 8462447
TI  - Effects of age and endogenously secreted human growth hormone on the regulation
      of gonadotropin secretion in female and male transgenic mice expressing the human
      growth hormone gene.
AB  - In aging rats and humans, GH secretion is reduced. In transgenic mice bearing the
      human (h) GH gene, hGH is secreted during the entire lifespan. To evaluate the
      effects of endogenously secreted hGH on age-related changes in hypothalamic
      pituitary function, the following two experiments were conducted in young (2.5-4
      months of age) and old (11-14 months of age) female and male transgenic mice
      expressing the hGH gene and their normal siblings. In Exp I, young and old female
      transgenic mice and their normal siblings were ovariectomized. On days 8 and 9
      after ovariectomy, mice were injected (sc) with oil or primed with 0.5 micrograms
      estradiol benzoate (EB) in oil, 24 h later treated with 10 micrograms EB/100 g
      BW, and a day later bled for the determination of FSH, LH, PRL, and hGH levels by
      RIAs. In Exp II, young and old male transgenic mice and their normal littermates
      were castrated and injected with either peanut oil or testosterone propionate
      (TP; 1 microgram/g BW) in oil. Blood samples were obtained 18-20 h after oil or
      TP injection. Plasma FSH, LH, PRL, and hGH levels were measured by RIAs. hGH was
      present in the circulation of young and old transgenic mice, but not in normal
      siblings. Circulating FSH and LH levels were significantly lower in
      ovariectomized young and old transgenic mice than in similarly treated young and
      old normal siblings. The suppressive effect of EB on LH secretion was reduced in
      ovary-ablated young and old transgenic mice. The PRL response to EB treatment was
      increased (P < 0.005) in old ovariectomized transgenic mice. In the male, the
      castration-induced increase in plasma LH levels was higher (P < 0.05) in young
      transgenic mice. Administration of TP failed to suppress the absolute plasma LH
      levels in castrated young and old transgenic mice. However, the percent decrease
      in circulating LH levels was lower in young and old transgenic mice. The
      castration-induced increase in FSH secretion was reduced (P < 0.005) in aged
      transgenic mice. The effects of TP on plasma FSH levels were similar to its
      effects on LH secretion. Gonad-ablated young and old transgenic mice of both
      sexes are hypoprolactinemic. These observations demonstrate that endogenously
      secreted hGH modulates gonadotropin and PRL secretion in young and old mice
      bearing the hGH gene and indicate that the changes in the hypothalamic-pituitary
      system of mice expressing the hGH gene are similar to those observed in aging
      human subjects.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8462448
TI  - Reciprocal modulation of interleukin-1 beta (IL-1 beta) and IL-1 receptors by
      lipopolysaccharide (endotoxin) treatment in the mouse brain-endocrine-immune
      axis.
AB  - The cytokine interleukin-1 (IL-1) alters a variety of immune, central nervous
      system, and neuroendocrine activities characteristic of an integrator of the
      brain-endocrine-immune response to stress. In an attempt to define the regulation
      of IL-1 and IL-1 receptors in the mouse brain-endocrine-immune axis, we measured
      tissue levels of IL-1 beta using an enzyme-linked immunosorbent assay and iodine
      125-labeled recombinant human IL-1 alpha ([125I]IL-1 alpha) binding in
      hippocampus, hypothalamus, pituitary, epididymus, testis, and spleen after ip
      injection of the bacterial endotoxin lipopolysaccharide (LPS). Basal IL-1 beta
      levels were detectable in all of the tissues examined. IL-1 beta levels were
      dramatically increased in the peripheral tissues (pituitary, testis, and spleen)
      2-6 h after a single LPS injection; however, no significant changes were observed
      in the brain (hippocampus and hypothalamus). [125I]IL-1 alpha binding was
      decreased in the spleen, but was unchanged in the hippocampus and testis after a
      single LPS injection. To determine whether activation of IL-1 in brain may
      require more sustained exposure to endotoxin, we examined the effects of two
      injections of LPS at 0 and 12 h. After two LPS injections (0 and 12 h),
      significant increases in IL-1 beta concentrations were noted in the hippocampus,
      hypothalamus, spleen, testis and epididymus; [125I]IL-1 alpha binding using
      quantitative autoradiography was significantly decreased in all tissues,
      including the pituitary gland. Saturation studies in whole testis homogenates
      demonstrated that the LPS-induced decrease in [125I]IL-1 alpha binding was
      primarily due to a decrease in the density of IL-1 receptors. These data
      demonstrate that LPS treatment results in elevated circulating and/or tissue
      levels of IL-1, which, in turn, down-regulates IL-1 receptors in the brain
      endocrine-immune axis.

PMID- 8462449
TI  - Prostaglandin F2 alpha-induced mitogenesis in MC3T3-E1 osteoblasts: role of
      protein kinase-C-mediated tyrosine phosphorylation.
AB  - Prostaglandin F2 alpha (PGF2 alpha) stimulates DNA synthesis in osteoblasts
      through phospholipase-C-dependent increases in intracellular calcium and protein
      kinase-C (PKC) activity. We present evidence that stimulation of protein tyrosine
      phosphorylation by PKC is an additional component of the signaling pathways
      involved in PGF2 alpha-stimulated DNA synthesis in MC3T3-E1 osteoblast-like
      cells. Mitogenic doses of PGF2 alpha (42 nM) rapidly induced tyrosine
      phosphorylation of multiple substrates in these osteoblast-like cells. PGF2 alpha
      stimulated tyrosine phosphorylation of new proteins with apparent mol wt of 87,
      80, 50, 47, 36, and 33 kilodaltons and up-regulated phosphorylation of
      preexisting tyrosine components with mol wt of 123, 112, 68, and 56 kilodaltons.
      Stimulation of PKC by 1.6 microM phorbol 12-myristate 13-acetate mimicked the
      pattern of PGF2 alpha-induced protein tyrosine phosphorylation, whereas PKC
      deficient cells (induced by overnight pretreatment with 16 microM phorbol 12
      myristate 13-acetate) were refractory to PGF2 alpha-stimulated protein tyrosine
      phosphorylation and DNA synthesis. The tyrosine kinase inhibitors tyrphostin and
      genistein blocked PGF2 alpha-stimulated DNA synthesis and protein tyrosine
      phosphorylation, and the tyrosine phosphatase inhibitor orthovanadate prolonged
      PGF2 alpha-stimulated tyrosine phosphorylation; these findings are consistent
      with activation of a putative tyrosine kinase. Calcium/calmodulin antagonists
      also inhibited PGF2 alpha-stimulated DNA synthesis, but the calcium-signaling
      pathway played no role in PGF2 alpha-induced tyrosine phosphorylation. Our
      findings suggest that cross-talk between receptor-mediated activation of PKC and
      protein tyrosine phosphorylation is an important distal signaling pathway
      necessary for PGF2 alpha-induced DNA synthesis in osteoblast-like cells.

PMID- 8462450
TI  - Pulsatile administration of gonadotropin-releasing hormone does not alter the
      follicle-stimulating hormone (FSH) isoform distribution pattern of pituitary or
      circulating FSH in nutritionally growth-restricted ovariectomized lambs.
AB  - The experimental induction of puberty by GnRH administration to prepubertal lambs
      increases serum bioactive FSH (B-FSH) as measured in the rat Sertoli cell
      aromatase induction bioassay. Serum immunoreactive FSH (I-FSH) levels are
      unchanged. The increase in serum B-FSH is associated with an increase in the
      proportion of less acidic and more biopotent FSH serum isoforms. However, it is
      unknown if this effect of GnRH on serum FSH microheterogeneity is direct or
      mediated by gonadal factors. We have used the nutritionally growth-restricted
      ovariectomized lamb as a model of the neuroendocrine regulation of FSH isoform
      microheterogeneity. With this model, the hypothalamic-pituitary component of the
      neuroendocrine axis may be isolated from gonadal factors. In the present study,
      using the nutritionally growth-restricted ovariectomized lamb as a model, we
      investigated the role of GnRH on the regulation of FSH microheterogeneity.
      Specifically, we tested the hypothesis that GnRH increases the proportion of the
      less acidic (more biopotent) serum FSH isoforms. As an in vitro correlate, we
      investigated the effect of GnRH on gonadotropin secretion and FSH isoform
      distribution in ovine pituitary explant cultures. Seven ovariectomized
      nutritionally restricted lambs were administered GnRH (i.v., 2 ng/kg) for 36 h
      (at 2-h intervals for 24 h, then hourly for the final 12 h). Six others served as
      controls. Blood samples were withdrawn at 12-min intervals during the last 4 h
      for the measurement of serum immunoactive LH (I-LH) and I-FSH. Pituitary
      homogenates and serum from four animals from each group were individually
      chromatofocused, and the FSH isoform distribution patterns were determined.
      Pulsatile administration of GnRH to nutritionally growth-restricted lambs
      increased circulating I-LH concentrations from 0.6 +/- 1.0 to 5.9 +/- 3.1 ng/ml
      (P < 0.01), but did not significantly change circulating I-FSH (4.9 +/- 1.8 vs.
      11.5 +/- 4.2 ng/ml) nor B-FSH concentrations (3.9 +/- 1.2 vs. 5.7 +/- 1.5 ng/ml).
      The pituitary content of I-FSH, B-FSH, and I-LH were unchanged. Neither serum nor
      pituitary FSH isoform distribution patterns were altered by pulsatile GnRH
      administration. However, compared to the pituitary FSH isoforms, a higher
      percentage of circulating FSH isoforms eluted in the salt peak of both groups of
      lambs. Similar to the in vivo studies, in vitro, GnRH increased the release of I
      LH, as well as I-FSH, from pituitary explants, but did not significantly change
      the FSH isoform distribution in either the pituitary explant or media.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8462451
TI  - Malic enzyme gene expression in differentiating brown adipocytes: regulation by
      insulin and triiodothyronine.
AB  - Primary cultures of brown adipocytes were used to investigate the regulation of
      malic enzyme (ME) gene expression by insulin and T3. No ME gene expression was
      detected in undifferentiated preadipocytes. The levels of ME mRNA increased
      slightly during cell differentiation. Physiological doses of insulin or T3
      increased ME gene expression, which reached a maximum after 24 h, on whichever
      culture day they were added. The effects of insulin and T3 were at the
      transcriptional level, as measured by run-on assays. Both hormones also increased
      the stabilization of the transcripts and required ongoing protein synthesis to
      exert their effects. A comparison of the potencies of insulin and insulin-like
      growth factor-I and -II (IGF-I and -II) in this system indicated that induction
      by insulin is mediated via its own receptor. The effects of insulin and T3 were
      independent of the extracellular glucose concentration, but were additive to that
      of glucose. Moreover, insulin and T3 act additively to increase ME gene
      expression, suggesting that they interact either at the transcription level or
      that of mRNA stabilization.

PMID- 8462452
TI  - Direct effects of transforming growth factor-beta on chondrocytes are modulated
      by vitamin D metabolites in a cell maturation-specific manner.
AB  - Chondrocytes in the endochondral differentiation pathway produce transforming
      growth factor-beta (TGF-beta) and response to this growth factor both in vitro
      and in vivo. To clarify the role that cell maturation state plays in the
      response, we used a well characterized chondrocyte cell culture model which
      compares cartilage cells at two different stages of maturation. Confluent fourth
      passage cultures of rat costochondral resting zone and growth zone cartilage
      cells were incubated with recombinant human (rh) TGF-beta-1 for 24, 48, or 72 h,
      and the effect on cell number and [3H]thymidine incorporation was observed. To
      assess whether TGF-beta regulates chondrocyte differentiation to a calcifying
      cartilage phenotype, cells were incubated for 24 h with TGF-beta, and the
      specific activities of alkaline phosphatase and phospholipase A2, two enzymes
      associated with calcification, were assayed in isolated plasma membranes and
      matrix vesicles. Alkaline phosphatase-specific activity was also measured in the
      cell layer. Modulation of TGF-beta action by vitamin D metabolites, also known to
      regulate endochondral differentiation, was examined. The ability of the
      chondrocytes to produce latent TGF-beta was assayed. The results show that: 1)
      quiescent chondrocytes at two stages of endochondral maturation respond to rhTGF
      beta-1 by increasing [3H]thymidine incorporation; 2) growth zone cells exhibit no
      increase in cell number over a 72-h incubation with TGF-beta, whereas resting
      zone cells exhibit a dose-dependent increase in cell number at 72 h; 3)
      nonquiescent cells exhibit an increase in alkaline phosphatase-specific activity
      at 24 h; 4) the effects on this membrane enzyme are comparable in the plasma
      membranes and matrix vesicles, but the net effect is greater in the extracellular
      organelle due to the intrinsically higher levels of activity; 5) although
      differentiation is promoted in resting zone cells, it is limited in the growth
      zone cells by inhibition of phospholipase A2 activity; and 6) there is a
      synergistic enhancement of resting zone chondrocyte differentiation when cells
      are exposed to rhTGF-beta-1 and 24,25-dihydroxyvitamin D3.

PMID- 8462453
TI  - Cholecystokinin (CCK)-induced stimulation of luteinizing hormone (LH) secretion
      in adult male rhesus monkeys: examination of the role of CCK in nutritional
      regulation of LH secretion.
AB  - Studies were performed with the overall goal of testing the hypothesis that
      cholecystokinin (CCK), a peptide hormone released from the gastrointestinal tract
      in response to meal consumption, provides a metabolic signal which modulates LH
      secretion in response to changes in the body's nutritional intake. In an initial
      study to document the effects of CCK on LH secretion in adult male rhesus
      monkeys, sulfated CCK-8 (7 and 15 micrograms/kg) was administered to six monkeys,
      and blood samples were collected from indwelling venous catheters. The 15
      micrograms/kg dose of CCK elicited a rapid release of LH, with peak LH levels of
      31.29 +/- 7.19 ng/ml occurring within 5-15 min. To determine the CCK receptor
      type mediating the effect of CCK on LH secretion, specific CCK type-A (L-364,718)
      and type-B (L-365,260) receptor antagonists (1 mg/kg) were administered to five
      monkeys 15 min before CCK administration. The CCK-A antagonist completely blocked
      LH secretion in response to CCK, whereas the CCK-B antagonist had no effect. To
      assess whether endogenous CCK, released in response to food intake, stimulates LH
      secretion, six monkeys were fasted for 1 day and then provided with a normal meal
      of monkey chow (i.e. a refeed meal) the following day, with either no antagonist,
      CCK-A antagonist, or CCK-B antagonist administered 30 min before the meal. As
      previously demonstrated, meal consumption after a brief period of fasting caused
      a rapid stimulation of pulsatile LH secretion. The refeed meal led to a
      comparable stimulation of LH secretion regardless of whether monkeys received no
      antagonist (3.7 +/- 0.44 LH pulses/9 h), CCK-A antagonist (3.33 +/- 0.56 LH
      pulses/9 h), or CCK-B antagonist (4.0 +/- 0.78 LH pulses/9 h). These results
      indicate that CCK can stimulate LH secretion in adult male rhesus monkeys, acting
      via type-A CCK receptors. However, endogenous CCK released in response to meal
      intake does not appear to be responsible for the meal-induced stimulation of LH
      secretion that occurs when monkeys are fed a normal meal after a brief period of
      fasting.

PMID- 8462454
TI  - The involvement of inositol phosphoglycan mediators in the modulation of
      steroidogenesis by insulin and insulin-like growth factor-I.
AB  - We have investigated the mechanisms by which insulin and insulin-like growth
      factor-I (IGF-I) regulate the synthesis of progesterone by swine ovary granulosa
      cells. Analysis of the cell density dependence of the effects of insulin and IGF
      I showed that the induction of progesterone synthesis by these growth factors is
      consistent with an autocrine or paracrine model of action, which involves the
      insulin- and IGF-I-stimulated release of a soluble factor(s) into the culture
      medium. We have tested the hypothesis that this soluble factor(s) may be
      structurally related to inositol phosphoglycans, a class of putative second
      messengers of the action of insulin. Consistent with this hypothesis, we isolated
      an activator of pyruvate dehydrogenase (PDH) phosphatase from culture medium
      obtained from cells treated with insulin or IGF-I. Further analysis showed that
      specific antibodies raised against the inositol phosphoglycan anchor of the
      variant surface glycoprotein of Trypanosoma brucei blocked the activation of PDH
      phosphatase by the material isolated from the culture medium, suggesting a close
      structural relationship between this putative PDH phosphatase activator and
      inositol phosphaglycans. Pertussis toxin treatment, shown to inhibit the
      generation of inositol phosphoglycans in other systems, was found to inhibit the
      effects of insulin on progesterone synthesis in granulosa cells. Finally, the
      stimulatory effects of insulin and IGF-I on progesterone synthesis by intact
      granulosa cells were markedly inhibited by the addition of antiinositol
      phosphoglycan antibodies to the culture medium. Based on these observations, we
      propose that the release of inositol phosphoglycans into the extracellular medium
      plays an important role in the signaling mechanisms by which insulin and IGF-I
      regulate the synthesis of progesterone in swine ovary granulosa cells.

PMID- 8462455
TI  - Regulation of interleukin 6 gene expression in rat.
AB  - The effects of ip endotoxin administration on interleukin 6 (IL6) transcripts in
      brain and in peripheral tissues of rats were studied together with the effects of
      this treatment on IL6 and corticosterone concentrations in blood serum. Northern
      blot analyses showed a rapid increase of IL6 transcripts in spleen, pituitary
      gland, and adrenals that was paralleled by pronounced elevations in serum IL6 and
      corticosterone levels. Adrenalectomy further enhanced the induction of IL6
      messenger RNA (mRNA) in spleen and pituitary gland and augmented the increase in
      serum IL6 bioactivity after lipopolysaccharide (LPS) injection. Corticosterone
      pretreatment (10 mg/kg) completely blocked the increase of IL6 in serum and IL6
      mRNA in spleen, adrenals, and hypophysis. In several brain areas, low amounts of
      IL6 mRNA were detected under basal, noninflammatory conditions, but in response
      to LPS there was no change in the IL6 mRNA in hippocampus, hypothalamus, and
      cerebellum. Neither adrenalectomy nor peripheral injections of sublethal LPS
      doses of up to 10 mg/kg were capable of increasing IL6 mRNA in the hippocampus.
      The data do not support the hypothesis that central IL6 biosynthesis via
      transcription of the gene contributes to the endotoxin-mediated activation of the
      hypothalamic-pituitary-adrenal system. The results, however, clearly demonstrate
      that LPS-induced IL6 gene expression is subject to glucocorticoid suppression in
      peripheral tissues.

PMID- 8462456
TI  - The effect of recombinant human (1-84) or synthetic human (1-34) parathyroid
      hormone on the skeleton of adult osteopenic ovariectomized rats.
AB  - The purpose of this study was to evaluate the dose-effect relationship of
      recombinant human PTH [hPTH-(1-84)] and synthetic human PTH [sPTH-(1-34)] for the
      skeleton of estrogen-deplete osteopenic rats. Ex vivo densitometry of
      regionalized whole femurs and histomorphometry of proximal tibial cancellous bone
      were the end points. Retired breeder female rats, aged 6-7 months, were used. Ten
      were killed at baseline, and the rest were ovariectomized (OVX). On day 42, a pre
      PTH treatment OVX group was killed. The rest were then treated by daily sc
      injection with hPTH (0, 1.55, 15.5, or 155 micrograms/kg BW.day) or sPTH (0.55,
      5.5, or 55 micrograms/kg BW.day) and killed on day 70. The level of cancellous
      bone mineral was lower in pretreatment OVX rats than at baseline. It was higher
      in rats treated with 15.5-155 micrograms/kg.day hPTH and 5.5-55 micrograms/kg.day
      sPTH than in pretreatment and vehicle-treated OVX rats. Cancellous bone volume
      was also lower both 42 and 70 days after OVX. Although hPTH did not affect
      cancellous bone volume, treatment with 5.5-55 micrograms/kg.day sPTH caused
      higher bone volume than in either pretreatment or vehicle-treated OVX rats.
      Trabecular number declined after OVX and did not change with PTH treatment. In
      contrast, trabecular thickness declined after OVX, but was higher after 15.5-155
      micrograms/kg.day hPTH and 5.5-55 micrograms/kg.day sPTH treatment. In OVX rats,
      the amount of mineralizing surface was greater by day 42 and fell toward control
      levels by day 70. It was greater in rats treated with 15.5-155 micrograms/kg.day
      hPTH or 5.5-55 micrograms/kg.day sPTH than in vehicle-treated OVX rats. On a
      molar basis, sPTH was modestly more potent than hPTH. Osteoclast surface was not
      affected by PTH treatment. Treating estrogen-deplete osteopenic adult rats for 28
      days with 15.5-155 micrograms/kg.day hPTH or 5.5-55 micrograms/kg.day sPTH
      increases trabecular thickness, but not trabecular number, to cause a rise in
      bone mass. The extent of mineralizing surface rises without a change in
      resorption surface. The marked rise in mineralizing surfaces suggests that
      extended in vivo treatment with PTH activates osteogenic precursor cells near
      once quiescent surfaces to become osteoblasts.

PMID- 8462457
TI  - Ligands that activate protein kinase-C differ in their ability to regulate basic
      fibroblast growth factor and insulin-like growth factor-I messenger ribonucleic
      acid levels.
AB  - In this study, rat dermal fibroblasts were used as a model system to examine the
      ability of ligands that are known to activate protein kinase-C to regulate the
      levels of the mRNAs encoding basic fibroblast growth factor (bFGF) and insulin
      like growth factor-I (IGF-I), two growth factors that are thought to be important
      in processes such as tissue repair and regeneration and wound healing. Treatment
      of fibroblasts with the phorbol ester phorbol 12-myristate 13-acetate (PMA),
      thrombin, bradykinin, serotonin, angiotensin-II, or bombesin increased protein
      kinase-C activity to a similar degree. Treatment of fibroblasts with 1 microM
      serotonin transiently increased bFGF mRNA levels about 3-fold compared to the
      level in control cells maintained in serum-free medium with 0.25% BSA and
      decreased IGF-I mRNA levels by approximately 50% compared to the level in control
      cells. This is similar to the previously described changes induced by bradykinin
      in these cells, but different from the more marked and sustained changes induced
      by thrombin and PMA. In contrast, angiotensin-II and bombesin had no effect on
      bFGF or IGF-I mRNA levels. The effects of serotonin, bradykinin, and PMA on bFGF
      and IGF-I mRNA levels were abrogated by preincubation of cells in 250 nM PMA to
      down-regulate protein kinase-C. In contrast, the effect of thrombin on bFGF mRNA
      levels was only partially inhibited by down-regulation of protein kinase-C, while
      its effect on IGF-I mRNA levels was unaffected. The activation of signaling
      pathways by the different ligands was further investigated to begin to determine
      the mechanism for the differences in the effects of thrombin vs. serotonin and
      bradykinin and in the effects of these three ligands vs. angiotensin-II and
      bombesin. All of the ligands activated phospholipase-D to a similar degree,
      suggesting that activation of this enzyme was not responsible for the
      differential effects of the ligands. In contrast, thrombin, serotonin, and
      bradykinin had marked effects on the hydrolysis of phosphatidylcholine and
      phosphatidylinositol, whereas bombesin and angiotensin-II had a small effect on
      phosphatidylcholine hydrolysis and no effect on phosphatidylinositol
      hydrolysis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8462458
TI  - Transforming growth factor-beta 1 stimulates chondrogenesis and inhibits
      osteogenesis in high density culture of periosteum-derived cells.
AB  - Chick periosteum-derived mesenchymal cells have been reported to exhibit both
      osteogenic and chondrogenic potentials in high cell density culture conditions.
      Using this culture system, the effects of transforming growth factor-beta (TGF
      beta) on proliferation and differentiation of periosteal mesenchymal cells were
      studied. Supplementation with TGF beta 1 at doses of 0.3-1.0 ng/ml shortened the
      time course of chondrogenesis and increased the amount of cartilage formed in the
      lower part of the culture. On the other hand, the amount of bone formed in the
      upper part of the culture decreased with TGF beta treatment, whereas the time
      course of osteogenesis remained unaffected.

PMID- 8462459
TI  - Restoration of estrogen-dependent progesterone receptor expression in a uterine
      myocyte cell line.
AB  - Although the in vivo effect of estrogen on myometrial differentiation is well
      documented, estrogen effects on primary myocytes in vitro have been difficult to
      demonstrate. To construct a stable uterine myocyte system, capable of direct
      estrogen responsiveness, we used a transformed hamster myometrial cell line.
      Since these cells expressed a low level of estrogen receptors (ERs), we have
      stably transfected them with a vector for the human ER. After transfection, ER
      concentration increased from less than 300 sites per cell to 17,000 +/- 2,000
      sites per cell (mean +/- SEM). To test the functional integrity of the
      transfected receptors, a chloramphenicol acetyltransferase gene linked to an
      estrogen response element upstream of thymidine kinase promoter was transiently
      transfected, and the amount of chloramphenicol acetyltransferase activity, an
      indicator of estrogen responsiveness, was found to increase 20-fold in response
      to 17 beta-estradiol (1 nM for 48 h). Furthermore, we tested the ability of
      estrogen to activate endogenous genes by measuring progesterone receptor (PR)
      induction. PR concentration in the transfected cells was 3,700 +/- 800 and
      increased 9-fold to 33,000 +/- 6,000 with 17 beta-estradiol (2 nM). This receptor
      density increase was confirmed by immunoblotting. PR induction was maximal at 16
      h, was concentration dependent, and was not elicited by tamoxifen or ICI 164,384.
      We conclude that transformed hamster myocytes transfected with an ER gene are
      capable of estrogen-dependent PR expression in vitro and may serve as a useful
      system to study estrogen effect on myocytes.

PMID- 8462460
TI  - Biosynthesis and posttranslational processing of the neurotensin/neuromedin N
      precursor in the rat medullary thyroid carcinoma 6-23 cell line. Effect of
      dexamethasone.
AB  - Neurotensin (NT) and Neuromedin N (NN) are two biologically active peptides
      present in one copy each in the C-terminal region of a 169-residue precursor.
      Four basic Lys-Arg doublets occur within the precursor and represent putative
      processing sites. We investigated the effects of dexamethasone on the
      biosynthesis and the posttranslational processing of the NT/NN precursor in the
      rat medullary thyroid carcinoma 6-23 cell line (rMTC 6-23). Western blot analysis
      and RIA coupled to HPLC and arginine-directed tryptic cleavage of precursor forms
      were performed with antisera specific for precursor sequences adjacent to the
      four basic doublets. These studies revealed that rMTC 6-23 cells synthesized the
      NT/NN precursor in response to dexamethasone and had the capability to process
      this precursor at the three Lys-Arg doublets that flank and separate NT and NN,
      thus yielding authentic NT, NN, and several larger products. The most N-terminal
      Lys-Arg doublet was not processed in this system. Dexamethasone increased in a
      concentration- and time-dependent manner the levels of all the NT/NN precursor
      derived products. This increase did not affect the relative proportion of the
      different products. We also showed by Northern blot analysis that both the 1.1
      kilobase and 1.5-kilobase NT/NN precursor messenger RNAs were present in the rMTC
      6-23 cell line and that the time course and dose response of dexamethasone
      induced messenger RNA synthesis were in good agreement with those observed for
      dexamethasone-induced increase in processing products. The rMTC 6-23 cell line
      represents a good model to elucidate the steps involved in the posttranslational
      processing of the NT/NN precursor.

PMID- 8462461
TI  - Estrogen increases low voltage-activated calcium current density in GH3 anterior
      pituitary cells.
AB  - The effects of estrogen (17 beta-estradiol) on calcium current density were
      examined in the GH3 anterior pituitary cell line. The addition of 1 nM estrogen
      to the growth medium induces a 4- to 5-fold increase in low voltage-activated
      (LVA) Ca2+ current density without affecting high voltage-activated Ca2+ current
      density. The increase is significant after 24 h, reaches a maximum level in 3
      days, and reverses with a similar time course when the estrogen is withdrawn. The
      EC50 for estrogen stimulation of LVA Ca2+ current density is about 30 pM. The LVA
      current induced by estrogen has similar voltage dependence and time course of
      activation, inactivation, and deactivation as controls. The effect of estrogen
      requires protein synthesis, since it is blocked by cycloheximide. It is suggested
      that the estrogen-induced increase in LVA Ca2+ current density may be due to an
      increase in the number of functional channels in the membrane. This effect could
      be due to insertion of new channels or synthesis of a protein that converts
      preexisting silent channels into functional channels.

PMID- 8462462
TI  - Regulation of follistatin messenger ribonucleic acid in porcine granulosa cells
      by epidermal growth factor and the protein kinase-C pathway.
AB  - Follistatin is a 35-kilodalton monomer isolated from follicular fluid by virtue
      of its ability to suppress FSH secretion from cultured pituitary cells.
      Experiments were designed to test the hypothesis that the accumulation of
      follistatin RNA in the ovary is regulated by epidermal growth factor (EGF) and
      activation of the protein kinase-C (PKC) pathway. Follistatin mRNA was
      quantitated by slot blot hybridization of total RNA from primary cultures of
      porcine granulosa cells treated with the phorbol ester phorbol 12-myristate 13
      acetate (PMA), an activator of PKC. PMA (0.1, 1.0, 10, and 100 nM) induced a dose
      dependent increase in follistatin mRNA accumulation after 2 h, with a maximal
      increase of 40-fold over that in untreated control cultures at a dose of 10 nM.
      PMA (10 nM) induced a time-dependent increase in follistatin mRNA levels, with a
      maximal response at 2 h. Follistatin gene expression was induced by a 2-h
      incubation with EGF (3 nM), but not by LH (100 ng/ml), GnRH (10 nM) or
      prostaglandin F2 alpha (80 micrograms/ml). EGF (0.01, 0.1, 1, and 10 nM) induced
      a dose-dependent induction of follistatin gene expression in granulosa cells
      after 2-h incubation, with maximal stimulation of 33-fold at a dose of 1 nM. The
      time course of induction of follistatin mRNA by EGF was very similar to that
      induced by PMA, with maximal stimulation occurring at 2 h and declining
      thereafter. Pretreatment of granulosa cells for 24 h with PMA abrogated the EGF
      induced stimulation of follistatin mRNA accumulation. However, cotreatment of
      granulosa cells with EGF and PMA for 2 h resulted in additive stimulation of
      follistatin mRNA. These results demonstrate that 1) follistatin gene expression
      in cultured porcine granulosa cells is acutely stimulated by PMA and EGF in a
      time- and dose-dependent manner; 2) follistatin gene expression may be regulated
      by the PKC pathway; and 3) the stimulatory effect of EGF on follistatin gene
      expression may require PKC.

PMID- 8462463
TI  - Dynamic changes in hypothalamic angiotensin II levels and release in association
      with progesterone-induced luteinizing hormone surge.
AB  - To test the hypothesis that brain angiotensin II (Ang II) may be involved in the
      preovulatory release of LH on proestrus, we evaluated the pattern of changes in
      hypothalamic Ang II levels and release in ovariectomized (ovx) rats treated
      sequentially with estrogen and progesterone. This is an experimental paradigm
      that reliably evokes dynamic changes in hypothalamic LHRH levels in association
      with LH hypersecretion, simulating the LH surge on proestrus. Rats were ovx and
      after 4 weeks received estradiol benzoate followed by progesterone 2 days later
      at 1000 h. We observed that in these progesterone-treated rats, serum LH levels
      were low until 1400 h, but thereafter, the rate of LH secretion increased and
      remained elevated at 1600 h when the experiment was terminated. In these rats,
      hypothalamic Ang II levels increased abruptly at 1330 h and returned rapidly to
      baseline levels before the onset of LH surge. Also, a similar pattern in
      hypothalamic Ang II levels occurred at 1500 h with the rise and peak serum LH
      levels in the late afternoon. In the second experiment, Ang II levels in the
      cerebrospinal fluid (CSF) of rats similarly pretreated with ovarian steroids were
      evaluated. Again, CSF Ang II levels rose abruptly to a peak at 1330 h and
      returned to baseline range preceding the expected rise in serum LH. Thereafter,
      no further change in CSF Ang II levels was detected during the period of LH
      hypersecretion. In the third experiment, perfusates were collected from a push
      pull cannula aimed at the paraventricular nucleus in ovx rats similarly treated
      with ovarian steroids. A peak of Ang II was observed at 1330 h and a later peak
      at 1430 h. A comparison with LH profiles indicated that these peaks in Ang II
      levels were evident before and during the LH surge. Thus, in three separate
      experiments, the results showed that rapid dynamic changes in hypothalamic Ang II
      levels and release occur in association with the progesterone-induced LH surge in
      estrogen-primed ovx rats. These findings support the previous observations that
      Ang II can stimulate LHRH and LH release. Since similar, temporally correlated
      changes occur in hypothalamic neuropeptide Y and LHRH, the peptides involved in
      the induction of LH surge, these results are in agreement with the hypothesis
      that Ang II-expressing neurons may play an important role in the hypothalamic
      circuitry responsible for stimulation of LH surge in ovarian steroid-treated ovx
      rats.

PMID- 8462464
TI  - Relaxin stimulation of porcine granulosa cell deoxyribonucleic acid synthesis in
      vitro: interactions with insulin and insulin-like growth factor I.
AB  - Relaxin (RLX) is a product of the theca interna layer of the developing pig
      follicle. However, its physiological role within the ovary is unknown. The
      purpose of this study was to determine the effects of RLX alone or in conjunction
      with insulin and insulin-like growth factor-I (IGF-I) on porcine granulosa cell
      (GC) DNA synthesis and proliferation in vitro. The results showed RLX (1-1000
      ng/ml), insulin (1-1000 ng/ml), and IGF-I (1-30 ng/ml) alone stimulated
      [3H]thymidine incorporation into DNA by GC from small, medium, and large porcine
      follicles (P < 0.05). The effect of RLX in combination with insulin or with IGF-I
      on DNA synthesis by GC from small and medium follicles was greater than the
      effect of either single factor (P < 0.05). In the large follicle, RLX increased
      GC DNA synthesis synergistically with insulin and IGF-I. FSH (100 ng/ml) or
      estradiol (10(-7) M) had no effect on basal or RLX-induced [3H]thymidine
      incorporation into GC DNA at any stage of follicular development. After 6 days
      incubation in vitro, RLX dose-dependently increased proliferation of GC from
      small follicles (P < 0.05). The increased cell number in response to RLX
      correlates with RLX-induced [3H]thymidine incorporation into DNA by these GC.
      Hydroxyurea, an inhibitor of DNA synthesis, blocked RLX-induced thymidine
      incorporation, indicating that the increase in thymidine incorporation in
      response to RLX was due to DNA synthesis and not repair. This is the first
      demonstration that RLX acts as a growth factor in the porcine follicle by
      increasing GC DNA synthesis and proliferation in vitro. RLX enhanced the growth
      promoting effects of insulin and IGF-I on GC, which suggests an interaction of
      RLX with these proteins during follicular growth. These studies support the
      concept that locally produced thecal RLX alone or in combination with other
      growth effectors may play a key role in GC growth during porcine follicular
      development.

PMID- 8462465
TI  - Regulation of parathyroid hormone-related peptide production in vitro by the rat
      hypercalcemic Leydig cell tumor H-500.
AB  - The transplantable rat Leydig cell tumor H-500 is known to cause hypercalcemia in
      vivo by the release of abundant PTH-related peptide (PTHRP) and to closely
      reproduce the human syndrome of malignancy-associated hypercalcemia. In the rat
      only a single messenger RNA species of 1.4 kilobases is expressed which encodes a
      peptide of 141 amino acid as the sole molecular form. We have examined in
      cultured rat Leydig tumor cells H-500, the capacity of multiple factors to
      regulate PTHRP messenger RNA expression and secretion. Both fetal bovine serum
      and epidermal growth factor stimulated PTHRP gene expression and secretion into
      conditioned culture medium. Dexamethasone and 1,25-dihydroxyvitamin D3 produced
      inhibition of PTHRP gene expression and secretion. Furthermore, in these
      testicular cells, after 12 h or more of incubation, testosterone produced a dose
      dependent (10(-9)-10(-7) M) inhibition of PTHRP production. No significant
      difference in this inhibitory response was seen between testosterone and its 5
      alpha-reduced metabolite dihydrotestosterone whereas 17 beta-estradiol,
      progesterone, LH, FSH, and PRL were ineffective. An androgen receptor antagonist
      Win 49596 blocked the androgen-mediated inhibition of PTHRP gene expression and
      secretion, but not that due to dexamethasone. Epidermal growth factor caused an
      increase, whereas androgen caused a decrease in PTHRP gene transcription. These
      studies demonstrated that growth factors, dexamethasone, and 1,25
      dihydroxyvitamin D3 are broadly active regulatory agents of PTHRP production
      which cross species and tissue barriers. Testosterone may be a more selective
      modulator which can regulate PTHRP in tissues such as Leydig cell neoplasms which
      express the androgen receptor.

PMID- 8462466
TI  - Enterohepatic regulation and metabolism of 3,5,3'-triiodothyronine in hypothyroid
      rats.
AB  - Several steady state indices of thyroid hormone distribution, metabolism,
      excretion, and absorption were measured in intact hypothyroid and euthyroid rats,
      to explore the role of intestines and enterohepatic pathways in the dynamic
      regulation of whole-body thyroid hormone in these two states. Ten rats were
      studied, 5 normal control (N) and 5 rendered hypothyroid (3.48 vs. 19.8 ng/ml
      TSH) by surgical thyroidectomy 3.5 weeks earlier (HYPO). High specific activity
      125I-labeled T3 (T3*) was infused at the same constant rate for 7 days from
      osmotic minipumps implanted sc. Daily urine and feces, and seventh-day cardiac
      and portal venous blood, bile, and whole intestinal contents were assessed. Bowel
      and feces were homogenized, extracted, and chromatographed, along with serum,
      bile, and urine samples. Bile, bowel, and fecal extract samples were also
      hydrolyzed with aryl-sulfatase and/or beta-glucuronidase and chromatographed to
      identify conjugates and determine total T3* in all fluid and tissue samples. In
      the N group, the bowel contained 21.2 +/- 1.22 (SD) times more T3* (mass) than
      plasma (199 ng vs. 9.39 ng), this ratio falling to 9.03 +/- 1.78 in the HYPO
      group (30.4 ng vs. 3.37 ng), a shift to relatively more T3* in blood. Urinary T3*
      was zero in both groups. But fecal excretion was 34 +/- 4.43% of total T3*
      infused (production) in N and only 20.3 +/- 3.05% in HYPO rats, closely
      paralleling reduced fecal bulk flow, and thus providing more time for T3*
      absorption. Endogenous T3 and T4 concentrations measured in portal plasma were 15
      31% greater in normals and 69-95% greater in HYPO rats than in corresponding
      systemic plasma samples, a direct indication of absorption of endogenous T3 and
      T4 in both groups, with greater absorption in the HYPO group. About 66% total T3*
      was metabolically degraded in N rats, rising to approximately 80% in HYPO rats.
      Plasma clearance rates of T3 fell more than 50% in HYPO rats, and total T3
      production fell to about 20% of normal. It appears that HYPO rats compensate for
      low T3 by fecally excreting a much smaller fraction of total T3 production,
      absorbing more T3 and T4, and leaving a larger fraction for T3 action and
      degradative metabolism.

PMID- 8462467
TI  - The stimulatory effect of insulin on diacylglycerol generation in adipocyte
      membranes from ob/ob mice is impaired by growth hormone.
AB  - Physiologically, the action of insulin on carbohydrate and lipid metabolism is
      opposed by several hormones, including glucocorticoids, glucagon, catecholamines,
      and pituitary GH. Perhaps least is known about the mechanism(s) involved in the
      antiinsulin action of GH. Since the generation of diacylglycerol (DAG) appears to
      be an early event in the insulin-signaling cascade, it was of interest to
      determine whether GH would interfere with this effect of insulin. Experiments
      were conducted to determine whether insulin would stimulate the generation of DAG
      in adipocytes of the obese (ob/ob) mouse, and whether this response could be
      blocked by the diabetogenic GH derivative S-carboxymethylated human GH (RCM-hGH).
      Isolated adipocytes of the ob/ob mouse were used for these studies, because
      unlike normal rodents, the ob/ob mouse responds predictably to the antiinsulin
      action of GH. Insulin produced a rapid biphasic increase in the amount of DAG in
      a crude membrane fraction of the adipocytes. The first peak in DAG mass occurred
      within 5 min of exposure of the cells to insulin, and the second peak occurred
      after 30 min. The first peak in DAG mass did not occur in adipocytes that had
      been incubated with pertussis toxin before exposure to insulin. Also, adipocytes
      isolated from ob/ob mice that had been treated with RCM-hGH failed to respond to
      insulin with an increase in DAG mass. RCM-hGH blocked both the first and second
      insulin-induced peaks in DAG mass within 6 h of its administration. This is the
      time at which ob/ob mouse adipocytes exhibit increased insulin resistance in
      response to RCM-hGH. Neither exposure to insulin nor treatment with RCM-hGH had
      any appreciable effect on the fatty acid composition of the DAG present in the
      adipocyte membranes. These findings are compatible with the idea that GH produces
      some defect in the insulin-signaling cascade that is proximal to the events that
      result in the generation of DAG in the adipocyte.

PMID- 8462468
TI  - Seasonal changes in melatonin binding sites in the pars tuberalis of male
      European hamsters and the effect of testosterone manipulation.
AB  - Seasonal changes in specific 2-[125I]iodo-melatonin binding were assessed in the
      pars tuberalis of male European hamsters (Cricetus cricetus) kept under natural
      environmental conditions. Saturation studies were performed on pars tuberalis
      membrane preparations every 5-7 weeks for 13 months. The maximum number of
      melatonin binding sites occurred in spring and summer (Bmax, 4.0 +/- 0.3 fmol/mg
      protein, n = 9) with significantly reduced binding in winter (Bmax, 1.2 +/- 0.2
      fmol/mg protein, n = 2). As an assay control, simultaneous saturation studies
      were performed on rat pars tuberalis membranes. No summer-winter difference in
      binding site density was observed in the rat studies. In both hamsters and rats
      no seasonal changes in binding affinity were found. Although an apparent
      correlation between Bmax, values and paired testes weight of the hamsters was
      noted, in early spring the increase in the number of melatonin binding sites
      preceded the elevation in testicular weight. Castration during the period of
      sexual activity or sexual inactivity also failed to reduce the elevated number of
      binding sites observed in the spring and summer. In addition, testosterone
      implanted sc 5 weeks before had no effect on the low 2-[125I]iodo-melatonin
      binding site density found in winter (November). These results suggest that the
      observed seasonal variation in the number of melatonin binding sites is
      independent of seasonal changes in circulating testosterone concentrations.

PMID- 8462469
TI  - A supersensitive immunofluorometric assay for rat luteinizing hormone.
AB  - We have developed an immunofluorometric assay (IFMA) for rat (r) LH, which is
      based on two monoclonal antibodies, one to bovine and the other to human LH.
      Signal detection occurs by time-resolved fluorescence evoked by a europium label
      (Delfia, Wallac). The method is fast in comparison to the standard RIA with the
      NIDDK reagents (4 h vs. 3 days). The sensitivity of the IFMA assay (0.75 pg/tube;
      NIDDK rLH RP-2) is over 30-fold higher than that of the NIDDK RIA (usual
      detection limit, 20-30 pg/tube). Using 25-microliters serum samples, the
      sensitivity of IFMA is 0.03 micrograms/liter; with 100-microliters samples, it is
      0.0075 micrograms/liter. The cross-reactivity of the IFMA assay is 0.3% with
      rFSH, 3% with rTSH, and less than 0.05% with rGH, rPRL, and the rat alpha
      subunit. A linear correlation between IFMA and RIA values is seen at serum levels
      above 0.4 micrograms/liter. Below this level, only IFMA is able to detect
      concentration differences between samples. In practice, this means that only IFMA
      is able to provide meaningful measurements of suppressed levels of serum LH. The
      correlation coefficient between IFMA and the mouse interstitial cell in vitro
      bioassay for LH in randomly selected rat pituitary homogenates was 0.93 (n = 47).
      The serum concentration of LH determined by IFMA is 0.57 +/- 0.10
      micrograms/liter in intact adult male rats (mean +/- SEM; n = 12) and 0.41 +/-
      0.10 micrograms/liter (n = 10) in randomly cycling females. The level in
      hypophysectomized rat serum is 0.035 +/- 0.0033 micrograms/liter (n = 8), if the
      limit of sensitivity (0.03 microgram/liter) is assigned to unmeasurable levels.
      One-week treatment of male rats with 2-cm Silastic implants containing
      testosterone suppressed serum LH, measured by IFMA, from 0.56 +/- 0.057 to 0.086
      +/- 0.057 micrograms/liter (P < 0.01). The suppression of LH measured in the same
      samples by RIA was lower, from 0.73 +/- 0.057 to 0.44 +/- 0.048 micrograms/liter
      (P < 0.01). A 5-day starvation of intact male rats suppressed serum LH from 0.57
      +/- 0.10 to 0.30 +/- 0.05 microgram/liter by IFMA (P < 0.01), whereas the
      decrease determined by RIA was not significant (0.80 +/- 0.07 vs. 0.66 +/- 0.13
      micrograms/liter).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8462470
TI  - Cholesterol cell content affects prolactin but not growth hormone release in
      GH4C1 cells.
AB  - It is generally accepted that cholesterol affects dynamic membrane properties and
      the function of membrane bound proteins involved in secretion processes. In the
      present study we employed GH4C1 cells treated with human lipoprotein-deficient
      serum (h-LPDS), exogenous cholesterol and high density lipoprotein (HDL3) to
      investigate the role of cholesterol cell content on PRL and GH basal release.
      Incubation of GH4C1 cells with h-LPDS decreased free cholesterol content and
      cholesterol added to the media increased it. HDL3 did not act as a cholesterol
      acceptor in either cholesterol-depleted or cholesterol-loaded cells; however, in
      depleted cells HDL3 was a net donor, significantly increasing cell cholesterol.
      Control or cholesterol loaded cells incubated in media with h-LPDS increased
      their secretion of PRL in parallel with the loss of cell cholesterol. Conversely,
      the addition of either cholesterol or HDL3 to cholesterol depleted cells
      inhibited PRL release. However, GH secretion was not modified by changes in free
      cholesterol in any of these situations. In the experiments in which HDL3 was
      present, a highly positive correlation was found between cholesterol cell content
      at the end of the experiment and PRL secretion, no effect could be related to the
      amount of added HDL3, suggesting that the HDL3 had no specific effect on the
      secretion of PRL or GH. Our results indicate that cholesterol cell content is an
      important factor in the release of PRL but not of GH, and emphasize the
      differences in the basal regulation of the secretion of both hormones.

PMID- 8462471
TI  - Increased angiotensin II type-1 receptor gene expression in neuronal cultures
      from spontaneously hypertensive rats.
AB  - In this study we compared the expression of angiotensin II type 1 (AT1) receptor
      messenger RNA (mRNA) and AT1 receptors in neurons cultured from Wistar-Kyoto
      (WKY) and spontaneously hypertensive (SH) rat brains. Neuronal cultures from the
      hypothalamus and brain-stem of 1-day-old SH rats exhibited approximately 4-fold
      higher steady-state levels of AT1 receptor mRNA than the corresponding WKY
      cultures. This was attributable to greater levels of both AT1A and AT1B receptor
      mRNA subtypes in SH rat neuronal cultures compared with WKY rat neurons. SH rat
      neuronal cultures also exhibited increased numbers (approximately 2.3-fold) of
      binding sites for [3H]DuP753, an AT1 receptor selective ligand, and enhanced
      (approximately 3.4-fold) stimulation of inositol phospholipid hydrolysis by
      angiotensin II compared with WKY neurons. By contrast, cultured astroglia from SH
      and WKY rat brain exhibited no significant differences in either the levels of
      AT1 receptor mRNA or the specific binding of [3H]DuP753. These data suggest that
      in SH rat neurons, AT1 receptor transcription and translation is increased,
      compared with neurons from WKY rats.

PMID- 8462472
TI  - Cholecystokinin stimulates gonadotropin-releasing hormone release in the monkey
      (Macaca mulatta).
AB  - There is evidence to suggest that the arginine vasopressin release observed in
      association with emesis after i.v. injection of cholecystokinin (CCK) and N
      methyl-D-aspartate (NMDA) is mediated by stimulation of emetic centers in the
      brainstem. That the GnRH-releasing action of NMDA is also sometimes accompanied
      by emesis led to the suggestion that stimulation of this parvocellular system by
      the glutamate agonist may also be mediated in part via activation of brainstem
      pathways. If this is the case, then other nauseogenic agents, such as CCK, should
      similarly elicit GnRH release. The foregoing prediction was tested in the
      castrated juvenile male monkey, an experimental model characterized by the
      absence of spontaneous GnRH release. GnRH discharges were monitored indirectly by
      measuring changes in circulating LH concentrations after the responsivity of the
      gonadotroph had been heightened by a chronic intermittent i.v. infusion of the
      decapeptide. An i.v. bolus of CCK at 10 and 30 micrograms/kg BW led to a distinct
      discharge of GnRH accompanied by emesis or other behaviors suggestive of nausea.
      Lower doses of CCK (1 and 3 micrograms/kg BW) failed to significantly perturb
      GnRH release or cause emesis, although NMDA (5 mg/kg BW; racemic form) injected
      i.v. 3 h after the CCK challenge led to a robust rise in GnRH. In a parallel
      study, three repetitive i.v. CCK injections at 2h intervals maintained
      intermittent GnRH release. Pretreatment with a long-acting GnRH receptor
      antagonist ([AcD2Nal1,4ClPhe2,DTrp3,DArg6,DAla10]GnRH -HOAc) abolished the LH
      response to CCK, confirming that the action of this peptide was mediated by GnRH
      release. Although a direct hypothalamic site of action for these agents remains
      the most likely possibility, since both NMDA and CCK receptors are present in the
      infundibular region, the present data are consistent with the notion that CCK
      and, by inference, NMDA may activate GnRH release in part via the stimulation of
      brainstem emetic centers. Plasma GH, PRL, and cortisol concentrations were also
      monitored during the course of some of these experiments, and the release of
      these hormones was observed after the administration of either the 10 or 30
      micrograms/kg BW dose of CCK.

PMID- 8462473
TI  - Mitogenic signaling by prostaglandins in chemically transformed mouse
      fibroblasts: comparison with phorbol esters and insulin.
AB  - In the quiescent mouse BP-A31 fibroblasts, prostaglandin F2 alpha (PGF2 alpha)
      induces the expression of cell cycle-related genes c-fos, c-jun, and c-myc, and
      after a delay of approximately 12 h the entry into the phase of DNA replication.
      A weaker mitogenic effect was produced by certain other PGs (F1 alpha > D2),
      whereas the effects of PGs E and I were marginal or absent. The mitogenic effects
      of PGF2 alpha as well as of 12-O-tetradecanoyl phorbol 13-acetate (TPA; activator
      of protein kinase C) but not those of insulin (acting via the insulin-like growth
      factor 1 receptor) were abolished by a low concentration (7.5 nM) of
      staurosporine (inhibitor of protein kinase C). Moreover, long-time (24 h)
      preincubation with phorbol dibutyrate reduced the mitogenic effects of a
      subsequent exposure either TPA or PGF2 alpha. These observations favor the
      involvement of protein kinase C in the PGF2 alpha-dependent intracellular signal
      transduction. However, simultaneous stimulation of the quiescent cells with
      saturating concentrations of PGF2 alpha and TPA had a greater mitogenic effect
      than either drug alone, both in cells with and without down-regulation of protein
      kinase C, indicating that the protein kinase C-dependent signaling does not
      entirely account for the mitogenic activity of PGF2 alpha.

PMID- 8462474
TI  - Transfer kinetics of 3,5,3'-triiodothyronine and thyroxine from rat blood to
      large and small intestines, liver, and kidneys in vivo.
AB  - Enterohepatic circulation of thyroid hormone in the rat involves transfer of
      hormone to intestines in bile from the liver and absorption of some intestinal
      hormone, via portal blood to liver. Transfer of hormone to intestines from
      mesenteric arterial blood has generally been considered minimal, although this
      alternate pathway has received little attention. We have measured uptake kinetics
      of iv trace doses of radioactivity labeled T3 (T3*) and T4* from blood to
      intestines, longitudinally in 14 segments of total intestines in situ, with bowel
      contents included and bile duct ligated, and also to liver and kidneys, for
      comparison. Both T3* and T4* entered the entire length of intestines from blood,
      and into contents as well as tissue. Tissue uptake of T3* and T4* were fairly
      uniform longitudinally, but uptake into contents and thus into total intestines
      (tissue + contents) decreased linearly from pylorus to anus. Unidirectional
      uptake rate constants (hours-1) or clearance rates (milliliters per h) of T3*
      were 13 times greater than corresponding T4* fractional uptake rates to
      intestines. In contrast, T4 mass fluxes (congruent to 38 ng/h.100 g body wt)
      exceed T3 fluxes (congruent to 6.3 ng/h.100 g body wt) about 6-fold, because
      plasma contains far more T4 than T3. Comparing these results with published
      biliary and fecal T3 and T4 flux data, it appears that mesenteric arterial mass
      influxes to intestines are 3-5 times greater than both biliary secretion and
      fecal excretion of T3 and T4. Intestinal kinetics, in the absence of biliary
      influx, are characterized by a moderately rapid uptake followed by a very slow
      washout phase, which fit into neither the fast nor slow compartment paradigms of
      a 3-compartment mammillary model, in contrast to liver and kidney kinetics, which
      fit well into a single fast compartment. Intestinal dynamics are consistent with
      an organ in which storage and exchange of thyroid hormone dominate over metabolic
      and excretory processes.

PMID- 8462475
TI  - Transforming growth factor-beta 1 modulates calcium metabolism in Sertoli cells.
AB  - The mechanism of signal transduction by transforming growth factor-beta 1 (TGF
      beta 1) is largely unknown. In this study, TGF-beta 1 was able to stimulate
      45Ca2+ uptake in cultured rat Sertoli cells. In contrast to the rapid stimulation
      of 45Ca2+ uptake previously observed in response to FSH (< 1 min), the response
      to TGF-beta 1 required several hours and was abolished by actinomycin-D. Although
      TGF-beta 1 had no effect on basal calcium uptake before 1 h, it completely
      inhibited the FSH-stimulated calcium uptake in short term incubations (2 and 20
      min). These effects of TGF-beta 1 on calcium metabolism may be directly related
      to the ability of this cytokine to regulate cell growth and differentiation in
      many cell systems.

PMID- 8462476
TI  - Effects of estrous cycle stage and pregnancy on follistatin gene expression and
      immunoreactivity in rat reproductive tissues: progesterone is implicated in
      regulating uterine gene expression.
AB  - Follistatin, a monomeric protein originally isolated from ovarian follicular
      fluid, is now believed to be a major local regulator of the multifaceted actions
      of activin by virtue of its activin-binding properties. In view of the ability of
      follistatin to stimulate progesterone production from granulosa cells and its
      presence in newly formed corpora lutea, the following study was conducted to
      determine the effects of cycle stage and pregnancy on follistatin gene expression
      and immunoreactivity in the rat ovary and uterus with the intent of gaining
      additional insights into the regulation of follistatin in these tissues. Decidua
      and placentas were also examined on days 15, 18, and 21 of pregnancy. Follistatin
      messenger RNA (mRNA) levels were quantified using a sensitive solution
      hybridization-RNase protection assay and values normalized to the amount of
      cyclophilin mRNA present in each sample. Levels of follistatin-like
      immunoreactivity (FLI) in serum and tissues were estimated using a homologous
      porcine follistatin RIA. Follistatin message levels in the ovary increased
      between proestrus and estrus with a return to proestrous values on both days of
      diestrus. In the nonpregnant uterus, mRNA levels on proestrus were similar to
      levels measured in uteri taken from hypophysectomized or ovariectomized rats.
      Interestingly, follistatin gene expression increased almost 3-fold between
      proestrus and estrus. An additional experiment demonstrated that this increase
      could be abated by treatment of proestrous rats with pentobarbital which blocks
      preovulatory rises in serum progesterone levels and could be restored by
      administration of progesterone to pentobarbital-treated proestrous rats. In
      pregnant rats, ovarian follistatin message levels on days 3 and 6 of pregnancy
      were identical to levels observed on day 2 of diestrus. However, an abrupt 4-fold
      increase in ovarian mRNA levels occurred between days 6 and 9 with a further 58%
      increase occurring by day 12. This marked increase in message levels was
      unaccompanied by changes in ovarian FLI levels. A precipitous decrease in
      transcript levels accompanied by a decline in FLI levels then followed with
      ovarian gene expression on days 15 through 21 being slightly higher than
      expression during the initial stages of gestation. Expression of the gene in the
      decidua and placenta did not vary between days 15 and 21 of pregnancy. Levels of
      FLI in serum also were invariant during the cycle and pregnancy.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8462477
TI  - Differential regulation of transcription initiation from insulin-like growth
      factor-I (IGF-I) leader exons and of tissue IGF-I expression in response to
      changed growth hormone and nutritional status in sheep.
AB  - In the mammalian insulin-like growth factor-I (IGF-I) gene, exons 1 and 2 are
      differentially spliced to exon 3 producing alternate class 1 and class 2
      transcripts. The aim of this study was to investigate the tissue expression of
      these leader exons in lambs growing at different rates as a result of chronic
      manipulation of nutritional and GH status. Riboprobes were developed so that
      leader exon-specific and total IGF-I gene expression could be determined using a
      single RNase protection assay. Lambs were fed a diet containing high or low
      protein content either ad libitum or at a restricted intake; within these dietary
      groups they were treated with either saline or GH for 10 weeks. Total hepatic IGF
      I messenger RNA (mRNA) transcripts were significantly increased by GH (P =
      0.004), protein (P = 0.002), and energy (P < 0.001) status as were circulating
      IGF-I concentrations (GH, P < 0.001; protein, P = 0.026; energy, P < 0.001).
      Exons 1 and 2 were expressed in liver but to a variable extent. Increased dietary
      energy and protein induced increased expression from both class 1 and 2
      transcripts, but the percent increases was at least 5-fold greater for class 2
      than for class 1 mRNA. GH treatment only stimulated significant increases in
      expression from class 2 transcripts. In the low protein, energy-restricted,
      saline-treated lambs exon 1 transcripts accounted for approximately 70% of total
      class 1 and 2 transcripts, and this proportion declined significantly as class 1
      and 2 transcripts, and this proportion declined significantly as GH and
      nutritional status increased to only 30% in the high protein, ad libitum-fed, GH
      treated animals; class 2 transcripts therefore displayed the opposite pattern of
      expression. These data indicate that exon 2 may be far more sensitive than exon 1
      in intact animals which have been stimulated within normal physiological limits.
      Muscle IGF-I gene expression was at least 20-fold less than that for the liver
      and consisted mainly of class 1 transcripts. Muscle total IGF-I mRNA was
      insensitive to changed nutritional status or to GH treatment, even though
      significant increases in muscle growth occurred in response to ad libitum intake
      and GH, indicating that hepatically derived endocrine IGF-I could have a role in
      the regulation of muscle growth.

PMID- 8462478
TI  - Enhancement of thyrotropin-stimulated iodide organification in porcine thyroid
      cells after protein kinase-C inhibition.
AB  - We and others have previously shown that 12-O-tetracanoylphorbol-13-acetate
      (TPA), a protein kinase-C (PKC) activator, inhibits TSH-stimulated iodide
      organification in porcine thyroid cells. However, TPA action may be independent
      of PKC. To further explore the role of PKC in the regulation of differentiated
      thyroid function, we studied the effects of the PKC inhibitors 1-O-hexadecyl-2-O
      methylglycerol (AMG-C16), 1-(5-isoquinolinesulfonyl)2-methylpiperazine (H7), and
      staurosporine on TSH-stimulated iodide organification in porcine thyroid cells in
      the presence and absence of TPA. AMG-C16 increased basal iodide organification in
      concentrations ranging from 15-240 microM (P < 0.01, by analysis of variance).
      Such stimulation by AMG-C16 (30-120 microM) persisted in the presence of
      submaximal (10 microU) and maximal (1 mU) concentrations of TSH. However, in the
      presence of TPA (> 10 nM), the effects of AMG-C16 were abolished. H7 (50 microM)
      and staurosporine (100 nM) also enhanced TSH-stimulated iodide organification. In
      the presence of staurosporine and TPA, no inhibition of TSH-stimulated iodide
      organification was observed. However, H7 could not reverse the effects of TPA. In
      summary, these studies indicate that in porcine thyroid cells, three distinct PKC
      inhibitors all enhanced TSH-stimulated iodide organification and that
      staurosporine reversed the effects of TPA on TSH-stimulated iodide
      organification. These findings are consistent with the concept that PKC acts as
      an endogenous negative modulator of iodide organification in vitro.

PMID- 8462479
TI  - Neuropeptide-Y stimulates growth hormone and gonadotropin-II secretion in the
      goldfish pituitary: involvement of both presynaptic and pituitary cell actions.
AB  - We have previously reported that neuropeptide-Y (NPY) stimulates GH and
      gonadotropin-II (GtH-II) release from perifused pituitary fragments in the
      goldfish. Since the teleost pituitary is directly innervated by neurosecretory
      terminals from the brain, we further investigated the possible sites of action of
      NPY. Both synthetic human NPY and NPY-(18-36), an agonist selective for the NPY
      Y2-receptor, stimulated GH and GtH-II release from the pituitary fragments; the
      magnitude of the response to NPY (18-36) was smaller than that to the whole
      molecule of NPY. NPY also stimulated the release of GH and GtH-II from perifused
      dispersed pituitary cells. In contrast, NPY-(18-36) had no effect on either GH or
      GtH-II release from dispersed pituitary cells. These data suggest that Y2 action
      is not direct at the level of pituitary cells, but may be indirect through
      actions on nerve terminals in the pituitary. The hypothesis that the action of
      NPY on GH and GtH-II release is mediated in part by GnRH was then tested. Both
      NPY and NPY-(18-36) stimulated the GnRH release from preoptic-anterior
      hypothalamic slices and pituitary fragments with similar potency. Furthermore, a
      GnRH antagonist significantly reduced the effects of NPY on both GH and GtH-II
      release in perifused pituitary fragments. Similar to previous findings, NPY, when
      given at 55-min intervals, desensitized the hormone responses in pituitary
      fragments. Similarly, the same treatment with NPY in perifused dispersed
      pituitary cells induced desensitization of GH and GtH-II responses. Together,
      these results suggest that 1) more than one type of NPY receptors are present in
      the goldfish pituitary; and 2) NPY has at least two sites of action in the
      pituitary. One site of action is the pituitary cells, where NPY directly
      stimulates GH and GtH-II secretion; the second is the nerve terminals, where NPY
      presynaptically stimulates GnRH release via Y2-like receptors, and GnRH, in turn,
      stimulates GH and GtH-II release.

PMID- 8462480
TI  - Estrogen action in the reproductive tract of rhesus monkeys during antiprogestin
      treatment.
AB  - We previously reported that RU486 can reverse progesterone (P)-induced
      suppression of the estrogen receptor (ER) in the uterus of pregnant rhesus
      monkeys, but we did not determine whether estrogen (E) could act through its
      receptor in the presence of P and RU486. To pursue this question, we treated
      spayed rhesus monkeys with various hormonal regimens and evaluated the effects of
      E in the oviduct and endometrium, with and without RU486 treatment, on ER and
      progestin receptor (PR) levels, morphology, apoptosis, and degree of
      proliferation. The latter was assessed immunocytochemically with a monoclonal
      antibody (Ki-67) against a nuclear antigen present only in proliferating cells.
      Animals were treated for 2 weeks with 17 beta-estradiol (E2) and then for 2 weeks
      with E2 plus P to produce a regressed oviduct and a secretory endometrium. The
      animals were then treated for 2 more weeks with four different treatments, as
      follows: I) E2, P, and vehicle; II) E2 and vehicle; III) E2, P, and RU486; and
      IV) E2 and RU486 (n = 4 each). In group I, menstruation did not occur, and the
      endometrium exhibited stromal cell enlargement, extensive development of the
      spiral arteries, few Ki-67-positive cells, and low levels of ER and PR. Oviducts
      in group I remained regressed, Ki-67-positive epithelial cells were few, and
      levels of ER and PR were low. In contrast, in groups II, III, and IV, the
      oviducts had responded to E2 and were fully ciliated and secretory, with elevated
      levels of ER and nuclear PR. All animals in these three groups menstruated and
      then regenerated their endometrium. The regenerated endometria expressed
      elevations in ER, nuclear PR, and epithelial Ki-67 index. However, the endometria
      of RU486-treated monkeys in groups III and IV had significantly more epithelial
      cell death by apoptosis, increased stromal cell compaction, and fewer Ki-67
      positive stromal cells than in the E2 controls (group II). In group IV, RU486
      caused a significant decrease in endometrial weight. Thus, RU486 blocked P action
      and allowed E2 to act in a normal fashion in the oviduct and endometrium on
      several end points, but it also had antiproliferative effects that opposed E2
      action, especially in the endometrium.

PMID- 8462481
TI  - Expression of the genes for the epidermal growth factor receptor and its ligands
      in porcine corpora lutea.
AB  - Using reverse transcription-polymerase chain reaction (RT-PCR), transcripts for
      EGF receptor and for EGF, transforming growth factor-alpha (TGF alpha),
      amphiregulin (AR) and heparin binding-EGF (HB-EGF) were detected in porcine
      corpora lutea at day 4, 10 and 20 of the estrous cycle. No cycle-dependent
      changes were apparent in the expression of the receptor, AR or TGF alpha. In
      contrast, HB-EGF mRNA levels appeared highest on day 4 during luteal growth and
      development, whereas EGF mRNA levels appeared highest on day 20 when the corpora
      lutea undergo luteolysis. These results suggest that luteal function may be
      subject to regulation by members of the EGF family acting in an autocrine,
      paracrine or intracrine manner.

PMID- 8462482
TI  - Porcine oocytes release cumulus expansion-enabling activity even though porcine
      cumulus expansion in vitro is independent of the oocyte.
AB  - In the mouse, the oocyte secretes a factor that enables cumulus cells to undergo
      expansion in response to epidermal growth factor (EGF) or FSH while expansion of
      the porcine cumulus oophorus has been shown to be independent of the oocyte. This
      study was undertaken to confirm independence of the porcine cumulus oophorus of
      the oocyte for its expansion and to determine if the porcine oocyte secretes the
      putative cumulus expansion-enabling factor that is required for FSH-stimulated
      mouse cumulus expansion. Porcine oocyte-cumulus cell complexes (P-OCC),
      oocytectomized oocyte-cumulus cell complexes (P-OOX) and intact clumps of cumulus
      cells (P-CCC) were cultured at 39 C in TCM-199 medium containing EGF (1 ng/ml) or
      FSH (1.5 micrograms/ml). After 24h culture periods, cumulus expansion was scored
      on an arbitrary scale of 0 to +4. EGF stimulated similar cumulus expansion
      (expansion score +3 compared to 0 for controls) in all the three groups. FSH
      stimulated cumulus expansion in significantly higher number of complexes in all
      groups compared to EGF. However, there was no difference in cumulus expansion
      among the three groups with EGF or FSH. To determine the production of the factor
      by the porcine oocyte, isolated clumps of cumulus cells of the mouse (M-CCC) were
      cocultured with porcine denuded oocytes (P-DO) in TCM-199 with or without 1.5
      micrograms/ml FSH at 37 C for 24h. No expansion was observed when M-CCC were
      cultured alone in the presence of FSH or cocultured with P-DO in the absence of
      FSH. However, coculture of M-CCC with P-DO in the presence of FSH resulted in
      expansion of M-CCC similar to that observed in intact mouse oocyte-cumulus cell
      complexes (M-OCC) in response to FSH. These studies indicate that even though
      porcine cumulus expansion in vitro is not dependent on the oocyte, the porcine
      oocyte is capable of secreting cumulus expansion-enabling factor(s).

PMID- 8462483
TI  - Evidence for generation of the growth hormone-binding protein through proteolysis
      of the growth hormone membrane receptor.
AB  - The growth hormone-binding protein (GHBP) which circulates in plasma is a soluble
      short form of the membrane growth hormone receptor (GHR). In rats and mice, GHR
      and GHBP originate from two alternatively spliced mRNAs (4.5 and 1.2 kb). In
      human and rabbit tissues, a single predominant mRNA of 4.5 kb was detected and it
      was hypothesized that GHBP could be produced by proteolytic cleavage of the GHR.
      Using gel filtration and HPLC, we have detected a high level of GH binding
      activity in media of cells transfected with rabbit GHR cDNA. The [125I]hGH-GHBP
      complex eluted at the same time as the plasma complex and both the binding
      affinity and specificity of the BP were comparable to that of rabbit plasma.
      Immunoprecipitation experiments and Western blots confirmed that GHBP in the
      media of transfected cells was a 55 kDa protein related to the extracellular
      domain of the GHR. In contrast, no BP was detected in the media of cells
      transfected with the cDNA encoding the rat GHR. These results strongly suggest
      that, in rabbit and probably in man, the GHBP could, at least in part, be
      produced by proteolytic cleavage of the GHR.

PMID- 8462484
TI  - Selenium deficiency aggravates the necrotizing effects of a high iodide dose in
      iodine deficient rats.
AB  - The effect of selenium deficiency associated with various iodide intake was
      investigated in rats in order to better understand its possible role in the
      etiopathogeny of myxedematous cretinism. Groups of rat pups were fed from birth a
      low selenium diet (Se-) and submitted to goitrogenic treatment (1% perchlorate in
      water) for one month. Some animals were refed iodide after perchlorate
      withdrawal. The gland morphology was analyzed in correlation with the glutathione
      peroxidase (GPX) activity and the thyroid hormone plasma levels. In all Se- rats,
      the GPX activity was strongly reduced as compared to selenium sufficient (Se+)
      animals (P < 0.01). Goitrous rats were hypothyroid whatever the selenium intake.
      After iodide refeeding, plasma T4 and T3 levels were increased by 160% in Se-
      rats and by respectively 330% and 580% in Se+ rats. The thyroid morphology was
      different according to the selenium intake: necrotic cells were about three times
      more numerous in Se- than in Se+ rats (P < 0.01) and the inflammatory reaction
      was increased. These experimental data demonstrate the detrimental role of
      selenium deficiency in one experimental case of thyroid disease. Such reduction
      of cell defences could contribute to the thyroid failure of African myxedematous
      cretins.

PMID- 8462485
TI  - Detection of C-type natriuretic peptide (CNP) transcript in the rat heart and
      immune organs.
AB  - Previous studies suggested the expression of mRNA, coding for CNP, exclusively in
      the central nervous system. In the present study, using the polymerase chain
      reaction (PCR) technique instead of the less sensitive Northern blot
      hybridization, CNP-specific sequences have also been detected in rat atria and
      ventricles of the heart as well as in organs of the immune system (thymus, spleen
      and lymph nodes). Parallel PCR-assays documented ANP-mRNA in these tissues. To
      verify specificity of the PCR-products, Southern blots have been hybridized with
      a third internal oligonucleotide and amplification products have been sequenced.
      The relative level of CNP-mRNA in these tissues was estimated to be in the range
      of 1-9% of total brain CNP transcripts. The results suggest that the peptide may
      have a peripheral as well as a central site of action. In light of its pronounced
      effect on cell proliferation, particular interest should focus on a possible role
      of CNP in the immune system.

PMID- 8462487
TI  - Status epilepticus. Proceedings of the American Epilepsy Society Course.
      Philadelphia, Pennsylvania, December 1991.

PMID- 8462488
TI  - Convulsive status epilepticus in children.
AB  - Status epilepticus (SE) occurs most commonly in infancy and childhood. Children
      with prior neurological abnormalities are most susceptible. More than 90% of
      cases are convulsive and the majority are generalized. SE may occur in the
      setting of an acute illness, in patients with established epilepsy or as a first
      unprovoked seizure. The etiology can be classified as idiopathic, remote
      symptomatic, febrile, acute symptomatic, or associated with a progressive
      encephalopathy. The morbidity and mortality of status have dramatically declined
      in recent years. Overall mortality in recent pediatric series was 3-10%, with
      almost all fatalities associated with acute central nervous system insults or
      progressive neurologic disorders. Neurological sequelae in children with
      idiopathic or febrile status are rare. Neurologically normal children with SE as
      their first unprovoked seizure have the same risk of experiencing subsequent
      seizures of any type as children who present with a brief first seizure. The risk
      of recurrent episodes of convulsive SE approaches 50% in neurologically abnormal
      children but is very low in neurologically normal children. The favorable outcome
      of SE in children may be related to advances in therapy and to the resistance of
      the immature brain to damage from seizures.

PMID- 8462486
TI  - Regulation of c-fos proto-oncogene expression by growth hormone: protein
      synthesis is not required for down-regulation.
AB  - Growth hormone (GH) has been previously shown in Ob1771 adipose cells to
      transiently stimulate the expression of the c-fos gene by a protein kinase C
      (PKC)-dependent pathway. This regulation takes place at a transcriptional level.
      In the presence of cycloheximide (CHX), stimulation by PKC activators or by serum
      leads to a "superinduction" of the c-fos gene. In contrast, upon GH stimulation
      in the presence of CHX, no superinduction takes place and neither prolonged
      transcription nor mRNA stabilization are observed.

PMID- 8462489
TI  - Generalized convulsive status epilepticus in the adult.
AB  - Status epilepticus (SE) is defined as recurrent epileptic seizures without full
      recovery of consciousness before the next seizure begins, or more-or-less
      continuous clinical and/or electrical seizure activity lasting for more than 30
      min whether or not consciousness is impaired. Three presentations of SE are now
      recognized: recurrent generalized tonic and/or clonic seizures without full
      recovery of consciousness between attacks, nonconvulsive status where the patient
      appears to be in a prolonged "epileptic twilight state," and
      continuous/repetitive focal seizure activity without alteration of consciousness.
      Generalized convulsive status epilepticus (GCSE) encompasses a broad spectrum of
      clinical presentations from repeated overt generalized tonic-clonic seizures to
      subtle convulsive movements in a profoundly comatose patient. Thus, GCSE is a
      dynamic state that is characterized by paroxysmal or continuous tonic and/or
      clonic motor activity, which may be symmetrical or asymmetrical and overt or
      subtle but which is associated with a marked impairment of consciousness and with
      bilateral (although frequently asymmetrical) ictal discharges on the EEG. Just as
      there is a progression from overt to increasingly subtle clinical manifestations
      of GCSE, there is also a predictable sequence of progressive EEG changes during
      untreated GCSE. A sequence of five patterns of ictal discharges has been
      observed: discrete electrographic seizures, waxing and waning, continuous,
      continuous with flat periods, and periodic epileptiform discharges on a
      relatively flat background. A patient actively having seizures or comatose who
      exhibits any of these patterns on EEG should be considered to be in GCSE and
      should be treated aggressively to stop all clinical and electrical seizure
      activity to prevent further neurological morbidity and mortality.

PMID- 8462490
TI  - Nonconvulsive status epilepticus in adults and children.
AB  - Nonconvulsive status epilepticus (SE) accounts for approximately one-quarter of
      all cases of SE. The actual proportion may be higher because patients with
      nonconvulsive SE may go unidentified. This disorder may be divided into
      generalized (absence) or partial (complex partial) forms. Nonconvulsive SE may
      occur de novo or in patients with epilepsy. Absence SE is considered more
      frequent and is characterized by a continuous neurocognitive alteration. Complex
      partial SE may be associated with recurrent seizure activity and a cycling of the
      clinical states. Treatment includes antiepileptic drug(s) (AEDs) and avoidance of
      seizure precipitants. Electrophysiological studies are necessary to confirm the
      diagnosis of nonconvulsive SE and to monitor the response to AED therapy. Prompt
      recognition and treatment may be necessary to avoid neurological morbidity in
      select patients. Epilepsy with continuous spikes and waves during slow sleep
      (ESES) and the Landau-Kleffner syndrome are two rare childhood disorders that are
      difficult to classify but may be appropriate to include in a discussion of
      nonconvulsive SE.

PMID- 8462491
TI  - Systemic effects of generalized convulsive status epilepticus.
AB  - Generalized convulsive status epilepticus (GCSE) is accompanied by a marked
      increase in plasma catecholamines. This produces a number of changes in general
      systemic physiology including hypertension, tachycardia, cardiac arrhythmias,
      hyperglycemia, acidosis, and hyperpyrexia. If SE is stopped quickly, these
      changes are self-correcting and do not produce an increased risk of
      neuropathology. However, if seizures continue, many of the early physiologic
      changes reverse, and late status epilepticus is marked by hypotension,
      hypoglycemia, pulmonary edema and a continued acidosis and elevation of body
      temperature. Prevention of serious hypoglycemia, maintenance of adequate systemic
      blood pressure to provide adequate cerebral perfusion, and normalizing the body
      temperature will minimize or prevent neuropathologic sequelae to SE of extended
      duration.

PMID- 8462492
TI  - Epileptogenic effects of status epilepticus.
AB  - Determining whether and under what conditions status epilepticus (SE) leads to
      undesirable long-term sequelae has major clinical ramifications. In addition to
      structural brain damage and enduring neurological deficits following SE, it has
      been suggested that SE can establish a chronic condition of active epilepsy.
      These three residua (epileptic brain damage, neurological deficits, and epilepsy)
      have been especially linked to protracted SE. The older clinical literature
      indicates that these sequelae are especially likely if SE occurs in an immature
      brain, but this point has been challenged in recent studies. Clinical and animal
      model work that examines the issue of chronic nervous system deficits arising as
      a consequence of SE is reviewed, with particular attention to the question of the
      epileptogenic effect of SE. Because of the inherent problem of not being able to
      exclude occult neurological disease antecedent to SE in brain, animal model work
      promises to be especially relevant to the issues at hand. Work done on adult rats
      has shown that a previously normal brain can be "converted" after a bout of SE to
      an epileptic brain, as manifest both by epileptic brain damage resembling that
      found in the hippocampus of patients with intractable temporal lobe epilepsy and
      by spontaneous recurrent seizures registered in the hippocampus. A two-step model
      is proposed: morphological brain injury takes place first and this change, in
      turn, promotes seizures. This model is offered as one way in which chronic active
      epilepsy can be established by a transient episode of SE. Although some findings
      from work with animal models have been interpreted as not supporting the idea
      that the immature brain is sensitive to a chronic epileptogenic influence
      initiated by SE, the majority of such work is consistent with this idea. On the
      other hand, a considerable amount of animal work indicates that the brains of
      immature animals are quite resistant to SE-induced brain damage, in contrast to
      those of adults. Thus, under these circumstances, a different process of
      epileptogenesis than the two-step model may be operational. It is concluded that,
      under appropriate conditions, SE does exert an epileptogenic effect that
      persists.

PMID- 8462493
TI  - Treatment of status epilepticus.
AB  - Status epilepticus, particularly the convulsive form, is a medical emergency,
      warranting prompt and aggressive treatment. To do this, one must have a thorough
      understanding of the pharmacology of the anticonvulsant agents. Therapy should be
      directed toward rapid termination of the status epilepticus, prevention of
      seizure recurrence, and treatment of any underlying cause. Most importantly, one
      should establish and adhere to a standard treatment protocol for best results.

PMID- 8462494
TI  - Coping with a breast cancer diagnosis: a prospective study.
AB  - Employing the stress and coping theory of Lazarus and Folkman, this study
      followed 117 women age 40 or over regarding personality, cognitive appraisal,
      coping, and mood variables before breast biopsy, after diagnosis, and, for those
      who had cancer, after surgery. Upon biopsy, 36 received a cancer diagnosis, and
      81 received a benign diagnosis. The 2 groups did not differ on appraisals,
      coping, or affect before diagnosis. With prebiopsy affect controlled, cancer
      patients reported more negative affect postbiopsy than did benign patients.
      Postsurgery, cancer patients expressed less vigor and more fatigue than benign
      patients, but the groups did not differ on other negative emotions. Prebiopsy,
      psychosocial predictors accounted for 54% and 29% of the variance in negative and
      positive emotion, respectively. Prebiopsy variables also predicted postbiopsy and
      postsurgery mood; cognitive avoidance coping was a particularly important
      predictor of high distress and low vigor.

PMID- 8462495
TI  - The relationship between body weight concerns and adolescent smoking.
AB  - Although a number of factors have been found to predict smoking status among
      adolescents, few researchers have examined how belief in smoking as a weight
      control strategy may be related to smoking in this high-risk population. With the
      goal of discovering whether belief in smoking as a weight-control strategy
      predicted smoking status, the present investigation surveyed 659 Black and White
      high school students. Analyses showed that among regular smokers, 39% of White
      female and 12% of White male smokers reported using smoking to control their
      appetite and weight. In contrast, not a single Black male or female reported
      using smoking to control appetite and weight. Although belief in smoking as a
      weight-control strategy did not predict regular smokers versus never smokers, the
      weight-belief item reliably separated experimental smokers from regular smokers.
      The survey also revealed that White female restrained eaters were the most likely
      to actually use smoking as a weight-control strategy.

PMID- 8462496
TI  - Reactivity research on sociodemographic groups: its value to psychophysiology and
      health psychology.
AB  - Research on sociodemographic group differences in cardiovascular reactivity has
      provided support for the potential importance of reactivity as marker-mediator of
      susceptibility to cardiovascular disease and has facilitated our understanding of
      the nature of reactivity itself. The article by Treiber et al. in this issue of
      Health Psychology exemplifies this area of reactivity research. Yet
      sociodemographic group differences in reactivity and other physiological
      processes are now in themselves in need of explanation. Thus, the principal
      scientific challenge facing researchers is the development of testable
      theoretical models that will facilitate the search for, and ultimate
      understanding of, the basis for these group differences. This process will not
      only clarify the determinants of sociodemographic group differences in
      psychophysiological functioning, but may significantly advance the general
      understanding of biopsychosocial interactions.

PMID- 8462497
TI  - Dietary disinhibition, perceived stress, and glucose control in young, type 1
      diabetic women.
AB  - Examining the relationship of stress, dietary disinhibition, and blood glucose
      control in diabetic young women was the goal of this study. Sixty-five diabetic
      girls and women, ranging in age from 12 to 26 years, completed eating behaviors
      and perceived stress scales during regular clinic visits. Blood glucose control
      was assessed by concurrent glycosylated hemoglobin measurements. Multiple
      regression analyses indicated that high levels of perceived stress predicted
      dietary disinhibition and that within the age range studied, young women were
      more likely than early adolescent girls to perceive their life as stressful.
      Contrary to previous findings that failed to show that stress can indirectly
      affect glucose control by interfering with compliance behaviors, the present work
      indicated a Stress X Dietary Disinhibition interaction in predicting glucose
      control. Blood glucose control was poorest in those diabetic women who both
      perceived their lives as stressful and reported medium to high disinhibition.
      Blood glucose control was unrelated to stress in young women who reported low
      levels of disinhibition. These results have implications for the development of
      specific interventions for young diabetic women who perceive their lives as
      stressful and who may respond to stress by eating.

PMID- 8462498
TI  - Attributions of responsibility and persuasion: increasing mammography utilization
      among women over 40 with an internally oriented message.
AB  - One hundred ninety-seven women over 40 years old and not adhering to national
      guidelines for screening mammography viewed persuasive messages varying in
      attributional emphasis (internal, external, or information-only). Internal
      attributions of responsibility for health-promoting behavior were expected to
      motivate the greatest change in women's attitudes and behaviors in relation to
      breast cancer and mammography. Attitudes about breast cancer and mammography were
      measured immediately and 6 months after the presentation. Twelve months later,
      women who viewed the internal message were more likely to have obtained a
      screening mammogram than women assigned to the other 2 conditions. The
      attributions of responsibility encouraged by the persuasive messages were
      associated with whether viewing the presentation led to behavior change.

PMID- 8462499
TI  - Men, family-role quality, job-role quality, and physical health.
AB  - The relationship between the quality of men's family roles, as spouse and as
      parent, and the quality of men's job role, on the one hand, and their reports of
      physical symptoms, on the other, was examined in men drawn from a random sample
      of 300 dual-earner couples. The main effect of marital-role quality (i.e.,
      rewards and concerns) on physical health was estimated, as was the Marital-Role
      Quality x Job-Role Quality interaction effect. With respect to the parent role,
      the effect of both parent-role occupancy and parent-role quality was estimated.
      After controlling for job-role quality, it was found that parent-role occupancy
      had neither main nor interactive effects. However, among the men who occupied all
      3 roles (n = 180), only parent-role concerns were a significant predictor of
      physical health reports. Thus, concerns in the parent role are a major unmeasured
      source of variance in studies of the stress-illness relationship in men.

PMID- 8462500
TI  - Social support and long-term recovery from coronary artery surgery: effects on
      patients and spouses.
AB  - Using a longitudinal design, the effect of social support on recovery from
      coronary bypass surgery was examined in 155 patients and 103 of their spouses.
      Perception of the availability of 5 types of social support was relatively stable
      from preoperation to 1 year after surgery and was significantly related to
      emotional and functional outcomes. Of the 5 types of support measured, only
      esteem support was significantly and consistently related to outcomes for
      patients and spouses. This relationship was strongest within-time, and across
      time relationships effects were weaker. Spouse's perception of support was
      related to patient outcomes, controlling for patient perceptions of support.
      Results suggest that perception of esteem support may be the most salient type of
      support related to feelings of well-being during and after an acute health-care
      event. In addition, perception of social support may be characterized by stable
      individual differences.

PMID- 8462501
TI  - Ethnicity, gender, family history of myocardial infarction, and hemodynamic
      responses to laboratory stressors in children.
AB  - Relationship among ethnicity, gender, grandparents' histories of early myocardial
      infarction, and hemodynamic responses to forehead cold and treadmill exercise
      were examined in 87 6-to-8-year-olds (57 White, 30 Black). Boys had greater
      increases in systemic vascular resistance and decreases in cardiac index to
      forehead cold. Girls had greater increases and quicker recovery in heart rate to
      dynamic exercise. Blacks had greater increases and slower recovery in diastolic
      pressure to exercise and forehead cold. Blacks showed greater increases and
      slower recovery in systemic vascular resistance to forehead cold. Positive-family
      history children had greater increases in diastolic pressure and systemic
      vascular resistance to forehead cold and greater diastolic pressure increases to
      exercise. Positive-family-history Blacks had greater increases in systolic
      pressure to exercise and slower recovery than all other groups.

PMID- 8462502
TI  - Children with persistent feeding difficulties: an observational analysis of the
      feeding interactions of problem and non-problem eaters.
AB  - This study examined the relationship between parent's feeding practices and the
      feeding behavior of toddlers and preschool-age children with (n = 19) or without
      (n = 29) persistent feeding difficulties. Specifically, patterns of parent-child
      interaction were assessed during standardized family mealtime observations in the
      clinic. Parents also kept observational records of their children's mealtime
      behavior at home and rated the degree of difficulty they experienced in feeding
      their child during each meal on a daily basis. Observational results showed that
      feeding-disordered children engaged in higher levels of disruptive mealtime
      behavior (food refusal, noncompliance, complaining, oppositional behavior, and
      playing with food) and lower levels of chewing during mealtime. There were
      several significant age effects, with younger children (under age 3) engaging in
      more vomiting and less aversive demanding and verbalizations. Parents of feeding
      disordered children were more negative and coercive in their feeding practices
      and engaged in higher levels of aversive instruction giving, aversive prompting,
      and negative eating-related comments. There were several significant associations
      between coercive parental behaviors and children's food refusal and noncompliance
      in the sample as a whole. Measures of children's disruptiveness at mealtimes in
      the clinic were significantly correlated with measures of mealtime behavior in
      the home.

PMID- 8462503
TI  - Chronic exposure to an environmental hazard: risk perceptions and self-protective
      behavior.
AB  - The risk perceptions and self-protective behavior of 282 immigrant farm workers
      (all of Mexican origin) in response to pesticide exposure were examined. Several
      variables were predicted to influence reactions, but some deviations from past
      studies were expected because cultural or socioeconomic factors could modify risk
      responses. In keeping with predictions, greater risk perceptions were associated
      with beliefs that past harm had occurred, future harm to self or offspring was
      likely, precautions were less effective, and cancer-causing agents were mostly
      unavoidable. Self-protective behavior was most likely for those receiving risk
      information, having greater perceptions of control over health and the
      occupational situation, and believing that precautionary methods were effective.
      The discussion considers variability in responses to chronic risk and the broader
      perspective offered by environmental hazard studies.

PMID- 8462504
TI  - Theory of band broadening for DNA gel electrophoresis and sequencing.
AB  - The problem of (thermal) band broadening during DNA gel electrophoresis is
      studied analytically and numerically using the reptation model. It is shown that
      the orientation of the end-to-end vector of the molecules leads to increased
      diffusion and even to molecular size-independent band broadening. Thus, the
      Einstein relation between mobility and diffusion holds for only very small
      molecules. Also, "self-trapped" molecules are predicted to give fuzzy bands, as
      observed experimentally. Finally, megabase molecules are discussed and the
      consequences of our predictions for the improvement of sequencing are considered.

PMID- 8462505
TI  - Studies on 16 kDa selenium-containing proteins enriched by means of preparative
      electrophoresis.
AB  - By in vivo labeling with [75Se]selenite and separation of the proteins in the
      tissue homogenates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      (SDS-PAGE), several selenium-containing proteins or protein subunits were
      detected in rat tissues (liver, lung, spleen and prostate). Their distribution
      among the cell components was investigated after fractionation by means of
      differential centrifugation. The selenium-containing proteins in the 16 kDa range
      were found to be mainly membrane-bound. By two-dimensional electrophoresis they
      were resolved into three labeled spots, two with the same relative molecular mass
      and pI values of about 4.8 and 5.0 and the third with a slightly lower molecular
      mass and a pI of 4.8. For further investigation they were concentrated and
      separated from the other labeled compounds by SDS-PAGE using preparative flow
      through electrophoresis.

PMID- 8462506
TI  - Consecutive silver staining and autoradiography of 35S and 32P-labeled cellular
      proteins: application for the analysis of signal transducing pathways.
AB  - The methodology for the simultaneous analysis of protein synthesis concomitant
      with protein phosphorylation/dephosphorylation is described. The technique
      consists of metabolic labeling of rat liver epithelial (RLE) cells with
      [32P]orthophosphate and [35S]methionine, performing two-dimensional
      polyacrylamide gel electrophoresis (2-D PAGE) of the mixed samples, followed by
      silver staining and subsequent autoradiography of the dried silver stained 2-D
      PAGE electrophoretograms using two films placed back-to-back. The first film,
      which is positioned in direct contact with the dried silver-stained gel,
      visualized both exposure to 35S and 32P while the second film recorded exposure
      to only 32P due to the differential energy levels of the two isotopes. The juxta
      positioning of the silver-stained images with the two autoradiographic film
      images permits the unambiguous mapping of the phosphorylated polypeptides back to
      their corresponding silver-stained and methionine-labeled counterparts. This
      strategy provides quantitative information utilizing both silver staining
      (measure of constitutive levels of protein expression) and metabolic labeling to
      measure rates of protein synthesis and/or degradation and phosphorylation and/or
      dephosphorylation using [35S]methionine and [32P]orthophosphate, respectively. We
      have utilized this methodology for the in vitro analysis of transforming growth
      factor type beta 1 (TGF-beta 1)-mediated signal transduction in RLE cells and
      have identified three nuclear polypeptides, 1 (pI 4.95/M(r) 97 kDa), 2 (5.00/85
      kDa) and 3 (4.90/84 kDa) whose phosphorylation status is rapidly and transiently
      modulated by TGF-beta 1. The methodology described should have wide applications
      in studies where it is desirous to measure protein synthesis and/or degradation
      concomitant with signal transduction pathways involving protein phosphorylation.

PMID- 8462507
TI  - A comparative two-dimensional gel protein database of the intact and regenerating
      newt limbs.
AB  - In this paper we describe a two-dimensional gel database of the regenerating newt
      limb. Protein synthesis was compared in the intact limb, in the 1-week
      regenerating limb, representing the dedifferentiation stage, and in the 2-week
      regenerating limb, representing the formation of the blastema. This comparative
      database provided data on differential expression of about 800 proteins during
      the process of limb regeneration. In addition, a map has been generated for these
      proteins for future guidance in characterizing further new, unknown proteins. The
      overall expression patterns of the proteins indicated that the dedifferentiation
      stage was marked by down-regulation of most proteins, while the blastema
      formation was marked by the appearance of many new proteins. The potential use of
      such a database in isolating factors involved during limb regeneration is
      discussed.

PMID- 8462508
TI  - Comparisons of protein changes in human and rodent hepatocytes induced by the rat
      specific carcinogen, methapyrilene.
AB  - There is a growing concern that the rodent bioassay may not always serve as an
      appropriate model to assess the carcinogenic risk for humans exposed to certain
      compounds. Mechanistic research that examines the effects of a compound in rodent
      and man could help in the interpretation of bioassay results. This paper reports
      a novel use of two-dimensional polyacrylamide gel electrophoresis (2-D PAGE)
      technology to assess similarities and differences in the response of rodents and
      humans to the rat-specific hepatocarcinogen, methapyrilene (MP). A sequential
      examination of rodent and human hepatic proteins was conducted following in vivo
      exposure of rats and mice and in vitro exposure of rat, mouse, and human
      hepatocytes to MP. Results showed that covalent modifications observed in rats
      and mice in vivo were duplicated both qualitatively and quantitatively in the
      corresponding in vitro systems and that these modifications correlated with
      carcinogenic susceptibility. Covalent modifications in human hepatocytes were
      minimal despite exposure to concentrations of MP that were 6-fold higher than
      those used in rodent hepatocytes. These studies suggest that in the case of MP
      the rat is not the most appropriate model for assessing the human situation.
      Furthermore, these data show that in vitro-in vivo comparisons based on 2-D PAGE
      may provide adjunctive information for extrapolating rodent toxicity/bioassay
      results to human risk assessment.

PMID- 8462510
TI  - Electrophoretic detection of chitinase isoenzymes using the PhastSystem.
AB  - Zymographic assays are described for the detection of chitinase isoenzymes
      following isoelectric focusing. Method 1 used a polyacrylamide overlay gel
      containing glycol chitin. Following hydrolysis, visualisation of isoenzymes was
      achieved by fluorescent counter-staining of the gel with Fluorescent Brightener
      28. Method 2 used a cellulose acetate membrane overlay which incorporates 4
      methylumbelliferyl substrates, hydrolysis of which released a fluorescent product
      (4-methylumbelliferone). The pIs of chitinase isoenzymes were estimated by using
      coloured pI markers. A significant time advantage was obtained over previous
      methods. The method was used to demonstrate chitinase activity in control rat
      lungs and in rat lungs infected with the pathogen Pneumocystis carinii.

PMID- 8462509
TI  - Membrane electrophoresis of DNA.
AB  - We have separated double stranded DNA fragments by electrophoresis using a
      membrane instead of a gel as separating matrix. Such a membrane, containing
      separated DNA fragments, is suitable for subsequent hybridization analysis. The
      method combines electrophoretic separation and transfer onto a solid support and
      therefore eliminates the need for a transfer or blotting step.

PMID- 8462511
TI  - Relative efficiency of molecular sieving in solutions of four polymers.
AB  - The efficiency of size separations of polystyrene sulfate, 120-1085 nm radius, by
      molecular sieving in polymer solutions, expressed by the separation efficiency
      function S = M0 magnitude of dKR(R)/dR Te-KR(R)T [where M0 is the mobility in
      free solution, KR the retardation coefficient, R the geometric mean radius of the
      particle, KR(R) the retardation coefficient as a function of R, and the polymer
      concentration is T] increases from methylhydroxypropyl cellulose to polyvinyl
      alcohol to uncrosslinked polyacrylamide to agarose above its gelling temperature.
      Separations of DNA, in the size range of 3-21 nm radius, are by at least one
      order of magnitude more efficient than those of polystyrene sulfate in the size
      range of 120-1085 nm radius. A plot of S vs. R in the experimental range of T is
      constructed for the four polymer solutions; this allows one to select optimal
      media and concentrations for the sieving of particles in the desired range of
      molecular sizes.

PMID- 8462512
TI  - Sex identification by polymerase chain reaction of alpha-satellite in aged tissue
      samples.
AB  - In vitro amplification of the alphoid repeated sequences clustered in the
      centromeric regions of the human X and Y chromosomes was carried out. A
      modification of the amplification conditions reported by Witt and Erickson gave
      clear amplification bands from 10 pg of genomic DNA template. Results were
      obtained from the following aged tissue samples: 1 microL three-year-old blood
      stain, one-year-old single hair roots, six-month-old saliva stains and twelve
      year-old bone fragments. Good results were obtained even when the template was
      artificially fragmented into fragments of less than 1 kbp.

PMID- 8462513
TI  - Separation of cresols using coelectroosmotic capillary electrophoresis.
AB  - A new method of capillary electrophoresis was established to separate the three
      cresol isomers. Cresols are of importance due to their use as insecticides,
      precursors of various dye intermediates, resins, fire-resistant fluids and other
      purposes. Reversion of the electroosmotic flow was carried out by a polycationic
      ammonium compound. The separations were carried out at high pH values (pH 12) to
      obtain complete dissociation of the cresols and short times of analysis (less
      than 5 min) through fast migration of the cresol towards the anode. Various
      aliphatic alcohols were added to improve peak shape and resolution.

PMID- 8462514
TI  - Photopolymerization of polyacrylamide gels with methylene blue.
AB  - Photopolymerization of polyacrylamide gels in the presence of methylene blue (100
      microM) and a redox couple (1 mM sodium toluenesulfinate, a reducer, and 50
      microM diphenyliodonium chloride, an oxidizer) has been investigated. The gel
      point, i.e. the time needed for onset of gelation upon illumination, has been
      found to lengthen progressively at lower temperatures and at lower light
      intensities. If the three catalysts are progressively diluted, the gel point does
      not vary for a threefold dilution, but gelation is greatly hampered below a 1:5
      dilution of the three effectors. Photobleaching has been assessed as a function
      of liquid layer thickness (from 0.5 to 2 mm), of a progressive dye dilution (down
      to a fourfold dilution) and as a function of temperature. A maximum of elastic
      modulus is located in correspondence to a minimum of permeability (both situated
      at 5% cross-linker). It is found that methylene blue-activated polymerization
      produces polyacrylamide gels with elastic properties which are higher than in
      persulfate-activated gels, so far the most popular matrices for electrokinetic
      separations. Due to the ease of preparation, the full control of all experimental
      parameters, and the lack of oxidizing power of this catalyst system (as opposed
      to the strong oxidation power of persulfate catalysis), methylene blue catalysis
      is advocated as a valid alternative to other redox systems.

PMID- 8462515
TI  - The silver staining procedure of sodium dodecyl sulfate-gels may be accelerated
      by shortening fixation time.
AB  - In most silver staining methods the first step in the staining of proteins
      separated after sodium dodecyl sulfate-polyacrylamide gel electrophoresis is a
      rather protracted fixation of the gels. Optimum fixation should be short, cause
      no background staining and effectively immobilize the proteins in the gel without
      masking the proteins for reaction with the staining solution. Further, the
      concentration of the fixing compounds should be as low as possible due to the
      potential toxicity of fixatives. Fixation for only 5 min with mixtures of very
      low concentrations of formaldehyde and glutaraldehyde in ethanol, or a solution
      of formaldehyde or glutaraldehyde in picric acid and ethanol, fulfill these
      demands, provided that the gels were prefixed in ethanol-acetic acid for 10 min.
      As a consequence of these results a fast and sensitive silver staining procedure
      is proposed.

PMID- 8462516
TI  - Gel electrophoresis of giant proteins: solubilization and silver-staining of
      titin and nebulin from single muscle fiber segments.
AB  - Giant proteins in the megadalton range (> 0.5 MDa) appear to play important
      structural and functional roles in striated muscle. Titin (approximately 3 MDa)
      is involved in the generation of resting tension and the assembly and stability
      of the sarcomere in skeletal and cardiac muscle tissues, while nebulin
      (approximately 0.7 MDa) is thought to regulate thin filament length in skeletal
      muscle. Sodium dodecyl sulfate (SDS)-gel electrophoresis is an important tool in
      revealing the size, quantity and integrity of these giant proteins in muscle
      tissues. We report here a method for solubilizing, detecting and quantifying
      titin and nebulin from short segments of single fibers of the rabbit psoas
      muscle. Muscle proteins ranging from 15 kDa to 3 MDa were resolved on 3.3-12%
      gradient polyacrylamide gels that were silver-stained and quantitated by
      densitometry. Presoaking fiber segments in a low ionic strength pH 8.4 buffer
      enhances the amount of solubilized titin and nebulin. Solubilizing the presoaked
      fiber segments with SDS at 60 degrees C for 60 s maximizes the amount of intact
      titin; solubilizing at higher temperatures causes extensive degradation of titin.
      Detection sensitivity is sufficient to study titin and nebulin in fiber segments
      as short as 120 microns.

PMID- 8462517
TI  - Detection by nile red of agarose gel electrophoresed native and modified low
      density lipoprotein.
AB  - The use of nile red to track and stain low density lipoprotein (LDL) and modified
      LDL in agarose gels was investigated. Lipoproteins were prestained with nile red,
      a fluorescent dye, prior to electrophoresis. After 2 h of electrophoresis, the
      LDL and modified LDL were visualized using a UV transilluminator with an
      excitation wavelength of 302 nm. Spectrofluorometric analysis revealed that the
      nile red fluorescence of the stained LDL had an emission maximum of 609 nm. This
      rapid staining method of LDL and modified LDL can detect as little as 2.5
      micrograms of LDL protein and permits the immediate visualization of these
      lipoproteins in agarose gels.

PMID- 8462518
TI  - Electroblotting of proteins on agarose gel containing specific antibodies.
AB  - A method is described for electroblotting of proteins, separated by gradient
      polyacrylamide gel electrophoresis, onto an agarose gel matrix containing
      specific antibodies. Three proteins of different molecular weight, including
      human albumin, isolated and in plasma, human plasma transferrin and C3 complement
      were tested. Immunoblotting on agarose, compared with nitrocellulose, was
      quantitative and highly sensitive, with small amounts of protein (i.e., 100 pg)
      being detected. Moreover, albumin aggregates (i.e., dimer, trimer and tetramer)
      were blotted quantitatively in addition to the monomer, and their percentages
      were calculated. This method is sensitive, quantitative, reproducible, and
      includes fewer manipulations; furthermore, it is less expensive and does not
      require the use of toxic or carcinogenic agents.

PMID- 8462519
TI  - Semi-dry PhastTransfer detection of biotinylated cell surface molecules.
AB  - The PhastTransfer system is a semi-dry electrophoretic unit designed to optimize
      the transfer of small amounts of protein. Because of its efficiency, we adapted
      the PhastTransfer system for the detection of labeled membrane molecules. Biotin
      was used as the membrane molecule label because it permitted the long-term
      storage of labeled lysates as well as the flexibility of derivatizing several
      different functional groups. After immunoaffinity separation using magnetic
      microspheres, the protein was electrophoretically separated with the PhastSystem
      and transferred with the PhastTransfer unit. Using an avidin-linked enzyme
      amplification system, less than 10 ng of loaded protein could be detected on the
      transfer membrane. Based on these findings, the PhastTransfer system is a fast,
      reproducible, and convenient method for the transfer of small quantities of
      labeled cell surface protein.

PMID- 8462520
TI  - Gel electrophoresis of an end-labeled DNA. I. Dynamics and trapping in constant
      fields.
AB  - A theory for the gel electrophoresis of a flexible polyelectrolyte, bearing an
      uncharged bulky label or an uncharged section at one end, is presented. We first
      consider a gel that is fully permeable to the label: we calculate the degree of
      stretching of the polyelectrolyte and its mobility as a function of chain size,
      electric field and label friction. Various regimes are identified, and their
      "existence domains" are calculated. For increasing friction, we predict a
      transition from a mobility decreasing with chain size to a mobility increasing
      with chain size. Secondly, we consider the possibility that the label may get
      trapped at some locations of the gel, a situation relevant to a method of
      "trapping electrophoresis" recently proposed by Ulanovsky et al. for DNA
      sequencing. A molecular model for detrapping by thermally activated "backward
      reptation" is constructed and solved using the Kramers rate-equation theory.
      Different closed analytical expressions and approximate scaling laws
      corresponding to different regimes of stretching and field strengths are
      predicted. The most striking result is a mobility which exponentially decreases
      past a critical size Np*, which decreases with increasing field. In the regime
      relevant to the experiments by Ulanowsky et al., we predict Np* approximately E
      2/3. The predictions are in good qualitative agreement with presently available
      experiments, but further experimental investigations are suggested.

PMID- 8462521
TI  - Immune response to a hapten of fluorescein isothiocyanate in a single mouse
      analyzed by two-dimensional affinity electrophoresis.
AB  - Immune response to a hapten of fluorescein isothiocyanate (FITC) in a single
      BALB/c strain mouse was analyzed by two-dimensional affinity electrophoresis (2D
      AEP). Anti-FITC antibodies were induced by immunization with FITC-conjugated
      bovine serum albumin. The antibodies were separated into a large number of spots
      of IgG due to differences in their isoelectric points(pI) and binding affinities
      to the FITC ligand. These spots consisted of IgG families which were composed of
      several spots having an identical affinity to the ligand but a different pI. The
      spots were not clearly detected in the antiserum taken on day 7 after the primary
      immunization, but on day 21 the spots of IgG were clearly detected, with a high
      diversity and specificity for the ligand. The size and number of IgG spots were
      markedly increased by the secondary immunization; however, the third immunization
      did not increase the size and number of IgG spots. The IgG spots of each family
      were specifically stained with an antimouse IgG subclass antibody. Furthermore, a
      monoclonal antibody (FL-D6) was separated by 2D-AEP into a single family which
      consisted of seven IgG1 spots having an identical affinity to FITC but different
      pIs. Therefore, each of the IgG families of anti-FITC antibodies in the antiserum
      can be generated by a single clone of anti-FITC antibody-producing cells. The
      substitution of dextran T2000 or lipopolysaccharide for bovine serum albumin as a
      carrier for FITC induced much smaller amounts of anti-FITC antibodies with a low
      diversity but high specificity to FITC.

PMID- 8462522
TI  - Electrophoretic analysis of plant cysteine and serine proteinases using gelatin
      containing polyacrylamide gels and class-specific proteinase inhibitors.
AB  - Inclusion of gelatin in polyacrylamide gels provides a sensitive way of detecting
      multiple proteolytic activities in crude extracts from any source. The present
      study describes a method allowing discrimination between cysteine and serine
      proteinases in plant extracts, using gelatin-containing gels in combination with
      class-specific proteinase inhibitors. Preincubation of extracts with 4 mM
      phenylmethylsulfonyl fluoride, a serine proteinase inhibitor, or with 25 microM L
      trans-epoxysuccinyl-L-leucylamido(4-guanidino) butane, a cysteine proteinase
      inhibitor, allowed the identification of enzymes from both classes in extracts of
      tomato fruit and papaya latex. The efficiency of the two low molecular weight
      inhibitors used was very high, and the irreversibility of the inhibiting effect
      was maintained during electrophoresis conducted in the presence of sodium dodecyl
      sulfate. The analytic procedure described here, with a detection threshold of
      less than 100 pg enzyme, is the first that allows quick and accurate
      discrimination of plant cysteine and serine proteinases separated in
      electrophoretic gels. This simple and rapid technique could be of interest for
      studying the evolution of class-specific proteinases in plant extracts during
      various developmental, physiological, and pathogenic processes. It is also
      potentially applicable to the majority of eucaryotic and procaryotic systems.

PMID- 8462523
TI  - Influence of the electrode compartment separating membranes on continuous flow
      electrophoresis.
AB  - The influence of the ion permeable diaphragms, separating the electrode
      compartments of continuous flow electrophoresis chambers from the separation
      space, are described in detail. A set of equations is derived from a simplified
      phenomenological model of the ion transport across media boundaries. These
      equations are useful to predict the magnitude of concentration changes near the
      membranes due to the electrophoretic ion transport. Adaption to any CFE geometry,
      membrane material and electrolyte system is possible with only a few
      measurements, which yield the transference number difference as a characteristic
      transport property of the membrane material for a special electrolyte. The
      validity of the equations is checked by experiments. Local electric field
      strength and local conductivity are measured with a potential gradient
      conductivity scanner developed in our laboratory. This device yields data on the
      dynamics of the concentration changes.

PMID- 8462524
TI  - Can nongenotoxic carcinogens be detected with the lacI transgenic mouse mutation
      assay?

PMID- 8462525
TI  - Genotoxicity of volatile and secondary reactive oxygen species generated by
      photosensitization.
AB  - Reactive oxygen species were generated in the gas phase by photosensitization
      involving illumination of Rose Bengal. Depending on whether the chromophore is
      dry or solubilized, this system produces either energy-transfer reactions leading
      to generation of singlet oxygen specifically, or a combination of energy-transfer
      and electron-transfer reactions, providing both singlet oxygen and reduced forms
      of oxygen, such as superoxide anion and hydrogen peroxide. In neither case were
      the reactive species mutagenic in strain TA104 of Salmonella typhimurium, which
      had been previously shown to be reverted by oxygen species generated by the
      hypoxanthine-xanthine oxidase system in aqueous medium. However, mixed oxygen
      species induced an increased lethality in a variety of DNA repair-deficient
      Escherichia coli strains. This genotoxic effect, mainly reparable by the uvrA and
      recA mechanisms, was efficiently prevented by the thiol N-acetyl-L-cysteine.
      Singlet oxygen itself failed to exert direct genotoxic effects, although
      secondary reactants produced by its reaction with cell components enhanced
      lethality in some repair-deficient bacteria. Distance-dependence analyses
      provided measurements of the lifetimes of the oxygen species generated in the gas
      phase.

PMID- 8462526
TI  - Relative efficiency of Phyllanthus emblica fruit extract and ascorbic acid in
      modifying lead and aluminium-induced sister-chromatid exchanges in mouse bone
      marrow.
AB  - The identification of desmutagens and bioantimutagens in plants has prompted the
      search for additional plant extracts capable of modifying adverse cellular
      effects of environmental toxicants. The protective action of crude extracts of
      Phyllanthus emblica fruits (PFE) against lead (Pb) and aluminium (Al)-induced
      sister chromatid exchanges (SCEs) was studied in bone marrow cells of Mus
      musculus. The modifying effect of the crude extract was compared with that of
      comparable amounts of synthetic ascorbic acid (AA), a major component of the
      fruits. Oral administration of PFE or AA for 7 consecutive days before exposure
      of mice to the metals by intraperitoneal injections reduced the frequencies of
      SCEs induced by both metals. PFE afforded a more pronounced protective effect
      than AA in counteracting the genotoxicity induced by both Al and Pb: This
      difference was significant with Pb. The higher protection afforded by PFE may be
      attributed to the interaction of AA with other natural ingredients present in the
      crude fruit extract.

PMID- 8462527
TI  - Formation and characterization of bacterial mutagens from reaction of the
      alternative disinfectant monochloramine with model aqueous solutions of fulvic
      acid.
AB  - Monochloramine has been suggested as an alternative disinfectant to chlorine to
      reduce levels of trihalomethanes in treated drinking water, but little is known
      of the toxicological properties and potential health implications of by-products
      specific to the chloramination process. Model aqueous fulvic acid solutions (200
      400 mg C/liter), serving as surrogates for humic surface waters, were
      chloraminated over a range of molar Cl:C ratios from 1:40 to 1:2. The resulting
      by-products were extracted into diethyl ether at pH 2 and investigated with the
      Ames plate incorporation assay. Extractable mutagenicity increased with
      increasing chlorine and carbon dose up to about 30,000 revertants/liter at Cl:C
      ratios of 1:2. Mutagenicity was higher in Salmonella typhimurium strain TA100
      than in strain TA98, and was decreased in the presence of S9, indicating that the
      mutagens formed were direct-acting and induced predominantly base-pair
      substitutions. Bovine serum albumin decreased slightly, and glutathione reduced
      greatly, the mutagenic activity detected in extracts. HPLC fractionation of the
      by-products indicated that most of the mutagenic activity was found in the
      earliest-eluting (most polar) fraction. The mutagenic by-products appeared to be
      qualitatively similar to 3-chloro-4-dichloromethyl-5-hydroxy-2-(5H)-furanone (MX)
      in their chromatographic behavior and responses to glutathione and bovine serum
      albumin, but were less readily detoxified by S9 than was MX.

PMID- 8462528
TI  - Mutagenicity of iso-butyl nitrite vapor in the Ames test and some relevant
      chemical properties, including the reaction of iso-butyl nitrite with phosphate.
AB  - We examined the mutagenicity of iso-butyl nitrite (IBN) vapor and aqueous IBN
      solution in the Ames test to help evaluate the hazard of sniffing this vapor, a
      habit which might play a role in the induction of Kaposi's sarcoma associated
      with acquired immune deficiency syndrome. Chemical analysis showed that the
      saturated vapor contained 190 micrograms IBN/ml at 25 degrees C, and saturated
      aqueous solution, 2.6 mg IBN/ml at 21-23 degrees C. When agar plates containing
      Salmonella typhimurium TA-1535 and rat liver S-9 were exposed to IBN vapor, the
      number of mutants reached a maximum after 40 min. A mean of 307 mutants/plate (22
      x background) was observed when the plates were exposed to IBN vapor for 30 min.
      Addition of 0.2 ml saturated IBN solution in water to similar plates gave a mean
      of 179 mutants/plate (7.9 x background) in the absence of S-9, confirming
      published results. The S-9 did not affect the results. Based on the IBN level in
      medium exposed to IBN vapor, the vapor was apparently 11 times more mutagenic
      than IBN solution. This was attributed to continuous replenishment of unstable
      IBN in the medium by the vapor. The half-life of IBN at 21-23 degrees C was > 1
      hr for solutions in water and < 3 min for solutions in the assay medium. This
      instability was traced to a reaction with phosphate, presumably hydrolysis to
      nitrite and iso-butanol. IBN in solution was 2.8 times more mutagenic than sodium
      nitrite, suggesting that IBN was not mutagenic because of its conversion to
      nitrite. Iso-butanol was not mutagenic. The results demonstrate the potential
      hazard of sniffing IBN vapor.

PMID- 8462529
TI  - Base-pair mutations caused by six aliphatic epoxides in Salmonella typhimurium
      TA100, TA104, TA4001, and TA4006.
AB  - Salmonella typhimurium strains TA100, TA104, TA4001, and TA4006 were used to
      detect the base-pair mutations caused by six aliphatic epoxides: chloropropylene
      oxide, glycidyl 1-naphthyl ether, glycidyl 4-nitrophenyl ether, 1-naphthyl
      propylene oxide, styrene oxide, and trichloropropylene oxide. Dose-mutagenicity
      relationships could be established for all six epoxides in strains TA100 and
      TA104 but not in strains TA4001 and TA4006. These results, together with the lack
      of sensitivity of the TA100 revertants to DL-1,2,4-triazole-3-alanine, indicate
      CG-->TA transitions and/or CG-->AT transversions are of major importance for
      mutations induced by these epoxides in Salmonella TA100 and possibly TA104. In
      addition, since the reproducibility of the effect of the triazole on TA104
      reversions was poor, TA-->AT transversions were not eliminated as also
      contributing to the mutagenicity of these epoxides in this Salmonella strain.

PMID- 8462530
TI  - Evaluation of the potential of riddelliine to induce unscheduled DNA synthesis, S
      phase synthesis, or micronuclei following in vivo treatment with multiple doses.
AB  - Riddelliine (RID) is a pyrrolizidine alkaloid found in plants of the genera
      Crotalaria, Amsinckia, and Senecio in the United States. RID has been extensively
      studied in a wide variety of in vitro short-term genotoxicity tests and has
      yielded positive responses in most test systems; however, there are fewer data
      available on the effects of RID in in vivo assays and no data under repeat-dose
      regimens. We have evaluated the ability of RID to induce unscheduled DNA
      synthesis (UDS) in hepatocytes, S-phase synthesis (SPS) in hepatocytes, and
      micronuclei in bone marrow from animals dosed for 5 or 30 days in conjunction
      with prechronic toxicity testing conducted for the National Toxicology Program.
      Results of this study indicate that RID did not induce an increase in
      micronucleated polychromatic erythrocytes (PCE) in bone marrow of mice after 5
      days of dosing or in PCE from rats or mice after 30 days of dosing. RID did not
      induce an increase in UDS in rat hepatocytes after 5 or 30 days of dosing, but it
      did induce an equivocal UDS response in male mice after both time points and a
      positive response in female mice after 30 days of dosing. RID induced significant
      elevations in SPS in rat hepatocytes after both 5 and 30 days of dosing, even at
      low doses. An increase in SPS was observed in male and female mouse hepatocytes,
      but only after 30 days of dosing. Rats and mice of both sexes showed a depression
      in SPS at higher doses. This effect may be a result of toxicity, which
      compromises the ability of the liver to regenerate. These results demonstrate
      that repeated administration of test chemicals may alter the genotoxic response
      to chemicals.

PMID- 8462532
TI  - Availability of the GENE-TOX database on the National Library of Medicine TOXNET
      system.

PMID- 8462531
TI  - Studies for a genotoxic potential of some endogenous and exogenous sex steroids.
      I. Communication: examination for the induction of gene mutations using the Ames
      Salmonella/microsome test and the HGPRT test in V79 cells.
AB  - The mutagenicity results and data of nine progestins (cyproterone acetate,
      dehydrospirorenone, gestodene, gestonorone caproate, levonorgestrel,
      norethisterone, norethisterone acetate, norethisterone enanthate, norethynodrel),
      one hypothetical metabolite (6,7-epoxy-cyproterone acetate), four estrogens
      (estradiol, ethinylestradiol, cyclodiol, cyclotriol), and four other sex steroids
      (atamestane, lilopristone, onapristone, propylmesterolone) are reported. All 17
      sex steroids were investigated using the Ames salmonella/microsome direct plate
      incorporation protocol, and seven were additionally tested using the
      preincubation modification. Seven sex steroids were also studied in the HG-PRT
      test with V79 cells for the induction of gene mutations in mammalian cells. The
      metabolite was examined in the Ames salmonella/microsome assay using the standard
      protocol and the preincubation modification. In all assays the test compounds
      were investigated up to concentration levels where cytotoxicity and/or visible
      precipitation occurred or at least the solubility limit of the test compound was
      reached. For all assays, evaluation of the data indicates that neither any of the
      sex steroids nor the hypothetical metabolite was able to induce gene mutations
      whether in the absence or the presence of an extrinsic metabolizing system (S9
      mix).

PMID- 8462533
TI  - Central nervous system symptoms after intravenous lignocaine: dose-response
      during pregnancy.
AB  - There is continuing controversy over what dose of what drug should be used to
      identify an accidental intravascular or subarachnoid catheter placement in
      obstetric epidural anaesthesia. The purpose of this randomized, double-blind
      study was to evaluate the dose-effect relationship for the production of central
      nervous system (CNS) symptoms by intravenous lignocaine. Sixty first-trimester,
      pregnant patients divided into groups of 10 received saline or one of five doses
      of lignocaine (0.39, 0.5, 0.63, 0.79, and 1.0 mg kg-1) i.v. An ED95 of 1.12 mg kg
      1 was calculated to produce reliable CNS symptoms when injected intravascularly.
      Lignocaine is an effective and reliable marker for intravenous injection in
      pregnant women.

PMID- 8462534
TI  - Effect of intravenous diclofenac on pain and recovery profile after day-case
      laparoscopy.
AB  - Diclofenac sodium, 100 mg, or saline was given intravenously after the induction
      of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic
      laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as
      the main anaesthetic agent and fentanyl and paracetamol were given for post
      operative pain relief. In the post-anaesthesia care unit the amount of analgesics
      given and the incidence of nausea and vomiting were recorded. The time until oral
      intake, voiding and walking without assistance were recorded as parameters of
      recovery and guidelines for discharging the patient. In the diagnostic
      laparoscopy group, the patients given diclofenac needed significantly (P < 0.05)
      less fentanyl (25 +/- 33 micrograms, mean +/- SD) and paracetamol (230 +/- 40 mg)
      for post-operative pain than the patients given saline (fentanyl 47 +/- 53
      micrograms and paracetamol 690 +/- 100 mg), which was not the case in the tubal
      ligation group. However, patients in the tubal ligation group needed
      significantly more post-operative analgesia than patients in the laparoscopy
      group. Diclofenac had no influence on the rapidity of recovery or home readiness
      in either group. It is concluded that diclofenac has no influence on home
      readiness, but prevents postoperative pain in patients undergoing diagnostic
      laparoscopies, whereas it was not a potent enough analgesic to prevent pain after
      laparoscopic tubal ligation.

PMID- 8462535
TI  - Tiapride versus metoclopramide: comparison after minor gynaecological surgery.
AB  - Tiapride (Tiapridal, Delagrange), a dopaminergic D2 receptor blocking agent
      having anxiolytic, sedative, antiemetic and analgesic properties was compared
      with metoclopramide and placebo in a randomized double-blind trial to determine
      its effects on post-operative nausea, vomiting, and sedation. The agents were
      given intravenously immediately before induction of anaesthesia to 75 women
      scheduled for minor elective gynaecological surgery. A standardized anaesthetic
      technique was used in all the patients. In the recovery room anti-emetic and
      sedative effects of tiapride and metoclopramide were similar and significantly
      better (P < 0.001) than placebo. In the ward at the end of 5 h anti-emetic (P <
      0.05), and sedative (P < 0.01) effects of tiapride were significantly better than
      both metoclopramide and placebo.

PMID- 8462536
TI  - Intra-individual open comparison of burst-suppression-isoflurane-anaesthesia
      versus electroconvulsive therapy in the treatment of severe depression.
AB  - Isoflurane anaesthesia was proposed instead of electro-convulsive therapy (ECT)
      in patients with treatment-refractory depression. This open study compared burst
      suppression-isoflurane-anaesthesia (BSIA) and ECT in 12 severely depressed
      patients. A series of 6 BSIA was administered in every patient. If improvement
      was insufficient or only temporary, a series of up to 12 ECT was given. A marked
      improvement of the depression was shown after both BSIA and ECT. Three patients
      were discharged from hospital after BSIA, nine patients were treated with BSIA
      and then ECT. The therapeutic effect of both regimens was equal as evidenced by
      the Hamilton-depression-rating-scale, a visual-analog-scale and the clinical
      global impression. BSIA requires more time and monitoring than ECT. Our
      exclusions of coronary, cerebral and peripheral vascular disease, untreated
      hypertension and focal neurological disease are strongly recommended. Due to the
      ease of application, ECT remains the standard treatment in depressed patients,
      but we consider BSIA a valuable alternative at least in patients who object to
      ECT.

PMID- 8462537
TI  - Pharmacokinetics of intravenously administered nicomorphine and its metabolites
      in man.
AB  - Intravenous doses of 30, 20 and 10 mg nicomorphine (Vilan) are extremely quickly
      metabolized into the metabolites 6-nicotinoylmorphine and morphine. The half
      lives of elimination are respectively 3 min for nicomorphine, 3 and 15 min for 6
      nicotinoylmorphine, and 135-190 min for morphine. The kinetics of the 30 and 20
      mg dose are comparable, the 10 mg dose shows patient dependent variations in
      metabolism. The AUC of the parent drug and its metabolites is linearly related to
      the dose.

PMID- 8462538
TI  - Successful treatment of vasospastic acute ischaemia with intra-arterial
      nicardipine.
AB  - Accidental intra-arterial injection of a colouring agent (Bonney's blue) in a 28
      year-old male patient induced acute ischaemia of the lower limb, resistant to
      standard therapy. Its successful treatment was finally obtained by intra-arterial
      infusion of nicardipine.

PMID- 8462539
TI  - Thoracotomy wound exploration in a single lung transplant recipient under
      extrapleural paravertebral nerve blockade.
AB  - Instillation of bupivacaine through a catheter accurately placed in the
      extrapleural space prior to closure of a thoracotomy incision provides effective,
      reliable post-operative analgesia. Its usefulness for further surgery in the post
      operative period, in this case wound exploration in a lung transplant recipient,
      is described.

PMID- 8462540
TI  - Purification and characterization of the major 50-kDa repressor protein from
      cytoplasmic mRNP of rabbit reticulocytes.
AB  - A 50-kDa protein has been purified to homogeneity from free mRNP of rabbit
      reticulocytes. This protein, designated as p50, is present within both free mRNP
      (approximately 4 mol protein/mol globin mRNA) and polyribosomal mRNP
      (approximately 2 mol protein/mol globin mRNA). p50 is a basic protein (pI
      approximately 9.5) and is characterized by a high glycine content of
      approximately 20%. Nitrocellulose-filter analysis has shown that p50 interacts
      with globin mRNA with an association constant of approximately 2.5 x 10(8) M-1
      (100 mM KAc, 4 degrees C). Various RNA and polyribonucleotides have the following
      relative affinity for p50; poly(G) > poly(U) > globin mRNA approximately 16S rRNA
      > poly(A) > poly(C). p50 can be phosphorylated both in vitro and in vivo.

PMID- 8462541
TI  - Primary structure of N-linked carbohydrate chains of a human chimeric plasminogen
      activator K2tu-PA expressed in Chinese hamster ovary cells.
AB  - A recombinant human plasminogen activator hybrid variant K2tu-PA, expressed in
      Chinese hamster ovary cells, is partially glycosylated at Asn12 (A chain, kringle
      2 domain) and completely glycosylated at Asn247 (B chain, protease domain). After
      release of the N-linked carbohydrate chains by peptide-N4-(N-acetyl-beta
      glucosaminyl)asparagine amidase F, the oligosaccharides were separated from the
      protein by gel permeation chromatography, then fractionated by FPLC on Mono Q,
      followed by HPLC on Lichrosorb-NH2, and analysed by 500-MHz 1H-NMR spectroscopy.
      The following types of carbohydrates occur: monosialylated diantennary (8%),
      disialylated diantennary (45%), disialylated tri- and tri'-antennary (1%),
      trisialylated tri- and tri'-antennary (28%), and tetrasialylated tetra-antennary
      (18%) structures, all having fucose in alpha(1-6)-linkage at the Asn-bound N
      acetylglucosamine. Sialic acid occurred exclusively in alpha(2-3)-linkage to
      galactose, and consisted of N-acetylneuraminic acid (94%), N-glycolylneuraminic
      acid (3%), and N-acetyl-9-O-acetylneuraminic acid (3%). In addition, glycopeptide
      fragments corresponding with the A or B chain of K2tu-PA were analysed. The
      oligosaccharides attached to Asn12 are less processed than those attached to
      Asn247. Comparison of the glycosylation pattern of K2tu-PA with that of tissue
      type plasminogen activator from different biological sources showed significant
      differences. Profiling studies on different K2tu-PA production batches
      demonstrated that the structures of N-linked oligosaccharides were identical, but
      that relative amounts vary with the applied isolation procedure of the chimeric
      glycoprotein.

PMID- 8462542
TI  - The NMR solution structure of a Kunitz-type proteinase inhibitor from the sea
      anemone Stichodactyla helianthus.
AB  - The solution structure of a 55-amino-acid Kunitz-type proteinase inhibitor, ShPI,
      purified from the Caribbean sea anemone Stichodactyla helianthus, was determined
      by NMR spectroscopy. Nearly complete sequence-specific 1H-NMR assignments were
      obtained at pH 4.6 and 36 degrees C, and stereo-specific assignments were
      determined for 23 pairs of diastereotopic substituents. A data set of 666 upper
      distance limit constraints and 122 dihedral angle constraints collected on this
      basis was used as input for a structure calculation with the program DIANA.
      Following energy minimization with the program OPAL, the average root-mean-square
      diviation (RMSD) of the 20 DIANA conformers used to represent the solution
      structure relative to the mean structure is 61 pm for all backbone atoms N, C
      alpha and C', and 106 pm for all heavy atoms of residues 2-53. This high-quality
      solution structure of ShPI has a nearly identical molecular architecture as the
      bovine pancreatic trypsin inhibitor (BPTI), despite a mere 35% of sequence
      similarity between the two proteins. Exchange rates measured for 48 out of the 51
      backbone amide protons showed that the positions of 20 slowly exchanging amide
      protons correlate well with hydrogen bonds involving these protons in the energy
      minimized solution structure. The solution structure of ShPI is compared to the
      four homologous proteins for which the three-dimensional structure is also
      available.

PMID- 8462543
TI  - N-carbamoyl-D-amino acid amidohydrolase from Comamonas sp. E222c purification and
      characterization.
AB  - N-Carbamoyl-D-amino acid amidohydrolase was purified 119-fold, with 36% overall
      recovery from a cell-free extract of Comamonas sp. E222c. The purified enzyme was
      homogeneous as judged by SDS/PAGE. The relative molecular mass of the native
      enzyme was 120,000 and that of the subunit was 40,000. The purified enzyme
      hydrolyzed various N-carbamoyl-D-amino acids to D-amino acids, ammonia and carbon
      dioxide. N-Carbamoyl-D-amino acids having hydrophobic groups served as good
      substrates for the enzyme. The Km and Vmax values for N-carbamoyl-D-phenylalanine
      were 19.7 mM and 13.1 units/mg, respectively, and those for N-carbamoyl-D-p
      hydroxyphenylglycine were 13.1 mM and 0.56 units/mg, respectively. The enzyme
      strictly recognized the configuration of the substrate and only the D-enantiomer
      of the N-carbamoyl amino acid was hydrolyzed. The enzyme activity was not
      significantly affected by N-carbamoyl-L-amino acids and ammonia. The enzyme was
      sensitive to thiol reagents and did not require metal ions for its activity. The
      enzyme did not hydrolyze N-carbamoyl-beta-alanine or N-carbamoyl-DL-aspartate
      suggesting that the enzyme is different from the N-carbamoylamide-hydrolyzing
      enzymes involved in the pyrimidine degradation pathway. The enzyme did not
      hydrolyze allantoin and allantoic acid, which are intermediates in purine
      degradation, N-carbamoylsarcosine and citrulline, suggesting that it is a novel N
      carbamoylamide amidohydrolase.

PMID- 8462544
TI  - Possible intermediates in the biosynthesis of mycoside B by Mycobacterium
      microti.
AB  - Two lipids were isolated from Mycobacterium microti which became labelled when
      the cells were grown in the presence of [2-14C]propionate. They were purified by
      thin-layer chromatography and studied by chemical degradation and mass
      spectrometry. The lipids were identified as phenolphthiocerol dimycocerosate and
      phenolphthiodiolone dimycocerosate, the aglycosyl derivatives of mycoside B, the
      phenolic glycolipid produced by M. microti. Cell-free extracts of the organism
      were able to glycosylate the lipids to form mycoside B in vitro. It is probable
      that the lipids are intermediates in the biosynthesis of phenolic glycolipids by
      mycobacteria.

PMID- 8462545
TI  - Interaction of ATP analogs with yeast 3-phosphoglycerate kinase. Affinity
      labeling of the hinge region.
AB  - Yeast 3-phosphoglycerate kinase is inactivated by incubation with pyridoxal 5'
      diphospho-5'-adenosine (AdoP2Pxy) [Tamura, J. K., Rakov, R. D. & Gross, R. L.
      (1986) J. Biol. Chem. 261, 4126-4133). Incorporation of 1 mol affinity label/mol
      enzyme was sufficient for complete inactivation of 3-phosphoglycerate kinase. The
      substrate ATP affords substantial protection against inactivation. Partial
      protection is afforded by the substrate glycerate 3-phosphate. When AdoP2Pxy
      modified phosphoglycerate kinase was reduced with [3H]NaBH4 and subjected to
      trypsin hydrolysis, only one radioactive peptide was isolated by reverse-phase
      high-performance liquid chromatography. The amino acid composition and sequence
      analysis of the purified radioactive peptide revealed that it spans residues 379
      403 of the enzyme and Lys385 specifically reacted with the affinity label. This
      peptide represents the hinge region between the two domains of the protein, where
      the active site is also located. The fluorescence intensity of enzyme-bound
      AdoP2Pxy is enhanced when glycerate 3-phosphate is added, suggesting exposure of
      the fluorescent probe to a more hydrophobic environment. Another fluorescent
      analog, anthraniloyl-dATP (ant-dATP), which carries the fluorescent reporter
      group on the ribose ring, binds to the enzyme at two distinct sites with Kd
      values of 6 +/- 2 microM and 25 +/- 3 microM, as determined by steady-state
      anisotropy measurements. Bound ant-dATP was displaced from the enzyme by
      glycerate 3-phosphate and ATP, as monitored by the fluorescence anisotropy. These
      results suggest that both fluorescent ATP analogs bind to the active site, which
      is at the hinge region of the enzyme. Model-building studies showed that when
      AdoP2Pxy is built into the open form of the enzyme, as described in X-ray
      studies, the pyridoxyl group of AdoP2Pxy cannot reach Lys385 for Schiff-base
      formation. Labeled Lys385 is on a beta-turn immediately following helix XII,
      which was suggested to interact with the nucleotide and become ordered at the
      active site of 3-phosphoglycerate kinase [Watson, H. C., Walker, N. P. C., Shaw,
      P. J., Bryant, T. N., Wendell, P. L., Fothergill, L. A., Perkins, R. E., Conroy,
      S. C., Dobson, M. J., Tuite, M. F., Kinesman, A. J. & Kinesman, S. M. (1982) EMBO
      J. 1, 1635-1640]. The results presented here suggest that binding of substrates
      cause significant structural changes in the enzyme.

PMID- 8462546
TI  - Molecular cloning and expression of the gene for serine hydroxymethyltransferase
      from an obligate methylotroph Hyphomicrobium methylovorum GM2.
AB  - The gene encoding serine hydroxymethyltransferase (SHMT), one of the key enzymes
      of the one-carbon-compound assimilation of a methylotroph, Hyphomicrobium
      methylovorum GM2, and its flanking regions were isolated using a DNA fragment
      encoding Escherichia coli SHMT as a probe. Nucleotide sequencing of the
      recombinant plasmids revealed the SHMT gene codes for the 434-amino-acid protein
      with a calculated molecular mass of 46,068 Da. The amino-acid sequence of the
      enzyme showed identity to the sequences of the enzymes from E. coli (55%) and
      rabbit liver (44%). The recombinant plasmid, which was constructed by ligation of
      the cloned gene and an expression vector pKK223-3, was introduced to an SHMT
      deficient E. coli mutant ME5427 (glyA-). The transformed E. coli cells expressed
      SHMT, which was immunologically and enzymologically indistinguishable from the
      enzyme isolated from H. methylovorum GM2.

PMID- 8462547
TI  - Purification, characterisation and crystallisation of selenomethionyl recombinant
      human interleukin-5 from Escherichia coli.
AB  - Interleukin-5 (IL-5) plays a key role in the proliferation and differentiation of
      eosinophils. To aid the solution of the crystallographic three-dimensional
      structure, we have expressed large quantities of recombinant human IL-5 (hIL-5)
      in a methionine auxotroph strain of Escherichia coli (DL41) grown on an enriched
      seleno-DL-methionine-containing medium. Cell densities of A650 = 10 have been
      achieved. The selenomethionyl-labelled hIL-5 (Se-hIL-5) has been purified and
      found to contain 3.6 selenium atoms/dimer, and 0.4 methionine residues/dimer. In
      a B-cell growth factor assay, the Se-hIL-5 is significantly more active than the
      non-labelled hIL-5. Electrospray mass spectrometry shows two major peaks, with
      relative molecular masses of 26,326 +/- 6 and 26,280 +/- 8 corresponding to the
      4Se and 3Se/1S forms of hIL-5. Unlike the methionine-containing hIL-5, the N
      terminal selenomethionine is neither oxidised nor carbamoylated and can only be
      resolved into two species in isoelectric focusing gel electrophoresis. Se-hIL-5
      crystallises in the same space group and unit cell as hIL-5. Difference Fourier
      calculations identify two of the selenomethionines corresponding to Met107 in the
      dimer. However, the N-terminal is disordered in the crystal, and the N-terminal
      selenomethionines are not resolved in the difference Fourier.

PMID- 8462548
TI  - Influence of the immunization against heterologous alcohol dehydrogenase on liver
      alcohol dehydrogenase isozymes and alcohol abuse of rats.
AB  - The possible biochemical and immunological mechanisms of the previously
      discovered phenomenon of significant and prolonged decrease of alcohol abuse of
      albino rats after the intravenous injection of the heterologous alcohol
      dehydrogenase (ADH) were studied. It was found that immunization of rats against
      horse liver S-ADH result in the appearance of a high titre of antibodies against
      rat liver ADH-3 isozyme. This isozyme is responsible for the metabolism of 90% of
      alcohol administrated in vivo. It is shown that immunization against horse liver
      S-ADH leads also to a significant (2--3-fold) lowering of the activity level of
      ADH-3 in rat liver. The activity level of the other rat ADH isozymes, ADH-1 and
      ADH-2, was not found to be changed. The intravenous injection of the specific
      anti-(horse liver S-ADH) serum, purified by affinity chromatography on
      immobilized horse liver S-ADH, resulted in a significant decrease of alcohol
      abuse in alcohol-dependent animals. These results allow us to assume an important
      role of rat liver ADH-3 in the mechanism of alcohol addiction.

PMID- 8462549
TI  - Removal of N-terminal formyl groups and deblocking of pyrrolidone carboxylic acid
      of proteins with anhydrous hydrazine vapor.
AB  - Many proteins have a blocked alpha-amino group which renders them inaccessible to
      sequence analysis by the classical Edman degradation procedure. Blockage
      typically occurs when the alpha-amino groups are acylated with acetyl or formyl
      groups or when the N-terminal residue is pyrrolidone carboxylic acid formed by
      cyclization of glutamine. We have found that N-formyl groups of proteins and
      peptides can be removed by exposure to hydrazine vapor at -5 degrees C for 8 h.
      Under these conditions, peptide-bond cleavage or modification of the constituent
      amino-acid residues does not occur. Deblocking of N-terminal pyrrolidone
      carboxylate residues by conversion to gamma-hydrazidyl glutamic acid can be
      achieved by exposure to hydrazine vapor at 20 degrees C for 4 h. These conditions
      cause partial modification of asparagine and glutamine residues to their
      corresponding hydrazides, and conversion of arginine residues to ornithine.

PMID- 8462550
TI  - The sum of the control coefficients of all enzymes on the flux through a group
      transfer pathway can be as high as two.
AB  - In simple metabolic pathways the control exerted by enzyme concentrations on the
      pathway flux adds up to one when the control is quantified in terms of control
      coefficients. In this paper we demonstrate that this classical summation theorem
      has to be modified in pathways where the enzymes participate by transferring a
      group between each other. We derive the corresponding new control theorem and
      show how it is consistent with standard metabolic control analysis. In group
      transfer pathways lacking enzyme complexes, the sum of the flux control by enzyme
      concentrations and by the donor and acceptor couples of the pathway, equals two.
      In group-transfer pathways with enzyme-enzyme interactions the flux control by
      the dissociation rate constants of the enzyme-enzyme complexes must be added to
      obtain this sum of two. In all cases, the sum of the controls by all reaction
      activities remains one. Both by using the new theorem and by numerical
      simulations, we then demonstrate that, in group-transfer pathways with or without
      enzyme interactions, the sum of the control of enzymes on the pathway flux is
      higher than one and can reach a value of two. The total control of all enzymes on
      the concentration of any intermediate either with or without the transferred
      group can be equal to one, rather than to the zero found in the classical case.
      Examples of group-transfer pathways are the bacterial phosphoenolpyruvate:sugar
      phosphotransferase system, the main pathway for uptake of sugars in
      Enterobacteriaceae, and the electron-transfer chain in free-energy transducing
      membranes.

PMID- 8462551
TI  - Structural studies of the O-antigenic polysaccharide of Fusobacterium
      necrophorum.
AB  - The O-specific polysaccharide component of the lipopolysaccharide produced by
      Fusobacterium necrophorum is of the teichoic acid type, with repeating units
      connected by phosphoric diester linkages. Dephosphorylation of the polysaccharide
      by treatment with aqueous hydrogen fluoride yielded a carbohydrate composed of a
      trisaccharide linked to an acidic component. This product, and the
      polysaccharide, were investigated by chemical methods and 1H-, 13C-, 31P- and 15N
      NMR spectroscopy and the former also by fast-atom-bombardment mass spectrometry.
      It is proposed that the polysaccharide is composed of repeating units having the
      following structure, in which Fuc represents fucose (6-deoxy-galactose), Am
      represents an acetamidino group and Sug 2,4-diamino-2,4,6-trideoxy-D-glucose
      ('bacillosamine') acetylated at the 2-position and acylated with a (S)-3
      hydroxybutanoic acid at the 4-position. The acid was identified as a 2-amino-2
      deoxy-2-C-methyl-pentonic acid (2-amino-2-methyl-3,4,5-trihydroxypentanoic acid).
      The configuration of this acid remains to be determined. [formula: see text]

PMID- 8462552
TI  - pH-induced structural transitions of bovine serum albumin. Histidine pKa values
      and unfolding of the N-terminus during the N to F transition.
AB  - 1. Titration curves have been constructed for all the resolvable resonances of
      defatted bovine serum albumin [pH meter readings in 2H2O solution (pH*) 2-10],
      including complete curves for six His residues and partial curves for a further
      four. Three His residues have unusually low pKa values (less than 5.5). 2. Abrupt
      discontinuities in the titration curves of nearly all resonances were observed
      near pH 4.3 (N to F transition), together with a marked loss of chemical shift
      dispersion at low pH*. No such loss of dispersion occurs in the high pH region
      previously associated with the N to B transition (approximately pH 8). The NMR
      data provide strong evidence that the N to F transition is not localised in
      domain III as had been previously suggested. 3. A localised unfolding of the N
      terminal region occurs below pH* 4.5.

PMID- 8462553
TI  - Taking enzyme kinetics out of control; putting control into regulation.
AB  - The matrix formulation of metabolic control analysis, which states that
      multiplying the elasticity matrix for any system by the corresponding control
      matrix yields an identity matrix, can be transformed into a statement that
      multiplying a matrix expressing internal regulatory properties by a matrix
      expressing external regulatory properties also yields an identity matrix. This
      transformation supplies the formal basis for metabolic regulation analysis, and
      provides the key to determining the control structure of a system without the
      need to know the exact changes in enzyme activities that are made to measure
      control coefficients.

PMID- 8462554
TI  - Isolation and chemical characterization of a novel insulin-related neuropeptide
      from the freshwater snail, Lymnaea stagnalis.

PMID- 8462555
TI  - Mechanistic studies on rhodopsin kinase. Light-dependent phosphorylation of C
      terminal peptides of rhodopsin.

PMID- 8462556
TI  - Urinary tract infection with Corynebacterium urealyticum in South Africa.
AB  - Corynebacterium urealyticum has been well documented as a urinary pathogen in
      Europe. The purpose of this study was to investigate the incidence and clinical
      relevance of Corynebacterium urealyticum as a urinary pathogen in a predominantly
      Third World population (South Africa) and to attempt to increase the isolation
      rate by culturing urine specimens on a selective medium. Two methods were used to
      isolate Corynebacterium urealyticum from urine specimens. Blood agar plates from
      routine urine cultures of 7,912 urine specimens were incubated for 48 hours and
      1,281 specimens were cultured on a selective medium as well as on routine media.
      The antimicrobial susceptibility of all isolates of Corynebacterium urealyticum
      was tested. The yield of Corynebacterium urealyticum on blood agar was three
      isolates in three patients (0.038% of 7,912), all of whom had pyuria, alkaline
      urine and risk factors for Corynebacterium urealyticum infection. Use of
      selective media increased the yield of Corynebacterium urealyticum to 15 of 1,281
      specimens (1.17%), however 73% of these urine samples yielded other pathogens and
      none had an alkaline pH which could not be attributed to the presence of another
      urealytic pathogen. All isolates were susceptible to vancomycin and 92.6%
      susceptible to norfloxacin. The pathogenic potential of Corynebacterium
      urealyticum was confirmed in South African patients, but the incidence of
      infection was low. The use of a selective medium is therefore not cost-effective
      in all cases but could be used selectively on the basis of typical urine findings
      and patient criteria.

PMID- 8462557
TI  - Rapid detection of Shigella dysenteriae and Shigella flexneri in faeces by an
      immunomagnetic assay with monoclonal antibodies.
AB  - A rapid and sensitive method for the detection of Shigella dysenteriae type 1 and
      Shigella flexneri serotypes in faeces based on capture of the bacteria with
      immunomagnetic particles is described. The particles were coated with either of
      two different monoclonal antibodies specific for the O-antigens of Shigella
      dysenteriae type 1 and Shigella flexneri serotypes. Captured bacteria were
      detected by an enzyme immunoassay with O-antigen specific rabbit antiserum. The
      whole assay required 2 to 3 hours to perform and the sensitivity limit was 10(3)
      cfu/ml as determined by viable cell counting. One hundred and fifty
      enterobacteria strains, including 100 Shigella strains from a strain collection,
      and 302 fresh faecal samples were used for the study. All Shigella dysenteriae
      type 1 and Shigella flexneri culture-positive faecal samples were positive in the
      immunomagnetic assay. In addition 18 of 252 culture-negative faecal samples were
      positive. The immunomagnetic assay was compared with latex agglutination and
      indirect immunofluorescence using culture as the reference method. The
      immunomagnetic assay had a sensitivity of 100%, latex agglutination a sensitivity
      of 72% with 28% false-negative results, and indirect immunofluorescence a
      sensitivity of 95%. The immunomagnetic assay was superior in sensitivity since it
      also detected Shigella in faecal samples up to two days after antibiotic therapy
      had been started, which both latex agglutination and indirect immunofluorescence
      failed to do. The high sensitivity in detecting live and dead bacteria, and the
      ease of performance of the immunomagnetic assay render it an attractive method
      for detection of Shigella.

PMID- 8462558
TI  - Acute lower respiratory tract infection associated with Chlamydia pneumoniae in
      Germany.
AB  - Serum specimens from 223 patients with acute lower respiratory tract infection
      were examined for antibodies to Chlamydia pneumoniae using the
      microimmunofluorescence test. Antibodies to Chlamydia pneumoniae were detected in
      18 (20%) of 91 children and 64 (48%) of 132 adults. Among those individuals, 4
      (4%) children and 15 (11%) adults had elevated IgG antibody titres indicating
      acute or recent infection. Specific IgM antibodies were observed in two patients.
      These results suggest that a significant proportion of lower respiratory tract
      infections in Germany is caused by Chlamydia pneumoniae.

PMID- 8462559
TI  - Acute meningoencephalitis as the sole manifestation of Q fever.
AB  - The case of a 25-year old man who presented with meningoencephalitis as the sole
      clinical manifestation of Q fever is described. Serological studies revealed the
      presence of IgM and IgG antibodies to Coxiella burnetii. The patient responded
      favourably to a ten-day course of i.v. ceftriaxone and was discharged without any
      neurological sequelae.

PMID- 8462560
TI  - Invasive infection with Mycobacterium genavense in three children with the
      acquired immunodeficiency syndrome.
AB  - Three children with human immunodeficiency virus infection and invasive infection
      with Mycobacterium genavense are reported. Fever spikes, abdominal cramps and
      distension, diarrhea or ileus, and anemia were the predominant symptoms in the
      severely immunodeficient patients (CD4 lymphocytes < 0.04 x 10(9)/l). Numerous
      acid-fast bacilli were readily detectable by microscopy in stool samples and in
      lymph node biopsies, but cultures for mycobacteria remained negative.
      Mycobacterium genavense should be sought when invasive non-tuberculous
      mycobacteriosis is suspected and mycobacterial cultures from blood or other sites
      show limited growth. Multiple-drug regimens including amikacin, ethambutol,
      rifampin, and clarithromycin may be of benefit in controlling the infection, as
      observed in two patients.

PMID- 8462561
TI  - Three cases of varicella thrombophlebitis as a complication of varicella zoster
      virus infection.
AB  - Three cases of deep venous thrombosis following varicella infection are described
      which were successfully treated with bed rest and anticoagulants. Two of these
      patients had severe pulmonary manifestations of varicella and the third was
      complicated by pulmonary embolism. Deep vein thrombosis is an uncommon systemic
      manifestation of varicella, possibly associated with vascular endothelium wall
      damage caused by varicella zoster virus infection.

PMID- 8462562
TI  - Characterization of penicillinase-producing strains of Neisseria gonorrhoeae.
AB  - Twenty-three penicillinase-producing strains of Neisseria gonorrhoeae were
      characterized. All strains showed hybridization with a TEM-1 probe and production
      of a TEM-1 type beta-lactamase (pI 5.4) on isoelectric focusing. Eight strains
      also showed a beta-lactamase band of pI 5.5. The penicillin MICs for the strains
      producing only TEM-1 were in the range 4-16 micrograms/ml; MICs of the strains
      with the additional pI 5.5 band were > or = 128 micrograms/ml for seven strains
      and 4 micrograms/ml for an arginine-hypoxanthine dependent strain. The
      association of the high MICs with the presence of the pI 5.5 band was
      statistically significant. The pI 5.5 band could represent a new beta-lactamase
      type or a TEM-1 mutant.

PMID- 8462563
TI  - In vitro susceptibility of quinolone-resistant Campylobacter jejuni to new
      macrolide antibiotics.
AB  - The MICs of erythromycin and three new macrolide antibiotics were determined for
      36 quinolone-susceptible and 106 quinolone-resistant Campylobacter jejuni. The
      MIC90 values of azithromycin, clarithromycin, roxithromycin and erythromycin were
      0.5, 4, 16 and 4 mg/l respectively. No difference was found between macrolide
      activity against the quinolone-susceptible and the quinolone-resistant strains.
      Clarithromycin and especially azithromycin might eventually replace erythromycin
      for the treatment of Campylobacter jejuni infections in view of their
      pharmacological properties.

PMID- 8462564
TI  - Evaluation of a rapid latex test for direct detection of Streptococcus agalactiae
      in various obstetrical and gynaecological disorders.
AB  - Cervical samples collected during speculum examination in 413 women were tested
      for the presence of Streptococcus agalactiae by Gram staining, a new latex
      agglutination test and standard cultures. The results of each method are reported
      in correlation with the clinical circumstances of isolation. Gram stain and the
      latex agglutination test had a sensitivity of 30% and 78%, and a specificity of
      89% and 98% respectively compared with culture. The sensitivity of the latex
      agglutination test was higher in cases of premature rupture of membranes (90%),
      presumed chorioamnionitis (86%), presumed post-partum endometritis (86%) and
      presumed salpingitis (87%). This latex agglutination test appears to be useful
      for identifying patients who are heavily colonized with Streptococcus agalactiae
      and are at a high risk of infection.

PMID- 8462565
TI  - Two cases of Actinomyces pyogenes infection in humans.
AB  - Few confirmed human cases of Actinomyces pyogenes infection have been reported
      partly because of inadequate identification of this bacterium. In this study, two
      new cases are reported with emphasis on the characteristics which are relevant
      for identification of the isolates. A review of previously reported cases is
      presented.

PMID- 8462566
TI  - Association of hepatitis B and human immunodeficiency virus infections in
      Tanzanian population groups.
AB  - A study was performed to determine whether there is a correlation between
      hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection in
      population groups in the Dar es Salaam area in Tanzania where HBV infection is
      endemic. A panel of 460 sera from army recruits, health personnel and pregnant
      women was tested. In the whole group seromarkers of HBV infection were found in
      61.9% of 134 HIV positive subjects versus 51.5% of 326 seronegative subjects, a
      difference which was not statistically significant (p > 0.05). In the group of
      pregnant women, however, 66.7% of 120 HIV positive subjects had markers of HBV
      infection versus 49.0% of the 157 HIV seronegative subjects (p < 0.01). This
      shows that a considerable proportion of young females are also exposed to HBV at
      the time they acquire HIV infection.

PMID- 8462567
TI  - Pasteurella stomatis infection following a dog bite.

PMID- 8462568
TI  - Spontaneous peritonitis due to Brucella melitensis in a patient with cirrhosis.

PMID- 8462569
TI  - Frequency of plasmid-mediated beta-lactamases in Enterobacteriaceae isolated in
      Spain.

PMID- 8462570
TI  - Killing kinetics of vancomycin and rifampin tested alone and in combination
      against penicillin-resistant Streptococcus pneumoniae.

PMID- 8462572
TI  - Radiologic diagnosis of pseudoaneurysms complicating pancreatitis.
AB  - Angiographic and computed tomographic (CT) examinations in five patients with
      arterial pseudoaneurysms complicating pancreatitis were evaluated
      retrospectively. Selective arteriography was superior to CT imaging in
      demonstrating pseudoaneurysm formation. However, angiography was performed in
      four patients after a CT study considered suspicious for a pseudoaneurysm; none
      of these four patients had clinical evidence of bleeding. Correlation with
      surgical findings was established in four patients, indicating that
      pseudoaneurysms complicating pancreatitis were not located within a pancreatic
      pseudocyst. Some thrombus-containing pseudoaneurysms may present with a
      pseudocyst appearance on CT images.

PMID- 8462573
TI  - Artifacts in the ascending aorta on computed tomography: another measure of
      aortic distensibility?
AB  - The appearance of the ascending aorta was studied in 53 patients undergoing
      computed tomography on a modern system capable of routine 1 second data
      acquisition times. Motion artifact caused a blurred aortic outline in 48
      patients; the extent was objectively and subjectively assessed. The maximum and
      minimum cross-sectional aortic areas were measured at the margins of the blur.
      The area of the blur, expressed as a fraction of the minimum aortic cross
      sectional area, decreased with age (P < 0.001) and was significantly smaller in
      the 13 patients with known cardiovascular problems (P < 0.05). These findings
      were substantiated by the subjective gradings which showed less marked artifacts
      amongst elderly patients (although this observation did not reach statistical
      significance). Artifacts were less prominent in 16 patients with evidence of
      aortic wall calcification, both on subjective grading (P < 0.05) and formal area
      measurements (P < 0.05). These observations lead us to believe our postulation
      that this artifact is an indicator of aortic distensibility and thus, indirectly,
      of cardiovascular status.

PMID- 8462571
TI  - Influence of selective decontamination of the digestive tract on microbial
      biofilm formation on endotracheal tubes from artificially ventilated patients.
AB  - The effect of selective decontamination of the digestive tract on the nature and
      incidence of microbial biofilm formation on endotracheal tubes was assessed.
      Thirty endotracheal tubes were obtained post-extubation from patients in the
      intensive care unit who had been ventilated for a 1 to 15 day period and who did
      or did not receive the antibiotic regimen. Extensive biofilm formation was
      identified by scanning electron microscopy on 97% of tubes examined. Endotracheal
      tube biofilm in tubes obtained from patients who received selective
      decontamination of the digestive tract showed a high prevalence of colonization
      with yeast (4 of 15 tubes) and gram-positive bacteria (streptococci,
      staphylococci and diphtheroids) (14 of 15 tubes). Staphylococcus aureus was
      isolated only from this group. Pseudomonas spp. were isolated from 2 of 15 tubes
      in both patient groups. Enteric gram-negative organisms (coliforms, Klebsiella
      and Proteus spp.) were isolated only from tubes of patients who did not receive
      the antibiotic regimen (4 of 15 tubes). Yeasts, however, were not isolated from
      these tubes. Group D streptococcal isolates were resistant to tobramycin as were
      half of the Staphylococcus aureus isolates. For gram-negative bacteria, the MIC
      of tobramycin was in the range 1-64 micrograms/ml and the MIC of polymyxin in the
      range 0.5-16 micrograms/ml. Although a reduction was observed in the incidence of
      gram-negative microorganisms, this antibiotic regimen does not inhibit biofilm
      formation on the endotracheal tube by other pathogens associated with pneumonia
      in ventilated patients. This persistent nidus may be a factor in the pathogenesis
      of nosocomial pneumonia.

PMID- 8462574
TI  - CT findings in unusual inflammatory masses of the parotid gland. Report of four
      cases.

PMID- 8462575
TI  - Benign tumors of the small intestine: preoperative evaluation with a barium
      infusion technique.
AB  - During a seven year period 18 benign small intestinal tumors were histologically
      documented in patients referred to us for a small bowel study, using a barium
      infusion technique. These included seven leiomyomas, five adenomatous polyps, two
      Peutz-Jeghers hamartomas, one myoepithelial hamartoma, one lipoma, one Brunner's
      gland adenoma and one neurilemmoma. Ten of the patients were women and eight were
      men, with their ages ranging from 20 to 75 years (mean age 45 years). Presenting
      symptoms were gastrointestinal bleeding in 12, anemia in 9, abdominal pain in 4,
      partial intestinal obstruction in 3 and bloody diarrhea in one. The time elapsed
      from onset of symptoms to radiological diagnosis ranged between one month and
      seven years (mean time 16 months). Multiple lesions were encountered in four
      cases and solitary in fourteen. The site of involvement was the duodenum in 3
      patients, the jejunum in 8 and the ileum in 7 of them. Main radiological
      appearances included solitary or multiple intraluminal filling defects, mass
      effect on neighbouring loops and dilation of intestinal loops proximally to the
      lesion. The primary tumor, in the form of a mass or other abnormality of the
      small intestine was identified in all study cases. Correlation with surgical or
      endoscopic findings showed that radiology depicted all single lesions, whereas
      multiple lesions were underestimated in one case. The individual morphological
      changes shown on examination of the resected specimens resembled the appearances
      on the barium study in all cases. However, enteroclysis missed four out of seven
      ulcers and a stalk in one of the five pedunculated lesions. A specific tumor-type
      diagnosis was reached preoperatively in eleven patients, it was suggestive in
      five and mistaken in two of them. Our experience indicates that enteroclysis is
      an effective means in evaluating patients with suspected benign small bowel
      tumors, preoperatively.

PMID- 8462576
TI  - The value of MRI in the evaluation of the ACL deficient knee and in the post
      operative evaluation after ACL reconstruction.
AB  - To evaluate the usefulness of magnetic resonance imaging (MRI) in the exploration
      of the anterior cruciate ligament (ACL) deficient-knee, a total of twenty-five
      patients with chronic instability of the knee joint and who underwent both MRI
      and arthroscopy were studied prospectively. Twenty-three of these patients
      underwent an intra-articular reconstruction of the ACL with bone-patellar tendon
      bone autografts. For the ACL lesions MRI had a sensitivity of 95.8%, a
      specificity of 100% and a diagnostic accuracy of 97.7%. Associated bowing of the
      PCL was seen in 20 cases of the study group. For the associated meniscal lesions
      MRI had a sensitivity of 77.7%, a specificity of 94.7% and a diagnostic accuracy
      of 91.5%. In no case did MRI allow to detect the minimal cartilage irregularities
      observed in the arthroscopy. MRI had great accuracy for the evaluation of the
      anchoring points, direction of the tunnels and the state of the autografts at
      intra-articular level. It is concluded that MRI is a useful imaging diagnostic
      modality for evaluation of the ACL deficient-knee and the intra-articular
      reconstruction of the ACL, thereby MRI affords the surgeon better preoperative
      planning.

PMID- 8462577
TI  - Mesoinnominate shunt for the treatment of Budd-Chiari syndrome: evaluation with
      multimodality imaging.
AB  - The construction of a mesoinnominate shunt between the superior mesenteric vein
      and the left innominate vein is a recent surgical procedure for the treatment of
      Budd-Chiari syndrome with vena caval obstruction. The purpose of this study was
      to determine the role of the different imaging modalities for the follow-up of
      mesoinnominate shunts. Doppler US (n = 32), and MR imaging examinations (n = 32)
      were prospectively performed in 10 patients with mesoinnominate shunts. Shunt
      patency or thrombosis was confirmed with angiography (n = 32) and transhepatic
      portography with pressure measurement (n = 6). For each follow-up evaluation, all
      examinations were performed within 4 days. Shunt patency was correctly
      demonstrated in 28/28 cases with Doppler US, CT and MR imaging. Shunt thrombosis
      was correctly demonstrated in 4/4 cases with Doppler US, CT and MR imaging. Since
      Doppler US, CT and MR imaging have the same accuracy for diagnosing
      mesoinnominate shunt patency and detecting thrombosis, our study suggests that
      redundant screening methods can be avoided. Doppler US is accurate enough and
      should be the preferred technique in the evaluation of mesoinnominate shunts.

PMID- 8462578
TI  - Visualization of basal pleural space and lung with advanced multiple beam
      equalization radiography (AMBER).
AB  - During clinical use of AMBER (Advanced Multiple Beam Equalization Radiography) it
      was frequently felt that the basal lung and pleural space were better appreciated
      than with standard chest radiography. We aimed to quantify the amount of
      additional relevant anatomy seen in this part region and to review the normal
      radiographic anatomy. Four hundred patients without known chest disease were
      evaluated. Two groups of 200 patients (50% female) were studied with either AMBER
      or standard chest radiography (140 kVp, 180 cm FFD, Kodak Tmat G film, Lanex
      regular screen; for both techniques). Visualization of the pleural sinuses (in
      percent of the transverse thoracic diameter) and the basal pulmonary vessels (4
      point scale) was evaluated by a panel of 3 radiologists. The shape of the sinus
      was traced if sufficiently visible and subjectively evaluated. A significantly (P
      < 0.05) larger segment of the dorsal (41 +/- 34%) and ventral (14 +/- 15%)
      sinuses was seen with the AMBER technique than with the standard technique (16 +/
      21% and 9 +/- 11%, respectively). Vessel visibility was also significantly (P <
      0.001) better with AMBER (3.2 +/- 0.6) than with the standard technique (1.9 +/-
      0.6). The dorsal sinus showed alternatively a curved or pointed configuration.

PMID- 8462579
TI  - The reliability and value of determining mediastinal involvement and width on
      chest radiographs in patients with Hodgkin's disease.
AB  - Over the years several methods for evaluating mediastinal involvement in
      Hodgkin's disease have been applied to chest radiographs and conflicting results
      have been reported. In a retrospective study of 104 patients we evaluated
      interobserver variability in assessing mediastinal involvement and investigated
      various cut-off points for mediastinal size as to their ability to identify
      patients with high- and low-risk for recurrence. For mediastinal involvement the
      concordance rate for two reviewing radiologists was 94% (98/104) and compared
      with prior assessment by outside radiologists the concordance rates were 90%
      (94/104) and 88% (92/104), respectively. A good correlation between the reviewing
      radiologists was found for the quantitative evaluation of mediastinal diameter
      and thoracic ratios. ROC curves and relative risk figures were used to
      investigate the various cut-off points for mediastinal width and for the ratios
      of the maximal mediastinal diameter to the chest diameter at Th 5-6 (M1) and to
      the chest diameter at the widest thoracic level (M2). Neither the ROC curve
      analysis nor the use of relative risk figures revealed a cut-off point clearly
      more accurate in predicting recurrence. In conclusion, our results do not suggest
      that interobserver variability in mediastinal assessment, differences in the
      method of mediastinal measurement, or the cut-off points applied to mediastinal
      width can explain the discrepancies in the reported data on the prognostic value
      of mediastinal width in Hodgkin's disease, but rather factors such as patient
      selection and differences in treatment given may be responsible.

PMID- 8462580
TI  - Epidural and subdural contrast in myelography and CT myelography.
AB  - A retrospective study of 624 lumbar myelographic and CT myelographic procedures
      was undertaken to evaluate the frequency, radiographic and clinical relevance of
      contrast medium outside the dural sac. Our findings indicate that epidural
      contrast is frequently identified on CT scans with highly sensitive window
      settings (in 35.4% of all CT myelographic studies). Standard myelographic films
      are less sensitive for the detection of epidural contrast (9.6%). Subdural
      contrast is far less often encountered (in 2.4% of CT myelographic studies and in
      3.2% of standard myelographic films). We believe leakage of contrast to occur
      through the puncture site into the epidural and subdural space.

PMID- 8462581
TI  - Diffuse intrahepatic periportal plexiform neurofibroma.

PMID- 8462582
TI  - Chest "gestalt" and detectability of lung lesions.
AB  - Image perception in chest radiography is thought to occur on two levels, (a) a
      fast global response based on learned templates ("gestalt") and, (b) a slower
      systematic scan process. The relative importance of "gestalt" on the detection of
      nodular lung cancers was studied by disturbing the "gestalt" through rotation of
      the radiograph but not actually diminishing the image content available for
      viewing. Sixty chest radiographs (20 normals, 21 with subtle lung cancers, 19
      with obvious lung cancers) were presented to three readers in normal and abnormal
      (rotated randomly in 90 degree increments) orientation for varying durations
      (0.25 s, 1 s, 4 s and unlimited viewing time). The results indicate that the
      detectability of obvious and subtle lung lesions was degraded by the disturbed
      "gestalt" for both short and long viewing times. The readers did not
      significantly increase their unlimited viewing time when faced with rotated
      images (4.4 +/- 3.4 s) as opposed to non-rotated images (4.0 +/- 3.2 s). We
      conclude that the detection of lung lesions relies heavily on the chest "gestalt"
      and that systematic scanning cannot fully compensate for an impaired global
      response due to a disturbed "gestalt."

PMID- 8462583
TI  - Pediatric bronchography performed through the flexible bronchoscope.
AB  - Ten children, ranging in age from 2 months to 16 years, were evaluated by
      bronchograms performed during bronchoscopy. Nine of the ten children had
      significant pathology demonstrated by the bronchogram that elucidated findings
      unclear from other imaging procedures at the time of bronchoscopy. Despite the
      generally negative opinions about the utility of bronchograms in children,
      information obtained by bronchography can be quite useful. Bronchography during
      bronchoscopy proved to be quick, simple, and safe.

PMID- 8462584
TI  - Unusual cystic liver lesions: a pictorial essay.
AB  - Cystic liver lesions are being increasingly detected by ultrasound (US), computed
      tomography (CT) and magnetic resonance imaging (MRI). These lesions produce a
      wide spectrum of radiological features. Unfortunately their appearance is not
      always specific and they may resemble and be mistaken for other lesions. Cystic
      lesions can be classified into congenital, inflammatory, neoplastic and
      miscellaneous groups. In this pictorial essay a number of unusual cystic lesions
      are illustrated with a brief analysis of morphological features of the individual
      lesion and a diagnostic approach for cystic liver lesions is suggested.

PMID- 8462585
TI  - The functional effects of gadolinium-DTPA on the isolated perfused rat kidney.
AB  - Clinical experience suggests that Gd-DTPA has no deleterious effect on renal
      function. We have evaluated the effects of a large dose (0.6 ml/kg body weight)
      of this contrast agent on the function of the isolated perfused rat kidney. Gd
      DTPA led to a mild, transient increase in glomerular filtration rate with no
      subsequent fall during the 30 minute observation period. However, Gd-DTPA induced
      an increase in renal vascular resistance (+ 10%, P < 0.05) as a mild decrease in
      renal perfusate flow was observed during the experimental phase when compared to
      that of control kidneys. No significant effect was demonstrated on the fractional
      excretion of albumin or the fractional reabsorption of sodium. These data
      support, in an ex vivo experimental model, the clinical experience of the safety
      of this paramagnetic contrast agent in relation to renal function.

PMID- 8462586
TI  - Relaxation time changes of the uterus during the menstrual cycle: correlation
      with hormonal status.
AB  - Six women volunteers underwent pelvic MR imaging at 0.02 T four times during
      their menstrual cycle. The T1 and T2 relaxation times of the myometrium and
      endometrium were measured and correlated with the serum estradiol and
      progesterone levels. The magnitude of the relaxation times were highly individual
      but the pattern of their variation during the menstrual cycle was similar. The
      relaxation times were shortest at the beginning and end of the cycle. The most
      rapid increase occurred during the proliferative phase, followed by little or no
      increase through to the middle of the secretory phase. The T1 and T2 times of the
      endometrium correlated directly with the serum estradiol levels during the entire
      menstrual cycle (r = 0.5, P = 0.02) and the T2 times of the endometrium with the
      serum progesterone levels during the secretory phase (r = 0.6, P = 0.05). The
      correlation between the relaxation times of the myometrium and the serum hormonal
      levels was poor. The results indicate that the relaxation times of the myometrium
      and endometrium vary during the menstrual cycle reflecting the serum hormonal
      status. MR imaging of the uterus with relaxation time measurements may be
      clinically useful to examine the menstrual cycle and its pathology.

PMID- 8462587
TI  - Posttransplant renal artery stenosis--outpatient intraarterial DSA versus color
      aided duplex Doppler sonography.
AB  - A prospective trial was conducted to assess the accuracy of color aided duplex
      Doppler (CADD) sonography to rule out transplant renal artery stenosis (TRAS) and
      to determine feasibility and safety of intraarterial digital subtraction
      angiography (DSA) in hypertensive renal allograft recipients on an outpatient
      basis. All patients were hypertensive (n = 18, mean age: 42 +/- 11 years) and
      underwent CADD and an i.a. DSA with 4F catheters. There was a 4 hour rest post
      DSA. Duplex Doppler measurements of maximum velocity were obtained. Absolute
      values of > or = 100 cm/s were considered indicative to suspect TRAS. DSA
      revealed severe TRAS in 4 patients (22%). The stenoses were located near the
      iliorenal anastomosis (n = 2) and at the bifurcation of the renal artery (n = 2).
      Duplex Doppler classified twelve (67%) renal artery pedicles normal (maximum
      velocity: 79 +/- 23 cm/s). TRAS was suspected in 6 patients with a maximum
      velocity of 159 +/- 48 cm/s (P < 0.01). False positive CADD diagnoses were due to
      tortuous graft vessels and a postbiopsy arteriovenous fistula. Sensitivity of
      CADD was 100%, specificity 86%. There were no DSA related complications. No
      impairment of graft function occurred. CADD allows renal angiography to be
      reserved to clarify an inconclusive ultrasound study and for definite diagnosis
      of angiomorphology and lesion classification. Intraarterial DSA of renal grafts
      in outpatients may be performed without an increased risk of procedure-related
      complications.

PMID- 8462588
TI  - Cell adhesion to streptavidin via RGD-dependent integrins.
AB  - Biotin-blocked streptavidin binds specifically (Kd approximately 3 x 10(-8) M) to
      cell surfaces, presumably via an RYD-containing sequence. This site is distinct
      from the biotin-binding cleft of the protein and bears high homology to the RGD
      containing cell-binding domain of fibronectin. We show here that various cell
      types adhere to immobilized streptavidin and that the soluble protein interferes
      specifically with cell adhesion to fibronectin substrata (with an IC50 of about 1
      x 10(-7) M) but less so to other adhesive glycoproteins (e.g., collagen type I,
      vitronectin). Immunochemical evidence combined with peptide competition studies
      demonstrated that cells bind to streptavidin primarily via the major fibronectin
      receptor (the alpha 5 beta 1 integrin). The results suggest that streptavidin
      acts as a relatively strict fibronectin mimetic, thus reflecting the great
      similarity in their respective RYD/RGD sequence and the immediate flanking
      regions. The bacterial protein emulates and competes with fibronectin and other
      extracellular matrix adhesive proteins in the initial recognition and binding to
      cell surfaces, but appears not to induce subsequent processes (e.g., anchorage
      and spreading). Streptavidin may thus represent a novel example of bacterial
      protein mimicry of a key adhesion motif.

PMID- 8462589
TI  - The time courses of intracellular transport of some secretory proteins of rat
      liver are not affected by an induced acute phase response.
AB  - To study the effects of changed synthesis on intracellular transport of secretory
      proteins, an acute phase response was induced in rats. The synthesis and
      secretion of haptoglobin, complement C3, transferrin and albumin were then
      investigated by pulse labeling with [3H]leucine. Maximal increase in the
      syntheses of the positive acute phase proteins was observed after 24 h, amounting
      to an increase of nine, three and twofold for haptoglobin, C3 and transferrin,
      respectively. The synthesis of albumin decreased to a minimum after 48 h,
      reaching approximately one fourth of normal synthesis. The time courses for
      transit through rough endoplasmic reticulum and for secretion were determined
      after 36 h, and were found to be roughly unchanged for all four proteins despite
      the different changes in synthesis. The fraction of haptoglobin associated with
      the microsomal membrane was reduced during the acute phase response, but there
      was no significant change in membrane association as a function of time after
      labeling with [3H]leucine. It is concluded that the altered protein synthesis
      during an acute phase response in vivo has little effect on the time course of
      secretion of the proteins studied. Furthermore, the basal mechanisms for
      intracellular transport appear relatively unchanged during this condition.

PMID- 8462590
TI  - Retention of the fetoacinar pancreatic (FAP) protein to the endoplasmic reticulum
      of tumor cells.
AB  - The fetoacinar pancreatic (FAP) protein is a specific component of the human
      exocrine pancreas associated with the differentiation and proliferation of acinar
      cells. FAP expression is enhanced in cases of pancreatic exocrine cancer and it
      is found in relatively high concentrations in pathological pancreatic juices.
      However, tumor cell lines do not secrete FAP into the culture medium. In this
      paper we analyze the intracellular localization of FAP in cell lines and compare
      some biological properties of the tumoral FAP with the normal adult and fetal
      forms. Immunocytological experiments performed using Mab J28 which characterizes
      FAP, gave a staining pattern suggestive of FAP localization in the ER.
      Subcellular fractionation corroborated this localization and established that FAP
      is tightly associated with the microsomal membranes. The absence of reactivity of
      the tumoral FAP with wheat germ agglutinin lectin and its strong reactivity with
      concanavalin A is consistent with the idea that FAP in tumor cells does not reach
      the Golgi apparatus and it is consequently retained in the endoplasmic reticulum
      (ER). FAP contained in hepatic metastasis derived from pancreatic adenocarcinoma
      appeared to be similar, if not identical, to that expressed by cell lines. This
      supports the hypothesis that FAP retention in the ER of malignant cells is a
      physiological phenomenon and not the result of a modification of cell lines due
      to the culture conditions. FAP expressed by cancer cell lines and metastases
      appeared by sodium dodecyl sulfate polyacrylamide gel electrophoresis a
      homogeneous protein with a M(r) of 120,000. Instead, the secreted mature protein
      consists of a main component of M(r) 110,000 and shows pronounced polymorphism
      (dispersion from M(r) 110,000 to 80,000). Increased size of the ER-retained
      protein is likely due to elongation of the peptide chain. Defective processing in
      the ER as a result of amino acid mutation could therefore explain the behavior of
      this protein in tumors.

PMID- 8462591
TI  - Specific internalization of basal membrane domains containing the integrin alpha
      6 beta 4 in dispase-detached cultured human keratinocytes.
AB  - The integrin alpha 6 beta 4 is polarized towards the basal side of basal
      keratinocytes and helps anchor these cells to the basement membrane components.
      We have found that cultured human epidermal keratinocytes, when detached from
      their culture substratum, as for grafting, using the enzyme dispase, rapidly
      internalize the basal membrane domains containing the integrin alpha 6 beta 4,
      while integrins of the very late antigen subtype remain on the cell surface.
      Detachment and incubation at 4 degrees C prevent this internalization, as well as
      the contraction of the detached sheet area. Subsequent incubation at 37 degrees C
      initializes this contraction and allows the basal integrin alpha 6 beta 4 to be
      internalized. We took advantage of this blockage to label upon detachment using
      immunogold techniques, the alpha 6 subunit present on the basal cell surface;
      then we studied its internalization with the electron microscope. This
      internalization pathway differs from classical receptor-mediated endocytosis, and
      intermediate filaments might possibly play a role in this process. Interestingly,
      1 h after their internalization from the basal membrane, a third of the gold
      particles labeling the alpha 6 subunit was found between lateral membranes of
      basal cells, strongly suggesting that the integrin alpha 6 beta 4 can be partly
      recycled to the cell surface in these conditions.

PMID- 8462592
TI  - Receptor-mediated endocytosis of ricin in rat liver endothelial cells. An
      immunocytochemical study.
AB  - The endocytic pathway of ricin in sinusoidal liver endothelial cells (EC) was
      traced by means of immunocytochemical labeling of ultrathin cryosections. Ricin,
      a highly mannosylated glycoprotein, is internalized mainly by receptor-mediated
      endocytosis via the mannose receptor in the EC. Labeling of specimens fixed at
      different time points after injection of ligand showed that several subcellular
      compartments are involved in processing of endocytosed ricin. One minute after
      injection ricin is seen in coated pits, coated vesicles and cisternal-shaped
      endosomes. After 6 min, the ligand associates with electron-dense, spherical
      vesicles and electron-lucent vesicles, presumably representing late endosomes. In
      the same time period we observed labeling in the vicinity of the Golgi stack. At
      later time points, ricin is increasingly localized in lysosomes. Both late
      endosomes and lysosomes showed labeling for Igp120, the lysosomal membrane
      glycoprotein. To compare uptake of ricin with another mannosylated ligand, we
      coinjected ricin and mannosylated colloidal gold particles (Man-Aun). Man-Au20,
      injected 24 h before fixation as a marker for late endocytic compartments, was
      found in two distinct compartments, presumably representing late endosomes and
      lysosomes. The distribution of ricin and Man-Au10, the latter injected 15 min
      before fixation, in early endosomes was strikingly different, indicating that the
      structure of this compartment is important in the process of sorting of ligand
      and receptor.

PMID- 8462593
TI  - Isolation of cytolytic granules from sea urchin amoebocytes.
AB  - Calcium-dependent, heat-labile lytic activity was detected in whole Paracentrotus
      lividus coelomocytes. The molecules responsible for this activity were mainly
      expressed by an enriched amoebocyte population and were contained in cytoplasmic
      granules which could be isolated by Percoll density gradient centrifugation. The
      isolated cytoplasmic granules were small (0.1-0.25 micron) organelles containing
      the lysosomal marker arylsulfatase. The functional implication of our results is
      that P. lividus amoebocytes represent cytotoxic cells which mediate the killing
      event by a secretory phenomenon involving the release of cytolytic material from
      cytoplasmic granules.

PMID- 8462594
TI  - Sequential O-glycosylation of nuclear pore complex protein gp62 in vitro.
AB  - Gp62 is a nuclear pore complex glycoprotein of vertebrates containing multiple O
      linked N-acetylglucosamine monosaccharides. We have recently shown (Cordes et
      al., Eur. J. Cell Biol. 55, 31-47 (1991)) that gp62 of mouse and Xenopus laevis
      is predominantly glycosylated in the amino-terminal half of the molecule. Here we
      describe in vitro glycosylation in rabbit reticulocyte lysate of gp62 and of
      individual segments of this protein expressed as recombinant polypeptides in E.
      coli. Competition experiments between purified polypeptides revealed that gp62
      exhibits in vitro at least two types of binding sites for a cytosolic N
      acetylglucosaminyltransferase resulting in a sequential glycosylation of the
      protein. High affinity binding sites for this glycosyltransferase were located in
      the amino-terminal domain between amino acids 248-341 of mouse gp62, whereas low
      affinity binding sites were scattered in the entire amino-terminal half. The
      segment containing amino acids 248-341 was able to compete with in vitro O
      glycosylation of gp62 subdomains containing low affinity binding sites. This gp62
      segment was also able to compete with O-glycosylation of other unrelated cellular
      proteins in vitro.

PMID- 8462595
TI  - In situ localization of cAMP-dependent protein kinases in nuclear and chromosomal
      substructures: relation to transcriptional activity.
AB  - Catalytic (C) and regulatory subunits (RI, RII) of cAMP-dependent protein kinase
      (PKA) were localized in cell nuclei of various rat tissues by immunogold electron
      microscopy. A specific labeling within the interchromatin space was found to be
      associated with perichromatin fibrils, interchromatin granules, and coiled
      bodies. Condensed chromatin and perichromatin granules were not labeled. In the
      nucleolus, most gold particles were found in the dense fibrillar component.
      Quantitation of labeling densities for the C-subunit from cells at different
      stages of spermatogenesis indicated that the nuclear concentration of PKA varies
      inversely with the amount of condensed chromatin. No parallel alterations in C
      immunoreactivities were observed in the cytoplasm. Immunofluorescence studies on
      polytene chromosomes of Chironomus thummi with a confocal laser scanning
      microscope showed a significantly more intense labeling of the C-subunit in
      transcriptionally active sites (puffs) as compared to inactive bands. Our results
      indicate that local concentrations of PKA in the nucleus have physiological
      significance in the control of gene activity. In addition, they suggest that PKA
      plays a regulatory role also in RNA processing.

PMID- 8462596
TI  - Core substructure in phycobilisomes of red algae. II. The central part of the
      tricylindrical core--APCM--a constituent of hemidiscoidal phycobilisomes of
      Rhodella violacea.
AB  - The central part of the tricylindrical core of phycobilisomes from Rhodella
      violacea was isolated by hydroxylapatite adsorption chromatography followed by
      density gradient centrifugation. In the electron microscope negatively stained
      APCM complexes showed a tricylindrical face view with an edge length of 20 to 24
      nm and a thickness of 9 to 10 nm in profile view. These complexes had a M(r) of
      900,000, and a sedimentation coefficient 24S. The fluorescence emission maximum
      at room temperature lay at 671 nm when excited at 590 nm. The presence of the
      high molecular linker polypeptide LCM exclusively in APCM and the existence of
      beta AP19.5, alpha AP18, and beta AP17 were demonstrated in SDS-polyacrylamide
      gel electrophoresis. The presence of "trimeric" allophycocyanin complexes in a
      separate band, with a sedimentation coefficient 6S, confirms the uncoupling of
      these complexes from the core; their maximal fluorescence at 680 nm in the second
      derivative hints at alpha AP-8. The results indicate a high conformity in the
      molecular organization of the core of hemidiscoidal phycobilisomes of red algae
      (Rhodella violacea) and cyanobacteria (Mastigocladus laminosus).

PMID- 8462597
TI  - Depleting cell cholesterol alters calcium-induced assembly of tight junctions by
      monolayers of MDCK cells.
AB  - A role for lipids in the formation of tight junctions (TJ) has been proposed.
      Attempts to relate changes in whole cell phospholipid composition to the
      formation of TJs, however, have yielded equivocal results. The object in the
      present study was to relate changes in TJ of MDCK cells more specifically to
      alterations in plasma membrane lipids. Cholesterol, which resides primarily in
      the plasma membrane, was reduced by 25% after incubation of cell monolayers for
      24 h in a low Ca2+ medium supplemented with (1-2 microM) Lovastatin, an inhibitor
      of hydroxymethylglutarylcoenzyme A (HMG-CoA) reductase. This was associated with
      a halving of the time required for Ca2+ to induce TJ formation as monitored by
      transepithelial electrical resistance (TER). [3H]Mannitol flux, and morphometric
      measurements made on freeze fracture replicas confirm that the effects on TER
      reflect changes in the characteristics of the paracellular pathway. Peak and
      steady state values of TER were also elevated over control values. The changes in
      cholesterol content and the time course for TJ assembly were apparent at levels
      of Lovastatin which do not affect prenylation of proteins, and were prevented if
      5 mM mevalonate was present along with Lovastatin. Paradoxically, despite a
      decrease of approximately 1/3 in the Ca concentration required to yield maximum
      rates of TJ assembly, 45Ca2+ uptake was actually reduced after cholesterol
      depletion. The data suggest that cholesterol may modulate the properties of
      membrane proteins and/or phospholipids which interact with Ca2+, possibly on the
      exoplasmic leaflet, during TJ assembly.

PMID- 8462598
TI  - von Willebrand factor storage requires intact prosequence cleavage site.
AB  - Large multimers of the adhesive glycoprotein von Willebrand factor (vWf) are
      stored in endothelial cells in rod-shaped granules called Weibel-Palade bodies,
      while small multimers are secreted constitutively. Expression of pro-vWf in other
      cells with a regulated pathway of secretion, results in formation of vWf
      containing storage granules that have a morphology similar to Weibel-Palade
      bodies. vWf expressed without its prosequence is not stored. To evaluate the
      importance of prosequence cleavage in vWf storage, the Arg at position -1, known
      to be necessary for cleavage, was mutated to Gly. Transfection of this cleavage
      mutant into two cell lines with a regulated pathway of secretion (RIN 5F and AtT
      20 cells) led to the formation of large multimers. However, treatment of the cell
      lysates by the enzyme endoglycosidase H (Endo-H) did not reveal significant
      amounts of intracellular Endo-H-resistant vWf, which indicates the absence of a
      pool of stored processed vWf. In addition, no Weibel-Palade body-like structure
      was detected in these cells by immunofluorescence labeling with anti-vWf
      antiserum. Electron microscopy and immunocytochemistry of RIN 5F cells expressing
      the pro-vWf mutant confirmed the absence of Weibel-Palade body-like structures.
      In addition, anti-vWf-linked gold particles were found in the ER, occasionally in
      rounded granules and particularly in lysosomal structures which were abundant. We
      conclude that the formation of large aggregates is not sufficient to induce
      efficient vWf storage, and that the lack of cleavage of the prosequence may
      direct the mutant pro-vWf molecule to a degradative pathway. Therefore, the
      prosequence cleavage is a requirement for vWf storage.

PMID- 8462599
TI  - Isolation and characterization of mouse monoclonal antibodies against a human
      vascular endothelial cell-specific antigen.
AB  - A murine hybridoma clone was isolated secreting IgG-antibodies specific for human
      vascular endothelial cells. The antibody recognized a plasma membrane antigen
      (designated HECMA-112) of an apparent molecular weight of 112,000. Indirect
      immunofluorescence with cultured endothelial cells showed a staining pattern
      clearly distinct from previously described endothelial cell-specific antigens.
      The antibody bound to untreated as well as ethanol-fixed, confluent human
      umbilical vein endothelial cells (HUVEC) but not to other human primary cells
      (corneal endothelial cells, fibroblasts, keratocytes, lymphocytes, thrombocytes,
      or erythrocytes) or endothelial cells isolated from bovine or porcine aorta.
      HECMA-112 can be regarded as an additional marker for human vascular endothelial
      cells in vivo and in vitro.

PMID- 8462600
TI  - Preservation of differentiated phenotypes in cultured aortic endothelial cells by
      malotilate and phosphoascorbic acid.
AB  - Confluent bovine aortic endothelial cells (BAECs) formed a cobblestone-shaped
      cell monolayer when cultured on a collagen gel in a 1:1 mixture of Dulbecco's
      modified Eagle's medium and Ham's-F12 supplemented with 5% newborn calf serum.
      Within a few days, however, they lost cell-cell attachment and became
      fibroblastic. When BAECs were cultured in the same culture medium but further
      supplemented with either 10 micrograms/ml malotilate or 1 mM phosphoascorbic
      acid, the monolayer organization and the cobblestone-like cell morphology were
      maintained for more than 2 weeks although many sprout cells were observed
      underneath the monolayer. In contrast, if both malotilate and phosphoascorbic
      acid were present in the culture medium, a tight monolayer without underlying
      sprout cells was maintained for at least 4 months and the cells expressed factor
      VIII-related antigens and massively internalized acetylated low density
      lipoprotein. By electron microscopy, we observed well-developed gap and adherence
      junctions, Golgi apparatuses and vesicles many of which were open to the outside
      by fusing with either the apical or the basal surface, indicating high metabolic
      activity of the cells cultured for weeks in the same dish. Although malotilate
      treated BAEC monolayers secreted increased levels of prostacyclin (PGI2), the
      drug did not appear to directly affect the PGI2 production pathway since the
      similarly increased PGI2 production was noted in tight monolayers formed without
      the use of malotilate. Our results indicate that malotilate and phosphoascorbic
      acid together preserve differentiated phenotypes in cultured endothelial cells.

PMID- 8462601
TI  - Heterogeneity in the distribution of actin filaments in the endothelial cells of
      arteries and arterioles in the rat kidney.
AB  - The distribution of actin filaments (AFs) in arterial and arteriolar endothelial
      cells (ECs) was examined in situ by staining with rhodamine-phalloidin in the rat
      kidney after perfusion-fixation under physiological pressure. ECs possessed two
      populations of AF bundles, namely, peripheral bands (PBs) at the cell border and
      stress fibers (SFs) in the cytoplasm. The distribution of AFs was heterogeneous
      and exhibited three patterns in the arterial tree. In large arteries (> 120
      microns in luminal diameter) ECs contained predominantly PBs in addition to
      occasional SFs mainly in the upstream side of cells (PB-pattern). In arteries
      with intermediate diameters (30-120 microns), both PBs and SFs were conspicuous
      (PB-SF-pattern). In small arteries and arterioles (< 45 microns), SFs were
      prominent and PBs were rare (SF-pattern). In electron micrographs, we found that
      PBs were attached not to the lateral but to the basal plasma membrane via
      electron-dense materials and that SFs included two subpopulations, namely, thick
      basal and thin apical SFs. Morphometric analysis revealed that the length density
      of PBs was higher in segments with the PB-pattern than in those with the PB-SF
      pattern. The length density of SFs was significantly higher in the SF-pattern
      than in the PB-SF-pattern, whereas there was little difference in this parameter
      among vessel segments with the SF-pattern. We suggest that PBs and SFs are
      fundamentally structures that anchor ECs on the substratum, and are
      differentiated according to their different mechanical burdens.

PMID- 8462602
TI  - Multiple plasma membrane-associated MTOC systems in the acentrosomal cone cells
      of Drosophila ommatidia.
AB  - Multiple plasma membrane-associated microtubule-organizing centers operate in the
      cone cells of Drosophila ommatidia. A transcellular array of about 250
      microtubules assembles in each cone cell during late pupal ommatidial
      morphogenesis. While these arrays are assembling, cone cells do not possess
      conventional centriole-containing centrosomal microtubule-organizing centers. The
      microtubules are associated with plasma membrane-associated plaques at both the
      apical and basal surfaces. During assembly of the arrays there is a progressive
      decrease in the number of microtubules/cell cross section at successively lower
      levels in each cell which is indicative of apicobasal microtubule elongation. In
      this respect, assembly of the arrays closely resembles that of transcellular 15
      protofilament microtubules in late pupal wing cells (Mogensen et al. J. Cell
      Biol. 108, 1445-1452 (1989)). However, cone cell microtubules are almost
      certainly of the 13 protofilament variety as found in eukaryotic cells generally.
      We suggest that plasma membrane-associated microtubule-organizing centers are
      widely employed in polarized epithelia in Drosophila during late pupal
      morphogenesis.

PMID- 8462603
TI  - Characteristic and differential calcium signals from cell structures of the root
      cap detected by energy-filtering electron microscopy (EELS/ESI).
AB  - Characteristic calcium signals were analyzed in structures of three cell types of
      the root cap of cress: statocytes, meristematic cells and secretion cells. Twenty
      four hour-old roots were fixed with glutaraldehyde (postfixed with
      osmiate/potassium bichromate) or with potassium permanganate. No visible
      precipitates were formed, but calcium signals typical for different cell
      structures could be detected by means of energy-filtering transmission electron
      microscopy (EELS/ESI). In statocytes, calcium signals were recorded from the
      plasma membrane, the membranes of the endoplasmic reticulum, the amyloplast
      envelope and the mitochondrial membranes. In contrast to the excitable
      statocytes, the two other, non-excitable cell types, meristematic and secretion
      cells, exhibited much lower intensities of the calcium signals recorded from the
      same membrane systems. The revealed characteristic calcium-related properties of
      the different membrane systems may be related to the special function of
      statocytes, namely transduction of the gravity stimulus. In all three cell types,
      additional calcium signals were recorded from cell structures with well known
      calcium contents, i.e., mitochondrial granules, starch grains and cell walls. For
      the first time, clear calcium signals were detected from the lipid bodies which
      are mobilized during the developmental stage of the examined roots. It is
      supposed that free fatty acids and lipases are the binding sites for calcium. The
      reliability of the applied method is especially proven by comparison of the
      electron microscopic images from lipid bodies according to the two different
      fixation methods. After glutaraldehyde fixation followed by osmiate/potassium
      bichromate postfixation, the lipid bodies were well fixed and appeared
      homogeneously grey with homogeneous calcium signals. However, due to potassium
      permanganate fixation the lipid bodies were only partly fixed; they had an
      electron-lucid core, from which the lipids are lost during the dehydration
      procedure, without calcium signals and an electron-dense border zone, which is a
      reaction product of potassium permanganate with triacylglycerols, with calcium
      signals.

PMID- 8462604
TI  - Criteria for labelled meals for gastric emptying studies in nuclear medicine.

PMID- 8462605
TI  - Pregnancy after high therapeutic doses of iodine-131 in differentiated thyroid
      cancer: potential risks and recommendations.
AB  - Seventy female patients who had been treated with high doses of iodine-131 for
      differentiated thyroid cancer (DTC) and who had a subsequent pregnancy were
      evaluated. The total 131I dose ranged from 1.85 to 16.55 GBq (mean +/- SD = 4.39
      +/- 25.20 GBq). Age at first therapy ranged from 15 to 36 years (mean +/- SD =
      24.3 +/- 5.0 years) and the interval from 131I therapy to pregnancy varied from 2
      to 10 years (mean +/- SD = 5.3 +/- 2.8 years). The estimated radiation dose to
      the gonads ranged from 10 to 63 cGy (mean +/- SD = 24.0 +/- 13.5 cGy). All
      patients were treated with L-thyroxine at doses capable of suppressing thyroid
      stimulating hormone. Seventy-three children were followed-up and seven
      pregnancies are still in progress. One child was affected by Fallot's trilogy and
      three had a low birth weight through with subsequent normal growth; the others
      were healthy with subsequent normal growth. No newborn with clinical or
      biochemical thyroid dysfunctions was found. Two spontaneous abortions during the
      second month of pregnancy were recorded. One of two patients in question
      subsequently had two healthy children. On the basis of these data, previous
      administration of high 131I doses does not appear to be a valid reason for
      dissuading young female DTC patients from considering pregnancy. However,
      patients should be advised to avoid pregnancy after 131I administration for a
      period sufficient to ensure complete elimination of the radionuclide and to
      permit confirmation of complete disease remission, i.e. at least 1 year in our
      opinion.

PMID- 8462606
TI  - Comparison of simultaneous 99mTc-HMPAO and 111In oxine labelled white cell scans
      in the assessment of inflammatory bowel disease.
AB  - Forty-seven patients, 29 with chronic inflammatory bowel disease (IBD) and 18
      with presumed irritable bowel syndrome, including one with uncomplicated
      diverticular disease, were studied with simultaneous technetium-99m
      hexamethylpropylene amine oxime and indium-111 oxine labelled leucocyte scans
      performed at 1, 3 and 24 h. Twenty-seven patients with IBD had active disease as
      judged by clinical and laboratory criteria and all of these had positive scans
      with both agents. No false positive studies were obtained. The 1-h 99mTc-HMPAO
      WBC scans showed the same distribution to disease as the 3-h 111-In WBC scans,
      with no difference in intensity (P < 0.92); they showed more extensive disease (P
      < 0.02) and more intense uptake (P < 0.001) than did the 1-h 111-In scans. The 3
      h 99mTc-HMPAO WBC scans showed more extensive disease (P < 0.002), with greater
      intensity (P < 0.0005), than did the 3-h 111In WBC scans. Physiological bowel
      activity on 3-h 99mTc-HMPAO WBC scans was present in 12 patients but was faint
      and did not interfere with assessment of disease extent and activity. It is
      concluded that in terms of isotope availability, radiation dosimetry and image
      quality, 99mTc-HMPAO is the agent of choice in detecting active IBD, with
      localization of disease possible at 1-h after re-injection and optimal resolution
      and definition of disease extent at 3 h. A negative scan reliably excludes active
      disease.

PMID- 8462607
TI  - Evaluation of white cell scintigraphy using indium-111 and technetium-99m
      labelled leucocytes.
AB  - Indium-111 oxine labelled leucocyte (111In oxine leucocyte) scintigraphy is the
      test of choice in detecting occult infection and localising focal inflammation.
      111In oxine labelling is technically difficult and expensive and leucocyte
      labelling with technetium-99m stannous colloid (99mTc Sn colloid) has been
      considered to be an alternative. Leucocytes from 40 cases referred for
      investigation of occult infection or localisation of inflammation were
      simultaneously labelled with 111In oxine and 99mTc Sn colloid with dual isotope
      acquisition performed at 1, 3 and 24 h. Twenty-four hour 99mTc Sn colloid scans
      were corrected for 111In downscatter. Each case was independently interpreted by
      two experienced observers. Twenty-one patients demonstrated positive 111In oxine
      leucocyte scans. Using 111In oxine leucocyte scans as the gold standard, 99mTc Sn
      colloid leucocyte scanning had an overall sensitivity of 86% and a specificity of
      95%. Clinical follow-up verified that three patients had false negative 99mTc Sn
      colloid leucocyte scans and one patient had a false positive. Further clinical
      evaluation of 99mTc Sn colloid labelled leucocytes is required before they can
      become a reliable replacement for 111In oxine leucocytes.

PMID- 8462608
TI  - Sympathetic innervation of the left ventricle is impaired in arrhythmogenic right
      ventricular disease.
AB  - Arrhythmogenic right ventricular disease (ARVD) is a disease of unknown origin
      that primarily affects the right ventricle and is characterized by ventricular
      tachyarrhythmias which may lead to syncope and even, though rarely, sudden
      cardiac death. In 25 patients with ARVD, sympathetic innervation of the left
      ventricle was assessed by iodine-123 metaiodobenzylguanidine single photon
      emission tomography (123I-MIBG SPET). In addition, thallium-201 SPET was
      performed. The diagnosis of ARVD was made by an electrophysiological study and
      right and left heart catheterization including right ventricular endomyocardial
      biopsy. Ischaemic heart disease was excluded by coronary angiography. A group of
      seven patients without any evidence of heart disease served as a control group.
      Twenty-two of the 25 patients showed reduced uptake of 123I-MIBG. The abnormal
      areas were located predominantly in posterior and posteroseptal segments of the
      heart. No focus of increased 123I-MIBG activity could be demonstrated. No patient
      had signs of left ventricular involvement on left ventricular angiography. In
      contrast to the results of the 123I-MIBG SPET, those of 201T1 SPET were normal in
      16 patients. The remaining nine patients showed areas of slight hypoperfusion not
      correlated with the reduced 123I-MIBG uptake. 123I-MIBG scintigraphy allows
      detection of left ventricular adrenergic dysinnervation in ARVD patients without
      morphological or functional abnormalities of the left ventricle.

PMID- 8462609
TI  - Prospective evaluation of thallium-201 reinjection in single-vessel coronary
      patients undergoing coronary bypass surgery.
AB  - Twenty-two patients with single-vessel left anterior descending coronary artery
      disease were investigated by means of dipyridamole stress thallium-201 myocardial
      perfusion scintigraphy, using single photon emission tomography (SPET), 1 week
      before and 2-5 weeks after coronary bypass surgery. The dose of dipyridamole was
      0.56 mg/kg, and the injected activity of 201Tl was 74 MBq. Before surgery, and
      after completion of the redistribution study, a further 37 MBq of 201Tl was
      injected. Ten minutes and 1 h later, repeated SPET imaging were performed. SPET
      images were evaluated both subjectively and semiquantitatively, using a five
      grade segmental defect score system, with higher scores for more severe perfusion
      defects. Before surgery, the 3-h redistribution images revealed complete or
      partial persistence of the perfusion defects in all patients. On the images taken
      10 min after reinjection, these defects were completely filled in four cases, and
      partially filled in ten cases. Further positive changes were observed on the 1-h
      post-reinjection images in four cases. Three of the 1-h post-reinjection images
      exhibited a paradox redistribution. The stress images after surgery corresponded
      well to the 201Tl distribution on the preoperative 1-h post-reinjection images in
      11 cases. The average of the segmental defect severity scores was 17.0 after
      stress, 10.1 at rest, 7.1 10 min after reinjection and 6.4 1 h after reinjection.
      After surgery, the average of both the post-stress and the 3-h redistribution
      scores was 3.1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462610
TI  - Myocardial scintigraphy with thallium-201 and technetium-99m-hexakis
      methoxyisobutylisonitrile in left bundle branch block: a study in patients with
      and without coronary artery disease.
AB  - In left bundle branch block (LBBB) thallium-201 myocardial scintigraphy
      frequently reveals septal abnormalities in the absence of coronary artery disease
      (CAD) and gives rise to "false-positive" results in patients with suspected CAD.
      It has not yet been clarified which pathophysiological mechanism is responsible
      for these perfusion abnormalities. A total of 66 patients with constant LBBB were
      investigated with 201Tl or technetium-99m-hexakis-methoxyisobutylisonitrile
      (MIBI), 62 underwent coronary angiography. Of 12 patients without left anterior
      descending artery (LAD) or right coronary artery (RCA) stenoses, 11 had a
      reversible septal activity deficit after 201Tl stress injection, whereas 20 of 22
      patients without relevant CAD showed a constant stress/rest septal deficit using
      MIBI. Regarding patients with significant LAD and/or RCA stenoses, both radio
      pharmaceuticals almost always showed a "reversible" septal deficit: with 201Tl in
      15 of 16 individuals and with MIBI in 14 of 15. In 12 patients 201Tl was
      reinjected at rest. In those who had LAD or RCA stenoses (n = 5), early septal
      activity uptake after stress injection was poorer than that after rest injection;
      in the absence of CAD (n = 7), septal stress uptake corresponded with that of
      rest injection. It is concluded that septal perfusion abnormalities in LBBB and
      the absence of CAD are characterized by an exercise-independent reduction of
      septal blood flow per mass of viable myocardium and that stress/rest injection
      protocols of myocardial perfusion tracers are able to differentiate between LBBB
      with and without CAD.

PMID- 8462611
TI  - Beta-oxidation of 1-[14C]-17-[131I]-iodo-heptadecanoic acid following
      intracoronary injection in humans results in similar release of both tracers.
AB  - Radioiodine labelled 17-iodo-heptadecanoic acid (IHA) is used for non-invasive
      study of myocardial metabolism in coronary heart disease and cardiomyopathy. Yet
      in the interpretation of in vivo myocardial tracer kinetics, it is controversial
      whether the intracellular degradation of IHA or the removal of iodide across
      cellular membranes is the rate-limiting step in iodide release from the
      myocardium. In five patients undergoing coronary sinus catheterization, a mixture
      of about 40 kBq of [123I] NaI was injected into the left coronary artery. During
      the following 15-min period, frequent blood samples were taken from the aorta and
      the coronary sinus. In the aqueous phase of the venous blood, 14CO2 and inorganic
      131I appeared nearly in parallel, with a peak time of 4-5 min. Moreover, as shown
      by the AV difference, there was no significant back diffusion of IHA and no
      significant non-specific deiodination detectable over the period of observation.
      There was myocardial retention of inorganic iodide (123I) injected into the left
      coronary artery. The data strongly support the premise that lipid turnover
      through beta-oxidation is the rate-limiting step in the externally measured
      release of iodide after IHA injection, provided that recirculating inorganic
      radioactive iodide is corrected for. In addition, 15 volunteers were studied
      using [11C]palmitic acid and [123I]IHA using PET and dynamic planar camera
      scintigraphy with iodide correction. There was no significant difference between
      the mean values of the elimination half-times, and also no significant
      correlation between half-times of both fatty acids for single individuals.

PMID- 8462612
TI  - Oxidative metabolism in the myocardium in normal subjects during dobutamine
      infusion.
AB  - To assess the biventricular response of the clearance rate of carbon-11 acetate
      as an index of myocardial oxidative metabolism to increase in work-load, dynamic
      positron emission tomography was performed at rest and during dobutamine infusion
      in 14 normal subjects. The clearance rate constant (Kmono) of the left
      ventricular (LV) myocardium increased during dobutamine infusion (0.112 +/- 0.020
      min-1 vs 0.065 +/- 0.015 min-1 at rest) (P < 0.001) in proportion to the increase
      in the pressure-rate product. Kmono in the right ventricular (RV) myocardium also
      increased (0.080 +/- 0.018 min-1 vs 0.034 +/- 0.013 min-1 at rest) (P < 0.001),
      with an excellent correlation with the LV Kmono (r = 0.920). The fact that the
      increase in RV Kmono during dobutamine infusion was greater (158% +/- 81%) than
      that in LV Kmono (79% +/- 39%) (P < 0.005) indicates a greater increase in
      oxidative metabolism in the RV in response to inotropic stimulation in normal
      subjects.

PMID- 8462613
TI  - N-(2-diethylaminoethyl)-4-[123I]iodobenzamide as a tracer for the detection of
      malignant melanoma: simple synthesis, improved labelling technique and first
      clinical results.
AB  - In order to evaluate the behaviour of N-(2-diethylaminoethyl)-4
      [123I]iodobenzamide in malignant melanotic disease, we synthesized the bromo
      compound in a simple one-step reaction. Labelling was performed by non-isotopic
      bromine-iodine-123 exchange in radiochemical yields up to 60%. By means of
      isocratic high-performance liquid chromatography, the iodinated product could be
      isolated with high apparent specific activity. First clinical studies in patients
      with malignant melanoma using N-(2-diethylaminoethyl)-4-[123I]iodobenzamide
      showed moderate uptake of the tracer in the tumour and the suspected metastases
      in all patients. Most of the lesions were detectable with technetium-99m
      diethylene triamine penta-acetic acid (DTPA) scintigraphy too, but we were able
      to detect additional, previously unidentified metastases with benzamide
      scintigraphy. This changed the therapeutic procedure in two of the five cases
      investigated so far.

PMID- 8462614
TI  - Determination of the technetium-99m mercaptoacetyltriglycine plasma clearance in
      children by means of a single blood sample: a multicentre study. The Paediatric
      Task Group of the EANM.
AB  - A multicentre European study was undertaken in order to determine a reasonable
      algorithm allowing the determination of overall technetium-99m
      mercaptoacetyltriglycine clearance using a single blood sample. Employing
      multiple blood sample clearance as a reference method, it was shown that an
      acceptable estimation of the MAG3 renal clearance could be obtained using a blood
      sample taken at any time between 30 and 40 min after tracer injection. After
      correction for body surface area, comparison of clearance determined using (a)
      the single blood sample and (b) the multiple blood samples provided a coefficient
      of correlation of 0.949 and an SEE of 27 ml/min. This algorithm is valid for
      clearance values higher than 100 ml/min/1.73 m2 and for children older than 1
      year of age.

PMID- 8462615
TI  - Verification of the integral transformation of the projections technique for
      scatter correction in positron tomographs.
AB  - A scatter correction algorithm, based on the integral transformation of the
      projections, has been implemented when using the C.N.R. positron tomograph in
      Pisa. The performance of the method has been evaluated by measurements on ad hoc
      phantoms. The technique allows a significant average reduction of the
      reconstructed scatter fraction. The limitations of this approach have also been
      investigated.

PMID- 8462616
TI  - A simple scintigraphic method for continuous monitoring of gastric emptying.
AB  - A new and simple scintigraphic method for the measurement of gastric emptying was
      developed and validated. The test meal consists of 200 g potato mash mixed with
      0.5 g Dowex 2X8 particles (mesh 20-50) labelled with 37 MBq (1 mCi) technetium
      99m. After ingestion of the meal, sequential dynamic 15-s anteroposterior
      exposures in the supine position are obtained for 90 min. A second recording
      sequence of 20 min is added after a 30-min interval. The results can be displayed
      as immediate cine-replay, as time-activity diagrams and/or as activity retention
      values. Complicated mathematical fittings are not necessary. The method lends
      itself equally to the testing of in- and outpatients.

PMID- 8462617
TI  - Highlights of the annual meeting of The European Association of Nuclear Medicine,
      Lisbon 1992. How to increase the impact of nuclear medicine on clinical decision
      making.

PMID- 8462618
TI  - The use of SEP-PAK SI cartridges for the preparation of gallium chloride from the
      citrate solution.

PMID- 8462619
TI  - Lack of relationship between hip and spine bone mineral density and oral
      contraceptive use.
AB  - The aim of this study was to examine the relationships between oral contraceptive
      use and bone mineral density at the hip and spine. Community based women aged 41
      76 years (n = 841) were recruited from four general practices in Cambridge. Each
      subject completed a health questionnaire. Spine (L2-L4, n = 841) and hip (n =
      833) bone mineral density were measured by dual energy X-ray absorptiometry using
      the Hologic QDR-1000. After adjustment for age, there was no significant
      difference in regional bone mineral density between ever and never users of oral
      contraceptives. Similar results were obtained after stratifying for potential
      confounding factors including menopausal status, parity, smoking, hormone
      replacement therapy use, and body mass index. There was no relationship between
      duration of oral contraceptive use and bone mineral density. These results
      suggest that there is no relationship between oral contraceptive use and bone
      mineral density at the hip and spine in middle-aged women.

PMID- 8462620
TI  - Very long chain n-3 and n-6 polyunsaturated fatty acids inhibit proliferation of
      human T-lymphocytes in vitro.
AB  - The effect of marine n-3 polyunsaturated fatty acids on proliferation of human T
      cells in vitro was compared to other polyunsaturated, monounsaturated and
      saturated fatty acids. Monoenes and saturated fatty acids had little effect on T
      cell proliferation. Eicosapentaenoic acid and docosahexaenoic acid exerted a
      strong dose-dependent inhibitory effect on proliferation of mitogen- or antigen
      stimulated T-cells, similar to that observed for arachidonic acid. Sixty microM
      of albumin-bound eicosapentaenoic acid or arachidonic acid promoted 25-40%
      inhibition of proliferation of T-cells stimulated with mitogen, whereas the same
      concentration of albumin-bound docosahexaenoic acid promoted 60% inhibition. When
      epidermal cells (Langerhans cells) were used as antigen-presenting cells, 100
      microM of albumin-bound eicosapentaenoic acid or arachidonic acid caused 40%
      inhibition on T-cell proliferation. Low density lipoprotein (LDL), isolated after
      four months of dietary intake of fish oil or corn oil, inhibited mitogen
      stimulated T-cell proliferation in a dose-dependent manner. Fish oil- and corn
      oil-enriched LDL showed similar ability to inhibit T-cell proliferation.
      Epidermal cells preincubated with docosahexaenoic acid, and extensively washed
      before adding purified T-cells and antigen, resulted in a strong inhibition of T
      cell proliferation, whereas preincubation of purified T-cells with
      docosahexaenoic acid did not cause any inhibitory effect. Cyclooxygenase and
      lipoxygenase inhibitors (indomethacin, acetylsalicylic acid, nordihydroguaertic
      acid) did not affect the antiproliferative effect of eicosapentaenoic acid and
      arachidonic acid, neither did the antioxidants butylated hydroxytoluene or alpha
      tocopherol. Eicosanoids, (PGE2, PGE3, LTB4, LTB5 and lipoxin A or lipoxin B)
      added directly to mitogen-stimulated peripheral blood mononuclear cells (PBMC)
      did not influence T-cell proliferation significantly. Decreased viability was
      observed when mitogen-stimulated lymphocytes were cultured with essential
      polyunsaturated fatty acids, whereas the viability of unstimulated lymphocytes
      was hardly influenced by the same fatty acids. We conclude that; (a)
      pharmacological albumin-bound concentrations of the highly unsaturated fatty
      acids eicosapentaenoic acid and docosahexaenoic acid promote a strong
      antiproliferative effect on mitogen- and antigen-stimulated human T-cells: (b)
      docosahexaenoic acid can suppress accessory cell function and consequently
      suppress T-cell activation; (c) physiologic concentration of LDL particles rich
      in n-3 and n-6 fatty acids, both promote a dose-dependent antiproliferative
      effect on mitogen-stimulated PBMC; (d) the inhibition is independent of
      eicosanoid metabolites; and (e) lipid peroxidation seems unlikely to be
      responsible for the antiproliferative effect.

PMID- 8462621
TI  - Reverse cholesterol transport: relationship between free cholesterol uptake and
      HDL3 in normolipidaemic and hyperlipidaemic subjects.
AB  - High density lipoproteins (HDL) are responsible for the Reverse Cholesterol
      Transport (RCT). The role of the composition of the HDL particle in RCT,
      involving free cholesterol (chol) uptake from cell membranes, is not completely
      understood. We have therefore studied the uptake capacity from subjects with a
      wide variety of plasma HDL cholesterol concentrations in an HDL-receptor free
      model consisting of bovine heart mitochondrial membranes labeled with
      [14C]cholesterol. HDL were isolated by molecular sieve chromatography from fresh
      plasma samples of eight subjects with low plasma HDL chol concentrations (< or
      equal to 1.0 mmol L-1) and 15 subjects with normal HDL chol concentrations. The
      latter were subdivided into an intermediate (HDL chol: 1.0-1.4 mmol L-1; n =9)
      and a high HDL chol group (> or equal to 1.4 mmol L-1; n = 6). In the HDL
      fractions isolated by chromatography (cHDL), total chol and apolipoprotein (apo)
      AI were measured. Free chol uptake was significantly decreased by 32% in the
      tertile with the lowest plasma HDL chol (49.1 +/- 15.8 arbitrary units; mean +/-
      SD), compared to the tertile with high HDL chol (72.1 +/- 16.6 au). Linear
      regression analysis showed a positive correlation between the free chol uptake
      and plasma HDL3 concentrations (r = 0.61; P < 0.01), HDL chol (r = 0.56; P <
      0.01), HDL associated apo AI (R = 0.46; P < 0.05), cHDL apo AI (r = 0.56; P <
      0.05) and cHDL chol (r = 0.46; P < 0.05) in all subjects combined. Stepwise
      multiple-regression analysis confirmed the association of [14C] cholesterol
      uptake with plasma HDL3 concentrations (beta, 0.61; P = 0.004). No correlations
      were found between free chol uptake and total plasma apo AI (r = 0.26. ns) or
      HDL2 (r = 0.27; ns). After an oral fat load in four FCH patients, free chol
      uptake paralleled the changes in plasma HDL 3 chol concentrations. We conclude
      that HDL3 is involved in the early steps of RCT and low HDL 3 levels may result
      in less efficient RCT in hypertriglyceridemia.

PMID- 8462622
TI  - Accumulation of iron in erythroblasts of patients with erythropoietic
      protoporphyria.
AB  - We have studied the iron metabolism in nine patients with erythropoietic
      protoporphyria (EPP) and three patients with sideroblastic anaemia (SA). All,
      except one EPP patient were iron deficient. The SA patients had a secondary
      haemochromatosis. The bone marrow aspirates of patients with SA and also three
      patients with EPP had a high incidence of ring sideroblasts. Ultrastructural
      examination of the bone marrow consistently showed finely dispersed electron
      dense deposits localized in mitochondria of erythroblasts in all patients with
      EPP and SA. Mitochondrial electron energy-loss spectroscopy (EELS) indicated
      identical iron compounds in erythroblasts of all EPP and SA patients. These
      findings indicate that the mitochondrial iron utilization is disturbed in EPP and
      SA. The observation of mitochondrial iron deposition in erythroblasts in EPP and
      SA suggests that this failure is not of pathognomonic value for diagnosis of SA,
      but is apparently the result of an inefficient haem synthesis, in EPP due to a
      defective ferrochelatase. The mitochondrial iron deposition does not depend on
      the iron status (iron overload or iron deficiency) of the EPP patient.

PMID- 8462623
TI  - Non-insulin dependent diabetes mellitus: defects in insulin secretion.
AB  - NIDDM is a heterogeneous disorder, characterized by defects in insulin secretion
      as well as in insulin action. Several pathophysiological mechanisms are involved
      in the development of disturbances in insulin secretion. One of the histological
      features of islets of NIDDM patients is the deposition of amyloid-like material.
      Accumulation of amyloid over many years can lead to slowly progressive disruption
      of islet architecture and possibly to some of the abnormalities in insulin
      secretion, as found in NIDDM patients. Loss of pulsatility is the earliest
      detectable abnormality of insulin secretion in the disease, either as a specific
      early defect or as a disturbance caused by minimally elevated blood glucose
      levels. Although it has been shown that maximum insulin release is decreased by
      50% in NIDDM, the B-cell sensitivity to glucose appears to be normal.
      Coregulatory factors such as prostaglandins do not play a major role in the
      derangements of insulin secretion in NIDDM. An imbalance between stimulatory and
      inhibitory endorphins, or in sympathetic tone may be of more importance.
      Hyperglycaemia by itself has a deleterious effect on insulin release, and may
      perpetuate the disturbances of insulin secretion.

PMID- 8462624
TI  - Vasoactive peptides in Bartter's syndrome.
AB  - Patients with Bartter's syndrome exhibit an increased vascular resistance to the
      pressor effects of angiotensin II and noradrenaline. Further, an increased
      production of vasodilating renal prostaglandins, perhaps mediating the vascular
      unresponsiveness, has been hypothesized in this syndrome based on high urinary
      prostaglandins. To determine whether different peptides might contribute to blood
      pressure control in this syndrome, the basal immunoreactive plasma levels of an
      array of vasoactive peptides and catecholamines were analysed in six patients
      with Bartter's syndrome. Among the vasoconstrictors analyzed, the mean plasma
      levels of noradrenaline (NA), adrenaline (A) and neuropeptide Y-like
      immunoreactivity (NPY-LI) were significantly increased as compared to healthy
      subjects (P = 0.030, 0.046 and 0.001, respectively). The plasma level of the
      vasodilator substance P (SP-LI) was also higher in these patients (P = 0.057).
      These results indicate that in Bartter's syndrome the vasoconstrictive effect of
      catecholamines and angiotensin II may be enhanced by concomitant NPY release.
      Whether a release of the vasodilator substance P is an independent mechanism or
      represents a reflex response to the increased secretion of angiotensin II,
      catecholamines and/or NPY remains to be established. However, the significance of
      these biochemical findings for blood pressure maintenance in Bartter's syndrome
      remains to be settled.

PMID- 8462625
TI  - Diabetes mellitus induces accelerated growth of aortic smooth muscle cells:
      association with overexpression of PDGF beta-receptors.
AB  - The mechanism of diabetic macroangiopathy was studied from the view point of
      phenotypic change of aortic smooth muscle cells (SMC). The growth rates of
      cultured SMC of diabetic rats or rabbits were higher than those of non-diabetic
      animals (controls). This difference of the growth responses was observed
      specifically with platelet-derived growth factor (PDGF). Of the three PDGF
      dimers, PDGF-AB heterodimer (PDGF-AB) and PDGF-BB homodimer (PDGF-BB) stimulated
      growth of diabetic SMC more than that of control SMC but PDGF-AA homodimer (PDGF
      AA) did not. The binding of 125I-PDGF to the diabetic SMC was greater than that
      to control SMC. This was due to increase in the number of cell surface receptors
      for PDGF. On in vitro culture, SMC from diabetic rats expressed more PDGF beta
      receptor mRNA than SMC from non-diabetic rats. Moreover, in vivo, the aortic
      media of diabetic rabbits expressed PDGF beta-receptor mRNA, but that from non
      diabetic rabbits did not. Thus diabetic SMC over-react on PDGF stimulation
      through over-expression of the PDGF beta-receptor gene. The significance of this
      fact in development of diabetic macroangiopathy is discussed.

PMID- 8462626
TI  - Fc-gamma receptor III shedding by polymorphonuclear cells in primary Sjogren's
      syndrome.
AB  - A sandwich enzyme-linked immunosorbent assay was developed to assess Fc-gamma
      receptor III (Fc gamma RIII), based on a combination of two non-competing
      monoclonal antibodies. This receptor was detectable in the serum of eight out of
      23 patients with primary Sjogren's syndrome and two out of 23 normal controls.
      The proportion of Fc gamma RIII-carrying polymorphonuclear (PMN) cells was lower
      (P < 0.05) in the patients with cell-free Fc gamma RIII (90.4 +/- 7.5%) than in
      the remainder (84.8 +/- 8.3%). The PMN cell functions were evaluated and the
      diminished adherence (71.7, geometric mean) and chemotaxis (1.23) paralleled the
      Fc gamma RIII release. The relative inefficiency of PMN cells in SS might be due
      to phagocytosis of immune complexes.

PMID- 8462627
TI  - Studies on coprophagy in experimental animals.

PMID- 8462628
TI  - [Diurnal rhythms in locomotor activity of the house musk shrew, Suncus murinus].
AB  - A diurnal rhythm of locomotor activity in male and female house musk shrews
      (Jic:SUN) aged approximately one year was observed under a schedule of 12 hr
      light and 12 hr darkness (light on at 07:00) over a period of 10 days. In
      general, the pattern of locomotor activity was similar in both sexes, with around
      24-hr diurnal rhythm. A few typical patterns of locomotor activity in these
      animals were as follows: A. Locomotion interval was close in the light phase,
      while was sparse in the dark phase. B. As opposed to the pattern of A, locomotion
      interval was close in the dark and sparse in the light phases. C. Its interval
      remains stationary through a whole day.

PMID- 8462629
TI  - Hereditary hydronephrosis in C57L/MsNrs mice.
AB  - Inbred C57L/MsNrs mice (66 males and 72 females) maintained at the National
      Institute of Health, Japan, were examined grossly for hydronephrosis. Unlike the
      hydronephrotic strains of mice reported so far, C57L mice showed no sex-related
      difference in the incidence (62% in males and 75% in females; P > 0.05) and
      severity of hydronephrosis. The right kidney was more severely affected than the
      left kidney in both sexes. Age appeared to have no influence on the incidence.

PMID- 8462630
TI  - Morphological studies on the bone and cartilage of laboratory animals.

PMID- 8462631
TI  - Effects of p-chloroamphetamine (PCA) on ejaculation in aged rats.
AB  - In general, sexual activity in normal animals declines with increasing age. In
      aged male rats, for example, no ejaculation occurs when paired with receptive
      females. The ejaculatory response induced by p-chloroamphetamine (PCA) in aged
      adult rats, 14 to 18 months of age, was observed. The animals were treated
      intraperitoneally with PCA. The ejaculation rates were 0.28.6, 57.1 and 100% at
      doses of 0.3125, 0.625, 1.25 and 2.5 mg/kg, respectively. These animals, with a
      few exceptions, showed an ejaculation within 2 hrs of PCA injection. These data
      for aged adults are similar to those for young adults.

PMID- 8462632
TI  - A new method for the long-term collection of the bile from the unrestrained
      rabbit.
AB  - A method for the long term bile collection of the unrestrained rabbit was
      developed. A steel needle was tunneled subcutaneously from the dorsum of the neck
      to the abdomen of the animal. A catheter was threaded through this needle from
      the dorsum and brought out below the abdomen. The catheter was introduced into
      the common bile duct and the tip on the dorsum was passed through a steel
      protective coil which was attached to the dorsal skin. This method allows the
      animal to move freely in the metabolic cage. The bile of the unrestrained rabbit
      weighing 3.7 kg was collected for 120 hr at 8.9-10.2 ml per hour of the output
      rate.

PMID- 8462633
TI  - Isolation of Salmonella from impounded dogs introduced to a laboratory.
AB  - Isolation of Salmonella from the feces of impounded dogs was carried out to make
      clear the recent microbiological condition of dogs introduced into our
      facilities. Salmonella was isolated from 10 out of 283 samples (3.5%).
      Inparticular, during the first week after introduction, Salmonella was isolated
      from nine out of 74 dogs (12.2%). The isolation rate during the first week after
      introduction was significantly higher than that for dogs introduced later. No
      isolates were detected from dogs reared for more than 3 weeks after introduction.
      This study indicates that impounded dogs had the highest risk of infecting a
      person with Salmonella during the first week after introduction into our
      laboratory animal facilities, and that we need to pay attention to this fact when
      handling them.

PMID- 8462634
TI  - [Immunohistochemical and morphometric studies on the development of the thyroid,
      parathyroid and ultimobranchial body in Xenopus laevis Daudin].
AB  - The development of the thyroid, parathyroid and ultimobranchial body was examined
      by immunohistochemistry and morphometric analysis in the larvae of Xenopus laevis
      Daudin from the time immediately after hatch to the end of metamorphosis. The
      thyroid appeared at stage 43 and began to secrete thyroglobulin from stage 47/48.
      Both the volume of the thyroid and the height of the follicular epithelium
      reached the peak at stage 61 and decreased thereafter towards the end of
      metamorphosis at stage 66. The parathyroid first appeared at stage 43 as the
      thickening of the wall of the third and fourth visceral pouch. The volume of the
      parathyroid gradually increased with the progress of development until the end of
      metamorphosis. The ultimobranchial body appeared at stage 45 as a recess of the
      epithelium lining the floor of the pharynx. It became follicular in the structure
      at stage 53. Its volume reached the peak at stage 61 and decreased thereafter
      towards the end of metamorphosis. Calcitonin-immunoreactive cells first appeared
      in the ultimobranchial body at stage 47/48, showed the most intense reaction at
      stage 59, and rapidly decreased in number thereafter towards the end of
      metamorphosis.

PMID- 8462635
TI  - [Diurnal fluctuations of heart rate and locomotive activity in the vole (Microtus
      arvalis)].
AB  - Diurnal fluctuations of heart rate and locomotive activity were observed in the
      unanesthetized and unrestrained voles (Microtus arvalis) and mice, and the
      differences in these biological characters between voles and mice were also
      investigated. The mean heart rate of vole in whole day was lower than that of
      mice. In voles, there were no significant differences in the mean heart rate
      between in light period and in dark period. It was observed that most of voles
      were active in not only dark period but light period. On the other hand, in mice,
      the mean heart rate in dark period was significantly higher than that in light
      period, and the nocturnal habit was shown obviously in the locomotive activity.
      In voles, the ultradian rhythmicities of 95-210 min in the heart rate and those
      of 160-210 min in the locomotive activity were recognized, and the fluctuations
      of heart rate due to ultradian rhythmicity in voles exceeded the difference
      between the heart rate in light period and that in dark period. In mice, one of
      three animals showed the ultradian rhythmicity of 85 min in the fluctuation of
      heart rate. Diurnal fluctuation of the heart rate in voles consisted of the two
      patterns which the peaks of heart rate were coincident with the active period or
      the resting period. However, all the peaks of heart rate in mice were coincident
      with the active period. These results suggested that the fluctuations of heart
      rate in voles were dependent on ultradian rhythmicities in addition to the
      circadian rhythmicities.

PMID- 8462636
TI  - Morphometric profiles of the mandible of SMXA recombinant inbred strains of mice
      and strain identification on the basis of mandible measurements.
AB  - SMXA recombinant inbred (RI) strains were derived from the F2 generation of a
      cross between two progenitor inbred strains, A/J and SM/J, which differ
      considerably with respect to many characters. In order to determine the
      morphometric profiles of the mandible of SMXA RI strains and to identify these
      strains, principal component and discriminant analyses (mandible analysis) were
      carried out using 11 mandible measurements. Principal component analysis revealed
      that the mandibles of each strain have their own characteristic size and shape.
      The RI strains, however, were roughly divided into 15 groups based on the
      morphometric profile of their mandibles. Discriminant analysis showed the
      probability of erroneous discrimination to be 6.49% (20/308) for the males and
      8.06% (27/335) for the females. In both sexes, most of the erroneous
      discrimination (13 in the male, 17 in the female) occurred between RI strains
      having comparatively similar morphometric profiles. This suggested that all of
      the SMXA RI strains examined could be regarded as genetically homogeneous within
      each strain.

PMID- 8462637
TI  - Lung free cells following short-term inhalation of coal fly ash particles in
      golden hamsters.
AB  - Male golden hamsters were exposed to coal fly ash (FA) at the concentration of 2
      or 5 mg/m3 for 10 days (20 hr/day, Experiment 1) or 5 mg/m3 for 4 weeks (10
      hr/day, 7 days/week) and maintained in clean air condition for subsequent 4 weeks
      (Experiment 2) to investigate the effect on the induced changes of lung free
      cells. Free cells were collected by lung lavage in Exp. 1 and histologically
      examined in lung sections in Exp.2. In Exp. 1 the number of alveolar macrophages
      (AMs) increased in a dose-dependent manner. In Exp. 2 AMs increased till at 2
      weeks of exposure, while the subsequent increase did not occur. The ratio of
      particle-laden AMs increased in a dose- and time-dependent manner in each exposed
      group. Particle number ingested in AMs tended to increase with exposure time. In
      the recovery period in Exp. 2 the ratio of particle-laden AMs reduced from about
      80 to 20% at the 1st week after the cessation of exposure and remained at the
      similar level to the termination of the experiment. On the other hand decrease in
      the number of total AMs was slight in the recovery period. These results suggest
      that the pool size of AMs is mainly dependent on the inhaled dust concentrations
      and some of particle-laden AMs remain in alveoli for a long time. The number of
      polymorphonuclear leukocytes (PMNs) also increased after inhalation of FA
      particles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462638
TI  - [Antibody responses against Japanese cedar pollen allergen (Cry j I) in different
      strains of rats].
AB  - We established an IgE-capture ELISA for rat IgE antibody, and examined rat strain
      differences in the antibody responses against the major allergen of Japanese
      cedar pollen (Cry j I). First, IgE-capture ELISA and passive cutaneous
      anaphylaxis (PCA) method were compared. IgE-capture ELISA was found to be, in
      sensitivity, about 10 times higher than, and, in specificity, equal to, PCA.
      Second, seven strains of rat were immunized three times at days 0, 14 and 28 by
      intraperitoneal injections of 1 or 10 micrograms Cry j I mixed with 4 mg
      aluminium hydroxide gel. Anti-Cry j I IgE was detected by IgE-capture ELISA. Anti
      Cry j I IgG and IgM responses were found not significantly different among
      different strains, but IgE responses in Brown-Norway (BN) rat were about 10 times
      higher than in other strains of rats. These results suggest that BN rat may be a
      useful animal model for studying physiological and pathological changes in the
      nose after pollen challenge to that organ.

PMID- 8462639
TI  - [Effects of repeated restraint stress at 30-minute intervals during 24-hour on
      serum testosterone, LH and glucocorticoids levels in male Japanese monkeys
      (Macaca fuscata)].
AB  - We investigated effects of frequent blood collections under the compulsory
      restraints on serum testosterone, LH and glucocorticoids in adult male Japanese
      monkeys. Blood samples were withdrawn from three animals at 30-min intervals and
      two animals at 4-hr intervals during 24 hr. Serum testosterone and LH were
      measured by a radioimmunoassay, and glucocorticoids was determined by a
      competitive protein binding assay. Sampling at 4-hr intervals during 24 hr
      revealed diurnal changes in serum testosterone and glucocorticoids. Levels of
      testosterone were high throughout the night and low at the day time, conversely
      serum glucocorticoids were high levels in the morning and low in the evening. On
      the other hand, 30-min intervals sampling, serum testosterone levels decreased
      and glucocorticoids levels increased, respectively, immediately after the start
      of blood sampling. And then, low in testosterone and high in glucocorticoids
      levels were continually maintained. But serum LH levels had the pulsatile pattern
      and did not change markedly during 24 hr. After ACTH administration in five
      animals, serum glucocorticoids levels increased markedly and also testosterone
      levels increased slightly, but LH levels did not change. These data indicated
      that the every 30-min restraint stress caused the increment of glucocorticoids
      levels and the suppression of testosterone levels, but did not affect the serum
      LH levels. The increased glucocorticoids might inhibit the testicular
      steroidogenesis, without suppressing the LH secretion from the pituitary.

PMID- 8462640
TI  - [The change with age of the copulatory behavior of the male rats aged 67 and 104
      weeks].
AB  - Changes with age in sexual fertility in male rats of the Wistar-Imamichi strain
      were investigated. Litter size and numbers of implantation sites in females mated
      with males aged 14 to 44 weeks tended to decrease with increased aging of males.
      These indicators in females mated with males aged over than 44 weeks decreased,
      compared with that aged 14 to 44 weeks (P < 0.05 to 0.001). In addition, all
      females mated with males aged 95 weeks were not pregnant. In male copulatory
      behavior with aging, incidences and numbers of mounting at 67 and 104 weeks of
      age were 100%, 42.6 +/- 15.3 (Mean +/- S.D.) and 42%, 1.8 +/- 2.8, respectively.
      The intromission and ejaculation were observed at 67 weeks, but not at 104 weeks
      of age. These incidences and frequencies were 86%, 10.3 +/- 10.2 for
      intromission, and 43%, 1.0 +/- 1.3 for ejaculation. Mount latencies (ML) at 67
      and 104 weeks of age were 535.4 +/- 607.9 and 3,822.0 +/- 1,753.4 sec,
      respectively. There were significant differences in ML between two groups (P <
      0.05). At 67 weeks of age, intromission and ejaculation latencies, and post
      ejaculatory intervals were 2,563.0 +/- 2,216.3, 1,633.7 +/- 977.6, and 657.3 +/-
      320.6 sec, respectively. The pregnant rate and numbers of implantation sites in
      females mated with males aged 67 weeks were 43% and 5.4 +/- 6.8, respectively. In
      females mated with males aged 104 weeks, all were not pregnant. The weights of
      tests, epididymides, ventral prostate and seminal vesicles at 104 weeks were
      light, compared with those at 67 weeks of age (P < 0.05). From these results, the
      copulatory behavior in male rats of the Wistar-Imamichi strain declined with
      aging. Sexual fertility in males aged 67 weeks decreased in less than 50%, and
      males aged 104 weeks showed no intromission and ejaculation.

PMID- 8462641
TI  - Genetic polymorphisms of salivary proteins in the rat.
AB  - Two genetic polymorphisms of salivary proteins were found by polyacrylamide gel
      electrophoresis among inbred strains of rats. Both proteins (RSP-1 and RSP-2)
      were inherited as a single autosomal trait. The loci were designated as Rsp-1
      (rat salivary protein-1) and Rsp-2. Rsp-1 had two codominant alleles (Rsp-1a, Rsp
      1b), and Rsp-2 had two alleles (Rsp-2a, and Rsp-2b); Rsp-2a was dominant over Rsp
      2b. The Rsp-1 locus is not linked with the linkage groups (LGs) I, II, IV, V and
      the LGs containing Acp-2 and Pg-1. The Rsp-2 is not linked with the LGs I, II, V,
      X and the LGs containing Amy-1, Es-6 and Pg-1.

PMID- 8462642
TI  - Comparison of plasma endotoxin levels in germ-free, SPF and conventional
      laboratory animals (mice and rats).
AB  - Plasma endotoxin levels were examined in laboratory mice and rats sustained under
      germ-free (GF), SPF and conventional (CV) conditions. The values were 1.72 (GF
      mouse), 2.67 (SPF mouse), 2.44 (CV mouse), 2.05 (GF rat), 2.56 (SPF rat), and
      3.13 pg/ml (CV rat). The GF animals showed the lowest levels, followed by SPF and
      CV animals, in that order. When SPF animals were transferred into the
      conventional condition (conventionalization), the plasma endotoxin levels changed
      slightly, but not significantly. The present study demonstrates that the levels
      of plasma endotoxin in healthy laboratory animals are relatively stable and are
      not affected by microbiological conditions.

PMID- 8462643
TI  - [On the flank gland in Syrian hamsters].
AB  - The scent gland of Syrian hamsters is named the flank gland and thought to play
      an important role in the communication among individuals of the same species as
      in a few other rodents. In the present paper, the flank gland of Syrian hamsters
      of both sexes was macroscopically and histologically studied with special
      reference to the aging. This gland reached the plateau in size at 21 days of age
      in females, while it continued to develop until 70 days of age in males. Its
      shape was circular in adult females, and elliptical in adult males, respectively.
      Histologically, it was identified as the developing sebaceous glands with hair
      follicles in both sexes at 21 days of age. Thereafter, it gradually increased in
      size and number of lobules. It was always better developed in males than in
      females at each day examined in the present study, although there were no sex
      differences in its histological structure.

PMID- 8462644
TI  - [Comparison between the blood from orbital sinus and heart in analizing plasma
      biochemical values--increase of plasma enzyme values in the blood from orbital
      sinus].
AB  - Plasma biochemical values, blood urea nitrogen (BUN), glucose, aspartate
      aminotransferase (AST), lactate dehydrogenase (LDH) and creatine phosphokinase
      (CPK), were compared between the samples collected from orbital sinus, heart and
      tail vein in mice, rats and hamsters. The significant higher values of AST, LDH
      and CPK were shown in samples from orbital sinus as compared with that from other
      sites. The blood from orbital sinus was bleeding by two methods and compared in
      the plasma enzyme values. It is suggested that the leakages of these enzymes from
      destroyed ocular tissues result in the increase of the plasma enzyme values.

PMID- 8462645
TI  - A study on diurnal fluctuation of blood-aqueous barrier permeability to plasma
      proteins.
AB  - The diurnal change of blood-aqueous barrier permeability to protein molecules was
      investigated in 20 eyes of 10 normal volunteers. Simultaneous determinations of
      aqueous flow rate and the coefficient of entry into the anterior chamber (k(in))
      for plasma protein were performed at different times of the day: (a) 0800 to 1100
      hr; (b) 1900 to 2200 hr of the same day; (c) 0800 to 1100 hr of the next day; (d)
      1400 to 1700 hr 1 week later; and (e) 0200 to 0500 hr of the following morning.
      Aqueous flow rate was determined by fluorophotometry and k(in) was calculated for
      each period from flow rate, plasma protein concentration, anterior chamber volume
      and aqueous protein concentration measured with a laser flare-cell meter.
      Calculated values for k(in) did not fluctuate significantly among the periods,
      and there were no significant changes in anterior chamber volume or plasma
      protein concentration. Aqueous protein concentration and flow rate showed diurnal
      fluctuations, the patterns of which inversely corresponded to each other. It was
      concluded that permeability of the blood-aqueous barrier to protein remains
      fairly stable over a 24-hr period and the diurnal variation of aqueous protein
      concentration is mostly attributable to that of aqueous flow rate.

PMID- 8462646
TI  - Effects of ciliary ganglionectomy on contractile responses in the dilator muscle
      of the rat iris.
AB  - Effects of removing the ciliary ganglion (CGR) on contractile responses of the
      rat iris dilator muscle to agonists were examined and compared with those after
      removing the superior cervical ganglion (SCGR). Denervations were considered
      successful if the atropine or phentolamine-sensitive mechanical responses to
      transmural nerve stimulation were abolished. After CGR, muscle sensitivity to
      noradrenaline (NA) increased two to three times in terms of their ED50, whereas
      the ED50 for methoxamine did not change. The sensitivity of both the control and
      denervated dilator muscles to NA increased after treatment with 30 microM
      cocaine, and resulted in similar ED50s. The content of NA in the whole iris
      decreased by about 27% after CGR. Maximal responses of the dilator muscle to NA
      and 5-hydroxytryptamine were significantly increased by CGR, but decreased by
      SCGR. These results indicate that sympathetic post-ganglionic nerves running
      through the CG and short ciliary nerves contribute about 27% of the total
      sympathetic innervation of the iris region. The CGR, therefore, induced a small
      presynaptic supersensitivity specific to NA. The non-specific increase in the
      maximal responses to agonists after CGR may be attributable to a parasympathetic
      denervation since sympathectomy by SCGR decreased the maximal responses.

PMID- 8462647
TI  - Polylysine stimulated protein phosphorylation in rabbit ciliary processes: casein
      kinase activities.
AB  - Protein phosphorylation in response to polylysine was investigated in vitro in
      rabbit ciliary process homogenates by SDS-PAGE autoradiography. The degree of
      phosphorylation was greater in the soluble/cytoplasmic fraction than in the
      particulate fraction and was antagonized by heparin. Time and dose-dependent
      studies indicated several different kinetic patterns of
      phosphorylation/dephosphorylation among the approximately 15 significantly 32P
      labeled bands found in each fraction. These results are consistent with
      phosphorylation of endogenous substrates by casein kinase II, and
      dephosphorylations by type I and type II phosphoprotein phosphatase enzymes. The
      presence of EGF receptors in ciliary processes was indicated by high affinity (kD
      < 0.5 nM) binding sites and by intraocular pressure and blood-aqueous barrier
      responses to injection of low doses of EGF (100 ng per eye). EGF did not
      stimulate protein phosphorylation in ciliary process homogenates in vitro. The
      results show that casein kinase II is a significant kinase activity in ciliary
      processes and may have a modulatory role on signal transduction proteins involved
      in cellular response to hormones.

PMID- 8462648
TI  - Comparative studies on fatty acid composition and phospholipases A2 and C
      activities in rabbit and bovine iris-ciliary body.
AB  - It is well established that production of prostaglandins by ocular tissues is
      dependent upon the species. The rabbit iris-ciliary body produces greater amounts
      of prostaglandins than that of the bovine. To throw more light on the biochemical
      basis underlying these differences we have compared the fatty acid composition
      and phospholipases A2 and C activities in rabbit and bovine irides. When the
      concentration of arachidonic acid is expressed as % of total fatty acids,
      phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol, separated
      from rabbit iris phospholipids, contained 56, 38 and 18% more arachidonic acid,
      respectively, than those of the bovine. The total lipid phosphorus in rabbit and
      bovine iris-ciliary body were found to be 13.74 and 9.34 mumol g-1 wet tissue,
      respectively. Subcellular fractions, prepared from rabbit iris, contained 30-230%
      more phospholipase C activity than those of the bovine, and about 5-41 times
      higher phospholipase A2 activity than those of the bovine. In the rabbit iris
      microsomal fraction, phospholipase C activity is 33 times higher than that of
      phospholipase A2. However, the data presented suggest that phospholipase A2,
      rather than phospholipase C, is the enzyme which is more involved in arachidonic
      acid release for eicosanoid biosynthesis. These findings suggest that the high
      contents of arachidonic acid and phospholipases A2 and C in the rabbit iris could
      contribute to its unique capacity to synthesize and release prostaglandins in the
      anterior segment as compared to that of other mammalian species.

PMID- 8462649
TI  - A soluble product of human corneal fibroblasts inhibits lymphocyte activation.
      Enhancement by interferon-gamma.
AB  - Corneal stromal fibroblasts expressed HLA-DP, -DQ and -DR Class II MHC antigens
      in response to interferon-gamma, but did not induce proliferative responses by
      allogeneic peripheral blood mononuclear cells in vitro when used as stimulator
      cells in a mixed leukocyte-type reaction. Furthermore, corneal stromal
      fibroblasts inhibited mixed leukocyte reactions between peripheral blood
      mononuclear cells of allogeneic donors, even when the corneal stromal fibroblasts
      were separated from the peripheral blood mononuclear cells by a 0.4 micron pore
      membrane. Pretreatment of the corneal stromal fibroblasts with interferon-gamma
      increased the inhibitory activity. Both [3H]thymidine incorporation and
      interleukin-2 production were inhibited, and the inhibition appeared to be
      mediated by a soluble factor whose production required protein synthesis. The
      inhibitory activity was not abolished by including 1-10 micrograms ml-1
      indomethacin in the culture media. No inhibition was observed in the
      proliferation dose-response curves of responder peripheral blood mononuclear
      cells that had been cultured with corneal stromal fibroblasts for 3 days, prior
      to culture with allogeneic stimulator peripheral blood mononuclear cells. Thus,
      the ability of corneal stromal fibroblasts to interfere with alloimmune responses
      in vitro was dependent upon the continued presence of the fibroblasts and their
      continued production of a soluble inhibitory factor or factors. Inhibitors of
      allogeneic reactions that are produced by corneal stromal fibroblasts stimulated
      by immune cytokines (e.g. interferon-gamma) may play a role in prolonging corneal
      allograft survival.

PMID- 8462650
TI  - Uveitis and retinal vasculitis in acute experimental allergic encephalomyelitis
      in the Lewis rat: an ultrastructural study.
AB  - The histopathological features of uveitis and retinal vasculitis in acute
      experimental allergic encephalomyelitis (EAE) were investigated using light and
      electron microscopy. Lewis rats were immunized by spinal cord homogenate,
      complete Freund's adjuvant and Bordetella pertussis. The eyes of rats with EAE
      exhibited vasculitis in the iris, trabeculitis and endothelial abnormalities in
      the retinal vessels; vasculitis was observed in the optic nerve and brain.
      Endothelial cells in the vessels in the iris, retina, optic nerve and central
      nervous system were noted to be elevated (high endothelial-like venules, or
      HELV). Inflammatory cells in the vascular lumen were attached to the surface of
      endothelial cells in abnormal areas in the iris. By comparison with the findings
      in the iris and retina, there were no significant changes in the vessels of the
      ciliary body and choroid. The ultrastructural features indicated that anterior
      uveitis in acute EAE resulted from vasculitis in the iris due to changes of the
      endothelial cells and was not due to a reaction against the myelinated nerves or
      any other particular components of the iris. In addition, our results suggested
      that vasculitis in the iris was consequent upon specialized changes of the
      endothelial cells similar to HELV which were responsible for the transcellular
      emigration of lymphocytes in other inflammatory diseases or in experimental
      models. HELV change plays an important role in the perivascular inflammatory
      process in the iris, retina, optic nerve and central nervous system in EAE and
      possibly in multiple sclerosis.

PMID- 8462651
TI  - Glycation mediated lens crystallin aggregation and cross-linking by various
      sugars and sugar phosphates in vitro.
AB  - Glycation of lens crystallins results in protein conformational changes,
      oxidation, browning and aggregation. Though glucose is the major sugar, other
      sugars and sugar phosphates generated as intermediates of metabolic pathways are
      present in the lens, albeit at low concentrations. In this study we incubated
      bovine lens soluble fraction with various sugars and sugar phosphates (5mM for 10
      days). The reactivity was in the order trioses > tetroses > pentoses > hexoses.
      High molecular weight (HMW) aggregates were also formed at a comparable rate.
      Increased levels of fluorescence were associated with the HMW aggregates with
      fast reacting sugars. The phosphorylated derivatives were only slightly more
      reactive than their respective sugars. Interestingly, fructose-1,6-diphosphate
      was more reactive and cross-linked more readily than fructose-6-phosphate. Gel
      electrophoresis under reducing and nonreducing conditions showed formation of
      disulfide linked protein aggregates with slow reacting sugars such as glucose and
      non-disulfide covalent linked protein aggregates with fast reacting sugars such
      as erythrose. In contrast, if 0.1 m DTT was present in erythrose incubations (a
      fast reacting sugar), the HMW aggregate formation was significantly reduced. In
      order to show the reactivity among the slow reacting hexoses, we incubated lens
      proteins with 1 M hexoses for 30 days and the results showed that galactose was
      more reactive and showed higher cross-linking than fructose and glucose. These
      results thus indicate that relatively low levels of some sugars and sugar
      phosphates in the lens could be compensated by enhanced lens protein cross
      linking and the combined effect could be rather significant with respect to
      cataractogenesis.

PMID- 8462652
TI  - Modelling cortical cataractogenesis. 13. Early effects on lens ATP/ADP and
      glutathione in the streptozotocin rat model of the diabetic cataract.
AB  - A possible contribution to cell toxicity in the diabetic lens due to early ATP
      loss is not well characterized prior to the appearance of vacuoles in the lens.
      Changes in lens ATP levels at longer periods of hyperglycaemia (6-8 weeks) have
      been reported. We used [31P]NMR analysis of lens extracts at three time periods,
      comparing diabetic to concurrent control groups at 1, 2 and 4 weeks of
      hyperglycaemia. With this design, significant alterations (> 10%) in the ATP/ADP
      ratio can be monitored. NMR analysis revealed a decreased ATP/ADP ratio at all
      time periods, averaging a 38% decrease. Luminescent determination of ATP levels
      indicates that this decrease is mainly caused by a decrease of 25% in ATP
      concentration. The early loss of GSH was large and not accompanied by an
      appearance of GSSG, as monitored by HPLC electrochemical detection. A 1-week
      experiment with animals receiving daily insulin treatment was carried out to
      control for effects of STZ on the lens. This treatment resulted in normal lens
      GSH levels and a near normal [31P]NMR profile.

PMID- 8462653
TI  - Changes in the retinal ganglion cell layer and optic nerve of rats exposed
      neonatally to cocaine.
AB  - The effects of neonatal exposure to cocaine upon the structure of the visual
      system are poorly understood despite the evidence of eye abnormalities in infants
      exposed in utero to cocaine. We previously demonstrated alterations in the optic
      nerve of rats exposed neonatally to cocaine, although no changes were detected in
      the number of its axons. This study was undertaken to investigate the retinal
      ganglion cell layer and the size distribution of the optic axons, in an attempt
      to assess further changes in the visual pathways. Groups of rats (Wistar strain)
      were given subcutaneous injections of cocaine hydrochloride (15 mg kg-1 body
      weight day-1) divided into two daily doses, from the day following birth until
      postnatal day 30 Controls were given subcutaneous saline throughout the same
      experimental period. Per group, five animals from three different litters were
      evaluated morphometrically. Following perfusion with aldehydes, samples from the
      median ventral and dorsal parts of the retina and the optic nerves were processed
      for electron microscopy. Morphometric techniques at light and electron
      microscopic levels allowed us to determine the following. (a) In the optic nerve:
      (1) frequency size-distribution of myelinated nerve fibres; and (2) number of
      myelin sheaths per fibre. (b) In the retina: (1) thickness of the layers; (2)
      frequency size-distribution of ganglion layer neurons; (3) mean cell nuclear
      size; and (4) packing density of ganglion cell layer neurons.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8462654
TI  - Features of the polarity of the Golgi apparatus of frog photoreceptors: studies
      with lectins and with Brefeldin A.
AB  - The cis-trans polarity of the Golgi apparatus is important in Golgi functioning
      in glycosylation, sorting and other processes. The present work extends our prior
      studies on the polarity of the Golgi apparatus of frog (Rana) rod photoreceptors.
      We demonstrate that Golgi structures with the morphology and distribution of cis
      elements show the heaviest deposition of osmium. Elements with morphology and
      cytochemical reactivities resembling trans Golgi structures remain discernible as
      discrete arrays after exposure of the cells to Brefeldin A. These properties
      strengthen our identification of cis and trans elements since they are shared
      with corresponding Golgi structures in other cell types. We have also
      investigated the binding of lectins to sections prepared by cryoultramicrotomy.
      We find that Concanavalin A, with probable chief affinity for core mannoses in
      oligosaccharides, localizes to cis, medial and trans elements of the
      photoreceptor's Golgi apparatus. Wheat germ agglutinin, with likely affinity at
      least partly for terminal N-acetylglucosamines, localizes to trans and medial
      elements. A trans localization is seen with Ricinus communis agglutinin (RCA
      120), but this lectin binds extensively only after neuraminidase treatments
      suggesting that its chief affinity is for galactose residues that are penultimate
      to sialic acids (neuraminic acids) in the native oligosaccharides. Overall, the
      pattern of lectin binding to Golgi structures that we observe resembles that seen
      in a variety of other cell types. The distribution of glycosylated molecules we
      detect in the photoreceptor's Golgi apparatus may bear upon such matters as the
      unusual features of the glycosylation of mature opsin.

PMID- 8462655
TI  - Immunocytochemical identification of serotonin-synthesizing neurons in the
      vertebrate retina: a comparative study.
AB  - Serotonin-synthesizing neurons in the retinas of goldfish, axolotl, turtle,
      chick, rabbit and cat were identified using double labelling with anti-serotonin
      and anti-phenylalanine hydroxylase antibodies. The latter antibody recognizes
      tryptophan 5-hydroxylase, one of the synthesizing enzymes for serotonin. Neurons
      labelled by both markers were considered to be serotonin-synthesizing neurons,
      while those only with serotonin-immunoreactivity were assumed to be serotonin
      accumulating neurons. In the goldfish and chick retinas, all serotonin
      immunoreactive amacrine cells (S1) were positive for phenylalanine hydroxylase.
      In the axolotl and turtle retinas, all the S1 amacrine cells, and only 52.8% and
      40.5% of S2 amacrine cells were double-labelled. Although serotonin
      immunoreactive bipolar cells were observed in the turtle and chick retinas, the
      synthesizing enzyme for serotonin could not be detected in these cells. In the
      rabbit and cat retinas, tryptophan hydroxylase could not be revealed in any cell
      type with immunocytochemistry. In control experiments SLI neurons in the raphe
      nuclei of the brain stem always exhibited PH-LI in all species examined,
      including mammals, indicating that our anti-PH antibody is able to recognize
      tryptophan hydroxylase across vertebrate classes. These results indicate that the
      majority of serotonin-immunoreactive amacrine cells are able to synthesize
      serotonin and are the source of endogenous serotonin in the non-mammalian retina,
      while some serotonin-immunoreactive amacrine and bipolar cells possibly only
      accumulate serotonin. We also suggest that serotonin may not be a primary
      neurotransmitter in the serotonin-accumulating bipolar and amacrine cells of the
      non-mammalian retina.

PMID- 8462656
TI  - Intercellular adhesion molecule-1 on rat corneal endothelium in experimental
      uveitis.
AB  - We studied the expression of the intercellular adhesion molecule-1 (ICAM-1) on
      the corneal endothelium of the rat in the experimental uveitis induced by
      interphotoreceptor peptides (R-4) as an immunogen using immunohistochemical
      methods. ICAM-1, which was not detected in eyes without inflammation, was
      expressed on the corneal endothelium, vascular endothelium and inflammatory
      cells, such as monocytes and lymphocytes, in R-4 induced uveitis. The ocular
      inflammation in the iris, ciliary body and anterior chamber associated with the
      adherence of inflammatory cells to the corneal endothelium (keratic precipitates)
      first appeared on the 11th day and were most remarkable on the 14th day and then
      gradually subsided after 18th day. The expression of ICAM-1 on the corneal
      endothelium was noticed from the 12th day of immunization to the 16th day and was
      most prominent on the 14th day but disappeared after the 18th day. The present
      study proved that ICAM-1 was expressed on the corneal endothelium in anterior
      uveitis and further indicated that the corneal endothelium modulates the
      inflammation of the anterior ocular segment by expressing ICAM-1 and forming
      keratic precipitates.

PMID- 8462657
TI  - The hematopoietic deficiencies in osteopetrotic (op/op) mice are not permanent,
      but progressively correct with age.

PMID- 8462658
TI  - Optimal erythroid cell production during erythropoietin treatment of mice occurs
      by exploiting the splenic microenvironment.
AB  - In this study, quantitative effects on erythroid cell production by a prolonged
      recombinant human erythropoietin (rhEpo) treatment of mice are presented. Epo
      treatments, given subcutaneously (s.c.) twice per day in doses of 0.5 to 500 U
      per day, were performed under steady-state production conditions. We found
      striking differences between the behavior of the different erythroid cell
      compartments (burst-forming unit erythroid [BFU-E], colony-forming unit erythroid
      [CFU-E] and erythroid precursors), as well as between the microenvironments of
      bone marrow and spleen. Whereas the total-body BFU-E was not changed by Epo, a
      redistribution of BFU-E from marrow to spleen occurred, resulting in decreasing
      marrow and increasing splenic BFU-E numbers. Splenic BFU-E produced CFU-E as much
      as 8 times more efficiently than marrow BFU-E at 50 U of Epo. At low Epo doses
      (to 1 U/day) no difference was found. The CFU-E in the spleen produced
      erythroblasts at a higher efficiency at all Epo doses (1.5 to 5 times). It seems
      as if this efficiency was higher at low Epo doses. Because of the migration
      phenomenon and the excellent microenvironment in the spleen, at the highest Epo
      concentrations nearly 70% of all erythroid cells reside in the spleen. Even at
      the highest Epo doses, granuloid cell production was not affected. Similar to the
      BFU-E, total-body granuloid cells remained constant (despite a shift of
      granulocyte-macrophage progenitors [CFU-GM]) from marrow to spleen; however,
      these cells did not flourish in the spleen. Under these conditions, 90% of the
      granuloid precursors were still localized in the marrow. Erythropoietin did not
      change the transit time of erythroid cells at high Epo doses.

PMID- 8462659
TI  - Regulation of myelopoiesis by murine fibroblastic and adipogenic cell lines.
AB  - The regulation of hematopoiesis has been suggested to take place in close
      association with various cell types found in the bone marrow (BM)
      microenvironment. In the present study the role of fibroblasts, adipocytes and
      cell surface heparan sulfate in regulating hematopoiesis in an in vitro mouse
      system was examined. Mouse BM cells were allowed to adhere to a mouse embryo
      fibroblast cell line (C3H 10T1/2) or a clonally derived adipogenically determined
      derivative (Clone D) of the 10T1/2 cell line. Nonadherent cells were removed,
      cultures were overlaid with semisolid media supplemented with growth factors and
      colony formation by granulocyte-macrophage (CFU-GM), erythroid (BFU-E) and
      multipotential (CFU-GEMM) progenitor cells was quantitated. Adherence and co
      culture of BM cells with the fibroblast cell line resulted in increased numbers
      of total CFU-GM and CFU-GEMM colonies. In contrast, adherence and co-culture of
      BM cells with the adipocytic cell line resulted in an increase only in CFU-GEMM
      colonies. Morphological analysis revealed a preferential adherence/growth of
      granulocyte and macrophage progenitors at the expense of bipotent granulocyte
      macrophage progenitors to the fibroblastic cell line and an increase in the
      adherence/growth of granulocyte progenitors to the adipogenic cell line.
      Progenitor cell adherence was abolished when the fibroblastic or adipocytic cell
      lines were pretreated with heparitinase. These results demonstrate enhanced
      proliferation/differentiation of hematopoietic progenitor cells when there is
      direct contact between hematopoietic progenitors and cell types characteristic of
      those found in the microenvironment and that heparan sulfate and different types
      of stromal cells appear to play different roles in this interaction.

PMID- 8462660
TI  - Preparation of a monoclonal antibody directed against the receptor for murine
      colony-stimulating factor-1.
AB  - Studies were undertaken to produce monoclonal antibodies directed against the
      murine receptor for macrophage colony-stimulating factor (M-CSF or CSF-1).
      Sprague-Dawley rats were injected with lysates prepared from a murine
      myelomonocytic cell line (RAW cell line) that has high levels of M-CSF receptors.
      Spleen cells from immunized animals were fused with murine plasmacytoma cells and
      expanded. Supernatants from these cells caused inhibition of 125I-CSF binding to
      either RAW cells or normal murine marrow cells. Antibody-producing cells were
      cloned by limiting dilution and by colony growth in agar. The antireceptor
      antibodies appear specific as they neutralize colony formation by M-CSF but have
      little or no effect on colony growth in response to the other hemopoietic growth
      factors granulocyte CSF (G-CSF), granulocyte-macrophage CSF (GM-CSF), interleukin
      3 (IL-3) or erythropoietin. These antibodies should aid in defining the role of M
      CSF in hemopoiesis in vivo.

PMID- 8462661
TI  - Molecular evolution of cytokines and their receptors.

PMID- 8462662
TI  - Induced myeloid differentiation of K562 cells with downregulation of erythroid
      and megakaryocytic transcription factors: a novel experimental model for
      hemopoietic lineage restriction.
AB  - The human erythroleukemia cell line K562 can be induced to differentiate along
      the erythroid and megakaryocytic lineages. Here we demonstrate that hexamethylene
      bisacetamide (HMBA) induced K562 cells to differentiate along a third pathway.
      This was accompanied by downregulation of two transcription factors normally
      expressed in erythroid, mast and megakaryocyte lineages. Northern analysis
      demonstrated coordinate downregulation of alpha globin and gamma globin in
      addition to the two lineage-restricted transcription factors, SCL and GATA-1.
      Proliferation of the K562 cells was also suppressed. Clonal assay showed that the
      suppression was irreversible and appeared analogous to the commitment of murine
      erythroleukemia (MEL) cells to terminal differentiation. In contrast to MEL
      cells, however, K562 cells acquired a macrophage-like morphology and exhibited a
      complete failure to generate benzidine-positive cells. Electron microscopy
      revealed a marked increase in granules resembling those specific for eosinophils.
      Surface marker analysis showed that HMBA-induced cells expressed reduced levels
      of glycophorin A, CD5, CD7 and CD11b. No upregulation of megakaryocyte or
      lymphoid markers occurred. Thus the response of K562 cells to HMBA may provide a
      useful experimental system for studying the molecular mechanisms responsible for
      downmodulation of lineage-restricted transcription factors during hemopoietic
      lineage commitment.

PMID- 8462663
TI  - Establishment of bone marrow-derived macrophage cell lines by soft-agar cloning:
      regulation of macrophage heterogeneity at bone marrow level.
AB  - To study the regulation of macrophage (m phi) heterogeneity at bone marrow level,
      we developed a liquid culture system in which bone marrow-derived soft-agar
      colonies were expanded in the presence of colony-stimulating factor-1 (CSF-1).
      Several cloned m phi precursor cells were established as CSF-1-dependent cell
      lines, and were analyzed for morphological, phenotypic and functional
      characteristics. The continuously proliferating cell lines expressed both
      immature and mature m phi markers. Only minor differences between the established
      cell lines were detected. Thus, our results show that during long-term culture
      CSF-1-responsive cloned m phi precursor cells develop along identical pathways,
      giving rise to progeny with comparable phenotype and function in vitro.

PMID- 8462664
TI  - Circadian variations in myelosuppressive activity of interferon-alpha in mice:
      identification of an optimal treatment time associated with reduced
      myelosuppressive activity.
AB  - A number of antitumor drugs have been shown to vary in their toxicity and in
      their antitumor potency according to the time in the circadian cycle at which
      they are administered. It was of interest to determine whether other agents, such
      as a biological response modifier, would also exhibit differential potency during
      the circadian cycle. Interferons (IFNs) are biological response modifiers which
      have antitumor and antiviral activity and which also have toxic side effects. A
      mouse model was used to study one of these toxic side effects, peripheral white
      blood cell (WBC) suppression. Interferon-induced peripheral WBC suppression was
      evaluated as a function of the time of recombinant human (rh) IFN-alpha A/D
      administration. Mice were maintained on cycles of 12 hours of light and 12 hours
      of darkness. The rhIFN-alpha A/D was administered at various hours after light
      onset (HALO). The rhIFN-alpha A/D-induced peripheral WBC suppressive effect
      varied in its intensity in a cyclical manner. Administration of rhIFN-alpha A/D
      at 0 HALO caused the greatest suppressive effect, while administration of rhIFN
      alpha A/D at 8 HALO caused the least suppressive effect. Mice treated at 8 HALO
      were found to be about 10-fold less sensitive to the peripheral WBC suppressive
      effects of rhIFN-alpha A/D than mice treated at 0 HALO. This differential
      sensitivity to the peripheral WBC suppressive effects of rhIFN-alpha A/D was
      examined for 6 different times in the circadian cycle and was found to be a
      general effect, occurring throughout the circadian cycle. Using a
      granulocyte/macrophage colony-forming unit (GM-CFU) assay, bone marrow function
      was also shown to be differentially affected by treatment with rhIFN-alpha A/D at
      0 HALO and 8 HALO in a manner parallel to that seen with peripheral WBC. Thus,
      rhIFN-alpha A/D exerts a differential effect on peripheral WBC counts and on bone
      marrow function according to the time in the circadian cycle at which it is
      administered to the mouse. Such temporal variation in the myelosuppressive
      activity of interferons could be important in designing future clinical trials
      with these antiviral and antitumor agents. Administration of interferons at
      empirically determined times in the circadian cycle could be used to reduce the
      myelotoxic side effects of interferons in humans.

PMID- 8462665
TI  - Identification of an alternatively spliced transcript of human interleukin-4
      lacking the sequence encoded by exon 2.
AB  - The expression of interleukin-4 (IL-4) mRNA of human peripheral blood mononuclear
      cells stimulated with phytohemagglutinin (PHA) for 15 hours was analyzed by
      reverse transcription and subsequent polymerase chain reaction (RT/PCR). These
      analyses revealed an additional smaller fragment that hybridizes with an IL-4
      cDNA probe and an oligonucleotide that is specific for a fragment lacking the
      sequence encoded by exon 2. Sequencing of this fragment demonstrates that it is
      generated from an alternatively spliced transcript of the IL-4 gene with the
      sequence encoded by exon 2 being skipped. Skipping of exon 2 does not result in a
      frame shift but would delete part of the mature protein (48 bp coding for amino
      acid residues 22 to 37), including Cys24 but not a region directly involved in
      receptor binding. Differential splicing of other exons or exon combinations has
      not been observed. The data suggest that the alternatively spliced transcript is
      not generated by a splicing or PCR error and is not detectable solely because of
      the high sensitivity of RT/PCR, but in contrast, argue for a physiological role
      of the transcript and its potentially encoded protein.

PMID- 8462666
TI  - Spectrophotometric determination of clonogenic capacity of leukemic cells in a
      semisolid microtiter culture system.
AB  - In this study we describe a semiautomated clonogenic assay in which human
      leukemic cell lines (U937 and HL60) are cultured in a semisolid 96-well
      microtiter culture system and clonogenicity is measured spectrophotometrically in
      a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT)-assay and
      sulforhodamine (SRB)-assay. Culture medium with 0.6% (wt/vol) methylcellulose and
      10% (vol/vol) fetal calf serum (FCS) appeared to provide optimal culture
      conditions with a low background absorbance in both colorimetric assays and an
      optimal linearity between cell number and optical density (OD). An excellent
      correlation between clonogenic growth of U937 and HL60 cells in the conventional
      colony-forming unit assay (CFU-assay) and the microtiter CFU-assay was observed.
      The value of this microtiter CFU-assay was assessed by modulating U937 and HL60
      cells with either 1,25(OH)2D3 or cytosine arabinoside (Ara-C). Additionally, the
      number of living cells was quantitated spectrophotometrically in both MTT- and
      SRB-assays. Results obtained by either method did not differ significantly (p <
      0.001). In liquid culture, however, significantly (p < 0.001) less reduction of
      cellular growth was observed with 1,25(OH)2D3-modified cells. No significant
      differences between the liquid and semisolid assay systems could be observed in
      the presence of Ara-C. In conclusion, the microtiter clonogenic assay provides a
      rapid and objective way of measuring clonogenic capacity of (leukemic) cell
      lines. The semiautomated clonogenic assay will be useful to assess large series
      of immune modulations and/or cytostatic drug screening.

PMID- 8462667
TI  - DNA ploidy and cell kinetic characteristics in canine non-Hodgkin's lymphoma.
AB  - Malignant lymphoma in the dog is frequently postulated and used as a therapeutic
      model for non-Hodgkin's lymphoma (NHL) in humans. In this study DNA ploidy and
      the cell kinetic characteristics of canine malignant lymphoma were studied by
      flow cytometric (FCM) nuclear DNA measurements on fresh frozen tumor tissue from
      94 dogs with NHL and on material from non-neoplastic lymph nodes from 20 dogs.
      The results were correlated with histomorphology, immunophenotype and survival.
      All non-neoplastic tissues were diploid, whereas of the 94 lymphomas 74 were
      diploid or near-diploid and 20 aneuploid. Of the aneuploid lymphomas, 1 contained
      a hypoploid cell population. DNA-indices of the aneuploid peaks ranged from 0.87
      to 1.21 (mean 1.11). The mean S-phase fraction (8.2%, SD 4.8) was significantly
      lower in the non-neoplastic tissues than in the lymphomas (11.4%, SD 5.1). A
      linear correlation was observed between FCM S-phase fractions and
      bromodeoxyuridine (BrdU) labeling indices (r = 0.78; p < 0.001) determined in
      paraffin-embedded tissue sections from 18 dogs with NHL after in vivo BrdU
      labeling. DNA ploidy status did not correlate to the S-phase fraction. There were
      no differences in S-phase fraction and DNA ploidy between B cell and T cell
      lymphomas or between different histological classes using the Working
      Formulation. No correlation was found between S-phase fraction or DNA ploidy and
      survival in a series of 59 dogs treated with a combination chemotherapy protocol.
      It is concluded that the frequency of DNA aneuploidy in canine malignant lymphoma
      is similar to that in human NHL. In contrast to findings in human NHL, however,
      no relationship was found between DNA ploidy or cell kinetic features and
      histomorphology or prognosis.

PMID- 8462668
TI  - How does the switch II region of G-domains work?
AB  - The transition of guanine nucleotide binding proteins between the 'on' (GTP
      bound) and 'off' (GDP-bound) states has become a paradigm of molecular switching
      after a chemical reaction. The mechanism by which the switch signal is
      transmitted to the downstream recipients in the intracellular signal pathway has
      been extensively studied by biochemical, biophysical and genetic methods, but a
      clear picture of this process has yet to emerge. Based on the similarities of ras
      p21 and elongation factor Tu we propose here a model of the GDP state of ras-p21
      that is in agreement with all relevant experimental evidence. The model provides
      important clues about: (1) a possible molecular mechanism for signal transmission
      from the site of GTP hydrolysis to downstream effectors; (2) a major
      conformational change during signal generation and a key residue involved in this
      process (Tyr-64); and (3) regions in ras-p21 that can be differentially
      recognized by binding to external partners in a GTP/GDP state dependent fashion,
      most notably residues D69, Q70, R73, T74, R102, K104, D105 at the end of the
      alpha-helices 2 and 3.

PMID- 8462669
TI  - Crystal structure of a distal site double mutant of sperm whale myoglobin at 1.6
      A resolution.
AB  - The three-dimensional structure of sperm whale myoglobin His64(E7)-
      >Val,Thr67(E10)-->Arg double mutant has been studied by X-ray crystallography at
      1.6 A resolution, and refined to a crystallographic R-factor of 0.197. The
      Arg67(E10) side chain is extended in the direction of the ligand binding site,
      and its NH1 atom is at a distance of 3.11 A from the NH1 atom of Arg45(CD3),
      which is also pointing towards the distal site. Both are kept in this position by
      hydrogen bonding and electrostatic interactions with a solvent sulfate ion,
      located amongst the two, on the protein surface. No liganded water molecule is
      present at the sixth coordination position of the Fe(III) heme.

PMID- 8462670
TI  - Chemical crosslinking studies of the isolated light-harvesting B800-850 complex
      of Chromatium minutissimum.
AB  - The spatial relationship of polypeptides comprising the light-harvesting B800-850
      complex of Chromatium minutissimum has been studied by means of chemical
      crosslinking of the isolated complex with cleavable, 1.2 nm-long
      dithiobis(succinimidyl propionate). The samples were analyzed by different types
      of electrophoresis and spectrophotometrically. No difference was shown between
      crosslinking of the B800-850 complex either solubilized or incorporated into
      proteoliposomes. It was found that two main polypeptides form only one type of
      heterodimer. The crosslinked complex was more thermostable. This crosslinkage
      restricted the conformational transitions causing the shift of the long
      wavelength band in the near infrared region. A structure of the complex is
      discussed.

PMID- 8462671
TI  - Expression of a pokeweed antiviral protein in Escherichia coli and its
      characterization.
AB  - Two expression vectors were constructed to produce a putative mature alpha
      pokeweed antiviral protein (alpha-PAP) in Escherichia coli with its NH2- and COOH
      terminal extrapeptides excised. One was for its intracellular expression with a
      methionine at its NH2-terminal. The other was for its secretion using an ompA
      signal peptide. The former product was purified from the total soluble proteins
      of the transformant with a yield of 1.74 mg/liter and the latter had a yield of
      5.55 mg/liter. Both products exhibited RNA N-glycosidase activity on wheat
      ribosomes and inhibitory activity to protein synthesis in a rabbit reticulocyte
      system.

PMID- 8462672
TI  - Amino acid sequence of alkaliphilic serine protease from silkworm, Bombyx mori,
      larval digestive juice.
AB  - Alkaliphilic protease, P-IIc, from silkworm, Bombyx mori, larval midgut digestive
      juice consists of 232 amino acids. It has a catalytic triad, Asp-His-Ser,
      invariably found in a serine protease. A shift of optimal pH value towards the
      alkaline side diminished at mu = 1.0. This suggests the existence of an
      electrostatic interaction that affects the proteolytic activity. The higher Arg
      content may be responsible for this phenomenon. Two cysteine residues probably
      exist unpaired in a novel position among serine proteases.

PMID- 8462673
TI  - Differentiation-associated expression of prostaglandin G/H synthase in monocytic
      cells.
AB  - Significant progress in the investigation of the regulation of prostanoid
      formation has recently been made by cloning a second gene coding for
      prostaglandin G/H synthase (PGHS; EC 1.14.99.1). In this study we examined the
      expression of the two PGHS isoforms during phorbol ester induced monocytic
      differentiation of human myeloid leukemia cells (U937). Murine and ovine PGHS-1
      probes hybridized to 2.8- and 5.5-kb mRNA species, whereas the murine PGHS-2
      probe hybridized to a 5.3-kb species. Western blot analysis using antisera to
      mouse PGHS-1 and to a synthetic peptide derived from a mouse PGHS-2-specific
      region revealed a band of 70 kDa for PGHS-1 and a doublet of about 85 kDa for
      PGHS-2. Unlike PGHS-2, which was not expressed in U937 control cells, both PGHS-1
      protein and mRNA were detected in untreated U937 cells. TPA strongly induced PGHS
      2 protein and also increased the amount of PGHS-1 protein. Correspondingly, a
      marked induction of PGHS-2 mRNA was found, but virtually no change in the
      expression of the PGHS-1 2.8-kb mRNA occurred. The induction of both PGHS
      isoforms turned out to be dexamethasone-sensitive. The suppression of PGHS-2
      induction was more pronounced. These results suggest that both PGHS-1 and to a
      larger extent PGHS-2 contribute to the upregulation of prostanoid synthesis
      during monocytic differentiation.

PMID- 8462674
TI  - Primary structure determination and cloning of the cDNA encoding toxin 4 of the
      scorpion Centruroides noxius Hoffmann.
AB  - A peptide (toxin II-10), shown to be a Na+ channel blocker, was purified from the
      venom of the scorpion Centruroides noxius Hoffmann and sequenced by Edman
      degradation. It has 66 amino acid residues with the C-terminal residue
      (asparagine) amidated, as demonstrated by mass spectrometry. In addition, we
      report the cloning and the nucleotide sequence of the cDNA (CngtV) that codes for
      this toxin. We discuss the mechanism for processing the precursor peptide to its
      final form and compare the primary structure to that of other Na+ channel toxins.
      Two distinct groups of toxins seem to emerge from this comparison, suggesting a
      structure-function relationship of these peptides towards the recognition of
      either mammalian or insect tissues.

PMID- 8462676
TI  - Purification and partial characterisation of NADP(+)-linked isocitrate
      dehydrogenase from rat liver cytosol.
AB  - NADP(+)-linked isocitrate dehydrogenase from rat liver cytosol was purified
      (approximately 135-fold) to apparent homogeneity in 27% yield. The purified
      enzyme has specific activity of 73 units.mg-1. The native enzyme showed an
      apparent M(r) of 94,000 by gel filtration and was composed of two identical
      subunits of M(r) 45,000 as judged by SDS/PAGE. In isoelectric focusing, a pI
      value of 5.7 was estimated for the enzyme.

PMID- 8462675
TI  - Potentiation of diacylglycerol-induced activation of protein kinase C by
      lysophospholipids. Subspecies difference.
AB  - Lysophospholipid, particularly 2-lysophosphatidylcholine (lysoPtdCho),
      significantly potentiates the diacylglycerol (DAG)-induced activation of protein
      kinase C (PKC) in vitro. LysoPtdCho shows no effect, unless DAG and
      phosphatidylserine (PtdSer) are present. This lysoPtdCho action also depends on
      its own as well as on Ca2+ concentration. At physiological Ca2+ concentrations,
      the activation of the alpha-, beta-, and gamma-subspecies (cPKC) is enhanced by
      lysoPtdCho in the 10(-6) M range, but inversely inhibited in the 10(-5) M range.
      The delta- and epsilon-subspecies (nPKC), which are enzymatically insensitive to
      Ca2+, are mostly inhibited by lysoPtdCho at its low concentrations. The
      enhancement of cPKC activation by lysoPtdCho is due to the increase in an
      apparent affinity of the enzyme for PtdSer but not for DAG. The results may
      account, at least in part, for the previous observations made with intact cell
      systems that lysoPtdCho significantly potentiates the DAG-induced cellular
      responses such as T-lymphocyte activation and HL-60 cell differentiation [(1992)
      Trends Biochem. Sci. 17, 414-417].

PMID- 8462677
TI  - Structure of the nuclear encoded gamma subunit of CF0CF1 of the diatom Odontella
      sinensis including its presequence.
AB  - Using a PCR-product as homologous probe for screening of a cDNA library of the
      diatom Odontella sinensis overlapping cDNA clones were obtained which showed
      homologies to atpC-genes of F0F1-ATPases from different sources. Comparison of
      the deduced amino acid sequence with the N-terminal sequence of the Odontella
      gamma subunit obtained by protein sequencing, indicated that the complete 370
      amino acid protein is processed to a mature protein of 315 amino acids. The 55
      amino acids comprising the presequence consists of two segments, one resembling a
      signal sequence for cotranslational transport through ER membranes and one
      showing characteristics of a transit sequence for transport of proteins into
      chloroplasts of higher plants. This result is discussed with respect to the
      particular envelope structure of chromophytic plastids consisting of four
      membranes. The outer membrane contains ribosomes on its cytosolic surface. As in
      cyanobacterial gamma subunits the regulatory sequence region, which is involved
      in thiol modulation of chloroplast ATPase of green algae and higher plants, is
      absent in the Odontella gamma subunit.

PMID- 8462678
TI  - Purification and properties of a 155 kDa bone marrow-derived glycoprotein
      enhancing the activity of granulocyte-macrophage colony stimulating factor (GM
      CSF).
AB  - A protein has been purified from pig bone marrow which enhances the activity of
      exogenously added granulocyte-macrophage colony stimulating factor (GM-CSF) on
      mouse myelopoietic colony formation in vitro. The substance alone did not exhibit
      any colony stimulating activity. The active fraction was isolated from the medium
      of pig bone marrow suspension cultures during 20-24 h. Purification to
      homogeneity was then performed by subsequent HPLC and SDS-PAGE. The GM-CSF
      enhancing protein was identified as a 155 kDa glycoprotein.

PMID- 8462679
TI  - NO, thiols and disulfides.
AB  - The chemical nature of the messenger molecule, nitric oxide (NO), and especially
      its reactivity towards thiol groups and disulfides, could explain, at least
      partly, its intervention in so many different biological processes. NO can be
      regarded as the smallest molecule suitable for electron transport in biological
      systems. The S-nitrosation reaction and its reverse reaction represent the most
      convenient general way to store, to transport and finally to release NO. Nitric
      oxide is also particularly convenient for playing a role in interconversions of
      thiol groups and disulfides in chain radical or oxidation-reduction processes,
      and to be subsequently engaged in complex sequences of reactions accounting for
      different biological situations.

PMID- 8462680
TI  - Metabolic channelling and control of the flux.
AB  - Metabolic control theory is extended to include channelled metabolism in general.
      A simple relationship between the flux control by the enzymes and the degree of
      metabolite channelling is derived. This relationship suggests experiments in
      which modulation of gene expression allows one to quantify channelling.

PMID- 8462681
TI  - 'Channelled' pathways can be more sensitive to specific regulatory signals.
AB  - In 'simple' metabolic pathways the response to an external signal is readily
      described in terms of the effect of the signal on its receptor enzyme and the
      control exerted by that enzyme. We show here that in the response of 'channelled'
      pathways to such a signal, additional terms appear that reflect the direct enzyme
      enzyme interactions. They tend to enhance the responsiveness of the pathway. The
      normalized value of the response is called the signal transduction coefficient.
      We show that in channelled pathways these coefficients are usually larger than in
      corresponding non-channelled (simple) pathways.

PMID- 8462682
TI  - Distribution of non-class-III beta-tubulin isoforms in neuronal and non-neuronal
      cells.
AB  - beta-Tubulin isoforms in brain tissues and in cell lines were analyzed by high
      resolution isoelectric focusing in combination with monoclonal antibodies. Post
      translational modifications of brain non-class-III beta-tubulin isoforms were
      found in phylogenetically distant species ranging from pig to carp. Less
      extensive modifications were also observed in Neuro-2a, HeLa and 3T3 cells, where
      most acidic isoforms were glutamylated, while the basic, most abundant isoforms
      were not. The data suggest post-translational modification of non-class-III beta
      tubulin isoforms in neuronal as well as in non-neuronal cells. Such modification
      might modulate interaction of tubulin with microtubule-associated proteins.

PMID- 8462683
TI  - Tyr-571 is involved in the T7 RNA polymerase binding to its promoter.
AB  - The in vitro studies of three T7 RNA polymerase point mutants suggest that
      substitutions of Ala and Thr for Pro-563 and of Ser for Tyr-571 have little
      effect on the enzyme catalytic competence, but result in its inability to utilize
      the promoter. Both P563A and P563T mutants retain the promoter-binding ability,
      whereas the promoter affinity of the Y571S mutant drops drastically.

PMID- 8462684
TI  - The IP3-sensitive calcium store of HIT cells is located in a surface-derived
      vesicle fraction.
AB  - Electron microscopic and biochemical techniques were used to study the cellular
      localization of the ATP-dependent, IP3-sensitive, Ca2+ store in the glucose- and
      phosphatidylinositol(PI) agonist-sensitive hamster insulinoma cell line HIT-T15.
      Scanning electron microscopy revealed conspicuous shape changes of the microvilli
      following stimulation of these cells with bombesin or thapsigargin. These changes
      closely resemble those previously shown to accompany stimulation of hexose
      transport in adipocytes with insulin [J. Cell. Physiol. 142 (1990) 1-14]. Using a
      hydrodynamic shearing technique for the isolation of microvilli, two cell surface
      derived vesicle fractions were prepared containing 80% of the total cellular
      Ca(2+)-storing activity. In contrast, subcellular fractionation using normal
      homogenization with a glass/teflon homogenizer yielded the well-known
      distribution of the Ca(2+)-storing activity which is then predominantly recovered
      within the microsomal fraction. The surface-derived vesicle fraction was clearly
      distinguished from the microsomal fraction by its high content of Na+/K(+)-ATPase
      and an immunoreactive fragment of the GluT-1 glucose transporter isoform which
      both are not detectable in the microsomal fraction isolated from homogenates from
      sheared cells. The Ca2+ uptake properties of the cell surface-derived vesicle
      fractions including the vanadate, A23187, and thapsigargin sensitivity were found
      to be identical with those described for the microsomal Ca2+ stores of various
      cell types. Inositol 1,4,5-trisphosphate (IP3) at 1 microM induced a maximal
      release of 35-40% of the stored Ca2+ from these vesicles.

PMID- 8462685
TI  - Site-directed mutagenesis of yeast phosphoglycerate kinase. Arginines 65, 121 and
      168.
AB  - In the absence of a structure of the closed form of phosphoglycerate kinase we
      have modified by site directed mutagenesis several of the residues which, on the
      basis of the open form structure, are likely to be involved in substrate binding
      and catalysis. Here we report on the kinetic and anion activation properties of
      the yeast enzyme modified at positions 65, 121 and 168. In each case an arginine,
      thought to be involved in the binding of the sugar substrate's non-transferable
      phosphate group, has been replaced by lysine (same charge) and by methionine (no
      charge). Km values for 3-phosphoglycerate of all six mutant enzymes are only
      marginally higher than that of the wild-type enzyme. Removing the charge
      associated with two of the three arginine residues appears to influence (as
      judged by the measured Km's) the binding of ATP. Although binding affinity is not
      necessarily coupled to turnover the substitutions which have the greatest effect
      on the Km's do correlate with the reduction in enzymes maximum velocity. The one
      exception to this generalisation is the R65K mutant which, surprisingly, has a
      significantly higher kcat than the wild-type enzyme. In the open form structure
      of the pig muscle enzyme each of the three substituted arginines residues are
      seen to make two hydrogen bonds to the sugar substrate's non-transferable
      phosphate. From this it might be expected that anion activation would be
      similarly affected by the substitution of any one of these three residues.
      Although the interpretation of such effects are complicated by the fact that one
      of the mutants (R65M) unfolds at low salt concentrations, this appears not to be
      the case. Replacing Arg121 and Arg168 with methionine reduces the anion
      activation whereas a lysine in either of these two positions practically destroys
      the effect. With the substitutions at residue 65 the opposite is observed in that
      the lysine mutant shows anion activation whereas the methionine mutant does not.

PMID- 8462686
TI  - Differential inhibition of fungal oxidosqualene cyclase by 6E and 6Z isomers of
      2,3-epoxy-10-aza-10,11-dihydrosqualene.
AB  - Inhibitory properties of 6E (compound 1) and 6Z (compound 2) isomers of 2,3-epoxy
      10-aza-10,11-dihydrosqualene against oxidosqualene-lanosterol cyclase were
      assayed on microsomes and whole cells of Saccharomyces cerevisiae and Candida
      albicans. Only the 6E isomer (compound 1), bearing a correct substrate-like
      configuration, strongly inhibited the enzyme both in microsomes and cell
      cultures. The difference between compounds 1 and 2 (which had an unfavorable
      geometry) was especially evident when measuring [14C]acetate incorporation into
      non-saponifiable lipids extracted from treated cells. While isomer Z was totally
      ineffective at up to 30 microM, in cells treated with 5 microM isomer E, labelled
      oxidosqualene, the level of which was negligible in the control, rose to over 60%
      of the non-saponifiable lipids.

PMID- 8462687
TI  - Identification of a key domain in annexin and 14-3-3 proteins that stimulate
      calcium-dependent exocytosis in permeabilized adrenal chromaffin cells.
AB  - Calcium-dependent secretion in digitonin-permeabilized adrenal chromaffin cells
      is stimulated by exogenous annexin II and 14-3-3 proteins. These proteins share a
      conserved domain that has been suggested to be involved in specific protein
      protein interactions. We examined whether this domain was involved in secretion
      by using a synthetic peptide (P16) of sequence KGDYQKALLYLCGGDD corresponding to
      the C-terminus of annexin II. P16, but not truncated peptides, prevented the
      stimulation of secretion by 14-3-3 proteins and produced a partial inhibition of
      control secretion. These data suggest that the shared annexin/14-3-3 domain is
      important in the mechanisms controlling Ca(2+)-dependent secretion and may play a
      key role in protein-protein interactions during exocytosis.

PMID- 8462688
TI  - Analysis of the role of the COL1 domain and its adjacent cysteine-containing
      sequence in the chain assembly of type IX collagen.
AB  - The mechanisms of chain selection and assembly of type IX collagen, a
      heterotrimer alpha 1(IX)alpha 2(IX)alpha 3(IX), must differ from that of
      fibrillar collagens since it lacks the characteristic C-propeptide of these
      latter molecules. We have tested the hypothesis that the information required for
      this process is contained within the C-terminal triple helical disulfide-bonded
      region (LMW). The reassociations of the purified LMW fragments of pepsinized
      bovine type IX collagen were followed by the formation of disulfide-bonded
      multimers. Our data demonstrate that only three triple helical assemblies form
      readily, (alpha 1)3, (alpha 2)3 and alpha 1 alpha 2 alpha 3. The information
      required for chain selection and assembly is thus, at least in part, contained in
      the studied fragments. Molecular stoichiometries different from the classical
      heterotrimer may thus also form under certain conditions.

PMID- 8462689
TI  - Positional and additive effects of basic amino acids on processing of precursor
      proteins within the constitutive secretory pathway.
AB  - We have recently shown that the Arg/Lys-X-Lys/Arg-Arg or Arg/Lys-X-X-X-Lys/Arg
      Arg sequence serves as a signal for cleavage of precursor proteins within the
      constitutive secretory pathway, and this cleavage is catalyzed by furin, a
      mammalian homolog of the yeast Kex2 protease. In this study, we further examined
      sequence requirements for the constitutive precursor cleavage. Based on the data
      concerning cleavage efficiencies of various prorenin mutants with amino acid
      substitution(s) around the native cleavage site expressed in CHO cells, we
      revised the sequence rules that govern the constitutive cleavage as follows: (i)
      the Arg residue at position -1 is essential; (ii) in addition to the Arg at
      position -1, at least two out of the three basic residues at positions -2, -4,
      and -6 are required for efficient cleavage (the presence of all the three basic
      residues results in most efficient cleavage); (iii) at position +1, a hydrophobic
      aliphatic amino acid is not suitable.

PMID- 8462690
TI  - Nicking of the tryptophan synthase beta 2-subunit at Glu-296 prevents the
      conformational change undergone on binding the alpha-subunit.
AB  - Using a monoclonal antibody as conformational probe it has been shown that the
      weakly active nicked-beta 2 dimer of tryptophan synthase generated by proteolytic
      cleavage at Glu-296, does not undergo on association with alpha subunit a
      conformational change known to occur in intact beta 2 subunit. This alpha induced
      conformational change is also prevented in intact beta 2 by the coenzyme
      pyridoxal-5'-phosphate when the substrate L-serine is absent.

PMID- 8462691
TI  - Isolation and characterization of a protease from the marine sponge
      Spheciospongia vesparia.
AB  - A protein that showed activity against proteic (casein and hide powder azure) and
      synthetic (BAEE and HLPA) substrates was isolated from the marine sponge
      Spheciospongia vesparia. The protease was purified from an aqueous extract by
      ammonium sulfate precipitation, gel filtration, hydrophobic and HPLC-anion
      exchange chromatographies. The purified protease showed a single band in SDS-PAGE
      minigels and had a molecular weight of 29,600, but when submitted to isoelectric
      focusing it showed 2 bands with isoelectric points of 4.56 and 4.43. Its
      catalytic action was inhibited by EDTA and 1,10-phenanthroline, so it seemed to
      be a metalloprotease.

PMID- 8462692
TI  - Localization of a fibrin polymerization site complementary to Gly-His-Arg
      sequence.
AB  - Dansyl-labeled tetrapeptide Gly-His-Arg-Pro which mimics the central fibrin
      polymerization site was used to investigate its binding to a number of fibrinogen
      fragments containing different numbers of domains. The tetrapeptide was found to
      bind to fragments DH(95 kDa), DL(82 kDa) and DY(63 kDa) but not to the TSD(28
      kDa) fragment. The DY fragment differs from the TSD by the presence of beta and
      beta C domains. Therefore these domains, which are formed by the C-terminal part
      of the beta chain, possess a polymerization site complementary to the Gly-His-Arg
      containing counterpart.

PMID- 8462693
TI  - What is hemimethylated DNA?

PMID- 8462695
TI  - Bioluminescence of the Ca(2+)-binding photoprotein, aequorin, after histidine
      modification.
AB  - Modification studies of the 5 histidine residues in aequorin employing site
      directed mutagenesis and diethyl pyrocarbonate suggested that His169 may be the
      site of binding of molecular oxygen in aequorin. The modification of this residue
      led to complete loss of activity, whereas modification of the remaining 4
      histidine residues yielded mutant aequorins with varying bioluminescence
      activities.

PMID- 8462694
TI  - Isolation of two members of the rat MAP kinase kinase gene family.
AB  - Mitogen-activated protein (MAP) kinase kinase (MAPKK) is a recently characterized
      activator of MAP kinase (MAPK), and is considered to be regulated by a
      protooncogene product c-Raf-1. It is, however, unclear whether the signals
      originating from c-Raf-1 utilize this phosphorylation cascade to lead to
      oncogenesis. To clarify this point, we isolated rat MAPKK cDNAs, and identified
      two distinct cDNAs encoding MAPKK and a highly related kinase, both with
      molecular weights of approximately 45 kDa (MEK1 and MEK2). Genomic Southern blot
      analyses suggested that MAPKK may form a large gene family.

PMID- 8462696
TI  - Two structural genes are encoding malate synthase isoenzymes in Saccharomyces
      cerevisiae.
AB  - We report on the isolation of a gene encoding yeast malate synthase. A yeast
      genomic library was screened using a probe homologous to the yeast enzyme
      obtained by the polymerase chain reaction. The nucleotide sequence of the cloned
      gene was determined. Computer analysis showed that the isolated gene is identical
      to the one previously described as DAL7, which is involved in allantoin
      metabolism [Mol. Cel. Biol. 9 (1989) 3231-3243]. Enzymatic activities of
      multicopy transformants, Southern analysis and disruption mutants predict the
      existence of two genes encoding malate synthases that are differentially
      regulated at the transcriptional level.

PMID- 8462697
TI  - Restoration of dystrophin-associated proteins in skeletal muscle of mdx mice
      transgenic for dystrophin gene.
AB  - Duchenne muscular dystrophy (DMD) patients and mdx mice are characterized by the
      absence of dystrophin, a membrane cytoskeletal protein. Dystrophin is associated
      with a large oligomeric complex of sarcolemmal glycoproteins, including
      dystroglycan which provides a linkage to the extracellular matrix component,
      laminin. The finding that all of the dystrophin-associated proteins (DAPs) are
      drastically reduced in DMD and mdx skeletal muscle supports the primary function
      of dystrophin as an anchor of the sarcolemmal glycoprotein complex to the
      subsarcolemmal cytoskeleton. These findings indicate that the efficacy of
      dystrophin gene therapy will depend not only on replacing dystrophin but also on
      restoring all of the DAPs in the sarcolemma. Here we have investigated the status
      of the DAPs in the skeletal muscle of mdx mice transgenic for the dystrophin
      gene. Our results demonstrate that transfer of dystrophin gene restores all of
      the DAPs together with dystrophin, suggesting that dystrophin gene therapy should
      be effective in restoring the entire dystrophin-glycoprotein complex.

PMID- 8462698
TI  - Varicose veins and the vascular surgeon: from nuisance to challenge.

PMID- 8462699
TI  - A method to transluminally seed angioplasty sites with endothelial cells using a
      double balloon catheter.
AB  - Acute arterial reocclusion and late restenosis following angioplasty may be
      partially caused by loss of the endothelial cell monolayer during balloon
      dilatation. Rapid restoration of the endothelial cell monolayer by endothelial
      cell transplantation has the potential to increase the antithrombotic nature of
      the angioplasty site and also to prevent myointimal hyperplasia which is the
      cause of late restenosis. We have investigated a method to transluminally deliver
      endothelial cells to angioplasty sites using a double balloon catheter with a
      central instillation port. Inflation of the balloons allows a segment of artery
      to be isolated from the circulation which may then be incubated with infused
      endothelial cells. The external iliac arteries of New Zealand white rabbits were
      dilated for 30 s at 8 atm pressure using a 3 mm balloon angioplasty catheter.
      Indium-111 labelled allogeneic rabbit endothelial cells were seeded onto the
      angioplasty site and retained in contact with the vascular surface for 30 min by
      continued inflation of the isolation balloons. After 30 min, the balloons were
      deflated and flow restored. Percentage cell retention was calculated by
      determining the gamma activity of the seeded angioplasty site, and referencing
      this to the contralateral sham seeded site. Results are expressed as a median
      with 95% confidence intervals and suggest that endothelial cells may be
      successfully delivered and retained on damaged vascular surfaces [table: see
      text].

PMID- 8462700
TI  - Postoperative graft incorporation after aortic reconstruction--comparison between
      computerised tomography and Tc-99m-HMPAO labelled leucocyte imaging.
AB  - Aortic graft infection may result in high mortality ranging up to 88%. Therefore,
      early diagnosis is imperative in the treatment of this serious complication.
      Computerised tomography (CT) is considered as a sensitive tool in the diagnosis
      of aortic graft infection. Some findings used as the criteria for infection, such
      as periprosthetic gas and fluid are, however, normal postoperative findings. The
      aim of this prospective study was to compare CT-scan and Tc-99m-HMPAO labelled
      leucocytes in the early diagnosis of aortic graft infection. The present study
      includes 24 consecutive patients (all men, age 70 +/- 8 years, range 55-85
      years), who were operated on for abdominal aortic aneurysm. Prosthetic and suture
      materials were the same in all operations. Each patient was examined with the aid
      of CT-scan and imaged with Tc-99m-HMPAO labelled leucocytes 2 weeks and 3, 6 and
      12 months after the reconstructive aortic surgery. Two radiologists and two
      specialists in nuclear medicine examined the data independently without knowing
      the clinical picture of the results of any other examinations of the patients.
      Seven patients (7/24; 29%) showed significant accumulation of labelled leucocytes
      in the first imaging (2 weeks postoperatively) with Tc-99m-HMPAO labelled
      leucocytes. Three months after the surgery only four patients (4/24; 17%) were
      positive in this respect. One of these patients had clinically proven aortic
      graft infection and another positive was a patient with resected and
      reconstructed mycotic aneurysm. CT-examination in all scans was suggestive for
      aortic graft infection in two cases (2/24; 8%), but neither of these patients
      showed any signs of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462701
TI  - Cellular biology of human intimal hyperplastic stenosis.
AB  - Restenosis after angioplasty and vascular surgery remains a major unsolved
      clinical problem. Vascular smooth muscle cell (VSMC) hyperplasia is an invariable
      response, but in 20-50% of cases proceeds to compromise the vessel lumen. We
      sought to identify cellular characteristics of human VSMC which are associated
      with restenosis. Human VSMC were grown from 135 samples of vascular tissue
      derived from patients undergoing primary cardiovascular surgery and revision
      surgery for restenosis. Cells derived from normal vein and artery,
      atherosclerotic plaques and from stenotic lesions were studied for successful
      proliferation in cell culture. Furthermore, growth rates were measured in
      response to 15% foetal calf serum +/- inhibition with heparin (100
      micrograms/ml). Significantly fewer cells from atherosclerotic plaques progress
      to the third passage in cell culture than those derived from stenoses and
      controls (p < 0.001, Chi square) and growth rates after the third passage could
      not be studied in these cells. Of cells that progress to this stage, growth rates
      do not differ between stenosis-derived and normal cells under standard
      conditions. VSMC from mature atherosclerotic plaques may have undergone senescent
      changes. Stenosis-derived cells do not grow more rapidly than normal cells, but
      are significantly less sensitive to heparin (p < 0.001, Mann-Witney test), which
      is a major physiological inhibitor of VSMC growth. Differences in biological
      characteristics of human VSMC, observed in cell culture, may provide important
      insights into human vascular disease.

PMID- 8462702
TI  - Management of asymptomatic popliteal aneurysms: the use of a Markov decision tree
      to determine the criteria for a conservative approach.
AB  - With recent improvements in the results of treatment of popliteal aneurysms, it
      has been suggested that it may be preferable to treat asymptomatic aneurysms
      conservatively and to operate only if symptoms develop. This hypothesis has been
      tested using decision analysis, with sensitivity and threshold analysis to
      establish the conditions under which such a policy would be appropriate. A Markov
      decision tree has been used to model the problem and the relevant probabilities
      have been obtained from a review of the current literature. A computer
      spreadsheet was used to calculate the results of policies of immediate operation
      or operation only if symptoms occur. Sensitivity and threshold analysis have been
      carried out to assess the effect of inaccuracy or alteration in the key variables
      and to determine the optimum policy under different conditions. The results
      suggest that early elective operation produces better results than conservative
      management at 1-2 years after presentation. Sensitivity analysis reveals that the
      most crucial data are the rate of development of symptoms in patients with
      asymptomatic aneurysms and the expected limb loss and mortality of treatment for
      symptomatic aneurysms. Threshold analysis has been used to define the values of
      these parameters that would be necessary for conservative management to be
      preferred. It is concluded that, based upon the currently available data, the
      optimum policy is elective treatment of asymptomatic aneurysms.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8462703
TI  - Cardiac risk stratification using dipyridamole myocardial perfusion imaging and
      ambulatory ECG monitoring prior to vascular surgery.
AB  - Both dipyridamole myocardial perfusion imaging (cardiolite) and ambulatory ECG
      monitoring (Holter) for silent ischaemia have been found to be useful for
      stratification of cardiac risk in patients undergoing vascular surgery. The
      purpose of this study was to compare the diagnostic accuracy of these two non
      invasive tests for prediction of perioperative cardiac events. One hundred
      patients (86 males, 14 females; mean age 67 +/- 8 years) underwent out-patient 48
      h Holter monitoring and cardiolite imaging prior to vascular surgery (70
      abdominal aortic aneurysm, 21 aortobifemoral, nine femoralpopliteal grafts).
      Ischaemia on Holter was defined as one or more episodes of ST segment depression
      1 mm or greater, lasting 1 min or longer. Myocardial perfusion imaging was
      carried out with the high dose dipyridamole protocol (0.84 mg/kg), cardiolite and
      planar imaging. Ischaemia was defined as a segmental perfusion abnormality
      following dipyridamole with improved perfusion on rest imaging. Holter was
      positive for ischaemia in 34/100 patients (34%). Cardiolite scans were positive
      for ischaemia in 30/100 patients (30%). Perioperative myocardial infarction
      occurred in nine patients (two cardiac deaths). [table: see text] The diagnostic
      accuracy of the two tests was similar, with a low positive predictive value of 15
      20%, and an extremely high negative predictive value of 94-96%. The event rate in
      patients with both tests negative was 2/48 (4.2%), with only one test positive
      3/40 (7.5%) and with both tests positive 4/12 (33%). A reasonable approach to
      risk stratification would be to obtain either a Holter or cardiolite scan
      initially.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462704
TI  - The integrity of experimental vein graft endothelium--implications on the
      etiology of early graft failure.
AB  - INTRODUCTION: the vascular endothelium serves as a functional barrier between the
      circulating blood and the vessel wall. It is an essential element for the
      maintenance of vascular homeostasis and is implicated in the pathogenesis of
      vascular disease. Reversed vein bypass grafting is considered to be a devastating
      procedure for the endothelial cell layer of the graft during the first 7 days. At
      this time, smooth muscle cell proliferation, the forerunner of intimal
      hyperplasia, begins. Loss of endothelial cell integrity is cited as an important
      factor in this smooth muscle cell response. The integrity of the vein graft
      endothelial lining after grafting was examined in this study. METHODS: reversed
      vein bypass grafting of the common carotid artery using external jugular vein was
      performed in 24 New Zealand white rabbits. All grafts were pressure fixed (80
      mmHg) in situ, at 0 and 10 min, 6 h and 1, 3, 5, 7 and 14 days postoperatively.
      The endothelial cell layer was examined by light microscopy (LM), scanning (SEM)
      and transmission electron microscopy (TEM) and immunohistochemistry (Factor VIII)
      using standard histological procedures. RESULTS: the endothelium was observed by
      SEM and confirmed by both LM, Factor VIII and TEM in all specimens. It covered
      almost the entire surface examined. At 0 and 10 min, endothelial cells were
      present and displayed minimal evidence of injury. At 6 h and 1 day, numerous red
      cells, polymorphonucleocytes (PMNs), platelets and fibrin were adherent to the
      luminal surface. Blood cells were also seen beneath the endothelium. At day 3,
      the adherent fibrin and cellular elements were reduced with most of the
      endothelial lining intact. Within 10 min, TEM demonstrated that these cells were
      stretched, very thin with few microvesicles and a blurred cytoplasm, which would
      indicate viability but a degree of cellular injury. By day 1, the endothelial
      cells were lifted from their underlying structures by subendothelial oedema and
      an infiltrate predominantly of PMNs. By day 5, the blood cells and fibrin which
      were adherent to the endothelium had been dispersed and the subendothelial
      infiltrate was to a large extent replaced by disintegrated PMNs. On days 7 and
      14, a viable confluent endothelial cell layer was present and a degree of intimal
      hyperplasia was noted. The endothelial cells appeared to have enlarged nucleoli
      and cytoplasms filled with a considerable quantity of rough endoplasmic
      reticulum. CONCLUSION: the endothelium of reversed vein grafts is preserved at
      the time of implantation and at all time intervals studied in this model. These
      findings do not support the assumption that endothelial denudation is a
      prerequisite for intimal hyperplasia. Endothelial cell dysfunction and
      morphological changes are maximal within the first 3 days after grafting but
      appear to recover by the 5th postoperative day. The gross preservation of the
      endothelial cell layer implies that therapeutic approaches, to mitigate
      endothelial cell injury and its consequences, should be focused on the
      preoperative period and the first 5 days following implantation.

PMID- 8462705
TI  - Natural history of patients with unoperated atherosclerotic carotid artery
      disease--results from a retrospective study.
AB  - The natural history of carotid artery disease was studied in a retrospective
      study of 609 angiograms performed during 1969-1979 on patients who had
      subsequently not been operated on. The indication for angiography differed, but
      was aimed at clarifying suspected cerebrovascular events. 578 patients could be
      followed-up after a median time of 10.4 years (0-22). The median survival time
      after angiography was 9.7 years for the 355 men and 12.8 years for the 223 women
      (p = 0.0099). Internal carotid stenosis of > 50% was seen in 9.0% (bilaterally in
      2.2%), a stenosis > 75% in 4.5% (bilaterally in 0.9%) and occlusion in 9%
      (bilaterally in 0.7%). Ulceration was present in 10.7% (bilaterally in 1.6%).
      26.5% of the patients had a cerebrovascular event during follow-up, of which
      31.4% had transient ischaemic attack or amaurosis fugax. Survival was not
      influenced by the degree of stenosis, but presence of arteriosclerotic carotid
      artery disease significantly reduced the median survival time from 11 to 3 years.
      The main cause of death for men was myocardial infarction (27.7%) and for women a
      cerebrovascular event (27.8%), a significant difference. From this study, in
      selected patients it can be concluded that the annual frequency of
      cerebrovascular events was low, approaching frequencies reported in asymptomatic
      patients. The cause of death differed between men and women, with more cardiac
      deaths among men and more cerebrovascular deaths among women.

PMID- 8462706
TI  - Three dimensional time-of-flight magnetic resonance angiography in carotid artery
      surgery: a comparison with digital subtraction angiography.
AB  - Three dimensional time-of-flight magnetic resonance angiography (MRA) and intra
      arterial digital subtraction angiography (DSA), considered the gold-standard
      technique, were compared for pre- and postoperative evaluation of the carotid
      bifurcation. Images of suitable quality of 194 bifurcations were available with
      both techniques. Percentage stenosis was graded into 5 groups: A = 0-29%, B = 30
      59%, C = 60-89%, D = 90-99%, E = 100% (occlusion). Preoperative MRA (126
      bifurcations) overgraded the stenosis in 14 cases and undergraded it in 11. The
      two techniques agreed in 101 cases and the extent of misgrading was never more
      than one category. Regression analysis showed a good correlation between the two
      methods. Severe ulceration was better identified by DSA. As far as the surgical
      indication was concerned, MRA had a sensitivity of 92.6% and a specificity of
      98.3%. In 68 operated cases, postoperative MRA and intraoperative completion
      angiography showed a satisfactory endarterectomy with no residual stenosis in any
      of the cases. In conclusion, MRA seems an accurate modality for imaging of
      carotid bifurcations. Significant limitations still exist for an adequate
      demonstration of intracranial circulation.

PMID- 8462707
TI  - Calf vessel preservation in peripheral vascular disease--angiography versus pulse
      generated run-off.
AB  - Previous angiographic and radiological studies have suggested that the peroneal
      artery is the best preserved of the calf vessels in peripheral vascular disease
      and should be a site of preference for a femorodistal bypass graft. Calf vessel
      run-off assessed by pulse generated run-off (PGR) provides a more accurate
      prediction of graft success or failure than angiography and may therefore give a
      better functional picture of vessel patency than angiography. This study compares
      the presence and degree of preservation of the three calf vessels in patients
      with severe peripheral vascular disease using both intra-arterial digital
      subtraction angiography (IADSA) and PGR. Thirty-four limbs in patients with
      either ischaemic rest pain, ulceration or gangrene were studied and the results
      were scored according to the extent and severity of disease in the peroneal,
      posterior tibial and anterior tibial arteries. On IADSA, the peroneal artery was
      patent significantly more often (79%) than the posterior tibial artery (47%) or
      the anterior tibial artery (38%). Conversely, PGR examination showed no
      difference in patency between the three vessels (peroneal 91%, posterior tibial
      88%, anterior tibial 79%). The peroneal artery was also significantly better
      preserved on IADSA (65%) compared to the posterior tibial artery (38%) and the
      anterior tibial artery (23%). PGR studies again showed no difference in the best
      preserved vessel between peroneal (47%), posterior tibial (50%) and anterior
      tibial (50%) arteries. Thus, the peroneal artery appears the better preserved
      vessel on angiography but this appearance may be misleading because the more
      functional PGR studies show no significant difference in the patency or degree of
      preservation of the three calf vessels.

PMID- 8462708
TI  - Cardiac risk screening of peripheral arterial surgical patients by the use of
      combined simple clinical and non-invasive cardiodynamic parameters.
AB  - Arterial surgical patients have a poor long-term survival and suffer significant
      risks of experiencing perioperative cardiac events, mainly due to a high
      incidence of coronary atherosclerosis impairing left ventricular function. The
      perioperative cardiac risk can be assessed by use of clinical cardiac risk
      indices, which are inexpensive but may have suboptimal sensitivity, or by more
      extensive cardiac tests. In this study the efficacy of a combined, non-invasive
      and inexpensive technique of risk assessment was prospectively evaluated in 195
      patients undergoing peripheral arterial surgery (aortic aneurysms not included).
      All patients were preoperatively examined by a nurse registering the Detsky
      cardiac risk index score (DRI) and performing resting computerised bioimpedance
      cardiodynamic measurements (CM). Cardiac deaths (CD, n = 6), potentially lethal
      cardiac complications (PLC, n = 11) within 30 days and long-term survival during
      20 +/- 12 (S.D.) months of follow-up were identified. CD was best predicted by
      combining CM and DRI, while PLC was best predicted by combining DRI and the
      haemoglobin concentration of the blood (Hb). A group without CD containing 88% of
      the cases was identified. Furthermore, the combination of DRI < or = 10 and Hb >
      120 g/l identified a low risk group (57% of all cases) with no PLC or CD. Using
      CM, DRI and Hb in combination, patient groups with long-term survival from 0-90%
      were identified. We conclude that this inexpensive cardiac risk screening both
      identifies low risk vascular surgical patients, for whom more sophisticated
      preoperative cardiac testing can be omitted, and predicts long-term survival.

PMID- 8462709
TI  - Renal duplex scanning: correlation with angiography and isotopic renography.
AB  - The purpose of this study was to assess the accuracy of Duplex scanning in
      detecting renovascular disease and to compare it with angiography, renal
      scintigraphy and captopril test for plasma renin activity and isotopic
      renography. A Duplex scan was performed in 92 renal arteries (46 patients) and
      compared to angiography. Three degrees of stenoses were established: 0-60%, 61
      99% and occlusion. The peak systolic velocity (PSV) in the renal artery and its
      ratio to the peak velocity in the aorta (RAR) were used to discriminate stenoses
      > 60%. PSV in the interlobar arteries was used to assess the relative perfusion
      of both parenchyma. Angiography demonstrated a stenoses > 60% in 23 hypertensive
      patients. In all of the patients, plasma renin activity was measured and isotopic
      renograms (pre- and post-captopril) obtained in order to discriminate
      hypertension of vascular origin. A PSV in the renal artery > 210 cm/s and a RAR >
      3.5 were found to be the diagnostic criteria with the best sensitivity and
      specificity in detecting stenoses > 60%. Based on these data, Duplex correctly
      identified 49/54 stenoses > 60%; 28/33 stenoses < 60%; and 5/5 occlusions (kappa
      0.79). Sensitivity and specificity in detecting stenoses > 60% were 89.5 and
      90.7%, respectively. The ratio between PSV in the interlobar arteries of both
      parenchyma accurately predicted the relative perfusion (ratio between DTPA uptake
      in both kidneys) in the isotopic test (n = 23, r = 0.91, p = 0.001). The
      captopril test (for plasma renin activity and isotopic renography) was positive
      in only five patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462710
TI  - Peripheral nerve function in chronic venous insufficiency.
AB  - Abnormalities of vasomotion, impairment of the venoarteriolar reflex and
      increased skin blood flow reported in the liposclerotic skin of patients with
      chronic venous insufficiency (CVI) suggest altered nervous control of the skin
      microcirculation. The aim of this study was to determine whether patients with
      CVI have a peripheral neuropathy. Forty patients with CVI and
      lipodermatosclerosis (LDS) and 35 age and sex-matched controls were examined for
      neuropathy using three modalities of testing. Threshold to warming was used to
      assess unmyelinated fibres, and threshold to cooling and vibration to assess
      myelinated fibres. Warming and cooling thresholds were measured on the sole of
      the foot by a purpose built, computer controlled instrument. The threshold to
      vibration was measured on the big toe using the Ohio Bio-thesiometer. A
      significantly raised threshold to warming and vibration was found in the CVI
      group compared to the normal controls [median threshold to warming (interquartile
      range) in CVI group = 5.3 (0.1-9.1) median threshold to warming (interquartile
      range) in controls = 1.21 (0.17-3.5), p = 0.005 and median threshold to vibration
      (interquartile range) in CVI group = 22 (13-31) median threshold to vibration
      (interquartile range) in controls = 12 (8.5-27.5), p = 0.024]. The thresholds to
      cooling was not statistically different in the two groups. This study
      demonstrates the presence of a peripheral neuropathy in patients with chronic
      venous insufficiency, and this may be important in the pathogenesis of venous
      ulceration.

PMID- 8462711
TI  - Congenital absence of inferior vena cava.

PMID- 8462712
TI  - Chylous ascites: a rare complication following aortic surgery.

PMID- 8462713
TI  - Two vascular complications of the Ehlers-Danlos syndrome.
AB  - Patients with Ehlers-Danlos syndrome type IV have thin walled, friable arteries
      and veins and are prone to spontaneous arterial rupture. We present a patient who
      suffered severe damage to the common femoral vein during surgery for varicose
      veins and who subsequently suffered a spontaneous rupture of the right external
      carotid artery, treated by ligation and oversewing. Intraarterial radiology and
      surgery in such patients are hazardous and should be avoided if possible. Where
      operation is essential, the simplest available procedure should be performed.
      Patients should be counselled to inform every doctor they consult that they have
      the Ehlers-Danlos syndrome.

PMID- 8462714
TI  - False aortic aneurysm presenting as sciatic nerve root pain.
AB  - Neurological symptoms and signs are rarely the only presenting feature of
      abdominal aortic aneurysm. We present a patient presenting with sciatic nerve
      root pain due to a large false aneurysm in iliopsoas.

PMID- 8462715
TI  - Autumnal aneurysm ruptures.

PMID- 8462716
TI  - Femoropopliteal arterial reconstruction.

PMID- 8462717
TI  - Second European Consensus Document on Chronic Critical Limb Ichaemia.

PMID- 8462718
TI  - Why, when and how does the poly(A) tail shorten during mRNA translation?
AB  - 1. The length of the poly(A) tail at the 3'-end of mRNA may control protein
      synthesis by bringing the 3'-end in close proximity to the 5'-end of the
      noncoding region as well as increasing the duration of mRNA translation by its
      binding to the poly(A) binding protein. 2. The rate-limiting step in the decay of
      the body of the message is the shortening of a long poly(A) tail during mRNA
      translation. The shortening of the poly(A) tail occurs during pre-elongation in
      the protein synthesis cycle. 3. The shortening of the poly(A) tail during mRNA
      translation may not involve RNase activity, however poly(A) binding protein seems
      to play a role, at least in part, in shortening of the poly(A) tail.

PMID- 8462719
TI  - Control of glycolytic enzymes through binding to cell structures and by glucose
      1,6-bisphosphate under different conditions. The role of Ca2+ and calmodulin.

PMID- 8462720
TI  - Protein engineering on subtilisin.

PMID- 8462721
TI  - Occurrence of a 29 kDa polysaccharide in the slime layer of both smooth and rough
      strains of Pseudomonas aeruginosa.
AB  - 1. The lipopolysaccharide (LPS) and the extracellular products (slime) of a
      smooth, nonmucoid Pseudomonas aeruginosa strain (PAC IR) and its rough mutant
      (PAC 605) were subjected to a comparative biochemical analysis. 2. Chemical and
      electrophoretic analyses suggested that the slime preparation of both strains are
      composed mainly of similar carbohydrate components which are different from those
      of the respective lipopolysaccharides. 3. Chromatographic analysis of the two
      slime preparations on gel permeation HPLC columns revealed the presence of a
      major polysaccharide in both strains with an apparent molecular weight 29 kDa and
      a minor high molecular weight polysaccharide in the PAC IR strain.

PMID- 8462722
TI  - The inhibitory effect of tetramethylethylene diamine on water soluble and
      membrane bound acetylcholinesterase activity.
AB  - 1. The inhibitory effect of N,N,N',N'-tetramethylethylene diamine (TEMED) on
      water soluble (WSAChE) and membrane bound (MBAChE) acetylcholinesterase was
      investigated. 2. TEMED (0.5-4.0 mM) reversibly inhibited WSAChE activity (18-62%)
      and MBAChE (20-61%) in a concentration dependent manner. 3. The IC50 being about
      2.8 mM for WSAChE and 2.6 mM for MBAChE. 4. Lineweaver-Burk plots indicated that
      the nature of inhibition is noncompetitive for both water soluble and membrane
      bound acetylcholinesterase, with Km values 68 microM and 123 microM respectively.
      5. An Arrhenius plot showed that the transition temperature (TT) is unaffected in
      the presence of TEMED. 6. The activation energy was increased below and above TT
      in the case of WSAChE only. 7. On the basis of this behaviour of TEMED with AChE,
      it can be proposed that it can be used as an eluting agent for the bounded AChE
      to affinity ligand and may have beneficial action on the reactivatability of
      irreversibly-inhibited AChE due to its structure. 8. Moreover there is a
      possibility that it can be used as a therapeutic agent for the treatment of
      Alzheimer's disease, myasthenia gravia and glaucoma like some other inhibitors of
      AChE.

PMID- 8462723
TI  - Hyaluronidase degradation of hyaluronic acid from different sources: influence of
      the hydrolysis conditions on the production and the relative proportions of tetra
      and hexasaccharide produced.
AB  - 1. Hyaluronic acid (HA) can be digested with a Streptomyces hyaluronidase. 2. The
      rate of production and the ratio of tetrasaccharide (T) and hexasaccharide (H),
      studied by HPLC, varied with the temperature and duration of hydrolysis. 3. The
      rates of production and the respective amounts of the two oligosaccharides
      depended on the rheological properties of the HA from different sources. 4. A
      close relationship was found between the initial rate of hydrolysis and the
      intrinsic viscosity of the HA (eta i). 5. Our data suggest that enzymatic
      degradation at a given pH value, temperature, and duration of hydrolysis is
      dependent on the conformation of HA. 6. Moreover, under given conditions, the
      relative proportions of the two oligosaccharides depend on the eta i and may also
      reflect the degree of hydrolysis of the substrate.

PMID- 8462724
TI  - Monoclonal antibodies prepared against heparin lyase I and their reactivity
      toward heparin lyase I, II and III.
AB  - 1. Six different monoclonal IgG mouse antibodies to heparin lyase I from
      Flavobacterium heparinum were prepared. 2. The monoclonal antibodies were used to
      detect heparin lyases I, II and III by dot-blotting immunoassay and by Western
      blotting. 3. Individual antibodies showed different reactivity toward the three
      heparin lyases. 4. The reactivity of two of the monoclonal antibodies was
      destroyed by exposing heparin lyases to sodium dodecyl sulfate. 5. The antibodies
      can be used to rapidly distinguish between the three heparin lyases.

PMID- 8462725
TI  - Effects of exercise training and anabolic steroids on plantaris and soleus
      phospholipids: a 31P nuclear magnetic resonance study.
AB  - 1. The purpose of this study was to examine the effect of exercise, anabolic
      steroid treatment, and a combination of both treatments on the phospholipid
      composition of predominantly fast twitch (plantaris) and slow twitch (soleus)
      skeletal muscles. The 4 experimental groups analyzed were sedentary control (C),
      steroid-treated (S), exercise-trained (E), and exercise plus steroid-treated
      (ES). 2. Among the 11 phospholipids quantitated, for the plantaris muscle,
      phosphatidylcholine was reduced in ES relative to C, while
      phosphatidylethanolamine and phosphatidylethanolamine plasmalogen were elevated
      in E and ES relative to C. For the soleus muscle, phosphatidylserine was reduced
      in S and E relative to C, and cardiolipin was elevated in E relative to C. 3. Of
      the 27 metabolic indices calculated for the plantaris, 15 changed significantly
      among E and ES relative to S and C, while for the soleus, only three indices
      changed among the four groups, two among E and ES relative to S and C and one
      between S and C. 4. For the plantaris muscle, the results are consistent with an
      exercise-induced alteration of membrane phospholipid composition that increases
      ion translocation activity. For the soleus muscle, this membrane alteration
      essentially does not take place. 5. Steroid treatment had little to no
      statistically significant effect on plantaris and soleus muscle phospholipid
      systems, regardless of the imposed regimen.

PMID- 8462726
TI  - Inactivation of ornithine decarboxylase by intermediates of tyrosinase-catalyzed
      reaction.
AB  - 1. Intermediates in the process of melanin synthesis formed through oxidation of
      catechols by tyrosinase produced the inactivation of ornithine decarboxylase
      (ODC), a key enzyme in the polyamine biosynthesis pathway. 2. The inactivation
      was dependent on the substrate used (dihydroxybenzylamine > L-3,4
      dihydroxyphenylalanine > L-tyrosine) and on the concentration of intermediate
      produced rather than on the rate of formation. 3. Sulfhydryl compounds
      (dithiothreitol and glutathione) or quinone-reducing agents (ascorbic acid)
      prevented the inactivation of ODC; L-ornithine, but not other amino acids, also
      protected partially ODC. The results suggest that different cysteine residues in
      ODC molecule are implicated in the inactivatory event. 4. When 14C-labeled
      catechols were used, numerous polypeptides resulted labeled, showing that the
      reactive quinones formed as intermediates in the process of melanin biosynthesis
      bind covalently to many cellular proteins.

PMID- 8462727
TI  - Expression of a putative catalytic domain of the human APEX nuclease (a major
      apurinic/apyrimidinic endonuclease) in Escherichia coli.
AB  - 1. Sequence analyses of APEX nuclease, a mammalian major apurinic/apyrimidinic
      (AP) endonuclease homologous to Escherichia coli exonuclease III, suggested that
      APEX nuclease is organized into two domains, a Mr 6000 N-terminal domain
      containing nuclear location signals and a Mr 29,000 C-terminal catalytic domain.
      2. In order to study the enzyme structure further, vectors expressing APEX
      nuclease (pTAPXH1) and the Mr 29,000 C-terminal region (pTAPXH61) were
      constructed using cDNA (APX cDNA) for the human APEX nuclease and pTrc99A
      plasmid. The constructs were introduced into BW2001 strain (xth-11, nfo-2) cells
      of E. coli to produce transformants designated as BW2001/pTAPXH1 and
      BW2001/pTAPXH61, respectively. Both the APEX nuclease expressed in BW2001/pTAPXH1
      and the Mr 29,000 C-terminal peptide expressed in BW2001/pTAPXH61 were partially
      purified by column chromatography and highly purified by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. 3. The purified APEX nuclease and the Mr
      29,000 C-terminal peptide both showed equally high AP endonuclease activity which
      indicates that the Mr 29,000 C-terminal region of the APEX nuclease is (or
      contains) the AP endonuclease domain.

PMID- 8462728
TI  - Measurement of non-enzymic glycosylation with a radiochemical assay.
AB  - 1. A radiochemical assay has been developed to measure non-enzymic glycosylation
      (glycation), which is free from interference from enzymic glycosylation and which
      can be used in batch analysis. 2. Glycated residues were isolated by affinity
      chromatography on mini-columns, after reduction with Na[3H]BH4 and hydrolysis. 3.
      The specific activity of the labelled borohydride was measured by a novel
      procedure. 4. The method was used to measure glycation of albumin, immunoglobulin
      G and fibrinogen isolated from diabetic and non-diabetic subjects.

PMID- 8462729
TI  - Lipoxygenase and other enzymes of arachidonic acid metabolism in the brain of
      chicks affected by nutritional encephalomalacia.
AB  - 1. Prostaglandin endoperoxide synthetase (PES) and lipoxygenase (Lox) activities
      were compared in the cerebella and cerebra of vitamin E-sufficient young chicks
      and in chicks in which nutritional encephalomalacia (NE) was induced by a diet
      deficient in vitamin E. 2. Eicosanoid production patterns were qualitatively
      similar in the brains of both groups of chicks, but prostaglandin production was
      50-60% less in cerebella of ataxic chicks, compared to control cerebella, while
      the opposite trend was observed in the cerebellar Lox pathway, as measured by
      radioimmunoassay of 15-HETE. 3. Cerebellar phospholipase A2 activity was twice
      that of the cerebrum but was not affected by NE. 4. Purification of Lox activity
      from the cerebellar homogenates produced a lower yield and enrichment when the
      starting material was taken from ataxic chicks, compared to the controls. 5. In
      addition there were qualitative differences in the purified fractions from both
      groups, as seen by pH optima and kinetics. 6. The results are consistent with the
      view that the cerebellum has less antioxidant protection than the cerebrum and
      that its higher phospholipase A2 activity and greater propensity to oxygenate
      arachidonic acid via the Lox pathway at the expense of the PES pathway may render
      this region of the brain particularly vulnerable to oxidative damage in NE.

PMID- 8462730
TI  - Comparative analysis of the antibodies against capsular polysaccharides of
      Escherichia coli K-92 and K-235: an immunochemical method for the identification
      of polysialic acids.
AB  - 1. The antibodies produced against the capsular poly-N-acetylneuraminic acid
      (poly-Neu5Ac) of E. coli K-92 (alpha 2-8-, alpha 2-9-linked) were 100-fold less
      sensitive than those obtained against E. coli K-235 capsular polysaccharide (CP)
      (alpha 2-8-linked) and recognized both kinds of polymers to a similar extent. 2.
      The partial hydrolysis of each purified polysaccharide revealed that E. coli K-92
      CP is more labile at acidic pH than the polymer alpha 2-8-linked of E. coli K
      235. 3. The antisera against CP from E. coli K-92 bound its own oligomers in
      which the number of Neu5Ac units was higher than three, whereas they only cross
      reacted with the oligomers derived from E. coli K-235 containing a number of
      residues higher than 12. 4. The antisera against E. coli K-235 CP that recognized
      alpha 2-8 oligomers with a number of Neu5Ac residues higher than 5, also reacted,
      although very weakly, with those containing alpha 2-8 and alpha 2-9 linkages in
      which the carbon length was higher than (Neu5Ac)3. 5. Both types of antibodies
      were also able to recognize the native antigens in living bacteria and could be
      employed for the recognition of the type of linkage presents in different
      sialylpolymers.

PMID- 8462731
TI  - Selective effect of melatonin on the proliferation of lymphoid cells.
AB  - 1. The present study was designed to investigate the effect of melatonin on the
      proliferation of normal lymphocytes and certain T-lymphomas and myelomas under in
      vitro conditions. 2. The results revealed that administration of 200 microM
      melatonin inhibited significantly the incorporation of [3H]thymidine into both
      normal mouse and human lymphocytes and T-lymphoblastoid cell lines. 3. On the
      contrary, melatonin provoked an increase of myeloma cell proliferation. 4. The
      influence of melatonin on hybridoma cell lines was negligible. 5. Collectively,
      these data demonstrated that the chief pineal indole affect selectively the
      processes of lymphoblastoid cell growth.

PMID- 8462732
TI  - The phospholipase activities present in preheparin mouse plasma are inhibited by
      antiserum to hepatic lipase.
AB  - 1. Preheparin plasma from mice, but not rats or man, contains high levels of
      phospholipase A and lysophospholipase activities which are distinct from
      lecithin:cholesterol acyltransferase (LCAT). 2. Neither the phospholipase A nor
      the lysophospholipase activities in preheparin plasma are inhibited by incubation
      in the presence of protamine sulphate or high salt concentrations. 3. When mouse
      plasma is incubated in the presence of an antiserum specific for rat hepatic
      triacylglycerol lipase (HTGL), the phospholipase activities are abolished. 4.
      These observations suggest that the phospholipase activities are attributable to
      the action of HTGL, which, in the mouse appears to be a freely circulating
      enzyme, whereas for other species this enzyme only appears in the blood following
      administration of heparin.

PMID- 8462733
TI  - Proliferation of chicken myoblasts is regulated by specific isoforms of platelet
      derived growth factor: evidence for differences between myoblasts from mid and
      late stages of embryogenesis.
AB  - In the present study we measured the level of PDGF receptor expression by chicken
      myoblasts and the effect of the three different PDGF isoforms (AA, AB, BB) on DNA
      synthesis by myoblasts. We examined PDGF receptor expression and function on
      clonally derived myoblasts in order to eliminate contaminating fibroblasts which
      are present in myogenic cultures and which bind PDGF. Furthermore, since we have
      previously shown that fetal myoblasts are replaced with adult myoblasts during
      late chicken embryogenesis, we compared PDGF receptor expression and function on
      myoblasts from Embryonic Day 10 (E10, mid development) and from Embryonic Day 19
      (E19, late development). We found that all myogenic clones from late embryos
      (E19) express many receptors for PDGF-BB, far fewer receptors for PDGF-AB, and
      even fewer, if any, receptors for PDGF-AA. Myoblast clones derived from E10 were
      more heterogeneous in their PDGF binding pattern ranging from clones similar to
      E19 clones to clones having very few PDGF binding sites. We also found that both
      PDGF-AB and PDGF-BB can promote DNA synthesis by clonally derived chicken
      myoblasts maintained in 2.5% fetal bovine serum whereas PDGF-AA has no detectable
      effect. Finally, we observed that primary myogenic cultures from E10 and E19
      differ strikingly in levels of PDGF binding; E19 cultures bind much more PDGF
      than do E10 cultures. We conclude that PDGF can enhance the proliferation of
      chicken myoblasts and that myoblasts responsive to PDGF are more frequent in late
      than in mid stages of development. We propose that PDGF may be a modulator of
      myogenesis of adult but not fetal myoblasts.

PMID- 8462734
TI  - Expression of the SmN splicing protein is developmentally regulated in the rodent
      brain but not in the rodent heart.
AB  - The SmN protein is a tissue-specific splicing factor which is closely related to
      the ubiquitous SmB splicing protein but which is expressed only in the adult
      brain and heart. SmN is also detectable albeit at a low level in both the
      embryonic brain and heart. During heart development, SmN levels remain constant
      while during rodent brain development the levels of SmN rise such that SmN
      replaces SmB as the predominant protein in adult brain. This increase in SmN
      levels is dependent upon a corresponding increase in the SmN mRNA which is
      detectable by in situ hybridization within neurons in virtually all areas of the
      adult brain.

PMID- 8462735
TI  - A functional role for the middle extracellular region of the neural cell adhesion
      molecule (NCAM) in axonal fasciculation and orientation.
AB  - A new monoclonal antibody (mAb HR1) was used to study the function of a
      previously neglected region in the extracellular domain of the neural cell
      adhesion molecule (NCAM). Application of mAb HR1 in retina organ culture
      interferes with several axonal functions in the developing eye. The antibody
      disturbs the orientation of axons growing in the peripheral retina and the
      tracking of axons in the middle retina. In the central retina, fasciculation is
      disturbed and a proportion of the ganglion cell axons do not leave the eye at the
      optic fissure but are misrouted to the contralateral side of the retina. Analysis
      of peptide fragments of NCAM indicates that the epitope of mAb HR1 resides in the
      region C-terminal to the fifth immunoglobulin (Ig) domain. Moreover, mAb HR1
      binds to the oligopeptide comprising the 15 amino acids immediately C-terminal to
      the fifth Ig domain of NCAM. In addition, binding of mAb HR1 to NCAM is increased
      by removal of the large polysialic acid chains of the fifth Ig domain. Taken
      together, the data show that this region of NCAM--which has been previously
      reported to represent the flexible hinge region of the molecule--is crucial for
      the function of this molecule, in particular on cell surfaces in motion, e.g.,
      those of growing axons in the developing nervous system.

PMID- 8462736
TI  - Neural crest-derived cells isolated from the gut by immunoselection develop
      neuronal and glial phenotypes when cultured on laminin.
AB  - The neural crest-derived cells that colonize the bowel are different from their
      predecessors in the premigratory crest. A procedure, which utilized the
      immunoselection of cells with a magnet, was thus devised to obtain crest-derived
      precursors from developing gut. Primary antibodies against cell surface antigens,
      NC-1 in chick, quail, and rat, or antibodies to a 110-kDa laminin binding protein
      (alpha-110) in mouse, were used in conjunction with secondary antibodies coupled
      to magnetic beads. Immediately after immunoselection with NC-1, almost all of the
      selected cells were NC-1-immunoreactive. Neurons and glia, identified
      immunocytochemically with antibodies to specific markers, developed
      preferentially in cultures of immunoselected cells. Some of the phenotypes
      expressed by neurons arising in vitro were appropriate for the bowel (serotonin-
      and vasoactive intestinal peptide-immunoreactive); however, catecholaminergic
      neurons, which are not present in the enteric nervous system, also differentiated
      in the cultures. Neuronal development, as well as neurite outgrowth, were
      promoted by laminin. Cells selected with alpha-110 from the fetal murine bowel
      preferentially gave rise in vitro to neurons and glia. These data suggest that
      the population of crest-derived cells that colonizes the gut is multipotent, that
      development of catecholaminergic neurons in situ is prevented by the intact
      enteric microenvironment, that laminin is important in the formation of enteric
      ganglia, and that the 110-kDa laminin binding protein is expressed on the
      surfaces of the immediate precursors of enteric neurons and glia.

PMID- 8462737
TI  - Characterization of the mineralization process in cultures of rabbit growth plate
      chondrocytes.
AB  - The present study was undertaken to investigate the mineralization process in
      chondrocyte cultures. Chondrocytes were isolated from the growth plate of ribs of
      4-week-old rabbits. The nature and properties of mineral crystals precipitated in
      chondrocyte cultures were compared with those of crystals formed in the
      hypertrophic zone and bone of rabbit rib growth plates in vivo. The chondrocytes
      were maintained at high density on type II collagen-coated dishes in Eagle's
      medium, alpha-modification, with 10% fetal bovine serum and 50 micrograms/ml of
      ascorbic acid. These cells differentiated into hypertrophic cells 10 days after
      seeding and produced alkaline phosphatase and 1,25-dihydroxyvitamin D3 receptors
      on Days 30-70 at levels as high as those in the lower hypertrophic zone in vivo.
      Mineralization was initiated between Days 20 and 30 and advanced progressively
      throughout the culture period. However, mineralization was suppressed by the
      addition of parathyroid hormone (2 x 10(-8) M) or by the presence of fibroblasts.
      Examination by electron microscopy and Fourier transform infrared (FTIR)
      spectroscopy verified that mineralized nodules formed in vitro were composed of
      small apatite crystals. Importantly, FTIR spectral features of the apatite
      crystals (e.g., the prominent PO4 bands at 1125 and 1032 cm-1) were similar to
      those of cartilage apatites formed in vivo and differed markedly from those of
      carbonated bone apatites. These results suggest that growth plate chondrocytes
      cultured on collagen-coated dishes are an appropriate model for studies on
      cartilage mineralization.

PMID- 8462738
TI  - Transient appearance and localization of a 26-kDa lectin, a novel member of the
      Periplaneta lectin family, in regenerating cockroach leg.
AB  - A lectin consisting of a 26-kDa subunit was purified from the hemolymph of adult
      American cockroaches (Periplaneta americana) and shown to be a member of the
      Periplaneta lectin family. Immunoblotting analysis revealed that this lectin
      appeared transiently in regenerating legs after nymphal legs were amputated.
      Thus, its mode of appearance was similar to that of regenectin, another member of
      the Periplaneta lectin family. However, its time of appearance and localization
      in the regenerates were different from those of regenectin: the 26-kDa lectin
      appeared in regenerates in the middle stage of regeneration and was localized in
      the vicinity of the outside of newly formed epidermal cells. These results
      suggest that this lectin participates in the organization or stabilization of the
      epidermis during leg regeneration.

PMID- 8462739
TI  - Mosaic methylation in clonal tissue.
AB  - Current models suggest that de novo methylases add methyl groups to mammalian DNA
      early in development, establishing cell-specific patterns of methylation, and
      that these patterns are maintained by maintenance methylases that copy them onto
      newly replicated DNA strands. To test the prediction that clonal populations of
      histologically homogeneous cells should, therefore, have homogeneous methylation
      patterns, we studied methylation in leiomyomas. Despite the clonality and
      histological homogeneity of these solid tumors, we found that cells were
      heterogeneously methylated at a number of genomic sites. The heterogeneity was
      not caused by random methylation events within the leiomyomas because methylation
      patterns were similar in the core and periphery of a given tumor, and similar
      also among samples of independent leiomyomas and surrounding myometrial tissues
      extracted from a single uterus. Our results also showed that methylation of a
      site in the YNZ22 locus--in leiomyomas and in smooth muscle--was determined
      independently from the methylation of a neighboring site. Similar results were
      obtained for the IGH locus in colon and in several tumor tissues. These data
      indicate that methylation patterns are not identical in progeny cells, as current
      models suggest. Instead, it seems likely that methylation of a specific site
      reflects an equilibrium frequency defined by a continual loss and gain of methyl
      groups. Hence, the specificity found for the methylation of mammalian tissues is
      not achieved by strictly determining the methylation fate of individual cells,
      but by determining the overall methylation frequencies for individual sites.

PMID- 8462740
TI  - Identification of DNA-binding protein(s) in the developing heart.
AB  - An antiserum (anti-H2) directed at the second helix of the helix-loop-helix (HLH)
      protein MyoD1 reacts with a protein expressed during avian cardiac myocyte
      differentiation. Indirect immunohistochemical whole mount staining with anti-H2
      detected a protein expressed in stage 11 hearts, but not in hearts of older
      embryos. At the cellular level, this staining is confined to the nucleus of
      cardiac cells suggesting that these proteins may have DNA-binding abilities.
      Several proteins were immunoprecipitated by anti-H2 from stage 11 heart tissue.
      Protein extracts from similarly staged hearts, when incubated with the muscle
      specific enhancer sequence of muscle creatinine kinase (MCK), gave a stage
      specific band shift in electromobility shift assays (EMSA), and these protein-DNA
      complexes were recognized and supershifted by anti-H2. Incubation with a MCK
      sequence containing a mutated E box did not produce a shift. The specific shift
      was present as early as stage 6, remained through stage 13, and disappeared by
      stage 17. These data suggest the presence of at least one protein that is
      transiently expressed in the differentiating cardiac myocyte, that is
      immunochemically reactive with an antiserum raised against the second helix of
      MyoD1, and that binds to a muscle-specific DNA enhancer sequence.

PMID- 8462741
TI  - Expression of AV-1, a position-specific molecule, in response to retinoic acid
      beads and ZPA grafts in chick limb development.
AB  - Local application of retinoic acid (RA) to the anterior-distal margin of chick
      limb buds causes digit pattern duplications identical to those that result from
      zone of polarizing activity (ZPA) grafts. The AV-1 antigen is a cell membrane
      glycoprotein which is expressed during chick limb bud development in a stage- and
      position-specific manner that correlates with cartilage pattern formation. In
      order to further understand the limb patterning mechanisms affected by RA and by
      ZPA grafts, we first examined the effects of RA treatment on AV-1 expression. We
      then compared the effect of RA with those of ZPA grafts. When beads soaked in
      varying concentrations of RA were applied to the anterior-distal margin of wing
      buds, changes in the pattern of AV-1 antigen expression were observed. AV-1
      expression appears to correlate with regions that will give rise to a digit 3.
      These results suggest that the AV-1 protein is one of the molecules which may be
      involved in the process of cartilage pattern formation during limb development.
      ZPA grafts produced similar alterations in AV-1 expression, but the initial
      changes were observed earlier with ZPA grafts than with RA beads. These results
      support the idea that RA changes anterior limb bud cells into ZPA cells.

PMID- 8462742
TI  - Transcriptional elements from the human SP-C gene direct expression in the
      primordial respiratory epithelium of transgenic mice.
AB  - Transgenic animals bearing a chimeric gene containing 5'-flanking regions of the
      human surfactant protein C (SP-C) gene ligated to the bacterial chloramphenicol
      acetyltransferase (CAT) gene were analyzed by in situ hybridization
      histochemistry to determine the temporal and spatial distribution of transgene
      expression during organogenesis of the murine lung. Ontogenic expression of the
      SP-C-CAT gene was compared to that of the endogenous SP-C gene and to the Clara
      cell CC10 gene. High levels of SP-C-CAT expression were observed as early as Day
      10 of gestation in epithelial cells of the primordial lung buds. Low levels of
      endogenous SP-C mRNA were detected a day later, but only in the more distal
      epithelial cells of the newly formed, primitive, lobar bronchi. On Gestational
      Days 13 through 16, transcripts for both the endogenous and chimeric gene were
      restricted to distal epithelial elements of the branching bronchial tubules and
      were no longer detected in the more proximal regions of the bronchial tree.
      Although high levels of SP-C-CAT expression were maintained throughout
      organogenesis, endogenous SP-C expression increased dramatically on Gestational
      Day 15, coincident with acinar tubule differentiation at the lung periphery. Low
      levels of endogenous CC10 expression were detected by Gestational Day 16 in both
      lobar and segmental bronchi. By the time of birth, CC10 transcripts were
      expressed at high levels in the trachea and at all levels of the bronchial tree;
      endogenous SP-C mRNA was restricted to epithelial cells of the terminal alveolar
      saccules; and SP-C-CAT expression was now detected in both alveolar and
      bronchiolar epithelial cells. These results indicate that (1) cis-acting
      regulatory elements of the human SP-C gene can direct high levels of foreign gene
      expression to epithelial cells of the embryonic mouse lung; (2) expression of the
      human SP-C-CAT chimeric gene is developmentally regulated, exhibiting a
      morphogenic expression pattern similar, but not identical, to that of the
      endogenous murine SP-C gene; (3) the embryonic expression of endogenous SP-C and
      chimeric SP-C-CAT transcripts identifies progenitor cells of the distal
      respiratory epithelium; and (4) differentiation of bronchial epithelium is
      coincident with loss of SP-C expression and subsequent acquisition of CC10
      expression in proximal regions of the developing bronchial tubules.

PMID- 8462743
TI  - Fibroblast growth factor influences the development and cycling of murine hair
      follicles.
AB  - The effects of basic fibroblast growth factor (bFGF) on the development of hair
      follicles in neonatal mouse skin were examined. Newborn mice (B6C3-based strain)
      were given daily subcutaneous injections of bFGF and bovine serum albumin (BSA)
      for 7 days. By Day 9, distinct areas of hairless, unpigmented skin were observed
      surrounding the sites treated with bFGF. This phenomenon persisted until about 14
      16 days of age when the emergence of hair in the bald patches was first seen.
      Hair growth continued in the treated regions until they were mostly covered at 18
      20 days of postnatal age. Control sites injected with BSA only were
      indistinguishable from the surrounding pigmented, hairy skin at all ages.
      Histological examination of skin from various ages of bFGF-treated mice suggested
      that the growth factor had affected both the initiation and the development of
      the hair follicles. This resulted in a significant delay in the first and
      subsequent hair cycles when compared to control animals injected with BSA only.

PMID- 8462744
TI  - Growth cones respond in diverse ways upon encountering neurites in cultures of
      chick dorsal root ganglia.
AB  - To help in understanding the role that interactions with other axons may have in
      helping to guide sensory neuron growth cones along the appropriate pathways in
      the chick hindlimb, we have examined how sensory growth cones respond when they
      contact the processes of other sensory neurons. Videotaping of neurons in
      dissociated cell cultures, as they participated in such encounters, showed that
      sensory growth cones can demonstrate any one of a number of responses: crossing,
      fasciculation, parallel growth, or retraction. We observed a variety of responses
      even among neurons from a single segment, suggesting the possibility that this is
      due to a heterogeneity of cell-surface labels among the neurons present within an
      individual dorsal root ganglion. If sensory neurons behave in vivo as we found
      they do in culture, the diverse behaviors of sensory growth cones may contribute
      to the process by which different subsets of axons sort out into separate,
      discrete bundles as they extend into the periphery during development. The
      diversity of responses we observed stands in contrast to the results of
      Kapfhammer, J.P., and Raper, J.A., [(1987) J. Neurosci. 7, 1595-1600] who found
      that sensory growth cones always cross sensory neurites. Possible explanations
      for the differences in the results were explored and are discussed.

PMID- 8462745
TI  - Cell sorting within the prespore zone of Dictyostelium discoideum.
AB  - Dictyostelium discoideum forms elongate cell aggregates called "slugs" which
      migrate over the substrate before completing their conversion into fruiting
      bodies. Prespore cells are found in a zone which occupies the rear four-fifths of
      the slug. Both front- and rear-prespore cells, marked by a bacterial beta
      galactosidase gene, sort out to their original positions in experiments in which
      slugs are reconstituted from disaggregated tissue. When cells from the rear of
      the prespore zone are transplanted to the middle or front, sorting is also
      observed: the transplanted cells return rapidly to the rear. Cells from the front
      of the prespore zone, however, were not observed to "home" to the front after
      transplantation to the rear. Since front-prespore cells sort out in
      disaggregation/reaggregation experiments, but fail to do so after transplantation
      to the rear, it is possible that the transplanted cells are converted to rear
      prespore cells by extracellular signals present in the rear of the slug. In an
      experiment designed to test this hypothesis, front cells were transplanted to the
      rear and the host and transplant together then subjected to
      disaggregation/reaggregation. The results showed that front-prespore cells had
      not been converted to rear-prespore cells. Instead, there was an unanticipated
      effect: cells placed in the rear of the prespore zone underwent an anterior shift
      in positional preference, while cells placed in the front of the prespore zone
      showed a posterior shift. The specific sorting properties of front- and rear
      prespore cells thus do not appear to result from the action of positional
      signals; positional signals destabilize rather than reinforce sorting
      preferences. Our observations are consistent with a model in which innate
      differences among cells bias them to differentiate as front-prespore or rear
      prespore types, but the proportions of these types are also modulated by a
      negative-feedback mechanism.

PMID- 8462746
TI  - Effects of the mesonephros and insulin-like growth factor I on chondrogenesis of
      limb explants.
AB  - The mesonephros has been shown to have a growth-promoting influence in vivo on
      limb outgrowth. This influence has been studied in detail using an organ culture
      system. The results show that in the presence of the mesonephros limb explants
      formed larger cartilages than cultures without mesonephros. Furthermore, with
      mesonephros, morphology of the cartilages is comparable to that of skeletal
      elements in vivo while cartilages formed in cultures lacking mesonephros were
      amorphous. The mesonephric influence also promoted the formation of a well
      organized extracellular matrix in the cartilage while cartilage in cultures
      without mesonephros formed an abnormal appearing matrix. Cartilage matrices in
      cultures with or without mesonephros were immunoreactive to type IX and type II
      collagens, cartilage proteoglycan PGH, and link protein although cultures lacking
      mesonephros had a very restricted distribution of type IX collagen
      immunoreactivity. Despite the different distribution of type IX collagen, long
      form-type IX collagen transcripts appeared similar in both types of culture based
      on in situ hybridization. The mesonephric effect on limb explants could be
      partially duplicated by the addition of insulin-like growth factor I (IGF-I) to
      cultures without mesonephros. Furthermore, the mesonephric influence on cartilage
      growth and morphological differentiation could be blocked by the addition of a
      blocking antibody to IGF-I to cultures with mesonephros. The results support the
      hypothesis that IGF-I is one of the growth factors produced by the mesonephros
      which may play a role in early limb development and chondrogenesis.

PMID- 8462747
TI  - Formation of myotubes in aneural rat muscles.
AB  - Skeletal muscles formed in the absence of innervation are deficient in number of
      fibers, atrophic, and prone to degeneration. We and others have suggested that
      primary myotubes form autonomously, and the major effect of embryonic denervation
      is to halt the formation of secondary myotubes by removing the mitotic stimulus
      for generation of their precursor myoblasts. This hypothesis has recently been
      put into question by the results of work by Condon et al. (Dev. Biol., 138, 275
      295, 1990) and by B. J. Fredette and L. T. Landmesser (Dev. Biol. 143, 19-35,
      1991) who propose that lowered secondary myotube numbers are at least in part due
      to absence of the primary myotubes which would normally serve as scaffold for
      their formation. We distinguish between these hypotheses by studying generation
      and degeneration of primary myotubes and formation of secondary myotubes in fetal
      rat muscles denervated by injection of beta-bungarotoxin at different times
      between Embryonic Days (E) 14 and 17. Denervation at any of these times reduced
      primary myotube numbers on E18 to about 80% of control. Despite this modest
      decrease in primary myotube numbers, secondary myotube generation fell to below
      3% of normal in extensor digitorum longus (EDL) muscles denervated on E14 or E15
      and to below 12% of control in soleus muscles denervated on E14-E16. Secondary
      myotubes were associated with degenerating as well as intact primary myotubes.
      More secondary myotubes were generated only if nerves had been present up until
      E16 for EDL or E17 for soleus. We suggest that these observations of a critical
      period until E16 (EDL) or E17 (soleus) during which innervation is an absolute
      prerequisite for secondary myotube formation reflect the presence of a nerve
      dependent population of myoblasts which must be activated before secondary
      myotube formation can commence.

PMID- 8462748
TI  - Formation of primary and secondary myotubes in aneural muscles in the mouse
      mutant peroneal muscular atrophy.
AB  - The role of motor innervation in supporting and regulating muscle development was
      studied using aneural muscles in the hindlimb of the mouse mutant peroneal
      muscular atrophy (pma). This is a single-locus autosomal mutation where
      homozygous animals lack the common peroneal nerve, so that muscles in the
      anterolateral compartment of the lower leg develop entirely without innervation.
      In adults, these muscles are extremely atrophied, and the mice display a clubfoot
      deformity. The mutant animals provide a preparation in which aspects of muscle
      formation can be studied in muscles that have never been exposed to direct
      contact with somatic motor or sensory axons, without pharmacological or surgical
      intervention. Using quantitative electron microscopy, we found that normal
      numbers of primary myotubes formed in aneural pma EDL muscles, but a greater than
      normal proportion degenerated during the first 2 days after their formation.
      Secondary myotubes appeared at their normal time and position within the muscle,
      initially in normal numbers, so that the ratio of secondary to primary myotubes
      initially was greater in pma than in CF1 control strain mice. No abnormalities in
      ultrastructure were seen until the time of birth, when retardation in development
      was obvious, together with invading macrophages and degenerating myofibres. The
      results show that secondary myotube formation in the mouse, as in the chick (B.
      J. Fredette and L. T. Landmesser, Dev. Biol. 143, 19-35, 1991) is not directly
      dependent on innervation. In control muscles, secondary myotubes first form in
      the vicinity of endplates on primary myotubes. No aggregations of ACh receptors
      or acetylcholinesterase were present in the aneural muscles, showing that these
      are neurally induced in the mouse, but secondary myotubes formed in their normal
      position indicating that positional information related to endplate formation is
      present in aneural muscles.

PMID- 8462749
TI  - Regulation of myogenesis in paralyzed muscles in the mouse mutants peroneal
      muscular atrophy and muscular dysgenesis.
AB  - The roles of innervation, muscle electrical activity, and muscle contraction in
      regulating the formation and survival of primary and secondary myotubes during
      embryonic and fetal development of skeletal muscle were studied using the mouse
      mutants peroneal muscular atrophy (pma) and muscular dysgenesis (mdg). The pma
      phenotype includes the absence of the peroneal division of the sciatic nerve, so
      muscles in the anterior compartment of the lower hindlimb are aneural throughout
      development. Muscles in mdg mice are paralyzed due to the absence of excitation
      contraction coupling and hyperinnervated due to suppression of motoneuron death
      in consequence of their paralysis, but otherwise are electrically excitable and
      receive synaptic transmission. In a quantitative comparison between control and
      mutant extensor digitorum longus (EDL) muscles at E15, primary myotube numbers
      were depressed by 20-30% in both mutants and in paralyzed or denervated muscles
      from control strain animals. The number of secondary myotubes, however, was
      normal in pma mutants and two and a half times greater than normal in the
      hyperinnervated mdg EDL muscles, so that the ratio of secondary to primary
      myotubes was increased by 300% in the mutant with respect to heterozygous or -/-
      littermates. Chronic paralysis with tetrodotoxin (TTX) caused no further
      depression of primary myotube numbers in aneural pma muscles, but secondary
      myotube numbers were reduced by 40%, reducing the ratio of secondary to primary
      myotubes by 35%. We conclude that during normal development the generation of
      secondary myotubes depends on neurally evoked electrical activity in primary
      myotubes, which stimulates mitosis of secondary myoblasts. The effect of TTX
      shows that aneural pma primary myotubes discharge spontaneous myogenic action
      potentials, while mdg muscles may receive greater than normal electrical
      activation due to their hyperinnervation, explaining the presence and numbers of
      secondary myotubes in the mutant mouse muscles.

PMID- 8462750
TI  - Reporter gene expression in G2 of the 1-cell mouse embryo.
AB  - Similar amounts of expression of a luciferase reporter gene that is driven by the
      SV40 early promoter are detected in G2 of 1-cell mouse embryo following injection
      of the male pronucleus in either early or mid/late S. No luciferase activity is
      observed when the male pronucleus is injected in early S and the embryos analyzed
      for expression in late S. Last, no luciferase activity is observed when the
      female pronucleus is injected in mid/late S and the embryos analyzed for
      luciferase activity in G2 of the first cell cycle. These results suggest that
      zygotic gene activation initiates in the 1-cell embryo rather than in the 2-cell
      embryo, as previously thought, and that differences between the transcriptional
      activity of male and female pronuclei exist.

PMID- 8462751
TI  - Developmental control elements in the promoter of a Drosophila vitelline membrane
      gene.
AB  - DNA fragments from the 5' flanking region of Drosophila melanogaster vitelline
      membrane gene VM26A1 were fused to hsp/lacZ reporter genes, reintroduced via P
      element-mediated germ line transformation, and functionally assayed by
      histological staining for beta-galactosidase activity. A developmental control
      element capable of promoting the basic vitelline membrane (VM) expression pattern
      was found within a 176-bp region. Additional multiple genetic control elements
      were found to be involved in modifying the level and spatial pattern of reporter
      gene expression but these required the 176-bp element in order to function.
      Unexpectedly, in isolation this 176-bp core element also promotes abnormal
      expression of the reporter gene in border cells of stage 8 and 9 egg chambers.
      This abnormal border cell expression is apparently suppressed in the native gene
      by an adjacent negative control element.

PMID- 8462752
TI  - Structural changes of the endoplasmic reticulum of sea urchin eggs during
      fertilization.
AB  - The endoplasmic reticulum (ER) of the sea urchin egg includes a system of
      cisternae, a cortical tubular network, and the nuclear envelope. In previous work
      (Terasaki and Jaffe, 1991, J. Cell. Biol. 114, 929-940) we showed that the long
      chain fluorescent lipophilic dye DiI spread from an intracellularly injected oil
      drop into all of these parts of the ER. In this previous study, we observed that
      in the first minute after fertilization, the ER cisternae became more finely
      partitioned; the large cisternae then reformed by 5-8 min after fertilization. To
      investigate whether these changes indicated a breaking up of the ER into
      discontinuous pieces, we have now examined the ability of DiI to spread in the ER
      at various times after fertilization. In eggs injected after fixation with
      aldehydes, we find that DiI spreads through the ER in unfertilized eggs and in
      eggs at 10 min postinsemination. However, DiI does not spread out of the oil drop
      in eggs fixed at 1 min postinsemination. We also find that in live eggs, the
      spreading of DiI is slower in eggs at 1-3 min postinsemination than in
      unfertilized eggs or in eggs later after fertilization. We interpret these
      observations to indicate that in the first few minutes after fertilization, the
      egg's ER is fragmented. This may be functionally significant for the early events
      of egg activation.

PMID- 8462753
TI  - Treatment is not enough.

PMID- 8462754
TI  - Spastic quadriplegia in Western Australia. II: Pedigrees and family patterns of
      birthweight and gestational age.
AB  - Pedigrees were obtained for all 74 index children and for three controls for each
      case. Recurrence of similar spastic quadriplegic phenotypes occurred in two
      families. A karyotype of 46,XY,dup(13)(q14q34), resulting in a partial trisomy
      13, was found in another case. Rates of miscarriages and stillbirths plus
      neonatal deaths were higher among siblings of index cases than in siblings of
      birth-year controls, but were similar to siblings of birthweight controls.
      Average birthweights and gestational ages were lower in index cases than in birth
      year controls. Children with spastic quadriplegia had significantly lower
      birthweights and gestational ages than their siblings. However, they also tended
      to come from families with a pattern of low birthweight and preterm delivery. The
      differences between families remained after controlling for factors affecting
      birthweight.

PMID- 8462755
TI  - Effects of upper-extremity weight-bearing on hand-opening and prehension patterns
      in children with cerebral palsy.
AB  - The purpose of this study was to determine whether upper-extremity weight-bearing
      has an effect on hand-opening and prehension patterns of children with spastic
      cerebral palsy. Children at the Bobath Centre (London) were studied.
      Effectiveness of intervention was determined by blind scoring of video-tapes of
      prehension components. Computer calculations of hand surface-area were done.
      There was an over-all increase in surface area, indicating an increased ability
      to open the hand; in addition, there was an increase in the maturity of movement
      components of prehension. These results provide relevant information about the
      application of upper-extremity weight-bearing.

PMID- 8462756
TI  - Auditory event-related potentials and reaction time in children: evaluation of
      cognitive development.
AB  - The authors studied age-related correlations of auditory event-related potentials
      (ERPs) using the conventional 'oddball' paradigm and reaction time in 175 normal
      subjects, aged between four and 21 years. From four years, the latencies of N100,
      N200 and P300 in ERP progressively shortened until about 16 to 17 years, after
      which they reached adult level, but with a slight tendency to prolongation
      towards 20 years; there was no trend for amplitude changes. The reaction time was
      more rapid than that of P300 latency. These findings indicate that the cognitive
      function of children improves rapidly until 16 to 17 years. A reduced difference
      between P300 latency and reaction time with age implies additional progress in
      motor skill. Combining P300 latency and reaction-time studies may provide more
      detailed information for the evaluation of the development of cognitive function
      and motor skill.

PMID- 8462757
TI  - Clinical epidemiology of childhood abdominal migraine in an urban general
      practice.
AB  - The present study examined the epidemiology of abdominal migraine among 1104
      children registered with a general practice. There was a similar prevalence of
      recurrent abdominal pain as in other studies (8.4 per cent). The prevalence of
      headache was higher among children with recurrent abdominal pain and
      significantly so among girls. Migrainous headache was not significantly more
      prevalent in children with recurrent abdominal pain. The prevalence of abdominal
      migraine with and without migrainous headache was 0.7 and 1.7 per cent,
      respectively. The peak prevalence of abdominal migraine without migrainous
      headache was between five and seven years for both sexes. When associated with
      migrainous headache, it peaked at five to seven years in girls and seven to nine
      years in boys. The syndrome was associated with travel sickness and was more
      common among girls and those with a maternal history of migraine. Many children
      were photo- and phonophobic during an attack.

PMID- 8462758
TI  - Neurological findings in newborn infants after extracorporeal membrane
      oxygenation, with special reference to the EEG.
AB  - Seventeen newborn infants were treated with extracorporeal membrane oxygenation
      (ECMO). Two died shortly after the start of ECMO due to the underlying disease,
      two died later in the course due to a lack of recovery of lung function and two
      others died weeks after ECMO from renal damage and a cardiac defect. Of the
      survivors, nine are developing normally (aged between one and four years) and two
      are severely disabled because of infarctions of the left hemisphere, acquired
      before and after ECMO. Intermittent-discontinuous EEGs did not indicate a poor
      prognosis if normalization of the EEG occurred within seven days. However,
      infarcted areas on ultrasonography, persistent EEG changes or deteriorating
      findings indicated disability or early death.

PMID- 8462759
TI  - Idiopathic lumbosacral plexus neuropathy in two children.
AB  - Two children diagnosed as having idiopathic lumbosacral plexopathy are presented.
      Although an apparently rare condition, it is probably underdiagnosed since it is
      difficult to recognise. Before such a diagnosis, careful exclusion of compressive
      and infiltrative lesions of the spinal cord, cauda equina and lumbosacral plexus
      is of utmost importance.

PMID- 8462760
TI  - Hemodynamic instability of myelomeningocele patients during anterior spinal
      surgery.
AB  - Surgery for spinal fusion for patients with myelomeningocele is accompanied by a
      high rate of complications. The authors report six cases of sudden intra
      operative hemodynamic instability which occurred during anterior spinal fusion;
      the procedures had to be aborted. All children were successfully resuscitated and
      four patients subsequently underwent successful anterior and posterior spinal
      fusion. Four of the children had positive skin and serum allergy tests to latex.

PMID- 8462761
TI  - Seizure exacerbation related to beta-lactam antibiotics in a child with cerebral
      dysgenesis.
AB  - A three-year-old boy with right hemimegalencephaly, developmental delay and left
      hemiparesis had well-controlled left focal seizures. Occasionally he had
      generalized seizures if he was given beta-lactam antibiotics. An EEG with
      simultaneous penicillin injection was performed to examine this apparent
      association: a secondarily generalized seizure was documented within two minutes
      of intravenous administration of the penicillin. This procedure confirmed the
      suspicion of a causal link between antibiotic treatment and seizures. The factors
      increasing susceptibility to beta-lactam antibiotic-induced seizures are
      reviewed.

PMID- 8462762
TI  - Does computed tomography have a role in the evaluation of complicated acute
      bacterial meningitis in childhood?

PMID- 8462763
TI  - Seizures and intellectual disability associated with tuberous sclerosis.

PMID- 8462764
TI  - 'Status epilepticus. I: Pathogenesis'.

PMID- 8462765
TI  - Islet amyloid polypeptide in the rabbit and European hare: studies on its
      relationship to amyloidogenesis.
AB  - In this study, we determined the cDNA-predicted amino acid sequence of positions
      9-31 of islet amyloid polypeptide from the rabbit and European hare. A synthetic
      rabbit/hare islet amyloid polypeptide 20-29 peptide was subsequently shown to be
      strongly fibrillogenic in vitro even though the putative amyloidogenic AILS
      sequence at positions 25-28 of human and cat islet amyloid polypeptide is
      modified in the rabbit and hare by a substitution of phenylalanine for leucine at
      position 27 (i.e. AIFS). Although islet amyloid polypeptide of both the rabbit
      and hare has an amyloidogenic sequence and is in fact amyloidogenic in vitro, the
      apparent lack of in vivo islet amyloidosis in rabbits and hares may be related to
      relatively low levels of islet amyloid polypeptide production by the islet beta
      cells in these species. This was supported by our findings that there is no
      substantial immunoreactivity in either rabbit or hare islets, and no measurable
      amount either in extracts of rabbit pancreases, or in rabbit plasma. This study
      supports the need for at least two prerequisites for the development of islet
      amyloidosis in vivo: an inherent fibrillogenic sequence within the islet amyloid
      polypeptide molecule and an adequate local concentration of islet amyloid
      polypeptide to promote self aggregation and formation of islet amyloid.

PMID- 8462766
TI  - The impact of experimental diabetes mellitus in rats on glomerular capillary
      number and sizes.
AB  - The structural counterpart of the increased glomerular filtration found in acute
      diabetes mellitus and experimental diabetes has been ascribed to the increased
      glomerular filtration surface. Using modern design-based stereological methods
      and light microscopy on perfusion-fixed rat kidneys the average total surface
      area of capillaries per glomerulus in control rats was 291 +/- 42 10(-3) mm2 (+/-
      SD) increasing to 383 +/- 55 10(-3) mm2 in 10-day-diabetic rats. There was a
      further increase to 469 +/- 70 10(-3) mm2 in 50-day-diabetic rats. The average
      total length of capillaries per glomerulus increased from 12.5 +/- 2.2 mm in the
      control rats to 16.9 +/- 2.4 mm in the 10-day-diabetic rats whereas the further
      increase to 19.4 +/- 3.0 mm in the 50-day-diabetic rats failed to reach
      statistical significance. The average number of topologically defined capillaries
      per glomerulus increased from 215 +/- 29 in the control rats to 260 +/- 45 and
      316 +/- 29 in the 10-day-diabetic and 50-day-diabetic rats, respectively. The
      results showed just a slight increase in the mean length of a capillary from 58.1
      +/- 6.2 microns in the control rats to 65.6 +/- 2.6 microns in the 10-day
      diabetic rats after which it normalized in the 50-day-diabetic rats to 61.3 +/-
      3.6 microns. The geometric factor or "resistance" in Poiseuille's law did not
      differ between the three groups, neither did the diameter of the capillaries, nor
      the number of glomeruli.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462767
TI  - Insulin resistance and mechanical dysfunction in hearts of Wistar rats with
      streptozotocin-induced non-insulin-dependent diabetes mellitus.
AB  - The present study correlates the insulin resistance seen in the myocardium of
      rats with streptozotocin-induced non-insulin-dependent diabetes mellitus with
      insulin secretory defects, hyperglycaemia and disease duration. Two-day-old male
      Wistar rats were given a bolus injection of streptozotocin (0.09 mg/g body
      weight) which caused glucose intolerance when these animals reached adulthood.
      Although these rats developed a progressive resistance to the actions of insulin
      in the heart this did not correlate with the development of glucose intolerance.
      However, a correlation was seen with a shift in insulin secretory response from
      hyper- to hypo-secretion which developed between 6 and 14 months of age.
      Moreover, this shift in secretory pattern can be associated with the onset of a
      cardiac mechanical malfunction.

PMID- 8462768
TI  - Adipose tissue glycogen synthase activation by in vivo insulin in spontaneously
      insulin-resistant and type 2 (non-insulin-dependent) diabetic rhesus monkeys.
AB  - In skeletal muscle, a defect in the covalent activation of glycogen synthase by
      insulin has been identified in insulin resistance and in Type 2 (non-insulin
      dependent) diabetes mellitus, but a similar defect in insulin action at the
      adipose tissue has not been demonstrated. We sought to determine whether this
      defect in insulin action in muscle was also present in the same pathway in
      adipose tissue. We examined the effect of in vivo insulin on adipose tissue
      glycogen synthase and phosphorylase activity in normal (n = 11),
      hyperinsulinaemic (n = 8), and impaired glucose tolerant and Type 2 diabetic (n =
      8) rhesus monkeys. Adipose tissue samples were obtained before and during a
      euglycaemic hyperinsulinaemic clamp. Glycogen synthase fractional velocity,
      independent and total activities were significantly higher in the insulin
      stimulated samples compared to the basal samples in the normal group (p < 0.05,
      respectively). In the hyperinsulinaemic group, however, insulin had no effect on
      glycogen synthase fractional velocity or independent activity, but did increase
      the total activity of glycogen synthase and phosphorylase (p < 0.05,
      respectively). Furthermore, both the basal and the insulin-stimulated total
      activities of these two enzymes were significantly greater in the
      hyperinsulinaemic group as compared to both the normal and the diabetic groups (p
      < 0.05, respectively). In the diabetic group, insulin was without effect on
      glycogen synthase fractional velocity, independent activity or total activity. We
      conclude that the covalent activation of adipose tissue glycogen synthase by
      insulin is absent in both obese hyperinsulinaemic and in spontaneously diabetic
      monkeys.

PMID- 8462769
TI  - Long-term effectiveness of oral vanadyl sulphate in streptozotocin-diabetic rats.
AB  - Recent studies have demonstrated the insulin-like effects of oral vanadyl
      sulphate in the streptozotocin-diabetic rat, including the amelioration of
      hyperglycaemia and the prevention of diabetes-related cardiac and adipose tissue
      dysfunction. However, the possibility that vanadyl treatment, routinely initiated
      at 3 days after the induction of diabetes, had prevented the full cytotoxic
      destruction of the beta cell, and thus accounted for the apparent anti-diabetic
      properties of vanadyl was questioned. Hence in the present study, we examined the
      effectiveness of vanadyl sulphate as a glucose-lowering and anti-diabetic agent
      when administration was delayed from the time of induction of diabetes. Male
      Wistar rats were injected with a single intravenous dose of streptozotocin (55
      mg/kg). Vanadyl sulphate was administered in the drinking water at a
      concentration of 0.75 mg/ml from 3, 10 and 17 days after the streptozotocin
      injection and treatment was then maintained for 5 months. Vanadyl intake was
      accompanied by lowered serum levels of triglyceride and cholesterol with no
      associated enhancement in circulating insulin. Vanadyl-treated diabetic animals
      showed improved glucose tolerance while insulin release in vivo was still
      markedly lower than in non-diabetic rats. Adipose tissue function, as expressed
      by basal and epinephrine-stimulated lipolysis in isolated adipose tissue, was
      also normalized in vanadyl-treated diabetic animals. These responses were all
      observed whether vanadyl treatment was initiated 3, 10 or 17 days after induction
      of diabetes. Finally, prolonged treatment with vanadyl sulphate (in this case up
      to 5 months) did not cause any apparent hepatic toxicity as assessed
      histologically. Diabetes-induced morphological changes in the kidney were also
      prevented by vanadyl treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462770
TI  - Fetal growth and impaired glucose tolerance in men and women.
AB  - A follow-up study was carried out to determine whether reduced fetal growth is
      associated with the development of impaired glucose tolerance in men and women
      aged 50 years. Standard oral glucose tolerance tests were carried out on 140 men
      and 126 women born in Preston (Lancashire, UK) between 1935 and 1943, whose size
      at birth had been measured in detail. Those subjects found to have impaired
      glucose tolerance or non-insulin-dependent diabetes mellitus had lower
      birthweight, a smaller head circumference and were thinner at birth. They also
      had a higher ratio of placental weight to birthweight. The prevalence of impaired
      glucose tolerance or diabetes fell from 27% in subjects who weighed 2.50 kg (5.5
      pounds) or less at birth to 6% in those who weighed more than 3.41 kg (7.5
      pounds) (p < 0.002 after adjusting for body mass index). Plasma glucose
      concentrations taken at 2-h in the glucose tolerance test fell progressively as
      birthweight increased (p < 0.004), as did 2-h plasma insulin concentrations (p <
      0.001). The trends with birthweight were independent of duration of gestation and
      must therefore be related to reduced rates of fetal growth. These findings
      confirm the association between impaired glucose tolerance in adult life and low
      birthweight previously reported in Hertfordshire (UK), and demonstrate it in
      women as well as men. It is suggested that the association reflects the long-term
      effects of reduced growth of the endocrine pancreas and other tissues in utero.
      This may be a consequence of maternal undernutrition.

PMID- 8462771
TI  - Gender differences in a type 2 (non-insulin-dependent) diabetic population with
      respect to apolipoprotein E phenotype frequencies.
AB  - Apolipoprotein E polymorphism was examined in an Italian population of Type 2
      (non-insulin-dependent) diabetic patients. There were significant differences (p
      < 0.05) in allele frequencies between male and female patients due to an under
      representation of the E4 allele in the female group. No differences in allele
      frequencies were noted when non-diabetic male and female control subjects were
      compared. Both control groups exhibited similar allele distributions to that of
      male diabetic patients, but were significantly different (p < 0.05) from female
      diabetic patients. A closer examination of the female diabetic population
      revealed that under-representation of the E4 allele was principally confined to
      patients aged 60 years or older. This subgroup showed a significantly different
      (p < 0.05) allele frequency profile from control subjects (both men and women)
      and diabetic men, whereas this was not observed in the younger diabetic women (<
      or = 59 years). The results are consistent with the suggestion that the E4 allele
      may be a particular risk factor for female diabetic patients.

PMID- 8462772
TI  - HLA-associated susceptibility to type 2 (non-insulin-dependent) diabetes
      mellitus: the Wadena City Health Study.
AB  - Epidemiologic data suggest that a parental history of Type 2 (non-insulin
      dependent) diabetes mellitus increases the risk of Type 1 (insulin-dependent)
      diabetes in siblings of a Type 1 diabetes proband. This increase in risk is
      consistent with a shared genetic susceptibility between Type 1 and Type 2
      diabetes. We have previously reported evidence that HLA-DR4-linked factors may
      represent a homogeneous subset of diabetes susceptibility. First, HLA-DR4
      frequency was higher in Type 1 diabetic study subjects with a Type 2 diabetic
      parent than in Type 1 diabetic subjects whose parents were not diabetic. Second,
      a DR4-haplotype was transmitted from the Type 2 diabetic parent to the Type 1
      offspring more often than expected. These data are consistent with the hypothesis
      that families with a Type 2 diabetic parent and Type 1 diabetic child, heavily
      determined by HLA-DR4 linked factors, may represent a homogeneous subset of
      diabetes susceptibility. In this report, we further explore the relationship
      between the high-risk HLA antigen (HLA-DR4) in study subjects with differing
      glycaemic status (National Diabetes Data Group criteria). In this community-based
      study, we find evidence that HLA-DR4 is increased in study subjects with Type 2
      diabetes and may be a marker for Type 2 diabetes susceptibility.

PMID- 8462773
TI  - Serum levels of growth hormone-binding protein and insulin-like growth factor I
      in children and adolescents with type 1 (insulin-dependent) diabetes mellitus.
AB  - Serum levels of insulin-like growth factor I are reduced in patients with Type 1
      (insulin-dependent) diabetes mellitus. To evaluate the role of the hepatic growth
      hormone receptor in the decreased serum concentrations of insulin-like growth
      factor I, serum levels of the high affinity growth hormone-binding protein, which
      is qualitatively and quantitatively related to the hepatic growth hormone
      receptor, and of insulin-like growth factor I were measured in 70 children and
      adolescents with Type 1 diabetes and 105 healthy control children. Analysis of
      variance revealed a significant negative effect of Type 1 diabetes on serum
      levels of the growth hormone-binding protein and of insulin-like growth factor I.
      In the diabetic patients, serum levels of the growth hormone-binding protein were
      positively related to body mass index and to insulin dose per kg body weight, and
      were not influenced by pubertal stage, gender, or plasma levels of haemoglobin
      A1c. Serum levels of insulin-like growth factor I increased during early puberty
      reaching peak levels at mid-puberty and decreasing thereafter. No relationship
      was found between serum levels of growth hormone-binding protein and of insulin
      like growth factor I. Our data suggest that decreased liver somatogenic receptor
      levels, as reflected by the concentrations of circulating growth hormone-binding
      protein, play a minor role in the suppressed concentrations of circulating
      insulin-like growth factor I. Post-growth hormone receptor defects or changes in
      the insulin-like growth factor binding proteins probably contribute more to the
      lower serum levels of insulin-like growth factor I.

PMID- 8462774
TI  - Size- and charge selectivity of glomerular filtration in Type 1 (insulin
      dependent) diabetic patients with and without albuminuria.
AB  - Albuminuria is the first clinical event in the development of diabetic
      nephropathy. We assessed glomerular charge- and size selectivity in 51 patients
      with Type 1 (insulin-dependent) diabetes mellitus of juvenile onset and 11
      healthy individuals. Patients were allocated to five groups. The urinary albumin
      excretion rate was normal in group D1; 30-100 mg/24 h in group D2; 101-300 mg/24
      h in group D3 and greater than 300 mg/24 h in groups D4 and D5. Group D5 had
      elevated serum creatinine (above 110 mumol/l). Glomerular filtration rate and
      renal plasma flow were determined by constant infusion techniques and tubular
      protein reabsorption by excretion of beta 2-microglobulin. Charge selectivity was
      estimated from the IgG/IgG4 selectivity index. Size selectivity was measured by
      dextran clearance. Dextran was measured by refractive index detection after
      fractionation (2 A fractions in the range 26-64 A) by size exclusion
      chromatography. IgG/IgG4 selectivity index was significantly decreased in
      patients with albuminuria (p < 0.001). The drop in IgG/IgG4 selectivity index was
      found in patients with minimal albuminuria (D2) and was not accompanied by any
      changes in tubular function or glomerular haemodynamics. Size selectivity was
      significantly altered only in patients with the most advanced nephropathy (D5) as
      reflected by an increase in the clearance of 62 A dextran (p < 0.04). We conclude
      that loss of glomerular charge selectivity precedes or accompanies the formation
      of new glomerular macromolecular pathways in the development of diabetic
      nephropathy.

PMID- 8462775
TI  - Both DQA1 and DQB1 genes are implicated in HLA-associated protection from type 1
      (insulin-dependent) diabetes mellitus in a British Caucasian population.
AB  - Inherited susceptibility to Type 1 (insulin-dependent) diabetes mellitus is
      partly determined by HLA genes. It has been suggested that protection from
      disease may be conferred by HLA-DQB1 genes which encode molecules with aspartate
      at position 57. We investigated the contributions of HLA-DRB1, DQA1 and DQB1
      genes to protection from disease. Restriction fragment length polymorphism and
      sequence specific oligonucleotide analysis in 156 British Caucasian Type 1
      diabetic and 116 control subjects showed protection from disease was associated
      with DR2, DRw6 and DR7 haplotypes. The most protective DQA1 allele was DQA1*0102
      which occurred on both DR2 and DRw6 haplotypes. The DQB1 alleles DQB1*0303,
      DQB1*0602 and DQB1*0603 were associated with protection, as was DQB1*0604, which
      encodes an Asp-57 negative DQ beta molecule. Heterozygosity for both protective
      and predisposing HLA markers was reduced in diabetic compared with control
      subjects. We conclude that both DQA1 and DQB1 genes are implicated in HLA
      associated protection from Type 1 diabetes in this British Caucasian population.
      The overall structure of the DQ heterodimer is critical and DQ beta-Asp 57 is of
      secondary importance in determining protection from disease. The effect of
      protective HLA types may predominate over that of predisposing markers.

PMID- 8462776
TI  - Metabolism by human endothelial cells of very low density lipoprotein
      subfractions isolated from type 1 (insulin-dependent) diabetic patients.
AB  - The very low density lipoprotein (VLDL) fraction was isolated from 11
      normolipidaemic Type 1 (insulin-dependent) diabetic patients in good to fair
      glycaemic control and from 11 age-, sex- and race-matched, non-diabetic, control
      subjects. The rate of receptor-mediated degradation by human endothelial cells
      was significantly greater (p < 0.02) for the total VLDL fraction isolated from
      diabetic patients compared to control subjects and averaged 1008 +/- 300 and 717
      +/- 150 ng.mg cell protein-1.16 h-1, respectively. The total VLDL fraction was
      separated into three subfractions: VLDL-I, Sf 100-400 (Sf = Svedberg units); VLDL
      II, Sf 60-100; VLDL-III, Sf 20-60. Rates of receptor-mediated degradation of VLDL
      I and VLDL-II isolated from diabetic patients were significantly greater than the
      comparable subfraction isolated from control subjects and averaged 1023 +/- 279
      vs 361 +/- 122 (p < 0.01) and 433 +/- 70 vs 294 +/- 70 ng.mg cell protein-1.16 h
      1 (p < 0.03), respectively. Rates of receptor-mediated degradation of the V-III
      subfraction isolated from the two groups did not differ significantly. There were
      no significant differences in the chemical composition or in the plasma
      concentrations of the VLDL subfractions isolated from diabetic patients compared
      to control subjects. There was a significant increase in the apoprotein E content
      of VLDL-I (p < 0.01) and VLDL-II (p < 0.05) isolated from diabetic patients.
      There was a significant increase in the ratio of apoprotein C compared to
      apoprotein E (p < 0.03) in VLDL-I isolated from control subjects compared to the
      diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462777
TI  - Diabetes mellitus and hypertension: the possible role of hyperglycaemia through
      oxidative stress.

PMID- 8462779
TI  - Increasing opportunities for women benefits the entire research community.

PMID- 8462778
TI  - Infant nutrition and subsequent risk of type 2 (non-insulin-dependent) diabetes
      mellitus.

PMID- 8462780
TI  - Effects of spaceflight on the musculoskeletal system: NIH and NASA future
      directions.
AB  - Prolonged bed rest, undertaken by volunteers or resulting from injury and
      disease, can impair bone and muscle function and structure; extended travel in
      space also induces these effects. Fluid shifts and disrupted fluid balance may
      also contribute to observed musculoskeletal aberrations in the weightless
      environment. Some molecular and cellular events involved in the loading and
      unloading of the musculoskeletal system are under neural and endocrine influence
      or control, whereas other events are influenced by local growth factors. Studies
      are in progress to develop interventions that preserve or improve musculoskeletal
      integrity in 1g. The NIAMS and NASA are interested in basic and clinical studies
      of the influence of microgravity on the musculoskeletal system. The interagency
      workshop results form the basis for new collaborative and cooperative research
      emphases for the biomedical community under a broad agreement between the
      National Institutes of Health and NASA.

PMID- 8462781
TI  - The design and application of residualizing labels for studies of protein
      catabolism.
AB  - Residualizing labels (R-labels) are chemical tags for proteins, originally
      designed for studies of the sites and mechanisms of plasma protein catabolism.
      The labels consist of oligosaccharides derivatized with radioactive, fluorescent,
      nuclear magnetic resonance (NMR), or positron emission tomography (PET) active
      reporter molecules. Because these glycoconjugates generally have molecular masses
      in excess of 500 daltons and are hydrophilic, they are relatively membrane
      impermeant. They are also designed to be resistant to lysosomal hydrolases and
      are therefore retained inside cells with half-lives of 2-5 days after endocytosis
      and degradation of the carrier protein. The R-labels thus provide a convenient
      means for following the cumulative uptake and catabolism of proteins by cells in
      vivo or in vitro. This review summarizes how R-labels have provided insights into
      the sites and regulation of the turnover of circulating proteins, and pathways
      for intracellular transport and degradation of endocytosed proteins. The
      potential use of R-labels for noninvasive studies of the distribution of protein
      pharmaceuticals in vivo is also discussed.

PMID- 8462782
TI  - Coaggregation: specific adherence among human oral plaque bacteria.
AB  - Nearly all human oral bacteria exhibit coaggregation, cell-to-cell recognition of
      genetically distinct cell types. Clumps or coaggregates composed of the two kinds
      of cells are formed immediately upon mixing two partner cell types. Members of
      all 18 genera tested exhibit lactose-reversible coaggregation. Many of these
      interactions appear to be mediated by a lectin on one cell type that interacts
      with a complementary carbohydrate receptor on the other cell type. A lactose
      sensitive adhesin has been isolated from Prevotella loescheii PK1295, and it
      exhibits the adherence properties observed with whole cells. Other adhesins have
      been identified and the genes for some of them have been cloned and sequenced.
      One Streptococcus sanguis adhesin is a lipoprotein that appears to have a dual
      function of recognizing both a bacterial carbohydrate receptor and a receptor in
      human saliva. Carbohydrate receptors for some adhesins have been purified from
      five oral streptococci, and they specifically block the coaggregations with the
      streptococcal partners that express the complementary adhesins. Coaggregation
      offers an explanation for the temporally related accretion of dental plaque and
      bacterial recognition of mucosal surfaces. Early colonizers of the tooth surface
      coaggregate with each other and late colonizers of the tooth surface coaggregate
      with each other, but with few exceptions, early colonizers do not recognize late
      colonizers. Furthermore, bacteria that colonize mucosal surfaces coaggregate with
      each other, indicating the high degree of specificity of coaggregation in the
      oral bacterial population.

PMID- 8462783
TI  - Is dehydroepiandrosterone an antiobesity agent?
AB  - The steroid hormone intermediate, DHEA, has been proposed as a therapeutic agent
      for the treatment of obesity. Its effects on lipogenesis, substrate cycling,
      peroxisome proliferation, mitochondrial respiration, protein synthesis, and
      thyroid hormone function have been reported. The results of these studies suggest
      that the antiobesity function of DHEA is not simply one of inhibiting fat
      synthesis and deposition but is one of affecting a number of pathways that
      contribute to the maintenance of the isoenergetic state rather than the promotion
      of positive energy balance.

PMID- 8462784
TI  - Role of the CD45 tyrosine phosphatase in signal transduction in the immune
      system.
AB  - CD45, a family of hematopoietic cell specific surface antigens, is the best
      characterized protein tyrosine phosphatase described to date. Considerable
      evidence from a number of laboratories suggests that surface expression of this
      molecule is required for normal signaling events to occur in T lymphocytes, B
      lymphocytes, and natural killer cells. In this paper, data supporting this
      contention are reviewed and a model proposing how CD45 may exert its regulatory
      function on signal transduction via the T cell antigen receptor is presented.

PMID- 8462785
TI  - Idiotypes: structure and immunogenicity.
AB  - Idiotopes are markers on the variable domains of antigen-specific immunological
      receptors recognized by anti-idiotypic antibodies or T cells. Therefore, a given
      antibody or T cell receptor can be identified on the basis of a characteristic
      idiotypic pattern. The structural correlates for idiotopes on antibodies have
      been studied by competitive binding assays, electron microscopy, site-directed
      mutagenesis, and X-ray crystallography. Immunoglobulin idiotopes, recognized by
      antiidiotypic antibodies, can involve amino acid residues from several
      hypervariable or framework regions and from either or both of the heavy and light
      chain variable domains. Recent studies suggest that it may be possible to exploit
      structural knowledge of idiotopes and anti-idiotopes for the design of new
      ligands for immunological or other cell surface receptors. In one instance, it
      has been possible to use the inferred structural features of an anti-idiotope,
      which mimics a viral protein, to design a small organic molecule with functional
      properties approximating those of the antigen and the native anti-idiotope. An
      alternative strategy being explored for creating new vaccines or therapeutic
      agents involves engineering an amino acid sequence, corresponding to a segment of
      a selected nominal antigen, into an immunoglobulin variable domain.

PMID- 8462786
TI  - Synthesis of vitamin K-dependent proteins.
AB  - The unique and characteristic feature of vitamin K-dependent proteins is the
      presence of gamma-carboxyglutamyl (Gla) residues formed during the
      posttranslational processing of these proteins. The energy needed to drive this
      microsomal carboxylation event comes from the reoxidation of the reduced,
      hydronaphthoquinone form of vitamin K to its 2,3-epoxide. Recent studies have
      suggested that an intermediate epoxide alkoxide is the strong base needed to
      abstract a proton from the relatively unreactive methylene carbon of the glutamyl
      residue. The primary gene product of the vitamin K-dependent proteins contains a
      homologous propeptide extension between the amino terminus of the mature protein
      and signal peptide. This region, which is cleaved before secretion of these
      proteins, serves to dock the protein substrate to the enzyme catalyzing the
      carboxylation event, and to also alter the apparent Km of the Glu binding site of
      the enzyme. The order in which the multiple Glu sites on the substrate proteins
      are carboxylated is unknown, but elucidation of this property of the enzyme and
      further details of the bioorganic mechanism should be aided by recent reports of
      purification of this unique carboxylase.

PMID- 8462787
TI  - Ca2+ antagonists inhibit DNA fragmentation and toxic cell death induced by
      acetaminophen.
AB  - Ca2+ accumulates in the nucleus and DNA undergoes enzymatic cleavage into
      internucleosome-length fragments before acetaminophen and dimethylnitrosamine
      produce hepatic necrosis in vivo and toxic cell death in vitro. However, Ca(2+)
      endonuclease fragmentation of DNA is characteristic of apoptosis, a type of cell
      death considered biochemically and functionally distinct from toxic cell death.
      The present studies investigate DNA fragmentation as a critical event in toxic
      cell death by testing whether the Ca(2+)-calmodulin antagonist chlorpromazine and
      the Ca2+ channel blocker verapamil prevent acetaminophen-induced hepatic necrosis
      by inhibiting Ca2+ deregulation and DNA damage. Acetaminophen overdose in mice
      produced accumulation of Ca2+ in the nucleus (358% of control) and fragmentation
      of DNA (250% of control) by 6 h, with peak release of ALT occurring at 12-24 h
      (38,000 U/l). Pretreatment with chlorpromazine prevented increases in nuclear
      Ca2+ and DNA fragmentation and nearly abolished biochemical evidence of toxic
      cell death. Verapamil pretreatment also decreased Ca2+ accumulation and DNA
      damage while attenuating liver injury. The Ca2+ antagonists did not protect
      against toxic cell death through hypothermia because neither produced the delay
      in toxicity that is customarily associated with hypothermia. Nor did
      chlorpromazine or verapamil protect through inhibiting acetaminophen
      bioactivation. Chlorpromazine failed to diminish glutathione depletion in whole
      liver and isolated nuclei. Verapamil (250 microM) also failed to alter
      glutathione depletion in whole liver and had no effect on acetaminophen
      glutathione adduct formation by mouse liver microsomes and by cultured mouse
      hepatocytes. Collectively, these results support the hypothesis that Ca(2+)
      induced DNA fragmentation plays a significant role in cell necrosis produced by
      acetaminophen and may contribute to toxic cell death caused by other alkylating
      hepatotoxins.

PMID- 8462788
TI  - Expression of the duck alpha-enolase/tau-crystallin gene in transgenic mice.
AB  - In many vertebrates, metabolic enzymes have been directly recruited to an
      additional structural role as crystallins in the eye lens. In some species the
      glycolytic enzyme alpha-enolase (alpha ENO) attains high concentrations in the
      lens, as tau-crystallin (tau CRY). A line of transgenic mice was constructed
      containing the entire duck alpha ENO/tau CRY gene with 5'- and 3'-flanking
      regions and all introns. Full-sized duck alpha ENO mRNA was expressed in the
      transgenic mice with the same pattern as the endogenous mouse alpha ENO isozyme.
      Although there was no evidence for tissue preference, the concentration of
      enolase increased markedly in transgenic lens as well as in other tissues. In
      spite of this, transgenic lenses were transparent and the animals were normal in
      appearance. The increase in enolase levels in the transgenic lens mimics the
      stepped increase that might occur in the early stages of enzyme crystallin
      recruitment. These results demonstrate that lens transparency is sufficiently
      robust to be refractory to some increase in metabolic enzyme concentration
      without the need for compensatory adaptation.

PMID- 8462789
TI  - Delayed internucleosomal DNA fragmentation in programmed cell death.
AB  - DNA fragmentation was evaluated in three instances of programmed cell death,
      interdigital cell death in embryonic mouse limbs, and metamorphic death of both
      the labial glands and intersegmental muscle in the tobacco hornworm Manduca
      sexta. In the mouse, we evaluated both developmental cell death and expanded
      range cell death induced by retinoic acid. The status of DNA was examined in
      several ways. Nuclei were examined by electron microscopy and Feulgen staining.
      Quantitative assessment of total DNA content in Feulgen-stained degenerating
      nuclei was made for the gland. In the labial gland, DNA content does not drop
      during the early phases of cell death; nor is an endonucleolytic ladder seen when
      DNA was examined by ethidium bromide staining or prelabeling with [3H]thymidine.
      Only by using end labeling of DNA could we detect DNA fragmentation at a very
      late stage in cell death, day 4 of the collapse of the gland. In contrast, WEHI
      7.1 lymphoma cells display an early and extensive ladder after treatment with
      glucocorticoids. In mouse limb, for which cell death follows a more classic
      apoptotic morphology, a ladder is likewise not seen. We conclude that activation
      of an endonuclease is neither a trigger nor a necessary or defining component of
      the early phases of developmental programmed cell death, and that reported
      failure by others to find such a ladder may depend on limitations in the system
      that is under investigation.

PMID- 8462790
TI  - Studies on enzyme inhibition--50 years ago.

PMID- 8462791
TI  - Motilin and erythromycin stimulate pepsinogen secretion by chief cells isolated
      from guinea pig stomach.
AB  - BACKGROUND: Motilin and erythromycin bind the same receptor in the
      gastrointestinal muscle cells. Motilin stimulates pepsinogen secretion in humans
      and dogs. However, it is unclear whether it acts directly on gastric chief cells
      or via other neurotransmitters. METHODS: Isolated gastric chief cells were
      obtained from guinea pig stomach by collagenase digestion and calcium chelation
      with ethylene glycol-bis(B-amynomethyl ether)-N,N,N',N'-tetraacetic acid.
      RESULTS: Significant stimulation of pespinogen secretion induced by motilin
      occurred at 1 pmol/L, half maximum at 10 pmol/L, and maximum at 100 pmol/L.
      Erythromycin caused significant stimulation at 1 pmol/L, half maximum at 100
      pmol/L, and maximum at 1 nmol/L. Atropine (1 mumol/L) had no effect on either
      motilin- or erythromycin-induced pepsinogen secretion. Motilin and erythromycin
      determined a threefold increase in the intracellular calcium concentrations.
      Pretreatment of isolated chief cells with motilin and erythromycin induced a
      reversible, dose- and time-dependent desensitization of the pepsinogen secretion
      stimulated by carbachol and cholecystokinin but not that stimulated by secretin,
      vasoactive intestinal peptide, or prostaglandin E2. CONCLUSIONS: Motilin and
      erythromycin directly stimulate pepsinogen secretion in isolated chief cells.

PMID- 8462792
TI  - Prognostic significance of K-ras mutations in colorectal carcinoma.
AB  - BACKGROUND: Mutations at codons 12, 13, and 61 of the ras genes have been found
      in a variety of human tumors and may have prognostic significance. K-ras
      mutations have been shown in 40%-50% of colorectal cancers. METHODS: Using a
      simple nonradioactive polymerase chain reaction-based technique, we have
      investigated the possible prognostic significance of point mutations of the K-ras
      gene in patients with human colorectal carcinomas. The prevalence and the type of
      ras mutations were compared between a group of 35 patients having recurrent
      disease within 5 years and a group of 64 patients who were disease free 5 years
      following surgery. RESULTS: First, we found that the overall prevalence of
      mutations within codons 12 and 13 of the K-ras gene was 25% in the nonrecurring
      group vs. 71% in the patients with recurrent disease (P < 0.0001) and, second,
      that mutations other than GGT to GAT occurred, with one exception, exclusively in
      recurring tumors. CONCLUSIONS: In Dukes' B and C primary tumors, mutations other
      than GGT to GAT identify patients at very high risk for recurrence. Our results
      indicate that determining the K-ras mutations provides a good prognostic factor
      in patients with advanced colorectal carcinoma.

PMID- 8462793
TI  - On the specificity of altered muscle function in experimental colitis in rats.
AB  - BACKGROUND: Studies on muscle contraction in colitis yield conflicting data that
      may reflect differences in the manner in which colitis is induced. Therefore, we
      compared distal colonic longitudinal muscle contraction in four models of colitis
      in the rat. METHODS: Distal colitis was induced by intrarectal administration of
      trinitrobenzene sulfonic, acetic acid, or Trichinella spiralis larvae, or by
      intraperitoneal injection of mitomycin C. Colonic myeloperoxidase activity was
      used to monitor acute inflammation. RESULTS: Myeloperoxidase activity increased
      in each model of colitis. In trinitrobenzene-treated rats, contractile responses
      to carbachol, substance P, and KCl decreased by 64%, 76%, and 58%, respectively.
      In acetic acid treated rats, responses induced by carbachol, substance P, or KCl
      were each significantly decreased by 73%, 68%, and 55% and were similarly reduced
      by 42%, 77%, and 46%, respectively, in rats with T. spiralis colitis. In
      mitomycin-induced colitis, these respective responses also decreased
      significantly by 71%, 55%, and 54%. CONCLUSION: Decreased contractility of
      longitudinal muscle in acute colitis in rats is independent of the manner in
      which the colitis is induced and is mediated at a receptor-independent locus on
      the muscle cell.

PMID- 8462794
TI  - Reflux-related gastric mucosal injury is associated with increased mucosal
      histamine content in humans.
AB  - BACKGROUND: Experimental studies in the dog and the rat have shown histamine
      involvement in reflux-related gastric mucosal injury. However, no definite
      demonstrations of a link between reflux-related gastric mucosal injury and mast
      cell mediators exist in humans. METHODS: The relationships between reflux,
      gastric mucosal histamine content, and gastric histology were assessed in
      partially gastrectomized subjects presumptively with high (11 Billroth II
      subjects) and low reflux levels (9 total biliary diversion subjects),
      respectively. Findings were compared with those in a control group consisting of
      8 endoscopically and histologically proven normal subjects. RESULTS: Bile acid
      quantity and concentration in the gastric aspirates were significantly greater in
      Billroth II subjects than in total biliary diversion subjects. Significantly
      higher cumulative scores for foveolar hyperplasia, mucosal edema, capillary
      dilatation and congestion, and smooth muscle fibers in the lamina propria were
      found in Billroth II subjects than in total biliary diversion subjects. Mucosal
      histamine content as well as mast cell density and degranulation differed
      significantly between Billroth II and the other two groups. CONCLUSIONS: These
      results represent the first demonstration in humans of an association between
      mast cell mediators and chemical gastric mucosal injury.

PMID- 8462795
TI  - Gut lavage fluid protein concentrations: objective measures of disease activity
      in inflammatory bowel disease.
AB  - BACKGROUND: Fluid obtained by whole gut lavage normally contains traces of
      immunoglobulin (Ig) G, albumin, and alpha-1-antitrypsin; higher concentrations
      have been found in patients with inflammatory bowel disease (IBD). METHODS: In a
      prospective study, 53 lavages were performed in 45 IBD patients (27 Crohn's
      disease, 18 ulcerative colitis), in whom disease activity was simultaneously
      assessed by Crohn's Disease Activity Index or Powell Tuck index. Concentration of
      IgG in lavage fluid was measured by enzyme-linked immunosorbent assay, and of
      albumin and alpha-1-antitrypsin by immunoturbidimetry. RESULTS: For IgG,
      concentrations in lavage fluid correlated closely with activity indices: in
      Crohn's disease, r = 0.723 (P < 0.0001), in ulcerative colitis, r = 0.714 (P <
      0.0001). Results for albumin and alpha-1-antitrypsin concentrations were similar
      to those for IgG, but they were less sensitive in detecting active disease.
      However, this method cannot be used as a diagnostic test for IBD; normal results
      were obtained for IgG in 6 (all inactive) of 42 lavages in patients who had
      unequivocal radiological or endoscopic abnormalities. CONCLUSIONS: Assay of
      protein concentrations in gut lavage fluid is a simple, objective means of
      grading disease activity in patients with IBD; its potential uses are likely to
      be in the evaluation of complex cases and in clinical trials.

PMID- 8462796
TI  - Nonsteroidal anti-inflammatory drugs and peptic ulcer hospitalization rates in
      New South Wales.
AB  - BACKGROUND: Consumption of nonaspirin nonsteroidal anti-inflammatory drugs
      (NANSAIDS) increased substantially during the 1980s. The effects of this trend on
      hospitalization rates for peptic ulcer in different age groups in New South
      Wales, Australia, was investigated. METHODS: A population model based on sales of
      NANSAIDS and aspirin, age specific estimates of the relative risk of ulcer
      complications with these drugs, and hospitalization data for 1979 through 1988
      was created. RESULTS: All age groups increased consumption of NANSAIDS. The
      increases were greatest in elderly subjects, with women over age 65 years
      increasing the prevalence of their use of the drugs from 11.9% in 1979 to 22.5%
      in 1988 and males over age 65 increasing use from 9.7% to 20%. Aspirin use
      remained relatively unchanged in all age groups. Hospitalization rates for peptic
      ulcer decreased in both sexes under age 64 despite increasing use of NANSAIDs.
      Hospitalization increased in males and females over age 65, but in females the
      increase was substantially greater than predicted by the computer model. In women
      and men over age 75 the increases in hospitalization rates predicted by the model
      were only 18% and 33%, respectively, of the observed rises. CONCLUSIONS: The
      increasing hospitalization rate for peptic ulcer among elderly subjects was only
      partly explained by the increasing consumption of NANSAIDS. Further research is
      needed.

PMID- 8462797
TI  - Developmental expression of the gastrin and cholecystokinin genes in rat colon.
AB  - BACKGROUND: To elucidate the hypothesis that gastrin and cholecystokinin (CCK)
      are local growth factors for colorectal mucosa, we have examined the peptide gene
      expression in rat colon during development. METHODS: Northern analysis, reverse
      transcription PCR, and sequence-specific radioimmunoassays were the essential
      methods. RESULTS: High concentrations of gastrin and CCK messenger RNA were found
      in the fetal colon. At birth, gastrin and CCK mRNA's were both undetectable but
      increased subsequently towards adult life. The fetal colon contained 5.5 and 4.2
      pmol/g tissue gastrin and CCK, respectively. After birth, carboxyamidated gastrin
      disappeared from the colon, whereas the concentration of CCK remained at 1
      pmol/g. Glycine-extended gastrin and CCK were also present in the fetal colon,
      but towards adult life they decreased below 0.2 pmol/g. In contrast, progastrin
      and proCCK were detectable at all ages. CONCLUSIONS: Rat colon expresses the
      gastrin and CCK genes throughout life. The posttranslational maturation of
      progastrin, however, ceases shortly after birth, indicating that gastrin may play
      a role in the developing colon. Whether CCK influences the development remains to
      be shown.

PMID- 8462798
TI  - Expression but incomplete maturation of progastrin in colorectal carcinomas.
AB  - BACKGROUND: To evaluate the hypothesis that gastrin is a local growth factor in
      colonic carcinomas, the expression of gastrin messenger RNA (mRNA) and peptides
      were examined in five human colon carcinoma cell lines, 12 solid colon
      carcinomas, and normal colonic tissue. METHODS: Northern analysis, reverse
      transcription PCR, and a library of sequence-specific radioimmunoassays were the
      principal methods. RESULTS: Cell lines, tumors, and normal tissue all expressed a
      gastrin mRNA of 0.7 kilobases, and all cell lines contained incompletely
      processed progastrin (range, 17-54 fmol/10(6) cells). Two cell lines secreted
      progastrin into the media (LoVo, 25 +/- 3 pmol/L; HCT116; 12 +/- 2 pmol/L).
      Normal colonic tissue and all the solid tumors also contained progastrin, the
      concentration being higher in tumors (range, 0.4-2 pmol/g) than in normal tissue
      (range, 0.1-0.2 pmol/g). Only one tumor contained carboxyamidated gastrins.
      CONCLUSIONS: Normal and neoplastic colonic mucosa both express the gastrin gene,
      but the posttranslational phase of expression is attenuated. The incomplete
      processing and low level of expression suggest that autocrine gastrin secretion
      has only minor significance for normal adult and most neoplastic colonic tissue.

PMID- 8462799
TI  - Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and
      enterotoxicity in rat ileum.
AB  - BACKGROUND: Saccharomyces boulardii is a nonpathogenic yeast used for the
      prevention and treatment of Clostridium difficile-associated diarrhea and
      colitis. However, the mechanism by which S. boulardii exerts its protective
      effects remains unclear. METHODS: The binding of [3H]toxin A to its brush border
      receptor preincubated with S. boulardii-cultured suspension or filtered
      conditioned medium was measured in vitro. The effect of toxin A on secretion,
      epithelial permeability, and morphology in rat ileal loops in vivo was also
      examined in rats pretreated with S. boulardii. RESULTS: S. boulardii reduced
      [3H]toxin A-receptor binding in a dose-dependent fashion. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis of ileal brush border exposed to S. boulardii
      conditioned medium revealed a diminution of all brush border proteins. Treatment
      of rats with S. boulardii suspension reduced fluid secretion and mannitol
      permeability caused by toxin A. CONCLUSIONS: S. boulardii may reduce some of the
      enterotoxic effects of toxin A by inhibiting toxin A-receptor binding. This
      effect appears to be manifested by a secreted product of the yeast, possibly a
      protease.

PMID- 8462800
TI  - Interferon alfa for patients with clinically apparent cirrhosis due to chronic
      hepatitis B.
AB  - BACKGROUND: The prognosis of advanced cirrhosis due to chronic hepatitis B is
      poor, and results of therapies, including liver transplantation, have been
      unsatisfactory. Little is known about the effectiveness of interferon alfa in
      patients with cirrhosis. METHODS: Between 1984 and 1991, 18 patients with
      clinically-apparent cirrhosis due to hepatitis B were treated with interferon
      alfa at the Clinical Center of the National Institutes of Health. RESULTS: Six
      treated patients (33%) had a sustained loss of hepatitis B virus DNA and
      hepatitis B e antigen (if present initially) and decrease of amino-transferase
      levels into the normal or near normal range. In follow-up, these 6 patients
      resolved all symptoms of cirrhosis and are alive and fully active. In contrast,
      the 12 patients who did not have a sustained loss of hepatitis B virus have had
      evidence of progressive liver disease, 6 have died and 4 underwent hepatic
      transplantation. Side effects of interferon were common and included bacterial
      infections (n = 5) and exacerbations of disease (n = 9). CONCLUSIONS: These
      findings indicate that interferon alfa is effective in selected patients with
      mildly decompensated cirrhosis due to hepatitis B.

PMID- 8462801
TI  - Recurrence of hepatitis D (delta) in liver transplants: histopathological
      aspects.
AB  - BACKGROUND: The viral/pathological correlates of recurrent hepatitis delta virus
      (HDV) disease in orthotoptic liver transplants are reported. METHODS: We examined
      the histological features of recurrent HDV disease in nine patients with
      transplants for terminal HDV cirrhosis were examined; intrahepatic HDV and
      hepatitis B virus (HBV) antigens were detected by immunoperoxidase techniques.
      Sera were tested for the battery of HDV and HBV markers. RESULTS: In four
      patients, HDV reinfection was accompanied by the recurrence of an HBV infection
      with features of active viral replication. In the other five, HDV reinfection was
      accompanied by an atypical recurrence of HBV infection without evidence of active
      HBV replication (no expression of intrahepatic hepatitis B core antigen). In four
      of the latter patients, the atypical HBV pattern changed during the follow-up
      into a pattern of active viral replication accompanied by chronic
      necroinflammation detected during histology. CONCLUSION: The pattern of recurrent
      HBV infection can influence the pathological aspects of the relapses of HDV
      disease in liver grafts.

PMID- 8462802
TI  - Immunogenicity of inactivated hepatitis A vaccine in children.
AB  - BACKGROUND: Inactivated hepatitis A vaccine is now becoming available in many
      countries. METHODS: To evaluate the immunogenicity and safety of inactivated
      hepatitis A vaccine in healthy children, 99 susceptible schoolchildren from 4 to
      15 years of age received 360 enzyme-linked immunosorbent assay units of the
      inactivated hepatitis A vaccine at months 0, 1, and 6. RESULTS: Antibody to
      hepatitis A virus seroconversion (> or = 20 mIU/mL) was 97% (96/99) in vaccinees
      after the first dose and 100% after the second (99/99) and booster (96/96) doses.
      The geometric mean titers of antibody to hepatitis A virus were 167, 465, and
      4133 mIU/mL after each dose of vaccine, respectively. There were no significant
      side effects during the vaccination. Levels of antibody to hepatitis A virus were
      also tested in 9 susceptible children at day 7 and months 1 and 4 after the
      intramuscular injection of 2 mL of immune serum globulin. All children had
      measurable titers of antibody to hepatitis A virus 1 week after receiving immune
      serum globulin by sensitive enzyme immunoassay, but measurable titers had
      disappeared 1-4 months later. CONCLUSIONS: The inactivated hepatitis A vaccine is
      safe and immunogenic in healthy children.

PMID- 8462803
TI  - Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with
      ascites.
AB  - BACKGROUND: This study was performed to investigate the risk factors for a first
      episode of spontaneous bacterial peritonitis in cirrhotic patients. METHODS: One
      hundred ten cirrhotics with sterile ascites, without previous spontaneous
      bacterial peritonitis (SBP), were included from March 1988 to October 1989 and
      followed up until October 1990 (follow-up, 46 +/- 3.5 weeks; range, 4-120 weeks).
      RESULTS: Twenty-eight patients (25.45%) suffered SBP. In multivariate analysis
      (Cox's regression model) including only variables commonly used in clinical
      practice, ascitic fluid protein concentration and serum bilirubin level
      independently correlated with first SBP development. Using these two variables
      the relative risk of a first SBP episode was calculated for each patient.
      According to the median relative risk coefficient (1.2), a low-risk group
      (relative risk, < 1.2) and a high-risk group (relative risk, > 1.2) were
      established. Kaplan-Meier estimates of patients free of SBP were significantly
      higher in the low-risk group. CONCLUSIONS: The probability of a first SBP episode
      is significantly influenced by the antimicrobial capacity of ascitic fluid and
      hepatic function.

PMID- 8462804
TI  - Arteriovenous shunting, hemodynamic changes, and renal sodium retention in liver
      cirrhosis.
AB  - BACKGROUND: Arterial vasodilation has been postulated to initiate sodium
      retention in cirrhosis. This work was designed to analyze whether arteriovenous
      shunting underlies vasodilation and influences renal function in cirrhosis.
      METHODS: The femoral arteriovenous difference in oxygen content (Ca-VO2) was
      measured in 10 healthy subjects (control group) and 31 cirrhotic patients: 9
      without ascites (group 1), 10 with ascites and a urinary sodium excretion rate
      (UNaV) of > 10 mEq/24 h (group 2), and 12 with ascites and UNaV of < or = 10
      mEq/24 h (group 3). In 8 subjects from each group, femoral blood flow and the
      cardiac output were determined by duplex-Doppler ultrasonography. In 9 cases
      arteriovenous shunting in the femoral territory was estimated using 30 +/- 5
      microns radiolabeled microspheres. RESULTS: Ca-VO2 was lower in group 3 than in
      controls or group 1. Ca-VO2 correlated inversely with femoral blood flow, plasma
      renin activity, plasma aldosterone concentration, and degree of shunting measured
      by microspheres. Ca-VO2 correlated directly with systemic vascular resistance and
      prothrombin index. CONCLUSIONS: In decompensated cirrhotic patients, there is an
      increased arteriovenous shunt for oxygen in the lower extremities that is
      associated with increased arterial blood flow, decreased systemic vascular
      resistance, and worsening of liver function. This shunt is due partly to opening
      of arteriovenous precapillary connections.

PMID- 8462805
TI  - Gabexate mesilate in human acute pancreatitis. German Pancreatitis Study Group.
AB  - BACKGROUND: A multicenter controlled study was performed to evaluate the effect
      of high doses of the low molecular weight protease inhibitor gabexate mesilate on
      mortality and complications associated with moderate and severe acute
      pancreatitis. METHODS: Two hundred twenty-three patients from 29 hospitals were
      entered in the randomized, double-blind trial. Admission to the study was based
      on strict criteria excluding mild acute pancreatitis. The patients received
      placebo or 4 g gabexate mesilate per day intravenously for 7 days. All patients
      were followed up for 90 days after randomization. The analysis was based on 14
      complications, including death. RESULTS: There was no statistical difference in
      either mortality or complications associated with acute pancreatitis between the
      placebo and gabexate mesilate groups. CONCLUSIONS: The results show that gabexate
      mesilate was not effective in preventing complications and mortality in acute
      pancreatitis.

PMID- 8462806
TI  - Agenesis of the dorsal pancreas in a woman with diabetes mellitus and in both of
      her sons.
AB  - Complete agenesis of the dorsal pancreas has rarely been described. Complete
      agenesis of the dorsal pancreas in a female who developed insulin-dependent
      diabetes mellitus at the age of 39 years is reported. The diagnosis of agenesis
      of the dorsal pancreas was suspected by abdominal ultrasound and confirmed by
      abdominal computed tomography (CT), magnetic resonance imaging, and endoscopic
      retrograde pancreatography. Her exocrine pancreatic function was essentially
      normal. Both of the patient's sons also had agenesis of the body and tail of the
      pancreas verified by abdominal CT but had no evidence of diabetes mellitus. This
      familial occurrence of agenesis of the dorsal pancreas suggests that hereditary
      mechanisms may play a role in the pathogenesis of this anomaly.

PMID- 8462807
TI  - Ulcerative colitis and total alopecia in a mother and her son.
AB  - Extraintestinal autoimmune disorders are associated with ulcerative colitis in
      selected patients and lend support to the theory of immune-mediated injury in
      inflammatory bowel disease. Rarely, alopecia areata has been associated with
      ulcerative colitis, and familial aggregation and an HLA association have been
      reported for both disorders. The occurrence of both alopecia and ulcerative
      colitis in a mother and son are reported with a detailed investigation of
      antineutrophil cytoplasmic antibodies and HLA alleles in this family. Treatment
      with the immunosuppressive agent cyclosporine proved beneficial in the child
      leading to remission of the ulcerative colitis and nascent growth of scalp and
      body hair.

PMID- 8462808
TI  - Buerger's disease presenting as acute small bowel ischemia.
AB  - The case of a young man with an unusual presentation of thromboangiitis
      obliterans with ischemia of the small bowel, 2 years before peripheral vascular
      disease of the extremities was clinically expressed, is reported.

PMID- 8462809
TI  - What are functional bowel disorders?

PMID- 8462810
TI  - Cytokines and animal models: a combined path to inflammatory bowel disease
      pathogenesis.

PMID- 8462811
TI  - Regulatory peptides and intestinal growth.

PMID- 8462812
TI  - The problem with pouchitis.

PMID- 8462813
TI  - Damage prevention versus damage control in acute pancreatitis.

PMID- 8462814
TI  - Pancreas divisum: to stent or not to stent.

PMID- 8462815
TI  - Food allergy: fact, fiction, and fatality.

PMID- 8462816
TI  - Evolution of Barrett's esophagus: the jury is still out.

PMID- 8462817
TI  - Are early electron-microscopic acinar cell derangements in opossum pancreatitis
      critical for coagulative necrosis at 7 days?

PMID- 8462818
TI  - Preventing infection in cirrhotics with gastrointestinal hemorrhage.

PMID- 8462819
TI  - Bowel rest and elemental diet in Crohn's disease.

PMID- 8462820
TI  - Omega-3 fatty acids and bowel cancer.

PMID- 8462821
TI  - High risk, low mortality in chronic ulcerative colitis: explanation.

PMID- 8462822
TI  - The mechanism of bismuth absorption.

PMID- 8462823
TI  - Interleukin-2 activity of colonic lamina propria mononuclear cells in a rat model
      of experimental colitis.
AB  - BACKGROUND: Altered interleukin 2 (IL-2) production has been implicated in the
      pathogenesis of inflammatory bowel diseases. METHODS: The temporal relationship
      between IL-2, prostaglandin E2 (PGE2) production, and mucosal injury was
      evaluated by isolated colonic lamina propria mononuclear cells (LPMC), using the
      trinitrobenzene sulfonic acid model of rat colitis. RESULTS: Spontaneous LPMC IL
      2 activity was significantly increased in chronic (5 weeks) but not acute (5
      days) or resolved colitis groups. IL-2 activity after concanavalin A activation
      was highest in the groups with resolved and chronic colitis. PGE2 production was
      significantly increased in LPMC cultures in acute or chronic colitis as well as
      the ethanol control groups but not the resolved colitis group. The addition of
      indomethacin to LPMC cultures decreased PGE2 levels in all groups, whereas IL-2
      activity increased only for the chronic and resolved colitis groups. No
      correlation was found between PGE2 and IL-2 production by LPMC. CONCLUSIONS: In
      this experimental model, LPMC IL-2 production varied according to the severity
      and duration of the inflammation. Increased PGE2 production does not appear to be
      responsible for the IL-2 alterations in colitis.

PMID- 8462824
TI  - Evaluation of the inflammatory infiltrate in pouchitis with 111In-labeled
      granulocytes.
AB  - BACKGROUND: The aim of this study was to elucidate the inflammatory infiltrate in
      pouchitis and define the changes following metronidazole therapy. METHODS: Twenty
      seven patients underwent functional grading, sigmoidoscopic and histological
      scoring, 111In-labeled granulocyte scanning, and 4-day fecal collections for
      111In-labeled granulocyte excretion. Six of the patients with pouchitis underwent
      repeat studies after 1-month treatment with metronidazole, 400 mg three times
      daily. RESULTS: The grade of macroscopic inflammation in the pouch mucosa
      (sigmoidoscopic score) correlated well with the acute histological score (P <
      0.0001), chronic histological score (P < 0.001), 4-hour 111In scan (P < 0.001),
      24-hour 111In scan (P < 0.001), and with 4-day fecal 111In excretion (P < 0.001).
      After metronidazole therapy there was decreased inflammatory grade
      sigmoidoscopically and histologically on the 4- and 24-hour scans and decreased 4
      day fecal 111In granulocyte excretion. CONCLUSIONS: This study confirms that the
      inflammatory infiltrate in pouchitis is acute or chronic, is characterized by
      neutrophils, is usually localized to pouch mucosa, and is always decreased after
      metronidazole therapy.

PMID- 8462825
TI  - [Management of mono-amnion twin pregnancy].
AB  - There have been only a few reports on monoamniotic twin pregnancies from the
      period of modern perinatology. Consequently, available recommendations about the
      management of these high-risk pregnancies are uncertain. In this study, we
      present the management and the outcome of three monoamniotic twin pregnancies and
      two further pregnancies with acardiac acephalus twin in comparison to other case
      reports and case series from the literature. Practical ways of caring for these
      high-risk pregnancies are outlined, emphasising the continuous search for
      entanglement of umbilical cord by ultrasound and cardiotocography. The special
      importance of intensified cardiotocographic monitoring is demonstrated.

PMID- 8462826
TI  - [Echographic evaluation of the integrity of adnexa tumors].
AB  - The preoperative diagnosis of pelvic tumours is getting more and more important.
      This has special relevance to the increasing possibilities of conservative
      management of adnexal tumours and cysts (puncturing or operating by laparoscopy).
      We reviewed sonographical and histological data of 514 patients, who were
      operated on in the 2nd Department of Obstetrics and Gynaecology in Vienna because
      of pelvic masses. We correlated sonographical parameters like size of tumour,
      distinctness of margins, different kinds of internal echo pattern, papillary
      vegetation on the cystic wall or septa, with the defined histopathological
      diagnosis. A close relationship between size of tumour and tumour status could be
      found. The size of benign tumours was 7.1 cm. Malignant tumours had a size of
      10.7 cm. The size of the high-echogenic area within the tumour, as well as its
      homogeneity, seemed to be of great importance. Such tumours with high-echogenic
      areas within, and especially those who had nonhomogeneous structures of these
      areas, proved to be malignant in 81% of the cases. Similarly, we found a close
      correlation of papillary vegetation either on cystic walls or on septa with the
      confirmed diagnosis of malignancy. Septa without papillarities or changing of
      their thickness were less important. By means of using our criteria a less
      experienced sonographic examiner could reach as good results as an experienced
      one in predicting malignancy.

PMID- 8462827
TI  - [Success and quality control in prolapse and stress incontinence operations-
      comparative use of urodynamics and transrectal endosonography].
AB  - We evaluated the significance of urodynamic parameters versus transrectal
      ultrasound with regard to postoperative outcome-control after operation for
      procedentia and urinary stress incontinence. We studied 30 continent women and 84
      women with purely stress induced urinary incontinence. All had a pre- and
      postoperative urodynamic testing including urethral profilometry and cystometry,
      paralleled by a transrectal ultrasound examination. From the urodynamic
      parameters only the transmission ratio is suitable to judge the surgical outcome,
      although it is less correlative to the patient's complaints (p = 0.033) than the
      bladder neck mobility (p < 0.0001, Tab. 5). Within the rather short time of
      follow-up, each of the operation-techniques was able to improve the bladder neck
      mobility significantly. Nevertheless, anterior colporrhaphia is not suitable for
      incontinence-surgery (Fig. 2/Tab. 5). Concerning operative results, transrectal
      endosonography was found to be an adequate or even superior method as compared to
      urodynamic studies, because it can likewise demonstrate the function of the
      bladder neck, but furthermore can show the morphologic aspects of bladder,
      urethra and pelvic floor. As a result, for the first time, this minimal invasive
      method offers quality control for the individual surgeon as well as for long-term
      follow-up studies after operation for procedentia and stress induced urinary
      incontinence without using much time or causing great discomfort to the patient.

PMID- 8462828
TI  - [SHBG serum level in women with endometriosis before, during and after long-term
      danazol therapy].
AB  - Ten patients with endometriosis, aged from 21 to 37 years, were treated with
      danazol at a dosage level of 200 mg three times daily for 6 months. Three blood
      samples were drawn 60 min apart for evaluation of the sex hormone binding
      globulin (SHBG), before danazol administration (4th day of the cycle), during the
      last two weeks of the six-month therapy and three months after the cessation of
      treatment (4th day of the cycle). In contrast to that, SHBG levels were also
      evaluated in ten normal women, aged 21-37 years (4th day of the cycle). It was
      found that: a) SHGB values were significantly higher in patients with
      endometriosis than in the control group (p < 0.01), b) danazol resulted in
      significant decrease of SHBG levels (p < 0.001), c) there was no correlation
      between SHBG levels before and during danazol administration, and d) SHBG levels
      were significantly lower three months after the cessation of danazol than before
      the administration of the medication (p < 0.05), while these levels were not
      significantly different, compared with those of normal women. Our results support
      the view, that SHBG production disturbances might interfere with the possible
      pathogenetic mechanisms of infertility observed in endometriosis.

PMID- 8462829
TI  - [Women after surgically corrected vaginal aplasia: a follow-up of psychosexual
      rehabilitation].
AB  - In 24 patients with Mayer-Rokitansky-Kustner syndrome we carried out a post
      operative follow-up examination. In the majority of cases, the operation had
      yielded functionally satisfactory results. 20 out of 24 of the patient collective
      now lead a healthy sexual life with an unimpaired emotional and sexual
      responsiveness. Early and regular postoperative cohabitation is vital for long
      term success of surgical results and more important than regular of the wearing
      phantom. A successful operation greatly increases the patient's self-esteem, her
      feeling of being sexually attractive, and her self-confidence. Despite general
      satisfaction with operational results, several women voiced criticism about
      inadequate perioperative psychological support. The patients' legitimate need for
      psychological help and guidance must not be neglected. This can take the form of
      regular discussions, in which detailed explanations about the disorder are given
      and which must also cover the subject of infertility, a cause of particular
      anguish in most women. This approach will contribute to enhancing the women's
      emotional stability and help them to better cope with their problems. It is our
      experience, that it is beneficial to include the patient's partner in such
      counselling.

PMID- 8462830
TI  - [Pelviscopic ovarian surgery: a new method of safe organ preserving surgery].
AB  - For pelviscopic removal of ovarian tumours, a puncture or morcellation of the
      tumour used to be necessary, frequently causing the peritoneal cavity to be
      contaminated with contents of cysts or tumourous material. This contamination can
      be avoided safely by placing the intact tumour into a bag, provided that the
      tumour has been dissected completely. The intact tumour is put into a bag and
      both are completely removed at the same time through the abdominal wall. This
      method increases the safety of pelviscopic ovarian surgery, and its indication
      for use can be broadened.

PMID- 8462831
TI  - [Hydronephrosis in pregnancy].
AB  - This is a report on the clinical course of a severe right-sided urinary retention
      in 21-year old patient, treated from the 24th week of pregnancy onwards. The
      special importance of the mechanical component involved in the genesis of this
      retention of urine is discussed on the occasion of the transitory spontaneous
      remission, observed, when the foetus turned to breech presentation.

PMID- 8462832
TI  - [Low-dose methotrexate in treatment of extra-uterine pregnancy].

PMID- 8462833
TI  - [Eclampsia and HELLP syndrome in puerperium].
AB  - We report on a case of a 34-year-old I. Grav./I. Para. After a normal pregnancy
      and Caesarean section, the patient developed a postpartum HELLP-syndrome with an
      eclamptic attack.

PMID- 8462834
TI  - [Adjuvant chemo- and hormone therapy of breast cancer].
AB  - During the past few years "consensus statements" on the adjuvant treatment of
      patients with breast cancer have been issued periodically (the last one in the
      spring of 1992). Many physicians have interpreted such a tabellary synopsis as a
      "push-button" treatment, which is, of course, beside the point, since the text of
      the original publications for several subgroups of patients defines this
      treatment as "optional". In fact, physicians cannot decide by themselves, which
      treatment a patient should have. All patients must be shown both sides of the
      medal, i.e. a small chance to live longer and the risk of side effects, and
      finally each individual patient has to decide for herself on the basis of
      "informed consent". In case of widespread acceptance, as mentioned by some
      authors, that nearly all patients should be treated in some adjuvant manner, a
      large group which does not need any adjuvant treatment at all, will remain
      undefined. This group comprises at least 50% of all women ever treated for
      primary breast cancer. All physicians should consider it to be an urgent
      responsibility to define this group. This can be achieved only by means of
      studies, which include untreated or placebo-treated controls.

PMID- 8462835
TI  - [Importance of plasma PMN granulocyte elastase concentration determination in
      pregnant patients with premature rupture of fetal membranes].
AB  - The aetiology of preterm rupture of membranes is not yet completely understood.
      Local infections of the vagina and cervix have attracted special attention during
      the last years. Ascending infection with subsequent chorioamnionitis is a common
      complication of preterm rupture of membranes. Recognition of the beginning of a
      chorioamnionitis is usually based on clinical symptoms and laboratory findings
      like white blood cell count and C-reactive protein. The purpose of this study was
      to find out the diagnostic value of elastase, a protease of polymorphonuclear
      granulocytes, which is known to be involved in inflammatory processes. Fifteen
      out of thirty-three patients with preterm rupture of membranes developed a
      chorioamnionitis. Elastase plasma concentration levels > or = 32 ng/ml one day
      before delivery showed a significant correlation (p = 0.02) to the development of
      a chorioamnionitis. At this time neither white blood cell count, nor rectal body
      temperature showed significant correlations. Low elastase levels do not exclude
      an infection, whereas high levels indicate an infectious process. We conclude
      that elastase is a relevant marker of chorioamnionitis.

PMID- 8462836
TI  - [Diagnosis of rupture of fetal membranes: comparison of vaginal detection of
      fetal fibronectin and intra-amnion injection of indigo carmine].
AB  - Amniotic fluid contains a heavily glycosylated pregnancy-related isoform of
      fibronectin (fFN), which can be detected using FDC-6, a monoclonal antibody
      directed against a novel epitope specific to fFN. It has been identified in the
      amniotic fluid in various concentrations throughout the different pregnancy
      periods and is localised at the interface of the chorion and the uterine decidua.
      Because of the unique pregnancy-associated expression of fFN, we determined the
      utility of cervicovaginal appearance of fFN as a marker of membrane integrity or
      rupture of membranes. In a prospective study we compared 1) the detection of fFN
      in cervicovaginal samples by a membrane-immunoassay (ROM-Check, Mast Diagnostica,
      Reinfeld, FRG) with 2) the results of intraamniotic injection of Indigo Carmine
      (IC), followed by the observation of dye spill into the vagina to confirm rupture
      of membranes. 65 patients were examined, 12 patients had to be excluded from the
      study for various reasons. Examination results were identical in 50 patients,
      while in three cases the fFN results were positive with a simultaneous negative
      result of the intraamniotic dye injection. In the case of blood contamination,
      the fFN test results were not valid; testing of maternal blood and of urine
      samples was fFN negative in all cases. We conclude, that oncofoetal fibronectin
      is an excellent marker for rupture of membranes. The test is easy to perform and
      does not involve the risk of an intraamniotic injection of dye.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8462837
TI  - [Folic acid supply in pregnancy--results of a prospective longitudinal study].
AB  - After discussing the problem of folic acid requirements and supply during
      pregnancy, the results of a longitudinal study on 162 pregnant women are
      presented. By measuring biochemical and morphological changes in two subgroups
      (non-substituted vs unspecifically substituted), the necessity of a substitution
      with folic acid is discussed, as there might be additional requirements for the
      pregnant and the foetal organism. Concentrations of folic acid in the maternal
      plasma and in the erythrocytes as well as the segmentation rate and
      hypersegmentation of the granulocytes show a clear decrease in pregnancy. At the
      same time there was a significant difference between the subjects substituted and
      not substituted; the foetus and newborn levels were much higher than their
      mothers' concentrations. Moreover, there was a correlation between red cells
      folic acid levels in the last trimester and duration and outcome of pregnancy.
      These results indicate a substitution with folic acid for certain populations in
      pregnancy, which are highlighted.

PMID- 8462838
TI  - William Ernest Castle, pioneer mammalian geneticist.

PMID- 8462839
TI  - Evolution of natural transformation: testing the DNA repair hypothesis in
      Bacillus subtilis and Haemophilus influenzae.
AB  - The hypothesis that the primary function of bacterial transformation is DNA
      repair was tested in the naturally transformable bacteria Bacillus subtilis and
      Haemophilus influenzae by determining whether competence for transformation is
      regulated by DNA damage. Accordingly, DNA damage was induced by mitomycin C and
      by ultraviolet radiation at doses that efficiently induced a known damage
      inducible gene fusion, and the ability of the damaged cultures to transform was
      monitored. Experiments were carried out both under conditions where cells do not
      normally become competent and under competence-inducing conditions. No induction
      or enhancement of competence by damage was seen in either organism. These
      experiments strongly suggest that the regulation of competence does not involve a
      response to DNA damage, and thus that explanations other than DNA repair must be
      sought for the evolutionary functions of natural transformation systems.

PMID- 8462840
TI  - The Cs sec mutants of Escherichia coli reflect the cold sensitivity of protein
      export itself.
AB  - We have found that temperature can have a striking effect upon protein export in
      Escherichia coli, suggesting that there is a cold-sensitive step in the protein
      export pathway. Cs mutations comprise the largest class of mutations affecting
      the membrane-localized Sec proteins SecD, SecE, SecF and SecY. Although some of
      these mutations could encode cold-labile proteins, this is unlikely to account
      for the Cs phenotype of most export mutants, as mutations which simply produce
      lower amounts of SecE protein have the same phenotype. Certain signal sequence
      mutations affecting maltose binding protein are also cold sensitive for export.
      These effects appear to arise by a specific interaction of cold with certain
      export defects. We believe that the Cs sec mutations are representative of a
      large class of conditional lethal mutations, whose conditional phenotype reflects
      an underlying thermal sensitivity of the process in which they are involved.

PMID- 8462842
TI  - A conditional allele of the Saccharomyces cerevisiae HOP1 gene is suppressed by
      overexpression of two other meiosis-specific genes: RED1 and REC104.
AB  - The HOP1 gene of Saccharomyces cerevisiae is believed to encode a protein
      component of the synaptonemal complex, the structure formed when homologous
      chromosomes synapse during meiotic prophase. Five new mutant alleles (three
      conditional, two nonconditional) of HOP1 were identified by screening EMS
      mutagenized cells for a failure to complement the spore viability defect of a
      hop1 null allele. Two high copy plasmids were found that partially suppress the
      temperature-sensitive spore inviability phenotype of one of these alleles, hop1
      628. The suppression is allele-specific; no effect of the plasmids is observed in
      hop1 null diploids. Mutation of either of the two suppressor genes results in
      recessive spore lethality, indicating that these genes play important roles
      during meiosis. The DNA sequence of one high copy suppressor gene matched that of
      RED1, a previously identified meiosis-specific gene. Our data strongly support
      the idea that RED1 protein is also a component of the synaptonemal complex and
      further suggest that the RED1 and HOP1 gene products may interact. The second
      suppressor maps to the right arm of chromosome VIII distal to CDC12 and is
      REC104, a meiosis-specific gene believed to act early in meiosis.

PMID- 8462841
TI  - Genetic evidence for transcriptional activation by the yeast IME1 gene product.
AB  - IME1 is required in yeast for meiosis and for expression of IME2 and other early
      meiotic genes. IME1 is a 360-amino acid polypeptide with central and C-terminal
      tyrosine-rich regions. We report here that a fusion protein composed of the lexA
      DNA-binding domain and IME1 activates transcription in vivo of a reporter gene
      containing upstream lexA binding sites. Activation by the fusion protein shares
      several features with natural IME1 activity: both are dependent on the RIM11 gene
      product; both are impaired by the same ime1 missense mutations; both are restored
      by intragenic suppressors. The central tyrosine-rich region is sufficient to
      activate transcription when fused to lexA. Deletion of this putative activation
      domain results in a defective IME1 derivative. Function of the deletion
      derivative is restored by fusion to the acidic Herpesvirus VP16 activation
      domain. The C-terminal tyrosine-rich region is dispensable for transcriptional
      activation; rather it renders activation dependent upon starvation and RIM11.
      Immunofluorescence studies indicate that an IME1-lacZ fusion protein is
      concentrated in the nucleus. These observations are consistent with a model in
      which IME1 normally stimulates IME2 expression by providing a transcriptional
      activation domain at the IME2 5' regulatory region.

PMID- 8462843
TI  - Meiotic mismatch repair quantified on the basis of segregation patterns in
      Schizosaccharomyces pombe.
AB  - Hybrid DNA with mismatched base pairs is a central intermediate of meiotic
      recombination. Mismatch repair leads either to restoration or conversion, while
      failure of repair results in postmeiotic segregation (PMS). The behavior of three
      G to C transversions in one-factor crosses with the wild-type alleles is studied
      in Schizosaccharomyces pombe. They lead to C/C and G/G mismatches and are
      compared with closely linked mutations yielding other mismatches. A method is
      presented for the detection of PMS in random spores. The procedure yields
      accurate PMS frequencies as shown by comparison with tetrad data. A scheme is
      presented for the calculation of the frequency of hybrid DNA formation and the
      efficiency of mismatch repair. The efficiency of C/C repair in S. pombe is
      calculated to be about 70%. Other mismatches are repaired with close to 100%
      efficiency. These results are compared with data published on mutations in
      Saccharomyces cerevisiae and Ascobolus immersus. This study forms the basis for
      the detailed analysis of the marker effects caused by G to C transversions in two
      factor crosses.

PMID- 8462844
TI  - Marker effects of G to C transversions on intragenic recombination and mismatch
      repair in Schizosaccharomyces pombe.
AB  - G to C transversion mutations show very strong allele-specific marker effects on
      the frequency of wild-type recombinants in intragenic two-factor crosses. Here we
      present a detailed study of the marker effect of one representative, the ade6
      M387 mutation of Schizosaccharomyces pombe. Crosses of M387 with other mutations
      at varying distance reveal highly increased prototroph frequencies in comparison
      with the C to T transition mutation ade6-51 (control without any known marker
      effect) located four nucleotides from M387. The marker effect of M387 is
      strongest (> 40-fold) for crosses with mutations less than 15 nucleotides from
      M387. It decreases to an intermediate level (5-10-fold) in crosses with mutations
      located 25-150 base pairs from M387/51 and is very low in crosses with mutations
      beyond 200 base pairs. On the basis of these results and the quantitation of the
      low efficiency of C/C mismatch repair presented in the accompanying publication
      we propose the existence of at least two different types of mechanisms for base
      mismatch repair in fission yeast. The major system is suggested to recognize all
      base mismatches except C/C with high efficiency and to generate long excision
      tracts (approximately 100 nucleotides unidirectionally). The minor system is
      proposed to recognize all base mismatches including C/C with low and variable
      efficiency and to have short excision tracts (approximately 10 nucleotides
      unidirectionally). We estimate from the M387 marker effect that the minor system
      accounts for approximately 1-8% repair of non-C/C mismatches (depending on the
      nature of the mutation) in fission yeast meiosis.

PMID- 8462845
TI  - A mutational analysis of killer toxin resistance in Saccharomyces cerevisiae
      identifies new genes involved in cell wall (1-->6)-beta-glucan synthesis.
AB  - Recessive mutations leading to killer resistance identify the KRE9, KRE10 and
      KRE11 genes. Mutations in both the KRE9 and KRE11 genes lead to reduced levels of
      (1-->6)-beta-glucan in the yeast cell wall. The KRE11 gene encodes a putative 63
      kD cytoplasmic protein, and disruption of the KRE11 locus leads to a 50% reduced
      level of cell wall (1-->6)-glucan. Structural analysis of the (1-->6)-beta-glucan
      remaining in a kre11 mutant indicates a polymer smaller in size than wild type,
      but containing a similar proportion of (1-->6)- and (1-->3)-linkages. Genetic
      interactions among cells harboring mutations at the KRE11, KRE6 and KRE1 loci
      indicate lethality of kre11 kre6 double mutants and that kre11 is epistatic to
      kre1, with both gene products required to produce the mature glucan polymer at
      wild-type levels. Analysis of these KRE genes should extend knowledge of the beta
      glucan biosynthetic pathway, and of cell wall synthesis in yeast.

PMID- 8462846
TI  - Mutational analysis of pre-mRNA splicing in Saccharomyces cerevisiae using a
      sensitive new reporter gene, CUP1.
AB  - We have developed a new reporter gene fusion to monitor mRNA splicing in yeast.
      An intron-containing fragment from the Saccharomyces cerevisiae ACT1 gene has
      been fused to CUP1, the yeast metallothionein homolog. CUP1 is a nonessential
      gene that allows cells to grow in the presence of copper in a dosage-dependent
      manner. By inserting previously characterized intron mutations into the fusion
      construct, we have established that the efficiency of splicing correlates with
      the level of copper resistance of these strains. A highly sensitive assay for 5'
      splice site usage was designed by engineering an ACT1-CUP1 construct with
      duplicated 5' splice sites; mutations were introduced into the upstream splice
      site in order to evaluate the roles of these highly conserved nucleotides in
      intron recognition. Almost all mutations in the intron portion of the 5'
      consensus sequence abolish recognition of the mutated site, while mutations in
      the exon portion of the consensus sequence have variable affects on cleavage at
      the mutated site. Interestingly, mutations at intron position 4 demonstrate that
      this nucleotide plays a role in 5' splice site recognition other than by base
      pairing with U1 snRNA. The use of CUP1 as a reporter gene may be generally
      applicable for monitoring cellular processes in yeast.

PMID- 8462847
TI  - Linkage group XIX of Chlamydomonas reinhardtii has a linear map.
AB  - Linkage group XIX (or the UNI linkage group) of Chlamydomonas reinhardtii has
      been reported to show a circular meiotic recombination map. A circular map
      predicts the existence of strong chiasma and chromatid interference, which would
      lead to an excess number of two-strand double crossovers during meiosis. We have
      tested this prediction in multipoint crosses. Our results are consistent with a
      linear linkage group that shows positive chiasma interference and no chromatid
      interference. Chiasma interference occurs both within arms and across the
      centromere. Of the original loci that contributed to the circular map, we find
      that two map to other linkage groups and a third cannot be retested because the
      mutant strain that defined it has been lost. A second reported unusual property
      for linkage group XIX was the increase in meiotic recombination with increases in
      temperature during a period that precedes the onset of meiosis. Although we
      observed changes in recombination frequencies in some intervals on linkage group
      XIX in crosses to CC-1952, and in strains heterozygous for the mutation ger1 at
      16 degrees, we also show that our strains do not exhibit the previously observed
      patterns of temperature-sensitive recombination for two different pairs of loci
      on linkage group XIX. We conclude that linkage group XIX has a linear genetic map
      that is not significantly different from other Chlamydomonas linkage groups.

PMID- 8462848
TI  - Feedback control of sex determination by dosage compensation revealed through
      Caenorhabditis elegans sdc-3 mutations.
AB  - In Caenorhabditis elegans, sex determination and dosage compensation are
      coordinately controlled through a group of genes that respond to the primary sex
      determination signal. Here we describe a new gene, sdc-3, that also controls
      these processes. In contrast to previously described genes, the sex determination
      and dosage compensation activities of sdc-3 are separately mutable, indicating
      that they function independently. Paradoxically, the sdc-3 null phenotype fails
      to reveal the role of sdc-3 in sex determination: sdc-3 null mutations that lack
      both activities disrupt dosage compensation but cause no overt sexual
      transformation. We demonstrate that the dosage compensation defect of sdc-3 null
      alleles suppresses their sex determination defect. This self-suppression
      phenomenon provides a striking example of how a disruption in dosage compensation
      can affect sexual fate. We propose that the suppression occurs via a feedback
      mechanism that acts at an early regulatory step in the sex determination pathway
      to promote proper sexual identity.

PMID- 8462849
TI  - The genetics of feeding in Caenorhabditis elegans.
AB  - The pharynx of Caenorhabditis elegans is a nearly self-contained neuromuscular
      organ responsible for feeding. To identify genes involved in the development or
      function of the excitable cells of the pharynx, I screened for worms with visible
      defects in pharyngeal feeding behavior. Fifty-two mutations identified 35 genes,
      at least 22 previously unknown. The genes broke down into three broad classes: 2
      pha genes, mutations in which caused defects in the shape of the pharynx, 7 phm
      genes, mutations in which caused defects in the contractile structures of the
      pharyngeal muscle, and 26 eat genes, mutants in which had abnormal pharyngeal
      muscle motions, but had normally shaped and normally birefringent pharynxes
      capable of vigorous contraction. Although the Eat phenotypes were diverse, most
      resembled those caused by defects in the pharyngeal nervous system. For some of
      the eat genes there is direct evidence from previous genetic mosaic and
      pharmacological studies that they do in fact affect nervous system. In eat-5
      mutants the motions of the different parts of the pharynx were poorly
      synchronized. eat-6 and eat-12 mutants failed to relax their pharyngeal muscles
      properly. These pharyngeal motion defects are most easily explained as resulting
      from abnormal electrical excitability of the pharyngeal muscle membrane.

PMID- 8462850
TI  - The mog-1 gene is required for the switch from spermatogenesis to oogenesis in
      Caenorhabditis elegans.
AB  - Caenorhabditis elegans hermaphrodites make first sperm, then oocytes. By
      contrast, animals homozygous for any of six loss-of-function mutations in the
      gene mog-1 (for masculinization of the germ line) make sperm continuously and do
      not switch into oogenesis. Therefore, in mog-1 mutants, germ cells that normally
      would become oocytes are transformed into sperm. By contrast, somatic sexual
      fates are normal, suggesting that mog-1 plays a germ line-specific role in sex
      determination. Analyses of double mutants suggest that mog-1 negatively regulates
      the fem genes and/or fog-1: mog-1; fem and mog-1; fog-1 double mutants all make
      oocytes rather than sperm. Therefore, we propose that wild-type mog-1 is required
      in the hermaphrodite germ line for regulation of the switch from spermatogenesis
      to oogenesis rather than for specification of oogenesis per se. In addition to
      its role in germline sex determination, maternal mog-1 is required for
      embryogenesis: most progeny of a mog-1; fem or mog-1; fog-1 mother die as
      embryos. How might the roles of mog-1 in the sperm/oocyte switch and
      embryogenesis be linked? Previous work showed that fem-3 is regulated post
      transcriptionally to achieve the sperm/oocyte switch. We speculate that mog-1 may
      function in the post-transcriptional regulation of numerous germ-line RNAs,
      including fem-3. A loss of mog-1 might inappropriately activate fem-3 and thereby
      abolish the sperm/oocyte switch; its loss might also lead to misregulation of
      maternal RNAs and thus embryonic death.

PMID- 8462851
TI  - Molecular characterization of lengthy mitochondrial DNA duplications from the
      parasitic nematode Romanomermis culicivorax.
AB  - Complete nucleotide sequences, precise endpoints and coding potential of several
      3.0-kilobase mitochondrial DNA (mtDNA) repeating units derived from two isofemale
      lineages of the mermithid nematode Romanomermis culicivorax have been determined.
      Endpoint analysis has allowed us to infer deletion and inversion events that most
      likely generated the present day repeat configuration. Each amplified unit
      contains the genes for NADH dehydrogenase subunits 3 and 6 (ND3 and ND6), an open
      reading frame (ORF 1) that represents a cytochrome P450-like gene, and three
      additional unidentified open reading frames. The primary nucleotide sequences of
      the R. culicivorax mt-repeat copies within individual haplotypes are highly
      conserved; three nearly complete copies of the repeat unit vary by 0.01% at the
      nucleotide level. These observations suggest that concerted evolution mechanisms
      may be active, resulting in sequence homogenation of these lengthy duplications.

PMID- 8462852
TI  - Unusual variability of the Drosophila melanogaster ref(2)P protein which controls
      the multiplication of sigma rhabdovirus.
AB  - The ref(2)P gene of Drosophila melanogaster was identified by the discovery of
      two alleles, Po and Pp, respectively, permissive and restrictive for sigma
      rhabdovirus multiplication. A surprising variability of this gene was first
      noticed by the observation of size differences between the transcripts of
      permissive and restrictive alleles. In this paper, another restrictive allele,
      Pn, clearly distinct from Pp, is described: it exhibits a weaker antiviral effect
      than Pp and differs from Pp by its molecular structure. Five types of alleles
      were distinguished on the basis of their molecular structure, as revealed by S1
      nuclease analysis of 17 D. melanogaster strains; three alleles were permissive
      and two restrictive. Comparison of the sequences of four haplotypes revealed
      numerous point mutations, two deletions (21 and 24 bp) and a complex event
      involving a 3-bp deletion, all affected the coding region. The unusual
      variability of the ref(2)P locus was confirmed by the high ratio of amino acid
      replacements to synonymous mutations (7:1), as compared to that of other genes,
      such as the Adh (2:42). Nevertheless, nucleotide sequence comparison with the
      Drosophila erecta ref(2)P gene shows that selective pressures are exerted to
      maintain the existence of a functional protein. The effects of this high
      variability on the ref(2)P protein are discussed in relation to its specific
      antiviral properties and to its function in D. melanogaster, where it is required
      for male fertility.

PMID- 8462853
TI  - A genetic analysis of the stoned locus and its interaction with dunce, shibire
      and Suppressor of stoned variants of Drosophila melanogaster.
AB  - The genetic complementation patterns of both behavioral and lethal alleles at the
      stoned locus have been characterized. Mosaic analysis of a stoned lethal allele
      suggests that stoned functions either in the nervous system or in both the
      nervous system and musculature, but is not required for gross neural development.
      The behavioral alleles stnts and stnC, appear to be defective in a diametrically
      opposite sense, show interallelic complementation, and indicate distinct roles
      for the stoned gene product in the visual system and in motor coordination. A
      number of other neurological mutations have been investigated for their possible
      interaction with the viable stoned alleles. Mutations at two loci, dunce and
      shibire, act synergistically with the stnts mutations to cause lethality, but
      fail to interact with stnC. A third variant (Suppressor of stoned) has been
      identified which can suppress the debilitation associated with the stnts
      mutations. These data, together with a previously identified interaction between
      the stnts and tan mutants, indicate a central role for the stoned gene product in
      neuronal function, and suggests that the stoned gene product interacts, either
      directly or indirectly, with the neural cAMP second messenger system, with the
      synaptic membrane recycling pathway via dynamin, and with biogenic amine
      metabolism.

PMID- 8462854
TI  - Complex function and expression of Delta during Drosophila oogenesis.
AB  - Delta (Dl) encodes a cell surface protein that mediates cell-cell interactions
      central to the specification of a variety of cell fates during embryonic and
      postembryonic development of Drosophila melanogaster. We find that the Delta
      protein is expressed intermittently in follicle cells and in germ-line cells
      during stages 1-10 of oogenesis. Furthermore, Delta expression during oogenesis
      can be correlated with a number of morphogenetic defects associated with
      sterility observed in Dl mutant females, including failure of stalk formation
      within the germarium and subsequent fusion of egg chambers, necrosis in germ-line
      cells, and multiphasic embryonic arrest of fertilized eggs. We have also
      identified a Dl mutation that leads to context-dependent defects in Dl function
      during oogenesis. Direct comparison of Delta protein expression with that of the
      Notch protein in the ovary reveals substantial, but incomplete, coincidence of
      expression patterns in space and time. We discuss possible roles for the Delta
      protein in cell-cell interactions required for cell fate specification processes
      during oogenesis in light of available developmental and histochemical data.

PMID- 8462855
TI  - Delimiting the location of the scrapie prion incubation time gene on chromosome 2
      of the mouse.
AB  - Scrapie is a transmissible neurodegenerative disease caused by unusual pathogens
      called prions. The interval between inoculation and illness for experimental
      mouse scrapie is dramatically influenced by an incubation time gene (Prn-i) that
      is linked to Prn-p, the structural gene for prion protein (PrP). Although prion
      proteins from mouse strains with short and long scrapie incubation times differ
      by two amino acids, mice with discordant disease phenotype and Prn-p genotype
      occur in segregating crosses, suggesting recombination between Prn-p and a
      distinct incubation time locus. In addition, expression of Prn-pb transgenes from
      long incubation time mice shortened, rather than prolonged, incubation time. In
      this study, mice carrying chromosomes with meiotic crossovers near Prn-p were
      analyzed for scrapie incubation time phenotype. The results indicated that Prn-i
      (should it exist) must lie within an interval 0.67 cM proximal and 0.22 cM distal
      to Prn-p. The results also suggest that the cumulative effects of other genes,
      rather than meiotic recombination, were responsible for the putative recombinants
      of earlier studies. However, the effect of Prn-pb transgene expression in
      abbreviating scrapie incubation time was mitigated when the transgenes were
      transferred to mice with an endogenous long incubation time allele. Thus, Prn-pb
      transgenes and Prn-i may modulate scrapie pathogenesis by different mechanisms.

PMID- 8462856
TI  - Plastome-genome interactions affect plastid transmission in Oenothera.
AB  - Plastids of Oenothera, the evening primrose, can be transmitted to the progeny
      from both parents. In a constant nuclear background, the frequency of biparental
      plastid transmission is determined by the types of plastid genomes (plastomes)
      involved in the crosses. In this study, the impact of nuclear genomes on plastid
      inheritance was analyzed. In general, the transmission efficiency of each
      plastome correlated strongly with its compatibility with the nuclear genome of
      the progeny, suggesting that plastome-genome interactions can influence plastid
      transmission by affecting the efficiency of plastid multiplication after
      fertilization. Lower frequencies of plastid transmission from the paternal side
      were observed when the pollen had poor vigor due to an incompatible plastome
      genome combination, indicating that plastome-genome interactions may also affect
      the input of plastids at fertilization. Parental traits that affect the process
      of fertilization can also have an impact on plastid transmission. Crosses using
      maternal parents with long styles or pollen with relatively low growth capacity
      resulted in reduced frequencies of paternal plastid transmission. These
      observations suggest that degeneration of pollen plastids may occur as the time
      interval between pollination and fertilization is lengthened.

PMID- 8462857
TI  - Characteristics and mechanisms of nocturnal asthma.
AB  - Nocturnal worsening of asthma is a very common and significant problem for the
      vast majority of all asthmatic patients. The involved mechanisms are multiple and
      interactive. These include circadian alterations in inflammation/mediators,
      epinephrine, beta 2 receptor function, vagal tone, and body temperature. Other
      factors may include aspiration, sinusitis, and sleep apnea. Understanding of the
      mechanisms involved in nocturnal asthma directs the therapeutic approach of these
      patients.

PMID- 8462859
TI  - Alternative treatments for severe, chronic asthma.
AB  - The current focus of treatment for chronic asthma is anti-inflammatory
      pharmaceuticals and minimizing of environmental factors that contribute to airway
      inflammation. Despite the development of increasingly potent inhaled
      glucocorticoids, certain select asthmatic patients require chronic systemic
      glucocorticoids for management. Several nonglucocorticoid, anti-inflammatory
      agents have been shown or suggested to be beneficial in the treatment of chronic
      asthma. The major purpose of using these agents has been to maximize airway
      function and to minimize the use of systemic glucocorticoids, with their
      attendant side effects. Some of these alternative anti-inflammatory agents are
      reviewed in this paper, with emphasis on clinical experience in the treatment of
      asthma. Additional double-blind, placebo-controlled studies are necessary to
      define the role of these agents in the management of chronic asthma.

PMID- 8462858
TI  - Reactions to imported fire ant stings.
AB  - Reactions to the sting of the imported fire ant are an increasing problem for
      residents of the Gulf South. Three recent evolutionary changes suggest that the
      habitat of the ants will continue to expand. This article gives a brief review of
      the problem, including unresolved questions related to management of sting
      reactions.

PMID- 8462860
TI  - Twice-daily peak expiratory flow rate monitoring for the assessment of childhood
      asthma.
AB  - The reliability of the home recording of peak expiratory flow rate (PEFR) in 31
      newly diagnosed school-aged asthmatic children was monitored. The patients
      recorded their PEFR values in the morning and at bedtime and filled in their
      diary cards for 14 days. The mean amplitude of PEFR variation between the highest
      and lowest daily recordings varied from 1.9 to 34.4% (mean 6.7%) of the daily
      mean. Seven children, six of whom belonging to the most seriously affected half
      in the group had two or more daily PEFR variations of 15% or higher, but only two
      of them had their mean amplitude of variation at that limit or more. When the
      whole group was considered, however, no significant correlation was found between
      the mean amplitude of PEFR variation and the symptom score, the medication
      needed, baseline FEV1/FVC, or the methacholine threshold. The findings indicate
      that twice-daily PEFR monitoring may help the physician detect some troublesome
      cases of childhood asthma, but it is of limited value for diagnostic purposes or
      when assessing the degree of severity of asthma in routine clinical work.

PMID- 8462861
TI  - Benefits of antibiotic prophylaxis in children with chronic sinusitis: assessment
      of outcome predictors.
AB  - Eighty-six children with chronic sinusitis, documented by x-ray with symptoms and
      signs for more than 12 weeks, were evaluated for atopy and B-cell immune
      abnormalities. Twenty-nine percent (25/86) of the patients had some B-cell
      abnormality of immunoglobulin isotype, IgG subclass, and/or hyporesponsiveness to
      pneumococcal polysaccharide (PPS) vaccine (Pneumovax). Eleven of 17 patients who
      were hyporesponsive to PPS vaccine had normal immunoglobulin isotypes and IgG
      subclasses. Twenty-six of these 86 children were followed prospectively for > or
      = 1 year on prophylactic antibiotics. The 12-month period before the use of
      prophylactic antibiotics was taken as the control period for each child for
      comparison. Nineteen of 26 (74%) children had a good outcome (greater than a 50%
      reduction in the number of exacerbations of sinusitis during a 12-month period
      compared with the previous year) on prophylactic antibiotics with a reduction in
      exacerbations of sinusitis from 9.8 per year to 2.7 episodes per year. In
      contrast, 7/26 had a poor outcome (p < .0001) on prophylactic antibiotics (from
      12.6 per year to 8.7 per year on prophylactic antibiotics). There were no
      significant differences in age, gender, atopy, or presence of a B-cell immune
      abnormality in the good versus the poor outcome groups to prophylactic antibiotic
      therapy. Treatment outcome correlated inversely with the number of sinus
      infections before prophylactic antibiotics, p = .036. Underlying B-cell immune
      abnormalities could not be correlated with intervention outcome on prophylactic
      antibiotics. The use of prophylactic antibiotics was an effective treatment
      modality in children with chronic sinusitis, even in patients with selective
      immune abnormalities.

PMID- 8462862
TI  - Mechanisms of inflammation in the asthmatic patient.
AB  - Our concept of asthma has changed dramatically in the past decade. Although many
      factors contribute to airflow obstruction in asthma, there is now an expanded
      focus on all events in bronchial obstruction including bronchospasm, edema,
      mucous formation, and inflammation. The last of these airway changes, bronchial
      inflammation, not only causes symptoms of asthma but also contributes or is the
      cause of a basic characteristic of asthma: airway hyperresponsiveness. It has
      become apparent that asthma is a complex disease in which the causes of airflow
      obstruction are multi-factorial, multicellular, and redundant. It is important to
      identify the cellular mechanisms involved in airway inflammation and to
      understand how they contribute to changes in airway responsiveness and
      obstruction.

PMID- 8462863
TI  - Contribution of the New World food to the world supply.

PMID- 8462864
TI  - Early Spanish physicians and hospitals in Cuba.
AB  - Very little is known about the early history of medicine in the Caribbean. Five
      hundred years ago medicine practitioners from Europe started to settle in the New
      World. Hospitals were built in very rudimentary houses to care for the sick.
      Diseases were received and transmitted by the new settlers. The author, a
      philatelist and a Columbus scholar, uses postage stamps to highlight the
      introduction of European medicine in Cuba.

PMID- 8462865
TI  - Spain, Portugal, Christopher Columbus, and the Jewish physician: Part 1.

PMID- 8462866
TI  - Treatment of nocturnal asthma.
AB  - Extensive work has been done over the past decade to determine the best drug
      regimen for the treatment of nocturnal asthma. Much of the work has been directed
      at the evaluation of theophylline preparations and beta sympathomimetic agents.
      With a better understanding of the mechanisms causing nocturnal asthma, future
      therapeutic advances will be targeted at the underlying pathophysiological causes
      of the disorder. This article will review current treatment modalities, including
      those shown to have some effect as well as those that have no benefit.

PMID- 8462867
TI  - Transcriptional control of yeast phosphoglycerate mutase-encoding gene.
AB  - Yeast genes encoding enzymes of the glycolytic pathway are highly expressed due
      to transcriptional control elements in their promoters. We provide data on such
      elements in the 5'-noncoding sequences of the Saccharomyces cerevisiae GPM1 gene,
      encoding phosphoglycerate mutase. Using fusions to the lacZ reporter gene, a
      detailed deletion analysis was performed. A palindromic sequence was shown to
      function as an upstream activation site (UAS) and two upstream repressing sites
      (URS1 and URS2) were located. Western and Northern blot analyses were used to
      substantiate the data obtained in enzymatic measurements. The regulatory
      sequences were shown to be functional in the heterologous CYC1 promoter. In
      addition, a promoter region was detected which mediated general glycolytic
      control by the GCR1 regulatory factor.

PMID- 8462868
TI  - Molecular analysis and overexpression of the gene encoding endothiapepsin, an
      aspartic protease from Cryphonectria parasitica.
AB  - The gene, epn-1, encoding endothiapepsin (Epn), an aspartic protease (AspP)
      synthesized and secreted by the ascomycete fungus responsible for chestnut
      blight, Cryphonectria (Endothia) parasitica, was identified and characterized.
      Inspection of the nucleotide and deduced amino acid (aa) sequences revealed
      perfect agreement with the experimentally derived 330-aa sequence of mature Epn
      [Barkholt, Eur. J. Biochem. 167 (1987) 327-338] and an additional 89 aa of
      putative preprosequence. Of the nine fungal AspP characterized to date, Epn was
      found to be most closely related to aspergillopepsin and penicillopepsin (52% and
      55% identity, respectively), proteases produced by the ascomycetes Aspergillus
      awamori and Penicillium janthinellum, and least related to proteases produced by
      the yeasts Candida albicans and Saccharomyces cerevisiae (27% and 26% identity,
      respectively). Epn production was found to be the same in isogenic virus-free and
      virus-containing strains, indicating that this AspP is not down-regulated by the
      presence of a hypovirulence-associated viral double-stranded RNA, as has been
      reported for several other secreted C. parasitica gene products. Strains
      containing multiple copies of epn-1 were obtained by transformation with a
      plasmid vector containing the cloned epn-1. One of these strains was shown to
      produce seven to ten times more Epn than the parental wild-type strain.

PMID- 8462869
TI  - Sequence analysis suggests a recent duplication of the growth hormone-encoding
      gene in Tilapia nilotica.
AB  - The sequence of two growth hormone(GH)-encoding genes from tilapia fish (Tilapia
      nilotica) is reported. Our data indicate that the presence of two GH in the
      tilapia genome is a consequence of a relatively recent duplication event. The two
      genes are highly homologous, having a similar intron (five)/exon (six)
      arrangement, and both encode an identical polypeptide. Sequence similarity
      extends up to bp -628 upstream to the transcription start point, after which the
      sequences of the two genes are not related to each other. The presence of two GH
      in the tilapia genome is supported both by the nucleotide sequence and by genomic
      DNA blot hybridization analysis. Tilapias, like salmonids, contain an extra
      intron compared with the mammalian GH structure. We suggest that within the
      superorder Teleostei, the insertion of intron 5 into GH took place after the
      evolutionary separation of Cyprinoidea, but before Isospondyli (salmonids) and
      Acanthopterygii (tilapias) were separated. Thus, the additional intron which is
      probably present in many teleost fish GH may provide an excellent natural marker
      for evolution and classification studies.

PMID- 8462870
TI  - Structure of rat genes encoding androgen-regulated cystatin-related proteins
      (CRPs): a new member of the cystatin superfamily.
AB  - Cystatin-related proteins (CRPs) are abundant androgen-regulated secretory
      glycoproteins that are specifically synthesized in the ventral prostate and
      lachrymal gland of the rat. Two complete 6-kb genes, Crp1 and Crp2, have been
      cloned and characterized. They are differentially expressed and encode slightly
      different proteins. The genes each contain four exons which are interrupted by
      large introns. An alignment of their sequences demonstrates an overall homology
      of 90%. The 3' end of a third gene, Crp3, from which only a 1.5-kb fragment was
      isolated, displays a sequence identity of 84%. These data indicate the existence
      of a Crp multigene family. The 5' flanking regions of Crp1 and Crp2 are highly
      homologous and contain a GATAAA sequence 29 nt upstream from the transcription
      start point. This TATA-box-like element is also found in the promoters of the
      genes encoding cystatin type-2 proteins. No other recognizable transcription
      control elements can be detected. Potential binding sites (ARE) for the androgen
      receptor are scattered throughout the entire genes. The exon/intron organization
      of the genes encoding CRPs, the size of the exons and their encoding amino acid
      sequences exhibiting a characteristic spacing of the Cys residues are structural
      elements displaying a remarkable similarity with the corresponding elements in
      the genes encoding cystatin type-2 proteins. CRPs must therefore belong to the
      cystatin superfamily. However, due to their additional domain encoded in an extra
      exon 2, CRPs must be classified as a new family, type 5.

PMID- 8462871
TI  - Promoter region of the rat gene encoding ornithine aminotransferase:
      transcriptional activity, sequence, and DNase-I-hypersensitive sites.
AB  - In the rat, the gene (rOAT) encoding ornithine aminotransferase (OAT) is
      expressed in all cell types examined; however, regulation of rOAT expression is
      complex and cell-type specific. Various regions of the rOAT 5' flanking domain
      were cloned upstream from the cat reporter gene, and the expression of these
      OAT::cat fusions was examined following transfection into rat kidney epithelial
      cells (NRK-52E), human embryonic kidney cells (293), and rat hepatoma cells (H-4
      II-E). Although these experiments suggested the presence of one or more positive
      regulatory elements between nucleotides -661 and -158, and one or more negative
      elements upstream from nt -897, none of these putative elements appeared to
      function in a cell-type-specific manner. The nt sequence of 2531 bp of the rOAT
      domain flanking the promoter revealed several putative promoter/enhancer elements
      in positions analogous to the human OAT gene, numerous AGGTCA-like motifs related
      to the binding sites for the estrogen and thyroid hormone receptors, and multiple
      motifs resembling a putative regulatory element associated with genes encoding
      enzymes of the urea cycle. Finally, sensitivity of the 5' end of rOAT to cleavage
      by DNase I was examined, as DNase-I-hypersensitive sites (DHS) are often found in
      association with cis-acting regulatory elements. Two DHS were identified; one DHS
      approximately 140 bp upstream, and the second DHS approximately 300 bp
      downstream, of the transcription start point (tsp). These data provide the
      foundation upon which to base future studies aimed at elucidating the molecular
      mechanisms through which rOAT expression is regulated in a cell-type specific
      manner.

PMID- 8462873
TI  - Isolation and characterization of the Aspergillus oryzae gene encoding
      aspergillopepsin O.
AB  - We have cloned and determined the nucleotide sequence of a genomic DNA segment
      from Aspergillus oryzae which contains pepO, the gene encoding the aspartic
      proteinase, aspergillopepsin O (PEPO). The organization of pepO is strikingly
      similar to that of pepA from A. niger var. awamori (previously called A. awamori)
      in that both are composed of four exons and three introns with virtually
      identical lengths, and the positions of the introns are exactly conserved. From
      the deduced amino acid (aa) sequence, it appears that PEPO, like other fungal
      aspartic proteinases, is synthesized as a zymogen containing a putative N
      terminal prepro-region of 77 aa followed by a mature protein of 327 aa. Southern
      blotting experiments suggest that a single copy of pepO exists in the A. oryzae
      genome.

PMID- 8462872
TI  - Sequence of the Schizosaccharomyces pombe gtp1 gene and identification of a novel
      family of putative GTP-binding proteins.
AB  - A new gene, gtp1, has been identified by sequence analysis in Schizosaccharomyces
      pombe. The open reading frame was identified downstream from the stf1 locus. The
      deduced GTP1 protein has strong sequence similarity to a family of putative GTP
      binding proteins from Halobacterium cutirubrum, Bacillus subtilis, Drosophila
      melanogaster and mouse. The conserved P-loop phosphate-binding motif places gtp1
      in a family separate from previously described groups of such proteins.

PMID- 8462874
TI  - Hidden domains and active site residues in beta-glycanase-encoding gene
      sequences?
AB  - Reading-frame corrective shifts in the nucleotide sequence upstream, within, or
      downstream from the putative coding region of several beta-glycanase-encoding
      genes reported in the literature reveal hidden active-site residues or even
      additional domains, including a cellulose-binding domain on a beta-mannanase
      encoding gene. These findings also help in assigning, to cellulase family A, two
      enzymes previously found to lack sequence similarity with known cellulase
      families.

PMID- 8462875
TI  - The Drosophila melanogaster developmental gene g1 encodes a variant zinc-finger
      motif protein.
AB  - In Drosophila melanogaster, the mechanisms involved in the pattern formation of
      complex internal organs are still largely unknown. However, the identity of the
      molecular determinants that control the development of these specific tissues is
      emerging from the combined use of genetic and molecular approaches. We have
      cloned a gene that is expressed in the mesoderm, one of the fundamental embryonic
      germ layers which gives rise to internal structures, such as the musculature.
      Here, we describe the molecular characterization of this gene, designated as g1.
      The nucleotide (nt) sequence of its cDNA shows an open reading frame of 852 nt,
      which encodes a 32-kDa protein with two putative zinc fingers, and a
      serine/glutamine/proline-rich region. These features indicate a functional role
      for g1, which remains to be elucidated, in regulating gene expression during
      mesoderm formation.

PMID- 8462876
TI  - Characterization of the 130-bp repeat enhancer element of the rat ribosomal gene:
      functional interaction with transcription factor E1BF.
AB  - The 130-bp repetitive element (RE) of the rat rDNA (ribosomal RNA-encoding gene)
      intergenic spacer stimulated the synthesis of rRNA four- to sixfold, in
      comparison with that of the promoter alone, both in vivo and in vitro, when
      ligated to the rat rDNA promoter. The addition of increasing amounts of highly
      purified E1BF (enhancer-1 binding factor), which binds to the rat rDNA promoter
      and an upstream nonrepetitive enhancer element [Zhang and Jacob, Mol. Cell. Biol.
      10 (1990) 5177-5186], to an in vitro transcription system resulted in enhancement
      of rDNA transcription from the recombinant plasmids containing the promoter or
      promoter-RE. However, E1BF-mediated stimulation of transcription under the
      influence of the RE continued at higher concentrations of E1BF than did the
      control transcription from the promoter alone. The binding affinity of E1BF for
      the RE was comparable to its affinity for the nonrepetitive far upstream enhancer
      element previously characterized in our laboratory. The sequences protected by
      E1BF in the RE differed from those protected by UBF (upstream control element
      binding factor), a well characterized pol I transcription factor. These data
      suggest that E1BF belongs to a class of transcription factors which interact with
      the promoter and spacer cis-acting RE to modulate rDNA transcription.

PMID- 8462877
TI  - Cytoplasmic and periplasmic production of human apolipoprotein E in Escherichia
      coli using natural and bacterial signal peptides.
AB  - To understand the toxicity of high levels of heterologous human serum
      apolipoprotein E (ApoE) in Escherichia coli, as well as to prepare a system for
      producing the structural domains of this protein, plasmids were constructed in
      which the coding sequence of the N-terminal domain or all of ApoE followed E.
      coli or human apolipoprotein signal peptides (SP) or the N-terminal eleven amino
      acids (f10) of the gene 10-encoded protein of phage T7. High levels of production
      of the 22-kDa N-terminal domain (22K) of ApoE were obtained either as an f10::22K
      fusion protein, or using the natural SP, or SP derived from the periplasmic
      protein, alkaline phosphatase (PhoA), or from the outer membrane protein A
      (OmpA). Microsequencing showed that the SP of sPhoA::22K and sOmpA::22K, but not
      sApoE::22K, were correctly processed and, in the former cases, the protein could
      be released from the cells by osmotic shock. The extent of maturation of
      sPhoA::22K depended upon the host strain; with JM109, about 50% of the protein
      was not processed. Microsequencing of the f10::22K fusion protein, which could
      easily be purified following lysis of the cells, showed that the N-terminal
      methionine had been removed in agreement with the length parameter rule. Although
      considerable levels of the f10::ApoE fusion protein could be produced in the
      cytoplasm, production was markedly less using the PhoA signal peptide and the
      protein was not easily isolated following osmotic shock. The recombinant protein
      was biologically active after reconstitution with lipids in spite of the N
      terminal modifications introduced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8462878
TI  - A human genome YAC library in a selectable high-copy-number vector.
AB  - An experimental yeast artificial chromosome (YAC) library consisting of one
      genome equivalent of human DNA was prepared in a selectable high-copy-number
      (hcn) YAC vector. Screening for unique loci was accomplished by PCR of
      successively smaller DNA pools and by hybridization to high-density microcolony
      blots. Inserts averaged 200 kb in size, but several YACs with inserts averaging
      about 650 kb were obtained when polyamines were added prior to yeast
      transformation. YACs were identified for 17 out of 29 sequence-tagged sites (STS)
      screened by a PCR-based approach. All YACs in the size range of 100-600 kb that
      were examined could be obtained at significantly elevated copy numbers following
      growth of the clones in methotrexate/sulfanilamide/thymidine-supplemented medium.
      The hcn YACs could also be selected during growth in microtiter dishes, and the
      resulting clones were used to prepare high-density microcolony DNA blots for
      hybridization with radiolabeled PCR products. DNA pools for the PCR-based
      screening of this experimental library are available to investigators interested
      in applications of hcn YACs.

PMID- 8462879
TI  - Nucleotide sequence of a ras gene from the basidiomycete Coprinus cinereus.
AB  - The basidiomycete Lentinus edodes (Le.) ras gene (or its cDNA clone) [Hori et
      al., Gene 105 (1991) 91-96] was utilized to identify and clone the corresponding
      gene (Cc.ras)-containing genomic fragment from the basidiomycete, Coprinus
      cinereus. Cc.ras encodes 215 amino acids (aa) interrupted by six small introns.
      The deduced Cc.RAS protein exhibits significant homology (84.7% identical) to the
      Le.RAS protein (217 aa) in size and aa sequence.

PMID- 8462880
TI  - Sequence of the goat alpha s2-casein-encoding cDNA.

PMID- 8462881
TI  - Hospitals: danger zone of the '90s.

PMID- 8462882
TI  - Common skin disorders of aging: diagnosis and treatment.
AB  - The incidence of skin disorders increases with age because of changes in skin
      structures and a lifetime accumulation of environmental insults. Photoaging,
      resulting from exposure to harmful ultraviolet wavelengths in sunlight, is
      responsible for many common skin disorders, from wrinkles to melanoma. Older
      patients also see their physicians with complaints of various types of
      dermatitis, including contact and seborrheic. Although skin disorders vary in
      severity, they all adversely affect an older patient's health and/or quality of
      life. Early recognition, prevention, and treatment of skin diseases by the
      primary care physician is therefore an important element in the overall care of
      the middle-aged and older patient.

PMID- 8462883
TI  - Hypertension: patient evaluation, indications for treatment.
AB  - Hypertension in older adults is a prevalent problem with significant morbid
      consequences, including cerebrovascular, cardiac, and renal disease. Recent
      studies have established a firm rationale for drug therapy in this population,
      and therapeutic developments have made effective treatment possible. Patient
      evaluation includes searches for secondary causes, risk factors for
      cardiovascular disease, and comorbidity. Antihypertensive therapy requires
      lifestyle interventions aimed at addressing overall cardiovascular risk factors.
      Drug therapy decisions are based on level of hypertension, side effects, and
      comorbid conditions. Older patients can be treated safely and effectively with
      any of the available antihypertensive agents, but drug selection should be
      individualized.

PMID- 8462884
TI  - Common blood disorders: a primary care approach.
AB  - Many anemias and diseases of the blood-forming elements increase in incidence
      with advancing age. Iron deficiency remains the cause of most cases of anemia and
      may be related to inapparent blood loss. Other responsive anemias that can be
      managed by the primary care physician include vitamin B12 and folate deficiencies
      and drug- or autoimmune-related hemolytic anemia. Nonresponsive anemias,
      including hematologic malignancies, are quite common in older patients and
      require referral to a specialist. Platelet disorders are often produced by
      certain drugs and, like most refractory anemias, often require a bone marrow
      aspirate for diagnosis.

PMID- 8462885
TI  - Blood-retinal barrier permeability and its relation to progression of retinopathy
      in patients with type 2 diabetes. A four-year follow-up study.
AB  - Forty patients with late-onset diabetes (age at diagnosis 30 years or more) and
      minimal retinopathy as found by fundus photography were followed prospectively by
      repeated examination (baseline, 1 year, and 4 years). The study shows that early
      retinopathy changes are not permanent or invariably progressive. In the 1st year
      of follow-up microaneurysms worsened in 25%, improved in 10%, and remained
      stabilized in 65%. Vitreous fluorometry was able to detect an overall increase of
      0.84 +/- 1.06 x 10(-6) min-1 in blood-retinal barrier (BRB) penetration ratios.
      After 4 years, 16 of the 40 patients had undergone photocoagulation (focal photo
      coagulation in 11 and pan retinal photocoagulation in 5). The eyes that needed
      photocoagulation were the eyes that had higher fluorometry penetration ratios at
      the patient's entry into the study and showed a higher rate of deterioration
      during the 1st year of the study (5.54 +/- 1.97 vs 3.11 +/- 1.22 x 10(-6) min-1,
      P < 0.001, initial values; 1.52 +/- 0.76 vs 0.45 +/- 0.99 x 10(-6) min-1, P <
      0.001, annual increase in leakage). The eyes that did not need photocoagulation,
      24 out of 40, showed stable fluorometry readings within the 4-year period of
      follow-up (+0.02 +/- 0.98 10(-6) min-1). Abnormally high vitreous fluorometry
      values and their rapid increase over time appear to be good indicators of rapid
      progression and worsening of the retinopathy.

PMID- 8462886
TI  - Correlation of spatial contrast sensitivity and visual fields in glaucoma.
AB  - Perimetry is the standard examination in glaucoma, whereas contrast sensitivity
      is often proposed as a complementary test. This study investigates the extent to
      which the outcomes of the two tests correlate. One eye each of 44 glaucoma
      patients and 16 glaucoma suspects was tested with the Haag-Streit Visometer and
      the Octopus 201 perimeter (program G1). Contrast sensitivities correlated highest
      with the center of the visual field (Spearman's rho = 0.76; P < 0.001) and
      slightly less with the mean sensitivity of the entire visual field (rho = 0.63; P
      < 0.001). Mean contrast sensitivity correlated weakly with the square root of
      corrected loss variance (rho = -0.45; P < 0.001) and short-term fluctuation (rho
      = -0.34; P < 0.007). The two tests differed considerably only in very few
      patients. We recommend careful evaluation of the central area of glaucomatous
      visual fields whenever contrast sensitivity testing is not available.

PMID- 8462887
TI  - The progression of retinopathy of prematurity and fluctuation in blood gas
      tension.
AB  - In this study, the relationship between the fluctuation in blood oxygen and
      carbon dioxide tension and the progression of acute retinopathy of prematurity
      (ROP) was evaluated. Eighteen extremely premature infants were selected on the
      basis of the following criteria: gestational age less than 26 weeks, oxygen
      supply or mechanical ventilation for more than 50 days, transcutaneous oxygen
      pressure (TcPO2) recorded almost once per hour, and arterial oxygen pressure
      (PaO2) and arterial carbon dioxide pressure (PaCO2) measured intermittently, for
      over 8 weeks after birth. All of these infants developed ROP, which ceased
      progressing in 7 infants (group I, stage 1 or 2 ROP, international
      classification), but advanced in 11 (group II, stage 3 or 3+). The fluctuations
      in TcPO2, PaO2, and PaCO2 are represented as coefficients of both variation (CV)
      and mean difference (D) in these two groups. The results demonstrate that both
      the CV and D values of TcPO2 are significantly elevated in group II infants
      compared with group I infants, in the first and second 3-weeks periods, and over
      the entire 9-week period after birth. The incidences of extreme hyperoxemia
      (TcPO2 > or = 100 mm Hg) and hypoxemia (TcPO2 < 30 mm Hg) in recorded TcPO2 time
      series show no significant differences between these two groups. We conclude that
      extremely premature infants with widely fluctuating arterial oxygen tension may
      have a greater chance of developing progressive ROP.

PMID- 8462888
TI  - Sodium hyaluronate 0.25% used as a vehicle increases the bioavailability of
      topically administered gentamicin.
AB  - Sodium hyaluronate (SH) solutions have a longer precorneal residence time than
      isotonic saline solution in rabbits and in humans. The present study investigates
      the effect of a 0.25% SH vehicle, compared with a phosphate buffer solution
      (PBS), on the tear concentration after topical administration of gentamicin
      sulfate (GS) in humans. Eight volunteers received 25 microliters 0.5% GS in PBS
      in the left eye and 25 microliters 0.5% GS in 0.25% SH in the right eye. Tear
      samples of 1 microliters were taken from the inferior sulcus using a capillary
      before instillation and 5, 10, 20, and 40 min after instillation. The tear
      concentration of GS was determined by radioimmunoassay. There was a statistically
      significantly higher concentration of GS in the inferior conjunctival sulcus of
      the SH-instilled eye at 5 min (P < 0.01) and at 10 min (P < 0.05) after
      instillation (paired t-test, n = 9). At 20 min the concentration of GS in the SH
      instilled eye was only slightly higher, and at 40 min GS concentrations in left
      and right eyes were comparable. SH 0.25% used as a vehicle therefore increases
      the availability of GS at the ocular surface for at least 10 min. This effect
      could be due to the prolonged precorneal residence time of SH.

PMID- 8462889
TI  - Clinical and immunohistochemical correlation of herpetic keratitis with the
      expression of HLA-DR antigen.
AB  - The corneal buttons after corneal graft of 22 patients with herpetic keratitis
      were studied (16 male, 6 female; 7-87 years of age). Ten still had active
      inflammation, while 12 had stabilized by the time of the study. Different degrees
      of neovascularization were observed in 19 cases. HLA-DR antigen was detected in
      the corneal epithelium in 7 of 22 cases (32%), in the corneal stroma in 17 of 22
      cases (77%), and in the endothelium in 9 cases (41%) by using the
      immunohistochemical technique. The expression of HLA-DR antigen was more common
      and more marked in active herpetic keratitis (90%) and in neovascularized corneas
      (84%). The frequency and density of HLA-DR expression in perforating corneal
      ulcers were no higher than in other cases, but anterior synechia was accompanied
      by strong expression of HLA-DR antigen in the corneas. The expression of HLA-DR
      antigen was not only detected in the peripheral, but also in the central area of
      the specimens. The cells expressing HLA-DR antigen in corneas were mainly corneal
      cells. The results showed a close relationship between HSV-keratitis and the
      expression of HLA-DR antigen, which may be induced during the clinical course of
      the disease. The expression of HLA-DR might be one of the factors in the
      recurrent onset of the disease and a significant sign of the prognosis of corneal
      transplantation for these patients.

PMID- 8462890
TI  - Chronic granulomatous anterior uveitis associated with multiple sclerosis.
AB  - A retrospective review is presented of the medical records of seven female
      patients with uveitis associated with definite multiple sclerosis. Six of the
      patients had severe bilateral chronic granulomatous anterior uveitis, which in
      four cases resulted in extensive posterior synechiae and scarring of the
      peripupillary iris. One patient had bilateral intermediate uveitis with
      unilateral posterior synechiae. Severe chronic granulomatous anterior uveitis
      associated with multiple sclerosis has a predilection for women, can precede
      neurological symptoms and can be controlled with topical steroids.

PMID- 8462891
TI  - A morphometric and stereologic analysis of ganglion cells of the central human
      retina.
AB  - Unbiased estimates of the cell density of the ganglion cell layer (GCL) were made
      by the Disector method, and the topography of the nerve fibre layer (NFL) between
      the centre of the fovea and the optic disc was studied, in human retina under
      both normal and pathological conditions. Three human retinae were examined, the
      eyes having been removed in the course of cancer surgery. Before operation two of
      the patients had visual acuity within normal limits. The third patient had
      impaired vision. In the two normal retinae, the cell densities of the GCL in the
      foveal wall were approximately 60,000/mm2. Estimates were also made outside the
      fovea and these showed a progressive reduction in cell density from the foveal
      wall towards the optic disc. The NFL simultaneously increased in thickness to
      approximately 70-100 microns at the peripapillary border. At 4 deg eccentricity
      nasal to the fovea the majority of axons had a mean diameter of less than 0.42
      microns. Closer to the optic disc, the number of large axons increased in the
      inner parts of the NFL. In the third eye with long- and short-term visual
      impairment there was a substantial cell loss in the GCL, with only some 15,000
      cells/mm2 in the foveal wall. In spite of cell/axon loss the thickness of the NFL
      was increased due to axonal swelling.

PMID- 8462892
TI  - Immunohistochemical detection of blood-retinal barrier breakdown in
      streptozotocin-diabetic rats.
AB  - Immunohistochemical staining for albumin (69 kDa) and fibrinogen (340 kDa), as
      markers of blood-retinal barrier (BRB) breakdown of the retinas of streptozotocin
      treated diabetic rats, was performed. The number of rats with BRB breakdown was
      three of nine at 6 months, four of seven at 12 months, and three of three at 18
      months. Extravasation of albumin from the retinal vessels was detected in the
      retinas of rats maintained for 6, 12, and 18 months, while extravasation of
      fibrinogen was detected only in the retinas of rats maintained for 18 months.
      These findings suggested that the duration of diabetes has an influence on BRB
      breakdown and that each substance in the blood starts to permeate the vascular
      wall individually.

PMID- 8462893
TI  - New sites of ocular involvement in late-infantile metachromatic leukodystrophy
      revealed by histopathologic studies.

PMID- 8462894
TI  - The British Society of Gastroenterology, spring meeting. 24-26 March 1993.
      Abstracts.

PMID- 8462895
TI  - Challenges in immunoscintigraphy of ovarian cancer.

PMID- 8462896
TI  - Clinical assessment of 111In-CYT-103 immunoscintigraphy in ovarian cancer.
AB  - The ability of 111In-CYT-103 immunoscintigraphy to aid in the diagnosis of
      patients with primary or recurrent/residual ovarian cancer was evaluated in a
      multicenter trial. The 111In-labeled immunoconjugate of the monoclonal antibody
      B72.3 was prepared using a site-specific conjugation method. A total of 103
      patients received a 1 mg infusion of 111In-CYT-103 and subsequently underwent
      surgery or biopsy. The infusion of 111In-CYT-103 was well tolerated; only 1
      patient experienced a modest elevation in blood pressure that was likely related
      to the infusion. 111In-CYT-103 immunoscintigraphy correctly identified surgically
      confirmed tumor in 68% of patients with ovarian adenocarcinoma. The sensitivity
      of 111In-CYT-103 immunoscintigraphy was positively influenced both by the size of
      the tumor lesion and the tumor TAG-72 antigen expression. The overall sensitivity
      of 111In-CYT-103 immunoscintigraphy was greater than that of CT imaging (44%).
      Antibody imaging detected occult disease in 20 of 71 patients with surgically
      documented ovarian adenocarcinoma; 6 patients being evaluated after initial
      surgery and chemotherapy had an otherwise negative presurgical workup and a
      normal CA 125 serum level. The results of this trial also indicate that 111In-CYT
      103 immunoscintigraphy can contribute to the medical and surgical management of
      some patients with ovarian cancer. The results of this trial indicate that 111In
      CYT-103 immunoscintigraphy should be a valuable addition to the presurgical
      evaluation of patients with suspected persistent or recurrent ovarian cancer.

PMID- 8462897
TI  - The gynecologist and multiple organ failure syndrome (MOFS).
AB  - Multiple organ failure syndrome (MOFS) has been alluded to since the early 1940s.
      It was recognized as a progressive failure to organs in the mid 1970s. Mortality
      from this syndrome increases proportionally, as the number of failed organs
      increases. Therapies to prevent MOFS and current concepts about treating failures
      of individual organs will be presented. Data sources were retrieved from critical
      care and surgical literature using MEDLINE from 1966 to the present. Searches
      were confined to English. Several promoters of MOFS are related to the care of
      gynecologic patients, especially sepsis and hemorrhage. Treatment strategies,
      especially those related to pulmonary, gastrointestinal, renal, cardiovascular,
      and nutritional aspects are discussed. Outcome and prognosis may be affected if
      recognition and therapeutic intervention are initiated early in the clinical
      course. The ability to prognosticate outcome is related to the number of organs
      involved. Gynecologists should have clear knowledge of the prognosis of
      progressive organ failure in order to appropriately counsel the patient and her
      family.

PMID- 8462898
TI  - Lymphocytes isolated from the peritoneal fluid of women with advanced ovarian
      carcinoma differ significantly from autologous peripheral blood lymphocytes.
AB  - The phenotypic and functional analysis of ovarian carcinoma-associated
      lymphocytes (OCAL), obtained from a group of patients with neoplastic carcinosis,
      reveals major differences between OCAL and peripheral blood lymphocytes (PBL).
      Virtually all of the OCAL belong to the T cell lineage, whereas both B and
      natural killer (NK) cells are virtually absent. NK activity is also significantly
      lower than that exerted by PBL. Following treatment with rIL-2, lymphokine
      activated killer cell activity is poorly inducible in OCAL. In addition, in vitro
      stimulated OCAL produce low amounts of lymphokines. Clonal analyses reveal a low
      clonal efficiency, which indicates a severe proliferative defect. T cell clones
      obtained show peculiar features: the percentage of CD4 and CD8 clones varies
      greatly in the different samples. Both CD8 and a significant proportion of
      proliferating CD4+ clones are cytotoxic in a lectin-dependent cytolytic assay.
      These findings, together with the results obtained from comparative analyses of
      the peripheral blood of the same group of patients, demonstrate the unique
      characteristics of OCAL and should be considered in the preparation of protocols
      for the locoregional immunotherapy of ovarian carcinoma.

PMID- 8462899
TI  - Expression of alpha-smooth muscle actin in benign or malignant ovarian tumors.
AB  - We compared the expression of alpha-smooth muscle actin (alpha-SMA) between
      benign and malignant human ovarian tissues by immunohistochemical staining and
      Western blot analysis using the monoclonal antibody specific to alpha-SMA. In
      normal human ovaries, alpha-SMA was found in the blood vessel walls, muscle
      fibers, and stromal cells surrounding the follicles. The main source of alpha-SMA
      in the benign ovarian tumors was the blood vessel walls which highly expressed
      the alpha-SMA throughout the tumor. In malignant tumor tissues, however, the
      vessels located in or close to the cluster of cancer cells did not express alpha
      SMA. It corresponded to the results of the Western blot analysis, showing that
      the amount of alpha-SMA in malignant ovarian tumor tissues was much smaller than
      that in benign tumor tissues. Thus, the alteration in alpha-SMA expression seems
      to reflect the qualitative difference in vessels between benign and malignant
      ovarian tissues, and therefore alpha-SMA is considered to potentially be a
      histopathologically useful marker for indicating the malignant potential of
      ovarian tumors.

PMID- 8462900
TI  - Solitary recurrent metastasis of epithelial ovarian cancer in the spleen.
AB  - In epithelial ovarian cancer, solitary metastasis to and recurrences in the
      parenchyma of the spleen are rare in the absence of apparent disease in other
      sites. We report four patients who developed isolated, solitary splenic
      parenchymal recurrences of their epithelial ovarian adenocarcinomas and underwent
      a splenectomy to remove the recurrent disease. They had undergone optimal
      cytoreductive surgery for stage III grades 2-3 serous cystadenocarcinoma of the
      ovary, followed by six to nine cycles of cisplatin and cyclophosphamide
      chemotherapy and a negative second-look laparotomy. Evidence of relapse developed
      2, 4, 6, and 10 years after initial treatment. In two patients, a rising CA-125
      heralded the recurrence that was subsequently documented by computed tomography
      (CT) of the abdomen and pelvis with a single defect noted only in the splenic
      parenchyma. Two others had only a defect on CT scan. Based on these findings, the
      otherwise healthy women underwent an exploratory laparotomy, each had a single
      focus of recurrent poorly differentiated disease that was found in the splenic
      parenchyma and a splenectomy was performed. Multiple biopsies and cytologies
      revealed no other evidence of microscopic disease. There was no major
      postoperative morbidity. Subsequently, one woman was treated with intraperitoneal
      cisplatin, two with intravenous carboplatin, and one declined further therapy.
      Three women are alive and free of disease at 6 months to 3 years. The fourth
      woman is alive with recurrent disease near the site of the resected spleen found
      10 months postsplenectomy. Thus, splenic recurrence of epithelial ovarian cancer
      can occur in the absence of other demonstrable metastasis, and it can be preceded
      by elevation of CA-125 and an abnormal CT scan. Based on this limited experience
      with selected patients, splenectomy may have a role in the management of this
      unusual recurrence.

PMID- 8462901
TI  - Skin metastasis from carcinoma of the uterine cervix.
AB  - Of 1190 patients with carcinoma of the uterine cervix, 15 (1.3%) developed skin
      metastases. The incidence of skin metastasis was 0.8% in stage I, 1.2% in stage
      II, 1.2% in stage III, and 4.8% in stage IV. The incidence of skin metastasis
      seemed to be higher in patients with adenocarcinoma and undifferentiated
      carcinoma than in patients with squamous cell carcinoma. The interval between the
      diagnoses of cervical cancer and skin metastasis ranged from 0 to 69 months, with
      a mean of 16.9 months. The most common sites of skin lesions were the abdominal
      wall and vulva, followed by the anterior chest wall. Skin lesions presented as
      nodules in 86.7% (13/15), and 66.7% of the patients had multiple lesions. Skin
      metastasis was detected as the initial metastatic lesion in 9 patients. However,
      only 4 patients had neither local recurrence nor other distant metastasis at the
      time of diagnosis of skin metastasis. The prognosis was grave, but 3 patients
      survived more than 12 months after the diagnosis of skin metastasis. The main
      treatment for these patients was extirpation of the skin lesion followed by
      radiotherapy.

PMID- 8462902
TI  - Radical hysterectomy for stage IB adenocarcinoma of the cervix: the University of
      Miami experience.
AB  - The treatment of adenocarcinoma of the cervix has traditionally followed that of
      squamous cancer. A 25-year review of 88 radical hysterectomies for Stage IB
      adenocarcinoma of the cervix at the University of Miami/Jackson Medical Center
      (UM) is compared to over 1600 cases reported in the literature. Adenocarcinoma
      represented 10.4% of 978 radical hysterectomies performed at UM from July 1965 to
      December 1990. In a survey of the literature, patients with Stage IB cervical
      adenocarcinoma treated by radical surgery alone had a statistically better 5-year
      survival than those treated by radiation alone (79% vs 67%, respectively; P < or
      = 0.05). Furthermore, no additional benefit was achieved by combining the two
      therapeutic modalities. The corrected 5-year survival at UM is 81% for Stage IB
      adenocarcinoma of the cervix treated with radical hysterectomy, a number
      consistent with the cumulative data base. Radical surgery is an acceptable
      primary therapy in Stage IB adenocarcinoma of the cervix.

PMID- 8462903
TI  - Immunohistochemical staining for CA-125 in fallopian tube carcinomas.
AB  - From 1981-1991, 15 patients with primary fallopian tube carcinomas were treated
      at the University of Kentucky Medical Center. Immunohistochemical staining for CA
      125 was performed on tumor specimens from all cases. Thirteen tumors (87%)
      stained positively for CA-125. Antigen staining was most intense in the apical
      portions of carcinoma cells. Serum CA-125 levels were measured in 5 patients and
      were elevated in 4 (80%). There was a positive correlation between tumor and
      serum antigen expression in these cases. Serum CA-125 levels accurately reflected
      disease status in the patients studied. These data suggest that CA-125 is a
      useful marker in patients with fallopian tube carcinoma. Immunohistochemical
      localization of CA-125 in tumor tissue should predict which patients will benefit
      most from serial antigen determinations.

PMID- 8462904
TI  - Primary leiomyosarcoma of the ovary in a perimenarchal female.
AB  - A case of primary leiomyosarcoma of the ovary in a perimenarchal female is
      presented. Previous to this report, ovarian leiomyosarcoma was thought to arise
      predominantly in postmenopausal women and, indeed, this is the first reported
      case in a pubertal adolescent. The sarcoma was associated with bilateral cellular
      ovarian leiomyomas, suggesting malignant degeneration of such tumors. After
      complete resection, the patient is alive without evidence of recurrent disease 20
      months after diagnosis. A review of the literature suggests that chemoradiation
      is of unproven benefit and aggressive surgical management is recommended.

PMID- 8462905
TI  - Venous air embolism through a Groshong catheter.
AB  - Individuals with cancer frequently require long-term central venous access to
      deliver chemotherapy, blood products, and other fluids. A rare, but potentially
      lethal complication associated with central venous catheterization is venous air
      embolism which occurs most commonly after damage or disconnection at the catheter
      hub. The Groshong (Bard Access Systems, UT) catheter is a device with a unique
      three-position valve at its distal tip which eliminates the need for routine
      heparin flushing and minimizes the risk of venous air embolism. This report
      describes for the first time a near fatal venous air embolism in a patient with
      an externally accessed Groshong catheter.

PMID- 8462906
TI  - Primary ovarian melanoma arising in a dermoid stage IIIc: long-term disease-free
      survival with aggressive surgery and platinum therapy.
AB  - A 20-year-old female with a primary melanoma of the ovary arising from a mature
      cystic teratoma presented with bulky peritoneal metastases. Following aggressive
      surgical resection and platinum-based chemotherapy the patient remains disease
      free 5 years following diagnosis.

PMID- 8462907
TI  - Endodermal sinus tumor of the vagina in an infant: magnetic resonance imaging
      evaluation.
AB  - Endodermal sinus tumor is a rare and highly malignant lesion. This report
      documents the clinical findings and magnetic resonance imaging (MRI) of an
      uncommon case of the endodermal sinus tumor arising in the vagina of a 6-month
      old infant. MRI was extremely accurate in delineating the possible extent and
      location of the vaginal lesion. This is the first report to demonstrate MRI of
      vaginal endodermal sinus tumor.

PMID- 8462908
TI  - Cryosurgery for cervical intraepithelial neoplasia: 10-year follow-up.

PMID- 8462909
TI  - Monitoring CA 125 serum levels during early chemotherapy is an excellent
      prognostic method in advanced ovarian cancer.

PMID- 8462910
TI  - [Current diagnosis of Crohn disease and ulcerative colitis].

PMID- 8462911
TI  - [Therapy of chronic hepatitis B, C and D with alpha-interferon].

PMID- 8462912
TI  - [Diagnosis in general practice. Part 6: Shoulder-arm pain].

PMID- 8462913
TI  - [A layered lattice antacid with long-term effectiveness. Profile of action and
      safety exemplified by magaldrate].

PMID- 8462914
TI  - [Fracture management in elderly patients. A technically and ethically challenging
      responsibility].
AB  - The accident surgeon is increasingly being confronted with typical fractures of
      old age. These differ from those seen in other phases of life in that they
      characteristically occur in a situation of reduced mental performance, and
      coordination, and are associated with structural bone weakness. Also typical is
      the fact that there is usually no external causal factor involved. Many patients
      are polymorbid. Treatment of lower-limb fractures concentrates on early re
      mobilization. Uncontrolled full weight bearing cannot be avoided, and medullary
      nailing is therefore preferable to plating. In the case of comminuted fracture of
      the humerus head or medial femoral head fractures, the chances of reconstruction
      with preservation of bone vitality are poor and the use of an endoprosthesis
      permits early functional recovery. Rehabilitation facilities tailored to the
      needs of elderly trauma patients are required. In the acute trauma unit, the
      increasing demands being made by geriatric trauma care make staff and structural
      changes necessary.

PMID- 8462915
TI  - [Thoracic surgery in advanced age. Indications and results with special reference
      to bronchial cancer].
AB  - BACKGROUND: As the life expectancy in the general population increases, a
      constant rise in the number of patients of advanced age undergoing thoracic
      surgery is also observed. MAJOR TOPICS DISCUSSED: Among the indications for
      operations on the chest, malignant diseases head the list. Thanks to advances in
      anesthesia, intensive care and surgical techniques, the peri-operative mortality
      rate in this age group has been appreciably reduced in recent years. In our own
      patient material, the relevant figure was 4.37%, and is thus in the lower range
      of internationally comparable mortality associated with major oncological
      operations on the chest. CONCLUSION: Patients in their seventies or eighties
      should not be denied thoracic surgery for age reasons; the decisive factors are
      the general level of activity of the patient and his/her motivation.

PMID- 8462916
TI  - [New guidelines for fracture treatment. Part 7: Ambulatory after care of
      fractures--course of healing].

PMID- 8462917
TI  - [Treatment of chronic diarrhea in Crohn disease. A pilot study of the clinical
      effect of tannin albuminate and ethacridine lactate].
AB  - METHOD: The present prospective controlled study investigated the effect of a
      combination of 500 mg of tannin albuminate and 50 mg ethacridine lactate
      (Tannacomp) on chronic diarrhea in stable-phase Crohn's disease. Of the 30
      patients admitted to the study, Crohn's disease was confined to the small
      intestine in 5, involved both small and large bowel in 11 patients, and only the
      large intestine in 14 cases. TREATMENT: Basic treatment was continued throughout
      the study; in addition, three times 2 tablets of Tannacomp were administered for
      5 days, followed by a 5-day period of no such treatment, and then a further 5
      days with the same regimen. RESULTS: At the end of the treatment phases, there
      was a significant reduction in stool frequency from 5.5 +/- 0.6 (mean +/- SEM) to
      4.0 +/- 0.8, and the summed score of the symptoms decreased from 6.3 +/- 0.6 to
      5.3 +/- 0.6; in comparison with the initial situation or at the end of the five
      day period of no additional treatment, the consistency of the stools also
      increased. The effect of Tannacomp showed a tendency to be more marked among
      patients with Crohn's disease limited to the large intestine, as compared with
      patients with small intestinal involvement. However, before Tannacomp can be
      recommended as treatment of chronic diarrhea in stable-phase Crohn's disease,
      further studies are needed.

PMID- 8462918
TI  - [Therapy of aspergillus infection in AIDS].

PMID- 8462919
TI  - [Hepatitis B in obstetrics is serious! E. Petersen, Freiburg, on transmission of
      HBV infection. Interview by Elisabeth B. Moosmann].

PMID- 8462920
TI  - Non-parasitic liver cysts and polycystic liver disease: results of surgical
      treatment.
AB  - The results of surgical treatment in 8 patients with polycystic liver disease
      (group A) and 6 patients with symptomatic simple cysts (group B) are presented.
      In group A, all patients underwent hepatic resection, in some cases combined with
      deroofing or fenestration procedures. Complications occurred postoperatively in 3
      patients (37.5%). Two of these three patients had no perceived benefit from the
      surgical treatment. Two other patients had recurrent symptoms 12 and 20 months
      after operation, and one patient underwent a second resection after a 5-year
      interval; she is now symptom-free after 19 months of follow-up. In group B, no
      complications occurred after surgical treatment consisting of either deroofing or
      pericystectomy. These patients were symptom-free after 5-32 months of follow-up.
      The therapeutic management of non-parasitic cystic liver disease is still under
      discussion. We advocate wide deroofing or pericystectomy for symptomatic simple
      cysts. Hepatic resection in highly symptomatic polycystic disease is surgically
      demanding and should be performed by an experienced liver surgeon. Relief of
      symptoms can be achieved, but the rate of complications is relatively high.

PMID- 8462921
TI  - Liver resection and intractable postoperative ascites.
AB  - Among 211 patients who, between 1985 and 1990, underwent liver resection in
      Kyushu University Hospital, uncontrollable ascites occurred in 53 (25%). A
      univariate analysis revealed that postoperative death with liver failure occurred
      more frequently in patients with intractable ascites (p < 0.05). Alanine amino
      transferase levels were significantly higher in patients with intractable ascites
      (p < 0.05), but serum bilirubin, alkaline phosphatase and serum albumin levels
      did not differ significantly. Portal pressure (p < 0.05), the operation time (p <
      0.01) and blood loss (p < 0.01) were significantly higher in patients with
      intractable postoperative ascites. A multiple analysis showed a correlation
      between the operation time, portal hypertension and postoperative intractable
      ascites. Postoperative histology revealed that a larger number of patients with
      cirrhosis had intractable ascites (p < 0.05). We conclude that cirrhosis, portal
      pressure and operating time are the most important factors related to intractable
      ascites in the case of hepatectomy. Areas of the liver to be resected should be
      limited in cirrhotic patients with portal hypertension.

PMID- 8462922
TI  - Utilization of split liver grafts in orthotopic liver transplantation.
AB  - Among a total of 220 liver transplants, reduced-size liver was used in 21 cases
      due to discrepancies in size between recipient and donors in 19 patients. In the
      case of two adult patients suffering from fulminant hepatic failure and in a
      critical condition, only one donor organ became available, so that the graft was
      divided to give the two recipients an equal opportunity. The two patients with
      fulminant hepatic failure were admitted to the ICU requiring mechanical
      respiration almost at the same time. Hepatitis serologies were HBcAb+, HBsAb+,
      and VCA+ in one and negative in the second. They had different blood groups
      (A.Rh+, O.Rh-), and the only donor available was located in Milan, Italy. The
      graft perfused with UW. was divided into two (right side, segments IV, V, VI,
      VII, and VIII, and left side, segments I, II and III). The recipients were
      transplanted 50 and 48 hours after admission. The cold ischemia time was 7.10 and
      16.50 hours. The first patient, who received the right lobe, was extubated at 48
      hours and discharged on the 40th postransplant day. The second patient remained
      unconscious with progressive deterioration; an EEG on the 4th day revealed
      absence of higher cortical function.

PMID- 8462923
TI  - Clinicopathological characteristics of hepatic hilar bile duct carcinoma.
AB  - We reviewed thirty cases of hepatic hilar bile duct carcinoma found in 5,800
      consecutive autopsy cases, mainly of the aged, and analysed their
      clinicopathological characteristics. Eleven cases had a record of tumor resection
      (8 men, 3 women, mean age 75.1 years). At operation, the gross type was mainly
      infiltrative in all eleven cases, and the stage was II, III or IV in as many as
      ten cases. Cholecystectomy and bile duct resection were performed in all cases
      except one in whom additional hepatic lobectomy was performed. In none of the
      cases was the operation curative. The main cause of non-curability was residual
      carcinoma on the surgical cut or ablated surface due to longitudinal or lateral
      cancerous interstitial spread. This was confirmed by the fact that local relapse
      of carcinoma, either in the hepatic hilus or hepatoduodenal ligament, was found
      in all the cases at autopsy. This fact also indicates the difficulty in achieving
      complete resection of carcinoma in this part. On the other hand, a relatively
      "benign" aspect of hepatic hilar bile duct carcinoma was suggested as follows: 1.
      Most of the cases were well-differentiated adenocarcinoma. 2. Although there was
      no case of curative resection, three out of of nine cases (excluding the cases of
      death during operation) survived more than two years. 3. Distant metastasis found
      at autopsy was relatively rare, being seen in four of these eleven cases. In the
      light of these data an operation, even though palliative, is considered to be
      justified.

PMID- 8462924
TI  - Clinical significance of serum HBVDNA detected by the PCR method.
AB  - Changes in serum HBVDNA and their relationship to the prognosis following
      interferon (IFN) therapy were examined by the polymerase chain reaction (PCR) in
      4 patients with chronic hepatitis B infection undergoing IFN therapy. The
      disappearance of HBVDNA was confirmed by the PCR methods in 3 out of 4 patients
      who showed favorable subsequent courses. The remaining patient was positive for
      HBVDNA despite the disappearance of the HBe antigen. In this patient, the
      hepatitis recurred, and was accompanied by a persistent hepatic disorder. The PCR
      assay was also carried out to clarify the involvement of the hepatitis B virus in
      12 patients who were positive for the HBe antibody and who showed fluctuating
      transaminase levels. The PCR method revealed that all 12 patients were positive
      for HBVDNA. These findings indicate the clinical usefulness of the PCR assay for
      hepatitis B virus infection.

PMID- 8462925
TI  - Hepatic functional scintigraphic imaging with 99mtechnetium galactosyl serum
      albumin.
AB  - 99mTc-galactosyl serum albumin (GSA), a specific radiolabeled synthetic ligand
      for asialoglycoprotein receptors on hepatocytes, was used for functional liver
      imaging in 18 patients. Six patients had chronic hepatitis, and 12 had liver
      cirrhosis. Serial scintigraphic images were obtained for 60 minutes after
      intravenous administration of 1 mg of the ligand. High-quality images of the
      liver was obtained in all the patients. Dispersed accumulation in the liver in
      association with delayed clearance of the ligand from the heart was noted in
      cirrhotic patients. The activity of the entire liver (L) and that of the heart
      (H) were measured. The capacity of the liver in terms of elimination of the
      ligand was estimated by calculating [L/H+L] 15 and 30 minutes after the
      administration. [L/H+L] showed significant differences between patients with
      chronic hepatitis and those with liver cirrhosis, and also showed significant
      correlations with laboratory values such as indocyanine green clearance,
      prothrombin time, hepaplastin test, serum albumin level, and the Child-Turcotte
      classification score. 99mTc-GSA might be a useful radiopharmaceutical for
      obtaining hepatic functional images.

PMID- 8462926
TI  - Expression of ras and c-myc oncoproteins and hepatitis B surface antigen in human
      liver disease.
AB  - One of the major antecedent factors preceding the development of hepatocellular
      carcinoma is chronic hepatitis B virus infection. Also, recent molecular studies
      have shown that activation of c-oncogenes might be responsible for the malignant
      transformation in some cases of hepatocellular carcinoma. We used
      immunohistochemical methods to investigate the correlation of ras and c-myc
      oncogene expression with the presence of HBsAg in human liver disease. Our
      material consisted of 23 chronic active hepatitis B needle liver biopsies and
      surgical specimens from 11 cases of cirrhosis, 23 hepatocellular carcinoma and 10
      normal adult livers. Direct, three-step and streptavidin-biotin-complex
      immunoperoxidase techniques using polyclonal (anti-HBsAg) and monoclonal
      antibodies (anti-ras p21, anti-myc p62), were performed. Normal liver tissues
      were negative for all antibodies used. In HBsAg+ chronic active hepatitis B cases
      enhancement of c-myc, and less frequently of ras oncogene expression, was a
      common observation. Increased myc p62 and ras p21 expression was a finding not
      restricted to HBsAg+hepatocytes, which occasionally were negative for oncoprotein
      immunostaining. All HBsAg-chronic active hepatitis B cases were negative for ras
      p21 and myc p62 specific staining. Cirrhotic livers showed more frequently
      enhanced c-myc expression. Most of the immunostained cells were negative for
      HBsAg. HBsAg- cases of hepatocellular carcinoma more often showed ras p21 than
      myc p62 overexpression. HBsAg+ hepatocellular carcinomas presented only ras p21
      positive immunostaining, which was not detected in HBsAg+ hepatocytes. Our recent
      data supports the view that continued expression of HBsAg in human liver disease
      is not necessary for the enhancement of ras and c-myc oncogene expression.

PMID- 8462927
TI  - Eosinophilic gastroenteritis: possible role of sonography in diagnosis and follow
      up.
AB  - Eosinophilic gastroenteritis (EGE) is a rare disease of unknown etiology. The
      clinical and radiological diagnoses have to be confirmed by histological
      examination of biopsy specimens. The authors now present a case of a 19-year-old
      man with recurrent epigastric pain and vomiting, whose sonographic features and
      eosinophilia suggested the diagnosis of EGE, which was subsequently confirmed by
      histology. Sonographic follow-up permitted an effective evaluation of the
      evolution of the disease under steroid therapy.

PMID- 8462928
TI  - Secondary early carcinoma in a reconstructed gastric tube after subtotal
      esophagectomy for early carcinoma of the esophagus.
AB  - A 70-year-old man was found to have a moderately differentiated squamous cell
      carcinoma in the mid-esophagus on X-ray and endoscopy. These examinations
      revealed no lesion in the stomach at that time. Ten days after termination of
      preoperative hyperthermo-chemo-radiotherapy (HCR), a subtotal esophagectomy and
      gastric tube reconstruction via the retrosternal route were performed (pTNM stage
      I). Seven months later, another early cancer was detected in the reconstructed
      gastric tube. Via a median sternotomy, a wedge resection of the gastric tube was
      performed, and histopathological studies revealed a well-differentiated
      adenocarcinoma, which was limited to the submucosa (pTNM stage I). The patient
      has since done well with no signs of recurrence for the twenty-two months that
      have elapsed since the second operation was performed. Since the incidence of
      double cancer in the esophagus and stomach is high, and cases such as that
      described here will be detected more and more frequently in the future, not only
      a thorough investigation of a stomach intended for use in the reconstruction of
      the esophagus, but also strict postoperative checkups of the gastric tube when
      the esophagus has been reconstructed using the stomach must be considered of
      great importance.

PMID- 8462929
TI  - Swallowing function and gastric emptying in patients undergoing replacement of
      the esophagus.
AB  - In order to assess functional changes after esophagectomy, esophageal transit
      scintigraphy and gastric emptying measurements were performed in a group of 10
      patients after esophagus substitution by the tubulized stomach, and in a group of
      12 patient with an interposed colon. The swallowing function of the rest of the
      esophagus was preserved in 15 out of 22 patients. The best results were obtained
      on using a liquid bolus in an upright position, the worst function was found on
      using a solid bolus in a supine position. Reflux at the level of the anastomosis
      with the esophagus was detected in only 7 out of 22 patients. The gastric
      emptying rate was normal in 4 out of 12 examined patients. Scintigraphic methods
      proved to be suitable for the detection of functional changes after surgery. The
      function tests performed proved that substitution of the esophagus by either
      tubulized stomach or interposed colon provides the patient with adequate comfort,
      provided that he adopts certain habits.

PMID- 8462930
TI  - Pancreatic duct width: its significance as a diagnostic criterion for pancreatic
      disease.
AB  - The significance of main pancreatic duct width in the diagnosis of pancreatic
      disease, was studied in 338 endoscopic retrograde pancreatographies. Two hundred
      and forty patients referred for suspected biliary disease had normal
      pancreatograms (Group 1), 60 had pancreatic carcinoma (Group 2) and 38 had a
      history and pancreatogram compatible with chronic pancreatitis (Group 3). After
      categorizing patients by decade, in group 1 the effect of aging on the pancreatic
      duct width in the head, body and tail (F5,234 > 3.71, p < 0.003) was pronounced,
      especially after the fifth decade. There was a significant difference between
      groups 1, 2 and 3 in terms of the width of the main pancreatic duct in all three
      parts of the pancreas (F2,325 > 42.24, p < 0.001). The upper range of normal
      pancreatic duct width was 8.0 mm, 4.0 mm and 2.4 mm in the head, body and tail,
      respectively. Abnormal ductograms were wider than the normal ranges in the head,
      body and tail of the pancreas in 14%, 49% and 59% (p < 0.001) of the patients,
      respectively. Establishing normal ranges of the pancreatic duct width may help in
      the diagnosis of pancreatic disease. Measurements in the body and tail, as
      compared with the head, are a more sensitive indicator of pancreatic duct
      dilation.

PMID- 8462931
TI  - Association between gallbladder cancer and anomalous union of the
      pancreaticobiliary ductal system.
AB  - Between 1978 and 1989, gallbladder cancer was diagnosed in 17 out of 48 patients
      with anomalous union of the pancreaticobiliary system. The clinical, surgical,
      and pathological features of these 17 patients are described. We classified them
      into two groups, those with and those without dilation of the common bile duct,
      and compared the clinicopathological features. Patients with dilation of the bile
      duct often had early onset of symptoms, so that cancer was detected at a
      relatively early stage. Most of those without dilation of the common bile duct
      already had a number of severe symptoms at the first consultation, and the cancer
      was usually at an advanced stage. We believe that early diagnosis of patients
      without dilation of the bile duct is an important clinical problem that needs to
      be resolved.

PMID- 8462932
TI  - Albumin inhibits hemolysis of erythrocytes induced by ethanolamine oleate during
      endoscopic injection sclerotherapy.
AB  - In attempts to avoid hemolytic nephropathy following injection of 5% ethanolamine
      oleate during endoscopic injection sclerotherapy for esophageal varices, the
      relationship between serum levels of albumin and hemolysis induced by
      ethanolamine oleate was investigated. The rate of hemolysis at various
      concentrations of ethanolamine oleate and albumin was examined using a
      spectrophotometer in ten cirrhotic patients and five healthy volunteers
      (controls). Hemolysis induced by ethanol-amine oleate increased in an
      ethanolamine oleate concentration-dependent fashion (p < 0.01) but was dose
      dependently inhibited by albumin (p < 0.05). The state of liver function was
      unrelated to the rate of hemolysis. The relationship between hemoglobinuria and
      serum albumin levels in seventy-nine cirrhotic patients with esophageal varices
      treated by endoscopic injection sclerotherapy with ethanolamine oleate was also
      examined. Hemoglobinuria was evident in 20 out of 24 patients (83.8%) in whom the
      serum albumin level was less than 3.0 g/dl, and in 24 out of 55 (43.6%) in whom
      it exceeded 3.0 g/dl, the difference being statistically significant (p < 0.01).
      On the day after endoscopic injection sclerotherapy, creatinine clearance fell
      from 81.6 +/- 33.8 m/l min to 60.1 +/- 31.4 ml/min in the hemoglobinuria-positive
      patients (p > 0.01) and two went into acute renal failure. The creatinine
      clearance ranged from 79.5 +/- 27.9 ml/min to 83.0 +/- 39.9 ml/min in the
      hemoglobinuria-negative patients (p < 0.1). In the light of this evidence we
      correct the serum albumin level cut off point to 3.0 g/dl prior to endoscopic
      injection sclerotherapy in order to maintain renal function.

PMID- 8462933
TI  - Definition and diagnosis of early cancer of the biliary tract.
AB  - From the study on correlation between the depth of cancer invasion and the
      results of surgery, early cancer of the biliary tract may be defined as cancer
      cell invasion limited to the mucosal or muscularis propria in the case of
      carcinoma of the gallbladder, and to the mucosal or fibro-muscular layer in the
      case of carcinoma of the bile duct. With few exceptions, these tumors had no
      lymph node metastasis, venous invasion, perineural infiltration or involvement of
      the lymphatic vessels. Since the cumulative 5-year survival rate was 100% after
      resection of early cancer, the choice of surgical procedures was considered to be
      extended cholecystectomy for early cancer of the gallbladder, and the standard
      radical resective operation for early cancer of the bile duct. An accurate
      diagnosis was not made preoperatively in most cases of early cancer of the
      biliary tract. The diagnostic approach is discussed, including the recently
      developed imaging modalities, such as endoscopic ultrasonography and percutaneous
      transhepatic cholecystoscopy or cholangioscopy.

PMID- 8462934
TI  - Acute abdomen caused by torsion of the pedicle in a wandering spleen.
AB  - A case of acute abdomen caused by acute torsion of a wandering spleen in a 20
      year-old female patient is presented. It underscores the efficiency of the
      ultrasonic examination in the diagnosis of this type of pathology.

PMID- 8462935
TI  - Ending stigma and discrimination begins at home.

PMID- 8462936
TI  - Confidentiality in group therapy.

PMID- 8462937
TI  - Ten trends in managed care and their impact on the biopsychosocial model.

PMID- 8462938
TI  - The agitated patient, Part I: Evaluation and behavioral management.

PMID- 8462939
TI  - When a therapist overindulges a demanding borderline patient.

PMID- 8462940
TI  - The video violence debate.
AB  - Some researchers and theorists are convinced that graphic scenes of violence on
      television and in movies are inextricably linked to human aggression. Others
      insist that a link has not been conclusively established. This paper summarizes
      scientific studies that have informed these two perspectives. Although many
      instances of children and adults imitating video violence have been documented,
      no court has imposed liability for harm allegedly resulting from a video program,
      an indication that considerable doubt still exists about the role of video
      violence in stimulating human aggression. The author suggests that a small group
      of vulnerable viewers are probably more impressionable and therefore more likely
      to suffer deleterious effects from violent programming. He proposes that research
      on video violence be narrowed to identifying and describing the vulnerable
      viewer.

PMID- 8462941
TI  - Residents' and nurses' perceptions of difficult-to-treat short-stay patients.
AB  - OBJECTIVE: Characteristics attributed by nurses and by psychiatric residents to
      difficult-to-treat inpatients in a short-stay setting were compared to determine
      whether discipline-specific perceptions of such patients existed. METHODS: A
      total of 117 patients consecutively admitted to a short-stay inpatient unit were
      assessed by both psychiatric residents and nurses during the third week of
      hospitalization using subscales of the Hospital Treatment Rating Scales. The
      degree of management difficulty presented by each patient in 28 areas was rated,
      and an overall rating was calculated. Two separate regression analyses were used
      to examine characteristics of patients rated difficult. RESULTS: Self-harm
      behaviors, violence toward others, and behaviors that sabotage treatment were
      identified by both nurses and residents as characteristics of difficult patients,
      although these characteristics contributed less to residents' perceptions of
      patient difficulty than to nurses'. For nurses, the most important additional
      characteristics contributing to treatment difficulty were related to patients'
      inability to form a therapeutic alliance. For residents, by far the most
      significant contributor to overall treatment difficulty was lack of response to
      medication. CONCLUSIONS: The discipline-specific differences in perceptions of
      difficult-to-treat patients were associated with differences in professional
      roles. Communication problems between physicians and nurses may be due in part to
      their different perceptions of treatment and management difficulty.

PMID- 8462942
TI  - Patients' fear of and objection to electroconvulsive therapy.
AB  - Patients' fear of and objection to electroconvulsive therapy (ECT) have
      complicated the administration of this modality since its inception. Despite
      modifications in technique and pretreatment education over the years, these
      problems have not disappeared. The author discusses the literature on fear of
      convulsive therapy and provides three case examples from his clinical experience.
      The review suggests that some patients gradually develop a pathological fear of
      ECT over the course of treatment, which creates a significant obstacle to
      compliance and in some cases leads to refusal of treatment. The author suggests
      that this clinical phenomenon, described during the 1950s but often
      underrecognized today, merits further study.

PMID- 8462943
TI  - Assessing psychiatric patients' competency to agree to treatment plans.
AB  - The issue of therapists' liability for patients who commit suicide may depend on
      whether courts view the suicidal patient as competent to decide to follow or not
      follow an agreed-upon treatment plan. Therapists have not been found liable for
      malpractice when courts have viewed a patient's decision not to seek help when
      feeling suicidal as being voluntary rather than reflecting global incompetence
      due to mental illness. The author offers practical suggestions, including sets of
      specific questions, for assessing and documenting a psychiatric patient's
      competency to agree to a treatment plan. An important element of the procedure is
      direct assessment of the patient's understanding of the risks of withholding
      information from caretakers and the benefits of providing it. Such competency
      assessments can facilitate clinical management of patients and can also help
      reduce the risk of malpractice liability resulting from patients' suicide.

PMID- 8462944
TI  - Long-term psychotherapy and informed consent.
AB  - Many long-term psychotherapies begin without sufficient attention to an informed
      consent process. Failure to obtain informed consent may leave patients ill
      prepared to question the recommendation for long-term psychotherapy or to make
      alternate treatment choices. The author presents a model for informed consent to
      stimulate debate on ethical approaches to this type of treatment. The approach
      covers six areas therapists should discuss with candidates for long-term
      psychotherapy: the diagnostic model used and the recommendation for treatment,
      potential risks and benefits of treatment, availability of less expensive short
      term interventions, clarification of the necessity for psychotherapy, limits of
      insurance coverage, and plans for measuring the patient's response to treatment.
      The decision to recommend long-term psychotherapy should be made through careful
      analysis of indications and contraindications for such treatment and in the
      context of informed consent.

PMID- 8462945
TI  - Hospital characteristics, diagnoses, and staff reasons associated with use of
      seclusion and restraint.
AB  - OBJECTIVE: Patterns of seclusion and restraint over a one-year period at 82
      Veterans Affairs medical centers were examined to determine whether use of these
      interventions was influenced by hospital characteristics (such as geographic
      location, per diem cost, patient-staff ratio, and university affiliation),
      patient diagnoses, or reasons for use. METHODS: For comparison, medical centers
      were grouped into seven geographic regions and into three frequency-of-use
      groups. Mean use rates and hospital characteristics were examined by rank
      correlational analysis. RESULTS: Among hospital characteristics, only geographic
      location was associated with differences in use of seclusion and restraint. Mean
      rates of use in the Pacific and Mid-Atlantic regions were significantly lower
      than those in other regions. Total hours of seclusion and restraint at the 20
      highest-use centers differed from those at the 20 lowest-use centers by a factor
      of ten. Patients with schizophrenic disorders were secluded or restrained most
      frequently. Centers with the highest rates used these interventions most
      frequently for reasons not associated with violent or potentially violent
      behaviors. CONCLUSIONS: The large geographic variations in use of seclusion and
      restraint may be a function of different standards of practice or of different
      state laws.

PMID- 8462946
TI  - Frequent psychiatric visitors to a Veterans Affairs medical center emergency care
      unit.
AB  - OBJECTIVE: The study examined characteristics of patients who made repeat visits
      to the psychiatric emergency service of a Veterans Affairs medical center.
      METHODS: Computer records of patients who visited the emergency service were
      retrospectively examined for a one-year period after their index visit. Patients
      were divided into three groups according to the number of visits; nonrepeaters
      had only one visit, occasional repeaters had two or three visits, and frequent
      repeaters had four or more visits. RESULTS: Of 1,144 patients who visited the
      emergency service during the one-year study period, 26 percent were occasional
      repeaters and 8 percent were frequent repeaters; the latter group accounted for
      24 percent of all visits. Schizophrenic patients were overrepresented among
      frequent repeaters. Compared with nonrepeaters, repeat visitors were admitted to
      the hospital more often and were less likely to be referred to an outpatient
      clinic for follow-up. Frequent repeaters were more likely than occasional
      repeaters to revisit within one month and to visit during evening hours.
      CONCLUSIONS: One-third of patients seen during a one-year period revisited the
      emergency service, a rate substantially higher than those reported for large
      urban non-VA hospitals. The higher rate may have been due to the longer sampling
      period, to a more seriously ill population, or to fewer community resources for
      veterans because of misperceptions about their eligibility.

PMID- 8462947
TI  - Characteristics of repeat users of a psychiatric emergency service.
AB  - OBJECTIVE: Patients who visited a psychiatric emergency service were studied to
      determine whether repeat visitors, who consume a disproportionate share of
      services, could be identified by demographic and diagnostic characteristics.
      METHODS: Data were obtained from a semistructured diagnostic interview given to
      all 16,257 persons who made 29,214 visits to an urban psychiatric emergency
      service in Pittsburgh, Pennsylvania, from 1985 to 1989. Patients were categorized
      into four groups based on the number of visits in the five-year period. Patients
      in group 1 made a single visit, while those in group 2 averaged less than one
      visit per year; those in group 3 made one or two visits per year, and those in
      group 4, more than two visits per year. RESULTS: Groups 3 and 4 constituted 5.1
      percent of the sample but made 27.1 percent of the total visits. Repeat users
      were significantly more likely to be male, younger, unmarried, unemployed, and
      nonwhite and to have diagnoses of schizophrenia, other psychotic disorders, and
      personality disorders. CONCLUSIONS: Repeat users of psychiatric emergency
      services appear to have demographic and diagnostic characteristics that may
      permit their early identification. For such patients, implementation of
      alternative management strategies, such as intensive case management, may reduce
      their use of services.

PMID- 8462948
TI  - Prevalence of psychopathology in elderly persons in nursing homes and in the
      community.

PMID- 8462949
TI  - Using interactive video to supplement HIV counseling.

PMID- 8462950
TI  - Violence toward family caregivers by mentally ill relatives.

PMID- 8462951
TI  - Ethics and the expert witness.

PMID- 8462952
TI  - Hospital advertising.

PMID- 8462953
TI  - Outdated information.

PMID- 8462954
TI  - Collaboration.

PMID- 8462955
TI  - Staff in state hospitals.

PMID- 8462956
TI  - Concern for public hospitals.

PMID- 8462957
TI  - No nurse cap needed.

PMID- 8462958
TI  - No volunteer coverage.

PMID- 8462959
TI  - Shared sacrifice: the right message for America.
AB  - Is President Clinton naive to ask Americans to buy into "shared sacrifice"?
      Actually, shared sacrifice seems the right message for America in the 1990s,
      writes Dick Davidson, president of the AHA. In fact, he says, it's probably the
      only way we'll be able to repair our economy and our health care system.

PMID- 8462960
TI  - Health care reform: nursing's vision of change.
AB  - "Health care reform will change the role of nursing more dramatically than that
      of any other health care profession," says one nursing educator. Her statement is
      echoed by leaders of a variety of groups. The issue, everyone agrees, is how that
      role will change. And leaders of organized nursing and organized medicine find
      themselves scattered across a spectrum of opinion on that critical question.

PMID- 8462961
TI  - The data debate. CIOs weigh issues, obstacles to information networks. Panel
      discussion.
AB  - CEOs are looking toward the development of provider networks in a post-reform
      environment, as envisioned in the AHA's proposal for Community Care Networks. But
      CIOs face conceptual and technical challenges on the path to true information
      networking. An exclusive Hospitals panel discussion.

PMID- 8462962
TI  - Future fears: organized medicine faces managed competition.

PMID- 8462963
TI  - Funding risks. Rising health care costs and the current public policy climate.

PMID- 8462964
TI  - Benefits equity. Providers anticipate core mental health coverage.
AB  - In recent years, payer restrictions have led to many belt-tightening measures in
      the psychiatric field. But word that the administration may expand mental health
      insurance coverage has provided a needed shot in the arm for that field.

PMID- 8462966
TI  - Do physicians and hospitals share capitation?

PMID- 8462965
TI  - Medicare meets reform. Integrating Medicare poses a puzzle for reformers.
AB  - Many reformers say reform must extend to Medicare to control rising costs. But
      getting Medicare patients to embrace managed care, and melding disparate payment
      methods during the transition, will pose major challenges.

PMID- 8462967
TI  - Medical waste transport issues aired.

PMID- 8462968
TI  - OIG stance causes concern over purchases.

PMID- 8462969
TI  - Data watch. Fourth-quarter data from AHA Monitrend II.

PMID- 8462970
TI  - Proving our value: why we documented it.

PMID- 8462971
TI  - Molecular cytogenetic study of patients with Pallister-Killian syndrome.
AB  - The Pallister-Killian syndrome (PKS) is characterized by tissue limited
      chromosomal mosaicism, i.e. the presence of a supernumerary metacentric
      chromosome [i(12p)] often confined to skin fibroblasts while the karyotype of
      cultured lymphocytes is normal. In the present study, chromosome painting by
      chromosomal in situ suppression (CISS) hybridization and interphase cytogenetic
      procedures employing biotinylated or digoxigenin labelled probes was carried out.
      These probes comprised a chromosome 12 specific library (LA 12NS01) and
      chromosome 12 centromere specific alpha-satellite (pSP12-1). They were used to
      analyse and quantify the presence of i(12p) in lymphocytes,
      granulocytes/monocytes, skin fibroblasts and buccal mucosal cells from five
      patients and one aborted fetus with PKS, and ten normal donors. CISS
      hybridization on mitotic skin fibroblasts reliably indicated the presence of
      i(12p) cells, even when metaphases of poor quality were included in the analysis.
      Two of the five patients showed i(12p) in a small proportion (< or = 0.5%) of the
      cultured lymphocytes too. The interphase cytogenetics procedure did not reveal
      the isochromosome in lymphocytes or granulocytes/monocytes in any of the
      patients. Two of the six patients had a twofold increase in the number of buccal
      mucosal cells with three hybridization signals over control values. However, for
      mucosal cells, methodological improvements are required. For cytogenetic
      diagnosis of PKS, cultured fibroblasts subjected to chromosome painting by CISS
      hybridization with a chromosome 12 specific library probe are recommended.

PMID- 8462972
TI  - Efficient identification of marker chromosomes in 27 patients by stepwise
      hybridization with alpha-satellite DNA probes.
AB  - Using a procedure involving stepwise hybridization of alpha-satellite DNA probes
      at various conditions of stringency, 33 marker chromosomes from 27 patients were
      identified. The markers were ascertained prenatally in fetal amniotic fluid and
      chorionic villi samples or postnatally in blood from liveborn children. The
      marker chromosomes first were characterized by cytogenetic techniques and later
      identified by fluorescence in situ hybridization. There were 14 bisatellited
      markers, 3 metacentric nonsatellited marker chromosomes, 2 nonsupernumerary sex
      chromosomal rings, and 9 patients carrying markers that appeared to be small
      rings. Multiple stringency conditions were used for the identification of 14
      supernumerary ringlike chromosomes detected in 8 patients. Ring-like markers were
      initially screened at low stringency and grouped into alpha-satellite families.
      Subsequent higher stringency hybridization led to marker identification. Ringlike
      chromosomes originated from chromosomes 1, 2, 8, 12, 13 or 21, 14 or 22, 15, 18,
      and X. Multiple ringlike markers ascertained in a single patient were determined
      to originate from different chromosomes.

PMID- 8462973
TI  - A missense mutation in the low density lipoprotein receptor gene causes familial
      hypercholesterolemia in Sephardic Jews.
AB  - Familial hypercholesterolemia (FH) is an autosomal dominant disease caused by
      mutations in the low density lipoprotein (LDL) receptor gene. Here, we
      characterize an LDL receptor mutation that is associated with a distinct
      haplotype and that causes FH in the Jewish Sephardic population originating from
      Safed, a town in northern Israel. The mutation was found in eight FH families
      originating from this community comprising 10% of heterozygote FH index cases
      screened in Israel. The mutation was not found in four additional FH
      heterozygotes whose hypercholesterolemia co-segregated with an identical LDL
      receptor gene haplotype. A guanine to cytosine substitution results in a missense
      mutation (asp147 to his) in the fourth repeat of the binding domain encoded by
      exon 4 of the LDL receptor gene. The mutant receptor protein was synthesized in
      cultured cells as a 120 kDa precursor form that failed to undergo normal
      processing to a mature cell surface form. Most of the receptor precursors were
      degraded in the endoplasmic reticulum. The small number of mutant receptors on
      the cell surface were unable to bind LDL or beta very low density lipoprotein.
      The abnormal behavior of the mutant receptor was reproduced by site-directed
      mutagenesis and expression of the mutant protein in CHO cells. The mutation can
      be diagnosed by allele-specific oligonucleotide hybridization of polymerase chain
      reaction amplified DNA from FH patients.

PMID- 8462974
TI  - A new human brain cDNA molecule: assignment to chromosome 11q21-q23.1 and
      description of two polymorphisms studied by the polymerase chain reaction.
AB  - A new human brain cDNA molecule was mapped by in situ hybridization to the 11q21
      q23.1 region of the human genome, probably to the 11q22 band. An EcoRI
      restriction site and a (GT)n repeat element within the gene were shown to be
      polymorphic. Both polymorphisms were readily studied by the polymerase chain
      reaction. A two-allele polymorphism was described for the EcoRI restriction site,
      whereas four different alleles were detected for the second genetic marker. The
      observed heterozygosities were 37% and 42% for the former and the latter
      polymorphism, respectively. The combined heterozygosity index was estimated to be
      0.56. These new genetic markers will be useful for linkage analysis of
      neurogenetic diseases that have been mapped to this chromosomal region.

PMID- 8462975
TI  - Detection and characterization of new genetic mutations in individuals
      heterozygous for lactate dehydrogenase-B(H) deficiency using DNA conformation
      polymorphism analysis and silver staining.
AB  - Human lactate dehydrogenase (LDH)--B(H) mutant genes were analyzed by polymerase
      chain reaction (PCR) and DNA conformation polymorphism. We used polyacrylamide
      gradient gel and silver staining procedures for DCP analysis, and observed
      abnormal migration patterns in individuals heterozygous for the LDH-B deficiency.
      Subsequent sequence determination of the mutant alleles consistently resulted in
      detection of three single base substitutions (transversions), viz., a C to A at
      residue "35" (GCG, Ala-->GAG, Glu), a T to G at residue "172" (TTT, Phe-->GTT,
      Val), and an A to T at residue "176" (ATG, Met-->TTG, Leu). Furthermore,
      mismatched PCR or amplification refractory mutation system was developed for the
      rapid screening and confirmation of these mutations. These amino acid
      replacements may cause conformational changes in neighboring residues; this
      probably affects the active site arrangement and results in the loss of enzyme
      activity.

PMID- 8462976
TI  - Are the nail-patella syndrome and the autosomal Goltz-like syndrome the
      phenotypic expressions of different alleles at the COL5A1 locus?
AB  - The COL5A1 gene, which encodes the pro alpha 1(V) chain, was recently mapped to
      9q34.3 in the same region as the nail-patella locus. This was taken as an
      indication that the nail-patella syndrome may be an inherited connective tissue
      disorder. We demonstrate COL5A1 heterozygous deletion and fibroblast under
      expression of alpha 1(V) chains in a girl with an unbalanced translocation
      resulting in 9q32-->qter monosomy. The patient presents dysplastic nails, a sign
      typical of nail-patella syndrome, but normal patella. Moreover, she has skin and
      bone disorders similar to those found in the Goltz syndrome. We suggest that
      monosomy for the COL5A1 gene is responsible for these connective tissue
      disorders. Accordingly, the nail-patella syndrome could be attributable to
      mutations inside the COL5A1 gene rather than to a deletion of it.

PMID- 8462977
TI  - Physical mapping identifies DXS265 as a useful genetic marker for carrier
      detection and prenatal diagnosis of X-linked agammaglobulinemia.
AB  - The gene responsible for X-linked agammaglobulinemia (XLA) has not been
      identified; however, in the course of genetic linkage studies designed to map the
      locus more precisely, a number of closely linked polymorphic loci have been
      identified. These have proved to be useful in identifying carriers and in pre
      natal diagnosis of this disease. The DXS178 locus was found to be closest to the
      XLA locus and has been the most usefully employed probe to date. Using physical
      mapping techniques, we have identified a previously cloned genetic marker,
      DXS265, as being situated within 5 kb of DXS178. So far, we have found one family
      that is not informative for DXS178 but that is informative for DXS265; females in
      this family can now be offered the possibility of carrier determination and pre
      natal diagnosis for this life-threatening disease.

PMID- 8462978
TI  - Deletion breakpoints associated with the Prader-Willi and Angelman syndromes
      (15q11-q13) are not sites of high homologous recombination.
AB  - Deletions of 15q11.2-q12 are associated with either the Prader-Willi (PWS) or
      Angelman (AS) syndromes. It has been suggested that excessive recombination in
      this region might explain the high frequency of such deletions, and the frequent
      involvement of chromosome 15 in translocations and nondisjunction. We have
      studied recombination in the PWS region by linkage analysis of non-PWS families.
      No recombination was found (with maximum lod scores greater than 3.0) for most
      pair-wise combinations of probes: 39, IR4-3R, ML34, 189-1, 3-21. A 'hotspot' of
      recombination is observed between loci detected by p3-21 and pIR10-1. The female
      recombination fraction in this region was significantly higher than that for
      males. Close linkage with 0.06 recombination was found for the IR10-1 and CMW-1
      pair. No excess recombination was found between sites bounding common breakpoints
      observed in deletions associated with PWS and AS. It is suggested that these
      deletions form frequently because of the presence of duplicated DNA sequences
      and/or inversions in this region, and not because of a high rate of homologous
      recombination.

PMID- 8462979
TI  - Changes of telomere lengths in human intracranial tumours.
AB  - The termini of human chromosomes comprise stretches of G-rich repeats that are
      about 5-20 kilobase (kb) in length. The size of the telomeres can be determined
      by hybridization with probes specific for these (ttaggg)n sequences after
      digestion of chromosomal DNA with appropriate restriction enzymes and
      electrophoretic separation of the fragments. Here, probing with the 32P-labelled
      synthetic (TTAGGG)3 oligonucleotide revealed length changes of the telomeres
      occurring in intracranial tumours. Among 60 samples, analysed, 41.7% showed
      telomere elongation, and 21.7% telomere reduction, whereas 36.7% of the tumours
      exhibited equal lengths compared with the patients' peripheral blood leukocytes.
      Most of the elongated glioma telomeres exceeded in length those of untransformed
      astrocytes derived from human fetal tissue.

PMID- 8462980
TI  - A novel nonsense mutation in the protein C (PROC) gene (Trp-29-->term) causing
      recurrent venous thrombosis.
AB  - A novel heterozygous TGG-->TAG (Trp-29-->Term) substitution was detected in three
      members of a family with inherited type 1 protein C deficiency and recurrent
      venous thrombosis.

PMID- 8462982
TI  - Combining mass media and contest in smoking cessation. An experience from a
      series of national activities in Finland.

PMID- 8462983
TI  - Indian culture--symbols as communication tools.

PMID- 8462984
TI  - New challenges for health promotion through mass-media.

PMID- 8462985
TI  - South East Asia: intercountry consultative meeting on comprehensive school health
      education. A call for action to implement and strengthen comprehensive approaches
      to school health education in South East Asia.

PMID- 8462986
TI  - Health education through mass media.

PMID- 8462981
TI  - Why are some genetic diseases common? Distinguishing selection from other
      processes by molecular analysis of globin gene variants.
AB  - Various processes (selection, mutation, migration and genetic drift) are known to
      determine the frequency of genetic disease in human populations, but so far it
      has proved almost impossible to decide to what extent each is responsible for the
      presence of a particular genetic disease. The techniques of gene and haplotype
      analysis offer new hope in addressing this issue, and we review relevant studies
      of three haemoglobinopathies: sickle cell anaemia, and alpha and beta
      thalassaemia. We show how for each disease it is possible to recognize a pattern
      of regionally specific mutations, found in association with one or a few
      haplotypes, that is best explained as the result of selection; other patterns are
      due to population migration and genetic drift. However, we caution that such
      conclusions can be drawn in special circumstances only. In the case of the
      haemoglobinopathies it is possible because a selective agent (malaria) was
      already suspected, and the investigations could be carried out in relatively
      genetically homogenous populations whose migratory histories are known. Moreover,
      some data reviewed here suggest that gene conversion and the haplotype
      composition of a population may affect the frequency of a mutation, making
      interpretation of gene frequencies difficult on the basis of standard population
      genetics theory. Hence attempts to use the same approaches with other genetic
      diseases are likely to be frustrated by a lack of suitably untrammelled
      populations and by difficulties accounting for poorly understood genetic
      processes. We conclude that although this combination of molecular and population
      genetics is successful when applied to the study of haemoglobinopathies, it may
      not be so easy to apply it to the study of other genetic diseases.

PMID- 8462987
TI  - Africa: using radio soap operas to promote family planning.
AB  - Programmes that combine mass media and popular entertainment formats can be a
      potent force in health communication since they can reach large audiences with
      persuasive messages. Not only can such programmes increase knowledge and
      stimulate approval, but also, when used effectively, they can change behaviour.

PMID- 8462988
TI  - Cloning of the beta 2-microglobulin gene in the zebrafish.
AB  - The beta 2-microglobulin (beta 2m) is a protein found in the serum in a free form
      and on the cell surface in a form noncovalently associated with the alpha chain
      of the class I major histocompatibility complex (Mhc) molecules. In mammals, the
      beta 2m-encoding gene (B2m) is found on a chromosome different from the Mhc
      proper. We have isolated and characterized the B2m gene of the zebrafish,
      Brachydanio rerio, family Cyprinidae. We obtained both cDNA and genomic clones of
      the Brre-B2m gene. The cDNA clones contained the entire coding sequence, the
      entire 3' untranslated (UT) region, and at least part of the 5'UT region. The
      genomic clone contained the entire Brre-B2m gene. The coding sequence specifies
      97 amino acid residues of the mature protein so that the zebrafish beta 2m is two
      residues shorter than human and one residue shorter than cattle, fowl, or turkey
      beta 2m (codons at positions 85 and 86 have been deleted in the Brre-B2m gene).
      The amino acid and nucleotide sequence similarities between zebrafish and human
      beta 2m (B2m) are 45% and 59%, respectively. Approximately 24% of the positions
      are invariant and an additional 9% show only conservative substitutions in
      comparisons which include all known beta 2m sequences (fish, avian, and
      mammalian). Most of the conserved positions are in the beta strands (some 47% of
      the beta-strand positions are conserved in the three vertebrate classes). The
      Brre-B2m gene consists of four exons separated by three introns. All of the
      introns are considerably shorter than the corresponding introns in the mammalian
      B2m genes. The coding sequences of the cDNA and the genomic clones are almost
      identical but the sequences of the 3'UT regions differ at 1.7% of the sites,
      suggesting that the genes borne by these clones might have diverged at least 0.7
      million years (my) ago. In contrast to the human B2m gene, the Brre-B2m gene
      shows no bias in the distribution of the CpG dinucleotides: the dinucleotides are
      distributed evenly along the entire available sequence. The haploid genome of the
      zebrafish contains only one copy of the B2m gene.

PMID- 8462989
TI  - Sequence and evolution of cattle MHC class I cDNAs: concerted evolution has not
      taken place in cattle.
AB  - To explore genetic mechanisms responsible for major histocompatibility complex
      (MHC) class I evolution in the artiodactyls, we cloned and sequenced MHC class I
      cDNAs from a Bos taurus bull heterozygous for cattle MHC (BoLA) class I
      serological specificities w2 and w30. Four unique cDNAs were found, indicating
      the presence of at least two MHC class I loci. Analysis of these four cDNAs and
      all previously published BoLA cDNA sequences suggested that there may be three
      cattle MHC class I loci. Additionally, comparison of all of the BoLA class I
      cDNAs to MHC class I cDNAs of other artiodactyls showed that some of the BoLA
      class I cDNAs were more similar to certain sheep cDNAs than they were to other
      cattle cDNAs. These data indicate that each BoLA class I locus has evolved
      independently after an ancestral gene duplication event and that inter-locus
      segmental exchange or concerted evolution has not occurred rapidly enough to
      cause extensive divergence between the orthologous MHC class I loci of sheep and
      cattle.

PMID- 8462990
TI  - Polymorphism in the regulatory region of HLA-DRB genes correlating with haplotype
      evolution.
AB  - Class II genes of the human major histocompatibility complex (MHC) are
      polymorphic. Allelic variation of the coding region of these genes is involved in
      the antigen presentation and is associated with susceptibility to certain
      autoimmune diseases. The DR region is unique among human class II regions in that
      multiple DRB genes are expressed. Differential expression of the different DRB
      loci has been demonstrated, and we sequenced the proximal promoter region of the
      HLA-DRB genes, known to be involved in the regulation of these genes. We found
      locus-specific and allele-specific nucleotide variations in their regulatory
      regions and we determined the relationship between the regulatory regions of HLA
      DRB genes. This polymorphism found in the regulatory conserved boxes could be
      involved in the observed differential expression of DRB loci. In addition, we
      found a polymorphism between the regulatory regions of DRB1 alleles which might
      be involved in an allele-specific regulation and therefore could be considered as
      an additional factor in susceptibility to autoimmune diseases.

PMID- 8462991
TI  - Characterization of beta 2-microglobulin transcripts from two teleost species.
AB  - Using degenerate primers based on published beta 2-microglobulin sequences we
      were able to obtain an expected 111 base pairs (bp) polymerase chain reaction
      (PCR) fragment from tilapia genomic DNA. The sequence of this fragment showed a
      high degree of similarity to mouse beta 2-microglobulin at the protein level. We
      used these primers in an "anchored PCR" to obtain a 213 bp PCR fragment from a
      carp cDNA library. This was then used to clone a full-length beta 2-microglobulin
      cDNA from carp. The carp sequence showed the highest similarity to rabbit beta 2
      microglobulin. Both sequences showed strong similarities to all previously
      published vertebrate beta 2-microglobulin sequences. The predicted protein
      secondary structure of both the carp and tilapia clones was almost identical to
      the corresponding regions of previously known vertebrate beta 2-microglobulin
      protein sequences. When either the carp or tilapia probes were used against
      corresponding northern blots, they hybridized to a message of approximately 800
      1000 bases long, which corresponds to the previously published lengths of beta 2
      microglobulin mRNAs. Southern blotting indicated that beta 2-microglobulin was
      encoded by a single copy gene in both cases. Phylogenetic analysis indicated that
      the sequences were related to the beta 2-microglobulins of higher vertebrates but
      grouped together in an ancestral position.

PMID- 8462992
TI  - Preimplantation mouse embryos express Mhc class I genes before the first cleavage
      division.
AB  - We have used oligonucleotide primers complementary for polymorphic regions of the
      mouse H-2D gene in a highly sensitive polymerase chain reaction (PCR) assay to
      detect the transcription of maternal and paternal class I mRNAs in gametes and
      preimplantation embryos. Using congenic strains of mice differing only at the
      major histocompatibility loci, class I (H-2D) mRNA of both the maternal and
      paternal haplotypes was demonstrated in embryos from the one-cell zygote to the
      late blastocyst stage of development but could not be detected in vas deferens or
      in vitro capacitated sperm or in ovulated secondary oocytes. These data clearly
      show that both paternally and maternally inherited Major histocompatibility
      complex (Mhc) class I genes are transcribed from the earliest stages of embryonic
      development, and suggest that developmental regulation of expression of their
      protein products is principally at the post-transcriptional level.

PMID- 8462993
TI  - HLA class I binding of synthetic nonamer peptides carrying major anchor residue
      motifs of HLA-B27 (B*2705)-binding peptides.
AB  - Eight nonamer peptides that comply with the major anchor residue motifs (the
      combination of amino acid residues at positions 2 and 9), R - K and R - R, of HLA
      B27 (B*2705)-binding peptides were synthesized and tested for their direct
      binding to HLA class I alpha chains by the HLA class I alpha chain refolding
      assay previously described. One was a known B27 (B*2705)-binding heat shock
      protein peptide, HSP89 alpha (201-209), and the other seven were derived from the
      sequence of wild-type P53, a human tumor suppressor protein. A total of 36 HLA
      class I allospecificities were tested. HSP89 alpha (201-209) and two P53
      peptides, P53 (362-370) and P53 (378-386), all possessing the motif R - K, bound
      strongly to B27 (B*2705) alpha chains. A weak binding was seen for P53 (272-280)
      and P53 (334-342), both showing the motif R - R. Most of these B27-binding
      peptides were found to bind to A3 alpha chains as well. In addition, P53 (173
      181) and P53 (334-342), both with the R - R motif, showed substantial binding
      with A31 alpha chains. All the peptides carrying the motif R - K also showed weak
      binding with A31 alpha chains. The remaining two peptides, P53 (201-209) and P53
      (282-290), with the motif R - R, did not show significant binding with any of the
      alpha chains tested. This study demonstrates both the specificity of peptide
      binding to a given HLA allelic product and the occurrence of cross-peptide
      binding between the allelic products of different HLA loci.

PMID- 8462995
TI  - Evidence of positive selection at the Lyb-2 locus of the mouse.

PMID- 8462994
TI  - A novel coding sequence belonging to a new multicopy gene family mapping within
      the human MHC class I region.
AB  - The human major histocompatibility complex (MHC) region is a genomic region
      spanning about 4000 kilobases (kb) including the class I, class II, and class III
      subregions. The class I subregion is larger than the two others but with fewer
      genes described to date. It includes a) classical human leucocyte antigen (HLA)
      class I genes (HLA-A, HLA-B, HLA-C) which are highly polymorphic and encode
      products presenting the endogenous antigenic peptides to the T-cell receptors,
      and b) non-classical class I genes (HLA-E, HLA-F, HLA-G) whose function is still
      unknown. In this study, we describe the first coding sequence which is not
      structurally related to the class I genes, although it is localized within the
      MHC class I region. This novel gene, P5-1, belongs to a multiple copy family, all
      members of which map within the MHC. Although the P5-1 sequence showed no
      similarity to sequences in different databanks, its transcription, which is
      restricted to lymphoid tissues, argues for an immunological function of its
      product.

PMID- 8462996
TI  - Assignment of three human high-affinity Fc gamma receptor I genes to chromosome
      1, band q21.1.

PMID- 8462997
TI  - Isolation and sequence analysis of cDNA for the dog T-cell receptor Tcr alpha and
      Tcr beta chains.

PMID- 8462998
TI  - Human T-cell receptor TCRAV, TCRBV, and TCRAJ sequences newly found in T-cell
      clones reactive with allogeneic HLA class II antigens.

PMID- 8462999
TI  - Diversity of exon 2 of major histocompatibility complex class I genes in wild
      mice.

PMID- 8463000
TI  - DR2 haplotypes (DRB1, DQA1, DQB1) associated with systemic lupus erythematosus.

PMID- 8463001
TI  - A new HLA-DPB1 allele from Santa Cruz Island, Solomon Islands.

PMID- 8463002
TI  - A second new HLA-DPB1 allele from Santa Cruz Island, Solomon Islands.

PMID- 8463003
TI  - The production of coronary vasoconstrictor substances by freshly harvested
      endothelial cells.
AB  - The effects of cell free superfusates from freshly harvested bovine endothelial
      cells attached to microcarrier beads on the isolated rabbit and rat heart and on
      superfused rabbit jugular veins were observed. Cell free conditioned filtrates
      from freshly harvested cells caused marked diminution in coronary flow and
      cardiac output in the isolated rabbit heart; in the perfused rat heart an
      increase in coronary perfusion pressure and a decline in left ventricular
      systolic tension and maximal left ventricular contractility (dP/dt) were
      recorded. Marked differences were found between changes induced by conditioned
      filtrate as compared to synthetic endothelin. Endothelin as present in
      conditioned filtrate could not account for the pronounced effect on coronary
      perfusion pressure, dp/dt and cardiac output induced by conditioned filtrate;
      more than one hundred times that of synthetic endothelin was needed to achieve
      comparable cardiodynamic effects. This suggested that additional non-prostanoid
      vasoconstrictor substance or substances are produced by freshly harvested
      endothelial cells. This conclusion was supported by the observation that BQ-123,
      a specific inhibitor of endothelin A (ETA) receptor significantly prevented
      contractions by endothelin, while failing to inhibit those induced by freshly
      harvested endothelial cells. These constrictor substances may be leukotrienes.

PMID- 8463004
TI  - Prostacyclin analogue, beraprost, sustains recanalization duration after
      thrombolytic therapy in acute myocardial infarction model.
AB  - Platelets play an important role in acute reocclusion after thrombolysis in acute
      myocardial infarction. We tested a new antiplatelet agent, the stable
      prostacyclin analogue, beraprost, in the prevention of reocclusion of reperfused
      vessels with a combination of recombinant tissue-type plasminogen activator (rt
      PA) in a canine preparation of coronary artery thrombosis superimposed on high
      grade stenosis. Intravenous infusion of rt-PA (17 micrograms/kg/min for 30 min)
      was combined with beraprost (100, 200 or 300 ng/kg/min for 60 min) or aspirin (35
      mg/kg bolus i.v. before rt-PA infusion). The reperfusion time did not differ
      among the 4 groups. The time from reperfusion to reocclusion (one cycle) in the
      rt-PA plus beraprost 200 ng/kg/min group was significantly longer than the rt-PA
      alone group (40 +/- 8 min vs. 9 +/- 2 min, P < 0.05) and the recanalization
      duration calculated as the mean time from reperfusion to reocclusion in each
      cycle was prolonged in the rt-PA plus beraprost 200 ng/kg/min group compared with
      the rt-PA alone group (48 +/- 6 min vs 18 +/- 5 min, P < 0.05) and the
      reocclusion time and recanalisation duration tended to be elongated in the rt-PA
      plus beraprost 300 ng/kg/min group, whereas those were not altered by aspirin and
      100 ng/kg/min of beraprost. Bleeding time was slightly prolonged and ex vivo
      platelet aggregation was slightly depressed by beraprost and aspirin. Systemic
      blood pressure was lowered with higher doses of beraprost. Beraprost sustained
      coronary reperfusion time and recanalization duration at the higher doses with an
      optimal level, but could not eliminate reocclusion completely.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8463005
TI  - Right aortic arch with aberrant retroesophageal innominate artery: a report of 2
      cases and review of the literature.
AB  - We describe two patients of right aortic arch associated with aberrant
      retroesophageal innominate artery. One case was associated with tetralogy of
      Fallot and a tortuous left common carotid artery originating from the
      retroesophageal innominate artery. Tetralogy of Fallot associated with this kind
      of aortic arch anomaly has never before been reported. The other case was
      associated with a perimembranous ventricular septal defect. Symptoms such as
      dyspnea, dysphagia and recurrent respiratory infection due to the compression by
      the vascular anomaly were not noted in these two cases. The morphological
      findings are indicative of a double aortic arch with an interruption of the left
      arch proximal to the common carotid artery.

PMID- 8463006
TI  - Acute myocardial infarction treated with intravenous streptokinase: 6-year follow
      up.
AB  - Our objective was to investigate variables which, although occurring during the
      acute period, could influence the medium (1st year) and long-term (6th year)
      survival of infarcted patients. Of a total of 332 patients treated consecutively
      and prospectively according to the same protocol which included intravenous
      streptokinase, 305 survived the hospital phase and represent the study
      population. Mean patient age was 55.6 +/- 10 years and mean follow-up time was
      3.33 years, with 1008.59 patient-years. The clinical course of the group was
      analyzed according to the following variables: left ventricle ejection fraction,
      hypotension per/peri streptokinase infusion, CK-MB peak, previous myocardial
      infarction, number of obstructed coronaries, reinfarction, sex, 'definitive'
      treatment, residual obstruction, age, pain/streptokinase infusion interval,
      patency of the 'culprit' coronary and infarct location. Overall, patient survival
      was 93.8 +/- 1.4% during the 1st year and 83.7 +/- 2.6% at the 6th. The following
      groups showed significantly different (log-rank) survivals: (a) 1st year: 94.6%
      for absence and 82.6% for presence of reinfarction (P = 0.0451); 97.9% for
      inferior and 91.4% for anterior infarct location (P = 0.044); 96.4% for ejection
      fraction > 50% and 90.6% for ejection fraction < or = 50% (P = 0.0187); 96.5% for
      angioplasty/surgery and 90.1% for clinical treatment (P = 0.0028); 95.5% for
      absence and 80.6% for presence of previous infarct (P = 0.0001). (b) 6th year:
      88.3% for ejection fraction > 50% and 73.9% for ejection fraction < or = 50% (P =
      0.028); 87.4% for < or = 65 and 66.4% for > 65 years (P = 0.0114); 89.6% for
      aggressive and 76.8% for conservative treatment (P = 0.013); 86.6% for absence
      and 60.7% for presence of previous infarct (P = 0.0009).

PMID- 8463007
TI  - Functional significance of coronary collateral vessels in patients with previous
      'Q' wave infarction: relation to aneurysm, left ventricular end diastolic
      pressure and ejection fraction.
AB  - The importance of coronary collateral circulation in relation to the left
      ventricular function, aneurysm formation and size was investigated in 100
      patients with previous 'Q' wave myocardial infarction who underwent coronary
      angiography. Aneurysms were present in 20% of patients. The majority of these
      (80%) patients had severe or total occlusion of the left anterior descending
      artery. Thirty four percent of patients without aneurysm had significant
      collaterals whereas 25% of patients with aneurysms had collaterals (P > 0.05).
      However, the size of the aneurysm was smaller when adequate collateral
      circulation was present (Collateral Index 2 or above). The incidence of
      hypertension and diabetes was similar in both groups. Collateral circulation was
      more frequently seen in the anterior (60%) as compared to inferior myocardial
      infarction (40%), but Collateral Index was higher in right coronary artery
      disease. The number of patients with an elevated left ventricular end-diastolic
      pressure (> 12) or poor ejection fraction was similar in the two groups with and
      without collaterals. Thus, there was no beneficial effect of collateral
      circulation on left ventricular function. The incidence of aneurysm was not
      significantly lower, although the size of the aneurysm was significantly smaller
      in the presence of collateral circulation.

PMID- 8463008
TI  - Atrio-ventricular regurgitations in constrictive pericarditis: incidence and post
      operative outcome.
AB  - We studied 33 surgically proven cases of constrictive pericarditis during the
      period 1989-1991 by color Doppler echocardiography and angiography to look for
      incidence and postoperative outcome of atrioventricular regurgitation. The mean
      age was 27.2 + 16.5 years (21 males, 12 females). There was a very high incidence
      of mitral (79%, trivial in 13, mild in 11 and moderate in 2) and tricuspid (73%,
      trivial in 7, mild and moderate in 6 each and severe in 5) regurgitation. There
      was good correlation between 'color Doppler' and angiography for detection and
      quantification of these regurgitations (r = 0.89 for mitral and 0.76 for
      tricuspid regurgitation, respectively). There were no preoperative clinical or
      hemodynamic predictors for the incidence or severity of these regurgitations.
      Immediate postoperative (7-10 days) evaluation by color Doppler did not show any
      change in these regurgitations. A follow-up study (by color Doppler and
      angiography) in 18 patients at a mean period of 229 + 105 days revealed
      regression of these regurgitations by at least 1 grade in 50% of patients.
      Patients with persisting regurgitations had persisting hemodynamic abnormality
      and relatively longer duration of symptoms. The presence of atrio-ventricular
      regurgitations should not be taken as evidence favoring diagnosis of restrictive
      cardiomyopathy and against that of constrictive pericarditis. The mechanism of
      these regurgitations is not clear to us.

PMID- 8463009
TI  - Occlusive arterial disease of the hand due to repetitive blunt trauma: a review
      with illustrative cases.
AB  - OBJECTIVE: to increase clinical awareness of the role of repetitive blunt trauma,
      often occupational, in the development of occlusive arterial disease of the hand.
      STUDY DESIGN: illustrative cases are presented to emphasize the varied etiology
      and clinical features of occlusive arterial disease of the hand resulting from
      repetitive blunt trauma and an historical review of the literature is presented.
      RESULTS: Occlusive arterial disease of the hand due to repetitive blunt trauma is
      a common but often preventable disorder. The superficial location of many of the
      arteries of the hands and digits plus their close proximity to the bones of the
      hand makes them uniquely susceptible to injury from repetitive blunt trauma. An
      ever increasing number of occupations and leisure activities have been causally
      related to occlusive arterial disease of the hand. The diagnosis of occupational
      occlusive arterial disease due to blunt trauma is suggested by eliciting a
      history of repetitive blunt trauma to the hand in a patient with symptoms and/or
      signs of digital ischemia. The dominant hand is most commonly involved, but the
      non-dominant hand or both hands are affected in certain occupations. Possible
      predisposing or aggravating factors include tobacco use and working in a cold
      environment. The diagnosis of occlusive arterial disease confined to the hand or
      digits is confirmed by non-invasive studies in the vascular laboratory and
      demonstrated by arteriography. Conservative measures and protection of the hand
      from further trauma is sufficient for most patients, with surgical therapy being
      reserved for patients refractory to medical therapy or those with more severe
      ischemia. CONCLUSION: occlusive arterial disease of the hand may be more common
      than formerly thought and is often preventable by the proper use of hand tools or
      instruments and hand protection. This is another type of occlusive arterial
      disease in which tobacco may be a predisposing or aggravating factor.

PMID- 8463010
TI  - Late onset atrioventricular nodal tachycardia.
AB  - AV nodal tachycardia may present at any age, but onset in late adulthood is
      considered uncommon. To evaluate whether onset of AV nodal tachycardias at older
      age is related to organic heart disease (possibly setting the stage for re-entry
      due to degenerative structural changes) 32 consecutive patients with symptomatic
      AV nodal tachycardia were studied. The age at onset of attacks showed a bimodal
      pattern, with 2 peaks: one between 15 and 35 years (22 patients) and one around
      55 years (10 patients). Significantly more older patients had an underlying heart
      disease (60% versus 14%, P < 0.01), with coronary artery disease in 4 and
      hypertensive heart disease in 3. Frequent supraventricular ectopic activity was
      seen during baseline 24-h ambulatory monitoring in all the older patients, versus
      in only half of the younger patients (P = 0.005). These results indicate that
      late onset AV nodal tachycardia (i.e. > age 45 years) is not infrequent (33%).
      The frequent supraventricular arrhythmias on one hand and age-related structural
      AV nodal changes, potentially enhanced by underlying heart disease on the other,
      both may contribute to the development of late onset re-entrant AV nodal
      tachycardia.

PMID- 8463011
TI  - Carotid sinus hypersensitivity abolished by aminophylline.
AB  - A 56-year-old patient with syncope due to carotid sinus hypersensitivity is
      presented. Carotid massage-induced sinus arrest was completely abolished by
      intravenous aminophylline.

PMID- 8463012
TI  - Incidence of atrioventricular block and chronic atrial flutter/fibrillation after
      implantation of atrial pacemakers; follow-up of more than ten years.
AB  - The incidence of atrioventricular (AV) block and chronic atrial
      flutter/fibrillation was determined in 41 patients, mean age 62.2 years (22 to 88
      years) who received atrial pacemakers before October 1980. The mean follow-up
      period was 12.3 years, range 11-14.4 years. Twenty-five patients suffered from
      bradycardia-tachycardia syndrome, 13 symptomatic bradycardia, and 3 bradycardia
      related ventricular tachycardia. At follow-up: 18 patients (44%) had permanent I
      AV block; 11 patients had II-AV block, 9 patients (22%) transient Wenckebach
      block and 2 patients (5%) transient Mobitz block, all asymptomatic. The
      cumulative incidence of III-AV block was 1 (2.5%). Chronic atrial
      flutter/fibrillation occurred in 6 patients (15%), 5 were not pacemaker
      dependent; 1 received a ventricular pacemaker. Seventeen patients died after a
      mean of 7 years (0.6-12.2 years). Cumulative survival rate of 58% for 14.4 years,
      did not differ from a matched cohort of the normal population. There were no
      pacemaker related deaths. We conclude that long-term atrial pacing was safe and
      effective. The incidence of III-AV block and chronic atrial flutter/fibrillation
      was low.

PMID- 8463013
TI  - Longitudinal transgastric echocardiographic views utilizing a single-plane probe:
      anatomic correlations and clinical applications.
AB  - In order to widen the diagnostic capability of single-plane transesophageal
      echocardiography, which has been so far confined to transverse imaging planes, we
      obtained four transgastric longitudinal echocardiographic views which have not
      been previously described. These views can image structures such as superior and
      inferior vena cava, the right ventricular inflow and outflow tract, the mitral
      apparatus and the ascending aorta, which are poorly visualized by transesophageal
      transverse single-plane echocardiography. Among 400 consecutive patients these
      scans gave relevant additional diagnostic information in 62 cases (15.5%) and
      provided the correct diagnosis in 37 (9.2%). There were no complications related
      to the longer gastric manipulation of the probe and the quality of the images was
      high. We conclude that longitudinal echotomographic scanning of the heart is not
      exclusively confined to the use of biplane or omniplane probes, but longitudinal
      views can be consistently obtained with a single-plane instrument.

PMID- 8463014
TI  - Long-term echocardiographic evaluation of closed and open mitral valvulotomy.
AB  - From 1968 to 1989, 280 patients with post-rheumatic pure mitral stenosis
      underwent surgical commissurotomy; 134 a closed and 146 an open technique. Follow
      up exceeded 15 years in 56.7% of the patients. Echocardiographic analysis was
      performed in 120 patients and disclosed a larger mitral valve area in patients
      who underwent open valvulotomy (1.9 +/- 0.5 cm2 vs. 1.5 +/- 0.4 cm2 for the
      closed technique, P < 0.0002). On the other hand, considering the occurrence of
      post-surgical mitral regurgitation at a level greater than, or equal to moderate,
      open valvulotomy produced less favorable results (18.5% vs. 5% for the closed
      technique, P < 0.01).

PMID- 8463015
TI  - Balloon dilatation of a bioprosthetic pulmonary valve.
AB  - A 37-year-old man with stenosis of a bioprosthetic pulmonary valve underwent
      percutaneous balloon valvoplasty. After the procedure the patient had moderate
      pulmonary regurgitation which has been well tolerated. The patient remains well
      with good functional capacity on follow-up at 2 years. Percutaneous balloon
      dilatation may be effective as a palliative procedure in the management of
      stenosis of a bioprosthetic valve in the pulmonary position.

PMID- 8463016
TI  - Anomalous origin of the left pulmonary artery from the aorta in an adult as an
      isolated anomaly: a case report.
AB  - The rare occurrence of anomalous origin of the left pulmonary artery in an adult
      as an isolated malformation and normal pressures in the pulmonary artery arising
      from the right ventricle are described. The possible implications of surgery are
      also discussed.

PMID- 8463017
TI  - Apical hypertrophic cardiomyopathy presenting as acute subendocardial myocardial
      infarction.
AB  - Two patients with apical hypertrophic cardiomyopathy presented with angina at
      rest and giant inverted T waves in precordial leads on the electrocardiogram. At
      cardiac catheterisation one patient had mild coronary artery disease, the other
      had normal coronary arteries. In both, there was a systolic pressure gradient
      between the apex and main left ventricular cavity exceeding 100 mmHg. The
      presence of rest angina with the electrocardiographic findings lead to a
      mistaken, initial diagnosis of acute subendocardial myocardial infarction.

PMID- 8463018
TI  - Garlic--the other side of the coin.

PMID- 8463019
TI  - Alcohol, tobacco, and father's aggressive behavior in relation to socioeconomic
      variables in Cretan low versus medium income families.
AB  - In order to identify socioeconomic factors affecting parents' alcohol and
      cigarette consumption and father's aggressiveness toward other family members, 87
      low-income and 92 medium-income Greek families were tested. Father's alcohol
      consumption correlated positively with his smoking (p < .0008) and aggressive
      behavior (p < .00005), while mother's alcohol correlated positively with her
      smoking (p < .0001) and number of marriages (p < .01), and negatively with the
      family's overcrowding index (p < .006). Furthermore, father's smoking correlated
      positively with his alcohol (p < .01), and mother's smoking with her alcohol (p <
      .0004) and tenancy (p < .01). Finally, father's aggressiveness was found to be
      positively related to his alcohol consumption and negatively to his work and
      level of education.

PMID- 8463020
TI  - Methodological issues in surveying older persons concerning drug use.
AB  - Despite beliefs that surveys involving older persons are less valid than those
      with other groups (due to memory loss, etc.), empirical verifications do not
      support this. Certain factors related to reduced validity must be considered
      (e.g., little education) and the confounding factors of cohort and time of
      measurement must be evaluated. Persons presumably suffering from dementia and
      institutional residents may be needlessly excluded. Methods suggested for
      improving validity include: sampling techniques, proxy respondents,
      administration and instrumentation, and interviewer variables. It is important to
      cross-validate data from surveys by using several concurrent methods. Instruments
      developed with younger subjects may be inappropriate or invalid with elders.

PMID- 8463021
TI  - Vulnerabilities and cultural change: drug use among Puerto Rican adolescents in
      the United States.
AB  - The investigations examined drug usage-based and culture-based differences in
      young Puerto Ricans living in New York (100 nonusers and 192 drug users),
      Americans living in New York (100 nonusers and 99 drug users), and Puerto Ricans
      living in Puerto Rico (100 nonusers and 98 drug users). The Associative Group
      Analysis method was used to measure cultural change in three dimensions: dominant
      perceptions, priorities, and evaluations. The findings show that the Puerto Rican
      drug user and nonuser groups in New York differed significantly in their paths of
      acculturation. The nonusers were shown to progress successfully in learning
      American meanings and adopting American perspectives and cultural norms. The drug
      users were attracted to dominant American priorities (e.g., wealth and freedom)
      but showed little progress in adopting deeper American cultural meanings
      necessary for effective coping.

PMID- 8463022
TI  - Alcohol consumption, low birth weight, and preterm delivery in the National
      Addiction Survey (Mexico).
AB  - In 1988 the Mexican General Directorate of Epidemiology and the Mexican Institute
      of Psychiatry carried out the first National Addiction Survey that provided
      prevalence estimates at national and regional levels of alcohol consumption,
      tobacco smoking, and several other drugs use. In addition, a questionnaire
      included questions regarding alcohol consumption during pregnancy and adverse
      outcomes. According to the results of logistic regression, women classified as
      suffering from Alcohol Dependence Syndrome had a very high risk of low birth
      weight and/or preterm delivery: Odds ratio = 12.1 with a 95% confidence interval
      of (1.3, 108.9) and p = .026. After controlling for several confounding
      variables, the findings remained basically the same.

PMID- 8463023
TI  - Lay beliefs about the causes and consequences of smoking cessation maintenance.
AB  - Descriptive research has corroborated the Relapse Prevention (RP) model of
      smoking relapse, but RP interventions have been generally ineffective. This
      discrepancy might arise from disagreement between the theory and ex-smokers'
      beliefs about what determines successful maintenance. We therefore asked 100
      recent ex-smokers why they believed they would (or would not) be able to abstain
      for the following year, and what benefits they anticipated if they did. Modal
      responses were that personal attributes (e.g., willpower) would determine
      maintenance and that improved physical health would be its most important result.
      Twelve-month continuous abstinence was more common among those anticipating
      improved feelings of psychological or physical well-being than among those
      anticipating a reduction in problems or a diffuse health benefit.

PMID- 8463024
TI  - Interpersonal influences in college students' initial use of alcohol and drugs-
      the role of friends, self, parents, doctors, and dealers.
AB  - The use of alcohol and drugs by 1,711 college students was surveyed anonymously,
      with a special interest in determining the sources of influence that led them to
      the initial use of different substances. Depending on the chemical, friends,
      parents, the person himself or herself, and doctors were named as the initial
      introducers. Drug dealers, by contrast, were named rarely and only in connection
      with a few hard drugs. Factors influencing drug use are discussed, and
      suggestions for prevention and treatment are made.

PMID- 8463025
TI  - Neuromuscular fatigue and recovery in male and female athletes during heavy
      resistance exercise.
AB  - To examine neuromuscular fatigue and recovery ten male and nine female athletes
      performed a strenuous heavy resistance exercise protocol. The subjects strained
      their leg extensor muscles with the same maximal relative intensity by performing
      one maximal squat-lift with a load of 100% of 1 RM (one repetition maximum) 20
      times (20 x 1 x 100%). Maximal voluntary neural activation (integrated EMG),
      maximal bilateral isometric force, force-time and relaxation-time curves of the
      leg extensor muscles were measured before and immediately after the exercise
      session as well as after resting for 1 hour, 2 hours, 1 day and 2 days. The
      session resulted in considerable gradual decreases in maximal force in the males
      by 24.1 +/- 14.4% (p < 0.001) and in the females by 20.5 +/- 11.8% (p < 0.01) as
      recorded immediately after the session. Significant (p < 0.05-0.01) decreases
      also took place in the males in the maximal IEMGs of the exercised muscles, while
      the corresponding decreases in the females were minor. The force-time curve
      shifted greatly to the right both in the males (p < 0.001) and in the females (p
      < 0.01) but the average change of 27.8 +/- 13.8% in the males was greater (p <
      0.05) than that of 18.7 +/- 8.3% recorded for the females. The time of force
      relaxation lengthened (p < 0.05) in both groups. Maximal force recovered during
      the first hour of rest was more (p < 0.05) in the females than in the males but
      thereafter the recovery took place gradually in both groups to the same
      degree.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463026
TI  - Cardiorespiratory responses to exercise training in septuagenarian women.
AB  - Cardiorespiratory responses to a 12wk moderate exercise training program were
      examined in 30 sedentary elderly women (mean age = 73.6 +/- 0.7 yr). In addition,
      12 highly conditioned (HC) older women (mean age = 72.5 +/- 1.8 yr; 11.2 +/- 1.2
      yr training; 1.6 +/- 0.2 hr.d-1 aerobic activity) were tested at baseline for
      cross-sectional comparisons. The VO2max and VEmax of the HC subjects were 67% and
      36% higher, respectively, (p < 0.001) than the combined sedentary subjects at
      baseline. Sedentary subjects were randomly assigned to a walking (WALK) or
      calisthenics control (CAL) group. The WALK group exercised 5 d.wk-1 for 30-40 min
      per session at 60.0 +/- 1.9% heart rate reserve while the CAL group engaged in
      mild musculoskeletal exercise. The WALK group demonstrated significant
      improvement in VO2max compared to CAL subjects at 12 wk (12.6% vs 2.2%, F = 5.74,
      p = 0.005). These data show that septuagenarian women demonstrate significant
      improvement in maximal cardiorespiratory fitness through moderate exercise
      training.

PMID- 8463027
TI  - Maximal aerobic power in cycle ergometry in middle-aged men and women, active in
      sports, in relation to age and physical activity.
AB  - Reliable standards of maximal power output in middle-aged and physically active
      men and women are desirable in sports-medical practice. For this purpose maximal
      cycle ergometer tests were evaluated in 2038 men and 898 women over 40 years of
      age (46.8 +/- 6.1 years (mean +/- SD) and 47.5 +/- 6.6 years), who volunteered in
      a sports-medical check-up and all of whom were active in sports for at least
      three months in the year preceding the screening (4.3 +/- 3.1 hours/week
      respectively 3.6 +/- 2.5 hours/week). The range of maximal values for power
      output (Wmax), heart rate (HRmax), systolic blood pressure (SBPmax) and peak
      plasma lactate concentrations (PPLa) during progressive cycle ergometer testing
      are presented for males and females who were divided into groups with a 5-years
      age difference. Wmax varied with sex (male = 1, female = 0), age (year) and
      height (cm); Wmax = 65.3 x (sex) + 2.0 x (height) -1.9 x (age) - 67.9 (See =
      38.2; r = 0.76). The weighing of different factors that influence performance was
      also studied by multiple regression analysis to provide improved precision in
      standards used to interpret exercise tests. In both men and women about half of
      the variation of Wmax could be explained by the independent variables age, body
      mass, body fat, smoking habits, vital capacity, heart rate, and physical activity
      parameters. It is concluded that active involvement in endurance sports and/or
      the use of the bicycle for transport, contributed substantially to cardiovascular
      fitness in healthy, middle-aged men and women.

PMID- 8463028
TI  - Physiological comparison of roller skating, treadmill running and ergometer
      cycling.
AB  - This study was undertaken to determine the metabolic and cardiorespiratory
      differences between treadmill running, ergometer cycling and roller skating in
      top level roller skaters. The subjects performed 3 discontinuous graded tests
      until exhaustion. The protocol was established so that heart rate kinetics during
      exercise were similar in all the tests. Maximal oxygen uptake (VO2max), maximal
      heart rate and exercise time to exhaustion were higher during running (p < 0.05)
      than during cycling. Blood lactate during submaximal and maximal running exercise
      was significantly lower (p < 0.05) than during cycling or roller skating. There
      were no differences between cycling and roller skating in any of the variables
      studied. These results seem to suggest that, compared with running, VO2max during
      cycling is limited more by local muscle fatigue than by cardiac factors. The
      similar response found during roller skating and cycling supports the concept
      that cycloergometer testing is a valid simple laboratory test for testing
      physical fitness in top level roller skaters.

PMID- 8463029
TI  - Reduction of postprandial lipemia after acute exposure to high altitude hypoxia.
AB  - The effects of acute exposure to high altitude hypoxia upon plasma levels of
      lipids and lipoproteins were studied in 6 healthy subjects observed under strict
      dietary control. Fasting and postprandial values, first measured at low altitude
      (< 300 m), were compared to values measured 7 days after transfer by helicopter
      to the Observatoire Vallot (4350 m) near Mont-Blanc. Plasma levels of
      catecholamines and thyroid hormones were measured in parallel. Under normoxic
      conditions, a rise in plasma levels of cholesterol, triglycerides and
      phospholipids was found 4 hr after the test-meal, whereas circulating
      norepinephrine fell. Under hypoxic conditions, postprandial effects on lipid
      parameters disappeared, lipemic responses to the test-meal were dramatically
      reduced and plasma levels of norepinephrine increased. These effects were
      accompanied by a fall in triglyceride-rich lipoproteins, generally associated
      with a slight elevation of HDL-cholesterol, especially the less dense HDL2
      fraction. When all results obtained in normoxic and hypoxic conditions were
      analyzed together, a series of highly significant correlations were found between
      the magnitude of postprandial lipidemia and various lipid parameters, in
      particular HDL2-cholesterol which was negatively correlated. These observations
      strongly suggest that high altitude hypoxia, independent of interfering variables
      such as exercise training or cold exposure, induced a net stimulation of the
      lipolysis of plasma triglycerides.

PMID- 8463030
TI  - The effect of chronic and acute exercise on immunity in rats.
AB  - The effects of exercise training and acute exercise on the immune system were
      investigated in rats. For chronic exercise training, the rats ran on a drum
      exerciser at the intensity of about 60-70% of maximal oxygen consumption (VO2max)
      for 30 min and then extended up to 60 min per day, 5 days per week for 10 weeks.
      The rats were at rest for 3 days before sacrifice. The mitogenic activity of
      spleen lymphocytes to concanavalin A (Con A) and staphylococcal enterotoxin B
      (SEB) decreased as compared to the sedentary control, while proliferative
      response to lipopolysaccharide (LPS) increased. The interleukin-2 (IL-2)
      production in the training group was reduced. The immunomodulatory effect after
      acute exercise has also been investigated and it showed profound enhancement of
      cell proliferation to Con A, SEB and LPS in mild (50% VO2max for 10 min) and
      moderate (70% VO2max for 10 min) exercise groups. The enhancing activity was less
      prominent after severe exercise (> 75%) VO2max until exhaustion). The IL2
      production increased in all of these acute exercise groups. Nevertheless, there
      was no significant variation between exercise and control groups in the cell
      number per spleen and the percentages of various lymphocyte populations, i.e.,
      total T, CD4+, CD8+ and IL-2R+ T cells as well as B cells. In summary, this study
      indicates that chronic exercise training may cause the reduction of T cell
      activity while acute exercise manifests an enhancing effect. However, B cell
      proliferation was elevated in both chronic and acute exercise groups.

PMID- 8463031
TI  - The associations between family history of coronary heart disease, physical
      activity, dietary intake and body size.
AB  - Physical activity has been associated with coronary heart disease (CHD) as well
      as several CHD risk factors. In this study, we examine the association of a
      positive family history of CHD and physical activity on dietary intake and body
      size indicators among 891 healthy young adults (18 to 39 years of age) and 471
      older adults (40 to 83) observed between 1980 and 1986. Participants reported the
      number of times per week they walked and/or jogged one mile, biked three miles,
      participated in sports, or performed other intense activities. Older men with a
      family history of CHD reported more physical activity than men without a family
      history of CHD (60% compared to 28.6%; p = 0.002). Younger women without a family
      history of CHD reported more physical activity than women with a family history
      of CHD (30.2% compared to 15.9%; p = 0.004). Fruit and vegetable intake increased
      with increasing levels of physical activity in younger adults. The only dietary
      association with family history was higher levels of fatty foods reported among
      older women with a family history versus those without a family history (p =
      0.03). Young women with a family history of CHD were more likely to have higher
      BMI levels at all levels of physical activity and a higher percent of their ideal
      body weight per unit of physical activity (p = 0.01). For instance, young women
      who were most active with a family history of CHD were at 115% of their ideal
      body weight, while those without a family history were at 110.2% of their ideal
      body weight. There were no significant interactions between physical activity and
      CHD family history in this population. These findings suggest that family history
      of CHD alone may not be adequate to stimulate one to adopt a more healthy
      lifestyle.

PMID- 8463032
TI  - Embryologic clues to human yolk sac tumors: a review.
AB  - Morphological similarities and differences in the developmental structure of the
      human yolk sac and human yolk sac tumors (HYSTs) are reviewed to determine the
      histogenesis of the currently recognized multiple tumoral patterns. Although many
      equivalent histochemical markers, secretory hyaline globules, and hemopoiesis
      occur in both HYSTs and the secondary human yolk sac (SHYS), few similarities are
      found in their comparative morphology. For example, HYSTs do not reproduce the
      characteristic morphology of SHYS with its large, clear cells and endodermal and
      intracellular tubules; basement membrane is abundant in tumors but only an
      inapparent and temporary structure in the SHYS; no Schiller-Duval sinuses are
      found in either primary or secondary human yolk sacs, and the plentiful
      mesenchymal (mesoblastic) components of tumors are absent in the SHYS except for
      the collagenous connective tissue that occurs during regression. Unlike the SHYS,
      which is a terminal structure incapable of polydifferentiation and only rarely
      develops any somatic structures, HYSTs frequently differentiate tissues of
      endodermal origin such as intestine, liver, and even lung. The primary human yolk
      sac is capable of multiple differentiation, both endodermal and possibly
      mesenchymal, as well as its ultimate differentiation into the SHYS with its
      characteristic endodermal markers. Thus, it seems more appropriate to correlate
      the comparative morphology of HYSTs with the primary human yolk sac, rather than
      the SHYS, and, in the light of this, reconsider their classification as
      extraembryonally differentiated tumors.

PMID- 8463033
TI  - Tumor-like lesions of the ovary associated with pregnancy.
AB  - Six nonneoplastic ovarian lesions (or alterations) are associated with pregnancy
      or the puerperium, each of which can simulate a neoplasm on clinical, gross, or
      microscopic examination. These lesions include pregnancy luteoma, hyperreactio
      luteinalis, large solitary luteinized follicle cyst of pregnancy and puerperium,
      intrafollicular granulosa cell proliferations, hilus cell hyperplasia, and
      ectopic decidua. Because these lesions involute spontaneously after termination
      of pregnancy or are adequately treated by a conservative surgical approach,
      unnecessarily radical operations can be avoided if the correct diagnosis is made
      by the pathologist.

PMID- 8463034
TI  - Differential diagnosis of peritoneal lesions of mullerian type and similar
      epithelial tumors of the peritoneum.
AB  - The female peritoneum is the site of various tumor-like and tumorous lesions that
      resemble derivatives of the primary mullerian system. Those lesions can therefore
      be summarized under the term secondary mullerian system. These lesions can cause
      problems in macroscopic and microscopic examination if clinicians or pathologists
      are not acquainted with them. The relationship between the derivatives of the
      embryonal mullerian duct and the secondary mullerian system is underscored by the
      expression of many different antigens, as revealed by immunohistology.

PMID- 8463035
TI  - The behavior of serous tumors of low malignant potential: are they ever
      malignant?
AB  - Although the literature describing the clinicopathologic features of serous
      borderline or low malignant potential (LMP) tumors of the ovary is extensive, the
      behavior of these neoplasms is not well understood. While some studies indicate a
      30 to 40% mortality for advanced stage tumors, it is not clear whether this poor
      outcome is related to "benign" complications of the disease, such as bowel
      obstruction from adhesions, or to development of carcinomatosis from malignant
      transformation. In an effort to determine more clearly the cause of death of
      patients with serous LMP tumors and to assess the malignant potential of these
      tumors, defined by progression to invasive serous carcinoma, we reviewed 22
      series, totalling 953 patients. Analysis of these studies reveals that for
      patients with stage I tumors, survival is 99%. For advanced stage disease,
      survival is 92%. Advanced-stage tumors associated with so-called invasive
      implants were excluded from this analysis because they were considered invasive
      serous carcinomas at the time of diagnosis rather than noninvasive LMP tumors.
      Various causes of death in patients with advanced-stage tumors include
      complications of the disease, complications of therapy, and, rarely, malignant
      transformation. Our review of 953 cases disclosed only seven (0.7%) tumors that
      appeared to have undergone malignant transformation, resulting in death from
      intraabdominal carcinomatosis. Because the rate of malignant transformation is
      exceedingly low and because classifying these tumors as malignant often leads to
      unnecessary treatment, we believe that the term low malignant potential or
      borderline tumor is not justified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463036
TI  - Ovarian Brenner tumors and transitional cell carcinoma: recent developments.
AB  - Brenner tumor variants--such as metaplastic, proliferating, and low-malignant
      potential (three categories recently designated as intermediate Brenner tumors)-
      and malignant Brenner tumors are unusual tumors presenting problems in
      classification. DNA ploidy and S-phase reflect the intermediate status of
      metaplastic, proliferating, and low-malignant-potential Brenner tumors. The
      category of "transitional cell carcinoma of the ovary" has been proposed for
      those primary ovarian carcinomas in which definite urothelial features are
      present, but no benign, metaplastic, and/or proliferating Brenner tumor is
      identified. Two subtypes have been described, the papillary and the malignant
      Brenner-like types. These tumors are more aggressive than malignant Brenner
      tumors, but they appear to respond better to chemotherapy than other types of
      ovarian epithelial cancer.

PMID- 8463037
TI  - Proliferative endometrioid tumors and endometrioid tumors of low malignant
      potential of the ovary.
AB  - Endometrioid epithelial tumors occur as adenofibromas, proliferative endometrioid
      tumors, endometrioid tumors of low malignant potential, and endometrioid
      carcinoma. Criteria for each category are given. Proliferative endometrioid
      tumors are benign, and the low-malignant-potential ones seldom, if ever,
      metastasize; they should not be designated carcinomas or regarded as malignant.
      However, invasive carcinoma may arise in both, and both may be associated with a
      similar tumor outside ovary, the latter a result of either a second primary
      neoplasm or rupture of the primary ovarian tumor. Endometrioid tumors of low
      malignant potential do not need a staging procedure. Their behavior is more akin
      to that of Brenner and mucinous tumors of low malignant potential than to that of
      serous tumors of low malignant potential. Vague terms such as "malignant
      adenofibroma" and "borderline endometrioid tumor" have been attached to a variety
      of intermediate endometrioid neoplasms and should be dropped in favor of more
      specific designations defined by semiquantitative criteria.

PMID- 8463038
TI  - Sertoli-Leydig cell tumors of the ovary: review with emphasis on historical
      aspects and unusual variants.
AB  - Among the many contributions to gynecological pathology of Dr. Robert Meyer were
      his observations on Sertoli-Leydig cell tumors and the formulation of a
      classification of them that is the basis of the one used today. Selected variants
      in this category of tumors are reviewed here. Sertoli cell tumors are of interest
      clinically because, in contrast to other tumors in this category, they tend to be
      estrogenic rather than androgenic. They are important for the pathologist to be
      aware of, because other neoplasms of diverse types may mimic them. Heterologous
      Sertoli-Leydig cell tumors are noteworthy; since they may feature mucinous
      epithelium, carcinoid, skeletal muscle, and/or cartilage, they may present a
      confusing histologic picture that could result in a misdiagnosis. Similarly, the
      recently recognized retiform variant of Sertoli-Leydig cell tumor is apt to be
      misdiagnosed because its pattern of slit-like glandular spaces and papillae is
      often confused with tumors in the common epithelial category. These retiform
      lesions are also less often androgenic than are other Sertoli-Leydig cell tumors.
      Finally, neoplasms with bizarre nuclei and tumors that occur in pregnancy, which
      often have prominent intercellular edema, are briefly discussed.

PMID- 8463039
TI  - Pathology of early malignant change in the ovary.
AB  - Our scanty knowledge of the pathology of early malignant change in the ovary is
      reviewed. The concept of ovarian intraepithelial neoplasia is discussed, and the
      malignant potential of ovarian cystadenomas is considered. The question of overt
      malignant change in tumors of borderline malignancy is reviewed. It is concluded
      that any advance in our understanding and our knowledge of the early stages of
      malignant change in the ovary will only come from the use of newer techniques
      that allow a more sophisticated approach than that allowed by purely
      morphological methods.

PMID- 8463040
TI  - Prognostic markers in epithelial ovarian cancer.
AB  - Useful prognostic markers are available in certain areas of clinical management
      of epithelial ovarian tumors. CA125 and the flow cytometric determinants of DNA
      index and S-phase fraction are of obvious value in evaluating the outlook of
      patients particularly in stage II and more advanced cases as well as in the
      follow-up for recurrent disease. Combinations of other serological markers with
      CA125 add to the usefulness and may increase the proportion of stage I cases
      scoring positive with these tests. At the moment, none of the molecular
      biological markers associated with the oncogen and growth-suppressor gene
      derangement pathways can be used as candidates for screening markers. Development
      in this area is very rapid, however, and with increasing understanding of such
      key conceptual questions as the biological nature of the ovarian borderline
      tumors, more accurate prognostic markers will emerge.

PMID- 8463041
TI  - Diagnosis of endocrinally active ovarian tumors.
AB  - The preoperative localization of small occult ovarian or adrenal androgen
      secreting tumors is difficult. Selective sampling of glandular effluent by
      retrograde venous catheterization constitutes a reliable combined radiographic
      endocrine approach. Steroid gradients between peripheral and organ vein levels
      are suspicious of a tumor especially when the testosterone gradient is elevated,
      e.g. more than 2.7 ng/ml between ovarian and peripheral venous blood. Therefore,
      selective catheterization is currently the most sensitive method for detection of
      androgen-secreting tumors smaller than 1 cm in diameter.

PMID- 8463042
TI  - Histomorphometry of normal and abnormal endometrial samples.
AB  - One hundred forty samples of normal and pathological endometrium were examined
      morphometrically in order to achieve a discriminant function among normal and
      pathological diagnoses. Samples of proliferative and secretory normal
      endometrium, simple and atypical hyperplasia, and well-differentiated
      adenocarcinoma were included in this study. Morphometrical and stereological
      characteristics for both glands and lumina as well as epithelium were registered.
      Stepwise discriminant analysis was performed. There is an increase in size of
      glands from proliferative endometrium to well-differentiated adenocarcinoma. The
      stereological measurements parallel morphometrical measurements. The accuracy of
      diagnosis by morphometrical and stereological means were 91% when the normal
      group (proliferative and secretory phase) were included. Accuracy increases to
      95% when only three pathological groups were used; only one simple hyperplasia
      and one well-differentiated adenocarcinoma were incorrectly diagnosed. In all
      functions, the volume density of epithelium was selected. The reproducibility on
      a new data set demonstrates an efficiency of 92, 87, and 100% for three
      discriminant analyses (five, four, and three diagnostic groups, respectively).

PMID- 8463043
TI  - Immunocytochemical study of insulin-like growth factor I and insulin-like growth
      factor I receptor in human endometrium during the normal menstrual cycle.
AB  - Our aims were to detect, using immunocytochemistry, IGFI and IGFI R in the human
      endometrium and to assess semiquantitatively their levels in the phases of the
      normal menstrual cycle. Twelve normal proliferative and 10 normal secretory
      endometrial samples were studied. Each specimen was subjected to an
      immunocytochemical peroxidase antiperoxidase protocol. The antibodies used to
      detect IGFI and IGFI R were, respectively, 3D1/2/1 and alpha 1R3. Analysis of
      variance (ANOVA) was performed to evaluate mean IGFI and IGFI R levels in the
      glandular epithelium and stroma of each sample while correcting for intra- and
      interobserver variation. These experiments show the presence of IGFI and IGFI R
      in human endometrium. There are significant variations in the IGFI and IGFI R
      levels from patient to patient within each cycle phase, and between glands and
      stroma within each sample. These findings highlight the importance of the use of
      in situ studies to clarify endometrial IGFI and IGFI R physiology.

PMID- 8463044
TI  - Natural history of cervical intraepithelial neoplasia: a critical review.
AB  - The literature dealing with the natural history of cervical intraepithelial
      neoplasia (CIN) since 1950 is reviewed, in particular from the viewpoint of
      regression, persistence, and progression. When stratified into the various grades
      of severity, the composite data indicate the approximate likelihood of regression
      of CIN 1 is 60%, persistence 30%, progression to CIN 3 10%, and progression to
      invasion 1%. The corresponding approximations for CIN 2 are 40%, 40%, 20%, and
      5%, respectively. The likelihood of CIN 3 regressing is 33% and progressing to
      invasion greater than 12%. It is obvious from the above figures that the
      probability of an atypical epithelium becoming invasive increases with the
      severity of the atypia, but does not occur in every case. Even the higher degrees
      of atypia may regress in a significant proportion of cases. As morphology by
      itself does not predict which lesion will progress or regress, future efforts
      should seek factors other than morphological to determine the prognosis in
      individual patients.

PMID- 8463045
TI  - Tribute to Robert Meyer.

PMID- 8463046
TI  - The evaluation of type I and type II beta-turn mixtures. Circular dichroism, NMR
      and molecular dynamics studies.
AB  - Circular dichroism (CD) and 1H-(1H)NOE spectra were obtained for Piv-Pro-Ser
      NHCH3 (1), [Piv-(CH3)3-C-CO], Boc-Pro-Ser-NHCH3 (2) and Boc-Val-Ser-NHCH3 (3), to
      determine the solution conformation of these beta-turn models. In the crystal, 1
      and 3 adopt an ideal type I beta-turn, while 2 is characterized by a semifolded
      backbone geometry incorporating a cis Boc-Pro tert-amide bond. The predominance
      of a beta-turn conformation in solution was suggested for models 1-3 on the basis
      of 1H-(1H)NOE data. In a nonpolar solvent the prevailing trans rotamer form (>
      80%) of 2 has a beta-turn conformation according to heteronuclear NOE
      measurement. Positive 1H-(1H)NOEs were detected between the H alpha(Pro)/NH(Ser),
      H alpha(Ser)/NH(Ser) and NH(NHCH3)/HN(Ser) protons in the trans Boc-Pro rotamer
      form of 2 at -20 degrees in CDCl3. Similar positive homonuclear NOE enhancements
      were also observed on the appropriate proton signals in other models, such as Boc
      Val-Ser-NHCH3 (3), Boc-Val-D-Ser-NHCH3 (4) and Boc-Pro-D-Ser-NHCH3 (5), in
      various solvents. The 1H-(1H)NOE experiments carried out in CD3CN clearly showed
      that besides the type I (or III) beta-turn structure, one of the main
      conformations of models 1-5 is close to the type II beta-turn backbone geometry
      in a nonpolar solvent. Unexpectedly, the conformational mixture of models 1-3
      were characterized by class C (helix-like) CD spectra, although class C spectra
      are generally only correlated with the type I beta-turn conformation. These
      acyclic models are the first carefully investigated examples of -L-L- triamide
      systems, containing a significant amount of a type II beta-turn, as well as the
      type I beta-turn and, however, yielding a class C circular dichroism spectra. The
      CD spectra recorded for 3 and 4 in acetonitrile were 'calibrated' using the 1H
      (1H)NOE data. Such a "calibration", as well as the semi-quantitative CD and NMR
      comprehensive analyses, demonstrated that class C, class B, as well as class C'
      CD spectra may be obtained from the linear combination of the same two-component
      spectra, with different conformational weights. Therefore, it is suggested that
      the extraction of the conformational components of such models, simply on the
      basis of their CD spectra, must be made with caution.

PMID- 8463047
TI  - Solid-phase peptide synthesis on proteins.
AB  - A new method for solid-phase peptide synthesis in which a protein is used as the
      solid support has been developed. Two aspects of the method have been
      demonstrated. The peptides H-Phe-Leu-Glu-Glu-Val-OH (1) and H-Leu-Leu-Ala-Gly-Val
      OH (2), respectively, were synthesized on the amino groups of BSA via a cleavable
      linker, using the Fmoc group protecting scheme. The free peptides were obtained
      by cleavage from the protein with 95% TFA, precipitation in diethyl ether and
      additional work-up by either dialysis or centrifugation through a membrane
      followed by gel filtration. The identity of the products was determined by amino
      acid analysis and HPLC. The peptide-protein conjugates, H-Ser-Met-Asp-Thr-Ser-Asn
      Lys-Glu-Glu-Lys-BSA (3) and H-Thr-Val-Leu-BTG (4), were obtained in the same
      manner, omitting the cleavable linker group. It was found that 35-50 peptide
      chains were conjugated per molecule BSA and BTG, respectively. Immunization of
      rabbits with conjugate 3 gave rise to peptide specific antibodies. This method
      will be useful for generation of sequence specific antibodies, since the peptide
      is conjugated to the carrier protein exclusively via its C-terminus, and will
      allow synthesis of highly specific peptide-protein conjugates.

PMID- 8463048
TI  - Comparison of GH-stimulation by GH-RH(1-29)NH2 and an agmatine29 GH-RH analog,
      after intravenous, subcutaneous and intranasal administration and after pulmonary
      inhalation in rats.
AB  - Many studies have shown that human GH-RH(1-29)NH2 possesses full intrinsic
      activity of GH-RH(1-44)NH2 in vitro and in vivo. This investigation was performed
      to evaluate the efficacy of GH-RH(1-29)NH2 given by different routes of
      administration in stimulating GH release in rats. In each case GH-RH(1-29)NH2 was
      administered intravenously, subcutaneously, intranasally and by pulmonary
      inhalation at two different doses to groups of seven males rats. At a dose of 150
      micrograms/kg GH-RH(1-29)NH2, the magnitude of GH response was significantly
      higher for the pulmonary inhalation group (355 +/- 33.2 ng GH/mL) than for the
      subcutaneous group (246 +/- 36 ng GH/mL) or for the intranasal group (175 +/- 30
      ng GH/mL). The group injected intravenously with GH-RH(1-29)NH2 at a dose of 2.5
      micrograms/kg showed the highest response, GH levels reaching 877.2 +/- 115
      ng/mL. A similar pattern of responses was obtained for the superactive GH-RH(1
      29) agmatine29 analog, MZ-3-149, at doses that were 50 times lower. Our results
      indicate a high bioavailability of GH-RH(1-29)NH2 or analog MZ-3-149 administered
      by a convenient pulmonary inhalation route. The GH-releasing effect of GH-RH(1
      29)NH2 or analog MZ-3-149 delivered by pulmonary inhalation is superior to
      subcutaneous and intranasal administration.

PMID- 8463049
TI  - Multiple column peptide synthesis, Part 2 (1, 2).
AB  - A manually operated apparatus for parallel multiple column soli-phase peptide
      synthesis is described. It employs Fmoc-amino acid-O-Dhbt or -Pfp esters in the
      continuous flow version of the polyamide method on small packed columns of
      kieselguhr supported resin in a reaction block of Teflon. The solvents and
      deprotecting reagents are dispensed from two washers in a parallel fashion and
      reagent consumption is low. Activated and protected amino acids are transferred
      from a dispenser tray as solutions, eight at a time. The use of the method is
      demonstrated by the synthesis of overlapping peptides from a protein structure
      and of analogous protease substrates. The products have been characterized by
      HPLC, FAB mass spectroscopy and amino acid analysis.

PMID- 8463050
TI  - Efficient solution phase synthesis and use of multiple O-phosphothreonyl
      containing peptides for calcium phosphate binding studies.
AB  - The protected phosphothreonine derivative Boc-Thr(PO3Ph2)-OH was prepared in high
      yield from Boc-Thr-OH by a simple three-step procedure which involved 4
      nitrobenzylcarboxyl protection, either phosphorotriester (diphenyl
      phosphorochloridate) or "phosphite-triester" (diphenyl N,N
      diethylphosphoramidite) phosphorylation of the threonine hydroxyl group of Boc
      Thr-ONb followed by hydrogenolytic carboxyl deprotection. The three Thr(P)
      containing peptides, H-Thr(P)-Glu-Glu-NHMe.TFA, H-Thr(P)-Thr(P)-Glu-Glu-NHMe.TFA
      and H-Thr(P)-Thr(P)-Thr(P)-Glu-Glu-NHMe.TFA, were prepared in high yield by the
      use of Boc-Thr(PO3Ph2)-OH in the Boc mode of peptide synthesis (mixed anhydride
      method) followed by platinum-mediated hydrogenolytic deprotection of the
      Thr(PO3Ph2)-containing peptides. The use of the phosphopeptides in calcium
      phosphate binding studies showed that the triple Thr(P)-cluster was a basic
      structural requirement, since only the pentapeptide was able to bind calcium
      phosphate efficiently.

PMID- 8463051
TI  - Serine-containing 10-membered cyclodepsipeptides. Synthesis and molecular
      structure of PhCH2CO-DSer-Pro-Pro- and PhCH2CO-DSer-Pro-DPro-.
AB  - As a part of a research program aimed at studying synthesis and conformation of
      small ring peptides, the cyclization of diastereoisomeric N-phenylacetyl-seryl
      propyl-proline tripeptides has been examined. Two 10-membered peptide lactones,
      PhCH2CO-DSer-Pro-Pro- 5a and PhCH2CO-DSer-Pro-DPro- 5b, have been isolated by
      treating the corresponding linear p-nitrophenyl esters with DBU in dry benzene.
      In these two compounds the serine lactone fragment (a common structural feature
      of several bioactive cyclodepsipeptides) is inserted into a highly strained small
      ring system. The conformation in the crystal of 5a and 5b has been studied by X
      ray analysis. Both the 10-membered rings of 5a and 5b adopt an overall cis-cis
      trans conformation in which the lactone junction is trans. The deviations from
      planarity of the peptide units vary from delta omega = 30 degrees for the DSer
      Pro bond in 5b to delta omega = 5-6 degrees for the DSer-Pro bond in 5a and Pro
      DPro bond in 5b. The skeletal atoms of 5b, containing the Pro-DPro sequence, are
      related by a pseudo-symmetry mirror plane passing through the Pro carbonyl and
      the opposite DSer C beta H2 group. In both the molecules the exocyclic amide bond
      adopts an extended conformation with respect to the DSer-Pro ring junction; this
      arrangement gives rise to a C5-type ring structure which is well evidenced in the
      case of 5a.

PMID- 8463053
TI  - Suppression of tuftsin activity by the partial sequences of adenovirus type 2
      proteins.
AB  - The synthesis of tuftsin inhibitor-like partial sequences of adenovirus type 2
      proteins: TVPPR (1), TRPPR (2), TGPPT (3), PRPPT (4), FVPPR (5), ARPPA (6) and
      YGPPK (7) are described. The choice of peptides for synthesis was performed by
      using a simple computer-aided method for predicting antigenic determinants of
      proteins. For all these peptides an inhibitory activity against tuftsin was
      found.

PMID- 8463052
TI  - Synthesis and conformational studies on peptides corresponding to a putative
      autophosphorylation site of abl TPK.
AB  - The transforming gene of Abelson murine leukaemia virus (v-abl) codes for a
      membrane-associated tyrosine-specific protein kinase (abl TPK). Analysis of the v
      abl gene has shown that both the fibroblast-transforming and tyrosine-protein
      kinase activities reside within a minimal region encoding a protein of 43 kDa
      (p43v-abl), which represents the most active, isolated form of this enzyme. Since
      the cellular substrates for p43v-abl are yet to be identified, we synthesized by
      classical solution methods the octapeptide H-Gly-Asp-Thr-Tyr-Thr-Ala-His-Ala-OH,
      corresponding to the structural sequence of the main putative autophosphorylation
      site (Tyr 515) of the abl TPK, as well as some of its analogs modified in
      positions -2, -1, +1 and +3. The synthetic peptides were tested as substrates for
      the p43v-abl. The kinetic data obtained indicate that the rates of their
      phosphorylation vary considerably depending on the sequence of the peptide, as
      expected. As a rule, no significant increment of the efficiency results from each
      substitution in the parent sequence. While the replacement of the two charged
      residues, namely Asp-2 and His-7, with neutral Ala is well tolerated, the
      substitution with amino acids bearing opposite charges is detrimental. The
      correlation between secondary structure of our synthetic octapeptides and their
      substrate recognition by p43v-abl was studied using CD and fluorescence
      spectroscopy in 5 mM Tris, in 98% TFE/Tris and in 30 mM SDS solutions. The
      comparison of the spectroscopic data with the kinetic parameters does not confirm
      a close relationship between the conformational properties of these peptides and
      their enzymatic role.

PMID- 8463054
TI  - Acidolytic cleavage of tris(alkoxy)benzylamide (PAL) "internal reference" amino
      acyl (IRAA) anchoring linkages: validation of accepted procedures in solid-phase
      peptide synthesis (SPPS).
AB  - Under the normal conditions of acidolytic cleavage/deprotection of
      tris(alkoxy)benzylamide (PAL) anchoring linkages in Fmoc solid-phase peptide
      synthesis (SPPS), product release occurs by a straightforward single-step
      pathway. A recently reported cleavage of the NH--alpha CH bond of an amino acyl
      residue adjacent to PAL [see Int. J. Peptide Protein Res. 38, 146-153 (1991)]
      could not be confirmed in novel experiments incorporating a double "internal
      reference" amino acid (IRAA) design. The results of the present work revalidate
      the widely accepted application of IRAAs to monitor yields in SPPS, and confirm
      the reliability of PAL methodology for the preparation of C-terminal peptide
      amides.

PMID- 8463055
TI  - Nursing in Europe.
AB  - In the long and frequently troubled history of Europe a span of 20 years seems
      insignificant, but placed in context of a century and a half of modern nursing
      the last two decades have been rich in growth and significance for the
      profession. As a nurse privileged to work with colleagues from the EC member
      states over this period, I have witnessed a great "sea change" brought about by
      nurses' own efforts through close cooperation and trust. These nurses came from
      12 very different countries but had a common link: membership with the
      International Council of Nurses (ICN). Nursing in Europe faces many daunting
      challenges but we have more things to unite us that to divide us. The following
      articles should convince the reader that this is indeed the case.

PMID- 8463056
TI  - Nursing's strategy in the European community.
AB  - The nursing profession in Europe has undergone tremendous changes over the past
      20 years. Below, a look at the new face of European nursing and its principal
      actors: The Standing Committee of Nursing in the EC, the women's liberation
      movement and the Nursing Unit at the WHO European Office in Copenhagen, Denmark.

PMID- 8463057
TI  - How nurses can work with the EC Commission.
AB  - For nurses in the European Community it is important that their voice be heard in
      Brussels, particularly when new initiatives are being developed. Below, the
      author introduces nurses to the workings of the Commission.

PMID- 8463058
TI  - Free-lance nursing in Italy.
AB  - In 1987 Registered Nurses Ernesta 'Tina' Galli and Joanne Lindsay embarked on a
      unique venture--a private agency* organized and run by nurses that engages free
      lance nurses to fill the need for nursing assistance both at home and in public
      and private institutions. The response has been overwhelming. Today they have
      branches throughout Italy and have expanded their services to include research
      and primary health care. Below, their story.

PMID- 8463059
TI  - Regulation and the empowerment of nursing.
AB  - The International Council of Nurses (ICN) has been a vanguard for the regulation
      of nursing standards worldwide. In the European region ICN has organized three
      workshops at which nurses representing 14 countries* critically examined their
      national legislations and, with their respective nurses' associations, devised
      concrete plans to change the regulations where necessary in their respective
      countries. Compared with developing countries, the structures in the European
      countries are more established and resistant to change, thus making it more
      difficult for European nurses to break the hard-fast regulatory encasement. An
      area that has received special attention has been the regulation of nursing
      specialties, particularly issues relating to their identity and control. An
      active participant in ICN's European regulation workshops and chief executive of
      the UK's regulatory body for nursing and midwifery, Colin Ralph takes a stand for
      empowering the nursing profession through regulation and offers assistance to
      those who need help in developing nursing regulations, not only in Europe but
      worldwide.

PMID- 8463060
TI  - Biochemical correlates of long-term potentiation in hippocampal synapses.
AB  - Figure 2 summarizes biochemical events which are currently known or hypothesized
      to participate in LTP induction/maintenance. Current evidence strongly suggests
      that postsynaptic Ca2+, both entered from the outside of cells and released from
      intracellular stores, is the initial key substance for the induction of LTP. A
      rise of [Ca2+]i triggers a variety of enzymatic reactions and initiates the
      enhancement of synaptic transmission. This first step may be achieved by
      direct/indirect phosphorylations of protein molecules in postsynaptic
      receptors/ion channels. This would result in an increase in receptor sensitivity.
      An immediate increase in the number of available postsynaptic receptors by
      modifications of spine morphology is another candidate. Such modifications may be
      accomplished by cytoskeleton rearrangements or changes in extracellular
      environments. A change in spine structure may also cause an increase in spine
      neck conductance. Although it is unknown to what extent the increase in [Ca2+]i
      affects cellular chemistry, Ca2+ probably also directly/indirectly stimulates
      cascades which exert effects more slowly. A delayed increase in metabotropic
      receptor sensitivity may occur. New synthesis of protein molecules may be
      involved in late periods of LTP by replacing turnovered molecules and/or by
      supplying new materials. Some of these chains of biochemical events may also
      apply to presynaptic terminals, although the existence of retrograde messenger
      substances must still be confirmed. In addition, interactions between different
      protein kinases and second messengers appear to occur to bring about final
      effects.

PMID- 8463061
TI  - Striatal dopamine in reward and attention: a system for understanding the
      symptomatology of acute schizophrenia and mania.

PMID- 8463062
TI  - Acetylcholine transport, storage, and release.
AB  - ACh is released from cholinergic nerve terminals under both resting and
      stimulated conditions. Stimulated release is mediated by exocytosis of synaptic
      vesicle contents. The structure and function of cholinergic vesicles are becoming
      known. The concentration of ACh in vesicles is about 100-fold greater than the
      concentration in the cytoplasm. The AChT exhibits the lowest binding specificity
      among known ACh-binding proteins. It is driven by efflux of protons pumped into
      the vesicle by the V-type ATPase. A potent pharmacology of the AChT based on the
      allosteric VR has been developed. It has promise for clinical applications that
      include in vivo evaluation of the density of cholinergic innervation in organs
      based on PET and SPECT. The microscopic kinetics model that has been developed
      and the very low transport specificity of the vesicular AChT-VR suggest that the
      transporter has a channel-like or multidrug resistance protein-like structure.
      The AChT-VR has been shown to be tightly associated with proteoglycan, which is
      an unexpected macromolecular relationship. Vesamicol and its analogs block evoked
      release of ACh from cholinergic nerve terminals after a lag period that depends
      on the rate of release. Recycling quanta of ACh that are sensitive to vesamicol
      have been identified electrophysiologically, and they constitute a functional
      correlate of the biochemically identified VP2 synaptic vesicles. The concept of
      transmitter mobilization, including the observation that the most recently
      synthesized ACh is the first to be released, has been greatly clarified because
      of the availability of vesamicol. Differences among different cholinergic nerve
      terminal types in the sensitivity to vesamicol, the relative amounts of readily
      and less releasable ACh, and other aspects of the intracellular metabolism of ACh
      probably are more apparent than real. They easily could arise from differences in
      the relative rates of competing or sequential steps in the complicated
      intraterminal metabolism of ACh rather than from fundamental differences among
      the terminals. Nonquantal release of ACh from motor nerve terminals arises at
      least in part from the movement of cytoplasmic ACh through the AChT located in
      the cytoplasmic membrane, and it is blocked by vesamicol. Possibly, the
      proteoglycan component of the AChT-VR produces long-term residence of the
      macromolecular complex in the cytoplasmic membrane through interaction with the
      synaptic matrix. The preponderance of evidence suggests that a significant
      fraction of what previously, heretofore, had been considered to be nonquantal
      release from the motor neuron actually is quantal release from the neuron at
      sites not detected electrophysiologically.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463063
TI  - Molecular neurobiology of dopaminergic receptors.
AB  - Table I summarizes the properties of all of the dopamine receptors that have been
      cloned to date. Thus far, five different genes encoding pharmacologically
      distinct receptors have been identified and isolated. Based on their structural,
      pharmacological, and functional similarities, two of these, D1A and D1B (or D1
      and D5), comprise the D1 subfamily. D2, D3, and D4 receptors represent a D2
      subfamily whose members are also structurally and pharmacologically similar. In
      fact, given these considerations, it has been suggested that the D2, D3, and D4
      receptors be termed the D2A, D2B, and D2C receptors, respectively, in recognition
      of their D2-like properties. Given the unexpected heterogeneity of the
      dopaminergic receptor system, it is logical to ask if there are other dopamine
      receptor subtypes remaining be identified. This seems probable, as the
      characteristics of the cloned subtypes do not match all of the properties of some
      dopamine receptors which have been previously investigated. For instance, there
      is extensive evidence that "D1-like" dopamine receptors exist which are linked to
      the activation of phospholipase C, phosphatidylinositol turnover, and Ca2+
      mobilization. Dopamine, as well as several "D1-selective" agonists, has been
      shown to stimulate phosphatidylinositol turnover in both brain slices and kidney
      membranes (Felder et al., 1989; Undie and Friedman, 1990; Vyas et al., 1992), and
      injection of striatal mRNA into Xenopus oocytes leads to dopamine-stimulated
      phosphatidylinositol turnover and Ca2+ mobilization (Mahan et al., 1990). These
      dopamine receptors might be analogous to the alpha 1-adrenergic receptors which
      stimulate phospholipase C activity and might define a third distinct subfamily of
      dopamine receptors. There is also evidence for additional members of the D2
      subfamily of receptors. Using gene transfer methods, a receptor with D2-like
      pharmacology has been identified and expressed but not yet sequenced (Todd et
      al., 1989). Also, a D2-related receptor has been characterized in kidney inner
      medulla membranes (Huo et al., 1991). It thus appears that there may be more
      dopamine receptor subtypes yet to be discovered.

PMID- 8463064
TI  - Molecular aspects of photoreceptor adaptation in vertebrate retina.

PMID- 8463066
TI  - Cardiovascular disease: treatment and referral.

PMID- 8463065
TI  - The neurobiology and genetics of infantile autism.
AB  - Autism is a syndrome with multiple etiologies, as is made clear both by the
      evidence of neurobiological research and by the catalog of disorders that present
      with autistic behaviors. What remains unclear are the specific neuropathological
      mechanisms that produce autistic behaviors; for example, is there a common
      neuroanatomic pathology for all cases of autism, or can autistic behaviors emerge
      from different pathological sequences within the brain? Although it is premature
      to generalize, neuropathological studies appear to have identified common
      abnormalities in the cerebellum and limbic system of at least five autistic
      subjects. These subjects, with variable levels of mental retardation,
      demonstrated marked Purkinje cell loss in the cerebellar hemispheres, together
      with retained fetal neuronal circuitry in cerebellar nuclei and increased
      neuronal packing in specific regions of the limbic system, amygdala, and
      hippocampus. The architecture of the cerebral cortex was not affected. Although
      our knowledge of brain functioning is incomplete, alterations of the kind noted
      in the cerebellum and limbic system could reasonably produce autistic behaviors.
      For more detail, readers are directed to a review of cerebellar contributions to
      higher functions by Schmahmann (1991). Neuroimaging studies allow less resolution
      of brain structure than do neuroanatomic studies, and the reported findings from
      neuroimaging are somewhat contradictory. However, a number of investigators have
      reported structural abnormalities in ventricle size and cerebral hemispheric
      asymmetry using CT. MRI, which offers greater resolution, has uncovered some
      consistent findings, along with a variety of nonspecific abnormalities. Common
      abnormalities include reduced volume of cerebellar hemispheres and vermal lobules
      -findings not inconsistent with the above-mentioned neuropathological defects. It
      is also interesting to note that individuals with fragile X syndrome have similar
      cerebellar findings. PET and NMR studies of autism are at a preliminary stage,
      but these methodologies allow insight into the functioning of the brain, rather
      than simply brain anatomy. Recent PET studies indicating decreased association
      between paired regions of the brains of autistic subjects are of interest,
      particularly if they can be confirmed and refined by additional studies.
      Neurophysiological studies also offer insight into brain function, but are
      subject to numerous methodological criticisms. Nevertheless, recent reports of
      diminished P300 waves and absent NC components in autistic subjects seem to
      indicate fundamental defects in attention and secondary processing, which could
      help explain the self-stimulatory behaviors often seen in autism. The
      disturbances in brain development associated with autism can be produced in a
      number of ways, and at different times during development of the nervous
      system.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463067
TI  - Intussusception presenting as encephalopathy.

PMID- 8463068
TI  - Is your management team operating effectively?

PMID- 8463069
TI  - Quanta of ambiguity.

PMID- 8463071
TI  - Want to just be a doctor? Try locum tenens.

PMID- 8463072
TI  - Heart disease and Iowa's high school athletes.

PMID- 8463074
TI  - Dying safely.

PMID- 8463073
TI  - Medical treatment rights of older persons and persons with disabilities: 1991-92
      developments.
AB  - This article covers developments occurring from the beginning of October 1991 to
      the end of September 1992. During this period, the federal government considered
      the issues of health care rationing, the medical rights of residents in long-term
      care facilities, and advance directives. The federal courts decided cases
      involving section 504 and its application to medical treatment decisions, the due
      process rights of persons needing medical care, and the liberty to accept or
      refuse medical treatment. The states continued to consider legislation on advance
      directives and surrogate decision making. Numerous state courts heard cases
      involving such issues as the removal of life-sustaining treatment from never
      competent persons, the definitions of living human being and personhood with
      respect to individuals with substantial disabilities, and the legalization of
      lethal injections and assisted suicide.

PMID- 8463075
TI  - Assisted suicide and the case of Dr. Quill and Diane.

PMID- 8463076
TI  - What about legalized assisted suicide?

PMID- 8463077
TI  - Euthanasia: a concept whose time has come?

PMID- 8463078
TI  - In re guardianship of Doe.

PMID- 8463079
TI  - In re L.W.

PMID- 8463080
TI  - Christian Medical & Dental Society ethical statement: suicide.

PMID- 8463081
TI  - Christian Medical & Dental Society ethical statement: physician-assisted suicide.

PMID- 8463082
TI  - The Southern Baptist convention. Resolution on euthanasia and assisted suicide.

PMID- 8463083
TI  - In loco parentis. Minimal risk as an ethical threshold for research upon
      children.

PMID- 8463084
TI  - In the U.K., children can't just say no.

PMID- 8463085
TI  - In Hungary, children help decide.

PMID- 8463086
TI  - Getting the bad news about your artificial heart valve.

PMID- 8463088
TI  - Keeping moral space open. New images of ethics consulting.

PMID- 8463087
TI  - How best shall we serve? Case study.

PMID- 8463090
TI  - Save the life of the child.

PMID- 8463089
TI  - Meeting at Maastricht.

PMID- 8463091
TI  - What kind of leave?

PMID- 8463092
TI  - What do you say to a child with AIDS?

PMID- 8463093
TI  - [Staphylococcus aureus and atopic eczema].
AB  - The bacterial skin flora of patients with atopic eczema is different from that in
      healthy normal persons. In addition, such patients more often suffer from
      microbial infections. Differences in sebum and sweat secretion and increased
      bacterial adhesion to epithelial cells in atopic eczema may predispose to
      enhanced amounts of Staphylococcus aureus, for example, on the skin. Defective
      host-defence mechanisms with dysfunction of cellular and humoral immune reactions
      have been suggested. On the other hand, bacterial antigens may induce allergic
      reactions, e.g. increased IgE synthesis and enhanced expression of the low
      affinity receptor for IgE (CD23, Fc epsilon RII), and the release of inflammatory
      mediators such as leukotrienes and histamine. The production of bacterial toxins
      might be important for the pathophysiology of atopic eczema. This paper
      summarizes the present data and tries to integrate them into a model for the
      induction of atopic eczema.

PMID- 8463094
TI  - [Dexamethasone-cyclophosphamide pulse therapy in bullous autoimmune dermatoses].
AB  - The problem in the treatment of bullous autoimmune dermatoses with long-term
      corticosteroids is that the high doses cause side-effects. An alternative form of
      therapy with high-dose dexamethasone-cyclophosphamide pulses was used to treat 20
      patients between 33 and 86 years: 7 patients had bullous pemphigoid, 6 pemphigus
      vulgaris, 5 pemphigus foliaceus, and 2 cicatricial pemphigoid. On each of days 1
      3 100 mg dexamethasone was administered i.v. and on day 1, 500 mg
      cyclophosphamide i.v. In the therapy interval between the pulses 50 mg
      cyclophosphamide per day. Initially the pulses were repeated every 2 weeks and
      later at 10-week intervals. After 6 months of this regimen 13 patients were
      symptom-free, 4 had improved, and 3 showed no change. The efficacy of treatment
      was equal in newly diagnosed and previously treated cases. (Side-effects were
      leucopenia (n = 3), myalgia and arthralgia (n = 2), taste disturbance (n = 2),
      diffuse hair loss (n = 2), thrombophlebitis (n = 1), herpes zoster (n = 1) and a
      delayed-type hypersensitivity reaction to mesna. Owing to the rather short follow
      up, no conclusions on long-term side-effects of this therapy are possible.
      However, dexamethasone-cyclophosphamide pulse therapy appears so far to be a good
      alternative to the standard continuous corticosteroid treatment.

PMID- 8463095
TI  - [Imre modified bilobed flap rotation graft for plastic surgery management of skin
      tumors in the area of the nose and eyes].
AB  - The modification and development of the rotation-flap graft described by Imre in
      1924 gave rise to the bilobed flap rotation graft, which is now a standard
      operative method of defect coverage and corrective plastic surgery, especially
      for the facial region. The advantages of this operative technique are presented
      with reference to case reports. They result from its ability to neutralize the
      tractive and expansion forces that arise within the tissue and to guarantee
      adequate blood supply to and innervation of the rotation flap by shifting the
      axis of rotation to a site far distant from the operating area.

PMID- 8463096
TI  - [Incontinentia pigmenti in a male patient].
AB  - Incontinentia pigmenti (Bloch-Sulzberger syndrome) is a rare genetic disorder
      usually affecting females. Familial cases show an X-linked dominant inheritance
      with male lethality. The typical skin manifestations occur in several stages and
      can be associated with various extracutaneous anomalies. We report on a 10-month
      old male patient with incontinentia pigmenti (IP) and a normal male karyotype.
      Besides the typical cutaneous lesions no other signs have been found so far. IP
      in male patients can be explained by the presence of Klinefelter syndrome, by the
      half-chromatid mutation model, or by an early somatic mutation. On the basis of
      this case report we discuss the clinical findings in and the genetics of IP.

PMID- 8463097
TI  - [Camptodactyly. The syndrome of flexion contracture of the fingers].
AB  - We report on three cases of a nonpainful flexion contracture of the proximal
      interphalangeal joint of the little finger. The word camptodactyly means bent
      finger, and the condition can occur either as an inherited or as a sporadic
      disorder. Simple camptodactyly should be borne in mind in the differential
      diagnosis of Dupuytren's contractures, other nontraumatic contractures of the
      fingers, and sclerodermia.

PMID- 8463098
TI  - [Cutaneous condylomata acuminata of an unusual site and extent. Successful CO2
      laser therapy].
AB  - We report on a 33-year-old patient with unusually extensive and predominantly
      cutaneous condylomata acuminata spreading from the penis over the mons pubis to
      the entire lower abdominal wall but almost completely sparing the genital mucous
      membranes. Single lesions were found on the left arm and on the buttocks.
      Southern blot hybridization detected HPV-6a DNA sequences within the
      fibroepithelial tumours. Carbon dioxide laser treatment resulted is cosmetically
      acceptable healing without recurrence.

PMID- 8463099
TI  - [Malignant blue nevus].
AB  - A 35-year-old male patient suffering from a malignant blue naevus is presented.
      An uncommon melanocytic naevus and malignant melanoma were considered in the
      differential diagnosis. The final diagnosis was established by histological
      examination. Immunohistochemical studies showed a strongly positive reaction of
      the tumour cells for vimentin and S-100 protein. In addition, tumour cells
      reacted with the antibody HMB-45.

PMID- 8463100
TI  - [Pemphigus foliaceus caused by penicillamine].
AB  - We report the case of an 80-year-old woman who developed pemphigus foliaceus
      while taking penicillamine for rheumatoid arthritis. On the basis of this new
      case, we discuss fresh insights into the pathogenesis of drug-induced pemphigus.
      In addition, having reviewed the literature, we give a list of drugs that have
      been reported to induce this disease.

PMID- 8463101
TI  - [Metastasizing eccrine porocarcinoma].
AB  - We report on an 84-year-old female patient who presented with abundant firm skin
      nodules and massive lymphoedema restricted to the left leg. Metastasizing eccrine
      porocarcinoma was diagnosed by the unusual circumscribed pattern of the cutaneous
      metastases and the histological detection of intraepidermal and intradermal PAS
      positive tumour cells. This diagnosis was established by the histopathological
      reexamination of a small skin tumour on the left ankle, which had been
      misinterpreted as actinic keratosis 5 years before. The initiated local radiation
      therapy with fast neurons and cobalt-60 resulted in partial regression of the
      cutaneous metastases and lymphoedema, but was not able to hamper the fatal
      outcome directly resulting from tumour cachexia.

PMID- 8463103
TI  - [Morphology and follow-up of seborrheic eczema] ].

PMID- 8463102
TI  - [Tapered treatment with corticosteroids].

PMID- 8463104
TI  - [Historical development of skin surface microscopy].
AB  - Within the last decade, skin surface microscopy has been rediscovered as an
      useful technique for preoperative diagnosis of pigmented skin lesions. This
      method was originally developed early this century as one component of
      "functional diagnosis" in constitutional pathology.

PMID- 8463105
TI  - [Decreased work capacity in dermatologic expert assessment. Comment on the
      contribution by T. Bergner et al].

PMID- 8463106
TI  - [Antimycotic agents. I].

PMID- 8463107
TI  - Factors affecting conversion rates to Medicaid among new admissions to nursing
      homes.
AB  - OBJECTIVE: This study examines conversion to Medicaid as a payment source among a
      cohort of newly admitted nursing home residents. DATA SOURCE: The longitudinal
      data used came from regular assessments of residents in the National Health
      Corporation's 43 for-profit nursing homes in Missouri, Kentucky, South Carolina,
      and Tennessee. This information system tracked all residents who were discharged,
      providing a comprehensive record that may have spanned multiple admissions. STUDY
      DESIGN: Using survival analysis methods, Cox regression, and survival trees, we
      contrasted the effect of state, initial payment source, education, age, and
      functional status on the rate of spend-down to Medicaid. DATA EXTRACTION METHODS:
      New-admission cohorts were created by linking an admission record for a newly
      admitted resident with all subsequent assessments and follow-up records to
      ascertain the precise dates of any payment source changes and other discharge
      transitions. PRINCIPAL FINDINGS: For the 1,849 individuals who were admitted as
      self-payers and who were still in the nursing home at the end of one year, there
      is a 19 percent probability of converting to Medicaid. All analytic methods
      revealed that education, age, and state of residence were predictive of spend
      down among residents who were admitted as self-payers. CONCLUSIONS: Our results
      confirm the effect of education as an SES indicator and state as a proxy for
      Medicaid policy on spend-down. Future research should model the effects and
      duration of intervening hospitalizations and other transitions on Medicaid spend
      down among new admissions.

PMID- 8463108
TI  - ASIM: a system for monitoring and evaluating the long-term care of the elderly
      and disabled.
AB  - OBJECTIVE: A system for monitoring and evaluating the long-term care of the
      elderly and disabled is presented, and its problems of completeness, reliability,
      and validity are discussed. DATA SOURCES/STUDY SETTING: Half-yearly (before 1987)
      and yearly (after 1987) surveys were taken from 1984 to 1990 of all persons
      living in the city of Solna, Sweden, who at May 1 and November 1, or November 1,
      were receiving long-term care services from the municipality or county council,
      or both. STUDY DESIGN: Completeness of observations was studied by linking survey
      and admission/discharge observations and checking for breaks in the chain of
      care. Reliability was estimated by comparing involuntary double registrations.
      Validity of the chosen measures of need was tested by comparing them with the
      actual provision of care services. DATA COLLECTION: Registrations concerning
      actually provided services, assessed need, social environment, and disability
      were collected on a regular basis by the staff responsible for the care services.
      PRINCIPAL FINDINGS: Completeness was estimated to be more than 99 percent after a
      special procedure was carried out for filling in gaps in the "care chain."
      Reliability testing of the disability measures showed between .69 and .76 Kappa
      coefficient of agreement. Disability variables were shown to explain 56 percent
      of variance in the need measure "appropriate level of care." CONCLUSIONS: Tests
      of completeness, reliability, and validity showed satisfactory results with
      regard to the purpose of the monitoring system and the limitations inherent in a
      system intended for routine application.

PMID- 8463109
TI  - Effect of prospective reimbursement on nursing home costs.
AB  - OBJECTIVE: This study evaluates the effect of Maine's Medicaid nursing home
      prospective payment system on nursing home costs and access to care for public
      patients. DATA SOURCES/STUDY SETTING: The implementation of a facility-specific
      prospective payment system for nursing homes provided the opportunity for
      longitudinal study of the effect of that system. Data sources included audited
      Medicaid nursing home cost reports, quality-of-care data from state facility
      survey and licensure files, and facility case-mix information from random,
      stratified samples of homes and residents. Data were obtained for six years (1979
      1985) covering the three-year period before and after implementation of the
      prospective payment system. STUDY DESIGN: This study used a pre-post,
      longitudinal analytical design in which interrupted, time-series regression
      models were estimated to test the effects of prospective payment and other
      factors, e.g., facility characteristics, nursing home market factors, facility
      case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS:
      Prospective payment contributed to an estimated $3.03 decrease in total variable
      costs in the third year from what would have been expected under the previous
      retrospective cost-based payment system. Responsiveness to payment system
      efficiency incentives declined over the study period, however, indicating a
      growing problem in achieving further cost reductions. Some evidence suggested
      that cost reductions might have reduced access for public patients. CONCLUSIONS:
      Study findings are consistent with the results of other studies that have
      demonstrated the effectiveness of prospective payment systems in restraining
      nursing home costs. Potential policy trade-offs among cost containment, access,
      and quality assurance deserve further consideration, particularly by researchers
      and policymakers designing the new generation of case mix-based and other nursing
      home payment systems.

PMID- 8463110
TI  - Ecological analysis of the first generation of community clinical oncology
      programs.
AB  - OBJECTIVE: An ecological framework is proposed for assessing factors important to
      consider in allocating funds to promote sound performance of interorganizational
      programs. DATA SOURCE/STUDY SETTING: This framework is used to examine the first
      generation of Community Clinical Oncology Programs (CCOPs) funded by the National
      Cancer Institute (NCI) from 1983-1986 to coordinate clinical research activity at
      the local level. The research reported is based on secondary data collected for
      the Community Cancer Care Evaluation at the Fred Hutchinson Cancer Center. STUDY
      DESIGN: A repeated measures design was used to analyze differences in the level
      and patterns of CCOP productivity, a measure of the number of patients enrolled
      on NCI-approved Phase III trials. The predictive dimensions include (1) measures
      of environmental inputs (population density, organizational dominance,
      professional support, NCI funding); (2) measures of organizational inputs (number
      of hospitals, number of staff, number of physicians, NCI experience, clinical
      research experience); and (3) structural measures (functional specialization,
      administrative concentration). Predicted relationships were assessed using
      general linear models procedures. DATA COLLECTION/EXTRACTION METHODS: Data
      obtained from NCI files were supplemented by interviews with NCI personnel and
      published statistics. PRINCIPAL FINDINGS: Funding level, clinical research
      experience, and number of staff are the most important predictors of patient
      enrollment. Clinical research experience has a positive relationship with patient
      enrollment and a negative association with changes in enrollment. The reversal is
      explained by the influence of the CCOPs that had the greatest amount of clinical
      research experience at the beginning of the program. CONCLUSIONS: The ecological
      approach provides a useful framework for understanding factors that should be
      considered in funding interorganizational programs and promoting their
      development. Most importantly, results suggest that a somewhat different approach
      is needed to initiate programs rather than to expand existing programs.

PMID- 8463112
TI  - [Is a transplantation law necessary?].

PMID- 8463111
TI  - A cost-effectiveness analysis of hepatitis B vaccine in predialysis patients.
AB  - OBJECTIVE: Our objective was to assess the cost effectiveness of hepatitis B
      vaccine in predialysis patients. DATA SOURCES: Costs were calculated from
      estimated rates of health services use and unit costs of resource use. Efficacy
      data were based on probability estimates from the medical literature and included
      vaccination response rates, anticipated hepatitis B virus (HBV) infection rates,
      and outcomes from HBV. STUDY DESIGN: Costs and effectiveness of HBV vaccination
      was modeled with a decision tree constructed to analyze three vaccination
      strategies for patients with renal insufficiency: vaccine given prior to
      dialysis, vaccine given at time of dialysis, and no vaccine. Sensitivity analyses
      were performed to assess the effect of varying important clinical and cost
      variables. DATA COLLECTION/EXTRACTION METHODS: All analyses were based on
      efficacy and cost estimates derived from the medical literature. Analyses were
      conducted with the aid of SMLTREE software. PRINCIPAL FINDINGS: The number of
      patients requiring vaccination per case of HBV prevented was higher for dialysis
      patients (625 vaccinees/case prevented) than for predialysis patients (434
      vaccinees/case prevented). The cost-effectiveness ratios were $25,313/case of HBV
      prevented for vaccination at the time of dialysis and $31,111 for the predialysis
      vaccine. When a higher HBV infection rate (based on clinical trial data) was
      substituted in the analysis, the cost effectiveness of a predialysis vaccination
      strategy improved to $856 per case prevented. Results were sensitive to the cost
      of the vaccine and the incidence of HBV infection in dialysis patients. For the
      predialysis strategy to become cost saving, the price of the vaccine would have
      to decrease from $114 to $1.50, or the incidence of infection would have to
      increase from 0.6 percent to 38 percent, holding all other variables constant.
      CONCLUSIONS: Additional HBV infection can be prevented by immunizing predialysis
      patients, but the cost is high. Decisions concerning vaccination policy should be
      influenced by local prevalence of HBV infection.

PMID- 8463113
TI  - ["Ultrasound hearing aid" for deaf patients? Comments on human ultrasound
      hearing].

PMID- 8463114
TI  - [Microvascular tissue transfer in the area of the head-neck. Status of the
      technique and outlook].

PMID- 8463115
TI  - [List of damage to the mucous membranes of the upper aerodigestive tract caused
      by chemically irritating, toxic and allergic environmental substances].

PMID- 8463116
TI  - [Social responsibility for organ donation. Legal aspects of modern
      transplantation surgery].
AB  - In the recent past there has been considerable discussion about the legal and
      legislative aspects of transplantation surgery. The present legal codes with
      German reunification now require a uniform law for the country as a whole. In
      addition to the different legal models already presented, any "expanded"
      agreement must not only respect the right of self-determination but also the
      responsibility of the individual for his societal obligations. The German
      legislator is now required to enact a uniform law which is reasonable and also
      considers the necessities of modern transplantation medicine in order to have the
      best concordance of the constitutional laws involved.

PMID- 8463117
TI  - [Perspectives of molecular genetics of hearing disorders].
AB  - In the last few years research efforts have succeeded in detectury the genetic
      background of several hereditary hearing disorders by molecular biological
      methods. The genetic code was been decoded for Neurofibromatosis types 1 and 2,
      as well as for such X-linked diseases as Alport's syndrome or Norrie's disease.
      Besides the classic genetic tools as chromosomal analysis, molecular biological
      techniques and methods have become important clinically for the ENT-specialist.
      In the present review we show the principles and applications of DNA-and RNA
      analysis with hybridization techniques in Southern- and Northern-blot techniques,
      as well as in-situ hybridization and polymerase chain reaction (PCR). These
      molecular biological techniques will help improve the detection and analysis of
      hereditary inner ear disorders, but also be able to study in greater detail tumor
      carcinogenesis and mutagenesis. The various techniques are explained and the
      applications are demonstrated.

PMID- 8463118
TI  - [Otosclerosis in the elderly. The effect of stapes-plasty on hearing ability and
      hearing aid management].
AB  - We examined 105 patients who underwent partial stapedectomies at the age of 65
      years or older as treatment for combined hearing losses due to otosclerosis.
      Among other things investigated was the influence of the operation on the hearing
      of both the operated and unoperated ears, as well as on tinnitus existing
      preoperatively and the use of a hearing aid. Findings showed that tinnitus
      decreased or vanished in 75% of the cases. Sixty-one percent of the patients
      needed a hearing aid continuously preoperatively, with 48% not needing it post
      operatively and 13% using it only occasionally. The degree of sensorineural
      hearing loss had by the other patients was so severe that the use of a hearing
      aid was also necessary post-operatively. However, in some of these cases, a
      successful use of a hearing aid became possible for the first time due to the
      surgical improvement in hearing.

PMID- 8463119
TI  - [The epidemiology of parotid tumors. A case control study].
AB  - From 1989 to 1991 a case-control study was conducted at the ENT Department of the
      University of Heidelberg. One hundred and one patients with parotid tumors (84
      benign and 17 malignant) were compared with 404 control patients in a matched
      pair study design. Using a questionnaire containing 21 sides, all interviews were
      conducted by the same interviewer. The questionnaire contained such aspects as
      "professional surroundings and exposure to environmental dusts", "consumption of
      tobacco and alcohol", "living area", "nutrition", "hobbies" and "social life".
      Questions about personal and familial diseases, consumption of medicine and
      exposure to irradiation were also asked. Differences in exposure to occupational
      dusts were seen. The highest relative risk (RR) for developing a parotid tumor
      was seen with weekly exposure to nickel during a period of more than 10 years (RR
      = 6.0; confidence interval, 1.4-25.5). Similar risk was found with exposure to
      chromium, asbestos and cement dusts (RR chromium = 3.4; confidence interval, 0.9
      14.5; RR asbestos + cement = cement 3.0, confidence interval 1.0-8.9). Higher
      relative risks were also detected in patients exposed to diagnostic dental x
      rays.

PMID- 8463120
TI  - [Personal experience with Ionocem in head- and neck surgery].
AB  - Ionomeric bone bond cement (Ionocem) is a new alloplastic bone replacement
      material, which was used by us for functional and aesthetic purposes in surgery
      of the head and neck. We have used the cement 44 times (in 43 patients) for
      repair of skull and mid-face trauma, reconstruction of defects after tumor
      removal and for aesthetic augmentation. Ionocem was distinguished by its ready
      shaping on existing bony structures, its adaptation of bone fragments and bone
      implants without gaps and its help in avoiding ancillary procedures requiring
      autogenous grafts. Complications occurred in 22 patients, with most involving
      swelling, seromas, granulation, fistulas and sequestration which occurred after
      unsuitable indications or application.

PMID- 8463121
TI  - [Endoscopic paranasal sinus surgery. The most important anatomic variations of
      the main paranasal sinus and accessory paranasal sinus].
AB  - Anatomic variations of the nasal cavity and paranasal sinuses are described in
      order of their appearance in endoscopy. Variations of the pyriform aperture are
      followed by variations of the agger nasi, inferior and middle conchas, inferior
      and middle nasal meati, and variations of the bulla ethmoidea, uncinate process
      and fontanelles. Variations of the maxillary sinus are described from their
      anterior and lateral views. Partial and total septation of the maxillary sinus,
      variations of its dimensions and its relation to dental roots are stressed. The
      dimensions of the frontal sinus, frontal bulla or bullae are noted. The variation
      of the sphenoid sinus and its dimensions and relationships to the structures of
      the cavernous sinus and the endocranium are described. Pneumatization of the
      anterior clinoid process and the region around the optic canal by the frontal
      sinus, ethmoid labyrinth or sphenoid sinus is discussed. Knowledge of these
      different variations will help the rhinologic surgeon in his orientation during
      endoscopic surgical interventions.

PMID- 8463122
TI  - Unfolded HLA class I alpha chains and their use in an assay of HLA class-I
      peptide binding.
AB  - Unfolded HLA class I alpha chains were isolated from B-cell lysates by alkaline
      denaturation and subsequent gel filtration and used for the detection of HLA
      class-I-peptide binding. Binding to specific peptides in the presence of excess
      beta 2-microglobulin induced the unfolded alpha chains to refold and acquire a
      conformation that is specific to folded alpha chains. This conformational change
      was measured by a specific RIA that involves inhibition of the binding of 125I
      labeled HLA-A2 alpha/beta dimers and rabbit anti-HLA-B7 serum absorbed with beta
      2-microglobulin. This assay procedure does not require labeling of either test
      peptides or test class I proteins and does not seem to have specificity
      degeneracy. It is applicable to the detection of peptide binding by all HLA class
      I allelic proteins. Evaluation of the assay conditions and HLA allelic
      specificity of the peptide binding defined by the use of synthetic peptides are
      described here, including the technical details, specificity, and
      reproducibility.

PMID- 8463123
TI  - Heterogeneity of type-II interleukin-1 receptors. Heterogeneity of B-cell
      interleukin-1 binding created by dimerization of type-II interleukin-1 receptors.
AB  - The binding of IL-1 alpha and IL-1 beta to two human lymphoblastoid B-cell lines,
      Raji and RPMI 1788, was compared with binding to the murine T-cell line, EL4.
      Dramatic differences in IL-1 binding were observed. Both human B-cell lines bound
      much less IL-1 alpha than IL-1 beta, expressed 5-10 times more receptors per cell
      for IL-1 beta than did the EL4 cell line, and demonstrated a large difference in
      the ability of IL-1 alpha to compete with IL-1 beta for binding. The B-cell lines
      demonstrated a low number of high-affinity IL-1 alpha receptors and a large
      number of IL-1 alpha receptors with a much lower affinity. Inhibition studies
      demonstrated that only IL-1 beta could compete for the binding of radiolabeled IL
      1 beta to the B-cell IL-1R. Furthermore, SDS-PAGE analyses of lysates of the B
      cell lines that had been affinity cross-linked with 125I-IL-1 alpha revealed two
      bands corresponding to IL-1R structures of 60 and 110 kD. These results coupled
      with a nonequilibrium binding study suggested a dimerization of a common type-II
      IL-1R polypeptide, the dimer being responsible for the high-affinity IL-1 alpha
      binding site of the B-cell lines.

PMID- 8463124
TI  - Identification of alloantisera reacting with HLA-C blank (Cx52) using a mouse L
      cell transfected with the HLA-Cw*1201 allele.
AB  - The HLA-C locus frequently has a serologically undefined "blank" (CwBL)
      specificity. A cDNA clone derived from the HLA-C gene with a blank specificity
      (Cx52) strongly associated with the most common haplotype in a Japanese
      population, A24-CwBL-B52-DR2-DQ6-DP9, has been recently cloned and sequenced in
      our laboratory and officially designated Cw*1201 as an allelic name, indicating
      that the inability to define the HLA-C antigen serologically in this haplotype is
      not due to an HLA-C antigen gene deletion or mutation, but to the absence of
      typing sera. In this paper, a mouse L-cell transfectant expressing this Cw*1201
      gene product was constructed and employed for screening of alloantisera
      recognizing the HLA-C antigen with the Cw*1201 specificity. Two alloantisera
      against Cw*1201 were thus identified and characterized using HLA homozygous B
      cell lines and local panel PBL cells, indicating that a transfectant expressing a
      single HLA provides an efficient screening system for collection of HLA-typing
      sera, especially reacting with serologically unclassifiable "blank" antigens.

PMID- 8463125
TI  - Defective signal transduction via T-cell receptor-CD3 structure in T cells from
      rheumatoid arthritis patients.
AB  - T cells from patients with active RA are known to produce low levels of IL-2 and
      proliferate poorly in response to various mitogenic stimuli. The present work
      shows that cross-linking of CD3 antigen on patients' T-cell surface induces two-
      to threefold lower Ca2+ response than in T cells from age-matched controls.
      Immunofluorescence studies indicate that the attenuated signal may be due to the
      suppressed expression of CD3 and/or CD45 molecules on patients' T cells. In the
      majority of the patients, the level of CD45 expression is reduced by 60%-70% as
      compared with that in the control T cells. Therefore, the poor mitogenic response
      of patient cells is apparently due to a defect in early stages of signal
      transduction through the T-cell receptor (TCR-CD3).

PMID- 8463126
TI  - Cytochrome P-450: the Japanese connection.

PMID- 8463127
TI  - Induction of BCR-ABL fusion genes by in vitro X-irradiation.
AB  - The Philadelphia chromosome consists of a reciprocal translocation between the
      ABL oncogene at chromosome 9q34 and the BCR gene at chromosome 22q11, resulting
      in the expression of chimeric BCR-ABL mRNAs specific to chronic myelogenous
      leukemia (CML). Presence of the fusion gene can be detected with high specificity
      and sensitivity by means of reverse transcription and polymerase chain reaction.
      Using this assay, it was possible to detect BCR-ABL fusion genes induced among
      HL60 cells after 100 Gy of X-irradiation in vitro. In total, five fusion gene
      transcripts were obtained among 10(8) cells examined. These fusion genes
      contained not only CML-specific BCR-ABL rearrangements, but also other forms of
      BCR-ABL fusions. These latter genes had junctions of BCR exon 4/ABL exon 2
      intervened by a segment of DNA of unknown origin, BCR exon 5/ABL exon 2, and BCR
      exon 4/ABL exon 2. The results appear to be direct evidence for the induction of
      the BCR-ABL fusion gene by X-irradiation. In terms of leukemogenesis, it appears
      that only those cells bearing certain CML-related BCR-ABL fusion genes are
      positively selected by virtue of a growth advantage in vivo.

PMID- 8463128
TI  - Helicobacter pylori may be transmitted through gastrofiberscope even after manual
      Hyamine washing.
AB  - Endoscopy is an effective diagnostic technique for gastric cancer, which is
      believed to be associated with Helicobacter pylori. Manual Hyamine washing is a
      widely used fiberscope cleaning method. Urease B gene of Helicobacter pylori was
      detected in 50% of the wash-out samples from the biopsy-suction channel of a
      fiberscope after manual Hyamine washing by nested polymerase chain reaction, and
      bacterial culture revealed viable Helicobacter pylori in 19%. However,
      Helicobacter pylori was not detected by either of the above methods in the biopsy
      suction channel of the fiberscope after mechanical washing. These findings
      indicate that manual Hyamine washing of fiberscopes is insufficient to prevent
      iatrogenic Helicobacter pylori transmission, and that mechanical washing after
      manual Hyamine washing is essential.

PMID- 8463129
TI  - Inhibitory effects of inhibitors of arachidonic acid metabolism on the evolution
      of rat liver preneoplastic foci into nodules and hepatocellular carcinomas with
      or without phenobarbital exposure.
AB  - Effects of inhibitors of arachidonic acid (AA) metabolism on the evolution of
      preneoplastic foci into nodules and of nodules into hepatocellular carcinomas
      were examined in F344 male rat livers with or without phenobarbital (PB)
      exposure. p-Bromophenacyl bromide (BPB), acetylsalicylic acid (ASA), and
      quercetin (QU) were used as inhibitors of phospholipase A2, cyclooxygenase and
      lipoxygenase, respectively. Preneoplastic liver foci were induced by initiation
      with N-nitrosodiethylamine (200 mg/kg, i.p.) followed by selection using the
      procedure of Cayama et al. For the nodule experiment, starting 1 week after
      completion of the selection procedure, animals bearing foci were given diets
      containing 0.05% PB plus 0.75, 1, or 1.5% of one of the inhibitors, 0.05% PB
      alone, or 0.75, 1 or 1.5% of inhibitor alone, or basal diet for 9 weeks. For the
      carcinoma experiment, 3 weeks after completion of the selection procedure,
      animals bearing nodules were given the same diets mentioned above for 29 weeks.
      BPB, ASA and QU either with or without PB accelerated the remodeling of
      preneoplastic foci, significantly decreasing the numbers of persistent nodules
      and hyperplastic nodules. ASA either with or without PB significantly decreased
      the number of hepatocellular carcinomas per rat. BPB and QU, however,
      significantly decreased the numbers of hepatocellular carcinomas with but not
      without PB. The results suggested an involvement of AA metabolism in the process
      of evolution of preneoplastic foci into nodules and hepatocellular carcinomas in
      rat liver with or without PB exposure.

PMID- 8463130
TI  - Time-dependent modulation of liver lesion development in Opisthorchis-infected
      Syrian hamster by an antihelminthic drug, praziquantel.
AB  - In the North-east of Thailand, repeated antihelminthic therapy has been
      introduced for control of the opisthorchiasis known to be a major risk factor for
      cholangiocellular carcinomas. What influence this may have on tumorigenesis,
      however, remains unclear. The effects of administration of praziquantel, an
      antihelminthic drug, at different time points subsequent to infection with
      Opisthorchis viverrini (OV) on 2,2'-dihydroxy-di-n-propylnitrosamine (DHPN)
      initiated lesion development in the liver of female Syrian hamsters were
      therefore investigated. Praziquantel (250 mg/kg body weight, i.p.) was given 4,
      12 or 20 weeks after infection of DHPN-treated animals (two 1000 mg/kg i.p.
      injections at weeks 0 and 2) with 60 OV metacercariae (at week 4). Survivors at
      week 38 were killed and examined. It was found that whereas praziquantel
      administration at the earlier two time points was effective at reducing
      hepatocellular nodule development, the results for cholangiocellular lesions were
      less pronounced, significant reduction only being evident in hamsters treated 4
      weeks after parasite infestation. The findings thus indicate that enhancement of
      DHPN-initiated bile duct carcinogenesis by opisthorchiasis is both rapid and to a
      large degree irreversible. Hepatocellular lesion development in this model, on
      the other hand, appears to correlate more closely with the duration of parasite
      associated proliferative stimulus.

PMID- 8463131
TI  - Influence of aging on multi-organ carcinogenesis in rats induced by N-methyl-N
      nitrosourea.
AB  - The effects of aging on the multi-organ carcinogenesis induced in rats by N
      methyl-N-nitrosourea (MNU), a direct carcinogen which does not need metabolic
      activation to exert carcinogenicity, were examined in male F344 rats. In the
      first experiment, rats at 6, 52, and 98 weeks of age were treated with MNU (20
      mg/kg body weight, i.p.) twice weekly for 6 weeks and then maintained without any
      further treatment for 24 weeks in the case of young and middle-aged rats and for
      18 weeks in the case of the old rats. In young rats, malignant lymphomas,
      particularly thymic types, were observed at significantly high incidence. A
      striking result in the middle-aged rats was the significantly higher incidence of
      adenocarcinomas in the small intestine than in young or old animals. The
      induction of proliferative and neoplastic lesions of the large intestine also
      tended to be increased in middle-aged rats. In addition, epithelial hyperplasia
      of the tongue, but not the forestomach, occurred at the highest incidence in the
      middle-aged group. There were no differences in the induction of epithelial
      lesions in the urinary bladder among the groups. In a second experiment,
      investigation of DNA synthesis in the tongue, small and large intestines, urinary
      bladder and lymph nodes did reveal significant increases or tendency for increase
      in the MNU-treated groups, but without differences with age. In contrast, the
      thymus of young rats showed significantly increased incorporation of BrdU label
      after administration of MNU, whereas it was markedly reduced in middle-aged rats.
      In a third experiment, O6-methyldeoxyguanine (O6-medG) DNA adduct formation was
      immunohistochemically detected in various organs including the thymus,
      forestomach, and small intestine without any differences with age. Thus, the
      results demonstrated that while the target organs of MNU are modified by the age
      of the animals, levels of DNA synthesis and O6-medG DNA adduct formation in most
      cases can not explain the observed differences in carcinogenic susceptibility.

PMID- 8463132
TI  - Persistently human immunodeficiency virus type 1-infected T cell clone expressing
      only doubly spliced mRNA exhibits reduced cell surface CD4 expression.
AB  - Several cell clones possessing the human immunodeficiency virus type 1 (HIV-1)
      genome, consisting of an almost full-length DNA sequence, were isolated by
      limiting dilution of the clonal cell line M10 derived from MT-4 that survived
      infection with HIV-1 vpr mutant (M10/vpr-). One of the isolated clones (termed
      Vpr-1) expressed only doubly spliced mRNA, but not unspliced or singly spliced
      mRNA. Western blots of Vpr-1 revealed the presence of the nef translation
      product, although no expression of major structural genes such as gag, pol, and
      env was detected by indirect immunofluorescence and assay of reverse
      transcriptase activity. These HIV-1 phenotypes differed greatly from those of the
      original M10/vpr-, most of which expressed major structural HIV-1 proteins.
      Despite undetectable levels of env expression in Vpr-1, CD4 antigens were greatly
      down-modulated on the surface without alteration of steady-state levels of CD4
      mRNA expression, similar to M10/vpr-. These HIV-1 phenotypes in Vpr-1 did not
      change after the treatment of the cells with both phorbol 12-myristate 13-acetate
      and phytohemagglutinin. Therefore, the abnormal HIV-1 life cycle in Vpr-1 seems
      to be due to some viral factor(s), as well as cellular factors. Thus, Vpr-1 could
      be a useful model for understanding one HIV-1 latent form.

PMID- 8463133
TI  - Infrequent ras mutation in human stomach cancers.
AB  - Mutations of ras oncogenes in 37 human stomach cancers and 13 adenomas were
      investigated with regard to the histological phenotypes using polymerase chain
      reaction (PCR), allele-specific oligonucleotide hybridization and/or direct
      sequencing of the PCR products. The ras mutation was found only in one case
      (2.7%), the histology of which was poorly differentiated adenocarcinoma. We found
      no mutation in stomach adenomas. The mutation consisted of a guanine-to-adenine
      transition in the first base of codon 13 of c-Ki-ras which replaced wild-type
      glycine with serine, indicating that a putative glycine-to-aspartic acid change
      is not necessarily the critical event for c-Ki-ras gene activation in codon 13.
      These results further confirm the infrequency of ras mutation in stomach tumors
      and also suggest that ras mutations are not specific to the differentiated type
      of stomach cancer.

PMID- 8463134
TI  - Quantitative comparison of initiation and mutation phenotypes in hepatocytes of
      the analbuminemic rat.
AB  - The potential relationship between mutagenesis and carcinogenesis has been
      examined in the Nagase analbuminemic rat treated with a single dose of
      benzo[a]pyrene, an incomplete liver carcinogen. The apparent mutation rate at the
      albumin locus was calculated by determining the number of hepatocytes expressing
      a cross-reactive product of albumin in analbuminemic rats treated with
      benzo[a]pyrene. The rate of initiation, the first stage in carcinogenesis, was
      determined by assessing the number of hepatocytes expressing the placental
      isozyme of glutathione S-transferase (PGST) after administration of
      benzo[a]pyrene. Since the expression of PGST may represent hepatocellular changes
      independent of initiation, promotion with phenobarbital was employed to clonally
      expand those putatively initiated hepatocytes expressing PGST. With
      immunohistochemical measures to assess changes in albumin expression, a threefold
      increase in the number of hepatocytes expressing albumin was detected after
      administration of benzo[a]pyrene in Nagase analbuminemic rats. A more than five
      fold increase in altered hepatic foci (AHF) exhibiting increased PGST expression
      was observed in animals given benzo[a]pyrene treatment followed by phenobarbital,
      compared with those given benzo[a]pyrene alone. The number of albumin-expressing
      single hepatocytes detected was of the same order of magnitude as the number of
      individual hepatocytes and AHF expressing PGST, suggesting that similar events
      may be involved in their formation. Since 3 x 10(6) single hepatocytes expressing
      albumin were found in the analbuminemic rat liver after a single administration
      of benzo[a]pyrene, while less than 2 x 10(4) AHF expressing PGST were observed,
      formation of individual hepatocytes expressing albumin was a far more frequent
      event than clonal expansion of initiated hepatocytes in the Nagase analbuminemic
      rat. However, the number of loci of PGST expression including AHF and single
      hepatocytes is comparable to that of single hepatocytes expressing albumin.

PMID- 8463135
TI  - Intracellular metabolism and cytotoxicity of transferrin-neocarzinostatin
      conjugates of differing molar ratios.
AB  - Transferrin-neocarzinostatin (NCS) conjugates with differing molar ratios of drug
      to protein were synthesized and their intracellular metabolism was investigated.
      The conjugate mixtures of transferrin-NCS were separated by DEAE-Sephacel column
      chromatography. The separated molecular species were examined with respect to
      binding affinity to transferrin receptor, cytotoxicity and intracellular
      metabolism using the human leukemia cell line, K562. Transferrin-NCS conjugate is
      capable of binding to transferrin receptors specifically and its reactivity
      became weaker as the ratio of bound NCS to transferrin was increased. Transferrin
      6NCS did not bind measurably to the receptor. On the other hand, the cytotoxicity
      was augmented when the number of NCS molecules bound per molecule of transferrin
      was increased to 4NCS/transferrin, while transferrin-5NCS and transferrin-6NCS
      species exhibited low activity. Examination of the kinetics of metabolism by
      pulse chase study using 125I-labeled ligand indicated that unconjugated
      transferrin and transferrin-NCS conjugates were internalized in similar ways,
      although the degradation of internalized conjugate was more marked in the case of
      transferrin-4NCS than transferrin-1NCS. Thus, the molar ratio of transferrin-drug
      conjugate could be optimized with respect to both the binding activity to
      receptor and the intracellular metabolic pathway.

PMID- 8463136
TI  - Comparative studies on the metabolism of new fluorinated pyrimidine drugs in the
      liver by in vivo 19F magnetic resonance spectroscopic observation.
AB  - 1-Ethoxymethyl-5-fluorouracil (EM-FU) is a fluorinated pyrimidine derived from 5
      FU, and 3-cyano-2,6-dihydroxypyridine (CNDP) is a chemical modulator which
      suppresses the catabolism of 5-FU by inhibiting dihydrouracil dehydrogenase in
      the liver. In this study, the metabolism of EM-FU and the suppression of 5-FU
      catabolism by CNDP were observed by in vivo 19F magnetic resonance spectroscopy
      in comparison with other similar drugs, because it is considered that the most
      effective mode of therapy using 5-FU is to suppress the catabolism of 5-FU in the
      liver and so to maintain for longer an effective blood level of 5-FU. The
      metabolism of EM-FU was very slow and the production of fluoro-beta-alanine was
      very low as compared to the case of tegafur. The catabolic suppression by CNDP
      was much stronger than that of uracil. Therefore co-administration of EM-FU and
      CNDP should suppress catabolism and maintain an effective blood level of 5-FU for
      a long period of time.

PMID- 8463138
TI  - Feeding sorbitol alone or in combination with monensin to finishing cattle.
AB  - Three trials were conducted with finishing steers to study the effect of feeding
      sorbitol alone or combined with monensin. For each trial 15 pens of eight steers
      were fed high-corn-silage diets. In the first two trials three pens of eight
      steers each were fed no additive, 35 g of sorbitol, 350 mg of monensin, or 30 g
      of sorbitol plus 350 mg of monensin per day. In Trial 1 three pens were fed 200 g
      of sorbitol per animal every 6 d, and in Trial 2 three pens were fed 60 g/d of
      sorbitol plus 350 mg/d of monensin. For the third trial, three pens were fed 0,
      20, 40, or 80 g/d of sorbitol per animal and three pens were fed 40 g/d after 56
      d; all the steers were fed 350 mg/d of monensin. In the first trial sorbitol had
      no effect on daily gain, and monensin increased (P < .05) daily gain. Intake of
      DM was lower (P < .05) for the steers fed sorbitol (35 g/d). Dry matter
      intake/gain was improved by feeding monensin (P < .05) or 35 g/d of sorbitol (P <
      .07). The improvement amounted to 18% when the additives were used in
      combination. In the second trial daily gains were similar for the cattle fed all
      diets. Dry matter intake was lower (P < .05) for steers fed monensin or 60 g/d of
      sorbitol and tended to be lower (P < .12) for the cattle fed 35 g/d of sorbitol.
      Dry matter intake/gain tended to be lower for cattle fed monensin and sorbitol,
      especially when fed in combination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463139
TI  - Effects of dietary lysine levels on performance and immune response of weanling
      pigs housed at two floor space allowances.
AB  - Three 35-d trials involving 288 crossbred weanling pigs (initial weight, 7.1 kg;
      age, 28 d) were used to determine the separate and interactive effects of two
      floor space allowances (.28 and .14 m2/pig) and three dietary lysine levels (NRC
      recommended, NRC+ .1% crystalline lysine-HCl, and NRC+ .2% crystalline lysine
      HCl) on growth performance and several factors that measure variation within
      pens. Each trial was conducted as a 2 x 3 factorial arrangement of treatments in
      a randomized complete block design. There were four pens (four pigs per pen) for
      each of the six treatment combinations in each trial. The lysine x floor space
      allowance interaction was not significant (P = .25) for daily gain, daily feed
      intake, or gain/feed. Restriction of the floor space allowance decreased (P <
      .001) daily gain and daily feed intake, but gain/feed was not affected. The
      humoral immune response, as measured by the level of antibodies produced after
      two injections of ovalbumin, was not affected by floor space allowance. Addition
      of .1 and .2% crystalline lysine-HCl improved daily gain (P < .07), gain/feed (P
      < .10), and humoral immune response (P < .05) and was without effect (P = .28) on
      feed intake. Natural logarithms of variance, coefficients of variation, and range
      of daily gain and body weights were not changed by floor space allowance or
      dietary lysine level. Pigs on adequate and restricted floor space allowances
      responded similarly to dietary lysine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463137
TI  - Delivery of lymph node-targeted adriamycin by gastric submucosal liposomal
      injection in rabbits.
AB  - We investigated the feasibility of specifically delivering adriamycin (ADR) to
      the regional lymph nodes via gastric submucosal injection of liposomal adriamycin
      (Lipo-ADR) in a rabbit model. We determined the tissue distribution of ADR for up
      to 7 days after the gastric submucosal injection of Lipo-ADR (0.4 mg/kg of ADR
      potency) and i.v. administration of an equal dose of free adriamycin (F-ADR). The
      area under the ADR concentration-time curve (AUC) of the regional lymph nodes was
      85.4 micrograms.day/g after gastric submucosal injection of Lipo-ADR and 8.44
      micrograms.day/g after i.v. administration of F-ADR. The targeting index of the
      regional lymph nodes, defined as the ratio of the AUC after gastric submucosal
      injection of Lipo-ADR to the AUC after i.v. administration of F-ADR, was 10.1.
      Gastric submucosal injection of Lipo-ADR enhanced lymph node-specific delivery of
      ADR compared with i.v. administration of F-ADR. The targeting index was 0.47 for
      the heart, 0.25 for the bone marrow, and 0.41 for the spleen, indicating that
      gastric submucosal injection of Lipo-ADR reduced delivery of ADR to these organs,
      as compared with i.v. administration of F-ADR. These data demonstrate that
      gastric submucosal injection of Lipo-ADR is well suited for specific delivery of
      ADR to the regional lymph nodes, suggesting that this method of administration
      may be useful in delivering preoperative adjuvant chemotherapy for preventing
      gastric cancer recurrence.

PMID- 8463140
TI  - Influence of source and amount of dietary protein on performance, blood
      metabolites, and reproductive function of primiparous beef cows.
AB  - Forty Angus x Hereford 2-yr-old primiparous cows (358 kg) were used to determine
      the effects of source and amount of CP on performance, reproductive function, and
      metabolic status of suckled primiparous cows. A 2 x 2 factorial treatment
      arrangement was used; cows received either 100 or 150% of NRC recommendations for
      CP in diets that contained either soybean meal (low escape = L) or corn gluten
      meal/blood meal (high escape = H) as the principal supplemental protein source.
      Resulting treatments were 100-L, 100-H, 150-L, and 150-H. Cows were individually
      fed diets for 100 d or until they were observed to be in standing estrus. Diets
      were isoenergetic and limit-fed to meet NRC recommendations for NE, Ca, and P for
      364-kg, 2-yr-old primiparous cows producing 4.5 kg of milk daily and gaining .23
      kg/d. Increased CP tended (P = .09) to increase ADG in cows, but body condition
      score was unaffected. Increased CP and use of a CP source with higher potential
      for ruminal escape increased ADG in calves from d 0 to 97 (P = .002 and .04,
      respectively), which corresponded with numerical changes in milk production.
      Feeding high escape CP sources decreased plasma glucose and urea N (P = .04 and
      .0001, respectively). Increased CP tended (P = .12) to increase plasma glucose
      and increased (P = .0001) plasma urea N. Treatment had no effect on profiles of
      LH or progesterone. Although numerical differences in conception rate seemed
      large for 100-L compared with the remaining treatments, statistical significance
      was not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463141
TI  - Evaluation of long-term somatotropin implants in finishing pigs.
AB  - Ninety pigs were used to investigate the efficacy of long-term implants of
      porcine somatotropin (pST) in improving growth, feed:gain ratio, and carcass
      characteristics in pigs at three dose levels (0-, 100-, and 200-mg pST implant)
      from 71 to 99 kg live weight. The use of long-term implants did not alter (P >
      .05) growth rate. Administration of the 200-mg pST implant resulted in a 15%
      reduction in feed consumption, and this reduction was significant (P < .05). The
      feed:gain ratio was improved (P < .05) in pigs that received the 200- compared
      with 0-mg pST implant (3.2 vs 2.62 of kg feed/kg of gain). In pigs that received
      the 200- or 100-mg pST implant, there was a reduction (P < .05) in carcass
      weight; however, carcass length was similar (P > .05) regardless of pST
      treatment. Administration of the 200-mg pST implant resulted in 25 and 38%
      reductions (P < .05) in last rib fat and leaf fat compared with the 0-mg pST
      implant. The weights of kidneys and head were increased by the pST
      administration. The weights of wholesale cuts were not affected by the
      administration of the pST implant. However, separable skin and fat from the ham,
      loin, and picnic were lower (P < .05) in pigs that received the 200-mg pST than
      in pigs that received the 0-mg pST implant. Meat color and structure were similar
      across pST treatments, indicating that the use of long-term pST implants was not
      detrimental to meat quality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463142
TI  - Alternative methods of selection for litter size in mice: III. Response to 21
      generations of selection.
AB  - Alternative methods of selection to increase litter size in mice have been
      practiced for 21 generations followed by six generations of relaxed selection.
      Three replicates were used with four selection criteria: index of components
      (IX:I = 1.21 x total ovulation rate + 9.05 x ova success), uterine capacity (UT),
      litter size (LS), and an unselected control (LC). In IX, ovulation rate and ova
      success were measured by number of corpora lutea and number of pups born/number
      of corpora lutea, respectively. In UT, uterine capacity was measured and defined
      as number of pups born to unilaterally ovariectomized (right ovary excised)
      females. Selection in LS was based on number born to unaltered dams. In all
      cases, number born was fully formed, live or dead pups. Pups from 16 randomly
      chosen LC dams and from the top 16 dams in IX, UT, and LS were selected to
      produce the next generation in each criterion-replicate line. Response in number
      born, selected criteria deviated from control, was regressed on generation number
      over the 21 generations of selection. Responses for the IX and LS criteria were
      quite similar (.14 +/- .01 and .16 +/- .01 pups per generation, respectively),
      whereas response in UT, with only one functional horn, was slightly lower (.09 +/
      .01). The average cumulative selection differentials for IX, LS, and UT at
      Generation 21 were 32.78 index units, 36.38 pups, and 28.53 pups, respectively.
      The LC criterion had an unintentional cumulative selection differential of 3.3
      pups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463143
TI  - Potential shortcomings of output:input ratios as indicators of economic
      efficiency in commercial beef breed evaluations.
AB  - In recent years animal breeders have increasingly made use of output:input ratios
      and simple measures of economic efficiency, such as annual profits, as a basis
      for comparisons and evaluations of the commercial applicability of alternative
      beef breeds. In many instances, however, output:input ratios may produce
      fallacious indications of economic efficiency that may, in turn, lead to
      erroneous conclusions regarding the true commercial applicability of the breeds
      evaluated. Errors potentially arising from the use of output:input ratios in
      breed evaluations may be attributed to a combination of 1) a narrow range of
      input use values under which most breeds are evaluated and 2) the inability of
      output:input ratios, including average annual profitability, to reflect
      consistently the economic objectives of commercial cow-calf producers. An
      alternative basis for breed comparison and evaluation is, therefore, developed
      from economic theories related to optimal investment and asset replacement.
      Comparison of the results obtained with this alternative to those obtained from
      output:input ratio evaluation, including annual profitability, indicate that
      potential value differences of as much as 33% may result from the use of
      output:input ratios as a primary basis of commercial breed evaluation.

PMID- 8463144
TI  - Evaluation of mating systems involving five breeds for integrated beef production
      systems: IV. Accounting for variability and genetic trends.
AB  - Computer models were used to simulate integrated cow-calf-feedlot production
      systems. Angus (A), Charolais (C), Hereford (H), Limousin (L), and Simmental (S)
      purebreds and two- and three-breed rotational crossbreds were included. Models
      were deterministic and based on data reported primarily from the 1970s. Variation
      in carcass weights were determined to predict distributions of carcass weights
      and values for 272- to 318-kg carcasses. Data were updated to a 1984 base by
      increasing birth, weaning, yearling, and mature weights to account for genetic
      trends within breeds. Two slaughter end points were considered: 288-kg carcass
      weight and low Choice grade. At low Choice grade, accounting for variation in
      carcass weights around the 272- to 318-kg target weight increased the estimated
      efficiency of A and AH crosses (input costs/carcass value), whereas at the 288-kg
      end point, efficiency rankings among other breed combinations were relatively
      unchanged. Including genetic trends resulted in increased estimated efficiencies
      among breed combinations with previously underweight carcasses at low Choice (A
      and AH), measured either as input costs/carcass weight or lean weight values.
      Within breeds, accounting for genetic trends and variation for weights caused
      breeds to be ranked differently when evaluated at low Choice.

PMID- 8463145
TI  - Correlated responses in reproductive and carcass traits to selection for 200-day
      weight in Landrace pigs.
AB  - Correlated responses in reproductive and carcass traits from a line of Landrace
      pigs selected for increased 200-d weight along with a randomly selected control
      line were studied in 195 litters (109 select, 86 control) and 285 pigs (132
      select, 153 control). Reproductive and maternal traits studied included litter
      sizes born, born alive, and alive at 21 d and litter weights at birth and at 21
      d. Carcass traits studied were carcass length, longissimus area, average backfat
      thickness, 10th-rib backfat thickness, specific gravity, weights of closely
      trimmed ham, loin, and shoulder, belly weight, subjective scoring of the
      longissimus muscle for color and marbling, estimated percentage of muscle, and
      lean growth. Total weighted cumulative selection differential for 200-d weight
      over six generations was 88.7 kg. The realized heritability for 200-d weight was
      .26 +/- .08, and the change in 200-d weight was 4.2 +/- 1.3 kg per generation.
      None of the regression coefficients for reproductive traits differed
      significantly from zero. Ham weight, belly weight, marbling score, and lean
      growth increased by .069 +/- .027 kg, .051 +/- .020 kg, .045 +/- .012 points, and
      .0042 +/- .0007 kg/d, respectively, per generation. Specific gravity decreased by
      -.00063 +/- .00023 per generation in response to the selection for 200-d weight.
      The increase in lean growth in the select line was the result of an increased
      growth rate and not from an improvement in percentage of lean in carcasses from
      pigs from the select line.

PMID- 8463146
TI  - Effects of selection strategies using heifer pelvic area and sire birth weight
      expected progeny difference on dystocia in first-calf heifers.
AB  - A stochastic computer simulation model was developed to evaluate the effects of
      selection strategies based on heifer pelvic area and sire birth weight EPD on
      dystocia in first-calf heifers. Parameters and relationships used were taken from
      the literature. Unrelated sets of yearling heifers were simulated. Replacement
      heifer selection was based on breeding the top 40, 60, 80 or 100% (i.e., no
      selection) of available heifers as determined by yearling pelvic area (YRLGPA).
      Selected heifers were bred to bulls that were selected based on EPD for birth
      weight (SEPD). Levels of SEPD were -2.7, -1.8, -.9, 0, .9, and 1.8 kg. Simulated
      responses included precalving pelvic area, calf birth weight, calving difficulty
      score (1, 2, 3, 4), and incidence of dystocia (0, 1). Both measures of dystocia
      were predicted from the ratio of precalving pelvic area to calf birth weight.
      Simulated data were analyzed using least squares procedures. The effects of SEPD
      were significant (P < .05) for birth weight, calving difficulty score, and the
      frequency of dystocia. Differences among levels of heifer selection for YRLGPA
      were significant for YRLGPA, precalving pelvic area, birth weight, and calving
      difficulty score but not for the frequency of dystocia. Based on partial
      regressions calculated from weighted replication means, a 1-kg decrease in SEPD
      will decrease average calving difficulty score by .12 units and decrease the
      frequency of dystocia by 4%, whereas each 10% increase in selection pressure on
      YRLGPA will reduce the average calving difficulty score by only .02 units and
      have no detectable effect on the frequency of dystocia.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8463147
TI  - Changes in ovulation rate, uterine capacity, uterine dimensions, and parity
      effects with selection for litter size in swine.
AB  - This study was conducted with random samples of pigs of a line (LS) selected for
      eight generations for litter size and a randomly selected control line (RS) in
      the Nebraska Gene Pool population and of crosses of these lines with a Large
      White-Landrace composite line (I) that was selected for an index of ovulation
      rate and embryonic survival to 50 d of gestation. Two experiments were done to
      obtain information on ovulation rate, uterine dimensions, and uterine capacity.
      In Exp. 1, 103 gilts were slaughtered 9 to 16 d after their second estrus to
      obtain reproductive tracts for evaluation of ovulation rate and uterine
      dimensions. In Exp. 2, unilateral hysterectomy-ovariectomy was performed 3 to 10
      d after puberty in 109 gilts that were then mated at their next estrus and
      slaughtered at 93 to 100 d of gestation to recover reproductive tracts for
      evaluation. Litter size at birth was recorded at first (n = 414), second (n =
      159), and third (n = 143) parity of pureline and crossline gilts. The cumulative
      response to eight generations of selection for litter size pooled over type of
      cross and parity was 1.21 +/- .38 pigs, in good agreement with the realized
      response of 1.06 pigs previously estimated for the period of selection. This
      response was due to an increase of 1.30 +/- .54 eggs in ovulation rate (measured
      by the number of corpora lutea in cyclic and pregnant gilts) and .66 +/- 1.28
      pigs in uterine capacity (measured after unilateral hysterectomy-ovariectomy). No
      significant changes were found in uterine dimensions in cyclic gilts.
      Approximately 25% of the increase in litter size could be explained by a
      reduction in number of mummified pigs at birth, an indication that uterine
      capacity in late gestation was increased. Estimated differences between lines
      (gLS - gRS) were not significantly different for pureline and crossline gilts and
      sows, and no interactions of these estimates with parity were detected. Estimates
      of heterosis for LS x I and RS x I did not differ significantly, nor were
      interactions of heterosis with parity significant.

PMID- 8463148
TI  - The effects of different methods of estimating fecal output on plasma cortisol,
      fecal output, forage intake, and weight change in free-ranging and confined
      wethers.
AB  - Thirty-four white-face wethers (avg BW 56 kg) were used in two experiments to
      investigate differences in plasma cortisol, forage intake, fecal output, and BW
      change associated with two methods of estimating fecal output. The methods were
      fecal collection bags (B) and marker estimates of fecal output (U). A control
      treatment (C) was included in each experiment in which wethers were not bagged or
      dosed with the marker. Experiment 1 was conducted with wethers grazing dormant
      sagebrush-bunchgrass range. Experiment 2 was conducted with wethers housed in
      metabolism crates. In Exp. 1, the following differences were detected: 1) basal
      and mean integrated (following ACTH challenge) plasma cortisol levels were higher
      (P < .05) for U wethers than for C wethers, 2) no differences (P > .05) between B
      and C wethers were detected for basal or mean integrated plasma cortisol, 3) both
      B and U wethers gained (P < .05) weight, whereas C wethers lost weight, and 4) no
      differences (P > .05) between B and U wethers were detected for cortisol
      measurements, weight change, or fecal output. No differences (P > .05) were noted
      for any of the variables tested in Exp. 2. When treatments were combined within
      experiment to test Exp. 1 vs 2, time to peak cortisol levels was longer (P < .05)
      and mean integrated cortisol levels and weight change were lower (P < .05) for
      wethers in confinement than for wethers on range. No difference (P > .05) was
      detected for basal cortisol levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463149
TI  - Comparison of the fatty acid composition of subcutaneous adipose tissue from
      mature Brahman and Hereford cows.
AB  - The fatty acid composition of adipose tissue was measured in 37 mature Brahman
      and 32 mature Hereford cows to determine breed effect. Diet was held constant
      among all cows. When biopsied, cows were on oats and native cool-season annual
      pastures of good quality. Real-time ultrasound measurements of subcutaneous fat
      were taken at three locations (between the 12th and 13th rib, at the rump, and at
      the perianal region) to determine overall fatness. Overall fat thickness from
      these measurements was 1.3 cm for Brahman cows and 1.7 cm for Hereford cows (P <
      .01). Subcutaneous adipose tissue biopsy samples were collected from the perianal
      region, and fatty acid composition was determined using a gas chromatograph.
      Fatty acids were expressed in both normalized (area percentage) and gravimetric
      (grams/100 grams of fresh tissue) formats. In addition to greater overall
      subcutaneous fat thickness, Hereford cows contained 5 g more of fatty acids per
      100 g of fresh adipose tissue than Brahman cows (P < .05). Subcutaneous adipose
      tissue from Hereford cows was higher (P < .01) in total saturated fatty acids and
      lower in mono- and polyunsaturated fatty acids than subcutaneous adipose tissue
      from Brahman cows. Compositional differences remained when breeds were compared
      by analysis of covariance at a common body fatness. The data suggest a genetic
      basis for the differences in fatty acid composition of Brahman and Hereford cows.

PMID- 8463150
TI  - Growth and slaughter characteristics of ram and wether lambs implanted with
      zeranol.
AB  - Forty-nine Columbia ram and wether lambs born in April 1990 and 46 born in April
      1991 were studied to determine the effects of zeranol implants on growth,
      difficulty of pelt removal, and carcass characteristics. Implanting ram and
      wether lambs once (1990) or twice (1991) with 12 mg of zeranol did not change
      live weight or ADG but gain/feed decreased (P < .05) in ram lambs slaughtered at
      approximately 50 kg. Testes weight was reduced approximately 50% by implanting.
      Two implants reduced (P < .05) the force needed to pull the pelt from the hind
      legs of ram lambs, but implanting tended to increase the force required to pull
      the pelt from wether lambs. Data for pelt weight, force required to pull the
      pelt, percentage of the carcass in the shoulder or splenius muscle, and Warner
      Bratzler shear values showed that zeranol implants resulted in ram lambs becoming
      more like wethers and wether lambs becoming more like rams. Implanting with
      zeranol did not affect closure of the metacarpal growth plate in ram or in wether
      lambs. Difficulty of pelt removal can be reduced by implanting ram lambs with 12
      mg of zeranol at approximately 114 d of age and reimplanting zeranol 28 d later.

PMID- 8463151
TI  - Palatability of prerigor cooked boar meat.
AB  - Cooking reduces odor intensity in boar meat but also may induce lipid oxidation
      unless the meat pH is above approximately 6.0. This research was designed to
      determine the feasibility of cooking boar meat in the prerigor state to overcome
      boar odor and lipid oxidation problems. Prerigor and postrigor triceps brachii
      muscle samples from 40 boars (20 Duroc and 20 Yorkshire) were cooked to 60
      degrees C, frozen and stored at -20 degrees C, reheated in a 60 degrees C water
      bath for 1 h, and then subjected to pH, thiobarbituric acid (TBA), and sensory
      analyses. Boar odor intensity and skatole concentration in backfat samples were
      determined by olfactory test and HPLC, respectively. Cooked (initial cooking)
      prerigor meat was found to have higher (P < .05) pH and lower (P < .05) TBA
      values than comparable postrigor meat (6.44 vs 6.09 and 2.15 vs 3.23,
      respectively). Regression analysis indicated an inverse relationship between pH
      and TBA values (r = -.52; P < .01). No appreciable changes in TBA values were
      noted after frozen storage for 14 to 98 d, but reheating increased TBA values (P
      < .05) in both prerigor and postrigor samples (3.45 vs 4.32, respectively).
      Sensory evaluation scores indicated that prerigor cooked meat was less tender
      with more pronounced rancid flavor than postrigor cooked meat (P < .05), but
      panelists may have allowed the toughness of the prerigor samples to adversely
      affect their flavor scores. No difference in boar odor was detected between rigor
      states or breeds. Mean skatole concentration in backfat was .12 micrograms/g and
      no difference was detected between breeds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463152
TI  - Effect of supplemental niacin on sow reproduction and sow and litter performance.
AB  - In this study the effects of supplemental crystalline niacin on sow reproduction
      and sow and litter performance were evaluated using 240 litters produced by 67
      sows. A basal 12.80% CP corn-soybean meal-oat diet was supplemented with 0 or 33
      mg of crystalline niacin/kg during gestation and lactation. The sows were grouped
      to equalize initial BW and parity among the two treatment groups. Each sow was
      fed 2.0 kg/d during gestation and 1.8 kg plus .45 kg per nursing pig during
      lactation. Sows not culled due to reproductive or structural problems remained on
      the experiment for five parities (average 3.6). Supplemental niacin did not
      improve (P > .20) any of the sow reproductive or sow and litter performance
      variables evaluated, including the subjective scores for sow lameness, toe
      cracks, and hair and skin condition. In conclusion, these results suggest that a
      12.80% CP corn-soybean meal-oat diet provides adequate niacin during gestation
      and lactation without supplementation with crystalline niacin.

PMID- 8463153
TI  - Effect of chromium picolinate on growth and serum and carcass traits of growing
      finishing pigs.
AB  - Three experiments were conducted to evaluate chromium picolinate (CrPic) in
      growing-finishing pigs. Treatments were replicated four times within each
      experiment with three pigs per replicate in Exp. 1 and four pigs per replicate in
      Exp. 2 and 3. Average initial weights were 37.8, 30.5, and 22.4 kg in Exp. 1, 2,
      and 3, respectively. In Exp. 1, the basal corn-soybean meal diet (B, 120% NRC
      Lys) was supplemented with 0, 25, 50, 100, or 200 ppb of Cr from CrPic. Daily
      gain was increased (Cr cubic, P < .02) and serum cholesterol decreased (Cr cubic,
      P < .08) by addition of CrPic. In Exp. 2, the basal diet was supplemented with 0,
      100, 200, 400, or 800 ppb of Cr from CrPic. Daily gain and ADFI were decreased
      (Cr linear, P < .05) by CrPic. Serum cholesterol also was decreased (Cr
      quadratic, P < .05) by CrPic. Longissimus muscle area (LMA) and percentage of
      muscling (MUS) were increased (Cr quadratic, P < .01) and 10th rib fat (TRF) was
      decreased (Cr quadratic, P < .01) by CrPic. In Exp. 3, pigs were allotted to the
      following treatments: 1) B, 2) B + 1,467 ppb of picolinate (Pic), 3) B + 200 ppb
      of Cr from CrCl3.6H2O, 4) B + 1,467 ppb of Pic + 200 ppb of Cr from CrCl3.6H2O,
      5) B + 100 ppb of Cr from CrPic, or 6) B + 200 ppb of Cr from CrPic. Longissimus
      muscle area and MUS were increased (P < .01) and TRF decreased (P < .01) in pigs
      fed CrPic but not in pigs fed CrCl3.6H2O and(or) Pic.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8463154
TI  - Interrelationships between porcine somatotropin and dietary lysine on growth
      performance and carcass characteristics of finishing swine.
AB  - Seventy-two barrows (initial weight = 57.1 kg) were used to determine the
      interrelationship between porcine somatotropin (pST) and dietary lysine and their
      effects on growth performance and carcass characteristics. Pigs were injected
      daily in the extensor muscle of the neck with either 4 or 8 mg of pST and fed a
      pelleted corn-soybean meal-sesame meal diet (.8% lysine; 17.8% CP) or diets
      containing 1.0, 1.2, or 1.4% lysine provided by additions of L-lysine.HCl (2 x 4
      factorial arrangement). Control pigs (placebo injection) received the .8% lysine
      diet. All diets were formulated to contain > or = 200% of current recommendations
      for other amino acids, vitamins, and minerals. A tendency for a pST x lysine
      interaction was observed for cumulative ADG (P < .15) and feed conversion (G/F; P
      < .05). Average daily gain and G/F were improved by increasing dietary lysine
      level in pigs injected with 4 mg/d of pST; however, pigs injected with 8 mg/d of
      pST had greater improvements in cumulative ADG and G/F with added lysine. Feed
      intake was reduced (quadratic, P < .10) as dietary lysine level and pST dosage
      increased. Increasing pST dosage and dietary lysine increased (linear, P < .05)
      longissimus muscle area and decreased backfat thickness. Trimmed ham and loin
      weights were increased (linear, P < .10) by pST dosage. Chemical composition of
      samples taken from the loin, ham, and belly indicated increased moisture and CP
      and decreased lipid content as pST dosage and dietary lysine level increased
      (quadratic, P < .05). Shear force values from loin and semimembranosus increased
      with increasing lysine level (quadratic, P < .01) and pST dosage (linear, P <
      .05); however, these differences were not detected by sensory analysis (P > .20).
      Plasma urea concentrations on d 28 decreased with increasing lysine level
      (quadratic, P < .05), and plasma lysine concentrations increased (linear, P <
      .01). Based on the pST x lysine interaction for ADG and G/F, these data suggest
      that the lysine level needed to maximize growth performance and carcass
      characteristics may be proportional to the pST dosage provided. Growth and
      carcass characteristics were maximized by dietary lysine intakes of 27 to 32 and
      > or = 36 g/d for pigs injected with 4 and 8 of mg/d of pST, respectively.

PMID- 8463155
TI  - Porcine somatotropin and dietary lysine influence bone mineralization and
      mechanical properties of bones in finishing swine.
AB  - The femur, a rib, and a third metacarpal were collected from 108 barrows (initial
      weight = 57 kg) and analyzed to determine the effects of porcine somatotropin
      (pST) and dietary lysine on bone mineralization and mechanical properties. In
      Exp. 1, pigs were injected daily with 4 mg of pST and fed diets containing 1.0%
      Ca and .9% P and either .6, .8, 1.0, 1.2, or 1.4% lysine. Control pigs (placebo
      injection) received the .6% lysine diet. Bone wall thickness (BWT) of the femur
      increased (linear, P < .05) but ash content decreased (linear, P < .10) as
      dietary lysine level increased. Stress and ash content of the rib also decreased
      (linear, P < .05) with increasing dietary lysine level. In Exp. 2, pigs were
      injected with either 4 or 8 mg/d of pST and fed diets containing 1.1% Ca and 1.0%
      P and either .8, 1.0, 1.2, or 1.4% lysine. Control pigs received the .8% lysine
      diet. Increasing pST dosage increased BWT of the femur (linear, P < .10) but
      decreased ash content (linear, P < .10). In the rib, increasing pST dosage
      reduced stress, modulus of elasticity (linear, P < .10), and ash content (linear,
      P < .01). Increasing lysine level resulted in increased BWT of the femur and
      decreased ash content of rib, femur, and metacarpal (linear, P < .10). These data
      indicate that pST administration in conjunction with increasing lysine levels
      decreases bone ash content but increases BWT of finishing pigs.

PMID- 8463156
TI  - Reduction of fertility and alteration of uterine pH in heifers fed excess
      ruminally degradable protein.
AB  - The objective of these studies was to elucidate the causes underlying the
      reduction of fertility associated with feeding of excess ruminally degradable
      protein to cattle. Holstein heifers were fed total mixed rations that either met
      (Normal) or exceeded (High) ruminally degradable protein requirements. In Exp. 1
      heifers (n = 80) were inseminated at estrus after being fed the experimental
      diets for 4 wk. First-service conception rates were 82 and 61% for the Normal and
      High groups, respectively (P < .05). Plasma urea nitrogen (PUN) levels were
      elevated (10.2 +/- .17 vs 14.8 +/- .19 mg/dL) in the High group throughout the
      experiment (P < .05). In Exp. 2, heifers (n = 32) receiving the same diets as in
      Exp. 1 were fitted with catheters in a jugular vein, in the bladder, and in the
      uterus on either the day before expected estrus or d 6 after estrus. On estrus or
      d 7, plasma and urinary NH4 and urea nitrogen and uterine pH were determined at 4
      h intervals for 24 h beginning just before feeding. Plasma NH4 was variable and
      did not differ between treatments or days of the estrous cycle. During the 24-h
      period, urinary urea nitrogen and PUN were elevated (P < .05) in the High groups
      and did not differ between days of the cycle. Urinary NH4 excretion was elevated
      (P < .05) during the 24-h period only in the High group on d 7. Uterine pH did
      not change over time after feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463157
TI  - Alterations of pH in response to increased dietary protein in cattle are unique
      to the uterus.
AB  - This study was undertaken with two objectives: 1) to determine whether the effect
      of excess dietary protein on intrauterine pH in cattle is specific to the uterus
      or manifested in other bodily fluids and 2) to determine whether the effect of
      excess ruminally degradable protein on uterine pH can be ameliorated by
      substitution with a less-degradable protein source. Thirty-six Holstein cows in
      early lactation were fed isoenergetic total mixed rations that either 1) met
      undegradable intake protein (UIP) and degradable intake protein (DIP)
      requirements (Balanced), 2) met DIP requirements and exceeded UIP requirements by
      25% (High UIP), or 3) met UIP requirements and exceeded DIP requirements by 25%
      (High DIP). After diets had been fed > or = 2 wk, uterine, blood, salivary, and
      urinary pH and plasma urea nitrogen were determined at estrus (d 0) and d 7.
      Plasma urea nitrogen (mg/dL) was not different between estrus and d 7 but was
      significantly affected by diet (Balanced, 16.1 +/- 2.3; High UIP, 19.2 +/- 1.6;
      High DIP, 22.3 +/- 2.6; P < .05). There was no effect of treatment on the pH of
      any fluid measured at estrus: intrauterine, blood, salivary, and urinary pH
      averaged 6.84 +/- .05, 7.39 +/- .01, 8.30 +/- .05, and 8.15 +/- .05,
      respectively. In contrast, on d 7, uterine pH was significantly lower in both
      high-protein groups, regardless of protein degradability (Balanced, 7.13 +/- .05;
      UIP, 6.95 +/- .04; DIP, 6.85 +/- .05; P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463158
TI  - Sperm transport and distribution during the puberal transition in ewe lambs.
AB  - Sperm transport through and distribution within the anterior reproductive tract
      were evaluated at either 2 or 22 h after artificial insemination in ewe lambs at
      first (1E; n = 15) or third (3E; n = 14) estrus and in mature (MAT; n = 12) ewes.
      Each ewe was inseminated immediately upon detection of estrus with 7.5 x 10(8)
      progressively motile sperm placed into the external os cervix. Ewes were
      hysterectomized at either 2 or 22 h after insemination. Sperm were recovered from
      the uterus, isthmi, and ampullae by flushing with sterile .9% saline. The
      distribution of sperm recovered from the uterus, isthmus, and ampulla did not
      differ (P > .10) among 1E, 3E, and MAT ewes at either 2 or 22 h. However, there
      was a tendency (P = .08) for more sperm to be recovered from the anterior
      reproductive tract in 3E and MAT ewes than from that in 1E ewes. There was a time
      of hysterectomy x anatomical segment interaction (P < .05) for percentage of
      sperm recovered of the total number of sperm in the inseminate because more sperm
      were recovered from the isthmus and ampulla at 22 h than at 2 h after
      insemination. Percentages of 1E, 3E, or MAT ewes from which sperm were recovered
      from the anterior reproductive tract did not differ (P > .10). However, sperm
      were recovered from the oviducts in a greater (P < .05) percentage of ewes at 22
      h after insemination than at 2 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463159
TI  - Effects of sire and dam on late-pregnancy conceptus and hormone traits in beef
      cattle.
AB  - Forty-six primiparous F1 heifers produced from mating Brahman (B), Charolais (C),
      Jersey (J), Longhorn (L), or Shorthorn (S) sires to crossbred cows were bred by
      AI to one of two Angus sires selected to produce high (H) or moderate (M) fetal
      growth. Dams were slaughtered at an average of 231 d of gestation. Daily blood
      samples were obtained from the dam on d 228 to 231 to determine serum estradiol,
      progesterone, and testosterone concentrations. Pelvic height was greatest (P <
      .05) in B, C, and L and pelvic width was greatest (P < .05) in S, C, and J dams,
      but pelvic areas did not differ (P > .10). Dams with greater hip height had
      larger pelvic areas (r = .45; P < .01). Intact fetuses from C and S dams were
      heaviest (P < .05), those from S dams had the greatest (P < .05) head width, and
      heart girth was greatest (P < .05) in fetuses from L dams. Fetuses from H sires
      were greater in weight (P < .01), body length (P < .01), and cannon circumference
      (P < .01). Dam differences were found in fetal heart weight (P < .01), trimmed
      placental membrane weight (P < .01), and average placentome weight (P < .05).
      Weights of eviscerated fetuses were greatest from C dams (P < .05). Placentome
      number was lowest (P < .05) in J dams, but J dams had the highest (P < .05)
      average placentome weight. Interactions between fetal genotype and breed of
      maternal environment were found for weight of eviscerated fetus (P < .05), body
      length, and heart weight (P < .01) and resulted from both magnitude and direction
      of change in the sire effect. The H sire increase in fetal weight was greatest in
      J dams, whereas B dams allowed expression of the fetal growth potential but at a
      lower level. Fetal trait interactions were also found for breed x sex and sex x
      sire (P < .05 to P < .01) and were due to the magnitude of differences expressed
      between the M and H sires. Serum testosterone concentrations were highest (P <
      .05) in B and L dams, dams gestating fetuses sired by the H sire (P = .08), and
      those with male fetuses (P < .01). We interpret these results to indicate that
      some maternal environments can suppress fetal growth, whereas others seem to
      complement the growth and allow maximum expression of the fetal genetic growth
      potential.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463160
TI  - Uptake of orally administered beta-carotene by blood plasma, leukocytes, and
      lipoproteins in calves.
AB  - The uptake of beta-carotene by blood cells, plasma, and lipoproteins was studied
      in bull calves that were orally administered a single (Exp. 1; n = 18 Angus
      calves) or multiple (Exp. 2; n = 16 Holstein calves) doses of beta-carotene.
      Administration of beta-carotene increased plasma beta-carotene and the amount of
      beta-carotene associated with each lipoprotein fraction. Before beta-carotene
      treatment, the total amount of beta-carotene associated with the high-density
      lipoprotein (HDL) was three- to fourfold higher than the amount associated with
      low-density lipoprotein (LDL) and fivefold higher than the amount associated with
      very-low-density lipoprotein (VLDL). The relative increase in total beta-carotene
      associated with the lipoproteins was greater for LDL than for HDL or VLDL. Orally
      administered beta-carotene increased the uptake of beta-carotene by lymphocytes.
      Subcellular fractions of blood lymphocytes isolated from animals fed beta
      carotene revealed that beta-carotene was taken up in significant amounts by the
      mitochondrial, nuclear, and microsomal fractions. The profile of beta-carotene
      uptake by these subcellular fractions did not mirror that observed in plasma. In
      contrast, beta-carotene was not detectable in blood neutrophils and erythrocytes
      in either beta-carotene-supplemented or unsupplemented calves. Treatment did not
      influence the concentrations of retinol or alpha-tocopherol in plasma,
      lipoproteins, lymphocytes, neutrophils, or erythrocytes. These data revealed the
      presence of beta-carotene in bovine lymphocyte subcellular fractions and suggest
      a possible physiological role of beta-carotene in these cells.

PMID- 8463161
TI  - Protein sources for finishing calves as affected by management system.
AB  - Two beef production systems were evaluated in conjunction with an evaluation of
      escape protein sources for finishing calves. Two hundred forty crossbred steers
      and 80 crossbred heifer calves (BW = 267 +/- 2 kg) were split into two groups: 1)
      control, finished (207 d) after a 3-wk feedlot adjustment period and 2) grazing
      cornstalks for 74 d after a 3-wk feedlot adjustment period, then finished (164
      d). Finishing treatments were sources and proportions of supplemental CP: 1) urea
      100%; 2) soybean meal (SBM) 100%; 3) blood meal (BM) 50%, urea 50%; 4) feather
      meal (FTH) 50%, urea 50%; 5) SBM 50%, FTH 25%, urea 25%; 6) SBM 25%, FTH 38%,
      urea 37%; 7) FTH 25%, BM 25%, urea 50%, and 8) FTH 38%, BM 13%, urea 50%.
      Treatments 1 to 8 were fed in dry-rolled corn (DRC)-based diets. Treatments 9 and
      10 were supplement Treatments 1 and 7 fed in diets based on high-moisture corn.
      Calves finished after a 74-d period of grazing cornstalks consumed more feed (P <
      .01) and gained faster (P < .01) but were less efficient (P < .05) than calves
      finished directly after weaning. Although not statistically different, calves
      finished after grazing cornstalks and supplemented with natural protein in the
      feedlot were 7% more efficient than calves supplemented with urea alone.
      Efficiency of calves finished directly after weaning was similar for calves
      supplemented with natural protein or urea alone. Supplementing SBM/FTH/urea or
      BM/FTH/urea improved feed efficiency compared with supplementing FTH/urea alone.
      These data suggest that allowing calves to graze cornstalks before finishing is a
      possible management option, but this system may require more metabolizable
      protein in the finishing diet to maximize feed efficiency if the calves are
      expressing compensatory growth.

PMID- 8463162
TI  - Technical note: an improved method to quantify nonesterified fatty acids in
      bovine plasma.
AB  - Nonesterified fatty acids (NEFA) are measured routinely in the study of nutrition
      and growth physiology. To improve the efficiency with which this variable is
      measured, a two-reaction, enzymatic-based assay was adapted and validated to
      quantify NEFA in bovine blood plasma using 96-well microtiter plates. The effects
      of incubation time, temperature, and of sample volume were examined in addition
      to possible interfering substances, recovery, reagent stability, and range of
      linearity. Incubation for 30 min at 21 degrees C for each of the two reactions
      resulted in maximal slope and r2 values (1.94 and .999, respectively). Percentage
      of recovery was 107% when using 5 microL and 100% when using 10 microL of
      heparinized bovine plasma in the assay. Uniform linear standard curves (r2 > .99)
      were obtained using reagents stored at 4 degrees C for 9 d. An equal volume of 1
      mM acetate, propionate, valerate, and butyrate added to plasma did not affect
      results. The assay was linear from 125 to > 1,000 microEq/L. Intra- and
      interassay CV for the 5-microL sample volume were 3.6 and 3.7%, respectively.
      This modified assay provides results comparable to the standard assay yet reduces
      reagent and labor requirements and increases sample capacity.

PMID- 8463163
TI  - Growth and endocrine responses of cattle to implantation of estradiol-17 beta
      during continuous or discontinuous grazing of high- and low-endophyte-infected
      tall fescue.
AB  - Forty-eight Angus x Hereford steers (initial BW = 336 +/- 8.3 kg) were used in a
      56-d study to evaluate growth and endocrine responses to continuous or
      discontinuous grazing of high-endophyte-infected Kentucky-31 (K; > 57%
      infestation rate) or low-endophyte-infected Johnstone tall fescue (J; < 1%
      infestation rate) and implantation with 0 or 24 mg/steer of estradiol-17 beta
      (E2; Compudose). Steers were allotted by weight to eight 3-ha paddocks (four
      paddocks of each fescue variety) with six steers per paddock. Two paddocks of
      each variety were grazed continuously (KK and JJ), whereas steers on the
      remaining four paddocks were rotated every 14 d from K to J (KJ) or from J to K
      (JK). Three steers in each paddock were implanted with E2 on d 0. The study
      extended from May 25, 1988 to July 20, 1988 with steers exposed to potential heat
      stress conditions for 52 d of the 56-d study. Body weights were obtained on d 0,
      28, and 56, and blood samples were taken on d 28 and 56. Overall ADG, serum
      prolactin, and serum alkaline phosphatase activity were greater (P < .05) in JJ
      than in KK steers. Rotation from K to J did not increase overall ADG, prolactin,
      insulin-like growth factor I (IGF-I), or alkaline phosphatase activity compared
      with the continuously grazed KK, whereas JK steers had lower (P < .10) ADG,
      prolactin, and alkaline phosphatase activity than JJ steers. Estradiol-17 beta
      increased (P < .10) IGF-I in JJ, KJ, and JK steers but not in KK steers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463164
TI  - Effect of sire and dam breed on copper status of fat lambs.
AB  - To determine the effect of breed on copper status of crossbred (F1) lambs, a
      study was conducted using 187 crossbred wether lambs. Wether lambs were progeny
      of five ram breeds (Dorset, Finnsheep, Montadale, Romanov, and Texel) and two ewe
      breeds (Rambouillet and a composite breed [1/2 Columbia, 1/4 Suffolk, 1/4
      Hampshire]). Diets were adjusted to decrease crude protein twice during the
      experimental period, with analyzed copper levels for the three diets of 5.2, 4.4,
      and 3.6 ppm. All means were adjusted to a constant carcass weight of 27.265 kg
      using a covariate analysis. Least squares means of the liver copper concentration
      for sire breeds ranged from 307 to 458 micrograms/g on a DM basis. Romanov- (307
      micrograms/g) and Finnsheep-sired (327 micrograms/g) lambs had the lowest liver
      copper concentration, whereas Montadale- (359 micrograms/g) and Dorset-sired (360
      micrograms/g) lambs were intermediate and Texel-sired (458 micrograms/g) lambs
      were significantly higher compared with other lamb breeds. Least squares means
      for total liver copper for the five ram breeds ranged from 69 to 101 mg.
      Finnsheep- (69 mg), Romanov- (72 mg), and Montadale-sired (80 mg) lambs were
      lowest, Dorset-sired (85 mg) lambs were intermediate, and Texel-sired (101 mg)
      lambs were higher (P < .02) compared with other lamb breeds for total liver
      copper. Least squares means for serum copper ranged from .86 to 1.05 ppm. Levels
      of serum copper were similar for Montadale- (.86 ppm), Finnsheep- (.90 ppm),
      Texel- (.93 ppm), and Dorset-sired (.94 ppm) lambs and higher (P < .02) for
      Romanov-sired (1.05 ppm) lambs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463165
TI  - Is an objective assessment of antibiotic therapy in exacerbations of chronic
      bronchitis possible?

PMID- 8463166
TI  - New directions in the diagnosis and treatment of pelvic inflammatory disease.

PMID- 8463167
TI  - Nitroimidazole drugs--action and resistance mechanisms. II. Mechanisms of
      resistance.

PMID- 8463168
TI  - Distribution of genes encoding erythromycin ribosomal methylases and an
      erythromycin efflux pump in epidemiologically distinct groups of staphylococci.
AB  - Erythromycin-resistant staphylococci can be divided into two phenotypic classes
      based on their pattern of cross-resistance to other macrolides, lincosamides and
      type B streptogramins. Strains inducibly or constitutively resistant to all MLS
      antibiotics possess erythromycin ribosomal methylase (erm) genes, whereas strains
      inducibly resistant to only 14 and 15-membered ring macrolides and type B
      streptogramins harbour msrA, which encodes an ATP-dependent efflux pump. Dot-blot
      hybridization was used to study the distribution of ermA, ermB, ermC and msrA in
      five epidemiologically distinct groups of staphylococci. The most widely
      distributed resistance determinant was ermC, which was detected in 112 (50.6%) of
      221 isolates, alone in 106 isolates and in combination with a second erythromycin
      resistance determinant in six strains. MsrA was detected in 73 (33%) of isolates,
      alone in 65 and in combination with a methylase gene in eight strains. This
      determinant was responsible for erythromycin resistance in over one-third (36.4%)
      of clinical isolates of coagulase-negative staphylococci. ErmA and ermB were
      present in only a minority of isolates (5.9 and 7.2% of strains, respectively).
      The resistance determinants present in ten strains did not hybridize to any of
      the four probes although, in all cases, their resistance phenotype was consistent
      with the possession of a methylase gene. Interestingly, ermB was found
      exclusively in animal isolates of Staphylococcus intermedius, Staphylococcus
      xylosus and Staphylococcus hyicus, but not in coagulase-negative staphylococci of
      human origin. This determinant has previously only been found in a small number
      of epidemiologically related strains of Staphylococcus aureus.

PMID- 8463169
TI  - A membrane-bound precursor beta-lactamase in strains of Moraxella catarrhalis and
      Moraxella nonliquefaciens that produce periplasmic BRO-1 and BRO-2 beta
      lactamases.
AB  - By employing the non-ionic detergent Triton X-100, a membrane-bound beta
      lactamase was extracted from strains of Moraxella (Branhamella) catarrhalis and
      Moraxella nonliquefaciens that produce BRO-1 and BRO-2 beta-lactamases. Unlike
      BRO-1 and BRO-2, which exhibit multiple major bands on isoelectric focusing
      (IEF), the membrane-bound enzyme focused as a single IEF band at a pI of 6.20,
      which was not present with either of the other two enzymes. The membrane-bound
      beta-lactamase could be extracted from all strains producing BRO-1 and BRO-2,
      including recombinant strains constructed by transformation or conjugation. The
      enzyme was also recovered from Escherichia coli strain HB101 carrying vector
      plasmid pLQ521 into which the BRO-1 beta-lactamase gene from M. catarrhalis had
      been cloned. All three beta-lactamases were indistinguishable by inhibitor
      profiles with clavulanic acid, BRL 42715, sulbactam and tazobactam. These data
      suggested that all three beta-lactamases were the product of a single gene in
      Moraxella spp., and that the membrane-bound beta-lactamase serves as a precursor
      of both BRO-1 and BRO-2. Species differences in cellular processing of the
      membrane-bound enzyme could explain the minor differences in IEF patterns that
      occurred with BRO-1 and BRO-2 beta-lactamases when present in different species.

PMID- 8463170
TI  - Effects of imipenem on Escherichia coli studied using bioluminescence, viable
      counting and microscopy.
AB  - The effects of imipenem on the growth of Escherichia coli ATCC 25922 were studied
      using a bioluminescence assay of bacterial ATP, microscopy and viable counting in
      iso-osmotic Mueller-Hinton broth (MHB) and hypo-osmotic nutrient broth (NB).
      Imipenem showed a post-antibiotic effect (PAE) of > 2 h for E. coli in both MHB
      and NB after 2 h exposure to 1 and 8 mg/L of imipenem when determined by
      bioluminescence and microscopy. The intracellular ATP level increased after 2 h
      exposure of E. coli to 1 mg/L of imipenem in MHB. In this culture there was a
      predominance of spheroplasts. These spheroplasts were large and osmotically
      fragile and a 10 min treatment in water-diluted MHB (hypo-osmotic) prior to the
      assays lysed the large spheroplasts. This reduced the intracellular ATP level and
      shortened the PAE when determined by bioluminescence, and caused more rapid
      initial killing and a negative PAE when determined by viable counting. At 8 mg/L
      imipenem in MHB and at all concentrations in NB there was a predominance of rods
      and only a small number of spheroplasts which all disappeared when the cultures
      resumed logarithmic growth. In these cultures there was a significant initial
      decrease in intracellular ATP. This study showed reasonable agreement between
      microscopy and bioluminescence, which are direct methods, for determining the
      initial killing and PAE of imipenem on E. coli. More rapid initial killing and
      shorter or no PAEs, were in general, obtained in both MHB and NB when determined
      by viable counting. However, the effective regrowth time, defined as the time for
      the bacterial density to increase 1 log10 from the pre-exposure inoculum, was
      independent of the method used for measuring regrowth in both MHB and NB.

PMID- 8463171
TI  - A novel antimicrobial central venous catheter impregnated with benzalkonium
      chloride.
AB  - Catheter-related sepsis is a common complication associated with the use of
      central venous catheters (CVC). In an attempt to overcome this problem
      benzalkonium chloride was incorporated into a CVC polymer. The effect of the
      presence of benzalkonium chloride on microbial colonization of the CVC was then
      assessed in vitro. MICs and MBCs of benzalkonium chloride for a range of
      organisms were performed and good activity against Gram-positive organisms was
      confirmed. In order to assess the antimicrobial activity of the benzalkonium
      chloride-impregnated catheter, 2 cm lengths were placed on to nutrient agar
      plates inoculated with various micro-organisms. Zones of inhibition against five
      strains of Staphylococcus epidermidis and two strains of Staphylococcus aureus
      were demonstrated. Smaller zones of inhibition was also produced with Gram
      negative species and Candida albicans. The zone sizes correlated with the MICs.
      Bacterial adherence to the benzalkonium-chloride-impregnated catheters was
      determined in both static and dynamic models and was significantly reduced
      compared with control catheters, containing no antimicrobial agent (P < 0.01).
      Inhibition of microbial adherence to benzalkonium-chloride-impregnated catheters
      placed in 25% human blood in phosphate-buffered saline (PBS), for up to seven
      days or PBS alone for 14 days was detected. The findings indicate that
      benzalkonium-chloride-impregnated catheters exhibit reduced microbial
      colonization by a range of organisms in vitro. The incorporation of benzalkonium
      chloride into a CVC may thus offer an effective method for the prevention of
      catheter related sepsis.

PMID- 8463173
TI  - Rapid fluorometric measurement of the intra-cellular concentration of
      ciprofloxacin in mouse peritoneal macrophages.
AB  - A simple fluorometric assay requiring only a single sample of cells to determine
      the number of cells, from the DNA linked to the fluorochrome 4',6-diamidino-2
      phenylindol (DAPI), and the uptake of ciprofloxacin, a natural fluorescent
      quinolone is described. Mouse peritoneal macrophages were found to concentrate
      ciprofloxacin up to 12.7 (+/- 1.5)-fold. Combined fluorometry provides a precise,
      sensitive method for determining the intracellular concentration of
      fluoroquinolones, as well as that of naturally fluorescent or fluorochrome-linked
      drugs.

PMID- 8463172
TI  - Susceptibility of 170 penicillin-susceptible and penicillin-resistant pneumococci
      to six oral cephalosporins, four quinolones, desacetylcefotaxime, Ro 23-9424 and
      RP 67829.
AB  - MICs of six oral cephalosporins (cefdinir, cefpodoxime, cefaclor, cefuroxime,
      cefixime and Ro 40-6890), four quinolones (ciprofloxacin, ofloxacin, OPC-17116
      and fleroxacin), desacetylcefotaxime, Ro 23-9424 (a fused combination of
      fleroxacin + desacetylcefotaxime) and RP 67829 (a benzonaphthyridine) were
      determined for 49 penicillin-susceptible (S), 38 penicillin-intermediate (I), and
      83 penicillin-resistant (R) strains of Streptococcus pneumoniae. All MICs were
      determined by a standardized agar dilution method utilizing Mueller-Hinton agar
      supplemented with sheep blood. MIC90s of OPC-17116 and RP 67829 were < or = mg/L,
      and were unaffected by penicillin-susceptibility. MICs of all beta-lactams
      increased with increasing penicillin-MICs, with cefdinir, cefpodoxime, cefuroxime
      and Ro 40-6890 being the most active compounds, followed by cefaclor and
      cefixime. MIC90s of ciprofloxacin and ofloxacin were 2 mg/L. MIC90s of Ro 23-9424
      were lower than those of either parent compound (fleroxacin 8 mg/mL for all three
      groups; desacetylcefotaxime 0.5 mg/mL [S], 0.5 mg/mL [I], 4 mg/mL [R]; Ro 23-9424
      0.125 mg/L [S], 0.25 mg/L [I], 0.5 mg/L [R]). The results indicated that several
      newly introduced and experimental antimicrobials have potential for the treatment
      of infections caused by resistant strains of S. pneumoniae.

PMID- 8463174
TI  - Comparative chemotherapeutic activity of temafloxacin, cefoxitin, clindamycin,
      imipenem and ampicillin/sulbactam against Bacteroides fragilis in a mouse
      subcutaneous abscess model.
AB  - The new fluorinated 4-quinolone temafloxacin was compared with cefoxitin,
      clindamycin, imipenem (with or without cilastatin) and ampicillin/sulbactam in a
      mouse subcutaneous abscess model of Bacteroides fragilis infection. Based upon in
      vitro susceptibility data, temafloxacin may represent an effective oral and
      parenteral alternative to standard oral and parenteral anti-anaerobic agents
      currently in use. Temafloxacin therapy with dosage regimens of < 200 mg/kg/day
      typically yielded 2-3 x log10 reductions in cfu/abscess, similar to
      ampicillin/sulbactam, while cefoxitin and clindamycin were generally unable to
      produce similar reductions at doses up to 400 mg/kg/day. Imipenem (with or
      without cilastatin) was unable to produce a 1 x log10 reduction at doses of 400
      mg/kg/day. This study suggests that temafloxacin has potential for the treatment
      of anaerobic or mixed aerobic-anaerobic infections in man.

PMID- 8463175
TI  - A comparison of the cost of ceftazidime therapy and gentamicin combinations in
      three UK hospitals.

PMID- 8463176
TI  - MIC audit for routine ciprofloxacin sensitivity testing.

PMID- 8463177
TI  - Antistaphylococcal activity of vancomycin and teicoplanin under anaerobic
      conditions.

PMID- 8463178
TI  - Increasing prevalence of resistance to ampicillin, penicillin and vancomycin of
      enterococci isolated from blood cultures during 1990-1991.

PMID- 8463179
TI  - Immortalization of human mammary epithelial cells by SV40 large T-antigen
      involves a two step mechanism.

PMID- 8463180
TI  - Measurement of strain in cultured bone and fetal muscle and lung cells.

PMID- 8463181
TI  - Mitogens in bovine pituitary for cultured rat tracheal cells.

PMID- 8463182
TI  - Synergistic inhibition of human rhabdomyosarcoma cells by sodium phenylacetate
      and Tretinoin.

PMID- 8463183
TI  - Liposomes can specifically target entrapped melanin to hair follicles in
      histocultured skin.

PMID- 8463184
TI  - Stability of a murine hybridoma is dependent on the clonal line and culture
      media.

PMID- 8463185
TI  - Extracellular calcium does not contribute to cryopreservation-induced
      cytotoxicity.
AB  - The possible role of extracellular calcium ([Ca+2]e) in cryopreservation-induced
      cytotoxicity was tested using Madin-Darby canine kidney (MDCK) cells and a
      fluorescent multiple endpoint assay. MDCK cells maintained in 2 mM [Ca+2]e and
      treated with the calcium ionophore, ionomycin, increased their intracellular
      calcium ([Ca+2]i) as revealed by the calcium indicator dye, Fluo3 and the bottom
      reading spectrofluorometer, CytoFluor 2300. The addition of 10 mM [ethylene bis
      (oxyethylenenitrilo)]-tetraacetic acid (EGTA) to the extracellular medium before
      treatment with ionomycin blocked this ionomycin-dependent increase in [Ca+2]i. A
      number of site and activity-specific fluorescent probes were surveyed to
      determine which indicator dye might best reveal the ionomycin-induced cytotoxic
      events during this increase in [Ca+2]i. Although most dyes changed their emission
      profiles in response to calcium, neutral red was found to best reflect the loss
      of [Ca+2]i homeostasis. The NR50 for a 15-min exposure to ionomycin in the
      presence of 2 mM [Ca+2]e was approximately 2 microM ionomycin, but ionomycin had
      little apparent effect on neutral red retention when 10 mM EGTA was added to the
      extracellular medium. Thus it was clear that an increase in [Ca+2]i could be
      cytotoxic to MDCK cells and that neutral red could monitor this cytotoxic
      episode. To test if [Ca+2]e was similarly cytotoxic during cryopreservation, MDCK
      cells were subjected to cryopreservation in the presence of dimethylsulfoxide
      (DMSO). In contrast to previous studies, plasma membrane integrity, not lysosomal
      function, seemed to best correlate with cell survival subsequent to
      cryopreservation. In addition, decreasing [Ca+2]e had no discernable effect on
      the retention of plasma membrane indicator dyes, neutral red, or cell survival.
      It is concluded that a) plasma membrane indicator dyes, not neutral red, might be
      better indicators of cytotoxicity occurring during cryopreservation; b) DMSO
      might be toxic to lysosomes during cryopreservation of cultured cells; and c)
      although [Ca+2]e can contribute to cytotoxicity, the presence of [Ca+2]e might
      not influence cryopreservation-induced cytotoxicity.

PMID- 8463186
TI  - Nickel-induced increases in gap junctional communication in the uterine cell line
      SK-UT-1.
AB  - Previous studies have suggested that gap junctions may have a role in various
      uterine functions, including parturition. Because nickel has been demonstrated to
      increase uterine contractility in vitro, the effect of nickel (II) chloride on
      gap junctional communication was assessed in a tumorigenic uterine cell line, SK
      UT-1 (ATCC HTB 114). Cells were exposed in vitro to 25 and 50 microM NiCl2 for 24
      h or 100 microM NiCl2 for 3, 12, and 24 h, then functional gap junctional
      communication was measured as the transfer of Lucifer yellow dye from
      microinjected donor cells to their primary neighbor cells. Dye transfer was
      significantly increased only in cell cultures exposed to 100 microM NiCl2 for 24
      h, compared to untreated controls, lower doses, and shorter exposure periods.
      This response was inhibited by the simultaneous co-treatment of SK-UT-1 cells
      with magnesium by adding 100 microM MgSO4 to the dosing medium. Possible
      mechanisms and implications for these findings are discussed.

PMID- 8463187
TI  - Absence of trypsinogen autoactivation and immunolocalization of pancreatic
      secretory trypsin inhibitor in acinar cells in vitro.
AB  - To establish the significance of the addition of trypsin inhibitors to pancreatic
      acinar cells maintained in vitro, cells were cultured in the presence or absence
      of soybean trypsin inhibitor. Both cultures exhibited similar growth pattern,
      ultrastructural appearance, as well as secretory properties. Moreover, there was
      no evidence of trypsinogen activation in the culture medium. Using the
      immunocytochemical approach, pancreatic secretory trypsin inhibitor antigenic
      sites were revealed with specific polyclonal and monoclonal antibodies. The
      results obtained demonstrated that this trypsin inhibitor is in fact a typical
      pancreatic secretory protein being processed through the endoplasmic reticulum
      Golgi-granule secretory pathway of the acinar cells in rat and human tissues.
      While the polyclonal antibody yield labelings of increasing intensities along the
      secretory pathway, the monoclonal one probably due to the molecular nature of its
      specific antigenic determinant, gave higher labelings in the endoplasmic
      reticulum. In conclusion the present study has shown that pancreatic acinar cells
      secrete a specific pancreatic trypsin inhibitor which most probably is involved
      in the mechanism to prevent trypsinogen activation.

PMID- 8463188
TI  - Epidermal growth factor and insulin-like growth factor-1 preserve cell viability
      in the absence of protein synthesis.
AB  - Prolonged exposure of cells to the potent protein synthesis inhibitor
      cycloheximide (CHX) terminates in cell death. In the present study we
      investigated the effect of epidermal growth factor (EGF), insulin-like growth
      factor-1 (IGF-1), and insulin on cell death induced by CHX in the human cancerous
      cell lines MDA-231 and MCF-7 (breast), KB (oral epidermoid), HEP-2 (larynx
      epidermoid), and SW-480 (colon), and correlated this effect to the inhibition
      rate of protein synthesis. Cell death was evaluated by measuring either dead
      cells by trypan blue dye exclusion test or by the release of lactic dehydrogenase
      into the culture medium. CHX was shown to induce cell death in a concentration (1
      to 60 micrograms/ml) and time (24 to 72 h)-dependent manner in each of the five
      cell lines. EGF at physiologic concentrations (2 to 40 ng/ml) reduced cell death
      close to control level (without CHX) in the cell lines HEP-2, KB, MDA-231, and SW
      480, but had almost no effect on cell death in the MCF-7 cells. IGF-1 at
      physiologic concentrations (2 to 40 ng/ml) reduced cell death nearly to control
      level in the MCF-7 cells, but had only a partial effect in the other four cell
      lines. Insulin at supraphysiologic concentration (10,000 ng/ml) mimicked the
      effect of IGF-1 in each of the cell lines. CHX at concentrations that induced
      about 60% cell death, inhibited about 90% of protein synthesis as measured by
      [3H]leucine incorporation. Protein synthesis remained inhibited although cell
      viability was preserved by EGF or IGF-1. These results indicated that the
      mechanism by which EGF or IGF-1 preserve cell viability does not require new
      protein synthesis and may be mediated via a posttranslational modification
      effect.

PMID- 8463189
TI  - Fetal bovine serum and other sera used in tissue culture increase epithelial
      permeability.
AB  - Fetal bovine serum (FBS) or heat-inactivated FBS (56 degrees C for 30 min, HFBS)
      caused a dose-dependent decrease in the transepithelial electrical resistance of
      an epithelial monolayer (MDCK). A saturating concentration of HFBS (30%) caused
      an average fall of 25 +/- 2% within 60 min. Upon removal of HFBS, the resistance
      returned to its starting value within 1 h. Flux studies with [3H]mannitol
      demonstrate that the fall in resistance is due to an increased permeability of
      the tight junctions. Thirty percent heat inactivated sera from goat, newborn
      calf, calf, bovine, and horse caused falls ranging from 26 to 47%. In contrast
      with the basolateral preference of human and bovine adult sera, fetal bovine and
      newborn calf sera elicit this response primarily by interacting with the apical
      surface of the epithelium. HFBS-treated monolayers show a significant increase in
      the condensation of F-actin at points where > or = 3 cells meet. These results
      demonstrate that FBS and other sera used as nutritional supplements can increase
      the permeability of the tight junctions of cultured epithelial cells.

PMID- 8463190
TI  - Culturing of primary hepatocytes as entrapped aggregates in a packed bed
      bioreactor: a potential bioartificial liver.
AB  - Conventional culture systems for hepatocytes generally involve cells cultured as
      flat, monolayer cells, with limited cell-cell contact, in a static pool of
      medium, unlike the liver in vivo where the parenchymal cells are cuboidal, with
      extensive cell-cell contact, and are continuously perfused with blood. We report
      here a novel bioreactor system for the culturing of primary hepatocytes with
      cuboidal cell shape, extensive cell-cell contact, and perfusing medium. The
      hepatocytes were inoculated into the bioreactor and allowed to recirculate at a
      rate optimal for them to collide and form aggregates. These newly-formed
      aggregates were subsequently entrapped in a packed bed of glass beads. The
      bioreactor was perfused with oxygenated nutrient medium, with controlled oxygen
      tension, pH, and medium perfusion rate. The hepatocytes were viable for up to the
      longest time point studied of 15 days in culture based on urea synthesis, albumin
      synthesis and cell morphology. Light microscopy studies of hepatocytes cultured
      for 15 days in the bioreactor showed interconnecting three-dimensional structures
      resembling the hepatic cell plate in the liver organ. Electron microscopy studies
      on the same cells revealed ultrastructure similar to the hepatocytes in vivo,
      including the presence of plentiful mitochondria, rough and smooth endoplasmic
      reticulum, glycogen granules, peroxisomes, and desmosomes. We believe that our
      hepatocyte bioreactor is a major improvement over conventional culture systems,
      with important industrial applications including toxicology, drug metabolism, and
      protein/peptide synthesis. The hepatocyte bioreactor concept may also be used as
      the basis for the development of a bioartificial liver to provide extracorporeal
      hepatic support to patients with hepatic failure.

PMID- 8463191
TI  - Visual orienting deficits in high-functioning people with autism.
AB  - There has been renewed interest in the idea that attentional dysfunction may
      underlie autistic symptomatology (e.g., Bryson, Wainwright-Sharp, & Smith, 1990;
      Dawson & Lewy, 1989a, 1989b). Existing research indicates problems with
      overfocused attention (Lovaas et al., 1971; Rincover & Ducharme, 1987), and with
      shifting attention between sensory modalities (Courchesne et al., 1990). These
      phenomena were examined further by using Posner's (1978) visual orienting task
      with a group of high-functioning autistic adolescents and adults, and matched
      normal controls. Our results indicate that autistic people have difficulty
      processing briefly presented cue information. Evidence of problems disengaging
      and shifting attention within the visual modality was also provided. The findings
      can be seen as consistent with previous behavioral, autonomic, and
      electrophysiological research which has revealed impairments in the registration,
      processing, and response to external stimuli.

PMID- 8463192
TI  - Nonverbal expression in autism of Asperger type.
AB  - Short unstructured social interactions between a volunteer interviewer, an adult
      with autism of Asperger type, and a control subject with a schizoid personality
      disorder were video-recorded. Asperger subjects tended to look less at the other
      person, to make more self-stimulatory gestures, and to look at the interviewer
      significantly less than normal subjects, and substantially less than schizoid
      subjects, during the periods when the interviewer was vocalizing although there
      were no such differences when the interviewer was listening. We suggest that the
      gaze avoidance of autism may in actuality be a lack of expected gaze (e.g., gaze
      when the other person is talking) rather than an absolute avoidance, and suggest
      that a lifelong absence of gaze response to social cues including speech could
      explain a number of the developmental features of autism including lack of joint
      attention with others, lack of understanding and affective response to others,
      and poor discrimination of facial expressions.

PMID- 8463193
TI  - Trajectory of adaptive behavior in males with fragile X syndrome.
AB  - Adaptive behavior in males with fragile X syndrome was longitudinally examined in
      17 subjects, ages 1 to 17. Subjects received adaptive behavior evaluations on two
      occasions within one of three age periods. All domains of the Vineland Adaptive
      Behavior Scales increased from youngest to oldest age groups, yet older subjects
      (ages 10 to 17) showed significant declines in their adaptive behavior scores
      from first to second testing. A relative strength in Daily Living Skills and
      weakness in Socialization emerged only among older subjects. There was a
      significant relationship between adaptive behavior and mental age scores in all
      subjects. Discussion emphasized the parallels between declines in IQ and adaptive
      behavior as well as the need for further research on adaptive skills in young
      adults with fragile X syndrome.

PMID- 8463194
TI  - Depression and social adjustment in siblings of boys with autism.
AB  - Compared 22 siblings of autistic boys and 34 other siblings on measures of
      depression, social adjustment, and the amount of child care and domestic
      responsibility the siblings carry within the family. The relationship between
      sibling gender, age, birth order, qualities of the boy with autism, and family
      characteristics, and siblings' scores on the above measures were examined.
      Results of this research showed that siblings of autistic boys scored
      significantly higher on depression than the comparison group, but not on problems
      of social adjustment. There were no statistically significant gender differences;
      however, different gender-related patterns emerged on the correlates which may be
      of theoretical significance for future studies.

PMID- 8463196
TI  - Brief report: a case study assessing the validity of facilitated communication.

PMID- 8463195
TI  - Auditory brainstem responses in autism: brainstem dysfunction or peripheral
      hearing loss?
AB  - The advent of electrophysiological techniques for audiologic and neurologic
      assessment in the late 60s has generated at least 11 auditory brainstem response
      (ABR) studies in autism designed to test the integrity of the auditory brainstem
      pathways. The results reported are contradictory, involving prolongation,
      shortening, and no abnormalities in central transmission latencies. When sample
      and methodological factors influencing the ABR are taken into consideration in
      the interpretation of results, the ABR data available at present can be seen as
      only suggestive, rather than supportive, of brainstem involvement in autism.
      Paradoxically, these studies revealed the presence of peripheral hearing
      impairment in a non-negligible number of autistic individuals. Additional
      evidence of auditory abnormalities as well as the implications for the clinician
      are considered.

PMID- 8463197
TI  - Brief report: facilitated communication with adults with autism.

PMID- 8463198
TI  - Brief report: vocabulary development in an autistic boy.

PMID- 8463199
TI  - Brief report: lack of response in an autistic population to a low dose clinical
      trial of pyridoxine plus magnesium.

PMID- 8463200
TI  - Brief report: low frequency of the fragile X syndrome among Japanese autistic
      subjects.

PMID- 8463201
TI  - Contextual probability evaluation in autistic, receptive developmental language
      disorder, and control children: event-related brain potential evidence.
AB  - Compared 8- to 14-year-old children with either autism or receptive developmental
      language disorder (RDLD) to age- and IQ-matched normal controls in their ability
      to detect both frequent (p = .70) and infrequent (p = .30) randomly presented
      auditory stimuli under task and no-task conditions. Event-related brain
      potentials (ERPs), behavioral reaction times, and target detection accuracy rates
      were measured. Although the three groups of children performed in a similar
      manner on behavioral measures, only the children with autism demonstrated an
      abnormally small amplitude of the P3b, a component of the ERP. This result is
      interpreted in terms of (a) the consistency of this finding with other ERP
      studies involving older individuals with autism; and (b) its significance with
      respect to the difficulty children with autism have in modifying their
      expectancies to contextually relevant sequences of auditory information.

PMID- 8463202
TI  - Hypothalamic-pituitary-adrenal axis function in children with attention-deficit
      hyperactivity disorder.
AB  - Examined hypothalamic-pituitary-adrenal axis (HPA axis) function in 30 children
      with attention-deficit hyperactivity disorder (ADHD) by measuring the diurnal
      variation and response to the dexamethasone suppression test (DST) of saliva
      cortisol. Normal diurnal saliva cortisol rhythm was found in only 43.3% of the
      ADHD children. DST showed suppression in 46.7% of the ADHD children. An abnormal
      diurnal rhythm and nonsuppression to the DST were more frequent in the severely
      hyperactive group than in the mildly were more frequent in the severely
      hyperactive group than in the mildly hyperactive group of children with ADHD.
      These results suggest abnormalities in HPA axis function in some children with
      ADHD, especially those exhibiting severe hyperactivity.

PMID- 8463203
TI  - Receptor inhibition by immunoglobulins: specific inhibition by autistic children,
      their relatives, and control subjects.
AB  - Forty-two parents of children with autistic disorder, 15 children with autistic
      disorder, 17 siblings of children with autistic disorder, and 12 unrelated normal
      adult controls were studied to determine if immunoglobulins isolated from their
      plasma would inhibit binding of the 5HT1A agonist, [3H]-8-hydroxy-N,N-dipropyl-2
      aminotetralin (DPAT) to 5HT1A receptors in human hippocampal membranes. There
      were no significant differences among the means of percentage inhibition of DPAT
      binding of parents, children with autistic disorder, siblings, or unrelated
      controls. In addition, there were no differences in the proportion of subjects
      with > 15% DPAT inhibition among autistic children, their parents, their
      siblings, or unrelated controls. Immunoglobulin inhibition was not specific for
      the 5HT1A receptor binding site, since immunoglobulins inhibited binding to 5HT2,
      D1, D2, and alpha 2-adrenergic binding sites. The immunoglobulins isolated from
      normal controls inhibited [3H]-rauwolscine binding at alpha 2-adrenergic sites
      less than immunoglobulins of children with autistic disorder and their parents
      and siblings. This study did not support the hypothesis that autoantibodies to
      5HT1A or 5HT2 receptors are characteristic of autistic disorder.

PMID- 8463204
TI  - Self-injurious behavior in Rett syndrome: interactions between features of Rett
      syndrome and operant conditioning.
AB  - Operant and biological theories of the cause of self-injurious behavior (SIB) in
      people with a mental handicap are often viewed as mutually exclusive. In this
      single case study, interactions between features of Rett syndrome and operant
      conditioning as determinants of SIB are examined. Functional analysis by analog
      methodology indicated different functions for two forms of SIB shown by the
      subject: automatic reinforcement by sensory stimulation and escape from social
      interactions. It is suggested that features of Rett syndrome established
      conditions under which operant conditioning of self-injurious responding was
      maximized. The implications of this interaction between features of syndromes and
      operant conditioning for the conceptualization of the cause of SIB are discussed
      and it is proposed that the notion of a unitary cause of SIB is inappropriate. It
      is more productive to consider operant conditioning as the process that maintains
      responding against a background of predisposing and mediating factors which may
      be biologically determined.

PMID- 8463205
TI  - Regulation of adipocyte gene expression in differentiation and syndromes of
      obesity/diabetes.

PMID- 8463206
TI  - Formation of inter- and intramolecular disulfide bonds can activate cardiac
      troponin C.
AB  - Troponin C regulates contraction in striated muscle by alternating between the
      Ca(2+)-bound and apo conformations. We report here that spontaneous formation of
      an intramolecular disulfide bond between Cys-35 and Cys-84, or dimerization via
      an intermolecular disulfide bond between Cys-84 in cardiac troponin C, renders
      the protein Ca(2+)-independent when assayed in fast skeletal muscle myofibrils
      but to a much lesser extent in cardiac myofibrils. Formation of the
      intramolecular disulfide bond appears to expose hydrophobic surfaces, as
      indicated by an increase in fluorescence from hydrophobic fluorescent dyes, but
      does not alter the affinity of Ca(2+)-binding site II. These disulfide bonds
      constrain the protein into a conformation that either resembles or can substitute
      for the Ca(2+)-bound form of cardiac troponin C in fast skeletal muscle
      myofibrils.

PMID- 8463207
TI  - Demonstration of protein tyrosine phosphatase activity in the second of two
      homologous domains of CD45.
AB  - It has been reported that alteration of deletion of critical residues within one
      of the two homologous protein tyrosine phosphatase (PTPase)-like domains of CD45
      completely abolishes all activity, suggesting that only the more N-terminal
      domain is catalytically active. However, we now demonstrate, by two independent
      techniques, that the second (C-terminal) domain is also a viable phosphatase.
      Limited proteolysis by endoproteinase Lys-C or trypsin increased the phosphatase
      activity toward reduced, carboxymethylated, and maleylated lysozyme approximately
      8-fold. A 50-kDa fragment, isolated by ion exchange chromatography, was found to
      be responsible for this activity. N-terminal sequencing revealed that this
      fragment includes less than half of the first phosphatase domain and most, if not
      all, of the second. In a second experiment, 109 residues, including the presumed
      catalytic region, were removed from domain I by site-directed mutagenesis.
      Expression of this construct in a mammalian cell line resulted in increased
      PTPase activity over nontransfected control cells. Isolation of the recombinant
      CD45 by immunoprecipitation and immunoaffinity chromatography revealed that it
      had phosphatase activity. Both of these experimental approaches demonstrate that
      the second conserved PTPase domain of CD45 is a functioning PTPase, but that
      external regulation may be required to express its activity in the context of the
      native molecule.

PMID- 8463208
TI  - Alternative splicing gives rise to a nuclear protein tyrosine phosphatase in
      Drosophila.
AB  - A novel Drosophila protein tyrosine phosphatase gene (dPTP61F) undergoes
      alternative splicing to encode two non-receptor-like proteins of 61,000 daltons.
      This splice selection occurs at the 3' end of the message, altering the carboxyl
      termini of the encoded proteins. These carboxyl-terminal sequences govern the
      targeting of each protein tyrosine phosphatase either to a cytoplasmic membrane
      or to the nucleus. The catalytic activity of the two protein products is
      indistinguishable, suggesting that substrate specificity is modulated by the
      protein's subcellular location.

PMID- 8463209
TI  - Mutations in the catalytic subunit of the cAMP-dependent protein kinase interfere
      with holoenzyme formation without disrupting inhibition by protein kinase
      inhibitor.
AB  - Three amino acids were identified in the catalytic (C) subunit of the cyclic AMP
      dependent protein kinase that are involved in interaction with regulatory (R)
      subunit, but not with the specific protein kinase inhibitor, PKI. In a functional
      assay for gene induction, a C expression vector with serine or arginine
      substituted for Leu-198 and the double mutant C, His-87-->Gln/Trp-196-->Arg
      (Orellana, S. A., and McKnight, G. S. (1992) Proc. Natl. Acad. Sci, U.S.A. 89,
      4726-4730), retained activity in the presence of an excess of RI or RII. In
      contrast, cotransfection of a full-length PKI expression vector completely
      inhibited the activity of both mutant and wild type C subunits. These data
      suggest that although the substrate/pseudosubstrate sites of R and PKI interact
      with C at the catalytic site, there is an additional domain on the C subunit that
      is involved in holoenzyme formation with R subunit and is distinct from sites
      specifying high affinity PKI binding.

PMID- 8463210
TI  - Tyrosine phosphorylation of pp125FAK by the aggregation of high affinity
      immunoglobulin E receptors requires cell adherence.
AB  - The aggregation of the high affinity IgE receptor (Fc epsilon RI) in adherent rat
      basophilic leukemia (RBL-2H3) cells induces the tyrosine phosphorylation of
      several proteins. We examined whether focal adhesion-associated tyrosine kinase,
      pp125FAK, is one of these proteins. Anti-pp125FAK monoclonal antibody
      immunoblotted and precipitated a 115-kDa tyrosine-phosphorylated protein. In the
      absence of Fc epsilon RI aggregation, pp125FAK was tyrosine-phosphorylated only
      in adherent cells. Aggregating Fc epsilon RI in adherent cells markedly enhanced
      tyrosine phosphorylation of pp125FAK. This increase was detectable within 1 min
      of Fc epsilon RI aggregation and was maximal by 15 min. In contrast, in
      nonadherent cells Fc epsilon RI aggregation did not induce tyrosine
      phosphorylation of pp125FAK. The enhanced influx of calcium by calcium ionophore
      or the activation of protein kinase C by phorbol myristate acetate induced
      tyrosine phosphorylation of pp125FAK only in adherent cells. Thus, Fc epsilon RI
      induced tyrosine phosphorylation of pp125FAK could be mediated by the activation
      of protein kinase C and/or the induction of calcium influx. The data indicate
      that cell adherence is essential for Fc epsilon RI-induced tyrosine
      phosphorylation of pp125FAK.

PMID- 8463211
TI  - Ligand diffusion in the distal heme pocket of myoglobin. A primary determinant of
      geminate rebinding.
AB  - There are at least two picosecond kinetic components in the rebinding of NO to
      native sperm whale myoglobin. Petrich et al. (Petrich, J. W., Lambry, J.-C.,
      Kuczera, K., Karplus, M., Poyart, C., and Martin, J.-L. (1991) Biochemistry 30,
      3975-3987) attribute the slowing of the reaction to a movement of the iron atom
      out of the plane of the heme following ligand dissociation. In contrast, Gibson
      et al. (Gibson, Q. H., Regan, R., Elber, R., Olson, J. S., and Carver, T. E.
      (1992) J. Biol. Chem. 267, 22022-22034) have explained multiphasic geminate
      reactions by diffusion of NO into the distal heme pocket as determined by its
      detailed structure. O2 and NO rebinding to iron and cobalt derivatives of native,
      V68F, and V68I sperm whale myoglobin has been examined. Each iron protein shows a
      biphasic time course of NO rebinding reactions with widely different rates and
      amplitudes. Although cobalt does not move out of the plane of the porphyrin on
      ligand removal, the reactions of the iron and cobalt derivatives of each protein
      were closely similar. The time course of O2 rebinding to cobalt was also similar
      to that of NO rebinding to iron. These results are consistent with a primary role
      for the structure of the distal pocket in determining diffusion of ligands away
      from the metal atom and as a result the time course of picosecond ligand
      rebinding.

PMID- 8463212
TI  - Interaction cloning of protein kinase C substrates.
AB  - We have previously used an overlay assay technique to detect proteins that
      interact with protein kinase C (PKC) (Hyatt, S. L., Klauck, T., and Jaken, S.
      (1990) Mol. Carcinogenesis 3, 45-53). In some cases, binding proteins were also
      identified as substrates. Therefore, we used the overlay assay approach to screen
      a rat kidney lambda gt11 cDNA library to isolate and identify additional PKC
      substrates. Two clones have now been characterized. 35A is the rat homologue of
      the myristoylated alanine-rich C kinase substrate (MARCKS)-related F52 cDNA,
      whereas 35H is a partial cDNA with substantial homology to the 3' end of beta
      adducin. Both cDNAs encode proteins that bind phosphatidyl-serine (PS) and are
      substrates for PKC. Phosphorylation decreased both PS and PKC binding activities.
      Both proteins contain high density positive charge domains similar to that found
      in the major PKC substrate MARCKS. These results demonstrate that PKC
      interactions with certain substrate proteins are of sufficiently high affinity to
      facilitate their isolation via interaction cloning.

PMID- 8463213
TI  - Serine- and threonine-rich domain regulates internalization of muscarinic
      cholinergic receptors.
AB  - Upon agonist exposure, most membrane receptors internalize into the cell as part
      of an adaptation process. Receptor domains that mediate internalization have been
      defined for several receptor classes, e.g. growth factor and transport receptors,
      but not yet for any of the numerous members of the family of G protein-coupled
      receptors (GPCRs), having seven putative transmembrane helices. With the use of
      deletion mutations, we previously showed that a small region in the middle of the
      third intracellular loop (i3) appears to be required for the agonist-induced
      internalization of the Hm1 muscarinic cholinergic receptor (Lameh, J., Philip,
      M., Sharma, Y. K., Moro, O., Ramachandran, J., and Sadee, W. (1992) J. Biol.
      Chem. 267, 13406-13412). Using point mutations, we now demonstrate that domain
      286-292 (ESLTSSE) is required, with TSS playing a crucial role. Although the i3
      loops of GPCRs share minimal overall sequence identity, even among closely
      related subtypes, small domains containing multiple S/T residues are also present
      in several other GPCRs, e.g. peptide, catechol, and all the muscarinic
      cholinergic receptor subtypes. S/T-->A mutations in analogous i3 domains also
      prevented receptor internalization in the case of Hm3 and attenuated
      internalization of Hm2. We propose that an S/T-rich domain in the i3 loop,
      possibly via phosphorylation reactions, regulates one pathway of GPCR
      internalization.

PMID- 8463214
TI  - Binding-incompetent adenovirus facilitates molecular conjugate-mediated gene
      transfer by the receptor-mediated endocytosis pathway.
AB  - Molecular conjugate vectors may be constructed that accomplish high efficiency
      gene transfer by the receptor-mediated endocytosis pathway. In order to mediate
      escape from lysosomal degradation, we have incorporated adenoviruses into the
      functional design of the conjugate. In doing so, however, we have introduced an
      additional ligand, which can bind to receptors on the cell surface, undermining
      the potential for cell specific targeting. To overcome this, we have treated the
      adenovirus with a monoclonal anti-fiber antibody, which renders the virus
      incapable of binding to its receptor. The result is a multi-functional molecular
      conjugate vector, which has preserved its binding specificity while at the same
      time being capable of preventing lysosomal degradation of endosome-internalized
      conjugate-DNA complexes. This finding indicates that adenoviral binding is not a
      prerequisite for adenoviral-mediated endosome disruption.

PMID- 8463215
TI  - Peptides derived from a sequence within beta 3 integrin bind to platelet alpha
      IIb beta 3 (GPIIb-IIIa) and inhibit ligand binding.
AB  - Peptides derived from a sequence within the loop structure of human platelet
      glycoprotein (GP) IIIa (integrin beta 3) were previously shown to inhibit
      fibrinogen binding to purified GPIIb-IIIa. In this study a series of peptides
      based on the GPIIIa sequence 211-221 (SVSRNRDAPEG) was synthesized. The most
      active peptide was determined to be RNRDA, and its inhibitory potency was 4-fold
      greater (IC50 = 4.8 microM) than that of SVSRNRDAPEG. These GPIIIa peptides also
      inhibited the binding of two monoclonal antibodies, pl-55 and PAC-1, which are
      directed against the activated conformer of GPIIb-IIIa. To determine whether
      these peptides bound directly to GPIIb-IIIa, an affinity matrix was prepared by
      coupling RNRDAPEGC to Sepharose. Fibrinogen or purified GPIIb-IIIa was applied to
      the affinity column. Only GPIIb-IIIa was retained on the column, and it could be
      specifically eluted by GPIIIa peptide or RGDV but not by an irrelevant peptide.
      Additionally, we observed that the binding of GPIIIa peptides to purified GPIIb
      IIIa induced exposure of a neoepitope on GPIIb that was recognized by the
      monoclonal antibody pl-80. These data suggest that sequences within the loop
      structure of GPIIIa can interact with the ligand binding domain of GPIIb-IIIa.
      Thus, this GPIIIa domain may be involved in regulating the accessibility of
      ligands to GPIIb-IIIa following platelet activation.

PMID- 8463216
TI  - K(+)-dependent Na+/Ca2+ exchange in human platelets.
AB  - Ca2+ influx via Na+/Ca2+ exchange was examined using fura-2 fluorescence
      techniques in human platelets loaded internally with Na+ by pretreatment with
      ouabain. In 140 mM LiCl, Ca2+ influx via the exchanger was completely dependent
      upon the presence of extracellular K+ (Km approximately 1 mM). In 140 mM N-methyl
      D-glucamine (NMDG), Ca2+ influx was stimulated by K+ but was not absolutely
      dependent upon it; the inclusion of 20 mM NaCl in the NMDG medium restored the K+
      dependence of Ca2+ influx. Stimulation of Ca2+ influx by K+ was confirmed by
      45Ca2+ flux studies. 86Rb+ fluxes were measured to determine if Ca2+ and Rb+ were
      co-transported by the exchanger. The presence of extracellular Ca2+ stimulated
      86Rb+ influx in ouabain-treated platelets in 160 mM LiCl or NMDG. The Rb+/Ca2+
      influx ratio was 0.42 +/- 0.04 (n = 3) at [Rb+] = 0.2 mM and 0.89 at [Rb+] = 1.3
      mM. Neither K(+)-dependent Ca2+ influx nor Ca(2+)-dependent Rb+ influx was
      observed in 160 mM NaCl or in platelets that had not been pretreated with
      ouabain, indicating that these fluxes resulted from Na+/Ca2+ exchange activity.
      Na(+)-dependent Ca2+ efflux was also shown to be dependent upon the presence of
      internal K+. These properties are similar to those of the Na+/Ca(2+)-K+ exchanger
      found in retinal rods, as distinct from the more widely distributed cardiac-type
      exchanger.

PMID- 8463217
TI  - Isolation of the non-myristoylated form of a major substrate of protein kinase C
      (MARCKS) from bovine brain.
AB  - A substrate protein of protein kinase C with an apparent molecular mass of 70 kDa
      has been purified from bovine brain. This protein shares several properties with
      a major substrate of protein kinase C (myristoylated alanine-rich C kinase
      substrate; MARCKS). It is heat-stable and copurifies with MARCKS during various
      steps (ammonium sulfate precipitation and gel filtration). However, its elution
      from a calmodulin affinity column is different from that of MARCKS. It can be
      eluted by high ionic strength in the presence of calcium, whereas MARCKS can be
      eluted only in the absence of calcium. Its earlier elution from a reversed phase
      column suggests that p70 is less hydrophobic than MARCKS. The electrospray mass
      spectrum revealed an actual mass of 31,550 +/- 6.5 Da, very far from the apparent
      molecular mass in SDS-polyacrylamide gel electrophoresis (70,000 Da). This mass
      is about 200 Da smaller than that of MARCKS determined by mass spectrometry
      analysis (Manenti, S., Sorokine, O., Van Dorsselaer, A., and Taniguchi, H. (1992)
      J. Biol. Chem. 267, 22310-22315), close to the value expected for the change due
      to N-terminal myristoylation (210 Da). N-terminal amino acid sequencing showed
      that the N terminus is not blocked, and the sequence found for the 10 first amino
      acids is identical to that deduced from the cDNA sequence of bovine MARCKS. These
      data clearly establish that this protein is a non-myristoylated form of MARCKS
      and that the absence of the myristoyl moiety at the N terminus lowers the
      affinity to calmodulin. The purification performed both from the membrane and the
      cytoplasmic fractions of bovine brain indicated that this non-myristoylated form
      represents 20-30% of the MARCKS protein in the cytoplasmic fraction, and less
      than 5% in the membrane one.

PMID- 8463218
TI  - Cloning of a human gene, PIG-F, a component of glycosylphosphatidylinositol
      anchor biosynthesis, by a novel expression cloning strategy.
AB  - The glycosylphosphatidylinositol (GPI)-anchored proteins are widely distributed
      in eukaryotic cells, from yeasts to mammals. A number of proteins, such as
      glycosyltransferases, are necessary for GPI anchor biosynthesis. Cloning of genes
      encoding these proteins is required for analyses of their nature and the
      biosynthetic pathway. Here we report a new method of expression cloning that is
      applicable to many mutant rodent and human cells, and its application for cloning
      a human cDNA termed PIG-F (for Phosphatidyl-Inositol-Glycan class F) using a Thy
      1-negative mutant murine thymoma cell line of complementation class F. PIG-F
      takes a part in the step of transfer of ethanolamine phosphate to the GPI
      intermediate containing three residues of mannose. This expression cloning
      strategy is applicable to the identification of not only other genes involved in
      GPI anchor biosynthesis but also human disease-associated genes using mutant
      mammalian cell lines.

PMID- 8463219
TI  - ATP-stimulated tetraethylammonium transport by rabbit renal brush border membrane
      vesicles.
AB  - These studies examined the ability of ATP to stimulate transport of the organic
      cation tetraethylammonium (TEA) into proximal tubular brush border membrane
      vesicles. ATP markedly enhanced TEA uptake for 1 h or more to values severalfold
      above those observed in the absence of ATP. The poorly hydrolyzable analogue of
      ATP, AMP-PNP (adenyl-5'-yl imidodiphosphate), reduced the effect of ATP but alone
      did not stimulate TEA uptake. GTP and ITP also stimulated TEA uptake, whereas
      other nucleotides did not. ATP-stimulated TEA uptake was saturable, temperature
      dependent, and markedly reduced by the organic cations amiloride, quinidine,
      cimetidine, and verapamil, but only modestly reduced by the organic cations N'
      methylnicotinamide and choline. Some inhibitors of other transport ATPases,
      including N-ethylmaleimide, N,N'-dicyclohexylcarbodiimide, and oligomycin,
      reduced the effect of ATP, whereas ouabain, vanadate, and azide did not. 4,4'
      Diisothiocyanatostilbene-2,2'-disulfonic acid also reduced TEA uptake in the
      presence of ATP. Vinblastine, but not actinomycin D and colchicine (all
      inhibitors of P-glycoprotein-mediated transport), reduced TEA uptake. The
      reduction of TEA transport by amiloride and cimetidine was most consistent with
      competitive inhibition, whereas the inhibition produced by N-ethylmaleimide and
      vinblastine evidently was not. ATP also stimulated uptake of N'
      methylnicotinamide but not that of vinblastine. These studies have identified a
      previously unrecognized process by which ATP hydrolysis may directly energize the
      reabsorption of organic cations from the renal tubule lumen.

PMID- 8463220
TI  - Uteroferrin and intracellular tartrate-resistant acid phosphatases are the
      products of the same gene.
AB  - Uteroferrin (Uf) is a purple acid phosphatase with a bi-iron center. It is the
      major secretory product of the porcine uterus under the influence of progesterone
      and supplies iron to the developing fetuses during pregnancy. Tartrate-resistant
      acid phosphatases (TRAP) are clearly similar to Uf in many of their properties
      but are generally located intracellularly in lysosomes. To determine whether Uf
      and intracellular TRAP are distinct gene products, cDNA for the TRAP from pig
      spleen were compared with Uf cDNA. Although no full-length cDNA for the former
      were isolated, a TRAP cDNA of 1.1 kilobases was identical in nucleotide sequence
      to a Uf cDNA (1.42 kilobases) in the region of overlap, which included the entire
      3'-end of the transcript and most of the open reading frame. TRAP purified from
      porcine spleen also had an NH2-terminal amino acid sequence that corresponded to
      that of Uf purified from uterine secretions and was also similar in sequence to
      intracellular TRAP isolated from tissues of other species, including ones from
      human osteoclastomas and spleen. Finally, Southern hybridization analysis with
      two probes specific for exons 1 and 2 of the Uf gene strongly suggested the
      presence of only a single gene for acid phosphatases of this class in the pig. A
      similar analysis performed on human DNA with an exon-specific probe for human
      TRAP was also consistent with a single gene. It is concluded that the difference
      in trafficking between a secreted TRAP, such as Uf, and TRAP located in lysosomes
      is not the result of distinctive primary sequence of the polypeptides and that
      the variability within species ascribed to such enzymes is most likely the result
      of minor posttranslational changes.

PMID- 8463221
TI  - Ricin-resistant Madin-Darby canine kidney cells missort a major endogenous apical
      sialoglycoprotein.
AB  - gp114 is a major sialoglycoprotein expressed on the apical membrane of Madin
      Darby canine kidney (MDCK) II cells. We investigated its distribution in two
      lectin-resistant mutant cell lines derived from MDCKII cells, MDCKII-RCAr and
      MDCKII-ConAr cells. gp114 was present on the apical membrane of MDCKII-ConAr
      cells but was predominantly basolateral in MDCKII-RCAr cells. No change of
      polarity was observed for several apical and basolateral markers in this cell
      line. Reversal of polarity of gp114 mainly resulted from a modification of its
      intracellular sorting. gp114 showed altered endocytosis in MDCKII-RCAr cells. In
      MDCKII cells gp114 was slowly endocytosed, whereas in MDCKII-RCAr cells
      endocytosis of gp114 was highly increased. Using mannosidase I and II inhibitors
      we found that N-glycosylation only slightly affects gp114 sorting and
      endocytosis. Our results suggest that gp114 or an associated component in MDCK
      RCAr fails to express apical information or that a mutation creates a basolateral
      sorting signal which could be related to endocytic signals.

PMID- 8463222
TI  - Elimination of the hydroxyl groups in the ribose ring of ATP reduces its ability
      to phosphorylate the sarcoplasmic reticulum Ca(2+)-ATPase.
AB  - 2'-Deoxyadenosine 5'-triphosphate, 3'-deoxyadenosine 5'-triphosphate, and 3'
      amino-3'-deoxyadenosine 5'-triphosphate were substituted for ATP in the Ca2+
      pumping cycle of the sarcoplasmic reticulum Ca(2+)-ATPase. The rate of
      phosphorylation of the enzyme decreased by more than an order of magnitude when
      either of the hydroxyl groups was eliminated from the ribose ring. This resulted
      in low rates of hydrolysis and low levels of phosphoenzyme intermediate. In
      addition, the Km(1) of hydrolysis and the K1/2 of phosphorylation of the
      derivatives modified in the 3' position were decreased by a factor of 5-10.
      Otherwise, the 3'-amino-3'-deoxyadenosine 5'-triphosphate was utilized in a
      manner equivalent to ATP. Because the observed rates of phosphoenzyme formation
      with the deoxynucleotides were lowered to the extent that they would be rate
      limiting in the enzyme cycle, and the level of phosphoenzyme intermediate
      remained low when the enzyme was back-inhibited by high Ca2+ concentrations, it
      was concluded that the majority of the enzyme remained in a preliminary
      conformation, in which the phosphorylation reaction could not proceed although
      substrate and Ca2+ were bound. It was then proposed that, following Ca(2+)
      induced changes in conformation, the hydroxyl groups are able to form hydrogen
      bonds with pertinent segments of the phosphorylation domain, helping to stabilize
      an enzyme-substrate complex, one function of which may be to provide the proper
      stereochemistry for phosphate transfer.

PMID- 8463223
TI  - Biochemical analysis of rab9, a ras-like GTPase involved in protein transport
      from late endosomes to the trans Golgi network.
AB  - rab9 is a ras-like GTPase which has been implicated in the transport of mannose 6
      phosphate receptors between late endosomes and the trans Golgi network. We have
      expressed recombinant rab9 in Escherichia coli, purified the protein to
      homogeneity, and initiated a biochemical analysis of this enzyme. rab9 hydrolyzed
      GTP with a rate constant of 0.0052 min-1 at 37 degrees C. rab7, a highly
      homologous endosomal GTPase, hydrolyzed GTP with a rate constant of 0.0023 min-1
      at 37 degrees C. At this temperature, GDP and GTP each dissociated from rab9 with
      first-order rate constants of 0.017 min-1. GDP and GTP dissociated from rab7 at
      37 degrees C with first-order rate constants of 0.0054 and 0.0024 min-1,
      respectively. We modified the procedure of John et al. (John, J., Sohmen, R.,
      Feuerstein, J., Linke, R., Wittinghofer, A., and Goody, R. (1990) Biochemistry
      29, 6058-6065) for the preparation of nucleotide-free ras such that the procedure
      can now be applied to 1000-fold smaller quantities of protein. Using this method,
      we prepared microgram quantities of nucleotide-free rab9 in a form which is heat
      stable, free of exogenous nucleotide-degrading enzymes and which can be stored at
      -80 degrees C. At 37 degrees C for GDP and GTP, the second-order rate constants
      for association with nucleotide-free rab9 were 1.7 x 10(6) M-1 s-1 and 1.2 x
      10(5) M-1 s-1, respectively, and equilibrium binding constants were 170 pM and
      2.4 nM, respectively.

PMID- 8463224
TI  - Kinetic and stereochemical comparison of wild-type and active-site K145Q mutant
      enzyme of bacterial D-amino acid transaminase.
AB  - D-Amino acid transaminase (EC 2.6.1.21), from Bacillus sp. YM-1, a thermostable
      enzyme with pyridoxal 5'-phosphate as coenzyme and a target for the design of
      novel antimicrobial agents, catalyzes the reversible transfer of an amino group
      between D-alanine and alpha-ketoglutarate to form pyruvate and D-glutamate,
      respectively. To explore the catalytic role of Lys-145, which binds the coenzyme,
      a site-specific mutant enzyme, K145Q (in which Lys-145 had been mutated to
      glutamine) constructed earlier (Futaki, S., Ueno, H., Martinez del Pozo, A.,
      Pospischil, M. A., Manning, J. M., Ringe, D., Stoddard, B., Tanizawa, K.,
      Yoshimura, T., and Soda, K. (1990) J. Biol. Chem. 265, 22306-22312) was compared
      to the wild-type enzyme for its kinetic parameters. Initial velocity studies and
      partial reaction isotope exchange experiments showed that the low activity of the
      mutant enzyme (about 1.5% the activity of the wild-type enzyme with saturating
      substrates) is an intrinsic property, confirming that contaminating enzymes do
      not account for the low activity of the K145Q mutant enzyme. The rates of the
      forward reaction for both wild-type and mutant enzymes were 30-40 times higher
      than the rates of the reverse reaction. KM values for the four substrates were 10
      to 100 higher for the mutant compared to the wild-type enzyme. Whereas D-alanine
      is preferred over L-alanine by the wild-type enzyme (10(3) higher kcat/KM for D-
      over L-alanine), the K145Q enzyme does not efficiently discriminate between L-
      and D-alanine. Both wild-type and mutant enzymes also catalyze the slow
      racemization of L- and D-alanine. Proton NMR studies showed that wild-type enzyme
      catalyzed a time-dependent exchange of the C alpha proton of D-alanine with
      solvent D2O and a slow exchange of the alpha proton of L-alanine; the latter slow
      exchange rate is the same for the C alpha proton of both L- and D-alanine with
      the K145Q mutant enzyme. Thus, in addition to binding pyridoxal 5'-phosphate, the
      active-site Lys-145 of D-amino acid transaminase is involved in several other
      important functions, i.e. it optimizes catalytic efficiency and it maintains
      stereochemical fidelity. The steady-state kinetic results on the K145Q mutant
      enzyme together with the findings on the relative racemization rates and the NMR
      protein exchange data suggest that an alternate base catalyzes abstraction of the
      alpha proton of substrate in this mutant D-amino acid transaminase.

PMID- 8463225
TI  - A single amino acid substitution confers progesterone 6 beta-hydroxylase activity
      to rabbit cytochrome P450 2C3.
AB  - A cDNA encoding a naturally occurring variant of cytochrome P450 (P450) 2C3 that
      catalyzes the 6 beta- and 16 alpha-hydroxylation of progesterone exhibits six
      differences of nucleotide sequence leading to five amino acid substitutions from
      that encoding 2C3, a progesterone 16 alpha-hydroxylase that does not catalyze 6
      beta-hydroxylation. Analysis of chimeric and mutant enzymes indicates that a
      Ser/Thr difference at position 364 underlies the difference between the two
      enzymes in 6 beta-hydroxylase activity as well as sensitivity to the inhibitor,
      16 alpha-methylprogesterone. In addition, an Ile/Met difference at position 178
      influences the apparent Km for progesterone. The two mutations, S364T and 1178M,
      together convert 2C3 to a form that exhibits kinetic properties which are similar
      to the 2C3v enzyme, and the reciprocal mutations in 2C3v convert it to an enzyme
      that resembles 2C3. Interestingly, position 364 of 2C3 maps to a substrate
      contacting domain suggested by models for mammalian P450 enzymes based on the
      structure of P450cam. Ile178 is highly conserved among mammalian microsomal P450s
      with the exception of CYP4A and CYP19 enzymes which exhibit a Met at this
      alignment position.

PMID- 8463226
TI  - Spontaneous Ca2+ spiking in a vascular smooth muscle cell line is independent of
      the release of intracellular Ca2+ stores.
AB  - Monolayers of fura-2-loaded A7r5 cells, a cell line derived from rat embryonic
      aorta, generated spontaneous Ca2+ spikes that were synchronized within the cell
      population. These Ca2+ spikes were abolished by removal of extracellular Ca2+ or
      addition of nimodipine (50 nM), and their frequency was increased by
      depolarization with high K+ or by treatment with BAYK 8644 (1 microM), indicating
      that Ca2+ entry through L-type Ca2+ channels is required for Ca2+ spiking.
      Several lines of evidence indicate that mobilization of intracellular Ca2+ stores
      is not necessary for this Ca2+ spiking. 1) Ryanodine (0.1-50 microM) neither
      stimulated Ca2+ mobilization nor affected Ca2+ spiking; 2) the complex effects of
      caffeine were mimicked by theophylline, 8-bromo-cyclic adenosine 3':5'
      monophosphate (8-bromo-cAMP), and forskolin, suggesting that the caffeine effects
      may be mediated by cAMP and not by ryanodine receptors; 3) prolonged incubation
      with thapsigargin (50 nM), which depletes intracellular Ca2+ stores, did not
      affect the frequency of Ca2+ spiking; 4) Ba2+ or Sr2+ could substitute for Ca2+
      in the spike-generating mechanism even when intracellular stores were depleted of
      Ca2+. Under conditions where the sarcoplasmic reticulum (SR) contained Ca2+, Ba2+
      spikes did not cause Ca2+ mobilization. The mechanisms involved in generating
      spontaneous Ca2+ spiking in A7r5 cells are therefore likely to reside in the
      sarcolemma and to operate independently of SR Ca2+ uptake and release.

PMID- 8463227
TI  - Transcription of photoreceptor genes during fetal retinal development. Evidence
      for positive and negative regulation.
AB  - Rod photoreceptor outer segments are elaborated at approximately 6 months
      gestation in the cow coinciding with a dramatic increase in mRNAs encoding many
      visual transduction and associated proteins. Nuclear run-on determination of
      relative transcription rates demonstrates that gene expression follows three
      distinct patterns. Opsin, S-antigen, and transducin are all minimally detectable
      at 5.2 months gestation and increase throughout development. Only opsin
      demonstrates an additional sharp increase in transcriptional activity which
      resembles a positive gene-specific enhancer that is first effective between 6.3
      and 7.4 months gestation. In contrast, interphotoreceptor retinoid binding
      protein (IRBP) transcription is already at 43% of its adult level at 5.2 months
      gestation. To further understand these differences, the relative contributions of
      initiation and elongation to nuclear run-on signals were examined using either
      Sarkosyl or ammonium sulfate. Transcriptional rates for S-antigen and transducin
      were not affected, however, opsin was reduced approximately 4-fold and IRBP was
      increased approximately 2-fold. Opsin is therefore likely to be initiated de novo
      during the run-on reaction and responds to a gene-specific positive regulator.
      The increase in IRBP transcription rate suggests the removal of an elongation
      inhibitory factor and supports the idea that a negative regulatory element may be
      involved in controlling IRBP expression.

PMID- 8463228
TI  - Physiologic concentrations of glucose regulate fatty acid synthase activity in
      HepG2 cells by mediating fatty acid synthase mRNA stability.
AB  - Carbohydrate feeding of animals results in striking increases in hepatic fatty
      acid synthesis but much of this induction is presumed to be hormone mediated. To
      clarify the mechanisms responsible for the specific effect of carbohydrate on
      fatty acid synthesis, the effects of D-glucose on the expression of human fatty
      acid synthase (FAS) in HepG2 cells cultured in serum-free medium were studied.
      Northern blots of total RNA from these cells showed a single FAS mRNA band of 9.3
      kilobases that was increased 2.7-5.4-fold in the presence of D-glucose. Lactate
      and citrate but not L-glucose mimicked this effect. Glucose induction of FAS mRNA
      was time- and concentration-dependent and most of the increase in FAS message was
      detected within the range of physiologic glucose concentrations. Glucose
      induction of FAS mRNA, protein synthetic rate, and enzyme activity were similar
      suggesting that glucose regulates FAS expression at a pretranslational level in
      this system. Transcription run-off experiments showed that glucose feeding was
      associated with no change in the FAS transcription initiation rate despite a 5
      fold increase in FAS mRNA. FAS mRNA stability as determined by actinomycin D
      chase was 7-fold greater in the presence of glucose. Differences between FAS mRNA
      levels in cells grown in the presence versus the absence of glucose were
      inhibited by cycloheximide but not puromycin, suggesting that glucose regulation
      of FAS mRNA stability is not dependent on translation. Glucose, at physiologic
      concentrations and in the absence of hormones, appears to regulate FAS gene
      expression in HepG2 cells predominantly by mediating FAS mRNA stability.

PMID- 8463229
TI  - Oxygenation of (3Z)-nonenal to (2E)-4-hydroxy-2-nonenal in the broad bean (Vicia
      faba L.).
AB  - Incubation of (3Z)-nonenal (NON) with the 269,000-g particle fraction of seed
      homogenate of the broad bean (Vicia faba L.) afforded (2E)-4-hydroxy-2-nonenal
      (HNE) as the principal product. One pathway of HNE formation consisted of initial
      oxygenation of NON into (2E)-4-hydroperoxy-2-nonenal (HPNE) by a novel (3Z)
      alkenal oxygenase activity, followed by conversion of HPNE into HNE by a
      previously recognized hydroperoxide-dependent epoxygenase. The hydroperoxide
      intermediate was detected in coincubations of NON and oleic acid, in which
      experiments the HPNE generated from NON supported epoxygenase-catalyzed
      epoxidation of oleic acid into 9,10-epoxystearic acid. Furthermore, by using an
      enzyme preparation in which the epoxygenase had been inactivated by pretreatment
      with hydrogen peroxide it was possible to isolate and characterize racemic
      (4R,4S) HPNE following incubation of NON. Although the (3Z)-alkenal oxygenase
      resembled a lipoxygenase in its action, it was not inhibited by the lipoxygenase
      inhibitors, 5,8,11,14-eicosatetraynoic acid and nordihydroguaiaretic acid. In a
      second pathway, HNE was produced by rearrangement of 3,4-epoxynonenal, which was
      in turn formed from NON by a reaction catalyzed by hydroperoxide-dependent
      epoxygenase. Support for this pathway came from experiments in which 18O-labeled
      HNE was isolated following coincubation of NON and 13-18O-labeled linoleic acid
      13-hydroperoxide. The existence of 3,4-epoxynonenal as a transient intermediate
      in HNE biosynthesis was further demonstrated by the isolation of 3,4-epoxynonenal
      (61% (4R)-configuration) as a trapping product in short time incubations
      interrupted by addition of sodium borohydride. The two pathways established for
      biosynthesis of HNE involved the hydroperoxide-reducing and the olefin
      epoxidizing activities of hydroperoxide-dependent epoxygenase. In the absence of
      extraneous olefins and hydroperoxides the two pathways would be tightly coupled
      and follow the stoichiometry: 2NON + 1O2-->2HNE. It was also shown that the V.
      faba particle fraction catalyzed oxygenation of (3Z)-hexenal into (2E)-4-hydroxy
      2-hexenal.

PMID- 8463230
TI  - The cysteine introduced into the alpha subunit of the Escherichia coli F1-ATPase
      by the mutation alpha R376C is near the alpha-beta subunit interface and close to
      a noncatalytic nucleotide binding site.
AB  - Mutation of the alpha subunit of the Escherichia coli F1-ATPase to convert Arg
      376 to a Cys (alpha R376C) lowers multisite ATPase activity 400-1,000-fold while
      affecting unisite catalysis only around 6-fold, suggesting that the mutation is
      in a region important for transmission of conformational changes between
      catalytic sites (Soga, S., Noumi, T., Takeyama, M., Maeda, M., and Futai, M.
      (1989) Arch. Biochem. Biophys. 268, 643-648; this study). To learn more of the
      structural features of the segment of the alpha subunit around Arg-376, mutant
      enzyme with a Cys at this position was modified with several maleimides. N
      [14C]Ethylmaleimide reacted rapidly with this Cys in one of the three alpha
      subunits/F1 (2,500 M-1 s-1); more slowly with a second alpha subunit (390 M-1 s
      1); and the same Cys in the third copy of the alpha subunit was completely
      unreactive to the reagent, indicating asymmetry of alpha subunits in the ECF1
      complex. The photoactivatable cross-linker N-(4-azido-2,3,5,6-tetrafluorobenzyl)
      3-maleimidopropionamide++ +, when reacted via its maleimide to alpha Cys-376 of
      the mutant, covalently linked alpha to beta subunits upon photolysis, indicating
      that Cys-376 of alpha is close to an interface between the alpha and beta
      subunits. The EDTA-induced exchangeable noncatalytic site could be filled by TNP
      ATP in both wild type and alpha R376C mutant ECF1. Occupancy of this site in the
      alpha R376C mutant altered the rate of reaction of the second-fastest reacting
      Cys-376 from 390 M-1 s-1 to below 130 M-1 s-1, suggesting that the two sites are
      on the same alpha subunit. TNP-ATP in the EDTA-induced exchangeable noncatalytic
      site was quenched by reacting Cys-376 with 4-maleimido-(2,2,6,6
      tetramethylpiperidine-N(oxyl), indicating that the region around Cys-376, which
      is involved in transmission of conformational changes between alpha and beta, and
      noncatalytic sites are maximally 10-12 A from each other.

PMID- 8463231
TI  - Characterization of endogenous carrier-mediated taurocholate efflux from Xenopus
      laevis oocytes.
AB  - Taurocholate efflux was studied in Xenopus laevis oocytes and is consistent with
      a carrier-mediated process. This carrier can be competitively inhibited and trans
      stimulated by glycocholate. Transport is also trans stimulated by
      taurochenodeoxycholate and S-hexylglutathione, but not taurolithocholate or
      daunomycin, reflecting a range of specificity including substrates of both the
      hepatic canalicular bile acid transporter and the multispecific organic anion
      transporter. In addition, ATP added to the outside of the oocyte results in an
      increase in the maximal velocity of this transport process. The physiologic
      function of this endogenous carrier is not known, but it may act as a generalized
      system for the efflux of potentially toxic organic anions.

PMID- 8463232
TI  - Lysine 155 in beta-subunit is a catalytic residue of Escherichia coli F1 ATPase.
AB  - The "homology A" ("glycine-rich" or "P-loop") consensus sequence occurs in the
      catalytic sites of F1F0 ATP synthase enzymes. The conserved lysine of this motif
      is beta-subunit Lys-155 in Escherichia coli F1. The role of this lysine in
      binding and catalysis at the high affinity ATP binding site was studied with the
      mutants beta K155Q and beta K155E by measuring the rates of ATP binding/release,
      ATP hydrolysis/synthesis, and Pi release as a function of pH varied from 5.5 to
      9.5. In wild type, protonated beta Lys-155 appears to contribute significantly to
      high affinity binding of ATP, probably through hydrogen bonding to the gamma
      phosphate. ATP hydrolysis and synthesis were impaired strongly in the mutants,
      and the reaction equilibrium constant, which was pH-independent in wild type, was
      highly pH-dependent in beta K155Q and beta K155E. Studies of steady-state ATPase
      turnover showed that positive catalytic cooperativity was virtually absent and
      the pH-dependent component of positive catalytic cooperativity was abolished or
      reversed in the mutants. The data demonstrate that residue beta K155 is a
      critical catalytic residue in F1 ATPase.

PMID- 8463233
TI  - The mechanism of autooxidation of myoglobin.
AB  - Time courses for the autooxidation of native and mutant sperm whale and pig
      myoglobins were measured at 37 degrees C in the presence of catalase and
      superoxide dismutase. In sperm whale myoglobin, His64(E7) was replaced with Gln,
      Gly, Ala, Val, Thr, Leu, and Phe; Val68(E11) was replaced with Ala, Ile, Leu, and
      Phe; Leu29(B10) was replaced with Ala, Val, and Phe. In pig myoglobin, His64(E7)
      was replaced with Val; Val68(E11) was replaced with Thr and Ser; Thr67(E10) was
      replaced with Ala, Val, Glu, and Arg; Lys45(CD3) was replaced with Ser, Glu, His,
      and Arg. The observed pseudo-first order rate constants varied over 4 orders of
      magnitude, from 58 h-1 (H64A) to 0.055 h-1 (native) to 0.005 h-1 (L29F) at 37
      degrees C, pH 7, in air. The dependences of the observed autooxidation rate
      constant on oxygen concentration and pH were measured for native and selected
      mutant myoglobins. In the native proteins and in most mutants still possessing
      the distal histidine, autooxidation occurs through a combination of two
      mechanisms. At high [O2], direct dissociation of the neutral superoxide radical
      (HO2) from oxymyoglobin dominates, and this process is accelerated by decreasing
      pH. At low [O2], autooxidation occurs by a bimolecular reaction between molecular
      oxygen and deoxymyoglobin containing a weakly coordinated water molecule. The
      neutral side chain of the distal histidine (His64) inhibits autooxidation by
      hydrogen bonding to bound oxygen, preventing both HO2 dissociation and the
      oxidative bimolecular reaction with deoxymyoglobin. Replacement of His64 by amino
      acids incapable of hydrogen bonding to the bound ligand markedly increases the
      rate of autooxidation and causes the superoxide mechanism to predominate.
      Increasing the polarity of the distal pocket by substitution of Val68 with Ser
      and Thr accelerates autooxidation, presumably by facilitating protonation of the
      Fe(II).O2 complex. Increasing the net anionic charge at the protein surface in
      the vicinity of the heme group also enhances the rate of autooxidation.
      Decreasing the volume of the distal pocket by replacing small amino acids with
      larger aliphatic or aromatic residues at positions 68 (E11) and 29 (B10) inhibits
      autooxidation markedly by decreasing the accessibility of the iron atom to
      solvent water molecules.

PMID- 8463234
TI  - CD22, a B cell-specific immunoglobulin superfamily member, is a sialic acid
      binding lectin.
AB  - The B lymphocyte cell surface receptor CD22 is an adhesion molecule that can
      mediate binding to several leukocyte subsets. The first CD22 ligand to be
      identified was the receptor-linked phosphotyrosine phosphatase CD45, but several
      lines of evidence suggest that CD22 may interact with multiple counter receptors
      on adjacent lymphocytes. In the present work, we show that in addition to CD45, a
      soluble CD22-immunoglobulin fusion protein (CD22Rg) recognizes several other
      distinct lymphocyte sialoglycoproteins. CD22-mediated adhesion is dependent upon
      the presence of sialic acids on ligands. CD22Rg is observed to bind specifically
      to a 115-kDa sialoglycoprotein in COS cells transfected with an alpha-2,6
      sialyltransferase cDNA, but not in COS cells transfected with unrelated cDNA
      clones, indicating that at least some CD22-mediated interactions require
      presentation of sialic acid in an alpha-2,6 linkage by CD22 ligands. In all
      cases, truncation of the side chain of sialic acids by mild periodate oxidation
      abolishes recognition by CD22Rg. Direct binding of CD22Rg to lymphoid cells also
      requires sialic acids and their side chains. Taken together, these observations
      indicate that CD22 is a sialic acid-binding lectin and may define a novel
      functional subset of immunoglobulin superfamily adhesion molecules.

PMID- 8463235
TI  - Natural ligands of the B cell adhesion molecule CD22 beta carry N-linked
      oligosaccharides with alpha-2,6-linked sialic acids that are required for
      recognition.
AB  - CD22 beta is a glycoprotein found on the surface of B cells during restricted
      stages of development. It is believed to play a role in cell-cell interactions
      and B cell activation. The accompanying paper (Sgroi, D., Varki, A., Braesch
      Andersen, S., and Stamenkovic, I. (1993) J. Biol. Chem. 268, 7011-7018) shows
      that CD22 beta recognizes multiple glycoproteins on the surfaces of T and B cells
      and that sialylation of these ligands is essential for binding. To identify the
      structure(s) of the sialylated oligosaccharide(s) recognized by CD22 beta,
      [3H]glucosamine-labeled glycoproteins were purified from Daudi cells by
      adsorption onto a CD22 beta recombinant immunoglobulin (CD22 beta Rg) chimera
      attached to protein A-Sepharose (PAS), and the N-linked oligosaccharides were
      released by peptide N-glycosidase F. These released oligosaccharides failed to
      bind to CD22 beta Rg-PAS under the conditions used initially to adsorb the
      glycoproteins, but their elution from a column of CD22 beta Rg-PAS was
      significantly retarded. Populations of oligosaccharides with different affinities
      could be identified by their order of elution. Specific sialidases were used to
      determine the content of alpha-2,3- and alpha-2,6-linked sialic acid in these
      different populations and their contribution to binding. Multiantennary
      oligosaccharides with one alpha-2,6-linked residue bound marginally, and those
      with two or more bound more tightly. alpha-2,3-Linked sialic acid residues were
      without effect. Binding did not require divalent cations and was abrogated by
      mild periodate oxidation of the outer side chain of sialic acid. No marked
      differences in size or fucose content were found between the populations of high
      and low affinity oligosaccharides. However, the low affinity population could be
      partially converted into higher affinity by treatment with beta-galactoside alpha
      2,6 sialyltransferase and CMP-sialic acid. Thus, CD22 beta is a mammalian lectin
      that can recognize specific N-linked oligosaccharide structures containing alpha
      2,6-linked sialic acids.

PMID- 8463236
TI  - Alpha 4/180, a novel form of the integrin alpha 4 subunit.
AB  - The integrin alpha 4 beta 1 (VLA-4) is a versatile cell-cell and cell
      extracellular matrix adhesion receptor. The alpha 4 subunit can be expressed on
      the cell surface in two forms: an intact form (alpha 4/150) and a cleaved form
      (alpha 4/80,70). Here we have characterized a third form of alpha 4, called alpha
      4/180. Although alpha 4/180 (M(r) 180, nonreduced) is different in size than
      alpha 4/150 (M(r) 150, nonreduced), these two forms are clearly related, as they
      (i) shared the same amino-terminal sequence, (ii) were both recognized in Western
      blots by an anti-alpha 4 COOH-terminal antiserum, (iii) migrated with the same
      apparent size and charge when reduced, and (iv) were both immunoprecipitated
      using anti-VLA-4 reagents. In pulse-chase experiments, precursors to both forms
      appeared simultaneously and matured at the same rate, indicating that one is most
      likely not the biosynthetic precursor of the other. Although reduction of alpha
      4/180 to yield alpha 4/150 suggested the release of a cysteine-linked 30-kDa
      fragment, seven different biochemical techniques failed to identify such a
      fragment. Also, alpha 4/180 was converted to alpha 4/150 by incubation at pH 11,
      by treatment with EDTA at 56 degrees C, or by heating in the presence of elevated
      SDS levels. Together our findings suggest that alpha 4/180 and alpha 4/150
      represent different conformations of the same alpha 4 polypeptide, with the
      former having anomalous slower migration in SDS-polyacrylamide gel
      electrophoresis. This unusual biochemical feature of alpha 4 is not shared by
      other beta 1-associated integrin alpha subunits and suggests that VLA-4 has
      unique structural properties.

PMID- 8463237
TI  - BLH1 codes for a yeast thiol aminopeptidase, the equivalent of mammalian
      bleomycin hydrolase.
AB  - We have cloned the BLH1 gene of the yeast Saccharomyces cerevisiae coding for a
      peptidase with significant homology to rabbit bleomycin hydrolase. Bleomycin is a
      glycopeptide antibiotic used for the treatment of human cancers. The antitumor
      activity of the drug is limited by its metabolic inactivation caused by bleomycin
      hydrolase, a member of the cysteine protease family. The open reading frame of
      BLH1 consists of 1,449 base pairs encoding a 55.4-kDa protein consistent with the
      molecular mass found in sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. The consensus sequence within the active site region of cysteine
      proteases is conserved in the yeast enzyme. Biochemical studies on the purified
      enzyme confirm its classification as a thiol protease. The nonvacuolar enzyme has
      a molecular mass of 220 kDa, suggesting a homotetrameric structure. It exhibits
      an aminopeptidase activity with broad substrate specificity. Biochemical and
      genetic linkage data give evidence that the BLH1 and the LAP3 (Trumbly, R. J.,
      and Bradley, G. (1983) J. Bacteriol. 156, 36-48) encoded aminopeptidases are
      identical. Deletion of the BLH1 gene is not lethal under normal growth
      conditions. However, blh1 mutants show hypersensitivity to bleomycin, indicating
      that bleomycin hydrolase is able to inactivate bleomycin in vivo and to protect
      cells from bleomycin-induced toxicity.

PMID- 8463238
TI  - Functional and chemical characterization of Hymenoptaecin, an antibacterial
      polypeptide that is infection-inducible in the honeybee (Apis mellifera).
AB  - As part of our ongoing search for novel antimicrobial agents and their use in
      singular or combined drug therapy, we have isolated a series of polypeptides from
      the lymph fluid of honeybees. These polypeptides are synthesized de novo,
      following experimental infection of the insect with live Escherichia coli cells,
      and confer a broad-spectrum antibacterial defense to the host. We have dissected
      this humoral "immune" system into its constituent components. In addition to the
      previously characterized apidaecins and abaecin, we also isolated a member of the
      defensin family of peptide antibiotics and, now, a novel 93-amino acid long,
      cationic polypeptide, termed hymenoptaecin. Detailed analysis established the
      complete chemical structure, including a 2-pyrrolidone-5-carboxylic acid at the N
      terminus, and indicated major differences with all known antibacterial
      polypeptides. Under physiological conditions, it inhibits viability of Gram
      negative and Gram-positive bacteria, including several human pathogens. Lethal
      effects against E. coli are secondary to sequential permeabilization of outer and
      inner membrane. In combination, the six-constituent "peptide antibiotics" of bee
      lymph provide wide-spectrum antibacterial protection in vitro by virtue of
      complementarity rather than synergism.

PMID- 8463239
TI  - Effect of myristoylation on GTP-dependent binding of ADP-ribosylation factor to
      Golgi.
AB  - ADP-ribosylation factors (ARFs), a family of approximately 20-kDa guanine
      nucleotide-binding proteins that activate cholera toxin ADP-ribosyltransferase in
      vitro, have been implicated in intracellular protein trafficking and are thought
      to cycle between cytosolic and membrane compartments. Although isolated
      predominantly as soluble proteins, ARFs associate with membranes and
      phospholipids in a GTP-dependent manner. In contrast to other small GTP-binding
      proteins, ARFs are NH2 terminally myristoylated. Using a bacterial expression
      system, recombinant myristoylated and non-myristoylated human ARF5 were produced
      to investigate the role of myristoylation in its association with Golgi. The
      recombinant ARFs (myristoylated and non-myristoylated) exhibited similar
      biochemical activity as measured by GTP binding and in vitro activation of
      cholera toxin. Myristoylated ARF5, however, demonstrated a temperature- and GTP
      dependent association with Golgi membranes, whereas non-myristoylated ARF did not
      bind to Golgi under any of the experimental conditions. These data indicate that
      myristoylation is necessary, although not sufficient, for membrane attachment,
      but is not necessary for activation of cholera toxin.

PMID- 8463240
TI  - The ATP-dependent translocation of phosphatidylserine to the mitochondria is a
      process that is restricted to the autologous organelle.
AB  - The general properties of phosphatidylserine synthesis and translocation to the
      inner mitochondrial membrane which occur in both intact and permeabilized cells
      are now shown to occur in cells that are disrupted by shearing. In disrupted
      cells the synthesis of phosphatidylserine requires ATP and is blocked by
      preventing Ca2+ sequestration. The translocation of nascent phosphatidylserine to
      the mitochondria also requires ATP in disrupted cells. Using disrupted cells it
      is possible to test whether the translocation of nascent phosphatidylserine to
      the mitochondria is restricted to autologous mitochondrial acceptors or is
      possible with heterologous mitochondrial acceptors. To examine the nature of the
      transport process, a donor and acceptor population of cells were prepared. The
      donor cells were poisoned with hydroxylamine which irreversibly inactivates
      phosphatidylserine decarboxylase and will prevent the conversion of nascent
      phosphatidylserine to phosphatidylethanolamine. The acceptor cells were not
      treated with hydroxylamine so that any phosphatidylserine generated in the donor
      cell that reached the inner mitochondrial membrane of the acceptor cells would be
      decarboxylated to form phosphatidylethanolamine. Disrupted donor cells were pulse
      labeled with [3H]serine for 40 min to permit the synthesis of [3H]
      phosphatidylserine, and then further incorporation of radiolabel was arrested by
      chelating Ca2+. When the prelabeled disrupted donor cells were mixed with
      disrupted acceptor cells the latter failed to decarboxylate the nascent
      phosphatidylserine. In control experiments the addition of hydroxylamine-poisoned
      cells did not alter the transfer of nascent phosphatidylserine to autologous
      mitochondria present in unpoisoned cells. These results indicate that the ATP
      dependent translocation of phosphatidylserine to the mitochondria is a process
      that is restricted to the autologous organelle.

PMID- 8463241
TI  - Identification of two subunit A isoforms of the vacuolar H(+)-ATPase in human
      osteoclastoma.
AB  - Subunit A is thought to be the main component of the catalytic site of the
      vacuolar-type H(+)-ATPase. Screening of a cDNA library made from human
      osteoclastoma tumor tissue revealed the presence of two isoforms of subunit A.
      HO68 is a cDNA of 3.1 kilobase pairs, corresponding to a mRNA of approximately
      3.4 kilobases in osteoclastoma only, encoding a protein of 615 amino acids with a
      predicted molecular mass of 68177 Da. A second subtype, VA68, corresponding to a
      mRNA of approximately 4.8 kilobases was present in all tissues analyzed, and
      codes for a predicted protein of 617 residues and theoretical molecular mass of
      68264 Da. These clones share homology with previously published subunit A
      sequences, and this, together with the tissue distribution of the mRNA, suggests
      there are ubiquitous (VA68-type) and tissue-specific (HO68-type) isoforms. HO68
      shows the closest sequence homology (95% at the amino acid level) to subunit A of
      a proton-secreting vacuolar-type H(+)-ATPase located in the apical membrane of
      midgut goblet cells of tobacco hornworm larva (Manduca sexta). We propose that
      HO68 could correspond to an isoform of subunit A specific for a vacuolar-type
      H(+)-ATPase located in the osteoclast plasma membrane.

PMID- 8463243
TI  - A calorimetric study of Ca2+ binding by wheat germ calmodulin. Regulatory steps
      driven by entropy.
AB  - A hypothesis has been proposed for Ca(2+)-binding proteins that a regulatory Ca2+
      binding step is endothermic and is driven solely by entropy in the absence of
      Mg2+ (Imaizumi, M., Tanokura, M., and Yamada, K. (1987) J. Biol. Chem. 262, 7963
      7966). To confirm this idea, microcalorimetric titrations of wheat germ
      calmodulin, with Ca2+ in the presence and absence of Mg2+ and with Mg2+ in the
      absence of Ca2+, have been carried out at 25 degrees C and at pH 7.0. The results
      indicate that the four binding sites in each molecule are thermodynamically
      equivalent to one another for both Ca2+ and Mg2+ binding and that the reaction is
      endothermic for Ca2+ binding in the absence of Mg2+. As compared with bovine
      brain calmodulin on Ca2+ binding in the absence of Mg2+, Ca2+ binding in both
      proteins is driven solely by a large favorable entropy change despite unfavorable
      enthalpy change. Therefore, the above idea seems plausible.

PMID- 8463242
TI  - Characterization of the mouse carbonic anhydrase II gene promoter.
AB  - This work characterizes a 250-base pair (bp) fragment of the mouse carbonic
      anhydrase II (CAII) gene as an efficient but not cell-specific promoter. This
      fragment contains multiple consensus cis regulatory regions that interact in a
      complex fashion to regulate transcriptional activity from the promoter. Truncated
      fragments of the 250-bp promoter retain transcriptional activity. The 90-bp 5'
      "GC"-rich portion of the promoter can direct transcription independently from the
      consensus TATA box and also contains a silencer that diminishes transcription
      from the 3' 160-bp portion of the CAII promoter as well as from the SV40
      promoter. There are two nonconsensus dual functioning Ap2-like elements on the
      promoter that are essential for core promoter activity and cAMP-mediated
      increases in transcription of the gene. A nuclear protein of approximately 65 kDa
      binds to these elements and is present in nuclear extracts of nonstimulated and
      forskolin-stimulated NIH-3T3 cells. I conclude that these nonconsensus Ap2-like
      elements and their cognitive binding protein play a major role in the expression
      of the CAII gene.

PMID- 8463244
TI  - Formation of the stable myosin-ADP-aluminum fluoride and myosin-ADP-beryllium
      fluoride complexes and their analysis using 19F NMR.
AB  - The effects of aluminum fluoride and beryllium fluoride on smooth muscle myosin
      and its subfragments were studied. Mg(2+)-ATPase activity was inhibited in the
      presence of aluminum fluoride (beryllium fluoride). [3H]ADP bound to heavy
      meromyosin (HMM) in the presence of aluminum fluoride (beryllium fluoride) and
      was not dissociated after 3 days of dialysis demonstrating that [3H]ADP was
      trapped in HMM. These results suggest the formation of a stable HMM-ADP
      fluoroaluminate (fluoroberyllate) complex. The intrinsic tryptophane fluorescence
      intensity was increased in the presence of ADP and aluminum fluoride (beryllium
      fluoride). Acto-S1 was dissociated upon the formation of S1-ADP-fluoroberyllate
      and actin destabilized S1-ADP-fluoroberyllate complex, while S1-ADP
      fluoroaluminate failed to bind to actin. Furthermore, when S1 formed the complex
      with actin, nucleotide trapping did not occur in the presence of fluoraluminate.
      These results indicated that the myosin-ADP-fluoroberyllate complex resembles a
      weak binding state while myosin-ADP-fluoroaluminate complex is a distinct
      conformation although the binding to actin was also weak. The structure of the
      ternary complex was investigated using 19F NMR. The 19F NMR spectrum of the S1
      ADP-fluoroaluminate complex showed a peak at -66.7 ppm which is due to the
      binding of fluoraluminate to S1. The peak was not observed when 5'
      adenylylimidodiphosphate was substituted for ADP suggesting that aluminum
      fluoride plays a role as a phosphate analogue. The stoichiometry of the bound
      fluoride was determined to be 3.8 mol/mol S1 suggesting that the bound species is
      AlF-4.

PMID- 8463245
TI  - Kinetics of structural changes of reconstituted skeletal muscle thin filaments
      observed by fluorescence resonance energy transfer.
AB  - Fluorescence resonance energy transfer was measured between probes attached to
      Troponin-I and actin in the reconstituted skeletal muscle thin filament. Cys-133
      on TnI was labeled with 4-acetamido-4'-maleimidylstilbene-2,2'-disulfonic acid,
      and Lys-61 on actin was labeled with fluorescein 5-isothiocyanate. A large
      difference in the efficiency of resonance energy transfer was observed between
      the presence (0.55) and absence (0.76) of Ca2+, which corresponds to the change
      in the distance of 0.53 nm and is in good accordance with a previous report
      (Miki, M. (1990) Eur. J. Biochem. 187, 155-162). The fluorescence titration curve
      of this reconstituted thin filament was measured versus free Ca2+ concentration
      under physiological conditions in the presence of 8 mM MgCl2. The transfer
      efficiency changed sharply between pCa 6.9 and 5.75, with a midpoint at pCa 6.25,
      suggesting that a conformational change of thin filaments occurs with a highly
      cooperative mode. The time course of this conformational change was followed by
      measuring the fluorescence intensity change (energy transfer efficiency change)
      of the labeled reconstituted thin filament after rapid decrease or increase of
      free Ca2+ concentration with a stopped-flow fluorometer. When the free Ca2+
      concentration was increased in the presence of 5 mM MgCl2, the fluorescence
      intensity increased (the transfer efficiency decreased) with a rate constant of
      530 +/- 170 s-1 at 20 degrees C. On the other hand, when the free Ca2+
      concentration was decreased, the fluorescence intensity decreased with a rate
      constant of 43 +/- 5 s-1. The results indicate that the conformational change
      observed by fluorescence resonance energy transfer corresponds well to the
      regulation mechanism by troponin-tropomyosin on the reconstituted skeletal muscle
      thin filament.

PMID- 8463246
TI  - Molecular characterization of hasB from an operon required for hyaluronic acid
      synthesis in group A streptococci. Demonstration of UDP-glucose dehydrogenase
      activity.
AB  - The membrane-associated hyaluronate synthase produces capsular hyaluronate in
      group A streptococci by the alternate addition of UDP-N-acetylglucosamine and UDP
      glucuronic acid. Previous studies identified a locus required for hyaluronate
      synthase activity and suggested that a gene involved in the production of UDP
      glucuronic acid (UDP-glucose dehydrogenase) also mapped to the locus. In the
      present study the putative UDP-glucose dehydrogenase gene (hasB) was cloned and
      the DNA sequence determined. The hasB gene product was shown to have global
      similarity with AlgD, a dehydrogenase, which catalyzes the production of GDP
      mannuronic acid for the alginate capsule of Pseudomonas aeruginosa. Regions of
      local homology have been identified which apparently correspond to the NAD
      binding and enzyme active sites of HasB and AlgD. In order to show that hasB
      expression correlated with UDP-glucose dehydrogenase activity, the hasB gene was
      cloned under control of the T7 promoter. Hyperexpression of hasB resulted in a
      protein of approximately 47 kDa and high levels of UDP-glucose dehydrogenase
      activity were observed. These data demonstrate that hasB encodes the UDP-glucose
      dehydrogenase of group A streptococci.

PMID- 8463247
TI  - Interleukin-8 antagonists generated by N-terminal modification.
AB  - We have previously shown that the residues Glu4-Leu5-Arg6 (ELR) preceding the
      first cysteine at the N terminus of the 72-residue form of interleukin-8 (IL-8)
      are essential for receptor binding and neutrophil activation (Clark-Lewis, I.,
      Schumacher, C., Baggiolini, M., and Moser, B. (1991) J. Biol. Chem. 266, 23128
      23134). We have now synthesized a series of analogs of IL-8(4-72), the truncated
      form of IL-8 with the N-terminal sequence ELRC, as potential IL-8 antagonists.
      Among 26 analogs with deletions or amino acid replacements in the ELR region
      several inhibited IL-8 function. The most potent were IL-8(6-72), with Arg6 at
      the N terminus, and IL-8,AAR(7-72) with N-terminal Ala4-Ala5 instead of Glu4
      Leu5. They inhibited IL-8 receptor binding, exocytosis (IC50 0.3 microM), as well
      as chemotaxis and the respiratory burst. Inhibition was restricted to responses
      elicited by IL-8, GRO alpha, or NAP-2, and no effect was observed when the
      unrelated agonists fMet-Leu-Phe or C5a were used as stimuli. These results
      demonstrate that selective antagonists that prevent or attenuate the action of IL
      8 and its related chemotactic cytokines are obtained by modification of the ELR
      sequence at the N terminus.

PMID- 8463248
TI  - Mass changes of inositol 1,3,4,5,6-pentakisphosphate and inositol
      hexakisphosphate during cell cycle progression in rat thymocytes.
AB  - Changes in the cellular mass and the cellular concentration of the highly
      phosphorylated inositol derivatives inositol 1,3,4,5,6-pentakisphosphate
      (Ins(1,3,4,5,6)P5) and inositol hexakisphosphate (InsP6) were observed during a
      complete cell cycle of proliferating rat thymocytes. Inositol polyphosphates were
      determined by a recently developed anion-exchange HPLC/post-column complexometric
      dye system (Mayr, G. W. (1988) Biochem. J. 254, 585-591), and data were expressed
      as mass amounts per cell number or as absolute intracellular concentrations based
      on cell volume determinations by the cell analyzer system CASY 1. After a very
      early transient rise in both Ins(1,3,4,5,6)P5 and InsP6 at the beginning of the
      cell cycle, a decrease of the intracellular concentration of both compounds
      occurred which then remained on a low level between 24 and 48 h. Between 48 and
      72 h the cells divided resulting in a decrease of the cell volume by a factor of
      approximately 2. During this phase a pronounced increase of Ins(1,3,4,5,6)P5 and
      InsP6 was observed. These increases were already seen when the data were
      expressed as mass per cell number, but were even enhanced when expressed as
      absolute intracellular concentrations. In conclusion, we present as a novel
      finding long term changes in the intracellular concentrations of Ins(1,3,4,5,6)P5
      and InsP6 in proliferating thymocytes. This may indicate a role for these
      compounds during cell cycle progression.

PMID- 8463249
TI  - Active baculovirus recombinant p70s6k and p85s6k produced as a function of the
      infectious response.
AB  - Rat p70s6k and p85s6k have been expressed in baculovirus recombinants propagated
      in Sf9 insect cells. Surprisingly, both recombinant isoforms were active without
      coinfection of other kinases which lie upstream in the signaling pathway.
      Treatment of either recombinant form with phosphatase 2A leads to immediate
      inactivation in the absence of phosphatase inhibitors. Further studies show that
      the same four major Ser/Thr-Pro sites associated with p70s6k activation following
      mitogenic stimulation in vivo are also the four major sites phosphorylated in
      both the p70s6k and p85s6k during the infection process. It is proposed that the
      production of phosphorylated and activated recombinant p70s6k and p85s6k is due
      to activation of a host cell signaling pathway which is triggered by viral
      infection. In support of this hypothesis, wild-type virus-, but not mock-infected
      cells, exhibit the multiple phosphorylation of a ribosomal protein which migrates
      similar to ribosomal protein S6 on two-dimensional-polyacrylamide gels and
      extracts from these same cells contain elevated levels of S6 kinase activity.

PMID- 8463250
TI  - Thrombospondin is a tight-binding competitive inhibitor of neutrophil elastase.
AB  - Thrombospondin, a glycoprotein of three identical disulfide-bonded subunits, is a
      constituent of platelet alpha-granules and a variety of normal and transformed
      cells and binds to cell surfaces and becomes incorporated into extracellular
      matrix. It has been implicated in processes such as wound healing and tumor
      growth and metastasis. In addition, thrombospondin was shown recently to be an
      inhibitor of the fibrinolytic enzyme, plasmin. In the cause of studying the
      effects of thrombospondin on other serine proteinases, we found that
      thrombospondin binds neutrophil elastase in an active-site-dependent manner and
      competitively inhibits the activity of the enzyme. In a competitive binding
      assay, neutrophil elastase bound to thrombospondin with a dissociation constant
      of 17 +/- 7 nM, expressed per mole of thrombospondin trimer, or 52 +/- 20 nM,
      expressed per mole of thrombospondin subunit. In kinetic studies of the
      inhibition of the amidolytic activity of neutrophil elastase by thrombospondin,
      2.7 +/- 0.3 mol of elastase interacted with 1 mol of thrombospondin trimer with a
      site-binding constant of 57 +/- 13 nM. Lower limits for the on rate constant of 5
      x 10(6) M-1 s-1 and off rate constant of 0.27 s-1 were established. Affinity of
      binding of neutrophil elastase to thrombospondin was sensitive to ionic strength
      and calcium ions. Thrombospondin was cleaved by neutrophil elastase, but the
      site(s) of the limited cleavage are independent of the competitive inhibition of
      elastase activity by thrombospondin. Neutrophil elastase inactivated with
      phenylmethylsulfonyl fluoride did not compete with active elastase for binding to
      thrombospondin, implying that a functional active site is important for the
      interaction of elastase with thrombospondin. Thrombospondin protected fibronectin
      from cleavage by neutrophil elastase. In summary, the binding of neutrophil
      elastase to thrombospondin is tight, reversible, and close enough to the active
      site of elastase to exclude small synthetic tripeptidyl p-nitroanilide substrates
      and macromolecular protein substrates. Two potential reactive centers that may be
      involved in binding elastase have been identified in the calcium-binding type 3
      domains of thrombospondin. Neutrophil elastase is the enzyme primarily
      responsible for degrading and solubilizing connective tissue during inflammatory
      processes. These findings suggest a previously unsuspected mechanism for
      regulation of elastase activity at inflammatory sites.

PMID- 8463251
TI  - Replication protein A is the major single-stranded DNA binding protein detected
      in mammalian cell extracts by gel retardation assays and UV cross-linking of long
      and short single-stranded DNA molecules.
AB  - Band shift and UV cross-linking assays were used to analyze the major single
      stranded DNA (ssDNA) binding activity in lysates of primate and rodent cells. The
      ssDNA binding activity behaved chromatographically similar to that of replication
      protein A (RP-A), a multisubunit protein containing three polypeptides of
      molecular mass 70, 34, and 14 kDa. A 70-kDa protein was found to harbor the ssDNA
      binding activity when UV cross-linked to long ssDNA or to oligonucleotide probes.
      Monoclonal antibodies against the 70- and the 34-kDa subunits produced super-gel
      shift patterns, demonstrating that the reactive protein is indeed RP-A and that
      the retarded native binding complex included both subunits. RP-A displayed
      oligonucleotide-specific binding dependent on oligomer length. Increasing
      oligonucleotide length led to the formation of slow migrating complexes harboring
      multiple RP-A molecules, suggesting that an interval of about 20-30 bases is
      required for the binding of RP-A molecules. While similar binding activity was
      detected in cell extracts derived from proliferating and quiescent cells, a sharp
      decline in ssDNA binding activity was observed in the SV40-transformed Chinese
      hamster cell line 631 following UV irradiation. The nature of this decrease in
      activity and its possible effect on DNA replication is discussed.

PMID- 8463252
TI  - Vaccinia virus ribonucleotide reductase. Correlation between deoxyribonucleotide
      supply and demand.
AB  - Ribonucleotide reductase has been suggested as a rate-limiting enzyme in DNA
      synthesis, partly because activities of the enzyme in cell-free preparations are
      low relative to rates needed to sustain DNA replication at observed rates.
      Vaccinia virus, with a large duplex DNA genome, encodes both subunits of a
      specific ribonucleoside diphosphate reductase. In this report, we describe
      quantitative analysis of ribonucleotide reductase protein levels and DNA
      accumulation in vaccinia virus-infected cell extracts, to correlate the supply of
      deoxyribonucleotides with the demand for these precursors in viral DNA synthesis.
      To do this, we generated polyclonal antisera to TrpE fusion proteins constructed
      from the carboxyl termini of both subunits of viral ribonucleotide reductase. We
      used S1 nuclease and immunoprecipitation analysis to determine the
      transcriptional and translational kinetics of vaccinia virus ribonucleotide
      reductase expression. Enzyme activity and ribonucleotide reductase protein
      stability were also assayed during the time course of viral infection. Enzyme
      linked immunoassays were used to quantitate protein levels, and filter
      hybridizations were used to measure the accumulation of viral DNA. We show that
      ribonucleotide reductase activity in vaccinia virus-infected cells is severalfold
      higher than needed to provide deoxyribonucleotides at rates commensurate with DNA
      synthesis. Thus, while the enzyme is important as catalyst for the first
      committed reaction in DNA replication, it is not rate-limiting for this process.

PMID- 8463253
TI  - Contribution of platelet microparticle formation and granule secretion to the
      transmembrane migration of phosphatidylserine.
AB  - Activation of human platelets by complement proteins, C5b-9, thrombin plus
      collagen, or a Ca2+ ionophore results in surface exposure of phosphatidylserine
      (PS), accompanied by the expression of membrane catalytic activity for the tenase
      (VIIaIXa) and prothrombinase (VaXa) coagulation enzyme complexes. The mechanism
      underlying this surface exposure of PS upon platelet activation remains
      unresolved. Using fluorescent derivatives of PS (NBD-PS), we have investigated
      how the transmembrane migration of PS is related to microvesiculation of the
      platelet plasma membrane and to fusion of storage granules with the plasma
      membrane. Gel-filtered platelets were incubated with NBD-PS, allowing 90 +/- 10%
      of the incorporated NBD-PS to accumulate into the inner leaflet of the plasma
      membrane. Migration of NBD-PS from the inner leaflet to the plasma membrane
      surface was monitored by time-based flow cytometry, and correlated with the
      appearance of platelet microparticles and alpha-granule secretion. Platelet
      activation by C5b-9 or the Ca2+ ionophore, A23187, increased surface exposure of
      NBD-PS, due to acceleration of the apparent rate of migration from inner to outer
      plasma membrane leaflets. The onset of this accelerated migration of NBD-PS to
      the surface coincided with the onset of plasma membrane vesiculation, and the NBD
      PS that partitioned into the membrane of the shed microparticle was also rapidly
      exposed to the surface (t1/2 < 2 min). In addition to a temporal correlation,
      microparticle formation and the surface exposure of inner leaflet NBD-PS showed a
      similar requirement for Ca2+. These results demonstrate that agonist-induced
      microvesiculation of the platelet plasma membrane is accompanied by accelerated
      migration of a PS analogue from the inner leaflet to the surface of the shed
      microparticle membrane, suggesting the mechanism by which induction of platelet
      microparticle formation exposes catalytic surface for tenase and prothrombinase
      assembly.

PMID- 8463254
TI  - Mechanochemistry of the alternatively spliced spectrin-actin binding domain in
      membrane skeletal protein 4.1.
AB  - Protein 4.1's interaction with the erythroid skeletal proteins spectrin and actin
      and its essential role in regulating membrane strength are both attributable to
      expression of an alternatively spliced 63-nucleotide exon. The corresponding 21
      amino acid (21-aa) cassette is within the previously identified spectrin-actin
      binding domain (10 kDa molecular mass) of erythroid protein 4.1. This cassette is
      absent, however, in several isoforms that are generated by tissue- and
      development-specific RNA splicing. Four isoforms of the 10-kDa domain were
      constructed for comparative assessment of functions particularly relevant to red
      cells. In vitro translated isoforms containing the 21-aa cassette, denoted 10k21
      and 10k19,21, were able to bind spectrin, stabilize spectrin-actin complexes, and
      associate with red cell membrane. Isoforms replacing or lacking the 21-aa
      cassette, 10k19 and 10k0, did not function in these assays. A bacterially
      expressed fusion protein with glutathione-S-transferase, designated GST-10k21,
      congealed spectrin-actin into a network in vitro as found with purified protein
      4.1. Additionally, incorporation of GST-10k21 into mechanically weak, 4.1
      deficient membranes increased mechanical strength of these membranes to normal.
      GST-10k19 did not function in these assays. These results show that the 21-aa
      sequence in protein 4.1 is critical to mechanical integrity of the red cell
      membrane. These results also allow the role of protein 4.1 in membrane mechanics
      to be interpreted primarily in terms of its spectrin-actin binding function.
      Alternatively expressed sequences within the 10-kDa domain of nonerythroid
      protein 4.1 are suggested to have different, yet to be defined functions.

PMID- 8463255
TI  - A polyomavirus enhancer A-binding protein-3 site and Ets-2 protein have a major
      role in the 12-O-tetradecanoylphorbol-13-acetate response of the human
      stromelysin gene.
AB  - The expression of stromelysin, a major matrix metalloproteinase of connective
      tissues, is regulated by several cytokines, growth factors, protooncogenes as
      well as by 12-O-tetradecanoylphorbol-13-acetate (TPA). The human stromelysin gene
      promoter contains an activator protein-1 (Fos/Jun) binding site at -70, which is
      required for basal expression but is not necessary for the TPA response. In this
      study, using promoter deletion mutants in transient gene transfection
      experiments, we first identify the sequence from -220 to -202 as necessary for
      the TPA response of the stromelysin gene. Further, among the restriction
      fragments from the 1.3-kilobase long promoter, only the proximal fragment (-274
      to -101) conferred a TPA response on the heterologous thymidine kinase gene
      promoter. The -220 to -202 sequence contains two copies of a motif similar to the
      polyomavirus enhancer A-binding protein-3 (PEA-3) site, which binds the Ets
      family of oncoproteins and transcription factors. Point mutations of either one
      of the two PEA-3 sites, in the 1.3-kilobase long stromelysin promoter context,
      reduced basal gene expression. However, only the mutation of the proximal, but
      not the distal PEA-3 site, significantly inhibited the TPA response. In
      cotransfection experiments, the Ets-2 protein transactivated the stromelysin
      promoter and the promoter proximal fragment containing the PEA-3 sites but not
      the promoters containing mutated PEA-3 sites. These data suggest that the PEA-3
      site, but not the activator protein-1 site, and Ets-2 protein have a major role
      in the TPA induction of the human stromelysin gene transcription.

PMID- 8463256
TI  - The kinetics of formation of complexes between Escherichia coli RNA polymerase
      and the rrnB P1 and P2 promoters of Bacillus subtilis. Effects of guanosine
      tetraphosphate on select steps of transcription initiation.
AB  - The kinetics of formation and dissociation of heparin-resistant transcription
      initiation complexes between Escherichia coli RNA polymerase and the rrnB P1 and
      P2 promoters from Bacillus subtilis were investigated using a gel retardation
      assay. The results suggest that the formation of polymerase-promoter complexes
      proceeds by a three-step reaction mechanism. The bimolecular collision between
      free RNA polymerase and the promoter creates a heparin-sensitive complex, which
      then isomerizes to an initial, and then a subsequent, heparin-resistant complex.
      We propose that a sequential mechanism best describes the bimolecular collision
      and that the forward rate constants predominate in the overall rate of heparin
      resistant complex formation. At 35 degrees C, the association of polymerase with
      P1 and P2 was very rapid (ka = 1.5 - 2.1 x 10(8) M-1 s-1; kf > or = 0.56 s-1).
      Direct information on the formation of the closed and intermediate transcription
      complexes and indirect information on the formation of open complexes suggest
      that guanosine tetraphosphate did not differentially affect any step between
      growth rate-regulated and non-growth rate-regulated rRNA promoters by more than 2
      fold.

PMID- 8463257
TI  - Characterization of abnormal free glycophosphatidylinositols accumulating in
      mutant lymphoma cells of classes B, E, F, and H.
AB  - Several mutant lymphoma lines are unable to add glycophosphatidylinositol
      membrane anchors to proteins. Some of them accumulate abnormal glycolipids which
      can be labeled by tritiated myo-inositol, mannose, or ethanolamine and which are
      not present in the corresponding parental cell lines. The [3H]myo-inositol
      labeled abnormal lipids were isolated and characterized using hydrofluoric acid
      dephosphorylation, nitrous acid deamination, acetolysis, and exoglycosidase
      treatments alone or in combination. This partial characterization suggests that
      the class F mutant EL-4-f contains 3 abnormal glycolipids containing 3, 2, or 1
      mannose residues, the headgroups of which are Man alpha 1,2Man alpha 1,6(X-->)Man
      alpha-GlcN-acylinositol, Man alpha 1,6(X-->)Man alpha-GlcN-inositol, and (X-
      >)Man alpha-GlcN-acylinositol where X represents a charged, hydrofluoric acid
      sensitive substituent. A fourth, minor abnormal lipid with a Man alpha 1,6(X-
      >)Man alpha-GlcN-inositol headgroup but a different lipid moiety is also found.
      The substituent X is likely to consist of phosphoethanolamine since hydrofluoric
      acid releases [3H]ethanolamine from the [3H]ethanolamine-labeled version of these
      lipids. Pulse-chase experiments indicate that the abnormal
      glycophosphatidylinositols of class F mutants are very long-lived. The class B
      mutant S1A-b has previously been shown to contain an abnormal Man alpha
      1,6(phosphoethanolamine-->)Man alpha-GlcN-acylinositol-P-lipid intermediate. Here
      we show that S1A-b also accumulates a more polar but less abundant lipid which
      has the identical headgroup structure but lacks the acyl group on the inositol
      residue. The class E mutant BW5147-e accumulates a hydrophobic glycolipid with
      the headgroup structure GlcN-acylinositol. All the abnormal glycolipids except
      those of EL-4-f are heterogeneous with regard to their lipid moiety since base
      resistant as well as base-sensitive lipids are present. This suggests that the
      base-resistant alkylglycerols typical of mammalian anchors can get integrated
      into anchors at early stages of glycophosphatidylinositol formation.

PMID- 8463258
TI  - Molecular cloning of rat amidophosphoribosyltransferase.
AB  - The cDNA of rat amidophosphoribosyltransferase (EC 2.4.2.14, ATase), which is the
      supposed regulatory allosteric enzyme of de novo purine nucleotide biosynthesis,
      has been cloned by polymerase chain reaction. The predicted open reading frame
      encodes a protein of 517 amino acids with a deduced molecular weight of 57,436
      including a supposed 11-amino acid propeptide. The 16 amino acid residues next to
      the propeptide were identical to the N-terminal amino acid microsequence of a
      purified rat liver ATase, which is consistent with the cleavage of the propeptide
      from the proenzyme in rat liver. The derived amino acid sequence is the first
      sequence reported for a mammalian ATase and it exhibits 81, 41, 36, and 31%
      identity with the sequences of chicken, Bacillus subtilis, Escherichia coli, and
      Saccharomyces cerevisiae ATases, respectively. The molecular weight (M(r)) of
      57,436 suggests a tetrameric structure of native ATase with a M(r) of 240,000
      248,000. Southern blot analysis suggested that the ATase gene exists as a single
      copy in the rat genome. Northern blot analysis revealed that ATase is expressed
      at a high level in brain, heart, liver, and stomach. The ATase mRNA in brain,
      heart, and stomach was 3.5 kilobases (kb) and in liver the 3.5-kb band was
      observed as well as an additional band of 4.2 kb. Reverse transcription
      polymerase chain reaction analysis showed that ATase is ubiquitously expressed in
      all tissues examined. Comparison with chicken ATase showed that 2 cysteine
      residues for an iron-sulfur cluster were conserved. Three conserved and two non
      conserved consensus phosphorylation sites for cAMP-dependent protein kinase were
      found.

PMID- 8463259
TI  - Role of zinc-binding- and hemopexin domain-encoded sequences in the substrate
      specificity of collagenase and stromelysin-2 as revealed by chimeric proteins.
AB  - The relationship of enzyme structure to substrate specificity for the matrix
      metalloproteinases interstitial collagenase and stromelysin-2 has been
      investigated by analysis of the cleavage specificity of recombinant human
      collagenase-stromelysin-2 hybrid proteins and C terminally truncated collagenase
      and stromelysin-2. Two series of chimeric proteins were devised by progressive
      substitution of exon-encoded domains. The recombinant proteins were expressed in
      COS-7 cells as protein A-fusion proteins and purified on an IgG affinity matrix.
      Treatment with 4-amino-phenylmercuric acetate released active metalloproteinase
      of the sizes predicted for the chimeric proteins. Active forms of both the
      chimeric protein series and the short form enzymes expressed both casein- and
      gelatin-degrading activities. Like stromelysin, the catalytic activity of
      stromelysin-2 was contained in the N-terminal domain (encoded by exons 1-5) and
      was apparently independent of the C-terminal domain (encoded by exons 6-10). Only
      full-length collagenase displayed a triple helicase (collagenolytic) activity; no
      combination of N- or C-terminal collagenase domains fused with stromelysin-2
      domains had such activity. This suggests that the triple helicase activity is a
      composite of elements derived from both halves of the collagenase molecule. C
      terminally truncated collagenase (exons 1-5) and a hybrid of collagenase exons 1
      5 and stromelysin-2 exons 6-10 cleaved denatured type I collagen (gelatin) to
      generate diagnostic peptides in gelatin fingerprint assays. When exon 5 (the exon
      encoding the zinc-binding domain) was derived from stromelysin-2, the enzyme
      specificity in the fingerprint assay changed to that of native stromelysin-2. In
      contrast, when exon 5 was derived from collagenase, the specificity reflected
      that of the parent enzyme. Our data also suggest that mismatching of exons 2 and
      5 destabilizes the enzyme, presumably by altering the geometry of the propeptide
      zinc-binding site interaction. We conclude that the loss of triple helicase
      collagenolytic activity is not accompanied by a shift to the broad specificity
      characteristic of stromelysin. Rather, the zinc-binding domain confers a distinct
      cleavage specificity on each metalloproteinase.

PMID- 8463260
TI  - Mutations within the nucleotide binding site of immunoglobulin-binding protein
      inhibit ATPase activity and interfere with release of immunoglobulin heavy chain.
AB  - Immunoglobulin-binding protein (BiP), a 70-kDa heat shock protein in the
      endoplasmic reticulum, binds transiently to nascent proteins, releasing them upon
      folding and assembly. The in vitro release of bound proteins from BiP requires
      ATP hydrolysis. Recently, the three-dimensional structure was solved for an ATP
      hydrolyzing proteolytic 44-kDa fragment of a 71-kDa heat shock cognate protein,
      HSC71. Because of the high degree of homology in this region, BiP presumably
      forms a similar ATP binding structure. Amino-terminal deletions in BiP eliminated
      ATP-agarose binding. Alteration of a second potential ATP binding site had no
      effect, suggesting that only the HSC71-like site was capable of ATP binding.
      Crystallographic data from HSC71 implicated certain amino acids in interactions
      with the beta-phosphate, gamma-phosphate, and divalent cation of ATP. Mutation of
      each corresponding residue in BiP (Thr-37, Thr-229, and Glu-201) severely
      inhibited its ATPase activity. These BiP mutants were still capable of binding
      ATP and immunoglobulin heavy chains, suggesting that these mutations did not
      drastically alter the structure of BiP. They did however block the ATP-mediated
      release of heavy chains from BiP. Our results demonstrate that the structure of
      BiP in this region must be extremely similar to that elucidated for HSC71 and
      that mutations of residues proposed to interact with ATP block the ATP-mediated
      release of bound protein by inhibiting ATP hydrolysis.

PMID- 8463261
TI  - Immunochemical and biochemical evidence for distinct basement membrane heparan
      sulfate proteoglycans.
AB  - Two antigenically and structurally related heparan sulfate proteoglycans (HSPG),
      with masses of 200 and 350 kDa, have been isolated and characterized from bovine
      renal tubular basement membranes (BTBM) using DEAE-Sephacel, octyl-Sepharose CL
      4B, and Propac PA-1 chromatography. Heparitinase treatment revealed core proteins
      of 145 and 125 kDa, with corresponding core proteins after
      trifluoromethanesulfonic acid treatment of 88 and 82 kDa, from the 200- and 350
      kDa HSPGs, respectively. The separated HSPGs produced similar tryptic peptide
      maps, had similar amino acid compositions, and had similarly sized GAG chains.
      The 200-kDa HSPG had 2.1 mg of protein/mumol of hexuronic acid compared with 1.1
      mg/mumol for the 350-kDa HSPG. Anti-BTBM HSPG monoclonal antibody (mAb A12)
      reacted with core proteins derived from the 200- and 350-kDa HSPGs, whereas anti
      perlecan polyclonal and monoclonal antibodies did not bind to the BTBM HSPG core
      proteins described above but reacted with a 230-kDa core protein, which was
      nonreactive with mAb A12. Immunohistochemical studies of the kidney demonstrated
      differences in the distribution of BTBM HSPG and perlecan. Comparison of amino
      acid sequences from BTBM HSPG tryptic peptides with the sequence of perlecan
      revealed similarities but not extensive identity. Two tryptic peptides show
      homology to rat agrin, a basement membrane component of synaptic junctions. These
      data suggest that the two BTBM HSPGs are immunologically and structurally related
      and that differences in these molecules may arise from alternative splicing or
      posttranslational modifications. In addition, the two BTBM HSPGs are
      immunologically and structurally distinct from perlecan but may share homology
      with agrin.

PMID- 8463262
TI  - Preferential repression of the H subunit of ferritin by adenovirus E1A in NIH-3T3
      mouse fibroblasts.
AB  - Ferritin is the major intracellular iron-storage protein in eucaryotic cells and
      plays a prominent role in maintaining intracellular iron homeostasis. We observed
      that transfection of NIH-3T3 mouse fibroblasts with the adenovirus E1A oncogene
      specifically repressed the mRNA for one of the subunits of ferritin, ferritin H.
      This occurred in the absence of any effect of E1A on the mRNA for the L subunit
      of ferritin. The repression of ferritin H was not a general feature of oncogene
      expression since transfection of NIH-3T3 cells with H-ras did not affect ferritin
      composition. Deletion of the conserved regions of E1A responsible for
      immortalization and transcriptional repression impaired the ability of E1A to
      repress ferritin H. Immunoprecipitation of ferritin in E1A transfectants
      demonstrated that the decrease in the ferritin H/L ratio observed at the mRNA
      level was also exhibited at the protein level. The E1A-dependent inhibition of
      ferritin H was also observed in a chimeric gene containing the ferritin H
      promoter ligated to the chloramphenicol acetyltransferase reporter gene, but was
      not observed in control genes in which chloramphenicol acetyltransferase activity
      was dependent on promoters derived from SV40 or the interleukin-3 gene. This
      suggests that E1A may repress ferritin H at the transcriptional level. These
      results demonstrate that the adenovirus E1A oncogene specifically modulates
      ferritin H expression. They also suggest that alterations in cellular iron
      metabolism may be among the diverse array of cellular responses induced by E1A.

PMID- 8463263
TI  - Isolation and characterization of recombinant human cathepsin E expressed in
      Chinese hamster ovary cells.
AB  - The cDNA sequence encoding precursor forms of human cathepsin E (CE), an
      intracellular aspartic proteinase, was expressed in Chinese hamster ovary cells
      using an SV40 promotor-driven expression vector. By immunoelectron microscopic
      studies using an anti-human CE antibody and by Percoll density gradient
      fractionation, the expressed CE was found to be in two different intracellular
      fractions; the cytosolic compartment and the vacuolar system. The CEs in both the
      cytosolic and the vacuolar fractions were highly purified by a simple method
      involving Percoll density gradient fractionation, chromatography on concanavalin
      A-Sepharose, Mono Q, and TSK-GelG2000SW, and termed s-CE and v-CE, respectively.
      The v-CE was further separated into a major (v-CE1) and a minor (v-CE2) form by
      Mono Q chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      and immunoblotting revealed that the s-CE and v-CE1 consists of two polypeptides
      of 90 and 84 kDa, whereas v-CE2 is composed of 84- and 82-kDa polypeptides. The
      NH2-terminal amino acid sequence analyses showed that the 90- and 84-kDa proteins
      from both s-CE and v-CE started with Ser3 and Lys30 of the sequence of human
      gastric CE predicted from its cDNA sequence, respectively, and that the NH2
      terminus of the 82-kDa protein of v-CE2 is the Ile37. Upon acid treatment at pH
      3.5 and 37 degrees C for 5 min, the 90- and 84-kDa forms are rapidly converted to
      the 82-kDa form, indicating that the 90-, 84- and 82-kDa proteins are the pro-CE,
      the intermediate form, and the mature CE, respectively. All the forms of CE are N
      glycosylated with high-mannose-type oligosaccharides. The catalytic properties of
      s-CE and v-CE are comparable to those of natural human CE. These results suggest
      that the recombinant CE is initially synthesized on membrane-bound ribosomes as a
      N-glycosylated preproenzyme and that, after cleavage of the signal segment, the
      90-kDa proenzyme is proteolytically processed to the intermediate (84 kDa) and
      mature (82 kDa) forms by the transport system.

PMID- 8463264
TI  - Importance of the amino terminus of the interleukin-8 receptor in ligand
      interactions.
AB  - Interleukin-8 (IL-8) and growth regulatory gene/melanoma growth stimulatory
      activity (GRO/MGSA) are small polypeptide molecules involved in the chemotactic
      response of certain cell types. Two receptors have been described which interact
      with IL-8, designated type 1 and type 2. IL-8 binds with high affinity to both
      receptors, whereas GRO/MGSA and neutrophil-activating peptide-2 demonstrate a
      high degree of binding only to the type 2 receptor. The two forms of IL-8
      receptor are members of the rhodopsin seven-helix membrane-spanning superfamily,
      and share a high degree of overall homology, although the amino termini are very
      divergent. By using conserved restriction enzyme sites, a series of chimeric IL-8
      receptor molecules were constructed between the type 1 and type 2 receptors and
      transfected into human 293 kidney epithelial cells. These chimeric molecules
      altered regions of the receptor presented to the ligand. The ability of the
      chimeric receptors to bind IL-8 was determined, as well as the ability of IL-8
      and GRO/MGSA to inhibit radiolabeled IL-8 binding. The amino terminus of the IL-8
      receptors was found to be important for differential binding of GRO/MGSA and IL
      8. In addition, a series of peptides was also constructed to further investigate
      which residues of IL-8 receptor interact with IL-8. These peptides also
      identified the amino-terminal sequence of the IL-8 receptors as being important
      in interacting with IL-8.

PMID- 8463265
TI  - Toxicity of Bordetella avium beta-cystathionase toward MC3T3-E1 osteogenic cells.
AB  - Bordetella avium is the etiological agent of an upper respiratory disease in
      birds which, symptomatically and pathologically, resembles bordetellosis in
      humans. Studies of the virulence of this organism revealed a novel cytotoxic
      protein, designated osteotoxin, that was lethal for MC3T3-E1 osteogenic cells,
      fetal bovine trabecular cells, UMR106-01(BSP) rat osteosarcoma cells, and
      embryonic bovine tracheal cells. The osteotoxin lacked dermonecrotic toxin
      activity, exhibited no cross-reactivity with antibody against B. avium
      dermonecrotic toxin, and was non-proteolytic. Osteotoxin (M(r) approximately
      80,000 by gel filtration, pI 5.4) was purified to electrophoretic homogeneity
      from B. avium 197. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and
      spectrophotometric analyses showed that the native protein was a homodimer and
      that each of the non-covalently linked subunits (M(r) approximately 41,000)
      contained one molecule of pyridoxal 5'-phosphate. Microsequencing of the first 32
      amino acids from the NH2 terminus allowed the synthesis of two oligonucleotide
      probes, which, together with polyclonal antibody to the purified protein,
      facilitated cloning, sequencing, and expression of the osteotoxin gene product in
      Escherichia coli. The open reading frame encodes a polypeptide of 396 amino acid
      residues (M(r) = 42,606, calculated pI 5.9), whose sequence exhibits
      approximately 38% identity (approximately 60% similarity) to pyridoxal 5'
      phosphate-dependent beta-cystathionase(s) from E. coli, Salmonella typhimurium,
      and rat liver. The characteristic motif, TKYXXGHSD, associated with binding the
      cofactor in these enzymes is also present in osteotoxin. Physicochemical and
      enzymatic analyses established the coidentity of osteotoxin with beta
      cystathionase. The region upstream of the beta-cystathionase (metC) gene in B.
      avium 197 lacked regulatory sequences ("Met boxes") described for metC in enteric
      species, and enzyme production was not repressed by methionine. Incubation of
      MC3T3-E1 osteogenic cells in medium containing L-[35S]cystine and purified beta
      cystathionase resulted in 35S-labeling of the enzyme and at least one major MC3T3
      E1 cell protein (M(r) approximately 50,000). cytotoxicity can be attributed to:
      1) beta-cystathionase-catalyzed cleavage of L-cystine in the medium and formation
      of reactive sulfane-containing derivative(s), and 2) transfer of sulfane sulfur
      to metabolically sensitive or structurally important proteins in the osteogenic
      cells.

PMID- 8463266
TI  - The carboxyl terminus of isocitrate lyase is not essential for import into
      glyoxysomes in an in vitro system.
AB  - A procedure has been established for the isolation of intact and import-competent
      glyoxysomes from the cotyledons of sunflower (Helianthus annuus) seedlings.
      Radiolabeled isocitrate lyase (a glyoxysomal matrix protein) was produced by in
      vitro transcription of the castor bean cDNA and translation of the RNA in a wheat
      germ lysate. The heterologous isocitrate lyase was imported into isolated
      sunflower glyoxysomes and protease-protected. Dihydrofolate reductase, a
      cytoplasmic protein, neither bound to nor imported into the glyoxysomes. Import
      of isocitrate lyase was not observed when the glyoxysome fraction was replaced by
      a mitochondrial fraction. The import of isocitrate lyase into glyoxysomes was
      temperature- and ATP-dependent. Progressive carboxyl-terminal truncations of the
      isocitrate lyase gene were transcribed and translated to yield polypeptides with
      the same amino terminus but lacking varying amounts of the carboxyl terminus. All
      these polypeptides imported with the same characteristics as the full-length
      protein, suggesting that targeting information must be present within the first
      168 amino acids, and, unlike some other peroxisomal proteins, the carboxyl
      terminus is dispensable for targeting and import.

PMID- 8463267
TI  - Bovine stefin C, a new member of the stefin family.
AB  - Four low M(r) cysteine proteinase inhibitors with different pI values were
      isolated from bovine thymus using alkaline activation of the gland homogenate,
      affinity chromatography on carboxymethyl-papain-Sepharose, gel filtration on
      Sephadex G-50, ion-exchange chromatography on a DEAE-cellulose column and a fast
      protein liquid chromatography Mono Q column, and hydrophobic chromatography on a
      TSK Phenyl-5 PW column. One of the inhibitors was identified both as the
      monomeric and dimeric forms of stefin B. Two others, called cysteine proteinase
      inhibitor-1 and cysteine proteinase inhibitor-2, were N terminally blocked and
      most likely belong to the stefin family. The complete amino acid sequence of the
      last inhibitor, namely bovine stefin C, was determined. The inhibitor consisted
      of 101 amino acids and its M(r) was calculated to be 11,546. It exhibits
      considerable sequence homology with other inhibitors from the stefin family. It
      was identified as the first tryptophane-containing stefin and it had a prolonged
      N terminus. The four inhibitors had similar inhibitory activities on cysteine
      proteinases. They were fast-acting inhibitors of papain and cathepsin L (kass >
      or = 1.8 x 10(6) M-1 s-1) and formed very tight complexes with the enzymes (Ki <
      or = 180 pM). In contrast, they were relatively poor inhibitors of cathepsin B
      (Ki > 100 nM).

PMID- 8463268
TI  - The human low affinity immunoglobulin G Fc receptor IIC gene is a result of an
      unequal crossover event.
AB  - We have isolated and characterized three genes coding for hFc gamma RIIA, IIB,
      and IIC. Each gene spans approximately 15-19 kilobases of DNA and consists of
      eight exons. Two exons encode the 5'-untranslated region and signal peptides, two
      exons code for homologous Ig-like extracellular domains, a single exon encodes
      the transmembrane spanning region, and three exons encode the cytoplasmic domains
      and 3'-untranslated regions. Analysis of gene structures support the concept that
      the hFc gamma RIIA and hFc gamma RIIB genes originated via gene duplication and
      divergence processes. The hFc gamma RIIC gene, however, showed a remarkable
      homology at its 5' end with the hFc gamma RIIB gene, whereas its 3' region was
      highly homologous with the hFc gamma RIIA gene, suggesting that the hFc gamma
      RIIC gene results from an unequal crossover event between the hFc gamma RIIA and
      IIB genes. This hypothesis was supported by nucleotide sequence analyses of the
      putative break-point region. The proposed site of recombination was located
      approximately 300 nucleotides downstream from the sixth (C1) exon. These data
      provide a unique model for the evolutionary generation of a receptor family with
      multiple biological functions.

PMID- 8463269
TI  - Regulation of heme oxygenase and metallothionein gene expression by the heme
      analogs, cobalt-, and tin-protoporphyrin.
AB  - Two heme analogs, cobalt- and tin-protoporphyrin (CoPP and SnPP, respectively)
      have been used to probe the heme-hemopexin interaction, hemopexin receptor
      binding, and the mechanism of regulation of heme oxygenase (HO) and
      metallothionein-1 (MT-1) gene expression by hemopexin. Both CoPP and SnPP are HO
      inhibitors and hemopexin binds SnPP (Morgan, W. T., Alam, J., Deaciuc, V.,
      Muster, P., Tatum, F. M., and Smith, A. (1988) J. Biol. Chem. 263, 8226-8231) and
      CoPP. The association of CoPP with hemopexin produces characteristic changes in
      the absorbance spectrum of CoPP and quenches the intrinsic fluorescence of
      hemopexin. Binding of CoPP is tight (Kd ca. 3 x 10(-7) M) although of lower
      affinity than heme itself (Kd < pM); and CoPP binding, like heme, produces
      conformational changes in hemopexin shown by an increase in the molar ellipticity
      at 233 nm and affords protection from proteolysis of the hinge region between the
      two structural domains of hemopexin. The coordination of the central cobalt atom
      is predicted to be similar to that of heme and to involve His56 and His127 of
      rabbit hemopexin. Furthermore, CoPP-hemopexin, like SnPP-hemopexin, binds to the
      hemopexin receptor as shown by competitive inhibition studies with radioactive
      heme-hemopexin. The effect of free heme analogs and their hemopexin complexes on
      HO and MT gene regulation was investigated and compared with the extent of
      induction by heme and heme-hemopexin. Free CoPP is a more effective inducer of HO
      steady state mRNA levels than free heme and produces a 5-fold increase within 1 h
      compared to only a 2-fold increase with heme, but free SnPP (up to 10 microM)
      produces no detectable increase in HO mRNA. In contrast, by 3 h heme-hemopexin
      and SnPP-hemopexin increase HO mRNA levels 11- and 6-fold, respectively; but the
      CoPP-hemopexin complex causes no detectable change in HO mRNA levels. The
      complexes of hemopexin with heme or either of the two heme analogs are effective
      inducers of metallothionein (MT) mRNA. Induction of MT mRNA by heme-hemopexin is
      rapid, increasing 4-fold within 1 h and 14-fold by 3-4 h. Strikingly, an even
      more rapid and slightly more extensive induction of MT mRNA is seen in response
      to either CoPP- or SnPP-hemopexin complexes, with MT mRNA rising 8-fold within 1
      h. In contrast, free heme and the free analogs are far less effective inducers,
      increasing MT and mRNA levels and in vitro transcription rates only 3-4-fold and
      declining after 2-3 h.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463270
TI  - Peptide splicing in the vacuolar ATPase subunit A from Candida tropicalis.
AB  - Subunit A of the vacuolar proton pump appears to be responsible for the ATP
      hydrolysis which is coupled to the pumping of protons into a variety of
      intracellular acid compartments, including the fungal vacuole. We report here the
      cloning and sequence determination of the gene encoding subunit A from Candida
      tropicalis. Southern blot hybridization analysis indicates that there is a single
      gene which encodes this protein. The gene contains a single intron at the extreme
      5'-end of the coding region. The gene is predicted to encode a polypeptide of
      1088 residues with a calculated molecular mass of 119,019 daltons, yet the mature
      polypeptide appears to be approximately 67 kDa, indicating that this protein
      probably undergoes the same sort of processing that is evidenced in the
      homologous protein from Saccharomyces cerevisiae in which an approximately 50-kDa
      polypeptide (the spacer) is spliced out of the mature protein. The Candida gene,
      with and without this middle portion, has been expressed in S. cerevisiae and
      found to restore a Saccharomyces subunit A deletion mutant (tfp1-delta 8) to
      apparently wild-type growth at pH 7.6, and normal vacuolar acidification. The
      peptide sequence of the two predicted mature ends is very similar to the
      sequences of the analogous proteins from Daucus carota, S. cerevisiae, and
      Neurospora crassa (60.5, 87.4, and 72.9% identity, respectively), but the middle
      portion bears only very limited homology with the Saccharomyces protein sequence.
      Processing of the gene product occurs in S. cerevisiae, Escherichia coli, and in
      rabbit reticulocyte-mediated in vitro translation, indicating that the excision
      is probably autocatalytic. The limited sequence identity seen between the
      Saccharomyces and Candida spacer domains may considerably narrow the functionally
      important regions responsible for the excision event.

PMID- 8463271
TI  - Extract-specific heterogeneity in high-order complexes containing apolipoprotein
      B mRNA editing activity and RNA-binding proteins.
AB  - The mechanism for tissue-specific differences in apolipoprotein B (apoB) mRNA
      editing efficiency is not known. Structural data are presented which demonstrate
      tissue-specific, quantitative differences in the high order complexes containing
      apoB mRNA editing activity and RNA-binding proteins. The bulk of rat enterocyte
      extract editing activity sedimented at 11 S with an additional 5-10% at 60 S. Rat
      liver extract activity was less abundant and only sedimented at 60 S. Ultraviolet
      light cross-linking revealed two protein activities of approximately 66 and 44
      kDa which specifically associated with apoB RNA substrates and cosedimented with
      editing activity. Extracts differed in the cross-linking yield of p66 and p44 and
      kinetically, enterocyte RNA-protein complexes reached maximum abundance more
      rapidly than those in liver extracts. Both 60 and 11 S forms of the editing
      activity redistributed to 27 S during in vitro editosome assembly. The
      redistribution of editing activities was accompanied by a corresponding
      redistribution of p66/p44 to 27 S. The data demonstrate that p66 and p44 are
      common to liver and enterocyte 27 S editosome assembly processes and suggest that
      differences in both the pre-editosomal assembly state of editing factors and
      their abundance may be mechanistically important for tissue-specific differences
      in editing efficiency.

PMID- 8463272
TI  - Relationship between alpha subunit ligand occupancy and beta subunit
      autophosphorylation in insulin/insulin-like growth factor-1 hybrid receptors.
AB  - Insulin receptor beta subunit autophosphorylation occurs in an intramolecular
      trans-reaction in which one beta subunit phosphorylates the adjacent beta subunit
      within an alpha 2 beta 2 holoreceptor complex (Frattali, A. L., Treadway, J. L.,
      and Pessin, J. E. (1992) J. Biol. Chem. 267, 19521-19528). To determine the
      spatial relationship between alpha subunit occupancy and beta subunit
      autophosphorylation, the vaccinia virus/bacteriophage T7 transient expression
      system was used to generate insulin/insulin-like growth factor (IGF)-1 hybrid
      receptors. The extent of hybrid receptor formation was proportional to the molar
      ratio of the insulin and IGF-1 receptor expression plasmids used for transfection
      of cultured fibroblasts. Insulin/IGF-1 hybrid receptors displayed high affinity
      binding for insulin and IGF-1 similar to that observed for homotypic insulin and
      IGF-1 receptors, respectively. As expected, insulin poorly competed for 125I-IGF
      1 binding to the insulin/IGF-1 hybrid receptors compared with IGF-1. IGF-1,
      however, competed more efficiently than insulin for 125I-insulin binding,
      indicating interactions between the alpha subunit binding sites. Furthermore,
      insulin or IGF-1 stimulated the autophosphorylation of both beta subunits within
      wild type insulin/IGF-1 hybrid receptors. Ligand-stimulated autophosphorylation
      of two different mutant/wild type insulin/IGF-1 hybrid receptors also resulted in
      the labeling of each beta subunit independent of which alpha subunit was occupied
      with ligand. These data demonstrate that insulin/IGF-1 hybrid receptors bind both
      ligands with high affinity and that occupancy of either alpha subunit results in
      a series of intramolecular trans-autophosphorylation reactions between beta
      subunits.

PMID- 8463273
TI  - A Ca(2+)-independent protein kinase C from fission yeast.
AB  - A protein kinase C homologue of Schizosaccharomyces pombe, pkc1+, was isolated
      from a genomic library by screening with the Saccharomyces cerevisiae PKC1 probe.
      From its primary sequence and biochemical properties, we conclude that S. pombe
      pkc1+ encodes a phospholipid-activated Ca(2+)-independent protein kinase,
      homologous to the delta/epsilon classes of mammalian protein kinase C. Gene
      disruption experiments show that pkc1+ is not essential for cell viability;
      however, overexpression of the protein leads to an abnormal cell morphology and a
      block in cell separation following mitosis suggestive of a role in cell division.
      In vitro phosphorylation experiments reveal several potential pkc1+ substrates.

PMID- 8463274
TI  - Synthesis and turnover of photosystem II reaction center polypeptides in
      cyanobacterial D2 mutants.
AB  - Several mutations in psbD (coding for the photosystem II reaction protein D2)
      lead to a loss of the entire photosystem II complex from the thylakoid membrane.
      For two site-directed D2 mutants, E69V (Glu-69 mutated to Val) and ET-9
      (introducing a premature stop codon in psbD), and two psbD deletion mutants, the
      synthesis and degradation of photosystem II reaction center components were
      analyzed. In E69V, no D2 or psbC-encoded CP43 was detected upon 5-min pulse
      labeling or Western blotting, whereas a psbDI/C transcript was present. Either D2
      and CP43 are very unstable in this mutant, or the mutation causes an inhibition
      of translation of the psbDC operon. In E69V, the predominant lifetime of D1 is
      several minutes, but a small fraction of D1 remains stable in the thylakoid for
      several hours. In E69V, also a 43-kDa band is detected by D1 antisera. We
      attribute this band to a D1 cross-linking product possibly involved in D1
      degradation. We identified a D1 precursor in E69V and psbDI/C/DII-, two mutants
      with particularly short D1 lifetimes. A unique feature of the E69V mutant is that
      destabilization of the photosystem II complex is triggered by a single-site
      mutation leading to extremely rapid turnover or lack of synthesis of D2.

PMID- 8463275
TI  - In situ capture of mu-calpain activation in platelets.
AB  - In situ detection of calpain activation in intact cells has not been possible to
      date. Here we present the first direct evidence, employing a novel approach, that
      mu-calpain is rapidly activated at cell membranes in platelets upon a rise in
      intracellular calcium concentration. Immunoelectron microscopy using antibodies
      capable of distinguishing between the pre- and postautolysis forms of mu-calpain
      revealed that treatment of platelets with calcium ionophore causes the
      preautolysis form of the protease to translocate from cytosol to membranes, where
      it becomes activated by autolysis. This indicates that proteins associated with
      membranes serve as primary substrates for calpain in cells.

PMID- 8463276
TI  - Role of oligosaccharides in the processing and function of human transferrin
      receptors. Effect of the loss of the three N-glycosyl oligosaccharides
      individually or together.
AB  - When the coding sequence for human transferrin receptors was expressed in a
      Chinese hamster ovary cell line lacking endogenous transferrin receptors, 86-kDa
      molecules containing three N-glycosidically linked oligosaccharides were
      synthesized. These rapidly dimerized to form 172-kDa molecules which increased in
      size to 190 kDa. After site-directed mutagenesis of all three N-glycosylation
      sites, 80-kDa receptors were synthesized and only a few dimers were formed. 84
      kDa monomers were synthesized in the absence of the oligosaccharide attached to
      Asn727 or Asn317. Dimerization and maturation through the Golgi body of the
      Asn727 mutant receptors were much slower than the wild type whereas the Asn317
      mutant receptors behaved more similarly to the wild type. Lack of the
      oligosaccharide at Asn251 gave rise to 73-kDa monomers because of proteolytic
      processing (Hoe, M. H., and Hunt, R. C. (1992) J. Biol. Chem. 267, 4916-4923),
      but a second mutation at a potential cleavage site allowed the formation of 84
      kDa receptors. These also dimerized at a similar rate to wild type receptors. The
      three-site mutant receptors were degraded in the endoplasmic reticulum but all
      three 84-kDa single site mutant receptor species migrated to the cell surface.
      However, receptors lacking the oligosaccharide at Asn727 bound and internalized
      little transferrin as a result of reduced affinity.

PMID- 8463277
TI  - A distal heat shock element promotes the rapid response to heat shock of the
      HSP26 gene in the yeast Saccharomyces cerevisiae.
AB  - Induction of heat shock genes is mediated by heat shock factor (HSF). Our recent
      genomic footprinting experiments demonstrate that HSF binds constitutively to
      perfect and imperfect heat shock elements (HSEs) in the HSP26 gene in yeast. Site
      directed mutagenesis of the single perfect HSE, previously reported to not be
      involved in regulating gene expression, significantly reduces the rate of
      response of the gene to heat shock. However, the same mutation only slightly
      reduced the rate of accumulation of HSP26 mRNA during heat shock. Genomic
      footprinting experiments indicate that this lag in response to heat shock is due
      to the failure of HSF to bind efficiently to the mutated HSE. The rate of
      response to heat shock of synthetic promoters containing one, two, three, or
      seven perfect HSEs was similar to that observed for the wild-type HSP26 gene.
      These results suggest that the rate of response to heat shock is correlated with
      HSF occupancy of HSEs, rather than the number of HSEs in a promoter. As with the
      wild-type and mutant HSP26 genes, the rate of accumulation of mRNA from synthetic
      promoters increased only moderately with an increase in the number of HSEs. These
      results suggest that as few as two HSE-HSF complexes are sufficient to saturate
      HSF's target in the basal transcription apparatus.

PMID- 8463278
TI  - A novel class of murine POU gene predominantly expressed in central nervous
      system.
AB  - A mouse gene (referred to as Emb) encoding a novel class of POU domain is
      described. The Emb POU domain shares only 40-50% homology to that of any other
      POU proteins. Nonetheless, the Emb POU domain can bind to the octamer sequence
      like other POU domains. Emb is a single-copy gene, located on the distal region
      of mouse chromosome 15. It is expressed in embryo throughout post-implantation
      stages, where the most prominent expression is seen in developing central nervous
      system. In the adult, it is highly expressed in brain, whereas weaker expression
      can be detected in other organs such as testis, skeletal muscle, and kidney. The
      expression in adult brain is most evident in neurons of hypocampus formation. Two
      types of Emb mRNA are expressed in brain; one type encodes a protein of 301 amino
      acids residues, whereas the other codes for a protein with two extra amino acids
      residues added at the amino-terminal end of POU domain. These two mRNA species
      are generated by alternative splicing by utilizing an unusual splice acceptor
      site: CCTCCCTCTG/. Emb mRNA expressed in testis, on the other hand, encodes a
      smaller protein lacking most of the amino-terminal region.

PMID- 8463279
TI  - Ad4BP regulating steroidogenic P-450 gene is a member of steroid hormone receptor
      superfamily.
AB  - Bovine cytochrome P-450(11 beta) gene (CYP11B) has six different cis-acting
      elements, Ad1, Ad2, Ad3, Ad4, Ad5, and Ad6, in the promoter region. The Ad4 site
      also exists in the promoter regions of other steroidogenic P-450 genes as well as
      in CYP11B1. An Ad4-binding protein (Ad4BP) which specifically binds to the Ad4
      site was purified from bovine adrenal cortex nuclear extract, and its molecular
      mass was 53 kDa. A complementary DNA encoding Ad4BP was isolated from a bovine
      adrenal cortex cDNA library. The cDNA clone contained an open reading frame of
      1383 base pairs encoding 461 amino acids, whose calculated molecular weight was
      51,020. The predicted amino acid sequence of Ad4BP revealed that the protein has
      a zinc finger domain and a ligand binding/dimerization domain. Ad4BP is a novel
      member of the steroid hormone receptor superfamily. Comparison of the primary
      structures of the hormone receptor superfamily showed that Ad4BP was highly
      homologous to FTZ-F1, which regulates the fushi tarazu gene, and ELP, which is
      expressed in the murine embryonal carcinoma cells. Transfection of a Ad4BP
      expression plasmid into CV-1 cells activated the transcription of the CAT
      reporter gene carrying the Ad4 sequence in the promoter region.

PMID- 8463280
TI  - Secreted LasA of Pseudomonas aeruginosa is a staphylolytic protease.
AB  - Full expression of the elastolytic phenotype of Pseudomonas aeruginosa depends on
      LasA, an extracellular protease with restricted specificity whose mode of action
      on elastin and biological role is not understood. LasA exhibits amino acid
      sequence homology to some bacteriolytic proteases and shares several
      physicochemical properties with the staphylolytic protease of P. aeruginosa. This
      led us to examine whether the two proteases are the same. Production of LasA and
      staphylolytic protease by prototrophic and lasA mutant strains of P. aeruginosa
      was investigated. The two prototrophic strains examined, PAO1 and FRD2, exhibited
      extracellular staphylolytic activity and secreted LasA. LasA mutants, PAO-E64
      lasA1 (Ts), FRD2128 delta lasA, and FRD244 lasA::mTn10, did not exhibit
      staphylolytic activity. A low level of the LasA protein was detected in the
      culture filtrate of the temperature-sensitive lasA mutant PAO-E64, but none was
      detectable in those of the deletion and insertion mutants, FRD2128, and FRD244,
      respectively. The staphylolytic protease was purified from the culture filtrate
      of P. aeruginosa strain FRD2 by DEAE-cellulose chromatography. The purified
      enzyme hydrolyzed pentaglycine into the respective di- and tripeptides and
      reacted specifically with antibodies against a synthetic peptide identical in
      sequence to positions 77-98 in LasA. The amino-terminal sequence of the first 15
      amino acid residues of the staphylolytic protease was found to be identical with
      that of the secreted LasA. These results clearly indicate that LasA is a
      staphylolytic protease. In addition to lysing staphylococci, it may enhance
      elastolysis by cleaving Gly-Gly bonds, which are abundant in elastin.

PMID- 8463281
TI  - Isolation of human glycogen branching enzyme cDNAs by screening complementation
      in yeast.
AB  - Functional complementation of the Saccharomyces cerevisiae glycogen branching
      enzyme deficiency was screened to isolate human cDNAs that encode this enzyme.
      Human hepatoma cell line HepG2-derived cDNA libraries using the pAB23BXN yeast
      expression vector yielded four cDNAs capable of complementing the glc3::TRP1
      glycogen branching enzyme mutation. Complementation was recognized by an altered
      iodine-staining trait. This illustrates that interspecies complementation can be
      used to isolate rare plasmids from libraries by screening if there is sufficient
      resolution. The human and yeast glycogen branching enzymes have a 67% identical
      amino acid sequence over a major portion of their length. The human gene is on
      chromosome 3.

PMID- 8463282
TI  - SecY, an integral subunit of the bacterial preprotein translocase, is encoded by
      a plastid genome.
AB  - Although the paradigm for the acquisition of photosynthetic organelles is the
      endocytosis of cyanobacteria-like progenitors by heterotrophic protists, details
      of this evolutionary process are unclear. The small organellar chromosomes are
      remnants of the larger bacterial genomes with most genes from the endosymbiont's
      DNA having been either relocated to the protist's nucleus or entirely lost. As a
      result of those gene transfers, differences exist between plastids from different
      algal phyla and higher plants. We report here on the retention of a secY gene in
      cyanelle (= plastid) DNA of the eukaryotic protist Cyanophora paradoxa. This
      cyanelle secY encodes a functional protein homologous to SecY of Escherichia
      coli, identified as a subunit of the preprotein translocase complex. Similarity
      of the cyanelle and E. coli SecY topology, predicted from sequence information,
      has been confirmed experimentally through SecY-PhoA fusion protein analysis in E.
      coli. Cyanelle SecY, expressed in an E. coli secY mutant, substituted for the
      defective prokaryotic SecY. A plastid-encoded gene for a membrane protein
      functioning in protein transport across plastid membranes is unprecedented in
      higher plants. From these results we infer that a functional homolog of the
      prokaryotic preprotein translocation machinery is retained in some plastids.

PMID- 8463283
TI  - Mutational analysis of the cAMP-dependent protein kinase-mediated phosphorylation
      site of Rap1b.
AB  - Rap1b, a member of the Ras superfamily of low molecular weight GTP-binding
      proteins, can be phosphorylated by cAMP-dependent protein kinase (protein kinase
      A). The experiments presented here were undertaken to determine the precise site
      of this phosphorylation. Because the Rap1 proteins are highly homologous, there
      are no specific antibodies able to discriminate between them. To overcome this
      problem, we used a transient expression system of a fused protein containing in
      the NH2 terminus an epitope for a known antibody. Using this system, the
      transfected protein was expressed at a high level and was localized in a
      perinuclear structure, as previously reported for the endogenous Rap1 proteins.
      The mutational analysis of Rap1b revealed Ser179 as the residue involved in the
      protein kinase A-mediated phosphorylation. The presence of a Lys179 instead of
      the wild-type Ser179 (resembling the Rap1a sequence) rendered Ser180 a better
      substrate for phosphorylation caused by protein kinase A. The mobility shift of
      Rap1b in SDS gels, observed in cells that were stimulated with agonists that
      increase cAMP, was caused, at least in part, by the phosphorylation of Rap1b.

PMID- 8463284
TI  - Identification of protein kinase C (PKC) phosphorylation sites on human lamin B.
      Potential role of PKC in nuclear lamina structural dynamics.
AB  - Protein kinase C (PKC) is activated at the nuclear membrane in response to a
      variety of mitogenic stimuli. In human leukemic cells, the beta II PKC isotype is
      selectively translocated and activated at the nucleus. We recently identified the
      nuclear envelope component lamin B1 as a major substrate for nuclear PKC both in
      whole cells and in vitro. Using highly purified human beta II PKC and isolated
      nuclear envelopes from the human promyelocytic (HL60) leukemia cell line, we have
      now determined the major sites for beta II PKC-mediated lamin B phosphorylation.
      Using a combination of cyanogen bromide cleavage, direct microsequencing, tryptic
      phosphopeptide, and phosphate release analyses, two major sites of PKC-mediated
      phosphorylation, Ser395 and Ser405, have been identified. These sites lie within
      the carboxyl-terminal domain of lamin B immediately adjacent to the central alpha
      helical rod domain. Functionally, beta II PKC-mediated phosphorylation of these
      sites leads to the time-dependent solubilization of lamin B indicative of mitotic
      nuclear envelope breakdown in vitro. beta II PKC-mediated lamin B phosphorylation
      is inhibited by 1) a monoclonal antibody directed against the active site of PKC,
      2) a PKC pseudosubstrate inhibitor peptide, and 3) a PKC peptide substrate. Two
      observations indicate that PKC-mediated lamin B phosphorylation and
      solubilization is due to direct phosphorylation of lamin B by PKC rather than
      indirect activation of a cdc2 kinase. Neither immunodepletion with p13suc1
      Sepharose beads nor the presence of a p34cdc2 kinase peptide substrate had any
      effect on PKC-mediated lamin B phosphorylation. Therefore, we conclude that beta
      II PKC represents a physiologically relevant lamin kinase that can directly
      modulate nuclear lamina structure in vitro. Nuclear beta II PKC, like p34cdc2
      kinase, may function to regulate nuclear lamina structural stability during cell
      cycle.

PMID- 8463285
TI  - Critical residues involved in FMN binding and catalytic activity in cytochrome
      P450BM-3.
AB  - Cytochrome P450BM-3 from Bacillus megaterium is a soluble, catalytically self
      sufficient fatty acid mono-oxygenase that, in structural organization and amino
      acid sequence, resembles the Class II (microsomal) P450 systems. Its single
      polypeptide chain contains both a P450 heme domain and an NADPH:P450 reductase
      domain, each of which bears significant homology with its microsomal
      counterparts. We report here the critical nature of three amino acids in the
      reductase domain of this enzyme with respect to FMN binding and catalytic
      activity. We used site-directed mutagenesis to change glycine 570 to bulkier
      amino acids; none of these mutant enzymes contained FMN after purification. We
      also made substitutions for tryptophan 574 and tyrosine 536, which by sequence
      analogy (Porter, T. D. (1991) Trends Biochem. Sci. 16, 154-158) were proposed to
      bind FMN through stacking of the aromatic rings with the isoalloxazine ring of
      the flavin. Mutants of tryptophan 574 which retained the aromatic side chain
      contained no less than 0.85 mol of FMN per mol of enzyme, while aspartate and
      glycine substitutions yielded enzymes which did not incorporate FMN. Substitution
      of tyrosine 536 with aspartate gave an enzyme which contained 0.44 mol of FMN per
      mol of enzyme but was inactive as a fatty acid hydroxylase and had only 2% of
      wild-type cytochrome c reductase activity, while the glycine mutant at this
      position bound no FMN. Furthermore, although all of the mutant enzymes contained
      1 mol of FAD per mol of enzyme, the Y536D mutant and those entirely lacking FMN
      retained no more than 40% of wild-type ferricyanide reductase activity. By
      assaying these enzymes in the presence of added FMN, we were able to assess the
      relative importance of the residues in the wild-type sequence with respect to
      their contribution to FMN binding. In addition, the aromatic mutants of
      tryptophan 574, which were nearly as active in cytochrome c reduction as wild
      type P450BM-3, were only 20% as active in myristate hydroxylation as the wild
      type enzyme, suggesting that this amino acid plays an important role in the flow
      of electrons between the P450 heme and reductase domains.

PMID- 8463286
TI  - High affinity binding, endocytosis, and degradation of conformationally modified
      albumins. Potential role of gp30 and gp18 as novel scavenger receptors.
AB  - Scavenger receptors interact with a variety of modified proteins, mediate their
      endocytosis and degradation, and may play an important role in protein catabolism
      and pathogenic processes such as atherosclerosis, aging, and diabetes. Many
      scavenger receptors have been detected kinetically but few such binding proteins
      have actually been identified. Recently, we found that two membrane-associated
      proteins, gp30 and gp18, interact more avidly with albumins conformationally
      modified by chemical means or by surface adsorption to colloidal gold particles
      than with native albumin. In this study, we show that gp30 and gp18 behave
      similarly to other known scavenger receptors. Competition studies indicate a
      similar ligand binding profile to other known scavenger receptors. Polyanionic
      molecules (dextran sulfate, fucoidan, polyglutamic acid, polyinosinic acid,
      heparin) and modified albumins such as formaldehyde-treated or maleylated albumin
      (Mal-bovine serum albumin) competed with albumin conjugated to colloidal gold
      particles (A-Au) for the blotting of gp30 and gp18. A-Au and Mal-bovine serum
      albumin bound cultured endothelial cells with high affinity. Modified and native
      albumins were each internalized, but only modified albumins were then released
      degraded. Inhibition studies revealed that only the same molecules that were
      effective in blocking A-Au blotting of gp30 and gp18, also inhibited A-Au
      degradation. Addition of the lysosomotropic agent chloroquine resulted in more
      than 70% inhibition of degradation. Differential processing of A-Au by cultured
      smooth muscle and endothelial cells along with fibroblasts was observed in a
      manner consistent with gp30 and gp18 expression. Cumulatively, these results
      suggest that gp30 and gp18 may mediate the high affinity binding, endocytosis,
      and degradation of conformationally modified albumins but not native albumin.

PMID- 8463287
TI  - Interaction of the human insulin receptor tyrosine kinase from the baculovirus
      expression system with protein kinase C in a cell-free system.
AB  - The cytoplasmic domain of the human insulin receptor (HIR) from the baculovirus
      expression system (BIRK) is a soluble, constitutively activated protein-tyrosine
      kinase. In a cell-free system, BIRK is phosphorylated on serine and threonine
      residues by protein kinase C (PKC) purified from rat brain. Two-dimensional
      tryptic phosphopeptide mapping of PKC-phosphorylated BIRK identified one
      phosphothreonine and three phosphoserine peptides, which were also in tryptic
      digests of insulin receptors from insulin- or PMA-treated Chinese hamster ovary
      (CHO) cells transfected with the HIR. After Lys-C proteolysis of PKC
      phosphorylated BIRK, radioactive phosphopeptides were purified on a C8 reverse
      phase high pressure liquid chromatography column. Amino acid sequence analysis
      identified a phosphothreonine peptide corresponding to amino acids 1331-1340 of
      the HIR. This peptide contains only one threonine, amino acid 1336, which is
      identified as a site for PKC phosphorylation in BIRK. CHO cells transfected with
      the wild type (CHO/HIR) or a mutant human insulin receptor (CHO/HIRT1336N), in
      which threonine 1336 was substituted with asparagine, were 32P labeled and then
      stimulated with insulin or phorbol 12-myristate 13-acetate (PMA). Two-dimensional
      phosphopeptide analysis of the HIR revealed that phosphorylation of
      phosphothreonine peptide T, shown to be in PKC-phosphorylated BIRK, was increased
      by insulin or PMA. However, the corresponding peptide was not in the mutant
      receptor. Therefore, the present study directly identifies threonine 1336 in the
      HIR as a phosphorylation site for insulin and PMA. These data also show that BIRK
      can be used as a model for the study of the regulation of the insulin receptor
      kinase.

PMID- 8463288
TI  - Propeptide processing during factor IX biosynthesis. Effect of point mutations
      adjacent to the propeptide cleavage site.
AB  - Factor IX is synthesized in a precursor form with a propeptide that contains the
      gamma-carboxylation recognition site, an element which directs the post
      translational gamma-carboxylation of adjacent glutamic acid residues. After
      protein synthesis, the propeptide is cleaved to yield the mature Factor IX. To
      study propeptide processing, anti-proFactor IX antibodies were prepared using a
      synthetic peptide based upon the sequence of the Factor IX propeptide.
      Immunoaffinity-purified anti-proFactor IX antibodies were reactive with Factor IX
      Cambridge, a mutant form of Factor IX containing the propeptide, but were not
      reactive with Factor IX. These antibodies were used to examine the proteolytic
      processing of forms of Factor IX containing point mutations at P6, P3, P2, P1,
      P1', P2', and P3' adjacent to the propeptide cleavage site in order to determine
      the requirement of each of these amino acids for propeptide cleavage.
      Furthermore, the hierarchy of different pairs of basic residues at positions P1
      and P2 was analyzed. The mutated cDNA constructs were expressed in Chinese
      hamster ovary cells. Propeptide processing was examined using intrinsically
      labeled Factor IX immunoprecipitated with either anti-pro-Factor IX antibodies or
      anti-Factor IX:total antibodies, and the Factor IX species were separated by SDS
      gel electrophoresis. Under the expression conditions employed, the propeptide of
      wild type Factor IX was almost completely removed, whereas Factor IX mutated to
      threonine at P1 was not cleaved. The percentage of propeptide cleaved varied with
      the amino acid sequences of residues P2 and P1, respectively: Lys-Arg (93%), Arg
      Arg (66%), Thr-Arg (33%), Arg-Lys (19%), Lys-Lys (10%), and Lys-Thr (< 1%). Apart
      from alterations of basic amino acids at P1 and P2, nonconservative mutations at
      P6 and P3 decreased propeptide cleavage, whereas conservative mutations at P3,
      P1', P2', or P3' resulted in cleavage efficiencies approximately equal to that
      for wild type Factor IX. These results indicate that the preference of paired
      basic residues at P1 and P2 is similar to other endopeptidases active toward
      proteins secreted through the constitutive pathway and that the propeptide
      residues NH2-terminal to these paired basic residues are important in defining
      enzyme-substrate binding.

PMID- 8463289
TI  - An NH2-terminal peptide from the vaccinia virus L1R protein directs the
      myristylation and virion envelope localization of a heterologous fusion protein.
AB  - The vaccinia virus L1R gene product is a late protein destined for insertion into
      the envelope of intracellular virus particles. Because this protein is co
      translationally modified by the addition of myristic acid to the penultimate NH2
      terminal glycine residue, it was of interest to identify the modification signal
      within the L1R protein and to assess the relevance of myristylation to protein
      localization. To this end, a family of chimeric reporter genes containing 0-13
      codons from the NH2 terminus of the L1R open reading frame fused in-frame to the
      bacterial chloramphenicol acetyltransferase gene was constructed. The encoded
      proteins were tested as myristylation substrates in cell-free extracts and
      infected cells. The results obtained in vitro and in vivo were similar and
      suggested that although the NH2-terminal 5 amino acids of the L1R protein were
      the minimum signal required to observe modification by myristate, 12 amino acids
      were required to obtain wild type levels of myristylation with a modulating role
      played by the intervening amino acid residues. Furthermore, subcellular
      fractionation of infected cells expressing the fusion proteins indicated that the
      NH2 terminus of the L1R protein was capable of targeting the fusion proteins to
      membrane-containing fractions only if myristylated. In particular, the
      myristylated fusion protein containing the first 12 amino acids of the L1R
      protein abutted to the chloramphenicol acetyltransferase protein was found
      associated with the envelope of intracellular vaccinia virus particles.

PMID- 8463290
TI  - Binding of Ku protein to DNA. Measurement of affinity for ends and demonstration
      of binding to nicks.
AB  - Ku, also known as nuclear Factor IV, is an abundant nuclear DNA-binding protein
      which requires free DNA ends for the initial interaction with double-stranded DNA
      (dsDNA) and can bind at multiple sites along dsDNA in an energy-independent
      manner. Its function in vivo is unknown, but it has been implicated in both DNA
      replication and repair and in transcriptional control. We have used an
      electrophoretic mobility shift assay to further define the DNA binding properties
      of the Ku protein. Titration of Ku to a fixed amount of any of several target
      linear dsDNA fragments produced ladders of shifted bands proportional to the
      length of DNA, confirming the multiple binding activity of Ku and demonstrating
      its sequence-independent nature. Using a short DNA fragment with one Ku binding
      site, the binding constant of Ku for dsDNA ends was calculated to be 2.4 x 10(9)
      M-1. Competitive inhibition experiments confirmed the requirement of a free DNA
      end for binding by Ku and demonstrated that Ku binds isolated nicks in dsDNA.
      Nick binding was also observed directly using radiolabeled singly nicked circular
      DNA. The relative affinities of Ku for specific nick sites and free DNA ends were
      approximately equal, and nick binding was sequence-independent. Finally, in a
      study of a possible role for Ku in protecting or repairing damaged DNA, Ku was
      shown to inhibit the ability of T4 DNA ligase to circularize linear dsDNA
      molecules, demonstrating that some Ku molecules remain at the DNA terminus rather
      than translocate. A similar inhibition was not observed at nicks. These
      experiments document a new DNA binding specificity for Ku and further suggest
      that the high affinity end and nick binding activity is biologically relevant to
      its functions in vivo.

PMID- 8463291
TI  - Selective inhibition of farnesyl-protein transferase blocks ras processing in
      vivo.
AB  - The ras oncogene product, Ras, is synthesized in vivo as a precursor protein that
      requires post-translational processing to become biologically active and to be
      capable of transforming mammalian cells. Farnesylation appears to be a critical
      modification of Ras, and thus inhibitors of the farnesyl-protein transferase
      (FPTase) that catalyzes this reaction may block ras-dependent tumorigenesis.
      Three structural classes of FPTase inhibitors were identified: (alpha
      hydroxyfarnesyl)phosphonic acid, chaetomellic acids, and zaragozic acids. By
      comparison, these compounds were weaker inhibitors of geranylgeranyl-protein
      transferases. Each of these inhibitors was competitive with respect to farnesyl
      diphosphate in the FPTase reaction. All compounds were assayed for inhibition of
      Ras processing in Ha-ras-transformed NIH3T3 fibroblasts. Ras processing was
      inhibited by 1 microM (alpha-hydroxyfarnesyl)phosphonic acid. Neither
      chaetomellic acid nor zaragozic acid were active in this assay. These results are
      the first demonstration that a small organic chemical selected for inhibition of
      FPTase can inhibit Ras processing in vivo.

PMID- 8463292
TI  - Expression of a kinase anchor protein 75 depletes type II cAMP-dependent protein
      kinases from the cytoplasm and sequesters the kinases in a particulate pool.
AB  - A kinase anchor proteins (AKAPs) have a C-terminal binding site for the
      regulatory subunit (RII beta) of cAMP-dependent protein kinase II beta (PKAII
      beta) and an N-terminal domain that mediates the targeting and attachment of the
      anchor protein to intracellular structures. In vitro biochemical studies and
      recent in situ immunocytochemical analysis (Glantz, S. B., Amat, J. A., and
      Rubin, C. S. (1992) Mol. Biol. Cell 3, 1215-1228) suggest that AKAPs anchor PKAII
      beta at specific sites in the dendritic cytoskeleton of neurons. This arrangement
      would place PKAII beta in proximity with its substrates and create "target sites"
      for cAMP actions. The foregoing model predicts that (a) RII subunits are freely
      accessible to AKAPs, (b) PKAII holoenzymes, as well as RII subunits, are
      anchored, and (c) changes in the level of AKAP can alter the intracellular
      distribution of type II PKAs. We have addressed these previously untested
      propositions by overexpressing bovine AKAP75 in a human cell line (HEK293). Non
      transfected cells express a low level of endogenous AKAP79, and approximately 90%
      of RII alpha and RII beta subunits are isolated in the cell cytosol. In contrast,
      stably transfected cells, which express a 10-fold excess of AKAP75, sequester >
      90% of their RII subunits in a particulate pool. Catalytic subunits are also
      transferred to this pool. AKAP75 accumulates in a cell compartment with
      biochemical properties characteristic of cytoskeleton. Thus, AKAPs have access to
      and avidly bind cytoplasmic type II PKAs. Moreover, an increase in AKAP content
      can alter the particulate/cytoplasmic distribution of PKAII beta and PKAII alpha.

PMID- 8463293
TI  - Transepithelial glycylsarcosine transport in intestinal Caco-2 cells mediated by
      expression of H(+)-coupled carriers at both apical and basal membranes.
AB  - Glycylsarcosine (Gly-Sar) transport in human intestinal epithelial (Caco-2) cells
      has been investigated. Gly-Sar transport, from apical to basal surfaces (Ja-b),
      and intracellular accumulation are greatest when the apical medium is acidified
      (apical pH 6.0, basal pH 7.4). Both transport and accumulation are susceptible to
      saturation and competition. Similarly, Gly-Sar transport, from basal to apical
      surfaces (Jb-a), is increased with acidification of the basal medium (basal pH
      6.0, apical pH 7.4). Apical addition of 20 mM Gly-Sar (pH 6.0) to Caco-2 cell
      monolayers loaded with the pH indicator BCECF (2',7'-bis(2-carboxyethyl)-5-(6)
      carboxyfluorescein) caused a marked cytosolic acidification. Basolateral
      application of 20 mM Gly-Sar (pH 6.0) also caused a fall in intracellular pH.
      These observations are consistent with the expression of H(+)-coupled dipeptide
      transporters at both membrane faces of the human intestinal epithelial Caco-2
      cell line. We also provide direct evidence for dipeptide-stimulated H(+)-influx,
      across both apical and basolateral membranes, in this intact epithelial cell
      system.

PMID- 8463294
TI  - Pyridoxal 5'-phosphate binds specifically to soluble CD4 protein, the HIV-1
      receptor. Implications for AIDS therapy.
AB  - Considerable effort is being made to design anti-viral drugs for the human
      immunodeficiency virus type 1 (HIV-1) infection process. Some of this work has
      focused on CD4 protein, the HIV-1 receptor on T helper lymphocytes. One drug that
      binds to CD4 protein and inhibits both viral infection and growth is DIDS (4,4'
      diisothiocyanato-2,2'-stilbenedisulfonate). DIDS is best known for its ability to
      inhibit erythrocyte band 3 anion exchange. Although the antiviral potency of DIDS
      is evident in vitro (IC50 approximately 30 microM), intravenous administration of
      DIDS should not be effective owing to the large number of band 3 molecules
      present on the red blood cell membrane (approximately 10(6)/cell), and to the
      very small Kd for DIDS binding to band 3 (approximately 30 nM). Therefore, we
      sought to identify other anion transport inhibitors that would bind weakly to
      band 3, but tightly to CD4 protein, and that could be administered to humans
      without significant toxic side effects. On the basis of our previous work with
      band 3 (Salhany, J. M., Rauenbuehler, P. B., and Sloan, R. L. (1987) J. Biol.
      Chem. 262, 15965-15973), we elected to study the binding of pyridoxal 5'
      phosphate (PLP) to soluble CD4 protein. We have discovered that PLP binds
      surprisingly tightly to soluble CD4 protein (Kd = 45 microM), with a
      stoichiometry of about 1 mol of PLP/mol of protein. Furthermore, PLP binding was
      found to be competitive with DIDS for its binding site on soluble CD4 protein.
      These results suggest that PLP may be an effective anti-viral agent for the HIV-1
      infection process.

PMID- 8463295
TI  - Utilization of exogenously supplied sphingosine analogues for sphingolipid
      biosynthesis in Chinese hamster ovary and mouse LM cell fibroblasts.
AB  - Growth of Chinese hamster ovary and LM cells is inhibited by relatively low
      concentrations of sphingosine in the culture media. This effect is diminished by
      an order of magnitude by conversion of this positively charged long-chain amino
      alcohol to a number of N-acetylated analogues, such as N-acetylsphingosine, N
      acetylsphingosine phosphate, and N-acetylsphingosine phosphorylcholine. Synthesis
      of sphinganine and its incorporation into ceramide, sphingomyelin, and
      glycosphingolipids (GSL) was monitored using a short pulse of [14C]serine
      together with a long pulse of [3H]-galactose. Compared to unsupplemented
      cultures, growth with 15-30 microM N-acetylsphingosine suppressed incorporation
      of 14C radioactivity into ceramide, sphingomyelin, and GSL by 75-95% without
      accumulation of labeled sphinganine and without any appreciable change in
      membrane phospholipid or total GSL content. Furthermore, when cells were
      cultivated with 15 microM [4,5-3H]N-acetylsphinganine to monitor its utilization
      for sphingolipid synthesis, considerable loss of radiolabel occurred due to
      desaturation of sphinganine to sphingosine. Nevertheless, most of the residual
      label was found in the long-chain base and not the acyl group of sphingomyelin,
      indicating that the exogenously supplied base was utilized intact for complex
      lipid synthesis. Radiolabel was also found in ceramide and glycosphingolipid
      fractions. Thus, established cell lines whose growth is very sensitive to long
      chain amino alcohols can be cultivated with sphinganine (sphingosine) analogues
      at concentrations which suppress endogenous sphinganine production but support
      continued synthesis of complex sphingolipids.

PMID- 8463296
TI  - Primary structure of the gene for glycyl-tRNA synthetase from Bombyx mori.
AB  - The primary structure of the gene encoding Bombyx mori glycyl-tRNA synthetase was
      determined by sequence analysis of one cDNA and two genomic clones. The sequence
      of the protein deduced from the nucleotide sequence was verified by sequence
      analysis of eight peptides. The M(r) 77,667 protein is encoded in a single open
      reading frame of 2061 nucleotides. There are no introns in the gene. The deduced
      protein sequence has no obvious similarity to Escherichia coli glycyl-tRNA
      synthetase but contains a sequence in its amino terminus that is similar to a
      sequence found in the Drosophila melanogaster and human glutamyl-tRNA
      synthetases, the hamster and human histidyl-tRNA synthetases, bovine tryptophanyl
      tRNA synthetase, and the mammalian peptide chain release factor. The B. mori
      glycyl-tRNA synthetase also has sequence similarity with the Saccharomyces
      cerevisiae (cytoplasmic and mitochondrial), E. coli, and human threonyl-tRNA
      synthetases. This sequence similarity occurs in a sequence motif that is
      characteristic of other class II aminoacyl-tRNA synthetases. Two transcription
      start sites approximately 100 nucleotides apart were identified by ribonuclease
      mapping. One of the transcription start sites is used preferentially in the
      posterior silk gland. The peak in mRNA accumulation occurs 80-100 h prior to the
      peak in glycyl-tRNA synthetase activity and enzyme protein.

PMID- 8463297
TI  - Thermodynamics of monosaccharide binding to concanavalin A, pea (Pisum sativum)
      lectin, and lentil (Lens culinaris) lectin.
AB  - Titration calorimetry measurements of the binding of methyl alpha-D
      mannopyranoside (Me alpha Man), D-mannopyranoside (Man), methyl alpha-D
      glucopyranoside (Me alpha Glu), and D-glucopyranoside (Glu) to concanavalin A
      (Con A), pea lectin, and lentil lectin were performed at 281 and 292 K in 0.01 M
      dimethylglutaric acid-NaOH buffer (pH 6.9) containing 0.15 M NaCl and Mn+2 and
      Ca+2 ions. The site binding enthalpies, delta H, are the same at both
      temperatures and range from -28.4 +/- 0.9 (Me alpha Man) to -16.6 +/- 0.5 kJ mol
      1 (Glu) for Con A, from -26.2 +/- 1.1 (Me alpha Man) to -12.8 +/- 0.4 kJ mol-1
      (Me alpha Glu) for pea lectin, and from -16.6 +/- 0.7 (Me alpha Man) to -8.0 +/-
      0.2 kJ mol-1 (Me alpha Glu) for lentil lectin. The site binding constants range
      from 17 +/- 1 x 10(3) M-1 (Me alpha Man to Con A at 281.2 K) to 230 +/- 20 M-1
      (Glu to lentil lectin at 292.6 K) and exhibit high specificity for Con A where
      they are in the Me alpha Man:Man:Me alpha Glu:Glu ratio of 21:4:5:1, while the
      corresponding ratio is 5:2:1.5:1 for pea lectin and 4:2:2:1 for lentil lectin.
      The higher specificity for Con A indicates more interactions between the amino
      acid residues at the binding site and the carbohydrate ligand than for the pea
      and lentil lectin-carbohydrate complexes. The carbohydrate-lectin binding results
      exhibit enthalpy-entropy compensation in that delta Hb (kJ mol-1) = -1.67 +/-
      0.06 x 10(4) + (1.30 +/- 0.12)T(K) delta Sb (J mol-1K-1). Differential scanning
      calorimetry measurements on the thermal denaturation of the lectins and their
      carbohydrate complexes show that the Con A tetramer dissociates into monomers,
      while the pea and lentil lectin dimers dissociate into two submonomer fragments.
      At the denaturation temperature, one carbohydrate binds to each monomer of Con A
      and the pea and lentil lectins. Complexation with the carbohydrate increases the
      denaturation temperature of the lectin and the magnitude of the increases yield
      binding constants in agreement with the determinations from titration
      calorimetry.

PMID- 8463298
TI  - Molecular cloning and expression of SmIrV1, a Schistosoma mansoni antigen with
      similarity to calnexin, calreticulin, and OvRal1.
AB  - Protective immunity against schistosomiasis induced by vaccination of mice with
      irradiated cercaria can be passively transferred to uninfected mice with sera or
      IgG. Antigens that are uniquely or more strongly recognized by such protective
      sera compared with sera from infected unprotected mice have been identified
      previously. Two genes, SmIrV1 and SmIrV5, were selected from an adult worm cDNA
      library by screening with antibodies raised against these candidate vaccine
      proteins. Active immunization with the SmIrV5 protein induces high levels of
      protection in mice. We report here the molecular cloning and sequencing of SmIrV1
      which contains a deduced amino acid sequence of 582 residues with similarity to
      three proteins: calnexin, calreticulin, and OvRal1, a surface antigen of the
      filarial nematode Onchocerca volvulus. SmIrV1 can be divided into three regions:
      a neutral N-terminal region with a putative signal sequence, followed by a
      proline- and tryptophan-rich P region in which two sets of sequences are repeated
      four times and a C-terminal region which is highly acidic with an isoelectric
      point of 4.7. We expressed the P and C regions of SmIrV1 and showed that this
      polypeptide reacts with sera of immunized as well as chronically infected mice.

PMID- 8463299
TI  - Kinetic destabilization of the hydroperoxy flavin intermediate by site-directed
      modification of the reactive thiol in bacterial luciferase.
AB  - Bacterial luciferase catalyzes the formation of visible light, FMN, and a
      carboxylic acid from FMNH2, O2, and the corresponding aldehyde. The reactive
      cysteinyl residue at position 106 of the alpha subunit has been replaced by
      serine, alanine, and valine by site-directed mutagenesis (Baldwin, T. O., Chen L.
      H., Chlumsky, L. J., Devine, J. H., and Ziegler, M. M. (1989) J. Biolumin.
      Chemilumin. 4, 40-48) and the kinetics of the reaction catalyzed by each mutant
      protein measured by stopped-flow spectrophotometry at pH 7 and 25 degrees C. The
      time courses for the formation and decay of the various intermediates for the
      three alpha C106 mutants have been followed by monitoring the absorbance at 380
      and 445 nm and the emission of visible light using n-decanal as the aldehyde
      substrate. The time courses for these events have been incorporated into a
      comprehensive kinetic model; 16 individual rate constants have been obtained for
      this model by numeric simulations of the time courses for the wild-type enzyme
      and for the three alpha C106 mutants. The mutants catalyzed the production of
      visible light demonstrating that the reactive thiol is not involved in the
      bioluminescence reaction. All three mutants have been found to catalyze the
      formation of the C4a-hydroperoxy flavin intermediate with rate constants equal to
      that of the wild-type enzyme. These results are incompatible with those reported
      by Xi et al. who have suggested that the major pathway for the oxidation of alpha
      C106V-bound FMNH2 does not involve the C4a-hydroperoxy flavin as an intermediate
      (Xi, L., Cho, K.-W., Herndon, M.E., and Tu, S.-C. (1990) J. Biol. Chem. 265, 4200
      4203). The rates of decay of the C4a-hydroperoxy flavin intermediate with the
      mutant enzymes were found to be two orders of magnitude faster than that of the
      wild-type enzyme. Luciferase has been shown to be inhibited at high levels of
      aldehyde substrate when the enzyme is assayed by injecting FMNH2 into an aerobic
      mixture of enzyme and aldehyde. This aldehyde inhibition has been shown to occur
      by the formation of a dead-end enzyme-aldehyde complex which blocks the binding
      of FMNH2 to the enzyme; loss of activity is due to the rapid nonenzymatic
      decomposition of the reduced flavin with molecular oxygen.

PMID- 8463300
TI  - Mechanism of agonist-induced [Ca2+]i oscillations in pituitary gonadotrophs.
AB  - Gonadotropin-releasing hormone (GnRH) activates oscillatory Ca2+ signaling in
      pituitary gonadotrophs at a frequency (up to 25 min-1) that is dose-dependent and
      is determined by the degree of receptor-mediated inositol 1,4,5-trisphosphate
      (Ins(1,4,5)P3) formation. Similar dose-dependent and frequency-modulated Ca2+
      oscillations were elicited by intracellular administration of Ins(1,4,5)P3 and
      its nonhydrolyzable analogs, consistent with models in which Ins(1,4,5)P3 levels
      determine the frequency of Ca2+ oscillations but do not fluctuate in synchrony
      with [Ca2+]i. At constant agonist concentrations, Ca2+ spiking varied in
      amplitude, with a number of progressively larger transients before the onset of
      maximal oscillations, followed by a gradual decrease in spike amplitude that was
      accompanied by an increase in spiking frequency. The decline in the amplitude and
      increase in frequency of Ca2+ transients during stimulation by GnRH were not
      related to a decrease in the propagation of the Ca2+ signal within the cell but
      were associated with gradual depletion of the agonist-sensitive Ca2+ pool. Once
      initiated, the pattern of Ca2+ spiking was not altered by blockade of receptor
      occupancy, by inhibition of phospholipase C, or by reduction of extracellular
      [Ca2+]. Also, the endoplasmic reticulum (Ca2+)-ATPase blocker, thapsigargin,
      could substitute for Ins(1,4,5)P3 in initiating the oscillatory Ca2+ response.
      These findings indicate that although the Ins(1,4,5)P3 concentration determines
      the pattern of transients at the initiation of the oscillatory Ca2+ signal,
      maintenance of the signal does not require a sustained rise in Ins(1,4,5)P3.
      Since the frequency of Ca2+ oscillations is also influenced by depletion of
      luminal [Ca2+], it is possible that the Ins(1,4,5)P3-sensitive channels in the
      endoplasmic reticulum are tonically inhibited by high intraluminal Ca2+ levels
      and that Ins(1,4,5)P3 surmounts such inhibition by promoting Ca2+ discharge. When
      a critical level of Ca2+ discharge is attained, repetitive Ca2+ transients are
      generated by an autocatalytic mechanism in which a sustained rise in Ins(1,4,5)P3
      is not an essential requirement.

PMID- 8463301
TI  - Deletion between directly repeated DNA sequences measured in extracts of
      bacteriophage T7-infected Escherichia coli.
AB  - An in vitro system based upon extracts of bacteriophage T7 infected Escherichia
      coli was used to study genetic deletions and to examine the importance of DNA
      replication in the deletion process. When T7 genomes with gene 1.3 inactivated by
      a 43-bp insert of random sequence DNA bracketed by 11-bp direct repeats were
      replicated in vitro the inserts were deleted with a frequency of about 10(-5)
      deletions per genome replication. Under conditions where deletion could take
      place only by recombination between direct repeats on distinct DNA molecules
      deletion frequency was at least an order of magnitude lower. These data
      demonstrate the utility of the in vitro system as a means for examining deletion
      mechanisms and underscore the importance of DNA replication in deletions.

PMID- 8463302
TI  - 2',5'-Oligoadenylate-dependent RNase L is a dimer of regulatory and catalytic
      subunits.
AB  - The subunit composition of RNase L, a key enzyme in the interferon system, has
      been characterized. RNase L was purified from human Daudi cells on a column of 2
      5A-Sepharose and used to immunize Balb/c mice. A specific monoclonal antibody
      which recognizes a protein of 80 kDa has been isolated. This protein has been
      characterized and shown to be an RNA-binding protein with nuclease activity which
      is associated with, but distinct from, the 80-kDa 2-5A-binding protein known
      previously as RNase L. It is therefore proposed that the 2-5A-dependent RNase L
      is a complex of two distinct subunits: an 80-kDa RNA-binding protein (i.e. the
      catalytic subunit) and an 80-kDa 2-5A-binding protein (i.e. the regulatory
      subunit).

PMID- 8463303
TI  - Inhibition of macrophage-mediated low density lipoprotein oxidation by stimulated
      rat serosal mast cells.
AB  - Mast cells and macrophages coexist in the human arterial intima where oxidation
      of low density lipoproteins (LDL) also takes place during atherosclerosis. To
      investigate whether mast cells play a role in macrophage-mediated oxidation of
      LDL, a model system was designed in which mast cells and macrophages were
      cocultured in incubation medium containing LDL. Stimulation of rat serosal mast
      cells to induce exocytosis of their cytoplasmic granules was found to inhibit
      macrophage-mediated oxidation of LDL. The inhibitory effect depended on the
      ability of mast cell-derived histamine, released from the exocytosed granules
      into the medium, to bind the copper ions necessary for propagation of the
      macrophage-initiated oxidation of LDL. In addition to binding free copper ions,
      the mast cell-derived histamine was also capable of inhibiting oxidation of LDL
      propagated by copper ions bound to the apolipoprotein B component of the LDL
      particle. The results indicate that mast cells may prevent cell-mediated
      oxidation of LDL and imply a potentially preventive role for the mast cell in
      atherosclerosis.

PMID- 8463304
TI  - Phosphorylation of peptide substrates for the catalytic subunit of cAMP-dependent
      protein kinase.
AB  - The steady-state kinetic parameters for the phosphorylation of four peptides by
      the catalytic subunit of cAMP-dependent protein kinase were measured as a
      function of pH. For peptides containing the minimum consensus sequence, R-R-X-S
      hyd (where hyd is a hydrophobic residue), the kcat/Kpeptide profile is bell
      shaped with pK values of 6.4 and 9.4. Inhibition studies with the peptide LRRNAI
      indicate that the lower pK corresponds to an intrinsic pK on the enzyme, whereas
      the higher pK is perturbed upward by 1 pH unit. Viscosity studies verify that
      substrate stickiness accounts for the kinetic perturbation of the higher pK in
      kcat/Kpeptide. Substitution of the P-3 arginine with alanine (where serine is the
      P-site) yields a kcat/Kpeptide versus pH profile that is also bell-shaped,
      although both pK values are intrinsic acid dissociation constants of the enzyme.
      Replacement of the P-2 arginine with alanine removes the lower pK in the pH-rate
      profile without altering the higher pK. These results indicate that recognition
      of the P-2 arginine requires the ionization of an enzyme residue. This result
      implies that if the catalytic subunit mechanism involves general base catalysis,
      the ionization of this bse is not manifested in the pH-rate profiles.

PMID- 8463305
TI  - Activation by G protein beta gamma subunits of beta-adrenergic and muscarinic
      receptor kinase.
AB  - We have shown previously that GTP-binding regulatory protein (G protein) beta
      gamma subunits stimulate the agonist- or light-dependent phosphorylation of
      muscarinic acetylcholine receptors (mAChRs) and rhodopsin by a protein kinase
      partially purified from porcine brain (mAChR kinase) but not the phosphorylation
      of rhodopsin by rhodopsin kinase (Haga, K., and Haga, T. (1992) J. Biol. Chem.
      267, 2222-2227). We report here that the mAChR kinase phosphorylates beta
      adrenergic receptors (beta-ARs) purified from bovine lung in an agonist-dependent
      manner, and the phosphorylation is also stimulated by G protein beta gamma
      subunits. We also report that recombinant beta-adrenergic receptor kinase 1 (beta
      ARK1) expressed in COS-7 cells phosphorylates mAChRs (human m2 subtype) and
      rhodopsin in an agonist- or light-dependent manner, respectively, and that this
      phosphorylation is stimulated by G protein beta gamma subunits. By contrast, the
      beta gamma subunits do not stimulate the phosphorylation of mAChRs or rhodopsin
      by a beta-ARK1 mutant lacking a part of the carboxyl-terminal region which is
      present in beta-ARKs but not in rhodopsin kinase. These results indicate that the
      beta-ARK1 is the same as or very similar to the mAChR kinase but is distinguished
      from the rhodopsin kinase with respect to activation by the beta gamma subunits
      and that the extra carboxyl-terminal sequence in beta-ARKs is required for the
      stimulation by the beta gamma subunits.

PMID- 8463306
TI  - Kinetics of glucocorticoid receptor phosphorylation in intact cells. Evidence for
      hormone-induced hyperphosphorylation after activation and recycling of
      hyperphosphorylated receptors.
AB  - Glucocorticoid receptors are basally phosphorylated in the absence of hormone and
      become hyperphosphorylated after hormone treatment of intact cells. To determine
      the sequence of changes which the receptor undergoes following hormone binding,
      we analyzed the kinetics of receptor phosphorylation in WEHI-7 mouse thymoma
      cells and in stably transfected Chinese hamster ovary cells that overexpress the
      mouse receptor. No major differences were found between these two cell types.
      Cells were preincubated with 32P(i) and [35S] methionine to label the receptors
      metabolically. The phosphate content of the receptor protein was determined from
      the ratio of 32P to 35S in radioactive gel slices after immunopurification and
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Hormone-induced
      increases in phosphorylation were seen as early as 5 min after adding hormone and
      persisted for 20 h. Analysis of newly formed cytosolic and nuclear-bound
      activated (DNA-binding) receptors showed that activation precedes
      hyperphosphorylation. Nonactivated receptors, both unliganded and hormone
      liganded, also became hyperphosphorylated but more slowly than activated
      receptors. The rate of receptor dephosphorylation, determined by chasing with
      unlabeled P(i), was much slower than the rate of phosphorylation or of hormone
      dissociation and appeared to be slightly increased by agonists and by the
      antagonist RU486 (which does not cause hyperphosphorylation). Mutant WEHI-7 cells
      lacking cAMP-dependent protein kinase activity gave basal and hormone-induced
      receptor phosphorylation indistinguishable from wild type cells. We conclude that
      (a) the substrate for hormone-dependent hyperphosphorylation is the activated
      hormone-receptor complex; (b) most hyperphosphorylated receptors are recycled and
      reutilized in hyperphosphorylated form; (c) control of receptor phosphorylation
      may not be cell-specific; (d) cAMP-dependent protein kinase is not involved
      directly or indirectly in phosphorylating major sites on the receptor in vivo.

PMID- 8463307
TI  - Inversion of the substrate specificity of yeast alcohol dehydrogenase.
AB  - The relationship between the size of the substrate binding pocket and the
      catalytic reactivities with varied alcohols was studied with the Saccharomyces
      cerevisiae alcohol dehydrogenase I (ScADH) and compared with the liver enzymes
      from horse (EqADH, EE isoenzyme) and monkey (MmADH alpha, alpha-isoenzyme). The
      yeast enzyme is most active with ethanol, and its activity decreases as the size
      of the alcohol is increased, whereas the activities of the liver enzymes increase
      with larger alcohols. The substrate pocket in ScADH was enlarged by single
      substitutions of Thr-48 to Ser (T48S), Trp-57 to Met (W57M), and Trp-93 to Ala
      (W93A), and a double change, T48S:W93A, and a triple, T48S:W57M:W93A. The T48S
      enzyme has the same pattern of activity (V/K) as wild-type ScADH for linear
      primary alcohols. The W57M enzymes have lowered reactivity with primary and
      secondary alcohols. The W93A and T48S:W93A enzymes resemble MmADH alpha in having
      an inverted specificity pattern for primary alcohols, being 3- and 10-fold more
      active on hexanol and 350- and 540-fold less active on ethanol, and are as
      reactive as the liver enzymes with long chain primary alcohols. The three Ala-93
      enzymes also acquired weak activity on branched chain alcohols and cyclohexanol.

PMID- 8463308
TI  - Inhibition of glycolysis by amino acids in ascites tumor cells. Specificity and
      mechanism.
AB  - The effect of glutamine and asparagine on glucose metabolism has been studied in
      ascites tumor cells. Either of these amino acids decreased the glycolytic flux
      about 80%. Half-maximal effects were obtained with 0.14 mM glutamine and 0.087 mM
      asparagine. Among the 20 L-amino acids, only glutamate produced a similar effect.
      Glutamine and asparagine caused a 70% increase of hexose monophosphates and a
      large decrease of fructose-1,6-P2 and triose phosphates, evidencing a strong
      inhibition of the phosphofructokinase (EC 2.7.11) reaction. Analysis of the
      levels of various phosphofructokinase effectors revealed that fructose-2,6-P2 and
      AMP decreased 4-fold, phosphoenolpyruvate, citrate, and ATP increased 4-, 3-, and
      1.8-fold, respectively, and that there was no change in ADP, Pi, and
      intracellular pH. Assay of phosphofructokinase at concentrations of substrates
      and effectors determined to be in the cells showed that the low activity of this
      enzyme could be accounted for by the change in the concentration of effectors,
      the major mechanism being the change in adenine nucleotides. The decrease in
      fructose-2,6-P2 contributed very little to the inhibition of phosphofructokinase
      activity. The effects of amino acids were prevented by amino-oxyacetate,
      suggesting that transamination was an obligatory step for these changes.

PMID- 8463309
TI  - Site-specific mutations in a loop region of the C-terminal domain of the large
      subunit of ribulose bisphosphate carboxylase/oxygenase that influence substrate
      partitioning.
AB  - Amino acids composing a flexible loop (loop 6) of the eight-stranded barrel
      domain of the L-subunit of Synechococcus ribulose bisphosphate
      carboxylase/oxygenase (EC 4.1.1.39) involved in reaction intermediate
      stabilization have been modified by site-specific mutagenesis. Changes at
      positions both distant and within the active site affect overall catalysis and
      substrate partitioning. Most significantly, replacement of the active site Lys
      (Lys-334) with Arg at the apex of the loop almost completely suppressed the
      carboxylase activity of the enzyme relative to oxygenation, with only a modest
      reduction in overall catalysis. Val-331 and Thr-342, more distant from the active
      site but with interacting side chains, were changed to larger and smaller
      residues with differential effects on both turnover and substrate partitioning.
      Substitution of the loop with the sequence found in more efficient carboxylases
      only increased partitioning marginally when accompanied by alterations in the C
      terminal tail of the L-subunit that interacts with the loop. Generally,
      modifications to the loop composition also affected enediol formation, the first
      step of catalysis, suggesting that the geometry and hence flexibility of this
      segment affect more than just stabilization of the intermediates immediately
      following reaction with CO2 or O2.

PMID- 8463310
TI  - The plastocyanin-deficient phenotype of Chlamydomonas reinhardtii Ac-208 results
      from a frame-shift mutation in the nuclear gene encoding preapoplastocyanin.
AB  - Ac-208 is a plastocyanin-deficient mutant of Chlamydomonas reinhardtii that
      contains only 2-3% of the wild-type level of plastocyanin-encoding mRNA and no
      detectable plastocyanin. Sequence analysis of the ac-208 plastocyanin-encoding
      gene reveals a single nucleotide insertion in the first exon compared with the
      wild-type gene; this alters the reading frame and results in a premature nonsense
      codon. We have introduced the genomic sequence encoding plastocyanin from a wild
      type strain into ac-208 by cotransformation with a selectable marker encoding
      nitrate reductase. Of 22 nit+ transformants characterized, nine contained
      additional plastocyanin-encoding sequences (compared with untransformed cells)
      and each of these nine transformants was found to accumulate the protein.
      Transformants that do not contain newly introduced plastocyanin sequences retain
      the plastocyanin-deficient phenotype. The introduced plastocyanin-encoding
      sequences are stable during mitotic growth in liquid culture over a period of
      several months, as is expression from the introduced sequences. We suggest that
      the decreased steady state level of plastocyanin-encoding messages is a
      consequence of the frame-shift mutation in the structural gene. The ability to
      complement ac-208 with plastocyanin-encoding sequences will allow the
      introduction and analysis of in vitro mutagenized plastocyanin sequences in vivo
      in transgenic C. reinhardtii cells.

PMID- 8463311
TI  - The adipocyte lipid-binding protein at 1.6-A resolution. Crystal structures of
      the apoprotein and with bound saturated and unsaturated fatty acids.
AB  - Crystals of the adipocyte lipid-binding protein which diffract to near atomic
      resolution have been obtained in Na/K phosphate buffer/precipitant system. The
      structures of the apo-form and the protein with bound oleic acid and stearic acid
      have been determined and refined to 1.6-A resolution with R-factor around 18%.
      The conformations of the bound fatty acids are nearly the same. In both cases,
      the carboxylate group of the ligand interacts directly with Arg126 and Tyr128,
      indirectly with Arg106 through a water molecule. The hydrocarbon tail sticks out
      of the protein surface through a hydrophobic patch. Saturated and unsaturated
      fatty acids bind in essentially the same conformation. The remaining space of the
      binding pocket is filled with well ordered water molecules interacting with most
      of the polar side chains. Comparisons between the holo- and apostructures reveal
      that the hydrophobic patch on the protein surface formed by a helix and several
      tight turns might serve as a portal for lipid binding. Since the adipocyte lipid
      binding protein is phosphorylated at Tyr19 by the insulin receptor kinase, the
      position of this side chain has been re-evaluated using the coordinates of the
      holo-forms. It appears that the position of Tyr19 does not change significantly
      upon the binding of either of the fatty acids.

PMID- 8463312
TI  - Modulation of ligand binding affinity of the adipocyte lipid-binding protein by
      selective mutation. Analysis in vitro and in situ.
AB  - The crystal structure of the adipocyte lipid-binding protein (ALBP) with
      coordinated fatty acid shows the hydrophobic ligand bound within a water-filled
      central cavity with its carboxyl group engaged in a hydrogen bonding network
      involving, at least in part, the functional groups of residues R126 and Y128. We
      produced mutant forms of ALBP which altered these amino acids, expressed these in
      Escherichia coli as glutathione S-transferase (GST) fusion proteins, and examined
      their ligand-binding properties using the fluorescent fatty acids cis-parinaric
      acid (c-PA) and 12-(9-anthroyloxy)-oleate (12-AO). The wild-type and all mutated
      forms of GST-ALBP displayed similar binding affinities for 12-AO, with Kd,app
      values ranging from 0.5 to 2.4 microM. The binding affinity of ALBP forms R126Q
      and Y128W for c-PA were reduced about 30-50-fold in comparison to GST-ALBP, while
      that for the double mutation R126L + Y128F was below the limits of detection. To
      determine if the hydrogen bonding system functioned in situ, Chinese hamster
      ovary (CHO) cell transfectants expressing wild-type ALBP demonstrated a moderate
      (1.5-2-fold) increase in the total rate of [3H]oleate uptake and trafficking into
      the esterified lipid pools over that of untransfected cells, while the rate of
      [3H]oleate uptake of the transfected CHOs expressing the R126L + Y128F mutation
      was identical to that of the control CHOs. In summary, these results suggest that
      the primary factor contributing to binding affinity of ALBP for fatty acids such
      as c-PA or oleic acid both in vitro and in situ is the hydrogen bonding network
      involving at least R126, Y128, and the lipid carboxyl group. However, a ligand
      with sufficiently large hydrophobic character such as 12-AO can bind in the
      absence of a functional carboxylate hydrogen bonding network, presumably due to
      stabilizing entropic interactions with other cavity atoms.

PMID- 8463313
TI  - Induction of Sp1-p53 DNA-binding heterocomplexes during granulocyte/macrophage
      colony-stimulating factor-dependent proliferation in human erythroleukemia cell
      line TF-1.
AB  - The involvement of Sp1 in regulating cell proliferation in myeloid leukemia cells
      was determined by measuring the levels and DNA binding activity of Sp1 in TF-1
      cells, a human erythroleukemia cell line dependent on granulocyte/macrophage
      colony-stimulating factor (GM-CSF) for viability and cell growth. DNA binding of
      Sp1 to a specific double-stranded oligodeoxynucleotide was increased markedly in
      a dose-dependent manner in proliferating cells in response to GM-CSF compared
      with growth-arrested or apoptotic cells. Competition experiments and mobility
      shift interference assays with antibodies against Sp1 as well as wild-type or
      mutant p53 indicated that GM-CSF-inducible DNA-binding complexes contained both
      Sp1 and p53 and that these heterocomplexes bound to both p53- and Sp1-binding
      sequences with high affinity. Immunoprecipitation of nuclear extracts with a p53
      antibody indicated that Sp1 was associated as a heterocomplex with p53. Formation
      of this complex was dependent on the level of p53 since p53 was more abundant in
      proliferating cells and decreased upon induction of growth arrest and apoptosis
      by withdrawal of GM-CSF while Sp1 levels remained unchanged. These results
      suggest that the association of Sp1 with p53 may represent a novel mechanism of
      growth regulation in cytokine-dependent leukemia cells.

PMID- 8463314
TI  - Differential binding of retinol analogs to two homologous cellular retinol
      binding proteins.
AB  - A comparative study of the interactions of rat cellular retinol-binding protein
      (CRBP) and cellular retinol-binding protein II (CRBP II) with a number of
      synthetic phenyl-substituted analogs of all-trans-retinol was performed using
      fluorescence and nuclear magnetic resonance analysis. These studies indicate that
      CRBP II is more sensitive to modifications of the ring moiety than CRBP. Removal
      of the two methyl substituents on the ring which are ortho to the polyene chain
      abolishes binding to CRBP II. Conformational analysis of the ligands indicates
      that these two methyl groups influence the planarity of the ligand. The
      identification of monospecific ligands may prove useful for studying the
      physiological roles of these two proteins.

PMID- 8463315
TI  - Mutations in a zinc-binding domain of human insulin-degrading enzyme eliminate
      catalytic activity but not insulin binding.
AB  - Insulin-degrading enzyme is a nonlysosomal metalloprotease that initiates
      degradation of internalized insulin in some cells. We previously identified a
      potential catalytic site containing an inversion of the Zn(2+)-binding domain of
      the thermolysin family (Kuo, W.-L., Gehm, B. D., and Rosner, M. R. (1991) Mol.
      Endocrinol. 4, 1580-1591). The role of this site in catalysis was examined by
      mutating one of the presumptive Zn(2+)-coordinating histidines (His108) in human
      insulin-degrading enzyme to leucine or glutamine, which were predicted to reduce
      or eliminate Zn2+ binding without substantially altering secondary structure.
      cDNAs for the mutant and wild-type enzymes were incorporated into an expression
      vector and transfected into COS cells. Expression of the transfected genes was
      confirmed by Northern and Western blots. In contrast to the wild-type gene, which
      increased insulin degradation by cell extracts and intact cells several-fold, the
      mutated genes had no effect on insulin degradation, indicating a loss of
      catalytic activity. However, the mutants' ability to bind substrate was
      unimpaired, as affinity labeling with 125I-insulin was increased compared to the
      wild type. These results suggest that an intact Zn(2+)-binding domain in human
      insulin-degrading enzyme is required for catalytic activity and can affect, but
      is not required for, substrate binding.

PMID- 8463316
TI  - Ca2+, caldesmon, and myosin light chain kinase exchange with calmodulin.
AB  - Wheat calmodulin (CaM) was labeled at Cys-27 with the sulfhydryl-specific
      fluorescent probe 2-(4'-maleimidoanilino)-naphthalene-6-sulfonic acid (MIANS), to
      form MIANS.CaM. In the presence of Ca2+, MIANS.CaM undergoes a large fluorescence
      increase when it binds myosin light chain kinase (MLCK) and caldesmon (CaD), but
      little fluorescence change when it binds CaM antagonists or Ca2+. MLCK associates
      with MIANS.CaM at a rate of 2.8 x 10(7) M-1 s-1 and dissociates at 0.031 s-1 (Kd
      = 1.1 nM). Protein kinase A phosphorylation of MLCK (P-MLCK) produces a 3.5-fold
      decrease in its association rate with CaM and a 6-fold increase in its
      dissociation rate (Kd = 23 nM). CaD associates with MIANS.CaM with a rate of 5.3
      x 10(8) M-1 s-1 and dissociates at 57 s-1 (Kd = 108 nM). EGTA disrupts the
      CaM.MLCK, CaM.P-MLCK, and the CaM.CaD complexes at rates of 3.5 s-1, 6.5 s-1, and
      13.5 s-1, respectively. MLCK, therefore, dissociates from CaM more quickly by
      Ca2+ removal while the lower affinity CaD is dissociated more quickly by
      competition from higher affinity CaM target proteins than by Ca2+ removal. MLCK
      binding to CaM slowed Ca2+ dissociation from CaM's C-terminal Ca(2+)-binding
      sites from 30 s-1 to 6 s-1 while CaD had little effect on Ca2+ dissociation from
      these sites. During a Ca2+ transient, CaM could exchange with MLCK and CaD
      rapidly enough for these proteins to be directly involved in the
      contraction/relaxation cycle of smooth muscle.

PMID- 8463317
TI  - Enzymatic studies of lyso platelet-activating factor acylation in human
      neutrophils and changes upon stimulation.
AB  - Resting human neutrophils acylate 1-O-alkyl-2-lyso-sn-glycero-3-phosphocholine (1
      O-alkyl-2-lyso-GPC; lyso-PAF) specifically with arachidonate (AA); upon
      stimulation, however, the specificity is lost and other fatty acid residues are
      added. The major goals of this study were to compare the various acylation
      reactions present in the cells and to determine the cause of the specificity loss
      upon stimulation. The CoA-independent transacylase was active in neutrophil
      homogenates and was found to be both highly specific for AA and stereospecific,
      requiring 1-O-alkyl-2-lyso-GPC for activity. Homogenates also contained acyl
      CoA:1-radyl-2-lyso-sn-glycero-3-phosphocholine acyltransferase activity, which
      transferred acyl chains from oleoyl-, linoleoyl-, or linolenoyl-CoA to both 1
      alkyl and 1-acyl acceptors, but preferred the 1-acyl acceptor when arachidonoyl
      CoA was used. The CoA-dependent and -independent activities co-sedimented on a
      discontinuous Percoll gradient in a single band containing plasma membrane and
      possibly other membranes. CoA alone promoted nonspecific acylation in the
      homogenates. The AA-specific acylation was attenuated up to 80% in sonicates of
      ionophore-stimulated cells, whereas the CoA-dependent acyltransferase remained
      unchanged. Potential phospholipid AA donors for the transacylase were
      substantially depleted in the stimulated cells but could not account for the
      large decrease in acylation. An accumulation of 1-O-alk-1'-enyl-2-lyso-sn-glycero
      3-phosphoethanolamine (alkenyl-2-lyso-GPE), which acts as a competing substrate,
      appeared to be the major cause of the reduced AA-specific acylation of lyso-PAF
      observed in the stimulated preparations. Removal of the alkenyl-2-lyso-GPE
      restored the activity, whereas the addition of alkenyl-2-lyso-GPE (2 microM) to
      resting membrane preparations resulted in a marked decrease in transacylation of
      lyso-PAF.

PMID- 8463318
TI  - Differences in microtubule binding and self-association abilities of bovine brain
      tau isoforms.
AB  - We have fractionated tau isoforms by elution at increasing pH values using iron
      chelated affinity chromatography, which discriminates between isoforms
      phosphorylated to different extents. Microtubule-associated tau elutes from the
      column at a pH gradient narrower than that of total brain tau. Neither under
      phosphorylated nor highly phosphorylated isoforms are found in the microtubule
      associated tau protein preparation. This indicates that phosphorylation at
      certain sites is needed for tau binding to microtubules, whereas phosphorylation
      at some other sites may prevent the association. The self-association ability of
      the different tau isoforms has also been analyzed. Tau isoforms containing three
      tubulin binding motifs form covalently bound dimers more efficiently than tau
      isoforms containing four motifs. This dimer-forming ability is notably diminished
      in the presence of a reducing agent, as determined by SDS-polyacrylamide gel
      electrophoresis, thus suggesting the involvement of cysteine residues.
      Additionally, tau forms larger aggregates, as detected by gel permeation
      chromatography, which are solubilized by SDS and cannot, therefore, be observed
      by SDS-polyacrylamide gel electrophoresis. These tau aggregates are observed even
      in the presence of reducing agents. These results support the idea that other
      regions in the tau molecule, besides the Cys-containing tubulin binding region,
      also contribute to tau self-association. Tau dimerization and aggregation may be
      prior steps to the formation of paired helical filaments.

PMID- 8463319
TI  - Repair of aflatoxin B1 DNA adducts by the UvrABC endonuclease of Escherichia
      coli.
AB  - The repair by UvrABC endonuclease of two major adducts formed by aflatoxin B1 in
      DNA was found to be similar. Aflatoxin epoxide was used to generate the aflatoxin
      B1.N7-guanine adduct which can convert to aflatoxin B1-formamidopyrimidine
      adduct. The reaction of the aflatoxin B1 epoxide with DNA follows pseudo-first
      order kinetics. The DNA sequence-specific relative reactivity of the epoxide is
      the same as previously observed for aflatoxin B1 activated by liver microsomes,
      therefore strongly reinforcing the notion that aflatoxin B1 reacts with DNA
      through the epoxide intermediate. For the majority of lesion sites, a high
      affinity protein-DNA complex was formed from the UvrA and the UvrB proteins with
      similar efficiency to both adducts, and to pyrimidine dimers, and then nicks the
      DNA when UvrC was added. The two incisions are at the eighth phosphodiester
      moiety 5' and the sixth phosphodiester moiety 3' of a modified guanine
      nucleotide. Both incisions appeared to be concerted. For some sites, the DNA
      sequence can alter the relative incision efficiency up to 15-fold. However, the
      majority of these AFB1 lesion structures in most DNA sequences are similar with
      respect to recognition by this nucleotide excision repair enzyme. Therefore the
      observation that the aflatoxin B1.N7-guanine lesion is removed rapidly, while the
      aflatoxin B1-formamidopyrimidine lesion persists in the mammalian cell may have
      other mechanistic explanations.

PMID- 8463320
TI  - Binding and phasing of Escherichia coli single-stranded DNA-binding protein by
      the secondary structure of phage G4 origin of complementary DNA strand synthesis
      (G4oric).
AB  - The origin of phage G4 DNA complementary strand synthesis (G4oric) consists of
      three stem-loop structures (stem loops I, II, and III) that have been proposed as
      a recognition site for primase during primer RNA (pRNA) synthesis (Godson, G. N.,
      Barrell, B. G., Staden, R., and Fiddes, J. C. (1978) Nat. New Biol. 276, 236-247;
      Fiddes, J. C., Barrell, B. G., and Godson, G. N. (1978) Proc. Natl. Acad. Sci.
      U.S.A. 75, 1081-1085; Sims, J., Capon, D., and Dressler, D. (1979) J. Biol. Chem.
      254, 12615-12628). It is generally considered that the double-stranded DNA stem
      loop structure is not coated with Escherichia coli single-stranded DNA-binding
      protein (SSB), but is recognized by primase as naked DNA (Kornberg, A., and
      Baker, J. (1992) DNA Replication, 2nd Ed., p. 280, W. H. Freeman & Co., New
      York). Using small G4oric single-stranded DNA fragments of various sizes (302,
      278, 149, and 100 nucleotides) consisting of the core 100-nucleotide stem-loop
      region plus differing lengths of 3'- and 5'-flanking sequence as substrates for
      gel retardation and DNase I and micrococcal nuclease digestion, we show that
      under conditions of pRNA synthesis, two SSB tetramers bind to the stem-loop
      structure. With increasing lengths of 5'- and 3'-flanking sequence, more SSB
      tetramers are added. Regardless of the number of SSB tetramers bound, however,
      the region of DNA containing the pRNA initiation site is always left accessible
      to nuclease digestion. In situ copper-phenanthroline footprinting of individual
      gel shift assembly intermediates shows that on the 302-nucleotide G4oric, the
      first two SSB tetramers assemble at random, but the addition of more SSB
      tetramers results in formation of a unique structure. In this structure, SSB
      tetramers protect both sides of stem loop III plus the intervening region between
      stem loops III and I, but leave most of stem loop I and the CTG pRNA initiation
      site accessible to copper-phenanthroline. Primase can only synthesize pRNA when
      the stem-loop structure is saturated with SSB and presumably in the unique
      configuration. The G4oric stem-loop structure therefore appears to dictate the
      phasing of SSB to leave a primase recognition site as free DNA.

PMID- 8463321
TI  - Induction of basic fibroblast growth factor mRNA and protein synthesis in smooth
      muscle cells by cholesteryl ester enrichment and 25-hydroxycholesterol.
AB  - Basic fibroblast growth factor (bFGF) is a potent smooth muscle cell mitogen.
      Smooth muscle cell and macrophage-derived foam cells, resulting from cholesteryl
      ester accretion, are hallmark characteristics of atherosclerosis. We wanted to
      determine if bFGF synthesis is altered during cholesteryl ester accumulation in
      smooth muscle cells. Cholesteryl ester enrichment causes a 3-fold increase in
      bFGF in cellular lysates and a 3-fold increase in steady state mRNA levels for
      bFGF, as compared with control cells. Conditioned media from cholesteryl ester
      enriched smooth muscle cells contains 6 times more mitogenic activity than
      conditioned media from control cells; this activity is neutralized by an antibody
      directed against bFGF but not by an antibody directed against platelet-derived
      growth factor. These results suggest that cholesteryl ester enrichment also
      enhances bFGF release. Since oxysterols have been implicated in the pathogenesis
      of atherosclerosis, we determined if oxysterols could affect bFGF production and
      release. 25-Hydroxycholesterol also increases the release of bFGF-like mitogens
      from smooth muscle cells, as well as increasing mRNA transcript levels for bFGF.
      Cholesteryl ester enrichment and 25-hydroxycholesterol did not promote bFGF
      release secondary to cell injury. In conclusion, these data define a basic
      mechanism for smooth muscle cell hyperplasia during atherogenesis involving the
      generation of bFGF by smooth muscle cell-derived foam cells.

PMID- 8463322
TI  - Covalently immobilized laminin peptide Tyr-Ile-Gly-Ser-Arg (YIGSR) supports cell
      spreading and co-localization of the 67-kilodalton laminin receptor with alpha
      actinin and vinculin.
AB  - The laminin-based nonapeptide Cys-Asp-Pro-Gly-Tyr-Ile-Gly-Ser-Arg (CDPGYIGSR) and
      pentapeptide Tyr-Ile-Gly-Ser-Arg (YIGSR) have been previously demonstrated to
      support the attachment of several cell types and to competitively bind to the 67
      kDa high affinity laminin receptor. Cell attachment, but not spreading, on
      substrates containing adsorbed CDPGYIGSR or YIGSR was observed. In this report we
      describe YIGSR-mediated attachment and spreading of a wide variety of cell types.
      GYIGSRY promoted cell spreading and stress fiber formation when it was covalently
      immobilized through the amino-terminal Gly residue, used as a spacer arm.
      Spreading was not observed when adsorbed YIGSR peptide was used. Functionally
      blocking antiserum directed against the 67-kDa and related laminin-binding
      proteins blocked human foreskin fibroblast (HFF) spreading, but not attachment,
      on covalently grafted GYIGSRY substrates. However, functionally blocking antisera
      directed against the vitronectin receptor, integrin alpha v beta 3, and the
      fibronectin receptor, integrin alpha 5 beta 1, did not affect HFF spreading on
      these substrates. When HFFs spread on these substrates, the 67-kDa laminin
      receptor co-localized with the cytoplasmic proteins alpha-actinin and vinculin
      into discrete structures. These results suggest that the adhesion ligand YIGSR is
      solely sufficient for cell spreading when it is conformationally constrained by
      covalent attachment to a solid substrate, at least when attached via its amino
      terminus. Furthermore, the role of the 67-kDa laminin receptor in recognition of
      this ligand and mediating cell attachment is confirmed in this study. This report
      also provides the first evidence for direct or indirect association of this
      receptor with vinculin and alpha-actinin when YIGSR-mediated cell spreading
      occurs.

PMID- 8463323
TI  - The identification, purification, and characterization of two invariant surface
      glycoproteins located beneath the surface coat barrier of bloodstream forms of
      Trypanosoma brucei.
AB  - Two new polypeptides, termed ISG70 and ISG64, have been found in Trypanosoma
      brucei, using enzyme-catalyzed radioiodination techniques. Both are externally
      disposed integral membrane glycoproteins, containing N-linked carbohydrate
      chains. No structural homology was detected between ISG70, ISG64, or the variant
      surface glycoprotein (VSG) when assessed by 1) comparative peptide mapping, 2)
      immunoprecipitation analysis, and 3) lectin affinity chromatography. ISG70
      occurred in 5.1 x 10(4) copies/cell and has been purified 880-fold from detergent
      extracts of plasma membranes by a procedure that includes gel filtration, lectin
      affinity chromatography, and preparative SDS-polyacrylamide gel electrophoresis.
      ISG70 was present only in bloodstream forms and was specifically detected in six
      different cloned variants from the Molteno Institute trypanosomal antigen type
      (MITat) serodeme of T. brucei and from the single cloned variant of the
      International Laboratory for Research on Animal Diseases trypanosomal antigen
      type (ILTat) serodeme that was examined. Rabbits with chronic infections of T.
      brucei displayed circulating antibodies against ISG70. Both the immunogenicity of
      ISG70 and its invariant nature suggest that it may be useful in the development
      of an effective serodiagnostic test. Furthermore, its stage-specific location
      combined with its invariant nature implies that its function is strictly related
      to a physiological role required for the parasite's residence in its mammalian
      host.

PMID- 8463324
TI  - Molecular cloning of the cDNAs for the four subunits of mouse DNA polymerase
      alpha-primase complex and their gene expression during cell proliferation and the
      cell cycle.
AB  - The DNA polymerase alpha-primase complex purified from mouse FM3A cells is
      composed of four polypeptides with molecular masses of 180, 68, 54, and 46 kDa.
      The largest subunit has DNA polymerase activity, the two smallest subunits have
      DNA primase activity, and the function of the 68-kDa subunit is unknown. We have
      isolated the cDNAs of the four subunits by low stringency hybridization and
      reverse transcription polymerase chain reaction and determined their nucleotide
      sequences. The predicted amino acid sequence of the 180-kDa subunit shows 88, 38,
      34, and 32% identity to those of the catalytic subunits of human, Drosophila
      melanogaster, Schizosaccharomyces pombe, and Saccharomyces cerevisiae DNA
      polymerase alpha, respectively, and contains seven regions whose orders and
      sequences are highly conserved among viral and other eukaryotic DNA polymerases.
      The deduced amino acid sequence of the 68-kDa subunit shows 25% identity to that
      of the 73-kDa subunit of D. melanogaster DNA polymerase alpha-primase, shows no
      significant sequence similarity to any other protein in the data bases, but
      contains a potential phosphorylation site(s) for cdc2 kinase. The amino acid
      sequence of the 54-kDa subunit shows 32% identity to that of the large subunit of
      S. cerevisiae DNA primase. During activation of quiescent Swiss mouse 3T3 cells
      to proliferate, the levels of mRNA of the four subunits of the DNA polymerase
      alpha-primase complex increased before DNA synthesis. In growing mouse FM3A
      cells, the transcripts of the four subunits are present throughout the cell cycle
      and increase slightly prior to the S phase.

PMID- 8463325
TI  - Quiescence-dependent activation of the p20K promoter in growth-arrested chicken
      embryo fibroblasts.
AB  - We described the synthesis of a quiescence-specific p20K protein in quiescent
      chicken heart mesenchymal cells and contact-inhibited chicken embryo fibroblasts
      (Bedard, P.-A., Balk, S.D., Gunther, H.S., Morisi, A., and Erikson, R.L. (1987a)
      Mol. Cell. Biol. 7, 1450-1459). We now report that the expression of p20K is
      enhanced in cells rendered quiescent by other conditions of growth arrest such as
      serum starvation or treatment with hydroxyurea. Chicken embryo fibroblasts
      transformed by the Rous sarcoma virus also expressed p20K upon serum/medium
      depletion. In all conditions investigated, the synthesis of p20K was correlated
      with decreased DNA synthesis, indicating that growth arrest regulates the
      expression of p20K in fibroblasts. The abundance of p20K mRNAs was elevated in
      quiescent cells, and the p20K gene was more active in nuclear run-on
      transcription assays in conditions of growth arrest. The p20K gene was isolated,
      and the promoter region was analyzed in transient expression assays. Serum
      starvation increased the activity of the promoter, indicating that the expression
      of p20K is controlled at least in part at the transcriptional level. Deletion
      analysis revealed that a region of less than 217 base pairs (bp) is sufficient
      for quiescence-dependent activity of the promoter. Within this region, a segment
      of 48 bp was essential to basal and quiescence-induced activity of the promoter
      in dividing and nondividing cells, respectively. The 48-bp region enhanced the
      activity of a minimal heterologous promoter in quiescent cells but had no effect
      in conditions of proliferation, indicating that it functions as a quiescence
      responsive unit (QRU). Therefore, the transcription of the p20K gene in quiescent
      fibroblasts is controlled by the one or several growth-regulated elements located
      in the 48-bp QRU of the promoter.

PMID- 8463326
TI  - Folding and assembly of bacterial alkaline phosphatase in vitro and in vivo.
AB  - Alkaline phosphatase (PhoA), localized in the periplasmic space of Escherichia
      coli, is a homodimeric metalloprotein containing two intramolecular disulfide
      bonds. We attempted to clarify the folding-assembly pathways of this enzyme by
      allowing in vitro-synthesized PhoA polypeptide to fold into active enzyme and by
      examining the occurrence of similar pathways in vivo by pulse-chase experiments.
      PhoA (lacking the signal sequence) that was synthesized in a coupled
      transcription-translation system was effectively converted into active enzyme
      when incubated with either oxidized glutathione, periplasmic proteins, or
      purified DsbA protein in the presence of Zn2+. The first appreciable event in the
      activation of initially unfolded translation product (species I) was the
      disulfide bond formation, which was immediately followed by folding into a
      partially trypsin-resistant monomer (species II), and then by assembly into
      active dimer (species III). The species II PhoA molecules, but not the species
      III molecules, were found to be sensitized to trypsin in the presence of a
      reducing agent, dithiothreitol. Pulse-chase studies showed that PhoA acquires
      disulfide bonds immediately after the biosynthesis, whereas it acquires
      resistance to both dithiothreitol and certain endogenous protease over some 2 min
      at 15 degrees C. These results indicate that PhoA undergoes a series of folding
      assembly steps, some of which are of measurable speeds in vivo and mimicable in
      vitro.

PMID- 8463327
TI  - Testicular temperature-labile cholesteryl ester hydrolase. Relationship to
      isoenzymes from other tissues, correlation with spermatogenesis, and inhibition
      by physiological concentrations of divalent cations.
AB  - Temperature-labile cholesterol ester hydrolase (TLCEH) was purified 2,000-fold
      from rat testis cytosol using sequential ammonium sulfate precipitation, cation
      exchange chromatography, and isoelectric focusing chromatography. the purified
      enzyme, which exhibited a single silver-stained band (66 kDa) on sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis, was inhibited 89% by the elevation of
      the temperature from 32 to 37 degrees C and 65% by treatment with alkaline
      phosphatase. Its amino acid composition and amino-terminal sequence differed
      markedly from those of isoenzymes from other tissues, although 6 of 20 residues
      were conserved. Polyclonal antibodies raised to TLCEH exhibited no cross
      immunoreactivity with cytosolic proteins from other rat tissues and inhibited 70%
      of testis cytosolic CEH. Western blot analysis demonstrated a high correlation
      between immunoreactive protein and catalytic activity in the testis during
      maturation of the rat, with a marked increase at the onset of spermatogenesis.
      TLCEH was inhibited by physiological levels of Cu2+ (I50 = 0.60 microM) and Zn2+
      (I50 = 0.75 microM) and by Cd2+ (I50 = 0.15 microM) but not by 0.5-5 mM Mn2+.

PMID- 8463328
TI  - Analysis of the functions of the first epidermal growth factor-like domain of
      factor X.
AB  - Upon activation, factor X participates in the prothrombin activation complex.
      Similar to 4-carboxyglutamic acid (Gla)-domainless protein C, the Gla-domainless
      factor X (GDFX) contains a high affinity Ca(2+)-binding site critical for the
      function of these molecules. In the case of protein C, we recently demonstrated
      that the high affinity Ca(2+)-binding site critical for activation is outside the
      first epidermal growth factor (EGF) homology domain. To examine if this is also
      true for factor X, we have expressed in human 293 cells a deletion mutant of
      factor X (E2FX) which lacks the entire Gla region as well as the NH2-terminal EGF
      homology region of factor X. Direct binding studies by equilibrium dialysis
      indicate that E2FX contains a single Ca(2+)-binding site with a dissociation
      constant (Kd) of 154 +/- 48 microM. The functional properties of E2FX are
      equivalent or improved over those of GDFX. For instance, the factor X coagulant
      protein of Russell's viper venom activates E2FX three times faster than
      recombinant GDFX. Kinetic analysis of prothrombin activation in the absence of
      membranes indicates that activated GDFX and E2FX bind to factor Va with equal
      affinity (Kd = 4.1 microM). The Ca2+ concentration required for half-maximal
      prothrombin activation rates in the above activation system shifted from 721 +/-
      113 microM for activated GDFX to 193 +/- 64 microM for activated E2FX. GDFX and
      E2FX activation rates with the soluble tissue factor-factor VIIa complex were
      identical as was the Ca2+ dependence of the reaction. We conclude that E2FX
      retains a high affinity Ca(2+)-binding site and that the first EGF homology
      domain does not appear to have a positive functional role in the GDFX molecule.
      However, Ca2+ occupancy of the Ca(2+)-binding site in the first EGF domain of
      intact factor X may be essential for optimal prothrombin activation.

PMID- 8463329
TI  - Membrane vesicles containing overproduced SecY and SecE exhibit high
      translocation ATPase activity and countermovement of protons in a SecA- and
      presecretory protein-dependent manner.
AB  - Everted membrane vesicles were prepared from Escherichia coli cells containing
      either overproduced amounts (OP-membrane vesicles) or normal amounts (normal
      membrane vesicles) of SecY and SecE, both of which are essential components of
      the protein translocation apparatus. The rates of translocation of pro-OmpA were
      similar in the two types of membrane vesicles, whereas translocation ATPase
      activity, which requires SecA, a precursor protein (pro-OmpA), and membrane
      vesicles, was appreciably higher with OP-membrane vesicles than with normal
      membrane vesicles. Since ATP hydrolysis has been shown to take place at an
      earlier part of the translocation reaction, these results suggest that the
      overproduction of SecY and SecE enhanced the activity of the earlier process, but
      not the entire process, of the translocation reaction. The addition of pro-OmpA
      in the presence of SecA caused the partial collapse of delta pH (inside acidic)
      generated on OP-membrane vesicles, suggesting that protons come out from the
      inside of the membrane vesicles in a pro-OmpA-dependent manner. The collapse of
      delta pH caused by pro-OmpA required SecA, ATP, and SecY and was not detected
      when normal membrane vesicles were used. These results indicate that the early
      event of protein translocation, which requires the functioning of SecA, SecY, and
      SecE, causes the countermovement of protons.

PMID- 8463330
TI  - Oxidized ATP. An irreversible inhibitor of the macrophage purinergic P2Z
      receptor.
AB  - The effects of oxidized ATP (oATP) on responses triggered by extracellular
      adenosine 5'-triphosphate (ATPe) were investigated in the mouse macrophage-like
      cell line J774. ATPe induced in this cell line two kinds of responses mediated by
      two different P2 purinergic receptors: 1) an early permeabilization of the plasma
      membrane to extracellular hydrophilic markers of M(r) up to 900 mediated by P2Z
      receptors; and 2) a fast mobilization of Ca2+ from intracellular stores mediated
      by P2Y receptors. Low oATP concentrations (100 microM) completely blocked the
      first response without affecting the second. ATPe-dependent cell swelling,
      vacuolization, and lysis were also inhibited. Antagonism developed slowly, as an
      incubation at 37 degrees C for at least 2 h in the presence of oATP was needed
      and was irreversible, thus suggesting that the inhibitory action was due to
      covalent modification of the receptor. The rate of hydrolysis of exogenous ATP
      was slightly decreased by oATP, indicating a minor blocking effect of this
      compound on plasma membrane ecto-ATPases in the concentration range tested. These
      observations suggest that oATP may be a potentially very useful tool for
      isolation and characterization of the P2Z purinergic receptor.

PMID- 8463331
TI  - Partial revertants of tryptophan synthetase alpha chain active site mutant Asp60-
      >Asn.
AB  - Residue Asp60 of the tryptophan synthetase alpha chain of Escherichia coli is
      though to interact with the pyrrole NH of substrate indole-3-glycerol phosphate
      and facilitate its cleavage to indole and glyceraldehyde 3-phosphate. Two
      distinguishable partial revertants of DN60 tryptophan synthetase alpha mutant
      trpA34 were analyzed. The slower growing partial revertant, PR1, had the second
      site change, YD102. The other partial revertant, PR2, lacked three consecutive
      base pairs, resulting in replacement of Ala59 and Asn60 of the DN60 mutant alpha
      polypeptide by Asp. Inspection of the three-dimensional structure of the enzyme
      substrate analog complex revealed that Tyr102 is in the vicinity of the pyrrole
      NH of the substrate. The PR1 alpha chain has a near normal Km for substrate,
      whereas the PR2 polypeptide has greatly reduced substrate affinity. The PR2
      polypeptide is more active than the PR1 polypeptide in the alpha beta reaction in
      vitro and appears to be more active than the PR1 polypeptide in vivo. Attempts to
      obtain repeat occurrences of the PR2 deletion mutation were unsuccessful. A third
      type of trpA34 partial revertant, PR3, that grows very poorly in minimal medium,
      also has a Tyr102 replacement: YF102. These findings demonstrate that each of the
      second-site mutations affects a residue located in the vicinity of the active
      site residue altered by the primary mutation. Slightly leaky mutant trpA89,
      genetically altered near the site of the trpA34 mutation, was found to have a
      GS61 substitution.

PMID- 8463332
TI  - Evidence that the CryIA crystal protein from Bacillus thuringiensis is associated
      with DNA.
AB  - Toxin generated by activation of the Bacillus thuringiensis CryIA(c) crystal
      protein (protoxin) with bovine trypsin was separated into two components by anion
      exchange chromatography. One component (T2) was DNA-associated toxin, and the
      other was the DNA-free toxin (T1). Only one major protoxin component was
      observed, and it was found to be associated with DNA. The DNA from the T2 toxin
      varied in size from 100 to 300 base pairs, whereas the crystal and the
      solubilized protoxin contained 20-kilobase DNA as the major DNA component. DNase
      treatment converted the T2 toxin to the DNA-free T1 toxin. In contrast, the DNA
      in the crystal and the solubilized protoxin was resistant to DNase digestion and
      was not dissociated from the protein by 1.5 M NaCl. The protoxin and DNA appeared
      to elute as a complex with a molecular mass of > 2 x 10(6) Da on gel-filtration
      chromatography. No toxin was generated from the protoxin with trypsin after
      extensive digestion of the protoxin with DNase or dissociation of the DNA by
      succinylation of the lysine residues. It is proposed that DNA binds to the COOH
      terminal half of the crystal protein and is essential for maintaining the
      conformational integrity required for crystal formation and generation of toxin.

PMID- 8463333
TI  - Molecular cloning of a novel melanocortin receptor.
AB  - Using the technique of the polymerase chain reaction primed with oligonucleotides
      based on the homologous transmembrane regions of seven transmembrane G protein
      linked receptors, we isolated three full-length human genes that encode a novel
      subgroup of this receptor family. Recently, two of these receptors were
      identified as specific for alpha-melanocyte-stimulating hormone (alpha-MSH) and
      adrenocorticotropic hormone. We report the molecular cloning and pharmacologic
      characterization of a third member of this subgroup. The gene for this receptor
      encodes a protein of 361 amino acids in length. Its pharmacology characterizes it
      as an MSH receptor specific to the heptapeptide core common to
      adrenocorticotropic hormone and alpha-, beta-, and gamma-MSH. By Northern blot
      hybridization and polymerase chain reaction, it is expressed in brain, placental,
      and gut tissues but not in melanoma cells or in the adrenal gland. These findings
      may yield insight into the physiology of peptides derived from pro
      opiomelanocortin post-translational processing.

PMID- 8463334
TI  - Myristoylation of proteins in platelets occurs predominantly through thioester
      linkages.
AB  - We have demonstrated by several lines of evidence that in platelets myristate is
      linked to proteins predominantly via thioester bonds as is palmitate, and the
      covalent binding of the two long chain saturated fatty acids to proteins involves
      the same mechanisms. The first piece of evidence to support the thioester linkage
      between myristate and proteins is that [3H]myristate could be removed from
      proteins via alkaline methanolysis, which disrupts ester bonds but not amide
      bonds. The second piece of evidence is that unlabeled palmitate, which can form
      only thioester bonds in physiologic concentrations, competitively inhibits the
      formation of alkaline methanolysis-sensitive covalent bonds between [3H]myristate
      and proteins. Third, by SDS-polyacrylamide gel electrophoresis and fluorography,
      the patterns of labeled proteins from [3H]myristate- and [3H]palmitate-labeled
      platelets are identical. Fourth, [3H]myristate-labeled proteins, like
      [3H]palmitate-labeled proteins, both release their fatty acid moieties when
      exposed to hydroxylamine at neutral pH, which disrupts thioester but not
      hydroxyester bonds. These findings indicate that although the covalent binding of
      palmitate to proteins was found to occur at a faster rate than that of myristate,
      protein S fatty acid acylation that occurs posttranslationally is not specific
      for palmitate.

PMID- 8463335
TI  - The binding site for the beta gamma subunits of heterotrimeric G proteins on the
      beta-adrenergic receptor kinase.
AB  - The beta gamma subunits of heterotrimeric G proteins play important roles in
      regulating receptor-stimulated signal transduction processes. Recently
      appreciated among these is their role in the signaling events that lead to the
      phosphorylation and subsequent desensitization of muscarinic cholinergic (Haga,
      K., and Haga, T. (1992) J. Biol. Chem. 267, 2222-2227) and beta-adrenergic
      (Pitcher, J. A., Inglese, J., Higgins, J. B., Arriza, J. L., Casey, P. J., Kim,
      C., Benovic, J. L., Kwatra, M. M., Caron, M. G., and Lefkowitz, R. J. (1992)
      Science 257, 1264-1267) receptors. Beta gamma mediates the membrane targeting of
      the beta-adrenergic receptor kinase (beta ARK), in response to receptor
      activation, through a specific beta ARK-beta gamma interaction. This process
      utilizes the membrane-anchoring properties of the isoprenylated gamma subunit of
      beta gamma. In the present study, we have employed three distinct approaches to
      identify the region within the carboxyl terminus of beta ARK which binds beta
      gamma and thereby results in membrane translocation. We studied the ability of
      beta gamma to enhance the enzymatic activity of a series of truncated mutants of
      bovine beta ARK1, the ability of glutathione S-transferase fusion proteins
      containing various lengths of the carboxyl terminus of beta ARK to bind beta
      gamma subunits, and the ability of synthetic peptides comprised of beta ARK
      sequences to inhibit beta gamma activation of beta ARK1. We find that the minimal
      beta gamma binding domain of beta ARK is localized to a 125-amino acid residue
      stretch, the distal end of which is located 19 residues from the carboxyl
      terminus. A single 28-mer peptide (Trp643 to Ser670) derived from this sequence
      effectively inhibited beta gamma activation of beta ARK1, with an IC50 of 76
      microM. The identification of this "beta gamma binding domain" on beta ARK and
      the development of peptide inhibitors provide important tools for the study of G
      protein-coupled receptor desensitization, as well as for the investigation of
      beta gamma activation of other G protein-effector systems.

PMID- 8463336
TI  - Effects of adenine tracts on the B-Z transition. Fine tuning of DNA
      conformational transition processes.
AB  - The effects exerted by short runs of adenines (A-tracts), alternating (AT)n
      segments, and single-stranded DNA upon the right- to left-handed DNA transition,
      as well as upon the energetic and structural parameters of the B/Z junctions,
      were investigated by using synthetic segments in which these motifs are coupled
      to a potentially Z-forming core. UV, CD, and 31P NMR studies of the salt-induced
      B to Z transition occurring in the various segments indicate that the transition
      is composed of two phases: a slow rate-determining induction of an initial
      structural deformation followed by a cooperative propagation of this "nucleus" in
      the form of a left-handed Z-DNA. The first phase is found to be crucially
      affected by the nature of the sequences coupled to the potentially Z-forming
      core. Thus, a higher rigidity of the flanking segments, such as that
      characterizing adenine tracts, is associated with higher energy values required
      for the induction of the initial conformational deformation, as well as with more
      defined structural parameters of the ultimate B/Z junctions. The second phase is
      affected mainly by the composition and sequence of the Z-forming segment. The
      observations that DNA conformational changes can be finely tuned and modulated by
      parameters pertaining to both the segment which undergoes the transition and the
      flanking sequences support the notion that DNA secondary motifs, such as the Z
      form and A-tracts, might be involved in the regulation of cellular processes.

PMID- 8463337
TI  - Cellular retinol-binding proteins are determinants of retinol uptake and
      metabolism in stably transfected Caco-2 cells.
AB  - The mammalian small intestine contains two related cellular retinol-binding
      proteins, CRBP and CRBP II, which are thought to have distinct functions. The
      human intestinal cell line, Caco-2, was used as a model system for testing the
      hypothesis that intracellular levels of these proteins directly modulate the
      absorption and subsequent metabolism of retinol in enterocytes. Immunoblot and
      Northern blot hybridization demonstrated that Caco-2 cells express CRBP II and
      cellular retinoic acid-binding protein I in increasing amounts as the cells
      become more differentiated but do not express detectable quantities of CRBP.
      Stably transfected cloned Caco-2 cell lines that over-express CRBP II or
      coexpress CRBP and CRBP II and a control cell line that contains the expression
      vector without an insert were established. Retinol uptake and retinyl ester
      synthesis were increased up to 2-fold by coexpression of CRBP or over-expression
      of CRBP II. No significant differences were detected in the pattern of retinyl
      esters synthesized from exogenous [3H]retinol. This suggests that the fatty acid
      pools utilized for retinol esterification were the same despite differences in
      the CRBP and CRBP II phenotype of the cell lines. There were no differences
      between apical and basolateral [3H]retinol uptake or metabolism for filter grown
      transfected or wild type cell monolayers. Thus, neither CRBP II nor CRBP appear
      to preferentially interact with luminal- or plasma-derived retinol. Notably, in a
      cell line which over-expressed CRBP, endogenous CRBP II was reduced by 5-10-fold
      compared with the wild type and control cell lines. These studies indicate that
      CRBP and CRBP II levels are determinants of intracellular retinol accumulation
      and esterification, and they suggest that CRBP-bound retinol or a metabolite can
      regulate the expression of CRBP II in the mammalian intestine.

PMID- 8463338
TI  - On the mechanism of the activation of human plasminogen by recombinant
      staphylokinase.
AB  - The mechanism of activation of human plasminogen by recombinant staphylokinase
      (STAR) was studied using the active site titrant p-nitrophenyl-p'
      guanidinobenzoate (NPGB). NPGB prevented active site exposure in equimolar
      mixtures of plasminogen and STAR but reacted stoichiometrically with mixtures
      preincubated in the absence of titrant. Active site generation occurred
      progressively, with a marked initial lag phase followed by an exponential growth
      phase, and was associated with the conversion of single-chain plasminogen to two
      chain plasmin. Incubation of mixtures of plasminogen and STAR with catalytic
      amounts (< 0.2% molar ratio) of preformed plasmin.STAR complex or of urokinase
      shortened the lag hase, whereas catalytic amounts (5% molar ratio) of the plasmin
      inhibitor alpha 2-antiplasmin delayed active site generation. The following
      kinetic model for the activation of plasminogen (P) by STAR (S) fits the
      experimental data, [formula: see text] and is described by [formula: see text] or
      [formula: see text] In this model, plasminogen and STAR produce an inactive
      complex (P.S), in which active plasmin.STAR (p.S) is generated in a rate limiting
      step, which is accelerated by plasminogen activators and delayed by plasmin
      inhibitors. At room temperature in a 0.1 M Veronal buffer, pH 8.3, containing 0.1
      M arginine, the data are adequately fitted by the integrated equation with k1 =
      4.0 x 10(-7) s-1 and k2 = 1.3 x 10(-2) microM-1 s-1. The k1 value could be
      explained by contamination of the plasminogen preparation with 3 ppm plasmin,
      converted by S to p.S. It is concluded that STAR activates plasminogen via a
      mechanism which differs in several essential aspects from that of streptokinase.

PMID- 8463339
TI  - G2 delay induced by nitrogen mustard in human cells affects cyclin A/cdk2 and
      cyclin B1/cdc2-kinase complexes differently.
AB  - We investigated the temporal regulation of cyclin A- and B1-dependent kinases in
      human lymphoma cells treated with nitrogen mustard (HN2) and pentoxifylline, to
      determine whether the activity of these complexes correlated with cell cycle
      arrest induced by DNA damage. Cells were synchronized in G1/S, treated with HN2,
      and then postincubated with pentoxifylline. HN2-induced a protracted delay in G2
      phase. This delay correlated with suppression of cyclin B1- and cdc2-kinase
      activities, and stabilization of hyperphosphorylated-cdc2 in the presence of
      similar cyclin B1 levels to those found in mitosis. HN2 had no discernible effect
      on the S phase activity of cyclin A- or cdk2-immune complexes. Entry of control
      cells into mitosis correlated with destruction of cyclin A, disappearance of
      cyclin A-bound cdk2 and decreased cdk2 kinase activity. G2 delay induced by HN2
      was associated with stabilization of cyclin A, increased abundance of cyclin A
      bound cdk2, and increased cdk2 activity. Cyclin A was also associated with cdc2,
      which, contrary to complexes containing cdk2, were only activated upon entry into
      mitosis. Pentoxifylline abrogated cell cycle arrest induced by aphidicolin and
      HN2 in human lymphoma cells. Pentoxifylline also reverted the activity of cyclin
      A- and B1-kinases in HN2-treated cells to approximately that observed in
      controls. Our findings suggest that delayed entry into mitosis following DNA
      damage correlates with suppression of cyclin B1/cdc2 and cyclin A/cdc2 complexes,
      while maintaining cyclin A/cdc2 complexes in an active state. Furthermore, we
      found that pentoxifylline disrupts the signal transduction pathway that regulates
      these complexes when damaged DNA is present, resulting in abrogation of cell
      cycle arrest.

PMID- 8463340
TI  - Characterization of the promoter-regulatory region and structural organization of
      E1 alpha gene (BCKDHA) of human branched-chain alpha-keto acid dehydrogenase
      complex.
AB  - We have isolated genomic clones containing the complete exon 1 and the promoter
      regulatory region of the E1 alpha gene (BCKDHA) of human branched-chain alpha
      keto acid dehydrogenase complex. The cloning was achieved by amplification of a
      genomic library in the SRB (P2) host strain that allowed the replication of
      nonstandard DNA structures. The results of this and previous (Dariush, N.,
      Fisher, C. W., Cox, R. P., and Chuang, D. T. (1991) FEBS Lett. 284, 34-38)
      studies showed that the human E1 alpha gene contains 9 exons, and spans at least
      55 kilobases (kb). Exon 1 is 135 bp in length, and contains multiple
      transcription initiation sites at bases +1, +18, and +22. The complete human E1
      alpha cDNA is, therefore, 1,758 bp in length excluding the poly(A)+ tail, and has
      27 nucleotides in the 5'-untranslated region. Sequencing of the 5'-flanking
      region disclosed the absence of a canonical TATA-box in the vicinity of base -30.
      Several sets of "CAAT" box-like sequences and Sp1 binding-sites are present. Also
      present are copies of potential AP-2 binding, fat-specific element 1, fat
      specific element 2, glucocorticoid-responsive element, and cAMP-responsive
      element sequences, as well as multiple sets of direct and inverted repeats. The
      promoter-regulatory region was characterized using deletion constructs and the
      luciferase reporter assay. The human hepatoma cells (Hep-G2) and Chinese hamster
      ovary (CHO) cell lines were used as hosts. The results obtained with Hep-G2 cells
      indicate that the region for high level transcription is located between bases 
      320 and -115. Extension of the 5'-end of the insert to beyond base -320 markedly
      reduces promoter activity. The results strongly suggest the presence of
      inhibitory elements in the region upstream of base -320. Assays in CHO cells show
      that the region for high level transcription lies between bases -909 and -115.
      The variation in the region for high level transcription in Hep-G2 and CHO cells
      may represent cell-type specific differences in the E1 alpha gene promoter
      function.

PMID- 8463341
TI  - Analysis of heat shock element recognition by saturation mutagenesis of the human
      HSP70.1 gene promoter.
AB  - We analyzed the human HSP70.1 gene promoter heat shock element by saturation
      point mutagenesis and performed quantitative assays of in vitro heat shock factor
      binding and of in vivo transcription activity in HeLa cells with this extensive
      set of mutants. These results showed a significant correlation between
      measurements of heat shock factor binding and heat-inducible expression and
      provided a detailed thermodynamic description of the preferred recognition
      consensus sequence. In particular, this work demonstrated that outer positions 1
      and 5 of the 5-base pair motif NGAAN, in addition to the most conserved triplet
      in the center, can have a strong influence on activity. Optimal activity occurred
      with the sequence AGAAC, and the levels of activity for all single base
      substitution variants were established. This analysis should be useful both for
      predicting the activity of potential heat shock element sequences near mammalian
      promoters and for interpreting structural features of protein-nucleic acid
      interactions in this system.

PMID- 8463342
TI  - Cytochrome P-450 55A1 (P-450dNIR) acts as nitric oxide reductase employing NADH
      as the direct electron donor.
AB  - Cytochrome P-450dNIR (P-450dNIR), involved in the fungal denitrification by
      Fusarium oxysporum, was purified to homogeneity. The cytochrome P-450 (P-450)
      exhibited a potent nitric oxide (NO) reductase activity to form nitrous oxide
      (N2O) employing NADH but not NADPH as the sole effective electron donor. The
      apparent maximum turnover rate against NO was estimated as high as 31,500 min-1.
      The stoichiometry of the reaction between NO:NADH:N2O was 2:1:1. The reaction
      required neither an artificial electron-carrying mediator nor other proteinaceous
      components. An anaerobic incubation of ferric P-450dNIR.NO complex, but not of
      free ferric P-450dNIR, resulted in rapid reduction of the P-450, indicating that
      P-450dNIR.NO complex was reduced directly by NADH. Spectral changes during
      catalytic turnover indicated that decomposition of the ferrous P-450.NO complex
      might be rate-limiting. The reaction was not inhibited by carbon monoxide at all,
      suggesting that the free ferrous P-450 is not formed during turnover. On the
      basis of these results a possible reaction mechanism was considered. The present
      results demonstrated not only the unique reaction catalyzed by P-450, but also
      the first P-450-dependent reaction where the electron transport from NAD(P)H to P
      450 is not supported by other components. Now that the physiological function of
      P-450 55A1 (P-450dNIR) has been found, we propose to alter the trivial name to P
      450nor.

PMID- 8463343
TI  - Recombinant laminin G domain mediates myoblast adhesion and heparin binding.
AB  - A recombinant mouse cDNA fragment encoding the G domain of the basement membrane
      laminin A chain was inserted into the eukaryotic baculovirus expression vector
      pVL1392 modified to produce fusion proteins carrying the rat fibronectin signal.
      G domain, expressed and secreted as a soluble glycoprotein (rG), was purified to
      near homogeneity without denaturing conditions. By electron microscopy rG
      possessed the same globular morphology as found in laminin. rG was cleaved with
      elastase into two fragments, rG70 and rG50. The latter fragment possessed the
      identical N terminus as laminin fragment E3 and both shared the same secondary
      structure by circular dichroism. rG, and rG containing a deletion (residues 2980
      3028) rich in basic residues bound to heparin with similar avidity. rG also
      promoted mouse C2 myoblast cell adhesion and spreading, and evaluation of
      myoblasts on rG70 and rG50 further revealed that cell spreading was an activity
      confined to the more proximal sequence of rG70. Antibody specific for rG70
      completely blocked cell adhesion to intact laminin in contrast to antibody
      specific for E3. Finally rG did not inhibit laminin polymerization. These data
      support the role of G domain in cell and heparin binding, but not laminin self
      assembly, and the approach provides a means to further characterize these
      functions.

PMID- 8463344
TI  - Regulation of tissue-specific splicing of the calcitonin/calcitonin gene-related
      peptide gene by RNA-binding proteins.
AB  - Transcripts of the rat calcitonin/calcitonin gene-related peptide (CGRP) gene are
      alternatively spliced in a tissue-specific manner resulting in the production of
      calcitonin mRNA and peptide in thyroid C cells and CGRP mRNA and peptide in
      neurons. Transfection studies using calcitonin and chimaeric human beta
      globin/calcitonin exon minigene constructs showed that the splice acceptor and
      exon specific to calcitonin mRNA are spliced much less efficiently in CGRP
      producing cells (F9 teratocarcinomas) than in cells that preferentially make
      calcitonin (HeLa cells). In vitro splicing of chimaeric human beta
      globin/calcitonin transcripts in HeLa nuclear extracts were inhibited by the
      addition of nuclear extract from CGRP-favoring cells or tissues such as rat
      brain. This inhibition was specific as splicing of human beta-globin first intron
      transcripts was not affected by comparable amounts of rat brain extract.
      Fractionation of rat brain nuclear extracts allowed the partial purification of
      two brain-specific polypeptides of apparent molecular mass of 43 and 41 kDa which
      preferentially bind RNA containing the calcitonin-specific splice acceptor. Since
      these polypeptides cofractionate with the calcitonin mRNA-specific splicing
      inhibition activity, we suggest that they may mediate the inhibition of splicing
      observed in vitro and underlie, in part, the inefficient calcitonin mRNA
      production observed in CGRP-favoring cells in vivo.

PMID- 8463345
TI  - Expression of human platelet glycoprotein Ib alpha in transgenic mice.
AB  - Platelets are cytoplasmic fragments of megakaryocytes and, therefore, their
      membrane proteins cannot be manipulated by expression methods in culture. To
      overcome this limitation, we have expressed human glycoprotein (GP) Ib alpha in
      transgenic mouse megakaryocytes and found that it was present on the surface of
      platelets associated with the mouse GP Ib beta subunit. This finding demonstrates
      that assembly of the heterooligomeric GP Ib complex occurs through mechanisms
      conserved across species. In contrast, the receptor function of GP Ib exhibited
      restricted species specificity, since only the chimeric complex containing human
      GP Ib alpha bound human von Willebrand factor and supported platelet aggregation
      mediated by ristocetin. These studies demonstrate the transgenic engineering of a
      platelet adhesion receptor under control of the human GP Ib alpha promoter and
      illustrate a new approach to manipulate platelet receptors and study structure
      function relationships in hemostasis and thrombosis.

PMID- 8463346
TI  - Tissue reaction to alumina implants inserted into the tibiae of rats.
AB  - We examined the tissue reaction to three alumina implants--single-crystal alumina
      (SA), dense polycrystal alumina (DPA), and porous polycrystal alumina (PPA)-
      inserted transcortically, extending into the medullary canal of rat tibiae, and
      assessed the quantitative differences in bone reaction using an image processing
      system. There was no difference in the degree of maturation of newly formed bone
      around the three kinds of alumina. SA and DPA were encapsulated with a continuous
      bone layer, but some bone tissue was attached focally around PPA. Bone trabeculae
      in the control site diminished in size and number chronologically. Multinucleated
      giant cells were observed on the surface of DPA and PPA, but not on SA.
      Tabulation of the quantitative evaluation indicated that SA showed the highest,
      DPA a lower, and PPA the lowest in bone contact rate, bone contact thickness, and
      bone contact area. These data suggest that SA is superior to the other two as an
      implant material.

PMID- 8463347
TI  - Guided bone tissue elaboration by osteogenic cells in vitro.
AB  - Primary rat bone marrow cells were cultured for 2 weeks in polystyrene dishes
      whose surfaces had been roughened using 600- or 320-grit silicon carbide paper.
      Eight samples were prepared of each of the three groups of dishes, to include a
      nontreated control surface. Following the culture period, the dishes were stained
      by von Kossa's method. The distribution of bone formed during the culture period
      was examined by light microscopy and the area of bone formed quantified. Results
      demonstrated that both the amount and spatial distribution of bone were
      influenced by the roughness of the underlying substratum. Differences between the
      smooth and roughened surfaces were statistically different at P < .05.

PMID- 8463348
TI  - Plasma protein adsorption to hemodialysis membranes: studies in an in vitro
      model.
AB  - Upon interaction of whole blood with foreign materials, heterogeneous protein
      films are deposited onto the artificial surface (eg, hemodialysis membranes). The
      composition of these protein films subsequently affects various processes, eg,
      thrombogenesis or activation of the complement system. We developed an in vitro
      model with which we can identify and study proteins interacting with capillaries
      during hemodialysis. Using this model we studied the cuprophane dialyzer GFS 120
      (CP) and the polymethylmetacrylate membrane Filtryzer B2-1.2 (PMMA). Heparinized
      whole blood from healthy young volunteers was dialyzed on an extracorporeal
      dialysis machine. After the dialysis procedure the adsorbed material was eluted
      from the hemodialysis membranes by different eluants and subsequently analyzed by
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and
      immunoblotting. A number of proteins could be identified in the eluates of both
      membrane types. Interestingly, platelet glycoproteins could only be found in PMMA
      eluates. Albumin, IgG, and antithrombin III were mainly present in the cuprophane
      eluates. Fibrinogen was demonstrable in all eluates, but in relatively low
      amounts, and the protein was significantly degraded. Degradation products of
      antithrombin III and complement factor 3 could also be identified. The process
      causing the degradation has not yet been identified, but may be due to proteases
      released from damaged cells.

PMID- 8463349
TI  - Attachment and proliferation of bovine aortic endothelial cells onto additive
      modified poly(ether urethane ureas).
AB  - To better understand endothelial cell interactions with poly(ether urethane urea)
      (PEUU) materials, and to assess bovine aortic endothelial cell attachment, films
      were incubated for 24 h with BAEC in media containing 5% fetal bovine serum.
      Other films were allowed to incubate for 4 more days in media containing 5% fetal
      bovine serum without cells to assess BAEC proliferation. The assay was performed
      on PEUU films modified with acrylate and methacrylate polymer and copolymer
      additives that spanned a wide range on the hydrophobicity/hydrophilicity scale.
      Tissue culture polystyrene (TCPS) was used as a control. The assay showed that
      PEUU films loaded with Methacrol 2138F [copoly(diisopropylaminoethyl methacrylate
      [DI-PAM]/decyl methacrylate [DM]) (3/1)] or with its hydrophilic component,
      DIPAM, in homopolymer form (i.e., h-DIPAM), significantly enhanced BAEC
      attachment (approximately 80% of TCPS values) and proliferation (approximately
      80%) when compared to unloaded PEUU films (attachment 73%; proliferation, 47%) or
      to PEUU films loaded with the more hydrophobic acrylate or methacrylate polymer
      additives (attachment, 32-69%; proliferation, 18-57%). The assay also showed that
      PEUU films coated with homopoly(diisopropylaminoethyl acrylate) (h-DIPAA)
      significantly enhanced BAEC attachment and proliferation when compared to PEUU
      films coated with h-decyl acrylate (h-DA); films coated with the copolymer of
      these two acrylates (i.e., co-[DIPAA/DA] [3/1]) showed intermediate behavior. To
      explain the enhancement of BAEC interaction with films loaded with Methacrol
      2138F or h-DIPAM, when compared to unmodified PEUU films or to PEUU films loaded
      with more hydrophobic acrylate and methacrylate polymer additives, it was assumed
      that the additives near the surface region of the solvent swollen PEUU matrix may
      have migrated to, or near to, the PEUU-air interface during film formation,
      creating an additive enriched PEUU surface region. It is suggested that, once at
      this surface region, dynamic reorientation in response to an aqueous medium
      ensured the additives were able significantly to influence protein adsorption,
      and concomitant endothelial cell behavior, but only if they interacted with
      aqueous media more favorably than the PEUU. The ability of Methacrol and h-DIPAM
      additives to enhance endothelial cell behavior is argued to be the result of
      increased hydrophilicity. This is the result of exposed, hydrogen-bonding DIPAM
      moieties and increased surface flexibility, which is itself due to the hydration
      of unhindered Methacrol chains, which may create an additive enriched PEUU-water
      interfacial zone.

PMID- 8463350
TI  - Patency and blood flow in gas denucleated arterial prostheses.
AB  - Biomaterials exposed to blood often fail due to thrombosis. Gas nuclei (air) in
      the material are thrombogenic and a potential cause of failure. The effects of
      gas nuclei on patency and blood flow were studied in 4 mm diameter arterial
      grafts (Gore ePTFE; Johnson and Johnson Vitagraft ePTFE; Bard ACG EXS) in the
      femoropopliteal position of dogs. Control and denucleated (air-free) grafts were
      implanted bilaterally. Grafts were denucleated by immersion in degassed saline
      and exposure to 4 torr vacuum and 3,000-20,000 psig pressure. Graft patency was
      determined at harvest in 46 dogs. Blood flow was measured with acoustic flow
      probes in eight dogs. Denucleated graft patency was 60% after 2 days of implant
      while control patency was 22% (P < .05). Measured blood flow was higher in
      denucleated grafts than in control grafts (P < .02) in 4 of 5 dogs which had
      significantly different flows. Patency and flow decreased to zero for both
      control and denucleated grafts over periods of up to 80 days. Air in the control
      grafts may have been absorbed within several days, leading to late similarity
      with the denucleated grafts. Thus, removing the air from 4 mm ePTFE grafts
      decreased acute thrombosis and increased the patency.

PMID- 8463351
TI  - Protein adsorption and endothelial cell attachment and proliferation on PAPI
      based additive modified poly(ether urethane ureas).
AB  - To better understand vascular interactions with poly(ether urethane urea) (PEUU)
      materials, protein adsorption, and endothelial cell attachment and proliferation
      assays were performed on a base PEUU formulation, on PEUU formulations loaded
      with hydrophobic and amphiphilic poly(methylene-[polyphenyl isocyanate]) (PAPI)
      based additives, and on PEUU formulations in which some of the polymer chains had
      been endcapped with either diisopropylaminoethyl (DIPAA) or decyl (DA) moieties.
      Protein adsorption experiments with PAPI-based additives showed that additive
      loaded PEUU formulations adsorbed significantly lower amounts of the studied
      proteins than did the unloaded PEUU. Protein adsorption to the DA and DIPAA
      endcapped PEUU films was found not to vary consistently from that of the unloaded
      PEUU film. Endothelial cell attachment and proliferation experiments with PAPI-DA
      and polyethylene glycol-PAPI-DA (PEG-PAPI-DA) loaded PEUU films showed that many
      of the films exhibited attachment and proliferation that was significantly
      enhanced compared to PEUU A' and that approached or equaled that of the tissue
      culture polystyrene control. Experiments with PAPI-DIPAA and PEG-PAPI-DIPAA
      loaded PEUU films exhibited attachment and proliferation data that was often
      below 10% of the tissue culture polystyrene control values. Experiments with the
      DA and DIPAA endcapped PEUU films showed endothelial cell attachment and
      proliferation that was statistically indistinguishable from the PEUU A' values.
      Contact angle analysis was carried out on the endcapped PEUU films, on the PAPI
      based additive loaded PEUU films, and on PEUU A' using the sessile drop method.
      The advancing and receding contact angle behavior of the PAPI-based additive
      loaded PEUU films deviated markedly from the behavior of PEUU A', suggesting that
      the additives were present at the PEUU-water interface. The contact angle
      behavior of the endcapped PEUUs was similar to that of PEUU A', suggesting that
      the DA and DIPAA endcap moieties did not exist at the hydrated PEUU surface in
      appreciable quantities. To explain the differences in protein adsorption and
      endothelial cell behavior on 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.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463352
TI  - Human umbilical vein endothelial cell culture on heparin-like microcarriers.
AB  - Biospecific functional polymers, i.e., polymers randomly substituted with
      specific chemical functional groups, were designed to interact with living
      systems. Interactions between polystyrene sodium sulfonate (PSSO3Na) and insulin
      secreting RINm5F cells have been previously described. For the sake of
      comparison, interactions of PSSO3Na with human umbilical vein endothelial cells
      (HUVEC) were studied. In this case, the interaction is indirect, i.e., mediated
      by a binding protein, fibronectin (Fn). This was evidenced by HUVEC culture on Fn
      precoated PSSO3Na microcarriers. The interactions between PSSO3Na and HUVEC
      result in a biologically normal proliferation of cells and synthesis and
      secretion of Von Willebrand Factor (VWF). These results show that different
      biospecific interactions may occur between cells in culture, binding proteins and
      polymers randomly substituted with suitable functional groups. HUVEC, when
      cultured on heparin-like microcarriers, behave differently from other cells like
      RINm5F, whose interaction with the same polymers is not mediated by binding
      proteins.

PMID- 8463353
TI  - Toxicity of L-ascorbic acid to L929 fibroblast cultures: relevance to
      biocompatibility testing of materials for use in wound management.
AB  - Fibroblast cultures are often used to evaluate materials intended for medical
      use, cytotoxicity being taken as an indicator of bioincompatibility. Such an
      approach has previously been taken with ascorbic acid in determining its value in
      wound healing. We have now reexamined the toxicity of L-ascorbic acid to L929
      fibroblast cells in culture. Concentrations of ascorbic acid between 0.5 mM and
      11 mM were tested. At concentrations above 2 mM, ascorbic acid was found to
      inhibit cell proliferation, with cell viability decreasing as the concentration
      was increased. This effect could be prevented by the addition of either
      superoxide dismutase or catalase to the culture medium. Assays of glutathione and
      glutathione disulfide were carried out on 8 day old cultures exposed for 24 h to
      the same concentrations of ascorbic acid. A dose-related depletion of glutathione
      occurred whilst glutathione disulfide levels remained essentially constant.
      Lactate dehydrogenase and glucose-6-phosphate dehydrogenase activities were
      induced by ascorbic acid at all concentrations tested but the ratio of NADP to
      NADPH nevertheless increased as the concentration of ascorbic acid increased.
      Finally, ATP in cells from 8-day-old cultures became depleted in the presence of
      ascorbic acid at concentrations in excess of about 5 mM when assayed after 24 h
      incubation. These biochemical changes and the concomitant cytostatic/cytotoxic
      effects may be ascribed to the reactive oxygen species produced by the
      autoxidation of ascorbic acid in the culture medium. Ascorbic acid breakdown
      products appeared not to be directly involved. In addition, our results suggested
      that superoxide acted cooperatively with hydroxyl to elicit these effects on the
      fibroblasts. It is evident from this study that the microenvironment surrounding
      fibroblasts in culture may differ fundamentally from that surrounding fibroblasts
      in a healing wound, making it impossible to extrapolate directly to an in vivo
      situation and hence to make any recommendations from these results concerning the
      use of ascorbic acid in wound healing.

PMID- 8463354
TI  - Effect of interfacial variables on metal-porcelain bonding.
AB  - While ceramic-to-metal bonding has been used in many applications, the actual
      chemical and physical factors leading to optimum bond strength are not well
      understood. In this work, several variables affecting the bonding between dental
      porcelain and a palladium alloy (85% Pd, 10% Cu, and 5% Ga) were investigated: 1)
      precoating the metal by sputtering various oxides before porcelaining; 2)
      peroxidation of the metal base before porcelaining; 3) porcelaining under
      reducing atmosphere; and 4) surface roughening at controlled levels before
      porcelaining. Using a modification of the push doughnut shear bond strength test
      to measure bond strength the following results were obtained. 1) Compared with
      standard "control" samples, the aluminum oxide precoated specimens showed a bond
      strength improvement of 46%, while the copper, manganese, and tin oxide
      precoatings exhibited smaller effects. 2) Preoxidation of the metal base led to
      pronounced bond strengthening (152%) by surface roughening as well as oxide
      formation. 3) Porcelaining under a reducing atmosphere severely reduced bond
      strength (88% lower than the controls) indicating the role of oxidation during
      the standard firing cycle. 4) Mechanical roughening of the surface by controlled
      amounts gave pronounced improvements with greater notch depth. Coarse roughening
      produced the highest bond strength improvements (486%).

PMID- 8463355
TI  - Phase studies of a urethane model compound and polyether macroglycols by infrared
      spectroscopy and the relationship between eutectic composition of soft segment
      and blood compatibility.
AB  - The binary mixtures of a urethane model compound, diethyl 4,4'-methylenebis(N
      phenylcarbamate) (MDU), and various polyether macroglycols have been investigated
      mainly by infrared (IR) spectroscopy. The mixtures of macroglycol and MDU showed
      two C=O bands (free C=O at higher wave number, hydrogen bonded C=O at lower wave
      number), and the intensity of free C=O increased while that of hydrogen bonded
      C=O decreased linearly with increasing molar ratio of macroglycol/MDU. The slope
      of the increase or decrease suddenly changed at the specific molar ratio around
      the eutectic composition. The eutectic molar composition for PTMO1000/MDU was
      determined as 1.15 or 1.1 by differential scanning calorimetry (DSC) or infrared
      (IR) studies while that for PTMO3000/MDU as 0.345 or 0.55 by DSC or IR,
      respectively. The eutectic compositions for other sets were determined by IR
      studies as follows: PEO1000/MDU, 0.4; PEO3000/MDU, 0.16; PPO1000/MDU, 1.4;
      PPO3000/MDU, 0.45. The number of ethylene oxide, tetramethylene oxide, and
      propylene oxide units to form a eutectic with MDU calculated from these values
      were 15-20, 10-11, and 23-24, respectively. The similar DSC or IR changes were
      observed in the various kinds of polyurethanes such as MDI/BD, MDI/PTMO/BD, and
      MDI/PTMO polymers. The relationship between the eutectic compositions of soft
      segments (MDI/macroglycol) and the ideal Mn of the macroglycols in blood
      compatibility of segmented polyurethanes are discussed.

PMID- 8463356
TI  - Evaluation of a relationship between polymer bulk hydroxyl and surface oxygen
      content and in vitro serum-material interaction.
AB  - To evaluate serum-material interaction for six types of minimodule and to assess
      the relationship between the interaction and chemical composition, notably bulk
      polymer hydroxyl (-OH) percent of polymer, or surface oxygen (SO) percent,
      polymeric membranes with varying -OH and SO percents were evaluated with normal
      human serum. The membrane materials (-OH percent and SO percent) evaluated
      included polypropylene (PP; 0% and 1.9%), polyvinyl alcohol (PVA; 23.7% and
      27.3%), ethylene vinyl alcohol (EVAL 4A and D; 30.4% and 25.3%), Cuprophan (CP;
      31.5% and 37.4%), and Hemophan (HP; 30.9% and 23.6%), respectively. Data from
      serum perfusions expressed as percent changes to sham perfusion showed that
      solute percent decreases were less than 10% in all materials except PVA (10-22%).
      PVA and CP had higher C3a, C4a, and C5a, and C3a concentration increases, and had
      larger suppressive effects for all three mitogen-induced mononuclear cell
      transformation functions (MNCTF) and concanavalin A-induced MNCTF, respectively.
      PVA had higher SO percent than EVAL and CP was higher than HP, despite PVA and CP
      having lower or comparable bulk -OH percent to EVAL or HP. The results obtained
      in the serum material interaction studies related more with the SO percent of the
      polymer rather than bulk -OH percent. The differences for C4a and PHA-induced
      MNCTF observed between the two EVAL membranes may be associated with
      significantly different pore size and therefore different surface structural
      properties. These results suggest that surface chemical (SO percent on the
      materials) and structural property analyses are important factors in
      biocompatibility parameter studies.

PMID- 8463357
TI  - The interesting patient.

PMID- 8463358
TI  - Skin lesion in an acutely ill man with HIV.

PMID- 8463360
TI  - Fatigue and edema in steroid therapy.

PMID- 8463359
TI  - Diagnosis and management of neurocysticercosis.
AB  - Long endemic in developing countries, cysticercosis is surfacing in the United
      States. Diagnosis of CNS involvement has been aided by laboratory and radiologic
      advances. Anthelmintic agents add to treatment options.

PMID- 8463361
TI  - Drug-induced renal disease.
AB  - Many pharmacologic agents affect the kidney, but special attention should be paid
      to four classes: aminoglycoside antibiotics, radiocontrast agents, ACE
      inhibitors, and NSAIDs. Iatrogenic complications associated with these agents
      include acute renal failure, acute interstitial nephritis, and prerenal failure,
      which are frequently reversible with early diagnosis.

PMID- 8463362
TI  - The kindly Dr. Guillotin.

PMID- 8463363
TI  - A prescription for national health care reform.
AB  - Insurance systems for controlling costs--quality assurance, preadmission
      clearance, length-of-stay control--actually add to costs, and also subtract from
      the quality of patient care. Step one: Eliminate those systems.

PMID- 8463364
TI  - Syncope, wide mediastinum, and pericardial effusion.

PMID- 8463365
TI  - Current understanding of Lyme disease.
AB  - It is now the most common vector-borne disease in the United States. But because
      of misdiagnosis, the spread of this disease may also be more apparent than real.
      Lack of standardized serologic tests and varying clinical presentations do create
      confusion. Nevertheless, it is possible to distinguish Lyme disease from look
      alike disorders, such as chronic fatigue syndrome and fibromyalgia.

PMID- 8463366
TI  - Cytokines and cancer cachexia.
AB  - A by-product of cancer (and of other chronic diseases or severe trauma), cachexia
      appears to be mediated by various cytokines. The first to be identified--tumor
      necrosis factor--may be a principal mediator. With molecular cloning techniques,
      future treatment strategies could include blockade of TNF activity using highly
      specific reagents.

PMID- 8463367
TI  - Back pain in the elderly patient.

PMID- 8463368
TI  - Annotation: autism, executive functions and theory of mind: a neuropsychological
      perspective.

PMID- 8463369
TI  - Mental development in late infancy after prenatal exposure to benzodiazepines--a
      prospective study.
AB  - Seventeen infants born to mothers who used benzodiazepines (BZD) throughout
      pregnancy were followed prospectively and compared with 29 infants born to
      mothers who had not used psychoactive substances. On the Griffiths' Developmental
      Scale, the BZD-exposed infants demonstrated consistently lower mean GQs and DQs
      for all subscales at 5, 10 and 18 months of age. The differences in GQ reached
      statistical significance at 10 and 18 months. The DQs differed significantly for
      all subscales at 10 months and for the personal-social behaviour and hearing and
      speech subscales at 18 months of age. We suggest that prenatal exposure to BZD
      may cause a general delay in mental development up to 18 months of age.

PMID- 8463370
TI  - A cross-national prevalence study of children with emotional and behavioural
      problems--a WHO collaborative study in the Western Pacific Region.
AB  - Emotional and behavioural problems in primary school children were investigated
      with Rutter's questionnaires, in Japan (N = 2638), China (N = 2432) and Korea (N
      = 1975). The prevalence rates of children with deviant scores on the teachers'
      and parents' scales were 3.9 and 12.0% in Japan, 8.3 and 7.0% in China and 14.1
      and 19.1% in Korea, respectively. Deviance of the antisocial type was more
      frequent than the neurotic type in Japan and China. Both types were almost
      equally frequent in Korea. The prevalence of deviance was higher in boys, and
      also higher in those children with poor school achievement. In China and Korea,
      the prevalence was higher in children from one-parent families. Although other
      family background factors had major effects on deviant behaviour in these two
      countries, the number of siblings and birth order had only a limited effect on
      the deviant behaviour of children in Japan, China and Korea.

PMID- 8463371
TI  - Psychiatric disorders in Japanese secondary school children.
AB  - Approximately 2000 ordinary secondary school children were investigated using
      screening methods such as the Rutter teacher's and parent's questionnaires and a
      diagnostic interview. The prevalence estimate was 16% for the 12-13-year-olds and
      14% for the 14-15-year-old children. Disorders were identified in boys more often
      than in girls (boys: girls = 2.4:1, as the ratio of prevalence estimates).
      Emotional disorders were equally common in boys and girls. However, conduct
      disorders were found more frequently in boys (boys: girls = 7:1). Out of the
      children who were judged as having psychiatric disorders only one had received
      any professional help except from that given by teachers, regardless of severity.

PMID- 8463372
TI  - Behaviour and emotional problems in three-year-old children of Asian parentage.
AB  - Three-year-old Asian children in inner Birmingham were found to have a similar
      prevalence of behaviour and emotional disturbance to white English children. The
      Asian children had fewer sleep problems than the white and their mothers had less
      difficulty in controlling them. There was a difference in parental attitude to
      difficult behaviour between the two groups and also several differences in
      associated social variables. In both groups there was a high level of
      psychological distress in the mothers of the children with behaviour problems and
      to a lesser extent the fathers. Implications for service provision are discussed.

PMID- 8463373
TI  - Pride and mastery in children with autism.
AB  - The goal of this study was to compare expressions of pride and mastery in samples
      of preschool autistic, mentally retarded and normal children. A paradigm was used
      in which children completed developmentally appropriate puzzles, both with and
      without praise. Results indicated that compared to the other children, as many
      autistic children smiled upon completion of the task, but many fewer looked up to
      share their pleasure with the parent or experimenter or drew attention to the
      task. Moreover, significantly more autistic children showed avoidant responses,
      particularly in response to praise. These findings are discussed in terms of
      theoretical issues regarding the development of pride and mastery in children
      with significant social deficiencies.

PMID- 8463374
TI  - The Family System Test: differences in perception of family structures between
      nonclinical and clinical children.
AB  - Nonclinical respondents and psychiatric outpatients (N = 400) between the first
      and twelfth grades portrayed their families as they perceived them in typical and
      in conflict situations using the Family System Test (FAST), a figure placement
      technique that focuses on cohesion and hierarchy in the family. Results showed
      that typical representations were influenced by whether a respondent was a
      patient or not, but not by the type of mental disorder. Clinical respondents were
      less likely to represent their families as being either cohesive, moderately
      hierarchical or as having clear generational boundaries. In conflict
      representations, both clinical and nonclinical respondents indicated low cohesion
      in family patterns. Results were interpreted from a family systems approach as
      well as from a clinical perspective.

PMID- 8463375
TI  - The emotional impact of frightening stories on children.
AB  - This study of the impact of fairy tales examined catharsis vs repetition
      compulsion hypotheses. Children with high- or low-trait anxiety, aged 6-9 (n =
      132), listened either to a frightening story, a frightening-happy end story, a
      pause story (for measuring anxiety), or a neutral story. They were tested for
      state anxiety before and afterwards and their preference for a second hearing was
      evaluated. The procedure was repeated after three weeks. The findings show an
      increase in anxiety following the frightening story only. Preference and state
      anxiety correlated positively in the frightening story (repetition compulsion)
      and negatively in the pause story (catharsis). It was concluded that anxiety is
      elicited by the frightening elements of the story, rather than the unconscious
      symbolic content.

PMID- 8463376
TI  - The behaviour of 3-year-old children: prevalence and parental perception of
      problem behaviour: a research note.
AB  - A rating of parental concern was added to the Behaviour Checklist (BCL), which
      was then used as part of a Health Visitor administered routine developmental
      assessment of 1170, 3-year-old children. The overall prevalence of behaviour
      problems using a cut-off score of 10 was 10%, with 66% of parents having one or
      more concerns about their child. There were no sex differences. Parents of only
      children had more concerns on 6 of the 19 items even though their children
      behaved no differently from those with siblings. The usefulness of the BCL as a
      routine screening measure and the need to identify and address parental concerns
      at an early stage is discussed.

PMID- 8463377
TI  - Protein sorting by high-performance liquid chromatography. I. Biomimetic
      interaction chromatography of recombinant human deoxyribonuclease I on polyionic
      stationary phases.
AB  - Chromatographic separations can be tailored to exploit specific interactions
      between a stationary phase ligand and a protein structural feature of interest.
      Variations in this feature then form the basis for sorting a mixture of closely
      related proteins into defined subpopulations. This report describes the sorting
      of variants of recombinant human deoxyribonuclease I (rhDNase) that differ in the
      occurrence of deamidation at a single residue. rhDNase, an enzyme that non
      specifically hydrolyzes DNA, is glycosylated and exhibits considerable charge
      heterogeneity owing to the sialylation and phosphorylation of its N-linked
      oligosaccharides. This heterogeneity obscures the relatively subtle differences
      between deamidated and intact rhDNase, preventing separation on this basis in
      conventional ion-exchange HPLC. Published structural information on bovine DNase
      reveals that the analogous labile asparagine residue is involved in DNA binding,
      so stationary phases containing polyanionic ligands mimicking nucleic acids were
      employed to separate the deamidation variants of rhDNase. Electrostatically
      immobilized DNA, a "tentacle" cation exchanger (TCX) and immobilized heparin
      columns all resolved the deamidated and intact forms of rhDNase when operated at
      pH 4.5. The ligands of the TCX and heparin columns are sufficiently long,
      flexible and polyanionic to interact with rhDNase in a manner similar to DNA and
      to sort rhDNase variants on the basis of the charge difference of a single
      residue involved in that interaction. A non-hydrolyzable double-stranded
      oligonucleotide analogue of DNA was also synthesized and immobilized to an HPLC
      support. This column, operated at pH 6, where rhDNase is active, resolved the two
      isomeric products of deamidation of rhDNase, i.e., variants of the enzyme
      containing either aspartate or isoaspartate in lieu of asparagine at the
      deamidation site in rhDNase. This is the first reported separation of intact
      variants of a glycoprotein differing on the basis of these isomeric products of
      deamidation through the common cyclic imide mechanism.

PMID- 8463378
TI  - UV red fluorescence of Eubacterium lentum.
AB  - Twenty-nine clinical isolates of Eubacterium lentum and two type species were
      evaluated for the ability to fluoresce under UV light. Twenty-one of the 29
      isolates and both of the reference strains showed orange-to-red fluorescence.
      This fluorescence did not require blood or hemin in the culture media and did not
      fade upon air exposure. The fluorescent pigment, after extraction by 1 N NaOH,
      showed peak excitation at a wavelength of around 400 nm. The capacity of E.
      lentum to produce fluorescence may be a useful and time-sparing laboratory aid
      for its identification.

PMID- 8463379
TI  - Cellular fatty acid compositions of "Achromobacter groups B and E".
AB  - Strains of "Achromobacter groups B and E" were examined for cellular fatty acid
      (CFA) composition to evaluate their chemical relatedness to known bacterial
      species and groups. The CFAs were liberated from whole cells by base hydrolysis,
      methylated, and analyzed by capillary gas-liquid chromatography. The CFA profiles
      of the two groups were identical and were distinct from CFA profiles of all other
      bacteria we have previously tested. These data provide support for results from
      whole-cell protein pattern analysis and DNA-DNA and rRNA-DNA hybridization
      studies, which show that "Achromobacter groups B and E" are biotypes of a single
      new genus and species.

PMID- 8463380
TI  - Rapid and highly reproducible method for antifungal susceptibility testing of
      Aspergillus species.
AB  - A new method for determining the MICs for Aspergillus species with slant-shaking
      incubation is described. The method was rapid (24 h), produced sharp visual end
      points, and showed high reproducibility. Additionally, MICs measured by this
      method correlated well with, as well as were two- to sixfold lower than, those by
      a reference method.

PMID- 8463381
TI  - Comparison of the Seradyn Color Vue passive agglutination test and complement
      fixation for detection of Mycoplasma pneumoniae antibodies.
AB  - We compared traditional complement fixation (CF) with a new passive agglutination
      method, the Seradyn Color Vue (SCV) test (Seradyn, Indianapolis, Ind.), for
      detection of Mycoplasma pneumoniae antibodies in 170 stored serum samples. The
      SCV test was 90% sensitive in identifying as positive 27 of 30 CF high-titer (>
      or = 1:64) serum samples and 100% specific in identifying as negative 134 of 134
      CF low-titer (< or = 1:32) or negative (< 1:8) serum samples. The SCV test was
      technically undemanding, and it required no expensive equipment.

PMID- 8463382
TI  - Detection of Trichomonas vaginalis in pregnant women with the InPouch TV culture
      system.
AB  - Trichomonas vaginalis causes a common genitourinary infection which is frequently
      asymptomatic. At present, pregnant women are not usually screened for the
      infection unless they are symptomatic. In the present study, we screened and
      obtained samples for culture from all pregnant women attending a prenatal clinic
      with the InPouch TV culture system and compared results with those of standard
      culture in Diamond's medium and slide wet mount examination. The InPouch TV
      culture system was as reliable as Diamond's medium in detecting T. vaginalis and
      may be useful and effective in a pregnancy clinic setting.

PMID- 8463383
TI  - Detection of Mycobacterium tuberculosis DNA in clinical samples by using a simple
      lysis method and polymerase chain reaction.
AB  - We have evaluated the polymerase chain reaction for detection of Mycobacterium
      tuberculosis in clinical samples from patients with tuberculous infection. Two
      simple methods for mycobacterial DNA release have been compared: sonication and
      lysis with nonionic detergents and proteinase K. The more effective method was
      the enzymatic technique. By using this protocol with 75 specimens we detected M.
      tuberculosis DNA in all of the samples, whereas only 48 and 71 samples were
      positive by acid-fast staining and culture, respectively.

PMID- 8463384
TI  - The resurgence of tuberculosis: is your laboratory ready?

PMID- 8463385
TI  - Current practices in mycobacteriology: results of a survey of state public health
      laboratories.
AB  - Fifty-six state and territorial public health laboratories were surveyed to
      determine whether currently available rapid methods for the identification and
      drug susceptibility testing of Mycobacterium tuberculosis were being performed.
      Forty (71%) laboratories use fluorochrome rather than conventional basic fuchsin
      stains for screening clinical specimens for acid-fast bacilli. Of the 55
      laboratories that routinely culture for mycobacteria, 16 (29%) use the more rapid
      radiometric methods. Species identification of isolates is done by biochemical
      tests in 13 (23%) laboratories; 40 (72%) use nucleic acid probes, high
      performance liquid chromatography, or the BACTEC p-nitro-alpha-acetylamino-beta
      hydroxypropiophenone (NAP) test (rapid tests); 3 laboratories do not perform
      species identification. Drug susceptibility testing is performed with solid media
      by 36 of 45 (80%) laboratories, while the more rapid radiometric methods are used
      by 9 (20%) laboratories. Compared with the laboratories that use conventional
      methods, laboratories that use rapid methods report results more quickly: for
      species identification, 43 days (conventional) versus 22 days (rapid); for drug
      susceptibility testing, 44 days (conventional) versus 31 days (rapid) from
      specimen processing. Rapid technologies for microscopy and species identification
      are being used by many, but not all, state and territorial public health
      laboratories; however, most laboratories do not use the more rapid radiometric
      methods for routine culture or drug susceptibility testing of mycobacteria.
      Implementation of such rapid technologies can shorten turnaround times for the
      laboratory diagnosis of tuberculosis and recognition of drug resistance.

PMID- 8463386
TI  - Progress toward a simplified polymerase chain reaction and its application to
      diagnosis of tuberculosis.
AB  - The complexity, expense, and susceptibility to contamination of the polymerase
      chain reaction (PCR) are all issues which need to be overcome if PCR is to be
      used outside of research laboratories. We addressed these problems with respect
      to the diagnosis of tuberculosis. First, we simplified the procedure for
      extracting Mycobacterium tuberculosis DNA from sputum samples. Two methods of
      sample preparation were compared: the chaotrope-silica method and a novel, more
      simple chloroform method. Second, we developed a colorimetric method for product
      detection. This method was as sensitive and specific as agarose gel
      electrophoresis for detection of PCR product. By using a one-tube nested
      protocol, 5 to 50 genome equivalents of M. tuberculosis DNA were detected. The
      simplified colorimetric PCR was compared with microscopy and culture for
      detection of M. tuberculosis in clinical specimens of sputum. A total of 171
      sputum samples were investigated from 108 patients, 12 of whom were subsequently
      found to have tuberculosis by culture and/or microscopy. PCR of samples prepared
      by the chaotrope-silica method had a sensitivity of 75% and a specificity of 100%
      whereas PCR of samples prepared by the chloroform method had a sensitivity of 92%
      and a specificity of 99% when compared with the sensitivities and specificities
      of the combined classical microbiological methods for the diagnosis of
      tuberculosis. The simplified colorimetric PCR in combination with the chloroform
      sample preparation method was at least as sensitive as microscopy but had a
      greater specificity because samples with atypical mycobacteria were not detected
      by PCR. The sensitivity of the method for detection of smear-negative and
      extrapulmonary tuberculosis remains to be investigated.

PMID- 8463387
TI  - Detection of Helicobacter pylori in dental plaque by reverse transcription
      polymerase chain reaction.
AB  - To investigate whether the oral cavity is a potential reservoir and possible
      sanctuary for Helicobacter pylori, supragingival and subgingival plaques were
      analyzed by a Helicobacter genus-specific reverse transcriptase-polymerase chain
      reaction based on the sequence data of H. pylori 16S rRNA. The amplified 500-bp
      DNA fragment was identified by ethidium bromide staining after agarose gel
      electrophoresis and by Southern hybridization. Twenty-five dyspeptic patients
      were studied. Histologic examination of gastric biopsy specimens revealed that 18
      had H. pylori gastritis and 7 did not. For seven of the 18 (38.8%) patients with
      proven H. pylori gastritis, H. pylori was also identified in their dental plaque.
      None of the patients without H. pylori gastritis had H. pylori in their dental
      plaque. The detection of H. pylori in dental plaque suggests that this H. pylori
      colonization is not restricted to the gastric mucosa and that this ecological
      niche may serve as a possible sanctuary which may be responsible for
      reinoculation of the stomach after topical anti-H. pylori therapies such as
      bismuth.

PMID- 8463388
TI  - Comparison of the BacT/Alert pediatric blood culture system, Pedi-BacT, with
      conventional culture using the 20-milliliter Becton-Dickinson supplemented
      peptone broth tube.
AB  - The performance of the Pedi-BacT system, the BacT/Alert (Organon Teknika Corp.,
      Durham, N.C.) pediatric blood culture bottle, was compared with that of a
      conventional 20-ml supplemented peptone broth tube (Becton-Dickinson Corp.,
      Cockeysville, Md.) (BD system) in matched aerobic cultures. The tubes of the BD
      system were visually examined daily for 7 days and were subcultured during the
      first 24 h of incubation. Pedi-BacT cultures were mechanically agitated and
      continuously monitored for growth by the instrument. Of the 6,628 compliant
      pairs, 331 (5.0%) were positive in both systems, 220 (3.3%) were positive in the
      Pedi-BacT system only, and 170 (2.6%) were positive in the BD system only. One
      (0.02%) false-negative culture and 15 (0.2%) false-positive cultures occurred
      with the Pedi-BacT system while 20 (0.3%) false-negative cultures and 35 (0.5%)
      false-positive cultures occurred with the BD system. Of 288 clinically
      significant organisms detected in matched pairs from which a single isolate was
      recovered, 176 (61%) were recovered from both systems, 83 (29%) were recovered
      from the Pedi-BacT system only (P < 0.0001), and 29 (10%) were recovered from the
      BD system only. Members of the family Enterobacteriaceae (P < 0.01),
      miscellaneous nonfermenters (P < 0.05), and Candida spp. (P < 0.01) were isolated
      more frequently in the Pedi-BacT system than in the BD system. No significant
      difference in recovery of other organisms was found between the systems. The
      average time to detection for the Pedi-BacT system ranged from 11.5 h for
      streptococci to 29.7 h for enterococci, while that for the BD system ranged from
      20.3 h for streptococci to 66.4 h for some nonfermenters. The BacT/Alert system
      is a reliable, labor-saving alternative to conventional blood culture methods.

PMID- 8463389
TI  - Comparison of phage typing and DNA fingerprinting by polymerase chain reaction
      for discrimination of methicillin-resistant Staphylococcus aureus strains.
AB  - A typing procedure for methicillin-resistant Staphylococcus aureus (MRSA) based
      on the polymerase chain reaction (PCR) amplification of both mecA sequences and
      variable DNA sequences as present in the prokaryotic genome has been developed.
      Two primers based on the sequences of DNA repeats as discovered in gram-negative
      members of the family Enterobacteriaceae allow detection of variable regions in
      the genome of a gram-positive bacterium such as S. aureus, as does a newly
      described arbitrary primer. This procedure, enabling the detection of 23
      different genotypes in a collection of 48 MRSA isolates, was validated by
      comparisons with phage typing studies. It appeared that within the same group of
      isolates only 13 different phagovars could be identified. Combination of the
      results from both phage typing and genotyping allowed the discrimination of 34 of
      48 isolates. However, depending on the primer-variable complexity of the PCR
      fingerprints, which could also be modulated by combination of PCR primers, clear
      homologies between the groups defined by either phage typing or fingerprinting
      were observed. An analysis of an MRSA outbreak in a geriatric institution showed
      a collection of genetically homogeneous isolates. In agreement with phage typing,
      PCR fingerprinting revealed the identical natures of the MRSA strains isolated
      from all patients.

PMID- 8463390
TI  - Role of beta-hemolytic group C streptococci in pharyngitis: incidence and
      biochemical characteristics of Streptococcus equisimilis and Streptococcus
      anginosus in patients and healthy controls.
AB  - The biochemical characteristics and the isolation rates of the two Lancefield
      group C streptococcal species (S. equisimilis and S. anginosus) from patients
      with pharyngitis and asymptomatic controls were compared. Some 239 strains of
      beta-hemolytic group C streptococci were isolated from 1,480 patients (209
      strains) with pharyngitis and 227 controls (30 strains). A total of 44 strains
      displayed broad hemolysis, were Voges-Proskauer test negative, and produced
      glucuronidase. Some 72.7% of these strains also fermented ribose. A second group
      of 159 strains was Voges-Proskauer test positive and glucuronidase negative;
      98.8% also displayed minute hemolysis and only 3.7% fermented ribose. These two
      groups represent typical large-colony S. equisimilis and small-colony S.
      anginosus, respectively. A small number of strains (36 in total) exhibited
      intermediate characteristics; morphologically, all 36 strains resembled S.
      anginosus, but 6 strains biochemically resembled S. equisimilis. No strains of S.
      equisimilis fermented sorbitol (unlike S. zooepidemicus) and all fermented
      trehalose (unlike S. equi). The structural carbohydrate profiles of S.
      equisimilis and S. anginosus both included galactosamine (consistent with their
      being group C organisms), but the profiles were not distinguishable. In total,
      78.5% of strains from controls and 83.3% of strains from patients were determined
      to be the species S. anginosus. S. equisimilis was isolated from 3.0% of patients
      and 2.2% of controls, and S. anginosus was isolated from 11.1% of patients and
      11.0% of controls. Thus, S. equisimilis and S. anginosus are both members of the
      normal flora of asymptomatic individuals. The incidence and biochemical
      characteristics of these two species are similar in patients who are healthy and
      those who have disease. However, a companion article provides clinical evidence
      associating S. equisimilis (but not s. anginosus) with pharyngitis.

PMID- 8463391
TI  - Role of group C beta-hemolytic streptococci in pharyngitis: epidemiologic study
      of clinical features associated with isolation of group C streptococci.
AB  - All Lancefield group C beta-hemolytic streptococci isolated over 12 months from
      college students with clinical pharyngitis and age-matched healthy controls were
      identified. Clinical features of upper respiratory tract infection and pyogenic
      pharyngitis as well as colony counts were tabulated for each patient according to
      throat culture results. Of 1,480 patients, Lancefield group C Streptococcus
      equisimilis was isolated from 45 (3%) patients and Streptococcus anginosus
      ("Streptococcus milleri") was isolated from 164 (11.1%) patients. Patients from
      whom S. equisimilis was isolated had clinical features more suggestive of
      pyogenic infection than did patients from whom S. anginosus was isolated. Colony
      counts on primary throat culture plates from patients from whom S. equisimilis
      and Streptococcus pyogenes were isolated were higher than those from patients
      from whom S. anginosus was isolated. This study presents epidemiologic evidence
      supporting a role for S. equisimilis in causing pharyngeal infection and for S.
      anginosus as representing part of the normal oropharyngeal flora.

PMID- 8463392
TI  - Evaluation of immunoglobulin E-specific antibodies and viral antigens in
      nasopharyngeal secretions of children with respiratory syncytial virus
      infections.
AB  - Enzyme immunoassays were developed to detect the presence of specific
      immunoglobulin E (IgE) antibodies and respiratory syncytial (RS) virus structural
      proteins in nasopharyngeal secretions in order to improve the knowledge on some
      aspects of the pathogenesis of severe acute lower respiratory tract infections
      caused by RS virus. These assays were used to analyze clinical specimens from
      children with RS virus-associated infections (bronchiolitis and pneumonia), and
      the findings were correlated with the patients' clinical symptoms. The results
      indicate the presence of specific IgE against the two external glycoproteins (G
      and F) and the absence of detectable IgE levels for the internal viral antigens.
      There was a correlation between the levels of IgE-specific antibodies and the
      amount of viral protein F in the secretions, indicating that the IgE response
      against the viral glycoproteins might be related to the antigen load. In
      addition, a correlation was found between higher levels of both viral protein F
      specific IgE and F antigen with higher respiratory rates in children with
      pneumonia. These findings may be relevant because they suggest an association
      between the virus load and the immune response in the pathogenesis of RS virus
      infections.

PMID- 8463393
TI  - Effect of heterosubtypic immunity on infection with attenuated influenza A virus
      vaccines in young children.
AB  - Resistance to infection with an influenza A virus conferred by previous infection
      with an influenza A virus belonging to another subtype is called heterosubtypic
      immunity. Heterosubtypic immunity is demonstrable in laboratory animals but is
      believed to be weak in humans. The present study examined whether heterosubtypic
      immunity from previous influenza virus infection induced resistance to infection
      with an attenuated influenza A vaccine virus. Two groups of vaccinees consisting
      of young infants and children who received either influenza A H1N1 or H3N2
      attenuated virus were studied. Influenza A H3N2 virus vaccine recipients were
      classified by their preexisting H1N1 heterosubtypic antibody level induced by
      prior infection with wild-type virus, and the H1N1 vaccinees were classified by
      their history of infection with H3N2 vaccine virus. For both groups of vaccinees,
      the rates of seroconversion and virus shedding and the level of vaccine virus
      replication were compared in subjects with and without heterosubtypic immunity.
      In 48 influenza A H3N2 virus and 39 H1N1 virus vaccinees, heterosubtypic immunity
      had no demonstrable effect on infectivity, immunogenicity, or replication of
      attenuated vaccine virus. These observations confirm the weak nature of
      heterosubtypic immunity in humans and suggest that it will not limit the utility
      of live attenuated influenza A viruses in young infants and children.

PMID- 8463394
TI  - Novel, rapid optical immunoassay technique for detection of group A streptococci
      from pharyngeal specimens: comparison with standard culture methods.
AB  - A novel immunoassay system based on the changes in the reflection of light,
      termed an optical immunoassay (OIA), was utilized to directly detect group A
      streptococcal (GAS) carbohydrate antigen from clinical specimens. In two studies,
      a total of 1,275 throat swabs were tested for the presence of this antigen with
      the Strep A OIA rapid detection system and the results were compared with those
      of standard culture methods. In both studies, the Strep A OIA yielded more
      positive results than plating of the throat swab onto a selective agar,
      Trypticase soy agar containing sheep blood, or an enriched broth. In one study,
      the sensitivity and specificity of Strep A OIA compared with those of the broth
      enriched culture were 97.4 and 95.6%, respectively. In a second study a
      sensitivity of 98.9% and a specificity of 98.6% were achieved. It was also shown
      that the carbohydrate antigen could be detected in the absence of viable GAS
      organisms. The Strep A OIA is an easily interpretable method and was shown to be
      more sensitive than routine culture methods for detecting GAS infections directly
      from throat swabs.

PMID- 8463395
TI  - Evaluation of commercially available acridinium ester-labeled chemiluminescent
      DNA probes for culture identification of Blastomyces dermatitidis, Coccidioides
      immitis, Cryptococcus neoformans, and Histoplasma capsulatum.
AB  - Four commercially available acridinium ester-labeled DNA probes directed against
      rRNA were evaluated for their ability to identify Blastomyces dermatitidis,
      Coccidioides immitis, Histoplasma capsulatum, and Cryptococcus neoformans in
      culture. rRNA was extracted by sonication of 1- to 2-mm2 portions of cultures of
      fungi in two chaotropic reagents with glass beads. Following a heat inactivation
      step, the extracts were hybridized in solution with probes specific for each
      pathogen. The acridinium ester reporter moiety of nonhybridized probe was
      selectively hydrolyzed, and chemiluminescence of specific DNA:RNA hybrids was
      quantitated in relative light units with a luminometer. A positive identification
      required a relative light unit value of > or = 50,000. Sensitivity and
      specificity of the probes were determined by probing cultures of the respective
      pathogenic fungi (target) and nontarget fungi. Both mycelial and yeast forms of
      the dimorphic fungi (B. dermatitidis and H. capsulatum) were tested. For B.
      dermatitidis, sensitivity and specificity were 87.8 and 100%, respectively (74
      target and 219 nontarget fungi tested). For C. immitis, sensitivity and
      specificity were 99.2 and 100%, respectively (122 target and 164 nontarget fungi
      tested). For H. capsulatum, sensitivity and specificity were 100 and 100%,
      respectively (86 target and 154 nontarget fungi tested). For C. neoformans,
      sensitivity and specificity were 97 and 100%, respectively (100 target and 230
      nontarget fungi tested). For B. dermatitidis, C. immitis, and C. neoformans,
      repeat testing increased the respective sensitivities to 97.3, 100, and 100%. The
      high sensitivities and specificities of the probes, the relatively short time
      (less than 1 h) required to perform the assay, and the availability of
      standardized reagent kits make the acridinium ester-labeled DNA probes well
      suited to laboratories in need of a rapid method to identify these fungal
      pathogens. Further, use of the probes to identify pathogenic fungi as soon as
      colonies appear on primary recovery media significantly shortens the time to
      reporting.

PMID- 8463397
TI  - Computerized surveillance in clinical microbiology with time series analysis.
AB  - An automatic surveillance system to detect changes in the incidences of
      microorganisms diagnosed in the department of clinical microbiology has been
      developed. The program is incorporated into the laboratory computer system and
      gives a weekly list of microorganisms whose isolation rates compared with those
      of a previous period exceed a chosen limit. The system uses time series analysis
      with moving weighted averages, and the detection limit is based on the
      distribution of the residuals. Output from the system included information about
      potential outbreaks of gastroenteritis, nosocomial infection with Corynebacterium
      jeikeium, and a seasonal epidemic of respiratory syncytial virus. The system also
      listed organisms not commonly isolated in the laboratory and detected incorrect
      reports. We conclude that continuous surveillance of laboratory data with time
      series analysis is a valuable tool for epidemiologic surveillance and quality
      control. Large quantities of data may be screened.

PMID- 8463396
TI  - Characterization of enterotoxigenic Escherichia coli isolated from U.S. troops
      deployed to the Middle East.
AB  - Enterotoxigenic Escherichia coli (ETEC) was a common cause of traveler's diarrhea
      in U.S. soldiers in the Middle East in 1989 and 1990. To determine which
      bacterial components would be useful in a vaccine, potential protective antigens
      (toxin, colonization factor antigen [CFA], and serotype) from 189 ETEC isolates
      were examined. Nearly half of the isolates expressed both ETEC toxins, 39% had
      only heat-stable enterotoxin (ST), and 17% had heat-labile enterotoxin (LT).
      CFA/I was the least common colonization factor antigen (11%), CFA/II was common
      (34%), as was CFA/IV (31%), and 24% expressed none of these CFAs. Fifty-seven O:H
      serotypes were found. Serotype O6:H16 was the most common, occurring in 29% of
      the ETEC isolates, usually with LT-ST and CFA/II. Generally, CFA/II was
      associated with expression of both toxins, CFA/IV was associated with expression
      of ST, and none of the CFAs was routinely found with LT. We conclude that ETEC
      from soldiers in the Middle East expressed a variety of antigens and that an
      effective vaccine will require multiple protective antigens.

PMID- 8463398
TI  - Improved recovery of mycobacteria from respiratory secretions of patients with
      cystic fibrosis.
AB  - Pulmonary colonization and infection of patients with cystic fibrosis by
      Mycobacterium spp. has recently been recognized as a potentially important
      clinical problem. However, frequent contamination of mycobacterial cultures by
      pseudomonads has hampered efforts to define the extent of this problem. This
      study was done to evaluate current techniques and to establish a more efficient
      method of recovering mycobacteria from respiratory secretions of patients with
      cystic fibrosis. Decontamination of respiratory specimens (n = 121) with 0.25% N
      acetyl-L-cysteine and 1% sodium hydroxide (NALC-NaOH) was associated with a high
      rate of pseudomonas overgrowth for both Lowenstein-Jensen slants (74%) and BacTec
      vials supplemented with PANTA (polymyxin B [50 U/ml], amphotericin B [5
      micrograms/ml], nalidixic acid [20 micrograms/ml], trimethoprim [5
      micrograms/ml], azlocillin [10 micrograms/ml]) (36%). This overgrowth limited
      recovery of mycobacteria to only 64% (9 of 14) of specimens positive by smear for
      acid-fast bacilli (AFB). Decontamination of specimens (n = 441) with NALC-NaOH,
      followed by 5% oxalic acid treatment, resulted in contamination of only 5% of
      Lowenstein-Jensen slants and 3% of BacTec vials. AFB were recovered from all 90
      AFB smear-positive specimens following the use of this decontamination technique.
      We recommend that respiratory secretions be decontaminated with NALC-NaOH and
      oxalic acid to decrease the incidence of Pseudomonas aeruginosa overgrowth.

PMID- 8463399
TI  - Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus
      26 aerobic blood culture bottle, and 10-milliliter isolator blood culture system
      for detection of fungemia and bacteremia.
AB  - The BACTEC high-blood-volume fungal medium (HBV-FM) (Becton Dickinson Diagnostic
      Instrument Systems, Sparks, Md.) was compared with the Isolator (IS) tube and the
      BACTEC Plus 26 (BP26) blood culture bottle for the ability to recover fungi from
      the blood of adult patients suspected of having fungemia. A total of 6,836 blood
      culture sets that fulfilled criteria for inclusion in the study were received.
      Three separate comparisons were performed: 4,907 HBV-FM versus IS, 4,886 BP26
      versus HBV-FM, and 4,949 BP26 versus IS. For the HBV-FM versus IS comparison, 218
      isolates were recovered: 125 (57.3%) were bacteria and 93 (42.7%) were fungi. HBV
      FM was comparable to IS for recovery of yeasts, but IS was superior for recovery
      of Histoplasma capsulatum (25 versus 0 isolates recovered [P < 0.001]). Growth of
      Torulopsis glabrata was detected earlier (P < 0.05) in HBV-FM bottles. For the
      BP26 versus HBV-FM comparison, 229 isolates were recovered: 161 (70.3%) were
      bacteria, and 68 (29.7%) were fungi. HBV-FM was superior for recovery of T.
      glabrata (P < 0.025) and all fungi combined (P < 0.025). There were no
      statistically significant differences in the speed of detection of microbial
      growth. For the BP26 versus IS comparison, 251 isolates were recovered: 165
      (65.7%) were bacteria, and 86 (34.2%) were fungi. IS was superior for recovery of
      H. capsulatum (P < 0.001), T. glabrata (P < 0.05), and fungi other than H.
      capsulatum (P < 0.025). BP26 was superior for recovery of all bacteria combined
      (P < 0.001) and viridans group streptococci (P < 0.01). Growth of T. glabrata (P
      < 0.05) was detected earlier in IS tubes. Growth of Staphylococcus aureus (P <
      0.01), viridans group streptococci (P < 0.01), Pseudomonas aeruginosa (P < 0.05),
      and all microorganisms combined (P < 0.05) was detected earlier in BP26 bottles.
      For yeast, 57 of 59 (96.6%), 79 of 80 (98.7%), and 64 of 67(95.5%) were recovered
      from BP26 bottles, HBV-FM bottles, and IS tubes, respectively, by day 14; for H.
      capsulatum, 14 of 36 (38%) isolates were recovered from IS tubes by day 14. Mean
      times of recovery were similar for BACTEC bottles and IS. We conclude that (i)
      for recovery of fungi from blood cultures, HBV-FM is equivalent to IS (with the
      exception of H. capsulatum); (ii) for recovery of bacteria, BP26 is superior to
      IS; (iii) BP26 bottles are inferior to both HBV-FM bottles and IS tubes for
      recovery of T. glabrata; and (iv) HBV-FM bottles must be paired with another
      blood culture bottle or system to optimize detection of bacteremia.

PMID- 8463400
TI  - Determination of carbohydrate profiles of Bacillus anthracis and Bacillus cereus
      including identification of O-methyl methylpentoses by using gas chromatography
      mass spectrometry.
AB  - Bacillus anthracis and Bacillus cereus are closely related pathogenic organisms
      that are difficult to differentiate phenotypically or genotypically. It is well
      known that vegetative and spore forms of bacilli are quite distinct both
      morphologically and chemically, but spore-specific chemical markers allowing
      these species to be distinguished have not been previously described. By using
      gas chromatography-mass spectrometry, vegetative cells and spores of the two
      species were shown to exhibit distinct carbohydrate profiles. Profiles of
      vegetative B. anthracis typically contained high levels of galactose but did not
      contain galactosamine, whereas B. cereus contained galactosamine and generally
      low levels of galactose. Spore cultures exhibited unique carbohydrate profiles
      compared with those of vegetative cultures. B. anthracis spore profiles contained
      rhamnose alone, whereas B. cereus spore profiles contained rhamnose and fucose.
      Additionally, two spore-specific O-methylated methylpentoses were discovered.
      Both B. anthracis and B. cereus spores contained 3-O-methyl rhamnose, whereas B.
      cereus spores also contained 2-O-methyl rhamnose. Carbohydrate profiling is
      demonstrated to be a powerful tool for differentiating the two closely related
      species. Differentiation does not depend on whether organisms are in the
      vegetative or spore stage of growth.

PMID- 8463401
TI  - Evaluation of polymerase chain reaction amplification of Mycobacterium leprae
      specific repetitive sequence in biopsy specimens from leprosy patients.
AB  - Biopsy specimens were obtained from 102 leprosy patients before chemotherapy and
      examined by polymerase chain reaction (PCR) using the primers amplifying the 372
      bp DNA of a repetitive sequence of Mycobacterium leprae. The PCR results were
      then compared with bacterial indices (BI) of slit-skin smears and biopsy
      specimens. The intensities of DNA bands were in general correlated with the
      numbers of acid-fast bacilli, and even a sample with only one organism gave a PCR
      positive result. Ten 5-micron sections from each frozen tissue sample were pooled
      and processed for DNA preparation. PCR was positive for 11 (73.3%) of 15 biopsy
      specimens with BI of 0 determined for the paraffin sections from the same biopsy
      samples. PCR also gave positive results for 84 (96.6%) of 87 BI positive biopsy
      samples. Although the difference in overall results between the two methods was
      not statistically significant, PCR seemed to have an advantage over microscopic
      examination in detecting M. leprae in biopsy specimens negative for acid-fast
      bacilli. Further evaluation of PCR using more specimens from leprosy patients who
      are bacteriologically negative is warranted to ensure PCR's advantage over the
      conventional microscopic examination for the diagnosis of leprosy.

PMID- 8463402
TI  - Evaluation of commercial antisera for serotyping heat-labile antigens of
      Campylobacter jejuni and Campylobacter coli.
AB  - Commercial antisera for serotyping 22 heat-labile antigens of Campylobacter
      jejuni and Campylobacter coli were evaluated by using 66 isolates from human and
      nonhuman sources. Test results were compared with results of tests using antisera
      produced at the Centers for Disease Control (CDC), Atlanta, Ga. All strains
      (three isolates of each of the 22 serotypes) were typeable with the CDC antisera.
      Of 66 test strains, 39 (59%) were typed as the same serotype with both sets of
      antisera. Twenty-four strains (36%), including two heat-labile serotype reference
      strains, were nonreactive with the commercial antisera, and three strains (4.5%)
      were typed as serotypes different from those obtained with CDC antisera. Five of
      the 22 commercial antisera correctly serotyped all homologous strains. Our study
      indicated that two polyvalent antiserum pools, 7 unabsorbed antisera, and 16
      absorbed monovalent antisera are weak and need modification to enhance their
      antibody titers. Further studies are necessary to explain the antigenic change to
      a different serotype in three strains.

PMID- 8463403
TI  - Rapid, polymerase chain reaction-based identification assays for Candida species.
AB  - Polymerase chain reaction (PCR) amplification of specific regions in the genomes
      of a variety of lower eukaryotes permits rapid identification of these
      microorganisms. First, on the basis of the presence of both constant and variable
      regions in the small subunit (ssu) rRNA, a nested PCR for direct identification
      of various Candida species can be designed. Amplification of the entire ssu rRNA
      gene and subsequent reamplification of variable sequences within the V4 domains
      of these PCR products were combined with direct sequencing. Restriction enzyme
      maps were made, and species-specific oligonucleotides for hybridization analysis
      were selected. Unequivocal discrimination of four of the major human pathogenic
      yeasts (Candida albicans, Candida glabrata, Candida tropicalis, and Candida
      krusei) is possible if a combination of these techniques is used. Second, by
      using oligonucleotides aimed at repeated sequences which occur at dispersed
      positions in the genomes of all eukaryotes, species-specific DNA fingerprints
      could be generated. This interrepeat PCR using genomic DNA as template proved to
      be an effective tool in Candida species typing. Both techniques described here
      can be extrapolated to the high-speed diagnostics of numerous other prokaryotic
      and eukaryotic pathogens.

PMID- 8463404
TI  - Comparison of three enzyme immunoassays, a cytotoxicity assay, and toxigenic
      culture for diagnosis of Clostridium difficile-associated diarrhea.
AB  - Enzyme immunoassays (EIAs) based on monoclonal antibodies for the detection of
      Clostridium difficile toxins have recently been developed for clinical use. The
      aim of this study was to compare three commercially available EIAs, two for toxin
      A (Premier C. difficile Toxin A; Meridian, Osi, Elancourt, France; and Vidas C.
      difficile Toxin A; bioMerieux, Marcy l'Etoile, France) and one for toxins A and B
      (Cytoclone A + B EIA; Cambridge Biotech Corp., Codiapharm, Evian, France), with a
      cytotoxicity assay and toxigenic culture for the diagnosis of C. difficile
      associated diarrhea (CDAD). The study was performed with 285 fresh stools from
      285 patients with suspected CDAD. In case of disagreement, the tests were
      repeated on a frozen aliquot of the same stool sample, and the patient's chart
      was reviewed. CDAD diagnosis was established in 55 cases (incidence, 19.3%). The
      sensitivities and specificities of the methods were, respectively, 92.7 and 100%
      for the cytotoxicity assay, 96.4 and 99.1% for toxigenic culture, 75.5 and 97.8%
      for Cytoclone, 65.4 and 99.6% for Premier, and 65.4 and 100% for Vidas. The
      results were uninterpretable in 3.2% of cases with Cytoclone, 0.3% with Premier,
      and 2.5% with Vidas. We conclude that the cytotoxicity assay and toxigenic
      culture remain the best methods for the diagnosis of CDAD even though they lack
      standardization and require 48 to 96 h to obtain the result. Despite their
      rapidity and simplicity, EIAs are not sensitive enough to be relied on as the
      sole laboratory test.

PMID- 8463405
TI  - Rapid screening test for enterotoxin-producing Bacillus cereus.
AB  - Culture supernatants of 30 enterotoxin-producing Bacillus cereus isolates
      produced a characteristic progressive destruction of McCoy cell monolayers.
      Enterotoxin-negative B. cereus and other group 1 Bacillus spp. caused no
      monolayer disruption. The McCoy cell tissue culture system appears to provide a
      rapid screening assay for detection of enterotoxin-producing B. cereus.

PMID- 8463406
TI  - Random amplified polymorphic DNA assay is less discriminant than pulsed-field gel
      electrophoresis for typing strains of methicillin-resistant Staphylococcus
      aureus.
AB  - Twenty-six strains of methicillin-resistant Staphylococcus aureus with different
      pulsed-field gel electrophoresis fingerprints were tested by random amplified
      polymorphic DNA assay with three primers, resulting in 15 to 20 different random
      amplified polymorphic DNA fingerprints. By summing the results for the three
      primers, the number of different fingerprints increased to 25, but two strains
      could not be differentiated. We conclude that pulsed-field gel electrophoresis
      remains the best method of typing methicillin-resistant S. aureus strains.

PMID- 8463407
TI  - Mycobacteriosis due to Mycobacterium genavense in six pet birds.
AB  - Six cases of mycobacteriosis due to Mycobacterium genavense in three budgerigars
      (Melopsittacus undulatus), one orange-winged amazon (Amazona amazonica), one
      flycatcher (Cyanoptila cyanomelana), and one zebra finch (Taeniopygia guttata)
      are discussed. Gross lesions associated with the infection included a high degree
      of muscular wasting (five cases), hepatomegaly (four cases), and thickening of
      the wall of the small intestine (four cases). Granulomas were found in the lung
      (one case) and the subcutis (one case). Acid-fast bacilli were detected in the
      liver of all six birds. Only the use of acidic BACTEC mediums consistently led to
      growth, whereas the egg-based medium failed. These findings point to a possible
      role of the environment as a reservoir for M. genavense.

PMID- 8463408
TI  - Increased specificity of antibody detection in surgical patients with invasive
      candidiasis with cytoplasmic antigens depleted of mannan residues.
AB  - In this study, it was shown that the diagnostic accuracy of antibody detection by
      a counterimmunoelectrophoresis technique could be improved by using cytoplasmic
      antigens depleted of mannan residues. The specificity of the
      counterimmunoelectrophoresis increased from 28.6 to 78.6% when cytoplasmic
      antigens depleted of mannan were used, while the sensitivity slightly decreased
      from 80 to 70%.

PMID- 8463409
TI  - Detection of serum antibodies to Chlamydia trachomatis in patients with
      chlamydial and nonchlamydial pelvic inflammatory disease by the IPAzyme Chlamydia
      and enzyme immunoassay.
AB  - A novel serological test, IPAzyme Chlamydia (Savyon Diagnostics Ltd., Beer Sheva,
      Israel), was compared with an enzyme immunoassay (EIA) for the ability to detect
      serum immunoglobulin G and A antibodies in the diagnosis of acute chlamydial
      pelvic inflammatory disease. In comparison with cell culture, which is the "gold
      standard," IPAzyme Chlamydia and EIA exhibited sensitivities of 63 and 68% and
      specificities of 76 and 87%, respectively. Thus, IPAzyme Chlamydia offers no
      advantages over the EIA, and neither serological test can be recommended for the
      diagnosis of acute Chlamydia trachomatis infection. So far, conventional cell
      culture remains the most reliable diagnostic test for chlamydial pelvic
      inflammatory disease.

PMID- 8463410
TI  - How to tackle a possible Creutzfeldt-Jakob disease necropsy.

PMID- 8463411
TI  - ICSH recommendations for measurement of erythrocyte sedimentation rate.
      International Council for Standardization in Haematology (Expert Panel on Blood
      Rheology)
AB  - The Expert Panel on Blood Rheology of the International Council for
      Standardization in Haematology (ICSH) has prepared new recommendations for
      measurement of the erythrocyte sedimentation rate (ESR) under the following
      categories: 1. ICSH reference method-ICSH now recognises, as its reference method
      for the ESR, the sedimentation of EDTA-anticoagulated but undiluted blood in
      traditional Westergren pipettes that meet ICSH specifications. 2. ICSH
      standardised method-ICSH recommends specifications for a new standardised method
      for the ESR based on the sedimentation of EDTA-anticoagulated, but undiluted
      blood in pipettes with a 200 mm scale and which are designed to avoid spillage of
      blood or aerosol generation. This standardised method may be used for
      verification or quality control of other ESR methods and, in future, may replace
      the reference method. 3. ICSH selected methods-ICSH recommends specifications for
      working methods, using diluted or undiluted blood, which may be considered as
      ICSH selected methods for routine use. A protocol is outlined for evaluation of
      such working methods against the ICSH reference method or the new ICSH
      standardised method.

PMID- 8463413
TI  - Observer reliability in assessing villitis of unknown aetiology.
AB  - AIMS: To evaluate observer variation in diagnosis of villitis of unknown
      aetiology. METHODS: Fifty haematoxylin and eosin stained sections were circulated
      to three pathologists who were asked to assess if villitis was present. These
      slides, with an additional 20, were recirculated and reassessed by the same
      pathologists. RESULTS: Intra-observer agreement was 84.7% (range 74--92%) and
      interobserver agreement was 81%. A conjoint review by the three pathologists
      revealed that sources of differences included the overlooking of isolated single
      or small numbers of affected villi, the difficulty in assessing stromal
      cellularity close to infarcted parenchyma, and apparent stromal hypercellularity
      in immature villi. CONCLUSIONS: Experienced pathologists can show a significant
      interobserver variation in assessing villitis of unknown aetiology. Future
      studies on villitis of unknown aetiology should address the problem of observer
      reproducibility of diagnosis.

PMID- 8463412
TI  - Expression of c-myc and c-fms oncogenes in trophoblastic cells in hydatidiform
      mole and normal human placenta.
AB  - AIMS: To compare the expression of c-myc and c-fms proto-oncogenes in the
      placenta and hydatidiform mole. METHODS: Twelve hydatidiform moles and six
      induced abortion cases were collected. c-myc and c-fms proto-oncogene expression
      was analysed by northern blot hybridisation and immunohistochemical staining.
      RESULTS: The results of northern blot hybridisation analysis showed that c-fms
      was expressed more strongly in hydatidiform moles compared with normal placenta
      of similar gestational age. Moreover, c-fms mRNA concentrations increased with
      more advanced gestational age in moles but not in normal placentas. c-myc
      expression was very low in hydatidiform moles and normal placentas. Both
      oncogenes, however, had no direct correlation with the clinical course of the
      molar pregnancies. CONCLUSION: The difference in c-fms expression between
      hydatidiform moles and normal placentas suggests that c-fms may have a role in
      the development of molar pregnancies.

PMID- 8463414
TI  - Pulmonary platelet aggregates: possible cause of sudden peroperative death in
      adults undergoing liver transplantation.
AB  - AIMS: To determine if massive pulmonary platelet thromboembolism is a common
      cause of peroperative death following liver transplantation; and to compare the
      incidence of this event with patients dying after non-transplantation procedures.
      METHODS: Necropsy tissues from all patients dying within 10 days of operation
      during the past three and a half years were studied (six liver transplantations
      and 13 unrelated operations). Haematoxylin and eosin stained sections of all
      tissues were examined. Additional sections of lung tissue were immunostained for
      constituents of thrombus (fibrin and platelets). RESULTS: At necropsy the lungs
      from all six liver transplant recipients were heavy with a rubbery texture and
      little oedema fluid. Those from non-transplantation patients appeared normal or
      very oedematous. Microscopic examination showed that there were numerous platelet
      aggregates occluding pulmonary capillaries in all six transplant recipients, but
      in only three of the non-transplant patients. These thrombi were numerous in
      patients dying during surgery and the number was underestimated in routine
      sections because of the surrounding capillary congestion. Detection was improved
      by immunostaining for platelets with factor XIIIA and platelet glyco-protein
      IIIa. CONCLUSIONS: Massive platelet thromboembolism is a likely cause of death in
      patients dying unexpectedly following recent liver transplantation. Non
      transplantation patients dying during surgery who show similar appearances
      usually have conditions known to have a high risk of thrombosis or embolism
      (cement hypotension syndrome and disseminated intravascular coagulation). The
      cause of this extensive platelet activation in liver transplant recipients is
      uncertain and may be multifactorial. The unusual rubbery consistency of the lungs
      on macroscopic examination could alert the pathologist to the underlying
      condition. Immunostaining for platelets improves the detection microscopically.

PMID- 8463415
TI  - Radiation disease of the urinary tract: histological features of 18 cases.
AB  - AIMS: To study the spectrum of histological changes in the urinary tract caused
      by pelvic irradiation. METHODS: Biopsy specimens of ureter and bladder and
      cystectomy specimens from 18 patients who had received pelvic irradiation were
      studied and the histological features were arbitrarily grouped into early and
      late changes. RESULTS: A wide range of histological changes were noted of which
      submucosal inflammation, fibrosis, and epithelial damage were the commonest.
      Other less common features were interstitial haemorrhage, ureteritis and cystitis
      cystica, squamous metaplasia of vaginal type and perineural inflammation.
      CONCLUSIONS: Although epithelial changes were most prominent in early cases and
      stromal changes in the late cases, there was a continuing spectrum of epithelial
      damage which persisted many years after initial radiation. Similarly, submucosal
      fibrosis was equally prominent in early and late phases.

PMID- 8463416
TI  - Certifying the cause of death: an audit of wording inaccuracies.
AB  - AIMS: To audit wording and formulation inaccuracies in certifying the cause of
      death. METHODS: Five hundred causes of death were analysed from the counterfoils
      of medical death certificates (Form 66). Wording and formulation inaccuracies
      were defined as terms contrary to the notes given to doctors in books on death
      certificates. RESULTS: One or more inaccuracies were identified in 29% of cases.
      In 5.8% of cases, the inaccuracies were sufficiently serious to warrant further
      action or enquiry by the Registrar of Births and Deaths, including referral to
      Her Majesty's Coroner. CONCLUSIONS: Most inaccuracies could have been avoided by
      adhering to the notes for medical practitioners contained in books of death
      certificates. The wording and formulation of causes of death warrants special
      prominence in under-graduate and postgraduate medical education. The topic should
      be audited and medical practitioners should pay particular attention to cases
      worthy of referral to HM Coroner.

PMID- 8463417
TI  - Bile reflux and intestinal metaplasia in gastric mucosa.
AB  - AIM: To determine associations between enterogastric bile reflux and gastric
      mucosal pathology. METHOD: A retrospective study using fasting gastric juice bile
      acid measurements and antral or prestomal biopsy specimens from 350 patients, 66
      of whom had previously undergone surgery that either bypassed or disrupted the
      pyloric sphincter. RESULTS: Bile reflux was positively associated with reactive
      gastritis and negatively with Helicobacter pylori density. After stratification
      for previous surgery, age, and H pylori status, the histological feature most
      strongly associated with bile reflux was intestinal metaplasia, including all its
      subtypes. The prevalence of intestinal metaplasia was greatest in patients with
      both H pylori infection and high bile acid concentrations. Bile reflux was also
      positively associated with the severity of glandular atrophy, chronic
      inflammation, lamina propria oedema and foveolar hyperplasia. CONCLUSIONS: Bile
      reflux is a cause of reactive gastritis. It modifies the features of H pylori
      associated chronic gastritis. The changes are not confined to patients who have
      had surgery to their stomachs. The positive associations with atrophy and
      intestinal metaplasia have implications for models of gastric carcinogenesis.

PMID- 8463418
TI  - Mucin exocytosis: a major target for Helicobacter pylori.
AB  - AIMS: To determine whether Helicobacter pylori impairs the secretory function of
      mucous cells. METHODS: The mucus secreting human cell line CL. 16E, maintained as
      confluent monolayers on nitrocellulose filters, was infected with H pylori strain
      CIP 101260. After three hours of incubation with H pylori the monolayers were
      washed and reincubated with fresh culture medium for various time periods (24,
      48, or 72 hours) before evaluating both the morphology and function of mucous
      cells. For morphological studies, epithelial monolayers were fixed in situ and
      processed for both standard histochemistry on paraffin wax sections, and electron
      microscopy. To measure mucins secreted from cultured cells, the cells were
      metabolically labelled with 3H-glucosamine. Undegraded mucins were quantitated as
      the radioactive glycoproteins blocked at the stacker gel interface after sodium
      dodecyl sulphate-polyacrylamide gel electrophoresis of the secretory
      glycoproteins. RESULTS: Control cultures of CL. 16E cells grew on filters as
      homogeneous monolayers of polarised mucous cells secreting a visco-elastic gel of
      mucins at the apical surface. In infected monolayers H pylori was in close
      contact with the apical surface of mucous cells. Cell counts and histological
      evaluation of the monolayers did not reveal any significant deleterious effect of
      H pylori on the mucous cells. H pylori induced only a modest inhibition of
      baseline mucus secretion from CL. 16E cells, this inhibition being significant
      only at 24 hours. In contrast, the mucus secretory response to two agents that
      raise intracellular cAMP and calcium--forskolin and ionophore A23187--was
      strongly inhibited. The inhibitory effect of H pylori on the exocytotic response
      was not paralleled by an inhibition of glycoprotein synthesis. CONCLUSION:
      Considering the fact that the exocytotic response to a variety of secretagogues
      constitutes the primary line of defence of the gastric mucosa in an emergency, it
      is suggested that H pylori exerts its deleterious effects by weakening this
      important physiological defence.

PMID- 8463419
TI  - Assay of gastricsin and individual pepsins in human gastric juice.
AB  - AIMS: To develop and validate an analytical procedure for the quantitation of
      pepsins and gastricsin in human gastric juice and to assess its potential in a
      controlled gastric secretory study. METHODS: High performance ion-exchange
      chromatography was used to separate human pepsin 1, 3a, 3b, 3c and gastricsin
      from gastric juice. Computed chromatographic areas for each enzyme were
      quantified by relation to a known amount of a secondary standard porcine pepsin.
      The assay procedure was validated by recovery and analytical precision studies.
      Gastric secretions after pentagastrin and insulin stimulation from 10 patients
      with portal hypertension were used to assess the potential of the analytical
      procedure. RESULTS: The assay precision varied from 1.5 to 9.0% within batch and
      7.5 to 18.1% between batch, with about 100% recoveries of porcine pepsin A from
      human gastric juice over the assay range 0.025-0.5 mg/ml. A fourfold increase in
      combined pepsin and gastricsin concentration was observed following pentagastrin
      and insulin stimulation. The mean percentage content of pepsins 3a, 3b, 3c, and 1
      in non-stimulated gastric juice were 4%, 72%, 12% and 1.4%, respectively, and did
      not change significantly after gastric stimulation. An approximate doubling of
      the percentage of gastricsin (10% to 20%) relative to the pepsins was observed,
      however, after both insulin and pentagastrin stimulation. CONCLUSIONS: This
      procedure for quantifying individual human pepsins and gastricsin in gastric
      juice is simple and reliable. It may be of considerable importance in determining
      the mechanisms involved in the control and secretion of these digestive enzymes
      in man, including the effect of anti-ulcer drugs and our understanding of the
      pathophysiology of peptic ulcer disease.

PMID- 8463420
TI  - Comparison between liver and serum concentrations of mannan binding protein.
AB  - AIMS: To investigate staining patterns for mannan binding protein (MBP) by
      immunocytochemistry in liver biopsy specimens from patients with various hepatic
      disorders; to measure the serum MBP concentration in the patients at the time of
      biopsy; and to compare these to define further the role of MBP in disease.
      METHODS: Fifty seven consecutive patients with a variety of types of liver
      disease were studied. Fresh liver biopsy specimens were immunostained with anti
      MBP and graded for intensity of staining. Serum MBP concentrations were measured
      on samples obtained on the day of biopsy, as were a full range of liver blood
      tests. RESULTS: MBP was only detectable in liver biopsy specimens from patients
      with morphological evidence of liver disease. MBP was most prominent in the
      livers of patients with severe alcoholic liver disease; livers harbouring
      metastases or showing biliary disease had moderate concentrations. Patients with
      liver disease were more likely to have raised serum MBP concentrations, but there
      was no correlation between these values and those found in the biopsy specimens.
      There was also no significant correlation between either of these concentrations
      and liver blood test abnormalities. CONCLUSIONS: Patients with liver disease tend
      to have raised MBP concentrations in both the liver and serum, but the exact
      relation between the two is as yet undefined.

PMID- 8463421
TI  - Is serum creatine kinase:aspartate aminotransferase ratio useful for diagnosing
      acute myocardial infarction in elderly patients?
AB  - AIM: To evaluate the usefulness of the serum creatine kinase: aspartate
      aminotransferase (CK:AST) ratio in differentiating between myocardial and non
      myocardial increases in serum creatine kinase activity in the elderly. METHODS: A
      three month prospective study of all patients admitted to an acute geriatric unit
      who were clinically assessed and investigated with electrocardiograms and
      measurement of CK, AST, and lactate dehydrogenase (LDH) activities on the first
      three days of admission. Excluding those with liver disease and alcohol misuse,
      patients with increased CK activity were then classified into four groups
      depending on whether they had fallen or had an acute myocardial infarction (AMI),
      or both. RESULTS: 270 patients were evaluated. CK activity was raised in 86 (31%)
      patients on any of the first three days of admission. Of these, 31 had fallen, 19
      had an AMI, and five had both fallen and sustained an AMI. The CK:AST ratio, on
      all days, was higher (p < 0.05) in those who had fallen. On the second and third
      days, the CK:AST ratio was higher (p < 0.01) in those patients who did not have
      an AMI. The overlap, however, between these groups was large. CONCLUSIONS: These
      results did not allow discrimination to be made between myocardial and skeletal
      sources for increased CK activity. The CK:AST ratio is, therefore, of limited use
      when applied to the diagnosis of AMI in elderly patients. Clinical evaluation
      rather than the pattern of enzyme change is more likely to determine the cause of
      increased CK activity.

PMID- 8463422
TI  - Lipoprotein (a) as an independent risk factor for myocardial infarction in
      patients with common hypercholesterolaemia.
AB  - AIMS: To examine whether lipoprotein (a) (Lp(a)) increases the risk of myocardial
      infarction (MI) in patients with common hypercholesterolaemia. METHODS: 15 middle
      aged men with common hypercholesterolaemia (mean serum low density lipoprotein
      (LDL) cholesterol 4.94 mmol/l, SD 1.0) and a history of MI were selected
      consecutively from referrals to a lipid clinic. A control group that had not
      sustained an MI and with similar age, sex, cigarette smoking and blood pressure
      characteristics was also selected from the same clinic. Serum cholesterol,
      triglyceride, LDL cholesterol, high density lipoprotein cholesterol,
      apolipoproteins AI and B and Lp(a) were measured in both groups. Lp(a) was
      assayed by immunoturbidity. RESULTS: The serum concentration of Lp(a) was
      significantly higher in patients with MI (geometric mean 0.64 (95% confidence
      interval 0.36 to 1.14) v 0.30 (0.21 to 0.42) g/l, p = 0.02), but there were no
      significant differences in other variables. Stepwise logistic regression analysis
      showed that Lp(a) was the only significant predictor of MI (p < 0.02). The odds
      ratio of MI (adjusted for age, smoking, blood pressure and apolipoprotein B) for
      an Lp(a) of > 0.57 g/l was 16.5, 95% confidence interval 2.3 to 125.4 (p =
      0.001). CONCLUSION: In middle aged men with common hypercholesterolaemia the
      serum concentration of Lp(a) is a powerful and independent risk factor for MI.
      Lp(a) should probably be routinely measured in all patients referred to a lipid
      clinic.

PMID- 8463423
TI  - Fatal pulmonary infection due to Mycobacterium fortuitum.
AB  - Environmental (atypical, opportunist, other) mycobacteria were first isolated
      nearly a century ago. The classification of these "other than Mycobacterium
      tuberculosis" organisms was initially chaotic until Runyon proposed a scheme of
      four groups in 1959. Mycobacterium fortuitum is a member of group IV: Rapid
      growers. These ubiquitous terrestrial and aquatic forms contaminate water
      supplies, reagents, and clinical samples. They may colonise the respiratory
      systems of patients whose local defence mechanisms have been impaired or those
      with congenital and acquired immune defects. They can also cause disease in
      immunocompetent individuals. There have been fewer than 20 published cases of
      pulmonary infection caused by M fortuitum. A further case is reported of fatal
      pulmonary infection in an elderly patient with long standing chronic obstructive
      airways disease (COAD). He had left upper zone shadowing on chest radiography and
      lung abscesses at post mortem examination yielded only M fortuitum.

PMID- 8463424
TI  - Human T lymphotropic virus type I associated myelopathy with pulmonary and
      cutaneous lesions.
AB  - A necropsy case of human T lymphotropic virus I (HTLV-I) associated myelopathy
      (HAM) in a 64 year old man with serological and genetical confirmation of HTLV-I
      infection is reported. The spinal cord, lung, and skin were mainly affected.
      Severe degeneration had occurred in the spinal cord, not only in the lateral
      columns but also in the anterior and posterior columns. The degenerate lesions
      showed proliferation of capillaries, loss of myelin and axon, and perivascular
      and parenchymal infiltration with T lymphocytes and foamy macrophages in the
      white matter. T lymphocytes had infiltrated the lung and there was vascular
      proliferation in the peribronchus. OPD4 positive cells predominated in the lung.
      The patient also had erythrodermia where dense and bandlike HTLV-I infected
      lymphoid cell infiltration was observed, with mild atypia and epidermotropism.
      HTLV-I may cause multiorganic inflammatory disorders, although the definitive
      role of HTLV-I in the pathogenesis is still unknown.

PMID- 8463425
TI  - Needle tract implantation of thymoma after transthoracic needle biopsy.
AB  - A 73 year old woman was admitted to hospital because of an anterior mediastinal
      mass. For definite diagnosis, needle biopsy was performed under fluoroscopic
      observation. The histopathological diagnosis was thymoma and combination
      chemotherapy was given. The tumour almost completely disappeared and the patient
      was discharged. But the tumour recurred in the left anterior chest wall four
      months later. It is suggested that the thymoma tissue had been implanted in the
      needle tract.

PMID- 8463426
TI  - Biochemical diagnosis of phaeochromocytoma: two instructive case reports.
AB  - The biochemical features of two patients with phaeochromocytomas illustrate the
      inadvisability of depending on a single group of analytes for the diagnosis. The
      first case presented as a surgical emergency with retroperitoneal haemorrhage.
      Biochemical diagnosis was difficult since total 24 hour urinary free
      catecholamine excretion was within normal limits in two out of three samples, and
      only marginally raised in the third with an atypical preponderance of adrenaline.
      Plasma catecholamine concentrations were also normal. But urinary excretion of
      the catecholamine metabolites, metadrenaline and 4-hydroxy-3-methoxy mandelic
      acid (HMMA), was consistently raised. In contrast, the second patient presenting
      with headache and labile hypertension showed normal metabolite excretion in the
      face of grossly increased free noradrenaline excretion and raised plasma
      noradrenaline concentrations. It is therefore recommend that, as well as urinary
      free catecholamines, one group of their main metabolites, the 3-methoxy amines
      (normetadrenaline and metadrenaline) or HMMA, should routinely be measured
      whenever a phaeochromocytoma is suspected.

PMID- 8463427
TI  - Determination of serum cholesterol concentration in the presence of ascorbate.
AB  - Pretreatment of a serum or plasma sample with ascorbate oxidase removed
      interfering ascorbate and allowed the determination of cholesterol to be carried
      out by a current enzymatic cholesterol method available in kit form. The Cobas
      Fara was programmed to carry out pretreatment of the sample with ascorbate
      oxidase before addition of the cholesterol colour reagent.

PMID- 8463428
TI  - Misunderstandings about methyl methacrylate.

PMID- 8463429
TI  - Sentinel and Bactec blood culture systems.

PMID- 8463430
TI  - Staging and follow up of patients with lymphoproliferative disorder.

PMID- 8463431
TI  - Farmer Jesty and the discovery of vaccination.

PMID- 8463432
TI  - Intramammary lymph nodes.

PMID- 8463433
TI  - Pediatric pharmacology: the path clears for a noble mission.
AB  - Unlabeled use of drugs in children occurs frequently and contributes to the
      therapeutic orphan dilemma. This situation can no longer be condoned; few
      acceptable reasons still exist for not evaluating potentially effective drug
      therapy in children. An apparent lack of research funds is not one of these
      reasons; only allocation of these funds to pediatric pharmacology is found
      wanting. Availability of clinical pharmacology programs, pediatric pharmacology
      manpower, sensitive analytical techniques, and acceptable ethical approaches to
      pediatric research reveal that drug evaluation is feasible in children. Studies
      readily include the required therapeutic indication for drug use in pediatrics.
      Efforts of academia, government and industry are now converging to show that the
      path for the noble mission of pediatric pharmacology--rational use of FDA
      approved drugs for children--is now clear for action.

PMID- 8463434
TI  - Adverse effects of drugs and chemicals in breast milk on the nursing infant.
AB  - Breastfeeding is an essential physiologic process that provides nutrition to the
      infant and protects the child against infection and immunologic disorders. The
      incidence of various diseases and metabolic disorders is known to be less in a
      breastfed infant compared with a child given a milk substitute. Psychologically,
      a breastfed infant forms a maternal bond that enables adaptation more readily to
      a social environment. It is well-established that all drugs are excreted into
      breast milk and are bioavailable to the infant. In general the majority of drugs
      do not pose a significant problem to the nursing infant and breastfeeding should
      be encouraged. The physician should be aware of which drugs are contraindicated
      during lactation and which drugs should be used with caution. There are also
      environmental chemicals that readily enter breast milk and may induce adverse
      effects. At present, the advantages of breastfeeding for infant development
      outweigh the potential adverse consequences and this physiologic process should
      be encouraged. With the use of available data on pharmacokinetics, milk-to-plasma
      ratio, excretion, etc. a supportive approach can be delineated by the
      pediatrician to reassure the nursing mother that they can safely breastfeed and
      continue therapy with minimal effects on the infant. It is thus imperative to
      document the extent to which a drug or chemical appears in breast milk and any
      apparent effects in the infant.

PMID- 8463435
TI  - The influence of pretreatment periods with diltiazem on nifedipine kinetics.
AB  - The effect of durations of diltiazem pretreatment on nifedipine kinetics was
      evaluated. Eighteen healthy male subjects were randomly allocated to three
      groups, 6 subjects each, for single doses of 60 mg diltiazem, and 3 days and 6
      days with diltiazem 60 mg three times a day. All subjects received 20 mg
      nifedipine orally on two occasions using a double-blind cross-over, placebo
      controlled method. No significant difference on pharmacokinetic parameters of
      nifedipine without diltiazem were observed among three groups. The single dose
      with 60 mg diltiazem significantly increased the area under the plasma
      concentration-time curve (AUC) for nifedipine compared with that in control an
      average of 35.1% (P < .05) and decreased the total body clearance (CL) an average
      of 24.0% (P < .05). Three days and 6 days pretreatment with diltiazem 60 mg three
      times a day significantly increased mean nifedipine AUC to 151.1% (P < .01),
      188.0% (P < .05) of control values, and decreased CL to 58.2% (P < .01), 63.9% (P
      < .05) of control values, respectively. The elimination half-life (t1/2) of
      nifedipine were significantly prolonged both after 3 days' and after 6 days'
      pretreatment of diltiazem. These results suggest that diltiazem affects the
      nifedipine kinetics rapidly and pretreatment duration dependently. A clinically
      important drug interaction may occur when both drugs are administered
      simultaneously.

PMID- 8463436
TI  - Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a
      double-blind, placebo-controlled study.
AB  - Inhibitors of HMG-CoA reductase are new safe and effective cholesterol-lowering
      agents. Elevation of alanine-amino transferase (ALT) and aspartate-amino
      transferase (AST) has been described in a few cases and a myopathy with elevation
      of creatinine kinase (CK) has been reported rarely. The inhibition of HMG-CoA
      reductase affects also the biosynthesis of ubiquinone (CoQ10). We studied two
      groups of five healthy volunteers treated with 20 mg/day of pravastatin (Squibb,
      Italy) or simvastatin (MSD) for a month. Then we treated 30 hypercholesterolemic
      patients in a double-blind controlled study with pravastatin, simvastatin (20
      mg/day), or placebo for 3 months. At the beginning, and 3 months thereafter we
      measured plasma total cholesterol, CoQ10, ALT, AST, CK, and other parameters
      (urea, creatinine, uric acid, total bilirubin, gamma GT, total protein).
      Significant changes in the healthy volunteer group were detected for total
      cholesterol and CoQ10 levels, which underwent about a 40% reduction after the
      treatment. The same extent of reduction, compared with placebo was measured in
      hypercholesterolemic patients treated with pravastatin or simvastatin. Our data
      show that the treatment with HMG-CoA reductase inhibitors lowers both total
      cholesterol and CoQ10 plasma levels in normal volunteers and in
      hypercholesterolemic patients. CoQ10 is essential for the production of energy
      and also has antioxidative properties. A diminution of CoQ10 availability may be
      the cause of membrane alteration with consequent cellular damage.

PMID- 8463437
TI  - The effect of stress on glycemic control in patients with type II diabetes during
      glyburide and glipizide therapy.
AB  - Stress adversely affects glycemic control in patients with type II diabetes
      mellitus. In addition, stress reduction with relaxation techniques or medication
      use in the management of hyperglycemia has been recommended. This study examined
      the relationship of glycemic control to self-reported stress in 19 patients with
      type II diabetes mellitus who were randomly allocated to receive either glyburide
      or glipizide for 16 weeks in a double-blind crossover design. Each treatment
      phase was preceded by a 2-week washout period. A previously designed and
      validated nine-item stress questionnaire was used to assess areas such as safety,
      financial wellbeing, energy level, health, etc. These areas were evaluated as
      more/less, better/worse, or no change. The stress questionnaire, fasting blood
      glucose (FBG), and glycosylated hemoglobin (GHb) concentrations were completed or
      measured at the end of glyburide and glipizide treatment periods. By assigning a
      value of 1, 2, or 3 to a positive, no change, or negative response, respectively,
      a composite stress score was computed and compared with glycemic control as
      assessed by FBG and GHb. Regression analysis showed highly significant
      correlations (P < .05) between stress scores and FBG (r = .70) as well as GHb (r
      = 0.84) with glipizide therapy. No such correlation was noted with glyburide
      (FBG: r = 0.29; GHb: r = 0.29). These findings suggest that during glyburide
      treatment, in contrast to glipizide, an increase in stress was not associated
      with a corresponding rise in blood glucose or worsening of metabolic
      control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463438
TI  - Performance of human mass balance/metabolite identification studies using stable
      isotope (13C, 15N) labeling and continuous-flow isotope-ratio mass spectrometry
      as an alternative to radioactive labeling methods.
AB  - Stable isotope labeling in therapeutic and subtherapeutic quantities of drug
      (15N2(13)C-phenobarbital) can be quantitated in biological matrices (urine) and
      high performance liquid chromatography (HPLC) peaks from urine using continuous
      flow isotope-ratio mass spectrometry (CF-IRMS). Standard curves for 15N2(13)C
      phenobarbital were reproducible and linear (R2 > 0.985) over the ranges of 3-100
      micrograms/ml for whole urine (15N2 or 13C labeling) and 0.1-8.0 micrograms/mL
      for HPLC peaks derived from urine (15N2 labeling). The lower limit of
      quantitation values for urine drug concentration was 0.46-2.62 micrograms/mL in
      whole urine and 0.10-0.70 micrograms/mL in HPLC peaks. Validation samples
      quantitated with these standard curves yielded close to expected values. These
      data suggest stable isotope labeling and CF-IRMS may be used as an alternative to
      14C labeling and radioactivity counting methods in mass balance/metabolite
      identification and other biomedical studies.

PMID- 8463439
TI  - Clinical use of androgenic steroids at a major medical center: who prescribes
      androgens and how well do they do it?
AB  - To assess prescribing practices for androgens at Wilford Hall USAF Medical
      Center, the authors analyzed prescriptions for all patients receiving therapy
      during a 12-month period (n = 201) and reviewed the available outpatient records
      not maintained elsewhere (n = 105). The most commonly prescribed androgens were
      testosterone enanthate (144/201; 56.7%), and danazol (52/201; 25.9%). Review of
      the available outpatient medical records of 73 male patients using testosterone
      enanthate showed a mean age of 59.5 years, mean frequency of injection of 20
      days, mean duration of therapy of 3.5 years, and mean dose of 226 mg. Therapy was
      initiated by a urologist (34/73; 46.6%), an endocrinologist (33/73; 45.2%), or an
      internist (6.73; 8.2%). Indications for therapy based on pretreatment laboratory
      and historical data included hypergonadotropic hypogonadism (24/73; 32.9%),
      hypogonadotropic hypogonadism (23/73; 31.5%), unspecified hypogonadism (7/73;
      9.6%), and empiric treatment of elderly men with erectile dysfunction without
      evidence of hypogonadism (9/73; 26%). Pretreatment prostate examinations as well
      as measurement of serum testosterone (66/73; 90.4%) and serum gonadotropins
      (52/73; 71.2%) were often not performed. The authors conclude that records of
      patients treated with androgens show: 1) Doses are appropriate; 2) Empiric
      treatment of erectile dysfunction in elderly men is common despite the associated
      risks; 3) Laboratory and physical evaluation before treatment is often
      incomplete; 4) There was no evidence of androgenic substance abuse in patients
      studied.

PMID- 8463440
TI  - Risk factors not addressed in antihypertensive therapy based solely on blood
      pressure control.
AB  - There has been a considerable revolution in the field of hypertension therapy. We
      have gone through an era in which patients with severe hypertension and those
      with accelerated hypertension had a very short life expectancy. Currently blood
      pressure can be readily controlled with a marked improvement in longevity. We
      have gone from an era in which stroke was common due to hypertensive
      cardiovascular disease to an era in which patients are effectively treated and
      there has been a marked reduction in the incidence of stroke. The challenge is
      whether we can reduce the very high mortality due to coronary artery disease in
      patients with hypertension as we have done with stroke. New groups of drugs that
      may have a more favorable effect on metabolic and hemodynamic risk considerations
      have been developed over the last decade. These agents may reduce the risk for
      coronary heart disease to a greater extent than previously employed therapy.
      While there are no randomized placebo-controlled studies demonstration this, a
      theoretical basis does exist to give the physician reason to think about
      prioritizing therapies and tailoring them to the needs of the individual patient.

PMID- 8463441
TI  - Comparison of the effects of zolpidem and triazolam on memory functions,
      psychomotor performances, and postural sway in healthy subjects.
AB  - Zolpidem is a rapid-onset, short-duration imidazopyridine hypnotic drug and is
      specific agonist of the omega-1 (BZD1) receptors. Its hypnotic characteristics
      resemble those of triazolam. The aims of this study were to assess the effects of
      zolpidem on memory (the main objective), psychomotor performances, and postural
      sway (secondary objectives) in 18 healthy subjects and to compare them with those
      of triazolam and placebo. Short- and long-term memory (paired words associate and
      pictures test), psychomotor performances (critical flicker fusion frequency,
      choice reaction time, digit symbol substitution test), and postural sway were
      evaluated before and 1.5, 4, 6, and 8 h after the administration of a single dose
      of zolpidem (10 mg), triazolam (0.25 mg), and placebo. For each assessment, the
      maximal effect for both hypnotic drugs occurred 1.5 hour after intake. Both drugs
      decreased psychomotor performance, impaired memory, and increased postural sway.
      The effects of both hypnotic agents were short lasting, and no alterations were
      found 6 and 8 hours, respectively, after drug intake. No clinically relevant
      differences were found between zolpidem and triazolam for memory, psychomotor
      performance, postural sway, or adverse effects. It may be concluded that
      zolpidem, like triazolam, impairs short- and long-term memory, psychomotor
      performances, and postural sway and that these effects are of short duration.

PMID- 8463442
TI  - Open prospective trial of fluoxetine for posttraumatic stress disorder.
AB  - Twenty-seven patients with combat-related posttraumatic stress disorder (PTSD)
      entered an open, prospective, 10-week trial of fluoxetine, beginning with 20
      mg/day and increasing to 80 mg/day until response was optimal or side effects
      prohibited dose increase. Nineteen patients completed 3 or more weeks and were
      included in the data analysis. Total Clinician-Administered PTSD Scale scores
      decreased from a mean of 64.5 at baseline to 42.7 at endpoint (F = 7.17, p <
      0.001), and improvement was significant in each of the three PTSD subscales
      (reexperiencing, avoidance/numbing, and hyperarousal). Depression and anxiety
      ratings showed similar improvements, and suicidality ratings did not increase.
      Global improvement scores decreased from 4.0 at baseline to 2.67 at endpoint (F =
      12.08, p < 0.001); however, improvement in social and occupational functioning
      was minimal. Appreciable improvement tended to occur after 6 weeks, suggesting
      that higher fluoxetine doses and/or duration than that used for depression may be
      indicated in this population. Panic attack frequency decreased by at least 50% in
      six of eight patients who kept panic diaries. The high dropout rate reflects
      problems with side effects, anxiety symptoms, external events, and substance
      abuse. Our data suggest that fluoxetine is effective in reducing reexperiencing,
      avoidance, and hyperarousal symptoms of PTSD, and this improvement is independent
      of comorbid panic disorder. In addition, fluoxetine appears to be effective in
      reducing panic attacks in PTSD patients. The efficacy of fluoxetine for some PTSD
      patients is interesting in light of emerging neuropharmacologic data suggesting
      serotonergic dysregulation in some PTSD patients. Noradrenergic hypotheses are
      also discussed. The findings should be confirmed by double-blind, placebo
      controlled studies.

PMID- 8463443
TI  - Imipramine is effective after unsuccessful cognitive therapy: sequential use of
      cognitive therapy and imipramine in depressed outpatients.
AB  - As a partial test of whether the same or different patients benefit from
      cognitive therapy and tricyclic antidepressant agents, depressed outpatients
      first received cognitive therapy, then nonresponders were treated with either
      imipramine or placebo. If the two treatments were effective for the same subgroup
      of patients, imipramine should not be more effective than placebo because
      potential responders should already have been removed by treatment with cognitive
      therapy. Alternatively, if cognitive therapy and imipramine are effective for
      different subtypes of depressive disorder, then imipramine ought to be more
      effective than placebo for patients failing to benefit from cognitive therapy
      because some potential imipramine failures would already have been removed.
      Thirty-six depressed outpatients were treated with weekly cognitive therapy for
      16 weeks with 17 (47%) responding. Nonresponders were then randomly assigned to
      imipramine or placebo for 6 weeks to a maximum dose of 300 mg of imipramine per
      day. Of 12 patients completing the double-blind medication trial, all 5 assigned
      to imipramine had a clear-cut response, whereas none of the other seven benefited
      from placebo (chi 2 = 12.00; p = 0.001). Although the numbers are small, these
      results suggest rejection of the hypothesis that imipramine is effective for the
      same subpopulation of depressed patients as is cognitive therapy.

PMID- 8463444
TI  - The assessment and clinical implications of haloperidol acute-dose, steady-state,
      and withdrawal pharmacokinetics.
AB  - In order to evaluate comprehensively haloperidol pharmacokinetics under fixed
      dose treatment conditions, psychiatric patients were studied after treatment with
      an acute dose, during maintenance therapy, and after withdrawal from haloperidol
      following steady-state conditions. After single doses, haloperidol appeared
      rapidly in serum, achieving peak concentration at a mean of 4.5 hours. The range
      of observed elimination half-life was broad, between 8.5 and 66.6 hours, with a
      mean of 19.5 hours. Under conditions of chronic dosing, serial measurements of
      steady-state serum concentration revealed intrapatient coefficients of variation
      between 2 and 72%. The mean for all patients was 26.4%. Body clearance decreased
      nonsignificantly, and elimination half-life increased significantly after chronic
      dosing compared with kinetic parameters determined after a single dose. The
      concentration of haloperidol in serum obtained at 8 hours after a single dose
      correlated most strongly (r = 0.73; p < 0.0001) with steady-state concentration
      resulting from chronic dosing. A value of 4 ng/ml or lower determined 8 hours
      after a single oral dose of 0.2 mg/kg identified patients who did not accumulate
      haloperidol during chronic dosing of 0.4 mg/kg per day above a presumed
      therapeutic range for haloperidol of 5 to 15 ng/ml. The implications of these
      data for the clinical use of haloperidol are discussed.

PMID- 8463445
TI  - Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia
      associated with intravenous haloperidol in the medically ill.
AB  - Consultation psychiatrists are frequently called upon by their medical and
      surgical colleagues to assist in the management of agitated, delirious patients
      in the intensive care unit. Intravenous haloperidol has a reputation for safe and
      effective sedation of these patients and has been found to be free of many of the
      dangerous anticholinergic and cardiac side effects of the lower-potency
      neuroleptics. The authors report the cases of three patients who developed
      torsades de pointes arrhythmia or lengthening of the Q-T interval during
      treatment with intravenous haloperidol. The cases suggest that the use of
      intravenous haloperidol should be accompanied by cardiac monitoring and that risk
      factors for torsades de pointes during haloperidol treatment may include dilated
      cardiomyopathy and a history of alcohol abuse.

PMID- 8463446
TI  - A systematic approach to the classification and pharmacotherapy of nonpsychotic
      major depression and dysthymia.
AB  - Nonpsychotic depressive and dysthymic states are reclassified and reorganized in
      order to maximize relevance to clinical psychopharmacology. In the initial phase
      of assessment, patients are divided into two easily recognized categories: mood
      nonreactive (autonomous) depression and mood-reactive depression. After family
      and past history of response and cost of drug are considered, a tricyclic
      antidepressant is usually selected for autonomous depression patients, and mood
      reactive depression patients are initially given a serotonin reuptake inhibitor.
      Nonresponders from either category are changed to the alternative medication or
      have it added to their first drug. Nonresponders to both of these initial trials
      are then assessed for the presence of atypical depression symptoms by the
      Columbia criteria. If these symptoms are present, the patients may be offered a
      third medication trial with a monoamine oxidase inhibitor. Bupropion could be the
      choice if the monoamine oxidase inhibitor cannot be given expeditiously. This
      completes the initial assessment and treatment phase. Autonomous and mood
      reactive patients who do not respond to this sequence of interventions are then
      reassessed for the presence of characterologic syndromes and comorbidity with
      some frequently encountered conditions. These may determine the choice of
      medication and the prognosis for a positive result from the next choices
      selected. When possible, specific recommendations are given for the various
      situations.

PMID- 8463447
TI  - Prolonged psychotic relapse after abrupt clozapine withdrawal.

PMID- 8463448
TI  - Transient fever and hematologic abnormalities during clozapine use.

PMID- 8463449
TI  - A naturalistic follow-up of panic patients after short-term pharmacologic
      treatment.

PMID- 8463450
TI  - Clomipramine treatment of sexual preoccupation.

PMID- 8463451
TI  - Pharmacotherapy in the prevention of suicidal behavior.

PMID- 8463452
TI  - Combining drugs and electroconvulsive therapy: safe and/or effective?

PMID- 8463454
TI  - Systemic sclerosis.
AB  - Systemic sclerosis affects the connective tissue of various organs. It is
      characterized by alteration of the microvasculature with a dense inflammatory
      cellular infiltrate, followed by massive deposition of collagen. This review
      discusses diagnostic criteria, clinical subsets, survival data, clinical
      evaluation, epidemiology, pathogenesis, immunobiology, genetics, and therapy for
      systemic sclerosis in adults. Because the diagnosis of systemic sclerosis is most
      dependent on its cutaneous involvement, knowledge of this is essential in the
      evaluation and management of patients with this disorder.

PMID- 8463453
TI  - Acute interactions of buprenorphine with intravenous cocaine and morphine: an
      investigational new drug phase I safety evaluation.
AB  - Recent preclinical and clinical studies suggest that buprenorphine, an opioid
      mixed agonist-antagonist, may be useful for the treatment of dual dependence on
      cocaine and opiates. This report describes an inpatient clinical evaluation of
      the safety of buprenorphine alone and in combination with single doses of cocaine
      and morphine. Twenty subjects with a DSM-III-R diagnosis of concurrent cocaine
      and opioid dependence were randomly assigned to maintenance treatment with single
      daily doses of 4 or 8 mg of sublingual buprenorphine for 21 days. Side effects
      and vital signs were evaluated every day once every 8 hours and for 2 hours after
      daily buprenorphine administration. The physiologic effects of a single-blind
      challenge dose of cocaine (30 mg intravenously), morphine (10 mg intravenously),
      and intravenous saline placebo were measured before and during buprenorphine
      maintenance. Before buprenorphine maintenance, subjects underwent methadone
      detoxification followed by a 9-day drug-free period. Three baseline single-blind
      challenge dose studies were conducted on study days 7, 8, and 9 during the drug
      free period. Cardiovascular responses to cocaine and to morphine were equivalent
      under drug-free and buprenorphine maintenance conditions. Respiration and
      temperature changes in response to cocaine were also equivalent before and during
      buprenorphine maintenance. Respiratory rates were slightly lower after morphine
      administration during maintenance on 8 mg of buprenorphine, but this was not
      statistically significant. Mild opioid agonist-like side effects were reported
      during buprenorphine induction and maintenance. These included headache,
      sedation, nasal discharge, abdominal discomfort, and anxiety. Most opioid agonist
      side effects decreased within 12 to 14 days. An electrocardiogram and blood
      chemistry measures were normal before and during buprenorphine maintenance. These
      data suggest that daily maintenance on buprenorphine is not associated with
      adverse side effects or toxic interactions with a single acute dose of
      intravenous cocaine or morphine.

PMID- 8463455
TI  - Characterization of T-cell clones generated from skin of patients with psoriasis.
AB  - BACKGROUND: The infiltrating cells in psoriasis include a subpopulation of
      autoreactive T cells. OBJECTIVE: The aim of this study was to further
      characterize skin-infiltrating T lymphocytes in patients with psoriasis. METHODS:
      Forty-five T-cell clones were generated from skin biopsy specimens from two
      patients. RESULTS: Phenotypic studies on 25 of 45 clones revealed that 19 (76%)
      of the clones were CD4+, 5 (20%) were CD8+, and 1 (4%) clone was CD4- and CD8-.
      Twenty-three clones were stained for identification of T-cell receptors. Twenty
      two clones expressed alpha/beta T-cell receptors and one clone (CD4-/CD8-)
      expressed no T-cell receptor. Nineteen clones (42%) were autoreactive with no
      restriction to class I or class II HLA antigens. By contrast, proliferation of
      two of the seven clones was inhibited by class I monoclonal antibody, whereas
      proliferation of four of seven clones was inhibited by class II monoclonal
      antibody. CONCLUSION: These data suggest that skin-infiltrating lymphocytes in
      patients with psoriasis may recognize HLA-associated molecules, perhaps the
      peptide of the HLA groove. The recognition of the peptide is presumably inhibited
      when monoclonal antibody is bound to the HLA molecule.

PMID- 8463456
TI  - Familial and cutaneous features of dysplastic nevi: a case-control study.
AB  - BACKGROUND: Although dysplastic nevi are an important risk factor for melanoma,
      little is understood about the epidemiology of these nevi. To further
      characterize some of the correlates of dysplastic nevi, we reexamined patients
      from one of the original prevalence reports and their first-degree relatives.
      OBJECTIVE: Our purpose was to characterize the prevalence and correlates of
      dysplastic nevi. METHODS: We studied 25 persons originally diagnosed with
      dysplastic nevi in 1980 and 1981, 28 controls stratified by age, sex, race, and
      date of initial examination, and all willing first-degree relatives of both
      patients (n = 78) and control subjects (n = 76). Each study subject underwent a
      full skin examination and biopsy of nevi suspected of being dysplastic nevi, if
      willing. RESULTS: Eighty percent of the case kindreds were multiplex (2 members
      or more affected) for dysplastic nevi; the relative risk of having dysplastic
      nevi was 7.2 (95% confidence interval 2.1 to 24) if one or more relatives had
      dysplastic nevi. Three of the cases (12%) in multiplex families also had a first
      degree relative with melanoma. Cases and relatives with dysplastic nevi of both
      patients and control subjects tended to have increased numbers of nevi. The risk
      of having dysplastic nevi rose 99-fold in persons with more than five nevi 4 mm
      or larger and/or scars on their back (p < 0.001). CONCLUSION: These data support
      the hypothesis that family members of unselected persons with dysplastic nevi are
      likely to have dysplastic nevi and may be at increased risk of melanoma.

PMID- 8463457
TI  - Pigmented spindle cell nevus: a clinicopathologic analysis of ninety-five cases.
AB  - BACKGROUND: Pigmented spindle cell nevus (PSCN) is often interpreted as a Spitz
      nevus or misdiagnosed as malignant melanoma. OBJECTIVE: The purpose of this study
      was to analyze the clinical and histologic features and to determine the biologic
      behavior of 95 cases of PSCN. METHODS: We reviewed clinical data, follow-up
      information, and microscopic features of all 95 cases of PSCN. RESULTS: PSCNs are
      dark brown to black, 3 to 6 mm in diameter, and occur most commonly on the
      extremities (75%) and back (16%) with a predilection for the legs. These lesions
      are more common in women in the third decade of life. Microscopically, PSCNs are
      characterized by uniform, spindle-shaped, pigmented melanocytes. Although some
      histologic features overlap with those in spindle and epithelioid cell nevus,
      PSCN is a separate entity. In addition, PSCN must be differentiated from
      malignant melanoma. Fifty-seven patients (60%) observed for an average of 6 years
      did not develop local recurrence or metastasis. CONCLUSION: PSCN is a
      distinctive, acquired, benign melanocytic lesion, that should not be confused
      with spindle and epithelioid cell nevus or malignant melanoma. Complete excision
      is recommended for treatment.

PMID- 8463458
TI  - Parenteral administration of 8-methoxypsoralen in photopheresis.
AB  - BACKGROUND: Extracorporeal photochemotherapy (EP) is used for the treatment of
      cutaneous T-cell lymphoma (CTCL), progressive systemic sclerosis (PSS), pemphigus
      vulgaris, and rheumatoid arthritis. During this procedure, the oral
      administration of the photoactive drug 8-methoxypsoralen (8-MOP) results in an
      unpredictable range of serum levels and in side effects limiting its efficacy.
      OBJECTIVE: To circumvent this limitation, extracorporeally administrable 8-MOP
      (EX-8-MOP) was developed. It is administered directly to the leukocyte/plasma
      concentrate in the treatment bag of the EP apparatus before irradiation with UVA
      light. METHODS: Efficacy, tolerance, and side effects of EX-8-MOP were evaluated
      in 108 consecutive treatments of 16 patients who had previously been treated with
      oral 8-MOP (91 treatments). RESULTS: With EX-8-MOP constant drug levels for UV
      light exposure were obtained; for equivalent levels only a small fraction of the
      oral dose (1/250 to 1/500) was required with none of the side effects associated
      with oral 8-MOP. Effective and reproducible inhibition of lymphocyte
      proliferation and cell viability was attained. No difference in clinical efficacy
      could be observed. CONCLUSION: EX-8-MOP eliminates the need for premedication and
      drug level monitoring of 8-MOP and should improve the effectiveness of EP.

PMID- 8463459
TI  - Abnormal lymph drainage in patients with chronic venous leg ulcers.
AB  - BACKGROUND: Edema often occurs in association with venous leg ulcers. OBJECTIVE:
      Our purpose was to assess lymphatic function in the legs of patients with venous
      leg ulcers. METHODS: Quantitative lymphoscintigraphy was performed in 22 normal
      control subjects, 32 patients with venous leg ulcers, and 7 patients with
      varicose veins only. RESULTS: Lymph drainage declined with age in the normal
      controls (r = -0.57; p = 0.0001). Lymphatic function was reduced in the ulcerated
      legs compared with normal limbs (age < 65 years; p < 0.0001) and in edematous
      legs compared with nonedematous legs (age > 65 years; ulcerated legs, p = 0.016;
      nonulcerated legs, p = 0.021). Lymph drainage was lower in the legs of patients
      with varicose veins only (p = 0.004). CONCLUSION: Impaired lymphatic function is
      associated with both venous leg ulcers and chronic venous hypertension.

PMID- 8463460
TI  - Malignant melanoma in xeroderma pigmentosum: search for a precursor lesion.
AB  - BACKGROUND: Malignant melanomas occur with increased frequency and at an early
      age in patients with xeroderma pigmentosum (XP). OBJECTIVE: The purpose of this
      study was to describe the histologic features of malignant melanomas in patients
      with XP and to search for a possible precursor lesion. METHODS: Clinical records
      and hematoxylin-eosin-stained sections of 19 malignant melanomas from seven
      patients with XP were examined. A search was conducted for malignant melanoma
      precursor lesions (melanocytic nevi and solar lentigines lateral to and
      contiguous with the malignant melanomas). Basal cell carcinomas removed from the
      same patients were used as controls. RESULTS: Malignant melanomas were
      characteristically found in biopsy specimens of small elevations and/or changed
      color foci arising in large, flat, darkly pigmented, gradually enlarging macules.
      Histologically, solar lentigo was lateral to and contiguous with malignant
      melanoma in 88% of the malignant melanomas. Transitional areas were present. A
      significantly lower number (22%) of contiguous solar lentigines, without
      transitional areas, were observed in the basal cell carcinoma controls. Most of
      the invasive malignant melanomas were spindle cell malignant melanomas.
      CONCLUSION: We propose that solar lentigo is the most common precursor lesion of
      malignant melanoma in patients with XP.

PMID- 8463461
TI  - Long-term oral antibiotics for acne: is laboratory monitoring necessary?
AB  - BACKGROUND: The role of laboratory monitoring in patients receiving long-term
      oral antibiotics for acne vulgaris has not been clearly defined. OBJECTIVE: The
      purpose of our study was (1) to evaluate the literature for objective evidence on
      the value of routine laboratory monitoring of the asymptomatic patient receiving
      oral antibiotics for acne and (2) to determine the utilization of laboratory
      monitoring of these patients by Connecticut dermatologists. METHODS: We surveyed
      Connecticut dermatologists by phone and inquired about the laboratory monitoring
      performed in patients receiving long-term oral tetracycline, minocycline, or
      erythromycin for acne. RESULTS: Eight published studies reported a total of 777
      patients who had laboratory monitoring at various frequencies while receiving
      oral antibiotics for acne. Only one adverse drug reaction (ADR) was detected in a
      patient in whom mild hyperbilirubinemia developed. Of the 75 Connecticut
      dermatologists who participated in our survey, 48 (64%) perform some laboratory
      monitoring; 29% do so routinely, and 35% under special circumstances. CONCLUSION:
      Our literature review does not support routine laboratory monitoring in all
      patients who receive long-term oral antibiotics for acne; rarely does such
      screening detect an ADR and thus does not justify the cost of such testing. A
      relatively small proportion of Connecticut dermatologists check laboratory tests
      more frequently than appears necessary; in our opinion, laboratory monitoring
      should be limited to patients who may be at higher risk for an ADR.

PMID- 8463462
TI  - Pruritus in the elderly: management by senior dermatologists.
AB  - BACKGROUND: Pruritus in older patients is common, yet remains a challenge for
      clinicians. By virtue of their years of experience and older age, senior
      dermatologists may have developed opinions and approaches that are insightful.
      METHODS: A random sample of board-certified dermatologists older than 64 years of
      age was surveyed by a written anonymous questionnaire to assess their opinions,
      diagnostic approaches, and treatments of pruritus and xerosis in the older adult.
      RESULTS: The 63 respondents whose surveys were analyzed believe the most common
      cause of generalized pruritus in the elderly is xerosis. Of those respondents who
      believe laboratory evaluation is necessary for generalized pruritus in this
      population, a complete blood cell count and a multichemistry panel were the most
      frequently ordered tests. Treatment regimens and products recommended were highly
      variable and included topical emollients, corticosteroids, and others. The most
      common systemic agent employed was hydroxyzine hydrochloride, followed by
      corticosteroids, doxepin, diphenhydramine, and terfenadine. Various topical,
      physical, and miscellaneous treatments were recommended. CONCLUSION: This study
      provides a glimpse into the diagnostic and therapeutic approaches of senior
      dermatologists.

PMID- 8463463
TI  - Hydroxychloroquine sulfate (Plaquenil) improves oral lichen planus: An open
      trial.
AB  - BACKGROUND: Oral lichen planus is chronic and can be debilitating. Topical
      corticosteroids are most frequently used for treatment, but they are not always
      effective. OBJECTIVE: Hydroxychloroquine sulfate (Plaquenil), an antimalarial
      agent, was evaluated in an open trial (10 patients) for its ability to improve
      oral lichen planus. METHODS: Patients received hydroxychloroquine, 200 to 400 mg
      daily, as a monotherapy for 6 months. Patients were assessed at baseline and
      every 4 to 8 weeks during treatment. Baseline ophthalmologic examinations were
      performed, and laboratory values were monitored before and during treatment.
      RESULTS: Nine of ten patients had an excellent response to therapy. Three of six
      patients with erosions at baseline had complete healing. Pain relief and reduced
      erythema were usually observed after 1 to 2 months of therapy, but erosions
      required 3 to 6 months of treatment before they resolved. There were no adverse
      effects. CONCLUSION: Hydroxychloroquine may be useful in the treatment of oral
      lichen planus.

PMID- 8463464
TI  - Contact allergy to corticosteroids.
AB  - Recent evidence shows that contact allergy to topical corticosteroids is more
      frequent than earlier believed. This review summarizes the current knowledge of
      this condition, including methods for clinical diagnosis.

PMID- 8463465
TI  - The clinical spectrum of lipodermatosclerosis.
AB  - Lipodermatosclerosis refers to the skin induration and hyperpigmentation of the
      legs that often occurs in patients who have venous insufficiency.
      Lipodermatosclerosis has also been termed hypodermitis sclerodermiformis and
      appears to be similar if not-identical to the recently described sclerosing
      panniculitis of the leg. There has been much confusion about the nature, clinical
      course, and treatment of lipodermatosclerosis. We believe that
      lipodermatosclerosis has an acute, inflammatory phase and a chronic, fibrotic
      stage, although a spectrum exists. Direct immunofluorescence studies of early and
      late lesions are helpful in that they show dermal pericapillary fibrin deposits
      without other immunoreactants. Treatment of lipodermatosclerosis consists of
      compression therapy with either graded stockings or elastic bandages. We and
      others have found that the anabolic steroid stanozolol improves this condition
      rapidly and consistently.

PMID- 8463466
TI  - Guidelines of care for cutaneous squamous cell carcinoma. Committee on Guidelines
      of Care. Task Force on Cutaneous Squamous Cell Carcinoma.

PMID- 8463467
TI  - Guidelines of care for psoriasis. Committee on Guidelines of Care. Task Force on
      Psoriasis.

PMID- 8463468
TI  - Guidelines of care for malignant melanoma. Committee on Guidelines of Care. Task
      Force on Malignant Melanoma.

PMID- 8463469
TI  - Melanoma screening: critique and proposal.

PMID- 8463470
TI  - Early detection of melanoma: an ounce of prevention may be a ton of work.

PMID- 8463471
TI  - Topical terbinafine and clotrimazole in interdigital tinea pedis: a multicenter
      comparison of cure and relapse rates with 1- and 4-week treatment regimens.

PMID- 8463472
TI  - Disseminated superficial porokeratosis: complete remission subsequent to
      discontinuation of immunosuppression.

PMID- 8463473
TI  - Congenital giant common blue nevus.

PMID- 8463474
TI  - Concurrent pemphigus and myasthenia gravis as manifestations of penicillamine
      toxicity.

PMID- 8463475
TI  - Phototesting and phototoxic side effects in bath PUVA.

PMID- 8463476
TI  - Lip leishmaniasis.

PMID- 8463477
TI  - Exogenous ochronosis.

PMID- 8463478
TI  - Lichen sclerosus as a cutaneous manifestation of thyroid disease.

PMID- 8463479
TI  - Tanning operators in North Carolina.

PMID- 8463480
TI  - Defining purpura.

PMID- 8463481
TI  - Cutaneous melanoma.

PMID- 8463482
TI  - Treatment of solar urticaria with terfenadine.

PMID- 8463483
TI  - Release of volatile branched-chain and other fatty acids from ruminant milk fats
      by various lipases.
AB  - Bovine, ovine, and caprine milk fats were treated with pregastric lipases (kid
      goat, calf, and lamb), microbial lipases (Candida cylindracea, C. cylindracea
      AY30, Aspergillus niger APF12, Rhizopus arrhizus, Penicillium roqueforti R10, and
      Mucor zavanicus Map 10), porcine pancreatic lipase, or milk lipase. All three
      pregastric lipases preferentially hydrolyzed volatile branched-chain and short n
      chain fatty acids from each milk fat. Pregastric lipases also released a
      relatively low proportion of C10 from bovine milk fats but a high proportion of
      C10 from caprine milk fat. Milk lipase released very low concentrations of
      butanoic acid and did not release 4-methyloctanoic acid in significant amounts
      except from caprine milk fat. Ovine milk fat yielded a substantially greater
      concentration of butanoic acid than did bovine or caprine milk fats when it was
      hydrolyzed by porcine pancreatic lipase. Candida cylindracea lipase yielded high
      amounts of volatile n-chain fatty acids nonselectively and only small quantities
      of volatile branched-chain fatty acids. High amounts of the medium-chain branched
      fatty acids were produced by kid goat, P. roqueforti, A. niger, and R. arrhizus
      lipases.

PMID- 8463484
TI  - Detection of estrus by radiotelemetric monitoring of vaginal and ear skin
      temperature and pedometer measurements of activity.
AB  - Methods to improve detection of estrus in dairy cows have been studied
      extensively without wide acceptance of any one method. In the present study, the
      use of body temperatures and pedometer-monitored activity were evaluated as
      methods of estrus detection. Twice daily activity levels of 13 lactating cows
      were monitored using pedometers, and vaginal and ear skin temperature
      measurements were made continuously using radiotelemetry. Activity increased 2.8
      fold at estrus for the 8-h daytime period (0630 to 1430 h), during which cows
      were given a 5-h turnout period, but not for the 16-h overnight period (1430 to
      0630 h), during which cows were confined to tie stalls. When increased activity
      was used to detect estrus on an individual cow basis, 20 of 25 estruses were
      detected with 4 false positives. Vaginal temperature increased by .6 +/- .3
      degree C at estrus and remained elevated by at least .3 degree C for 6.8 +/- 4.6
      h. When increased vaginal temperature was used on an individual basis, 17 of 21
      estruses were detected with 3 false positives. Rate of detection of estrus by
      visual observation was 66%.

PMID- 8463485
TI  - Effects of intramammary endotoxin infusion on milking-induced oxytocin release.
AB  - One overt sign of clinical coliform mastitis in dairy cows is the failure to
      eject milk normally or to "milk out" the udder. The effect, if any, of coliform
      mastitis on oxytocin release is unknown. Therefore, the objective of this study
      was to determine the effect of endotoxin mastitis on milking-induced release of
      oxytocin in lactating cows. Fifteen multiparous pregnant lactating Holstein cows
      were divided into three groups of 5 cows each. Cows in group 1 served as controls
      and received an intramammary infusion of sterile physiological saline. Cows in
      groups 2 and 3 received intramammary infusions of 12.5 and 25 micrograms of
      Escherichia coli endotoxin, respectively. Serum concentrations of oxytocin were
      measured by radioimmunoassay before, during, and after milkings commencing at 6
      and 12 h after treatment. Rectal temperatures and milk SCC were monitored to
      follow the course of inflammation and to verify the biological activity of
      infused endotoxin. Endotoxin resulted in a 1.5- to 2-fold increase in milking
      induced oxytocin release compared with that of control treatments. The effect was
      most prominent during the first 6 h after infusion and coincided with the peak
      pyretic response. This study shows that endotoxin-induced mastitis potentiates,
      rather than inhibits, milking-induced oxytocin release.

PMID- 8463486
TI  - The effect of manipulation in energy allowance during the rearing period of
      heifers on hormone concentrations and milk production in first lactation cows.
AB  - Fifteen Holstein heifers that were 175 +/- 4.0 d old and at BW of 175 +/- 4.9 kg
      were used to determine the effect of three feeding regimens from 6 to 12 mo of
      age on growth, blood concentration of several hormones, and milk production
      during first lactation. The feeding regimens consisted of two periods, the first
      lasting for 4 mo and the other for the subsequent 2 mo. For group A (restricted)
      heifers, the diet during period 1 was restricted to 85% of NRC (1988)
      recommendations (a daily BW gain of .7 kg); during period 2, a high energy, high
      protein diet was provided for ad libitum intake. Group B (control) heifers
      received a diet that corresponded to 100 and 90% of the NRC (1988)
      recommendations in periods 1 and 2, respectively. Group C (ad libitum) intake
      heifers received a high energy, high protein diet throughout both periods. Daily
      BW gains of heifers of groups A, B, and C were, respectively, .625, .768, and
      1.100 kg for period 1 and 1.162, .705, and .797 kg for period 2. The different
      feeding regimens influenced the age at which the heifers achieved puberty but did
      not affect BW at puberty. Milk production during 250 d of lactation was 7056,
      6070, and 5975 kg for groups A, B, and C, respectively. A statistical model that
      included serum derived mitogenic activity and serum prolactin of period 2
      accounted for 63% of the difference in milk production at first lactation.

PMID- 8463487
TI  - Effects of decreased availability of glucose for dairy cows.
AB  - After a preliminary trial to establish dose responses to phlorizin, five Holstein
      cows at 6 wk postpartum were used to test the response of cows in negative energy
      balance to a sudden decrease in availability of glucose caused by phlorizin. Cows
      were fed equal amounts of feed twice daily to supply 100% of NRC recommendations
      for protein and 90% of NRC recommendations for NEL and were in negative energy
      balance throughout the experiment. Phlorizin at 0, 2, and 4 g/d was injected
      subcutaneously in equal amounts every 6 h for 48 h and caused excretion of 0,
      225, and 337 g/d of glucose in urine. Milk production was not decreased, but
      percentage of milk fat increased linearly (3.34, 3.56, and 3.70%) with increasing
      phlorizin. Concentrations of glucose (64.2, 62.6, and 59.4 mg/dl) and insulin
      (518, 432, and 329 pg/ml) in blood plasma decreased linearly, whereas beta
      hydroxybutyrate (6.11, 8.88, and 9.98 mg/dl) and NEFA (181, 220, and 271 mu eq/L)
      increased linearly. The changes were most dramatic during the final 12 h of the
      48-h injection interval. Healthy, early lactation cows in negative energy balance
      seem to have the capacity to make metabolic adjustments to provide adequate
      substrates for maintenance and milk synthesis and to compensate for short-term
      increased needs for glucose.

PMID- 8463488
TI  - Mammary amino acid utilization in dairy cows fed fat and its relationship to milk
      protein depression.
AB  - Changes in mammary AA utilization associated with dietary fat-induced milk
      protein depression were assessed in cows with disturbed AA status. Four first
      lactation cows fitted with rumen cannulas were assigned to a factorial
      arrangement of treatments: two diets and two casein infusion sites within a 4 x 4
      Latin square design. Diets were formulated with yellow grease at 0 or 4% of DM.
      An 8% sodium caseinate solution was infused continuously at 5.04 kg/d into the
      rumen or abomasum during the last 5 d of each 21-d period. Arterial AA
      concentrations were reduced by dietary fat treatment and increased by abomasal
      sodium caseinate infusion. Mammary arteriovenous differences of essential AA
      tended to increase with both abomasal casein infusion and dietary fat treatments.
      With ruminal casein infusion treatments, yellow grease supplementation increased
      the percentage of extraction of blood essential AA into mammary tissue. Mammary
      blood flow rate dropped 7% on high fat treatments, preventing an increase in
      uptakes of critical AA to accompany the improved efficiency of milk synthesis,
      which was evident from a significantly reduced ratio of mammary blood flow to
      milk volume, resulting in depressed milk protein content.

PMID- 8463489
TI  - Diets containing high oil corn and tallow for dairy cows during early lactation.
AB  - Four multiparous Holstein cows averaging 49 DIM and fitted with ruminal cannulas
      were utilized in a 4 x 4 Latin square design with 21-d periods to determine the
      effects of diets containing high oil corn grain and tallow. Cows were fed diets
      of alfalfa haylage and concentrate (37:63, DM basis) for ad libitum intake.
      Treatments were 1) control, no added fat; 2) high oil corn grain replacing
      regular corn grain; 3) high oil corn grain and 2.5% tallow; and 4) high oil corn
      grain and 5% tallow. Intake of DM, milk production, and yields of milk fat, milk
      protein, milk SNF, and 4% FCM were not affected by dietary fat, although DMI
      tended to be lower when cows were fed 5% tallow. Percentages of protein and SNF
      in milk were lower when cows were fed diets containing fat. Percentage of milk
      fat was lower when cows were fed diets containing tallow. Supplemental fat
      decreased total VFA concentrations in ruminal fluid. Cows fed high oil corn had a
      greater molar proportion of acetate and a larger acetate to propionate ratio in
      ruminal fluid than cows fed high oil corn and tallow. Digestibility of total
      fatty acids decreased when tallow was added to diets containing high oil corn. No
      differences were observed among treatments for total tract apparent
      digestibilities of DM and fiber or utilization of energy and N. Dietary high oil
      corn and 5% tallow tended to decrease DMI and to alter ruminal fermentation
      characteristics.

PMID- 8463490
TI  - Selection of killer yeasts (Kluyveromyces lactis) to prevent aerobic
      deterioration in silage making.
AB  - Killer spectra were investigated to select killer yeast strains to inhibit the
      growth of wild yeasts that cause aerobic deterioration of silage. Kluyveromyces
      lactis IFO 1267 was characterized by its rapid killing activity and wide spectrum
      against the target yeasts. Crude killer protein produced by K. lactis IFO 1267 or
      inoculation of the cell itself inhibited the growth of the target strain,
      Saccharomyces cerevisiae IFO 0304 (in liquid or in solid culture), particularly
      when lactose was used as carbon source instead of glucose.

PMID- 8463491
TI  - Effect of protein quality and evaporative cooling on lactational performance of
      Holstein cows in hot weather.
AB  - Twenty-four Holstein cows in midlactation during summer in southern Arizona were
      fed diets supplemented with a combination of blood, fish, and soybean meals (high
      quality protein) or corn gluten meal (low quality protein). Diets were balanced
      for CP content and estimated ruminal protein degradability, but they differed in
      Lys concentration (.98 vs. .59% of DM). Milk yield for the 56-d trial was higher
      by 11% for cows fed high than for cows fed low quality protein and higher by 9%
      for cows receiving evaporative cooling plus shade than for cows receiving shade
      alone. Milk fat and protein yields also were greater for high than for low
      quality protein and for evaporatively cooled plus shade than for shade
      treatments. Intake of DM tended to be higher for cooled cows but was unaffected
      by protein source. Cooled cows had lower rectal temperatures (38.6 vs. 39.1
      degrees C) and respiration rates (64 vs. 82/min) than noncooled cows.
      Interactions between protein quality and cooling method were not statistically
      significant; however, cooled cows fed high quality protein had higher milk yield
      than noncooled cows. Digestibility of DM was higher for the low than for the high
      quality diet, but CP digestibilities were not different. Cows fed supplemental
      protein of higher Lys content were more productive.

PMID- 8463492
TI  - Another theory for the action of ruminal buffer salts: decreased starch
      fermentation and propionate production.
AB  - Sodium carbonates have been fed to ruminants for more than 20 yr and, in many
      cases, have alleviated milk fat depression. These effects usually have been
      ascribed to increased ruminal buffering capacity, but this mode of action has
      several problems. For the buffering capacity to increase, the concentrations of
      ruminal bicarbonate, dissolved CO2, and Na have to increase. Ruminal fluid
      already is saturated with CO2, and the cation concentration of ruminal fluid is
      regulated closely to prevent hemoconcentration or hemodilution. Based on these
      latter observations, a significant increase in ruminal buffering capacity is
      unlikely. The action of bicarbonates is explained more easily by increased water
      intake, increased ruminal fluid dilution rate, increased flow of undegraded
      starch from the rumen, and decreased ruminal propionate production.

PMID- 8463493
TI  - Efficacy of a dried colostrum powder in the prevention of disease in neonatal
      Holstein calves.
AB  - The efficacy of a dried colostrum powder, DCW Concentrate, as a colostrum
      supplement or substitute was tested using four groups of 15 calves. Physical
      condition and IgG status were examined during the first 30 d of life. Calves were
      fed the dried colostrum powder (group A), pooled colostrum (group C), or both
      (groups B and D) 2 h after birth. Calves fed 85 g of the dried colostrum powder
      dissolved in 3 kg of whole milk (group A) had significantly lower IgG
      concentrations 24 h after birth than calves of the other groups. Administration
      of 85 g of the dried colostrum powder plus 3 kg of colostrum (group C) did not
      lead to significantly higher IgG concentrations 24 h after birth than did
      administration of 3 kg of colostrum alone (group B). Calves fed 85 g of the dried
      colostrum powder plus 1.5 kg of colostrum (group D) had an IgG concentration at
      24 h of age that was not significantly different from that of calves given 3 kg
      of colostrum (group B). Morbidity and mortality rates were not significantly
      different among groups. One calf died in each of groups A and B; no losses
      occurred in groups C and D. Body weight increase was not significantly different
      among groups.

PMID- 8463494
TI  - Low incidence of citrullinemia carriers among dairy cattle of the United States.
AB  - Bovine citrullinemia is an autosomal recessive disorder that is lethal in the
      early postnatal period. Dairy bulls from the US were screened for citrullinemia
      genotype with a mutation-specific assay of semen or leukocyte DNA. One
      heterozygote was detected among 367 US Holstein bulls tested, corresponding to an
      incidence of .3%; DNA sequencing showed that this bull (bull C) was heterozygous
      for the translation-termination mutation described as the cause of bovine
      citrullinemia. Tests on daughters of bull C revealed that 26 were heterozygous
      and 25 were homozygous normal, confirming that the condition is autosomal
      recessive and that bull C was heterozygous. Although bull C was among 273 bulls
      tested from the top 400 bulls based on Type-Production Index as of July 1990, he
      was not among the 90 tested from the top 100. He has fewer than 2000 offspring
      registered with the Holstein Association of America and has few sons in AI.
      Furthermore, he was culled for other reasons before his citrullinemia status was
      known. Accordingly, the incidence of citrullinemia carriers is low among US
      Holsteins, and the impact of the one carrier found on the future of the breed is
      expected to be minor. No carriers were found among 102 US Guernsey bulls and 53
      US Jersey bulls tested.

PMID- 8463495
TI  - Biological action of mycotoxins.
AB  - Mycotoxins are ubiquitous, mold-produced toxins that contaminate a wide variety
      of foods and feeds. Ingestion of mycotoxins cause a range of toxic responses,
      from acute toxicity to long-term or chronic health disorders. Some mycotoxins
      have caused outbreaks of human toxicoses, and at least one mycotoxin, aflatoxin
      B1, is a presumed human hepatocarcinogen. As part of a comprehensive effort to
      curtail the adverse health effects posed by mycotoxins, substantial research has
      been conducted to determine the mechanism of action of mycotoxins in animals.
      This review presents some of the current knowledge on the biological action of
      four diverse classes of mycotoxins--aflatoxin B1, tricothecenes, zearalenone, and
      fumonisin B1--with particular emphasis on mechanisms of action.

PMID- 8463496
TI  - Immunotoxicity of mycotoxins.
AB  - The immune system is primarily responsible for defense against invading
      organisms. The effects of several mycotoxins on the immune responses have been
      investigated; however, most data concern laboratory animals. In some instances,
      farm animals and cells derived from livestock species have been employed to
      evaluate the immunotoxicity of mycotoxins. Immune responses are highly variable,
      and cost considerations usually preclude the use of dairy cattle as experimental
      models. Immunosuppression caused by aflatoxin B1 has been demonstrated in various
      livestock species (e.g., turkeys, chickens, and pigs) and also in laboratory
      animals (mice, guinea pigs, and rabbits). The response of bovine lymphocytes to
      aflatoxin in vitro is similar to that of other laboratory animals. Trichothecenes
      are potent immunosuppressive agents that directly affect immune cells and also
      modify immune responses as a consequence of tissue damage elsewhere. Sheep and
      calves treated with fusarium T-2 toxin develop leukopenia and decreased
      functioning of peripheral lymphocytes. Immunosuppressive effects of ochratoxin A,
      rubratoxin B, and patulin have been reported. Citrinin produced lymphopenia but
      stimulated responses against antigens. Antibodies against mycotoxins conjugated
      to proteins have been produced and are useful for analytical purposes.

PMID- 8463497
TI  - Strategies of mold control in dairy feeds.
AB  - Mold growth can occur in dairy feeds only when nutrients are available, correct
      temperatures exist, oxygen is present, and unbound water is available. Because
      elimination of any one of these four factors prevents mold growth, management of
      feed that accounts for these elements is essential. Use of multiple ingredient
      mold inhibitors recently has become another tool for affecting successful
      microbiological control of feed.

PMID- 8463498
TI  - Acoustical Society of America, 125th meeting. Ottawa, Canada, 17-21 May 1993.
      Abstracts.

PMID- 8463499
TI  - The differential validity of hyperactivity/attention deficits and conduct
      problems among mentally retarded children.
AB  - The independence of hyperactivity, attention deficits, and conduct problems among
      mentally retarded children was addressed using factors of the Conners' Teacher
      Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners'
      inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were
      obtained for children of normal intelligence and for mentally retarded children.
      Differences between the groups were examined as were intercorrelations of the
      Conners' factors and IOWA subscales. Conduct problems proved to be less strongly
      associated with hyperactivity and attention deficits among mentally retarded
      children compared to children of normal intelligence. However, attention problems
      and conduct problems may be associated with mental retardation in general.
      Implications of these data and CTRS scoring system recommendations for mentally
      retarded children are discussed.

PMID- 8463500
TI  - Narrative abilities in children with attention deficit hyperactivity disorder and
      normal peers.
AB  - A story retelling task was used to assess narrative abilities in 30 boys with
      attention deficit hyperactivity disorder (ADHD) and 30 normally developing boys,
      matched on age and IQ. Each boy listened to two stories and retold them for
      another child. Results indicated that the two groups did not differ in their
      ability to comprehend and extract the main ideas from the stories, but did differ
      in the production of narratives. Boys with ADHD provided less information
      overall, and their stories were more poorly organized and less cohesive and
      contained more inaccuracies. As a result, their stories were often confused and
      hard to follow. Organization and monitoring of information are functions of
      executive control. Thus the observed deficits in narrative production in children
      with ADHD may reflect underlying deficits in executive processes.

PMID- 8463501
TI  - Parental functioning and children's adjustment in families of divorce: a
      prospective study.
AB  - This paper prospectively examined relations between marital status, predivorce
      parenting practices, and children's adjustment, using data from the New York
      Longitudinal Study (NYLS). Prospective analyses of children's predivorce
      adjustment indicated that neither boys nor girls showed more problematic behavior
      prior to parental separation, and only boys had more difficulties after divorce.
      However, parents of to-be-divorced families reported more difficulties in
      childcare practices before divorce than did parents of always-married families.
      Parenting difficulties in to-be-divorced families were found consistently for
      boys but not for girls. Results suggest that the difficulties found among boys
      after divorce may be linked with parenting problems that begin before divorce.

PMID- 8463502
TI  - Impact of social problem-solving training on aggressive boys: skill acquisition,
      behavior change, and generalization.
AB  - This study examined the impact of social problem-solving training on the behavior
      of five aggressive boys. Acquisition of problem-solving skills and changes in
      classroom behavior were evaluated using multiple-baseline designs within and
      across subjects. A generalization-programming procedure to promote the use of
      problem-solving skills in the natural environment was introduced across children
      in multiple-baseline fashion. Direct observation and behavior ratings were used
      to evaluate the treatment. Results indicated that each subject acquired the
      problem-solving skills at levels comparable to well-adjusted peers. Only one
      child showed behavioral improvement coincident with problem-solving skill
      acquisition. Three others showed moderate behavior change after the
      generalization-programming procedure was introduced. Only one child's gains on
      teacher ratings were maintained at the 6-month followup. The results suggest that
      cognitive-behavioral treatment of childrens' aggressive behavior may produce
      changes of limited magnitude and durability.

PMID- 8463503
TI  - The prediction of adjustment at age 7 from activity level at age 5.
AB  - One-hundred and ninety-two children (equally split between boys and girls) were
      studied when they were 5 years old in two settings, school and home. The children
      were observed in playgroups and at home, and were rated on activity level by
      their parents on the Rothbart Child Behavior Questionnaire. At age 7, the
      children were tested in our laboratory on the Harter Test of Perceived Competence
      and on an achievement task, and parents filled out the Child Behavior Checklist,
      the Child Behavior Questionnaire, and the Conners Parent Rating Scale. Home
      observations of activity level were significantly related to parent ratings of
      activity level, but not to school observations. Activity level at age 5 was
      related to parents' ratings of aggression and hyperactivity and to girls'
      learning problems at age 7. Activity level was not related to the children's self
      perceived competence, but mothers' rating of high activity level at age 5 was
      related to low reading comprehension at age 7.

PMID- 8463504
TI  - Communication styles of children of mothers with affective disorders, chronic
      medical illness, and normal controls: a contextual perspective.
AB  - Research has demonstrated impaired parent-child relationships in families with
      affective disorders. The present study examines the association of children's
      interactional style during a direct conflict-solving task to both the mother's
      interactional style and the child's diagnostic status. The sample includes 63
      children, ages 8 to 16, of mothers with affective disorders, chronic medical
      illness, and normal controls. Children's dominant coping style profile (CS)
      (autonomous, neutral, or critical) was related to their mother's affective style
      (AS) (benign or negative). Affective disorder in the child at 6-month followup
      was associated with a critical CS profile at intake, while the child's
      nonaffective symptomatology was unrelated to CS. Findings indicate that
      children's affective disturbance is linked to interpersonal deficits in
      affectively charged situations. Results suggest that the child's CS is more
      strongly predicted by maternal AS than by either the child's or the mother's
      diagnostic status.

PMID- 8463505
TI  - Three forms of stress in Cambodian adolescent refugees.
AB  - Sixty-nine Cambodian adolescents and young adults were interviewed to determine
      their experience as children surviving the Pol Pot regime (1975-1979); their
      first-year experience of resettlement in this country; and their experience of
      stressful events during the past year. Current DSM-III-R diagnostic status was
      also determined. A strong relationship between earlier war trauma, resettlement
      strain, and symptoms of posttraumatic stress disorder (PTSD) was found. In
      contrast, the strongest relationship with depressive symptoms was found for
      recent stressful events. These results are discussed in light of current findings
      from stress and PTSD research.

PMID- 8463506
TI  - Allergic disorders and attention deficit disorder in children.
AB  - It has been suggested that children with attention deficit disorder-hyperactivity
      (ADDH) are likely to show allergic disorders, and that both ADDH and allergic
      disorders may share a common biological background. In a large sample of children
      from the general population we found no association between parent, teacher, and
      self-reports of ADDH behaviors and a history of allergic disorders (asthma,
      eczema, rhinitis, and urticaria) at ages 9 or 13 years. Similarly, reports of
      ADDH behaviors at age 13 years were not related to level of atopic responsiveness
      by skin test or serum IgE levels. Our findings call into question the hypothesis
      that there is a relationship between ADDH and allergic disorder.

PMID- 8463507
TI  - Parent reports of child behavior problems: bias in participation.
AB  - This paper compares the characteristics of 274 children whose parents agreed to
      provide information about their children's functioning in research with children
      whose parents did not. Parents had provided permission for child participation in
      school-approved research. Measures included self-, peer, teacher, and parent
      ratings. Parents of minority children were less likely to participate than
      parents of nonminority children. Among nonminorities, children of parent
      participants were viewed as more socially skilled and liked by their peers;
      teachers rated them as having less attention problems, less depression, and
      better academic skills than children of nonparticipating parents. Among
      minorities, no differences emerged. Implications for research involving the use
      of parent ratings are discussed.

PMID- 8463508
TI  - A review of the epidemiology of nutrition and adolescent pregnancy: maternal
      growth during pregnancy and its effect on the fetus.
AB  - Maternal growth during adolescent pregnancy and its effects on pregnancy outcome
      have been a source of controversy. Maternal growth during pregnancy has been
      difficult to quantify because of the tendency of young and older women to
      "shrink" in stature with pregnancy. In the Camden Study, maternal growth during
      pregnancy was monitored with the Knee Height Measuring Device, which measures
      growth of the lower leg, a body segment less susceptible to "shrinkage." Attempts
      of other investigators to detect maternal growth during adolescent pregnancy are
      reviewed here. New data from the Camden Study, also presented, suggest that
      growing adolescents have infants that weigh less compared to nongrowing
      adolescents and mature controls (aged 19-29 years). Prior work had suggested that
      the effects of maternal growth on birth weight were confined to adolescent
      multiparas. However, with expanded enrollment it was found that infants of
      growing primiparas and multiparas were both affected. The hypothesis of the
      competition for nutrients between a still-growing gravida and her fetus is
      discussed.

PMID- 8463509
TI  - Nutrient intakes of adolescents with phenylketonuria and infants and children
      with maple syrup urine disease on semisynthetic diets.
AB  - Adequacy of nutrient intakes of adolescents with and without phenylketonuria
      (PKU) and infants and children with and without maple syrup urine disease (MSUD)
      were assessed using 3-day diet records sorted by disease and by age of the
      subject. Mean intakes of all nutrients were greater than two-thirds of the
      Recommended Dietary Allowances (RDA) or Estimated Safe and Adequate Daily Dietary
      Intakes (ESADDI) for all adolescents studied, with the exception of selenium (Se)
      in PKU adolescents, which averaged 27.8 micrograms. For adolescents with PKU, >
      50% of the RDA or ESADDI for all nutrients was provided by elemental or modified
      protein hydrolysate medical foods, except for vitamin A in children aged 11-15
      years and Se in children 11-18 years. Mean nutrient intakes of all infants and
      children were greater than two-thirds of the RDA or ESADDI for all nutrients
      except Se in MSUD children aged 1-11 years, where intakes ranged from 6.4 to 13.2
      micrograms (21-66% of the RDA). The medical foods provided for most of the RDA
      and ESADDI recommendations, with the exception of Se in MSUD children.

PMID- 8463510
TI  - Histidinemia: a biochemical variant or a disease?
AB  - Histidemia, first described by Ghadimi in 1961, is caused by a defect in
      histidase. The defect results in elevated urinary excretion of histidine and its
      transamination products, and in high blood histidine. Blood histidine levels in
      histidinemic patients range from 290 to 1420 microM (normal 70-120 microM). The
      clinical picture of histidinemia varies from complete normality to severe
      retardation, with many patients being asymptomatic. No correlation has been found
      between clinical and biochemical data. Most reported cases have been identified
      in newborn screening programs. Frequency of histidinemia ranges from 1 in 8000
      (Japan) to 1 in 37,000 (Sweden). Histidinemia is inherited as an autosomal
      recessive trait. Maternal histidinemia is believed to be benign. Studies in
      animal models have shown similar metabolic changes in animals and humans, but
      clinical changes differ. Histidinemia may be treated with a low-histidine diet,
      which reduces elevated histidine levels, although in most cases no improvement of
      clinical symptoms has been observed.

PMID- 8463511
TI  - Plasma lipid physical properties in swine fed margarine or butter in relation to
      dietary magnesium intake.
AB  - Plasma lipids obtained from swine which had been fed butter or margarine at two
      dietary magnesium (Mg) levels indicated that the level of dietary Mg was more
      significant to plasma total cholesterol (TC), low-density lipoprotein cholesterol
      (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels than was the
      presence of butter or margarine. At 270 mg Mg/kg, which is considered adequate
      for swine, there was a significant difference in the plasma TC between swine fed
      margarine and those fed butterfat (105 and 126 mg %, respectively). Plasma LDL-C
      was higher in swine fed butter than in those fed margarine (88 and 71 mg %,
      respectively). In swine fed an additional 247 mg Mg/kg, however, there was no
      significant difference in plasma TC between those fed margarine or butter.
      Although at 247 mg Mg/kg, however, there was no significant difference in plasma
      TC between those fed margarine or butter. Although at 247 mg Mg/kg plasma LDL-C
      was higher in swine fed margarine and HDL-C was higher in those fed butter, there
      were no significant differences in the order parameters of LDL and HDL. Studies
      in which the influences of dietary fats on plasma cholesterol were first noted
      were carried out on liquid diets deficient in Mg. Mg, a cofactor in the enzymes
      involved in desaturation of saturated fatty acids, is also necessary in
      desaturation of linoleic to arachidonic acid.

PMID- 8463512
TI  - Dietary magnesium affects susceptibility of lipoproteins and tissues to
      peroxidation in rats.
AB  - Magnesium (Mg)-deficient and control diets were pair-fed to weanling Wistar rats
      for 8 days. Plasma lipoproteins were separated into various density classes by
      sequential preparative ultracentrifugation. The extent of lipid peroxidation was
      measured in terms of thiobarbituric acid reactive substances in lipoproteins and
      tissue homogenates before or after iron-induced lipid peroxidation. Hyperlipemia
      in Mg-deficient rats was accompanied by increased oxidation of very-low-density
      lipoproteins and low-density lipoproteins. Moreover, very-low-density
      lipoproteins and high-density lipoproteins from Mg-deficient rats were more
      susceptible to oxidative damage following iron incubation. Mg deficiency
      increased lipid peroxidation in liver, heart and skeletal muscles. Their
      homogenates were more susceptible to in vitro peroxidation. Mg deficiency has
      been discussed as a possible contributory factor in the development of
      cardiovascular disease and was associated with tissue damage and membrane
      alteration. These results demonstrate for the first time that Mg affects the
      susceptibility of lipoproteins to peroxidation and suggest that the mechanism
      responsible for the pathological consequences of Mg deficiency may be mediated by
      lipid peroxidation products.

PMID- 8463513
TI  - Cataract: relationship between nutrition and oxidation.
AB  - Opacification of the lens, or cataract, is causally related to the precipitation
      of proteins or other constituents upon aging. Proteins in the lens are unusually
      long lived and are subject to extensive damage, including (photo)oxidation.
      Accumulation of damaged proteins also appears to be due in part to attenuated
      activity of some proteolytic pathways, which in younger tissue may serve to
      identify and remove such moieties. The damaged proteins accumulate, aggregate,
      and precipitate. Compared with other health problems, surgery to remove cataract
      and related visits to physicians consume the largest proportion of the Medicare
      budget, i.e., $3.2 billion annually in the United States. The situation is
      exacerbated in many parts of the world where there is a dearth of
      ophthalmologists to perform the required number of procedures. Historically
      efforts to delay cataract assumed a low profile in ophthalmologic research.
      Recent data, however, indicate that consuming elevated levels of antioxidants
      such as ascorbate, carotenoids, and tocopherol is associated with delayed
      development of various forms of cataract. The same beneficial relationship to
      vision pertains to plasma antioxidant status and to fruit and vegetable intake.
      Thus, it seems that assuring optimal antioxidant intake can extend lens function.
      It has been estimated that in the United States over half of the cataract
      extractions and associated costs would be obviated if cataract could be delayed
      by 10 years. The data reviewed indicate that optimizing nutrition will help
      achieve that objective.

PMID- 8463514
TI  - Vitamin-mineral supplement use and nutritional status of athletes.
AB  - Dietary, anthropometric, and chronic disease risk factors (CDRF) including blood
      lipids and blood pressure (BP), were measured in 91 vitamin-mineral supplement
      users (SU) and nonusers (NU) representing a wide range of athletic interests.
      Supplements were used by 46 (51%) subjects; 100% of female athletes and 51% of
      male athletes used supplements while none of a group of 15 control female
      subjects currently used supplements. Both dietary intake and energy expenditure
      were measured using 7-day records. Adiposity was determined from body weight,
      body mass index, and skinfolds. Total cholesterol, high-density lipoprotein
      cholesterol, serum ferritin, hemoglobin, hematocrit, zinc, copper, and vitamin C
      were based on 12-hour fasting blood samples. Dietary intake (excluding
      supplements) for SU tended to be greater than NU for vitamin C, thiamin,
      riboflavin, niacin, B6, B12, folate, calcium, iron and magnesium. Plasma vitamin
      C levels were significantly higher among SU than NU of both gender groups (p <
      0.05). Although SU may exhibit additional healthy lifestyle practices, lipid
      profiles for many of these athletes were unfavorable with regard to CDRF.

PMID- 8463515
TI  - Wheat gluten-based diet retarded ethanol metabolism by altering alcohol
      dehydrogenase and not carnitine status in adult rats.
AB  - The objective of this study was to determine the effect of a lysine-deficient
      diet on carnitine status in adult rats and subsequently on ethanol metabolism.
      Adult male rats were fed either the AIN-76 diet (NS), the AIN-76 diet with wheat
      gluten (WG) replacing casein, the WG diet plus 0.8% L-lysine (LS), or the LS diet
      plus 0.5% L-carnitine (CS) for 30 days. On the 31st day the rats were given an
      oral dose of ethanol and blood-ethanol concentrations (BEC) were monitored for
      the next 8 hours. One week later the rats were given a second dose of ethanol and
      urine was collected until killed, 3 hours post-ethanol administration (PEA).
      Besides growth retardation and hypoproteinemia, BEC were significantly elevated
      in the WG group compared to the other group at hours 3-8 PEA. There were no
      significant differences in BEC between the LS and CS groups; however, their BEC
      were significantly higher than that of the NS group. The BEC were inversely
      related to liver alcohol dehydrogenase (ADH) activities which were significantly
      lower in WG, LS and CS groups than in the NS group. Plasma, liver and urine
      carnitine values were significantly higher in the CS group than in the NS, WG and
      LS groups, wherein the values were similar. It is concluded that the WG diet
      reduced ADH activity and attenuated ethanol metabolism without significantly
      altering blood, liver and urinary carnitines in the adult rat.

PMID- 8463516
TI  - Low serum folic acid levels in a nursing home population: a clinical experience.
AB  - Four hundred fifty-five residents of the Wisconsin Veterans Home had fasting
      serum specimens obtained for folic acid as part of standard practice. Twenty-nine
      percent were taking folic acid supplements. Six percent (n = 28) were taking
      phenytoin, a folate antagonist. No resident receiving a folate supplement (400
      mcg/day) had a low serum folic acid level. This finding may be important for
      practitioners selecting a dose of folic acid for nursing home patients. Of the
      325 residents not receiving a folate supplement, nine (3%) had low folic acid
      levels (< 2.5 ng/mL). Two of the nine were receiving phenytoin. Five were
      characterized by staff as eating well. As low serum levels are preventable with a
      multivitamin, we believe that supplementation with a multivitamin containing 400
      mcg folic acid/day should be considered in nursing home residents.

PMID- 8463517
TI  - Negative findings for use of coconut water as an oral rehydration solution in
      childhood diarrhea.
AB  - This study reports the chemical composition of coconut water during its
      maturation. Composition was measured at 5, 6, 7, 8, 9, 10, 11 and 12 months
      maturation. Concentrations of sodium and glucose, and the osmolality values
      showed great variation throughout maturation. The concentration of sodium
      remained constant between the 5th and 7th months (mean 2.9 mEq/l), but increased
      after the 8th month (mean 12.5 mEq/l). The concentration of glucose remained
      constant between the 5th and 8th months (mean 3392.4 mg%), but abruptly decreased
      after the 9th month (mean 820 mg%). Osmolality followed the variation of the
      glucose concentration averaging 377.3 mOsm/l up to the 8th month, then decreasing
      to 310.3 mOsm/l after the 9th month. This study showed great variability in
      coconut water composition during maturation of the fruit. In no instance did the
      coconut water contain sodium and glucose concentrations of potential value as an
      oral rehydration solution.

PMID- 8463518
TI  - Recent issues related to nutrition during pregnancy.
AB  - In July 1990, new guidelines for nutrition during pregnancy were published by the
      National Academy of Sciences. The Subcommittee on Weight Gain During Pregnancy
      revised the weight gain recommended for pregnancy. During the process of
      developing new recommendations, the subcommittee considered several factors that
      might help to determine the appropriate weight gain for an individual pregnant
      woman. Some of these factors include demographic and biological changes that
      might influence the effect of weight gain. Clinical issues that must be
      considered in implementing the weight gain recommendations include the importance
      of accurate weight and height measurement, categorizing the woman's weight for
      height, determining rate of gain at different times during pregnancy, and
      evaluating the significance of deviations from the expected weight gain pattern.
      A review of prior studies reveals that body composition changes, which might be
      important to consider in conjunction with weight changes, have not been well
      studied. Data are presented from a current study that indicates the problems
      encountered if traditional methods of body composition measurement are used
      during pregnancy.

PMID- 8463519
TI  - The importance of dietary protein in healing pressure ulcers.
AB  - OBJECTIVE: To determine the effect of dietary protein on healing of pressure
      ulcers in malnourished patients. DESIGN: Nutritional intervention trial with the
      non-randomized assignment of patients by pressure ulcer stage and bed type.
      SETTING: Long-term care facility. PATIENTS: Twenty-eight malnourished patients
      (age = 72 +/- 18 years, mean +/- SD) with a total of 33 truncal pressure ulcers.
      Nine patients had stage II ulcers, eight had stage III ulcers, and 16 had stage
      IV ulcers. METHODS: Patients received liquid nutritional formulas as tubefeedings
      or meal supplements containing either 24% protein (61 g protein/L; n = 15) or 14%
      protein (37 g protein/L; n = 13) for 8 weeks. RESULTS: There was a significant
      decrease in total truncal pressure ulcer surface area of the 15 patients in the
      24% protein group (-4.2 +/- 7.1 cm2, P < 0.02), but not in the 13 patients in the
      14% protein group (-2.1 +/- 11.5 cm2, P = NS). The change in total ulcer area
      correlated with both dietary protein intake per kg body weight (rs = -0.50, P <
      0.01) and caloric intake per kg body weight (rs = -0.41, P < 0.03). The decrease
      in stage IV ulcer area in eight patients in the 24% protein group (-7.6 +/- 5.8
      cm2, P < 0.02) was significantly greater (P < 0.05) than in eight patients in the
      14% protein group (-3.2 +/- 16.4, P = NS). In these 16 patients, the decrease in
      ulcer size also correlated with dietary protein intake per kg body weight (rs = 
      0.63, P < 0.01). CONCLUSION: High protein diets may improve the healing of
      pressure ulcers in malnourished nursing home patients.

PMID- 8463520
TI  - Treatment of vasculogenic sexual dysfunction with pentoxifylline.
AB  - OBJECTIVE: To evaluate the use of pentoxifylline to treat impotence in men with
      mild to moderate penile vascular insufficiency. DESIGN: Double-blind randomized
      clinical trial. SETTING: Sexual Dysfunction Clinic at VA Medical Center,
      Sepulveda, CA. PARTICIPANTS: Convenience sample of couples. INTERVENTION: Twelve
      weeks of treatment with placebo or 400 mg tid of pentoxifylline. MEASUREMENTS:
      (1) Report of patient verified by partner as to number of coital episodes per
      month; (2) penile-brachial pressure index determinations. RESULTS: Pentoxifylline
      therapy regularly increased the PBPI in impotent men in comparison with the
      placebo, frequently into the normal range. Pentoxifylline therapy was
      particularly useful in restoring the PBPI in men with the pelvic steal syndrome;
      six of seven such subjects improved into the normal range. During the
      pentoxifylline treatment period, in contrast with the control period, nine men
      were able to reestablish coital function and three had no improvement. Six
      couples did not attempt intercourse despite a professed interest in sexual
      activity; however five out of the six men experienced erections during episodes
      of fantasy or attempts at masturbation during treatment. There were no
      complications of therapy. CONCLUSIONS: These promising preliminary results
      suggest a well tolerated alternative therapy for erectile dysfunction in patients
      with mild to moderate penile vascular disease.

PMID- 8463521
TI  - L-deprenyl in the treatment of mild dementia of the Alzheimer type: preliminary
      results.
AB  - OBJECTIVE: To examine the short-term cognitive and behavioral effects of L
      deprenyl in persons with mild dementia of the Alzheimer type (DAT) over a 2-month
      period. DESIGN: A 15-month randomized, double-blind, placebo-controlled trial
      using a parallel-group design. This report deals with the first 2 months of the
      trial. PARTICIPANTS: 39 subjects with mild DAT (CDR 1) selected using NINCDS
      ADRDA criteria. MEASURES: A battery of neuropsychological tests and clinical
      rating scales. RESULTS: The placebo and L-deprenyl subjects were similar at
      baseline on the clinical and neuropsychological tests. There was no evidence of a
      L-deprenyl effect on any clinical or neuropsychological measures after 2 months.
      CONCLUSION: L-deprenyl did not have a measurable impact on behavior or cognitive
      function over a 2-month period in this group of subjects with mild DAT.

PMID- 8463522
TI  - The dark side of incontinence: nighttime incontinence in nursing home residents.
AB  - OBJECTIVE: To describe the characteristics of nighttime urinary incontinence in a
      sample of nursing home (NH) residents. DESIGN: Prospective descriptive study of a
      convenience sample of incontinent NH residents. SETTING: Four NHs. PARTICIPANTS:
      136 incontinent NH residents. MEASUREMENTS: Frequency and volume of incontinent
      and continent voids for three 10-hour daytime and three 10-hour nighttime data
      collection periods. RESULTS: The frequency of nighttime incontinence was the same
      as during the day, but the volume of nighttime incontinent voids and total
      nighttime volume were higher than during the day. There was substantial between-
      and within-subject variability in volumes, but the distribution of ratios of
      night/total volumes approximated a normal curve. Diuretic use was associated with
      relatively low nighttime volumes. CONCLUSION: About one-quarter of the NH
      residents we studied produced substantially more urine at night than during the
      day. Several medical, behavioral, and environmental approaches should be
      considered for reducing the frequency and volume of nighttime incontinence in
      this population.

PMID- 8463523
TI  - Influence of age on measurement of health status in patients undergoing elective
      surgery.
AB  - PURPOSE: To assess the influence of age on the relationships between global
      measures of health and specific health dimensions. DESIGN: Cross-sectional cohort
      study. SETTING: University tertiary care hospital. PATIENTS: Patients older than
      50 years admitted for major elective non-cardiac surgery. MEASUREMENTS:
      Consenting patients underwent preoperative evaluations including a medical
      history, physical examination, and administration of health status assessment
      instruments. Global health status was measured with the Medical Outcomes Study
      Short Form (SF-36) and with a 0 to 100 verbal measure of global health. Specific
      health dimensions (physical function, role function, social function, mental
      health, energy and fatigue, and pain) were measured using the SF-36. Subjects
      also completed a second validated measure of physical functioning, the Specific
      Activity Scale (SAS). RESULTS: Although patients aged > 70 years (n = 276) had
      poorer role function, energy, and fatigue scores and poorer physical function on
      both the SF-36 and SAS than younger patients (n = 469) (P < 0.05), they had
      similar overall health perception. In the entire population, global health status
      as measured with the SF-36 health perception scale had the greatest correlation
      with the energy and fatigue scale (r = .45), correlated moderately with mental
      health (r = .35), social function (r = .32), and physical function (r = .33), and
      correlated less well with the surgically remediable dimension of pain (r = .23).
      However, correlations of global health perception with pain and global health
      perception with role functioning were significantly (P < or = 0.05) lower in
      older patients when compared with subjects 70 years or younger (r = .13 vs .28
      and r = .19 vs .33, respectively). CONCLUSION: Despite poorer role function,
      poorer energy and fatigue scores, and poorer physical function, elderly persons
      have similar global health perception when compared with younger individuals.
      These data indicate that global health perception may be determined by different
      factors in the elderly or that the elderly have fundamentally different
      expectations of what their global health status should be. Our findings emphasize
      the importance of multidimensional scales when evaluating quality of life
      because, particularly in the elderly, the use of global measures alone may not
      reflect critically important dimension-specific impairments in health.

PMID- 8463524
TI  - Utilization of cardiopulmonary resuscitation in nursing homes in one community:
      rates and nursing home characteristics.
AB  - OBJECTIVE: To determine the rate of cardiopulmonary resuscitation use among all
      nursing homes in a large urban area, to examine CPR use over time, to discover
      whether CPR use varies among nursing homes, and to describe characteristics of
      patients undergoing CPR. DESIGN: Retrospective survey. SETTING: Nursing homes in
      a large urban area. PARTICIPANTS: One hundred ninety-six nursing home residents
      of 68 nursing homes underwent cardiopulmonary resuscitation over a 4-year period
      (1986-1989). Over this time there were 9,486 deaths in these homes, which
      comprised 10,252 beds. MEASUREMENTS: The CPR:death ratio was determined for each
      facility. The ratio was analyzed over time and by type of facility (eg,
      proprietary, non-profit, size of facility). The ratio was also examined among
      facilities with variable death rates. Patients undergoing CPR are described.
      RESULTS: The ratio of CPR:death over the 4-year period was 0.02. CPR:death ratio
      was higher (0.03) for the proprietary homes compared with the non-profit homes
      (0.01) P < 0.0001. A significant downward trend of CPR:death was noted over the
      study period for the non-profit homes; no such trend was noted in the proprietary
      homes. Size of nursing home did not influence the rate of CPR use. Homes with
      greater numbers of deaths per bed had a lower utilization of CPR. Patients
      undergoing CPR were old, frail, and had multiple medical problems. CPR attempts
      were frequent around the time of nursing home admission. CONCLUSION: The
      utilization of CPR in nursing homes is quite low. Non-profit homes utilize CPR
      less than proprietary homes. Nursing homes with the highest numbers of deaths per
      bed utilize CPR less than homes with lower numbers of deaths per bed. Nursing
      home residents receiving CPR are quite old, have multiple illnesses, and are
      impaired.

PMID- 8463525
TI  - A practical equation to predict resting metabolic rate in older females.
AB  - OBJECTIVE: To develop a practical and accurate age-specific equation for
      predicting resting metabolic rate (RMR) in older women and, thereafter, to cross
      validate existing equations for predicting RMR in older females. DESIGN: Cross
      sectional validation study. SETTING: General Clinical Research Center.
      PARTICIPANTS: A convenience sample of 75 healthy older women (age 50-81) free of
      significant cardiovascular or any other non-cardiac disease that may affect
      cardiovascular function or metabolic rate. MEASUREMENTS: All 75 volunteers were
      characterized for resting metabolic rate (RMR), body composition,
      anthropometrics, physical activity, and energy intake. RESULTS: A practical
      equation for predicting RMR in older women using easily measured variables was:
      [RMR (kcal/d) = 7.8 (weight,kg) + 4.7 (standing height, cm) -39.5 (menopausal
      status; 1-3) + 143.5]. These variables accounted for 59% (R2) of the variation in
      RMR and predicted RMR within +/- 66 kcal/d. When five previously published
      equations were applied to our sample of older women to predict RMR, individual
      predicted values deviated by -31% to 20% from the measured value. CONCLUSION: We
      offer a practical equation to predict RMR in healthy older women based on a
      measure of body weight, standing height, and menopausal status.

PMID- 8463526
TI  - The role of prognostic scores in targeting stroke rehabilitation in elderly
      patients.
AB  - OBJECTIVE: To determine the validity of clinically derived prognostic scores in
      targeting stroke rehabilitation in elderly patients. DESIGN, SETTING AND
      PARTICIPANTS: One-year prospective cohort study in 96 hospitalized stroke
      patients over 75 years of age from a well defined geographical area.
      MEASUREMENTS: Edinburgh prognostic score (incorporating measures of motor
      deficit, proprioception, and power), Orpington prognostic score (Edinburgh score
      modified to include a measure of cognition), and Barthel ADL scores were measured
      at 1, 2, and 4 weeks after stroke. These scores were correlated with outcome and
      patients' Barthel ADL score at discharge or at 16 weeks if still in hospital.
      RESULTS: Edinburgh prognostic score measured at 2 weeks correlated significantly
      with Barthel ADL score at discharge or at 16 weeks (r2 = 0.57, P < 0.001), and
      Orpington prognostic scores showed greater correlation (r2 = 0.89 vs 0.57),
      especially in patients with dementia (r2 = 0.81 vs 0.39). Barthel ADL scores at 2
      weeks showed a weak correlation with Barthel ADL scores at discharge or 16 weeks
      (r2 = 0.58). Patients with Orpington Score < 3.2 were discharged within 3 weeks
      of stroke, whereas those scoring > 5.2 required long-term care. Most patients
      (90%) with Orpington Score of 3-5 were eventually discharged home although this
      was not always apparent on initial clinical assessment at the time of admission.
      CONCLUSIONS: The Orpington score when assessed at 2-weeks post-stroke is a useful
      prognostic indicator with special suitability for the elderly and may help to
      select patients most likely to benefit from stroke unit rehabilitation.

PMID- 8463527
TI  - Sensory impairment and quality of life in a community elderly population.
AB  - OBJECTIVE: To determine the association between quality of life measures and
      sensory impairment in aged individuals living at home. DESIGN: Survey SETTING: A
      community survey, carried out in the historical center of a town in Northern
      Italy. PATIENTS: 1191 non-institutionalized elders (age 70-75 years).
      MEASUREMENTS: Comprehensive QOL questionnaire, free-field voice testing, and
      Snellen eye chart. RESULTS: Single sensory impairments (either visual or
      auditory) were significantly and independently associated with increased risk for
      depression (odds ratio: 2.3, 95% confidence interval: 1.5-3.4; OR:1.8, CI:1.1
      2.7, respectively) and decreased self-sufficiency in daily living activities
      (OR:1.7, CI:1.1-2.6; OR:2.1, CI:1.4-3.2, respectively). Visual dysfunction, but
      not hearing dysfunction, was independently associated with lower social
      relationships (OR:2.0, CI:1.3-3.1). CONCLUSION: The quality of life of community
      dwelling elderly people is significantly linked to sensory impairment, which can
      be detected through simple physical examination. Mood level and social
      relationships are particularly affected by visual impairment, whereas self
      sufficiency in daily living is more strongly related to hearing impairment.

PMID- 8463528
TI  - Drug use patterns of persons with Alzheimer's disease and related disorders
      living in the community.
AB  - OBJECTIVE: To describe drug use patterns by persons with Alzheimer's disease,
      multi-infarct dementia, and mixed Alzheimer's disease and multi-infarct dementia.
      DESIGN: Multicenter, patient registry. SETTING: Community-living persons
      evaluated in primary care, geriatric, and Alzheimer ambulatory settings.
      PARTICIPANTS: Of the 930 persons in three diagnostic categories, there were 671
      with probable or possible Alzheimer's disease by NINCDS/ADRDA criteria or
      Alzheimer's disease by DSM-III-R criteria, 162 multi-infarct cases by DSM-III-R
      criteria, and 97 mixed cases by DSM-III-R criteria. In each diagnostic category,
      65% were women, and the majority were 70 years or older. MEASUREMENTS: The
      average number of all prescription and non-prescription drugs and selected
      therapeutic categories by age, sex, diagnosis, and mini-mental status score at
      the time of diagnosis or evaluation. RESULTS: Alzheimer patients average 2.3
      drugs compared with multi-infarct (4.3; P < 0.0001) and mixed (3.7; P = 0.002)
      patients, and their pattern of drug use was different when stratified by
      therapeutic categories and drug classes. Drug use increased with age, and women
      used significantly more drugs than men in all three diagnostic categories. Women
      with Alzheimer's disease used significantly more cardiovascular drugs than men
      with Alzheimer's disease (P < 0.05). The lower the mini-mental status score in
      patients with any dementia, the greater the mean number of central nervous system
      agents used. The higher the mini-mental status score in a patient with multi
      infarct or mixed dementia, the greater the use of cardiovascular drugs.
      CONCLUSION: Drug use by Alzheimer patients was lower than in multi-infarct and
      mixed patients, primarily due to a lower prevalence of cardiovascular drugs.

PMID- 8463529
TI  - Exogenous calciferol (vitamin D) and vitamin D endocrine status among elderly
      nursing home residents in the New York City area.
AB  - OBJECTIVE: To determine the role and relative importance of sources of exogenous
      calciferol (vitamin D) in maintaining vitamin D endocrine status in the mid
      winter and early spring in a representative sample of institutionalized elderly
      persons in the New York City area. DESIGN: Cross-sectional survey. SETTING: A
      privately-run urban nursing home and the long-term care unit of a suburban public
      hospital. PARTICIPANTS: Residents aged 60 years and older scheduled for a routine
      annual physical examination and an additional group of individuals ascertained by
      random sampling. Those with a history of anti-convulsant or glucocorticoid use,
      liver disease, chronic renal disease (or serum creatinine > 1.5 mg/dL),
      parathyroid disease, Paget's disease, gastric surgery, or pharmacological vitamin
      D use were excluded. Of 301 sampled individuals, 221 were found eligible to
      participate, and 109 were successfully enrolled. RESULTS: The average vitamin D
      intake was 379 IU/day (range 55-1006 IU/day) and total vitamin D intake was below
      the Recommended Dietary Allowance in 16% of subjects. Fifty percent of total
      vitamin D intake came from fortified milk, and 26% came from vitamin supplements.
      Vitamin supplement use was not associated with low dietary intake. Among subjects
      taking a supplement containing 400 IU/day, none had serum calcidiol levels below
      15 ng/mL, while among subjects with vitamin D intake between 200 and 400 IU/day,
      46% had serum calcidiol levels below 15 ng/mL and 14% had calcidiol levels below
      10 ng/mL. Vitamin D intake from non-supplement sources (but not from supplements)
      appeared to have a negative association with serum calcitriol levels.
      CONCLUSIONS: Many nursing home residents may require vitamin supplements in order
      to achieve optimal levels of calciferol replacement. The choice of a vehicle for
      calciferol replacement may affect calcitriol levels.

PMID- 8463530
TI  - Interarm blood pressure difference in acute hemiplegia.

PMID- 8463531
TI  - Sudden death and resisted mechanical restraint: a case report.

PMID- 8463532
TI  - The menopause: health implications and clinical management.
AB  - OBJECTIVE: To review the anatomy, physiology, clinical symptoms, long-term health
      effects, and treatment of the menopause and climacteric syndrome, with a special
      emphasis on features, such as incontinence, particularly relevant to geriatric
      medicine. DATA SOURCES: English-language publications on menopause and the
      climacteric. STUDY SELECTION: Articles and books containing recent information
      pertinent to the topics covered. Studies in human subjects were given priority,
      but primate studies that amplify physiologic concepts are included. DATA
      SYNTHESIS: Due to increased longevity, the average US woman will spend one-third
      of her life as a postmenopausal individual. Anatomic and physiologic changes
      associated with the peri- and postmenopausal state include hot flushes,
      genitourinary atrophy, and bone loss. Possible correlates of the menopausal
      transition and postmenopause include affective changes and unfavorable
      alterations in lipoproteins and other cardiac risk factors. Clinical correlates
      of these changes can include incontinence, sexual dysfunction, increased risk of
      fracture, dysphoric mood, and increased risk of cardiovascular disease. Formal
      indications for estrogen therapy are hot flushes, genital atrophy, and
      osteoporosis prevention; other common clinical uses are reviewed. Non
      contraceptive estrogens can be administered orally, transdermally, vaginally, or
      by injection. Each route and preparation has some unique features with respect to
      actions and side effects. Progestins, in adequate doses, protect against the
      unwanted side effect of endometrial hyperplasia; alternatives to progestin use
      are presented. Non-hormonal alternatives for some peri- and postmenopausal
      symptoms are described. CONCLUSIONS: A discussion of the menopause and the
      benefits and risks of hormone therapy should be part of the routine health care
      of older women. Since the use of hormone therapy is elective, health care
      providers must elicit the goals, needs, and preferences of each patient, supply
      her with relevant information, and serve as a facilitator of her individual
      decision.

PMID- 8463533
TI  - Functional status care categories and national health policy.
AB  - Our society clearly needs to set limits on health care. The United States health
      care delivery system is the fourth largest economy in the world, yet its
      inflation continues to grow at twice the normal rate of other products and
      services. The inefficiencies are built in in such a way that while intensive care
      beds are plentiful, and very expensive, 37 million Americans cannot gain access
      to health care because they are either uninsured or underinsured. It is estimated
      that this figure will approach 39 million by the end of the decade. Since many of
      these individuals are young, the problem, it is said, has no real practical
      consequences because the young are relatively healthy. Yet evidence exists that
      the uninsured and underinsured receive poorer care than covered individuals. This
      and other inequities in the system have led many thinkers like Leonard Fleck to
      ask how just we must be in society. The answer to this question would presumably
      help us determine the lengths we must go in correcting the inequities. Even if
      the peace-dividend emerges from the new political events around the world, and we
      are able to spend more of our money on health care, our resources are not a
      bottomless pit. If need alone drives the system, just performing open-heart
      surgery on everyone who needs it would cost more than the annual budget itself.
      Virtually everyone agrees, then, that escalating health care costs are a moral
      problem because justice is involved, a political problem because public interest
      is involved, and that limits must be set that are moral and public.

PMID- 8463534
TI  - How many physicians will be needed to provide medical care for older persons?
      Physician manpower needs for the twenty-first century.
AB  - To estimate the number of full-time-equivalent (FTE) physicians and geriatricians
      needed to provide medical care in the years 2000 to 2030, we developed
      utilization-based models of need for non-surgical physicians and need for
      geriatricians. Based on projected utilization, the number of FTE physicians
      required to care for the elderly will increase two- or threefold over the next 40
      years. Alternate economic scenarios have very little effect on estimates of FTE
      physicians needed but exert large effects on the projected number of FTE
      geriatricians needed. We conclude that during the years 2000 to 2030, population
      growth will be the major factor determining the number of physicians needed to
      provide medicare care; economic forces will have a greater influence on the
      number of geriatricians needed.

PMID- 8463536
TI  - The future practice of long-term care.

PMID- 8463535
TI  - Who cares for Missouri's Medicaid nursing home residents? Characteristics of
      attending physicians.
AB  - OBJECTIVE: To describe the characteristics of physicians attending Medicaid
      recipients in Missouri's certified nursing homes (NH). DESIGN: Retrospective
      survey of multiple data sources. SETTING: Missouri's certified nursing homes.
      PARTICIPANTS: 1,339 physicians attending 22,452 Medicaid recipients.
      MEASUREMENTS: Physician characteristics were determined by reviewing a roster of
      medical directors of NHs compiled by the Missouri Department of Social Services'
      Division of Aging and physician directories compiled by the Missouri State Board
      of Registration for the Healing Arts, the AMA, the AOA, the ABFP, and the ABIM.
      Physician clinical activity was determined by examining NH inspection of care
      reports compiled by the Missouri Department of Social Services' Division of
      Aging. RESULTS: Each physician attended a mean of 16.8 and a median of six
      Medicaid recipients in the nursing home. The skewed distribution is reflected by
      426 (31.8%) of the physicians attending only one or two residents, and 28 (2.1%)
      of the physicians attending 100 or more residents. Twenty-seven percent of the
      state's licensed osteopaths (DOs, 362) attended nursing home patients, compared
      with 11% of allopathic physicians (MDs, 977). Significantly more DOs than MDs
      attended more than the median number of patients (57% vs 45%, P < 0.001). Half
      were attended by the 605 (45%) physicians without board certification. Of those
      who were board certified, family physicians were more likely to include Medicaid
      nursing home patients in their practices than internists (43% vs 18%, P < 0.001).
      Physicians licensed for 11 to 20 years and rural physicians had the heaviest
      patient loads. CONCLUSIONS: Many doctors are caring for very few nursing home
      residents while a few doctors may be caring for too many patients. In addition,
      half the Medicaid recipients residing in Missouri's nursing homes in 1988 were
      attended by physicians without board certification, and almost one-third were
      attended by physicians who may be retiring between 2000 and 2010.

PMID- 8463537
TI  - Geriatric medicine: a true primary care discipline.

PMID- 8463538
TI  - When the limits are not their own: why the elderly must participate in health
      care reform.

PMID- 8463539
TI  - Drinking in the elderly.

PMID- 8463540
TI  - Screening for depression.

PMID- 8463541
TI  - Statistical impact of truncated sampling or alteration of administration: the
      case of the Geriatric Depression Scale.

PMID- 8463542
TI  - OBRA-1987 nursing home regulations.

PMID- 8463543
TI  - Caregiver stress.

PMID- 8463544
TI  - Acute stooped position in elderly with Alzheimer's disease.

PMID- 8463545
TI  - Magnesium and hypertension.

PMID- 8463546
TI  - Plasma 3 alpha-androstanediol glucuronide in precocious adrenarche.
AB  - The aim was to study 3 alpha-androstanediol glucuronide (3AG) plasma levels and
      its relationship with 5-ene and 4-ene steroids in children with the benign form
      of precocious pubarche (precocious adrenarche). Sixty-five children with
      precocious adrenarche (PA), aged 3.6-8.2 yr (55 girls and 10 males) and 15 normal
      age-matched children were studied. We evaluated plasma androstenedione (A),
      dehydroepiandrosterone (DHA), its sulfate (DHA-S), testosterone (T),
      dihydrotestosterone (DHT), its glucuronide (DHTG), 3 alpha-androstanediol (3Ad)
      and its glucuronide (3AG) in all subjects. All androgens are expressed as mean +/
      SD. We found significantly higher plasma levels not only in glandular androgens
      but also in peripheral androgens (A, 2.4 +/- 1.5 nM vs 0.79 +/- 0.46 nM, p <
      0.001; DHA, 9.8 +/- 4.9 vs 2.7 +/- 0.76 ng/dl, p < 0.001; DHA-S, 3.4 +/- 2 microM
      vs 2.4 +/- 0.65 microM, p < 0.05; T, 0.74 +/- 0.5 nM vs 0.4 +/- 0.1 nM, p <
      0.001; DHT, 0.36 +/- 0.13 nM vs 0.12 +/- 0.05 nM, p < 0.001; 3Ad, 0.13 +/- 0.1 nM
      vs 0.054 +/- 0.03 nM, p < 0.001; DHTG, 0.5 +/- 0.3 nM vs 0.26 +/- 0.09 nM p <
      0.01). As far as the plasma 3AG levels are concerned we found significantly
      higher values in PA with respect to controls (1.17 +/- 0.7 nM vs 0.61 +/- 0.04
      nM, p < 0.01), suggesting that 3AG may be considered a marker of skin androgen
      utilization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463547
TI  - Acromegalic cardiopathy: a left ventricular scintigraphic study.
AB  - In order to study "acromegalic cardiomyopathy", cardiac function was examined,
      using gated radionuclide ventriculography, in 18 acromegalic patients and 21
      control subjects with no clinical evidence of cardiac involvement. In these
      acromegalic subjects, while the Ejection Fraction (EF) did not appear to be
      significantly different, the Peak Filling Rate (PFR) was reduced while the Time
      to Peak Filling Rate (TPFR) resulted significantly greater than in control
      subjects. These findings indicate that chronic growth hormone (GH)
      hypersecretion, as observed in acromegaly, deteriorate the cardiac ventricular
      relaxation (diastolic phase) while it has no influence on contractility (systolic
      phase).

PMID- 8463548
TI  - Smoking--a risk factor for hypothyroidism.
AB  - Smoking is associated with a spectrum of disorders. Recent reports have shown
      decreased serum concentrations of thyrotropin in euthyroid smokers, and there is
      an association between smoking and development of goiter (toxic and euthyroid).
      In a 12-year follow-up of a randomly selected sample of women we found a strong
      association between smoking at the time of initial screening and later
      development of hypothyroidism, the relative risk for a female smoker to develop
      hypothyroidism being 3.9 (95% confidence interval 1.6-9.1). There was, however,
      no association between smoking habits at the end of the follow-up and
      hypothyroidism. This indicates that several women who developed hypothyroidism
      may have done so in association with a change in smoking habits.

PMID- 8463549
TI  - Oxandrolone in constitutional delay of growth: analysis of the growth patterns up
      to final stature.
AB  - In order to evaluate the effects of low-dosage, 6-12 months course of oxandrolone
      treatment in constitutional delay of growth, we compared the growth responses on
      treatment, the pattern of sexual development and pubertal growth events, up to
      final stature of 11 prepubertal boys, aged 10.6-14.1 yr, with those of 11
      prepubertal, age-matched untreated controls. Treatment caused a significant
      increase of height velocity, from 4 to 9 cm/yr, and a significant acceleration of
      bone maturation, without affecting the timing of onset of puberty, the
      progression of sexual development or the onset of pubertal growth spurt. On the
      other hand, oxandrolone induced an earlier skeletal growth arrest but did not
      affect the expected final height. Treated boys showed an adult stature not
      significantly different from that of control subjects. Our data suggest that 6
      months-1 year, low dosage oxandrolone treatment in constitutionally delayed
      growth has no significant effect on the pattern of pubertal growth, nor on the
      rate of sexual maturation or on final height.

PMID- 8463550
TI  - Metastatic thyroid carcinoma of the adrenal gland.
AB  - Follicular thyroid carcinoma may spread distant metastases in sites such as bone,
      lung and brain. In our series of 448 patients with follicular thyroid carcinoma,
      distant metastases were present in 25% of cases. We report here a case of
      follicular thyroid carcinoma with a single metastasis at the right adrenal gland,
      that was found 12 years after total thyroidectomy and radioiodine therapy. Chest
      X ray, neck and liver echography and total body scan (TBS), performed after
      radioiodine therapy, were negative. During hormone therapy, serum thyroglobulin
      (Tg) levels were less than 1 ng/ml until 1990, and then Tg progressively
      increased in eighteen months up to 149 ng/ml. A new TBS was negative. At computer
      tomography a node at the right adrenal gland was found. The patient underwent
      adrenalectomy and histology showed a metastatic follicular thyroid cancer with
      Hurthle cells. After 1 and 5 months from surgery Tg serum levels were 0.9 ng/ml.
      This case shows once again the importance of Tg serum levels during follow-up of
      differentiated thyroid cancer.

PMID- 8463551
TI  - The effect of epidermal growth factor in human granulosa cells varies with
      follicle size.
AB  - EGF decreases aromatase activity and stimulates the proliferation of granulosa
      cells. To determine if EGF affects follicles of different maturity differently,
      human granulosa cells obtained from 6 patients at the time of IVF were pooled
      according to size and cultured in serum free medium with or without EGF. Estrogen
      production at 72 h was determined by measuring tritiated water formed in a 1-h
      culture with 1 beta [3H] androstenedione. The change in estrogen production with
      EGF was compared for cells from the smallest and largest follicles for each
      patient. Estrogen production in response to EGF decreased with increasing
      follicular size in all six observations. EGF may mediate luteinized granulosa
      cell aromatase activity in vivo, and may be a factor responsible for the relative
      decline in estrogen production in the preovulatory follicle.

PMID- 8463553
TI  - The behavioral syndrome induced by adreno corticotropic hormone in rats is
      prevented by Ca++ channel blockade.
AB  - The most typical signs (stretchings, yawnings, penile erections, excessive
      grooming) of the behavioral syndrome induced in rats by the
      intracerebroventricular administration of ACTH- (1-24) (4 micrograms/rat) were
      dose-dependently antagonized by the intraperitoneal injection of the selective
      Ca++ channel inhibitor, nicardipine (dose range: 0.1-1 mg/kg). These data suggest
      that the influx of Ca++ into target neurons is a step of key importance for the
      occurrence of ACTH-induced behavioral signs, and that Ca++ may play the role of
      second intracellular messenger for the behavioral effects of melanocortins.

PMID- 8463552
TI  - Hormonal regulation of glucose transporters in muscle cells in culture.

PMID- 8463554
TI  - Retinoic acid inhibits human thyroid peroxidase and thyroglobulin gene expression
      in cultured human thyrocytes.
AB  - The effect of retinoic acid (RA) on thyroid peroxidase (TPO) and thyroglobulin
      (Tg) gene expression was investigated in cultured human thyrocytes. Thyrocytes
      dispersed from Graves' thyroid tissues were incubated with TSH 5mU/ml and RA 0,
      0.01, 0.1, 1.0 microM for 72 h respectively. The samples were then subjected to
      Northern gel analysis. Northern gel analysis using the specific cDNA probes
      showed that RA suppressed the accumulation of TPO and Tg mRNA stimulated by TSH
      in a time- and dose-responsive manner. Furthermore, RA inhibited forskolin and 8
      Bromo-cyclic-AMP-induced TPO and Tg gene expression, suggesting a distal action
      site for these cAMP mediated gene expressions. Immunoprecipitation analysis using
      the specific monoclonal antibodies showed that TSH increased newly synthesized
      100, 75, 36-kDa [35S] TPO. The increased de novo TPO was markedly inhibited by
      RA. Tg secretion from monolayer cultures was measured by radioimmunoassay. RA
      also inhibited TSH-induced Tg secretion in a dose dependent manner. RA did not
      affect [3H] thymidine uptake into primary cultured human thyrocytes. In
      conclusion, RA inhibits the synthesis of TPO and Tg via the suppression of
      thyroid-specific gene expression although the exact site of RA action on these
      genes in human thyroids remains to be further elucidated. These results suggest
      that RA may play a regulatory role in Tg and TPO gene expression, subsequently
      resulting in the suppression of thyroid hormone synthesis.

PMID- 8463555
TI  - Epidermal growth factor receptor and lipid membrane components in human lung
      cancers.
AB  - The binding of 125I-epidermal growth factor (EGF) to the plasma membranes of 54
      samples of human lung tumors was determined. These included 34 squamous cell
      carcinomas and 20 adenocarcinomas. Twenty samples of histologically normal lung
      excised surgically along with the tumors were used as controls. Most of the
      plasma membranes showed an EGF receptor level higher than that of normal tissue.
      A moderate increase in the amount of 125I-EGF bound (2-5 fold) was observed in
      the majority of the tumors. Only a few cases (5-10% of the total) showed a large
      increase (> than 10 fold). The binding of 125I-EGF was compared with clinical
      stages and grades of differentiation. No correlation between the stage of the
      tumor and 125I-EGF binding was observed. However, the highest levels of EGF
      receptor (EGF-R) were found in poorly differentiated squamous cell carcinomas.
      The total amount and the distribution pattern of gangliosides and phospholipids
      were analyzed in individual tumors. A decrease in GD1b, GD1a and sphingomyelin
      and an increase in GM1 and GM3 was observed. No correlation was detected when
      tumors with the highest or lowest levels of gangliosides or phospholipids were
      compared with tumors exhibiting the highest binding of 125I-EGF.

PMID- 8463557
TI  - [Medical termination of pregnancy. Who decides? Who terminates? Who regulates?
      Questions for the legislator to work on].

PMID- 8463556
TI  - [Anxiety and depressive disorders in the postpartum period in pregnant females].
AB  - Several authors have found that caesarean section might be a risk factor for post
      partum depression, while others consider that mood disturbances are not a
      specific response to delivery and can be observed in women undergoing
      hysterectomy. This longitudinal prospective study was carried out in 156 in
      patient women at the Maternity department of Louis Mourier hospital, near Paris.
      These women were divided into three groups: 52 with normal delivery, 63 with
      caesarean section and 41 with gynecological surgery. Seventeen per cent of the
      women who had delivered suffered from baby-blues. The figure for anxiety (De
      Bonis scale > or = 20) was 23% in the 1st group, 41% in the 2nd group and 54% in
      the 3rd group. The figure for mood disturbances (according to DSM III criteria)
      was 4% in the 1st group, 16% in the 2nd group and 21% in the 3rd group. There was
      no significant difference between the 3 groups in figures for anxiety and
      depression during the first 3 months after delivery or surgery, but anxiety and
      depression ratings seem to fall faster and more steadily in women who had
      surgery.

PMID- 8463558
TI  - [Complications of laparoscopic surgery...(continued)!].

PMID- 8463559
TI  - [The C.C.L. culdotomy extractor for laparoscopic surgery].

PMID- 8463560
TI  - [Demons-Meigs syndrome].

PMID- 8463561
TI  - [Laparoscopic treatment of extra-uterine pregnancy. Results apropos of a series
      of 109 cases].
AB  - We report our experience concerning the laparoscopic treatment of ectopic
      pregnancy (EP). One-hundred and nine women with EP were treated in our department
      over a 4 year period, between February 1988 (date of our first laparoscopic
      surgery for EP) and December 1991. Twenty-two of these women underwent laparotomy
      and the remaining 87 laparoscopic surgery alone. Four therapeutic failures were
      noted in women treated by laparoscopy. Our results are compared with those of
      other series and the indications, as well as the modalities of laparoscopic
      treatment are detailed. It is concluded that laparoscopic surgery of EP is a
      reliable method which must always be considered, except for a few rare
      indications.

PMID- 8463562
TI  - [Pregnancy following female surgical sterilization. A study apropos of 38 cases].
AB  - A study of 38 cases of pregnancy that occurred after sterilisation between 1st
      January 1981 and the 30th September 1987 at the Maternity and Neonatology
      Department of La Rabta, Tunis. This complication is rare because the overall
      global figure for failure is 7.1/1000. This is what is found in the literature.
      When we came to analyse the failures we found there were two groups: 15% of these
      failures were in women who had been sterilised correctly. This also happens when
      women have been sterilised with the Yonn ring as with Pomery's ligation
      technique. In this case when patients become pregnant there is a big chance of
      their being ectopic (2 tubal pregnancies as against 5 intrauterine pregnancies).
      85% of failures were due to technical faults. They particularly happen with
      laparoscopic sterilisation (85%). They are usually due to lack of experience on
      the part of the operator. In any case patients do not like it; in fact 73.7% of
      the patients asked for a termination of the pregnancy and sterilisation was
      repeated in 87% of the cases.

PMID- 8463563
TI  - [Treatment using laparoscopic surgery of dermoid cysts. Apropos of a series of 33
      cysts].
AB  - Laparoscopy is a surgical method which is now widely used for the treatment of
      ovarian cysts. The authors wish to present their experience concerning the
      management and treatment of dermoid cysts or dysembryomas since these lesions
      embody all the problems persisting in this field. They report 33 cases
      exclusively treated by laparoscopic surgery in a series of 407 adnexal cysts
      treated over a 4-year period (April 1988 to April 1992). As regards diagnosis,
      the principal difficulty is not to miss the odd malignant lesion (1 to 2%)
      encountered mainly in older women. Technically, the most delicate stage in the
      operation is extraction of the cyst, especially when it is large and has an
      important solid component. Provided all precautions are taken in the diagnosis
      and the operative technique, this new method seems to be quite acceptable as it
      enables women who carry these lesions, which require excision, to benefit from
      the well-known advantages of laparoscopic surgery.

PMID- 8463564
TI  - [The malignant potential of adenofibroma and cystadenofibroma of the ovary and
      mesovarium. 118 cases including 13 proliferative and 5 carcinomatous].
AB  - The relationship between adenofibroma and cystadenofibroma and the frequency and
      features of carcinomas developed on these benign tumours are little known. Eight
      hundred and forty-five epithelial tumours of the ovary diagnosed over a 10-year
      period have been re-examined. One-hundred and eighteen adenofibromas and
      cystadenofibromas were recorded. One-hundred were benign and formed an
      architectural spectrum from which emerged: (1) surface papillary adenofibroma
      accounting for 5% of the cases and appearing at a mean age of 27 years; (2)
      cystadenofibroma in 77.5% of the cases at a mean age of 53 years; (3)
      adenofibroma in 17.5% of the cases at a mean age of 64 years. Adenofibroma was
      bilateral in 18 cases. Among the other cases were an endometrioid cyst and two
      simple serous cysts. The cells were serous in 110 cases, mucinous in 6 cases and
      weakly acidophilic to clear in 2 cases. Eighteen of these tumours were malignant:
      13 were associated with epithelial hyperplasia and 5 with a carcinoma. The 13
      adenofibromas with atypical epithelial hyperplasia (at a mean age of 60 years)
      were all made of serous cells; 6 of them were low-grade and 7 high-grade tumours
      with 3 microinvasions. One patient died at the age of 78, of an unknown cause;
      the others are still alive after a mean follow-up of 11.3 years. The 5 invasive
      carcinomas appeared on an adenofibroma at the mean age of 70 years; 3 patients
      died (2 of metastases), one is alive after 9 years and one was loss sight
      of.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463565
TI  - [A rare ovarian pseudotumor: massive edema of the ovary].
AB  - The authors report a case of massive ovarian edema which declared itself by pain
      in the abdomen and pelvis and an ovarian mass measuring 13 cm in diameter,
      occurring in a 22-year-old woman. Since it was not possible to make a diagnosis
      by any frozen-section examination, histology was carried out on the ovary that
      had been removed. This showed that the stroma of the ovary had become separated
      by massive edema preserving the albuginea and the superficial cortex. This case
      history of massive edema of the ovary shows the characteristics of this ovarian
      pseudotumour as described in the literature. The principal differential diagnoses
      of the condition are oedematous fibroma, and myxoma of the ovary. Apart from the
      fact that torsion of the adnexae can occur in some of these cases, the
      pathogenesis is still unexplained. When an ovarian tumour is found in a young
      woman a frozen-section examination must be carried out to make the diagnosis and
      perhaps avoid oophorectomy, particularly when untwisting a torsion can lead to
      resorption of the edema.

PMID- 8463566
TI  - [Teratogenicity of retinoids. A case and review of the literature].
AB  - Retinoids are vitamin A derivatives used in dermatology. One of them,
      isotretinoin, is frequently prescribed for refractory juvenile acne. The
      teratogenetic power of this drug is substantial, being estimated at 15 to 45% of
      exposures in utero. The risk is maximum in the first trimester of pregnancy and
      persists up to one month after treatment has been discontinued. The most
      frequently described multiple malformation syndrome involves the face, the
      central nervous system and the heart. There is also a 20 to 30% rate of
      spontaneous abortion. The authors report a case where exposure during the first
      trimester did not result in foetal malformation. From a full review of the
      literature the various malformations observed, the presumed mechanisms of
      teratogenesis and the strict rules of prescription and surveillance in women
      child-bearing age are presented. The problem of the measures to be taken in case
      of retinoid treatment during pregnancy is discussed. The teratogenic risk from
      other retinoids is dealt with.

PMID- 8463567
TI  - [Embryofetopathy of the newborn infant of a phenylketonuric mother. A diagnosis
      not to be missed].
AB  - Children with phenylketonuria (PKU) detected in the neonatal period and who have
      received the appropriate diet develop normally whatever their sex. However,
      female PKU patients who, before becoming pregnant, do not take the precaution to
      follow a diet bringing phenylalanine to "normal levels" (2 to 5 mg in 100 ml of
      blood) give birth to children presenting with severe embryofoetal damage (e.g.
      intrauterine growth retardation, microcephaly, mental retardation, various
      malformations) directly due to their hyperphenylalaninaemia (20 mg or more in 100
      ml of blood under a free diet). It is important to know these facts, since the
      benefits of systematic neonatal PKU detection may be cancelled by this late
      complication. The therapeutic approach in such cases is a follows: 1. Young women
      with known PKU must be informed of this risk and how it can be avoided by a
      preconception therapeutic diet. This means that they must permanently reside in
      the same geographical area, receive an adequate information at the end of
      puberty, use and effective contraception method and program their pregnancies
      preceded by a return to low phenylalanine diet. 2. Doctors must remember that
      because PKU detection has not become systematic until 1978, PKU girls of child
      bearing are remain undetected, that they are not always mentally debilitated and
      can normally five birth to children with embryofoetal damage. In case of e.g.
      unexplained intrauterine growth retardation or microcephaly, it is necessary to
      perform a Guthrie test on the woman, since a prenatal diagnosis may lead to
      therapeutic abortion, and a postnatal diagnosis to a genetic counselling which
      will avoid recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463568
TI  - [Prenatal diagnosis of adenomatoid malformation of the lung. 5 cases and review
      of the literature].
AB  - The authors report five cases of adenomatoid malformation of the lung (AML)
      diagnosed in the antenatal period. Since 1977, when Stocker et al. published
      their classification of these malformations into three anatomical types, the
      ultrasonographic features have been well systematized, thereby enabling treatment
      to be modified according to the AML type. Type I and II have a good prognosis
      (about 20% of neonatal deaths) and only require close supervision.
      Thoracocentesis may be necessary in case of significant anasarca or hydramnios.
      The progression and prognosis of type III AML are very bad, since a favorable
      course is observed in only 10% of the foetuses. Intrauterine surgery has already
      been successfully attempted in on case and might modify the situation. Most
      authors are in favour of therapeutic abortion when signs of bad prognosis are
      present.

PMID- 8463569
TI  - [Acute aortic dissection during pregnancy. Surgical treatment with maternal and
      fetal rescue].
AB  - Acute aortic dissection (AD) seldom affects young women, but when it occurs it
      is, in almost one out of two cases, during pregnancy. We report a case of severe
      AD during pregnancy in which emergency surgery immediately saved the life of the
      mother and the foetus. The mother died of cardiac complications 13 days after the
      operation; the condition of the newborn is satisfactory.

PMID- 8463570
TI  - [Pregnancy and non-Hodgkin's lymphoma: a case].
AB  - We report for the first time in the French literature the case of a malignant non
      Hodgkin's type lymphoma associated with pregnancy in a 19 year old woman. The
      evolution with corticotherapy was rapidly unfavourable and led to premature birth
      of a child who died 24 hours later, and to maternal death 48 hours later in spite
      of an attempt of chemotherapy. The prognosis of these tumours is bad, for the
      fetus because of the risks of premature delivery, for the woman because of the
      risks of tumoural evolution during the postpartum period.

PMID- 8463571
TI  - [Cerebral tumors and pregnancy. Apropos of 8 cases].
AB  - Pregnancy is an aggravating factor for brain tumours on which it acts by three
      mechanism: acceleration of tumour growth, increase of peritumoral oedema and the
      immunotolerance to foreign tissue antigens that is proper to pregnancy.
      Histologically, the brain tumour most frequently encountered is glioma, usually
      revealed during the third trimester. Brain tumours is pregnant women have no
      special clinical features, and their diagnosis rests on computerized tomography
      or nuclear magnetic resonance completed, if required, by stereotactic biopsy.
      Following a review of the literature, the authors present an updated description
      of the neurological and obstetrical actions to be taken, illustrated by a report
      of eight personal cases. The indications for surgery depend on the site and
      histological nature of the tumour. As regards obstetrical measures, induced
      therapeutic abortion and caesarean section, no longer routinely performed, are
      now being replaced by vaginal delivery with systematic instrumental extraction.
      In both mother and foetus the prognosis has improved over the last ten year, but
      it remains very sombre.

PMID- 8463572
TI  - [Advanced cancer of the rectum and pregnancy. Review of the literature apropos of
      a case].
AB  - The authors report a case of advanced rectal cancer in a pregnant woman of 30
      years of age. It was a glandular adenocarcinoma discovered in the second
      trimester of pregnancy. The clinical picture was one of rectal bleeding with
      digestive disturbances. The patient had a caesarean operation at 29 weeks of
      amenorrhoea because of a change in her general state. Post-operatively palliative
      chemotherapy was started. The patient died on the 13th day.

PMID- 8463573
TI  - [Placental aspergillosis: myth or reality? Apropos of a case with fetal death in
      utero].
AB  - The authors report an original case-history of massive aspergillosis of the
      placenta that occurred in a 24 year old primigravida who had had no previous
      history or clinical changes in pregnancy. It caused fetal death in utero with
      retention and maceration of the fetus. Macroscopic examination showed that the
      left lip was cleft and that the placenta was studded with isolated confluent
      diffuse whitish granulations. Histologic examination made us think that these
      appearances were those of aspergillar granulomas occurring even in the placental
      villi and intravillous spaces. Laboratory findings showed that there was
      Aspergillus Niger in the blood of the mother. A wide search of the literature
      failed to find any case in humans. On the other hand aspergillosis occurs
      frequently in animals causing intrauterine growth retardation and prematurity
      with abortion. There is great economic loss as a result. Why the animal placenta
      should be susceptible to infection of aspergillosis and how it acquires it is
      discussed! Finally the association of aspergillosis of the placenta with a cleft
      lip found in our case, is unique and one wonders if there is any relationship.

PMID- 8463574
TI  - [Distal tubal surgery using laparoscopy].
AB  - Between January 1987 and May 1990, forty-four women were treated in our
      department by laparoscopic surgery for distal tubal pathology. Among them, 10 had
      an intrauterine pregnancy (22.7%) and 2 had an ectopic pregnancy (4.5%) within 28
      months after surgery. Subsequently, our results were expressed in terms of the
      type of operation performed (fimbrioplasty or neosalpingostomy) and according to
      the tubal and adhesion scores (Mage and Bruhat). We found that most pregnancies
      were obtained within the first 16 months, that fimbrioplasty gave better results
      than neosalpingostomy (35.7% versus 16.6%) and that the tubal score was fairly
      predictive and more so than the adhesion score. These results enabled us to keep
      as indication of distal tubal laparoscopic surgery those patients who had pure
      distal tubal lesions with a tubal core of 1 to 2 and normal other parameters of
      infertility. In case of failure, i.e. if the woman does not become pregnant
      within 12 months post-laparoscopic surgery, in vitro fertilization is advised.

PMID- 8463575
TI  - [The value of RU-486 (mifepristone) in medical indications of the induction of
      labor at term. Results of a double-blind randomized prospective study (RU-486
      versus placebo)].
AB  - One hundred and twenty term women (> 37.5 weeks amenorrhea) with unripe cervixes
      (Bishop < 4) and with a clear clinical indication for labour induction were
      randomized to receive either mifepristone (RU 486) or placebo. The patients'
      regimens consisted of 200 mg of mifepristone on days 1 and 2 over an observation
      period of 4 days, with labour induction planned for day 4. Within 12 hours after
      taking the first tablet, fetal distress was diagnosed in 8 patients (3 in the
      Mifepristone group and 5 in the control group), who underwent immediate cesarean
      section. These 8 patients could not therefore participate in our survey and have
      been excluded from the final results. Forty one patients had spontaneous onset of
      labour, 31 in the mifepristone group and 10 in the control group (p < 0.001).
      Forty seven patients needed cervical maturation with prostaglandin, 32 from the
      control group and 13 from the mifepristone group (p < 0.001). Thirteen patients
      in each group had cervical maturation sufficient for classical labour induction.
      We noted that patients delivering vaginally needed significantly lower amount of
      oxytocin in the mefepristone group and that the mean time interval between day 1
      and the onset of labour was also significantly shorter in this group. The high
      cesarean section rate (32%), which is equivalent in both the placebo and the
      treated groups, may be attributed to the fact most of the patients in this survey
      had high risk pregnancies. There was no difference in the occurrence of fetal
      distress during labour in the 2 groups. Neonatal parameters were similar in both
      groups. These results establish mifepristone as an induction agent for the
      initiation of labour in term women. Though more studies are needed, Mifepristone
      has shown itself to be safe and appropriate in situations where labor has to be
      induced in term women.

PMID- 8463576
TI  - The hand and evolution.

PMID- 8463577
TI  - Tension band arthrodesis of small joints in the hand.
AB  - Two-hundred three patients underwent 290 tension band arthrodeses of the
      metacarpophalangeal and proximal interphalangeal joints of the hand. Nine
      patients (3%) failed to achieve bony union, four had painless pseudarthroses, and
      one patient had a small finger amputation. Twenty-five fusions (9%) required
      hardware removal. There were 10 superficial infections (all responded to oral
      antibiotic therapy), and three fusions were malrotated. Tension band arthrodesis
      is our choice for fusion of the metacarpophalangeal and proximal interphalangeal
      joints. It is reliable and provides stable fixation, pins do not protrude, and
      external splinting is unnecessary in the cooperative patient.

PMID- 8463578
TI  - Stability and constraint of the proximal interphalangeal joint.
AB  - The kinematics of the intact proximal interphalangeal joint of 12 fresh cadaver
      index fingers were measured by means of an electromagnetic tracking system. The
      specimens were then randomly divided into two groups for ligament sectioning in
      two different sequences and for testing under lateral stress. Lateral stress of
      the intact proximal interphalangeal joints produced an average of 5 degrees of
      adduction and 9 degrees of supination motion throughout the arc of
      flexion/extension. Maximum lateral angulation was 15 degrees under 1 kg of force
      (30 N cm) applied at the distal end of the middle phalanx. Joint angulation
      increased to 20 degrees after total sectioning of the collateral ligament. Joint
      laxity was greatly reduced in full extension, in full flexion, and when the
      muscles were loaded. The proximal interphalangeal joint remained stable when one
      half of the collateral ligament was left intact. The results indicate that
      lateral stability of the proximal interphalangeal joint is provided primarily by
      the collateral ligament. When the lateral stress test is normal in proximal
      interphalangeal joint extension, an additional test in 20 to 30 degrees of
      flexion should be considered to avoid a false-negative result. Angulation greater
      than 20 degrees is abnormal and indicates a loss of collateral ligament
      integrity.

PMID- 8463579
TI  - Camitz palmaris longus abductorplasty for severe thenar atrophy secondary to
      carpal tunnel syndrome.
AB  - This is a retrospective review of 29 patients (33 hands) who underwent a palmaris
      longus transfer because of severe thenar atrophy secondary to median nerve
      entrapment at the wrist. The mean follow-up was 17 months. Ninety-four percent of
      our patients were satisfied because their thumb function improved. Twenty-six of
      the patients had the transfer at the time of initial release of the carpal
      tunnel, and three patients had the transfer when the carpal tunnel was released a
      second time. The transfer helps with thumb palmar abduction, and the palmaris
      longus is an expendable muscle for transfer.

PMID- 8463580
TI  - Upper extremity tourniquet tolerance.
AB  - Twenty unsedated volunteers were tested to compare the relative tolerance of an
      arm tourniquet on one side and of a forearm tourniquet on the other. The forearm
      tourniquet was tolerated an average of 13 minutes (45%) longer and was
      consistently rated as less painful during and immediately after the test. No
      subject tolerated the arm tourniquet longer than the forearm tourniquet. Two
      peaks of discomfort were found, one just before deflation beneath the tourniquet
      and one in the hand 2 minutes later. Ulnar nerve distribution paresthesias were
      the earliest changes experienced; however, complete numbness occurred first in
      the median nerve distribution. Complete paralysis occurred 7 minutes later (24%)
      with the forearm tourniquet. Pulse rate did not correlate with tourniquet pain,
      but blood pressure did. No measurable tourniquet-induced edema occurred on either
      side.

PMID- 8463581
TI  - The effect of hypothermia on changes in isometric contractile function in
      skeletal muscle after tourniquet ischemia.
AB  - The effect of hypothermia on changes in contractile function of skeletal muscle
      observed after an episode of tourniquet ischemia has been investigated. Male
      Wistar rats were subjected to 2 hours of unilateral hypothermic (n = 33) or
      normothermic (n = 39) pneumatic tourniquet ischemia of a hind limb. Isometric
      contractile function was measured bilaterally from the gastrocnemius muscles
      after 1, 7, 14, 28, or 42 days of recovery. Compared to muscle subjected to
      normothermic ischemia, muscle that underwent hypothermic ischemia demonstrated
      more twitch tension at 1 day postischemia, higher maximum tetanic tension at all
      time periods, including 6 weeks after ischemia, and greater muscle weight at 6
      weeks. Rat gastrocnemius muscle function is much better 1 day to 6 weeks after 2
      hours of hypothermic ischemia than after 2 hours of normothermic ischemia. The
      results thus document the benefit of hypothermia during tourniquet ischemia in
      preventing or minimizing the changes in isometric contractile function observed
      after normothermic ischemia.

PMID- 8463582
TI  - The use of ultrasonography to detect a radiolucent foreign body in the hand: a
      case report.

PMID- 8463583
TI  - Elbow arthroscopy in a mostly athletic population.
AB  - The effectiveness of elbow arthroscopy was assessed in 35 consecutive patients
      (primarily weight lifters and baseball players) treated by one surgeon. The most
      commonly treated lesions were loose bodies and impinging spurs. Most elbow
      problems resulted from repetitive or acute athletic trauma. Repetitive stress
      injuries usually involved the athlete's dominant arm (91%). A standardized rating
      system demonstrated significant improvement at 24 months' average follow-up.
      Flexion and extension improved an average of 9 and 6 degrees, respectively. Elbow
      arthroscopy appears to be a safe and effective treatment for athletes, allowing
      most a full return to participation in sports.

PMID- 8463584
TI  - Elbow pain presaging myocardial infarction: a case report.

PMID- 8463585
TI  - Anatomy of trapeziometacarpal ligaments.
AB  - The stabilizing ligaments of the thumb trapeziometacarpal joint were identified
      and studied during anatomic dissections of 30 hand specimens. Five main
      ligamentous structures were identified: (1) the anterior oblique ligament, (2)
      the ulnar collateral ligament, (3) the first intermetacarpal ligament, (4) the
      posterior oblique ligament, and (5) the dorsoradial ligament. It was observed
      that the anterior oblique ligament is the primary stabilizer of the
      trapeziometacarpal joint and is taut in abduction, extension, and pronation. The
      first intermetacarpal, ulnar collateral, and posterior oblique ligaments appear
      to be secondary stabilizers. In every specimen, the first intermetacarpal, ulnar
      collateral, and posterior oblique ligaments merged to form a force nucleus at the
      base of the first metacarpal. The dorsoradial ligament did not play a primary or
      secondary role in thumb stability. The clinical correlation of this anatomic
      study suggests that, at the minimum, the reconstruction of a primary thumb
      trapeziometacarpal ligament (anterior oblique ligament) is essential in the
      treatment of degenerative arthritis to maintain thumb stability.

PMID- 8463586
TI  - Acute and late radial collateral ligament injuries of the thumb
      metacarpophalangeal joint.
AB  - Eighteen patients were treated surgically for injuries to the radial collateral
      ligament of the thumb metacarpophalangeal joint. Late repairs were performed in
      12 and immediate repairs in 6. At follow-up after a mean of 6 years, 94% of the
      patients were completely satisfied with the results. No patients had significant
      pain in their thumbs, and none were limited in work or avocational activities. A
      stable repair was maintained in all patients. There was no difference in grip or
      pinch strengths between the immediate and late groups. Loss of thumb motion in
      the late group (mean = 77% of normal) was slightly more than that in the
      immediate group (mean = 89% of normal). Late repair gives equally good subjective
      results and causes a slightly greater loss of thumb motion than immediate repair.

PMID- 8463587
TI  - Contact patterns in the trapeziometacarpal joint: the role of the palmar beak
      ligament.
AB  - Twenty-three cadaver forearm specimens were mounted on a Plexiglas acrylic
      plastic base for study of the trapeziometacarpal joint. Extrinsic and intrinsic
      motors were loaded to simulate lateral pinch, and pressure-sensitive film was
      used to record joint contact patterns in various functional positions. The palmar
      compartment of the trapeziometacarpal joint was the primary contact area during
      flexion adduction of the thumb ray in lateral pinch. Simulation of dynamic pinch
      and release produced dorsal enlargement of the contact pattern, suggesting
      physiologic translation of the metacarpal on the trapezium. Detachment of the
      palmar beak ligament resulted in dorsal translation of the contact area,
      producing a pattern similar to that of cartilage degeneration seen in the
      osteoarthritic joint. End-stage osteoarthritic specimens had a nonfunctional beak
      ligament and demonstrated a pathologic total contact pattern of joint congruity
      that was unaffected by further manipulations of the beak ligament. This work
      defines the contact patterns in the normal and diseased trapeziometacarpal joint
      and establishes the important influence of the palmar beak ligament on those
      contact areas.

PMID- 8463588
TI  - An evaluation of rapid exchange and simultaneous grip tests.
AB  - The usefulness of the rapid exchange grip test and a modification of this test,
      the rapid simultaneous grip test, in detecting submaximal grip efforts was
      evaluated. Uninjured subjects giving maximal or submaximal grip efforts were
      tested at grip rates of 80 and 100 repetitions per minute. Rapid exchange grip at
      80 repetitions per minute yielded a sensitivity of 86% and a specificity of 97%.
      Rapid simultaneous grip at 80 repetitions per minute yielded a sensitivity of 81%
      and a specificity of 93%. Poorer sensitivities and specificities resulted when a
      clinical population of patients was tested. Patients who were not giving maximal
      efforts tended not to comply with the test protocol. The rapid exchange and rapid
      simultaneous grip tests do assist in detecting submaximal grip efforts; limits to
      these tests are emphasized.

PMID- 8463589
TI  - Measurement of wrist, metacarpophalangeal joint, and thumb extension strength in
      a normal population.
AB  - An objective method of measuring isometric wrist, finger (metacarpophalangeal
      joints) and thumb extension strength was developed, and values for a normal
      population were defined. Disability due to extensor dysfunction was not assessed
      in this study. The testing technique involved the use of a load cell myometer
      held in a specially constructed jig. A total of 2232 measurements in 372 persons
      were made. Mean values for the strength of extension were as follows: men--wrist,
      13 kg; metacarpophalangeal joint, 6 kg; thumb, 3 kg; women--wrist, 7 kg;
      metacarpophalangeal joint, 4 kg; thumb, 2 kg. Strength was greatest in the third
      decade and decreased in each subsequent age group. Wrist extension strength was
      10% greater in the dominant hand. Interrater and test-retest reliability were
      assessed and found to be satisfactory. The method is proposed primarily as a
      clinical research tool, providing the clinician with an objective means of
      assessing wrist, metacarpophalangeal joint, and thumb extensor function.
      Potential applications include measurements of recovery after radial nerve injury
      or grafting and after other reconstructive procedures to restore extensor
      function.

PMID- 8463590
TI  - Multiple hemophilic bone cysts in the hand.

PMID- 8463591
TI  - Mastocytosis of bone in the hand without systemic disease.

PMID- 8463592
TI  - Low-velocity gunshot wounds of the metacarpal: treatment by early stable fixation
      and bone grafting.
AB  - The results of early stable fixation of 64 metacarpal fractures due to low
      velocity gunshot wounds in 49 patients were reviewed retrospectively. These
      reconstructive procedures were performed between 1 and 7 days after injury and
      involved stable internal fixation supplemented with primary iliac crest bone
      graft in 40 fractures with bone loss or comminution. Postoperatively, the hands
      were splinted with 90 degrees of metacorpophalangeal flexion while early
      interphalangeal motion was emphasized. Follow-up averaged 12 months, with a range
      of 4 months to 7 years. Primary bone union was achieved in all metacarpals. The
      average range of motion was 65 degrees for the metacarpophalangeal joint, 72
      degrees for the proximal interphalangeal joint, and 60 degrees for the distal
      interphalangeal joint. Complications included two superficial infections. There
      were no cases of deep infections or persistent draining wounds. Early, stable
      fracture fixation of these injuries achieved union, alignment, and early
      rehabilitation with no appreciable increase in morbidity.

PMID- 8463593
TI  - Index transposition after resection of the long finger ray.
AB  - Ten patients underwent index-to-long-finger ray transposition for repair after
      resection of the long finger ray. Care was taken to preserve the second web space
      and prevent painful neuromas. Rigid internal fixation was achieved with a T
      plate, and mobilization was started immediately. There were no nonunions.
      Postoperative motion was equal to preoperative motion in acute cases and equal or
      better in chronic cases. Mean grip strength was 0.65, and pinch strength was 0.78
      compared with the uninjured hand. There were no painful neuromas, hypersensitive
      scars, or deterioration of monofilament or two-point sensibility. The breadth and
      appearance of the first and second web spaces were equal bilaterally. Digit
      alignment and rotation were normal. The six patients receiving worker's
      compensation returned to work in between 3 and 24 weeks, and the other patients
      returned in between 11 days and 12 weeks.

PMID- 8463594
TI  - Sensibility deficiencies in the hands of children with spastic hemiplegia.
AB  - We evaluated 40 children with spastic hemiplegia due to cerebral palsy for
      sensory function and relative limb size in the affected and unaffected upper
      extremities. Sensory function of each limb was evaluated with respect to
      stereognosis (12 objects), two-point discrimination, and proprioception. Four
      size measurements of each limb were made: arm and forearm circumference and
      forearm and forearm-hand length. This study showed that 97% of the spastic limbs
      had a stereognosis deficit, 90% had a two-point discrimination deficit, and 46%
      had a proprioception deficit. Thus sensory deficits are the rule rather than the
      exception in children with spastic hemiplegia. Those children with severe
      stereognosis deficits had significantly smaller limbs in all four measurement
      parameters than the children with mild or moderate stereognosis deficits. In the
      preoperative evaluation of children with spastic hemiplegia, severe size
      discrepancy is a physical examination tool that can be used as a predictor of
      severe sensory deficits. This information is helpful for the hand surgeon in
      establishing realistic surgical goals.

PMID- 8463595
TI  - Brachial plexus injury after median sternotomy.
AB  - Serious brachial plexus injury after median sternotomy is uncommon. However,
      affected patients experience considerable morbidity and their return to regular
      employment is often delayed. The pathogenesis of the injury is multifactorial.
      Wide sternal retraction is the major etiologic factor. Management is primarily
      conservative and should be guided by a team experienced in upper limb and hand
      surgery. Our experience at a major referral center during a 3-year period is
      described.

PMID- 8463596
TI  - Functional restoration of elbow flexion in brachial plexus injuries: results in
      167 patients (excluding obstetric brachial plexus injury).
AB  - From 1985 to 1990, 167 patients were treated for impaired elbow flexion caused by
      brachial plexus injury. Surgical procedures were divided into two categories:
      nerve reconstruction (128 patients) and muscle or tendon transfers (39 patients).
      Surgery in the nerve reconstruction group included direct suturing, nerve
      grafting of portions of the brachial plexus responsible for elbow flexion, or
      nerve transfer (intercostal, phrenic, or spinal accessory nerve) to the
      musculocutaneous nerve. The second category included tendon or muscle transfer or
      a functioning free muscle transplantation for biceps replacement. Results were
      assessed by the Medical Research Council grading system and weight-lifting
      evaluation. Functional results revealed that nerve reconstruction was superior to
      muscle tendon transfers, direct suturing was superior to nerve grafting, short
      nerve grafts (< 10 cm) were superior to long nerve grafts (> 10 cm),
      infraclavicular plexus injuries did better than supraclavicular injuries,
      vascularized ulnar nerve grafts (if indicated) were superior to conventional long
      nerve grafts, ruptured plexus injuries recovered better than root avulsions.
      Intercostal nerve transfer to the musculocutaneous nerve has satisfactory
      results. In the muscle tendon transfer group, Steindler flexorplasty resulted in
      upgrading muscle strength from level one to level two. Functioning free muscle
      transplantation had results similar to the latissimus dorsi transfer.

PMID- 8463597
TI  - Evaluation of patients with thoracic outlet syndrome.
AB  - This prospective study evaluated 50 patients with thoracic outlet syndrome.
      Detailed history and pain scale evaluation preceded physical examination, which
      included provocative tests (positional and compressive) and sensory evaluation
      (baseline and postprovocative vibration thresholds and two-point discrimination).
      Only one patient had a positive nerve conduction study/electromyograph at the
      brachial plexus level. Thirty-two percent of the patients had a compressive
      anatomic abnormality as seen on a computed tomography scan. Ninety-four percent
      had positive provocative position and compression test results. Two-point
      discrimination was normal in 98%. Clinical assessment of thoracic outlet syndrome
      is best achieved by reproduction of symptoms with compression and positional
      provocative testing. Results of the majority of tests (nerve conduction
      studies/electromyographs, x-ray films, sensory tests) will be normal.
      Measurements of changes in sensory thresholds during provocation of symptoms may
      be useful.

PMID- 8463598
TI  - Ulnar translation of the carpus in rheumatoid arthritis: an analysis of five
      determination methods.
AB  - Five x-ray methods of assessing ulnar translation of the carpus were compared to
      each other. Overall, we found the uncompensated semiquantitative method proposed
      by Gilula et al. to be the most practical and the best method with a sensitivity
      index of 82%, a specificity index of 88%, an accuracy of 87%, and an
      interobserver correlation of 90%. The method, however, decreased in specificity
      and accuracy when a corrective formula was applied to adjust the ulnometacarpal
      angle to zero degrees deviation. Our conclusion is that the sensitivity indices
      are relatively low for all methods, and underdiagnosis may occur. At present the
      semiquantitated method of Gilula et al. is the most practical, with the highest
      sensitivity index, and is recommended as a screening tool for assessment of ulnar
      translation of the carpus.

PMID- 8463599
TI  - Palmar midcarpal instability: results of surgical reconstruction.
AB  - We reviewed the cases of 13 patients who underwent 15 surgical procedures for
      palmar midcarpal instability from 1981 to 1989. Six patients had a limited
      midcarpal arthrodesis, and nine patients had one of four different soft tissue
      reconstructive procedures. One hundred percent clinical follow-up was obtained at
      an average of 48 months. All six of the limited midcarpal arthrodeses were
      successful. Six of the nine soft tissue reconstructions failed. However, one
      procedure, a distal advancement of the ulnar arm of the arcuate ligament combined
      with a dorsal capsulodesis, restored stability in three of five wrists. We
      concluded that patients with palmar midcarpal instability may have significant
      disability that may be refractory to nonsurgical management. Limited midcarpal
      arthrodesis provides definitive treatment.

PMID- 8463600
TI  - Preliminary experience with Ilizarov method in late reconstruction of radial
      hemimelia.
AB  - We report the outcome of ulnar lengthening with the Ilizarov technique in five
      adults with radial hemimelia and previous wrist centralization. The indications
      for ulnar lengthening in these patients were either a functional deficit due to
      the short ulna or poor appearance that caused the patient significant
      unhappiness. All patients had a successful lengthening of the ulna, with a gain
      in length from 4 to 13 cm; however, the procedures were prolonged (7 to 25
      months), and all patients experienced complications. At the time of follow-up
      examination no patient had residual pain or paresthesias. In four of five
      patients, although ulnar lengthening resulted in somewhat stiffer digits, it
      improved function of the extremity as a whole. When asked if they would repeat
      the lengthening, knowing what they know now, all five replied that they would.
      The technical difficulties encountered in these cases suggest a cautious approach
      to ulnar lengthening. This is a long, arduous, painful process that requires a
      psychologically robust patient. If the ulna is very short preoperatively,
      lengthening can enhance the volume of space accessible to the hand and in that
      way improve function.

PMID- 8463601
TI  - Posttraumatic physeal bar formation in the digit of a child: a case report.

PMID- 8463602
TI  - Biomechanical evaluation of distal radioulnar reconstructions.
AB  - Numerous reconstructive procedures have been described for the treatment of
      chronic instability of the distal radioulnar joint or instability of the stump of
      the resected distal ulna. This biomechanical study presents an evaluation of the
      three basic design types that have been used in reconstruction. The initial
      static stability provided by the reconstructions was tested and compared with the
      stability of the intact joint. Our findings show that all reconstructive
      procedures failed to restore natural joint stability. A radioulnar sling design
      was the most effective of the three types, whereas tenodesis procedures and ulnar
      collateral ligament reconstruction were much less effective in providing
      stability. We conclude that current designs have significant biomechanical
      shortcomings. On the basis of our observations during testing, we believe that
      improved designs will require an intra-articular reconstruction that more closely
      duplicates the biomechanical functions of the triangular fibrocartilage complex.

PMID- 8463603
TI  - Partial excision of the triangular fibrocartilage complex articular disk: a
      biomechanical study.
AB  - A cadaver study was performed to evaluate the effects of partial and complete
      excisions of the articular disk of the triangular fibrocartilage complex on the
      kinematics of the distal radioulnar joint and the structural integrity of the
      triangular fibrocartilage. An excision that did not violate the peripheral 2 mm
      of the disk and that comprised less than two thirds of the disk area resulted in
      no significant kinematic or structural changes, but larger excisions produced
      measurable changes. These results provide further support for limited excision of
      central triangular fibrocartilage complex tears.

PMID- 8463604
TI  - Measurement of carpal bone geometry by computer analysis of three-dimensional CT
      images.
AB  - The aim of this project was noninvasively to analyze and quantitate the geometry,
      load transfer characteristics, and spatial relationships of the carpal bones by
      using a new three-dimensional CT scan reconstruction technique. The determination
      of mechanical parameters such as distances between centroids and between bone
      surfaces, carpal alignment, volumes, surface areas, and contact areas can provide
      the basis for comparison between normal wrists and wrists with a variety of
      progressive instability patterns, types of fracture, pathologic and posttraumatic
      states, and different simulated surgical procedures. This new technology has
      demonstrated a volumetric accuracy of 94% and a linear accuracy of 97%.
      Simultaneous analysis of all articulating surfaces of multiple joints can be
      performed in cadavers and in patients because of the noninvasive nature of the
      imaging reconstruction technique. This new research offers much more information
      than has previously been available. It also promises direct application to the
      clinical setting and eliminates several limitations and questions that were
      inescapable with previous technology.

PMID- 8463605
TI  - Bilateral pronator syndrome associated with anomalous heads of the pronator teres
      muscle: a case report.

PMID- 8463606
TI  - The reverse flexor carpi ulnaris and ulnar nerve neuropathy.

PMID- 8463607
TI  - Intraosseous pressure in Kienbock's disease.
AB  - Intraosseous pressure was measured in the lunate of 10 patients undergoing
      surgery for Kienbock's disease. Using the styloid process of the radius and the
      capitate as reference points of bone pressure, I found a stasis rather than
      arterial insufficiency in the lunate. This pattern was observed regardless of the
      stage of the disease according to Stahl and regardless of the finding by
      technetium TC 99m-methylene diphosphonate scintigraphy. The significance of this
      finding is still unknown but questions the current concept that Kienbock's
      disease is caused by arterial insufficiency, because these results imply an
      interruption of the blood flow as a result of venous congestion.

PMID- 8463608
TI  - Dorsal approach to scaphoid nonunion.
AB  - The surgical approach for treatment of scaphoid nonunion usually involves various
      combinations of screws and Kirschner wires, with or without bone grafts. This
      article reports our results with 36 dorsal-approach bone grafting procedures for
      treatment of scaphoid nonunion with Kirschner wires. Union was achieved in 89%.
      The average follow-up was 5 years. Flexion/extension averaged 76% of the opposite
      wrist, and grip strength was 88% of the opposite hand. Ninety-one percent of the
      employed patients returned to their original jobs. The dorsal approach provides
      satisfactory exposure for fragment reduction and bone grafting.

PMID- 8463609
TI  - The scaphoid shift test.
AB  - The scaphoid test described by Watson has generally been accepted as the
      definitive test for scaphoid instability and uses pressure against the scaphoid
      tubercle as the wrist moves from ulnar to radial deviation for the evaluation.
      This article describes a stress test done with the wrist in neutral position,
      which actively provokes scaphoid instability. Variations in stability can be used
      to grade scaphoid laxity.

PMID- 8463610
TI  - The first nerve graft, Vulpian, and the nineteenth century neural regeneration
      controversy.
AB  - We present translations from the French of 1863 and 1870 papers in which
      Philipeaux and Vulpian reported performing first nerve allografts and then nerve
      autografts in dogs. With the latter, they had some evidence of success in two of
      seven animals. It is our belief, based on an extensive search of the literature,
      that this was the first nerve grafting performed.

PMID- 8463611
TI  - Benign gastric ulcer grossly resembling malignancy. A clinicopathologic study of
      20 resected cases.
AB  - Twenty cases of benign gastric ulcers preoperatively interpreted to be malignant
      were reviewed clinicopathologically to clarify why these ulcers grossly appeared
      malignant. Macroscopically, the lesions often had an irregular margin (75%) and
      elevated surrounding mucosa (45%), and were often located on the greater
      curvature (40%) and near the pylorus (40%). Microscopically, most ulcers were
      large (21 mm) and shallow, reaching the submucosa (70%), and many were
      characterized by marked fibrosis (35%) and inflammatory cell infiltration (25%),
      sometimes accompanied by lymphoid hyperplasia. For such ulcers, which look
      malignant, careful examination by radiography, endoscopy, and biopsy should
      diminish the indications for surgery.

PMID- 8463612
TI  - Blastocystis hominis in inflammatory bowel disease.
AB  - We retrospectively examined the hospital course of 12 patients with exacerbated
      inflammatory bowel disease (IBD), who also had stool specimens positive for
      Blastocystis hominis to determine the effect of B. hominis on their disease.
      Bloody bowel movements were common with ulcerative colitis patients and watery
      diarrhea with Crohn's disease; other findings included abdominal pain, fever,
      nausea, and vomiting. All patients responded favorably to medical therapy. Three
      responded to treatment with corticosteroids alone, and one patient improved with
      bowel rest without medications. Five patients failed to improve on metronidazole;
      four of them responded to a subsequent course of corticosteroids, whereas the
      fifth patient became asymptomatic after erythromycin treatment for concomitant
      Campylobacter jejuni. Finally, three patients responded to treatment with
      metronidazole alone, which is known to eradicate B. hominis but may also have a
      beneficial effect on IBD. In no case did corticosteroid treatment worsen the
      condition. Our findings indicate that B. hominis is not a significant pathogen in
      IBD and treatment must be directed toward the underlying illness.

PMID- 8463613
TI  - Prospective study of abdominal ultrasonography before laparoscopic
      cholecystectomy.
AB  - To investigate the role of abdominal ultrasonography (US) in predicting possible
      difficulties during laparoscopic cholecystectomy, we performed preoperative US
      evaluation prospectively in 82 consecutive patients. We correlated our
      predictions of "easy" and "difficult" with difficulties experienced at operation
      in surgery. The binary outcomes were analyzed by taking both easy category of US
      and surgical operation as positive results and both difficult category as
      negative results. We obtained satisfactory sensitivity (93.8%), accuracy (81.4%),
      and positive predictive value (84.7%), but low specificity (35.3%) and negative
      predictive value (60%). The highly positive results were the result of careful US
      examination. The low specificity and negative predictive value were attributed to
      the fact that most surgically difficult cases were due to adhesions around the
      gallbladder, difficult indeed to detect at US. We conclude that thorough
      abdominal US examination before laparoscopic cholecystectomy is useful in
      preoperative evaluation of patients undergoing laparoscopic cholecystectomy, even
      if it not infrequently fails to predict the surgically difficult cases mainly due
      to adhesions around the gallbladder.

PMID- 8463614
TI  - Percutaneous needle biopsy of hepatic cavernous hemangioma.
AB  - In a retrospective review of percutaneous needle biopsy in 38 patients, we
      assessed the safety of this procedure for establishing the diagnosis of cavernous
      hemangioma of the liver. Computed tomography (CT) or ultrasound was used to
      direct the biopsy of focal liver lesions ranging in size from 1 to 13.5 cm, with
      a median size of 3 cm. In all patients, the pathological diagnosis was
      established conclusively on the basis of core tissue samples obtained using a 20
      gauge cutting needle and an average of 2.7 passes. Biopsy was performed as an
      outpatient procedure in 31 patients (82%). Clinical or radiological follow-up of
      30 patients for an average of 32 months (range 7-57 months) supported the
      pathological diagnosis of cavernous hemangioma. Despite the reported risk of
      hemorrhage, we performed biopsies on all patients without serious complication;
      five patients complained of transient right upper quadrant pain, that did not
      require treatment. We conclude that percutaneous needle biopsy (PNB) of the liver
      is a safe and effective procedure for establishing the diagnosis of cavernous
      hemangioma in patients who have no bleeding diathesis.

PMID- 8463615
TI  - Carcinoid tumors of the gut. Our experience over three decades and review of the
      literature.
AB  - We review our institution's experience with gastrointestinal (GI) carcinoid
      tumors over the past three decades: fifty-five cases with complete follow-up. The
      majority of carcinoids were from the ileum and appendix--19 cases (35%) and 17
      cases (31%), respectively. Other locations included the cecum in five (9%),
      duodenum in three (5%), jejunum in three (5%), rectum in three (5%), and pylorus
      in one (2%). Four patients had metastatic carcinoid of uncertain primary (7%).
      Appendiceal carcinoids were frequently incidental and small (all < 1 cm). None
      were metastatic, and all appeared to have been cured with simple appendectomy. In
      contrast, ileal carcinoids were usually symptomatic and often metastatic at the
      time of diagnosis. Carcinoid syndrome occurred in 10 patients (18%), associated
      primarily with metastatic tumors from the ileum and cecum. Secondary malignancies
      were seen in 10 patients (18%). We provide a literature survey of GI carcinoid
      tumors and carcinoid syndrome.

PMID- 8463616
TI  - Fatal gastroduodenal necrosis after injection sclerotherapy for bleeding duodenal
      ulcer.
AB  - Complications after endoscopic injection therapy to control bleeding from peptic
      ulcers are uncommon and rarely fatal. We report a case of fatal gastroduodenal
      necrosis and postulate that accidental intra-arterial injection may be
      responsible for this event.

PMID- 8463617
TI  - Crohn's disease of the gallbladder.
AB  - In a 57-year-old woman, Crohn's disease involving the gallbladder and duodenum
      caused biliary tract obstruction and necessitated surgery. The patient's symptoms
      did not improve postoperatively until corticosteroids provided rapid resolution.
      Inflammatory bowel disease often involves the hepatobiliary tree, yet the
      gallbladder is rarely involved directly. This patient highlights a rare
      complication of Crohn's disease.

PMID- 8463618
TI  - Metastatic prostate cancer simulating sclerosing cholangitis.
AB  - We report what we believe to be the first case of metastatic prostate cancer
      presenting as sclerosing cholangitis. In a 71-year-old man with known prostate
      cancer and cholestatic jaundice, an endoscopic retrograde
      cholangiopancreatography revealed multifocal strictures of both the intrahepatic
      and extrahepatic biliary system consistent with sclerosing cholangitis. Review of
      a liver biopsy and cholecystectomy specimen showed metastases from prostate
      cancer, which stained positively with prostate-specific antigen. Multiple hepatic
      metastases from prostate cancer should be included among the conditions that
      simulate primary sclerosing cholangitis on cholangiography.

PMID- 8463619
TI  - Primary Sjogren's syndrome associated with chronic atrophic gastritis and
      pernicious anemia.
AB  - Sjogren's syndrome (SS) is a systemic, autoimmune exocrinopathy in which
      destructive, inflammatory-cell infiltration can affect any gland. Although
      chronic atrophic gastritis is the most common form of gastrointestinal
      involvement in SS, pernicious anemia develops in rare cases. We therefore report
      a patient with these three associated diseases.

PMID- 8463620
TI  - Open access endoscopy: a large-scale analysis of its use in dyspeptic patients.
AB  - We examined 2,253 consecutive dyspeptic patients referred to our endoscopy
      service by general practitioners ("open" group) and hospital clinicians ("clinic"
      group) to study the prevalence of the various endoscopic findings according to
      patient age and the route of endoscopic referral. The results obtained are
      representative of that specific population. Normal endoscopic findings
      progressively lessened as patients' age increased, and the overall rate was as
      low as 26.5% in the open and 30.3% in the clinic groups. Erosive prepyloric
      changes and duodenitis were the most frequently noted abnormalities in patients <
      40 years of age (16.9% and 20.1%, respectively, in the open and 11.6% and 14.2%
      in the clinic groups). Chronic gastritis was prevalent in patients > 60 years of
      age. Duodenal ulcer decreased from 9.7% (open) and 18% (clinic) in patients < 40
      to 2% and 1.1% in patients > 60. No malignancy was found in patients < 40, while
      only approximately 1% of those < 60 had neoplasms. All our endoscopic findings,
      both in the open and the clinic groups, were not significantly different. No
      significant differences in symptoms were observed among patients with different
      endoscopic findings. We conclude that (a) endoscopy is really useful only in a
      small group of patients < 40 years of age; (b) individual symptoms alone have a
      poorly discriminant diagnostic power; and (c) restriction of open access
      endoscopy is not justified.

PMID- 8463621
TI  - Assessment of portal contribution to liver perfusion by quantitative sequential
      scintigraphy and Doppler ultrasound in alcoholic cirrhosis. Diagnostic value in
      the detection of portal hypertension.
AB  - To assess the portal contribution to liver perfusion, we carried out quantitative
      sequential scintigraphy in 110 patients with alcoholic cirrhosis (22 Child-Pugh
      class A, 39 class B, 49 class C) and 15 normal subjects. Duplex Doppler
      ultrasound found a type of intrahepatic circulation that made the standard
      scintigraphic procedure inaccurate in four cases of cirrhosis, which were
      reevaluated. Portal contribution to liver perfusion was lower in cirrhotics than
      in normal subjects (48.7 +/- 29% versus 78.4 +/- 6%; p < 0.001). The sensitivity
      of scintigraphy in detecting portal hypertension, based on portal contribution <
      or = 66%, was 61.8% (with a 100% specificity) compared with 66.7% for endoscopy
      (diagnosis based on existence of varices). The overall sensitivity of the two
      tests together was 86.1%. Portal contribution to liver perfusion was inversely
      correlated to Child-Pugh score (r = 0.53; p < 0.001), to prothrombin time (r =
      0.52; p < 0.001), and to hepatic venous pressure gradient (r = 0.43; p < 0.001)
      and positively correlated to albuminemia (r = 0.42; p < 0.001). Concurrent
      alcoholic hepatitis and the existence of large portosystemic collaterals were
      related to a decrease in portal contribution to liver perfusion. We conclude that
      quantitative sequential scintigraphy, which shows a direct relationship between
      portal contribution to liver perfusion, on the one hand, and the amount of
      portosystemic shunting, the progression of liver disease, and/or acute liver
      injury, on the other, could serve as a diagnostic test for portal hypertension.
      The addition of scintigraphy improves the overall sensitivity of endoscopy.

PMID- 8463622
TI  - Hepatic hemangioma showing a mass effect on the stomach wall: endosonographic
      differentiation from submucosal tumor of the stomach.

PMID- 8463623
TI  - Rectal Hodgkin's disease in acquired immune deficiency syndrome.

PMID- 8463624
TI  - Metastases of a gastric adenocarcinoma to the rectum.

PMID- 8463625
TI  - Diarrhea, constipation, and hypothyroidism.

PMID- 8463626
TI  - Red jello stool and red dye-arrhea.

PMID- 8463628
TI  - Read my lips revisited.

PMID- 8463627
TI  - CEA in gastric juice and chronic atrophic gastritis: a prospective evaluation.

PMID- 8463629
TI  - "Not so easy to diagnose" dyspepsia.
AB  - The diagnosis of the cause of a dyspepsia should not rest on indiscriminate
      "routine" investigation. It should be based on historical and physical evidence
      supported by a therapeutic trial that confirms the clinical diagnosis. If
      necessary, it should be followed by selected investigations to confirm or exclude
      serious diseases that are likely to be the cause of the symptoms. If an organic
      explanation cannot be provided, it should not be assumed that one does not exist,
      only that the more serious and treatable causes have been excluded.
      "Sophisticated" high-technology investigations should not become part of the
      "routine" investigation of dyspepsia.

PMID- 8463630
TI  - Celiac (solar) plexus syndrome. A frequently overlooked source of abdominal pain.
AB  - Of the nonorganic abdominal disorders the celiac/solar plexus syndrome represents
      a frequently seen entity characterized by the typical association of epigastric
      pain and "lambda-type" tenderness. It is a special type of abdominal neurosis in
      which the pain arises in the periaortic nervous plexuses. Its clinical importance
      is in the differential diagnosis, since it is often misinterpreted as a painful
      condition of abdominal or retroperitoneal origin.

PMID- 8463631
TI  - Cervical dysphagia is associated with gastric hyperacidity.
AB  - There is some controversy regarding the association of upper esophageal symptoms
      and acid gastroesophageal reflux. We carried out gastric acid analysis, 24-h
      esophageal pH measurement, and esophageal manometry in 150 patients with symptoms
      suggestive of gastroesophageal reflux disease. Of these, 22 (15%) had gastric
      acid hypersecretion [basal acid output level > 5 mmol/h (19 patients) or maximum
      acid output level > 30 mmol/h (13 patients)]. They were compared to 25
      consecutive patients with normal gastric acid secretion. An incompetent lower
      esophageal sphincter was identified in a similar number of hypersecretors (HS)
      (59.1%) and normosecretors (NS) (44%). Esophageal acid exposure was more common
      in HS than in NS (score, 70 vs. 36.1, p < 0.05). This was reflected as a higher
      incidence of esophagitis in HS (67 vs. 14%, p < 0.0025). Symptoms of cervical
      dysphagia were present in eight of 22 HS and one of 25 NS (p = 0.009). There was
      no anatomical lesion on endoscopy to explain the dysphagia. Upper esophageal
      sphincter (UES) manometry showed normal pharyngeal pressure, resting UES
      pressure, and length in both groups. The mean closing UES pressure was 127 mm Hg
      in HS and 114 mm Hg in NS (0.1 > p > 0.05). The HS with cervical dysphagia were
      no different from HS without dysphagia in any respect. We conclude that patients
      with gastric acid hypersecretion have more acid reflux, esophagitis, and cervical
      dysphagia. This is not associated with demonstrable abnormality in stationary
      manometry. Prolonged measurement may be required to show any change.

PMID- 8463632
TI  - A medical sociologist looks at health promotion.

PMID- 8463633
TI  - Examining HIV-related knowledge among adults in the U.S.
AB  - Supplemental AIDS data from the 1987 National Health Interview Survey indicate
      that adults in the U.S. know the most frequent modes of HIV transmission, but
      lack a more comprehensive understanding of HIV and AIDS. Elements from a
      diffusion model were isolated to create a path-analytic framework for examining
      the effects of population or recipient characteristics and information sources or
      communication channels on HIV-related knowledge with these data. This
      multivariate analysis suggests that persons of lower socioeconomic status, older
      adults, those from racial/ethnic minority groups, those living outside of
      metropolitan areas, men, and those citing mass media (television or newspapers)
      as their primary source of information about HIV and AIDS have slightly lower
      levels of HIV-related knowledge. Decomposition of the effects in the path
      analysis suggests that use of information sources or channels, as measured by
      survey data, accounts for little of the observed variation in HIV-related
      knowledge. The implications of these results for future research and HIV-related
      education are discussed.

PMID- 8463634
TI  - Determinants of social support among gay men: the context of AIDS.
AB  - In this study, the determinants of social support are examined among a
      probability sample of gay men residing in San Francisco. Using two waves of data
      (collected in 1985 and 1987), cross-sectional and longitudinal analyses focused
      on the effects of five sets of factors (demographic, community
      integration/network, AIDS-related loss, individual, and health) on satisfaction
      with three types of support (emotional, informational, and practical). Personal
      acceptance of one's gay identity and talking to family members about AIDS showed
      the strongest positive associations with concurrent measures of support and
      changes in support satisfaction over the two-year period. Conversely, depression
      and number of HIV symptoms were negatively associated with cross-sectional
      support and support changes. Family knowledge of respondents' homosexuality
      interacted with HIV symptoms, such that knowledge was negatively associated with
      support among those experiencing greater numbers of HIV symptoms. Findings
      suggest that those most in need of support may be the least satisfied with the
      support they receive. Family appear to have the potential to be particularly
      helpful or especially harmful to gay men trying to cope with the AIDS crisis.

PMID- 8463635
TI  - Stress, role captivity, and the cessation of caregiving.
AB  - Difficulties experienced when caring for an impaired elderly relative, including
      decisions to place this person in institutional care, are examined as a function
      of caregiver stress. Three annual interviews were conducted with 555 caregivers
      to parents or spouses with Alzheimer's Disease. All patients were initially cared
      for at home, but 192 were subsequently placed in institutional care and 146 died.
      Background-contextual factors and disease characteristics have only limited
      associations with institutionalization. Two secondary stressors--consequences of
      caregiving that do not directly involve care-related tasks--exert the most
      proximal impact upon placement: role captivity and economic strain. Role
      captivity is stable over time when in-home care continues, but
      institutionalization alleviates this sentiment. The odds of patient death
      increase substantially following institutionalization, even when health status is
      controlled. These results illustrate that in-home care may be beneficial for care
      recipients, but increase role-related stress for the care provider.

PMID- 8463636
TI  - Monitoring AIDS and other rare population events: a network approach.
AB  - This paper replicates and extends an earlier attempt to use data from the General
      Social Survey (GSS) to track the distribution of AIDS across demographic
      subgroups. (The GSS asks respondents whether they know a person with AIDS [PWA].)
      The gender, racial, age, and regional composition of the set of PWAs reported by
      GSS respondents is compared with that of the official AIDS cases reported to the
      Centers for Disease Control (CDC). In an attempt to assess the accuracy of the
      GSS estimates, a similar analysis is performed in which GSS respondents are asked
      whether they know a homicide victim. Data from four consecutive GSS samples
      (1988, 1989, 1990, and 1991) are used, permitting a more detailed exploration of
      potential biases and problems with the network technique. In addition, time
      series data from the National Health Interview Survey on the percentage of people
      who know at least one PWA are used to validate the GSS data. Our earlier
      findings, that the GSS identifies proportionately more White and midwestern cases
      than are reported to the CDC, are corroborated by the additional data. Possible
      explanations for these discrepancies are given, and suggestions are made for
      improving the utility of the approach.

PMID- 8463637
TI  - Husband and wife differences in response to undesirable life events.
AB  - In the present study of 451 married couples living in the rural midwest, gender
      differences were examined in reports of exposure and vulnerability to specific
      types of undesirable life events. Consistent with expectations derived from
      either a social structural or identity perspective, the results demonstrated that
      men are more likely than women to report exposure to and to be distressed by work
      and financial events. Women, on the other hand, are more strongly influenced by
      exposure to negative events within the family but not within their network of
      friends. Outcomes vary according to the type of emotional distress. Financial
      stress, for example, increases hostility among men more than among women, but
      wives are more likely than husbands to report somatic complaints in response to
      the same stressor. The findings demonstrate the need for future research that
      more directly investigates the intraindividual and social mechanisms which
      account for gender differences in a broad range of emotional and behavioral
      responses to varying types of significant life changes.

PMID- 8463638
TI  - Each Medicare carrier has been directed to establish a physician advisory
      committee.

PMID- 8463639
TI  - Health care reform should begin with insurance industry.

PMID- 8463640
TI  - Just say 'no' to 'trips'.

PMID- 8463641
TI  - Reversing the decline and fall of the general internist.

PMID- 8463642
TI  - Medicaid rescue effort to be 'painful'. Interview by Bob Carlson.

PMID- 8463643
TI  - HIV seroprevalence in the Bell Flower STD Clinic.

PMID- 8463644
TI  - State program tracks Schedule II drugs.
AB  - By implementing the multiple copy prescription program, Indiana demonstrates its
      concern with the problems of doctor shoppers and physicians involved with abuse.
      By trying to track illegal diversion of Schedule II drugs, states that have
      implemented tracking programs are trying to rid the streets of illicit drug use.
      When it is time to renew the law, the state should consider using modern computer
      technology. Indiana's program could be even more effective if it incorporated
      electronic data transfer.

PMID- 8463645
TI  - Brain biopsy in Indiana AIDS patients.
AB  - The neuropathologic findings of brain biopsies in a series of Indiana AIDS
      patients were reviewed. All subjects displayed focal lesions on radiographic
      studies. The three most common diagnoses were toxoplasmosis, progressive
      multifocal leukoencephalopathy and primary central nervous symptoms (CNS)
      lymphoma. These findings were consistent with previous studies elsewhere. Biopsy
      appears to affect the course of treatment only if CNS lymphoma is discovered.
      Because the value of currently available therapy for this disease in AIDS
      patients is controversial, there is no clear consensus regarding the indications
      for biopsy in this population.

PMID- 8463646
TI  - From the museum.

PMID- 8463647
TI  - Diagnosis of infective endocarditis.
AB  - The diagnosis of IE is often difficult to establish with certainty. Current
      diagnostic criteria have several weaknesses, the most important being failure to
      utilize the results of echocardiography. This seems inconsistent with modern
      practice. In reality, the results of modern echocardiography, including
      appropriate use of transesophageal echocardiography, are critically important for
      diagnosis of infective endocarditis. New criteria are in the process of
      development which should prove more sensitive and more specific for disease
      classification, epidemiologic studies, and clinical trials.

PMID- 8463648
TI  - Aminoglycoside resistant enterococcal endocarditis.
AB  - There are few well-documented cases of infective endocarditis due to highly
      aminoglycoside-resistant enterococci reported to date. Nevertheless, strains with
      high-level resistance to both streptomycin and gentamicin are now sufficiently
      common that the number of cases of endocarditis due to these organisms will
      undoubtedly continue to increase. Serious efforts to develop appropriate
      alternative treatment strategies are now clearly necessary. All high-level
      gentamicin-resistant bloodstream isolates from patients with suspected or proven
      endocarditis should be screened for high-level streptomycin resistance. Because
      these two resistance traits are mediated by distinct genetic elements, a
      significant minority of highly gentamicin-resistant enterococci will be
      susceptible to synergistic killing by combinations of cell wall-active
      antibiotics with streptomycin. For strains highly resistant to both
      aminoglycosides, there is no evidence of benefit from use of these toxic
      antimicrobials, and treatment with a cell wall-active agent alone is warranted.
      Based on older literature and animal models, perhaps as many as 40% to 50% of
      cases of enterococcal endocarditis might be curable by such regimens. Alternative
      combinations using a cell wall-active antibiotic together with a fluoroquinolone
      or rifampin cannot be specifically recommended based on any firm data from the
      literature, but possible merits of such combinations can be explored in vitro
      under appropriate circumstances. For ampicillin- and vancomycin-susceptible
      strains, ampicillin would seem preferable because this drug typically
      demonstrates greater bactericidal activity in vitro as a single agent.
      Consideration could be given to administration of ampicillin by continuous
      intravenous infusion. Several animal studies indicating effectiveness of
      penicillins for enterococcal endocarditis have used dosing regimens resulting in
      sustained serum levels. It is unknown whether these observations are relevant to
      human enterococcal infections. Testing for beta-lactamase production should be
      undertaken if penicillins are to be used. For strains that are resistant to
      achievable concentrations of penicillins, or when the patient is intolerant of
      beta-lactams, vancomycin can be used. In animal models, teicoplanin has appeared
      to be superior to vancomycin, but high concentrations must be attained. This drug
      is not yet approved for clinical use, however, and it is unclear if any advantage
      would exist in treatment of human infections. The recent emergence of enterococci
      which are resistant to glycopeptides has introduced another potential
      complicating factor; some of these are also substantially resistant to beta
      lactams as well. In some reports, favorable interactions between vancomycin and
      beta-lactams have been observed against vancomycin-resistant strains.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8463649
TI  - Zoonotic endocarditis.
AB  - The so-called zoonotic endocarditis is transmitted from animals to humans and is
      frequently found in some cattle-raising countries. Brucella endocarditis is a
      destructive process of the aortic valve with abscess formation that commonly
      leads to heart failure. Q fever endocarditis is a more indolent infection, but it
      is also capable of producing severe valvular damage and hemodynamic compromise.
      Treatment of zoonotic endocarditis includes the prolonged administration of
      doxycycline in combination with other antimicrobial agents and a judicious use of
      valve replacement. Mortality of Brucella endocarditis has been decreased
      significantly by a medical-surgical approach to treatment. On the basis of
      serologic and valve tissue culture results, no treatment is consistently able to
      cure Q fever endocarditis, and thus mortality of this infection remains high.

PMID- 8463650
TI  - Management of complications of infective endocarditis with emphasis on
      echocardiographic findings.
AB  - This article reviews in brief the basic principles of echocardiography and their
      application in infective endocarditis. The role of echocardiography in relation
      to surgical decision making is emphasized. The special problems of vegetations,
      valve ring abscess, leaflet perforation, prosthetic valve endocarditis, and
      infective endocarditis in congenital heart disease are reviewed.

PMID- 8463651
TI  - Adherence events in the pathogenesis of infective endocarditis.
AB  - Infective endocarditis begins with adherence of microorganisms to cardiac
      tissues. These tissues have often been previously damaged, creating a thrombotic
      lesion consisting of platelets and fibrin. Circulating microorganisms localize to
      this lesion. The tissue specificity of endocarditis likely results from
      interactions between cell-surface determinants on the endocardium, platelet, and
      microorganism. Interference with these binding events may offer a means of
      modifying the course of the infection.

PMID- 8463652
TI  - Pharmacokinetic and pharmacodynamic aspects of therapy of experimental
      endocarditis.
AB  - Bacterial endocarditis is difficult to cure because of poor penetration of
      antibiotics into infected vegetations, altered metabolic state of bacteria within
      the lesion, and absence of adequate host-defense cellular response, that could
      cooperate with antibiotic action. Two main aspects are discussed for their effect
      on human therapy: (1) the kinetics of antibiotic diffusion into vegetations, with
      a special reference to the data obtained with autoradiography, and (2) the
      specificity of some pharmacodynamic aspects of antibiotics in endocarditis,
      including the clinical consequences of these two parameters on antibiotic dosing
      regimens and length of therapy.

PMID- 8463654
TI  - Short-course combination and oral therapies of Staphylococcus aureus
      endocarditis.
AB  - The experimental basis for use of 2-week semisynthetic penicillin plus
      aminoglycoside combination therapy for Staphylococcus aureus endocarditis is
      reviewed. The use of oral therapy is examined. Short-course combination of oral
      regimens can be effective and may be suitable for selected patients with S.
      aureus endocarditis.

PMID- 8463653
TI  - Staphylococcus aureus bacteremia and endocarditis. New diagnostic and therapeutic
      concepts.
AB  - Staphylococcus aureus is an important and prevalent cause of both uncomplicated
      bacteremia, as well as endocarditis. This article addresses the following
      controversial strategies: diagnosis of endocarditis in staphylococcemic
      populations; optimal treatment strategies for right-sided and left-sided S.
      aureus endocarditis; use of echocardiography in S. aureus endocarditis; and
      therapy options for catheter-associated staphylococcemias.

PMID- 8463655
TI  - Endocarditis due to coagulase-negative staphylococci. Microbiologic,
      epidemiologic, and clinical considerations.
AB  - Coagulase-negative staphylococci are the most frequently isolated pathogens in
      prosthetic valve endocarditis and cause 5% of infections involving native valves.
      Distinguishing contamination from bacteremia may be challenging. The presence of
      heteroresistance in many strains makes rigorous susceptibility testing a
      requirement for selecting appropriate antibiotic selection. Infection is
      frequently complicated by valvular insufficiency with congestive heart failure,
      local tissue invasion or synthetic embolization, making surgical intervention
      necessary in many cases.

PMID- 8463656
TI  - Risk factors for infective endocarditis.
AB  - The incidence of endocarditis is increased in patients with cardiac lesions
      causing turbulent flow. A 400-fold increase is observed in patients with
      prosthetic valves and a prior history of endocarditis. Other high risk lesions
      include rheumatic valvular disease, cyanotic congenital heart disease, and
      degenerative valve lesions. The smaller increased incidence in patients with
      mitral valve prolapse is important because of the high prevalence of mitral valve
      prolapse in the population. In addition, intravenous drug use and nosocomial
      bacteremia have emerged as important factors among patients with endocarditis.

PMID- 8463658
TI  - Introduction ethics in orthopaedic surgery "these are the times that try men's
      souls".

PMID- 8463657
TI  - Ceftriaxone and outpatient treatment of infective endocarditis.
AB  - There are a total of 8000 cases of infective endocarditis yearly in the United
      States. Central nervous system metastatic infections are not uncommon in
      infective endocarditis. Because ceftriaxone is highly bound to serum proteins,
      there is concern that the drug is highly bound to serum proteins, there is
      concern that the drug might not penetrate well in the core of an infected
      vegetation. To date, there are two published studies on the treatment of
      nonenterococcal streptococcal endocarditis by ceftriaxone in humans. Ceftriaxone
      appears to be an attractive alternative antibiotic therapy to conventional
      regimens in the treatment of streptococcal endocarditis.

PMID- 8463659
TI  - The diabetic foot: diagnosis and prevention.
AB  - Diabetes remains the world's leading cause of amputation. Like many other major
      health problems, prevention is the key to successful management. Patient
      education efforts coupled with a team approach of aggressive early management
      represent the optimum current strategy. Multidisciplinary physician teams
      consisting of orthopaedic and vascular surgeons, supported by consultation, serve
      as the focus for leadership and decision making. Their efforts are supported by
      allied health personnel, nurses, physician's assistants, and physical therapists
      trained in foot evaluation, pedicare, and nail trimming, assisted by competent
      trained shoe technicians, orthotists, or pedorthists. At each visit the patient
      is examined, footwear is evaluated, and ongoing education is provided. Visits are
      scheduled according to a risk protocol, and treatment is based on problem
      classification. This regimen should result in increased patient compliance and
      overall improved patient care.

PMID- 8463661
TI  - The diabetic foot: Charcot arthropathy.

PMID- 8463660
TI  - Outpatient diagnosis and care of the diabetic foot.

PMID- 8463662
TI  - Surgical management of ulcers, soft-tissue infections, and osteomyelitis in the
      diabetic foot.

PMID- 8463663
TI  - Salvage of a functional lower limb in diabetic patients after amputation.

PMID- 8463664
TI  - The diabetic foot: evolving technologies.
AB  - Diabetic malperforans ulcers are extremely challenging problems, and their
      treatment requires a multidisciplinary approach. The wound management technique
      is based on the depth of ulceration; necrosis and infection should be
      aggressively managed. Wound healing and prevention of adjacent breakdown is best
      assured through casting and professional shoewear techniques. The vascular
      aspects of the patient's disease must be addressed. Patients failing this
      multidisciplinary team approach may be candidates for adjunctive management. If
      transcutaneous oxygen studies indicate diminished oxygen perfusion, hyperbaric
      oxygen might be considered. Contraindications to this modality are certain
      pulmonary problems, including chronic obstructive pulmonary disease and pulmonary
      fibrosis. Some individuals, particularly those with claustrophobia, may find
      small hyperbaric chambers psychologically unacceptable. Studies on tissue and
      platelet growth factors are encouraging. Limited clinical experience with these
      materials has been encouraging and future clinical applications are anticipated;
      however, like hyperbaric oxygen, these growth factors are only an adjunct to a
      comprehensive foot care program.

PMID- 8463665
TI  - Functional nerve disorders in the athlete's foot, ankle, and leg.
AB  - Although neuropathies in the athlete's foot, ankle, and leg are uncommon, they
      are often underdiagnosed, primarily because of the complex interplay of causative
      factors. The physician should be aware of the possible occurrence of these
      neuropathies, and should be familiar with the anatomy and course of the nerves.
      Often, the problem only occurs during functional activity and cannot be
      demonstrated during the routine static examination. Other problems should also be
      considered when there is the possibility of a nerve compression syndrome.
      Metabolic processes, such as diabetes or abuse of alcohol, can certainly cause
      neuropathies. A double crush syndrome or pain from a higher source should also be
      considered. Finally, if surgery is done for chronic problems, only the area of
      constriction should be released, without interfering with the nerve itself.
      Release the fascia but leave the perineural fat intact. If instability is a
      factor, the joint should also be stabilized.

PMID- 8463666
TI  - Biomechanics of fractures and fracture fixation.

PMID- 8463667
TI  - The Jones fracture.
AB  - The Jones fracture is a fracture that occurs 1.5 cm distal to the styloid of the
      fifth metatarsal. The mechanism of injury in both the acute and chronic, or
      stress, fracture is repetitive weightbearing and pivoting on the involved foot.
      Acute fractures occur equally in both sexes, generally in nonathletes, and
      usually in individuals older than 21. Chronic or fatigue fractures occur in
      individuals between 15 to 21 years of age and predominantly in male athletes.
      Treatment of the acute fracture in the adult may require three months in a
      nonweightbearing cast. Surgical intervention with intramedullary screw
      compression is a surgical option that should be discussed with the patient.
      Chronic or fatigue fractures will require intramedullary compression screw
      fixation or open reduction and bone grafting using corticocancellous bone graft.
      The treatment outcome of this fracture is usually good if postoperative
      rehabilitation is prescribed and followed.

PMID- 8463668
TI  - Turf toe.

PMID- 8463669
TI  - Chronic exertional compartment syndrome.

PMID- 8463670
TI  - Foot orthoses.

PMID- 8463671
TI  - Mechanism, diagnosis, and treatment of running injuries.
AB  - Today running is an integral part of many people's lives. Despite an increased
      focus on the prevention of running injuries, overuse injuries are still rather
      frequent. It is important to identify the cause of the injury and treat the
      cause, not merely the symptoms. Of these injuries, 60% to 80% are associated with
      extrinsic factors, such as training errors and changes in running activities.
      Intrinsic factors are also common, especially malalignments, including excessive
      pronation and cavus foot. These changes are associated with common over-use
      injuries, but specific anatomic abnormalities and abnormal biomechanics of the
      lower extremity are not correlated with specific injuries on a predictable basis.
      Factors such as leg-length discrepancy, poor flexibility, muscle weakness and
      imbalance, deficit in neuromuscular coordination, and ligamentous laxity can also
      cause running injuries. Acquired or secondary factors, such as kinetic chain
      dysfunctions, are more common than previously acknowledged. Many running
      injuries, especially in patients with recurrent and previous injuries, are
      manifestations of a dysfunction of the kinetic chain. For this reason, it is
      important to examine the symmetry of stance and gait, and to look for
      abnormalities in both static and dynamic alignment and function. The whole
      kinetic chain must be carefully screened to rule out any underlying injuries or
      dysfunction. This process is difficult and requires experience and knowledge,
      especially because the cause of injury may be remote from the site of injury. The
      treatment of running injuries involves both a specific diagnosis, based on the
      primary problem, and the identification of kinetic chain dysfunctions. In order
      to be successful, treatment must be based on the specific diagnosis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463672
TI  - The biomechanics of the acromioclavicular, sternoclavicular, and scapulothoracic
      joints.

PMID- 8463673
TI  - Shoulders: frozen and stiff.

PMID- 8463674
TI  - Acromioclavicular joint injuries.
AB  - The effective treatment of injury to the acromioclavicular joint requires
      knowledge of the relevant anatomy and the pathoanatomy of a variety of injury
      patterns. The six-part classification system facilitates the understanding of the
      underlying pathoanatomy. Insight into the natural history of acromioclavicular
      joint injury is crucial to the success of any treatment program. Surgical
      reconstruction should be reserved for patients with grade IV, V, and VI lesions
      or those with lower grade lesions that have become chronically symptomatic. If
      the decision is made to proceed with surgical reconstruction, I prefer
      coracoclavicular fixation, over-drilling the clavicle, and use of an AO 6.5-mm
      cancellous lag screw to maintain reduction of the clavicle, followed by careful
      repair of the overlying soft tissues.

PMID- 8463675
TI  - Fractures of the scapula.

PMID- 8463676
TI  - The treatment of nonunion fractures of the midshaft of the clavicle with an
      intramedullary Hagie pin and autogenous bone graft.

PMID- 8463677
TI  - Reconstruction of the infected total hip and knee arthroplasty with gentamicin
      impregnated Palacos bone cement.

PMID- 8463678
TI  - Compression plate fixation and the effect of different types of internal fixation
      on fracture healing.

PMID- 8463679
TI  - Patellofemoral complications of total knee replacement.
AB  - Patellofemoral complications account for the majority of problems following total
      knee replacement. Many of these problems are technical, and attention to detail
      at the time of surgery can help avoid them. An understanding of the potential
      postoperative complications should help one to diagnose these early and prevent
      catastrophic problems.

PMID- 8463680
TI  - Unicompartmental knee arthroplasty.

PMID- 8463681
TI  - Principles of condylar knee arthroplasty: issues evolving.

PMID- 8463682
TI  - Revision knee arthroplasty technique.

PMID- 8463683
TI  - Alternatives to reimplantation for salvage of the total knee arthroplasty
      complicated by infection.

PMID- 8463685
TI  - Osteochondral allografts.

PMID- 8463684
TI  - The economic impact of infected total joint arthroplasty.
AB  - Infection in total joint replacement is a devastating and life-threatening
      complication for the patient. It can also be an economic disaster for hospitals
      that treat large numbers of these patients. The most important factor in both the
      clinical and economic area is to prevent the infection from occurring at all.
      However, once deep infection is established, rapid, aggressive, and definitive
      treatment must be rendered to the patient. A method of case-sharing must be
      established by medical centers that are best equipped to care for these patients.
      Reimbursement to hospitals and physicians must more realistically reflect the
      magnitude of resources consumed by these patients and the time-consuming and
      intensive care provided by a team of physicians.

PMID- 8463686
TI  - Principles and techniques of tissue banking.

PMID- 8463687
TI  - Revision arthroplasty using allograft bone.

PMID- 8463689
TI  - Bone grafting in revision cementless total knee arthroplasty.

PMID- 8463688
TI  - Allograft reconstruction of the anterior and posterior cruciate ligaments: report
      of ten-year experience and results.

PMID- 8463690
TI  - Use of allografts following resection of tumors of the musculoskeletal system.
AB  - Allografts are an effective method of reconstructing defects following the
      resection of benign or malignant tumors. The surgeon must carefully plan the
      procedure in two stages. Stage I involves resection of the tumor with an adequate
      margin to prevent local recurrence, and stage II involves reconstruction of the
      limb with a durable and functional technique that has a low risk of morbidity.
      Allograft reconstructions are technically demanding. The prerequisites to a
      successful reconstruction include rigid internal fixation of the allograft,
      competent soft tissues to cover the graft, preoperative and postoperative
      antibiotic coverage, meticulous hemostasis and postoperative wound drainage to
      prevent hematoma formation, and protection of the allograft to allow union.
      Whenever soft-tissue coverage of the graft is in question, local rotational flaps
      or free microvascular transfers should be used to cover the allograft with
      healthy muscle. Second surgical procedures, such as revision of necrotic soft
      tissue flaps, drainage of hematomas, bone grafting of nonunions, and revision of
      internal fixation, should be avoided by careful technique at the index operation
      because additional procedures place the allograft at risk for infection. Further
      basic science investigations and clinical studies should expand the applications
      of allograft reconstructions and lower the incidence of complications.

PMID- 8463691
TI  - Paget's disease of bone: pathophysiology and diagnosis.

PMID- 8463692
TI  - Medical treatment for Paget's disease of bone.

PMID- 8463693
TI  - Physical agents in musculoskeletal problems: heat and cold therapy modalities.

PMID- 8463694
TI  - Electrical stimulation of soft tissues.
AB  - It is well-documented that electrical potentials normally are present in biologic
      soft tissues. The discovery of these has generated interest in effecting a change
      in the biology of these tissues by externally imposing an electrical field. There
      is experimental evidence that ligament and tendon repair can be affected by ES,
      but there have been no clinical studies to demonstrate its effectiveness in human
      ligament or tendon injuries. The only clinical support for use of ES to enhance
      soft-tissue healing is for its use in chronic, open dermal wounds. ES has been
      shown to be effective for these chronic wounds under certain conditions. There is
      currently insufficient justification for the use of ES for reduction of soft
      tissue edema.

PMID- 8463695
TI  - The modality of therapeutic exercise.

PMID- 8463696
TI  - Spinal considerations in the young athlete.
AB  - The young athlete involved in modern sports activity may be subject to
      considerable problems involving the spine. An appreciation of the differences in
      spinal anatomy, development, and kinematics facilitates the evaluation of each
      individual. While a variety of factors are operant that could contribute to
      difficulty in evaluation and treatment, an organized approach with an emphasis on
      naturally-occurring variations of the immature spine will allow for appropriate
      recommendations. While concern exists regarding the individual with congenital,
      developmental, or hereditary conditions, it is important to respect the
      individuality of these young athletes and to assess each problem in a
      comprehensive manner before recommending full or restricted activity. Current
      research should yield important information that will serve as more absolute
      guidelines in formulating recommendations for involved adolescent athletes and
      will establish the natural history of conditions that today remain obscure.

PMID- 8463697
TI  - Acute knee injuries in the immature athlete.

PMID- 8463698
TI  - Knee overuse disorders in the pediatric and adolescent athlete.

PMID- 8463699
TI  - Adolescent anterior knee pain.

PMID- 8463700
TI  - Congenital dislocation of the knee and patella.

PMID- 8463701
TI  - Infantile tibia vara.

PMID- 8463702
TI  - Varus foot in cerebral palsy: an overview.
AB  - In cerebral palsy, imbalance of the invertor and evertor muscles can result in
      varus alignment of the foot. The primary functional problems of varus foot are
      weightbearing instability and/or difficulty in foot clearance in swing phase.
      Additional problems include difficulties in shoe fitting, abnormal shoe wear, and
      unacceptable cosmesis. Gait studies have shed some light on the alterations of
      the muscle activity that can cause this problem but have fallen short of
      providing clear guidelines for treatment of this common problem. Confusion exists
      because dynamic electromyography does not give definitive information about the
      quantity of muscle tension and because the analyses have not included movement
      measurements that distinguish between the movements that occur in the hind foot
      and forefoot. Technical limitations that have made it impossible to obtain this
      information are rapidly disappearing, and the way is opening up for biomechanical
      studies of foot and ankle function that will allow greater precision in the
      selection of surgical treatment for varus foot.

PMID- 8463703
TI  - Discrepancies in the orthopaedic literature: why? A statistical explanation.

PMID- 8463704
TI  - Flexible intramedullary nailing of long bone fractures.

PMID- 8463705
TI  - Distal radius fractures: nonsurgical treatment options.
AB  - In conclusion, each of these methods have been proven to be effective in selected
      patients. None of these methods, however, can be used in all patients. They must
      be carefully evaluated for use in young patients where anatomic alignment is
      essential to avoid impairment of function with loss of grip strength and the
      possibility of developing post-traumatic arthritis. If any of these methods is
      used, ideal cases would be those with nonarticular fractures, with minimal
      displacement and minimal bone loss, and some assurance that the fracture will
      remain stable during treatment. The techniques have been proven to be effective.
      If, however, fracture reduction is lost with any of these techniques, one must
      reassess the fracture, especially in the young, and be more aggressive in
      restoring and maintaining alignment until healing has occurred. Orthopaedic
      Knowledge Update 3, published in 1990, relates, "Depending on comminution,
      fixation may be best achieved with plate, screws, Kirschner wires, external
      fixation or some combination of these." It goes on to state, "In young adults
      particularly, accurate reduction of the articular surface appears critical to
      achievement of a good result after a Colles' fracture."

PMID- 8463706
TI  - Fractures of the distal radius: operative treatment.

PMID- 8463707
TI  - Malunion of the distal radius: current approach to management.

PMID- 8463708
TI  - Polypeptides synthesized in vitro by Biomphalaria glabrata hemocytes bind to
      Schistosoma mansoni primary sporocysts.
AB  - In vitro labeled polypeptides secreted by schistosome-susceptible and -resistant
      Biomphalaria glabrata were tested for their ability to bind the surface tegument
      of Schistosoma mansoni primary (= mother) sporocysts. Out of a complex pattern of
      SDS-PAGE-separated hemocyte polypeptides, only two (19 and 46 kDa) bound to
      sporocysts. The 19-kDa polypeptide consistently bound to both live and fixed
      sporocysts, although fixed larvae usually bound more than living sporocysts. The
      46-kDa component bound primarily to fixed sporocysts. A similar pattern of
      binding was seen when sporocysts were exposed to polypeptides secreted into
      culture medium by both resistant and susceptible snail hemocytes. However,
      previous work indicates that sporocyst secretory products, in the presence of
      homologous snail plasma components, can differentially influence the quantity of
      these two polypeptides. Therefore, it is hypothesized that "regulation" of the
      interaction of snail hemocyte polypeptides with the parasite may lie in the
      sporocyst-mediated differential effect on synthesis and/or secretion of the 19-
      and 46-kDa polypeptides by hemocytes of these two snail strains. Thus, the
      hemocyte polypeptides reported in this study may represent potential mediators of
      self/non-self-recognition or hemocyte activation in the B. glabrata internal
      defense system.

PMID- 8463710
TI  - Effect of Beauveria bassiana and Candida albicans on the cellular defense
      response of Spodoptera exigua.
AB  - A marked difference in the cellular response of Spodoptera exigua was observed
      when larvae were challenged with the insect mycopathogen Beauveria bassiana
      versus the yeast Candida albicans. Both fungi were rapidly phagocytized by
      circulating hemocytes. The relative growth rate of C. albicans as measured by
      daughter cell formation was partially suppressed, whereas B. bassiana
      blastospores produced germ tubes at rates equivalent to those under in vitro
      conditions. Limited growth by C. albicans within the phagocytic cells stimulated
      nodulation by hemocytes resulting in the protection of challenged larvae to C.
      albicans. Alternatively, B. bassiana suppressed the spreading ability of S.
      exigua hemocytes. These suppressed larvae, while capable of phagocytizing C.
      albicans, were unable to produce multicellular nodules. Circulating vegetative
      cells of both C. albicans and B. bassiana were observed to proliferate within
      these immunosuppressed host larvae.

PMID- 8463709
TI  - Toxicity and pathology of crude broth filtrate produced by Hirsutella thompsonii
      var. thompsonii in shake culture.
AB  - Metabolic products secreted by the fungal mycelia of Hirsutella thompsonii var.
      thompsonii (CBS 556.77D) in a defined culture broth in shake culture were tested
      for toxicity to Galleria mellonella larvae and Drosophila melanogaster adults via
      injection and per os application, respectively. In addition, the toxic effect of
      broth filtrate was observed in vitro in a cell line of Bombyx mori. Czapek-Dox
      broth fortified with 1% yeast extract stimulated more rapid mycelial growth and
      correspondingly more toxin production in time. At 25-30 degrees C, metabolic
      toxin(s) was detected in broth via bioassay at about 4-5 days postinoculation
      when mycelial biomass reached 5 mg/ml (dry wt). At these temperatures, biological
      activity of the filtrate peaked at about 8-10 days when mycelial growth reached a
      maximum (10 mg/ml, dry wt). This suggests a positive relationship between toxic
      metabolite and mycelial production. After 10 days, the toxicity of the filtrate
      appeared to decline gradually. Pathogenicity symptoms of the metabolites
      developed slowly in both G. mellonella and D. melanogaster. Early signs of
      lethargy appeared at 4 days postinjection and cumulative mortality of G.
      mellonella larvae was low after 1 week; however, the percentage of mortality
      reached 98-100% after 14 days. At death, G. mellonella larvae displayed small
      dark spots on a brownish cuticle. Histopathological effects were observed in the
      larval midgut, malpighian tubules, hypodermis, fat body, hemocytes, muscle, and
      silk glands. Cellular change consisted of pycnosis of the nucleus and a reduction
      in cytoplasm density. Highest mortality (78.8%) to adult D. melanogaster occurred
      after 10 days post-treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463711
TI  - Transfer of incompatibility factors between stocks of Nasonia (= Mormoniella)
      vitripennis.
AB  - The stock of Nasonia vitripennis marked by the nuclear eye color mutation
      "tinged" (ti) shows nonreciprocal cytoplasmic incompatibility with wild-type (+)
      strains. Homogenates prepared from ti female pupae and injected into + female
      pupae caused 39% of the recipients to acquire the incompatibility characteristics
      of the ti donors. When eggs obtained from ti females were fragmented and injected
      into + female pupae, or when the ti egg cytoplasm was injected into chick eggs
      and yolk sac homogenates were subsequently injected into + female pupae, 28% of
      the recipients acquired ti-type incompatibility characteristics. Results from
      passage of the egg cytoplasm through 0.23-microns millipore filters showed
      successful transfer of the incompatibility and suggest that the incompatibility
      system in N. vitripennis has two components: a bacterium and a smaller agent.

PMID- 8463712
TI  - Symposium on early leprosy.

PMID- 8463713
TI  - Primary involvement of scrotal skin in indeterminate leprosy.

PMID- 8463714
TI  - National strategy for elimination of leprosy in India.

PMID- 8463715
TI  - Variables influencing regularity of treatment.

PMID- 8463716
TI  - Dr. S.N. Ganapati.

PMID- 8463717
TI  - Meeting of the Leprosy Working Group of Rehabilitation International held on 9th
      Sept. 1992 at Nairobi, Kenya.

PMID- 8463718
TI  - Suspicious lesions and their diagnosis.

PMID- 8463719
TI  - Workshop on "MDT experiences and incidence trends" at Chilakalapalli (AP) on 14
      15, June 1992.

PMID- 8463720
TI  - Role of histopathology in the early diagnosis of leprosy.

PMID- 8463721
TI  - Animal models for early leprosy.

PMID- 8463722
TI  - Early diagnosis of leprosy under field conditions.

PMID- 8463723
TI  - Does serology help in diagnosing early leprosy?

PMID- 8463724
TI  - Mycobacterium leprae soluble antigen (Rees) skin test responses in an endemic
      population in India.
AB  - The response to intradermal administration of Rees soluble skin test antigen was
      studied in 12,142 randomly selected individuals living in a highly endemic area
      in South India. Taking a cut-off point of 12 mm induration as the criterion for
      'positivity', 73% of PB cases, 45% of MB cases and 63% of noncase population (67%
      in contacts and 63% in non-contacts) were found to be positive. Age-specific
      positivity rates were higher in males than in females and in adults than in
      children. The difference in age-adjusted positivity rates between cases, contacts
      an noncontacts in the female population was found to be significant. However, the
      differences in reaction response are not sufficient to identify the sub
      populations of cases, contacts and noncontacts and as such this antigen is not
      likely to be useful in epidemiological studies of infection and evolution of
      clinical disease in high endemic populations.

PMID- 8463725
TI  - Women and leprosy in Turkey.
AB  - Women in Turkey have many social, cultural and economical problems. Women with
      leprosy have problems in common with other women as well as those related to
      physical and social consequences of leprosy. There are 2,414 patients with
      leprosy in Turkey, registered to Istanbul Leprosy Hospital and 829 of them are
      females. The mean age and duration of disease of our female leprosy patients are
      high. Most women with leprosy were born in eastern part of Turkey where
      prevalence of leprosy is higher and most have moved to western regions. The
      proportion of women who have some kind of social security is very low. Their
      economic status is also not good and 79% of patients had stigma about their
      disease. Three fourths of these cases have been hospitalized some time, for
      different reasons. Most of them (97.2%) have inactive disease at present.
      Disability degrees of patients are high. Patients with disability degrees over
      one constitute 54% of total for eyes, 55% for hands and 51% for feet. High
      percentage of multibacillary form and long duration of disease, delayed
      diagnosis, insufficient self-care of patients due to low socio-economic and
      cultural status and failure of health personnel to control patients periodically
      may be among the reasons for such high ratios of moderate and severe
      disabilities. In the light of the data obtained in our study, some measures to
      alleviate the problems of patients resulting from their socio-economic, cultural
      and social status have been suggested.

PMID- 8463726
TI  - Fluoroquinolones and their adverse effects.

PMID- 8463727
TI  - Health and human resource mobilization: an assessment of staffing pattern in NLEP
      at operational level.
AB  - In this paper the staffing pattern, training and infrastructural facilities of
      the National Leprosy Eradication Programme (NLEP) at operational level as well as
      the attendant problems in mobilising human resources are discussed. The study
      shows that the major portion of the work of the NLEP is being shared by the PMWs
      (72%), followed by NMS (14%) and Medical Officers (5%). The population served by
      the PMW in all the high and moderate endemic regions is more than the prescribed
      limit except in Nagaland and Sikkim. In the same areas, the Medical Officer
      serves a population more than the norm in Andhra Pradesh, West Bengal,
      Maharashtra, Karnataka and Bihar. Regarding case load, in no state the M.O.
      serves more than 2500 cases except in Bihar and Kerala, in moderate endemic and
      low endemic regions respectively. The PMW in Haryana and Punjab states attends
      more than 250 cases. In NLEP every one out of four sanctioned posts is vacant.
      There is also an urgent need to rationalize the training programme so that there
      is optimal utilization of the training centres.

PMID- 8463728
TI  - Detection of antibodies to phenolic glycolipid by ELISA in leprosy patients.
AB  - Antibody (IgM) response to PGL-1, a surface glycolipid unique to Mycobacterium
      leprae has been studied in 25 cases each of lepromatous and tuberculoid leprosy
      and in 25 healthy controls. The absorbance value at 488 nm was expressed as
      antibody titre. Serum antibody titre was found to be significantly higher in
      patients than controls. Results confirm that antibody response in leprosy
      patients depend upon bacterial load.

PMID- 8463729
TI  - Intraocular pressure reduction and systemic absorption of timolol after
      administration of one side-coated inserts in rabbits.
AB  - The object of this study was to test whether flat, circular ophthalmic inserts
      releasing drug only from one side, would show improved activity parameters and
      reduced systemic absorption. To this purpose, uncoated and one-side coated
      hydroxypropylcellulose inserts containing timolol were prepared and evaluated. An
      acrylic copolymer (Eudragit RS) was used as coating material. Timolol release
      from inserts was studied both in vitro and in vivo. Timolol release in vitro from
      the coated inserts was much slower than from the uncoated ones, due to the
      smaller releasing surface area. Compared with timolol eyedrops (0.5%, 50
      microliters), administration of 250 micrograms of timolol in uncoated or coated
      inserts produced a significantly greater hypotensive effect at 6 and 8 hr post
      instillation in rabbits with artificially increased intraocular pressure. The
      coated inserts containing 62.5 micrograms of timolol antagonised isoproterenol
      induced ocular hypotension significantly more than timolol eyedrops (0.5%, 12.5
      microliters) and uncoated inserts containing 62.5 micrograms of timolol. Both
      uncoated and coated inserts provided a significant sustaining of timolol release
      in tear fluid and decreased systemic peak concentrations of timolol with respect
      to the eyedrop control. However, one-side coated inserts failed to show
      significant improvements with respect to the uncoated samples.

PMID- 8463730
TI  - Iontophoresis of reactive black 5 for pulsed dye laser sclerostomy.
AB  - Ab interno pulsed dye laser sclerostomy uses a gonioscopic approach to form a
      limbal fistula for the treatment of glaucoma. This procedure requires a full
      thickness penetration of stain in sclera for adequate absorption of the visible
      light energy. Iontophoresis is a technique using an electrical current to
      noninvasively deliver Reactive Black 5 (RB5) stain into sclera. This project
      determined the stability of RB5 stain as well as the optimal parameters for
      iontophoresis (probe tip surface area, current, and duration) in a rabbit model.
      RB5 stain was stable over time (72 hr) as well as after exposure to extreme heat
      (120 degrees C), scleral constituents (namely collagen), high concentrations of
      oxidants (1.5% H2O2), and laser light energy. Ideal parameters for iontophoresis
      included a probe tip surface area between 0.1 and 0.7 mm2, a current of 0.5 mA,
      and a duration of 5 min. The maximum concentration of RB5 stain achieved in
      sclera was 0.15%. The threshold of ablation for RB5 using an energy of 250 mJ was
      0.001%. Iontophoresis can effectively deliver RB5 stain into sclera and may be a
      viable adjunct to ab interno pulsed dye laser sclerostomy procedures in the eye.

PMID- 8463731
TI  - Identification of high intraocular pressure responders to topical ophthalmic
      corticosteroids.
AB  - To locate suitable candidates to study the intraocular pressure (IOP) effects of
      new ocular steroids, healthy volunteers must be challenged with topically applied
      steroids to verify that such individuals are indeed high "steroid responders";
      that is, they respond with IOP elevations of at least 5 mmHg during a 4- to 6
      week challenge with the topically applied steroid. We used first-degree offspring
      of individuals with primary open-angle glaucoma to develop a model to identify
      high steroid responders to topical ophthalmic prednisolone. We conducted a
      prospective, randomized, open-label, placebo-controlled study of prednisolone
      phosphate 1.0% in which 13 subjects received either topical prednisolone
      phosphate 4 times daily to the right eye and placebo to the left eye, or vice
      versa. Baseline evaluations occurred on study Day 0, and follow-up examinations
      were on Days 7, 14, 21, 28, 35, and 42. The medications were administered
      continuously for 6 weeks or until the IOP rose > or = 10 mmHg. After the effect
      of diurnal variation in IOP was taken into account, 4 of the 13 subjects (31%)
      had a maximum elevation in IOP of 4 mmHg or less, 7 subjects (54%) showed maximum
      elevations in IOP of 5 to 9 mmHg, and 2 subjects (15%) had a maximum IOP
      elevation of > or = 10 mmHg. Thus, a cumulative total of 9 subjects (69%) had IOP
      elevations of at least 5 mmHg and could be classified as moderate to high steroid
      responders. This model should become useful as a productive source of subjects
      for studies evaluating the effect on IOP of new ocular steroids.

PMID- 8463732
TI  - Formulation influence on ocular and systemic absorption of topically applied
      atenolol in the pigmented rabbit.
AB  - The objective of this study was to determine the relative efficacy of various
      formulations in maximizing the ratio of ocular to systemic absorption of
      topically applied atenolol following solution instillation in the pigmented
      rabbit. Formulations of various pH's and tonicities and containing various
      preservatives and polymers were tested. Ocular absorption was determined by
      monitoring atenolol concentrations in various anterior segment tissues at 30 min
      following solution instillation, while systemic absorption was determined by
      monitoring the time course of atenolol concentration over 480 min. Reversed phase
      HPLC was the analytical methodology. All formulations except those containing
      0.025% benzalkonium chloride or 0.5% EDTA showed similar drug concentration vs.
      time profiles in plasma, attaining a peak concentration of 30-50 ng/ml at about
      100 min. For benzalkonium chloride and EDTA, there was an undesirable increase in
      systemic absorption, although ocular absorption was also increased. By contrast,
      lowering the solution tonicity to 80 mOsm/kg increased the ratio of aqueous humor
      to plasma peak concentrations 2 times and the ratio of iris-ciliary body to
      plasma peak concentrations 3 times. Incorporation of 3.75% poly(vinyl alcohol)
      into the formulation afforded yet a larger increase in the iris-ciliary body to
      plasma drug concentration ratio (52 times.) It may therefore be concluded that,
      for a hydrophilic drug like atenolol, formulation changes that increase membrane
      permeability and/or enhance noncorneal drug access may be more promising than
      those that increase drug residence in the conjunctival sac with respect to
      maximizing the ratio of ocular to systemic drug absorption.

PMID- 8463733
TI  - Effect of ascorbic acid 2-0-alpha-glucoside on hydrocortisone-induced cataract
      formation in developing chick embryos: I. Comparison of the preventive effect of
      ascorbic acid derivatives.
AB  - The effect of ascorbic acid 2-O-alpha-glucoside (AA-2G) on hydrocortisone (HC)
      induced lens opacity in developing chick embryo was examined and compared with
      those of ascorbic acid (AsA) and ascorbic acid 2-phosphate (AA-2P). The opacity
      was dose-dependently inhibited by a single administration of 10 or 20 mumol/egg
      of AA-2G and by three repeated administrations of 1, 3 or 10 mumol/egg of AA-2G.
      AA-2G was the most effective among the three compounds. Glucose did not enhance
      the preventive effect of AsA against HC-induced opacity, and neither dehydro
      ascorbic acid nor glucose also prevented HC-induced cataract. In the histological
      study, we observed many small vacuoles in the nuclear region of the opaque lens
      treated with HC. AA-2G inhibited the formation of such vacuoles, an effect
      closely correlated with the prevention of cataract formation.

PMID- 8463734
TI  - Toxicity and pharmacokinetics of ciprofloxacin.
AB  - Ciprofloxacin is a fluorinated quinolone antibiotic with a broad spectrum of
      activity against both gram positive and gram negative organisms. Previous studies
      have indicated that oral or parenteral preparations of ciprofloxacin resulted in
      therapeutic concentrations in the aqueous humor but intravitreal levels were
      found to be only marginally higher than the MIC90 for gram positive cocci.
      Toxicity was evaluated following intravitreal doses of ciprofloxacin injected
      into the mid-vitreous cavity of one eye of pigmented rabbits. As a control, an
      identical volume of normal saline was injected into the fellow eye. Four doses of
      ciprofloxacin were studied, 100 micrograms, 250 micrograms, 500 micrograms and
      1000 micrograms. Electroretinograms (ERGs) were recorded prior to injection and
      1, 7 and 14 days after injection. These were analyzed as b-wave amplitude ratios
      between treated and untreated eyes. On ophthalmoscopic examination focal areas of
      retinitis were observed following injection of both 500 micrograms and 1000
      micrograms of ciprofloxacin but not at 250 micrograms. Additionally, ERG
      amplitude ratios were significantly reduced following the 1000 micrograms dose.
      At the 100 or 250 micrograms ciprofloxacin dose histological sections are
      comparable with control eyes and appear normal; ERG ratios were unchanged from
      the baseline level and careful indirect ophthalmoscopic examination revealed no
      alterations. Pharmacokinetic analysis after single intravitreal injection of 250
      micrograms of ciprofloxacin (N = 3 rabbits/dose) disclosed vitreous fluid levels
      (microgram/ml) of 146 at 0 hr, 77 at 4 hr, 32 at 8 hr, 0.49 at 24 hr and 0.24 at
      48 hr.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463735
TI  - Vascular effects of calcitonin gene-related peptide (CGRP) and cholecystokinin
      (CCK) in the monkey eye.
AB  - The effects of cholecystokinin (CCK) and calcitonin gene-related peptide (CGRP)
      on ocular blood flow were studied in monkeys using the labelled microsphere
      method. Intracameral administration of 800 pmole CGRP increased the blood flow
      significantly in the conjunctiva, ciliary body and sclera. There was no
      significant change in the choroid and retina. CCK-33 (800 pmole) caused no
      significant effects on the blood flow in the tissues examined, when compared to
      the control eyes. A miotic response was however noted, consistent with previous
      results. Neither peptide caused significant changes in the intraocular pressure.
      These results suggest that CGRP has a vasodilatory effect in some parts of the
      monkey eye, whereas CCK-33 is a miotic with no marked effect on ocular blood
      flow.

PMID- 8463736
TI  - Chronic systemic delivery of insulin through the ocular route.
AB  - Eyedrops of 0.25% insulin plus 0.5% BL-9 or Brij-78 were instilled into rabbit
      eyes twice a day for 3 months. It was found that the efficacy of insulin to lower
      the blood glucose concentration and the uptake of insulin into the systemic
      circulation remained the same throughout the experimental period. No allergic
      responses or local side effects could be detected, indicating that both insulin
      and permeation enhancers (BL-9 and Brij-78) are safe for instillation into the
      eyes for long periods of time. It is concluded that chronic administration of
      insulin and absorption enhancers into the eyes is a feasible method to replace
      injections for diabetes treatment.

PMID- 8463737
TI  - Bronchogenic carcinoma in young adults.
AB  - Lung cancer occurs most frequently in the sixth decade of life. It has been
      suggested that the incidence of bronchogenic neoplasm is increasing in the
      population under the age of 40. While this observation may simply reflect the
      general increase in lung cancer in both sexes, there is a distinct difference in
      the pathology and behavior of lung tumors that occur in the young.

PMID- 8463739
TI  - Cholera revisited.

PMID- 8463738
TI  - Preventive medicine: what do future practitioners really need? Are they getting
      it in medical school?
AB  - The purposes of our study were (1) to determine preventive medicine topics most
      relevant to clinical practice, and (2) to determine if medical education affects
      medical students' attitudes regarding preventive medicine. Our method of study
      was two surveys. The first survey asked practicing physicians to rank the 23
      topics identified in the Healthy People 2000 monograph and determine their
      usefulness in clinical practice. The second survey assessed medical students'
      attitudes about preventive medicine. Practitioners ranked tobacco, cancer, and
      diabetes as most relevant to the actual clinical practice of medicine. There were
      no correlations between practitioners' gender, age, or region and their rankings
      of topics. In terms of specialties, surgeons felt preventive medicine was less
      important than did family practitioners. Medical students' attitudes about
      preventive practices became significantly more positive as they progressed
      through medical school. Survey scores also improved significantly in second year
      students after their preventive medicine course. Students planning to be surgeons
      were less positive about preventive medicine. There is a continuing need for
      prevention education in medical school curricula, especially about tobacco,
      cancer, diabetes, and nutrition. Epidemiology and disease reporting might best be
      presented as "how to read the literature."

PMID- 8463740
TI  - Health care reform.

PMID- 8463741
TI  - Cognitive development and learning in the pediatric organ transplant recipient.
AB  - Although organ transplantation is considered a viable treatment approach for end
      stage organ disease, few empirical investigations have assessed the effects of
      transplantation on the cognitive development and learning of pediatric organ
      transplant recipients. This article reviews studies evaluating neurocognitive
      changes following organ transplantation in pediatric end-stage renal and liver
      disease. Despite numerous methodological problems inherent in the investigations
      examined, the findings of some studies are suggestive of potential neurocognitive
      benefits associated with organ transplantation. Recommendations are made
      regarding methodological improvements for future investigations assessing
      neurocognitive outcomes of organ transplantation.

PMID- 8463742
TI  - School reentry for the child with chronic illness.
AB  - Chronic illness affects up to 20% of children in the school-age population, 10%
      of whom are severely compromised. Reintegrating these children is a growing
      problem for schools, children and their families, and health care professionals,
      as it has become apparent that school adjustment is highly significant in the
      children's overall adjustment. This article focuses on the issues of
      reintegrating the chronically ill child into the school setting, the types of
      school problems encountered, the process of school reentry, with illustrative
      case material, and the implications for the school and family of returning the
      chronically ill child to school.

PMID- 8463743
TI  - Traditional IQ is irrelevant to learning disabilities--intelligence is not.
AB  - This investigation examined the relationship between intelligence and
      phonological coding when ability was redefined according to the Planning,
      Attention, Simultaneous, Successive (PASS) cognitive processing model. This study
      directly tested the hypothesis that traditional IQ tests may be irrelevant to the
      definition of learning disabilities, but a different theory of intelligence may
      be more sensitive to deficiencies related to reading failure. Normally achieving
      students (n = 30) and students with reading disabilities (n = 30) ranging in age
      from 7.7 years to 15.3 years (mean = 11.9 years, SD = 2.4 years) were
      administered measures of the PASS cognitive processes, the Woodcock-Johnson
      Psycho-Educational Battery-Revised pseudoword reading, and the Wide Range
      Achievement Test-Revised (WRAT-R) reading recognition tests. Results showed that
      the sample with reading disabilities earned significantly lower scores on the
      WRAT-R Reading (mean = 69.3) than the nondisabled subjects (mean = 91.4) and,
      similarly, on pseudowords those with reading problems earned a mean of 78.9 while
      the nondisabled earned a mean of 96.3. For the sample with reading disabilities,
      pseudoword reading scores were significantly predicted by successive processing
      scores (R2 = .267), but no other processing variable added to the prediction;
      successive scores (R2 = .212) and the combination of successive and planning (R2
      = .296) were significant predictors of WRAT-R Reading scores.

PMID- 8463744
TI  - Assessment of oral storytelling abilities of Latino junior high school students
      with learning handicaps.
AB  - This study investigated the relationship between reading comprehension and oral
      storytelling abilities. Thirty-one Latino junior high school students with
      learning handicaps were selected as subjects based on learning handicapped
      designation, home language, and language proficiency status. Reading
      comprehension was measured by the Reading Comprehension subtest of the Peabody
      Individual Achievement Test. Storytelling was measured by (a) the Oral Production
      subtest of the Language Assessment Scales using the standard scoring protocol and
      (b) a story structure analysis. A comparison of the standard scoring protocol and
      reading comprehension revealed no relationship, while the comparison of the story
      structure analysis and reading comprehension revealed a significant correlation.
      The implications of these results for language assessment of bilingual students
      are discussed.

PMID- 8463746
TI  - A look at the relationships of parties involved in medical malpractice litigation
      with a view toward helping the patient.

PMID- 8463745
TI  - Cognitive, neuropsychological, and academic sequelae in children with leukemia.
AB  - The literature concerning the cognitive and neuropsychological sequelae of
      children in whom leukemia has been diagnosed indicates that these children
      exhibit deficits in cognitive and neuropsychological functioning and academic
      achievement in response to the iatrogenic effects of central nervous system (CNS)
      irradiation. Preliminary studies suggest that similar emanative effects may
      follow intrathecal chemotherapy, an alternative to CNS irradiation for children
      given a favorable prognosis. It is concluded that treatment advances have
      lengthened the life expectancy of many children with leukemia, thereby changing
      their prognosis to a more favorable one. This has resulted in a recognition of
      the difficulties accompanying school reentry. In light of their documented
      neuropsychological, academic, and social adjustment problems, many of these
      children require special education services.

PMID- 8463747
TI  - Options at the end of life.

PMID- 8463748
TI  - Elements of causation in toxic tort litigation. Science and law must agree.

PMID- 8463749
TI  - Regulation of experimentation on the unborn.

PMID- 8463750
TI  - Abortion law today.

PMID- 8463751
TI  - Maternal substance abuse during pregnancy. Policy implications in the United
      States.

PMID- 8463752
TI  - Maternal-fetal relationship. The courts and social policy.

PMID- 8463753
TI  - Forcing the issue of physician-assisted suicide. Impact of the Kevorkian case on
      the euthanasia debate.

PMID- 8463754
TI  - Medicine, 2003.

PMID- 8463755
TI  - Self-referral legislation for Georgia?

PMID- 8463756
TI  - Economic credentialing revisited: watch out, here it comes!

PMID- 8463757
TI  - Ambitious agenda for the 1993 Georgia General Assembly.

PMID- 8463758
TI  - Cancer trends unique to Georgia.
AB  - Using information from 1980 through 1991 Cancer Statistics, published by the
      American Cancer Society, we assigned a rank order of new cancer cases for Georgia
      and eight other states. Female breast, colon and rectum, lung, oral, uterus,
      prostate, pancreas, and leukemia are the site-specific cancers that were
      considered. There was an increasing trend in Georgia for colon and rectal cancer
      and breast cancer during this study period. This increased trend for colorectal
      and breast cancer in Georgia was not apparent in the other index states. Possible
      influences of population, physician practices, and socioeconomic factors are
      considered. The results of this project indicate that further study is needed to
      evaluate this trend, possibly by examination of regional differences within the
      state of Georgia, especially with regard to environmental factors.

PMID- 8463759
TI  - Annotated guidelines on gifts to physicians from industry. AMA Council on Ethical
      and Judicial Affairs.

PMID- 8463760
TI  - Flying doctors.

PMID- 8463761
TI  - Nicotine dependence--treatment for the 1990s.
AB  - Physicians must recognize that nicotine is a powerfully addictive drug, and
      patients with nicotine dependence will have all the hallmarks of an addictive
      disorder. To successfully treat such patients will require compassion and
      patience on the part of the physician along with the realization that successful
      treatment will not be easy for most. As with other drugs, there is a very high
      relapse rate after initial abstinence and this can be discouraging for physicians
      and patients alike. Applying the principles outlined above in a stepped-care
      fashion will lead to greater success in dealing with this difficult problem. In
      the future, more effective treatment interventions will be developed and tested
      but it is unlikely that there will be a simple cure for this complex behaviour
      which is complicated by a powerfully addictive drug. Though not a cure-all,
      adjunctive pharmacologic therapy will play an increasingly important role as we
      learn how to better use existing agents and as others are shown to be effective.
      The key to the future is in the development of better relapse prevention
      techniques to enhance the rather remarkable short-term success rates that can be
      achieved with counselling and adjunctive pharmacologic therapy.

PMID- 8463762
TI  - Bone marrow transplantation in Europe--can the geographical differences be
      explained?

PMID- 8463763
TI  - The clinical importance of silent ischaemia during exercise--new insights in
      different stages of coronary artery disease.

PMID- 8463764
TI  - Diabetes education and insulin therapy: when will they ever learn?
AB  - The Diabetes Education Study Group of the European Diabetes Association was
      founded in 1979 with its major goal to make effective patient training an
      integral part of any diabetes therapy. However, even today, in many places
      diabetes education is not an obligatory part of treatment, but is regarded as an
      optional service to the patient which is frequently fragmentary and haphazard. On
      the other hand, many physicians still subject their patients to rigid dietary
      instructions and obedience training, an approach which is mistaken for diabetes
      education. Several misconceptions about diabetes education keep counteracting the
      spread and hence the availability of effective treatment and teaching programmes
      for all Type 1 diabetic patients. One such misconception is that diabetes
      education could compensate for deficiencies of inappropriate insulin treatment
      regimens. Studies failing to demonstrate the impact of diabetes education on
      metabolic control, typically used an insulin treatment regimen with only one or
      two insulin injections per day, the predominant use of intermediate acting
      insulin preparations, and without (day-to-day) adjustment of insulin dosages by
      the patients themselves. A further reason for a lack of success of diabetes
      education is an unstructured approach which is frequently mistaken for
      individualized care. The deleterious effects of putting patients on intensified
      insulin therapy without offering them sufficient and systematic training have
      manifested themselves at various places by an excessive increase in the risk of
      severe hypoglycaemia, and of ketoacidosis during therapy with continuous
      subcutaneous insulin infusion. The effective and safe performance of insulin
      therapy requires both a rational system of insulin substitution and intensive
      training of the patients to carry it out. The injection of regular insulin before
      main meals and the use of intermediate or long-acting insulin preparations for
      the substitution of basal insulin requirements combined with daily metabolic self
      monitoring and (day-to-day) adaptation of insulin dosages by the patients
      themselves allow a substantial improvement of glycaemic control without an
      increase in the risk of severe hypoglycaemia and the adoption of a more flexible
      life style largely freed from forcing and directive dietary and other
      impositions. Each diabetes centre should continuously evaluate the quality of
      care offered to their patients as a basis for a specific and systematic
      improvement of its treatment and education programmes. Such quality control
      measures must include a recording of the patients' degree of metabolic control
      and the frequencies of severe hypoglycaemia and ketoacidosis.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8463765
TI  - Smoking induces insulin resistance--a potential link with the insulin resistance
      syndrome.
AB  - OBJECTIVES: The acute effect of smoking and snuffing on insulin sensitivity was
      studied in a group of healthy habitual smokers. DESIGN: The euglycaemic clamp
      technique was combined with the subcutaneous injection of a bolus (0.1 U kg-1) of
      fast-acting insulin (Actrapid). Randomized subjects smoked either one cigarette
      per hour for 6 h, took one bag-packed snuff per hour for 6 h or refrained from
      nicotine for 48 h before as well as during the clamp. SUBJECTS: Seven healthy
      smokers, four females and three males, of normal weight (BMI, mean +/- SEM, 21 +/
      0.7 kg m-2 with a range of 18.6-23.9), aged 31 +/- 2 years (range 24-35 years),
      who had consumed at least 20 cigarettes per day for at least 5 years were
      studied. They were recruited through an advertisement in a newspaper. RESULTS:
      The steady-state plasma nicotine levels were similar during smoking and snuffing.
      The insulin and glucose levels were also similar during all three clamps.
      Smoking, but not snuffing, impaired insulin action (P < 0.05) mainly due to a
      lower peripheral glucose uptake. The mean growth hormone levels during the 6-h
      study were more than doubled during smoking (P < 0.01) while no significant
      differences were seen in the other counter-regulatory hormones. CONCLUSION:
      Smoking (also in habitual smokers) acutely impairs insulin action and leads to
      insulin resistance. Thus, smoking can be of importance for the development of the
      insulin resistance syndrome associated with risk for cardiovascular disease.

PMID- 8463766
TI  - Bone marrow transplantation in Europe: major geographical differences. The
      European Group for Bone Marrow Transplantation [EBMT].
AB  - In 1991 171 teams in 21 European countries performed 4976 bone marrow
      transplants. There were 1829 transplants from an HLA-identical sibling donor, 101
      from a nonidentical family member, 30 from a twin, 217 from an unrelated
      volunteer donor and 2799 autologous transplants. Indications for transplants were
      leukaemias in 2569 (52%), lymphoproliferative disorders in 1472 (30%), solid
      tumours in 549 (11%), aplastic anaemia and thalassaemia in 261 (5%), inborn
      errors in 97 and miscellaneous disorders in 28 patients. There are marked
      differences between the participating European countries. They relate to absolute
      numbers, indications and techniques. Less than 10 transplants per 10-million
      inhabitants are performed in Eastern European countries. Ten to fifty transplants
      per 10-million inhabitants are done in two, 50-100 transplants per 10-million
      inhabitants in five, 100-200 transplants per 10-million inhabitants in eight
      countries and more than 200 per 10-million inhabitants in one country (P < 0.01).
      The number of transplant teams ranges from less than one to twelve per 10-million
      inhabitants (P < 0.01). For the continent it becomes 3.3 per 10-million
      inhabitants. The reasons for these differences are not explained by this survey.
      The most likely explanation for the differences in transplant activity is
      availability of transplant beds, trained staff and resources. Bone marrow
      transplants are expensive. However, the demand is increasing and will increase
      further with the routine availability of unrelated volunteer donors. Clearly,
      criteria are required in Europe to define the indications and solutions to meet
      the legitimate requirements for transplantation in the various regions of Europe.

PMID- 8463767
TI  - Accelerated coronary artery disease after heart transplantation: the role of
      enhanced platelet aggregation and thrombosis.
AB  - The present study is a prospective examination of the relationship between
      platelet aggregation and the occurrence of graft failure in a single cohort of
      heart transplantation (HT) recipients. One-hundred-and-twenty-four patients
      underwent platelet function study and were then followed for 1 to 24 months (mean
      6.7 months). There were nine re-transplantations and 13 deaths (11 related to
      ischaemic events, and two others). In 15 patients, pathologic examination
      confirmed or revealed that recent acute myocardial infarction was the obvious
      cause of the graft failure. In five patients, myocardial fibrosis related to
      severe and diffuse coronary disease was the only microscopic finding. In the last
      two patients, the cause of the heart failure was not clearly identified. In
      recent myocardial infarction there was a high incidence (14/15) of coronary
      thrombi. Thrombi were multiple, disseminated in the coronary tree end of
      different age. Their presence at autopsy or after explantation was associated
      with an enhanced ex vivo platelet aggregability as compared with patients without
      coronary thrombi (n = 8): 43.3 +/- 1.7% of maximal aggregation vs. 34.4 +/- 2.4
      (P = 0.006) and 48.4 +/- 5.2 vs. 22.6 +/- 4.9 (P = 0.003) for the primary and
      secondary waves of ADP-induced aggregation. These results suggest that thrombosis
      and platelets may play a major role in the process of accelerated coronary artery
      disease after HT.

PMID- 8463768
TI  - Effect of coffee on ambulatory blood pressure in patients with treated
      hypertension.
AB  - Effects of caffeine on ambulatory blood pressure, heart rate, renin-angiotensin
      system, and ANP were studied in patients treated for mild to moderate
      hypertension in a randomized, double-blind, placebo-controlled, cross-over trial
      comparing 2 weeks of caffeine-free diet with 2 weeks of regular coffee use.
      Twenty-three patients (13 men; aged 28-74 years) with treated, mild to moderate
      essential hypertension and a regular intake of 3-4 cups of coffee daily completed
      the study. Mean 24-h, day- or night-time ambulatory blood pressure and heart rate
      were not different between regimens. Nor were there any effects on the renin
      angiotensin system while ANP was significantly increased during caffeine intake.
      Compliance of the dietary regimen was excellent as assessed by serum caffeine
      concentration measurements. We conclude that habitual coffee drinking did not
      influence the 24-h blood pressure profiles or cardiovascular hormones in treated
      hypertensives.

PMID- 8463769
TI  - Low blood pressure and blood glucose levels in Alzheimer's disease. Evidence for
      a hypometabolic disorder?
AB  - OBJECTIVE: To test possible differences between patients with Alzheimer's disease
      (AD) and patients with other forms of dementia and the healthy population
      concerning body composition, blood pressure, metabolic data and leukoaraiosis
      (LA). DESIGN: Retrospective study on data collected according to a predefined
      protocol. SETTING: A geriatric, neuropsychiatric diagnostic unit. SUBJECTS:
      Seventy-one consecutive patients with dementia. MAIN OUTCOME MEASURES: Body mass
      index, blood pressure, metabolism and LA in AD compared to other dementia forms.
      RESULTS: Mean blood pressure and fasting blood glucose levels were lower in
      patients with AD, 94 +/- 12 mmHg and 4.3 +/- 0.5 mmol l-1, compared to patients
      with unspecified dementia (NUD), 100 +/- 10 mmHg and 5.5 +/- 2.5 mmol l-1 (P <
      0.05) and vascular dementia (VAD), 114 +/- 12 mmHg and 5.6 +/- 1.6 mmol l-1 (P <
      0.001) and the age-matched healthy population. Body mass index, serum cholesterol
      and cortisol were similar in all groups of dementia patients whereas
      triglycerides were highest in the VAD group. No cases of diabetes or treatment
      for hypertension were found in the AD group while the prevalence was 21% and 36%
      for diabetes in the NUD and VAD groups and 8% in the population from the same
      region. There were 16% with antihypertensive treatment in dementia NUD, 50% in
      VAD, and 30% in the general population. Treated or newly detected hypothyreosis
      was present in 11% of the AD patients, none in the other dementia groups and 2%
      in the general population. Smoking was least common in AD. Degree of LA
      correlated with blood pressure and blood glucose levels. CONCLUSIONS: AD was
      clearly different to other dementia patients. They had lower blood pressure,
      blood glucose and higher prevalence of hypothyreosis than the healthy, age
      matched population. These findings may indicate that AD could be a hypometabolic
      disorder.

PMID- 8463770
TI  - Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis.
AB  - Cerebral toxoplasmosis is optimally treated with the combination of high doses of
      sulphadiazine and pyrimethamine. We described two patients with AIDS treated for
      cerebral toxoplasmosis who developed renal failure due to sulphadiazine-induced
      crystalluria. Symptoms and renal failure were rapidly reversed with urine
      alkalinization and hydration. A careful monitoring and adequate hydration of
      patients with AIDS treated with high doses of sulphadiazine appears mandatory to
      avoid this complication.

PMID- 8463771
TI  - Vitamin B12 deficiency.

PMID- 8463772
TI  - Vitamin B12 deficiency.

PMID- 8463773
TI  - Vitamin B12 deficiency.

PMID- 8463774
TI  - Human genome.

PMID- 8463775
TI  - Patient-physician relationship.

PMID- 8463776
TI  - Chiropractic.

PMID- 8463777
TI  - Chiropractic.

PMID- 8463778
TI  - Obtaining informed consent: it is not simply asking "do you understand?".

PMID- 8463779
TI  - Informed consent: who's informed? Who's consenting? And other questions.

PMID- 8463780
TI  - Differences in management of suspected myocardial infarction in men and women.
AB  - BACKGROUND: Men and women with ischemic heart disease receive different medical
      treatment. Men receive more aggressive intervention and at an earlier stage of
      disease. However, differences in treatment between sexes have thus far been
      demonstrated only for invasive treatment, which may be less effective for women
      than for men. METHODS: In a small community hospital, all patients admitted to
      the family practice service for suspected acute myocardial infarction from July
      1988 to June 1989 were evaluated retrospectively to determine the reasons for
      placement in the cardiac care unit (CCU) vs regular nursing bed units with
      telemetry. The variables considered were patient age, patient sex, physician sex,
      and the likelihood of ischemia based on the Acute Ischemic Heart Disease
      Predictive Instrument (HDPI). RESULTS: Ninety-three patients were entered in the
      study. The patient's age, sex, and likelihood of ischemia as measured by HDPI
      score were significantly related to probability of placement in the CCU. Women
      were less likely than men to be placed in the CCU, controlling for age and
      likelihood of ischemia (OR = 0.362, 95% CI = 0.135 to 0.977). CONCLUSIONS: Women
      appear to receive not only less intensive invasive treatment for ischemic heart
      disease than men, as previous studies have shown, but also less aggressive
      noninvasive treatment. This may represent unnecessary treatment of men rather
      than undertreatment of women. The findings of this study suggest, however, that
      physicians view women presenting with suspected acute myocardial infarction with
      less urgency than men presenting with similar symptoms.

PMID- 8463781
TI  - Sedation associated with a more complete colonoscopy.
AB  - BACKGROUND: This study examined the effect of sedation on the rate of complete
      colonoscopic examinations by a family physician performing colonoscopy at an
      urban family practice residency. The outcomes of biopsies and polypectomies
      performed during the period of the study were also evaluated. METHODS: Data were
      prospectively collected on 164 consecutive colonoscopies. Seventy-three percent
      (124/164) of the examinations were training experiences supervised by the first
      author. The outcomes of examinations of 126 sedated patients were compared with
      those of 38 nonsedated patients. Patients were not randomly selected. RESULTS:
      Examinations of 126 sedated patients were carried out with an 85% reach-the-cecum
      rate compared with a 31% reach-the-cecum rate for 38 nonsedated patients (P <
      .05). A higher percentage of examinations done without sedation (16%) were
      terminated because of pain than were terminated in sedated patients (5%) (P <
      .05). An electrolyte purge solution was found to be the most effective
      colonoscopy preparation; only 7% (7/100) of examinations on patients prepared by
      this method were terminated because of inadequate bowel preparation. Adenomas
      were found in 11% (14/126) of sedated patients and in 8% (3/38) of nonsedated
      patients. Cancer was detected in 4 sedated patients. CONCLUSIONS: These findings
      suggest that sedation in colonoscopy is associated with a higher percentage of
      complete examinations. Also, patients prepared with an electrolyte purge solution
      tend to have fewer examinations terminated because of inadequate preparation.

PMID- 8463782
TI  - Diet and exercise and gemfibrozil therapy for the management of dyslipidemia: a
      CEN study. Clinical Experience Network.
AB  - BACKGROUND: Dyslipidemia constitutes a serious health problem that should be
      diagnosed and treated by the family physician. Little is known about the efficacy
      of typical dietary therapy for patients with abnormal cholesterol levels. This
      study was the first large prospective family practice evaluation of the
      effectiveness of diet-and-exercise therapy followed by a pharmacologic
      intervention for those patients who remained dyslipidemic. METHODS: Patients who
      met standard criteria for cardiovascular disease risk based on lipid analysis
      were enrolled in a typical 6-week physician-directed diet-and-exercise program.
      Those patients who were still dyslipidemic after that period were started on 12
      weeks of pharmacologic treatment with gemfibrozil. RESULTS: Of the 2992 patients
      screened, 1193 were eligible for participation in the study. The diet-and
      exercise program led to a modest change in lipid values (average decrease in
      total cholesterol of 4.1%). Only 2% of the patients achieved desirable levels of
      all lipid values. Seven hundred thirty-nine subjects qualified for further
      therapy and were treated with gemfibrozil. Seventy patients discontinued drug
      therapy because of adverse effects. Those who completed 12 weeks of pharmacologic
      therapy had an additional 5.4% reduction in total cholesterol, 3.9% reduction in
      low-density lipoprotein cholesterol, 30.6% reduction in triglycerides, and a
      17.2% increase in high-density lipoprotein cholesterol. CONCLUSIONS: These
      findings suggest that in a typical clinical setting, a nonpharmacologic
      intervention of diet and exercise may not produce the desired overall lipid
      changes in the majority of dyslipidemic patients.

PMID- 8463783
TI  - Obtaining a durable power of attorney for health care from nursing home
      residents.
AB  - BACKGROUND: A durable power of attorney for health care (DPA) allows a person to
      appoint a surrogate decision-maker for any future period of mental incapacity.
      The absence of advance directives can lead to confusion and the expenditure of
      resources while trying to exert a substituted judgment. METHODS: The Wisconsin
      DPA was presented with an organized pilot program to 150 residents who had been
      judged by their social workers to have the capacity to make informed decisions
      regarding medical care. The reasons residents gave for accepting or rejecting a
      DPA were analyzed. RESULTS: Seventy-nine percent prepared a DPA. Reasons for
      signing included allowing the resident to decide who would make medical decisions
      and assuring that specific wishes would be carried out. Twenty-one percent did
      not execute a DPA. Reasons were categorized as confusion and misunderstanding
      regarding the legal system, mistrust, or social isolation. CONCLUSIONS: The high
      rate (79%) of DPA completion is probably related to individually counseling
      residents. However, competent residents who despite counseling do not choose to
      execute a DPA can have detailed advance directives ("living wills") prepared
      without appointing a decision-maker.

PMID- 8463784
TI  - Physician views on frequent medical use: patient beliefs and demographic and
      diagnostic correlates.
AB  - BACKGROUND: Health care "misusers" have long been identified as hypochondriacs,
      problem patients, "worried well" patients, and persistent somatizers. The
      stereotypical pattern includes persistent pursuit of medical care, a wide range
      of chronic symptoms, and underlying depression. The purpose of this study was to
      gather prevalence data on individual patients and to examine patient variables
      that influence the use of medical services by this population. METHODS: Frequent
      health care users in an HMO were classified by their primary care providers in
      terms of appropriate use (36%), moderate misuse (inappropriate or psychosomatic,
      27%), and extreme misuse (both inappropriate and psychosomatic, 37%) categories.
      Utilization and diagnostic data were compared using analysis of variance or chi
      square tests. RESULTS: All patients rated as misusers to any degree represented
      only 17.1% of the population, yet accounted for 42.7% of the visits. Extreme
      misusers accounted for 25% of visits and 10% of the population. Compared with
      frequent appropriate users, misusers had a greater belief in their own
      responsibility for health (internal health locus of control), expressed more
      concern about their mental health, and rated psychological symptoms as more
      serious. In addition, extreme misusers were younger, reported more symptoms, and
      believed less in the physician's control of their health. Misusers sought care
      for minor symptoms or for complaints that were not diagnosed as disease.
      CONCLUSIONS: Misuse as a physician-perceived variable is highly prevalent.
      Misusers differ in their beliefs about health care as well as in the kinds and
      severity of problems for which care is sought. Physicians need to be sensitive to
      the interpersonal nature of this problem so as not to discourage preventive
      medical use, and to recognize the value of these visits to the "worried well"
      population.

PMID- 8463785
TI  - Racial differentials in the identification of hypercholesterolemia.
AB  - BACKGROUND: African Americans have higher rates of cardiovascular disease than
      white Americans. To address this differential, barriers to cardiovascular risk
      reduction need to be identified. This study examines the association of race with
      the likelihood of screening for and diagnosis of hypercholesterolemia. METHODS:
      Possible associations between demographic variables and screening for and
      diagnosis of hypercholesterolemia were examined on data gathered in a prospective
      fashion in an office-based family medicine residency training program in
      Rochester, New York. A consecutive sample of all patients seen between December
      15, 1988, and April 15, 1990, about whom there was complete data collection (age,
      sex, insurance, race, and other cardiovascular risk factors) were included in the
      multivariate analyses (N = 4256). RESULTS: After controlling for age, sex,
      insurance status, socioeconomic status, number of visits, and other
      cardiovascular risk factors, it was found that minorities were less likely to
      have been screened for cholesterol levels than whites (adjusted odds ratio [AOR]
      = 0.84, 95% confidence interval [CI] = 0.98 to 0.72). The mean cholesterol level
      did not differ by race (mean cholesterol for whites, 204 mg/dL [5.28 mmol/L], and
      for minorities, 203 mg/dL [5.25 mmol/L], t = 0.7, P = .47). Among those screened,
      minorities were less likely than whites to have been diagnosed with
      hypercholesterolemia (AOR = 0.62, 95% CI = 0.86 to 0.44; and 0.47 (95% CI = 0.28
      to 0.78] in those with a cholesterol level greater than 240 mg/dL [6.2 mmol/L]).
      CONCLUSIONS: Our data suggest that provider behavior in diagnosing
      hypercholesterolemia varies by the race of the patient.

PMID- 8463786
TI  - Nursing home care in 2001.
AB  - As we move toward the 21st century, nursing home care will become an increasingly
      important part of family practice. The number of nursing home residents will
      grow, their illnesses will become more acute, and the types of medical services
      provided by nursing homes will broaden. The fiscal difficulty of providing
      nursing home care will intensify, and a variety of innovative payment programs
      will be introduced in an attempt to control costs. The only way these will
      succeed is by a partial reallocation of health care dollars from expensive high
      technology hospital care to less expensive low-technology care in nursing homes.
      As a result of these changes, hospitals will become more involved in the
      provision of what were traditionally nursing home services. Nursing homes will be
      used to a larger extent for medical education, and, under congressional pressure,
      a shrinking pool of federal research dollars will be more fairly allocated to
      clinical investigation in this setting.

PMID- 8463787
TI  - Parkinson's disease: early diagnosis and management.
AB  - Parkinson's disease is a common neurodegenerative disorder affecting
      approximately 1% of the population over the age of 50 years. There is no known
      cure for Parkinson's disease, but research gains over the last two decades have
      been substantial, resulting in improved medications and therapeutic strategies
      for managing early symptoms and delaying the onset of serious disability.
      Particularly promising is current research suggesting the possibility of
      neuroprotective therapies that may ultimately be capable of slowing disease
      progression. Early and accurate diagnosis is especially important to optimize the
      benefits of new therapies.

PMID- 8463788
TI  - Postpartum pyometra: a case report.
AB  - Pyometra is an uncommon result of endometritis. The diagnosis of pyometra is made
      when a collection of pus is found within the endometrial cavity. Antibiotic
      administration and drainage of the pus are essential to resolve this condition. A
      report of a case of pyometra is presented and a technique for drainage is
      described. This case demonstrates the use of office-based diagnostic
      ultrasonography to narrow the differential diagnosis and guide the drainage
      procedure, as well as the use of simple ingenuity to improve patient care.

PMID- 8463789
TI  - Mesenteric venous thrombosis: a case report.
AB  - Mesenteric venous thrombosis is an uncommon entity. The preoperative diagnosis is
      largely clinical; the hallmark is pain that is out of proportion to the physical
      findings. Treatment consists of thrombectomy with resection of necrotic small
      bowel and mesentery. In the absence of trauma or infection, an investigation of
      intrinsic anticoagulant deficiencies is warranted since these deficiencies are
      inherited in an autosomal dominant fashion. Treatment is warfarin sodium therapy.

PMID- 8463790
TI  - Beauty and the beast: do you really know your patient's family?

PMID- 8463791
TI  - The role of organic osmolytes in osmoregulation: from bacteria to mammals.
AB  - Cells of marine species are known to establish osmotic balance with their
      environment by adjusting the concentrations of organic osmolytes rather than
      inorganic osmolytes such as sodium, potassium, and chloride. These organic
      osmolytes fall into three classes: polyhydric alcohols such as sorbitol, amino
      acids and amino acid derivatives, and urea and trimethylamines. Substantial
      evidence is available for a central role of each of these classes in
      osmoregulation in marine species. In this chapter information on the importance
      of organic osmolytes is extended to a study of isolated mammalian kidney cells.
      The intracellular concentration of organic osmolytes in these cells responds
      dramatically to changes in the osmotic environment. The release of sorbitol
      following hypoosmotic exposure appears to be triggered by calcium, possibly via a
      mechanism involving membrane recycling. The summarized experiments provide a
      basis for further work in marine species.

PMID- 8463792
TI  - Cold shock damage is due to lipid phase transitions in cell membranes: a
      demonstration using sperm as a model.
AB  - When cells are cooled to temperatures above the freezing point of water at rates
      greater than a few degrees per minute, they sustain irreversible injury.
      Reduction of this "cold shock" damage could increase the survival of animals and
      plants at low environmental temperatures and improve the cryopreservation of
      plant and animal cells. Leakage of solutes across membranes, associated with
      thermotropic phase transitions in membrane lipids, is thought to be responsible,
      but this hypothesis has not been tested directly. Using Fourier transform
      infrared spectroscopy (FTIR), we measured the lipid phase transitions in intact,
      living sperm, the animal cell in which cold shock has been studied most
      extensively. A shift in the CH2 absorbance peaks indicates the transition from
      liquid-crystalline to gel phase. The phase transition in sperm membranes occurred
      at a lower temperature for a marine shrimp than for the pig. In each case,
      potassium leakage, which is a hallmark of cold shock damage, increased abruptly
      near the end of the phase transition. Human sperm are quite resistant to cold
      shock, and an abrupt lipid phase transition was not detected. This phase behavior
      is typical of membranes containing a high proportion of cholesterol, and human
      sperm have an unusually high sterol content. High cholesterol levels are known to
      stabilize membranes during cooling. Overall, the lipid phase behavior was
      consistent with the temperature range over which cooling was damaging for pig and
      shrimp sperm, and the with the extent of damage produced in pig and human sperm.
      This is the first direct evidence that cold shock results from lipid phase
      transitions in cell membranes.

PMID- 8463793
TI  - Production of an anti-allergic triterpene bryonolic acid, by plant cell cultures.
AB  - Cell suspension cultures of Luffa cylindrica, Citrullus lanatus, and related
      cucurbitaceous plants accumulate large quantities of bryonolic acid (3 beta
      hydroxy-D:C-friedoolean-8-en-29-oic acid) [1], an acidic, pentacyclic triterpene
      found exclusively in the roots of the intact plants. This compound could readily
      be isolated from cultured cells with CHCl3 and purified simply by
      recrystallization. Pharmacological tests using mice demonstrated that bryonolic
      acid or its derivative is active against at least three types of allergies and
      that its activity could be increased significantly by preparing synthetic
      derivatives, in particular a potassium salt of its succinate ester. The
      biosynthesis of bryonolic acid from mevalonic acid via isomultiflorenol has been
      elucidated by tracer and enzymological experiments using cultured cells of
      watermelon both in vitro and in vivo. Furthermore, cell fractionation and
      electron microscopic studies on subcellular structures of luffa cells suggested
      that minute vesicles originating from elongated, rough endoplasmic reticulum
      probably play an important role in the transport of bryonolic acid which largely
      accumulates in the cell wall of cultured cells. The results obtained from the
      present study indicate that plant cell culture would be useful not only as a
      biological system for elucidating biosynthetic mechanisms but also as a potential
      source of new pharmacologically active compounds.

PMID- 8463794
TI  - Crystal structure of artemisinic acid: a possible biogenetic precursor of
      antimalarial artemisinin from Artemisia annua.
AB  - Artemisinic acid [1], a possible biogenetic precursor of the antimalarial
      artemisinin [2], was isolated from the hexane extract of Artemisia annua. X-ray
      crystallography of the dimer of artemisinic acid shows that the cyclization
      during intermolecular hydrogen bonding occurs by the opposite orientation of the
      alpha, beta-methylene group in each molecule. Complete spectroscopic data of 1
      are also given.

PMID- 8463795
TI  - Combination effects of antifungal nagilactones against Candida albicans and two
      other fungi with phenylpropanoids.
AB  - Antifungal activity of three nagilactones isolated from the root bark of
      Podocarpus nagi (Podocarpaceae), alone and in combination with a variety of
      phenylpropanoids, was investigated against three fungi, Candida albicans,
      Saccharomyces cerevisiae, and Pityrosporum ovale. Nagilactone E [2], the most
      abundant norditerpene dilactone, showed moderate to weak activity against these
      fungi. This activity was dramatically enhanced by several naturally occurring
      phenylpropanoids such as anethole [5] and isosafrole. For example, anethole
      enhanced the activity of nagilactone E as much as 128-fold for C. albicans,
      decreasing the MIC of this nagilactone from 800 to 6.25 micrograms/ml.

PMID- 8463796
TI  - Triterpenoid saponins from Bupleurum fruticosum.
AB  - Three triterpenoid saponins 1-3 of the oleanane series, containing one fucose and
      two glucose units, were isolated from the MeOH extract of the roots of Bupleurum
      fruticosum. Their structures were elucidated by means of fabms and a combination
      of homo- and heteronuclear 2D nmr techniques. Two of the three saponins are new.

PMID- 8463797
TI  - Unprecedented oxylipins from the marine green alga Acrosiphonia coalita.
AB  - The Oregon marine chlorophyte Acrosiphonia coalita produces an assortment of
      oxidized polyunsaturated fatty acids, or oxylipins. The smallest of these was a
      10-carbon conjugated trienal 1 with antimicrobial properties. Related to 1 were
      three novel branched-chain conjugated trienals 4, 5, and 9 in which the aldehyde
      was present as a branch on a 17-carbon fatty acid chain. Additionally, two novel
      conjugated unbranched trienone octadecanoids 8 and 10 were also isolated and
      characterized. Finally, a family of related epoxy-alcohols (11, 12, 15, and 17)
      was obtained from A. coalita. Structures were determined by spectroscopic methods
      in combination with formation of various degradation products and derivatives.
      The absolute stereochemistry of several of these metabolites was determined by
      application of exciton chirality circular dichroic spectroscopy on benzoate
      derivatives.

PMID- 8463798
TI  - Isolation and structure of the marine sponge cell growth inhibitory cyclic
      peptide phakellistatin 1.
AB  - A new cell growth inhibitory (P-388 murine leukemia ED50 7.5 micrograms/ml)
      cycloheptapeptide designated phakellistatin 1 was isolated from two Indo-Pacific
      sponges, Phakellia costata and Stylotella aurantium. Structural elucidation was
      accomplished utilizing high field nmr, amino acid analyses, and mass spectral
      techniques (fab, tandem ms/ms), followed by chiral gas chromatographic procedures
      for absolute configuration assignments (all S-amino acid units). By these methods
      phakellistatin 1 [1] was found to be cyclo (Pro-Ile-Pro-Ile-Phe-Pro-Tyr), and
      this assignment was finally confirmed by an X-ray crystal structure
      determination.

PMID- 8463799
TI  - Isolation and identification of an antifungal naphthopyran derivative from
      Rhinacanthus nasutus.
AB  - Rhinacanthus nasutus (Acanthaceae) gave a new antifungal naphthopyran derivative.
      The structure of the compound was elucidated by spectroscopic methods as 3,4
      dihydro-3,3-dimethyl-2H-naphtho[2,3-b]pyran-5,10-dione [1].

PMID- 8463800
TI  - Changes in renal vein, renal surface, and urine oxygen tension during hypoxia in
      pigs.
AB  - To determine whether ureteral urine oxygen tension could serve as a monitor of
      renal hypoxia and its relationship to other renal O2 tension parameters, we
      simultaneously measured femoral artery (PaO2), renal vein (PrvO2), renal surface
      (PrsO2), and ureteral urine (PuO2) oxygen tensions in 8 anesthetized pigs while
      incrementally decreasing the inspired oxygen concentration (FiO2) from 21% to
      12%. Renal artery blood flow, measured by transit time ultrasound, renal oxygen
      consumption, and thermodilution cardiac output, was constant. Changes in PaO2,
      PrvO2, PrsO2, and PuO2 caused by decreasing FiO2 were evaluated by one-way
      analysis of variance. The relationships between PuO2 and the other O2 tension
      parameters were evaluated by correlation coefficient and linear regression
      statistics. Of six possible O2 decrements (combinations of 3, 6, and 9%), only
      PrvO2 significantly decreased with all six decrements. PuO2 decreased when FiO2
      decreased 6% or more. PuO2 is not a sensitive indicator of systemic hypoxia.
      Under constant renal perfusion and oxygen consumption, PuO2 had a correlation
      coefficient of 0.80 and a regression equation of PuO2 = 0.84 (PrvO2) + 11.6, with
      PrvO2. PuO2 is related to PrvO2 when renal perfusion is constant.

PMID- 8463801
TI  - Noninvasive continuous blood pressure measurement: a clinical evaluation of the
      Cortronic APM 770.
AB  - The Cortronic APM 770 (Cortronic, Ronkonkoma, NY) is a commercial device that
      claims to measure blood pressure noninvasively and continuously with the use of a
      standard blood pressure cuff. The aim of our study was to assess the performance
      of the continuous-mode blood pressure readings of the Cortronic during anesthesia
      and surgery. We recorded blood pressure in 5 patients bilaterally. An
      interaarterial pressure (IAP) curve was recorded from 1 arm and the Cortronic
      pressure curve (CPC) was recorded from the other. For statistical analysis the
      period between 2 Cortronic recalibrations was defined as the intercalibration
      interval. The duration of these intervals ranged from 20 to 0.5 minutes. Four
      paired samples were drawn from each interval. The first sample in an interval
      represented the recalibration blood pressure; the other samples represented the
      continuous blood pressure. A total of 1,232 samples were taken, of which 308 were
      recalibration. The median of the differences and the 2.5th and 97.5th percentile
      limits of agreement were determined. Their respective values for diastolic and
      systolic recalibration measurements were 5, -17, and 34 mm Hg, and 6, -12, and 38
      mm Hg. Their values for continuous measurements were 4, -23.5, and 32 mm Hg, and
      6, -30, and 70 mm Hg. Changes in CPC were evaluated against changes in the
      corresponding IAP by plotting them in 4-quadrant graphs. In these graphs the
      Spearman rank correlations were between r = -0.17 and r = 0.01. We observed
      opposite CPC and IAP trends on 24 occasions during this study. We performed a
      simple simulation study to better understand the measurement method of the
      Cortronic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463802
TI  - An adaptive controller for the administration of closed-circuit anesthesia during
      spontaneous and assisted ventilation.
AB  - Although reduced waste of expensive anesthetic gases is a strong incentive to use
      closed-circuit anesthesia, manual methods of performing closed-circuit anesthesia
      are labor intensive and thus not widely used. Automation of closed-circuit
      anesthesia delivery may reduce the work. A pressure-based adaptive controller was
      designed and tested on mongrel dogs to evaluate the feasibility of automating
      closed-circuit anesthesia using an accessory to an existing clinical anesthesia
      machine and a gas analyzer. The controller was found stable and responsive with
      good control of oxygen concentration and acceptable control of halothane end
      tidal concentration. The response time for oxygen was 5.23 +/- 1.26 minutes, and
      that for halothane was 2.67 +/- 1.83 minutes. The average peak overshoot for
      halothane at the start of the experiment was 26.9%. This pressure controller
      differs from previously published closed-circuit anesthesia controllers that
      measure gas volume changes within a mechanical ventilator. A pressure-based
      controller is easily attached to a standard anesthesia machine and is compatible
      with modes of ventilation other than controlled mechanical ventilation. The
      controller used in this study is not designed for clinical use, but was developed
      to investigate the feasibility of pressure as a basis for gas volume control in
      closed-circuit anesthesia administration.

PMID- 8463803
TI  - Integration of monitoring for intelligent alarms in anesthesia: neural networks-
      can they help?
AB  - Although there has been a decrease in the number of anesthesia-related critical
      incidents, there are still opportunities for further improvement. We discuss the
      potential of integrated monitoring and artificial neural networks as a means of
      vigilantly watching for patterns in multiple variables to detect incidents and
      reduce false alarms. We estimate that half the anesthesia-related events could be
      detected with integrated monitoring using only 5 variables. A review of research
      using artificial intelligence/expert systems indicates limited potential for
      success using these tools alone for integrated monitoring in the operating room.
      We present artificial neural networks as an approach that is more suited to the
      type of multivariable monitoring and pattern recognition required. Along with
      rule-based artificial intelligence, these now have the potential to help develop
      innovative monitoring in the operating room.

PMID- 8463804
TI  - Construction and use of catheter-manometer systems.
AB  - The accuracy of invasive arterial blood pressure monitoring is dependent on an
      adequate damped natural frequency (DNF) and damping factor (DF) of the system.
      Several factors influencing the DNF and DF were investigated to determine
      requirements for optimal design of catheter-manometer systems. The frequency
      sweep method was used in a specially constructed chamber that included
      linearizing and compensation circuitry. The DNF of isolated 20-gauge cannulae
      varied from 35.1 to 47.7 Hz. The DNF of 24-gauge cannulae varied from 27.7 to
      44.3 Hz. An arterial cannula was found to require a DNF above 40 Hz to prevent
      the DNF from decreasing to below 25 Hz with the addition of arterial pressure
      tubing. Arterial pressure tubings exceeding 300 mm in length had DNF values that
      were unacceptably low even before the addition of arterial cannulae (e.g., the
      DNF was 23.8 Hz for a 900-mm tubing length, 19.8 Hz for 1,000-mm length, and
      ranged from 12.9 to 21.4 Hz for 1,200-mm lengths). The 3-way stopcocks and
      continuous flush devices further decreased the DNF, especially when the diameters
      were not matched. The percentage decrease caused by 3-way stopcocks and flush
      devices ranged between 19.5 and 40.8% for 300-mm length tubings and between 2.3
      and 25.8% for tubings of 1,200-mm lengths. The radius ratio (outside diameter
      divided by inside diameter) is introduced as a new method to express the
      stiffness of arterial pressure tubing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463805
TI  - Effect of delay and storage on whole-blood clotting analysis as determined by
      thrombelastography.
AB  - The thrombelastogram (TEG) measures the viscoelastic properties of clotting
      blood, displaying a visual trace of all phases of coagulation and fibrinolysis.
      Thrombelastography can be performed on whole blood (WBTEG) or on citrated blood
      or plasma, citrated samples facilitating delayed analysis but requiring
      recalcification of the sample. The aim of this study was to investigate the
      effect of delay and storage method on WBTEG measurement. Thrombelastographic
      analysis of coagulation in whole blood was investigated after delays of 3 and 6
      minutes in polystyrene syringes (PS3 and PS6) and 3 minutes in silicone-coated
      glass tubes (SG3). Thrombelastograms of the delayed samples were compared with
      those measured immediately. Silicone-coated glass tubes activated coagulation, as
      seen by shorter r times (p < 0.01), shorter r + k times (p < 0.01), and larger
      maximum amplitude (ma) values (p < 0.01) compared with TEG values determined
      immediately after sampling. In the SG3 group, 20% of samples had clotted by 3
      minutes, and the use of SG tubes for this purpose cannot be recommended. A delay
      of 6 minutes in PS had less effect on the activation of clotting in the earlier
      stages in that the r time was prolonged (p < 0.01). However, there appeared to be
      some activation later in that k time was shorter (p < 0.01) and ma was wider (p <
      0.05). Overall, a 3-minute delay in PS produced the best values.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463806
TI  - Cable-testing device fails to indicate that hypertension is artifactual.
AB  - A patient undergoing neurosurgical anesthesia was noted to have a mean
      systolic/intraarterial pressure of 190/135 mm Hg, whereas the mean
      systolic/noninvasive blood pressure was 110/77 mm Hg. The problem was traced to a
      short circuit between the contacts in two adjacent sockets at the transducer-end
      of the interface cable. The short circuit prevented sufficient attenuation of the
      excitation voltage from the bedside monitor to the pressure-sensitive bridge
      circuit of the transducer. A test device (Cable Checker, Viggo-Spectramed,
      Oxnard, CA) containing a resistance network that could be attached to the
      interface cable in place of the transducer incorrectly indicated that the cable
      was functioning properly. The malfunction was confirmed by exposing the
      transducer to known static pressures. The manufacturer modified the transducer
      end of its interface cable to reduce the likelihood of a similar problem
      recurring. Subtleties of the function of the disposable transducer, reasons for a
      disparity between systolic intraarterial pressures and noninvasive blood
      pressures, and methods for bedside testing of intraarterial pressure equipment
      are discussed.

PMID- 8463807
TI  - The time has come for evolution from the circle breathing system.

PMID- 8463808
TI  - Current anesthesia breathing systems are just fine.

PMID- 8463809
TI  - Future anesthesia workstations and today's priorities.

PMID- 8463810
TI  - Bronchodilator aerosol propellant interferes with an infrared photoacoustic
      spectrophotometer respiratory gas analyzer.

PMID- 8463811
TI  - Equipment design errors.

PMID- 8463812
TI  - Base excess and inappropriate bicarbonate.

PMID- 8463813
TI  - Mass spectrometry: performance of long catheters.

PMID- 8463814
TI  - Failure of clinical signs to confirm intravascular placement of a central venous
      catheter.

PMID- 8463815
TI  - Peripheral vascular effects on auscultatory blood pressure measurement.
AB  - Experiments were conducted to examine the accuracy of the conventional
      auscultatory method of blood pressure measurement. The influence of the
      physiologic state of the vascular system in the forearm distal to the site of
      Korotkoff sound recording and its impact on the precision of the measured blood
      pressure is discussed. The peripheral resistance in the arm distal to the cuff
      was changed noninvasively by heating and cooling effects and by induction of
      reactive hyperemia. All interventions were preceded by an investigation of their
      effect on central blood pressure to distinguish local effects from changes in
      central blood pressure. These interventions were sufficiently moderate to make
      their effect on central blood pressure, recorded in the other arm, statistically
      insignificant (i.e., changes in systolic [p < 0.3] and diastolic [p < 0.02]).
      Nevertheless, such alterations were found to modify the amplitude of the
      Korotkoff sound, which can manifest itself as an apparent change in arterial
      blood pressure that is readily discerned by the human ear. The increase in
      diastolic pressure for the cooling experiments was statistically significant (p <
      0.001). Moreover, both measured systolic (p < 0.004) and diastolic (p < 0.001)
      pressure decreases during the reactive hyperemia experiments were statistically
      significant. The findings demonstrate that alteration in vascular state generates
      perplexing changes in blood pressure, hence confirming experimental observations
      by earlier investigators as well as predictions by our model studies.

PMID- 8463816
TI  - The morphology of the sensory neuron in the cockroach femoral tactile spine.
AB  - 1. The cockroach femoral tactile spine contains a single bipolar sensory neuron.
      The mechanosensitive dendrite in the wall of the spine leads through the spine
      lumen to a cell body, and then to an axon that proceeds proximally along the
      femur. The ultrastructure of the sensory ending has been examined before with
      electron microscopy. However, the morphology of the complete neuron and its
      relationship to the general spine structure have not been described before. 2.
      The tactile spine neuron has been extensively used in electrophysiological
      studies, including intracellular recordings. Action-potential amplitudes and
      thresholds were variable and inversely related in intracellular recordings, which
      could be caused by variability in the location of the action-potential initiation
      region, the position of the recording electrode, or the neuronal morphology.
      Attempts to observe the complete neuronal morphology by dye injection were
      hampered by the opaque and autofluorescent cuticle surrounding the neuron. 3. We
      examined 10 tactile spine neurons, and their surrounding structures, by taking
      serial 1-micron sections through the base of the spine, normal to its long axis.
      The sections were examined with light microscopy, digitized by tracing onto a
      graphics tablet, and then reassembled with the use of computer software.
      Reconstructions were made of the borders of the spine cuticle, neuron, neuronal
      nucleus, glial wrappings, and the main trachea in the spine lumen. 4. There was
      considerable variability in the size and shape of the neuronal cell body,
      although the sensory dendrite and axon had more consistent morphologies.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463817
TI  - Thalamic VPM nucleus in the behaving monkey. I. Multimodal and discriminative
      properties of thermosensitive neurons.
AB  - 1. The role of the thalamic ventroposterior medial (VPM) nucleus in the
      discriminative aspects of nociception and thermoreception was evaluated in alert,
      trained rhesus monkeys. Single-unit responses were recorded from VPM while the
      monkeys performed a battery of tasks involving noxious heat, innocuous cool, and
      air-puff stimuli presented to the face. The discriminative ability of the monkey
      was compared directly with the responses of single neurons, to determine whether
      the neuronal response could subserve the monkey's discriminative behavior. 2.
      Most thermally sensitive neurons exhibited multimodal properties. Only 18%
      responded exclusively to heat (HT-Heat neurons), whereas 27% responded to
      innocuous mechanical, as well as noxious mechanical and heat stimuli (WDR-Heat).
      Twenty-three percent responded to innocuous mechanical stimuli and innocuous skin
      cooling (Mechano-Cool), and 32% responded to mechanical, innocuous cool, and
      noxious heat stimuli (WDR-Heat-Cool). 3. Almost all mechanical receptive fields
      were confined to one division of the trigeminal nerve. This was true for all of
      the above categories of VPM neurons, even those showing highly convergent
      properties (WDR-Heat-Cool). 4. Heat-activated neurons produced graded responses
      to noxious skin heating in the 46 to 49 degrees C range. Stimulus-response
      functions of neurons that responded to both heat and cool did not differ from
      those of neurons that responded exclusively to skin heating. 5. When the monkeys
      were detecting small changes in the intensity of a noxious heat stimulus (e.g.,
      from 47 to 47.1-47.8 degrees C), heat-activated neurons responded to the smallest
      temperature changes that could be detected by the monkeys. Further, there was a
      high correlation between the monkey's success in detecting the stimulus changes
      and the magnitude of the neuronal responses to those changes. 6. Although the
      responsiveness of VPM cool-activated neurons was not compared with the monkeys'
      threshold for detecting cooling changes, larger stimulus changes (2 degrees C)
      that the monkey reliably detected produced significant neuronal responses.
      Further studies are needed to determine whether VPM neurons respond to the
      smallest detectable changes in skin cooling. 7. Several thermally sensitive VPM
      neurons were tested under two attentional conditions: 1) while the monkey was
      required to attend to a visual stimulus, and 2) while it was required to attend
      to the thermal stimulus to obtain reward. None showed a significant difference in
      heat- or cool-evoked activity in the two attentional states.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8463818
TI  - Contribution of the monkey corticomotoneuronal system to the control of force in
      precision grip.
AB  - 1. The contribution of 33 corticomotoneuronal (CM) cells, recorded in the primary
      motor cortex, to the production of precision grip force has been investigated in
      four monkeys (Macaca nemestrina). These CM cells were shown, by spike-triggered
      averaging, to facilitate electromyographic (EMG) activity of hand and forearm
      muscles. 2. Single-cell recordings were obtained as the monkey performed a low
      force precision grip task under either isometric or auxotonic conditions. The
      monkey had to produce independent control of the forces exerted by the thumb and
      index finger and maintain them for 1-1.5 s. Steady force segments of data were
      selected trial-by-trial from these hold periods. For each segment the following
      mean values were determined: 1) CM cell firing rate, 2) EMG activity of
      facilitated muscles, and 3) index finger, thumb, and total force. 3. Of the 33 CM
      cells, 18 had a phasic-tonic pattern of discharge during the task, 7 were tonic,
      5 had a ramplike increase, and 3 were deactivated during the hold period. 4. Of
      the 33 cells analyzed, 11 showed a significant positive (P < 0.05) correlation of
      their mean firing rate with static force; 4 of them had high correlation
      coefficients (P < 0.001). There was a considerable trial-by-trial variability in
      the cells' activity-force relationship. Six CM cells had significant negative
      correlations between their activity and isometric force (5 at the P < 0.001
      level), showing lower firing rates with higher forces. 5. The force sensitivity
      of the CM cells, calculated from the rate-force slopes, was higher for either the
      thumb or the index finger force. Under isometric conditions the mean rate-force
      slopes, calculated from the best correlated digit force, was 32.4 Hz/N for eight
      positively correlated cells and -21.3 Hz/N for the cells with a negative
      correlation. 6. Correlation between CM cell spike activity and force was more
      common among neurons with slowly conducting axons (4/6 correlated) than for those
      with fast axons (13/27). 7. Significant correlations between target muscle EMG
      and force were always positive. The correlations between CM cell firing rate and
      target muscle EMG were comparable with those found between firing rate and force.
      Three of the CM cells with a negative correlation to force also had a negative
      correlation with EMG in one of their target muscles. 8. Each CM cell facilitated
      the EMG activity of one to five target muscles; postspike facilitation (PSF) was
      most common among intrinsic hand muscles (68/82 CM cell/muscle
      combinations).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463819
TI  - Response properties of single units in the dorsal nucleus of the lateral
      lemniscus and paralemniscal zone of an echolocating bat.
AB  - 1. Connectional evidence suggests that the dorsal nucleus of the lateral
      lemniscus (DNLL) and the paralemniscal zone (PL) function as centers for binaural
      analysis interposed between the superior olivary complex and the midbrain. In
      addition, the DNLL is known to be a major source of inhibitory input to the
      midbrain. The aim of this study was to characterize the response properties of
      neurons in DNLL and PL of the echolocating bat Eptesicus fuscus, a species that
      utilizes high-frequency hearing and that might be expected to have a large
      proportion of neurons responsive to interaural differences in sound level. 2.
      Auditory stimuli were presented monaurally or binaurally to awake animals, and
      responses of single units were recorded extra-cellularly with the use of glass
      micropipettes. 3. Below the ventrolateral border of the inferior colliculus is a
      region that contains large gamma-aminobutyric acid-positive neurons. On the basis
      of its immunohistochemical reactivity, this entire region could be considered as
      DNLL. However, within the area, there was an uneven distribution of binaural
      responses. Caudally, binaural neurons made up 84% (41/49) of those tested, but
      rostrally only 29% (6/21). For this reason the rostral area is considered as a
      separate functional subdivision and referred to as the dorsal paralemniscal zone
      (DPL). PL is located ventral to DPL and medial to the intermediate and ventral
      nuclei of the lateral lemniscus; in PL 88% (14/16) of neurons were binaural. 4.
      Most neurons responded only to a contralateral stimulus when sounds were
      presented monaurally. Out of 49 neurons in DNLL, 42 responded only to a
      contralateral sound, 1 responded only to an ipsilateral sound, and 6 responded to
      sound at either ear. In the DPL, all of the 21 neurons tested responded to a
      contralateral sound and none to an ipsilateral sound. Out of 16 neurons in the
      PL, 11 responded only to a contralateral sound, 1 responded only to an
      ipsilateral sound, and 4 responded to sound at either ear. 5. When sounds were
      presented at both ears simultaneously, several different patterns of binaural
      interaction occurred. The most common pattern was suppression of the response to
      sound at one ear by sound at the other ear. In DNLL, 57% (28/49) of neurons
      showed this type of binaural interaction. Another 10% (5/49) showed facilitation
      at some interaural level differences and suppression at others, and another 10%
      (5/49) showed facilitation at some interaural level differences but no
      suppression.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463820
TI  - Effects of low-frequency stimulation of the superior colliculus on spontaneous
      and visually guided saccades.
AB  - 1. The first experiment of this study determined the effects of low-frequency
      stimulation of the monkey superior colliculus on spontaneous saccades in the
      dark. Stimulation trains, subthreshold for eliciting short-latency fixed-vector
      saccades, were highly effective at biasing the metrics (direction and amplitude)
      of spontaneous movements. During low-frequency stimulation, the distribution of
      saccade metrics was biased toward the direction and amplitude of movements
      induced by suprathreshold stimulation of the same collicular location. 2. Low
      frequency stimulation biased the distribution of saccade metrics but did not
      initiate movements. The distribution of intervals between stimulation onset and
      the onset of the next saccade did not differ significantly from the distribution
      of intervals between an arbitrary point in time and the onset of the next saccade
      under unstimulated conditions. 3. Results of our second experiment indicate that
      low-frequency stimulation also influenced the metrics of visually guided
      saccades. The magnitude of the stimulation-induced bias increased as stimulation
      current or frequency was increased. 4. The time course of these effects was
      analyzed by terminating stimulation immediately before, during, or after visually
      guided saccades. Stimulation trains terminated at the onset of a movement were as
      effective as stimulation trains that continued throughout the movement. No
      effects were observed if stimulation ended 40-60 ms before the movement began. 5.
      These results show that low-frequency collicular stimulation can influence the
      direction and amplitude of spontaneous or visually guided saccades without
      initiating a movement. These data are compatible with the hypothesis that the
      collicular activity responsible for specifying the horizontal and vertical
      amplitude of a saccade differs from the type of collicular activity that
      initiates a saccade.

PMID- 8463821
TI  - Dynamic clamp: computer-generated conductances in real neurons.
AB  - 1. We describe a new method, the dynamic clamp, that uses a computer as an
      interactive tool to introduce simulated voltage and ligand mediated conductances
      into real neurons. 2. We simulate a gamma-aminobutyric acid (GABA) response of a
      cultured stomatogastric ganglion neuron to illustrate that the dynamic clamp
      effectively introduces a conductance into the target neuron. 3. To demonstrate an
      artificial voltage-dependent conductance, we simulate the action of a voltage
      dependent proctolin response on a neuron in the intact stomatogastric ganglion.
      We show that shifts in the activation curve and the maximal conductance of the
      response produce different effects on the target neuron. 4. The dynamic clamp is
      used to construct reciprocal inhibitory synapses between two stomatogastric
      ganglion neurons that are not coupled naturally, illustrating that this method
      can be used to form new networks at will.

PMID- 8463822
TI  - Some early travails of tracing axonal pathways in the brain.

PMID- 8463823
TI  - Changes in protein synthesis accompanying long-term potentiation in the dentate
      gyrus in vivo.
AB  - The possibility that the induction of long-term potentiation (LTP) is followed by
      changes in protein synthesis has been examined using high-resolution two
      dimensional gel electrophoresis. 35S-methionine, infused into the third ventricle
      of anesthetized rats, was used to label hippocampal proteins. LTP was induced
      unilaterally in the dentate gyrus by tetanic stimulation of the perforant path,
      and followed either for 1 hr or for 3 hr. Two-dimensional gel autoradiographs
      were quantitatively analyzed using the PDQUEST system (Protein Databases Inc.).
      One hour after the unilateral induction of LTP, only one protein spot was found
      to be statistically different in intensity from corresponding spots in the
      contralateral control side. Three hours after LTP, however, 11 spots were found
      to have altered densities. Examination of basic proteins using the nonequilibrium
      pH gel electrophoresis system revealed changes in three proteins in the 3 hr
      group. Reductions as well as increases in spot intensities were observed. The
      results indicate that LTP is associated with a complex pattern of changes in
      protein synthesis.

PMID- 8463824
TI  - Regionalization and intersegmental coordination of rhythm-generating networks in
      the spinal cord of the chick embryo.
AB  - We have examined the regionalization and coordination of rhythm-generating
      networks in the isolated spinal cord of the chick embryo between embryonic days 9
      and 13, by recording the pattern of rhythmic activity recorded from muscle nerves
      and ventral roots following a variety of lesions. We found that the capacity for
      rhythmic activity is distributed along the rostrocaudal axis of the cord but can
      be expressed in a single, isolated segment. Specializations within the
      lumbosacral cord were investigated by isolating particular regions and recording
      their motor output. The rostral part of the lumbosacral cord generates more
      cycles than the caudal part, and this difference becomes more pronounced with
      development. In the unlesioned cord, motoneuron activity is synchronized along
      the rostrocaudal axis. Lesion experiments revealed that the synchronization of
      motoneuron activity and the synaptic drive to caudal motoneurons is mediated in
      part by propriospinal pathways traveling in the ventrolateral white matter tracts
      and by synaptic interactions within the gray matter. The dorsal fiber tracts may
      also be involved but their effects appear to be weak. Lesions in dorsal-ventral
      and mediolateral planes were used to localize regions critical for rhythmogenesis
      and for the alternation of flexor and extensor motoneurons. Rhythmic activity
      with alternation persisted in spinal cords in which the dorsal and medial half
      had been removed. Severe medial or dorsal lesions, resulting in a thin strip of
      lateral or ventral gray matter, altered the phasing of motoneuron activity from
      alternating to synchronous without effects on cycle timing. These results suggest
      that the critical neural components for alternation are located close to and
      dorsomedial to the lateral motor column, and that the capacity for rhythmogenesis
      is distributed widely throughout the ventral gray matter and is not localized to
      specific nuclei.

PMID- 8463825
TI  - Signal transduction, pharmacological properties, and expression patterns of two
      rat metabotropic glutamate receptors, mGluR3 and mGluR4.
AB  - The metabotropic glutamate receptors are coupled to intracellular signal
      transduction via G-proteins and consist of a family of at least five different
      subtypes, termed mGluR1-mGluR5. We studied the signal transduction mechanism and
      pharmacological characteristics of the rat mGluR3 and mGluR4 subtypes in Chinese
      hamster ovary cells permanently expressing the cloned receptors. Both mGluR3 and
      mGluR4 inhibit the forskolin-stimulated accumulation of intracellular cAMP
      formation in response to agonist interaction. Consistent with the high degree of
      sequence similarity to mGluR2, mGluR3 closely resembles mGluR2 in its agonist
      selectivity; the potency rank order of agonists is L-glutamate > trans-1
      aminocyclopentane-1,3-dicarboxylate > ibotenate > quisqualate. mGluR4 is totally
      different in its agonist specificity from any other member of the metabotropic
      receptors. This receptor potently reacts with L-2-amino-4-phosphonobutyrate (L
      AP4) in a stereo-selective manner and moderately responds to L-serine-O
      phosphate. mGluR4 thus corresponds well to the putative L-AP4 receptor
      characterized from brain preparations. Blot and in situ hybridization analyses
      indicated that both mRNAs are widely distributed in the rat brain. mGluR3 mRNA is
      highly expressed in neuronal cells of the cerebral cortex and the caudate
      putamen, and in granule cells of the hippocampal dentate gyrus. The expression
      pattern of mGluR4 mRNA is more restricted, and this expression is prominent in
      the cerebellum, olfactory bulb, and thalamus. Furthermore, the mGluR3 mRNA,
      unlike the other mRNAs for the metabotropic receptors, is highly expressed in
      glial cells throughout the brain regions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463826
TI  - Inhibition of brain protein synthesis by cycloheximide does not affect formation
      of long-term memory in honeybees after olfactory conditioning.
AB  - The honeybee forms a long-term memory in different training situations that lasts
      for a lifetime, but the cellular mechanisms of long-term memory formation are not
      known. We analyzed the dependency of long-term memory on the de novo brain
      protein synthesis. The protein synthesis inhibitor cycloheximide was injected via
      the median ocellus directly into the brain. 3H-leucine incorporation into brain
      proteins was inhibited by > 95% for > 3 hr. The time of protein synthesis
      inhibition was prolonged by a second injection of the same dose. Worker honeybees
      were conditioned to an olfactory stimulus at different times before and after
      injection. The proboscis extension response (PER) of bees restrained in tubes was
      classically conditioned with sugar water applied first to the antennae followed
      by feeding (unconditioned stimulus) paired with odor presentation (conditioned
      stimulus). The bees were tested by presenting the odor alone at different times
      up to 24 hr after injection. No significant reduction in the probability of the
      conditioned response in cycloheximide-treated bees was found when compared to the
      Ringer-injected controls in 4 series of experiments. Since protein synthesis was
      inhibited between 7 hr pre- and 7 hr postconditioning without affecting the
      formation of long-term memory, a possible role of de novo protein synthesis in
      the formation of long-term memory after olfactory conditioning of the PER is not
      supported by these experiments.

PMID- 8463827
TI  - Clonal patterns of cell proliferation, migration, and dispersal in the brainstem
      of the chicken embryo.
AB  - Retroviral-mediated gene transfer was used to study clonal patterns of
      proliferation, migration, and dispersal in the brainstem of the chicken embryo.
      Clones were generated at stages 13-17 (Hamburger and Hamilton, 1951), a period of
      neurogenesis in the brainstem neural tube subsequent to the formation of
      rhombomeres. Clones were examined in separate experiments at stages 24-27, when
      many neurons migrate and differentiate; at stages 28-29, when brainstem nuclei
      begin to form; and at stages 34-35, when brainstem nuclei are fully formed.
      Stages 24-29 are characterized by a general variability in proliferative kinetics
      and migratory behavior. Clone sizes range from 1 to 29 cells, and migration
      patterns range from strictly radial (i.e., normal to the ventricular surface) to
      combined radial and tangential (i.e., perpendicular to the radial component).
      There is, however, an underlying systematic variation: (1) clones exhibiting
      tangential migration contain on average more cells than clones exhibiting only
      radial migration, and (2) the proportion of tangentially migrating clones
      increases from medial to lateral. By stages 34-35 some individual clones have
      apparently dispersed to disparate neuronal groups. The regional diversity
      observed among clones suggests that position along the mediolateral axis may
      determine the proliferative potential of progenitors and the migratory behavior
      and subsequent dispersal of their descendants.

PMID- 8463828
TI  - Two-dimensional spatiotemporal coding of linear acceleration in vestibular nuclei
      neurons.
AB  - Response properties of vertical (VC) and horizontal (HC) canal/otolith-convergent
      vestibular nuclei neurons were studied in decerebrate rats during stimulation
      with sinusoidal linear accelerations (0.2-1.4 Hz) along different directions in
      the head horizontal plane. A novel characteristic of the majority of tested
      neurons was the nonzero response often elicited during stimulation along the
      "null" direction (i.e., the direction perpendicular to the maximum sensitivity
      vector, Smax). The tuning ratio (Smin gain/Smax gain), a measure of the two
      dimensional spatial sensitivity, depended on stimulus frequency. For most
      vestibular nuclei neurons, the tuning ratio was small at the lowest stimulus
      frequencies and progressively increased with frequency. Specifically, HC neurons
      were characterized by a flat Smax gain and an approximately 10-fold increase of
      Smin gain per frequency decade. Thus, these neurons encode linear acceleration
      when stimulated along their maximum sensitivity direction, and the rate of change
      of linear acceleration (jerk) when stimulated along their minimum sensitivity
      direction. While the Smax vectors were distributed throughout the horizontal
      plane, the Smin vectors were concentrated mainly ipsilaterally with respect to
      head acceleration and clustered around the naso-occipital head axis. The
      properties of VC neurons were distinctly different from those of HC cells. The
      majority of VC cells showed decreasing Smax gains and small, relatively flat,
      Smin gains as a function of frequency. The Smax vectors were distributed
      ipsilaterally relative to the induced (apparent) head tilt. In type I anterior or
      posterior VC neurons, Smax vectors were clustered around the projection of the
      respective ipsilateral canal plane onto the horizontal head plane. These distinct
      spatial and temporal properties of HC and VC neurons during linear acceleration
      are compatible with the spatiotemporal organization of the horizontal and the
      vertical/torsional ocular responses, respectively, elicited in the rat during
      linear translation in the horizontal head plane. In addition, the data suggest a
      spatially and temporally specific and selective otolith/canal convergence. We
      propose that the central otolith system is organized in canal coordinates such
      that there is a close alignment between the plane of angular acceleration (canal)
      sensitivity and the plane of linear acceleration (otolith) sensitivity in
      otolith/canal-convergent vestibular nuclei neurons.

PMID- 8463829
TI  - Activity of neurons in anterior inferior temporal cortex during a short-term
      memory task.
AB  - Inferior temporal (IT) cortex of primates is known to play an important role in
      visual memory. Previous studies of IT neurons during performance of working
      memory tasks have found modulation of responses when a current stimulus matched
      an item in memory; however, this effect was lost if other stimuli intervened in
      the retention interval. To examine how IT cortex retains memories while new
      stimuli are activating the cells, we recorded from IT neurons while monkeys
      performed a delayed matching-to-sample task, with multiple intervening items
      between the sample and matching test stimulus. About half of the cells responded
      differently to a test stimulus if it matched the sample, and this difference was
      maintained following intervening stimuli. For most of the affected cells, the
      responses to matching stimuli were suppressed; however, for a few cells the
      opposite effect was seen. Temporal contiguity alone could not explain the
      results, as there was no modulation of responses when a stimulus on one trial was
      repeated on the next trial. Thus, an active reset mechanism appears to restrict
      the memory comparison to just the stimuli presented within a trial. The
      suppressive effects appear to be generated within or before IT cortex since the
      suppression of response to matching stimuli began almost immediately with the
      onset of the visual response. The memory of the sample stimulus affected not only
      the responses to matching stimuli but also those to nonmatching stimuli. There
      was suggestive evidence that the more similar a nonmatching stimulus to the
      sample, the more the response was suppressed. About a quarter of the cells showed
      stimulus-selective activity in the delay interval following the sample. However,
      this activity appeared to be eliminated by intervening stimuli. Thus, it is
      unlikely that delay-interval activity in IT contributed to the performance of
      this particular version of delayed matching to sample. To determine how much
      information about the match-nonmatch status of the stimulus was conveyed by
      individual neurons, we analyzed the responses with discriminant analysis. The
      responses of an individual IT neuron could be used to classify a stimulus as
      matching or nonmatching on about 60% of the trials. To achieve the same
      performance as the animal would require averaging the responses of a minimum of
      25 IT neurons. There was no evidence that mnemonic information was carried by
      temporal variations in the spike trains. By contrast, there was a modest amount
      of temporal variation in sensory responses to different visual stimuli.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8463830
TI  - Dorsolateral prefrontal lesions and oculomotor delayed-response performance:
      evidence for mnemonic "scotomas".
AB  - The spatial memory functions of the monkey's prefrontal cortex were examined with
      oculomotor delayed-response (ODR) paradigms that required the animal to remember
      the spatial location of peripheral visual cues, while maintaining fixation on a
      central visual target during the presentation of each cue and during a subsequent
      1.5-8 sec delay period. Four rhesus monkeys received unilateral or serial
      prefrontal lesions in and around the principal sulcus after they reached
      criterion performance on the ODR tasks. Unilateral lesions disrupted the
      performance of memory-guided eye movements to spatial cues in the visual field
      contralateral to the hemisphere in which the lesion was placed. Memory-guided eye
      movements to ipsilateral cues were mildly affected by unilateral lesions, and
      these lesions had little or no effect on performance in visually guided control
      tasks. With addition of a second lesion in the opposite hemisphere, the deficit
      was extended to include the opposite hemifield. The impairment was characterized
      by eye movements of inappropriate direction, and, excepting the one lesion that
      extended into the frontal eye field region of the arcuate sulcus, saccadic
      reaction times and velocities were the same before and after the lesions. The
      effect of the lesions was delay dependent: performance was rarely altered at the
      shortest (1.5 sec) delay but became progressively worse as the delay period was
      lengthened. The present results strengthen the evidence that the delayed-response
      deficits of monkeys with prefrontal lesions are caused by failure to maintain a
      transient memory "trace" in working memory, and indicate for the first time that
      working memory mechanisms are lateralized: memories for visuo-spatial coordinates
      in each hemifield are processed primarily in the contralateral prefrontal cortex.
      These findings provide evidence for the concept of mnemonic hemianopias and
      mnemonic scotomas, that is, memory deficits for particular hemifields or visual
      field locations, unaccompanied by simple sensory or motor deficits.

PMID- 8463832
TI  - Testosterone enhancement of the nerve cell body response to injury: evidence
      using in situ hybridization and ribosomal DNA probes.
AB  - In axotomized peripheral motoneurons capable of successful regeneration, one of
      the earliest morphological indicators of the injury response occurs within the
      nucleolus. In the initial part of this investigation, we mapped the nucleolar
      response of injured adult hamster facial motoneurons from a molecular
      perspective, utilizing in situ hybridization and ribosomal DNA probes
      complementary to stable rRNA. Recently, we have discovered that the gonadal
      steroid, testosterone propionate (TP), accelerates recovery from facial paralysis
      in the hamster by increasing the rate of regeneration of the fastest regrowing
      axons. In the second part of this study, the hypothesis that TP accomplishes
      these effects on facial nerve regeneration through an enhancement of the nerve
      cell body response to injury was tested using in situ hybridization and rDNA
      probes. Adult intact male hamsters were subjected to right facial nerve axotomies
      at the stylomastoid foramen. One-half of the axotomized animals received
      subcutaneous implants of TP, with the remainder sham implanted. In situ
      hybridization with tritiated rDNA probes was accomplished and levels of
      hybridizable rRNA assessed both qualitatively and quantitatively. Axotomy alone
      induced an upregulation in rRNA levels, with peak changes occurring by 24 hr
      postoperative and continuing through postoperative day 4. These molecular changes
      in the nucleolar response preceded, by a full day, any morphological signs of the
      nucleolar reactive pattern previously found in this cell type, and, as such,
      point to the usefulness of in situ hybridization as a tool to identify the
      earliest events associated with the axon reaction. A secondary smaller increase
      in rRNA levels was observed during the later stages of regeneration. TP
      significantly augmented the ribosomal response to injury, with levels of rRNA
      increased as early as 6 hr and the magnitude of the response greater than that
      occurring following axotomy alone. These results provide the first mechanistic
      step in the identification of the cellular processes underlying gonadal steroid
      augmentation of neuronal reparative processes. We conclude that TP accelerates
      the "switch" from a normal to a reparative state and suggest that this priming
      effect may be causally related to the differential effects of TP on the
      regenerative properties of this cell type.

PMID- 8463831
TI  - Single mossy fiber axonal systems of human dentate granule cells studied in
      hippocampal slices from patients with temporal lobe epilepsy.
AB  - Previous histological and immunocytochemical studies suggest that reorganization
      of the dentate granule cell axons, the mossy fibers, can occur in epileptic human
      hippocampus (Sutula et al., 1989; Houser et al., 1990; Babb et al., 1991) and in
      animal models of epilepsy (Tauck and Nadler, 1985; Sutula et al., 1988; Cronin et
      al., 1992). However, neuroanatomical analyses of the trajectory and morphology of
      reorganized axons are not yet available. The present study was conducted to
      investigate single dentate granule cell axonal systems in human epileptic
      hippocampus. Individual mossy fibers were directly visualized by injecting a
      tracer (biocytin or Lucifer yellow) intracellularly in hippocampal slices
      prepared from temporal lobes that were surgically removed from patients for
      treatment of intractable epilepsy. Two major arborization patterns were
      identified: (1) the parent axons extended to and coursed through the hilus toward
      CA3, leaving collaterals along their paths in the hilus (N = 19 neurons); (2) in
      addition to the aforementioned axonal system, collateral(s) branched from the
      parent axon near the soma and projected to the granule cell layer and molecular
      layer, forming an aberrant axonal pathway (N = 9 neurons). These aberrant
      collaterals bore large boutons similar to those of the hilar axons and formed
      extensive plexuses in the granule cell layer and/or in the molecular layer. The
      summed length of collaterals in the granular/molecular layers was 1110.8 microns
      on average, which was one-fourth of the total summed length of the mossy fibers
      (3698.5 microns on average). The size of the somata in neurons that had aberrant
      collaterals was significantly larger than that of neurons without such
      collaterals (p < 0.025). In four cases, filopodium-like fine processes were
      present near the axon hillock and proximal parts of the parent axon, suggesting
      that the aberrant collateral formation might be an ongoing process in these
      tissues. The lack of control slices from normal living human hippocampus makes it
      difficult to assess to what extent the present findings are epilepsy associated.
      However, the presence of aberrant mossy fiber collaterals in the hippocampi used
      in the present study has been confirmed by Timm's staining and/or dynorphin
      immunohistochemistry in comparison with nonepileptic autopsy material, indicating
      its relation to epilepsy (Babb et al., 1991, 1992). At present, there seems to be
      a consensus that the projection of mossy fiber collaterals to the supragranular
      layer is a rare occurrence in normal rats (Lorento de No, 1934; Claiborne et al.,
      1986; Seress et al., 1991; present study), normal monkeys (Seress et al., 1991),
      and normal humans (Houser et al., 1990).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8463833
TI  - Nerve growth factor is a potent inducer of proliferation and neuronal
      differentiation for adult rat chromaffin cells in vitro.
AB  - Adult rat chromaffin cells in vitro show a large proliferative response to NGF,
      followed by neuronal differentiation. Infection of replicating chromaffin cells
      with a retrovirus carrying the Escherichia coli beta-galactosidase (beta-gal)
      gene demonstrates beta-gal expression in cells that continue to multiply, that
      differentiate into neurons, and that become static. The effects of NGF on
      proliferation and differentiation are abolished by the protein kinase inhibitors
      K252a and staurosporine, and by cholera toxin, an activator of adenylate cyclase.
      They are diminished, but not abolished, by high concentrations of dexamethasone.
      Both cholera toxin alone and phorbol myristate acetate (PMA), an activator of
      protein kinase C, elicit small and inconsistent mitogenic responses. The
      responses to PMA cannot be shown to be additive with the effects of NGF. NGF is a
      known mitogen and neuritogen for chromaffin cells from neonatal rats, but has not
      previously been believed to affect similarly chromaffin cells from adults. The
      present findings suggest that portions of NGF signaling pathways might continue
      to be involved in regulating proliferation of adult rat chromaffin cells in vivo,
      and might be constitutively activated in PC12 cells and other adrenal medullary
      tumors. They further suggest that rat chromaffin cells might be propagated in
      vitro to obtain large numbers of sympathetic neurons expressing normal or
      exogenous genes.

PMID- 8463834
TI  - The spectral sensitivity of dark- and light-adapted cat retinal ganglion cells.
AB  - The spectral sensitivity of cat retinal ganglion neurons (RGNs) was determined by
      means of extracellular recordings under scotopic and photopic conditions, in both
      receptive field center and surround. Test stimuli were presented either as square
      wave single flashes or as flicker stimuli. Chromatic adaptation was achieved by a
      large steady monochromatic background field. In the dark-adapted state the
      spectral sensitivity of the majority of ganglion cells (92%) was rod mediated
      (peak sensitivity at 501 nm). Under photopic conditions all neurons received
      input from a long-wavelength-sensitive (L-cone) system with a peak sensitivity of
      550 nm. Input from a short-wavelength-sensitive (S-cone) system (peak sensitivity
      at 450 nm), however, was found only in 15% of the ganglion cells. A small cell
      population (8%) located within the area centralis revealed a different receptive
      field organization. In these cells, spectral sensitivity in the field center
      peaked at 520 nm in the dark-adapted state and response threshold was about 1 log
      unit higher than in cells with a peak sensitivity of 501 nm. Critical flicker
      fusion was reached at 60-70 Hz, a frequency that usually is mediated by cones. We
      therefore postulate an additional input of a midspectral receptor system (M
      system) other than rods in cat retinal ganglion cells. This input was found only
      in the receptive field center of some ganglion cells in the dark-adapted state,
      whereas the surround sensitivity was mediated in all cells by rod signals under
      scotopic and predominantly by L-cone signals under photopic conditions.

PMID- 8463835
TI  - Immunocytochemical localization of a neuronal nicotinic receptor: the beta 2
      subunit.
AB  - We have characterized in adult rat the tissue-specific expression of the
      nicotinic ACh receptor (AChR) beta 2-subunit using antisera raised against fusion
      protein constructs. Immunohistochemical localization revealed immunoreactivity
      distributed throughout the neuraxis. Overall, beta 2-like immunoreactivity (beta
      2-LI) correlated well with in situ localization of beta 2 transcript in neuronal
      cell bodies. Particularly strong labeling was detected in the thalamus, and
      scattered other regions, whereas relatively weak staining was observed in the
      hypothalamus and amygdala. At the cellular level, beta 2-LI appeared to be
      exclusively neuronal and concentrated predominantly in perikarya, although
      strongly positive dendrites (cerebral cortical pyramidal neurons, cerebellar
      Purkinje cells) and axon terminals (e.g., striatum) were detected. At the
      ultrastructural level, beta 2-LI was membrane associated, with strong staining
      observed in endoplasmic reticulum and cytoplasmic transport vesicles. beta 2-LI
      was rarely detected at synapses. The widespread distribution of beta 2 suggests
      it may serve as a common subunit in different AChR combinations in various brain
      regions. Regulation of the expression of beta 2-subunit appears to be relatively
      unrestrained, with an apparent excess of protein synthesized in the cytoplasm
      relative to that which ultimately arrives at functional targets in the plasma
      membrane.

PMID- 8463836
TI  - Contrasting immunohistochemical localizations in rat brain of two novel K+
      channels of the Shab subfamily.
AB  - We have localized CDRK and DRK1, two novel K+ channels of the Shab subfamily by
      immunohistochemistry. The two channels are closely related in structure with
      about 90% amino acid identity in the N-terminal and middle portions and 60%
      identity in the C-terminal region. We observe striking differences in cellular
      localizations of the two channels. DRK1 tends to localize to cell bodies and
      proximal dendrites discretely, while CDRK is diffusely present in cell bodies and
      is also found on fibers in specific brain areas. In the cerebral cortex DRK1 is
      localized to pyramidal cells, whereas CDRK occurs in small cells, presumably
      interneurons. These localizations may reflect specialized delayed rectifier
      functions and targeting properties manifested differentially by K+ channel
      subfamily members.

PMID- 8463837
TI  - Neurofibromin is enriched in the endoplasmic reticulum of CNS neurons.
AB  - NF1 patients display CNS abnormalities including learning disabilities,
      clumsiness, astrocytomas, and abnormalities on magnetic resonance imaging exams.
      To determine whether the cellular and neuroanatomical distribution of
      neurofibromin reveals possible function for neurofibromin in the brain, we
      stained rat brain tissue sections with anti-neurofibromin antibodies.
      Neurofibromin is highly enriched in large projection neurons, such as cortical
      and hippocampal pyramidal cells and cerebellar Purkinje cells. Neurofibromin is
      present in cell bodies and in axons, but is highly enriched in dendrites.
      Immunoelectron microscopic analysis demonstrates that NF1 is associated with
      smooth vesiculotubular elements and cisternal stacks and with multivesicular
      bodies in the cell body and dendrites, but not with the plasma membrane, nucleus,
      nuclear envelope, Golgi apparatus, mitochondria, or rough endoplasmic reticulum.
      The preferential localization of neurofibromin to the smooth endoplasmic
      reticulum, together with evidence that neurofibromin modulates ras GTPase
      activity, suggests that some, if not all, of the CNS manifestations of NF1 might
      result from the altered expression of neurofibromin in neurons, perhaps through
      disruption of Ca2+ signaling, translocation of organelles, or endocytic pathways.

PMID- 8463838
TI  - Thalamocortical response transformations in simulated whisker barrels.
AB  - Layer IV of rodent somatosensory cortex contains identifiable networks of
      neurons, called "barrels," that are related one-to-one to individual whiskers on
      the face. A previous study (Simons and Carvell, 1989) described differences
      between the response properties of thalamic and cortical vibrissa neurons and
      proposed that these transformations can be explained by several features of
      barrel anatomy and physiology: nonlinear neuronal properties, strongly responsive
      inhibitory and less responsive excitatory neurons, convergent thalamic inputs to
      cells of both types, and interconnections among barrel neurons. In the present
      study these features were incorporated into a computational model in order to
      test their explanatory power quantitatively. The relative numbers of excitatory
      and inhibitory cells and the relative numbers of synapses of thalamic and
      intrabarrel origin were chosen to be consistent with available light and electron
      microscopic data. Known functional differences between excitatory and inhibitory
      barrel neurons were simulated through differences in spike activation functions,
      refractory periods, postsynaptic potential decay rates, and synaptic strengths.
      The model network was activated by spike trains recorded previously from thalamic
      neurons in response to three different whisker deflection protocols, and output,
      which consisted of spikes generated by the simulated neurons, was compared to
      data from our previous neurophysiological experiments. For each type of whisker
      stimulus, the same set of parameter values yielded accurate simulations of the
      cortical response. Realistic output was obtained under conditions where each
      barrel cell integrated excitatory and inhibitory synaptic inputs from a number of
      thalamic and other barrel neurons and where the ratios between network
      excitation, network inhibition, and thalamic excitation were approximately
      constant. Several quantities are defined that may be generally useful in
      characterizing neuronal networks. One important implication of the results is
      that thalamic relay neurons not only provide essential drive to the cortex but
      could, by changing their tonic activities, also directly regulate the tonic
      inhibition present in the cortex and thereby modulate cortical receptive field
      properties.

PMID- 8463839
TI  - Harmaline-induced impairment of Pavlovian conditioning in the rabbit.
AB  - In this study we examined the effects of harmaline on Pavlovian conditioning of
      the rabbit's nictitating membrane response. The acquisition of conditioned
      responses was determined during a single session consisting of 120 pairings of a
      tone-conditioned stimulus with a corneal air puff unconditioned stimulus.
      Harmaline severely retarded (5 mg/kg) or completely blocked (10 and 20 mg/kg)
      acquisition of conditioned responses. The blocked or retarded acquisition of
      conditioned responses could still be detected when the rabbits were tested 2 d
      after cessation of drug injections, suggesting that harmaline was affecting
      acquisition and not the motoric expression of conditioned responses. Control
      experiments established that harmaline (5 mg/kg) did not affect (1) baseline
      levels of responding, (2) the level of non-associative responding to the
      conditioned stimulus, (3) the amplitude or any of the temporal characteristics of
      the unconditioned response, (4) the development of habituation to the
      unconditioned stimulus, and (5) the threshold of the unconditioned stimulus for
      eliciting the unconditioned response. However, harmaline did produce a 12 dB
      increase in the intensity threshold of the conditioned stimulus for eliciting
      conditioned responses. We concluded that the primary effect of harmaline was to
      impair stimulus processing within brainstem circuits such as to reduce the
      excitatory properties of the conditioned stimulus, thus retarding its entry into
      associative learning. The results were discussed with respect to the possible
      role of the inferior olive in associative learning.

PMID- 8463840
TI  - Recoverable and nonrecoverable deficits in conditioned responses after cerebellar
      cortical lesions.
AB  - This study reexamined the effects of unilateral damage to cerebellar hemispheral
      lobule VI on the rabbit's conditioned nictitating membrane (NM) response.
      Extensive unilateral removal of hemispheral lobule VI in 11 rabbits impaired
      ipsilateral conditioned responses as reflected by reductions of 52% in mean
      frequency and 53% in mean amplitude during test trials on the first postoperative
      session. The decreases in the amplitude and frequency of conditioned responses
      were highly correlated (r = 0.82). The frequency of conditioned responses
      recovered to control levels but their amplitudes remained reduced such that the
      correlation between these two measures of responding was no longer significant by
      the 12th postoperative conditioning session. The decrease in the amplitude of
      conditioned responses was not accompanied by changes in onset latency or rise
      time. There was no significant impairment of conditioned responses in surgical
      controls and animals with only partial damage to hemispheral lobule VI. It was
      concluded that hemispheral lobule VI plays an important role in the regulation of
      motor centers in the brainstem so as to facilitate the initiation and optimum
      execution of the conditioned NM reflex. This cortical regulation of the
      conditioned NM response may contain learned elements; however, these cannot be
      resolved with lesion methods, nor has their existence been proven in this or
      other lesion studies. Nevertheless, the results of this study do demonstrate that
      the cerebellar cortex cannot be considered as the single locus necessary for NM
      conditioning.

PMID- 8463841
TI  - Phenotypic plasticity in adult sympathetic ganglia in vivo: effects of
      deafferentation and axotomy on the expression of vasoactive intestinal peptide.
AB  - The expression of neurotransmitters/neuromodulators in sympathetic neurons is
      regulated by anterograde and retrograde mechanisms. We have examined the role of
      such mechanisms in the regulation of the neuropeptide vasoactive intestinal
      peptide (VIP). The adult rat superior cervical ganglion (SCG) contains low levels
      of peptide-like immunoreactivity (IR) and mRNA for VIP. Some VIP-IR nerve
      processes, but only a few VIP-IR cell bodies, are detectable. Previous evidence
      demonstrates, however, that after the SCG is placed in organ culture for 48 hr,
      the level of VIP-IR and VIP mRNA and the number of VIP-IR cell bodies and fibers
      increase considerably. Two of the possible causes for these changes in peptide
      expression in sympathetic neurons are deafferentation and axotomy, both of which
      occur when the SCG is placed in culture. To determine the importance of
      deafferentation, the preganglionic cervical sympathetic trunk was cut and the
      ganglion left in situ. Forty-eight hours later, VIP-IR increased twofold. A
      corresponding increase in the number of VIP-IR nerve processes was seen, but
      there was no detectable change in the number of VIP-IR cell bodies. The content
      of VIP/PHI mRNA also increased by 1.8-fold. The effect of axotomy on VIP-IR was
      examined by cutting the postganglionic internal and external carotid nerves and
      leaving the ganglion in situ. Forty-eight hours later, the level of VIP-IR
      increased 22-fold, many immunostained neurons were found, and the content of VIP
      mRNA increased over fivefold. After either deafferentation or axotomy, changes in
      VIP-IR were accompanied by comparable changes in the related molecule peptide
      histidine isoleucine amide (PHI)-IR. Neuropeptide Y-IR, on the other hand,
      decreased after deafferentation and increased only twofold after axotomy. The
      results indicate plasticity in the expression of VIP- and PHI-IR in adult
      sympathetic neurons in vivo, and suggest that the changes previously seen in
      organ culture were primarily a response to axotomy.

PMID- 8463842
TI  - Expression of glutamate receptor genes in white matter: developing and adult rat
      optic nerve.
AB  - We have identified the glutamate receptor genes expressed by developing and adult
      rat optic nerve. Results from PCR suggested that of the ionotropic glutamate
      receptor (GluR) gene family, only GluR1 and GluR3 subunits are expressed by optic
      nerve. However, Northern blot analysis demonstrated that only the GluR1 subtype
      is expressed at appreciable levels. In situ hybridization histochemistry of GluR1
      was performed and a diffuse pattern of expression was observed in both postnatal
      day 15 and adult optic nerve. Restriction mapping of the GluR1 PCR product
      indicated the expression of the flip alternative splice version in optic nerve.
      The detected GluR1 message was not due to axons because no loss of expression was
      observed after the degeneration of axons. PCR analysis also revealed the presence
      of a metabotropic glutamate receptor in optic nerve.

PMID- 8463844
TI  - Bag cell extract inhibits tail-siphon withdrawal reflex, suppresses long-term but
      not short-term sensitization, and attenuates sensory-to-motor neuron synapses in
      Aplysia.
AB  - The peptides released from the bag cells (bag cell peptides, BCPs) in Aplysia
      californica are responsible for eliciting or modulating a repertoire of behaviors
      preceding and accompanying egg laying. Our interest was in determining to what
      extent behaviors that can occur simultaneously with egg laying are modulated. To
      address this issue, we examined the effects of an extract (bag cell extract, BCE)
      that contained BCPs, as well as egg-laying hormone (ELH), an identified BCP, on
      both the tail-siphon withdrawal reflex and the ability of that reflex to exhibit
      sensitization, a simple form of nonassociative learning. In addition, we examined
      the ability of BCE, as well as the individual BCPs, to modulate a component of
      the circuitry of the reflex. Behavioral experiments indicated that BCE inhibited
      the baseline withdrawal reflex and suppressed long-term sensitization of the
      reflex while leaving short-term sensitization unaffected. These effects were not
      observed in animals receiving an extract of a control ganglion or in animals
      receiving ELH, and therefore may be attributed to the actions of one or more
      BCPs, but presumably not to ELH alone. Electrophysiological experiments revealed
      that BCE also attenuated the monosynaptic EPSP elicited in tail motor neurons by
      tail sensory neurons. In subsequent experiments in which the BCPs were
      individually applied, only one BCP, beta-BCP, significantly attenuated the EPSPs.
      This effect was independent of narrowing of the presynaptic action potential.
      Taken together, these results suggest a novel behavioral modification attributed
      to BCPs, inhibition of the tail-siphon withdrawal reflex, and suggest a possible
      locus of action and peptide candidate for this effect. In addition, these
      experiments raise the possibility that BCPs may exert a long-lasting effect (> 24
      hr), selectively blocking a simple form of long-term memory.

PMID- 8463843
TI  - Neurodegeneration induced by beta-amyloid peptides in vitro: the role of peptide
      assembly state.
AB  - The progressive neurodegeneration of Alzheimer's disease has been hypothesized to
      be mediated, at least in part, by beta-amyloid protein. A relationship between
      the aggregation state of beta-amyloid protein and its ability to promote
      degeneration in vitro has been previously suggested. To evaluate this hypothesis
      and to define a structure-activity relationship for beta-amyloid, aggregation
      properties of an overlapping series of synthetic beta-amyloid peptides (beta APs)
      were investigated and compared with beta AP neurotoxic properties in vitro. Using
      light microscopy, electrophoresis, and ultracentrifugation assays, we found that
      few beta APs assembled into aggregates immediately after solubilization, but that
      over time peptides containing the highly hydrophobic beta 29-35 region formed
      stable aggregations. In short-term neuronal cultures, toxicity was associated
      specifically with those beta APs that also exhibited significant aggregation.
      Further, upon the partial reversal of beta 1-42 aggregation, a concomitant loss
      of toxicity was observed. A synthetic peptide derived from a different
      amyloidogenic protein, islet amyloid polypeptide, exhibited aggregation but not
      toxicity, suggesting that beta AP-induced neurotoxicity in vitro is not a
      nonspecific reaction to aggregated protein. The correlation between beta AP
      aggregation and neurotoxicity was also observed in long-term neuronal cultures
      but not in astrocyte cultures. These data are consistent with the hypothesis that
      beta-amyloid protein contributes to neurodegeneration in Alzheimer's disease.

PMID- 8463845
TI  - Casein kinase II phosphorylates the synaptic vesicle protein p65.
AB  - p65 (synaptotagmin), an abundant synaptic vesicle protein, has been implicated in
      the processes of vesicle docking and fusion. To characterize further the
      properties of this important neuronal protein, we have investigated its
      phosphorylation in vitro. Immunoprecipitation of p65 results in coprecipitation
      of a protein kinase that phosphorylates p65 as well as syntaxin, a plasma
      membrane protein that interacts with p65. p65 is phosphorylated on a threonine
      residue (Thr-128) within the cytoplasmic domain near the transmembrane region.
      The coprecipitating protein kinase was identified as casein kinase II based on
      its catalytic properties, the sequence surrounding Thr-128, and Western blot
      analysis of the anti-p65 immunoprecipitates. Affinity chromatography utilizing
      bacterially expressed fragments of p65 demonstrated that casein kinase II
      interacts with a domain of p65 distinct from the phosphorylation site. In a
      synaptic vesicle fraction, the phosphorylation of p65 is stimulated by
      sphingosine and by detergent solubilization, suggesting that p65 phosphorylation
      may be subject to regulatory processes.

PMID- 8463846
TI  - Cerebellar cortex lesions disrupt learning-dependent timing of conditioned eyelid
      responses.
AB  - Among the many issues surrounding the involvement of the cerebellum in motor
      learning, the relative roles of the cerebellar cortex and cerebellar nuclei in
      Pavlovian conditioning have been particularly difficult to assess. While previous
      studies have investigated the effects of cerebellar cortex lesions on the
      acquisition and retention of conditioned movements, we have examined the effects
      of these lesions on the timing of Pavlovian eyelid responses. The rationale for
      this approach arises from previous studies indicating that this timing is a
      component of Pavlovian eyelid responses that is learned and that involves
      temporal discrimination. To permit within-animal comparisons, rabbits were
      trained to produce differently timed responses to high- and low-frequency
      auditory conditioned stimuli (CSs). Before the lesion the conditioned responses
      to both CSs were appropriately timed--each peaked near the time at which the
      unconditioned stimulus was presented for that CS. However, after the lesion both
      CSs could elicit similarly timed conditioned responses that peaked
      inappropriately at very short latencies. The changes in responses timing were
      sensitive to the size of the lesion, particularly its rostral-caudal extent.
      Similar results were obtained in animals trained with one CS, indicating that the
      disruption of response timing is not related to impaired auditory discrimination.
      Because response timing is learned and therefore requires synaptic plasticity,
      these data suggest that there are at least two sites of plasticity involved in
      the motor expression of Pavlovian eyelid responses. Plasticity at one site is
      necessary for the learned timing of conditioned responses, while plasticity at
      another site is revealed by the inappropriately timed responses observed
      following removal of the cerebellar cortex. This lesion-induced dissociation of
      the expression of motor responses and their learned timing supports a synthesis
      of competing views by suggesting that motor learning involves both the cerebellar
      cortex and cerebellar nuclei. We hypothesize that motor learning involves a
      decrease in strength of the granule cell-Purkinje cell synapses (e.g., Ito and
      Kano, 1982) in the cerebellar cortex and an increase in strength of the mossy
      fiber-cerebellar nuclei synapses (e.g., Racine et al., 1986). Finally, these data
      suggest that the cerebellar cortex may mediate the temporal discriminations that
      are necessary for the learned timing of conditioned responses.

PMID- 8463847
TI  - Microstimulation in visual area MT: effects of varying pulse amplitude and
      frequency.
AB  - We have previously shown that perceptual judgements of motion direction are based
      in part on the activity of direction selective neurons in extrastriate visual
      area MT (Salzman et al., 1990, 1992). In those experiments, we applied low
      amplitude microstimulation pulses (10 microA, 200 Hz) to clusters of MT neurons
      whose preferred directions were similar. The effect of microstimulation was to
      bias the monkeys' choices on a direction discrimination task toward the preferred
      direction of neurons at the stimulation site. The results suggest that
      microstimulation generated a directionally specific cortical signal by activating
      selectively neurons near the electrode tip. To test this notion more directly, we
      have now examined the behavioral effects of varying current amplitude, current
      frequency, and electrode position. In the majority of experiments, the
      directional bias in the monkeys' choices was reduced or eliminated as current
      amplitude increased to 80 microA. In addition, 80 microA stimulating pulses
      frequently impaired overall performance as measured by the percentage of correct
      responses. This decrement in performance indicated that 80 microA pulses
      introduced "noise" into the neural circuitry encoding motion direction,
      presumably by increasing current spread to activate a larger population of
      neurons representing all directions of motion. In contrast, increasing current
      frequency to 500 Hz (10 microA pulses) preserved the directional specificity of
      microstimulation effects. The precise position of the stimulating electrode also
      influenced the magnitude of microstimulation effects; in some cases, differences
      in position on the order of 100 microns determined whether an experiment yielded
      a very large effect or no effect at all. Thus, directionally specific activation
      of cortical circuitry within MT can be disrupted by increases in current spread
      or by small changes in electrode position. These observations suggest that the
      effects of low-amplitude microstimulation depend upon direct activation of a well
      localized population of neurons.

PMID- 8463848
TI  - Neurons, astrocytes, and oligodendrocytes of the rat cerebral cortex originate
      from separate progenitor cells: an ultrastructural analysis of clonally related
      cells.
AB  - The diverse array of neurons and glia in the mammalian cerebral cortex arises
      from proliferating cells of the ventricular zone that surrounds the lateral
      ventricles of the developing brain. A fundamental but unresolved question is
      whether the individual cells of the ventricular zone are committed to producing
      progeny of only one particular phenotype or whether they generate progeny of more
      than one phenotype. We have begun to address this question by asking if
      individual cells of the ventricular zone generate exclusively neurons or glia at
      the onset of cortical neurogenesis in the rat. To assess the phenotypes of cells
      derived from a common progenitor cell, retroviral-mediated gene transfer was used
      to introduce the reporter gene, Escherichia coli beta-galactosidase, into
      ventricular zone cells at embryonic day 15 or 16. We used histochemistry to
      reveal beta-galactosidase-expressing cells in the mature rat cerebral cortex.
      Isolated clusters of beta-galactosidase-expressing cells, presumably clones, were
      identified in serial sections. Since the histochemical reaction product is
      electron dense, each cell could be examined at the ultrastructural level and
      assigned definitively to one of the major classes of cells in the cerebral cortex
      on the basis of well-established morphological criteria. This approach overcomes
      the problems of cell type identification encountered with light microscopy, where
      it is not always possible to distinguish between different cell phenotypes. We
      found that virtually all clones contained cells of exclusively one type: either
      all astrocytes, all oligodendrocytes, or all neurons. Furthermore, each
      particular cell type exhibited a different pattern and intensity of staining. The
      neuronal clones, with one exception, were composed of either all pyramidal cells
      (projection neurons), or all nonpyramidal cells (interneurons). The size and
      composition of neuronal clones did not seem related to their position in the
      cerebral cortex. Collectively, our observations indicate that separate progenitor
      cells exist for pyramidal neurons, nonpyramidal neurons, astrocytes, and
      oligodendrocytes. The striking phenotypic homogeneity in the clones arising from
      individual progenitor cells suggests that by the onset of cortical neurogenesis,
      at least some lineage restrictions have already occurred among the precursor cell
      population. Thus, our results suggest that lineage may play a pivotal role in
      determining some of the functionally important phenotypic attributes of cells in
      the cerebral cortex.

PMID- 8463849
TI  - Extended temporal gradient for the retrograde and anterograde amnesia produced by
      ibotenate entorhinal cortex lesions in mice.
AB  - Effects of ibotenic entorhinal cortex (EC) lesions on both retrograde and
      anterograde amnesia in mice were assessed using two-choice discrimination tasks
      learned at different intervals before surgery in two eight-arm radial mazes. The
      results indicated that EC-lesioned mice were severely impaired in postoperative
      retention of discrimination problems learned 3 d or 2 weeks prior to surgery, but
      showed no deficit on problems learned between 4, and up to 6 weeks before
      surgery, as compared to sham-operated controls. When trained on a novel two
      choice discrimination problem (not acquired preoperatively), experimental
      subjects demonstrated quite normal rates of acquisition, but were impaired in
      learning its reversal. Furthermore, they exhibited a faster rate of forgetting
      (anterograde amnesia) relative to controls over a 2-week retention interval.
      These results indicate that approximately 4 weeks is required before memory for a
      two-choice spatial discrimination problem no longer depends on the integrity of
      the entorhinal cortex, and suggests that, beyond this time, an EC-independent
      memory storage system is capable of supporting the retrieval of information. The
      data, together with complementary behavioral results, are discussed in the
      context of current theories of memory storage.

PMID- 8463850
TI  - The behavioral repertoire of the gastric mill in the crab, Cancer pagurus: an in
      situ endoscopic and electrophysiological examination.
AB  - Simultaneous endoscopic and electrophysiological recordings were used to observe
      the behavior of the gastric mill complex while recording the motor output of the
      stomatogastric ganglion (STG) in intact crabs. In the crab STG, many pattern
      generating neurons are able to fire in several distinct rhythmic motor patterns.
      Specifically, many neurons can switch between firing in time with the rapid
      pyloric rhythm to firing in time with the slower gastric mill rhythm (Weimann et
      al., 1991). We now correlate behaviorally relevant movements of the gastric mill
      with some of the modifications of neuronal firing patterns previously
      characterized using in vitro STG preparations. The intracellular and
      extracellular recordings from the intact crab are largely indistinguishable from
      those obtained from in vitro preparations. For the first time, we describe the
      movements that result as neurons switch their activity patterns associated with
      activation of the gastric mill rhythm. Extracellular stimulation and
      intracellular depolarization of individual motor neurons is used to determine the
      relationship between frequency of firing and movement in behaving animals.

PMID- 8463851
TI  - Oral arginine supplementation does not affect lymphocyte proliferation during
      endotoxin-induced inflammation in rats.
AB  - Earlier studies from this laboratory were unable to confirm reported
      immunostimulatory effects of supplemental dietary arginine on healthy, unstressed
      young or aged rats. The present study was undertaken to determine effects of oral
      arginine supplementation on in vitro measures of immune function using a stressed
      rat model. The stressor used was intraperitoneal injection of bacterial
      lipopolysaccharide (1 mg/kg body wt). Four-month-old male Sprague-Dawley rats
      were placed in either a control or an arginine-supplemented (7.5 g/L arginine-HCl
      in drinking water) group for 7 d, after which control and supplemented rats
      received injections of endotoxin or phosphate-buffered saline. Rats were killed 3
      d following injections. Endotoxin treatment resulted in lower food intake, less
      thymic cellularity and greater splenic weight. Endotoxin injections also enhanced
      proliferative response of rat splenocytes to pokeweed mitogen (1 mg/L) and
      lipopolysaccharide (25 and 100 mg/L) and enhanced response of thymocytes to
      concanavalin A (10 mg/L), phytohemagglutinin (25 and 100 mg/L) and pokeweed
      mitogen (1 mg/L). Supplemental arginine did not reduce thymic weight loss or
      influence mononuclear cell proliferation or interleukin-2 production in the
      presence or absence of endotoxin stress. These data indicate no benefit of
      arginine supplementation during endotoxin stress in rats.

PMID- 8463852
TI  - A diet history questionnaire ranks nutrient intakes in middle-aged and older men
      and women similarly to multiple food records.
AB  - We evaluated the reproducibility of a modified version of the National Cancer
      Institute diet history questionnaire and also studied comparability of nutrient
      estimates from this questionnaire to those from four 2-d food records. Subjects
      (n = 211) were from a population-based sample of middle-aged and older adults
      participating in the Beaver Dam Eye Study in south-central Wisconsin. Median age
      specific correlation coefficients between the questionnaire, administered twice
      at a 3-mo interval, were 0.8 in men and 0.7 in women (range = 0.5 to 0.9).
      Questionnaire estimates of protein, cholesterol, thiamin, niacin, iron and zinc
      were consistently lower than food record estimates whereas estimates of fat were
      higher. Correlation coefficients between estimates from the questionnaire and
      records were generally > 0.5, indicating overall good agreement in ranking.
      However, the range in correlation coefficients was wide [ranging from 0.06 for
      iron (without supplements) in middle-aged women to 0.8 for alcohol in middle-aged
      men and women]. Questionnaire estimates similarly classified persons into the
      lowest two food record quintiles of intake 50 to 93% of the time depending on
      nutrient. These results suggest that the questionnaire produces nutrient
      estimates that rank individuals on the basis of intake of most nutrients
      similarly to estimates from multiple food records.

PMID- 8463853
TI  - Regulation of intestinal nutrient transport is impaired in aged mice.
AB  - To determine the effect of age on the regulation of intestinal nutrient
      absorption, we fed young (7.6-mo-old) and aged (24.8-mo-old) C57BL mice diets
      designed to stimulate in vitro sugar or amino acid uptake in the isolated small
      intestine. In each age group, diet had no effect on feeding rates and body
      weights. D-Glucose and D-fructose uptakes by the small intestine each increased
      by about two times in young and 1.5 times in aged mice fed high carbohydrate
      diets as compared with those fed no carbohydrate. Adaptive increases in uptake by
      the aged group were not only reduced but also restricted to more proximal regions
      of the small intestine. In both age groups, diet-stimulated increases in D
      glucose transport were accompanied by parallel increases in number of Na(+)-D
      glucose cotransporters as estimated by specific phlorizin binding. Diet had no
      effect on transporter Kd for phlorizin, turnover rate of each transporter,
      mucosal mass or mucosal permeability. A high protein diet stimulated the uptake
      of L-aspartate and L-proline in young mice and of only L-aspartate in aged mice.
      Uptake of essential amino acids and of nonessential amino acids sharing
      transporters with essential ones were not regulated. Although aged mice possess
      adaptive mechanisms to diet that are similar to those in young mice, the
      effectiveness of these mechanisms may be impaired with age and may result in
      malabsorption symptoms so prevalent in the elderly.

PMID- 8463855
TI  - Bioavailable level and source of cysteine determine protein quality of a
      commercial enteral product: adequacy of tryptophan but deficiency of cysteine for
      rats fed an enteral product prepared fresh or stored beyond shelf life.
AB  - Young rats were used in bioassays designed to assess the protein quality and
      tryptophan as well as cystine adequacy of the enteral product TwoCal-HN that was
      either freshly prepared or had been stored (nonrefrigerated) in a warehouse for
      10 mo (i.e., beyond shelf life). Based upon supplementation studies, cystine was
      observed to be the first-limiting amino acid in both fresh and expired TwoCal-HN,
      and tryptophan was not second limiting. Protein efficiency ratio (PER) of
      expired, but not fresh, TwoCal-HN was lower than that of the casein control diet,
      but with cystine supplementation, PER of the TwoCal-HN products was equal to or
      greater than the PER of the casein control. With a diet containing 10 g
      protein/100 g that also contained energy-furnishing ingredients simulating TwoCal
      HN, maximal growth enhancement occurred with a supplement of 1 g cystine/kg diet.
      Both glutathione and N-acetyl-L-cysteine were observed to be equivalent to an
      isomolar level of L-cystine in stimulating growth. Using a chemically defined
      amino acid diet that was singly deficient in tryptophan, bioavailability of
      tryptophan was determined for casein, fresh TwoCal-HN, expired TwoCal-HN and D
      tryptophan. Slope-ratio bioefficacy values relative to L-tryptophan (weight gain
      regressed on supplemental tryptophan intake) indicated that none of the
      experimental sources of tryptophan had bioavailabilities different from 100%. The
      results indicated that tryptophan did not deteriorate, as measured analytically
      or biologically, as a result of storing TwoCal-HN beyond shelf life.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463854
TI  - Dietary lipid profile is a determinant of tissue phospholipid fatty acid
      composition and rate of weight gain in rats.
AB  - Modifications in membrane fatty acid composition and insulin action are possible
      through dietary intervention. We examined the metabolic fate of (n-3) fatty acids
      in male Wistar rats, using three isocaloric, high fat diets. The ET-L, OL-L and
      SAF-L diets contained edible tallow, olive oil and safflower oil, respectively,
      with identical amounts of (n-3) fatty acids as linseed oil. Despite isocaloric
      feeding, weight gain was lower (P < 0.001) in rats fed the more highly saturated
      ET-L diet (69 +/- 8 g) than in those fed either the high (n-9) fatty acid OL-L
      diet (93 +/- 2 g) or the high (n-6) fatty acid SAF-L diet (108 +/- 4 g). Analysis
      of red quadricep fatty acid composition revealed phospholipid (n-3) fatty acid
      levels in the ET-L-fed group (21.6 +/- 0.8 g/100 g fatty acids) to be
      significantly higher than in either the OL-L-fed (17.7 +/- 0.6 g/100 g fatty
      acids, P < 0.05) or SAF-L-fed (15.3 +/- 0.7 g/100 g fatty acids, P < 0.05) group.
      A similar pattern was observed in other muscles and white adipose tissue. A
      follow-up study using 14C-labeled (n-3) fatty acids in the diet showed greater (n
      3) fatty acid incorporation in the ET-L-fed group relative to the other two
      groups and conversely lower 14CO2 production than in the SAF-L-fed group. These
      results demonstrate that metabolic fate of dietary fatty acids is strongly
      influenced by the overall fatty acid profile of the diet.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8463856
TI  - Genetically determined body weight loss in mice fed diets containing salmon oil.
AB  - Several reports describe adverse effects of dietary fish oil. We examined the
      influence of dietary salmon oil (138 g/kg diet) fed without or with 5 g
      supplemental cholesterol/kg diet on body weight and plasma lipid concentrations
      of inbred mice. Salmon oil contained 0.17 g naturally occurring cholesterol/kg
      diet. Mice used were BALB/c, C57BL/6 and seven recombinant inbred strains derived
      from BALB/c and C57BL/6 (CXB). Parental strains BALB/c and C57BL/6 maintained or
      gained body weight when fed both salmon oil diets. Mice of recombinant inbred
      strains showed weight gain except for CXB-E and -H mice. Although CXB-E mice lost
      approximately 12% of initial body weight after 10 d of consuming either salmon
      oil diet, no further reductions in body weight were seen. CXB-H mice maintained
      or gained weight when fed the salmon oil-high cholesterol diet but showed a
      steady decline in body weight (up to 30% of initial weight) while consuming the
      salmon oil-low cholesterol diet. The biochemical basis for weight loss in CXB-H
      mice was studied and results suggest effects of diet on satiety and/or lipid
      utilization. Because nonparental body weight phenotypes were observed among
      recombinant inbred strains, body weight response to salmon oil feeding is
      controlled by multiple genes.

PMID- 8463857
TI  - High dietary calcium level decreases colonic phytate degradation in pigs fed a
      rapeseed diet.
AB  - The degradation of phytate (inositol hexaphosphate) in rapeseed meal diet not
      containing phytase activity was studied in 15 growing ileum-fistulated pigs.
      Stomach and small intestinal degradation and total gastrointestinal degradation
      were compared. The effect of addition of calcium carbonate to the rapeseed meal
      diet at two levels (9.2 and 18.5 g/kg diet) was investigated. A commercial barley
      wheat-soybean diet with intrinsic phytase activity was used as reference. Phytate
      and its hydrolysis products in diets, ileal digesta and feces were determined by
      HPLC ion-pair chromatography. Hydrolysis of phytate in the stomach and small
      intestine was 35-45% in pigs fed the rapeseed meal diet independent of calcium
      addition, and 65% in pigs fed the reference diet. Total gastrointestinal
      degradation of phytate in pigs fed the rapeseed diet was 97, 77 and 42% (P <
      0.001) when calcium intakes were 4.5, 9.9 and 15 g/d, respectively; total
      gastrointestinal degradation was 72% in pigs fed the reference diet. The
      intestinal phytate degradation pattern, when rapeseed diet was fed, indicated the
      activity of an unspecific phosphatase, whereas that of the reference diet
      indicated intrinsic dietary phytase activity. We conclude that dietary
      supplementation of calcium carbonate decreases the phytate degradation in the
      colon of pigs, but not in the stomach and small intestine.

PMID- 8463858
TI  - Cytotoxicity of fecal water is dependent on the type of dietary fat and is
      reduced by supplemental calcium phosphate in rats.
AB  - The effects of the type of dietary fat (180 g/kg diet) and of calcium phosphate
      (CaHPO4) supplementation (25 vs. 225 mmol/kg diet) on luminal solubility of fatty
      acids and bile acids, cytotoxicity of fecal water and intestinal epitheliolysis
      were studied in rats. In rats fed the low and high calcium phosphate diets, fecal
      excretion of fatty acids diminished in the order palm oil > milk fat > corn oil.
      Palm oil also caused the highest concentration of fatty acids measured in fecal
      water followed by milk fat and corn oil when fed at both calcium phosphate
      levels. The differences in concentrations of luminal surfactants in fecal water
      of rats fed the three fat diets resulted in a fat type-dependent cytotoxicity of
      fecal water, with that of palm oil-fed rats the most cytotoxic. The
      concentrations of fatty acids as well as bile acids in fecal water were, however,
      significantly lowered by calcium phosphate supplementation in rats fed all types
      of dietary fat. This reduction in concentration of fecal water surfactants
      resulted in a lower cytotoxicity of fecal water. The concentration of surfactants
      in fecal water and cytotoxicity were correlated by multiple regression analysis
      (R = 0.89). Intestinal epitheliolysis measured as alkaline phosphatase activity
      in fecal water was lowered comparably to the reduction in cytotoxicity by
      supplemental calcium phosphate. Intestinal epitheliolysis and cytotoxicity of
      fecal water were correlated (r = 0.92, P < 0.001). The type of dietary fat and
      the amount of dietary calcium phosphate influence the concentrations of
      surfactants in fecal water and consequently affect cytotoxicity of fecal water
      and intestinal epitheliolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463860
TI  - Comment on the paper by Perry et al. (1992): hemoglobin differences between
      blacks and whites.

PMID- 8463859
TI  - Colostrum protein digestion in newborn lambs.
AB  - The efficiency of colostral protein digestion was studied in nine newborn lambs
      fed one meal of bovine colostrum 3 h after birth. The results were compared with
      those obtained in two unfed lambs and four lambs fed bovine milk. The protein and
      peptide composition [immunoglobulins G1 and (IgG1), beta-lactoglobulin, alpha
      lactalbumin, caseins and peptides resulting from casein hydrolysis] of digesta,
      gastrointestinal tissues, blood and urine were determined in samples taken 0.75
      or 4 h after feeding. The amounts of ingested proteins in lambs fed colostrum
      were much higher than in those fed the milk diet, and their abomasal emptying was
      faster. alpha-Lactalbumin was highly degraded by abomasal and intestinal
      proteases, whereas beta-lactoglobulin and in particular the immunoglobulins were
      less sensitive. The gastric emptying of caseins was delayed in and the kinetics
      of appearance of peptides originating from casein hydrolysis was comparable to
      that observed in lambs fed milk and in 1-mo-old preruminant calves. Thirty-five
      percent of dietary amino acids ingested as colostrum were available within 4 h
      for amino acid metabolism; this percentage was 54% in the milk-fed lambs. In the
      lambs fed colostrum, these amino acids were provided by beta-lactoglobulin,
      casein and IgG1 (0.52, 0.43 and 0.30 g/kg body wt, respectively), whereas in milk
      fed animals casein and beta-lactoglobulin were the most important sources of
      these amino acids (0.40 and 0.20 g/kg, respectively).

PMID- 8463861
TI  - E. Neige Todhunter (1901-1991).

PMID- 8463862
TI  - Neural mechanisms in the responses to amino acid deficiency.
AB  - Food intake is rapidly and reliably reduced when animals are offered diets that
      result in an essential amino acid deficiency, such as those used in the
      imbalanced amino acid diet (IMB) paradigm. There seem to be at least three phases
      in the responses of rats to IMB: 1) In order to respond to a dietary challenge,
      the animals must first recognize that challenge. The available data suggest that
      before the behavioral effects occur, a decline in the concentration of an
      essential amino acid is sensed in a specific brain area, the prepyriform cortex.
      This recognition phase is associated with localized decreases in the
      concentrations of the limiting amino acid, norepinephrine and cyclic AMP and with
      altered protein synthesis. 2) Subsequent to recognition of the deficiency, a
      conditioned taste aversion develops, mediated in part by serotonin at the level
      of the vagus. 3) Finally, in the absence of a choice, the animals adapt to an IMB
      (but not a diet devoid of one or more essential amino acids) in approximately 1
      wk. Damage to certain extrahypothalamic brain areas or liver denervation
      accelerates adaptation to IMB, suggesting both central and peripheral control in
      the adaptation phase. The resulting behavioral responses provide adaptive
      advantage to an animal in the selection of a diet with an appropriate balance of
      amino acids.

PMID- 8463863
TI  - Chromium in human nutrition: a review.
AB  - This review summarizes the results of 15 controlled studies supplementing defined
      Cr(III) compounds to subjects with impaired glucose tolerance. Three of these (3
      4 mumol Cr/d for > 2 mo) produced no beneficial effects: serum glucose, insulin
      and lipid concentrations remained unchanged. The remaining 12 interventions
      improved the efficiency of insulin or the blood lipid profile of subjects
      (ranging from malnourished children and healthy middle-aged individuals to
      insulin-requiring diabetics). In addition, three cases of impaired glucose
      tolerance after long-term total parenteral alimentation responding to Cr
      supplementation have been reported. Chromium potentiates the action of insulin in
      vitro and in vivo; maximal in vitro activity requires a special chemical form,
      termed Glucose Tolerance Factor and tentatively identified as a Cr-nicotinic acid
      complex. Its complete structural identification is a major challenge to chromium
      research. The development and validation of a procedure to diagnose chromium
      status is the second challenge. Such a test would allow the assessment of
      incidence and severity of deficiency in the population and the selection of
      deficiency in the population and the selection of chromium-responsive
      individuals. The third challenge is the definition of chromium's mode of action
      on parameters of lipid metabolism that have been reported from some studies but
      not others. Future research along these lines might establish whether chromium
      deficiency is a factor in the much discussed "Syndrome X" of insulin resistance.

PMID- 8463864
TI  - Vitamin A is involved in maintenance of epithelial cells on the bronchioles and
      cells in the alveoli of rats.
AB  - We examined the effects of mild vitamin A deficiency and ozone (O3) exposure on
      the labeling index, a marker of cell proliferation, of epithelial cells on the
      bronchiole and cells in the alveoli of rat lungs, to assess the role of vitamin A
      in maintenance of epithelial cells on the distal airway and alveolus. Three-week
      old rats were fed a vitamin A-depleted diet for 4 wk to induce mild vitamin A
      deficiency. After 2 wk rats were exposed to 16.4 mumol O3/m3 for 1 to 14 d. In
      vitamin A-sufficient rats, labeling indices of epithelial cells on the bronchiole
      and cells in the alveolus increased significantly in comparison with those of
      controls exposed to clean air on d 2 and 3 of O3 exposure. In vitamin A-deficient
      rats as well, labeling indices were increased by O3 exposure, but the magnitude
      of increase was significantly smaller than for vitamin A-sufficient rats. These
      results indicate that vitamin A deficiency resulted in decrease of proliferation
      of epithelial cells on the distal airway and cells in the alveolus of rats when
      the proliferation of these cells was stimulated by O3 exposure, suggesting an
      involvement of vitamin A in maintenance of lung epithelial cells.

PMID- 8463865
TI  - Metallothionein expression in rat bone marrow is dependent on dietary zinc but
      not dependent on interleukin-1 or interleukin-6.
AB  - The comparative influence of dietary zinc status and recombinant human
      interleukin-1 alpha (rhIL-1 alpha) and recombinant human interleukin-6 (rhIL-6)
      on metallothionein (MT) gene expression was examined in rat bone marrow and
      liver. Growing male rats were fed a diet with 5 (restricted), 30 (control), or
      180 (supplemented) mg Zn/kg for 14 d. On d 15, rats were injected with 5
      micrograms of rhIL-1 alpha or rhIL-6. Marrow metallothionein responded directly
      to dietary zinc but did not respond to these cytokines. Significantly less zinc
      accumulated in marrow from the zinc-restricted rats compared with control or
      supplemented rats. Analysis of metallothionein isoform mRNA expression showed MT
      1 is the primary gene expressed in marrow. A significant interaction between
      dietary zinc and cytokine treatment was observed in the liver. Hepatic
      metallothionein induction following both rhIL-1 alpha and rhIL-6 injection was
      directly related to dietary zinc intake. Expression of hepatic metallothionein
      isoform mRNAs suggested MT-1 responded to zinc and MT-2 responded to cytokines.
      These results indicate that metallothionein gene expression in both the marrow
      and the liver responds to dietary zinc status. In contrast, liver metallothionein
      expression can be altered by these cytokines, which are known to act on many cell
      types. Furthermore, these results suggest that bone marrow metallothionein could
      be of importance in the development of marrow cells.

PMID- 8463866
TI  - Weight gain of Kenyan school children infected with hookworm, Trichuris trichiura
      and Ascaris lumbricoides is improved following once- or twice-yearly treatment
      with albendazole.
AB  - We studied growth in infected children given one dose (600 mg) or two doses of
      albendazole per school year. Children were examined and allocated at random
      within sex by descending hookworm egg count to one of three groups: placebo (n =
      93), one dose (1x, n = 96) or two doses (2x, n = 95). Each child was treated and
      then re-examined and treated 3.6 and 8.2 mo later (Exams 2 and 3). The 1x and 2x
      groups gained significantly more by Exam 3 than the placebo group in weight (1.1
      and 0.9 kg more, respectively), percent weight-for-age (3.3 and 2.7 percentage
      points more), percent weight-for-height (3.1 and 2.9 percentage points more),
      percent arm circumference-for-age (2.3 and 2.0 percentage points more) and
      triceps and subscapular skinfolds but did not differ significantly from each
      other. The placebo group showed significant decreases between exams (P < 0.0002)
      in percent weight-for-age and percent arm circumference-for-age and no change in
      percent weight-for-height, whereas the 1x and 2x groups exhibited significant
      increases (P < 0.005). At Exam 3, arithmetic mean egg reduction rates for the 1x
      and 2x groups were 84 and 95% for hookworm, 42 and 32% for Trichuris and 55 and
      87% for Ascaris, respectively. We conclude that one or two doses of albendazole
      per year resulted in similar growth improvements, despite reinfection, in school
      age children in an area where these helminths and poor growth are prevalent.

PMID- 8463867
TI  - High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects
      on the vitamin A status of mother and infant.
AB  - For regions where vitamin A deficiency is common, high dose vitamin A
      supplementation of lactating mothers is currently recommended, but the effects of
      this intervention have not been carefully evaluated. We conducted a randomized,
      double-blind trial in which 153 Indonesian mothers 1-3 wk postpartum received
      either a capsule containing 312 mumol of vitamin A as retinyl palmitate or a
      placebo. Mothers' serum retinol concentrations in the vitamin A group tended to
      be lower than in the placebo group at baseline but higher at 3 mo postpartum
      (1.39 vs. 1.24 mumol/L, P = 0.03) and 6 mo postpartum (1.23 vs. 1.08 mumol/L, P <
      0.01). The milk retinol concentrations of the vitamin A group were higher than
      those of the placebo group by 0.48 to 1.18 mumol/L at 1-8 mo postpartum (P <
      0.05). Among the infants at 6 mo of age, the prevalences of low serum retinol
      concentration (< 0.52 mumol/L) were 36 and 15% in the placebo and vitamin A
      groups, respectively (P < 0.005), and the prevalences of low vitamin A stores
      (assessed by relative dose response) were 23 and 10%, respectively (P < 0.03).
      High dose vitamin A supplementation of lactating mothers is an efficacious way to
      improve the vitamin A status of both mother and breast-fed infant.

PMID- 8463868
TI  - Fate of beta-cyclodextrin in the human intestine.
AB  - We assessed the fate of beta-cyclodextrin, which is composed of seven alpha(1-
      >4)-linked glucose units in ring structure, in the human gastrointestinal tract.
      In four healthy ileostomists, ileal effluent was collected after oral
      administration of beta-cyclodextrin during fasting (10 g of beta-cyclodextrin)
      and postprandially (10 g of beta-cyclodextrin three times daily with meals). In
      10 healthy volunteers, the amount of beta-cyclodextrin passing into the colon was
      determined by means of the breath hydrogen technique using lactulose as a
      standard, and stools were collected after oral administration of beta
      cyclodextrin during fasting (10 g of beta-cyclodextrin) and postprandially (10 g
      of beta-cyclodextrin three times daily with meals). In ileostomists, we recovered
      from the small intestine 91 +/- 5% and 97 +/- 10% (mean +/- SD) of beta
      cyclodextrin ingested during fasting and with meals, respectively. In healthy
      volunteers, H2 excretion in breath after beta-cyclodextrin ingestion was low
      compared with excretion after lactulose, but only traces of beta-cyclodextrin
      were recovered in stools. We conclude that beta-cyclodextrin is poorly hydrolyzed
      in the human small intestine but that it is fermented by the colonic flora with
      apparent minimal H2 production.

PMID- 8463869
TI  - Interaction between methane-producing status and diet on serum acetate
      concentration in humans.
AB  - About half the population excretes methane in the breath. To see if methane
      producing status influenced serum acetate, we studied six methane producers and
      six nonproducers on three separate days. For 36 h they ate a polysaccharide-free
      diet alone, or with 20 g of unabsorbed sugar lactulose, or 20 g of fermentable
      fiber, guar, in random order. The mean fasting serum acetate concentration on the
      three test days in producers was higher than in nonproducers, 84 +/- 5 vs. 69 +/-
      5 mumol/L (P < 0.05). Compared to the control diet, both lactulose and guar
      raised serum acetate concentration significantly in both groups of subjects.
      However, there was a significant interaction between methane producing status and
      diet. After lactulose consumption, postprandial serum acetate was similar in both
      groups of subjects, but guar consumption had a significantly greater effect in
      producers than nonproducers (98 +/- 8 vs. 73 +/- 5 mumol/L; P < 0.05). We
      conclude that methane producing status may influence serum acetate concentrations
      in humans, depending upon the type of fermentable carbohydrate in the diet.

PMID- 8463870
TI  - Synthesis of [75Se]selenoproteins is greater in selenium-deficient sheep.
AB  - Three Se-deficient and three Se-sufficient sheep with mean erythrocyte
      glutathione peroxidase activities of 30 and 249 mumol NADPH oxidized.min-1.g
      hemoglobin-1, respectively, were each labeled intraperitoneally with 555 MBq of
      sodium [75Se]selenite. All animals were killed and necropsied after 7 d. Peak
      plasma radioactivity occurred from 1 to 3 h post-labeling. Radioactivity in
      plasma associated with [75Se]selenoproteins was significantly higher in the Se
      deficient sheep than in the Se-sufficient sheep 3 and 6 d after isotope
      administration. SDS-PAGE analysis of plasma followed by autoradiography indicated
      five selenoproteins, all of which were present in both groups. The molecular
      weights were 21.0, 23.0, 48.0, 55.5 and > 100 kDa. The protein with a mass of
      55.5 kDa accounted for > 40% of the total radioactivity in both groups of sheep.
      Nine selenoproteins with molecular weights of 15.7, 18.8, 22.9, 26.8, 37.3, 42.4,
      56.1, 62.7 and 71.3 kDa were detected in extracts from a range of tissues. Liver,
      kidney, heart and pituitary retained more radioactivity than the other tissues
      examined and the total amount of protein-associated 75Se in the liver, kidney and
      pituitary of Se-deficient sheep was significantly greater than that in Se
      sufficient controls.

PMID- 8463871
TI  - Dietary cholesterol-induced down-regulation of intestinal 3-hydroxy-3
      methylglutaryl coenzyme A reductase activity is diminished in rabbits with
      hyperresponse of serum cholesterol to dietary cholesterol.
AB  - Key enzymes of cholesterol metabolism were studied in two inbred strains of
      rabbits with hyper- or hyporesponse of serum cholesterol to dietary cholesterol.
      Baseline 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase activity in liver was
      similar in hypo- and hyperresponders, but that in intestine was twofold higher in
      the hyporesponders. The addition of cholesterol (3 g/kg) to the diet caused
      similar depression of hepatic HMG-CoA reductase activity in the two strains,
      whereas intestinal HMG-CoA reductase activity was significantly reduced in
      hyporesponders but not in hyperresponders. Cholesterol feeding induced higher
      free cholesterol concentrations in hepatic and intestinal microsomes of both hypo
      and hyperresponders and higher activity of hepatic acyl-CoA:cholesterol
      acyltransferase (ACAT). Hepatic ACAT activity was significantly lower in
      cholesterol-fed hyperresponders than in hyporesponders, which may have
      contributed to the observed higher free cholesterol concentrations in hepatic
      microsomes of cholesterol-fed hyperresponders. Intestinal ACAT activity was
      similar in hypo- and hyperresponders; cholesterol feeding tended (P = 0.11) to
      elevate the activity of this enzyme. Hepatic cholesterol 7 alpha-hydroxylase
      activity was significantly higher in cholesterol-fed hyperresponders than in
      hyporesponders; it was slightly depressed after cholesterol loading in both
      rabbit strains.

PMID- 8463872
TI  - Rats fed high starch diets have lower colonic proliferation and fecal bile acids
      than high sucrose-fed controls.
AB  - We studied the effects of sucrose or starch in the diet (460 g/kg diet) on fecal
      bile acid concentrations in Sprague Dawley rats after 4 wk of feeding. Total bile
      acid concentration in the feces was significantly lower in the rats fed the
      starch diet than in those fed the sucrose diet (4.56 +/- 0.47 mg/g dry weight and
      8.03 +/- 0.94, respectively, SEM), due to a reduction of deoxycholic, alpha
      muricholic and beta-muricholic acids. Fecal and cecal pH values were
      significantly lower in the rats fed the starch diet compared to those fed the
      sucrose diet (6.79 +/- 0.08 and 7.15 +/- 0.09 for fecal pH and 7.02 +/- 0.05 and
      7.2 +/- 0.04 for cecal pH in the two diet groups, respectively). Colon
      proliferation was also significantly lower in the starch-fed rats compared to
      those fed sucrose (labeling index 3.51 +/- 0.6 and 5.69 +/- 0.74, respectively),
      and the reduction was apparent in the middle and upper compartments of the colon
      crypts. The mucosal proliferation, expressed as percentage of labeled cells in
      the upper compartment of the colon crypts, was positively correlated with the
      concentration of deoxycholic, lithocholic, alpha-muricholic, beta-muricholic,
      cholic and total bile acids in the feces (per gram wet weight). The results
      indicate a protective effect of starch versus sucrose diets on colon mucosa.

PMID- 8463873
TI  - [3H]phytic acid (inositol hexaphosphate) is absorbed and distributed to various
      tissues in rats.
AB  - To understand the mechanism of antineoplastic action of phytic acid, we
      investigated the absorption and distribution of myo-[inositol-2-3H(N)]
      hexakisphosphate in rats. The radioactivity was measured in urine, feces, blood,
      gastrointestinal tract contents and various organs and tissues at 1 and 24 h
      after intragastric administration. Of the total radioactivity, 79.0 +/- 10.0% was
      absorbed and at least 26.6% was degraded during the 24-h period following
      ingestion. The absorption was rapid; 11.0 +/- 2.6% of the radioactivity was
      detected in the wall of the stomach (4.4 +/- 3.7%) and upper small intestine (6.6
      +/- 1.9%), 6.5 +/- 2.6% in the skeletal muscle and 4.0 +/- 1.5% in the skin after
      1 h. Much of the radioactivity after 24 h was in the liver (4.0 +/- 0.9%),
      kidneys (2.2 +/- 1.1%), muscle (18.1 +/- 3.4%) and skin (10.1 +/- 3.3%). Analysis
      of plasma and urine demonstrated that most of the radioactivity was due to myo
      inositol and small amounts of inositol monophosphate (InsP1). Gastric epithelial
      cells, however, contained inositol and various inositol phosphates (InsP1-6). Our
      data suggest that soluble InsP6 when administered in drinking water is rapidly
      absorbed through the stomach and upper small intestine, becomes quickly
      dephosphorylated within the mucosal cells and is distributed to various organs as
      inositol and InsP1.

PMID- 8463874
TI  - Nutritional control of fatty acid esterification in differentiating Caco-2
      intestinal cells is mediated by cellular diacylglycerol concentrations.
AB  - The Caco-2 human intestinal cell line was used to investigate the effects of
      exogenous lipid on fatty acid esterification in differentiating intestinal
      absorptive cells. Preincubation of Caco-2 cells with either palmitate or
      palmitate plus 2-monoolein resulted in greater utilization of subsequently added
      fatty acid for triacylglycerol relative to phosphatidylcholine synthesis. Despite
      this lipid-induced alteration in metabolism, the activities of acyl-CoA
      synthetase, glycerol-3-phosphate acyltransferase and diacylglycerol
      acyltransferase were unchanged. In addition, monoacylglycerol acyltransferase
      activity was nearly undetectable, even after preincubation with 2-monoolein. The
      intracellular diacylglycerol concentrations were, however, increased with greater
      lipid substrate availability. These studies indicate that, under conditions of
      increased dietary lipid, intestinal fatty acid esterification via the glycerol-3
      phosphate pathway is modulated by cellular diacylglycerol concentrations.

PMID- 8463875
TI  - Menadione nicotinamide bisulfite is a bioactive source of vitamin K and niacin
      activity for chicks.
AB  - Young chicks were fed a vitamin K-deficient soybean concentrate basal diet
      containing graded levels of menadione from menadione nicotinamide bisulfite (MNB)
      or menadione dimethyl-pyrimidinol bisulfite (MPB) to assess prothrombin time as a
      function of menadione intake. Prothrombin time decreased linearly as menadione
      dose increased from 0 to 400 micrograms/kg. Multiple linear regression slope
      ratio calculations indicated that both sources of menadione were of equal
      potency. To assess niacin bioactivity of MNB, graded doses of nicotinamide (0 to
      5 mg/kg) from MNB or nicotinamide were added to a niacin-deficient diet based
      upon corn, corn gluten meal and vitamin-free casein. Weight gain increased
      linearly as a function of nicotinamide dose, and multiple linear regression
      analysis of weight gain as a function of supplemental nicotinamide intake
      revealed no significant differences in slope between the two sources of
      nicotinamide. Using excess doses, MNB was compared with MPB in acute (single crop
      intubation) or chronic (fed in the diet for 14 d) toxicity trials. With a single
      menadione dose of 1600 mg/kg body wt, weight gain in the subsequent 14-d period
      was reduced by MNB but not by MPB. Mortality rates of 25 and 17% occurred for MPB
      and MNB, respectively, at this dose level. Doses lower than 1600 mg/kg body wt
      caused neither morbidity nor mortality. When provided in the diet for a 14-d
      feeding period, menadione doses of 3000 mg/kg diet from MNB reduced gain, feed
      intake, gain:feed ratio and blood hemoglobin concentration. Menadione doses of
      6000 mg/kg diet were required to produce morbidity of this type when MPB was
      fed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463876
TI  - Requirement of hybrid striped bass for dietary (n-3) highly unsaturated fatty
      acids.
AB  - A feeding trial was conducted to quantify the requirement of hybrid striped bass
      (Morone chrysops female x M. saxatilis male) for dietary (n-3) highly unsaturated
      fatty acids (HUFA), specifically eicosapentaenoic [20:5(n-3)] and docosahexaenoic
      [22:6(n-3)] acids. Graded levels of (n-3) HUFA as ethyl esters were substituted
      for part or all of the 5 g olive oil/100 g diet in the semipurified basal diet.
      Total amount of 20:5(n-3) plus 22:6(n-3) in the experimental diets was 0.5, 1.1,
      1.5, 2.0 or 3.2 g/100 g dry wt. Control fish received a diet containing menhaden
      fish oil at 5 g/100 g. Each diet was fed to triplicate groups of hybrids (with an
      initial average weight of 13.0 g/fish) in aquaria for 10 wk. Significantly (P <
      0.05) higher relative weight gain as well as more efficient food and protein
      utilization were observed for fish fed the diets with 0.5, 1.1, 1.5 or 2.0% (n-3)
      HUFA or 5% menhaden fish oil as compared with those fed the basal diet. These
      responses generally reached a plateau between 1.1 and 1.5% (n-3) HUFA, but the
      lowest values were observed for fish fed the diet with 3.2% (n-3) HUFA. Fatty
      acid composition of body lipids (total lipid of intraperitoneal fat and polar
      lipids of muscle and liver) was affected by diet and indicated some elongation
      and desaturation of octadecatetraenoic acid [18:4(n-3)] and 20:5 (n-3) to 22:6(n
      3). These data indicated that 20:5(n-3) and 22:6(n-3) are essential for hybrid
      striped bass, and the minimum requirement is approximately 1% of diet or 20% of
      dietary lipid.

PMID- 8463877
TI  - Long-term phosphorus restriction prevents corticomedullary nephrocalcinosis and
      sustains reproductive performance but delays bone mineralization in rats.
AB  - In a long-term experiment with three successive generations of rats, the
      influence of dietary phosphorus restriction (2 instead of 4 g phosphorus/kg diet)
      on nephrocalcinosis, reproduction and bone mineralization was studied.
      Nephrocalcinosis in female rats, as based on kidney calcium concentration and
      histological examination, was prevented by phosphorus restriction. The low
      phosphorus diet caused reduced femur concentrations of magnesium, calcium and
      phosphorus in rats of the first and second generation aged 4 to 12 wk. The low
      phosphorus diet resulted in lower plasma phosphorus concentrations. In the
      kidneys of female rats, immediately after lactation, a higher degree of tubular
      hyperplasia was seen after the low phosphorus diet was fed. Reproductive
      performance was not affected by phosphorus restriction. We conclude that 0.2%
      phosphorus in the diet prevents nephrocalcinosis in female rats while it sustains
      reproduction but delays bone mineralization.

PMID- 8463878
TI  - 1,25-dihydroxycholecalciferol supplementation prevents hypocalcemia in magnesium
      deficient chicks.
AB  - To determine the relevance of circulating 1,25-dihydroxycholecalciferol
      [1,25(OH)2D3] to the pathogenesis of hypocalcemia during magnesium deficiency,
      growing chicks were pair fed control or Mg-deficient diets with or without
      1,25(OH)2D3 supplementation. Within 14 d, chicks fed the Mg-deficient diet
      without 1,25(OH)2D3 supplementation exhibited hypomagnesemia and hypocalcemia
      compared to control chicks. 1,25-Dihydroxycholecalciferol supplementation in Mg
      deficient chicks elevated plasma 1,25(OH)2D3 twofold and increased plasma calcium
      to control levels. Supplementation with 1,25(OH)2D3 did not increase plasma Mg
      concentration in Mg-deficient chicks, indicating that exogenous 1,25(OH)2D3
      prevented hypocalcemia in the absence of greater Mg availability. Magnesium
      deficient chicks supplemented with 1,25(OH)2D3 had more intestinal calbindin D
      28K relative to Mg-deficient nonsupplemented chicks, suggesting that increased
      absorption of dietary Ca may have contributed to the greater plasma Ca
      concentration in 1,25(OH)2D3 supplemented Mg-deficient chicks. Although clinical
      hypomagnesemia has been associated with vitamin D resistance, our data indicate
      that primary Mg deficiency did not impair target tissue responsiveness to
      1,25(OH)2D3, at least at the level of the intestine. Supplementation with
      1,25(OH)2D3 did not increase bone Mg concentration and did not alter the
      characteristic skeletal morphology. It also did not increase bone Ca
      concentration in Mg-deficient chicks. The data suggest that skeletal alterations
      during Mg deficiency result from hypomagnesemia per se, rather than hypocalcemia
      or insufficient 1,25(OH)2D3.

PMID- 8463879
TI  - Coordinated strategies for controlling micronutrient malnutrition: a technical
      workshop.
AB  - Participants in a November 1991 workshop concluded that coordinated strategies
      for controlling malnutrition due to iodine, iron, vitamin A and other
      micronutrients deficiencies are technically feasible and should be given
      consideration in planning control efforts. Coordinated surveys involving
      clinical, biochemical and dietary assessment of multiple micronutrients are
      feasible. Multiple fortification is also possible using such vehicles as salt,
      processed rice or sugar. Supplementation efforts can be integrated with existing
      health care programs. Food-based strategies are also effective. The best examples
      have been community-based and have included a strong nutrition and health
      education component designed to change food consumption patterns, improve food
      preservation and preparation practices, and link income-generating activities
      with food production activities. Successful coordinated efforts will require a
      strong political commitment and a supportive infrastructure. Specific
      recommendations include the formation of national coordinating bodies for
      micronutrient deficiency control, establishment of a micronutrient information
      network and expansion of technical exchange and training.

PMID- 8463880
TI  - [Orbital wall fractures: a comparison of computed tomography and conventional
      views].
AB  - A total of 59 cases of mild facial fractures (simple orbital wall fractures, 34
      cases, other facial fractures, 25 cases) with the clinical suspects of orbital
      wall fractures were evaluated both by conventional views (Waters' and Caldwell
      views) and coronal CT scans. Conventional views were obtained, as an average,
      after 4 days and CT after 7 days of injuries. Both the medial wall and the floor
      were evaluated at two sites, i.e., anterior and posterior. The ethmoid-maxillary
      plate was also included in the study. The degree of fractures was classified as,
      no fractures, fractures of discontinuity, dislocation and fragmentation. The
      coronal CT images in bone window condition was used as reference and the findings
      were compared between conventional views and CT. The correct diagnosis was
      obtained as follows: orbital floor (anterior, 78%, posterior, 73%), medial
      orbital wall (anterior, 72%, posterior, 72%) and ethmoid-maxillary plate (64%).
      The false positive diagnosis was as follows: orbital floor (anterior only, 13%),
      medial orbital wall (anterior only, 7%) and ethmoid-maxillary plate (11%). The
      false negative diagnosis was as follows: orbital floor (anterior, 9%, posterior,
      10%), medial orbital wall (anterior, 21%, posterior, 28%) and ethmoid-maxillary
      plate (21%). The results were compared with those of others in the past.

PMID- 8463881
TI  - [Statistical observations of clinical cases with frontal, ethmoid and sphenoid
      sinus mucoceles].
AB  - Ninety six patients with paranasal mucoceles (or pyoceles) were admitted and
      treated at Gunma University Hospital from 1977 to 1986 (age range 15-82 years;
      mean 46.4 years). We statistically investigated these cases paying a special
      attention to 25 patients with visual disturbance. 1) In 71 cases mucocele was
      located in the frontal or fronto-ethmoid sinus (FE group), in 12 it was found in
      the ethmoid sinus (E group), and in 13 it was situated in the sphenoid or spheno
      ethmoid sinus (SE group). 2) Sixty three cases had histories of previous surgery
      of paranasal sinuses and 29 cases were considered to have primary mucoceles. 3)
      The mean age of patients with primary mucocele was 56.4, while that with
      postoperative mucocele was 41.2. 4) In the FE group recurrence was so frequent
      that some device for surgical treatment should be considered (i.e., mucous
      membrane grafting, prolonged insertion of silicon tubes). 5) Visual disturbance
      was frequently observed in both the E group (7/12) and the SE group (9/13). 6)
      Visual disturbance may occur when mucocele compress the optic nerve and the globe
      at retrobulbar portion as well as at the optic canal. Twelve cases out of 25 with
      visual disturbance belonged in the former type. 7) Optic atrophy was most
      commonly seen in the SE group, but was recognized in 1 case even in the E group
      and the FE group respectively. 8) In patients with sudden visual disturbance, if
      only they were operated within a week after the onset, their visual acuity was
      remarkably improved except for serious cases. 9) In the cases presented with
      gradually attacked or varying visual disturbance, there was no correlation
      between the recovery of the vision and the duration of the disturbance.

PMID- 8463882
TI  - [Paranasal sinusitis due to Pasteurella multocida].
AB  - A case of paranasal sinusitis due to Pasteurella multocida (P. multocida) is
      reported. A 39-year-old woman presented with chief complaints of rhinorrhea and
      headache. The patient kept a cat in her house and kept such close contact with it
      as to wake up by being licked every morning. Bacteriological examination revealed
      P. multocida isolated from her nasal discharge and also from the saliva of the
      cat kept by the patient. The two isolates were compatible with respect to
      biochemical properties, serotype and drug susceptibility. Therefore, P. multocida
      infection in this case was considered to have originated from the pet cat. P.
      multocida infection has been increasing recently. One of the reasons is a pet
      boom. In order to prevent acquiring the infection from a pet animal, we should
      have knowledge about this infection, advise the patient to avoid close contact
      with pets, and provide valuable information concerning these problems to society
      from the viewpoint of zoonosis.

PMID- 8463883
TI  - [An evaluation of nasal patency with acoustic rhinometry--preop. and postop.
      comparisons].
AB  - Changes in nasal patency after nasal surgeries were evaluated with acoustic
      rhinometry. Fourteen cases (20 sides) were included in the evaluation and the
      following types of nasal surgery were performed: 2 partial maxillectomies, 11
      Caldwell-Luc operations, 4 endonasal ethmoidectomies, 1 endonasal maxillary
      sinusectomy and 2 septoplasties. The evaluation with acoustic rhinometry was
      routinely performed on two occasions; the day before and 7-14 days after the
      surgery. The preop. and postop. results of the evaluations of nasal volume (6.9
      14.1 cm by the area-distance curve) and nasal area (averaged areas at 11.0 cm and
      13.4 cm by the area-distance curve) were compared. Postop. results in all but one
      case demonstrated increases in both nasal volume and nasal area, indicating that
      acoustic rhinometry has practical applications in preop. and postop. evaluations
      of nasal patency. Three aspects remain to be clarified. The first is the
      influence of the nasal cycle, which varies considerably at the time of both preop
      and postop evaluations. The second is the influence of the paranasal sinuses.
      When the results of cases who had undergone endonasal ethmoidectomy or
      septoplasty were compared to those who had received partial maxillectomy or
      Caldwell-Luc operation, the latter showed greater increases in nasal patency,
      suggesting that the cavities of paranasal sinuses, especially of the maxillary
      sinus, influence the results of acoustic rhinometry. The third is the size of the
      anterior entrance of the middle meatus. When the entrance is narrow, the acoustic
      pulse generated by acoustic rhinometry will not reach up to the paranasal sinuses
      so that the size of the entrance will again influence the results.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8463884
TI  - [Effect of methamphetamine on the auditory system].
AB  - Four series of experiments were performed to evaluate the effects of
      methamphetamine on the auditory system of guinea pigs. Methamphetamine was
      administered to guinea pigs via intraperitoneal injection, and the time course of
      latencies of waves I, II, III, and IV, interpeak latencies of waves I-III, III
      IV, and I-IV of the ABR, and the near-field potential of the inferior colliculus
      and cochlear nerve were measured. These physiological data were analyzed in
      comparison with the distribution of methamphetamine in the inferior colliculus
      and cochlea following its immunohistochemical staining, as well as the serum
      methamphetamine concentration. The following results were obtained; 1. The wave
      latencies and interpeak latencies of ABR decreased up to 120 minutes after the
      administration. 2. In the cochlear nerve recording, the amplitude of the response
      increased and the latency decreased up to 90 minutes after the administration.
      These changes in responses were, however more prominent in the inferior
      colliculus recording. 3. Immunohistochemical examination revealed that
      methamphetamine was present in the hair cells of the organ of Corti, spiral
      ligament, spiral ganglion cells and the inferior colliculus 30 minutes after the
      administration. 4. The serum concentration of methamphetamine rapidly reached its
      maximal level, and then dropped gradually, logarithmically, having become almost
      horizontal at a low level 6 hours later. These results suggest that
      methamphetamine does exert an effect on the peripheral auditory system, as well
      as on the central nervous system, which is generally regarded as the effector
      organ. It is assumed that the pharmacological effect of methamphetamine on the
      cochlea involves excitation of sensory cells, afferent nerve fibers and spiral
      ganglion cells.

PMID- 8463885
TI  - [Innervation of the external ear in humans and the musk shrew].
AB  - The external ear appears only in mammals and possesses a great diversity of
      forms. In addition, multiple nerves are distributed in the external ear. The
      nerves which are distributed in the external ear were investigated in humans and
      in the musk shrew (Suncus murinus) in a macroscopic study. The following results
      were obtained. Cranial nerves (CN) V, VII, X and cervical nerves supply the
      auricle and the external meatus in both humans and the musk shrew. Branches of
      the third division of CN V supply an anterior part of the external meatus and the
      anterior part of the auricle in both humans and the musk shrew. A branch of CN X,
      together with a branch of CN VII, supply the posterior parts of the external
      meatus in humans. In the musk shrew, a branch of CN X, together with a branch of
      CN VII, supplies the posterior part of the external meatus and the central part
      and the anterior portion of the auricle. Branches of the cervical nerve supply
      the posterior part of the auricle. Branches of the cervical nerve supply the
      posterior part of the external meatus and the central and posterior parts of the
      auricle in the musk shrew.

PMID- 8463886
TI  - [Peritonsillar abscess--a comparison of treatment by needle aspiration and
      incision].
AB  - To compare the efficacy of permucosal needle aspiration with that of incision and
      drainage in the management of peritonsillar abscess, we reviewed the charts of 32
      patients, diagnosed as having peritonsillar abscess, who had been admitted to the
      Central Hospital of Social Health Insurance from June 1987 to December 1991.
      Twelve patients, 9 males and 3 females, were managed with incision and drainage.
      Their average age was 34 years, with a range of 23 to 69 years. Permucosal needle
      aspirations were performed in 20 patients, including 14 males and 6 females.
      Their age ranged from 16 to 65 with a mean of 36 years. All patients received
      parenteral antibiotics. The duration of fever over 37.0 degrees C averaged 2.0
      hospital days (range, 0 to 8 days) in patients treated with incision and
      drainage, and 2.1 hospital days (range, 0 to 4 days) in patients treated with
      needle aspiration. The average postoperative time elapsed until the patient could
      eat solid food with ease was 3.8 hospital days with a range of 1 to 9 days in
      patients treated with incision and drainage, and 3.2 hospital days with a range
      of 1 to 7 days in patients treated with needle aspiration. The hospital stay
      ranged from 3 to 9 days with an average of 5.4 days in patients treated with
      incision and drainage, and from 4 to 10 days with an average of 5.5 days in
      patients treated with needle aspiration. These data indicate that permucosal
      needle aspiration of peritonsillar abscess provides symptomatic relief and cure
      which are as rapid as those of incision and drainage.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8463887
TI  - [Computerized database system for pure tone audiometry].
AB  - The management and storage of pure tone audiometry data creates a major problem
      for otolaryngological clinics. We have devised a new computerized database system
      to overcome this problem. The hardware involved includes multiple audiometers and
      computers interfaced with a glassfiber local area network (Pi-Net). The software
      used is database 3 plus, a popular database language and utility software
      package. Programs were written for data entry, data transfer, reference, entry of
      patient ID, and evaluation of tympanoplasty. The following benefits of the system
      are noted. 1) Data entry is possible at every terminal (audiometer and computer).
      2) Storage capacity is sufficient for more than 10 years of operation. 3) All
      data can be retrieved rapidly at any terminal. Evaluations of pre- and post
      tympanoplasty hearing loss are facilitated by this system. This system is very
      effective for follow up of hearing disorders.

PMID- 8463888
TI  - [Consonant sounds processing in 22 channel cochlear implant device and consonant
      recognition of patients].
AB  - This report describes studies on electrode selection of the speech processor of a
      22 channel cochlear implant device for 14 Japanese consonants, and on consonant
      recognition of 23 cochlear implant patients as they relate to electrode
      selection. The means of electrode selection was studied using a special device
      capable of detecting code signals delivered from the speech processor for
      electrode selection. Young male voices consisting of/a/+consonant+/a/ were
      presented as sound stimuli, and the electrode numbers selected were recorded for
      each consonant. The recorded numbers were grossly divided into two groups; a
      higher frequency range of about 500Hz to 4,000Hz and a lower range of 0Hz to
      about 1,100Hz. They showed characteristic patterns for each consonant, and these
      electrode number patterns were compared with patterns estimated from a sonogram.
      Although there were some differences between these two patterns in unvoiced stop
      consonants, they were roughly parallel to each other in other consonants. The
      information transfer ratio was calculated based on confusion matrices obtained
      from test results on 23 patients for 14 consonants. The ratio was high in voicing
      and semivowels, whereas it was relatively lower in plosives. This seems
      reasonable on the basis of patterns of electrode number transitions. Nasals and
      fricatives, however, showed lower information transfer ratios despite adequate
      electrode selection, and this may due to poorer information transition or the
      high frequency components of these consonants.

PMID- 8463889
TI  - [Intravital microscopic and laser Doppler method estimates of cochlear blood flow
      -effect of transient ischemia on inner ear blood flow].
AB  - Cochlear blood flow (CoBF) was measured by intravital microscopy (IVM) and laser
      Doppler (LD) methods in normal guinea pigs and after a single norepinephrine (NE)
      injection into the carotid artery. CoBF changed in proportion to BP changes in
      normal animals. CoBF values by LD correlated well (r = 0.67) with CoBF measured
      by IVM when BP changed in the 35 and 70 mm Hg range. A linear regression line was
      obtained as y = 1.407X-2.996. No correlation was found between the diameters of
      radiating arterioles (RA) and blood volume (i.e., the hemoglobin concentration
      index). NE injection into the carotid artery induced the formation of sludge at
      RA, resulting in decreased local CoBF. A decrement in CoBF was also observed by
      LD after injection. Although similar patterns of CoBF changes were obtained by
      these two methods after injection, the degree of CoBF change by LD appeared to be
      lower than that by IVM. Our result indicates that the combination of these two
      methods provides a better understanding of cochlear circulation.

PMID- 8463890
TI  - [Effects of head positions on horizontal optokinetic afternystagmus in humans].
AB  - In order to study the space orientation of optokinetic afternystagmus in humans,
      I examined optokinetic afternystagmus in the yaw axis (horizontal OKAN, HOKAN) in
      both sitting and the 90 degree lateral tilted positions in 29 normal volunteers.
      Optokinetic stimuli of 80 degree/s were given for 120 seconds using a projection
      type stimulator. Eye movements were recorded in two dimensions, horizontal and
      vertical, to the head fixed coordinate axis using conventional
      electronystagmography. Five parameters of HOKAN (maximum slow phase velocity,
      time constant of slow phase velocity, total nystagmus number, frequency and
      duration) in the sitting position were compared with those in the 90 degree
      lateral positions tilted to the right and to the left. The following results were
      obtained. 1) OKAN were recorded from all subjects in the sitting position. The
      mean and the standard deviation of maximal slow phase velocity, duration and the
      time constant were 11.6 +/- 4.0/s, 35.7 +/- 15.6 seconds and 15.1 +/- 8.5
      seconds, respectively. 2) In the lateral positions, the rate of appearance of
      OKAN decreased to 72%. In the lateral positions, the slow phase velocity
      decreased to 68% of that in the sitting position. 3) The rate of appearance and
      the slow phase velocity of OKAN were more active in the direction horizontal to
      the ground than in the perpendicular direction. These results suggest that
      otolith input modifies HOKAN in humans.

PMID- 8463891
TI  - [Distribution of motor nuclei in feline ventral neck muscles].
AB  - The distribution of motor nuclei in feline neck muscles at the level of the third
      and fourth cervical vertebrae of spinal cord was investigated, using retrograde
      labelling with horseradish peroxidase (HRP). HRP powder was directly injected
      into the cut ends of the peripheral nerves innervating each muscle. Investigated
      muscles in this thesis included 5 ventral muscles: Levator scapulae m.(LS),
      Levator scapulae ventralis m.(LSV), Longus colli m.(LC), Longus capitis m. (LCP),
      Intertransversarius ventralis m.(ITV). Two dorsal muscles were also examined;
      Splenius m.(SP) and Biventer m.(BV). The findings in retrogradely labelled
      motoneurons of each muscle were as follows: 1) LS and LSV (V1 ventral muscles)
      Labelled motoneurons were observed at the lateral border of the ventral horn, and
      the distribution of LSV was more dorsal than that of LS. Their cellular
      distributions varied from the rostral end of the third cervical segment
      dorsolaterally to the caudal end of the fourth cervical segment ventromedially.
      2) LC, LCP and ITV (V2 ventral muscles) Labelled motoneurons were observed at the
      medial border of the ventral horn. The distribution of LCP was more dorsal than
      that of LC and ITV, but their cellular distributions were largely intermingled.
      The variation in cellular distribution, which was observed in V1 ventral muscles,
      was not recognized in this muscle group. 3) SP and BV (D1 and D2 dorsal muscles)
      Labelled motoneurons were observed at the apex of the ventral horn, referred to
      as the ventromedial nucleus by Rexed. The distribution of SP was more
      dorsolateral than that of BV, and the changes in cellular distribution seen in V1
      ventral muscles were also observed in these muscles. Some unorganized labelled
      cells were found at the medial border of the ipsilateral ventral horn, anterior
      funiculus, anterior commissure and contralateral ventral horn. These irregularly
      positioned cells were not found in the staining of the ventral muscles. Organized
      distributions of motoneurons in the ventral horn corresponded respectively to the
      classification of trunk muscles, as described by Nishi (1938) in accordance with
      the peripheral innervation of each trunk muscle. These results indicate that the
      pattern of peripheral innervation reflects the spinal level, and provides
      important information for electrophysiological analysis of the neural network
      between the central and peripheral nervous systems.

PMID- 8463892
TI  - Pulsed dye laser therapy for port-wine stains in children: psychosocial and
      ethical issues.
AB  - The port-wine stain is a disfiguring vascular birthmark that commonly occurs on
      the face. Amelioration of this condition in children was difficult or impossible
      until the introduction of the flashlamp-pumped pulsed dye laser in the late
      1980s. This article provides an interdisciplinary social and ethical examination
      of pulsed dye laser therapy for port-wine stain in childhood. Specific issues
      raised relate to the management of pain during therapy, rationale for care,
      expectations of treatment, the high costs of care, equity, marketing pressures,
      and therapeutic activism. Laser therapy in the dermatologic care of children is
      an exciting innovation that has transformed clinical practice and raised
      important social, ethical, and health policy issues.

PMID- 8463893
TI  - A prospective study of secondary prevention of child maltreatment.
AB  - This study sought (1) to retest an approach to the prediction of risk of child
      maltreatment and (2) to test the effect of a comprehensive prenatal and pediatric
      health services program on the rate of maltreatment. Of 2585 women screened at
      their first prenatal visit, 1154 qualified for the study. Risk assignment was
      determined by a structured interview. High-risk women (n = 314) were assigned to
      receive standard (high-risk control group; n = 154) or intervention (high-risk
      intervention group; n = 160) services throughout the prenatal period and during
      the first 2 years of their infants' life. A third group (low-risk control group;
      n = 295) was selected among low-risk women and received standard care without
      intervention services. State records were searched for substantive reports of
      child maltreatment up to 36 months after birth. Physical abuse was found for 5.1%
      of the study population; neglect was substantiated for 5.9%. Prediction efforts
      were effective in identifying risk of physical abuse but not of neglect.
      Comprehensive health services did not alter the reported abuse rate for high-risk
      parents and was associated with an increased number of neglect reports.
      Intervention reduced subject attrition and appeared to serve as a bias for
      detection of maltreatment. Thus this long-term, prospective approach was
      ineffective for child abuse prevention, perhaps because of detection biases and
      societal changes.

PMID- 8463894
TI  - Decreased Haemophilus colonization in children vaccinated with Haemophilus
      influenzae type b conjugate vaccine.
AB  - OBJECTIVE: The incidence of invasive Haemophilus disease has unexpectedly
      decreased in unvaccinated children since the introduction of conjugate vaccine in
      the United States. The purpose of this study was to determine whether conjugate
      vaccination decreases colonization with Haemophilus influenzae type b. DESIGN:
      This study was a prospective, bimonthly survey of pharyngeal colonization with H.
      influenzae type b in children attending day care from October 1987 through
      September 1989. Vaccination status was determined from the medical record.
      SUBJECTS: We obtained 1188 pharyngeal cultures from 283 healthy children, 18 to
      59 months of age; 51 children had received unconjugated polysaccharide vaccine
      (PRP), and 89 had received conjugate vaccine (94% PRP-diphtheria toxoid).
      MEASUREMENTS AND RESULTS: Multivariate analysis was used to test the possibility
      of an association between vaccination status and the rate of colonization with H.
      influenzae type b. Among children known to be exposed to at least one child with
      a positive culture result, the efficacy of conjugate vaccination to prevent H.
      influenzae type b colonization in an unmatched analysis was 64% (95% confidence
      interval: 5%, 86%; p = 0.02) and in a matched analysis 81% (95% confidence
      interval: 7%, 96%; p = 0.02). No effect on colonization was found with PRP
      vaccination. CONCLUSIONS: Conjugate vaccination decreases H. influenzae type b
      pharyngeal colonization and thereby may decrease transmission of this agent among
      healthy children.

PMID- 8463895
TI  - Quantitative leukoviremia and immune complex-dissociated antigenemia as
      predictors of infection status in children born to mothers infected with human
      immunodeficiency virus type 1.
AB  - Four methods of culturing human immunodeficiency virus type 1 (HIV-1) from
      peripheral blood mononuclear cells and two serum antigen tests were assessed as
      predictors of infection status in children born to HIV-1-infected mothers. Of 36
      infants whose cocultures were quantitative, all 15 who were deemed to be infected
      with HIV-1 (nine with symptoms, six without symptoms) by clinical criteria or
      persistence of Western blot reactive antibody had positive culture results, and
      all 21 uninfected seroreverters had negative culture results (sensitivity = 100%;
      specificity = 100%). Quantitative coculture was more sensitive than a technique
      in which cells were counted and stimulated with phytohemagglutin but not
      cocultivated with cells from seronegative donors, and more sensitive than two
      other qualitative techniques evaluated in samples from 80 children, in which
      cells were not enumerated before culture. The level of leukoviremia in children
      with symptoms did not differ appreciably from the level of leukoviremia in
      symptom-free infected children. Among those with positive results on quantitative
      coculture, only 40% also had free HIV-1 antigen in serum, whereas 86% had antigen
      in immune complexes. Among the methods evaluated, quantitative HIV-1 coculture
      was the best indicator of infection status in children.

PMID- 8463896
TI  - Atypical (non-diarrhea-associated) hemolytic-uremic syndrome in childhood.
AB  - We describe the clinical and laboratory features of 20 children who were seen
      during the past 20 years with idiopathic nondiarrhea-associated hemolytic-uremic
      syndrome. There was no seasonal variation in time of onset; a genetic pre
      disposition seemed likely in two of the cases. The prodromal illness was
      nonspecific and by definition did not include diarrhea. Hypertension was a major
      problem in the majority of the patients. Five died, three during the initial
      illness; four are in end-stage renal failure, and all but two of the survivors
      have residual nephropathy. Eleven patients had a "relapsing" course; up to eight
      additional documented episodes of hemolytic-uremic syndrome occurred in
      individual patients. Of the nine children treated before 1980, three died shortly
      after onset, two never recovered function after the initial illness, one had a
      relapsing course and died later, and one had residual nephropathy. Plasma
      exchange was introduced for the management of non-diarrhea-associated hemolytic
      uremic syndrome in 1980; since then, all of the 11 patients have recovered
      function after the initial episode, but 10 of them had relapses. It appears that
      with the introduction of plasma exchange there has been an improved outcome in
      the initial phase, but the survivors tend to have relapses. Atypical (non
      diarrhea-associated) hemolytic-uremic syndrome is a heterogeneous yet distinct
      subgroup of hemolytic-uremic syndrome that differs from diarrhea-associated
      hemolytic-uremic syndrome on epidemiologic, clinical, laboratory, histologic, and
      prognostic grounds.

PMID- 8463897
TI  - Economic evaluation of intravenous immune globulin therapy for Kawasaki syndrome.
AB  - OBJECTIVE: To determine the costs and clinical outcomes of three alternative
      treatments of the acute phase of Kawasaki syndrome: aspirin alone; low doses of
      intravenously administered immune globulin (IVIG-LD), 400 mg/kg per dose for 4
      days; and high doses of intravenously administered immune globulin (IVIG-HD), 2.0
      gm/kg for one dose. DESIGN: A model was developed that assumed the inclusion of
      100 patients with acute Kawasaki syndrome in each treatment option. Costs were
      valued by using the Chedoke-McMaster Corporate Cost Model in 1992 Canadian
      dollars. Clinical outcome, based on the published literature, was measured by the
      prevalence of coronary artery dilation at 7 weeks from the diagnosis of Kawasaki
      syndrome. RESULTS: For every 100 patients with Kawasaki syndrome, the cost was
      reduced by $323,400 when aspirin therapy alone was changed to IVIG-HD therapy and
      14 cases of coronary artery dilation were thereby prevented. When IVIG-HD therapy
      was compared with IVIG-LD therapy, the cost was reduced by $118,200 because two
      cases of coronary artery aneurysm were prevented. This latter result was
      sensitive to the duration of hospitalization, with IVIG-HD costing $8500 more for
      every 100 patients than IVIG-LD when it was assumed that both groups were
      hospitalized for 5 days, an unlikely occurrence. CONCLUSIONS: Treatment with IVIG
      HD for Kawasaki syndrome is preferred because it results in both lower costs and
      lower rates of coronary artery dilation.

PMID- 8463898
TI  - Psychologic and psychoeducational consequences of thyroxine therapy for juvenile
      acquired hypothyroidism.
AB  - The observation of severe behavioral reactions or learning problems in three
      teenagers treated with L-thyroxine for juvenile acquired hypothyroidism prompted
      us to conduct a prospective study of achievement and behavioral characteristics
      of patients with newly diagnosed juvenile acquired hypothyroidism. On diagnosis
      of juvenile acquired hypothyroidism and before treatment with L-thyroxine, 23
      children and adolescents underwent a comprehensive battery of psychoeducational
      tests, which was repeated after 3, 12, and 24 months of replacement therapy.
      Results revealed that adverse behavioral reactions and learning problems were
      relatively rare in these children, although symptoms of juvenile acquired
      hypothyroidism were associated with increased distractibility, hyperactivity, and
      poorer achievement. The least gain in achievement was made by children with more
      severe hypothyroidism at diagnosis; children with the best psychologic outcome
      were those who achieved euthyroidism more slowly. We conclude that severe
      behavioral manifestations of L-thyroxine therapy for juvenile acquired
      hypothyroidism are uncommon, but mild behavioral symptoms and poorer school
      achievement may occur in about 25% of patients, who represent the most severe
      cases at diagnosis.

PMID- 8463899
TI  - Relationship of genotype to early pulmonary function in infants with cystic
      fibrosis identified through neonatal screening.
AB  - To determine whether pulmonary function in infants with asymptomatic cystic
      fibrosis is related to genotype, we studied 18 infants with cystic fibrosis
      identified through neonatal screening and 18 healthy control infants. Infants
      with cystic fibrosis (mean age, 2.0 months; range, 1.0 to 4.6 months) were
      identified from June 1990 to September 1991 through a statewide screening program
      based on elevated immunoreactive trypsinogen concentrations. Pulmonary function
      testing was done before and after inhalation of albuterol. There were no
      differences in pulmonary function between the cystic fibrosis group and the
      control infants (mean age, 2.7 months; range, 0.9 to 4.5 months). However,
      infants homozygous for the delta F508 deletion (n = 10) differed from infants
      with other genotypic variants of cystic fibrosis and control infants with respect
      to respiratory system resistance (79.4 +/- 11.5 vs 52.0 +/- 3.8 vs 55.5 +/- 5.0
      cm H2O/L per second, respectively; p = 0.04) and specific conductance (0.15 +/-
      0.02 vs 0.21 +/- 0.02 vs 0.21 +/- 0.02 cm H2O-1 sec-1, respectively; p = 0.02).
      Infants homozygous for the delta F508 deletion, but not other infants, responded
      to albuterol with a decrease in respiratory system resistance. We conclude that
      infants with asymptomatic cystic fibrosis homozygous for the delta F508 deletion
      have early evidence of airways obstruction and may need early respiratory
      treatment.

PMID- 8463900
TI  - Resting metabolic rate in six- to ten-year-old obese and nonobese children.
AB  - The resting metabolic rate (RMR) and body composition of 130 obese and nonobese
      prepubertal children, aged 6 to 10 years, were assessed by indirect calorimetry
      and skin-fold thickness, respectively. The mean (+/- SD) RMR was 4619 +/- 449
      kJ.day-1 (164 +/- 31 kJ.kg body weight-1 x day-1) in the 62 boys and 4449 +/- 520
      kJ.day-1 (147 +/- 32 kJ.kg body weight-1 x day-1) in the 68 girls. Fat-free mass
      was the best single predictor of RMR (R2 = 0.64; p < 0.001). Step-down multiple
      regression analysis, with independent variables such as age, gender, weight, and
      height, allowed several RMR predictive equations to be developed. An equation for
      boys is as follows: RMR (kJ.day-1) = 1287 + 28.6 x Weight(kg) + 23.6 x Height(cm)
      - 69.1 x Age(yr) (R2 = 0.58; p < 0.001). An equation for girls is as follows: RMR
      (kJ.day-1 = 1552 + 35.8 x Weight (kg) + 15.6 x Height (cm) - 36.3 x Age (yr) (R2
      = 0.69; p < 0.001). Comparison between the measured RMR and that predicted by
      currently used formulas showed that most of these equations tended to
      overestimate the RMR of both genders, especially in overweight children.

PMID- 8463901
TI  - Renin-angiotensin-aldosterone system in healthy subjects aged ten to eighteen
      years.
AB  - We obtained normative data for plasma renin activity (PRA) and plasma aldosterone
      concentration from a biracial sample of 195 healthy, normotensive children and
      adolescents aged 10 to 18 years. The sample included 119 boys and 76 girls, of
      whom 103 were black and 92 were white. The mean PRA value (+/- SD) was 2.52 +/-
      1.95 ng/ml per hour, with minimal and maximal values of 0.1 and 13.50 ng/ml per
      hour. The mean plasma aldosterone concentration was 12.56 +/- 8.59 ng/ml, with
      minimal and maximal values of 1.6 and 50.1 ng/ml. We also examined the effects of
      subject characteristics and electrolyte intake. The slope relating sodium
      excretion to PRA was negative and highly significant (slope = -0.01; p < 0.003).
      The slope relating PRA to plasma aldosterone concentration was positive and
      highly significant (slope = 1.59; p < 0.0001). We did not observe differences in
      either variable as a function of age, sex, race, or family history of
      hypertension. These results suggest that differences based on race and family
      history of hypertension observed in adults are not present in youth.

PMID- 8463902
TI  - Prospective analysis and classification of patients with cystinuria identified in
      a newborn screening program.
AB  - Patients who inherit mutant cystinuria genes excrete high concentrations of
      cystine, ornithine, arginine, and lysine in the urine. At least three variants of
      cystinuria can be distinguished in heterozygotes. To determine whether certain
      combinations of mutant genes are more disadvantageous than others, we analyzed
      amino acid excretion in families of 17 probands with cystinuria identified by the
      Quebec neonatal screening program. Parents of the probands were classified into
      the three known phenotypes by calculating the sum of cystine, ornithine,
      arginine, and lysine excretion. Although parents of type I/I homozygotes excreted
      amounts of cystine in the normal range, their offspring excreted significantly
      greater amounts of urinary cystine than did children who have type I/III genetic
      compounds. This observation suggests that types I and III cystinuria mutations
      might involve two distinct genetic loci. Children with type I/I homozygous
      cystinuria often excrete cystine at levels greater than the theoretic solubility
      limit and may be at greatest risk for nephrolithiasis. We outline an approach to
      monitoring children with cystinuria who come to medical attention before
      formation of cystine stones.

PMID- 8463903
TI  - Peroxisomal disorders in children: immunohistochemistry and neuropathology.
AB  - Immunohistochemical studies with antisera against four peroxisomal enzymes,
      catalase and beta-oxidation enzymes (acyl-coenzyme A oxidase, bifunctional
      protein, and 3-ketoacyl-CoA thiolase), were performed on brain, liver, and kidney
      specimens from patients with peroxisomal disorders, as well as specimens from
      three control subjects, by using conventional paraffin-embedded autopsy material.
      The patients included eight with Zellweger syndrome and one with neonatal
      adrenoleukodystrophy. In the liver and kidney specimens from all patients, except
      one with Zellweger syndrome, diffuse immunostaining with all antisera in the
      cytoplasm of hepatocytes and renal tubular epithelium suggested an absence of
      peroxisomes but the presence of peroxisomal enzymes. Examination of brain
      specimens indicated a weak or negative reaction of neurons in the cerebral cortex
      and a weak reaction of glial cells in the white matter, which suggested
      maturational delay compared with control subjects. The delayed immunoreactive
      pattern of peroxisomal enzymes in Zellweger syndrome and neonatal
      adrenoleukodystrophy may be related to the significant neuropathologic features
      of polymicrogyria and dysmyelinogenesis. One patient with Zellweger syndrome had
      a unique finding of a positive granular catalase reaction and a negative reaction
      with antisera to 3-ketoacyl-coenzyme A thiolase, which suggested a diagnosis of
      pseudo-Zellweger syndrome. This study validates the application of these
      immunohistochemical methods to the study of peroxisomal enzymes. Use of these
      methods improves the accuracy of diagnosis of peroxisomal disorders.

PMID- 8463904
TI  - Effect of treatment with glycine and L-carnitine in medium-chain acyl-coenzyme A
      dehydrogenase deficiency.
AB  - To assess the relative contribution of glycine and carnitine conjugation pathways
      to total acyl-group excretion, we investigated the excretion of C6 to C10
      dicarboxylic acids, C6 to C8 acylglycines, and C6 to C8 acylcarnitines in five
      symptom-free patients with medium-chain acyl-coenzyme A dehydrogenase deficiency
      during sequential 1-week periods as follows: (1) no treatment, (2) oral
      supplementation with glycine, 250 mg/kg per day, (3) oral supplementation with L
      carnitine, 100 mg/kg per day, and (4) oral supplementation with both combined. In
      untreated patients, acylglycines and acylcarnitines represented 60% and less than
      1% of the total metabolite excretion, respectively; the average
      acylglycine/acylcarnitine ratio was 70:1. Oral supplementation with glycine did
      not alter the excretion of acylglycines or acylcarnitines. L-Carnitine
      supplementation increased the acylcarnitine excretion sixfold and caused a 60%
      reduction in acylglycine excretion (p < 0.001); however, even with carnitine
      supplementation, acylglycine excretion was still 10 times greater than that of
      acylcarnitines. The results suggest that glycine conjugation was the major
      pathway for the disposal of C6 to C8 acyl moieties and that oral L-carnitine
      supplements may inhibit glycine conjugation. The findings cast doubt on the value
      of long-term treatment of medium-chain acyl-coenzyme A dehydrogenase deficiency
      with L-carnitine.

PMID- 8463905
TI  - Verification bias in pediatric studies evaluating diagnostic tests.
AB  - Improperly designed evaluations of diagnostic tests may lead to inaccurate
      conclusions about a test's accuracy. One problem, verification bias, occurs if
      subjects are not equally likely to have the diagnosis verified by a gold-standard
      evaluation and if selection for further evaluation is dependent on the diagnostic
      test result. To determine whether verification bias is a problem in pediatric
      studies of diagnostic tests, we conducted a critical appraisal of all studies
      evaluating diagnostic tests published in three pediatric journals during a 3-year
      period. Thirty-six percent were subject to verification bias. The most prevalent
      cause was restriction of the patient sample to those whose diagnosis had been
      verified by a gold standard evaluation, when the decision to obtain the gold
      standard was influenced by the diagnostic test result. Verification bias may have
      serious effects on the estimated sensitivity and specificity of a test. Improved
      awareness of the potential for verification bias may help physicians improve
      their selection and interpretation of diagnostic tests and thereby improve the
      quality and efficiency of patient care.

PMID- 8463906
TI  - Long-term outcome of Lyme disease in children given early treatment.
AB  - Sixty-three patients treated with appropriate antimicrobial therapy between 1985
      and 1990 for physician-documented erythema migrans were identified. A telephone
      interview program 1 to 6 years after the initial episode of Lyme disease revealed
      that none of the patients had evidence of carditis, arthritis, or neurologic
      complications attributable to Lyme disease. A new episode of erythema migrans was
      reported in 7 (11%) of the patients 1 to 4 years after the initial episode.

PMID- 8463907
TI  - Acute splenic sequestration together with aplastic crisis caused by human
      parvovirus B19 in patients with sickle cell disease.
AB  - Three children with homozygous sickle cell disease, 22 months and 8 and 10 years
      of age, had clinical and hematologic manifestations of aplastic and splenic
      sequestration crisis simultaneously. They had an acute drop in hemoglobin level
      (16, 20, and 45 gm/L), reticulocytopenia (0.1%, 0.6%, and 0.3%), and sudden
      splenic enlargement. Evidence of recent parvovirus infection was demonstrated.

PMID- 8463908
TI  - Differentiation of systemic juvenile rheumatoid arthritis from acute leukemia
      near the onset of disease.
AB  - Many children with acute leukemia have musculoskeletal complaints and non
      specific hematologic abnormalities. A total of 10 children with acute leukemia
      and 10 with systemic juvenile rheumatoid arthritis were compared to delineate
      which early features could differentiate these diagnoses. Attention to evolving
      hematologic abnormalities and musculoskeletal findings may expedite diagnosis of
      these diseases.

PMID- 8463909
TI  - Recurrence of insulin-dependent diabetes mellitus after transient neonatal
      diabetes: a report of two cases.
AB  - Insulin-dependent diabetes mellitus developed in two patients with transient
      neonatal diabetes after more than 5 years without insulin therapy. The absence of
      islet cell antibodies and of the typical HLA types suggests that they may have a
      nonimmunologic form of diabetes.

PMID- 8463910
TI  - Epidermolysis bullosa and severe ulcerative colitis in an infant.
AB  - An infant with epidermolysis bullosa simplex had diarrhea at 3 weeks of age;
      severe ulcerative colitis was subsequently diagnosed. Epidermolysis bullosa
      simplex has not been associated with gastrointestinal disease except for buccal
      ulceration.

PMID- 8463911
TI  - Diaphragmatic hernia in tetrasomy 12p mosaicism.
AB  - Twelve infants with diaphragmatic hernias plus other anomalies who had mosaicism
      for tetrasomy isochromosome 12p (Pallister-Killian syndrome) are reviewed. A
      newborn infant with a diaphragmatic hernia plus dysmorphic features and a normal
      peripheral blood karyotype should have chromosome analysis performed on
      fibroblasts or bone marrow.

PMID- 8463912
TI  - Bilateral fiberoptic bronchoalveolar lavage in acute unilateral lobar pneumonia.
AB  - Bilateral cultures of bronchoalveolar lavage fluid were obtained from eight
      children with unilateral lobar pneumonia. In four patients bacterial pathogens
      were not isolated from lavage of the radiologically normal side but were
      subsequently cultured from the consolidated segment. This pattern helped to
      exclude contamination by oropharyngeal flora of bronchoalveolar lavage fluid.
      Bilateral bronchoalveolar lavage may help in the interpretation of lower
      respiratory tract cultures obtained by fiberoptic bronchoscopy.

PMID- 8463913
TI  - Randomized study of high-frequency oscillatory ventilation in infants with severe
      respiratory distress syndrome. HiFO Study Group.
AB  - We conducted a multicenter, prospective, noncrossover, randomized study to
      determine whether high-frequency oscillatory ventilation (HFOV) would decrease
      the development or progression of air leak syndrome in infants with severe
      respiratory distress syndrome. Air leak syndrome was defined as pulmonary
      interstitial emphysema or gross air leak such as pneumothorax. Infants were
      eligible for study entry if they were less than 48 hours of age and had severe
      respiratory distress syndrome, defined by peak inspiratory pressure or the
      presence of air leak syndrome. Infants who weighed > or = 0.5 kg at birth were
      randomly assigned to receive either conventional ventilation (CV) or HFOV. HFOV
      was provided by a ventilator that operated at 15 Hz, with a 1:2
      inspiratory/expiratory ratio and no background tidal breaths. Severity of
      pulmonary interstitial emphysema was scored independently by two neonatologists
      unaware of the infants' ventilatory group. Gross air leak severity was scored
      according to the number of chest tubes required and duration of air leak. Eighty
      six infants received HFOV; 90 received CV. During the first 24 hours of the
      study, patients in the HFOV group received significantly higher mean airway
      pressure and lower inspired oxygen concentration, had significantly lower
      arterial carbon dioxide tension, and had a higher ratio of arterial to alveolar
      oxygen tension. When the HFOV and CV groups were compared with control for birth
      weight strata, study site, and inborn versus outborn status, HFOV significantly
      reduced the development of air leak syndrome in those patients who entered the
      study without the syndrome. We conclude that HFOV, when the strategy employed in
      this study is used, provides effective ventilation, improves oxygenation, and
      significantly reduces the development of air leak syndrome in infants with severe
      respiratory distress syndrome.

PMID- 8463914
TI  - Time of first stool in extremely low birth weight (< or = 1000 grams) infants.
AB  - The time of first stool was studied in 144 infants with a birth weight of 1000 gm
      or less. Median age at passage of the first stool was 3 days, and 90% of the
      infants passed stool by 12 days after birth. There was no relationship between
      the time of passage of the first stool and either birth weight or gestational
      age. Of the 114 infants, 88 (77%) passed stool before the initiation of any
      enteral feeding. The passage of the first stool was delayed in male compared with
      female infants (p = 0.03).

PMID- 8463915
TI  - Lactic acid as a predictor for erythrocyte transfusion in healthy preterm infants
      with anemia of prematurity.
AB  - Elevated blood lactate levels that declined to normal after erythrocyte
      transfusion were observed in 17 of 37 otherwise healthy infants with anemia of
      prematurity (26.1 +/- 2.1 mg/dl vs 12.3 +/- 0.9 mg/dl; p < 0.001).
      Posttransfusion heart rate in this group decreased from 155 +/- 1 beats/min to
      150 +/- 2 beats/min (p = 0.01). Blood lactate concentration may be a predictor of
      the need for transfusion in anemia of prematurity.

PMID- 8463916
TI  - Effect of low intravaginal doses of prostaglandin E2 on the closure time of the
      ductus arteriosus in term newborn infants.
AB  - Seventeen term newborn infants (control subjects) and 17 whose mothers had been
      given intravaginal doses of prostaglandin E2 (PGE2) were examined serially by
      color Doppler echocardiography to determine whether maternal PGE2 prolonged
      ductal patency. No clinically relevant differences in closure times were found.
      Low-dose intravaginal PGE2 therapy was not associated with prolonged ductal
      patency in term infants.

PMID- 8463917
TI  - Nephrocalcinosis in very low birth weight neonates: family history of kidney
      stones and ethnicity as independent risk factors.
AB  - Serial renal ultrasonography was performed in 50 consecutive neonates with birth
      weights less than 1200 gm who survived to at least 3 weeks of age.
      Nephrocalcinosis developed in 8 (67%) of 12 white and only 6 (16%) of 38 nonwhite
      infants (p < 0.01). Seven (78%) of nine infants with a family history of kidney
      stones had nephrocalcinosis compared with only 7 (17%) of 41 without a family
      history of kidney stones (p < 0.001). We conclude that nephrocalcinosis in our
      population of very low birth weight neonates is significantly and independently
      associated with a family history of kidney stones and white race.

PMID- 8463918
TI  - Neonatal sepsis caused by a new group B streptococcal serotype.
AB  - Two infants with typical clinical presentations for invasive neonatal group B
      streptococcal disease caused by a new serotype, type V, are described. Organisms
      of this capsular type should be sought among isolates from sick neonates to
      evaluate their prevalence and associated patterns of disease.

PMID- 8463919
TI  - Identification of nonsteroidal antiinflammatory drug-induced gastroduodenal
      injury in children with juvenile rheumatoid arthritis.
AB  - In a cohort of children with juvenile rheumatoid arthritis treated with
      nonsteroidal antiinflammatory drugs and referred for gastrointestinal complaints,
      more than 75% had gastritis, antral erosions, or ulcers. Epigastric pain strongly
      correlated with documented gastroduodenal injury. Therapy with ranitidine or
      misoprostol led to clinical improvement. Nonsteroidal antiinflammatory drugs are
      associated with significant gastrointestinal abnormalities in children.

PMID- 8463920
TI  - Efficacy of herbal tea preparation in infantile colic.
AB  - We evaluated the effect of an herbal tea preparation on infantile colic in a
      prospective double-blind study. The use of tea eliminated the colic in 19 (57%)
      of 33 infants, whereas placebo was helpful in only 9 (26%) of 35 (p < 0.01). The
      mean colic score was significantly improved in tea-treated infants. No
      significant differences were noted between groups regarding number of night
      wakings.

PMID- 8463921
TI  - Prospective study of the electrocardiographic effects of imipramine in children.
AB  - Because imipramine and desipramine have been implicated in sudden death in
      children, noninvasive electrophysiologic data were accumulated in 25 patients.
      Two children were excluded on the basis of resting electrocardiographic and
      Holter abnormalities. The remaining 23 patients received imipramine to a maximum
      dose of 5 mg/kg or a serum level of 150 to 250 ng/ml. Consistent but clinically
      insignificant resting electrocardiographic changes occurred during treatment.
      Ambulatory electrocardiographic monitoring may be useful when one is assessing
      the cardiovascular risks of imipramine therapy.

PMID- 8463922
TI  - Single-dose pharmacokinetics of recombinant human erythropoietin in preterm
      infants after intravenous and subcutaneous administration.
AB  - Pharmacokinetics of recombinant human erythropoietin (rHuEPO) were studied in a
      group of very low birth weight infants after both intravenous and subcutaneous
      administration. The volume of distribution was larger and the clearance more
      rapid than those reported in adults. The maximum concentration of erythropoietin
      after subcutaneous doses of rHuEPO was variable, but bioavailability was high
      (42%) compared with values reported in adults. These observations could be useful
      in optimizing treatment of the anemia of prematurity with rHuEPO.

PMID- 8463923
TI  - Heparin-induced thrombocytopenia.

PMID- 8463924
TI  - Defining outcomes for otitis media studies.

PMID- 8463925
TI  - Aortic dissection and rupture in Turner syndrome.

PMID- 8463926
TI  - Treatment of Turner syndrome with growth hormone.

PMID- 8463927
TI  - Management of chlamydial infections in adolescents.

PMID- 8463928
TI  - Mothers' supervision and perception of young children's risk of unintentional
      injury in the home.
AB  - Investigated whether control exerted through supervision is believed by mothers
      to reduce risk of unintentional injury to their children. 150 mothers of 1-, 2-,
      and 3-year-old children rated the risk of their child having an injury and
      indicated what injuries they anticipated in different rooms of the home under
      four conditions of supervision. A clear effect of supervision was observed in
      that rated risk and the number of anticipated injuries decreased depending on
      whether the mother was in the same room or not. Furthermore, a decrease was found
      when the mother was in the same room engaged in the same activity as the child
      (either playing with or being assisted by the child). The observed effects of
      supervision were less strong for older children and for rooms perceived as less
      dangerous.

PMID- 8463929
TI  - Empirical selection of psychosocial treatment targets for children and
      adolescents with diabetes.
AB  - Used an empirical approach to determine psychosocial variables related to optimal
      metabolic control of diabetes in two samples (total n = 56) of children and their
      families. Children and adolescents classified as either in optimal or nonoptimal
      control of diabetes (based on glycosylated hemoglobin results) completed self
      report measures on variables of anxiety, coping, family environment and health
      locus of control, and a structured interview. Parents completed parallel self
      report measures and a child behavior checklist. Children in optimal control of
      diabetes had more structured and controlling family environments, and more
      frequently believed that "powerful others" were responsible for their health.
      There was a marginally significant difference in knowledge, with children in
      poorer metabolic control showing better knowledge about diabetes and its
      management than children in optimal control. The study illustrates an empirical
      approach to the selection of psychosocial treatment targets for children with
      diabetes, and underscores the importance of parental involvement with the
      diabetes regimen to ensure optimal control of diabetes in both children and
      adolescents.

PMID- 8463930
TI  - Safety hazards in households with young children.
AB  - Interviewed 230 mothers of young children concerning in-home observations of
      safety hazards related to burns, poisoning, and falls, and self-reported measures
      of maternal supervision, locus of control, social support, and safety attitudes.
      These were supplemented by measures of mothers' risk perceptions, stress and
      coping, their child's previous injury experience, and indicators of the family's
      socioeconomic status (SES) collected by telephone survey. SES was an important
      predictor of observed home hazards. Child-related variables, risk perceptions,
      and domain-specific attitudes had little influence on home hazards. Maternal
      supervisory style, rated on dimensions of protectiveness, was an important
      correlate of all types of household hazards. Results suggest that residential
      injury prevention strategies for young children should stress active as well as
      passive countermeasures.

PMID- 8463931
TI  - Measures of children's injuries: self-reported versus maternal-reported events
      with temporally proximal versus delayed reporting.
AB  - Although attention has recently been focused on understanding and preventing
      children's injuries, much controversy exists over the best data collection
      methods for examining child injuries. This study examined three methodological
      issues relevant to childhood injury data collection including the length of time
      children and parents can be expected to meaningfully recall injuries, whether the
      parent or child is a preferred informant about the injury, and the potential use
      of near injuries as a proxy measure for actual child injuries. Both children and
      their mothers were individually interviewed every 2 weeks for a total of 6 months
      about both injuries and near injuries. In addition, at the end of the 6-month
      period, they were asked to recall all injuries that occurred during those 6
      months. Overall, children reported more injuries than mothers. Children recalled
      far fewer and mothers recalled slightly fewer events than had been reported in
      the biweekly interviews. There were fewer near injury than actual injury events
      reported, although this varied across categories, with some categories (e.g., car
      passenger injuries) having more near than actual injuries, and other categories
      (e.g., cuts, bumps, and bruises) having many more actual than near injuries
      reported. Limitations of the project are discussed and implications for future
      research advanced.

PMID- 8463932
TI  - Stress management training for adolescents with diabetes.
AB  - Evaluated the effects of stress management training (SMT) for adolescents with
      diabetes in a 9-month controlled treatment-outcome study. Nine patients were
      randomly assigned to a stress management group while another 10 patients served
      as controls and received standard outpatient treatment. The treatment program
      consisted of 10 sessions over 3 months, 3 additional sessions over 3 months, and
      a 3-month follow-up without treatment. Diabetes-specific stress decreased
      significantly for patients in the SMT group over the course of the intervention
      and follow-up. However, metabolic control, regimen adherence, coping styles, and
      self-efficacy about diabetes were unchanged. These findings suggest a SMT program
      for adolescents with diabetes may be helpful in reducing diabetes-specific
      stress, but additional procedures are necessary to improve adherence, coping
      styles, and metabolic control.

PMID- 8463933
TI  - Treatment adherence difficulties among children with cancer: the role of
      parenting style.
AB  - Investigated the prevalence of treatment adherence problems among children
      undergoing cancer treatment and explored the relationship of sociodemographic
      factors, child functional status, and parenting style to these difficulties.
      Nurse ratings of adherence difficulties encountered during the cancer treatment
      regimen were completed on 77 children and their caregivers. A subset of
      caregivers also completed a measure of parenting attitudes and practices. Results
      indicated that certain adherence difficulties were related to the child's age and
      functional status, the family's socioeconomic status (SES), and parenting style.
      The child's age was related to adherence to procedure-related tasks; younger
      children had more frequent problems with completing these tasks. More functional
      children had a greater number of adherence problems. Families with a lower SES
      had more difficulties with timeliness and cancellations/delays of clinic
      appointments and promptness of reporting of the child's reactions to treatment.
      Children of caregivers who had a more "supportive" parenting style (were more
      sensitive to children's input, had a less restrictive attitude towards parenting,
      and were more nurturant) canceled and delayed fewer appointments, were on time
      more frequently for appointments, and reported reactions to treatment with less
      delay. Implications of these findings for future research on treatment adherence
      and for clinical interventions are discussed.

PMID- 8463934
TI  - Effective and ineffective management behaviors of parents of infants and young
      children with asthma.
AB  - To define the specific objectives of a planned behavioral intervention directed
      toward parents of very young children with asthma, 574 detailed descriptions of
      ineffective and effective asthma management behaviors of parents of infants and
      young children (through 6 years of age) with asthma were collected via interviews
      with 117 physicians and other health professionals and 112 parents. Analysis of
      these data resulted in the identification of 130 ineffective and effective asthma
      management behaviors of parents that could be grouped in five major areas of
      responsibility: symptom intervention; symptom prevention; use of medical and
      educational resources; communication among caregivers; and child development and
      family relationships. This report presents the methodology of the study,
      describes the identified behaviors, and discusses implications of the results for
      the development of a behavioral intervention to improve asthma management by
      parents.

PMID- 8463935
TI  - Conceptions of illness by children with juvenile rheumatoid arthritis: a
      cognitive developmental approach.
AB  - Investigated the conceptions of illness and accuracy of understanding about their
      disease for children with juvenile rheumatoid arthritis (JRA). 54 children
      between the ages of 6 and 17 were interviewed individually about various aspects
      of JRA, with results suggesting that accuracy and illness conceptions could be
      reliably measured. As predicted, children's understanding about their disease
      followed a developmental progression, with older children demonstrating a more
      sophisticated understanding of JRA than younger children (significant differences
      between age groups on 3 of the 5 questions). Multiple regression analysis
      indicated that conceptual level (p < .001) was a better predictor of the child's
      accuracy of knowledge than was age (ns). Despite the developmental progression,
      there were a significant number of children functioning below the level expected
      for their age. In fact, the majority (75%) of children exhibited an understanding
      of JRA at the concrete operational level of cognitive development. The within
      subject variability and striking misconceptions argue for ongoing evaluation of
      each child's understanding as a way to improve educational efforts.

PMID- 8463936
TI  - Microbial composition and pattern of antibiotic resistance in subgingival
      microbial samples from patients with refractory periodontitis.
AB  - A series of 993 subgingival microbial samples sent to a diagnostic microbiology
      laboratory included 196 samples that could be identified as compatible with a
      clinical diagnosis of refractory or recurrent periodontitis. In descending order
      of prevalence the associated microbiota included Bacteroides forsythus (84%),
      spirochetes (83%), motile rods (76%), Fusobacterium species (68%), Porphyromonas
      gingivalis (63%), Campylobacter rectus (47%), Capnocytophaga species (38%),
      Prevotella intermedia (23%), Peptostreptococcus micros (18%), Actinobacillus
      actinomycetemcomitans (16%), Candida (14%), enteric rods (9%), Staphylococcus
      species, not including aureus (5.6%). Eikenella corrodens (3%), Staphylococcus
      aureus (1.5%), and Enterococcus species (< 1%). Antibiotic resistance to
      tetracycline, penicillin G, or metronidazole was particularly noticeable for
      enteric rods, Fusobacterium species, Capnocytophaga species, Staphylococcus, and
      Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter
      rectus. No antibiotic sensitivity data were obtained for Porphyromonas gingivalis
      or Bacteroides forsythus, as these species were detected by immunofluorescence.
      The results indicate that a substantial number of microorganisms associated with
      refractory periodontitis are variably resistant to commonly-used antibiotics.
      Diagnostic microbiology must be considered an essential adjunct to the therapist
      faced with periodontal lesions refractory to conventional treatment.

PMID- 8463937
TI  - Colonization of retrieved polytetrafluoroethylene membranes: morphological and
      microbiological observations.
AB  - Polytetrafluoroethylene membranes (ePTFE) used in guided tissue regeneration
      (GTR) are accessible to colonization by oral bacteria. The bacterial composition
      of the adherent biomass is unknown. We examined a total of 6 membranes that were
      retrieved after 4 to 6 weeks from human periodontitis sites, using optical and
      transmission electron microscopy (TEM) as well anaerobic cultivation. Five of the
      6 membranes provided the microbiological data and microscopic data. TEM revealed
      an organized microbial mass covering the surfaces and also within the interstices
      of the open microstructure and occlusive portions of the membranes. Numerous
      bacterial forms including cocci, rods, and filaments with an interbacterial
      matrix, frequently in microcolonies, were identified. Anaerobic cultivation
      yielded Streptococcus and Actinomyces species with a minor component of Gram
      negative facultative rods comprised mainly of Haemophilus species. Candida
      species was recovered from one membrane. These data show that ePTFE is heavily
      colonized by oral bacteria during retention. The impact of bacterial colonization
      of ePTFE is not known but it seems reasonable to assume that colonization of
      membranes may affect connective tissue regeneration. Further studies will be
      needed to examine the effect of systemic antimicrobials on ePTFE colonization and
      in turn to examine the effect on GTR.

PMID- 8463938
TI  - Phenytoin increases gene expression for platelet-derived growth factor B chain in
      macrophages and monocytes.
AB  - The mechanism by which phenytoin (PHT) induces gingival overgrowth remains
      unclear. We hypothesized that PHT increases macrophage production of platelet
      derived growth factor (PDGF), an important cytokine in connective tissue growth
      and repair, and that excessive production PDGF in gingiva could lead to redundant
      growth. To test the hypothesis, rat peritoneal macrophages and human blood
      monocytes were cultured in the presence of PHT (5 to 20 micrograms/ml medium) or
      an equal volume of its solvent for 3 days and tested for expression of PDGF-B
      mRNA by in situ hybridization. Approximately 300 cells/culture well were examined
      (3 wells/drug level) for positive indication of PDGF-B mRNA. Data were compared
      by chi square test. All levels of PHT in both cell types induced a 2- to 8-fold
      increase in PDGF-B mRNA positive cells, significant in all cases at P < 0.001.
      Northern blot analysis of RNA from similarly cultured rat macrophages confirmed
      these findings. Cells treated with 10 micrograms PHT/ml medium or solvent
      revealed 2.2 +/- 0.3 and 1.0 +/- 0.2 (mean +/- SEM) arbitrary units PDGF mRNA
      respectively (t tests, P < 0.05). Additionally, rat macrophages were cultured in
      presence of 5 micrograms PHT/medium or its solvent and medium was analyzed for
      PDGF secretion by radioimmunoassay. Mean values (+/- SEM) were 1.28 +/- 0.49 and
      0.78 +/- 0.07 ng/mg protein respectively (t test, P < 0.05). These data showed
      that PHT augmented the expression of c-sis, the gene for PDGF-B, and offered a
      possible explanation for PHT-induced gingival overgrowth.

PMID- 8463939
TI  - The plaque removal effects of single rinsings and brushings.
AB  - Chemical plaque removal is one mechanism whereby an agent could improve oral
      hygiene and gingival health. As with toothpastes most agents, when delivered as
      rinses, would be considered adjunctive to mechanical tooth cleaning procedures.
      The aim of this study was to determine whether selected commercial rinses
      exhibited clinically significant plaque removal properties alone or when combined
      with toothbrushing with water or a toothpaste. A group of 12 volunteers took part
      in this single blind, randomized placebo-controlled, 12 cell cross-over study,
      employing 6 rinses. During each regimen subjects accumulated plaque from a zero
      baseline over 72 hours. Plaque removal was then measured by index and area after
      first a single rinse of product and second a subsequent brushing with water or
      toothpaste. Prebrushing rinsing removed less than 5% of the plaque with little
      difference between agents. No rinse was more adjunctive than water to postrinse
      brushings. Most statistically significant differences arose with the
      chlorhexidine rinse being apparently less effective. However, the possibility of
      a disclosing dye interaction cannot be discounted as explaining this anomalous
      result. This study could not support any claim of a direct prebrushing rinse
      benefit greater than that provided by water to mechanical plaque removal by any
      of the products tested.

PMID- 8463940
TI  - Glycosaminoglycans and periodontal disease: analysis of GCF by safranin O.
AB  - The purpose of this study was to quantify glycosaminoglycans (GAG) released into
      the gingival crevicular fluid (GCF) during health, gingivitis, and adult
      periodontitis. The investigation tested the hypothesis that increased amounts of
      GAG can be measured in GCF associated with gingivitis and adult periodontitis as
      compared to health. An individual patient's sampling sites were assigned to
      either a health (control) group or 1 of 3 experimental groups, gingivitis,
      periodontal "maintenance" (perio-M), or periodontal "non-maintenance" (perio-NM)
      according to standard clinical criteria of pocket probing depth, bleeding on
      probing, and radiographic evidence of bone loss. The perio-M group was defined as
      a periodontal patient who had received a dental prophylaxis and/or root planning
      within 6 months prior to GCF collection. The perio-NM group had received no
      periodontal therapy during the previous 6 months. Subsequent to air-drying and
      isolation, GCF was collected by a microcapillary pipette held at the gingival
      margin. All fluid samples were digested overnight at 37 degrees C with 25
      micrograms of papain and analyzed for GAG content using a chondroitin-4-sulfate
      standard. Data generated from safranin "O" dye binding assays of GAG revealed
      4.41 +/- 9.82 ng GAG from the health (control) group (n = 23); the gingivitis
      group (n = 13) showed 15.23 +/- 11.85 ng GAG/sample; perio-M group (n = 11)
      showed 23.64 +/- 12.98 ng GAG/sample and the perio-NM group (n = 12) exhibited
      119.08 +/- 33.14 ng GAG/sample.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8463941
TI  - Fructosamine as a possible monitoring parameter in non-insulin dependent diabetes
      mellitus patients with periodontal disease.
AB  - Fructosamine assay is a new test used in the diagnosis and monitoring of diabetic
      patients. This assay may be of interest to the periodontist for, while the
      traditional plasma glucose value would give a general view and information about
      diabetic control at a certain point, the fructosamine concentration gives an
      indication of the plasma glucose level over a considerable period of time, such
      as 1 to 3 weeks. We investigated whether there was any relation between the
      diseased state of the periodontal tissues and plasma fructosamine and the plasma
      glucose values in non-insulin dependent diabetes mellitus (NIDDM) patients. We
      found that fructosamine correlated with the degree of gingival bleeding, however
      serum glucose levels had little or no correlation.

PMID- 8463942
TI  - Serum IgG and IgM levels to bacterial antigens in necrotizing ulcerative
      gingivitis.
AB  - Previous studies of the systemic antibody response in necrotizing ulcerative
      gingivitis (NUG) have elicited varying results. The purpose of this study was to
      determine the humoral response to site-specific isolates of microbiota associated
      with NUG. Sera from 21 active NUG subjects and 21 age-sex-race matched controls
      were assessed for IgG and IgM antibodies to 4 clinical isolates of Prevotella
      intermedia and 3 clinical isolates of Treponema species. P. intermedia and
      Treponema strains were isolated from active and inactive sites of NUG patients
      and gingivitis sites of controls. P. intermedia was also isolated from
      noninflamed sites of the controls. IgG and IgM serum levels to these 7 bacteria
      were measured by ELISA. Compared to control subjects, the NUG sera exhibited
      significantly lower IgG and IgM levels to all 4 isolates of P. intermedia (P < or
      = 0.001). It was also noted that sera from NUG subjects had elevated IgM levels
      to all 3 spirochete isolates but significantly higher only to the spirochete
      isolated from a gingivitis site of a control subject (P < or = 0.005). The data
      suggest that failure to mount a substantial antibody response to P. intermedia
      may be associated with onset of disease activity in NUG. However, the assumed
      lack of "biological significance" between differences in antibody responses
      measured indicates the relationship is weak or nonexistent. It also appears that
      antibody response to spirochetes is not associated with onset of NUG.

PMID- 8463943
TI  - Histologic evaluation of periodontal attachment apparatus following the insertion
      of a biodegradable copolymer barrier in humans.
AB  - The purpose of this study was to histologically evaluate the effectiveness of
      polylactide:polyglycolide 50:50 (DL-PLGA) as a barrier to prevent epithelial
      migration and to promote new connective tissue attachment. Mucoperiosteal flaps
      were performed on 17 human teeth. DL-PLGA membrane was placed over the roots and
      alveolar bone. DL-PLGA was not placed over control teeth. Ninety days following
      surgery, block sections were obtained and processed for histologic evaluation.
      All specimens revealed a mean length of epithelial attachment within physiologic
      limits and recession of the gingival margin. There was little or no reattachment
      of the connective tissue. It is concluded that this copolymer barrier did not
      prevent epithelial migration nor enhance connective tissue attachment to human
      roots with severe horizontal bone loss and active periodontal disease.

PMID- 8463944
TI  - Experimental gingivitis during pregnancy and post-partum: immunohistochemical
      aspects.
AB  - The histoimmunological response of 8 individuals was studied longitudinally in
      relation to the development of experimental gingivitis during pregnancy and post
      partum. At day 0 as well as at day 14 of experimental gingivitis the mean
      periodontal pocket bleeding index (PPBI) was higher during pregnancy than post
      partum, whereas the amount of plaque that accumulated was similar. The number of
      CD1 positive cells (mainly Langerhans) in the oral epithelium was found to be
      higher during pregnancy. In the sulcular epithelium, however, the number of these
      cells tended to decrease during pregnancy as compared to post-partum. The number
      of CD4 positive cells in oral and sulcular epithelium was increased during
      pregnancy (P < 0.05). It was speculated that this increase in the number of CD4
      positive cells is confined to the Th-1 subset, since the number of CD14 positive
      cells (mainly macrophages and granulocytes) together with the number of B cells
      was found to be decreased during pregnancy. Th-1 cells are known to be cytotoxic
      against these HLA class II antigen bearing cells. Consequently, cytotoxicity
      directed against B cells and macrophages may result in diminished
      immunoresponsiveness in pregnancy gingivitis.

PMID- 8463945
TI  - Clinical furcation diagnoses and interradicular bone defects.
AB  - The purpose of the present study was to assess associations between clinical
      depth of involved furcations and their bony defect depth. Twelve patients with
      moderate to advanced periodontitis in molars were recruited for clinical
      evaluation of furcation involvement by 6 dentists. Two groups of 3 dentists were
      assigned to the right or left half of the dentition. All dentists assessed the
      clinical depth of involvement of the furcations using the Ramfjord index (2 mm)
      in patients 1 through 6, and using the Hamp index (3 mm) in patients 7 through
      12. Diagnoses were made with calibrated and uncalibrated Nabers 2 probes. After
      the clinical assessments the patients received full mouth scaling and root
      planing. After reevaluation the molars were surgically exposed. During surgery
      the depth of the bony furcation defects was assessed using horizontal probing and
      impressions. Clinically assessed depth of furcation involvement was then compared
      with the surgical measurements. A total of 1,180 clinical furcation diagnoses
      were available, of which 426 could be surgically evaluated using both the
      straight probe and the impressions. These evaluations were done in a total of 72
      furcations using probe and impressions. For the Ramfjord index, 5% of the
      clinical degree 1, 40% of the degree 2, and 43% of the degree 3 readings were
      overestimations. For the Hamp index, 7% of degree 1, 24% of degree 2, and 0% of
      degree 3 readings were overestimations. These clinical diagnoses were
      overestimations. Forty-three percent of surgical degree 3 involvements were not
      recognized when using the Ramfjord index, and 27% when using the Hamp Index.
      These results suggest that furcation diagnosis is of limited validity.

PMID- 8463946
TI  - Efficacy of 5 machining instruments in scaling of molar furcations.
AB  - The scaling efficacy of machining instruments was studied in the furcations of
      100 extracted molars. The molars were divided into 5 groups with similar
      furcation anatomy, painted with artificial calculus, partly submerged in stone
      blocks, and the furcation entrances covered with a heavy rubber dam material. Ten
      mandibular and 10 maxillary molars were scaled by an experienced operator with
      each of the following instruments/inserts: ultrasonic instrument with either a
      prototype ball point insert or with a new pointed insert; ultrasonic instrument
      with a ball point insert; reciprocating hand-piece with new inserts for
      furcations; and a sonic scaler with a universal insert. The molar groups were
      coded and graded in a stereomicroscope by 2 independent examiners, and the
      rankings were tested with the Kruskal-Wallis test and the multiple comparisons
      between treatments test. The results revealed statistically significant
      differences between the instruments, as well as between different topographical
      areas of the furcations. The sonic scaler with a universal insert and the
      ultrasonic instrument with ball point inserts were significantly more efficient
      (P < 0.05) than the reciprocating handpiece with inserts in most of the areas
      studied. For mandibular molars, significantly better results (P < 0.05) were
      obtained for lingual furcation entrances than for furcation roofs. For maxillary
      molars, significantly better results (P < 0.05) were obtained for distal and
      buccal entrance areas than for furcation roofs and inside of mesial roots. The
      present study may give some guidance to the practitioner in choosing machining
      instruments for furcation cleaning as well as identifying the most difficult
      topographical areas to instrument.

PMID- 8463947
TI  - Effects of dilantin on monocytic growth factors.

PMID- 8463948
TI  - Re: Temperature differences at periodontal sites in health and disease.

PMID- 8463949
TI  - Re: Tooth morphology following root resection procedures in maxillary first
      molars.

PMID- 8463950
TI  - Motivational similarity and interpersonal evaluations: the role of ambiguity,
      self-derogation, and emotion.
AB  - The present study tests two hypotheses which are based on a motivational threat
      model of interpersonal evaluation: (a) Dominance- and dependency-oriented
      perceivers evaluate motivationally similar others less favorably only when
      evaluation pertains to an ambiguous attribute and perceivers score high on self
      derogation; and (b) the relatively unfavorable evaluation of the similar target
      person is mediated by an arousal process. Males observed a working dyad in which
      one man was dominant and the other dependent, but both were ambiguous on
      sociability. Throughout the observation, subjects' emotion-related skin
      conductance responses were monitored. Subjects then evaluated the target person
      they expected to meet and recalled information. Results supported the first
      hypothesis, but were only partially consistent with the second hypothesis. In
      addition, dominance-oriented perceivers produced more assertiveness constructs
      than dependency-oriented perceivers in free recall. The findings suggest that the
      threat model should be revised to include the moderating factors of attribute
      ambiguity and attitude toward the self, and perhaps also an additional mediating
      process: generalization of attitude toward the self to motivationally similar
      others.

PMID- 8463951
TI  - Self-awareness, task failure, and disinhibition: how attentional focus affects
      eating.
AB  - Dieting and nondieting subjects were given either failure or neutral performance
      feedback on a problem-solving task. Failure subjects were then assigned to one of
      three self-awareness conditions: One group was forced to watch a video clip of
      themselves failing on the problem-solving task, one group was asked to watch a
      distracting video clip on bighorn sheep, and the final group was asked to sit
      quietly for 10 minutes. Subjects were then allowed to eat as much ice cream as
      they wanted. Only in those conditions which allowed--or promoted--low self
      awareness (the failure/distraction and simple failure condition) did dieters show
      disinhibited eating. In the failure/videotape condition, which enforced high
      levels of self-awareness, eating in dieters remained inhibited. This supports the
      proposal that a reduction in self-awareness is necessary for lifting of
      inhibitions. Eating in nondieters was reduced in the failure/videotape and simple
      failure conditions, possibly because of the autonomic correlates of distress.

PMID- 8463952
TI  - Being and feeling unique: statistical deviance and psychological marginality.
AB  - Two studies tested the hypothesis that people with culturally stigmatized and
      concealable conditions (e.g., gays, epileptics, juvenile delinquents, and incest
      victims) would be more likely to feel unique than people with culturally valued
      or conspicuous conditions (e.g., the physically attractive, the intellectually
      gifted, the obese, and the facially scarred). In Study 1, culturally stigmatized
      individuals with concealable conditions were least likely to perceive consensus
      between their personal preferences and those of others. In Study 2, they were
      most likely to describe themselves as unique and to make these self-relevant
      decisions quickly. Marginality is a psychological reality, not just a statistical
      one, for those with stigmatized and concealable "master status" conditions.

PMID- 8463953
TI  - [Tumor necrosis factor and AIDS].
AB  - Human immunodeficiency virus (HIV), an etiologic agent of AIDS, belongs to
      lentivirus subfamily of retroviruses. In striking contrast to oncoviruses HIV
      does not transform cells but instead causes chronic progressive diseases. This
      feature is demonstrable in vitro by dramatic cytopathic effects upon virus/cell
      coculture. Since virus-producing cells are generally destroyed, HIV must be
      transmitted to other cells after replication in order to maintain the infection.
      However, after viral infection, AIDS requires a long period of time before
      becoming full-brown. The virus appears to establish latent infection and stay
      dormant in many cells until activation signals have been received. We found that
      tumor necrosis factor can activate such latent HIV and selectively kill HIV
      infected cells. The mechanism of cell death was recently cleared as Apoptosis.

PMID- 8463954
TI  - [Chemical modification of nucleic acids and the mutagenicity of modified bases,
      with special reference to permanganate- and bisulfite-mediated modifications].
AB  - Methods for modifying nucleic acids and their components with permanganate and
      with bisulfite are reviewed, with emphasis on work developed by the author's
      group of investigators. N(4)Aminocytidine, a nucleoside analog obtainable on
      bisulfite-hydrazine modification of cytidine, is a potent mutagen, and the
      mechanism of its action in the mutagenesis is discussed.

PMID- 8463955
TI  - [Synthesis of thiazolo[3,2-a]pyridine derivatives and their reactions].
AB  - By the reaction of 2-benzoylmethyl-4-methylthiazole (6) with polarized olefins
      (3, 4) in the presence of base (K2CO3 or NaH), the corresponding thiazolo[3,2
      a]pyridine derivatives (7, 8) were obtained. Methylsulfinylthiazolopyridine
      derivative (11) obtained by the reaction of 8b with m-chloroperbenzoic acid
      (MCPBA), easily underwent nucleophilic substitution to give the corresponding
      substituted compounds (10, 12).

PMID- 8463956
TI  - [Studies on as-triazine derivatives. XIX. Synthesis of 2,3-diarylpyrazine 2,3
      diarylpyridine derivatives as blood platelet aggregation inhibitors].
AB  - 4,5-Diphenyl-2-ethoxypyrimidine (1), 3,4-diphenyl-6-ethoxypyridazine (2) and 2,3
      diphenyl-5-ethoxypyrazine (3) were evaluated for inhibitory activity towards
      arachidonic acid-induced aggregation of rabbit blood platelet in vitro. 2,3
      Diphenyl-5-ethoxypyrazine (3) exhibited significant inhibitory activity. Thus,
      various 5-substituted 2,3-bis(4-methoxyphenyl)pyrazines were synthesized by the
      nucleophilic substitution reaction of 5-chloro-2,3-bis(4-methoxyphenyl)pyrazine
      (9). In a similar manner, substituted 2,3-bis(4-methoxyphenyl)pyridines were
      prepared from 2,3-bis(4-methoxyphenyl)-6-methylsulfonylpyridine (17), which was
      synthesized by the cycloaddition retro Diels-Alder reaction of 5,6-bis(4
      methoxyphenyl)-3-methylsulfonyl-1,2,4-triazine (16) with norbornadiene. Among the
      compounds prepared, 6-isopropoxy-2,3-bis(4-methoxyphenyl)-pyrazine (10f) showed
      the most potent inhibitory activity, which was more than the activity of
      anitrazafen[5,6-bis(4-methoxyphenyl)-3-methyl-1,2,4-triazine.

PMID- 8463958
TI  - [Comparative studies on concentration of berberine in plasma after oral
      administration of coptidis rhizoma extract, its cultured cells extract, and
      combined use of these extracts and glycyrrhizae radix extract in rats].
AB  - The present study was carried out to evaluate the bioequivalence between Coptidis
      Rhizoma and the cultured cells of Coptis japonica Makino var. dissecta Nakai to
      compare the concentration of berberine in the rat plasma after oral
      administration of both aqueous extracts. The concentration of berberine in the
      plasma after oral administration of both extracts was determined by HPLC. It was
      found that the values of time required for the maximum concentration (Tmax), the
      maximum concentration (Cmax) and the area under the plasma-time curve (AUC24h) of
      berberine in the rat plasma after oral administration of both extracts were about
      the same. It was also found that the values of Tmax, Cmax and AUC24h of berberine
      after oral administration of both extracts and an aqueous extract of Glycyrrhizae
      Radix were about the same as that of individual administration of both extracts.
      From these results, to evaluate the bioequivalence between Coptidis Rhizoma and
      cultured cells, it is important that the values of Tmax, Cmax and AUC24h of
      berberine after oral administration of both extracts are not different, and about
      the same values of berberine by the combined use of both extracts and the aqueous
      extract of other crude drugs are required.

PMID- 8463957
TI  - [A new lupin alkaloid, (-)-leontalbinine N-oxide, in Sophora flavescens var.
      angustifolia seeds and its synthesis by biomimetic transformation from (+)
      matrine N-oxide].
AB  - The possibility of the biomimetic transformation of (+)-matrine N-oxide, a main
      alkaloid in Sophora flavescens var. angustifolia, under various oxidative
      conditions was examined by the use of several metallic ions. When (+)-matrine N
      oxide was warmed with FeSO4, or Fe(COOH)2 in MeOH-H2O at 40 degrees C, (-)-7, 11
      didehydromatrine [(-)-leontalbinine], a minor alkaloid in the same plant, was
      obtained along with (+)-matrine. This selective formation of (-)-leontalbinine
      seems to be specific to the reaction of (+)-matrine N-oxide with ferrous
      reagents. In addition, the structure of the newly isolated minor lupin alkaloid
      from the seeds of S. flavescens. was determined as (-)-leontalbinine N-oxide from
      its spectral comparison with the authentic sample.

PMID- 8463959
TI  - [An oxidation enzyme for hydrogen sulfide from Hyphomicrobium neptunium
      ATCC15444].
AB  - We described in our previous paper that the cell-free extract from Hyphomicrobium
      neptunium ATCC 15444 oxidized hydrogen sulfide to sulfur. We tried to purify the
      enzyme used for this oxidation to determine the molecular nature of this enzyme.
      The 40% ammonium sulfate precipitate from the supernatant of cell sonicate of H.
      neptunium was chromatographed on a column of Phenyl Sepharose CL-4B and its
      active fractions were collected. These fractions were further purified through
      Superose 12 and then TSK gel G3000SW column chromatographies. A protein of
      molecular weight about 54,000 and isoelectric point pI 6.8 was isolated. However,
      this final protein was found to reduce its activity to less than one-tenth of
      those of ammonium sulfate precipitate and of the fraction from Phenyl Sepharose
      CL-4B column chromatography. This might be caused either by the loss of accessory
      component or by its requirement of low molecular factors necessary for its
      activation at the stage of gel filtration. The neutral isoelectric point of this
      enzyme could be suitable as the function of H. neptunium because its final
      product was S0, and it grows at neutral pH. In contrast, the final oxidative
      product of hydrogen sulfide by Thiobascillus is sulfuric acid, and they grow at
      acidic pH.

PMID- 8463960
TI  - [Cyclosporine disposition in living related donor partial liver transplant
      recipients].
AB  - We studied the disposition of cyclosporine (CyA) in 8 living related donor
      partial liver transplant recipients (patient A-H). CyA blood levels were
      determined by fluorescence polarization immunoassay with specific monoclonal
      antibody (m-FPIA) and fluorescence polarization immunoassay with non-specific
      polyclonal antibody (p-FPIA). The ratio of the blood levels of CyA determined by
      p-FPIA to those by m-FPIA varied significantly, because the levels determined by
      p-FPIA were influenced by the function of graft liver. Thus, the levels of CyA
      determined by p-FPIA could not be used for the adjustment of CyA dose. The CyA
      dose ratios [DR; CyA blood level (mg/l)/dose (mg/kg)] of 3 in 8 patients were
      relatively large in 1-4 d after the transplant operation, however, it decreased
      within 2-5 d after the operation. CyA DR gradually increased from 5-8 d after the
      transplantation, and it reached to a maximum in 10-13 d in 5 patients to whom CyA
      was administered intravenously over 12 d after transplantation. The average ratio
      of DR in oral administration to that in intravenous one was about 43%. CyA
      bioavailability in the patient of living related partial liver transplantation
      was as usual as that in other organ transplant patient except for cadaveric liver
      transplant patients. The average DR of intravenous CyA administration in liver
      transplant recipients was 1.5 times larger than that in bone marrow transplant
      patients. CyA disposition had large inter-individual and intra-individual
      variation, and CyA blood level and DR varied in clinical time course at least
      within 1.5 month after operation. Therefore, it is necessary to measure CyA blood
      level frequently and to adjust CyA dose.

PMID- 8463961
TI  - [Brainstem neural mechanisms of sleep and wakefulness].

PMID- 8463962
TI  - Effect of adhesive metal primers on bonding a prosthetic composite resin to
      metals.
AB  - The effect of three adhesive metal primers on the shear bond strength of a light
      cured prosthetic composite resin bonded to cobalt-chromium or silver-palladium
      copper-gold casting alloy was evaluated. The adhesive metal primers used were New
      Metacolor opaque bonding liner, Cesead opaque primer, and 0.5% VBATDT in acetone.
      A newly prepared light-cured opaque resin was used to bond a light-cured
      veneering resin to dental alloys. The specimens were thermocycled in water for up
      to 20,000 cycles between 4 degrees C and 60 degrees C, and shear bond strengths
      were recorded. The light-cured composite resin bonded most strongly to Co-Cr
      alloy primed with Cesead primer and to Ag-Pd-Cu-Au alloy with the VBATDT primer.
      These adhesive metal primers may be clinically acceptable for bonding a light
      cured prosthetic composite resin to base or precious metal.

PMID- 8463963
TI  - Removable partial denture framework try-in.
AB  - Removable partial denture frameworks must fit accurately to function properly and
      not cause injury to remaining teeth or soft tissue. This article presents a
      logical method and rationale for seating a removable partial denture framework
      and a review of several disclosing media used in the try-in procedure.

PMID- 8463964
TI  - Radiographic and metallographic evaluation of porosity defects and grain
      structure of cast chromium cobalt removable partial dentures.
AB  - A study was undertaken to determine the defects in the internal microstructure of
      clasps of cast chromium cobalt removable partial denture frameworks. Ninety cast
      frameworks were radiographically evaluated for porosity with an industrial
      radiographic machine. The grain structure of the clasps was analyzed with an
      optical photomicroscope before and after various heat treatments. The
      radiographic study showed a large number of internal defects in various parts of
      removable partial denture frameworks. The grain structure study revealed
      microporosities randomly distributed within the matrix. Various heat treatments
      were performed and resulted in no change in the grain structure of the original
      castings.

PMID- 8463965
TI  - Tensile bond strength of maxillofacial adhesives.
AB  - A common technique for fixation of facial prostheses is the use of skin
      adhesives. The present study compared the tensile bond strength of five RTV
      silicone elastomers used with four different skin adhesives to human skin. The
      elastomers were: Silskin II, MDX4-4210, Cosmesil, Cosmesil HC2, and RS 330 T-RTV.
      The adhesives were: Dow Corning 355 medical adhesive, PSA 1, Daro, and 9874 3M
      double-coated medical tape. The RTV silicones were cured as described by the
      manufacturer, fixed in circular metal holders, and glued to the skin (inner
      aspect of forearm) with the various adhesives. The specimens were pulled off 20
      seconds after fixation by use of a universal testing machine with a crosshead
      speed of 1 mm/minute. Eight specimens of each silicone and adhesive combination
      were tested, and a mean bond strength was calculated for each combination and
      compared by Duncan's multiple range test on a personal computer. Significant
      differences were observed among the various combinations of silicones and
      adhesives. Dow Corning 355 adhesive showed the highest bond strength with all
      materials, and the medical tape had the lowest. Differences between the RTV
      silicones were also significant. The strongest bond with all adhesives was MDX4
      4210 elastomer and the weakest for RS 330 T-RTV elastomer.

PMID- 8463966
TI  - Orbital prosthesis with a magnetically retained ocular component supported by
      osseointegrated implants.
AB  - Positioning of the ocular component within an orbital prosthesis must simulate
      conversational gaze. Using osseointegrated implants and an associated
      superstructure, a fixed reference point can be established for positioning an
      ocular prosthesis. This method can simplify the laboratory procedure and obviate
      the need for ocular component repositioning in replacement prostheses. This
      article describes the fabrication of an orbital prosthesis with a magnetically
      retained ocular section supported by osseointegrated implants.

PMID- 8463967
TI  - CT scan as a radiologic data base for optimum implant orientation.
AB  - There are many factors directly related to the longevity of implant
      osseointegration. Overload has been considered an etiologic factor in implant
      failure after a prosthesis has been constructed. Optimum implant orientation can
      be aided by the three-dimensional radiographic data base provided by a CT scan.
      The reformatted sectional images, when related to each other, facilitate a
      thorough visualization of the bone topography, sinus and nerve location, and bone
      density. The fundamentals of the CT imaging and the interrelationship of the
      cross-sectional, panoramic, and three-dimensional reformatted images are
      described.

PMID- 8463968
TI  - Edentulous implants: overdenture versus fixed.
AB  - Implant restorations for edentulous patients may be planned as either fixed
      restorations or removable overdentures. Several factors should be considered when
      deciding between these treatment alternatives. They may be grouped into factors
      related to (1) the entire patient, (2) both arches, (3) maxillary restorations,
      and (4) mandibular restorations.

PMID- 8463969
TI  - Titanium alloy cylinders in implant framework fabrication: a study of the
      cylinder-alloy interface.
AB  - Titanium alloy has been proposed as a suitable alternative to noble metal alloys
      in premanufactured metal cylinders for fabricating implant prosthesis frameworks.
      The interfaces produced by standard lost wax procedures that use titanium and
      conventional noble metal implant cylinders with both high-fusing (high-palladium)
      and low-fusing (high-gold) noble metal casting alloys were compared. Elemental
      analysis by scanning electron microscopy and energy-dispersive spectroscopy
      (SEM/EDS) of the two titanium cylinders revealed that one commercial product had
      a composition similar to that for commercially pure titanium and the other had a
      composition consistent with that for Ti-6Al-4V alloy. The SEM observations and
      complementary elemental line scans indicated that the interfaces between the
      titanium cylinders and the two noble metal casting alloys did not meet proposed
      criteria for acceptable metal-to-metal unions. The interfaces between the noble
      metal cylinders and noble metal casting alloys did exhibit acceptable unions. The
      SEM observations and elemental analyses were supported by push-shear test results
      that showed that the resistance to failure was appreciably greater for interface
      specimens produced with alloy cast to noble metal cylinders compared with
      titanium cylinders.

PMID- 8463970
TI  - Adhesive abutment cylinder luting.
AB  - The connection between dental implants must be passive so that stress is not
      introduced between bone, implant, and prosthesis. To achieve this passivity
      clinically is difficult if not impossible with current procedures. A technique is
      presented in which premachined titanium abutment cylinders are clinically luted
      to a cast framework to create a stress-free connection. Possible advantages and
      disadvantages are discussed.

PMID- 8463971
TI  - Dental factors associated with temporomandibular joint sounds.
AB  - Dental factors commonly associated with signs and symptoms of temporomandibular
      disorders were investigated in a group of nonpatients. A highly sensitive
      technique was used to establish the presence of temporomandibular joint (TMJ)
      sounds. In a discriminant analysis nonworking side interferences, attrition,
      molar contacts, horizontal range of jaw movement, and morphologic occlusion
      contributed significantly to the prediction of sounds. Further study of
      morphologic aspects of the joint and stress-related parafunctions may contribute
      to the understanding of the development of TMJ sounds. We concluded that TMJ
      sounds are a fairly common sign associated with mild deviations in certain
      morphologic and functional aspects of the stomatognathic system.

PMID- 8463972
TI  - Biocompatibility: its future in prosthodontic research.
AB  - The future of prosthodontic research will involve replacing lost tissues by using
      scientific methods that evaluate biomaterials and treatment designs based on
      desired biologic outcomes. The present concept of a biocompatible material is one
      that elicits an appropriate host response in a specific application. To design
      optimal biomaterials, three interactive components should be considered: the
      chemical nature of the surface, the mediating pellicle layer, and microbial and
      host response. Surface chemistry determines which molecules are selectively
      absorbed onto a surface from oral fluids. The pellicle-coated surface should be
      designed to elicit a more desirable host response. Pellicle composition can be
      altered by chemically changing the surface, precoating surfaces with biological
      molecules, or using synthetic materials designed to mimic natural tissues.
      Several surface-sensitive techniques are available to assess these modifications,
      including vibrational spectroscopy, electron microscopy for chemical analysis,
      and bioanalytical methods. To develop more biocompatible materials, a further
      understanding of pellicle formation as a function of surface composition,
      microbial adhesion to biomaterials, and cellular reaction to implant biomaterials
      is necessary. This knowledge will facilitate development of new biologically
      based rationales for treatment modalities in restorative dentistry.

PMID- 8463973
TI  - Measurement of composite resin filler particles by using scanning electron
      microscopy and digital imaging.
AB  - Composite resins are routinely classified on the basis of filler particle size
      for purposes of research, clinical applications, and communications. The size and
      characterizations of filler particles have also been considered a significant
      factor in the rate of wear of composites. Making valid correlations between the
      filler particles within a composite and wear requires accuracy of filler particle
      size and characterization. This study was initiated to examine two methods that
      would (1) qualify the filler particle content of a composite resin and (2)
      quantify the number, size, and the area occupied by the filler particles in
      composite resins. Three composite resins, BIS-FIL I, Visio-Fil, and Ful-Fil, were
      selected as the materials to be examined, on the basis of their published
      composite classification type as fine particle. The findings demonstrated that
      scientific methods are available to examine qualitatively and measure
      quantitatively the composite resin filler particles in terms of their numbers,
      sizes, and area occupied by use of a scanning electron microscope and digital
      imaging. Significant differences in the filler particle numbers, sizes, and the
      area occupied were found for the three composite resins in this study that were
      classified as fine particle.

PMID- 8463975
TI  - Cytotoxicity of impression materials.
AB  - The purpose of this study was to assess the potential cytotoxicity of impression
      materials. The impression material brands tested included Impregum, Reprosil,
      Surgident, Permlastic, Jeltrate Regular and Jeltrate Fast Set. These impression
      materials and their components were tested for their possible cytotoxic effects
      by three different methods. The results showed that all impression materials were
      cytotoxic to some degree by all three assay methods and some of the components
      were also cytotoxic. These results support the literature showing in vivo adverse
      effects of certain impression materials and/or their components in patients and
      practitioners.

PMID- 8463974
TI  - Wear of ceramic inlays, their enamel antagonists, and luting cements.
AB  - The wear of ceramic inlay materials and antagonist enamel cups was measured in
      vitro. Per group, six MOD inlays were adhesively cemented in extracted molars.
      Castable glass ceramic, pressed glass ceramic, and feldspathic porcelain were
      used as inlay materials. A microfilled and a fine hybrid composite served as
      luting agents. The restorations were exposed to an in vitro wear test that
      corresponds to approximately 5 years of clinical service. The wear in the
      occlusal contact area was quantified during and at the end of the test with a
      three-dimensional scanner. Final wear measurements on the inlays (mean +/- SD)
      ranged from 21.8 +/- 8.8 microns for pressed glass ceramic to 59.0 +/- 37.9
      microns for castable glass ceramic. The mean wear of the enamel antagonists
      ranged from 74.6 +/- 32.9 microns for pressed glass ceramic to 153.2 +/- 61.5
      microns for feldspathic porcelain. The wear of the luting composites at the end
      of the test ranged from 4.9 +/- 5.1 microns for microfilled to 12.3 +/- 6.3
      microns for fine hybrid.

PMID- 8463976
TI  - In-office fabrication of a claspless interim partial denture.
AB  - This article describes a technique for making a claspless interim removable
      partial denture that can quickly and easily be made in the dental office. The
      unnecessary undercuts are eliminated by use of a block-out putty without the need
      for duplication of the cast. The prosthesis can be inserted with minimum
      adjustments.

PMID- 8463977
TI  - Modification of angulated abutments to avoid unesthetic display of metal.
AB  - A procedure is described whereby the facial margin of angulated abutments are
      repositioned to avoid unesthetic display of metal in the anterior maxilla. The
      procedure is not difficult and can make a considerable difference in the
      patient's acceptance of the restoration.

PMID- 8463978
TI  - A .22 caliber die holding device.

PMID- 8463979
TI  - Shim stock placement for contact evaluation.

PMID- 8463980
TI  - Removal of partially or fully polymerized resin from porcelain veneers.

PMID- 8463981
TI  - Removal of resin-bonded fixed partial dentures.

PMID- 8463982
TI  - Use of the University of Barcelona gauge in the design of direct retainers.

PMID- 8463983
TI  - Spray-on technique for autopolymerizing acrylic resin.

PMID- 8463984
TI  - Simplified technique of recording edentulous jaw relationship.

PMID- 8463985
TI  - The retentive and stress distributing properties of split threaded endodontic
      dowels.

PMID- 8463986
TI  - Psychological disturbances and an exaggerated response to pain in patients with
      whiplash injury.
AB  - Psychological state, response to pain and style of interpreting everyday
      experiences were measured in 32 patients who had suffered a whiplash injury 1-84
      months before the study. For comparison, measures were also obtained in 15
      general practice attenders. Ratings of depression and anxiety were greater in
      patients than in controls, and patients reported more cold-induced pain during a
      cold pressor test. Within the patient sample, anxious subjects gave the highest
      ratings of cold-induced pain. Those with the longest history of pain gave the
      highest ratings of whiplash injury pain, and were most depressed. Most of these
      patients were involved in litigation. The findings demonstrate that, like most
      patients with chronic pain, whiplash injury sufferers are anxious and depressed.
      Their psychological distress could be aggravated by litigation. Behavioural
      assessment and treatment of chronic pain syndromes such as whiplash injury could
      benefit from early evaluation of the patient's psychological state, and response
      to standard painful stimuli.

PMID- 8463987
TI  - A psychological profile of endometriosis patients in comparison to patients with
      pelvic pain of other origins.
AB  - In order to investigate the possibility of a specific psychological profile
      associated with endometriosis, 81 women with pelvic pain were studied, of whom 40
      were diagnosed as having endometriosis and 41 other gynaecological problems. Each
      patient completed six standardized psychometric tests to assess personality,
      psychopathology, marital state and pain. Endometriosis patients obtained higher
      psychoticism, introversion and anxiety scores in comparison to the other pain
      patients, although the two groups did not differ on pain ratings. Both groups
      obtained neuroticism, anxiety and psychiatric morbidity scores which were
      elevated relative to normative data. The possibility that there are certain
      psychological characteristics which make some women vulnerable to endometriosis
      is discussed.

PMID- 8463988
TI  - The prediction of somatic complaints using the Autonomic Nervous System Response
      Inventory (ANSRI) and the Daily Stress Inventory (DSI).
AB  - Understanding and prediction of veridical somatic complaints not caused by
      disease, dysfunction, trauma, or toxin, requires the assessment of at least two
      critical variables: predisposition to respond to stressors with peripheral
      physiological activation; and intensity/frequency/duration of stressors. The
      Autonomic Nervous System Response Inventory (ANSRI) and the Daily Stress
      Inventory (DSI) were used to assess these variables, and somatic complaints were
      recorded using the Wahler Physical Symptoms Inventory (WPSI). Subjects were 72
      healthy undergraduates who completed the inventories and reported illness and
      medication usage over a 2 week period. Regression analyses showed that ANSRI,
      DSI, illness, and medication accounted for 35% of the variance in somatic
      complaints, though only ANSRI and DSI contributed significantly. Neuroticism
      (Eysenck Personality Questionnaire) did not add to R2, but did influence
      stressors' subjective impact. The correlation between regression equation
      generated WPSI scores (derivation sample) and actual WPSI scores (holdout sample)
      was 0.59. A discriminant function analysis equation (derivation sample) applied
      to the holdout sample correctly classified 80% of the upper and lower third WPSI
      subjects. It was concluded that the ANSRI and DSI, and the variables they assess,
      are substantially related to the self-report of somatic complaints.

PMID- 8463989
TI  - The effects of aerobic exercise on premenstrual symptoms in middle-aged women: a
      preliminary study.
AB  - The effects of aerobic exercise and strength training on premenstrual symptoms
      were evaluated in 23 healthy premenopausal women. Premenstrual symptoms were
      assessed at baseline and following 3 months of exercise participation. Women who
      engaged in aerobic exercise significantly increased their aerobic capacity, while
      the women who participated in non-aerobic exercise did not. Results showed that
      while participation in both exercise conditions was associated with general
      improvement in many premenstrual symptoms, subjects in the aerobic exercise group
      improved on more symptoms, especially premenstrual depression.

PMID- 8463990
TI  - Discrimination between psychogenic and organic erectile dysfunction.
AB  - The aim of this study was to develop a screening test based on the Leiden
      Impotence Questionnaire (LIQ) in order to assist in the difficult process of
      differentiating between psychogenic and organic erectile dysfunction (ED). The
      main sample consisted of 176 patients with ED, which was classified according to
      the results of the urological and psychiatric assessment as either organic, in
      109 (62%) patients, or psychogenic, in 67 (38%) patients. A logistic regression
      model including six general items from the LIQ correctly identified psychogenic
      ED in 62% of the cases, and organic ED in 86%, with an overall correct
      classification rate of 76%. Adding information regarding sexual intercourse and
      the relationship in patients who had a partner and were having sexual intercourse
      the correct classification rates were: psychogenic 77%, organic 94%, and overall
      87%. Discrimination between psychogenic and organic ED is improved when more
      information concerning sexual activity can be assessed.

PMID- 8463991
TI  - Development of a fatigue scale.
AB  - A self-rating scale was developed to measure the severity of fatigue. Two-hundred
      and seventy-four new registrations on a general practice list completed a 14-item
      fatigue scale. In addition, 100 consecutive attenders to a general practice
      completed the fatigue scale and the fatigue item of the revised Clinical
      Interview Schedule (CIS-R). These were compared by the application of Relative
      Operating Characteristic (ROC) analysis. Tests of internal consistency and
      principal components analyses were performed on both sets of data. The scale was
      found to be both reliable and valid. There was a high degree of internal
      consistency, and the principal components analysis supported the notion of a two
      factor solution (physical and mental fatigue). The validation coefficients for
      the fatigue scale, using an arbitrary cut off score of 3/4 and the item on the
      CIS-R were: sensitivity 75.5 and specificity 74.5.

PMID- 8463992
TI  - Restless sleep, illness intrusiveness, and depressive symptoms in three chronic
      illness conditions: rheumatoid arthritis, end-stage renal disease, and multiple
      sclerosis.
AB  - Restless sleep was compared across 110 out-patients with rheumatoid arthritis
      (RA), 101 with end-stage renal disease (ESRD), 94 with multiple sclerosis (MS),
      and an unselected control group of 176 individuals attending their family
      practitioners (FP). It was also investigated in the three chronic illness groups
      as a contributor to illness intrusiveness--the extent to which one's illness
      and/or its treatment interfere with continued involvements in valued activities
      and interests--a determinant of depression and emotional distress in chronic
      conditions. Reported frequencies of restless sleep were highest in RA, lower in
      ESRD, and lowest in MS; FP patients reported frequencies that were similar,
      overall, to those observed in MS. These differences were evident among
      nondepressed, (chi 2 9, N = 309, p < 0.0001), but not depressed, individuals. The
      occurrence of restless sleep correlated significantly with increased illness
      intrusiveness, r (279) = 0.31, p < 0.001, in RA, ESRD, and MS. Results supported
      the hypothesis that the relation between restless sleep and emotional distress is
      mediated by illness intrusiveness. Treatment of restless sleep may offer the
      added benefit of diminishing illness intrusiveness and may, thereby, enhance
      quality of life in chronic physical illness.

PMID- 8463993
TI  - Psychosocial factors associated with the early termination of breast-feeding.
AB  - The relation between a number of psychosocial factors and the early termination
      of breast-feeding was examined in two large independent samples of puerperal
      women. The findings were remarkably similar. In both cohorts there was a
      significant association with depressive disorder which in the great majority
      preceded the cessation of breast-feeding. Other factors of importance were low
      social class, being young and lower educational attainment.

PMID- 8463994
TI  - The impact of oral contraceptives on the experience of perimenstrual mood,
      clumsiness, food craving and other symptoms.
AB  - Two-hundred and seventy-six oral contraceptive (o.c.) users (171 combine o.c. and
      105 triphasic o.c.) were compared with 276 non-o.c. users. All women regarded
      themselves as PMS sufferers, and the groups were matched for age, parity and
      marital status. Each woman rated severity of 27 symptoms during the premenstrual,
      menstrual and postmenstrual phases of their last menstrual cycle. The o.c. users
      reported significantly less menstrual pain and premenstrual breast tenderness.
      When controlling for the severity of premenstrual depression, there were no
      differences between the three groups in the timing or severity of perimenstrual
      food craving or clumsiness. When controlling for the severity of menstrual pain,
      the o.c. users showed significantly less improvement in negative mood during the
      menstrual phase, compared with non-users. The apparent tendency for o.c. users to
      show either a delayed or more prolonged pattern of perimenstrual negative mood
      deserves further study.

PMID- 8463995
TI  - Adult physical illness and childhood sexual abuse.
AB  - Recent interest has centred on the possible long-term physical effects of child
      sexual abuse. Research is now beginning to be carried out in this area. Some
      studies are portraying associations that are difficult to substantiate, as the
      methodological problems are considerable. This article attempts to summarize the
      literature to date and set some contexts for possible future research directions.

PMID- 8463996
TI  - Errors introduced in radioligand binding studies due to displaceable, cation
      dependent, [3H]prazosin binding to glass-fibre filters and glass surfaces.
AB  - [3H]prazosin not only specifically and homogeneously labels alpha 1
      adrenoceptors, but also binds to glass surfaces and non-linearly to the glass
      fibre filters, commonly used in radioligand binding experiments. Binding to
      filters can be modulated by unlabeled alpha-adrenergic compounds and cations. If
      no correction is applied for displaceable filter binding, analysis of
      [3H]prazosin binding experiments leads to erroneous results. Analysis of
      [3H]prazosin saturation experiments on guinea-pig cerebral cortex membranes with
      correction for filter binding before the non-linear fit procedure indicated that
      [3H]prazosin labels a homogeneous population of alpha 1-adrenoceptors (Rtot: 8.33
      fmol.mg-1 wet tissue) with a dissociation constant of 1.28 x 10(-10) M. However,
      analysis of the same data after correction for non-specific binding, (determined
      in parallel experiments by adding 10 microM phentolamine to the incubation
      medium) resulted in a best fit to a model in which [3H]prazosin labels two alpha
      1-adrenoceptor subpopulations (R1: 15.0 fmol.mg-1 and R2: 14.6 fmol.mg-1 wet
      tissue) with dissociation constants of respectively 1.78 x 10(-10) and 5.63 x 10(
      9) M. The discrepancy between the two methods of analysis is due to displacement
      of the radioligand from the filters by phentolamine. Prazosin and oxymetazoline
      are also able to displace filter-bound [3H]prazosin. The extent to which
      displaceable filter binding distorts the proper results depends on the actual
      magnitude of the error and also on the method of analysis.

PMID- 8463997
TI  - Characterization of [3H]SK&F 108566 as a radioligand for angiotensin type-1
      receptor.
AB  - Rat aortic smooth muscle cells were used as a model system to characterize the
      binding properties of [3H]SK&F 108566, an angiotensin type-1 (AT1) receptor
      antagonist. The binding was specific, saturable and reversible. The association
      and dissociation rates of [3H]SK&F 108566 binding to smooth muscle cells were
      monophasic and Scatchard analysis of equilibrium binding data yielded a linear
      plot indicating a homogenous population of binding sites. The maximum binding
      (Bmax) and apparent dissociation constant (Kd) were 22,000 +/- 6000 sites/cell
      and 0.83 +/- 0.08nM respectively. The pharmacological specificity of [3H]SK&F
      108566 binding to smooth muscle cells is consistent with that observed for AT1
      and confirms AT1 receptor specificity of this radioligand. High affinity binding
      was observed in membranes prepared from bovine adrenal cortex, rat liver and rat
      kidney glomeruli. COS cells transfected with cDNA encoding human AT1 angiotensin
      II receptors also displayed high affinity binding site for [3H]SK&F 108566. No
      specific binding could be detected on membranes prepared from bovine cerebellum,
      a tissue rich in the angiotensin type-2 (AT2) receptor. These observations
      indicate that [3H]SK&F 108566 binds to sites which have pharmacological
      characteristics of angiotensin II AT1 subtype receptors and can be used as a
      subtype-selective radioligand to characterize AII receptors in various systems.

PMID- 8463998
TI  - Myasthenia gravis: effect on antibody binding of conservative substitutions of
      amino acid residues forming the main immunogenic region of the nicotinic
      acetylcholine receptor.
AB  - In Myasthenia Gravis most anti-acetylcholine receptor (AChR) antibodies are
      against a highly conserved area of the AChR alpha-subunit called the Main
      Immunogenic Region (MIR). Amino acid residues critical for MIR formation have
      been located within the sequence alpha 67-76. In the present study, binding of
      anti-AChR monoclonal antibodies (mAbs) to synthetic peptide analogues of the
      sequence alpha 67-76 of human and Torpedo AChRs containing conservative single
      residue substitutions identified the amino acid residues most important to the
      antigenicity of the MIR sequence, and offered clues to its tridimensional
      structure. Conservative substitutions of residues Asn68 and Asp71 greatly
      diminished mAb binding, identifying them as critical contact residues for anti
      MIR mAbs. Substitutions at Asp70 and Tyr72 moderately affected binding. Cross
      reactive mAbs originally raised against Electrophorus AChR bound single residue
      substituted synthetic peptides in a manner consistent with the possibility that
      Electrophorus AChR may have a glutamic acid residue at position alpha 70 or alpha
      71. Substitutions at residues Asp/Ala70 and Val/Ile70 between human and Torpedo
      alpha-subunits may be size-compensating, suggesting these amino acids in the
      native AChR may be in closer proximity than proposed in previous models of the
      MIR.

PMID- 8463999
TI  - Stability of the sperm plasma membrane of hibernating bats (Myotis velifer)
      compared with other mammals.
AB  - Previous experiments have established that the long-lived spermatozoa of
      hibernating bats are resistant to the acrosome reaction and fertilization in
      vitro conventional techniques. We tested the hypothesis that the membranes of
      these spermatozoa are more resistant to perturbation than those of other mammals.
      We exposed them to non-specific bilayer destabilizing agents and abrupt changes
      in incubation temperature and tested their response by observing their status
      (motility and viability) after a time interval compared with other mammals
      (golden hamster, rabbit, human). The results did not support the hypothesis. The
      inherent longevity of bat spermatozoa may thus be a function of some component
      other than unique resilience of their plasma membrane.

PMID- 8464000
TI  - Protein content of rabbit embryos: one cell to peri-implantation blastocyst.
AB  - The protein content of rabbit embryos during the first 7 days of development in
      vivo was determined. The protein content of intact embryos, embryonic cells
      (intact embryos without mucin coats for developmental stages up to 96 h post
      coitum and free of blastocyst coverings for later stages) and blastocyst
      coverings were determined by the Pierce Micro BCA assay. The mean protein content
      of intact one-cell or two-cell embryos was 0.16 micrograms and increased at the
      four- to six-cell stage with no further increase until the late morula/early
      blastocyst stages (days 3 to 4). There was a 53-fold increase in protein from the
      early to late blastocyst stages. The protein content of embryonic cells was
      stable at a mean value of 0.16 micrograms until the late morula stage (day 3) and
      then increased to a mean of 6.85 micrograms on day 6 and 50.38 micrograms on day
      7. The increase in protein content of intact embryos up to about 72 h appeared to
      be due solely to an increase in the protein content of the mucin coat. The
      protein content of the blastocyst coverings increased from a mean of 2 micrograms
      on day 5 to a mean of 35 micrograms on day 7. For blastocyst stages, the total
      protein content of intact blastocysts and of embryonic cells was correlated with
      the surface area of the embryos (r2 = 0.895 and 0.873, respectively) and, thus,
      an increase in blastocyst size is a true index of blastocyst development.

PMID- 8464001
TI  - Control of testicular vasomotion by testosterone and tubular factors in rats.
AB  - Testicular vasomotion (rhythmical variations in testicular blood flow) was
      studied in adult rats using laser Doppler flowmetry. Vasomotion was not present
      in testes in which the Leydig cells had been destroyed, but it could be induced
      by a low dose of testosterone. Transposition of a scrotal testis into the
      abdominal cavity inhibited vasomotion and this was apparently not caused by
      Leydig cell malfunction. Depletion of specific germ cells (by unilateral X
      irradiation induced killing of spermatogonia and maturation depletion of germ
      cells) did not abolish vasomotion in the testis. It is suggested that testicular
      vasomotion is influenced by testosterone and by factors from Sertoli cells.

PMID- 8464002
TI  - Active immunization of ewes against prostaglandin F2 alpha to control ovarian
      function.
AB  - The hypothesis that pregnancy success could be improved in early postpartum ewes
      by prolonging the lifespan of the corpus luteum via active immunization against
      prostaglandin F2 alpha (PGF2 alpha) was tested. Further experiments in ewes
      immunized against PGF2 alpha investigated the effects of exogenous PGF2 alpha on
      the preovulatory follicle and the effects of PGF2 alpha and oestradiol benzoate
      on corpus luteum function. Four weeks pre-partum, 39 ewes bred to lamb during
      seasonal anoestrus received either 5 mg PGF2 alpha-ovalbumin conjugate (n = 20;
      immunized) or ovalbumin (n = 19; control) in Freund's complete adjuvant.
      Treatments were repeated on day 5 post-partum with reagents emulsified in
      Freund's incomplete adjuvant. On day 17 post-partum, ewes received 500 iu
      pregnant mares' serum gonadotrophin (PMSG) and 48 h later 50 micrograms
      gonadotrophin-releasing hormone (GnRH). Laparoscopy was performed 36 h after GnRH
      to assess ovarian activity and ewes with recent ovulations were inseminated into
      the uterus. No immunized ewes had ovulated, but ten had follicles that luteinized
      and secreted progesterone during the 8 weeks studied. Eighteen of 19 control ewes
      ovulated and 15 of 18 had increased progesterone concentration for at least 21
      days. By day 70 post partum, progesterone had returned to basal values in all
      control ewes. In a second study, 24 immunized ewes bearing persistent corpora
      lutea, and for which the interval from the previous parturition was greater than
      90 days, received 15 mg PGF2 alpha and 500 iu PMSG followed 48 h later by 50
      micrograms GnRH. PGF2 alpha induced corpus luteum regression in all
      ewes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464003
TI  - Changes in pituitary secretion during the early postnatal period and anovulatory
      syndrome induced by neonatal oestrogen or androgen in rats.
AB  - The following experiments were performed: (i) concentrations of follicle
      stimulating hormone (FSH), luteinizing hormone (LH) and prolactin in plasma were
      measured at 2, 5, 8, 10 and 15 days in female Wistar rats treated on the first
      day of life with 100 micrograms oestradiol benzoate or vehicle; (ii) females
      injected on day 1 with 100 micrograms of oestradiol benzoate or 1 mg of
      testosterone propionate and from day 1 to day 10 or 15 with FSH and LH were
      killed on day 90; (iii) females injected from day 1 to day 10 or 15 with
      prolactin or vehicle were killed on day 90; (iv) females injected on day 1 with
      oestradiol benzoate and from day 1 to day 15 with a luteinizing-hormone-releasing
      hormone (LHRH) agonist were killed on day 90; (v) groups of females injected on
      days 1, 4, 7, 10, 13 and 16 with an LHRH antagonist were killed on day 90. Onset
      of puberty, vaginal cycles, organ weights and hormonal plasma concentrations were
      measured. Females treated on the first day of life with 100 micrograms oestradiol
      showed inhibition of gonadotrophin secretion and stimulation of prolactin
      secretion during the neonatal period. Females injected on the first day of life
      with oestradiol benzoate or testosterone propionate showed, in adulthood,
      anovulation, ovarian atrophy, reduced FSH plasma concentrations, increased
      prolactin plasma concentrations and reduced pituitary prolactin content.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8464004
TI  - Role of the extracellular Ca2+ on the intracellular Ca2+ changes in fertilized
      and activated mouse oocytes.
AB  - Changes in intracellular calcium concentration ([Ca2+]i) in fertilized mouse
      oocytes were measured using the calcium-sensitive dye, fura-2. After
      fertilization, an initial long-lasting [Ca2+]i increase was followed by a
      periodic [Ca2+]i increase. The periodic increase in [Ca2+]i persisted for 1 to 3
      h and all fertilized oocytes extruded the second polar body within 4 h. The mean
      interval of periodic [Ca2+]i increase was 470 +/- 180 s (mean +/- SD). The
      frequency of the periodic [Ca2+]i increase depended on the extracellular calcium
      concentration. Verapamil and nifedipine inhibited the periodic [Ca2+]i increase.
      Sixty-five per cent of tested cells extruded the second polar body within 90 min
      of exposure to 7% ethanol. In these activated oocytes, the long-lasting [Ca2+]i
      increase was observed. However, no cells showed a repetitive increase in [Ca2+]i.
      Both release of calcium from intracellular stores and influx of extracellular
      calcium contribute to the increase in [Ca2+]i induced by ethanol. We conclude
      that the extrusion of the second polar body requires an increase in [Ca2+]i above
      a certain threshold level and the mobilization of calcium of both the
      intracellular and extracellular space in mouse oocytes.

PMID- 8464005
TI  - Tdy-negative XY, XXY and XYY female mice: breeding data and synaptonemal complex
      analysis.
AB  - In this paper we have compared the breeding performance of Tdy-negative XY, XXY
      and XYY females to assess the relative importance of the lack of a second X
      chromosome compared with the presence of a Y chromosome, in reducing fertility.
      The XY females were of poor fertility, although five of twelve produced at least
      one offspring. The XXY females had larger, more frequent litters, and a longer
      reproductive lifespan, implicating the lack of a second X as the major cause of
      the poor fertility of XY females. Nevertheless, XYY females appeared to be more
      seriously affected than the XY females, suggesting that the presence of the Y may
      be a contributory factor. Pachytene analysis demonstrated that the Y is a very
      inefficient pairing partner for the X during female meiosis. In XY females only
      11% of pachytene cells had the X and Y paired; in XXY females the two X
      chromosomes paired and the Y was almost always a univalent, while in XYY females
      the X paired with a Y in only 15% of pachytene cells. The presence of unpaired
      sex chromosomes has previously been implicated as a cause of oocyte loss during
      pachytene, and the proportion of cells with unsynapsed sex chromosomes decreased
      as pachytene proceeded, suggesting that they were progressively eliminated.
      Significantly, protection against elimination was afforded not only by synapsis
      between sex chromosomes, but also by self-synapsis if a sex chromosome remained
      as a univalent. It is concluded that sex chromosome univalence leading to
      pachytene oocyte failure is responsible for the postnatal oocyte deficiency seen
      in XY females. A separate study has shown that XXY females have a similar level
      of oocyte deficiency. It is suggested that the presence of a second X chromosome
      improves the fertility of XXY females, compared with XY females, by improving
      oocyte quality and by eliminating the production of lethal XY and OY zygotes. The
      genotype frequencies for the offspring of XY and XYY females differed from those
      predicted from the pachytene data. The XY females showed a marked deficiency of
      XO offspring compared with XXY and XYY aneuploid offspring, whereas the XXY
      females had fewer than expected XXY and XYY aneuploid offspring.

PMID- 8464006
TI  - Stimulation of release of beta-endorphin and oxytocin by prostaglandin F2 alpha
      in cattle at parturition.
AB  - Concentrations of beta-endorphin and oxytocin were measured in plasma of cows
      before, during and after parturition. The effect of the PGF2 alpha analogue
      cloprostenol on beta-endorphin and oxytocin release was investigated. During
      parturition, there were marked, parallel increases in beta-endorphin and oxytocin
      concentrations. Both hormones were released in an episodic manner in conjunction
      with uterine and abdominal contractions. It is therefore likely that factors
      stimulating oxytocin release also enhance beta-endorphin secretion. This suggests
      a role of labour or labour-associated hormones in stimulating peripheral beta
      endorphin release. Cloprostenol caused an immediate, pronounced increase in
      plasma beta-endorphin and oxytocin concentrations.

PMID- 8464007
TI  - Effects of progesterone and anti-progesterone RU486 on ovarian 3 beta
      hydroxysteroid dehydrogenase activity during ovulation in the gonadotrophin
      primed immature rat.
AB  - The effects of progesterone and RU486, a synthetic anti-progesterone, on ovarian
      3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) activity, a key enzyme of
      progesterone production, were studied during ovulation in immature 22-day-old
      rats primed with pregnant mares' serum gonadotrophin (PMSG) and human chorionic
      gonadotrophin (hCG). Ovarian 3 beta-HSD activities had increased significantly 4
      h after hCG injection. These increases were inhibited at 4 and 6 h after hCG when
      20 mg RU486 kg-1 was administered 2 h before hCG. However, RU486 had no influence
      on the activity of 3 beta-HSD when administered at the same time as hCG
      injection. A histochemical study revealed that 3 beta-HSD activities in the
      granulosa cell layer, but not in the theca cell layer, were inhibited when RU486
      was given 2 h before hCG. Serum progesterone concentrations, but not oestradiol
      concentrations, were significantly suppressed by RU486 treatment 4 and 6 h after
      hCG. The effect of progesterone on ovarian 3 beta-HSD activity was tested by
      administering graded doses of progesterone exogenously to rats 2 h before hCG
      injection. Ovarian 3 beta-HSD activity was increased in a dose-dependent manner,
      and more than 20 mg progesterone kg-1 significantly stimulated the activity.
      Although 10 mg progesterone kg-1 did not stimulate ovarian 3 beta-HSD activities,
      the RU486-inhibited activities were recovered by the concomitant administration
      of 10 mg progesterone kg-1 with RU486. These results indicate that ovarian 3 beta
      HSD activity depends on progesterone concentrations, and suggest an autocrine
      regulation of progesterone production during ovulation in immature rat ovaries
      stimulated with PMSG and hCG.

PMID- 8464008
TI  - Inhibition of the acrosome reaction by trypsin inhibitors and prevention of
      penetration of spermatozoa through the human zona pellucida.
AB  - In this study we evaluated the effect of several trypsin inhibitors (p
      aminobenzamidine: pAB; N-alpha-p-tosyl-L-lysine-chloromethyl-ketone: TLCK and p
      nitrophenyl-p'-guanidino-benzoate: NPGM) on sperm binding and penetration of the
      human zona pellucida. Motile spermatozoa, selected by a two-step Percoll
      gradient, were incubated at 1 x 10(7) cells ml-1 at 37 degrees C and in 5% CO2
      for 4.5 h. This was followed by the addition of 1 mmol pAB l-1 or phosphate
      buffered saline (control) for 30 min. Three to four non-viable human oocytes were
      then added to each sperm suspension and incubated for 3 h. The numbers of
      spermatozoa bound to the human zona pellucida and in the perivitelline space were
      determined by phase contrast microscopy. The results showed that pAB
      significantly inhibited zona penetration by spermatozoa (56 +/- 8% oocytes
      penetrated, control versus 0 +/- 0% oocytes penetrated, pAB, mean +/- SEM),
      without modifying spermatozoa-zona pellucida binding. The inhibition of zona
      penetration was due to a block of the acrosome reaction normally induced by the
      human zona pellucida. In separate experiments, sperm suspensions pretreated with
      1 mmol pAB l-1 or 10 mumol NPGB l-1 exhibited a marked decrease in the percentage
      of acrosome reactions on the zona surface (85 +/- 4% and 76 +/- 3% inhibition,
      respectively). In addition, the inhibitors prevented the acrosome reaction
      induced by human follicular fluid (percentage of acrosome-reacted spermatozoa:
      control 8 +/- 2; follicular fluid 25 +/- 3; pAB 6 +/- 2; NPGB 8 +/- 1; TLCK 12 +/
      2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464009
TI  - Hormonal control of proteins synthesized and secreted by guinea-pig endometrium.
AB  - The amounts of protein synthesized and secreted (as indicated by [3H]leucine
      incorporation) by guinea-pig endometrium cultured for 24 h increased 2.1-fold
      between days 7 and 15 of the oestrous cycle. This increase did not occur if the
      guinea-pigs were pregnant. In ovariectomized guinea-pigs, oestradiol acting on a
      progesterone-primed uterus was the optimum stimulus for the maximum increase in
      endometrial protein synthesis and secretion. The two main proteins synthesized
      and secreted by day-15 guinea-pig endometrium had molecular masses of 99.8 and
      192.1 kDa as determined on Sephacryl S-200HR. The production of the 99.8 kDa
      protein increased 5.2-fold between days 7 and 15 of the cycle. The 192.1 kDa
      protein was not detected in secretions produced by day 7 endometrium, and the
      99.8 and 192.1 kDa proteins were not detected in secretions produced by day-15
      pregnant endometrium. In ovariectomized guinea-pigs, progesterone did not
      stimulate the synthesis of secreted proteins of molecular masses above 77 kDa.
      Oestradiol stimulated the synthesis of secreted proteins with molecular masses of
      87.8 and 192.1 kDa. However, oestradiol acting on a progesterone-primed uterus
      stimulated the synthesis of the secreted proteins with molecular masses of 99.8
      and 192.1 kDa, which indicates that this combination of steroid hormones may be
      responsible for the increase in production of these two proteins by the day-15,
      nonpregnant guinea-pig endometrium. This stimulation by ovarian steroids of the
      synthesis and secretion of the 99.8 and 192.1 kDa proteins by the guinea-pig
      endometrium is apparently inhibited during early pregnancy.

PMID- 8464010
TI  - Ultrastructural changes of oocyte and follicular wall during oocyte maturation in
      the Japanese quail (Coturnix coturnix japonica).
AB  - This study examined structural changes in oocyte and follicular wall during
      oocyte maturation in Japanese quails. The structures of the germinal disc and the
      surrounding follicular wall were observed by light and electron microscopy 25, 6
      and 1 h before the expected time of ovulation. The germinal disc of the oocyte
      was located near the oocyte plasma membrane at 25 h before ovulation, and the
      germinal vesicle was located in the centre of the germinal disc. Numerous
      cytoplasmic elements, such as elongated membrane-bound vesicles, mitochondria and
      glycogen granules were also observed in the germinal disc. The surface of the
      oocyte made close contact with the cytoplasmic processes of the granulosa cells.
      Six hours before ovulation, fluid filled spaces formed between the oocyte and
      follicular wall. At 6 h before ovulation, the germinal disc was similar to that
      at 25 h before ovulation, whereas the oocyte and the granulosa cells were
      disconnected. Myelin bodies and dense bodies developed in the cytoplasmic
      processes of the granulosa cells, suggesting that lysosomal enzymes were
      activated. In the follicle at 1 h before ovulation, the second maturation spindle
      was located just beneath the surface of the oocyte, and the first polar body was
      in the perivitelline space. In the germinal disc, the membrane-bound vesicles
      were swollen and well developed. We suggest that, during the process of early
      oocyte maturation, the junctions between the oocyte and granulosa cells are
      disconnected, and factors that promote oocyte maturation may be activated in the
      germinal disc since the membrane-bound vesicles are developed.

PMID- 8464011
TI  - Regulation of dominant follicle turnover during the oestrous cycle in cows.
AB  - The effect of progestin and luteinizing hormone (LH) pulse frequency on dynamics
      of dominant follicle growth during the first follicular wave after oestrus was
      examined in non-lactating Holstein cows by ultrasonography. On day 8 of the
      cycle, cows (n = 8) received a luteolytic dose of prostaglandin F2 alpha (PGF2
      alpha; 25 mg) and an ear implant of Norgestomet (6 mg). On day 18, cows were
      assigned to a crossover design in which the implants were retained (T1) or
      replaced with a new implant (T2). All implants were removed on day 23. After
      oestrus, cows underwent a normal intervening oestrus cycle. On day 8 of the third
      cycle, T1 and T2 were reversed among cows. Ultrasonography and blood sampling
      were performed on alternate days throughout the experiment. On days 10 and 19 of
      the third cycle, blood was sampled every 15 min for 8 h in concert with an
      additional control group (n = 3) sampled on day 10 of the cycle. Progesterone
      concentration on day 8 before PGF2 alpha was 6.5 +/- 0.5 ng ml-1. Dominance of
      the first wave dominant follicle was extended beyond day 18 in 15 of 16 cows for
      T1 and T2 periods. The original dominant follicle ovulated in five of eight T1
      and none of eight T2 periods (P < 0.01). New dominant follicles were detected on
      day 24 +/- 1 in T1 (n = 3) and on day 20.6 +/- 1 in T2 (n = 8; P < 0.01)
      cows.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464012
TI  - Endocrine profiles and follicular development in early-weaned postpartum beef
      cows.
AB  - This study investigated whether treatment with progestagen, which improves
      fertility after early weaning in postpartum cows, altered concentrations of
      gonadotrophins or development and function of follicles. Patterns of luteinizing
      hormone (LH), oestradiol and follicle-stimulating hormone (FSH) and of follicular
      growth before first postpartum ovulation were compared in two experiments. At 17
      to 25 days post partum, suckled anoestrous beef cows received an ear-implant
      containing 6 mg progestagen (norgestomet) for 9 days or served as untreated
      controls. Calves were weaned from all cows 7 days after initiation of treatment.
      Cows were observed for oestrous behaviour twice a day until 10 days after
      weaning. As expected, the proportion of anoestrous cows that formed a corpus
      luteum with a normal lifespan was greater (P < 0.01) in cows treated with
      norgestomet (Expt 1, 17 of 24; Expt 2, 18 of 22) than in control cows (Expt 1, 2
      of 16; Expt 2, 3 of 18). In general, patterns of secretion of LH and oestradiol
      and of final growth of the preovulatory follicle did not differ between control
      and norgestomet-treated cows. However, there was a transient rise in FSH in
      association with weaning in control cows that did not occur in norgestomet
      treated cows. In addition, mean LH increased more rapidly and mean oestradiol was
      higher during the 3 days immediately before the preovulatory surge of LH in the
      norgestomet-treated cows (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464013
TI  - Potential synergism between platelet-activating factor and alpha 1-recombinant
      interferon in promoting luteal maintenance in cyclic ewes.
AB  - In sheep, the presence of an embryo in utero on the 12th to 13th day after
      oestrus prevents luteolysis. These studies investigated whether platelet
      activating factor (PAF) could exert an antiluteolytic function, either alone or
      in combination with interferon. The intrauterine administration of 250 micrograms
      PAF per horn per day, administered through indwelling cannulae into the uterus as
      injections twice a day (n = 12) or by continuous infusion (n = 4) failed to
      extend luteal function compared with controls (n = 8). When indwelling cannulae
      were used to administer (i) 125 micrograms PAF per uterine horn, as a bolus
      infusion twice a day (n = 5), (ii) continuous infusion of 500 micrograms bovine
      recombinant alpha 1-interferon each day (brIFN, n = 5), (iii) 125 micrograms PAF
      per horn twice a day, plus 500 micrograms brIFN per day (n = 8), or (iv) vehicle
      (n = 5), the luteal phase was significantly longer in co-infused (iii) than in
      control (iv) animals. These findings indicate that pharmacological doses of PAF
      may act synergistically with interferons to prevent luteolysis.

PMID- 8464014
TI  - Active immunization of heifers against a synthetic fragment of bovine inhibin.
AB  - Two experiments were conducted in cyclic beef heifers to determine whether active
      immunization against bovine inhibin alpha 1-26 Gly-Tyr (bINH) affected follicular
      dynamics, hormone concentration or ovulation rate. In Expt 1, heifers (n = 9)
      were actively immunized against bINH conjugated to human alpha globulins (HAG)
      using bis-diazotized benzidine in non-ulcerative Freund's adjuvant (NUFA; primary
      on day 0; booster injections on days 53, 84 and 116 using conjugated bINH and on
      days 176 and 366 using unconjugated bINH; ten heifers were used as controls).
      Ovaries were examined daily using ultrasound scanning (days 70-155 and 384-391)
      and corresponding blood samples were collected for bINH antibody titre,
      luteinizing hormone (LH), follicle-stimulating hormone (FSH) and oestradiol
      determinations. Four treated and four control heifers were injected with 10
      micrograms gonadotrophin-releasing hormone (GnRH) on day 386 (day 2 of the
      oestrous cycle). Although bINH-immunized heifers had variable antibody titres
      ranging from 4 to 50% I125-labelled bINH bound to serum diluted 1:2000, ovulation
      rate was unaffected. In oestrous cycles with three dominant follicles, the
      ovulatory follicles grew faster (2.5 +/- 0.2 versus 1.6 +/- 0.3 mm day-1; mean +/
      SEM), had shorter durations of growth (5.7 +/- 0.8 versus 9.6 +/- 1.6 days) and
      duration of detection (7.5 +/- 0.8 versus 12.0 +/- 2.4 days) in immunized
      heifers. Mean concentrations of FSH, LH and oestradiol were unaltered in most
      cases during oestrous cycles in bINH-immunized compared with control heifers.
      There was no significant difference in the percentage increase in FSH or LH,
      after GnRH injection, between control and immunized heifers. As ovulation rate
      was unaltered in the first experiment, a second similar study was designed using
      a different immunization protocol. In Expt 2, heifers were immunized with bINH
      conjugated to human serum albumin using glutaraldehyde with the following doses:
      0.0 (control; n = 7), 0.33 (n = 7), 1.0 (n = 8) and 3.0 (n = 7) mg. Three booster
      immunizations were given 33, 66 and 209 days after primary immunization.
      Immunization increased the number of oestrous cycles with multiple ovulations (42
      of 132 (32%) oestrous cycles examined) compared with controls (1 of 30 (3.3%)
      oestrous cycles examined). Neither titre nor ovulation rate was affected by dose
      of bINH used. In summary, following bINH immunization, ovulation rate was not
      increased despite changes in follicular dynamics in Expt 1, but was increased in
      32% of oestrous cycles in Expt 2.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8464015
TI  - Effect of prenatal and postnatal photoperiod on spermatogenic development in the
      Djungarian hamster (Phodopus sungorus sungorus).
AB  - The effect of the pre- and postnatal daylength on the start of spermatogenesis
      and further testicular development from day 4 up to day 127 was investigated in
      Djungarian hamsters. Hamsters were either gestated under long (16 h light:8 h
      dark) photoperiod and reared under long or short (4 h light:20 h dark)
      photoperiod after birth (L/L and L/S hamsters, respectively), or gestated under
      short photoperiod and transferred to long photoperiod after birth (S/L hamsters).
      In L/L and L/S hamsters, spermatogenesis started between day 4 and day 5 (day of
      birth = day 1), when the first gonocytes entered the S-phase. A, Intermediate and
      B spermatogonia were first observed on days 6, 8 and 9, respectively. The
      proliferation pattern of gonocytes and Sertoli cells, studied between day 4 and
      day 9, did not differ between L/L and L/S hamsters. Hence, the duration of the
      postnatal photoperiod had no effect on the start of spermatogenesis. The first
      effect of postnatal photoperiod on spermatogenic development was observed on day
      15, when testis weights and tubular diameters were reduced in L/S animals. From
      day 22 onwards, spermatogenesis was arrested mainly at the mid-pachytene stage,
      no tubular lumen was formed, and the number of preleptotene spermatocytes was
      reduced. The ultimate number of Sertoli cells per testis was not affected by
      postnatal short photoperiod. The duration of the prenatal photoperiod had a clear
      effect on spermatogenesis after birth. In S/L hamsters, the number of gonocytes
      per tubular cross-section was reduced on day 4 and 4.5. Gonocyte proliferation
      was reduced on day 5 and spermatogenesis started one day later. Consequently, A
      and Intermediate spermatogonia appeared on day 7 and 9, respectively. Sertoli
      cell proliferation was also shifted to later ages, but the ultimate number of
      Sertoli cells did not differ from L/L or L/S hamsters. From day 29 onwards, the
      number of preleptotene spermatocytes was increased in S/L hamsters, indicating
      that the Sertoli cells in these animals could support more germinal cells. In
      conclusion, a short postnatal photoperiod does not affect spermatogenesis before
      day 15 after birth, when further testicular development becomes arrested. A short
      prenatal photoperiod delays the start of spermatogenesis by one day, alters the
      proliferation pattern of Sertoli cells, and from day 29 onwards, enables the
      Sertoli cells to support more germinal cells. The duration of the pre- and
      postnatal photoperiod did not affect the ultimate number of Sertoli cells.

PMID- 8464016
TI  - Attenuation of antepartum relaxin surge and induction of parturition by
      antiprogesterone RU 486 in sheep.
AB  - Pregnant ewes were injected with either the antiprogesterone, RU 486 (4 mg kg-1
      body weight, i.m.; n = 5), 3000 iu relaxin (i.m.; n = 9), or diluent (n = 8) at
      12:00 h on days 144 and 145, to determine its effect on progesterone and relaxin
      secretion, and on induction of lambing. RU 486 induced earlier lambing (P < 0.01)
      compared with diluent treatment, but relaxin treatment did not significantly
      reduce the interval to parturition. Mean injection-lambing intervals were 31 +/-
      2, 109 +/- 23 and 121 +/- 27 h for the RU 486, relaxin and diluent groups,
      respectively. There was no incidence of difficult birth (dystocia); all lambs
      were vigorous at birth; and placenta delivery was rapid (within 207 min) with RU
      486 and relaxin treatments compared with diluent treated controls. Plasma
      progesterone concentrations averaged 11 ng ml-1 during the pretreatment period
      for all animals. RU 486 had a biphasic effect on progesterone concentrations,
      causing an initial increase (P < 0.05) within 2 h, and then an abrupt drop (P <
      0.01) to 6 ng ml-1 by 18:00 h on day 145. Progesterone concentrations remained
      consistently lower (P < 0.05) in relaxin-treated ewes than in diluent-treated
      controls from days 144 to 147 and then began a steady decrease to 4 ng ml-1 on
      the day of parturition (days 149 and 150) in both groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8464017
TI  - The effect of recombinant bovine somatotrophin on ovarian follicular growth and
      development in heifers.
AB  - The effects of recombinant bovine somatotrophin (BST) on the dynamics of ovarian
      follicular growth and development and peripheral insulin concentrations were
      investigated. Initially, studies were carried out in a population of Hereford x
      Friesian heifers to validate the ultrasound technique. In the first experiment,
      12 heifers were injected daily with either 25 mg BST or vehicle for two oestrous
      cycles, and the effects on follicular dynamics and peripheral insulin were
      determined. In a second experiment, 12 heifers were given a single injection of
      10 ml saline or 320 mg BST in a sustained-release formulation to examine the
      temporal relationships between growth hormone (GH), insulin-like growth factor-1
      (IGF-1), insulin and the number of follicles. The validation studies demonstrated
      that small follicles (< 5 mm in diameter) could be clearly detected by real-time
      ultrasound, and that 75% (9 of 12) of heifers showed three waves of dominant
      follicle development during the oestrous cycle, whereas the remainder had only
      two waves. The changes in the numbers of follicles of the three size categories
      (< 5 mm, small; 5-10 mm, medium-sized and > 10 mm, large) also displayed a wave
      pattern similar to that of the dominant follicle, with a marked reduction in the
      number of subordinate follicles as the dominant follicle grew and reached its
      maximum size. In Expt 1, BST treatment increased the number of small follicles
      and caused a rise in peripheral insulin concentrations (P < 0.01) throughout the
      treatment period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464018
TI  - Effect of immunization against synthetic peptide sequences of bovine inhibin
      alpha-subunit on ovulation rate and twin-calving rate in heifers.
AB  - Three peptide sequences from the bovine inhibin alpha-subunit (P1: 18-30; P2: 63
      72 and P3: 107-122) were synthesized and conjugated to human serum albumin (HSA).
      Hereford cross-heifers (n = 5 per group) were injected with 3 mg of one of the
      peptide conjugates, followed by three booster injections at intervals of 11
      weeks. Control heifers (n = 5) were injected with HSA only. Antibodies
      recognizing both the individual peptides and 32 kDa bovine inhibin were generated
      and ovulation rate was increased in peptide immunized heifers. In group P1, 1 of
      5 heifers responded with an increased ovulation rate whereas in groups P2 and P3,
      5 of 5 and 4 of 5 heifers, respectively, had an increased ovulation rate. In
      group P2, in the first oestrous cycle following booster injections 2 and 3, 4 of
      5 and 3 of 5 heifers, respectively, responded with twin ovulations, whereas a
      fourth heifer had three ovulations following booster injection 3. After breeding
      following booster injection 3, 3 of 5 heifers in group P2 and 1 of 5 in group P3
      gave birth to twin calves. This study demonstrates the potential of immunizing
      against synthetic peptide sequences of the alpha-subunit of bovine inhibin to
      increase ovulation and twinning rates in cattle.

PMID- 8464019
TI  - Comparison of follicular heterogeneity and ovarian characteristics in Meishan and
      large-white hybrid pigs.
AB  - Comparisons were made between characteristics of pre-ovulatory follicles
      recovered from prolific Chinese Meishan gilts (n = 12) and from European Large
      White hybrid gilts (n = 13) in the late follicular phase preceding their fifth
      oestrous cycle, to determine whether there is an ovarian basis for the enhanced
      prolificacy in the Meishan. A total of 177 follicles per breed was classified as
      pre-ovulatory, based on follicular fluid oestradiol concentrations. Results
      obtained demonstrated high variability in all follicular characteristics in both
      breeds and no decrease in heterogeneity was evident in the Meishan. The Meishan
      follicles tended to be smaller (P < 0.06) and had less follicular fluid (P <
      0.005), but total oestradiol content per follicle was similar (P < 0.1) with the
      result that the concentration of oestradiol in follicular fluid tended to be
      higher (P < 0.06) in Meishan than Large-White hybrid pigs. There were no
      differences between breeds in terms of testosterone concentrations in follicular
      fluid, hCG binding to granulosa cells or total DNA content of granulosa cells.
      Concentrations of inhibin in follicular fluid were similar in both breeds (P >
      0.1) which resulted in a trend towards less total inhibin content in Meishan than
      Large-White hybrid follicles (P = 0.065). Corpora lutea were recovered from both
      breeds (n = 12 per breed) on days 27-31 of pregnancy after mating at first,
      second and third oestrus:corpora lutea were smaller (P < 0.001) and contained
      less progesterone per corpus luteum in the Meishan (P < 0.05) than in Large White
      hybrid pigs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464020
TI  - Activity of gonadotrophin surge-attenuating factor during the luteal phase in
      superovulated women.
AB  - Gonadotrophin surge-attenuating factor (GnSAF) is a putative nonsteroidal ovarian
      factor that attenuates the luteinizing hormone (LH) surge in superovulated women.
      GnSAF bioactivity was studied during the luteal phase by investigating six
      normally ovulating women in two cycles--a spontaneous and a follicle-stimulating
      hormone (FSH)-treated cycle. In both cycles, the pituitary response to an acute
      intravenous injection (10 micrograms) of luteinizing-hormone-releasing hormone
      (LHRH) was investigated in late follicular (follicle size 16 mm), early luteal
      (day 5 after human chorionic gonadotrophin, hCG), midluteal (day 9 after hCG) and
      late luteal phase (day 12 or 13 after hCG). FSH was injected daily at the dose of
      225 iu on cycle days 2, 3 and 4, and 150 iu thereafter. The increase in LH and
      FSH (mean +/- SEM) 30 min after LHRH in the spontaneous cycles decreased
      significantly from early to late luteal phase and remained unchanged in the FSH
      treated cycles. Increases in LH and FSH 30 min after LHRH were significantly
      attenuated in the FSH-treated compared with the spontaneous cycles in late
      follicular and luteal phases. Serum oestradiol and progesterone concentrations
      were significantly higher in the FSH than in the spontaneous cycles only in
      early, but not in mid- and late luteal phase. The pattern of serum oestradiol and
      progesterone changes during the luteal phase did not correlate with the increases
      in LH and FSH 30 min after hCG both in the spontaneous and the FSH cycles. These
      results suggest that GnSAF bioactivity is high during the luteal phase of
      superovulated cycles.

PMID- 8464021
TI  - Effect of indomethacin administered during the normal time of implantation on the
      progesterone and protein composition of plasma and uterine flushings of rabbits.
AB  - The present experiment was designed to investigate the mode of action of
      indomethacin, a prostaglandin synthesis inhibitor, as an antifertility agent, and
      to examine a possible effect of indomethacin administered during the normal peri
      implantation period on the protein content and progesterone concentration in
      plasma and uterine fluid in pseudopregnant rabbits. The results showed that
      treatment with indomethacin significantly reduced the plasma progesterone
      concentrations, decreased progesterone concentrations in uterine flushing,
      significantly decreased the total plasma proteins, and particularly decreased
      albumin in the plasma and in the uterine flushings. Uteroglobin production by the
      rabbit uterus was not affected by this treatment. It is concluded that the
      antifertility effect of indomethacin at the time of implantation is exerted by
      reducing progesterone concentrations in plasma and uterine fluid, possibly
      affecting steroidogenesis, and by reducing the percentage of albumin in plasma
      and in uterine fluid, probably by increasing renal excretion of albumin. These
      effects of indomethacin provide an environment within the uterus that would not
      support embryo implantation and development.

PMID- 8464022
TI  - Sensory cues and the suppression of reproduction in subordinate female marmoset
      monkeys, Callithrix jacchus.
AB  - Subordinate female marmoset monkeys remain anovulatory and have low plasma
      concentrations of luteinizing hormone (LH) when maintained with their dominant
      females. Olfactory cues from the dominant female have been implicated in
      maintaining this reproductive suppression. Subordinate females that received
      either ablation of the vomeronasal organ (an accessory olfactory organ; n = 3),
      ablation of the main olfactory epithelium (n = 4), or both lesions (n = 5) did
      not ovulate in the following 7 weeks while housed with their dominant female.
      Plasma LH concentrations following either or both lesions were similar to pre
      lesion concentrations. Olfactory lesions (verified by histological and
      behavioural trials) did not impair reproductive activity, as olfactory-lesioned
      dominant females underwent ovarian cycles of similar duration to intact dominant
      females. Lesioned subordinate females (n = 6), maintained in visual-only contact
      with their dominant female and group ovulated 29.1 +/- 9.3 days (mean +/- SEM)
      after physical separation from their dominant females; this first onset of
      ovulation was significantly delayed (P < 0.05) compared with intact subordinate
      females completely isolated from their dominant females and group (10.8 +/- 1.3
      days, n = 8). Behavioural and visual cues together with olfaction all appear to
      play important roles in maintaining the suppression of ovulation in subordinate
      female marmoset monkeys.

PMID- 8464023
TI  - Testosterone response to a gonadotrophin-releasing hormone agonist in Hawaiian
      monk seals (Monachus schauinslandi).
AB  - Adult male Hawaiian monk seals were administered a gonadotrophin-releasing
      hormone (GnRH) agonist to determine its effectiveness in reducing the testicular
      production of testosterone. Blood samples were collected from four treated seals
      and two control seals at weekly intervals for 10 weeks and again at the beginning
      of the following breeding season. The GnRH-agonist had an initial, brief,
      stimulating effect on circulating testosterone, but this was followed by an
      inhibitory effect that lasted for 7 to 8 weeks. The plasma concentrations of
      testosterone were within normal ranges by the following spring. These results
      demonstrate a reversible form of long-term androgen suppression, which may have
      applicability in a variety of wildlife management programmes.

PMID- 8464024
TI  - Use of an oestrogen, androgen or gestagen as a potential chemosterilant for
      control of rat and mouse populations.
AB  - Three synthetic steroids were evaluated as potential chemosterilants for rodent
      control. Ethinyl oestradiol, methyl testosterone or Org 5933, a synthetic
      gestagen, were incorporated into paraffin blocks containing cereal grains and
      offered to laboratory rats and mice in addition to their standard laboratory
      diet. Ethinyl oestradiol (50 mg kg-1 paraffin block) was highly unpalatable to
      female rats, and the amount of steroid ingested was not sufficient to interfere
      with their oestrous cycles or inhibit ovulation. Methyl testosterone (5000 mg kg
      1 paraffin block), although not as palatable as untreated blocks, was effective
      in inducing almost immediate infertility in female rats and mice at an ingested
      dose of about 35 micrograms g-1 body weight day-1. This infertility persisted
      throughout the duration of treatment, and lasted for several weeks after the
      cessation of treatment. Male rats became infertile after 3 months of treatment
      owing to suppression of spermatogenesis. Female rats developed a specific
      aversion to methyl testosterone when they were pregnant or lactating; it was
      therefore not possible to masculinize the brains of their female offspring. In
      mice, the androgen treatment induced high levels of aggression in the females so
      that they fought with males and with one another. One female died of her wounds.
      Org 5933 (4 mg kg-1 paraffin block) was highly palatable to female rats and mice,
      and at doses of about 420 ng g-1 body weight day-1 was effective in inhibiting
      ovulation in rats within 3 to 4 days after the start of treatment. This
      infertility persisted throughout the duration of treatment, and the animals
      conceived within 5 days of cessation of treatment. A dose of about 930 ng g-1
      body weight day-1 was not completely effective in inhibiting ovulation in mice,
      but females that became pregnant during treatment gave birth to dead young. When
      the gestagen was given to female rats and mice in the last few days of pregnancy,
      the duration of gestation was significantly prolonged, and most young were born
      dead; some of the females also died in labour. The gestagen did not appear to
      inhibit lactogenesis, since the few animals that gave birth to live young reared
      them normally for the first 5 days of life. These results show that either methyl
      testosterone or Org 5933 in paraffin blocks could perhaps be used as a
      chemosterilant for the control of rat and mouse populations.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8464025
TI  - 1H nuclear magnetic resonance studies of seminal plasma from fertile and
      infertile men.
AB  - Glycerylphosphorylcholine (GPC), glycerylphosphorylethanolamine (GPE), citrate,
      and lactate content of human seminal plasma was analysed by measuring the peak
      area of 1H nuclear magnetic resonance (NMR) spectra in samples from four groups
      of patients: 21 spermatogenic failure subjects; 14 obstructive azoospermic
      subjects (vasectomized); seven patients presenting very severe
      oligoasthenozoospermia (OAT) and 18 normozoospermic subjects (control). The peak
      areas for GPC, citrate and lactate in seminal plasma were significantly smaller
      for patients with azoospermia than for the control group: 16.79, 8.18 and 2.28
      versus 23.38, 10.58 and 4.30, respectively (P < 0.01). The peak area ratios for
      citrate:lactate and GPC:lactate were significantly different (P < 0.01) between
      the control group and the spermatogenic failure or obstructive azoospermia
      groups. A significant difference was also found in GPE:GPC peak intensity ratio
      between spermatogenic failure and obstructive azoospermia subjects (P < 0.001).
      These results provide some quantitative markers which may be used for examining
      infertility by using 1H NMR of seminal plasma samples.

PMID- 8464026
TI  - Effects of substrate supplementation with hydroxycholesterol analogues and serum
      lipoproteins on ovine luteal cell progesterone secretion in vitro: demonstration
      of prostaglandin F2 alpha luteolytic actions in a defined model system.
AB  - In an attempt to establish a defined model system for studies aimed at
      elucidating the mechanism of PGF2 alpha action, we examined the effects of medium
      supplementation with soluble hydroxycholesterol analogues, alone and in
      combination with ovine luteinizing hormone (oLH) in the presence and absence of
      PGF2 alpha, on progesterone secretion by mixed ovine luteal cells in vitro. In
      short-term cultures (2-6 h), supplementary 22R-hydroxycholesterol (22R-OHC; 0.16
      20 micrograms ml-1) increased (P < 0.05) progesterone production in a dose
      dependent manner, whereas similar concentrations of 22S-hydroxycholesterol (22S
      OHC) and 25-hydroxycholesterol (25-OHC) had little effect. In incubations of < or
      = 24 h duration, 22R-OHC (1 micrograms ml-1) dramatically increased progesterone
      secretion, whereas oLH (100 ng ml-1) in the presence or absence of PGF2 alpha
      (250 ng ml-1) had no consistent effects, alone or in combination with 22R-OHC. In
      contrast, 22R-OHC (1 micrograms ml-1) alone had no effect in long-term
      incubations (72-192 h), nor did treatment with oLH (100 ng ml-1) in the presence
      or absence of PGF2 alpha (250 ng ml-1) in the absence of 22R-OHC. Together,
      however, 22R-OHC and oLH stimulated (P < 0.05) progesterone secretion, a
      synergistic effect consistently inhibited (P < 0.05) by PGF2 alpha. Equimolar
      (2.5 mumol l-1) concentrations of 22R-OHC and homologous serum low- or high
      density lipoprotein cholesterol exhibited comparable capacities to maintain
      progesterone secretion in long-term cultures (24-168 h), with and without
      gonadotrophin (oLH or human chorionic gonadotrophin, 100 ng ml-1)
      stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464027
TI  - Effects of dilution procedure and culture conditions after thawing on survival of
      frozen bovine blastocysts produced in vitro.
AB  - Blastocysts derived from bovine zygotes fertilized and matured in vitro and
      cultured for 7 days in conditioned medium were frozen in 1.36 mol glycerol l-1
      and 0.25 mol sucrose l-1. In vitro survival after thawing was unaffected by
      dilution rate in 0.25 mol sucrose l-1. The proportion of blastocysts that re
      expanded after 24 h was 81% (70 of 86) and 47% (33 of 70) hatched. Seven
      pregnancies beyond 2 months resulted from transfer of 21 blastocysts to 19
      recipients. Total embryonic loss was 46.2%, of which 31% occurred between days 21
      and 35. In vitro survival after thawing was influenced by culture conditions, the
      best being culture with oviduct epithelial cells, where 55-82% of blastocysts re
      expanded, of which 41-54% hatched. Conditioned medium also supported re
      expansion, but low hatching (6%), whereas M199 plus fetal calf serum allowed only
      limited re-expansion (19-40%). This behaviour was not a consequence of freezing.
      It is suggested that blastocysts produced in vitro have reduced metabolic
      activity leading to high embryonic loss before or just at the time of
      implantation and that oviduct cells create a favourable environment after
      thawing, allowing hatching in vitro.

PMID- 8464028
TI  - Seasonal fluctuation in diurnal rhythms of luteinizing hormone secretion in ewes
      during the mid-luteal phase of the oestrous cycle.
AB  - Diurnal and seasonal fluctuations were detected in luteinizing hormone (LH)
      interpulse interval, but not amplitude, in ewes examined during the mid-luteal
      phase of an oestrous cycle at five stages of the breeding season. Daytime and
      night-time LH interpulse intervals were greater in the early and late than in the
      mid-breeding season (P < 0.05). During the early and late breeding season, LH
      interpulse interval was less during daylight than during darkness (P < 0.05).
      Toward the mid-breeding season, interpulse interval decreased during daytime
      earlier in the season than the night-time decrease. It was concluded that the
      diurnal fluctuations observed are a component of a circannual rhythm in LH
      secretion resulting from gradual seasonal transitions in photoperiodic drive to,
      or an endogenous rhythm in, the hypothalamic-pituitary axis in ewes.

PMID- 8464029
TI  - Calmodulin-binding proteins in bovine semen.
AB  - An 125I-labelled calmodulin gel overlay procedure was used to direct calmodulin
      binding proteins in bovine spermatozoa and seminal plasma. Several calmodulin
      binding proteins with molecular masses ranging from 12 to > 200 kDa were detected
      in epididymal and ejaculated spermatozoa. Certain of these proteins exhibited
      preferential calmodulin-binding in the presence of Ca2+, while others exhibited
      binding only in its absence. In seminal plasma, only two major proteins with
      molecular masses of 15 and 16 kDa showed a higher calmodulin-binding activity in
      the presence of Ca2+, whereas several polypeptides in the range of 6-17 kDa bound
      higher amounts of radiolabelled calmodulin in the absence of Ca2+. Our previous
      study has shown that a group of closely related major proteins, designated as BSP
      A1, BSP-A2, BSP-A3 and BSP-30 kDa, isolated from bovine seminal plasma (BSP) have
      molecular masses in the range of 15-30 kDa. This prompted us to investigate
      whether these polypeptides from bovine seminal fluid interact with calmodulin.
      The results indicated that calmodulin binds to purified BSP-A1, -A2, -A3 and BSP
      30 kDa proteins in the presence and absence of Ca2+. Furthermore, many
      polypeptides of low molecular mass (6-14 kDa) in bovine seminal plasma that
      crossreact with these BSP proteins also show high calmodulin-binding activity,
      particularly in the absence of calcium. This was further demonstrated following
      the limited proteolysis of the BSP proteins. Several tryptic-peptides of BSP-A1/
      A2 and BSP-30 kDa exhibited higher calmodulin-binding activity than the intact
      BSP proteins. In view of the key role of Ca2+ in triggering the acrosome reaction
      and the role of calmodulin in intracellular transport of calcium, it is suggested
      that BSP proteins are involved in sperm capacitation and the acrosome reaction.

PMID- 8464030
TI  - Expression of interleukin 1, interleukin 6 and tumour necrosis factor alpha in
      mouse uterus during the peri-implantation period of pregnancy.
AB  - Interleukin 1 (IL-1), IL-6 and tumour necrosis factor alpha (TNF-alpha) are
      expressed in the mouse uterus on days 1-3 of pregnancy. Cytokine production is
      temporally associated with the post-mating intrauterine acute inflammatory
      response. In this study, IL-1, IL-6 and TNF-alpha were detected in the uterus of
      pregnant mice from day 3 to day 9, using northern blotting, bioassays and
      immunocytochemistry. IL-1 bioactivity increased from a low concentration on day 3
      to a peak between days 4 and 5 and decreased to low concentrations on days 7 and
      8. Blastocyst implantation occurs late on day 4. IL-6 bioactivity was high from
      day 3 to day 9 and activity was maximal on days 5 and 6. TNF-alpha bioactivity
      increased from its lowest concentration on day 3 to a peak on day 8. Although
      changes in bioactivity concentrations occurred at different times from changes in
      mRNA concentrations, the changes were approximately parallel. Translation of mRNA
      into an immunologically detectable product was confirmed using
      immunocytochemistry with polyclonal anti-cytokine antibodies. We conclude that
      the cytokines IL-1, IL-6 and TNF-alpha are produced in the uterus during the peri
      implantation period of pregnancy in mice. Changes in cytokine concentrations
      suggested the existence of some form of regulated expression.

PMID- 8464031
TI  - Control of peptides regulating mitosis of granulosa cells in immature rat ovary
      by oestrogen and gonadotrophin.
AB  - Previous studies in this laboratory have demonstrated the presence of a peptide
      that inhibits granulosa cell proliferation in medium sized follicles. This
      peptide was produced after 72-96 h of exposure to diethylstilboestrol (DES). This
      study analyses oestrogen and gonadotrophin modulation of this and another
      stimulatory peptide found in large follicles. Intact, immature, female rats were
      assigned to the following study groups: (i) one to four injections of DES (2 mg
      per rat) given at intervals of 24 h, animals killed 24 h after the last
      injection; (ii) DES at 0 and 24 h, animals killed 24 or 48 h after the last
      injection; and (iii) DES plus pentobarbital (37 mg kg-1 body weight) at 30 h,
      animals killed 48 h after the last injection. Small, medium and large follicles
      (diameters of < 200, 200-400 and > 400 microns, respectively) were isolated from
      ovaries, granulosa cells were harvested and follicular fluid supernatant (FFS)
      was collected. FFS proteins were tested for their effects on incorporation of
      [3H]thymidine into granulosa cell DNA. Results showed that unfractionated FFS
      protein (150 micrograms) from medium follicles in groups (i) (three and four
      injections only), (ii) and (iii) inhibited [3H]thymidine incorporation.
      Pentobarbital blockage of gonadotrophin secretion had no effect on the inhibitory
      peptide activity and two injections of diethylstilboestrol were enough to
      stimulate synthesis of the inhibitory peptide, provided sufficient time was
      allowed; FFS protein (150 micrograms) from large follicles was stimulatory, but
      only when it was collected 24 h after the second injection, and the effect was
      abolished with pentobarbital treatment. Fractionation of pooled FFS into proteins
      with three molecular mass ranges (< 10 kDa, 10-30 kDa and > 30 kDa) showed that
      the inhibitory activity was in the < 10 kDa fraction while the > 30 kDa fraction
      stimulated thymidine incorporation. The number of medium and large follicles
      increased 24 h after the second DES injection, but the number of granulosa cells
      in the large follicles was significantly reduced after pentobarbital blockage of
      gonadotrophins. Taken together, these findings show that (i) the inhibitory
      peptide is induced in effective amounts in the medium follicles 48 h after the
      second DES injection and induction is not modulated by gonadotrophins; and (ii)
      stimulatory activity seen in the large follicles is transient and under
      gonadotrophic control, since blockage of follicle-stimulating hormone (FSH)
      secretion led to loss of stimulatory activity and a resulting reduction in number
      of granulosa cells in large follicles.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8464032
TI  - Design, synthesis, and pharmacology of 3-substituted sodium azulene-1-sulfonates
      and related compounds: non-prostanoid thromboxane A2 receptor antagonists.
AB  - A series of novel azulene-1 carboxylic acid derivatives 28-30, azulene-1 sulfonic
      acid sodium salts 41a-c, and related compounds were synthesized. These compounds
      were tested for TXA2 receptor antagonistic activity. The inhibitory
      concentrations (IC50) of these compounds for vascular contraction (TXA2 tau
      receptor) and platelet aggregation (TXA2 alpha receptor) induced by (15S)-15
      hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5(Z),13(E)- dienoic acid (U-46619)
      were obtained. Azulene-1-sulfonic acid sodium salts 41a-c were over 3 times more
      potent than azulene-1-carboxylic acids 28-30. The most potent compound, 41b was 4
      orders of magnitude more potent than a TXA2 antagonist, BM13,177, in inhibiting
      vascular contraction (tau receptor) and had an IC50 of 9.0 x 10(-10) M. Compound
      41b was also found to be a tau receptor selective antagonist (IC50 of
      contraction/IC50 of aggregation = 378) and to have no TXA2 synthetase inhibitory
      activity at concentrations up to 10(-4) M and no partial agonistic activity at
      concentrations up to 10(-5) M in rabbit aorta (tau receptor) and up to 10(-4) M
      in rabbit platelet-rich plasma (alpha receptor). In a radioligand binding assay
      using rabbit gel-filtered platelets, compound 41b had a high-affinity binding for
      the TXA2 receptor. In an in vivo study, compound 41b inhibited U-46619-induced
      sudden death in mice at a dose of 0.3 mg/kg and its duration of action was over 8
      h when administered orally at 3 mg/kg.

PMID- 8464033
TI  - 7-Azetidinylquinolones as antibacterial agents. Synthesis and structure-activity
      relationships.
AB  - A series of novel antibacterial quinolones and naphthyridones has been prepared
      which contain 7-azetidinyl substituents in place of the usual piperazine or
      aminopyrrolidine groups. These azetidinyl derivatives were evaluated for in vitro
      activity by determining minimum inhibitory concentrations against a variety of
      bacteria. In vivo efficacy in the mouse infection model and blood levels in the
      mouse were determined for several compounds. The influence on the structure
      activity relationships of varying substituents in the azetidine ring and at
      position 8 (CH, CF, CCl, N) and N-1 (ethyl, fluoroethyl, cyclopropyl, tert-butyl,
      4-fluorophenyl, and 2,4-difluorophenyl) was also studied. Compounds with
      outstandingly broad-spectrum activity, particularly against Gram-positive
      organisms, improved in vivo efficacy, and high blood levels were identified in
      this work. 7-Azetidinyl-8-chloroquinolones were considered as warranting further
      development.

PMID- 8464034
TI  - Applications of neural networks in structure-activity relationships of a small
      number of molecules.
AB  - We investigated the applications of back propagation artificial neural networks
      (ANN) for a small dataset analysis in the field of structure-activity
      relationships. The derivatives of carboquinone were used as an example. It's been
      found that in this case the use of the same neural network results in unambiguous
      classification of new molecules. Predictions can be improved with statistical
      analysis of independent prognosis sets. We suggest that the sign criterion be
      used as a classification rule. We also compared neural networks with FALS and ALS
      in leave-one-out prediction. ANN applied to the same dataset has shown the same
      predictive ability as ALS but poorer than FALS.

PMID- 8464035
TI  - Synthesis and pharmacological evaluation of (nitrooxy)alkyl apovincaminates.
AB  - A series of (nitrooxy)alkyl apovincaminates has been synthesized and evaluated
      for their effects on vertebral and femoral blood flow. These derivatives were
      prepared from apovincaminic acid (4). In cerebral circulation, compound 5 (0.03
      1.0 mg/kg iv) caused a dose-dependent increase in cerebral blood flow (CerBF)
      without affecting the blood pressure. It was more potent than vinpocetine (2).
      The structures of 2 and 5, determined by X-ray crystallography, showed
      differences in the electrostatic potential image and in the conformation of the
      ethyl group at the 16-position.

PMID- 8464036
TI  - Modeling of human thromboxane A2 receptor and analysis of the receptor-ligand
      interaction.
AB  - In order to elucidate the mode of the thromboxane A2 (TXA2) receptor-ligand
      interaction at the molecular level, a model for the human TXA2 receptor, a member
      of the G protein-coupled receptor family with seven transmembrane segments, was
      constructed on the basis of its amino acid sequence, which was determined
      recently (Hirata, M.; et al. Nature 1991, 349, 617-620). First, we made a model
      for the human beta 2-adrenergic receptor using its amino acid sequence and the
      known helix arrangement of bacteriorhodopsin. Then, a TXA2 receptor model was
      constructed based on the beta 2 receptor model and was used to analyze the
      receptor-ligand interaction. The ligand-binding pocket of the TXA2 receptor
      includes a serine residue from segment V, an arginine residue from segment VII,
      and a large hydrophobic pocket between these two residues. These results are
      consistent with the known properties of TXA2 and TXA2 antagonists having a
      hydrogen-bonding group such as hydroxyl, a carboxyl group, and a hydrophobic
      moiety. This model should be helpful for rational design of potent TXA2
      antagonists.

PMID- 8464037
TI  - Uniformly modified 2'-deoxy-2'-fluoro phosphorothioate oligonucleotides as
      nuclease-resistant antisense compounds with high affinity and specificity for RNA
      targets.
AB  - "Uniformly" modified phosphodiester or phosphorothioate oligonucleotides
      incorporating 2'-deoxy-2'-fluoroadenosine, -guanosine, -uridine, and -cytidine,
      reported herein for the first time, when hybridized with RNA afforded consistent
      additive enhancement of duplex stability without compromising base-pair
      specificity. CD spectra of the 2'-deoxy-2'-fluoro-modified oligonucleotides
      hybridized with RNA indicated that the duplex adopts a fully A-form conformation.
      The 2'-deoxy-2'-fluoro-modified oligonucleotides in phosphodiester form were not
      resistant to nucleases; however, the modified phosphorothioate oligonucleotides
      were highly nuclease resistant and retained exceptional binding affinity to the
      RNA targets. The stabilizing effects of the 2'-deoxy-2'-fluoro modifications on
      RNA-DNA duplexes were shown to be superior to those of the 2'-O-methylribo
      substitutions. RNA hybrid duplexes with uniformly 2'-deoxy-2'-fluoro-modified
      oligonucleotides did not support HeLa RNase H activity; however, incorporation of
      the modifications into "chimeric" oligonucleotides has been shown to activate
      mammalian RNase H. "Uniformly" modified 2'-deoxy-2'-fluoro phosphorothioate
      oligonucleotides afforded antisense molecules with (1) high binding affinity and
      selectivity for the RNA target and (2) stability toward nucleases.

PMID- 8464039
TI  - Synthesis and biodistribution of iodine-125-labeled 1-azabicyclo[2.2.2]oct-3-yl
      alpha-hydroxy-alpha-(1-iodo-1-propen-3-yl)-alpha-phenylacetate. A new ligand for
      the potential imaging of muscarinic receptors by single photon emission computed
      tomography.
AB  - 1-Azabicyclo[2.2.2]oct-3-yl alpha-hydroxy-alpha-(1-iodo-1-propen-3-yl)- alpha
      phenylacetate (IQNP, 3), an analogue of QNB in which a phenyl ring has been
      replaced with an iodopropenyl substituent, was prepared and evaluated in vitro
      and in vivo for m-AChR selectivity and specificity. High specific activity
      [125]IQNP ([125I]-3) was synthesized in greater than 60% yield utilizing an
      electrophilic iododestannylation reaction with hydrogen peroxide for the
      oxidation of iodide. In in vitro receptor binding studies, 3 demonstrated high
      affinity for M1 (Ki = 0.78 nM), M2 (Ki = 1.06 nM), and M3 (Ki = 0.27 nM)
      subtypes. In vivo biodistribution studies in female rats [125I]-3 demonstrated
      high uptake in areas rich in muscarinic receptors such as the brain (cortex and
      striatum) and the heart. Blocking studies were performed with a series of
      receptor specific agents and demonstrated that the uptake of [125I]-3 was
      selective and specific for cerebral muscarinic receptor rich areas and that the
      binding to m-AChR is reversible. The high-yield preparation and specificity and
      selectivity of high specific activity [125I]IQNP for muscarinic receptors suggest
      that this is an attractive new agent for potential imaging of cerebral receptors
      using single photon tomographic imaging (SPECT).

PMID- 8464038
TI  - Design, synthesis, and neurochemical evaluation of 5-(3-alkyl-1,2,4- oxadiazol-5
      yl)-1,4,5,6-tetrahydropyrimidines as M1 muscarinic receptor agonists.
AB  - A series of 5-(3-alkyl-1,2,4-oxadiazol-5-yl)-1,4,5,6-tetrahydropyrimidines+ ++
      (7a-h) was synthesized for biological evaluation as selective agonists for M1
      receptors coupled to phosphoinositide (PI) metabolism in the central nervous
      system. Each ligand bound with high affinity to muscarinic receptors from rat
      brain as measured by inhibition of [3H]-(R)-quinuclidinyl benzilate ([3H]-(R)
      QNB) binding. 5-(3-Methyl-1,2,4-oxadiazol-5-yl)-1,4,5,6-tetrahydropyrimidine+ ++
      trifluoroacetate (CDD-0098-J;7a) displayed high affinity (IC50 = 2.7 +/- 0.69
      microM) and efficacy at muscarinic receptors coupled to PI metabolism in the rat
      cortex and hippocampus. Increasing the length of the alkyl substituent increased
      affinity for muscarinic receptors yet decreased activity in PI turnover assays.
      The hippocampal PI response of 7a was blocked by lower concentrations of
      pirenzepine (8) or by higher concentrations of either AF-DX 116 (9) or p
      fluorohexahydrosiladifenidol (10), suggesting that at low concentrations 7a
      selectively stimulates PI turnover through M1 receptors.

PMID- 8464040
TI  - Substituted 3-phenyltropane analogs of cocaine: synthesis, inhibition of binding
      at cocaine recognition sites, and positron emission tomography imaging.
AB  - It is now accepted that (-)-cocaine binds to specific recognition sites
      associated with monoamine transporters in the mammalian brain. In this study,
      several analogs of 3 beta-phenyltropane-2 beta-carboxylic acid methyl ester were
      prepared and their potency for inhibiting the binding of [3H]-3 beta-(4
      fluorophenyl)tropane-2 beta-carboxylic acid methyl ester to primate caudate
      putamen was evaluated. The synthesis and binding affinity of 3 beta-(3,4-
      dichlorophenyl)tropane-2 beta-carboxylic acid methyl ester, one of the most
      potent cocaine congeners yet reported, is presented. The feasibility of
      synthesizing high-affinity ligands for cocaine recognition sites and their
      suitability as PET imaging ligands for cocaine receptors in vivo is demonstrated.

PMID- 8464041
TI  - In vitro cytotoxicity of GC sequence directed alkylating agents related to
      distamycin.
AB  - Imidazole containing analogues 7, 10, and 17 of distamycin wherein the C-terminus
      contain a dimethylamino moiety have been shown to selectively bind to the minor
      groove of GC-rich sequences. Accordingly, these agents were employed as vectors
      for the delivery of a variety of alkylating agents to GC-rich sequences. The
      alkylating agents are attached to the N-terminus of these vectors thus providing
      the benzoyl N-mustards (8, 15, and 18 that contain one, two, and three imidazole
      units, respectively) and substituted acetamides 11-14. Results from the ethidium
      displacement assay for the formamides 7, 10, and 17 and mustards 15 and 18 showed
      that these agents bind to calf thymus DNA, poly(dA.dT), poly(dG.dC), and also to
      coliphage T4 DNA, thus confirming their binding in the minor groove. The reduced
      binding constants of these compounds for poly(dA.dT) while still binding as
      strongly, or more strongly, to poly(dG.dC) than distamycin provided evidence for
      their acceptance of GC sequences. Selectivity for GC-rich sequences was also
      indicated by CD titration studies. Titration of 10, 15, 17, and 18 to poly(dA.dT)
      produced weak drug-induced CD bands at approximately 330 nm; however, interaction
      of these agents to poly(dG.dC) in equimolar drug concentrations gave strong bands
      in this region. Results from dialysis and cross-link gel experiments provided
      evidence of alkylation and cross-linking of DNA by the mustards which could
      explain their enhanced cytotoxicity over the formamido analogues. The
      bifunctional N-mustard-containing analogues 15 and 18 are significantly more
      cytotoxic than the monoalkylating acetamides 11-14. The mustards also exhibited
      significant activity against cell lines derived from solid tumors such as
      melanomas, ovarian cancers, CNS cancers, and small cell lung cancer.

PMID- 8464042
TI  - Adenosine-5'-carboxaldehyde: a potent inhibitor of S-adenosyl-L-homocysteine
      hydrolase.
AB  - Adenosine-5'-carboxaldehyde (3) and its 4'-epimer (4) were synthesized and shown
      to be potent type I mechanism-based inhibitors of recombinant rat liver AdoHcy
      hydrolase with k2/KI values of 16.7 x 10(-3) and 5.5 x 10(-3) nM-1 min-1,
      respectively. The observation that 3 and 4 are potent inhibitors of AdoHcy
      hydrolase supports the hypothesis that they function as key intermediates in the
      mechanism by which the (Z)- and (E)-4',5'-didehydro-5'-deoxy-5'-fluoroadenosines
      1 and 2 inactivate this enzyme.

PMID- 8464043
TI  - Position 2 and position 2/Ala15-substituted analogs of bovine growth hormone
      releasing factor (bGRF) with enhanced metabolic stability and improved in vivo
      bioactivity.
AB  - In order to prepare GRF analogs with high activity in vivo, a strategy was
      undertaken to stabilize the peptide to dipeptidylpeptidase IV (DPP-IV), a
      protease found in plasma which inactivates native human and bovine GRF by
      cleavage of the Ala2-Asp3 bond. Replacement of the Ala2 residue with Ser, Thr, or
      Gly in [Leu27]bGRF(1-29)NH2 resulted in peptides greatly stabilized against
      proteolysis in plasma, but having low inherent GH-releasing activity when tested
      in bovine pituitary cell cultures. Replacement of Gly15 with Ala15 was marginally
      effective in improving the in vitro bioactivity of this group of peptides. When
      tested for GH-hormone release in steers, however, the Thr2,Ala15 analog was four
      times more potent than bGRF(1-44)NH2. Eleven additional analogs from the
      [X2,Ala15,Leu27]bGRF(1-29)NH2 series were synthesized and evaluated for metabolic
      stability in bovine plasma and for GH releasing activity in steers in vivo and in
      rat pituitary cells in vitro. Two compounds, [Val2,Ala15,Leu27]dGRF(1-29)NH2 and
      [Ile2,Ala15,Leu27]-bGRF(1-29)NH2, had increased GH-releasing activity in steers
      over that of [Thr2,Ala15,Leu27]-bGRF(1-29)NH2 and over a previously reported
      super-potent analog, [desNH2Tyr1,D-Ala2,Ala15]-hGRF(1-29)NH2.

PMID- 8464044
TI  - Glycosylated derivatives of benzophenone, benzhydrol, and benzhydril as potential
      venous antithrombotic agents.
AB  - A series of glycosylated derivatives of benzophenone, benzhydrol, and benzhydril
      has been synthesized and evaluated for potential activity as venous
      antithrombotic agents. Studies on structure-activity relationships revealed that
      compounds having an electron-withdrawing group in the benzhydril or benzhydrol
      moiety, and specifically those having the beta-D-xylopyranosyl structure in the
      sugar moiety, were good antithrombotic agents in a rat model of venous
      thrombosis.

PMID- 8464045
TI  - Synthesis and biological activities of angiotensin II, Sarilesin, and Sarmesin
      analogues containing Aze or Pip at position 7.
AB  - Analogues of [Sar1]angiotensin II, Sarilesin (type I antagonist), and Sarmesin
      (type II antagonist) with L-azetidine-2-carboxylic acid (Aze) and L-pipecolic
      acid (Pip) at position 7 have been prepared by the solid-phase method, purified
      by reverse-phase HPLC, and bioassayed in the rat uterus. Analogues of the
      superagonist [Sar1]ANGII with Aze or Pip at position 7 and sarcosine (Sar) or
      aminoisobutyric acid (Aib) at position 1 had high intrinsic activity in the rat
      isolated uterus assay (34-184%). Analogues of Sarilesin ([Sar1,Ile8]ANGII) with
      Aze or Pip at position 7 and Sar or Aib at position 1 retained high antagonist
      activity (pA2 = 7.1-8.3). Analogues of Sarmesin ([Sar1,Tyr-(OMe)4]ANGII) with Aze
      and Pip at position 7 had pA2 values of 7.4 and 6.5, respectively. [Aze7]-ANGII
      and [Pip7]ANGII had low activities (12% and 1%, respectively), and deletion of
      Sar at position 1 of Sarmesin analogues abolished binding (or affinity) as judged
      from pA2 values. Nuclear Overhauser effect (NOE) spectroscopy studies of
      [Sar1,Aze7]ANGII in DMSO-d6 have indicated a clustering of the three aromatic
      rings (Tyr, His, Phe) and proximity of Sar C alpha and Arg C delta protons to the
      Tyr/Phe ring protons. These data emphasize that replacement of Pro with the lower
      and higher homologs Aze and Pip does not greatly alter the structural
      requirements necessary for expression of agonist or antagonist activity, when
      sarcosine occupies position 1, but not when Asp occupies position 1, suggesting
      that there is an intimate relationship between the N-terminal and penultimate
      residues of the molecule in the biologically active conformation of the molecule.

PMID- 8464046
TI  - Prodrugs of doxorubicin and melphalan and their activation by a monoclonal
      antibody-penicillin-G amidase conjugate.
AB  - The syntheses and cytotoxic activities of substituted N-phenylacetamido
      derivatives of doxorubicin and melphalan are described. The derivatives were
      designed as prodrugs which could be activated in a site-specific manner by
      monoclonal antibody-penicillin-G amidase (mAb-PGA) conjugates. N
      (Phenylacetamido)doxorubicin (2) and N-(phenylacetyl)melphalan (6) were found to
      be 10- and 20-fold less cytotoxic against H2981 lung adenocarcinoma cells than
      doxorubicin and melphalan, respectively. When incubated with PGA, the
      cytotoxicity of 2 and 6 increased and became equivalent to that of the
      corresponding drugs from which they were made. The poor solubility
      characteristics of 2 in aqueous solutions provided the basis for the development
      of the more soluble doxorubicin derivatives, N-(4-aminophenylacetyl)doxorubicin
      (3) and N-(4-phosphonooxy)phenylacetyl)-doxorubicin (4). In vitro cytotoxicity
      assays indicated that 3 and 4 were at least 1000-fold less toxic than doxorubicin
      against H2981 cells. PGA and the mAb conjugate L6-PGA were able to effect the
      activation of 3 and 6 on H2981 cells (L6-antigen positive). Hydrolysis of the
      phosphate group of 4 was required prior to activation with PGA or L6-PGA. This
      was achieved using alkaline phosphatase, or by exposing 4 to phosphatases present
      in cell culture medium. The activation of 3, 4, and 6 on H2981 cells by L6-PGA
      occurred in an immunologically specific manner, since activation could be blocked
      by saturating cell surface antigens with L6 prior to treatment with L6-PGA. These
      results demonstrate that 3, 4, and 6 are prodrugs that can be specifically
      activated to release clinically approved anticancer agents by a mAb-PGA
      conjugate.

PMID- 8464047
TI  - Cyclic sulfolanes as novel and high affinity P2 ligands for HIV-1 protease
      inhibitors.

PMID- 8464048
TI  - Signal transduction by a 5-HT2 receptor: a mechanistic hypothesis from molecular
      dynamics simulations of the three-dimensional model of the receptor complexed to
      ligands.

PMID- 8464049
TI  - Significance of duplicated flagellin genes in Campylobacter.
AB  - The complex flagellum of Campylobacter coli VC167 contains two highly related
      (98%) flagellin subunit proteins which are produced from two 92% homologous,
      tandemly orientated genes, flaA and flaB. Mutants expressing only flaA form a
      full-length flagellar filament that confers slightly less than wild-type motility
      to the bacterium. However, flagellin mutants expressing only flaB produce
      extremely short, truncated filaments, and are only slightly motile. We have shown
      that the presence of two essentially identical genes is advantageous, in that
      flaAflaB+ mutants become highly motile upon passage by an event which allows the
      production of a full length simple flagellar filament containing a single FlaA
      FlaB chimeric flagellin protein. Furthermore, we have demonstrated that the
      reassortment of DNA that results in this chimeric protein can occur by two
      mechanisms: intragenomic recombination and transformation-mediated intergenomic
      recombination.

PMID- 8464050
TI  - Analysis of the backbone dynamics of interleukin-8 by 15N relaxation
      measurements.
AB  - The backbone dynamics of the cytokine interleukin-8, a symmetric homodimer of
      overall molecular mass 16 kDa, has been investigated at pH 5.2 by means of 15N
      relaxation measurements using heteronuclear two-dimensional inverse detected 1H
      15N spectroscopy. 15N T1, T2 and NOE data were obtained for 66 out of a total of
      67 backbone amide groups. The overall correlation time is 9.10(+/- 0.05) ns at
      26.6 degrees C. All residues exhibit very rapid motions on a time-scale of < or =
      20 ps. These very rapid motions alone can account for the 15N relaxation
      behaviour of 30 residues. The 15N relaxation data for another 21 residues can
      only be accounted for by the inclusion of an additional internal motion on a time
      scale ranging from 0.5 to 3.5 ns. These residues are clustered at the N and C
      termini, and in the loop regions connecting elements of secondary structures.
      Finally, the 15N relaxation data for another 15 residues could only be accounted
      for by the presence of chemical exchange on a time-scale ranging from
      approximately 170 ns to 2.25 ms. In addition, the inclusion of chemical exchange
      improved the fit to the experimental data for 10 of the 30 residues whose 15N
      relaxation behaviour could be accounted for by very fast motions alone. The
      residues exhibiting chemical exchange line broadening cluster at the interface of
      the long C-terminal alpha-helix and the underlying beta-sheet. It is suggested
      that this clustering is indicative of concerted rather than independent motions
      in regions of secondary structure, with motion at any one residue being
      propagated to neighbouring residues in van der Waals contact.

PMID- 8464051
TI  - Structural deviations at CpG provide a plausible explanation for the high
      frequency of mutation at this site. Phosphorus nuclear magnetic resonance and
      circular dichroism studies.
AB  - CpG sites in DNA are hotspots for mutations leading to human genetic disorders.
      However, the structural basis for these events were still unclear and
      necessitated a deeper evaluation. Our experiments with phosphorus-31 nuclear
      magnetic resonance, ultraviolet-melting and circular dichroism on two related CpG
      containing octanucleotide duplexes show that CpG is a malleable step whose
      conformation and thermal stability are strongly dependent on the nature of its
      flanking steps. We conclude that the CpG step may exert a deleterious structural
      influence on the helix very much like the mismatch containing steps. This
      peculiar property of CpG should constitute a molecular basis for its recognition
      by various ligands as well as for mutations affecting CpG and hence an
      explanation for its rarity in vertebrate genomes.

PMID- 8464052
TI  - Electron microscopy visualization of oligonucleotide binding to duplex DNA via
      triplex formation.
AB  - Using biotinylated oligonucleotides and streptavidin as a marker, we have
      visualized, with the help of electron microscopy, the triplex formation. We used
      the natural homopurine-homopyrimidine sequence from human papillomavirus 16
      cloned within a plasmid. Under conditions favouring the formation of pyrimidine
      purine-pyrimidine triplex the corresponding pyrimidine oligonucleotide formed a
      complex with the insert and this complex was detected by electron microscopy.
      Similarly, under conditions favouring the formation of pyrimidine-purine-purine
      triplex the corresponding purine oligonucleotide formed a stable complex detected
      by electron microscopy. In both cases the complexes we observed exhibited
      remarkable sequence specificity. Near 80% of DNA molecules carried the
      streptavidin marker in the correct position and very few cases of non-specific
      binding were detected. We conclude that the triplex mode of recognition may
      provide very efficient sequence-specific markers for electron microscopy of DNA.

PMID- 8464053
TI  - Imaging frozen, hydrated acrosomal bundle from Limulus sperm at 7 A resolution
      with a 400 kV electron cryomicroscope.
AB  - Actin and scruin are present in a highly ordered array in the acrosomal bundle
      from Limulus sperm. Frozen, hydrated acrosomal bundle can be imaged in a 400 kV
      electron cryomicroscope using the spot-scan technique. Quantitative analysis of
      the h0l projection images shows diffraction data beyond 7 A.

PMID- 8464054
TI  - Comparison of the dynamics of an engineered insulin monomer and dimer by acid
      quenched amide proton exchange. Non-local stabilization of interchain hydrogen
      bonds by dimerization.
AB  - Dynamic differences between an engineered insulin monomer and dimer are
      investigated under physiological conditions by an adaptation of the method of
      acid-quenched amide proton exchange. Although exchange lifetimes of amide protons
      involved in intrachain hydrogen bonds are similar in the two analogs,
      dimerization specifically stabilizes two interchain hydrogen bonds (LeuB6-NH...O
      = C-CysA6 and CysA11-NH...O = C-GluB4) that are distant from the dimer interface.
      Such non-local stabilization demonstrates that fluctuations in the tertiary
      structure of the monomer are damped by dimerization. As the B6-A6 and A11-B4
      hydrogen bonds are specific to the crystallographic T-state, their stabilization
      also indicates that the R-state (an allosteric feature of hexamer assembly) is
      not significantly populated in an isolated dimer. Our results are discussed in
      reference to recent hypotheses that crystal structures of insulin depict inactive
      conformers and that detachment of interchain contacts accompany receptor binding.

PMID- 8464055
TI  - Requirement for a disulfide bridge near the reactive site of protease inhibitor
      SSI (Streptomyces subtilisin inhibitor) for its inhibitory action.
AB  - The problem of why serine protease inhibitors having substrate-like structure
      around the reactive site are not degraded by the cognate protease has prompted us
      to investigate the structural requirements in Streptomyces subtilisin inhibitor
      (SSI) for its inhibitory action. We removed the disulfide bridge between Cys71
      and Cys101 near the reactive site by oligonucleotide-directed mutagenesis,
      replacing both Cys residues with Ser residues. Inhibitory activity of the mutated
      SSI toward subtilisin BPN' was initially potent, but decreased remarkably with
      increasing incubation time after mixing (temporary inhibition), due to
      degradation of the mutated SSI by subtilisin via a specific intermediate with a
      nick at the reactive site (Met73-Val74). Binding affinity of subtilisin for the
      mutated SSI was reduced by more than 10(3)-fold, and the mutated SSI showed a 20
      deg.C decrease in melting temperature, which probably mainly reflects the
      destruction of the region of alpha-helix containing Cys101. These results imply
      that the susceptibility of the mutated SSI to protease, and the irreversibility
      of the peptide bond cleavage at the reactive site, result from increased
      flexibility around the reactive site in the complex of the disulfide-bond-removed
      SSI with the protease, demonstrating the requirement of conformational rigidity
      around the reactive site of the inhibitor for its native inhibitory action.

PMID- 8464056
TI  - Evidence for a clustered genomic organization of FAX-zinc finger protein encoding
      transcription units in Xenopus laevis.
AB  - Finger associated box-zinc finger proteins (FAX-ZFPs) constitute a subfamily of
      the many C2H2 type ZFPs in Xenopus laevis. FAX is a highly conserved protein
      domain connected to variable zinc finger clusters. Three different FAX-ZFPs
      encoding genomic fragments were isolated and subjected to a detailed structural
      characterization. All three exhibit a common, highly conserved exon/intron
      organization, with the variant zinc finger clusters organized in a single exon
      for each gene analysed. Two of the three genomic fragments contain a second FAX
      ZFP encoding (partial) transcription unit each. Further evidence for a clustered
      organization of FAX-ZFP transcription units is provided by Southern blot analysis
      of large genomic restriction fragments separated by transverse field gel
      electrophoresis, and by in situ hybridization on intact chromosomes. Comparative
      sequence analysis of the genes isolated reveals an exceptional degree of DNA
      sequence conservation in both exon and intron regions in one part of the FAX
      encoding region, suggesting that recent gene conversion has led to the
      combination of these sequence elements with DNA segments including regions
      encoding variant zinc finger clusters. Overexpression of the FAX domain by itself
      or of a full-length FAX-ZFP in X. laevis embryos by means of mRNA injection does
      not interfere with the normal developmental program, suggesting general and not
      cell specific/regulatory functions for X. laevis FAX-ZFPs.

PMID- 8464057
TI  - Formation of a single base mismatch impedes spontaneous DNA branch migration.
AB  - DNA branch migration, a process whereby two homologous DNA duplexes exchange
      strands, is an essential component of genetic recombination. Models for
      homologous recombination have invoked spontaneous branch migration as one
      mechanism for the generation of large regions of heteroduplex DNA. During
      recombination, two homologous parental duplexes that contain similar, but not
      identical, sequences are paired and undergo strand exchange. An important issue
      is whether spontaneous branch migration is capable of traversing sequence
      heterology such as mismatches, insertions and deletions. We use a model four
      strand system to examine the effect of mispaired or unpaired bases on branch
      migration. The assay consists of annealing two short duplexes having defined
      sequence heterologies. Following annealing, a Holliday junction is formed that is
      free to branch migrate. Our results demonstrate that a single base mismatch,
      insertion or deletion is sufficient to pose a substantial barrier to spontaneous
      branch migration. In the presence of magnesium, branch migration through such
      sequence heterologies is almost completely blocked. Others have shown that non
      mobile four-way junctions undergo a dramatic shift in conformation in the
      presence of magnesium. Our data suggest that a similar transition occurs for the
      mobile Holliday junction. We also discuss how proteins may facilitate branch
      migration through sequence heterologies in vivo.

PMID- 8464058
TI  - Protein-DNA interactions of the mouse alpha A-crystallin control regions.
      Differences between expressing and non-expressing cells.
AB  - Genomic footprinting, in vitro footprinting and mobility shift assays were used
      to investigate the molecular basis for expression of mouse alpha A-crystallin, a
      major structural protein of the transparent lens of vertebrates. The putative
      control region of the mouse alpha A-crystallin gene was footprinted by DNase I
      digestion in nuclear extracts, by dimethylsulfate treatment in cultured cells,
      and by micrococcal nuclease digestion in isolated nuclei. The resulting digestion
      patterns were compared between alpha TN4-1 lens cells, which express alpha A
      crystallin, and L929 fibroblasts, which do not express alpha A-crystallin. Four
      regions of DNA were found occupied in both cell types. These included positions 
      111 to -97 (DE-1 region), positions -75 to -55 (alpha A-CRYBP1 region), positions
      -35 to -12 (TATA box and PE-1 region), and positions +23 to +43 (an AP-1
      consensus sequence). The DNase I footprints of the DE-1 and alpha A-CRYBP1
      regions, previously implicated as functional control elements, were substantially
      more pronounced using nuclear extract from the alpha TN4-1 cells than from the
      L929 fibroblasts, suggesting more stable protein binding with the former than
      with the latter. Numerous in vivo binding variations were noted between the two
      cell types in all four of the footprinted regions examined. Finally, two
      complexes (A and B) were formed specifically with nuclear extracts from the alpha
      TN4-1 cells and a synthetic deoxyoligonucleotide comprising the alpha A-CRYBP1
      region. These data indicate that specific differences in protein-DNA interactions
      with putative control regions are associated with tissue-preferred expression of
      the mouse alpha A-crystallin gene.

PMID- 8464059
TI  - Phenyl-azide-mediated photocrosslinking analysis of Cro-DNA interaction.
AB  - Using phenyl-azide-mediated photocrosslinking, we show that the alpha carbon of
      amino acid 2 of the helix-turn-helix motif of bacteriophage lambda Cro is within
      12 A of the bottom-strand nucleotides at positions 2 and 3 of the DNA half site
      in the Cro-DNA complex in solution. This result is in excellent agreement with
      the crystallographic structure of the Cro-DNA complex. The results of phenyl
      azide-mediated photocrosslinking analysis of Cro-DNA interaction, together with
      the previously reported results of phenyl-azide-mediated photocrosslinking
      analysis of CAP-DNA interaction, establish that phenyl-azide-mediated
      photocrosslinking is generalizable and provide information regarding the
      structural requirements for phenyl-azide-mediated photocrosslinking. Comparison
      of the results of phenyl-azide-mediated photocrosslinking to the results of EDTA:
      iron-mediated affinity cleaving indicates that phenyl-azide-mediated
      photocrosslinking yields superior resolution.

PMID- 8464060
TI  - Structural studies of the enveloped dsRNA bacteriophage phi 6 of Pseudomonas
      syringae by Raman spectroscopy. I. The virion and its membrane envelope.
AB  - We report and interpret the first Raman spectrum of a double-stranded RNA virus
      containing a membrane envelope. Spectra of the native bacteriophage phi 6 and of
      its isolated host-attachment (spike) protein and phospholipid-free core assembly
      were collected from aqueous solutions over a wide range of temperature.
      Comparison of the vibrational spectra by digital difference methods permits the
      following structural conclusions regarding molecular constituents of the fully
      assembled virion. (1) The double-stranded RNA, phospholipid and protein
      components of the phage exhibit Raman amplitudes in accordance with their
      biochemically determined compositions in the native virion (10, 20 and 70%,
      respectively). (2) alpha-Helix and irregular conformations are the dominant
      secondary structures in proteins of both the viral membrane and nucleocapsid.
      This represents a departure from previously examined icosahedral phage and plant
      viruses, which are dominated by beta-sheet structures. (3) The phospholipids of
      the viral membrane are liquid crystalline throughout the determined range of
      virus thermostability (0 to 40 degrees C). (4) The P3 spike protein of phi 6,
      which is anchored to, but not sequestered within the viral membrane, is largely
      alpha-helical (approximately 35%) and highly thermolabile. Denaturation of P3 at
      temperatures above 30 degrees C leads to appreciable loss (approximately 20%) of
      alpha-helix in favor of beta-strand structure, and alters significantly the
      environments of many aromatic side-chains. (5) The secondary structures of
      integral membrane proteins of phi 6 are overwhelmingly alpha-helical
      (approximately 70 to 80%) and also thermolabile. In contrast to P3, which
      exhibits aspartate and glutamate carboxyls in the ionized form (CO2-), the
      integral membrane proteins exhibit only protonated carboxyl groups (COOH).
      Treatment of phi 6 with butylated hydroxytoluene (BHT), which has been shown to
      remove the P3 spike protein, does not significantly perturb phospholipids and
      associated integral proteins of the viral membrane or structural proteins and
      packaged double-stranded RNA of the nucleocapsid. However, P3 subunits, which are
      recovered after BHT treatment, exhibit radically altered secondary and tertiary
      structures, including the loss of most subunit alpha-helices. Among the P3 side
      chains affected by BHT treatment, we note a general trend toward greater
      hydrophilicity and greater solvent exposure of the aromatic residues Trp and Tyr.
      On the other hand, the cysteine sulfhydryl groups of the BHT-isolated P3 monomer
      are not solvent exposed and function as strong hydrogen-bond donors in the
      protein core.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8464061
TI  - Structural studies of the enveloped dsRNA bacteriophage phi 6 of Pseudomonas
      syringae by Raman spectroscopy. II. Nucleocapsid structure and thermostability of
      the virion, nucleocapsid and polymerase complex.
AB  - Structures and thermostabilities of the double-stranded (ds) RNA bacteriophage
      phi 6 and of its isolated nucleocapsid-polymerase complex (nucleocapsid core) and
      dsRNA components have been investigated by Raman spectroscopy. The spectra show
      that proteins of the phi 6 virion are collectively deficient in beta-sheet
      secondary structure. In particular, the major protein (P8) of the outer spherical
      shell of the phi 6 nucleocapsid exhibits a secondary structure dominated largely
      by alpha-helix and irregular conformations. The absence of appreciable beta
      structure in the P8 subunit suggests a tertiary conformation lacking the beta
      barrel motif common to subunits of most other spherical viral capsids. In
      addition, the Raman spectra show that subunits of the dodecahedral nucleocapsid
      core are also predominantly alpha-helical. The results thus indicate a largely
      alpha-helical secondary structure for the major subunit (P1) of the phi 6
      nucleocapsid core, as well as for the P8 subunit of the outer spherical shell.
      Using Raman difference spectroscopy, we demonstrate that proteins of the
      nucleocapsid core (P1, P2, P4 and P7) interact extensively with the packaged phi
      6 RNA genome, and further, that conformational stability of the packaged RNA is
      reduced upon removal from the core. Also, we find that proteins of the phi 6
      nucleocapsid are significantly more thermostable than proteins of the viral
      membrane envelope, which are reported in the accompanying paper (Li et al.,
      1993). The present results suggest that both the architectural principles and
      modes of protein-RNA interaction in the phi 6 virion differ fundamentally from
      those of icosahedral single-stranded RNA viruses. Both Raman and circular
      dichroism spectra indicate that the dsRNA genome of phi 6 is an A-form structure.
      The Raman marker bands signify the presence only of C3'-endo/anti nucleoside
      conformers. The Raman signature of dsRNA, revealed in the spectrum of the phi 6
      genome, is discussed here as a model for assessing base-pairing and base-stacking
      interactions in other ribonucleoprotein assemblies.

PMID- 8464062
TI  - Function of IHF in lambda DNA packaging. II. Effects of mutations altering the
      IHF binding site and the intrinsic bend in cosB on lambda development.
AB  - cosB is the binding site on lambda DNA for terminase, the phage DNA packaging
      protein. cosB contains three binding sites for gpNu1, the small subunit of
      terminase, and a site for integration host factor (IHF). IHF plays an accessory
      role in lambda DNA packaging, and IHF stimulates the burst size of lambda several
      fold, presumably by assisting the interaction of terminase with cosB. The present
      work includes a study of the effect on lambda development of a mutation, called
      I1A-, which consists of three adjacent base-pair changes in the IHF binding site.
      The I1A- mutation was found to abolish IHF stimulation of the lambda burst size,
      indicating that IHF is unable to bind to the mutant I1A site. A second mutation,
      called I1B- and also consisting of three adjacent base-pair changes, is a
      mutation that reduces an intrinsic bend found in cosB. lambda I1B- was more
      dependent on IHF than lambda+, raising the possibility that the intrinsic bend in
      cosB plays a role in cos function for lambda+ under the IHF- conditions. In vitro
      DNA packaging experiments established that the I1 mutations affect DNA packaging
      per se. A series of Nu1 mutations that create terminases able to suppress a
      variety of cosB defects were found to suppress the defects of the I1A- and I1B-
      mutations under IHF- conditions.

PMID- 8464063
TI  - Refined structure of the pyruvoyl-dependent histidine decarboxylase from
      Lactobacillus 30a.
AB  - The crystal structure of the pyruvoyl-dependent histidine decarboxylase from
      Lactobacillus 30a has been refined to an R-value of 0.15 (for the 5.0 to 2.5 A
      resolution shell) and 0.17 (for the 10.0 to 2.5 A resolution shell). A
      description of the overall structure is presented, focusing on secondary
      structure and subunit association. The enzyme is a hexamer of alpha beta
      subunits. Separate alpha and beta-chains arise from an autocatalytic cleavage
      reaction between two serine residues, which results in the pyruvoyl cofactor. The
      central core of the alpha beta subunit is a beta-sandwich which consists of two
      face-to-face three-stranded antiparallel beta-sheets, flanked by alpha-helices on
      each side. The beta-sandwich creates a stable fold that allows conformational
      strain to be introduced across an internal cleavage region between the alpha and
      beta chains and places the pyruvoyl cofactor in a position for efficient electron
      withdrawal from the substrate. Three alpha beta subunits are related by a
      molecular three-fold symmetry axis to form a trimer whose interfaces have
      complementary surfaces and extensive molecular interactions. Each of the
      interfaces contains an active site and a solvent channel that leads from the
      active site to the exterior of the molecule. The trimers are related by a
      crystallographic two-fold symmetry axis to form the hexamer with an overall
      dumbbell shape. The interface between trimers has few molecular interactions.

PMID- 8464064
TI  - Backbone-dependent rotamer library for proteins. Application to side-chain
      prediction.
AB  - A backbone-dependent rotamer library for amino acid side-chains is developed and
      used for constructing protein side-chain conformations from the main-chain co
      ordinates. The rotamer library is obtained from 132 protein chains in the
      Brookhaven Protein Database. A grid of 20 degrees by 20 degrees blocks for the
      main-chain angles phi, psi is used in the rotamer library. Significant
      correlations are found between side-chain dihedral angle probabilities and
      backbone phi, psi values. These probabilities are used to place the side-chains
      on the known backbone in test applications for six proteins for which high
      resolution crystal structures are available. A minimization scheme is used to
      reorient side-chains that conflict with the backbone or other side-chains after
      the initial placement. The initial placement yields 59% of both chi 1 and chi 2
      values in the correct position (to within 40 degrees) for thermolysin to 81% for
      crambin. After refinement the values range from 61% (lysozyme) to 89% (crambin).
      It is evident from the results that a single protein does not adequately test a
      prediction scheme. The computation time required by the method scales linearly
      with the number of side-chains. An initial prediction from the library takes only
      a few seconds of computer time, while the iterative refinement takes on the order
      of hours. The method is automated and can easily be applied to aid experimental
      side-chain determinations and homology modeling. The high degree of correlation
      between backbone and side-chain conformations may introduce a simplification in
      the protein folding process by reducing the available conformational space.

PMID- 8464065
TI  - 1.8 A refined structure of the lipase from Geotrichum candidum.
AB  - A lipase from the fungus Geotrichum candidum is one of only three interfacially
      activated lipases whose structures have been reported to date. We have previously
      reported the partially refined 2.2 A structure of this enzyme. We have
      subsequently extended the resolution and here report the fully refined 1.8 A
      structure of this lipase. The structure observed in the crystal is apparently not
      the lipolytic conformation, as the active site is not accessible from the surface
      of the molecule. A single large cavity is found in the interior of the molecule
      and extends from the catalytic Ser to two surface helices, suggesting that this
      face may be the region that interacts with the lipid interface. The mobility of
      local segments on this face is indicated by temperature factors larger than
      elsewhere in the molecule and by the observation of several residues whose side
      chains are discretely disordered. These observations strongly suggest that this
      portion of the molecule is involved in interfacial and substrate binding, but the
      exact nature of the conformational changes induced by binding to the lipid
      interface can not be determined.

PMID- 8464066
TI  - Rotamers: to be or not to be? An analysis of amino acid side-chain conformations
      in globular proteins.
AB  - Originally, rotamers were defined as side-chain torsion (chi-angle) combinations
      corresponding to the local minima of potential energy (van-der-Waals and torsion
      terms) for the side-chain of a terminally blocked amino acid. If at least one chi
      angle differed by more than 20 degrees from that of a rotamer, the side-chain was
      considered as deviant both from energetic (increase in potential energy of no
      less than 1 to 2 kcal/mol) and geometric (precision of atom positioning is worse
      than 0.5 A) aspects. In this work the distribution of side-chain conformations in
      protein crystal structures is analysed. Large deviations from rotameric chi
      values occur systematically and cannot be attributed merely to errors in crystal
      structure determination. The "rotamericity" (the fraction of residues within +/-
      20 degrees of the chi-angles of a rotamer) not only remains substantially below
      100% (70 to 95% for various amino acids) with improving crystallographic
      resolution but actually decreases for 8 out of 17 amino acid types after a
      critical resolution limit is crossed. This effect has been observed for external
      as well as for internal residues. The set of amino acid side-chain conformations
      in globular proteins cannot be considered as normally distributed around some
      rotamer points. Outliers occur systematically. The rotamericity of an amino acid
      depends essentially on the different environments the amino acid meets in real
      protein structures. Factors such as the backbone torsion angles of the residue
      itself, the secondary structure and tertiary contacts influence the rotamericity.
      The deviations in regions of regular main-chain structure from the average g
      :t:g+ relationship in the chi 1-angle become much more evident if, in addition to
      the typical secondary structure assignments, the actual backbone torsion angles
      of the residue are taken into account. In alpha-helices the t:g+ distribution in
      the chi 1-angle correlates with physical properties describing volume, extension
      and flexibility of the side-chain. In beta-strands the factors influencing the
      t:g+ distribution in the chi 1-angle are the polarity and hydrophobicity of the
      side-chain. Nevertheless, a considerable number of residues do not comply with
      the statistical preferences observed for the side-chain conformation. Large
      deviations from the rotamer values are observed especially in cases when normally
      advantageous chi 1-values are not allowed and adjustments in chi 2 become
      necessary to accommodate the side-chain.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8464067
TI  - Crystal structure of the trigonal form of human plasma retinol-binding protein at
      2.5 A resolution.
AB  - The three-dimensional structures of the liganded and unliganded forms of human
      plasma retinol binding protein (RBP) in the trigonal crystal form have been
      solved at 2.5 A resolution. The final model of RBP complexed with retinol
      (holoRBP, space group R3, a = b = 104.0 A, c = 74.4 A) has a crystallographic R
      factor of 0.176 for 9652 reflections. The unliganded form, obtained through a
      purification procedure which included steps based on hydrophobic interaction
      chromatography, crystallized isomorphously with holoRBP and its structure has
      been refined to an R factor of 0.190 for 9614 reflections. The structure of the
      trigonal holo protein is quite similar to that of the orthorhombic form: the root
      mean-square deviation of all the equivalent alpha-carbons in the two chains is
      0.53 A. The structural comparison between the liganded and unliganded forms of
      RBP in the crystal did not reveal gross conformational changes. The most
      significant difference between the two forms of the protein is a conformational
      change involving residues from 34 to 37. In this region, the movements of side
      chains of Leu35 and Phe36 are most noticeable. In particular, in the unliganded
      form the side-chain ring of the latter residue is in the place previously
      occupied by the alcoholic moiety of retinol. Our data are consistent with a model
      in which a region comprising these residues and at least part of the opening of
      the beta-barrel is involved in the recognition between RBP and transthyretin. In
      the case of the unliganded form, the central cavity, that is occupied by the
      vitamin in the two human crystalline holoRBPs, is filled by electron density
      that, at the present resolution, we interpret as solvent.

PMID- 8464068
TI  - Solution structure of human plasma fibronectin under different solvent
      conditions. Fluorescence energy transfer, circular dichroism and light-scattering
      studies.
AB  - Human plasma fibronectin is a high molecular weight (530,000), multi-domain,
      modular glycoprotein, consisting of two nearly identical subunits disulfide
      bridged close to their C-terminal ends. Three sites that can be differentially
      labeled with fluorescent probes are present on each fibronectin subunit, the
      transglutaminase-sensitive Gln3 residue and the two free sulfhydryl residues,
      Cys1201 and Cys2196. These sites are located, respectively, in the N-terminal
      heparin/fibrin-binding domain, between the central DNA and cell-binding domains,
      and just before the C-terminal fibrin-binding domain. To map the relative spatial
      arrangement of these domains, steady-state and lifetime fluorescence energy
      transfer techniques were employed. Our results show that the minimal
      intramolecular distances between the labeled Gln3-Cys1201 and Gln3-Cys2196 pairs
      are 5.5(+/- 0.6) nm and 5.7(+/- 0.7) nm, respectively, as measured by steady
      state methods. Lifetime methods gave somewhat higher distances of 8.1(+/- 0.2) nm
      and 7.6(+/- 0.2) nm, respectively, between these sites. The binding of heparin or
      subjection to high ionic strength had only a minor effect, while in the presence
      of 50% (w/v) glycerol, an increase of about 25% in the intramolecular distances
      between these sites was observed. A similar effect was induced by binding of
      fibronectin to the surface of Cytodex beads, an event which was previously shown
      instead to markedly increase the intersubunit distances between the Gln3-Gln3 and
      Cys1201-Cys1201 pairs. The solution structure of fibronectin was further
      investigated by elastic light-scattering and circular dichroism measurements. By
      elastic light-scattering, the radius of gyration of fibronectin was found to be
      15.3(+/- 0.8) nm in the presence of 30% (w/v) glycerol, in contrast to a value of
      8.6(+/- 0.3) nm under physiological conditions. Far and near ultraviolet circular
      dichroism spectra showed that only minor changes in the secondary structure of
      fibronectin take place on increasing the glycerol content of the solvent up to
      34% (w/v). Our results complement previously available information on the
      solution structure of fibronectin and on its transition from the native compact
      conformation to a more expanded form on increasing ionic strength or glycerol
      content. In either situation, fibronectin seems to retain a basic structural
      core, in which the N-terminal, the central and the C-terminal regions of the two
      subunits strongly interact with each other. A major role of hydrophobic forces,
      in stabilizing the fibronectin conformations under these conditions, is therefore
      postulated. The transition to the extended forms seen in many electron
      micrographs can instead be explained by disruption of the proposed structural
      core upon adsorption to surfaces.

PMID- 8464069
TI  - What is the natural boundary of a protein in solution?
AB  - At what distance do proteins in solution interact? Molecular simulation of water
      around two helices is used to address this question. Calculations are done with
      two ideal, parallel, polyalanine alpha-helices separated by 9 A, 11 A, 13 A, and
      15 A. The second peak in the oxygen density (or loosely the second shell of water
      molecules) is used to define a hydration surface around the protein, which
      separates bulk solvent from water molecules strongly influenced by the protein.
      The hydration surface is contrasted with the Richards-Connolly molecular surface.
      It indicates that the helices are not completely separate until 15 A, while the
      molecular surface shows complete separation at 13 A. Suggesting shape-dependent
      aspects of hydration, the hydration surface only loosely follows the van der
      Waals outline of the protein surface. In particular, at the 9 A separation, the
      van der Waals envelopes of the helices make contact; two narrow crevices are
      formed on either side of the contact; and the water within the crevices is
      strongly localized in arrangements bridging the helices. A comparison of these
      'normal' water simulations with a simulation of a simple, uncharged solvent
      highlights the importance of hydrogen bonding in structuring liquid water and
      further contrasts the molecular surface and the hydration surface.

PMID- 8464070
TI  - Determination of the rate constants k1 and k2 of the Linderstrom-Lang model for
      protein amide hydrogen exchange. A study of the individual amides in hen egg
      white lysozyme.
AB  - The pH dependence of the amide/solvent hydrogen exchange of individual amide
      groups in hen egg-white lysozyme has been studied by nuclear magnetic resonance
      spectroscopy. Lysozyme has been used here as a model for a globular protein to re
      examine the hypothesis for the amide/solvent hydrogen exchange reaction proposed
      by K. Linderstrom-Lang and described in detail by Hvidt and Nielsen. The work has
      been focused on the most slowly exchanging amide at the temperature of 21 degrees
      C and in the pH range between 4 and 8. Exchange rates have been measured for 64
      of the 126 amide protons and the pH dependence has been determined for 52 of
      these. The amides examined represent a sample that includes all the types of
      secondary structure and they are placed in the globular structure in a range of
      3.2 A to 8.5 A from the closest water molecule on the surface. The measured
      exchange rates at pH 6 have been compared to these structural parameters and the
      results suggest that the rate constants are determined partly by the distance to
      the surface and partly by the type of secondary structure the amide is engaged
      in. Near the surface and in the very interior the distance to the surface seems
      to be rate-determining. Between the extremes the type of secondary structure is
      rate determining. The pH dependent exchange of the examined amides was shown to
      be in agreement with the Linderstrom-Lang model. For each of the amides examined
      the rate constants for the opening and the closing reaction in the first reaction
      step of the Linderstrom-Lang model has been calculated and compared to structural
      parameters.

PMID- 8464071
TI  - Crystals of beta-xylanase from Aspergillus oryzae.
AB  - An endo-xylanase was isolated from the culture of fungus Aspergillus oryzae
      variant D5. The purified enzyme had a molecular weight of 24,000 and the
      isoelectric point of 3.6. Xylanase crystals were obtained from a polyethylene
      glycol 6000 solution by the hanging-drop method. Seeding was used for the
      enlargement of the crystal size. Crystals belong to the monoclinic space group
      P2(1) with cell dimensions a = 54.9 A, b = 74.5 A, c = 50.8 A, and beta = 108.7
      degrees. Crystals diffract beyond 2.5 A resolution.

PMID- 8464072
TI  - Crystallization and preliminary X-ray analysis of a thermophillic Bacillus
      xylanase.
AB  - A xylanase of M(r) 20,700 from the hyperproductive mutant D3 of the thermophillic
      Bacillus, strain XE has been purified and crystallized from 2-methyl-2,4
      pentanediol. The unit cell is triclinic with a = 48.5 A, b = 51.5 A, c = 72.6 A,
      alpha = 90.4 degrees, beta = 95.4 degrees, gamma = 92.3 degrees (all +/- 0.2).
      There are four molecules in the asymmetric unit related by 222 symmetry. These
      crystals diffract to at least 2.5 A using X-rays from a rotating anode generator.

PMID- 8464073
TI  - Crystallization and preliminary crystallographic analysis of a tetrameric
      isolectin from Vicia villosa, specific for the Tn antigen.
AB  - Isolectin B4 isolated from Vicia villosa seeds is specific for the Tn antigen, a
      carcinoma-associated molecular marker. Crystals of the isolectin grown in the
      presence of carbohydrate are tetragonal, space group P4(1) (or P4(3), with a =
      91.3 A, c = 151.7 A and one tetramer in the asymmetric unit. The crystals
      diffract X-rays to 2.8 A resolution and are suitable for high-resolution
      structural analysis.

PMID- 8464074
TI  - Crystallographic characterization of tetanus toxin fragment C.
AB  - The C-terminal fragment from tetanus toxin has been crystallized. The 50 kDa
      protein forms prismatic crystals with an orthorhombic unit cell of dimensions a =
      64.03 A, b = 76.31 A and c = 135.3 A. The space group is P2(1)2(1)2(1). Assuming
      one molecule per asymmetric unit, the solvent occupies 63% of the unit cell.

PMID- 8464075
TI  - Crystallization of the maltodextrin-binding protein for active transport and
      chemotaxis in several different liganded and mutant forms.
AB  - We have crystallized the maltodextrin-binding protein complexed with two cyclic
      maltodextrins, and with no ligand at all. We have also grown crystals of two
      complexes of a mutant of maltodextrin-binding protein whose transport specificity
      has been altered. Studies of these crystals should provide considerable
      information about protein-oligosaccharide interactions, the effects of these
      interactions on oligosaccharide conformation, and particularly about the function
      of the periplasmic receptors in transport and chemotaxis.

PMID- 8464076
TI  - Preliminary crystallographic data for Pneumocystis carinii dihydrofolate
      reductase.
AB  - Dihydrofolate reductase from Pneumocystis carinii has been crystallized in a form
      suitable for high resolution X-ray diffraction studies. Recombinant enzyme that
      had been refolded following solubilization in guanidinium hydrochloride was
      crystallized as both a ternary complex with the cofactor NADPH and the inhibitor
      trimethoprim as well as a binary complex with NADPH. The two types of complex
      crystallized isomorphously from polyethylene glycol using sitting-drop vapour
      diffusion. The crystals were of space group P2(1) with unit cell parameters, a =
      69.9 A, b = 43.6 A, c = 37.6 A, beta = 117.7 degrees, with one molecule per
      asymmetric unit. The crystals diffracted to 1.8 A resolution.

PMID- 8464077
TI  - Preliminary X-ray study of naproxen esterase from Bacillus subtilis.
AB  - Single crystals of naproxen esterase from Bacillus subtilis have been obtained
      from PEG6000 solutions at pH 8.0 by liquid-liquid diffusion while applying a
      temperature gradient from 4 degrees C to room temperature over a period of four
      weeks. The crystals belong to the trigonal space group P3(1)21 or P3(2)21 with a
      = b = 47.59 A and c = 212.91 A. The asymmetric part of the unit cell contains one
      protein molecule with M(r) = 33,771. The crystals diffract to at least 3.0 A
      resolution and are suitable for an X-ray structure analysis.

PMID- 8464078
TI  - Prokaryotic members of a new family of putative helicases with similarity to
      transcription activator SNF2.
AB  - Cloning and sequence analysis of a new open reading frame from Bacillus cereus
      reveals the relationship to a recently identified family of putative eukaryotic
      transcription activators similar to the yeast SNF2 gene product. As a result of
      comparative analysis of sequence features conserved in all members of this
      family, a gene from a chilo iridescent virus, as well as a putative helicase from
      Escherichia coli (hepA), can also be grouped into this family. The unexpected
      presence of prokaryotic and viral sequences in the previously purely eukaryotic
      SNF2 family suggests a defined subgroup of DNA helicases present in all species,
      with specific function in transcription activation.

PMID- 8464079
TI  - Sweet-tasting protein monellin is related to the cystatin family of thiol
      proteinase inhibitors.
AB  - The structure of the intensely sweet protein monellin, isolated from an African
      berry, and the structures of two thiol proteinase inhibitors, cystatin and stefin
      B, are found to be very similar. An alignment of sequences of monellin and the
      inhibitors, deduced from the structural comparisons, has been extended to include
      other members of the cystatin superfamily. There is a significant homology (up to
      23% identical residues) with oryzacystatins, the only well defined plant
      cystatins. These results clearly indicate that monellin is a close relative of
      cystatins. Monellin and cystatins do not have the same sequence in the regions
      homologous to the cystatin active site. It is suggested here, however, that this
      region in monellin may be essential for a function in situ, because one of the
      loops comprising this part of the structure is found to be cleaved.

PMID- 8464080
TI  - Infected infrarenal aortic aneurysms: when is in situ reconstruction safe?
AB  - Twenty-five infected infrarenal aortic aneurysms operated on between 1968 and
      1989 were reviewed. They were classified into post-embolic (mycotic) aneurysms
      (group I), infective aortitis (group II), and infected atherosclerotic aneurysms
      (group III). Aortoduodenal fistulas were found in eight patients and aortocaval
      in two. Five patients were operated on in a state of shock, and 12 had
      preoperative positive blood cultures. Surgical procedures included in situ
      reconstruction of the aorta (n = 21) and extra-anatomic bypass associated with
      aneurysmal resection (n = 4). In 19 patients, prostheses were covered with
      omental flaps, and antibiotics were continued for more than 6 weeks in all
      patients. In patients who underwent in situ reconstruction, three deaths were
      related to the initial surgery. All surviving patients were regularly followed
      up, and none showed any sign of late septic recurrence. In patients who underwent
      extra-anatomic bypass, two died in the postoperative period, one underwent
      reoperation 2 years after the initial surgery, and the last patient is doing
      well. Positive postoperative blood cultures (n = 4) revealed persistent sepsis:
      two cholecystitis, one spondylitis, and one aortic infection. An exhaustive
      review of the literature was performed; clinical, bacteriologic, and operative
      features and results were analyzed; prognostic factors were evaluated; and a
      practical therapeutic approach was suggested. The importance of preoperative
      diagnosis, complete resection, debridement of infected tissues, omental flap
      coverage, and long-term antibiotic therapy with regular computerized tomographic
      scanning follow-up is stressed.

PMID- 8464081
TI  - Hemodynamics of a side-to-end proximal arterial anastomosis model.
AB  - PURPOSE: The purpose of this article was to analyze the fluid mechanical effects
      of a side-to-end proximal anastomosis and to compare the results with those from
      our earlier study on the end-to-side distal anastomosis. METHODS: The
      photochromic tracer technique was used to determine the instantaneous wall shear
      stress and to visualize the overall flow field under pulsatile flow conditions.
      The flow consisted of a sinusoid plus a steady component with mean and modulation
      Reynolds numbers of 355 and 565, respectively, and a Womersley number of 7.9.
      RESULTS: At the toe and heel of the junction, very high and positive wall shear
      stresses were seen together with substantial nonperiodic fluctuations. The peak
      wall shear stress was about four times higher at the toe and about seven times
      higher at the heel than the maximum values observed at about four tube diameters
      upstream from the junction. On the bed of the host vessel, nonperiodic
      fluctuations were also observed, but the shear stresses were mainly negative with
      magnitudes comparable to those seen upstream. With leakages of 11% and 28% of the
      mean flow through the blocked end of the host vessel, the shear stress pattern
      seemed to be significantly affected only at the toe for the higher leakage.
      Further, when the mean Reynolds number was reduced to 320, the magnitudes of the
      variations in the wall shear stress were reduced proportionately, except at the
      heel, where the reduction was much larger than expected. CONCLUSIONS: It appears
      that the preferential development of intimal hyperplasia at the distal end-to
      side anastomosis may be promoted by low wall shear stress at the toe and heel,
      and probably by high shear stresses or shear stress gradients on the bed.

PMID- 8464082
TI  - Three-dimensional display of calculated velocity profiles for physiological flow
      waveforms.
AB  - PURPOSE: To improve the understanding of the nature of pulsatile flow, three
      dimensional idealized velocity profiles corresponding to measured physiological
      mean flow velocity waveforms were displayed at selected instants throughout the
      flow cycle. METHODS: The Fourier harmonics for each waveform were determined, and
      their corresponding velocity profiles at each instant of time were calculated
      with the Womersley equations. Velocity profiles were calculated by summing the
      contributions from each harmonic. RESULTS: Calculated profiles were displayed in
      a three-dimensional perspective for both normal carotid and femoral arteries and
      for simple sinusoidal flow with a superimposed steady component. CONCLUSION: The
      potential value of such displays is discussed in terms of gaining an improved
      understanding of the nature of pulsatile flow and clarifying the interpretation
      of Doppler ultrasound recordings.

PMID- 8464083
TI  - Postischemic hyperglycemia worsens neurologic outcome after spinal cord ischemia.
AB  - PURPOSE: The neurologic effect of induced hyperglycemia in the postischemic
      period was investigated with a rat aortic occlusion model. METHODS: Sprague
      Dawley rats weighing 200 to 350 gm were anesthetized, intubated, and ventilated
      with 1% to 1.5% halothane. Temperature was continuously monitored and maintained
      at 37 degrees +/- 0.5 degrees C. The chest was opened, the thymus excised, and
      the aortic arch exposed. Snares were placed around the aorta distal to the left
      subclavian artery and the right and left subclavian arteries. The three vessels
      thus isolated were occluded for 8 minutes. With snare release and withdrawal, the
      rats received an intraperitoneal injection of 5% dextrose in water (2 gm/kg) or
      an equivalent volume of 0.9% saline solution. In a second group of rats the
      administration of glucose or saline solution was delayed until 30 minutes after
      snare release. Blood samples for blood glucose determination were obtained before
      operation, before occlusion, immediately after occlusion, and 15, 30, 45, 60, and
      240 minutes after occlusion. A neurologic deficit score was assigned at 1, 4, 18,
      and 24 hours after occlusion to quantify hindlimb neurologic deficit based on 15
      point scale (0 = normal, 15 = severe deficit). Sham-operated rats received the
      same operation and injection, but the snares were only manipulated and not made
      occlusive. RESULTS: The rats that were administered glucose immediately after
      snare release showed a statistically significant exacerbation of lower extremity
      neurologic deficit at 24 hours after occlusion (p < or = 0.05, Mann-Whitney U
      test). The sham-operated rats were normal (0 score) at 24 hours. Significant
      elevation of blood glucose (321 +/- 33 mg/dl) was seen in the glucose-injected
      rats at 15 minutes and continued for up to 4 hours after occlusion (p = 0.040 and
      0.014, respectively; Student's t test). CONCLUSION: Postischemic hyperglycemia
      immediately after a standard spinal cord ischemic stress worsens neurologic
      outcome.

PMID- 8464084
TI  - Leukocytes: their role in the etiopathogenesis of skin damage in venous disease.
AB  - The role of leukocytes in tissue damage in the liposclerotic skin of venous
      disease has been investigated. Twenty-eight skin biopsy specimens were obtained
      from 23 patients with varicose veins of the lower limb, with a spectrum of skin
      injury ranging from normal to severe liposclerosis. In no patient was a venous
      ulcer present. Immunohistochemistry was used to determine the cell types present
      and provide an indication of their activity. The predominant infiltrating cell
      types present were T lymphocytes and macrophages. B cells and neutrophils were
      rarely seen. As described previously, the capillaries were greatly increased in
      number in the papillary dermis and exhibited grossly increased expression of
      factor VIII-related antigen and major histocompatibility complex class II.
      Surprisingly, expression of adhesion molecules endothelial leukocyte adhesion
      molecule-1 and vascular cell adhesion molecule were not elevated, but
      intercellular adhesion molecule-1 expression did increase in more severely
      diseased skin. Perivascular fibrin was seen occasionally, but there was no
      evidence of microvascular occlusion. Staining for the cytokine tumor necrosis
      factor-alpha was not increased in liposclerotic skin. Dermal staining for both
      interleukin (IL)-1 alpha and IL-1 beta was increased in severely liposclerotic
      skin, but this was not seen at an early stage. Epidermal staining for IL-1 alpha
      and IL-1 beta was not increased. All changes were confined to the subpapillary
      region of the skin. These findings demonstrate that accumulation of macrophages
      and T cells is an event associated with the development of liposclerotic skin
      changes that may lead to ulceration in venous disease.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8464085
TI  - How can the assessment of the hemodynamic significance of aortoiliac arterial
      stenosis by duplex scanning be improved? A comparative study with intraarterial
      pressure measurement.
AB  - PURPOSE: The current diagnostic criteria used to assess the severity of stenoses
      in the aortoiliac arteries by duplex scanning are mainly based on information
      related to changes in cross-sectional area and are flow independent.
      Consequently, duplex scanning fails to detect approximately one quarter of
      hemodynamically significant aortoiliac lesions compared with intraarterial
      pressure measurements. The aim of this study is to improve the assessment of the
      hemodynamic significance of aortoiliac lesions by duplex scanning. METHODS: A
      prospective study in 60 patients was performed in which duplex scanning at rest
      was compared with intraarterial pressure measurements before and after the
      administration of papaverine. A simplified Bernoulli equation was used to
      calculate pressure gradients across stenoses (delta PBern). Two flow-related
      parameters, the increase in peak systolic velocity (delta PSV) across the
      stenosis and the end-diastolic velocity at the site of the stenosis, were also
      measured and compared with intraarterial pressure measurements. RESULTS: delta
      PBern and delta PSV showed a sensitivity and specificity of 81% and 88%,
      respectively, for the detection of hemodynamically significant lesions at rest.
      However, delta PBern could often not give an accurate calculation of the pressure
      gradient. Receiver operator characteristic analysis showed that a cut-off level
      for delta PSV in the range of 1.4 to 1.5 m/s was best able to detect significant
      lesions at rest. The end-diastolic velocity parameter had a limited diagnostic
      value. CONCLUSION: Although useful in clinical decision making, delta PBern often
      could not give an accurate calculation of the pressure gradient. delta PSV is a
      simple and practical spectral analysis parameter to differentiate between
      significant and insignificant stenoses. This parameter also has the potential to
      detect hemodynamically less critical lesions if duplex scanning is performed
      under conditions of increased flow. Further evaluation is needed.

PMID- 8464086
TI  - Attenuation of renal reperfusion injury in rats by the 21-aminosteroid U74006F.
AB  - PURPOSE: The 21-aminosteroids represent a new class of compounds that serve as
      potent inhibitors of iron-dependent lipid peroxidation, the latter being an
      important component of ischemia-reperfusion tissue injury. It is hypothesized
      that reperfusion injury accompanies renal ischemia, and postischemic
      administration of one of these steroids, U74006F, will reduce renal damage in a
      rodent model, as assessed by renal function (plasma creatinine), histologic
      evidence of renal injury, and animal survival during a 72-hour interval. METHODS:
      Fifty-one rats subjected to 45 minutes of renal ischemia were treated on clamp
      release with 3 or 10 mg/kg U74006F intravenously (n = 5 and 19, respectively), an
      inactive vehicle (n = 23), or sham operation (n = 4). RESULTS: Both doses of
      U74006F improved morphologic outcome compared with vehicle-treated animals.
      Statistically significant improvement in renal function was observed with the 10
      mg/kg dose of U74006F (p = 0.029, 0.014, and 0.065 at 24, 48, and 72 hours,
      respectively) but not with the 3 mg/kg dose. Only one (5.2%) of 19 rats receiving
      high-dose U74006F (10 mg/kg) died within 72 hours after ischemia, compared with
      five deaths (29.4%) in 17 rats receiving citrate vehicle alone (p = 0.060). All
      sham-operated animals survived 72 hours with normal morphology and plasma
      creatinine levels. CONCLUSION: These data suggest that iron-dependent lipid
      peroxidation is a component of reperfusion injury and indicate that U74006F may
      be useful in reducing this form of renal ischemic damage.

PMID- 8464088
TI  - Abdominal duplex ultrasound screening for occult aortic aneurysm during carotid
      arterial evaluation.
AB  - PURPOSE: The purpose of this study was to investigate the use of a modified
      abdominal ultrasound examination, which was performed at the time of routine
      diagnostic carotid artery duplex evaluation, to identify patients at risk for
      aortic aneurysms. METHODS: A prospective study was undertaken that consisted of a
      limited ultrasound examination of the abdominal aorta on patients referred to our
      facilities for duplex carotid evaluation. One hundred thirty-one patients were
      included in the study; 52% were men and 48% were women, who ranged in age between
      40 to 93 years. These patients were not known or suspected to have an abdominal
      aortic aneurysm. RESULTS: Eleven infrarenal aortic aneurysms (8.4%) were
      detected, four in patients with positive carotid studies (11%) and seven in those
      with negative studies (7%); size ranged from 3.0 to 7.5 cm. Categoric data
      analysis did not produce significance, but a stepwise regression and discriminant
      analysis model revealed a significant relationship between abnormal velocities
      and occlusive changes in the carotid arteries and the presence of aortic
      aneurysms. CONCLUSIONS: Hemodynamically significant carotid artery disease, as
      diagnosed by duplex examination, appears to be a definite marker for an increased
      incidence of abdominal aortic aneurysm when compared with the general population.
      When selective abdominal aortic ultrasonography is done in conjunction with the
      carotid study, the requirements of additional equipment and technologist time are
      modest, and the potential benefit to the patient may be significant.

PMID- 8464087
TI  - The cerebral hyperperfusion syndrome: diagnostic value of ocular
      pneumoplethysmography.
AB  - PURPOSE: There were two purposes to our study. The first was to characterize the
      ocular hyperperfusion associated with carotid endarterectomy. The second was to
      relate ocular hyperperfusion to the clinical presentation of cerebral
      hyperperfusion syndrome. METHODS: This was a retrospective chart review of 2331
      patients who underwent carotid endarterectomy at our institution between June
      1978 and May 1991. RESULTS: Twelve of these carotid endarterectomies were
      associated with ocular hyperperfusion on the side of operation. Clinical evidence
      of cerebral hyperperfusion syndrome was observed in five of these 12 procedures.
      In these five patients there were two associated fatal intracerebral hemorrhages
      and one permanent coma. In the latter three patients the contralateral internal
      carotid arteries were totally occluded. CONCLUSION: Ocular hyperperfusion, as
      documented with ocular pneumoplethysmography, is useful in alerting the physician
      to the potential for development of the cerebral hyperperfusion syndrome.

PMID- 8464089
TI  - Radiologic investigation of abdominal aortic aneurysm disease: comparison of
      three modalities in staging and the detection of inflammatory change.
AB  - PURPOSE: The purpose of this study was to compare the ability of ultrasonography
      (US), contrast-enhanced computed tomography (CT), and magnetic resonance imaging
      (MRI) to display the anatomy of abdominal aortic aneurysms and to detect the
      presence of inflammatory change. METHODS: We prospectively studied 79 patients
      with abdominal aortic aneurysms (64 noninflammatory aneurysms [NIAAs] and 15
      inflammatory aneurysms [IAAs]) with US, CT, and MRI. RESULTS: Ultrasonography
      failed to diagnose the level of the aneurysm neck in three IAAs and 18 NIAAs. It
      failed to differentiate NIAAs from IAAs and to visualize the origins of the renal
      arteries in all cases. With CT the level of the aneurysm neck was incorrectly
      stated as lying above the level of the renal arteries in two cases of IAA and
      four cases of NIAA, and the renal artery origins were seen in only 10 of 77
      patients. Inflammatory change was diagnosed correctly in seven of 15 patients,
      whereas six NIAAs were falsely diagnosed as inflammatory. MRI successfully
      diagnosed neck level and inflammatory change in all cases. Of two failures to
      visualize the renal artery origins, only one was caused by radiologic factors. In
      addition, characteristic radiologic features were seen in MRI images of IAAs, and
      these will be described both in vivo and in vitro. CONCLUSIONS: Our results
      suggest that MRI is superior to other methods in identifying the anatomy of
      aneurysms and the presence of inflammatory change.

PMID- 8464090
TI  - Human vascular endothelial cell attachment and growth inhibition by type V
      collagen.
AB  - PURPOSE: Human vascular prostheses develop a pseudointima that after time is
      devoid of a complete endothelial lining. The composition of this pseudointima
      consists of both cellular and noncellular components such as coagulation proteins
      and extracellular matrix proteins. Of these extracellular molecules, type V
      collagen has been reported to be localized to surfaces of vascular prostheses. We
      have hypothesized that type V collagen may be involved in the mechanisms of
      inhibition of endothelialization on vascular prostheses. In this study,
      interactions of human protein and cells with clinically used material and
      reference surfaces were analyzed in vitro. METHODS AND RESULTS: Human collagen
      types IV and V or human fibronectin was coated on disks punched from expanded
      polytetrafluoroethylene, bacteriologic polystyrene, and tissue culture-treated
      polystyrene. Fibronectin adsorbed equally to these surfaces, but differential
      adsorption of type V collagen occurred. The attachment and growth of human
      saphenous vein and umbilical vein endothelial cells and of human skin fibroblasts
      were also evaluated on protein-coated or uncoated surfaces. Type IV collagen and
      fibronectin promoted the attachment of these cells, but type V collagen reduced
      cellular adhesion. Growth of endothelial cells was significantly inhibited on
      surfaces coated with type V collagen even when additional growth substances such
      as serum, retinal-derived growth factor, and heparin were present in the medium.
      Human adult dermal fibroblast adhesion and cell growth were not affected by
      coating the surfaces with type V collagen. CONCLUSIONS: The components of the
      extracellular matrix of the pseudointima may directly influence endothelial cells
      by inhibiting cell proliferation, migration from within the graft or from
      anastomoses, or both. Type V collagen, a matrix protein found at luminal surfaces
      of vascular prostheses, may be one protein responsible for control of endothelial
      responses.

PMID- 8464091
TI  - Measurement of the ultrasonic intima-media complex thickness in normal subjects.
AB  - PURPOSE: The evolution of atherosclerosis can be studied before development of
      symptomatic plaque by evaluating morphologic changes of the intima-media (I-M)
      complex, seen on high-resolution ultrasonography of the arterial wall. These
      qualitative changes require large alterations in vessel wall appearance to
      recognize progression of atherosclerosis. It has been suggested that measurement
      of the thickness of the I-M complex may be a quantitative and more sensitive
      method of assessing these early atherosclerotic changes. METHODS: High-resolution
      ultrasonography has been used to measure the thickness of the I-M complex in 140
      symptom-free subjects. RESULTS: The mean thickness of the I-M complex of the
      common carotid arteries was linearly related to the age (r = 0.77; p < 0.001),
      pack-years of smoking (r = 0.39; p < 0.05), the systolic blood pressure (r =
      0.51, p < 0.01), and to the arterial ultrasound score (r = 0.85). The arterial
      ultrasound score has previously been shown to correlate with the presence of
      asymptomatic myocardial ischemia and with the development of cardiovascular
      symptoms. The mean thickness of the I-M complex in subjects without plaque (in
      the common carotid or common femoral artery bifurcations) was significantly
      thinner than in subjects with plaque (p < 0.001). CONCLUSION: The thickness of
      the I-M complex of the common carotid arteries is a measure of the risk for the
      development of cardiovascular symptoms in symptom-free individuals.

PMID- 8464092
TI  - Effects of donor characteristics and platelet in vitro time and temperature on
      platelet aggregometry.
AB  - PURPOSE: This study was undertaken to determine whether platelet donor
      characteristics and the duration and temperature of platelet storage affect
      platelet aggregation. METHODS: Half of each platelet-rich plasma sample, obtained
      from 42 healthy volunteers, was maintained at 37 degrees C and the other half at
      25 degrees C. Aggregation was stimulated with adenosine diphosphate (ADP),
      epinephrine, or collagen 1, 2, 4, and 6 hours after platelet donation. The lag
      time, slope of the aggregation curve, and percent peak aggregation were
      determined for each aggregation test. RESULTS: Age, sex, time of donation,
      smoking status, estrogen replacement, and menstruation did not significantly
      influence platelet aggregation. Storage time and temperature had a major
      influence on platelet reactivity, with the reactivity decreasing with prolonged
      storage and higher storage temperatures. Peak ADP-induced aggregation for
      platelets stored at 37 degrees C was significantly less (p < 0.0002) than the
      values obtained for ADP aggregation at 25 degrees C. Collagen-stimulated peak
      aggregation of platelets maintained at 37 degrees C for 4 and 6 hours was also
      significantly less than the corresponding values at 25 degrees C. Epinephrine
      stimulated aggregation produced similar results, with peak platelet aggregation
      decreasing with time (50.3% +/- 2.9% at 6 hours compared with 38.5% +/- 3.7% at 2
      hours at 25 degrees C) and high storage temperatures (there was less aggregation
      by platelets stored at 37 degrees C at each time period studied). CONCLUSIONS: It
      is recommended that platelet-rich plasma for platelet aggregation testing be
      maintained at room temperature and be used between 2 and 4 hours after platelet
      donation.

PMID- 8464093
TI  - Intestinal permeability is increased after major vascular surgery.
AB  - PURPOSE: In experimental animals increased intestinal permeability has been
      demonstrated after ischemia and reperfusion injury. In this study we determined
      intestinal permeability in patients after elective or emergency aortic aneurysm
      repair; the latter patients were in severe shock on hospital admission. METHODS:
      A dual sugar absorption test, with lactulose and mannitol as markers, was used to
      measure intestinal permeability on the second day between 24 and 30 hours after
      hospital admission. RESULTS: The lactulose/mannitol excretion ration was 0.012 +/
      0.005 in seven healthy control subjects, 0.118 +/- 0.116 in seven patients
      having elective operation, and 0.098 +/- 0.093 in eight patients having emergency
      operation, indicating a significant increase of intestinal permeability in both
      patient groups (p < 0.01). No significant difference was found in intestinal
      permeability between patients of the elective and emergency groups. CONCLUSIONS:
      A significant increase in intestinal permeability commonly occurs in patients
      after elective and emergency major vascular surgery. It is suggested that this is
      mainly due to reperfusion injury rather than the ischemic period of the intestine
      itself.

PMID- 8464094
TI  - Detection of celiac axis and superior mesenteric artery occlusive disease with
      use of abdominal duplex scanning.
AB  - PURPOSE: Detection of mesenteric arterial insufficiency is clinically difficult,
      and diagnosis frequently requires arteriography. Advances in duplex scanning make
      this an ideal technique to noninvasively screen patients for chronic mesenteric
      arterial occlusive disease. However, the accuracy of mesenteric duplex scanning
      compared with arteriography remains unclear. This study will clearly define the
      accuracy of abdominal duplex scanning for detection of mesenteric arterial
      insufficiency. METHODS: The mesenteric duplex scans of 38 patients obtained over
      a 4-year period were reviewed and compared with lateral aortograms to clarify
      this issue. Optimal peak systolic frequency (PSF) for predicting less than 50% or
      50% or greater stenoses of the superior mesenteric artery (SMA) and celiac axis
      (CA) were determined from receiver-operating characteristic curves. RESULTS: In
      the SMA a PSF of 4.5 kHz was 96% sensitive (24/25), 92% specific (12/13), and 95%
      accurate (36/38) at predicting stenoses less than 50% or 50% or greater. For
      arteries with stenoses 50% to 99%, regression analysis demonstrated excellent
      linear correlation between percent stenosis and PSF (r = 0.89). In the CA a PSF
      of 4.0 kHz had a sensitivity of 100% (30/30), a specificity of 88% (7/8), and an
      accuracy of 97% (37/38). Again, for arteries with stenoses 50% to 99%, an
      excellent linear correlation existed between PSF and percent stenosis (r = 0.86).
      All total arterial occlusions (14) were correctly identified. In all, mesenteric
      arterial duplex scanning was 96% accurate for predicting SMA and CA
      stenoses/occlusions. CONCLUSIONS: Abdominal duplex scanning is a noninvasive
      technique that accurately detects total occlusions and objectively quantitates
      SMA and CA arterial stenoses.

PMID- 8464095
TI  - Evaluation and performance standards for arterial prostheses.

PMID- 8464096
TI  - Spontaneous rupture of the iliac vein.
AB  - A spontaneous rupture of the left iliac vein is described. A 2 cm tear on the
      anterior surface of the left iliac vein was discovered at emergency laparotomy on
      a patient who was suspected of having a huge intraabdominal hemorrhage. Prodromal
      symptoms, cause, and treatment are discussed. The nine previously reported cases
      are reviewed. This case represents the seventh successful repair of an idiopathic
      rupture of an iliac vein.

PMID- 8464097
TI  - Polytetrafluoroethylene aorta-vena cava graft for hemodialysis: report of a case.
AB  - In children with chronic renal failure, vascular access for hemodialysis is
      difficult because of the small size of the vessels and the requirement for
      substantial blood flow through the fistula or graft. As the child grows older,
      the ease of constructing a satisfactory access usually increases as the vessels
      increase in size. Unfortunately, this increased ease is often offset by the
      paucity of suitable access sites because the larger peripheral sites have already
      been used with only transient success. We report a child with chronic renal
      failure since 1 month of age with no peripheral sites available because of prior
      failed procedures who underwent placement of polytetrafluoroethylene limbs to the
      aorta and vena cava at the age of 6 years. He has continued on hemodialysis for
      the past 4 1/2 years with this technique of vascular access.

PMID- 8464098
TI  - True and false aneurysms in Behcet's disease: case report with ultrastructural
      observations.
AB  - One of the most important aspects of Behcet's disease is aneurysmal arteriopathy.
      The major problem of this complication is its tendency to develop recurrent false
      aneurysms at anastomotic and traumatic sites, such as angiographic punctures. We
      present a clinical case in which five aneurysms, some true, some false, were
      operated on during a period of 6 years, with the aid of ultrastructural
      observations of the wall of a true and a false aneurysm. One of the true
      aneurysms, localized in the aorta, was treated by direct aneurysmorrhaphy, and
      the 6-year follow-up demonstrated the absence of recurrences. Based on both this
      experience and the data in the literature, we suggest that the most appropriate
      surgical approach would, when possible, be direct aneurysmorrhaphy.

PMID- 8464099
TI  - In situ replacement of infected vascular prostheses with rifampin-soaked vascular
      grafts: early results.
AB  - Based on the excellent results of experimental studies with antibiotic-bonded
      vascular prostheses for prevention of graft infection, gelatin-sealed grafts
      soaked with rifampin were implanted in situ in five patients with vascular
      infection. All patients were at risk for limb loss or death and could not be
      treated by standard techniques such as graft excision and extra-anatomic bypass.
      In one patient an infected aortic stump aneurysm with involvement of both renal
      and visceral arteries was found. He was treated by implantation of a bifurcation
      rifampin-soaked graft between the subdiaphragmal aorta and both renal arteries
      and reimplantation of celiac and superior mesenteric artery into the graft. In
      four patients with in-flow or runoff problems on angiography, an antibiotic
      soaked graft was used for replacement of a partially or totally infected graft.
      Cultures were positive for Staphylococcus aureus in three and coagulase-negative
      staphylococci in two patients. Wound healing was uncomplicated; there was no need
      for amputation. After a follow-up of at least 6 months, all grafts were patent
      without any evidence of reinfection on computed tomographic scan. We conclude
      that infected vascular prostheses can be replaced in situ by rifampin-soaked
      grafts in patients at high risk for death or major amputation.

PMID- 8464100
TI  - Recreational weight lifting and aortic dissection: case report.
AB  - Although there have been previous cases of ascending (type I) aortic dissection
      recognized in young weight lifters, this is the first reported instance of a
      descending (type III) dissection in such an individual. Successful treatment
      included aortic fenestration and an aortoiliac bypass. A new entity of aortic
      dissection in young weight lifters may be emerging.

PMID- 8464101
TI  - Nonanastomotic pseudoaneurysm of expanded polytetrafluoroethylene axillofemoral
      bypass graft.
AB  - A case of nonanastomotic pseudoaneurysm of a unilateral axillofemoral bypass
      graft is reported. The graft material used in this particular instance was an 8
      mm, reinforced, thin-walled, fluorinated ethylene-propylene-ringed, expanded
      polytetrafluoroethylene (ePTFE). The pseudoaneurysm occurred 1 year after
      insertion of the graft and was not associated with any direct trauma. It
      manifested with a painful tender mass at the top of the body of the axillofemoral
      bypass graft at the level of the nipple line. There were no symptoms of localized
      or diffuse sepsis. Immediate surgical exploration confirmed the diagnosis of a
      pseudoaneurysm of the ePTFE graft. Successful repair of the disrupted segment was
      accomplished by use of an interposition, nonringed, reinforced, thin-walled, 8 mm
      ePTFE graft. To our knowledge this is the first case of a nonanastomotic
      pseudoaneurysm of a ringed, ePTFE, axillofemoral bypass graft not associated with
      direct trauma.

PMID- 8464102
TI  - Chronic traumatic thoracic aneurysm: report of two cases with the question of
      timing for surgical intervention.
AB  - We report on two symptom-free patients with chronic thoracic aneurysms related to
      prior trauma and address the timing for surgical intervention. In addition, we
      reviewed our institutional experience with similar cases for the period 1970 to
      1990. Although natural history data remain incomplete, we propose that in the
      setting of improved imaging modalities, it may be reasonable to manage this group
      of patients nonoperatively and intervene surgically only when symptoms develop or
      there is radiologic evidence of aneurysm change.

PMID- 8464103
TI  - Inferior pancreaticoduodenal artery aneurysm: report of a case and review of the
      literature.
AB  - Inferior pancreaticoduodenal artery aneurysms are rare, with only 34 cases
      reported in the literature. Most cases reported have begun with variations of
      abdominal or epigastric pain. We report a unique case of aneurysm of the inferior
      pancreaticoduodenal artery that began with intestinal angina and weight loss.

PMID- 8464104
TI  - Bilateral carotid artery thrombosis in a young man.
AB  - Carotid artery thrombosis in young patients without evidence of premature
      atherosclerosis prompts investigation of unusual forms of carotid disease in
      addition to a workup for cardiac and arch vessel sources for emboli. Noninvasive
      imaging and conventional angiographic techniques play an important part in the
      diagnostic evaluation looking for potential vascular sources. Physicians should
      also be aware that, in addition, hypercoagulable conditions may predispose to
      carotid thrombosis. One such patient is presented with bilateral carotid
      thrombosis and stroke. The management of the problem is reviewed, as well as the
      investigation of potential hypercoagulable conditions, with a primary focus on
      qualitative and quantitative platelet abnormalities.

PMID- 8464105
TI  - Transcatheter embolization of an aortocaval fistula caused by residual renal
      artery stump from previous nephrectomy: a case report.
AB  - An arteriovenous fistula between the renal artery and vein is a rare complication
      of nephrectomy. We report the first case of direct inferior vena cava to renal
      artery fistula after nephrectomy. In addition, this was the first use of the
      Amplatz "spider," a vascular obstructing device used to trap coils during
      transcatheter embolization of a high-flow fistula. The patient's fistula was
      embolized successfully, with immediate improvement of symptoms and without
      pulmonary embolization.

PMID- 8464106
TI  - Carotid endarterectomy for asymptomatic stenosis: benefits confirmed by
      randomized trial.

PMID- 8464107
TI  - Lumbar radiofrequency sympatholysis.
AB  - PURPOSE: The purpose of this article is to present a modified technique for
      lumbar radiofrequency sympatholysis and to compare the results with chemical
      sympatholysis. METHODS: Eight patients underwent the percutaneous procedure on an
      outpatient basis. Sympatholysis was produced with a radiofrequency lesion
      generator according to distinct anatomic criteria. RESULTS: Six of eight patients
      met previously used criteria for sympatholysis 8 weeks after the procedure.
      Postsympatholytic neuralgia occurred transiently in 50% of patients. CONCLUSIONS:
      The technique produces sympatholysis comparable to that produced by phenol 6%,
      while it theoretically avoids the risk of neurologic deficits associated with
      chemical agents. The technique may be useful in patients for whom surgical
      sympathectomy is undesirable.

PMID- 8464108
TI  - Polytetrafluoroethylene interposition grafts for carotid reconstruction.

PMID- 8464109
TI  - Mitochondrial DNA studies help identify lost victims of human rights abuses.

PMID- 8464111
TI  - Physicians tell Washington 'you want our help'.

PMID- 8464110
TI  - Gene hunters nab the Huntington's defect; now tests can suggest not only if but
      when.

PMID- 8464112
TI  - From the Office of Technology Assessment.

PMID- 8464113
TI  - From the Centers for Disease Control and Prevention. Sliding-associated injuries
      in college and professional baseball--1990-1991.

PMID- 8464114
TI  - From the Centers for Disease Control and Prevention. Cigarette smoking among
      adults--United States, 1991.

PMID- 8464116
TI  - A piece of my mind. The captain.

PMID- 8464115
TI  - From the Centers for Disease Control and Prevention. Prenatal care, pregnancies
      complicated by diabetes.

PMID- 8464117
TI  - Transdermal nicotine: clarifications, side effects, and funding.

PMID- 8464118
TI  - Transdermal nicotine: clarifications, side effects, and funding.

PMID- 8464119
TI  - Transdermal nicotine: clarifications, side effects, and funding.

PMID- 8464120
TI  - Functional status in children with asthma.

PMID- 8464121
TI  - Social catastrophe: orphaned by AIDS.

PMID- 8464122
TI  - Social catastrophe: orphaned by AIDS.

PMID- 8464123
TI  - Can states take the lead in health care reform?

PMID- 8464124
TI  - Improving access to primary care.

PMID- 8464125
TI  - Improving access to primary care.

PMID- 8464126
TI  - Accuracy of the death certificate in a population-based study of asthmatic
      patients.
AB  - OBJECTIVE: To quantify the reliability of death certificate data concerning
      asthma. DESIGN: The complete medical records of decedents were reviewed by a
      physician certified in allergy and pulmonology who determined the cause of death
      without having access to the original death certificate. Disagreements between
      the death certificate and the reviewer were adjudicated by an expert panel.
      SETTING: The community of Rochester, Minn. PATIENTS: The mortality cohort
      included 339 deaths from a larger cohort of 5241 Rochester residents who received
      medical treatment for asthma between 1964 and 1983. MAIN OUTCOME MEASURES: Kappa
      coefficients were used to measure agreement beyond that expected by chance
      between the reviewer and the death certificate. The sensitivity and specificity
      of the death certificate diagnosis of asthma were calculated against the standard
      of the reviewer/panel diagnosis. RESULTS: Death certificates reported asthma as
      an immediate or underlying cause of death in 22 instances (6%), whereas the
      reviewer/panel identified asthma in 53 cases (16%). In four cases, the death
      certificate listed asthma and the panel identified another cause of death. The
      death certificate had a sensitivity of 42% and a specificity of 99% compared with
      the reviewer/panel. Agreement between death certificates and the reviewer was not
      influenced by whether an autopsy was performed. CONCLUSIONS: Death certificate
      diagnosis of asthma as an underlying cause of death had a low sensitivity but a
      high specificity. Increases in mortality due to asthma are not likely caused by
      false-positive diagnoses of asthma as an underlying cause of death. Asthma
      mortality rates, determined from death certificate data, may indeed underestimate
      actual asthma-related mortality.

PMID- 8464127
TI  - Relationship between parental trinucleotide GCT repeat length and severity of
      myotonic dystrophy in offspring.
AB  - OBJECTIVE: To assess the relationship between the GCT repeat number in the
      myotonic dystrophy gene and the clinical phenotype and examine its predictive
      utility in prenatal testing. DESIGN: DNA from patients was examined for the
      length of the myotonic dystrophy GCT repeat region, using both Southern blot
      analysis and polymerase chain reaction. The results were compared with the
      clinical onset of disease, as well as with pregnancy outcomes. SETTING: Patient
      samples were referred to the Kleberg DNA Diagnostic Laboratory at the Baylor
      College of Medicine for DNA analysis by geneticists and genetic counselors (84%),
      neurologists (10%), and obstetricians and other specialists (6%). Clinical
      features including onset of disease and family pedigrees were determined by the
      referring centers. PATIENTS: A total of 241 patient samples from 118 families
      referred from primarily genetic or neurological centers for genetic linkage
      analysis or mutation analysis for myotonic dystrophy. This included 44 families
      referred for prenatal diagnosis. MAIN OUTCOME MEASURES: A relationship between
      myotonic dystrophy disease onset and length of the GCT repeat allele, parental
      origin of the disease allele, and results of prenatal diagnosis predictions of
      disease status were measured. RESULTS: There is a relationship between increasing
      repeat length and earlier clinical onset of disease. Essentially all (> 99%)
      myotonic mutations causing myotonic dystrophy are accounted for by GCT repeat
      amplification. Congenital myotonic dystrophy occurs with as few as 730 GCT
      repeats but only with alleles of maternal origin. Maternal GCT repeats were found
      as low as 75 (asymptomatic) that were amplified to result in a child with
      congenital myotonic dystrophy. Application of DNA diagnosis to 32 pregnancies
      provided an accurate method for identification of at-risk fetuses and allele
      enlargement. CONCLUSIONS: The GCT repeat in myotonic dystrophy is highly mutable.
      The triplet repeat amplification is highly specific for mutations involving the
      myotonin protein kinase gene accounting for myotonic dystrophy. The quantitation
      of triplet repeats can be more sensitive than physical, ophthalmologic, and
      electromyography examinations since the mutation can be detected in patients
      without evidence of myotonic dystrophy clinical findings. The length of the
      triplet expansion is influenced by the sex of the transmitting parent and is
      related to the clinical onset of disease features. Prenatal measurement of the
      GCT triplet repeat has utility for families with myotonic dystrophy risk since
      mutant and normal repeats are distinguishable and the length of mutant repeat
      alleles is associated with clinical severity. Thus, GCT triplet measurement
      provides a highly accurate means of detecting the myotonic dystrophy mutation in
      patients and offers a new reproductive option for families at risk for myotonic
      dystrophy.

PMID- 8464128
TI  - Molecular structure of nucleic acids. A structure for deoxyribose nucleic acid.
      1953.

PMID- 8464129
TI  - Genetical implications of the structure of deoxyribonucleic acid. 1953.

PMID- 8464130
TI  - Inherited breast and ovarian cancer. What are the risks? What are the choices?

PMID- 8464131
TI  - What the double helix (1953) has meant for basic biomedical science. A personal
      commentary.

PMID- 8464132
TI  - Molecular medicine. A spin-off from the helix.

PMID- 8464133
TI  - Celebrating 40 years of the double helix. From a theory of biology to the care of
      patients.

PMID- 8464134
TI  - Asthma deaths. A social or medical problem?

PMID- 8464135
TI  - Methadone maintenance. New research on a controversial treatment.

PMID- 8464136
TI  - Altered fates--counseling families with inherited breast cancer.

PMID- 8464137
TI  - Alternate coronary artery spasm with ST-segment "seesaw" phenomenon in variant
      angina.
AB  - Five patients with variant angina showed alternating ST-segment elevation and
      contralateral ST-segment depression between the precordial and inferior leads in
      electrocardiographic recordings made during sequential anginal attacks. This
      electrocardiographic "seesaw" phenomenon was observed during ergonovine-induced
      attacks in 3 cases and during spontaneous attacks in 1 case. Another patient
      showed ST-segment elevation in a spontaneous attack and in other leads during
      hyperventilation. In all cases, the first attack was accompanied by ST-segment
      elevation in the inferior leads. Coronary arteriography demonstrated that in all
      cases, coronary arterial spasm occurred during the attacks in both coronary
      arterial systems. Significant organic coronary arterial stenoses (> 50%) were
      found in both the left anterior descending branch and the right coronary artery
      in 2 patients. The remaining 3 patients showed no significant organic stenoses in
      any major coronary artery. However, pre-anginal coronary arteriography
      demonstrated that 13 of the 15 major coronary arteries, including all 9 of the
      major coronary arteries in the patients without significant stenoses, were
      already spastic. An exercise stress test performed in the morning induced attacks
      with chest pain and electrocardiographic ST-segment elevation in all 5 patients.
      The patients having an alternate ST-segment elevation in separate leads had
      vasospastic tendencies in both coronary arterial systems.

PMID- 8464138
TI  - Effect of reperfusion by direct percutaneous transluminal coronary angioplasty on
      ventricular late potentials in cases of total coronary occlusion at initial
      coronary arteriography.
AB  - The relationship between the time required for reperfusion and the incidence of
      late potentials was studied in 94 patients who survived a first acute myocardial
      infarction (AMI) and who showed total occlusion of the infarct-related artery at
      an initial coronary arteriography. Sixty-three patients who successfully
      underwent direct percutaneous transluminal coronary angioplasty (PTCA), and 31
      who were treated conventionally (controls), underwent signal-averaged
      electrocardiography. Direct PTCA patients were classified into 5 groups according
      to the time required for reperfusion: < or = 4, 4-6, 6-8, 8-10, and > or = 10 h.
      The incidence of late potentials in these groups was 8%, 12%, 14%, 33%, and 43%,
      respectively, and 48% in the controls. Late potentials were recorded more
      frequently as the period until successful reperfusion increased: the incidence of
      late potentials was significantly lower in the < or = 4 and 4-6 h groups than in
      the controls (p < 0.005 and p < 0.05, respectively). Therefore, reperfusion
      achieved within 6 h reduced the incidence of late potentials in AMI patients and
      may be effective for preventing malignant ventricular arrhythmias.

PMID- 8464139
TI  - Prediction of exercise tolerance in the chronic phase of myocardial infarction by
      using ventilatory gas analysis.
AB  - To predict exercise tolerance in the chronic phase of myocardial infarction (MI),
      cardiopulmonary exercise testing was performed using a ramp treadmill protocol in
      25 patients at 1 and 3 months after the onset of MI. Oxygen uptake, heart rate
      and O2 pulse were estimated at rest, during a warm-up period, and at the levels
      of anaerobic threshold (AT), respiratory compensation (RC) and peak exercise.
      Results were as follows: 1) AT and peak oxygen uptake at 3 months after the onset
      of MI were 14.1 +/- 2.8 and 21.8 +/- 5.2 ml/min/Kg, respectively. 2) The subjects
      were divided into 2 groups according to peak oxygen uptake at 3 months: one
      showing peak oxygen uptake > 22 ml/min/Kg and the other < 22 ml/min/Kg. The
      former group (n = 13) was referred to as the good tolerance group, and the latter
      group (n = 12) was referred to as the poor tolerance group. Oxygen uptake at AT,
      RC and peak exercise was lower in the poor tolerance group than in the good
      tolerance group (11.2 vs 14.7, 15.1 vs 20.4, 17.1 vs 23.4 ml/min/Kg,
      respectively). 3) The increases in oxygen uptake from AT to RC and from AT to
      peak exercise were less in the poor tolerance group than in the good tolerance
      group. 4) O2 pulse at rest, warm-up, AT, RC and peak exercise were also lower in
      the poor tolerance group.2+ tolerance in the chronic phase of MI.

PMID- 8464140
TI  - The prognostic significance of exercise-induced silent ST-segment depression in
      patients after myocardial infarction.
AB  - To evaluate the prognostic value of exercise-induced silent ST-segment
      depression, 157 patients who had suffered myocardial infarction underwent symptom
      limited exercise testing and coronary angiography. Patients were divided into 3
      groups according to the presence or absence of ischemic ST-segment depression and
      angina during exercise testing. Group A patients had ST-segment depression
      without angina. Group B patients had both ST-segment depression and angina. Group
      C patients had neither ST-segment depression nor angina. All patients were
      followed without coronary artery bypass graft or percutaneous transluminal
      coronary angioplasty for an average of 36 months and the frequency of coronary
      events (cardiac death, recurrent myocardial infarction and unstable angina
      pectoris) was compared. Group A patients had less severe coronary artery disease,
      greater coronary reserve during exercise and exercised longer than group B.
      However, the prognosis of group A was similar to group B, and was worse than
      group C. Using the Cox proportional hazards model, ischemic ST-segment depression
      was the most useful index for predicting future coronary events among the
      baseline values, coronary angiographic and exercise testing variables. However,
      angina during exercise testing was not an independent predictor. Thus, post
      infarction patients showing exercise-induced ST-segment depression should be
      treated carefully regardless of the presence or absence of angina.

PMID- 8464141
TI  - Ventilatory anaerobic threshold before and after cardiac valve surgery.
AB  - The purpose of this study was to objectively assess exercise tolerance before and
      after cardiac valve surgery by using an objectively determined ventilatory
      anaerobic threshold (AT). Nine patients (mean age: 38.2 +/- 8.1 years) with
      predominantly mitral regurgitant lesions were studied by a symptomatic maximal
      treadmill exercise test which included a determination of AT. The mean lengths of
      time from preoperative exercise testing to cardiac surgery, and from surgery to
      postoperative exercise testing were 5.9 +/- 4.0 and 12.1 +/- 8.3 months,
      respectively. The determination of AT on data plots was performed after blinding
      to patient identification and pre- vs postoperative status. After surgery, the
      clinical symptoms and NYHA class improved significantly with a decrease in the
      cardio-thoracic ratio and echocardiographic diastolic dimensions. The mean peak
      VO2 (ml/kg/min) increased significantly from 20.2 +/- 7.1 to 29.7 +/- 7.9 (p <
      0.01). Together with these changes, AT (ml/kg/min in VO2) increased from a mean
      of 14.8 +/- 4.8 to 22.8 +/- 5.5 (p < 0.01). In conclusion, symptomatic
      improvement and an increase in peak oxygen uptake after cardiac valve surgery
      were accompanied by a significant increase in the objectively determined AT. AT
      determined in a blind manner provides an objective means of evaluating exercise
      tolerance when a double-blind intervention cannot be performed.

PMID- 8464142
TI  - Nonpharmacologic treatment of common atrial flutter guided by transient
      entrainment.
AB  - We attempted nonpharmacologic treatment for common atrial flutter in 7 patients,
      with direct current catheter ablation (CA) in 5 cases and cryoablation in 2 cases
      under the guidance of transient entrainment. Transient entrainment during common
      atrial flutter by pacing from the mid or low lateral right atrium (LLRA) revealed
      a long conduction time between the LLRA and the orifice of the coronary sinus
      (CSo) (73% to 121% of flutter cycle length). In 2 cases, fragmented electrograms
      were recorded at the low right atrial septum with durations of 150 msec and 155
      msec, respectively. Because these fragmented electrograms were transiently
      entrained by rapid atrial pacing in the same manner as other atrial electrograms
      and were recorded in an area of long conduction, we believe that fragmented
      electrograms represent critical slow conduction. In 5 cases, CA was directed at
      this area. Three cases were successfully treated with 3 to 4 DC shocks of 100 J
      (follow up periods of 11.3, 4.5 and 3 months). Two cases which received 1 to 2 DC
      shocks of 100 J had recurrence of atrial flutter 6 and 4.7 months later,
      respectively. Two cases which showed atrial septal defect received surgical
      treatment. They were successfully treated with extended cryoablation in this same
      area (follow up periods of 26 and 9.2 months). In conclusion, extended ablation
      of an area of fragmented electrograms using transient entrainment may be an
      effective treatment for common atrial flutter.

PMID- 8464143
TI  - A case report of isolated levocardia without intracardiac anomalies associated
      with sick sinus syndrome.
AB  - A 42-year-old female with cardiomegaly showed bradycardia without syncope.
      Clinical data showed that she had an isolated levocardia with interruption of the
      inferior vena cava. Isolated levocardia was defined as a normally placed heart
      associated with situs ambiguus of other viscera. She did not have intracardiac
      anomalies. Isolated levocardia without intracardiac anomalies, as in this case,
      has only been reported in 13 other cases. Isolated levocardia is often
      accompanied by severe complex intracardiac anomalies and, therefore, most of the
      patients have a short life span. Situs ambiguus, especially left isomerism, is
      frequently associated with deteriorated sinus node function, and an interruption
      of the inferior vena cava may also be an indication of this phenomenon.
      Therefore, the patient's sinus node function was examined using an
      electrophysiological study and a 24-hour ambulatory electrocardiogram. Sick sinus
      syndrome was finally confirmed.

PMID- 8464144
TI  - [Molecular epidemiology of hepatitis A virus].
AB  - The genome of hepatitis A virus (HAV) is a linear plus-strand RNA molecule of
      7,500 nucleotides and it shares common strategies of construction and function of
      the picornavirus family. Since it has a unique nucleotide sequence homology, HAV
      has been classified in the genus of hepatovirus, newly added to the family.
      Nucleotide sequence of the putative VP1/2A junction area was found variable and a
      168 nucleotide portion of the region has been compared with many HAV sequences
      obtained from all over the world. It was found that HAV strains could be
      identified and classified into 7 genotypes or 9 subgenotypes. Analyses of the
      nucleotide sequence homology of this particular region is useful, not only in the
      study of epidemiology of hepatitis A, but also in the study of the molecular
      epidemiology of HAV.

PMID- 8464145
TI  - [Molecular evolutionary analysis of hepatitis B virus (HBV) and genetic
      classification].
AB  - HBsAg of Hepatitis B virus (HBV) has been classified into four major subtypes
      (adw, adr, ayw, ayr) by the serological methods. Using molecular evolutionary
      analysis technique, we constructed the phylogenetic tree for the partial S gene
      (HBsAg gene) of HBV. The tree shows that 51 strains of HBV can be classified into
      following four genetic subgroups: (1) strains of subtypes ayw and adyw, (2) those
      of adw and adr, (3) another of adw, and (4) other subgroup of adr, adw, ayr, ar
      and ad. We propose that these subgroups be designated gyw, gdw-1, gdw-2, and gdr,
      respectively, with "g" standing for genetic classification. It is important that
      the genetic classification of HBVs is not always compatible with conventional
      serological subtypes. It is possible that the conventional subtypes do not
      represent a classification according to the degree of genetic difference among
      strains of HBVs. Thus, our genetic classification is more suitable for studies of
      epidemiological and virological features of HBVs.

PMID- 8464146
TI  - [Mutation in core and pre-core amino acid sequences of hepatitis B virus
      correlate with fulminant and severe hepatitis].
AB  - Infection with hepatitis B virus leads to a wide spectrum of liver injury,
      including self-limited acute hepatitis, fulminant hepatitis and chronic hepatitis
      with progression to cirrhosis or acute exacerbation to liver failure, as well as,
      an asymptomatic chronic carrier state. To investigate why an extreme
      immunological attack occurs in fulminant hepatitis and severe exacerbation, the
      entire precore and core region were sequenced in 13 subjects. No significant
      change was noted in the 6 self-limited acute hepatitis patients. In contrast,
      clustering changes in a small segment of core codons #84 to #99 were found in all
      7 fulminant and severe exacerbation patients. These data suggest that this
      mutation clustering region may play an important role in the pathogenesis, and
      such mutations appear to be related to severe liver damage.

PMID- 8464147
TI  - [Association of pre-core defective HBV mutant with anti-HBe positive chronic
      hepatitis].
AB  - Precore defective HBV mutant has been suggested to be responsible for the
      pathogenesis of fulminant hepatitis. This variant is unable to produce HBeAg
      because of the presence of a novel translational stop codon at the end of the
      precore region of the genome. We examined the precore region of the HBV
      nucleotide sequence in 12 Japanese anti-HBe positive chronic hepatitis patients
      in order to ascertain whether the genome has stop-codon mutation in the precore
      region. Precore defective HBV mutant was found in most of the examined cases. A
      few cases had a mixture of strains, wild type and precore defective HBV mutant.
      The variety of precore genome concerned with the pathogenesis of chronic
      hepatitis still needs to be clarified.

PMID- 8464148
TI  - [The point mutation of pre-C region HBV-DNA in sera from chronic hepatitis B].
AB  - To clarify the relationship between a point mutation of HBV-DNA Pre-C region and
      the serological feature of chronic hepatitis B, we determined the Pre-C region
      sequence of HBV-DNA obtained sera of 39 patients with chronic hepatitis B. The
      screening of the gene arrangement of Pre-C region of HBV-DNA was performed by a
      direct sequence method amplifying HBV-DNA by polymerase chain reaction methods.
      In 22 of HBeAg positive cases, a mutant type (the 28th codon changed from TGA to
      TAG: stop codon) was found in only one case. The other hand, In 17 of HBeAg
      negative cases, it was found in 6 cases with fluctuating ALT and DNA-polymerase
      levels. We concluded that mutant viral infections could be the main cause of
      HBeAg negative cases with fluctuating ALT and DNA-polymerase levels.

PMID- 8464149
TI  - [Defective short variants of S region in chronic HBV carriers].
AB  - We analyzed the pre-S and S region of hepatitis B virus by polymerase chain
      reaction in 60 chronic carriers. In 10 hepatitis B e antigen-positive chronic
      carriers, a single DNA band was detected at the expected size, whereas additional
      shorter DNA bands were observed in some cases with chronic hepatitis, liver
      cirrhosis, and hepatocellular carcinoma. The smaller-sized DNA bands from chronic
      hepatitis patients had the deletion of 183 bp in the pre-S gene, and the deletion
      of 492 bp in S gene. The reasons of the appearance of these mutants are unknown,
      but it may be interesting to study in relationship to the mechanism of host
      immune response.

PMID- 8464150
TI  - [Heterogeneity of delta virus RNA sequences in Japan].
AB  - Hepatitis delta virus RNA sequences were determined in isolates from two Japanese
      patients, M and S, by polymerase chain reaction and direct nucleotide sequencing
      and compared with three isolates from Italy, USA and Taiwan. The sequence
      obtained for hepatitis delta virus RNA from patient M was 92-96% identical to the
      sequences obtained for three other strains of hepatitis delta virus, whereas the
      sequence of hepatitis delta virus RNA obtained from patient S was approximately
      80% identical to the other sequenced strains. This suggests that the delta agent
      in Japan has a heterogeneous origin and the delta virus RNA sequence from
      Japanese patient S is the most divergent delta virus isolate yet analyzed.

PMID- 8464151
TI  - [Cloning and sequencing of cDNA of the hepatitis E virus genome--application to
      diagnosis].
AB  - Hepatitis E is endemic, often provoking epidemics in many developing countries.
      The hepatitis E virus has been molecularly cloned and sequenced and has a single
      stranded, positive-sense RNA genome, 7,194 nucleotides, followed by a poly(A)
      tail. There are three open reading frames. The non-structural gene, approximately
      5 kb, is located at the 5' end, while the structural gene, approximately 2 kb, is
      located at the 3' end of the genome. There is low level nucleotide variation
      among hepatitis E virus strains isolated from Myanmar and China.

PMID- 8464152
TI  - [Recent progress in molecular biology of chemically-induced hepatic
      carcinogenesis].
AB  - Chemically-induced hepatic carcinogenesis is a suitable model to investigate
      multistep process of carcinogenesis, because preneoplastic and neoplastic lesions
      develop in a sequential manner. The process is initiated by emergency of
      "genetically altered cells" or "initiated cells" which have a potential to
      progress to hepatocellular carcinomas. The cells can clonally expand under the
      effect of tumor promoters or carcinogens. Clonal expansion will increase the
      probability that a cell undergoes further genetic changes. By this stepwise
      manner, a cell may acquire neoplastic properties such as independence to growth
      factors, invasive growth, loss of antigenicity, metastatic capacity, etc. The
      author reviewed the recent advance in studies on oncogenes, tumor suppressor
      genes and growth factor genes concerning to rodent hepatic carcinogenesis.

PMID- 8464153
TI  - [Genotypes of alcohol dehydrogenase and aldehyde dehydrogenase and their
      significance for alcohol sensitivity].
AB  - Genotypes of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) loci
      were determined, using allele specific oligonucleotides. Gene frequencies of
      ADH2(1) and ADH2(2) were 0.29 and 0.71, respectively, in the Japanese control
      group. No significant difference was found in the ADH2 genotype between the
      patients and the control group. Gene frequency of ALDH2(1) and ALDH2(2) were 0.65
      and 0.35 in the control group, while 0.93 and 0.07, respectively in the patient
      group. Most of the patients, 20 out of 23, were homozygous Caucasian type. All
      individuals with homozygous atypical ALDH2(2)/ALDH2(2) and most of those with
      heterozygous atypical ALDH2(1)/ALDH2(1) were alcohol flushers, while all of the
      usual ALDH2(1)/ALDH2(1) were nonflushers. The results indicate that Japanese with
      the atypical ALDH2(2) allele are at a much lower risk in developing alcoholic
      liver disease than those with usual ALDH2(1)/ALDH2(1), presumably due to their
      sensitivity to alcohol intoxication.

PMID- 8464154
TI  - [ADH 2, 3 and ALDH 2 gene frequency in Japanese alcoholics].
AB  - To elucidate genetic susceptibility to alcoholic liver injury (ALD), polymerase
      chain reaction (PCR) method assay was developed to detect point mutations in each
      gene and gene frequency in various liver diseases was studied. It was shown
      previously that ALDH2(1) gene was more frequently found in patients with ALD
      (confirmed in this study), probably because they are able to consume too much
      alcohol (non-flushing type). This study revealed that, in addition to this ALDH
      heterogeneity, ADH heterogeneity may correlate with the severity of alcoholic
      liver injury, especially in those was low ADH activity and tend to have severe
      damage.

PMID- 8464155
TI  - [Apolipoprotein A-I, E, C-III and LDL-receptor mRNA expression in liver
      diseases].
AB  - The liver plays a major role in lipid metabolism, and quantitative and or
      qualitative changes in serum lipoproteins and apolipoproteins have been observed
      in various liver diseases. We investigated changes in hepatic mRNA expression of
      apolipoproteins A-I, C-III, and E and LDL receptor in human liver diseases, rat D
      galactosamine, CCl4 induced liver failure and regenerating liver. The
      apolipoprotein mRNA expression were significantly decreased in liver and severe
      acute hepatitis as compared with controls and were correlated with serum albumin
      levels. LDL receptor mRNA expression were decreased in liver cirrhosis and rat
      liver failure. These findings indicated that liver biosynthesis of these
      apolipoproteins and LDL receptor are suppressed in liver disease. On the other
      hand, LDL receptor mRNA expression increased in regenerating liver, and this
      shows that serum cholesterol was needed for membrane biosynthesis.

PMID- 8464156
TI  - [Molecular biology in development of fatty liver--regulation of apolipoprotein B
      synthesis].
AB  - Apolipoprotein B (apo B) synthesis in fatty liver was described in this review.
      Apo B synthesis has not been intensively studied in fatty liver. Recently, we
      demonstrated that hepatic apo B mRNA level increased in two experimental models
      of fatty liver. Davidson et al. reported that apo B mRNA editing was enhanced in
      fatty liver induced by refeeding after fasting. However, further investigation is
      needed to clarify whether alteration in apo B gene regulation participates in
      development of fatty liver.

PMID- 8464158
TI  - [Expression of the protein kinase C genes during liver regeneration].
AB  - Protein kinase C (PKC) plays an important role in intracellular signaling. PKC
      consists of a family of at least eight distinct enzymes. How PKC can be responded
      to liver regeneration and growth is largely unknown. In an in vivo experiment,
      regenerating liver after partial hepatectomy (Hx) and carbon tetrachloride (CCl4)
      administration, expression of the PKC alpha-type was increased, with a single
      peak, after Hx and CCl4 administration. On the other hand, the PKC epsilon-type
      gene was activated with biphasic peaks following Hx but was elevated with a
      single peak after the CCl4 administration. In an in vitro experiment using
      primary cultured hepatocytes, both of the PKC alpha-type and epsilon-type genes
      could be induced only by combination of insulin and serum. These results
      demonstrate that both isoforms of PKC are identically regulated by extra- and
      intracellular stimuli, thereby influencing growth control of hepatocytes.

PMID- 8464157
TI  - [Gene expression of MMPs and TIMPs in the process of hepatic fibrosis].
AB  - The matrix metalloproteinases (MMPs) gene family includes MMP-1 (interstitial
      collagenase), MMP-2 (72 kD type IV collagenase/gelatinase), MMP-3
      (stromelysin/transin), MMP-7 (putative MMP; pump-1), MMP-8 (granulocyte
      collagenase) and MMP-9 (92 kD type IV collagenase/gelatinase). This gene family
      has the common characteristics in the gene structure as follows: All of MMPs have
      the active site metal ion-binding domain. All six enzymes are activated with the
      concomitant removal of N-terminal segment of the latent enzyme. The removed
      segment contains an unpaired cystein residue within the conserved amino acid
      sequence PRCGVPDV, located immediately adjacent to the proenzyme cleavage site.
      The authors showed the gene expression of MMP-1 in the process of hepatic
      fibrosis. The remarkable expression was noted on fibroblasts and macrophages
      within the newly-formed fibrous bands with lots of infiltrated lymphocytes. Liver
      cirrhosis did not showed the positive dots of MMP-1 mRNA. On the other hands, the
      expression of TIMP reported by Takahara et al., revealed the high level of
      expression in the advanced fibrosis.

PMID- 8464159
TI  - [Amyloidosis and hepatic amyloidosis].
AB  - The classification of amyloid and amyloidosis has undergone several revisions.
      The 1990 revision of the nomenclature at the 6th Internal Symposium on
      Amyloidosis in Oslo has been widely accepted and the basis for nomenclature and
      classification is the fibril protein making up the amyloid deposits. The liver is
      a major site of amyloid deposition in the disseminated form of the disease. Many
      studies have shown that the morphologic distribution of amyloid within the liver
      is not a reliable method for distinguishing AA from AL amyloidosis.

PMID- 8464160
TI  - [Recent studies on Ito cells with molecular biology].
AB  - By Northern blot analysis of total RNA, extracted from normal human and rat Ito
      cells, either freshly isolated or in culture, recent studies demonstrated the
      expression of mRNA for collagen type I, III, IV, fibronectin, laminin,
      transforming growth factor-beta (TGF-beta), hepatocyte growth factor, nuclear
      retinoic acid receptor-beta and alpha-smooth m muscle actin. Moreover, Ito cells
      isolated from experimentally induced fibrotic livers exhibited a marked increase
      in mRNA for collagen type I, associated with a moderate increase in mRNA of
      collagen type III and TGF-beta. Although endothelial cells from the same liver
      also showed moderate increase in mRNA for collagen type I alone, hepatocytes
      showed no changes. From these results it is concluded that Ito cells are the most
      important cells in hepatic fibrogenesis.

PMID- 8464161
TI  - [Molecular defects in familial LCAT deficiency].
AB  - Lecithin: cholesterol acyltransferase (LCAT) is the enzyme that catalyzes the
      esterification of free cholesterol in plasma lipoproteins. Familial LCAT
      deficiency, which is a rare hereditary disorder of lipid metabolism, inherited as
      an autosomal recessive trait, is characterized by corneal opacity, anemia and
      frequently, though not invariably, renal failure. Recently, LCAT cDNA and gene
      have been cloned. Studies on DNA samples from unrelated patients with familial
      LCAT deficiency and fish eye disease, which is characterized by severe corneal
      opacity alone, revealed both diseases to be caused by respective mutations of the
      LCAT gene. It is suspected that defect or functional abnormality of LCAT, caused
      by these genetic defects, underlie the various clinical and biochemical
      characteristics observed in LCAT deficiency or fish eye disease.

PMID- 8464162
TI  - [Gene analysis of human cholinesterase variants].
AB  - People with genetic variants of cholinesterase (ChE) have been reported to have
      prolonged apnea with the use of myorelaxant succinylcholine. For the silent type
      variant ChE, two cases of mutation have been reported. In one case, the exon 2 of
      ChE gene was disrupted by a 342 bp insertion of Alu element. In the other case, a
      frame shift mutation was identified at Gly-117 (GGT-->GGAG) to create a stop
      codon at nucleotide 384. Dibucaine resistant ChE was examined and found to have a
      point mutation at nucleotide 209 (A-->G) that converted Asp-70 to Gly, and
      consequently reduced the affinity of ChE for choline esters. In addition, another
      two types of a point mutation reducing ChE activity were reported on K variant
      (Ala-539-->Thr) and a case of (Gly-365-->Arg) in a patient with liver cirrhosis.

PMID- 8464163
TI  - [Genetic analyses of alpha 1-antitrypsin deficiency].
AB  - The deficiency of alpha 1-antitrypsin, a strong protease inhibitor, is known to
      cause pulmonary emphysema, neonatal hepatitis and liver cirrhosis. Among 75
      variants reported so far, amino acid or DNA variations have been determined in
      about 30 variants. Many are caused by single base substitutions which then cause
      single amino acid replacements. In most of the null variants, base substitutions,
      base deletions or base insertions make stop codons appear somewhere beyond the
      mutation sites, which cause truncated proteins. Only several variants, including
      PiZ and PiMmalton, characterized as having cytoplasmic globules in hepatocytes,
      cause liver diseases. Recent analyses on the tertiary structure of alpha 1
      antitrypsin have elucidated the mechanism of the formation of insoluble polymers
      in PiZ patients. The accumulation theory seems more relevant to the mechanism of
      the liver damage than the protease-antiprotease imbalance theory.

PMID- 8464164
TI  - [Molecular basis of urea cycle disorders].
AB  - Five different enzymes, carbamyl phosphate synthetase I (CPS I), ornithine
      transcarbamylase (OTC) argininosuccinate synthetase (AS), argininosuccinate lyase
      (AL) and arginase (AR) play a role in urea synthesis from ammonium. The
      structures of cDNA of all these enzymes and those of genome DNA of some enzymes
      (OTC, AL, AR) have been already clarified, and using of the information, the
      alleles of each enzyme deficiency have been identified. Alleles are extremely
      heterogeneous in all enzyme deficiencies, in sharp difference from other inborn
      errors of metabolism, such as cystic fibrosis and hemoglobinopathies.

PMID- 8464165
TI  - [Hepatitis and hepatocarcinogenesis in the transgenic mice].
AB  - Persistent hepatitis B virus (HBV) infection is epidemiologically closely
      associated with the development of human hepatocellular carcinoma (HCC). A
      molecular mechanism that would explain the strong epidemiological link of
      persistent HBV infection with HCCs is still open to debate. Among HBV carriers,
      HCC develops only in patients with chronic liver disease, such as chronic active
      hepatitis, liver fibrosis, or liver cirrhosis. In other words, hepatitis-related
      proliferative changes, which are mainly sustained by repeating cycles of cell
      death and regeneration either immunologically or through virus infection, appear
      important for HBV hepatocarcinogenesis. The same mechanism may also be present in
      human hepatitis C virus-related hepatocarcinogenesis. In this article, I reviewed
      animal models of HBV-related hepatocarcinogenesis. It is important to evaluate
      and check whether the animal models are fit with human HBV hepatocarcinogenesis
      or not.

PMID- 8464166
TI  - [The establishment of a monolayer culture system of guinea pig chief cells and an
      enzyme immunoassay system for guinea pig pepsinogen].
AB  - For the purpose of studying pepsinogen secretion from gastric chief cells, we
      established a monolayer culture system of guinea pig chief cells and an enzyme
      immunoassay (EIA) system specific for guinea pig pepsinogen. Dispersed chief
      cells were obtained from gastric mucosa of a guinea pig using collagenase, GEDTA,
      and Percoll solution, suspended in DMEM/F-12 (1/1 containing 10% FCS) media, and
      cultured for 70hr. Then the monolayer culture system was established. Pepsinogen
      was purified from gastric mucosa of a guinea pig using DEAE-Sephacel and
      Sephacryl S-200 columns. Antibody to pepsinogen was raised by immunizing rabbit
      with the purified pepsinogen. A two-site EIA system was then established using
      beta-galactosidase-labeled Fab' antibody. The EIA system showed sensitivity to
      measure above 1.5ng of guinea pig pepsinogen, and the monolayer culture system
      responded well to secretagogues. These systems are useful for studying pepsinogen
      secretion.

PMID- 8464167
TI  - [The effect of prostaglandin E1 and prostaglandin F2 alpha in the ischemic small
      intestine of dogs].
AB  - The effect of PGE1 and PGF2 alpha in the ischemic intestinal tract were examined.
      In 40 mongrel dogs, we studied ischemic models of small intestine. PGE1 or PGF2
      alpha was injected into the anterior mesenteric artery after reperfusion
      according to each occlusion time, and the tissue blood flow was measured on both
      mucosal and serous sides of small intestinal loop by laser flowmeter to examine
      the relation to the extent of tissue damage. Tissue blood flow of the ischemic
      intestine after the injection of PGE1 increased by 148-208% in the 3-5 hr
      occlusion group and by 86-110% in the 7-10 hr occlusion group. Tissue blood flow
      after the injection of PGF2 alpha decreased by 39-59% in the 3-5 hr occlusion
      group and by 1-15% in the 7-10 hr occlusion group. These results indicate that
      the effect of PGE1 and PGF2 alpha in the ischemic intestine would be available up
      to 3-5 hr of ischemia. Histological examination revealed that viability of the
      remaining crypt was high in the PGE1 injection group but low in the PGF2 alpha
      injection group. These findings suggest that PGE1, if try at the early stage,
      would be effective for the treatment of ischemic lesion.

PMID- 8464168
TI  - [The long-term follow-up study of Japanese patients with ulcerative colitis].
AB  - To elucidate the long-term outcome of the ulcerative colitis we analyzed 124
      patients suffering for more than 10 years concerning the long-term prognosis,
      cumulative rate of colectomy, cumulative risk of cancer development and
      cumulative survival rate. Long-term prognosis were divided to three categories as
      good, fair and poor, according to present disease activities, social availability
      and subjective judgement. One hundred and twenty four patients were divided to 66
      patients with good prognosis, 27 fair and 31 poor (2:1:1). The rate of patients
      having active disease at each year were followed-up annually for 10 years
      according to final three categories of the prognosis. The serial curve of annual
      rate of having active disease of the patients with poor prognosis was the
      highest, fair prognosis the second, good prognosis the lowest. The factors
      affecting the final prognosis were the period before initiation of proper
      treatment, the severity of the first attack or the elder age (> 40 year old) at
      the first attack. Twenty six patients were undergone colectomy in relation to
      ulcerative colitis. The cumulative colectomy rate was 16.5% at 10 years and 38.5%
      at 15 years after the onset. Malignant disease or severe dysplasia of the colon
      developed in 4 patients 10 to 14 years after the onset. Cumulative survival rate
      was equal to the expected survival curve during 16 years. The main causes of
      death were intracranial hemorrhage and colorectal malignant disease.

PMID- 8464169
TI  - [Plasma cholecystokinin levels in rats with pancreatic insufficiency induced by
      intra ductal injection of oleic acid].
AB  - Plasma cholecystokinin (CCK) levels in rats with pancreatic insufficiency induced
      by a single injection of 50 microliters oleic acid into the pancreatic duct were
      determined by a sensitive and specific bioassay using the isolated rat pancreatic
      acini. Treatment with oleic acid significantly decreased pancreatic wet weight
      within 7 days, which lasted until the end of observation (56 days). Histologic
      examination revealed the destruction of acinar cells and the epithelium of intra-
      and interlobular ducts. Plasma CCK bioactivity was significantly increased from
      the pre-treatment values of 0.8 +/- 0.1pM to 5.1 +/- 1.4pM at 24h after oleic
      acid treatment. After this peak, plasma CCK levels gradually decreased. Even
      after 56 days, however, plasma CCK levels in oleic acid-treated rats were
      significantly high compared with those in control rats. In the present study,
      plasma CCK levels in rats with chronic pancreatitis did not correlate with the
      progress of pancreatic insufficiency.

PMID- 8464170
TI  - [A case of gastric malignant lymphoma occurred subsequent to idiopathic
      thrombocytopenic purpura].

PMID- 8464171
TI  - [A case of hematological metastatic tumor of the liver from sigmoid colon
      cancer].

PMID- 8464172
TI  - [A case of Yersinia enterocolitis diagnosed by culture of the biopsy specimen
      taken through colonofiberscope].

PMID- 8464173
TI  - [Interstitial pneumonitis associated with ulcerative colitis: a case report and
      review of the literature].

PMID- 8464174
TI  - [Follow-up study of a case of hepatic angiomyolipoma, after established diagnosis
      by ultrasonography-guided aspiration biopsy].

PMID- 8464175
TI  - [A case of gallbladder cancer associated with cholesterolosis within the cancer
      region].

PMID- 8464176
TI  - [Effect of TUDCA for cholestatic reaction due to serum in patient with primary
      biliary cirrhosis].

PMID- 8464177
TI  - [Analysis of proliferative activity in gastric biopsy specimens by combined BrdU
      and DNA polymerase alpha immunohistochemistry].
AB  - To evaluate correctly the proliferative activity of tumor cells, it is necessary
      to clarify not only S-phase fraction but also the growth fraction of tumor
      tissues. We used combined BrdU and DNA polymerase alpha (pol-alpha)
      immunohistochemistry to gastric biopsy specimens, and analyzed the proliferation
      of the neoplastic lesions of various degrees of malignancy. The results were as
      follows: The distribution of pol-alpha positive cells were almost the same as
      that of BrdU positive cells, but the percentage of pol-alpha positive cells was
      higher than that of BrdU positive cells irrespective of the mucosal specimens. In
      the adenomas, both BrdU and pol-alpha positive cells distributed generally
      superficially in the mucosal layer. In the well differentiated adenocarcinomas,
      both BrdU and pol-alpha positive cells distributed diffusely in the deeper layer
      of the mucosa. The ratio of the number of BrdU positive cells to that of pol
      alpha positive cells, which means the S-phase fraction in the growth fraction,
      was higher in the tumor and that higher in the well differentiated
      adenocarcinomas than that of the adenomas. In conclusion, the combined BrdU and
      pol-alpha immunohistochemistry in gastric biopsy specimens are useful to evaluate
      the degree of malignancy.

PMID- 8464178
TI  - [An efficient method for quantification of Helicobacter pylori in biopsy specimen
      using PCR].
AB  - A procedure for the detection and quantification of Helicobacter pylori in
      gastrointestinal tissue biopsy specimens by polymerase chain reaction (PCR) is
      presented. This method provides an accurate quantitative and sensitive
      measurement of the amount of H. pylori in the gastrointestinal tract without
      cultivation of this microorganism. We have used 30 cycles of PCR in the presence
      of 3.5mM Mg++ and demonstrated that the DNA content of one H. pylori cell is
      0.0076pg. Using this approach, we analyzed samples of gastrointestinal tissue
      biopsies from 10 patients with various gastrointestinal disorder. Each of these
      patients had detectable H. pylori at levels ranging from 0.10 to 60.61 cells for
      each tissue cell. This new technique thus provides a useful way to detect H.
      pylori in gastrointestinal tissue biopsy specimens.

PMID- 8464179
TI  - [Modern trends of treatment in male infertility].

PMID- 8464180
TI  - [A simple renal cyst].
AB  - Incidence of simple renal cysts was calculated in 30,316 patients receiving
      routine ultrasound examination in one hospital, and 170 cases visiting Chiba
      University Hospital were further analyzed in terms of their clinical features.
      Incidence of simple renal cyst was 14% in all populations and ratio of male to
      female was 1.6:1. Patients age ranged from 8 to 92 years (average age 58.6 years)
      and number of a renal cyst was increased after fifth decade in both sexes.
      Patients of Chiba University Hospital were examined on symptoms and clinical
      courses with maximal follow up to 132 months (average 18 months). Symptoms
      associated with simple renal cysts were: none (75.3%) pain (14.7%) and gross
      hematuria (6.4%). Urinalysis of patients without associated urinary diseases,
      showed microhematuria in 40% and proteinuria in 12%, however, grade of
      microhematuria and proteinuria was not correlated with size of cysts. Number of
      cysts tended to increase with age. Size of cysts and rate of enlargement were
      increasing along with age. In any cases, renal function was not and affected nor
      occurred malignant tumor during follow-up period. Cyst punctures with sclerosing
      agent were performed in 16 patients, and most of the cysts remained the same as
      or exceeded their original size. It is concluded that routine follow-up is
      sufficient in most cases without symptoms, since simple renal cysts increase
      slowly, and impairment of renal function and progression to malignant tumors do
      not occur.

PMID- 8464181
TI  - [Morphological investigation of external sphincter muscle of the male posterior
      urethra].
AB  - For investigation of function of the male posterior urethra, morphological study
      was performed in terms of the muscle architecture including sphincter muscle of
      the posterior urethra. The muscle localization was demonstrated by
      microdissection in eight male cadavers. Histological examination was also
      employed with HE staining and immunohistochemical method to detect the nature of
      these muscles. At the dorsal side, the muscle fibers of the deep trigone were
      located from the inter-ureteral ridge beyond the bladder neck to the vermontanum
      surrounding the posterior urethra. They were regarded as the internal urethral
      sphincter muscles. At the ventral side, the muscle fibers were also found just
      outside the ventral prostate running from the base to the apex of the prostate.
      Then, they were circularly located around the membranous urethra. These saddle
      shaped muscles were proved to be striated muscle by the immunohistochemical
      examination using anti-Desmin and anti-Myoglobin antibody. Therefore, the
      external urethral sphincter muscle would consist of the pelvic floor muscles and
      the urethral sphincter muscles.

PMID- 8464182
TI  - [Transrectal hyperthermia for the treatment of chronic prostatitis].
AB  - A total of 36 cases with chronic non-bacterial and non-chlamydial prostatitis or
      prostatodynia underwent 5 weekly, 1-hour sessions of transrectal microwave
      hyperthermia (43 degrees C) to the prostate. All patients had a long history of
      the condition and failed to respond to a variety of conventional treatments. The
      efficacy of the treatment was evaluated by the effects on subjective symptoms
      and/or on white blood cells in expressed prostatic secretions. Concerning the
      overall clinical efficacy, excellent results were obtained in 11 (30.6%), good in
      8 (22.2%), fair in 8 (22.2%) and poor in 9 (25.2%). Although minor complications
      were noted in 5 cases (anal pain; 2, hematospermia; 1, hematuria; 1), all cases
      received full sessions. These results indicated the usefulness of the
      hyperthermia for this benign condition, which has so far responded poorly to the
      conventional therapy.

PMID- 8464183
TI  - [A study of brain MRI findings and clinical response of bladder emptying failure
      in brain bladder].
AB  - In 45 patients (38 males and 7 females; average age: 78 years) with brain
      bladder, who did not have any peripheral neuropathies and spinal disturbances,
      cerebral findings of MRI (1.5 T) T2 enhanced image were analyzed in comparison
      with those of 7 control patients with normal urination after BPH operations.
      Patients with neurogenic bladder were divided into three groups as follows: 33
      patients with a chief complaint of urinary disturbance (Group I), 9 patients with
      urinary incontinence (Group II) and 3 patients with balanced bladder (Group III).
      High frequency of lacune (24%) of the globus pallidus and low signalling of the
      corpus striatum (30%) was found in Group I patients, but low frequency in other
      Group patients and control patients. Furthermore, pathologic changes with various
      grade in the globus pallidus were observed in 91% of Group I patients. In the
      treatment of urinary disturbance, a high improvement rate of micturition disorder
      (77%) was obtained in patients treated with a combination of dantrolene and TURp
      (TUIbn for females). However, patients which had clear lacune of the globus
      pallidus showed the low improvement rate. It should be possible that the globus
      pallidus contributes to control the movement of the external sphincter and the
      pelvic base muscles as well as other striated muscles. Moreover, lacune was
      rarely found in the urination center of the brain-stem on MRI.

PMID- 8464184
TI  - [The role of lymphocytes and histiocytes as mechanism of action of BCG for
      bladder cancer].
AB  - Antitumor activity of BCG for transitional cell carcinoma of the urinary bladder
      was evaluated in 103 patients from October, 1983 to October, 1989 at Hirosaki
      University Hospital. At the same time, the role of various inflammatory cells
      infiltrating in the bladder wall after intravesical BCG instillation as mechanism
      of action of BCG was studied. Of 72 patients with superficial bladder cancer, 19
      showed a complete response and 28 showed a partial response. The effective rate
      was 65.3 percent. Significant efficacy was obtained in patients received more
      than 5 times instillation of BCG. Before intravesical BCG instillation, a small
      number of lymphocytes or plasma cells infiltrated in the stroma of the tumor. But
      histiocytes, neutrophils or eosinophils were hardly found. After BCG
      instillation, the degree of infiltration of each of them tended to increase. The
      mean degree of infiltration of those inflammatory cells almost all significantly
      increased in the stroma of the tumor, while only lymphocyte and histiocyte counts
      significantly increased in both the basal areas of the advancing margin of tumor
      cells and the tumor free submucosa after BCG instillation. Epithelioid granulomas
      were recognized almost in the basal areas of the advancing margin of tumor cells
      and the tumor free submucosa after BCG therapy. Langhans' giant cells were
      occasionally found within these lesions. In 2 patients marked central necrosis
      (caseation) was noticed in epithelioid granulomas. In BCG effective cases with
      superficial bladder cancer lymphocytes and histiocytes increased significantly in
      all of the stroma of the tumor, the basal areas of the advancing margin of tumor
      cells and the tumor free submucosa. On the other hand, in BCG noneffective cases
      they increased significantly only in the stoma of the tumor. Subsets of
      lymphocytes which increases after intravesical BCG instillation were mainly T pan
      cells with the predominance of T helper/inducer cells (Th/Ts ratio always > 1).

PMID- 8464185
TI  - [Effects of testosterone on the autonomic receptor-mediated function in lower
      urinary tract from male rabbits].
AB  - Effects of testosterone on the autonomic receptor-mediated function of the male
      rabbit urinary bladder and proximal urethra were examined. The alteration of
      alpha 1-, alpha 2-, beta-adrenergic receptor and muscarinic cholinergic receptor
      densities in the urinary bladder and proximal urethra were determined by
      radioligand binding techniques after castration. The density of alpha 1
      adrenergic receptor in the proximal urethra decreased gradually after castration.
      This change was significant 8 weeks after castration. The alpha 2-adrenergic
      receptor density in the proximal urethra slightly increased after castration, but
      it was not statistically significant. The beta-adrenergic receptor density in the
      bladder dome did not change after castration. The density of muscarinic
      cholinergic receptor in the bladder dome significantly decreased in animals 2
      weeks after castration. Additionally, the density of autonomic receptors and the
      response of muscle strips to autonomic drugs were compared in three age-matched
      experimental groups: control group, castrated group and castrated and
      testosterone supplemented group. When the autonomic receptor densities in the
      castrated group were compared to those of the control, the changes similar to the
      result in the previous experiment were noted. Testosterone supplementation
      restored the densities of alpha 1-adrenergic and muscarinic cholinergic receptors
      in castrated group to control levels. The responses of muscle strips to autonomic
      drugs closely paralleled the receptor densities. Castration decreased the alpha 1
      adrenergic and the muscarinic cholinergic receptor function, however,
      testosterone restored those function. These findings indicate that testosterone
      affects the autonomic receptor-mediated function in the smooth muscle of lower
      urinary tract.

PMID- 8464186
TI  - [Inhibitory activity of urinary macromolecule upon calcium oxalate crystal
      aggregation using an aggregometer].
AB  - We studied inhibitory activity of urinary macromolecule upon the calcium oxalate
      crystal aggregation using an aggregometer. We have developed an aggregometric
      assay method to measure the anti-aggregation ratio of calcium oxalate crystals in
      vitro. The macromolecular fraction of urine with a molecular weight above 5,000
      was isolated by PD-10 (Sephadex G-25M, Pharmacia) and made up to three-fold by
      Centriprep Concentrator (Amicon). The urinary macromolecular substances of
      recurrent calcium stone formers showed much less inhibitory activity than those
      of healthy controls. There were no significant relationships between the anti
      aggregation activity and the concentration of urinary proteins and other
      parameters concerning with stone diseases. It was speculated that some proteins,
      molecular weight about 10,000-30,000, might inhibit the aggregation vigorously
      based on the result of gel filtration (Superrose 12 HR, 20/50, Pharmacia)
      technique used in a healthy man's 24 hours urine. Thus, it supports that some
      urinary macromolecules are important during the phase of aggregation of calcium
      oxalate crystals, and that the feeble activity to present the aggregation may be
      one of the cause of calcium oxalate stone formation.

PMID- 8464187
TI  - [Preoperative embolization using absolute ethanol for renal cell carcinoma-
      including the questionnaire survey in Japan].
AB  - The usefulness of transvascular embolization before radical nephrectomy using
      absolute ethanol was studied in thirty-two cases with renal cell carcinoma, among
      them, 30 cases received radical nephrectomy one day after transvascular
      embolization. And a nation wide questionnaire survey regarding the embolization
      was also reported. These results were as follows: 1. The infarcted areas were
      very extensive and among 28 cases examined, 26 cases showed more than 75% of
      infarct in the whole area of the cortex. 2. Among 32 cases, 22 cases complained
      of no pain after the embolization using absolute ethanol only by the preventive
      epidural administration of analgesics. 3. The questionnaire survey showed that
      the embolization before radical nephrectomy was performed in 62% of the hospitals
      as a whole, including 81 hospitals (41%) in which the embolization was performed
      case by case. In the whole of hospitals, 21% performed the embolization
      principally by evaluating the significance of the embolization. On the other
      hand, 19% of the hospitals did not perform by the reason of no significance of
      the embolization on the treatment of renal cell carcinoma. As shown in this
      questionnaire survey, the significance of the embolization before radical
      nephrectomy was still debatable in our country. 4. In 62% of the hospitals where
      the embolization is carried out, as a whole, the period from embolization to the
      nephrectomy was 3-7 days. And in 42% of the hospitals as a whole absolute ethanol
      was principally used as an embolizing agent. In conclusion we believe that
      absolute ethanol was useful and should find further application as an embolizing
      agent before the radical nephrectomy.

PMID- 8464188
TI  - [Subpopulation of leucocytes in the semen from fertile and infertile men-
      immunohistochemical and flow-cytometric analysis].
AB  - It is hard to differentiate leucocytes from immature germ cells among many round
      cells in ejaculated semen. Recently monoclonal antibodies (MoAbs) which recognize
      surface antigen of various subtypes of leucocytes are available. In this study we
      applied a panel of MoAbs for leucocyte subpopulations (granulocytes, T
      lymphocytes, B-lymphocytes, Monocytes/Macrophages and pan-leucocytes). Semen
      smears from 64 mild oligozoospermic patients and 5 fertile volunteers were
      stained by immunohistological technique (avidin-biotin-immunoperoxidase method).
      We found highly varying total leucocyte numbers ranging from 1200 to 2.2 x 10(8)
      per ejaculate. When comparing semen from infertile patients with those from
      fertile donors, statistically significant higher medians of total leucocytes,
      total granulocytes and monocytes/macrophages were seen in infertile group. We
      compared a total number of leucocytes obtained from conventional Papanicolaou
      staining with that from immunohistochemical staining. Both were almost identical
      but the former gave a little bit higher value, because of the difficulty in
      differentiating leucocytes from immature germ cell by Papanicolaou staining.
      Moreover we performed an experiment to evaluate the applicability of flow
      cytometry (FCM) to count leucocytes in semen. Cells in the semen smears were
      stained with MoAbs recognizing the surface antigen shared by every leucocyte, and
      percentage of the leucocytes which were thus stained with MoAbs was compared with
      that determined by FCM. Results from FCM constantly gave lower value than these
      from immunostaining. This is probably because FCM could not differentiate
      leucocytes from contaminated non cell substances (e.g. cell debris). From the
      present study it is not adequate to use FCM for the detection of leucocytes in
      semen as applied in haematology. Further techniques to remove non-cellular
      substances should be established for its application in semen analysis.

PMID- 8464189
TI  - [A study on cathepsin B-like substance in patients with urological cancer].
AB  - Cathepsin B is a lysosomal cysteine proteinase which is thought to regulate
      intracellular protein metabolism. In the present study, cathepsin B-like activity
      was determined in the urine of 53 patients with renal cell carcinoma, 22 patients
      with urothelial carcinoma and 41 control subjects. In addition,
      immunohistochemical study of cathepsin B was performed in specimens obtained from
      20 patients with renal cell carcinoma, 59 patients with bladder carcinoma and 20
      patients with renal pelvic and ureter carcinoma by using sheep anti-human liver
      cathepsin B antibody. Cathepsin B-like activity was higher in the urine from
      patients with renal cell carcinoma or urothelial carcinoma than in that from
      controls. Positive reactions for cathepsin B were found in 18 of 20 patients with
      renal cell carcinoma, in 37 of the 59 patients with bladder carcinoma and in 14
      of the 20 patients with renal pelvic and ureter carcinoma. In patients with
      urothelial carcinoma high rates of positive reaction for cathepsin B were
      observed in patients with advanced stage tumors, with INF gamma-type tumors and
      with metastatic lesions. In patients with renal cell carcinoma, there was no
      correlation between the rate of positive reaction and pathological findings.
      These results indicate that urinary cathepsin B-like activity is higher in
      patients with urological cancer and that a highly positive reaction for cathepsin
      B is a risk factor for tumor invasion, metastasis and poor prognosis in patients
      with urothelial carcinoma.

PMID- 8464190
TI  - [A case of bladder carcinoma representing leukemoid reaction].
AB  - A 60-year-old male with locally invasive bladder carcinoma (pT4 pNo Mo) had a
      remarkable leukocytosis of 64,900/mm3 in the peripheral blood count without any
      findings of inflammatory disease. The grade 3 transitional cell carcinoma (TCC)
      measuring 60 by 58 mm involved the prostate, but radiological examinations
      including abdominal CT scan and isotopic bone scan failed to prove distant
      metastasis. Serum calcium level was within normal level. Negative bone marrow
      finding for leukemia strongly suggested a leukemoid reaction by the bladder
      carcinoma. Preoperative arterial chemoembolization utilizing mitomycin C
      microcapsules and cisplatin infused into the tumor feeding arteries provided a
      normalization of leukocyte count (8,200/mm3) in association with a substantial
      tumor reduction, and was followed by radical cystoprostatectomy. Although the
      leukocyte count maintained a normal range for 2 months postoperatively,
      leukocytosis recurred and rapidly progressed to a leukocyte count of 51,300/mm3.
      CT scan revealed intrapelvic tumor recurrence, and serum analysis for granulocyte
      colony stimulating factor (G-CSF) demonstrated an elevated value of 130.9 pg/ml
      (normal, less than 30 pg/ml). The patient is now on systemic chemotherapy. The
      laboratory data and the response to the treatments would indicate that the
      leukocytosis in this patient is a leukemoid reaction due to the bladder carcinoma
      which may release G-CSF. Ten cases of bladder tumor representing leukemoid
      reaction have been reported in the literature.

PMID- 8464191
TI  - [Pelvic fibromatosis simulating urachal tumor--a case report].
AB  - We report a case of pelvic fibromatosis, which has been rarely found. A 36-year
      old man referred to our hospital complaining of right abdominal pain and a
      swelling mass. Abdominal CT and transabdominal echogram revealed a tumor
      contacted to the bladder. A nonpapillary tumor (little finger sized) at the
      bladder dome was observed by cystoscopy, and the tumor was clinically considered
      as urachal tumor. Wide radical excision including the bladder and prostate was
      performed. Pathological diagnosis was pelvic fibromatosis arising from
      musculoaponeurotic structures in the pelvis: The fibromatosis is benign
      nonmetastatic tumor but the recurrence rate is considerably high. However, in the
      present case, 14 months after operation there is no recurrence yet.

PMID- 8464192
TI  - [A case of an infant on continuous ambulatory peritoneal dialysis who markedly
      improved in subjective symptoms after total parathyroidectomy and
      autotransplantation].
AB  - Total parathyroidectomy and autotransplantation to treat secondary
      hyperparathyroidism (SHP) have been often performed on adult patients with a
      favorable result, but have rarely been reported in the pediatric literature. We
      performed the above operations on a 4-year-7-month girl who was treated by
      continuous ambulatory peritoneal dialysis (CAPD). The postoperative levels of
      serum calcium remained low in spite of oral calcium and Vitamin D3 medication,
      and intravenous calcium administration. But an administration of calcium into
      CAPF fluid has been maintained the normal level of serum calcium. A calcium
      balance study conducted for 3 days starting the 24th postoperative day showed 391
      mg/day of calcium absorption. The girl obtained a relief from the bone pain
      approximately 2 weeks after the operation and was able to run easily one and a
      half month after the operation. Total parathyroidectomy and autotransplantation
      were considered to be an effective treatment for severe symptoms of
      osteodystrophy in infantile patients with chronic renal failure.

PMID- 8464193
TI  - [Findings of combined ventilation/perfusion scintigraphy in children with
      abnormalities of the bronchi, the lung and lung blood vessels].
AB  - Combined ventilation/perfusion scintigraphy with 133Xe/99mTc-HAM was performed
      within the framework of bronchological diagnostics in 38 children suffering from
      malformations of the bronchi, lungs and pulmonary vessels, and in 9 children
      after surgery of hernia of the diaphragm. The findings in stenoses, cysts in the
      bronchial system and in children with pulmonary vessel malformations, in one
      child with pulmonary agenesia and in a few other malformations, are presented.
      The significance of these findings in bronchological diagnosis in case of
      pulmonary malformations or clinical follow-up is discussed. Combined
      ventilation/perfusion scintigraphy is a valuable contribution to preliminary
      diagnosis and in follow-up of children with pulmonary malformations.

PMID- 8464194
TI  - [New aspects of therapy of mucoviscidosis (CF)].
AB  - The authors survey of recent advances in CF research and their therapeutic
      implications: 1. the possibility of successful gene therapy by transfer of the
      normal gene to airway epithelial cells. 2. inhalations with the potassium-sparing
      diuretic amiloride that diminish the viscosity of the bronchial secretions, 3.
      application of adenosine or uridine triphosphate (ATP or UTP) to the apical
      surface of the respiratory epithelial cells which intervene with the function of
      ion channels, 4. enzymatic cleavage and liquidification of bronchial secretions
      by aerosolized human recombinante DNase. In addition, the possible advantages of
      (heart-) lung-transplantation are also discussed.

PMID- 8464195
TI  - [Treatment strategy in childhood bronchial asthma].
AB  - Although bronchial asthma is the most frequent chronic disease in childhood, not
      all of the affected children are readily recognised as asthmatics well in time
      for appropriate treatment. Since most of the children can get rid of the symptoms
      if all the available treatment methods are made use of systematically, early
      diagnosis and correct estimation of the disease pattern are essential for good
      long-term prognosis. New pathogenetic knowledge on the importance of inflammatory
      processes affecting the bronchial mucosa has definitely shifted the points of
      emphasis in asthma treatment as is evident from the international consensus
      recommendations. Focus of drug therapy is on prophylactic antiphlogistic
      treatment. Only in cases of severe asthma continual bronchodilatory medication is
      also recommended. The inhalative route is beneficial and feasible for all age
      groups. Long-term treatment, wherever necessary, also includes continual medical
      supervision in consultation with a paediatric pneumologist.

PMID- 8464196
TI  - [Normalization of HBA1--a realistic therapeutic goal?].
AB  - Optimal regimen for therapy should lead to near-normal glycaemia in children with
      diabetes mellitus. Therefore normal or near-normal values of glycated haemoglobin
      (HbA1) during long periods seem to be very important for the assessment of the
      quality of metabolic control. However, reports published so far indicate that
      this goal for paediatric diabetology is currently not achieved in a considerable
      number of patients. We report on the results of HbA1-estimations in 76 children
      with diabetes mellitus during a one-year period. We found in 14 (18.4%) children
      HbA1-values within the normal range (mean + 2 SD) and in 25 (32.9%) children HbA1
      values in the range below mean + 3.5 SD. The therapeutic goal near-normal
      glycaemia with HbA1-values below mean + 3.5 SD and probably no or only a small
      risk for diabetics to develop late vascular complications could be achieved in 39
      (50.1%) diabetic children. Our results are compared with those published in
      literature and with current therapeutic regimens.

PMID- 8464197
TI  - [Atopic eczema with generalized lymph node swelling and deficient antibody
      formation despite repeat vaccination with live vaccines (measles, mumps)-
      atypical vaccination reaction, vaccination damage or vaccination failure?].

PMID- 8464198
TI  - [Modification of pediatric lung function measurement by antibacterial filters].
AB  - The risk of cross-infection by contaminated lung function equipment can be
      reduced by the use of antibacterial filters. These filters, however, should have
      no significant influence on flow measurements. We investigated the effect of a
      new filter (Pall PF 30) on lung function measurements in 92 children and
      adolescents with bronchial asthma and cystic fibrosis. In randomized sequence,
      flow-volume curves and spirometry were registered in the whole body
      plethysmograph. Values measured with filter correlated closely to those
      registered without; individual values remained close to the line of identity.
      With high flow rates, however, there was a minimal tendency towards lower
      measurements with filter; this damping effect was flow-dependent and remained of
      a clinically insignificant dimension.

PMID- 8464199
TI  - [Correlation between tyndallometry with the "laser flare cell meter" in vivo and
      biochemical protein determination in human aqueous humor].
AB  - INTRODUCTION: The laser flare-cell meter allows noninvasive measurement of
      aqueous flare in humans. In vitro studies have shown good correlations between
      flare values and albumin concentrations. In this study, we compared aqueous flare
      values and aqueous protein concentrations in living human eyes. PATIENTS AND
      METHODS: We measured aqueous flare and the total aqueous protein concentration in
      52 eyes of 52 patients (age 58.4 +/- 18.8 years) that underwent cataract
      extraction (22 eyes) or trabeculectomy (30 eyes). Before surgery, aqueous flare
      was determined with the laser flare-cell meter (Kowa FC-1000). During surgery, 50
      microliters of primary aqueous humor was aspired, and total aqueous protein
      concentration was performed using a modified Pierce-BCA assay. Linear regression
      analysis was calculated. RESULTS: There was a high correlation between aqueous
      flare values and total aqueous protein concentration (y = 0.52x + 0.15, r = 0.98,
      p < 0.00001). This correlation was observed both in eyes with and without
      cataract. CONCLUSION: Our results indicate that aqueous flare values as
      determined with the laser flare-cell meter reflect the true aqueous protein
      concentration quite accurately. Lens opacities appear not to significantly alter
      the results of aqueous flare measurements. As expected by theoretical
      assumptions, flare measurements overestimate aqueous protein concentrations in
      eyes with severely impaired blood-aqueous barriers because, according to
      Rayleigh's law, larger protein molecules cause more light scattering. However,
      transformation and expression of flare values as "albumin concentration
      equivalents" according to in vitro-calibration may still be useful, especially if
      the results of different instruments are to be compared.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8464200
TI  - [Pseudo-accommodation of diffractive multifocal lenses and monofocal lenses].
AB  - 35 patients were examined for their pseudoaccommodation 6 to 18 months after
      cataract extraction and implantation of a diffractive multifocal intraocular lens
      (MIOL). While in 15 patients a MIOL had been implanted in both eyes 20 patients
      had a MIOL in one eye only. 45 type 3M 815 LE and 5 3M 825 XE lenses were
      implanted. The mean age was 58.2 years +/- 9.6 years (33 to 76). Only patients
      without any pathology except cataract and preoperative refractive errors < +/- 5
      diopters of spherical and +/- 1 diopter of astigmatic refraction were eligible
      for implantation of MIOLs. After estimation of the objective and subjective
      refraction the patients' pseudoaccommodation was measured by testing their visual
      acuity, adding lenses of +/- 1, 2, 3, 4, 5 diopters to their best distance
      correction. All patients with MIOLs reached a visual acuity of 0.4 or better with
      a maximum peak at 0 and -3 diopters. The visual acuity of the MIOL patients was
      significantly better in the range of -1 to -4 diopters compared to the results of
      a control group of patients with monofocal IOLs. This suggests a wider range of
      pseudoaccommodation in patients with MIOLs.

PMID- 8464202
TI  - [Tear production in premature infants, newborn infants and infants].
AB  - These investigations concerned 50 babies at the age of 34 to 47 weeks and two
      days. After local instillation of anesthetic drops, Schirmer-1-test was done. The
      average basal tear production was 5 mm +/- 3 mm in 5 minutes. This result was
      independent of absolute age of the babies, of birth weight, of the degree of
      maturity and of sex; there was no significant difference between right or left
      side.

PMID- 8464201
TI  - [Principles of measurements in tonometry at the time of Albrecht von Graefes to
      D2 mission and self-tonometry].
AB  - There is no doubt that an elevation of intraocular pressure (IOP) precedes any
      morphological or functional glaucomatous damage for years, if not decades.
      Surprisingly, in the present glaucoma literature methods for a quantification of
      such a damage are prevailing. There might be two reasons for this: The question
      of tonometry is supposed to be perfectly and definitely solved or tonometry as
      the most significant diagnostic tool for an early diagnosis of glaucoma has been
      lost out of sight. Two aspects shall be discussed in the following: Firstly, we
      want to deal with an improved glaucoma management especially in the early phase
      of the disease. The question is when and how often should tonometry be performed
      to detect the typically greater diurnal fluctuations of IOP in glaucoma. This has
      already been pointed out in particular by Sampaolesi and Hager. Secondly, the
      technique of the most appropriate tonometer for this purpose is outlined.
      Important aspects are the accuracy of the instrument according to the standard
      set by the Goldmann applanatation tonometer as well as safety and easy handling.
      Like in other branches of medicine where the patient is more and more involved in
      his own disease control (eg self-measurement of blood pressure in patients with
      arterial hypertension), self-tonometry is likely to become a revolutionary step
      towards an improved management and follow-up of glaucoma. These are the
      objectives we should concentrate on. Technical solutions, clinical applications
      and experiences are demonstrated.

PMID- 8464203
TI  - [Clinical electroretinography: standard protocol and normal values].
AB  - The International Standard of Clinical Electroretinography serves as standard
      protocol for recording electroretinographic responses in order to facilitate
      worldwide comparisons of examinations. To promote its distribution and acceptance
      throughout the German speaking countries, we established normal values for the
      five standard responses and added a German translation of the International
      Standard in the appendix. To determine normal values for electroretinographic
      data we suggest to use percentiles instead of parameters based on a Gaussian
      distribution. Patient-related (age, sex) and -unrelated (interstimulus-interval,
      diurnal rhythm) parameters proved to influence the data values significantly.
      With these variables taken into account one can increase the clinical value of
      electroretinography in terms of a greater reliability and predictiveness of data.

PMID- 8464204
TI  - [Resorbable implant materials in retinal detachment surgery. Initial animal
      experiment studies].
AB  - In detachment surgery after a mechanically stabile chorioretinal scar is at
      present full scleral indentation no longer mandatory. Following these
      considerations absorbable scleral implants have been developed and tested in an
      animal model. Cylindrical pieces of absorbable composite-material with a diameter
      of 5 mm were sutured as radial scleral explants in 18 rabbits. The composite
      material consisted of a polyglactin-polydioxanon ratio 7:1. The absorption time
      for polyglactin is 60 days, for polydioxanon 180 days. The explants produced
      initially in ultrasonographically measured buckle height between 3.2 and 4.0 mm.
      The clinical and ultrasonographical follow up study demonstrated a continuous
      decrease of buckle height. Two weeks after implantation there was a medium height
      of 2.0 mm after five weeks a medium elevation of 0.5 mm was found.
      Histopathological examinations showed incidence of a slight resorptive
      inflammation in the area of the buckle which was not evident after 12 weeks. No
      scleral infiltration or scleral thinning was found. The promising results have
      justified controlled clinical trials with the absorbable material which might
      allow to combine the advantages of silicone sponge explants (precise
      localization) with those of scleral buckles by inflatible balloons
      (reversibility).

PMID- 8464205
TI  - [Properties of injectable intraocular lenses].
AB  - An aphakic eye can be corrected by injecting a liquid into the lens capsule
      following phacoemulsification and hardening the lens by UV irradiation. Another
      technique is to implant a thin casing of silicone rubber, that is then filled
      with liquid. The eye's resulting refraction depends strongly on the refractive
      index of the lens material. In either case, continuous control of the index of
      refraction is necessary while injecting the artificial lens material.

PMID- 8464206
TI  - [Effect of pulse duration of the Er:YAG laser on photoablation in ocular tissue
      (cornea and sclera)].
AB  - After photoablation in corneal and scleral tissue with the Er:YAG laser, two
      zones of thermal damage can be detected: The first zone (about 3 microns thick)
      consists of thermally denatured debris. The second zone (about 30 microns thick)
      shows a slightly more intense staining (H&E) compared to the non-influenced
      tissue. Variation of laser pulse duration between 100 microseconds and 1300
      microseconds does not influence the extension of these two thermal damage zones.
      Furthermore, ablation rate and ablation volume remain nearly constant within this
      range of pulse durations. These data were obtained by histology (H&E staining)
      and with a recently published silicon cast replica method. All experiments have
      been performed on corneas and sclera of pig eyes.

PMID- 8464207
TI  - [Primary localized amyloidosis of the eyelid and conjunctiva].
AB  - Report on a case of amyloidosis in the orbits of a 81-year-old women with 20
      year's follow up. At first examination she presented with cystic changes of the
      palpebral conjunctiva and spontaneous hematoma of the lid. Preceding diagnosis by
      biopsy six years of unspecific local therapy with various eye drops followed then
      by cryotherapy and two surgical interventions. Discussion of primary localized
      amyloidosis and other variants of amyloidosis and therapeutic approach.

PMID- 8464208
TI  - [A new white-noise campimeter].
AB  - In this prototype white-noise field is now generated on a high definition
      adjustable 19" colour monitor. With the help of a "touch-screen" the patient can
      draw the borders of his scotoma himself. As the white-noise stimulus is produced
      by software, there is a much greater variability of white-noise field
      specifications (brightness, intensity of noise, colour, ...). Furthermore, these
      parameters can be changed exclusively in circumscribed parts of the noise field
      (e.g. in a scotoma area). By that way a simulation or even a quantification of
      perceived noise field defects can be realized. Fixation is controlled with the
      help of an IR video camera. Input and storage of data as well as their
      presentation and output (on a Laserwriter) have been substantially improved.

PMID- 8464209
TI  - [Intraocular inflammation--retrospect of the year 1991].

PMID- 8464210
TI  - [Osteoma of the choroid].

PMID- 8464211
TI  - [Comments on Kuckelkorn R., Reim M.: On a family with blepharophimosis, ptosis,
      epicanthus inversus and telecanthus--the occurrence of the hereditary marker in 5
      generations].

PMID- 8464212
TI  - [Experiences with disc lenses composed of silicone].
AB  - Our study presents the results with a silicone disc-lens (Adatomed 90D) over a
      postoperative period of 18 months. It includes 47 patients, 42 could be
      reexamined. The implantation was done after continuous circular capsulorhexis and
      phacoemulsification with a Faulkner-folder directly into the capsular bag. The
      implantation was sometimes difficult. Skill and experience of the surgeon are
      required. The IOL springs forth of the implantation forceps, which can lead to
      traumatization of the capsule and the iris. Three times the posterior capsule
      ruptured, in two cases the implantation was stopped because of vitreous pressure
      and the risk of rupturing the capsule. In 6 cases the rim of the anterior capsule
      ruptured during the implantation. Postoperatively one IOL had a sulcus position,
      all other IOLs were in the capsular bag. A deposit of viscoelastic substance
      (Healon) between the IOL and the posterior capsule in 34 cases (72%) was
      remarkable. In 14 cases (33%) it remained for 18 months. 16 times (38%)
      regeneratory after-cataract reached the central part of the capsule. The visual
      disturbance was different, in 6 cases (14%) a YAG-laser-capsulotomy was
      performed. An influence of the deposit of viscoelastic substance on the
      development of posterior capsule opacification could not be proved. 17 IOLs (40%)
      were minimally decentrated upwards. Only 11 cases (26%) had an excellent
      mydriatic pupillary reaction. The reason is not clear. 10 eyes (24%) developed
      iridocapsular synechia, 22 eyes (52%) foreign body giant cells and 20 eyes (48%)
      dispersed pigment on the IOL surface. The giant cells did not diminish.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8464213
TI  - The construct validity of Templer's death anxiety scale in Filipino students.

PMID- 8464214
TI  - Sex-related differences in perceptions of sexual harassment of women in India.

PMID- 8464215
TI  - Self-esteem and specificity in self-focused attention.

PMID- 8464216
TI  - The relationship between academic self-concept and school withdrawal.

PMID- 8464217
TI  - Dimensions of interpersonal relation among Australian children and implications
      for psychological well-being.
AB  - Three dimensions of interpersonal relations among Australian school children were
      hypothesized as reflecting tendencies (a) to bully others, (b) to be victimized
      by others, and (c) to relate to others in a prosocial and cooperative manner.
      School children from two secondary schools (School A, n = 285; School B, n = 877)
      answered 20 questions assessing styles of interpersonal relations. Factor
      analyses of the item scores obtained from each of the two schools provided highly
      similar results, supporting the factorial independence of the three hypothesized
      dimensions. Students attending School B answered additional questions to assess
      self-esteem, level of happiness, and liking for school. Generally low levels of
      self-esteem were found among children who reported being more victimized than
      others, and high self-esteem among children practicing more prosocial behavior.
      The tendency to bully others was correlated negatively with happiness and liking
      school, but no relationship was found between this variable and self-esteem.

PMID- 8464218
TI  - Social desirability of personality items as a predictor of endorsement: a cross
      cultural analysis.
AB  - Earlier studies using specialized instruments confirmed a positive relation
      between a personality item's desirability and its endorsement outside North
      America, but allowed for few conclusions about the strength of the relationship
      in non-Western societies and offered no explanations for the observed
      correlations. In Study 1 of this investigation, university students from Turkey
      (a country rich in non-Western cultural elements) were found to be as likely as
      their U.S. counterparts to describe themselves in socially desirable terms.
      Furthermore, the strength of the relationship between desirability and
      endorsement did not depend on their level of exposure to the English language or
      to Western concepts. Study 2 indicated that socially desirable traits were also
      the most common among students in Turkey (paralleling results with U.S. samples),
      in support of desirable traits' prevalence as an explanation for the desirability
      endorsement correlation.

PMID- 8464219
TI  - Effects of cooperative and individualistic learning on prospective elementary
      teachers' music achievement and attitudes.
AB  - The effects of cooperative and individualistic learning on the achievement and
      attitudes of prospective elementary school teachers (non-music majors) in a
      course in music teaching methods were examined. Forty-three American college
      students were randomly assigned to conditions stratified on the basis of previous
      musical experience. Cooperation promoted higher achievement than did
      individualistic efforts on assignments for which each student's grade was
      affected by the quality of groupmates' work. In addition, students in the
      cooperative condition were off-task academically (such as walking around the
      room) less frequently, initiated fewer interactions with the instructor,
      perceived the instructor to be more supportive, perceived the grading system to
      be fairer, and perceived the feedback received as being more helpful.

PMID- 8464220
TI  - Depressive symptoms among Vietnamese-American college students.
AB  - Fifty Vietnamese-American college students completed questionnaires measuring
      depressive symptoms, stressful life events, and acculturation to Vietnamese
      society versus U.S. society. In contrast to the findings of earlier studies, in
      which attention was limited to depressive symptoms specific to traditional
      Vietnamese culture, no gains in reliability or validity were apparent when
      analyses were limited to these symptoms. Acculturation to U.S. society was
      positively associated with increased reports of depressive symptoms, as was the
      occurrence of stressful life events. Implications of these findings are discussed
      in terms of the changing nature of the Vietnamese-American population.

PMID- 8464221
TI  - Length-tension characteristics of bovine tracheobronchial lymphatic smooth
      muscle.
AB  - Current information regarding the physiology of lymphatic smooth muscle is
      derived from experiments on mesenteric and thoracic duct lymph trunks. We
      hypothesized that tracheobronchial lymphatics share many of the same properties
      possessed by the mesenteric lymphatics, and examined the passive and active
      length-tension characteristics of the two. Fresh isolated lymph vessel rings were
      prepared from bovine mesenteric and tracheobronchial lymphatic collectors,
      mounted in organ baths, and connected to force-displacement transducers.
      Isometric contractions were induced by exposure to 65mM KCl-substituted perfusate
      after intermittent ring length changes. Active tension was calculated. Optimal
      vessel length was greater in tracheobronchial vessel rings, averaging 4.9 +/-
      0.4mm vs 2.8 +/- 0.3mm in mesenteric rings (p < 0.001). Optimal resting tension
      and ATmax were similar for both truncal types, measuring 738 +/- 95mg and 2379 +/
      289mg in tracheobronchial vessel rings, and 625 +/- 108mg and 2501 +/- 320mg in
      mesenteric vessel rings, respectively. Stress developed at L(o) (optimal length)
      was similar for tracheobronchial (35.4 +/- 4.3mN mm-2) and mesenteric (26 +/-
      4.3mN mm-2) lymphatics (P = N.S.). The data demonstrate that tracheobronchial
      lymph vessels are similar to mesenteric lymph vessels in their ability to
      generate significant stress, and suggest that these lymphatics participate in the
      regulation of lymph flow.

PMID- 8464222
TI  - Topical treatment of acute hindlimb lymphedema of the rat using a troxerutin
      phosphatidylcholine complex in liposomal-like microdispersion.
AB  - A new reversible complex between troxerutin and phosphatidylcholine (85-90mg/kg
      per day), in the form of a liposome-like water microdispersion, was topically
      applied to the rat thigh in an experimental counterpart of acute lymphedema.
      After four days there was 75% less hindlimb edema (mean decrease 40% of normal
      compared to control 10% of normal) in the treated compared with the untreated
      rats. These findings suggest that this drug preparation may be useful to minimize
      acute peripheral lymphedema in patients.

PMID- 8464223
TI  - The influence of local hyperthermia on lymphedema and lymphedematous skin of the
      human leg.
AB  - The influence of microwave and hot water immersion hyperthermia on lymphedema and
      lymphedematous skin of the leg in 12 patients was studied using circumference and
      volumetric measurements, immunohistochemistry and "quantitative"
      lymphoscintigraphy. Whereas heating was associated with a reduction in the girth
      and volume of the leg, lymph flow as assessed by lymphoscintigraphy was
      unchanged. Neither absorption of the radiolabeled nanocolloid from the injection
      site nor the rate of tracer accumulation in the inguinal lymph nodes was
      significantly altered by heat therapy. Histologically, the lymphedematous skin
      after heat treatment showed near resolution of perivascular cellular
      infiltration, disappearance of "lymph lakes" and dilatation of blood capillaries.
      Labeling of skin migrating immune cells with monoclonal antibodies confirmed
      subsidence of dermal cellular infiltration; nonetheless, there was nonspecific
      stimulation of resident epidermal immune cells, endothelial cells, macrophages,
      lymphocytes and keratinocytes by intense expression of class II and other
      antigens. There seemed to be a direct relationship between the subsidence of
      dermal inflammation and a decrease in leg edema. We suspect that subsidence of
      local inflammation in the lymphedematous limb with alteration in the
      extracellular protein matrix after regional heating accounts for the reduction in
      peripheral edema.

PMID- 8464224
TI  - Lipoperoxide in the dermis of patients with lymph stasis.
AB  - Lipoperoxide has been detected in the thoracic duct lymph of the dog. This
      finding suggests that lipoperoxides are normally transported in lymph and with
      impaired lymph drainage may be deposited in the skin and contribute to the soft
      tissue changes characteristic of chronic lymphedema. Accordingly, after obtaining
      skin specimens taken from 8 patients (7 with obstructive lymphedema) with lower
      extremity lymph stasis we determined dermal malondialdehyde (MDA) content (after
      conversion to fluorescent thiobarbituric acid or TBA), a marker of lipoperoxide.
      In all 7 patients with obstructive lymphedema, the MDA levels were increased
      compared to control dermis (p < 0.05). We suggest that inability to clear
      lipoperoxides from the dermis with lymphatic insufficiency may contribute to the
      pathogenesis and structural skin derangements of chronic lymphedema.

PMID- 8464225
TI  - Regulation of water balance between blood and lymph in the frog, Rana pipiens.
AB  - To determine the relative importance of the lymphatic system and transcapillary
      reabsorption in maintaining water distribution between blood and lymph in Rana
      pipiens, the hematocrit (HCT) was measured (12 frogs) when each frog was: 1)
      under tricaine methanesulfonate (MS222) anesthesia, which inactivates the lymph
      hearts, 2) conscious at rest (control), and 3) conscious after activity. Arterial
      pressure (AP), lymph-heart rate (LHR), and plasma and lymph protein
      concentrations and colloid osmotic pressures (COP) were also measured. The
      average HCT during control state was 26.0 +/- 5.2% (SD), AP was 21.9 +/- 5.2
      mmHg, and LHR was 86 +/- 13 bpm. MS222 increased HCT (42.6 +/- 7.9%), and did not
      affect AP. Experiments, in which plasma volumes were determined by intra-arterial
      injection of Evans blue-labeled albumin (EB-BSA) (16 frogs), showed that the
      increased HCT reflected a reduced plasma volume. Activity did not affect HCT, but
      increased AP (33.1 +/- 6.4 mmHg, p < 0.01), and LHR (115 +/- 26 bpm, p < 0.01).
      Thus lymph hearts are largely responsible for maintaining blood volume, and
      changes in transcapillary filtration rate are rapidly mirrored by changes in
      lymph heart function. Plasma and lymph COP values after MS222 or activity were
      not significantly different from control. This observation is consistent with the
      protein and fluid fluxes resulting from Starling forces if an average reflection
      coefficient to protein, sigma, of 0.5 is assumed, which is consistent with our EB
      BSA data.

PMID- 8464226
TI  - Scanning electron microscopy of the deep lymphatic network of the murine lung as
      viewed in corrosion casts.
AB  - The lymphatic microvessels of the deep lung tissue were studied in corrosion
      casts, which were observed by scanning electron microscopy (SEM) after injection
      of a methacrylate resin (Mercox) through the trachea of CD-1 mice. We found that
      the deep lymphatics of the murine lung were composed of two interconnecting
      networks: a poorly developed capillary system located at the interacinar region,
      and a rich plexiform complex surrounding the bronchus. Lymphatic capillaries did
      not penetrate the alveolar area, thus leaving most of the lung parenchyma devoid
      of direct access to lymphatic drainage. Lung lymphatic vessels showed a small
      luminal surface and a low density of endothelial nuclei. Pulmonary lymphatic
      capillaries often formed star-like anastomoses. The structural features of
      pulmonary lymphatics, including their three-dimensional organization, were
      distinctly separate from those of the blood microvasculature of the lung.

PMID- 8464227
TI  - Clinical implications of chromosomal abnormalities in 401 patients with
      myelodysplastic syndromes: a multicentric study in Japan.
AB  - It is well known that cytogenetic analysis in patients with myelodysplastic
      syndrome (MDS) provides information useful in determining their prognosis. Based
      on the chromosomal results obtained from 401 MDS patients by a multicentric study
      in Japan, we studied correlations between chromosomal findings and prognosis or
      leukemic transformation in MDS patients. Patients with complex aberrations
      (cytogenetic abnormalities at more than three chromosomes), of any subtype, had a
      poor prognosis; for example, > 60% of patients with refractory anemia (RA)
      showing complex aberrations died within one year, but only 11% of them developed
      leukemia. In patients with RA with ringed sideroblasts (RARS), > 70% of those
      with complex aberrations evolved into the leukemic phase and survived for less
      than one year, suggesting a biologic heterogeneity in RARS patients. By contrast,
      about 5% of patients with RA or RARS exhibiting chromosomal findings other than 
      7/7q-, +8, two aberrations, and complex aberrations, developed leukemia and had a
      favorable prognosis. Therefore, the presence of chromosome abnormalities alone in
      patients with RA or RARS is not a factor in predicting leukemic transformation or
      poor prognosis. In patients with refractory anemia with an excess of blasts
      (RAEB), the presence of chromosome aberrations at MDS diagnosis affected the
      occurrence of leukemic transformation (24% versus 43%), however, no particular
      difference was noted in patients with RAEB in transformation with regard to
      whether they had chromosome changes or not, and about 60% of them evolved into
      leukemia. The poor prognosis related to complex aberrations was consistently
      noted in all MDS subtypes or age-matched groups, indicating that this cytogenetic
      anomaly is an independent risk factor for a poor prognosis in MDS patients. The
      duration between MDS diagnosis and development of the leukemic phase and that
      between the latter and death were significantly shorter in patients with complex
      aberrations than those without this change. Although the clinical significance of
      certain chromosomal abnormalities differs among subtypes of MDS, a new scoring
      system for predicting prognosis by cytogenetic changes, in combination with
      hematologic parameters, was proposed.

PMID- 8464228
TI  - Multiple chromosome abnormalities in patients with acute leukemia after
      autologous bone marrow transplantation using total body irradiation and marrow
      purged with mafosfamide.
AB  - Cytogenetic follow-up studies such as those reported after allogeneic bone marrow
      transplantation are not available in patients submitted to an autologous bone
      marrow transplantation (ABMT). Of 114 patients with acute leukemia (69 acute
      myelocytic AML, 43 acute lymphocytic ALL, 2 undifferentiated) who underwent an
      ABMT in our institution in the period from February 1983 to December 1989, 66 had
      evaluable cytogenetic data post-transplant. They all received a pretransplant
      regimen consisting of cyclophosphamide (CY) and total body irradiation (TBI)
      followed by reinfusion of marrow purged with mafosfamide. Twenty patients showed
      chromosomal damage at some time; of these, six relapsed early post-ABMT, one died
      while in persisting remission at 81 months post-ABMT from overwhelming
      pneumococcal sepsis related to a previous splenectomy, and 13 are still alive and
      well at 13 to 88 months post-transplant. The bone marrow cytogenetic
      abnormalities were complex: they included various numbers of clonal aberrations
      or variations or combination of those; they affected all but the Y chromosome,
      with a predominance however for chromosomes 1, 3, 6, and 7; they were often
      transitory and in some instances became modified with time. None of these
      chromosomal abnormalities was connected with the initial leukemia, even in the 6
      patients who relapsed early. In the other 14 patients, these abnormalities have
      so far had no detectable unfavourable implication. The origin of these
      abnormalities is unknown: both the pretransplant regimen (CY and/or TBI) and/or
      marrow purging with mafosfamide can be incriminated. Additional studies in
      patients autografted with pretransplant regimen not containing TBI and/or with
      unpurged marrow are necessary to discriminate between these two possibilities.

PMID- 8464229
TI  - Trisomy 12 in chronic lymphoid leukemias--a metaphase and interphase cytogenetic
      analysis.
AB  - Trisomy 12 has been shown to be one of the most common chromosome abnormalities
      in chronic lymphoid leukemias of B-cell origin, and some studies suggested that
      it predicts poor overall survival. We have prospectively studied 42 patients with
      B-cell chronic lymphocytic leukemia (B-CLL) and three patients with B
      prolymphocytic leukemia (B-PLL) for the incidence of trisomy 12 and other
      chromosome 12 aberrations applying fluorescence in situ hybridization (ISH) and
      conventional G-banding analysis. Dual-color hybridization experiments using
      centromere-12-specific DNA probes were performed for interphase cytogenetics. A
      subset of patients (n = 11) was analyzed using a DNA library for painting of
      chromosome 12. The incidence of trisomy/partial trisomy 12 was 18% (8/45
      patients; 6/42 with B-CLL and 2/3 with B-PLL) by fluorescence ISH, and 11% (5/45
      patients; 4/42 with B-CLL including one patient with partial trisomy 12q13-qter,
      and 1/3 with B-PLL) on G-banding analysis. Four patients with trisomy 12 were
      detected by ISH alone. One of these patients only had 4.5% interphase cells with
      three fluorescence signals indicating the presence of a small subclone with
      trisomy 12. On G-banding analysis, three of the four patients had a normal
      karyotype, and one patient had no analyzable metaphases. In conclusion,
      fluorescence ISH to interphase nuclei is a sensitive method for detecting trisomy
      12 in patients with chronic lymphoid leukemias.

PMID- 8464230
TI  - Translocation t(6;9)(p23;q34) in acute myeloid leukemia without myelodysplasia or
      basophilia: two cases and a review of the literature.
AB  - The clinical, hematological, and cytogenetic data from two young adults with
      acute myeloid leukemia (AML) FAB type M1 is described. At diagnosis, cytogenetic
      investigation revealed the presence of the translocation t(6;9)(p23;q34). Bone
      marrow basophilia was not detected in either patient nor was there any evidence
      of preceding or underlying myelodysplasia. Both patients achieved complete
      remission (CR) and one patient remains in CR of over 5 years duration. It is
      suggested that the presence of basophilia may be associated with the
      myelodysplasia rather than the chromosome anomaly t(6;9).

PMID- 8464231
TI  - Early diagnosis of smoldering acute lymphoblastic leukemia using immunological
      marker analysis.
AB  - During a period of 9 years, we performed immunological marker analysis in 164
      children with acute lymphoblastic leukemia. In four children the diagnosis acute
      leukemia could not be established by cytomorphological analysis of bone marrow
      and peripheral blood samples at initial presentation. In two of these four
      children a hypoplastic bone marrow was found, whereas the bone marrow of the
      other two children was normocellular. Using double immunological marker analysis,
      we detected high frequencies of CD10+, TdT+ cells in bone marrow (range: 18-53%)
      as well as peripheral blood (range: 0.04-19.5%). In control bone marrow and
      peripheral blood samples from healthy children, the frequency of CD10+, TdT+
      cells does not exceed 10% and 0.03%, respectively. Based on the immunological
      data, a common acute lymphoblastic leukemia (ALL) was suspected. In addition,
      chromosome analysis revealed a high hyperdiploid (> 50 chromosomes) karyotype in
      three patients and t(9;22) in one patient. At 18 to 68 days after initial
      presentation, an ALL was diagnosed according to cytomorphological criteria in all
      four patients. At that time the percentage of CD10+, TdT+ cells in bone marrow
      and peripheral blood had increased significantly. One patient could be monitored
      frequently from initial presentation onwards. First a decline in the percentage
      of CD10+, TdT+ cells was found, although treatment consisted only of red blood
      cell transfusion and antibiotics. Subsequently the percentage of CD10+, TdT+
      cells gradually increased until the morphological ALL diagnosis. These results
      illustrate that CD10, TdT double immunological marker analysis is a useful tool
      for early diagnosis of smoldering ALL in patients with a suspicious bone marrow,
      even when the bone marrow is hypoplastic.

PMID- 8464232
TI  - Interphase in situ hybridization reveals minimal residual disease in early
      remission and return of the diagnostic clone in karyotypically normal relapse of
      acute lymphoblastic leukemia.
AB  - Early clinical remission of acute lymphoblastic leukemia (ALL) was examined by
      fluorescence in situ hybridization (FISH) in bone marrow cells from eight
      patients with high hyperdiploid (> 50 chromosomes) clones at diagnosis. Alphoid
      centromeric probes to chromosomes X, 10, 17, and 18, trisomic at diagnosis, were
      used as appropriate. Three hematologically normal marrows were used as controls.
      At diagnosis, trisomic interphase cells ranged from 69.3-84.4%. One month later,
      trisomic and tetrasomic interphase cells were significantly increased over
      control frequencies in 2/7 cases tested (p < 0.05 and p < 0.001) and trisomy
      alone in one case (p < 0.05). At two months post-diagnosis, trisomy and tetrasomy
      were in the control range. Pentasomy and hexasomy, not seen in controls, were
      found in 5/7 samples at one month and in 1/5 samples at two months. One patient
      examined in chromosomally normal relapse had 34.4% trisomic cells by FISH at
      confirmed relapse (p < 0.001). An additional hyperdiploid case, examined at
      central nervous system relapse, had increased numbers of trisomic cells (p <
      0.01) in a morphologically and cytogenetically normal marrow. These findings
      demonstrate the elimination of aberrant ploidy in most hyperdiploid cases two
      months from diagnosis and indicate that failure to detect the abnormal clone in
      relapse may result from selective mitotic activity of chromosomally normal cells,
      rather than relapse in a cytogenetically normal clone.

PMID- 8464233
TI  - Mitoxantrone, etoposide and intermediate-dose Ara-C (MEC): an effective regimen
      for poor risk acute myeloid leukemia.
AB  - A total of 74 patients with poor risk AML (median age 36.7 years, range 4.5-60.6)
      received a single course of a regimen including mitoxantrone (6 mg/m2 intravenous
      bolus daily, days 1 to 6), etoposide (80 mg/m2 intravenous over 1 h, daily, days
      1 to 6) and intermediate-dose Ara-C (1 g/m2 over 6 h, daily days 1 to 6). 28
      patients had failed initial remission induction with daunorubicin and
      conventional doses of Ara-C, 16 patients had secondary AML and 30 patients had
      relapsed from initial remission (five within six months, 15 over six months and
      ten after autologous or allogeneic bone marrow transplantation). Overall 41/74
      patients (55%) achieved complete remission, 26 (35%) had resistant disease and
      seven (10%) died of infection during marrow hypoplasia. A 4-day course of the
      same regimen was given as consolidation to patients in complete remission.
      Subsequent antileukemic therapy was individualized. Profound myelosuppression and
      pancytopenia were universal resulting in fever or documented infections in almost
      100% of patient; major hemorrhagic complications occurred in 39% of patients.
      Extrahematologic toxicity was mild to moderate consisting mostly of nausea and
      vomiting, oral mucositis and transient liver and cardiac dysfunction. We conclude
      that the MEC combination chemotherapy program seems to be an effective
      antileukemic regimen for secondary and advanced AML, with acceptable toxicity.

PMID- 8464234
TI  - Cytotoxic activities of recombinant immunotoxins composed of Pseudomonas toxin or
      diphtheria toxin toward lymphocytes from patients with adult T-cell leukemia.
AB  - We have previously shown that the recombinant single-chain immunotoxin anti
      Tac(Fv)-PE40, composed of the variable domains of the anti-Tac monoclonal
      antibody in a single-chain form joined to a derivative of Pseudomonas exotoxin
      (PE), is cytotoxic toward malignant cells from adult T-cell leukemia (ATL)
      patients. Using this assay, we have now compared the activity of anti-Tac(Fv)
      PE40 with that of an improved version, anti-Tac(Fv)-PE40KDEL which contains an
      altered carboxyl terminus, and also with two chimeric toxins made with diphtheria
      toxin (DT). One of these is a fusion of amino acids 1-388 of DT with anti-Tac(Fv)
      and is termed DT388-anti-Tac(Fv). The other, DT388-IL2, contains interleukin 2
      (IL2) at the carboxyl terminus of the same DT derivative. We incubated these
      toxins with malignant ATL peripheral blood mononuclear cells (PBMCs) for 1-3 days
      and then measured [3H]leucine incorporation. We found that anti-Tac(Fv)-PE40KDEL
      was the most cytotoxic agent and was followed in decreasing order of activity by
      anti-Tac(Fv)-PE40, DT388-anti-Tac(Fv), and finally DT388-IL2. Trypan blue
      staining showed that inhibition of protein synthesis correlated with cell death.
      Time course studies showed that the recombinant toxins containing anti-Tac(Fv)
      were cytotoxic even if exposed to the cells for only one hour. After intravenous
      injection into mice, the half-life of anti-Tac(Fv)-PE40 or anti-Tac(Fv)-PE40KDEL
      was 30 minutes. Normal PBMCs were resistant to all four toxins. Recombinant
      immunotoxins made with anti-Tac merit further study as potential reagents in the
      treatment of ATL.

PMID- 8464235
TI  - Quantitative analysis of the expression and regulation of an activation-regulated
      phosphoprotein (oncoprotein 18) in normal and neoplastic cells.
AB  - Activation of protein kinase C results in phosphorylation of a 19-kDa protein
      termed 19K. Isolation and sequence analysis of a cDNA encoding the 19K protein
      revealed that this protein has been studied in other systems under different
      names. The name oncoprotein 18 (Op18) has been proposed on the basis of a
      postulated up-regulation in neoplastic cells. In the present report we adopt the
      designation Op18 for the 19K protein, and quantify this phosphoprotein in a
      series of leukemia/lymphoma cell lines, a panel of non-transformed cells and some
      terminally differentiated cell types. For this purpose we have developed reagents
      allowing quantitative Western-blot analysis, and quantification of Op18 on the
      single cell level by flow cytometric analysis. The data demonstrates a pronounced
      up-regulation of the Op18 protein in most leukemia/lymphoma cell lines. The HPB
      ALL cell line provided the most extreme case and expressed 7 x 10(6) Op18
      molecules/cell, which compares with 0.65 x 10(6) Op18 molecules/cell in non
      transformed lymphoblastoid cells. The expression of Op18 appears to be restricted
      to cell types with proliferative potential, but it is clear from our results that
      up-regulation of Op18 is uncoupled from cellular proliferation. Moreover, by
      employing an Epstein-Barr virus based shuttle vector, we expressed Op18 cDNA in
      lymphoblastoid cells. This resulted in a three to fourfold up-regulation of Op18
      that did not have any detectable consequences for cell-surface phenotype or cell
      size. However, increased expression of Op18 resulted in a partial inhibition of
      cell proliferation. Taken altogether, the results suggest that up-regulation Op18
      levels in leukemia/lymphoma cells are strongly associated with, but not a direct
      cause of tumour progression.

PMID- 8464236
TI  - Molecular analysis of the LMP (latent membrane protein) oncogene in Hodgkin's
      disease.
AB  - Molecular analysis of the LMP (latent membrane protein) oncogene was performed in
      21 Epstein-Barr virus (EBV) positive cases of Hodgkin's disease (HD) with proven
      LMP gene expression. In each case, viral DNA of the LMP gene was assessed for
      polymorphism (deletions, insertions, mutations) by polymerase chain reaction
      (PCR) amplification with selected primers. Specificity of the amplified targets
      was proven by internal oligonucleotide hybridisation and nested primer PCR.
      Homogeneity of the 5' LMP gene region coding for the amino terminal,
      transmembrane, and short extracytoplasmic domains of the protein was identified
      in all cases. However, deletions or insertions of small DNA sequences within the
      coding region for the intracytoplasmic LMP domain were observed in about 20% of
      cases. In one of them, a 30-base-pair deletion was precisely localized by DNA
      sequencing. A particularly high frequency of DNA polymorphism (30% of cases) was
      found in the 3' untranslated LMP region. However, when analysing the LMP gene in
      seven benign conditions, no DNA polymorphism was found. These data suggest
      conservation of oncogenic LMP regions coding for the protein domains known to be
      associated with transforming capacities and immunogenic functions. They also show
      a considerable genomic heterogeneity of the coding region for the
      intracytoplasmic domain and the 3' untranslated mRNA region. This LMP DNA
      polymorphism identified within a localized (Swiss) population suffering from HD
      is unexpected. Its eventual clinical significance remains to be determined.

PMID- 8464237
TI  - Molecular diversification of dominant subclones in vivo and in vitro in Ph
      positive ALL.
AB  - A leukemia line KOPN30bi was established from a patient with acute lymphocytic
      leukemia (ALL) and Philadelphia (Ph) chromosome. The clonal rearrangement of the
      immunoglobulin heavy chain (IgH) gene and the expression of the P190 type BCR/ABL
      chimeric transcript were shown to be identical between KOPN30bi and the
      predominant clone (S1) in the blast cell population from which KOPN30bi was
      established, indicating that they are of the same clonal origin. Studies of the T
      cell antigen receptor (TCR) gene configuration including the TCR beta, gamma, and
      delta loci showed that none of them was identical between KOPN30bi and S1. The
      TCR delta region was rearranged on both of the alleles in KOPN30bi and was
      deleted on both alleles in S1 indicating that KOPN30bi was not derived from S1.
      Polymerase chain reaction analysis, using an oligonucleotide probe corresponding
      to the N region sequence of the V gamma-J gamma juncture of KOPN30bi, indicated
      that only 0.1% of the blast cells corresponded to KOPN30bi. Thus molecular
      diversification of dominant subclones in vivo and in vitro was shown in Ph
      positive ALL.

PMID- 8464238
TI  - Genetic alterations in the p53 gene in the blast crisis of chronic myelogenous
      leukemia: analysis by polymerase chain reaction based techniques.
AB  - Rearrangements of the c-abl protooncogene and the bcr-gene are found in > 90% of
      patients in chronic phase of chronic myelogenous leukemia (CML). The molecular
      events leading to blast crisis, however, have not been well characterized. Gross
      alterations of the p53 gene have been detected in 30% of patients with blast
      crisis. Since point mutations in the p53 gene appear to be important in the
      process of transformation in many epithelial tumors, we looked for these
      mutations in the critical regions of the p53 gene (exons 4, 5, 6, 7, and 8). We
      used the polymerase chain reaction (PCR), direct sequencing, differential PCR,
      and single strand conformation polymorphism (SSCP) analysis to detect mutations
      of the p53 gene in samples from 21 patients with CML blast crisis. Two of 21
      patients exhibited an intragenic deletion or rearrangement in p53. In addition,
      these patients were homozygous for the mutant p53 allele. No mutations were found
      in the p53 gene of the remaining 19 patients. However, sequencing of the CML
      blast crisis cell line, K562, revealed an insertion of a C at base position 956
      within the fifth exon, causing a frame shift mutation and an early translational
      stop at codon 148. We conclude that, in contrast to solid tumors, mutations in
      exons 4-8 of p53 are not frequently seen in primary samples from CML blast
      crisis. However, deletions and/or rearrangements within the p53 gene do occur and
      may contribute to the progression from chronic phase to blast crisis in a limited
      number of patients with CML.

PMID- 8464239
TI  - Effect of IL-4 and IL-6 on the proliferation and differentiation of B-chronic
      lymphocytic leukemia cells.
AB  - The proliferation and differentiation of purified malignant B cells from nine
      patients with chronic lymphocytic leukemia (B-CLL) were studied in vitro. We have
      demonstrated before that tumour necrosis factor alpha (TNF-alpha), in combination
      with low dose phorbol myristic acid (PMA) (0.1 ng/ml), can induce proliferation
      in these purified B-cell populations and that this TNF-alpha-induced
      proliferation is completely inhibited by the addition of interleukin 4 (IL-4). In
      this study we demonstrate that IL-6 is also able to inhibit this TNF-alpha
      induced proliferation. Inhibition is maximal with 400 pg/ml of IL-6. With the use
      of neutralizing antibodies we show that the inhibition by IL-4 and IL-6 are
      independent processes. In contrast, investigation of differentiation as measured
      by immunoglobulin M (IgM) production, showed that in combination with PMA (1
      ng/ml), IL-4 is the main cytokine to induce differentiation of these B-CLL cells.
      That we were indeed measuring differentiation of the malignant B cells could be
      demonstrated by the specific production of IgM/kappa or IgM/lambda. No induction
      of IgG or IgE production could be detected. In contrast to IL-4, in the majority
      of cases IL-6 does not play a role in the induction of differentiation of B-CLL
      cells. However, in two out of nine B-CLL patients we found that at low PMA
      concentrations (0.1 ng/ml), TNF-alpha can induce both proliferation and
      differentiation. In agreement with what was found for the proliferative response,
      this TNF-alpha-induced IgM production is inhibited both by IL-4 and IL-6. The
      possible therapeutic implications of our findings are briefly discussed.

PMID- 8464240
TI  - LIF mRNA expression is transcriptionally regulated in murine bone marrow stromal
      cells.
AB  - Recent evidence has established an important role for leukemia inhibitory factor
      (LIF) as hematopoietically active cytokine. The present study utilized two
      different murine bone marrow stromal cell lines, +/+-1.LDA11 and MBA-13, to
      define regulatory mechanisms of LIF messenger RNA (mRNA) induction. LIF mRNA was
      not detected in uninduced stromal cells under serum-free conditions. Incubation
      with interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha) or the cAMP
      analogue 8-bromoadenosine 3':5'-monophosphate (8BrcAMP) resulted in weakly
      induced LIF mRNA. Coincubation of combinations of the stimuli increased LIF mRNA
      expression additively. LIF mRNA stability, even after stimulation, was low with a
      half-life of about 30 min, suggesting a functional role for known AU-rich motifs
      in the 3' untranslated LIF mRNA region in mediating this instability. This
      possibility was further supported by the ability of cycloheximide to increase
      mRNA levels without affecting transcription. Transcriptional activation was found
      to be the main mechanism leading to LIF mRNA expression by IL-1, by TNF-alpha,
      and by 8BrcAMP. These stimuli appeared to act additively in this regard,
      suggesting involvement of distinct transcription factors. Induction of
      transcription was detected 45 min post-stimulation and showed peak levels at 90
      min. Kinetics of LIF transcriptional activation showed similarity with the
      kinetics of the transcription factors, jun-B and c-fos, suggesting a possible
      role for these proteins or other early response genes in events leading to LIF
      expression.

PMID- 8464241
TI  - Characterization of a t(1;19) pre-B acute lymphoblastic leukemia (ALL) cell line
      which proliferates in response to IL-7.
AB  - The present study describes the establishment of the cell line Pre-Alp from the
      bone marrow of a pediatric patient with a t(1;19) pre-B acute lymphoblastic
      leukemia (ALL) at diagnosis. Proliferation of leukemic blasts was found to be
      initially dependent on the presence of autologous stromal cells. However, after
      five weeks of culture, the stromal cells were no longer necessary and cells began
      to grow autonomously, with a doubling time of approximately 24 hours. The
      established Pre-Alp cell line displays a pre-B cell phenotype (CD19+, CD10+, CD34
      , c mu+, s mu-), with immunoglobulin (Ig) light chain DNA in germline
      configuration, and carries a (1;19)(p23;q13.3) chromosomal translocation
      identical to the freshly-isolated leukemic blasts. A unique feature of this cell
      line is represented by its ability to respond to interleukin 7 (IL-7). Thus, IL-7
      enhances 3H-thymidine uptake by Pre-Alp cells in a dose-dependent manner, under
      conditions of low cell density and serum concentration, and increases cell
      recovery. Finally, Pre-Alp cells were found to remain at a pre-B stage even upon
      addition of various cytokines, which failed to induce a transition to surface Ig+
      cells. The presently described cell line should constitute a useful model of
      t(1;19) pre-B ALL and permit the study of IL-7 dependent signal transduction in
      human pre-B cells.

PMID- 8464242
TI  - Inhibitory effect of interleukin-4 on the proliferation of acute myeloid leukemia
      cells with myelo-monocytic differentiation (AML-M4/M5); the role of interleukin
      6.
AB  - Since interleukin-4 (IL-4) specifically inhibits monocytic colony formation in
      human bone marrow cultures, we investigated whether a similar inhibition could be
      observed in cultures of optimally stimulated acute myeloid leukemia cells with
      myelomonocytic differentiation (AML-M4/M5). Sensitivity to IL-4 was tested in 19
      cases of AML-M4/M5, using both a 3H-thymidine incorporation assay and a
      clonogenic assay. Proliferation was stimulated with a combination of IL-3,
      granulocyte-monocyte colony-stimulating factor (GM-CSF), and conditioned medium
      from phytohemagglutinin-stimulated leukocytes (PHA-CM). In 13 out of 14 evaluable
      cases, IL-4 inhibited 3H-thymidine incorporation; stimulation was seen in one
      case. Using a clonogenic assay, IL-4 inhibited colony formation in all evaluable
      cases (n = 7). Addition of IL-6 did not alter the observed inhibition by IL-4 in
      9 out of 10 cases tested. We conclude that IL-4 inhibits the proliferation of
      optimally stimulated AML-M4/M5 cells in most cases tested, and that this effect
      is not generally caused by inhibition of autocrine IL-6 production.

PMID- 8464243
TI  - Combined immunophenotyping and interphase cytogenetics on cryostat sections by
      the new FICTION method.
AB  - A technique is described to detect tumor cells with certain chromosome
      aberrations within cryostat sections and to characterize these individual cells
      by immunophenotyping. This new method is called fluorescence-immunophenotyping
      and interphase cytogenetics as a tool for investigation of neoplasms (FICTION).

PMID- 8464244
TI  - Myelodysplastic disorders with hemizygous M-CSF receptor gene loss do not show
      point mutations of codon 969 within the remaining allele.

PMID- 8464245
TI  - Chronic myelogenous leukemia: biology and therapy.
AB  - There is remarkable recent progress in our understanding of the biology of
      chronic myelogenous leukemia (CML). First, the BCR/ABL rearrangement was
      identified as the molecular basis of the disease. Second, animal models support
      the notion that the BCR/ABL gene product causes a syndrome similar to CML. Third,
      recent advances in understanding the functions of the normal ABL protein have
      given clues to the mechanism(s) of ABL-induced leukemias and approaches to
      blocking this process. Extrapolating these findings to humans seems reasonable.
      The challenge now is to determine how the BCR/ABL gene product causes chronic
      phase CML. Also unresolved is whether BCR/ABL also plays a role in the acute
      phase of the disease. Finally, the relationship between the two common forms of
      BCR/ABL, the P190 and P210 configurations, and different disease phenotypes, like
      CML and Philadelphia (Ph1)-chromosome positive acute lymphoblastic leukemia
      (ALL), needs to be clarified. There is also substantial progress in treating CML.
      Bone marrow transplants have emerged as the preferred therapy. These result in
      long-term leukemia-free survival in more than one-half of appropriately selected
      subjects. How transplants cure CML is complex and controversial. Some data
      suggest high-dose treatment is the dominant factor whereas other data implicate
      antileukemia effects of the immune system. Interferon treatment has also proven
      effective in CML. Whether it prolongs survival of persons with CML remains to be
      determined, as does its mechanism of action. Certainly the most important and
      difficult challenge in CML therapy is determining how to use knowledge about the
      causes CML to treat the disease. These and other issues in the biology and
      therapy of CML were the subject of a recent meeting of basic and clinical
      scientists. The meeting, third in a series begun in 1987, was held on Martha's
      Vineyard, Cape Cod, Massachusetts, USA from 4-7 April, 1992. Four major topics
      were considered in five sessions: molecular biology, cell biology, Ph1-chromosome
      positive ALL, and therapy of CML. This report summarizes meeting highlights.

PMID- 8464246
TI  - Physician frustration in communicating with patients.
AB  - In this study, the nature of practicing physicians' "frustrating" visits was
      explored and a guide to help physicians identify problems in communicating with
      patients was developed. The study included 1,076 practicing physicians who
      attended a voluntary workshop on physician-patient communication. The physicians
      were from multiple specialties and diverse work settings geographically dispersed
      throughout the United States. The method included development of a preliminary
      item pool (descriptions of frustrating patients and occasions) by experienced
      physicians and teachers of medical communication, additions/deletions/revisions
      of items within the pool, empirical analyses to reduce redundancy and group-like
      items, and construct validation of the final 25-item questionnaire. Factor
      analysis was used to identify subscales. Physicians most often attributed
      communication problems to the patient rather than to their own limitations. Seven
      types of communication problems (subscales) were identified, including: 1) lack
      of trust/agreement, 2) too many problems, 3) feeling distressed, 4) lack of
      understanding, 5) lack of adherence, 6) demanding/controlling patient, and 7)
      special problems. Primary care physicians reported greater problems than
      specialists on four subscales. Physicians practicing in health maintenance
      organizations reported greater problems than physicians in fee-for-service
      practice on five subscales. Seven sources of frustration physicians experience in
      their work with patients were identified. Understanding these frustrations will
      allow physicians to reflect on their own experiences and potentially improve the
      quality of their patient visits.

PMID- 8464247
TI  - Medicare prospective payment reforms and hospital utilization. Temporary or
      lasting effects?
AB  - Early evaluations of the Medicare prospective payment reforms found them very
      effective in reducing hospital utilization. In this study, the author
      investigated whether the reforms remained effective throughout the first decade
      of implementation. Seasonal autoregressive-integrated-moving average (ARIMA)
      models with intervention components were applied to age-specific national times
      series of hospital admissions, average length of stay, inpatient days, and
      adjusted inpatient days. Three alternative regulatory impact patterns were tested
      using quarterly data collected by the National Hospital Panel Survey spanning the
      period 1970:1 to 1992:1 (n = 89). The reimbursement reforms seem to have reduced
      hospital admissions, average length of stay and patient days during fiscal years
      1983-1984, but significant readjustments relative to projected levels occurred
      for all four utilization measures during fiscal years 1985-1986. Similar, yet
      less pronounced readjustments, were found in the analysis of non-Medicare time
      series suggesting regulatory spill-over effects. Sicker patients and hospital
      diversification efforts are two plausible reasons for the relative increase in
      hospital utilization during 1985-1986. The Medicare reimbursement reforms appear
      to remain effective in reducing hospital utilization, but at a reduced rate.

PMID- 8464248
TI  - A preliminary case-mix classification system for Medicare home health clients.
AB  - In this study, a hierarchical case-mix model was developed for grouping Medicare
      home health beneficiaries homogeneously, based on the allowed charges for their
      home care. Based on information from a two-page form from 2,830 clients from ten
      states and using the classification and regression trees method, a four-component
      model was developed that yielded 11 case-mix groups and explained 22% of the
      variance for the test sample of 1,929 clients. The four components are
      rehabilitation, special care, skilled-nurse monitoring, and paralysis; each are
      categorized as present or absent. The range of mean-allowed charges for the 11
      groups in the total sample was $473 to $2,562 with a mean of $847. Of the six
      groups with mean charges above $1,000, none exceeded 5.2% of clients; thus, the
      high-cost groups are relatively rare.

PMID- 8464250
TI  - Main trends in hospital use in different cities in Japan.
AB  - In this study, trends in hospital use were identified in Japanese cities. Data
      for all inpatient care in May 1985 (9,555 patients) and in May 1988 (11,205
      patients) paid for by National Health Insurance in 12 cities in Osaka Prefecture
      were analyzed. The main factor affecting differences in inpatient days per
      insured person of all ages (hospital use) among the cities were differences in
      hospital use by long-stay patients aged 70 years or older, which depended not on
      inpatient days per patient but on the rate of hospital admission. The main factor
      affecting change in mean hospital use from May 1985 to May 1988 seemed to be an
      increase in hospital use by long-stay patients 70 years of age or older, which
      did not depend on increases in the rate of hospital admission, but did depend on
      the number of insured persons 70 years of age or older. Calculation showed that
      an increase of 13 long-stay patients 70 years of age or older for 10,000 insured
      persons 70 years of age or older per year was to have accounted for about 40% of
      the increase in hospital use by all patients. If the trend for increasing
      hospital use in Japan is to be altered, the first step might be the careful
      planning for this comparatively small increase in long-stay elderly patients by
      promotion of a non-hospital-based care system.

PMID- 8464249
TI  - Patterns of use of mammography among inner-city Detroit women: contrasts between
      a health department, HMO, and private hospital.
AB  - This study assessed the pattern of utilization of mammography among 2,880 inner
      city minority women 40 years of age or older who received ongoing primary care
      services during 1988 or 1989 at four practice sites operated by a health
      department (two sites), Health Maintenance Organization (HMO), and private
      hospital. Mammography referral could be documented for 23% to 32% of age eligible
      women and completed mammograms for 15% to 26%. Among women without a mammogram,
      85% had never been referred while 15% were referred but unable to complete the
      procedure. In multiple logistic regression analysis, factors associated with
      mammography include age less than 70 years, presence of a breast cancer risk
      factor and more frequent clinic visits. Mammography was somewhat more frequent at
      the HMO and hospital clinic than at the health department, but this relationship
      varied with the women's previous visit and mammography experience. At sites
      serving uninsured women, mammography use was not associated with the presence or
      absence of health insurance. It is concluded that the underutilization of
      mammography is a substantial barrier to the early detection of breast cancer in
      each of the three different health care organizations studied, and that
      interventions to improve breast cancer control should focus upon facilitating
      physician referral practices.

PMID- 8464251
TI  - Functional status outcomes in rehabilitation. Implications for prospective
      payment.
AB  - Previous studies have demonstrated that functional status is a significant
      predictor of resource utilization for rehabilitation patients. Before
      implementing a prospective payment system (PPS) for rehabilitation, it is
      important to first: 1) develop an underlying conceptual framework of
      rehabilitation resource use; and 2) understand how the role of functional status
      may vary by rehabilitation condition. In this study, a theoretical model of
      rehabilitation is presented that proposes relationships between patient and
      provider characteristics, rehabilitation treatment, costs, and clinical outcomes
      of rehabilitation. Also presented are regression analyses based on this model for
      a key outcome of rehabilitation, change in functional status, for nine
      rehabilitation conditions using variables that minimize adverse incentives by
      providers in selecting patients for admission to rehabilitation. The change-in
      functional-status model explained the most variance for back injury,
      cardiopulmonary, and arthritis, and less variance for stroke, spinal cord injury,
      and neurologic impairment. The significant predictors of change in functional
      status varied by condition. Results support the use of functional status
      measurements in a PPS for rehabilitation services, the need to refine the
      measurement of functional status, and the use of condition-specific activities of
      daily living (ADL) items to include in summary indices.

PMID- 8464252
TI  - Evaluating hospital discharge planning: a randomized clinical trial.
AB  - To select patients for early discharge planning, a randomized clinical trial
      evaluated a protocol that used risk factors identified upon hospital admission.
      The goal of the study was to determine if intervention with high-risk patients
      could reduce the need for hospital admission or skilled care. Of 13,255 patients
      screened, 835 study participants were identified as "at risk" for frequent health
      care resource use. Half of the high-risk patients were randomly assigned to the
      experimental group (n = 417) and received discharge planning from day 3 of their
      hospital stay, while the control group (n = 418) received discharge planning only
      if there was a written physician request. Those patients receiving early,
      systematic discharge planning experienced an increased likelihood of successful
      return to home after hospital admission and a decreased chance of unscheduled
      readmission for the 9-month study period. Length of the index hospital stay was
      not affected by early planning, however. The major clinical implication is the
      potential for discharge planners to decrease the need for, and use of, health
      care resources after hospital admission.

PMID- 8464253
TI  - Differences in length of hospital stay in patients with community-acquired
      pneumonia: a prospective four-hospital study.

PMID- 8464254
TI  - [The coronary sulcus and ischemic cardiopathy: an independent association of risk
      factors].
AB  - BACKGROUND: Coronary sulcus of the auricular lobe has been related to the
      presence of ischemic cardiopathy although the nature of this relation has not
      been well defined. The aim of the present study was to determine whether there is
      a relation between the sulcus and the classical coronary risk factors, or whether
      the association between coronariopathy and sulcus is independent of such factors.
      METHODS: Patients admitted into an intensive care unit (n = 222) were divided
      into two groups according to whether coronary sulcus was present and the
      following analysis were performed: 1) comparative study between the groups for
      the variables: age, sex, coronariopathy, hyperglycemia, hyperlipidemia,
      hypertension, index of body mass, and tobacco habit. 2) logistic regression
      analysis used as a variable to study the existence of coronary sulcus and as
      independent factors the different coronary risk factors. 3) calculation of
      sensitivity and specificity of the coronary sulcus as a marker of ischemic
      cardiopathy. RESULTS: In the comparison between groups the individuals with
      coronary sulcus had greater age, cholesterolemia, index of body mass, with
      greater frequency found in females with ischemic cardiopathy. In the logistic
      regression analysis the presence of coronary sulcus was only associated by order
      of statistical significance to the variables of age and the female sex. In this
      study, coronary sulcus was a sensitive (87.6%) although unspecific (41.2%) marker
      of coronariopathy. CONCLUSIONS: The prevalence of coronary sulcus increases with
      age, and is greater in patients with ischemic cardiopathy. This relation is
      independent of the classical coronary risk factors.

PMID- 8464255
TI  - [The use of antibiotics in surgical prophylaxis. The characteristics and
      consequences].
AB  - BACKGROUND: The efficacy of antibiotic prophylaxis in certain surgical procedures
      has been demonstrated in clinical trials. The present study aimed at getting
      knowledge on the way how it is used in a certain hospital. METHODS: In a certain
      day, all patients receiving antibiotics to prevent a postoperative infection were
      identified in a medical school hospital. Information on the operative procedure,
      prescribed antibiotics and clinical course of the patients was recorded. RESULTS:
      Out of 714 patients admitted, 255 (36%) were treated with antibiotics and, of
      these, 85 were given them to prevent a postoperative infection. In 52% of
      patients, two or more antibiotics were given. The mean (SD) duration of
      prophylaxis was 8.4 (8.6) days. It was judged as really indicated in 34 cases
      (40%). Only in 17 (20%) the first choice antibiotic was selected; in 11 (13%) a
      preoperative dose of the right antibiotic was administered and only in 3 (3.5%) a
      preoperative dose of the first choice antibiotic was administered and prophylaxis
      lasted up to 48 hours. CONCLUSIONS: The use of antibiotics in surgical
      prophylaxis in a medical school hospital is inappropriate in more than 95% of
      cases. The situation in other centres should be quantified and the universally
      accepted norms of prophylaxis should be implemented.

PMID- 8464256
TI  - [Inadequate hospital admissions and inactive days of hospital stay in patients
      with chronic obstructive pulmonary disease and lung neoplasms].
AB  - BACKGROUND: This study was carried out to evaluate the hypothesis that the
      proportion of inadequate hospital admissions and days is greater in patients with
      pulmonary neoplasm than in patients with chronic obstructive pulmonary disease
      (COPD) given the therapeutic and diagnostic features of both diseases and to
      establish the applicability of the Appropriateness Evaluation Protocol (AEP).
      METHODS: A retrospective review was performed of the medical records of patients
      admitted for COPD and pulmonary neoplasm. Two external physicians reviewed the
      clinical histories using the AEP. Admissions and hospital days considered as
      potentially inadequate by the reviewers were supervised by a clinical
      epidemiological panel which confirmed and identified the causes for inadequacy.
      One hundred sixty-six patients admitted with COPD and 79 with pulmonary neoplasm
      selected by a systematic sample of admissions whose principal diagnosis was COPD
      or pulmonary neoplasm were studied over one year in a tertiary level teaching
      hospital in Barcelona. RESULTS: It was found that 4.8% of the admissions with
      COPD and 15.5% of the days of hospital stay were inappropriate while in patients
      with pulmonary neoplasm 14% of the admissions and 40% of the days of hospital
      stay were inappropriate. The main causes of inadequacy were: social (33.3% in
      patients with COPD); patients inadequately admitted but who remained in hospital
      to undergo diagnostic tests which could have been performed on an out patients
      basis (46% in patients with pulmonary neoplasm). CONCLUSIONS: Inappropriateness
      was greater in admissions and in hospital days with greater diagnostic components
      (pulmonary neoplasm) than in fundamentally therapeutic cases (COPD). The
      Appropriateness Evaluation Protocol was valid in this hospital with the
      supervising panel being very useful in the judgement of cases not clearly
      established in the protocol. The level of inadequacy was found to be similar to
      that of other studies although the results are not directly comparable.

PMID- 8464257
TI  - [Dopamine and dobutamine in shock: together or separately?].

PMID- 8464258
TI  - [Hospitalization at home in the rural environment].

PMID- 8464259
TI  - [Bacteremia and multiple and recurrent skin ulcers due to Brucella melitensis. A
      new modality of self-induced infection].
AB  - Self-induced infections are a special form of factitious disease. They are
      characterized by the autoinoculation of contaminated substances or bacterial
      cultures which may lead to cutaneous infections, bacteremias, or arthritis by
      various germs. The conditions produced are difficult to diagnose and may lead to
      multiple operations, and sometimes mutilations or death of the patient. Herewith,
      a patient who, over a period of 10 months, presented 4 episodes of bacteremia and
      cutaneous abscess in which Brucella melitensis was isolated is described. In
      addition, during the second admission, the patient had factitious fever. Despite
      the evidence of self induced infection, the patient denied autoinoculation
      however, following confrontation with the facts and supportive psychotherapy the
      patient has not presented any further episodes after 6 months of follow up.
      Although the microorganisms involved in this type of disorders are various, this
      is the first case described in the literature of self-induced infections by
      Brucella melitensis.

PMID- 8464260
TI  - [The inappropriate antidiuretic hormone secretion syndrome associated with
      cryptococcal meningitis in a patient with the acquired immunodeficiency
      syndrome].
AB  - Meningitis and other infectious diseases of the central nervous system are
      predisposing causes of the inadequate secretion syndrome of the antidiuretic
      hormone (ISADH). The association between the acquired immunodeficiency syndrome
      (AIDS) and ISADH is recognized but little studied. In AIDS patients hyponatremia
      is a frequent finding and it is responsible for ISADH in most cases. However,
      there is little reference material concerning the incidence of presentation and
      the type of osmoregulation anomaly this entity presents in these patients. A case
      in which ISADH is associated to cryptococcal meningitis and AIDS is described
      with an evaluation of the hormonal response to the test of hypertonic saline
      serum infusion corresponding to a release of ADH.

PMID- 8464261
TI  - [Good clinical practice in clinical trials: the responsibilities of the
      investigator. A survey of 827 hospital physicians (and II). Patient consent].
AB  - BACKGROUND: Among the responsibilities of the investigator, good clinical
      practice (GCP) includes that of obtaining informed consent (IC) from the patients
      prior to his/her inclusion into a clinical trial (CT). The attitude of the
      hospital physicians towards this question before the implementation of the GCP
      became mandatory in Spain was considered to be of interest. METHODS: An anonymous
      survey with closed response questions was used. From December 1988 to February
      1990 the survey was distributed among 1,706 hospital medical staff members of any
      specialty who had or had not participated in CT. The results of the questions
      regarding different aspects intimately linked to the obtaining of the IC from the
      patient are presented in this article. RESULTS: A total of 827 hospital doctors
      responded to the survey. Most (96%) of those surveyed considered that the
      investigator must obtain the IC prior to inclusion in the CT with almost two
      thirds obtaining the same in writing in all CT. Nine out ten of those surveyed
      considered that the information provided to the patient to obtain the IC should
      be laid out in a document. At least 90% of the above consider that the document
      should always invite the patient to participate in a CT, declaring that
      participation is voluntary, that the patient may leave the study when he/she
      wishes and that refusing to participate does not imply loss of normal health
      care. To the contrary, at least 10% would not provide information as to who the
      promoter was, the design of the CT, specific experimental procedures of the CT as
      the number of patients to participate in the CT. CONCLUSIONS: According to the
      good clinical practice guidelines, the responsibilities of the researcher with
      respect to informed consent of patients to participate in a clinical trial have,
      in general, been accepted by most of the hospital physicians surveyed in the
      present study. Theoretically, only the reduced acceptance of informing the
      patient as to the design of the clinical trial may cause some problems in the
      future.

PMID- 8464262
TI  - [Amino-terminal procollagen type-III peptide and hepatic fibrogenesis].

PMID- 8464263
TI  - [Kaposi's sarcoma with pulmonary involvement in a heterosexual man seronegative
      for the human immunodeficiency virus].

PMID- 8464264
TI  - [Dysphagia as the presentation of amiodarone-induced hyperthyroidism].

PMID- 8464265
TI  - [Legionellosis with a splenic granulomatous reaction].

PMID- 8464266
TI  - [Gastric carcinoma secondary to an autologous bone marrow transplant. Apropos a
      case with a possible relationship].

PMID- 8464267
TI  - [Plasma fibronectin concentrations in critical patients].

PMID- 8464268
TI  - [The sicca syndrome and human immunodeficiency virus infection].

PMID- 8464269
TI  - [Health inequalities in Barcelona and Valencia].
AB  - BACKGROUND: Inequalities in health have been internationally recognized as an
      important public health problem with a reduction of 25% being the first target of
      WHO--Europe for the year 2000. It is, therefore, important to describe and
      monitor the same. METHODS: An ecological study was performed using secondary data
      from the statistics of mortality (years 1985-1988) and the municipal censuses
      from the year 1986 to describe and compare inequalities in health in the cities
      of Valencia and Barcelona with neighborhoods being the unit of observation and
      analysis. RESULTS: Although the rates of mortality in Barcelona city are slightly
      inferior and those of Valencia slightly higher to those of Spain, both cities
      demonstrate important inequalities in regard to mortality in their neighborhoods
      with respect to standardized mortality which ranged from 78 to 182 in Barcelona
      and from 63 to 147 in Valencia. The privileged zones in Barcelona are those of
      Pedralbes and Sant Gervasi and in Valencia in the neighborhoods of Sant Pau and
      Jaume Roig with the most unfavorable neighborhoods being District I in Barcelona
      (Gothic Quarter, City Park, Barceloneta and Raval) and the Na Rovella and
      Fuensanta neighborhoods of Valencia. The level of inequality in both cities is
      very similar. Statistically significant associations have been found in both
      cities between the state of health and the level of poverty in the neighborhoods
      according to an approximation to the Townsend et al indexes. CONCLUSIONS: The
      description of important inequalities in two large Spanish cities suggests the
      possibility of its existence in other cities and established the urgent need for
      a study using comparable methodologies. With the use of routine and presently
      available data sources it is possible to describe and posteriorly monitor the
      level of inequality in large cities in Spain. The development of policies to
      diminish the inequalities in the large cities would provide considerable gains in
      terms of human lives. The present results support the hypothesis that material
      conditions in everyday life play an important role as a condition for public
      health inequality.

PMID- 8464270
TI  - [Sleep apnea in arterial hypertension].
AB  - BACKGROUND: The sleep apnea syndrome (SAS) and high blood pressure (HBP) present
      multiple relations. Apnea culminates with an increase in arterial pressure, and a
      high percentage of apneic patients have HBP. It has also been reported that SAS
      is more frequent among hypertensive patients than among the general population.
      METHODS: In the present study 91 essential hypertensive individuals were studied
      by a questionnaire and polygraphic study of night sleep, to establish the
      prevalence of SAS among hypertensive subjects and the predictive value of the
      clinical questionnaire. RESULTS: The prevalence of SAS in HBP was 8.8%. The
      greatest predictive value was found for the presence of respiratory pauses every
      night and throughout the night. The risk factor of greatest association was
      cigarette smoking and the greatest organic repercussion was observed in renal
      function. CONCLUSIONS: An increase in the prevalence of sleep apnea syndrome was
      found among essential hypertensive subjects, thus leading this syndrome to be
      suggested as a risk factor of high blood pressure. The question as to whether the
      patients present daily pauses between snores and throughout the entire night is
      suggestive and implies confirmation by polygraphic study of night sleep.

PMID- 8464271
TI  - [Neurosarcoidosis: presentation of 14 cases].
AB  - BACKGROUND: The involvement of the nervous system in sarcoidosis occurs with a
      frequency of approximately 5%. The aim of this study was to review the frequency
      and characteristics of the neurologic manifestations of the a series of
      sarcoidosis. METHODS: During a period of 18 years (1974-1991) 270 patients were
      diagnosed with sarcoidosis in the Hospital de Bellvitge-Princeps d'Espanya. The
      diagnosis of neurosarcoidosis was performed in those presenting neurologic
      symptoms no attributable to other causes. The clinical histories were
      retrospectively reviewed collecting clinical, radiologic, analytic, therapeutic
      and evolutive data. RESULTS: Fourteen patients (5.1%) were diagnosed of
      neurosarcoidosis. Neurologic symptomatology was the first manifestation of the
      disease in 12 (85%). All showed extra-neurologic manifestations of sarcoidosis
      with the lung being the most frequently affected organ (78%). The clinical
      picture consisted of cranial neuropathy in 11 cases of which nine presented
      peripheral facial paralysis and 4 cases involvement of the central nervous
      system. In 13 patients the treatment schedule included glucocorticoids. All the
      patients (100%) with alteration of the central nervous system continued with
      active disease at 2 years while this only occurred in 33% of the cases with
      paralysis of the cranial pairs. CONCLUSIONS: The frequency of neurosarcoidosis in
      the authors' series was similar to that described in the literature and its most
      frequent clinical form was cranial neuropathy. The treatment of choice was
      glucocorticoid and the involvement of the cranial pairs presents a better
      prognosis than that of the central nervous system.

PMID- 8464272
TI  - [Health and social inequality].

PMID- 8464273
TI  - [Proteinuria as cardiovascular and renal risk factor].

PMID- 8464274
TI  - [Factitious torpid skin ulcers. New concepts and classification of chronic
      factitious disorders].
AB  - Chronic factitious disorders are diseases diagnosed after the discarding of
      organic causes. There are determined diagnostic data which may be suspicious:
      multiple hospitalization, submission to many invasive techniques and personal
      situations motivating simulation. The case of a 34 year old woman presenting a
      factitious disorder with dermal ulcers, subcutaneous abscesses and simulation of
      hematuria is described. An analysis of the concept and classification of this
      clinical picture is made. Following diagnostic suspicion, a search for objects or
      substances with which the patient was able to make the lesions was required to
      determine the appropriate therapy.

PMID- 8464275
TI  - [Septic shock (II). Treatment].

PMID- 8464276
TI  - [Anaphylactic reaction caused by vitamin B1].

PMID- 8464277
TI  - [Bacteroides fragilis meningitis complicated with thrombosis of the lateral
      sinus].

PMID- 8464279
TI  - [Endometriosis with urinary involvement associated with hepatic hemangioma].

PMID- 8464278
TI  - [Menopause and substitutive hormonal therapy].

PMID- 8464281
TI  - [Unforeseen shortages in market economy. Are there alternatives to the buy-sell
      system in health care?].

PMID- 8464282
TI  - [Let "Svensson" decide about his health care. Insurance instead of power of
      politicians].

PMID- 8464280
TI  - [Prevalence of serum markers of hepatitis B virus in patients hospitalized with
      pelvic inflammatory disease].

PMID- 8464283
TI  - [In the head of a general practitioner].

PMID- 8464284
TI  - [Buy and sell and emperor's new clothes].

PMID- 8464285
TI  - [Who has a bad back?].

PMID- 8464286
TI  - [Brain clinics are needed].

PMID- 8464287
TI  - [Nicotine supplementation to pregnant women, in spite of all].

PMID- 8464288
TI  - [Is the specialty of pediatric surgery overdimensioned?].

PMID- 8464289
TI  - [Significant bacteriuria--where should the line be drawn?].

PMID- 8464290
TI  - [The sociopsychiatric view is emphasized].

PMID- 8464291
TI  - [Quantitative measurement of atherosclerosis. Development of ultrasound
      techniques is worth while].

PMID- 8464292
TI  - [Reduced postoperative pain. Epidural infusion of bupivacaine in the ward].

PMID- 8464293
TI  - [Annual statistics of the Central Board of Animal Experiments: most increasing is
      the use of birds and swine as experimental animals].

PMID- 8464294
TI  - [Colitis--a partial phenomenon in adult Still disease?].

PMID- 8464295
TI  - [The man behind the syndrome: George F. Still. The first professor of
      pediatrics].

PMID- 8464296
TI  - [More and more children are stricken by asthma. Modern flats are the most usual
      breeding ground. Interview by Birgit Wilhelmson].

PMID- 8464297
TI  - [Diaphragmatic rupture caused ileus].

PMID- 8464298
TI  - [An atypical case of Kawasaki disease].

PMID- 8464299
TI  - [Johan von Hoorn. Father of Swedish obstetrics].

PMID- 8464300
TI  - [No to euthanasia and living wills. Patient's current wishes serve as guidance].

PMID- 8464301
TI  - Cisplatin-induced ototoxicity: the effect of pigmentation and inhibitory agents.
AB  - Cis-diamminedichloroplatinum II (cisplatin), a divalent platinum compound and
      potent cell-cycle nonspecific chemotherapeutic agent, produces a dose-limiting,
      permanent, high-frequency sensori-neural hearing loss and peripheral neuropathy,
      and a dose-related cumulative renal insufficiency with tubular necrosis and
      interstitial nephritis. The potential for dose-limiting and permanent cochlear
      (neuro) toxicity remains despite present methods of hypertonic saline,
      prehydration, and mannitol diuresis prior to drug administration. The exact
      mechanism(s) of ototoxicity and/or nephrotoxicity are still unknown. Continued
      aggressive high-dose cisplatin chemotherapy necessitates the investigation of
      ways to decrease the dose-limiting side effects that inhibit the administration
      of cisplatin at therapeutic and tumoricidal doses. This multifaceted project
      investigates two categories of potential inhibitors of cisplatin toxicity that,
      when coadministered with a known tumoricidal and ototoxic dose of cisplatin, will
      decrease or inhibit the ototoxicity: 1. phosphonic acid antibiotics (fosfomycin;
      1,2 epoxypropylphosphonic acid); 2. nonglucocorticoid 21-aminosteroids, which are
      free oxygen radical scavengers (LAZAROIDS: U74006F and U78517F). This project
      also investigates the role of pigmentation as a variable affecting the evaluation
      of platinum-induced ototoxicity in the guinea pig animal model. Identification of
      an optimal animal model for future cisplatin toxicity research should be based on
      previously established species-specific differences in total drug dose, systemic
      toxicity, and morphological and functional evidence of cochlear toxicity, as
      affected by differences in pigmentation and drug tolerance. Cytocochleography,
      brainstem auditory evoked response (BSER), scanning and transmission electron
      microscopy of organ of Corti and the stria vascularis, double-blind light
      microscopy of renal, small intestine, and peripheral nerve tissue, and gamma
      emission analysis of 195Mplatinum localization in inner ear neuroepithelium and
      the stria vascularis are used in the global evaluation of the ototoxic effects of
      cisplatin in both the adult albino and pigmented guinea pig.

PMID- 8464302
TI  - XeCl laser ablation of atherosclerotic aorta: luminescence spectroscopy of
      ablation products.
AB  - XeCl laser ablation of atherosclerotic aorta tissue was investigated.
      Luminescence spectra of ablation products were measured for soft and hard
      arterial tissues. A pronounced difference observed between plume luminescence for
      various plaques and normal vessel wall correlates with the chemical composition
      of the tissue. The mechanism of plume luminescence appeared to be thermochemical
      excitation ablation products (particles, atoms, molecules, etc.) in the air. The
      process of soft tissue ablation was delayed with respect to the exciting laser
      pulse at relatively low laser fluences close to the ablation threshold. The
      kinetics of the ablation process as a function of laser-pulse energy fluence is
      reported. The data indicate that tissue ejection mechanism, which involves vapor
      bubbles formation, expansion and explosion, is suitable for the description of
      the XeCl excimer laser ablation of soft tissues.

PMID- 8464303
TI  - Noncontact determination of skin blood flow using the laser speckle method:
      application to patients with peripheral arterial occlusive disease (PAOD) and to
      type-I diabetics.
AB  - The laser speckle method allows the noncontact determination of skin blood flow
      and its dynamics from a distance of 5 cm. The method is based on the time
      dependency of the speckle pattern formed by the scattered light of a 5 mW He-Ne
      laser (632.8 nm). Utilizing the speckle intensity measured through a pinhole, an
      electronic circuit generates an output signal denoted as blood flow parameter B.
      All measurements were carried out on the foot dorsum during steady-state,
      ischemia, and reactive hyperemia induced by a 3-min arterial occlusion. The
      investigations were carried out in four groups: healthy subjects, asymptomatic
      smokers, PAOD-patients, and type-I diabetics (D) with severe late complications.
      As shown by parallel measurements with the tcpO2-method, the initial value Binit
      of the blood flow parameter B indicates the steady-state blood flow. Binit
      decreases significantly from 5.95 +/- 2.55 (S.D.) for the control to 4.07 +/-
      1.69 (PAOD) and 3.81 +/- 1.51 (D). The half-time BTrh for the increase of B at
      the beginning of the reactive hyperemia is significantly increased from 4.10 +/-
      2.06 s (control) to 14.5 +/- 15.4 s (smokers), 17.6 +/- 32.7 s (PAOD), and 5.31
      +/- 3.55 s (D). Other characteristic values such as peak value and time of peak
      during the reactive hyperemia as well as the final steady-state value and the
      time of its achievement exhibit similar effects. The correlation coefficients
      between the different characteristic values obtained from the laser speckle
      method indicate that the characteristic times of the dynamics and the absolute
      values of B vary separately and provide supplemental information. A two
      dimensional representation of the characteristic values facilitates the
      differentiation between the four measured groups.

PMID- 8464304
TI  - Improved excimer laser photorefractive keratectomy system.
AB  - An improved 193 nm excimer laser photorefractive keratectomy system is described
      here. The delivery system was optimised to produce a smooth keratectomy bed, to
      minimise the healing response, and to reduce the regression of the refractive
      result. A spatial filtering system was used to smooth the energy distribution
      within each pulse, and the iris was adjusted for every pulse, to eliminate steps
      and other irregularities from the keratectomy profile. An image rotator was used
      to average out any remaining non-uniformities in the energy distribution. The
      results from the first 39 eyes treated with this laser system with a maximum
      follow-up of 18 months, are summarised. No epithelial healing problems were
      noticed, and little or no loss of corneal clarity was noted at any stage during
      healing. Twenty of the keratectomy procedures were normally sighted myopic
      corrections, with a maximum follow-up of 5 months. Minimal regression of the
      refractive correction was seen during the first 8 weeks.

PMID- 8464305
TI  - Effectiveness of corneal neovascularization photothrombosis using phthalocyanine
      and a diode laser (675 nm).
AB  - We used chloroaluminum sulfonated phthalocyanine as a photo-sensitizer and a
      diode laser as a light source for induction of photothrombosis of corneal
      neovascularization. Corneal neovascularization was induced in 1 eye of each of 10
      New Zealand white rabbits using intrastromal 6.0 silk sutures. After the
      intravenous injection of phthalocyanine in a dose of 4 mg per kg of body weight,
      photothrombosis was carried out using a diode laser emitting at 675 nm. The
      animals were followed up by both fluorescein angiography and slit-lamp
      photography for up to three months. At the end of the follow-up period the eyes
      were prepared for histology. After photothrombosis, thrombus formation was
      induced within new vessels demonstrating histological characteristics of both
      arterioles and venules. Most of the vessels disappeared or remained closed during
      the follow-up period. Recanalization of some of the thrombosed vessels occurred
      within the first 20 days after the operation. The combination of phthalocyanine
      and a 675 nm diode laser is effective for the induction of photothrombosis of
      corneal neovascularization.

PMID- 8464306
TI  - Transmission of corneal collagen during ArF excimer laser ablation.
AB  - The time-resolved transmission of collagen films and 10-microns sections of
      bovine cornea during ArF laser ablation has been investigated. The film studies
      were performed on thin layers of extracted bovine corneal collagen, the principal
      chromophore in 193 nm photoablation. Transmission measurements were made on both
      dry and water-saturated films to assess the sensitivity of the ablation process
      to hydration. Distinct transient optical changes were observed in both fully
      desiccated and rehydrated films. Dehydrated films exhibit rapid reduction in film
      absorption over the time-course of the ablating laser pulse, presumably due to
      chromophore bleaching or annihilation. In contrast, rehydrated films demonstrate
      a short-lived enhancement of the attenuation. In either case, a single ablative
      laser pulse increased the long-term transmission of the film, although this
      increase was a factor of five greater for dehydrated films than for rehydrated
      samples. Results obtained from corneal tissue sections were essentially identical
      to those derived from hydrated collagen films.

PMID- 8464307
TI  - Preliminary experience with transluminal laser-induced intrahepatic portacaval
      shunts.
AB  - This study investigated the feasibility of performing an intrahepatic portacaval
      shunt (IHPCS) by means of transluminal laser angioplasty. In 10 anesthized dogs,
      a catheter was introduced into a mesenteric vein and threaded into the portal
      vein (PV). Under fluoroscopy, a Ross needle was passed through the PV catheter,
      liver, and into the intrahepatic IVC. Following guidewire exchange, a neodymium
      YAG laser hot-tip probe (power setting 8 W) was passed over the guidewire to
      accomplish a transluminal IHPCS. In five animals, an IHPCS could not be
      accomplished. Initial and subsequent patency was confirmed by fluoroscopy. These
      early data suggest that transvenous laser-induced intrahepatic portacaval shunts
      may be feasible as a means of decompressing portal hypertension. Further research
      is necessary, to investigate the long-term patency as well as this technique's
      ability to decompress the portal system.

PMID- 8464308
TI  - Modeling the color perception of port wine stains and its relation to the depth
      of laser coagulated blood vessels.
AB  - To find the maximal depth of an ecstatic vessel in the dermis that contributes to
      the abnormal color of a port wine stain (PWS), "normal" and "laser treated PWS
      skin" are modeled, respectively, as a two-layer plane parallel geometry
      consisting of an epidermis and a dermis, and as a three-layer geometry consisting
      of an epidermis, a dermis without additional blood (the "treated" part of the
      stain, assumed identical to the "normal" dermis), and a layer of dermis
      containing 5% or 10% of blood per volume (the untreated part of the PWS).
      Spectral remittances were calculated for various wavelengths using the diffusion
      approximation to the transport equation for light propagation. These remittances
      were transformed into the CIE 1976 (L*a*b*)-color system. Color differences
      between "normal" and PWS skin as a function of the dermal depth of "injured"
      ecstatic blood vessels were calculated. The maximal depth where ecstatic blood
      vessels just contribute to the abnormal PWS color is predicted as 0.9 mm for a
      "normally" pigmented epidermis (60 microns thick) and a 5% or 10% blood per
      volume content. For a darker pigmented epidermis (60 microns thickness) and again
      at both 5% and 10% blood per volume content, this depth was found to be 0.8 mm.

PMID- 8464309
TI  - 600 nm flash pumped dye laser for fragile telangiectasia of the elderly.
AB  - Since 1984, a continuum of controlled studies have been done on the use of the
      fragile, superficial telangiectasia of the elderly, which were utilized as a
      model for some of the basic studies of the effects of lasers on the
      cardiovascular system. We report the use of the 600 nm flash pumped dye laser for
      the fragile telangiectasia of the elderly in our classification of the Class 2
      group. In some vessels studied, the special Teflon-insulated, intravenous
      electric needle of Kobayashi-Yamada was used. For the bluish vessels, the 600 nm
      flash pumped dye laser penetrated deeper into the vessel than the 585 nm, but
      multiple and repeated treatments were needed for clinical effect. Preliminary
      studies have also shown some initial response in port wine marks and facial
      telangiectasia.

PMID- 8464310
TI  - Fine structure of zonal changes in experimental Nd:YAG laser-induced interstitial
      hyperthermia.
AB  - Interstitial thermotherapy using Nd:YAG-laser induced hyperthermia is a new
      stereotactic method for the treatment of brain tumors in poorly accessible
      regions. To provide a basis for the underlying tissue alterations, we have
      analyzed the spatial and temporal pattern of interstitial laser hyperthermia
      lesions in the normal rat brain by histological, immunohistochemical, and
      electron microscopical methods. The acute changes corresponded to the temperature
      gradient surrounding the laser probe and showed a distinct zonal architecture.
      Membrane destruction on a cellular and subcellular level appears to be of major
      significance in the pathogenesis of the laser lesion. The tissue reaction
      followed the course known for coagulation necrosis and resulted in a well-defined
      defect. These results, although limited by the choice of the experimental model,
      may be helpful in the interpretation of images obtained in future applications of
      interstitial thermotherapy.

PMID- 8464311
TI  - Effects of plume produced by the Nd:YAG laser and electrocautery on the
      respiratory system.
AB  - Sprague-Dawley rats were exposed to Nd:YAG laser exhaust (contact and noncontact)
      as well as to electrocautery exhaust passed through smoke evacuation filters.
      Exposure periods for each group were equal and increasing in time. Histologic
      analysis revealed alveolar congestion and emphysematous changes in all modes.
      Controls exhibited similar change but to a milder degree. It appears that any
      plume produced by lasers or electrosurgical devices produces pathologic change in
      rat lungs and that effective smoke evacuation will help control these effects.

PMID- 8464312
TI  - Laser vaporization of Peyronie's plaques.
AB  - A series of four cases of surgical excision or vaporization of Peyronie's plaques
      using the Neodynium/Yag laser is presented. This technique would appear to
      decrease the need for grafting procedures with minimal blood loss. It results in
      straight erections without shortening the penis.

PMID- 8464313
TI  - Immunopathology of nerve involvement in leprosy.

PMID- 8464314
TI  - Long-term active surveillance of leprosy suspects--what are the likely returns?
AB  - Data are presented from the Karonga District in Northern Malawi on the long-term
      follow up of 277 leprosy suspects who were not given antileprosy treatment or
      kept on active surveillance. Individuals who were started on antileprosy
      treatment within a year after leprosy was first suspected, usually on the basis
      of histopathology results, are excluded from this analysis, because their active
      surveillance would not usually cause an organizational or financial problem for
      leprosy control projects. After an average follow-up period of 4.5 years 35 of
      the 277 suspects included in the analysis (13%) were diagnosed with what we
      consider to be 'unequivocal' leprosy, and 3 of the 35 had developed disabilities.
      In 211/277 (76%) all signs of leprosy had disappeared completely. Comparing
      clinical certainties at first and last examinations and comparing clinical with
      histopathological certainties at last examinations it is estimated that up to 50%
      of the 35 cases of unequivocal leprosy which 'arose' in this group were
      attributable to misdiagnosis at the 1st or 2nd examination rather than to genuine
      progression of the disease. This estimate is compatible with an overall
      sensitivity of 90% and an overall specificity of 95% at each examination. Leprosy
      suspects with 1 cardinal sign of leprosy, either a typical lesion without loss of
      sensation, or loss of sensation in an otherwise untypical lesion, should be
      considered a high-risk group in that approximately 25% of such suspects (19/78)
      were later found with unequivocal leprosy. Policies towards such suspects should
      be formulated by leprosy control projects.

PMID- 8464315
TI  - Oral manifestations of leprosy.
AB  - A total of 37 out of 187 patients with leprosy had oral lesions. All were
      biopsied. Oral lesions were found most frequently in patients with lepromatous
      leprosy. Prevalence of oral lesions was higher in males than in females
      (73%:27%). Oral lesions were recorded on the WHO topographical map, and in most
      cases (92%) several topographical locations were affected, including hard palate
      in all cases. Topographical locations affected increase with age; males are more
      extensively affected than females (p = 0.001); and patients with oral lesions who
      reported affected family members (11 out of 37) had more extensive oral lesions
      than those who did not. In 27 cases with oral lesions histopathological diagnosis
      was possible.

PMID- 8464316
TI  - A histological study of the eye lesions in 12 leprosy patients with tuberculoid
      lesion in 4 eyes.
AB  - The histological reactions in 12 eyes of 12 leprosy patients were studied (5 BT,
      1 BB, 1 BL and 5 LL). Granuloma lesions composed of epithelioid cells, Langerhans
      giant cells, macrophages and lymphocytes were found in various intraocular
      tissues, e.g. cornea, sclera, iris, ciliary body or retina in 4 patients (1 BT
      and 3 LL). Of the 3 LL patients, according to the records, 2 were cured and in
      the other patient the outcome of the treatment was not mentioned. In view of the
      finding of the granulomatous lesions in the clinically cured patients and
      tuberculoid granuloma in the intraocular tissues in the LL patients, could there
      be some peculiarities in the intraocular sites? Or perhaps the tuberculoid
      reaction is just a manifestation of an upgrading reaction? More examinations on
      human leprosy eye specimens will be needed to answer these questions.

PMID- 8464317
TI  - Distinguishing post-kala-azar dermal leishmaniasis from leprosy: experience in
      the Sudan.
AB  - In this study 4 patients were post-kala-azar dermal leishmaniasis (PKDL), whose
      lesions were similar to those of lepromatous and borderline leprosy, are
      described. In 2 patients there was no previous history of kala-azar but they were
      residents of an area of known endemic kala-azar. Lack of proper clinical and
      laboratory assessment was behind the failure to diagnose PKDL. Consequently the
      patients were treated with antileprosy drugs without proof of leprosy. The 3rd
      and 4th patients, though suspected clinically of leprosy, were correctly
      diagnosed as PKDL with adequate history, clinical assessment and appropriate
      laboratory investigations. The salient points in distinguishing PKDL from leprosy
      are described and discussed.

PMID- 8464318
TI  - Paralysis of occipitofrontalis in a borderline case of leprosy.
AB  - A patient with neuritic leprosy developed borderline skin lesions. Later, another
      skin lesion developed on the left side of the forehead with clinical involvement
      of the supraorbital branch of the ophthalmic division of the trigeminal nerve.
      Simultaneously, paralysis of the occipitofrontalis and mild paresis of
      orbicularis oculi occurred.

PMID- 8464319
TI  - Leprosy--the challenge.

PMID- 8464320
TI  - Immunotherapy with Mycobacterium w vaccine decreases the incidence and severity
      of type 2 (ENL) reactions.
AB  - Immunotherapy with Mycobacterium w (M.w) vaccine was given to 45 patients with
      multibacillary (MB) leprosy; 41 similarly classified patients served as controls.
      All patients received standard multidrug therapy (MDT). Incidence, severity and
      frequency of type 2 (ENL) reactional episodes were monitored in both groups in a
      follow-up extending up to 4 years. Reactions were seen in fewer vaccinated
      (10/37) BL and LL patients than in the control group (12/34). A total of 20
      episodes were recorded in the vaccine group as against 29 in the controls, 75% of
      reactions were mild in vaccinated and 51.72% were mild in the control group
      patients, and 3 patients in the control group had more than 3 reactional
      episodes. None of the vaccinated patients showed this. No additional incidence of
      neuritis were seen among vaccinated individuals during reactional episodes.

PMID- 8464321
TI  - A case report: dual mycobacterial infections in a Paraguayan patient due to
      Mycobacterium leprae and Mycobacterium fortuitum.

PMID- 8464322
TI  - Considerations in the integration of eye care into leprosy care services.

PMID- 8464323
TI  - Cor pulmonale subacute and recurrent erythema nodosum leprosum.

PMID- 8464324
TI  - Time course and magnitude of tolerance to the analgesic effects of systemic
      morphine in amphibians.
AB  - The systemic administration of morphine (100 nmol/g, s.c.) produced a significant
      and long-lasting analgesia (up to 8 h) in the Northern grass frog, Rana pipiens.
      Daily bolus injections of the same dose of morphine or saline for one week
      resulted in a significant analgesia for 3 days in the morphine group, which fell
      to levels indistinguishable from the saline-treated controls on days 4 through 7.
      In separate experiments, animals were treated identically with morphine or saline
      but were not tested daily for pain thresholds. In these animals, administration
      of a range of morphine doses on day 8 yielded dose-response curves significantly
      shifted rightward by a factor of 3.3 in the morphine-treated group compared to
      the saline-injected controls. These studies are the first to show the time course
      of tolerance development and the magnitude of morphine tolerance in a non
      mammalian vertebrate species.

PMID- 8464325
TI  - Acetaldehyde-collagen adducts in N-nitrosodimethylamine-induced liver cirrhosis
      in rats.
AB  - Increased acetaldehyde levels have been found in non-alcoholic liver diseases and
      an acetaldehyde-collagen adduct has been reported in rats with CCl4-induced
      cirrhosis. In cytosol and microsomes of rats with cirrhosis produced by N
      nitrosodimethylamine, a similar acetaldehyde-protein adduct of approximately 200
      kD was recognized by rabbit IgG raised against either an in vitro produced
      hemocyanin-acetaldehyde adduct or an in vivo occurring P4502E1-acetaldehyde
      adduct isolated from alcohol-fed rats, as well as by anti-rat collagen (I) IgG.
      Its immune complexes contained 3 proteins that reacted with the anti-collagen IgG
      and were digested by collagenase: 2 proteins with molecular weights similar to
      procollagens alpha 1 and alpha 2, and a beta 1,2(I)-like protein which was
      readily produced by in vitro modification of cytosol with acetaldehyde.

PMID- 8464326
TI  - Effects of verapamil on the acquisition of ethanol tolerance.
AB  - This study investigated the effects of verapamil on the acquisition of tolerance
      to the ataxic effects of ethanol. Four groups of rats (n = 20/group) were
      randomly assigned to oral treatment regimes. One group received chronic ethanol
      treatment (starting at 5 gm/kg/day and increasing by 1 gm/kg at weekly intervals
      to an eventual dose of 9 gm/kg/day). A second group received the same dose of
      chronic ethanol together with verapamil (10 mg/kg twice daily). A third group
      received the same dose of chronic verapamil while the fourth group received
      chronic placebo treatment. Every fourth day all rats received at least a 2 gm/kg
      ip test dose of ethanol. Following this, change in motor coordination was
      measured on an accelerating Rota-Rod treadmill. After six weeks the chronic
      ethanol group developed tolerance to the test dose of ethanol, while the ethanol
      and verapamil group did not. Blood ethanol concentrations were not different
      between the groups. The chronic verapamil and placebo groups developed
      sensitization to the effects of ethanol but were not different from each other.
      Chronic treatment with verapamil appeared to delay the acquisition of chronic
      tolerance to ethanol.

PMID- 8464327
TI  - Effects of the opioid antagonist naltrexone-estrone azine on the luteinizing
      hormone-releasing hormone induced release of luteinizing hormone from the
      pituitary glands of ovariectomized rats.
AB  - The effects were studied of in vivo administration of the new opioid antagonist
      estrogen hybrid, naltrexone-estrone azine (EH-NX), on subsequent luteinizing
      hormone-releasing hormone (LHRH)-stimulated luteinizing hormone (LH) release by
      the pituitary gland in vitro. It is well known that administration of estrogen
      exerts negative and positive effects on the pituitary LH response to LHRH,
      respectively after short-term and long-term treatment. Rats were injected
      subcutaneously with either 17 beta-estradiol-3-benzoate (EB), EH-NX or oil on
      days 18 and 19 (long-term treatment), and on day 21 (short-term treatment)
      following ovariectomy. Twenty minutes later the animals were killed and the
      pituitary glands were incubated in the presence of LHRH (1000 ng/ml) for 4 h.
      Whereas short-term treatment with EB on day 21 did not affect LH release in
      vitro, EH-NX significantly decreased the pituitary LH response to LHRH in oil
      pretreated rats. This inhibitory effect was partially blocked by the opioid
      antagonist naltrexone. After long-term EB or EH-NX, followed by short-term oil
      treatment, the pituitary LH response to LHRH was increased considerably, compared
      to the long-term oil controls. These observations demonstrate that the opioid
      antagonist estrogen hybrid EH-NX has estrogenic activity at the level of the
      pituitary gland. This hybridized drug is more effective in time than EB and an
      equimolar amount of EH (estrone hydrazone) to induce the negative estrogenic
      effect.

PMID- 8464328
TI  - Ethanol modulation of tumor necrosis factor and gamma interferon production by
      murine splenocytes and macrophages.
AB  - C57BL/6 female mice were fed a liquid ethanol (ETOH) diet (27% of calories
      derived from ETOH) for 5 months as an animal model of chronic alcohol use. A
      isocaloric liquid diet supplemented with maltose dextran was fed to controls.
      Splenocytes from ETOH-treated and control mice, and purified macrophages from
      normal mice and retrovirus infected mice were exposed in vitro to various
      concentrations of ETOH (0.1-1.0% v/v). The effect of chronic ETOH exposure in
      vivo, and of in vitro treatment with ETOH on tumor necrosis factor (TNF) and
      gamma-interferon (IFN) production by cultured murine splenocytes and purified
      macrophages was investigated. Dietary ethanol did not significantly affect in
      vitro TNF or IFN production. However, TNF and IFN production by splenocytes from
      mice fed either the ETOH or control diet decreased significantly when the cells
      were cultured with ETOH and stimulated with LPS or Con A in vitro. Thus ETOH in
      vitro directly down regulates TNF and IFN secretion by LPS- or Con A-stimulated
      spleen cells. ETOH treatment in vitro did not significantly change TNF production
      by purified peritoneal macrophage (PM) and thioglycollate-induced peritoneal
      macrophage (TPM) from normal mice, but increased TNF production by alveolar
      macrophage (AM). Although murine retrovirus infection per se increased TNF
      production it did not change the responsive pattern in TNF production of PM and
      TPM to ETOH in vitro and reduced the TNF production of AM.

PMID- 8464329
TI  - Endogenous morphine and codeine: release by the chromaffin cells of the eel.
AB  - Both the adrenomedullary equivalent and the plasma of the American eel (Anguilla
      rostrata) contain endogenous morphine and codeine. The opiate concentrations are
      similar to those found in the rat adrenal and human plasma, respectively. The
      adrenal medulla equivalent of the eel was perifused in vitro and the levels of
      catecholamines and endogenous opiate alkaloids in the perfusate were measured. A
      strong correlation between the release of morphine and codeine and between the
      release of norepinephrine (NE) and epinephrine (E) was found. On the other hand,
      there was no significant correlation between the release of dopamine (DA) and
      that of the other catecholamines or opiate alkaloids, suggesting three different
      ways of release of these components of the secretory cocktail of the chromaffin
      cells. The plasma of eels stressed by urethane anesthesia showed a substantial
      increase in DA, NE, and E levels but there was no clear stress response of plasma
      morphine and codeine.

PMID- 8464330
TI  - Distribution of low Km GTPase activity in mouse CNS: effect of chronic morphine.
AB  - The low Km GTPase displayed an apparent Km value of 0.2-0.4 microM in P2
      fractions from whole mouse brain. The activity of this enzyme ranged from 102
      (pmols of GTP hydrolysed per micrograms of protein per min) in the striatum to 39
      in the pons-medulla oblongata. Intermediate values were found in other
      structures, 74-62 in thalamus, hypothalamus, periaqueductal gray matter (PAG),
      rest of mesencephalon, cortex and spinal cord. The Km also varied throughout the
      mouse CNS: the spinal cord, striatum and PAG exhibited Km values (0.308-0.271
      microM) higher than cortex, thalamus, pons-medulla, hypothalamus and remaining
      mesencephalon (0.239-0.193 microM). Chronic morphine (3 days) decreased the low
      Km GTPase activity of PAG (42), whereas it increased the one of thalamus (99).
      After chronic exposure to the opioid the Km values of the enzyme in striatum
      (0.193), PAG (0.192) and spinal cord (0.201) diminished, and the ones of
      hypothalamus (0.357) and rest of mesencephalon (0.287) augmented. The herein
      reported diversity of low GTPase activity might be due to the presence of
      different ratios of G alpha types/subtypes in the neural structures studied. As a
      result of chronic morphine the ratio and/or the functionality of G proteins would
      be altered in particular areas of mouse CNS.

PMID- 8464331
TI  - Withdrawal from chronic haloperidol substitutes for the pentylenetetrazol
      discriminative stimulus.
AB  - The present study was designed to examine withdrawal from a therapeutic, non
      abused drug, haloperidol. Rats were trained to discriminate the anxiogenic
      compound pentylenetetrazol (PTZ) from water in a two lever, food reinforced, drug
      discrimination procedure. Dose effect curves were then determined for PTZ and the
      antipsychotic drug, haloperidol (0.1-1 mg/kg). Haloperidol did not substitute for
      PTZ, even at a dose that decreased rates of responding to approximately 15% of
      control values. Rats were then treated chronically with either 1 or 2 mg/kg/day
      haloperidol while training was suspended. After 5 days of chronic haloperidol 4/6
      animals in the 1 mg/kg/day group and 5/7 in the 2 mg/kg/day group chose the PTZ
      lever when tested 24-48 hours after the last haloperidol injection. Haloperidol,
      1 or 2 mg/kg, did not reverse PTZ-lever responding. After an additional 5 days of
      chronic haloperidol, 3/6 rats in the 1 mg/kg/day group and 5/7 rats in the 2
      mg/kg/day group responded on the PTZ lever 24 hours after the last injection, and
      this was reversed with the anxiolytic, chlordiazepoxide (3.2-5.6 mg/kg). The
      current findings indicate that there is an anxiogenic component to withdrawal
      from haloperidol. In psychotic patients, abrupt discontinuation of haloperidol
      results in nausea, vomiting and sweating, as well as a "relapse into psychosis"
      characterized by anxiety, depression and internal chaos (1). Interestingly, the
      authors caution that the so-called relapse into psychosis may simply be a sign of
      withdrawal. The current findings support their view and suggest that abrupt
      discontinuation of psychoactive therapeutic agents may result in anxiety.

PMID- 8464332
TI  - The cocaine analog WIN 35,428 binds to two sites in fresh rat caudate-putamen:
      significance of assay procedures.
AB  - Binding of the potent cocaine analog [3H]WIN 35,428 (2 beta-carbomethoxy-3 beta
      (4-fluoro-phenyl)-tropane) was examined in membrane homogenates prepared from
      fresh rat caudate-putamen. The number of rinses of the membranes following
      incubation with the ligand was varied. After one wash, only a single binding site
      was evident. With an increasing number of washes, however, two binding sites were
      observed. Additional rinses, up to a total of four, led to a decrease in the
      number of low affinity binding sites, with no change in the number of high
      affinity sites. These results suggest that the methodology used in these binding
      assays may be important for interpretation of the results.

PMID- 8464333
TI  - Ambient temperature effects on thermoregulation and endurance in
      anticholinesterase-treated rats.
AB  - In sedentary animals, physostigmine (PH) administration resulted in a decreased
      core temperature that is ambient temperature (Ta) dependent. PH administration in
      rats exercising on a treadmill (26 degrees C, 50% rh, 11m/min, 6 degrees incline)
      decremented endurance and increased rate of rise of core temperature (heating
      rate, HR). This study was undertaken to examine the effects of Ta on the
      endurance and thermoregulatory decrements of PH-treated running rats. Adult male
      rats (510-530g) were given either 0.2ml saline (C) or 100 ug/kg physostigmine
      salicylate in 0.2 ml saline via tail vein 15 min prior to the start of running to
      exhaustion at 10, 15, 26, or 30 degrees C. In both C- and PH-treated groups,
      endurance decreased and HR increased with increasing Ta from 15 to 30 degrees C.
      At 15 and 26 degrees C the C rats ran significantly (p < .05) longer and had
      significantly lower HR than the PH rats: C15 = 90 +/- 8 min, 0.022 +/- 0.006
      degrees C/min; C26 = 67 +/- 6, 0.051 +/- 0.007; PH15 = 57 +/- 5, 0.052 +/- 0.008;
      and PH26 = 43 +/- 6, 0.092 +/- 0.007. At 10 and 30 degrees C there were no
      significant differences between C and PH-treated rats. A Ta of 30 degrees C was
      too high for effective cooling in either group, and at 10 degrees C both groups
      were able to dissipate heat despite the increased metabolic rate of the PH
      treated rats. The PH-treated rat model of cholinergic drug effect is useful at a
      Ta of 15 and 26 degrees C.

PMID- 8464334
TI  - Single injection of pentobarbital induces long-lasting effects on ANP synthesis
      and gene expression in the rat atria.
AB  - To define the long-term effects of pentobarbital sodium on the plasma and atrial
      atrial natriuretic peptide (ANP) system, experiments were performed in female
      Sprague-Dawley rats. The plasma levels of immunoreactive (ir) ANP showed chronic
      as well as acute response to pentobarbital sodium administration. A single dose
      (30 mg/kg, i.p.) of pentobarbital sodium resulted in a suppression in the plasma
      levels of irANP up to 1 week of administration. The suppressive effect on plasma
      irANP concentrations was dose-dependent. Right but not left atrial contents of
      irANP increased by an administration of pentobarbital sodium up to 4 weeks. ANP
      mRNA contents of the atrial exposed to pentobarbital sodium began to increase
      after 2 days, reached to the peak after 2 weeks, and began to return to control
      values after 6 weeks. Surgical stress accentuated these patterns of plasma and
      atrial ANP responses to pentobarbital sodium treatment. The present data,
      therefore, suggest that even a single anesthetic dose of pentobarbital could
      elicit long-lasting profound changes in ANP system, i.e., changes in gene
      expression, synthesis and the secretion of ANP.

PMID- 8464335
TI  - Receptors implicated in the actions of serotonin on chicken ileum longitudinal
      smooth muscle.
AB  - The presence of serotonin (5-HT) in the chicken gastrointestinal tract has been
      previously reported, but its motor effects have been poorly described. The aims
      of this work were: A) to define the effects of 5-HT on chicken longitudinal
      ileum; B) to explore the mechanisms by which such effects occur and C) to
      identify the subtype(s) of 5-HT-ergic receptors implicated. The motor responses
      to 5-HT were assayed in vitro using ileal strips taken from male White Leghorn
      chickens 7-9 week old. 5-HT elicited ileal contraction (EC50 9.6 x 10(-8) M),
      which was markedly decreased in the presence of tetrodotoxin (TTX). Repeated
      exposure of the tissue to supramaximal concentrations of 5-HT did not however
      lead to desensitization. Atropine (10(-6) M), ketanserin (10(-5) M), methysergide
      (10(-5) M) and methiothepine (10(-6) M) attenuated the response to 5-HT.
      Ketanserin was an effective inhibitor of the residual response to 5-HT obtained
      even in the presence of TTX. Several serotonergic agonists were assayed to
      further analyse the type of receptors involved in the response to 5-HT. 5
      methoxytryptamine (5-MOT), a mixed 5-HT1, 5-HT2 and 5-HT4 agonist, reproduced all
      the effects of 5-HT. 8-OH-DPAT, a selective 5-HT1A agonist,
      trifluoromethylphenylpiperazine, a mixed 5-HT1B/C agonist, and m
      chlorophenylbiguanide, a 5-HT3 agonist, did not induce any consistent contractile
      effects. Sumatriptan, a 5-HT1D agonist, exerted a slight agonistic effect which
      was blocked by methiothepine and decreased by TTX but not by atropine. Cisapride,
      a 5-HT4 partial agonist in mammals, decreased the effects of both 5-HT and 5-MOT.
      These results indicate that chicken ileum contains 5-HT1 receptors similar to the
      5-HT1D mammalian subtype but not the 5-HT1A, 5-HT1B, 5-HT1C or 5-HT3 subtypes. 5
      HT2 receptors are also present and would appear to be located on smooth muscle.

PMID- 8464336
TI  - Lymphatic transport of eicosapentaenoic and docosahexaenoic acids as
      triglyceride, ethyl ester and free acid, and their effect on cholesterol
      transport in rats.
AB  - Lymphatic transport of docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids
      given in the forms of triglyceride, ethyl ester of free acid and their effect on
      cholesterol transport was compared in lymph-cannulated rats. Lymphatic recovery
      of DHA and EPA given by stomach tube in the form of triglyceride in which they
      were mainly located at the 2-position was significantly higher than that of the
      ethyl ester or free acid during the first 6 hr after the administration and the
      tendency continued until 9 hr. In contrast, the 9 to 24 hr recovery of DHA and
      EPA in the forms of ethyl ester and free acid was considerably higher than that
      of triglyceride. Consequently, cumulative 24 hr recovery of EPA was comparable
      among the three forms. However, the 24 hr recovery of DHA was highest in free
      acid, lowest in ethyl ester and intermediate in triglyceride. Recovery of the
      free acid between 9 and 24 hr after administration was significantly higher than
      that given in the forms of triglyceride or ethyl ester. Cholesterol recovery in
      lymph of rats given with ethyl ester or free acid was lower than that given with
      triglyceride at an early stage after the administration in both EPA and DHA.
      Cumulative 24 hr recovery of cholesterol in rats given these fatty acids as ethyl
      ester was significantly lower than in those given as the other two forms.

PMID- 8464337
TI  - Transforming growth factor-alpha activity in effusions: comparison of
      radioimmunoassay and radioreceptorassay.
AB  - Transforming growth factor-alpha (TGF-alpha) in pleural and peritoneal effusions
      was assayed by homologous radioimmunoassay (RIA) and radioreceptor assay (RRA)
      using human placental membrane. Effusions were obtained from 24 patients with and
      17 patients without cancer. Most of the effusions were found to contain TGF-alpha
      by RIA and RRA, but immunoreactive epidermal growth factor (EGF) was not
      detected. Effusions were chromatographed on Bio-Gel P-60 with several peaks of
      TGF-alpha activity by both RIA and RRA. A discrepancy in the chromatographic
      pattern of TGF-alpha between RIA and RRa suggested the existence of EGF-like
      substances capable of binding to EGF receptors which lack immunoreactivity for
      EGF or TGF-alpha. The TGF-alpha concentration of the acetic acid-extracted
      malignant effusions assayed by RRA significantly exceeded the value obtained from
      benign effusions (17.0 +/- 8.7 vs. 9.2 +/- 6.3 ng/ml; mean +/- SD: p < 0.02).
      However, the concentrations obtained by RIA did not differ.

PMID- 8464338
TI  - Central cocaine neurotoxicity at brainstem cardiorespiratory control sites.
AB  - Cocaine hydrochloride was applied topically to the ventrolateral medullary
      surface (VMS) where chemosensitive respiratory and vasomotor control sites are
      colocalized. Cats (n = 16) were anesthetized with urethane (2.0 g/kg, 80 percent
      of dose titrated over 60 min). The trachea of each animal was cannulated and the
      VMS was surgically exposed. Tidal volume (VT), frequency of breathing (f),
      systolic and diastolic blood pressure (SBP and DBP, respectively), and heart rate
      (HR) were measured. Cocaine (62.5 micrograms per site) administered at the VMS
      control sites decreased f, SBP, and DBP significantly (p < 0.05), without
      changing HR or VT values. This cocaine-induced hypoventilation was associated
      with brief intervals of inspiratory cramp (apneusis). Central cocaine
      neurotoxicity may result from interaction of cocaine with VMS sites, producing
      increased inspiratory drive and decreased vasomotor tone.

PMID- 8464339
TI  - Priming with murine recombinant interleukin-5 resulted in the augmentation of PAF
      induced airway hyperresponsiveness to histamine in guinea pigs.
AB  - The effects of pretreatment with murine recombinant interleukin 5 (mrIL-5) on
      platelet activating factor (PAF)-induced bronchoconstriction and airway
      hyperreactivity were investigated in guinea pigs. The intratracheal
      administration of mrIL-5 (2.5-10 micrograms) augmented platelet activating factor
      (PAF; 50 ng/kg)-induced bronchoconstriction in guinea pigs. When IL-5 (2.5
      micrograms) was injected intratracheally, PAF (25 ng/kg)-induced
      bronchoconstriction was not affected, but PAF-induced airway hyperresponsiveness
      to histamine was exacerbated. Airway inflammation, in terms of increased
      capillary permeability and the accumulation of leukocytes in bronchoalveolar
      lavage fluid, was not produced by pretreatment with PAF (25 ng/kg), mrIL-5 (2.5
      micrograms), or by a combination of these agents. This mrIL-5-induced
      augmentation of airway hyperreactivity by PAF was clearly inhibited by the
      phosphodiesterase-type III inhibitors, SDZ-MKS-492 and AH 21-132, but not by
      aminophylline.

PMID- 8464340
TI  - Lack of bupivacaine kinetic changes induced by flumazenil in mice.
AB  - This study was designed to document possible changes in bupivacaine kinetics in
      mice after a single 1 mg/kg injection of flumazenil. After a single 20 mg/kg i.p.
      dose of bupivacaine, C max, Vd, Cl and AUC were not significantly modified by
      flumazenil; even if T max was shown to be significantly shorter when flumazenil
      was associated, bupivacaine bioavailability did not seem to be modified and thus
      may not be involved in the explanation of previously reported increasing
      bupivacaine-induced mortality by flumazenil.

PMID- 8464341
TI  - Vascular smooth muscle and nitric oxide.
AB  - Experiments were performed to investigate the production of endothelium-derived
      relaxing factor (EDRF or nitric oxide; NO) by vascular smooth muscle cells. The
      lumen of bovine pulmonary arteries were filled with Krebs-Henseleit solution
      (incubates). Both endothelium-intact and endothelium-deprived vessels were used.
      Incubate solutions from the lumen of generator vessels contained a significant
      amount of nitric oxide (NO). Although the NO concentration was higher in
      incubates from endothelium-intact vessels, endothelium-deprived vessels also
      produced NO. The length of incubation did not influence the amount of nitric
      oxide released. Endothelium-deprived pulmonary arteries also generated NO as
      detected by chemiluminescence. The amount produced however was not sufficient to
      relax endothelium-deprived detector vessels in superfusion bioassay experiments.
      Samples from Krebs-Henseleit (K-H) solution surrounding the preparation (bathing
      solution) contained NO values which were also significantly higher than the
      control. Nitric oxide found in the bathing solution also appeared to originate
      from endothelium and vascular smooth muscle. Oxyhemoglobin attenuated NO signals.
      The results demonstrate that nitric oxide is released by vascular smooth muscle
      cells as well as by endothelium. However, the amount of NO released by muscle is
      insufficient to relax endothelium-deprived vascular preparations.

PMID- 8464342
TI  - Acute hyperinsulinemia increases neuropeptide Y concentrations in the
      hypothalamic arcuate nucleus of fasted rats.
AB  - Neuropeptide Y, a major hypothalamic peptide, stimulates feeding, insulin
      secretion and weight gain when injected intrahypothalamically. Hypothalamic NPY
      may be regulated by insulin availability at hypothalamic level, as its activity
      is apparently inhibited by intrahypothalamic insulin administration and is
      stimulated under insulin-deficient conditions. To determine the effects of acute
      physiological hyperinsulinemia, we measured regional hypothalamic NPY levels in
      rats during a hyperinsulinemic, euglycemic clamp. Seven male Wistar rats with
      implanted jugular cannulae, fasted for 24 h, were infused with insulin at 100
      mU/h together with variable-rate glucose to maintain euglycemia (3.9 +/- 0.1
      mmol/l), for 150 min. Controls were infused for the same period with polygeline
      vehicle alone (n = 8), and had blood glucose concentrations of 4.0 +/- 0.5
      mmol/l. Insulin levels were 80.2 +/- 3.9 mU/l in insulin-infused rats and 15.2 +/
      1.4 mU/l in polygeline-treated controls (p < 0.001). NPY levels, measured by
      radioimmunoassay, were significantly higher in the arcuate nucleus/median
      eminence (ARC/ME) of hyperinsulinemic rats than in controls (4.8 +/- 1.2 vs 2.5
      +/- 0.6 fmol/micrograms protein; p < 0.001), but were comparable with controls in
      7 other hypothalamic regions. Acute physiological hyperinsulinemia therefore
      increases NPY levels selectively in the ARC/ME. Insulin could cause NPY
      accumulation in the ARC by blocking its transport to NPY-sensitive areas. This
      would be consistent with the suggestions that insulin inhibits hypothalamic NPY
      activity and also acts as a central satiety factor.

PMID- 8464343
TI  - Direct vasopressor effects of erythropoietin in genetically hypertensive rats.
AB  - The purpose of this study is to compare the direct vasopressor effects of
      erythropoietin between spontaneously hypertensive rats (SHR) and normotensive
      Wistar-Kyoto rats (WKY). The aortic rings from SHR or WKY were suspended in
      tissue baths coupled with tension-recording devices. High concentrations of
      recombinant human erythropoietin (more than 20 U/ml) induced vasoconstriction in
      the aortic ring of genetically hypertensive SHR. Furthermore, only in SHR, 10
      U/ml erythropoietin enhanced contraction induced by 10(-7) M norepinephrine
      (+145% vs +121%, p < 0.04) and reduced relaxation by 10(-7) M acetylcholine (-69%
      vs -96%, p < 0.05). On the other hand, erythropoietin did not influence the
      contractility of aortic ring in normotensive WKY. These results suggest that
      erythropoietin exhibits its direct vasopressor effect preferentially in the blood
      vessels of genetically hypertensive animals.

PMID- 8464344
TI  - Anticonvulsant effects of intracerebroventricularly administered norepinephrine
      are potentiated in the presence of monoamine oxidase inhibition in severe seizure
      genetically epilepsy-prone rats (GEPR-9s).
AB  - Pharmacological and neurochemical evidence indicates that brain noradrenergic
      systems play an important role in the determination of audiogenic seizure
      severity in genetically epilepsy-prone rats (GEPRs). In earlier studies,
      intracerebroventricular (ICV) injections of norepinephrine suppressed convulsions
      in a now extinct moderate seizure GEPR colony. Also, ICV noradrenergic agonists
      are known to produce dose-related anticonvulsant effects in the extant moderate
      seizure GEPRs (GEPR-3s). The present experiments were undertaken to determine
      whether ICV norepinephrine also suppresses audiogenic seizures in the extant GEPR
      3s and in the severe seizure genetically epilepsy-prone rats (GEPR-9s).
      Injections of norepinephrine or vehicle were made into the lateral ventricle
      through implanted guides. GEPR-9s were pretreated systemically either with the
      monoamine oxidase inhibitor pargyline or with saline. GEPR-3s received no
      pretreatment. In pargyline pretreated GEPR-9s, seizure severity fell and the
      fraction of animals exhibiting an anticonvulsant response increased progressively
      as the dose of norepinephrine was increased. In saline pretreated GEPR-9s, the
      anticonvulsant dose response curve for norepinephrine was shifted to a higher
      dose range. Accordingly, the anticonvulsant dose50 for norepinephrine was
      significantly greater in saline pretreated GEPR-9s than in pargyline pretreated
      animals. Moreover, the dose required to produce the anticonvulsant effect in GEPR
      9s was approximately 10 fold greater than in the earlier studies in the extinct
      moderate seizure GEPRs. Also, the current experiment with extent GEPR-3s, showed
      that ICV norepinephrine was anticonvulsant in the same dose that was effective in
      the extinct colony of moderate seizure GEPRs. In general terms, these
      observations provide additional evidence that noradrenergic influences are
      anticonvulsant in the GEPR. The neurobiological factors responsible for reduced
      responsiveness of the GEPR-9 are presently unknown.

PMID- 8464347
TI  - Turnover of cholesterol and dipalmitoyl phosphatidylcholine in surfactant of
      adult rat lung.
AB  - In order to compare the turnover of two major surfactant components, [1 alpha,2
      alpha (n)-3H]cholesterol and [methyl14C choline] dipalmitoyl phosphatidylcholine
      (DPPC) were introduced as lamellar bodies via the trachea into lightly
      anesthetized rats which were then allowed to recover. The radiotracers were
      assumed to have entered the alveolar surfactant pool and to have subsequently
      recycled in part into the lamellar bodies of alveolar type II cells. For DPPC,
      the specific activity vs. time curves of tubular myelin rich (alv-1) and tubular
      myelin poor (alv-2) alveolar lavage fractions were similar, and there was a
      plausible precursor-product relationship between lamellar bodies and either (or
      both) of these compartments. In contrast, however, the specific activities of alv
      1 and alv-2 for cholesterol were quite different, allowing us to reject the
      hypothesis of a precursor-product relationship between classical lamellar bodies
      and alv-2. The estimated turnover time for DPPC in alv-1 was 240 or 206 min,
      depending on which subfraction of lamellar bodies one takes to be the precursor.
      For cholesterol it was 583 or 624 min. These longer turnover times for
      cholesterol should lead to a greater than twofold increase in the relative
      concentration of cholesterol in the putative product compartment. Such an
      increase was not found. We interpret this as reflecting either noncompartmental
      behavior of the alveolar surfactant pool, or multiple pools of lamellar bodies
      with different turnover times.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464345
TI  - Plasma-kallikrein clearance by the liver of acetaminophen-intoxicated rats.
AB  - The liver synthesizes prokallikrein and is the main organ to clear the active
      enzyme (plasma-kallikrein) from circulation. This clearance, a receptor-mediated
      endocytosis, is calcium-independent and not affected by the blockade of Kupffer
      cells. The effects of endothelial cells blockade and of acetaminophen
      intoxication on the clearance of 10 nM rat plasma-kallikrein (RPK) by the
      isolated, exsanguinated and perfused rat liver are now reported. Endothelial
      cells blockade obtained by the addition of large excess (30 uM) of formaldehyde
      treated serum albumin to the perfusion fluid does not affect the hepatic
      clearance of RPK (the half-lives of hepatic uptake were 15.5 +/- 1.0 min in the
      absence versus 16.5 +/- 1.4 min in the presence of the treated protein, p >
      0.05). Some livers were perfused 24 hours after acetaminophen intoxication: 6.6
      mmol/kg given i.p. after a 42-hour period of fast. Hepatocyte injury suggested by
      elevated aminotransferase activity (ALT 10 times control value, AST 30 times
      control value), acute phase inflammatory response (serum alpha 2-macroglobulin
      increase) and reduced synthetic function (serum albumin decrease), was confirmed
      histologically and only zone 3 hepatocytes were necrotic. A 66-hour period of
      fast does not affect by itself the hepatic clearance of RPK (16.9 +/- 1.3 min of
      half-life of hepatic uptake) when compared with the control group (15.5 +/- 1.0
      min, p > 0.05). On the other hand the RPK clearance by the livers of rats
      previously intoxicated with acetaminophen was markedly deficient (the half-life
      of hepatic uptake was 39.2 +/- 3.2 min). These findings suggest that RPK is
      internalized by hepatocytes, preferentially by those of the perivenular zone of
      the hepatic acinus.

PMID- 8464346
TI  - The effects of dietary fish oil on alveolar type II cell fatty acids and lung
      surfactant phospholipids.
AB  - The purpose of this study was to determine the responsiveness of alveolar type II
      cells to dietary fish oil and the consequent effects on alveolar and lung
      surfactant. Rats were fed a corn oil or a fish oil diet for four weeks. Dietary n
      3 fatty acids were readily incorporated into the type II cell phospholipids as
      indicated by higher levels of eicosapentaenoic acid (2.77 +/- 0.10%) and
      docosahexaenoic acid (1.63 +/- 0.10%) in the group receiving the fish oil diet.
      The elevated levels of n-3 fatty acids were accompanied by concomitant reduction
      in arachidonic acid and linoleic acid. Neither eicosapentaenoic acid nor
      docosahexaenoic acid was incorporated into type II cell triacylglycerols. Feeding
      a fish oil containing diet increased surfactant phospholipids, particularly 1,2
      disaturated acyl phosphatidylcholines in whole lung compared to a corn oil diet.
      However, the amount of surfactant found in the alveolus was not different between
      the two diet treatment groups. The results suggest that dietary n-3 fatty acids
      stimulate synthesis and/or inhibit degradation of lung surfactant without
      altering surfactant secretion in alveoli.

PMID- 8464348
TI  - Hypolipidemic effects of beta-cyclodextrin in the hamster and in the genetically
      hypercholesterolemic Rico rat.
AB  - The effect of increasing amounts of a cyclic oligosaccharide, beta-cyclodextrin
      (BCD), included in the diet on plasma cholesterol and triglycerides, was
      investigated in two animal models, namely in male genetically
      hypercholesterolemic Rico rats and in male Syrian hamsters. The distribution of
      bile acids in the gastrointestinal tract and in the feces of hamsters was also
      determined. In the Rico rats and hamsters, plasma cholesterol and triglycerides
      decreased linearly with increasing doses of BCD. In these two species, 20% BCD as
      compared to control diet lowered cholesterolemia (-35%) and triglyceridemia (
      70%). In the hamster, the BCD diet caused a marked decrease in cholesterol and
      triglycerides in chylomicrons and very low density lipoprotein, and in high
      density lipoproteins cholesterol. Composition and amounts of bile acids were
      modified in the gastrointestinal tract of hamsters receiving 10% BCD as compared
      to the control group. The total bile acid content of the gallbladder of treated
      hamsters was fourfold higher than in the control group, and the bile contained a
      large amount of hydrophilic bile acids. This trend was also observed in the small
      intestine, in which percentages and total quantities of cholic plus deoxycholic
      acids (cholic pathway) were higher than those of chenodeoxycholic plus
      ursodeoxycholic plus lithocholic acids (chenodeoxycholic pathway). The bile acid
      contents of the cecum and colon of treated hamsters were 2.7-fold higher than
      those of control animals, but the bile acid composition was similar in the two
      groups of hamsters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464350
TI  - Human platelets release a paf-acether: acetylhydrolase similar to that in plasma.
AB  - Intact washed human platelets aggregated in response to paf-acether (paf) and did
      not metabolize [3H]paf at concentrations up to 10 nM. However, when platelets
      were lysed by exposure to pH 9.5, resulting in 37.5 +/- 2.5% (mean +/- SD, n = 3)
      lactic dehydrogenase (LDH) release, 20.5 +/- 5.7% of the radioactivity was
      detected as labeled lyso paf and 5.7 +/- 3.1% as labeled
      alkylacylglycerophosphocholine. When platelets were aggregated with 0.5 IU/mL
      thrombin or high concentrations of paf (100 nM), they released a part of their
      acetylhydrolase without releasing LDH. In supernatants obtained from aggregated
      platelets, 21 +/- 2% or 10 +/- 2% (n = 3), respectively, of the total platelet
      acetylhydrolase activity was detected vs. none in supernatants of resting cells.
      The release of acetylhydrolase was concentration- and time-dependent and
      paralleled the release of PF 4, a marker for alpha-granules. The acetylhydrolase
      affinity for paf (Km) measured in sonicates of resting and thrombin-activated
      platelets was 8.3 +/- 1.5 microM vs. 10.6 +/- 1.5 microM, n = 5, n.s. in a "Mann
      Whitney" test. The latter Km was slightly but significantly different (P < 0.05,
      n = 5) from that of the thrombin-released acetylhydrolase (7.9 +/- 1.5 microM)
      and that of the latter was itself different from plasma acetylhydrolase (5.3 +/-
      0.5, P < 0.05, n = 5). Addition of plasma (acid-treated to inactivate
      acetylhydrolase) decreased the Km value of supernatant acetylhydrolase to 6.1 +/-
      1.4 microM. All preparations of acetylhydrolase exhibited similar pH requirements
      and sensitivity to various inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464351
TI  - Reaction of alpha-tocopherol with alkyl and alkylperoxyl radicals of methyl
      linoleate.
AB  - alpha-Tocopherol was reacted with alkyl and alkylperoxyl radicals at 37 degrees C
      in bulk phase. The lipid-free radicals were generated by the reaction of methyl
      linoleate with the free radical initiator, 2,2'-azobis(2,4-dimethylvaleronitrile)
      (AMVN) under air-insufficient conditions. The products were isolated by high
      performance liquid chromatography. Their structures were identified as 2-(alpha
      tocopheroxy)-2,4- dimethylvaleronitrile (1), a mixture of methyl 9-(8a-peroxy
      alpha-tocppherone)-10(E),12(Z)-octadecadienoate and methyl 13-(8a-peroxy-alpha
      tocopherone)-9(Z),11(E)-octadecadienoate (2), methyl 9-(alpha-tocopheroxy)
      10(E),12(Z)-octadecadienoate (3a), methyl 13-(alpha-tocopheroxy)-9(Z),12(E)
      octadecadienoate (3b), alpha-tocopherol spirodiene dimer (4) and alpha-tocopherol
      trimer (5). When methyl linoleate containing alpha-tocopherol was oxidized with
      AMVN under air-sufficient conditions, the main products were 8a-alkylperoxy-alpha
      tocopherones (2). In addition to these compounds, 6-O-alkyl-alpha-tocopherols (1,
      3a and 3b) were formed when the reaction was carried out under air-insufficient
      conditions. The results indicate that alpha-tocopherol can react with both alkyl
      and alkylperoxyl radicals during the autoxidation of polyunsaturated lipids.

PMID- 8464349
TI  - The effect of culture medium composition on ether lipid cytotoxic activity.
AB  - The effect of a serum-free medium (TNB-100), compared to RPMI 1640 containing 10%
      fetal bovine serum (FBS), on the lipid composition of HL60 and K562 leukemic
      cells was investigated. The 10% FBS RPMI medium contained approximately three
      times more phospholipids (PL), about three times more protein and eight times
      more cholesterol (CHOL) than did the TNB-100 medium. Cells cultured in TNB-100
      medium, referred to as HL60-TNB and K562-TNB cells, were significantly lower in
      PL and CHOL than 10% FBS RPMI cells, with about a threefold higher PL-to-CHOL
      ratio; however, these cells were significantly higher in protein content. Cells
      grown in TNB-100 were also significantly more fluid than 10% FBS RPMI cells and
      were more sensitive to the fluidizing action of the ether lipid 1-O-octadecyl-2-O
      methyl-rac-glycero-3-phosphocholine. The 50% inhibitory dose of the drug was
      about 50% lower in TNB-grown cells than in 10% FBS RPMI cells.

PMID- 8464352
TI  - Triacylglycerols of human milk: rapid analysis by ammonia negative ion tandem
      mass spectrometry.
AB  - Human milk triacylglycerols (TAG) were analyzed by ammonia negative ion chemical
      ionization tandem mass spectrometry. The deprotonated molecular ions of
      triacylglycerols were fractionated at the first mass spectrometry (MS) stage.
      Twenty-nine of the deprotonated TAG ions were further analyzed based on their
      collisionally activated (CA) spectra. The tandem MS analysis covered eleven major
      acyl carbon number fractions, two of which contained odd carbon number fatty
      acids. Fatty acids of 28 different molecular weights were recorded from the
      daughter spectra. Hexadecanoic acid was present in all CA spectra, octadecenoic
      acid in the CA spectra of all mono- and higher unsaturated TAG, and
      octadecadienoic acid in the CA spectra of all di- and higher unsaturated TAG. The
      major fatty acid combinations in triacylglycerols were: with 0 double bonds (DB),
      12:0/12:0/16:0; with 1 DB, 12:0/16:0/18:1; with 2 DB, 16:0/18:1/18:1; with 3 DB,
      16:0/18:2/18:1; with 4 DB, 18:2/18:1/18:1; and with 5 DB, 18:2/18:2/18:1;
      hexadecanoic acid typically occupied the sn-2 position. The most abundant TAG was
      shown to be sn-18:1-16:0-18:1, comprising about 10% of all triacylglycerols.

PMID- 8464353
TI  - Hypolipidemic activity of 6-alkoxycarbonyl-3-aryl-1,3,5-
      triazabicyclo[3.1.0]hexane-2,4-diones and 2-alkoxycarbonyl-5-aryl-1,3,5-triazine
      4,6(1H,5H)-diones in rodents.
AB  - Significant hypolipidemic activity was demonstrated by 6-ethoxycarbonyl-1-3
      phenyl-1,3,5-triazabicyclo[3.1.0]hexane-2,4-dione, 2-ethoxycarbonyl-5-phenyl
      1,3,5-triazine-4,6(1H,5H)-dione and 2-ethoxycarbonyl-5-(4-chlorophenyl)-1,3,5
      triazine-4,6(1H,5H)-dione in rodents at 20 mg/kg/day. These agents lowered serum
      cholesterol and triglyceride levels by approximately 40% in mice after 16 d.
      Tissue lipids in rat liver, small intestinal mucosa, aortic wall and feces were
      reduced by treatment with the agents. Very low density lipoprotein (VLDL) and low
      density lipoprotein (LDL) cholesterol levels were reduced in the rat; high
      density lipoprotein (HDL) cholesterol levels were elevated after 14 d of
      treatment. The activities of regulatory enzymes, e.g., acetyl-CoA synthetase,
      acyl-CoA:cholesterol acyltransferase, cholesterol 7 alpha-hydroxylase, sn
      glycerol-3-phosphate acyltransferase, phosphatidylate phosphohydrolase and
      heparin-induced lipoprotein lipase, involved in de novo synthesis of hepatic
      lipids were affected by the agents. The new compounds may represent another class
      of potentially useful hypolipidemic agents for the treatment of atherosclerosis
      since HDL cholesterol levels were increased and VLDL and LDL cholesterol levels
      were lowered by some of the agents.

PMID- 8464355
TI  - Simultaneous determination of the main molecular species of soybean
      phosphatidylcholine or phosphatidylethanolamine and their corresponding
      hydroperoxides obtained by lipoxygenase treatment.
AB  - A method for the simultaneous determination of the main molecular species of
      soybean phosphatidylcholine or phosphatidylethanolamine and their corresponding
      hydroperoxides is described. Hydroperoxides were formed by incubation of
      phospholipids with lipoxygenase at pH 9.2. Silicic acid column chromatography
      (silica Sep-Pak column) was used to separate the phospholipids into
      phosphatidylcholine and phosphatidylethanolamine. A single C-18 reverse-phase
      column was employed to separate the main molecular species of soybean
      phosphatidylcholine or phosphatidylethanolamine and their hydroperoxides by high
      performance liquid chromatography. The mobile phase consisted of 5% 10 mM
      ammonium acetate at pH 5 and 95% methanol. The molecular species of
      phosphatidylcholine and phosphatidylethanolamine were detected at 205 nm; the
      eluate was mixed with a chemiluminescence reagent (isoluminol and
      microperoxidase) and monitored by fluorometry. Under the experimental conditions
      used, three individual molecular species of both soybean phosphatidylethanolamine
      and phosphatidylcholine (18:3/18:2, 18:2/18:2 and 16:0/18:2), together with their
      corresponding hydroperoxides, were identified and quantitated.

PMID- 8464354
TI  - Antagonism of [3H]fatty acid incorporation into vimentin by sodium pyruvate:
      pitfalls of protein acylation.
AB  - In the course of studying possible fatty acid acylation of vimentin by cultured
      bovine lens epithelial cells, several potential pitfalls of protein-fatty acid
      acylation were recognized. Even exhaustive delipidation of vimentin with organic
      solvents failed to remove all noncovalently associated [3H]palmitate and
      [3H]myristate. Hydroxylamine treatment of vimentin, separated by sodium
      dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE), failed to remove
      either palmitate or myristate derived radiolabel. Hydroxylamine treatment did
      remove palmitate label from a group of lower molecular weight proteins. The
      myristate radiolabel associated with vimentin recovered after SDS-PAGE and
      subjected to acid hydrolysis was shown due to incorporated [3H]amino acids,
      mainly glutamic acid, generated from the fatty acid. Adding excess sodium
      pyruvate to labeling media has been used by others to reduce the metabolic
      conversion of fatty acids to amino acids; however, no direct evidence in support
      of this antagonism was presented. We observed that inclusion of sodium pyruvate
      at between 5 and 20 mM in the labeling medium produced a dramatic decrease in
      incorporation of myristic acid radiolabel into vimentin. However, inclusion of
      even 20 mM pyruvate did not completely antagonize the metabolic conversion of
      fatty acid label to amino acids. Furthermore, the sodium pyruvate antagonism
      could be totally obscured if the exposure of X-ray film by fluorography was even
      slightly prolonged. The results illustrate the danger in assuming that solvent
      extraction totally delipidates proteins and that adding sodium pyruvate to
      labeling media prevents the transfer of fatty acid label to amino acids.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8464357
TI  - Zinc and red cell fatty acid composition.

PMID- 8464356
TI  - A thermospray mass spectrometric assay for Fe-induced 4-hydroxynonenal in
      tissues.
AB  - A method is presented for the determination of 4-hydroxynonenal (HNE) in tissue
      homogenates following in vitro lipid peroxidation induced by iron (Fe++). HNE is
      measured as the pentafluorobenzyl oxime derivative using liquid chromatography
      thermospray mass spectrometry. In vitro metabolism of HNE via the
      glutathione/glutathione-S-transferase pathway was inhibited using iodoacetic and
      iodobenzoic acids. The assay has been used as an indicator of the
      peroxidizability of tissue samples from animals both adequate in and depleted of
      alpha-tocopherol. The concentrations of HNE produced in tissues taken from
      animals depleted of alpha-tocopherol were found to be up to 8 times higher than
      those taken from animals supplemented with alpha-tocopherol.

PMID- 8464358
TI  - Phased spectroscopic images: application to the characterization of the 1H 1.3
      ppm resonance in intracerebral tumors in the rat.
AB  - Spectra obtained with phase-encoding techniques show phase-shifts varying from
      voxel to voxel. The procedure allowing voxel-dependent phase-shifts to be
      compensated is presented. The method has been applied to the characterization of
      the 1.3-ppm resonance observed in intracerebral tumors in the rat.

PMID- 8464359
TI  - Nuclear magnetic resonance Hahn spin-echo decay (T2) in live rats with endotoxin
      lung injury.
AB  - To determine the possibility of using nuclear magnetic resonance imaging to study
      experimentally induced lung injury, we measured in the lungs of spontaneously
      breathing living rats the time course of both the Hahn spin-echo decay (T2) and
      the proton density after endotoxin injury. In order to minimize artifacts arising
      from motions of the nearby chest wall and heart, we used a motion-insensitive
      technique (the interleaved line scan). A typical Hahn T2 measurement was obtained
      over a region of interest from a series of images each with a different echo
      time, which ranged from 16 to 110 ms. Lung water content was determined by
      integrating the proton density over the region of interest. The Hahn T2 and
      proton density were measured before and at 1, 3, 6, and 9 h after intravenous
      injection of endotoxin. The effects of the treatment administered before and
      after endotoxin injection were also evaluated. Endotoxin treatment caused
      lengthening of both fast (T2f) and slow (T2s) Hahn T2 components but had no
      significant effect on the proton density, consistent with the notion that
      endotoxin causes lung injury without significant lung water accumulation in rats.
      However, the methylprednisolone treatment prevented the lengthening of T2s but
      did not seem to have a significant effect on T2f. Our results suggest that NMR
      imaging can be used to detect and monitor experimental lung injury in intact
      living animals, even in the absence of variations of lung water content.

PMID- 8464360
TI  - Imaging oxygen tension in liver and spleen by 19F NMR.
AB  - 19F NMR imaging of the perfluorocarbon emulsion Fluosol has been used to study
      regional variations in oxygen tension in rat liver and spleen. We have used the
      linear dependence of spin lattice relaxation rate (1/T1) on the partial oxygen
      pressure (pO2) of Fluosol to determine the oxygen tension in the
      reticuloendothelial system (RES) of the liver and spleen of male Sprague-Dawley
      rats which have received serial infusions of Fluosol. Oxygen tension maps have
      been computed from 19F NMR images using a calibration obtained for Fluosol in
      vitro at 37.5 degrees C. The spatial resolution of the pO2 maps computed using
      this technique is 1.2 x 1.2 mm in 3-mm thick slices. Calculations from in vivo
      pO2 maps indicate an average change in the median pO2 of the RES from 118 to 80
      mmHg for (n = 7) rats breathing 95% O2 and 5% CO2 (carbogen) and air,
      respectively.

PMID- 8464361
TI  - Field dependent transverse relaxation rate increase may be a specific measure of
      tissue iron stores.
AB  - The degree to which MRI magnet field strength affects measured transverse
      relaxation rates (R2) defines a measure termed the field dependent R2 increase
      (FDRI). We report here the results of in vivo and in vitro experiments that were
      conducted to evaluate whether FDRI is a potentially useful measure of tissue iron
      stores. T2 relaxation times were obtained using two clinical MRI instruments
      operating at 0.5 and 1.5 Tesla, and relaxation rates (R2) were calculated as the
      reciprocal of T2. The in vivo experiment measured R2 in human brain frontal white
      matter, caudate nucleus, putamen, and globus pallidus. The FDRI was very highly
      correlated with published brain iron levels for the four regions examined. The in
      vitro experiment measured R2 in agarose gel-based phantoms containing physiologic
      forms and amounts proteins involved in iron storage and transport (ferritin,
      apoferritin, transferrin, and apotransferrin). Significant field dependence was
      observed only for the ferritin phantoms. The differences in the R2 values
      obtained at the two field strengths were striking, and were proportional to the
      ferritin levels of the phantoms. These studies suggest that FDRI may be a
      specific measure of tissue ferritin. The quantitative significance of the results
      to imaging and possible applications to the clinical investigation of pathologic
      states are discussed.

PMID- 8464362
TI  - A technique for assessment of bone marrow composition using magnetic resonance
      phase interference at low field.
AB  - In disorders which involve the bone marrow, the fat/water ratio of the marrow is
      often an indicator of the progress of disease. A noninvasive method of monitoring
      this ratio in bone marrow could be clinically useful. We have investigated a
      method of bone marrow assessment, using magnetic resonance imaging at low field
      (0.064 Tesla). The method has been tested using calibrated phantoms; we also
      present results from normal human subjects.

PMID- 8464363
TI  - RF pulse design using the inverse scattering transform.
AB  - The inverse scattering transform (IST) is a mathematical transformation that can
      be used to derive RF pulses from functions called continuous spectra describing
      the final state of the spin system. This paper reviews three seemingly unrelated
      numerical algorithms that have appeared in the literature, and shows that they
      are all derivable from the IST. When the continuous spectra are rational, the
      finite rank kernel method is used to convert the IST to a matrix equation that is
      easily solved. Another algorithm, equivalent to the so-called "layer stripping"
      algorithm used in seismology, is derived by assuming that the spectra are Fourier
      series. Finally, the Shinnar-Le Roux (SLR) algorithm is derived by assuming that
      the spectra are ratios of Fourier series. With proper interconversion between the
      rational, series, and ratio of series forms of the continuous spectra, these
      algorithms generate RF pulses with identical or nearly identical shapes and
      performance properties, and can be regarded as equivalent.

PMID- 8464364
TI  - Diffusion imaging of experimental allergic encephalomyelitis.
AB  - Diffusion-weighted magnetic resonance imaging (MRI) was compared with T2-weighted
      MRI in longitudinal studies of experimental allergic encephalomyelitis (EAE), an
      animal model of multiple sclerosis, in five monkeys (Macaca fascicularis). In a
      region of the brain that had highly directional myelinated fibers (internal
      capsule) sequential changes were identified on diffusion-weighted images on and
      before the day these changes were detected on conventional T2-weighted images.
      Changes were also identified on diffusion-weighted images in brain areas that did
      not develop T2-weighted abnormalities. This result suggests that diffusion
      weighted image intensities are sensitive to pathologic conditions of the brain
      that can not be seen on T2-weighted images.

PMID- 8464365
TI  - Contrast-enhanced first pass myocardial perfusion imaging: correlation between
      myocardial blood flow in dogs at rest and during hyperemia.
AB  - The sensitivity of contrast-enhanced MR first pass perfusion imaging in detection
      and quantification of hypoperfused myocardium was evaluated using an
      instrumented, closed-chest dog model where graded regional hypoperfusion was
      induced by applying predetermined levels of stenosis to the left anterior
      descending artery (LAD). All measurements were performed at rest and under stress
      induced by dipyridamole (DIP). Myocardial perfusion was assessed both with MR and
      radiolabeled microspheres injected immediately before the administration of the
      MR contrast agent. Ultrafast MR imaging was performed using a Turbo FLASH
      sequence with a 180 degrees inversion prepulse. A Gd-DTPA bolus was injected into
      the left atrium and T1-weighted images were acquired with every heart beat.
      Signal intensity measured from the images in regions of the LAD and left
      circumflex (LCx) perfusion beds was plotted against time to generate signal
      intensity versus time curves (SI time curve). Various flow indices were derived
      according to the indicator dilution theory, and compared with and without volume
      correction due to vasodilation to the myocardial blood flow (MBF) calculated from
      radiolabeled microspheres. Correlation of the MR and MBF data demonstrated that
      different transmural and regional myocardial perfusion levels can be easily
      visualized in the perfusion images and accurately monitored by the SI time
      curves. Detection of the impairment of myocardial perfusion improved
      significantly after administration of DIP. The inverse mean transit time
      calculated from the SI time curve was found to yield a linear correlation to
      absolute MBF derived from the microsphere data. These results suggest that with
      intracardiac injections of exogenous contrast agent, myocardial perfusion can be
      assessed parametrically with first pass contrast enhanced ultrafast MRI.

PMID- 8464366
TI  - MRI gradient waveform design by numerical optimization.
AB  - This manuscript describes a method of gradient waveform design by nonlinear
      constrained optimization. Methods of formulation and solution of the waveform
      optimization problem are briefly described for minimization of root mean squared
      current and minimization of waveform moments. Waveforms generated using these
      objectives are presented and compared with those obtained with other objectives.
      The method uses waveforms which are defined as a set of discrete amplitudes in
      order to remove artificial constraints on waveform shape imposed by "multilobe"
      designs. These point-to-point amplitudes are the parameters determined in the
      optimization procedure which includes knowledge of the specific imaging
      conditions and the specific gradient hardware system. Some beneficial results of
      this design approach are: a) physically realizable waveforms which optimally
      achieve specific imaging and motion artifact reduction goals, b) waveforms which
      are guaranteed to be optimal with respect to one of several possible objective,
      c) less reliance on the experience of the designer, and d) a potential reduction
      in waveform design time.

PMID- 8464367
TI  - Phosphonate-modified Gd-DTPA complexes. III: The detection of myocardial
      infarction by MRI.
AB  - The potential of a phosphonate-modified-Gd-DTPA for MR image enhancement of
      myocardial infarction has been demonstrated in imaging experiments on rats. The
      agent, 1-hydroxy-3-aminopropane-1,1-diphosphonate-modified-Gd-DTPA (Gd-DTPA-HPDP)
      accumulates in two models of myocardial infarction, (i.e., drug-induced diffusely
      infarcted whole hearts and in focal acute myocardial infarction from a left
      coronary artery ligation). The time course of the accumulation of the agent in
      the focal model of infarction and subsequent washout has also been followed in
      vitro. Results of this kinetics demonstrate that the agent first perfuses all
      normal fluid spaces and then slowly diffuses into the occluded zone where it is
      retained for a prolonged period, in sufficient quantities to be useful as an MRI
      contrast agent. Wash-out of the agent from normal myocardium is fast and complete
      with MR signal returning to background in minutes. The specificity of Gd-DTPA
      HPDP for soft-tissue calcification and its retention within the infarcts
      permitted imaging at 1 to 2 h postinjection, (after unbound material has cleared
      the normal tissues). Infarcted tissue appeared as regions of increased signal
      intensity in T1-weighted images (> 200% enhancement), and correlated with
      histopathology. Unmodified Gd-DTPA was not retained under identical conditions.
      Gd-DTPA-HPDP permits a more accurate infarct delineation than is possible with
      the unmodified agent.

PMID- 8464368
TI  - A weighted least-squares method for nuclear magnetic resonance velocity imaging.
AB  - The phase method for velocity measurements in NMR imaging with more than two
      velocity encoding steps is discussed. The weighted least-squares method takes
      into account the variation in the accuracy of phase calculations at a voxel with
      the size of the velocity encoding gradients. We choose the weights so that the
      method is equivalent to the method of maximum-likelihood for high signal-to-noise
      ratios. We propose a method of implementation to minimize the problem of phase
      wrapping. We also discuss the number of velocity encoding steps, the choice of
      step size, and signal averaging, to improve the reproducibility of velocity
      measurements. Standard deviation images for the velocity have been calculated and
      used to reduce velocity noise by thresholding the velocity image.

PMID- 8464369
TI  - High-resolution variable flip angle 3D MR imaging of trabecular microstructure in
      vivo.
AB  - Two conceptually related variable-flip-angle 3D spin-echo pulse sequences were
      designed for imaging at voxel sizes of 2-5 x 10(-3) mm3 corresponding to pixel
      areas of less than 100 x 100 microns2 and section thicknesses on the order of 300
      400 microns on a conventional 1.5 T MR imaging system equipped with 1 G/cm
      imaging field gradients, providing 12 sections in 10 min imaging time. The pulse
      sequences make use of the concept of restoring longitudinal magnetization
      inverted by the 180 degrees phase reversal pulse and are derivatives of pulse
      sequences previously dubbed "FATE" and "RASEE." It is shown that even in the
      small-voxel regime (< 10(-2) mm3 voxel size) and at echo times on the order of 10
      ms, gradient echo images are sensitive to intrinsic fields causing artifactual
      boundary effects, including signal loss from intravoxel phase scrambling and
      spatial mismapping. At this resolution the variable flip-angle spin-echo pulse
      sequences are demonstrated to be better suited for imaging magnetically
      heterogeneous systems such as trabecular bone microstructure in vivo. These pulse
      sequences are found to be substantially less sensitive to distortions from
      magnetic dipole fields occurring at the boundaries of two phases of different
      magnetic permeability.

PMID- 8464370
TI  - Noninvasive analysis of aldose reductase activities in rat testis: 3-FDG NMR
      spectroscopy and imaging.
AB  - Noninvasive investigation of aldose reductase activities in rat testis was
      performed using 3-fluoro-3-deoxy-D-glucose (3-FDG) and nuclear magnetic resonance
      (NMR) spectroscopy/imaging. Quantitative determination of testis aldose reductase
      activities, expressed as the sorbitol index, showed a value similar to that of
      brain. Sorbitol imaging demonstrated aldose reductase activities in testis to be
      confined primarily to the central region of this organ. The 3-FDG 19F NMR method
      appears to have clinical potential in the evaluation of testicular function,
      especially that of spermatogenesis, noninvasively.

PMID- 8464371
TI  - The appearance of neutral lipid signals in the 1H NMR spectra of a myeloma cell
      line correlates with the induced formation of cytoplasmic lipid droplets.
AB  - The appearance of high resolution neutral lipid signals in the 1H NMR spectra of
      myeloma cells grown in the presence of oleate was shown to correlate with the
      appearance of cytoplasmic lipid droplets observable by electron microscopy. The
      spin-spin relaxation times of these lipid signals were similar to those measured
      previously for lipid resonances in other cell types. These data suggest that
      cytoplasmic lipid droplets could make a significant contribution to the neutral
      lipid signals observed in the 1H NMR spectra of some cells.

PMID- 8464372
TI  - Some contrast agents in oil well logging and in medical MRI.
AB  - Magnetite particles and paramagnetic ion chelates are used as contrast agents in
      both nuclear magnetism logging of oil wells and in medical MRI. An analytic
      expression for reduction of T2 for free precession signal decay (or gradient
      echoes) by magnetite particles does not depend on diffusion and agrees with
      published Monte Carlo computations.

PMID- 8464373
TI  - Pitfalls in MR measurement of tissue blood flow with intravascular tracers: which
      mean transit time?
AB  - Measuring tissue blood flow with NMR imaging of intravascular tracers is more
      difficult than measurements of tissue blood volume. One major obstacle to the
      application of the Central Volume Principle is the direct measurement of the mean
      transit time. In this note, we demonstrate that mean transit time (MTT), which
      relates tissue blood volume to blood flow via the Central Volume Principle, is
      not the first moment of the concentration-time curve for MR or CT imaging of
      purely intravascular tracers. However, while first moment methods cannot be used
      by themselves to determine absolute flow, we show that transit curves may provide
      a useful relative measure of flow, for example, by considering ratios of the
      first moments.

PMID- 8464374
TI  - Oxygen measurement inside an NMR magnet with a catheter electrode.
AB  - In this study we show the possibility of continuous oxygen tension measurement
      inside an NMR magnet without disturbance of simultaneous NMR data acquisition.
      Our modified Clark-type oxygen electrode has a fast response (2 s) and can be
      inserted deep into small bore NMR systems thanks to its small diameter (2 mm).

PMID- 8464375
TI  - A perifusion loop-gap resonator NMR probe for aerobic cell suspensions.
AB  - NMR studies of aerobic cell metabolism require that spectral data of high
      sensitivity and resolution be acquired from samples maintained under suitable
      conditions. The loop-gap resonator 31P NMR probe described here was designed for
      investigations of highly aerobic-dependent renal proximal tubules in an
      environment similar to those of conventional incubation flasks. The inherently
      higher sensitivity of the loop-gap resonator design and associated circuitry made
      it possible to obtain adequate spectra in short periods of time with small
      amounts of sample. Cellular physiological properties of perifused aerobic renal
      proximal tubule cell suspensions in the loop-gap resonator probe were found to be
      similar to equivalent tissue samples incubated in conventional flasks.
      Furthermore, the loop-gap perifusion probe was found to provide useful 31P NMR
      spectra of the kidney tubule system after acquisition times as short as 3 min.

PMID- 8464376
TI  - A wireless axial pair resonator.
AB  - A wireless axial pair resonator consists of two coils coupling inductively with a
      body coil, which is used as a signal transmitter and receiver. Computer
      simulations gave signal enhancements of 1.41 and 1.47 for the resonators of 15-
      and 20-cm diameter, whereas those of phantom studies gave 1.37 and 1.49.

PMID- 8464377
TI  - Diffusion in red blood cell suspensions: separation of the intracellular and
      extracellular NMR sodium signal.
AB  - It is shown that the signal of intracellular and extracellular sodium of red
      blood cells can be separated by a difference in diffusion. Comparison with proton
      diffusion experiments conducted in parallel showed that this difference was
      caused by restriction to the cell volume. The measured proton and sodium root
      mean square displacements agreed well with the cell dimensions. However, this
      experiment is limited to use in vitro by the required gradient strength.

PMID- 8464378
TI  - Development and characterization of an ergometer to study the bioenergetics of
      the human quadriceps muscle by 31P NMR spectroscopy inside a standard MR scanner.
AB  - A description is given of an ergometer made of nonmagnetic materials which fits
      into a standard whole body MR magnet. T2-weighted images show that exercise is
      highly specific for quadriceps muscles. The ergometer permits the noninvasive
      study of T2-related changes in the proton images of the leg as well as changes
      occurring in muscle bioenergetics during exercise and recovery.

PMID- 8464379
TI  - Metaphase chromosome and nucleoid differences between CHO-K1 and its
      radiosensitive derivative xrs-5.
AB  - The Chinese hamster ovary (CHO) cell line xrs-5 is a radiation-sensitive mutant
      isolated from CHO-K1 cells. The radiation sensitivity is associated with a defect
      in DNA double-strand break rejoining. Chromatin structure also appears altered in
      xrs-5 cells compared with the parental CHO-K1 cells. Metaphase chromosomes from
      xrs-5 are more condensed in appearance than CHO-K1 chromosomes. The overcondensed
      look is not the result of colcemid sensitivity. Electron microscopy studies
      suggest that xrs-5 metaphase chromosomes have larger loops of chromatin extending
      out from the chromosome core. There are also differences between CHO-K1 and xrs-5
      cells in the size and fluorescence pattern of ethidium bromide-stained nucleoid
      preparations. These results suggest that there is a fundamental difference
      between CHO-K1 and xrs-5 in either the organization of the supercoiled loops of
      DNA attached to the nuclear matrix or in the nature of the proteins that attach
      the DNA to the matrix. These alterations in chromosome structure may underlie, in
      part, the radiation sensitivity of xrs-5 cells.

PMID- 8464380
TI  - Standardization of the 32P-postlabeling assay for polycyclic aromatic hydrocarbon
      DNA adducts.
AB  - A modified method for the 32P-postlabeling assay that permits standardized
      quantitation for specific polycyclic aromatic hydrocarbon (PAH)-DNA adducts is
      described. This method has been designed to test the components of the 32P
      postlabeling assay for use in the chemically specific detection of individual
      adducts with the ultimate goal of testing the biological significance of PAH-DNA
      adducts in humans. The approach relies upon high performance liquid
      chromatography (HPLC), concomitant labeling of 2'-deoxyguanosine (dGp) as an
      internal standard and thin layer chromatography (TLC), which identifies
      unmodified nucleotides along with PAH-DNA adducts on the same TLC plate. This
      method assesses labeling efficiency, detects the presence of unknown inhibitors,
      assesses the adequacy of digestion (when combined with HPLC) and allows for the
      development of calibration curves for directly determined molar ratios
      (adduct:internal standard). Chemically synthesized adduct standards and
      quantitative 32P-postlabeling data have been corroborated by UV spectroscopy,
      fluorescence spectroscopy and liquid scintillation counting where radiolabeled
      materials were available. Labeling efficiencies of the PAH-DNA adducts were found
      to be up to 100-fold less than expected and depended upon both the adduct and
      adduct levels (lower levels being less efficiently detected). The presence of
      unmodified nucleotides resulted in a 1.5-fold lower labeling efficiency. Mixtures
      of selected PAH-DNA adducts did not affect the labeling efficiencies of each
      other. The data suggest that previous 32P-postlabeling assay studies for PAH-DNA
      adducts may have underestimated adduct levels due to variations in labeling
      efficiency.

PMID- 8464381
TI  - Mutagenic and lethal effects of halogenated methanes in the Ara test of
      Salmonella typhimurium: quantitative relationship with chemical reactivity.
AB  - The mutagenic and lethal effects of nine halogenated methanes (CCl4, carbon
      tetrachloride; CHCl3, chloroform; CH2Cl2, dichloromethane; CBr4, carbon
      tetrachloride; CHBr3, bromoform; CH2Br2, dibromomethane; CI4, carbon tetraiodide;
      CHI3, iodoform; and CH2I2, diiodomethane) have been investigated with the Ara
      forward-mutation assay of Salmonella typhimurium. Five substances (CH2Cl2, CBr4,
      CH2Br2, CHI3 and CH2I2) gave clear mutagenic responses. In all these cases the
      mutagenicity diminished in the presence of mammalian metabolic activation (S9
      mixture). Two halomethanes (CCl4 and CHBr3) were classified as 'questionable'
      mutagens since they did not double the spontaneous value although a dose-response
      curve was obtained. All halomethanes tested exerted a lethal effect. A high
      concordance was found between lethality and chemical reactivity, as expected from
      the type and number of halogenated substituents. Compounds with equal numbers of
      substituents were lethal in the order I > Br > Cl. Additionally, the lethality of
      compounds with identical halogen substituents increased by successive
      halogenations. No such concordances were observed with respect to mutagenic
      activity. Structure-activity quantitative relationships were investigated by
      using the previously reported values of the polarographic half-wave reduction
      potential (-E1/2), a physicochemical parameter related to the energy required to
      put an electron into the lowest unoccupied molecular orbital. The lethality,
      quantified as LD37, correlated highly with the -E1/2 values for the nine
      halogenated compounds (r = -0.955 P < 0.001). These data suggest that
      halomethanes which are reduced easily will induce higher lethality than those
      with low reduction potential, in agreement with the predicted effects on lipid
      peroxidation and hepatotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464382
TI  - Spontaneous mutagenesis in Escherichia coli harbouring plasmid pKM101: DNA
      sequence analysis of forward lacI- mutations.
AB  - To investigate the influence of plasmid pKM101 on spontaneous mutagenesis, 198
      lacI- mutations generated in Escherichia coli harbouring pKM101 were
      characterized at the DNA sequence level. pKM101 by itself did not enhance the
      lacI- forward mutation frequency. In general, the resultant distribution of
      mutation highlights particular sequences at which a variety of mutational events
      repeatedly occur, including 5'-(G/C)TGG-3', 5'-CCAGG-3', 5'-GATC-3' and 5'-TCGCG
      3' sequences. Specifically, the distribution of mutation within base substitution
      and deletion classes distinguishes the pKM101 spectrum from the wild-type
      distribution (i.e. absence of pKM101). An even distribution amongst base
      substitutions was observed which corresponds to a 2.9- to 6.3-fold increase in
      occurrence of low frequency events (A-->G,T,C; G-->C); high frequency events in
      the wild-type distribution (G-->A,T) were not influenced by the presence of
      pKM101. One complex event was recovered which was comprised of two base
      substitutions separated by 4 bp. An 11-fold increase in small deletion events (3
      6 bp) was also observed. The observed pKM101 spectrum does not closely resemble
      the mutational consequences of SOS induction in the absence of mutagenic
      treatment (recA441 spectrum) but does return a distribution like that obtained in
      E. coli deficient in polymerase I activity (polA1 spectrum).

PMID- 8464383
TI  - Radiosensitive Chinese hamster irs2 cells show enhanced chromosomal sensitivity
      to ionizing radiation and restriction endonuclease induced blunt-ended double
      strand breaks.
AB  - The Chinese hamster irs2 cell line shows cellular hypersensitivity to ionizing
      radiation although the induction and repair of double-strand breaks (dsb) in bulk
      DNA is normal. Here we report that irs2 shows chromosomal hypersensitivity to
      ionizing radiation and the restriction endonuclease PvuII. The ratio of induced
      chromosomal aberrations in irs2 versus V79 was similar to that for survival
      (factor of between 2 and 4). PvuII was administered during cell poration with the
      bacterial toxin streptolysin O. We also report that when streptolysin O porated
      irs2 and V79 cells were treated with PvuII, and dsb assayed by neutral filter
      elution, equivalent numbers of dsb were induced in the two lines as a function of
      time following treatment. Our data show that irs2 has a DNA damage processing
      defect that leads to enhanced conversion of blunt-ended dsb into visible
      chromosomal damage.

PMID- 8464384
TI  - Determination of target nucleotides involved in 7-methoxy-2-nitro-naphtho[2,1
      b]furan (R7000)-DNA adduct formation.
AB  - The characterization of target nucleotides involved in the binding to DNA of 7
      methoxy-2-nitro-naphtho[2,1-b]furan (R7000), a very potent genotoxic nitrofuran
      derivative, was investigated. Since R7000 undergoes metabolic activation prior to
      interacting with DNA, plasmids containing AT-rich and GC-rich sequences were
      devised and treated by R7000 in bacterial cells presenting nitroreductase
      activity. The nucleotide modifications to these homogeneous fragments that
      resulted from R7000 treatment were analyzed using the 'postlabeling' method. A
      preferential binding to the GC segment was demonstrated. Using a modification of
      the Maxam-Gilbert sequencing technique, it was demonstrated that activated R7000
      creates alkali-labile phosphodiester bonds at the positions of guanines. In
      addition, the analysis of DNA replication-blocking properties of R7000 lesions
      was performed using avian myeloblastosis virus (AMV) reverse transcriptase as DNA
      polymerase. The termination of DNA replication occurred preferentially at the
      sites of guanine residues in the template strand, indicating that one nucleotide
      was inserted opposite a lesion. All these results indicate that guanine residues
      are the preferential sites of formation of R7000-DNA adducts.

PMID- 8464385
TI  - A single-site mutation in the XPAC gene alters photoproduct recognition.
AB  - The XPAC (xeroderma pigmentosum group A complementing) gene, which is located on
      chromosome 9, carries a variety of point mutations in XP group A patients. We
      investigated the role of the XPAC gene product in excision repair by generating
      revertants of an XP group A cell line (XP12RO) that have increased resistance to
      ultraviolet light. One of these cell lines, XP129, can repair (6-4) pyrimidine
      pyrimidone photoproducts normally but has reduced repair of cyclobutane dimers,
      as in XP12RO. Sequence analysis of cDNA from the XPAC gene indicated that XP12RO
      contains a termination codon at amino acid position 207, resulting in a reduced
      amount of mRNA and no detectable protein. In the revertant XP129 line, this
      termination codon has been mutated further and now encodes glycine in one allele
      instead of the wild-type arginine. The mRNA level detected by allele-specific
      polymerase chain reaction amplification was greater for the reverted sequence
      than for the chain-terminating sequence. These observations indicated that a
      point mutation resulting in a mis-sense mutation in the XPAC gene and altered
      expression of the XPAC protein can alter the substrate specificity of the
      excision repair system, and imply that the XPAC gene product plays an important
      role in photoproduct recognition.

PMID- 8464386
TI  - Availability of the GENE-TOX database on the National Library of Medicine TOXNET
      system.

PMID- 8464387
TI  - [Aromatase inhibitor].

PMID- 8464388
TI  - [Decubitus ulcer. Etiology, clinical picture, treatment and prevention].

PMID- 8464389
TI  - [Intestinal side effects of antibiotics].

PMID- 8464390
TI  - [Antibiotic therapy in general practice].

PMID- 8464391
TI  - [In honor of Professor Dr. H. Goebell's 60th birthday].

PMID- 8464392
TI  - [The terminal ileum as a co-regulator of cyclic interdigestive pancreatic
      secretion in man].
AB  - Nutrients present in the ileum of humans can modulate endogenously stimulated
      pancreatic secretion. To determine whether cyclic interdigestive pancreatic
      secretion can also be influenced by nutrients in the ileum, six fasting
      volunteers were intubated with an oro-ileal multi-lumen tube for perfusing test
      and marker solutions, aspiration of duodenal contents and recording of motility.
      At the beginning of the interdigestive cycle, the ileum was perfused
      intermittently with solutions of carbohydrates, proteins or lipids in the
      physiological amounts observed in the ileum after a meal; saline solution was
      perfused as a control. After saline, protein and calcium perfusion, the expected
      periodic increase in chymotrypsin secretion was observed during phase II of the
      interdigestive cycle (p < 0.05 vs phase I). In contrast, carbohydrates and lipids
      inhibited the phase-II-associated increase in pancreatic secretion. These
      findings indicate that the ileum may be involved in the regulation of human
      interdigestive pancreatic secretion.

PMID- 8464393
TI  - [The synthetic somatostatin analog octreotide: effect on interdigestive pancreas
      secretion and gastrointestinal motility in man].
AB  - The aim of the present study was to determine the effects of a therapeutical dose
      of the long-acting cyclic somatostatin analogue octreotide (SMS 201-995) on
      cyclical interdigestive small intestinal motor function and exocrine pancreatic
      secretion in humans. Five fasting healthy subjects swallowed a gastroduodenal
      multi-lumen tube assembly and received continuous infusions of saline and
      octreotide (720 ng/kg/hr) for at least one interdigestive motor cycle or two
      hours. Upper gastrointestinal motility was recorded continuously by standard
      manometry. Duodenal chymotrypsin outputs were measured at 15 minutes intervals
      using polyethylene glycol as a dilution marker. Octreotide significantly
      decreased the length of the interdigestive motor cycle to one third of the
      control period (p < 0.01). Phase II proportion was reduced to less than 5% of the
      cycle length (controls: 66%; p < 0.01). The propagation velocity of octreotide
      induced motor activity fronts was significantly slower compared with migrating
      motor complexes during the control period (controls: 6.8 +/- 0.4 cm/min,
      octreotide: 2.3 +/- 0.4 cm/min; p < 0.05). Overall duodenal chymotrypsin output
      was markedly inhibited by octreotide (5% of controls; p < 0.01). Moreover, during
      octreotide administration coupling between interdigestive motor activity and
      pancreatic exocrine enzyme secretion was disrupted. In conclusion short
      administration of a therapeutical dose of octreotide exerts similar effects on
      upper intestinal interdigestive human motor secretory parameters as naturally
      occurring molecular forms of somatostatin at pharmacological doses.

PMID- 8464394
TI  - [Effect of the prostaglandin E2 analog nocloprost on motility and acid clearance
      of the tubular esophagus in man].
AB  - The effects of the E2 prostaglandin nocloprost (9b-chloro-16,16-dimethyl
      prostaglandin E2) on esophageal motility and acid clearance were evaluated in a
      double-blind placebo controlled study in six healthy volunteers. Motility of the
      tubular esophagus was measured by means of a low compliance perfusion system
      (four channels, recording ports 10 cm apart, the distal localized in the
      stomach). After eight hours fasting and a 60-minutes baseline measurement (with
      standardized swallowing of 5 cc water every three minutes) the volunteers
      swallowed on two separate days in randomized order either 200 micrograms
      nocloprost (solved in 50 cc water) or placebo. Then the motility of the tubular
      esophagus was assessed for another 60-minutes during standardized swallowing.
      Thereafter, the motility probe was removed and a pH-electrode placed 10 cm above
      the lower esophageal sphincter. In order to assess the esophageal clearance, four
      times 5 cc of 0.1 N HCl were infused into the esophagus 10 cm above the electrode
      and the time between the infusion of HCl and the increase of the pH above pH 4.0
      measured. RESULTS: In five out of six volunteers the duration of esophageal
      contractions were decreased after administration of nocloprost as compared to
      placebo (6.23 +/- 1.2 vs. 5.80 +/- 1.1 seconds, p = 0.07). In contrast, neither
      propagation velocity, nor amplitude of contraction or acid clearance were
      significantly affected by nocloprost. CONCLUSIONS: These findings suggest that in
      healthy volunteers nocloprost changes the pattern of esophageal contractions
      (duration) without affecting amplitude, velocity of propagation or acid
      clearance.

PMID- 8464395
TI  - [Postprandial serum bile acid level and 75SeHCAT retention in diagnosis of bile
      acid malabsorption syndrome. A comparative study].
AB  - Postprandial serum bile acids (expressed as integrated bile acid response [IR])
      after a standardized test meal were compared with 75SeHCAT retention, measured in
      a whole body counter, in healthy controls (n = 20), in 44 patients with ileal
      disease or resection and in 23 patients with colitis without ileal involvement.
      In the controls the IR after 180 min was 736 +/- 186 mumol x min x 1(-1) (mean +/
      standard deviation), the 75SeHCAT retention 31 +/- 9%. 80% of the patients with
      ileal disease or resection had a decreased 75SeHCAT retention, indicating bile
      acid malabsorption, but only 59% had a diminished IR. One of the 23 patients with
      colitis and radiologically normal ileum had a decreased 75SeHCAT retention but a
      normal IR, reflecting a dysfunction of the morphologically normal ileum. The
      characteristics of the two tests are: 75SeHCAT retention test: sensitivity 80%,
      specificity 98%, accuracy 89%; postprandial serum bile acids: sensitivity 64%,
      specificity 74%, accuracy 69%. With respect to chronic inflammatory bowel disease
      the positive predictive value of the 75SeHCAT retention test is 1.0%, for
      postprandial serum bile acids 0.1%, whereas the negative predictive values amount
      to 99% for both tests. Thus 75SeHCAT retention is more reliable in detecting bile
      acid malabsorption than the determination of postprandial serum bile acids,
      although both tests are not usefull for screening the population for ileal
      disease.

PMID- 8464396
TI  - [Differential diagnosis of chronic diarrhea: indicative findings of factitious
      diarrhea (Munchausen syndrome) with bisacodyl by the pathologist].

PMID- 8464397
TI  - [To what extent are sedation and monitoring in endoscopic examinations of the
      gastrointestinal tract necessary? A contribution to current discussions].

PMID- 8464398
TI  - [Differential effects of ethanol and alcoholic beverages on secretion of stomach
      acid and gastrin liberation in man--current status of research].

PMID- 8464399
TI  - [Smoking and ovulation inhibitor in inflammatory bowel diseases].
AB  - In a case-control study the effects of smoking and the use of oral contraceptives
      were examined in 83 patients with Crohn's disease and 37 patients with ulcerative
      colitis in comparison with members of the general population who served as
      controls. After controlling for oral contraceptives, smokers were found to have a
      significantly elevated relative risk of contracting Crohn's disease of 3.0 (1.3
      to 6.8). Patients on oral contraceptives for more than three years had an
      elevated risk for Crohn's disease of 4.3 (1.3 to 14.4); this elevated risk was,
      however, found only in the non-smoking group. In the case of ulcerative colitis,
      the relative risk in smokers was significantly lower (0.21 [0.04 to 0.91]) than
      in non-smokers. The use of oral contraceptives does not represent a risk factor
      for ulcerative colitis. While smoking has been established as a risk factor in
      the development of inflammatory bowel disease, the role of oral contraceptives in
      the aetiology of this condition remains unclear.

PMID- 8464400
TI  - [Benign recurrent intrahepatic cholestasis: a rare cause of juvenile jaundice].

PMID- 8464401
TI  - [Y1 receptors mediate inhibitory and stimulatory effects of peptide YY in
      isolated small intestine and large intestine muscles of the rabbit].
AB  - Peptide YY has been shown to have stimulatory and inhibitory effects on
      gastrointestinal motility. However, the receptors mediating these effects are
      unknown. To determine if specific YY receptor agonists can mediate the effects on
      gastrointestinal motility we studied the effects of peptide YY (PYY), of
      Pro34PYY, a selective Y1 agonist, and of PYY 3-36, a selective Y2 agonist, on the
      motility in isolated smooth muscle strips from rabbit small and large intestine.
      In strips from distal colon, PYY stimulated spontaneous motility whereas it
      inhibited spontaneous contractions in circular strips from distal ileum. In
      distal circular colon maximal inotropic response (10.1 +/- 2.1% of a maximal
      response to carbachol 10(-5) M) was found at PYY 10(-8) M; (ED50 3.1 +/- 1.2 x
      10(-9) M). In distal circular ileum maximal inhibition (by 39 +/- 20% of basal
      motility index) was found at 10(-7) M; (ID50 6.2 +/- 1.4 x 10(-9) M). PYY caused
      a dose-dependent inhibition of the on-contraction induced by electrical field
      stimulation. This inhibition could not be reversed by alpha- or beta-adrenergic
      blockade. PYY had no influence on the inotropic response evoked by carbachol.
      Both the stimulatory effect of PYY observed in distal colon and the inhibitory
      effect in distal ileum could be reproduced by the Y1 agonist Pro34PYY, but not by
      the Y2 agonist PYY 3-36. In distal circular colon the maximal inotropic response
      evoked by the Y1 agonist was 10 +/- 1.4%; (ED50 1.2 +/- 0.5 x 10(-8) M).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8464402
TI  - Bacillus subtilis sporulation: regulation of gene expression and control of
      morphogenesis.
AB  - Bacillus subtilis sporulation is an adaptive response to nutritional stress and
      involves the differential development of two cells. In the last 10 years or so,
      virtually all of the regulatory genes controlling sporulation, and many genes
      directing the structural and morphological changes that accompany sporulation,
      have been cloned and characterized. This review describes our current knowledge
      of the program of gene expression during sporulation and summarizes what is known
      about the functions of the genes that determine the specialized biochemical and
      morphological properties of sporulating cells. Most steps in the genetic program
      are controlled by transcription factors that have been characterized in vitro.
      Two sporulation-specific sigma factors, sigma E and sigma F, appear to segregate
      at septation, effectively determining the differential development of the mother
      cell and prespore. Later, each sigma is replaced by a second cell-specific sigma
      factor, sigma K in the mother cell and sigma G in the prespore. The synthesis of
      each sigma factor is tightly regulated at both the transcriptional and
      posttranslational levels. Usually this regulation involves an intercellular
      interaction that coordinates the developmental programmes of the two cells. At
      least two other transcription factors fine tune the timing and levels of
      expression of genes in the sigma E and sigma K regulons. The controlled synthesis
      of the sigma factors and other transcription factors leads to a spatially and
      temporally ordered program of gene expression. The gene products made during each
      successive stage of sporulation help to bring about a sequence of gross
      morphological changes and biochemical adaptations. The formation of the
      asymmetric spore septum, engulfment of the prespore by the mother cell, and
      formation of the spore core, cortex, and coat are described. The importance of
      these structures in the development of the resistance, dormancy, and germination
      properties of the spore is assessed.

PMID- 8464404
TI  - Ether polar lipids of methanogenic bacteria: structures, comparative aspects, and
      biosyntheses.
AB  - Complete structures of nearly 40 ether polar lipids from seven species of
      methanogens have been elucidated during the past 10 years. Three kinds of
      variations of core lipids, macrocyclic archaeol and two hydroxyarchaeols, were
      identified, in addition to the usual archaeol and caldarchaeol (for the
      nomenclature of archaeal [archaebacterial] ether lipids, see the text). Polar
      head groups of methanogen phospholipids include ethanolamine, serine, inositol, N
      acetylglucosamine, dimethyl- and trimethylaminopentanetetrol, and
      glucosaminylinositol. Glucose is the sole hexose moiety of glycolipids in most
      methanogens, and galactose and mannose have been found in a few species.
      Methanogen lipids are characterized by their diversity in phosphate-containing
      polar head groups and core lipids, which in turn can be used for chemotaxonomy of
      methanogens. This was shown by preliminary simplified analyses of lipid component
      residues. Core lipid analysis by high-pressure liquid chromatography provides a
      method of determining the methanogenic biomass in natural samples. There has been
      significant progress in the biosynthetic studies of methanogen lipids in recent
      years. In vivo incorporation experiments have led to delineation of the outline
      of the synthetic route of the diphytanylglycerol ether core. The mechanisms of
      biosynthesis of tetraether lipids and various polar lipids, and cell-free systems
      of either lipid synthesis, however, remain to be elucidated. The significance and
      the origin of archaeal ether lipids is discussed in terms of the lipid
      composition of bacteria living in a wide variety of environments, the oxygen
      requirement for biosynthesis of hydrocarbon chains, and the physicochemical
      properties and functions of lipids as membrane constituents.

PMID- 8464403
TI  - Protein secretion in Bacillus species.
AB  - Bacilli secrete numerous proteins into the environment. Many of the secretory
      proteins, their export signals, and their processing steps during secretion have
      been characterized in detail. In contrast, the molecular mechanisms of protein
      secretion have been relatively poorly characterized. However, several components
      of the protein secretion machinery have been identified and cloned recently,
      which is likely to lead to rapid expansion of the knowledge of the protein
      secretion mechanism in Bacillus species. Comparison of the presently known export
      components of Bacillus species with those of Escherichia coli suggests that the
      mechanism of protein translocation across the cytoplasmic membrane is conserved
      among gram-negative and gram-positive bacteria differences are found in steps
      preceding and following the translocation process. Many of the secretory proteins
      of bacilli are produced industrially, but several problems have been encountered
      in the production of Bacillus heterologous secretory proteins. In the final
      section we discuss these problems and point out some possibilities to overcome
      them.

PMID- 8464408
TI  - [Postoperative recurrence form of Crohn's disease: comparison between perforating
      and non perforating types].
AB  - Postoperative recurrence rate and recurrence form were analyzed in two clinical
      forms of Crohn's disease at primary resection, one of which was perforating and
      the other was non perforating. Forty four patients with Crohn's disease were
      included in this study, 18 of them were perforating type and 26 were non
      perforating type. Crude recurrence rates were 39% (7/18 cases) in perforating
      type group and 54% (14/26 cases) in non perforating type group, which were not
      significantly different. Cumulative recurrence rates 5 years after initial
      operation were 58% in perforating type group and 47% in non perforating group
      without statistically significance. The recurrence form was perforating type more
      frequently in perforating type group (86%) than non perforating group at primary
      resection (29%) with statistically significance (p = 0.013). Postoperative
      recurrence form had a tendency to be similar to the form at primary resection. It
      was suggested from this study that Crohn's disease had two different disease
      entities; perforating and non perforating types and that postoperative recurrence
      should be examined carefully from the view of primary resection.

PMID- 8464407
TI  - [Experimental studies on the development of residual stomach cancer--comparison
      of Billroth I and Billroth II].
AB  - The effects of duodenogastric reflex on the development of residual stomach
      cancer and cell proliferation kinetics were investigated in Wistar rats. Billroth
      II resection (B-II group) was performed on 24 rats and Billroth I resection (B-I
      group) was performed on 22 rats. The incidence of cancer in the B-II group was
      20.8%, though no cancer was noted in the B-I group. The incidences of the
      pseudopyloric gland, dilated gland and gastritis cystica profunda in the B-II
      group were significantly higher than those in the B-I group. The degree of
      mucosal atrophy was greater in the B-II group than in the B-I group. The stomal
      area in the B-II group had expansion of proliferative zone as well as increased S
      phase duration and turn over time, compared with those in the B-I group. The
      sequence of histological and proliferative events associated with duodenogastric
      reflux suggests that the residual stomach in the B-II group is susceptible to the
      development of cancer.

PMID- 8464409
TI  - [Radioimmunodetection of colorectal cancer, using anti-CEA monoclonal antibody
      CEA102: experience of 20 cases].
AB  - The monoclonal antibody CEA 102 against carcinoembryonic antigen was produced by
      immunization with purified CEA, and used as a radiotracer for the imaging of
      colorectal cancer. CEA102 was labeled with 131I by the chloramine-T or the
      Iodogen method, and administered i.v. to 20 patients with liver metastases, local
      recurrences, and/or primary tumors. Planar scintigraphy was performed during 5 or
      6 postinfusion days. Hypersensitivity reactions such as fever and chill occurred
      in 4 patients, but no side effects were noted after endotoxin was excluded.
      Overall sensitivity was 71.4% (primary tumor 4/4, liver metastasis 5/6, lymph
      node metastasis 1/1, local recurrence 5/10), and no false positive was observed.
      In the cases of local recurrences, this method was useful to distinguish
      postoperative fibrosis from local recurrence. These results revealed that
      radiolabeled CEA102 has a great potential in qualitative diagnosis of colorectal
      cancer.

PMID- 8464410
TI  - [Characterization of autologous-tumor specific cytotoxic T cells induced by means
      of butanol-extracted soluble antigen from T lymphocytes in colon cancer
      patients].
AB  - Tumor-specific T lymphocytes (CTL) are proliferated in vitro to induce by a
      stimulation with butanol-extracted soluble antigen (CBE) and human recombinant
      interleukin-2 (IL-2) from peripheral lymphocytes of cancer patients. Peripheral
      blood T lymphocytes (PBL-T), tumor infiltrating lymphocytes (TIL) and lymph node
      lymphocytes (LNC) from patients with colon cancer were stimulated in vitro with
      CBE and IL-2. Single stimulation with CBE (1 x 10(-3) micrograms/ml) also
      activated the proliferative response of the PBL-T (p < 0.01). On the other hand,
      high-dose (0.25-2 micrograms/ml) significantly inhibited the proliferation of the
      PBL-T that had been stimulated with 20U/ml IL-2 (p < 0.001). The IL-2 receptor
      expression of PBL-T, TIL and LNC was also activated with low-dose CBE and IL-2.
      The surface markers of stimulated lymphocytes responded anti-CD3 and CD8
      monoclonal antibodies, but some TIL and LNC displayed CD3 and CD4 phenotype. The
      lymphocytes responding anti-CD8 monoclonal antibody possessed the cytotoxic
      activity against autologous tumor cells, but not the lymphocytes responding anti
      CD4 monoclonal antibody. The results suggested that low-dose CBE and IL-2 augment
      the IL-2 receptor expression of T lymphocytes, thereby the proliferation of the
      antigen specific cytotoxic T cells.

PMID- 8464411
TI  - [Phenotypic and functional analyses of cells infiltrating rat hepatic allograft].
AB  - In order to elucidate the immunological characteristics of rat liver
      transplantation, graft infiltrating cells (GIC) were isolated from rat hepatic
      allografts, and phenotypic and functional analyses were performed. Long-surviving
      combination (Lewis engrafted BN liver, MST = 166.8 +/- 28.1 days, n = 10) and
      acutely-rejected combination (Lewis engrafted DA liver, MST = 9.6 +/- 0.3 days, n
      = 6) were compared. Relative proportions of all T cells and activated T cells
      assessed by flow cytometry were significantly higher in Lewis recipients of
      acutely-rejected combination than in those of long-surviving combination on day 6
      after transplantation. Phenotypic analyses of GIC on days 6, 14, and 45 after
      transplantation in Lewis hosts of long-surviving combination were assessed. All T
      cells, OX-8 positive cells (Tc/s, NK), and OX-39 positive (IL-2 receptor) cells
      showed peak levels on day 6 and decreased on day 45. Cytotoxic activity of GIC
      toward donor lymphocytes on day 6 was stronger in host of acutely-rejected
      combination (18.9 +/- 4.0%, E/T = 50) than in that of long-surviving combination
      (5.3 +/- 2.8%). On the other hand, NK activity in Lewis host of long-surviving
      combination was high (17.5 +/- 3.0%, E/T = 100) on day 6 after transplantation.
      These results demonstrate that some immunosuppressive mechanism is present
      already on day 6 after transplantation, and that infiltration or activation of
      cytotoxic T cells is inhibited in long-surviving combination of rat hepatic
      allografts.

PMID- 8464412
TI  - [Prognostic judgment of fulminant hepatitis by measurement of hepatosplenic
      volume ratio by computed tomography].
AB  - The liver and spleen volume ratio (S/L ratio) was estimated with X-ray computed
      tomography and evaluated by comparison with the prognosis in 10 patients with
      fulminant hepatitis. S/L ratio of control group (n = 10) was 0.122 +/- 0.026
      (mean +/- SD), that of the alive group with fulminant hepatitis (n = 5) was 0.112
      +/- 0.021, and that of the dead group (n = 5) was 0.308 +/- 0.136. There is a
      significant difference between S/L ratio of control group and that of the dead
      group with fulminant hepatitis. The rise of S/L ratio on the patients with
      fulminant hepatitis reflects the liver atrophy or splenomegaly and the prognosis
      was poor. The prognosis of the patients with fulminant hepatitis, whose S/L ratio
      indicated the near value of control group, was good. The measurement of S/L ratio
      by computed tomography was considered to be useful to evaluate the prognosis of
      fulminant hepatitis.

PMID- 8464413
TI  - [Hemodynamics and treatment based on endoscopic classification of esophago
      gastric varices].
AB  - The relationship between endoscopic findings and hemodynamics was studied in 262
      patients. The endoscopic findings were classified into 3 groups; 1) Type 1: case
      with esophageal varices. 2) Type 2: case with esophago-cardiac varices. 3) Type
      3: case with fundic varices. The hemodynamics were examined using late phase
      venography after conventional abdominal angiography. The blood vessels of type 1
      resembled those of type 2, and 72% of the cardiac varices were connected with
      esophageal varices. On the other hand, the blood vessels of type 3 were
      completely different from those of type 1 and type 2, and 84% of the fundic
      varices were connected with large gastro-renal shunts. From these results, I have
      been applying endoscopic in injection sclerotherapy for types 1 and 2, and
      Hassab's operation for type 3. The rates of hemostasis were 100%, 93% and 100% in
      types 1, 2 and 3, respectively. The rates of disappearance of the varices after
      treatment were 78.7%, 87% and 100% in types 1, 2 and 3, respectively. It is
      concluded that good therapeutic results can be obtained when an appropriate
      therapeutic method is selected. Treatment should be based on the hemodynamics
      associated with the endoscopic findings of esophago-gastric varices.

PMID- 8464406
TI  - Meningococcal lipopolysaccharides: virulence factor and potential vaccine
      component.
AB  - Lipopolysaccharides (LPS) are surface components of the outer membrane of
      Neisseria meningitidis. Today, 12 different types of meningococcal LPS
      (immunotypes) are known, of which 3 are prevalent in the western world. The
      differences between these immunotypes are in the oligosaccharide part of the LPS
      molecule and consist of small differences in the oligosaccharide structure, the
      amount and location of phosphoethanolamine groups, and the degree of O
      acetylation of individual monosaccharides. Although the differences between the
      various immunotypes are small, they have a profound influence on the
      immunochemical and immunological properties of these molecules. Furthermore, each
      individual strain synthesizes a number of different LPS molecules. The expression
      of the various components (protective epitopes) is influenced by growth
      conditions and growth phase. Meningococci can endogenously sialyate their LPS,
      which constitutes one of the mechanisms by which N. meningitidis can evade the
      response of the human host. Meningococcal LPS play a key role in the induction of
      septic shock and can probably enhance the invasiveness of meningococcal strains
      and shield protective epitopes. Therefore, incorporation of (detoxified) LPS or
      oligosaccharide components derived therefrom might be very beneficial for the
      efficacy of a vaccine against group B meningococci. An overview of the
      development of vaccines against group B meningococci is given, and the status and
      potential of meningococcal LPS-derived (synthetic) oligosaccharide-protein
      conjugate vaccines are discussed.

PMID- 8464414
TI  - [The growth activity and DNA ploidy in anaplastic carcinoma transplanted to nude
      mice].
AB  - Recently, nuclear DNA contents of various human tumors were studied, and DNA
      aneuploidy was thought to have prognostic significance in many kinds of malignant
      tumors. Although the same significance was reported in thyroid carcinoma, the
      anaplastic thyroid carcinoma which is one of the most aggressive tumor in human
      malignant neoplasms, not always shows DNA aneuploidy. Therefore, using 3
      xenografts established from 3 patients with anaplastic thyroid carcinomas, we
      investigated their growth activity, DNA ploidy and chromosome abnormalities. Two
      of these xenografts grew relatively fast in nude mice showing diploid or near
      diploid state in a flow cytometric study, and also, showed many structural
      abnormalities in chromosome analysis by the G-banding technique. The remaining
      one xenograft showed slower growth and aneuploidy, and had extensive numerical
      but less structural variability in its chromosomal constitution. These results
      indicate that some tumors showed DNA diploidy and have structural chromosome
      abnormalities and also suggest that the prognostic value of quantitative DNA
      measurement is limited in such tumors.

PMID- 8464415
TI  - [Ogilvie's syndrome in pregnancy--a case report].
AB  - A 23-year-old female in the 28th week of pregnancy was admitted with an acute
      abdominal distension. The plain X-ray films showed a marked gaseous dilatation of
      the colon from the cecum to the splenic flexure. A tube colostomy was performed.
      Her postoperative course was uneventful and she improved progressively. Her
      pregnancy and delivery elapsed uneventfully there after. After the delivery she
      again complained of marked abdominal distension. The colonoscopic decompression
      in combination with the administration of Cisapride was successfully
      accomplished. Ogilvie's syndrome is characterized by an unobstructed colon which
      progresses to marked dilatation. When the colonic diameter becomes 12cm or more,
      surgical decompression should be recommended to avoid the hazard of spontaneous
      rupture. This is the first reported case of Ogilvie's syndrome in pregnancy in
      Japan.

PMID- 8464416
TI  - [Single-stage management of postoperative sternal wound infection using a
      pectoral musculocutaneous flap].
AB  - Two patients with postoperative sternal wound infection were successfully treated
      by a pectral musculocutaneous flap. A single-stage procedure of debridement and
      immediate closure with a pectral musculocutaneous flap can eliminate irrigation,
      open wound management, or reoperation for closure. Therefore, this method is very
      safe, simple, and effective for the management of sternal wound infections.

PMID- 8464417
TI  - [Surgical treatment for true aneurysm of the deep femoral artery, and a review of
      literatures in Japan].
AB  - A true aneurysm of the deep femoral artery is very rare among peripheral
      aneurysms because of its anatomical position and characteristics of wall tissue.
      An early operation is mandatory because it has a tendency to become a large size
      and to rupture. During the last eight years, we experienced two cases. One
      ruptured case underwent only resection of aneurysm and another case received an
      additional reconstruction of deep femoral artery using saphenous vein graft. Both
      of them are doing well postoperatively. In this paper, a review of 24 cases
      including these two in Japanese literature was discussed.

PMID- 8464418
TI  - [Changes of the number of FdUMP binding sites of thymidylate synthase and folate
      pools in human colorectal carcinomas following the administration of tegafur and
      uracil: preliminary report].

PMID- 8464419
TI  - [Glucose intolerance in patients with oxyhyperglycemia after subtotal gastrectomy
      -study with IV GTT--preliminary report].

PMID- 8464420
TI  - [Orthotopically implanted human colon carcinoma xenografts can metastasize to
      liver via hematogenous spread: preliminary report].

PMID- 8464421
TI  - [Morphological alterations in the hepatocytes of tumor-bearing, cachectic rats:
      preliminary report].

PMID- 8464422
TI  - [A technique for studying the periportal (zone 1) hepatocytes metabolism using a
      new liver perfusion method: preliminary report].

PMID- 8464423
TI  - [A bioartificial parathyroid: preliminary report].

PMID- 8464424
TI  - [Specificity and biodistribution of human monoclonal antibody 4G12 (human IgM) to
      esophageal carcinoma: preliminary report].

PMID- 8464425
TI  - [Postoperative hypophosphatemia in patients with cancer of the thoracic
      esophagus].
AB  - Postoperative phosphate dynamics were studied in 30 patients who underwent
      radical surgery for thoracic esophageal cancer and who were postoperatively
      nourished by total parenteral nutrition. There was a significant fall in the
      serum phosphate level on the 2nd and 3rd postoperative days in all patients.
      Postoperative hypophosphatemia was due to an increase in urinary phosphate
      excretion which was indicated by the fall in TRP% and TmPO4/GFR. A highly
      significant positive correlation was observed between the increase in urinary
      phosphate loss and the enhanced secretion of parathyroid hormone which was
      possibly triggered by surgical stress, a decrease in the serum level of calcium,
      the action of phosphate buffer or diuretics. All the patients except for those
      with postoperative pulmonary complications responded to the drop in serum
      phosphate by renal conservation of phosphate. A slight decrease in the serum
      level of phosphate was also found on the 6th postoperative day in most patients
      who were receiving parenteral hyperalimentation. The second fall in phosphate was
      due to transcellular shifts of phosphate. It is concluded that patients with
      postoperative pulmonary complications develop severe hypophosphatemia which
      should be prevented by replacement therapy with phosphate in the immediate
      postoperative period.

PMID- 8464426
TI  - Rapid isolation and biochemical characterization of rat C1 and C1q.
AB  - Using a human IgG-Sepharose column to which rabbit anti-human IgG was bound
      (rabbit anti-human/human IgG-Sepharose), human and rat C1 or C1q were isolated
      from serum in a single step, and the C1q further purified to homogeneity by FPLC.
      This procedure allowed the rapid isolation of haemolytically active C1 or C1q,
      with a yield equal to or greater than published methods. The availability of
      human and rat C1q allowed comparison of the two molecules, revealing differences
      in their mobility on SDS-PAGE as well as on agarose gel electrophoresis. Amino
      terminal sequence analysis demonstrated greater than 78% residue identity between
      rat C1q A, B and C chains and the published human and mouse sequences. Similar
      amino acid compositions suggest that the homology extends throughout the
      molecules. In addition to the major A:B and C:C dimer bands, rat, unlike human
      C1q, contained minor dimer species. These may reflect heterogeneity in
      glycosylation and or lysine and proline hydroxylation.

PMID- 8464427
TI  - Differential expression of Fc gamma RIIA, Fc gamma RIIB and Fc gamma RIIC in
      hematopoietic cells: analysis of transcripts.
AB  - Fc gamma receptors (Fc gamma R) are glycoproteins that function in the immune
      response through their ability to bind the Fc portion of immunoglobulin G. Of the
      three human Fc gamma R classes, Fc gamma RII is most widely distributed among
      hematopoietic cells and is the only Fc gamma R class present on platelets and
      megakaryocytes. There are three different genes coding for Fc gamma RII: Fc gamma
      RIIA, Fc gamma RIIB and Fc gamma RIIC. Alternative splicing of at least two of
      these genes results in the production of multiple transcripts. Combining Northern
      blot analysis with reverse transcription-PCR, we analyzed steady state levels of
      Fc gamma RII mRNA in the megakaryocytic, myeloid and lymphoid lineages. We
      determined that megakaryocytic cells predominantly contain Fc gamma RIIA mRNA; Fc
      gamma RIIA transcripts with and without the transmembrane exon (Fc gamma RIIa1
      and Fc gamma RIIa2, respectively) are present in comparable amounts. In contrast,
      B lymphocytes do not express Fc gamma RIIA mRNAs, but do contain both Fc gamma
      RIIB transcripts, Fc gamma RIIb1 and Fc gamma RIIb2, as well as the Fc gamma RIIC
      transcript, Fc gamma RIIc. Myelomonocytic cells contain mRNAs from all three Fc
      gamma RII genes, predominantly the Fc gamma RIIa1 transcript, both Fc gamma RIIb1
      and Fc gamma RIIb2 transcripts and Fc gamma RIIc. Lineage-specific expression of
      the Fc gamma RII genes implies both differential regulation of expression and
      differential function in diverse cells.

PMID- 8464428
TI  - Comparison of nucleotide sequences from upstream of the DQ52 gene to the S mu
      region of immunoglobulin heavy-chain gene loci between Suncus murinus, mouse and
      human.
AB  - The nucleotide sequence of a 4621 base pair fragment of DNA, from a position
      upstream of DSQ52 to the S mu region within immunoglobulin heavy-chain gene loci
      of Suncus murinus was determined. The sequence contained one D gene, three JH
      genes and an enhancer. Suncus murinus is an insectivore and is one of the most
      primitive mammals. Both primates and rodents are thought to have originated from
      insectivores and to have evolved separately. We also determined the nucleotide
      sequence of a region between human JH genes and the enhancer which has not
      previously been reported. Thus, the sequences of the entire region from each of
      the three species, Suncus murinus, human and mouse are now available. Comparison
      of the nucleotide sequence of this region between these three species indicated
      that D and JH genes, consisting of coding and signal regions, are highly
      conserved. Moreover, although extensive sequence homology in the region between
      JH and S mu was observed between mouse and human, only core portions of the
      enhancer region of Suncus murinus exhibited homology to those of mouse and human.
      Sequence conservation of JH genes in Suncus murinus, mouse and human was observed
      not only at the amino-acid level, but also at the nucleotide level, including the
      third letters of the codons. It is suggested that JH genes may play a role in the
      metabolism of the DNA and/or RNA.

PMID- 8464429
TI  - Abnormal kappa B-binding protein in the cytoplasm of a plasmacytoma cell line
      that lacks nuclear expression of NF-kappa B.
AB  - The transcription factor NF-kappa B appears to play an important role in
      immunoglobulin gene expression and lymphokine production, and may play a role in
      primary B cell activation. Constitutive nuclear expression of NF-kappa B has been
      found in all mature B cell lines with the notable exception of the murine
      plasmacytoma, S107. We report herein that S107 cells express cytoplasmic kappa B
      binding material detected by electrophoretic mobility shift assay that by several
      criteria represents authentic NF-kappa B. Despite the presence of cytoplasmic NF
      kappa B, several stimuli known to induce nuclear translocation of NF-kappa B
      failed to do so in S107 cells, including: the PKC agonist, PMA; the protein
      synthesis inhibitor, cycloheximide; and LPS. Transfection of S107 cells with a
      kappa B-CAT reporter gene construct confirmed the absence of functional activity.
      Importantly, a global failure of nuclear transcription factor expression was
      ruled out by the ability of PMA to induce nuclear expression of another trans
      acting factor, AP-1. Thus, rather than lacking NF-kappa B altogether, S107 cells
      manifest disordered regulation of NF-kappa B in which cytoplasmic material is
      incapable of translocation to the nucleus. While Northern analysis failed to
      reveal a gross defect in the mRNA coding for the DNA binding subunit of NF-kappa
      B, UV-photo-cross-linking followed by denaturing gel electrophoresis demonstrated
      the presence of a cytoplasmic kappa B-binding protein of abnormally elevated
      molecular size. This finding suggests that the abnormal regulation of NF-kappa B
      in S107 cells is associated with the appearance of an unusual kappa B-binding
      molecule.

PMID- 8464430
TI  - Evaluation of structure-antigenicity relationship of peptides from human
      immunodeficiency virus type 1 (HIV-1) p18 protein by circular dichroism.
AB  - The antigenicity of Human Immunodeficiency Virus type 1 (HIV-1) matrix p18
      protein was evaluated by analyzing the specificity of anti-p18 antibodies
      elicited either in HIV-1 infected humans, or in HIV-1 infected or immunized
      chimpanzees, against a panel of long and short overlapping synthetic peptides
      [from 12 to 46 amino acid (aa) residues] covering the entire sequence of p18. The
      relationship between peptide structure and antigenicity was further investigated
      by probing the secondary structures of the peptides by circular dichroism. The
      results obtained clearly showed the immunodominance of the N-terminal region
      mimicked by peptide P1 (aa 2-45), which reacted with 52 and 100% of human and
      chimpanzee anti-p18 sera, respectively. In contrast smaller 15 aa long peptides
      C1, C2, C3, C4 and P3 which cover the entire sequence of immunodominant peptide
      P1, showed only weak or no reactivity. In contrast to widely accepted hypotheses,
      circular dichroism analysis of both small and large peptides secondary structures
      did not show any obvious correlation between antigenicity and the ability of
      peptides to adopt an ordered conformation.

PMID- 8464431
TI  - The efficacy of intensive dietary therapy alone or combined with lovastatin in
      outpatients with hypercholesterolemia.
AB  - BACKGROUND: A diet low in saturated fat and cholesterol is the standard initial
      treatment for hypercholesterolemia. However, little quantitative information is
      available about the efficacy of dietary therapy in clinical practice or about the
      combined effects of diet and drug therapy. METHODS: One hundred eleven
      outpatients with moderate hypercholesterolemia were treated at five lipid clinics
      with the National Cholesterol Education Program Step 2 diet (which is low in fat
      and cholesterol) and lovastatin (20 mg once daily), both alone and together. A
      diet high in fat and cholesterol and a placebo identical in appearance to the
      lovastatin were used as the respective controls. Each of the 97 patients
      completing the study (58 men and 39 women) underwent four consecutive nine-week
      periods of treatment according to a randomized, balanced design: a high-fat diet
      placebo period, a low-fat diet-placebo period, a high-fat diet-lovastatin period,
      and a low-fat diet-lovastatin period. RESULTS: The level of low-density
      lipoprotein (LDL) cholesterol was a mean of 5 percent (95 percent confidence
      interval, 3 to 7 percent) lower during the low-fat diet than during the high-fat
      diet (P < 0.001). With lovastatin therapy as compared with placebo, the reduction
      was 27 percent. Together, the low-fat diet and lovastatin led to a mean reduction
      of 32 percent in the level of LDL cholesterol. The level of high-density
      lipoprotein (HDL) cholesterol fell by 6 percent (95 percent confidence interval,
      4 to 8 percent) during the low-fat diet (P < 0.001) and rose by 4 percent during
      treatment with lovastatin (P < 0.001). The ratio of LDL to HDL cholesterol and
      the level of total triglycerides were reduced by lovastatin (P < 0.001), but not
      by the low-fat diet. CONCLUSIONS: The effects of the low-fat-low-cholesterol diet
      and lovastatin on lipoprotein levels were independent and additive. However, the
      reduction in LDL cholesterol produced by the diet was small, and its benefit was
      possibly offset by the accompanying reduction in the level of HDL cholesterol.

PMID- 8464432
TI  - Plasma triglyceride level and mortality from coronary heart disease.
AB  - BACKGROUND: Whether the plasma triglyceride level is a risk factor for coronary
      heart disease has been controversial, and evaluation of the triglyceride level as
      a risk factor is fraught with methodologic difficulties. METHODS: We studied the
      association between plasma triglyceride levels and the 12-year incidence of death
      from coronary heart disease in 10 North American populations participating in the
      Lipid Research Clinics Follow-up Study, while adjusting for the potential
      confounding effects of other risk factors for cardiovascular disease, including
      the level of high-density lipoprotein (HDL) cholesterol. All analyses were sex
      specific, and separate analyses were performed in high and low strata of HDL
      cholesterol, low-density lipoprotein (LDL) cholesterol, fasting plasma glucose,
      and age. RESULTS: The rates of coronary death in both men and women increased
      with the triglyceride level. In Cox proportional-hazards models adjusted for age,
      in which the natural log of the triglyceride levels was used to give a normal
      distribution, the relative risk per natural-log unit of triglyceride (e.g., a
      triglyceride level of 150 mg per deciliter vs. a level of 55 mg per deciliter)
      was 1.54 (95 percent confidence interval, 1.19 to 1.98; P < 0.001) in men and
      1.88 (95 percent confidence interval, 1.19 to 2.98; P < 0.007) in women. After an
      adjustment for potential covariates, however, these relative risks were not
      statistically significant. Analyses based on lipoprotein cholesterol levels
      revealed a positive association between the triglyceride level and coronary
      mortality in the lower stratum of both HDL and LDL cholesterol, but not in the
      higher stratum. Conversely, the HDL cholesterol level was unrelated to coronary
      mortality in the lower stratum of LDL cholesterol, but was strongly inversely
      associated with coronary death in the higher stratum of LDL cholesterol. The
      relative risk of coronary death associated with triglyceride level was higher at
      younger ages. The associations between the triglyceride level and coronary
      mortality in the lower HDL cholesterol, LDL cholesterol, and age strata were
      small and were further reduced by an adjustment for the fasting plasma glucose
      level. CONCLUSIONS: Overall, the plasma triglyceride level showed no independent
      association with coronary mortality. However, in subgroups of subjects with lower
      HDL and LDL cholesterol levels and in younger subjects, defined a priori, an
      association between the triglyceride level and coronary mortality was observed,
      although this association was small and was not statistically significant after
      an adjustment for the plasma glucose level.

PMID- 8464433
TI  - Combination chemotherapy in refractory immune thrombocytopenic purpura.
AB  - BACKGROUND: Chronic idiopathic thrombocytopenic purpura is a destructive
      thrombocytopenia caused by an autoantibody. About 80 percent of patients with
      chronic idiopathic thrombocytopenic purpura have remissions after either
      corticosteroid therapy or splenectomy. Some patients with resistant disease
      respond to other agents, but a substantial group are refractory to therapy.
      METHODS: We used combination chemotherapy to treat 10 patients with refractory
      immune thrombocytopenia. An average of 6.8 (range, 3 to 10) previous therapies,
      including corticosteroids and splenectomy, had been unsuccessful in these
      patients. The patients received from three to eight cycles of therapy consisting
      of cyclophosphamide and prednisone combined with either vincristine (one
      patient), vincristine and procarbazine (four patients), or etoposide (six
      patients, including one patient who received four cycles each containing
      procarbazine and etoposide). RESULTS: Among the 10 patients, 6 had complete
      responses (platelet count, > 180,000 per cubic millimeter); of these, 4 patients
      had responses that persisted for more than 11, 30, 54, or 126 months, 1 had a
      relapse 9 months after therapy but had a remission with further therapy and
      remained in remission for 48 months before dying of an unrelated illness, and
      another relapsed just before her fifth course of therapy. Two patients had
      partial responses (platelet count, > 50,000 per cubic millimeter); the platelet
      counts in one remained stable for more than nine months after the end of therapy,
      and the other patient relapsed. The remaining two patients had no response.
      Complete responses were associated with a disappearance or marked decrease in the
      level of platelet-associated autoantibody. CONCLUSIONS: Combination chemotherapy
      is beneficial in some patients in whom immune thrombocytopenia is refractory to
      corticosteroids and splenectomy.

PMID- 8464434
TI  - The occurrence of sleep-disordered breathing among middle-aged adults.
AB  - BACKGROUND: Limited data have suggested that sleep-disordered breathing, a
      condition of repeated episodes of apnea and hypopnea during sleep, is prevalent
      among adults. Data from the Wisconsin Sleep Cohort Study, a longitudinal study of
      the natural history of cardiopulmonary disorders of sleep, were used to estimate
      the prevalence of undiagnosed sleep-disordered breathing among adults and address
      its importance to the public health. METHODS: A random sample of 602 employed men
      and women 30 to 60 years old were studied by overnight polysomnography to
      determine the frequency of episodes of apnea and hypopnea per hour of sleep (the
      apnea-hypopnea score). We measured the age- and sex-specific prevalence of sleep
      disordered breathing in this group using three cutoff points for the apnea
      hypopnea score (> or = 5, > or = 10, and > or = 15); we used logistic regression
      to investigate risk factors. RESULTS: The estimated prevalence of sleep
      disordered breathing, defined as an apnea-hypopnea score of 5 or higher, was 9
      percent for women and 24 percent for men. We estimated that 2 percent of women
      and 4 percent of men in the middle-aged work force meet the minimal diagnostic
      criteria for the sleep apnea syndrome (an apnea-hypopnea score of 5 or higher and
      daytime hypersomnolence). Male sex and obesity were strongly associated with the
      presence of sleep-disordered breathing. Habitual snorers, both men and women,
      tended to have a higher prevalence of apnea-hypopnea scores of 15 or higher.
      CONCLUSIONS: The prevalence of undiagnosed sleep-disordered breathing is high
      among men and is much higher than previously suspected among women. Undiagnosed
      sleep-disordered breathing is associated with daytime hypersomnolence.

PMID- 8464435
TI  - Advances in diagnostic imaging and overestimations of disease prevalence and the
      benefits of therapy.

PMID- 8464436
TI  - Immunization of adults.

PMID- 8464437
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 17-1993. A 53-year-old woman who died after several years of a
      dementing illness with intermittent generalized seizures and abnormal movements
      of the extremities and head.

PMID- 8464438
TI  - Medicine at center stage.

PMID- 8464405
TI  - Pathogenesis of human immunodeficiency virus infection.
AB  - The lentivirus human immunodeficiency virus (HIV) causes AIDS by interacting with
      a large number of different cells in the body and escaping the host immune
      response against it. HIV is transmitted primarily through blood and genital
      fluids and to newborn infants from infected mothers. The steps occurring in
      infection involve an interaction of HIV not only with the CD4 molecule on cells
      but also with other cellular receptors recently identified. Virus-cell fusion and
      HIV entry subsequently take place. Following virus infection, a variety of
      intracellular mechanisms determine the relative expression of viral regulatory
      and accessory genes leading to productive or latent infection. With CD4+
      lymphocytes, HIV replication can cause syncytium formation and cell death; with
      other cells, such as macrophages, persistent infection can occur, creating
      reservoirs for the virus in many cells and tissues. HIV strains are highly
      heterogeneous, and certain biologic and serologic properties determined by
      specific genetic sequences can be linked to pathogenic pathways and resistance to
      the immune response. The host reaction against HIV, through neutralizing
      antibodies and particularly through strong cellular immune responses, can keep
      the virus suppressed for many years. Long-term survival appears to involve
      infection with a relatively low-virulence strain that remains sensitive to the
      immune response, particularly to control by CD8+ cell antiviral activity. Several
      therapeutic approaches have been attempted, and others are under investigation.
      Vaccine development has provided some encouraging results, but the observations
      indicate the major challenge of preventing infection by HIV. Ongoing research is
      necessary to find a solution to this devastating worldwide epidemic.

PMID- 8464439
TI  - Screening for lipid disorders under health system reform.

PMID- 8464441
TI  - Self-referral by physicians.

PMID- 8464440
TI  - Sleep apnea--a major public health problem.

PMID- 8464442
TI  - Self-referral by physicians.

PMID- 8464443
TI  - Self-referral by physicians.

PMID- 8464444
TI  - Increased costs and rates of use in the California workers' compensation system
      as a result of a self-referral by physicians.

PMID- 8464445
TI  - Increased costs and rates of use in the California workers' compensation system
      as a result of self-referral by physicians.

PMID- 8464446
TI  - "Self-referral"--what's at stake?

PMID- 8464447
TI  - "Self-referral"--what's at stake?

PMID- 8464449
TI  - "Self-referral"--what's at stake?

PMID- 8464448
TI  - "Self-referral"--what's at stake?

PMID- 8464450
TI  - Snoring and sleep-related breathing abnormality during partial sleep deprivation.

PMID- 8464451
TI  - Age and the cardiovascular system.

PMID- 8464452
TI  - The incidence of post-transfusion hepatitis.

PMID- 8464453
TI  - False positive tests for HIV in a woman with lupus and renal failure.

PMID- 8464454
TI  - Pneumococcal appendicitis in a man with HIV infection.

PMID- 8464455
TI  - Extrusion influence on the nutritive value of casein preparations.
AB  - Effect of extrusion (120 C; 8-12 s; extruder S 45-12-10 U) on amino acids and
      nutritive value of casein preparations in the form of calcium and low-calcium
      paracaseinates and in acidic form was studied. The following indices were found
      to decrease slightly: chemical score (CS) from the range 57.4-58.8 to 57.2-58.1;
      essential amino acids (EAA) from 86.1-88.3 to 84.9-88.1; NPU from 61.4-67.6 to
      60.2-66.6; PER from 2.40-2.47 to 2.38-2.45; apparent digestibility (AD) from 84.9
      87.2 to 84.8-87.2; true digestibility (TD) from 90.7-95.3 to 90.4-92.8 and
      biological value (BV) from 66.6-71.0 to 65.8-69.6. These results prove that the
      extrusion at 120 C does not result in a significant lowering of the protein
      quality in the casein preparations.

PMID- 8464456
TI  - Effect of sex hormones on copper, zinc, iron nutritional status and hepatic lipid
      peroxidation in rats.
AB  - Sex dependence of copper, zinc, iron nutritional status and hepatic lipid
      peroxidation was studied in gonadectomized, hormone substituted and sham-operated
      male and female rats. The experiment was performed on H-Wistar rats (106 +/- 10
      g) fed conventional laboratory food ad libitum for 12 weeks. The estrogen
      dependence of copper status is fully confirmed by the results of this study. In
      hormonally active females the malondialdehyde production was depressed which is
      supposed to be connected with high copper and low triglyceride levels in the
      liver. The anaemia observed in estrogen substituted rats may be a result of lower
      lipid peroxidation rate. The levels of retinol and alkaline phosphatase activity
      in sera are probably influenced by estrogen action. It is suggested that
      testosterone leads to acceleration of lipid peroxidation.

PMID- 8464457
TI  - Microsomal alkaline phosphatase activity in retinol deficiency induced albino
      rats.
AB  - The investigations showed a significant decrease in the alkaline phosphatase
      activity of retinol deficient liver (48.6%), kidney (65.8%) and spleen (61.9%),
      as compared to the controls (100%). An increase in Vmax and Km by 12 to 51.5% and
      90.4 to 189%, respectively, was observed in all the tissues in the retinol
      deficient group, as compared to the controls. Subsequent freezing and thawing
      reduced the activity of alkaline phosphatase by 22.5 to 35.8% in the experimental
      group; whereas the reduction in the control group ranged from 8.8 to 21.5%. In
      the presence of lectins and detergents the activity of alkaline phosphatase
      decreased in both the groups to different levels.

PMID- 8464459
TI  - NIH plans to begin AIDS drug trials at earlier stage.

PMID- 8464458
TI  - Alarm, but little action, on population.

PMID- 8464460
TI  - NSF does well, NIH does not in Clinton's 1994 budget.

PMID- 8464461
TI  - OTA panel opens inquiry into patenting of genes.

PMID- 8464462
TI  - SI units explained.

PMID- 8464463
TI  - Rall's farewell to frontiers.

PMID- 8464465
TI  - Biotechnology. Adventure capital.

PMID- 8464464
TI  - AIDS. I want a new drug.

PMID- 8464466
TI  - Genentech. Clone your own legend.

PMID- 8464468
TI  - The Salk. Oxbridge-on-sea.

PMID- 8464467
TI  - San Diego. Talk of the town.

PMID- 8464469
TI  - Huntington's disease. The end of the beginning.

PMID- 8464470
TI  - Malaria. That vaccine passes a trial.

PMID- 8464471
TI  - Developmental biology. Dorian gray mice.

PMID- 8464472
TI  - Sperm costs and lifespan.

PMID- 8464473
TI  - Aluminium in Alzheimer's?

PMID- 8464474
TI  - Maker's mark.

PMID- 8464475
TI  - Agrobacterium conjugation and gene regulation by N-acyl-L-homoserine lactones.
AB  - Conjugal opines secreted by crown gall tumours induce strains of Agrobacterium
      tumefaciens that are donors of Ti plasmids to produce a diffusible conjugation
      factor. This enhances the conjugal transfer efficiency of the Ti plasmid in other
      strains of A. tumefaciens. This factor behaves as a secondary messenger,
      transmitting the environmental information to tra genes. Here we report the use
      of spectrometry to show that this factor is identical to synthetic N-(beta-oxo
      octan-1-oyl)-L-homoserine lactone and confirm that the synthetic compound is
      biologically active. N-(Hexan-1-oyl)-L-homoserine lactone has also been detected.
      A closely related molecule, N-(beta-oxo-hexan-1-oyl)-L-homoserine lactone,
      autoinduces bioluminescence in the distantly related bacterium, Vibrio fischeri.
      N-Acyl-homoserine lactones thus seem to be conserved molecules in which the
      length and nature of the lipophilic acyl chain determines the biological function
      to be regulated. Mutants that do not produce the factor fail to conjugate unless
      supplied with it in the induction medium (our unpublished data). These data
      indicate that the conjugation factor is an autoinducer and a key signal molecule
      in the conjugation system of A. tumefaciens. It is, to our knowledge, the first
      example of a second messenger molecule in a bacterial conjugation system.

PMID- 8464476
TI  - Conjugation factor of Agrobacterium tumefaciens regulates Ti plasmid transfer by
      autoinduction.
AB  - Conjugal transfer of Ti plasmids from Agrobacterium donors to bacterial
      recipients is controlled by two types of diffusible signal molecules. Induction
      is mediated by novel compounds, called opines, that are secreted by crown gall
      tumours. These neoplasias result from infection of susceptible plants by virulent
      agrobacteria. The second diffusible signal, called conjugation factor, is
      synthesized by the donor bacteria themselves. Production of this factor is
      induced by the opine. Here we show that conjugation is regulated directly by a
      transcriptional activator, TraR, which requires conjugation factor as a coinducer
      to activate tra gene expression. TraR is a homologue of LuxR, the lux gene
      activator from Vibrio fischeri which also requires an endogenously synthesized
      diffusible coinducer. The two regulatory systems are related; the two activator
      proteins show amino-acid sequence similarities and the lux system cofactor,
      autoinducer, will substitute for conjugation factor in the TraR-dependent
      activation of Ti plasmid tra genes.

PMID- 8464477
TI  - Repair of demyelinated lesions by transplantation of purified O-2A progenitor
      cells.
AB  - The transplantation of well defined populations of precursor cells offers a means
      of repairing damaged tissue and of delivering therapeutic compounds to sites of
      injury or degeneration. For example, a functional immune system can be
      reconstituted by transplantation of purified haematopoietic stem cells, and
      transplanted skeletal myoblasts and keratinocytes can participate in the
      formation of normal tissue in host animals. Cell transplantation in the central
      nervous system (CNS) has been proposed as a means of correcting neuronal
      dysfunction in diseases associated with neuronal loss; it might also rectify
      glial cell dysfunction, with transplanted oligodendrocyte precursor cells
      eventually allowing repair of demyelinating damage in the CNS. Here we use co
      operating growth factors to expand purified populations of oligodendrocyte type-2
      astrocyte (O-2A) progenitor cells for several weeks in vitro. When injected into
      demyelinating lesions in spinal cords of adult rats, created in such a way as to
      preclude host-mediated remyelination, these expanded populations are capable of
      producing extensive remyelination. In addition, transplantation of O-2A
      progenitor cells genetically modified to express the bacterial beta-galactosidase
      gene gives rise to beta-galactosidase-positive oligodendrocytes which remyelinate
      demyelinated axons within the lesion. These results offer a viable strategy for
      the manipulation of neural precursor cells which is compatible with attempts to
      repair damaged CNS tissue by precursor transplantation.

PMID- 8464478
TI  - Oncogene ect2 is related to regulators of small GTP-binding proteins.
AB  - We have developed an efficient expression cloning system that allows rapid
      isolation of complementary DNAs able to induce the transformed phenotype. We
      searched for molecules expressed in epithelial cells and possessing transforming
      potential to fibroblasts, and cloned a cDNA for the normal receptor of a growth
      factor secreted by NIH/3T3 cells. Here we report a second novel transforming
      gene, ect2. The isolated cDNA is activated by amino-terminal truncation of the
      normal product. The Ect2 protein has sequence similarity within a central core of
      255 amino acids with the products of the breakpoint cluster gene, bcr (ref. 5),
      the yeast cell cycle gene, CDC24 (ref. 6), and the dbl oncogene. Each of these
      genes encodes regulatory molecules or effectors for Rho-like small GTP-binding
      proteins. The baculovirus-expressed Ect2 protein could bind highly specifically
      to Rho and Rac proteins, whereas the dbl product showed broader binding
      specificity to Rho family proteins. Thus ect2 is a new member of an expanding
      family, whose products have transforming properties and interact with Rho-like
      proteins of the Ras superfamily.

PMID- 8464479
TI  - Erythroid transcription factor GATA-1 is abundantly transcribed in mouse testis.
AB  - The transcription factor GATA-1 is a fundamental regulator of genes in
      haematopoietic cell lineages and belongs to a family of factors that bind to the
      consensus sequence WGATAR. The GATA motif was originally identified in cis
      regulatory regions of globin and other erythroid-specific genes, but the range of
      genes controlled by the GATA factors has since expanded. Members of the GATA
      transcription factor family share a conserved zinc-finger DNA-binding domain, but
      the expression profile of each GATA factor is distinct. Here we show that a
      testis form of murine (m)GATA-1 messenger RNA is transcribed from a promoter
      located 5' to the erythroid first exon, and the remaining exons (which encode the
      mGATA-1 protein) are used in common by both testis and erythroid transcripts. We
      use an anti-mGATA-1 monoclonal antibody to show that the factor expressed in
      erythroid cells is the same as that found in the seminiferous tubules of murine
      testis. The GATA-1-expressing cells in 10-week-old testis were found only in
      contact with the basement membrane of seminiferous tubules, suggesting that GATA
      1 regulates genes during the earliest stages of spermatogenesis.

PMID- 8464481
TI  - Criteria for science in the courts.

PMID- 8464480
TI  - TFIIIC relieves repression of U6 snRNA transcription by chromatin.
AB  - The U6 small nuclear (sn)RNA gene (SNR6) from the yeast Saccharomyces cerevisiae
      is transcribed by RNA polymerase III in vivo. This gene is unusual in having a
      TATA box at position -30, and an essential B-block element located downstream of
      the T-rich termination signal. The B block is one of the two intragenic promoter
      elements of transfer RNA genes that are recognized by transcription factor
      (TF)IIIC (ref. 4). But accurate in vitro transcription of yeast U6 snRNA gene by
      PolIII in a purified system requires only TFIIIB components, including the TATA
      box binding protein TBP. Here we report that, after nucleosome reconstitution or
      chromatin assembly, U6 snRNA synthesis becomes dependent on TFIIIC and on the
      integrity of the B-block element. This observation resolves an apparent paradox
      between in vitro and in vivo results concerning the necessity of the downstream B
      block element and sheds light on a new role of TFIIIC in gene activation.

PMID- 8464483
TI  - Genome project 'to be done by 1994'.

PMID- 8464482
TI  - AIDS administrators plan crisis meeting over future of AZT.

PMID- 8464484
TI  - Patent problems.

PMID- 8464485
TI  - The shadow of genetic injustice.
AB  - The effects of the inevitable discoveries emerging from the Human Genome Project
      will be catastrophic for some. Now is the time for preventative action to be
      taken.

PMID- 8464486
TI  - Pharmacology. ET touches down in Houston.

PMID- 8464487
TI  - Albert B. Sabin (1906-1993)

PMID- 8464488
TI  - Parasitology. The evolution of virulence.

PMID- 8464489
TI  - Palaeoanthropology. Secrets of the pit of the bones.

PMID- 8464490
TI  - Properties of an HIV 'vaccine'.

PMID- 8464491
TI  - Properties of an HIV 'vaccine'.

PMID- 8464492
TI  - Largest subunit of Drosophila transcription factor IID directs assembly of a
      complex containing TBP and a coactivator.
AB  - The TFIID complex consists of the TATA-binding protein (TBP) and associated
      factors (TAFs) serving to mediate transcriptional activation by promoter-specific
      regulators. Here we report the cloning of Drosophila TAFII250 and the assembly of
      a partial complex containing recombinant TBP, TAFII110 and the C-terminal domain
      of TAFII250. This triple complex supports Sp1 activation and reveals specific
      interactions between TAFII250, TBP and TAFII110.

PMID- 8464493
TI  - Three new human skulls from the Sima de los Huesos Middle Pleistocene site in
      Sierra de Atapuerca, Spain.
AB  - Three important fossil hominids were found in July 1992 in the Middle Pleistocene
      cave site called Sima de los Huesos (Sierra de Atapuerca, Burgos, Northern
      Spain). One is a complete calvaria (cranium 4), the second a virtually complete
      cranium (cranium 5), the third represents a more fragmentary cranium of an
      immature individual (cranium 6). There is a large difference in size between the
      two adult specimens (for example endocranial volume 1,125 cm3 versus 1,390 cm3).
      The Atapuerca human remains are dated to > 300,000 years. The Atapuerca cranial
      sample fits within the 'archaic Homo sapiens' group, but is well differentiated
      from the Asian Homo erectus group. The extensive Atapuerca human collection is
      the most complete sample of Middle Pleistocene humans yet discovered from one
      site, and appears to document an early stage in Neanderthal evolution.

PMID- 8464494
TI  - Neurotoxicity of a prion protein fragment.
AB  - The cellular prion protein (PrPC) is a sialoglycoprotein of M(r) 33-35K that is
      expressed predominantly in neurons. In transmissible and genetic
      neurodegenerative disorders such as scrapie of sheep, spongiform encephalopathy
      of cattle and Creutzfeldt-Jakob or Gerstmann-Straussler-Scheinker diseases of
      humans, PrPC is converted into an altered form (termed PrPSc) which is
      distinguishable from its normal homologue by its relative resistance to protease
      digestion. PrPSc accumulates in the central nervous system of affected
      individuals, and its protease-resistant core aggregates extracellularly into
      amyloid fibrils. The process is accompanied by nerve cell loss, whose
      pathogenesis and molecular basis are not understood. We report here that neuronal
      death results from chronic exposure of primary rat hippocampal cultures to
      micromolar concentrations of a peptide corresponding to residues 106-126 of the
      amino-acid sequence deduced from human PrP complementary DNA. DNA fragmentation
      of degenerating neurons indicates that cell death occurred by apoptosis. The PrP
      peptide 106-126 has a high intrinsic ability to polymerize into amyloid-like
      fibrils in vitro. These findings indicate that cerebral accumulation of PrPSc and
      its degradation products may play a role in the nerve cell degeneration that
      occurs in prion-related encephalopathies.

PMID- 8464495
TI  - Correlation of expression of Wnt-1 in developing limbs with abnormalities in
      growth and skeletal patterning.
AB  - The Wnt genes are members of a family of vertebrate genes related to the
      Drosophila gene wingless (wg). They encode secreted molecules that are thought to
      be important in patterning and growth control during ontogenesis. Several such
      genes are transcribed in localized domains during limb budding and morphogenesis.
      We report here a congenital limb malformation in a mouse transgenic line that
      ectopically expresses Wnt-1 in the developing limbs. The hemizygote phenotype,
      which is inherited as an autosomal dominant trait, presents extensive distal
      truncations of skeletal elements, skeletal fusions and interdigital webbing. The
      data shown here demonstrate that abnormal Wnt-1 expression is correlated with
      retarded mesenchymal condensations replaced by highly proliferative cells in the
      limb bud. This seems to lead to an inability of the affected cells to participate
      in normal skeletal development leading to the adult defects.

PMID- 8464496
TI  - Interaction between a transcriptional activator and transcription factor IIB in
      vivo.
AB  - Transcription of messenger RNA-encoding genes in vitro requires many protein
      factors. Transcription factor IID, possibly with the cooperation of TFIIA, binds
      to the TATA element of the promoter, forming a complex that can bind TFIIB (refs
      6, 7) followed by RNA polymerase II (refs 6, 8) and other factors. One or more of
      these steps is thought to be facilitated by gene-specific transcriptional
      activation proteins; this seems to require TFIID-associated auxiliary factors and
      may involve direct contact between the activator and TFIID and/or TFIIB. If such
      contact is necessary in vivo, activation might conceivably be blocked by a TFIIB
      derivative containing the sequences necessary for this interaction, but lacking
      those necessary for binding to the rest of the transcriptional apparatus, an
      effect similar to that referred to as squelching or transcriptional interference.
      Here we show that the activity of the glutamine-rich fushi tarazu activation
      domain is indeed blocked by truncated TFIIB derivatives in Drosophila Schneider
      L2 cells, suggesting that it is mediated by interactions with TFIIB.

PMID- 8464497
TI  - Human lysozyme gene mutations cause hereditary systemic amyloidosis.
AB  - Hereditary non-neuropathic systemic amyloidosis (Ostertag-type) is a rare
      autosomal dominant disease in which amyloid deposition in the viscera is usually
      fatal by the fifth decade. In some families it is caused by mutations in the
      apolipoprotein AI gene but in two unrelated English families under our care the
      amyloid deposits did not contain apoAI, despite a report that this may have been
      the case in one of them. Lysozyme is a ubiquitous bacteriolytic enzyme present in
      external secretions and in polymorphs and macrophages, but its physiological role
      is not always clear. Here we report that in these two families, lysozyme is the
      amyloid fibril protein. Affected individuals are heterozygous for point mutations
      in the lysozyme gene that cause substitution of highly conserved residues, namely
      threonine for isoleucine at position 56 in one family, and histidine for aspartic
      acid at residue 67 in the other. Amyloid fibrils from one individual were
      composed of the full-length Thr-56 variant lysozyme molecule. To our knowledge,
      this is the first report of naturally occurring variants of human lysozyme and of
      lysozyme-associated disease. As the structures of human and hen egg-white
      lysozyme are known to atomic resolution and their folding and structure-function
      relationships have been exhaustively analysed, our observations should provide a
      powerful model for understanding amyloidogenesis.

PMID- 8464498
TI  - Interactions of three domains distinguishing the Ras-related GTP-binding proteins
      Ypt1 and Sec4.
AB  - The genes SEC4 and YPT1 encode Ras-related GTP-binding proteins in the yeast
      Saccharomyces cerevisiae. Ypt1 is necessary for vesicular transport from the
      endoplasmic reticulum to the Golgi, whereas Sec4 is required for fusion of post
      Golgi secretory vesicles to the plasma membrane. Recently, three structural
      domains have been proposed to specify the stage in cellular transport at which
      members of the Sec4/Ypt1/Rab family act: the effector domain, the C-terminal
      hypervariable region, and a region corresponding to loop 7 in the structure of
      p21ras (ref. 8). Here we use Sec4/Ypt1 chimaeras to show that these three regions
      cooperate to specify Ypt1 function and that the C-terminal hypervariable region
      is needed for Ypt1 localization to the Golgi. Unexpectedly, we found that a
      single chimaera can function as either Ypt1 or Sec4 without missorting
      carboxypeptidase Y or invertase.

PMID- 8464500
TI  - The Caenorhabditis elegans genome sequencing project: first steps in automation.
AB  - Novel biochemical processes using magnetic particles have been automated to
      provide a robotic system to perform processes for large-scale shotgun sequencing.

PMID- 8464499
TI  - Specificity domains distinguish the Ras-related GTPases Ypt1 and Sec4.
AB  - The essential Ras-related GTPases Ypt1 and Sec4 act at distinct stages of the
      secretion pathway in the yeast Saccharomyces cerevisiae: Ypt1 is required for
      vesicular transport from the endoplasmic reticulum to the Golgi apparatus,
      whereas Sec4 is required for fusion of secretory vesicles to the plasma membrane.
      Here we use chimaeras of the two proteins to identify a 9-residue segment of Ypt1
      that, when substituted for the analogous segment of Sec4, allows the chimaera to
      perform the minimal functions of both proteins in vivo. This segment corresponds
      to loop L7 of the p21ras crystal structure. Substitution of a 24-residue Ypt1
      segment, including the residues just mentioned, together with 12 residues of Ypt1
      corresponding to the 'effector region' of p21ras (loop L2; refs 7,8), transforms
      Sec4 into a fully functional Ypt1 protein without residual Sec4 function.

PMID- 8464501
TI  - Venter's venture.

PMID- 8464502
TI  - Vaccine compromise.

PMID- 8464503
TI  - Synergen trims sails to survive.

PMID- 8464504
TI  - Spain expands despite financial and logistical hurdles.

PMID- 8464505
TI  - Japan increases share of Human Frontier awards.

PMID- 8464506
TI  - Russian nuclear accident opens up military complex.

PMID- 8464507
TI  - NIH genome centre begins build-up.

PMID- 8464508
TI  - US test of AIDS vaccines is broadened beyond VaxSyn.

PMID- 8464509
TI  - Interferon-tau.

PMID- 8464510
TI  - Neurobiology. Organizing the cerebrum.

PMID- 8464511
TI  - Should a lion change its spots?

PMID- 8464512
TI  - A structural motif in the variant surface glycoproteins of Trypanosoma brucei.
AB  - The variable domain of the trypanosome variant surface glycoprotein (VSG) ILTat
      1.24 has been shown by X-ray crystallography to resemble closely the structures
      of VSG MITat 1.2, despite their low sequence similarity. Specific structural
      features of these VSGs, including substitution of carbohydrate for an alpha
      helix, can be found in other VSG sequences. Thus antigenic variation in
      trypanosomes is accomplished by sequence variation, not gross structural
      alteration; the extensive sequence differences among VSGs may be required for
      another reason, such as the avoidance of recognition by helper T cells.
      Additionally, VSG sequences are found to define families, within a VSG
      superfamily, which have evolved in the trypanosome genome.

PMID- 8464513
TI  - Clonal dispersion in proliferative layers of developing cerebral cortex.
AB  - In the adult cerebral cortex, many retrovirally labelled clones are widely
      dispersed, though the mechanisms of this dispersion are not well understood. Here
      we investigate the temporal sequence of clonal dispersion after labelling
      progenitors of rat cortical cells with replication-incompetent retroviruses at
      early stages of cortical neurogenesis, 14-15 days after conception (E14/15). The
      location of labelled daughter cells was determined 3, 6 or 10 days later.
      Labelled sibling cells were radially arrayed three days after infection (E18). In
      contrast, by six days after infection (E20/21), 43% of cortical clones were
      dispersed non-radially by at least 500 microns. Four of these widespread clones
      were dispersed longitudinally by > or = 2 mm, implying sustained rates of
      dispersion of > 15 microns per hour. Dispersed sibling cells occurred within
      proliferative zones of the forebrain in 35% of widely dispersed clones,
      suggesting that some dispersion reflects movement of dividing cells. Some clones
      dispersed beyond the neocortex into the olfactory bulb. Progenitor cell
      dispersion represents a previously unrecognized mode of migration by which
      sibling cells become widely dispersed in the developing forebrain.

PMID- 8464514
TI  - Dispersion of neural progenitors within the germinal zones of the forebrain.
AB  - One of the early events in the establishment of regional diversity in brain is
      the subdivision of the forebrain into the cerebral cortex and underlying basal
      ganglia. This subdivision is of special interest, owing to the striking
      difference in cellular patterning in these two regions. Whereas the dorsal aspect
      of the telencephalon gives rise to the laminar, cortical regions of brain, the
      basal aspect gives rise to nuclear, subcortical regions. To examine early events
      in the regionalization of the forebrain, we visualized cell movement within the
      ventricular zones of the dorsal and basal regions of the E15 murine
      telencephalon. Over an 8-24-hour observation period, labelled cells moved
      extensively in the plane of the cortical ventricular zone. Cell dispersion was
      restricted, however, at the border between the cortical ventricular zone and the
      lateral ganglionic eminence, the basal telencephalic ventricular zone. We suggest
      that this restriction of cell movements establishes a regional pattern of
      neurogenesis in the developing brain.

PMID- 8464515
TI  - Radial mosaicism and tangential cell dispersion both contribute to mouse
      neocortical development.
AB  - The mammalian neocortex is generated by waves of migrating cells originating from
      the ventricular zone. Radial migration along radial glia has been proposed as the
      dominant mechanism for this process. The radial unit hypothesis is poorly
      supported by retroviral lineage studies, however, and although some clones show
      limited radial organization, the emphasis appears to be on widespread tangential
      dispersion. Here we investigate the pattern of cortical cell dispersion using
      transgenic mice in which roughly half of the brain cells are coloured by a
      transgene. We find that the neocortex is randomly divided into diffused bands,
      the majority of cells within each band have the same colour, and their radial
      orientation suggests radial dispersion. Superimposed upon this was a significant
      contribution by tangentially dispersed cells that did not respect clonal borders.
      These observations indicate that cortical specification is not dependent upon a
      single mechanism of cell allocation, but that both radial mosaicism and
      tangential cell migration are involved.

PMID- 8464516
TI  - Tyrosine kinase activation through the extracellular domains of cytokine
      receptors.
AB  - Interaction of cytokines with their membrane receptors induces the proliferation
      and differentiation of a specific lineage of haematopoietic progenitors. The
      molecular mechanism of cytokine receptor-mediated signal transduction is unclear
      because these receptors do not have tyrosine kinase activity. Interleukin-3 and
      erythropoietin, however, induce transient tyrosine phosphorylation of a common
      set of proteins as a growth signal, and interleukin-2 induces phosphorylation of
      an overlapping but distinct set of proteins. Here we show that chimaeric
      receptors consisting of the extracellular domains of the erythropoietin receptor
      and the cytoplasmic domains of the interleukin-2 (or interleukin-3) receptor
      induce an erythropoietin-dependent tyrosine phosphorylation in interleukin-3
      dependent Ba/F3 cells; however, chimaeric receptors composed of the extracellular
      domains of the interleukin-2 receptor and the cytoplasmic domains of the
      erythropoietin (or interleukin-3) receptor apparently transmit an interleukin-2
      dependent signal. Our results indicate that these cytokines transmit distinct
      signals for activation of specific tyrosine kinases through the extracellular
      rather than cytoplasmic domains of the receptors.

PMID- 8464517
TI  - Budding from Golgi membranes requires the coatomer complex of non-clathrin coat
      proteins.
AB  - Do the coats on vesicles budded from the Golgi apparatus actually cause the
      budding, or do they simply coat buds (Fig. 1)? One view (the membrane-mediated
      budding hypothesis) is that budding is an intrinsic property of Golgi membranes
      not requiring extrinsic coat proteins. Assembly of coats from dispersed subunits
      is super-imposed upon the intrinsic budding process and is proposed to convert
      the tips of tubules into vesicles. The alternative view (the coat-mediated
      budding hypothesis) is that coat formation provides the essential driving force
      for budding. The membrane-mediated budding hypothesis was inspired by the
      microtubule-dependent extension of apparently uncoated, 90-nm-diameter membrane
      tubules from the Golgi apparatus and other organelles in vivo after treatment
      with brefeldin A, a drug that inhibits the assembly of coat proteins onto Golgi
      membranes. This hypothesis predicts that tubules will be extended when coat
      proteins are unavailable to convert tubule-derived membrane into vesicles. Here
      we use a cell-free system in which coated vesicles are formed from Golgi
      cisternae to show that, on the contrary, when budding diminishes as a result of
      immunodepletion of coat protein pools, tubules are not formed at the expense of
      vesicles. We conclude that coat proteins are required for budding from Golgi
      membranes.

PMID- 8464518
TI  - Defective mismatch binding and a mutator phenotype in cells tolerant to DNA
      damage.
AB  - Acquired resistance to alkylating agents such as N-methyl-N-nitrosourea or N
      methyl-N'-nitro-N-nitrosoguanidine results from the ability to tolerate the
      potentially cytotoxic methylated base O6-methylguanine (m6-G) in DNA. In the
      absence of repair by demethylation in situ, m6-G is probably lethal through its
      inappropriate processing by the cell. DNA mismatch correction is an attractive
      candidate for the processing function because although it is replicated, m6-G has
      no perfect complementary base. Thus, m6-G in DNA might provoke abortive mismatch
      repair and tolerance could subsequently arise through loss of a mismatch repair
      pathway. Mismatch correction helps maintain genomic fidelity by removing
      misincorporated bases and deaminated 5-methylcytosine from DNA, and its loss by
      mutation confers a mutator phenotype on Escherichia coli. Here we describe human
      and hamster cell lines that are tolerant to N-methyl-N-nitrosourea and are
      defective in a DNA mismatch binding activity. The loss of this activity, which
      acts on G.T mispairs, confers a mutator phenotype.

PMID- 8464519
TI  - [Selection--a key concept for the structural and functional self-organization of
      the brain?].
AB  - Starting from well-known concepts and theoretical work in biology and economics,
      the self-organization of the brain is defined as a three-fold selection process
      with three different time scales. As a morphogenetic and functional principle,
      selection operates at a phylogenetic, an ontogenetic, and a cognitive level.
      Especially the hypothesis of a fast cortical selection extends the explanatory
      power of this central biological concept to conscious higher brain functions.

PMID- 8464520
TI  - Time delay of maximal human thyroid 131I uptake after the Chernobyl accident.

PMID- 8464521
TI  - Cardiomyocytes of adult mice in long-term culture.

PMID- 8464522
TI  - [Lumbar spinal stenosis].

PMID- 8464523
TI  - [The professional secret following the patient's death].

PMID- 8464524
TI  - [Diagnosis and treatment of soft tissue sarcomas].

PMID- 8464525
TI  - [Breast cancer in pregnancy].

PMID- 8464526
TI  - [Reconstructive surgery of the head and neck region using free muscle flaps].
AB  - Twenty-seven patients who underwent microvasculosurgical free tissue transfers
      for head and neck reconstruction with a M. rectus abdominis or M. latissimus
      dorsi flap are reviewed. In this series the flap reconstruction was completed in
      15 patients with extraoral defects, in six patients with an intraoral defect and
      in six patients with a combined intra and extraoral defect. Split thickness skin
      graft coverage was used in all cases. All free muscle grafts survived and good
      take of the split skin was obtained. In extraoral defects coverage of free muscle
      transfer with split thickness skin grafts results in a better color match than
      with musculocutaneous flaps and complements the appearance and pliability of the
      free muscle flap. Reshaping and three-dimensional positioning made reconstruction
      of every intraoral defect and combined intra and extraoral defects possible. In
      skilled hands, free tissue transfer provides a reliable method for reconstruction
      of almost every defect in the head and neck.

PMID- 8464527
TI  - [Combination heart-lung transplantation in children: 4-year experience in
      London].
AB  - Since 1987, 21 children under 16 years of age have undergone combined heart and
      lung transplantation at Great Ormond Street Hospital, London. All children had
      terminal pulmonary or cardiopulmonary disease. Eight children died one day to 21
      months after operation. Actuarial survival was 76% (SEM 10) at 1 year and 60%
      (SEM 12) at 3 and 4 years after transplantation. 13 children were alive, and all
      took part in all age-appropriate activities.

PMID- 8464528
TI  - [Wishes of residents in internal medicine with relation to working week, part
      time work, career length and practice pattern].
AB  - To investigate the wishes and ideas about length of working week, part-time work,
      length of career and future kind of establishment, a questionnaire was sent to
      all Dutch registrars of internal medicine. In the opinion of more than 70 percent
      of the registrars, the length of a full-time working week of an internist should
      be less than 50 hours. Of all registrars (62% men and 38% women), 68% would
      decide in favour of part-time work if the length of a full-time working week of
      an internist were to remain at about 68 hours (common length of a working week of
      Dutch internists nowadays). 33% would still like to work part-time when the
      length of a full-time working week became as they desired (about 47 hours). The
      preferred length of their career was for most registrars less than 30 years. The
      majority preferred a tenure to a position in a partnership. In conclusion, the
      wishes about the future of the registrars of internal medicine differ markedly
      from the current situation.

PMID- 8464529
TI  - [Perinatal asphyxia and postpartum resuscitation: starting always, but when to
      stop?].

PMID- 8464530
TI  - [Menstruation pattern and month of birth].

PMID- 8464531
TI  - [Menstruation pattern and month of birth].

PMID- 8464532
TI  - [Lupus erythematosus; current treatment methods].

PMID- 8464533
TI  - Special issue dedicated to Dr. Paul Greengard.

PMID- 8464534
TI  - Brain dopamine receptors: 20 years of progress.
AB  - I present a brief overview of the contributions of Paul Greengard's laboratory to
      the field of dopamine receptor research. I show that the work on the biochemical
      pharmacology of dopamine receptors was part of the intellectual foundation for
      the division of dopamine receptors into two general pharmacological categories.

PMID- 8464535
TI  - Neuronal localization of the tyrosine-specific protein kinase p62c-yes in rat
      basal ganglia.
AB  - The cellular localization of the tyrosine-specific protein kinase p62c-yes, the
      product of the proto-oncogene c-yes, has been examined in the striatonigral
      neurons which interconnect the rat neostriatum and substantia nigra. Although
      p62c-yes was more enriched in the neostriatum than in the substantia nigra,
      excitotoxin-induced necrosis of nerve cells in the neostriatum led to 50-60%
      decreases of p62c-yes both in the lesioned neostriatum and in the ipsilateral
      substantia nigra. Hence, the p62c-yes tyrosine kinase is present both in the cell
      body region and in the axonal and nerve terminal region of the striatonigral
      neurons. This localization indicates that the enzyme may be involved in both
      presynaptic and postsynaptic functions in mammalian forebrain neurons.

PMID- 8464536
TI  - Biogenesis of small synaptic vesicles and synaptic-like microvesicles.

PMID- 8464538
TI  - Neuropeptides: Function and Pharmacology. 3rd meeting of the European
      Neuropeptide Club. Cambridge, United Kingdom, 5-7 April 1993. Abstracts.

PMID- 8464539
TI  - The restoration of the function of the hypophyseal-gonadal system following its
      prolonged suppression by luliberin agonists.

PMID- 8464537
TI  - Kinetic properties of bovine brain protein L-isoaspartyl methyltransferase
      determined using a synthetic isoaspartyl peptide substrate.
AB  - Protein L-isoaspartyl methyltransferase, an enzyme enriched in brain, is
      implicated in the repair of age-damaged proteins containing atypical, isoaspartyl
      peptide bonds. We have investigated the kinetics of methylation using a synthetic
      peptide substrate having the structure Trp-Ala-Gly-Gly-isoAsp-Ala-Ser-Gly-Glu.
      Double-reciprocal plots of initial velocity versus concentration of S
      adenosylmethionine (AdoMet) at different fixed concentrations of peptide gave
      straight lines converging at a positive 1/v value and a negative 1/AdoMet value.
      The product S-adenosylhomocysteine (AdoHcy) was a competitive inhibitor towards
      AdoMet and a linear mixed-type inhibitor towards peptide. These results are
      consistent with the rapid-equilibrium random sequential bi-bi mechanism
      previously proposed for the enzyme, but they also reveal the formation of the
      dead-end, enzyme-peptide-AdoHcy, complex. The rate constants were: Vmax = 32-34
      nmol/min/mg, Kpeptide = 7.6-9.4 microM, KAdoMet = 1.9-2.2 microM, alpha = 0.43
      0.53, KAdoHcy = 0.08 microM, gamma = 2.9. The interaction factors alpha and gamma
      indicate that binding of enzyme to peptide increases its affinity for AdoMet and
      decreases its affinity for AdoHcy. Methylation was linear with time throughout
      the transfer of 2 mol of methyl groups/mol of enzyme. This absence of burst
      kinetics suggests that slow release of products cannot explain the low turnover
      number.

PMID- 8464540
TI  - An investigation of the topographic organization of cortical electrical activity
      during hypnotic analgesia.

PMID- 8464541
TI  - Neuronal analysis of hunting behavior of the pteropod mollusc Clione limacina.
AB  - The neurons of the cerebral ganglia controlling the movements of the hunting
      apparatus of the predatory pelagic pteropod mollusc, Clione limacina, are
      described in detail. A large group of high-threshold, electrically interconnected
      neurons, A, was identified, the impulse activity of which leads to the opening of
      the skin folds and the forward ejection of the hunting tentacles of the clione.
      Group B neurons which exhibit a constant background activity and which receive
      powerful inhibitory inputs from the A cells, conversely, induce the contraction
      and the withdrawal of the hunting tentacles into the head. The third group, are
      the C neurons, the impulse activity of which leads to the drawing together of the
      skin folds covering the hunting apparatus. The effect of such mediators as
      serotonin, dopamine, and gamma aminobutyric acid acid on the identified neurons
      was investigated. Serotonin depolarizes both A and B neurons, but the activation
      of the hunting apparatus appears to be an integrated effect: the activated A
      neurons inhibit the B neurons due to powerful IPSP, interrupting the direct
      excitatory effect of serotonin. Dopamine in various concentrations exerts the
      opposite effect: at low concentrations only B cells are activated and the
      tentacles are withdrawn into the head; at high concentrations the A neurons begin
      to operate; these neurons inhibit the B cells and activate the hunting apparatus.
      GABA exerts an integral, well-coordinated effect on the neurons controlling the
      movements of the hunting apparatus, and effect which is directed toward the
      activation of hunting behavior: it depolarizes-activates A neurons and
      hyperpolarizes-inhibits B and C neurons.

PMID- 8464542
TI  - The role of the specific and nonspecific afferent systems in the mechanism of
      changes in evoked cortical responses in the presence of vibration.
AB  - The interrelationship of the activity of specific and nonspecific afferent
      systems in the mechanism of changes in the electrical activity of the cortex
      under the influence of vibration was studied under chronic experimental
      conditions. The character of the postvibrational shifts in the vestibulo- and
      reticulocortical evoked responses in the presence of the isolated and combined
      disengagement of the specific (vestibular) and nonspecific afferent systems of
      the brain was investigated. It was established that vestibular afferentation
      plays a significant role in the mechanism of postvibrational shifts in the
      vestibulocortical evoked responses, whereas nonspecific, as well as
      proprioceptive, somatic, and visceral as well as other inputs play the dominant
      role for the reticulocortical system of integration.

PMID- 8464543
TI  - The chemical nature of the hypothalamocortical activation underlying drinking
      behavior.
AB  - The injection of cholinergic substances (carbocholine, carbathin [karbatin],
      acetylcholine) into the lateral field of the hypothalamus of cats is accompanied
      by the appearance in the electrohypothalamogram of characteristic
      hypersynchronized activity and drinking behavior. The swallowing of water
      temporarily stops the hypersynchronized activity; the injection of adrenaline
      into the hypothalamus elicits the same effect. The injection of the same
      cholinergic preparations into the posterior sigmoid gyrus of the cerebral cortex
      is accompanied by similar, but less pronounced bioelectrical and behavioral
      effects. The presentation of a closed drink dispenser containing water to the
      animals against the background of cholinergic activation of the hypothalamus or
      cortex leads to desynchronization of the bioelectrical activity and suppression
      of the bursts of hypersynchronized activity. The drinking behavior of cats which
      appears on the basis of centrally created thirst motivation reflects the activity
      of a primary dominant focus in the hypothalamus and of a secondary dominant focus
      in the sensorimotor cortex. These foci are cholinergic in nature. The cessation
      of the drinking behavior may be related to the activation of adrenergic
      mechanisms of the same brain structures.

PMID- 8464544
TI  - The features of the influence of "reward areas" on the electrical activity of the
      parafascicular complex of nuclei in the developing rabbit.
AB  - The influence of the electrostimulation of "reward areas", preliminarily
      identified by the self-stimulation technique, on the evoked potentials recorded
      in the parafascicular complex of the thalamus in response to peripheral
      nociceptive stimulation was studied in 35 rabbits, of 41-60 days of life. When
      comparison was made of the data obtained with the results of studies carried out
      previously in adult animals and in rabbits from the 30th-40th days, in addition
      to common characteristics, features of these influences which were
      characteristics only for the age interval under investigation were distinguished.
      The antinociceptive influences of the "reward areas" on the evoked potentials in
      the parafascicular complex were less pronounced with respect to a number of
      parameters in the period of the rabbits life occupying the intermediate position
      between the over-excitable and adult periods of development.

PMID- 8464545
TI  - Specific features of the electroretinogram of vertebrates induced by X-rays.
AB  - The net electroretinograms of dark-adapted retinas of the common frog in situ
      were investigated on an automated experimental system with programmed control and
      electronic differentiation of biopotentials with respect to the first and second
      derivatives. It was demonstrated that X-rays elicit an electroretinogram
      consisting of two components, provisionally called the first and second X-ray
      reactions (X-1 and X-2), which differ with respect to their parameters from
      electroretinograms elicited under the same conditions by red and blue light. The
      administration of sodium azide, sodium nitrate, monoiodo-acetate and other
      substances alter the X-1 and X-2 as well as the photo-induced ERGs in different
      ways; this indicates their relative independence and different mechanisms of the
      occurrence and passing of excitation across the structures of the retina, and
      makes it possible to partially isolate these for individual study. Thus, the
      assertion of a number of investigators regarding the absence of specific features
      in the X-ray induced electroretinograms becomes problematical. The discovery of X
      ray-specific reactions in the retina makes it possible to hope that the
      radiological phosphene (the X-ray phosphene) may serve as a test for the
      determination of the individual radiational excitability of the central nervous
      system.

PMID- 8464546
TI  - The influence of picrotoxin on the methylation of phospholipids of the olfactory
      cortex of the brain of rats.
AB  - It was demonstrated that a decrease in the intensity of methylation of
      phosphatidylethanolamine in sections of rat olfactory cortex is observed 15 min
      following the introduction of picrotoxin (10(-5) M) into the incubation medium.
      The decrease in the intensity of methylation of phospholipids may be closely
      linked to the opening of ion channels, since it is known that maximal
      depolarization of the membranes is observed during this period of the effect of
      the preparation.

PMID- 8464547
TI  - Cyclical processes in neuronal populations of the cat somatosensory cortex during
      extero- and interoceptive activation and in the course of its extinction.
AB  - The EEG reactions were recorded in chronic experiments in awake cats and the slow
      periodic changes in the frequency of the multicellular impulse activity were
      observed at points (standard localization) of the somatosensory (1) zone of the
      cortex. Results of the analysis of both processes were combined in graphs in a
      single time scale. The correlation of the expressivity of the activation reaction
      and degree of modulation of the cyclical fluctuations of the frequency of the
      impulse activity were followed both during the action of exteroceptive
      (conditional, light; unconditional, sound) and the interoceptive (mechanical and
      chemical) stimuli. A particular characteristic of the interoceptive stimulation
      as compared with the exteroceptive consisted in the inertia of the respondent
      reaction and the lesser contrast in relation to the background. During the
      extinction of the responses the decrease in the activation reaction correlated
      with a decrease in the initial (after the switching on of the stimulus)
      fluctuation of the frequency of the multicellular impulse activity. The data
      obtained serves as proof of the unity of the two processes: the regulation of the
      activation of the brain and the regulation of the periodicity of the neuronal
      impulse activity.

PMID- 8464549
TI  - The epidemiology of congenital abnormalities of the central nervous system in
      children.

PMID- 8464548
TI  - The effectiveness of amiridin in senile dementia of the Alzheimer's type.

PMID- 8464551
TI  - American Academy of Neurology 45th annual meeting New York, New York, April 25
      May 1, 1993. Abstracts.

PMID- 8464550
TI  - Postural motoric and cognitive functions in children with dyspraxia.

PMID- 8464552
TI  - [Hemodynamic changes in liver and multi-organ transplantation].
AB  - Multivisceral transplantation is a surgical technique developed as treatment for
      abdominal metastatic and/or multifocal malignancies. At present its clinical
      employment is reduced by our fragmentary knowledge of the intraoperative and
      postoperative outcome. The aim of this study is to compare intraoperative
      hemodynamic and respiratory changes during multivisceral transplantation (MTV, n
      = 12) and liver transplantation (OLTX, n = 14). The observations have been
      carried out a 4 phases: basal (I), visceral (II), reperfusion (III), final (IV).
      Phase I does not show differences between MTV and OLTX. In phase II MTV presents
      a lower temperature (T) and pulmonary arterial pressure (PAP) (p > 0.05). Phase
      III is marked by increasing T differences (p < 0.05), lower cardiac frequency
      (CF), pH and base excess (BE) (p < 0.05). PAP and cardiac output (CO) show a
      higher value in MTV (p < 0.05). Phase IV reports the vital signs close to
      normality in both groups, except pH in MTV (p > 0.05).

PMID- 8464553
TI  - [Liver injury in abdominal trauma. Review of the literature and personal
      observations].
AB  - In patients who suffered abdominal trauma, the liver is the most frequently
      involved organ, except the spleen. The % rises from 1520% to 30% if trauma is
      closed or open. Liver injury may spread from a simple parenchymal contusion to a
      break in vessels or biliary ducts. Life risk is related to hemorrhage. The
      mortality is due to: 1) extension of the injured liver surface, 2) possible
      damage to big vessels, 3) intra or extra abdominal associated injury in case of
      multiple trauma. It is important to known the kind of injury to choose the best
      therapy, not necessary surgical. The authors report on 15 patients with
      thoracoabdominal trauma and liver damage, comparing their cases with literature
      observations.

PMID- 8464554
TI  - [Pneumoperitoneum in preparation for surgery of large ventral hernia].
AB  - Reparative surgery of ventral hernia may be relatively simple or, on the other
      hand, the surgeon may be confronted with a number of tactical and technical
      problems. Many of these are caused by the "loss of the right of domicile". In
      order to avoid this particular condition it is useful to resort to preoperative
      pneumoperitoneum. This method entails the gradual and progressive introduction of
      air into the peritoneal cavity. In this way abdominal capacity is increased and
      it is therefore possible to re-insert all the viscera into their natural cavities
      avoiding all the harmful consequences for respiratory and cardio-circulatory
      organs following forced replacement. Preoperative pneumo-peritoneum is a
      relatively well consolidated surgical technique in large scale eventration. The
      methods is simple to perform and has a low incidence of complications.

PMID- 8464556
TI  - [Excisional and reconstructive treatment of stage IV tumors in the oral cavity.
      Results and limits].
AB  - The patients with advanced stages of intraoral cancer, having a limited life
      expectancy, are often considered non-surgical cases. Radiochemotherapy does not
      warrant an acceptable quality of life. The authors analysed the data obtained
      from their experiences in resections that had been extensive, as well as,
      reconstructive treatment of these kinds of neoplasms. They tried to evaluate the
      demolitive and reconstructive approach, in terms of morbidity, functional results
      and survival rate. Thirty-six patients, treated from January 1990 to August 1991
      for advanced intraoral cancer, were considered in this study; 58% of the cases
      had primary tumors and 42% had recurrences. The reconstructive procedure used in
      all cases, was the pectoralis major myocutaneous flap. Even though the expected
      oncological results had been poor, the functional ones, had been quite
      encouraging. In fact, the assessment of speech and swallowing was extremely
      satisfactory, respectively in 82% and 89% of cases. The morbidity related to the
      flap procedure had been low. The quality of the residual life of the patients was
      good, especially if compared with the life of those patients who had not been
      treated. In conclusion, the authors maintain that even patients with limited
      prognosis may be considered as potential candidates for demolitive and
      reconstructive treatment.

PMID- 8464555
TI  - [Osteosarcoma of the extremities metastatic at presentation. Results obtained
      with primary chemotherapy followed by simultaneous resection of the primary and
      metastatic lesion].
AB  - From September 1986 to September 1990 35 patients affected by osteosarcoma of the
      extremities with synchronous metastasis were treated with two cycles of high-dose
      methotrexate IV, cisplatin IA and adriamycin IV followed, in 22, by simultaneous
      resection of the primary and metastatic tumor. Six patients progressed and were
      not operated on, 7 patients with complete response of pulmonary nodules underwent
      surgical resection of the primary lesion. A complete histological examination of
      the resected specimens was always performed to evaluate the percentage of
      necrosis produced by chemotherapy on both the primary and metastatic tumor. After
      surgery the patients received 3 more cycles of the same drugs as used
      preoperatively plus ifosfamide. The histological response of the primary tumour
      was "good" (90% or more tumour necrosis) in 8 patients (27%) and "poor" (less
      than 90% of tumour necrosis) in 21 (73%) while in the 75 metastatic nodules the
      resulting necrosis was good in 18 (24%) and poor in 57 (74%). A good correlation
      between the histological response in the primary and metastatic tumour was
      observed. At an average follow-up of 30 months (R 12-60), 13 patients are alive,
      10 disease-free, and 3 with uncontrolled disease. This data suggest that
      prognosis of osteosarcoma of the extremities with synchronous metastases remains
      poor even with a very aggressive treatment. Our results also seem to confirm the
      validity of the present strategy in the treatment of non metastatic osteosarcoma:
      to introduce new drugs postoperatively in patients poor responder can allows a
      better treatment of microscopic disease and can improve the prognosis for these
      patients.

PMID- 8464557
TI  - [Surgical treatment of neoplasms of the lip].
AB  - The authors examine the surgical treatment of lip cancer and describe the
      reconstructive techniques used for various tumour localisation and extensions. In
      addition, they illustrate the current opinions regarding the treatment of
      satellite lymph node areas.

PMID- 8464558
TI  - [The Senning procedure in Budd-Chiari syndrome associated with complete portal
      vein thrombosis].
AB  - The authors report their experience of one case of Budd-Chiari syndrome with
      total thrombosis of the portal vein. The patient was undergoing hepatico-atrial
      anastomosis with Senning's procedure. The original technique utilised
      extracorporeal circulation with hypothermia; the authors utilised venovenous
      bypass from femoral vein to axillary vein. Anastomosis function is proved with
      nuclear magnetic resonance and echo-Doppler on year after operation. Senning's
      procedure is feasible in the case of Budd-Chiari syndrome with total portal
      thrombosis with venovenous bypass without extracorporeal circulation with
      hypothermia.

PMID- 8464559
TI  - [Primary stones of the common bile duct].
AB  - Primary stones can probably form, although rarely, in the common bile duct. The
      authors report a series of six cases which they considered as primary common duct
      stone disease and, in order to get more precise information on this problem, they
      review the literature on the subject. This disease would be caused by the
      presence of a lithogenic bile which, with a chronic obstruction of the Vater's
      ampulla, could let lithiasic particles accumulate in the common bile duct. On the
      basis of this hypothesis and in order to perform a correct procedure that allows
      easy drainage of the bile to the intestine to the chronic use of litholytic
      drugs.

PMID- 8464560
TI  - [Malignant schwannoma of the omentum. Considerations in a clinical case].
AB  - Authors describe a rare case of malignant schwannoma of the omentum. The
      diagnosis of schwannomas is often late because of the absence of early clinical
      signs. Clinical, diagnostic and histopathological considerations of these
      neoplasias are described in this work.

PMID- 8464561
TI  - [Rheologic features of erythrocytes in beta-thalassemia minor].
AB  - The study assessed the physical characteristics of erythrocytes, viscosity and
      deformability, measured by a widely described double-filtration method. At the
      same plasma-cell viscosity was measured and the importance of the rigidity of RBC
      was evaluated as one of the many forces which interact among the cells and
      between the plasma and cells. The results showed a marked increase in corpuscular
      viscosity with reduced deformability, and a significant diminution of plasma
      erythrocytic viscosity, whereas total viscosity remained unaltered. These
      parameters do not correlate with the quantitative pathological alterations of
      HbA2, but only with RDW-SD. Alterations of the proteic components with a relative
      increase in the alpha-chains of the erythrocytic membrane are thought to be
      responsible for these anomalies, by means af the modifications that the excess of
      alpha-globin causes to the structure and function of erythrocytic membrane; but
      the quantity of globin is not the decisive factor, and in fact the introduction
      of the beta-chains are able to correct erythrocytic deformability (Sorensen).
      Membrane rigidity is probably independent and unrelated to microcytemia, because
      these erythrocytes, have an excess of surface in relation to their volume, due to
      the simultaneous alteration of permeability. The diminished plasma-erythrocytic
      viscosity should be connected with the prevalence of repulsing forces, due to
      erythrocytic rigidity in relation to the attracting forces due to the proteic
      fractions which remain unchanged.

PMID- 8464562
TI  - [Activated partial thromboplastin time. Evaluation of sensitivity and validity
      for determination of factor VIII coagulant activity].
AB  - The authors evaluate the sensibility and validity of some reagents for activated
      partial thromboplastin time during construction of a curve for measurement of
      factor VIII coagulant activity. For every reagent three clotting factor VIII
      deficient plasmas have been used; Baldacci, Dade and Behering. Significant
      differences in results between every reagent for aPTT and laboratory have been
      observed. By these results the Authors show the best reagent for aPTT. Future
      fields of research have been analyzed.

PMID- 8464563
TI  - [Peptic activity of gastric juice in chronic gastritis. Morpho-functional
      aspects].
AB  - The aim of this study has been to evaluate peptic activity in gastric juice and
      gastric peptic cell mass in chronic gastritis. As regard peptic activity, there
      is a close correlation between it and the peptic gastric cell mass considered
      globally and expressed as Peptic Gastric Index (PGI), resulting from the
      individual average between fundic peptic index (chief cells + fundic muco-peptic
      cells) and antral peptic index (antral muco-peptic cells), both obtained by
      multiplying the number of peptic cells per mm2 by the thickness of respectively
      fundic and antral gland layer). In particular fundic and antral superficiale
      gastritis does not involve changes in peptic activity in gastric juice. On the
      contrary, in case of fundic pre-atrophic or atrophic there is a significant drop
      of peptic activity in gastric juice, regardless of the histological condition of
      the antrum. The lowest value of peptic activity may be noticed in case of
      atrophic pan-gastritis. Pre-atrophic and atrophic gastritis limited to the antrum
      -with superficial fundic gastritis--does not involve significant decreases of
      peptic activity in gastric juice. In this experiences Helicobacter pylori seem to
      influence peptic secretion: in fact, there is an increases of peptic activity in
      gastric juice in case of chronic pre-atrophic gastritis HP+.

PMID- 8464564
TI  - [Local immune response in neurofibromatosis type 1 and type 2].
AB  - Neurofibromatosis, in all its variant forms, is a hereditary disease
      characterized by dysplasia, neoplasia, and the tendency to expand and undergo
      malignant transformation. We underline the presence of chronic inflammation and
      of immunologic interdependency. The immune reactions against the non-self have
      been investigated histologically in light of the concepts of immunosurveillance
      and immunotolerance. Such investigations would ameliorate subsequent studies and
      favour the employment of immunomodulatory treatments.

PMID- 8464565
TI  - [Blood zinc levels in patients with dermatologic and neurologic disorders].
AB  - Plasma zinc levels in patients of both sexes suffering from an heterogeneous
      group of dermopathies were examined and compared with those in patients suffering
      from psychiatric-neurologic pathologies, in which recent literature has also
      suggested the role of low zinc levels. The results of the study show a prevalence
      of effective zinc deficiency in 9.2% of dermatologic patients and 3.9% of
      neurologic patients, as well as low plasma zinc levels with a different mean,
      mode and s.d. in comparison to other patients in the control group. These results
      were statistically significant. The findings are discussed and compared with
      those reported in the literature.

PMID- 8464566
TI  - [Electrophysiologic diagnosis of carpal tunnel syndrome in patients with diabetes
      mellitus].
AB  - The authors evaluated 406 patients affected by carpal tunnel syndrome diagnosed
      by clinical and electromyographic data. Diabetes mellitus was recognized in 57
      subjects. The others constituted the control group. The severity of the syndrome
      was similar in both groups. Also similar was the interval between onset and
      clinical diagnosis. Such parameters and the severity of the syndrome showed no
      modification with age in the diabetic group. In the control group, carpal tunnel
      syndrome was more pronounced in the aged patients, presumably for the longest
      latency of disease. Carpal tunnel syndrome onset was later in diabetic subjects
      compared the control. At lastly we found a prevalence of bilaterality in
      diabetics, and an M/F rate comparable in both groups, as described by other
      authors.

PMID- 8464567
TI  - [Preliminary results of a bacteriologic and immunologic study in patients
      subjected to colorectal surgery].
AB  - This study examines patients undergoing colorectal surgery for carcinoma,
      bacteriological data in faecal and systemic immunological data; these patients
      before surgery received short-term chemoprophylaxis with ceftriaxone (2 g e.v.)
      and thymopentina (1 phial/day for 15 days) and after surgery thymopentina (1
      phial for three time a week). With these data the authors try to create
      immunomodulation and antibiotic chemoprophylaxis protocol for the reduction of
      the septic complications due to intestinal bacterial flora and immunological
      defence reduction.

PMID- 8464568
TI  - [Personal experience in the treatment of esophago-cardial stenosis with the Nd
      YAG laser].
AB  - The authors analyze the results of treatment, by Nd-YAG laser. of benign and
      malignant esophageal and cardial stenoses. Particularly the personal technique,
      immediate and late complications and association with complementary techniques
      such as dilatation or intratumoral injection of polidocanol are evaluated.

PMID- 8464569
TI  - [Ruggero Oddi and the discovery of the common bile duct sphincter].
AB  - The author gives some information about life in Perugia in the years 1883-87,
      when Ruggero Oddi was a medical student at the "Libera Universita" of Perugia.
      Moreover the author gives notes about the Hospital and the University in those
      years with special reference to the situation of the Department of Physiology
      where the discovery of the sphincter of the common bile duct took place. Then,
      the author reports the most peculiar facts of Ruggero Oddi's life in a
      chronological way and finally, he deals with the history of Oddi's discovery of
      the sphincter of the common bile duct, when he was a student in the fourth year
      at the "Facolta di Medicina e Chirurgia" in Perugia.

PMID- 8464570
TI  - [Syndrome X and surgical stress. A clinical case].
AB  - The syndrome X is a clinical disease characterised by anginous pain with the
      absence of significant and angiographically visible stenosis of the coronary
      tree. D. P. M., a 61-year-old woman suffering from biliary lithiasis, underwent
      cholecystectomy. During the immediate postoperative period, the patient showed
      difficulty in regaining consciousness and there were electrocardiographic signs
      of extensive anterior ischemia; prior to the operation only a 1st degree atrio
      ventricular block and a positive history of occasional precordial pain had been
      reported. On the 2nd postoperative day the patient complained of violent
      retrosternal pain irradiated to the left shoulder. Given that the signs of
      ischemia had regressed, various instrumental tests were performed:
      echocardiogram, cycloergometric test, dipyridamole test, cold pressure test,
      Holter's dynamic ECG, all of which were within the normal; moreover, selective
      coronarography did not reveal significant stenosis of the coronary tree. The
      patient was therefore diagnosed as suffering from syndrome X. In the light of the
      present case, the authors conclusion may be summarised as follows: the diagnosis
      of syndrome X, which is by definition not easy, may sometimes become critical, as
      in the present case, since rapid intervention would have enabled prophylactic
      therapy to be performed to combat surgical stress.

PMID- 8464571
TI  - [Neurological complications in hyperparathyroidism].
AB  - The paper describes the clinico-instrumental diagnostic iter in a 57-year-old
      patient with amyotrophy of the pelvic and pectoral girdles and of the roots of
      the limbs, with lively and symmetric R.O.T., and without fasciculation, feeling
      deficit, bulbar involvement and pathological reflexes; EMG was probative for the
      neurogenic involvement of all four limbs, whereas muscular enzymes were normal.
      Laboratory controls showed primary hyperparathyroidism caused by a single
      operated parathyroid adenoma; other test enabled multiple endocrine adenomatosis
      to be excluded. The paper discusses the involvement of the nervous system during
      hyperparathyroidism paying special attention to spinal amyotrophy.

PMID- 8464572
TI  - Past, present, and future of psychiatry in New Jersey.
AB  - Society faces moral and practical choices of treatment for mental illness:
      warehousing, neglect, or appropriate treatment. Mental and physical health care
      must be available to all Americans. There must be a balance between cost
      containment and patient needs.

PMID- 8464573
TI  - Psychiatry in the 21st century: evolving diagnostic and therapeutic strategies.
AB  - Psychiatry has advanced rapidly in the past two decades, with many exciting new
      developments on the horizon. Today, psychiatry offers more precise diagnoses and
      an extensive range of effective treatment options. Newer treatment approaches
      focus on all aspects of psychiatric illness.

PMID- 8464574
TI  - The psychiatric aspects of HIV/AIDS.
AB  - The human immunodeficiency virus (HIV) that causes acquired immunodeficiency
      syndrome (AIDS) induces a multiplicity of neuropsychiatric symptoms. While some
      symptoms manifest before acquisition of infection, others become apparent after
      acquisition of infection.

PMID- 8464575
TI  - Somatoform disorders: diagnosis and treatment.
AB  - Somatoform disorders are a group of syndromes in which patients focus on and
      complain of physical symptoms when there is no demonstrable underlying organic
      pathology or when complaints are in excess of what is expected. Medical and
      psychiatric physicians must seek better treatment and diagnosis.

PMID- 8464576
TI  - Mood disorders: diagnosis and treatment in the 1990s.
AB  - We all experience fluctuations in mood. There are some persons who experience
      severe, persistent, or cyclical changes of mood. When this interferes with
      functioning, it may be a manifestation of those psychiatric illnesses known as
      mood disorders.

PMID- 8464577
TI  - Anxiety disorders in the general practice.
AB  - The author reviews the concept of anxiety and the diagnosis and treatment of
      panic disorder, generalized anxiety disorder, obsessive-compulsive disorder,
      social phobia, and post-traumatic stress disorder. The psychiatrist and primary
      care practitioner can collaborate for the patient's benefit.

PMID- 8464578
TI  - Differential diagnosis and management of suicidal behavior.
AB  - Suicidal behavior, like fever and headache, has a differential diagnosis. The
      physician, confronted with a patient who is suicidal, must identify the etiology
      of the self-destructive behavior and provide diagnostic-specific treatment.
      Suicide, in most instances, is a preventable cause of death.

PMID- 8464579
TI  - What to expect from a psychiatric consultation.
AB  - The authors present guidelines for psychiatric consultations. The authors
      emphasize the need for specifics in presenting reasons for psychiatric
      consultation and/or referral to consultants, and the need for responsive
      consultation and communication.

PMID- 8464580
TI  - Frontiers in biological psychiatry: new drug development.
AB  - This past decade has been a fertile time for new drug developments for the
      central nervous system. This article discusses cutting edge treatments for
      depression, anxiety, and psychosis. Some of these medications now are approved;
      many still are being researched.

PMID- 8464581
TI  - State HIV-positive physician policy.

PMID- 8464582
TI  - Detection of contralateral breast cancer by mammography in women with previous
      breast cancer and the impact of endocrine therapy.
AB  - AIMS: To determine the efficacy and extent of screening mammography for detection
      of contralateral breast cancer in a cohort of women with previous unilateral
      mammary carcinoma, and to assess the effect of endocrine therapy on the risk of
      developing cancer in the contralateral breast. METHODS: Women with previous
      breast cancer eligible for mammography were identified from the Auckland breast
      cancer data file and the extent and outcome of mammographic screening determined
      by questionnaire and survey of mammography reports. The extent of adjuvant
      hormonal therapy and development of contralateral breast cancer was ascertained
      from the ABCDF records. RESULTS: Of 703 eligible subjects, 59% had undergone
      screening mammography with a cancer detection rate of 17 per 1000 mammograms and
      a benign to malignant ratio was 1.7 to 1. Contralateral breast cancer developed
      in 2.9% of 1980 women with previous unilateral mammary tumours who did not
      receive endocrine therapy with 1.1% of 374 women who were given adjuvant hormonal
      treatment (p = 0.04). CONCLUSIONS: The efficacy of mammography in those screened
      was comparable to major overseas screening programs, but the proportion of women
      undergoing mammography in this high risk group was relatively low suggesting a
      need for greater promotion of mammography in Auckland. The use of adjuvant
      endocrine therapy significantly reduced the rate of development of contralateral
      breast tumours supporting the current development of formal trials of
      chemoprevention of breast cancer in women at high risk groups of the disorder.

PMID- 8464583
TI  - Transport and public health.

PMID- 8464584
TI  - Clinical features of individuals with cystic fibrosis in New Zealand.
AB  - AIMS: To determine the status of cystic fibrosis patients, their mode of
      diagnosis and source of medical care in New Zealand. METHODS: A database was
      established in 1988 to record clinical information on individuals with cystic
      fibrosis in New Zealand. Three hundred and two cystic fibrosis patients were
      identified and clinical information on 248 obtained. RESULTS: Thirty five per
      cent of patients at diagnosis had gastrointestinal and pulmonary and 33% had
      gastrointestinal symptoms alone. Ninety three infants were diagnosed after a
      positive screening test and confirmatory sweat test. The mean age at diagnosis
      overall was 1.8 years, while 61% of children were diagnosed before one year of
      age. 74.2% of patients were said to be pancreatic insufficient, 4% pancreatic
      sufficient and in 22% the results were unavailable or unknown. Medical care was
      provided by 28 sources comprising paediatricians, physicians or combined clinics.
      One cystic fibrosis clinic cared for more than 40 patients. Sixty-one per cent of
      cystic fibrosis subjects were colonised with Staphylococcus aureus at some time,
      and 44% were reported to be colonised with Pseudomonas aeruginosa. CONCLUSIONS:
      Common clinical features of cystic fibrosis have been characterised for New
      Zealand patients. It is unknown to what extent the clinical features of the
      disease and source of medical care in New Zealand are responsible for previously
      reported survival for the condition but it is planned to examine serial
      measurements of growth, nutrition, pulmonary function and survival and it is
      hoped that these measurements will be the subject of a further report.

PMID- 8464585
TI  - Renal artery stenosis as a cause of heavy albuminuria.
AB  - We report three cases of heavy albuminuria occurring in hypertensive patients
      with unilateral or bilateral renal artery stenosis. In two of the patients the
      albuminuria and hypertension were corrected by removing the ischaemic kidney. The
      mechanism of the albuminuria, particularly in atheromatous renal artery stenosis,
      is probably multifactorial.

PMID- 8464586
TI  - Percutaneous aortic valvuloplasty for aortic stenosis in the elderly.

PMID- 8464587
TI  - Extracorporeal lung support: an advance in treatment of severe lung disease.

PMID- 8464588
TI  - Noninsulin dependent diabetes mellitus.

PMID- 8464589
TI  - Breast cancer and the role of a specialist nurse.

PMID- 8464590
TI  - ACC assessment for lump sum payment.

PMID- 8464591
TI  - Tobacco smoking.

PMID- 8464592
TI  - Tuberculosis in Northland.

PMID- 8464594
TI  - Turner's syndrome.

PMID- 8464593
TI  - Activity of cefpodoxime, an oral 3rd generation cephalosporin.

PMID- 8464595
TI  - Human factors analysis useful for process safety management.

PMID- 8464596
TI  - Blended east-west medical theories, treatment methods gain acceptance.

PMID- 8464597
TI  - Industry profile: chemical. A focus on quality prevents worker injury. Interview
      by Elizabeth Juden Christy.

PMID- 8464598
TI  - DOT hazmat training rules emphasize employee safety.

PMID- 8464599
TI  - Proper oxygen use can help save lives in initial medical emergency response.
AB  - For many people who deal with medical emergencies--some human resource managers,
      emergency team administrators, CPR and first aid instructors, EMTs, nurses and
      physicians--the topic of oxygen use by nonmedical responders at the workplace is
      poorly understood. Workplace emergency response administrators may find it
      helpful to become familiar with the current emergency medical literature and
      learn that the previous literature may no longer apply. Furthermore, fear that
      use of emergency oxygen by nonmedical responders is "playing doctor," and will
      lead to some imagined uncontrollable catastrophe is based on statistically and
      medically unfounded misinformation. As is the case with many uncertain events,
      the perception of risk is unrelated to the actual risk. Refusing to allow
      appropriately trained nonmedical responders to use reliable emergency oxygen when
      it is available is a potentially grave error and makes emergency care in the
      workplace less efficient and valuable. There are many cases of workplace injury
      or illness in which oxygen use is not only appropriate but may help save a
      patient's life. Ensuring that the proper emergency oxygen equipment is available
      where appropriate and properly training personnel are responsible for first aid
      can, in some cases, lessen the severity of workplace illness and injury
      incidents.

PMID- 8464600
TI  - On-site first aid, CPR responders need to make fast, vital decisions.
AB  - The techniques of first aid and CPR can be learned easily through training
      programs offered by the American Red Cross and the American Heart Association.
      Programs designed for all levels of care can be suited to the individual's needs.
      Basic CPR skills include one rescuer and two rescuer techniques. Adjunct
      equipment such as pocket masks offer the rescuer protection against possibly
      infectious body fluids. As the role of the competent person and first responder
      continue to grow, employers must continue to rely more on the employee to make
      emergency decisions and administer aid. To ensure effective compliance with the
      standard and to provide life-saving care, employers must have ready availability
      of first aid supplies, equipment and trained personnel. Only in this fashion will
      they be able to ensure timely, adequate care during these critical early moments.

PMID- 8464601
TI  - The goal of safety training rules: reducing the threat of injury.

PMID- 8464602
TI  - Reconsideration of the bilaminar zone in the retrodiskal area of the
      temporomandibular joint.
AB  - The fibrous connection of the diskal attachment to the condyle and to the
      surrounding structures, and of the retrodiskal area was investigated
      histologically. Sections, obtained from six temporomandibular joints with the
      condyle protruded, were mainly observed. Most of the collagen fibers that compose
      the posterior band were attached to the condylar poles and to those vicinities
      behind them, and no diskal attachment was found to the posterior aspect of the
      condyle. Elastin-rich fibers that originate from the petrotympanic fissure were
      attached to the disk at the medial end. These fibers had many branches that
      compose a part of the retrodiskal area and were very wavy in spite of the
      protruded position of the disk-condyle complex. No other fibers directly
      connected the disk with the posterior wall of the fossa. Therefore we concluded
      that there were no upper and the lower strata as termed by Rees.

PMID- 8464603
TI  - Closed lock. A survey of 400 cases.
AB  - Four hundred consecutive classic closed lock cases were examined. Of these, 301
      were treated. Mandibular range of motion was restored by condylar distraction
      during jaw opening, anterior, and lateral movements. Mandibular appliances were
      used to prevent complete closure during healing. Of the 45 males and 355 females
      examined, almost all reported jaw restrictions, but 38% reported little or no
      pain. Secondary disorders of temporomandibular joint inflammation, muscle spasm,
      trigger points, and cervical dysfunction were seen on patients with
      temporomandibular joint pain. Of the 301 conservatively treated patients, 209
      were successfully treated, 55 were moderately successful, and 37 failed. Occlusal
      factors did not appear as primary etiologic factors. Because all locks were
      preceded by clicking, treatment is recommended for clicking temporomandibular
      joint's that lock, however briefly, to prevent future locking. Conservative
      closed lock treatment is successful in many cases.

PMID- 8464604
TI  - Avascular necrosis of the mandibular condyle-pathogenesis and concepts of
      management.
AB  - A vascular necrosis is a well-recognized pathologic entity in orthopedic surgery
      which most commonly affects the femoral head. Avascular necrosis of the
      mandibular condyle has been recognized recently, although controversy exists as
      to the appropriate methods of diagnosis and treatment. We present a discussion of
      the pathogenesis of avascular necrosis derived from the orthopedic literature and
      its extrapolation to management of the temporomandibular joint in the form of
      decompression corticotomy of the condyle by two techniques.

PMID- 8464605
TI  - Diplopia caused by orbital floor blowout fracture.
AB  - Diplopia caused by orbital floor blowout fractures is one of the major
      complications of orbital injuries. The records of 48 patients who had incurred
      orbital injuries were reviewed; 23 had a history of a pure orbital blowout
      fracture. Surgery was indicated when the vertical movement of the eye was
      impaired, and it was performed after complete resolution of orbital hemorrhage
      and edema. The maximal time before the first surgical procedure was 14 days. Two
      patients required a second procedure because of persistent diplopia and
      enophthalmos.

PMID- 8464606
TI  - Dimorphic study of surgical anatomic landmarks of the lateral ramus of the
      mandible.
AB  - Sixty-three human cadaver hemimandibles of known sexual origin were studied. The
      anatomic relationship between the midpoint of the waist of the lateral ramus and
      the mandibular foramen was examined and compared with that of the antilingula. No
      statistical differences were found between either these two landmarks or the
      sexes.

PMID- 8464607
TI  - Efficacy of various surface disinfectants on an irregular surface.
AB  - Representative samples of hard surface disinfectants were tested against
      Pseudomonas aeruginosa (ATCC 27853) on frosted glass rods. The same protocol was
      followed by two investigators on 100 rods for each product tested. Results showed
      Sporicidin surface disinfectant (Ash Dentsply, York, Pa.) and household bleach
      1:10 to be most effective against P. aeruginosa. Lysol disinfectant spray (Lehn &
      Fink Products, Montvale, N.J.), performed similarly whereas Biocide (Biotrol
      International, Woods Cross, Utah) failed to inhibit growth on more than half of
      the rods treated. Failure of the iodophor may be attributed to the use of cotton
      filled gauze, because cellulose is believed to react with nascent iodine.

PMID- 8464608
TI  - Dental manifestations of autoimmune hypoparathyroidism.
AB  - The histopathologic changes in three permanent molars from two siblings with
      autoimmune hypoparathyroidism as part of candida endocrinopathy syndrome are
      described. These teeth developed after the diagnosis of hypoparathyroidism and
      while each subject was receiving vitamin D and calcium supplementation. The
      pathogenesis of the dental changes is unknown, but it is possible that
      parathormone may directly influence tooth development independent of its role in
      calcium and phosphorous homeostasis.

PMID- 8464609
TI  - Mucormycosis of the oral cavity.
AB  - Mucormycosis (phycomycosis, zygomycosis) is an acute opportunistic infection
      caused by a saprophytic fungus found in soil, bread molds, and decaying fruits
      and vegetables. Numerous predisposing risk factors are associated with
      mucormycosis, although most cases have been reported in poorly controlled
      diabetics or in patients with hematologic malignant conditions. This report
      presents two cases of oral mucormycosis. One case occurred in the maxilla in a
      patient with well-controlled diabetes. The other involved the mandible and
      overlying gingiva in a patient with acute myelogenous leukemia. A review of the
      literature concerning oral mucormycosis is also presented.

PMID- 8464610
TI  - Oral paracoccidioidomycosis. A study of 36 South American patients.
AB  - Paracoccidioidomycosis (South American blastomycosis) is an uncommon, progressive
      systemic mycosis, virtually only seen in persons who have visited Latin America.
      Reports of oral lesions are extremely rare in the English-language literature.
      Thirty-six adults with oral lesions as the first sign of paracoccidioidomycosis
      are described; this appears to be the largest series in the dental literature.
      All had chronic proliferative mulberry-like ulcerated oral lesions; the diagnosis
      was confirmed histologically. The gingiva or alveolar process was the typical
      site, but lesions were also seen particularly on the palate and lip. Most of the
      patients proved to have detectable pulmonary involvement. Patients with lesions
      in the oropharynx, tongue, or floor of mouth all had confirmed pulmonary lesions.

PMID- 8464611
TI  - Mucin-containing lozenges in the treatment of intraoral problems associated with
      Sjogren's syndrome. A double-blind crossover study in 42 patients.
AB  - Irreversible hyposalivation is a common sequela of Sjogren's syndrome and may
      lead to a decreased quality of the patient's life. The aim of this study was to
      evaluate the efficacy and therapeutic value of mucin-containing lozenges in
      reducing patients' complaints of hyposalivation. In a double-blind crossover
      trial in 42 patients with Sjogren's syndrome, the efficacy and therapeutic value
      of both a mucin-containing and placebo lozenge were assessed by means of self
      administered questionnaires, which had to be completed before and after the use
      of each type of lozenge for a period of 2 weeks. Seventy-six percent of the
      patients preferred the mucin lozenge, 10% preferred the placebo, and 14% had no
      preference. In reducing patients' complaints, sucking the mucin lozenge resulted
      in a larger improvement of the total pattern of complaints and the sensation of
      oral dryness, and in a longer moistening of the oral cavity than the placebo.
      Oral functioning was improved after the use of the placebo, and the patients
      reported the taste of the placebo to be better than the mucin lozenge. From the
      responses it was concluded that the use of the mucin lozenges can be recommended
      in the treatment of oral symptoms of xerostomia.

PMID- 8464612
TI  - Histologic study on the metastatic process in the experimental model of lymph
      node metastasis.
AB  - The process of lymph node metastasis was studied in an experimental model that
      was successfully established in our laboratory. The model O-1N carcinoma was
      transplanted to the buccal pouch of 60 hamsters, and seven or eight hamsters were
      killed every week from 1 to 8 weeks for histologic examination. At 3 weeks,
      neoplastic invasion of vascular spaces was demonstrated, and early stage lymph
      node metastases were seen in five of seven animals. At 5 weeks, lymph node
      metastases were more advanced, and lung metastasis occurred in one animal. At 8
      weeks, lymph node metastases were seen in all eight animals and lung metastases
      were seen in two of them. Tumor cells initially seen as clusters in afferent
      lymphatic vessels and in the peripheral sinuses gradually spread to the medulla,
      replaced the entire lymph node, and extended into adjacent extranodal tissue. The
      process of metastasis closely resembled that seen in human oral carcinomas.

PMID- 8464613
TI  - Desmoplastic ameloblastoma. A case report and literature review.
AB  - The desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma.
      This article presents a case of desmoplastic ameloblastoma with unique and
      complex histologic findings. The tumor, which was located in the anterior
      mandible, was treated by an anterior marginal resection with preservation of the
      inferior border of the mandible. The clinical, radiographic, surgical, and
      pathologic aspects of this unusual lesion are presented, and the relevant
      literature is reviewed.

PMID- 8464614
TI  - Monoclonal plasmacytic ulcerative stomatitis. A plasma cell dyscrasia?
AB  - We report a case of extramedullary plasmacytoma that appeared in an
      uncharacteristic manner as an ulcerative stomatitis affecting particularly the
      tongue and buccal mucosa. The lesions were associated with a transient lichenoid
      skin rash. The literature is reviewed and comparisons made between this tumor and
      the related plasma cell dyscrasias of multiple myeloma and monoclonal gammopathy.

PMID- 8464615
TI  - Titanium lymph node pigmentation in the reconstruction plate system of a
      mandibular bone defect.
AB  - A case of titanium pigmentation that involved a submandibular lymph node is
      reported. A 41-year old man had been treated for ameloblastoma by partial
      resection of the mandible followed by reconstruction with the use of a titanium
      plate to bridge the mandibular defect. Titanium pigmentation occurred in the
      surrounding soft tissue adjacent to the plate and within a submandibular lymph
      node 2 years after reconstruction.

PMID- 8464616
TI  - Oral lichen planus in patients with diabetes. An epidemiologic study.
AB  - The prevalence of oral lichen planus was studied in 729 persons with diabetes and
      was found to be in 0.55% of cases. This result was compared with the results
      obtained from a group of controls without diabetes and from a sample of the
      general population of similar age and sex distribution. No statistical
      differences were observed.

PMID- 8464617
TI  - Taurodontism in premolars.
AB  - Taurodontism is not a dental anomaly that affects only the molars. In a review of
      379 premolars extracted for different pathologic reasons, three cases of
      taurodontism were found. The three cases were in upper premolars and were studied
      anatomically and radiographically. The literature was reviewed, as well as the
      low incidence of the condition in premolars, which is probably related to a
      genetic condition. Our observations support this fact, as suggested by the study
      of our cases from a restricted population nucleus, within a district area of the
      city of Seville, Spain. Among the diagnostic criteria of taurodontism, those
      established by Shifman and Chanannel are more objective. Finally, our findings
      support an embryologic origin as a result of a delay in the apical epithelial
      diaphragm evagination or by interference in the epitheliomesenchymatose
      induction.

PMID- 8464618
TI  - Basic technical properties of a system for direct acquisition of digital
      intraoral radiographs.
AB  - The Sens-A-Ray system for direct digital intraoral radiography may be used with
      any computer compatible with an IBM PC/AT. The system relies on a charge-coupled
      device designed for direct conversion of x-ray energy to an electronic signal. It
      is the first such device for direct acquisition of radiographs. Technical
      properties of charge-coupled device detectors when exposed to radiation energies
      in the range of x-rays used in dental radiography have been studied. Even in the
      absence of light or x-radiation there is a spontaneous generation of charge
      within a charge-coupled device detector that gives rise to a background signal, a
      dark current. It was found that the dark current is a linear function of exposure
      time. The dose response of the charge-coupled device detector was determined at
      nominal kilovoltages that range from 50 to 90 kVp. The dose response was shown to
      be a linear function of exposure. The functions for all kVp settings were
      practically identical. The charge-coupled device detector is more sensitive to x
      radiation than conventional dental films and, consequently, its exposure range is
      more narrow. The signal-to-noise ratio was calculated from the digital
      radiographs used for the dose response test. The ratio is above 10 for exposures
      higher than about 2 microC/kg. The line spread function was determined from test
      radiographs of a 10 microns wide slit in a test object of 1.5 mm thick tantalum.
      After curve fitting, the line spread function could be expressed as the sum of a
      Gaussian and an exponential function. Presampling modulation transfer functions
      valid at the detector plane and at an object plane were calculated from fitted
      data on the line spread function. It is concluded that the Sens-A-Ray system has
      such technical properties that it may replace conventional film-based systems.

PMID- 8464619
TI  - Stray-field imaging (STRAFI) of teeth.
AB  - During endodontic treatment radiographs are used to get information about the
      root configurations of the teeth. Another modern imaging system in medicine,
      magnetic resonance tomography, provides fine pictures of soft tissues without
      using ionizing radiation. Currently, imaging of bone and teeth cannot be achieved
      very well by magnetic resonance tomography, therefore in a research experiment a
      special variant of magnetic resonance microscopy, stray field imaging, was used,
      which promises new ways of looking into the structure of solids including teeth.
      Initial experiences in reproducing the outer and inner contours of teeth with
      this new technique are presented. Limitations and further applications are
      discussed.

PMID- 8464620
TI  - Dimensional reproduction in direct digital rotational panoramic radiography.
AB  - A linear x-ray detector array can be used to perform rotational panoramic
      radiography provided a technique for data acquisition is used that emulates the
      dimensional reproduction of a conventional rotational panoramic radiographic
      system. This may be accomplished with the use of a variable integration time
      throughout the excursion. The required interval depends upon the scanning
      geometry, the selected image plane, and the size of pixels used in the digital
      image. In a prototype device developed around an Orthopantomograph Model OP10
      with 0.225 mm square pixels, the integration times range from about 8
      milliseconds to 28 milliseconds. An experimental test was performed by
      radiographing a number of steel spheres positioned at different object depths.
      Within the limits of experimental error, there was satisfactory agreement between
      the measured and theoretical magnification.

PMID- 8464621
TI  - Magnetic resonance imaging of the temporomandibular joint. Value of axial images.
AB  - The purpose of this study was to determine the value of axial images for
      diagnosis of disk displacement and osseous changes of the temporomandibular
      joint. Sagittal, coronal, and axial magnetic resonance images were obtained of 35
      fresh temporomandibular joint autopsy specimens. The sagittal and coronal images
      were interpreted for position of the disk and osseous changes. The value of the
      axial images for diagnosis of the disk and osseous components was classified into
      one of four categories: 1) did not add diagnostic information, 2) confirmed
      findings of sagittal and coronal images, 3) added diagnostic information but did
      not change the diagnosis, 4) changed the diagnosis. The results showed that the
      axial images did not add diagnostic information concerning position of the disk
      in 5 joints, confirmed the diagnosis in 29 joints, and added information but did
      not change the diagnosis in 1 joint. Concerning osseous abnormalities, the axial
      images did not add any diagnostic information in 5 joints, confirmed findings of
      the sagittal and coronal images in 26 joints, added information but did not
      change the diagnosis in 3 joints and changed the diagnosis in 1 joint. On the
      basis of these results, it is concluded that the axial plane of imaging of the
      temporomandibular joint is of relatively little value for assessment of disk
      displacement and osseous changes. Axial imaging is therefore not recommended for
      diagnosis of disk position and osseous abnormalities.

PMID- 8464622
TI  - A misleading pharyngeal swelling.

PMID- 8464623
TI  - Wiskott-Aldrich syndrome, renal failure, and osteosclerosis.

PMID- 8464624
TI  - Hypoplastic neural arch: an anomaly of the first cervical vertebra.

PMID- 8464625
TI  - Aspiration of two dental units resulting from a motor vehicle accident.

PMID- 8464627
TI  - [Surgical management of congenital high vaginal atresia].
AB  - In the past 15 years five neonates and children have been treated for high
      vaginal atresia at the Surgical Unit of Department of Pediatrics, University
      Medical School, Pecs, Hungary. In three of the six patients distal atresia of the
      vagina was found (Type III). Two of the three were neonates and had a large
      hydrometrocolpos and the third, a 13-year-old girl, hematometrocolpos. In the
      fourth patient the vaginal atresia was associated with cloacal and anorectal
      malformation (Type V). In the fifth there was a duplication of uterus and vagina;
      however, only one of the two vaginas was atretic. In three patients a pull
      through of the vagina was carried out, in one of them according to Pena, in
      another a transvesical approach, as suggested by Monfort, was used. Following
      repeated surgeries in the patient with cloacal malformation the vagina was
      replaced with large intestine. In the case of duplication of vagina and uterus
      one half of the duplication was removed.

PMID- 8464626
TI  - [PGI2-like activity of the internal mammary artery and the saphenous vein used in
      coronary bypass surgery].
AB  - The best graft in coronary bypass operations is the internal mammary artery as
      its rate of staying open for long term is better than that of saphenous vein. The
      prostacyclin-producing capacity of these human blood vessels was studied using
      platelet aggregation bioassay. The synthesis of prostacyclin-analogous was
      significant higher in internal mammary artery than that was in saphenous vein (in
      10 min of incubation time internal mammary artery: 73.33; saphenous vein: 42.27
      pg/mg). Based on our results we conclude that the difference of "prostacyclin
      like" activity between artery and vein might play a role, at least partly, in the
      more successful operations performed with internal mammary artery.

PMID- 8464628
TI  - [Allergic inflammatory markers in upper respiratory allergies].
AB  - The inflammatory mediators of allergy were investigated in symptomatic patients
      suffering from upper respiratory tract allergy. The serum tryptase level as an
      indicator of mast cell activation and serum eosinophil cationic protein level as
      an indicator of eosinophil activation were measured. They did not find any
      alteration in the serum level of tryptase. The level of eosinophil cationic
      protein significantly increased in symptomatic patients comparing to normal
      healthy controls. There was not any correlation to the severity of symptoms and
      to the absolute eosinophil count in the peripheral blood. The different
      activation possibilities of the eosinophil granulocytes are discussed,
      highlighting the role of Th2-helper lymphocytes.

PMID- 8464629
TI  - [Dopamine, noradrenaline and serotonin levels in amniotic fluid during the second
      trimester in normal and pathologic pregnancy].
AB  - Authors measured the dopamine (DA), noradrenaline (NA) and serotonin (5-HT)
      contents of amniotic fluid between 19 and 21 weeks with fluorimetric method. The
      amniotic fluid samples were obtained by transabdominal amniocenteses performed
      due to elevated maternal serum-alphafetoprotein levels and suspect ultrasound
      findings. They considered as normal values the average of 30 amniotic fluid
      samples obtained from pregnant women who gave birth to healthy babies at term.
      The mean values (mean+SE) of normal cases were 136.6 + 20.2 nmol/l for DA, 29.5 +
      9.4 nmol/l for NA and 72.6 + 4.9 nmol/l for 5-HT. Against these values, in cases
      of open spina bifida the level of NA showed no significant difference, the DA
      level was higher (p < 0.05) and the 5-HT level was also higher (p < 0.001). The
      DA level was found higher (p < 0.05) in cases of intrauterine retardation as
      well, however there was no difference in the NA and 5-HT levels in these cases.
      In cases of preterm deliveries, none of the above parameters showed differences.
      Authors suggest that in cases of spina bifida the measurement of 5-HT in the
      amniotic fluid can be a complementary diagnostic method. They also state that no
      prognosis about the outcome of pregnancies can be expected from such
      examinations.

PMID- 8464630
TI  - [Clinico-pathological and orthopedic-surgical aspects of essential osteolysis
      (Gorham disease)].
AB  - Authors present two cases. One of their patient was followed for 30 years. They
      discuss the pathological characters and diagnostic difficulties of the disease.
      They have observed that with radical operations of--according to necessity-
      serial surgical interventions the outcome of patients can be properly controlled
      against recent pessimistic opinions.

PMID- 8464631
TI  - [Mineral baths and medicine in Hungary in the 13th-15th centuries].

PMID- 8464632
TI  - Mandible fractures--medical and economic considerations.
AB  - This article retrospectively evaluates 1278 mandibular fractures and compares
      intermaxillary fixation, plating, and interosseous wiring as to outcomes and cost
      effectiveness of treatment. The predominance of young men with personal
      altercations reflects the urban patient setting. The infection from plating
      exceeds other methods and this difference is also reflected in increased patient
      days (in the hospital) and an increased length of time for postoperative care. No
      significant differences are observed between treatments for non-union, malunion,
      facial nerve injury, or temporal mandibular joint problems. Other factors, such
      as site and severity of injury and experience of the surgeons are considered.
      Cost implications are important, but should be just one factor in evaluation for
      the best treatment for each patient.

PMID- 8464633
TI  - Predicting long-term facial nerve outcome after acoustic neuroma surgery.
AB  - Although anatomic preservation of the facial nerve is achieved in nearly 90% of
      reported cases after acoustic neuroma surgery, postoperative long-term facial
      function is of most concern to the patient. This study examines long-term facial
      nerve function in relation to the immediate postoperative function and the
      function at time of discharge from the hospital. Subjects included 515 patients
      who underwent primary acoustic neuroma removal at House Ear Clinic from 1982
      through 1989 and who had normal preoperative facial function, an intact facial
      nerve after surgery, and a House-Brackmann facial nerve grade available
      immediately postoperatively, at time of hospital discharge, and at least 1 year
      postoperatively. Rate of acceptable facial function (House grades I-IV) differed
      significantly (p < or = 0.001) at the three postoperative time intervals: 85.2%,
      immediate; 73.6%, discharge; 93.8%, long-term. Of those with good immediate
      function (grades I-II), 98.6% had acceptable long-term function. Of those with
      poor immediate function (grades V-VI), 69.8% had acceptable long-term function.
      We conclude that facial nerve recovery after acoustic neuroma surgery is
      characterized by slight deterioration in the immediate postoperative period, but
      subsequent improvement in the long-term. Patients can be reliably counseled that
      acceptable function immediately after surgery is associated with a favorable long
      term outcome; poor function immediately after surgery, despite an intact nerve,
      has a more guarded prognosis.

PMID- 8464634
TI  - Epidermoid carcinoma of the oral cavity and oropharynx: validity of the current
      AJCC staging system and new statistical tools for the prediction of subclinical
      neck disease.
AB  - The 1983 and 1988 AJCC T- and N-staging systems were compared using the case
      records of 531 patients with primary epidermoid malignancies of the oral cavity.
      All patients had a minimum followup of 5 years. There were 390 patients with
      early stage (T1, T2) disease and 141 with advanced stage (T3, T4) lesions
      according to both the 1983 and 1988 T-definitions: 342 patients manifested no
      clinical nodes (NO), 189 had clinically evident nodes (N1-N3), and none had
      metastatic disease. Cox regression analysis demonstrated that the 1983/1988 T
      stage definitions differentiated survival successfully (p < 0.001). The 1988
      staging system for nodal disease showed a highly significant separation of N2 and
      N3 when compared with the 1983 system (p < 0.001). Of the 342 patients who were
      staged N0, 154 had primary neck dissection. Logistic regression predicted the
      incidence of subclinical disease according to the site and the T-stage of the
      primary tumor with a sensitivity of 78% and a specificity of 95%. We conclude
      that the 1988 N-stage definition is a better prognosticator of survival than the
      1983 definition. Furthermore, a logistic regression model can be used to predict
      the probability of subclinical disease in primary oral cavity cancers.

PMID- 8464635
TI  - The synergistic effects of rhodamine-123 and merocyanine-540 laser dyes on human
      tumor cell lines: a new approach to laser phototherapy.
AB  - Many new photosensitizers and laser wavelengths are being tested to improve
      photodynamic therapy by enhancing specific tumor uptake and/or retention,
      lowering systemic toxicity, and increasing laser tissue penetration. In this
      study the potential synergistic effects of rhodamine-123 (Rh-123) and merocyanine
      540 (MC-540) sensitization of human tumor cell lines after laser exposure were
      explored. In a first series of experiments, the kinetics of uptake of Rh-123 and
      M-540 were tested on three human leukemia cell lines (K562, RAJI, 729HF2), P3
      squamous carcinoma, and M26 melanoma. Our results demonstrate a clear difference
      in the rate and amount of uptake of MC-540 (K562 > P3 > RAJI > 729HF2 > M26) and
      Rh-123 (P3 > RAJI > 729HF2 > K562 > M26) by these cell lines. In a second series
      of experiments, M26 tumor cells were sensitized with either Rh-123 (1
      microgram/ml) or with MC-540 (20 micrograms/ml) alone or with a combination of
      the two dyes for 60 minutes, then exposed to the argon (514.5 nm) laser at
      nonthermal energy levels. Our results demonstrate a significant enhancement of
      the tumoricidal effects of the laser on M26 carcinoma cells after sensitization
      with both dyes together (MC-540 and Rh-123) when compared to each dye alone. As
      with combination antibiotherapy, the synergistic effects of two laser dyes that
      have different intracellular targeting sites appear to enhance tumoricidal
      effects significantly after exposure to a matching laser wavelength. The data
      provide evidence for effective laser phototherapy by dye synergy.

PMID- 8464636
TI  - Intraoral ultrasonography in the diagnosis of peritonsillar abscess.
AB  - The diagnosis of quinsy is traditionally established on the basis of clinical
      observations and sometimes several diagnostic punctures. The present study has
      focused on the possible usefulness of intraoral ultrasonography (IOU) as a
      diagnostic tool when a peritonsillar abscess is suspected. The results show that
      it is possible to demonstrate, with a high degree of accuracy, the presence of an
      abscess, its volume, location, and its relation to the carotid artery. With this
      information an exact and safe diagnostic puncture can be performed when necessary
      and avoided in cases with clinical signs of quinsy with no abscess.

PMID- 8464637
TI  - Leukocyte esterase activity in effusion fluid of patients with otitis media.
AB  - Fluid obtained during myringotomy and tube placement in 20 patients with middle
      ear effusions was assayed for leukocyte esterase activity using a quantitative
      spectrophotometric assay. This quantitative assay used the synthetic substrate, N
      tosyl indoxyl alaninate. Seven of the 20 samples showed no measurable enzyme
      activity (8 U/ml or less). The remaining samples demonstrated activity ranging
      from 20 to 1600 units. Although enzyme activity did not correlate well with the
      physical appearance of the fluid, it did correlate with clinical history,
      suggesting the presence of a purulent exudate rather than serous effusion.
      Leukocyte esterase activity in the fluid appears to hold promise as an indicator
      for the presence of chronic middle ear infection. The enzyme can be assayed by a
      simple and fast diagnostic strip test, with results available almost immediately.

PMID- 8464638
TI  - Hearing levels of patients with otosclerosis 10 years after stapedectomy.
AB  - Hearing levels of 174 patients (213 ears operated on) with otosclerosis
      undergoing stapedectomy were analyzed. All patients had followup of 10 years or
      more, the mean follow-up period being 13.4 years. Eighty-seven ears (41%)
      underwent posterior crus stapedectomy, and in the remaining 126 ears (59%) a
      prosthesis was inserted. Large fenestra technique was used in all cases. In the
      long run, both air conduction and bone conduction thresholds of ears operated on
      showed remarkable deterioration from the best values obtained 6 to 12 months
      postoperatively. Ten years after surgery both air conduction and bone conduction
      thresholds of ears operated on were significantly worse than those of normal
      controls. At 10 years, 70 percent of the ears operated on had hearing levels (at
      0.5 to 2.0 kHz) of 30 dB or better and 88 percent had 40 dB or better. At the
      last follow-up examination, in 90% of the patients the better hearing ear had a
      hearing level of 40 dB or better. In 90% of patients with bilateral otosclerosis
      who had operations in only one ear, the ear operated on had better hearing
      function than the opposite ear that had not been operated on.

PMID- 8464639
TI  - Partial thyroarytenoid myectomy: an animal study investigating a proposed new
      treatment for adductor spasmodic dysphonia.
AB  - A new surgical procedure with potential application for the treatment of adductor
      spasmodic dysphonia was performed on ten rabbits to assess surgical effects on
      laryngeal function. Using an external approach, partial unilateral thyroarytenoid
      (TA) muscle excision was performed through a thyroplasty cartilage window. The
      contralateral side was left undisturbed as a control. The animals were studied
      acutely and at 3 months using videolaryngoscopy. Electrophysiologic measurements
      were recorded at 3 months. The procedure was well tolerated by all animals, with
      no postoperative infection or aspiration. At 3 months, spontaneous and evoked
      (recurrent laryngeal nerve stimulation) TA muscle electromyographic potentials
      were measurable bilaterally. TA compound muscle action potential amplitudes were
      reduced on the side of myectomy. The threshold of recurrent laryngeal nerve
      stimulation needed to produce observable vocal fold adduction was increased on
      the side operated on. Perioperative and long-term (3 months) videolaryngoscopy
      demonstrated preservation of laryngeal competence with good true vocal cord
      adduction. Histologic analysis with whole organ sections showed replacement of
      excised muscle with loose fibroareolar tissue. No evidence of muscle regeneration
      was observed. The vocal ligament and vocal fold mucosa were intact and
      undistorted in all specimens. This procedure is technically simple and appears to
      effectively result in a functional yet weakened TA muscle. Because myectomy
      includes motor unit end-plate excision, problems associated with reinnervation
      may be circumvented. TA myectomy may be applicable in patients with focal
      laryngeal dystonia to decrease muscle spasm.

PMID- 8464640
TI  - Short latency vestibular evoked potentials.
AB  - Auditory responses, including the well-characterized auditory brainstem response,
      have been used extensively in clinical investigations. Evoked responses have not
      been adequately developed to investigate the vestibular system. The purpose of
      this study is to describe a new method for the evaluation of short-latency
      vestibular evoked potentials in human subjects. Standard ABR equipment is used,
      with a customized solid-state modification of the triggering mechanism. Signal
      averaging is used to record responses to multiple linear decelerations. Results
      indicate the presence of a short-latency wave, which is absent in vestibular
      deficient subjects. The literature is reviewed and illustrative cases are
      presented. We believe vestibular evoked potentials are a promising new modality
      in investigation of vestibular physiology.

PMID- 8464641
TI  - Subtotal petrosectomy in the management of advanced parotid neoplasms.
AB  - Circumferential growth of parotid neoplasms may involve the external auditory
      meatus posteriorly, the floor of the middle cranial fossa superiorly, and the
      neurovascular structures of the jugular foramen medially. Inadequate tumor
      resection in these anatomically complex regions will result in local disease
      recurrence at the lateral skull base. A subtotal petrosectomy approach has been
      combined with a standard total parotidectomy in the management of 27 patients
      with aggressive parotid tumors. Twenty-two patients had malignant lesions and 10
      individuals had recurrent disease. The resultant conductive hearing loss is
      outweighed by the following advantages of this technique: (1) the ability to
      obtain tumor-free bony margins, (2) proximal intratemporal facial nerve
      identification, (3) vascular control of the jugular bulb and petrous carotid
      artery, and (4) the dissection and protection of cranial nerves IX through XII.
      Our series of 27 patients will be detailed with an emphasis on surgical technique
      and overall patient results.

PMID- 8464642
TI  - Indications and results of cordectomy for early glottic carcinoma.
AB  - Select early glottic carcinomas in patients with normal vocal cord mobility can
      be successfully treated with cordectomy, performed either endoscopically or by
      means of an open operation (laryngofissure-cordectomy). From 1976 to 1986, 95
      patients underwent cordectomy at our institution. There were 88 men and 7 women,
      with an age range at the time of surgery of 27 to 84 years. A laryngofissure was
      used to perform a cordectomy in 61 patients and an endoscopic approach was used
      in 34. The median number of days in the hospital for the endoscopic group was 2,
      and for the laryngofissure group it was 6. The Kaplan-Meier product-limit method
      showed the probability of no recurrence in the first 3 years after an endoscopic
      cordectomy was 0.9099, and in the laryngofissure-cordectomy group it was 0.9502.
      To date, there have been four recurrences (11.8%) in the endoscopic group and
      three (4.9%) in the laryngofissure group. Only one patient with recurrent tumor
      is known to have died of the cancer. Laryngectomy was necessary for ultimate
      control in three patients. The Kaplan-Meier survival curve for the 95 patients
      was the same as that for a sex- and age-matched control group. Cordectomy is an
      effective treatment option that results in minimal morbidity for select early
      glottic carcinomas.

PMID- 8464643
TI  - Wound healing of KTP and argon laser lesions in the canine nasal cavity.
AB  - The potassium titanyl phosphate (KTP) and argon lasers are increasingly used in
      nasal and sinus surgery. Histologic effects of these lasers on living nasal
      tissue have not been investigated. Sixteen dogs underwent laser nasal surgery
      (eight for each laser). Flexible fiberoptic quartz fibers were used with both
      lasers to deliver the laser energy to the tissue. The dogs were allowed to heal
      and then underwent biopsy at 3, 7, 21, and 90 days postoperatively. The argon and
      KTP lasers had similar tissue effects. Histologically, a thin rim of coagulation
      necrosis and acute inflammation were seen at 3 days postoperatively. By 7 days,
      fibroblasts and granulation tissue were observed. At 21 days, fibroblast
      proliferation and re-epithelialization with respiratory epithelium were the
      predominant findings. Finally, at 90 days postoperatively, respiratory epithelium
      and submucosal structures were found overlying a plug of scar filling the defect
      in the septal cartilage. This healing was consistent through a wide range of
      energy densities. These lasers are easily used with sinus endoscopes and the
      operating microscope to allow access to difficult areas. These factors and the
      wound-healing characteristics noted in this study would seem to make them suited
      for use in rhinologic surgery.

PMID- 8464644
TI  - Osteoma of the internal auditory canal.
AB  - The use of MRI for the evaluation of lesions in the internal auditory canal
      presents a potential pitfall in the diagnosis of bony lesions of the IAC, because
      bone is poorly visualized with this method of imaging. The presence of marrow in
      an osteoma might aid in its detection, since fat in the marrow has a bright
      signal intensity of T1-weighted imaging. Computed tomography remains the imaging
      modality of choice for bony lesions of the temporal bone. We demonstrate a case
      of IAC osteoma in which surgical removal resulted in improvement of symptoms. The
      gross and microscopic appearance of the IAC osteoma in this case is similar to
      the characteristic findings of osteomas of the EAC. This suggests that the
      criteria applied to osteomas and exostoses of the EAC may also be used to
      differentiate bony lesions of the IAC.

PMID- 8464645
TI  - Bilateral facial paralysis related to sexually transmitted herpes simplex:
      clinical course and MRI findings.

PMID- 8464646
TI  - A pediatrician's view. Choosing the right antibiotic.

PMID- 8464647
TI  - Antibiotic update. Introduction.

PMID- 8464648
TI  - Cefprozil.
AB  - Cefprozil is a new, orally bioavailable, cephalosporin with significant activity
      against the bacteria commonly associated with upper and lower respiratory tract
      infection, and skin and soft tissue infections. Its absorption and elimination
      dynamics suggest once- or twice-daily dosing. The low-rate of gastrointestinal
      and dermatologic side effects associated with cefprozil administration suggest
      that it may have a significant role in the management of patients with these
      infections. Children with pharyngitis or urinary tract infection are more
      appropriately treated with antibiotics having a narrower spectrum of activity.
      With a variety of newer cephalosporins being marketed in the early 1990s, it will
      be important for the clinician to examine the data from ongoing comparative
      clinical trials to determine which antibiotic is best for a patient with a
      specific infection and whether the added cost justifies its use.

PMID- 8464649
TI  - Cefixime.

PMID- 8464650
TI  - Cefpodoxime proxetil.

PMID- 8464651
TI  - Ampicillin-sulbactam.

PMID- 8464652
TI  - The American Pediatric Society 103rd annual meeting and the Society for Pediatric
      Research 62nd annual meeting. Washington, D.C., May 3-6, 1993. Abstracts.

PMID- 8464653
TI  - Beyond pediatrics: the health and survival of disadvantaged children. E. H.
      Christopherson lectureship on international child health.

PMID- 8464654
TI  - Sydenham's chorea: physical and psychological symptoms of St Vitus dance.
AB  - Eleven children with Sydenham's chorea (8 girls and 3 boys, mean age = 8.4 +/-
      2.2 [SD] years) underwent comprehensive physical, neuropsychologic, and
      psychiatric examination. The chorea was manifested as dysarthria, gait
      disturbances, and frequent adventitious movements of the face, neck, trunk, and
      extremities. Antineuronal antibodies were present in 10 of 11 children. All
      children exhibited concomitant psychologic dysfunction, specifically obsessive
      compulsive symptomatology, increased emotional lability, motoric hyperactivity,
      irritability, distractibility, and age-regressed behavior. Obsessive-compulsive
      symptoms were observed in 9 (82%) children, 4 of whom met diagnostic criteria for
      obsessive-compulsive disorder. These behavioral symptoms began several days to
      weeks before the chorea was observed, and they waxed and waned in severity along
      with the motoric abnormalities. These results suggest that psychologic,
      particularly obsessive-compulsive, symptoms are accompanying manifestations of
      Sydenham's chorea which may require medical attention.

PMID- 8464655
TI  - Cardiovascular abnormalities in children with fragile X syndrome.
AB  - It has been suggested by several authors that the prevalence of mitral valve
      prolapse and aortic root dilation is increased in individuals with the fragile X
      syndrome. The prevalence of these abnormalities in young children with fragile X
      has not been established. Sixteen boys and 1 girl 13 years or younger were
      studied. Only 1 child (6%) had the typical examination findings of mitral valve
      prolapse, although his echocardiogram was normal. From this study it appears that
      cardiac abnormalities in fragile X syndrome develop in late childhood and
      adolescence. It seems important to follow these children carefully so that these
      cardiac abnormalities can be documented when they do develop.

PMID- 8464656
TI  - Long-term results of treatment with low-dose fluoxymesterone in constitutional
      delay of growth and puberty and in genetic short stature.
AB  - This prospective study was designed to assess growth response, side effects,
      other possible long-term effects, and final adult height in boys treated with the
      oral androgen, fluoxymesterone. From 1973 to 1984, eighty-two short boys (71 with
      constitutional delay of growth and puberty [CDGP] and 11 with genetic short
      stature [GSS]) were treated with daily oral doses of 2.5 mg of fluoxymesterone
      from 6 to 60 months. Final height assessment was made from 1989 to 1991. A group
      of 34 untreated boys (26 with CDGP and 8 with GSS) were also followed to assess
      the accuracy of the Greulich-Pyle and Bayley-Pinneau (GP-BP) and sexual maturity
      index height prediction methods. During treatment, each patient had a 1.7- to 2.5
      fold increase in linear growth velocity. Accelerated velocity (over baseline)
      continued as long as the bone age was less than 14 years. No adverse androgenic
      effects (or undue acceleration of puberty) were observed. Final height exceeded
      pretreatment predictions for CDGP + GSS by 6.1 +/- 3.5 (SD) cm (GP-BP) and 5.4 +/
      3.2 cm (sexual maturity index). It is concluded that a daily oral dose of 2.5 mg
      of fluoxymesterone can be used to accelerate linear growth in boys with CDGP and
      GSS when needed to alleviate emotional problems secondary to slow growth and
      short stature without fear of compromising final adult height.

PMID- 8464657
TI  - Blunt trauma in children: causes and outcomes of head versus extracranial injury.
AB  - A subset of the National Pediatric Trauma Registry was analyzed to describe
      causes and outcomes of blunt trauma among children younger than age 15 years.
      This subset, of 8639 children with blunt trauma, was divided into three groups
      according to the injured body region: a group with extracranial injury only (ECI)
      accounted for one half of the population, and the remainder were equally
      distributed between a group with head injury only (HI) and one with both
      conditions (ECI + HI). The three groups were compared with respect to demographic
      characteristics, external cause of injury, injury severity, and outcomes. Falls
      were the leading cause of injury in the HI group, where children were younger,
      whereas traffic-related injuries predominated in children with ECI or ECI + HI.
      Pedestrian injuries accounted for a significant share of poor outcomes. The
      highest proportions of deaths and severe injuries were observed in the mixed
      group (ECI +HI), and the lowest, in the ECI group. In contrast, functional
      impairments at discharge were most frequently noted in the ECI group, where 60%
      of the children were discharged with at least one impairment. While only 6% of
      children with HI were discharged with impairment, those affected exhibited more
      deficits in cognition and behavior, which are expected to persist longer than
      dysfunction in activities of daily living.

PMID- 8464658
TI  - Management of cardiopulmonary and trauma resuscitation in the pediatric emergency
      department.
AB  - The etiology and management of critical illness and injury in a pediatric
      emergency department were reviewed to survey the use of cardiopulmonary and
      trauma resuscitation and to compare these data with the educational content of
      Pediatric Advanced Life Support (PALS) courses. The emergency department records
      of 183 patients treated in the cardiopulmonary/trauma resuscitation room of a
      pediatric emergency department over a 17-month period were reviewed for data on
      diagnosis, morbidity, presence of apnea or pulselessness, and utilization of
      several resuscitation skills: intubation, cardioversion, tibial interosseous line
      placement, and other resuscitation techniques. Apneic and pulseless pediatric
      patients had poor survival (10.3%), but apneic patients had excellent survival
      (96.9%). Endotracheal intubation (57.9%), bag-valve-mask ventilation (63.9%), and
      medications for rapid-sequence induction of anesthesia prior to endotracheal
      intubation (25.7%) were used frequently. Inasmuch as asystole was the most common
      rhythm in pulseless patients, cardioversion and defibrillation were rarely used
      (2.2%). Specialized vascular access techniques, tibial interosseous lines
      (24.0%), and femoral intravenous lines (19.7%), were used frequently in pediatric
      patients. The frequent use of airway management skills and the excellent survival
      of apneic pediatric patients supports the current emphasis on airway management
      in PALS courses. Cardioversion/defibrillation should receive less emphasis in
      PALS courses. The frequent use of rapid-sequence induction of anesthesia prior to
      endotracheal intubation indicates that these techniques might warrant increased
      emphasis in the training of pediatric emergency department personnel and in PALS
      courses.

PMID- 8464659
TI  - Human immunodeficiency virus-infected adolescents: the first 50 patients in a New
      York City program.
AB  - To address the unique manifestations of human immunodeficiency virus (HIV) among
      adolescents aged 13 through 21 years, a comprehensive evaluation and treatment
      program for high-risk and HIV-positive adolescents was developed in New York City
      in 1987. Among HIV-infected youth, mean age of testing was 18.2 years. One third
      of the HIV-positive patients were female and four fifths were African-American or
      Hispanic. No significant differences were found between HIV-positive (n = 50) and
      HIV-negative (n = 43) patients for age at first intercourse, injecting or other
      illicit drug use, history of sexually transmitted diseases, or survival sex
      (exchange of sex for money or drugs). HIV-positive males were more likely than
      HIV-negative males to have engaged in anal intercourse and to report a history of
      sexual abuse. Among infected females, 82% acquired HIV through heterosexual
      intercourse. Almost half (48%) of HIV-positive adolescents had significant immune
      dysfunction at the time of their initial visit (CD4 < 500/mm3) and were eligible
      for zidovudine. Many HIV-positive adolescents continued high-risk behaviors such
      as intercourse without condoms, particularly those with ongoing dependence on
      drugs or alcohol. With the epidemic of HIV infection increasing nationwide among
      adolescents, specialized, comprehensive programs are needed to counsel and treat
      HIV-infected adolescents and youth in high-risk situations.

PMID- 8464660
TI  - Neurologic history and examination results and their relationship to human
      immunodeficiency virus type 1 serostatus in hemophilic subjects: results from the
      hemophilia growth and development study.
AB  - In a prospective study of the growth and neuropsychologic function of hemophilic
      subjects, 333 boys, median age of 12.3 years, had baseline neurologic
      examinations. The study population included 207 individuals (62%) who were
      seropositive for human immunodeficiency virus type 1 (HIV-1). Overall results
      indicated that 11% had abnormalities of cranial nerve function, 17% had abnormal
      deep tendon reflexes, 23% had abnormal strength, 25% had abnormal coordination,
      and 31% had abnormal tone, bulk, or range of motion. By contrast, 2% or fewer
      displayed abnormal movements or had abnormal pain or vibratory sensation, or
      altered mental status. Abnormalities were more common in older hemophilic
      subjects (eg, 67 [38%] of 177 subjects > or = 12 years of age had abnormal tone,
      bulk, or range of motion vs 36 [23%] of 156 subjects < 12 years of age). When
      compared with regard to HIV-1 status, HIV-seronegative and HIV-seropositive
      subjects did not differ with regard to head circumference or the frequency of
      abnormalities of cranial nerve function, sensation, muscle strength, or
      coordination. However, deep tendon reflexes and tone, bulk, or range of motion
      were more frequently abnormal in HIV-1-seropositive individuals. More HIV-1
      positive subjects had at least one increased deep tendon reflex (13/207 [6.3%] vs
      1/126 [0.8%] in seronegatives) and more had non-hemophilia-related decreases in
      muscle bulk (7/207 [3.4%] vs 0/126 in seronegatives). These results indicate that
      hemophilia causes substantial neurologic dysfunction and that certain findings,
      such as changes in muscle-stretch reflexes or muscle bulk, may also reflect the
      neurologic consequences of HIV infection.

PMID- 8464661
TI  - The bicycle: a developmental toy versus a vehicle.
AB  - This study was designed to compare bicycle-motor vehicle collisions involving
      those children using the bicycle for play vs those using it for transportation.
      Data were obtained from a multihospital-based monitoring system of traffic
      related injuries among children aged 0 through 14 years, including the coroner's
      office, in a single urban county. The sample consisted of 289 children through 14
      years of age; 123 (43%) were playing; 166 (57%) were on a purposeful trip. Those
      playing were younger; closer to home; on residential streets with fewer traffic
      lanes, lower posted speed limits, and lighter traffic; and more frequently with
      other children. Those using the bicycle for transportation or for a purposeful
      trip were more commonly 10 to 14 years of age, riding on multilane streets, and
      riding alone. Forty-five percent of these children were en route to/from school.
      There were no significant differences between the two groups with respect to
      number, severity, or distribution of injuries. Extremity and head injuries were
      predominant. This study demonstrates that motor vehicle-bicycle injuries among
      young children bicycling in their own neighborhood are just as severe as those in
      older children who are using the bicycle as a means of transportation.
      Recommendations for interventions include establishing an appropriate age at
      which children are permitted to bicycle in the street, separating bicyclists from
      traffic, teaching bicyclists the rules of the road, consideration of licensure,
      and use of helmets.

PMID- 8464662
TI  - Safety and immunogenicity of an acellular pertussis vaccine booster in 15- to 20
      month-old children previously immunized with acellular or whole-cell pertussis
      vaccine as infants.
AB  - The objective of this study was to evaluate reactogenicity and immunogenicity of
      the recently US-licensed Connaught/BIKEN (C/B) acellular DTP (ADTP) vaccine as a
      booster for children aged 15 to 20 months after they had received either the C/B
      ADTP or the US-licensed Connaught whole-cell DTP (WDTP) vaccine as infants. After
      infants had received either three doses of C/B ADTP (n = 109) or three doses of
      WDTP vaccine (n = 30) at 2, 4, and 6 months of age according to a 3:1,
      randomized, prospective design, they all received booster doses at 15 to 20
      months of age with C/B ADTP. Fever > 101 degrees F (38.3 degrees C),
      irritability, injection site redness > or = 1 inch, injection site swelling, and
      injection site pain, among other reactions, were monitored for 14 days after
      vaccination. IgG antibody to pertussis toxin (PT) and filamentous hemagglutinin
      were analyzed by enzyme-linked immunosorbent assay and neutralizing antibody to
      PT was measured by Chinese hamster ovary (CHO) cell assay. No significant
      differences were observed between the WDTP- and ADTP-primed infants following
      their ADTP booster for any of the monitored reactions within 72 hours of vaccine
      administration or in the 4 to 14 days after vaccination. Prior to the ADTP
      booster, antibody levels were higher in children who had received ADTP compared
      with those who had received WDTP vaccine as infants for PT antibody as measured
      by enzyme-linked immunosorbent assay and CHO cell assay. Higher levels of IgG
      antibody following the ADTP booster were observed to filamentous hemagglutinin
      and to PT in ADTP-primed compared with WDTP-primed children.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8464663
TI  - Oscillometric blood pressures in the arm, thigh, and calf in healthy children and
      those with aortic coarctation.
AB  - Comparing blood pressure (BP) obtained in the arm with that obtained in the thigh
      or calf is important in the diagnosis of aortic coarctation. However, normative
      mean and range of differences in BP between the arm and lower extremity sites are
      not available for normal children. It is also not known how accurately the
      differences in BP between the arm and the lower extremity sites predict the
      pulsed Doppler estimation of systolic pressure (SP) gradient across an aortic
      coarctation. To resolve these questions, the authors obtained two BP measurements
      by an oscillometric (Dinamap) method in the arm, thigh, and calf in 74 healthy
      children aged 4 to 16 years. Oscillometric BP was also obtained in 21 children
      aged 3 to 17 years with preoperative or postoperative aortic coarctation and BP
      gradients were compared with that estimated by the pulsed Doppler method.
      Overall, SP was higher in the thigh and calf than in the arm. The gradients in SP
      expressed as arm SP minus calf SP [S(A-C)] and arm SP minus thigh SP [S(A-T)]
      were significantly greater in children 4 through 8 years old than in those 9 to
      16 years old. The S(A-C) was -9.3 (+/- 7.4 SD) mm Hg in the 4- through 8-year
      group and -5.0 (+/- 6.9 SD) mm Hg in the 9- to 16-year group. The S(A-T) was -7.1
      (+/- 6.8 SD) mm Hg in the 4- through 8-year group and -2.4 (+/- 7.7 SD) mm Hg in
      the 9- to 16-year group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464664
TI  - Does prolonged breast-feeding impair child growth? A critical review.
AB  - Recent epidemiologic evidence suggests that children in developing countries who
      terminate breast-feeding before their first birthday are less likely to be
      malnourished than those who are breast-fed for longer durations. This finding
      calls into question the advice women are given to breast-feed as long as
      possible. This review examines several studies that found a relationship between
      prolonged breast-feeding and malnutrition. Many studies have shown a negative
      association between prolonged breast-feeding and growth, but there is little
      reason to expect the association to be causal. Problems in study design and
      analysis, such as failure to control for confounding and reverse causality, leave
      the nature of the association largely unspecified.

PMID- 8464665
TI  - Evaluation of a promotional strategy to increase bicycle helmet use by children.
AB  - Bicycle-related head injuries are an important cause of death and disability,
      despite the availability of helmets. The objective of this study was to evaluate
      the effectiveness of a school-based bicycle helmet promotion program in
      increasing helmet use by children while controlling for secular trends. Two high
      income and two low-income schools in an urban Canadian community were selected to
      receive a bicycle helmet promotion intervention, with the remaining 18 schools
      serving as controls. Approximately 1800 observations of bicycling children were
      made at randomly selected observational sites 2 to 5 months after the
      intervention to assess changes in behavior. Helmet use at all observation sites
      tripled from 3.4% (1990, preintervention) to 16% (1991, postintervention). In the
      high-income intervention area, observed helmet use rose dramatically from 4% to
      36% in contrast to the more modest increase in the high-income control area from
      4% to 15%. In the low-income intervention area, there was a modest increase from
      1% to 7%, but it did not differ from the increase in the low-income control area
      from 3% to 13%. The program was highly successful in children of high-income
      families but not in children of low-income families. Developing strategies for
      low-income families remains a priority.

PMID- 8464666
TI  - Neurobehavioral profiles of neonates exposed to cocaine prenatally.
AB  - This study examined the effects of maternal cocaine use on performance on the
      Neonatal Behavioral Assessment Scale (NBAS). Cocaine-exposed newborns (n = 56)
      were compared with a non-cocaine-exposed group (n = 30) born to mothers with
      similar sociodemographic characteristics. Cocaine-exposed newborns showed
      significant reduction in birth weight but did not experience greater obstetric or
      postnatal complications. On neurobehavioral assessments using the NBAS, cocaine
      exposed newborns showed significantly depressed performance on the habituation
      cluster but not on other NBAS clusters when differences in birth weight were
      controlled. In a sample of 30 cocaine-exposed newborns matched on birth weight,
      gestational age, and race to the 30 non-cocaine-exposed newborns, cocaine-exposed
      newborns continued to show depressed habituation performance. The significance of
      a selective effect of cocaine exposure on early habituation performance is
      discussed in terms of the implications for attentional regulation in the first
      year of life.

PMID- 8464667
TI  - Influence of thumb sucking on peer social acceptance in first-grade children.
AB  - Chronic thumb sucking in school-age children may reduce peer social acceptance,
      an important contributor to social development. The influence of thumb sucking on
      social acceptance was assessed among 40 first-grade children, who were shown four
      slides of two 7-year-old children (one boy, one girl) in two poses (one thumb
      sucking, one not). After viewing each slide in their classrooms, the children
      answered 10 numerically weighted questions related to peer acceptance. To limit
      the possibility that the children would determine the girl and boy were the same
      in each pose, the slide presentation was counterbalanced across two sessions 1
      week apart. Using a repeated-measures analysis of variance, the authors compared
      composite scores on each question for both poses. The results indicate that while
      in the thumb-sucking pose, the children were rated as significantly less
      intelligent, happy, attractive, likeable, and fun and less desirable as a friend,
      playmate, seatmate, classmate, and neighbor than when they were in the non-thumb
      sucking pose. These findings suggest that the risk of reduced social acceptance
      should be added to the list of potentially harmful effects of chronic thumb
      sucking in school-age children.

PMID- 8464668
TI  - Issues involved in the definition and classification of chronic health
      conditions.
AB  - The need for a widely applicable definition of chronic conditions for research,
      policy, and program development has led to an extensive review of the development
      of such definitions, the considerations involved in their use, and some
      recommendations for a new approach. This paper examines some of the methodologic
      and conceptual issues related to defining and classifying chronic conditions and
      describes some consequences resulting from decisions made about these issues.
      While most examples are taken from child health applications, the basic concepts
      apply to all age groups. The dominant method for identifying and classifying
      children as having a chronic condition has relied on the presence of an
      individual health condition of lengthy duration. This condition-specific or
      "categorical" approach has increasingly seemed neither pragmatically nor
      conceptually sound. Thus, the development of a "generic" approach, which focuses
      on elements that are shared by many conditions, children, and families, is
      recommended. Such a definition might reflect the child's functional status or
      ongoing use of medical services over a specified time period. In addition, it is
      suggested that conditions be classified based on the experience of individual
      children, thus emphasizing the tremendous variability in expression of seemingly
      similar conditions.

PMID- 8464669
TI  - Neutrophil elastase and acute pulmonary damage in neonates with severe
      respiratory distress syndrome.
AB  - This study evaluated possible acute effects of neutrophil elastase on neonatal
      pulmonary morbidity. The activity of free elastase and alpha 1-proteinase
      inhibitor as well as concentrations of elastase-alpha 1-proteinase inhibitor in
      tracheal aspirate fluid of neonates with severe respiratory distress syndrome
      (fraction of inspired oxygen > 0.6, mechanical ventilation) were analyzed between
      6 and 36 hours after surfactant replacement therapy. One hundred forty neonates
      were included in this prospective study. Characteristics, disease severity, and
      ventilatory requirements were nearly identical in both groups. All patients were
      treated with natural porcine surfactant (Curosurf) at an age of 2 to 15 hours. In
      42 neonates (30%) considerable activities of free elastase were detected (805
      micrograms/L; 100 to 1850 [median, 25th to 75th percentile]); in 98 neonates
      (70%) who had protective levels of alpha 1-proteinase inhibitor, no elastase
      activity was detected. The average concentrations of elastase-alpha 1-proteinase
      inhibitor were significantly increased in patients with free elastase activity
      when compared with those of the nonelastase group. In logistic regression
      analyses, 28-day outcome data showed a pronounced increase in risk of pulmonary
      interstitial emphysema for patients with free elastase activity in tracheal
      aspirate fluid. The incidence of other pulmonary and nonpulmonary complications
      was very similar in both groups. It is concluded that elastolytic damage and
      barotrauma may both contribute to acute pulmonary injury in the early stages of
      respiratory distress syndrome.

PMID- 8464670
TI  - Hemoglobin S and C traits: contributing causes for decreased mean hematocrit in
      African-American children.
AB  - Several nutritional surveys have shown that African-American children have lower
      mean hematocrit and hemoglobin values than white children. While the high
      prevalence of both alpha and beta thalassemias in African-American children can
      partly account for the lower hematologic values, the remaining differences cannot
      be explained. African-American individuals have a high prevalence of traits for
      hemoglobin S (HbAS) and hemoglobin C (HbAC). The mean hematocrit of children with
      normal hemoglobin AA (HbAA) (n = 15637) was compared with that of children with
      traits for HbAS (n = 1197) and HbAC (n = 440). For both sexes, the mean
      hematocrit of subjects with HbAC and HbAS was 1.5 and 1 point lower,
      respectively, than that of subjects with HbAA. These differences were highly
      significant statistically. When the data were examined with regard to age and
      sex, statistically significant differences were present for all groups analyzed
      except the 11- through 14-year-old male group for HbAC and the 15- through 19
      year-old male group for HbAS. Thus, the presence of Hb S and C traits is
      associated with a lower hematocrit. This reduced hematocrit may significantly
      contribute to the racial differences in mean hematocrit due to the high
      prevalence of these traits in African-American children.

PMID- 8464671
TI  - Failure of cromolyn sodium to reduce the incidence of bronchopulmonary dysplasia:
      a pilot study. The Neonatal Cromolyn Study Group.
AB  - This prospective, randomized, blinded clinical trial was conducted to test
      whether therapy with cromolyn sodium might decrease the incidence or severity of
      bronchopulmonary dysplasia when given to newborns with respiratory distress
      syndrome. Cromolyn (20 mg) or placebo was aerosolized to intubated newborns with
      respiratory distress syndrome every 6 hours, beginning on the first day of
      intubation. Patients were stratified by birth weight less than 1000 g and 1000 to
      2000 g; primary outcome success was defined as survival to 30 days without oxygen
      dependence. Of 10 patients enrolled who were less than 1000 g birth weight, there
      were no treatment successes, preventing outcome analysis. The study was
      discontinued after 28 patients of 1000 to 2000 g birth weight had been studied,
      at which time it had been found with 95% confidence, with a power of .80, that
      cromolyn sodium did not decrease by 50% the incidence of bronchopulmonary
      dysplasia. Severity of bronchopulmonary dysplasia was also similar, with 4
      patients in the treatment group and 3 in the placebo group receiving mechanical
      ventilation at 30 days. Possible reasons for this study outcome include (1) a
      delivered dose too small to produce a clinical effect; (2) the start of therapy
      too late to prevent the onset of inflammation; (3) inadequate effect of cromolyn
      on polymorphonuclear cells in vivo; or (4) development of bronchopulmonary
      dysplasia through factors unaffected by the actions of cromolyn.

PMID- 8464672
TI  - Contralateral renal abnormalities in patients with renal agenesis and noncystic
      renal dysplasia.
AB  - The prevalence of contralateral renal abnormalities in noncystic-dysplastic
      kidney (NCDK) disease and renal agenesis is unknown. Twenty-four patients with
      NCDK disease and 16 patients with renal agenesis were studied in this 11-year
      retrospective study. In all patients the urinary system was evaluated by renal
      ultrasonography, and excretory urography or radionuclide scan. In addition,
      voiding cystourethrography was performed in 21 of 24 patients with NCDK disease
      and in 10 of 16 patients with renal agenesis. In those patients where voiding
      cystourethrography was performed, 14 (67%) patients with NCDK disease and 9 (90%)
      patients with renal agenesis had contralateral urologic abnormalities.
      Contralateral vesicoureteral reflux was the most common contralateral abnormality
      identified in 9 (43%) patients with NCDK disease and in 3 (30%) patients with
      renal agenesis. It is concluded that contralateral urologic abnormalities are
      common in patients with NCDK disease and in patients with renal agenesis and that
      vesicoureteral reflux is the most common contralateral abnormality noted.

PMID- 8464673
TI  - Attention deficit hyperactivity disorder, creativity, and the effects of
      methylphenidate.
AB  - Given that children with attention deficit hyperactivity disorder (ADHD) are more
      impulsive than peers, this study explored whether they are correspondingly more
      creative, and whether creativity declines when impulsivity is decreased through
      methylphenidate (Ritalin) therapy. A repeated-measures quasi-experimental design
      was used to compare the performance of 19 boys with previously diagnosed ADHD and
      21 comparison boys aged 8 through 11 on two administrations of alternate forms of
      the Torrance Tests of Creative Thinking-Figural (nonverbal). Boys with ADHD
      received prescribed methylphenidate only for the first session. Overall, mean
      Torrance summary scores for comparison boys (mean = 115.1, SD = 16.1) were higher
      than for boys with ADHD (mean = 107.6, SD = 12.7). However, the difference
      between means was small (7%) and did not meet the 25% criterion for a clinically
      significant difference. No changes in performance over time (comparison group) or
      medication state (ADHD group) were observed. These data suggest that, when
      measured nonverbally, the creative thinking performance of boys with ADHD is not
      superior to that of peers who do not have ADHD. Regarding the effects of
      methylphenidate, prescribed therapy did not influence performance on this measure
      of creative thinking.

PMID- 8464674
TI  - Appearance of the hymen at birth and one year of age: a longitudinal study.
AB  - The increase in the number of prepubertal girls who require evaluation of
      possible sexual abuse creates a need for detailed information, not previously
      available from cross-sectional studies, on the influence of aging on the hymen's
      appearance. This study was undertaken to evaluate and document, using a
      longitudinal design, changes in the hymen's morphology in 62 girls without a
      history of sexual abuse between birth and their first birthday. Labial
      agglutination extensive enough to obscure the inferior half of the hymen was
      observed in 5 girls (8%) at 1 year of age. Thirty-three (58%) of the remaining 57
      infants experienced a marked decrease in the amount of their hymenal tissue
      between birth and 1 year. Significantly more infants at 1 year of age had a
      crescentic configuration (0% vs 28%), and significantly fewer had an external
      ridge (82% vs 14%) as compared to the newborn period. An annular hymen with a
      central or ventrally displaced opening progressed to a crescentic hymen in 13
      children by 1 year, 77% (10/13) of whom were observed to have a notch (cleft) at
      the 12 o'clock position on the earlier study. A superior notch appeared for the
      first time in 9 girls. Lateral notches resolved in 5 cases and persisted in 2.
      Inferior notches between the 4 and 8 o'clock positions were not observed at birth
      or 1 year. Hymenal tags resolved in 2 instances, persisted in the same location
      in 2, and appeared for the first time in 4 cases.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8464675
TI  - Bulimic behaviors among interscholastic wrestlers: a statewide survey.
AB  - Wrestlers are known for their extreme weight-cutting practices including fasting,
      food and fluid restriction, and dehydration. Using a stratified statewide survey,
      this investigation elucidated weight loss practices, nutritional knowledge, and
      bulimic behaviors among 713 high school wrestlers in Wisconsin. Results showed
      that 1.7% of the wrestlers answered questions consistent with all five criteria
      for bulimia nervosa, a rate higher than expected for adolescent males. An
      additional 43% exhibited weight-cutting practices similar to those of the
      wrestlers who met all bulimia nervosa criteria. The average wrestler lost 3.2 kg
      to compete, cycled 1.8 kg weekly, and fasted 20 hours prior to weigh-in. More
      extreme behaviors occurred among the 45% who met two or more bulimia nervosa
      criteria on their questionnaire; 19% frequently fasted, 25% restricted fluids,
      34% used rubber suits, and 8% vomited. These results are comparable with data
      published over the past 20 years. Efforts to curtail these behaviors through
      regulations restricting weight loss coupled with sound nutritional information
      are warranted. Physicians and health professionals should be alert to potential
      eating disorders within this population.

PMID- 8464676
TI  - The physician-doctor relationship.

PMID- 8464678
TI  - Hair-grooming syncope seizures.

PMID- 8464677
TI  - Systemic reactions to measles-mumps-rubella vaccine skin testing.

PMID- 8464679
TI  - Perianal findings in infants 18 months of age or younger.

PMID- 8464680
TI  - Acellular pertussis vaccine booster.

PMID- 8464681
TI  - American Academy of Pediatrics Committee on School Health. Prevention of
      hepatitis B virus infection in school settings.

PMID- 8464682
TI  - Sale of individual cigarettes: a new development.

PMID- 8464683
TI  - It's not Henoch-Schonlein purpura (HSP)

PMID- 8464684
TI  - Sudden infant death syndrome and sleeping position.

PMID- 8464685
TI  - Guidelines vs the legal standard of care and screening for polycythemia.

PMID- 8464686
TI  - Screening for treatable disorders.

PMID- 8464687
TI  - Neonatal genital prolapse.

PMID- 8464688
TI  - Lead screening.

PMID- 8464689
TI  - Lead and IQ.

PMID- 8464690
TI  - The lead debate.

PMID- 8464691
TI  - Immunization of preterm infants.

PMID- 8464692
TI  - Noncomplementary DNA double-strand-break rejoining in bacterial and human cells.
AB  - We examined the rejoining of noncomplementary restriction enzyme-produced DNA
      double-strand breaks in Escherichia coli and in cultured human cells. The enzymes
      used in this study, ClaI, BamHI and SalI, produce double-strand breaks with 5
      protruding single strands. The joining of a ClaI-produced DNA end to a BamHI
      produced end or to a SalI-produced end was examined at the DNA sequence level.
      End rejoining in E.coli was studied by transforming cultures with linear plasmid
      DNA that was gel purified from restriction digests, and end rejoining in cultured
      human cells was studied by introducing enzymes into the cells by electroporation.
      The human cells used contain an Epstein-Barr virus (EBV)-based shuttle vector,
      pHAZE, that was recovered and introduced into E.coli for further analysis. The
      major products of DNA end-joining processes observed in linear plasmid
      transformed E.coli and in the human cells exposed to restriction enzymes were
      identical. Furthermore, the deletions observed in both systems and in the
      spontaneous mutant plasmids in untreated human cells had a common underlying
      feature: short stretches of directly repeated DNA at the junction sites.

PMID- 8464693
TI  - Sequence and organization of large subunit rRNA genes from the extrachromosomal
      35 kb circular DNA of the malaria parasite Plasmodium falciparum.
AB  - The malaria parasite Plasmodium falciparum carries an extrachromosomal 35 kb
      circular DNA molecule of unknown provenance. A striking feature of the circle is
      a palindromic sequence of genes for subunit rRNAs and several tRNAs, spanning ca.
      10.5 kb. The palindrome has an intriguing resemblance to the inverted repeat of
      plastid genomes, and the sequence and putative secondary structure of the
      malarial large subunit (LSU) rRNA described in this report were used as the basis
      of a phylogenetic study. The malarial rRNA was found to be highly divergent in
      comparison with a selected group of chloroplast LSU rRNAs but was more closely
      related to them than to mitochondrial LSU rRNA genes.

PMID- 8464694
TI  - Unique secondary and tertiary structural features of the eucaryotic
      selenocysteine tRNA(Sec).
AB  - Cotranslational insertion of selenocysteine into selenoenzymes is mediated by a
      specialized transfer RNA, the tRNA(Sec). We have carried out the determination of
      the solution structure of the eucaryotic tRNA(Sec). Based on the enzymatic and
      chemical probing approach, we show that the secondary structure bears a few
      unprecedented features like a 9 bp aminoacid-, a 4 bp thymine- and a 6 bp
      dihydrouridine-stems. Surprisingly, the eighth nucleotide, although being a
      uridine, is base-paired and cannot therefore correspond to the single-stranded
      invariant U8 found in all tRNAs. Rather, experimental evidence led us to propose
      that the role of the invariant U8 is actually played by the tenth nucleotide
      which is an A, numbered A8 to indicate this fact. The experimental data therefore
      demonstrate that the cloverleaf structure we derived experimentally resembles the
      hand-folded model proposed by Bock et al (ref. 3). Using the solution data and
      computer modelling, we derived a three-dimensional structure model which shows
      some unique aspects. Basically, A8, A14, U21 form a novel type of tertiary
      interaction in which A8 interacts with the Hoogsteen sites of A14 which itself
      forms a Watson-Crick pair with U21. No coherent model containing the canonical 15
      48 interaction could be derived. Thus, the number of tertiary interactions appear
      to be limited, leading to an uncoupling of the variable stem from the rest of the
      molecule.

PMID- 8464695
TI  - Cloning of the zebrafish krox-20 gene (krx-20) and its expression during
      hindbrain development.
AB  - To begin to examine the function of genes that control early development in the
      hindbrain, we have screened an embryonic zebrafish cDNA library with a murine
      krox-20 gene probe that contained the conserved zinc finger regions. We have
      isolated two overlapping cDNAs, zf187 and zf201 which are homologues of the
      murine krox-20 gene. The N-terminal of the longest cDNA (zf201) contains two
      acidic regions identical to those of the murine krox-20. This indicates that the
      functional organisation of these proteins is probably conserved. Northern Blot
      analysis identified a single transcript of 2.0 kb. Wholemount in situ
      hybridisation established that expression of the zebrafish gene (krx-20) first
      appears at 100% epiboly as a single anterior domain of the prospective
      neuroepithelium, followed very soon after by a second more posterior domain. The
      alternating pattern of expression of this gene in rhombomeres(r) r3 and r5 is
      apparent by 12 hr post-fertilisation, that is prior to the morphological
      appearance of the rhombomeres. Around 14 hr neural crest migration begins from
      the dorsal surface of r5, moving caudally into r6 and then ventrally towards the
      pharyngeal arches. Crest migration is not apparent at or after 16 hr. No neural
      crest migration was observed from r3. Expression of krx-20 is down regulated
      firstly in r3 around 26 hr and later in r5 around 30 hr.

PMID- 8464696
TI  - The abundance of various polymorphic microsatellite motifs differs between plants
      and vertebrates.
AB  - The abundance of different simple sequence motifs in plants was accessed through
      data base searches of DNA sequences and quantitative hybridization with synthetic
      dinucleotide repeats. Database searches indicated that microsatellites are five
      times less abundant in the genomes of plants than in mammals. The most common
      plant repeat motif was AA/TT followed by AT/TA and CT/GA. This group comprised
      about 75% of all microsatellites with a length of more than 6 repeats. The GT/CA
      motif being the most abundant dinucleotide repeat in mammals was found to be
      considerably less frequent in plants. To address the question if plant simple
      repeat sequences are variable as in mammals, (GT)n and (CT)n microsatellites were
      isolated from B.napus. Five loci were investigated by PCR-analysis and amplified
      products were obtained for all microsatellites from B. oleracea, B.napus and
      B.rapa DNA, but only for one primer pair from B.nigra. Polymorphism was detected
      for all microsatellites.

PMID- 8464697
TI  - Atomic force microscopy of DNA and bacteriophage in air, water and propanol: the
      role of adhesion forces.
AB  - We have developed a chemical treatment for the mica surface which allows
      biopolymers to be held in place for atomic force microscopy, even under water,
      using conventional, untreated force sensing tips. We illustrate the procedure
      with images of lambda DNA and fd phage. The phage adheres well enough to permit
      in situ imaging of the adsorption process in water. These experiments yield a
      mean length for the phage of 883 +/- 72 nm. This compares with a measured length
      of 883 +/- 33 nm when the phage are imaged after drying following adsorption from
      water, showing that the effect of dehydration is quite small. Adhesion forces
      between the force sensing tip and the substrate and the sensing tip and the
      biomolecules are very different in the three media (air, water and propanol). The
      apparent height of the phage and the width and height of the DNA depends upon
      these adhesion forces quite strongly. In contrast, changing the Hookean spring
      force exerted by the scanning tip makes little difference. These results suggest
      that the chemical factors involved in adhesion can dominate atomic force images
      and that the composition of the scanning tip is at least as important a factor as
      its geometry.

PMID- 8464698
TI  - Multifunctional repressor KorB can block transcription by preventing
      isomerization of RNA polymerase-promoter complexes.
AB  - The KorB protein of broad-host-range plasmid RK2 is a transcriptional repressor
      involved in the control of genes for plasmid replication, conjugative transfer
      and stable maintenance. We have purified this protein close to homogeneity from
      cells harbouring an overexpression vector with the korB gene under the control of
      the tac promoter. KorB binds to restriction fragments bearing its proposed
      operator sequence, OB. Its interaction with this palindromic site was confirmed
      by DNaseI or hydroxyl radical footprinting at two OB sequences from RK2.
      Comparisons showed that the OB context affects the nature of the footprint. Our
      evidence suggests that KorB is a tetramer. As such, it may be able to bind two
      sites simultaneously on the same or on different DNA molecules. Using the korABF
      promoter, which is subject to KorB repression, we demonstrate by footprinting and
      restriction protection that KorB and RNA polymerase can bind simultaneously.
      Permanganate footprinting showed that KorB represses this promoter by preventing
      isomerization of the RNA polymerase-promoter complex from the closed to open
      form.

PMID- 8464699
TI  - Correlation between observed transcripts and sequenced ORFs of chromosome III of
      Saccharomyces cerevisiae.
AB  - Most of the 155 transcripts of the genes on chromosome III of S.cerevisiae that
      were identified by a series of Northern hybridization experiments (Yoshikawa, A.
      and Isono, K., Yeast 6, 383-401, 1990) have been correlated with the open reading
      frames (ORFs) deduced from the nucleotide sequence data for this chromosome
      (Oliver, S.G. et al., Nature 357, 38-46, 1992). This was performed by comparing
      the experimentally constructed physical map and the one produced from the
      nucleotide sequence data, and then the sizes and positions of observed
      transcripts and those of sequenced ORFs. The data thus provide information for
      possible products of the sequenced ORFs (genes) of chromosome III of S.cerevisiae
      as well as their likely levels of expression in vegetatively growing cells.

PMID- 8464700
TI  - The production of PCR products with 5' single-stranded tails using primers that
      incorporate novel phosphoramidite intermediates.
AB  - We have prepared several novel phosphoramidites and have synthesised
      oligonucleotides incorporating them internally. The presence of these residues in
      an oligonucleotide template presents an impossible barrier to primed synthesis by
      Taq DNA polymerase. When extended as polymerase chain reaction products, these
      oligonucleotides no longer serve as templates for the polymerase beyond the
      insertion sites of the modified intermediates, thereby producing single-stranded
      tails on amplification products. These tails can then be used for solid phase
      capture and colorimetric detection of PCR products.

PMID- 8464701
TI  - Secondary structure of the HIV-2 leader RNA comprising the tRNA-primer binding
      site.
AB  - The initiation of reverse transcription of a retroviral RNA genome occurs by a
      tRNA primer bound near the 5' end of the genomic RNA at a position called the
      primer-binding site (PBS). To understand the molecular basis for this RNA-RNA
      interaction, the secondary structure of the leader RNA of the human
      immunodeficiency virus type 2 (HIV-2) RNA was analyzed. In vitro synthesized HIV
      2 RNA was probed with various structure-specific enzymes and chemicals. A
      computer program was then used to predict the secondary structure consistent with
      these data. In addition, the nucleotide sequences of different HIV-2 isolates
      were used to screen for the occurrence of covariation among putative base pairs.
      The primary sequences have diverged rapidly in some HIV-2 isolates, however, some
      strikingly conserved secondary structure elements were identified. Most
      nucleotides in the leader region are involved in base pairing. An exception is
      the PBS sequence, of which 15 out of 18 nucleotides are exposed in an internal
      loop. These findings suggest that the overall structure of the HIV-2 genome has
      evolved to facilitate an optimal interaction with its tRNA primer.

PMID- 8464702
TI  - Downregulation of HLA class I expression by c-myc in human melanoma is
      independent of enhancer A.
AB  - High constitutive expression of the c-myc oncogene in human melanoma leads to
      downregulation of expression of HLA Class I genes. The genes at the HLA-B locus
      are preferentially affected. To investigate the mechanism of downregulation, the
      activity of the main HLA Class I enhancer, enhancer A-region I, was compared in a
      panel of c-myc transfectants with increasing myc expression. Gel retardation
      experiments demonstrated in all tested cell lines binding of the transcription
      factors KBF1 and NF-kappa B to the enhancer. However, no correlation between the
      levels of HLA Class I expression and binding to the enhancer could be
      established. Strikingly, the cell line with the highest c-myc expression showed
      more binding of KBF1 and NF-kappa B than the parental cell line. By using CAT
      reporter plasmids in transient transfection assays we investigated the in vivo
      function of enhancer A-region I in the c-myc transfectant panel. Again, c-myc
      expression had no effect at all on the activity of enhancer A. This study shows
      that HLA Class I expression is regulated by the c-myc oncogene at the level of
      transcription, but that the main HLA Class I enhancer is not involved in this
      process.

PMID- 8464703
TI  - Differential splicing in mouse thymus generates two forms of terminal
      deoxynucleotidyl transferase.
AB  - A new form of TdT mRNA has been identified by screening a mouse thymus cDNA
      library. It contains an open reading frame of 1527 base pairs corresponding to a
      protein containing 509 aminoacids, whereas the previously identified mouse TdT
      mRNA is composed of 1587 base pairs and encodes a protein of 529 aminoacids.
      Analysis of a mouse genomic clone containing the 3' portion of the TdT gene shows
      that these twenty additional aminoacids are encoded by an additional exon located
      between exons X and XI. Both forms of TdT mRNA are present in the thymus and
      could be generated by alternative splicing. The cDNA reported here corresponds to
      the major form of TdT mRNA in Balb/c mice and closely resembles human and bovine
      TdT cDNA. Expression of this cDNA in mammalian cells shows that it encodes a
      functional protein capable of catalysing N region insertions at the recombination
      junction of an episomic recombination substrate.

PMID- 8464704
TI  - The pre-mRNA binding K protein contains a novel evolutionarily conserved motif.
AB  - The K protein is among the major pre-mRNA-binding proteins (hnRNPs) in vertebrate
      cell nuclei. It binds tenaciously to cytidine-rich sequences and is the major
      oligo(rC/dC)-binding protein in vertebrate cells. We have cloned a cDNA of the
      Xenopus laevis hnRNP K and determined its sequence. The X.laevis hnRNP K is a 47
      kD protein that is remarkably similar to its human 66 kD counterpart except for
      two large internal deletions. The sequence of hnRNP K contains a 45 amino acid
      repeated motif which is almost completely conserved between the X.laevis and
      human proteins. We found that this repeated motif, the KH motif (for K homology),
      shows significant homology to several proteins some of which are known nucleic
      acids binding proteins. The homology is particularly strong with the
      archeabacterial ribosomal protein S3 and with the saccharomyces cerevisiae
      protein MER1 which is required for meiosis-specific splicing of the MER 2
      transcript. As several of the proteins that contain the KH motif are known to
      bind RNA, this domain may be involved in RNA binding.

PMID- 8464705
TI  - HNF-4 increases activity of the rat Apo A1 gene.
AB  - Apolipoprotein A1 (Apo A1) is the major protein component of high density
      lipoprotein (HDL) particles. HDL particles mediate the removal of cholesterol
      from extra-hepatic tissues via a process known as reverse cholesterol transport.
      Augmented production of Apo A1 will likely be beneficial to those who suffer from
      the consequences of hypercholesterolemia. One approach to increase expression of
      the protein is to identify nuclear factor(s) that enhance Apo A1 promoter
      activity. Therefore, we have used transient transfection to study a limited
      portion (-474 to -7) of the gene and showed that a cis-regulatory element, site C
      had a permissive effect on the ability of an adjacent site B to increase promoter
      activity by 30-fold. The importance of element C prompted us to identify the
      factor(s) that interact with this site. Results showed that HNF-4, a new member
      of the thyroid/steroid hormone receptor superfamily interacts with site C to
      enhance activity of the promoter. Based on this observation and that of the known
      inhibitory effects of ARP-1 on site C, we postulate a model which may account for
      the tissue-specific expression of the rat Apo A1 gene.

PMID- 8464706
TI  - Large scale, liquid phase synthesis of oligonucleotides by the phosphoramidite
      approach.
AB  - A new method for the liquid phase synthesis of oligonucleotides is described
      which makes use of polyethylene glycol (PEG) as soluble support and
      phosphoramidite derivatives as synthons. The new synthetic protocol was applied
      to a quite large scale production (about 100 mumoles) of such compounds up to the
      20mer level. This solution method, called HELP High Efficiency Liquid Phase)
      Plus, appears effective in terms of speed and coupling yield and can be evaluated
      for the production of large amount of oligonucleotides.

PMID- 8464707
TI  - Splicing choice from ten variant exons establishes CD44 variability.
AB  - The enormous heterogeneity of the surface protein designated CD44 is in part due
      to posttranslational modification, and in part due to differential splicing.
      Alternative splicing occurs within one particular region encoding the
      extracellular portion of the protein. Comparison of various cDNA clones with
      different 'inserts' in this variable region with sequences of genomic clones from
      the mouse has revealed the existence of at least ten exons from which sequences
      are chosen by alternative splicing. Various combinations of these exons account
      for the tremendous heterogeneity of CD44 molecules expressed in different
      tissues, and in progressing tumor cells. The existence of different isoforms of
      CD44 suggests a broad spectrum of yet unknown physiologic functions.

PMID- 8464708
TI  - Exoquence DNA sequencing.
AB  - We have developed a strategy for DNA sequencing based on exonuclease III
      digestion followed by double strand specific endonuclease digestion and direct
      dideoxynucleotide sequencing reaction. This strategy eliminates the need for
      subcloning, oligonucleotide primers, and prior knowledge of the DNA to be
      sequenced. All template and primer duplexes needed for sequencing a complete
      insert can be prepared in one day from uncharacterized starting DNA. Sequence
      information can be obtained from different regions of the DNA simultaneously. The
      method uses double-stranded DNA to generate single-stranded template and primer,
      and thus produces high quality sequence results. Commercially available dideoxy
      sequencing kits are well suited for this method. The strategy should be
      applicable for both automatic and routine laboratory DNA sequencing.

PMID- 8464709
TI  - Hydrogen peroxide-induced c-fos expression is mediated by arachidonic acid
      release: role of protein kinase C.
AB  - We found previously that stimulation of c-fos and c-myc mRNA expression are early
      events in hydrogen peroxide-induced growth in rat aortic smooth muscle (RASM)
      cells. In the present study, we investigated the role of phospholipase A2 (PLA2)
      and protein kinase C (PKC) in mediating hydrogen peroxide-induced c-fos mRNA
      expression in RASM cells. Mepacrine and p-bromophenacylbromide, potent inhibitors
      of PLA2 activity, blocked hydrogen peroxide-induced c-fos mRNA expression.
      Arachidonic acid, a product of PLA2 activity, stimulated the expression of c-fos
      mRNA with a time course similar to that of hydrogen peroxide. PKC down-regulation
      attenuated both hydrogen peroxide and arachidonic acid-induced c-fos mRNA
      expression by 50%. Nordihydroguaiaretic acid (a lipoxygenase-cytochrome P450
      monooxygenase inhibitor) significantly inhibited both hydrogen peroxide and
      arachidonic acid-induced c-fos mRNA expression, whereas indomethacin (a
      cyclooxygenase inhibitor) had no effect. Together, these findings indicate that
      1) hydrogen peroxide-induced c-fos mRNA expression is mediated by PLA2-dependent
      arachidonic acid release, 2) both PKC-dependent and independent mechanisms are
      involved in hydrogen peroxide-induced expression of c-fos mRNA and 3) arachidonic
      acid metabolism via the lipoxygenase-cytochrome P450 monooxygenase pathway
      appears to be required for hydrogen peroxide-induced expression of c-fos mRNA.

PMID- 8464710
TI  - Comparative analysis of the locus control region of the rabbit beta-like gene
      cluster: HS3 increases transient expression of an embryonic epsilon-globin gene.
AB  - The rabbit homolog to the locus control region (LCR) of the human beta-like
      globin gene cluster was isolated, and long segments containing the DNase I
      hypersensitive sites (HS) were sequenced. The order and spacing of HS4, HS3, HS2
      and HS1 are conserved between rabbit and human. Alignment of these sequences with
      their homologs from human, goat, and mouse shows that very long segments of DNA
      match between species, for over a thousand base pairs on either side of the
      previously identified functional cores, indicating that some important functions
      are found outside the cores. The activity of rabbit HS2 and HS3 was tested by
      attaching each to a novel reporter gene constructed by inserting the luciferase
      coding region into the rabbit epsilon-globin gene. In contrast to previous
      reports showing no effect of human or mouse HS3 on transient expression, both the
      rabbit HS2 and HS3 DNA fragments separately increased transient expression from
      the epsilon-luciferase hybrid gene and expression from stably integrated
      constructs in K562 erythroleukemia cells.

PMID- 8464711
TI  - Identification and characterization of new human medium reiteration frequency
      repeats.
AB  - We report nine new families of human medium reiteration frequency interspersed
      repetitive elements (MER elements). They were identified by computer-assisted
      analyses. Six of them were independently confirmed as repetitive families by DNA
      DNA hybridization, and the number of elements for each of these families was
      estimated by plaque hybridization assay. The involvement of some of the reported
      MER elements in genetic rearrangements is demonstrated.

PMID- 8464712
TI  - DNA-substrate sequence specificity of human G:T mismatch repair activity.
AB  - G:T mispairs in DNA originate spontaneously via deamination of 5-methylcytosine.
      Such mispairs are restored to normal G:C pairs by both E. coli K strains and
      human cells. In this study we have analyzed the repair by human cell extracts of
      G:T mismatches in various DNA contexts. We performed two sets of experiments. In
      the first, repair was sequence specific in that G:T mispairs at CpG sites at four
      different CpG sites were repaired, but a G:T mismatch at a GpG site was not.
      Cytosine hemimethylation did not block repair of a substrate containing a CpG/GpT
      mismatch. In the second set of experiments, substrates with a G:T mismatch at a
      fixed position were constructed with an A, T, G, or C 5' to the mismatched G, and
      alterations in the complementary strand to allow otherwise perfect Watson-Crick
      pairing. All were incised just 5' to the mismatched T and competed for repair
      incision with a G:T substrate in which a C was 5' to the mismatched G. Thus human
      G:T mismatch activity shows sequence specificity, incising G:T mismatched pairs
      at some DNA sites, but not at others. At an incisable site, however, incision is
      little influenced by the base 5' to the mismatched G.

PMID- 8464714
TI  - Nucleotide sequence of the small ribosomal RNA of Encephalitozoon cuniculi.

PMID- 8464715
TI  - Nucleotide sequence of the 3' half of zucchini yellow mosaic virus (Singapore
      isolate) genome encoding the 4K protein, protease, polymerase and coat protein.

PMID- 8464713
TI  - c-Jun is phosphorylated by the DNA-dependent protein kinase in vitro; definition
      of the minimal kinase recognition motif.
AB  - The DNA-dependent protein kinase (DNA-PK) phosphorylates a number of
      transcription factors. Here, we show that the DNA-PK modifies c-Jun in vitro and
      that serine residue 249 (Ser-249) is required for phosphorylation to occur. This
      residue corresponds to one of three sites of c-Jun that are phosphorylated in
      vivo and which negatively regulate c-Jun DNA binding in vitro. However, we find
      that phosphorylation of c-Jun by the DNA-PK does not interfere with DNA binding,
      indicating that phosphorylation at other sites is required for this effect.
      Mutagenesis of the phosphorylated region of c-Jun reveals that the primary amino
      acid sequence recognised by the DNA-PK consists of the sequence Ser-Gln, and that
      adjacent acidic residues potentiate kinase activity. Furthermore, when this site
      is placed within the context of a second protein, it confers DNA-PK directed
      phosphorylation upon that protein. Our findings will facilitate identification of
      DNA-PK phosphorylation sites in other transcription factors.

PMID- 8464716
TI  - Cloning of a Drosophila cDNA with sequence similarity to human transcription
      factor RAP74.

PMID- 8464717
TI  - Determination of the DNA sequence of the 5.8S ribosomal gene of Heterobasidion
      annosum and Heterobasidion araucariae.

PMID- 8464718
TI  - PCR amplification of megabase DNA with tagged random primers (T-PCR).

PMID- 8464719
TI  - Cloning biologically active geminivirus DNA using PCR and overlapping primers.

PMID- 8464720
TI  - Microtechnique for electron microscopy of DNA.

PMID- 8464721
TI  - A putative homology of U2AF65 in S. cerevisiae.

PMID- 8464722
TI  - Lack of peptide-release activity responding to codon UGA in Mycoplasma
      capricolum.
AB  - In Mycoplasma capricolum, a relative of Gram-positive eubacteria with a high
      genomic AT-content (75%), codon UGA is assigned to tryptophan instead of
      termination signal. Thus, in this bacterium the release factor 2 (RF-2), that
      recognizes UAA and UGA termination codons in eubacteria such as Escherichia coli
      and Bacillus subtilis, would be either specific to UAA or deleted. To test this,
      we have constructed a cell-free translation system using synthetic mRNA including
      codon UAA [mRNA(UAA)], UAG [mRNA(UAG)] and UGA [mRNA(UGA)] in-frame. In the
      absence of tryptophan, the translation of mRNA(UGA) ceased at UGA sites without
      appreciable release of the synthesized peptides from the ribosomes, whereas with
      mRNA(UAA) or mRNA(UAG) the bulk of the peptides was released. Upon addition of
      the E.coli S-100 fraction or B.subtilis S-100 fraction to the translation system,
      the synthesized peptides with mRNA(UGA) were almost completely released from the
      ribosomes, presumably because of the presence of RF-2 active to UGA in the added
      S-100 fraction. These data suggest that RF-2 is deleted or its activity to UGA is
      strongly weakened in M.capricolum.

PMID- 8464723
TI  - Visualising the kinetics of dissociation of actinomycin from individual sites in
      mixed sequence DNA by DNase I footprinting.
AB  - We have investigated the kinetics of dissociation of actinomycin D from DNA by a
      variation of the footprinting technique. Complexes of actinomycin with a
      radiolabelled DNA fragment (tyrT) were dissociated by addition of a large excess
      of unlabelled calf thymus DNA and the mixture subjected to DNase I footprinting
      at subsequent intervals. The rates at which the footprints disappeared varied
      between the different binding sites. The dissociation was temperature dependent
      with average time constants of 30 s, 10 mins and 2 hours at temperatures of 37
      degrees C, 20 degrees C and 4 degrees C respectively. The dissociation from a DNA
      fragment containing the synthetic insert T9GCA9 was significantly faster, with a
      half-life of about 1 min at 20 degrees C. In contrast, the dissociation of
      distamycin was too fast to measure (< 5 s) even at 4 degrees C.

PMID- 8464724
TI  - Evolutionary conservation of excision repair in Schizosaccharomyces pombe:
      evidence for a family of sequences related to the Saccharomyces cerevisiae RAD2
      gene.
AB  - Cells mutated at the rad13 locus in the fission yeast, Schizosaccharomyces pombe
      are deficient in excision-repair of UV damage. We have cloned the S.pombe rad13
      gene by its ability to complement the UV sensitivity of a rad13 mutant. The gene
      is not essential for cell proliferation. Sequence analysis of the cloned gene
      revealed an open reading-frame of 1113 amino acids with structural homology to
      the RAD2 gene of the distantly related Saccharomyces cerevisiae. The sequence
      similarity is confined to three domains, two close to the N-terminus of the
      encoded protein, the third being close to the C-terminus. The central region of
      about 500 amino acids shows little similarity between the two organisms. The
      first and third domains are also found in a related yet distinct pair of
      homologous S.pombe/S.cerevisiae DNA repair genes (rad2/YKL510), which have only a
      very short region between these two conserved domains. Using the polymerase chain
      reaction with degenerate primers, we have isolated fragments from a gene
      homologous to rad13/RAD2 from Aspergillus nidulans. These findings define new
      functional domains involved in excision-repair, as well as identifying a
      conserved family of genes related to RAD2.

PMID- 8464725
TI  - Proposed roles for DNA methylation in Alu transcriptional repression and
      mutational inactivation.
AB  - Methylation at CpG dinucleotides to produce 5 methyl cytosine (5me-C) has been
      proposed to regulate the transcriptional expression of human Alu repeats.
      Similarly, methylation has been proposed to indirectly favor the transpositional
      activity of young Alu repeats by transcriptionally inactivating older Alu's
      through the very rapid transition of 5me-C to T. Both hypotheses are examined
      here by RNA polymerase III (Pol III) in vitro transcription of Alu templates
      using HeLa cell extracts. A limiting factor represses the template activity of
      methylated Alu repeats. Competition by methylated prokaryotic vector DNA's
      relieves repression, showing that the factor is not sequence specific. This
      competitor has no effect on the activity of unmethylated templates showing that
      the repressor is highly specific toward methylated DNA. While methylation of a
      single pair of CpG dinucleotides in the A box of the Poll III promoter is
      sufficient to cause repression, methylation elsewhere within the template also
      causes repression. The repressor causing these effects on the Pol III directed
      transcription of Alu repeats is thought to be a previously reported, repressor
      for Pol II directed templates. Young Alu repeats are transcriptionally more
      active templates than a representative older Alu subfamily member. Also, younger
      Alu's form stable transcriptional complexes faster, potentially giving them an
      additional advantage. The mutation of three CpG's to CpA's within and near the A
      box drastically decreases both the template activity and rate of stable complex
      formation by a young Alu member. The sensitivity of Alu template activity to CpG
      transitions within the A box partially explains the selective transpositional
      advantage enjoyed by young Alu members.

PMID- 8464726
TI  - Role of the 5' leader sequence of alfalfa mosaic virus RNA 3 in replication and
      translation of the viral RNA.
AB  - RNA 3 of alfalfa mosaic virus (AIMV) encodes the movement protein P3 and the
      viral coat protein which is translated from the subgenomic RNA 4. The 5'-leader
      sequences of RNA 3 of AIMV strains S, A, and Y differ in length from 314 to 392
      nucleotides and contain a variable number of internal control regions of type 2
      (ICR2 motifs) each located in a 27 nt repeat. Infectious cDNA clones were used to
      exchange the leader sequences of the three strains. This revealed that the leader
      sequence controls the specific ratio in which RNAs 3 and 4 are synthesized for
      each strain. In addition, it specifies strain specific differences in the
      kinetics of P3 accumulation in plants. Subsequent deletion analysis revealed that
      a 5'-sequence of 112 nt containing one ICR2 motif was sufficient for a 10 to 20%
      level of RNA 3 accumulation in protoplasts and a delayed accumulation in plants.
      An additional leader sequence of maximally 114 nt, containing two ICR2 motifs,
      was required to permit wildtype levels of RNA 3 accumulation. The effect of
      deletions in the leader sequence on P3 synthesis in vitro and in vivo was
      investigated.

PMID- 8464727
TI  - A study into the effects of protein binding on nucleotide conformation.
AB  - In this study, we examine the effects of binding to protein upon nucleotide
      conformation, by the comparison of X-ray crystal structures of free and protein
      bound nucleotides. A dataset of structurally non-homologous protein-nucleotide
      complexes was derived from the Brookhaven Protein Data Bank by a novel protocol
      of dual sequential and structural alignments, and a dataset of native nucleotide
      structures was obtained from the Cambridge Structural Database. The nucleotide
      torsion angles and sugar puckers, which describe nucleotide conformation, were
      analysed in both datasets and compared. Differences between them are described
      and discussed. Overall, the nucleotides were found to bind in low energy
      conformations, not significantly different from their 'free' conformations except
      that they adopted an extended conformation in preference to the 'closed'
      structure predominantly observed by free nucleotide. The archetypal conformation
      of a protein-bound nucleotide is derived from these observations.

PMID- 8464728
TI  - In vitro selection of fast-hybridizing and effective antisense RNAs directed
      against the human immunodeficiency virus type 1.
AB  - The rate of double strand formation between procaryotic antisense RNA and
      complementary RNA in vitro is known to correlate with the effectiveness of
      antisense RNA in vivo. In this work, an in vitro assay for determining the
      hybridization rates of a large number of antisense RNA species was developed. A
      set of HIV-1-directed antisense RNAs with the same 5'-end but successively
      shortened 3'-ends was produced by alkaline hydrolysis of a 150 nt HIV-1-directed
      antisense transcript. This mixture was used to determine hybridization rates for
      individual chain lengths with a complementary HIV-1-derived RNA in vitro. The
      second order binding rate constants of individual antisense RNA species differed
      by more than a factor of 100, although in some cases, slow-hybridizing and fast
      hybridizing antisense RNAs differed by only two or three 3'-terminally-located
      nucleotides. The results indicated that there was not a trivial dependence of
      binding rates on the chain length of antisense RNAs. Further, the binding rate
      constants determined in vitro for individual antisense RNA species correlated
      with the extent of inhibition of HIV-1 replication in vivo.

PMID- 8464729
TI  - The secondary structure of the 5'-noncoding region of beet necrotic yellow vein
      virus RNA 3: evidence for a role in viral RNA replication.
AB  - Secondary structure-sensitive chemical and enzymatic probes have been used to
      produce a model for the folding of the first 312 residues of the long 5'
      noncoding region of beet necrotic yellow vein virus RNA 3. The structure consists
      of two major domains, one of which includes long distance base-pairing
      interactions between two short sequence elements (Box I and Box II) situated
      between positions 237 and 292 and complementary elements (Box I' and II') near
      the 5'-terminus. Previous studies have shown that base pairing between these
      sequence elements (in either the plus-strand or minus-strand RNA) is important
      for RNA 3 accumulation during infection. RNA 3 transcripts were produced
      containing mutations which preferentially disrupted Box II-II' base pairing in
      either the plus- or minus-strand. In infection experiments, transcripts with
      mutations which disrupted the Box II-II' interaction in the plus-strand structure
      replicated less efficiently than mutants in which the Box II-II' interaction was
      disrupted in the minus-strand. These findings indicate that the complex 5'
      proximal plus-strand structure to which the Box II-II' interaction contributes
      comprises at least part of the promoter for plus-strand RNA synthesis.

PMID- 8464730
TI  - Use of a transactive regulatory mutant of Dictyostelium discoideum in a
      eucaryotic expression system.
AB  - The discoidin proteins of Dictyostelium discoideum are highly expressed during
      development. The Disc I gamma promoter allows the regulation of heterologous
      protein expression by experimental conditions. We report conditions under which
      the promoter activity is efficiently repressed during growth in the wildtype
      strain AX2. In addition we show that a mutant which overexpresses the discoidins
      also overexpresses the reporter genes beta-galactosidase, luciferase and CAT 10-
      to 100-fold when these are placed under the control of a Disc I gamma promoter.
      This system may be generally useful for the overexpression of genes in
      Dictyostelium, both for functional studies in vivo and for the production of
      heterologous proteins for purification.

PMID- 8464731
TI  - Template controlled coupling and recombination of oligonucleotide blocks
      containing thiophosphoryl groups.
AB  - Oxidation of a pair of 3'- and 5'-thiophosphoryloligonucleotides in the presence
      of a complementary oligonucleotide template is shown to provide an effective
      means for selectively linking oligonucleotide blocks. Coupling proceeds rapidly
      and efficiently under mild conditions in dilute aqueous solutions (microM range
      for oligomers, 2-15 min at 0-4 degrees C with K3Fe(CN)6 or KI3 as oxidant). This
      chemistry was demonstrated by polymerization of a thymidylate decamer derivative
      (sTTTTTTTTTTs) in the presence of poly(dA) and by coupling oligomers possessing
      terminal thiophosphoryl groups (ACACCCAATTs + sCTGAAAATGG and ACACCCAATs +
      sCTGAAAATGG) in the presence of a template (CCATTTTCAGAATTGGGTGT). Efficient
      linking of 5' to 3' phosphoryl groups can be achieved under conditions where
      virtually no coupling takes place in absence of a template. A novel feature of
      the chemistry is that catalyzed recombinations of oligomers containing internal 
      OP(O)(O-)SSP(O)(O-)O- linkages can be directed by hydrogen bonding to a
      complementary oligonucleotide. Convenient procedures are reported for solid phase
      synthesis of the requisite oligonucleotide 3'- and 5'-phosphorothioates.

PMID- 8464732
TI  - Duplicated KOX zinc finger gene clusters flank the centromere of human chromosome
      10: evidence for a pericentric inversion during primate evolution.
AB  - Two related zinc finger (ZNF) gene clusters from the pericentromeric region of
      human chromosome 10, defined by cDNAs of the KOX series, have been cloned in
      yeast artificial chromosomes (YACs). The two clusters evolved by duplication of
      an ancestral gene cluster before the divergence of the human and great ape
      lineages. Included in cluster A are the ZNF gene sequences ZNF11A, ZNF33A, and
      ZNF37A, while cluster B comprises the related sequences ZNF11B, ZNF33B and
      ZNF37B. Genes from both clusters are expressed: cDNAs KOX2, KOX31 and KOX21
      derive from ZNF11B, ZNF33A and ZNF37A, respectively. Further YACs have been
      isolated which link ZNF11A and ZNF33A to another gene, ZNF25, defined by cDNA
      clone KOX19. Therefore ZNF25 also forms part of cluster A, but has no counterpart
      in cluster B. Surprisingly, the KOX ZNF gene clusters are located on opposite
      sides of the centromere: cluster A maps to 10p11.2, while cluster B is in
      10q11.2. This suggests the occurrence during primate evolution of a previously
      undescribed pericentric inversion subsequent to the cluster duplication. The
      evolution of this subset of KOX ZNF genes has therefore involved three types of
      genetic event: local gene duplication, gene cluster duplication, and chromosome
      rearrangement.

PMID- 8464733
TI  - Identification of the catalytic and DNA-binding region of the human
      immunodeficiency virus type I integrase protein.
AB  - The integrase (IN) protein of the human immunodeficiency virus (HIV) is required
      for specific cleavage of the viral DNA termini, and subsequent integration of the
      viral DNA into target DNA. To identify the various domains of the IN protein we
      generated a series of IN deletion mutants as fusions to maltose-binding protein
      (MBP). The deletion mutants were tested for their ability to bind DNA, to mediate
      site-specific cleavage of the viral DNA ends, and to carry out integration and
      disintegration reactions. We found that the DNA-binding region resides between
      amino acids 200 and 270 of the 288-residues HIV-1 IN protein. The catalytic
      domain of the protein was mapped between amino acids 50 and 194. For the specific
      activities of IN, cleavage of the viral DNA and integration, both the DNA-binding
      domain and the conserved amino-terminal region of IN are required. These regions
      are dispensable however, for disintegration activity.

PMID- 8464734
TI  - Characterization of (GT)n and (CT)n microsatellites in two insect species: Apis
      mellifera and Bombus terrestris.
AB  - A set of 52 (CT)n and 23 (GT)n microsatellites in honeybee, 24 (CT)n and 2 (GT)n
      microsatellites in bumble-bee (n > 6) have been isolated from partial genomic
      libraries and sequenced. On average, (CT)n and (GT)n microsatellites occur every
      15 kb and 34 kb in honeybee and every 40 kb and 500 kb in bumble-bee,
      respectively. The prevailing categories are imperfect repeats for (CT)n
      microsatellites in bumble-bee, and perfect repeats for both (CT)n and (GT)n
      microsatellites in honey-bee. Comparisons with data available in vertebrates
      indicate a lower proportion of perfect repeats in bees but length distributions
      are very similar regardless the phylum. This result extends to insects the
      concept of an evolutionary conservation for quantitative and qualitative
      characteristics of (CT)n and (GT)n microsatellites. Many (CT)n and (GT)n repeats
      are surrounded with various types of microsatellites, revealing an associative
      distribution of short repeat sequences. As expected, a high level of
      intrapopulational polymorphism has been found with one tested honeybee
      microsatellite. Also, flanking regions of this microsatellite are similar enough
      to allow PCR amplification in several other species of Apis and Bombus.

PMID- 8464735
TI  - Demonstration of Z-d(5BrCGAT5BrCG) and B-d(CGCGATCGCG) form crystal structures in
      DNA-cobalt hexammine complexes by Kr 647.1 nm excitation of Raman spectra.
AB  - Cobalt hexammine [Co(NH3)6(3+)] is an efficient DNA complexing agent which
      significantly perturbs nucleic acid secondary structure. We have employed red
      excitation (647.1 nm) from a krypton laser to obtain Raman spectra of the highly
      colored complexes formed between cobalt hexammine and crystals of the DNA
      oligomers, d(5BrCGAT5BrCG) and d(CGCGATCGCG), both of which incorporate out-of
      alternation pyrimidine/purine sequences. The Co(NH3)6(3+) complex of
      d(5BrCGAT5BrCG) exhibits a typical Z-form Raman signature, similar to that
      reported previously for the alternating d(CGCGCG) sequence. Comparison of the
      Raman bands of d(5BrCGAT5BrCG) with those of other oligonucleotide and
      polynucleotide structures suggests that C3'-endo/syn and C3'-endo/anti thymidines
      may exhibit distinctive nucleoside conformation markers, and tentative
      assignments are proposed. The Raman markers for C2'-endo/anti adenosine in this Z
      DNA are consistent with those reported previously for B-DNA crystals containing
      C2'-endo/anti dA. Raman bands of the cobalt hexammine complex of d(CGCGATCGCG)
      are those of B-DNA, but with significant differences from the previously
      characterized B-DNA dodecamer, d(CGCAAATTTGCG). The observed differences suggest
      an unusual deoxyguanosine conformer, possibly related to a previously
      characterized structural intermediate in the B-->Z transition. The present
      results show that crystallization of d(CGCGATCGCG) in the presence of cobalt
      hexammine is not alone sufficient to induce the left-handed Z-DNA conformation.
      This investigation represents the first application of off-resonance Raman
      spectroscopy for characterization of highly chromophoric DNA and illustrates the
      feasibility of the Raman method for investigating other structurally perturbed
      states of DNA-cobalt hexammine complexes.

PMID- 8464736
TI  - The sequence of 28S ribosomal RNA varies within and between human cell lines.
AB  - The primary structure of 28S ribosomal RNA constitutes a conserved core which is
      similar among most 23S-like rRNAs and expansion segments which occur at specific
      positions in the sequence. The expansion segments account for most of the size
      difference between prokaryotic (archaeal and eubacterial) and eukaryotic rRNAs
      and they exhibit a sequence variation which is unique among rRNAs. We have
      investigated the sequence variation of one of the expansion segments, V8, by
      sequencing a total of 111 V8 segments from 9 different human cell lines and
      tissues and have found 35 different variants. The variation occur mainly at two
      'hot spots' which are separated by 170 nucleotides in the primary sequence but
      are neighbours in the secondary structure. The sequence of V8 segments varies
      both within and between human cell lines and tissues. The implications for the
      evolution of the eukaryotic 28S rRNA are discussed together with possible
      functions of the expansion segments. We also present a secondary structure model
      for the V8 segment based on comparative sequence analysis and chemical and
      enzymatic foot printing.

PMID- 8464738
TI  - Species-specific differential cleavage and polyadenylation of plasminogen
      activator inhibitor type 1 hnRNA.
AB  - Plasminogen activator inhibitor type 1 (PAI-1) is the primary physiologic
      inhibitor of the naturally occurring plasminogen activators. In higher primates
      two forms of mature PAI-1 mRNA (3.2 kb and 2.2 kb) arise by alternative cleavage
      and polyadenylation of PAI-1 hnRNA which is regulated in a tissue-specific
      fashion in humans. In other mammals only the 3.2 kb mRNA has been detected. The
      putative downstream polyadenylation site in humans that gives rise to the 3.2 kb
      PAI-1 mRNA consists of three overlapping copies of the consensus polyadenylation
      sequence while no consensus polyadenylation sequence is found upstream at a
      position that could generate the shorter mRNA species. To determine whether
      differential cleavage and polyadenylation of PAI-1 mRNA is due to species
      specific differences in trans-acting factors that process PAI-1 mRNA or to the
      presence of a nonconsensus polyadenylation site acquired recently during primate
      evolution we prepared plasmids in which the 3' nontranslated region of the human
      PAI-1 gene or the mouse PAI-1 cDNA was inserted downstream of the neomycin gene
      in the plasmid pSV2neo. We show that the 3'-nontranslated region of the human PAI
      1 gene but not the mouse PAI-1 cDNA conferred alternative cleavage and
      polyadenylation to the neomycin gene in transfected human Hep G2 cells as well as
      mouse NIH3T3 and rat L6 cells.

PMID- 8464737
TI  - Iron regulatory factor expressed from recombinant baculovirus: conversion between
      the RNA-binding apoprotein and Fe-S cluster containing aconitase.
AB  - Iron regulatory factor (IRF) is a cytoplasmic mRNA-binding protein that
      coordinates post-transcriptionally the expression of several important proteins
      in iron metabolism. Binding of IRF to iron-responsive elements (IRE) in the 5'
      untranslated region (UTR) of ferritin and erythroid 5-aminolevulinic acid
      synthase mRNAs inhibits their translation, whereas binding to IREs in the 3' UTR
      of transferrin receptor (TfR) mRNA prevents the degradation of this mRNA. IRF
      binds RNA strongly after iron deprivation, but is inactive, yet present, under
      conditions of high cellular iron supply. Recently, IRF was also shown to have
      aconitase activity indicating the existence of an Fe-S cluster in the protein. In
      the current study we expressed human IRF in insect cells from recombinant
      baculovirus and analysed IRE-binding and aconitase activities under various
      culture conditions. Newly made apoprotein, synthesized in the absence of iron,
      was fully active in IRE-binding, but showed no aconitase activity. In contrast,
      IRF made by cells grown in high iron medium bound RNA poorly, but exhibited high
      aconitase activity with a Km of 9.2 microM for cis-aconitate. Apo-IRF was
      converted in vitro to active aconitase by Fe-S cluster-generating conditions, and
      under the same conditions lost its RNA-binding capacity. These results indicate
      that the two activities are mutually exclusive and controlled through formation
      of the Fe-S cluster.

PMID- 8464739
TI  - Tissue-specific and developmentally regulated alternative splicing of a visceral
      isoform of smooth muscle myosin heavy chain.
AB  - Previous work demonstrated that the rabbit smooth muscle myosin heavy chain gene
      showed sequence divergence at the 25kDa/50kDa junction of the S1 subfragment when
      compared to chicken gizzard and chicken epithelial nonmuscle myosin. RNase
      protection analysis with a probe spanning this region detected two partially
      protected fragments which were not present in RNA from vascular tissue and only
      found in RNA from visceral tissue. The polymerase chain reaction was used to
      amplify a 162bp product from primers spanning the putative region of divergence
      and DNA sequence analysis revealed a seven amino acid insertion not previously
      detected in other characterised cDNA clones. RNase protection analysis using the
      PCR product as probe showed that the inserted sequence was expressed exclusively
      in RNA from visceral tissue. Similar RNA analysis showed that the visceral
      isoform was not expressed in 20 day fetal rabbit smooth muscle tissues. These
      results indicated that the new visceral isoform was expressed in a tissue
      specific and developmentally regulated manner. Genomic DNA sequencing and mapping
      of the exon-intron boundaries showed that the visceral isoform was the product of
      cassette-type alternative splicing. The inclusion of a visceral-specific sequence
      near the Mg-ATPase domain and at the 25kDa/50kDa junction suggests that the
      visceral isoform may be important for myosin function in smooth muscle cells.

PMID- 8464740
TI  - Solid-phase synthesis and hybridization properties of DNA containing sulfide
      linked dinucleosides.
AB  - Oligodeoxyribonucleotides incorporating non-hydrolyzable dialkyl sulfide linked
      thymidine dimers (TsT) were synthesized chemically by the solid-phase approach.
      The sulfide dimer TsT was stable to degradation by snake-venom phosphodiesterase,
      calf spleen phosphodiesterase, Nuclease P1 and Nuclease S1. Thermal denaturation
      analysis indicated that the incorporation of TsT dimers into DNA weakened, but
      did not prevent, binding to complementary DNA and RNA over a wide range of salt
      concentrations (10 mM to 2 M NaCl).

PMID- 8464741
TI  - Regulatory elements necessary for termination of transcription within the Ig
      heavy chain gene locus.
AB  - Previous experiments have shown that the extent of delta gene transcription
      during B cell development is regulated primarily at the transcriptional level. We
      have shown that deletion of a sequence located between the mu and delta coding
      regions in the Ig heavy chain locus where transcriptional termination has been
      previously mapped abrogates the termination. Restoration of termination requires
      reintroduction of this segment as well as sequence elements within the microM
      poly (A) site which cannot be substituted by the microS poly (A) site.
      Recognition of the termination site by non-lymphoid cells suggests that
      initiation of delta transcription in mature B lymphocytes requires the activation
      of an anti-termination mechanism not yet developed in early B cells.

PMID- 8464742
TI  - Secondary structure of the small subunit ribosomal RNA sequence of the
      microsporidium Encephalitozoon cuniculi.

PMID- 8464743
TI  - The nucleotide sequence of the 25S rRNA-encoding gene from Candida albicans.

PMID- 8464744
TI  - Nucleotide sequence of a gene encoding a histone-like protein in the archaeon
      Methanococcus voltae.

PMID- 8464745
TI  - Analysis of cDNA encoding Drosophila transcription initiation factor TFIIF alpha
      (RAP74).

PMID- 8464746
TI  - Rat and chick cDNA clones encoding HMG-like proteins.

PMID- 8464747
TI  - Wheat TFIID TATA binding protein.

PMID- 8464749
TI  - S26 ribosomal protein RNA: an invariant control for gene regulation experiments
      in eucaryotic cells and tissues.

PMID- 8464748
TI  - An African swine fever virus gene with similarity to bacterial DNA binding
      proteins, bacterial integration host factors, and the Bacillus phage SPO1
      transcription factor, TF1.

PMID- 8464750
TI  - Sequence of a DNA injection gene from Salmonella typhimurium phage P22.

PMID- 8464751
TI  - Cloning and sequencing of the genes of beta-glucosyl-HMC-alpha-glucosyl
      transferases of bacteriophages T2 and T6.

PMID- 8464752
TI  - A novel method to study DNA replication in vivo in organelles.

PMID- 8464753
TI  - [201Tl-myocardial scintigraphy (1974-1992): from perfusion defect to detection of
      viability].

PMID- 8464754
TI  - [Quantitative 201Tl-scintigraphy of the lower limb in arterial occlusive
      disease].
AB  - 201Tl scintigraphy is useful in evaluating the hemodynamic consequences of
      arterial stenoses in arterial occlusive disease. The aim of the present study was
      to determine normal values for absolute Tl uptake in the lower leg, for the
      quotient between left and right lower leg uptake as well as for the
      redistribution pattern after bicycle exercise. We examined as reference 49
      patients without clinical evidence of peripheral or coronary artery disease:
      absolute Tl uptake in the lower leg in anterior scintigraphy (acquisition time:
      120 sec) was 5.02 +/- 1.70 counts/pixel (left) and 5.21 +/- 1.53 counts/pixel
      (right), the quotient between right and left lower leg was 0.85 +/- 0.09 and the
      redistribution pattern (quotient of the mean activity exercise/rest) 0.82 +/-
      0.17 (left) and 0.83 +/- 0.15 (right). The arithmetic mean minus 2 standard
      deviations was regarded as the lower limit of normal. In 8 patients with
      mechanical compression of the left femoral artery before injection at least two
      scintigraphic parameters were abnormal, in 7 patients with angiographically
      proven peripheral artery disease at least one scintigraphic parameter was below
      normal. Quantification of Tl redistribution offers diagnostic advantages in
      bilateral peripheral artery disease.

PMID- 8464755
TI  - [Immunogenic hyperthyroidism following radioiodine ablation of a focal autonomy].
AB  - Immunogenic hyperthyroidism rarely develops after radioiodine elimination of
      focal autonomous thyroid tissue. We observed this phenomenon in 8 patients
      between 1989 and 1992. The occurrence of immunogenic hyperthyroidism shortly
      after elimination of autonomous nodules has not been studied nor is it properly
      understood. Most studies known today describe the development of autonomous
      nodules in the course of immunogenic hyperthyroidism or ignore the chronologic
      order of occurrence. The possibility that immunogenic hyperthyroidism may occur
      after radioiodine therapy of autonomous nodules, makes a consequent follow-up
      within the first year following radioiodine therapy mandatory.

PMID- 8464756
TI  - [The effect of ethylenediaminetetramethylenephosphonate on the biodistribution of
      tumor-seeking radionuclides].
AB  - It is well known that after application of radioactive complexes for tumour
      diagnosis or therapy, such as 67Ga-citrate or radiolanthanide complexes (167Tm-
      or 169Yb-nitrilotriacetate, -citrate, -alpha-hydroxyisobutyrate, 90Y-citrate,
      etc.) activity is accumulated not only in the tumour but also in other organs,
      above all liver and bone. This is the main obstacle to their medical use.
      Recently published results encouraged us to use ethylenediaminetetramethylene
      phosphonate (EDTMP) for the reduction of extratumoural liver activity. The
      results show that even small amounts of EDTMP (1-2 mg/kg BW) reduce the activity
      deposition in the liver by about one order of magnitude. EDTMP provoked
      elimination of activity from tumour, skeleton and other tissues but not to the
      same extent as from the liver. Tumor/liver activity ratios > 5 are achievable in
      this manner.

PMID- 8464757
TI  - [The effect of bone-seeking metal salts on the biodistribution of tumor-seeking
      heavy metal complexes].
AB  - This work attempted to overcome the problem of unwanted bone radioactivity after
      injection of tumour-affine heavy-metal compounds (prototype 169Yb-citrate) by pre
      application of stable yttrium- and calcium-compounds into tumour-bearing mice in
      doses of 1 mg metal/kg body weight. The pre-application of stable yttrium and
      calcium resulted in a smaller bone radioactivity. The most favourable results
      were achieved by injecting the metal salts simultaneously at or within 5 h before
      the 169Yb-citrate. On the other hand a strong radioactivity increase in the RES
      (liver and spleen) by a factor of 2 to 4 was observed after yttrium
      preapplication.

PMID- 8464758
TI  - [Determination of renal clearance with only a single access for injection and
      blood extraction].
AB  - An injection technique was developed to administer radioactivity to children and
      adults and to withdraw plasma samples through the same venous line. The error in
      clearance estimation due to "contamination" was smaller than that caused by the
      timing of blood sampling or the type of algorithm used for clearance calculation.

PMID- 8464759
TI  - [The trend distribution quotient, a new tool for evaluating renal perfusion
      scintigraphy using 99mTc-DTPA following renal transplantation].
AB  - We developed a new quantitative concept in dynamic renal transplant imaging, the
      Trend Distribution Ratio, and tested its diagnostic usefulness in 137
      examinations. This ratio is an expression of the distribution of blood flow
      velocity in different areas of the kidney. With regard to the differential
      diagnosis between acute tubular necrosis and the various forms of rejection we
      arrived at a sensitivity of 0.83 and a specificity of 0.54. A differentiation
      between the various histological types of rejection has not yet been possible.

PMID- 8464760
TI  - [A simple method of digitizing analog scintigrams for quantification and digital
      archiving].
AB  - This study was undertaken to evaluate a quick, reliable and cheap method of
      digitizing analog scintigrams. 40 whole-body bone scintigrams were obtained
      simultaneously in analog and genuine digital format. The analog scans on x-ray
      film were then digitized secondarily by three different methods: 300 dpi flat-bed
      scanning, high-resolution camera scanning and camcorder recording. A simple
      exposure approach using a light box, a cheap camcorder, a PC and image grabber
      hard- and software proved to be optimal. Visual interpretation showed no
      differences in clinical findings when comparing the analog images with their
      secondarily digitized counterparts. To test the possibility of quantification,
      126 equivalent ROIs were drawn both in the genuine digital and the secondarily
      digitized images. Comparing the ROI count to whole-body count percentage of the
      corresponding ROIs showed the correlation to be linear. The evaluation of phantom
      studies showed the linear correlation to be true within a wide activity range.
      Thus, secondary digitalization of analog scintigrams is an easy, cheap and
      reliable method of archiving images and allows secondary digital quantification.

PMID- 8464761
TI  - [Radiation exposure in diagnostic nuclear medicine: risk comparisons on the basis
      of effective doses].
AB  - The hypothetical risk of medical radiation exposure is often extrapolated to
      large population groups using arbitrary assumptions. To assess risk and benefit
      of diagnostic nuclear medicine and roentgenology, estimation of individual loss
      of life expectancy should be preferred. Employing ICRP 60 figures, diagnostic
      medical radiation exposure yields effective doses which commonly lie below or
      within the range of annual exposure from natural radiation (1-6 mSv). On an
      average, the individual medical exposure in Germany is estimated to be between 1
      and 2 mSv which--extrapolated to total lifespan--leads to a hypothetical loss of
      life expectancy of 20-40 days. In the light of the rapid increase of life
      expectancy due to progresses in medical diagnostics and treatment after the
      introduction of X-rays, this figure is negligibly small.

PMID- 8464762
TI  - [Topodiagnosis of Creutzfeldt-Jakob disease using HMPAO-SPECT].
AB  - An 80-year old female presented with early stage Creutzfeldt-Jakob disease with
      clinical, neurophysiological and neuropathological findings suggesting a focal
      involvement of the brain. HMPAO SPECT disclosed asymmetries of regional cerebral
      perfusion, thus suggesting that it may be a further diagnostic instrument in this
      disease.

PMID- 8464763
TI  - [The "white hole" phenomenon--a potential functional parameter in non-gated 201Tl
      myocardial scintigraphy].
AB  - In 50 patients with a "white hole" in their scintigram--among them 44 patients
      with a history of myocardial infarction--the relation between its relative volume
      and the ventriculographically determined ejection fraction was studied
      retrospectively. A relative volume of the "white hole" larger than 13.7% showed a
      specificity of 93% and a sensitivity of 45% for a decreased ejection fraction and
      had a significant correlation of r = -0.54 (alpha = 0.01) with the ejection
      fraction. Thus the relative volume of the "white hole" derived automatically from
      201Tl-SPECT is an easy-to-determine additional parameter which allows an at least
      semiquantitative statement about the function of the left ventricle.

PMID- 8464764
TI  - Whither academic orthopedic integrity?

PMID- 8464765
TI  - A clinical and comparative biomechanical evaluation of proximal femoral osteotomy
      fixation in children.
AB  - This study compared the biomechanical characteristics of a 90 degrees infant
      blade plate construct and anteriorly applied 120 degrees angled plate construct
      in response to an axial compression load. The blade plate construct stiffness was
      three times greater than the angled plate construct (238.9 vs 85.7 N/deg). Four
      degrees failure load was also significantly higher for the blade plate. Despite
      inferior biomechanical characteristics, the 120 degrees angled plate functioned
      very satisfactorily in a retrospective clinical review of 21 proximal femoral
      varus osteotomies. The authors conclude that the 120 degrees angled plate has
      practical benefits in terms of ease of insertion and intraoperative adjustability
      which may outweigh its biomechanical inferiority.

PMID- 8464766
TI  - Stability in relation to humeral head retroversion after surgical treatment of
      recurrent anterior shoulder dislocations.
AB  - This study reports the influence of the retroversion angle on the postoperative
      stability in 50 patients operated on for recurrent shoulder dislocations. Fifty
      two shoulders were reviewed by radiographic and clinical examinations. Particular
      attention was focused on humeral head retroversion, shoulder stability, and range
      of motion in relation to surgical technique. The retroversion angle was
      significantly reduced in 30 of 47 shoulders, for which satisfactory radiographs
      could be achieved. Mean humeral head retroversion was 24 degrees for both
      dominant and nondominant shoulders. Forty-eight of 52 reexamined shoulders became
      stable. Four had remaining instability following a Putti-Platt procedure, with a
      mean retroversion angle of 18 degrees. A reduced humeral head retroversion is
      therefore proposed as an important factor in creating instability, and may be one
      explanation for failed stability after soft tissue repair. Irrespective of the
      type of surgical procedure (Bristow or Putti-Platt), there was a significant
      decrease in range of shoulder rotation in the operated shoulder compared to the
      contralateral stable shoulder and to reference values for normal controls.
      However, decreased rotation was not found to impair shoulder function, and 48 of
      the 50 reexamined patients generally improved after surgery.

PMID- 8464767
TI  - Reinfusion of filtered postoperative orthopedic shed blood: safety and efficacy.

PMID- 8464768
TI  - Rehabilitation following reconstruction of the anterior cruciate ligament.
AB  - A closely supervised rehabilitation program is mandatory if maximum benefit is to
      be derived from anterior cruciate ligament (ACL) reconstruction. The author
      describes a postoperative rehabilitation protocol based on kinesiologic,
      histologic, and biomechanical factors affecting the ACL.

PMID- 8464769
TI  - Radial head dislocation following septic arthritis of the elbow.

PMID- 8464770
TI  - The distal oblique comminuted tibia fracture.

PMID- 8464771
TI  - Non-cemented total hip replacement for metastatic disease.

PMID- 8464772
TI  - Systemic mastocytosis with pathologic fractures of distal long bones.

PMID- 8464773
TI  - Arthroscopic suture fixation of displaced tibial eminence fractures.

PMID- 8464774
TI  - Chondroblastoma.

PMID- 8464775
TI  - Rehabilitation following arthroscopic subacromial decompression.

PMID- 8464776
TI  - Radiologic case study. Fractures of the proximal humerus.

PMID- 8464777
TI  - Answer please. Cavernous lymphangioma of the hand.

PMID- 8464778
TI  - Abnormal pulmonary bombesin immunoreactive cells in Wilson-Mikity syndrome
      (pulmonary dysmaturity) and bronchopulmonary dysplasia.
AB  - Wilson-Mikity syndrome (WMS) is a disorder of uncertain origin. It is sometimes
      considered a variant of bronchopulmonary dysplasia (BPD), but it lacks the
      characteristic microscopic stigmata of destruction and fibrosis caused by the
      barotrauma and oxygen toxicity of ventilator support. Conventional clinical and
      autopsy studies of WMS have failed to identify the underlying pathophysiology.
      This study evaluated bombesin-containing pulmonary neuroendocrine (PNE) cells in
      eight WMS cases, seven cases of BPD, and five controls, using the
      immunoperoxidase technique. The PNE cells were quantified by established
      morphometric techniques. The percentage of airways containing PNE cells in WMS
      (mean, 85.56%) was similar to that in the controls (mean, 82.6%) but
      significantly greater than that in BPD (mean, 21.28%) (p < .001). Measurement of
      intraepithelial PNE cell cytoplasm within the bombesin-immunopositive airways
      demonstrated apparent PNE cell hyperplasia in both WMS and BPD. Prominent numbers
      of PNE cells were also present in the respiratory bronchioles and alveolar units
      in WMS. The increased PNE cells in WMS may reflect chronic hypoxia from
      hypoventilation and or autonomic dysfunction. The profile in BPD may reflect a
      similar pathophysiology but complicated by ventilator-induced injury to airway
      epithelium.

PMID- 8464779
TI  - Maldescent of the thymus: 34 necropsy and 10 surgical cases, including 7 thymuses
      medial to the mandible.
AB  - Among 3236 pediatric necropsies over 23 years, abnormal position of thymic tissue
      was recorded in 34 cases. Cardiac anomalies, predominantly those seen in DiGeorge
      syndrome, were present in 24; 3 had noncardiac anomalies only, 4 had other
      diseases, and 3 were sudden infant deaths. Mediastinal thymic tissue was absent
      in 22 cases, small or unilateral in 7, and normal in 5. The maldescended thymic
      tissue was unilateral in 18, bilateral in 11, and multiple on one or both sides
      in 5. It was situated near the thyroid gland in 19, lower in the neck in 6, and
      higher in 9, including 7 medial to the submandibular salivary gland and 1 at the
      base of the skull. The maldescended tissue approached the size of a normal lobe
      of thymus in eight and was 2.4 to 0.1 cm in the remainder. Over the same period,
      in only two cases was no thymic tissue found. Among 68,000 surgical specimens
      over 40 years, there were 10 cases of ectopic thymus in the neck, including 1
      cutaneous and 4 cystic. This frequency of thymic tissue in the neck may explain
      why lymphoid tissues are sometimes relatively normal in cases of absent
      mediastinal thymus and behooves a search in the submandibular salivary gland
      region and higher before diagnosing thymic agenesis.

PMID- 8464780
TI  - Histochemistry of the atrioventricular conducting system during postnatal
      development.
AB  - The atrioventricular conduction system of 27 infants coming to autopsy was
      examined by histochemical methods. Twenty one were sudden infant deaths; six were
      explained deaths. A decrease of oxidoreductases and hydrolases activities was
      found in clusters of conducting cells protruding from the atrioventricular (AV)
      node and His bundle left into the collagen of the septum. These findings reflect
      regressive changes connected with reduction of the AV conducting system during
      postnatal development.

PMID- 8464781
TI  - Syndromal associations of common origin of the carotid arteries.
AB  - The term "common origin of the carotid arteries" (COCA) has been proposed to
      replace the older terms "origin of the left carotid artery from the innominate
      stem" and "bicarotid trunk with anomalous right or left subclavian artery." These
      anatomic patterns are usually reported to occur in about 11% of whites and 20-25%
      of blacks and have been reported to have increased frequency in patients with
      esophageal atresia-tracheoesophageal fistula, DiGeorge anomaly, and anomalous
      origin of the left coronary artery from the pulmonary artery. COCA is a
      significant, if not invariant, feature of the great arteries in the condition
      usually called in the more recent literature "anomalous origin of the innominate
      artery," the most frequent cause of symptomatic tracheal compression by anomalous
      systemic arteries. Analysis of associations of COCA with various other congenital
      cardiovascular lesions showed, in addition, significant association with
      congenital polyvalvular disease, truncus arteriosus, aorticopulmonary window,
      trisomy 13, 18, and 21 syndromes, acrocephalosyndactyly (especially Apert
      syndrome), tetralogy of Fallot not associated with DiGeorge anomaly, and clinical
      Noonan phenotype. Pentalogy of Cantrell was associated with no increase in
      incidence of COCA.

PMID- 8464782
TI  - Branching patterns of right pulmonary artery in cardiovascular anomalies.
AB  - The branch of the right pulmonary artery (RPA) to the upper lobe of the right
      lung (RUL), the truncus anterior of the RPA, and the pars anterior of the left
      pulmonary artery, which supplies the left upper lung lobe (LUL), were
      demonstrated by both dissection of postmortem specimens and angiography for 20
      infants and children, by angiography only for 57, and by specimen dissection only
      for 59 (total 136). In posteroanterior angiograms, the RUL artery branches from
      the RPA near the right lateral border of the vertebral column, while the LUL
      artery or arteries arise more laterally, near the left midclavicular plane. This
      pattern is reversed in situs inversus (eight patients studied). Thirty-nine
      patients in other categories of congenital cardiovascular disease showed an
      abnormal RUL or LUL arterial pattern, including pulmonary isomerism, right lung
      type (RUL artery pattern present bilaterally, 12 patients); pulmonary isomerism,
      left lung type (RUL artery pattern absent bilaterally, 11 patients); scimitar
      syndrome (RUL artery pattern normal, 1 patient; absent bilaterally, 4 patients);
      and left pulmonary artery sling (RUL artery normal, one; hypoplastic, one;
      absent, two patients). Five patients with tetralogy of Fallot (TOF) with right
      aortic arch (RAA) and 1 of 15 with RAA not TOF or situs inversus showed a
      relatively large RUL artery arising more laterally than usual. Three of six
      patients with double outlet right ventricle had the LUL artery larger than usual
      plus two accessory RUL arteries, and one patient with crossed pulmonary arteries
      showed a similar pattern. Two patients with single ventricle had an RUL artery of
      normal pattern although the RUL bronchus was absent, and one patient with single
      ventricle and situs inversus had a comparable pattern in the left lung. The ease
      of demonstration of the right and left upper lobe branches of the pulmonary
      artery by dissection or angiocardiography warrants greater attention to their
      patterns in patients with congenital cardiovascular disease. Dissociation of
      upper lobe bronchial and vascular patterns is unusual and may also be of
      diagnostic value.

PMID- 8464783
TI  - Intestinal neuronal density in childhood: a baseline for the objective assessment
      of hypo- and hyperganglionosis.
AB  - In the absence of reliable baseline data for normal neuron density in the
      intestine, the diagnosis of hypo- and hyperganglionosis is purely subjective.
      This study has established the normal neuron density by neuron counts in paraffin
      sections taken both transversely (transverse sections, TS) and longitudinally
      (longitudinally sections, LS) in relation to the long axis of normal postmortem
      jejunum, ileum, and colon from 21 children (aged 4 weeks to 10 years). Intestine
      from two adults (aged 16 and 42 years) and colon alone from a further six adults
      (aged 16 to 83 years) were also studied. The mean density values in childhood
      were for jejunum 3.6/mm (TS), 3.7/mm (LS); for ileum 4.3/mm (TS, LS); and for
      colon 7/mm (LS), 7.7/mm (TS). The proximal margins of surgically resected colons
      from six patients with Hirschsprung's disease and one patient with suspected
      isolated hypoganglionosis were also analyzed and the neuron densities compared
      with the established postmortem data. Neuron density values outside two standard
      deviations from the postmortem mean were shown to correlate with continuing
      pseudo-obstructive symptoms in these patients.

PMID- 8464784
TI  - Renal tubular dysgenesis: a description of early renal maldevelopment in
      siblings.
AB  - A family is described in which three siblings, born after pregnancies complicated
      by oligohydramnios, developed renal abnormalities. In the first infant, of 38
      weeks gestation, histologic changes were nearly identical to those found in renal
      tubular dysgenesis (RTD), a recently identified disorder characterized by the
      absence of recognizable renal proximal tubules. Additional findings include
      bilateral renal vein thrombosis and marked calvarial bone hypoplasia. The other
      two gestations were 20 and 22 weeks long. Renal histology in these cases showed
      nonspecific abnormalities with focal tubular dilatation, decreased tubule
      formation, and increased interstitial connective tissue. Clearly recognizable
      proximal tubules were present, though decreased in number. The latter two
      gestations described herein are the earliest examined in a family with RTD and
      the renal abnormalities may represent early changes seen in this disorder.

PMID- 8464785
TI  - An infant with X-linked myotubular myopathy.

PMID- 8464786
TI  - Divergent genetic selection for incidence of tibial dyschondroplasia in broilers
      at seven weeks of age.
AB  - Selection for a high (H) or low (L) incidence of tibial dyschondroplasia (TD) at
      7 wk of age was practiced for four generations in broiler breeders using low
      intensity x-ray imaging (Lixiscope) for TD diagnosis. As a result, broiler lines
      with H or L incidence of TD at 7 wk of age were developed keeping a randomly
      selected control (C) broiler line. A total of 4,232 chicks were hatched
      representing 172 sires and 612 dams over four generations for the H, L, and C
      lines. The TD scores at 7 wk were collected on 4,056 broilers. Incidence of TD at
      4 and 7 wk of age were studied in the C, H, and L lines of broilers. Direct
      response to selection in the H and L lines were estimated per generation and per
      weighted cumulative selection differential (WCSD). Total WCSD deviation from the
      C line for incidence of TD at 7 wk of age was 1.496 and -.42 units for the H and
      the L lines, respectively. The response per generation for incidence of TD at 7
      wk of age for the H line was .153 +/- .028 units. The realized heritability for
      the H line for incidence of TD at 7 wk of age was .437 +/- .065. The incidence of
      TD was not significantly decreased in the L line at 7 wk of age.

PMID- 8464787
TI  - Exclusion of broiler breeder females from male feeders with a male only grill. 1.
      Behavioral and technical aspects of design and development.
AB  - A series of experiments was conducted in order to develop a feeder grill that
      would allow broiler breeder males, but not females, to eat. Females are typically
      excluded from male feeders by increasing the height of the feeder. However, male
      feeder heights that exclude most females increase the time required for males to
      consume a given amount of feed 19 to 60%. Typical male feeder height from floor
      to feeder pan lip in commercial practice is 55 cm, which is about the distance
      from floor to the head of the male in an erect posture. Females measure about 40
      cm in an erect posture. Because the necks of males (8.0 cm) are longer than those
      of females (6.3 cm), the lip of male feeder pans was extended horizontally 12.7
      cm with a wire mesh on the assumption that females could not stretch their necks
      enough to reach the feed. However, the females learned quickly to perch on the
      extended lip and eat. Total exclusion of females from the male feeder, regardless
      of feeder height, was achieved by placing a horizontal upper mesh 5.6 to 10.2 cm
      above the extended lip, and connecting the upper mesh to the lower extended lip
      of the feeder with vertical bars spaced 5.1 cm apart. The horizontal upper mesh
      prevented perching by females and the 5.1-cm spacing of the vertical bars allowed
      males but not females to reach the feed by inserting their heads and necks up to
      their shoulders.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464789
TI  - Fibronectin synthesis in the harderian gland of the chicken.
AB  - Immunoelectron microscopic staining with a monoclonal antibody against
      fibronectin demonstrated the presence of this extracellular matrix glycoprotein
      in the avian Harderian gland. Fibronectin was detected as a component of the
      electron-dense material, which has been observed both between the epithelial
      cells lining the ducts of the gland and between the lymphoid cells within the
      subepithelial lymphoid tissue. Additionally, intracellular fibronectin was
      detected in the rough endoplasmic reticulum, Golgi complex, and secretory
      vacuoles in the cytoplasm of a cell, showing the ultrastructural features of a
      myofibroblast. These findings indicate that the Harderian gland myofibroblasts
      secrete and release fibronectin into the extracellular matrix.

PMID- 8464788
TI  - Effects of feeding Fusarium moniliforme culture material, containing known levels
      of fumonisin B1, on the young broiler chick.
AB  - The effects of feeding Fusarium moniliforme culture material, containing known
      concentrations of fumonisin B1 (FB1), were studied in broiler chicks. Day-old
      chicks were allotted randomly to dietary treatments containing 0, 1.02, 2.04,
      3.06, 4.08, 5.10, 6.12, and 7.14% fumonisin culture material (FCM). These levels
      of FCM supplied 0, 75, 150, 225, 300, 375, 450, and 525 mg of FB1/kg of feed.
      Each dietary treatment was fed to four pen replicates of six birds each for 21
      days. Chicks fed FCM that supplied 450 and 525 mg FB1/kg diet had lower (P < .05)
      feed intakes and BW gains; increased (P < .05) liver and kidney weights; and
      increased (P < .05) mean cell hemoglobin, and mean cell hemoglobin
      concentrations. Compared with controls, chicks fed FCM had increased (P < .05)
      free sphinganine levels and sphinganine:sphingosine ratios. Treatment-associated
      histological lesions were only observed in the liver of chicks fed diets
      containing FCM that supplied 225 mg FB1/kg or higher. Diets containing FCM that
      supplied levels as low as 75 mg FB1/kg affected the physiology of chicks by
      increasing free sphinganine levels and sphinganine:sphingosine ratios. Because
      inhibition of sphingolipid biosynthesis has been hypothesized as the mechanism of
      action of FB1, this suggests that diets containing 75 mg FB1/kg FCM may be toxic
      to young broiler chicks.

PMID- 8464790
TI  - Vitamin profiles of eggs as indicators of nutritional status in the laying hen:
      riboflavin study.
AB  - Two experiments determined the effect of dietary riboflavin supplementation on
      egg yolk and albumen riboflavin concentrations, egg production, egg weight, shell
      thickness, hen weight, hatchability, incidence of clubbed down, and incidence of
      hemorrhagic embryos. In the first experiment, hens were fed rations containing
      1.55, 2.20, 4.40, and 8.80 mg of riboflavin/kg of diet for 27 wk. Significant (P
      < .05) depressions in both yolk and albumen riboflavin concentrations were noted
      at the two lower riboflavin levels after 1 wk. Egg production, egg weight,
      hatchability, and hen weight were all significantly depressed by the two lower
      riboflavin levels later in the experiment when compared with the two higher
      levels. Results indicate that egg riboflavin concentrations are related to
      important production parameters that may be used to predict future dietary
      riboflavin inadequacies. In the second experiment, hens were fed either an
      unsupplemented diet or a riboflavin-adequate diet. Measurements of egg albumen
      riboflavin content, egg production, hatchability, and embryo abnormalities were
      made twice each week. Results showed depressed albumen riboflavin concentrations
      and hatchability and increased incidence of hemorrhagic embryos and clubbed down
      without changes in egg production during the 4- to 7-day period following feeding
      of the unsupplemented diet. These results show that low albumen riboflavin
      content immediately affect hatchability and embryonic development. The estimated
      minimum critical albumen riboflavin concentrations needed to support maximum
      reproductive function are between 1.9 and 2.9 micrograms of riboflavin/g of egg
      albumen. These critical values might be used to evaluate riboflavin status of
      laying and breeding flocks.

PMID- 8464791
TI  - Effects of lighting pattern and dietary tryptophan supplementation on growth and
      mortality in broilers.
AB  - The effect of lighting pattern and supplementation of the diet with Trp on growth
      and mortality of male broiler chickens was evaluated in three experiments using
      2,392, 2,608, and 2,400 chickens, respectively. There were two lighting
      treatments, either a constant 23 h of continuous light/24-h period or an
      increasing photoperiod lighting system, i.e., 0 to 3 days, 23 h light (L):1 h
      dark (D); 4 to 14 days, 6L:18D; 15 to 21 days, 10L:14D; 22 to 28 days, 14L:10D;
      29 to 35 days, 18L:6D; 36 to 42 days, 23L:1D. The design was a completely
      randomized 2 x 2 factorial, with four replicates per treatment. In the first two
      experiments, a starter diet with or without .2% supplemental L-Trp (feed grade)
      was fed from 0 to 3 wk of age and a finisher diet with or without .2%
      supplemental Trp was fed from 3 to 6 wk of age. In the third experiment, the
      level of supplemental Trp was .4% in the starter and finisher diet. Birds raised
      on the increasing light pattern consumed less feed during the first 3 wk, were
      lighter in weight at 3 wk, and had lower feed:gain ratios (P < .001) than their
      counterparts on constant light. By market age (6 wk) they had similar body weight
      but feed intake was significantly (P < .05) lower in all experiments, and
      feed:gain ratio was significantly lower in these birds in Experiment 3 (P < .05)
      than in their counterparts on constant light.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464792
TI  - Evaluation of two novel biochemicals on plasma and egg yolk lipid composition and
      laying hen performance.
AB  - PD132301-2, an inhibitor of acyl-coenzyme A:cholesterol O-acyltransferase (ACAT;
      EC 2.3.1.26), and 1-stearylboronic acid (SBA), a fatty acid analogue, were orally
      administered to White Leghorn hens in separate experiments to evaluate their
      effects on layer performance and plasma and egg yolk lipids. Five 60-wk-old hens
      each were fed either a corn-soybean meal basal layer ration, or the basal diet
      supplemented with .0121, .0363, or .1089% PD132301-2. In a second experiment, 12
      37-wk-old hens each were fed either a basal layer ration, or the basal diet
      supplemented with .20 or .40% SBA. The duration of the experiments were 21 and 16
      days, respectively. Neither compound significantly affected hen-day production,
      egg weight, yolk weight, BW gain, feed consumption, feed efficiency, plasma total
      cholesterol and triglyceride concentrations, or egg yolk cholesterol content.
      PD132301-2 had no effect on yolk fatty acid profiles, and C22:6n3 was the only
      fatty acid altered by SBA. Although 3-hydroxy-3-methylglutaryl-coenzyme A
      reductase inhibitors have been successful in reducing egg cholesterol, ACAT
      inhibitors and fatty acid analogues apparently hold little promise in this
      regard. The results of the present work also support the concept that, in order
      to pharmacologically alter the cholesterol content of eggs, direct inhibition of
      key enzymes in the cholesterol biosynthetic pathway is necessary.

PMID- 8464793
TI  - Dietary addition of cellular metabolic intermediates and carcass fat deposition
      in broilers.
AB  - Ninety-six 1-day-old male broilers were fed a diet containing 0, 2, 4, 6, 8, or
      10% of a 1:1 mixture of pyruvic acid (PY) and dihydroxyacetone (DH) for ad
      libitum consumption for 42 days. Feed intake, body weight gain, and feed
      efficiency decreased linearly (P < .001) with increasing levels of PY and DH.
      There were no significant differences among treatments for abdominal fat
      percentage. Carcass chemical analysis revealed small but significant (P < .05)
      differences among dietary treatments for protein and fat percentages. In a second
      experiment, 192 1-day-old male broilers were fed diets containing 5% of PY,
      lactic acid (LA), citric acid (CI), DH, or glycerol (GY) or mixtures (1:1) of DH
      or GY in combination with each organic acid. Bird performance was impaired (P <
      .05) by PY or CI but not by DH or GY. Lactic acid reduced (P < .05) feed intake
      by 9% without affecting weight gain. Lactic acid plus DH, CI plus DH, and CI plus
      GY mixtures decreased (P < .05) bird performance but other combinations had no
      effect. Pyruvic acid or CI decreased abdominal fat and carcass lipid percentages.
      Dihydroxyacetone increased (P < .05) carcass lipid percentage and GY increased (P
      < .05) abdominal fat percentage. Lactic acid plus DH increased (P < .05) carcass
      lipid percentage. Only PY and CI decreased carcass fat deposition, but they also
      impaired broiler performance.

PMID- 8464794
TI  - Evaluation of egg injection of folic acid and effect of supplemental folic acid
      on hatchability and poult weight.
AB  - Two experiments were conducted with Large White turkey hens housed individually
      in cages in a conventional house. In Experiment 1, three dietary treatments were
      used: an unsupplemented practical corn-soybean meal basal diet; the basal diet
      supplemented with 2.64 mg folic acid/kg of diet; and the basal diet supplemented
      with 5.51 mg folic acid/kg of diet. Eggs from hens fed 2.64 mg folic acid/kg of
      diet were injected with folic acid in 20 injection trials over two production
      cycles. The response data from dietary supplemental folic acid were analyzed on a
      production period basis using all of the hens, and on a subset of hens producing
      eggs in each production period, for hatchability of fertile eggs and poult
      weight. The response patterns in each case were similar. Incremental dietary
      supplemental folic acid levels produced a positive linear response pattern on the
      transfer of folic acid in eggs, but did not result in a hatchability increase
      over the unsupplemented folic acid basal diet. Hatchability increase did not
      occur for eggs injected at 25 days of incubation with 19.3 micrograms folic acid
      per egg in 20 injection trials over two cycles of production. The results of the
      study indicate that hatchability is not increased in turkey eggs from hens fed
      supplemental folic acid or with egg folic acid injections. However, egg and poult
      weights were significantly increased (P < .05) in eggs containing 6 to 7 mg folic
      acid/g of dried egg, from hens fed 5.51 mg folic acid/kg of diet.

PMID- 8464795
TI  - The relationship between muscle growth and the growth of different fiber types in
      the chicken.
AB  - A relationship of muscle growth to fiber growth was investigated histochemically
      and allometrically in the chicken from 1 to 35 wk of age. Muscle fibers were
      classified into three types (I, IIA, and IIB) based on the reactivities for
      myosin adenosine triphosphatase and reduced nicotinamide adenine dinucleotide
      dehydrogenase. Fiber type composition widely varied in the four muscles examined
      in this study. Longus colli dorsalis contained all three types. The Pectoralis
      was composed only of IIB fibers. The caudal portion of Femorotibialis medius was
      made up of Type I and IIA fibers. The caudal Iliotibialis lateralis and the
      cranial portion of Femorotibialis medius were composed of two types, IIA and IIB.
      These latter two muscles showed a progressive increase of Type IIA fibers and
      decrease of Type IIB fibers with advancing age. Two processes controlling muscle
      growth were elongation and enlargement of muscle fibers. The elongation of muscle
      fibers stops by 15 wk of age, coincident with the cessation of bone growth.
      However, the enlargement of muscle fibers, the increase in diameter of muscle
      fibers, continued until 35 wk of age. The rate of enlargement of muscle fibers
      varied by muscle and fiber type. In general, greatest growth occurred in Type IIB
      fibers of hindlimb muscles.

PMID- 8464796
TI  - Fragmentation, tenderness, and post-mortem metabolism of early-harvested broiler
      breast fillets from carcasses treated with electrical stimulation and muscle
      tensioning.
AB  - Two 72-bird trials were conducted to determine the effects of 15 s electrical
      stimulation (ES) (440 V, 2 s on and 1 s off) and prechill muscle tensioning (MT)
      on fragmentation, tenderness, and post-mortem metabolism of early-harvested (1 h
      post-mortem) broiler breast fillets. Compared with controls, all treatments
      increased sarcomere length and decreased shear value. Electrical stimulation
      reduced muscle pH values. Histological examination of samples from fillets
      harvested early and then aged 24 h revealed that all treatments increased fiber
      disruption compared with controls. Both fragmentation and excessive sarcomere
      shortening prevention were important to the improvement in fillet tenderness
      associated with the ES and MT treatments.

PMID- 8464797
TI  - Variations in muscle chemical composition, pH, and protein extractability among
      eight different broiler crosses.
AB  - Variations in muscle chemical composition, pH, and protein extractability were
      studied using male broilers of eight different genetic crosses of commercial
      strains. Three replicate groups of 24 birds of each cross were grown in floor
      pens using commercial corn-soybean meal diets. At 8 wk of age, three birds per
      replicate, weighing within 5% of the pen average, were slaughtered, scalded,
      defeathered, eviscerated, and chilled in ice slurries overnight. Muscles were
      excised from breasts and thighs, and trimmed of skin and external fat. Proximate
      analysis was conducted using ground muscle pooled within replicate groups. Breast
      muscle of all strain crosses contained more (P < or = .05) total protein (ranging
      from 20.7 to 23.6%) and moisture (74.6 to 75.9%), and less fat (1.0 to 2.0%) than
      thigh muscle, which contained 18.1 to 21.3% protein, 72.8 to 73.8% moisture, and
      5.0 to 7.2% fat. The pH of breast muscle was lower (P < or = .05) than that of
      thigh muscle for four of the eight strains, and protein extractability of breast
      muscle was greater (P < or = .05) than that of thigh muscle for all strains.
      There were significant differences among strains in chemical composition, pH, and
      protein extractability for both breast and thigh muscles. The correlation between
      percentage protein and fat was positive in breast (r = .72, P < .05) and negative
      in thigh muscle (r = -.77, P < .05). However, no significant correlations were
      observed between the chemical constituents of breast muscle with the respective
      constituents of thigh muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464798
TI  - Effect of two stunning voltages on blood loss and objective texture of meat
      deboned at various post-mortem times.
AB  - Two experiments were conducted to determine the effect of different stunning
      voltages on the objective texture of the Pectoralis major muscles deboned at
      various post-mortem times. Broilers were stunned at either 50 or 200 V
      alternating current (VAC) for 10 s in a brine stunner. The artery and vein on one
      side of the neck were severed, blood collected for 90 s, and blood loss
      calculated as percentage of live weight. Carcasses were then processed under
      simulated commercial conditions. In the first experiment, the right and left
      Pectoralis major muscles were excised at 1 and 2 h post-mortem respectively,
      weighed, vacuum-sealed in plastic bags, and held overnight at 2 C. In the second
      experiment, the Pectoralis major muscles were excised at 4 h post-mortem and held
      overnight at 2 C. The muscles were then heated at 85 C for 30 min, equilibrated
      to room temperature, and prepared for Warner-Bratzler shear analysis. The
      stunning treatments did not significantly affect blood loss, which averaged 2.86
      and 2.64% for 50 and 200 VAC, respectively. Birds subjected to the 50 VAC
      treatment had a mean shear value of 7.3 kg, which was significantly lower (P <
      .05) than the mean shear value of 10 kg for birds subjected to the 200 VAC
      treatment for muscles excised 2 h post-mortem. The use of 200 VAC for stunning
      could be used without any detrimental effect on the cooked meat as long as the
      standard deboning time of 4 h was maintained.

PMID- 8464799
TI  - Research note: effect of age on the yolk to albumen ratio in chicken eggs.
AB  - The effect of age on the yolk:albumen (Y:A) ratio was studied for eggs obtained
      from Hy-Line W36 and Arbor Acres hens. Albumen weight was more closely associated
      with egg weight (EW) than yolk weight for both commercial layers and broiler
      breeder hens. A small positive relationship between EW and Y:A ratio was found. A
      significant increase in Y:A ratio was evident in older flocks from both breeds.

PMID- 8464800
TI  - Research note: effects of perfluorochemical diluent additives on fertilizing
      capacity of turkey semen.
AB  - The perfluorochemicals (PFC) have a high capacity for dissolving oxygen and
      carbon dioxide. Two experiments were conducted using PFC as diluent components to
      assess their effect on the fertilizing capacity of, and the hatchability of eggs
      from hens inseminated with, turkey semen stored for 30 min or 3 h. Two PFC were
      tested for the 30-min experiment: perfluorohexane (FC-72) and
      perfluorobutyltetrahydrofurane (FC-80). For the 3-h experiment, these PFC plus
      bis-1,2-(F-butyl)-ethene (F-44E) were studied. The PFC were emulsified with an
      equal volume of a standard aqueous salt diluent, Beltsville Poultry Semen
      Extender (BPSE). The BPSE alone was used as a control in both experiments. Semen
      was diluted 1:2 with oxygen-saturated extender and stored in closed tubes at 20
      to 30 C prior to insemination. For the 30-min study, PFC diluents resulted in
      fertility rates comparable to (FC-72) or significantly greater than (FC-80) BPSE
      alone (P < or = .05). There was no significant difference in hatchability due to
      any semen treatment. When semen was stored for 3 h, PFC diluents resulted in
      comparable (FC-80) or significantly higher (F-44E and FC-72) fertility and
      hatchability rates. Significantly lower embryonic deaths at Day 10 of incubation
      were noted for all PFC diluents. These findings provide evidence that PFC
      emulsions are not toxic and prolong fertilizing capacity of turkey sperm during
      short-term storage, and suggest that providing oxygen carriers such as PFC in
      semen diluents may be beneficial.

PMID- 8464801
TI  - Research note: responses of laying hens on saline drinking water to dietary
      supplementation with various zinc compounds.
AB  - Production variables, eggshell defects, eggshell quality, the concentration of
      calcium-binding protein (CaBP), and the activity of carbonic anhydrase (CA) in
      the shell gland mucosa were determined in hens receiving town water (10 mg Na/L),
      or town water supplemented with 2 g NaCl/L (796 mg Na/L). Five treatments were
      examined. Control hens received town water and a proprietary layer mash
      containing .17% Na. The remaining four treatments received the water containing
      NaCl (2 g/L). Hens of Treatment 2 were fed the proprietary layer mash and those
      of Treatments 3, 4, and 5 received, respectively, the layer mash containing
      supplements of Zn-methionine (Zinpro-200; .5 g/kg), Zn sulfate (ZnSO4.7H2O; .46
      g/kg), or chelated Zn-EDTA (.54 g/kg) to supply the same concentration of Zn (.1
      g/kg). The treatments were applied for 6 wk. Hens receiving the saline drinking
      water without any dietary Zn supplement produced significantly (P < .05) more
      eggs with shell defects than hens receiving the town water. This increase in the
      incidence of eggshell defects was associated with significant reductions in
      eggshell breaking strength, the concentration of CaBP, and the activity of CA.
      Supplementing the saline drinking water with any of the three Zn compounds
      significantly reduced the incidence of eggshell defects and in some cases
      improved shell breaking strength, the concentration of CaBP, and the activity of
      CA.

PMID- 8464802
TI  - Research note: effect of diet density and pelleting on productive parameters of
      Japanese quail.
AB  - An experiment was conducted to determine the response of growing Japanese quail
      to two dietary energy levels, high (3,200 kcal ME/kg) versus low (3,000 kcal
      ME/kg), and two forms of presentation, mash versus pellet. Seven thousand, two
      hundred day-old Japanese quail (Coturnix coturnix japonica) were randomly
      distributed into 24 floor pens containing 300 quail each. The experiment was
      divided in two phases: starter (until 2 wk of age) and finisher (Days 14 to 33).
      Weight gain was less (P < .05) for quail fed the low-energy mash diet than for
      those on other treatments. Feed consumption increased (P < .001) when low-energy
      and mash diets were fed. Metabolizable energy consumption was greater with the
      mash diets. Feed conversion improved (P < .001) when high-energy and pelleted
      diets were fed as compared with low-energy and mash diets, respectively. Results
      indicated that daily gain and feed conversion of quail fed the low-energy,
      pelleted diet equaled those of quail fed the high-energy mash diet. Pelleting
      improved the caloric efficiency of gain by quail. Quail seemed to adjust caloric
      intake according to the energy level of the diet.

PMID- 8464803
TI  - Solid-state nuclear magnetic resonance spectroscopy: theory and pharmaceutical
      applications.
AB  - The theory of solid-state nuclear magnetic resonance (NMR) spectroscopy is
      reviewed, with specific discussions of magnetic interactions in the solid state.
      Each magnetic interaction (Zeeman, dipole-dipole, chemical-shift, spin-spin, and
      quadrupolar) is addressed and manifestations of these interactions in the solid
      state NMR spectrum are explained. The techniques of high-power decoupling, magic
      angle spinning, and cross-polarization, used to acquire highly resolved solid
      state NMR spectra, are also illustrated. Application of solid-state NMR to
      pharmaceutical problem solving and methods development is then briefly reviewed.

PMID- 8464804
TI  - Solid-state diode laser-induced fluorescence detection in high-performance liquid
      chromatography.
AB  - The need to measure ultralow levels of pharmaceuticals in biological matrices at
      femtogram and attogram levels presents a significant challenge to bioanalysts.
      Liquid chromatography has proven to be a versatile and valuable tool for
      separating analytes from complex biological matrices and fluorescence detection
      provides both the sensitivity and the selectivity required to measure femtogram
      and attogram levels of analytes. Solid-state diode lasers have been used
      primarily in printers, compact disc recorders, and bar code scanners but have
      recently been adapted for use as light sources for fluorescence detection.
      Excellent spectral features in the visible and near-infrared regions of the
      spectrum, together with low cost and ruggedness, make diode lasers an attractive
      alternative for use as light sources in analytical measurement. Biological
      matrices demonstrate minimal background signals in the far-red regions of the
      spectrum which diode lasers emit and diode lasers are among the most stable light
      sources available. These facts along with expected developments in labeling
      systems make the potential for use of diode lasers in LC-detection quite
      promising. This paper reviews characteristics of diode lasers, the properties of
      potential visible and near-infrared fluorescent probes, instrumental aspects of
      diode laser fluorometers, and future trends that can be expected in this exciting
      field of bioanalytical research.

PMID- 8464805
TI  - In vivo microdialysis sampling in the bile, blood, and liver of rats to study the
      disposition of phenol.
AB  - Methods for continuous in vivo sampling in the bile, blood, and liver
      extracellular fluid are described. These methods are based on microdialysis
      sampling in anesthetized rats. A new flow-through microdialysis probe is
      described for sampling bile while maintaining normal bile flow. All three sites
      are simultaneously and continuously sampled to provide concentration-time
      profiles at multiple sites in a single experimental animal. This technique is
      demonstrated by studying the hepatic metabolism and biliary excretion of phenol
      in rats. Following an i.v. infusion of phenol, the major hepatic metabolite was
      found to be phenyl-glucuronide. Hydroquinone and 2-glutathionyl-hydroquinone were
      also detected but at lower concentrations. A similar pattern of metabolites was
      found in the bile and blood. For all of the metabolites, bile concentrations are
      higher than liver concentrations, indicating that the metabolites are actively
      excreted into the bile.

PMID- 8464806
TI  - Low-substituted hydroxypropylcellulose as a sustained-drug release matrix base or
      disintegrant depending on its particle size and loading in formulation.
AB  - Tablets of acetaminophen as a model drug were prepared with low-substituted
      hydroxypropylcellulose (L-HPC) of various particle sizes at various loadings in
      the formulation. Drug release into an aqueous dissolution medium (pH 1.2) was
      remarkably sustained from tablets prepared with fine L-HPC (LH41) at loadings of
      more than 20%. Tablets prepared with less than 20% LH41 or with coarse L-HPCs
      (LH11, LH21, and LH31) disintegrated in the medium, resulting in rapid release of
      the drug. The difference in behavior could not be explained in terms of
      differences in tablet strength, but in swelling and water uptake abilities of the
      tablet's polymer. Swelling work (swelling force), water penetration speed, and
      water uptake of LH41 (4.4-microns average particle size) were much smaller than
      those of coarse L-HPCs. The formation of a continuous gel-like layer on the
      surface of tablets containing more than 20% LH41 was another factor to sustain
      the drug release rate.

PMID- 8464807
TI  - Drug release mechanism from a microcrystalline cellulose pellet system.
AB  - A common form of modified release is the encapsulation of specially formulated or
      coated pellets. An important first step in the development of a multiparticulate
      coated dosage form is to characterize the uncoated pellet. In earlier work, an
      uncoated pellet system developed in these laboratories and prepared from
      microcrystalline cellulose (MCC) was investigated and found to exhibit both the
      physical characteristics of an inert matrix and varying degrees of in vitro
      modified release. The use and characterization of MCC as a spheronization matrix
      material forms the basis for this formulation study. The drug release mechanism
      has been verified by varying selected formulation factors and evaluating the
      resulting pellets according to the relationship developed by T. Higuchi for
      granular inert matrices. In all cases, this MCC pellet system adhered to the
      theoretical relationships and the drug release mechanism can, therefore, be
      classified as an inert matrix.

PMID- 8464808
TI  - The preparation and characterization of poly(lactide-co-glycolide)
      microparticles. II. The entrapment of a model protein using a (water-in-oil)-in
      water emulsion solvent evaporation technique.
AB  - Poly(lactide-co-glycolide) (PLG) microparticles with entrapped antigens have
      recently been investigated as controlled-release vaccines. This paper describes
      the preparation of PLG microparticles with an entrapped model antigen, ovalbumin
      (OVA), using a (water-in-oil)-in-water emulsion solvent evaporation technique. In
      a series of experiments, the effects of process parameters on particle size and
      OVA entrapment were investigated. It was found that smooth, spherical
      microparticles 1-2 microns in diameter containing up to 10% (w/w) OVA could be
      produced using a small volume of external aqueous phase containing a high
      concentration of emulsion stabilizer and a 1:5 antigen:polymer ratio. PAGE
      analysis, isoelectric focusing, and Western blotting of OVA released from the
      microparticles in vitro confirmed that the molecular weight and antigenicity of
      the protein remained largely unaltered by the entrapment procedure.

PMID- 8464809
TI  - Tissue response to bioerodible, subcutaneous drug implants: a possible
      determinant of drug absorption kinetics.
AB  - The fibrous tissue compartments that develop in response to the subcutaneous
      implantation of bioerodible heat-fused rods of norethindrone and cholesterol (85
      and 15%, respectively) were studied by light and electron microscopy at various
      intervals after implantation to determine whether the biological inflammatory
      response may play a role in drug absorption. Thirty-five regularly menstruating,
      sterilized (tubal ligation), healthy females each received four Annuelle rods.
      The microanatomy of seven of the largest implants (135 mg norethindrone) was
      studied. A dense fibrous biological compartment was found to surround each rod.
      By light microscopy no abnormal tissue response was revealed. Scanning and
      transmission electron microscopy showed that the surfaces of the rods were
      covered by a cellular matrix of mononuclear cells. The fibrous compartment was
      composed of a loose cellular bed immediately surrounding the norethindrone rod, a
      dense fibrous connective tissue envelope containing blood and lymphatic vessels,
      and an outer fatty connective tissue layer. Transmission electron microscopy
      confirmed that the cellular tissue immediately surrounding the rods was composed
      mainly of lipid laden macrophages. Norethindrone levels in tissue capsules at 3
      and 10.5 months were 0.05 and 8.4% by weight, respectively. These observations
      suggest that the local inflammatory response plays a role in the active
      processing of this delivery system. This picture is qualitatively different from
      the general view of the fibrous capsule as a simple rate limiting membrane. The
      effects observed in this study suggest that a more complex, functional biological
      system develops in response to the subcutaneous introduction of a drug delivery
      device.

PMID- 8464810
TI  - Electrochemical characterization of human skin by impedance spectroscopy: the
      effect of penetration enhancers.
AB  - The electrochemical properties of human cadaver skin were studied in a diffusion
      cell with impedance spectroscopy as a function of time in the absence and
      presence of penetration enhancers dodecyl N,N-dimethylamino acetate and Azone. An
      improved electrochemical model of skin is presented, and combining the novel
      model with modern fractal mathematics, the effect of enhancers on the surface of
      skin is demonstrated. The enhancers appeared to open new penetration routes and
      increase the ohmic resistance, capacitive properties, and fractal dimension of
      skin, which means a rougher or more heterogeneous surface.

PMID- 8464811
TI  - Poly(epsilon-caprolactone) nanocapsules in carteolol ophthalmic delivery.
AB  - In order to increase the ocular absorption of carteolol, this antiglaucomatous
      drug was incorporated into either nanoparticles (NP) or nanocapsules (NC). The
      polymer used was poly(epsilon-caprolactone) (PCL). The dosage forms were tested
      on intraocular hypertensive-induced rabbits. Results are presented as the
      chronological variations of the intraocular pressure (IOP) in comparison with the
      commercial aqueous solution (Carteol eye drops). The therapeutic results
      (decrease in IOP) were much more pronounced with carteolol incorporated into the
      colloidal carriers than with the commercial eye drops. Further, NC displayed a
      better effect than NP because the drug was entrapped in the oily core of the
      carrier, thus more readily available to the eye. The incorporation of the drug
      into nanocapsules produced a decline in the cardiovascular side effects in
      comparison with aqueous eye drops, thus showing that the undesired noncorneal
      absorption was reduced. In conclusion, colloidal suspension made of poly(epsilon
      caprolactone) could offer a good opportunity for ophthalmic delivery of drugs.

PMID- 8464812
TI  - Polyanhydride microspheres that display near-constant release of water-soluble
      model drug compounds.
AB  - A new method to prepare polyanhydride microspheres capable of near-constant
      sustained release of low molecular weight, water-soluble molecules is presented.
      The polyanhydrides used were poly(fatty acid dimer) (PFAD), poly(sebacic acid)
      (PSA), and their copolymers [P(FAD-SA)]. Acid orange 63 (AO), acid red 8 (AR),
      and p-nitroaniline, were used as model release molecules. P(FAD-SA) microspheres
      containing the molecules with or without gelatin were prepared by a modified
      solvent evaporation method using a double emulsion. The microspheres were
      spherical with diameters of 50-125 microns and encapsulated more than 85% of the
      molecule, irrespective of the compound used. Near-zero-order degradation kinetics
      were observed for 5 days as judged by sebacic acid (SA) release. Microsphere
      degradation was pH sensitive, being enhanced at high pH, and became more stable
      in acidic conditions, irrespective of the incorporation of gelatin in the matrix.
      For the gelatin-free microspheres, a close correlation of SA release and AO
      release was observed (2% loading), suggesting a release mechanism that was
      controlled dominantly by degradation. However, the incorporation of gelatin into
      the microsphere significantly extended the periods of molecule release from P(FAD
      SA) microspheres, although the degradation profile of the microspheres themselves
      was quite similar to that of gelatin-free microspheres. It is possible that an
      interaction between FAD monomers and gelatin molecules causes continued release,
      even after the polymer matrix completely degrades (even after complete
      degradation, FAD monomers remain because of their poor water solubility). Thermal
      analysis of polyanhydride microspheres at different degradation stages
      demonstrated that a crystalline structure was formed between gelatin and the FAD
      monomers produced with microsphere degradation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464813
TI  - Peptide carrier-mediated transport in intestinal brush border membrane vesicles
      of rats and rabbits: cephradine uptake and inhibition.
AB  - The uptake kinetics of cephradine, an amino-beta-lactam antibiotic, were studied
      in rat and rabbit intestinal brush border membrane vesicles preparations using
      both the Ca2+ and the Mg2+ methods of preparation, in the presence of an inward
      proton gradient. The Ca2+ method demonstrated greater uptake of cephradine in
      intestinal brush border vesicles prepared from both rat and rabbit and was used
      for these studies. The transport was observed to be of Michaelis-Menten carrier
      mediated type with a passive transport component. The kinetic parameters obtained
      were as follows: for rat and rabbit, respectively, Km, 1.6 and 1.9 mM; Jmax', 1.7
      and 20.7 nmol/mg/min; Pc' (= Jmax'/Km), 1.1 and 10.9 microL/mg/min; and Pm', 0.4
      and 0.8 microL/mg/min. The kinetic parameters for the rat vesicles are consistent
      with those from our previous perfusion study using a conversion factor of 0.71
      cm2/mg protein. The rabbit vesicles exhibited a similar Michaelis constant and a
      10-fold larger maximal transport velocity, suggesting a quantitative advantage
      for the study of carrier-mediated transport in the rabbit compared to rat
      vesicles from the intestine. Cephradine uptake was inhibited by
      phenylpropionylproline, a proline derivative, and enalapril, an ACE inhibitor,
      which do not have an alpha-amino group, as well as dipeptides, tripeptides, and
      amino-beta-lactam antibiotics in both rat and rabbit vesicles. These results
      support the suggestion that they share the same peptide carrier pathway for oral
      absorption and that the vesicles may be a useful tool in developing orally
      effective peptide-type drugs.

PMID- 8464814
TI  - An investigation into the mechanical and transport properties of aqueous latex
      films: a new hypothesis for the film-forming mechanism of aqueous dispersion
      system.
AB  - The effects of plasticizer, physical aging, and film-forming temperature on the
      mechanical and transport properties of films formed from aqueous dispersions of
      ethylcellulose latex were investigated. The water vapor permeability of latex
      films was found to decrease with diethyl phthalate to a minimum value and then to
      increase with diethyl phthalate at higher concentrations. Because of the decrease
      in free volume and the further coalescence of particles of latex polymer films in
      the physical aging range, the creep compliance of latex films decreased with
      physical aging time. Within 60 to 100 degrees C, the film-forming temperature was
      found to have no effect on the mechanical and transport properties of Aquacoat
      films. However, since many pinholes formed in the latex films when the film
      forming temperature was above 100 degrees C, the water vapor permeability of
      latex films was higher than that of latex films formed between 60 and 100 degrees
      C. The formation of films from aqueous latex dispersions is suggested to proceed
      gradually from the top to the bottom of the latex dispersion in this study.

PMID- 8464815
TI  - Viscoelasticity of anionic polymers and their mucociliary transport on the frog
      palate.
AB  - The influence of formulation variables on the rheology of polyanionic
      formulations and the relationships between viscoelastic properties and
      mucociliary transport rate were investigated. Polymeric samples were oscillated
      from 0.001 to 5 Hz using either a "cone and plate" or a "coaxial cylinder"
      measuring system. The mucociliary transport rates of polymeric samples were
      determined and compared movement of charcoal powder on the frog palate. For the
      linear polymeric solutions, sodium carboxymethylcellulose and sodium alginate,
      the elastic modulus (G') increased with increasing amplitudes during frequency
      scan. However, the G' or viscous modulus (G'') of partially cross-linked
      polyacrylic acid (cPAA) samples did not change significantly under oscillation.
      Both G' and G'' of cPAA samples were significantly influenced by the amount of
      salt present in the formulation. The rheology of 2% (w/w) cPAA in 90:10 (w/w)
      propylene glycol:alcohol changed from a viscous fluid to a coarse suspension
      after neutralization. The pH increased gradually when the nonaqueous formulation
      reacted with water and the maximum dynamic moduli were obtained after
      incorporating 20% (w/w) water in the formulation. A negative correlation was
      found between the G' of linear polyanionic samples and the relative transport
      rate. However, the lowest mucociliary transport rate was observed when the loss
      tangent (G''/G') was around 0.4-0.5.

PMID- 8464816
TI  - Disposition of azole antifungal agents. I. Nonlinearities in ketoconazole
      clearance and binding in rat liver.
AB  - The disposition of ketoconazole was characterized in the rat over a wide
      dose/concentration range. Bolus dose (0.03-10 mg/kg) studies indicate that plasma
      concentration-time profiles for ketoconazole are not superimposable when dose
      normalized because of nonlinearities occurring in both volume of distribution and
      clearance. The volume of distribution decreases from 3 to less than 1 L/kg, while
      the plasma clearance decreases 10-fold from 25 mL/min/kg as the dose is
      escalated. From these results, infusion rates were calculated to maintain the
      plasma concentrations achieved with particular bolus doses. The curvilinear
      relationship between steady-state plasma concentration (0.015-8.3 mg/L) and
      ketoconazole infusion rate (0.021-2.45 mg/hr/kg) was analyzed in terms of
      Michaelis-Menten kinetics. A Vmax of 3.2 mg/hr/kg and Km of 2.1 mg/L were
      obtained by nonlinear regression analysis. At the end of the ketoconazole
      infusion, liver, adrenals and kidneys were removed and assayed for ketoconazole.
      Tissue-to-plasma partition coefficients for the liver and adrenals showed a
      marked dependence upon steady-state plasma concentration. Both parameters (liver,
      22; and adrenals, 53) showed a decrease of approximately 10-fold as the plasma
      concentrations were increased. In contrast, the kidney:plasma partition
      coefficient (1.8), blood:plasma concentration ratio (0.6), and plasma binding
      (96%) of ketoconazole did not show a concentration dependence over the range
      studied. It is concluded that the liver is an important determinant of
      ketoconazole's volume of distribution and that saturation of this process
      accounts largely for the reduction in volume of distribution with increasing
      dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464817
TI  - Interaction of nucleoside analogues with the sodium-nucleoside transport system
      in brush border membrane vesicles from human kidney.
AB  - The therapeutic efficacy of nucleosides and nucleoside analogues as antitumor,
      antiviral, antiparasitic, and antiarrhythmic agents has been well documented.
      Pharmacokinetic studies suggest that many of these compounds are actively
      transported in the kidney. The goal of this study was to determine if
      therapeutically relevant nucleosides or analogues interact with the recently
      characterized Na(+)-driven nucleoside transport system of the brush border
      membrane of the human kidney. Brush border membrane vesicles (BBMV) were prepared
      from human kidney by divalent cation precipitation and differential
      centrifugation. The initial Na(+)-driven 3H-uridine uptake into vesicles was
      determined by rapid filtration. The effect of several naturally occurring
      nucleosides (cytidine, thymidine, adenosine), a pyrimidine base (uracil), a
      nucleotide (UMP), and several synthetic nucleoside analogues [zidovudine (AZT),
      cytarabine (Ara-C), and dideoxycytidine (ddC)] on Na(+)-uridine transport was
      determined. At a concentration of 100 microM the naturally occurring nucleosides,
      uracil, and UMP significantly inhibited Na(+)-uridine transport, whereas the
      three synthetic nucleoside analogues did not. Adenosine competitively inhibited
      Na(+)-uridine uptake with a Ki of 26.4 microM (determined by constructing a Dixon
      plot). These data suggest that naturally occurring nucleosides are substrates of
      the Na(+)-nucleoside transport system in the renal brush border membrane, whereas
      synthetic nucleoside analogues with modifications on the ribose ring are not. The
      Ki of adenosine is higher than clinically observed concentrations and suggests
      that the system may play a physiologic role in the disposition of this
      nucleoside.

PMID- 8464818
TI  - Pharmacokinetics of a novel antiarrhythmic drug, actisomide.
AB  - The pharmacokinetics of a novel antiarrhythmic drug, actisomide, were examined in
      the rat, dog, monkey, and human. The terminal half-life of actisomide was similar
      (1.15-1.89 hr) across species, regardless of dose. The total plasma clearance was
      higher in the monkey (13.5-16.4 mL/min/kg) than in the dog (9.01-9.32 mL/min/kg),
      rat (8.6-9.8 mL/min/kg), or human (6.79 +/- 1.07 mL/min/kg). Excretion of the
      parent drug was higher in urine than in feces in the dog and rat, whereas in the
      monkey and human, urinary and fecal excretions of actisomide were similar. In
      humans, atypical plasma concentration-time curves with double peak concentrations
      were observed following oral doses. Systemic availability of actisomide was
      higher in the dog than in the rat, monkey, and human. Further, the systemic
      availability appeared to increase with dose in the rat and monkey. The species
      dependent systemic availability appeared to be due primarily to species-dependent
      absorption of actisomide, and not to species-dependent first-pass metabolism,
      biliary excretion, and/or renal elimination. The absorption of actisomide in the
      rat and its in vitro uptake in CaCo-2 cells were pH dependent. The higher
      systemic availability of actisomide observed in the dog may be due partly to the
      higher pH in the gastrointestinal (GI) tract of the dog. However, the pH
      differences in the GI tract of the different species alone did not appear to be
      enough to explain the difference in systemic availability of actisomide.

PMID- 8464819
TI  - Comparison of the hepatic uptake clearances of fifteen drugs with a wide range of
      membrane permeabilities in isolated rat hepatocytes and perfused rat livers.
AB  - The hepatic uptake clearances of 15 ligands with a wide range of permeabilities
      were determined in rats using two techniques: centrifugal filtration with
      isolated hepatocytes and the multiple indicator dilution (MID) method with
      isolated perfused livers. Some of the uptake clearance values were taken from the
      literature. Uptake clearance values obtained from isolated hepatocytes were
      extrapolated to that per gram liver (PSinf.cell), assuming that 1 g of liver has
      1.3 x 10(8) cells. The values of PSinf.cell varied from approximately 0.1 to 72
      (mL/min/g liver). The values of PSinf.cell were similar to those (PSinf.MID)
      determined by the MID method for ligands with uptake clearances below
      approximately 1 mL/min/g liver. However, for the ligands with larger uptake
      clearances, the PSinf.MID values were lower than the PSinf.cell values and
      appeared to reach an upper limit (approx. 15-20 mL/min/g liver). The PSinf.cell
      values of 1-propranolol, tetraphenylphosphonium (TPP+), and diazepam were 72, 43,
      and 22 mL/min/g liver, respectively, whereas their uptake clearances (PSinf.MID)
      determined by the MID method were 4 to 10 times lower. One of the possible
      mechanisms for this discrepancy is that an unstirred water layer, which may exist
      in Disse's space in isolated perfused livers (and probably under in vivo
      condition), limits the hepatic uptake rate of ligands with extremely high
      membrane permeabilities.

PMID- 8464820
TI  - Rapid determination of methadone in plasma, cerebrospinal fluid, and urine by gas
      chromatography and its application to routine drug monitoring.
AB  - Determination of methadone (MET) in biological fluids can serve to adjust dosages
      in patients suffering from cancer pain or participating in methadone maintenance
      programs. We developed a gas chromatographic assay using nitrogen-phosphorus
      detection. The method involves a single-step extraction from alkalized plasma,
      cerebrospinal fluid, or urine into n-hexane/isoamyl-alcohol (99/1, v/v).
      Dextropropoxyphene was used as internal standard. Separation was achieved with a
      silica SE-52-CB column (13 m x 0.25-mm I.D.). The method was validated for the
      determination of MET in plasma, urine, and cerebrospinal fluid with a
      quantification limit of 0.5 ng/mL. The coefficients of variation for within-day
      and between-day precision were within 10.2 and 14.1%, respectively. Approximately
      100 samples can be analyzed by one person in the course of a working day, making
      the method applicable to routine drug monitoring. The method was demonstrated to
      be sensitive and accurate for pharmacokinetic studies in plasma, urine, or
      cerebrospinal fluid.

PMID- 8464821
TI  - Stabilization of oxygen-sensitive formulations via a secondary oxygen scavenger.
AB  - The ability to stabilize dopamine hydrochloride formulations via the utilization
      of a secondary bag containing an antioxidant has been established. By physically
      separating the drug formulation from the stabilization solution, the chemistry of
      both solutions can be optimized independently so as to ensure product efficacy.
      Factors controlling the effectiveness of the proposed stabilization strategy are
      discussed in the context of actual experimental results. Such a strategy is
      effective in terms of protecting the formulation during processing/storage only
      if the product is stored in an oxygen barrier overpouch.

PMID- 8464822
TI  - Three approaches to the analysis of trace formaldehyde in bulk and dosage from
      pharmaceuticals.
AB  - Trace-level determinations for the presence of formaldehyde in both bulk and
      dosage form pharmaceuticals were developed using three innovative strategies. One
      system adapted the chromotropic acid spot test for formaldehyde. This was
      accomplished spectrophotometrically over a linear detection range against
      authentic control samples. The other two chromatographic approaches necessitated
      rapid derivatization. One derivative was its corresponding oxime, formaldoxime,
      which was resolved on a gas chromatographic porous polymer column and sensed by a
      nitrogen-specific detector. The other derivative, sodium formate, was detected
      and quantified on an ion chromatograph using an anion-exchange column and a
      conductivity detector. The chromotropic acid technique was sensitive but not
      specific for formaldehyde. The chromatographic techniques required a high degree
      of water solubility. All were subject to interferences that could preclude their
      use for a particular application. None of the tested samples, which included a
      penicillin analogue, a pharmaceutical dosage from additive, a vitamin, and
      biological proteins, showed the presence of formaldehyde at trace levels.

PMID- 8464823
TI  - Axial ratio measurements for early detection of crystal growth in suspension-type
      metered dose inhalers.

PMID- 8464824
TI  - Loading of bovine serum albumin into hydrogels by an electrophoretic process and
      its potential application to protein drugs.

PMID- 8464826
TI  - Feasibility of developing a neural network for prediction of human
      pharmacokinetic parameters from animal data.

PMID- 8464825
TI  - Molecular cloning of two cDNAs encoding the mouse bilirubin/phenol family of UDP
      glucuronosyltransferases (mUGTBr/p).

PMID- 8464827
TI  - Formation of a chromophoric complex between alendronate and copper(II) ions.

PMID- 8464828
TI  - [Maternal child rearing attitudes, family environment and neurodermatitis in
      children--a pilot study].
AB  - To test hypotheses about pathogen relations in mother-child-dyads with children
      suffering from eczema, 25 mothers of children with acute eczema, 25 mothers of
      children with chronic eczema, and 31 mothers of healthy children (average age:
      2.4, 2.8, and 1.9 years) were asked to answer a questionnaire concerning
      educational attitudes (aversive, authoritarian, tenderhearted, overprotective)
      and family's atmosphere (cooperative, controlled, achievement orientated,
      dependent). Analyses of variance showed only one significant effect. The results
      suggest that mothers of children in chronic state are more aversive than mothers
      of healthy children or mothers of children in acute state. Nevertheless, the
      mothers' aversion has to be interpreted as a consequence, not at all as an
      original cause of the disease. Furthermore the mothers' aversion seems to
      indicate a psychic exhaustion more than an aggressive education.

PMID- 8464829
TI  - [Separation and divorce counseling in child guidance centers with special
      reference to criteria of child development].
AB  - A socio-ecological concept of counseling in situations of separation and divorce
      is presented in this article, dividing the process of counseling into specific
      levels of intervention and phases of divorce. The child's occupation with
      separation and divorce depends on the level of socio-cognitive development as
      well as defense and coping strategies. A particular danger of diffusion of roles
      and of parentifying the child exists in these families. For the long-termed
      developmental prognosis the degree of cross-linkage and protective factors in the
      child's environment are vital. The article refers to results of longitudinal
      studies and research in invulnerability. Furthermore the results of an empirical
      inquiry at German counseling boards concerning the work with families of divorce
      are presented.

PMID- 8464830
TI  - [Anxiety and unconscious fantasies in adoptive families].
AB  - First, after a short introduction, the author goes into the threatened identity
      in adoptive families and the role sexuality hereby plays. This is demonstrated
      with a case example. Then the unconscious fantasies and dealing with the incest
      prohibition are described, followed by thoughts about therapy and the problem of
      the right time to tell the child about his adoption.

PMID- 8464831
TI  - [Adoption--an irrevocable decision].

PMID- 8464832
TI  - Low-dose sulprostone for pregnancy termination in cases of fetal abnormality.
AB  - Thirty-two pregnancies (11 primi- and 21 multi-gravid) with an abnormal fetus
      were terminated between 16 and 35 weeks (mean 22 weeks; median 20 weeks) and a
      continuous intravenous infusion of 1 microgram of the prostaglandin analogue
      sulprostone. All pregnancies were terminated vaginally, 31 of them with this
      regimen in a median induction-expulsion interval of 23 h (range 8-52 h). Complete
      expulsion of the placenta occurred in 72 per cent of cases. Median blood loss was
      100 ml (range 20-2000 ml). There were only a few side-effects. We conclude that
      this induction regimen is both appropriate and safe for pregnancy termination in
      cases of fetal anomaly.

PMID- 8464833
TI  - Unusual segregation for 11q;22q parental translocation in a triplet pregnancy:
      prenatal diagnosis in chorionic villi and amniotic fluid.
AB  - The prenatal diagnosis of an 11q;22q translocation in a triplet pregnancy
      detected at the time of chorionic villus sampling (CVS) because of advanced
      maternal age is reported. Karyotypes obtained from two apparently different CV
      samples showed the balanced form of translocation, while the one obtained from a
      third empty sac showed the unbalanced form: 46,XX,-22,+der(22)t(11;22). Second
      trimester amniocentesis confirmed the balanced translocation in one of the two
      viable fetuses and a normal karyotype in the other. The detected karyotypes
      derived from two different types of meiotic segregation, alternate and adjacent
      1. To our knowledge, this is the first reported case of an unbalanced karyotype
      not due to a 3:1 meiotic segregation of this specific translocation.

PMID- 8464834
TI  - Prenatal diagnosis of Hb H disease due to compound heterozygosity for South-east
      Asian deletion and Hb constant spring by polymerase chain reaction.
AB  - A pregnant woman has two children affected by moderately severe Hb H disease due
      to compound heterozygosity of South-east Asian deletion and Constant Spring
      mutation. In her third pregnancy, transabdominal chorionic villus sampling was
      performed at the tenth gestational week to obtain fetal DNA. The polymerase chain
      reaction was used for detection of both the South-east Asian deletion and the
      Constant Spring mutation. Hb H disease was diagnosed in the fetus. After genetic
      counselling, the couple elected to have the pregnancy terminated.

PMID- 8464835
TI  - Prenatal diagnosis of Zellweger syndrome using DNA analysis.

PMID- 8464836
TI  - Prenatal detection of succinic semialdehyde dehydrogenase deficiency (4
      hydroxybutyric aciduria)

PMID- 8464837
TI  - Genomic imprinting, human chorionic gonadotropin, and triploidy.

PMID- 8464838
TI  - Prenatal diagnosis of tetrasomy 12p (Pallister-Killian syndrome)

PMID- 8464839
TI  - Prenatal diagnosis of trisomy 9 mosaic presenting as a case of Dandy-Walker
      malformation.
AB  - Trisomy 9 syndrome is a rare chromosomal anomaly associated with specific
      patterns of multisystem dysmorphism and occasional central nervous system (CNS)
      malformations, the most common being the Dandy-Walker malformation. Milder
      anomalies are usually seen with trisomy 9 mosaicism. We report what we believe to
      be the first case of a baby with an isolated Dandy-Walker malformation which was
      diagnosed prenatally and was subsequently found to have a trisomy 9 mosaic
      syndrome.

PMID- 8464840
TI  - Prenatal diagnosis of Dandy-Walker malformation in a family displaying X-linked
      inheritance.
AB  - The diagnosis of Dandy-Walker malformation was made on the ultrasonographic
      evaluation of a 33-week male fetus. Pedigree analysis revealed a family history
      of isolated Dandy-Walker malformation in three other males, suggesting an X
      linked recessive inheritance pattern.

PMID- 8464841
TI  - Utilization of beta-carotene from Spirulina platensis by rats.
AB  - The availability of beta-carotene from Spirulina as compared to standard all
      trans beta-carotene was studied by the liver and kidney vitamin A storage method.
      After 21 days of vitamin A depletion, the rats were repleted with beta-carotene
      from Spirulina and a standard source at two dietary levels (60 and 120
      micrograms/day) for a 10 day period. At lower levels, the liver storage levels of
      vitamin A and the percent of beta-carotene absorption were comparable to those of
      the standard. At higher levels both these parameters of the Spirulina fed group
      were significantly (P < 0.01) inferior to the standard source fed group. However,
      the Spirulina fed group showed better (P < 0.05) growth than the standard fed
      group did at both low and high levels of feeding.

PMID- 8464842
TI  - Effect of supplementation of blue green alga (Spirulina) on outcome of pregnancy
      in rats.
AB  - To study the supplementary effect of Spirulina, pregnant rats were fed 5
      different kinds of diets (casein, Spirulina, wheat gluten, Spirulina + wheat
      gluten, Spirulina-without additional vitamins and minerals), each providing 22%
      protein during the period of pregnancy. The outcome of pregnancy was assessed
      from litter and dams' weight and litter size. Maternal weight gain was found to
      be maximum with Spirulina + wheat gluten and least with the wheat gluten diet.
      Rats receiving Spirulina containing diets produced significantly (p < 0.05)
      higher litter size than those receiving casein and wheat gluten. In spite of
      having higher litter size, Spirulina containing diet groups produced pups with
      birth weights comparable to those of casein. Spirulina appears to be a good
      dietary supplement during pregnancy.

PMID- 8464843
TI  - Isolation of amaranth flour proteins by fractionation procedures and sonication.
AB  - The use of whole and defatted amaranth flour for protein isolation of Osborne
      fractions is described. Extractability of prolamins, the minor fraction,
      increased from 2.8 to 5% by adding a reducing agent. Glutelins proved to be
      poorly solubilized (3.3%) in dilute acetic acid, but they reached a high
      solubility value (40.8%) using a borate buffer in the presence of a reducing
      agent and a detergent; solubility remarkably declined without the latter two
      chemicals. Sonication (a fast and simple technique) in the presence of a
      detergent proved to be more efficient, compared with stirring, for extractability
      of total unreduced proteins.

PMID- 8464844
TI  - Available carbohydrates of cereal grains as affected by storage and insect
      infestation.
AB  - Total soluble sugar, reducing sugar, non-reducing sugar and starch contents of
      wheat, maize and sorghum grains were affected adversely at 25, 50 and 75% insect
      infestation caused by Trogoderma granarium Everts and Rhizopertha dominica
      Fabricius, separately and mixed population. R. dominica caused significant (P <
      0.05) reduction in available carbohydrates at 50 and 75% infestation levels
      whereas T. granarium achieved similar effect at 75%. Mixture of both insect
      species caused intermediate losses. Storage of cereal grains up to 4 months
      resulted in substantial increase in sugars and decrease in starch content, but
      storage for a shorter period of time did not cause any significant changes in
      levels of carbohydrates.

PMID- 8464845
TI  - Reduced plasma fibrinogen, serum peroxides, lipids, and apolipoproteins after a 3
      week vegetarian diet.
AB  - The influence of a 3-week vegetarian diet and fasting on serum concentration of
      peroxides, lipids, apolipoproteins, and plasma fibrinogen was studied in ten
      middle-aged fibromyalgia/fibrositis patients (eight women, two men). Mean serum
      peroxide concentration (estimated as thiobarbituric acid reacting substances) was
      reduced from 3.60 +/- 0.14 to 2.82 +/- 0.15 umol/l (p = 0.01) and plasma
      fibrinogen from 3.33 +/- 0.25 to 2.74 +/- 0.15 g/l (p = 0.02). Serum total
      cholesterol fell from 6.61 +/- 0.50 to 4.83 +/- 0.35 mmol/l (p < 0.0001),
      apolipoprotein B from 1.77 +/- 0.14 to 1.31 +/- 0.11 g/l (p < 0.0001), and
      apolipoprotein A from 1.41 +/- 0.09 to 1.23 +/- 0.05 g/l (p = 0.03). High density
      lipoprotein cholesterol concentration also decreased somewhat (from 1.26 +/- 0.09
      to 1.07 +/- 0.04 mmol/l, p = 0.03) An atherogenic index, reflecting the balance
      between low and high density lipoproteins, was reduced by 31% (from 5.74 +/- 0.79
      to 3.97 +/- 0.60, p = 0.02). The results suggest that vegetarian diet/fasting may
      have a beneficial influence on the concentration of serum peroxides and plasma
      fibrinogen concentration, and on the serum level of several lipoprotein-related
      coronary risk factors.

PMID- 8464846
TI  - Early effects and the possible mechanism of the effect of Concanavalin A (con A)
      and Phaseolus vulgaris lectin (PHA-P) on intestinal absorption of calcium and
      sucrose.
AB  - Food lectins are known to affect the absorption of nutrients in experimental
      animals and altered morphology of the intestinal mucosa due to prolonged feeding
      of lectins is suggested to be the cause. However, toxic symptoms appear in humans
      immediately after consumption of lectin rich foods and the mechanism of this
      immediate action is not known. This study reports the immediate effect of
      Concanavalin A (Con A) and Phaseolus vulgaris lectin (PHA-P) on the absorption of
      Ca2+ and sucrose in rat intestine and the possible role of lectin-membrane
      interactions in the process. Calcium absorption was lowered by Con A, and this
      was observed to be due to Con A interacting with the intestinal mucosal membrane.
      Similarly, sucrose absorption was also altered, probably due to Con A binding the
      intestinal mucosal membrane. On the other hand PHA-P did not have any effect on
      either sucrose or calcium absorption. Results indicate that the effect on
      intestinal nutrient absorption depends on the type of lectin used (and its
      concentration) as well as the type of nutrient, besides the duration of exposure
      of intestinal mucosa to the lectin.

PMID- 8464847
TI  - Control of enzymatic browning in apple slices by using ascorbic acid under
      different conditions.
AB  - Control of phenol oxidase activity in apple slices by the use of ascorbic acid at
      different pH values, temperature and time of incubation was investigated. The
      enzyme was almost inactivated at 1% and 1.5% ascorbic acid. Ascorbic acid
      solution (1%) caused a remarkable inhibition with the increasing acidity up to pH
      = 1. Heating treatments for apple slices dipped in 1% ascorbic acid caused a
      reduction of enzymatic browning, optimum temperature for inactivation of the
      enzyme was between 60-70 degrees C for 15 minutes. Increasing the time of dipping
      apple slices in 1% ascorbic acid solutions and at different pH values reduce
      phenolase activity.

PMID- 8464848
TI  - Effect of sample pretreatments on the storability of ground melon 'egusi'
      Colocynthis citrillus L.
AB  - In the maintenance of shelf-stability, nutritional and organoleptic properties of
      ground melon 'egusi'-Colocynthis citrullus L., vacuum-packaged samples were found
      to be better than unpackaged samples and samples treated with 0.2% butylated
      hydroxyanisole (BHA) and 0.02% BHA + 0.045% sodium metabisulphite. After 56 days
      at 35 degrees C, stored samples showed significant differences (P < or = 0.01) in
      chemical composition peroxide value (PV), fungal counts and organoleptic
      attributes. Lipid oxidation and, to a lesser extent, fungal deterioration were
      responsible for the spoilage of stored ground melon kernel. The dominant fungal
      flora isolated from stored samples were of the genera Penicillium,
      Botryodiplodia, Rhizopus and Aspergillus.

PMID- 8464849
TI  - Niacin, thiamin, and pantothenic acid bioavailability to humans from maize bran
      as affected by milling and particle size.
AB  - The objective of the project was to determine the bioavailability of selected B
      vitamins (niacin, pantothenic acid and thiamin) to humans from wet and dry milled
      maize brans which were coarsely or finely ground. Using a double cross-over
      design, the nine subjects were fed laboratory controlled diets containing
      unsupplemented bread or bread supplemented with finely ground, wet milled maize
      bran; coarsely ground, wet milled maize bran; finely ground, dry milled corn
      bran; or coarsely ground, dry milled maize bran. Subjects made complete
      collections of urine throughout the study which were analyzed for contents of the
      test vitamins. Although varying somewhat among vitamins, in general, better
      apparent bioavailability was achieved with the finely ground, dry milled maize
      bran than with the other test brans.

PMID- 8464851
TI  - [Tumor necrosis factor alpha in lung diseases].

PMID- 8464850
TI  - Tocotrienol and fatty acid composition of barley oil and their effects on lipid
      metabolism.
AB  - Barley oil was extracted with hexane from the grain of a high oil waxy hull-less
      barley. Twelve male broiler chicks were fed corn-based diets with either 10%
      barley oil, 10% corn oil or 10% margarine ad libitum for ten days. Total plasma
      cholesterol concentration of the chicks fed barley oil was 34% lower (p < 0.05)
      than that of the chicks fed margarine. Plasma low density lipoprotein cholesterol
      concentration of chicks fed barley oil was 53% and 59% lower (p < 0.05) than
      those of chicks fed corn oil and margarine, respectively. Plasma high density
      lipoprotein cholesterol and triglyceride concentration of the barley oil group
      were similar to those of the margarine but higher (p < 0.05) than those of the
      corn oil group. Chicks fed the barley oil gained more (p < 0.05) body weight than
      those fed the corn oil and margarine. Barley oil had an effect in suppression of
      TC and LDLC in chicks compared to margarine. Barley oil suppressed LDLC but not
      HDLC in chicks compared to corn oil. A greater weight gain of the chicks fed
      barley oil suggested that these chicks had normally functioning digestion and
      absorption. alpha-Tocotrienol and gamma-tocotrienol content of the barley oil
      were 24 and 17 times greater, respectively, than those observed in the corn oil,
      while the same fractions were not detectable in the margarine. Polyunsaturated
      fatty acid content of the barley oil was more than threefold that of margarine.
      These data suggest that alpha-tocotrienol and polyunsaturated fatty acids are
      hypocholesterolemic components in barley oil.

PMID- 8464852
TI  - [T4/T8 ratio in bronchoalveolar lavage in sarcoidosis--a marker of activity
      and/or prognosis?].
AB  - In 158 patients with histologically confirmed intrathoracic sarcoidosis the T4/T8
      quotient was checked in broncho-alveolar lavage (BAL) for its informative value
      with regard to activity and prognosis of the disease. In asymptomatic patients
      with x-ray type I and normal lung function, in radiological remissions of x-ray
      types I and improvement in the course of disease in patients whose disease had
      initially been classified acute, we found statistically significantly higher
      T4/T8 quotients than in the other patient groups; we did not observe any
      deterioration in the course of the disease. High T4/T8 quotients will thus not
      generally point to an active or progressing disease; the information conveyed by
      these data is of limited clinical usefulness in individual cases only.

PMID- 8464853
TI  - [Benign metastatic leiomyoma of the lung].
AB  - The authors report on the case of a woman of 41 years of age presenting with
      asymptomatic multiple circular foci in the lung that were primarily suspected of
      being malignomas. Diagnosis of benign metastasising leiomyomas was confirmed for
      bilateral multiple circular foci suspected of lung metastasising originating from
      an unknown tumour of the lung. This diagnosis was achieved by open biopsy. The
      seemingly contradictory diagnosis of a benign but metastasising tumour is
      characteristic of a rare disease pattern that, however, is well documented in the
      literature. The course of the disease is compared with the data given in the
      literature.

PMID- 8464854
TI  - [Spontaneous pneumothorax as the initial symptom of bronchial cancer].
AB  - Spontaneous pneumothorax is caused by benign lung diseases in more than 95
      percent. Mainly presenting in younger male patients between 20 and 40 years of
      age its prognosis is generally good.--On the other hand, pneumothorax as initial
      manifestation of bronchial carcinoma is a rare complication with poor prognosis.
      We report such a case of a 70 year-old man, review the literature and describe
      characteristical problems in diagnosis and therapy of very small bronchogenic
      tumors. Estimating that only 2 percent of all spontaneous pneumothoraces are
      coexisted with malignant lung diseases--either primary or secondary--this tumor
      complication especially must be considered in older patients. Their prognosis may
      be improved entirely by rapid diagnosis and therapy.

PMID- 8464855
TI  - [Bronchial hyperreactivity and epidemiology of bronchial asthma in childhood].
AB  - Respiratory symptoms are common in childhood with as many as 25% of children aged
      7-10 years being troubled by recurrent episodes of cough and wheeze. Subjects
      with and without asthma differ both in the ease with which airway narrowing is
      produced by inhalation of nonallergic or nonsensitizing stimuli. A few
      epidemiologic studies are concerned with the prevalence of bronchial
      hyperresponsiveness in unselected children. Although increased airway
      responsiveness is predominantly reported in atopic individuals, even children
      with no history of atopy or symptoms suggesting asthma produce a bronchial
      obstruction being challenged by physical exercise, inhalation of cold air or
      distilled water and pharmacologic stimuli. The relationship between
      responsiveness to different challenges was investigated in 2 large
      epidemiological studies on school aged children. The following reports are an
      informative survey on acceptance, sensitivity, specificity and predictive value
      of epidemiologic instruments estimating bronchial responsiveness.

PMID- 8464856
TI  - [Cold air hyperventilation provocation].
AB  - The prevalence of asthma was determined by a parental questionnaire in 9403
      schoolchildren aged 9-11 years. A cold air challenge was done in 7248 of these
      children to test for bronchial hyperresponsiveness. Regarding the doctor
      diagnoses of asthma as reported by the parental questionnaire the specificity of
      the cold air challenge was 92.5%, the sensitivity 28.7%, the positive predictive
      value 9.1% and the negative predictive value 98%.

PMID- 8464857
TI  - [Longitudinal study of bronchial hyperreactivity using the carbachol test with
      school children].
AB  - STUDY DESIGN: Bronchial hyperresponsiveness of 476 schoolchildren (10.8 +/- 2.3
      years) was studied three times at 12 months' intervals. The cumulative dose of
      400 micrograms carbachol was applied in 50 + 50 + 100 + 200 micrograms steps. A
      fall of FEV1 of at least 15% was regarded as positive reaction. The test was
      save, as no severe obstruction was observed, only three children withdrew because
      of unpleasant cough. RESULTS: Reactivity was observed in 19.1, 10.0, and 5.2% of
      children at the occasion of the first, second and third test
      (sensitivity/specificity for prevalence of physician diagnosed asthma: 70/83,
      35/91, and 24/96%, respectively). Reactivity was age dependent (7-11 years: 35%,
      12-16 years: 18%), not influenced by sex, and the relative risk to be reactive
      was 1.9 in children 2-3 weeks after a respiratory tract infection. CONCLUSION:
      For epidemiological purposes carbachol provocation test--like other unspecific
      bronchial provocation tests--is inappropriate as a single test to classify
      individuals as asthmatics.

PMID- 8464858
TI  - [Variability of peak expiratory flow in an unselected sample of school children].
AB  - In the framework of an epidemiological study, the information by peak flow
      variability (PEFV) was compared to the history of asthma in a non-selected
      population of primary-school children (n = 1812). PEFV as assessed by twice daily
      recordings of PEF for a one week period (n = 1237) was calculated as average of
      daily amplitudes (AVAM: average amplitude mean) in the case of at least complete
      data for five days (n = 991). Elevated PEFV defined as AVAM > 12%, was cross
      tabulated with the asthma history (self-administered questionnaire). The median
      (90%-confidence-interval) of AVAM is 6.3% (2.2-15.9%). In 11.2% (n = 111) of the
      population, AVAM > 12% occurred). The sensitivity of AVAM > 12% with regard to
      "doctor's diagnosed asthma" (n = 35) is 37%. Under exclusion of children with
      recurrent wheezy bronchitis a specificity for AVAM > 12% of 90% is found. Our
      data on primary-school children suggests that PEFV is a specific but only
      slightly sensitive measurement with regard to previously diagnosed bronchial
      asthma.

PMID- 8464859
TI  - [Asthma screening with a standardized running test].
AB  - Exercise induced asthma is a common feature of asthma in childhood. We performed
      a standardized free running test in 1461 primary schoolchildren in first grade
      (mean age: 7.3 years). A decrease of peak expiratory flow of at least 15% after a
      6 minutes exercise period was considered a positive response. For a lifetime
      prevalence of a physician's diagnosis of asthma the sensitivity of the test was
      35.4% and the specificity 94.3%. A positive response was associated with atopy
      (defined as a positive skin prick test) and with the clinical severity of asthma.

PMID- 8464860
TI  - [Bronchial hyperreactivity to distilled water].
AB  - For an epidemiological study 446 children were challenged with distilled water.
      The protocol consisted of 10 minutes tidal inhalation of an ultrasonically
      nebulized aerosol of distilled water. For children presenting with a clinical
      diagnosis of asthma the odds ratio for a positive challenge test was 9.1 compared
      to non-asthmatics [95% confidence intervals: 2.4-34.9; p = 0.001]. Symptoms cough
      (p = 0.03), cough at night (p = 0.03) and atopy defined by prick-test (p = 0.001)
      were also significantly associated with a positive challenge. The easy conduct of
      our protocol, the--from a pathophysiological point of view--"close to asthma"
      stimulus, and the small number of side-effects, indicate that the challenge with
      distilled water can be regarded as an alternative to metacholine provocation
      testing.

PMID- 8464861
TI  - [Bronchoscopic complication].

PMID- 8464862
TI  - Bioconversion of chitin to chitosan: purification and characterization of chitin
      deacetylase from Mucor rouxii.
AB  - Chitin deacetylase, the enzyme that catalyzes the hydrolysis of acetamido groups
      of N-acetylglucosamine in chitin, has been purified to homogeneity from mycelial
      extracts of the fungus Mucor rouxii and further characterized. The enzyme
      exhibits a low pI (approximately 3). Its apparent molecular mass was determined
      to be approximately 75 kDa by sodium dodecyl sulfate/polyacrylamide gel
      electrophoresis and approximately 80 kDa by size-exclusion chromatography,
      suggesting that the enzyme exists as a monomer. Carbohydrate analysis of purified
      chitin deacetylase revealed that the enzyme is a high-mannose glycoprotein and
      that its carbohydrate content is approximately 30% by weight. Chitin deacetylase
      is active on several chitinous substrates and chitin derivatives. The enzyme
      requires at least four N-acetylglucosamine residues (chitotetraose) for
      catalysis, and it is inhibited by carboxylic acids, particularly acetic acid.
      When glycol chitin (a water-soluble chitin derivative) was used as substrate, the
      optimum temperature for enzyme activity was determined to be approximately 50
      degrees C and the optimum pH was approximately 4.5.

PMID- 8464863
TI  - Structure-function relationship of human neutrophil collagenase: identification
      of regions responsible for substrate specificity and general proteinase activity.
AB  - The family of matrix metalloproteinases is a family of closely related enzymes
      that play an important role in physiological and pathological processes of matrix
      degradation. The most distinctive characteristic of interstitial collagenases
      (fibroblast and neutrophil collagenases) is their ability to cleave interstitial
      collagens at a single peptide bond; however, the precise region of the enzyme
      responsible for this substrate specificity remains to be defined. To address this
      question, we generated truncated mutants of neutrophil collagenase with various
      deletions in the COOH-terminal domain and chimeric molecules between neutrophil
      collagenase and stromelysin and assayed the expressed enzymes against type I
      collagen and the general substrate, casein. Our data suggest that substrate
      specificity for interstitial collagen is determined by a 16-aa sequence in the
      COOH-terminal domain of neutrophil collagenase and is influenced by the integrity
      of a disulfide-defined loop at the COOH terminus for maximal activity. It was
      found that a relatively large region of 62-aa residues influenced the relative
      efficiency of collagenolytic activity. In addition to the region that conferred
      this specificity, a site at the COOH side of the presumptive zinc-binding locus
      was found to be necessary for general catalytic activity. Mutation of a critical
      aspartic residue at position 253 within this area resulted in complete loss of
      proteolytic activity, suggesting that Asp-253 might function as one of the
      ligands for divalent cations, which are essential for enzymatic activity.

PMID- 8464864
TI  - Construction and characterization of a bacteriophage T4 DNA polymerase deficient
      in 3'-->5' exonuclease activity.
AB  - Bacteriophage T4 DNA polymerase has a proofreading 3'-->5' exonuclease that plays
      an important role in maintaining the accuracy of DNA replication. We have
      constructed a T4 DNA polymerase deficient in this exonuclease by converting Asp
      219 to Ala. The exonuclease activity of the mutant T4 DNA polymerase has been
      reduced by a factor of at least 10(7), but it retains a polymerase activity whose
      kinetic parameters, kcat, Kd DNA, and Kd dATP, are very close to those of the
      wild-type enzyme. Bacteriophage T4 with the mutant polymerase gene has a markedly
      increased mutation frequency. Asp-219 in T4 DNA polymerase is within a sequence
      similar to those surrounding Asp residues previously shown to be essential for
      the exonuclease activities of the Klenow fragment of Escherichia coli DNA
      polymerase I (Asp-424), bacteriophage phi 29 DNA polymerase (Asp-66), and
      Saccharomyces cerevisiae DNA polymerase delta (Asp-405). Thus, these studies
      support the proposal that there are similar sequences in the active sites for the
      proofreading exonucleases of these and related DNA polymerases.

PMID- 8464865
TI  - Hepoxilin A3 is the endogenous lipid mediator opposing hypotonic swelling of
      intact human platelets.
AB  - When human blood platelets are exposed to hypotonic medium they swell first but,
      shortly thereafter, revert toward their original volume in a process termed
      regulatory volume decrease (RVD). RVD is the result of an enhanced efflux of K+
      and Cl- ions and associated water. Platelet RVD is controlled by a short-lived
      lipoxygenase-derived product (LP). By using a combination of high-performance
      liquid chromatography, gas chromatography-mass spectrometry, and RVD
      reconstitution bioassay, we show that LP is identical with hepoxilin A3. In
      addition we demonstrate that authentic hepoxilin A3 possesses the same biological
      properties on RVD reconstitution as LP and that the activity of both compounds is
      amplified through epoxide hydrolase inhibition with 3,3,3-trichloropropene-1,2
      oxide. Therefore, we report here that volume expansion causes the formation and
      release of hepoxilin A3 from intact human platelets and that this hepoxilin plays
      a major role in volume regulation.

PMID- 8464866
TI  - Technique for in situ measurement of calcium in intracellular inositol 1,4,5
      trisphosphate-sensitive stores using the fluorescent indicator mag-fura-2.
AB  - Stimulation of cells with calcium-mobilizing agonists frequently results in
      inositol 1,4,5-trisphosphate (InsP3)-mediated discharge of Ca from an internal
      store. We report here a technique for directly monitoring Ca within this and
      other stores in gastric epithelial cells. This technique takes advantage of the
      propensity of the acetoxymethyl ester derivative of the fluorescent dye mag-fura
      2 (which is sensitive to Ca concentrations above 5 microM) to accumulate in
      subcellular compartments where it can report changes in the free Ca
      concentration. Intact dye-loaded cells responded to cholinergic stimulation with
      a decrease in the 350 nm/385 nm excitation ratio, as measured in individual cells
      with a digital imaging microscope, consistent with reduced Ca concentration in
      one or more cellular compartments. When cells were permeabilized with digitonin
      and incubated in an "intracellular buffer," the cytoplasmic dye was released,
      leaving the mag-fura-2 in the internal store. InsP3 caused the ratio from the
      trapped indicator to decrease (i.e., Ca was released) in a dose-dependent manner,
      and this effect was blocked by the InsP3 receptor antagonist heparin. Ca
      sequestration into the internal store was ATP-dependent, and reuptake into the
      InsP3-sensitive pool was blocked by thapsigargin, a specific inhibitor of the Ca
      ATPase of the internal store. We used this technique to investigate the role of
      Cl on the release and reloading of the InsP3-sensitive internal store and found
      that Ca uptake was reduced in Cl-free solutions, suggesting an important function
      for Cl in the refilling of this pool.

PMID- 8464867
TI  - Neurotrophin 3 supports the survival of developing muscle sensory neurons in
      culture.
AB  - Target-dependent cell death of different sub-populations of sensory neurons may
      be regulated by different trophic factors. To investigate this possibility, we
      have taken advantage of the fact that the fractions of muscle sensory and
      cutaneous sensory neurons in chicken dorsal root ganglia (DRG) are probably
      different at different segmental levels, and we have compared the responses of
      chicken DRG from levels that do and do not innervate limb tissue to various
      growth factors in vitro. Nerve growth factor (NGF) and brain-derived neurotrophic
      factor (BDNF) both supported neurite outgrowth from DRG explanted from all
      segmental levels. In contrast, neurotrophin 3 (NT-3) supported robust neurite
      growth only from DRG explanted from the cervical or lumbar levels, which
      innervate limb muscles. Similarly, NGF and BDNF both promoted survival of
      dissociated neurons from limb and nonlimb segmental levels, whereas NT-3 promoted
      survival of more neurons from limb compared to nonlimb levels. This suggests that
      muscle sensory neurons, which are probably more prevalent at the cervical and
      lumbar levels, may be specifically affected by NT-3. To evaluate this possibility
      directly, we compared the survival of retrogradely labeled muscle and cutaneous
      neurons in NGF, BDNF, and NT-3. Identified muscle sensory neurons survived best
      in vitro in the presence of NT-3, while the survival of identified cutaneous
      sensory neurons was greatest in NGF. This work provides direct evidence for a
      potential role of NT-3 versus NGF in the survival of a specific subpopulation of
      DRG neurons.

PMID- 8464868
TI  - Widespread activation of calcium-activated neutral proteinase (calpain) in the
      brain in Alzheimer disease: a potential molecular basis for neuronal
      degeneration.
AB  - Calcium-activated neutral proteinases (CANPs or calpains) are believed to be key
      enzymes in intracellular signaling cascades and potential mediators of calcium
      induced neuronal degeneration. To investigate their involvement in Alzheimer
      disease, we identified three isoforms of muCANP (calpain I) in human postmortem
      brain corresponding to an 80-kDa precursor and two autolytically activated
      isoforms (78 and 76 kDa). As an index of changes in the in vivo activity of
      muCANP in Alzheimer disease, the ratio of the 76-kDa activated isoform of muCANP
      to its 80-kDa precursor was measured by immunoassay in selected brain regions
      from 22 individuals with Alzheimer disease and 18 normal controls. This muCANP
      activation ratio was elevated 3-fold in the prefrontal cortex from patients with
      Alzheimer disease but not from patients with Huntington disease. The activation
      ratio was also significantly elevated, but to a lesser degree, in brain regions
      where Alzheimer pathology is milder and has not led to overt neuronal
      degeneration. These findings indicate that muCANP activation is not simply a
      consequence of cellular degeneration but may be associated with dysfunction in
      many neurons before gross structural changes occur. The known influences of CANPs
      on cytoskeleton and membrane dynamics imply that persistent CANP activation may
      contribute to neurofibrillary pathology and abnormal amyloid precursor protein
      processing prior to causing synapse loss or cell death in the most vulnerable
      neuronal populations. Pharmacological modulation of the CANP system may merit
      consideration as a potential therapeutic strategy in Alzheimer disease.

PMID- 8464869
TI  - Function of yeast cytoplasmic C1-tetrahydrofolate synthase.
AB  - The protein product of the ADE3 gene of the yeast Saccharomyces cerevisiae has
      been identified as the cytoplasmic trifunctional C1-tetrahydrofolate (THF)
      synthase, which possesses 10-formyl-THF synthetase (EC 6.3.4.3), 5,10-methenyl
      THF cyclohydrolase (EC 3.5.4.9), and 5,10-methylene-THF dehydrogenase (EC
      1.5.1.5) activities. However, it has been suggested that the ADE3-encoded C1-THF
      synthase does not play a role in providing the enzymes involved in the generation
      of one-carbon intermediates in the biosynthesis of the purine bases but functions
      in maintaining the structural integrity of the enzyme complex involved in purine
      biosynthesis [Barlowe, C. K. & Appling, D. A. (1990) Mol. Cell. Biol. 10, 5679
      5687]. This hypothesis is based on their finding that the presence of the full
      length ADE3 C1-THF synthase, whether catalytically active or not, is correlated
      with the Ade+ phenotype. In contrast to their results, our deletion analysis of
      the ADE3 gene indicates that the presence of either the synthetase or
      dehydrogenase/cyclohydrolase domains of C1-THF synthase is enough to complement
      the adenine requirement in ade3 strains. These results are also consistent with
      those obtained in heterologous expression of spinach and Clostridium acidiurici
      monofunctional synthetases in ade3 strains. Heterologous expression studies show
      that the high synthetase activity may be correlated with the increased growth in
      medium lacking adenine. These results suggest that the catalytic activity of the
      C1-THF synthase is involved in purine biosynthesis.

PMID- 8464870
TI  - Bradyrhizobium japonicum rhizobitoxine genes and putative enzyme functions:
      expression requires a translational frameshift.
AB  - Some strains of Bradyrhizobium japonicum produce rhizobitoxine, a phytotoxin that
      causes foliar chlorosis on susceptible host plants. We have previously obtained
      Tn5-induced rhizobitoxine null mutants of B. japonicum. DNA sequence analysis of
      the region surrounding two Tn5 insertions identifies two overlapping open reading
      frames. The first open reading frame (rtxA) predicts a 54-kDa protein for which
      the N-terminal 280 residues have sequence similarity to serine: pyruvate
      aminotransferase. The sequence homology to aminotransferase is consistent with
      the involvement of this gene in serinol production, a likely intermediate in
      rhizobitoxine biosynthesis. Previously, a mutant in this open reading frame was
      shown not to make serinol. The predicted amino acid sequence of the second open
      reading frame (rtxB) has similarity to yeast O-acetylhomoserine sulfhydrolase.
      This enzyme function is similar to that required for dihydrorhizobitoxine
      synthase. The DNA sequence shows that the rtxB open reading frame overlaps rtxA,
      suggesting that expression of rtxB requires a -1 translational frameshift.
      Protein expression experiments demonstrate production of an RtxAB fusion protein.
      The ability of the overlapping rtxA and rtxB sequences to promote a translational
      frameshift was confirmed in a heterologous expression system. In Escherichia
      coli, this frameshift appears to be unusually efficient, occurring at a frequency
      of 80-90%.

PMID- 8464871
TI  - Role of oxygen vs. glucose in energy metabolism in a mammary carcinoma perfused
      ex vivo: direct measurement by 31P NMR.
AB  - The role of glycolysis vs. respiration in tumor energy metabolism has been
      studied, to date, primarily in vitro by using single cells, multicellular
      spheroids, or tissue slices. With the advent of in vivo NMR spectroscopy, several
      investigators have shown that tumor energy status depends on its blood flow.
      Since manipulation of blood flow alters both oxygen and glucose delivery to a
      solid tumor, these studies have not been able to separate the relative
      contribution of oxygen vs. glucose in energy metabolism in vivo. In the present
      study, we have overcome this problem by combining two methods: the tissue
      isolated R3230AC mammary adenocarcinoma perfused ex vivo and 31P NMR
      spectroscopy. The isolated tumor permits one to control the perfusion pressure as
      well as the metabolite concentrations in the perfusate. NMR spectroscopy permits
      one to measure the ratio of nucleoside triphosphate to inorganic phosphate
      (NTP/Pi) and pH. Our results show that (i) the NTP/Pi ratio ex vivo is similar to
      that observed in vivo prior to surgery, (ii) the NTP/Pi ratio is insensitive to
      flow changes at high flow rates but is proportional to flow rate at flows
      comparable to those found in vivo, (iii) the NTP/Pi ratio of these tumors is
      resistant to hypoxia and is not maintained when glucose is removed or replaced
      with glutamine, and (iv) although both O2 and glucose are consumed by these
      tumors, the effect of perfusate flow rate appears to be mediated largely through
      glucose delivery. The current approach not only provides information about the
      role of glycolysis vs. respiration in a rodent tumor but also is general and
      versatile enough to provide similar data in human tumors perfused ex vivo.

PMID- 8464872
TI  - Expression of truncated forms of liver microsomal P450 cytochromes 2B4 and 2E1 in
      Escherichia coli: influence of NH2-terminal region on localization in cytosol and
      membranes.
AB  - The currently accepted model for the membrane topology of microsomal cytochrome
      P450 is that of a largely cytoplasmic domain bound by only one or two
      transmembrane segments at the NH2 terminus. However, as we have reported
      previously, P450 2E1 lacking the hydrophobic NH2-terminal signal peptide, like
      the full-length protein, is located in the inner cell membrane when expressed in
      Escherichia coli and is active with typical substrates. In the present study,
      additional variants of alcohol-inducible P450 2E1 as well as truncated forms of
      phenobarbital-inducible P450 2B4 were similarly expressed to determine the
      influence of the NH2-terminal region on the membrane-binding properties. After
      deletion of S1 (the NH2-terminal hydrophobic segment), or both S1 and L1 (the
      following hydrophilic region, expected to be lumenal or cytosolic), one-third of
      the resulting P450 2B4 (delta 2-20) and 2B4 (delta 2-27) remained membrane bound.
      Furthermore, the idea that the first two hydrophobic segments are required for
      attachment by a hairpin loop is not supported by the finding that after deletion
      of the S1, L1, and S2 segments about half of the P450 2E1 (delta 3-48) remained
      membrane bound. Since Na2CO3 treatment of the membrane fraction had no
      significant effect, the findings are apparently not attributable to a loose
      attachment or occlusion of the truncated proteins. The replacement of neutral
      amino acids by positively charged residues in positions 3 and 8 of P450 2E1
      (delta 3-29) changed the amount in the cytosol from 35% to 50%, and the deletion
      of residues 2-20 or 2-27 from P450 2B4, which resulted in positive charges
      occurring in the NH2-terminal region, changed the amount in the cytosol from 27%
      to 67%. We conclude that alterations in the NH2-terminal region can change the
      location of the cytochrome from largely membranous to largely cytosolic and that
      the first two hydrophobic segments are not uniquely involved in membrane
      attachment.

PMID- 8464873
TI  - Cholesterol deprivation affects the fluorescence properties of a ceramide analog
      at the Golgi apparatus of living cells.
AB  - Previous studies have established that a fluorescent analog of ceramide, N-[7-(4
      nitrobenzo-2-oxa-1,3-diazole)] -6-aminohexanoyl-D-erythro-sphingosine (C6-NBD
      Cer), is a vital stain for the Golgi apparatus and a useful tool for studying the
      sorting and transport of sphingolipids along the secretory pathway in animal
      cells. Here, we examine the effects of various culture conditions on labeling of
      the Golgi apparatus of human skin fibroblasts by C6-NBD-Cer and demonstrate that
      cholesterol deprivation affects the fluorescence properties of the probe at this
      organelle. Labeling of the Golgi apparatus by C6-NBD-Cer was dramatically reduced
      in cells grown in medium containing lipoprotein-deficient serum compared to cells
      grown in medium containing normal serum. Quantitative fluorescence microscopy
      showed that this apparent reduction in labeling resulted from accelerated photo
      bleaching of the fluorescent analog. C6-NBD-Cer labeling of the Golgi apparatus
      was restored in cholesterol-deprived cells by stimulating endogenous cholesterol
      biosynthesis with mevalonic acid or by adding exogenous nonlipoprotein
      cholesterol or low density lipoprotein to the culture medium. In addition, when
      cells grown in medium containing normal serum were perforated and treated with
      cholesterol oxidase, an apparent reduction in labeling resulted, further
      implicating an intracellular pool of cholesterol in the potentiation of C6-NBD
      Cer fluorescence. These results demonstrate that cytological studies using C6-NBD
      Cer are affected by cholesterol deprivation and suggest that this fluorescent
      lipid may be used to monitor cholesterol at the Golgi apparatus of living cells.

PMID- 8464874
TI  - Effect of T-cell receptor antagonism on interaction between T cells and antigen
      presenting cells and on T-cell signaling events.
AB  - T-cell receptor (TCR) antagonism induced by complexes of antigen analogue with
      major histocompatibility complex (MHC) molecules results in efficient inhibition
      of antigen-dependent T-cell responses. We have investigated some of the possible
      mechanisms by which TCR antagonists bound to the MHC molecules of antigen
      presenting cells (APCs) can inhibit T-cell activation. Using a nonstimulatory
      analogue of the antigenic peptide influenza hemagglutinin-(307-319), we showed
      that MHC/antagonist complexes completely inhibit very early intracellular events
      of antigen-dependent T-cell activation, such as inositol phosphate turnover and
      Ca2+ influx. In a parallel series of experiments, the effect of TCR antagonist
      peptide on membrane-related activation events was also investigated. It was found
      that MHC/antagonist complexes on the surface of APCs did not induce stable
      conjugates with T cells and, most interestingly, did not inhibit antigen-induced
      conjugate formation. Thus, our data suggest that antagonistic peptides do not
      interfere with the cellular events that are required for stable T-cell/APC
      conjugate formation but do inhibit early biochemical events required for T-cell
      proliferation. The data are discussed with respect to the role of surface
      receptor clustering in TCR antagonism.

PMID- 8464875
TI  - Recognition of vaccinia virus-encoded major histocompatibility complex class I
      antigens by virus immune cytotoxic T cells is independent of the polymorphism of
      the peptide transporters.
AB  - In the cytotoxic T-cell response to viruses, peptide antigens of cytoplasmic
      origin are presented at the cell surface by the highly polymorphic major
      histocompatibility complex (MHC) class I molecules to CD8+ T-lymphocyte
      receptors. Peptide transporter molecules and other MHC-linked gene products have
      been implicated in the generation and import of antigenic peptides into the lumen
      of the endoplasmic reticulum for assembly with MHC class I glycoproteins. These
      accessory molecules in the antigen-presentation pathway map to a polymorphic
      region in the class II MHC, and the possibility of their allele-specific
      selectivity in antigen presentation has been raised. Here we show that
      additional, functionally polymorphic components are not apparent in an in vitro
      mouse MHC class I-restricted cytotoxic T-cell response to vaccinia and influenza
      viruses. When the mouse H-2Kd molecule was expressed via a recombinant vaccinia
      virus in target cells of different mouse MHC haplotypes or cells of rat, Syrian
      hamster, monkey, and human origin, efficient Kd-restricted and vaccinia virus
      specific lysis was observed as measured with bulk effectors and at the clonal
      level. In addition, human transporters efficiently processed peptides originating
      from influenza virus nucleoprotein and hemagglutinin antigens as recognized by
      mouse influenza immune cytotoxic T cells.

PMID- 8464876
TI  - p70 lupus autoantigen binds the enhancer of the T-cell receptor beta-chain gene.
AB  - The p70 (Ku) autoantigen has been described as a nonhistone nuclear protein
      recognized by antibodies from lupus patients. In our studies on the regulation of
      T-cell receptor (TCR) beta-chain gene expression we have identified the p70 lupus
      autoantigen as a DNA-binding protein that binds the enhancer of the TCR beta
      chain gene. This enhancer is essential for expression of the TCR beta gene. The
      core TCR beta enhancer contains the E3 motif, which we show here is essential for
      enhancer activity. The protection of the E3 motif in T cells and the marked
      reduction in enhancer activity when the E3 motif is mutated underline its
      physiological importance in regulating beta enhancer activity. The p70 lupus
      autoantigen gene was identified by screening T-cell lambda gt11 libraries with an
      E3 probe. The gene encodes a protein which binds the E3 motif in a sequence
      specific manner. The identification of a 70-kDa protein as a major E3-binding
      protein by UV crosslinking is consistent with the conclusion that the p70 lupus
      autoantigen binds the beta enhancer. Finally, we have shown that T-cell nuclear
      proteins which bind the E3 motif bear p70 (Ku) lupus autoantigenic determinants.
      Together these data suggest that the p70 autoantigen binds a critical motif in
      the beta enhancer and probably regulates TCR beta gene expression.

PMID- 8464877
TI  - Blockade of human immunodeficiency virus type 1 production in CD4+ T cells by an
      intracellular CD4 expressed under control of the viral long terminal repeat.
AB  - A retroviral vector was constructed in which a gene encoding a mutated soluble
      CD4 protein that is retained in the endoplasmic reticulum (sCD4-KDEL) is
      expressed under control of human immunodeficiency virus type 1 (HIV-1) regulatory
      elements. HIV-1 infection of a human T-cell line transduced with this vector led
      to induction of sCD4-KDEL synthesis and a block in transport of the HIV envelope
      protein to the cell surface. There was a complete block to maturation of
      infectious HIV-1 in the transduced cells, no viral spread, and little or no
      syncytium formation. Infected cells gradually disappeared from the culture over a
      period of 2 months. This intracellular trap for HIV has potential application in
      gene therapy for AIDS.

PMID- 8464878
TI  - Infection of colonic epithelial cell lines by type 1 human immunodeficiency virus
      is associated with cell surface expression of galactosylceramide, a potential
      alternative gp120 receptor.
AB  - The gastrointestinal tract plays a major role in the pathogenesis and
      pathophysiology of infection by the type 1 human immunodeficiency virus (HIV-1).
      It is a potential route for viral entry and it is the site of a number of
      complications, including both opportunistic infections and a primary HIV-induced
      enteropathy. Correspondingly, both in vivo and in vitro studies have demonstrated
      HIV infection of gastrointestinal cells of lymphoid and epithelial origin. HT-29,
      a human colonic epithelial cell line that is infectable with many HIV-1 strains,
      does not express CD4 protein or mRNA. Recent studies showed that antibodies
      recognizing a neutral glycolipid related to galactosylceramide (GalCer) in HT-29
      cells inhibited HIV-1 infection of this cell line, extending previous findings in
      neural cells. In the current studies, we further analyzed the neutral glycolipids
      of HT-29 cells and showed that they contained authentic GalCer and that
      recombinant gp120 bound to this glycolipid. Moreover, by analyzing GalCer
      expression in clones derived from HT-29 and Caco-2 (another human colonic cell
      line), we observed that the level of expression of this glycolipid was associated
      with the sensitivity to HIV-1 infection. Subclones of Caco-2 did not express
      GalCer and were not infectable with any of three HIV-1 strains. These results
      strengthen the possibility that GalCer is an alternative receptor in CD4- cell
      lines. Furthermore, since GalCer is a major glycolipid in epithelial cells of the
      small intestine and colon, these results provide a structural basis for the
      binding of HIV-1 by gastrointestinal epithelial cells and the entry of the virus
      into those cells.

PMID- 8464879
TI  - Learning selectively increases protein kinase C substrate phosphorylation in
      specific regions of the chick brain.
AB  - The effect of imprinting, an early form of exposure learning, on the
      phosphorylation state of the protein kinase C substrates myristoylated alanine
      rich C-kinase substrate (MARCKS) and protein F1/43-kDa growth-associated protein
      (F1/GAP-43) was studied in two regions of the chick forebrain. One region, the
      intermediate and medial part of the hyperstriatum ventrale (IMHV), is probably a
      site of long-term memory; the other, the wulst, contains somatic sensory and
      visual projection areas. After imprinting, a significant increase in MARCKS
      protein phosphorylation was observed in the left IMHV but not the right IMHV. No
      significant alteration in F1/GAP-43 was observed in IMHV. MARCKS was resolved
      into two acidic components of pI approximately 5.0 and approximately 4.0.
      Phosphorylation of the pI approximately 5.0 MARCKS but not the pI approximately
      4.0 MARCKS was significantly altered by imprinting. The partial correlation
      between preference score (an index of learning) and phosphorylation, holding
      constant the effect of approach activity during training, was significant only
      for the pI approximately 5.0 MARCKS in the left IMHV. A significant negative
      partial correlation between preference score and F1/GAP-43 phosphorylation in the
      right wulst was observed. Because the imprinting-induced alteration in MARCKS is
      selective with respect to phosphoprotein moiety, hemispheric location, and brain
      region, we propose that these alterations may be central to the learning process.

PMID- 8464880
TI  - Adenine nucleoside diphosphates block adaptation of mechanoelectrical
      transduction in hair cells.
AB  - By adapting to sustained stimuli, hair cells in the internal ear retain their
      sensitivity to minute transient displacements. Because one model for adaptation
      asserts that this process is mediated by a myosin isozyme, we reasoned that we
      should be able to arrest adaptation by interfering with myosin's ATPase cycle
      though introduction of ADP into hair cells. During tight-seal, whole-cell
      recordings of transduction currents in cells isolated from bullfrog (Rana
      catesbeiana) sacculus, dialysis with 5-25 mM ADP gave variable results. In half
      of the cells examined, the rate of adaptation remained unchanged or even
      increased; adaptation was blocked in the remaining cells. Because we suspected
      that the variable effect of ADP resulted from the conversion of ADP to ATP by
      adenylate kinase, we employed the ADP analog adenosine 5'-[beta-thio]diphosphate
      (ADP[beta S]), which is not a substrate for adenylate kinase. Adaptation
      consistently disappeared in the presence of 1-10 mM ADP[beta S]; in addition, the
      transduction channels' open probability at rest grew from approximately 0.1 to
      0.8 or more. Both effects could be reversed by 2 mM ATP. When used in conjunction
      with the adenylate kinase inhibitor P1,P5-bis(5'-adenosyl) pentaphosphate (Ap5A),
      ADP had effects similar to those of ADP[beta S]. These results suggest that
      adaptation by hair cells involves adenine nucleotides, and they lend support to
      the hypothesis that the adaptation process is powered by a myosin motor.

PMID- 8464881
TI  - Cocatalytic zinc motifs in enzyme catalysis.
AB  - Cocatalytic zinc binding sites are characteristic of enzyme molecules which
      contain two or more zinc and/or other metal atoms. In each site an aspartate,
      glutamate, or histidine residue simultaneously binds to two zinc atoms or a zinc
      and a different metal atom. In the resultant amino acid bridge, two of the
      cocatalytic metal atoms bind to the same amino acid. Consequently the
      participating metal atoms are in close proximity and function as a catalytic
      unit, typical of this motif. In these functional units aspartate seems to be
      preferred over glutamate. Serine, threonine, tryptophan, and lysine residues are
      encountered as zinc ligands, although they have not so far been identified as
      ligands in monozinc enzymes or DNA-binding zinc proteins. The resultant
      coordination spheres and their mechanistic implications raise interesting
      questions for further study.

PMID- 8464882
TI  - Vimentin mRNA location changes during muscle development.
AB  - The mRNAs for some cytoskeletal proteins are localized, suggesting that mRNA for
      these proteins may concentrate at sites appropriate for assembly. To test this
      hypothesis, we observed vimentin mRNA in developing chicken muscle cultures by in
      situ hybridization with a digoxigenin-labeled DNA probe to vimentin, detected by
      confocal microscopy using fluorescent anti-digoxigenin antibody. This method has
      submicrometer resolution. In developing muscle, vimentin mRNA was bipolar in
      young myoblasts, somewhat perinuclear in elongated myoblasts and spread
      fibroblasts, and diffuse in young and developing myotubes. In mature myotubes,
      vimentin mRNA occurred at costameres with vimentin protein. Localization of mRNA
      may prove important for assembling and maintaining differentiated cytoskeletal
      structures, as it is for organizing the embryo.

PMID- 8464883
TI  - A dominant-negative mutant of Max that inhibits sequence-specific DNA binding by
      Myc proteins.
AB  - Myc proteins are basic helix-loop-helix/leucine-zipper proteins that bind to
      specific DNA sequences. In vivo, Myc proteins have been found associated with
      Max, another basic helix-loop-helix/leucine-zipper protein. However, it is not
      known to what extent the dimerization of Myc with Max is required for the
      manifestation of the Myc-induced phenotype. To investigate this, we constructed a
      dominant-negative mutant of Max, named dMax, that inhibits sequence-specific DNA
      binding of Myc proteins. Using a rat neuroblastoma model system, we show that
      dMax reverts N-Myc-induced changes in cellular gene expression. A control mutant
      of dMax that contains a proline residue in the leucine-zipper region was unable
      to bind to N-Myc and did not revert the N-Myc-induced changes in cellular gene
      expression. These data support the hypothesis that N-Myc affects neuroblastoma
      gene expression through the formation of a DNA-binding heterodimeric complex with
      Max in vivo.

PMID- 8464884
TI  - Primary structure and functional expression of a cDNA encoding the thiazide
      sensitive, electroneutral sodium-chloride cotransporter.
AB  - Electroneutral Na+:Cl- cotransport systems are involved in a number of important
      physiological processes including salt absorption and secretion by epithelia and
      cell volume regulation. One group of Na+:Cl- cotransporters is specifically
      inhibited by the benzothiadiazine (thiazide) class of diuretic agents and can be
      distinguished from Na+:K+:2Cl- cotransporters based on a lack of K+ requirement
      and insensitivity to sulfamoylbenzoic acid diruetics like bumetanide. We report
      here the isolation of a cDNA encoding a thiazide-sensitive, electroneutral sodium
      chloride cotransporter from the winter flounder urinary bladder using an
      expression cloning strategy. The pharmacological and kinetic characteristics of
      the cloned cotransporter are consistent with the properties of native thiazide
      sensitive sodium-chloride cotransporters in teleost urinary bladder and mammalian
      renal distal tubule epithelia. The nucleotide sequence predicts a protein of 1023
      amino acids (112 kDa) with 12 putative membrane-spanning regions, which is not
      related to other previously cloned sodium or chloride transporters. Northern
      hybridization shows two different gene products: a 3.7-kb mRNA localized only to
      the urinary bladder and a 3.0-kb mRNA present in several non-bladder/kidney
      tissues.

PMID- 8464885
TI  - Cysteine desulfurase activity indicates a role for NIFS in metallocluster
      biosynthesis.
AB  - Biological nitrogen fixation is catalyzed by nitrogenase, a complex metalloenzyme
      composed of two separately purifiable component proteins encoded by the
      structural genes nifH, nifD, and nifK. Deletion of the Azotobacter vinelandii
      nifS gene lowers the activities of both nitrogenase component proteins. Because
      both nitrogenase component proteins have metallocluster prosthetic groups that
      are composed of iron- and sulfur-containing cores, this result indicated that the
      nifS gene product could be involved in the mobilization of the iron or sulfur
      required for metallocluster formation. In the present work, it is shown that NIFS
      is a pyridoxal phosphate-containing homodimer that catalyzes the formation of L
      alanine and elemental sulfur by using L-cysteine as substrate. NIFS activity is
      extremely sensitive to thiol-specific alkylating reagents, which indicates the
      participation of a cysteinyl thiolate at the active site. Based on these results
      we propose that an enzyme-bound cysteinyl persulfide that requires the release of
      the sulfur from the substrate L-cysteine for its formation ultimately provides
      the inorganic sulfide required for nitrogenase metallocluster formation. The
      recent discovery of nifS-like genes in non-nitrogen-fixing organisms also raises
      the possibility that the reaction catalyzed by NIFS represents a universal
      mechanism that involves pyridoxal phosphate chemistry, in the mobilization of the
      sulfur required for metallocluster formation.

PMID- 8464886
TI  - Alteration of the cleavage distance of Fok I restriction endonuclease by
      insertion mutagenesis.
AB  - Fok I restriction endonuclease recognizes the nonpalindromic
      pentadeoxyribonucleotide 5'-GGATG-3'.5'-CATCC-3' in duplex DNA and cleaves 9 and
      13 nucleotides away from the recognition site. Recently, we reported the presence
      of two distinct and separable protein domains within this enzyme--one for the
      sequence-specific recognition and the other for endonuclease activity. Here, we
      report the construction of two insertion mutants of Fok I endonuclease. The
      mutant enzymes were purified, and their cleavage properties were characterized.
      The mutants have the same DNA sequence specificity as the wild-type enzyme.
      However, compared with the wild-type enzyme, they cleave one nucleotide further
      away from the recognition site on both strands of the DNA substrates. Thus, it is
      possible to alter the cleavage distance of Fok I by protein engineering.

PMID- 8464887
TI  - The envelope glycoprotein of human immunodeficiency virus type 1 stimulates
      release of neurotoxins from monocytes.
AB  - Mononuclear phagocytes infected with human immunodeficiency virus 1 (HIV-1)
      produce soluble factors that kill neurons in culture. To define the molecular
      events that lead to neuron killing, HIV-1 proteins were tested for the ability to
      trigger release of neurotoxins from human monocytes and lymphocytes. None of the
      recombinant-derived HIV-1 proteins examined (reverse transcriptase, protease,
      gag, nef, or gp120) were directly neurotoxic at concentrations from 100 pM to 10
      nM. The envelope glycoprotein gp120 did, however, stimulate both isolated human
      blood monocytes and the monocytoid line THP-1 (but not lymphocytes or the
      lymphoid cell line H9) to discharge neurotoxic factors. These toxins consisted of
      heat-stable, protease-resistant molecules (< 500 Da) that copurified with
      neurotoxins from HIV-1-infected THP-1 cells and were blocked by antagonists to N
      methyl-D-aspartate receptors. Release of neurotoxins through gp120 stimulation
      involved monocytoid CD4 receptors because toxin production could be inhibited
      either by a monoclonal antibody to the CD4-binding region of gp120 or by soluble
      CD4 receptors. Alternatively, production of neuron-killing factors could be
      induced with a peptide from the CD4-binding region of gp120. These data show that
      the HIV-1 envelope glycoprotein alone can stimulate neurotoxin release by binding
      to CD4 receptors of mononuclear phagocytes. Such neurotoxic factors may, in turn,
      contribute to the central nervous system dysfunction associated with HIV-1 by
      acting on neurons through N-methyl-D-aspartate receptors.

PMID- 8464888
TI  - Mechanisms of rejection induced by tumor cell-targeted gene transfer of
      interleukin 2, interleukin 4, interleukin 7, tumor necrosis factor, or interferon
      gamma.
AB  - Interleukin (IL)-2, IL-4, IL-7, tumor necrosis factor (TNF), or interferon-gamma
      (IFN-gamma) has been shown to be able to induce tumor rejection if produced
      locally by the tumor cells after gene transfer. To analyze whether the cellular
      rejection mechanisms are different or redundant we have expressed the cytokines
      in the same tumor cell line (J558L). Cell depletion experiments revealed that all
      cytokines required CD8+ T cells for complete long-term tumor eradication,
      although effective but transient host-dependent tumor suppression was also
      observed in the complete absence of CD8+ T cells. The transient tumor suppression
      induced by IL-2, IL-4, TNF, or IFN-gamma was also operative in nude and severe
      combined immunodeficient mice, whereas only tumor suppression induced by IL-7 was
      dependent on the presence of CD4+ T cells and was not evident in nude mice. The T
      cell-independent effector arm of IL-2 and IFN-gamma but not IL-4 and TNF was
      mediated in part by natural killer cells. The transience of tumor suppression in
      the absence of T cells reflected loss of cytokine production in the case of TNF,
      IL-2, and IL-4 but not IFN-gamma. Immunohistologic analysis revealed all cytokine
      producing tumors to be heavily infiltrated by macrophages. IL-4 and IL-7 tumors
      additionally contained eosinophils. The infiltration by T cells did not
      necessarily reflect their contribution to tumor rejection. Thus, the different
      cytokines activate heterogeneous transient tumor-suppressive mechanisms but
      always require CD8+ T cells for complete tumor rejection.

PMID- 8464889
TI  - Class II-positive hematopoietic cells cannot mediate positive selection of CD4+ T
      lymphocytes in class II-deficient mice.
AB  - Generation of immunocompetent alpha/beta T-cell receptor-positive T cells from
      CD4+CD8+ thymocytes depends upon their interaction with thymic major
      histocompatibility complex (MHC) molecules. This process of positive selection
      provides mature T cells that can recognize antigens in the context of self-MHC
      proteins. Previous studies investigating haplotype restriction in thymic and bone
      marrow chimeras concluded that radioresistant thymic cortical epithelium directs
      the positive selection of thymocytes. There is controversy, however, as to
      whether intra- or extrathymic radiosensitive bone marrow-derived macrophage and
      dendritic cells also can mediate positive selection. To determine whether CD4+ T
      cells can be positively selected by hematopoietic cells, we generated chimeric
      animals expressing MHC class II molecules on either bone marrow-derived or thymic
      stromal cells by using a recently produced strain of MHC class II-deficient mice.
      CD4+ T cells developed only when class II MHC molecules were expressed on
      radioresistant thymic cells. In contrast to what recently has been observed for
      the selection of CD8+ T lymphocytes, MHC class II-positive bone marrow-derived
      cells were unable to mediate the selection of CD4+ T cells when the thymic
      epithelium lacked MHC class II expression. These data suggest that CD4+ and CD8+
      T cells may be generated by overlapping, but not identical, mechanisms.

PMID- 8464890
TI  - HMT, encoded by H-2M3, is a neoclassical major histocompatibility class I
      antigen.
AB  - H-2M3 encodes HMT, the major histocompatibility complex (MHC) class I heavy chain
      of the maternally transmitted antigen (Mta). Like classical MHC class I genes,
      the expression of M3 can be stimulated by gamma-interferon and its message can be
      detected from mid-gestational embryos (day 8) through adulthood. HMTb, a
      nonimmunogenic allelic form of HMT, differs from the common HMTa molecule by four
      amino acids, of which only two (residues 31 and 95) are located in the alpha 1
      and alpha 2 domains that form the peptide-binding groove. Recognition of site
      directed mutants by Mta-specific cytotoxic T lymphocytes was hardly affected by
      the substitution of Met for Val31 but was abolished by the substitution of Gln
      for Leu95, which is located in the beta-sheet floor of the peptide-binding
      groove. Thus a single amino acid difference is responsible for the immunological
      silence of HMTb.

PMID- 8464891
TI  - Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non
      lead-exposed suburban populations in the United States.
AB  - Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood
      Pb levels are indices of absorption during the previous 21-30 days. This study
      was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence
      (LXRF) in a United States suburban population which was exposed to unusually high
      levels of Pb in emissions from an adjacent factory during 1963-1981, compared
      with concentrations similarly estimated in a matched suburban community without
      unusual Pb exposure. The mean bone Pb value in 269 residents of the highly
      exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5
      ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse
      effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated
      bone Pb concentrations in residents of the unusually exposed suburb approximated
      estimated values in workers at Pb-processing factories.

PMID- 8464892
TI  - Attempts to restore scrapie prion infectivity after exposure to protein
      denaturants.
AB  - A wealth of experimental evidence argues that infectious prions are composed
      largely, if not entirely, of the scrapie isoform of the prion protein. We
      attempted to restore scrapie infectivity after exposure to protein denaturants
      including urea, chaotropic salts, and SDS. None of the procedures restored
      infectivity. Dialysis to remove slowly chaotropic ions and urea failed to restore
      scrapie infectivity. Attempts to create monomers of the scrapie isoform of the
      prion protein under nondenaturing conditions using a wide variety of detergents
      have been unsuccessful, to date, except for one report claiming that scrapie
      infectivity could be recovered from 12% polyacrylamide gels after SDS/PAGE
      [Brown, P., Liberski, P. P., Wolff, A. & Gajdusek, D. C. (1990) Proc. Natl. Acad.
      Sci. USA 87, 7240-7244]. We found that < 0.001% of the infectious prion titer
      could be recovered from the region of a polyacrylamide gel where the denatured
      proteinase K-resistant core of the scrapie isoform of the prion protein and other
      30-kDa proteins migrate. We conclude that under the denaturing conditions used
      for SDS/PAGE, the scrapie isoform of the prion protein is denatured and little or
      no renaturation occurs upon injection of fractions eluted from gels into animals
      for bioassays.

PMID- 8464893
TI  - Adenovirus-mediated transfer of low density lipoprotein receptor gene acutely
      accelerates cholesterol clearance in normal mice.
AB  - We have explored the use of adenovirus-mediated gene transfer to transiently
      elicit production of low density lipoprotein (LDL) receptors in mice. A
      recombinant adenovirus carrying the human LDL receptor cDNA restored LDL receptor
      function in receptor-deficient cultured cells. Intravenous injection of
      recombinant virus acutely lowered plasma cholesterol levels and increased the
      rate of 125I-labeled LDL clearance from the circulation in normal mice. At 4 days
      after virus injection, the t1/2 of plasma LDL was reduced up to 10-fold. An
      estimated 90% of the parenchymal cells in liver expressed the adenovirus
      transferred genes as judged by immunofluorescence of LDL receptors or by beta
      galactosidase staining. These results demonstrate that adenovirus-mediated
      transfer of the LDL receptor gene provides an efficient way of augmenting LDL
      receptor gene function in the liver over the short term.

PMID- 8464894
TI  - Mutation of p53 in primary biopsy material and cell lines from Hodgkin disease.
AB  - The p53 tumor-suppressor gene encodes a nuclear phosphoprotein that arrests cell
      cycle progress at G1. It may facilitate DNA damage repair and is frequently
      mutated in many human tumors. Hodgkin disease, a malignant condition of the
      lymphoid system, is characterized by the presence of Reed-Sternberg cells and
      mononuclear variants (Hodgkin cells), whose etiology remains unknown. The large
      multinucleated Reed-Sternberg cells often comprise < 1% of the total cell
      population within a biopsy specimen and are thought to be the neoplastic
      component in an admixture of reactive cells. It has been shown in the large
      majority of cases that up to 60% of these multinucleated cells react with CM-1,
      an anti-p53 antibody. However, whether this "overexpression" of p53 protein
      reflects abnormality at the DNA level can no longer be assumed by
      immunocytochemistry alone. p53 from six Hodgkin disease-derived cell lines was
      examined by immunoprecipitation, polymerase chain reaction (PCR)-single-strand
      conformation polymorphism analysis, and sequencing. In one cell line, point
      mutations were identified in exons 5 and 8 of p53. Sequencing of cloned PCR
      products confirmed the mutations to be on different alleles. A strategy involving
      extraction of nuclei followed by enrichment by flow cytometry was used to
      determine whether p53 overexpression in the Reed-Sternberg cells from patient
      biopsy material was due to mutations in this gene. Single-strand conformation
      polymorphism revealed additional bands in the polyploid nuclear preparations,
      suggesting abnormalities, and sequence analysis confirmed the presence of point
      mutations.

PMID- 8464895
TI  - Kedarcidin chromophore: an enediyne that cleaves DNA in a sequence-specific
      manner.
AB  - Kedarcidin chromophore is a 9-membered enediyne, recently isolated from an
      actinomycete strain. In vivo studies show this molecule to be extremely active
      against P388 leukemia and B16 melanoma. Cytotoxicity assays on the HCT116 colon
      carcinoma cell line result in an IC50 value of 1 nM. In vitro experiments with
      phi X174, pM2 DNA, and 32P-end-labeled restriction fragments demonstrate that
      this chromophore binds and cleaves duplex DNA with a remarkable sequence
      selectivity producing single-strand breaks. The cleavage chemistry requires
      reducing agents and oxygen similar to the other naturally occurring enediynes.
      Certain cations (Ca2+ and Mg2+) prevent strand cleavage. High-resolution 1H NMR
      studies on the chromophore in the presence of calcium chloride implicate the 2
      hydroxynaphthoyl moiety in DNA binding. Interestingly, the kedarcidin chromophore
      appears structurally related to neocarzinostatin yet recognizes specific DNA
      sequences in a manner similar to calicheamicin gamma 1I, an enediyne with a
      significantly different structure. Moreover, kedarcidin and calicheamicin share a
      DNA preferred site, the TCCTN-mer. These observations indicate that the
      individual structural features of these agents are not solely responsible for
      their DNA selectivity. Rather, a complementarity between their overall tertiary
      structure and the local conformation of the DNA at the binding sites must play a
      significant role in the recognition process.

PMID- 8464896
TI  - Progression toward tumor cell phenotype is enhanced by overexpression of a mutant
      p53 tumor-suppressor gene isolated from nasopharyngeal carcinoma.
AB  - We recently reported the detection of a heterozygous G-->C point mutation at
      codon 280 of p53 in nasopharyngeal carcinoma, which causes an Arg-->Thr
      substitution. To test whether this mutant p53 has gained function as an oncogene,
      we overexpressed the mutant p53 in nontumorigenic cells of two model systems: (i)
      human Saos-2 cells lacking endogenous p53 and (ii) mouse JB6 variants that bear
      endogenous wild-type p53. Although they have no growth advantage over the
      neomycin controls in monolayer culture, human Saos-2 transfectants overexpressing
      mutant p53 do show enhanced progression to tumor cell phenotype, as assayed by
      anchorage-independent growth and in vivo tumorigenicity. The enhancement is seen
      only in transfectants expressing higher levels of p53 protein. In the mouse JB6
      system, the mutant p53 functions dominantly in the presence of endogenous wild
      type p53 to enhance progression of preneoplastic promotion-sensitive cells toward
      anchorage-independent phenotype. Mouse JB6 transfectants of mutant p53 are,
      however, not tumorigenic in nude mice. We conclude from these studies that the G-
      >C point mutation of p53 at codon 280 is a gain-of-function mutation that appears
      to operate dominantly and that the mutant p53-thr280 has only moderate oncogenic
      activity. This mutation may cooperate with other yet-to-be isolated genes in the
      genesis of nasopharyngeal carcinoma.

PMID- 8464897
TI  - Highly lytic CD8+, alpha beta T-cell receptor cytotoxic T cells with major
      histocompatibility complex (MHC) class I antigen-directed cytotoxicity in beta 2
      microglobulin, MHC class I-deficient mice.
AB  - Targeted disruption of the beta 2-microglobulin (beta 2m) gene results in major
      histocompatibility complex (MHC) class I deficiency and virtual disappearance of
      functional CD8+ cytotoxic T lymphocytes (CTLs) in beta 2m-deficient (beta 2m-/-)
      mice. We asked whether the beta 2m-/- mice are able to reject tumor cells
      injected i.p. and what is the cellular composition of peritoneal exudate
      leukocytes (PELs) from such mice. We found that beta 2m-/- mice do reject MHC
      class I-bearing tumor cells injected i.p. Surprisingly, analysis of PEL CTLs
      obtained from i.p. tumor-injected beta 2m -/- mice revealed the presence of a
      large proportion of functional, tumor-destroying CD8+, CD4-, alpha beta T-cell
      receptor-positive, CD3+, Thy-1+, MHC class I-negative CTLs with strong MHC class
      I-directed cytotoxic activity. These results call for careful studies of local
      accumulation of CD8+ CTLs in beta 2m -/- mouse models and suggest that the
      dramatic decrease in MHC class I expression caused by beta 2m gene disruption
      does not prevent CD8+/CD4- cell selection and expansion.

PMID- 8464898
TI  - Tissue typing the HLA-A locus from genomic DNA by sequence-specific PCR:
      comparison of HLA genotype and surface expression on colorectal tumor cell lines.
AB  - A system devised for tissue typing the HLA-A locus by PCR from genomic DNA has
      been used to investigate abnormalities of HLA expression in a panel of 30
      colorectal tumor cell lines, by comparing the HLA-A locus genotype with surface
      expression of HLA. Three cell lines showed complete lack of HLA expression
      associated with failure to express beta 2-microglobulin. In two other cell lines,
      loss of expression of HLA-A2 was observed, in spite of the presence of the gene
      in genomic DNA. Eleven cell lines gave a single HLA-A locus specificity on PCR
      typing. In one of these cell lines we have demonstrated the loss of an HLA-A
      locus gene in the tumor cell by comparison with DNA from a lymphoblastoid B-cell
      line derived from the same patient. These data indicate that at least three
      independent mechanisms were involved in the loss of HLA expression on the
      colorectal tumor cell lines.

PMID- 8464899
TI  - Antibody-promoted dimerization bypasses the regulation of DNA binding by the heme
      domain of the yeast transcriptional activator HAP1.
AB  - The yeast transcriptional activator HAP1 contains a DNA-binding domain homologous
      to the zinc finger of GAL4 and an adjacent regulatory domain that blocks DNA
      binding in the absence of the inducer heme. We show that short HAP1 fragments
      containing the zinc finger are unable to bind to DNA but can be rescued by
      antibody to the HAP1 zinc finger. These fragments are missing a coiled-coil
      sequence similar to that within the dimerization domain of GAL4 and dimerization
      domains of myosin heavy chain. We surmise that the antibody promotes DNA binding
      by bringing together two monomers. Interestingly, the antibody will also promote
      DNA binding of a larger HAP1 fragment containing the DNA-binding and the heme
      regulatory domains. This suggests that the regulatory domain acts by preventing
      dimerization of HAP1 in the absence of heme. Consistent with this view is an in
      vivo assay that also reveals that heme promotes HAP1 dimerization in yeast cells.

PMID- 8464900
TI  - Cloning of the cDNA encoding a myosin heavy chain B isoform of Xenopus nonmuscle
      myosin with an insert in the head region.
AB  - The complete amino acid sequence of Xenopus laevis nonmuscle myosin heavy chain B
      (MHC-B) has been deduced from overlapping cDNA clones isolated from an XTC cell
      library. RNA blots of various developmental stages, adult tissues, and XTC cells
      detect a single transcript of 7.5 kb which is expressed at similar levels
      throughout development. MHC-B mRNA was detected in XTC cells, heart, lung,
      spleen, and brain, at lower levels in ovary, testis, pancreas, stomach, liver,
      and eye, but not in kidney and skeletal muscle. Protein expression in adult
      tissues, as detected by immunoblot analysis, correlates well with mRNA
      expression. In chickens and humans, a fraction of the mRNA encoding the MHC-B
      isoform was found previously to contain a 10-amino acid insert at amino acid 211
      near the ATP-binding site. As reported elsewhere, in the chicken this insert
      bearing isoform is nervous system-specific. The Xenopus sequence shows a 16-amino
      acid insertion at the same position; 7 of 16 residues are identical to those in
      the chicken and human insertion, and these identical residues include a consensus
      target sequence for cyclin-p34cdc2 kinase. In contrast to chicken, all frog
      tissues and embryonic stages tested contained the insert-bearing form, and no
      evidence for a non-insert-bearing MHC-B isoform was found in Xenopus.

PMID- 8464901
TI  - Osteoarthritis associated with mild chondrodysplasia in transgenic mice
      expressing alpha 1(IX) collagen chains with a central deletion.
AB  - Type IX collagen, containing molecules of the three distinct polypeptides alpha
      1(IX), alpha 2(IX), and alpha 3(IX), is an interesting hybrid extracellular
      matrix component in cartilage and eye tissues, with the properties of both a
      proteoglycan and a collagen. The alpha 1 (IX) chain has two forms, as a result of
      the tissue-specific utilization of two alternative promoters; the alpha 2(IX)
      chain carries a covalently attached glycosaminoglycan side chain. We have
      introduced a gene construct controlled by a tissue-specific promoter/enhancer and
      expressing a truncated alpha 1(IX) chain into mice. Examination of the offspring
      of two different founders revealed pathological changes similar to osteoarthritis
      in the articular cartilage of knee joints. In addition, mice homozygous for the
      transgene developed mild chondrodysplasia (i.e., mild dwarfism, anterior tonguing
      in the vertebral bodies, and ophthalmopathy). The relative ratio of transgene
      product to the endogenous alpha 1(IX) chain was approximately one in homozygotes
      and less than one in heterozygotes. Therefore, the phenotypic severity correlated
      well with the level of transgene expression. These findings suggest that
      mutations in type IX collagen genes may cause certain forms of osteoarthritis and
      chondrodysplasia in humans.

PMID- 8464902
TI  - High-molecular-weight proteins of nontypable Haemophilus influenzae mediate
      attachment to human epithelial cells.
AB  - Nontypable Haemophilus influenzae are Gram-negative bacilli that represent a
      common cause of human disease. These organisms initiate infection by colonizing
      the upper respiratory tract. Despite the essential role of colonization, the
      bacterial determinants of this process remain poorly defined. We recently
      identified a family of surface-exposed high-molecular-weight proteins of
      nontypable H. influenzae that are related to filamentous hemagglutinin, a
      critical adherence factor of Bordetella pertussis. The genes encoding the two
      such high-molecular-weight proteins (HMW-1 and HMW-2) expressed by a prototypic
      nontypable H. influenzae strain have now been cloned and sequenced. In this study
      we examined the role of the HMWs in adherence to human epithelial cells. We found
      that loss of expression of HMW-1 by the prototypic strain and a HMW-1-like
      protein in a heterologous nontypable H. influenzae strain markedly decreased the
      capacity to adhere. The absence of expression of both HMW-1 and HMW-2 in the
      prototypic strain or their homologs in the second strain was associated with a
      further decrease in adherence. Expression of either HMW-1 or HMW-2 in nonadherent
      laboratory strains of Escherichia coli resulted in acquisition of the adherence
      phenotype. These results indicate that both HMW-1 and HMW-2 and the homologous
      proteins from a second strain can mediate attachment. We speculate that these
      proteins and the related proteins in other nontypable H. influenzae isolates are
      important colonization factors.

PMID- 8464903
TI  - Mutant human cells defective in induction of major histocompatibility complex
      class II genes by interferon gamma.
AB  - Using immunoselection, we have isolated 11 independent mutant HT1080 fibrosarcoma
      cell lines defective in the induction by interferon gamma (IFN-gamma) of the
      expression of the human leukocyte antigen HLA-DRA. The mutations are recessive
      and fall into five complementation groups. All the mutants are affected mainly in
      the expression of major histocompatibility complex class II and invariant-chain
      genes. Type I mutants (three complementation groups) are completely defective in
      induction of the invariant-chain and class II HLA-DP, -DQ, -DR, and -DM genes,
      whereas type II mutants (two complementation groups) induce these genes weakly in
      response to IFN-gamma, in the order DPB > DRA > invariant chain. The induction by
      IFN-gamma of the mRNAs for class I, TAP1, LMP7, and 9-27 is partially defective
      and the induction of the proteins IRF-1 and ICAM-1 is normal in both types of
      mutants. All the mutants respond normally to IFN-alpha. The mutants are stable
      and thus can be used to clone the affected genes by reversion.

PMID- 8464904
TI  - Purification, characterization, and cDNA cloning of an NADPH-cytochrome P450
      reductase from mung bean.
AB  - We report here the isolation and deduced amino acid sequence of the flavoprotein,
      NADPH-cytochrome P450 (cytochrome c) reductase (EC 1.6.2.4), associated with the
      microsomal fraction of etiolated mung bean seedlings (Vigna radiata var. Berken).
      An 1150-fold purification of the plant reductase was achieved, and SDS/PAGE
      showed a predominant protein band with an apparent molecular mass of
      approximately 82 kDa. The purified plant NADPH-P450 reductase gave a positive
      reaction as a glycoprotein, exhibited a typical flavoprotein visible absorbance
      spectrum, and contained almost equimolar quantities of FAD and FMN per mole of
      enzyme. Specific antibodies revealed the presence of unique epitopes
      distinguishing the plant and mammalian flavoproteins as demonstrated by Western
      blot analyses and inhibition studies. Peptide fragments from the purified plant
      NADPH-P450 reductase were sequenced, and degenerate primers were used in PCR
      amplification reactions. Overlapping cDNA clones were sequenced, and the deduced
      amino acid sequence of the mung bean NADPH-P450 reductase was compared with
      equivalent enzymes from mammalian species. Although common flavin and NADPH
      binding sites are recognizable, there is only approximately 38% amino acid
      sequence identity. Surprisingly, the purified mung bean NADPH-P450 reductase can
      substitute for purified rat NADPH-P450 reductase in the reconstitution of the
      mammalian P450-catalyzed 17 alpha-hydroxylation of pregnenolone or progesterone.

PMID- 8464905
TI  - Demonstration of ligand-dependent signaling by the erbB-3 tyrosine kinase and its
      constitutive activation in human breast tumor cells.
AB  - The predicted human erbB-3 gene product is closely related to epidermal growth
      factor receptor (EGFR) and erbB-2, which have been implicated as oncogenes in
      model systems and human neoplasia. We expressed the erbB-3 coding sequence in NIH
      3T3 fibroblasts and identified its product as a 180-kDa glycoprotein, gp180erbB
      3. Tunicamycin and pulse-chase experiments revealed that the mature protein was
      processed by N-linked glycosylation of a 145-kDa erbB-3 core polypeptide. The
      intrinsic catalytic function of gp180erbB-3 was shown by its ability to
      autophosphorylate in vitro. Ligand-dependent signaling of its cytoplasmic domain
      was established employing transfectants that express a chimeric EGFR/erbB-3
      protein, gp180EGFR/erbB-3. EGF induced tyrosine phosphorylation of the chimera
      and promoted soft agar colony formation of such transfectants. These findings
      combined with the detection of constitutive tyrosine phosphorylation of gp180erbB
      3 in 4 of 12 human mammary tumor cell lines implicate the activated erbB-3
      product in the pathogenesis of some human malignancies.

PMID- 8464906
TI  - Human BMP sequences can confer normal dorsal-ventral patterning in the Drosophila
      embryo.
AB  - The type beta transforming growth factor family is composed of a series of
      processed, secreted growth factors, several of which have been implicated in
      important regulatory roles in cell determination, inductive interactions, and
      tissue differentiation. Among these factors, the sequence of the DPP protein from
      Drosophila is most similar to two of the vertebrate bone morphogenetic proteins,
      BMP2 and BMP4. Here we report that the human BMP4 ligand sequences can function
      in lieu of DPP in Drosophila embryos. We introduced the ligand region from human
      BMP4 into a genomic fragment of the dpp gene in place of the Drosophila ligand
      sequences and recovered transgenic flies by P-element transformation. We find
      that this chimeric dpp-BMP4 transgene can completely rescue the embryonic dorsal
      ventral patterning defect of null dpp mutant genotypes. We infer that the
      chimeric DPP-BMP4 protein can be processed properly and, by analogy with the
      action of other family members, can activate the endogenous DPP receptor to carry
      out the events necessary for dorsal-ventral patterning. Our evidence suggests
      that the DPP-BMP4 signal transduction pathway has been functionally conserved for
      at least 600 million years.

PMID- 8464907
TI  - Opioid peptides activate phospholipase D and protein kinase C-epsilon in chicken
      embryo neuron cultures.
AB  - The mu-opioid peptide morphiceptin stimulated a Ca(2+)-independent protein kinase
      C (PKC-epsilon) that is expressed both in embryonic day 6 chicken telencephalon
      and in derived neuronal cultures. This activation was seen as a 2-fold increase
      in the activity and level of cytosolic PKC-epsilon and as a transient increase in
      membrane-associated PKC-epsilon following morphiceptin treatment. Morphiceptin
      did not activate phospholipase C-mediated phosphatidylinositol hydrolysis but did
      transiently activate (2- to 3-fold) phospholipase D (PLD), as measured by
      phosphatidylethanol formation in neuron cultures derived from embryonic day 6 or
      day 7 cerebral hemispheres. This PLD activation could provide an alternative
      source of diacylglycerol for the activation of PKC-epsilon and was naloxone
      reversible and at least partially blocked by the tyrosine kinase inhibitor
      herbimycin A. Addition of phorbol 12-myristate 13-acetate stimulated both PLD and
      PKC-epsilon activities to a greater extent than opioids. The phorbol ester and
      insulin stimulation of PLD was also blocked by herbimycin. Both morphiceptin (in
      a naloxone-reversible manner) and phorbol ester increased phosphorylation of
      similar cytosolic proteins in intact cells, demonstrating a functional role for
      the PKC-epsilon activation by opioids. This is evidence that opioid receptors are
      transiently coupled to tyrosine kinase, PLD and PKC-epsilon activation and, by
      implication, to neuronal cell growth during brain morphogenesis.

PMID- 8464908
TI  - Experimental resolution of the free energies of aqueous solvation contributions
      to ligand-protein binding: quinone-QA site interactions in the photosynthetic
      reaction center protein.
AB  - Equilibrium binding free energies of 14 benzo-, naphtho-, and anthraquinone
      cofactors have been determined at the QA redox catalytic site of the purified
      photosynthetic reaction center protein from Rhodobacter sphaeroides solubilized
      in water (delta G degrees B,w), in hexane solution containing 30 mM water (delta
      G degrees B,hh), and after partial dehydration (delta G degrees B,dh) with
      magnesium sulfate. Our aim is to resolve the contributions of aqueous bulk phase
      solvation and protein hydration contributions to binding in order to characterize
      in detail the direct interactions between the ligands and protein at the QA site.
      This is accomplished by comparing the differences between delta G degrees B,w and
      delta G degrees B,hh (or delta G degrees B,dh) with the water to hexane solvent
      transfer free energies of the quinones (delta G degrees tr,Q). Values of delta G
      degrees tr,Q are determined separately in binary solution and range from 0.65 to 
      5.69 kcal/mol (1 cal = 4.184 J). The results are interpreted in terms of a
      thermodynamic cycle that links the species involved in the binding and solvent
      transfer equilibria. Values of delta G degrees B,hh -delta G degrees B,w are
      linearly correlated with -delta G degrees tr,Q (slope, 0.78 +/- 0.04; ordinate
      intercept, -0.13 +/- 0.12 kcal/mol). The deviation of the experimental slopes
      from the predicted value of unity is attributed in part to a systematic decrease
      of quinone thermodynamic activity in the aqueous binding medium relative to the
      aqueous phase in the binary partitioning solvent system. The difference between
      the quinone-QA site binding free energies measured in hydrated hexane and water
      is therefore related only to the difference in bulk phase quinone solvation, as
      given by 0.78 delta G degrees tr,Q. The linear relation obtained using delta G
      degrees B,dh -delta G degrees B,w has the same slope, but the intercept is
      decreased to -1.48 +/- 0.19 kcal/mol, indicating that quinone binding strengths
      in the hexane system are uniformly enhanced after partial dehydration. This
      suggests that the quinones encounter a common opposition to interaction with the
      site in the hydrated, relative to the partially dehydrated, state. The further
      utility of the method to directly assess ligand-site binding free energies is
      demonstrated with examples that address the contributions of molecular size and
      dipolar or hydrogen bond interactions to the binding of quinones at the QA site.

PMID- 8464909
TI  - Crystal structure of CATGGCCATG and its implications for A-tract bending models.
AB  - The single-crystal x-ray analysis of orthorhombic CATGGCCATG has revealed a
      previously unrecognized mode of intrinsic bending in DNA. The decamer shows a
      smooth bend of 23 degrees over the central four base pairs, caused by
      preferential stacking interactions at guanine bases. The bend is produced by a
      roll of base pairs along their long axes, in a direction that compresses the wide
      major groove of the double helix. This major-groove-compressing bend at GGC, plus
      the abundant crystallographic evidence that runs of successive adenine bases (A
      tracts) are straight and unbent, requires rethinking of the models most commonly
      invoked to explain A-tract bending. A decade of excellent experimental work
      involving gel migration experiments, cyclization kinetics, and nucleosome phasing
      has clearly established that introduction of short A-tracts into a general DNA
      sequence in synchrony with the natural repeat of the helix leads to bending. But
      it does not logically and inevitably follow that the actual bending is to be
      found within these introduced A-tracts or even at junctions with general-sequence
      B-DNA.

PMID- 8464910
TI  - Biocatalytic synthesis of acrylates in supercritical fluids: tuning enzyme
      activity by changing pressure.
AB  - Supercritical fluids are a unique class of nonaqueous media in which biocatalytic
      reactions can occur. The physical properties of supercritical fluids, which
      include gas-like diffusivities and liquid-like densities, can be predictably
      controlled with changing pressure. This paper describes how adjustment of
      pressure, with the subsequent predictable changes of the dielectric constant and
      Hildebrand solubility parameter for fluoroform, ethane, sulfur hexafluoride, and
      propane, can be used to manipulate the activity of lipase in the
      transesterification of methylmethacrylate with 2-ethyl-1-hexanol. Of particular
      interest is that the dielectric constant of supercritical fluoroform can be tuned
      from approximately 1 to 8, merely by increasing pressure from 850 to 4000 psi
      (from 5.9 to 28 MPa). The possibility now exists to predictably alter both the
      selectivity and the activity of a biocatalyst merely by changing pressure.

PMID- 8464911
TI  - Expression of the major protein kinase C substrate, the acidic 80-kilodalton
      myristoylated alanine-rich C kinase substrate, increases sharply when Swiss 3T3
      cells move out of cycle and enter G0.
AB  - The expression of the major protein kinase C (PKC) substrate, originally called
      "80K" for acidic SDS/PAGE-observed 80-kDa PKC substrate and now called "MARCKS"
      for myristoylated alanine-rich C kinase substrate, in Swiss 3T3 fibroblasts
      changes strikingly (15- to 22-fold) during transitions of cell growth. Quiescent
      cells in G0 express high levels of MARCKS mRNA and protein. However, plating
      these cells in fresh medium at low density to stimulate multiple rounds of cell
      division caused a striking down-regulation of MARCKS expression. The mRNA level
      declined to a minimum of 4.5% compared with quiescent control cells 6 hr after
      plating, and protein levels declined during the same period to 6.5% of the
      control value. This rapid down-regulation was independent of PKC activation and
      length of exposure to trypsin (1-10 min) but required plating in medium
      containing fresh serum. MARCKS mRNA and protein levels remained down-regulated
      for 3 days, during which time the cells were actively progressing through the
      cell cycle as judged by fluorescence-activated cell sorting analysis. However, on
      reaching quiescence, the expression of MARCKS mRNA and protein increased
      markedly. Furthermore, the rate of recovery of MARCKS mRNA and protein levels was
      shown to be dependent on the supply of serum-derived growth factors in the
      medium. Addition of hydroxyurea to arrest the cells in S phase or at the G1/S
      boundary rather than G0 completely prevented the recovery of MARCKS protein. The
      down-regulation of MARCKS following plating and its serum-dependent recovery was
      also demonstrated in tertiary cultures of mouse embryo fibroblasts. The results
      suggest that MARCKS may play a role in the regulation of entry and exit of cells
      from G0.

PMID- 8464912
TI  - Epigenetic mechanisms of drug resistance: drug-induced DNA hypermethylation and
      drug resistance.
AB  - In a model system employing Chinese hamster V-79 cells, the DNA synthesis
      inhibitor 3'-azido-3'-deoxythymidine (BW A509U, AZT) was shown to induce genome
      wide DNA hypermethylation, low-frequency silencing of thymidine kinase (TK; EC
      2.7.1.21) gene expression, and resistance to AZT. Twenty-four hours of exposure
      of V-79 cells to 150 microM AZT led to > 2-fold enhancement of genomic 5
      methylcytosine levels and produced TK- epimutants at a rate approximately 43-fold
      above background. Such AZT-induced TK- epimutants were shown to be severely
      reduced in their capacity to activate AZT to its proximate antiviral form, AZT 5'
      monophosphate, as compared with the TK+ parental cell line from which they were
      derived. TK- clones isolated under these conditions were shown to be 9- to 24
      fold more resistant to the cytotoxic effects of AZT than the parental TK+ cell
      line and showed collateral resistance to 5-fluoro-2'-deoxyuridine. Three of four
      TK- epimutants could be reactivated at very high frequency (8-73%) to the TK+ AZT
      sensitive phenotype by 24 hr of exposure to the demethylating agent 5
      azadeoxycytidine (5-azadC), implying that drug-induced DNA hypermethylation,
      rather than classical mutation, was involved in the original gene-silencing event
      in these three clones. These 5-azadC-induced TK+ revertants concomitantly
      regained the ability to metabolize AZT to its 5'-monophosphate. RNA slot blot
      analyses indicated that the four AZT-induced TK- clones expressed 8.9%, 15.6%,
      17.8%, and 11.1% of the parental level of TK mRNA. The three clones that were
      reactivatable by 5-azadC showed reexpression of TK mRNA to levels 84.4%, 51.1%,
      and 80.0% that of the TK+ parental cell line. These experiments show that one
      potential mechanism of drug resistance involves drug-induced DNA hypermethylation
      and resulting transcriptional inactivation of cellular genes whose products are
      required for drug activation.

PMID- 8464913
TI  - Molecular characterization of an operon required for pertussis toxin secretion.
AB  - Mutants of Bordetella pertussis which are defective in secretion of pertussis
      toxin were isolated and characterized. The region of the B. pertussis chromosome
      identified by mutagenesis as playing a role in transport of pertussis toxin was
      sequenced. Analysis of this region revealed eight open reading frames, seven of
      which predict a protein exhibiting homology with one of the VirB proteins of
      Agrobacterium tumefaciens, which are involved in the transport of the T-DNA
      molecule across bacterial and plant membranes. Thus a set of accessory proteins
      are most likely involved in the secretion of pertussis toxin, and these proteins
      appear to be members of a family of proteins involved in the secretion of
      macromolecules from bacteria.

PMID- 8464914
TI  - Electrophysiological tests of neural models: evidence for nonlinear binocular
      interactions in humans.
AB  - Evoked cortical potentials were used to test neural models of binocular
      interactions in humans. The critical feature that distinguished between basic
      models was whether the two monocular signals combined linearly or nonlinearly.
      Stimuli were presented separately and simultaneously to two eyes with the
      relative temporal phase parametrically varied. Fourier analysis was applied to
      the recorded electroencephalogram to measure the frequency response of the visual
      cortex to this stimulation. Comparisons of the models' predictions with the
      experimental results indicate that the greatest contribution to the cortical
      response originates in a neural pathway that contains nonlinear binocular
      combination, and a smaller contribution originates in a pathway with linear
      binocular combination. Current models, based on psychophysical studies of humans
      and on single-cell neurophysiological investigations of cats, are inadequate to
      explain these results. A model of binocular interaction is proposed that does
      account for the present findings and is also supported by neurophysiological
      studies on monkeys. This model, which contains both nonlinear and linear
      binocular interactions, has profound implications for perceptual processing.

PMID- 8464915
TI  - Identification of sequence elements in mouse calbindin-D28k gene that confer 1,25
      dihydroxyvitamin D3- and butyrate-inducible responses.
AB  - We have examined the 5' flanking region of the mouse calbindin-D28k gene and
      identified a 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]-responsive element by
      deletion mutant analysis of the native promoter as well as by studies with a
      heterologous thymidine kinase (TK) promoter. The segment between residues -200
      and -169 was found to confer a dose-dependent 1,25-(OH)2D3 responsiveness through
      the TK promoter in Ros 17/2.8 cells as well as in CV-1 cells cotransfected with
      pAV-hVDR (human vitamin D receptor expression vector). This region contains
      sequences homologous to the rat osteocalcin vitamin D response element (VDRE).
      Incubation of this element with nuclear extracts from 1,25-(OH)2D3-treated Ros
      17/2.8 cells or from 1,25-(OH)2D3-treated COS cells that had been transfected
      with pAV-hVDR resulted in a specific protein-DNA interaction. In addition to 1,25
      (OH)2D3, sodium butyrate, a differentiating agent, has also been found to
      modulate expression of calbindin-D28k. Deletion analysis of the mouse calbindin
      D28k promoter as well as studies with a heterologous TK promoter resulted in
      identification of a butyrate-responsive element between -180 and -150 that was
      found to bind specifically to nuclear factors from butyrate-treated Ros 17/2.8
      cells. This butyrate-responsive element may represent a genetic element acted
      upon by enhancer binding proteins. In summary, the 5' flanking region of the
      mouse calbindin-D28k gene contains responsive elements that interact with nuclear
      factors and may mediate, at least in part, the enhanced expression of this gene
      by 1,25-(OH)2D3 and butyrate.

PMID- 8464916
TI  - Observing the helical geometry of double-stranded DNA in solution by fluorescence
      resonance energy transfer.
AB  - The efficiency of fluorescence resonance energy transfer (FRET) between
      fluorescein and rhodamine covalently attached to both 5' termini of a series of
      double-stranded DNA species (ranging from 8 to 20 bp) was measured. FRET
      efficiency varied with a dependence compatible with dye-to-dye distances (R)
      calculated on the basis of double-stranded B-DNA structure; the helical geometry
      of double-stranded DNA in solution is clearly evident. The experimental data were
      consistent with a 1/[1 + (R/R0)6] dependence of FRET efficiency characteristic
      for the Forster dipole-dipole mechanism. The thermal dissociation of the strands
      of the duplex DNA species can be followed by using FRET, and from these data we
      have been able to obtain enthalpies of duplex formation in good agreement with
      earlier measurements using alternative techniques. FRET measurements at very
      different salt concentrations can be accurately compared. We conclude that FRET
      is a reliable and valuable method for studying structure and conformational
      transitions in nucleic acids.

PMID- 8464917
TI  - Markedly prolonged incubation period of hepatitis B in a chimpanzee passively
      immunized with a human monoclonal antibody to the a determinant of hepatitis B
      surface antigen.
AB  - The protective efficacy of a human monoclonal antibody directed against the a
      determinant of hepatitis B virus (HBV) surface antigen was studied in a
      chimpanzee. A single high dose of 5 mg/kg (body weight) of monoclonal antibody
      SDZ OST 577 was intravenously administered to a chimpanzee, followed by
      intravenous challenge with 10(3.5) chimpanzee infectious doses of a wild-type
      HBV, the MS-2 strain (ayw subtype). The passively acquired antibody to HBV
      surface antigen could be detected for 40 weeks. Serum HBV DNA tested by a
      "nested" polymerase chain reaction assay was negative through the 36th week after
      virus challenge but became positive by the 38th week. The chimpanzee subsequently
      developed acute hepatitis B approximately 1 year after challenge. The nucleotide
      sequence of the a determinant of the surface gene of the replicated virus was
      identical with that of the inoculated wild-type virus. Thus, a human monoclonal
      antibody directed against the a determinant of HBV surface antigen delayed but
      did not prevent experimental infection of HBV and hepatitis in the chimpanzee.
      Our results indicate an incomplete ability of this antibody to protect against
      HBV infection in vivo after a single infusion.

PMID- 8464918
TI  - In vitro assembly of multiprotein complexes containing alpha, beta, and gamma
      tubulin, heat shock protein HSP70, and elongation factor 1 alpha.
AB  - We have isolated two sets of multiprotein complexes from supernatants from high
      speed centrifugation of nocodazole-arrested CHO cells. One set, assembled in
      vitro after a 37 degrees C incubation in the presence of ATP or GTP, is composed
      of equivalent amounts of alpha- and beta-tubulin and a 50-kDa protein,
      provisionally identified as elongation factor 1 alpha. These complexes, which are
      heterogeneous in size when analyzed by sucrose gradient ultracentrifugation, also
      contain the cognate form of heat shock protein HSP70 and gamma-tubulin, a tubulin
      isoform of low abundance, along with other proteins known to be involved in the
      regulation of mitosis. Similar but distinct complexes assemble in vitro if the
      same extracts are incubated at 37 degrees C without added nucleotides;
      multiprotein complexes generated under these conditions lack HSP70 but contain
      instead a 43-kDa protein identified as an actin isoform. Both sets of assembled
      complexes exhibit a globular substructure when analyzed by electron microscopy,
      and their size distribution suggests that they assemble by the step-wise addition
      of smaller precursors. The properties of these multiprotein complexes and their
      presence in cells arrested in a stage between prophase and metaphase suggest that
      they may be precursors to mitotic centrosomes and are possibly involved in
      mitotic spindle nucleation.

PMID- 8464919
TI  - Carbohydrate binding activities of Bradyrhizobium japonicum: unipolar
      localization of the lectin BJ38 on the bacterial cell surface.
AB  - A polyclonal antiserum generated against the Bradyrhizobium japonicum lectin BJ38
      was characterized to be specifically directed against the protein. Treatment of
      B. japonicum cells with this antiserum and subsequent visualization with
      transmission electron microscopy and both conventional and confocal fluorescence
      microscopy revealed BJ38 at only one pole of the bacterium. BJ38 appeared to be
      organized in a tuft-like mass, separated from the bacterial outer membrane. BJ38
      localization was coincident with the attachment site for (i) homotypic
      agglutination to other B. japonicum cells, (ii) adhesion to the cultured soybean
      cell line SB-1, and (iii) adsorption to Sepharose beads covalently derivatized
      with lactose. In contrast, the plant lectin soybean agglutinin labeled the
      bacteria at the pole distant from the bacterial attachment site. These results
      indicate that the topological distribution of BJ38 is consistent with a suggested
      role for this bacterial lectin in the polar binding of B. japonicum to other
      cells and surfaces.

PMID- 8464920
TI  - Granulocytes, macrophages, and dendritic cells arise from a common major
      histocompatibility complex class II-negative progenitor in mouse bone marrow.
AB  - The developmental origin of dendritic cells, a specialized system of major
      histocompatibility complex (MHC) class II-rich antigen-presenting cells for T
      cell immunity and tolerance, is not well characterized. Granulocyte-macrophage
      colony-stimulating factor (GM-CSF) is known to stimulate dendritic cells,
      including growth and development from MHC class II-negative precursors in
      suspension cultures of mouse bone marrow. Here we studied colony formation in
      semi-solid methylcellulose cultures, a classical bioassay system in which GM-CSF
      induces the formation of mixed granulocyte-macrophage colonies. When colonies
      were induced from MHC class II-negative precursors, a small subset (1-2%) of
      typical dendritic cells developed alongside macrophages and granulocytes. The
      dendritic cells were distinguished by their cytologic features, high levels of
      MHC class II products, and distinct intracellular granule antigens. By using
      differential adherence to plastic, enriched populations of the various myeloid
      cell types were isolated from colonies. Only the dendritic cells stimulated a
      primary T-cell immune response, the mixed leukocyte reaction, and the potency was
      comparable to typical dendritic cells isolated from spleen. Macrophages from
      mixed or pure colonies were inactive as stimulator cells. Therefore, three
      distinct pathways of myeloid development--granulocytes, macrophages, and
      dendritic cells--can develop from a common MHC class II-negative progenitor under
      the aegis of GM-CSF.

PMID- 8464921
TI  - An 83-nucleotide promoter of the acetylcholine receptor epsilon-subunit gene
      confers preferential synaptic expression in mouse muscle.
AB  - The expression of the acetylcholine receptor epsilon-subunit gene is restricted
      to the endplate of adult muscle fibers. We have started to study the regulatory
      elements of the epsilon-subunit gene promoter that are important for its synaptic
      expression. We used, for this purpose, a rapid method of in vivo expression after
      DNA injection into the muscle tissue [Wolff, J. A., Malone, R. W., Williams, P.,
      Chong, W., Acsadi, G., Jani, A. & Felgner, P. L. (1990) Science 247, 1465-1468].
      Our results show that a construction containing 83 nucleotides upstream from the
      transcription start site is sufficient to obtain preferential endplate
      expression. Moreover, mutation of a MyoD binding site located around position-70
      does not alter this synaptic expression. We also studied the expression of this
      promoter in vitro in muscle primary cultures and showed the presence of a
      positive element between positions -122 and -83. Comparison of in vivo and in
      vitro results reveals that the elements important for in vivo localization at the
      synapse and in vitro expression in cultured muscle cells may differ.

PMID- 8464922
TI  - Presumptive Renshaw cells contain decreased calbindin during recovery from
      sciatic nerve lesions.
AB  - A subpopulation of calbindin-immunoreactive neurons in lamina VII of the spinal
      cord has been identified by its location as Renshaw cells, the anatomical
      substrate for recurrent inhibition. The expression of calbindin (28 kDa) in these
      calbindin-containing rat ventral horn interneurons was studied with
      immunocytochemistry after sciatic nerve injuries. One week after axotomy
      calbindin immunoreactivity was strongly reduced on the lesioned side between
      levels L4 and L6, while calbindin-containing neurons and fibers were still
      numerous contralaterally and cranially to the lesioned levels. With the
      progression of regeneration, calbindin-immunoreactive neurons reappeared,
      reaching a normal distribution 6-8 weeks after the crush. Similar changes could
      be mimicked by the intramuscular administration of botulinum toxin. These results
      suggest that calbindin expression in putative Renshaw cells of the spinal cord
      might be functionally responsive and that maintenance of calbindin expression may
      depend on the integrity of motoneurons and neuromuscular transmission.

PMID- 8464923
TI  - Chromosomal localization of glutamate receptor genes: relationship to familial
      amyotrophic lateral sclerosis and other neurological disorders of mice and
      humans.
AB  - Receptors for the major excitatory neurotransmitter glutamate may play key roles
      in neurodegeneration. The mouse Glur-5 gene maps to chromosome 16 between App and
      Sod-1. The homologous human GLUR5 gene maps to the corresponding region of human
      chromosome 21, which contains the locus for familial amyotrophic lateral
      sclerosis. This location, and other features, render GLUR5 a possible candidate
      gene for familial amyotrophic lateral sclerosis. In addition, dosage imbalance of
      GLUR5 may have a role in the trisomy 21 (Down syndrome). Further characterization
      of the murine glutamate receptor family includes mapping of Glur-1 to the same
      region as neurological mutants spasmodic, shaker-2, tipsy, and vibrator on
      chromosome 11; Glur-2 near spastic on chromosome 3; Glur-6 near waltzer and
      Jackson circler on chromosome 10; and Glur-7 near clasper on chromosome 4.

PMID- 8464924
TI  - Molecular cloning and expression of cDNA for mammalian translation initiation
      factor 5.
AB  - Eukaryotic translation initiation factor 5 (eIF-5) catalyzes the hydrolysis of
      GTP bound to the 40S ribosomal initiation complex (40S.AUG.Met-tRNAf-eIF-2.GTP)
      with the subsequent joining of a 60S ribosomal subunit resulting in the formation
      of a functional 80S initiation complex. A rat cDNA that encodes eIF-5 has been
      isolated and expressed in Escherichia coli to yield a catalytically active eIF-5
      protein. The 3.55-kb cDNA encodes a protein of 429 amino acids (calculated M(r)
      48,926) with properties that are similar to eIF-5 isolated from rabbit
      reticulocyte lysates. The deduced amino acid sequence of eIF-5 contains sequence
      motifs characteristic of proteins of the GTPase superfamily.

PMID- 8464925
TI  - Two distinct gene subfamilies within the family of cysteine protease genes.
AB  - A cDNA clone for a physiologically regulated Tetrahymena cysteine protease gene
      was sequenced. The nucleotide sequence predicts that the clone encodes a 336
      amino acid protein composed of a 19-residue N-terminal signal sequence followed
      by a 107-residue propeptide and a 210-residue mature protein. Comparison of the
      deduced amino acid sequence of the protein with those of other cysteine proteases
      revealed a highly conserved interspersed amino acid motif in the propeptide
      region of the protein, the ERFNIN motif. The motif was present in all of the
      cysteine proteases in the data base with the exception of the cathepsin B-like
      proteins, which have shorter propeptides. Differences in the propeptides and in
      conserved amino acids of the mature proteins suggest that the ERFNIN proteases
      and the cathepsin B-like proteases constitute two distinct subfamilies within the
      cysteine proteases.

PMID- 8464926
TI  - Association of GAD-65, but not of GAD-67, with the Golgi complex of transfected
      Chinese hamster ovary cells mediated by the N-terminal region.
AB  - Glutamic acid decarboxylase (GAD) is the enzyme responsible for synthesis of the
      neurotransmitter gamma-aminobutyric acid in neurons and pancreatic beta cells. It
      is represented by two isoforms, GAD-65 and GAD-67, which are the products of two
      different genes and differ substantially only at their N-terminal regions. GAD-65
      is a dominant autoantigen in stiff-man syndrome and insulin-dependent diabetes
      mellitus. In neurons and beta cells, GAD is concentrated around synaptic vesicles
      and synaptic-like microvesicles, respectively, as well as in the area of the
      Golgi complex. The mechanisms responsible for specific targeting of GAD to these
      organelles are not yet understood. The elucidation of the mechanism of
      subcellular targeting of GAD may be relevant to understanding its role as an
      autoantigen. In this study, the cloned genes for GAD-65 and GAD-67 were expressed
      separately in Chinese hamster ovary (CHO) cells and COS cells. While GAD-67 had a
      diffuse cytoplasmic localization, GAD-65 had a punctate distribution, with most
      of the immunoreactivity being concentrated in the area of the Golgi complex. A
      chimeric protein in which the 88 N-terminal amino acids of GAD-67 were replaced
      by the 83 N-terminal amino acids of GAD-65 was targeted to the Golgi complex,
      indicating that the N-terminal region of GAD-65 contains a targeting signal
      sufficient for directing the remaining portion of the molecule, highly similar in
      GAD-65 and GAD-67, to the Golgi complex-associated structures.

PMID- 8464927
TI  - Dual control of heat shock response: involvement of a constitutive heat shock
      element-binding factor.
AB  - Heat shock factor (HSF) has been implicated as the key regulatory protein in the
      heat shock response. Our studies on the response of rodent cells to heat shock or
      sodium arsenite indicate that a high level of HSF-DNA-binding activity, by
      itself, is not sufficient for the induction of hsp70 mRNA synthesis; furthermore,
      a high level of HSF binding is also not necessary for this induction. Analysis of
      the binding of protein factors to the heat shock element (HSE) in extracts of
      stressed rodent cells indicates that the regulation of heat shock response
      involves the heat-inducible HSF and a constitutive HSE-binding factor. Our
      results also suggest that overexpression of human hsp70 may decrease the level of
      heat-induced HSF-HSE-binding activity in rat cells.

PMID- 8464928
TI  - Soluble antigen profoundly reduces memory B-cell numbers even when given after
      challenge immunization.
AB  - The splenic B-cell repertoire of unimmunized C57BL/6 mice can be examined for
      anti-(4-hydroxy-3-nitrophenyl)acetyl (NP) B cells of relatively high affinity by
      using a dual strategy. First, limiting numbers of splenocytes are polyclonally
      activated by Escherichia coli lipopolysaccharide and a mixture of interleukins 2,
      4, and 5 in the presence of 3T3 filler cells, thus ensuring that many B-cell
      clones switch to IgG1 antibody production. Second, an enzyme-linked immunosorbent
      assay is geared to register only higher-affinity antibody by (i) detecting only
      bivalent IgG1 antibody and ignoring IgM and (ii) using a lowly substituted NP
      conjugated protein as the capture layer. Naive spleens contain very few higher
      affinity anti-NP B cells thus defined, but thymus (T)-dependent immunization
      causes the appearance of approximately 10(5) per spleen within 2 weeks. The
      development of these clonable anti-NP antibody-forming cell precursors can be
      virtually eliminated by a single injection of 1 mg of soluble, freshly
      deaggregated NP2-human serum albumin (HSA). This toleragen works not only if
      injected prior to challenge immunization, but even if given up to 6 days later.
      Soluble HSA works partially but not nearly as well as NP2-HSA, suggesting the
      possibility that the toleragen must act on T and B cells. NP conjugated to
      irrelevant carriers achieved partial tolerance in only one of four experiments.
      The studies demonstrate the need for continuing T-cell help throughout the
      process of memory B-cell generation. They also show that those recently activated
      T cells involved in this process can be silenced in vivo by soluble toleragen.

PMID- 8464929
TI  - Noninvasive somatosensory homunculus mapping in humans by using a large-array
      biomagnetometer.
AB  - To validate the feasibility of precise noninvasive functional mapping in humans,
      a large-array biomagnetometer was used to map the somatosensory cortical
      locations corresponding to numerous distinct tactile sites on the fingers, hand,
      arm, and face in different subjects. Source localizations were calculated by
      using a single equivalent current dipole (ECD) model. Dipole localizations were
      transposed upon the corresponding subject's magnetic resonance image (MRI) to
      resolve the anatomic locus of the individual dipoles within a given subject.
      Biomagnetic measurements demonstrated that (i) there were distinct separations
      between the ECD locations representing discrete sites on the face and hand; (ii)
      the ECD localizations from facial sites clustered in a region inferior to ECD
      localizations from hand and digit sites; and (iii) there was clear spatial
      resolution of ECD locations representing closely spaced tactile sites on the hand
      and face. The ability of magnetoencephalography (MEG) to provide high-resolution
      spatial maps of the somatosensory system noninvasively in humans should make MEG
      a useful tool to define the normal or pathological organization of the human
      somatosensory system and should provide an approach to the rapid detection of
      neuroplasticity.

PMID- 8464930
TI  - Redox-activated expression of the cytosolic copper/zinc superoxide dismutase gene
      in Nicotiana.
AB  - Superoxide dismutases (SODs; superoxide: superoxide oxidoreductase, EC 1.15.1.1)
      play a key role in protection against oxygen radicals, and SOD gene expression is
      highly induced during environmental stress. To determine the conditions of SOD
      induction, the promoter of the cytosolic copper/zinc SOD (Cu/ZnSODcyt) gene was
      isolated in Nicotiana plumbaginifolia and fused to the beta-glucuronidase
      reporter gene. Oxidative stress is likely to alter the cellular redox in favor of
      the oxidized status. Surprisingly, the expression of the Cu/ZnSODcyt gene is
      induced by sulfhydryl antioxidants such as reduced glutathione, cysteine, and
      dithiothreitol, whereas the oxidized forms of glutathione and cysteine have no
      effect. It is therefore possible that reduced glutathione directly acts as an
      antioxidant and simultaneously activates the Cu/ZnSODcyt gene during oxidative
      stress.

PMID- 8464932
TI  - Overview of substance abuse.
AB  - Psychoactive substances have been used by humans from the earliest recorded
      times, and evidence shows that from the beginning some people have used drugs
      excessively, thus developing problems. From the 1960s to the 1980s, there has
      been a dramatic upswing in the use of alcohol and illicit substances, but some
      evidence demonstrates that this trend is beginning to reverse. Current substance
      abuse is estimated to cost US society about $152 billion and cause over 75,000
      deaths annually. Research and treatment efforts have increased significantly over
      the past two decades. Although the exact cause of substance abuse disorders is
      unknown, evidence indicates that it is a complex interaction between biologic
      predispositions, and psychologic and social factors. The majority of research
      seems to indicate that at least in a subtype of patients with more severe abuse,
      genetic factors appear to be the single most important influence. Considerable
      research is underway to further clarify these factors, and it is reasonable to
      expect that we will soon have a much clearer understanding of the cause of these
      disorders. In turn, this understanding should lead to a better understanding of
      the optimal treatment for the millions of patients and families afflicted with
      substance abuse disorders.

PMID- 8464933
TI  - The twelve steps. A pathway to recovery.
AB  - Alcoholics Anonymous and its 12 Steps and 12 Traditions have arisen out of the
      experiences of recovery of alcoholics. It offers an important treatment option to
      the clinician who sees destructive compulsive disease in his or her practice.
      Despite their nonscientific, nonrational approach, AA and other 12-step programs
      have evolved to offer a set of attitudes, beliefs, and behaviors that can
      facilitate change in this group of patients. AA is the forerunner of the others
      and offers as its most important characteristics an unconditional acceptance of
      the patient's alcoholism, an unshaken belief in the concept of alcoholism as a
      disease, and support to foster a healthy dependence in the alcoholic. The
      recovery of an alcoholic involves a fairly long initial stage in which denial
      about alcoholism is broken down with slow and halting identity change. This
      characteristic underscores the primitive level of ego development in the
      alcoholic and the need for much continuing support, nurturance, and tolerance.
      Clinicians can be an important part of this support network by working with AA
      and other 12-step groups to help break down denial in the patient and direct
      individuals to the appropriate program. By allying themselves with this method
      and groups, clinicians will be making powerful statements about their beliefs and
      attitudes toward these destructive illnesses.

PMID- 8464931
TI  - Increased manganese superoxide dismutase expression suppresses the malignant
      phenotype of human melanoma cells.
AB  - Introduction of a normal human chromosome 6 into human melanoma cell lines
      results in suppression of tumorigenicity. This suggests that a gene(s) on
      chromosome 6 controls the malignant phenotype of human melanoma. Because
      antioxidants can suppress the tumor-promotion phase of carcinogenesis, and
      because the antioxidant enzyme manganese superoxide dismutase (MnSOD) has been
      localized to a region of chromosome 6 frequently lost in melanomas, we have
      examined the effect of transfecting sense and antisense human MnSOD cDNAs into
      melanoma cell lines. Cell lines expressing abundant (+)-sense MnSOD-5 cDNAs
      significantly altered their phenotype in culture and lost their ability to form
      colonies in soft agar and tumors in nude mice. In contrast, the introduction of
      antisense MnSOD or +psv2neo had no effect on melanoma tumorigenicity. These
      findings indicate that stable transfection of MnSOD cDNA into melanoma cell lines
      exerts a biological effect that mimics that observed after introduction of an
      entire human chromosome 6.

PMID- 8464934
TI  - Alcohol abuse. A family disease.
AB  - Alcohol problems have a serious impact on families. Physicians who identify
      alcohol-abusing persons in their practices will note that these people belong to
      families who seem "stuck" in a confusing family situation with no ready solution.
      Research and clinical observations have demonstrated that families adopt roles,
      rules, and interactional patterns around the alcohol abuse problems that can be
      destructive to individual development. These consequences of alcohol abuse are
      particularly troubling when we consider that family dysfunction, like the disease
      itself, is transmitted from generation to generation. Physicians can be most
      helpful to these families when they understand how to identify the presence of
      alcohol use problems, evaluate the impact on both the alcohol abuser and the
      family members, and facilitate the necessary treatment for these patients.

PMID- 8464935
TI  - Substance abuse among women.
AB  - Physicians' attitudes are important in dealing with issues of substance abuse in
      women. The primary care physician is in a unique position to take advantage of
      the doctor-patient relationship and initiate diagnosis and treatment of substance
      abuse. When the primary care physician is supportive of the patient, both begin
      from a position of strength. Patients are no more to blame for contracting the
      disease state than for getting other medical conditions for which they are at
      risk. Treatment of substance abuse in women must acknowledge that significant
      differences exist between men and women patients. Most treatment programs have
      been based on research studies in men. Current efforts are under way to update
      the information necessary to deal effectively with the problem of substance abuse
      among women.

PMID- 8464936
TI  - Adolescent substance abuse. Recognition and early intervention.
AB  - Adolescent substance abuse is a common problem, with 90% of high school seniors
      reporting alcohol use and nearly half reporting some illicit drug use. Substance
      abuse interferes with the developmental tasks of adolescence: establishing an
      adult identity, achieving independence from parents and family, and learning to
      form intimate relationships with others. Although not all adolescent substance
      abuse leads to chemical dependency, even initial experimentation can have
      disastrous or fatal consequences. The early signs and symptoms of substance abuse
      are subtle, frequently presenting as behavioral changes, and less often as
      physical or laboratory findings. Early stages of substance abuse may be treated
      by the primary care physician in outpatient treatment settings. More advanced
      stages usually require inpatient treatment and should be referred to specialists
      in adolescent substance abuse treatment. Family involvement is a critical part of
      the treatment process. In addition to a key role in the early diagnosis,
      intervention, and referral of substance abuse problems, the primary care
      physician is an important source of support, reinforcement, and continuity in the
      aftercare program once the adolescent has completed initial substance abuse
      treatment.

PMID- 8464937
TI  - Recognition and treatment of substance abuse in the elderly.
AB  - Elderly people do use substances to alter mood and states of awareness. Detection
      is difficult because presenting symptoms are often those that are commonly
      associated with aging itself. All patients who present with symptoms of self
      neglect, falls, cognitive and affective impairment, and social withdrawal should
      be screened for substance abuse. The CAGE and MAST, although not perfect, can be
      used. When abuse is found, the elderly should be treated as aggressively as their
      younger counterparts, with slow, careful detoxification and the use of some form
      of group therapy, such as AA.

PMID- 8464938
TI  - Substance abuse among minority populations.
AB  - Substance abuse problems and their solutions not only vary considerably depending
      on the ethnicity of the patient, but also are influenced by factors such as age,
      gender, education, and socioeconomic status. Familiarity with the epidemiology of
      substance abuse problems of different sociocultural groups can help the clinician
      better understand and anticipate the needs of the patient population she or he is
      serving. The five-part sociocultural assessment model provides a framework to
      help the practitioner assess the sociocultural needs of an individual patient.
      Application of this model can help reveal the individual patient's beliefs,
      motivations, and sociocultural strengths and liabilities with regard to substance
      abuse. With this information, the clinician can then better address special
      treatment needs.

PMID- 8464939
TI  - Dual diagnosis.
AB  - Although the problem of patients with dual diagnoses is not new, it has only been
      in the last few years that their unique and complex problems have begun to be
      addressed. This recognition coincides with society's concern regarding the
      magnitude of substance abuse problems in general. Currently, treatment consists
      of integrating concepts from substance abuse and mental health fields. This
      integration may improve the therapeutic outcome for these patients. As more
      experience is gained in this specialty, it is hoped that new treatment concepts
      will evolve that will more powerfully address the interactive aspect of substance
      abuse and psychiatric disorders.

PMID- 8464940
TI  - The pharmacology of mood-altering drugs of abuse.
AB  - The majority of mood-altering drugs that have significant abuse potential possess
      several properties that contribute to drug dependence, including behavioral
      reinforcing and rewarding actions, tolerance to behavioral effects, and
      development of physical dependence. Although various drug classes may differ in
      the relative importance of these properties, it is generally recognized that they
      form the basis of abuse and misuse of many drugs. These phenomena are not the
      result of novel or unique drug actions but represent biochemical or neurochemical
      modulation of normal functional mechanisms in the central nervous system.

PMID- 8464941
TI  - Substance abuse during pregnancy.
AB  - Use and abuse of both licit and illicit drugs is common. Although certain
      variables can appropriately serve as markers for increased risk, the possibility
      of substance abuse should be considered in all pregnant women. Alcohol is the
      leading identified cause of teratogenesis by drugs or environmental agents; most
      other drugs of abuse do not increase the risk of congenital malformations on a
      large scale. Substance abuse can produce significant degrees of toxicity in both
      pregnant women and their offspring. Screening and counseling of pregnant women
      concerning past and present use of tobacco, alcohol, and illicit drugs should be
      routine. Prenatal care must include increased surveillance for drug-related
      complications; coordinated, comprehensive, family-oriented drug treatment; and
      social services. Rehabilitation and support efforts should continue after
      delivery and address issues that lead to and maintain patterns of abuse. The drug
      exposed neonate must be anticipated and evaluated with a knowledge of the
      maternal drug abuse history and specific drug risks, including neonatal
      abstinence syndrome. Continuing care of the child should address the increased
      risk of developmental and behavioral problems from both prenatal exposures and
      continuing socioenvironmental barriers.

PMID- 8464942
TI  - Impaired physicians.
AB  - The prevalence of chemical dependency among physicians in the United States is
      probably the same as for the general population, about 8% to 12%. Organized
      medicine has responded to this problem by establishing programs to help these
      impaired physicians. Chemically impaired physicians can be treated and followed
      by structured programs with favorable results. To prevent the tragic outcomes of
      untreated physician impairment due to chemical dependency, nonimpaired physicians
      must learn about this problem and take the appropriate actions. Impaired
      physicians need not fear treatment, for it can help them return to a productive
      career. To further lessen the tragic effects of substance abuse among physicians,
      proactive strategies of prevention should be adopted by medical schools,
      residency programs, hospital staffs, and similar physician organizations.

PMID- 8464943
TI  - Illicit drugs of abuse.
AB  - Primary care physicians should be aware of the popular street drugs being abused
      in their practice areas. A basic understanding of the drugs and their use will
      make the physician more credible in the eyes of the patient. Patients may present
      a variety of symptoms associated with their chemical abuse. Specific presenting
      complaints, physical findings, and laboratory tests will help establish the
      diagnosis of substance abuse. After the diagnosis is established, a drug
      treatment program can bring about a seemingly miraculous recovery from the
      disease of chemical dependency, to the lasting benefit of the patient and the
      patient's family.

PMID- 8464944
TI  - Prescription drug abuse.
AB  - Misuse and abuse of prescription medication can be a difficult clinical area for
      physicians. Prior to prescribing any mood-altering medication, the physician
      should screen for patients at risk for abuse by asking about an individual or
      family history of alcohol or other drug abuse. When prescribing a psychoactive
      medication, the clinician should be sure that there is a clear clinical
      indication and should identify a therapeutic end-point and time limit.
      Nonpharmacologic interventions should be emphasized when appropriate. When misuse
      rather than abuse is suspected, the intervention may be one of education and
      simplification or clarification of the therapeutic contract. Physicians should
      recognize apparent drug-seeking behaviors and feel comfortable questioning for
      possible alcohol or other drug-related problems so that drug abuse can be
      identified as an additional problem requiring attention. Physicians should be
      comfortable with assertively denying drugs to drug-seeking patients when
      appropriate. Although sometimes difficult, to do otherwise would be to facilitate
      the continuation of a potentially serious problem. The potential frustration and
      aggravation of dealing with prescription drug abuse can be minimized by
      thoughtful attention to prevention, the development of a rational style of
      prescribing, and the appropriate use of intervention.

PMID- 8464945
TI  - Educational strategies for clinicians.
AB  - Largely because of a lack of training, many primary care physicians are unaware
      of how they can prevent, detect, or manage substance abuse within their clinical
      practice. The educational process used to develop a teaching unit can be
      simplified by initially asking a few directed questions. The answers to these
      questions determine what needs to be taught while facilitating the subsequent
      steps of determining learning goals and objectives and selecting appropriate
      teaching materials and strategies. Evaluating the teaching unit on at least a
      cursory level provides useful information for future planning. A variety of
      curriculum manuals and clinical text parts can be readily incorporated into
      teaching units. These same sources can alternatively be adapted to an
      individual's own self-directed course of study. Incorporation of experimental
      educational strategies is especially useful in substance abuse instruction.
      Including recovering individuals, attendance at self-help group meetings, and
      role play exercises are all useful experimental strategies for engaging the
      learner. Tapping into organizational resources and networking with others
      involved in similar activities enhances one's potential through the sharing of
      information and through the synergism created by networking with others.

PMID- 8464946
TI  - Office evaluation and treatment of the dependent smoker.
AB  - Nicotine addiction is the most prevalent of all substance dependence, resulting
      in profound medical, social, and psychologic costs. Evidence supporting the
      addictive nature of nicotine is compelling. Recognition of this addiction has
      opened treatment options not currently available, including pharmacologic
      options. Physicians can contribute to cessation success even with minimal
      interventions. For those interested in stronger interventions, careful assessment
      of the smoker is essential. This assessment should identify the degree of
      nicotine dependence, the presence of negative affect related to cessation, and
      the pervasiveness of meaning of tobacco in the patient's life. Treatment options
      include white knuckle or will power quitting, guided self-treatment, referral,
      and office cessation with or without pharmacologic support. A four-visit protocol
      that includes (1) recruitment, (2) assessment, (3) treatment, and (4) relapse
      prevention is described.

PMID- 8464947
TI  - Early recognition of chemical dependence.
AB  - Chemical dependence is a leading cause of morbidity and death in the United
      States. At least 20% of patients seen by primary care physicians in both the
      outpatient and inpatient setting are chemically dependent. Up to 90% of these
      patients go undiagnosed by their primary physicians. Chemical dependence is
      defined as a chronic, progressive illness characterized by the repeated and
      persistent use of alcohol or drugs despite negative health, family, work,
      financial, or legal consequences. Primary care physicians are in an ideal
      position to detect chemical dependence at its earliest stages, when irreversible
      medical consequences and death are most likely preventable. Alcohol is the most
      common drug of abuse. Improving the rate of recognition of chemical dependence
      depends on being familiar with the constellation of physical, mental, and social
      indicators. Early medical manifestations of alcoholism common in the primary care
      setting include: gastric complaints, elevated blood pressure, palpitations,
      traumatic injuries, headaches, impotence, and gout. Early psychosocial
      manifestations common in both alcohol and drug dependence include anxiety,
      depression, insomnia, persistent relationship conflicts, work or school problems,
      and financial or legal problems. Particularly useful laboratory indicators of
      alcoholism include elevated levels of GGT and MCV, both displaying high
      specificity, with the GGT level being the most sensitive. Similarly specific
      laboratory tests for drug dependence are not available. Any patient presenting
      with any of the above medical, psychosocial, or laboratory manifestations should
      be screened for chemical dependence. The CAGE questionnaire for alcoholism, a
      four-question test, is particularly well suited to the primary care setting,
      where it can be administered in fewer than 60 seconds. The CAGE has demonstrated
      high sensitivity (in the 80% range) and specificity (approximately 85%) for
      alcoholism. Comparably convenient instruments do not yet exist for drug
      dependence, although a 28-item instrument, the DAST (Drug Abuse Screening Test),
      has demonstrated high sensitivity and specificity for drug abuse.

PMID- 8464948
TI  - Dealing with substance misuse, abuse, and dependency.
AB  - Using this model, clinicians can enhance skills for screening, assessing, and
      aiding at-risk and problem drinkers. The six-step model incorporates the
      transtheoretic model of behavior change and uses motivational interviewing
      strategies and the concept of brief, early interventions. Primary care physicians
      can apply this model for patients in their offices and in hospital settings where
      they provide continuity of care. Furthermore, physicians can also use this model
      to intervene successfully at both the secondary and tertiary levels of
      prevention. In essence, this model uses a variety of strategies to aid at-risk
      and problem drinkers. These strategies can help patients and families overcome
      their ignorance about the role that alcohol plays in their lives and to motivate
      them toward a healthier lifestyle. Physicians can select strategies that range
      from simple advice to motivational counseling. Depending on the presenting
      problems and the likelihood and severity of an alcohol problem, the physician can
      select strategies described in this model to develop an individualized approach
      to motivate at-risk and problem drinkers to move through the phases of behavioral
      change: precontemplation, contemplation, preparation, action, and maintenance.
      Such an approach can help patients take responsibility for changing their
      drinking habits.

PMID- 8464949
TI  - Outpatient management of alcohol abuse.
AB  - Patients with alcohol problems come to their primary care physicians at different
      points along the spectrum of experiences with alcohol; therefore, physicians need
      to be able to respond with a variety of interventions. In addition, patients
      present in different stages of change, and physicians need to be aware of where
      the patient is in that continuum. Evidence shows that less intensive, outpatient
      treatment may be as beneficial as inpatient treatment for some patients and that
      primary care physicians can offer some of their patients relatively simple
      interventions that are effective. Medications such as disulfiram offer little in
      the treatment of alcoholism but may be of benefit in selected situations. Of
      greater benefit are more complex psychosocial interventions carried out by a team
      of health care professionals.

PMID- 8464950
TI  - Principles and practice of detoxification.
AB  - Detoxification is the medical care that safely carries the patient through
      withdrawal. It is normally not an end point but is a step toward rehabilitation.
      Protocols should be tailored to meet the needs of individual patients.

PMID- 8464951
TI  - The hospital treatment of alcoholism and drug addiction.
AB  - Inpatient treatment of alcoholism is an option indicated by certain clinical
      criteria. The American Society of Addiction Medicine suggests four levels of
      care, and six assessment dimensions determine which level of care is indicated.
      An addiction medicine physician can consult with the primary care physician to
      recommend appropriate placement in difficult cases. Abstinence is a primary goal
      of treatment; for without abstinence, no other recovery will be possible. The
      remaining goals of recovery are detoxification, medical evaluation, stabilization
      of life-threatening emotional issues, education, identification of barriers to
      recovery, readjustment of behavior toward recovery, and orientation and
      membership in a self-help group. Successful family contributions can make the
      difference between success or failure of treatment goals; the role the family
      plays in recovery is discussed. Treatment for family members is important; the
      physical, emotional, and spiritual effects on family members can be just as
      profound on them as they are on the alcoholic. Continuing care maintains the link
      between the patient and the professional recovery community after discharge and
      is appropriate for all patients. Extended care allows for structured support of
      sobriety and often further progress through psychosocial issues identified during
      the initial treatment phase (i.e., abuse, molestation, unresolved grief).
      Extended care is indicated for patients requiring further structured assistance
      in early recovery. A large variety of treatment options are available once the
      decision has been made to hospitalize the patient.

PMID- 8464953
TI  - Light visor treatment for seasonal affective disorder: a multicenter study.
AB  - The effectiveness of light therapy in seasonal affective disorder (SAD) was
      evaluated in 105 subjects across five centers. Three intensities of light (60
      lux, 600 lux, and 3500 lux) were used in a 2-week randomized, parallel design.
      There was no significant difference in antidepressant efficacy of the three
      intensities of light. All three intensities produced a similar frequency of
      antidepressant response to each other and to that reported in previous studies.
      There were site differences in the severity of depression during light treatment,
      but diagnosis and medication status did not affect antidepressant response. These
      findings suggest that light therapy has an antidepressant action by a nonspecific
      effect or that light is biologically active in the treatment of SAD across a wide
      range of intensities.

PMID- 8464952
TI  - Effect of desipramine on cerebrospinal fluid concentrations of corticotropin
      releasing factor in human subjects.
AB  - To assess the effect of desipramine (DMI) on corticotropin-releasing-factor (CRF)
      activity in the central nervous system, we measured cerebrospinal fluid (CSF)
      concentrations of CRF in healthy volunteers following short-term administration
      of DMI or placebo. DMI administration for 2 days was associated with a
      significant dose-related reduction in CRF concentrations. There was a
      nonsignificant 6% reduction in CRF concentrations among the 10 subjects who
      received 50 mg DMI (delta CRF: -3 +/- 2 pg/ml) and a significant 14% fall in the
      CRF concentrations of the eight subjects who received 100 mg DMI (delta CRF: -8
      +/- 3 pg/ml). The mean CSF concentration of CRF was unchanged in the six subjects
      randomized to placebo (delta CRF: 1 +/- 5 pg/ml). DMI administration had no
      effect on CSF norepinephrine concentrations (n = 24) or on plasma cortisol (n =
      25). We conclude that short-term administration of DMI in healthy volunteers is
      associated with a dose-related reduction in CSF concentrations of CRF.

PMID- 8464954
TI  - Frequency of seasonal affective disorder among individuals seeking treatment at a
      northern Canadian mental health center.
AB  - The frequency of seasonal affective disorder (SAD) was examined in clients
      receiving treatment for recurrent mood disturbances in a northern Canadian site.
      Approximately one-fifth of these individuals were identified as having SAD when
      file histories and a statistical criterion were used as the basis for assessment.
      The failure to find a higher prevalence rate at this latitude may be due to other
      studies' reliance on client self-report, a tendency for individuals with SAD to
      relocate south, or a greater tendency for clients with SAD to be seen by general
      practitioners and alcohol treatment centers in the north.

PMID- 8464955
TI  - Psychosis proneness scales in schizophrenia spectrum personality disorders:
      familial vs. nonfamilial samples.
AB  - The authors evaluated the extent of overlap between DSM-III-R schizophrenia
      spectrum personality diagnoses (SSPD) and the Psychosis Proneness Scales of
      Chapman and his associates. The subjects were recruited from the family members
      of schizophrenic patients ("familial" subjects; n = 45) and members of the
      community with negative family histories for schizophrenia ("nonfamilial"
      subjects; n = 60). Clinical interviews were performed to obtain DSM-III-R Axis I
      and II diagnoses. In 105 individuals with no Axis I diagnosis, the five Chapman
      Scales were administered. The results suggest that the nonfamilial subjects with
      diagnoses of SSPD (n = 24) scored significantly higher on the Chapman Scales of
      Magical Ideation, Perceptual Aberration, and Impulsive Nonconformity compared
      with the familial SSPD subjects and the other non-SSPD groups. The familial SSPD
      subjects (n = 17) scored significantly higher than the nonfamilial, non-SSPD
      groups on the Physical Anhedonia Scale. Scores on the Social Anhedonia Scale were
      highest in the SSPD subjects, but only scores for the nonfamilial SSPD subjects
      were statistically different from those for the other non-SSPD groups. The data
      were reanalyzed by first dividing the scores from the Chapman Scales into high
      and low scores based on different cutoff points. Sensitivities, specificities,
      and predictive powers of the "high" Chapman scores for SSPD diagnoses were then
      calculated. These were done because the Chapman Scales are often used to identify
      individuals with schizophrenia-related personality disorders on the basis of
      scores that exceed arbitrary cutoff points. The results suggest that the Chapman
      Scales (other than the Physical Anhedonia Scale) and DSM-III-R criteria
      identified mostly the same subjects, when only nonfamilial subjects were
      considered (with sensitivities and specificities of about 0.70). However, the
      overlap between these two constructs was poor when only schizophrenia spectrum
      subjects recruited from the family members of schizophrenic patients were
      considered.

PMID- 8464956
TI  - Anxiety disorders in the joint hypermobility syndrome.
AB  - A case-control study was designed to test the association between joint
      hypermobility syndrome (JHS), an inherited disorder of collagen synthesis, and
      anxiety and phobic disorders. One hundred fourteen cases of JHS diagnosed at the
      rheumatology outpatient clinic of the Hospital del Mar (Barcelona) were compared
      to 59 control subjects randomly selected from patients seen at the same clinic.
      Both cases and controls were examined by a psychologist who used the Structured
      Clinical Interview for DSM-III-R and who was unaware of their medical diagnoses.
      DSM-III-R diagnoses of panic disorder, agoraphobia, and simple phobia, but not
      generalized anxiety disorder, dysthymic disorder, or major depression were found
      to be highly associated with JHS (age- and sex-adjusted odds ratio = 10.7).
      Mitral valve prolapse (MVP) was present only among JHS cases. Among cases of JHS,
      subjects with MVP were almost three times more likely to suffer from anxiety than
      subjects without MVP (odds ratio = 2.95), although the association was not
      statistically significant. The strong association between panic anxiety and JHS
      appears to occur at a higher level than the association between panic and MVP,
      and provides a new basis for further studies on the genetic background of panic
      anxiety.

PMID- 8464957
TI  - No evidence of linkage between schizophrenia and D3 dopamine receptor gene locus
      in Icelandic pedigrees.
AB  - The D3 dopamine receptor gene is an important candidate gene for schizophrenia,
      since--because of its almost exclusive expression in the limbic system--it
      combines the dopamine receptor hypothesis with the limbic system hypothesis of
      schizophrenia. Pairwise linkage analyses were carried out between the D3 dopamine
      receptor gene locus (DRD3) and schizophrenia (including major depression among
      its pleiotropic manifestations). On the basis of these analyses, which assumed a
      penetrance of 0.71 and a dominant mode of inheritance, we were able to exclude
      the DRD3 locus with a lod score of -2.50 in four Icelandic pedigrees. The area of
      exclusion (lod score < -2.00) extended 1.2 centimorgans. We conclude that the
      genetic predisposition to schizophrenia in these pedigrees is not due to a
      mutation in the DRD3 locus. However, these results cannot exclude the possibility
      that a defect in other genes regulating the expression of the D3 dopamine
      receptor gene could be involved in the pathogenesis of schizophrenia or that
      linkage analyses in other families or population-based association studies might
      show a positive result.

PMID- 8464958
TI  - Sodium lactate infusion in late luteal phase dysphoric disorder.
AB  - The effects of sodium lactate infusion were compared in 13 women who sought
      treatment for marked premenstrual dysphoric changes that met criteria for late
      luteal phase dysphoric disorder and 7 control women. No subject had a lifetime
      history of panic disorder. The rate of blindly rated panic to sodium lactate was
      7 (58%) in patients and 0% in controls. Nonpanicking patients also had higher
      Modified Acute Panic Inventory scores than control subjects. The differences
      cannot be fully explained on the basis of a history of panic attacks. Further
      study is warranted.

PMID- 8464959
TI  - Decreased heart rate variability in panic disorder patients: a study of power
      spectral analysis of heart rate.
AB  - We have previously found decreased standard deviations and mean consecutive
      differences of R-R intervals in panic disorder patients in standing posture,
      compared with control subjects. In the present study, we used spectral analysis
      of heart rate variability to examine autonomic function in 21 panic disorder
      patients and 21 normal control subjects. Patients had a significantly lower
      standard deviation of heart rate in supine as well as standing postures. Absolute
      low frequency power (0.01-0.05 Hz) was also significantly lower in panic disorder
      patients in standing postures. Upon standing, the panic disorder patients had
      significantly higher relative mid-frequency power (0.07-0.15 Hz). During a
      standing deep-breathing condition at six breaths per minute, the patients had a
      significantly decreased absolute and relative mid-frequency (0.07-0.15 Hz) power
      compared with control subjects. These findings suggest a decrease in cholinergic
      and a relative increase in adrenergic responsiveness in panic disorder patients
      compared with control subjects.

PMID- 8464960
TI  - Antisocial symptoms in preadolescent boys and in their parents: associations with
      cortisol.
AB  - Conduct disorder (CD) symptom counts in preadolescent boys, and antisocial
      personality disorder (ASP) and childhood conduct disorder symptom counts in their
      parents, were used as dimensional measures of behavioral deviation. A significant
      correlation was found for CD and ASP symptom counts between the two parents and
      between CD symptom counts of the children and parental CD and ASP symptom counts.
      Although socioeconomic level correlated negatively with parental symptom counts,
      no association was observed between parental socioeconomic status and children's
      CD symptom counts. Saliva cortisol level in the children was negatively
      associated with their CD symptom count and with their fathers' ASP count.
      Cortisol level was also lower among sons whose fathers had CD as children and
      subsequently developed ASP compared with the cortisol level in sons whose fathers
      either did not have any Axis I psychiatric disorder or did not develop ASP.

PMID- 8464961
TI  - [Psychosomatic aspects of rheumatic diseases].
AB  - The spectrum of rheumatic diseases includes syndromes characterized solely by
      musculoskeletal pain and discomfort. Indeed, muskuloskeletal pain and dysfunction
      are experienced by almost everyone in the course of a lifetime. The rheumatic
      syndromes are diverse and often of unclear etiology. For many years,
      psychosomatic theories have been advanced as an attempt at explanation,
      especially in the case of chronic polyarthritis. This article discusses the
      meaning of risk factors viewed as relevant to the course of back pain syndromes
      in particular. Therapeutic and rehabilitative-psychological interventions for
      comprehensive treatment of chronic rheumatic pain-patients are presented, and the
      necessity for a well-coordinated psychosomatic-interdisciplinary approach is
      emphasized.

PMID- 8464962
TI  - ["Burnout" and the need for psychosocial education and supervision in inpatient
      care of the aged].
AB  - 255 staff persons in the inpatient care for elderly (mainly nursing home staff,
      nurses and assisting personal) were included in a multicenter questionnaire
      study. Main strain was reported as time pressure at work (59%), followed by
      organisational deficits (22%) and compassion with the suffering of some
      inhabitants. The analysis of influencing factors yielded only a few results, job-
      and occupation-related factors might increase the risk of getting "burned out"
      (especially qualification and responsibility taken), as well as younger age. Two
      risk groups with respect to "burnout" were identified by cluster analysis: a
      bigger group (47%) of younger staff, markedly strained, but also highly skilled
      and motivated ("burnout-endangered" group), and a smaller group (8%) with high
      strain and low job satisfaction ("burnout-group"). More than half confirmed that
      psychosocial staff training and supervision is important and necessary and should
      mainly deal with problems of team interaction and ways of emotional relieve.
      Training units of 90 minutes once a month was the mode mostly favoured. Main
      issues were aspects of interaction with problematic elderlies (especially with
      depressive or aggressive persons) as well as dealing with death and dying.

PMID- 8464963
TI  - [Coping and life satisfaction in patients with Hodgkin's disease in remission. A
      contribution to the question of adaptive aspects of coping processes].
AB  - Widening the focus from survival time to the "quality of survival" this cross
      sectional study was designed to find correlations between coping strategies,
      quality of life, sociodemographic and medical data. 61 patients (31 women, 30
      men; mean age 41 [22-74] with Hodgkin's disease receiving no treatment since 1
      month to 16 years (mean 5 years) were assessed for coping and quality of life.
      Two standardized questionnaires were used: "Freiburg Questionnaire of Coping with
      Chronic Illness" (FKV 102) and "Questions for Life Satisfaction" (FLZ). Coping
      strategies were evaluated. The most used strategies were compliance strategies
      and trust in doctors. Some coping strategies correlated significantly with age,
      sex, marital status, education, and medical data as B symptoms and occurrence of
      recidivs. The scores for life satisfaction were absolutely high in comparison
      with postoesophagectomy patients and healthy controls from other studies. Life
      satisfaction was correlated with age, B symptoms and type of therapy. These
      correlations and correlations between FKV and FLZ were discussed and basic
      problems were reflected.

PMID- 8464964
TI  - [Collection of relevant data in psychoanalytically oriented inpatient
      psychotherapy--The Tiefenbrunn Documentation System].
AB  - We inform about development of the Tiefenbrunn documentation system for inpatient
      psychotherapy. Aims and scaffolding of the system and some difficulties to make
      the system run are outlined. The newly developed instruments are sketched.
      Patients received a questionnaire concerning their social situation and their
      family of origin. At the same time therapists indicate symptoms, diagnosis, work
      ability, prognosis, pretreatments and chronification (diagnosis sheet I) and
      results of treatment (diagnosis sheet II) when patients leave. During treatment
      complementary therapy (as e.g. massage etc.) is documented. From 1988 on we have
      230 variables on every patient in our computers. Actual and further use of the
      system is described.

PMID- 8464965
TI  - [Attitude, process fantasy and progress assessment after inpatient psychotherapy-
      the Tiefenbrunn Termination Interview].
AB  - This is a preliminary study on the qualitative evaluation of inpatient
      psychotherapy by means of a semistandardized interview at the end of treatment.
      The interview focus is on the patients' attitude, fantasy of cure and view of
      achieved progress. These components are formulated in a metaphoric, every-day
      language which are set in relation to the patient's quantitative evaluation of
      treatment. Experience of therapy appears as consistently embedded in, and
      depending from the patient's lay theory of cure, which also determines his
      measure of outcome. Obviously, an important dimension of psychotherapeutic
      interaction can be described as "negotiating" the lay theory of cure.

PMID- 8464966
TI  - [Crohn disease--addiction--neurosis: comparison of ego functions].
AB  - 25 neurotic patients, 25 alcoholics, and 25 patients suffering from Crohn's
      disease were rated with a german adaption (by Streeck) of Bellak's Ego Function
      Assessment scales. Crohn's disease patients showed personality characteristics
      similar to those of patients suffering from psychosomatic illnesses. Ego function
      disturbances could be found with respect to Introspection as a subfunction of
      Reality Testing, Creativity and Capacity for Abstraction as a subfunction of
      Thought Processes. The results indicated a remarkable heterogeneity of the
      Crohn's-patient group as well as possible influences of gender-specific
      personality differences in that group.

PMID- 8464967
TI  - [Interpersonal problems, interpersonal orientation and success of treatment after
      inpatient group psychotherapy].
AB  - To describe and estimate the importance of interpersonal problems and
      orientations for inpatient group psychotherapy, a total of 78 inpatients from two
      different hospitals (university hospital Kiel, psychotherapeutic hospital Berlin
      Hirschgarten) were investigated using the Inventory of Interpersonal Problems and
      the SCL90R prior to and (partly) following longterm psychotherapy. Both groups
      reported more interpersonal problems than a group of 55 outpatients. The
      subgroups differed from each other in terms of their symptoms reported in the
      SCL90R and their interpersonal orientation (sensu Horowitz) which was smaller in
      the patient group from the Berlin Hospital (an institution of the former German
      Democratic Republic). Within this subgroup, treatment success (obtained with a
      variety of different measures) appeared to be less in those patients whose
      interpersonal problems were mainly related to the dimension of dominance. The
      ratio of interpersonal to impersonal problems was not significantly related to
      therapy outcome in either of the subgroups. The results of this study are mainly
      discussed with respect to the different psychotherapeutic concepts practiced in
      both hospitals. Generally, the investigation supported the significance of the
      interpersonal dimension for empirical research within the field of inpatient
      psychotherapy.

PMID- 8464968
TI  - [Situational anxiety in myasthenia gravis].
AB  - Neuromuscular block can cause anxiety. These known experimental results lead to
      the expectation of conditioned phobic reactions in myasthenia gravis. A sample of
      240 patients with the disease do not show the theoretically expected results in
      the Fear-Survey-Schedule. But interindividual variation of anxiety corresponds to
      some clinical parameters, relevant for the disease. Patients with facial muscular
      symptoms have higher values on social phobia but no higher scores on a depression
      scale. Opposite to the facial-feedback theory, this result supports the
      hypothesis, that intersubjective feedback is more significant to the development
      of the emotional reaction than proprioceptive (facial) feedback. Social anxiety
      also covariates with defensive coping-strategies. Implications for supportive
      psycho(behaviour)therapy are discussed.

PMID- 8464969
TI  - Health promotion and disease prevention--10 years of student inventiveness.

PMID- 8464970
TI  - Breast self-examination for visually impaired women.
AB  - Regularly practiced breast self-examination (BSE) has been demonstrated to be an
      effective method in the early detection of breast abnormalities. Women are
      becoming increasingly aware of the importance of BSE as a means of self-health
      care and are seeking instruction on how to perform such examinations properly.
      Unfortunately, not all women have equal access to BSE instruction. This project
      addresses the need for BSE instruction specifically tailored to meet the needs of
      visually impaired women. A review of existing sources revealed that no formal
      methods of BSE instruction are being used to meet the needs of this population.
      The participants in this study included 20 women between the ages of 30 and 75
      years, all of whom are partially sighted or legally blind. The women participate
      in life skills classes on a regular basis at a county association for the blind.
      The authors conducted an instructional seminar demonstrating BSE and used methods
      which focus on the senses of touch and hearing. According to the authors, the
      instructional seminar can result in an increased self-awareness of the importance
      of BSE and help to meet the unique needs of the visually impaired women.

PMID- 8464971
TI  - Teen Peer Outreach-Street Work Project: HIV prevention education for runaway and
      homeless youth.
AB  - Each year, there are approximately 2 million homeless and runaway youths in the
      United States. On any given night, there are 1,000 homeless youngsters living on
      the streets of San Diego, CA. Homeless young people are commonly involved in one
      or more of the following activities that place them at risk for HIV infection-
      unprotected sexual intercourse, needle-sharing in the use of injectable drugs,
      sex with someone who injects drugs. The Teen Peer Outreach-Street Work Project
      trains teen peer educators to work in three existing San Diego youth service
      programs with street outreach staff members to provide HIV prevention education
      and referral services to San Diego's homeless youth. Selected teens from the
      target population also participate in street-based case management that provides
      skill development to bring about behavioral and attitudinal changes. An HIV
      outreach program cannot stand alone and is most successful if it is integrated
      with services that meet the basic needs of its clients. In the three
      participating youth service programs of the Teen Peer Outreach-Street Work
      Project, food, clothes, and shelter information are provided. There are shelters
      in two of the three programs that become places where HIV educational messages,
      delivered on the street, can be reinforced. Immediate and concrete assistance can
      be offered to homeless youth. Low literacy among the target population presents a
      significant obstacle to adequate and appropriate HIV prevention education for
      homeless youth. Currently, education materials that specifically target homeless
      youth do not exit. The outreach street project is being expanded to develop
      materials for homeless youth with low literacy levels. Teen peers will be used to
      facilitate structured focus groups composed of members of the target population.
      Focus groups will be used in concept development, product development, and
      evaluation of draft products.Because the project is unique.in San Diego, it
      addresses an unmet need, reaching a population often missed by traditional HIV
      education efforts.

PMID- 8464972
TI  - Cervical cancer prevention project for inner city black and Latina women.
AB  - Early detection, appropriate intervention, and adequate followup treatment make
      cervical cancer one of the most preventable of all diseases. The authors propose
      a project designed to increase knowledge and awareness of cervical cancer and its
      prevention and ultimately to decrease morbidity and mortality rates for cervical
      cancer in black and Latino inner-city communities of Boston. During a 3-year
      project the authors hope to reach about 500 high-risk women who currently do not
      have access to health care services. The interventions would be based in the
      Boston, MA, community areas of Roxbury and Jamaica Plain, specifically in those
      neighborhoods served by a designated community health center. High rates of
      cervical cancer are found in inner-city communities, where black and Latina women
      usually are overrepresented. About 80 percent of the women served by the
      designated community health center are either black or Latina. The proposed
      intervention has three objectives: (a) to increase the use of health services by
      so-called hard-to-reach women in those communities; (b) to reduce the numbers of
      women who, after learning of their abnormal Papanicolaou test results, do not
      return for followup; and (c) to increase sensitivities toward the problem and to
      encourage participation in such a project among health care providers at the
      community health center.

PMID- 8464973
TI  - Model prenatal program of Rush Medical College at St. Basil's Free Peoples
      Clinic, Chicago.
AB  - The lack of adequate prenatal and gynecological care for indigent women has
      reached crisis proportions. The situation is aggravated by the diminishing supply
      of primary care physicians who are willing to practice obstetrics in community
      settings. Added to this condition is the rapidly declining number of medical
      students seeking careers in the primary care field. The Rush Prenatal Program at
      St. Basil's Free Peoples Clinic on Chicago's south side addresses these problems
      by (a) delivering comprehensive prenatal care to poor and disadvantaged women;
      (b) providing a learning environment in which medical students are taught to be
      humane, culturally sensitive, and competent physicians through active involvement
      in patient management; and (c) creating an experience that reinforces the
      student's self-motivation to practice community-oriented primary care. At the
      clinic 24 medical students, working in teams supervised by the three program
      physicians, maintain continuity of excellent prenatal care that follows the
      expectant mother from pregnancy through delivery and beyond. The Rush Prenatal
      Program, which has been initiated, organized, and managed by medical students,
      has evolved into a model of education and service that can be emulated at other
      institutions. All participants in the program--students, faculty, patients, and
      community representatives--are being followed longitudinally as a method of
      assessing program efficacy. This collaborative effort between an academic medical
      center and a neighborhood clinic demonstrates that such a partnership is not only
      feasible but potentially cost effective and socially responsible.

PMID- 8464974
TI  - The psychological consequences of the Chernobyl accident--findings from the
      International Atomic Energy Agency Study.
AB  - In October 1989, more than 3 years after the nuclear power plant accident at
      Chernobyl, in the Ukraine, the Government of the Union of Soviet Socialist
      Republics requested that the International Atomic Energy Agency (IAEA) evaluate
      the medical and psychological health of residents living in areas identified as
      being contaminated with radioactive fallout. The IAEA designed and conducted a
      collaborative study to examine whether there were any measurable effects of
      exposure to the low levels of ionizing radiation resulting from the accident. The
      study, using structured interviews and IAEA laboratory equipment, collected data
      on more than 1,350 residents of 13 villages. IAEA clinical staff members
      concluded that they could not identify any health disorders in either the
      contaminated or nearby (uncontaminated) control villages that could be attributed
      directly to radiation exposure. The clinical staff, however, did note that the
      levels of anxiety and stress of the villagers appeared to be disproportionate to
      the biological significance of the levels of IAEA-measured radio-active
      contamination. Almost half the adults in all the villages were unsure if they had
      a radiation-related illness. More than 70 percent of persons in the contaminated
      villages wanted to move away, and approximately 83 percent believed that the
      government should relocate them. The IAEA effort indicates that the villagers
      need to be educated about their actual risks, and they need to understand what
      types of illnesses are, and are not, associated with exposure to radioactive
      contamination. Unfortunately, the villagers' needs may exceed the available
      resources of their local and central governments.

PMID- 8464975
TI  - Cirrhosis hospitalization and mortality trends, 1970-87.
AB  - The decline in cirrhosis mortality in recent years in light of increases in
      cirrhosis morbidity, as reflected in hospital discharge data, is examined.
      Although there does not appear to be a single explanation for the decline in
      mortality, it is suggested that increased identification and treatment, as
      measured by substantial increases in the rates of hospitalization involving
      cirrhosis, may be a contributing factor. If, as suggested by hospitalization data
      that indicate a decreasing proportion of patients with cirrhosis die during their
      hospital stay, a major portion of the increase in cirrhosis admissions was for
      patients with less severe cases, these patients would be more responsive to
      treatment and would have a relatively better prognosis. The identification of
      contributing factors that may be responsible for the decline in cirrhosis
      mortality can provide support for the continuation of early diagnosis and
      treatment in already identified populations. The same kind of support can be
      extended to other population subgroups that have yet to show the same decline in
      cirrhosis mortality.

PMID- 8464976
TI  - Assessing the public's health: community diagnosis in North Carolina.
AB  - The community diagnosis process in North Carolina has evolved over a period of
      years. It began in 1974 and gained great impetus during and after 1983. It serves
      to address the "true" health problems of the State's citizenry through the
      identification and communication of these problems from the local level to the
      State. In this "bottom-up" planning process, conducted biennially, the State
      health department prepares 100 county-specific health data books and an
      accompanying guide that advise local health department personnel on the concepts,
      methods, and materials of community diagnosis. The data books and guides are
      presented at a series of workshops to county health department personnel who
      subsequently analyze the data in the light of their local situations and report
      back to the State their county's priority health problems and strategies for
      solving them. This county information is then used by the State health director
      to determine funding requests to the legislature. In the end, it is hoped that
      the products of this process serve the ultimate goal of allocating resources
      according to priorities to meet the documented health needs of North Carolinians.
      "The Future of Public Health," authored by a committee of the Institute of
      Medicine, defines a health planning and leadership role for a local health
      authority that is fundamental to the protection of the community's health.
      Community diagnosis provides for the kind of needs assessment that is crucial to
      that role.

PMID- 8464977
TI  - A cost-benefit analysis of a California county's back injury prevention program.
AB  - Back-related injuries have become a major health problem in the workplace,
      affecting as many as 35 percent of the work force and accounting for about 25
      percent of all compensation claims. This study evaluates a back injury prevention
      program among employees in a northern California county in 1989-90. Six divisions
      of the county government were selected for the study because they had the highest
      prevalence of back pain experienced and the most back-related injuries in recent
      years. Four of the six divisions were randomly selected as the intervention group
      and the remaining two, the control group. Overall, 77 percent or 205 of the
      targeted employees in the intervention group participated in the study. The
      intervention group was given an identical health risk assessment (HRA) before and
      after the 1-year back injury prevention program that offered employees a
      combination of education, training, physical fitness activities, and ergonomic
      improvement. The control group was neither given the HRA nor offered the program.
      The back injury and cost data of both the control and intervention groups were
      collected before and after the 1-year intervention. The results showed a modest
      overall decline in back pain prevalence rates, but significant improvement in
      satisfaction and reduction in risky behaviors. Cost-benefit analysis showed the
      net benefit of introducing back injury prevention program was $161,108, and the
      return on investment is 179 percent. Therefore, the study offers suggestive
      evidence for the initial benefits of a back injury prevention program and lends
      support to the widely held belief that health promotion in the workplace can
      reduce employee health risks, increase healthful behaviors and attitudes, and
      improve attitudes toward the employer organization.Whether such intervention will
      continue to reap benefits in future years depends, to a large extent,on a
      favorable work environment and the maintenance and continuation of positive
      behavioral changes.

PMID- 8464979
TI  - Smoking behavior of adolescents exposed to cigarette advertising.
AB  - The purpose of the study was to explore the relationship between the exposure of
      adolescents in the seventh and eighth grades to cigarette advertising and their
      being smokers. A survey questionnaire given to 602 adolescents assessed their
      exposure to cigarette advertising and provided measures of their smoking
      behavior, demographic characteristics, and some psychosocial variables. The
      results indicated that exposure to cigarette advertising and having friends who
      smoked were predictive of current smoking status. Adolescents with high exposure
      to cigarette advertising were significantly more likely to be smokers, according
      to several measures of smoking behavior, than were those with low exposure to
      cigarette advertising. The findings extend previous research identifying factors
      that may play a role in the initiation and maintenance of smoking among
      adolescents.

PMID- 8464978
TI  - Bicycle helmet use by adults: the impact of companionship.
AB  - Most of the nearly 1,000 fatal bicycle-related injuries annually could be
      prevented if riders used safety helmets. Helmet use by adult bicyclists has
      received relatively little attention because educational campaigns to promote
      helmet use generally focus on children. Helmet use by adult and child bicyclists
      at 120 suburban and rural sites in three Maryland counties was observed on two
      Saturdays in 1990-91 during an evaluation of the impact of a mandatory helmet
      law. Concordance or discordance of helmet use within various groups of bicyclists
      -adults only, adults with children, and children only--was recorded. Helmet use
      among 2,068 adult bicyclists was 49 percent, 51 percent, and 74 percent in the
      three counties. In two counties combined, 52 percent (365 of 706) of solo adult
      bicyclists wore helmets compared with only 5 percent (5 of 94) of solo child
      bicyclists (P < .001). Helmet use or nonuse was concordant among 87 percent of
      277 adult-adult pairs, 94 percent of 50 child-child pairs, and 91 percent of 32
      adult-child pairs of bicyclists observed. Concordance rates of helmet use or
      nonuse were similarly high among pairs of adult bicyclists of the same or mixed
      sexes. These data are consistent with the concept that both adults and children
      tend to adopt the helmet-wearing behaviors of their companions. Public health
      efforts focused on adults should encourage helmet use by adult bicyclists both to
      prevent head injuries and to provide a role model for children.

PMID- 8464980
TI  - A fetal alcohol syndrome surveillance pilot project in American Indian
      communities in the Northern Plains.
AB  - A pilot fetal alcohol syndrome (FAS) surveillance was carried out in four
      American Indian communities in the Northern Plains by the Aberdeen Area Indian
      Health Service to determine the incidence of FAS and to evaluate the feasibility
      of establishing continuing surveillance for FAS. Baseline data on the incidence
      of FAS would be used by the Indian Health Service to develop and evaluate
      preventive interventions, including treatment programs for pregnant women who
      drink alcohol. Four of the 1,022 children included in the project were found to
      have FAS, a rate of 3.9 per 1,000 live births. The rate is believed to
      underestimate the true rate of FAS because some low birth weight children were
      not screened, parents or guardians were reluctant to bring children suspected of
      FAS for evaluation, clinicians were hesitant to diagnose possible alcohol-damaged
      children for fear of labeling the child, and some children with FAS died before
      the diagnosis of FAS could be confirmed. If the rate of FAS is similar for the 39
      percent of the infants not screened and for the 25 percent of suspected infants
      who were not evaluated, a rate of 8.5 cases of FAS per 1,000 live births may be
      postulated. The authors recommend routine screening of prenatal patients for
      substance abuse and establishing a tracking system for low birth weight infants
      suspected to have FAS or other alcohol-related developmental disorders, in an
      effort to establish more accurate FAS rates. Such a surveillance system would
      identify women at risk of having alcohol-affected infants so that appropriate
      treatment and counseling could be provided, possibly reducing the severity of
      adverse effects of alcohol on their fetuses.

PMID- 8464981
TI  - Development of the New York State Nutrition Surveillance Program.
AB  - New York State established a Nutrition Surveillance Program (NSP) in 1984.
      Precedents for the program included the Pediatric Nutrition Surveillance System
      of the Public Health Service's Centers for Disease Control and Prevention and
      periodic food and nutrition surveys conducted by the National Center for Health
      Statistics and the Human Nutrition Information Service, Department of
      Agriculture. The first phase of NSP was connected to a new program, the
      Supplemental Nutrition Assistance Program (SNAP), which established support for
      more than 1,000 emergency food programs across the State. SNAP also expanded the
      home delivered meal program for the frail elderly and the Special Supplemental
      Food Program for Women, Infants, and Children. NSP provided information on the
      extent of unmet nutrition needs that was used to establish funding requests and
      provided data describing the characteristics of SNAP participants that were used
      in developing new SNAP program components. The second phase of NSP began in 1988.
      It identified populations that were thought to be at nutrition risk and compiled
      information about the extent of unmet need, the characteristics of the
      population, and the status of current nutrition programs to meet the needs. As a
      result of this review, NSP added a nutrition component to the Dental Survey of
      School Children; conducted a dietary survey; developed an inventory of
      information sources in all State agencies; and established an annual work plan
      using department of health objectives. The third phase of NSP is the policy and
      planning phase, monitoring the Year 2000 Objectives and the Five-Year Plan of the
      New York State Food and Nutrition Policy Council.

PMID- 8464982
TI  - The Public Health Service's response to Hurricane Andrew.

PMID- 8464983
TI  - Elderly persons' attitudes towards footwear--a factor in preventing falls.
AB  - Injuries from falls are the main cause of trauma morbidity that leads to
      mortality among the elderly. One prevention strategy is to wear sturdy shoes.
      This study was undertaken to determine the attitudes towards and use of sturdy
      shoes among older adults. A random sample of persons ages 65 years and older was
      contacted by phone; 652 completed interviews. Sturdy shoes were worn by 26
      percent of persons at the time of the call; more than two-thirds reported wearing
      such shoes at some time. Barriers to use of sturdy shoes included foot problems,
      difficulty putting them on, expense, style, and lack of knowledge about their
      importance. There was no difference in shoe use by the respondents' history of
      previous falls. The results provide information useful in the development of a
      program to increase the use of sturdy shoes by this population.

PMID- 8464984
TI  - Study of road-rail crashes in Claremore, OK, and allocation of resources for
      preventive measures.
AB  - Road-rail crossings where a train and motor vehicle crashed were compared with
      the next crossing in the direction from which the train traveled at the same time
      of day and day of week of the crash. The odds of a crash were much lower at
      crossings with automatically lowered gates (odds ratio = 0.11). Average road
      traffic was much higher at crash sites; the presence of automatic gates was
      unrelated to the volume of road traffic. Federally funded modifications of road
      rail crossings have substantially reduced deaths at such sites. The program would
      be more cost effective, however, if criteria for highest risk sites were applied
      more systematically, and funds were apportioned among the States according to
      their relative proportions of the problem.

PMID- 8464985
TI  - FDA warns frequent yeast infections could be early sign of HIV.

PMID- 8464986
TI  - Antibodies to gangliosides in Guillain-Barre syndrome: specificity and
      relationship to clinical features.
AB  - Antibodies to ganglioside GM1 have been associated with Guillain-Barre syndrome.
      To clarify their role we have studied their frequency, fine specificity and
      relationship to clinical features in a series of patients with this disease.
      Antibodies to ganglioside GM1 were identified, by both enzyme-linked
      immunosorbent assay and binding to thin-layer chromatograms of human brain, in 12
      (28.6%) of 42 patients with Guillain-Barre syndrome and in only 1 (2.4%) of 41
      normal control subjects (p = 0.002). Eight sera contained IgM antibodies and six
      sera contained IgG antibodies, including 2 sera which contained both. The fine
      specificity of the sera varied. Only four of the 12 sera also showed reactivity
      with ganglioside GD1b and gangliotetraosyl-ceramide (asialo-GM1), consistent with
      reactivity with the terminal Gal beta 1-3GalNAc disaccharide. Two sera had low
      titre anti-asialo-GM1 antibodies of a different class to the anti-ganglioside GM1
      antibodies. The antibodies in these sera therefore react with a variety of
      epitopes. There was a strong relationship between the presence of anti
      ganglioside GM1 antibodies in the acute stage and prolonged disability,
      especially if IgG antibodies were present. Seven of 12 patients with anti
      ganglioside GM1 antibodies had serological evidence of recent Campylobacter
      jejuni infection, but antigens from a strain of this bacterium not associated
      with Guillain-Barre syndrome did not absorb the anti-ganglioside GM1 antibodies.

PMID- 8464987
TI  - Clinical, biochemical and histological features in 102 patients with chronic
      hepatitis C virus infection.
AB  - The clinical, biochemical and histological features of 102 consecutively referred
      patients with chronic hepatitis C virus infection were analysed. Demographic,
      epidemiological, biochemical, haematological and histological details were
      catalogued for each patient. The mean follow-up was 49 +/- 6 months. Liver
      biopsies were obtained from 92 patients; a second biopsy was obtained from 35
      patients. The average known duration of infection was 8.6 +/- 0.7 years. The most
      common risk factors that could be identified were past blood transfusion, surgery
      or intravenous drug abuse. Twenty-four of the 27 patients (85%) with past blood
      transfusion had received blood in countries outside of northern Europe. In
      contrast, 12 of the 16 former drug users were northern European. Patients were
      frequently diagnosed incidentally; one-quarter had no symptoms of liver disease
      and were generally asymptomatic or had presented with non-specific complaints and
      were found to have abnormal serum aminotransferase levels after routine
      screening. The mean serum aminotransferase levels were not significantly
      different in those presenting with fatigue compared to those diagnosed
      incidentally. The most common physical sign in these patients was a palpable
      liver, which was present in 52%. The mean serum albumin concentration in patients
      older than 40 years was significantly lower than that in younger patients.
      Splenomegaly and endoscopic evidence of varices was also more common in older
      patients. Cirrhosis was present in 37% of patients at presentation: 20% showed
      progression on rebiopsy, and 5% developed cirrhosis within 4 years of initial
      presentation. Of those treated, 27% showed histological improvement. Histological
      severity did not correlate with duration of disease, but did correlate with
      age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8464988
TI  - Reversible hypocalciuria with marginal hypercalcaemia in renal magnesium wasting.
AB  - Low urinary calcium levels and hypomagnesaemia were observed in three subjects
      with renal tubular abnormalities. The first, with severe hypomagnesaemia due to
      congenital renal magnesium wasting, had mildly raised serum ionized calcium
      levels (1.34-1.36 mmol/l). The other two, a brother and sister, had features of
      Bartter's syndrome with hypokalaemia, mild hypomagnesaemia and hyperreninaemia
      with normal serum ionized calcium levels. Hypocalciuria was seen in 24-h urine
      collections and in 2-hourly timed urine collections. Magnesium loading with
      intramuscular MgSO4 was used to raise serum Mg to within the normal range.
      Tubular reabsorption of Mg (TMg) rose while TCa fell, with a rise in fractional
      excretion of ionized Ca and a small drop in serum ionized Ca. Serum parathyroid
      hormone levels rose or remained constant. This pattern is consistent with a
      shared Ca/Mg reabsorptive pathway with a rise in TCa when TMg is low, returning
      to normal when TMg is raised by Mg loading. In one subject, this imbalance was
      associated with marginal hypercalcaemia. The site for this pathway is likely to
      be the thick ascending limb of the loop of Henle.

PMID- 8464989
TI  - Anti-reticulin antibody in gluten sensitive enteropathy.

PMID- 8464990
TI  - Hypogammaglobulinaemia and replacement therapy.

PMID- 8464992
TI  - DNA diagnosis: PCR on archival tissue.

PMID- 8464991
TI  - Patient self-referral in acute myocardial infarction.

PMID- 8464993
TI  - ANCA-associated renal disease.

PMID- 8464994
TI  - Renal replacement therapy on the intensive care unit.

PMID- 8464995
TI  - Lipids and cardiovascular disease: ephemeral and elusive receptors.

PMID- 8464996
TI  - Acute renal failure treated by haemofiltration: factors affecting outcome.
AB  - Two hundred and fifty consecutive patients with acute renal failure treated by
      continuous haemofiltration on one intensive care unit (ICU) were studied
      prospectively to investigate the possibility of predicting outcome at the time of
      referral. Logistic regression analysis was used to identify important prognostic
      factors and the regression coefficients were used to weight a scoring system for
      the severity of illness of patients with acute renal failure. Overall survival
      was 53% with improvement over the course of the study. Multivariate analysis
      showed that outcome was related to age, need for artificial ventilation, use of
      inotropes, urine volume, serum bilirubin, arterial base deficit and serum
      creatinine. The scoring system based on the first five of these variables had a
      specificity of predicting death of 67% and a sensitivity of 76%.

PMID- 8464997
TI  - Acid-base status in paediatric Plasmodium falciparum malaria.
AB  - We measured the acid-base status of children with falciparum malaria in order to
      determine the prognostic significance and rate of resolution of acidaemia in
      patients with severe disease. We prospectively studied 141 Malawian children who
      were admitted to Hospital, with falciparum malaria, 60 of whom had cerebral
      malaria (unrousable coma, unable to localize a painful stimulus). Of the 60
      patients with cerebral malaria 25 (42%) were acidaemic (capillary blood pH <
      7.3); of 81 children with uncomplicated malaria 4 (5%) were acidaemic (p <
      0.0001). Eleven patients died; of these, eight presented with cerebral malaria,
      eight with acidaemia and seven with both. The strong association of altered acid
      base status with disease severity and mortality was independent of other
      previously identified predictors of illness and death in malaria. Acidaemia was
      not associated with shock, bacteraemia or hypoxaemia. Acidaemic patients had a
      slower mean respiratory rate and a higher incidence of respiratory rhythm
      abnormalities than other patients, suggesting that acidaemia is in part the
      result of inadequate respiratory compensation for metabolic acidosis. Although
      acidaemia is quickly corrected by fluids and antimalarial drugs, specific therapy
      to correct acidaemia needs evaluation in children with severe malaria.

PMID- 8464998
TI  - Molybdenum/aluminum filters perform effectively.
AB  - In this study, the performances of stacked niobium/aluminum and
      molybdenum/aluminum filters were compared to that of a standard 2.5 mm aluminum
      filter. The molybdenum/aluminum filter had the same performance characteristics
      as the niobium/aluminum filter but was less expensive. The study results show
      that the molybdenum/aluminum filter should be a good filter choice for facilities
      embracing ALARA principles.

PMID- 8464999
TI  - Student meetings can enhance learning.
AB  - This article shows how competency-based clinical education may be enhanced by
      scheduled clinical meetings designed to clarify and intensify the educational
      experience. Incorporating these meetings into the clinical education component
      allows flexibility and creativity in delivering quality clinical experiences.
      Meeting with students on a regular basis also helps distinguish between students
      and staff and provides faculty members the opportunity to remain current in
      topics outside their areas of expertise.

PMID- 8465000
TI  - Minority students benefit from mentoring programs.
AB  - Mentoring has been proposed as one strategy to attract minority students to the
      radiologic sciences profession. This case study describes a minority mentoring
      program conducted for pre-radiologic science students at a Midwestern university
      during the 1991-92 academic year. Ten minority radiologic science students
      enrolled in the mentoring program. The study showed that mentoring may be a
      viable option to serve the special needs of minorities for recruitment and
      retention.

PMID- 8465001
TI  - Gender-related biases in admission decisions.
AB  - This study tested the effects of applicant gender and attractiveness on admission
      ratings, personality attributions and causal attributions in the student
      admission decision-making process in allied health education. The study showed
      that although gender stereotypes are very strong, they did not affect admission
      ratings. However, the study did reveal that attractive candidates received higher
      admission ratings than unattractive applicants and the past successes of
      attractive applicants were more likely attributed to internal causes while the
      past successes of unattractive applicants were more often attributed to external
      causes.

PMID- 8465002
TI  - Outcomes assessment is vital to educators.

PMID- 8465003
TI  - Food irradiation: green eggs and ham?

PMID- 8465004
TI  - At the foot of Kilimanjaro.

PMID- 8465005
TI  - Your patient deserves no less than the best.

PMID- 8465006
TI  - The ARRT's disciplinary process.

PMID- 8465007
TI  - [The dead mother].
AB  - This study is not concerned, as the title might suggest, with the actual death of
      the mother but with the child's experience of a mother who is physically present
      but internally absent due to depression. The child simultaneously introjects and
      splits off the mother imago, making mourning and "burial" equally impossible. The
      consequence of this cathectic deprivation is what the author calls "psychic
      holes" or "white depression". Green attributes to the dead mother a similar
      structuring function for the psychic apparatus to that attributed to the dead
      father in Freud's Totem and Taboo, and places the dead mother complex side by
      side with the Oedipus complex.

PMID- 8465008
TI  - [The dispute between searching and healing in psychoanalysis].
AB  - In the age-old dispute as to whether psychoanalysis is a science or belongs
      rather to the humanities, the author favours a scientific stance. He sees
      interpretation in the analytic situation as providing scope for reasoned
      hypotheses which can be validated by empirical examination. In terms of
      interpretive technique this implies that interpretations must not only be framed
      in brief and simple terms but also in such a way as to lend themselves less to
      the verification of theoretical psychoanalytic truths than to the clarification
      of the truth specific to the given dyadic constellation. Etchegoyen claims that
      it is then possible for the analysand to confirm or refute an interpretation by
      the analyst. A successful interpretation, where the analysand finds the
      hypothesis convincing, is both a scientific discovery and a healing factor.

PMID- 8465009
TI  - [Organ worlds: basic principles of analytic body psychology].
AB  - In this article, the author introduces the expression organ fantasies,
      pathological zones in the body self and organ world with the intention of
      formulating an analytical psychology of the body. He presents the view that a
      person's own body has the significance of a primary object which, under normal
      circumstances, enables a person to make several important basic experiences, such
      as the experience of being alive, of having a body, and of being separate from
      others. On the basis of this work with borderline patients, the author
      demonstrates that the pathological zones in the body self can be understood by
      means of a phase model and that the illness-producing effect of a pathological
      organ world is related to a defective symbolization of experiences. The author
      suspects that the analytical psychology of the body can be applied to
      psychosomatic illness as well.

PMID- 8465010
TI  - Adjuvant radiation therapy versus surgery alone in operable breast cancer: long
      term follow-up of a randomized clinical trial.
AB  - This paper presents long-term results from a randomized trial of pre- or
      postoperative megavoltage radiation therapy versus surgery alone in pre- and
      postmenopausal women with operable breast cancer. Treatment outcome after relapse
      among patients who developed loco-regional recurrences was also analyzed. A total
      of 960 patients were included in the trial. The mean follow-up was 16 years
      (range: 13-19 years). The radiation therapy was individually planned. It included
      the chest wall (and the breast in the preoperative cases) and the regional lymph
      nodes. The tumor dose was 45 Gy/5 weeks. No adjuvant systemic therapy was used.
      The results showed a significant benefit with radiation therapy in terms of
      recurrence-free survival during the entire follow-up period. There was also an
      overall survival difference-corresponding to a 16% reduction of deaths-in favor
      of the irradiated patients which, however, was not statistically significant (p =
      0.09). Among those 169 patients who developed locoregional recurrences long-term
      control was only achieved in about one-third of the cases. This figure was
      similar among those who had received adjuvant radiation therapy (34%) compared to
      those initially treated with surgery alone (32%). This implied that the overall
      proportion of patients who eventually developed uncontrolled local disease was
      significantly higher among those initially allocated to surgery alone (16%)
      compared to those allocated to pre- or postoperative radiation therapy (6%, p <
      0.01). These results suggest that local undertreatment may be deleterious in
      subgroups of patients.

PMID- 8465011
TI  - Dose-fractionation sensitivity of mouse kidney clonogens measured using different
      interfraction intervals and postirradiation assay times.
AB  - The fractionation sensitivity of kidney clonogenic epithelial cells (X
      irradiation in vivo, assay in vitro) was quantified using the linear-quadratic
      model. The cells were assayed either immediately after the fractionation schedule
      or after a time delay in order to compare the relative amounts of dose sparing
      due to fractionation (conventionally sublethal damage repair) and to post
      irradiation delay intervals before assay (conventionally potentially-lethal
      damage repair). As the delay before assay was increased, there was a tendency for
      both alpha and beta to decrease, and as a consequence the alpha/beta ratio stayed
      virtually unchanged (3.3-4.4 Gy) regardless of delay time before assay. No change
      in survival was observed from 12 h to 6 weeks after neutron irradiation (62 MeVp-
      >Be), suggesting that the change observed after X-rays was due to repair rather
      than repopulation. As the interfraction intervals in an 8-fraction X-irradiation
      schedule were increased in steps from 6 h to 5 days, there was improved survival,
      consistent with the presence of long-term repair. These studies provide further
      evidence for the potential importance of long-term repair in late reacting
      tissues not only during but also after multifraction irradiation schedules.

PMID- 8465012
TI  - Multiple primary tumours in patients treated with radiotherapy for breast cancer.
AB  - Between January 1954 and March 1964, 3926 patients with primary breast cancer
      were referred to The Department of Clinical Oncology, Edinburgh. One hundred and
      eighty patients developed 195 malignancies subsequent to the treatment of their
      initial breast cancer. Overall, the total number of second tumours was not
      significantly in excess of the expected incidence in the general population.
      However, statistical analysis revealed a significant increase in the incidence of
      rectal, skin and bone tumours. The excess of bone tumours was likely due to
      radiation exposure. There was not an overall excess of tumours within the
      irradiated or scattered radiation volume.

PMID- 8465013
TI  - Re-irradiation tolerance in the rat spinal cord: influence of level of initial
      damage.
AB  - The influence of the level of initial radiation damage on the long term recovery
      and re-irradiation tolerance in the rat spinal cord was investigated. Rats were
      irradiated with 0, 10, 20, 30 and 36 daily fractions of 2.15 Gy initially
      representing 0, 25, 50, 75 and 90% of cord tolerance. After an interval of 20
      weeks, retreatments were given using graded single doses of X-ray. The end-point
      was paralysis of the forelimbs due to white matter necrosis. Latent times to
      paralysis were inversely proportional to the level of initial injury and
      retreatment doses. The retreatment ED50S were 19.0, 17.0, 15.7, 14.0 and 11.8 Gy
      for the control animals and animals irradiated initially with 10, 20, 30 and 36
      fractions of 2.15 Gy respectively. Using the extrapolated response dose (ERD)
      concept, alpha/beta of 3.0 Gy, the retreatment ED50S in % ERD were 81, 70, 58 and
      42% after initial doses of 25, 50, 75 and 90% ERD respectively. The level of
      initial injury appeared to influence the proportion of residual injury. For an
      initial injury of 25 and 90% of ERD, the respective residual injury was 74 and
      65% of the initial damage; for an initial injury of 50 and 75% ERD, the residual
      injury decreased to 59 and 57% respectively. It is concluded that there was
      significant long-term recovery in the rat spinal cord, and that the level of
      initial radiation damage influenced both the retreatment tolerance and the time
      to expression of injury.

PMID- 8465014
TI  - Neutron capture imaging of 10B in tissue specimens.
AB  - Boron Neutron Capture Therapy (BNCT) is an attractive concept for radiation
      treatment of malignant tumours. The patients receive a 10B-carrying compound with
      selective uptake in tumour cells, after which they are irradiated with epithermal
      neutrons. Theoretically, the tumour cells are killed by the high-LET particles
      produces in 10B(n, alpha)7Li reactions inside or close to the cell nucleus, while
      healthy brain cells with no boron uptake will be spared. In practice, a
      successful BNCT depends on the actual boron-distribution in the tissue, and
      consequently a new boron-compound aimed for BNCT must undergo detailed bio
      distribution studies before clinical trials. In experimental work there is
      accordingly a great need for methods for quantitative bio-distribution
      measurements in tissue samples. In this paper we present an improved technique
      for neutron activated autoradiography providing quantitative boron images of
      freeze-sectioned tissue specimens from highly malignant rat brain gliomas.
      Particular attention has been paid to the correlation with the morphology of the
      specimens and to the altered self-absorption properties due to freeze-drying. A
      self-absorption correction factor for tumour tissue has been experimentally
      determined.

PMID- 8465015
TI  - Treatment charts in radiation therapy. An analysis of European treatment records.
AB  - The radiotherapy treatment chart (dose prescription, set-up parameters, dose
      computation and daily dose recording form) represents an important working tool
      in radiotherapy, not only as a compilation of data, but also as a method of
      communication among physicians, physicists and technicians. In addition to
      administrative and medical data, physical and simulation data that are
      indispensable for the daily accurate reproduction of the therapy procedures
      should be recorded, as well as accurate daily entries of the fractional and
      cumulative absorbed doses. Moreover, any radiation therapy quality assurance
      programme must rely on the accessibility of the radiation treatment history and a
      correct record of the therapy protocol in order to be verifiable. We have
      analysed the treatment charts of 92 European Departments of Radiation Oncology,
      with the aim of identifying their salient characteristics and data recorded. The
      study shows strong differences among the charts analysed, not only in the amount
      of information recorded, but also in the kind of data and concepts used.

PMID- 8465016
TI  - Clinical thermoluminescence dosimetry: how do expectations and results compare?
AB  - Thermoluminescence dosimetry (TLD) for radiotherapy treatment verification is
      performed in the Prince of Wales Hospital in Sydney for a wide range of
      applications: (A) to determine the dose in difficult treatment geometries, (B) to
      record the dose to critical organs, and (C) to monitor special treatments such as
      total body irradiation (TBI). TLD measurements were performed with the aim to
      investigate cases where dose prediction is difficult and not as part of a routine
      verification procedure. We reviewed 1058 reports of TLD performed during the
      treatment of 502 patients between 1986 and 1991 to evaluate how the TLD results
      compare with the dose determined by the treatment plan. Reasons for possible
      discrepancies should be identified. In 19% of all investigated cases a
      discrepancy of more than 10% was found between expected and measured doses. The
      discrepancies could be divided into three groups: (1) errors made in the TLD
      determination or evaluation, such as placement errors of the TLD chips (21% of
      all discrepancies); (2) mistakes made during the patient set-up, such as
      insufficient shielding or inadequate patient immobilisation (30%); (3) inadequate
      treatment planning and dose calculation procedure, such as wrong inverse square
      law corrections or errors due to limitations of the two-dimensional treatment
      planning system used (41% of all). In 8% of all discrepancies the reason remained
      unclear. A number of changes to treatment plans and modalities (e.g. changed
      scrotal shield, modified bolus) were introduced due to TLD results. The
      increasing number of TLD requests per year attests to the value of TLD as a
      treatment verification method in clinical practice.

PMID- 8465017
TI  - Time trend of patient setup deviations during pelvic irradiation using electronic
      portal imaging.
AB  - An electronic portal imaging device (EPID) was used to detect patient setup
      displacement during the course of a 3-field pelvic irradiation of two groups of
      patients: 10 rectal and 10 prostate carcinomas. These patients were irradiated
      with conventional treatment techniques in routine clinical practice. A total of
      469 portal images and 60 simulator films were used to determine the values of
      setup deviations in the X- Y- and Z-directions of a fixed coordinate system,
      corresponding to the medio-lateral, cranio-caudal and antero-posterior direction,
      respectively. The absolute displacement averaged over all setups and patients
      ranged between 0.4 mm and 1.4 mm with a standard deviation (S.D.) of 1.6-3.9 mm.
      The overall distribution along each direction could be separated into a
      distribution of random deviations (S.D.s ranging from 1.2 to 2.8 mm) around the
      mean deviation of each patient and a distribution of the means themselves: the
      distribution of systematic deviations (S.D.s ranging from 1.0 to 2.6 mm).
      Significant gradual displacement as a function of time was detected in 5 out of
      the 20 patients, 2 in the rectum and 3 in the prostate group. This "time trend"
      was found along each of the 3 directions specified. The magnitude of the time
      dependent displacement throughout the course of treatment ranged between 4 and 11
      mm. It can be concluded that for treatments requiring a high level of precision,
      portal images should be made and analyzed during the whole treatment course in
      order to detect and correct significant time trends.

PMID- 8465018
TI  - Sizes and sources of field placement error in routine irradiation for prostate
      cancer.
AB  - Discrepancies between prescribed and treated field edges have been measured from
      76 film pairs taken on 29 patients being treated for prostate cancer. The
      distribution of field edge discrepancies is described by a standard deviation of
      4.5 mm and has an average absolute value of 3.5 mm. The observed discrepancies
      are shown to be attributable to field position errors and hence, in principle,
      are easily rectifiable.

PMID- 8465019
TI  - Suppressive effect of low dose total body irradiation on lung metastasis: dose
      dependency and effective period.
AB  - The dose dependency and effective period of suppressive effects by low dose total
      body irradiation (TBI) in both artificial and spontaneous lung metastasis were
      investigated using murine squamous cell carcinoma. In the artificial lung
      metastasis of the tumour cells injected through a tail vein, the TBI of 0.15-0.20
      Gy resulted in significant net suppression of lung colony formation. With this
      dose range, the effective period lasted for 12 h ranging from 9 h before to 3 h
      after the tumour cell injection. Similar suppressive effect was also observed in
      the spontaneous lung metastasis. These data suggest that careful assessment of
      effective dose and duration of low dose TBI on human metastasis could provide a
      new therapy to suppress clinical metastasis.

PMID- 8465020
TI  - Total body irradiation in Hodgkin's disease.

PMID- 8465021
TI  - Combined modality therapy in high dose radioneurosurgery.

PMID- 8465022
TI  - A trial of Ro 03-8799 (pimonidazole) in carcinoma of the uterine cervix: an
      interim report from the Medical Research Council Working Party on advanced
      carcinoma of the cervix.
AB  - A randomised controlled clinical trial of Ro 03-8799 (pimonidazole) was performed
      in advanced stage II and stage III squamous cell carcinoma of the uterine cervix.
      A total of 183 patients were contributed by 15 centres in Western Europe and
      coordinated by the Medical Research Council Trials Office in Cambridge. Analysis
      has shown poorer local tumour control with a hazard ratio (HR) of 2.1 [95%
      confidence interval (CI) 1.2 to 3.7] and survival with a HR of 1.6 (95% CI 1.0 to
      2.5) in the group given the Ro 03-8799. These results were not materially
      affected after adjustment of stage or haemoglobin levels in stratified analysis
      or to inadequate radiotherapy being given to the sensitiser group. A true adverse
      effect caused by the drug is a possible cause and this might be related to a drug
      induced impairment of blood supply to the tumour. When compared with results
      recorded previously for advanced cervical carcinoma treated by radiotherapy, it
      was apparent that the tumour control and survival in the sensitiser arm was
      similar, but the control arm showed results superior to those previously
      recorded. Whatever is the explantation it can certainly be concluded that the
      radiosensitising drug, pimonidazole, gave no benefit in the radiotherapy of
      advanced cervical cancer.

PMID- 8465023
TI  - [Day-night differences of arterial pressure in "white coat" arterial
      hypertension].
AB  - Prevalence and day-night differences of blood pressure (BP) are studied in "White
      Coat" Hypertension (AHT). An outpatient register of BP was performed during 24
      hours in 95 patients with mild AHT. "White Coat" Hypertension was defined when
      diastolic BP during the day was below 90 mmHg (WCH group) and with no "White
      Coat" Hypertension (non-WCH) when it was over said figure. BP values for WCH
      group (n = 36) in comparison with non-WCH (n = 59) were: Day period 130 +/- 13/85
      +/- 4 versus 143 +/- 14/99 +/- 7 mmHg (p < 0.001; p < 0.001). Night period 119 +/
      18/74 +/- 8 versus 127 +/- 15/84 +/- 8 mmHg (p < 0.05/p < 0.001). Day-night
      differences in BP were lower in WCH in comparison with non-WCH group: 11 +/- 9/11
      +/- 8 versus 17 +/- 10/15 +/- 7 mmHg (p < 0.01; p < 0.01). A positive correlation
      was observed between BP variability in 24 hours and day-night difference in non
      WCH group (Systolic BP: r = 0.512, p < 0.001; Diastolic BP: r = 0.676, p <
      0.001). This correlation was not found in the WCH group. "White Coat"
      Hypertension is present in 38% of the subjects with mild AHT and could constitute
      an independent aspect of the alert reaction.

PMID- 8465024
TI  - [Clinical diagnosis of Biswanger's disease].
AB  - Fifty patients with periventricular hypodense lesions in cerebral CAT
      (leucoaraiosis) were included in a prospective study. All of them were
      intensively evaluated considering both the clinical and neuropsychological
      aspects. Fifteen of these patients were diagnosed of dementia following the
      criteria proposed by Bennett et al for Binswanger's disease. The group of
      patients with dementia was compared with the rest of patients with leucoaraiosis
      from the radiological, semiological and neuropsychological aspects; the incidence
      of vascular risk factors and the score obtained in the Ischemic Scale were also
      compared. We found that the patients with dementia have, in the CAT study, more
      severe periventricular lesions than the rest of patients. We have not found any
      significative differences in the incidence of vascular risk factors. Deambulation
      disorders, constructive apraxia and visual-perceptive disorders were the symptoms
      more strongly related with dementia, even tough only the latter two showed this
      relationship in the statistical multivariant analysis. Differences in the score
      of test and scales were highly significant. We think that Bennett's criteria are
      of great value for the clinical diagnosis of Binswanger's disease.

PMID- 8465025
TI  - [Comparative study of pneumococcal bacteremia in patients with and without HIV
      infection].
AB  - A retrospective study of bacteriemias due to S. pneumoniae in adults is
      performed, from all the cases observed in our hospital during the 1989-1990
      period. We compare the clinical characteristics of the disease depending if the
      affected patients were infected or not by the human immunodeficiency virus (HIV).
      In the considered period bacteriemia due to S. pneumoniae has been diagnosed in
      12 patients with HIV infection and 29 without it. Ten of the twelve patients with
      HIV infection (83.3%) were in Stage IV (CDC) of the disease, staying the rest in
      a less developed phase of the disease. Age was significantly higher in non-HIV
      patients (p < 0.001) and a high percentage of patients in this group (75%) showed
      some disease considered as predisposing to bacteriemia due to S. pneumoniae. When
      a respiratory foci was present, VIH positive individuals showed more frequently
      bilateral radiologic infiltrates and less frequently pleural effusion. Leucocyte
      count when diagnosis was done were significantly higher in non-HIV group.
      Sensibility of isolated S. pneumoniae was similar in the two groups, being the
      immediate mortality related with bacteriemia due to S. pneumoniae higher in the
      non-HIV group. In our center 29.3% of bacteriemias due to S. pneumoniae are
      diagnosed in patients with HIV infection. This disease in itself could constitute
      an added risk factor in the development of bacteriemia due to S. pneumoniae.

PMID- 8465026
TI  - [Cardial adenocarcinoma following sclerotherapy of esophageal varices:
      presentation of a case and review of the literature].
AB  - The case of a patient with a diagnosis of chronic alcoholic hepatopathy is
      discussed. This patient developed an adenocarcinoma of the esophageal-gastric
      union after several sessions of sclerotherapy indicated to treat hemorrhage of
      esophageal varices. Similar cases published until now are reviewed.

PMID- 8465027
TI  - [Psittacosis of avian origin as etiology of community-acquired pneumonia with
      severe onset].
AB  - We present two cases of community acquired pneumonia (extra-hospital) of severe
      onset, secondary to Chlamydia psittaci of avian origin. Each patient have bought
      a parakeet in the same pet-shop, and took care of them personally. Both developed
      a respiratory insufficiency, one of them needing mechanical ventilation. Out of
      nine relatives to whom serological determinations were performed, there was
      evidence of infection in two of them, but only one referred an auto-limited
      febrile syndrome during that period of time. Psittacosis incidence is discussed
      as origin of community acquired pneumonias, as well as its epidemiology,
      diagnosis and treatment.

PMID- 8465028
TI  - [White coat hypertension: a debatable issue].

PMID- 8465030
TI  - [Mediastinal cystic mass].

PMID- 8465029
TI  - [Angiotensin-converting enzyme inhibitors: effects on renal physiology and
      applications in hypertension and renal disease].

PMID- 8465031
TI  - [Diet and cardiovascular disease].

PMID- 8465032
TI  - [Malignant neuroleptic syndrome treated with bromocriptine].

PMID- 8465033
TI  - [Anaphylactic shock caused by spontaneous rupture of hepatic hydatid cyst into
      inferior vena cava].

PMID- 8465034
TI  - [Late seroconversion in Legionella pneumophila pneumonia].

PMID- 8465035
TI  - [Pulmonary cavitations caused by Pneumocystis carinii in an HIV+ patient].

PMID- 8465036
TI  - [Guillain-Barre syndrome as initial manifestation of human immunodeficiency virus
      infection].

PMID- 8465037
TI  - [Organic or functional? Diagnoses not necessarily exclusive. Report of a patient
      with vomits].

PMID- 8465038
TI  - [Mediastinal benign teratoma. Report of a case].

PMID- 8465039
TI  - [Idiopathic polyneuritis and IgA monoclonal gammapathy].

PMID- 8465040
TI  - [Dehydroepiandrosterone sulfate and testosterone in acute myocardial infarction].

PMID- 8465041
TI  - [Ventricular tachycardia in myotonic dystrophy].

PMID- 8465042
TI  - [Effectiveness of endoscopic sclerotherapy in the treatment of bleeding
      esophageal varices].
AB  - 92 patients to whom urgent endoscopy and sclerotherapy of esophageal varices was
      performed are studied retrospectively. After the bleeding episode, elective
      sclerosis sessions were performed to eradicate varices, to prevent hemorrhagic
      complications and post-sclerotic stenosis somatostatin, H2 antagonists and
      sucralfate were administered. The Total number of sessions was 331, with a mean
      of 3.6 per patient (range 1-10). Immediate hemostasis was achieved in 93% of
      patients, with an early relapse in 10.4% of them. Hemorrhagic relapse two years
      following therapy was 35.8%. Mortality was 41%; 8% of the decreased patients
      belonged to Child's A functional grade, 24% belonged to B; and 68% to C. There
      was a 44% of complications, but only one death was due to the technique. No
      patient developed symptomatic stenosis neither hemorrhage secondary to esophageal
      ulceration. We conclude that endoscopic sclerotherapy is one of the principal
      therapeutic options in the hemorrhage due to esophageal varices, although new
      studies are necessary to define the role of somatostatin and H2 antagonists in
      the prophylaxis of complications.

PMID- 8465043
TI  - [The study of zinc in osteonecrosis].
AB  - Plasmatic, urinary and intra-erythrocytic zinc levels did not modify in patients
      with head of femur aseptic osteonecrosis (HFAO), except for those patients with
      raised alkaline phosphatase who showed a diminution in zinc plasmatic levels,
      being found a negative correlation between plasmatic zinc levels and a raise in
      serum alkaline phosphatase. A raise on the latter would mean a raise on the
      osteoblastic activity in a repair intent from the bone of the small trabecular
      fractures and/or of the necrotic zone which is produced in HFAO. These results
      show the relationship of zinc with the increase on bone metabolic activity in
      patients with HFAO, but the scarce previous references force to study them in
      depth.

PMID- 8465044
TI  - [The cut-off points used in chemiluminescent probes for the identification of
      mycobacteria].
AB  - 441 strain of mycobacteria were exposed to probes marked with luminous material
      belonged to M. tuberculosis complex and M. avium complex. We analyzed the
      following points: 1. If the cut-off points obtained with our strains were in
      accordance to those recommended by the manufacturer, using two different
      luminometers. 2. If the correlation constant makes possible the conversion of the
      units form one luminometer to the units obtained with the other one. 3. Data for
      sensibility, specificity and predictive positive and negative values using
      different cut-off points. Cut-off points were different in all cases except for
      the data obtained with one luminometer using a probe belonged to M. tuberculosis
      complex. In this case the correlation constant could not be used. In contrast,
      whichever the luminometer employed was, we found no significant differences
      between sensibility, specificity and predictive values.

PMID- 8465045
TI  - [Infections in the postoperative period of a liver transplant. A comparison of 2
      protocols for anti-infectious prophylaxis].
AB  - We discuss the incidence of infection in 198 liver transplants during the
      immediate post-surgical period. All of them were treated with protocols with anti
      infective prophylaxis, and have been divided in two groups regarding the
      antibiotic scheme used, in the second of said groups we have included parenteral
      vancomycin. Global incidence of infection was different for both groups (46.9% in
      group A and 15.3% in group B) (p < 0.01). We stress that the most frequent germ
      found in the cultures of the group without vancomycin was Staphylococcus aureus,
      with a great difference between groups (p < 0.01); global incidence of pneumonias
      was also different between both groups (p < 0.05). After the introduction of
      vancomycin in the second group the most frequent found germ was Candida but with
      a low percentage. Gram-negative germs appear preferably in both groups when
      hospital stay was over 10 days. It is important to stress that transplanted
      patients who did not show rejection got significantly lesser infected (p < 0.05)
      than patients who shown rejection. We think that parenteral prophylaxis with
      ceftazidime and vancomycin, associated with oral-rhino-gastric decontamination,
      is useful for the control of early infections in patients with liver transplant.

PMID- 8465046
TI  - [Salmonellosis and ulcerative colitis. A case report and review of the
      literature].
AB  - A propos of a case of intestinal infection due to Salmonella non typhi in a
      patient with ulcerative colitis, we have reviewed the disease and, therefore ran
      a search through the scientific literature in which we have found 16 cases of
      ulcerative colitis diagnosed in a clinical setting which began as an
      enterocolitis due to Salmonella. Bacteriological studies, clinical evolution and
      response to treatment, normally allow to differentiate between the two clinical
      entities. Colitis due to Salmonella and ulcerative colitis can coexist in the
      same patient. Duration of the clinical manifestations oven four weeks, previous
      history of diarrhea with blood, the sudden worsening of a mild prolonged
      diarrhea, non-response to specific antibiotic treatment and fast response to
      therapy with corticoids of a diarrhea positive isolation of Salmonella in stools,
      should make us immediately think in the coexistence of a subjacent ulcerative
      colitis. Treatment with steroids always must be associated with systemic
      antibiotics if Salmonella has been isolated just before or during their
      administration.

PMID- 8465047
TI  - [Psoas abscess. The diagnostic and therapeutic considerations in 5 patients].
AB  - Five cases of psoas abscesses are discussed, four pyogenes and one tuberculous,
      the current etiology of this process, together with its pathogenesis and clinical
      manifestations are discussed. In all of them the guided punction through
      Computerized Axial Tomography (CAT) has been the way to diagnose and treat the
      process. Utility of this technique considering both aspects is discussed because
      it allows to determine the etiology and avoids the surgical drainage; even tough
      this therapy should be individualized in each case, probably is in primary
      staphylococci abscesses where this therapeutic option is best indicated.

PMID- 8465048
TI  - [A toxic syndrome and subcutaneous nodules as the only clinical manifestation of
      systemic sarcoidosis].
AB  - Sarcoidosis is a systemic disease with frequent cutaneous manifestations. Among
      these exists a predominance of the so-called unspecific lesions because of their
      histopathological features. Within the specific lesions, that is those which
      showed non-caseous granulomas, subcutaneous nodules are underlined, which have
      been associated with chronic sarcoidosis with a frequency of 1.4%-6%. These
      lesions appear during the evolution of the disease but rarely constitute an
      initial manifestation of it. The patient whose case is discussed had a debut with
      toxic syndrome and subcutaneous nodules. Histopathological study of these nodules
      showed the existence of non caseous granulomas formed by histiocytes, epithelioid
      cells, Langhans and foreign body giant cells. Lobulet hepatic granulomas were
      showed together with mediastinal pulmonary captation of gallium. We conclude that
      sarcoidosis must be considered when performing the differential diagnosis of the
      disease which debut with subcutaneous nodules.

PMID- 8465049
TI  - [An analysis of drug advertising in non-specialty medical journals].
AB  - It has been evaluated drug advertisement in four medical journals during 1989. A
      questionnaire allows us to evaluate pharmacological and advertising data. The
      main results obtained are the following: amoxicillin + clavulanic acid was the
      more advertising drug; the ratio publicity/pharmacological information was 3:1;
      60% of the advertising products were new drugs, and only a 6% were essentials
      drugs according to WHO; slogans were acceptable; generally, aspects such as
      dosage and toxicology are referred. However, it is necessary to improve
      information about drug use in elderly patients, patients with impaired renal
      functional, as well as the necessary information in adverse drug reactions.

PMID- 8465050
TI  - [Retroperitoneal hematoma: a computed tomographic study].

PMID- 8465051
TI  - [The Sandostatin treatment of digestive carcinoid tumors].

PMID- 8465052
TI  - [Spontaneous bacterial peritonitis in systemic lupus erythematosus].

PMID- 8465053
TI  - [Toxic hepatitis due to fosfosal].

PMID- 8465054
TI  - [Dermatomyositis in a patient with 2 neoplasms].

PMID- 8465055
TI  - [Hysteria: the diagnostic error problem].

PMID- 8465056
TI  - [Tuberculous pericarditis as the first manifestation of AIDS. The indication for
      diagnostic pericardiocentesis].

PMID- 8465057
TI  - [Sneddon's syndrome: apropos a case].

PMID- 8465058
TI  - [A pulmonary abscess due to Rhodococcus equi in an AIDS patient].

PMID- 8465059
TI  - [Superior mesenteric vein thrombosis and the primary antiphospholipid syndrome].

PMID- 8465060
TI  - [Familial hypercalciuric hypercalcemia. A family study].

PMID- 8465061
TI  - [Working conditions of nurses at public hospitals 1980 to 1990].
AB  - The 1988 and 1991 strikes among nurses were motivated by claims concerning the
      status of the nursing profession, wages and working conditions. A study of
      working conditions was carried out from two samples: 1) a cohort of nurses (N =
      571) recruited in 7 hospitals and followed up in 1980 (follow up rate: 85%) and
      in 1990 (follow up rate: 69%); 2) a sample of nurses who began to work in the
      same settings between 1985 and 1989 (N = 108). The results indicate no
      improvement in the organisation of shiftwork on the 10 years period. Working
      conditions deteriorated during the last 5 years. These findings are discussed in
      the light of the global evolution of hospital and of the specific problems of the
      nursing profession.

PMID- 8465062
TI  - [Cost-benefit analysis of prenatal screening for trisomy 21 through analysis of
      HCG in maternal blood].
AB  - Introduction of maternal serum markers for prenatal screening of Down's syndrome
      implies a redefinition of the criteria used for identifying at risk women for
      screening by amniocentesis, which are currently based on maternal age. On the
      basis of the first French prospective study of human chorionic gonadotropin
      measurement in maternal serum as a predictor of Down's syndrome, this paper shows
      that a screening policy combining maternal age with hCG measurement was more cost
      effective than one relying on maternal age alone. A cost-benefit analysis (using
      the "avoided" lifelong costs of care for a trisomic 21 child that are allowed by
      prenatal screening) would justify lower hCG cut-off values and an higher
      detection rate of Down's syndrome (74.5%) than other decision rules based on
      alternative principles such as: equalization to 1% of fetal risk of Down's
      syndrome for access to amniocentesis at all maternal ages or equalization to
      1/1000 of fetal risk of Down's syndrome among women not undergoing amniocentesis.
      However, results of the cost-benefit analysis are very sensitive to other factors
      such as the cost associated with loss of a normal fetus due to iatrogenic risk of
      amniocentesis (false positives of hCG). Ethical and value-laden issues that
      necessarily underlie economic evaluation of screening programmes, as well as
      other decision rules based on equalization of acceptable risk for each maternal
      age, are discussed.

PMID- 8465063
TI  - [Urban atmospheric pollution and mortality: analysis of epidemiological studies
      published between 1980 and 1991].
AB  - This paper analyses 14 epidemiologic investigations (published from January 1980
      to September 1991) about the relationship between urban air pollution and
      mortality. Air pollution indicators and mortality indicators are examined.
      Methods to analyse the relationships between these two kinds of indicators are
      classified according as they bring "qualitative information" trying to answer the
      question: "is there any relationship between air pollution and mortality?" or
      according as they try to quantify this relationship. Results are presented by
      author. Confounding factors and means to take them into account are described.
      This paper ends by a discussion about interest and limits of these studies. It
      emphasizes the importance of the collaboration between metrologists of urban air
      pollution and epidemiologists.

PMID- 8465064
TI  - [Prevalence of severe mental retardation and trisomy 21 in 3 generations: 1972,
      1976, and 1981].
AB  - With the aim of studying whether improved prenatal and perinatal care would lead
      to a decrease in the prevalence of severe mental retardation and/or in Down
      syndrome, handicapped children born in 1972, 1976 and 1981 and residing in 14
      French "departements" were systematically registered in 1985-86 and 1989 in
      collaboration with the "Commissions Departementales de l'Education Speciale"
      (CDES), which centralizes requests for specialty services. The findings showed a
      stable rates of Down's Syndrome (0.7 p. 1000 in 1972, 0.8 p. 1000 in 1976 and 0.9
      p. 1000 in 1981) and of severe mental retardation (1.6 p. 1000 in 1972, 1.5 p.
      1000 in 1976 and 1.6 p. 1000 in 1981) in the three generations among children
      below the age of 9 years. The survey shows that implementation of perinatal
      health care programs starting in the 1970s, had not been followed by a decrease
      of severe mental retardation prevalence or Down syndrome prevalence across the
      three generations 1972, 1976 and 1981.

PMID- 8465065
TI  - Determinants of estrogen replacement therapy use in northern Italy.
AB  - Socio-demographic characteristics, general lifestyle habits and menstrual and
      reproductive history were compared in 83 women aged 45 years or more who had at
      some time used estrogen replacement therapy (ERT) and 1759 never users
      interviewed as control subjects in the framework of a large case-control survey
      on risk factors for gynecological neoplasms conducted in Northern Italy. ERT use
      was strongly related to social class and level of education. The odds ratio of
      "ever" use was 3.0 (95% confidence interval, CI, 1.8-5.1) for women with 12 or
      more years of education, compared with those with less than 7 years. No
      relationship emerged between marital status and ERT use, but parous women tended
      to be less frequently ever users than nulliparous, and ERT use decreased with
      increasing number of births (chi 2 1 trend = 10.51, p. = 0.001). Post-menopausal
      women reported more frequent ERT use than peri-menopausal ones, and among post
      menopausal subjects the use was more frequent in those reporting earlier age at
      menopausal (chi 2 1 trend = 5.33, p = 0.02). There was no association between
      smoking habits and ERT use, but Quetelet's index was inversely related to the use
      of ERT.

PMID- 8465066
TI  - Number of sexual partners and age at first intercourse in subsequent generations
      of Italian males and females.
AB  - Trends in the number of sexual partners and in age at first intercourse were
      analyzed using data on 706 men and 1206 women drawn from the hospital control
      groups of two case-control studies conducted since 1981 in Northern Italy. The
      overall lifelong mean number of sexual partners was 7.5 +/- 12.8 for men and 1.4
      +/- 1.8 for females. The mean number of sexual partners was 6.0 for men born
      between 1910 and 1919, and 7.3, 9.0, 6.3 and 5.5 for subsequent 10 year birth
      cohorts. Mean age at first intercourse was 20.7 for the cohort born in 1910-19
      and was fairly stable in men born after 1919, ranging from 18.4 to 18.8. Women
      had a substantially lower number of sexual partners than men in each subsequent
      birth cohort. However, the mean number of sexual partners increased from 1.1 in
      the 1910-19 cohort to 1.2, 1.2, 1.4 and 2.3 in subsequent birth cohorts, and the
      mean age at first intercourse decreased from 23.6 years to 23.1, 22.7, 21.3 and
      19.7. These figures should be considered with caution, on account of the non
      representativeness of the sample and of a possible under-reporting of number of
      partners by women. Still, Italian women, although not necessarily men, report
      substantially fewer sexual partners than northern European on American ones.

PMID- 8465067
TI  - [Evaluation of quality of life: construction of a scale].
AB  - Research in public health has recently tended to take a more global perspective
      when considering the individual patient. In addition to a measure of functional
      status, the integration of the disease into the daily life of the individual, or
      his quality of life is what is being evaluated. This concept, while relatively
      recent (10-15 yrs), is the result, in part, of changes in the diagnosis and
      treatment of patients, particularly those with chronic and severe diseases. In
      clinical trials, what is sought is a measurement of change in the level of well
      being during the evolution of an illness or of the different levels that exist
      between two groups. The validation of a scale of this type requires both a
      qualitative and a quantitative phase with attention being paid to the
      methodological issues in scale development Specific statistical techniques are
      used to modify evolving versions. The adaptation of an existing scale into
      another language requires a rigorous qualitative phase before the quantitative
      phase is begun.

PMID- 8465068
TI  - [Inter-rater agreement of a functional analytical measure of the upper limb].
AB  - The determination and the follow-up of a patient having an upper limb lesion need
      a functional assessment instrument. This study examined the inter-rater
      agreements of the "400 points Measure", between two occupational therapists and a
      physiotherapist. One occupational therapist only had already used this
      instrument. The others raters received preliminary training with an audio-visual
      projection. The scale included four tests with 57 activities: (E1) Functions of
      the hand and fingers, (E2) Prehension strengths, (E3) Handling and displacement
      of things, and (E4) Functions with both hands. The study population consisted of
      85 patients of a rehabilitation centre. Inter-rater agreements were quite good
      for E1 and E3, but they were not as good for E4, that included several functions
      of both limbs. For E1, the physiotherapist rated slightly but significantly
      different from the other raters. For E3 and E4, the occupational therapist having
      used the scale, rated lower than the other raters; but the difference was small.
      For E1, the physiotherapist rated higher than the two occupational therapists for
      the elderly. A discussion with the raters and a new trying showed that the
      differences will be small when the above training is completed by a short
      training about the standard gestures and the detection of the abnormalities.

PMID- 8465069
TI  - Case-control study of fibrocystic breast disease.
AB  - An epidemiological case-control study of FBD has been conducted to evaluate the
      differences observed between cases and controls in relation to the presence or
      absence of clinical findings and risk factors for fibrocystic breast disease
      (FBD). A total of 334 patients with FBD were identified among 6,232 women aged 40
      59 who had participated in the National Breast Screening Study in Montreal while
      340 age-matched controls were selected at random from the same cohort. All women
      were interviewed by a well trained nurse. Controls were significantly heavier and
      had a higher body mass index (BMI) than cases; however, cases had longer school
      attendance than controls. The menstrual cycle was shorter in cases and the number
      of pregnancies was greater in controls. Significant odds ratios were observed for
      BMI (O.R. = 0.72, 95% CI = 0.51 - 1.02) suggesting that a higher value of BMI had
      a rather protective effect; a similar pattern was observed in women using oral
      contraceptives. Since nodularity was strongly associated with FBD, it was
      excluded from a model of logistic regression; in this instance, longer school
      attendance (> 12 years), older age at menopause (> 45 years) and breast pain were
      significantly associated with an increased risk of FBD.

PMID- 8465070
TI  - [Mortality of cerebral infarction with auricular fibrillation. Results of a
      population study].
AB  - To evaluate the relationship between atrial fibrillation (AF) and mortality of
      the cerebral infarction, we have studied in a population survey, 540 cerebral
      infarctions, whose 162 were with AF (30%) and 378 without AF (70%). The group
      with AF differs significantly from that without AF, by the higher frequency of
      women (62% versus 35%), older subjects (75.4 +/- 10.2 years old versus 69.1 +/-
      9.7 years old), a severe loss of consciousness, a more frequent subcortical
      infarction on CT-Scan. During a period of 24 months, 139 patients died, 64 among
      the 162 patients with AF (40%), 75 among the 378 patients without AF (20%). Rates
      of death are different in the 2 groups with, in the group with AF, at 1, 6, 18
      and 24 months a rate of 20, 24, 37 and 40 percent. To the opposite, in the group
      without AF, the rates are 8, 12, 16 and 20 percent. The authors try to research
      the factors that may explain the mortality linked to AF, and they insist on the
      necessity to look for AF on admission for a stroke, to identify a subgroup of
      stroke patients with a high risk of death.

PMID- 8465071
TI  - [HIV seroprevalence in pregnant women: knowledge of women of the tests used].

PMID- 8465072
TI  - [Anesthetic immunopharmacology?].

PMID- 8465073
TI  - [Utilization of veno-venous bypass in orthotopic liver transplantation].
AB  - BACKGROUND:  AIMS: The aim of the present study was to evaluate the hemodynamic
      effects of venovenous bypass (VVB) and its possible protective action during the
      clamping of the hepatic vessels carried out in the anhepatic phase of the
      orthotopic liver transplantation. PATIENTS AND METHODS: Forty-one liver
      transplant patients, 15 of whom were operated with VVB, were studied. VVB
      consisted of a bridge from the primitive iliac veins and the portal vein to the
      left axillary vein. The hemodynamic, metabolic and biologic variables as well as
      the components of reposition and the drugs administered were measured. The
      results obtained in both groups were statistically compared and analyzed.
      RESULTS: During the anhepatic phase the values of cardiac output did not modify
      in the patients operated with VVB, while these values significantly decreased in
      other patients. Peripheral resistances increased less in the VVB group. During
      the reperfusion phase there were no significant differences between the
      hemodynamic parameters of either group. The decrease in temperature during the
      anhepatic phase was significantly greater in the VVB group. CONCLUSIONS:
      Venovenous bypass offers greater hemodynamic stability during the anhepatic phase
      of orthotopic liver transplantation.

PMID- 8465074
TI  - [Intrapulmonary short-circuit during coronary or aortic valve heart surgery].
AB  - BACKGROUND: The alterations in gas exchange during cardiac surgery was studied by
      the measurement of the perioperative intrapulmonary shunt. PATIENTS AND METHODS:
      Forty patients divided into two groups were studied. Group 1 consisted of 20
      patients undergoing myocardial vascularization and group 2 consisted of 20
      patients undergoing aortic valve replacement. The anesthetic technique was
      similar in both groups but the patients in group 1 received a continuous
      perfusion of nitroglycerin from the beginning of surgery plus a bolus of
      intranasal nifedipine 30 minutes prior to the exit of extracorporeal circulation.
      The measurement of the shunt was performed 5 times: following the induction of
      anesthesia, prior to and after extracorporeal circulation, upon termination of
      surgery and one hour following admission to the ICU. RESULTS: In both groups an
      increase of the shunt was produced at the end of extracorporeal circulation which
      later returned to basal levels. The increase was greater in patients of group 1
      during the different phases of surgery although significant differences only
      existed at the beginning and end of extracorporeal circulation. The variations of
      the shunt were not related with the state of preoperative pulmonary function or
      with the duration of extracorporeal circulation. CONCLUSIONS: Although
      intrapulmonary shunt increases during cardiac surgery, especially coronary, its
      clinical transcendence is nul and no special measures are required.

PMID- 8465075
TI  - [The contribution of "La Espana Medica" (1856-1866) to the introduction of
      anesthesiology in Spain].
AB  - The aim of this study was to analyse the contribution of "La Espana Medica "
      (1856-1866) to the introduction of anesthesiology in Spain. Thirty-seven articles
      on anesthesiology were published, with 19 articles (51.35%) being originals from
      spanish authors and 18 (48.64%) from abroad. By means of this medical newspaper
      from Madrid, Spanish physicians received information concerning the latest
      changes in anesthesiology with special emphasis on the introduction of amylene.

PMID- 8465076
TI  - [Anesthesia in a case of hyperkalemic familial periodic paralysis].
AB  - Periodic familial hyperpotassemic paralysis is a dominant autosomic disease of
      brief periods of acute flaccid paralysis with complete posterior recovery. During
      surgical-anesthesia a number of factors concur which may trigger a paralytic
      episode. To this effect anesthetic drugs such as barbiturates and muscle
      relaxants have been involved. The case of a 12 year old patient with familial
      hyperpotassemic paralysis who received general anesthesia with propofol and
      atracurium besylate for emergency appendectomy is presented. During surgery the
      plasma levels of potassium were monitored and prophylaxis of the factors which
      potentially trigger a paralytic picture was performed. Both, the perioperative
      and the postoperative period, were without complications.

PMID- 8465078
TI  - [Presentation of 2 cases of neuromuscular excitation associated with propofol].
AB  - The cases of two patients who received peridural and intradural anesthesia and
      propofol as sedation are presented. In one case generalized tonic and clonic
      convulsions, and in the other, opisthotonos appeared. Neither patient had
      previous neurologic disease nor, in the context of complications, did other
      causes to explain the same appear except for the possible association with
      propofol to which similar secondary effects have been described.

PMID- 8465077
TI  - [Anesthesia in a case of hereditary angioneurotic edema].
AB  - The case of a 51 year old woman diagnosed with hereditary angioneurotic edema
      (HANE) requiring hospital admission on one occasion is presented. The patient was
      scheduled for abdominal hysterectomy of uterine myomas. Upon presentation to the
      authors, the patient was not under treatment and was asymptomatic. The patient
      was given 1000 units of C1-INH two hours prior to surgery. The operation was
      performed under peridural anesthesia to which no complications were presented.
      Specific treatment included: short term prophylaxis prior to surgery with C1-INH
      or fresh plasma and/or antifibrinolytic and hormonal agents. The authors
      considered that the locoregional techniques are elective to avoid tracheal
      intubation.

PMID- 8465079
TI  - [Dysfunction of the central nervous system in the postoperative period].

PMID- 8465081
TI  - [Accidental subdural block during epidural anesthesia].

PMID- 8465080
TI  - [Peri-thyroidectomy pulmonary edema: various etiopathogenic considerations].

PMID- 8465082
TI  - [Boerhaave syndrome: implications for the anesthesiologist].

PMID- 8465083
TI  - [Hereditary angioneurotic edema: anesthetic considerations].

PMID- 8465084
TI  - [Milrinone, heart surgery, and hyperthyroidism].

PMID- 8465085
TI  - [0.0625% bupivacaine compared with 0.125% bupivacaine continuously perfused
      epidurally during vaginal delivery].
AB  - BACKGROUND: The effects of two continuous epidural perfusions of bupivacaine at
      different small concentrations on maternal analgesia, motor paralysis, the
      progress of delivery and the newborn were compared. PATIENTS AND METHODS: Forty
      primigravida patients were divided into two homogeneous groups, A and B, with 20
      patients in each. Group A patients were administered a perfusion of bupivacaine
      at 0.625% and those of group B received a perfusion of bupivacaine at 0.125%.
      Both perfusions were administered at 10 mg/hour. The following variables were
      collected: analgesia (visual analogic scale), time of perfusion, local anesthetic
      doses, re-injections, tenesmus, APGAR at the first minute, APGAR at 5 minutes,
      use of forceps and motor paralysis. RESULTS: The perfusion of bupivacaine 0.125%
      (group B) was more effective in the control of pain since no re-injections were
      required in this group. The time of perfusion and delivery was significantly less
      (p < 0.05) in group B (2.95 +/- 0.74 hours) than in group A (3.42 +/- 0.62
      hours). There were no significant differences in the total dose (group A: 55.9 +/
      14.09 mg and group B 57.47 +/- 9.06 mg), tenesmus and APGAR: Instrumentation
      during delivery carried out in both groups (55% in group A and 30% in group B)
      was at the limits of significance (p = 0.057). Motor paralysis of the lower limbs
      did not surpass the value of 1 of the modified Bromage scale in either group.
      CONCLUSIONS: Both techniques (continuous perfusion of bupivacaine at 0.0625%
      versus bupivacaine at 0.125%) are effective in the control of pain during the
      second stage of labour with the perfusion of the latter dose (12.5 mg/hour) being
      more advantageous by diminishing the length of delivery and achieving continuous
      analgesia.

PMID- 8465086
TI  - [Is it possible to obtain a reduction of body weight exclusively via a loss in
      fat mass? Experience with d-fenfluramine].
AB  - Aim of the study was to observe if the administration of an anorectic drug, d
      fenfluramine, in addition to hypocaloric diet, could influence the body
      composition and adipose mass distribution during a weight decrease programme in
      17 obese women. Drug's effects plus diet on body weight changes were compared
      with those of a "only-diet programme" in another group of 18 obese subjects, sex
      and age matched. Both groups were observed for a 6-month period. All subjects
      were selected on the base of Index Body Weight % within 120-200 and without any
      therapy for other diseases. Blood samples were drawn before, during (3rd month)
      and after the period of observation for the measurement of OGTT, serum lipids,
      liver and kidney function parameters, blood cells count. Body weight and height,
      body composition, waist-to-hip ratio were also evaluated. Results documented: 1)
      significant reduction of body weight in the group kept on the combined therapy;
      2) significant variation of body composition with increment of fat free mass and
      adipose mass decrease; 3) significant improvement of glucose tolerance, liver and
      kidney function parameters. In conclusion, our data show beneficial effects of d
      fenfluramine on appetite reduction, influencing the carbohydrates assumption and
      the consequent fat mass loss with a good tolerability of the drug.

PMID- 8465087
TI  - [Interferon therapy in liver cirrhosis].
AB  - Ten patients were given 3MU/3 times/week of r-interferon alpha 2b for 4 months;
      six patients were given 1MU/3 times/week for 4 months. The choice of these
      regimes has been based on the number of platelets. Among the patients treated
      with 9MU/week we observed a type I response (alanine-aminotransferases
      normalization) in 40% of cases, a type II (ALT fifty percent reduction) in 40% of
      cases, and a type III (no response) in 20% of cases. Among the patients treated
      with 3MU/week we observed a type II response in 16.7% and a type III in 83.3% of
      cases. Treatment of Child A liver cirrhosis with r-interferon demonstrates to
      rise, therefore, the same percentage of response which are obtained in the
      treatment of chronic active hepatitis, when the same doses are administered
      (9MU/week).

PMID- 8465088
TI  - [Nuclear magnetic resonance in the neurological complications in a case of
      thrombotic thrombocytopenic purpura].

PMID- 8465089
TI  - [Native anti-DNA antibodies and the synovial fluid. A report of a problematic
      clinical case].
AB  - The authors report the unusual case of a 30-years-old woman affected by bilateral
      gonarthritis with anti-ds DNA antibodies at higher level in synovial fluid than
      in serum. This finding, and the presence of an intensive infiltration of
      polyclonal plasma cells in the synovial membrane, studied by biopsy, lead to
      suppose a local production of autoantibodies with a probable pathogenetic role.

PMID- 8465090
TI  - [The clinical picture of anxiety. The problems and prospects].
AB  - Recent studies on anxiety as well as clinical practice submit several questions
      regarding definition and nosography. The role played by the serotonergic system
      with reference to different symptoms is also discussed. The solution of these
      questions has important therapeutical implications.

PMID- 8465091
TI  - [The microcirculatory pathogenetic hypothesis of neoplasm proliferation].

PMID- 8465092
TI  - [The current situation of malaria].

PMID- 8465093
TI  - [Integrated teaching in the new regulations of studies in medicine and surgery].

PMID- 8465094
TI  - Tumor necrosis factor/cachectin in Crohn's disease. Relation of serum
      concentration to disease activity.
AB  - Inflammatory mediators seem to be involved in the pathogenesis of Crohn's
      disease. Tumor necrosis factor is a primary mediator of inflammatory responses
      which causes metabolic effects related to tissue wasting. The aims of this study
      were to establish the presence of tumor necrosis factor in Crohn's disease
      patients, to determine of its serum levels reflect disease activity and to
      examine the relationship if this cytokine with other assessments of the activity
      of the disease. Serum concentration of tumor necrosis factor, measured with a
      biological assay, was significantly raised in 56 Crohn's disease patients (201
      determinations) as compared with 44 controls (P < 0.0001). Patients with inactive
      disease had significantly lower tumor necrosis factor levels (3.58 +/- 0.55
      ng/mL) as compared to patients with active disease (8.17 +/- 1.01 ng/mL). There
      was a significant correlation between serum tumor necrosis factor concentration
      and disease activity (r = 0.237, P < 0.002). Higher tumor necrosis factor levels
      were detected in patients with colonic involvement (ileocolitis and colitis) as
      compared with ileal localizations, and the difference was significant (t = 2.16,
      P < 0.05). Besides, it correlated negatively with albumin, haemoglobin and
      cholesterol.

PMID- 8465096
TI  - [A new way of training physicians at Italian universities. The university tutor:
      a new aspect].

PMID- 8465095
TI  - [Tuberculosis, still an unsolved problem].

PMID- 8465097
TI  - [Differentiating agents in myelodysplastic syndromes. Analysis of personal
      cases].
AB  - The Myelo-Dysplastic Syndromes are a heterogeneous group of diseases which
      includes patients with different prognosis. There is no agreement about the
      management and the therapeutic strategy must be based on many individual
      parameters, particularly the age of the patients and their performance status.
      The therapeutic options range from no cytotoxic therapy for low-risk patients up
      to more aggressive treatment for high-risk patients, with disappointing results
      except for the very few cases eligible for allogenic bone marrow transplantation.
      The leukaemic cell can be induced to differentiate, so losing its self
      maintenance potential; different drugs such as Interferon, vitamin D3, retinoids
      and arabinosyl-cytosine (low doses) have shown a differentiating action on
      myeloid blasts in "vitro". We summarize the general strategy in the treatment of
      myelo-dysplastic syndromes based on literature data, and on our results about the
      efficacy and tolerance of a combination of the above mentioned differentiating
      drugs, in a group of 27 elderly patients affected by myelodysplastic syndrome
      with poor prognosis. We obtained 14 objective responses (52%), and the median
      overall survival of these patients have been compared with that of 25 patients
      with severe myelodysplastic syndrome treated with a conventional regimen. In the
      27 patients receiving the differentiating combination the median survival was
      found to be 14.7 months, versus 8.4 months for the control group. The results
      obtained are encouraging about the tolerance and the efficacy of this combination
      in elderly patients with a poor MDS prognosis. Further randomized studies are
      necessary to establish whether this treatment can really improve the survival in
      this group of patients.

PMID- 8465099
TI  - [Localization of rheumatoid arthritis at the craniocervical junction].

PMID- 8465098
TI  - [Monovascular coronary disease in the pre-angioplasty era].
AB  - Single-vessel coronary disease has been considered so far a benign condition, for
      which the medical therapy may represent the optimal treatment. In order to assess
      the effectiveness of this approach, we studied 323 patients who had come to our
      attention for ischemic heart disease and resulted affected by single-vessel
      coronary artery disease. From our data it appears that single-vessel coronary
      artery disease is frequently associated with myocardial infarction and post
      infarction aneurysm. Coronary angiography indicated that left anterior descending
      coronary artery is the most frequently affected vessel, and that its involvement
      is often associated with lethal outcome. Forty-two out of the 323 patients
      underwent coronary artery bypass surgery; the remaining patients were medically
      treated. Surgical patients showed a better improvement respect to the medical
      group, while survival was not statistically different. An unexpected result was
      the relatively high risk in circumflex artery lesion. These data may justify a
      broader utilization of invasive therapy in recent onset angina, in light of the
      excellent results recently obtained with percutaneous transluminal coronary
      angioplasty.

PMID- 8465100
TI  - [Cocaine poisoning in acute renal insufficiency].
AB  - We report the case of a young man who developed acute renal failure after
      ingestion of cocaine wrapped in foil. We did not find either clinical or clear
      biochemical signs of rhabdomyolysis. The possible role of high blood cocaine
      level in the development of acute renal failure has been speculated and a direct
      vasoconstrictive effect on renal vessels followed by acute tubular necrosis has
      been hypothesized.

PMID- 8465101
TI  - [Calcification of the basal ganglia and Fahr disease. Report of two clinical
      cases and review of the literature].
AB  - Computed Tomography (CT) is superior to conventional skull radiographs in
      detecting calcifications of the basal ganglia. Basal ganglia calcification has
      been associated with different conditions, abnormality in the calcium-phosphorus
      metabolism being the most common of these associations. Some patients, without
      any evident disease, are well documented and called idiopathics of Fahr's
      syndrome; less numerous patients present familiar trait, with autosomal dominant
      inheritance. The correlation of neurological impairment with symmetrical
      calcification of basal ganglia is not so frequent. Here we present two cases of
      Fahr's disease, in whom CT aspects were very similar, but the neurological
      manifestations were different. The review of the literature shows, now, that
      there is no definite pathogenesis of basal ganglia calcifications.

PMID- 8465102
TI  - [Ultrasonographic changes in the abdominal organs in the 10th decade of life].
AB  - 10 patients in perfect health, aged between 90 and 101 (mean age: 93 +/- 3), have
      been studied with echography in order to investigate the possible changes in
      volume and echo-pattern of abdominal organs, linked to the "physiological" aging.
      Our resulting data (reduced volume of liver and kidneys, changes in echo-pattern
      of pancreatic parenchyma, reduced thickness of renal cortical-medullary) seem to
      confirm the well known data of an atrophic change interesting the parenchyma of
      abdominal organs in aging: this latter, however, remains compatible with function
      preservation.

PMID- 8465103
TI  - [Microalbuminuria: theoretical bases and new applications].
AB  - The constant presence of albumin, as detected by common biochemical methods, in
      multiple urine samples of a patient, was first considered by Bright, in 1836, as
      a cardinal sign of renal disease ("clinical proteinuria"). Since then this view
      was widely adopted for studying the clinical evolution of the patients with
      diabetes mellitus, whose high risk to develop proteinuria and subsequently a
      progressive decline of renal function was well known. Thus the finding of
      "clinical proteinuria" by traditional, merely biochemical techniques, has been
      considered for more than one century as the opening event in the onset of
      diabetic nephropathy, and a distinctive sign of glomerulopathy in general. More
      recently, this view has been deeply criticized, mainly because it lies on the
      implicit assumption that the sensitivity limits of the biochemical tests for the
      detection of urinary protein concentrations (about 300 mg/dl), coincide with the
      ones that can distinguish non nephropathic from nephropathic patients (either
      diabetic or not). Indeed new techniques, that detect urinary proteins down to 1
      microgram/ml, have shown that the upper limit of protein excretion in healthy
      people is well below the minimum concentration detectable by all the traditional
      tests. Therefore a new clinical entity, named "microproteinuria" has been
      defined, meaning the urinary excretion rate ranging between the "physiological"
      and the "clinical" proteinuria; its pathophysiologic, diagnostic and prognostic
      significance has been extensively evaluated in the last 20 years.
      Microproteinuria has been shown to represent a crucial event in the natural
      history of the diabetic nephropathy; in diabetic patients it is strictly related
      to the risk of future (months to years) development of overt nephropathy and
      chronic renal failure, and it may predict the risk of macroangiopathic
      complications. More recently new settings have been proposed for the study of
      microproteinuria, as an early and sensitive marker of cardiovascular diseases in
      hypertensive non diabetic patients and even in non hypertensive non diabetic
      elderly people. The role of microproteinuria in the diagnosis and follow-up of
      many non-diabetic glomerulopathies is a very interesting though still unexplored
      field.

PMID- 8465104
TI  - [Bile acids in the therapy of chronic liver diseases].
AB  - In the last 10 years, interest about the employment of bile acids, especially of
      ursodeoxycholic acid (UDCA), in the treatment of chronic liver diseases has
      increased. The mechanism has not been completely explained yet, but this agent
      has been thought to act mainly by making bile less toxic for the liver cells,
      reducing the fraction of hydrophobic detergent bile acids. UDCA is effective in
      decreasing serum concentrations of liver enzymes in chronic liver diseases,
      especially in those associated with cholestasis. This effect discloses new
      perspectives about the employment of this agent, even in association with other
      drugs, i.e. interferon; however, further investigations will be necessary in
      order to standardize the use of UDCA in the treatment of chronic liver diseases.

PMID- 8465105
TI  - [Dangerous errors due to similar names of diverse drugs].

PMID- 8465106
TI  - [Challenges and perspectives in rehabilitation. Recommendations for further
      development in rehabilitation].

PMID- 8465107
TI  - [Occupational and vocational rehabilitation of psychiatric patients: a control
      and attribution theory approach to examining the effect of working conditions].
AB  - In recent years, work and occupational activity have come to assume a therapeutic
      orientation in the rehabilitation of persons with mental illness. The study
      presented addressed the specific ways in which work activities during
      rehabilitation programme participation may act in a manner conducive to
      rehabilitation. The findings point to a positive relationship between the
      opportunities objectively available in the work setting for rehabilitees to
      influence aversive conditions or occurrences and their work-related subjective
      well-being. A second step enabled us to show that subjective well-being is
      determined less by the situation objectively at hand but primarily by the
      mentally ill rehabilitees' perceptions of influenceability and, hence, the
      experience of controllability. Further, examination of the rehabilitees'
      attributional patterns concerning the various control experiences revealed that
      the extent to which their subjective well-being is affected is mediated
      cognitively. The findings are discussed in view of their implications for the
      vocational rehabilitation of persons with mental illness.

PMID- 8465108
TI  - [Vocational promotion of psychiatrically handicapped patients in a Frankfurt am
      Main vocational training center].
AB  - In 1988, the Frankfort on Main Vocational Retraining Centre had decided in favour
      of increased, on-going admission of psychiatrically disabled adults, offering
      opportunities for their vocational education. The centre's objective is to enable
      psychiatrically disabled rehabilitees to successfully complete formal
      occupational training in as "normal" a setting as possible. This means: the
      Centre is a vocational rehabilitation facility, and is not directed at therapy or
      care. Psychiatrically disabled rehabilitees are accepted for up to 10 percent of
      available places in the various programme types. The overall objective is formal
      occupational qualification. A "training centre" open to all training orientations
      has been established for individualized service provision in the event of crisis
      situations during programme participation. Special attention is focussed on
      intensive, continuous further education of staff, inter alia by group
      supervision.

PMID- 8465109
TI  - [The status of medical-occupational rehabilitation exemplified by urologic tumor
      patients].
AB  - Many patients with urological carcinomas feel able, and indeed are able, to
      return to work after medical treatment. From a medical, psychological and
      socioeconomic point of view, routine pensioning must nowadays be rejected.
      Vocational reintegration is prepared in an individual and comprehensive manner in
      facilities for medical-vocational rehabilitation (phase II). The indication for
      vocational rehabilitation measures depends on the prognosis, on age and
      motivation, as well as on treatment aftereffects. The implications of operative,
      radiation and chemotherapy for the timing and course of the rehabilitation
      measures are set out, tumour- and treatment-related restrictions in future
      working life are discussed from an occupational medical view. Special emphasis is
      placed on carcinomas that should give rise to very early initiation of vocational
      rehabilitation services.

PMID- 8465110
TI  - ["Supported employment": equal opportunity for severely handicapped men and
      women].
AB  - This article examines the "supported employment" approach, which tries
      systematically to integrate severely disabled men and women into the open labour
      market. After describing the target population, we shall outline the specific
      support required, along with the benefits, risks and problems involved. Examples
      from a few industrialized countries, demonstrating the viability of training and
      employing severely disabled people, will illustrate the new approach. The
      activities described in this article are inn line with the goals of the ILO
      Vocational Rehabilitation and Employment (Disabled Persons) Recommendation, 1983
      (No. 168), which calls for "research and the possible application of its results
      to various types of disability in order to further the participation of disabled
      persons in ordinary working life".

PMID- 8465111
TI  - [Liver transplantation in alcoholic liver cirrhosis: social psychological aspects
      and occupational rehabilitation].
AB  - Social-psychological aspects and rehabilitation after liver transplantation were
      examined in 21 patients. One-year survival was not different in patients with
      alcoholic liver disease compared with patients with other end-stage liver disease
      (65% vs 71%). After liver transplantation a temporary return to alcohol drinking
      was observed in 3 patients (14%). 52% of patients transplanted for alcoholic
      liver disease are occupationally rehabilitated. Social-psychological conflicts
      were reported by 46%. Patients with alcoholic liver disease are potential
      candidates for hepatic transplantation.

PMID- 8465112
TI  - [Requirements for a "rehabilitation law" manual within social regulations from
      the viewpoint of the administrative practice].
AB  - Rehabilitation in Germany falls within the purview of the various branches of the
      social security and public welfare system, a decentralized approach which has
      stood the test of time. Notwithstanding, deficits exist primarily due to a lack
      of up-to-date intersectoral alignment a shortcoming to be remedied by comprising
      rehabilitation in a separate book of the Social Code. The various social security
      schemes responsible for rehabilitation are attaching much importance in this
      context to the linkages with their specific fields of competence as well as their
      programming latitude being maintained. The demands to be made from an overall
      perspective relative to a "rehabilitation" book are set out inter alia on the
      example of social assistance and youth services, on terminological issues,
      benefit scope, needs coverage, rehabilitation principles and procedures, as well
      as on cooperation aspects, also clarifying differing views among the branches of
      our social security and welfare system. A Social Code book on "rehabilitation"
      should essentially be aimed at focussing the variety of rehabilitative measures
      in terms of a holistic rehabilitation approach, i.e., to respond to the person's
      overall needs by overall service provision.

PMID- 8465113
TI  - [Social medicine position in the rehabilitation discharge report from the
      viewpoint of quality assurance].
AB  - The sociomedical statements given on the basis of Sociomedical Clinic apraisement
      of 103 patients were compared with those rendered at discharge from previous in
      patient rehabilitation. Discrepant judgements and evaluation problems in
      describing functional capacity at work are pointed out, and their causes
      discussed. Proposals are submitted for enhancing more effective cooperation
      between rehabilitation clinics and the Sociomedical Services of the pension
      insurance administrations.

PMID- 8465114
TI  - [17th International Congress and Membership Meeting of Rehabilitation
      International September 1992 in Nairobi, Kenya].

PMID- 8465116
TI  - Mechanisms and regulation of water transport in the kidney.

PMID- 8465115
TI  - Urea transport in the kidney.
AB  - Urea transport within the kidney is regulated and varies dramatically between
      different nephron segments. The terminal IMCD displays very high rates of
      transepithelial urea transport enabling delivery of large amounts of urea into
      the deepest portions of the inner medulla to maintain a high interstitial
      osmolality for concentrating the urine maximally. Urea in the terminal IMCD is
      transported by a specific urea transporter that is stimulated by vasopressin and
      hyperosmolarity. Although the urea transporter has not been cloned, individuals
      have been identified who lack the urea transporter. Individuals who lacked the
      Kidd antigen (a minor blood group antigen) also lacked carrier-mediated urea
      transport in their erythrocytes (and presumably in their kidneys). These same
      subjects were unable to concentrate their urine above 800 mOsm following
      overnight water deprivation. This experiment of nature illustrates the critical
      importance of the urea transporter to concentrating ability in humans.

PMID- 8465117
TI  - Urinary concentrating mechanism: the role of the inner medulla.

PMID- 8465118
TI  - Organic osmolytes in the kidney.

PMID- 8465119
TI  - Ion transport by the collecting duct.

PMID- 8465120
TI  - The thick ascending limb as a site of renal bicarbonate reabsorption.

PMID- 8465121
TI  - The role of adenosine in cell-to-cell signaling in the juxtaglomerular apparatus.

PMID- 8465122
TI  - Impact of methotrexate, vinblastine, adriamycin, and cisplatin chemotherapy in
      patients with lymph node metastases from transitional cell carcinoma of the lower
      urinary tract.

PMID- 8465123
TI  - Urologic cancer research at the National Cancer Institute.

PMID- 8465124
TI  - Repeat operations after continent urinary reconstruction.

PMID- 8465125
TI  - The treatment of localized prostate cancer: what are we doing, what do we know,
      and what should we be doing? The Prostate Patient Outcome Research Team.

PMID- 8465126
TI  - The use of ex vivo-activated memory T cells (autolymphocyte therapy) in the
      treatment of metastatic renal cell carcinoma: final results from a randomized,
      controlled, multisite study.

PMID- 8465127
TI  - Adoptive immunotherapy of renal cell carcinoma: studies from the Surgery Branch,
      National Cancer Institute.

PMID- 8465128
TI  - [What is your diagnosis? Wilson's disease (hepatolenticular degeneration)].

PMID- 8465129
TI  - [Chronic polyarthritis: interdisciplinary therapy and reflections on differential
      diagnosis].

PMID- 8465130
TI  - [Early-stage polyarthritis].
AB  - Prodromes, articular signs and the different courses in the early stage of
      rheumatoid arthritis are explained. Atypical forms and variants of rheumatoid
      arthritis are especially described. These are the following syndromes:
      palindromic rheumatism, polymyalgic rheumatoid arthritis, Sjogren-syndrome with
      rheumatoid arthritis, acute symmetric polyarthritis with pitting edema of elderly
      people. Furthermore the significance of radiological procedures and the
      investigation for rheumatoid factors in the early stages are discussed. Early
      diagnosis and consecutively early therapeutic strategies in patients suffering
      from rheumatoid arthritis are of paramount importance for prognosis.

PMID- 8465131
TI  - [Low-dose steroids in chronic polyarthritis: a basic therapy?].
AB  - The symptomatic and disease-modifying efficacy of low-dose corticosteroids in
      rheumatoid arthritis is explained. A possible therapeutic effect of low-dose
      corticosteroids is shown by long-term studies which include radiological
      evaluation. The safety and side-effects of low-dose corticosteroids are
      described. Steroid-induced osteoporosis in rheumatoid arthritis is discussed
      especially based on recently accomplished longitudinal bone density studies.
      Finally consequences in the management of rheumatoid arthritis are defined.

PMID- 8465132
TI  - [If I had chronic polyarthritis--current ideas on basic therapy].
AB  - Rheumatoid arthritis (RA) is a chronic inflammatory disorder of largely unknown
      etiology and complex multifactorial pathogenesis. To date, the medical management
      has been less than optimal and has consisted primarily of drugs that modulate the
      acute inflammatory process. Over the years a treatment program referred to as the
      classical therapeutic pyramid has evolved. A new concept and a controversial one
      in therapy of RA is that already at the time of definitive diagnosis, a more
      concerted effort towards vigorous treatment using second-line drugs such as
      methotrexate, should be made. It is very likely that over the next 5 years
      interventions such as monoclonal antibodies directed against predetermined T-cell
      subpopulations and anti-cytokines such as TNF-alpha binding proteins will evolve
      as new concepts in therapy of RA.

PMID- 8465133
TI  - [Local joint treatment in chronic polyarthritis: intra-articular corticosteroids
      and radioactive isotopes].
AB  - Intrasynovial injection of corticosteroids is currently one of the routine
      measures in the treatment of patients with rheumatoid arthritis. Crystalline
      corticosteroid suspensions have proved their value and are effective for
      approximately one to three weeks. One or two injections can control synovitis for
      prolonged periods of time. Special attention has to be given to impeccable
      technique of instillation. However, it must be kept in mind that, within the
      overall management of rheumatoid arthritis, the intra-articular injection of
      corticosteroids is a local, palliative and temporary measure. The intrasynovial
      instillation of radionuclides is used only in selected cases. Therapy of the knee
      joint is mainly performed with Yttrium-90, less frequently, the interphalangeal
      joints are treated with Erbium-169. Costs and radiation exposure are low, but a
      favourable result is only achieved in slightly more than 50 per cent of cases.
      This review provides a synopsis of the basic concepts and practical applications
      of intrasynovial corticosteroid and radioisotope injection therapy.

PMID- 8465134
TI  - [Nutrition and chronic polyarthritis].
AB  - Patients suffering from chronic and incurable diseases often try to influence
      their symptoms by dietary modification. The effect of complete fasting on pain in
      rheumatoid arthritis is remarkable, but not fully understood. Polyunsaturated
      fatty-acids, specially omega-3-fatty-acids from fish oil, are significant as
      precursors of mediators for inflammation. In rare instances food allergy may
      cause or aggravate arthritis. The actual knowledge is presented in a concentrated
      form and some practical advice is given.

PMID- 8465135
TI  - Effectiveness of acoustic reflex threshold criteria in the diagnosis of
      retrocochlear pathology.
AB  - This study examines the acoustic reflex threshold criteria, derived from a large
      group of patients with cochlear hearing loss proposed by Cohen & Prasher (1992),
      in order to evaluate their effectiveness in differentiating between cochlear and
      retro-cochlear lesions. This criterion was tested on 63 patients with surgically
      confirmed cerebello-pontine angle (CPA) lesions. The false results obtained with
      this and other criteria were compared. The best balance between the false
      positive and negative results in the cochlear and retrocochlear group is provided
      by the criterion of any two adjacent test frequencies (proposed in the companion
      paper) having an upper limit of 105 dB for hearing below 60 dB and 110 dB for
      hearing over 60 dB. This study has also singled out the interaural difference
      criterion as the best diagnostic indicator with the lowest false results with
      only 1 false negative from 63 CPA cases and 3 false positive cases from 61
      cochlear lesions with hearing thresholds over 55 dB.

PMID- 8465136
TI  - Acoustic neuroma and non-tumour retrocochlear patients: audiological features.
AB  - Seventeen surgically confirmed acoustic neuroma subjects and seventeen
      radiologically confirmed non-tumour subjects with retrocochlear pathology of
      unknown aetiology were selected to investigate retrospectively the diagnostic
      yield of basic audiological test procedures. Puretone audiometry, tympanometry,
      reflexometry and auditory brainstem response audiometry were used in the
      identification of acoustic neuromas versus non-tumour retrocochlear disorders.
      All subjects had been referred originally for neuroaudiological assessment
      because of suspected acoustic neuroma and had been found to have a range of
      abnormal ABR findings consistent with retrocochlear pathology. Detailed
      retrospective analysis of audiological results following surgical and
      radiological classification showed subject similarities for most parameters of
      the individual audiological tests for both acoustic neuroma and non-tumour
      groups. A significant difference was noted, however, between the two clinical
      populations for the ABR Wave V absolute interaural latency difference parameter.

PMID- 8465137
TI  - High-frequency tone burst-evoked ABR latency-intensity functions.
AB  - High-frequency tone burst stimuli (8, 10, 12, and 14 kHz) have been developed and
      demonstrated to provide reliable and valid auditory brainstem responses (ABRs) in
      normal-hearing subjects. In this study, latency-intensity functions (LIFs) were
      determined using these stimuli in 14 normal-hearing individuals. Significant
      shifts in response latency occurred as a function of stimulus intensity for all
      tone burst frequencies. For each 10 dB shift in intensity, latency shifts for
      waves I and V were statistically significant except for one isolated instance.
      LIF slopes were comparable between frequencies, ranging from 0.020 to 0.030
      msec/dB. These normal LIFs for high-frequency tone burst-evoked ABRs suggest the
      degree of response latency change that might be expected from, for example,
      progressive hearing loss due to ototoxic insult, although these phenomena may not
      be directly related.

PMID- 8465138
TI  - Spontaneous otoacoustic emissions in different racial groups.
AB  - To determine if there are racial differences in the prevalence of spontaneous
      otoacoustic emissions (SOAEs), both ears of 20 Negro, 20 Asian and 20 Caucasian
      subjects were examined for the presence of SOAEs. Within each racial group, equal
      numbers of normally hearing males and females were tested. Significant
      differences in the occurrence of SOAEs were found between the three racial
      groups, with Negroes expressing more SOAEs than Caucasians, and Asians
      demonstrating an intermediate number of these emissions. In support of previous
      observations, more emissions were recorded from female than from male ears, and a
      significant correlation of the number of emissions in the two ears of an
      individual was also noted.

PMID- 8465139
TI  - High-frequency air conduction audiometry. Testing of a new low impedance
      circumaural transducer system in normal young persons.
AB  - A new circumaural transducer was tested in the frequency range 125 Hz to 20 kHz.
      The new transducer has a low acoustic impedance and loads the ear closely to free
      field conditions, thus ensuring that sensitivity to different positions of the
      transducer around the ear is reduced compared to conventional audiometric
      headphones. The transducer was tested on 57 individuals (114 ears) in the age
      range 10 to 20 (median age 17.0 years). The results, showing a fairly good
      accordance with the ISO standard free-field thresholds values, seem to confirm
      that the new transducer system loads the ears similarly to free-field conditions.
      The results were also compared with the threshold values from other high
      frequency investigations using different transducer systems. In order to verify
      the reliability of the system, a test-retest was carried out on 12 inexperienced
      normal individuals (24 ears) (median age 26.5 years; range values from 22 to 44
      years). The standard deviations of the test-retest ranged from 2.8dB to 6.6dB. A
      comparison of these values with the results from other high-frequency test
      retests is of dubious value, as such retests have often been performed and
      estimated in different ways. International standards for high-frequency
      audiometry threshold and international standards for test-retest procedure are
      needed. The increasing administration of cytotoxic drugs in the treatment of
      malignant diseases will increase the need for reliable high-frequency audiometry
      equipment.

PMID- 8465140
TI  - Performance of assistive listening devices using insertion gain measures.
AB  - The electroacoustic performance characteristics of seven assistive listening
      devices (ALDs), that did not need to be coupled with a hearing aid, were measured
      using real ear insertion gain. The ALDs, which included TV listening systems and
      personal amplification systems, were measured on ten subjects. Electroacoustic
      performance of the ALDs varied although there were similarities for different
      types of devices. Frequency responses were either basically flat or had an
      emphasis in the low or mid-frequency region. The majority of devices provided
      negligible amplification when set at or below half volume. Total harmonic
      distortion was 10% or less for most ALDs. Overall, insertion gain measures were
      found to be of value in evaluating the effectiveness of this type of
      amplification device.

PMID- 8465141
TI  - Factors to consider when in-the-canal hearing instruments are used in aural
      rehabilitation.
AB  - The purpose of this investigation was to determine what subjective factors may
      influence the success of fitting in-the-canal hearing instruments (ITCs). Four
      different types of ITC were fitted to four matched groups of 20 experienced ITC
      users. In addition to the subjective experiences of the users, the results were
      checked using insertion gain (IG) measurements. The results indicate that too
      sharp sound quality from paper rustle, from running water and from use of kitchen
      utensils is a common problem that it is important to be aware of. The possibility
      of maximal venting is of special importance in order to avoid autophony. Feedback
      may be a problem, especially when maximal venting is necessary. However, for
      several models of ITC, feedback is, in reality, a minor problem. High cost of
      batteries may be a problem for persons with ITC using 10/230 batteries. IG
      measurements indicated that a gain of approximately 0.3 in relation to the
      hearing losses was preferred. It may be advantageous to choose a model of ITC
      that has extensive flexibility.

PMID- 8465142
TI  - ABR latency-intensity function abnormality in the early detection of a
      cerebellopontine angle tumour: a case study.
AB  - A case is presented of a 27-year-old male subject with a cerebellopontine angle
      tumour which was provisionally diagnosed on the basis of the ABR latency
      intensity function findings and later confirmed by MRI. The patient initially
      presented with decreased hearing sensitivity, tinnitus and dizziness. The
      findings of neuroaudiological assessments and radiological examinations are
      described. The importance of the neuroaudiological test battery, in particular
      the ABR latency-intensity function, in this case is discussed; and the need for
      its inclusion for earlier detection and diagnosis of cerebellopontine angle
      tumours emphasized.

PMID- 8465143
TI  - The prevalence of perilymphatic hypertension in subjects with tinnitus: a pilot
      study.
AB  - This study investigated the prevalence of perilymphatic hypertension (raised
      perilymphatic pressure) in a population of subjects with tinnitus. A review of
      the literature showed how changes in perilymphatic pressure could affect tympanic
      membrane displacement measurements. This review also revealed that perilymphatic
      hypertension was more likely to occur in young females (less than 45 years) than
      in other subjects. An experiment was designed to test 32 subjects, who were
      divided into four groups according to their age and sex. These subjects underwent
      several routine audiological tests and were then tested with the tympanic
      membrane measurement system to determine the perilymphatic pressure of both ears.
      Statistical analysis of the experimental results showed that the young females
      had raised perilymphatic pressure. This was significantly higher than the
      perilymphatic pressure of the other test groups and of that of a normal
      population. The young females also exhibited other symptoms indicative of raised
      perilymphatic pressure. The raised pressure was thought to be due to an increase
      in fluid pressure which is more likely to occur in females due to variations in
      the levels of circulating hormones with menstrual irregularities, pregnancy and
      the menopause.

PMID- 8465144
TI  - A model for quality achievement--the NORDKEM protein project.
AB  - The Nordic protein project demonstrates a model for the process of achieving
      analytical quality. GOAL: based on use of common reference intervals leading to
      the quality specifications. Creation of quality: through common high quality
      calibrator (with IFCC-values) (external factor) and individual trouble-shooting
      and guidelines (internal factor). Control of quality: with specially designed set
      of control samples and problem-related evaluation of control data. Establishing
      common reference intervals: through associated projects.

PMID- 8465145
TI  - Appropriate sera for calibration and control of specific protein assays.
AB  - An ultracentrifugation technique is described which makes it possible to prepare
      protein calibrators and control sera which (i) are stable (more than 8 years
      documented for nine proteins), (ii) are clear (remains clear for more than 8
      years at -80 degrees C), (iii) contain genuine proteins (documented
      electrophoretically and immunologically), and (iv) are reproducible to prepare
      (collection and preparation).

PMID- 8465146
TI  - Development of criteria for the evaluation of reference method values.
AB  - We present a uniform concept for the requirements of reference methods (RMs) used
      for target-setting in the German external quality assessment (EQA) scheme. It is
      proposed that the total allowable error (TAE) of the RMs shall be 0.2 times the
      acceptance limits in the EQA-scheme. From the TAE are derived limits for maximum
      RM-bias, RM-imprecision, and the number of measurements.

PMID- 8465147
TI  - Approaches for providing target values to improve usefulness of external quality
      assessment scheme. The Spanish experience.
AB  - The aim of this communication is to highlight the specific aspects of external
      quality assessment schemes that need to be discussed in a European context:
      target values, transferability of results and accredit of laboratories. The
      Spanish situation is presented here. The most reliable way to provide target
      values is to analyse the control samples by reference methods. However, it is not
      possible for the majority of national schemes and other approaches are presently
      used: the verification of consensus means is a practicable solution adopted in
      Spain. An initial network involving selected routine laboratories has been
      developed, to attain transferability of results. The traceability of routine
      calibrators from certified reference materials should be demonstrated. To
      accredit laboratories for licensing is a complex activity that should consider
      many aspects, results from the national quality assessment scheme bring one. A
      scoring system is being used in Spain for guidance, and the complete guidelines
      are under preparation.

PMID- 8465148
TI  - Validation of target values in external quality assessment schemes for peptide
      hormones and tumour markers.
AB  - Consensus means are tacitly assumed to provide correct target values in many
      external quality assessment schemes EQAS for peptide hormones and tumour markers.
      We suggest, however, that such targets should not be used without some evidence
      of their validity. Comparison of the expected and found increments in the target
      value on adding known quantities of International Standards to serum pools can
      provide confirmation of the correctness of target values or, in some cases,
      identify clearly incorrect targets. Validation of targets is important if EQAS
      are to stimulate use of correctly calibrated assays, rather than those that
      simply agree with the most commonly used method(s).

PMID- 8465149
TI  - The World Health Organization's role and future plans in laboratory
      standardization.
AB  - WHO is monitoring health care and the status of health of the population in each
      of its member states. The statistics provides valuable information for the
      comparison of the effectiveness of different health systems. As part of its
      global responsibility on health WHO issues international reference materials
      (IRMs), assigns international nonproprietary names for therapeutics (INNs),
      publishes guidelines for good manufacturing practice (GMP) and good laboratory
      practice (GLP) and, in collaboration with international professional
      organizations, makes recommendations towards achieving global harmonization of
      clinical laboratory investigations.

PMID- 8465150
TI  - A programme for assigning target values for external quality assessment schemes
      in countries with no authorized reference laboratories. Annex. Experiences with
      deviating results on Ektachem 700 XR.
AB  - The use of consensus values in external quality assessment schemes (EQAS)
      involves several problems and should preferably be replaced with target values
      obtained by methods of high metrological level. However, such values are
      difficult to obtain. In the present study we transferred values from the NIST
      (former NBS) certified reference serum SRM 909 to lyophilized and frozen test
      sera for various inorganic components using flame absorption or flame emission
      spectrometry. Enzyme values were assigned by laboratories of members of the
      former Scandinavian Enzyme Committee. The assignment was based on 2-4
      determinations each day through 3 days of experiment. A total of 10 laboratories
      participated in the work. The results were utilized in a Danish EQAS. One
      practical concern is the fairly long time (9 months) which was needed for
      production, collection and compiling all data. To get an impression of how much
      dry chemistry analysers, e.g, could influence consensus values a Kodak Ektachem
      700 XR was studied using lyophilized and frozen sera. The results are reported in
      the annex. On NIST SRM 909 the values found for sodium(I) were 6% too high even
      though the findings on frozen human sera were accurate. For aspartate
      aminotransferase a result three times the target values was found on a human
      lyophilized serum, while the values on the frozen sera only were slightly too
      high.

PMID- 8465151
TI  - Isotope-specific measurements as reference for iron(II+III) in serum in an
      external quality assessment scheme based on 'real life' samples.

PMID- 8465152
TI  - Report on a common survey in clinical laboratories in Belgium and in The
      Netherlands: immunoassays.
AB  - A common survey for immunoassays was organized for Belgian and Dutch
      laboratories. We compared the different statistical approaches used in the two
      schemes; both approaches lead to comparable results. Differences in overall
      consensus values and overall precision are related to a different selection of
      kits in the two countries. When analyzing results from users of representative
      kits in both countries, we found a very good correlation in accuracy but detected
      also some significant differences in precision for some samples for cortisol and
      theophylline determinations. For some observed differences there is actually no
      acceptable explanation.

PMID- 8465153
TI  - A study of interferences in routine methods for creatinine measurement.
AB  - A survey was undertaken through the Irish External Quality Assessment Scheme to
      investigate the extent to which acetoacetate and bilirubin affect routine methods
      in current use for measurement of serum creatinine. Spiking a sample with 10
      mmol/l acetoacetate caused errors ranging from -28% to +22%. The greatest errors
      were found with end-point Jaffe methods and kinetic Jaffe methods in which there
      was no time delay between final reagent addition and start of absorbance
      measurement. A sample with high bilirubin concentration gave apparent creatinine
      results ranging from zero to 280 mumol/l. Although these interferences are well
      documented in the literature, this knowledge seems to have had little effect on
      methods in actual use.

PMID- 8465154
TI  - External quality assessment scheme for cyclosporin in body fluids.
AB  - The United Kingdom Cyclosporin Assessment Scheme has over eight years experience
      in the measurement of cyclosporin and has over 176 participants World wide. The
      scheme provides a source of reference material which has been assayed by many
      laboratories and, thereby, provides external quality assessment for the clinical
      measurement of cyclosporin. The results also allow the direct comparison of the
      available analytical methodologies. The data presented are a summary of the
      results received during the period July 1990 to July 1991, inclusive.

PMID- 8465155
TI  - Results of external quality assessment of analysis of urinary calculi by various
      methods.

PMID- 8465156
TI  - External quality assessment of analysis of urinary calculi--a new scheme based
      mainly on natural concrement materials.

PMID- 8465157
TI  - Quality assurance for decentralised testing in primary and secondary care.

PMID- 8465158
TI  - A quality manual for the clinical laboratory including the elements of a quality
      system. Proposed guidelines.
AB  - Development of quality manuals is a means for the promotion of quality in
      clinical laboratories by describing the total quality system. It also provides
      opportunity of checking whether the quality system is implemented in reality and
      demonstrates to the hospital administration and the clinicians that the
      laboratory is committed to quality. The intention of these guidelines is to
      describe the elements of the quality system for a large clinical laboratory, and
      to present such a system in the form of a quality manual. The proposed guidelines
      comply, where relevant, with ISO/IEC guide 25 'General requirements for the
      technical competence of testing laboratories' and EN 45001 'General criteria for
      the operation of testing laboratories'. The document may be used as an aid for
      laboratories wishing to be accredited according to EN 45001, or intending to
      apply for formal certification of their quality systems, according to ISO 9001
      'Quality systems--Model for quality assurance in design/development, production,
      installation, and servicing' utilizing ISO 9004 'Quality management and quality
      system elements--guidelines; Part 2 Guidelines for service'. However, information
      about the minimum requirements for official recognition should be obtained from
      the particular accreditation or certification body concerned.

PMID- 8465159
TI  - Quality goals in external quality assessment are best based on biology.

PMID- 8465160
TI  - Surface areas in ultrasound therapy. Evaluation of seven methods for measuring
      the treated skin area in physiotherapeutic application of ultrasound.
AB  - Recent articles on ultrasound (US) do not contain information about precise
      dosage, thus risking a non-valid conclusion of possible effects. To ensure safer
      standards in treatment-time, the present study compared 7 methods for the
      calculation of areas. Measurement by eye had a median relative difference (MRD)
      from the true reading of 22% (lower quartile (l.q.) = -14%, upper quartile(u.q) =
      -+46%), with large intraindividual variation, the span of MRD being -46% to +53%.
      Measuring with the transducer showed a systematic error: MRD was -48% (l.q. = 
      55%, u.q.= -35%), which is unacceptable. Areas were measured with satisfactory
      accuracy with 5 methods that require little training and use accessories some of
      which are inexpensive. Plates with ellipses of known size had a MRD of 0.1%,
      (l.q. = -3%, u.q. = +2%), while rulers showed MRD of -2%, (l.q. = -0.6%, u.q. =
      +5%) both on selected material. The most accurate and versatile instruments were
      a planimeter (MRD = -0.1%; l.q. = -0.6%; u.q. = +0.5%), a Mettler weighing
      apparatus (MRD = 3%; l.q. = 2%; u.q. = 6%), and a digitizer (MRD = -0.1%; l.q. = 
      0.4%; u.q. = +0.3%).

PMID- 8465161
TI  - A three-year follow-up of 195 reported occupational over-exertion injuries.
AB  - Three years after reporting occupational over-exertion injuries, 181 persons took
      part in a follow-up study by questionnaire. The objective was to study these
      persons with respect to their current status of health, well-being and functional
      capacity and when possible compare collected data to reference data from the
      "normal population". The studied group reported more physical and psychological
      symptoms than the reference groups. More than 50% reported difficulties in
      activities of daily living. Long sick-leaves in the year following the reported
      injury were associated with remaining pain and low rate of employment. Three
      years after the injury, 109 persons were in employment. Almost one third of these
      had changed occupations and now had more varied tasks than at the time of the
      report. Those whose work loads had been reduced after the injury, did not report
      less musculoskeletal disorders than others. However, access to social support was
      positively related with health and psychological well-being.

PMID- 8465162
TI  - Improvement in gait one year after surgery for knee osteoarthrosis: a comparison
      between high tibial osteotomy and prosthetic replacement in a prospective
      randomized study.
AB  - The aim of this study was to analyse gait improvement one year after high tibial
      osteotomy and unicompartmental knee arthroplasty in patients with strictly
      unilateral osteoarthrosis of the medial compartment of the knee. Thirty-six
      patients, 18 men and 18 women, received a unicompartmental Brigham knee
      prosthesis and 23 patients, 10 men and 13 women, were operated on with a high
      tibial osteotomy. Clinical and radiographical assessments were supplemented by a
      functional test, measurements of thigh muscle torque with a Cybex II dynamometer
      and analysis on a force plate walkway with electrogoniometers. All patients were
      assessed prior to, and one year after surgery. Both groups showed overall
      clinical improvement, as assessed by the British Orthopaedic Association (BOA)
      score. Pain during walking decreased. The range of knee flexion remained
      unchanged. The ability to ascend and descend steps improved. The isokinetic thigh
      muscle torque remained unchanged. In the prosthetic group free walking speed
      increased from 1.03 to 1.09 m/s (p < 0.001). Step frequency and step length
      increased (p < 0.001). Single stance phase ratio increased from 0.96 to 0.99 (p <
      0.01), indicating a more symmetrical gait. Double stance phase (% gait cycle) of
      both legs decreased (p < 0.001), indicating a faster transfer of weight during
      walking. In the osteotomy group, free walking speed did not increase. Step length
      of the uninvolved leg increased (p < 0.01). Double stance phase of the involved
      leg decreased (p < 0.001) and double stance phase of the uninvolved leg decreased
      (p < 0.01). Both groups improved after surgery and there was no difference
      between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465163
TI  - Effect of preoperative physiotherapy in unicompartmental prosthetic knee
      replacement.
AB  - The purpose of this study was to analyse the effects of preoperative
      physiotherapy on pain and function in 39 patients scheduled for unicompartmental
      prosthetic knee replacement. Nineteen patients were selected at random to receive
      preoperative physiotherapy. The control group received no preoperative therapy.
      Evaluations were performed 3 months prior to surgery, immediately before and 3
      months after operation. Evaluations included: Clinical assessment, measurements
      of the knee muscle strength, self-selected walking speed and the oxygen cost of
      walking. Three months before surgery the patients in both groups had similar
      types and levels of problems. Before surgery patients who had received
      physiotherapy showed slight improvements in pain, perceived stability of the knee
      during walking, and faster self-selected and maximal walking speeds compared to
      the control group, but were unchanged in muscle strength, ROM, and oxygen cost.
      Three months after surgery pain was significantly decreased in all patients,
      however, no significant differences were found between the two groups for any
      variable except muscle strength. This was unchanged compared to preoperative
      values for patients of the control group while patients who received preoperative
      physiotherapy showed a decrease in strength. In summary, this study did not
      disclose any major benefit from the program of preoperative physiotherapy tested.

PMID- 8465164
TI  - Vertical ground reaction force feedback to enhance stroke patients' symmetrical
      body-weight distribution while rising/sitting down.
AB  - A force platform with an auditory output consisting of two electronic balances
      was used to reinforce symmetrical body-weight distribution in stroke patients.
      Forty patients randomly assigned to an experimental group or a control group
      practised rising and sitting down for 15 min, thrice daily, 5 days a week for 6
      weeks. The experimental group but not the control group received ground reaction
      force feedback through the auditory output. Vertical ground reaction forces under
      each foot were measured with two force plates. Mean difference in improvement of
      body weight distribution on the paretic leg was 13.2 +/- 10.7 (M, SD) per cent
      total body weight in the experimental group and 5.1 +/- 6.7 per cent in the
      control group in rising (p < 0.01) and 12.7 +/- 7.5 per cent total body weight
      and 4.6 +/- 6.6 per cent in sitting down tests (p < 0.001). The patients in the
      experimental group achieved in average close to a symmetrical body-weight
      distribution while rising and sitting down. Improvements in physical performance
      and sit-stand tests were greater in the experimental group (p < 0.05 and p <
      0.01, respectively). No differences were seen in improvement in performance of
      activities of daily living. Symmetry in body-weight distribution in rising and
      sitting down correlated with high scores in physical performance, motor function
      in rising, and with functional ability.

PMID- 8465165
TI  - A new nasal mask for nocturnal home ventilation in chronic neuromuscular
      disorders.
AB  - A new nasal mask for nocturnal, intermittent positive pressure ventilation was
      used by patients with symptomatic sleep hypoventilation due to chronic
      neuromuscular disorders. The custom-fabricated mask is cast in visible light
      curing acrylic from a plaster model. Air is delivered through plastic tubes cast
      in the mask. The treatment was introduced through close cooperation between a
      physiotherapist and a technician. Evaluation was performed after 4-34 months'
      regular use. The mask was well tolerated. All patients reported comfortable sleep
      and symptom relief. The effectiveness was confirmed by whole-night measurements
      of oxygen saturation and end-tidal carbon dioxide.

PMID- 8465166
TI  - Carcinogenicity of mercury and mercury compounds.
AB  - Mercury and mercury compounds are widely used in modern society, but only sparse
      data are available on their carcinogenicity. Methylmercury chloride causes kidney
      tumors in male mice. Mercury chloride has shown some carcinogenic activity in
      male rats, but the evidence for female rats and male mice is equivocal. Other
      mercury compounds and metallic mercury have not been tested adequately in
      experimental animals. Epidemiologic data are available for chloralkali workers,
      dentists and dental nurses, and nuclear weapons workers, three groups
      occupationally exposed to low levels of mercury and its compounds, but those
      highly exposed in the past, such as miners, or populations which have suffered
      massive environmental exposure have not been adequately studied. However, the
      sparse epidemiologic data point toward the possibility of a risk of lung, kidney,
      and central nervous system tumors. Better data are needed on the carcinogenicity
      of mercury and mercury compounds in humans and experimental animals.

PMID- 8465167
TI  - Lung cancer among textile workers in the Prato area of Italy.
AB  - The association between lung cancer and occupational exposure in the textile
      industry was investigated in a population-based case-referent study conducted in
      the Prato area of the province of Florence (Italy) where there is a concentration
      of textile factories. A complete response to a postal questionnaire was obtained
      for 207 cases (85.1%) and 440 referents (76.1%). Those who had ever worked in the
      textile industry had an odds ratio (OR) of 1.45 [95% confidence interval (95% CI)
      1.0-2.1]; when nine different textile job titles were considered, an increased OR
      was observed only for rag sorters (OR 2.2, 95% CI 1.3-3.8) and weavers (OR 1.7,
      95% CI 1.1-2.7). Analysis by different "time windows" showed an OR of 3.0 (95% CI
      1.6-5.8) for rag sorters at work in the 1950s and an OR of 2.8 (95% CI 1.5-5.0)
      for weavers at work in the 1970s. This result supports the suggestion of two
      different carcinogenic exposures in the Prato textile industry (asbestos and
      mineral oils).

PMID- 8465169
TI  - Chromosome aberrations in lymphocytes of high-voltage laboratory cable splicers
      exposed to electromagnetic fields.
AB  - Thirteen high-voltage laboratory employees and 20 referents participated in a
      cross-sectional, matched-pairs study of cytogenetic damage. During cable testing
      the workers were exposed to static, alternating, or pulsed electric and magnetic
      fields. The alternating magnetic field levels of 50 Hz were 5-10 microT,
      occasionally much higher. Chromosome aberrations, sister chromatid exchanges, and
      aneuploidy were studied in peripheral blood lymphocytes. In addition, chromosome
      aberrations were investigated in lymphocyte cultures treated with hydroxyurea and
      caffeine, to inhibit deoxyribonucleic acid synthesis and repair. Among seven
      smoking laboratory employees the mean number of chromosome breaks/200 cells was
      2.3, as compared with 0.7 for the job-matched referents. The comparable figures
      for inhibited cultures were 12.0 versus 6.0. No increase was detected in
      nonsmokers with either method. The other genetic parameters showed no differences
      between the exposed workers and the referents. The results support, to some
      extent, the hypothesis of an increased risk of genotoxic effects among high
      voltage laboratory workers.

PMID- 8465168
TI  - Measuring work organization exposure over the life course with a job-exposure
      matrix.
AB  - In most epidemiologic studies of occupational stress, work exposure is measured
      at only one point in time. This article presents a methodology for measuring the
      intensity and duration of work organization exposure over a lifetime. A job
      exposure matrix for work organization was developed from data on a random sample
      (N = 12,084) of the Swedish labor force. The matrix consisted of mean exposure
      estimates for work control, social support, psychological and physical job
      demands, and job hazards for 261 occupations. Several validations of the matrix
      were undertaken. The matrix scores were found to be significantly correlated with
      individual self-report scores, and a similar increase in chronic disease
      prevalence with decreasing work control was found for both the matrix and the
      individual scores. The matrix was applied to occupational history data to
      construct lifetime exposure profiles. Potential problems in using attribution
      systems for exposure assessment are discussed.

PMID- 8465170
TI  - Contribution of the tonic vibration reflex to muscle stress and muscle fatigue.
AB  - The aim of the investigation was to determine the influence of vibration
      displacement amplitude (200, 300 microns peak-to-peak), as opposed to
      acceleration effects at selected frequencies (40, 80, 100, 120, 150, 200 Hz), on
      a commonly observed but often undesired motor response elicited by local
      vibratory stimulation, that is, the tonic vibration reflex (TVR). Vibration was
      applied to the distal tendons of the hand flexor muscles. Changes in the activity
      of hand flexor and extensor muscles were analyzed as a function of both their
      initial contraction level (0, 10, 20% of maximal voluntary contraction) and the
      vibration parameters. The main results indicate that TVR increases with the
      initial muscle contraction and increases with vibration frequency up to 100-150
      Hz but decreases beyond. High-frequency vibration seems to induce less muscle and
      tendon stress. This result is particularly important for the design of handheld
      vibrating tools.

PMID- 8465171
TI  - Shoulder tendinitis and its relation to heavy manual work and exposure to
      vibration.
AB  - Three categories of construction industry workers (54 bricklayers, 55
      rockblasters, and 98 foremen) were compared in a cross-sectional study. In a
      structured interview they reported exposure to loads lifted, vibration, and years
      of manual work. They were also subjected to a clinical investigation including
      medical history and a detailed shoulder examination. Among the rockblasters 33%
      had signs of tendinitis in the left and 40% in the right shoulder. Among the
      bricklayers and foremen 8-17% had signs of shoulder tendinitis. In a multiple
      logistic regression being a rockblaster compared with being a foreman showed an
      odds ratio (OR) of 3.33 for left-sided and 1.71 for right-sided shoulder
      tendinitis. Vibration exposure yielded an OR of 1.84 and 1.66 for the left and
      right sides, respectively. Vibration exposure or work as a rockblaster seemed to
      be risk indicators for tendinitis of the shoulders.

PMID- 8465172
TI  - Bias in risk estimates from variability of exposure to postural load on the back
      in occupational groups.
AB  - Variability of exposure can be a source of information bias in studies with
      exposure assessment based on the use of a sample of workers in each occupational
      group under study. This paper presents a method to assess the rate of exposure
      misclassification from the magnitude of overlap of exposure distributions and,
      consequently, to evaluate the bias to risk estimates in cross-sectional and
      prospective studies. The percentage of work-time with trunk flexion and rotation
      was studied in five occupational groups. The rate of misclassification of
      exposure to trunk flexion and rotation varied from 0.03 to 0.35.
      Misclassification below 0.10 was found only for occupational groups with at least
      a 14-fold difference in mean exposure. Higher rates of misclassification can
      easily bias the risk estimates up to 50%. In the cross-sectional design the odds
      ratio was more sensitive to bias than the prevalence rate ratio. The estimate of
      the relative risk in a prospective study design was the least biased.

PMID- 8465173
TI  - Hepatic metabolism of toluene after gastrointestinal uptake in humans.
AB  - The metabolism of toluene and the influence of small doses of ethanol were
      measured in eight male volunteers after gastrointestinal uptake, the toluene
      concentration in alveolar air and the urinary excretion of hippuric acid and
      ortho-cresol being used as the measures of metabolism. During toluene exposure to
      2 mg.min-1 for 3 h the alveolar toluene concentration was 0.07 (range 0-0.11)
      mg.m-3; exposure to 6 mg.min-1 for 30 min increased the alveolar concentration to
      0.9 (range 0.03-2.6) mg.m-3. Ingestion of 0.08, 0.16, and 0.32 g of ethanol per
      kilogram of body weight during toluene exposure of 2 mg.min-1 increased the
      alveolar concentration within 10 min, and maximal alveolar concentrations of 5
      (SD 3), 24 (SD 11), and 39 (SD 28) mg.m-3 were reached after 30, 60, and 90 min
      for the three doses, respectively. Hippuric acid excretion was only decreased by
      an ethanol dose of 0.32 g.kg-1. Very low doses of ethanol inhibit toluene
      metabolism, and the procedure is sensitive enough to measure metabolic
      interactions between solvents and other xenobiotics in humans.

PMID- 8465174
TI  - Solvents in pesticides.
AB  - Solvents are extensively used in pesticide formulations. This study concerns the
      solvents notified to the Italian Registry of Pesticides, which has information on
      approximately 8000 pesticide formulations. Solvents with evidence of
      carcinogenicity in humans or animals, including benzene, chloroform, carbon
      tetrachloride, 1,2-dichloroethane, 1,4-dioxane, and 2-nitropropane, have been
      notified for use in pesticides. Exposure to such solvents could partly explain
      some of the reported excesses of leukemia and non-Hodgkin's lymphoma among
      farmers.

PMID- 8465175
TI  - The International Commission on Occupational Health. Past and present.

PMID- 8465176
TI  - Formaldehyde exposure and respiratory cancer--a meta-analysis of the
      epidemiologic evidence.
AB  - A recent meta-analysis by Blair and his co-workers stimulated the undertaking of
      a reanalysis of the epidemiologic evidence of an association between formaldehyde
      and respiratory cancer. Emphasis was placed on extracting the maximal amount of
      relevant data from the source studies. In close agreement with the original
      analysis, the aggregated evidence did not indicate an excess risk or an exposure
      response gradient for lung cancer. An exposure-response gradient was seen for
      both sinonasal and nasopharyngeal cancers. The risk for substantial exposure was
      significantly elevated (odds ratio 1.7 for sinonasal and 2.7 for nasopharyngeal
      cancer). It is suggested that at least substantial levels of occupational
      exposure to formaldehyde are associated with a risk of these cancers. The excess
      risk would be of the order of 100% or more over background rates.

PMID- 8465177
TI  - [30 years of the Swine Health Service].
AB  - The establishment of a Porcine Health Service (PHS) was pioneered in the early
      sixties. After reviewing the history of the formation of the PHS, a few examples
      of how it stimulated research in several fields in our two faculties are given.
      The development of the PHS was noticeably slowed down by yearly recurrent
      "mysterious" outbreaks of actinobacillosis and especially enzootic pneumonia.
      Epidemiologic investigations have since shown that the reintroductions of these
      pathogens can occur by airborne transmission. This information filled the last
      important gap in the battle against these economically and public health
      important diseases. Simultaneously it became apparent that enzootic pneumonia and
      actinobacillosis are not merely herd problems but epizootics which can only be
      eradicated by means of modern disease control legislation. The question is posed
      whether or not the PHS, which is potentially a valuable tool in the hands of the
      state veterinarians, should continue to remain under the control of the
      producers.

PMID- 8465178
TI  - [Infection with Bacillus piliformis (Tyzzer's disease) in foals].
AB  - Tyzzer's disease, caused by Bacillus piliformis and characterized by a
      multifocal, necrotizing hepatitis was diagnosed in a 25 days old, male, German
      warmblood foal. The animal was submitted to the clinic of horses because of colic
      symptoms and a severe depression. Upon arrival it was comatose, recumbent and
      showed opisthotonos. Due to a severe, metabolic acidosis and a rapid progression
      of the disease, the foal was euthanatized. In immediately formalin-fixed tissue
      samples Bacillus piliformis was detected in the cytoplasma of hepatocytes by
      different histological techniques (Giemsa stain, silver impregnation technique by
      Warthin-Starry, immunohistology). This case is discussed within a literature
      review.

PMID- 8465179
TI  - [Local and systemic infections with bacteria of group EF-4 in dogs, cats and in a
      badger: bacteriologic and pathologico-anatomic results].
AB  - Bacteria of Group EF-4 were isolated in 7 dogs and in 5 cats from local purulent
      lesions in areas of natural openings of the head and from bite wounds, from lungs
      with focal necrotizing pneumonia in 2 additional cats and from internal organs in
      a badger with septicemia. The organisms grew mostly in pure culture. In
      conventional biochemical tests, 12 isolates were shown to belong to biovar EF-4a
      and 3 isolates to EF-4b. Classification as Group EF-4 was confirmed by
      assimilation tests performed with the commercially available gallery ATB 32 GN.
      Results of this study indicate that in veterinary medicine, bacteria of Group EF
      4 are not only important from an epidemiological point of view, but that they may
      be more pathogenic for animals than considered hitherto.

PMID- 8465180
TI  - [Umbilical blood flow relations in pregnancy complications. Part 2. Pathologic
      index constellations].
AB  - In a study comprising a total of 700 pregnant women, umbilical resistance was
      examined. Measurements were taken at both sides of the cord. A decline in
      resistance was registered from the fetal abdominal wall to the placental
      insertion of the vessels. According to a collective of 500 patients with a normal
      development and outcome of their pregnancies a physiological constellation of the
      resistance indices could be confirmed. It was taken as a basis for the definition
      of pathological cases. Different pathologies were related quite clearly to a
      special (unphysiological) constellation of the indices.

PMID- 8465181
TI  - [Blood flow in the umbilical artery in maternal hypotonia].
AB  - We performed a study in Doppler sonography in pregnant patients with hypotension
      compared with women in pregnancy with normal blood pressure. The flow was
      measured in the foetal aorta, the umbilical artery such as in the A. arcuate and
      A. cerebri media. Low blood pressure is followed by decreased uteroplacental
      perfusion. That means a haemodynamic danger for the foetus reflected in
      significantly increased flow parameters. The low central flow indices show a
      centralisation of the foetal blood circulating system. These findings describe
      the importance of hypotension as a risk of pregnancy we have to observe
      carefully.

PMID- 8465182
TI  - [Apple-Macintosh compatible software for documentation, management and evaluation
      of ultrasound findings in obstetrics].
AB  - The advantage of using a computer to automate routine calculations and print out
      charts of the obstetrical ultrasound examination is obvious. This report
      describes a software designed to simplify the documentation and analysis of
      ultrasound data in obstetrics. The system is easy to use, even for persons with
      little computer knowledge. The programme was written in FoxBase+/Mac (Fox
      Software, Inc., USA). FoxBase+/Mac takes full advantage of the easy-to-learn,
      easy-to-use Macintosh interface and is also very fast. Another advantage of this
      software is that it can be used in teaching. Non-experienced examinators can
      double-check the correctness of their scanning planes by observing the ultrasound
      pictures with the markers indicating the right measurement sites and the lists of
      standard values of biometrical parameters for the corresponding gestational age
      on the screen. In routine obstetrical ultrasound examinations it takes less than
      5 min to enter the foetal biometry data and print out reports. These reports are
      informative and easy to interpret.

PMID- 8465183
TI  - [Ultrasound diagnosis of cervical lymph node tuberculosis].
AB  - Lymph node tuberculosis is the most frequent tuberculous manifestation in the
      otorhinolaryngological area. In 13 patients with histologically verified
      tuberculous lymphadenitis cervical sonographic examinations revealed
      characteristic findings. The sonographic features typical for this disease were
      multiple, enlarged, conglomerating roundish and oval lymph nodes. These lymph
      nodes were hypoechoic, exhibited dorsal sound amplification and had sharp
      margins. With caseation, however, there were blurred borders. In cold abscesses
      an inhomogeneous texture with inhomogeneous shadows was found. Differential
      diagnosis included non-specific abscess-forming lymphadenitis, lymph node
      metastases and malignant lymphoma. A tentative diagnosis of cervical lymph node
      tuberculosis may be made due to the polymorphous sonographic pattern if history
      and clinical findings are taken into account. A proper histological and
      microbiological work-up is still essential for confirmation of the sonographic
      diagnosis.

PMID- 8465184
TI  - [Prenatal diagnosis of fetal polymicrogyria--case report].
AB  - Migration disorders of foetal neurons are rare conditions which are normally
      diagnosed after birth and may be followed by severe alterations of neurological
      development. We describe a case of foetal hemilateral polymicrogyria in
      combination with hemihypoplasia of the brain, the symptoms of which were
      diagnosed in the 23rd week of pregnancy, leading to termination of pregnancy. To
      the best of our knowledge, this is the first case report of antenatal diagnosis
      of this disorder by vaginal sonography.

PMID- 8465185
TI  - [Early recognition of fetal abnormalities by transvaginal ultrasonography].
AB  - Three case reports illustrate situations where transvaginal sonography (TVS) can
      be important for detecting foetal malformation. In each of these cases a reliable
      diagnosis was not possible by abdominal ultrasound either because the part of the
      foetus to be examined lay too low in the pelvis or because it could not be imaged
      clearly enough due to lack of amniotic fluid. As we would recommend in such
      cases, diagnosis was then made by TVS. Since the area which can be imaged by TVS
      is limited mechanically by the anatomical situation, however, it should not be
      used as the primary method for prenatal screening, whereas in certain selected
      cases it can provide information not obtainable otherwise.

PMID- 8465186
TI  - [Acute renal vein thrombosis in children. Early detection with duplex and color
      coded Doppler ultrasound].
AB  - Two children with clinically suspected renal vein thrombosis were evaluated by
      duplex Doppler sonography and colour flow imaging. Both cases presented
      unspecific findings with an enlarged kidney and loss of cortico-medullary
      delineation on gray-scale ultrasound, but an unusual flow pattern with retrograde
      plateau-like frequency shifts during diastole. No venous signal could be
      obtained. By colour flow imaging only the main renal artery and its proximal
      branches could be visualised with a reverberating oscillation of blood flow. In
      addition, partial thrombosis of inferior vena cava in one patient and iliac vein
      thrombosis in the other could be demonstrated. Clinical improvement during
      fibrinolytic therapy in one case and nephrectomy in the other case confirmed the
      diagnosis.

PMID- 8465187
TI  - [Intrauterine meconium peritonitis. A rare cause of non-immunologic hydrops
      fetalis].
AB  - A case of foetal non-immune hydrops fetalis is presented. A second gravida was
      referred to our department at 31 weeks' gestation after normal pregnancy course.
      Sonography revealed marked foetal ascites as well as a polyhydramnion. Prenatal
      examinations did not yield a safe diagnosis. The foetal ascites was punctured via
      a pigtail-catheter that was left in the foetal abdomen. This procedure was
      supposed to facilitate the development of foetal lungs. At 33 weeks' gestation,
      after spontaneous rupture of membranes, a boy was spontaneously delivered.
      Postpartal radiography pointed to bowel perforation. Surgery on the first day of
      life showed a severe meconium peritonitis following a perforation of the ileum.
      22 months after this operation, the boy is physically and mentally well
      developed. Until now, there is no sign of mucoviscidosis. We believe that early
      diagnosis, the possibility of prenatal therapy and the close collaboration of
      disciplines made the survival of this child possible.

PMID- 8465188
TI  - [Introduction to ultrasonic diagnosis].

PMID- 8465189
TI  - [References for prenatal diagnosis of morphological defects including the central
      nervous system].
AB  - Clinical and autopsy records of 209 stillborn and 81 miscarried infants with 484
      congenital defects of the central nervous system were analysed. Sets of more than
      one defect were retrospectively classified by pathogenetic criteria as syndrome,
      sequence, association and midline defects. Pathogenetic thinking makes the
      prenatal diagnosis of further defects easier if one has already been diagnosed.
      Statements regarding the most probable localisation of neural tube defects have
      been made.

PMID- 8465190
TI  - Improvements in health care.

PMID- 8465191
TI  - EMF and cancer. ORAU Panel on Health Effects of Low-Frequency Electric and
      Magnetic Fields.

PMID- 8465192
TI  - Drug abuse research.
AB  - The references in Philip H. Abelson's editorial of 5 February, "Science,
      technology, and national goals" (p. 743), were incorrect. The first reference
      should have read, "H. T. Shapiro, The Bridge 22 (no. 3), 14 (1992)." The second
      reference should have read, "R. E. Gomory, ibid. (no. 2), p. 18."

PMID- 8465193
TI  - DOD to single out MicroGeneSys vaccine.

PMID- 8465194
TI  - Researchers win decision on knockout mouse pricing.

PMID- 8465195
TI  - NSF wins, NIH loses in Clinton's 1994 budget.

PMID- 8465196
TI  - Huntington's gene finally found.

PMID- 8465197
TI  - Toxicologists-and snow-descend on New Orleans.

PMID- 8465198
TI  - DNA repair and transcription: the helicase connection.

PMID- 8465199
TI  - Cognitive neurophysiology of the motor cortex.
AB  - A major challenge of current neuroscience is to elucidate the brain mechanisms
      that underlie cognitive function. There is no doubt that cognitive processing in
      the brain engages large populations of cells. This article explores the logic of
      investigating these problems by combining psychological studies in human subjects
      and neurophysiological studies of neuronal populations in the motor cortex of
      behaving monkeys. The results obtained show that time-varying psychological
      processes can be visualized in the time-varying activity of neuronal populations.
      Moreover, the functional interactions between cells in the motor cortex are very
      similar to those observed in a massively interconnected artificial network
      performing the same computation.

PMID- 8465200
TI  - Molecular mechanism of transcription-repair coupling.
AB  - Lesions in the transcribed strand block transcription and are repaired more
      rapidly than lesions in the nontranscribed (coding) strand which do not block RNA
      polymerase (RNAP). It has been shown previously that in Escherichia coli the mfd
      (mutation frequency decline) gene is necessary for strand-specific repair. The
      mfd gene was cloned and sequenced and the Mfd protein was purified and used to
      reconstitute strand-specific repair in a completely defined system. The mfd gene
      encodes a protein of 130 kilodaltons and contains the so-called "helicase
      motifs," a leucine zipper motif, and regions of sequence similarity to UvrB and
      RecG proteins. The Mfd protein was shown to (i) displace RNAP stalled at a lesion
      in an adenosine triphosphate-dependent reaction, (ii) bind to the damage
      recognition subunit (UvrA) of the excision nuclease, and (iii) stimulate the
      repair of the transcribed strand only when transcription is taking place. Thus,
      Mfd appears to target the transcribed strand for repair by recognizing a stalled
      RNAP and actively recruiting the repair enzyme to the transcription blocking
      lesion as it dissociates the stalled RNAP.

PMID- 8465201
TI  - DNA repair helicase: a component of BTF2 (TFIIH) basic transcription factor.
AB  - The human BTF2 basic transcription factor (also called TFIIH), which is similar
      to the delta factor in rat and factor b in yeast, is required for class II gene
      transcription. A strand displacement assay was used to show that highly purified
      preparation of BTF2 had an adenosine triphosphate-dependent DNA helicase
      activity, in addition to the previously characterized carboxyl-terminal domain
      kinase activity. Amino acid sequence analysis of the tryptic digest generated
      from the 89-kilodalton subunit of BTF2 indicated that this polypeptide
      corresponded to the ERCC-3 gene product, a presumed helicase implicated in the
      human DNA excision repair disorders xeroderma pigmentosum and Cockayne's
      syndrome. These findings suggest that transcription and nucleotide excision
      repair may share common factors and hence may be considered to be functionally
      related.

PMID- 8465202
TI  - Aqueous-phase photochemical formation of peroxides in authentic cloud and fog
      waters.
AB  - Gas-to-drop partitioning of hydrogen peroxide and its precursor, the hydroperoxyl
      radical (HO2.), has been considered the predominant or sole source of hydrogen
      peroxide in atmospheric water drops. However, atmospheric water can absorb solar
      ultraviolet radiation, which initiates the photoformation of peroxides (primarily
      hydrogen peroxide). Measurements of peroxide photoformation rates in authentic
      atmospheric water samples demonstrate that aqueous-phase photochemical reactions
      are a significant, and in some cases dominant, source of hydrogen peroxide to
      cloud and fog drops. This additional source could significantly change the
      current understanding, and hence, the models, of sulfuric acid deposition because
      hydrogen peroxide is the limiting reagent in the dominant pathway for the
      oxidation of sulfur dioxide to sulfuric acid in the troposphere over eastern
      North America.

PMID- 8465203
TI  - Altered growth of human colon cancer cell lines disrupted at activated Ki-ras.
AB  - Point mutations that activate the Ki-ras proto-oncogene are presented in about 50
      percent of human colorectal tumors. To study the functional significance of these
      mutations, the activated Ki-ras genes in two human colon carcinoma cell lines,
      DLD-1 and HCT 116, were disrupted by homologous recombination. Compared with
      parental cells, cells disrupted at the activated Ki-ras gene were morphologically
      altered, lost the capacity for anchorage-independent growth, grew more slowly
      both in vitro and in nude mice, and showed reduced expression of c-myc. Thus, the
      activated Ki-ras gene plays a key role in colorectal tumorigenesis through
      altered cell differentiation and cell growth.

PMID- 8465204
TI  - Magnetic resonance imaging of the scrotum.

PMID- 8465205
TI  - Case of the season. Intussusception.

PMID- 8465206
TI  - The role of nuclear medicine in the evaluation of the male genital tract.
AB  - Scintigraphic techniques for evaluation of impotence are still evolving. Blood
      pool studies are most useful in assessing the integrity of arterial inflow, but
      may also be used to generate indices of venous leak. A non-imaging version of
      this test may represent a simple and cost-effective alternative. Washout of
      intracavernosal xenon during erection seems the most useful method of testing
      venous integrity. Washout using Tc-RBC may emerge as a convenient alternative to
      the more technically difficult xenon examinations. Development of more effective
      pharmacologic stimuli may further improve the utility of this quantitative and
      physiologic examination.

PMID- 8465207
TI  - Duplex Doppler ultrasonography: noninvasive assessment of penile anatomy and
      function.

PMID- 8465208
TI  - Ultrasound of the scrotum.

PMID- 8465209
TI  - Magnetic resonance imaging of the prostate.

PMID- 8465210
TI  - Imaging of the seminal vesicles.

PMID- 8465211
TI  - Multiple cerebral aneurysms in patients with sickle cell disease.
AB  - Patients with sickle cell disease appear to have a high incidence of cerebral
      aneurysm. These aneurysms are not associated with the usual risk factors of
      hypertension, renal disease, or connective tissue disease. We present two recent
      cases of patients with sickle cell disease and multiple cerebral aneurysms,
      review the literature on the association between sickle cell disease and cerebral
      aneurysms, and discuss a mechanism by which sickle cell disease may lead to the
      formation of cerebral aneurysms.

PMID- 8465212
TI  - Expectations and needs of persons with family members in an intensive care unit
      as opposed to a general ward.
AB  - The positive effect of family support on the outcome from serious illness that
      requires intensive care has been recognized by clinicians for decades. We have
      all seen that family visitation and an intensive care environment more similar to
      that of a general ward (sunlight, radio, television) can benefit patients with
      psychosis related to intensive care. The severity of illness of the individual
      patient exerts a powerful stress on the family unit, but it has been difficult to
      measure this effect. We used a 40-question family needs survey with a degree of
      importance scale to compare the intensive care unit (ICU) with the general ward
      in terms of impact on the family. Five needs were found to discriminate these two
      environments. The family members of patients in an ICU considered it very
      important (1) for staff to give directions on what to do at the bedside, (2) to
      receive more support from their own family unit, (3) to have a place to be alone
      as a family unit in the hospital, (4) to be informed in advance of any transfer
      plan, and (5) to have flexibility in the time allowed for visitation. Family
      members are willing to accept decreased visitation time if the physicians and
      nurses can equate this decrease with the complexity of care in the ICU. The
      results of this survey have helped us modify and individualize our approach based
      on family expectations especially when patients are transferred from the general
      ward to the ICU or from the ICU to the ward.

PMID- 8465213
TI  - The Texas Breast Screening Project: Part I. Mammographic and clinical results.
AB  - The 1987 Texas Breast Screening Project was designed to educate women about the
      benefits and safety of mammographic screening. During the 2-week promotion,
      109,339 women called toll-free telephone numbers to inquire about the program,
      and 64,459 (65%) of 99,650 eligible callers had $50 mammograms at 306
      participating community radiology centers. Biopsies were obtained for 1,122 women
      (1.7% of those screened), and the ratio of benign to malignant biopsy results was
      4.2:1. Among the women having biopsies, 214 cancers were found (3.3 cancers per
      1,000 women screened). Forty-seven percent of the tumors were not palpable, 80%
      were smaller than 2 cm, and 72% were clinicopathologic stage 0 or I. These
      results show that women will respond to an invitation to attend mammographic
      screening, and that community radiology centers can detect large numbers of
      early, curable breast cancers.

PMID- 8465215
TI  - Incentives for physicians to treat HIV-seropositive patients: results of a
      statewide survey.
AB  - We asked primary care physicians in South Carolina about their knowledge,
      attitudes, and beliefs regarding patients with human immunodeficiency virus (HIV)
      infection and acquired immunodeficiency syndrome (AIDS) and the services they
      provide for these patients. In support of an effort to develop more effective
      state policies regarding HIV/AIDS, the survey focused on conditions under which
      physicians would provide additional services for such patients; 597 of 900
      physicians (66%) responded. Among responding physicians, 40% had not seen a
      patient with HIV infection/AIDS during the past year and 50% had seen only one to
      nine. Respondents identified lack of specialty backup support, insufficient
      clinical knowledge, and lack of available community services as the major
      barriers to providing care for these patients. Gaps in their knowledge included
      state and federal policies, available community resources, and clinical issues.
      Respondents said they would provide additional services if they had specialty
      backup (54%), better community and social support services (50%), additional
      training (46%), and limited liability (44%). We concluded that policy changes in
      these areas could expand access to care for HIV/AIDS patients in South Carolina.

PMID- 8465214
TI  - The Texas Breast Screening Project: Part II. Demographics, risk profiles, and
      health practices of participants.
AB  - More than 36,000 of the 64,459 women who had $50 mammograms after a media
      campaign in 1987 completed a demographic and risk factor questionnaire. The
      screened women were young and well educated with high annual incomes. Only 32%
      had had mammograms before 1987. Most women reported that high cost and lack of
      referral for mammography by their physicians were their reasons for not being
      screened previously. Publicity promoting the project and the lower cost for
      mammography were the features of the project that attracted participants.
      Population-based telephone surveys before and after the project showed a change
      in attitudes about breast cancer screening. The model used for recruitment in
      this project can improve compliance with recommendations for regular mammographic
      screening if charges for screening are reduced. Additional efforts are needed to
      attract minorities and poor or elderly women to regular breast screening.

PMID- 8465216
TI  - Conservative alternatives in the management of early adenocarcinoma of the
      rectum.
AB  - The majority of patients with adenocarcinoma of the rectum are treated with
      radical surgical procedures. Lesions located in the distal third of the rectum
      are usually treated by abdominoperineal resection, and those situated in the
      proximal portion of the rectum are treated by low-anterior resection. Relatively
      small, moderately or well differentiated lesions have a low risk of lymph node
      metastasis, and are therefore amenable to conservative (ie, rectum-sparing)
      procedures. Conservative management options consist of transrectal excision,
      transrectal excision and preoperative or postoperative radiotherapy, endocavitary
      contact radiotherapy, and interstitial therapy. Discussion of these options, the
      experience at the University of Florida with two of these options, and review of
      the literature follow.

PMID- 8465217
TI  - Pregnant patients in the intensive care unit: a descriptive analysis.
AB  - We present a descriptive analysis of experience with pregnant women in the
      intensive care units at a tertiary hospital. During the period from 1983 through
      1990, 38 women were admitted to our intensive care units during their pregnancy
      or within 2 weeks postpartum. This was a rate of 1 per 400 pregnant patients. The
      mean age of these 38 women was 25 years; 68% of them were white and 32% were
      primigravidas. Nineteen of the 38 women were mechanically ventilated. Twelve
      women were admitted for hypertensive disease and 10 for adult respiratory
      distress syndrome. Maternal mortality was 18% (7/38). Follow-up was available for
      33 women. The fetal and neonatal loss rate in this group was 4 of 33 pregnancies.
      In this case series of 38 very ill women, it was apparent that a team approach of
      obstetricians, anesthesiologists, and intensive care workers provided optimal
      management for the mother and child.

PMID- 8465218
TI  - Doppler ultrasonography of the umbilical cord in complicated pregnancies.
AB  - Ninety-two gravid women had Doppler insonation of the umbilical cord after
      diagnosis of various pregnancy complications. Calculations of the systolic
      diastolic (S/D) ratio were plotted against a nomogram of values developed at the
      Hospital of the University of Pennsylvania. An S/D ratio greater than the 95th
      percentile for gestational age correctly predicted 58% of women who became
      preeclamptic and 61% of infants who were small for gestational age (SGA). Of
      those fetuses with an elevated S/D ratio, 42% suffered fetal distress as defined
      by an abnormal fetal heart rate tracing, a 1- or 5-minute Apgar score less than 5
      or 7, respectively, or a cord blood pH determination less than 7.20; 60% required
      operative delivery; and 49% stayed in the hospital longer than 5 days or were
      admitted to the Neonatal Intensive Care Unit (NICU). All these values are
      significantly greater than those obtained in a control group of uncomplicated
      pregnancies or a group of women with similar pregnancies, but with normal
      measurements of the umbilical artery S/D ratio. Moreover, 69% of abnormally
      elevated umbilical artery S/D ratios were detected at or before 30 weeks'
      gestation. Calculation of an S/D ratio of the umbilical cord greater than the
      95th percentile for gestational age is an early and sensitive predictor of poor
      perinatal outcome.

PMID- 8465219
TI  - Management of borderline tumors of the ovary.
AB  - We retrospectively reviewed the cases of 51 patients with borderline ovarian
      tumors seen over a 9-year period. Half of these tumors were manifested by
      abdominal distention and pain; the remainder were found incidentally at the time
      of surgery planned for other reasons. Overall survival is excellent, but proper
      surgical staging reveals that approximately 15% of patients have metastasis
      beyond the ovaries, most commonly to the omentum, peritoneum, and retroperitoneal
      lymph nodes.

PMID- 8465221
TI  - Personality disorders: an overview for the physician.
AB  - Personality disorders are common clinical syndromes that often go unrecognized in
      medical practice. Because patients with personality disorders receive care in all
      clinical settings, physicians could profit from a heightened awareness of the
      personality psychopathology of their patients and its impact on medical practice.
      Personality traits are universal and describe the "normal" range of behavior,
      while personality disorders are characterized by enduring maladaptive patterns.
      The etiology of personality disorders is multifactorial. Physician awareness of
      the multiple manifestations of specific personality disorders is helpful in
      matching the proper interventions to appropriate patients. Although management is
      symptomatically palliative rather than curative, physicians and patients alike
      can benefit from appropriate recognition and treatment of personality disorders.

PMID- 8465220
TI  - Superiority of amniotic fluid index over amniotic fluid pocket measurement for
      predicting bad fetal outcome.
AB  - Semiquantitative amniotic fluid volume (AFV) determination is a component of the
      fetal biophysical profile (BPP). To assess decreased AVF we did BPPs of 174
      fetuses within 1 week of delivery. Two methods were used: measurement of the
      single largest vertical pocket (oligohydramnios = depth < 1 cm) and the four
      quadrant amniotic fluid index (AFI) (oligohydramnios = AFI < or = 5 cm). AFV, as
      determined by each method, was related to measures of fetal outcome (perinatal
      mortality, fetal distress, Apgar score, meconium-stained amniotic fluid, and
      intrauterine growth retardation [IUGR]). The AFI was more sensitive in predicting
      mortality (87.5%) and the following measures of perinatal morbidity: low 5-minute
      Apgar score (88.8%), fetal distress during labor (86.6%), meconium-stained
      amniotic fluid (63.6%), and the presence of IUGR (79.4%). The sensitivity of
      amniotic fluid pocket measurement of < 1 cm was 75%, 72.2%, 66.6%, 47.7%, and
      55.8%, respectively, for the same measures. Using the AFI instead of a single
      pocket measurement in BPP assessment increased the sensitivity and positive
      predictive value of the BPP from 64.7% to 76.4% and from 45.8% to 68.4%,
      respectively. Our data suggest that qualitative AFV measurement using the AFI is
      superior to that of the single largest pocket in multiple component fetal
      biophysical testing.

PMID- 8465222
TI  - Deep venous thrombosis.
AB  - Deep venous thrombosis is a common problem in clinical medicine and the focus of
      research from many perspectives, including incidence, identification of risk
      factors, diagnosis, treatment, and sequelae. Because of their frequency and
      resultant morbidity and mortality, these thromboses demand our continued respect
      and necessitate vigilance in continuing education regarding new developments in
      diagnosis and management.

PMID- 8465223
TI  - Moonlighting in a university surgical training program.
AB  - The impact of house officer moonlighting on training performance was assessed
      through a faculty questionnaire and house officer survey distributed in the
      Department of Surgery at Tulane University School of Medicine. Responses were
      obtained from 30 house officers and 15 faculty members. Most house officers who
      moonlighted did so one or two times each month; most were employed in emergency
      departments. Yearly earnings from moonlighting averaged approximately $10,000.
      Although many house officers were in debt from medical school, debt was not the
      primary reason for moonlighting. Many faculty members disapproved of
      moonlighting, but agreed to monitoring by clinical performance and American Board
      of Surgery In-Training Examination. A statistically significant relationship was
      found between yearly income from moonlighting and decreasing scores on the
      American Board of Surgery In-Training Examination.

PMID- 8465224
TI  - Juvenile laryngeal papillomatosis: a new complication.
AB  - Extension of juvenile papillomas to the lung parenchyma is unusual. When it
      occurs, the patient's prognosis worsens because these lesions destroy lung tissue
      as they grow. Respiratory complications eventually occur in the presence of
      multiple nodular and cystic lesions due to the attendant parenchymal destruction.
      We have observed that pneumothorax can occur after the development of cystic
      pneumatoceles, presumably from the ball valve effect of a nodular lesion (Fig 3).

PMID- 8465225
TI  - Cryptococcal pneumonia occurring as an infiltrative mass simulating carcinoma in
      an immunocompetent host: plain film, CT, and MRI findings.
AB  - Cryptococcosis, a potentially fatal pulmonary infection, rarely occurs in
      advanced form in immunocompetent individuals. Radiographic findings are variable
      and include single and multiple mass-like infiltrates, nodules, and segmental
      infiltrates. MRI manifestations of pulmonary cryptococcosis have not been
      reported previously. We have compared MRI, CT, and plain film radiographic
      findings in a case of multisegmental cryptococcal pneumonia occurring as a mass
      simulating carcinoma in an immunocompetent individual; we have also discussed the
      differential radiographic evaluation of pulmonary cryptococcosis.

PMID- 8465226
TI  - Holt-Oram syndrome associated with hypoplastic peripheral vasculature and
      midsystolic click.
AB  - Holt-Oram syndrome is a rare, autosomal dominant syndrome characterized by upper
      extremity skeletal abnormalities and cardiac defects. The most common skeletal
      anomalies involve the thumbs and range from minor radiographic abnormalities to
      phocomelia. The most common cardiovascular abnormality is ostium secundum ASD,
      followed by ventriculo-septal defect and ostium primum ASD. MVP and hypoplastic
      peripheral vasculature of the upper extremities have been reported only rarely.
      We have reported the case of a patient with HOS who has both hypoplastic
      peripheral upper extremity vasculature and evidence of MVP.

PMID- 8465227
TI  - Unusual calcified goiter associated with increased iodoprotein in serum.
AB  - For 30 years we have followed the case of a euthyroid patient who had a goiter
      diagnosed at age 15. It was originally diffuse and did not shrink during
      treatment, first with desiccated thyroid extract and then with triiodothyronine.
      After treatment was stopped, the goiter gradually became nodular and calcified
      when the patient was in her late teens or early 20s; it then shrank. She remains
      clinically and chemically euthyroid, with a calcified, multinodular goiter and
      persistent elevation of the serum PBI concentration which, early in the course of
      the disease was shown to include a substantial fraction of butanol-insoluble
      iodine. In a euthyroid patient, the association of an elevated serum PBI
      concentration (with an abnormally large butanol-insoluble iodine fraction) with a
      diffuse goiter that became nodular and calcified may be unique.

PMID- 8465228
TI  - Cicatricial pemphigoid.
AB  - This case of CP is of interest because of its "not-so-benign" course in this
      patient, its unusual immunofluorescence patterns, and the need for a complex
      therapeutic regimen to achieve control. This patient had severe ocular;
      laryngeal, and oropharyngeal involvement leading to visual problems, hoarseness,
      and marked weight loss and dehydration. He also had anemia thought to be
      partially related to dapsone use. We believe the side effects of dapsone,
      combined with fluid retention due to prednisone therapy, contributed to cardiac
      failure. The diagnosis of CP is usually established by correlation of clinical
      findings with immunofluorescence studies. However, indirect immunofluorescence
      may show strong intercellular antibody binding in the epidermis (ie, pemphigus
      like antibodies). Treatment alternatives for patients with CP who have adverse
      reactions to, or no significant benefit from, conventional agents such as dapsone
      or prednisone may include immunosuppressive agents such as azathioprine or
      cyclophosphamide. As this case demonstrates, care of patients having CP involves
      a cooperative effort from a number of different specialties, including
      dermatology, primary care, ophthalmology, and otolaryngology.

PMID- 8465229
TI  - Dilated cardiomyopathy as an early and rapidly progressive presentation in a
      woman with acquired immunodeficiency syndrome.
AB  - Cardiac disease associated with AIDS is common and is manifested by a variety of
      lesions. With the advances in therapy for common opportunistic infections, AIDS
      associated cardiac abnormalities will play a prominent role in morbidity and
      mortality. This case illustrates a rapidly progressive and fetal course of AIDS
      associated dilated cardiomyopathy in an HIV-infected young woman in relatively
      stable condition. It is important to be aware of the cardiac manifestations of
      AIDS so that one can undertake a rational diagnostic and therapeutic approach.

PMID- 8465230
TI  - Pustulotic arthro-osteitis: a cause of atypical chest pain and a new arthritic
      syndrome.
AB  - We have described a 38-year-old white American woman who had a 7-year history of
      pain in the left anterior chest, neck, right wrist, and buttocks. The pain
      fluctuated in severity and appeared to coincide with worsening of her skin
      condition, palmoplantar pustulosis (PPP). She manifested the typical skeletal
      features of an arthritic condition referred to as pustulotic arthro-osteitis,
      which is frequently associated with the characteristic rash of PPP. This is an
      infrequently described disorder in the United States, possibly reflecting lack of
      familiarity or confusion with related disorders.

PMID- 8465231
TI  - Gaucher's disease associated with chronic lymphocytic leukemia.
AB  - To date, only five cases of associated Gaucher's disease and chronic lymphocytic
      leukemia (CLL) have been reported in the world literature. The exact relationship
      of the two diseases to one another has been puzzling, and Gaucher's disease has
      been viewed as both a cause of and an epiphenomenon to chronic lymphocytic
      leukemia. In this case, because of the temporal relationship of the two
      conditions and the confirmation of Gaucher's disease by both histochemical means
      and electron microscopy, we believe that a cause/effect interaction may exist.
      However, the exact mechanism by which this may occur is, as yet, speculative.

PMID- 8465232
TI  - Severe bruxism in a demented patient.

PMID- 8465233
TI  - Granular cell myoblastoma involving multiple organs.
AB  - We have described a rare case of multifocal granular cell myoblastoma affecting
      respiratory and hepatobiliary tracts in a young woman. The patient had successful
      tracheal resection and biliary stent placement to alleviate symptoms. Long-term
      follow-up will clarify the true nature of the disease.

PMID- 8465234
TI  - On 60 years of observation and interpretation in one disease: a comment on the
      career of L. W. Diggs, MD.

PMID- 8465235
TI  - Does social deprivation during gestation and early life predispose to later
      schizophrenia?
AB  - We employed a case-control study design to investigate whether schizophrenic
      patients differed from non-psychotic psychiatric patients in terms of place of
      birth and paternal occupation. "Cases" were first-contact schizophrenic patients
      ascertained from the Camberwell Cumulative Psychiatric Case Register. "Controls"
      were the next (non-psychotic) patient on the Register matched for age and sex. In
      comparison with controls, cases were more likely to have: (1) been born in the
      deprived inner-city Camberwell catchment area (odds ratio 2.3), and (2) had
      fathers who had "manual" as opposed to "non-manual" occupations (odds ratio 2.1).
      The results were compatible with the notion that socio-economic deprivation
      during gestation and early life predisposes to later schizophrenia.

PMID- 8465236
TI  - The needs of high and low expressed emotion families: a normative approach.
AB  - Comparison of the needs and characteristics of relatives classified as high and
      low expressed emotion (EE) across a range of measures including social
      functioning and indices of stress and family burden revealed that high EE
      relatives reported higher levels of disturbed behaviour, subjective burden, and
      perceived themselves as coping less effectively. Individuals from high-EE
      households were more impaired in terms of social functioning, particularly in
      terms of independence and interpersonal functioning. No difference in overall
      knowledge about schizophrenia was observed between high and low EE relatives,
      although high EE relatives possessed more information about hospital procedures.
      Analysis of needs assessment data, based on a normative approach to need,
      revealed that two-thirds of high EE relatives, as against one-third of low EE
      relatives had high needs in at least one or more of the following five areas:
      knowledge about schizophrenia, subjective burden, personal stress, behavioural
      disturbance and perceived coping. No low EE relative had high needs on all five
      criteria. The implications of the results for the meaning and genesis of EE and
      for service provision are considered.

PMID- 8465237
TI  - Utilization patterns of community mental health services by newly referred
      patients.
AB  - The present study compared the pattern of service utilization over a 1-year
      period, of 349 newly referred adult patients to the four community mental health
      clinics in Jerusalem. Treatment in these clinics is provided free of charge and
      there are no limits on length of treatment. Irrespective of patient diagnosis and
      clinic setting, the percentage of patients remaining in contact with the clinics
      declined sharply during the first 3 months, and after 6 months stabilized to
      around 25-40%. However, among patients with nonmajor psychiatric disorders, inter
      clinic variation in compliance with treatment was observed. In clinics with a
      long-term psychotherapeutic orientation, a larger proportion of patients was
      referred to other services following intake, and a larger proportion of patients
      dropped out of treatment. In these clinics, more patients were placed on waiting
      lists before beginning treatment, and the drop-out rate among these patients was
      significantly higher than that of patients in treatment. The implications of
      these results for treatment policy in public services are discussed.

PMID- 8465239
TI  - Psychiatric morbidity in social workers' clients. A comparison between an inner
      city area and a small town.
AB  - The rate of psychiatric disorder in a social services sample in a small town was
      compared to the rate in an inner-city sample. Nearly 40% of respondents in the
      small town had a positive General Health Questionnaire score and 37% had case
      status (ID greater than 5) on the Present State Examination. Most of these were
      cases of neurotic depression and were generally recognised as such by the social
      workers. The type of intervention undertaken by social workers differed in the
      two settings. Small-town social workers were more likely to offer advice,
      guidance, exploration and mobilisation of resources. The small-town social
      workers were more likely to have success in helping their clients with problems
      of social isolation and marital disharmony than were their inner-city
      counterparts. Mental illness problems, however, showed less improvement than in
      the inner-city sample, with over one-third of the small-town cases remaining
      unwell throughout the 12-month follow-up. Both previous psychiatric history and
      current depression were indicators of a poor outcome. The present findings
      provide further support for the argument that unless there is close collaboration
      between social workers, the medical profession, and health care teams, people who
      present their problems to social services are unlikely to have their mental
      health problems addressed adequately.

PMID- 8465238
TI  - Suicide in Hong Kong 1971-1990: age trend, sex ratio, and method of suicide.
AB  - This study gives an overview of the suicide rates in Hong Kong in the last 2
      decades (1971-1990). It was found that the average suicide rate for the whole
      population was 11.3 per 100,000 population and it has been quite steady in recent
      years. The male and female adolescent (age-group 10-24 years) suicide rates were
      approximately the same, while the ratio of the overall male to female rate was
      1.3:1. This indicated a relatively high female rate as compared with other
      countries. An examination of the suicide rates for various age-groups showed that
      the rate increased with age. The adolescent suicide rate was not particularly
      high (4.7 per 100,000 population for the age-group 10-24 years), but that for the
      elderly was 4-5 times the overall rate (49.5 per 100,000 population for those
      aged over 70 years). As regards the method of suicide, jumping from a height and
      hanging predominated in all age-groups. These methods were in great contrast to
      those used in other countries.

PMID- 8465240
TI  - Physical morbidity in older people with moderate, severe and profound mental
      handicap, and its relation to psychiatric morbidity.
AB  - This report describes a study of physical health problems and their relation to
      psychiatric morbidity in a community sample of 105 people with severe mental
      handicap and over the age of 50 years from a Metropolitan Borough. An extensive
      outreach exercise ensured that almost 100% of people fulfilling the age and
      ability criteria were included in the study. All the physical and mental health
      assessments were carried out by a psychiatrist at senior registrar level.
      Physical assessments used a combination of physical examination and access to the
      subject's medical records. Results showed that, with minor exceptions, the
      physical health of the handicapped population was no worse than that of controls.
      Contrary to expectation, no relationship was demonstrated between physical and
      psychiatric morbidity. However, this may be due to the greater difficulty in
      identifying psychiatric morbidity in people who are more severely handicapped.
      Since physical health problems increase with level of handicap, the potential
      relation between physical and mental health is masked.

PMID- 8465241
TI  - A community survey of psychotropic drug consumption in South Verona: prevalence
      and associated variables.
AB  - A cross-sectional community survey was undertaken to investigate the pattern of
      psychotropic drug consumption in 453 community residents of South Verona.
      Overall, 15.0% of the subjects were taking psychotropics (benzodiazepines 13.5%,
      antidepressants 2.2%, neuroleptics 1.1%). Prevalence was higher in females
      (20.0%), in those over 45 years (25%), in high General Health Questionnaire (GHQ)
      scorers (26.2%), and in subjects with physical ill-health (27.0%), with social
      problems (20.0%), with distressing events (22.0%) and with alcohol abuse (32.3%).
      Logistic regression analysis showed that age, sex, GHQ score, physical ill-health
      and life events were all significantly and independently associated with
      psychotropic drug consumption.

PMID- 8465242
TI  - The sectorisation of psychiatric services in England and Wales.
AB  - Sectorisation is the establishment of small geographical catchment areas with
      dedicated mental health staff providing services to all patients living in the
      area. This model of care became very widespread during the 1980s in England and
      Wales: 81% of District Health Authorities responding to a postal questionnaire in
      this study were sectorised, and around three-quarters of these had become
      sectorised after 1980. However, this has occurred without central planning and
      with very little evaluation. Important questions remain to be answered about its
      efficacy for the severely mentally ill, about the provision of 24-h cover in a
      sectorised service, and about which services are appropriately provided at a
      sectorised and which at a centralised level.

PMID- 8465243
TI  - [Frequency of x-ray and alternative studies].

PMID- 8465244
TI  - [Radiation exposure in x-ray diagnosis and dose levels as a basic risk in present
      day radiation protection discussions].

PMID- 8465245
TI  - [Computed tomography of the gastrointestinal tract using water as contrast
      medium].

PMID- 8465246
TI  - [Magnetic resonance tomographic changes in intracranial and spinal tumors
      following radiotherapy].

PMID- 8465247
TI  - [Thymic hyperplasia as a potential differential diagnosis of mediastinal space
      occupying lesions following cytostatic therapy].

PMID- 8465248
TI  - [Gynecologic brachytherapy--from low-dose-rate to high-tech].
AB  - The transition from low-dose-rate (LDR) brachytherapy to high-dose-rate (HDR)
      afterloading treatment is in progress in most centres of radiation therapy. First
      reports of studies comparing HDR and LDR treatment in cervix cancer demonstrate
      nearly equal local control. In our own investigations on 319 patients with
      primary irradiated carcinoma of the cervix (125 HDR/194 LDR) we found the
      following control rates: Stage FIGO I 95.4%/82.9% (HDR versus LDR), stage FIGO II
      71.4%/73.7%, stage FIGO III 57.9%/38.5%. The results are not significant. The
      side effects--scored after EORT/RTOG criteria--showed no significant differences
      between both therapies for serious radiogenic late effects on intestine, bladder
      and vagina. The study and findings from the literature confirm the advantage of
      the HDR-procedure for patient and radiooncologist and for radiation protection
      showing at least the same results as in the LDR-area. As for radiobiological
      point of view it is important to consider that the use of fractionation in the
      HDR-treatment is essential for the sparing of normal tissues and therefore a
      greater number of small fractionation doses in the brachytherapy should be
      desirable too. On the other hand the rules, which are true for fractionated
      percutaneous irradiation therapy (overall treatment time as short as possible to
      avoid repopulation of tumor cells) should be taken into consideration in combined
      brachy-teletherapy regime in gynecologic tumors. The first step in this direction
      may be accelerated regime with a daily application of both treatment procedures.
      The central blocking of the brachytherapy region from the whole percutaneous
      treatment target volume should be critically reflected, especially in the case of
      advanced tumors.

PMID- 8465249
TI  - [Adjuvant radiotherapy following radical prostatectomy--results, acute and late
      toxicity].
AB  - Between 1975 and 1987, 53 patients with radical retropubic prostatectomy for
      adenocarcinoma of the prostate (pathological stage C or D1) underwent adjuvant
      radiotherapy. 26 of these patients additionally underwent subcapsular
      orchiectomy. Radiation therapy was given to 45 patients as 40 to 50 Gy to the
      pelvic lymph nodes followed by a boost to the tumor bed to a total of 64 to 70
      Gy. Only five of the 45 patients received treatment to prostate and pelvis
      developed progression, whereas four out of eight patients who were irradiated to
      the prostate alone showed progression (p < 0.01). The five- and ten-year disease
      free survival rates of 33 patients with stage C tumors were 91% and 83%, the
      local control rate 97% and 94%. 20 patients with stage D1 carcinoma showed a five
      year disease-free survival of 79% and a local control rate of 95%. 25/26 patients
      with subcapsular orchiectomy are living disease-free, 8/27 patients without
      hormonal manipulation had a progression of disease (p < 0.05). All 13 patients
      with well or moderate differentiated tumor are alive without evidence of disease,
      9/40 patients with poor differentiated carcinoma have shown tumor progression (p
      < 0.05). Compared to published results, our data suggest, that adjuvant
      radiotherapy can decrease local recurrence and probably increase disease-free
      survival in stage C and D1 carcinoma of the prostate.

PMID- 8465250
TI  - [Three-dimensional radiation planning. Studies on clinical integration].
AB  - The routine use of three-dimensional treatment planning was evaluated in a
      clinical project funded by the German Krebshilfe at the Radiological Department
      of the University of Heidelberg. 166 patients entered the prospective study
      within 14 months, 155 of them were treated according to the 3D-plans. More than
      50% of the patients had thoracic tumors, followed by pelvic tumors. One medicine
      physicist and one specially trained technician performed the treatment planning.
      The target volumes were contoured in the CT slices at the planning computer by
      the responsible radiotherapists. A mean of 6.5 hours per patient was necessary
      for all planning procedures, however, this time consumption shows a trend toward
      less time of only four hours including about ten optimization steps. Meanwhile
      approximately 20 to 30% of all computer assisted planning are performed in 3D,
      corresponding to about one plan per day. The achieved time consumption is a
      clinically accepted quantity, that allows the introduction of 3D-planning into
      clinical routine.

PMID- 8465251
TI  - Radiation therapy verification in brachytherapy combining iron sulphate gel
      irradiation and magnetic resonance imaging (MRI).
AB  - We developed a verification method that allows the three-dimensional qualitative
      delineation of the dose inside an applicator during intracavitary brachytherapy
      using MRI of dose-dependent changes of iron sulphate. In addition to computer
      calculations, the verification of the dose distribution is depicted now within
      the applicator. Therefore one can get a qualitative information about the
      relative position of the applicator according to the tumor volume and the desired
      brachytherapy radiation volume.

PMID- 8465252
TI  - [The physical and technical outlook for neutron therapy in Germany].
AB  - All five fast neutron therapy centres in Germany use low energy cyclotrons or
      neutron generators and are, therefore, at the low energy end of the 21 neutron
      therapy facilities presently in use worldwide. The depth dose characteristics are
      worse than for 60Co gamma rays, the absorbed dose rate is too low and the
      treatment is technically restricted because of the lack of those modern features
      like multileaf collimators and full gantry rotation that are available with
      modern linear accelerators. A survey of the statistical and methodical data on
      the neutron treatment in Germany is presented. To avoid masking the potential
      biological benefits of high LET neutron irradiation by the use of suboptimal
      equipment and to utilise the real therapeutical benefit for specific tumor types,
      the German neutron therapy centres urgently need modernization of their outdated
      facilities. Specific recommendations of how to meet the requirements of modern
      neutron therapy are given.

PMID- 8465253
TI  - Quality assurance in radiotherapy in Germany (as far as distinctions may occur
      compared to Britain).
AB  - The distinction between radiation protection and quality assurance in
      radiotherapy plays an important role. Together with the chronology of legal
      regulations for both subjects they are discussed subsequently for better
      understanding of the German position. A survey on actual technical regulations
      for safety and quality in radiotherapy by DIN-IEC and DIN standards is given with
      special attention to the connection of legal and technical regulations, the
      structure of the DIN committee for radiology and of its standards. Concepts of
      requirements and test methods for quality assurance are demonstrated for medical
      electron accelerators, especially the significance of performance values, the
      reliability of test methods, the volume of test conditions, the interpretation of
      test results, and the responsibility for test executions.

PMID- 8465254
TI  - Cell kinetic analysis after irradiation in L929- and LLC-MK2-cells by a BrdU/DNA
      assay.
AB  - Exponentially growing L929- and LLC-MK2-cells were X-irradiated in vitro.
      Irradiation-induced cell cycle kinetic effects were examined by the calculation
      of the cell number doubling time (TD), the duration of the cell cycle phases by
      the BrdU/DNA assay and the number of micronuclei. The number of cells arrested in
      G2/M and the duration of the delay are dose-related. The effect of irradiation on
      the duration of cell cycle phases was estimated by following the BrdU-labeled
      cells through the cell cycle. With increasing radiation doses the duration of the
      G2/M-phase increases whereas G1- and S-phase show only slight variations. Due to
      the problems involved in evaluation of radiation effects on the cell cycle a
      comparison with other methods proves the BrdU/DNA-assay to be a valuable
      instrument in those experiments. The micronucleus frequency is dependent on
      irradiation dose. However, after 7.52 Gy the number of micronuclei increases,
      whereas no cells in G1-phase and no increase of cell number could be detected,
      indicating a mechanism of micronucleus formation that is not linked with mitosis.

PMID- 8465255
TI  - Health data on older Americans: United States, 1992. Introduction. Background.

PMID- 8465256
TI  - Health data on older Americans: United States, 1992. Acute care.

PMID- 8465257
TI  - Selected issues in long-term care: profile of cognitive disability of nursing
      home residents and the use of informal and formal care by elderly in the
      community.
AB  - In summary, this section suggests that hospital care and physician office care
      are frequently used community health care services. There were relatively few
      differences by sex, age, or race in patterns of community health service use.
      There were differences by sex, age, race, and level of ADL disability in the
      number of informal helpers a frail elder used. Marital patterns appear to be an
      important underlying influence on the number of informal helpers. When a spouse
      is present, he or she becomes the primary and only helper in many instances. The
      number of informal helpers that a frail elder had was associated with an
      increased risk of mortality and institutionalization. Overall, there is somewhat
      more stability than change in the number of informal helpers over the 2-year
      period. This section, however, could not identify if the composition of the
      informal helper network remained the same over time.

PMID- 8465258
TI  - Health data on older Americans: United States, 1992. Patterns of drug
      prescribing.

PMID- 8465259
TI  - Health data on older Americans: United States, 1992. Cost of health care and
      sources of payment.

PMID- 8465260
TI  - Health of older black Americans.

PMID- 8465261
TI  - Health data on older Americans: United States, 1992. Functional status and living
      arrangements.

PMID- 8465262
TI  - Musculoskeletal disorders: time trends, comorbid conditions, self-assessed health
      status, and associated activity limitations.
AB  - In this report, cases of musculoskeletal disease were identified by a yes
      response to questions involving joint pain and/or physician-diagnosed arthritis
      in four national surveys for the following objectives: (a) to assess time trends
      in case prevalence; (b) to describe respondent health status; (c) to estimate
      prevalence of joint pain by location; (d) to estimate prevalence of selected
      comorbid medical conditions; and (e) to estimate among these persons the burden
      of ADL and IADL disability. These surveys were conducted over a 25-year interval
      (1960-84). Joint pain is the final common pathway through which a number of these
      disorders operate and could be expected to identify a subset of persons who have
      not sought medical consultation. Physician diagnosis of disease is an item that
      is conceptually a measure of severity. In these samples, there were slightly more
      persons reporting joint pain than reporting a diagnosis of arthritis in most
      years. Increases in the prevalence of both joint pain and physician-diagnosed
      arthritis were noted across survey years and for the cohort aged 65-69 years in
      NHANES I. Although this analysis is based on national data from persons with
      arthritis, estimates of disability prevalence from national surveys of the total
      U.S. population (18,28) are also available for comparison. In this report,
      persons with arthritis suffer from poorer health status and more disability when
      compared with U.S. population prevalence. Overall, 14 percent of persons aged 65
      74 years reported difficulty walking, and 20 percent of persons with arthritis
      reported this difficulty. In the U.S. cohort aged 75-84 years, 23 percent
      reported difficulty walking, compared with 31 percent of those with arthritis.
      Among persons aged 85 years and over, 40 percent reported difficulty walking,
      compared with 46 percent of respondents with arthritis. It should be recognized
      that persons with arthritis are included in the total population estimates and
      these differences in disability prevalence, therefore, could be much larger. It
      is important to note, however, that for tasks such as toileting, dressing, and
      managing money, estimates of disability for the total U.S. and arthritic U.S.
      populations are similar. These data suggest that arthritis may be a large
      contributor to certain types of disability.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8465264
TI  - Health data on older Americans: United States, 1992. Technical notes on methods.

PMID- 8465263
TI  - International aging.

PMID- 8465265
TI  - Health data on older Americans: United States, 1992. Changes in functional status
      and risk of institutionalization and death.

PMID- 8465266
TI  - Health data on older Americans: United States, 1992. Mortality.

PMID- 8465267
TI  - Health data on older Americans: United States, 1992. Measures of health.

PMID- 8465268
TI  - A player of many parts: the spotlight falls on thrombin's structure.
AB  - The wealth of structural information now available for thrombin, its precursors,
      its substrates, and its inhibitors allows a rationalization of its many roles.
      alpha-thrombin is a rather rigid molecule, binding to its target molecules with
      little conformational change. Comparison of alpha-thrombin with related trypsin
      like serine proteinases reveals an unusually deep and narrow active site cleft,
      formed by loop insertions characteristic of thrombin. This canyon structure is
      one of the prime causes for the narrow specificity of thrombin. The observed
      modularity of thrombin allows a diversity in this specificity; its "mix-and
      match" nature is exemplified by its interactions with macromolecules (Fig. 20).
      The apposition of the active site to a hydrophobic pocket (the apolar binding
      site) on one side and a basic patch (the fibrinogen recognition exosite) on the
      other allows for a fine tuning of enzymatic activity, as seen for fibrinogen.
      Thrombin receptor appears to use the same sites, but in a different way. Protein
      C seems only able to interact with thrombin if the recognition exosite is
      occupied by thrombomodulin. These two sites are also optimally used by hirudin,
      allowing the very tight binding observed; thrombin inhibition is effected by
      blocking access to the active site. On the other hand, antithrombin III makes
      little use of the recognition exosite; instead, its interactions are tightened
      with the help of heparin, which binds to a second basic site (the heparin binding
      site). Thrombin's modularity is a result of the conjunction of amino acid
      residues of like properties, such as charge or hydrophobicity. The charge
      distribution plays a role, not only in the binding of oppositely charged moieties
      of interacting molecules, but also in selection and preorientation of them.
      Nonproteolytic cellular properties are attributed to 1) the rigid insertion loop
      at Tyr60A, and 2) a partially inaccessible RGD sequence. The former can interact
      with cells in the native form; the latter would appear to be presented only in an
      (at least partially) unfolded state. The membrane binding properties of
      prothrombin can be understood from the ordered arrangement of calcium ions on
      binding to the Gla domain. Kringle F2 binds to thrombin at the heparin binding
      site through charge complementarity; a conformational change appears to occur on
      binding. The observed rigidity of the thrombin molecule in its complexes makes
      thrombin ideal for structure based drug design. Thrombin can be inhibited either
      at the active site or at the fibrinogen recognition exosite, or both.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8465269
TI  - Free radical scavenging mechanisms during pulmonary thromboembolism in rats.
AB  - In the present investigation alterations in the free radical generating and
      scavenging enzymes in platelets, neutrophils (PMNLs), heart and lung homogenates
      following rat pulmonary thromboembolism have been studied. Thrombosis was induced
      by intravenous infusion of collagen and adrenaline. Levels of malonaldehyde (MDA)
      were elevated in the PMNLs after thrombosis. Activities of superoxide dismutase
      (SOD) and catalase (CAT) were found to increase in platelets and PMNLs
      respectively. However, there was no significant alteration in the lactate
      dehydrogenase (LDH), lysozyme (LYS), ratio of xanthine oxidase to dehydrogenase
      (XO/XH) and PMNLs O2- generation before and after thrombosis. Migration of PMNLs
      following thrombosis was indicated by increased activity of myeloperoxidase (MPO)
      in the heart. In addition, pretreatment with allopurinol, a xanthine oxidase
      inhibitor and indomethacin, a cyclooxygenase inhibitor offered protection against
      thromboembolism induced death/paralysis. Results suggest the involvement of free
      radicals in thrombosis.

PMID- 8465271
TI  - D-dimer plasma concentration in various clinical conditions: implication for the
      use of this test in the diagnostic approach of venous thromboembolism.
AB  - Plasma measurement of D-Dimer (DD) represents a definite aid in the diagnostic
      approach of outpatients with suspected venous thromboembolism (VTE). However, the
      high sensitivity (about 95%) of the test which allows to rule out VTE when
      concentrations are below a given cutoff (500 micrograms/L as measured by the
      ELISA technique) is counterbalanced by a poor specificity (about 40%). Because
      the specificity might even be lower in patients who are hospitalized we
      determined the DD plasma concentration in 255 patients who were consecutively
      admitted in general internal medicine wards with various pathological conditions.
      The proportion of patients who had DD levels below the cutoff of 500 micrograms/L
      was 6% (1/18) in patients with VTE and 22% (52/237) in hospitalized patients
      without VTE: the figure was 21% in patients with pulmonary infections, 14% in
      patients with other infections, 11% in patients with neoplastic diseases, 34% in
      patients with coronary or cerebrovascular disease, 19% in patients with cardiac
      failure, 69% in patients with rheumatologic disease and in 16% in subjects with
      miscellaneous clinical conditions. The high rate of elevated plasma DD in
      hospitalized patients questions the usefulness of this test in the diagnostic
      approach of VTE in aged patients who present with concomitant disease like
      infections, neoplasia, cardiac failure and many other pathological conditions,
      except rheumatologic affections and coronary or cerebrovascular diseases.

PMID- 8465270
TI  - The role of protein kinase C in the initial events of platelet activation by
      thrombin assessed with a selective inhibitor.
AB  - The role of protein kinase C (PKC) in platelet activation by thrombin was
      assessed using a PKC inhibitor Ro 31-7549/001 (R2) which, in vitro, shows more
      selectivity for PKC than other kinase inhibitors. During early (1.5 s) thrombin
      induced platelet activation, when phosphorylation of 47 kDa protein (pleckstrin)
      and myosin light chain by PKC and myosin light chain kinase, respectively, are
      most readily differentiated, R2 suppressed phosphorylation of pleckstrin more
      effectively than myosin light chain. R2-inhibited dense granule secretion
      (measured 0-10 s using quenched-flow techniques) with a dose dependency similar
      to that for inhibition of pleckstrin phosphorylation, supporting a role for PKC
      in this process. R2, at 0.5 microM inhibited 47 kDa protein phosphorylation by
      more than 60%, but had only minimal effects on the kinetics (0-3s) of ADP-induced
      primary aggregation. At this same concentration, R2 potentiated the thrombin
      induced rise in cytosolic calcium during early (0-15 s) activation as measured in
      the presence or absence of external calcium. These data support the hypothesis
      that activation of PKC during early platelet function helps regulate cytosolic
      calcium levels by limiting calcium release into the cytosol.

PMID- 8465272
TI  - Cytosolic free magnesium concentration in human platelets.
AB  - Although the magnesium ion (Mg2+) is considered to play an important role in cell
      activation, information is limited by the lack of suitable methods for measuring
      cytosolic free Mg2+ concentration ([Mg2+]i). We measured [Mg2+]i in resting and
      activated human platelets using a new fluorescent Mg(2+)-indicator, mag-fura-2.
      [Mg2+]i was 0.54 +/- 0.14 mM in resting platelets from 15 healthy volunteers.
      [Mg2+]i was elevated to 1.33 +/- 0.44 mM and 0.92 +/- 0.37 mM in platelets
      stimulated with thrombin and collagen, respectively. Increased Mg2+ was
      considered to be derived chiefly from intracellular Mg2+ mobilization. These
      results suggest that platelet activation is associated with the increase in
      [Mg2+]i. The estimation of [Mg2+]i using this method is useful for the
      investigation of mechanism for various cell activation.

PMID- 8465273
TI  - Stimulation of endothelin production in cultured human endothelial cells by
      fluorescent compounds associated with blackfoot disease.
AB  - The fluorescent compounds (FC) in humic substances isolated from the drinking
      water of endemic areas of blackfoot disease have been characterized as the
      causative factor of the disease. In this report we studied the effects of these
      fluorescent compounds on the synthesis and secretion of endothelin-1 by cultured
      human umbilical cord vein endothelial cells (HUVEC) in order to explore the
      possible pathological mechanism(s) of FC in the development of atherothrombotic
      vasculopathy in blackfoot disease. Incubation of confluent HUVEC with FC (100
      micrograms/ml) enhanced endothelin mRNA expression. A sensitive ELISA method was
      developed to quantitate secreted endothelin antigen levels in conditioned medium.
      Incubation of confluent HUVEC cultures with different concentrations of FC (0-200
      micrograms/ml) resulted in concentration-dependent enhanced production of
      endothelin. No significant changes in endothelin production were observed when
      subconfluent HUVEC cultures were incubated with FC. FC dose-dependently reduced
      the growth rate of subconfluent cultured HUVEC and exerted cytotoxic effects on
      the viability and integrity of confluent HUVEC monolayers. Since endothelin is
      one of the most potent vasoconstrictors affecting blood pressure and blood flow,
      and is mitogenic for smooth muscle cell proliferation, these results imply that
      the enhanced endothelin production and the reduced cell viability and growth rate
      induced by FC may contribute to the atherothrombotic vasculopathy observed in
      blackfoot disease.

PMID- 8465274
TI  - Thrombin generation after physical exercise.
AB  - Many investigators have studied the influence of physical exercise on hemostatic
      system and it is well accepted that exercise causes an activation of coagulation
      as indicated by a shortening of aPTT and by an increase in plasma factor VIII
      activity and levels. A controversial point remains whether this clotting
      activation leads to a significant thrombin generation and fibrin formation. The
      type of physical exercise performed and the methods used to study blood
      coagulation may be two major sources of discrepancies in different studies. In
      the last years sensitive and reliable methods became available to evaluate
      prothrombin activation and thrombin generation. Thus in this study we have
      investigated the influence of a well standardized treadmill stress test,
      controlled by the measurement of cardiorespiratory and metabolic parameters, on
      plasma concentration of different markers of clotting activation in healthy
      untrained young subjects. Blood samples were also withdrawn just before anaerobic
      threshold to investigate a possible role of metabolic acidosis in changes of
      clotting system.

PMID- 8465275
TI  - Alteration of pharmacokinetics and pharmacodynamics of recombinant hirudin (rHV2
      Lys 47) after repeated intravenous administration in dogs.
AB  - Native hirudin is a heterogenous polypeptide obtained from the medicinal leech,
      Hirudo medicinalis. Recent advances in molecular biological techniques have led
      to the availability of large amounts of hirudin in the recombinant form.
      Recombinant hirudins (rH) are currently being investigated for potential use in
      the prophylaxis and treatment of deep venous thrombosis (DVT), in disseminated
      intravascular coagulation (DIC) and during cardiovascular bypass surgery. In this
      study, one specific variant of rH with a lysine residue in position 47 (rHV2-Lys
      47) was administered in dogs in a multiple dose regimen of 2 mg/kg (i.v. bolus)
      for three weeks with a dosing interval of one week. After each dose, blood
      samples were collected at regular time intervals, plasma separated and stored at 
      4 degrees C. Concentrations of rHV2-Lys 47 in each sample were determined using
      an enzyme-linked immunosorbent assay (ELISA). Ex vivo antithrombin responses
      measured included activated partial thromboplastin time (APTT), calcium-thrombin
      time (Ca++TT-10 NIH units/ml) and a chromogenic anti-IIa assay. It was the
      purpose of this study to detect any sensitization or desensitization of
      antithrombin responses when rHV2-Lys 47 is used in a repeated fashion such as
      would be expected in the prophylaxis of DVT. The results indicated that there was
      no attenuation in the responses; however, there was a sensitization of response
      as measured by the Ca++TT (10 NIH units/ml). These findings could have major
      implications in the clinical use of rH where this drug is expected to be used in
      a multiple dose regimen.

PMID- 8465276
TI  - In vivo pharmacology of aprosulate, a new synthetic polyanion with anticoagulant
      activity.
AB  - The in vivo effects of a new synthetic inhibitor of blood coagulation, aprosulate
      sodium, were investigated. Intravenous bolus injection of aprosulate or standard
      heparin in rats produced an immediate prolongation of the APTT which were
      characterized by a moderate dose-dependency and long-lasting duration when
      compared with those of standard heparin. Standard heparin inhibited plasma factor
      Xa activity, but aprosulate did not even at the highest dose used. Both agents
      inhibited thrombus formation in a dose-dependent manner in an arterio-venous
      shunt model. At antithrombotic doses, standard heparin prolonged the bleeding
      time measured by the tail transection method, but aprosulate did not. The present
      results suggest that aprosulate has promising in vivo profile as an anticoagulant
      and antithrombotic agent.

PMID- 8465277
TI  - Fibrinolytic response to venous occlusion in healthy subjects: relationship to
      age, gender, body weight, blood lipids and insulin.
AB  - The physiological variability of fibrinolytic response to 20 min upper arm venous
      occlusion was studied in 191 healthy women and men, 19-80 years old. It was
      observed that fibrinolytic response measured by the absolute amount of t-PA
      antigen after venous occlusion increased with increasing age (from 10.7 at 19-30
      years to 25.0 ng/ml at 71-80 years), was higher in men than in women (20.9 vs
      15.6 ng/ml), higher in obese than in slim subjects (29.5 vs 12.3 ng/ml) and
      higher in subjects with moderately elevated blood cholesterol (33.3 vs 18.2
      ng/ml) and triglycerides (30.0 vs 24.4 ng/ml, all p < 0.05 or less) than in
      subjects with normal levels of these variables. Due to simultaneous increase in
      basal levels of t-PA antigen in all these cases, relative increases in t-PA
      antigen after venous occlusion were not altered. Fibrinolytic response measured
      by t-PA activity, but not with euglobulin clot lysis time, increased with age.
      PAI-1 antigen was not affected by venous occlusion, while PAI activity decreased
      to zero in most subjects (in 61-80%) regardless of age, gender or blood lipids.
      However, in obese subjects and especially in subjects with elevated insulin,
      fibrinolytic response was reduced as determined by residual PAI activity after
      venous occlusion (1.3 and 10.6 IU/ml, respectively) due to the increased basal
      level of PAI-1. It was concluded that age, gender, body weight, blood lipids and
      insulin significantly modulate fibrinolytic response to venous occlusion.

PMID- 8465278
TI  - The antithrombotic effect of low molecular weight synthetic thrombin inhibitors,
      argatroban and PPACK, on He-Ne laser-induced thrombosis in rat mesenteric
      microvessels.
AB  - The antithrombotic effect of low molecular weight synthetic thrombin inhibitors,
      argatroban ((2R, 4R)-4-methyl-1-[N2-[(3-methyl-1, 2, 3, 4-tetrahydro-8
      quinolinesulfonyl)-L-arginyl]-2-piperidinecarbox ylic acid monohydrate]) and
      PPACK (D-phenylalanyl-L-prolyl-L-arginyl-chloromethyl ketone) on He-Ne laser
      induced thrombosis in rat mesenteric microvessels was studied. Both inhibitors
      showed a significant antithrombotic effect at 0.5 mg/kg which lasted for 50 min
      and 50-60 min using argatroban and PPACK, respectively. A dose-dependent effect
      was observed in arterioles and venules. The results suggest that thrombin plays
      an important role in the formation of a platelet thrombus in vivo.

PMID- 8465279
TI  - [Development of sports medicine].

PMID- 8465280
TI  - [Rehabilitation after head injuries--local use of regional knowledge].

PMID- 8465281
TI  - [Preoperative fasting--softening of rigid rules?].

PMID- 8465282
TI  - [High-dose glucocorticoids in surgery and trauma].

PMID- 8465283
TI  - [Anti-inflammatory agents in acute tissue trauma. Choice and effects].
AB  - The choice of drugs to reduce pain and excessive inflammatory reactions after
      surgery or accidental trauma is reviewed and discussed, with particular reference
      to a series of Norwegian studies based on bilateral oral surgery. In this model,
      paracetamol has proved capable of reducing post-operative swelling by about 30%,
      while acetylsalicylic acid (in common analgesic doses) failed to reduce or even
      tended to increase swelling. Paracetamol is a recommendable alternative for
      reducing acute post-traumatic pain and swelling, while acetylsalicylic acid
      should be avoided. Non-steroidal anti-inflammatory drugs which efficiently reduce
      rheumatoid swelling may provide good pain relief, but the effect on an acute post
      operative swelling is less impressive. In the oral surgical model,
      glucocorticoids reduced post-traumatic swelling by about 50% and provided better
      or at least as good pain relief as any tested non-steroidal anti-inflammatory
      drug, including paracetamol. Single dose or short-term administration of a
      glucocorticoid is recommended as an efficient and valuable means of reducing both
      pain and excessive inflammation in surgery and traumatology. Of practical
      implication in traumatology is the finding that, for both paracetamol and
      glucocorticoids, almost the same reductions were recorded in swelling and pain
      whether the drug was administered prior to surgery or 2-3 hours afterwards.

PMID- 8465284
TI  - [Response to inhaled bronchodilators in chronic airway obstruction].
AB  - OBJECTIVE: To assess the proportion of patients with chronic limited airflow who
      obtain a meaningful bronchodilatory effect from the betaadrenergic agonist
      salbutamol and the anticholinergic agent ipratropiumbromide. PATIENTS: 198
      patients with varying degrees of airflow limitation. The state of all patients
      was stable. METHODS: Spirometry was recorded before inhalation, and ten, 20 and
      30 minutes after inhalation of 0.2 mg salbutamol or 0.04 mg ipratropiumbromide.
      RESULTS: FVC increased by 0.5 litres or more in 77 patients with salbutamol and
      in 104 patients with ipratropiumbromide. FEV1 increased by 0.3 litres or more in
      76 patients with salbutamol and in 95 patients with ipratropiumbromide. In 77
      patients, neither of the drugs caused this improvement in FEV1. CONCLUSION: In
      patients with chronic limitation of airflow use of inhaled bronchodilators should
      be based on the proven clinically significant effect of the drug in question.

PMID- 8465285
TI  - [Diagnostic imaging in sciatica. A short historical overview and current status].
AB  - Cotugno described the clinical entity of sciatica in 1764. However, the
      association between sciatica and compression of lumbar nerve roots was not
      realized until the 1920s. Back surgery for herniated nucleus pulposus then became
      fashionable, and plain radiography and myelography enabled preoperative mapping.
      Recently other imaging techniques have emerged, such as computed tomography and
      magnetic resonance imaging. This has increased the knowledge of the etiology of
      lumbar root compressions, and invasive therapies for sciatica have become more
      diversified. It is easy to lose perspective among the available imaging
      procedures and therapeutic techniques. The aim of this paper is to present the
      current status from a historical point of view, with special emphasis on the most
      common imaging methods for the investigation of lumbosacral radiculopathies.

PMID- 8465287
TI  - [Gastrointestinal manifestations in neurofibromatosis].
AB  - Gastrointestinal involvement in neurofibromatosis occurs in three major forms:
      solitary neurogenic tumours, diffuse ganglioneuromatosis and visceral
      vasculopathy. The entire gastrointestinal tract may be affected. According to the
      literature, 10-25% of the patients with neurofibromatosis develop intestinal
      manifestations. However, the recorded incidence is probably too low, since many
      cases are undiagnosed. Two cases of large plexiform neurofibromas and diffuse
      ganglioneuromatosis of appendix and intestine are reported.

PMID- 8465286
TI  - [Accessory soleus muscle as a tumor in the ankle region].
AB  - We report the case of a 21-year ice hockey player with an accessory soleus muscle
      located medially in the ankle region. The swelling made it increasingly difficult
      for him to fit his skating boots and caused some pain during play. He was
      successfully treated by excising the muscle. Previously, the diagnosis was
      verified surgically in most reported cases. Like most recent authors, we believe
      that the diagnosis can be confirmed by CT-scan and/or MRI-scan. Surgical excision
      of the muscle should be reserved for symptomatic cases.

PMID- 8465288
TI  - [Non-typhoid Salmonella aortitis].
AB  - Non-typhoid Salmonella enteritis may be complicated by aortitis. Three cases of
      Salmonella enteritidis aortitis are described. One patient, who survived, was
      operated with resection of the infected part of the aorta. An axillo-femoral
      bypass was made. The patient was treated for 18 months with antibiotics. The two
      patients who died were only treated with antibiotics. Aortitis is diagnosed by
      means of blood-cultures and topographic examination of the aorta with CT
      scanning, ultrasonography or angiography. The treatment of Salmonella aortitis is
      a combination of surgery and long-term administration of antibiotics.

PMID- 8465289
TI  - [Sports medicine in Norway].
AB  - In Norway sports medicine is not organized as a single specialty among the
      medical disciplines. It involves work carried out by doctors with different
      specialties, dominated by physical medicine and rehabilitation, along with
      orthopaedic surgery, internal medicine, gynaecology and physiology. Preventive
      work, acute treatment and rehabilitation of injured athletes, as well as
      scientific work in the field of sports and sports medicine, are major elements of
      this field of medicine. It is important to educate medical students and doctors
      in sports medicine. This education started years ago at the university hospitals
      in Oslo and Trondheim. It is expected to be extended, and to become organized in
      future as an integrated part of the regular education of medical students and the
      post-graduate education of doctors.

PMID- 8465290
TI  - [The importance of physical activity in the modern health concept].
AB  - Physical activity has increasingly become an integrated part of both the
      prevention and treatment of many diseases. This approach is based on data from
      large studies linking either physical activity or physical capacity to the
      incidence of disease. Furthermore, regular physical activity can influence health
      indirectly, since people who become physically active also tend to change other
      health-related habits in a positive direction. The author outlines some specific
      effects of exercise on certain diseases, and discusses the data indicating how
      much training is necessary to obtain the desired effects on health.

PMID- 8465291
TI  - [Optimal use of acid-inhibitors in acid-related diseases. Physiological and
      physiopathological considerations with implications on therapeutic choice].
AB  - Most animal species produce gastric acid. This acid denaturates the proteins in
      the food and thus makes them accessible to the proteolytic enzymes. The main
      function of the gastric acid is probably to kill swallowed microorganisms.
      However, the gastric acid plays an essential role in the pathogenesis of common
      and important diseases like peptic ulcer and reflux oesophagitis. Drugs that
      inhibit the secretion of gastric acid suppress both symptoms as well as lesions
      in patients with peptic ulcer or reflux oesophagitis. However, both reflux
      oesophagitis and peptic ulcer tend to recur when the acid-inhibitory treatment is
      stopped. In this overview the author warns against long-term profound inhibition
      of acid, since, in the long term, both the reduced killing of microorganisms as
      well as the secondary hypergastrinemia may induce increased risk of gastric
      cancer. In this context the role of the enterochromaffin-like (ECL) cell in
      gastric carcinogenesis is thoroughly discussed. There is probably a spectrum of
      neuroendocrine tumours in the stomach as like in the lungs, which also are
      foregut derived. Gastrin regulates the function (release of histamine) as well as
      the growth of the ECL cell, and a maximal trophic effect seems to be reached at a
      lower gastrin concentration than previously realized.

PMID- 8465292
TI  - [Postoperative enteral nutrition].
AB  - The need for postoperative nutrition is often discussed, but no consensus has
      been reached regarding the assessment of this need. The common opinion is that
      patients who are unable to feed themselves by 5-7 days after the operation need
      nutritional support. This is commonly given parenterally via a central venous
      catheter. This method may lead to sepsis. Owing to the serious complications,
      alternatives have been searched for. Methods for enteral ways of support and
      suitable preparations have been evaluated. We have tried one of these methods
      together with one of the many preparations. Peptison has been administered
      continuously through a peroperatively placed jejunal catheter. This technique and
      its possible advantages are described. By this method patients can be given
      sufficient nutritional support with no or only few complications. We consider
      this method to be a good alternative to parenteral infusion.

PMID- 8465293
TI  - [Prevention of aspiration--preoperative fasting. Time for reevaluation of old
      routines?].
AB  - The article reviews the epidemiology, pathophysiology and recent clinical
      research on aspiration prophylaxis and preoperative fasting before surgical
      procedures. Elective, pain-free patients should be allowed a glass of clear fluid
      up to two hours before start of anaesthesia. A light meal should be allowed up to
      four hours before the procedure. The anaesthesist should always make an
      individual evaluation of patients with pain or gastrointestinal obstruction, or
      who have received opioids. Aspiration of gastric contents and/or prophylactic use
      of histamine H2 antagonist or sodium citrate may be considered. The use of
      prophylactic treatment should always be evaluated against the side-effects of
      such treatment and the very low occurrence of serious sequelae from aspiration of
      gastric contents into the lungs.

PMID- 8465294
TI  - [Who is responsible for EDP-based records? Experiences with introduction of EDP
      in a public health center].
AB  - In 1991, about 150 general practitioners in 37 health care units in the county of
      Oslo introduced computerized systems of case records which replaced the previous
      paper records. The hardware units were located outside the units, and were
      physically interconnected by a large computer network within the county of Oslo.
      By losing physical contact, the general practitioners also lost control of their
      patient records. The files could be looked into and manipulated with or without
      the doctors' knowledge. It was no longer clear who was responsible for the
      computerized case records. These experiences are discussed, paying attention to
      the Norwegian legislation and official regulations in the area. The conclusions
      are that a health care unit using EDP should have its hardware at the unit
      itself. The chief doctor of the unit should be responsible for the daily
      management of the EDP-unit, and for safeguarding the confidentiality of the
      patient records.

PMID- 8465296
TI  - [The lobotomy debate in Norway].

PMID- 8465295
TI  - [The lobotomy debate in Norway].

PMID- 8465297
TI  - [Records, subjectivity and dissatisfied patients].

PMID- 8465298
TI  - [Regional psychiatric function for especially difficult and dangerous mentally
      disturbed persons].

PMID- 8465299
TI  - [The concept of disease in the light of economic and political realities].

PMID- 8465300
TI  - [Effects of vitamins and trace elements on immune defence].

PMID- 8465301
TI  - [Medical education--ready for failure?].

PMID- 8465302
TI  - [Empathy].

PMID- 8465303
TI  - [Ethical mobilization in preventive health care].

PMID- 8465304
TI  - [Chronic hepatitis C infection. Some aspects brought up again through patients'
      complaints].

PMID- 8465305
TI  - [Life style].

PMID- 8465306
TI  - [Diphtheria in Batsfjord. "Old" diseases may return].

PMID- 8465307
TI  - [When the media take over].

PMID- 8465308
TI  - [Multiple organ failure. "Horror autotoxicus?"].

PMID- 8465309
TI  - [Spinal injuries].

PMID- 8465310
TI  - [Intravenous anesthetics].

PMID- 8465311
TI  - [Thoracolumbar injuries. Surgical treatment of patients with neurological
      damage].
AB  - This article presents the neurological outcome after surgery of a series of 54
      patients with damage to the spinal cord and/or cauda equina caused by
      thoracolumbar injuries. The fractures, dislocations or fracture-dislocations were
      all reduced and stabilized by a Harrington distraction device or transpedicular
      fixation system (posterior segment fixator). Peroperative inspection revealed
      that correction and distraction alone may be inadequate to achieve intraspinal
      decompression. Additional anterior decompression by posterolateral approach was
      necessary in 31 patients (57%). In this series there was an unexpected high rate
      of dural rents. Tears were found in 11 patients (20%) and nerve roots (cauda
      equina) appeared to have herniated through the tear in eight. Significant
      improvement of the neurological deficits was obtained in 81%. The improvement
      rate was much better in patients with incomplete lesions than among those with
      complete lesions. We are convinced that surgery improves the neurological outcome
      if carried out at the proper time, after sufficient decompression of the spinal
      cord and nerve roots, and repair of dural rents.

PMID- 8465312
TI  - [Pathogenetic mechanisms in acute respiratory failure in adults].
AB  - A large variety of mediators and mediator systems are involved in the
      pathogenesis of acute respiratory failure in adults, and the complexity of the
      syndrome should be considered in both prophylaxis and therapy. The locally
      accentuated and organ-related activation of several mediator systems over a long
      period of time is likely to be responsible for the irreversible damage to cells
      and tissue. Surfactant dysfunction or degradation, regardless of the cause,
      contributes to the pathophysiology of severe respiratory failure, and might be a
      common denominator in the pathogenesis of the syndrome. Cytokines from
      macrophages are important, since these mediators have the potential to convert a
      primarily functional and reversible systemic reaction into irreversible damage to
      specific organs.

PMID- 8465313
TI  - [Meningoencephalitis after Mycoplasma pneumoniae infection].
AB  - A 15 year-old boy developed meningoencephalitis two weeks after onset of a
      respiratory tract infection caused by Mycoplasma pneumoniae. Central nervous
      complications are seen in 2-7% of patients hospitalized for M pneumoniae
      infection. Meningoencephalitis, meningitis, ataxia, polyradiculitis, psychosis
      and a few cases of apoplexy have been reported. In clinical practice one should
      be aware of M pneumoniae in the differential diagnosis of patients with suspected
      microbiologically induced central nervous complications. The pathogenetic aspects
      and prognosis are briefly discussed.

PMID- 8465314
TI  - [Tracheal compression treated with endoluminal stents].
AB  - Tracheobronchial stenoses can be caused by growth of endoluminal tumour or by
      external compression. Endoluminal tumours can be treated by means of
      endoscopically applied lasers, while tumours in the oesophagus, thyroid gland, or
      lymph nodes which compress the airways connor be reached by this type of
      treatment. We report four cases where life-threatening compression of airways by
      malignant tumours was successfully relieved by stenting the trachea with a
      silicone stent, Endoxane. The stent was inserted through a rigid bronchoscope,
      and the operative procedure was uneventful in all cases. Postoperatively, the
      patients did not experience severe discomfort from the stent, and neither
      dislocation of the stent nor retention of secretions was a problem. All the
      patients died of cancer-related causes, but none died from suffocation. It is
      concluded that tracheo-bronchial stenting is a valuable supplement to irradiation
      in palliative treatment of airway compression of airways caused by malignant
      tumours.

PMID- 8465315
TI  - [Bacterial arthritis].
AB  - During the years 1980-89, 13 patients were hospitalized because of bacterial
      arthritis of the peripheral joints. There were five juvenile patients (under 15
      years of age). The remaining eight patients were adults, of whom seven were older
      than 50 years. The mean delay in establishing the diagnosis was four days (0-10
      days). Monarthritis was found in 12 patients, and in one patient two joints were
      involved. The most commonly affected joints were the shoulder (four cases), knee
      (four cases), ankle (three cases), hip (two cases) and toe (one case). A
      predisposing condition was found in five patients, and three cases suffered from
      reduced mobility of the joint at follow-up. Staphylococcus aureus was the most
      common etiologic agent.

PMID- 8465316
TI  - [Malacoplakia in the endometrium. A rare cause of postmenopausal bleeding].
AB  - Malacoplakia of the endometrium and the rest of the female genital tract is rare.
      The condition is usually postmenopausal, and an important clinical finding is
      vaginal bleeding. Clinically, what is actually malacoplakia is often suspected to
      be a malignant disease. Pathologically, however, malacoplakia is easily
      distinguishable from carcinoma, owing to the typical, light colour of the swear
      when examined under the microscope, showing. Histiocytes with abundant
      eosinophilic granular cytoplasm and varying degrees of intracellular and
      extracellular Michaelis-Gutman bodies. As far as we know, we describe the first
      case in Norway of postmenopausal bleeding in a 78 year old woman, caused by
      malacoplakia of the endometrium.

PMID- 8465317
TI  - [Testing aerobic energy metabolism].
AB  - The purpose of testing the aerobic metabolism is to evaluate the athlete's
      capacity for aerobic ATP synthesis during the events she/he is preparing for. In
      endurance events lasting less then eight minutes the maximal O2-intake is the
      most important determinant of performance, with an increasing contribution of
      anaerobic metabolism as intensity is raised. In long distance events (> 8 min),
      the capability to avoid lactate production is more important. Although a high
      maximal O2-intake will reduce lactate production at a given intensity, other
      factors are also involved, probably confined to the working muscles. Finally, in
      all endurance events, another important factor is working economy. Direct
      measurements of maximal O2-intake, and of O2-intake and lactate concentrations in
      blood at several submaximal intensities, constitute a test complex that is
      capable of separating these abilities.

PMID- 8465318
TI  - [Anaerobic capacity--theoretical basis and methods for practical testing].
AB  - The ATP turnover rate is raised during highly intensive exercise. Part of the ATP
      used is regenerated anaerobically independently of oxygen consumption. Lactate
      production accounts for 75% of the anaerobic ATP production, while breakdown of
      phosphocreatine accounts for the remaining 25%. Anaerobic processes can provide
      energy for about one minute's exercise during exhausting exercise lasting several
      minutes. An athlete may improve his anaerobic capacity by 10% during two months
      of proper training, and the measured improvement is of significance for athletes.
      The accumulated oxygen deficit has been introduced to quantify the anaerobic
      release of energy during exercise. The method is discussed briefly.

PMID- 8465319
TI  - [Integrins, structure and function].
AB  - Integrins are molecules of central importance in physiological and pathological
      processes. Integrins are an important factor in intercellular adhesion processes
      and cell migration leading to normal architecture of tissue, in inflammatory and
      tumour cell migration and in reparatory processes of damaged tissue. The integrin
      designation is derived from the role of these substances in integrating processes
      within and outside the cell. Therefore these membrane proteins play a role in
      cell growth, differentiation and gene expression. The role played by integrins in
      cell signal transduction and inflammation is discussed in this article. During
      the past few years we have seen an explosion of research in this field, which may
      lead to therapeutic benefits in a few years time.

PMID- 8465320
TI  - [Diagnostic tests--use and interpretation].
AB  - Diagnostic tests are often difficult to interpret. Use of methods intended for
      binary tests leads to loss of information when these methods are applied to
      quantitative tests. The author reviews methods for correctly interpreting
      qualitative and quantitative tests, for finding the best combination of tests,
      and for assessing when to test.

PMID- 8465321
TI  - [Is left ventricular hypertrophy in hypertension a marker for coronary risk
      factors?].
AB  - 86 asymptomatic men with mild to moderate hypertension were examined by
      echocardiography, exercise ECG and measurements of their lipid profile. Left
      ventricular hypertrophy, defined as an increased left ventricular mass index > or
      = 130 g/m2, was found in 38 (44%) patients. Only two men showed evidence of
      silent ischemia during maximum exercise. The men with left ventricular
      hypertrophy had a higher systolic blood pressure at rest (p = 0.0002), at
      submaximal (p = 0.02) and maximal exercise (p = 0.01). The prevalence of smokers
      was the same, as were the concentrations of lipids, lipoproteins and apoproteins
      in the two groups. Except for a higher blood pressure, left ventricular
      hypertrophy is not a special marker for other coronary risk factors.

PMID- 8465322
TI  - [Primary health care and patients with severe mental disorders living at their
      own homes].
AB  - Lack of relevant information has been stated as a major obstacle to the
      development of better services for persons with serious mental disorders. The
      information on patients not in contact with the specialist services seems to be
      particularly incomplete. The objective of this study was to describe a subgroup
      of psychiatric patients living in a semi-rural municipality in Norway who had no
      contact with the specialist mental health services. 15 patients below 70 years of
      age (0.3% of the population at risk) with a diagnosis of schizophrenia from
      psychiatric hospital, and still on neuroleptic maintenance-treatment prescribed
      by a primary physician were identified. The authors present the characteristics
      of this group, with emphasis on their health status, their social network, and
      the actual treatment and care provided, and discuss the need for clear case
      definitions in community surveys of psychiatric disorders. They finally describe
      the current trend towards new and improved models for cooperation between the
      primary health care and the specialist services.

PMID- 8465323
TI  - [Combination therapy with antidepressive agents--risks for interactions].

PMID- 8465324
TI  - [The minister of health and the tobacco policy].

PMID- 8465325
TI  - [Does the crisis of health services originate in shortage of resources or
      shortage of theories?].

PMID- 8465326
TI  - [Child and adolescent psychiatry--will it be part of Norwegian health care in the
      year 2000?].

PMID- 8465327
TI  - [Drinking water and occurrence of colorectal polyps. An epidemiological study in
      Telemark].

PMID- 8465328
TI  - [Income differences between female and male physicians].

PMID- 8465329
TI  - [Anti-shock trousers--over and out? From fighters and Vietnam to civilians].

PMID- 8465330
TI  - [Sinusitis--research in general practice].

PMID- 8465332
TI  - [Sinusitis in general practice--a diagnostic challenge].
AB  - Sinusitis is a common problem in general practice, but diagnosis is often
      difficult. The greatest clinical challenge is to distinguish between purulent and
      nonpurulent sinusitis. This differential diagnosis has consequences for
      treatment. A questionnaire was sent to a randomized sample of Norwegian general
      practitioners and to all ear, nose and throat specialists in private practice.
      79% of the general practitioners felt that diagnosis is more uncertain for
      sinusitis than for otitis media. When anamnestic questions and clinical findings
      were grouped, it was shown that general practitioners consider pain to be much
      more relevant in the differential diagnosis than purulent secretion. The ear,
      nose and throat specialists consider pain and purulent secretion to be equally
      important in the differential diagnosis. Pain in cheek and forehead, and pain in
      the upper teeth are regarded as the most relevant single anamnestic symptoms.
      Duration of illness is considered to have little differential diagnostic
      relevance. Among supplementary tests only C-reactive protein is regarded as
      helpful. X-ray and erythrocyte sedimentation rate are evaluated as far less
      relevant.

PMID- 8465331
TI  - [Doxazosin (Carduran)--a research survey].
AB  - 4,260 patients were included in an open surveillance study simultaneously with
      the introduction of doxazosin for treatment of essential hypertension in Norway.
      The main aim of the study was to systematically collect information on side
      effects and events in patients being treated with a new drug. The effect on blood
      pressure, heart rate and lipids was also recorded. The study lasted for one year.
      21 deaths were reported. 53% of the patients reported side effects and/or events.
      The frequency of side effects was particularly high during the first month of
      treatment. No new types of side effects were found. The initial higher frequency
      of reported side effects referred to all organ systems, and was also of the same
      magnitude in the different systems. A relation was found between certain cardiac
      side effects and/or events and cessation of previous medication upon starting
      treatment with doxazosin. The study shows that certain safety precautions should
      be observed in patients with coronary heart disease and heart failure. In three
      patients, doxazosin should be used only in combination with more specific
      treatment. Special caution should be observed when changing the specific basic
      treatment. Doxazosin had a very favourable antihypertensive effect. A drop in
      cholesterol and triglycerides was observed, as expected. The HDL-cholesterol
      value declined, which was unexpected. The results are difficult to interpret,
      owing to lack of a control group. On the other hand, the study shows how high
      blood pressure is being treated with drugs in ordinary practice. The authors
      discuss the methodology of surveillance studies.

PMID- 8465333
TI  - [Public opinion on organ donations from recently decreased persons. A
      questionnaire study].
AB  - Organ transplantation is at present hampered by a shortage of organs. This
      problem is increasing, and can be helped by more information and knowledge among
      health professionals and the general public. The frequency of families who
      consent to donation of organs from a recently deceased family member varies from
      country to country and has previously not been examined in Norway. In this survey
      a random sample of 1,050 persons (15 years and older) were interviewed. 71% (95%
      CI 68-74) would consent to donation of an organ from a close family member.

PMID- 8465334
TI  - [Reticulocytes--new possibilities with automated counting].
AB  - A fully automated reticulocyte counter, Sysmex R-1000 has been evaluated at three
      Norwegian hospitals. The instrument measures fluorescence-labelled RNA in the
      reticulocytes by flow cytometry. It also generates information on reticulocyte
      maturity. Instrument precision was superior to that achieved with the routine
      visual counting method. Samples preserved at room temperature remain stable for
      one day, whereas samples preserved at 5 degrees C remain stable for four days. An
      increasing number of reticulocytes is often the first sign of marrow regeneration
      after bone marrow transplantation or treatment of leukaemia with cytostatica. In
      patients with chronic renal failure who are receiving erythropoietin, the
      increase in reticulocytes is seen within days, and precedes the increase in
      haemoglobin by 2-3 weeks.

PMID- 8465335
TI  - [Residual urine after intermittent catheterization in patients with spinal cord
      injuries].
AB  - Residual urine following catheterization was studied using ultrasonography
      (Ultramark II Scientific Medical System) in 12 patients with spinal cord injury,
      for an average of four months (range 3-7 months) after time of injury. All
      patients were examined three times. Urinary tract infections were also
      registered, and the functional type of the urinary bladder was identified by
      cystometric examination. Ultrasonography showed residual urine volumes after 25
      of a total of 36 catheterizations (70%). In seven of these catheterizations the
      residual urine volume exceeded 50 ml, and in two cases was more than 100 ml. None
      of the patients had a residual urinary volume of more than 50 ml after all three
      catheterizations, but in all but two patients, some residual urine volume was
      found after at least one of the catheterizations. Low and non-significant
      correlations were found between residual volume and frequency of urinary tract
      infections. It is possible that even small residual urine volumes after
      catheterization may predispose for urinary tract infections in these patients.

PMID- 8465336
TI  - [Urinary bladder fistulas].
AB  - During the period 1978 to 1991, 19 patients were treated for fistula of the
      urinary bladder, 12 of the fistulas were enterovesical, four vesicovaginal, one
      vesicouterine and two vesicocutaneous. Most of them occurred after diverticulitis
      or operation, or when the patient suffered from a malignant disease. Four
      patients received conservative treatment. One patient decided against an
      operation, two were inoperable, and one fistula closed with use of an indwelling
      catheter. 15 were operated on. 12 extirpations of fistula were carried out.
      Additional resection of intestine was performed in seven patients and
      hysterectomia in two patients. Other procedures included two enterostomias and
      one ileum bladder. In ten patients postoperative courses were uneventful. Four
      patients died during the first month after operation. One suffered a relapse, and
      another damage to the nerves of the bladder.

PMID- 8465337
TI  - [Overtraining among elite athletes--causes, diagnosis and treatment].
AB  - Overtraining is an imbalance between training and recovery. We review the
      pathogenesis of overtraining, with emphasis on the neuroendocrinal changes which
      occur in response to acute overtraining. At present, no sensitive and specific
      tests are available to allow early diagnosis of overtraining. The diagnosis is
      based on medical history, clinical evaluation and exercise testing. The treatment
      is rest, and may take weeks to months.

PMID- 8465338
TI  - [Physical activity and the metabolic syndrome].
AB  - Hypertension may be accompanied by decreased insulin sensitivity, lipid
      abnormalities and increased haemostatic risk, all of which, constitute risk
      factors for coronary artery disease. Modifications of lifestyle, including more
      physical exercise, are important, and may reduce the coronary risk profile.
      Physical activity has been shown to lower blood pressure, reduce
      hypertriglyceridemia, improve insulin sensitivity and increase the fibrinolytic
      capacity. Hypertensive patients should be encouraged to increase physical
      activity as an adjuvans to both pharmacological and non-pharmacological treatment
      of high blood pressure.

PMID- 8465339
TI  - [Growth hormone and prolactin receptors belong to a new receptor family.
      Biological and medical aspects].
AB  - The molecular structures of the receptors of growth hormone and prolactin have
      recently been identified by molecular cloning, and have been characterized in a
      number of species and different tissues. The receptors consist of one polypeptide
      chain with a single transmembrane region. The extracellular region contains
      cysteines for disulphide bonding and potential sites for glycosylations. The
      intracellular part which mediates the biological actions displays considerable
      heterogeneity of size. A high degree of homology is demonstrated between the
      extracellular part of these receptors and the receptors of a number of cytokines,
      interferons and growth factors. Together they comprise a new family of receptors
      called the cytokine/growth hormone/prolactinreceptor family. Their structure is
      reviewed, along with the actions of growth hormone and prolactin in vivo. In
      spite of numerous biological effects the molecular mechanisms of actions for this
      class of receptors are unknown, even though they convey important cell regulatory
      functions. The molecular analysis of growth hormone receptor has provided new
      medical insight on the results of growth hormone replacement therapy in persons
      with deficient growth.

PMID- 8465340
TI  - [Smoking habits among Norwegian soldiers in Lebanon 1986].
AB  - The smoking habits in 287 Norwegian soldiers, mean age 24 years, who served for
      six months in the United Nations' peace-keeping forces in Lebanon was studied by
      self-administered questionnaire and determination of serum-thiocyanate. According
      to the questionnaires and verified by serum thiocyanate 42% were non-smokers at
      departure, 88% of them were still non-smokers at return. 7% of the smokers quit
      smoking while in Lebanon. The other smokers increased the consumption of
      cigarettes. The study indicates that campaigns against smoking should preferably
      be directed toward the youngsters since success among them will have long lasting
      effect.

PMID- 8465341
TI  - [Lost faces are restored].

PMID- 8465342
TI  - [Blood cultures in emergency situations].

PMID- 8465343
TI  - [Behavioral theory and preventive work in practice].

PMID- 8465344
TI  - [Breast implants and connective tissue diseases].

PMID- 8465345
TI  - [Medical education--ready for failure?].

PMID- 8465346
TI  - [An echo of another pain. Physicians' meeting with the hidden violence against
      women].

PMID- 8465347
TI  - [Does higher efficiency adversely affect patient care? Some thoughts on Oslo
      psychiatry prior to year 2000].

PMID- 8465348
TI  - [SLE (systemic lupus erythematosus)-related clinical features in dogs].
AB  - Three dogs presented with lameness and/or vague clinical signs. The results of
      immunological tests were suggestive of a SLE-related syndrome. ANA (antinuclear
      antibodies) titres were very high, 1:40960 in one of the dogs, and antibodies
      against single-stranded DNA were detected. Complement levels were very low in two
      dogs. Antibodies against histones were detected in both the serum and the
      synovial fluid of one dog. In another dog there was evidence of high
      concentrations of PCNA antibodies, which in humans are specific for SLE. It is
      concluded that the three dogs showed signs of a syndrome possibly related to SLE.
      The description of the clinical signs and of the laboratory diagnostics serve as
      a clinical demonstration to draw colleagues' attention to this nosologically
      interesting clinical syndrome and to the need to request specific immunological
      tests when this syndrome is suspected.

PMID- 8465349
TI  - [Antibiotic sensitivity of bacteria isolated by health services in The
      Netherlands].

PMID- 8465350
TI  - [An umbilical cord broken off too shortly].

PMID- 8465351
TI  - [Umbilical cord broken off too shortly].

PMID- 8465352
TI  - [Tuberculosis in cattle].

PMID- 8465353
TI  - [Overcharging: keeping both feet on the ground and going a step forward].
AB  - The intrinsic value of animals and their place in human society influence
      veterinary practice. The role-responsibility of the veterinarian is under
      pressure of practical circumstances, client requests and constraints of breeding
      and management systems. A reflection on human needs as related to the intrinsic
      value and welfare of animals, is required inside and outside the profession. It
      is in the interest of life to think and act out of total ecological concepts. In
      order to be better prepared to deal with ethical problems in practice, students
      should receive adequate training. The assumed value-free research and the need
      for outside financial support are a hindrance for research projects that aim at
      sustainability of human and animal life. It is concluded that the profession
      needs a philosophy about her objectives.

PMID- 8465354
TI  - Health effects in man from long-term exposure to pesticides. A review of the 1975
      1991 literature.
AB  - The scientific literature published over the period 1975-1991 on long-term health
      effects from prolonged exposure to pesticides has been reviewed, in order to
      document the state-of-knowledge on the mortality and morbidity of groups of the
      population exposed to pesticides. Specific aims of the review were to identify
      (1) which groups of the population have been more broadly surveyed, (2) which
      adverse effects have been consistently associated with specific pesticide
      exposures, (3) which are the pesticides of concern and (4) which health effects
      would require special attention in future research. The literature on acute
      effects and animal toxicology studies have not been considered at all in this
      monograph. In the period of interest, 440 papers have been published. Apart from
      97 reviews and a small number of case reports, approximately half of the original
      investigations were of the case-control design (n = 108), while the remaining
      papers reported results from proportionate mortality (n = 10), cohort (n = 66) or
      cross-sectional studies (n = 51), carried out on pesticide applicators (n = 48),
      agricultural workers (n = 26) or people employed in the pesticide manufacturing
      industry (n = 50). Most of the case-control studies related to cases of cancer
      from various sites, especially myelolymphoproliferative disorders (MLP) and soft
      tissue sarcomas (STS). When compared to the general population total mortality
      has been found to be consistently lower among pesticide manufacturers as well as
      among other groups of workers. This observation has been mostly attributed to the
      'healthy worker effect' or, in the case of agricultural workers, to the healthier
      lifestyle of farm families. With the exception of deaths by accidental causes,
      non-cancer causes of death (mainly represented by cardiovascular diseases), were
      generally found to be less frequent than expected among manufacturers or users of
      pesticides, in particular among farmers. No consistent evidence of a global
      cancer mortality different from that of the general population has been reported
      among pesticide manufacturers or applicators. On the other hand, the papers
      examined have been strikingly consistent in reporting a low overall cancer risk
      among agricultural workers; life-style, clean air, low prevalence of smoking have
      been hypothesized so as to explain this observation. Numerous studies considered
      the possible link between exposure to phenoxyherbicides and occurrence of certain
      types of cancer, especially STS and MLP disorders.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8465355
TI  - Lobar hemorrhages. Where do they come from? How do they get there?

PMID- 8465356
TI  - Predictors of major vascular events in patients with a transient ischemic attack
      or nondisabling stroke. The Dutch TIA Trial Study Group.
AB  - BACKGROUND AND PURPOSE: Very few studies have addressed the identification of
      prognostic factors in patients with a transient ischemic attack or minor stroke.
      METHODS: We prospectively studied the prognostic value of clinical, laboratory,
      radiological, and electrocardiographic findings in 997 patients with a transient
      ischemic attack and 2,130 patients with a minor stroke who were entered into a
      multicenter clinical trial. The mean follow-up period was 2.6 years. RESULTS: A
      total of 302 patients died (212 from a vascular cause), 272 had a stroke, and 200
      had a cardiac event. By means of a multivariate analysis we identified the
      following independent risk factors for stroke, myocardial infarction, or vascular
      death: age of > 65 years; male sex; dysarthria; multiple attacks; diabetes;
      angina pectoris; intermittent claudication; computed tomographic evidence of any
      cerebral infarct, especially a border zone infarct or white matter hypodensity;
      and electrocardiographic evidence of an anteroseptal infarct, ST depression, left
      ventricular hypertrophy, or left atrial conduction delay. Protective predictors
      were monocular attacks only or the presence of rotatory dizziness. CONCLUSION: A
      limited number of easily obtainable characteristics are powerful predictors of
      major vascular events in patients with cerebral ischemia.

PMID- 8465357
TI  - Prognostic factors in first-ever stroke in the carotid artery territory seen
      within 6 hours after onset.
AB  - BACKGROUND AND PURPOSE: We sought to detect prognostic factors related to
      functional outcome during the first 6 hours after a first-ever stroke in the
      carotid artery territory. METHODS: All patients with these characteristics seen
      during a 3-year period were included. Outcome was evaluated according to a
      modified Rankin scale. The following variables were examined at univariate
      analysis: sex, age, severity of deficit at entry and at day 7, level of
      consciousness at entry, time after symptom onset, history of smoking, history of
      hypertension, diabetes, myocardial infarction, atrial fibrillation, rheumatic
      heart disease, dilated cardiomyopathy, all potential cardioembolic sources,
      presence of a consistent lesion on computed tomography at entry and at days 5-9,
      and the size of such lesion. RESULTS: All entry criteria were met by 172
      patients. Age > or = 70 years, a Canadian Neurological Scale score < 6.5 at entry
      and at day 7, atrial fibrillation, presence of a potential cardioembolic source,
      and a "large" lesion (involving more than half the cerebral lobe) on computed
      tomography at days 5-9 were associated with a significantly worse outcome both at
      30 days and at 6 months. After multivariate analysis, a Canadian Scale score <
      6.5 at entry (p < 0.0001) and atrial fibrillation (p = 0.005) were associated
      with a significant handicap or death at 30 days, whereas only a Canadian Scale
      score < 6.5 (p < 0.0001) was associated with a worse prognosis at 6 months. An
      association of age > or = 70 years with a worse outcome at 6 months was of
      borderline significance (p = 0.054). CONCLUSIONS: Some prognostic indicators are
      available during the first few hours after onset of a carotid ischemic stroke and
      may be useful in the stratification of patients in clinical trials. Severity of
      deficit is the most important indicator, whereas the presence of atrial
      fibrillation worsens the prognostic outlook with respect to early handicap but
      not mortality.

PMID- 8465358
TI  - Questions people ask about stroke.
AB  - BACKGROUND AND PURPOSE: We sought to identify the type and frequency of questions
      asked about stroke by patients, relatives, and caregivers. METHODS: All stroke
      related inquiries made to Stroke Association Advice Centers in the United Kingdom
      during a 4-month period were recorded. RESULTS: During the study period, 1,397
      people asked 1,908 questions. Nearly one quarter needed more information about
      the nature of stroke. The other most common inquiries concerned help at home
      (with many expressing concern about their current level of community support),
      requests for information about stroke clubs, speech difficulties, rehabilitation,
      personality changes, and depression. CONCLUSIONS: Knowledge of the questions
      asked should enable health professionals to provide better information to stroke
      victims and allow modification of stroke information pamphlets.

PMID- 8465359
TI  - Anterior ischemic optic neuropathy is not associated with carotid artery
      atherosclerosis.
AB  - BACKGROUND AND PURPOSE: The relation between anterior ischemic optic neuropathy
      and carotid artery atherosclerotic disease is unclear. We studied patients with
      anterior ischemic optic neuropathy to determine if they had an increased
      occurrence of carotid artery stenosis. METHODS: Fifteen consecutive patients with
      anterior ischemic optic neuropathy were evaluated prospectively for cervical
      carotid artery stenosis and compared with 30 age- and sex-matched asymptomatic
      patients and also with 11 age- and sex-matched patients experiencing transient
      monocular blindness. RESULTS: There was no difference in the mean stenosis of the
      internal carotid artery between patients with anterior ischemic optic neuropathy
      (mean carotid stenosis, 19%) and asymptomatic patients (mean carotid stenosis,
      9%; p > 0.05), whereas patients with transient monocular blindness had
      significantly more stenosis (mean, 77%) in the cervical carotid arteries than
      both control subjects (p < 0.0001) and patients with anterior ischemic optic
      neuropathy (p < 0.0001). There was also no difference in the percentage of
      patients with stenosis > or = 30% in anterior ischemic optic neuropathy (two of
      15) and asymptomatic patients (five of 30), whereas 10 of 11 patients with
      transient monocular blindness had stenoses > or = 30%, significantly more than
      patients with anterior ischemic optic neuropathy (p < 0.0001) and asymptomatic
      patients (p < 0.0001). CONCLUSIONS: Anterior ischemic optic neuropathy is not a
      marker for atherosclerotic carotid artery stenosis. The pathogenesis of
      nonarteritic anterior ischemic optic neuropathy does not involve carotid artery
      stenosis in most patients.

PMID- 8465360
TI  - Trial of secondary prevention with atenolol after transient ischemic attack or
      nondisabling ischemic stroke. The Dutch TIA Trial Study Group.
AB  - BACKGROUND AND PURPOSE: beta-Blockers prevent vascular events in patients after
      myocardial infarction and lower blood pressure, the main risk factor for stroke.
      Hence, we assessed the effects of atenolol on the occurrence of death from
      vascular causes, stroke, or myocardial infarction and on blood pressure in
      patients after a transient ischemic attack or nondisabling ischemic stroke.
      METHODS: In a double-blind, placebo-controlled randomized clinical trial we
      studied the occurrence of the outcome event death from vascular causes, nonfatal
      stroke, or nonfatal myocardial infarction and the outcome event fatal or nonfatal
      stroke as well as blood pressure on follow-up. A total of 1,473 aspirin-treated
      patients with transient ischemic attack or nondisabling ischemic stroke were
      randomized to 50 mg atenolol daily or placebo. The mean follow-up was 2.6 years.
      RESULTS: Patients on atenolol had a risk of 97/732 (13.3%) for the combined
      outcome event versus a risk of 95/741 (12.8%) for those on placebo (adjusted
      hazard ratio, 1.00; 95% confidence interval, 0.76-1.33). The adjusted hazard
      ratio for fatal or nonfatal stroke was 0.82 (95% confidence interval, 0.57-1.19).
      More patients on beta-blocker (153) reported adverse effects than on placebo
      (103). At the first follow-up visit after randomization (median at 4 months)
      systolic blood pressure in the atenolol group had dropped by 8.0 mm Hg compared
      with 2.2 mm Hg in the placebo group (difference, 5.8 mm Hg; 95% confidence
      interval, 2.9-8.6 mm Hg). For diastolic blood pressure this difference was 2.9 mm
      Hg (95% confidence interval, 1.5-4.4 mm Hg). CONCLUSIONS: Our data neither
      confirm nor rule out that atenolol prevents important vascular events in patients
      after transient ischemic attack or nondisabling ischemic stroke, given the modest
      effect on blood pressure, the restrictions in patient selection, and the limited
      number of patient-years.

PMID- 8465361
TI  - Angiographic evaluation of brain infarction limited to the anterior cerebral
      artery territory.
AB  - BACKGROUND AND PURPOSE: Brain infarction localized in the anterior cerebral
      artery territory is rather uncommon, and its etiology has not yet been fully
      elucidated. METHODS: Based on computed tomographic findings, 17 patients with
      solitary anterior cerebral artery territory infarction were selected from among
      3,619 patients admitted consecutively to our institute. Patients without
      angiographic examinations were excluded. The angiographic findings and clinical
      category of stroke were analyzed in each patient. RESULTS: Angiographic
      abnormalities were revealed in all patients. These consisted of occlusive changes
      (n = 10) or reversible segmental dilatation (n = 3) of the anterior cerebral
      artery, A1 hypoplasia (n = 5), and occlusive changes of the carotid artery (n =
      3). In one patient with anterior cerebral artery occlusion, the occluded artery
      was reopened and subsequently became reoccluded. The clinical category of stroke
      was classified as atherothrombotic in 10 patients, cardioembolic in three, and
      undetermined in the remaining four. In eight of the 10 patients with
      atherothrombotic infarction, the anterior cerebral artery was narrowed or
      occluded. In all patients with cardioembolic infarction, the A1 segment
      contralateral to the infarction was hypoplastic. CONCLUSIONS: In our series,
      solitary anterior cerebral artery territory infarction was attributable most
      commonly to local atherothrombosis and occasionally to cardiogenic embolism. A
      hypoplastic A1 segment may facilitate the occurrence of embolism in the anterior
      cerebral artery. Reversible dilatatory and occlusive changes of this artery may
      be another important cause of infarction.

PMID- 8465362
TI  - Intracerebral hemorrhage after fibrinolytic therapy for acute myocardial
      infarction.
AB  - BACKGROUND AND PURPOSE: Intracerebral hematoma may complicate treatment of acute
      myocardial infarction in patients treated with fibrinolytic agents. We studied
      the clinical presentation and computed tomographic characteristics. METHODS: We
      studied eight patients with lobar intracerebral hematomas after fibrinolytic
      treatment of acute coronary occlusion. All patients had electrocardiographic and
      laboratory evidence of acute myocardial infarction and were treated with tissue
      plasminogen activator or streptokinase followed by heparin infusion to prevent
      reocclusion. Computed tomography scans of 17 patients with cerebral hemorrhage
      from other causes were used for comparison. RESULTS: For most patients, outcome
      was fatal within hours of the ictus. Computed tomography scans showed
      superficially large lobar hematomas in six patients. One patient had a putaminal
      hemorrhage, and one had a vermis hemorrhage. Multiple sites of intracerebral
      hemorrhage were noted in three patients. Fluid levels inside the hematoma
      suggesting continuing hemorrhage into multiple compartments were common.
      Radiologically, fluid levels in hematomas, multiple hematomas, and blood in
      multiple compartments served to differentiate fibrinolysis-induced hemorrhage
      from hemorrhage of other causes. Severe amyloid angiopathy was found in one
      patient who was operated on. CONCLUSIONS: Hemorrhages in multiple compartments
      and the presence of fluid levels inside the hematoma suggest fibrinolysis
      associated cerebral hematomas. Severe amyloid angiopathy may be a crucial factor
      in this clinical entity. Outcome is poor, and a high proportion of patients have
      rapid progression to brain death. Therefore, emergency neurosurgical evacuation
      will probably be unsuccessful.

PMID- 8465363
TI  - Transforming growth factor-beta 1 reduces infarct size after experimental
      cerebral ischemia in a rabbit model.
AB  - BACKGROUND AND PURPOSE: The aim of this study was to examine the effect of
      transforming growth factor-beta 1, a cytokine shown to amelioriate cardiac
      ischemia, in a rabbit model of thromboembolic stroke. METHODS: An autologous clot
      embolus was introduced intracranially through the right internal carotid artery
      in 21 New Zealand White rabbits, with seven in each group receiving either
      vehicle control (albumin) or 10 or 50 micrograms transforming growth factor-beta
      1 administered as an intracarotid bolus immediately before autologous clot
      embolization. Multiple physiological parameters were monitored, including
      regional cerebral blood flow, arterial blood gases, hematocrit, glucose, core
      temperature, and mean arterial pressure. The brain was harvested 4 hours after
      embolization, and infarct size was determined planimetrically as a percentage of
      the entire hemisphere. RESULTS: Brain infarct size was reduced in both the 10
      microgram (16.7 +/- 4.0% [mean +/- SEM], p < 0.05) and 50-microgram (21.7 +/-
      4.5%) transforming growth factor-beta 1-treated groups when compared with the
      control group (31.9 +/- 6.6%). Regional cerebral blood flow did not show any
      significant intergroup or intragroup variation over time, although the 10
      microgram transforming growth factor-beta 1 group experienced a greater return of
      cerebral blood flow in the first 2 hours after embolization. CONCLUSIONS:
      Transforming growth factor-beta 1 reduced brain infarct size in a rabbit model of
      thromboembolic stroke. This effect was not related to a direct effect on blood
      flow. Studies are ongoing to determine the mechanism by which transforming growth
      factor-beta 1 salvages ischemic brain.

PMID- 8465364
TI  - Cerebral blood flow alterations in a rat model of cerebral sinus thrombosis.
AB  - BACKGROUND AND PURPOSE: Outcome from sinus vein thrombosis is very variable, with
      symptoms from headache to coma. Experimental findings suggest that an involvement
      of cortical veins is necessary to affect the cerebral microcirculation. Laser
      Doppler flowmetry was used to investigate the regional and temporal changes in
      local cortical blood flow after experimental occlusion and thrombosis of the
      superior sagittal sinus and tributary cortical veins in rats. METHODS: Thrombosis
      was induced by slow injection of kaolin-cephalin suspension after frontal and
      caudal ligation of the sagittal sinus in rats. Local cerebral blood flow was
      measured by laser Doppler flowmetry and correlated with parenchymal damage found
      24 hours after induction of thrombosis. RESULTS: Local cerebral blood flow 1 hour
      after sinus occlusion and induction of thrombosis had decreased to 60.92 +/-
      29.05% (p < 0.01); however, there was a large variability among individual
      animals. Only five of 12 rats showed histological damage and intracerebral
      hemorrhages 24 hours after induction of thrombosis. A subgroup analysis revealed
      that parenchymal damage occurred in concurrence with reduced blood flow values
      after sinus ligation and injection of the thrombogenic material. Sinus thrombosis
      alone, without alteration of blood flow, did not cause tissue necrosis.
      CONCLUSIONS: The data support the contention that sinus vein thrombosis evolves
      gradually, with major symptoms occurring only if the thrombus expands from the
      sinus into bridging and cortical veins. Collateral venous outflow pathways are
      thereby occluded, and local blood flow may become reduced to and below the
      ischemic threshold.

PMID- 8465365
TI  - Isolated or predominant ocular motor nerve palsy as a manifestation of brain stem
      stroke.
AB  - BACKGROUND AND PURPOSE: There have been few reports of strokes producing isolated
      or predominant ocular motor nerve palsies as a clinical manifestation. METHODS:
      We studied seven patients with brain stem stroke who had ocular motor palsies as
      the only or the predominant neurological manifestation, and we correlated their
      clinical features with radiological findings. RESULTS: Five patients had small
      strokes in the area of oculomotor nuclei or fascicles and showed various
      combinations of oculomotor disturbances. Three of these patients showed vertical
      gaze paresis of the opposite eye. One patient with a small hemorrhage near the
      aqueduct of Sylvius showed fourth nerve palsy on the contralateral side, and a
      patient with a small infarct in the pontine tegmentum showed isolated sixth nerve
      palsy. Nonocular minor neurological signs included trigeminal sensory changes in
      four patients and clumsy arm in two. Ocular and nonocular dysfunctions generally
      improved within several months. Radiological findings of the brain stem
      correlated well with the ocular signs. CONCLUSIONS: We conclude that acute brain
      stem stroke should be included in the differential diagnosis of isolated ocular
      motor nerve palsies and that appropriate diagnostic investigations should be
      performed in these cases.

PMID- 8465366
TI  - Myocardial infarction, thrombolytic therapy, and stroke. A community-based study.
      The MITI Project Group.
AB  - BACKGROUND: Thrombolytic therapy used in patients with acute myocardial
      infarction may increase the risk of stroke. Scant information is available from
      community-based studies. SUMMARY OF REPORT: Among 5,635 consecutive patients
      admitted with acute myocardial infarction to hospitals in Seattle and surrounding
      suburban King County, Washington, 116 (2.1%) experienced strokes during
      hospitalization. Of these strokes, 82 (71%) were ischemic and 34 (29%) were
      hemorrhagic, defined by a patient's having had a computed tomographic scan of the
      head that showed blood. Thrombolytic therapy was given to 1,413 of these patients
      (25%) and was associated with increased risk of hemorrhagic stroke but reduced
      risk of ischemic stroke. The relative risk of stroke with thrombolytic therapy
      was estimate using multiple logistic regression to adjust for potential
      confounding factors. The adjusted relative risk for hemorrhagic stroke was 3.6
      (95% confidence interval [CI], 1.7-8.0); for ischemic stroke, 0.4 (95% CI, 0.2
      0.9); and for overall stroke, 1.0 (95% CI, 0.6-1.7). The adjusted risk for death
      from any cause following stroke was 3.0 (95% CI, 1.4-6.4). CONCLUSIONS: Although
      thrombolytic therapy had little effect on the overall occurrence of stroke,
      thrombolytic therapy increased the risk of stroke death because more patients
      with hemorrhagic than ischemic strokes died during their hospitalization. The
      rates of hemorrhagic stroke with thrombolytic therapy reported in the present
      study are higher than those reported in clinical trials in which treatment is
      given to select patients under strict protocols.

PMID- 8465367
TI  - Dynamic computed tomographic imaging of regional cerebral blood flow and blood
      volume. A clinical pilot study.
AB  - BACKGROUND AND PURPOSE: The advent of faster computed tomography scanners has
      evoked considerable interest in using this technology as a more practical method
      of regional cerebral hemodynamic evaluation than the currently available positron
      emission and single-photon emission computed tomography. The theoretical concepts
      have been worked out and validated in the laboratory by several groups. The aim
      of the present study was the development of a clinically useful system. METHODS:
      Software was developed for dynamic computed tomography-based calculation and
      color-coded representation of regional cerebral blood flow and blood volume.
      Normal values, reproducibility, and sensitivity to acetazolamide challenge were
      established in 13 volunteers. The method was applied to an additional three
      patients with internal carotid artery occlusion and known decreased vascular
      reserve capacity as diagnosed by transcranial Doppler ultrasonography. RESULTS:
      Normal regional cerebral blood flow was determined as 50 +/- 13 ml/100 ml per
      minute and normal fractional cerebral blood volume as 58 +/- 12 ml/1,000 ml (mean
      +/- SD). In five volunteers, two examinations were performed within 15 minutes
      for determination of reproducibility. Intermeasurement variability of hemispheric
      blood flow and blood volume was determined as +/- 23% and +/- 16%, respectively.
      Intravenous administration of 1 g acetazolamide resulted on the average in a 75%
      increase of blood flow and a 65% increase of fractional blood volume. In the
      patients with decreased cerebrovascular reserve capacity, baseline fractional
      blood volume in the ischemic hemispheres was significantly increased. Baseline
      regional cerebral blood flow in the ischemic territories was overestimated.
      Reactivity to acetazolamide of both regional blood flow and fractional blood
      volume was clearly reduced in the ischemic hemispheres. CONCLUSIONS: The present
      results demonstrate that the method is a simple and effective means of
      determining regional cerebral blood volume. Spatial resolution is superior to
      that of the radioactive tracer methods. Hemodynamic evaluation of ischemic
      conditions can be performed on the basis of increased resting cerebral blood
      volume and a diminished increase after acetazolamide. Accuracy of cerebral blood
      flow measurements, on the other hand, is affected by abnormal cerebral blood
      volume, and corresponding adjustments need to be made in pathological conditions.

PMID- 8465368
TI  - Recurrent ischemic events in two patients with painless vertebral artery
      dissection.
AB  - BACKGROUND AND PURPOSE: Vertebral artery dissection causes endothelial changes
      and stenosis that may lead to recurrent ischemic neurological events. The
      diagnosis may not be obvious because the dissection may be painless and
      "spontaneous" (no obvious trauma). Magnetic resonance angiography has
      increasingly been used to screen patients for this disorder, but its accuracy has
      not yet been established. CASE DESCRIPTION: Two patients were admitted with
      repeated transient ischemic attacks and strokes over 11 months and 1 month,
      respectively. Neither had a history of trauma, cervical pain, or headache.
      Magnetic resonance angiography failed to visualize vertebral artery dissections
      that were later revealed by conventional angiography. One patient's events were
      stopped by balloon occlusion of the vertebral artery proximal to the posterior
      inferior cerebellar artery branch. CONCLUSIONS: Magnetic resonance angiography is
      not yet sensitive enough to always visualize vertebral artery dissection.
      Vertebral artery dissection is a life-threatening condition that requires
      aggressive evaluation and treatment.

PMID- 8465369
TI  - An unusual cause of cerebral venous thrombosis in a four-year-old child.
AB  - BACKGROUND AND PURPOSE: Inherited protein S deficiency has been associated with
      an increased risk of thromboembolic disease. It is possible that such a
      coagulopathy could predispose children to the development of strokes by
      permitting clot formation in response to stimuli that ordinarily would be
      insufficient to cause thrombus formation. CASE DESCRIPTION: We evaluated a
      previously well 4-year-old boy who developed cerebral venous thrombosis after
      suffering minor head trauma. Crossed-immunoelectrophoresis of his plasma showed a
      marked decrease of the free, active form of protein S. Family studies revealed
      that the patient's father and other paternal relatives had a similar abnormality
      of protein S. CONCLUSIONS: We suggest that the cerebral venous thrombosis in this
      child was initially precipitated by minor head trauma and pathological thrombus
      formation was then potentiated by inherited protein S deficiency. This case
      extends the clinical spectrum for protein S deficiency and emphasizes the
      importance of evaluating family members to establish a specific diagnosis and
      therapeutic intervention.

PMID- 8465370
TI  - Evidence for embolization from a posterior cerebral artery thrombus by
      transcranial Doppler monitoring.
AB  - BACKGROUND: Transcranial Doppler monitoring enables the detection of emboli
      passing through intracranial arteries. Comparison of the different intracranial
      vessels with respect to emboli detection can be of use in identifying the source
      of embolism. CASE DESCRIPTION: We report the case of a patient with an acute
      posterior cerebral artery (PCA) infarct on the right side, with evidence for high
      degree ipsilateral PCA narrowing on admission. During transcranial Doppler
      monitoring 3 days later, we found frequent emboli-like signals in the power
      spectrum of the right PCA distal to the stenosis but not in any other
      intracranial vessels. Four days later, angiography and transcranial Doppler
      failed to show PCA narrowing, and transcranial Doppler monitoring of the right
      PCA showed no further emboli-like signals. A stenosis of the right vertebral
      artery was regarded as the possible source of thromboembolic narrowing of the
      PCA. CONCLUSIONS: We assume that in our patient a thrombotic clot in the PCA was
      resolved autolytically through detachment of small emboli into the distal part of
      the PCA. We speculate that in the early course of autolysis a larger fragment of
      the clot had occluded one of the distal branches, thus leading to the small PCA
      territory infarct.

PMID- 8465371
TI  - Current role of electroencephalography in cerebral ischemia.
AB  - BACKGROUND: The electroencephalogram has been largely supplanted by neuroimaging
      techniques for the diagnosis and localization of ischemic stroke. However,
      because of its close correlation with cerebral metabolism and its ability to
      detect brief transient alterations in cortical function, the electroencephalogram
      may still be useful for certain diagnostic applications in stroke. SUMMARY OF
      REVIEW: The relation of electroencephalographic phenomena to cerebral blood flow
      and metabolism is reviewed. Ten clinical questions that can be addressed by the
      electroencephalogram in patients with stroke are posed. The presence of seizures,
      confirmation of diagnosis, intraoperative monitoring, and level of consciousness
      are areas of proven usefulness. The electroencephalogram provides less worthwhile
      information about the time course, prognosis, and localization of strokes.
      Computerized techniques are of potential but unproven value. CONCLUSIONS: The
      electroencephalogram retains a worthwhile place in the evaluation of patients
      with cerebral ischemia when it is used to answer specific questions. All patients
      with strokes do not need electroencephalograms, but the test can provide uniquely
      useful data in some.

PMID- 8465372
TI  - Secular trends in stroke incidence and mortality.

PMID- 8465373
TI  - Simultaneous bihemispherical assessment of cerebral blood flow velocity changes
      during a mental arithmetic task.

PMID- 8465374
TI  - Middle cerebral artery embolism and unilateral visual loss after autologous fat
      injection into the glabellar area.

PMID- 8465375
TI  - Perinatal health in developing countries.

PMID- 8465376
TI  - Phlebotomus (Phlebotomus) duboscqi (Diptera: Phlebotominae), naturally infected
      with Leishmania major in southern Ethiopia.
AB  - In a survey of Leishmania infections in phlebotomine sandflies in visceral
      leishmaniasis focus at Aba Roba, Segen Valley, southern Ethiopia, Phlebotomus
      duboscqi was found naturally infected with L. major (zymodeme MON-74). This is
      the first isolation of L. major from a vector sandfly in Ethiopia, from an area
      where human and/or rodent infections with L. major are, so far, unknown.

PMID- 8465377
TI  - Use of 'original antigenic sin' theory to determine the serotypes of previous
      dengue infections.
AB  - Determination of serotypes of dengue viruses involved in sequential infections is
      important since, according to a theory of the pathogenesis of dengue haemorrhagic
      fever, a particular serotype may be a risk factor. It has been reported in Asia
      that at least the serotypes involved in the first infections could be
      serologically identified by the plaque reduction neutralization test (PRNT)
      because the highest PRNT titres after the second infections corresponded to the
      serotypes in the first infections. We re-examined the application of this theory
      of 'original antigenic sin' in Puerto Rico to evaluate its utility in
      serodiagnosis. Our results showed that it could not be applied reliably because
      of discrepant results.

PMID- 8465378
TI  - Immune activation in human rabies.
AB  - Serum cytokines were compared by enzyme-linked immunosorbent assay among (i) 28
      patients with rabies, (ii) 13 patients with non-fatal encephalitis due to other
      viruses, (iii) 16 patients with immune-mediated neurological diseases, and (iv)
      15 patients with non-viral central nervous system infections and non-HTLV-I
      progressive spastic paraparesis. Levels of soluble interleukin 2 receptor (S
      IL2R) were comparable in groups (i)-(iii). Fewer paralytic (1/6) than
      encephalitic (12/22) rabies patients had elevated S-IL2R. Only one patient with
      rabies and one with non-fatal viral encephalitis (group ii) had elevated S-CD8.
      Interleukin 6 (IL-6) was elevated in 5/22 rabies patients with encephalitis and
      in 0/6 paralytic rabies patients. Four individuals in groups (ii) and (iii) had
      elevated IL-6. Patterns of cytokine responses in group (iv) were similar to those
      in groups (i)-(iii). The results suggest defects in immune responsiveness in
      paralytic rabies.

PMID- 8465379
TI  - The effect of nutritional supplementation and stunting on morbidity in young
      children: the Jamaican study.
AB  - Infection and undernutrition in young children are thought to act
      synergistically. However, studies of the relationship between low height-for age
      (stunting) and morbidity in young children have had inconsistent findings and
      there are few adequate data on the effects of nutritional supplementation on
      morbidity. 129 stunted and 21 non-stunted children aged between 9 and 24 months,
      from poor Kingston neighbourhoods, identified from a house-to-house survey, were
      studied. The stunted children were randomly assigned to supplementation or no
      supplementation. Every week for 24 months the mothers were asked about the
      occurrence of any symptoms of illness. Supplementation had no consistent effect
      on the incidence or duration of symptoms. The stunted children had significantly
      more attacks of diarrhoea, fever, anorexia and apathy than the non-stunted
      children. The differences remained after controlling for social background and
      previous attacks of diarrhoea. There was also some indication of more severe
      illness in the stunted than in the non-stunted children.

PMID- 8465380
TI  - Urban beri-beri in The Gambia, west Africa.
AB  - Thirty-eight patients with beri-beri (13 dry, 14 wet and 11 mixed type) were seen
      at the Royal Victoria Hospital, Banjul, The Gambia, in 1990-1991, with a peak in
      September-October (25 cases) during the latter half of the rainy season. They
      were all non-confined residents of urban areas. Overt risk factors were pregnancy
      (6), alcohol (5), fevers (4), chronic disability (4), and exercise (2). Four
      patients (10.5%) died. The potential for large outbreaks of beri-beri exist in
      many urban areas of West Africa where polished rice is the staple diet.

PMID- 8465381
TI  - Discriminatory ability of typing systems in Leishmania.

PMID- 8465382
TI  - Chagas disease in north-west Argentina: association between Trypanosoma cruzi
      parasitaemia in dogs and cats and infection rates in domestic Triatoma infestans.
AB  - The association between Trypanosoma cruzi parasitaemia in dogs and cats and Tryp.
      cruzi infection rates in domestic Triatoma infestans was studied in a cross
      sectional survey of 31 houses (89%) in the rural villages of Trinidad and
      Mercedes, north-west Argentina, where no spraying of insecticides had ever been
      done. Similar prevalence rates of parasitaemia, determined by xenodiagnosis, were
      recorded among 68 dogs (41.2%) and 28 cats (39.3%). Bug infection rates were
      significantly associated with the presence of infected cats (those with positive
      xenodiagnosis) stratified by the number of infected dogs (relative risk = RR =
      1.90; 95% confidence interval = CI = 1.51-2.38), and with the number of infected
      dogs stratified by the presence of infected cats (RR = 2.71; CI = 1.81-4.07). The
      percentage of infected bugs in houses with and without children stratified by the
      presence of infected dogs or cats was not significantly different (RR = 0.69; CI
      = 0.45-1.05). The combined effect of infected dogs and infected cats on bug
      infection rates fitted closely with an additive transmission model. Bug infection
      rates were significantly higher when infected dogs shared the sleeping areas of
      people than when they did not (RR = 1.79; CI = 1.1-2.91). Our study showed that
      infected dogs and infected cats increase the risk of domestic transmission of
      Tryp. cruzi to T. infestans.

PMID- 8465383
TI  - A Melanesian sciapod.

PMID- 8465384
TI  - Relationship between the degree of poverty and the IgE response to Ascaris
      infection in slum children.
AB  - We examined a group of urban slum children in Caracas, Venezuela, and
      demonstrated the relationship that exists between poverty, conditions of hygiene
      and the prevalence of helminth infection. Concordant with the high prevalence of
      helminth infection in these children, the total serum levels of immunoglobulin E
      (IgE) and blood eosinophilia were elevated and were directly related to the
      degree of poverty and lack of sanitary facilities. However, in contrast, the
      reverse pattern was observed for the specific allergic response to these
      parasites. Thus, the immediate hypersensitivity skin test reactivity to Ascaris
      antigens, and the serum levels of specific anti-Ascaris IgE antibody, were lowest
      in the poorest children, who had the highest prevalence of helminth infection and
      the highest total IgE levels. As allergic-type reactions may participate in
      protective mechanisms against helminths, these results suggest that poverty and
      poor sanitary conditions may, by influencing the IgE response, compromise the
      resistance of such children to parasitic infections.

PMID- 8465385
TI  - Prevalence of antibody to Helicobacter pylori in children in northern Nigeria.
AB  - Helicobacter pylori infection is common in northern Nigeria, but the age of
      acquisition is unknown. In a prospective study, immunoglobulin G antibodies to H.
      pylori were measured in 143 children under the age of 20 years. Ninety-one
      percent of 43 randomly chosen subjects over 10 years had antibodies to H. pylori.
      A further 100 children under 10 years presenting to the University of Maiduguri
      Teaching Hospital were also tested. Sixty-nine percent had antibodies, including
      58% of those aged under 1 year. H. pylori infection is acquired at an early age,
      and in this study was not associated with any other pathology. This study was
      carried out in an area where peptic ulceration and gastric cancer are uncommon.
      The early acquisition of H. pylori infection may be important in relation to its
      apparent lack of pathogenicity.

PMID- 8465386
TI  - Population growth, fertility, mortality and migration in drought prone areas in
      Ethiopia.
AB  - To assess the population dynamics of drought-prone communities, we investigated
      605 households in the pastoralist Boran community of Dubluk and in the
      agricultural community of Elka, both located in southern Ethiopia. The age and
      sex composition of the population as well as records of births, deaths and
      patterns of migration were observed for 2 consecutive years. Repeated surveys of
      the same households revealed much higher rates for deaths and births than did
      cross-sectional surveys with a one-year recall period. Indirect mortality
      estimates showed that the under 5 years mortality rates (per 1000 births) were
      135 in Dubluk and 219 in Elka. Highest crude death rates were observed in Elka
      during periods of meningitis and malaria epidemics. During the period of
      observation, death rates fluctuated to a greater extent than birth rates. Both
      communities had very high rates of natural increase: in Dubluk 39.0/1000 and in
      Elka 37.1/1000. In Dubluk, this rate was far higher than any previously recorded
      and may have indicated that fertility regulating mechanisms, traditionally
      inherent in the pastoralist social organization, had become weaker as part of
      cultural changes. Dubluk represented a semi-nomadic society with a moderately
      high mobility pattern. Peak periods of migration coincided with times of food
      scarcity in Elka.

PMID- 8465387
TI  - The development and validation of a simple antigen detection ELISA for Plasmodium
      falciparum malaria.
AB  - A double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) is described
      for the detection of Plasmodium falciparum antigen. The test is based on an
      immunoglobulin (Ig) M capture monoclonal antibody on the solid phase and an IgG
      monoclonal antibody conjugated to peroxidase. The simple test takes about 2.5 h
      to complete and, because it uses whole blood with no prior treatment, it is
      possible to process batches of 50-100 samples simultaneously. The test is
      specific to P.falciparum and has a sensitivity close to that usually achieved
      with Giemsa-stained blood films. The reagents employed are stable at refrigerator
      temperatures for over 6 months, and as the test is compatible with human
      immunodeficiency virus and hepatitis B surface antigen ELISAs it could be
      suitable for blood transfusion screening.

PMID- 8465388
TI  - Infectivity of Plasmodium vivax and P. falciparum to Anopheles tessellatus;
      relationship between oocyst and sporozoite development.
AB  - The assessment of malarial infectivity, for example in the evaluation of
      transmission blocking immunity, is generally based on counting oocysts in
      mosquitoes fed on infected blood. Ultimate transmission of the disease may,
      however, depend on the sporozoite load in the mosquito and its relationship to
      the size of the inoculum introduced to man. We conducted a laboratory study on
      Anopheles tessellatus infected with 108 different natural isolates of Plasmodium
      vivax from patients and 24 of P. falciparum to determine the relationship between
      oocyst numbers, sporozoite loads, and the effect of these on mosquito mortality.
      It was found that the P. vivax parasite density was positively correlated with
      the proportion of mosquitoes infected by a given feed at both the midgut and
      gland stages of parasite development (correlation coefficient [r] = 0.77, P <
      0.001 and r = 0.6, P < 0.05 respectively). A significant positive linear
      correlation was observed between the number of oocysts and sporozoites in P.
      vivax (r = 0.5; P < 0.05); the proportions of mosquitoes infected with oocysts
      and sporozoites were also similarly related, although in general about 15% of
      mosquitoes infected with oocysts failed to develop salivary gland infections with
      sporozoites. The number of mosquitoes infected with P. falciparum parasites was
      too low for statistical analysis. Infection with either species of parasite did
      not appear to affect mosquito survival, nor was parasite density in the mosquito
      correlated with mosquito mortality.

PMID- 8465389
TI  - Field study of an antigen-detection ELISA specific for Plasmodium falciparum
      malaria.
AB  - We field-tested a specific antigen-detection enzyme-linked immunosorbent assay
      (ELISA) based on the histidine-rich protein of Plasmodium falciparum, in a
      district hospital in Thailand. The test was simple to perform, takes less than 3
      h to complete, can deal with batches of sera, be read visually, and was 98.05%
      sensitive and 96.22% specific. However, 3 of 154 microscopically identified P.
      falciparum cases gave false negative ELISA results. One of these patients had
      been admitted to hospital for P. falciparum malaria 3 months previously and all 3
      came from hyperendemic villages and were thought to have had previous episodes of
      malaria, possibly resulting in high titres of circulating blocking antibody. The
      test was more sensitive when whole blood was frozen and thawed before testing.
      This test is promising but requires further refinement to eliminate false
      negatives before it can be used safely for screening acutely ill patients for
      falciparum malaria. The sensitivity of this ELISA appears to be sufficiently high
      to consider it as a tool for blood donor screening in regions with a high
      prevalence of P. falciparum carriers with low parasitaemia. There is at present
      no satisfactory routine screening method for large numbers of blood donors for
      malaria.

PMID- 8465390
TI  - Autoantibodies give false positive reactions in the serodiagnosis of Trypanosoma
      cruzi infection.

PMID- 8465391
TI  - Enzyme-linked immunosorbent assay for the detection of anti-Giardia specific
      immunoglobulin G in filter paper blood samples.
AB  - Conventional diagnosis of infection with Giardia duodenalis is by faecal
      examination but the sensitivity of a single examination is low. Serological
      tests, although not always positive, are more acceptable to patients and are
      useful in determining the prevalence of giardiasis in large populations. We show
      here that blood collected on filter paper and dried provides an excellent source
      of material for enzyme-linked immunosorbent assays; using samples from a group of
      88 stool-negative and 45 positive patients, the optimum results were obtained by
      taking the control mean optical density plus one standard deviation as the
      negative/positive cut-off value. The sensitivity was 91% (2/45 false negatives),
      and the specificity 95% (4/88 false positives). This method should be
      particularly useful for large-scale surveys in developing countries or wherever
      serological testing is done in central laboratories.

PMID- 8465392
TI  - A field and laboratory evaluation of a commercial ELISA for the detection of
      Giardia coproantigens in humans and dogs.
AB  - A capture enzyme linked immunosorbent assay (CELISA) was evaluated for its
      ability to detect Giardia coproantigens in the faeces of humans and dogs in the
      Perth metropolitan area and Aboriginal communities in Fitzroy Crossing, Western
      Australia. Using zinc sulphate flotation and light microscopy, Giardia cysts
      and/or trophozoites were observed in 8 of 57 (14%) human stool samples from Perth
      and 21 of 55 (38%) stool samples from Fitzroy Crossing, after 2 separate
      examinations. Analysis of diagnostic sensitivity using the ELISA revealed that
      coproantigens were detected in all 29 human samples (100%) in which Giardia cysts
      and/or trophozoites were also present. Coproantigens were detected in one further
      sample from Perth and in 3 samples from Fitzroy Crossing in which no Giardia cyst
      or trophozoite was observed. The specificity of the test, as defined using
      Fitzroy Crossing samples free from Giardia, was 91%. The assay did not cross
      react with Giardia-free stool samples containing Hymenolepis nana, Entamoeba
      coli, E. hartmanni, Chilomastix mesnili or Ancylostoma duodenale. Giardia cysts
      and/or trophozoites were also observed in 11 of 32 dog faecal samples (34%) in
      Perth and 11 of 29 dog samples (38%) in Fitzroy Crossing, after one zinc sulphate
      examination. The sensitivity of the ELISA for dogs was 64% and 55% for Perth and
      Fitzroy Crossing specimens respectively. The specificity was 95% when Fitzroy
      Crossing samples were used. Other parasites observed in Giardia-free faecal
      samples from dogs which did not produce a positive reaction with the kit were
      Ancylostoma caninum, Sarcocystis sp. and Isospora sp.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8465393
TI  - Seroepidemiology and serodiagnosis of schistosomiasis in Kenya using crude and
      purified egg antigens of Schistosoma mansoni in ELISA.
AB  - The performance of antibody detection for the diagnosis of schistosomiasis has
      been evaluated in Kenya. Approximately 1500 blood samples from 3 areas with
      endemic schistosomiasis (Schistosoma mansoni only, S. haematobium only, and a
      mixed infection area), and from a non-endemic control area, were tested for their
      antibody reactivity in an enzyme-linked immunosorbent assay (ELISA). The results
      were compared with infection status determined by parasitological examination.
      Two test antigens were used: unfractionated S. mansoni egg homogenate (SEA), and
      CEF6, a previously described, partially purified fraction of SEA containing 2
      cationic antigens. The antigens prepared from eggs of Kenya and Puerto Rico S.
      mansoni isolates gave very similar results. Bloods from patients with S.
      haematobium infection cross-reacted significantly with the two S. mansoni antigen
      preparations, but reactivity against CEF6 appeared more specifically indicative
      of S. mansoni infection. Of 254 blood samples from schoolchildren in the non
      endemic area, 100% gave ELISA optical density readings at 492 nm (OD492) < 0.20
      against SEA, and 98% were < 0.20 against CEF6. With 887 blood samples from
      subjects of all ages in the area endemic for S. mansoni alone, using an ELISA
      OD492 cut-off point of 0.20, SEA and CEF6 had sensitivities of 94% and 97%
      respectively, and specificities of 64% and 59% respectively. Increasing the OD492
      cut-off value reduced the sensitivity and increased the specificity of both test
      antigens. Specificity of both antigens was poor with samples from 234 children in
      an area endemic for both S. mansoni and S. haematobium (< 20% for both antigens
      at an OD492 cut-off value of 0.20).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465394
TI  - Serum ionized calcium, serum and intracellular phosphate, and serum parathormone
      concentrations in acute malaria.
AB  - Previous studies have shown depressed serum corrected calcium and phosphate
      concentrations in acute falciparum malaria. To characterize malaria-associated
      disturbances in mineral homoeostasis further, serum ionized calcium and
      intracellular phosphate were measured in 18 patients (10 with falciparum malaria,
      8 with vivax malaria) and 10 healthy controls. Six patients (4 falciparum, 2
      vivax) had admission serum ionized calcium concentrations below the absolute
      control range (< 1.15 mmol/litre) and a further six (3 falciparum, 3 vivax)
      developed ionized hypocalcaemia during treatment. The patients with falciparum
      malaria had the lowest values at presentation (median [95% confidence intervals
      in brackets]: 1.17 [1.12-1.23] vs. 1.20 [1.18-1.24] mmol/litre in controls, P =
      0.035) in the presence of depressed simultaneous serum parathormone
      concentrations (1.2 [0.6-1.9] vs. 1.6 [1.1-2.6] pmol/litre; P = 0.05). Admission
      serum phosphate concentrations were lower in the malaria patients (P = 0.007 vs.
      controls), especially in those with falciparum malaria (0.85 [0.7-1.1] vs. 1.2
      [1.1-1.3] mmol/litre in controls; P = 0.002); patients with falciparum malaria
      also had significantly lower intracellular phosphate than controls (0.74 [0.58
      0.90] vs. 0.88 [0.66-1.04] mmol/litre red cells; P = 0.047). There was a weak
      association between serum corrected and ionized calcium in the malaria patients
      (rs = 0.31, n = 18, P > 0.1), but serum and intracellular phosphate correlated
      significantly (rs = 0.71, n = 17, P < 0.001) with a regression line slope of 0.49
      and intercept of 0.27 mmol/litre of red cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465395
TI  - Interleukin-8 and Plasmodium falciparum malaria in Thailand.

PMID- 8465396
TI  - Pneumocystis carinii pneumonia and tuberculosis in Tanzanian patients infected
      with HIV.

PMID- 8465397
TI  - Chlamydial infection in the Amazon region of Brazil.
AB  - The prevalence of antibodies to Chlamydia was determined in 9 population groups
      with different risk levels for sexually transmitted diseases in Belem, Para
      state, Brazil. 583 serum samples were examined by the indirect immunofluorescence
      test. The prevalence rates varied from 33.3% in patients attending a sexually
      transmitted disease clinic to 97.1% in Parakana Indians. One or more pathogens
      were found in 55 of 86 patients presenting a clinical picture of urethritis; C.
      trachomatis was isolated from 11% (6/55) of these cases by inoculation to McCoy
      cell cultures, accounting for 30% (6/20) of the cases of non-gonococcal
      urethritis. C. trachomatis was isolated from one of 28 female patients (3.6%)
      attending gynaecology and obstetrics outpatient clinics. The positive patients
      had no symptom or complaint that would have suggested the diagnosis.

PMID- 8465398
TI  - Two cases of HIV-associated cryptococcosis due to the variety gattii in Rwanda.

PMID- 8465399
TI  - Detection of clinically and epidemiologically significant strains of Escherichia
      coli in faeces from young children in the tropics.

PMID- 8465400
TI  - Accidental envenoming by a Gaboon viper (Bitis gabonica): the haemostatic
      disturbances observed and investigation of in vitro haemostatic properties of
      whole venom.
AB  - We report the successful treatment of envenoming by the Gaboon viper (Bitis
      gabonica) and include results of in vitro investigations of the haemostatic
      properties of the whole venom. The patient was admitted to casualty soon after
      the bite with chest tightness, dizziness, nausea and swelling at the site of the
      bite and was treated immediately with polyspecific antivenom, hydrocortisone,
      chlorpheniramine and antibiotics. Results of haemostatic investigations were
      essentially normal on admission but on day 3 the thrombin time became prolonged
      and was associated with significant hypofibrinogenaemia and elevated D-dimers.
      Factors V and VIII, antithrombin III and protein C levels and platelet number
      were not significantly reduced. The haemostatic disturbances persisted for more
      than 24 h despite treatment with blood products (16 units of cryoprecipitate, 2
      units of fresh frozen plasma and 6 units of platelet concentrate). Resolution of
      the abnormalities occurred only after administration of a further dose of
      antivenom. The period of hypofibrinogenaemia occurred at a time when venom
      antigen was undetectable in plasma by enzyme-linked immunosorbent assay. Studies
      in vitro with whole venom and a panel of amidolytic substrates commonly employed
      for measurement of haemostatic proteins revealed significant activity of venom
      with substrates sensitive to kallikrein and plasmin. The venom inhibited washed
      platelet aggregation induced by collagen, thrombin, arachidonic acid and the
      calcium ionophore A23187 in a dose-dependent manner.

PMID- 8465401
TI  - Fifteen years of cutaneous and mucocutaneous leishmaniasis in Bolivia: a
      retrospective study.
AB  - This paper present the results of a retrospective study of cases of cutaneous and
      mucocutaneous leishmaniasis in Bolivia between 1975 and 1991. The total number of
      cases reported was 4058, 739 of which were mucous. Three different areas of
      endemic leishmaniasis are defined in Bolivia.

PMID- 8465402
TI  - Life-threatening bradycardia and hypotension in a patient with ciguatera fish
      poisoning.

PMID- 8465403
TI  - Choice of therapy for imported cases of falciparum malaria in children: a
      retrospective study of 100 cases seen in Marseilles, France.
AB  - We have carried out a retrospective study on 100 children in hospital in
      Marseilles, France with a diagnosis of Plasmodium falciparum malaria. On
      admission, the main clinical features were anaemia (90 cases), fever (83 cases, >
      40 degrees C in 22 cases), hepatomegaly (44 cases), vomiting (29 cases),
      neurological signs (22 cases), thrombocytopenia (13 cases), hyperparasitaemia (6
      cases), jaundice (4 cases), shock (1 case) and hypoglycaemia (1 case). Severe
      malaria, as defined by the World Health Organization Malaria Action Programme,
      was rare in our study (only 2 cases) and the prognosis was good (no death, no
      sequela). The search for neurological signs such as impaired consciousness,
      prostration or convulsions is an effective and simple way to diagnose potentially
      severe cases. In the presence of these signs, intravenous quinine treatment
      resulted in a shortened duration of fever (30 h instead of 63 h) and thereby
      avoided patients becoming worse. In children without neurological signs or
      persistent vomiting, oral therapy may be used even if there is high fever or
      hyperparasitaemia, but close surveillance is required. Patients treated with
      halofantrine or mefloquine had a shorter stay in hospital than those treated with
      chloroquine (mean = 4 d instead of 5.7 d). The resistance of some strains to
      chloroquine may explain this difference.

PMID- 8465404
TI  - Treatment of Plasmodium falciparum malaria with pyrimethamine-sulfadoxine:
      selective pressure for resistance is a function of long elimination half-life.
AB  - In an area of continuing transmission of Plasmodium falciparum on the Kenya
      coast, children treated with pyrimethamine-sulfadoxine experienced rapid parasite
      clearance, although a high proportion became reinfected within a short time. The
      frequency of pyrimethamine resistance in vitro in new infections was higher
      during the elimination phase of drug from a previous treatment. In infections
      which occurred at times when predicted residual drug concentrations were no
      longer inhibitory, incidence of pyrimethamine resistance was no different from
      the natural or background frequency. These results are discussed in terms of the
      selective pressure for resistance which is exerted by drugs with long elimination
      half-lives and a consideration of possible ways by which the problem might be
      addressed.

PMID- 8465405
TI  - Activity in vitro of the enantiomers of halofantrine.

PMID- 8465406
TI  - Halofantrine treatment of uncomplicated falciparum malaria with high
      parasitaemia.

PMID- 8465407
TI  - Reversal of mefloquine resistance with penfluridol in isolates of Plasmodium
      falciparum from south-west Nigeria.
AB  - The susceptibilities of isolates of Plasmodium falciparum from Nigeria and two
      reference cloned strains (D6 and W2) to mefloquine or chloroquine alone and in
      combination with either penfluridol, a piperidine analogue, or verapamil were
      determined using a modification of the semiautomated microdilution technique. Six
      of the isolates showed reduced susceptibility to mefloquine in vitro. The
      response of the 6 isolates was similar to that of the mefloquine resistant
      reference clone D6, with 50% inhibitory concentration (IC50) values = 3.29-9.72
      ng/ml. Only 2 of the Nigerian isolates were sensitive to mefloquine (IC50 = 1.16
      ng/ml and 2.62 ng/ml) and were similar to the reference mefloquine sensitive
      clone W2 (IC50 = 1.78 ng/ml). All the isolates tested were sensitive to
      chloroquine, with IC50 values = 1.5-3.04 ng/ml. Simultaneous incubation of the
      parasites with a constant sub-inhibitory concentration of penfluridol (5.0 x 10(
      7)M) and mefloquine increased the susceptibility of the resistant parasites to
      mefloquine. Addition of the neuroleptic drug penfluridol did not alter the
      response of sensitive parasites to mefloquine or chloroquine. Similarly, addition
      of 1.0 x 10(-6)M verapamil did not affect the activity of mefloquine against the
      sensitive or resistant parasites.

PMID- 8465408
TI  - Albendazole as a treatment for infections with Giardia duodenalis in children in
      Bangladesh.
AB  - Albendazole, a broad spectrum anthelmintic recently shown to be active in vitro
      against Giardia duodenalis, was given at 4 different dosages and compared with
      metronidazole in the treatment of children in Bangladesh infected with Giardia.
      Three stools were collected over 10 d after treatment and examined
      microscopically. Albendazole was found to be effective: single doses of either
      600 mg (n = 103) or 800 mg (n = 114) successfully treated 62% and 75% of
      infections, respectively; 400 mg given either once a day for 3 d (n = 116) or for
      5 d (n = 115) successfully treated 81% and 95% of all infections, respectively.
      Albendazole given daily at 400 mg for 5 d was as effective as metronidazole,
      which cured 97% of infections (n = 230). Albendazole may thus be an alternative
      treatment for infections with Giardia, while the moderate efficacy of single
      doses may provide a benefit in addition to its effects on several species of
      intestinal helminths.

PMID- 8465409
TI  - Treatment of mixed Oesophagostomum and hookworm infection: effect of albendazole,
      pyrantel pamoate, levamisole and thiabendazole.
AB  - Oesophagostomum bifurcum has recently been recognized as a common parasite of man
      in northern Togo and in Ghana. In a preliminary trial several anthelmintics were
      evaluated in the treatment of mixed Oesophagostomum and hookworm infections.
      Diagnosis was based on faecal culture, since the eggs of Oesophagostomum and
      hookworm cannot be distinguished morphologically. Of the anthelmintics tested,
      albendazole was most effective against both parasites. Pyrantel pamoate, 2 x 10
      mg/kg, was effective against Oesophagostomum but not against hookworm. The cure
      rates for both parasites were moderate with thiabendazole and poor with
      levamisole.

PMID- 8465410
TI  - Treatment failure of a single high dose of ivermectin for Mansonella perstans
      filariasis.
AB  - Infections with Mansonella perstans are common in certain parts of Africa and
      South America. There is no standard treatment at present. We evaluated the effect
      of a single high dose of ivermectin (600 micrograms/kg) on microfilaraemia in 7
      consecutive patients. No decrease in microfilarial counts could be demonstrated
      after a follow-up period of 7-56 d.

PMID- 8465411
TI  - Induction and modulation of the immune response to Leishmania by Montenegro's
      skin test.
AB  - The intradermal inoculation in naive or in previously sensitized individuals of
      small amounts of Leishmania extract (Montenegro's skin test) induced or
      modulated, respectively, the immune response to Leishmania, as assessed by
      subsequent Montenegro's skin tests. These phenomena could hinder the
      interpretation of Montenegro's skin tests in a population already subjected to
      the test in the past and, in addition, could affect in an unknown way the
      development of mucosal lesions in people infected with L. braziliensis or L.
      amazonensis, since those lesions have been associated with hypersensitivity to
      Leishmania antigens. Anti-Leishmania antibody responses, assessed by enzyme
      linked immunosorbent assay, were not induced in naive individuals by Montenegro's
      skin tests, but tended to become more intense following these tests in previously
      sensitized individuals.

PMID- 8465412
TI  - HIV-Leishmania co-infections in Italy: serological data as an indication of the
      sequence of acquisition of the two infections.
AB  - Twenty-two sera from visceral leishmaniasis (VL) patients with human
      immunodeficiency virus (HIV) infection (50% with the acquired immune deficiency
      syndrome) were examined for anti-Leishmania immunoglobulin G (IgG) antibodies and
      compared with 35 sera from VL patients without HIV (controls). Significant titres
      of specific IgG were found in 81.8% of co-infections. However, while control sera
      showed a restricted range of anti-Leishmania IgG titres, sera from co-infection
      cases displayed a considerable degree of variability, both quantitative and
      qualitative. They were clearly divided into 2 groups: one (18 sera) showing a
      continuous grading from nil to mid-concentrations of specific antibodies, the
      other (3 sera) showing titres 30-fold higher than this range. Taking into account
      the major immunological abnormalities involving humoral response described in HIV
      patient, the 2 groups may reflect a different sequence of acquisition of the 2
      infective agents; the former representing VL acquired after HIV infection, and
      the latter representing the contrary situation.

PMID- 8465413
TI  - Partial characterization of antigens in circulating immune complexes in cystic
      hydatid patients treated with albendazole.
AB  - Immune complexes were precipitated by 3% polyethylene glycol (PEG) from 4 sera
      from albendazole-treated hydatid patients from Uruguay, and together with sheep
      hydatid cyst fluid were analysed by ion-exchange fast protein liquid
      chromatography (FPLC). FPLC-eluted fractions of serum preparations and cyst fluid
      were tested in an enzyme-linked immunosorbent assay for the detection of specific
      Echinococcus granulosus antigens and also for presence of specific immunoglobulin
      (Ig) M and IgG in the serum samples. Two peaks (nos 13 and 25) were found to have
      antigenic activity. Antigens were identified in both serum and cyst fluid
      preparation (fraction 25) after sodium dodecyl sulphate-polyacrylamide gel
      electrophoresis immunoblotting analysis, with approximate molecular masses 50 kDa
      and 62 kDa. Specific IgM antibody was also detected in the same FPLC fraction
      (no. 25) of PEG-precipitated serum complexes.

PMID- 8465414
TI  - Rationale for OKT3 monoclonal antibody treatment in transplant patients.

PMID- 8465415
TI  - General aspects of cytokine-release syndrome: timing and incidence of symptoms.
AB  - OKT3 has become a commonly employed immunosuppressant for transplantation both as
      a prophylactic agent and as a means of reversing rejection. It was first thought
      to have few side effects associated with its use, but many findings have become
      recognized as manifestations of cytokine release. The severity of some CRS
      symptoms can be reduced by careful patient management. Strategies to moderate CRS
      show promise. The potential for use of nonactivating anti-CD3 antibodies may
      obviate the symptom complex entirely.

PMID- 8465416
TI  - Cardiopulmonary effects of OKT3: determinants of hypotension, pulmonary edema,
      and cardiac dysfunction.

PMID- 8465417
TI  - OKT3-induced cytokine-release syndrome: renal effects (cytokine nephropathy).

PMID- 8465418
TI  - Cytokine nephropathy during antilymphocyte therapy.

PMID- 8465419
TI  - Encephalopathy following the use of OKT3 in renal allograft transplantation.

PMID- 8465420
TI  - Cytokine-release syndrome: differences between high and low doses of OKT3.

PMID- 8465421
TI  - Procoagulant properties of OKT3 at the monocyte level: inhibition by
      pentoxifylline.

PMID- 8465422
TI  - Administration of OKT3 in the operating room.

PMID- 8465423
TI  - Safety of OKT3 use in the operating room.

PMID- 8465424
TI  - Prophylactic OKT3: practical considerations for the prevention of first-dose
      reactions.

PMID- 8465425
TI  - OKT3-induced cytokine-release syndrome: prevention effect of anti-tumor necrosis
      factor monoclonal antibody.

PMID- 8465426
TI  - Reduction of the initial febrile response to OKT3 with indomethacin.

PMID- 8465427
TI  - Interleukin-10 inhibits OKT3-induced cytokine release: in vitro comparison with
      pentoxifylline.

PMID- 8465428
TI  - Pentoxifylline reduces the first-dose reactions following OKT3.

PMID- 8465429
TI  - Cytokine-release syndrome: general risk-factor modification--preparation of high
      risk patients for use of OKT3.

PMID- 8465430
TI  - Humoral immune response against OKT3.

PMID- 8465431
TI  - Transmembrane signaling requirements of T cells.

PMID- 8465432
TI  - OKT3 antibody response study: comparative testing of human antimouse antibody.

PMID- 8465433
TI  - Antibody response to OKT3 and methods for monitoring.
AB  - Monitoring the antibody response to OKT3 is essential. Retreatment with OKT3 can
      be accomplished successfully in the great majority of patients. It is important
      to know the patient's peak antibody status before and during retreatment.
      Patients with no anti-OKT3 antibodies, or with low-titer (< or = 1:100)
      antibodies, especially if these do not include anti-idiotypic antibodies, have
      retreatment success similar to that of patients undergoing primary treatment with
      OKT3. In contrast, patients with high-titer (> or = 1:1000) antibodies should be
      treated with immunosuppression other than OKT3. Methods for monitoring the OKT3
      antibody response have progressed, allowing one to estimate the titer and
      specificity (anti-idiotype and/or anti-isotype) in a timely fashion. Improvements
      still must be made in the area of standardization, so that results between
      various transplant centers can be more accurately compared.

PMID- 8465434
TI  - Consequences of anti-OKT3 antibody development: OKT3 reuse and long-term graft
      survival.

PMID- 8465435
TI  - Monitoring OKT3 treatment: pharmacodynamic and pharmacokinetic measures.

PMID- 8465436
TI  - Consensus statement regarding OKT3-induced cytokine-release syndrome and human
      antimouse antibodies.

PMID- 8465437
TI  - Clinical observations on bovine parasitic otitis in Tanzania.
AB  - Between January 1982 and December 1989 more than 5,000 clinical cases of bovine
      parasitic otitis were examined. Clinical signs were mild in early cases and were
      characterised by dullness, anorexia and occasional head shaking, but were severe
      in long standing cases where the major presenting clinical signs were dark brown
      aural discharges which soiled the hair below and in front of the ear, emaciation,
      central nervous signs, recumbency and death.

PMID- 8465438
TI  - An evaluation of strategic and short interval tick control in indigenous exotic
      and crossbred cattle.
AB  - The performance of Nguni, Bonsmara and Hereford oxen which were maintained free
      of ticks by short interval treatment with acaricide irrespective of tick load
      (tactical) was compared with similar groups which were treated for tick
      infestation only when the numbers of adult ticks on the cattle increased to
      moderately high proportions (strategic). Strategically treated Nguni oxen
      acquired a strong resistance against ticks and showed weight gains comparable
      with the tick free Nguni group. Weight gains in the Bonsmara group were higher in
      the strategically treated group suggesting a possible effect of the acaricide on
      the tick free group. Strategically treated Hereford oxen acquired heavy tick
      burdens and performed poorly compared with the tick free group. Practical
      approaches to strategic tick control under African conditions are discussed.

PMID- 8465439
TI  - Oral vaccination of chickens with the V4 strain of Newcastle disease virus.
      Cooked and raw white rice as a vehicle.
AB  - Uncooked white rice and cooked white rice were tested as vehicles for the V4
      strain of oral Newcastle disease vaccine. The results of feeding experiments were
      evaluated by the measurement of haemagglutination inhibition antibodies against
      Newcastle disease virus. Little of the virus applied to uncooked white rice could
      be recovered, even immediately after mixing, whereas when the virus was applied
      to cooked white rice most of it could be recovered. In 4 separate experiments,
      chickens failed to respond serologically to vaccine supplied on uncooked white
      rice. In all of 4 experiments with cooked white rice, there were serological
      responses in vaccinated chickens, from 45% to 100% of the chickens developing
      titres sufficiently high to indicate protection against challenge with virulent
      virus. Development of haemagglutination inhibition antibodies in some control
      chickens indicated the ability of the vaccine virus for lateral spread or
      persistence in the environment.

PMID- 8465441
TI  - Preweaning growth performance of west African shorthorn cattle and their Jersey
      crossbreds in Ghana.
AB  - Calf records on 621 West African Shorthorn (WASH) and 3 grades of Jersey x WASH
      crossbreds were analysed for the effects of the level of Jersey breeding and
      other factors on birth weight, 205-day weaning weight and average daily gain
      (ADG). Crossbred calves were significantly (P < 0.01) heavier at birth than
      purebred WASH and birth weights increased with increasing level of Jersey
      breeding. No significant differences were established for 205-day weaning weight,
      however ADG declined with increasing level of Jersey breeding suggesting possible
      problems of adaptation for calves of over 75% Jersey breeding. Age of dam effect
      was significant and linear (P < 0.0001) for birth weight and significant and
      quadratic (P < 0.01) for weaning weight and ADG, with values increasing from 3
      year old dams to a peak in 7 year old dams.

PMID- 8465440
TI  - Efficacy of closantel against fenbendazole and levamisole resistant Haemonchus
      contortus in small ruminants.
AB  - Sheep infected with a fenbendazole resistant strain of Haemonchus contortus and
      goats with a levamisole resistant strain of the same parasite were used to
      evaluate the anthelmintic efficacy of closantel. Closantel at the rate of 10
      mg/kg body weight was 100% effective against the 2 resistant strains of the
      parasite as indicated by faecal egg count and worm reduction. The efficacy of
      fenbendazole in sheep and of levamisole in goats was 56.68 and 76.90%,
      respectively.

PMID- 8465442
TI  - Grass hay and Acacia fruits: a local feeding system for improved calf performance
      in semi-arid Ethiopia.
AB  - A 90-day growth trial was designed to compare the performance of calves on 3 dry
      season diets composed of local resources from the Borana pastoral system. The
      control group received the traditional diet of cut-and-carry, standing-brown
      grass while the other diets consisted of grass hay stored since the previous wet
      season with or without Acacia tortilis fruits as a protein supplement. All calves
      had access to water once every 3 days as traditional. The objective was to see
      whether modest changes in traditional feeding management could enhance nutrient
      intake and growth of calves under conditions of restricted water access. The hay
      had a higher nitrogen content and in vitro digestibility than the standing grass,
      and the Acacia fruits had higher nutrient concentrations than the hay (both at P
      < or = 0.05). Calves on hay plus Acacia fruits had higher nitrogen intakes than
      those on hay only, and those on hay only had higher nitrogen intakes than those
      on standing grass (both at P < or = 0.05). Calves on standing grass lost weight
      and condition, those on hay only maintained weight but lost condition, and those
      on hay plus Acacia fruits gained weight and maintained condition (all at P < or =
      0.05). Calves consumed the most feed on day 2 of the watering cycle, regardless
      of treatment. Water intake increased 27% for animals on both hay diets compared
      to those on standing grass (P < or = 0.01). Feeding packages based on hay making
      and collection of browse legumes are appropriate options for extension to these
      semi-settled pastoralists.

PMID- 8465443
TI  - Effect of change in body weight and condition during the dry season on capacity
      for work of draft oxen.
AB  - Work oxen supplemented at different levels during a feeding period of 3 months,
      were divided into 3 groups of average weight change -25, +35 and +70 kg and
      worked under loadings of either 7.5 or 12.5 kgf/100 kg of liveweight for 2 weeks,
      in order to assess the impact of dry season supplementation on capacity for work.
      At approximately equal levels of stress in work, manifest in maximum heart rate
      one minute after ceasing work (MHR), oxen with higher dry-season weight gain
      produced higher levels of work output, in proportion to their increased body
      weight. Rate of work and mean daily work output increased from the first to the
      second week of work, in spite of average daily weight losses of 2.63 kg
      throughout the period. Decline in rate of working through each day was continuous
      and essentially linear with relation to distance worked. The time taken to cover
      1 km increased at an average of 0.16 and 0.68 min/km for light and heavy loadings
      respectively. Although MHR appeared to provide a retrospective measure of the
      level of stress attained in work, it was of limited use as a predictor of
      reasonable work demand. Maximum heart rate was related to work output (MJ) and
      animal liveweight (kg), as follows: MHR = 17.7 (+/- 3.94) WO - 0.15 (+/- 0.080)
      LWT + 118.5 (r2 = 0.70 P < 0.01).

PMID- 8465444
TI  - [Surgery of acoustic neurinoma--a national function].

PMID- 8465445
TI  - [Acoustic neurinomas in Denmark. Incidence and therapeutic strategies].
AB  - The annual incidence of diagnosed acoustic neurinomas in Denmark during two 7
      year-periods from mid 1976 to mid 1990 is compared. Data on all patients operated
      via the translabyrinthine, transtemporal and suboccipital approach, as well as
      data on non-operated patients, was collected from the entire country. During the
      first period, from June 1976 to June 1983, the incidence was 7.8 tumors per
      million per year. During the second period, from June 1983 to June 1990, the
      annual incidence rose to 9.4 tumors per million per year. The number of newly
      diagnosed small tumors increased, and that of large tumors decreased. A
      significant increase was observed in Copenhagen. An incidence of 11 to 12 tumors
      per million per year, or nearly 60 newly-diagnosed tumors per year is thus
      expected around the year 2000. This limited number supports the continuation of
      the present centralized model of acoustic neurinoma surgery in Denmark.

PMID- 8465446
TI  - [Acoustic neurinoma: observation prior to surgery].
AB  - During the period from 1977 to 1989 (both years included) 79 acoustic neurinomata
      were diagnosed in 76 patients in the County of Arhus. Twenty-four of these
      neurinomata were followed for varying periods clinically and radiographically.
      The symptoms of the patients and the results of successive computed-tomographic
      scans are mentioned. During the periods of observation, four patients were
      submitted to operation and operation was recommended in two cases. Seventeen
      patients are still under observation and are in good clinical condition with
      cessation or limited growth of the tumour in eight. These patients have been
      observed for between 1 and 13 years, on an average 4.5 years and are
      characterised by advanced age which averaged 61 years at the time of the
      diagnosis. The rate of growth of the tumour was calculated to be 1.1 mm per annum
      on an average with a variation from 0 mm to 4.8 mm per annum. As operative
      treatment of acouistic neurinoma exposes the patient to a not inconsiderable risk
      of deterioration the medical and/or socioeconomic status, the authors consider
      that an expectant and controlled attitude (wait and scan) is justified in elderly
      patients with acoustic neurinoma.

PMID- 8465447
TI  - [Results of suboccipital removal of acoustic neurinomas in Denmark 1979-1990].
AB  - In the period from 1979 to 1990, a series of 59 patients with 59 acoustic
      neuromas were operated upon in five departments of neurosurgery by at least five
      different neurosurgical teams, employing the suboccipital approach. The
      perioperative mortality rate was 8.5%. Complications including hematoma,
      ventricular hemorrhage, meningitis, hemiparalysis, abducens nerve paralysis,
      recurrent nerve paralysis, postoperative wound infection and CSF leak were
      observed in 21 patients (35.6%). Radical removal of the tumor was not possible in
      17 patients (28.8%). Converting the postoperative facial nerve function to the
      House-Brackmann (HB) classification, 34 patients (57.6%) were regarded as HB VI.
      Reconstruction of the facial nerve was attempted in 19 patients (32.2%). Attempts
      at preservation of hearing were unsuccessful in all patients. Failure to attain
      better results and the importance of the centralized Danish model of acoustic
      neuroma surgery are emphasized.

PMID- 8465448
TI  - [Lewy-body dementia--a new disease entity].
AB  - Senile dementia of Lewy-body type (SDLB) is a new clinical entity characterized
      by mild extrapyramidal features and progressive dementia, a relative acute onset
      of fluctuating loss of memory and confusion, frequently accompanied by visual
      hallucinations. The syndrome is more frequently identified in women than in men
      and it occurs after the age of 60 years. A case history is presented and the
      diagnosis discussed on the basis of literature concerning Lewy-body dementia
      (LBD).

PMID- 8465449
TI  - [Magnesium therapy in pregnancy-induced hypertension and pre-eclampsia].
AB  - At present, magnesium treatment is employed routinely in the treatment of
      hypertension induced by pregnancy (PIH) and preeclampsia in USA with the object
      of preventing seizures. In USA the treatment of election consists of intravenous
      infusion of large doses of magnesium sulphate in order to obtain a therapeutic
      concentration. The anticonvulsive mode of action of magnesium is only partially
      understood. Magnesium is presumed to block the neuromuscular transmission but a
      central effect cannot be excluded. Treatment with magnesium has, in addition, an
      antihypertensive effect. The effect of magnesium on the blood pressure is
      probably a direct vasodilatory effect which explains the ability of magnesium to
      reduce the maternal blood pressure. Probably the same mode of action is
      responsible for the relaxing effect of magnesium on the vascular tone in the
      umbilical and placental vessels. This can probably explain the favourable effect
      of magnesium on the birth weight. Even if magnesium treatment implies a potential
      risk for neonatal hypermagnesemia and hypocalcaemia, only few side effects have
      been reported.

PMID- 8465450
TI  - [Effect of pneumatic compression in connection with ergotherapeutic treatment of
      Colles' fracture. A clinical controlled trial].
AB  - We followed forty women with functional deficits in the wrist and hand after
      sustaining a Colles' fracture. The women participated in occupational therapy
      three times a week for three weeks. At the initial evaluation, after three weeks,
      and at a three month evaluation, we measured the following: range of joint
      movement, grip strength, hand volume (oedema), pain and ADL. There was
      significant improvement in most of the parameters measured after three weeks of
      occupational therapy, with a less significant improvement from three weeks to
      three months. Seventeen of the forty women received twenty minutes of
      intermittent pneumatic compression before occupational therapy. These patients
      showed significant improvement in wrist extension, compared with the control
      group of twenty-three patients. Occupational therapy is recommended for patients
      showing a functional deficit after Colles' fracture. Intermittent pneumatic
      compression is recommended as a supplement to occupational therapy.

PMID- 8465451
TI  - [24 G Sprotte spinal cannula for anesthesia in young patients].
AB  - We studied 75 patients aged 15-40 years who received spinal anaesthesia with the
      Sprotte 24-gauge spinal needle. The incidence of post dural puncture headache was
      4%. Other types of headache occurred in 8% of the patients. The patient
      acceptance was high. We conclude that spinal anaesthesia is easy to perform with
      a 24-gauge Sprotte needle and is associated with a low incidence of post dural
      puncture headache.

PMID- 8465452
TI  - [Spinal analgesia in young patients using the Whitacre needle G25].
AB  - A material of 100 patients aged 20-50 years was assessed after spinal analgesia
      with the Whitacre cannula G 25. None of the patients developed post-dural
      puncture headache.

PMID- 8465454
TI  - [Total serum cholesterol in postmenopausal women: prediction of future levels
      through a simple measurement].

PMID- 8465453
TI  - [Serology in patients with scleroderma].
AB  - In order to evaluate the practical clinical value of centromere, Scl-70, and
      nucleolar antibodies as demonstrated routinely by the Autoimmune Department of
      the Serum Institute of Copenhagen, 1293 sera from 497 patients with scleroderma
      (SSc) and other connective tissue diseases were tested for the three antibodies
      and for other nuclear antibodies. The three antibodies were found in 32, 15 and
      15%, respectively, of sera from patients with SSc. Since more than one of the
      three antibodies was rarely demonstrated in any one serum, one of them was found
      in two thirds of sera from patients with SSc. The specificity of the three
      antibodies for SSc was 95% or more. Centromere antibody was found most frequently
      in patients with limited SSc. Scl-70 antibody was found almost exclusively in
      sera from patients with extensive SSc (involving the skin of the trunk). In such
      sera, centromere antibody was found in only 21%. Scl-70 antibody was
      overrepresented and centromere antibody was underrepresented in sera from
      patients with pulmonary involvement, the converse being true for sera from
      patients with calcinosis, esophageal involvement and telangiectasia.

PMID- 8465455
TI  - [Age at menarche among schoolgirls in Odense. Is age at menarche still decreasing
      in Denmark?].
AB  - The average age at the menarche has decreased from the 1850s to the 1950s. It is
      controversial whether there has been a continued decrease since the 1950s. The
      object of this investigation is to illustrate whether this trend has continued
      into the 1980s. This study is based on the ages at the menarche as recalled by
      908 girls aged 14-16 years in 40 schools in Odense. The information was obtained
      during intervals of differing lengths and consequently, the parameters of the
      distribution of the age at the menarche were estimated in a randomly grouped
      normal distribution. The average age at the menarche was found to be the same
      throughout the municipality (13.27 years; 95% confidence limit 13.20-13.35). The
      variations were found to be significantly differentiated by the type of school
      district. The variations were low in the suburbs and in the surrounding rural
      districts, higher in the inner city areas and highest among girls attending
      private schools. Compared with the results from other recent Danish studies,
      these findings suggest a halt in the decline of the average age at the menarche,
      which may be temporary.

PMID- 8465456
TI  - [Electrocoagulation of the endometrium. A new method for the treatment of
      hemorrhagic disorders in women].
AB  - The purpose of this investigation was to evaluate endometrial ablation as an
      alternative treatment for heavy dysfunctional menstrual bleeding in women with
      indications for hysterectomy. After preliminary treatment with danazol 200 mg
      q.i.d. for four weeks, transcervical endometrial ablation was performed in
      general anaesthesia with a hysteroresectoscope and the "rollerball" electrode.
      Twenty-five consecutive patients were treated and discharged the following day.
      Twenty-two patients (88%) were very satisfied with the result. 68% became
      hypomenorrhoeic and 20% amenorrhoeic. Three patients required a hysterectomy
      because of continuing bleeding due to intrauterine septum and fibroma. The median
      follow-up time was seven months. Eight patients (32%) had either a submucus
      fibroid or an intrauterine septum. Neither uterine perforations nor major
      complications occurred. Endometrial ablation with the "rollerball" method appears
      to be an easy, cost-effective, safe and efficient treatment for heavy severe
      menorrhagia.

PMID- 8465457
TI  - [Treatment with ACE inhibitors after acute myocardial infarction].

PMID- 8465458
TI  - [Smoking and involuntary sterility].

PMID- 8465459
TI  - [Castration per occasionem].

PMID- 8465460
TI  - [Castration of women as prevention against cancer].

PMID- 8465461
TI  - [Transportation of critically ill patients].

PMID- 8465462
TI  - [Osteoinduction with the dog tibial defect model].
AB  - The objectives of this study were to investigate the osteoinductive effect of
      demineralized bone matrix powder and of cancellous bone in a comparative
      experiment in a standardized dog defect model. 16 adult shepard dogs were divided
      into two test subgroups. One group underwent application of demineralized bone
      matrix (DBM) into the defect. The second group had their defects treated with
      autogenous cancellous bone (ACG) only. The progress of bone formation was
      observed for twelve weeks. The excised tibiae were examined by correlating serial
      X-rays with histologic sections stained with Giemsa and fluorescent labels. In
      this experiment no osteoinductive effect of demineralized bone powder could be
      demonstrated. The amount and localisation of bone regeneration in the matrix
      group seemed to be spontaneous, corresponding to the radiological and
      histological parameters. In the group of cancellous bone grafts, the defect
      (length 30 mm) was bridged by incorporation of the graft and graft mediated bone
      formation within twelve weeks. Disturbing factors such as instability, infection,
      insufficient vascularity, and cellular immune response to the graft were excluded
      in this model. The failure of the osteoinductive implants in our experiment
      compared with the good results obtained in rodents limits their value also in
      clinical situations. As long as there is no explanation for this failure, this
      technique should not be used in a clinical situation.

PMID- 8465463
TI  - [Dynamic force measurement in implantation of total endoprostheses of the hip
      joint].
AB  - The forces within the femoral shaft have been studied in preparation for the
      total hip replacement. The experimental device consisted of a personal computer
      connected with a digital enhanced measurement system which converted the data,
      that was received from the strain gauges, mounted on the femur. The bitochanter
      hip replacement designed by Ecke was used as an example of a press fit
      endoprosthesis which is anchored cementless. It was implanted in femora of
      cadavers. The results showed an extension of the femur at first within the
      intertrochanteric region, and as the rasp was further implanted, it showed at the
      distal end of the rasp a medial extension and a lateral traction with a delay of
      3 ms, proving that it was a result of a medullary extension. The maximum forces
      applied with the metal hammer were 3500 N. Fractures and fissures were provoked
      and the result showed that they were mostly due to a misplacement of the rasp.

PMID- 8465464
TI  - [CORSET, experience with a new method of graft saving tissue replacement in large
      soft tissue defects].
AB  - Following the proposal of Oedekoven we investigated the method of continuous and
      rapid skin enlargement by dynamic traction (which we named the CORSET-method) at
      the border of wounds, applied through elastic silicon rubber bands. Since March
      1992 we operated more than 20 patients. By means of the "rubber bands" mentioned
      above soft tissues can be stimulated to grow, that is to say increase the area of
      skin that had to be treated with transplants priorily in order to close soft
      tissue defects following a compartment-syndrome or septic complications in the
      abdomic wall following operations in the abdomen. Applying the CORSET-method
      there is no risk of inflammation or soft tissue damage caused by the operation
      itself.

PMID- 8465465
TI  - [American football in Germany--aspects of trauma surgery].
AB  - While football injuries in the USA are well documented and thoroughly studied,
      informations on injuries caused by this spreading sport in Germany are not
      available. For this reason the Berufsgenossenschaftliche Unfallklinik in
      Frankfurt conducted a prospective study to register all injuries in major league
      football in southern Germany in 1991. In 49 games that were evaluated we found
      281 minor injuries, mainly skin lesions and concussions of extremities. In
      addition 33 significant injuries were registered, amongst them 30% injuries of
      knee ligaments. The only severe injury was an abdominal hit causing a
      intrahepatic hematoma. The results of our study are comparable to the injury
      risks found in US college football as well as to those found in German statistics
      on soccer and hockey. Although no fatal injuries in our study were registered,
      this should not lead to neglecting the potential risks in football.

PMID- 8465466
TI  - [Management of acromioclavicular joint dislocation with the Wolter hook-plate.
      One year follow-up of 35 cases].
AB  - Wolter's hook-plate provides active abduction and forward-flexion of up to 90
      degrees two days postoperatively. Prebending of the plate and a precise drill
      hole for the hook in the acromion prevents later impingement of the hook on the
      humeral head or subluxation in the acromioclavicular joint, respectively.
      According to the shoulder evaluation form of C.R. Constant, 33 of 35 patients
      operated on between 1987 and 1991 at the trauma departments in Schwaz/Tirol and
      Bad Ischl showed excellent results one year postoperatively.

PMID- 8465467
TI  - [Indications, technique and results in treatment of the chronically unstable
      ankle joint].
AB  - This paper shall prove that with the chronic unstable ankle-joint the unit of
      both joints is to be taken into account. This unit consists anatomically as well
      as biomechanically and neuromuscularly. The practicable diagnostic of the
      instability in the lower ankle-joint ist presented. Then the known therapy
      methods are analysed. In our clinic some treatment methods for the single
      decompensate instabilities have proved success. The results of 119 operated
      decompensate ankle-joints are satisfied.

PMID- 8465468
TI  - [Anatomic studies of percutaneous bore wire osteosynthesis of the distal radius].
AB  - Modified percutaneous K-wire pinning has been used for unstable distal radius
      fractures groups A 2.2-3, A 3.1-3, B 1.1-2, B 2.1-2, B 3.3, C 1.1-3, C 2.1-3, and
      C 3.1-2 according to the ASIF-classification in 90 patients with good results. No
      tendinous rupture or any weakness respectively, infection or secondary
      dislocation either had occurred six months postoperatively. In five cadavers
      experimental anatomical studies had revealed possible lesions of the tendons of
      the brachioradialis muscle, the short and long wrist extensors, the long thumb
      abductor and his short extensor respectively as well as the superficial radial
      nerve and the cephalic vein. Abnormous sensations in the scar or in the region of
      distribution of the superficial radial nerve had occurred in every second patient
      but had subsided six months postoperatively. No permanent nerve lesion was found.
      There has been bleeding from the cephalic vein after the stab incision for
      exposure of the tip of the styloid process in every third patient but had healed
      uneventfully in every case.

PMID- 8465469
TI  - [Development of statutory accident insurance in the new German districts from the
      medical viewpoint].
AB  - In the five eastern federal districts of Germany the condition for organizing
      treatment forms of the Social Insurance for Occupational Accidents were
      different. In 1990 qualification of traumatologic surgeons demonstrated intensive
      standards and similarly positions as western Germany. On the other hand we have
      miserable buildings for patients and poor equipment. After two years the
      development of statutory accident insurance is respectable. The present situation
      reflects very good co-operation between western and eastern institutions, to
      remove some insufficiencies and to establish a sure territorial system for
      medical treatment.

PMID- 8465470
TI  - [A case of hyponatremia].

PMID- 8465471
TI  - [Genetics in medicine: the 5th decade in Quebec].

PMID- 8465472
TI  - [The diagnosis of mental retardation in fragile X syndrome is revolutionized by
      molecular genetics].
AB  - The fragile X syndrome is the most common cause of inherited mental retardation.
      Clinical signs, which are neither specific to the syndrome nor constant, become
      apparent late in childhood or after puberty, making early diagnosis difficult on
      a clinical basis alone. The inheritance of the syndrome is peculiar for an X
      linked disease, since a high proportion of female carriers show a certain degree
      of mental retardation and "normal transmitting males" do exist. Affected males
      can be diagnosed by cytogenetic demonstration of the typical fragile X site but
      only a minority of female carriers can be identified. This makes genetic
      counseling difficult. In 1991, the cloning and sequencing of the target site of
      the mutation marked an important step towards full understanding of the
      peculiarities of inheritance of the fragile X syndrome. A new type of mutation
      has been revealed: a multistep "expansion" of a small part of a gene that takes
      place over several generations. A new diagnostic technique by direct genotypic
      analysis has been developed. With a very high sensitivity and specificity, this
      analysis detects affected individuals with a "full mutation" (a large "expansion"
      associated with abnormal methylation of the surrounding region) and individuals
      with a "premutation" (smaller "expansion") who do not show mental retardation but
      are at risk of having affected children or grand children. With the direct DNA
      analysis at the fragile X locus, it is now possible to diagnose easily those
      children affected with the syndrome and to offer adequate genetic counseling and
      prenatal diagnosis to female carriers in affected families.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8465473
TI  - [The emergence of viruses resistant to antiviral agents: a new challenge].
AB  - Recent use of antiviral drugs and the increase in the number of viral infections
      in immunocompromised hosts have led to the development of viral resistance. In
      this paper, the author reviews the antiviral drugs on the market, the antiviral
      susceptibility tests and presents a review of the literature concerning
      infections with resistant viruses. Acyclovir-resistant herpes simplex and
      varicella-zoster virus, ganciclovir-resistant cytomegalovirus and zidovudine
      resistant human immunodeficiency virus will be discussed.

PMID- 8465474
TI  - [A anatomo-clinical conference at the Hotel-Dieu Hospital in Montreal. A 56-year
      old women presenting with bicytopenia].

PMID- 8465475
TI  - [From the molecule to the drug: innovation or distribution].

PMID- 8465476
TI  - [Revised guidelines related to booster vaccines against hepatitis B. The National
      Conference Committee on Immunization].

PMID- 8465477
TI  - [Tuberculosis: a new disease. An interview with Dr. Alix Adrien].

PMID- 8465478
TI  - Influence of immunotherapy (IL2 + LAK + inhibition of prostaglandin synthesis) on
      peripheral blood immune parameters and in vitro cytokine production in metastatic
      renal cell carcinoma.
AB  - Previous results on the peripheral blood immune status of renal cell carcinoma
      had indicated immunosuppression in metastatic disease, possibly mediated by
      prostaglandin E2 (PGE2). In the present study the immunologic effects of
      inhibition of PG synthesis by piroxicam in combination with interleukin 2 (IL 2)
      + lymphokine-activated killer (LAK) cell therapy were tested by immunomonitoring.
      In addition to peripheral blood parameters (lymphocyte subpopulations, neopterin,
      beta 2-microglobulin, TNF, IL 1, IFN gamma) we recorded in vitro cellular
      activity by incubating the patients' peripheral blood mononuclear cells (PBMC) in
      media containing fetal calf serum (FCS) or autologous serum, and either IL 2 or
      buffer. After 24 h of incubation we measured PGE2 and cytokine levels in
      supernatants. Systemic application of IL 2 induced in vivo lymphocyte
      proliferation and clearly influenced the serum levels of neopterin, beta 2
      microglobulin and TNF. There was minor affection of IFN gamma and none of IL 1.
      PBMC in vitro produced high amounts of PGE2, IL 1 and TNF pretherapeutically,
      during therapy in vitro synthesis of these parameters decreased. Consistent
      production of IFN gamma was detected in supernatants only when FCS and IL 2 were
      added to the medium. Lack of affection of IFN gamma production in the autologous
      system during therapy indicated impaired cellular activity, which could neither
      be improved by therapy of the patient using IL 2 nor by adding IL 2 to the
      culture medium. Immunosuppression seems to interfere in a complex way with
      immunotherapy. Therapeutical influence of immunosuppression based on the results
      of immunomonitoring, however, seems to be a promising strategy for improving the
      still limited clinical results of immunotherapy.

PMID- 8465479
TI  - Effects of thiols on prostaglandin synthesis in bovine bladder epithelium.
AB  - The regulation of prostaglandin (PG) synthesis was characterized in microsomes of
      bovine bladder epithelium. Coenzyme A (CoA) and its metabolite cysteamine
      drastically decreased total PG synthesis. Furthermore, CoA inhibited solubilized
      cyclooxygenase which was precipitated by anti-cyclooxygenase antibody. Reduced
      glutathione (GSH) slightly increased total PG production and changed the pattern
      of PG synthesis. Other thiols, cysteine and ergothioneine, did not change total
      PG production. None of the thiols stimulated the incorporation of arachidonic
      acid into the phospholipid fraction. These findings suggest that CoA may directly
      regulate cyclooxygenase activity and GSH may subsequently change the pattern of
      PG production in bovine bladder epithelium.

PMID- 8465480
TI  - Intra- and perivesical tumor growth in preoperative staging of bladder cancer:
      the role of transrectal ultrasonography and high resolution magnetic resonance
      imaging.
AB  - Bladder tumors were staged preoperatively before and/or after M-VEC poly
      chemotherapy using transrectal ultrasonography and magnetic resonance imaging in
      46 patients. The resultant findings were each compared with histomorphologic
      results. The sensitivity of both methods compared with pathohistology was 88%.
      Using this technique, the degree of tumor invasion of the bladder wall could be
      evaluated and the appropriate therapy selected. Further applications included the
      monitoring of transurethral resection determine its adequacy as a treatment
      modality.

PMID- 8465481
TI  - Quantification of prostaglandin E1 receptors in cavernous tissue of men, monkeys
      and dogs.
AB  - Prostaglandin E1 (PGE1) has been shown to relax the muscles of the corpora
      cavernosa and inhibit spontaneous activity, and clinical trials have proved its
      safety and effectiveness when given intracavernously to induce erection. Through
      use of a specific PGE1 receptor binding assay, we undertook this study to
      quantify its receptor density and measure binding affinity. The cavernous tissue
      of normal and impotent men as well as that of monkeys and dogs was studied in an
      attempt to understand their different responses to the intracavernous injection
      of PGE1. Our results showed a lower receptor density in impotent men than in
      normal men and monkeys and a complete absence of receptors in dogs. These
      findings correlated well with the clinical response to intracavernous injection
      of PGE1.

PMID- 8465482
TI  - Spontaneous passage of upper urinary tract calculi in relation to composition.
AB  - The composition of 2,755 calculi obtained from the upper urinary tract (1,409 by
      spontaneous passage and 1,346 by urological procedures) was analyzed using an
      infrared spectrophotometer, and the spontaneous passage rate was investigated in
      relation to the composition as well as other variables, such as stone size, and
      patient age and sex. Mixed stones of calcium oxalate and calcium phosphate were
      most frequently found, followed by those of calcium oxalate. The mean size (the
      maximum diameter) was largest in struvite stones and smallest in calcium oxalate
      ones. The sizes of stones from women were significantly larger than those from
      men (p < 0.01). As expected, the stone passage rates were inversely related to
      increasing stone size. The size of 55.6% of the stones passed was < or = 5 mm,
      and that of 96.6% of the stones < or = 10 mm.

PMID- 8465483
TI  - Studies on changes in parameters of the coagulation and fibrinolysis in
      association with extracorporeal shock wave lithotripsy.
AB  - Tissue damage by extracorporeal shock wave lithotripsy (ESWL) is assumed to be
      attributable to ischemic changes in the treated region surrounding the particular
      vessel which is first ruptured by shock waves. Such changes cannot take place
      without being accompanied by acceleration of coagulation and fibrinolysis. In the
      literature on renal damage by ESWL, no parameters of the coagulation and
      fibrinolysis of blood were used. The present study was designed to investigate
      renal damage by shock waves through the quantification of sequential changes in
      the following parameters between before and after ESWL: thrombin antithrombin III
      complex (TAT), alpha 2-plasmin inhibitor-plasmin complex (PIC), fibrin and
      fibrinogen degradation products (FDP) and D-dimer (D-D). In ESWL for renal
      stones, a significant acceleration of TAT occurred on the 1st postoperative day,
      followed by acceleration of PIC on the 3rd postoperative day. A transient
      acceleration was observed for FDP and D-D after operation. The levels of these
      parameters, however, returned to normal by the 1st postoperative week. In ESWL
      for ureteral stones, unlike for renal stones, none of the parameters showed
      statistically significant acceleration. In the construction of percutaneous
      nephrostomy (PNS) cases for ureteral stones before ESWL, none of the parameters
      showed significant acceleration either. Changes in these parameters of
      coagulation and fibrinolysis due to ESWL for renal stones were greater than those
      of construction of PNS or ESWL for ureteral stones. The reason for the difference
      of the alteration in these parameters between renal stones and ureteral stones
      were more abundant vessels in the kidney than the ureter. All these changes in
      the parameters, however, disappeared within almost 1 week.

PMID- 8465484
TI  - Calculus disease in duplex system--role of extracorporeal shockwave lithotripsy.
AB  - We report 8 patients with urolithiasis in a duplex system. These patients (7
      males and 1 female) underwent 16 extracorporeal shock wave lithotripsy (ESWL)
      treatments. Five had renal and 3 had ureteral stones. The mean stone size was 21
      mm (12-54 mm). Five patients had incomplete and 3 had complete duplication, of
      which one had an associated horseshoe kidney. Retrograde ureteropyelography was
      done in all the patients and in 7 a JJ stent was inserted. The JJ stent could not
      be inserted in 1 patient with incomplete duplication and retrograde
      catheterization with saline infusion was used as an auxiliary procedure. One
      patient with complete duplication had stones in both the ipsilateral ureters with
      a stone bulk of 54 mm and required two JJ stents. Only 1 paediatric patient
      required general anaesthesia. The 3-month stone-free rate was 100%.

PMID- 8465485
TI  - Splenic gonadal fusion with persistent mullerian duct syndrome.
AB  - Splenic gonadal fusion is a rare anomaly that is frequently associated with
      skeletal abnormalities or occasionally with cryptorchism. But the case of this
      anomaly accompanied by male pseudohermaphroditism here represents, to our
      knowledge, the first report of splenic gonadal fusion with persistent mullerian
      duct syndrome.

PMID- 8465486
TI  - Three cases with different types of short-tailed spermatozoa.
AB  - Short-tailed spermatozoa were found in 3 men attending our subfertility clinic.
      Light microscopy revealed basically normal sperm heads, but a short tail was
      found in 90% or more of the spermatozoa. Scanning and transmission electron
      microscopic examinations of the ejaculate revealed several types of short-tailed
      spermatozoa. In one case, the majority of the spermatozoa had a short, thick
      tail. In another case, all the spermatozoa were short-tailed, although two
      different types could be distinguished. As in the first case some spermatozoa
      were short- and thick-tailed, whereas others possessed an incomplete neck and
      middle piece, and a short, thick principal piece. In the third case, an elongated
      middle piece and short principal piece were found in almost all the short-tailed
      spermatozoa. Our electron-microscopic study revealed that the type of short
      tailed spermatozoa was different in each patient.

PMID- 8465487
TI  - Membranous lipodystrophy (Nasu's disease): a rare cause of neuropathic urinary
      incontinence.
AB  - A 37-year-old man with membranous lipodystrophy (Nasu's disease) was
      urodynamically studied, to elucidate his urinary incontinence. Although
      medication failed to improve this unfavorable condition, urodynamic assessment of
      this patient clearly demonstrated the existence of an uninhibited overactive
      bladder.

PMID- 8465488
TI  - Zoon's balanitis.
AB  - Superficial lesions of the glans penis can cause diagnostic difficulties. Zoon's
      balanitis can be distinguished by characteristic histological changes affecting
      the epidermis and the dermal vasculature. A 44-year-old male presented after
      having blood-staining of his underclothes for 5 months. Upon examination, the
      glans showed a red, moist plaque. Circumcision was performed, and the biopsy
      showed plasma cell balanitis. Following circumcision, the lesion healed
      completely.

PMID- 8465489
TI  - Principles of conventional radiography and fluoroscopy.
AB  - Diagnostic radiology is an extremely valuable tool in the practice of veterinary
      medicine. Basic knowledge of primary exposure factors and their interrelationship
      are required to consistently produce quality radiographs. This article discusses
      basic radiation physics and radiation safety guidelines.

PMID- 8465490
TI  - Radiographic positioning for the spine and skull.
AB  - This article presents an overview of the basic techniques for taking radiographs
      of the canine and feline spinal column and cranium. Radiographic landmarks,
      central ray positioning, centimeter measurement, and restrictive beam uses are
      discussed.

PMID- 8465491
TI  - Contrast agents.
AB  - Pharmacologic development and clinical use of nonionic low osmolality contrast
      agents have lowered incidences of contrast reactions. Exclusive use of these
      agents may be limited owing to their high costs. Ionic high osmolality agents
      still provide reliable means of positive contrast enhancement, and minimal
      problems with reactions have been experienced in veterinary patients.

PMID- 8465492
TI  - Contrast studies of the urogenital system.
AB  - Traditional contrast radiographic techniques for evaluation of the urogenital
      system are reviewed. Specific procedural protocols are suggested. The
      indications, limitations, and interpretation of the studies are discussed.

PMID- 8465493
TI  - Myelography and epidurography.
AB  - To summarize the points discussed in this article, Small animal myelography can
      be performed competently and safely without specialized equipment. The newer
      myelographic contrast media (iohexol, iopamidol) have less neurotoxic potential
      than those media previously used. Myelography is necessary for the diagnosis of
      many neurologic disorders in small animals. Metrizamide is no longer recommended
      for myelography in dogs and cats. Iohexol (Isovue) in concentration of 180 mg
      I/mL to 300 mg I/mL is recommended for small animal myelography. Some patients
      with serious spinal cord disease can exhibit normal myelograms. Recognizing
      abnormal myelographic patterns is the hallmark of myelographic interpretation.
      Anticonvulsive drugs (diazepam, pentobarbital, and phenobarbital) should be
      available for therapy of postmyelographic seizures. Epidurography is an effective
      diagnostic technique in the evaluation of canine lumbosacral compressive disease.
      Abnormalities identified with epidurography correlate well with surgically
      confirmed lesions.

PMID- 8465494
TI  - Selected contrast studies. Portal venography and cerebral angiography.
AB  - Portography is the most commonly used technique for demonstrating portal venous
      anatomy and abnormal communications between the portal and systemic venous
      systems. This article reviews normal anatomy, anomalies, and radiology of the
      portal venous system. Also included is a discussion of cerebral angiography,
      which is mainly used in the diagnosis of space-occupying lesions of the brain.

PMID- 8465495
TI  - Ultrasonography.
AB  - The basic principles of diagnostic ultrasonography are discussed. Normal and
      abnormal ultrasonographic appearances of the major organs are presented in tables
      and with illustrations. A description of the current status of neurosonology with
      illustrations of hydrocephalus is also presented.

PMID- 8465496
TI  - Nuclear imaging.
AB  - Nuclear imaging (scintigraphy) is a noninvasive diagnostic procedure that can
      provide complementary information to that obtained by radiography, CT, MRI, or
      ultrasonography. Nuclear imaging is based on physiologic distribution of
      radiopharmaceutical compounds within the body so that it allows assessment of
      organ functions. When digital image processing is employed, nuclear imaging can
      allow quantitative assessment of organ function. This article provides an
      overview of common nuclear imaging procedures used in veterinary medicine.

PMID- 8465497
TI  - Principles and concepts of computed tomography.
AB  - The final CT image is actually made of a grid of tiny squares called pixels. The
      scale of grays assigned to each pixel represents the attenuation of x-rays by the
      structures in the tomographic slice. Manipulation of the gray scale allows
      optimal visualization of all the tissues within the slice. This control over the
      gray scale and the absence of structure superimposition are the advantages of CT
      over conventional x-ray techniques. The steps used to acquire the final CT image
      are collection of data from the patient (recording of transmitted x-ray
      intensities from many angles), computer processing of data (mathematical
      calculation of attenuation of each structure in the tomographic slice), image
      display (assigning of appropriate gray scale to CT image to evaluate all
      structures), and data storage (recording series of tomographic images on x-ray
      film and archiving image data for later review). Common image artifacts that must
      be identified and interpreted as such include aliasing, ring artifacts, beam
      hardening effect, metal, motion, partial volume averaging, and streaking from out
      of-field objects.

PMID- 8465498
TI  - Interpretation of computed tomographic images.
AB  - This article discusses the production of optimal CT images in small animal
      patients as well as principles of radiographic interpretation. Technical factors
      affecting image quality and aiding image interpretation are included. Specific
      considerations for scanning various anatomic areas are given, including
      indications and potential pitfalls. Principles of radiographic interpretation are
      discussed. Selected patient images are illustrated.

PMID- 8465499
TI  - Magnetic resonance imaging.
AB  - The advent of advanced imaging techniques in veterinary diagnostics has broadened
      the scope of our diagnostic capabilities. MRI is one of the newer advanced
      imaging techniques, and its characteristics differ considerably from CT or
      conventional radiography. This article presents an introduction to MRI and
      interpretation of MR images.

PMID- 8465500
TI  - New and future advanced imaging techniques.
AB  - The advances in diagnostic imaging in the past 20 years have been nothing short
      of phenomenal. This article presents what is available with some of the latest in
      state-of-the-art techniques. Included are three-dimensional techniques, vascular
      MRI, high-resolution three-dimensional video animation, positron emission
      tomography, MR spectroscopy, and other developing methodology in diagnostic
      imaging.

PMID- 8465501
TI  - Experimental transmission of an apparent viral pneumonia in conventional and
      gnotobiotic pigs.
AB  - Endemic pneumonia in five- to eight-week-old pigs induced microscopic lesions of
      proliferative interstitial pneumonia which were compatible with a viral
      aetiology. The disease was transmitted experimentally to conventional and
      gnotobiotic pigs by means of a lung homogenate filtered through a 0.22 micron
      filter. No common viral respiratory pathogens of pigs were isolated. Two types of
      virus particles were observed in cell culture by electron microscopy; one was
      about 70 nm in diameter and had an envelope and short surface spicules, the other
      also had an envelope, was elongated, pleomorphic, measured 80 x 320 nm and was
      coated by antibodies.

PMID- 8465502
TI  - Two fatal cases of diarrhoea in horses associated with larvae of the small
      strongyles.
AB  - Detailed pathological examinations of two horses with subacute fatal diarrhoea
      suggested an association between the diarrhoea and damage to the colonic and
      caecal mucosae caused by large numbers of cyathostome larvae (larval
      cyathostomiasis). The affected animals deteriorated rapidly, and died after a
      short illness.

PMID- 8465503
TI  - Renal dysplasia in two adult horses: clinical and pathological aspects.
AB  - Renal dysplasia is reported in two adult horses in chronic renal failure. Renal
      dysplasia, complicated by severe interstitial pyelonephritis, was diagnosed on
      renal biopsy and confirmed on post mortem examination.

PMID- 8465504
TI  - Effects of the accidental feeding of lasalocid sodium to broiler breeder
      chickens.
AB  - Lasalocid sodium was accidentally introduced into the feed of several broiler
      breeder chicken farms at levels between 115 and 150 ppm. On one farm, leg
      weakness and ataxia were observed in a few cockerels. A reduction in egg
      production and a sharp decrease in fertility and hatchability were observed in
      all the flocks receiving the contaminated feed. Many piping chicks were unable to
      hatch and there was an increase in the number of weak ataxic chicks at the
      hatchery. Histological examination of the muscle tissues of the affected
      cockerels, the piping chicks unable to hatch and the one-day-old chicks with leg
      weakness and ataxia revealed severe muscle damage. Increasing levels of lasalocid
      were detected in the yolk of eggs collected from the affected flocks.

PMID- 8465505
TI  - A paralytic-like disease of the ostrich (Struthio camelus masaicus) associated
      with Clostridium chauvoei infection.
AB  - Two adult Masai ostriches in a zoological collection became recumbent. The birds
      could not raise the neck or the head, had difficulties in breathing, and died
      eight and 13 days, respectively, after the first clinical signs appeared. On post
      mortem examination the heart had a globous appearance accompanied by gelatinous
      atrophy. The lungs were hyperaemic and oedematic, while the intestines had
      prominent haemorrhages in their mucosa. The liver and kidney were enlarged, and
      the former had also necrotic foci. Smears taken from the hyperaemic regions of
      the intestines and the necrotic foci of the liver were positive to Clostridium
      chauvoei after staining with specific fluorescein-labelled antiserum. No other
      pathogenic agents were identified or isolated from these birds. This report
      appears to be the first of a pathogenic condition associated with C chauvoei in
      an avian species.

PMID- 8465506
TI  - Foot-and-mouth disease in Italy.

PMID- 8465507
TI  - Qualifications in Europe.

PMID- 8465508
TI  - Meat hygiene service.

PMID- 8465509
TI  - Fatal BVDV infection in adult cattle.

PMID- 8465510
TI  - Streptococcus suis infection in fallow deer.

PMID- 8465511
TI  - Deworming of pigeons with Panacur capsules.

PMID- 8465512
TI  - Grain overload in two dogs.

PMID- 8465513
TI  - Immunohistochemical detection of the p53 oncoprotein in tumours of melanocytic
      origin.
AB  - We employed the polyclonal anti-p53 antibody NCL-CM1 to cultured cells and
      pathological tissues in order to investigate the expression of p53 oncoprotein in
      human malignant melanomas. The results in the cultured cells showed that the
      antigenic determinant was sensitive to formalin fixation, resulting in a lower
      reactivity than with fixation by alcohol. In pathological tissues, the expression
      of p53 oncoprotein increased with progression of the tumour. Among 79 melanomas
      37 (47%) showed distinct nuclear labelling and the highest proportion of reactive
      cells was observed in metastatic melanomas (mean 4.8%). An immunocytochemical
      study also revealed the presence of mutant-type oncoprotein in human melanoma
      cell lines, which was recognized by monoclonal antibody P240, and we confirmed
      that the molecular weight of the antigens recognized by both antibodies was 53
      kDa by Western blot analysis. Therefore, although the presence of point mutations
      in human melanomas is yet to be confirmed our data suggest that the antigen
      detected by NCL-CM1 is a mutant-type or a complex of mutant and wild-type p53
      oncoproteins. This antibody may be useful in retrospective studies of tumours of
      melanocytic origin.

PMID- 8465514
TI  - Cellular and matrix changes in drug abuser liver sinusoids: a semiquantitative
      and morphometric ultrastructural study.
AB  - The aim of the present work was to analyse, at the ultrastructural level, the
      action of heroin of 150 centrilobular sinusoids from liver biopsies of five
      intravenous drug abusers, who presented clinical and biological manifestations of
      hepatic impairment. A comparative study of 90 sinusoids from liver biopsies of
      three control patients was performed. Electron microscopic observations showed a
      thickening of the sinusoidal wall related to endothelial cell hypertrophy and to
      fibrosis of the space of Disse. This was generally associated with basement
      membrane-like material and hepatocyte microvilli flattening. In addicts, hepatic
      vascular pole changes were a constant finding, accompanied by interhepatocyte
      space disjunction and perisinusoidal collagenization. Morphometric assessment
      confirmed a significant increase of sinusoidal wall surface, endothelial cell
      body and processes and Ito cell process surface was significantly different
      between the patient groups. This cellular hypertrophy may represent
      hyperactivation of the sinusoidal cell functional capacity, triggering the
      fibrogenesis in the space of Disse. While this mechanical barrier might hinder
      the free exchange through the space of Disse, it may equally well protect the
      liver against heroin toxicity.

PMID- 8465515
TI  - Role of the notochord in the development of cephalic structures in normal and
      anencephalic human fetuses.
AB  - Normal and anencephalic human conceptuses were analysed histologically to
      investigate the role of differentiation of the intracranial notochord and its
      relation to the formation of the basichondrocranium. We have examined 16 normal
      embryos and fetuses and 4 anencephalic fetuses. Each developmental stage of
      formation of the normal basichondrocranium presented specific morphological
      changes during the course of notochord depletion. In contrast with normal
      specimens, anencephalic fetuses presented malformations of the basichondrocranium
      which were always related to an abnormal position of the notochord. Macroscopical
      differences between craniorachischisis and cranioschisis in fetuses with
      anencephaly correlated with the existence of two histologically different degrees
      of malformation. In fetuses with craniorachischisis we found severe disturbances
      in the shape, position and ossification of the basichondrocranium and in the
      course of the intracranial notochord. In fetuses with cranioschisis the described
      disturbances of the basichondrocranium and intracranial notochord were mild. In
      addition, marked differences in affection of the central nervous system and the
      hypophysis were observed. These findings suggest different periods of
      dysmorphogenesis. Our results underline the importance of the chordal mesoderm in
      the differentiation for the formation of cephalic structures in Man.

PMID- 8465516
TI  - Thrombendarteriitis pulmonalis carcinomatosa Ceelen: an immunohistological
      investigation.
AB  - A 65-year-old woman died in sudden right heart failure caused by
      thrombendarteriitis pulmonalis carcinomatosa Ceelen 16 months after resection of
      a rectal carcinoma. Autopsy disclosed a complex picture of multiple tumour cell
      emboli in small pulmonary arteries associated with local thrombosis and thrombus
      associated vessel wall reaction. This was characterized by movement of medial
      muscle cells into the thrombus. In addition, affected vessels showed a prominent
      perivascular tumour-related infiltration by lymphocytes which are identified
      immunohistochemically as CD3-reactive T-cells.

PMID- 8465517
TI  - Notochordal alterations in axial skeletal-neural dysraphic disorders.

PMID- 8465519
TI  - [Acquired hyperostosis syndrome (so-called pustular arthro-osteitis). Review of
      the literature including 73 personal cases].
AB  - The acquired hyperostosis syndrome (AHS) (best known synonym: pustulotic arthro
      osteitis) is a system disease of the supporting and gliding tissue with sites of
      predilection characterized by inflammation-induced bony reconstruction of
      positive balance. This syndrome is affiliated with the seronegative
      spondylarthropathies. The main finding is the sternocostoclavicular hyperostosis
      in about 80% of patients. Focal hyperostoses also occur on the skeleton of
      truncus and extremities and joints. AHS is accompanied by psoriasiform and
      acneform dermatoses. Overlapping findings with spondylitis ankylosans are
      reported. Terminology, aetiology, nosology, pathogenesis, histomorphology,
      clinical and laboratory findings, complications, imaging diagnostic, differential
      diagnosis and therapy of AHS are discussed. Knowing AHS helps to prevent
      misdiagnoses (as especially bacterial osteomyelitis, spondylitis, osteoplastic
      tumor and metastases) and interventional diagnostic procedures.

PMID- 8465518
TI  - Modulation of perisinusoidal cell cytoskeletal features during experimental
      hepatic fibrosis.
AB  - Hepatic perisinusoidal cells (PSCs) proliferate and are thought to be the
      principal source of extracellular matrix proteins during the development of liver
      fibrosis. We have studied the classical model of carbon tetrachloride induced
      liver fibrosis in order to evaluate the possible modulation of PSCs into a
      synthetically active and contractile cell: the myofibroblast (MF). At the
      ultrastructural level, this modulation was characterized by reduction of lipid
      vacuoles and appearance of a developed rough endoplasmic reticulum as well as of
      microfilament bundles. On investigating the cytoskeletal equipment of PSCs and
      MFs using light and electron microscopic immunohistochemistry, we found a
      heterogeneity of phenotypic features. While typical PSCs in normal and fibrotic
      livers always contained desmin, MFs expressed alpha-smooth muscle (SM) actin in
      areas of tissue injury and active fibrogenesis. Cells co-expressing alpha-SM
      actin and desmin were most prominent in the prevenular zone of the lobule (known
      to be vulnerable to carbon tetrachloride toxicity) and in developing fibrous
      septa. As demonstrated by immunogold electron microscopy, labelling of
      microfilament bundles by alpha-SM actin antibody was noted in PSCs containing
      lipid droplets in early stages of fibrosis; here MFs gradually accumulated and
      showed alpha-SM actin containing microfilament bundles. In scar tissue, alpha-SM
      actin expression decreased in both PSCs and myofibroblasts. Our observations
      support the concept of phenotypic plasticity of PSCs and confirm, at the
      ultrastructural level, previous suggestions of modulation of these cells into MFs
      in the course of liver fibrosis.

PMID- 8465520
TI  - [Aneurysma spurium after iatrogenic arterial puncture--incidence, risk factors
      and surgical therapy].
AB  - Due to the markedly increased number of arterial punctures performed during
      diagnostic angiography and angioplasty procedures for cardiac and peripheral
      vessel disease, the complication of false aneurysms after arterial puncture has
      gained increasing significance. The incidence of false aneurysms after puncture
      reported in the literature ranges from 0.05-2%. However, careful sonographic
      follow-up may reveal an incidence twice as high. The goal of this retrospective
      investigation of 28 patients with false aneurysms was to elucidate risk factors
      leading to failure of spontaneous closure of the arterial site, as well as to
      examine the symptoms and clinical course of such patients. Pseudoaneurysms became
      manifest, depending on the method of puncture, on average 16.4 days after the
      procedure. The highest risk was seen in adipose patients (18 pts., 64.3%). In
      these patients the number of tangential and multiple vessel punctures was also
      highest. Further risk factors were local vessel sclerosis, hypertension, diabetes
      mellitus, poor general condition, and disturbances of blood coagulation. The
      typical clinical findings were seen in only 13 patients. In 3 patients blood loss
      was the predominant symptom. Twelve further pseudoaneurysms (42.8%) were found
      incidentally at follow-up. The diagnosis was made in all patients
      sonographically. In 1 patient it was initially identified as an incidental
      finding at angiography. In 25 cases simple vessel reconstruction was possible
      (stitch or patch). In 3 cases (10.7%) a more extensive procedure involving vessel
      replacement was necessary. Severe postoperative complications included local
      infection (in 2 patients, 1 of whom also had a recurrent false aneurysm) and
      arterial bleeding necessitating surgical intervention (1 patient).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8465521
TI  - [Retroperitoneal vascular injuries as a complication of lumbar disc operation].
AB  - We describe 2 cases of retroperitoneal hematoma after lumbar disc surgery
      following injury to retroperitoneal vessels. One patient sustained a partial tear
      of the right common iliac artery during left L4/5 discectomy, the other a
      complete tear of the lowest lumbar artery during left L5/S1 discectomy. Both
      patients developed hypovolemic shock 4-5 hours postoperatively, with acute
      abdominal symptoms and signs; the former patient also showed signs of ischemia of
      the right lower extremity. Both recovered completely after surgical intervention
      with vascular repair and evacuation of the retroperitoneal hematoma.

PMID- 8465522
TI  - [Replacement of the anterior cruciate ligament with an artificial Leeds-Keio
      ligament].

PMID- 8465523
TI  - [Percutaneous transluminal angioplasty of the carotid artery].
AB  - This paper presents personal experience of 169 percutaneous transluminal
      angioplasties (PTA) and more than 1,000 worldwide published results of
      angioplasty on supraaortic stenoses especially of the carotid artery. The
      technique of the angioplastic procedure, essential pretherapeutic diagnostic
      methods and indications of PTA are described and discussed. Results of published
      and own experience indicate that PTA is an effective and alternative method to
      vascular surgery in the treatment of symptomatic carotid artery stenoses. With
      strict definition of the indication, the complication rate for PTA is not likely
      to be higher than that for vascular surgical treatment. PTA of carotid artery
      stenosis should be used exclusively in medical centers in which a cooperation by
      vascular surgeons, internists, neurologists and interventional radiologists or
      neuroradiologists comes true.

PMID- 8465524
TI  - [Stenosis of the extracranial carotid artery].
AB  - Magnetic resonance angiography (MRA) as well as intraarterial digital subtraction
      angiography (DSA) were performed in 45 patients suffering from cerebrovascular
      disease, both procedures within one week of each other. MRA und DSA were
      evaluated separately for every patient retrospectively by two experienced
      radiologists on consensus basis. The results were then compared using catheter
      angiography as gold standard. Evaluation was confined to the common and internal
      carotid arteries (CCA, ICA) in the neck subdivided into 5 grades of stenosis. A
      comparative assessment was impossible in 9% cases due to motion artifacts and
      patient malposition. Out of 18 verified CCA stenoses 13 were demonstrated by MRA
      and 39 out of 44 ICA stenoses were assessed by MRA. There was a highly
      significant correlation between degree of stenosis detected by the two methods.
      Spearman Rank correlation coefficients of 0.824 and 0.913 were found for CCA and
      ICA, respectively.

PMID- 8465525
TI  - [Psychological aspects as predicting factors for the indication of acupuncture in
      migraine patients].
AB  - 30 patients with chronic migraine received needle acupuncture after investigation
      of personality traits, cognitive and social factors. Treatment response was
      evaluated in two different ways (documentation of attacks in a migraine diary and
      subjective judgment of outcome). Diary documentation showed that the frequency of
      attacks was halved, with no essential relation to psychological factors. Short
      duration of illness was the best predictor of a good response to therapy.
      Patients' subjective judgement demonstrated a mean improvement of 60%. Unlike
      diary documentation, the subjective response rates were closely related to
      personality traits. In particular, patients with high scores for extroversion and
      low scores for neuroticism reported a better response. Age, sex, social status,
      and expectations of benefit did not show any relation to treatment efficacy.

PMID- 8465526
TI  - [Development and testing of a model for simultaneous evaluation of muscle
      relaxation on three intrinsic laryngeal muscles and on the anterior tibial
      muscle].

PMID- 8465527
TI  - [Human dignity and Christian ethics].
AB  - The jurisdiction of most states presumes that human dignity is unconditional. Yet
      a last reason for this dignity cannot be furnished by a state jurisdiction.
      Christian ethics for instance argue on a line beyond strictly rational
      interpretation: human dignity roots in man's affirmation by God. Beyond a simply
      negative definition it is essential today to define the conditions of human
      dignity in a positive way.

PMID- 8465528
TI  - [The concepts of "human dignity" and "sanctity of life" and their relations to
      ethical conflicts in modern medicine Bielefeld, 1 to 3 October 1992)].

PMID- 8465529
TI  - [Holistic anthropology in oncology].

PMID- 8465530
TI  - [Brief definitions of medical ethics concepts. 24. "Human dignity" in documents].

PMID- 8465531
TI  - [Arterial vascular training].
AB  - By means of a specific arterial vessel training--indoor or outdoor--it is in any
      case possible to improve the individual walking performance. In the first phase
      of the training there is an increase of the arterial maximal flow, which then
      remains constant and may even rapidly decline without further training. The
      continual increase can be explained through metabolic, hemorheologic, and
      possibly microcirculatoric changes (microbiopsy studies, not yet published). At
      the moment it is only Germany where you can find the complete offer of all
      different vessel training. In Austria there is only the indoor training which
      works at the moment. The different German health-insurance pay the training
      programs, the criteria for the education of "the vessel-trainer" are established
      by the health-insurance, by the "Deutsche Gesellschaft fur Angiologie" and the
      "Deutsche Gesellschaft fur Gefasssport (vessel training)". The vessel trainer has
      to achieve his diploma via the "A" and "coronar certificate". In Austria there
      are no obligatory criteria for this education--neither for the coronary nor for
      the vessel training--there is no observation of the education and no payment
      system.

PMID- 8465532
TI  - [Therapeutic training and sports in chronic diseases of the lung].
AB  - Training is defined as systematic physical activity in order to improve the
      physical working capacity, which causes measurable morphological and functional
      changes in organs. Effects and the rules of applying aerobic endurance training
      in patients with chronic diseases of the lungs are dealt with. Training does not
      replace the normal medication, but is an additional therapeutic mean in order to
      regain physical working capacity, lost by chronic immobilization in the natural
      course of disease. Contraindications are acute diseases and exacerbations, but
      not a certain degree of the disease. Training does not improve the lung function,
      but the function of the other organs, the physical working capacity ist based on
      (circulation, musculature). This helps to use optimally the remaining reserves of
      lung function. Methods of aerobic endurance training are described, the
      definition of aims, performance diagnostic and the finding of the exact doses of
      training according to intensity, duration, frequency and the weekly netto
      training time. The training in different diseases of the lungs is discussed: In
      asthma bronchiale the prophylaxis of the exercise induced asthma and permitted
      and forbidden drugs for asthmatics according to the rules of international
      olympic committee. In chronic bronchitis with arterial hypoxemia, in restrictive
      lung diseases and in pulmonary hypertension. At last the way to prescribing
      training for patients with chronic pulmonary diseases is described as well as the
      advising of patients wishing to do sport by their own motivation or planning
      projects, for instance touristic ones, which require physical stress.

PMID- 8465533
TI  - [Ambulatory medical training therapy in coronary heart disease].
AB  - Physical exercise plays a central role within cardiac rehabilitation. Most often,
      endurance exercises are restricted only to inpatient rehabilitation regimes.
      According to the guidelines of sports medicine, endurance training is only
      effective if it is performed regularly and systematically. With regards to safety
      and best control, bicycle ergometer is the training device of choice for the
      cardiac patient. Prescription and organisation of endurance training sessions in
      cardiac rehabilitation are discussed. Beside the well accepted changes of risk
      factors by regular endurance training, studies of pooled data showed a
      significant reduction of mortality of patients in the rehabilitation groups. The
      lack of data regarding training time and intensity within the single studies was
      remarkable.

PMID- 8465534
TI  - [The science of medical training].
AB  - The medical science of training (MST) is the theoretical basis for a proper
      advice in problems of physical performance in healthy and people with chronic
      diseases. This is comparable with the pharmacology as a basis for the advice in
      internal medicine. The MST deals with the rules, which are valid for improving
      the physical performance by training, changing the morphology and function of
      organ systems. Basis of MST is the knowledge of the effects of each training
      measure and the knowledge of a relation between the doses and the effect of
      training. Out of 5 basic motoric properties, endurance, strength, coordination,
      flexibility and fastness, the MST deals with endurance and strength. These 2
      basic motoric properties are determined by the morphology and function of organ
      systems and are changeable by training. Endurance is defined as the faculty of
      resynthesizing ATP which was consumed by muscular activity. According to the type
      of resynthesis two aerobic types, extensive aerobic endurance and intensive
      aerobic endurance, and 2 anaerobic types, lactacide anaerobic endurance and a
      lactacide anaerobic endurance can be distinguished. These 4 types of endurance
      are defined biochemically and the methods of training are described, proved and
      evaluated for use in preventive and therapeutic training. Strength is defined as
      the faculty of the muscle to produce tension. The methods of training are
      described, proved physiologically, and evaluated for use in preventive and
      therapeutic training. General and special rules for sport medical advice for
      people with enhanced health risk and or chronic diseases are presented.

PMID- 8465535
TI  - [Diabetes and sports].
AB  - Through better understanding of the physiology of physical exercise in normal and
      diabetic subjects we can more closely define the significance of regular physical
      exercise in the treatment of diabetes. Although patients with type I and type II
      diabetes can obtain different advantages from regular physical exercise, this
      activity is in turn connected with different risks. The introduction of self
      monitoring of blood glucose has though considerably eased management in relation
      to physical activity by type I diabetics. Essentially the risk to type I
      diabetics is that of developing hypoglycemia during or after exercise as well as
      the danger of a worsening of metabolic levels with the development of
      ketoacidosis. In type II diabetics the risk of hypoglycemia is less pronounced
      and in patients treated solely by dietary means the regulation of blood glucose
      presents no great problem. With these individuals regular physical activity can
      be implemented as a further therapeutic tool towards the normalisation of body
      weight and an improvement in insulin sensitivity. With appropriate training and
      self-control the potential hypoglycemia in type I diabetic patients can easily be
      avoided. For this reason regular physical exercise can be recommended as a
      cornerstone of therapy, both in the management of type I as well as type II
      diabetes. The positive effect of exercise is significantly better defined in
      regard to type II diabetics than with type I diabetics. In particular, regular
      physical exercise can be implemented as a supplement to caloric restriction for
      weight reduction and as a means to improve insulin sensitivity in the obese
      insulin-resistant individual.

PMID- 8465536
TI  - Child alert 10-33.

PMID- 8465537
TI  - SMS reform plan needs revisions.

PMID- 8465538
TI  - Discuss WIPRO letters with patients.

PMID- 8465539
TI  - Short-term focused cognitive therapy of panic disorder with aerophobia: a case
      report.
AB  - The efficacy of focused cognitive therapy was evaluated in the short-term
      treatment of a flight instructor suffering from panic disorder with aerophobic
      and agoraphobic symptoms. A modified panic induction technique (hyperventilation)
      was used in session to activate the specific bodily sensations he typically
      experienced during panic attacks. The patient was then asked to articulate his
      catastrophic interpretations of the physiological sensations he was experiencing
      and taught to re-interpret them in a non-catastrophic manner, which enabled him
      to reduce his symptoms to a more manageable level. After four sessions of focused
      cognitive therapy, the patient's panic and phobic symptoms were significantly
      reduced and no longer interfered with his daily functioning. Posttreatment follow
      up at 6 and 9 months revealed that the patient was completely free of panic while
      flying.

PMID- 8465540
TI  - Munchausen's syndrome: the importance of a comprehensive medical history.
AB  - Munchausen's syndrome was first described by Asher in 1951. Then Ireland, et al,
      described eight criteria that characterized these patients. These characteristics
      include factitious illness of a dramatic nature, factitious evidence of disease,
      evidence of multiple medical procedures, pathologic lying, aggressive behavior,
      leaving the hospital against medical advice, multiple hospitalizations with
      traveling and absence of any obvious secondary gain. Another form of this disease
      is Munchausen's syndrome by proxy which describes parental behavior that creates
      the appearance of, or produces, physical illness in a child with harmful
      consequences to the child. In this report, we present a complex case of
      Munchausen's syndrome in a patient who has been traveling around the country,
      going from one hospital to another for several years. We ask physicians to be
      aware of the features of this patient, bearing in mind that this was her third
      hospitalization at the University of Wisconsin Hospital in Madison.

PMID- 8465541
TI  - Unusual scrotal mass in the neonate.
AB  - Ultrasound is an ideal imaging modality that may be used to evaluate scrotal
      masses. It will frequently detect the presence of a mass, localize its site of
      origin, and characterize the abnormality. The most valuable information provided
      by ultrasound is the separation of intra- and extratesticular lesions. The
      importance of this distinction is understood when it is recognized that the
      majority of intratesticular lesions are malignant, while more extratesticular
      lesions are benign. The accuracy in this determination is between 90% and 95%.
      The overall accuracy in detecting and characterizing soft tissue masses as cystic
      or solid is in the range of 90% to 100%. Once a solid mass is identified, it is
      not possible to distinguish benign from malignant. We present the ultrasound
      findings of a newborn with renal vein thrombosis and a left scrotal enlargement,
      and discuss its pathogenesis.

PMID- 8465542
TI  - Adult occupational lead exposure in Wisconsin.

PMID- 8465543
TI  - Recent court ruling on blood alcohol testing has no effect on physician's role.

PMID- 8465544
TI  - Alternative dispute resolution of medical malpractice cases in Wisconsin.

PMID- 8465545
TI  - [Ulcerative colitis and Crohn disease from the immunologic viewpoint].
AB  - A critical immunological survey is given on etiology and pathogenesis of
      ulcerative colitis and Crohn's disease. Since antigen specific suppressor cells
      are presumably not very likely, the appropriate hypotheses must be replaced by
      new ones. Assuming disturbances of the regulation of the immune system as the key
      to etiopathogenesis, a genetic hypothesis can be presented. This hypothesis is
      based on the assumption of physiological and pathogenic autogenes as well as
      regulator genes.

PMID- 8465546
TI  - [Possibilities and limits of medical graphology: determination of current status
      and perspectives (III)].

PMID- 8465547
TI  - [Endoscopic ultrasound in TN staging of stomach cancer. A comparison with
      computerized tomography and conventional ultrasound].
AB  - 64 patients with histologically proven gastric carcinoma were investigated by
      endosonography (EUS), computed tomography (CT) and conventional transcutaneous
      sonography (US). In 50 patients a resection of the stomach was performed and the
      histological findings were compared with the results of preoperative staging. In
      all cases EUS was successful in demonstrating the tumour. With CT tumour
      visualisation was possible in 17 (35.4%), with US in 7 (14.6%) cases. The pT
      stage was correctly determined preoperatively by EUS in 40 (81.6%) with CT and US
      in only 12 (25%) and 4 (8.3%) patients, respectively. The staging accuracy of EUS
      amounted to 80% in T1-, 81% in T2-, 100% in T3-, and 67% in T4-stage. The
      sensitivity in demonstrating lymph node metastases was 81.3% for EUS, 25.8% for
      CT and 9.7% for US. The specificity in this regard was 72.2% for EUS, 83.3% for
      CT and 100% for EUS. The overall accuracy for determination of pN-stage was 78%
      for EUS, 47.9% for CT and 41.7% for US. EUS is clearly superior to CT and US in
      the locoregional TN-staging of gastric carcinoma.

PMID- 8465548
TI  - [Coronary vessel anomalies in adults--harmless variation or changes with clinical
      significance].
AB  - A review of 1097 consecutive coronary angiograms performed for evaluation of
      angina pectoris or valvular dysfunctions showed 3 patients with arteriovenous
      fistulas (0.25%), 6 patients with malpositions (0.55%), 29 patients with
      aneurysms (2.65%) and 59 patients with myocardial bridging (5.4%). The clinical
      significance of coronary artery anomalies as variation or malformation was
      evaluated. A malformation has been found in Bland-White-Garland syndrome,
      arteriovenous fistulas, congenital coronary stenosis and atresia. In case of
      clinical symptoms surgical correction should be considered. There is a
      controversy on the clinical significance of muscular bridging. Further clinical
      investigations are needed for a better understanding of coronary artery
      anomalies.

PMID- 8465549
TI  - [Results of animal experiments with videodensitometry in the assessment of
      gastrointestinal motility].
AB  - It is possible to register video-densitometrically the gastrointestinal motility
      visible in fluoroscopic image using a video-signal analyser. The influence of
      metoclopramide at the propulsive movement of the stomach wall of rats was checked
      in vivo. The propulsive gastric movement increased in case of small doses of
      metoclopramide, higher doses stopped the motility. The propulsive gastric
      movement is parallel to the evaluation of the stomach. Metoclopramide has only a
      mild influence on the contraction frequency. We found that videodensitometry is
      also a practical method for evaluation of local wall motility of an intestinal
      segment of a rabbit. The non-visible motion is recorded and evaluated by means of
      several physical parameters (frequency, moving velocity of waves).
      Videodensitometry does not supply information on the causes of motion; hence, a
      combination with other methods, i.e. the registration of the electromyogram
      (EMG), is useful. In this way the mechanical answer to EMG-changes is simple to
      quantify. The experiment with rabbits affords a proof regarding the
      practicability of the method for pharmaco-physiological investigations.

PMID- 8465550
TI  - [General practice-oriented forms of education of the 18th century. On the 250th
      anniversary of the birth of Johann Friedrich Gottlieb Goldhagen (1742-1788)].
AB  - Widely differing conditions applied to practice-oriented medical teaching at
      universities in the various German principalities or territorial states in the
      18th century. Initially, the institutions used by professors as "collegium
      clinicum" belonged either to foundations or were being run on a private basis. It
      was only in the second half of the 18th century that these institutions became
      state-supervised, with the inclusion of the discipline of surgery. The results of
      such reorganization are demonstrated, taking Halle and the work done by Johann
      Friedrich Gottlieb Goldhagen as examples.

PMID- 8465551
TI  - [The public health structure regulation].

PMID- 8465552
TI  - The 13C-urea breath test--detection of Helicobacter pylori infection in patients
      with partial gastrectomy.
AB  - The 13C-urea breath test (13C-UBT) for diagnosis of Helicobacter pylori (Hp)
      infection was evaluated in 41 patients after partial gastrectomy and was used for
      determination of the Hp-prevalence after two different procedures of
      reconstruction of the gastrointestinal tract, i.e. Billroth's II operation and
      Roux-en-Y anastomosis. Breath samples were taken at various time points within 30
      minutes after a motility inhibiting liquid test meal with citric acid followed by
      75 mg of 13C-urea. The 13CO2/12CO2-ratio (delta-value) was measured using isotope
      ratio mass spectrometry and the recovery of tracer in the exhaled breath was
      calculated (UBT-value). In all patients and in the corresponding control groups
      comparison of established reference methods (culture, CLO test, and Fuchsin
      staining) with the 4 point breath analysis for detection of Hp was investigated.
      In patients with partial gastrectomy, the sensitivity of the 13C-UBT to detect
      the presence of Hp and the negative predictive values were 100%, whereas the
      specificity and the positive predictive values were about 80%. In patients
      without gastric surgery quality control parameters were not significantly
      different. Hp-prevalence in postoperative patients was about 45%. All results
      were independent of their expression either as delta-value or as UBT-value and
      were not significantly different between the patients with Billroth's II
      operation and the patients with Roux-en-Y anastomosis. In conclusion, the 13C-UBT
      is a suitable method for diagnosis and therapeutic monitoring of Hp-status in
      patients after partial gastrectomy.

PMID- 8465553
TI  - Polyamine deficiency impairs proliferation and differentiation of cultured
      enterocytes (CaCo-2).
AB  - The polyamine dependence of enterocyte growth and differentiation was studied in
      the human intestinal cell line CaCo-2 using a specific inhibitor of the key
      enzyme ornithine decarboxylase (ODC), difluoromethylornithine (DFMO). ODC was
      highest during the initial phase of rapid growth and was inhibited in a dose
      dependent fashion by DFMO at 0.06-2 mM. At low levels DFMO only delayed cell
      replication without affecting final cell count whereas at concentrations of 0.125
      mM and above the final cell number was diminished by at least 53% compared to
      controls. In contrast, DFMO even at 0.03 mM reduced sucrase activity to 44% of
      controls when added at day 2 but was ineffective when supplemented at day 7 of
      culture or later. The inhibitor also diminished the number and length of
      microvilli in a dose dependent fashion, although this effect required higher DFMO
      levels than the reduction of sucrase activity. The DFMO mediated suppression of
      cell replication, enzymatic and morphologic differentiation was reversible in the
      presence of the ODC product putrescine. Putrescine alone did not affect any of
      the above parameters. In conclusion, the present data suggest that ODC and
      polyamines are involved both in enterocyte growth and differentiation.

PMID- 8465554
TI  - Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a
      stable phase of Crohn's disease with special respect to chronic diarrhea--a pilot
      study.
AB  - In a randomized, single-center, double-blind, placebo-controlled pilot study, 20
      patients with established Crohn's disease suffering from diarrhea and moderate
      complaints as measured by the BEST Index, were treated with the yeast preparation
      Saccharomyces boulardii (S.b.) in a dosage of 250 mg t.i.d., initially for two
      weeks in addition to the basic treatment. A reduction in the frequency of bowel
      movements (5.0 +/- 1.4 vs. 4.1 +/- 2.3 evacuations/day, p < 0.01) and in the BEST
      Index (193 +/- 32 vs. 168 +/- 59, p < 0.05) as compared to baseline was
      registered. After this initial phase, the patients were allocated in randomized
      order to the control group (n = 7) receiving placebo, or to the verum group (n =
      10) receiving S.b.(250 mg t.i.d.) for 7 weeks, while the basic treatment was
      maintained. The group treated with S.b. showed a significant reduction in the
      frequency of bowel movements in the tenth week, to 3.3 +/- 1.2 evacuations per
      day, and in the BEST Index, to 107 +/- 85. In the control group taking placebo,
      however, this effect was not observed. By contrast, the frequency of bowel
      movements and the BEST Index rose again in the tenth week until reaching initial
      values (4.6 +/- 1.9 evacuations daily and 180 +/- 61, respectively). No adverse
      drug events were observed. In order to confirm these positive effects of S.b. in
      patients with Crohn's disease, further controlled multicenter trials in a larger
      patient population should be performed.

PMID- 8465555
TI  - Laxative use not a risk for colorectal cancer: data from the Melbourne Colorectal
      Cancer Study.
AB  - Commercial laxative use as a risk factor in colorectal cancer was investigated as
      one part of a large population based epidemiological study of colorectal cancer
      incidence, aetiology and survival "The Melbourne Colorectal Cancer Study",
      conducted in Melbourne, Australia. Commercial laxative use was similar in 685
      colorectal cancer patients and 723 age/sex matched community based controls.
      Also, when laxatives were subdivided into various groups containing
      anthraquinones, phenolphthalein, mineral salts and others, previous laxative
      intake was similar between cases and controls. Previous use of anthraquinone
      laxatives and of phenolphthalein containing laxatives was not associated with the
      risk of colorectal cancer.

PMID- 8465556
TI  - [Collagenous sprue--a rare form of celiac disease in adulthood].
AB  - The authors report a case of collagenous sprue. This condition is characterized
      by coeliac type small bowel malabsorption, resistant to gluten free diet and
      other therapeutic efforts, associated with poor prognosis. The diagnosis depends
      on the histological demonstration of extensive collagenization of the lamina
      propria in the flat jejunal mucosa. This disease must be kept in mind at
      differential diagnosis of chronic diarrhea with progressive malabsorption,
      especially if it is resistant to gluten withdrawal in contrast to conventional
      coeliac disease.

PMID- 8465557
TI  - [The common channel syndrome in adults].
AB  - Congenital abnormalities of the distal bile and pancreatic duct occur
      predominantly as a long common channel. A common channel of more than 15 mm is
      considered abnormal, since the length allows a reflux of pancreatic secretion
      into the bile duct and vice versa. The very rare occurrence of a long common
      channel syndrome in adults has been observed in two female patients (24 and 58
      years old). Both presented cholangitis and/or pancreatitis. Diagnosis was
      established by ERCP. The definitive therapy in both cases was hepatico-jejunal
      anastomosis which improved symptoms in both patients. Endoscopic sphincterotomy
      is unsatisfactory since it does not cut the entire common channel. The rare
      etiology of a long common channel in patients with cholangitis and pancreatitis
      is safely verified by ERCP and safely cured by surgical intervention.

PMID- 8465558
TI  - [Mini-endoscopy of the bilio-pancreatic system].

PMID- 8465559
TI  - [The effects of bile salts in the duodenum on exocrine pancreatic secretion:
      stimulating, inhibiting or both?].

PMID- 8465560
TI  - [Recurrent and acquired hepatitis C virus infection in patients after liver
      transplantation].

PMID- 8465561
TI  - [Comment on the contribution: "The diagnostic value of the amino acid absorption
      test in detection of disordered exocrine pancreas function" by Kemmer et al].

PMID- 8465562
TI  - [Guidelines for patient monitoring in endoscopic examinations in
      gastroenterology. The German Society of Digestive and Metabolic Diseases].

PMID- 8465563
TI  - [Behavior of various activity-controlled cardiac pacemakers in treadmill stress
      tests with variable slopes].
AB  - New activity pacemaker systems with the principle of sensing low-frequency
      acceleration in the anterior-posterior axis are currently under clinical
      evaluation. We compared the pacemaker system Relay, which represents this new
      generation of accelerometer controlled devices, with conventional activity
      systems sensing pressure and vibration. Ten pacemaker patients with implanted
      Activitrax, Sensolog or Relay pacemakers and 10 healthy volunteers with
      externally strapped-on pacemakers were studied. The aim was to evaluate the
      systems' ability to distinguish different workloads during graded treadmill
      testing with changes in speed and/or slope. The rate adaption of the new
      acceleration sensing pacemakers was found to be more adequate compared to
      vibration and pressure-sensing pacemakers when only the slope of the treadmill
      was varied. The acceleration-sensing pacemaker adjusted its rate according to the
      workload largely independent from the type of stress (n.s.). With the vibration
      and pressure-sensing pacemakers, however, significant differences (p < 0.05) were
      seen between rate adaption in the two stress test modes. The new generation of
      acceleration-sensing pacemakers has certain advantages over conventional
      vibration-sensitive systems in terms of a higher sensitivity to varying workloads
      and higher specificity to the type of exercise performed.

PMID- 8465564
TI  - [Ventricular macro-reentry tachycardia of the bundle branch type--indications for
      catheter ablation].
AB  - Out of 115 patients with recurrent sustained monomorphic ventricular tachycardia
      who underwent catheter ablation between August, 1987 and May, 1992, 7 were found
      to have bundle branch reentry. Bundle branch reentrant tachycardia was assumed if
      His potential or bundle branch potential preceded ventricular activation during
      tachycardia with identical H-H'- and V-V'-intervals. In 5 patients, catheter
      ablation of the right bundle branch and in 2 patients, ablation of the proximal
      left bundle branch were performed with direct current or radiofrequency energy.
      The procedure was successful in all 7 patients. During the follow-up of 15 +/- 12
      months, 3 patients died due to cardiac failure. One patient had sustained
      ventricular tachycardia 12 months after catheter ablation which was not due to
      bundle branch reentry and was treated with an implantable
      cardioverter/defibrillator. Atrioventricular conduction delay in the surface
      electrogram and during electrophysiologic study may give a hint at bundle branch
      reentrant ventricular tachycardia since it was seen in 5 of our 7 patients.
      Catheter ablation of one bundle branch is an effective treatment which can
      prevent recurrence of this tachycardia.

PMID- 8465566
TI  - [Antegrade balloon valvuloplasty of critical aortic stenosis in an infant
      weighing 1,820 g].
AB  - A case of antegrade balloon-valvuloplasty in an 34-day-old premature 1820 g baby
      with a critical aortic stenosis is reported. After transseptal puncture of the
      interatrial septum a loop was formed within the apex of the left ventricle. In
      order not to endanger the anterior leaflet of the mitral valve a maximum distance
      to the mitral valve was maintained. After two antegrade balloon-dilatations the
      pressure gradient over the stenotic aortic valve was reduced from 80 mmHg to 15
      mmHg. No hemodynamic relevant aortic regurgitation occurred. Antegrade balloon
      valvuloplasty in critical aortic stenosis represents an alternative to the
      retrograde technique. Severe laceration of the ileofemoral arteries, which has
      been reported in up to 45% of all retrograde procedures, is avoided in antegrade
      balloon-dilatation. Comparatively, the antegrade passage of the catheter through
      the stenotic aortic valve is easily performed. No dislocation of the balloon
      occurs during antegrade valvuloplasty. Through this procedure the aortic
      occlusion-time is reduced to a minimum. Besides protection of the arterial
      vessels, reduction of the aortic occlusion-time seems to be an important
      advantage of this technique when compared with the retrograde approach.

PMID- 8465565
TI  - [Interventional high frequency perforation and enlargement of the outflow tract
      of pulmonary atresia].
AB  - In 18 patients with pulmonary atresia interventional perforation of the atresia
      was attempted using radiofrequency. All patients were referred for palliative
      surgery. The age ranged from 4 days to 19 years. After angiographic delineation
      of the relations between the right ventricular outflow tract and main pulmonary
      artery the tip of a radiofrequency perforation catheter (Cerablate-catheter, 2F,
      Osypka) was brought into contact with the atresia. The radiofrequency was applied
      in the unipolar fashion (radiofrequency-generator HAT 200, Osypka).
      Radiofrequency perforation was successfully performed in 14/18 patients,
      subsequent balloon dilatation was performed in 12 of these patients. In six
      patients with muscular atresia a Palmaz-stent was implanted into the right
      ventricular outflow tract. An inadvertent perforation of the right ventricular
      outflow tract occurred in three patients, of the pulmonary artery in two
      patients. However, these were tolerated without sequelae or clinical symptoms.
      The arterial oxygen saturation increased by 21%; in none of the patients was
      cardiac failure or pulmonary edema observed. Using the Cerablate-catheter even
      muscular atresias could be perforated. Implantation of a stent into the newly
      created right ventricular outflow tract results in a predictable communication
      between the right ventricle and the pulmonary artery. Although this
      interventional right ventricular outflow tract creation seems to be a promising
      new technique, experience is limited and there are no long-term results.

PMID- 8465567
TI  - [Left cerebral ischemia in mitral valve aneurysm].
AB  - An anterior mitral leaflet aneurysm was detected by two-dimensional
      echocardiography using the transesophageal approach in a 53-year-old patient with
      cerebral ischemic event. The transesophageal examination allowed a clear
      description of the aneurysm which was confirmed during surgery. This case
      demonstrates that transesophageal echocardiography is the method of choice in
      evaluation of distinct valvular lesions. The importance of TEE examination in
      patients with a neurological history is evident.

PMID- 8465568
TI  - [Trends in patient composition before PTCA and bypass operation. Implication for
      secondary prevention and rehabilitation. Report of the discussion group 23 April
      1992 within the scope of the spring meeting of the German Society of
      Cardiovascular Research].

PMID- 8465569
TI  - [Multicenter results of coronary implantation of balloon expandable Palmaz-Schatz
      vascular stents].
AB  - Intracoronary stenting was designed to handle acute vessel closure after balloon
      angioplasty and to reduce the rate of restenosis. In three cardiology centers the
      implantation of 200 balloon-expandable Palmaz-Schatz stents was attempted in 179
      patients. The implantation was successful in 170 patients (95%). During bail-out
      implantation for acute vessel closure or symptomatic dissections after balloon
      angioplasty, implantation succeeded in 60 (91%) of 66 attempted patients, who
      recovered immediately from ischemia. Three patients received emergency bypass
      surgery and three patients were kept on medical therapy. Restenosis after 4 to 6
      months, defined as > 50% diameter reduction, was documented angiographically in
      18 (15.3%) of 118 presently controlled patients. Patients with single stent
      implantation (n = 106) presented a late restenosis rate of 10.4% in contrast to
      patients with multiple stent implantation (n = 12), who presented a restenosis
      rate of 58.4%. Similar results on restenosis were found for patients with
      elective and bail-out stent implantation. Acute thrombotic stent occlusion
      occurred in three patients (1.8%) during the first 24 h after stenting. Three to
      9 days after implantation subacute stent thrombosis occurred in 15 (8.8%) of 170
      patients. Despite adequate therapy including thrombolysis, balloon angioplasty or
      emergency bypass surgery in 14 of 15 patients Q-wave myocardial infarction was
      documented in six patients and non Q-wave myocardial infarction in five patients.
      The following parameters were identified as risk factors for the development of
      subacute stent thrombosis: bail-out indication, unstable angina, type C lesion,
      stenosis length > 1.5 cm, plaque area > 3.5 mm2, symptomatic dissection after
      balloon angioplasty, incomplete wrapping of the dissection after stenting and
      residual distal vessel irregularities after stenting. Bleeding complications
      occurred in 12.4% of the patients and were related to the anticoagulation and
      antiaggregation therapy. In conclusion, the implantation of Palmaz-Schatz stents
      is an excellent bail-out device to treat acute vessel closure or symptomatic
      dissections after angioplasty. Elective and bail-out single stent implantation is
      associated with a reduced rate of restenosis when compared to conventional
      balloon angioplasty. At present, subacute stent thrombosis and bleeding
      complications are the major limitations with a combined rate of 15.9%.

PMID- 8465570
TI  - [In vitro studies of shock wave effects during ablation of normal and
      atherosclerotic vascular wall by excimer laser].
AB  - Ablation of atherosclerotic plaque and normal arterial wall was performed using a
      xenon-chloride-excimer laser with a wavelength of 308 nm and a pulse duration of
      115 ns. The light was transmitted via a 600 micron fiber and adjusted to an
      energy density of 3.5 J/cm2. The acoustic signals generated by the laser pulse
      were measured with hydrophones consisting of polyvinylidenefluoride with active
      diameters of 0.3 mm and recorded on a dual-channel digital storage oscilloscope
      using either a 0.5 m coaxial cable or a broadband transmission system. From 19
      cadavers human aortic tissue segments were excised and macroscopically classified
      as either normal or calcified atherosclerotic plaque. Approximately 500
      measurements were performed in saline and blood each. Histological analysis was
      carried out after the experiments to verify the macroscopic diagnosis and to
      correlate the acoustic responses with the tissue characteristics. For "normal"
      arterial segments, maximum peak pressure was 1.25 MPa +/- 0.85 MPa, rise time 163
      ns +/- 43 ns, and pressure increase 8.2 kPa +/- 5.4 kPa/ns in saline. For
      calcified, atheromatous segments a significantly higher maximum pressure (2.20
      MPa +/- 1.16 MPa), a significantly shorter rise time (69.9 ns +/- 25.8 ns), and a
      significantly higher pressure increase (32.3 kPa +/- 21.3 kPa/ns) was found in
      saline (p < or = 0.0001). In blood, maximum peak pressure was 1.29 MPa +/- 0.43
      MPa, rise time 93.3 ns +/- 27.7 ns, and pressure increase 14.6 kPa +/- 5.2 kPa/ns
      for "normal" arterial segments. Maximum peak pressure (2.28 MPa +/- 0.63 MPa) and
      pressure increase (32.8 kPa +/- Pa/ns) were significantly higher for calcified
      tissue segments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465571
TI  - [Subepicardial hematoma (haemorrhagia per rhexin) after elective PTCA with
      consecutive compression of the distal RIVA].
AB  - A transmural coronary dissection occurred immediately after elective angioplasty
      of a 90% stenosis of the proximal left anterior descending coronary artery (LAD)
      within the dilated segment and was followed by subepicardial bleeding
      (haemorrhagia per rhexin), although no perforation by the guide-wire or the
      balloon catheter took place. A subepicardial blood bolster led to rapid
      extravasal compression of the LAD distal from the PTCA site resulting in acute
      ischemia. None of the conventional rescue-interventions such as stents or
      autoperfusion catheters were likely to resolve this critical situation and the
      patient successfully underwent emergency bypass surgery.

PMID- 8465572
TI  - [Cardioverter-defibrillator implantations without thoracotomy: clinical
      experience with various electrode configurations and defibrillation wave forms of
      an endocardial/subcutaneous defibrillator system].
AB  - Twenty-seven consecutive patients with refractory ventricular arrhythmias were
      investigated for implantation of an nonthoracotomy cardioverter-defibrillator
      lead system. Supply with a nonthoracotomy lead system could be achieved in 25 of
      27 patients (92.5%), while implantation proved impossible in two patients due to
      elevated defibrillation thresholds. After implantation of an endocardial
      defibrillation electrode no differences were found compared to the implantation
      of an endocardial defibrillation electrode with a subcutaneous chest wall
      defibrillation patch with regard to the defibrillation thresholds obtained for
      monophasic defibrillation waveform. Supply with an endocardial defibrillation
      lead system was successful in 18 of 25 patients (72%). Ten consecutive patients
      with implantation of an endocardial defibrillation lead system alone were
      compared for defibrillation efficacy following monophasic and biphasic
      defibrillation waveforms. Defibrillation with biphasic waveforms led to a
      decrease in the necessary defibrillation energy from 19 J (4.6 J) to 10 J (4.0
      J). There was occurrence of refractory ventricular fibrillation that could not be
      controlled by endocardial and transthoracic defibrillation in two patients during
      the intraoperative testing of defibrillation thresholds. In both cases these
      arrhythmias could be terminated by the described method of
      endocardial/extrathoracic defibrillation (200 J). Further perioperative
      complications were not observed. Over a mean follow-up of 6.8 (1-17) months all
      patients demonstrated regular functioning of the cardioverter-defibrillator.
      Dislocation of defibrillation electrodes did not occur. Implantation of a
      cardioverter-defibrillator can be performed without thoracotomy in the majority
      of cases. The use of defibrillator systems with biphasic waveform widens the
      scope for implantation of nonthoracotomy defibrillating lead systems.

PMID- 8465573
TI  - [Diseases of the musculoskeletal system in the elderly].

PMID- 8465574
TI  - [Polyarthritis in the elderly].
AB  - Ten to thirty-three per cent of all cases of rheumatoid arthritis (RA) develop
      after sixty years of age. Late-onset RA patients are more likely to be male, to
      have faster onset of symptoms, to experience shoulder and hip disease initially,
      and to have higher erythrocyte sedimentation rates; they are less likely to
      develop rheumatoid nodules, extraarticular manifestations, positive serologic
      tests, or unfavorable outcomes. There are roughly three patterns of late-onset
      RA: a classical form which resembles typical adult-onset RA; a limited, fairly
      mild form in which Gougerot-Sjogren syndrome often coexists; and a form in which
      the shoulders and hips are involved first. The latter form, whose early stage
      closely resembles polymyalgia rheumatica (PMR), accounts for approximately 25% of
      cases, is very specific of elderly patients, and is difficult to differentiate
      from PMR. RS3PE (Remitting Seronegative Symmetrical Synovitis with Pitting Edema)
      is a different entity from RA.

PMID- 8465575
TI  - [Subacute benign edematous polyarthritis in the elderly].
AB  - Subacute edematous polyarthritis of the elderly is a recently described syndrome.
      The condition is characterized by its sudden onset and by the presence of
      important edema of the four limbs, symmetrical polyarthritis, marked inflammatory
      syndrome, and negative serological test for the rheumatoid factor. Men are
      predominantly affected, and many of them are carrying the HLA B-7 antigen. The
      illness subsides within a few months without sequelae. It seems that this
      syndrome should be clearly distinguished from late onset rheumatoid arthritis and
      polymyalgia rheumatica.

PMID- 8465576
TI  - [Aging phenomena and arthrosis].
AB  - The incidence of arthroses has a highly significant correlation with age.
      However, a clearly defined relationship from a causal basis does not yet exist.
      This association is not through the time-dependent accumulation derived from the
      mechanical "destruction-quantum" at a molecular level in the cartilage.
      Indicative for the transformation is progressive degeneration with considerations
      of disease values, norms, and biochemical parameters of the joint and associated
      indicators. We use the example of the knee joint to illustrate this point. The
      discrepancy over deficit in strength and regulatory mechanisms is also
      considered, as well as the passive chondroprotective shock-absorption of the
      subchondralia spongiosa, and, conversely, the apparent protective mechanism of
      osteoporosis preceding arthrosis. Epidemiologically, osteoporosis and arthroses
      have been proven incompatible; what remains to be elucidated is the well-known
      dichotomy in their courses of development.

PMID- 8465577
TI  - [Polymyalgia rheumatica].
AB  - Giant cell arteritis-mediated polymyalgia rheumatica is a typical disease of old
      age; though manifestation is rare in patients younger than 50 years, there is no
      upper age limit. Average disease-onset is at age 70. Typical symptoms and high
      serological inflammation are found. Laboratory data is nonspecific; temporal
      artery biopsy is imperative in unclear cases. Only glucocorticoid therapy
      initiates prompt pain relief, stops the inflammatory process and apprehends
      vascular complications. Monitoring of therapy requires careful guidance and
      experience.

PMID- 8465578
TI  - [Crystal-induced arthropathies].
AB  - The formation and deposition of crystals in articular tissues increases with
      growing age. As a consequence crystal-induced or crystal-associated arthritides
      or arthropathies can be observed particularly in the elderly where these
      disorders comprise a considerable part of inflammatory joint diseases. Gout,
      induced by monosodiumrate crystals mostly presents as acute monarthritis, less
      frequently as a chronic polyarthritis. Calciumpyrophosphate deposition may induce
      acute pseudo-gout, rheumatoid-arthritis-like (pseudo-rheumatoid) arthritis and a
      variety of other clinical syndromes. Basic calciumphosphate crystals may be
      associated with acute and chronic recurrent or destructive arthropathies. The
      detection of crystals in joint fluids by polarized microscopy as well as typical
      X-ray-findings allow to make a diagnosis in the context of characteristic
      clinical features. In addition to the antiinflammatory treatment it is important
      to detect and treat underlying metabolic disorders.

PMID- 8465579
TI  - [Senile osteoporosis--prevention and therapy].
AB  - Senile osteoporosis (type II-osteoporosis) is the final result of a large number
      of risk factors and negative effects on bone tissue which affect the skeleton
      throughout life. Important phases include bone formation during childhood and
      adolescence, the following obligatory loss of bone substance in the process of
      bone remodeling, periods of increased bone loss due to individual risk factors
      and augmented bone resorption in advanced age. According to this complex
      pathogenesis affecting the skeleton throughout life prevention is a lifelong
      task. The most important measures include a high calcium diet, regular physical
      activity, avoidance of risk factors and in postmenopausal women long-term
      sequential estrogen-progesteron substitution. The primary goal of therapy of
      established osteoporosis in the elderly is to relief symptoms and pain. Further
      treatment with the aim to keep or even increase bone mass (e.g. calcitonin,
      fluoride, calcium) may be indicated in individual patients taking into
      consideration age, disease activity and other individual prognostic factors.

PMID- 8465580
TI  - Anti-rheumatic treatment in the elderly.
AB  - The elderly are more liable to problems from drugs used systemically. An accurate
      diagnosis may reveal conditions in which drug treatment is not required,
      especially those due to faulty habits and environmental problems, and local
      conditions susceptible to injections or surgery. Obesity, sepsis, hypothyroidism,
      osteomalacia, unsuspected fractures and drug side-effects may give correctable
      rheumatological problems. Use of analgesic anti-inflammatory drugs needs great
      care in the elderly; use analgesics instead when possible. Rheumatoid arthritis
      in the elderly demands maximum use of nonpharmacological treatment and local
      treatment. Analgesic anti-inflammatory drugs should be used carefully and
      sparingly. Use slow-acting drugs as in younger patients.

PMID- 8465581
TI  - [Characteristics of physical therapy in diseases of the musculoskeletal system in
      the elderly].
AB  - Physical therapy is application of different kinds of energy for treatment. It
      provokes reactions by stimulation using physiological principles. Physical
      measures induce immediate effects as well as long-term reactions with adaptation.
      In diseases of the locomotor system in higher age, physical therapy is applied
      for diminishing pain and stiffness, amelioration of metabolism and function and
      especially for the maintenance of functional independence. Also fitness, good
      health and self-confidence can be stimulated. The age-dependent pecularities of
      the locomotor system, the skin and the cardiovascular system should be taken into
      consideration. Each method of physical treatment (hydrotherapy, heat and cold
      treatment, massages, exercise treatment, electrotherapy) has its age-specific
      peculiarities, which should be known by the treating physician. Modification of
      treatment can become necessary also by the kind of the disease. Dosage and
      technics of physical therapy must be adapted individually and supervised
      carefully.

PMID- 8465583
TI  - [Aging, flexibility, training].
AB  - The aging process is characterised by a reduction of the physical capacity of
      coordination, flexibility, strength, power, velocity and endurance. At the same
      time the kind of adaptation is modified. Details are described about the
      influences of aging on the cardio-pulmonary-metabolic system. In comparison to
      the internal organs the importance of training for alterations in connection with
      aging within the musculo-skeletal system are less known. Bones, cartilage,
      synovia, ligaments, and tendons are underlying also consequences of aging
      process. Strength and/or endurance training can help to reduce those negative
      influences. The description of exercises for the improvement of flexibility and
      coordination finishes the necessary program of training of the older and old men
      within the preventive medicine.

PMID- 8465584
TI  - Evaluation of arteriosclerosis progression with ultrasonic biopsy and intima
      media thickness measurements.
AB  - Noninvasive ultrasonic biopsy (UB) can be used to classify arteriosclerotic
      lesions and their progression in the carotid and femoral bifurcation. Six UB
      classes have been defined. The rate of progression (ROP) to the next UB class in
      four years has been defined in 1270 normal subjects: it was 1.4% from class I to
      class II, 3.1% from II to III, 10.7% from III to IV, 17.9% from IV to V and 79.2%
      from class V to VI. In high risk subjects (HRS)--305 hyperlipidemics, 269
      diabetics and 381 hypertensives--the ROP in 4 years was significantly higher
      considering all classes. This finding was matched by a more significant increase
      in intima-media thickness (IMT) increase in HRS in comparison with normal
      subjects. In conclusion UB and IMT measurements can be used to monitor
      arteriosclerosis progression. HRS have a comparable increase in ROP and IMT in
      four years indicating rapid progression in comparison with normals. UB appear to
      be more effective in evaluating progression when plaques and wall irregularities
      make IMT measurements difficult.

PMID- 8465582
TI  - [Critical life change events and adjustment in a group of elderly single women].
AB  - Women that were children or adolescents during World War II have rarely been
      studied in psychological and sociological research. Because of the death of over
      3.5 million German men in that war, there remained many single (especially, never
      married) women of corresponding age. In a research project at the University of
      Munster some psychological and social aspects of the life situation of never
      married, employed women born between 1919 and 1933 in comparison to married women
      of the same age that had never been employed were studied by means of detailed
      interviews. Parts of the results concerning the retrospective experience of
      critical life events and coping strategies are described. The results indicate
      that the interviewees were confronted with difficult life events, but that they
      coped with them in a very active way. Differences between women of different
      martial statuses (e.g., for the never-married women a more frequent mentioning of
      events concerning the war, a higher involvement in personal health problems, a
      lower importance of their occupation than expected by the authors, and, for
      example, for the married women a higher family-centeredness) are discussed.

PMID- 8465585
TI  - [Color-coded duplex ultrasound and contrast medium enhanced duplex ultrasound in
      deep venous thrombosis].
AB  - Even with highly developed ultrasound systems, diagnosis of deep leg vein
      thrombosis is difficult in lower leg veins and in the area of the adductor
      channel. In order to evaluate color duplex-sonography, contrast media duplex
      sonography and phlebography in comparison, 79 patients (38 men and 40 women aged
      54 to 89) with deep leg vein thrombosis were examined. As a result, patients
      suffering from thrombosis were characterized by a vein-artery quotient of > 2.0
      (p < 0.01). In color Doppler duplex-sonography false negative findings occurred
      in 12 cases of lower leg vein thrombosis and in 3 cases of thrombosis within the
      adductor channel. By contrast media duplex-sonography the diagnostic reliability
      could be increased to a sensitivity of over 95 per cent.

PMID- 8465586
TI  - [Differences in prognoses of aorto-iliac and femoro-popliteal reconstructions in
      peripheral arterial occlusive disease. Results after at least 15 to 25 years].
AB  - The results of 729 extremities, operated for peripheral vascular disease and
      followed for at least 15 up to 29 years are presented. 457 aortoiliac
      reconstructions are compared with 272 in the femoropopliteal area. All patients
      suffered only from intermittent claudication. The two groups were compared as to
      patency rate, reocclusion, amputation rate and mortality. It is of great
      interest, that the great majority of patients dying in the follow up have open
      reconstructions and have taken therefore advantage of surgery in being free of
      walking difficulties up to their death. The results of aortoiliac reconstructions
      are better, the patency rate is higher, the amputation rate lower, but even
      femoropopliteal reconstructions do better and have lower amputation rates than in
      natural course of the disease. Patients with intermittent claudication below 50
      years of age should not be admitted to femoropopliteal surgery, because the risk
      of amputation before death is higher.

PMID- 8465587
TI  - [Endoscopic perforant vein revision. Current status].
AB  - Blind dissection of incompetent perforators is common practice for vein surgeons.
      Since many years some of them have been trying to do this endoscopically by means
      of the proctoscope or other endoscopes used for different purposes. At present,
      however, several surgeons are developing special instruments for this type of
      endoscopy. Lately some of these surgeons came together to work up their
      experiences and to study the probable future of the method. It permits the
      diagnosis and at the same time the treatment of incompetent perforators. It
      allows the healthy ones to be spared. All this can be done from a small incision
      distant to the site of the perforators where the skin often presents with trophic
      changes. However, general or regional anesthesia as well as the bloodless limb
      technique are prerequisites. As any endoscopy also this one has its specific
      dangers and complications and therefore has to be learned and performed
      carefully.

PMID- 8465588
TI  - [Long-term results of unsuccessful thrombolysis and secondary thrombectomy of
      deep leg-pelvic vein thromboses: a critical analysis].
AB  - According to the literature, fibrinolytic therapy of acute thrombosis of the
      pelvic and deep lower leg fails in about 15%. As the primary patency rate
      correlates with the long term results, we intended to investigate whether the
      failures of 15% might be improved by a secondary thrombectomy. 87% of 31
      thromboses treated by secondary thrombectomy were investigated by clinical,
      morphological and functional examinations. The data show that in case of the
      intervention taking place within 8 days (total age of the thrombus including the
      period of lysis treatment) the results were excellent, within 8-14 days they were
      still good. Patients below the age of 30 years benefited most by the therapy.
      However, the postulated "airtight effect" could not be demonstrated. Early
      diagnosis is of paramount importance. The period of lysis treatment should be
      limited and in case of failure a secondary thrombectomy should be offered to the
      patient.

PMID- 8465589
TI  - [Long-term results of percutaneous transluminal angioplasty and stent
      implantation in venous stenoses following transfemoral thrombectomy].
AB  - Thirty consecutive patients were operated on for iliofemoral venous thromboses.
      In each case, a transfemoral thrombectomy was performed and an arterio-venous
      fistula was created. Three to six months later, a cross-over arterio-venography
      revealed 10 severely stenosed venous segments in 8 patients (common iliac vein 4,
      external iliac vein 3, common femoral vein 3). All stenoses were treated by
      percutaneous transvenous angioplasty (PTA). Six times a flexible, self-expanding
      Wallstent was placed within the stenosis after dilation (PTA+S). Complications
      did not occur. Median follow up was 17 months (3-23 months). PTA+S proved
      superior (4/6 excellent results) when compared to PTA alone (1/4 excellent
      result), because of frequent restenosis after the latter. Minor results following
      PTA+S were caused by intimal hyperplasia within the stent, when the av-fistula
      was kept patent for more than a year after stent placement.

PMID- 8465590
TI  - [Ablation of venous valves with Nd-Yag laser--an alternative to conventional
      valvulotomy?].
AB  - The careful removal of venous valves during in situ venous bypass procedures is a
      problem that has not been completely solved. In this experimental study, valve
      ablation with the Nd-Yag laser was compared with conventional valvulotomy. The
      investigation was performed in vitro using human vein segments with a length of
      20 cm. Conventional valvulotomy was performed 16 times, 20 valves were removed
      with a 400 mu-fibre and 26 with the hot tip. The results were evaluated by
      endoscopy, light and electron microscopy. There were no vein perforations with
      the valvulotome and the hot tip. Endothelial damage was documented in 85% with
      the valvulotome and was reduced significantly to 58% with the 400 mu-fibre. With
      the hot tip endothelial lesions were seen in only 30%. Valve remnants were always
      present with the valvulotome and in no more than 15% with the hot tip. Electron
      microscopy supported these results in general. There was no endothelial damage in
      69%.

PMID- 8465591
TI  - [Aorto-enteric fistula].
AB  - Between 1974 and 1991 six patients with an aortoenteric fistula were treated. A
      primary aorto-jejunal fistula was successfully operated. The other 5 cases were
      suffering from secondary fistulas due to aortoiliac reconstructions. None of
      these patients survived. The diagnostic procedures, therapy and prophylaxis are
      discussed.

PMID- 8465592
TI  - [Metabolic changes after transperitoneal vascular interventions].
AB  - Thirty patients who had undergone transperitoneal vascular surgery were examined
      for hormonal disturbances and alterations of energy and protein metabolism. Of
      all hormonal alterations only the increased level of insulin activity in the
      early postoperative period is clinically important. The higher oxygen consumption
      and carbon dioxide production together with the increased protein turnover
      indicate an elevated energy expenditure. In order to prevent decompensation of
      the hypermetabolic metabolism, a reduced nutritional support after major vascular
      surgery is justified.

PMID- 8465593
TI  - [Long-term follow-up of Mobin-Uddin umbrella filter implantation for prevention
      of pulmonary embolism].
AB  - A follow-up of 40 cases of Mobin-Uddin-umbrella implants for prophylaxis of
      secondary pulmonary embolism is presented. The all-over lethality was 35% (14
      patients) including one embolic recurrence. 25 patients could be re-examined 0.2
      11.1 years after the implantation, using the patient's history, clinical
      examination, native X-ray of the umbrella, B-scan of the inferior vena cava,
      phlebodynamometry of the legs, spirometry, ergometry, manometry of the pulmonary
      artery pressure. Possible or probable recurrences of embolism were recorded in
      15% (5 patients). The umbrella was totally occluded in 48% and partially occluded
      in 23%. Umbrella-related complications due to faulty insertion were not observed.
      Patients without additional cardiopulmonary diseases did not show pulmonary
      hypertension or ventilatory disorders at rest. 86% of the patients suffered from
      a symptomatical chronic venous insufficiency of one or both legs. Today the Mobin
      Uddin-umbrella has been replaced by other percutaneously applicable cava filters.
      However, their application may also be followed by complications. Therefore the
      decision to use cava filters of any type should be based on severe selection
      criteria.

PMID- 8465594
TI  - [Severe Raynaud disease of all four extremities].
AB  - A 64-year-old woman presented with a serious Raynaud's disease affecting all four
      extremities and resulting in fingertip necroses. The symptoms had initiated after
      her second pregnancy in association with anorexia requiring treatment in a
      psychosomatic clinic and necessitating parenteral feeding. After successful
      sympatholysis a sympathectomy was performed. After initial success a recurrence
      in the right arm was treated by intraarterial prostaglandin infusion. This
      treatment brought a temporary benefit whereas intravenous infusions had been
      without effect. A further medical blockade of the stellate ganglion was followed
      by a complete disappearance of the symptoms. A subsequent re-operation was
      performed. Since all the cervical branches of the sympathetic nerve cord had been
      resected during the first intervention, a partial resection of the stellate
      ganglion (ganglion cervical inferior) was performed. There was a temporary
      benefit which lasted a few months. Medical long term treatment was unsuccessful.
      However, no further necroses occurred and the intermittent pain is tolerable.

PMID- 8465595
TI  - [Current status of combined physical decompression therapy in primary and
      secondary lymphedema of the legs].
AB  - Clinical lymphology has become an important part of angiology. Patients suffering
      from lymphedema are in need of physicians and physiotherapists who guide them
      trough this chronic disease and who are familiar with the different complications
      of chronic lymphatasis. The necessary experience in the treatment of lymphedema
      of the lower extremities can be achieved only at lymphologic treatment centers
      with adequate numbers of such patients. Nihilism concerning therapy of these
      disorders is not justified as our experience with the enumerated combined
      physical drainage therapy demonstrates.

PMID- 8465596
TI  - [Aneurysm spurium after resection of aortic coarctation].
AB  - 25 years after reconstruction of an aortic coarctation by prosthetic material, an
      insufficiency of the anastomosis gave rise to the development of a false
      aneurysm. The aneurysm was resected and the anastomosis was reconstructed in
      parallel extracorporal circulation with femoral cannulation in order to prevent
      ischemic lesions of the spinal cord and the visceral organs. The patient who
      works as a circus acrobat, made a successful recovery.

PMID- 8465597
TI  - [Unilateral "nevoid" spider nevi].
AB  - A case of unilateral spider telangiectasia on the left side of the face
      initiating at puberty is reported. With respect to its therapy and prognosis this
      alteration must be distinguished from other telangiectasias. With unilateral
      nevoid telangiectasia it shares the unilateral distribution of the lesions and
      the predilection for the female sex during hormonal instability periods. Both of
      these types of acquired telangiectasia seem to occur in relation with endocrine
      influences. Unilateral nevoid telangiectasia may also show typical spider
      telangiectasia but occurs in combination with other telangiectatic alterations.
      Unilateral "nevoid" spider telangiectasia consists exclusively of spider
      telangiectasia. Pathogenesis and further differential diagnosis of this peculiar
      type of primary telangiectasia are outlined.

PMID- 8465599
TI  - [The new Frankenstein].

PMID- 8465598
TI  - [Recurrent acute occlusions of the popliteal artery before age 50: popliteal
      entrapment syndrome?].
AB  - Compression of the popliteal artery by the medial head of the gastrocnemius
      muscle is termed "Popliteal Artery Entrapment". The anatomical course of the
      artery can be normal or abnormal. The entrapment can cause occlusion of the
      artery or peripheral embolism. This syndrome is an important differential
      diagnosis in younger patients with recurrent peripheral arterial ischemia.
      Diagnosis is made by history, clinical findings, arteriography and CT-scan of the
      knees. All cases of popliteal artery entrapment, whether the artery is occluded
      or not, should be operated on.

PMID- 8465601
TI  - Cloning and genetic analysis of the gene encoding a new protein kinase in
      Saccharomyces cerevisiae.
AB  - We have isolated a single gene from the yeast Saccharomyces cerevisiae encoding a
      potential 800 amino acid polypeptide of calculated M(r) 90,098 Da. This protein
      consists of an N-terminal region that shares significant homology with the
      catalytic domains of several serine- and threonine-specific protein kinases, as
      well as a large, unique, C-terminal domain of unknown function. Haploid
      disruption mutants are viable and do not exhibit any readily observable growth
      defects under varying conditions of temperature, nutrients or osmotic strength.
      Due to the apparent structural similarity between this kinase and the protein
      products of the KIN1 and KIN2 genes, we have chosen to name this new gene KIN3.

PMID- 8465600
TI  - Galactose inhibition of the constitutive transport of hexoses in Saccharomyces
      cerevisiae.
AB  - The relationship between the pathways of glucose and galactose utilization in
      Saccharomyces cerevisiae has been studied. Galactose (which is transported and
      phosphorylated by inducible systems) is a strong inhibitor of the utilization of
      glucose, fructose and mannose (which have the same constitutive transport and
      phosphorylation systems). Conversely, all these three hexoses inhibit the
      utilization of galactose, though with poor efficiency. These cross-inhibitions
      only occur in yeast adapted to galactose or in galactose-constitutive mutants.
      The efficiency of galactose as inhibitor is even greater than the efficiencies of
      the other three hexoses to inhibit the utilization of each other. Phosphorylation
      is not involved in the inhibition and the transport of sugars is the affected
      step. The cross-inhibitions between galactose and either glucose, fructose or
      mannose do not implicate utilization of one hexose at the expense of the other,
      as it occurs in the mutual interactions between the latter three sugars. It seems
      that, by growing the yeast in galactose, a protein component is synthesized, or
      alternatively modified, that once bound to either galactose or any one of the
      other three hexoses (glucose, fructose or mannose), cross-interacts respectively
      with the constitutive or the inducible transport systems, impairing their
      function.

PMID- 8465602
TI  - Cloning and genetic characterization of a calcium- and phospholipid-binding
      protein from Saccharomyces cerevisiae that is homologous to translation
      elongation factor-1 gamma.
AB  - We have isolated a gene (CAM1) from the yeast Saccharomyces cerevisiae that
      encodes a protein homologous to the translational cofactor elongation factor-1
      gamma (EF-1 gamma) first identified in the brine shrimp Artemia salina. The
      predicted Cam1 amino acid sequence consists of 415 residues that share 32%
      identity with the Artemia protein, increasing to 72% when conservative
      substitutions are included. The calculated M(r) of Cam1p (47,092 Da) is in close
      agreement with that of EF-1 gamma (M(r) = 49,200 Da), and hydropathy plots of
      each protein exhibit strikingly similar profiles. Disruption of the CAM1 locus
      yields four viable meiotic progeny, indicating that under normal growth
      conditions the Cam1 protein is non-essential. Attempts to elicit a translational
      phenotype have been unsuccessful. Since EF-1 gamma participates in the regulation
      of a GTP-binding protein (EF-1 alpha), double mutants with cam1 disruptions and
      various mutant alleles of known GTP-binding proteins were constructed and
      examined. No evidence was found for an interaction of CAM1 with TEF1, TEF2, SEC4,
      YPT1, RAS1, RAS2, CDC6, ARF1, ARF2 or CIN4. The possibility that Cam1p may play a
      redundant role in the regulation of protein synthesis or another GTP-dependent
      process is discussed.

PMID- 8465603
TI  - The role of ALA-S and ALA-D in regulating porphyrin biosynthesis in a normal and
      a HEM R+ mutant strain of Saccharomyces cerevisiae.
AB  - Catabolite repression and derepression on delta-aminolevulinate synthase (ALA-S)
      and delta-aminolevulinate dehydratase (ALA-D) in a normal yeast strain, D27, and
      its derived D27/C6 (HEM R+) were investigated. ALA-S and ALA-D activities and
      intracellular ALA (I-ALA) at different physiological states of the cells were
      measured. In YPD medium, under conditions of repression and when glucose was
      exhausted, both strains behaved identically as if the mutation was not expressed.
      In YPEt medium, however, both ALA-S and ALA-D activities were higher than in YPD,
      but the I-ALA content and the enzymic activity profiles shown by the two strains
      were quite different. It appears, therefore, that the mutation causes a
      deregulation of ALA-S, so that its activity is kept at a high level throughout
      the cell cycle. This would explain the increased levels of cytochromes present in
      the mutant. This mutation may affect some regulatory aspect of ALA formation and
      renders an ALA-S of high activity; moreover, this enzyme species seems to be more
      stable than in the normal strain.

PMID- 8465604
TI  - The VPH2 gene encodes a 25 kDa protein required for activity of the yeast
      vacuolar H(+)-ATPase.
AB  - Strains bearing the vph2 mutation are defective in vacuolar acidification. The
      VPH2 gene was isolated from a genomic DNA library by complementation of the zinc
      sensitive phenotype of the mutant. Deletion analysis localized the complementing
      activity to a 1.2 kb DNA fragment. Sequence analysis of this fragment revealed
      the presence of a single open reading frame that encoded a protein of 215 amino
      acids. Computer analysis indicated that the protein, which has a predicted
      molecular mass of 25,286 Daltons, has two distinct membrane-spanning domains.
      Biochemical studies indicated that strains bearing the vph2 mutation have greatly
      reduced levels of vacuolar proton pumping and ATPase activity and that the
      nucleotide binding subunits of the multimeric vacuolar H(+)-ATPase failed to be
      correctly targeted to the vacuolar membrane. The vph2 mutant fails to grow on YEP
      glycerol medium and on media containing 100 mM-CaCl2 or 4 mM-ZnCl2 or buffered to
      pH 7.5, a phenotype observed in strains carrying deletions in the genes encoding
      several vacuolar H(+)-ATPase subunits. The VPH2 gene is identical to the VMA12
      gene (T. Stevens and Y. Anraku, personal communication).

PMID- 8465605
TI  - CNE1, a Saccharomyces cerevisiae homologue of the genes encoding mammalian
      calnexin and calreticulin.

PMID- 8465606
TI  - The complete sequence of a 19,482 bp segment located on the right arm of
      chromosome II from Saccharomyces cerevisiae.
AB  - We report here the sequence of a 19,482 bp DNA segment of chromosome II of
      Saccharomyces cerevisiae. The fragment contains 16 open reading frames (ORFs)
      covering 74% of the sequence. Four predicted products present homology with known
      proteins. The ORF YBR1732 exhibits a strong homology to serine hydroxymethyl
      transferase; the best score is 53.1% identity in 458 amino acids overlap with the
      serine hydroxymethyl transferase from rabbit liver. YBR1724, which shows homology
      with riboflavin synthase of Bacillus subtilis, is probably the RIB5 gene implied
      in riboflavine synthesis and mapped in this region. YBR1733 is homologous to rab
      protein and YBR1728 is presumably a GTPase activating protein.

PMID- 8465607
TI  - [Chemical composition of eight edible mushrooms].
AB  - A comparative analysis of crude protein, crude ash, phosphorus (P), potassium (K)
      and calcium (Ca) contents of 57 samples of eight common edible mushroom species
      was made. The most important protein sources were: Marasmius oreades and Lepista
      nebularis. Species of the Boletaceae formed an intermediate group, while
      relatively proteinless species were: Armillariella mellea and Cratarellus
      cornucopioides. The lowest crude protein content was established in Cantharellus
      cibarius. The ash contents varied more widely. The greatest P contents were
      measured in Lepista nebularis and Marasmius oreades but most mushrooms contained
      6-7 gP/kg. The analysed mushroom samples contained 30-40 gK/kg dry weight and 0,2
      0,3 gCa/kg. These analyses are important from the point of view of the
      nutritional role of mushrooms.

PMID- 8465608
TI  - Microbiological status of rabbit carcases in Egypt.
AB  - A total of 40 New Zealand white rabbits, 20 freshly slaughtered rabbits from an
      experimental farm and 20 processed rabbit carcases from grocery stores in Beni
      Suef city, were examined bacteriologically. The mean values of aerobic plate
      counts at 37 degrees C and 1 degrees C, Enterobacteriaceae counts, Pseudomonas
      counts and Staphylococcus counts of freshly slaughtered rabbits were 10(4) +/- 2
      x 10(3), 8 x 10(2) +/- 10(2), 6 x 10(2) +/- 10(2), 3 x 10(2) +/- 10(2), and 10(2)
      +/- 60 organisms per gram respectively, whereas the equivalent values were 8 x
      10(5) +/- 3 x 10(4), 2 x 10(5) +/- 10(4), 4 x 10(4) +/- 8 x 10(3), 2 x 10(4) +/-
      6 x 10(3), and 4 x 10(3) +/- 4 x 10(2) organisms per gram of processed rabbit
      carcases from grocery stores, respectively. The freshly slaughtered rabbits
      showed a low bacterial load compared with processed rabbit carcases from grocery
      stores. Escherichia coli and Listeria monocytogenes could be isolated from the
      rabbit carcases examined in addition to Salmonella typhimurium, Pseudomonas
      aeruginosa and Staphylococcus aureus from processed rabbit carcases. Yersinia
      enterocolitica could not be isolated from any sample examined. Suggested measures
      to reduce the microbial load in rabbit carcases are discussed.

PMID- 8465609
TI  - Selenium distribution in egg white proteins.
AB  - The present studies were undertaken to characterize selenium distribution in egg
      white. Ion-exchange chromatography fast protein liquid chromatography (FPLC) and
      flow injection atomic (absorption) spectrometry (FIAS) were used to separate egg
      white proteins and to determine the selenium content of different fractions.
      After purification, nine different proteins were identified with sodium dodecyl
      sulphate-polyacrylamide gel electrophoresis and 56% of the total selenium content
      was found to be associated with ovalbumin-1 and -2 (+/- 500 ng/g), which is the
      main protein in egg white. Flavoprotein was determined to be the richest selenium
      containing protein (1800 ng/g). The selenium content of the other proteins
      (lysozyme, conalbumin, globulins and ovomucoid) ranged from 359 to 1094 ng/g.

PMID- 8465610
TI  - Disulphide bonds in wheat gluten: further cystine peptides from high molecular
      weight (HMW) and low molecular weight (LMW) subunits of glutenin and from gamma
      gliadins.
AB  - Glutenin was prepared from gluten of the wheat variety Rektor by extraction of
      gliadin with aqueous ethanol. It was cleaved successively into soluble peptides
      by the enzymes trypsin and thermolysin. Separation of the peptide mixtures was
      performed by gel permeation chromatography (GPC) on Sephadex G25 and reversed
      phase high performance liquid chromatography (RP-HPLC) on ODS-Hypersil. Cystine
      peptides were detected by differential chromatography of the samples prior to and
      after reduction. After isolation by multi-step RP-HPLC, the cystine peptides were
      reduced. The resulting cysteine peptides were alkylated with 4-vinylpyridine,
      separated by RP-HPLC and sequenced by means of the Edman degradation. The
      isolated cystine peptides represented a considerable portion of the total
      cysteine in glutenin: four out of seven cysteine residues of HMW subunits, and
      eight out of nine cysteine residues of LMW subunits are documented by at least
      one cystine peptide. Most of the peptides corresponded to known sequences of
      gluten protein components. From the structures of some tryptic peptides, inter-
      and intramolecular disulphide bonds for HMW subunits of glutenin have been
      proven. Cystine peptides from the thermolytic digest have been assigned to LMW
      subunits of glutenin and to gamma-gliadins. Other peptides have been closely
      related to partial sequences of these protein components. The results have
      allowed several conclusions about the arrangement of intra- and intermolecular
      disulphide bridges in gluten proteins.

PMID- 8465611
TI  - Polymerase chain reaction (PCR): a possible alternative to immunochemical methods
      assuring safety and quality of food. Detection of wheat contamination in non
      wheat food products.
AB  - A rapid, sensitive and specific analysis of food samples determining wheat
      contamination was established using polymerase chain reaction (PCR) technology.
      First, primers specific for highly conserved eukaryote DNA sequences were used to
      prove isolated nucleic acid substrate accessibility to PCR amplification.
      Subsequently, a highly repetitive and specific genomic wheat DNA segment was
      amplified by PCR for wheat detection. This assay was tested with 35 different
      food samples ranging from bakery additives to heated and processed food samples.
      In addition, the PCR method was compared to an immunochemical assay that detected
      the wheat protein component gliadin. Combination of both assays allowed a
      detailed characterization of wheat contamination. Hence, wheat flour
      contamination could be distinguished from gliadin used as a carrier for spices as
      well as from wheat starch addition.

PMID- 8465612
TI  - [Information on surgical risk--proper timing].

PMID- 8465613
TI  - [Treatment of breast cancer "one hundred years ago"].

PMID- 8465614
TI  - [Therapeutic consequences of early detection of locoregional recurrences in
      breast cancer].
AB  - The value of follow-up investigations depends on the therapeutic consequences of
      early detection of recurrences and metastatic disease. After breast conservation
      early detection of recurrent disease by physical and apparative examinations has
      to be aimed for due to a possible curation by salvage surgery. Also in
      recurrences of the chest wall a great deal of local controls can be achieved when
      detected early and at smaller sizes. While axillary recurrences can be controlled
      by surgery and radiation therapy the prognosis is poor in the case of a
      supraclavicular and retrosternal lymph node involvement. Diagnostic and
      therapeutic options will be discussed for these five types of recurrences.

PMID- 8465615
TI  - [Spectrum and effectiveness of emergency care by surgeons acting as rescue unit
      surgeons in a large city].
AB  - From 1.1. 1985 to 31. 12. 1990 n = 10,569 emergency cases were prospectively
      documented. The aim of the study was to evaluate, whether surgeons on a mobile
      emergency care and rescue unit were able to treat surgical and non-surgical
      emergencies sufficiently during the prehospital period. 16.8% of the patients
      were trauma patients while 47% suffered from medical disorders, e.g. myocardial
      infarction (12%), other cardiocirculatory disorders (7%) and acute opiate and
      multidrug poisoning (16%). Additionally, other problems out of the broad spectrum
      of emergency medicine such as disorders from pediatrics, neurology/neurosurgery,
      gynecology, toxicology, pulmonology, endocrinology etc. had to be solved. More
      than 50% suffered from life-threatening emergencies, 5.6% required cardio
      pulmonary resuscitation, 45% of which were primarily successful. In-field deaths
      where emergency treatment was not successful occurred in 3.2%. The mortality rate
      during transport to the next available hospital was 0.1%. It can be concluded
      from the study that well trained surgeons are very capable to perform high
      efficient in-field emergency treatment for various disorders.

PMID- 8465616
TI  - [Changes in surgery of diverticulitis].
AB  - This retrospective study investigates the surgical progress in the treatment of
      diverticular disease during the last two decades. We reviewed 304 patients (149
      women and 155 men) operated for diverticular disease from 1970-1992 at the
      Surgical Clinic of Steglitz Medical Center, Free University of Berlin. Comparing
      the results between the first and the second decade, we observed a significant
      increase in the total number of patients who have been treated surgically (from
      118 to 186) and in the proportion of elective surgery (from 45% to 57%). In the
      second decade, early elective resection in selected patients with a severe
      diverticulitis and primary resection for perforated diverticulitis were the
      procedures of choice. Through this concept the over-all operative mortality rate
      could be reduced from 24% in the first to 7% in the last decade of this report.

PMID- 8465617
TI  - [Diagnosis and therapy of cecal diverticulitis].
AB  - Acute pain in the lower right side of the abdomen caused by caecal diverticulitis
      is very rare and hardly to distinguish from acute appendicitis. Therefore it is
      usually diagnosed intraoperatively. We report our experience with 12 patients,
      who received surgical treatment from 1984 to 1991. The diagnosis was made not
      before operation in 11 cases. Because of a severe inflammation of the caecal wall
      we performed an ileocaecal resection in 10 cases, in 2 cases it was necessary to
      perform a right hemicolectomy because of additional diverticulitis of the
      ascending colon. The surgical resection of the inflammatory mass was followed by
      an uncomplicated postoperative healing in all cases.

PMID- 8465618
TI  - [Deep rectovaginal fistula and incontinence after labor trauma].
AB  - The commonest cause of traumata to the organ of continence is the injury during
      childbirth. Specially after negligent or missing reconstruction apart from
      incontinence rectovaginal fistulas can arise. This report deals with 24
      incontinent women with a perineal laceration. After delivery 17 women had
      developed a low rectovaginal fistula. In addition to clinical recording of the
      incontinence, the proctological examination including anal manometry was carried
      out before and 25 months after surgery on an average. All patients get the same
      operation: Section of the anterior commissure, cutting out the fistula if
      necessary, separated suture of the animalic and voluntary sphincter, vaginal
      plasty. Preoperative resting pressure was 30 cm H2O and the voluntary pressure 46
      cm H2O-on an average. Postoperative there was an increase to 61 cm H2O for the
      resting pressure and to 77 cm H2O for the voluntary pressure. 22 patients
      reported an improvement. 13 women are completely continent, 7 x soiling, 2 x
      incontinence for flatus, one incontinence for liquid stool and one stool
      incontinence were found. One fistula occurred again during follow up. Our
      surgical procedure compared with others has the advantage to give similar results
      avoiding protective colostoma. Besides the option for an other surgical procedure
      is still remained.

PMID- 8465619
TI  - [Renal effects of adenosine: possible consequences for kidney transplantation].
AB  - This review summarizes in the first part the action of adenosine on the kidney.
      In the second part we discuss the pathophysiological consequences and the
      possibilities of a pharmacological intervention to improve impaired kidney
      function. Adenosine causes vasoconstriction in the kidney and reduces glomerular
      filtration rate (GFR). This action is enhanced in proportion to elevated plasma
      renin activity. Chronic elevation of ureteral pressure enhances and reduction of
      renal perfusion pressure attenuates adenosine-induced vasoconstriction. From the
      kidney-specific relationship between renal blood flow and tubular electrolyte
      transport the concept is developed which ascribes adenosine a role of a mediator
      that is essentially contributing to the homeostatic regulation of kidney
      function. The accumulation of adenosine in the kidney tissue after ischemia or
      after administration of nephrotoxic substances led to the hypothesis that
      adenosine is an important intrarenal factor in the pathogenesis of acute renal
      failure. The possibility to antagonize adenosine actions in the kidney with
      theophylline was used successfully in a number of experimental studies in acute
      renal failure and most recently in a study in humans after contrast media
      administration. Adenosine actions mediated via membrane receptors must be
      separated from adenosine actions in the cell to increase ATP tissue content. The
      concept of the "University of Wisconsin" (UW) solution to improve the energy
      state of the tubular cells appears to be successful, however, we propose that the
      potential dangerous adenosine actions in the kidney, especially during the
      reperfusion phase may be antagonized by the administration of theophylline.

PMID- 8465620
TI  - [Recent results regarding indications for the "morning after pill"].
AB  - Results of interrogating 150 women who visited our department because of
      postcoital contraception are demonstrated. 80% did actually use one method of
      contraception. The rate of "condom accidents" was 70 per cent. Only 21 per cent
      did not use any method of contraception. Taking the facts of sexual habits into
      consideration we can conclude that women who wish to take the "morning after
      pill" have a more active sexual life. The intention to prevent an unwanted
      pregnancy through this postcoital method of contraception indicates a more
      responsible attitude towards sexuality. The popularity of this method may be
      increased.

PMID- 8465621
TI  - [Control of labor with prostaglandins after previous cesarean section].
AB  - The authors studied the possibilities of vaginal labour management by induction
      after previous caesarean section. They compared the effectiveness of oxytocin and
      prostaglandins in uterus action. A total of 48 patients after previous caesarean
      section were induced, 26 by oxytocin and 22 by prostaglandins. The success of the
      induction was 30.7% with oxytocin and 95.4% with prostaglandins. Compared were
      also both the incidence of complications during labour and the effect of the
      uterotonic used on the fetus. It follows from the results that local application
      of prostaglandins is more advantageous than overall application and carries
      practically no risk for the patient in labour.

PMID- 8465622
TI  - [Correlation between cytogenetic anomalies of human spermatozoa and sperm
      morphology as well as age of patients studied].
AB  - Sperm chromosomes from 15 fertile men were analyzed after fusion of their
      spermatozoa with zona-free hamster eggs. The total proportion of abnormal
      metaphases as well as the proportions of aneuploidy and structural aberrations
      were calculated for every man and examined for linear correlations with sperm
      morphology and the age of the persons studied. A positive correlation between the
      cytogenetic parameters and the percentage of abnormal sperm morphology was not
      evident, suggesting that assessment of sperm morphology cannot be used as an
      indicator of chromosomal damage in human spermatozoa. In contrast, there was a
      more distinct positive correlation between the age of donors and the three
      cytogenetic parameters studied. Analogous calculations for two other study groups
      (group S: male subfertility; group HA: habitual abortions of the wives with
      unknown etiology) provided less clear results that may be attributed to the lower
      number of patients or to the existence of special indications as mentioned above.

PMID- 8465623
TI  - [Dramatic reduction of the incidence of trichomonas vaginalis infections].
AB  - In contrary to former meanings the trichomonas-vaginalis-infection doesn't play
      any longer an important role. Nowadays it even seems to be a rarity. So we found
      an infection-rate of 2.17% in 1979 (n = 4005), whereas in 1992 only in 0.19% (n =
      1048). The possible causes for this pleasant development are discussed.
      Nevertheless a gynaecologist on principle should think of a trichomonas-vaginalis
      infection not only when her/his patients show specific symptoms as to burning,
      itching, discharge and dyspareunia, but in every case of discharge a trichomonas
      infection should be excluded-or diagnosed and treated specifically, in special
      cases even by culture.

PMID- 8465624
TI  - [Use of the hysteroscope in pediatric gynecology for diagnosis of vaginal
      hemorrhage and injury].
AB  - The vaginal bleeding, injury and suspected foreign body are commonest indications
      for vaginoscopy in pediatric gynecology. A special hysteroscope, the
      resectoscope, permits the exploration of vaginal pathologies of girls with intact
      hymenal ring. Authors have used the resectoscope for vaginoscopy with excellent
      result. The small diameter, the magnification and the continuous fluid irrigation
      give ideal conditions for endoscopic evaluation of vaginal disorders in babies
      and virgins. The possibility of biopsy and coagulation is given by monopolar loop
      electrode.

PMID- 8465625
TI  - [First manifestation of non-Hodgkin's lymphoma in the labia major].
AB  - In this report the case of an extranodal Non-Hodgkin's lymphoma with its
      manifestation in the external genitalia is described. The necessity of
      histological examination as well as the need of an cytostatic therapy is shown.

PMID- 8465626
TI  - [Lymph node metastasis in microcarcinoma of the uterine cervix].

PMID- 8465627
TI  - [Maternal deficiency of IgG 2 and IgG 4 and neonatal infection caused by B
      streptococci].
AB  - We describe here an newborn infant born in the 39th week of gestation with an
      early onset sepsis caused by group B streptococci. The intravenous administration
      of antibiotics and immunoglobulin preparation was unable to prevent the fatal
      outcome. The boy died after 16 hours of life. In the maternal serum a marked
      deficiency of IgG 2 and IgG 4 could be demonstrated. According to the results
      from the literature it seems possible that partial immunodeficiencies are
      important factors in the pathogenesis of the B-streptococcal disease of the
      newborn.

PMID- 8465628
TI  - The Bethesda System for reporting cervical/vaginal cytologic diagnoses: revised
      after the second National Cancer Institute Workshop, April 29-30, 1991.

PMID- 8465629
TI  - Fine needle aspiration biopsy in pediatric ophthalmic tumors and pseudotumors.
AB  - In an eight-year period (1983-1990) approximately 500 fine needle aspiration
      biopsies (FNABs) of eye lesions were processed in our laboratory. Eighty-one of
      the cases, obtained from 77 pediatric patients (ranging from 4 weeks to 16 years
      of age), were the subject of this study. The specimens included 73 intraocular
      and 8 orbital aspirates. Forty-four of the specimens were from diagnostic
      procedures, whereas 37 were obtained from surgical specimens immediately after
      enucleation. Eight FNABs (four diagnostic and four postenucleation) were deemed
      inadequate for cytologic diagnosis. Of the remaining 73 cases, 38 were diagnosed
      as malignant (34 retinoblastomas, 3 medulloepitheliomas, 1 rhabdomyosarcoma), and
      all were confirmed upon subsequent histologic examination. Four cases were
      diagnosed as suspicious for malignancy; all of them proved to be malignant (two
      retinoblastomas, two rhabdomyosarcomas). One orbital aspirate contained cells
      suggestive of a glial origin and was confirmed histologically as pilocytic
      astrocytoma. Ten cases were reported as compatible with Coats' disease; all were
      confirmed to be benign by histologic examination (three cases) or clinical follow
      up (seven cases). The remaining 20 benign aspirates (13 with inflammatory cells,
      6 with macrophages and 1 with blood) proved to be from benign conditions by
      histologic examination (4 cases) or clinical follow-up (16 cases). There were no
      false-positive diagnoses. The overall accuracy of FNAB was 95%, and the accuracy
      of cytologic interpretation was 100%. We conclude that FNAB is a reliable and
      accurate diagnostic modality in the assessment of selected pediatric ophthalmic
      diseases.

PMID- 8465630
TI  - Fine needle aspiration cytology of oral cavity and jaw bone lesions. A report of
      102 cases.
AB  - Fine needle aspiration cytology of oral cavity and jaw bone lesions was performed
      on 102 patients. The cytologic diagnoses were compared with the results of
      histologic examination. Thirteen of the 15 histologically malignant lesions and
      71 of the 87 histologically benign lesions were cytologically diagnosed
      accurately. In 12 (92%) of the malignant and 69 (97%) of the benign lesions,
      specific cytologic diagnoses were given that proved the same or very similar to
      the final histologic diagnoses. This study showed that the overall accuracy of
      fine needle aspiration cytology in the oral cavity and jaw bones is high and is
      not significantly different from that obtained in other body regions.

PMID- 8465631
TI  - Fine needle aspiration cytology of cutaneous metastases.
AB  - By fine needle aspiration biopsy, 58 cases of cutaneous metastases were
      clinically and cytologically diagnosed at the Hines Veterans Administration
      Hospital from January 1987 to December 1990. Immunologic and electron microscopic
      studies affirmed the diagnosis and in some instances defined the primary
      neoplasm. The age of the patients ranged from 54 to 83 years (mean, 65). All were
      men. Two groups of patients emerged: group 1, 37 patients with known cancer,
      constituted the majority (64%). Group 2 consisted of 21 patients with cutaneous
      metastasis as the presenting sign (36%). Our patient survival times, a few weeks
      to 16 months (average, 4 months) are consistent with previous reports.

PMID- 8465632
TI  - Crystalline bodies in cervical smears. Clinicocytologic correlation.
AB  - We examined 6,132 cervical smears, applying strict criteria separating hematoidin
      cockleburrs from crystalline bodies. We found only crystalline bodies in 37
      cases. There was a significant increase in the incidence of crystalline bodies in
      women taking oral contraceptives and in pregnant women. The bodies were not
      associated with an increase in complications of pregnancy or of abnormal births.
      A review of the literature led us to the conclusion that in cervical smears two
      types of crystalline structures may be found. One of these is the hematoidin
      body, which is related to hemorrhage during pregnancy and is probably associated
      with an increase in complications of pregnancy or abnormal births; the other,
      crystalline bodies, is not. We also conclude that crystalline bodies are much
      more common than hematoidin bodies. We found an unexpectedly high association of
      crystalline bodies with low grade squamous intraepithelial lesion (CIN1) in
      cervical smears.

PMID- 8465633
TI  - Comparison of morphologic features of benign hepatocytes associated with
      nonmalignant and malignant liver lesions.
AB  - In fine needle aspirates (FNAs) of focal liver lesions, the absence of neoplastic
      cells and presence of hepatocytes with prominent reactive changes often raise the
      question of whether the lesion was adequately sampled or whether the aspirate
      represents an area adjacent to the neoplasm. To study this problem we reviewed 51
      FNAs of focal liver lesions: 29 metastatic deposits, 4 primary malignancies and
      18 nonneoplastic lesions. Fifteen cytologic features were scored on a scale of 0
      3 by two independent observers using conventional light microscopy. Hepatocytes
      in 18 aspirates of nonneoplastic lesions showed considerable degrees of
      cytoplasmic vacuolation, nuclear enlargement, cytoplasmic pigmentation,
      binucleation, anisonucleosis and intranuclear inclusions. In contrast,
      hepatocytes in 29 aspirates of metastatic deposits displayed a considerably lower
      degree of some of these features (cytoplasmic pigment, binucleation,
      anisonucleosis and nuclear enlargement.) The four aspirates of hepatocellular
      carcinoma showed nuclear enlargement of hepatocytes comparable to that in the
      nonmalignant aspirates; other accompanying features, however, were less
      conspicuous. We conclude that marked cytologic alterations in hepatocytes are
      seen most frequently in FNAs of nonneoplastic liver lesions, such as focal
      nodular hyperplasia, cirrhosis, abscess and hepatitis, and that hepatocytes
      accompanying metastatic deposits typically show less-pronounced cytologic
      alterations.

PMID- 8465634
TI  - Fine needle aspiration biopsy of the spleen in the evaluation of neoplastic
      disorders.
AB  - Splenic fine needle aspiration (FNA) biopsy has been used mainly in Europe to
      diagnose nonneoplastic systemic diseases. A few reports have described FNA biopsy
      of the spleen for the diagnosis of lymphoma. There is a definite paucity of North
      American reports concerning FNA biopsy for metastatic disease involving the
      spleen; that probably is a reflection of both the relative infrequency of splenic
      metastases and concern about potential hemorrhagic complications of the
      procedure. We report a series of 11 FNA biopsies of the spleen in patients with
      known carcinoma or hematologic malignancies. The FNA biopsies were performed on
      eight males and three females with a median age of 45 years and a range of 6-77
      years. Six patients had a known hematopoietic malignancy at the time of
      aspiration (five non-Hodgkin's lymphoma, one acute myelogenous leukemia [AML]).
      The one patient with Hodgkin's disease had an FNA biopsy of the spleen as part of
      the initial workup; cytologic impression was atypical lymphoid cells with
      granulomas suggestive of Hodgkin's disease, which was confirmed by splenectomy.
      Four patients with carcinoma (two testicular, one lung, one ovarian) had FNA
      biopsies for the evaluation of splenic nodules; FNA biopsy confirmed metastatic
      carcinoma in three of these patients. In the entire series splenic FNA biopsy
      documented malignancy in 6 of the 11 patients. The one patient with AML had
      Aspergillus identified in the splenic aspirate, while granulomatous inflammation
      with yeast consistent with Candida was seen in a patient with non-Hodgkin's
      lymphoma. One aspirate demonstrated abscesses without recognizable organisms, and
      another showed extensive necrosis in a patient with testicular choriocarcinoma.
      Only one hemorrhagic complication was noted following splenic biopsy. Our
      experience demonstrates that FNA biopsy of the spleen is a useful and safe
      procedure in evaluating infectious and neoplastic splenic masses in patients with
      hematopoietic malignancies and carcinoma.

PMID- 8465635
TI  - Accuracy of urinary cytology in the diagnosis of primary and recurrent bladder
      cancer.
AB  - Two thousand two hundred thirteen smears of urinary specimens from 263 patients
      with bladder disorders were reviewed and the results correlated with the clinical
      status at the time of urine collection and with the histologic diagnosis during
      follow-up. In all cases a cytologic diagnosis of malignancy was histologically
      confirmed at follow-up, reflecting the high predictive value of a positive result
      in cytology. Cytologic diagnoses were also analyzed for the interval between the
      cytologic and histologic diagnosis of malignancy. In cases of cytologic diagnosis
      of malignancy, at times without a clinical suspicion of severe abnormality, an
      interval of up to 691 days was registered before a malignant process was
      confirmed histologically. Furthermore, the influence of tumor grade and mode of
      therapy on the diagnostic accuracy of urinary cytology was evaluated. The
      accuracy of urinary cytology differed clearly between untreated and treated
      patients with both high and low grade tumors. Patients who received surgical
      therapy, radiotherapy and chemotherapy were grouped into three groups. Accuracy
      of cytologic diagnosis was calculated in relation to variations in therapy and in
      tumor grade. Minor differences in accuracy were found between specimens from
      patients after surgical therapy, chemotherapy and radiotherapy. The data from
      this study suggest that the diagnostic accuracy of urinary cytology is very much
      related to the histologic grade of bladder tumors, to pretreatment and
      posttreatment status, and only minimally to the mode of therapy itself (e.g.,
      radiotherapy, chemotherapy or surgical therapy). The high percentage of cytologic
      diagnoses of atypia in specimens from patients undergoing chemotherapy and
      radiotherapy reflects the diagnostic problems.

PMID- 8465636
TI  - Fine needle aspiration of abdominal fat for the diagnosis of amyloidosis.
AB  - Amyloidosis is a dysproteinemia characterized by extracellular deposition of
      amyloid fibrils. Its diagnosis depends on the demonstration of the characteristic
      apple-green birefringence in tissue stained with Congo red. Aspiration of
      subcutaneous fat as a means of procuring tissue has received attention in the
      internal medicine literature. However, this application of fine needle aspiration
      biopsy has not been investigated extensively by cytopathologists. We therefore
      report our experience. Over the past two years we performed 18 aspirations of
      subcutaneous fat on 17 patients in whom amyloidosis was clinically suspected.
      Eight aspirates were positive for amyloid, and nine were negative. There were no
      known false-negative results. False positives were more problematic, occurred
      early in our experience and were due to overinterpretation of occasional long,
      slender, green strands representing collagen. The true positives were all
      characterized by large numbers of short, apple-green strands intimately
      associated with the fat, oriented in multiple directions and occurring in much,
      if not all, of the aspirated fat. Attention to details of the aspirated material
      other than the presence or absence of apple-green birefringence can lead to a
      correct distinction between amyloid and collagen. We conclude that abdominal fat
      pad aspiration is useful in the workup of suspected amyloidosis, especially since
      it is a safe, easily performed procedure.

PMID- 8465637
TI  - Epidemiology of cervical carcinoma in Brunei Darussalam. Analysis of data on
      27,208 women screened with cytologic examinations.
AB  - During the five-year period from January 1985 to December 1989 a total of 27,208
      women, representing 44.0% of the total female population over age 15 years in
      Brunei Darussalam, underwent a cytologic examination. The majority of them were
      Malays (62.32%), followed by Chinese (22.23%), while the remainder were the
      expatriate population living in the country. High grade squamous intraepithelial
      lesion (moderate dysplasia) was detected in 88 women (3.3/1,000), high grade
      squamous intraepithelial lesion (carcinoma in situ) was seen in 32 women
      (1.22/1,000), and invasive carcinoma was found in 43 women (1.37/1,000). The
      overall detection rate for cervical cancer was 2.79/1,000 women in the population
      screened. In Brunei Darussalam Malay women marry at an early age, 44% by the age
      of 19 years, leading to sexual contact before the age of 20. However, the
      incidence of cervical cancer is low among them. This could be because they belong
      to the Orthodox Muslim Society, in which promiscuity is not permitted. Hence,
      multiple sex partners could be an important factor in the etiology of cervical
      cancer, confirming the current trend of thought that cervical cancer is a
      sexually transmitted disease. A comparison of the epidemiologic risk factors
      among the various races living in Brunei Darussalam is made.

PMID- 8465638
TI  - Helicobacter pylori infection. Rapid diagnosis with brush cytology.
AB  - The validity of brush cytology of the gastric mucosa with Diff-Quik rapid
      staining was studied in 69 samples, and its effectiveness was compared with two
      other techniques (culture and urease test). Brush cytology is the method of
      choice for detecting Helicobacter pylori since it is rapid, easy to perform and
      has good sensitivity and specificity.

PMID- 8465639
TI  - Sinus histiocytosis with massive lymphadenopathy. Report of a case with fine
      needle aspiration cytology.
AB  - Sinus histiocytosis with massive lymphadenopathy is usually a benign disorder
      with spontaneous remission, although a protracted clinical course with death has
      been reported rarely. The author reports a case diagnosed by fine needle
      aspiration cytology, the clinical utilization of which is discussed.

PMID- 8465640
TI  - Splenic fine needle aspiration biopsy in the diagnosis of lymphoreticular
      diseases. A report of four cases.
AB  - Splenic fine needle aspiration biopsy (FNAB) is rarely performed in the United
      States for several reasons: there is a perception that there is an increased risk
      of bleeding, and rendering a diagnosis of lymphoma (the most common primary
      splenic neoplasm) by FNAB is controversial. During a three-year period, we saw 11
      cases of splenic FNAB. We present four cases of lymphoreticular neoplasms
      occurring between 1988 and 1991 in which the spleen was the only or most
      accessible organ in which to establish a diagnosis by FNAB: one case of small
      cleaved cell lymphoma, two cases of immunoblastic lymphoma (one T cell, one B
      cell by immunophenotyping studies) and one case of hairy cell leukemia in which
      the disease was confined to the spleen. All FNABs were radiologically guided,
      none of the patients suffered significant complications, and all had specimens
      sufficiently cellular to establish the diagnosis. Splenic puncture with FNAB may
      be an important and underutilized procedure for establishing a diagnosis in
      patients who have undetectable disease at other sites.

PMID- 8465641
TI  - Cytomorphology of subependymal giant cell astrocytoma. A case report.
AB  - Cytologic smears made from minute fragments of tissue removed during
      neurosurgical procedures are a useful alternative to frozen sections for rapid
      diagnosis. We describe the cytomorphologic features of a rare brain neoplasm,
      subependymal giant cell astrocytoma (SEGA). On cytologic grounds this neoplasm is
      difficult to separate from gemistocytic astrocytoma. The clinical presentations
      of the two neoplasms, however, are quite distinct, with SEGA an intraventricular
      neoplasm mostly seen in young adults with tuberous sclerosis, whereas
      gemistocytic astrocytoma occurs in the cerebral hemisphere of older adults.

PMID- 8465642
TI  - Fine needle aspiration biopsy of a cutaneous relapse of lymphomatoid
      granulomatosis. A case report.
AB  - We present the cytopathologic features of lymphomatoid granulomatosis in a case
      affecting the subcutaneous tissue. Atypical lymphocytes mixed with histiocytes
      and well-formed granulomas were the main findings. Fine needle aspiration biopsy
      can be a useful method of diagnosing subcutaneous relapses in lymphomatoid
      granulomatosis. To our knowledge, this is the first case report of these
      characteristics.

PMID- 8465643
TI  - Barium sulfate crystals in a fine needle aspiration biopsy specimen from a neck
      mass in a patient with squamous cell carcinoma. A case report.
AB  - A fine needle aspirate of a neck mass in a 79-year-old man with a previous
      laryngectomy for squamous cell carcinoma was submitted for examination. In
      addition to cytologic findings of squamous cell carcinoma, there were numerous
      birefringent crystals of varying shapes and sizes. Energy dispersive x-ray
      analysis confirmed that these crystals were barium sulfate. Recognition of barium
      sulfate crystals in a fine needle aspiration or other cytologic specimens is
      important since barium granulomas may mimic neoplasms clinically. Barium sulfate
      may also indicate rupture of an organ or the presence of a fistula.

PMID- 8465644
TI  - Primary aspergillosis of the breast. Report of a case with fine needle aspiration
      cytology diagnosis.
AB  - We report an unusual case of primary Aspergillus flavus fungal colonization in a
      subareolar breast mass in a middle-aged woman. The patient was clinically normal,
      with no evidence of immunosuppression. Fine needle aspiration cytology was
      carried out as a routine procedure to rule out malignancy, and Aspergillus
      infection was diagnosed on cytology. Cultures from fine needle aspiration
      cytology and the surgical biopsy material yielded a heavy growth of A flavus. The
      etiology and pathology of this fungal lesion presenting as a breast mass are
      discussed.

PMID- 8465645
TI  - Sebaceous variant of mucoepidermoid carcinoma of the salivary gland. A case
      report with cytohistologic correlation.
AB  - The findings on fine needle aspiration biopsy cytology of a case of sebaceous
      variant of mucoepidermoid carcinoma of the parotid gland are described. The
      aspirates consisted predominantly of uniform intermediate-type epithelial cells,
      which led to erroneous diagnosis of a benign neoplasm. The cytologic features of
      the intermediate, clear, mucinous and sebaceous cells were correlated with the
      different histologic patterns seen within the neoplasm. Problems encountered with
      the diagnosis are discussed.

PMID- 8465646
TI  - Diagnosis of primary nerve sheath tumor of the sphenoid sinus by fine needle
      aspiration biopsy. A case report.
AB  - This paper describes the aspiration cytologic characteristics of a histologically
      proven cellular schwannoma of the sphenoid sinus. The aspirate contained several
      large clusters of spindle-shaped cells in a compact, fascicular pattern.

PMID- 8465647
TI  - Hodgkin's disease beginning as a thyroid nodule.

PMID- 8465648
TI  - Respiratory epithelium in aspirates of thyroid gland lesions.

PMID- 8465649
TI  - Amyloid goiter in fine needle aspirates.

PMID- 8465650
TI  - Origin of foam cells in breast tissue.

PMID- 8465651
TI  - Nucleolar organizer regions in human maxillary sinus squamous cell carcinoma.
AB  - A silver colloid technique for nucleolar organizer regions (AgNOR) was applied to
      paraffin sections of maxillary sinus squamous cell carcinomas (MSSCC) of 25
      patients. The patients were divided into two groups, one with MSSCC recurring in
      the primary lesion after treatment with radiotherapy, chemotherapy and/or surgery
      and one without recurrence. Notable differences between the numbers of NOR in
      neoplastic epithelia and the normal mucosa were observed (P = 0.0001), but there
      were no differences between the numbers of NOR in the recurrent and non-recurrent
      carcinomas. This investigation found no prognostic importance in the number of
      AgNOR in MSSCC.

PMID- 8465652
TI  - Gastric cytoprotection: morphological perspectives.
AB  - In 1979, a new mechanism of gastric defense named cytoprotection was followed by
      numerous reports elucidating this interesting and important phenomenon. During
      this decade, however, the concept and definition of gastric cytoprotection have
      been modified from the morphological and ultrastructural viewpoints. This review
      attempts to describe the concept and mechanisms of cytoprotection as well as its
      pathophysiological features. Specifically, in vitro studies using isolated cells
      or monolayer cultured cells as well as molecular investigations of signal
      transduction system have been documented.

PMID- 8465653
TI  - DNA ploidy and stromal bone formation as prognostic indicators of thyroid
      papillary carcinoma in aged patients: a retrospective study.
AB  - The prognostic value of flow cytometry for thyroid papillary carcinoma in aged
      patients was studied and compared with that of tumor histology. Seventy-five
      surgically removed primary papillary thyroid carcinomas larger than 30 mm in
      diameter were obtained from patients over 60 years of age. A subtotal
      thyroidectomy with modified radical neck dissection was performed in all
      patients. Sixteen female patients died of the carcinoma (non-survivors) and 18
      survived longer than 12 years without recurrence (survivors). Histologically,
      papillary carcinoma was subclassified into poorly and well differentiated types,
      and the presence of stromal bone formation was noted. Flow cytometry was
      performed using paraffin-embedded materials. The incidence of the poorly
      differentiated type was 2/18 among the tumors of survivors and 6/16 among the
      tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the
      tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of
      the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of
      non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the
      remaining six tumors of the non-survivors, two showed a third peak at 6C and one
      showed a higher S fraction. Therefore, only three showed a DNA diploid pattern
      that was indistinguishable from that of the survivors. These results suggest that
      flow cytometry is useful for estimating the prognosis of thyroid papillary
      carcinoma.

PMID- 8465655
TI  - Silver-binding argyrophilic nucleolar organizer regions (AgNOR) in gall-bladder
      cancer: correlations with malignant grading and prognosis.
AB  - Silver-binding nucleolar organizer regions (AgNOR) were investigated and compared
      in 43 cases of gall-bladder cancers and 10 normal gall-bladder samples using an
      image analyzer. The mean numbers of AgNOR per nucleus (AgNOR number) were 3.28 +/
      1.38 in the gall-bladder cancers and 1.86 +/- 0.20 in the normal gall-bladder
      cases. The respective mean areas of AgNOR per nucleus (AgNOR area) were 6.96 +/-
      3.78 microns2 and 1.89 +/- 0.21 microns2. The differences were statistically
      significant (P < 0.0001) for both parameters. In addition, increased frequency
      and enlargement were both apparently correlated with poor prognosis (P < 0.011
      and P < 0.046, respectively), with AgNOR number and AgNOR area showing tendencies
      for increase in cases of histologically high grade malignancy, advanced cancer
      and regional lymph node involvement. In conclusion, AgNOR number and AgNOR area
      appear to be useful indicators for the grading of malignancies and for the
      prediction of gall-bladder cancer prognosis.

PMID- 8465654
TI  - Pulmonary vasculature in idiopathic dilated cardiomyopathy: a morphometric study.
AB  - The pulmonary vascular alterations of seven patients with idiopathic dilated
      cardiomyopathy (IDC) were morphometrically examined, and the relation between the
      vascular alterations and morphological status of the hearts was studied. Most
      patients with IDC showed not only fibrous thickening of small pulmonary veins but
      also intimal circumferential fibrosis and medial hypertrophy of small pulmonary
      muscular arteries to various degrees. The histological features of the pulmonary
      vessels were compatible with hypertensive vascular changes observed in patients
      with mitral stenosis. There was a significant correlation between medial
      hypertrophy of the pulmonary muscular arteries and right ventricular hypertrophy.
      The pulmonary vascular changes in IDC were always associated with left
      atrioventricular dilatation, but were only found in patients with prominent
      hypertrophy of the left ventricles. Medial hypertrophy of the pulmonary muscular
      arteries was related more to left ventricular hypertrophy than to left
      ventricular dilatation. These findings suggest that the pulmonary vascular
      changes in IDC are caused by venous pulmonary hypertension, which may be
      developed at the late stage when left ventricular hypertrophy predominates.

PMID- 8465656
TI  - Clinicopathologic study of primary mediastinal non-lymphoblastic non-Hodgkin's
      lymphomas among the Japanese.
AB  - We studied the morphologic, immunologic and clinical features of 14 cases of
      primary non-lymphoblastic non-Hodgkin's lymphomas of the mediastinum. The
      patients ranged in age from 3 to 76 years, with a median age of 28 years.
      According to the Ann Arbor classification, 71% of our cases were in an early
      stage. Three cases were in Stage I, eight in Stage II, one in Stage III and two
      in Stage IV (one with multiple hepatic lesions and another with bone marrow
      involvement). The patients were heterogeneous in terms of the disease and were
      therefore histologically classified into three categories: diffuse large B cell
      lymphoma with sclerosis (DLS; n = 8); large cell anaplastic lymphoma (LC-Ana; n =
      5); and low grade B cell lymphoma of mucosa-associated lymphoid tissue (MALT
      lymphoma; n = 1). DLS was the most common group and was characterized as CD5-,
      CD10-, CD19+, CD20+, CD21- and CD22+. Imprint smears showed azurophilic granules
      in the cytoplasm of the tumor cells of three of four DLS cases. All of the six
      cases examined were negative when tested for Epstein-Barr virus (EBV) sequences
      after hybridization with the EBV internal repeat probe. DLS and MALT lymphoma
      cases were of a B-lineage lymphoma of the thymus, while most of the LC-Ana cases
      were of a T-lineage lymphoma. Patients with non-lymphoblastic non-Hodgkin's
      lymphomas had a relatively favorable prognosis compared with lymphoblastic
      lymphoma (P < 0.01 by the generalized Wilcoxon test). There was no significant
      difference in the survival between non-lymphoblastic non-Hodgkin's lymphoma and
      Hodgkin's disease (P > 0.05 by the generalized Wilcoxon test).

PMID- 8465657
TI  - Multiple penetrating colonic ulcers in secondary amyloidosis caused by rheumatoid
      arthritis.
AB  - An autopsy case of multiple penetrated colonic ulcers with secondary amyloidosis
      caused by rheumatoid arthritis in a 61 year old woman is reported. Amyloid
      deposition was conspicuous in the transverse colon with numerous penetrating
      ulcers that were circumferentially scattered. Deposition was mainly in the small
      vessel walls of the submucosal layers. In the quantitative comparison of the
      histological components between the colonic segments affected by severe and mild
      ulcer formation, occlusive vascular amyloid deposition was revealed more
      frequently in the severe involved portion than in the mild involved portion. In
      addition, submucosal fibrosis that tended to appear around ulcers was more
      extensive and thicker in the former than in the latter. The complete vascular
      occlusion caused by amyloid deposition was particularly concentrated in the
      submucosal layer adjacent to the ulcer. These findings indicate that peripheral
      circulatory disturbance by amyloid deposition in the small vascular walls leads
      to ulcer formation in the colon.

PMID- 8465658
TI  - Inflammatory pseudotumor of the stomach: report of a highly infiltrative case
      with electron microscopic and immunohistochemical studies.
AB  - A large, poorly demarcated, elevated lesion over the area ranging from the lower
      end of the esophagus to the lesser curvature of the cardiac region was examined
      in a 19 year old woman, and demonstrated an irregular and highly infiltrative
      proliferation of spindle cells over the full thickness of the gastric wall.
      Although the spindle cells grew mainly in the submucosa, they penetrated the
      muscularis propria, leaving intact muscle tissue that formed an irregular, island
      like pattern, and reached the subserosa. The cells were identified as
      myofibroblasts by light microscopy, immunohistochemistry and electron microscopy.
      The present case is considered to be of an inflammatory pseudotumor due to
      extremely infiltrative growth of myofibroblasts. This lesion differed from
      inflammatory fibroid polyp (similarly consisting of proliferating myofibroblasts
      accompanied by inflammatory cells) in terms of age at onset, tumor size, pattern
      of cell proliferation and main inflammatory cell component. This report also
      discusses the relationship between this lesion and a very recently advocated new
      entity, inflammatory fibrosarcoma of the mesentery and retroperitoneum, which is
      a tumour closely simulating inflammatory pseudotumor.

PMID- 8465659
TI  - Primary leiomyosarcoma of the thyroid gland.
AB  - A primary leiomyosarcoma of the thyroid gland in a 72 year old Japanese woman is
      described. This is the second case reported in the English literature. The
      patient presented with a 7 month history of a gradually expanding tumor in the
      right neck. The surgical specimen taken by thyroid lobectomy revealed a
      relatively well demarcated tumor, 2 x 2 x 3 cm in size, confined to the right
      lobe. Histologically, the tumor showed a classical leiomyosarcomatous appearance
      of interlacing fascicles of spindle-shaped cells with occasional blunt-ended
      nuclei and a high frequency of mitotic figures. Immunohistochemistry of the tumor
      cells clearly showed smooth muscle differentiation; the cells were positive for
      desmin, muscle-specific actin and vimentin and negative for cytokeratin,
      epithelial membrane antigen, carcinoembryonic antigen, thyroglobulin and
      calcitonin. The patient was free of disease for 3 years and 11 months without
      further treatment when evidence of multiple bone metastases appeared on bone
      scintigraphy. She died of pneumonia 4 years and 3 months after the lobectomy.

PMID- 8465660
TI  - An autopsy case of pulmonary artery leiomyosarcoma.
AB  - A case of pulmonary artery leiomyosarcoma in a 37 year old Japanese man is
      reported. The patient complained of chest pain and hemosputum. CT scan and
      angiography revealed that a tumor arose from the right main branch of the
      pulmonary artery. The surgical specimen was interpreted as an undifferentiated
      sarcoma at this time. The tumor recurred 6 months after the resection, and he
      died of right-sided heart failure. At autopsy, the pulmonary artery truncus was
      distended by the tumor, which protruded into the lumen. The tumor was composed of
      pleomorphic cells, giant cells and spindle-shaped cells. Many of the tumor cells
      were immunohistochemically positive for alpha-smooth muscle actin and vimentin.
      Electron microscopy revealed microfilaments with dense bodies in the cytoplasm
      and a discontinuous basement membrane around the cells. Although adenocarcinoma
      was also observed in the colon, the authors conclude that the present tumor is
      not a metastasis but a primary leiomyosarcoma arising from the pulmonary artery.
      Imaging techniques were very useful for differentiating sarcoma from thrombus in
      this site, and immunohistochemical demonstration for alpha-smooth muscle actin
      was necessary for making a histological diagnosis of leiomyosarcoma.

PMID- 8465661
TI  - Carcinoma of the gall-bladder arising in adenomyomatosis.
AB  - We describe a case of well differentiated adenocarcinoma of the gall-bladder that
      arose from a localized type of adenomyomatosis. Grossly, the cancer was located
      in the fundus and exhibited a polypoid and well demarcated nodule with multiple
      small cysts. Histologically, the nodule consisted of glandular structures and
      stroma containing bundles of smooth muscle cells. The glandular epithelia were
      varied in appearance, ranging from malignant to benign glands. The adenocarcinoma
      was limited to the nodule, with normal surface mucosal epithelia and without
      obvious stromal invasion.

PMID- 8465662
TI  - The round table in a community-based outpatient service.
AB  - The community-based outpatient service of Berne has used the round table for 8
      years. It has become a strong element of the care of long-term outpatients. The
      aim of the present study is to examine how the round table is used and estimated
      by the patients: whether it only fulfils the function of a psychosocial contact
      facility to reduce social isolation or whether it has other helpful functions of
      social relationship. Further, we were interested to find out which of the
      therapeutic factors in group therapy are of importance. Four major factors could
      be elaborated by factor analysis: the functions and the importance of the
      caretakers at the round table, the acceptance and social integration of the
      patients and psychotherapeutic factors such as self-disclosure and vicarious
      learning. The round table is not only a social contact facility but also a new
      form of an informal, open, socio-therapeutic group.

PMID- 8465663
TI  - Autoimmunity in depression: increased antiphospholipid autoantibodies.
AB  - Some groups have recently reported higher titers of autoantibodies in depressed
      subjects than in normal controls. The present study investigates whether
      depressed patients exhibit increased antiphospholipid antibody titers compared
      with normal controls. The authors measured the binding index (BI) of
      antiphosphatidylserine (APSA), antipartial thromboplastin (APTA) and
      anticardiolipin (ACA) in 22 minor, 23 simple major and 20 melancholic
      depressives, 10 healthy controls and 104 normal controls with negative
      autoantibody sera. Depressed subjects exhibited significantly higher APSA and
      APTA antibody titers compared with normal controls. A large number of depressed
      subjects (+/- 54%) showed APTA and APSA positivity, defined as BI > or = 2
      standard deviations above the mean BI of normal controls. There was a significant
      discrimination (> or = 2.8 standard deviations) between melancholic subjects and
      healthy controls with respect to BI of ACA, APSA and APTA. However, by using a
      more conservative value for phospholipid positivity (i.e., BI > or = 5 standard
      deviations above the mean BI of a reference sample of normal sera), the subject's
      autoantibody titers were, on the whole, within the normal range. Our results
      point towards a higher expression of antiphospholipid antibodies during
      depression but a much lower incidence of positive patients than in classical
      autoimmune disorders, such as systemic lupus erythematosus.

PMID- 8465664
TI  - Blinking, alpha brain waves and smoking in schizophrenia.
AB  - Blink rates (BR) and alpha brain waves were studied in 13 schizophrenic and 13
      healthy smokers under conditions of smoking deprivation as well as smoking
      saturation and under different task conditions of smooth pursuit eye movements.
      Task conditions significantly changed BR and alpha power; smoking enhanced BR and
      alpha frequency, the latter effect being especially pronounced in schizophrenics
      for F3-F4 leadings. Concerning BR, groups differed significantly as long as
      smoking quantity was not statistically controlled. BR, alpha power and smoking
      quantity were consistently correlated above chance levels. Results are discussed
      with respect to the blink alpha neurocircuit model.

PMID- 8465665
TI  - Differences in P300 amplitudes and topography between cycloid psychosis and
      schizophrenia in Leonhard's classification.
AB  - In a polydiagnostic approach, we investigated the parameters of auditory P300 in
      a group of 18 remitted schizophrenics and in 18 age- and sex-matched controls.
      All patients fulfilled the criteria of schizophrenic disorder according to DSM
      III-R. Applying Leonhard's classification, patients were to be subdivided into 7
      cycloid psychosis and 11 Leonhard's schizophrenics. Patients with cycloid
      psychosis fulfilled the operational criteria of Brockington et al. We found
      significantly lower P300 amplitudes in the group of Leonhard's schizophrenics
      than in controls and in cycloid psychosis, whereas no difference could be shown
      between patients with cycloid psychosis and controls. Both the maxima and the
      minima of the P300 field map were dislocated significantly to the right in the
      group of Leonhard's schizophrenics but not in cycloid psychosis.

PMID- 8465666
TI  - Life events and depression in Japan.
AB  - The relationship of life events to the onset of depression as well as the
      relationship between positive family history and reactivity to stress were
      investigated. Our results indicated that life stress in general plays an
      important role for women in the onset of depression and that undesirable events
      and problems of work specifically play a role in the onset of depression. The
      dichotomy of reactive and endogenous depression was not supported based on our
      result that no relationship was observed between the presence of familial loading
      and reactivity to stress.

PMID- 8465667
TI  - Comparative study of classification of psychosis of childhood and adolescent
      onset.
AB  - Classification of psychosis in childhood and adolescence has always been
      controversial due to the possible developmental modulation of symptom expression.
      Major classificatory systems have no special criteria for children, and recommend
      the use of adult criteria. Hence, this study aimed to study the nosology of
      psychosis of childhood and adolescence, using adult criteria (ICD-9, ICD-10 and
      DSM-III-R). Fifty subjects between the age of 5 and 16 years who met the ICD-9
      definition of psychosis were studied using the Intake Sheet for Adolescents:
      cross-cultural study and the Interview Schedule for Children and Adolescents.
      Most of the subjects could be classified into one of the major functional
      psychosis categories, indicating the applicability of adult criteria in children
      and adolescents.

PMID- 8465668
TI  - The prevalence of mental disorders in school-age children attending a general
      paediatric department in southern India.
AB  - This study was conducted over a period of 18 months in a medical college hospital
      in southern India. Of 313 children of age 5 and above referred for detailed
      psychiatric evaluation, 101 were found to have a mental disorder according to DSM
      III-R criteria; the remaining had organic disorders. Children above 8 years (74%)
      registered higher morbidity. There was no sex difference in overall morbidity.
      Precipitating factors were discernible in half of these cases, of which school
      related problems were found in the majority. Almost two-thirds had multiple
      stressors, of which chronic family and social adversity (39%) and learning
      disabilities (28%) were common. Mental disorders were significantly related to
      urban background, middle-class socioeconomic status and literate parents compared
      with age- and sex-matched controls. There was no significant relationship with
      the type of family and number of siblings. Conversion disorder (31%) was the
      commonest, followed by conduct disorders (16%). The symptoms, stressors, response
      to treatment and the transcultural aspects are also discussed.

PMID- 8465669
TI  - Ethnicity as a risk factor for mental illness. A population-based study of 338
      Latin American refugees and 996 age-, sex- and education-matched Swedish
      controls.
AB  - This article shows the influence of ethnicity on mental health compared with
      material factors and lifestyle, which are well-known risk factors for mental
      illness. The study was designed as a case-control study, with 338 Latin American
      refugees aged 16-74 years (response rate = 81.8%) in Lund, and a random sample of
      996 age-, sex- and education-matched Swedish controls. The data were analysed
      unmatched with logistic regression in main effect models. The strongest
      independent risk mediator for mental illness was ethnicity, with an estimated
      odds ratio of 4.11 (2.31-6.92). Low material standard was associated with mental
      illness, with an odds ratio of 2.13 (1.07-4.11). Individuals who did not feel
      secure in daily life were at risk of mental illness, as were those with poor
      leisure opportunities. The combination of ethnicity, age over 44, and not feeling
      secure in daily life increased the odds ratio of mental illness to 26.62.
      Ethnicity, a low material standard, not feeling secure in daily life and poor
      leisure opportunities were significant risk factors for mental illness.

PMID- 8465670
TI  - Interhemispheric electroencephalographic coherence as a biological marker in
      alcoholism.
AB  - Electroencephalographic coherence scores in 21 teetotaler first-degree relatives
      of alcoholics, 27 subjects with alcohol dependence and 21 healthy subjects
      without a family history of alcohol abuse were compared. The relatives had
      significantly higher coherence scores in the frontal and parietal leads than the
      alcoholics and in the frontal and centroparietal leads than in the healthy
      subjects. This might represent a trait marker of resilience in subjects at high
      risk for the development of alcoholism.

PMID- 8465671
TI  - Abnormal perception of body weight is not solely observed in pubertal girls:
      incorrect body image in children and its relationship to body weight.
AB  - Perceived actual body weight and perceived ideal weight were assessed in 255
      Japanese children and adolescents (130 boys, 125 girls) aged 6 years through 18
      years using the drawing test to clarify whether they wanted to be thinner or to
      gain weight. More than half (68%) of the girls attending high school and 41% of
      the elementary school girls perceived their ideal weight to be less than the
      standard. The mean difference between the perceived actual weight and the ideal
      weight was positive in the high school girls of normal weight as well as in the
      overweight girls, meaning that even the normal-weight girls wanted to lose
      weight. The difference was also slightly positive in the underweight girls. The
      difference in the high school boys was negative, demonstrating that they wished
      to gain weight. It is suggested that girls want to lose weight even before
      adolescence; this tendency becomes more prominent in the high school period and
      is mostly unrelated to their own weight.

PMID- 8465672
TI  - Controlled intoxication treatment goals and procedures for alcoholics.

PMID- 8465673
TI  - Genetic models for the natural history of smoking: evidence for a genetic
      influence on smoking persistence.
AB  - We reanalyze data from the 1981 mailed questionnaire survey of the Australian
      twin register, to test for a genetic effect on smoking persistence (whether or
      not a smoker quits smoking). In the young cohort, aged 18-30 years, there are too
      few ex-smokers to permit resolution of genetic and non-genetic models. In the
      older cohort, we find a significant and substantial genetic effect on smoking
      persistence, accounting for 53% of the variance. This genetic effect on smoking
      persistence is independent of genetic effects on smoking initiation.

PMID- 8465674
TI  - Effects of situational demands on the direction of electrodermal activation
      during smoking.
AB  - Task demands (normal smoking; sham smoking; smoking or non-smoking during complex
      cognitive performance; and, smoking or non-smoking during monotonous vigilance
      performance) were manipulated in three experiments. Smoking increased
      electrodermal activity (EDA) arousal from pre-smoking baseline. Sham smoking (as
      a control for motoric aspects) also increased EDA arousal but to a lesser degree.
      In contrast the demands of complex cognitive performance were associated with
      lower EDA arousal during smoking than during non-smoking. Finally, during
      vigilance performance smoking maintained EDA arousal which during non-smoking
      decreased. Smoking did not improve performance during complex cognitive
      processing or vigilance above deprivation performance levels. It was concluded
      that smoking did have bidirectional effects as a function of task demand.
      However, there was no evidence that these physiological changes were functional
      and the smoking behavior data gave no indication as to the cause of these
      changes.

PMID- 8465675
TI  - Predicting alcohol use among young adults.
AB  - Factors influencing alcohol use among young people were studied using a
      questionnaire administered in Oklahoma and Wisconsin to 257 single males and 358
      single females between the ages of 17-24. Predictors were broken down into the
      sets of demographics, family, religion, peer behavioral standards, approval of
      deviance, value of love and pleasure, and sex role variables. It was hypothesized
      that the predictors for alcohol use in males would differ from that of females.
      Data were analyzed separately for both male and female subjects. The multiple
      regression analysis found that the blocks of demographics, religion, peer
      behavioral standards, and approval of deviance were positive predictors for the
      use of alcohol in both males and females. The blocks, value of love and pleasure,
      and sex role variables were not found to be predictors of alcohol use in both
      males and females. Block number two (family) was found to be a predictor for
      females use of alcohol but not for males.

PMID- 8465676
TI  - Science and fascism: confronting unpopular ideas.

PMID- 8465677
TI  - Demographic, psychosocial and behavioral differences in samples of actively and
      passively consented adolescents.
AB  - Requiring active consent from parents leads to different self-reports by
      adolescents than when it is not required. The present study compares self
      reported demographic, psychosocial, and behavior variables between those students
      from whom active consent was and was not obtained. As found in previous studies,
      fewer minorities, fewer persons who were dissatisfied with school, fewer persons
      whose parents were of lower educational levels, and fewer cigarette smokers were
      represented in the sample recruited by active parental consent. Extending on
      previous work, we found those students whose parents failed to respond to the
      consent procedure were less likely to live with both parents, were more likely to
      be latch-key children, placed a lower priority on health, and were higher in risk
      taking, lower in self-esteem, and lower in assertiveness than those whose parents
      had responded. These data further support the suggestion that those children who
      are omitted from a research study because of lack of action on the part of the
      parent are at higher risk for a number of health and social problems. These
      children need to be included in evaluation samples in order to accurately assess
      the effectiveness of prevention programming. Future studies should employ a
      passive consent procedure as a means of recruiting a representative subject pool
      in school-based prevention research.

PMID- 8465678
TI  - Alcohol consumption and presenting problems in an out-patient mental health
      clinic.
AB  - Alcohol use has been shown to co-occur with a range of psychiatric disorders and
      psycho-social problems in both clinical and general population studies. The
      current survey of 683 out-patient mental health clients examined the relationship
      of self-reported alcohol use (as measured by the Quantity-Frequency index and the
      Retrospective Diary) with self-ratings of common mental health concerns. The
      South Shore Problem Inventory was developed as a brief self-report instrument to
      be used for routine assessment and research. The inventory yielded three factors
      after principal components analysis and Varimax rotation: affective/physiological
      signs and symptoms (Factor 1), interpersonal/family problems (Factor 2), and
      vocational/legal difficulties (including a self-rating of substance abuse)
      (Factor 3). MANOVA revealed that heavy drinking predicted significantly higher
      problem scores for all three factors. The SSPI showed good initial reliability
      and utility, and the three sub-scales were theoretically congruent with a social
      learning model of assessment. The use of similar problem scales and substance
      abuse indices can be used with a wider variety of both mental health and
      substance abuse treatment populations to provide routine self-report data for
      clinical and research applications.

PMID- 8465679
TI  - A sequential behavioral analysis of craving sweets in obese women.
AB  - This study compared 40 female participants in a behavioral weight loss program
      who frequently reported craving sweets to 40 who rarely reported craving sweets
      using 2-week behavioral eating diaries. The two groups were compared on
      physiological, demographic, and questionnaire measures and no significant
      differences were found. There were no significant differences in macronutrient
      intake either overall or in a wide range of specific situations. The relative
      proportions of carbohydrate, protein, and fat consumed in association with
      craving sweets differed only slightly from the composition of other meals and
      snacks. Carbohydrate and protein intake when craving sweets was similar to
      breakfasts while the relative amount of fat consumed when craving sweets was
      comparable to episodes of overeating. The two groups differed in their reporting
      of moods with the high-craving group reporting more boredom and less stress than
      the low-craving group. The relationship between situational and mood variables
      and reports of craving sweets did not differ between the two groups. Craving
      sweets was negatively associated with hunger and was not associated with meal
      skipping. A sequential analysis demonstrated that eating in response to craving
      sweets triggers an abstinence violation effect. These data are not consistent
      with the hypothesis that sweet craver's consume high-carbohydrate, low-protein
      meals and snacks in order to self-medicate depression caused by serotonin
      depletion. Instead, the data suggest that we should further explore the role of
      food palatability and food-related cognitions in order to understand craving
      sweets.

PMID- 8465680
TI  - Is there a general tendency to become addicted?
AB  - The tendency to become addicted across a number of different substances or
      activities was determined for a sample of 573 subjects, including college
      students and their parents. Four components of addiction were defined: craving,
      tolerance, withdrawal and lack of control. Subjects rated the extent to which
      each of these components characterized their relationships to each of ten
      substance/activities: coffee, tea, cola beverages, favorite alcoholic beverage,
      chocolate, nonchocolate sweets, hot chili pepper on food, cigarettes, gambling
      and video games. An "addiction score" was computed for each subject and each
      substance/activity, by summing the scores on the four components. Correlations in
      addiction scores for almost all activities were positive, but low (between 0 and
      .30), with the exception of chocolate and nonchocolate sweets, where the
      correlation was higher. The results suggest, at best, a weak tendency to become
      addicted, across a wide range of substances or activities. Other explanations for
      the low positive correlations are available, besides the notion of a general
      tendency to become addicted. There were a few significant mother-father
      correlations in various addiction scores, but none between mid-parent and child
      values. Three of the four components of addiction (craving, lack of control and
      withdrawal), were highly correlated. We conclude that there is little basis for
      the assumption of a general tendency to become addicted, a conclusion which casts
      doubt on the derivative notion of an addictive personality.

PMID- 8465681
TI  - Coping with dietary relapse crises and their aftermath.
AB  - We examined dieters' attempts to cope with dietary relapse crises (Immediate
      coping) and their aftermath (Restorative coping). We analyzed posttreatment
      interviews with 57 obese subjects with Type-II diabetes, comparing coping in
      situations in which subjects lapsed with those in which they survived temptations
      to overeat. Performance of Immediate coping predicted survival but the particular
      type of coping made little difference. Eight types of Immediate cognitive coping
      were equally associated with survival: each was significantly more effective than
      no coping and equal to the aggregate of the other types. A similar pattern held
      for 5 types of Immediate behavioral coping, except that social support was no
      more effective than no coping and restraint was less effective than the other
      types. Restorative behavioral coping was elicited as a response to overeating,
      while Restorative cognitive coping seemed elicited by the negative thoughts and
      feelings that sometimes accompany lapses or temptations. Implications for
      treatment and future research on relapse crises and coping are discussed.

PMID- 8465682
TI  - Social skills and depression in adolescent substance abusers.
AB  - The present study provided an assessment of social skills and depression in
      adolescent substance abusers hospitalized in an inpatient psychiatric setting.
      Level of social skill was evaluated using the Adolescent Assertion Expression
      Scale and the Loneliness Scale. Depression and related problems were examined
      through administration of the Beck Depression Inventory. Beck Hopelessness Scale,
      and the Rosenberg Self-Esteem Scale. Comparisons with normative values and
      clinical cut-offs (by gender) indicated that female adolescent substance abusers
      were less submissive and more aggressive than normative counterparts; male
      substance abusers exhibited less assertiveness. In addition, mild to moderate
      levels of depression were evident in both female and male substance abusers.
      Further, results of correlational analyses revealed several significant
      relationships between measures of social skills and depression. Results are
      discussed in terms of: (a) the need for finer grained analyses of social
      functioning in adolescent substance abusers, (b) the potential value of skills
      intervention for a subgroup of these individuals, and (c) the need for
      longitudinal data to more clearly explicate patterns and sequencing of social
      (mal)adjustment, affective disorder, and onset of substance abuse in this
      population.

PMID- 8465683
TI  - [Clinical use of an extracorporeal shock wave lithotriptor, Biolithos MARK III,
      for upper urinary tract stone].
AB  - The results of clinical use of an extracorporeal shock wave lithotripter
      (Biolithos MARK III) are presented. From May 1991 through February 1992, a total
      of 50 sessions were carried out on 33 patients with upper urinary tract stones.
      Treatments were performed on an outpatient basis, and none of the patients needed
      anesthesia or analgesia. One month after the last session, 18 patients (54.5%)
      were free from stone fragments and 6 (18.2%) had stone fragments equal to or
      smaller than 4 mm. The over-all successful rate obtained by these categories was
      72.7%. After treatment no serious complications were observed. Although gross
      hematuria appeared in almost all patients, pain was noted in only 5 patients.
      Laboratory data after treatments showed slight and transient changes. It is
      concluded that Biolithos MARK III is useful and safe in the management of upper
      urinary tract stones on an outpatient basis.

PMID- 8465684
TI  - [Clinical experience of percutaneous renal cyst puncture in recent six years].
AB  - Ultrasound-guided renal cyst puncture of 69 renal cysts was performed in our
      department, between April, 1986 and March, 1992. The indications for this
      procedure consisted of cysts over 4 cm in diameter and those of less than 4 cm in
      diameter with caliceal or pelvic distortion and compression. Fifty-four cysts
      were instilled with dehydrated ethanol, 10 cysts with minocycline, one cyst with
      50% dextrose as a sclerosing agent, and four cysts underwent only aspiration of
      the cyst fluid. We instilled dehydrated ethanol when the aspirated fluid was not
      bloody and there existed no extravasation of the contrast medium or communication
      between the cyst cavity and the urinary tract. The instilled volume of dehydrated
      ethanol ranged from 8 to 400 ml (average: 72.8 ml), equivalent to 35.0-100%
      (average: 62.1%) of the aspirated volume. Retention time was 20 minutes, the
      follow-up period was 2-67 months (mean follow-up period: 13.7 months), and the
      reduction rate of the cyst volume was 60.0-100% (average: 96.2%). There were no
      major complications due to puncture or dehydrated ethanol instillation.
      Ultrasound-guided renal cyst puncture was shown to be a safe non-surgical
      approach and a useful method of treating renal cysts.

PMID- 8465685
TI  - [Clinical significance of multiple mucosal biopsies in new cases of superficial
      papillary bladder tumor].
AB  - We assessed the clinical significance of multiple mucosal biopsies in new cases
      of superficial papillary bladder tumor. Biopsy findings were abnormal (5
      dysplasia, 5 transitional carcinoma) in 10 of the 71 cases examined.
      Abnormalities were observed exclusively at G2 or G3, and more frequently at pT1
      than pTa. Cases with multiple tumors showed significantly more abnormalities than
      cases with a solitary tumor. Recurrence rates were not significantly different
      between the cases with abnormal biopsy findings and those with normal findings.
      However, the invasive tumor developed more frequently in the former. Mucosal
      biopsies seemed to be more useful in cases with multiple tumors than in those
      with a solitary tumor.

PMID- 8465686
TI  - [Clinical assessments on pre-treatment prognostic factors in 138 patients with
      advanced prostatic carcinoma (stage D2)].
AB  - We investigated the prognostic factors in 138 patients with stage D2 prostatic
      cancer by univariate and multivariate analyses. Analysis was restricted to 8 pre
      treatment parameters, that is, age, general condition (PS), pain, number of
      metastases on bone scan, acid phosphatase value, Gleason's primary pattern,
      secondary pattern, and nucleoli grading. In addition, 4 therapeutic modalities
      except routine endocrine therapy, that is, castration, oral administration of
      estramustine phosphate, of 5-fluorouracil (5-FU) or its analogue, and combination
      chemotherapy, during the whole treatment period were included in the analysis.
      Univariate analysis (Kaplan-Meier method) showed only PS to be a significant
      prognostic factor. Multivariate analysis (Cox's proportional hazard model)
      revealed that PS, Gleason's primary pattern, oral administration of 5-FU or its
      analogue and combination chemotherapy were significant prognostic factors.
      However, patients treated by combination chemotherapy had poorer prognosis and
      chi 2 values of combination chemotherapy was the highest among the four
      parameters cited above. These results suggested that the 8 pre-treatment
      parameters examined in this study were not sufficient for predicting the
      prognosis of each patient.

PMID- 8465687
TI  - [Double inferior vena cava discovered by examination of traumatic rupture of
      congenital hydronephrotic renal pelvis: a case report].
AB  - A case of double inferior vena cava associated with congenital hydronephrosis is
      reported. A 6-year-old girl was referred to our hospital with the chief complaint
      of severe left flank pain of sudden onset which occurred after she fell down some
      steps. Abdominal computerized tomographic (CT) scan revealed a huge perinephric
      urinoma, severe left hydronephrosis with obstructive atrophy and double inferior
      vena cava. Left nephrectomy was performed under a diagnosis of traumatic rupture
      of the left renal pelvis associated with left congenital hydronephrosis and
      double inferior vena cava. Rupture of the renal pelvis and ureteropelvic junction
      obstruction with severe parenchymal thinning were found. The postoperative course
      was uneventful. Double inferior vena cava is a relatively rare anomaly and most
      cases in recent years have been incidentally found by ultrasonography and CT
      scan. Urologists should keep in mind the possibility of this anomaly of the
      inferior vena cava, especially when reforming left nephrectomy.

PMID- 8465688
TI  - [A case of deoxycorticosterone-producing adrenal tumor].
AB  - We present a case of a 11-deoxycorticosterone (DOC)-producing adrenocortical
      tumor. A 55-year-old female was admitted to our hospital with the chief
      complaints of sustained hypertension and weakness of lower extremities. A
      laboratory study revealed a decrease in the serum potassium level and plasma
      renin activity, a normal level of plasma aldosterone and a significant elevation
      of plasma DOC and 18-OH-DOC levels. The plasma DOC level was increased by ACTH
      stimulation and was not suppressed by dexamethasone. The tumor appeared at a low
      intensity of the T1 weighted image of magnetic resonance imaging (MRI) and at a
      high intensity on the T2 weighted image. Left adrenalectomy was performed and
      histological examination revealed a benign adrenal adenoma. Postoperatively, the
      abnormal blood pressure, serum potassium level and plasma level of DOC and 18-OH
      DOC became normal.

PMID- 8465689
TI  - [Idiopathic thrombocytopenic purpura (ITP) associated with renal injury: report
      of a case].
AB  - A 42-year-old woman with gross hematuria, left flank pain and vomit after being
      hit on her back admitted to our hospital. She has been under treatment for
      idiopathic thrombocytopenic purpura (ITP) with prednisolone for these last 14
      years. Computerized tomographic (CT) scan revealed moderate laceration,
      subcapsular hematoma and perirenal hematoma of the left kidney. We tried treating
      her conservatively. The main treatment was absolute rest for two weeks, increase
      in the prednisolone dose and prevention from infection. On the 3rd day, the
      platelet count dropped to 4,000/mm3, but transfusion of platelets was not done to
      provide for emergency. The platelet count increased gradually and returned to
      normal on the 8th day. We decreased the prednisolone dose according to the
      platelet count. After 5 weeks, microscopic hematuria disappeared. Her clinical
      course was uneventful and she was discharged after 7 weeks.

PMID- 8465690
TI  - [Renal cell carcinoma with contralateral adrenal metastasis: a case report].
AB  - A case of contralateral adrenal metastasis of renal cell carcinoma is reported.
      The patient was a 54-year-old male, who underwent a right radical transperitoneal
      nephrectomy for renal cell carcinoma, and had been administered interferon alpha
      intramuscularly. Nine months after the operation computerized tomography revealed
      the presence of an adrenal mass on the left side, undetected at nephrectomy,
      which suggested that the renal cell carcinoma had metastasized. A left
      adrenalectomy was performed. Histologically, the mass was identical to metastasis
      of renal cell carcinoma. The patient was administered supplementary
      hydrocortisone and was well 3 months after the adrenalectomy with no evidence of
      recurrence or other metastasis. This is the 24th case of contralateral adrenal
      metastasis of renal cell carcinoma in the Japanese literature.

PMID- 8465691
TI  - A case of spontaneous recanalization following renal infarction.
AB  - A 30-year-old-male was admitted to our hospital with a tentative diagnosis of
      appendicitis. We found no signs of peritonitis, and therefore suspected urinary
      tract calculi. Intravenous pyelography revealed his right kidney to be
      nonfunctional, while retrograde pyelography was normal. Angiography revealed
      right renal infarction. Renovascular hypertension was present, and treatment with
      captopril was prescribed. Two years later without medication he had normal blood
      pressure and plasma renin activity. Intravenous pyelography revealed a right
      kidney functioning well, and digital subtraction angiography (DSA) revealed
      spontaneous recanalization of his right renal artery.

PMID- 8465692
TI  - [Multifocal renal oncocytoma: a case report].
AB  - A case of multifocal renal oncocytoma in a 55-year-old man admitted for further
      examination following the detection of left renal tumors, is reported.
      Computerized tomographic (CT) scanning and magnetic resonance imaging (MRI)
      revealed 2 masses in the left kidney. A left radical nephrectomy was performed
      and two tumors were found. Both tumors were confirmed to be renal oncocytomas by
      light and electron microscopic examination. Including this patient, 42 cases of
      bilateral and multifocal renal oncocytoma have been reported in the literature to
      date. The clinical features of bilateral and multifocal renal oncocytomas are
      discussed accordingly.

PMID- 8465693
TI  - [Extracorporeal shock wave lithotripsy for ureteral stones which caused
      spontaneous peripelvic extravasation: report of three cases].
AB  - We treated 3 cases of ureteral stones which caused spontaneous peripelvic
      extravasation by extracorporeal shock wave lithotripsy (ESWL). None had histories
      of trauma or operation. The obstructing stones measured 6 x 5, 6 x 5 and 4 x 3 mm
      respectively, and each was located in a left upper, right upper and right lower
      ureter. The drip infusion pyelography (DIP) and computerized tomography (CT)
      revealed a mildly dilated collecting system and ureter of affected site and
      extravasation of contrast material around the kidneys. These stones were
      successfully crushed and discharged by ESWL performed with an EDAP LT-01 device.
      One week after the last ESWL, the DIP showed favorable urograms and extinctions
      of extravasation. As ESWL could achieve a release of calculous obstruction easily
      with a safe and non-invasive procedure, we confirmed it to be an effective
      treatment for similar types of ureteral stones causing peripelvic extravasation.

PMID- 8465694
TI  - [Bilateral ectopic ureteroceles: a case report].
AB  - The twelfth case of bilateral ectopic ureteroceles in Japan is reported. A two
      month-old girl was referred to our clinic because of urinary tract infection. Two
      large intravesical cystic lesions communicating to the dilated upper urinary
      tracts, which were compatible with bilateral ectopic ureteroceles were detected.
      Histological findings of the upper moieties of the duplex kidney showed dysplasia
      on the left side, and immaturity on the right side. Left heminephrectomy was
      performed, and a pyeloureterostomy was applied on the right side after placement
      of nephrostomy for 6 months. The ureteroceles collapsed satisfactorily to void
      smoothly. The patient has not been in trouble for more than thirty months
      postoperatively. Indications for preservation of the upper segment and
      ureterocelectomy in small infants are discussed.

PMID- 8465695
TI  - [Transurethral resection of papillary tumor in the lower end of the ureter:
      report of two cases].
AB  - Two cases of papillary ureteral end tumors, treated by transurethral resection
      are presented. Case 1: A 71-year-old female visited us for asymptomatic
      macroscopic hematuria. Cystoscopy revealed a papillary pedunculated tumor in the
      bladder protruding from the right ureteral orifice. Under a diagnosis of
      superficial tumor at the right ureteral end, transurethral resection was
      performed using a rigid ureteral resectoscope. Pathological examination revealed
      transitional cell carcinoma, grade 2 without muscular invasion. There is no
      evidence of recurrence after 25 months of follow up postoperatively. Case 2: On a
      routine cystoscopy after transurethral resection of bladder tumor in a 68-year
      old male, papillary pedunculated tumors protruding from the right ureteral
      orifice were found. Under a diagnosis of superficial tumor at the right lower
      ureter, transurethral resection was performed using cold cup forceps and loop
      electrocoagulation. The tumor was transitional cell carcinoma, grade 1 without
      invasion. No evidence of recurrence was detected 15 months postoperatively.
      Transurethral resection of the ureteral tumor at the lower end appeared to be
      useful for the selected cases. The indications, complications and follow up for
      this procedure were discussed.

PMID- 8465696
TI  - [A case of genital tuberculosis occurring in the tunica albuginea and the tunica
      vaginalis].
AB  - We report a case of genital tuberculosis occurring in the tunica albuginea and
      the tunica vaginalis. A 29-year-old man came to our department with the complaint
      of a nodule in the right scrotum. The physical and radiological examinations
      revealed no signs of pulmonary or urogenital tuberculosis. The urine and the
      semen were clear and negative in culture of acid fast bacteria, but the
      tuberculin reaction was moderately positive. Surgical exploration revealed a
      white yellowish soybean sized nodule in the surface of the tunica albuginea of
      the right testicle apart from the epididymidis, and we therefore enucleated it.
      No abnormalities were found in other parts of the tunica vaginalis, epididymidis
      or the funiculus. Histopathological examination demonstrated typical tuberculomas
      in the tunica albuginea and the tunica vaginalis, but the seminiferous tubules
      were almost intact. We diagnosed this case as tuberculosis arising in the tunica
      albuginea and the tunica vaginalis and started antituberculosis therapy.

PMID- 8465697
TI  - [A case of cholesterol granuloma with hematoma of tunica albuginea].
AB  - A case of cholesterol granuloma with hematoma of the tunica albuginea is
      reported. A 52-year-old man complained of a painless mass in the left scrotum.
      The mass was 50 x 25 x 30 mm in size. An operation was performed. Macroscopically
      the mass originated from the tunica albuginea and was a cystic lesion with a
      thick fibrous capsule. The cystic lesion was filled with an old hematoma. An
      extirpation was performed. Microscopically, the sections showed
      fibrogranulomatous tissue containing innumerable cholesterol clefts and numerous
      foreign body giant cells. The histological diagnosis was cholesterol granuloma
      with hematoma. This is the sixth case of cholesterol granuloma of the external
      genitalia, and is the first case of cholesterol granuloma with hematoma of the
      tunica albuginea in the literature.

PMID- 8465698
TI  - [Clinical experience in extracorporeal shock wave lithotripsy with Sonolith 3000
      for urinary stones].
AB  - Extracorporeal shock wave lithotripsy (ESWL) using Sonolith 3000 was performed on
      153 patients with urolithiasis form October, 1990 to April, 1992. The location of
      the stone was as follows; kidney in 70 cases, ureter in 82 cases and a Kock
      reservoir in one case. A double J catheter was installed in 6 cases before ESWL.
      Epidural anesthesia was required in 4 cases because of severe pain. Among 149
      cases available for follow up one month after ESWL, 119 cases (79.9%) became
      stone free and 19 cases (12.8%) retained stone fragments less than 4 mm in
      diameter. The effectiveness rate, calculated as the sum of the cases stated
      above, was 92.7%. A side effect was observed in one case which was perirenal
      hematoma but required no therapy.

PMID- 8465699
TI  - The family physician and lumbar disk disease.

PMID- 8465700
TI  - Folic acid for the prevention of neural tube defects.

PMID- 8465701
TI  - Food irradiation: let's move ahead.

PMID- 8465702
TI  - L-epinephrine for croup: a new study.

PMID- 8465703
TI  - Cardiovascular complications of cocaine abuse.

PMID- 8465704
TI  - Fragile-X syndrome.

PMID- 8465705
TI  - Medical malpractice.

PMID- 8465706
TI  - Warfarin therapy.

PMID- 8465707
TI  - The shortage of generalist physicians.

PMID- 8465709
TI  - Diary of a week in practice.

PMID- 8465708
TI  - The shortage of generalist physicians.

PMID- 8465710
TI  - Lumbar disk disease: pathophysiology, management and prevention.
AB  - Patients with symptomatic lumbar disk disease may present with back pain,
      referred leg pain, radicular leg pain, sensory changes and leg weakness. Because
      neurologic deficits are commonly localized to the L5 or S1 nerve roots,
      evaluation of patients with such symptoms should focus on these dermatomes and
      muscle groups. Myelography, computed tomography, postmyelogram computed
      tomography and magnetic resonance imaging are the most valuable diagnostic
      studies. Initial management consists of physical therapy and reduced activity,
      followed by gradually increasing mobilization and exercise. Conservative
      treatment is effective for most patients. Surgical treatment is reserved for
      patients who have failed to improve with conservative therapy or those who
      present with a profound neurologic deficit. Prevention of recurrent symptoms
      centers on patient education and reassurance. A program of weight control,
      regular exercise and posture correction may reduce the frequency and severity of
      recurrent disk herniation and pain.

PMID- 8465711
TI  - Methylene chloride toxicity.
AB  - The effects of acute exposure to methylene chloride (dichloromethane) are due to
      its central nervous system depressant properties, which have resulted in
      fatalities. Manifestations of acute exposure include mental confusion, fatigue,
      lethargy, headache and chest pain. Metabolic conversion of methylene chloride to
      carbon monoxide may place persons with preexisting coronary artery disease at
      increased risk. Sequelae following chronic exposure are unknown, but data suggest
      serious long-term effects. The Environmental Protection Agency considers
      methylene chloride to be a probable human carcinogen.

PMID- 8465712
TI  - Alcoholic hepatitis.
AB  - Anorexia, weight loss, fatigue, symptoms of alcohol withdrawal and hepatomegaly
      are common early presenting signs and symptoms of alcohol abuse. The clinical
      diagnosis of alcoholic hepatitis can be made in alcoholics with associated fever,
      leukocytosis, jaundice and tender hepatomegaly. Associated laboratory
      abnormalities may include leukocytosis or leukopenia, anemia, a prolonged
      prothrombin time and elevated liver enzymes, including aspartate amino
      transferase (AST), alanine aminotransferase (ALT), alkaline phosphatase and
      bilirubin. An AST-to-ALT ratio greater than 2 is common in patients with
      alcoholic hepatitis. Liver biopsy may be required to establish the diagnosis and
      to identify other pathology, such as cirrhosis. Histologic diagnosis of alcoholic
      hepatitis requires the presence of liver cell damage, an inflammatory infiltrate
      and fibrosis. Biopsy-proven cirrhosis with alcoholic hepatitis or a significantly
      elevated total bilirubin level and prolonged prothrombin time are associated with
      a worse prognosis. Abstinence from alcohol, nutritional supplementation and
      corticosteroids are the mainstays of treatment for severe alcoholic hepatitis.

PMID- 8465713
TI  - Treatment of obesity in the elderly.
AB  - Obesity is a common form of malnutrition among the elderly. Excessive weight gain
      is associated with decreased physical activity and a progressive decline in
      caloric requirements for weight maintenance. Obesity increases the risk of
      myocardial infarction, stroke, hypertension, noninsulin-dependent diabetes,
      osteoarthritis of the lower extremities and several types of cancer. Specific
      guidelines are recommended for weight-loss programs used in the elderly. While
      calories from dietary fats and carbohydrates are restricted, a protein intake of
      approximately 70 g per day is desirable. Exercise is an important part of the
      weight-loss program and contributes to a general sense of well-being. Limitation
      of motion may necessitate innovative forms of exercise for elderly patients.

PMID- 8465714
TI  - Neurocysticercosis.
AB  - Neurocysticercosis can be a cause of new-onset seizures. Cysticercosis is caused
      by fecal-oral spread of the parasite Taenia solium, the pork tapeworm, from
      affected individuals. Neurocysticercosis results from parasitic invasion of the
      central nervous system. The clinical presentation ranges from headaches to acute
      obstructive hydrocephalus. Computed tomography or magnetic resonance imaging is
      usually diagnostic, while serologic tests are generally less reliable. Treatment
      consists of praziquantel or albendazole, generally prescribed in combination with
      oral corticosteroids.

PMID- 8465715
TI  - Splenic artery aneurysms.
AB  - Splenic artery aneurysms are potentially life-threatening lesions with an
      uncertain propensity for serious consequences. These aneurysms are most often
      discovered incidentally in asymptomatic patients. Current practice standards
      suggest that definitive treatment should be undertaken in female patients in
      their childbearing years with lesions larger than 1 cm in diameter, in patients
      with lesions greater than 2 cm in diameter, in symptomatic patients and in
      patients with enlarging lesions. Patients with splenic artery aneurysms should be
      referred to vascular surgeons or vascular interventional radiologists for surgery
      or percutaneous embolization therapy.

PMID- 8465716
TI  - Pressure ulcers in nursing home patients.
AB  - Pressure, moisture, shear forces and friction lead to skin ulcer formation.
      Nursing home and home-bound patients with restricted mobility, poor nutrition,
      incontinence and chronic conditions such as anemia, diabetes and dementia are at
      risk for ulcer formation. Bedridden patients should be turned from side to side
      at 30-degree angles at least every two hours. Mattress and chair cushions,
      splints and cradle boots may reduce pressure. Good hygiene and barrier ointments,
      condom catheters, absorptive products and scheduled toileting for incontinence
      may control moisture. Calorie and protein supplements, feeding assistance and
      serial weight measurements are essential in the management of malnourished
      patients. Treatment should be based on the stage of the ulcer and the presence of
      conditions such as necrotic debris, infection and drainage. Saline wet-to-dry
      dressings and enzymatic and surgical debridement are necessary to remove necrotic
      tissue. Saline-soaked gauze, hydrogel preparations and occlusive dressings
      provide the physiologic environment for fibroblasts to grow and form granulation
      tissue. Patients with sepsis may require hospital admission for both further
      evaluation and systemic antibiotic therapy.

PMID- 8465717
TI  - Adverse effects of noise on hearing.
AB  - Excessive exposure to noise causes cells in the inner ear to degenerate and
      eventually can lead to permanent hearing loss. Although it has long been known
      that exposure to work-place noise can damage hearing, concern has recently been
      raised about hearing loss from excessive noise in recreational activities. The
      most effective way to decrease the incidence of noise-induced hearing loss is to
      educate people about the adverse health effects of excessive noise and to teach
      them how to protect their hearing.

PMID- 8465718
TI  - Asymptomatic bacteriuria in pregnancy.
AB  - Asymptomatic bacteriuria occurs in 4 to 7 percent of pregnancies and is
      associated with the development of acute pyelonephritis, preterm labor and low
      birth-weight infants. Treatment of bacteriuria prevents up to 80 percent of cases
      of pyelonephritis and reduces the risk of preterm delivery. All women should be
      screened for bacteriuria by a urine culture at the first prenatal visit. Women
      with bacteriuria should be treated with appropriate antibiotics and should be
      monitored throughout pregnancy to identify recurrences. Women with persistent
      bacteriuria require antibiotic suppression until delivery and urologic evaluation
      following delivery. Urologic evaluation during pregnancy is indicated if
      bacteriuria persists despite antibiotic therapy.

PMID- 8465719
TI  - Use of fluoroquinolones: practical considerations.
AB  - The fluoroquinolone class of antibiotics has expanded the therapeutic options
      available for serious bacterial infections. These antibiotics have activity
      against a wide variety of gram-negative organisms, including Pseudomonas
      aeruginosa, and selected gram-positive pathogens. Fluoroquinolones are well
      absorbed orally and are widely distributed into most tissues and fluids.
      Therapeutic indications include urinary tract infections, urethral and cervical
      gonorrhea, traveler's diarrhea, selected gram-negative respiratory and bone
      infections, and certain mycobacterial infections. Because adequate concentrations
      of fluoroquinolones are not achieved in cerebrospinal fluid, their use should be
      avoided in meningitis. Cost, drug interactions, adverse effects and resistance
      pose problems for the clinician. Fluoroquinolones should be restricted to proven
      indications when less costly agents are inappropriate.

PMID- 8465720
TI  - APA issues practice guidelines for eating disorders.

PMID- 8465721
TI  - AHA releases guidelines for CPR and emergency cardiac care.

PMID- 8465722
TI  - Lidocaine and dextran sulfate inhibit leukocyte accumulation but not postischemic
      contractile dysfunction in a canine model.
AB  - Leukocytes have been implicated as a possible factor in the pathogenesis of
      postischemic contractile dysfunction, probably through the release of oxygen free
      radicals. Lidocaine and dextran sulfate are known to inhibit leukocyte adherence
      to endothelial cells in vitro and in vivo. In an acute open-chest canine model
      both agents were found to inhibit the augmented accumulation of indium-111
      labeled leukocytes in briefly ischemic and subsequently reperfused myocardium.
      Pharmacologic inhibition of leukocyte accumulation by lidocaine and dextran
      sulfate, however, was not associated with improvement in postischemic contractile
      dysfunction.

PMID- 8465723
TI  - Cardiac arrest and sudden unexpected death in variant angina: complications of
      coronary spasm that can occur in the absence of severe organic coronary stenosis.
AB  - Experiences in 81 patients with variant angina were reviewed with the goal of
      determining which clinical features were associated with the greatest risk of
      angina-linked cardiac arrest (13 patients) or sudden unexpected death (9
      patients). The risk of occurrence of one of these actually or potentially fatal
      events was approximately tripled by the presence of either a history of angina
      linked syncope or documentation of serious arrhythmia complicating attacks. An
      unexpected finding was that the risk was increased 1.5-fold by the absence of
      high-grade organic coronary stenosis. Cardiac arrest and sudden death are
      important risks of variant angina, which can occur without the presence of severe
      organic coronary stenosis. These risks can be reduced by adequate vasodilator
      therapy that includes a calcium channel blocker.

PMID- 8465724
TI  - The effectiveness and safety of the simultaneous administration of quinidine and
      amiodarone in the conversion of chronic atrial fibrillation.
AB  - The effectiveness and safety of quinidine in the conversion of chronic atrial
      fibrillation after administration of amiodarone was assessed in 15 patients. A
      total quinidine dosage of 1097 +/- 408 mg was administered up the point of
      conversion or for a total of 48 hours. Nine of 15 patients (60%) converted to
      sinus rhythm. No clinical variable such as the duration of atrial fibrillation,
      left atrial size, left ventricular fractional shortening, amiodarone duration, or
      maintenance dose of amiodarone was able to discriminate between converters and
      nonconverters when patients were treated with the combination of amiodarone and
      quinidine. The mean QT interval with amiodarone was 414 +/- 44 msec and slightly
      increased to 434 +/- 40 msec (p = 0.01) when quinidine was added. The amiodarone
      quinidine combination was well tolerated, and no side effects or proarrhythmias
      were recorded.

PMID- 8465725
TI  - Radiofrequency versus pharmacologic modification of the atrioventricular node.
AB  - Although transcatheter radiofrequency modification of the atrioventricular (AV)
      node has been proposed as curative treatment in AV nodal reentry tachycardias,
      its role for the control of the ventricular rate in atrial tachyarrhythmias
      remains unclear. The aim of this study was to analyze the acute effect of
      radiofrequency current on AV nodal conduction and refractoriness, and to compare
      it with the effects of two antiarrhythmic drugs such as amiodarone (class III)
      and flecainide (class I). Twenty-one dogs were studied: (1) radiofrequency group
      (5 W for less than 45 seconds; 2 to 12 discharges; seven dogs); (2) amiodarone
      group (5 mg/kg intravenously; seven dogs); and (3) flecainide group (2 mg/kg
      intravenously; seven dogs). The following parameters were measured under basal
      conditions and after each procedure: AH interval, AV nodal functional refractory
      period, Wenckebach cycle length, minimum R-R interval during atrial fibrillation,
      and fitting of AV nodal function curve to a hyperbolic equation using its linear
      transformation. The AV nodal effective refractory period could not be calculated
      in any dog in the basal study because it was shorter than the atrial functional
      refractory period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465726
TI  - Anterograde and retrograde decremental conduction over left-sided accessory
      atrioventricular pathways in the Wolff-Parkinson-White syndrome.
AB  - The electrophysiologic properties of left-sided accessory pathways (APs) were
      examined by cardiac stimulation in 55 patients with Wolff-Parkinson-White
      syndrome. Atrioventricular and ventriculoatrial conduction times were assessed at
      the coronary sinus level nearest to the AP and then plotted graphically as a
      function of coupling interval (for atrial and ventricular refractory period
      determinations). Of 29 patients with anterograde conduction over the AP, 10 (34%)
      exhibited decremental conduction. However, only two (7%) had a maximal decrement
      equal to or more than 30 msec. In the other eight (27%) patients the maximal
      decrement ranged from 10 to 20 msec. The longest coupling interval at which
      anterograde decremental conduction was demonstrated ranged from 260 to 440 msec
      (346 +/- 52 msec). The shortest coupling interval ranged from 240 to 320 msec
      (265 +/- 24 msec). The anterograde decremental conduction zone was 91 +/- 55
      msec. Of 51 patients with retrograde conduction over the AP, 23 (45%) exhibited
      decremental conduction. However, only eight (15%) had a maximal decrement equal
      to or greater than 30 msec. In the other 15 (29%) patients the maximal decrement
      ranged from 10 to 25 msec. The longest coupling interval was 338 +/- 70 msec. The
      shortest coupling interval was 275 +/- 42 msec. The retrograde decremental
      conduction zone was 72 +/- 47 msec. There was a significant inverse correlation
      between the AP effective refractory period and the maximal decrement (r = -0.42;
      p < 0.05). The comparison of maximal ventriculoatrial conduction time with the
      maximal decrement revealed a positive correlation (r = 0.63; p < 0.01). These
      data reveal that minimal decremental conduction over left-sided APs is not an
      uncommon finding and stress that care should be taken in evaluation of conduction
      over these connections.

PMID- 8465727
TI  - Cardiac geometry and mass changes associated with pacing-induced cardiomyopathy
      in the dog.
AB  - We evaluated the effects of chronic rapid pacing (240 beats/min) on ventricular
      geometry and function and on cardiac mass in a canine model. Forty dogs were
      studied by two-dimensional echocardiography before and after 45 days of pacing.
      Compared with sham-operated control animals, the paced animals had significant
      increases in end-diastolic and end-systolic volume and a decrease in ejection
      fraction. The increase in ventricular volume was primarily the result of dilation
      of the short axis of the ventricular lumen, without significant changes in the
      long-axis dimension. Paced animals had biatrial hypertrophy but no change in
      ventricular or total cardiac mass.

PMID- 8465728
TI  - Velocity-encoded cine MRI in the evaluation of left ventricular diastolic
      function: measurement of mitral valve and pulmonary vein flow velocities and flow
      volume across the mitral valve.
AB  - Left ventricular diastolic function has been evaluated by means of analysis of
      the flow pattern through the mitral valve. Velocity-encoded cine magnetic
      resonance imaging (VEC-MR) is a new method for characterizing flow patterns in
      the heart. The feasibility of using VEC-MR to measure early diastolic (E) and
      atrial systolic (A) peak flow velocities and E/A ratios in the mitral inflow, as
      well as systolic (X), early diastolic (Y), and atrial systolic (Z) peak flow
      velocities and X/Y ratios in the pulmonary vein, was evaluated in 10 normal
      volunteers. The VEC-MR-derived velocities and indexes were compared with Doppler
      derived results. Volumetric flow across the mitral valve was also used to measure
      stroke volume, cardiac output, and the left atrial contribution of left
      ventricular filling. VEC-MR yielded lower peak velocities than Doppler
      echocardiography. The velocities of the two measurements showed a significant
      linear correlation (Doppler E velocity = 1.30 x VEC-MR + 1.6 cm/sec, r = 0.68;
      Doppler A velocity = 1.83 x VEC-MR - 5.2 cm/sec, r = 0.83; and Doppler X velocity
      = 0.45 x VEC-MR + 0.09 cm/sec, r = 0.74). Consequently the E/A and X/Y ratios
      measured by these two methods showed statistically significant linear
      correlations with r values of 0.94 and 0.83. The volume of blood flow across the
      mitral valve measured by VEC-MR (5610 +/- 620 ml/min) was not statistically
      different from the cardiac output measured from the ascending aorta by VEC-MR
      (5670 +/- 590 ml/min) or by left ventricular cine magnetic resonance imaging
      (5440 +/- 614 ml/min). The left atrial contribution to left ventricular filling
      was 25.9 +/- 7.5%. Our results indicate that VEC-MR can be used not only for
      evaluation of left ventricular diastolic filling from the mitral valve and
      pulmonary vein flow velocities but also for quantitative measurement of the
      volume of blood flow across the mitral valve.

PMID- 8465729
TI  - Echocardiographic and anatomic correlation of ventricular septal defect
      morphology in newborn Yucatan pigs.
AB  - With the use of a Yucatan micropig strain with a high incidence of ventricular
      septal defects (VSDs), results of two-dimensional and color-flow Doppler
      echocardiography of VSD morphology in newborn piglets were correlated with
      autopsy findings. A spectrum of perimembranous, muscular outlet, and doubly
      committed subarterial VSDs was found. Echocardiography was performed in 29
      piglets weighing 1.2 to 4.4 (mean 2.8) kg, studied at age 4 to 18 (mean 8) days.
      VSD was diagnosed by means of echocardiography in 16 of 29 subjects; morphologic
      findings included perimembranous defects in 12, muscular outlet in two, and
      doubly committed subarterial defect in two. At autopsy the presence and location
      of defects were confirmed in all pigs. No additional defects were found. VSD
      diameters were 1.0 to 5.0 (mean 3.94) mm on echocardiography and 1.0 to 6.0 (mean
      2.84) mm at autopsy. After aortic valve diameter was used as an internal control
      for tissue shrinkage during fixation, echocardiography/color Doppler imaging
      tended to overestimate VSD diameter by 21% (0.6 mm). In conclusion,
      echocardiography/Doppler imaging accurately identified the presence, morphology,
      and size of even the smallest VSDs in newborn Yucatan micropigs.
      Echocardiographic classification of VSD morphology in vivo will facilitate future
      research on specific types of VSDs in this animal model.

PMID- 8465730
TI  - Noninvasive evaluation of right ventricular and pulmonary artery systolic
      pressures in patients with ventricular septal defects: simultaneous study of
      Doppler and catheterization data.
AB  - The method for evaluating right ventricular and pulmonary artery systolic
      pressures by subtracting the systolic pressure gradient across the ventricular
      septal defect from the cuff systolic blood pressure is documented. To confirm the
      reliability and accuracy of this method, simultaneous continuous wave Doppler
      echocardiography and left and right cardiac catheterization were performed in 66
      patients with congenital ventricular septal defects. The comparisons between the
      Doppler-derived right ventricular or pulmonary artery systolic pressures and
      those measured by catheterization yielded an excellent correlation (r = 0.969, y
      = 1.035x - 3.627, SEE = 8.2 mm Hg, p < 0.001 and r = 0.972, y = 1.012x - 2.904,
      SEE = 7.6 mm Hg, p < 0.001), respectively. There was a close agreement between
      the Doppler-derived right ventricular or pulmonary artery systolic pressures and
      those measured by catheters, and the differences between the two measurements did
      not differ significantly from zero. It is concluded that Doppler echocardiography
      offers a reliable and accurate method for noninvasive assessment of right
      ventricular and pulmonary artery systolic pressures in patients with ventricular
      septal defects.

PMID- 8465731
TI  - Quantification of aortic regurgitation by magnetic resonance velocity mapping.
AB  - The use of magnetic resonance (MR) velocity mapping in the quantification of
      aortic valvular blood flow was examined in 10 patients with angiographically
      verified aortic regurgitation. MR velocity mapping succeeded in identifying and
      quantifying the regurgitation in all patients, and the regurgitant volume
      determined with MR velocity mapping agreed well with the grade obtained by aortic
      root angiography (p < 0.02). The accuracy in quantification of the aortic
      valvular flow rate was demonstrated by a significant correlation between the
      stroke volume (ml) measured by MR velocity mapping and calculated from MR imaging
      of the left ventricular end-diastolic and end-systolic volumes in eight patients
      (Y = 0.89 x X + 11, r = 0.97, p < 0.001). This finding was confirmed by a good
      agreement between the net cardiac output (L/min) quantified with MR velocity
      mapping and simultaneous 125I-indicator dilution measurement in all subjects (Y =
      0.89 x X + 0.08, r = 0.82, p < 0.01). In conclusion, MR velocity mapping may be
      used as a noninvasive tool in the quantification of aortic regurgitation.

PMID- 8465732
TI  - Immediate and long-term results of balloon and surgical closed mitral valvotomy:
      a randomized comparative study.
AB  - Balloon mitral valvotomy (BMV) constitutes an important alternative to surgical
      closed mitral valvotomy (CMV) for the treatment of rheumatic mitral stenosis. To
      compare the immediate and long-term results of these procedures, 200 patients
      with rheumatic mitral stenosis were randomly assigned to undergo either BMV (n =
      100) or CMV (n = 100). The age range was 10 to 30 (mean 19.4 +/- 6.5) years. Both
      procedures resulted in significant and similar increases in mitral valve area
      (BMV: 0.85 +/- 0.26 to 2.39 +/- 0.94 cm2; CMV: 0.79 +/- 0.21 to 2.2 +/- 0.85 cm2;
      p = NS). Mitral regurgitation developed in 14 patients after BMV and in 12
      patients after CMV. Eighty patients in each group have now been followed for a
      mean period of 22 +/- 6.3 (range 6 to 38) months by repeat echocardiographic
      study. Restenosis (defined as a loss of more than 50% of the achieved increase in
      mitral valve area) was seen in four (5%) patients after BMV and in three (4%)
      after CMV. Symptomatic restenosis was seen in only one patient who at follow-up
      examination 20 months after CMV had a mitral valve area of 0.8 cm2 and underwent
      successful balloon valvotomy. We conclude that the immediate and long-term
      results obtained with percutaneous BMV and surgical closed mitral commissurotomy
      are comparable.

PMID- 8465733
TI  - The comparative value of transesophageal and transthoracic echocardiography
      before and after percutaneous mitral balloon valvotomy: a prospective study.
AB  - Transthoracic (TTE) and transesophageal echocardiography (TEE) were performed
      prospectively on 53 consecutive patients (mean age 59 +/- 14 years) immediately
      before and within 24 hours of mitral balloon valvotomy to compare the relative
      value of the two techniques. Biplane TEE was used in 38 patients and single-plane
      imaging was done in 11. All patients underwent left and right cardiac
      catheterization, left ventriculography, and coronary angiography. While TEE
      provided excellent images of the mitral valve in all patients, imaging planes
      were more limited than by TTE. Mitral valve morphology could be assessed
      satisfactorily by either technique. Echo scores derived from each showed good
      correlation (r = 0.90, p < 0.001). TEE transgastric longitudinal scanning
      provided superior detail of the subvalvar apparatus but only in 20 (53%) of 38
      patients. Patients with good transgastric views had significantly smaller left
      atrial volumes than those without (58 +/- 22 vs 106 +/- 41 cm3, p < 0.001).
      Mitral valve orifice and the commissures were better assessed by TTE. Before
      valvotomy, mitral regurgitation (MR) graded by TEE and TTE color flow mapping was
      concordant with angiography in 80% and 81%, respectively. After valvotomy, TTE
      color flow mapping failed to detect MR in two of the three patients who developed
      severe MR. Two of these patients were examined by TEE, which demonstrated both
      the MR jets as well as leaflet tears. Thrombus was diagnosed in the left atrium
      in eight patients by TEE and in only one patient by TTE. Biplane TEE was required
      for accurate thrombus localization and for assessing its size and extent. Five
      patients with thrombus underwent balloon valvotomy without complications. Left-to
      right atrial shunting was detected by TEE and TTE in 95% and 48% of patients,
      respectively. Flow convergence regions, from which quantitative flow information
      can be derived, were imaged by TEE only. TTE and TEE have complementary roles.
      However, TEE is essential for excluding thrombus in the left atrium before
      balloon valvotomy. After the procedure, TEE is recommended for the evaluation of
      patients with severe mitral regurgitation.

PMID- 8465734
TI  - Percutaneous balloon mitral valvotomy in pregnant patients with tight pliable
      mitral stenosis.
AB  - Percutaneous balloon mitral valvotomy was attempted in severely symptomatic (New
      York Heart Association class III or IV) pregnant patients (mean age 30 years)
      with tight mitral stenosis. Nineteen patients were pregnant (mean gestation 30
      weeks, range 26 to 34) and one patient was in the immediate postpartum period.
      All patients had undergone a trial of diuretic therapy and 16 were also taking
      atenolol. Percutaneous valvotomy was performed with the Inoue catheter (18
      patients) or the Schneider-Medintag bifoil (2 x 19 mm) balloon catheter (2
      patients). The fluoroscopy time was 9.2 +/- 3.4 minutes. After percutaneous
      valvotomy the mean mitral gradient decreased from 17.9 +/- 6.2 to 5.9 +/- 2.4 mm
      Hg (p < 0.001). The mitral valve area (pressure half time) increased from 0.8 +/-
      0.2 to 1.7 +/- 0.2 cm2 (p < 0.001). These hemodynamic changes were accompanied by
      immediate symptomatic improvement by at least one New York Heart Association
      functional grade in all patients. Moderate (3+) mitral regurgitation developed in
      one patient. Eighteen patients had normal infants delivered vaginally at term
      without assistance, and one patient had a normal infant delivered by cesarean
      section at 35 weeks' gestation. We conclude that percutaneous balloon mitral
      valvotomy for pliable mitral stenosis in pregnancy is safe for both the mother
      and fetus. We recommend that it be performed in symptomatic patients with tight
      mitral stenosis so as to avoid hemodynamic complications in the latter stages of
      pregnancy.

PMID- 8465735
TI  - Pulmonary artery pressure and pulmonary vascular resistance before and after
      mitral balloon valvotomy in 100 patients with severe mitral valve stenosis.
AB  - We studied the pulmonary vascular hemodynamics before and after mitral balloon
      valvotomy in 100 patients with severe mitral valve stenosis. Before balloon
      valvotomy 23 patients had a pulmonary artery systolic pressure of < 31 mm Hg
      (group 1), 54 patients had a pulmonary artery systolic pressure between 31 and 50
      mm Hg (group 2), and 23 patients had a pulmonary artery systolic pressure of > 50
      mm Hg (group 3). After balloon valvotomy the mean systolic pulmonary artery
      pressure in group 1 decreased from 28 +/- 3 to 26 +/- 5 mm Hg (p = NS). In group
      2 the systolic pulmonary artery pressure after balloon valvotomy decreased from
      41 +/- 5 to 33 +/- 7 mm Hg (p < 0.0001) and normalized to < 31mm Hg in 27
      patients (50%). The mean left atrial pressure was abnormal (> or = 13 mm Hg) in 6
      of 27 patients (22%) who had a systolic pulmonary artery systolic pressure of <
      31 mm Hg and in 6 of 27 patients (22%) with a pulmonary artery systolic pressure
      of > or = 31 mm Hg. The pulmonary vascular resistance was abnormal in 36 of 54
      patients (67%) after mitral balloon valvotomy; only 5 of 36 patients (14%) had a
      raised left atrial pressure (> or = 13 mm Hg). In group 3 the pulmonary vascular
      resistance was abnormal (> 125 dynes/sec/cm-5) in all 23 patients before and in
      19 of 31 patients (91%) after balloon valvotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465736
TI  - Medical complications of cocaine: possible relationship to low plasma
      cholinesterase enzyme.
AB  - What predisposes some cocaine users to its complications is not known. Because
      cocaine is metabolized by plasma cholinesterase enzyme, we evaluated this enzyme
      in 14 patients with cocaine-induced complications, 11 long-term cocaine users
      from Bolivia, 14 persons in the United States without any documented cocaine
      induced complications, and 14 subjects who have not used cocaine. The enzyme was
      found to be significantly lower in patients with cocaine-induced complications as
      compared to other groups (p < 0.05). A low level of plasma cholinesterase enzyme
      may predict complications from cocaine use.

PMID- 8465737
TI  - The left ventricle in systemic lupus erythematosus: initial observations and a
      five-year follow-up in a university medical center population.
AB  - The objectives of this study were to determine the natural history of
      abnormalities in left ventricular size and function in patients with systemic
      lupus erythematosus and to determine whether changes in ventricular function can
      be attributed to a primary lupus cardiomyopathy. The design was a prospective 5
      year follow-up study in a university hospital. There were 28 patients with
      systemic lupus erythematosis who were enrolled in an echocardiographic study from
      1985 to 1986 and who were available for follow-up echocardiographic examinations.
      Patients were prospectively subgrouped according to the presence or absence of
      systemic hypertension. Twenty healthy volunteers participated as normal control
      subjects. Measurements of left ventricular mass index, mean wall thickness,
      volumes, and ejection fraction and Doppler indices of mitral inflow were
      performed on all patients and control subjects. Increases in left ventricular
      mass index, mean wall thickness, and end-systolic volume and decreases in
      ejection fraction were seen in the patients with lupus when compared with control
      subjects (p < or = 0.05) and were related to the presence of hypertension and
      coronary artery disease. In the group of patients without hypertension, no
      significant differences in left ventricular mass index, volumes, or ejection
      fraction were detected when compared with the control group. The normotensive
      patients did demonstrate mild abnormalities of mitral inflow that did not worsen
      during the follow-up period. It was concluded that abnormalities of systolic and
      diastolic left ventricular function are common in patients with lupus, are
      progressive over time, and are related to the coexistence of hypertension and
      coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465738
TI  - A comparison of cardiac valvular involvement in the primary antiphospholipid
      syndrome versus anticardiolipin-negative systemic lupus erythematosus.
AB  - Recurrent thrombosis and pregnancy loss are well-recognized features of the
      antiphospholipid syndrome. Uncertainty exists, however, as to whether other
      reported features of the antiphospholipid syndrome such as cardiac valvular
      vegetations are truly part of this disorder or more reflective of associated
      systemic lupus erythematosus (SLE). Several recent studies have concluded that
      patients with antiphospholipid antibodies have a higher risk of developing Libman
      Sacks endocarditis. This study was performed to determine whether
      antiphospholipid antibodies are the only risk factors for cardiac valvular
      disease in patients with primary antiphospholipid syndrome (PAPS) or SLE. Ten
      patients with PAPS were matched with 20 patients with SLE and 20 healthy control
      subjects by sex. All participants were tested for anticardiolipin (aCL)
      antibodies by means of a standardized enzyme-linked immunosorbent assay
      technique, and all underwent two-dimensional and color-flow Doppler
      echocardiography. The echocardiograms were interpreted by two cardiologists
      blinded to the patients' underlying disease. Sixty percent of the PAPS group had
      cardiac valvular involvement compared with 40% of the SLE group (p = NS). We
      conclude that cardiac valvular vegetations are common both in aCL-negative
      patients with SLE and in patients with PAPS. This suggests that aCL antibodies
      either play no causative role or are not the only risk factors in the development
      of cardiac valvular vegetations.

PMID- 8465739
TI  - Identification of high-risk patients with left main and three-vessel coronary
      artery disease by adenosine-single photon emission computed tomographic thallium
      imaging.
AB  - The purpose of this study was to examine the ability of SPECT imaging with
      thallium-201 during adenosine-induced coronary hyperemia to detect high-risk
      patients with left main or three-vessel CAD. There were 339 patients: 102 with
      either left main or three-vessel CAD (group 1) and 237 with no CAD, one-, or two
      vessel disease (group 2). By means of univariate analysis, several variables were
      found to differ between groups 1 and 2: Q wave myocardial infarction (35% vs 25%,
      p < 0.05), ST segment depression (35% vs 19%, p < 0.001), age (67 +/- 9 vs 62 +/-
      10 years, p < 0.001), resting systolic blood pressure (142 +/- 22 vs 135 +/- 20
      mm Hg, p < 0.01), abnormal thallium images (95% vs 74%, p < 0.0001), multivessel
      thallium abnormality (76% vs 39%, p < 0.0001), extent of thallium abnormality (24
      +/- 11% vs 19 +/- 13%, p < 0.0001), and increased lung thallium uptake (39% vs
      15%, p < 0.01). According to stepwise discriminant analysis, only three variables
      were predictors of high risk: multivessel thallium abnormality (chi 2 = 27),
      increased lung thallium uptake (chi 2 = 10), and ST depression (chi 2 = 5). On
      the basis of these variables, patients were divided into three groups with
      different prevalence rates for left main and three-vessel CAD: 63% in 68
      patients, 30% in 137 patients, and 13% in 137 patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8465740
TI  - The diagnostic utility of contrast echocardiography in patients with refractory
      hypoxemia.
AB  - Three illustrative cases of refractory hypoxemia in adults are presented. In two
      cases contrast echocardiography was invaluable in establishing the diagnosis of a
      true anatomic right to left shunt, as well as in localizing the shunt to an
      intracardiac or extracardiac site. In the third case true anatomic right to left
      shunt was excluded by means of contrast echocardiography. The pathophysiology of
      hypoxemia is discussed with emphasis on the potential diagnostic utility of
      contrast echocardiology in patients with refractory hypoxemia. A diagnostic flow
      chart is proposed.

PMID- 8465741
TI  - Platelet and neutrophil imaging techniques in the investigation of the response
      to thrombolytic therapy and the no-reflow phenomenon.

PMID- 8465742
TI  - Influence of heart rate on mortality among persons with hypertension: the
      Framingham Study.
AB  - Previous studies have shown positive associations between heart rate and both all
      cause and cardiovascular mortality. These relationships, however, have not been
      investigated in persons with hypertension. Using 36-year follow-up data from the
      Framingham Study, we evaluated from 4530 subjects, aged 35 to 74, whose blood
      pressures were > or = 140 mm Hg systolic or > or = 90 mm Hg diastolic and who
      were not treated with antihypertensive medication. We used pooled logistic
      regression to calculate biennial mortality rates. Odds ratios and 95% confidence
      intervals for each increment in heart rate of 40 beats/min, adjusted for age and
      systolic blood pressure level, were: for all-cause mortality, 2.18 (1.68, 2.83)
      for men and 2.14 (1.59, 2.88) for women; and for cardiovascular mortality, 1.68
      (1.19, 2.37) for men and 1.70 (1.08, 2.67) for women. Exclusion of outcomes in
      the first 2 or 4 years after measurement of heart rate did not materially change
      the results, which suggests that rapid heart is not merely an indicator of
      preexisting illness. Therefore heart rate may be an independent risk factor for
      cardiovascular death in persons with hypertension.

PMID- 8465743
TI  - Secular blood pressure trends in normotensive persons: the Framingham Study.
AB  - Trends in hypertension prevalence are difficult to assess because of a massive
      increase in the prevalence of antihypertensive treatment. Over the past three
      decades mean blood pressure levels among the 5209 members of the Framingham Study
      cohort have declined, and elevated blood pressure is only one third as prevalent.
      However, if those receiving treatment who have normalized blood pressures are
      defined as hypertensive, in addition to those with elevated blood pressure, the
      prevalence of hypertension has increased. No consistent secular trend in the
      incidence of hypertension was noted over three decades, but high blood pressure
      eventually developed in two thirds of the study cohort. To determine whether
      untreated blood pressure levels are changing over time, trends in mean blood
      pressure were examined in normotensive subjects over three decades. Only a 1 mm
      Hg decline in mean systolic and diastolic pressure over each 10-year interval was
      noted (p < 0.001). Thus blood pressure in the normotensive segment of the
      population has been quite stable. Because the incidence of hypertension is very
      high and future hypertension arises from the upper end of the normal blood
      pressure distribution, there is an urgent need for primary prevention. Preventive
      measures such as exercise, avoidance of salt and alcohol, and especially weight
      control deserve a high priority.

PMID- 8465744
TI  - Monitoring cyclical coronary blood flow alterations after coronary angioplasty
      for stent restenosis with a Doppler guide wire.

PMID- 8465745
TI  - Emergent saphenous vein graft stent after unsuccessful balloon angioplasty:
      clinical, angiographic, and histologic findings.

PMID- 8465746
TI  - Coronary angioplasty of radiation-induced stenosis.

PMID- 8465747
TI  - Coronary steal through a patent internal mammary artery graft: treatment by
      subclavian angioplasty.

PMID- 8465748
TI  - Revascularization in fibromuscular dysplasia of the coronary arteries.

PMID- 8465749
TI  - The combined presence of myocardial bridging and fixed coronary artery stenosis.

PMID- 8465750
TI  - Coronary atherectomy complicated by coronary embolus in a cardiac transplant
      recipient.

PMID- 8465751
TI  - Analysis of VNTR loci amplified by the polymerase chain reaction for
      investigating the origin of intimal smooth muscle cells in a coronary artery
      lesion developing after heart transplantation in man.

PMID- 8465752
TI  - Morbidity of endomyocardial biopsy in cardiac transplant recipients.

PMID- 8465753
TI  - Fatal aortic rupture during balloon dilatation of recoarctation.

PMID- 8465754
TI  - Complete heart block after percutaneous Inoue balloon mitral valvotomy.

PMID- 8465755
TI  - Ruptured congenital aneurysm of the sinus of Valsalva with persistent left
      superior vena cava imaged by intraoperative transesophageal echocardiography.

PMID- 8465756
TI  - Critical discrete subaortic stenosis in the newborn period.

PMID- 8465757
TI  - Transesophageal echocardiographic diagnosis of a primary intraaortic tumor.

PMID- 8465758
TI  - Endarteritis associated with a clinically silent patent ductus arteriosus.

PMID- 8465759
TI  - Effusive constrictive epicarditis and atrial septal defect.

PMID- 8465760
TI  - Medical management of prosthetic aortic valve endocarditis and aortic root
      abscess.

PMID- 8465761
TI  - Ventricular tachycardia with retrograde 2:1 atrial activation masquerading as T
      wave alternans.

PMID- 8465762
TI  - Accelerated secretion of atrial natriuretic peptide during exercise in effort
      angina.

PMID- 8465763
TI  - Central precordial reciprocal ST-segment elevation in posterolateral myocardial
      infarction.

PMID- 8465764
TI  - Aortic rupture after balloon angioplasty of aortic coarctation.

PMID- 8465765
TI  - Emergency coronary angioplasty for acute myocardial infarction: predictors of
      early occlusion of the infarct-related artery after balloon inflation.
AB  - THE FACTORS RESPONSIBLE FOR EARLY OCCLUSION OF THE INFARCT VESSEL AFTER emergency
      percutaneous transluminal coronary angioplasty (PTCA) were retrospectively
      examined in 191 patients with acute myocardial infarction. During the 24-hour
      period after the initial balloon inflation, 47 patients (25%) had occlusion of
      the vessel (occlusion group), whereas 144 did not (nonocclusion group). The
      former patients immediately underwent repeat PTCA, which was successful in 37.
      Univariate correlates of early occlusion were a shorter time interval between the
      onset of symptoms and PTCA (3.5 +/- 2.2 vs 4.5 +/- 2.9 hours, p = 0.025), right
      coronary artery involvement (53% vs 30%, p = 0.015), prior thrombolytic therapy
      (49% vs 32%, p = 0.035), and undersized inflation (43% vs 17%, p < 0.001). With
      multivariate analysis the three independent predictors were undersized inflation
      (p < 0.001), right coronary artery involvement (p = 0.004), and a shorter time
      interval until PTCA (p = 0.011). Thus patients undergoing early PTCA and having
      right coronary artery involvement appear to be at greater risk of having early
      occlusion. Thrombolytic agents and undersized inflation may also play an
      important role in its development.

PMID- 8465766
TI  - Functional recovery after reperfusion is predicated on recovery of myocardial
      oxidative metabolism.
AB  - To test the hypothesis that recovery of myocardial oxidative metabolism (MVO2) is
      a necessary prerequisite for recovery of contractile function following
      reperfusion and to evaluate its dependency on the interval of antecedent ischemia
      before reflow, we evaluated 11 dogs serially for 4 weeks. Six dogs were subjected
      to prompt reperfusion (after 1 hour of coronary artery occlusion) and five were
      subjected to delayed reperfusion (after 4 hours of ischemia). Despite equivalent
      levels of myocardial blood flow with reperfusion, hearts subjected to prompt
      reperfusion had faster and more complete recovery of MVO2 (assessed by sequential
      positron emission tomography with [11C]acetate) and function (assessed by
      echocardiography) compared with dogs subjected to delayed reperfusion. Infarct
      size was diminished in dogs with prompt reperfusion. In all dogs, recovery of
      function with reperfusion was predicted and correlated with early recovery of
      MVO2 (r = 0.61, p < 0.04). The results demonstrate that prompt reperfusion is
      associated with more rapid and complete recovery of oxidative metabolism and
      function and support the hypothesis that the ability to metabolize substrate
      oxidatively is a necessary prerequisite for recovery of function.

PMID- 8465767
TI  - Prediction of single and multivessel coronary disease in patients after
      myocardial infarction according to quantitative ultrasound wall-motion analysis.
AB  - Regional changes in left ventricular size and function characterize left
      ventricular remodeling and start very early after myocardial infarction. We
      studied the diagnostic value of left ventricular dyssynergic patterns in
      predicting the presence of single versus multivessel disease (MVD). Fifty-three
      consecutive patients with acute myocardial infarction were studied by ECG, two
      dimensional echocardiography, and angiography during the same hospitalization.
      Thirty-eight normal subjects served as the control group. According to the
      angiographic findings, the patients were categorized as having: single-vessel
      disease (SVD, n = 17), two-vessel disease (n = 17), and three-vessel disease (n =
      19). Two-dimensional echocardiography was performed and optimal frames from five
      cardiac cycles were digitized and quantitatively analyzed off-line with a
      microcomputer. Echocardiographic wall-motion analysis demonstrated a depressed
      regional segmental thickening in the infarcted area that was characteristic for
      each echocardiographic view. In the segments remote from the infarcted area,
      however, the three patient groups displayed differences in function that ranged
      from hyperkinetic in patients with SVD to hypokinetic in patients with MVD.
      Patients with SVD constantly displayed a wider range of segmental thickening when
      compared with patients with MVD and the control group (p < 0.05). In conclusion,
      patients with SVD after myocardial infarction display compensatory hyperkinesis
      of remote segments, which is attenuated in patients with MVD. The present study
      introduces new parameters of segmental myocardial function that might be helpful
      in predicting SVD and MVD in patients after myocardial infarction.

PMID- 8465768
TI  - Oxygen free radicals and hypercholesterolemic atherosclerosis: effect of vitamin
      E.
AB  - We investigated the effects of a high-cholesterol diet in the presence and
      absence of vitamin E on the lipid peroxidation product malondialdehyde of blood
      and aortic tissue, the oxygen-free-radical-producing activity of
      polymorphonuclear leukocytes (PMNs) (PMN chemiluminescence), and the blood lipid
      profile in rabbits. The animals were divided into four groups each of which
      comprised 10 rabbits. Rabbits in group I received a regular rabbit chow diet;
      those in group II received vitamin E; those in group III received high
      cholesterol + vitamin E; and those in group IV received a high-cholesterol diet.
      Blood concentrations of triglycerides, total cholesterol, low-density lipoprotein
      cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), very low
      density lipoprotein cholesterol (VLDL-C), malondialdehyde, and PMN
      chemiluminescence were measured. The aorta of each rabbit was removed at the end
      of the protocol for assessment of atherosclerotic changes (gross and microscopic)
      and malondialdehyde. Serum triglycerides, total cholesterol, HDL-C, LDL-C, and
      VLDL-C increased while HDL/LDL ratio decreased in groups III and IV but remained
      unchanged in group I. There was an increase in the HDL-C component and HDL/LDL
      ratio and a decrease in the LDL-C component and triglycerides in group II. Blood
      and aortic tissue malondialdehyde increased in group IV but decreased in groups
      II and III. PMN chemiluminescence increased in groups III and IV. Atherosclerotic
      changes were marked in group IV as compared with those in group III. However,
      histologic changes in the aortas were similar in groups III and IV. The increased
      levels of blood and aortic tissue malondialdehyde and PMN chemiluminescence,
      which were associated with development of atherosclerosis, suggest a role of
      oxygen free radicals in the pathogenesis of hypercholesterolemia-induced
      atherosclerosis. The protection afforded by vitamin E, which was associated with
      a decrease in blood and aortic tissue malondialdehyde concentration in spite of
      hypercholesterolemia, supports the hypothesis that oxygen free radicals are
      involved in the development of hypercholesterolemic atherosclerosis.

PMID- 8465769
TI  - Lipid peroxides and antioxidant defenses in accelerated transplantation
      associated coronary arteriosclerosis.
AB  - Accelerated coronary artery disease develops in most if not all heart transplant
      recipients within the first year after transplantation. Increased lipid
      peroxidation seems to be involved in atherogenesis. In these patients we have
      investigated whether there is an association between lipid peroxidation, reduced
      antioxidant defenses, and some conventional coronary risk factors. Lipid
      peroxides, lipids, uric acid, albumin, antioxidant enzymes and their cofactors
      (the trace elements selenium, iron, copper, and zinc) have been determined in
      heart transplant recipients compared with nonrecipients with coronary artery
      disease. Lipid peroxides (p = 0.002) and uric acid (p = 0.01) were higher and
      zinc (p = 0.001) was lower in heart transplant recipients. Thirteen of 30
      transplant recipients compared with one of 30 nonrecipients (p < 0.001) had very
      low (less than 10 mumol/L) zinc levels. Antioxidant enzymes and other trace
      elements were not significantly different. In univariate regression analysis,
      zinc correlated positively with albumin (p = 0.02) and negatively with lipid
      peroxides (p < 0.05). Uricemia had a strongly positive correlation with
      hydroperoxides (r = 0.45; p = 0.0001). In stepwise multivariate regression
      analysis, lipids, uricemia, creatinine, and zinc were significant (p < or =
      0.004) predictors of the lipid peroxide level. Cyclosporine and corticosteroid
      dosages were significant (p = 0.01) determinants of zinc concentration in the
      transplant recipients. Although a causal relationship between increased lipid
      peroxidation and accelerated arteriosclerosis is not definitely demonstrated, the
      results of this analysis suggest new insights into conventional coronary disease
      risk factors and possible therapeutic interventions; further controlled trials
      are needed.

PMID- 8465770
TI  - Transient terminal U wave inversion as a more specific marker for myocardial
      ischemia.
AB  - Transient U wave inversion can be caused either by regional myocardial ischemia
      or by an elevation of systemic blood pressure. The characteristics of U wave
      inversion during chest pain attacks in 21 patients with variant angina were
      compared with those observed in 38 patients with hypertension without apparent
      ischemic heart disease. Differentiation was possible according to the ECG phase
      in which U wave inversion appeared. U wave inversion was considered to be
      significant if there was a discrete negative deflection of more than 0.05 mV
      within the TP segment. U wave inversion proceeded to positive deflection of U
      wave in patients with hypertension without ischemic heart disease (initial U wave
      inversion). In contrast, inverted U wave occurred after positive U wave
      deflection during attacks in patients with variant angina (terminal U wave
      inversion). When cold pressor test was performed in patients with variant angina
      during treatment with calcium entry blockers, no patient had either anginal
      attacks or ischemic ST-segment deviation, but 9 of 21 patients (43%) had
      transient initial U wave inversion, which was followed by positive U wave
      deflection. U wave inversion can be classified as initial U wave inversion and
      terminal U wave inversion according to the phasic relationship to positive U wave
      deflection; the latter is observed in association with regional myocardial
      ischemia. The former seems to be related to elevated blood pressure rather than
      to myocardial ischemia.

PMID- 8465771
TI  - Protective effect of coronary sinus obstruction from primary ischemia-induced
      ventricular fibrillation in the dog.
AB  - We examined whether partial coronary sinus obstruction affects the latency of the
      early ventricular fibrillation (VF) of acute ischemia. During baseline trials 15
      of 19 open-chest dogs fibrillated repeatedly and predictably within 2 to 5
      minutes (251.6 +/- 64 seconds) after reversible, double coronary artery occlusion
      without developing profound hemodynamic deterioration. The effect of partial
      coronary sinus obstruction sufficient to increase coronary sinus pressure to 40
      mm Hg could be adequately tested in 11 dogs. Coronary sinus obstruction
      consistently prevented VF in five dogs, significantly prolonged the VF latency in
      three (p < 0.01 to p < 0.001), and had no clear effect in another three. The
      overall effect was significant at the p < 0.01 level. VF latency
      prolongation/prevention was also positively correlated to the residual coronary
      sinus pressure at the time of VF (r = 0.76; p < 0.008), as well as the baseline
      VF latency (r = 0.75; (p < 0.008). The protective effect of coronary venous
      hypertension most likely reflects preservation of adequate extracellular fluid in
      the ischemic region after the perfusion arrest. This extracellular fluid may
      constitute a key component in the prevention of early ischemic arrhythmias by
      preserving interstitial hydraulic continuity and tissue homogeneity through
      enhanced dilution and diffusion of solutes.

PMID- 8465772
TI  - Additional antianginal efficacy of amiodarone in patients with limiting angina
      pectoris.
AB  - Sixty-three patients with stable angina New York Heart Association (NYHA) class
      III and a positive stress test despite triple therapy were randomized to a double
      blind protocol, receiving either placebo or amiodarone in a dose of 600 mg/day
      for 10 days, followed by 400 mg/day for an additional 10 days, and then by 200
      mg/day over a total period of 2 months. Comparable bicycle exercise times were
      observed at baseline in the amiodarone group (6.0 +/- 1.6 minutes) and in the
      placebo group (6.0 +/- 1.8 minutes). With amiodarone, there was a increase in
      exercise duration of 6.7 +/- 2.2 minutes versus 6.3 +/- 2.2 minutes at 1 month
      and 7.5 +/- 2.1 minutes versus 6.2 +/- 1.7 minutes at 2 months (p < 0.05). Also,
      the amiodarone group had a significant decrease in the double product when
      compared with the placebo group at 1 month (14,134 +/- 3,316 versus 17,570 +/-
      4,092 mm Hg/min, p < 0.001) and at 2 months (14,022 +/- 3,303 and 17,298 +/-
      4,872 mm Hg/min, p < 0.001). The degree of ST segment depression at peak exercise
      was also significantly reduced. Combination therapy of amiodarone with
      conventional antianginal therapy is well tolerated and results in a significant
      improvement in exercise capacity and a mild reduction of symptoms in patients who
      have continued, limiting angina pectoris with conventional triple therapy.

PMID- 8465773
TI  - Three-dimensional transesophageal echo imaging of the descending thoracic aorta.

PMID- 8465774
TI  - Exercise responses after cardiac transplantation in mitochondrial myopathy.

PMID- 8465775
TI  - Exercise hyperventilation chronic congestive heart failure and its relation to
      functional capacity and hemodynamics.

PMID- 8465776
TI  - More on death in the opera.

PMID- 8465777
TI  - Usefulness of myocardial contrast echocardiography in detecting the immediate
      changes in anterograde blood flow reserve after coronary angioplasty.
AB  - Myocardial contrast echocardiography has revealed that successful coronary
      angioplasty results in an immediate decrease in the amount of collateral blood
      flow to the perfusion bed supplied by the dilated vessel. This information could
      potentially be used with pharmacologic stress in the catheterization laboratory
      to also assess the improvement in coronary flow reserve after angioplasty. The
      immediate changes in area under the time intensity curve produced by a 1 ml slow
      injection of sonicated albumin immediately proximal to a stenosis before and
      after 14 angiographically successful angioplasties was studied in 12 patients.
      Area under the curve was assessed before and after an 8 mg selective injection of
      papaverine. The changes in area under the curve were correlated with percent
      improvement in epicardial area stenosis. Visually successful angioplasty resulted
      in > 30% improvement in area under the curve after papaverine in 9 of 14 studies.
      There was a significant correlation between improvement in area under the curve
      after papaverine and percent improvement in epicardial area stenosis (r = 0.75; p
      < 0.01). No patient had left ventricular wall motion abnormalities after
      papaverine before or after angioplasty. These changes suggest that quantitatively
      successful angioplasty results in decreased collateral blood flow to the involved
      myocardium during pharmacologic stress. These improvements in coronary flow
      reserve cannot be predicted by visual analysis of angioplasty results.

PMID- 8465778
TI  - Angioplasty versus bypass surgery for multivessel coronary artery disease with
      left ventricular ejection fraction < or = 40%.
AB  - Patients with multivessel coronary artery disease and left ventricular
      dysfunction represent a high-risk subgroup in whom coronary artery bypass
      grafting has been shown to improve survival compared with that of medically
      treated patients. The comparative benefits and risks of coronary angioplasty and
      bypass surgery in this subgroup of patients are unclear. This study
      retrospectively analyzes 100 consecutive patients treated with bypass surgery
      compared with a matched, concurrent cohort of 100 treated with multivessel
      angioplasty. Early results favored angioplasty; a hospital stay of 12.8 days was
      noted in the bypass group compared with 4.3 days in the angioplasty group (p <
      0.001). In-hospital mortality rates were similar in the bypass (5%) and
      angioplasty (3%) groups (p = NS). Stroke was observed significantly more often in
      the bypass group (7 vs 0%). However, late follow-up favored bypass patients;
      repeat revascularization procedures and late myocardial infarction occurred more
      frequently during follow-up in the angioplasty group. During 5-year follow-up,
      superior relief from disabling angina (99 vs 89%; p = 0.01) and a trend toward
      improved survival (76 vs 67%; p = 0.09) were observed in the bypass group as
      compared with the angioplasty group. Multivariate correlates of late mortality
      included age and incomplete revascularization, but not mode of revascularization.
      Thus, in patients with multivessel coronary artery disease and left ventricular
      dysfunction, early results favor angioplasty, whereas late follow-up favors
      bypass surgery. However, late survival was similar in both groups of patients who
      were completely revascularized.

PMID- 8465779
TI  - Diagnosis of right ventricular infarction by overlap images of simultaneous dual
      emission computed tomography using technetium-99m pyrophosphate and thallium-201.
AB  - The validity of dual energy single-photon emission computed tomography (SPECT)
      with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 for the diagnosis
      of right ventricular (RV) infarction, and the clinical features of RV infarction,
      were investigated in 190 patients with acute myocardial infarction. Diagnosis of
      RV infarction was performed by Tc-99m PPi accumulation in the RV myocardium on
      thallium-201 and Tc-99m PPi over-lay images at the dual SPECT with simultaneous
      imaging taken 2 to 9 days after the onset of myocardial infarction. Thirty RV
      infarctions were found among the 190 patients with left ventricular infarction
      (15.8%): 29 (97%) in association with the inferior and 1 (3%) with the lateral
      infarction. Tc-99m PPi accumulation was mostly observed in the posterior wall of
      the right ventricle. A total occlusion or a severe stenosis of the right coronary
      artery was demonstrated angiographically in 92% of the patients with RV
      infarction. The prevalence of RV infarctions was significantly lower in patients
      who achieved successful early reperfusion than in those who did not (26.7 vs
      68.4%, respectively, p < 0.01). However, a successful early reperfusion therapy
      could not significantly decrease the rate of RV involvement in patients without
      significant collateral flow (p < 0.01). Thus, dual isotope SPECT with Tc-99m PPi
      and thallium-201 can be used as a reliable method for the diagnosis of RV
      infarction.

PMID- 8465780
TI  - Rationale and design of a secondary prevention trial of increasing serum high
      density lipoprotein cholesterol and reducing triglycerides in patients with
      clinically manifest atherosclerotic heart disease (the Bezafibrate Infarction
      Prevention Trial).
AB  - Controlled clinical trials have demonstrated the efficacy of reducing the blood
      levels of low-density lipoprotein cholesterol in reducing the incidence of
      coronary artery disease in hypercholesterolemic middle-aged men. However, a
      similar reversibility of the risk of coronary artery disease has not been
      demonstrated for high-density lipoprotein cholesterol elevation and triglyceride
      reduction. Therefore, the effect of administering 400 mg of bezafibrate retard
      daily versus placebo (double blind) to patients with myocardial infarction
      preceding randomization by 6 months to 5 years, or a clinically manifest anginal
      syndrome documented by objective evidence of dynamic myocardial ischemia, or
      both, is being investigated. Three thousand subjects (aged 45 to 74 years) are
      being enrolled from 19 cardiac departments in Israel, with total serum
      cholesterol between 180 and 250 mg/dl, high-density lipoprotein cholesterol < or
      = 45 mg/dl and triglycerides < or = 300 mg/dl. In addition, low-density
      lipoprotein cholesterol concentrations are required to be < or = 180 mg/dl (< or
      = 160 mg/dl for patients aged < 50 years). Patients needing lipid-modifying
      therapy, exhibiting > or = 1 prespecified exclusion criterion or not giving
      informed consent, or a combination, are not randomized. The primary end points
      for evaluating efficacy are the incidence of fatal and nonfatal myocardial
      infarction, and sudden death. The hypothesized effect of bezafibrate
      administration under the aforementioned protocol is to reduce an estimated
      cumulative end point event incidence of > or = 15% by 20 to 25% over an average
      follow-up period of 6.25 years, through early 1998, when the last patient
      recruited will have completed 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465781
TI  - Trans-fatty acid patterns in patients with angiographically documented coronary
      artery disease.
AB  - The plasma trans-fatty acids of 47 patients with angiographically documented
      coronary artery disease were compared with those of 56 reference subjects using
      high-resolution capillary column gas-liquid chromatography to test the hypothesis
      that trans-fatty acid intake is a risk factor for cardiovascular disease.
      Individual and total trans-fatty acids were higher in patients than in reference
      subjects (1.38 vs 1.11% for total trans-fatty acids, p < 0.003; 0.40 vs 0.31% for
      palmitoleic acid trans, p < 0.001; and 0.28 vs 0.22% for linoleic acid trans, p <
      0.007). High-density lipoprotein (HDL) cholesterol and HDL cholesterol/total
      cholesterol were negatively correlated (r = -0.29, p < 0.004; and r = -0.35, p <
      0.001, respectively), whereas triglycerides, total cholesterol and low-density
      lipoprotein cholesterol were positively correlated (r = 0.47, p < 0.001; r =
      0.22, p < 0.03; r = 0.20, p < 0.05, respectively) with palmitoleic acid trans.
      The correlations were similar and significant for linoleic acid trans, but less
      strong for total trans-fatty acids (which is more difficult to measure and has
      greater variability). Saturated and trans-fatty acids and total cholesterol are
      positively associated, whereas HDL/total cholesterol and polyunsaturated fatty
      acids are negatively associated with coronary artery disease. These results are
      consistent with the hypothesis that dietary trans-fatty acids are a
      cardiovascular risk factor.

PMID- 8465782
TI  - Daily physical activity levels in congestive heart failure.
AB  - To determine the level of daily physical activity routinely performed by patients
      with congestive heart failure (CHF) and the ability of clinical and laboratory
      assessments of function to predict peak daily activity levels, 45 patients with
      CHF were evaluated in the laboratory and during 2 days of usual activity.
      Subjects performed symptom-limited treadmill exercise tests with respiratory gas
      analysis and wore a Vitalog activity monitor with continuous measurement of heart
      rate and body motion. Mean maximal oxygen uptake for this sample was 16.8
      ml/kg/min. Peak daily physical activity involved walking on a flat surface (44%),
      or general activities (housework/yardwork, 42%). Most subjects were asymptomatic
      (49%) during daily physical activity, 22% noted dyspnea, 16% fatigue and 13% sore
      muscles/joints. Perceived intensity of peak daily physical activity (mean = 4.19,
      SD = 2.21) was similar to perceived exertion (mean = 3.73, SD = 1.37) reported at
      ventilatory threshold measured during treadmill exercise testing. Subjects may
      control their peak daily physical activity to minimize symptoms experienced. It
      was further observed that current methods of assessing functional capacity in
      these patients were inadequate for estimating the peak level of daily activity.
      In conclusion, daily physical activity levels are low in patients with congestive
      heart failure and a gap exists between exercise capacity and actual performance
      of daily physical activity.

PMID- 8465783
TI  - Adjustable tricuspid valve annuloplasty assisted by intraoperative
      transesophageal color Doppler echocardiography.
AB  - Intraoperative transesophageal echocardiography (TEE) can play a major role in
      active guidance of cardiac surgery. This study describes a new application of TEE
      for assisting tricuspid suture annuloplasty. Twenty-five patients (aged 52 +/- 11
      years) who underwent mitral valve replacement and tricuspid valve annuloplasty
      were studied intraoperatively by TEE. After cardiopulmonary bypass, the suture
      annuloplasty was adjusted on the beating heart until palpable regurgitation was
      eliminated. Further adjustment of the suture was performed under
      echocardiographic guidance until color Doppler flow imaging showed the most
      adequate correction of tricuspid regurgitation (TR). A significant decrease in
      the semiquantitative grade of TR, of regurgitant jet area and of the ratio jet
      area/right atrial area was obtained when the suture was adjusted under
      echocardiographic guidance. The peak inflow velocity and the gradient across the
      tricuspid valve did not show significant changes throughout the procedures. The
      results showed that the tricuspid suture annuloplasty guided by TEE enables a
      substantial reduction in residual TR without creating valve stenosis.

PMID- 8465784
TI  - Left ventricular diastolic pressure-volume response immediately after successful
      percutaneous transvenous mitral commissurotomy.
AB  - The left ventricular (LV) diastolic pressure-volume response after percutaneous
      transvenous mitral commissurotomy (PTMC) was investigated to determine whether it
      was related to the baseline conditions of the left ventricle. Left
      ventriculography was performed, and the measurements of LV pressure were obtained
      in 32 patients before and after PTMC. Mitral valve area increased from 1.0 +/-
      0.3 to 1.9 +/- 0.4 cm2 (p < 0.005) after PTMC, which caused a decrease in left
      atrial mean pressure (14.8 +/- 5.9 to 7.4 +/- 2.7 mm Hg; p < 0.005). LV end
      diastolic pressure increased in all patients 5 minutes after PTMC. However,
      patients could be divided into 2 groups according to the following changes in LV
      end-diastolic pressure 20 minutes after PTMC: In 22 patients, LV end-diastolic
      pressure returned to the near-baseline level 20 minutes after PTMC (before 5.0 +/
      2.2, 5 minutes after 8.6 +/- 3.1, and 20 minutes after 6.3 +/- 2.5 mm Hg) with a
      significant increase in LV end-diastolic volume index (64 +/- 12 to 74 +/- 14
      ml/m2; p < 0.001) and augmentation of LV stroke volume index (39 +/- 9 to 47 +/-
      11 ml/m2; p < 0.001). However, in the remaining 10 patients with a larger LV
      volume (> 80 ml/m2) and reduced ejection fraction (< 50%) at baseline, LV end
      diastolic pressure further increased 20 minutes after PTMC (before 5.5 +/- 2.8, 5
      minutes after 7.8 +/- 2.7, and 20 minutes after 11.0 +/- 2.9 mm Hg) without
      significant changes in LV volume.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465785
TI  - Immediate and one-year results of percutaneous mitral balloon valvuloplasty using
      Inoue and double-balloon techniques.
AB  - Many investigators have reported the results of percutaneous mitral valvuloplasty
      (PMV) using the Inoue or double-balloon technique, but to date, the immediate and
      long-term follow-up results of the 2 different procedures have not been compared
      in a prospective study. Therefore, a prospective, randomized trial was performed
      in 120 consecutive patients who underwent PMV using Inoue (n = 59; group I) or
      double (n = 61; group D) balloons. The success rate was 83% in group I, and 89%
      in group D. The magnitude of changes in mitral valve area and hemodynamic
      variables was the same in both groups. Immediately after dilation, the long
      diameter changes of the mitral orifice was greater in group D, and the increase
      in ejection fraction slope was significantly greater in group D. The duration of
      the total procedure, and the fluoroscopic time was significantly shorter in group
      I. The incidence of left-to-right shunt at the atrial level (Qp/Qs > 1.5) was
      3.4% in group I and 4.9% in group D. Severe mitral regurgitation (grade > or = 3)
      occurred in 2 patients in each group. At follow-up, the mitral valve area had
      significantly decreased at 6 months, but no further changes occurred at 1-year
      follow-up in both groups. The long diameter of the mitral orifice was greater in
      group D until 6 months after PMV, but the difference was not apparent at 1-year
      follow-up. In conclusion, the Inoue and double-balloon techniques obtained
      equivalent results in the success rate and frequency of complications.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8465786
TI  - Rapid systolic intraventricular velocities after valve replacement for aortic
      stenosis.
AB  - To assess the frequency and severity of intraventricular gradients after valve
      replacement for severe valvular aortic stenosis 25 patients (valve area 0.59 +/-
      0.19 cm2) were studied serially with Doppler echocardiography on postoperative
      days 1, 2, 3, 5 and 7. Pulsed Doppler was used to search for increased
      intraventricular velocities. Mid-to-late systolic intraventricular velocities >
      or = 2 m/s were defined as intraventricular gradients. In 13 patients (52%)
      intraventricular gradients were found at least once during days 1 to 7 (group A)
      and were most frequent at day 3 (44%). The typical location of these velocities
      was at the midventricular level close to the septum. In 4 patients
      intraventricular gradients > 64 mm Hg were found. Left ventricular end-diastolic
      and end-systolic diameters recorded preoperatively were significantly smaller in
      group A than in the rest (43.6 +/- 5.4 vs 50 +/- 5.8 mm and 24.6 +/- 5.6 vs 33.1
      +/- 7.3 mm, both p < 0.05) and the fractional shortening was significantly higher
      (44 +/- 9 vs 34 +/- 9%, p < 0.05). It is concluded that intraventricular
      gradients are frequent during the first week after valve replacement for severe
      aortic stenosis. These gradients are mostly mild and transient in nature, but
      significant gradients associated with clinical deterioration may occur. The risk
      of developing intraventricular gradients postoperatively may be predicted at a
      preoperative echocardiographic examination, and patients with a small left
      ventricular cavity size and maintained contractility are at particular
      risk.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465787
TI  - Comparison of mitral valve dimensions in adults with valvular aortic stenosis,
      pure aortic regurgitation and hypertrophic cardiomyopathy.
AB  - To assess the effect of left ventricular dilatation on mitral valve size, this
      study compared the dimensions of the mitral valve in patients with aortic valve
      disease and hypertrophic cardiomyopathy (HC). A total of 216 valves, removed at
      operation or necropsy, was analyzed by quantitative morphometric methods from:
      (1) 2 patient groups with dilated left ventricular cavities (i.e., 17 patients
      with dilated valvular aortic stenosis [AS] and 31 with pure aortic
      regurgitation), (2) 2 patient groups without dilated left ventricular cavities
      (i.e., 29 patients with nondilated AS and 94 with HC), and (3) 45 control
      subjects without heart disease. Mean mitral leaflet areas in patients with AS
      with dilated left ventricular cavities (13.1 +/- 3.0 cm2) and aortic
      regurgitation (12.0 +/- 3.6 cm2) were significantly greater than in control
      subjects (8.7 +/- 2.0 cm2; p < 0.001). Mean mitral leaflet areas in patients with
      AS without dilated left ventricular cavities (9.8 +/- 2.0 cm2) were similar to
      those of normal valves (p = NS). However, mean mitral leaflet area in patients
      with HC, in whom left ventricular cavities were also nondilated, was
      significantly greater (12.8 +/- 3.7 cm2) than in those with nondilated AS and in
      normal subjects (p < 0.001). Therefore, increased mitral leaflet area: (1) is
      often present in patients with aortic valve disease with dilated left ventricles
      in whom it appears to be secondary to left ventricular chamber dilatation; and
      (2) cannot be attributed to left ventricular cavity dilatation in patients with
      HC, since their cavities were of normal or small size.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8465788
TI  - Prevalence and incidence of left ventricular dysfunction in patients with human
      immunodeficiency virus infection.
AB  - The prevalence and incidence of left ventricular (LV) dysfunction was examined in
      patients infected with the human immunodeficiency virus (HIV). Sixty-nine
      randomly selected patients diagnosed with HIV infection who were followed in HIV
      clinics were prospectively evaluated by 2-dimensional echocardiography. Mean
      follow-up duration was 11 months. Additionally, 39 consecutive HIV-infected
      patients referred to the Cardiomyopathy Service and found to have LV dysfunction
      by 2-dimensional echocardiography were also studied. Of the 39 referred patients,
      34 (87%) were referred for recent onset, unexplained, congestive heart failure.
      During this time, the HIV clinic population comprised 1,819 alive and actively
      followed patients; the 39 cardiomyopathy referrals therefore constituted a crude
      rate of 2.1% for this population. Of the 69 prospectively studied patients
      without clinical heart disease, a 14.5% prevalence of global LV hypokinesia and
      an incidence of 18%/patient-year were found. During a maximal 18-month follow-up
      period, 4 prospective patients (5.8%) developed symptoms of congestive heart
      failure. A greater proportion of prospective and referred patients with LV
      dysfunction had CD4 counts < 100/mm3 (62 and 79%, respectively) than did that of
      those without LV dysfunction (35%). In conclusion, the high rate of unexpected LV
      dysfunction in this HIV-infected population suggests that early cardiac
      contractile abnormalities may involve a significant number of patients, most of
      whom have low CD4 counts. A subgroup of these patients appears to progress to
      symptomatic congestive heart failure.

PMID- 8465789
TI  - Usefulness of the bidirectional Glenn procedure as staged reconstruction for the
      functional single ventricle.
AB  - The bidirectional Glenn operation may be particularly useful as an intermediate
      procedure before Fontan correction in high-risk patients. From October 1989
      through February 1992, 50 patients 1 to 60 months old (median 12) have undergone
      a bidirectional Glenn operation. Diagnoses included hypoplastic left heart
      syndrome in 21 patients, pulmonary atresia with intact ventricular septum in 10,
      tricuspid valve atresia in 9, other complex univentricular heart defects in 9,
      and Ebstein's anomaly in 1. Mean pulmonary vascular resistance was 2.2 +/- 0.2
      Wood U (range 0.5 to 7.3) and mean pulmonary artery area Nakata index was 318 +/-
      mm2/m2 (range 80 to 821). Additional procedures were performed in 17 patients,
      including pulmonary artery reconstruction in 15 (29%) and bilateral caval
      anastomoses in 5 (10%). There were 4 hospital deaths (8%). Two deaths resulted
      from myocardial infarction in patients with pulmonary atresia with intact
      ventricular septum and sinusoids and 1 from severe pulmonary vascular disease in
      a patient with hypoplastic left heart syndrome. There was 1 late death from
      pneumonia. Actuarial survival is 92 +/- 4% at 1 month and beyond, with a mean
      follow-up of 13.4 +/- 1 months. Risk factor analysis showed that pulmonary
      vascular resistance > 3 Wood U and pulmonary artery distortion were associated
      with increased mortality. Twelve patients have undergone a Fontan procedure at a
      mean duration after bidirectional Glenn of 18 months with 1 death (8%). The
      bidirectional Glenn procedure provides excellent palliation in high-risk patients
      and appears useful as a staging procedure before Fontan correction.

PMID- 8465790
TI  - Aortic "recoarctation" at rest versus at exercise in children as evaluated by
      stress Doppler echocardiography after a "good" operative result.
AB  - The mechanism for exercise systolic hypertension after a "good" operative repair
      of coarctation of the aorta remains speculative. Twenty-four children (mean age
      +/- SD 10.3 +/- 3.8 years) were studied with continuous-wave Doppler
      echocardiography while they performed continuous, graded, maximal treadmill
      exercise. Patients were free of "recoarctation" based on conventional resting
      echocardiography. Measurements of ascending and descending aortic peak
      instantaneous systolic velocity were obtained at rest, throughout exercise and
      during recovery. Results were compared with 24 age- and gender-matched control
      subjects. Fifteen patients were normotensive (group 1) (peak systolic blood
      pressure, 147 +/- 21 mm Hg) and 9 developed systolic hypertension during exercise
      (group 2) (196 +/- 32 mm Hg) (p < 0.05) (control subjects, 143 +/- 21 mm Hg).
      Descending aortic peak systolic velocity at rest ranged from 1.50 +/- 0.27 m/s in
      the control group to 2.57 +/- 0.57 m/s (group 1) and 2.93 +/- 0.43 m/s (group 2)
      (p < 0.05, group 2 vs control). Differences were amplified at peak exercise with
      systolic velocity increasing to 4.26 +/- 0.61 m/s in group 2 but only to 3.61 +/-
      0.70 m/s in group 1 and 2.26 +/- 0.38 m/s in control subjects (p < 0.05, group 2
      vs group 1 and control). Seven patients developed a descending aortic diastolic
      velocity during exercise. Stepwise linear regression analysis identified 2
      variables to be significant determinants of peak exercise systolic blood pressure
      in the "total" patient group: (1) age at exercise testing, and (2) descending
      aortic peak systolic velocity at peak exercise (r2 = 0.88, p < 0.001) (group 2,
      alone - r2 = 0.98, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465791
TI  - Early results after pediatric cardiac transplantation with triple
      immunosuppression therapy.
AB  - Pediatric heart transplant recipients were previously reported to have higher
      early mortality and morbidity than do adult patients treated with triple
      immunosuppression therapy (steroids, azathioprine and cyclosporine). Nineteen
      patients (11 infants and 8 older children) underwent orthotopic transplantation
      using triple immunosuppression therapy. Surveillance for cellular rejection and
      coronary arteriopathy was performed with endomyocardial biopsy and selective
      coronary angiography in all patients, with continuous monitoring for hypertension
      and serious infection. Seventeen of 19 patients (89%; 10 infants and 7 older
      children) are current survivors, with a median follow-up of 29 months (range 17
      to 94). There were 5 and 7 episodes of rejection in the first 12 months after
      transplantation in the infant and older groups, respectively, for actuarial
      freedom-from-rejection rates of 65% at 3 months and 54% at 12 months. Severe
      coronary arteriopathy was detected in 1 infant 11 months after transplantation.
      In the first 12 months after transplantation, there were 3 hospitalizations for
      infection, and 2 patients needed treatment for hypertension in the infant group,
      compared with 1 hospitalization for infection, and 4 patients on
      antihypertensives in the older group. An increased prevalence of noninfectious
      complications in the infant group led to significantly longer postoperative stays
      than in the older group (mean 27.3 vs 19.4 days; p < 0.05). The results indicate
      that cardiac transplantation using triple immunosuppression therapy in infants,
      children and adolescents is associated with a high survival rate, and low rates
      of rejection and serious infection.

PMID- 8465792
TI  - Left atrial appendage blood flow determined by transesophageal echocardiography
      in healthy subjects.
AB  - Transesophageal echocardiography was performed in 46 healthy subjects to define
      characteristics of normal left atrial appendage blood flow. Three different flow
      wave patterns were observed that were heart rate dependent (p < 0.01). A
      quadriphasic pattern, consisting of 2 diastolic forward (emptying) flow waves
      each followed by a backward (filling) flow wave, was present in 36 subjects
      (78%). Triphasic appendage flow was observed in 6 subjects (13%) and biphasic
      flow in 4 (9%). Mean heart rates among subjects with quadri-, tri- and biphasic
      flows were 75 +/- 11, 95 +/- 6 and 112 +/- 7 beats/min, respectively. Analysis of
      pulsed Doppler recordings of subjects with quadriphasic or triphasic appendage
      flow patterns showed that the onset of transmitral early diastolic peak flow wave
      was followed at 17 +/- 15 ms by the onset of pulmonary venous diastolic flow and
      at 43 +/- 17 ms by the onset of the first diastolic forward flow in the
      appendage. This sequence was constant and independent of heart rate (p < 0.01),
      suggesting a causal relation between left ventricular relaxation and the first
      diastolic forward flow wave in the appendage. The second diastolic forward flow
      followed the P wave on the electrocardiogram at 79 +/- 23 ms. Thus, left atrial
      appendage blood flow pattern in normal subjects is heart rate dependent, and
      ventricular relaxation appears to initiate early diastolic emptying of the
      appendage.

PMID- 8465793
TI  - Demographic features and prevalence of idiopathic myocarditis in patients
      undergoing endomyocardial biopsy.
AB  - From January 1985 through December 1990, 534 patients underwent endomyocardial
      biopsy at Johns Hopkins Hospital for suspected myocarditis. One hundred thirty
      eight (26%) biopsy specimens were diagnosed histologically by 2 cardiac
      pathologists as either active (n = 85, 16%) or borderline (n = 53, 10%)
      myocarditis. Of the 138 patients, 60 were excluded based on either specific
      concurrent clinical conditions or noncongestive heart failure presentations.
      Immunohistochemical staining for common leukocyte antigen infiltrating cells
      performed on the remaining 78 specimens confirmed the presence of focal or
      multifocal inflammatory infiltrates in 58, of which 49 had histologic evidence of
      active myocarditis. All 49 patients presented with congestive heart failure and
      left ventricular ejection fractions of < 40%. Compared with patients with either
      idiopathic dilated cardiomyopathy (n = 207) or ischemic cardiomyopathy (n = 44),
      these patients with myocarditis had a less striking male predominance (58 vs 69
      and 83%, respectively) (p = 0.02) and were younger (43 +/- 16 vs 50 +/- 17 and 55
      +/- 13 years, respectively, p = 0.005). Racial distributions were similar. A
      recent history of a discrete flu-like illness was obtained in 52%, two-thirds of
      which were clustered between the months of December and March. Onset of heart
      failure peaked between December and April (63% and was low between May through
      September (22%). A peak in the proportion of patients found to have active
      myocarditis on biopsy occurred in 1986 (17 vs 7 to 10% in other years).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8465794
TI  - Left ventricular myocardial function in myotonic dystrophy.
AB  - Myotonic dystrophy is an autosomal dominant disease affecting many organ systems,
      including the heart. Abnormalities of the cardiac conduction system are a
      frequent and well-documented finding in this neuromuscular disease, whereas overt
      signs of heart failure are rarely reported. However, controversy exists about the
      prevalence of preclinical left ventricular (LV) dysfunction in patients with
      myotonic dystrophy who have no symptoms of heart failure. To address this issue,
      load-independent LV function indexes were compared in patients with myotonic
      dystrophy and in normal subjects. LV measurements were obtained with M-mode
      echocardiography in 43 consecutive patients with myotonic dystrophy (mean age 35
      +/- 14 years) who had no clinical evidence of heart failure, and in 35 sex- and
      age-matched controls. A cuff sphygmomanometer was used to determine blood
      pressure. No difference was found between patients and control subjects in the
      percentage of LV ejection fraction predicted for end-systolic stress (103 +/- 7
      vs 103 +/- 7%; p = 0.97) or in the end-systolic stress/volume index ratio (2.9 +/
      0.5 vs 2.7 +/- 0.4 dyne7/cm3; p = 0.09). Similarly, no significant difference in
      LV myocardial function was detected between the 19 patients with a mild degree of
      the neuromuscular disease and in the 24 with a moderate or severe degree of the
      disease. Finally, LV myocardial function was compared between patients with
      myotonic dystrophy and atrioventricular or intraventricular conduction
      disturbances (n = 8) and those without these disturbances (n = 35), but no
      significant difference in the percentage of LV ejection fraction predicted for
      end-systolic stress or in the end-systolic stress/volume index ratio could be
      detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465795
TI  - Effects of ibopamine on the increase in plasma norepinephrine levels during
      exercise in congestive heart failure.

PMID- 8465796
TI  - Effect of balloon valvuloplasty for mitral stenosis on right ventricular
      function.

PMID- 8465797
TI  - Regulation of QT interval during postural transitory changes in heart rate in
      normal subjects.

PMID- 8465798
TI  - Prevalence of atherothrombotic brain infarction and extracranial carotid arterial
      disease, and their association in elderly blacks, Hispanics and whites.

PMID- 8465799
TI  - How should physicians view heart failure? The philosophical and physiological
      evolution of three conceptual models of the disease.
AB  - During the last 50 years, physicians have developed three distinct conceptual
      models of heart failure that have provided a rational basis for the treatment of
      the disease. In the 1940s through the 1960s, physicians regarded heart failure
      principally as an edematous disorder and formulated a cardiorenal model of the
      disease in an attempt to explain the sodium retention of these patients. This
      model led to the widespread use of digitalis and diuretics. In the 1970s and
      1980s, physicians viewed heart failure principally as a hemodynamic disorder and
      formulated a cardiocirculatory model of the disease in an attempt to explain
      patients' symptoms and disability. This model led to the widespread use of
      peripheral vasodilators and the development of novel positive inotropic agents.
      Now, in the 1990s, physicians are beginning to think about heart failure as a
      neurohormonal disorder in an attempt to explain the progression of the disease
      and its poor long-term survival. This new conceptual framework has led to the
      widespread use of converting-enzyme inhibitors and the development of beta
      blockers for the treatment of heart failure. Which conceptual model most
      accurately describes the syndrome of heart failure and leads physicians to
      utilize the most effective treatment? This paper critically reviews the available
      evidence supporting and refuting the validity of all three models of heart
      failure. We conclude that, to varying degrees, all three approaches provide
      useful, but incomplete, insights into this physiologically complex and
      therapeutically challenging disease.

PMID- 8465800
TI  - The xamoterol experience in the treatment of heart failure.
AB  - Beta blockers may benefit patients with dilated cardiomyopathy but low output
      failure can be a problem. Thus a beta 1-selective beta blocker with about 45%
      intrinsic sympathomimetic activity (ISA), such as xamoterol, was thought to have
      a desirable pharmacologic profile. Long-term studies of xamoterol in patients
      with idiopathic dilated cardiomyopathy have shown improved cardiac performance
      and exercise tolerance, while exercise heart rate, left ventricular ejection
      fraction, and pulmonary artery wedge pressure were decreased. This improvement in
      exercise capacity and overall quality of life in patients treated with xamoterol
      has been confirmed in further controlled trials of patients with mild-to-moderate
      heart failure (NYHA class I and II). However, in patients with moderate-to-severe
      heart failure (NYHA class III and IV), mortality was unfavorably influenced by
      xamoterol. The therapeutic role of xamoterol in patients with heart disease needs
      further refinement.

PMID- 8465801
TI  - p values, hypothesis tests, and likelihood: implications for epidemiology of a
      neglected historical debate.
AB  - It is not generally appreciated that the p value, as conceived by R. A. Fisher,
      is not compatible with the Neyman-Pearson hypothesis test in which it has become
      embedded. The p value was meant to be a flexible inferential measure, whereas the
      hypothesis test was a rule for behavior, not inference. The combination of the
      two methods has led to a reinterpretation of the p value simultaneously as an
      "observed error rate" and as a measure of evidence. Both of these interpretations
      are problematic, and their combination has obscured the important differences
      between Neyman and Fisher on the nature of the scientific method and inhibited
      our understanding of the philosophic implications of the basic methods in use
      today. An analysis using another method promoted by Fisher, mathematical
      likelihood, shows that the p value substantially overstates the evidence against
      the null hypothesis. Likelihood makes clearer the distinction between error rates
      and inferential evidence and is a quantitative tool for expressing evidential
      strength that is more appropriate for the purposes of epidemiology than the p
      value.

PMID- 8465802
TI  - A comparison of prospective and retrospective assessments of diet in the study of
      breast cancer.
AB  - Fat intake was examined in relation to risk of breast cancer using dietary
      questionnaires administered both before and after the diagnosis of breast cancer.
      Among the Nurses' Health Study cohort members who completed a food frequency
      questionnaire and were free of cancer in 1986, 398 were diagnosed with breast
      cancer during 2 years of follow-up. These cases and 798 age-matched controls
      (cohort members who also completed a dietary questionnaire in 1986 but did not
      develop breast cancer) were sent another food frequency questionnaire in 1989
      inquiring about their diet in 1985. Three hundred cases and 602 controls
      responded to the second questionnaire. The age-adjusted analysis using the
      prospective (1986) questionnaire demonstrated no appreciable associations between
      breast cancer incidence and intakes of total fat (odds ratio (OR) between highest
      and lowest quintiles = 0.87; 95% confidence interval (CI) 0.54-1.40) and
      saturated fat (OR = 0.97; CI 0.64-1.46). The age-adjusted analysis using the
      retrospective (1989) questionnaire suggested positive associations between breast
      cancer incidence and intakes of total fat (OR = 1.43; 95% CI 0.90-2.27) and
      saturated fat (OR = 1.38; 95% CI 0.89-2.13). When nutrients were adjusted for
      total energy intake, the direction and magnitude of the differences between the
      prospective and retrospective analyses were similar to the analyses unadjusted
      for energy intake. These results suggest that case-control studies of diet and
      breast cancer may yield biased associations between fat intake and the risk of
      breast cancer.

PMID- 8465803
TI  - A cohort study of alcohol consumption and risk of breast cancer.
AB  - The association between alcohol consumption and breast cancer risk was examined
      in 519 newly incident, histologically confirmed cases of breast cancer diagnosed
      between 1982 and 1987 within a cohort of 56,837 women enrolled in the Canadian
      National Breast Screening Study. These women had completed a self-administered
      food frequency questionnaire including alcohol consumption at enrollment into the
      study prior to their breast cancer diagnosis. For the total cohort, only a weak
      association between total alcohol consumption and breast cancer risk is observed,
      the adjusted relative risk for those drinking 30 or more g/day being 1.22 (95%
      confidence interval (CI) 0.78-1.90) compared with nondrinkers. There is some
      evidence for a positive association in women who were premenopausal at the time
      of enrollment for whom there was a monotonic increase in risk with increasing
      alcohol intake. Compared with nondrinkers, the adjusted relative risk for alcohol
      consumption of between 0 and < 10 g of alcohol daily was 1.11 (95% CI 0.71-1.71),
      between 10 and < 20 g was 1.37 (95% CI 0.79-2.36), between 20 and < 30 g was 1.51
      (95% CI 0.80-2.86), and > or = 30 g was 1.86 (95% CI 0.96-3.66; p (trend) =
      0.07). These findings contrasted with the results for postmenopausal women where
      there appeared to be no evidence of any relation. The association in
      premenopausal women is generally reasonably consistent with that of other studies
      that have found positive associations with alcohol intake.

PMID- 8465804
TI  - Association of alcohol intake, cigarette smoking, and occupational status with
      the risk of idiopathic osteonecrosis of the femoral head.
AB  - To investigate the association of alcohol intake, cigarette smoking, occupation,
      and other factors with the development of idiopathic osteonecrosis of the femoral
      head, a nationwide multicenter case-control study was conducted in Japan during
      1988-1990, comparing 118 cases with no history of systemic corticosteroid use
      with 236 controls matched for sex, age, ethnicity, clinic, and date of initial
      examination. The risks of developing femoral head necrosis associated with
      potential risk factors were estimated by adjusted relative odds obtained by a
      conditional logistic regression model. The elevated relative odds were observed
      for occasional drinkers (relative odds = 3.2, 95% confidence interval 1.1-9.2)
      and regular drinkers (relative odds = 13.1, 95% confidence interval 4.1-42.5)
      with a significant dose-response relation (p < 0.001). For current drinkers, the
      relative odds were 2.8, 9.4, and 14.8 for < 320, 320-799, and > or = 800 g/week
      of ethanol intake, respectively. An increased risk was found for current smokers
      (relative odds = 4.7, 95% confidence interval 1.5-14.5), but a linear increasing
      trend in the cumulative effect of smoking was not evident at 20 pack-years or
      over. A weak but significant dose-response relation was observed for daily
      occupational energy consumption (p < 0.05). The present study confirmed the
      strong association of alcohol intake and positive association of cigarette
      smoking and suggested the role of heavy physical work.

PMID- 8465805
TI  - Work activities and the onset of first-time low back pain among New York City
      fire fighters.
AB  - In a prospective study of first-time low back pain among New York City fire
      fighters, a total of 115 cases and 109 randomly selected controls were
      interviewed by telephone between December 1988 and July 1989 to examine the role
      of recent work activities in the onset of first-time low back pain. After
      adjusting for known risk factors and off-duty activities, statistically
      significant high-risk work activities included operating a charged hose inside a
      building (odds ratio (OR) = 3.26), climbing ladders (OR = 3.18), breaking windows
      (OR = 4.45), cutting structures (OR = 6.47), looking for hidden fires (OR =
      4.32), and lifting objects > or = 18 kg (OR = 3.07). Low-risk activities included
      connecting hydrants to pumpers (OR = 0.36), pulling booster hose (OR = 0.19), and
      participating in drills (OR = 0.09) or physical training (OR = 0.16). When
      further adjusted for exposure to smoke (OR = 13.59), a surrogate for severity of
      alarms, the ORs associated with high-risk activities were no longer significant.
      This, however, does not diminish the role of activities in the onset of low back
      pain. Instead, it suggests an inseparable role for activities and environmental
      hazards. To examine this, the risk of low back pain was measured within five work
      zones sequential in time relative to location and distance from a structural
      fire. The risk gradually increased as the fire fighter moved away from the
      firehouse (OR = 0.10) and closer to the site of fire (OR = 3.91).

PMID- 8465807
TI  - Prevalence and correlates of lower extremity arterial disease in elderly women.
AB  - Although lower extremity arterial disease occurs in 15-20% of the population over
      the age of 75 years, little is known about the etiology of the disease in women.
      In this cross-sectional study involving 1,601 healthy elderly women (mean age, 71
      years; range, 65-93 years), the occurrence of lower extremity arterial disease
      was assessed noninvasively by measuring brachial and ankle pressures bilaterally.
      Disease prevalence ranged from 2.9% in those aged 65-69 years to 15.5% in those
      aged 80 years or older. Approximately 20% of those with disease had symptoms of
      claudication. Age, systolic blood pressure, and current smoking status were
      strong independent risk factors for arterial disease; a history of arthritis, use
      of nonthiazide diuretics, current coffee drinking, and upper body obesity were
      also independent correlates. The number of pack-years in current and former
      smokers and the number of cigarettes per day used by current smokers showed a
      dose-response relation with disease. The population attributable risk for current
      smoking was 26%. The major correlates for symptomatic arterial disease were
      current smoking and systolic blood pressure. It is concluded that the major risk
      factors for lower extremity arterial disease in elderly women are similar to
      those in men. Preventive efforts should focus on smoking cessation and management
      of hypertension.

PMID- 8465806
TI  - Divergent age-associated patterns of high density lipoprotein cholesterol and its
      percentage in Jewish and Moslem Arab Israeli children and adolescents: the Petach
      Tikva Project.
AB  - We studied three groups of Israeli Jewish schoolchildren in and surrounding
      Petach Tikva, Israel, cross-sectionally, at ages 9-10, 13-14, and 16-18 years,
      and compared lipid and lipoprotein levels and age-associated lipoprotein patterns
      in the same age groups of boys and girls in neighboring Israeli Moslem Arab
      schools during 1986-1987. Moslem children displayed striking differences in the
      levels of lipids and age-associated patterns of lipoproteins compared with Jewish
      schoolchildren. The mean total cholesterol levels were lower in the Moslem
      children, in both sexes, in every age grouping. High density lipoprotein
      cholesterol (HDL-C) levels were significantly higher at age 16-18 in the Moslem
      boys than in the Jewish boys. While the Jewish boys displayed a previously
      reported "typical" pattern of lower HDL-C levels postpuberty compared with
      prepuberty, the Moslem boys had markedly higher mean HDL-C levels at age 16-18
      compared with those at age 9-10. The Moslem girls also had higher HDL-C levels at
      age 16-18 than those observed in the age 9-10 group. Concomitantly higher HDL-C
      levels (HDL-C/total cholesterol (%)) were seen in the Moslem boys and girls, at
      age 16-18 compared with age 9-10, but were not observed in the Jewish children.
      The identification of an ethnic group in whom HDL-C appears to increase at or
      near puberty could provide opportunities to elucidate factors that may increase
      HDL-C in individuals or in populations.

PMID- 8465808
TI  - Prevalence of bulimic behaviors and bulimia among a sample of the general
      population.
AB  - Data are presented on the prevalence of bulimic symptoms and bulimia among a
      sample of adults residing in north-central Florida (n = 2,075). The data were
      gathered between 1984 and 1986. The sample included 1,736 whites and 339 blacks,
      of whom 1,040 were females and 1,035 were males. A current diagnosis of bulimia
      was made using the criteria of the Diagnostic and Statistical Manual, Third
      Edition (DSM-III), of the American Psychiatric Association. Females had
      significantly higher rates than did males on nine of the 10 bulimic symptoms.
      Blacks had symptom rates equal to or greater than whites on eight of the 10
      items, and those in the lowest socioeconomic groups (SES) had rates greater than
      those in the highest SES group on nine of the 10 symptoms. Eight persons, 0.4% of
      the total sample, met the DSM-III criteria for a diagnosis of bulimia. These
      included six white females and two black males. Five of the females were aged 18
      29 years; one was over 45. Five of the females were in the lower middle SES
      group; one was in the upper middle SES group. Both of the black males were aged
      30-44, and both were in the lowest SES group. The data emphasize the need to
      distinguish between bulimic type symptoms and bulimia when estimating the
      prevalence of eating-related problems in the general population.

PMID- 8465809
TI  - Relation of tubal infertility to history of sexually transmitted diseases.
AB  - We studied the history of sexually transmitted diseases in 283 nulliparous women
      diagnosed with infertility due to tubal adhesions or occlusion and 3,833 women
      admitted for delivery at seven collaborating hospitals. The adjusted risks of
      tubal infertility associated with the history of each sexually transmitted
      disease were estimated by the odds ratios obtained by multiple logistic
      regression. Women who reported prior infection with gonorrhea were at a
      significantly increased risk of tubal infertility (relative odds = 2.4, 95%
      confidence interval 1.3-4.4). In addition, the risk of tubal infertility was
      almost twice as high in women who recalled previous trichomoniasis compared with
      women with no such infection (relative odds = 1.9, 95% confidence interval 1.3
      2.8). Furthermore, there was a trend of increasing risk with an increasing number
      of episodes of gonorrhea or trichomoniasis.

PMID- 8465811
TI  - Re: "Race/ethnicity and other risk factors for gestational diabetes".

PMID- 8465810
TI  - Re: "Congenital defects and electric bed heating in New York State: a register
      based case-control study".

PMID- 8465812
TI  - Mechanisms of proteinuria in noninflammatory glomerular diseases.
AB  - Neither the initiating factors nor the proximate causes of injury that produce
      proteinuria in nephrotic syndrome have been clearly defined. Immune mechanisms
      have been postulated in minimal-change nephrotic syndrome (MCNS), focal segmental
      glomerular sclerosis (FSGS), and glomerular sclerosis associated with human
      immunodeficiency virus (HIV) infection. Circulating factors have been proposed in
      MCNS and FSGS, although no specific mediator has been identified. Prompt
      remission of proteinuria following steroid treatment and the presence of altered
      immune responsiveness in patients with MCNS have been used to support the
      participation of an immune mechanism in the pathogenesis of MCNS. Both FSGS and
      HIV-related nephropathy are usually steroid-resistant. Immune mechanisms are
      postulated in FSGS because of early recurrence after transplantation, and in HIV
      related nephropathy because of the numerous associated immune abnormalities.
      Experimental models of nephrotic syndrome based on neutralization of glomerular
      charge, toxic injury to podocytes, injection of antibodies to glomerular
      components, or abnormalities in transgenic mice have been used to define
      mechanisms of glomerular injury. This review summarizes physiologic and
      immunologic abnormalities in MCNS, FSGS, and HIV-associated nephropathy and in
      several experimental models of nephrotic syndrome, and outlines the immunologic
      mechanisms and cellular reactions that may be responsible for glomerular
      dysfunction in these entities.

PMID- 8465813
TI  - Effect of dietary protein on glomerular renin secretion.
AB  - Previous studies from our and other laboratories demonstrated that dietary
      protein restriction lowers plasma renin activity by impairing renin release. The
      effect of protein intake on glomerular renin secretion has not been investigated.
      Accordingly, we studied male Sprague-Dawley rats weighing 180 to 200 g for 3
      weeks that were receiving isocaloric diets that provided either standard 20%
      protein (SP) or low 6% protein (LP). Renin secretion was measured in the
      glomeruli isolated from these rats, at baseline and following stimulation with
      arachidonic acid and isoproterenol. The activity of plasma renin (3.0 +/- 0.5
      ng/mL/min on SP v 1.1 +/- 0.1 ng/mL/min on LP) was significantly (P < 0.02) lower
      on LP intake. In contrast, glomerular renin content (22.9 +/- 0.7 ng/micrograms
      protein on SP v 32.3 +/- 1.4 ng/micrograms protein on LP) was significantly (P <
      0.01) higher on the LP diet. Furthermore, renin secretion (ng/mL/h) from the
      isolated glomeruli at baseline (3.9 +/- 1.0 on SP v 12.5 +/- 3.0 on LP, P <
      0.02), and following incubation with arachidonic acid 10(-5) mol/L (5.9 +/- 1.7
      on SP v 19.6 +/- 3.1 on LP, P < 0.005), and isoproterenol 10(-3) mol/L (6.0 +/-
      0.5 on SP v 17.3 +/- 3.3 on LP, P < 0.01) was significantly higher on the LP
      diet. These studies suggest that dietary protein restriction impairs in vivo
      renin release. In contrast, in vitro glomerular renin release is augmented by
      protein restriction. The factors modulating in vivo renin release require further
      characterization.

PMID- 8465815
TI  - Irreproducibility of the activity and chronicity indices limits their utility in
      the management of lupus nephritis. Lupus Nephritis Collaborative Study Group.
AB  - Histological indices of renal pathology in lupus nephritis have been proposed as
      prognostic signs and as a method to quantitate therapeutic response. We tested
      the reproducibility of the activity (AI) and chronicity indices (CI) in the renal
      biopsies from 83 patients with lupus nephritis, enrolled in a controlled
      therapeutic trial. The AI/CI were calculated separately by four renal
      pathologists using published criteria. Pair-wise Spearman's rank correlation
      coefficient was used to examine the relationship among the scores of the four
      raters, and their degree of reproducibility was evaluated using the coefficient
      of reliability. The mean CI scores ranged from 2.84 to 4.61, and the mean AI
      ranged from 9.64 to 12.89. The correlation among the different pathologist's
      scores ranged from 0.44 to 0.63 for the AI and 0.60 to 0.76 for the CI. One
      pathologist (M.M.S.) rated the biopsies twice, and the correlation between the
      two ratings was 0.58 for the AI and 0.74 for the CI. Thus, the AI and CI
      calculated by different pathologists and the temporally separate observations of
      a single observer were only moderately correlated. The reproducibility of a
      single rating was low, showing a reliability coefficient of 0.48 for the AI and
      0.57 for the CI. The low reliability coefficient suggests that the variability
      among pathologists was the result of interpretative differences. We conclude that
      the AI/CI are too subjective to be used as therapeutic guides or as
      prognosticators.

PMID- 8465814
TI  - Neutrophil alloantibodies react with cytoplasmic antigens: a possible cause of
      false-positive indirect immunofluorescence assays for antibodies to neutrophil
      cytoplasmic antigens.
AB  - Antibodies to neutrophil cytoplasmic antigens (ANCA) can be detected in patients
      with Wegener's granulomatosis and systemic vasculitis. During pregnancy or
      following transfusion, subjects sometimes produce alloantibodies to neutrophil
      antigens. If patient sera being tested for ANCA contain alloantibodies directed
      at neutrophil antigens that residue in the cytoplasm, the results may be
      difficult to interpret. At least one neutrophil antigen, NB1, is expressed on
      both neutrophil plasma membranes and secondary granules. We tested alloantibodies
      specific for neutrophil antigens NA1, NA2, NB1, NB2, 5b, 9a, and Mart in an ANCA
      indirect immunofluorescence (ANCA-IF) assay to determine if these alloantibodies
      reacted with neutrophil cytoplasmic or granule antigens. Alloantibodies specific
      for neutrophil antigens NA1, NA2, NB2, 5b, and 9a did not react with neutrophil
      cytoplasmic components. However, all three NB1 alloantibodies studied
      demonstrated a cytoplasmic pattern of immunofluorescence (C-ANCA) when NB1
      positive neutrophils were tested. While control ANCA resulted in cytoplasmic
      immunofluorescence of all neutrophils from each donor tested, NB1 antibodies
      reacted with a subpopulation of neutrophils from some donors. Cytoplasmic
      immunofluorescence was also observed with an antibody directed against the Mart
      neutrophil antigen. The Mart antigen is located on integrin CR3 (CD11b/CD18). To
      confirm that these reactions were due to anti-Mart, monoclonal antibodies to
      CD11b and CD18 were also tested and found to cause cytoplasmic
      immunofluorescence. When the ANCA-IF assay was performed using neutrophils that
      did not express Mart or NB1 antigen, cytoplasmic immunofluorescence was seen with
      the ANCA control antisera, but not with the NB1 or Mart alloantibodies.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8465816
TI  - A race-controlled human leukocyte antigen frequency analysis in lupus nephritis.
      The South-Eastern Organ Procurement Foundation.
AB  - Systemic lupus erythematosus (SLE) has higher incidence and mortality rates in
      addition to a greater risk for nephropathy in African Americans (blacks),
      compared with whites. We analyzed the South-Eastern Organ Procurement Foundation
      (SEOPF) database from 1982 through 1986 to determine if variation in human
      leukocyte antigen (HLA) frequencies, beyond those normally present between the
      races, were associated with lupus nephritis (LN). HLA antigen frequencies in 271
      black and 230 white renal transplant recipients with LN as the cause of end-stage
      renal disease (ESRD) were compared with 4,506 race-matched cadaveric kidney donor
      controls. Odds ratios (ORs) and chi-square values were computed to assess the
      prevalence of each HLA phenotype among the cases versus the controls separately
      for blacks and whites. HLA-B8 and -DR2 frequencies were increased, and HLA-DR4
      frequency was decreased in cases of both races compared with race-matched
      controls (race-combined ORs, 1.68, 1.46, and 0.49, respectively; all P < 0.01).
      Race-specific analyses showed that HLA-DR6 was decreased in black cases versus
      black controls (OR, 0.48; P < 0.001) and HLA-DR3 was increased in white cases
      versus white controls (OR, 1.88; P < 0.001). HLA-B8 and DR2 are positively
      associated and HLA-DR4 is negatively associated with LN in patients of both
      races. HLA-DR3 and -DR6 demonstrate race-specificity in LN and place whites at a
      disadvantage relative to blacks. It is likely that non-HLA-mediated genetic
      factors and/or environmental factors contribute to the increased risk of
      nephritis observed in black patients with SLE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465817
TI  - The effect of racial misclassification on estimates of end-stage renal disease
      among American Indians and Alaska Natives in the Pacific Northwest, 1988 through
      1990.
AB  - Although several recent studies have documented a high incidence of end-stage
      renal disease (ESRD) among American Indians (AI) and Alaska Natives (AN), racial
      misclassification of AI/AN as members of other races on disease registries has
      not been accounted for. We conducted a study to link the Northwest Renal Network
      (NRN) ESRD database, which includes persons known to have begun dialysis in
      Idaho, Oregon, and Washington, and the Indian Health Service (IHS) patient
      registration file, which includes AI/AN enrolled for health care provided or paid
      for by IHS in the same states, for the period January 1, 1988 to December 31,
      1990. Among the 3,356 persons included on the NRN ESRD database, 68 (2.0%) were
      coded as AI/AN. Of the 68 listed as AI/AN, 54 (79.4%) were identified on the IHS
      patient registration file. In addition to the 68 cases coded on the NRN as AI/AN,
      we identified 12 cases that were definitively matched to the IHS patient
      registration file but not coded AI/AN on the NRN. The age-adjusted annual
      incidence of ESRD treatment initiation among AI/AN in Idaho, Oregon, and
      Washington was 267.5 per million according to original racial coding on the NRN,
      but it increased to 311.6 per million after correction for racial
      misclassification. Among IHS-registered AI/AN, the annual incidence increased
      from 394.1 per million to 474.3 per million. Racial misclassification of AI/AN in
      ESRD registries may result in underestimates of AI/AN ESRD incidence for the
      United States.

PMID- 8465818
TI  - The familial risk of end-stage renal disease in African Americans.
AB  - African Americans have higher overall incidence rates of end-stage renal disease
      (ESRD) compared with American whites. Hypertensive nephrosclerosis (HN),
      nephropathy secondary to diabetes mellitus types I and II, and chronic
      glomerulonephritis (CGN) all occur more frequently in African Americans. To
      explore the possibility that hereditary factors may play a role in the increased
      risk of ESRD in African Americans, the family history of 131 African American
      hemodialysis patients (cases) was compared with 115 age-, sex-, and race-matched
      non-ESRD controls. Odds ratios (ORs) were calculated to define the prevalence of
      a relative with ESRD among cases versus controls. Chi-square values were
      estimated from a log-linear model, while controlling for gender, to test for
      significance of ORs. Forty percent (12/30) of HN cases, 35% (18/51) of type II
      diabetes mellitus-induced renal failure cases, and 13% (5/38) of CGN cases had a
      first-, second-, or third-degree relative with ESRD. The presence of a first
      degree relative with ESRD increased an African American's risk for developing
      ESRD ninefold (OR, 9.13; 95% confidence interval [CI], 2.6 to 31.8; P < 0.001).
      The presence of a first- or second-degree relative increased the risk fivefold
      (OR, 5.23; 95% CI, 2.2 to 12.3; P < 0.0002). First-, second-, or third-degree
      relatives with ESRD were more prevalent among cases with ESRD due to hypertension
      and type II diabetes mellitus compared with CGN (P < or = 0.05). Gender
      differences among the ORs were nonsignificant (P > 0.2) and socioeconomic class
      (level of education and income) did not differ markedly between cases and
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465819
TI  - Stimulation of mononuclear cells by contact with cuprophan membranes: further
      increase of beta 2-microglobulin synthesis by activated late complement
      components.
AB  - Contact of mononuclear cells (MNC) with cuprophan membranes in vitro causes an
      increase in beta 2-microglobulin (beta 2m) synthesis. Since in vivo the dialyzer
      membrane is rapidly coated with plasma proteins, contact activation of MNC was
      tested in the presence of normal human serum (NHS). After contact with cuprophan,
      deposition of C5b-9 on the cells was seen, followed by an increase in beta 2m
      synthesis and cytokine release, exceeding that seen after contact activation in
      the absence of serum. Inactivated serum or serum deficient in C8 did not increase
      beta 2m production, indicating that the additional activation was due to
      complement C5b-9. The results suggest that there are two cuprophan-related
      mechanisms of cell activation: one by contact of cells with the membrane, the
      other by the complement activation products. Both might synergistically
      contribute to an increased beta 2m synthesis in hemodialysis patients.

PMID- 8465820
TI  - A prospective comparative study of continuous arteriovenous hemodiafiltration and
      continuous venovenous hemodiafiltration in critically ill patients.
AB  - We have prospectively studied and compared two consecutive groups of critically
      ill patients treated with either continuous arteriovenous hemodiafiltration
      (CAVHD) (n = 28) or continuous venovenous hemodiafiltration (CVVHD) (n = 25) to
      establish the technique of choice. The two groups were comparable in mean age (59
      v 58 years), mean Acute Physiology and Chronic Health Evaluation (APACHE) II
      score (29.6 v 27.4, P = NS), requirements for inotropic drugs, and mean number of
      failing organs (2.9 v 3.2). CVVHD led to a greater amount of hourly ultrafiltrate
      (mean, 590 v 424 mL; P < 0.001), but urea and creatinine clearances were not
      significantly different with the two techniques. Twelve patients survived in the
      CAVHD group (42.8%) and 13 in the CVVHD group (52%; P = NS). The major advantage
      for CVVHD use was the substantial decrease in the number of access-related
      complications (2 v 10; P < 0.025). We conclude that while CVVHD does not offer a
      significant increase in solute clearance, it significantly minimizes vascular
      access-related morbidity and should therefore be regarded as the therapeutic
      modality of choice.

PMID- 8465821
TI  - The effect of dialyzer reprocessing on performance and beta 2-microglobulin
      removal using polysulfone membranes.
AB  - Increased biocompatibility and lower cost are the two major arguments favoring
      routine dialyzer reprocessing. The impact of longer-term reprocessing is critical
      to the practical use of polysulfone membranes (PMs), because of the possibility
      of decreasing efficiency and performance, especially in the removal of beta 2
      microglobulin (beta 2M), a protein that has been implicated in the development of
      dialysis-associated amyloidosis (DDA). In this study, we examine urea clearance
      (Kd), urea mass transfer coefficient (h0), ultrafiltration coefficient (K(uf)),
      and percent removal of beta 2M up to 24 uses. The study involved 11 patients on
      hemodialysis for 5.27 +/- 4.6 years, with a mean age of 62.5 +/- 9.7 years and
      average run-time treatment of 2.78 +/- 0.3 hours. PMs were tested after being
      reprocessed manually using bleach and formaldehyde. The efficacy of the dialyzer
      was examined on uses 1, 5, 10, 15, 20, and 24, and the percent removal of beta 2M
      was determined except in the twentieth use and corrected for ultrafiltration. The
      Kd obtained through 24 uses showed no significant change, although h0 was
      significantly increased in the fifteenth use, and K(uf) was significantly
      increased in the 10th and 20th use (P < 0.05). The percent removal of beta 2M
      increased significantly from 44.1 +/- 2.8 (mean +/- SEM) in the first use to 59.4
      +/- 2.19 (P < 0.05) in the 10th use, and 62.1 +/- 4.07 and 63.1 +/- 4.27 in the
      15th and 24th uses, respectively (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465822
TI  - Biocompatibility of a glucose-polymer-containing peritoneal dialysis fluid.
AB  - The currently available glucose-containing peritoneal dialysis fluids (PDF),
      which are all hyperosmolar, are toxic to the cells present in the peritoneal
      cavity. However, glucose-polymer solutions, being isosmolar, may have improved
      biocompatibility in this respect. We therefore compared in vitro the effects of
      PDF containing glucose-polymers with that of glucose solutions on the function of
      donor granulocytes and monocytes (MN), and on the viability of mesothelial cells.
      In addition, the function of peritoneal macrophages (PMO) of eight patients was
      studied in a randomized cross-over setting following intraperitoneal exposure to
      glucose-polymer-versus glucose-monomer-containing fluid of comparable
      ultrafiltration capacity. Donor granulocytes, as well as MN, showed significantly
      better phagocytosis of both Staphylococcus epidermidis and Escherichia coli after
      incubation in the glucose-polymer solution as compared with the 3.86% glucose
      containing fluid. Their oxidative metabolism, as measured by chemiluminescence,
      also showed that the glucose-polymer solution was less inhibitory than fluids
      containing 2.27 or 3.86% glucose. Patient-derived PMO showed a significantly
      better phagocytic capacity for S epidermidis and E coli, a significantly higher
      killing of E coli, and a significantly higher chemiluminescence response after
      intraperitoneal exposure to the glucose-polymer solution as compared with the
      glucose-monomer-based fluid. Increasing the osmolality of the glucose-polymer
      solution to that of the respective glucose solutions blunted the favorable effect
      on phagocyte function, suggesting the beneficial effect to be osmolality
      mediated. However, no major difference was observed between the glucose-polymer
      solution and the glucose-based fluid in their effects on mesothelial
      viability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465823
TI  - Determinants of oxalate balance in patients on chronic peritoneal dialysis.
AB  - We assessed plasma levels and removal rates of oxalate in 24 patients on chronic
      peritoneal dialysis (CPD) for oxalosis-unrelated renal failure. The ion
      chromatographic (IC) measurements of oxalate in plasma, dialysate, and urine (in
      seven patients with residual renal function) were used to calculate peritoneal
      and renal clearances of oxalate. The serum state of saturation with calcium
      oxalate was calculated by means of a computer-based model system. Patient data
      were compared with those from 19 healthy individuals. Peritoneal clearance of
      oxalate was 6.3 +/- 4.7 mL/min, ie, 8% of the normal renal clearance. As a
      result, both plasma oxalate and calcium oxalate saturation were higher than in
      controls and did not overlap. Plasma was supersaturated with calcium oxalate in
      only two of 24 patients (8%). Removal of oxalate by dialysis was related to the
      amount of fluid infused. Overall removal of oxalate (dialysate plus urine) was
      similar to 24-hour excretion of normal subjects and was taken as a measure of its
      generation. Oxalate generation rate was dependent on protein (whole and animal)
      intake, but not on caloric intake or pyridoxine status. Pyridoxine
      supplementation, 75 and 300 mg daily for 1 months, was not effective in reducing
      plasma levels or generation rates of oxalate. Residual renal function had a minor
      influence on oxalate patterns. We conclude that current programs are adequate to
      maintain oxalate balance in patients on CPD under basic conditions.

PMID- 8465824
TI  - Advantages of donor-specific blood transfusion in the rat via the portal vein for
      renal transplantation.
AB  - It is well known that blood transfusion can promote immune unresponsiveness to a
      renal allograft in both animals and humans. The present study examined the
      differences between either portal venous (PV) or intravenous (IV) donor-specific
      transfusion (DST) alone on the survival of rat renal allografts without other
      immunosuppression. Seven days before LEW (RT1(1)) renal transplantation,
      recipient WKA rats (RT1u) were inoculated with graded doses (1.0 to 0.0001 mL) of
      LEW whole blood through either the portal vein or the tail vein. A dose of 0.001
      mL whole blood PV resulted in significantly greater prolongation of renal
      allograft survival than occurred with IV preimmunization (38.5 +/- 10.6 days v
      12.5 +/- 2.7 days). Although recipient survival was not significantly different
      for the two routes for a lower dose (0.1 mL) of whole blood preimmunization 7
      days before transplantation, azotemia and rejection were prevented when the PV
      route, but not the IV route, was used. However, when 0.1 mL of whole blood was
      administered 5 days before transplantation, survival was prolonged only in
      animals preimmunized by the PV route (54.7 +/- 14.0 days v 14.3 +/- 4.0 days). In
      the stronger reciprocal combination of WKA to LEW, there was an advantage of PV
      with 0.1 mL whole blood, but not with 1 mL. These results indicate that the
      beneficial effects of DST on renal allograft survival can be obtained when a
      smaller volume of blood is given via the PV rather than the IV route and a
      shorter interval elapses between preimmunization and transplantation.

PMID- 8465825
TI  - Treatment of hyponatremia: a quantitative analysis.
AB  - The bulk of clinical and experimental evidence seems to support the view that a
      catastrophic outcome can accompany rapid correction of chronic hyponatremia.
      However, the dilemma that faces the clinicians is controlling the rate at which
      the serum sodium concentration is increased during the treatment of hyponatremia.
      We present a case of severe hyponatremia and hypokalemia to illustrate, in a
      quantitative fashion, that the increase in serum sodium concentration will be
      determined not only by the tonicity of infused fluids, but also, and to a major
      degree, by the rate of excretion of free water by the kidney. A rapid increase in
      serum sodium concentration would occur if antidiuretic hormone (ADH) release is
      inhibited and water diuresis ensues. We suggest that the administration of
      potassium chloride (orally or via a central line) would have been the appropriate
      therapy for this patient.

PMID- 8465826
TI  - Transient syndrome of inappropriate antidiuretic hormone secretion during
      pregnancy.
AB  - Plasma osmolality normally decreases in early pregnancy, reaching a minimum at
      approximately 10 weeks and remaining depressed until term. This is associated
      with a mean decrease of 4 mEq/L in the plasma sodium level, and with an altered
      threshold for arginine vasopressin (AVP) release and for thirst. We describe a
      patient who developed more severe hyponatremia (120 mEq/L), which accompanied the
      development of hypertension and edema at 37 weeks in her fourth pregnancy.
      Hyponatremia and hypo-osmolality were associated with marked elevation of the
      plasma AVP level. The hyponatremia and elevated AVP level resolved after the
      delivery of the infant. To our knowledge, this is the first reported example of
      transient inappropriate antidiuretic hormone secretion (SIADH) associated with
      pregnancy.

PMID- 8465827
TI  - Posthysteroscopy fungal peritonitis in a patient on continuous ambulatory
      peritoneal dialysis.
AB  - We report the first case of posthysteroscopy fungal peritonitis, which developed
      in a woman 11 days after she had a hysteroscopy for menorrhagia. A high vaginal
      swab grew Candida albicans and the same organism was cultured from the peritoneal
      dialysate effluent. A vaginoperitoneal communication was suspected to allow the
      distension medium to carry the fungus into the peritoneum. The potential use of a
      prophylactic local antifungal agent before hysteroscopy is discussed.

PMID- 8465828
TI  - Central venous hemodialysis catheters.

PMID- 8465829
TI  - L-arginine and progressive glomerulosclerosis.

PMID- 8465830
TI  - The bioanthropological context of disease.
AB  - Apparent differences in susceptibility to disease continue to be major
      delineators between human groups. From the vantage of human evolutionary biology,
      disease is the biocultural product of the interactions of human biology, culture,
      and ecology. These interactions are graphically represented in a working model
      and the characteristics of their interactions are discussed. The variability
      observed in contemporary African Americans is seen as having its roots in Africa
      and in the collective history of human origins. Thus, identifying simple factors
      contributing to disease susceptibilities in African Americans is considerably
      problematic given the high rate of inherent heterogeneity in this group and their
      retention and expression of various African ecogenetic variants. By focusing more
      intensively on comparisons among "US blacks," researchers may be able to better
      identify specific anatomic, physiochemical, or molecular "markers" that will
      clarify the diversity in clinical response of many African Americans to disease.

PMID- 8465831
TI  - Epidemiologic analysis of existing data to investigate hypertensive renal
      disease: an example from the Maryland End-Stage Renal Disease Registry.
AB  - Observational epidemiology provides powerful methods for studying the etiology
      and natural history of renal disease in populations. Existing data sets can be
      used in the conduct of cross-sectional, case-control, and cohort studies that
      complement experimental investigations. Analysis of existing data sets is
      extremely efficient and, in many instances, provides results of similar quality
      to those derived from studies that depend on the collection of original data. A
      study based on linkage of hypertensive end-stage renal disease (ESRD) incidence
      rates from the Maryland Regional ESRD Registry with corresponding prevalence data
      from a state-wide survey of cardiovascular risk factors (The Maryland Statewide
      Household Hypertension Survey) illustrates the power, efficiency, and flexibility
      of observational epidemiologic methods in investigating racial differences in
      hypertensive ESRD. Such analyses can both test previously established hypotheses
      and generate new hypotheses for subsequent investigation.

PMID- 8465833
TI  - The health of African Americans: special emphasis on kidney disease.

PMID- 8465832
TI  - Hypertensive end-stage renal disease in blacks: the role of end-stage renal
      disease surveillance.
AB  - The end-stage renal disease (ESRD) networks and the United States Renal Data
      System recently have described the epidemiology of ESRD and broadened our
      appreciation of the impact of ESRD in the United States. This surveillance system
      also can be used to study the occurrence and control of ESRD. Among the
      epidemiologic study designs available to conduct research on the etiology of
      renal failure, case-control studies are uniquely suited for this purpose. The
      case of hypertensive ESRD illustrates this concept; risk factors for hypertensive
      ESRD, as a hypothetical exposure in case-control studies, are briefly described.
      Case-control studies are an efficient and readily used means to study causes of
      renal failure.

PMID- 8465834
TI  - Ethnicity and renal disease: lessons from the Multiple Risk Factor Intervention
      Trial and the Treatment of Mild Hypertension Study.
AB  - Hypertension, particularly severe hypertension, has proven to be a risk factor
      for renal disease. Whether the relationship of blood pressure (BP) and high renal
      disease exists across a wide range of BP levels has been less clear. Compared
      with whites, blacks have a higher rate of end-stage renal disease from a
      multiplicity of causes, including hypertension, most prominently in younger age
      groups. To examine ethnic patterns of renal disease across BPs spanning the range
      of "normal" to "elevated," data were summarized from three large studies: (1) 12
      year mortality for the 347,978 men (22,471 black and 325,507 white) without prior
      myocardia infarction (MI) screened for the Multiple Risk Factor Intervention
      Trial (MRFIT) who have been followed an average of 12 years for cause-specific
      mortality, (2) the baseline and 6-year change in renal function in 5,524
      hypertensive men (463 black and 5,061 white) randomized in the MRFIT, and (3) the
      baseline and 1-year change in creatinine level are compared in 902 black and
      white men and women (177 black and 725 white) with mild hypertension in the
      Treatment of Mild Hypertension Study (TOMHS). In the MRFIT screenees, there was a
      monotonic increase in the risk of renal mortality at higher BP levels, even
      within the "normal range," both in black and white men. Blacks had higher
      baseline creatinine levels in both the MRFIT and TOMHS. In the MRFIT hypertensive
      patients, 6-year change in creatinine predicts coronary heart disease and all
      cause mortality while the baseline creatinine level did not. Comparisons of
      randomized groups in the MRFIT or TOMHS did not demonstrate improved renal
      function with more aggressive BP lowering, but in MRFIT average on-treatment DBP
      < 95 mm Hg was associated with more favorable slopes of reciprocal creatinine. At
      1 year, no gender-specific ethnic differences in creatinine change were observed
      in TOMHS. In the MRFIT hypertensive men, 6-year creatinine change was slightly
      more favorable in white men than in black men (-0.088 mumol/l v +3.09 mumol/L, P
      = 0.004). These data demonstrate (1) a graded and continuous relationship between
      BP and renal disease in blacks and whites across a wide BP range, (2) that
      creatinine change predicts subsequent mortality, at least in hypertensive men
      treated with diuretic-based pharmacologic regimen, and (3) possibly different
      pattern of creatinine change in response to antihypertensive drug therapy in
      blacks and whites.

PMID- 8465835
TI  - Racial differences in renal sodium excretion: relationship to hypertension.
AB  - Black Americans are more susceptible to hypertension and to renal disease than
      white Americans. Both normotensive and hypertensive blacks are more apt to have
      salt-sensitive blood pressure responses to the challenge of a salt load than
      whites. Moreover, salt sensitivity of blood pressure in both normotensive and
      hypertensive subjects is associated with a decreased excretory capacity for
      sodium, implicating the kidney in this phenomenon. Salt sensitivity of blood
      pressure also is associated with increasing age and, in normotensive subjects,
      may predict the subsequent development of hypertension. Radical differences in a
      variety of humoral as well as hemodynamic responses to physical and mental
      stressors have been identified. The relationships between these observations and
      renal sodium handling require further investigation.

PMID- 8465836
TI  - Ethnic differences in cellular ions and transport.

PMID- 8465837
TI  - Essential hypertension in blacks: is it a metabolic disorder?

PMID- 8465838
TI  - Kidney disease and hypertension in blacks: scope of the problem.

PMID- 8465840
TI  - Aase syndrome: novel radiographic features.
AB  - We report on a female with hypoplastic anemia and abnormally digitalized thumbs
      who presented with growth failure and novel osseous radiologic abnormalities. In
      addition to thumb anomalies, abnormalities of the clavicles, ilia, distal sacrum,
      and coccyx and described.

PMID- 8465839
TI  - Hyperfiltration and conservation of renal function in hypertensive
      nephrosclerosis patients.
AB  - Renal glomerular hyperfiltration has been proposed as an important contributing
      factor to the progression of hypertensive nephrosclerosis in rats with reduced
      renal mass. However, no clinical studies have assessed the role of glomerular
      hyperfiltration in the pathogenesis of hypertensive nephrosclerosis in humans. In
      a prospective, randomized, long-term blood pressure control study with up to 3
      years follow-up, we showed that good blood pressure control with a mean diastolic
      blood pressure < or = 95 mm Hg preceded by a 2- to 4-month period of diastolic
      blood pressure < or = 80 mm Hg improved renal function in hypertensive
      nephrosclerosis patients. Patients treated with minoxidil, an angiotensin
      converting enzyme inhibitor (enalapril), or a calcium entry blocker (nifedipine)
      had improvement in renal function, as indicated by a positive slope of the
      reciprocal serum-creatine concentration versus time and an increment in
      glomerular filtration rate. These results suggested that improvement in renal
      function occurred with these major types of antihypertensive drug treatment. To
      assess the renal hemodynamics of minoxidil, enalapril, and nifedipine, eight
      patients with hypertensive nephrosclerosis were admitted to the General Clinical
      Research Center for renal clearance studies on each drug while ingesting a fixed
      calorie, 12% protein, 40% fat, and 100 mEq Na/d diet. Mean blood pressure,
      effective renal plasma flow, and renal vascular resistance did not change during
      the three phases of treatment. However, minoxidil treatment increased the
      glomerular filtration rate by 48% versus enalapril and by 79% versus nifedipine.
      Since minoxidil treatment improves renal function while causing a relative
      hyperfiltration, glomerular hyperfiltration per se is an unlikely mechanism for
      the progression of hypertensive nephrosclerosis in humans.

PMID- 8465841
TI  - Brachymesomelia and Peters anomaly: a new syndrome.
AB  - We report on a child with an unusual mesomelic bone dysplasia and Peters anomaly.
      While there is some resemblance to the radiographic findings and corneal clouding
      described by Pillay in the OMMD (ophthalmomandibulo-melic dysplasia) syndrome,
      there are also differences. The several syndromes that combine brachymesomelia
      and corneal clouding are discussed.

PMID- 8465842
TI  - Segregation analysis of hypospadias: a reanalysis of published pedigree data.
AB  - Little is known about the cause of hypospadias, one of the most common urogenital
      anomalies in males. Familial clustering of hypospadias is well recognized, with
      heritability estimated to be about 70% under a simple multifactorial threshold
      model. Neither alternative genetic mechanisms nor shared environmental factors
      within families have been explored fully. To learn more about possible genetic
      mechanisms, we used 2 methods of segregation analysis to analyze a set of
      published family data. These analyses are based on the families of 103 probands
      with hypospadias, who were ascertained through surgery departments in Denmark
      [Sorensen, 1953]. Urogenital examinations were performed on 95% (n = 1,510) of
      available male relatives, and 2.2% were found to have hypospadias. Within the
      probands' nuclear families, 12% of nonproband sons of normal fathers were
      affected. Using the mixed model of inheritance, both the autosomal dominant (AD)
      and codominant models fit these data better than either autosomal recessive (AR)
      or multifactorial models. Using the regressive logistic models, both AD and AR
      models were equally likely, and a model of nonMendelian sibship clustering gave a
      better fit to these data. These inconsistent findings illustrate the difficulties
      commonly encountered in segregation analysis. Using 2 different statistical
      approaches, we found 2 different explanations, both of which differ from the
      autosomal recessive model originally suggested by Sorensen [1953]. Hypospadias in
      these families is almost certainly heterogeneous. Determining the cause of
      familial clustering of hypospadias will require careful delineation of persons
      with recognized syndromes from uncomplicated cases and detailed information on
      potential prenatal risk factors.

PMID- 8465843
TI  - Axial mesodermal dysplasia spectrum.
AB  - We report on a 4-month-old boy with manifestations of both the oculo
      auriculovertebral spectrum and the caudal regression sequence. He has
      preauricular appendages, thoracic and lumbar hemivertebrae, anomalies of the
      ribs, dextrocardia, sacral "dysplasia," dislocated hips, bilateral talipes
      equinovarus, imperforate anus, recto-vesical fistula, malformed scrotum, and
      undescended testes. As suggested by Russell et al. [1981], who reported a patient
      with similar anomalies, the spectrum of anomalies probably is due to a
      generalized alteration in mesodermal cell migration during the primitive streak
      period. The term "axial mesodermal dysplasia spectrum" best describes the
      widespread anomalies in the cranial and caudal regions.

PMID- 8465844
TI  - Photoanthropometric study of facial growth in Noonan syndrome.
AB  - We present a photoanthropometric analysis of 104 individuals with Noonan
      syndrome. The study contained 53 males and 51 females with an age range of one to
      60 years (mean 13.8 years). The results provide an objective evaluation of facial
      abnormality in Noonan syndrome. Individuals with Noonan syndrome are demonstrated
      to have an increased mid face height, hypertelorism, retrognathia, a lower nasal
      bridge and nasal root, a wider mouth, a more prominent upper lip, and apparently
      lower set ears than normal control individuals. Within the patient group an
      apparent alteration of facial structure was noted with increasing age, suggesting
      that remodelling of the characteristic face in Noonan syndrome may occur into
      adult life.

PMID- 8465845
TI  - Genetic counselling in Noonan syndrome.
AB  - A clinical and echocardiographic study is presented of 117 families with Noonan
      syndrome. The 117 families contained 144 individuals with typical Noonan
      syndrome. The age range of these individuals was from one week to 45 years (mean
      12.0 years). One parent was definitely affected with Noonan syndrome in only 14%
      of the 117 families (mother 11%, father 3%). In a further 31% of families, one
      parent had possible signs of Noonan syndrome, based on facial appearance only.
      Within the apparently sporadic group of probands there was no evidence of
      increased parental age. Echocardiography demonstrated no cases of subclinical
      cardiac disease in all first degree relatives examined, and clinical examination
      alone missed no case of cardiac disease. Segregation analysis of affected
      pedigrees confirmed autosomal dominant inheritance. If both parents had only
      possible or no signs of Noonan syndrome, subsequent to the birth of the first
      child with Noonan syndrome in a family, an empiric recurrence risk of 5% was
      obtained.

PMID- 8465846
TI  - Confirmation of a particular but nonspecific metacarpophalangeal pattern profile
      in patients with the Smith-Magenis syndrome due to interstitial deletion of 17p.

PMID- 8465847
TI  - Eye abnormalities in the Smith-Magenis contiguous gene deletion syndrome.
AB  - We present the results of ophthalmologic assessment in 10 patients with
      interstitial chromosome deletions of 17p11.2, otherwise known as the Smith
      Magenis syndrome (SMS). The most common abnormalities noted were strabismus,
      Brushfield spots, high myopia, and retinal detachments. We have previously
      reported high myopia and retinal detachments in 6 patients with SMS (Finucane et
      al.: Am J Hum Genet 49:262A, 1991). We present additional details on these
      individuals, as well as findings in 4 newly reported patients. Ocular pathology
      appears to be very common in SMS, significantly contributing to disability in
      people with this syndrome. The combination of high myopia, self-injurious head
      banging, aggression, and hyperactivity among these patients makes them
      particularly susceptible to retinal detachments. Detailed ophthalmologic
      assessment should be included in the clinical work-up and monitoring of all
      patients with SMS resulting from deletion 17p11.2.

PMID- 8465848
TI  - Mosaicism for deletion 17p11.2 in a boy with the Smith-Magenis syndrome.
AB  - We describe a 14-year-old boy with physical and behavioral manifestations of the
      Smith-Magenis syndrome. Low level mosaicism (11%) for deletion 17p11.2 was found
      in peripheral blood lymphocytes. The deletion was also observed in 100% of
      metaphases examined from skin fibroblast cultures. We confirm that the Smith
      Magenis syndrome is associated with a highly recognizable phenotype. Because
      evidence of the abnormal cell line may be minimal or absent in peripheral blood,
      fibroblast studies are indicated for patients in whom mosaicism for deletion
      17p11.2 is suspected clinically.

PMID- 8465849
TI  - Tricho-rhino-phalangeal syndrome type I (TRP I) due to an apparently balanced
      translocation involving 8q24.
AB  - Tricho-rhino-phalangeal (TRP) syndromes type I and II are caused by a defective
      gene located on chromosome 8q24.1. We report a family with 2 sibs affected with
      TRP type I in combination with an apparently balanced chromosome (8;18)
      translocation involving 8q24.11. It is very likely that the 8q24 translocation
      breakpoint is physically linked to the TRP gene(s), thereby facilitating future
      efforts to clone the TRP gene(s).

PMID- 8465850
TI  - Duplication of 9q12-q33: a case report and implications for the dup(9q) syndrome.
AB  - We report on a boy with a direct tandem duplication of 9(q12-q33) and
      dolichocephaly, beaked nose with prominent philtrum, deep-set eyes, receding
      small chin, failure to thrive, developmental delay, simian creases, long fingers,
      stiff joints, and hypoplastic scrotum. This patient is compared to the 5 other
      reported cases with pure partial dup(9q), and the "trisomy 9q syndrome" described
      by Turleau et al. [1975].

PMID- 8465851
TI  - Dysspondylochondromatosis.
AB  - We report on 3 unrelated patients with an unusual form of neonatal dwarfism with
      unequal limb length. Radiographs show multiple enchondromatosis of the tubular
      and the flat bones and severe segmentation abnormalities of the vertebral column.
      These observations differ from the hitherto described forms of multiple
      enchondromatosis with growth disorders of the spine, spondyloenchondroplasia, and
      others. Therefore we propose to delineate this disorder as a new entity.

PMID- 8465852
TI  - Familial cases of gastroschisis in a population-based registry.
AB  - Only a few familial cases of gastroschisis have been reported. Consequently, the
      risk of a recurrence has been thought to be very small. In a population-based
      study of gastroschisis that included an extended pedigree of all probands, 6
      (4.7%) out of 127 families had more than one affected relative. The relationships
      of the affected were: sib, half-sib (2), first cousin, second cousin once
      removed, and great uncle. Sib recurrence was 3.5%. Our results suggest that
      pregnancies occurring in a family with a history of gastroschisis may be at
      higher risk of recurrence than previously thought.

PMID- 8465853
TI  - Are the wolffian anomalies in males the phenotype corresponding to the mullerian
      anomalies in females?
AB  - The Wolffian and Mullerian ducts are embryologically closely related. This survey
      was aimed to determine whether, as has been suggested, Wolffian duct anomalies in
      males are the phenotype corresponding to Mullerian anomalies in females. This was
      done by analysis of the phenotype of the males in associations and syndromes in
      which Mullerian duct anomalies are frequent, and of the phenotype of the females
      in families in which anomalies of the Wolffian ducts are found. It appears that
      the only relation between the 2 types of defects seems to be a developmental one.
      In cases of early insult, anomalies are seen in males and females (e.g., in the
      association of renal agenesis with Mullerian or Wolffian defects). On the other
      hand, in all the other associations or syndromes, no relation was observed. This
      suggests that Wolffian anomalies in males are not the phenotype corresponding to
      Mullerian anomalies in females.

PMID- 8465854
TI  - Skeletal histopathology in fetuses with chondroectodermal dysplasia (Ellis-van
      Creveld syndrome).
AB  - Chondroectodermal dysplasia (CED) is an uncommon autosomal recessive disorder and
      one of the short rib polydactyly syndromes (SRPS). It is characterized by
      acromelic and mesomelic shortness of limbs, postaxial polydactyly, small chest,
      ectodermal dysplasia, and in many cases, congenital heart defects. Controversy
      exists over possible changes in the growth plate. With the advent of
      ultrasonographic examination, increasing numbers of fetuses with
      osteochondrodysplasias are examined by pathologists. Since histopathologic
      examination of the skeletal system is useful in defining various
      osteochondrodysplasias and it has not been described in the fetus with CED, we
      herein describe 3 cases of fetal CED with emphasis on skeletal histopathology.
      All 3 pregnancies were terminated at 22-23 weeks because of ultrasonographic
      demonstration of short limbs and growth retardation. Radiologically, each fetus
      had acromelic and mesomelic shortness of long bones with smooth round metaphyses,
      vertically short iliac bones, short ribs and normal vertebrae. These findings are
      similar to those described in the larger newborn infant with CED.
      Histopathologically, the cartilage of the long bones showed chondrocytic
      disorganization in the physeal growth zone. The findings are dissimilar to those
      of larger infants and older children in whom chondrocytic columnization has been
      seen in the central physis and disorganization in peripheral physis. Furthermore,
      a variable degree of chondrocytic disorganization was also seen in the central
      physeal growth zone of vertebrae in these fetuses. Other findings noted at
      fetopsy were: polydactyly in all 3 cases, congenital heart defect in 2 and an
      abnormal frenulum in one case. The foregoing phenotypic and radiographic
      manifestations and skeletal histopathology help separate CED from other SRPS.

PMID- 8465855
TI  - Protein-losing gastroenteropathy with facial anomaly and growth retardation: a
      mild case of Hennekam syndrome.
AB  - A 7-year-old boy with a peculiar face, protein-losing gastroenteropathy and
      growth retardation is reported. Although he has a face similar to those 5 cases
      reported previously by Hennekam et al. (Am J Med Genet 34:593-600, 1989) and
      Gabrielli et al. (Am J Med Genet 40:244-247, 1991), he is not mentally retarded
      nor does he have severe lymphedema. This patient seems to have a mild case of the
      Hennekam syndrome.

PMID- 8465856
TI  - Otopalatodigital syndrome type II associated with omphalocele: report of three
      cases.
AB  - We present 3 patients with otopalatodigital (OPD) syndrome type II and
      omphalocele; 2 of the cases are brothers. There are now 6 known cases of OPD type
      I or II with omphalocele. We propose that this combination is not coincidental
      and discuss mechanisms that may result in the combination of OPD, omphalocele,
      and other midline defects.

PMID- 8465857
TI  - Further delineation of spondylo-meta-epiphyseal dysplasia, short limb-abnormal
      calcification type, with emphasis on diagnostic features.
AB  - Further delineation of a generalized bone dysplasia which we call spondylo-meta
      epiphyseal dysplasia, short limb-abnormal calcification type is presented. This
      dwarfing condition has several serious complications, with the most common cause
      of death being spinal cord damage secondary to atlantoaxial instability. It is a
      heritable condition with an autosomal recessive mode of transmission. Radiologic
      diagnostic criteria are developed on the basis of studies in 8 patients with the
      oldest being between 4 and 5 years old. The condition is clinically and
      radiographically apparent neonatally or in early infancy, and it is probable that
      all or almost all affected individuals will come to medical attention in the age
      range screened by this study.

PMID- 8465858
TI  - Multiple epiphyseal dysplasia, Fairbank type: morphologic and biochemical study
      of cartilage.
AB  - We have performed histochemical, immunohistochemical, electron microscopic, and
      biochemical studies on the upper tibial cartilage from a case of multiple
      epiphyseal dysplasia, Fairbank type. Most chondrocytes had intracytoplasmic
      inclusions which took the stains for proteins and were resistant to microbial
      collagenase digestion. The electron microscopic study showed that the inclusions
      are dilatations of the rough endoplasmic reticulum containing a material with
      alternately wide electron dense and electron lucent layers. Both in optical and
      in electron microscopy the inclusions fixed antibodies against the core protein
      of the large cartilage proteoglycans (aggrecans). They didn't stain with
      antibodies against type II collagen. The gel electrophoretic pattern of the large
      proteoglycans was different from normal controls. The morphologic and biochemical
      alterations found in multiple epiphyseal dysplasia are similar to those already
      described in pseudoachondroplasia (Stanescu et al.: Eur J Pediatr 138:121-225,
      1982; Stanescu et al.: J Bone Joint Surg 66A:817-836, 1984). However, the
      inclusions are smaller and the growth cartilage much less disorganized in
      multiple epiphyseal dysplasia. The similarity of morphologic and biochemical
      abnormalities strongly suggests that the two diseases have a similar pathogenesis
      and belong to the same bone dysplasia family.

PMID- 8465859
TI  - Unusual lymphangioma observed prenatally in a 45,X fetus.
AB  - We present a case of a large frontal lesion, suspected on antenatal ultrasound to
      be a cephalocele. The cardiac anatomy was abnormal and fetal blood sampling
      showed a 45,X chromosome constitution. Postmortem examination proved this to be a
      lymphangioma and confirmed the presence of a cardiac defect. We suggest that this
      lymphangioma represents an unusual manifestation of monosomy X and discuss the
      importance of doing chromosome analysis in the presence of such a lesion which is
      of similar appearance as a cephalocele.

PMID- 8465860
TI  - New autosomal recessive lethal disorder with polycystic kidneys type Potter I,
      characteristic face, microcephaly, brachymelia, and congenital heart defects.
AB  - We report on 3 pairs of sibs from unrelated families, who present with polycystic
      kidneys Potter type I claimed to be specific for the ARPKD, and with
      microbrachycephaly, hypertelorism with telecanthus, large posteriorly angulated
      fleshy ears and various congenital malformations including congenital heart
      defects. We suggest that they represent a previously unrecognized autosomal
      recessive lethal developmental disorder within the group of infantile polycystic
      kidney disease and Potter sequence.

PMID- 8465861
TI  - Further delineation of the Baller-Gerold syndrome.
AB  - Three new patients with the Baller-Gerold syndrome bring the number of reported
      cases to 20. In addition to craniosynostosis involving various sutures and
      preaxial reduction defects of variable severity, affected patients may have anal,
      urogenital, cardiac, central nervous system, and vertebral defects. Autosomal
      recessive inheritance is supported by the presence of affected sibs and parental
      consanguinity.

PMID- 8465862
TI  - Morfan: a new syndrome characterized by mental retardation, pre- and postnatal
      overgrowth, remarkable face and acanthosis nigricans in 5-year-old boy.

PMID- 8465863
TI  - Limb deficiencies and chorion villus sampling.

PMID- 8465864
TI  - Hereditary erythermalgia and acquired erythromelalgia.

PMID- 8465865
TI  - X-linked mental retardation with agenesis of the corpus callosum.

PMID- 8465866
TI  - Confirmation of the mandibulofacial dysostosis, Toriello type.

PMID- 8465867
TI  - Waardenburg syndrome and spina bifida.

PMID- 8465868
TI  - Cigarette smoking: implications for psychiatric illness.
AB  - Psychiatry has been essentially uninterested in cigarette smoking and nicotine.
      However, it is the view of this author that both cigarette smoking and smoking
      cessation are highly relevant to the clinical psychiatrist in the care of
      patients and that they are potentially a source of important insights into
      psychopathology. To support that view, the author reviews the evidence that both
      major depression and depressive symptoms are associated with a high rate of
      cigarette smoking and that lifetime history of major depression has an adverse
      impact on smoking cessation. He also reviews the data available on the influence
      of cigarette smoking cessation on the course of major depression, the
      relationship between cigarette smoking and other psychiatric diagnoses,
      particularly schizophrenia, and the neuropharmacology that might underlie these
      associations. Finally, the implications of these relationships for psychiatry are
      discussed.

PMID- 8465869
TI  - Help-seeking pathways: a unifying concept in mental health care.
AB  - The authors argue that the concept of help-seeking pathways, defined generically,
      oriented toward institutional structures, and put at the forefront of research,
      can help integrate much of what we know about the use of mental health care and
      how to make such care more accessible and effective among underserved
      populations. They focus the concept of help-seeking pathways on current issues
      and research findings pertinent to the onset of psychological distress, the
      contacting of mental health care facilities, and treatment in such facilities.
      Pathways are not random; they are structured by the convergence of psychosocial
      and cultural factors and have sufficient integrity to be studied directly as
      unfolding processes.

PMID- 8465870
TI  - Loss of drug effects during continuation therapy.
AB  - OBJECTIVE: This study sought to determine what proportion of relapses during
      continuation therapy with antidepressants can be attributed to loss of
      nonspecific placebo effects while the patients are taking the drugs. METHOD:
      Depressed patients were studied over a 12-week period. One hundred sixty-four
      patients were randomly assigned to placebo, 174 to imipramine, and 169 to
      phenelzine. At 6 weeks 35 were judged to be responders to placebo, 70 to
      imipramine, and 96 to phenelzine. These patients continued their double-blind
      treatment for weeks 7-12. RESULTS: Thirty-one percent of the patients who were
      taking placebo, approximately 12% who were taking imipramine, and approximately
      9% who were taking phenelzine relapsed in the 7- to 12-week phase. Two different
      methods of estimating relapses suggested that during the first 3 months of
      treatment, a large percentage of the relapses of patients taking drugs was
      attributable to the loss of nonspecific placebo effects rather than true drug
      effects. CONCLUSIONS: A considerable proportion of relapses in the first 3 months
      of treatment with antidepressants appears to be due to loss of placebo effects.
      These clinically relevant data may be used to encourage patients who relapse
      during this period, and who erroneously conclude that anti-depressant effects are
      temporary, to try another medication.

PMID- 8465871
TI  - Further evidence that a placebo response to antidepressants can be identified.
AB  - OBJECTIVE: The authors' goal was to analyze the acute phase of antidepressant
      drug treatment to identify placebo responses. METHOD: Patients rated as improved
      after 6 weeks of double-blind treatment with imipramine or phenelzine were
      followed for an additional 6 weeks of double-blind treatment. Initial responses
      were classified according to the speed of improvement (abrupt or gradual), the
      persistence or nonpersistence of improvement, and the timing of improvement
      (early or late onset). RESULTS: It was predicted that patients with
      nonpersistent, abrupt responses to the drugs were actually experiencing a placebo
      response and would have the worst prognosis. In fact, this group accounted for a
      disproportionate number of the relapses. Nonpersistent responders to a drug had a
      23.7% relapse rate, but persistent responders had only a 9.0% relapse rate, a
      significant difference. CONCLUSIONS: The authors conclude that a significant
      proportion of relapses within the first 6 weeks of treatment with an active drug
      are not related to loss of a true drug effect. Rather, some are related to loss
      of nonspecific placebo effects, and abrupt nonpersistent responses during drug
      treatment are most likely the result of placebo effects.

PMID- 8465872
TI  - Trends in the prescription of antidepressants by office-based psychiatrists.
AB  - OBJECTIVE: This study was done in an effort to determine whether there was a
      change over the past decade in the number and proportion of patients prescribed
      antidepressants by psychiatrists in private practice. METHOD: The authors
      analyzed data from the National Ambulatory Medical Care Survey for the years
      1980, 1985, and 1989, focusing on visits by adults over the age of 18 years to
      physicians specializing in psychiatry and psychiatric subspecialties. RESULTS:
      The number of visits that included prescribing an antidepressant medication grew
      from approximately 2.5 million in 1980 to 4.7 million in 1989, or from 17.9% to
      30.4% of all office-based psychiatric visits. Fluoxetine, which first became
      available in 1988, accounted for 29.6% of the prescriptions for antidepressants
      in 1989. Increases in prescriptions for antidepressants were particularly evident
      for male patients, young adult patients, and patients with neurotic disorders.
      CONCLUSIONS: There was an increase in the 1980s in the use of antidepressants in
      office-based psychiatric practice. The advent of new agents and the broadening of
      the clinical usefulness of existing agents may have contributed to this increase.

PMID- 8465873
TI  - Is antisocial personality a valid diagnosis among the homeless?
AB  - OBJECTIVE: It has been argued that among the homeless many of the features of
      antisocial personality may be artifacts of homelessness and that strict
      application of the diagnostic criteria may be insensitive to social and cultural
      factors in this group. The authors studied a large group of homeless men and
      women to investigate the appropriateness of the diagnosis of antisocial
      personality disorder among the homeless. METHOD: Six hundred homeless men and 300
      homeless women were randomly selected from shelters and street locations in St.
      Louis and interviewed with the National Institute of Mental Health Diagnostic
      Interview Schedule. RESULTS: In this sample of homeless men and women, most, but
      not all, adult symptoms of antisocial personality disorder were significantly
      associated with number of childhood conduct disorder symptoms. The onset of
      symptoms of antisocial personality disorder usually preceded the onset of
      homelessness. The rates of antisocial personality disorder were not significantly
      affected by discounting the antisocial disorder symptoms thought to be confounded
      with homelessness. CONCLUSIONS: Overall, the data support the appropriateness of
      the diagnosis of antisocial personality disorder among homeless populations. It
      cannot be said from these data that homelessness often leads to antisocial
      behaviors.

PMID- 8465874
TI  - Patients' attitudes toward hallucinations.
AB  - OBJECTIVE: This study examined patients' attitudes toward their hallucinations by
      assessing their beliefs about the purposes served by hallucinations and the
      adverse effects of hallucinations. It also investigated whether these attitudes
      were related to characteristics of the hallucinations or of the patients, whether
      the attitudes changed after treatment, and whether attitudes before treatment
      predicted the presence or absence of hallucinations after treatment. METHOD:
      Fifty hallucinating psychiatric inpatients were given semistructured interviews
      shortly after admission to the hospital and again shortly before discharge. The
      interviews elicited detailed descriptions of 12 phenomenologic characteristics of
      hallucinations and 11 attitude variables. RESULTS: The majority of subjects
      reported some positive effects of hallucinations. The presence of olfactory
      hallucinations and the ability to predict hallucinations were significantly
      related to valuing hallucinations. Attitudes usually did not change with
      treatment; when they did change they usually became more positive. Subjects who
      valued hallucinations more before treatment were significantly more likely to be
      hallucinating after treatment. CONCLUSIONS: The findings are consistent with the
      idea that psychological factors contribute to the expression of hallucinations.
      Assessing adaptive functions of hallucinations may predict whether hallucinations
      will respond to treatment and identify fruitful areas for psychosocial
      intervention.

PMID- 8465875
TI  - Schizophrenic patients' sensitivity to social cues: the role of abstraction.
AB  - OBJECTIVE: Since individuals with schizophrenia often have difficulty with
      abstract tasks, they should have more problems recognizing abstract social cues
      (e.g., inferences regarding actors' affect and goals) than concrete cues (e.g.,
      observations of actors' behavior and dialogue). Moreover, recognition of abstract
      and concrete cues should interact with the level of emotional arousal engendered
      by the situation; previous research has shown that schizophrenic patients perform
      better on cue recognition tasks when the situation produces moderate rather than
      low levels of arousal. METHOD: These hypotheses were tested in 24 patients with
      schizophrenia diagnosed according to the DSM-III-R criteria and 15 normal
      comparison subjects. All subjects viewed eight short vignettes of interpersonal
      situations that produce low and moderate levels of arousal. They then answered
      questions representing perception of abstract and concrete cues that had been
      matched for difficulty and consistency. RESULTS: The schizophrenic patients were
      significantly less sensitive to interpersonal cues than the normal subjects. The
      patients were also less sensitive to abstract than to concrete social cues, and
      for them there was a significant interaction between cue abstraction level and
      situational arousal. Specifically, the schizophrenic subjects performed worse on
      the abstract cue recognition task for the low-arousal situations. CONCLUSIONS:
      Findings regarding the social cue recognition patterns of schizophrenic patients
      could play an important role in the development of valid measures of social
      cognition for this population.

PMID- 8465876
TI  - Separation anxiety in panic disorder.
AB  - OBJECTIVE: A number of researchers have provided evidence that separation anxiety
      is an important antecedent or current affect in panic disorder. The objective of
      this pilot study was to test this hypothesis by comparing dreams, screen
      memories, and life situations of panic disorder patients with those of comparison
      patients. METHOD: A recent dream with associations, screen memories with
      associations, and life situations at onset of symptoms were recorded verbatim
      during semistructured interviews with 20 patients with DSM-III-R panic disorder
      and 20 comparison subjects upon referral to a private outpatient practice. A
      judge blind to the diagnoses rated each of the dreams, screen memories, and life
      situations separately on each of the 10 Gottschalk-Gleser Content Analysis
      Scales, thereby measuring manifest and latent death, mutilation, separation,
      guilt, and shame anxiety and overt and covert hostility in each group. RESULTS:
      mean separation anxiety scores were significantly higher in both the dreams and
      screen memories of the panic disorder patients than in the comparison patients.
      Mean scores for covert hostility directed outward were significantly higher in
      the dreams of the panic disorder patients than in the comparison patients.
      CONCLUSIONS: The hypothesis that separation anxiety is a prevalent affective
      undercurrent in the dreams and screen memories of panic disorder patients was
      supported. Significantly higher covert hostility in the panic disorder patients'
      dreams may support Bowlby's observation that people with high separation anxiety
      tend to disavow their anger.

PMID- 8465877
TI  - Quality of life and psychiatric morbidity in panic disorder and generalized
      anxiety disorder.
AB  - OBJECTIVE: This report examines the impact of panic disorder and/or generalized
      anxiety disorder on quality of life and the implications of these findings on
      nosological categories. METHOD: A total of 357 subjects with a current episode of
      panic disorder and/or generalized anxiety disorder were diagnosed according to
      DSM-III-R criteria, using structured clinical interviews, as part of a
      prospective, naturalistic, longitudinal, multicenter study of a clinical
      population with anxiety disorders. RESULTS: There was a high degree of
      coexistence of anxiety disorders and major depressive disorder. Subjects with
      generalized anxiety disorder almost universally had other disorders, were the
      most likely to have at least one other anxiety disorder or major depressive
      disorder at intake, had the earliest age at onset, and had the worst emotional
      health rating. Subjects with panic disorder without agoraphobia had the most
      likelihood of a history of alcohol abuse. Nine percent of the subjects had a
      history of suicide attempts or gestures. CONCLUSIONS: The subjects showed
      significant impairment in quality of life. The highly frequent coexistence of
      other anxiety disorders with generalized anxiety disorder and the overall lack of
      differences on many quality of life measures raise questions of nosology,
      particularly for generalized anxiety disorder.

PMID- 8465878
TI  - Long-term psychosocial effects of childhood exposure to parental problem
      drinking.
AB  - OBJECTIVE: The effects of childhood exposure to parental problem drinking remain
      unclear because of inconsistent findings and methodologic difficulties in
      previous studies. The authors used a large community sample to examine whether
      exposure to parental problem drinking in childhood was related to a greater
      number of psychiatric symptoms and impaired social and occupational functioning
      in adulthood. METHOD: The study used self-report data from the Piedmont Health
      Survey, a project of the Epidemiologic Catchment Area program, which were
      collected from a stratified random sample of 2,936 adults residing in a five
      county catchment area in North Carolina. The National Institute of Mental Health
      Diagnostic Interview Schedule was used to measure the subjects' lifetime
      psychiatric symptoms. Social and occupational functioning were assessed with two
      scales measuring social support, a scale measuring occupational prestige, and an
      occupational problem index. Regression analyses were used to determine whether
      exposure to parental problem drinking in childhood was associated with adverse
      psychosocial outcomes in adulthood. RESULTS: Adults who had been exposed to
      parental problem drinking in childhood were more likely to manifest psychiatric
      symptoms and marital instability, but they showed no difference from the rest of
      the sample in occupational functioning. CONCLUSIONS: Exposure to parental problem
      drinking in childhood is positively associated with specific adverse effects in
      adulthood even after controlling for other confounding childhood risk factors.

PMID- 8465879
TI  - Psychiatric complications of family reunion after four decades of separation.
AB  - OBJECTIVE: After four decades of separation due to civil war, many people who had
      migrated to Taiwan from mainland China had the unexpected opportunity to briefly
      visit their families in mainland China. A study was conducted to examine
      psychiatric complications associated with these family reunions following long
      involuntary separation. METHOD: Eighty subjects who made the journey were given
      semistructured interviews investigating their psychological experiences relating
      to the family reunion. The variables investigated were sociodemographic
      characteristics, the subject's previsit emotional condition, factors related to
      the family reunion experience, and stress encountered during the visit. RESULTS:
      The survey indicated that more than one-fifth of the subjects (22.5%) developed
      psychiatric complications, mainly depression, immediately after the visit.
      Determinants found to contribute significantly to the occurrence of emotional
      disorders were previous ways of expressing homesickness, family members seen
      during the reunion, family misfortunes that the subjects discovered, family
      conflict encountered at the reunion, and tactics for coping with such stressors.
      CONCLUSIONS: The study results suggest that family reunions after long-term
      separation can be trauma-repairing experiences for some but for others can lead
      to trauma reexperiencing and psychiatric complications requiring mental health
      intervention.

PMID- 8465880
TI  - Psychophysiologic assessment of traumatic imagery in Israeli civilian patients
      with posttraumatic stress disorder.
AB  - OBJECTIVE: This study used a script-driven imagery technique, previously used
      with combat veterans, to assess physiologic responses of Israeli survivors of
      noncombat traumas. METHOD: Each subject had experienced an event meeting DSM-III
      R criterion A for posttraumatic stress disorder (PTSD). The subjects were
      classified on the basis of the full DSM-III-R criteria into a current PTSD group
      (N = 13) and a non-PTSD group (N = 13). Thirty-second scripts describing each
      subject's personal traumatic event, as well as other events, were prepared. The
      scripts incorporated subjective visceral and muscular responses reported to have
      accompanied each experience. In the laboratory, the scripts were read one at a
      time to the subject, who was instructed to imagine each event portrayed as
      vividly as possible, while heart rate, skin conductance, and left lateral
      frontalis electromyogram levels were measured. RESULTS: Multivariate analysis of
      variance revealed that the physiologic responses of the PTSD subjects during
      imagery of their personal traumatic experiences were significantly greater than
      those of the non-PTSD subjects. This difference was not explained by age, gender,
      or rated severity of the traumatic event. A physiologic discriminant function
      derived from previously studied Vietnam veterans correctly classified nine of the
      13 PTSD subjects (sensitivity = 69%) and 10 of the 13 non-PTSD subjects
      (specificity = 77%). CONCLUSIONS: These results replicate previous findings of
      heightened physiologic responses during personal combat imagery in male American
      war veterans and extend them to a group of male and female Israeli civilian
      victims of trauma, supporting the robustness of physiologic responding during
      personal traumatic imagery as a measure of PTSD.

PMID- 8465881
TI  - The roles of psychiatrists in organized outpatient mental health settings.
AB  - OBJECTIVE: This paper describes the clinical roles of psychiatrists in U.S.
      organized outpatient mental health settings. METHOD: Data were analyzed from the
      1986 National Institute of Mental Health Client/Patient Sample Survey. The
      authors determined the range, volume, and content of services provided to
      established outpatients treated by psychiatrists at six types of mental health
      organizations: state and county mental hospital clinics, general hospital mental
      health clinics, private psychiatric hospital clinics, U.S. Department of Veterans
      Affairs medical center mental health clinics, free-standing mental health
      clinics, and multiservice mental health organizations. RESULTS: The psychiatrists
      treated nearly one-half (48.2%) of the established outpatients in organized
      settings, more than any other discipline. Most of the psychiatrists' patients
      (68.3%) were also treated by other mental health professionals. Psychiatrists
      treated a greater proportion of the patients at hospital-based clinics (60.7%)
      than at clinics without hospital affiliations (43.6%). They also treated larger
      proportions of the patients with schizophrenia (77.9%), affective disorders
      (50.6%), or anxiety disorders (59.2%) than those with adjustment disorders
      (23.7%), substance use disorders (34.3%), or childhood mental disorders (29.5%).
      The patients treated by psychiatrists commonly received psychotropic medications
      (77.3%) and individual therapy (66.3%) but less commonly received group (20.7%),
      skills (11.9%), or family (5.9%) therapy. CONCLUSIONS: In organized outpatient
      settings, psychiatrists typically work with other mental health professionals to
      treat a select group of severely ill patients. However, there is considerable
      variation in the extent to which different types of mental health organizations
      rely on psychiatrists to provide clinical care.

PMID- 8465882
TI  - Course of depression in patients with hypertension, myocardial infarction, or
      insulin-dependent diabetes.
AB  - OBJECTIVE: The authors examined the course of depression over 2 years for
      outpatients with and without a history of hypertension, a history of myocardial
      infarction, or current insulin-dependent diabetes. METHOD: Among outpatient
      visitors to the practices of 523 general medical clinicians and mental health
      specialists, 626 depressed patients were followed for 1 or 2 years with a
      telephone-administered interview based on the format of the National Institute of
      Mental Health Diagnostic Interview Schedule. RESULTS: Depressed patients with and
      without medical illness had high rates of persistent depressive symptoms and
      spells over 2 years. Patients with a lifetime history of myocardial infarction
      had significantly more spells of depression over the first follow-up year, more
      total symptoms of depression in the second follow-up year, and more depressive
      symptoms at the end of each follow-up year than depressed patients without
      myocardial infarction. The course of depression did not differ significantly for
      depressed patients with and without a lifetime history of hypertension or current
      insulin-dependent diabetes. CONCLUSIONS: Among depressed adult outpatients, a
      history of myocardial infarction is associated with a particularly poor clinical
      prognosis. A relatively high percentage of all depressed patients in this study
      had persistent depression regardless of the extent of medical comorbidity.

PMID- 8465883
TI  - Psychopathology in younger versus older persons with very mild and mild dementia
      of the Alzheimer type.
AB  - OBJECTIVE: The psychopathology associated with early-onset dementia of the
      Alzheimer type was investigated by comparing the prevalence of psychiatric
      symptoms in younger subjects (mean age = 59 years) who had very mild or mild
      dementia with that in older adults (mean age = 72) whose dementia was of
      equivalent severity. METHOD: Nondemented comparison subjects and persons with
      very mild or mild dementia of the Alzheimer type were recruited to participate in
      longitudinal studies. All subjects met strict inclusion and exclusion criteria.
      Information pertaining to personality changes, affective symptoms, and psychotic
      symptoms was included in the 90-minute semistructured, physician-administered
      interview, which was used to assign a clinical dementia rating according to
      published guidelines. The younger group were age 64 or younger and consisted of
      20 nondemented subjects, 11 subjects with very mild dementia, and 18 subjects
      with mild dementia. The older group, described previously, were 64-83 years old
      and consisted of 83 nondemented subjects, 41 persons with very mild dementia, and
      68 subjects with mild dementia. RESULTS: The psychopathology in the younger
      subjects was similar to that in the older group. Personality changes occurred in
      over 80% of the younger persons with very mild illness. Psychotic symptoms were
      present in over 40% of the younger persons with mild illness but were rare in the
      group with very mild dementia. CONCLUSIONS: Similar patterns of psychopathology
      in younger and more elderly persons with dementia of the Alzheimer type support
      the suggestion that these changes are direct effects of the illness on the CNS.
      Increased attention to documenting these noncognitive symptoms and studying
      various treatments is urgently needed.

PMID- 8465884
TI  - The relationship between dementia and elder abuse.
AB  - OBJECTIVE: Alzheimer's disease and other dementias may be associated with greater
      risk for physical abuse than other illnesses of the elderly. The authors examined
      the relationship between dementia and abusive behavior in a group of demented
      patients and their caregivers. METHOD: An anonymous questionnaire was distributed
      to 1,000 caregivers who called a telephone help line specializing in dementia.
      Demographic characteristics of patients and caregivers were assessed, the
      occurrence of abuse was examined, and caregivers completed the Zarit Burden
      Interview and the Zung Self-Rating Depression Scale. RESULTS: Questionnaires were
      completed by 342 caregivers. The mean age of caregivers was 56.1 years; 163
      (54.5%) were adult children caring for parents, 111 (37.1%) cared for spouses,
      and 25 (8.4%) cared for other relatives. Thirty-three caregivers (11.9%) reported
      that they had directed physically abusive behavior (e.g., pinching, shoving,
      biting, kicking, striking) toward the dementia patient in their care. These
      caregivers had been providing care for more years, cared for patients functioning
      at a lower level, displayed higher burden scores, and displayed higher depression
      scores than caregivers who reported no abuse. In addition, 92 caregivers (33.1%)
      reported that the patient directed abuse toward them during the course of
      providing care. Caregivers who had been abused by patients, in comparison to
      those who had not, were more likely to direct abusive behavior back toward the
      patient in their care. CONCLUSIONS: These results support the hypothesis that
      abuse involving cognitively impaired older adults and their caregivers may be
      associated with the relatively high psychological and physical demands placed on
      family members who care for relatives with dementia.

PMID- 8465885
TI  - Limited therapeutic effect of addition of buspirone in fluvoxamine-refractory
      obsessive-compulsive disorder.
AB  - The authors found that buspirone added to the treatment of 33 patients with
      obsessive-compulsive disorder who were refractory to the serotonin reuptake
      inhibitor fluvoxamine was no better than placebo in reducing obsessive
      compulsive, depressive, or anxiety symptoms. This finding suggests that addition
      of buspirone to ongoing fluvoxamine therapy is not an effective treatment
      strategy for most patients with obsessive-compulsive disorder.

PMID- 8465886
TI  - Side effects of light therapy in seasonal affective disorder.
AB  - The authors report the frequency of side effects of light therapy in 105 patients
      with seasonal affective disorder treated with three intensities of light. Common
      symptoms to emerge during treatment were headache (19%), eyestrain (17%), and
      feeling "wired" (14%). There was no relationship between side effects and
      intensity of light used.

PMID- 8465887
TI  - Association of nonsuppression of cortisol on the DST with primary polydipsia in
      chronic schizophrenia.
AB  - Thirteen polydipsic and 40 nonpolydipsic chronic schizophrenic patients received
      the dexamethasone suppression test while stabilized on psychotropic medication
      regimens. Thirty-eight percent (N = 5) of those with polydipsia but only 5% (N =
      2) of those without polydipsia were nonsuppressors of cortisol (i.e., had an
      abnormal response). It is suggested that hippocampal dysfunction could cause both
      polydipsia and cortisol dysregulation in these patients.

PMID- 8465889
TI  - Alexithymia in victims of sexual assault: an effect of repeated traumatization?
AB  - The authors compared scores on the Toronto Alexithymia Scale of 12 rape victims
      with PTSD, 12 rape victims without PTSD, and 12 nontraumatized comparison
      subjects. Rape victims were more alexithymic than were nontraumatized comparison
      subjects, and subjects with a history of more than one episode of rape were more
      alexithymic than were subjects with a single episode.

PMID- 8465888
TI  - Association of fluoxetine treatment with reductions in CSF concentrations of
      corticotropin-releasing hormone and arginine vasopressin in patients with major
      depression.
AB  - The authors measured CSF concentrations of corticotropin-releasing hormone (CRH)
      and arginine vasopressin in nine depressed patients before and after fluoxetine
      treatment. They found significant decreases in CSF CRH, CSF arginine vasopressin,
      and Hamilton depression ratings. Thus, the therapeutic effect of this serotonin
      uptake inhibitor may be related to diminution of these arousal-promoting
      neuropeptides.

PMID- 8465890
TI  - Continuous infusion of haloperidol.

PMID- 8465891
TI  - Fetishism and clomipramine.

PMID- 8465892
TI  - Culture-bound trichotillomania.

PMID- 8465893
TI  - Salt appetite with psychosis, intermittent hyponatremia, and polydipsia.

PMID- 8465894
TI  - Methadone dosage, cocaine and opiate abuse.

PMID- 8465895
TI  - Disulfiram therapy in patients abusing cocaine and alcohol.

PMID- 8465896
TI  - APA position statement on abortion.

PMID- 8465897
TI  - APA position statement on abortion.

PMID- 8465898
TI  - APA position statement on abortion.

PMID- 8465899
TI  - Competency for execution.

PMID- 8465900
TI  - Competency for execution.

PMID- 8465901
TI  - Deja vu and holographic images.

PMID- 8465902
TI  - Empirical evaluation of the global deterioration scale for staging Alzheimer's
      disease.

PMID- 8465903
TI  - Frequency of diagnosis of obsessive-compulsive disorder.

PMID- 8465904
TI  - Suicide and panic disorder.

PMID- 8465905
TI  - Efficacy of brief dynamic psychotherapy.

PMID- 8465907
TI  - The AIDS dilemma.

PMID- 8465906
TI  - Practice guideline for major depressive disorder in adults. American Psychiatric
      Association.

PMID- 8465908
TI  - A review of allograft processing and sterilization techniques and their role in
      transmission of the human immunodeficiency virus.
AB  - Human immunodeficiency virus (HIV) infection via vascular organ and tissue
      transplantation is well documented. The majority of these transmissions occurred
      before the development of HIV antibody testing, which is now a routine screening
      tool used before organ and tissue procurement and transplantation. There exists
      what is commonly referred to as a "window" of seronegativity after HIV infection.
      Potential donors may be infectious with the HIV virus but not yet detected with
      available HIV antibody tests. Bone and soft tissue retrieval may be done in
      either a sterile or clean, nonsterile manner. Deep freezing and freeze-drying
      (lyophilization) are two commonly used modes of preserving bone and soft tissue
      allografts. In 1985, a screened donor who was in the window of seronegativity
      underwent vascular organ and musculoskeletal tissue harvest. The bone and soft
      tissue procured underwent a variety of processing and preservation techniques.
      There have been no known cases of HIV transmission from the processed freeze
      dried tissues. Evidence now exists that early HIV infection, before HIV antibody
      production, may be the most infectious period. The HIV antigen testing may allow
      earlier detection of an infectious donor, thus closing the window of
      seronegativity. It is unknown whether this nontransmission of HIV to the
      recipients of the processed and freeze-dried tissue was due to the processing or
      the nature of the tissue itself.

PMID- 8465909
TI  - A comparison of patellar tendon autograft and allograft used for anterior
      cruciate ligament reconstruction in the goat model.
AB  - Similar-sized patellar tendon autografts and fresh-frozen allografts were used to
      reconstruct the anterior cruciate ligament of one knee in 40 female goats.
      Evaluations of the reconstructions and contralateral controls at the 6-week and 6
      month postoperative periods included anterior-posterior translation, mechanical
      properties determined during tensile failure tests, measurement of cross
      sectional area, histology, collagen fibril size and area distribution, and
      associated articular cartilage degenerative changes. Six months after anterior
      cruciate ligament reconstruction, the autografts demonstrated a smaller increase
      in anterior-posterior displacement, values of maximum force to failure two times
      greater, a significant increase in cross-sectional area, a more rapid loss of
      large-diameter collagen fibrils, and an increased density and number of small
      diameter collagen fibrils compared to the allografts. Clinical significance. More
      surgeons are allowing their patients to return to running and sports 6 months
      after anterior cruciate ligament reconstruction. While the structural and
      material properties of autografts and allografts at time zero are similar, in the
      goat model during the first 6 months they differ. The allografts demonstrate a
      greater decrease in their implantation structural properties, a slower rate of
      biologic incorporation, and the prolonged presence of an inflammatory response.
      At 6 months the autograft demonstrates a more robust biologic response, improved
      stability, and increased strength to failure values.

PMID- 8465910
TI  - Arthroscopic treatment of synovial impingement of the ankle.
AB  - Twenty-nine cases of operative arthroscopy of the ankle were done between 1985
      and 1989 for synovial impingement of the ankle. The average age of the patients
      was 37 years. All patients (17 men, 12 women) reported an earlier history of
      injury, with 24 of the patients (83%) noting chronic ankle pain after an
      inversion injury and 5 of the patients (17%) reporting a previous ankle fracture.
      Physical examination elicited anterolateral tenderness at the ankle in all cases
      with associated anteromedial pain in 4 patients. A demonstrable "click" was
      evident in 6 of the patients (21%) on forced dorsiflexion of the ankle. All
      patients failed conservative treatment including physical therapy and
      nonsteroidal antiinflammatory drugs. Surgery was performed at an average of 36
      months postinjury. Ankle arthroscopy revealed extensive hypertrophic synovial
      thickening and scar tissue anterolaterally, indicating synovial impingement in
      all patients. Associated chondromalacia of the distal tibia was seen in 21% of
      the patients. Operative arthroscopy included partial synovectomy and debridement
      of the hypertrophic tissue and partial shaving chondroplasty of the tibia when
      indicated. Postoperatively, patients were weightbearing as tolerated. Results
      were assessed subjectively and objectively. At 25-month followup 26 patients had
      excellent or good results and 3 had fair results; there were no poor results.
      There were no major complications, including infection or neurovascular
      compromise. The 3 patients with associated ankle instability comprised the "fair"
      result group and eventually required lateral ankle reconstruction. Thus, chronic
      ankle pain due to synovial impingement can be safely, predictably, and
      effectively treated by operative ankle arthroscopy.

PMID- 8465911
TI  - Experimental muscle strain injury. Early functional and structural deficits and
      the increased risk for reinjury.
AB  - The structural and functional strength of a muscle immediately after an
      experimentally created strain injury was examined to provide clinically relevant
      information for the early treatment of muscle strain injuries. The extensor
      digitorum longus muscles of 12 adult male rabbits were studied. Contractile force
      and shortening, and peak load were determined for control muscles. A
      nondisruptive strain injury was created by stretching the experimental muscles
      just short of complete rupture. Contractile force generation and shortening, and
      peak load were determined after the experimental strain injury. Peak load was 63%
      and elongation to rupture was 79% for the experimental muscles relative to the
      controls. Statistically significant lower values for contractile force generation
      and shortening were also seen in the experimental muscles. Histologic and gross
      examinations revealed that incomplete disruptions occurred near the distal muscle
      tendon junction. These experimental data suggest clinical implications, such as
      1) a muscle-tendon unit is significantly more susceptible to injury following a
      strain injury than normal muscle, 2) early return to the uncontrolled environment
      of athletic competition may place the injured muscle at risk for further injury,
      and 3) therapeutic regimens designed to achieve an early return to competition
      may further increase the risk for additional injury by eliminating protective
      pain mechanisms. Although the decrements in peak load and elongation to failure
      are less than normal muscle, the values seem high enough to allow mobilization of
      the injured extremity and functional rehabilitation.

PMID- 8465912
TI  - Sports and osteoarthrosis of the hip. An epidemiologic study.
AB  - To investigate if participation in sports increases the risk of developing
      osteoarthrosis of the hip, we did a case-control study on the sports activities
      of 233 men (up to age 49) who were recent recipients of a prosthesis because of
      severe idiopathic osteoarthrosis of the hip and 302 men randomly selected from
      the general population. Assessments of sports, job history, and health status
      were made by an interview. Men with high exposure to sports of all kinds combined
      (in hours) had a relative risk to develop osteoarthrosis of the hip of 4.5
      compared to those with low exposure. Track and field sports and racket sports
      seemed to be the most hazardous to the hip joint. Men who had been exposed to
      high physical loads both from their occupation and sports had a relative risk of
      8.5 to develop osteoarthrosis of the hip compared to those with low physical load
      in both activities. Potential confounding factors, such as age, body mass index,
      and smoking, were considered. Long-term exposure to sports among men seems to be
      a risk factor for developing severe osteoarthrosis of the hip; this is increased
      when combined with heavy load from occupation.

PMID- 8465913
TI  - Lower extremity equipment-related injuries in alpine recreational skiers.
AB  - Lower extremity equipment-related injuries are the most significant injury group
      in alpine skiing. The lower extremity equipment-related injuries occurring at
      four Norwegian ski resorts were studied during the winter of 1985 to 1986. A
      total of 132 skiers with injuries were included (40% of all injured skiers) and
      compared with a randomly selected control population of 316 uninjured skiers. The
      most common lower extremity equipment-related injuries were knee sprains (56%)
      and lower leg fractures (14%), usually caused by no or late binding release.
      Significantly more lower extremity equipment-related injuries (33%) than other
      skiing injuries (19%) needed hospital admittance. Children below 10 years had a
      risk of lower leg fractures nine times that of skiers beyond 20 years. Beginners
      were six times more at risk for a lower extremity equipment-related injury than
      skiers of higher skiing abilities. The following factors were also associated
      with a significantly increased risk for a lower extremity equipment-related
      injury: less than three skiing seasons, no skiing instruction, and no self
      testing of the bindings.

PMID- 8465914
TI  - Deterioration of patellofemoral articular surfaces after anterior cruciate
      ligament reconstruction.
AB  - One hundred eighty-seven patients who had undergone intraarticular anterior
      cruciate ligament reconstruction using either a fresh-frozen allogeneic tendon or
      central third autogenous pateller tendon 3 to 89 months previously were
      arthroscopically evaluated. The focus was on secondary changes of the
      patellofemoral joint at the time of second-look arthroscopy. Overall, 93 knees
      deteriorated, 74 knees remained unchanged, and 14 improved. The deteriorative
      changes were predominantly located around the central ridge of the patellae,
      although all but two knees remained free from anterior knee pain. Statistical
      multivariate analysis showed surgical approach by conventional medial
      parapatellar incision and use of the central one-third of the autogenous patellar
      tendon graft as possible risk factors for the deterioration, although chi-square
      analysis failed to demonstrate statistical significance for the latter.

PMID- 8465915
TI  - An in vitro analysis of patellofemoral contact areas and pressures following
      procurement of the central one-third patellar tendon.
AB  - Patients have complained of pain after the use of the central one-third patellar
      tendon for reconstruction of the anterior cruciate ligament-deficient knee. This
      study investigated the effect on patellofemoral contact areas and pressures of
      harvesting the central 10 mm of the patellar tendon in five cadaveric knees.
      Isometric quadriceps forces were applied to produce approximately 30% of reported
      maximum voluntary extension moments at the knee. Using Fuji pressure-sensitive
      film, measurements were recorded for three states: the normal knee, after the
      graft removal, and after the tendon was closed. Contact areas and pressures were
      measured at 20 degrees, 30 degrees, 60 degrees, and 80 degrees of knee flexion in
      each specimen. Tests of the reproducibility of our methods were performed.
      Average patellofemoral contact areas for three states ranged from 1.6 cm2 at 20
      degrees of knee flexion to 3.0 cm2 at 60 degrees. The average patellofemoral
      contact pressures ranged from 1.9 MPa at 20 degrees of knee flexion to 3.0 MPa at
      30 degrees. At each flexion angle there were no significant differences in
      average patellar contact area or pressure for the three states (P < 0.05). These
      results suggest that neither harvesting the central 10 mm of the patellar tendon,
      nor closing the gap, significantly alters patellofemoral contact area or
      pressure.

PMID- 8465916
TI  - "Bone bruises" on magnetic resonance imaging evaluation of anterior cruciate
      ligament injuries.
AB  - Magnetic resonance imaging of the knees of 98 consecutive patients with
      clinically diagnosed anterior cruciate ligament injuries revealed 47 patients
      (48%) with focal signal abnormalities consistent with the diagnosis of a "bone
      bruise." Seventy-one percent of the magnetic resonance images taken within 6
      weeks of injury demonstrated a bone bruise, whereas no scans done longer than 6
      weeks after injury showed a bruise (P < 0.0001). Also significant was the
      tendency for lesions to be located in the lateral compartment (P < 0.0001). In
      the sagittal plane, lesions were most likely to be in the middle third of the
      lateral femoral condyle and the posterior third of the lateral tibial plateau (P
      < 0.0001). In 31 patients evaluated arthroscopically, there was no correlation
      between the presence or location of a bone bruise and articular alterations or
      meniscal tears observed at surgery.

PMID- 8465917
TI  - The influence of an ankle orthosis on the talar and calcaneal motions in chronic
      lateral instability of the ankle. A stereophotogrammetric analysis.
AB  - The mechanical support provided by a semirigid ankle orthosis was tested in 14
      ankles with symptoms of chronic lateral instability by use of
      stereophotogrammetric analysis. Talar and calcaneal rotations were measured with
      and without the Strong ankle orthosis during manual adduction test and adduction
      test with a predetermined torque (5 N-m). Significant reduction of talar and
      calcaneal plantar flexion, internal rotation, and varus angulation was noted when
      the orthosis was applied. The results of this study suggest that the semirigid
      orthosis may provide enough external support to prevent ankle sprains and to
      protect ligament reconstructions.

PMID- 8465918
TI  - Hamstrings--an anterior cruciate ligament protagonist. An in vitro study.
AB  - A cadaveric model that incorporated quadriceps and hamstrings muscle loads was
      developed to simulate the squat exercise. The addition of hamstrings load
      affected knee kinematics in two ways. First, anterior tibial translation during
      flexion ("femoral roll-back") was significantly reduced (P = 0.003) and second,
      internal tibial rotation during flexion was reduced (P = 0.008). However,
      quadriceps force was unaffected by the addition of hamstrings load. Thus, it
      seems likely that hamstrings muscle activity that has been observed in vivo
      during a squat probably functions synergistically with the anterior cruciate
      ligament to provide anterior knee stability. After the ACL was sectioned,
      anterior tibial translation was significantly increased during the squat (P =
      0.04). The anterior cruciate ligament was then reconstructed using a graft
      instrumented with a load cell. During passive motion, maximal graft tension was
      at full extension. During simulated squat exercise, the addition of hamstrings
      caused a significant decrease in graft load (P = 0.006). During the squat,
      maximal graft tension was at full extension, and was equal to the graft tension
      at full passive extension. Thus, the squat exercise may be useful in the early
      stages of anterior cruciate ligament rehabilitation.

PMID- 8465919
TI  - Shoulder pain in wheelchair athletes. The role of muscle imbalance.
AB  - Shoulder rotator cuff impingement syndrome is a common and disabling problem for
      the wheelchair athlete. In this study we investigated the role of shoulder
      strength imbalance as a factor for the development of this syndrome. Nineteen
      paraplegic male athletes underwent clinical and isokinetic examination of both
      shoulders with peak torque values measured in abduction, adduction, and internal
      and external rotation. Twenty athletic, able-bodied men without shoulder problems
      were tested as controls. Ten (26%) of the paraplegic athletes had rotator cuff
      impingement syndrome. The results of the isokinetic testing demonstrated that 1)
      the paraplegics' shoulders were stronger than the controls in all directions (P <
      0.05); 2) the strength ratio of abduction: adduction was higher for paraplegic
      athletes (P < 0.05); 3) paraplegics' shoulders with rotator cuff impingement
      syndrome were weaker in adduction and external and internal rotation than the
      paraplegic athletes without impingement syndrome (P < 0.05); and 4) paraplegics'
      shoulders with rotator cuff impingement syndrome had higher abduction:adduction
      and abduction:internal rotation strength ratios than the shoulders of paraplegics
      without impingement syndrome (P < 0.05). We concluded that shoulder muscle
      imbalance, with comparative weakness of the humeral head depressors (rotators and
      adductors), may be a factor in the development and perpetuation of rotator cuff
      impingement syndrome in wheelchair athletes.

PMID- 8465920
TI  - The effect of early versus late return to vigorous activities on the outcome of
      anterior cruciate ligament reconstruction.
AB  - The effect of early (mean, 5 months) versus late (mean, 9 months) return to
      vigorous cutting activity on the long-term outcome of anterior cruciate ligament
      reconstruction was evaluated retrospectively. Sixty-four reconstructions, using a
      distally attached medial one-third patellar tendon, were reviewed on an average
      of 46 months postoperatively. After surgery, the timing of return to vigorous
      activity was based on biologic fixation of the graft, a negative Lachman test,
      absence of effusion, and the patient's desire to return to previous activity. The
      64 patients were retrospectively separated into two groups. The early group
      consisted of 31 patients who returned to activity 2 to 6 months after
      reconstruction, and the late group consisted of 33 patients who returned to
      activity 7 to 14 months after reconstruction. By clinical examination, KT-1000
      arthrometer measurements, subjective evaluation, and Cybex testing, there were no
      differences between the early and late return groups except for reestablishment
      of final range of motion. At an average followup of 46 months, this study
      indicates that an early return to vigorous physical cutting activities after ACL
      reconstruction does not predispose patients to reinjury or a less satisfactory
      longterm result.

PMID- 8465921
TI  - Arthroscopically assisted anterior cruciate ligament reconstruction with the pes
      anserine tendons. Comparison of results in acute and chronic ligament deficiency.
AB  - Fifty anterior cruciate ligament-deficient knees treated consecutively with
      arthroscopically assisted reconstruction using a pes anserine tendon autograft
      were retrospectively studied. The mean followup was 36.7 months (range, 26 to
      58). All patients had reconstruction with a double-stranded graft. The mean
      injury to surgery interval was 9.6 days in 22 patients (acute group) and 22.5
      months in 28 patients (chronic group). Objective outcome, which was noted to be
      more optimal in the acute group, was better than subjective outcome in either
      group. Examination revealed 95% of patients treated acutely and 82% of those
      treated later to have 1+ or less Lachman test result (P < 0.036) and 96% of the
      acute group and 82% of the chronic group to have an absent pivot shift (P <
      0.036). Eighty-eight percent of acutely treated patients had a KT-1000 result of
      < or = 3 mm, as compared to 61% of chronically treated patients (P < 0.001). Loss
      of range of motion was significantly greater in the acute group (P < 0.018).
      Using a strict overall rating system, patients reconstructed earlier were noted
      to have a better outcome compared to those after delayed reconstruction (P <
      0.021). Cumulative meniscal injury appears to be the most significant
      contributing factor.

PMID- 8465922
TI  - The role of the lateral extraarticular restraints in the anterior cruciate
      ligament-deficient knee.
AB  - We measured the increases in tibiofemoral motion when lateral structures were
      sectioned in anterior cruciate ligament-deficient knees of 20 unembalmed
      cadaveric whole lower limbs. Motion was measured with a six degrees-of-freedom
      electrogoniometer. The lateral structures investigated were the iliotibial band
      and mid-lateral capsule, lateral collateral ligament, and popliteus tendon and
      the posterolateral capsule. Cutting the anterolateral structures increased
      anterior translation and internal rotation, particularly in flexion. Increases in
      motions were highly variable, reflecting the variation in function in the lateral
      collateral ligament and posterolateral structures. Cutting the lateral collateral
      ligament produced small changes in anterior translation and external rotation and
      larger increases in adduction. Cutting the posterolateral structures produced
      small increases in external rotation. Large increases in external rotation were
      found only if the lateral collateral ligament was also sectioned. The
      posterolateral structures act in concert with the lateral collateral ligament in
      restraining internal and external rotation. External rotation was affected at all
      flexion angles; internal rotation was affected mainly in extension. Our results
      can be used in the diagnosis of complex knee ligament injuries. Findings of
      increased anterior translation in both flexion and extension and increased
      internal rotation at 90 degrees of flexion are consistent with combined injury to
      the anterior cruciate ligament and the anterolateral structures. The anterior
      cruciate ligament-deficient knee with significant posterolateral compromise
      (posterolateral structures/lateral collateral ligament) would exhibit larger
      anterior translation in extension than in flexion, increased adduction, and
      increased external rotation in both flexion and extension.

PMID- 8465923
TI  - The effect of rehabilitation and return to activity on anterior-posterior knee
      displacements after anterior cruciate ligament reconstruction.
AB  - Anterior-posterior knee displacements were measured sequentially with the KT-1000
      arthrometer on 84 patients after anterior cruciate ligament reconstruction for
      chronic deficiency. We determined the correlations between the initial onset of
      abnormal displacements (greater than 2.5 mm between limbs) and time from surgery
      or the phase of rehabilitation. Group 1 (N = 52) had a bone-patellar tendon-bone
      allograft and Group 2 (N = 32), an iliotibial band extraarticular procedure in
      addition to the allograft. The mean followup was 37 months (range, 23 to 65). At
      followup in Group 1, 24 patients (46%) had less than 3 mm of displacement between
      limbs, 22 (42%) had 3 to 5.5 mm, and 6 (12%) had greater than 5.5 mm. In Group 2,
      23 patients (72%) had less than 3 mm of displacement, 8 (25%) had 3 to 5.5 mm,
      and 1 (3%) had greater than 5.5 mm. The difference between the groups was
      significant (P < 0.05). The advanced rehabilitation program of immediate knee
      motion and early weightbearing, did not result in an increased incidence of
      abnormal displacements in the early phases. The abnormal displacements typically
      occurred during the latter two rehabilitation phases (intensive strength training
      or return to sports). Further, one-third of the abnormal displacement occurred
      more than 2 years postoperatively.

PMID- 8465924
TI  - Women's gymnastics injuries. A 5-year study.
AB  - A 5-year prospective study on the time course of women's gymnastics injuries was
      conducted on a successful NCAA Division I team. Gymnasts recorded injuries on a
      computer terminal or via computer dot sheets immediately before each training
      session, including the injured body part, the event or activity, and the date of
      the injury. The definition of injury was "any damaged body part that would
      interfere with training." Athletes recorded injuries on the 1st day of onset and
      subsequently until the injury was healed. The initial onset of injury was
      considered a new injury. Subsequent records of the injury were considered
      continuing injury. Thirty-seven athletes participated through five collegiate
      seasons. They accounted for 5602 total training exposures with an average of
      151.4 exposures per athlete. The analyses showed that gymnasts trained with an
      injury approximately 71% of the exposures, and a new injury could be expected
      from a gymnast during approximately 9% of the exposures. The largest number of
      injuries were of the repetitive stress syndrome type. The time series information
      showed that total injuries tended to increase until the middle of the competitive
      season, while new injuries showed prominent increases during specific training
      periods and during competition preparation and performance.

PMID- 8465925
TI  - Arthroscopic and histologic analysis of human patellar tendon autografts used for
      anterior cruciate ligament reconstruction.
AB  - To evaluate the fate of patellar tendon autografts in humans, the knees of 23
      patients who had undergone anterior cruciate ligament reconstruction were
      examined 3 weeks to 6.5 years postoperatively. Arthroscopy and biopsy were
      performed on all patients. The patellar tendon autografts progressed through four
      stages of ligamentization after reconstruction. The first stage of repopulation
      occurred during the first 2 months and was evidenced by a viable 3-week specimen
      with an increasing fibroblast number and active nuclear morphology. Over the next
      10 months, the graft went through a stage of rapid remodeling in which the
      fibroblast count increased markedly, the active nuclear morphology and
      neovascularity remained increased, and more areas of degeneration were present as
      the percentage of mature collagen decreased. The third stage or "maturation"
      stage occurred over the next 2 years and was characterized by a slow decline in
      the nuclei and the maturation of the collagen matrix. By 3 years the grafts were
      ligamentous by all histologic criteria examined. The authors conclude that human
      autogenous patellar tendon grafts are viable as early as 3 weeks postoperatively
      and may not go through a necrotic stage. They then progress through a prolonged
      process of ligamentization that takes as long as 3 years to complete.

PMID- 8465926
TI  - Knee flexor and extensor strength during concentric and eccentric muscle actions
      after anterior cruciate ligament reconstruction using the semitendinosus tendon
      and ligament augmentation device.
AB  - The purposes of this study were to compare operated and nonoperated knees after
      anterior cruciate ligament reconstruction using the semitendinosus tendon and a
      polypropylene ligament augmentation device, and to determine the
      interrelationships among strength, knee stability, and current activity levels.
      Isokinetic tests for knee flexion (prone position) and extension (sitting
      position) strength during concentric-eccentric muscle action cycles were
      completed at 60 and 180 deg/sec angular velocities, and passive anterior
      displacement were determined for 15 male and 15 female patients (mean age, 27 +/-
      8 years; mean time since surgery, 21 +/- 3 months). With the exception of
      eccentric muscle actions during knee extension, peak torque and work done were
      significantly greater on the nonoperated leg (P < 0.05). Passive anterior
      displacement was significantly greater in the operated than the nonoperated knee
      (P < 0.01). Strength measurements tended to be modestly related to current
      activity level (R > 0.40 in 24 of 32 correlations; P < 0.05), whereas anterior
      displacement was not related to current activity level (R = -0.19, operated knee;
      R = -0.09, nonoperated knee; P > 0.05). Greater emphasis should be directed
      toward strengthening the knee flexors and knee extensors after this surgery.
      Although joint-specific tests (completed actively via isokinetic dynameter) are
      more related to activity levels than are knee laxity tests (completed passively
      via knee arthrometer), neither test should be relied on as the only predictor of
      activity level in this patient population.

PMID- 8465927
TI  - Roofplasty requirements in vitro for different tibial hole placements in anterior
      cruciate ligament reconstruction.
AB  - In this study we sought both to quantify the forces that result in anterior
      cruciate ligament graft impingement and the amount of roofplasty necessary to
      prevent it. The perpendicular force of the intercondylar roof against an anterior
      cruciate ligament graft was measured in seven fresh-frozen cadaveric knees. Two
      tibial hole placements were evaluated: an anterior/eccentric hole (26.6% +/- 3.1%
      of the sagittal depth) and a customized hole aligned 4 to 5 mm posterior and
      parallel to the slope of the intercondylar roof in the extended knee (42.0% +/-
      2.6% of the sagittal depth). A transducer that measured the contact force with
      the graft was implanted in the roof. An extensive roofplasty was performed so
      that the sensor would bear all of the roof force. Graft tension was also
      measured. Extension moments were applied to 20 N-m with a six degree of freedom
      load application system. Load cycles were repeated with the roof force sensor
      backed out in 0.8 mm increments. The sensor backout represented a corresponding
      amount of bone removal in a roofplasty. The flexion angle at roof-graft contact
      was consistently greater using the anterior tibial hole than the customized one.
      This held true for all increments of sensor backout. With the anterior hole, the
      roof sensor (no backout) contacted the graft at 12.8 degrees +/- 6.7 degrees of
      flexion, whereas the customized hole resulted in contact at 4.1 degrees +/- 4.2
      degrees (P = 0.020).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465928
TI  - Relationship between changes in length and force in in vitro reconstructed
      anterior cruciate ligament.
AB  - The effect of tibial and femoral attachment site on the length change and force
      of an anterior cruciate ligament graft during unloaded flexion in eight cadaver
      specimens was examined. Two tibial sites (anteromedial and central portion of the
      anterior cruciate ligament attachment) and three femoral sites (anterior and
      central portions of the anterior cruciate ligament attachment, and over-the-top)
      were evaluated. Graft length changes between all combinations of attachment sites
      were measured from full extension to 150 degrees of passive flexion at 15 degrees
      intervals using the displacement of a 2-mm inextensible cord. The anterior
      cruciate ligament was then reconstructed using a Kennedy Ligament Augmentation
      Device, and graft forces at the same angles of passive flexion were measured with
      a buckle transducer. Graft length change and force were more affected by the
      femoral attachment site than the tibial site. There was a close correlation
      between length change and force measurements in flexion, but not near extension.
      The pattern of force and length change versus flexion angle for a given
      combination of attachment sites sometimes varied over the knees tested. Our
      results suggest that intraoperative isometry measurements are worthwhile for
      indicating an overloaded graft in flexion; however, length changes near extension
      may not adequately reflect graft force, creating the possibility that a graft may
      be more highly loaded than realized.

PMID- 8465929
TI  - Effects of postoperative immobilization on the reconstructed anterior cruciate
      ligament. An experimental study in rabbits.
AB  - To investigate the effects of postoperative immobilization and limited motion on
      reconstructed anterior cruciate ligaments, 28 rabbits received an anterior
      cruciate ligament reconstruction using autogenous Achilles tendon and were then
      divided into three groups: fully immobilized, 4 weeks immobilized, and limited
      motion. Two rabbits from each group were evaluated macroscopically,
      histologically and microangiographically at 4-week intervals until 12 weeks
      postoperatively. An additional six rabbits in the 4 weeks immobilized and limited
      motion groups were studied biomechanically at 12 weeks postoperatively.
      Macroscopically, both immobilized groups showed more proliferation of the
      infrapatellar fat pad, which was adherent to the reconstructed anterior cruciate
      ligament. Histology revealed more rapid regeneration of reconstructed anterior
      cruciate ligaments in the limited motion group, with no findings of necrosis in
      the mid-substance. Microangiography indicated faster normalization of vascularity
      in the limited motion group. The biomechanical study showed no significant
      difference in laxity between the 4 weeks immobilized and limited motion groups.
      The graft stiffness and maximum load to failure were greater for the limited
      motion group, although the increase was not statistically significant. The
      histologic and microangiographic results from the limited number of animals in
      this study support limited postoperative motion in the anterior cruciate ligament
      reconstructed knee. However, there were no differences in terms of the
      biomechanical parameters at 12 weeks postoperatively between the immobilized and
      limited motion treatment modes.

PMID- 8465930
TI  - Women's intercollegiate gymnastics. Injury patterns and "permanent" medical
      disability.
AB  - A prospective study was established to record the patterns of injury incurred by
      all members of women's college gymnastics team. Twenty-six women were followed
      over a 4-year period (53 gymnast seasons) from 1983 to 1987. To identify which
      injuries resulted in persisting impairment, these same athletes were contacted
      again 3 years later. The 26 athletes sustained 106 injuries. Sixty (57%) of these
      were of acute onset and were related to an identifiable gymnastics event. The
      remaining 46 (43%) were of gradual onset or overuse injuries. For the follow-up
      phase, 22 of the 26 women were contacted from 10 to 70 months (38.5 average)
      after completion of their gymnastics careers. Forty-five percent of the injuries
      recorded in their competitive years still bothered them at the time of followup,
      especially low back, ankle, great toe, shoulder, and knee injuries. Athletic and
      recreational activity exacerbated the complaints. Twenty-nine percent felt that
      their sports activity level was now limited. Forty-six percent felt that their
      injury was at less than full recovery, yet most felt that they were capable of
      strenuous physical activity and continued to be active despite complaints such as
      pain and stiffness.

PMID- 8465931
TI  - Simultaneous dorsal dislocation of both interphalangeal joints in a finger.
AB  - This paper has described three cases of simultaneous dorsal dislocation of both
      interphalangeal joints of a finger. Although two of three patients had minimal
      limitation of the active range of motion of the PIP and DIP joint, none had
      complaints of functional disability in their finger.

PMID- 8465933
TI  - Scaphoid waist fracture in a weight lifter. A case report.

PMID- 8465932
TI  - Posterior tibial nerve impingement from a tibial spine fixation screw. A case
      report.

PMID- 8465934
TI  - [Ambulatory myringoplasty].
AB  - Description of a technique for ambulant Myringoplasty applicable to repair
      tympanic perforations no greater than a drum quadrant, by means of lyophilized
      dura mater and perichondrium. The results in 61 cases, two years after surgery,
      were gratifying both otoscopically and audiologically, and accordingly the AA,
      vindicate this alternative option for endaural myringoplasty.

PMID- 8465935
TI  - [Maxillo-facial site of localized and widespread forms of ossifying myositis.
      Literature review and discussion of two clinical cases].
AB  - This paper present 2 different cases of extra-articular ankylosis of the temporo
      mandibular joint by a maxillo-facial presentation of localized and generalized
      ossifying myositis. A review of the literature about this subject allow the AA,
      to describe the clinical, diagnostical and therapeutic features of this unusual
      pathology.

PMID- 8465936
TI  - [Echography of the thyroid gland].
AB  - Report on the value of ultrasonic studies in thyroid "cold nodules" prior to
      surgery. In 196 cases was done this complementary examination which was
      correlated afterwards with the anatomopathological findings, in all of them. The
      pathologist control is the most valuable aspect of the work done, in the A's
      opinion.

PMID- 8465937
TI  - [Tuberculoma as expansive process of the cerebellopontine angle. Case report and
      bibliographical survey].
AB  - We present a case of intracranial Tuberculoma of the cerebellopontine angle and
      discuss the problems to set up the preoperative etiological diagnosis. Finally we
      make a review of the literature of the subject.

PMID- 8465938
TI  - [Idiopathic associated paralysis of the Xth and XIIth cranial nerves].
AB  - We are putting forward a case of associated laryngeal paralysis placed among the
      paralyses of the lateral pharyngeal area. Due to the association of the Xth and
      XIIth cranial nerves we could consider it within the labelled as Tapia's
      syndrome. Nevertheless, the presumable viral etiology of the case makes such
      classification entitled to discussion, because only are accepted as
      etiopathogenetic noxes both the traumatisms and tumours.

PMID- 8465939
TI  - [Necrotic sialometaplasia of the hard palate].
AB  - Necrotizing Sialometaplasia is an intrabucal bening pathological change,
      clinically presented as an ulceration of the hard palate. Either clinically or
      histologically its resemblance with an squamous carcinoma offers heavy problems
      of differential diagnosis. The process heals spontaneously in different periods
      of time. The AA. present 2 cases diagnosed at their Department.

PMID- 8465940
TI  - [The phylogenetic imprint on the embryonic development of the inner ear].
AB  - The AA. present a review of the embryologic development of the internal ear
      linked with evolutive phylogenic events, which will determine the morphogenesis
      of this organ, of ancestral origin. The significance of those phenomena in order
      to bring about several physiological attributes as the possibility of vestibular
      hearing and even to set off pathologic conditions like the otosclerosis are
      considered.

PMID- 8465941
TI  - Enzymatic synthesis of 6R-[U-14C]tetrahydrobiopterin from [U-14C]GTP.
AB  - An enzymatic method for preparing 6R-[U-14C]-tetrahydrobiopterin from [U-14C]GTP
      is presented. This method utilizes purified preparations of three biosynthetic
      enzymes for 6R-tetrahydrobiopterin, i.e., Escherichia coli GTP cyclohydrolase I,
      rat 6-pyruvoyl-tetrahydropterin synthase, and rat sepiapterin reductase. Based on
      the catalytic properties of these enzymes, the reaction conditions were optimized
      to complete the entire conversion reaction from GTP to 6R-tetrahydrobiopterin in
      a single reaction solution without the need to isolate unstable intermediates
      after each enzymatic reaction. The reaction conditions thereby established
      yielded [U-14C]biopterin in an amount equivalent to 75%, on a molar basis, of the
      initial amount of [U-14C]GTP. The product was subsequently isolated by high
      performance liquid chromatography. The method produced labeled 6R
      tetrahydrobiopterin with a specific activity of 450 Ci/mol and an overall yield
      of more than 60%.

PMID- 8465942
TI  - N-isopropyliodoacetamide in the reduction and alkylation of proteins: use in
      microsequence analysis.
AB  - A new reagent, N-isopropyliodoacetamide (NIPIA), for alkylation of sulfhydryl
      groups on proteins for microdigestion and microsequencing is described. The
      utility of this reagent in both of these procedures has been demonstrated. NIPIA
      was shown to be especially useful in microsequence analysis, where it yields high
      sensitivity in detection of Cys residues. This is because the phenylthiohydantoin
      (PTH) derivative of NIPIA-alkylated cysteine [PTH-Cys(NIPCAM)] appears as a sharp
      peak in a standard reverse-phase HPLC analysis of PTH amino acids, and elutes
      between PTH-Tyr and PTH-Pro where no other peaks are present. Thus the use of
      NIPIA circumvents various problems associated with HPLC analysis of PTH-Cys when
      other commonly used agents are employed for sulfhydryl alkylation, such as
      coeluting peaks or low signal levels. Procedures for the synthesis of NIPIA and
      other analogs, as well as PTH-Cys(NIPCAM), are also presented, and HPLC retention
      times for their corresponding PTH-Cys derivatives are compared.

PMID- 8465943
TI  - Reduction of ricin toxicity without impairing the saccharide-binding properties
      by chemical modification of the carboxyl groups.
AB  - The usefulness of ricin as a research tool is handicapped by its extremely
      biohazardous nature. In this work, ricin toxicity has been reduced by chemical
      modification of carboxyl groups using 1-ethyl-3(3-dimethylaminopropyl)
      carbodiimide and [14C]glycine methyl ester. The reaction was carried out in 8 M
      urea and in the presence of 0.1 M lactose to protect the groups involved in
      saccharide binding. Together with carboxyl groups, tyrosine residues were also
      modified. The maximum modification achieved was 13 carboxyl groups and 7
      tyrosines per molecule (about 30% of total carboxyls and tyrosines). The
      modification did not alter substantially the strength and specificity of the
      carbohydrate-binding ability of the lectin, as observed by hemagglutination tests
      and by inhibition assays with different carbohydrate structures. However, the
      LD50 decreased 90-fold when the highest modification was achieved. Therefore, the
      modified lectin can be used more safely in the study of galactose-containing
      carbohydrates.

PMID- 8465944
TI  - Quantitation of hydroperoxy-eicosatetraenoic acids and hydroxy-eicosatetraenoic
      acids as indicators of lipid peroxidation using gas chromatography-mass
      spectrometry.
AB  - Peroxidation of cellular membrane lipids has been implicated in a wide variety of
      acute and chronic pathologies. We have developed a method for quantifying lipid
      peroxidation products using gas chromatography-mass spectrometry (GC-MS) in order
      to help elucidate the role of lipid peroxidation in such disorders. The method
      involves analysis of the methyl ester, trimethylsilyl ether derivatives of
      various hydroxyeicosatetraenoic acids (HETEs). 16-Hydroxy-9,12,14
      heneicosatrienoic acid was synthesized for use as an internal standard. The assay
      involves the following steps: The internal standard is added to the sample and
      cellular lipids are extracted and trans-esterified. Next, any hydroperoxides are
      reduced with triphenylphosphine and the samples are subjected to two steps of
      solid phase extraction. The samples are then hydrogenated and the trimethylsilyl
      ether derivative of the hydroxyls formed. The derivatized HETEs are analyzed by
      electron impact GC-MS. 12-HETE, 11-HETE, 9-HETE, and 8-HETE are assayed by
      monitoring ions at m/z 301, 287, 259, and 271, respectively. Standard curves were
      constructed for each HETE and were linear over the range 1 to 250 ng; correlation
      coefficients were typically greater than 0.99. The assay has been applied to the
      study of autoxidation of lipids in both in vitro and in vivo systems.

PMID- 8465945
TI  - Rapid and accurate microfractionation of the contents of small centrifuge tubes:
      application in the measurement of molecular weight of proteins via sedimentation
      equilibrium.
AB  - The contents of small centrifuge tubes containing solutions of radiolabeled
      proteins that had been centrifuged to sedimentation equilibrium were fractionated
      using a new device based upon the mechanical design of Attri and Minton (Anal.
      Biochem. 152, 319-328, 1986). Individual fractions, corresponding to laminae of
      0.15 mm column height within the tube, were collected using one of two methods:
      (a) automatic mixing with scintillation fluid and delivery to vials mounted in a
      fraction collector, or (b) collection of undiluted fractions on scintillation
      vial caps impregnated with solid scintillator. Gradients of protein concentration
      were obtained via scintillation counting of sequential fractions. Molecular
      weights of proteins ranging from 4 x 10(4) to 3.5 x 10(5) were calculated by
      fitting the theoretical expression for sedimentation equilibrium of an ideal
      homogeneous solute to the experimental gradients. The values so obtained agree
      well with values obtained by optical scanning of the unfractionated centrifuge
      tube, and with values obtained from the literature.

PMID- 8465946
TI  - A method to detect polysialic acid in polymers of 10 or more sialyl residues
      synthesized in vivo and in vitro.
AB  - An immunoaffinity column has been used to detect polysialic acid containing 10 or
      more sialyl residues. Antibodies specific for colominic acid were purified from
      horse serum by immobilized colominic acid and were bound to CH-Sepharose-4B. The
      immunoaffinity column was used to assay the activity of CMP-NeuNAc: poly alpha 2-
      >8-sialosylsialyltransferase by detecting the products which were synthesized in
      vitro by an extract from rat brain and CMP-[14C]NeuNAc. In addition, polysialic
      acid was demonstrated in a fraction of glycoproteins from human neuroblastoma
      cells, labeled metabolically with [3H]GlcN. The column was further characterized
      by binding of 3H-colominic acid and by treatment of the bound polymers with
      endoneuraminidase, specific for the degradation of polysialic acid. The method
      can be used for rapid detection of polysialic acid synthesized in vivo and in
      vitro.

PMID- 8465948
TI  - Silver-enhanced copper staining of protein blots.
AB  - Copper staining of protein blots has previously been shown to detect proteins
      rapidly, quantitatively, and sensitively. The sensitivity of this assay can now
      be enhanced nearly 10-fold with an additional step of silver staining. The silver
      enhanced assay retains many of the virtues of copper staining, including a
      quantitative optical response with the amount of adsorbed protein, low variation
      between proteins, and reversibility. In addition, both copper staining and silver
      enhanced copper staining do not detect nucleic acid, thus allowing for selective
      measurement of nucleic acid binding proteins or protein contamination in nucleic
      acid preparations. Silver-enhancement requires only a 5-min incubation with a
      single reagent. Since copper staining is performed first, it can be used to
      determine if the greater sensitivity provided by silver enhancement is desirable.
      For quantitation, an inexpensive reflectance scanning densitometer utilizing
      optical scanners and NIH Image is described.

PMID- 8465947
TI  - Synthesis of [35S]thiophosphoryl adenylic acid, utilizing a general procedure for
      [35S]thiophosphoryl chloride production.
AB  - Elemental [35S]sulfur was shown to equilibrate with the sulfur of thiophosphoryl
      chloride when these materials are heated together. This isotopic exchange
      reaction is the basis of a convenient, microscale synthesis of high specific
      activity [35S]PSCl3. [35S]Thiophosphoryl chloride is otherwise not commercially
      available except through custom synthesis. The labeled thiophosphoryl chloride
      was used in a novel procedure for the preparation of [35S]adenosine 5'
      phosphorothioate. This isotopic exchange method should find wide application in
      the synthesis of many radiolabeled thiophosphoryl esters which utilize PSCl3 as
      the source of the thiophosphoryl group.

PMID- 8465949
TI  - A thin-layer gas-solution microcalorimeter for the determination of heat binding
      curves.
AB  - A thin-layer gas-solution microcalorimeter has been developed to study the
      binding reactions of gaseous ligands with ligand binding macromolecules in
      solution. Gas partial pressures are accurately changed logarithmically by means
      of a precision dilution valve allowing for the stepwise determination of reaction
      heats. Heat binding curves are constructed in which the enthalpy per mole of
      reaction site is plotted versus the logarithm of the ligand activity. MicroJoule
      sensitivity is achieved through closed loop proportion computer control and
      precisely twinned highly isolated sample and reference geometry. The sample,
      typically 50 microliters and 1 to 4 mM heme protein, is placed on a filter paper
      membrane which acts as a matrix of support. This orientation allows for the rapid
      equilibrium of reacting ligand in approximately 10 min while not significantly
      altering the ligand activity. The system is controlled by computer measuring the
      heat of reaction as the partial pressure is changed automatically, typically by
      flushing the system with reacting ligand then reducing its partial pressure
      logarithmically with a nonreacting gas such as nitrogen. Binding curves can be
      constructed with as little as 20 nmol of oxygen binding sites.

PMID- 8465950
TI  - An assay to detect glycoproteins that contain mannose 6-phosphate.
AB  - We have developed a broadly applicable solid phase assay for quantitative and
      qualitative analysis of phosphorylated lysosomal enzymes and other glycoproteins
      that contain mannose 6-phosphate (Man6-P) residues. Samples are immobilized on
      membranes and proteins that contain Man6-P are detected using an iodinated,
      soluble form of the cation-independent Man6-P receptor. The assay is highly
      specific, sensitive, and linear over 3 orders of magnitude. The technique has two
      general applications. First, it can be used in a dot blot format to analyze large
      numbers of samples for total levels of Man6-P glycoproteins. Second, it can be
      used in a western blot format to identify Man6-P glycoproteins that have been
      fractionated by polyacrylamide gel electrophoresis. Specific applications of this
      novel assay include structural characterization of glycoproteins, diagnosis of
      mucolipidosis II and III, and screening of pharmaceuticals for lysosomotropic
      activity. Other potential applications are discussed.

PMID- 8465951
TI  - A method for identifying the carboxy terminal amino acid of a protein.
AB  - A highly sensitive new method for identifying the carboxy terminus of a protein
      was developed. The carboxyl terminal amino acid was racemized by reaction with
      acetic anhydride. The resulting modified protein was subjected to acid
      hydrolysis. The hydrolysate was derivatized with (+)-1-(9-fluorenyl)ethyl
      chloroformate to give fluorescent amino acid diastereomers. The amino acid
      diastereomers were separated on a reversed-phase column. Only carboxyl terminal
      amino acids give a D-amino acid. Application of this method was described for the
      isolation and identification of carboxyl terminal peptides from an enzymatic
      digest of a protein.

PMID- 8465952
TI  - Combined alcian blue and silver staining of subnanogram quantities of
      proteoglycans and glycosaminoglycans in sodium dodecyl sulfate-polyacrylamide
      gels.
AB  - Proteoglycans stain weakly in polyacrylamide gels by traditional protein stains
      such as coomassie brilliant blue or silver. In the present work preparations of
      large aggregating proteoglycan from human articular cartilage were used to
      evaluate a convenient staining method based on successive staining with alcian
      blue and neutral silver. The method is developed for sodium dodecyl sulfate
      polyacrylamide gel electrophoresis; with ultrathin minigels in a semiautomated
      electrophoresis system, takes 1 1/2 h, and uses stable reagents. Preparations,
      electrophoresis, and staining of up to 24 samples can be completed within 2 1/2
      h. The method has a detection limit of 0.04-1 ng proteoglycan and less than 0.5
      ng of glycosaminoglycan. In addition the method can be adjusted for selective
      staining of proteoglycans and glycosaminoglycans.

PMID- 8465953
TI  - Methods for electrophoretic karyotyping of filamentous fungi in the genus
      Trichoderma.
AB  - Methods for electrophoretic karyotyping of filamentous fungi in the genus
      Trichoderma were developed. These techniques permitted the separation and
      visualization of intact chromosomes from viable protoplasts. Three strains were
      analyzed: Trichoderma harzianum strains T12 his-2 and T95 lys-1, and a
      prototrophic strain (1295-22) produced by protoplast fusion of T12 his-2 with T95
      lys-1. Four chromosome bands ranging in size from 2.2 Mb (megabase pairs) to 5.4
      Mb were visualized with strain T95 lys-1, whereas two chromosome bands were
      visualized for strains T12 his-2 and 1295-22. The largest chromosome of all three
      strains seems to be similar in size and has been estimated to be approximately
      5.4 Mb. All remaining chromosomes observed were dissimilar in size. Methods for
      protoplast isolation, protoplast embedding, and electrophoretic conditions useful
      for separation of intact chromosomes ranging in size from 50 kb (kilobase pairs)
      up to approximately 6.0 Mb utilizing transverse alternating field electrophoresis
      (TAFE) will be discussed. The techniques provided should be applicable to a
      variety of lower eukaryotic organisms when using the TAFE system.

PMID- 8465954
TI  - Enzyme complex amplification--a signal amplification method for use in enzyme
      immunoassays.
AB  - An amplification system for enzyme immunoassays, in which complexes of
      streptavidin, biotinylated horseradish peroxidase, antibody are used to detect
      biotinylated target molecules was developed. In enzyme-linked immunosorbent assay
      (ELISA) experiments this enzyme complex enhancement (ECA) system gave up to a
      better than two orders of magnitude increase in sensitivity, compared to a
      horseradish peroxidase-conjugated streptavidin detection system. The ECA system
      was shown to be applicable to direct detection of biotinylated antigens, as well
      as in ELISA employing biotinylated antibodies and in sandwich ELISA. The ECA
      system was also applicable to immunoblots, giving a sensitivity comparable to
      that obtained using a radiochemical detection system.

PMID- 8465955
TI  - A preparation of lambda phage DNA based on affinity chromatography.

PMID- 8465957
TI  - Rapid analysis of mammalian sperm nuclear proteins.

PMID- 8465956
TI  - C-terminal labeling of ribonuclease A with an extrinsic fluorescent probe by
      carboxypeptidase Y-catalyzed transpeptidation in the presence of urea.
AB  - For use in protein folding studies, ribonuclease A (RNase A), a 124-residue
      protein with the C-terminal sequence Phe-Asp-Ala-Ser-Val, has been labeled site
      specifically by a carboxypeptidase Y (CPase Y)-catalyzed transpeptidation
      reaction which replaces the C-terminal residue(s) of RNase A with the extrinsic
      fluorescent probe 3-(2-naphthyl)-L-alanine amide (Nal-NH2). It was found that
      this CPase Y-catalyzed transpeptidation required the presence of the chemical
      denaturant urea (ca. 5 M) and that, under these conditions, effective
      transpeptidation occurred only in the pH range of ca. 5.5 to 6.5. The two major
      products from this labeling reaction were purified to homogeneity by ion-exchange
      and reverse-phase chromatography and characterized by tryptic mapping, amino acid
      analysis, and mass spectrometry. The major product, obtained in the reproducible,
      isolated molar yield of 20%, is the derivative in which only the single C
      terminal residue, Val-124, is replaced directly by the probe Nal-NH2. Another
      isolated product, obtained in 11% yield, is the derivative in which two of the C
      terminal residues, Ser-123 and Val-124, are replaced by one Nal-NH2. Both of
      these purified derivatives are enzymatically active (85 and 18%, respectively),
      and both exhibit spectral properties characteristic of the extrinsic probe
      including an observed fluorescence lifetime which is approximately
      monoexponential (tau = 42 ns) when the naphthyl chromophore is excited in the
      region of its absorption band.

PMID- 8465958
TI  - Rapid isolation of full length cDNA clones by "inverse PCR:" purification of a
      scorpion cDNA family encoding alpha-neurotoxins.

PMID- 8465959
TI  - "One-buffer" protocol for primer end-labeling and subsequent dideoxy-mediated DNA
      sequencing.

PMID- 8465960
TI  - A self-consistent method for the analysis of protein secondary structure from
      circular dichroism.
AB  - A self-consistent procedure for estimating the secondary structure content from
      circular dichroism spectra of proteins is presented. In this method the spectrum
      of the protein to be analyzed is included in the basis set and an initial guess
      is made for the unknown structure as a first approximation. The resulting matrix
      equation is solved using the singular value decomposition algorithm and the
      initial guess is replaced by the solution. The process is repeated until self
      consistency is attained. The best features of the variable selection and the
      locally linearized methods are incorporated in this procedure. We have applied
      this method to examine the inconsistencies in the CD data, to compare the
      predictions with different ranges and resolutions of the CD data, and to compare
      different assignments of secondary structures from X-ray structure analyses in
      the context of secondary structure predictions. The results are compared using
      the root mean square differences and correlation coefficients. The results
      obtained are as good as or better than the previous analyses. For most of the
      proteins considered the self-consistent solutions obtained with different initial
      guesses were similar. We find the Kabsch and Sander protein crystal structure
      analysis to be most suitable for our prediction method.

PMID- 8465961
TI  - A rapid fluorometric method for the determination of carnitine
      palmitoyltransferase.
AB  - A rapid and sensitive fluorometric assay for the measurement of carnitine
      palmitoyltransferase (CPT) activity is described. In this assay the coenzyme A
      (CoA) liberated from palmitoyl-CoA by CPT reacts with N-(9-acridinyl)-maleimide
      to form a fluorescent product. By comparing the fluorescence intensities of
      external CoA standards, CPT activity can be determined. The coefficients of
      variation within-run and between-run of the method were 6.9 and 10%,
      respectively. The CPT activity of human muscle samples measured with this assay
      is comparable to those obtained with a commonly used radiochemical assay and CPT
      deficiency in skeletal muscle from a patient was detected by this new
      fluorometric assay.

PMID- 8465962
TI  - Two-dimensional polyacrylamide gel electrophoresis of proteins labeled with the
      fluorophore monobromobimane prior to first-dimensional isoelectric focusing:
      imaging of the fluorescent protein spot patterns using a cooled charge-coupled
      device.
AB  - A new method for visualizing 2D protein spot patterns is described whereby
      proteins containing sulfhydryl groups are labeled with the fluorophore
      monobromobimane prior to the isoelectric focusing step of 2D polyacrylamide gel
      electrophoresis. The method requires the addition of a single reagent and a delay
      of only 15 min during sample preparation. High resolution spot patterns were
      obtained without the need for any post-electrophoretic gel handling. The gel
      patterns were imaged digitally immediately post-electrophoresis while the gels
      were still within their glass electrophoresis cassettes. The imaging system was
      based on a cooled charge-coupled device. The fluorescent spot patterns of
      proteins from the lymphoid cell-line IM9 were similar but not identical to silver
      stained gel spot patterns of the same but underivatized sample. There was an
      overall increase (approx. 10%) in the number of spots visible on the fluorescent
      gels compared to those visible on the silver-stained gels.

PMID- 8465963
TI  - A simple method of detecting amplified DNA with immobilized probes on microtiter
      wells.
AB  - We have developed a simple hybridization method for the detection of specific DNA
      sequences amplified by polymerase chain reaction (PCR). This method is similar to
      an enzyme-linked immunosorbent assay (ELISA) format in that labeled PCR products
      at the 5' termini are hybridized with probes immobilized on a microtiter well and
      the bound PCR products are detected in a manner similar to that of an enzyme
      immunoassay (EIA). Two improvements have been made in immobilizing the probe to
      the microtiter wells, in terms of increasing both immobility and hybridization
      efficiency. One is that single-stranded (ss) DNA, without the complementary
      strand, is used. The other is that instead of a single copy, a tandem array of
      the probe is used for immobilization and hybridization. Using of ssDNA containing
      about a 60-repeat array of a relevant sequence as an immobilized probe, the
      sensitivity increased 10-fold over that of a single oligonucleotide unit. We also
      found that the hybridization conditions such as time, temperature, and solution
      composition could be simplified. Therefore this method is especially suited for
      handling of a large number of samples, for example detection of viruses,
      bacteria, and other pathogens, as well as mot human genetic disorders.

PMID- 8465964
TI  - Simultaneous determination of free tissue-type and free urokinase-type
      plasminogen activators in biological fluids by a solid-phase immunoassay.
AB  - Tissue-type and urokinase-type plasminogen activators (t-PA and u-PA) coexist in
      numerous biological fluids, where their fibrinolytic activities are determined by
      the concentration of the free, uncomplexed species. A simple, sensitive method
      has been developed for the simultaneous determination of free t-PA and u-PA
      concentrations in biological fluids using a solid-phase immunoassay. Microtiter
      plates were coated with polyclonal goat antibodies and incubated with PA
      standards or unknown samples. The absorbed PAs were then assayed by incubation
      with a mixture of plasminogen, poly-L-lysine, and the chromogenic substrate H-D
      norleucylhexahydrotyrosyllysine-p-nitroanilide. Free t-PA and free u-PA were
      detectable in human plasma and urine, and in conditioned media from different
      endothelial cell cultures. The method is sensitive, with lower limits of
      quantitation being 0.76 mU/ml (1.25 pg/ml) for free t-PA and 0.16 mU/ml (2.0
      pg/ml) for free u-PA. There was no cross-reaction between the two PA species and
      the recovery in plasma was greater than 95% for both. The intra- and interassay
      coefficients of variation for t-PA and u-PA were 3.5-12.2 and 3.2-11.3%, and 2.4
      11.8 and 1.6-10.4%, respectively. The presence of PA-inhibitor complexes and PA
      inhibitors in biological fluids did not interfere with the assay. Application of
      the assay has demonstrated that free u-PA levels are several fold higher than
      free t-PA levels in human plasma and in conditioned media of human vascular
      endothelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8465965
TI  - Isolation of oligomannose-type glycans from bean glycoproteins.
AB  - We have isolated individual oligosaccharyl-asparagine derivatives from the total
      soluble glycoproteins from kidney beens (Phaseolus vulgaris) and from lima beans
      (Phaseolus limensis). The protein/glycoprotein mixture was digested exhaustively
      by pronase, and the glycan-containing fractions were separated from free amino
      acids and peptides by gel filtration. The oligosaccharyl-asparagine derivatives
      were finally fractionated on Dowex 50 (C. C. Huang, H.E. Meyer, and R.
      Montgomery, Carbohydr. Res. 13, 127-137, 1970), and the individual fractions were
      characterized by mass spectrometry, NMR, and ion exchange chromatography. With
      the procedures described, only oligomannose derivatives were obtained from the
      beans. In the case of kidney beans, six different derivatives were observed and
      characterized, Man9GlcNAc2Asn, two positional isomers of Man8GlcNAc2Asn, two
      positional isomers of Man7GlcNAc2Asn, and Man6GlcNAc2Asn. Under identical
      conditions the lima beans yielded primarily the Man9GlcNAc2Asn derivative along
      with a small amount of the two Man8GlcNAc2Asn derivatives. The oligomannose
      structures can be isolated in reasonable quantities (2-20 mg) from about 200 g of
      dry beans.

PMID- 8465966
TI  - 31P NMR examination of phosphorus metabolites in the aqueous, acidic, and organic
      extracts of Phaseolus vulgaris seeds.
AB  - 31P NMR spectroscopy was used to compare the phosphorus compound content in
      aqueous, acidic, and organic extracts of Phaseolus vulgaris seeds. Two chloroform
      methanol and three ethanol extractions were used to isolate phospholipids from
      dry cotyledons and the phospholipid profiles were compared. Variations in
      phospholipid composition and artificially high concentrations of
      lysophosphatidylcholine were observed in the ethanol extracts. Other phosphorus
      compounds were extracted using perchloric acid, trichloroacetic acid,
      trichloroacetic acid in ether, hydrochloric acid, boiling water, and aqueous
      Hepes. The Hepes extraction was introduced in order to compare the results of a
      gentle procedure with those involving heat and acid treatments. Low
      concentrations of phospho-sugars and other phosphorus metabolites were found in
      all these extracts. High concentrations of phytate were found in all aqueous and
      acidic extractions; however, 31P NMR spectra of aqueous extractions did not show
      the phytate resonance. The NMR silence of the phytate resonances is attributed to
      complexation of phytate. The 31P NMR spectra of aqueous extracts contained a
      broad resonance at 0.1 ppm assigned to protein-bound RNA. Various extraction
      procedures on the same biological material are presented, and the comparison of
      these methods will facilitate future analysis and interpretation of literature
      reports involving these methods of tissue analysis.

PMID- 8465967
TI  - Ultrastructure of epididymal epithelium in Equus caballus.
AB  - The ultrastructure of the epithelial lining of the ductuli efferents and the
      ductus epididymis in the horse (Equus caballus) is described. Several types of
      cells can be distinguished: ciliated and non-ciliated cells make up the
      epithelium of the ductuli efferents, whereas principal, apical and basal cells
      are found in the ductus epididymis. The observations are compared with those made
      in other species, in particular in the donkey (Equus asinus), and the possible
      functional roles of the different cell types are discussed.

PMID- 8465968
TI  - The hundred and twenty-fifth anniversary of the birth of Henryk Ferdinand Hoyer
      Junior (1864-1989).

PMID- 8465969
TI  - [Clinical anatomy of the fat body in the forearm and in the palm].
AB  - In the hand the space between the deep flexor tendons and the interosseous fascia
      is named the midpalmar space, spatium palmare medianum. A fat body, Corpus
      adiposum palmare profundum, can be found there regularly. Despite the anatomical
      narrowness in this region, it reaches up into the carpal canal. Also in the deep
      forearm space there is always a fat body, Corpus adiposum profundum antebrachii,
      located dorsally to the deep flexor tendons, lying on the palmar fascia of the
      pronator quadratus muscle. Usually it is not connected to the Corpus adiposum
      palmare profundum. The regular occurrence of both fat bodies indicates their
      functional importance. It is to be supposed that they serve as a gliding layer
      for the deep flexor tendons. Especially the Corpus adiposum palmare profundum may
      provide an essential protecting function to the dorsally located deep branch of
      the ulnar nerve and deep palmar arch. In contrast there is a higher risk of
      mechanical irritation and compression of the deep branches of the ulnar nerve and
      artery during their more proximal course through the opponens muscle of the
      little finger ("opponens-canal") and the ulnar marginal septum. Characteristic
      features of dimensions and location of the Corpus adiposum profundum antebrachii
      and the Corpus adiposum palmare profundum and of the deep branches of the ulnar
      nerve and artery are described. The clinical relevance is discussed.

PMID- 8465970
TI  - Innervation of the levator scapulae, the serratus anterior, the rhomboideus and
      the scapular muscles in the gray kangaroo (Macropus giganteus). Comparisons are
      drawn to the crab-eating macaque and man.
AB  - The origin, course and distribution of the nerves to the levator scapulae,
      rhomboideus, serratus anterior, supraspinatus, infraspinatus, subscapularis,
      teres minor, deltoid, teres major and latissimus dorsi muscles were examined in 7
      kangaroo body-halves. The levator scapulae and the serratus anterior formed a
      continuous muscle sheet arising from the transverse processes of the lower 5
      cervical vertebrae and the upper 6 ribs. The rhomboideus arose from the occipital
      bone in addition to the cervical dorsal median raphe. Six segmental nerves from
      C3 to C8 innervated these 3 muscles. Each segmental nerve originated from the
      dorsal surface of the corresponding root of the cervicobrachial plexus. All these
      nerves innervated the levator-serratus muscle sheet and 4 segmental nerves from
      C3 to C6 innervated the rhomboideus. Of the remaining scapular muscles, the
      supraspinatus was well developed, and the teres minor was a small muscle. The
      nerves supplying the scapular muscles originated from the area between the upper
      trunk and the posterior cord of the brachial plexus. Four segmental nerves from
      C5 to C8 usually innervated these 7 muscles. Judging from the relationships
      between nerves and muscles, all of these muscles are thought to have originally
      belonged to the same 2 groups of the dorsal musculature extending between the
      trunk, the shoulder girdle, and the limb. Muscle type and modes of nerve supply
      to the muscles in the grey kangaroo are similar to those found in the crab-eating
      macaque.

PMID- 8465971
TI  - Interconnections of muscles in the adductor mandibulae complex of birds.
AB  - In addition to a variety of connections at or near the attachment of muscles,
      some of the adjacent bellies in the adductor mandibulae complex of birds merge
      with one another across the whole or most of their contiguous sides. Such
      continuous intermuscular transitions are found between the adductor posterior and
      the deep part of the adductor externus, the posterior adductor and
      quadratomandibularis muscle, the adductor posterior and pterygoideus muscle and
      between the quadratomandibularis and pseudotemporalis muscles. Since a complete
      breakup of the adductor premuscle mass occurs early in development and there is
      no indication of adult intermuscular transitions in any of the studied avian
      embryos, the muscles must coalesce at some stage of growth. Therefore, the
      intermuscular transitions of adult birds cannot be derived with any certainty
      from the primary connections in the adductor mandibulae of early gnathostomes.
      The coalescence of developmentally discrete muscles is invariably seamless and
      appears to be contingent not only upon the contiguity of muscles but also upon
      the congruent arrangement of their fibers.

PMID- 8465972
TI  - Age-related changes in glycosaminoglycan distribution in different anatomical
      sites on the surface of knee-joint articular cartilage in young rabbits.
AB  - In spite of the fact that the various anatomical regions of a given articular
      cartilage surface are subjected to different degrees of stress, the present
      observations strongly suggest that there exists a topographical homogeneity in
      the distribution of glycosaminoglycans in the same articular cartilage. In
      contrast to this age-related changes in the proportion of the different types of
      glycosaminoglycan species in articular cartilage are remarkable. Non-sulphated
      chondroitin could only be detected in very young articular cartilage. Dermatan
      sulphate, which has already been detected in young adult rabbits, was followed by
      the appearance of keratan sulphate in older rabbits. Chondroitin 4-6-sulphates
      were detected in all articular cartilages studied, the proportion of the 6
      sulphated variably increasing with age. The present report suggests that the
      distribution of glycosaminoglycans in articular cartilage varies with species and
      age, and the data can further vary, depending on the methods used. It is
      therefore concluded that generalizations against the results reported in the
      literature should be considered skeptically.

PMID- 8465973
TI  - An ultrastructural study of mitotic chondrocytes in the proliferative zone of the
      rat tibial growth plate.
AB  - Mitotic chondrocytes containing fairly prominent cell organelles were observed in
      the proliferative zone of the rat tibial growth plate by electron microscopy.
      During the later stage of mitosis, the endoplasmic reticulum was mostly
      vacuolated, and the Golgi stacks were replaced by spherical and cylindrical
      vacuoles and small vesicles. The cytoplasmic division began at early telophase.
      However, the cytoplasmic cleavage furrow was so narrow that dividing chondrocytes
      looked as if they were partitioned by a slit. This is probably one reason for the
      appearance of the binuclear cells that are occasionally observed in the tibial
      growth plate.

PMID- 8465974
TI  - Changes in the coxofemoral articular cartilage in Wistar rats after systemic
      administration of corticoids.
AB  - A structural, ultrastructural and morphometric study of the coxofemoral articular
      cartilage of 48 Wistar rats was carried out after daily intramuscular injections
      of 2.5 mg prednisolone. The animals were divided into four groups, members of
      which were killed 15, 30, 60 and 90 days respectively after the start of the
      experiment. A degenerative process developed in the experimental animals, which
      led progressively to the death of chondrocytes in the middle zone of the
      articular cartilage after 90 days. Structural, ultrastructural and morphometric
      alterations were observed, both in cells and in the cartilage matrix. These gave
      rise to superficial changes in the femoral head.

PMID- 8465975
TI  - The coronary arteries of the Syrian hamster, Mesocricetus auratus (Waterhouse
      1839).
AB  - Bearing in mind that the Syrian hamster provides an animal model for the study of
      congenital coronary artery anomalies, we decided to undertake a definition of its
      normal coronary artery pattern. The sample examined consisted of 1204 specimens.
      They were studied both histologically and by means of a corrosion-cast technique.
      The course of the coronary arteries in this species is intramyocardial. The right
      coronary artery has two principal branches: the right circumflex branch and the
      dorsal interventricular branch. The conal branch usually originates from the main
      trunk of the right coronary artery. The main branches of the left coronary artery
      are the obtuse marginal branch, the left circumflex branch, and usually a dorsal
      ventricular branch as well. The ventral interventricular branch is often absent.
      When it is present, it always originates from the left coronary artery and seldom
      reaches the apex of the heart. The interventricular septum is principally
      supplied by one, or rarely two, septal arteries arising from the right and/or
      left coronary arteries. According to the number and origin of these vessels,
      three septal coronary artery patterns were established; namely, the right, the
      left, and the right-left septal patterns. In the Syrian hamster, the left septal
      pattern is the most frequent (70.4%). The right septal pattern occurred in 28.1%
      of the specimens studied, whereas the right-left septal pattern was only found in
      1.5% of them.

PMID- 8465976
TI  - Melano-macrophage centre-like structure in the heart of the medaka, Oryzias
      latipes.
AB  - Endocardial lining cells in the heart of certain teleosts are phagocytic against
      foreign materials. In the medaka Oryzias latipes, in addition to the endocardial
      lining cells, cells in the subendocardial spaces are also phagocytic. Most
      subendocardial cells contain yellowish-brown pigments and are often aggregated to
      form nodules resembling splenic and kidney melano-macrophage centres.
      Subendocardial cells are positive to PAS and Schmorl's reaction. Macrophages
      containing large heterogeneous inclusions together with lymphocytes, were
      observed with the TEM. The definitive characteristics of reticular cells,
      including the cell sheaths, were not observed. Because of these two
      characteristics they were regarded as more primitive aggregates of macrophages
      than the ordinary melano-macrophage centres. The possible analogy between these
      structures and MMCs is discussed.

PMID- 8465977
TI  - An update of the stereology of the myocyte of the baboon's heart: analysis of the
      crista terminalis, interatrial and interventricular septa, and atrioventricular
      bundle.
AB  - We used light microscopy to compare the stereology of the myocytes from the
      following regions of the baboon's heart: a) cardiac walls (crista terminalis,
      interatrial and interventricular septa) and b) cardiac conduction tissue
      (atrioventricular bundle). Six hearts were perfused and several pieces of tissue
      were taken from these regions. A staggered test lattice consisting of cycloids
      was superimposed on twelve random pairs of photomicrographs in order to make
      disectors, and on twelve other random fields for each cardiac region in order to
      estimate certain stereological parameters. Statistically significant differences
      were found when comparing the number of myocytes from the crista terminalis
      (highest value) with either the interatrial or interventricular septum. There is
      also a significant difference between the number of myocytes in the
      interventricular septum and the atrioventricular bundle (highest value). For the
      mean profile area of the myocytes, significant differences were found between the
      myocytes of both the crista terminalis and the interatrial septum, and those of
      the interventricular septum (highest value). Under the light microscope, myocytes
      from the two regions of the atrial wall studied were indistinguishable in size,
      since they constitute a single cell population. It was also impossible to
      distinguish them from the atrioventricular cells. The myocytes from the
      interventricular septum differed in both size and number from those of the right
      atrium, but only in number from those of the atrioventricular bundle.

PMID- 8465978
TI  - The hairlet follicle in the skin of the wild Norway rat (Rattus norvegicus
      Berkenhout, 1769). Its morphology and function.
AB  - The hairlet follicle of the wild Norway rat (Rattus norvegicus Berkenhout 1769)
      differs from the other follicles in position and in structural characteristics.
      As an element of the guard (tylotrich) hair follicle group the hairlet follicles
      are arranged at the margin of the hair disk. The hairlet follicle, which produces
      the finest hair fibre, is enclosed by an active unilobular sebaceous gland. The
      arrector pili muscle is absent, but the follicle does have a supply of lanceolate
      nerve endings and Ruffini endings. The axons of the lanceolate endings are
      enclosed sandwich-like by Schwann cells and contact the basal lamina of the outer
      epithelial root sheath. Ruffini endings run within the band of connective tissue
      fibres that girdle the follicle at the level of the sebaceous gland. The
      appropriate stimulus for excitation of the nerve fibres can not be achieved by
      bending the tiny hairlet fibre. Tissue compression, induced by bending the
      central guard (tylotrich) hair, which is transformed via the sebaceous gland and
      the slim outer epithelial root sheath, may exicite the nerves of the hairlet
      follicle. It can be assumed that the hairlet follicle functions as a
      mechanoreceptor.

PMID- 8465979
TI  - Neuroanatomical and immunohistochemical studies on the dorsal neurons in the
      spinal cord of Trigla lucerna L. and Scorpaena porcus L. (Scorpaeniformes).
AB  - Peculiar dorsal neurons present in the dorsal spinal cord of Trigla lucerna L.
      and Scorpaena porcus L. were investigated by neuroanatomical and
      immunohistochemical methods. These neurons were previously defined as commissural
      cells, but have now been identified as supramedullary neurons. The following
      fundamental criteria for identifying the supramedullary neurons of Teleosts are
      proposed: a) dorsomedial location in the spinal cord; b) large size of the soma
      and axon; c) immunoreactivity to gastrin/CCK-like peptides.

PMID- 8465980
TI  - The confronting cisternae in the hippocampal neurons of rats and Japanese
      monkeys.
AB  - The ultrastructure of the neurons in the hippocampal formation of Wistar rats and
      Japanese monkeys was investigated. Confronting cisternae were observed in the
      cytoplasm of pyramidal neurons and granule cells. The structures were composed of
      closely apposed parallel cisternae, presumably continuous with the cisternae of
      the rough endoplasmic reticulum. The cytoplasmic matrix between the confronting
      cisternae contained electron dense flocculent material. In the pyramidal neurons
      irregular confronting cisternae were also observed. Possible functions of the
      confronting cisternae are discussed.

PMID- 8465981
TI  - The development of the blood-brain barrier in the chick. Studies with evans blue
      and horseradish peroxidase.
AB  - The development of the blood-brain barrier was microscopically examined in the
      optic tectum of the chick. The permeability of neural vessels to Evans blue and
      horseradish peroxidase decreases progressively during the period of incubation.
      Diffusion is massive on the 6th and 10th days of incubation and is reduced on the
      14th day; on the 18th-21st day of incubation the vascular walls still allow Evans
      blue to diffuse but prevent extravasation of horseradish peroxidase completely.
      In one month old chickens the nervous substrate is free of both tracers.

PMID- 8465982
TI  - Development of the proximal tubule of the fetal rat kidney: morphometry and
      ultrastructural findings.
AB  - The development of the kidney in fetal rats was investigated morphometrically and
      ultrastructurally. Both the length and volume of the proximal tubule increased
      with age. The total volume of functional glomeruli increased markedly from fetal
      day 20 onward. The ratio of total glomerular volume to total proximal tubular
      volume decreased with age and was less than 1 from fetal day 20 onward. The cells
      of the proximal tubule had numerous microvilli on their free surfaces and
      vacuoles in the apical region of the cytoplasm after fetal day 20. These findings
      indicate that the relative growth of the proximal tubule has exceeded that of the
      glomeruli by fetal day 20, and that increased filtration induces both the growth
      and the differentiation of the proximal tubule during development of the fetal
      rat kidney.

PMID- 8465983
TI  - [The cell response of rat esophagus after intraluminal irradiation with Nd-YAG
      laser (1064 nm) after various postoperative times: a light and electron
      microscopic study].
AB  - The esophagi of Wistar rats were irradiated by a Nd-YAG-laser and studied by
      light and transmission electron microscopy immediately, 2 days and 14 days after
      the operation. In the immediate group the lasercentre showed a destruction of the
      stratified epithelium. On the contrary the cells and fibres of the underlying
      connective tissue were hardly affected. In the lasercentre we have found
      occlusion of microvascular lumina. Both the layer of smooth muscular tissue and
      the layer of skeletal muscular tissue showed defects in their myofilaments and
      altered nuclei. The damage of the skeletal muscle fibres extended up to 4 mm
      distant from the lasercentre. After 2 days a migrating epithelial sheet was
      present below the necrotic epithelium and an inflammatory reaction was found in
      the connective tissue. After 14 days a new regenerated epithelium and an
      underlying granulation tissue had caused a stenosis of the esophageal lumen. The
      smooth and striated muscle fibres also showed signs of regeneration. We assume a
      high regenerative capacity of all involved tissues.

PMID- 8465984
TI  - Establishment of heterogeneity among blood vessels: hormone-influenced appearance
      of hepatic lipase in specific subsets of the ovarian microvasculature.
AB  - We used biochemical and structural approaches to analyze the influence of
      gonadotropic hormones on the association of hepatic lipase with specific subsets
      of ovarian blood vessels. Western blotting was used to detect this enzyme in
      effluent collected from heparin-perfused ovaries of nonhormone-treated immature
      rats and those primed with pregnant mare's serum gonadotropin (PMSG) alone or in
      combination with human chorionic gonadotropin (hCG). The effects of these
      hormones on hepatic lipase distribution among ovarian blood vessels was assessed
      before and after hCG and/or PMSG treatment by immunofluorescence and immunogold
      cytochemistry. For the latter, immunoreagents and fixative were delivered
      directly to chilled, unfixed ovaries by in situ vascular perfusion. Data from
      biochemical and structural analyses indicated that hepatic lipase was absent from
      nonhormone-treated ovaries. As shown by Western blotting of ovarian effluent, the
      enzyme appeared following treatment with PMSG and PMSG-hCG; it increased in
      amount in a time-dependent manner, with a transient decline in the early hours
      after hCG injection. Enzyme levels paralleled growth and vascularization of
      follicles and corpora lutea; the fall tended to coincide with early events in
      luteal angiogenesis. Immunogold microscopy showed that hepatic lipase was
      abundant in thin-walled blood vessels of theca interna of follicles, corpora
      lutea, and interstitial cells but sparse in those of the stroma. Moreover, during
      neovascularization of differentiating corpora lutea, vascular sprouts arising
      from hepatic lipase-laden thecal vessels appeared to lose, then regain, the
      enzyme as development progressed. Our findings thus suggest 1) that hormones
      influence the establishment of endothelial cell heterogeneity within the
      microvasculature of a single organ and 2) that development of novel endothelial
      cell properties in specific subsets of blood vessels underlies
      compartmentalization of function within a tissue.

PMID- 8465985
TI  - Distribution of dystrophin and neurofilament protein in muscle spindles of normal
      and Mdx-dystrophic mice: an immunocytochemical study.
AB  - Dystrophin is a high molecular weight protein localized under the sarcolemma of
      normal extrafusal muscle fibers but absent in skeletal muscle of Duchenne
      muscular dystrophy patients and mdx mice. Muscle spindles in the soleus of 32
      week-old normal and age-matched mdx mice were examined by immunocytochemical
      methods to determine the localization of dystrophin in polar and equatorial
      regions of the intrafusal fibers. Spindles were serially sectioned in transverse
      and longitudinal planes, and were double-labelled with an antibody to dystrophin
      and with an antibody to a 200 kD neurofilament protein, which revealed their
      sensory innervation. By fluorescence microscopy, intrafusal fibers in the soleus
      of mdx mice were deficient in dystrophin throughout their lengths, whereas their
      sensory nerve terminals stained intensely with the nerve-specific antibody and
      appeared unaltered in dystrophy. In the normal soleus, intrafusal fibers
      displayed a regional variability in the distribution of dystrophin. Polar regions
      of bag and chain fibers exhibited a peripheral rim of sarcolemmal staining
      equivalent to that seen in the neighboring extrafusal fibers. Dystrophin
      labelling in equatorial regions of normal intrafusal fibers, however, showed
      dystrophin-deficient segments alternating in a spiral fashion with positive
      staining domains along the sarcolemma. Double-labelling for dystrophin and
      neurofilament protein showed that these dystrophin-deficient sites were subjacent
      to the annulospiral sensory nerve wrappings terminating on the intrafusal fibers.
      These findings suggest that dystrophin is not an integral part of the subsynaptic
      sensory membrane in equatorial regions of normal intrafusal fibers and thus is
      not directly related to sensory signal transduction. The complete absence of this
      protein in mdx intrafusal fibers indicates that these fibers exhibit the same
      primary defect in muscular dystrophy as seen in the extrafusal fibers. However,
      because of their small diameters, capsular investment, and relatively low tension
      outputs, dystrophic intrafusal fibers may be less prone to the sarcolemmal
      membrane disruption that is characteristic of extrafusal fibers in this disorder.

PMID- 8465986
TI  - Blood-urine barrier formation in mouse urinary bladder development.
AB  - Formation of the blood-urine permeability barrier in differentiating mouse
      transitional urothelium was studied. It was established that the development of
      superficial cell barrier is a two-phase process: beginning with formation of the
      tight junctions, followed by formation of fusiform vesicles and asymmetric apical
      plasma membranes. Fusiform vesicles differentiate during days 15 and 17 of
      gestation and fuse with the apical plasmalemma. Thus a thick membrane is formed
      before the excretion of hypertonic urine into the embryonic bladder. Through some
      degenerative superficial cells slough between fetal day 17 and the day of birth,
      the bladder epithelium in mice does not lack an effective permeability barrier.

PMID- 8465987
TI  - Morphometric analysis of intact sperm heads and of sperm nuclei in the mouse.
AB  - A morphometric analysis of mouse sperm and of their nuclei was undertaken to
      investigate their respective post-testicular maturation. Sperm were collected
      from the testis, caput and cauda epididymidis, and their corresponding nuclei
      were isolated. Results indicate that the post-testicular maturation of sperm is
      distinct from that of nuclei. The size of intact sperm heads increases in the
      caput followed by a subsequent decrease in the cauda. In contrast, sperm nuclei
      decrease progressively in size. In general, a greater magnitude and number of
      alterations in intact heads and nuclei occur while in transit from the testis to
      the caput than during passage to the cauda epididymis. These results suggest that
      the period immediately following their release from the testis is crucial to the
      complete morphological maturation of sperm heads and nuclei.

PMID- 8465988
TI  - Basement membrane formation and re-distribution of the beta 1 integrins in a
      human intestinal co-culture system.
AB  - We have developed a co-culture system suited for the study of epithelial
      mesenchymal interactions in the human fetal small intestine. As the epithelial
      component of this model, we used the human intestinal cell line Caco-2 that is
      unique in its property to differentiate in vitro into a mature fetal enterocyte
      like cell type. A sheet of human intestinal mesenchymal cells, which we derived
      from an 18-week-old fetus, was used as mesenchymal element. Expression and
      distribution of cell-specific markers (cytokeratin 18 and dipeptidyl peptidase
      IV), major basement membrane components, and beta 1 integrins were analyzed. In
      14-day co-cultures, Caco-2 cells formed a cytokeratin 18-positive epithelial-like
      sheet covering the vimentin-positive HIM cell layers. As assessed by brush border
      dipeptidyl peptidase IV expression, co-cultured Caco-2 cells achieved
      cytodifferentiation as when cultured on plastic. A complete deposition of all
      known major human fetal intestinal basement membrane components occurred at the
      Caco-2/HIM interface. Type IV collagen and tenascin were produced from the
      mesenchymal compartment, whereas laminin and fibronectin were contributed by both
      cell types. Interestingly, synthesis and deposition of basement membrane heparan
      sulfate proteoglycan were exclusively observed in co-cultures, suggesting
      modulation of epithelial expression of this molecule by HIM cells. Finally, we
      observed that epithelial integrin-beta 1 chains redistributed at the basal domain
      of co-cultured Caco-2 cells. Taken together, these observations indicate that the
      Caco-2/HIM co-culture model is a valuable system to study in vitro human basement
      membrane formation in the context of intestinal epithelial-mesenchymal
      interactions.

PMID- 8465989
TI  - Intercellular communication within the rat anterior pituitary gland: V. Changes
      in cell-to-cell communications as a function of the timing of castration in male
      rats.
AB  - Cell-to-cell communication by gap junctions was investigated in the male rat
      anterior pituitary gland following several experimental regimens involving
      castration. The regimens included the following animals: (1) Group 1, castrated
      at 10-day intervals from day 10 to 50 and sacrificed at 60 days of age; (2) Group
      2, castrated every 10 days from days 10 to 50 and sacrificed 50 days after
      castration; (3) Group 3, castrated at 5 days of age and sacrificed every 10 days
      from day 10 to 60; or (4) Group 4, remained intact and sacrificed every 10 days
      from days 10 to 60. In all of the castrated animals, numerous so-called
      castration cells were scattered throughout the pars distalis of the pituitary
      gland, with occasional "signet ring cells" being observed. In Groups 1 and 2, the
      pattern of gap junction development and their number was no different from the
      intact control (Group 4). In contrast, the number of gap junctions in the animals
      castrated on day 5 remained very small even into adulthood. These data
      demonstrate that gonadal steroids are important in the initial development of gap
      junctions within the pituitary gland but are not necessary to sustain their
      presence once an animal becomes an adult.

PMID- 8465990
TI  - Ultrastructure of the human anogenital "sweat" gland.
AB  - A newly described type of cutaneous gland occurring in the human anogenital
      region was investigated in specimens from the vulva by electron microscopy. This
      gland, which is characterized by a long excretory duct opening at the skin
      surface, by a wide coiled secretory part with multiple lateral extensions in the
      form of diverticula and branches lined by a two-layered pseudostratified
      epithelium of myoepithelium, and by a luminal layer of tall columnar cells with
      conspicuous "snouts," could not be categorized as an eccrine, apocrine, or
      mammary gland. Electron microscopy confirmed its separate position by showing
      that the luminal layer of secretory cells with prominent cytoplasmic caps had
      elaborately folded lateral membranes, occasional canaliculi, and a large number
      of uniform electron-lucent to moderately electron-dense secretory granules as
      part of a probable merocrine secretion. The excretory duct showed a poorly
      developed cuticular border. This combination of ultra-structural features is
      alien to the other tubular cutaneous glands. The function of this anogenital
      "sweat" gland remains obscure, but the presence of these granules suggests a
      secretion product that is different from that of other cutaneous glands.

PMID- 8465991
TI  - Monoclonal antibodies identifying subsets of ectodermal, mesodermal, and
      endodermal cells in gastrulating and neurulating avian embryos.
AB  - The goal of our laboratory research is to elucidate the mechanisms underlying
      gastrulation and neurulation, using the avian embryo as a model system. In
      previous studies, we used two approaches to map the morphogenetic movements
      involved in these processes: (1) we constructed quail/chick transplantation
      chimeras in which grafted quail cells could be identified within chick host
      embryos by the presence of nucleolar-associated heterochromatin, and (2) we
      microinjected exogenous cell markers. However, it would be advantageous to be
      able to detect endogenous markers to demarcate various subsets of cells within
      the unmanipulated embryo. To elucidate such a series of natural markers, we have
      used monoclonal antibodies to identify epitopes found on subsets of ectodermal,
      mesodermal, and endodermal cells. Antibodies were made by immunizing mice against
      either homogenized ectoderm (i.e., prospective neural plate and surface ectoderm)
      or primitive streak, which had been microdissected from stage 3 chick embryos.
      Additionally, we screened a panel of antibodies made against soluble protein
      obtained from isolates of cell nuclei from late embryonic chick brain. Here, we
      describe the labeling patterns of three monoclonal antibodies, called MAb-GL1,
      GL2, and GL3 (GL, germ layer), during avian gastrulation and neurulation. Our
      results show that labeling early avian embryos with monoclonal antibodies can
      reveal previously undetected distributions of cells bearing shared epitopes,
      providing new labels for subsets of cells in each of the three primary germ
      layers.

PMID- 8465992
TI  - Isolation of chick primordial germ cells from stages 4-8 embryos.
AB  - Chick embryo primordial germ cells (PGCs) stages 4-8 were manually isolated for
      the first time from the late hypoblast layer. They were confirmed to be PGCs by
      periodic acid-Schiff (PAS) staining and examination by scanning electron
      microscopy (SEM). They were subsequently introduced onto a variety of artificial
      substrata. On two dimensional substrata, the cells change from a spherical shape
      covered with numerous microvilli to a rounded cell with a "skirt" of cytoplasm.
      Eventually a process projects from one side of the smooth cell. On a three
      dimensional substrate the PGCs change from a spherical shape covered with
      numerous microvilli to a smooth surfaced cell with a long single process. It is
      concluded that the PGCs which are originally spherical in situ in stage 4 alter
      their morphology both in vivo during their migration and in vitro studies.

PMID- 8465993
TI  - Foveal topography in the optic nerve and primary visual centers in Falconiforms.
AB  - The topography of the retinal nasal and temporal foveal projections upon the
      optic nerve and primary visual centers was studied in diurnal bifoveate birds of
      prey by means of restricted tritiated proline intraocular injection. According to
      the degree of retinotopy, this study reveals that a single injection of tracer in
      the nasal or temporal fovea produces a well-defined and complementary pattern of
      projections in the following contralateral nuclei: lateral anterior thalamus,
      lateroventral geniculate nucleus (glv), superficial synencephalic (ss), tectal
      grey (gt), and optic tectum. In the thalamic nucleus dorsolateral anterior, the
      nasal foveal projections are seen mainly in the lateral and rostrolateral
      subdivision, while temporal projections are seen mainly in the magnocellular
      subdivision. In the external and ectomammillary nuclei there is some evidence of
      retinotopic innervation. Finally, a discrete field of projection from the nasal
      or temporal fovea is detected in lateral hypothalamus, ventrolateral thalamus,
      lateral geniculate intercalated nucleus, and pretectal optic area. The
      nasotemporal axis of the retina is ventrodorsally oriented in the optic nerve
      with ganglion cell axons of the temporal fovea more dorsally placed than the
      nasal ones. In the primary visual centers this retinal axis is mediolaterally
      represented in the nuclei glv, ss, and gt, and dorsoventrally oriented in the
      optic tectum.

PMID- 8465994
TI  - Breed and seasonal variation of plasminogen activator activity and plasminogen
      activator inhibition in spermatozoa and seminal plasma of the ram in correlation
      with testosterone in the blood.
AB  - Plasminogen activator activity (PAA) and plasminogen activator inhibition (PAI),
      against t-PA (t-PAI) or u-PA (u-PAI), in spermatozoa and seminal plasma as well
      as testosterone in the blood of Friesland, Chios, and Karagouniki rams all showed
      a seasonal variation with the highest values during the corresponding breeding
      season of the ewes (Autumn-Winter). The seasonal variation of PAA and PAI in
      spermatozoa or seminal plasma as well as blood testosterone was different among
      the three breeds studied. Increased spermatozoal PAA was observed in November and
      May in Friesland rams, in October and November in Chios rams, and in October in
      Karagouniki rams. Spermatozoal t-PAI was increased in December and June in
      Friesland rams, in November and December in Chios rams, and in November in
      Karagouniki rams. Spermatozoal u-PAI was increased in December in Friesland rams,
      in October and December in Chios rams, and in November and December in
      Karagouniki rams. Plasminogen activator activity and PAI in seminal plasma also
      showed similar seasonal variations. Plasminogen activator activity and PAI in
      spermatozoa and seminal plasma showed a positive correlation with blood
      testosterone. The results of the present study support our previous findings on
      the possible role of spermatozoal PAA and PAI in the fertilizing ability of
      spermatozoa.

PMID- 8465995
TI  - Human sperm acrosin activity with relation to semen parameters and acrosomal
      ultrastructure.
AB  - It was suggested that although not related to the standard semen parameters the
      level of the acrosin enzyme system is related to the fertility potential in men.
      Recently a simple clinical assay for total acrosin level was recommended for
      routine semen analysis. The improved clinical assay was analysed on the freshly
      liquified semen of 198 Asthenoteratozoospermic men and compared with the routine
      semen parameters including biochemical data and the ultrastructure of the
      acrosome. Only the sum of the per cent of live, motile, and normal-shaped
      spermatozoa had positive significant and reasonably high correlation with the
      acrosin level (r = 0.382, P < 0.0001). Each characteristic exhibits significant
      but low (< 0.35) correlation. Similarly negative significant and reasonably high
      correlation was obtained between the acrosin level and the sum of the principle
      acrosomal malformations observed by TEM (r = 0.396, P < 0.0001) while lower
      negative correlation was found only with agenesis or loss of the acrosome.
      Acrosin levels below 8.1 microIU 10(-6) cells were obtained in 4 specimens with
      above 80% round-form associated with more than 95% of agenesis of the acrosome.
      The possible significance of the low correlation obtained between the acrosin
      levels and seminal plasma zinc levels, malformations in the acrosomal equatorial
      region, and the presence of white blood cells is also discussed. We concluded
      that the acrosin activity reflects an aspect of male fertility which is not
      diagnosed by the routine semen analysis or by the ultrastructure of the acrosome,
      and is therefore a useful diagnostic sperm parameter.

PMID- 8465996
TI  - A motile human sperm head fixation method.
AB  - In a solution containing less than 5% seminal fluid, human sperm has a tendency
      to attach its head on the smooth surface of an object. Based on such a
      phenomenon, a simple method was developed to fix sperm head on the surface of
      glass slide. This method was demonstrated by studying caffeine effect on the tail
      movement of human sperm in phosphate buffered saline. By analysing the images
      recorded on a videocassette, caffeine, a well known stimulator of human sperm
      motility, was shown to induce an immediate increase of sperm TBF (tail beat
      frequency) and the amplitude of TBF increase was found to be larger in sperm with
      lower basal TBF value. This method can provide a flock of head-fixed motile sperm
      for a precise sperm tail movement assessment or for other purposes.

PMID- 8465997
TI  - Influence of peritoneal fluid from spontaneous and stimulated cycles on sperm
      motility in vitro.
AB  - Peritoneal fluids (PFs) from spontaneous (n = 14) and gonadotrophin-stimulated
      cycles (n = 20) were obtained during diagnostic laparoscopy and gamete
      intrafallopian transfer (GIFT) procedures, respectively. The effects of these
      fluids on the linear component of sperm motility and on the percentage of motile
      spermatozoa were studied in vitro by objective motility assessments and compared
      to a control medium (B2-Menezo). Overall, the two types of PFs were found to have
      rather similar effects on the motility parameters studied. However, the fluids
      from hormonally-stimulated cycles sustained motility better (i.e., sperm velocity
      and percentage of motile sperm) and in a rather constant manner as a function of
      time (narrower range distributions of the motility measurements). Furthermore, it
      was observed that under identical experimental conditions motility measurements
      depended not only on the type of PF used but also on the sperm sample. These
      results suggest that assisted reproduction procedures in which PF is the medium
      where the gametes eventually meet and interact, such as direct peritoneal
      insemination (DIPI) or peritoneal oocyte and sperm transfer (POST), could have
      different success rates if performed in spontaneous rather than in stimulated
      cycles. At the same time, our results may help to explain why different pregnancy
      rates were reported in different studies using DIP or POST.

PMID- 8465998
TI  - Lack of HLA-molecules on human spermatozoa and in seminal plasma.
AB  - The expression of human leukocyte antigens (HLA) on ejaculated spermatozoa and on
      lymphocytes was compared by flow cytometry using monoclonal antibodies towards
      HLA class I (pan-HLA-A, -B, -C) and class II (DR) antigens. Soluble antigens of
      HLA class I (s HLA-A, -B, -C) in seminal plasma and in blood plasma were
      monitored with an ELISA technique. Lymphocytes showed specific fluorescence after
      incubation with the antibodies against HLA class I and class II (DR), whereas, on
      spermatozoa no positive immunofluorescence could be detected. No antibodies were
      bound to any significant extent either after modifications of sperm preparation
      (density gradient centrifugation, swim up-technique, addition of azide, foetal
      calf serum or benzamidine chloride) or after treatment of spermatozoa with
      detergents. Furthermore, different concentrations of soluble HLA-A, -B, -C in
      seminal plasma and in blood plasma were detected. The latter one showed soluble
      HLA about four-fold more concentrated than the seminal plasma (means +/- SD:
      262.5 +/- 144.4 nmol l-1 vs. 62.5 +/- 27.1 nmol l-1). These results suggest, that
      the HLA-expression differs between human spermatozoa and somatic cells.

PMID- 8465999
TI  - Molecular organization of the plasma membrane in the post-acrosomal region of
      some farm animals.
AB  - According to the distribution of IMP, three different regions can be recognized
      on PF of the post-acrosomal plasma membrane of bull, ram, and boar spermatozoa.
      They are: (1) a region with linear aggregation of IMP, (2) a region with fewer
      and scattered IMP, and (3) a region with more numerous IMP. In the last two
      regions IMPs are randomly distributed or a clustering of certain particles is
      visible. In stallion spermatozoa the last two areas are undistinguishable. There
      are evident interspecies differences in the arrangement of linear aggregations of
      IMP which are characteristic for each species.

PMID- 8466000
TI  - Ultrastructural and immunocytochemical study of P1 protamine localization in
      human testis.
AB  - Two monoclonal antibodies (MAbs) directed against human protamine P1 were
      realized. Anti-P1 specificity was assessed by western-blot and confirmed by
      ELISA. Monoclonal antibody 97-3 was selected. Protamine P1 was specifically
      demonstrated in human testis by immunoelectron microscopy, using 97-3 MAb and an
      indirect post-embedding immunogold technique. Our results clearly demonstrated
      the precise time of appearance of P1 protamine in the nuclei of human spermatids.
      P1 first appeared in the nucleus of step 5 spermatids and its concentration was
      increased in steps 6-8 spermatids, cytoplasm was not labelled.

PMID- 8466001
TI  - Anesthesia and health care reform in 1993.

PMID- 8466002
TI  - What are the normal levels of cerebral blood flow and cerebral oxygen consumption
      during cardiopulmonary bypass in humans?

PMID- 8466003
TI  - Identification of patients at risk for excessive blood loss during coronary
      artery bypass surgery: thromboelastography versus coagulation screen.
AB  - In light of the potential morbidity associated with transfusion of blood
      products, a reliable preoperative screening test to identify cardiothoracic
      surgical patients who are at potential risk for increased intraoperative blood
      loss would be useful. Accordingly, we examined the efficacy of a variety of
      coagulation tests to predict intraoperative blood loss in 60 patients presenting
      for coronary artery bypass surgery (CABG). A complete coagulation screen,
      activated clotting time (ACT), and thromboelastograph (TEG) were performed before
      surgery. Intraoperative blood loss was determined by weighing sponges and
      measuring the quantity of blood in suction canisters. The duration of
      cardiopulmonary bypass was 100 +/- 4 min, and total surgery time was 5.0 +/- 0.1
      h. Total crystalloid and colloid requirements were 5.5 +/- 0.2 and 1.4 +/- 0.1 L.
      Forty-eight percent of the patients required blood with an average requirement of
      2.5 +/- 0.5 units. Total intraoperative blood loss averaged 1590 +/- 95 mL with a
      range from 640 to 3928 mL. Using multiple linear regression, all coagulation and
      TEG variables were used to model perioperative blood loss. Results showed that
      all components of the TEG failed to predict blood loss (r < 0.25, P > 0.78).
      However, three components of the routine coagulation assay, including bleeding
      time, prothrombin time, and platelet count could be modeled to predict
      perioperative blood loss (r = 0.75, P < 0.05). Although TEG has been shown to
      have potential in identifying postcardiopulmonary bypass coagulopathies, these
      results suggest that it does not appear to be useful in determining the
      coagulation status of CABG patients preoperatively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466004
TI  - The effect of epidural/general and cervical plexus block anesthesia on activated
      clotting time in patients undergoing vascular surgery.
AB  - The effect of anesthetic induction and surgical incision on activated clotting
      time (ACT) was determined in patients undergoing vascular surgery. Patients
      undergoing carotid endarterectomy (CAE) (n = 50) and abdominal aortic aneurysm
      repair (AAA) (n = 45) were studied. Patients in the CAE group had cervical plexus
      block anesthesia, whereas patients in the AAA group had a combination of epidural
      and general anesthesia. The ACT was measured 1) before induction of anesthesia,
      2) 5 min after induction, 3) 5 min after incision, 4) 5 min after heparinization,
      and 5) at the onset of skin closure. Heparin was reversed with protamine only if
      the ACT after revascularization was > 200 s. Reversal was considered adequate if
      the ACT was < 200 s and the surgeon felt that hemostasis was adequate. The ACT
      decreased by 12.26 +/- 1.23 (mean +/- SE) (P = 0.006) in the CAE group and by
      12.47 +/- 1.01 (P = 0.002) in the AAA group with induction of anesthesia. There
      was a further decrease of 5.06 +/- 0.62 (P = 0.26) in the CAE group and 5.17 +/-
      0.83 (P = 0.22) in the AAA group with incision. There was a significant
      difference in ACT in both groups from postinduction and postincision to skin
      closure (higher at skin closure). No patient in either group required additional
      protamine or clotting factors post-operatively, or return to the operating room
      for excessive bleeding. This study demonstrates that anesthetic induction with
      cervical block or epidural/general anesthesia decreases ACT.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8466005
TI  - Prophylactic nitroglycerin infusion during noncardiac surgery does not reduce
      perioperative ischemia.
AB  - We evaluated the impact of prophylactic nitroglycerin on the incidence of
      perioperative myocardial ischemia in patients with known or suspected coronary
      artery disease who undergo noncardiac surgery. Our goals were to better define
      the role of nitroglycerin in the management of high-risk patients and to explore
      the mechanisms of perioperative myocardial ischemia. Patients were assigned
      randomly to either a control group (n = 23) or to receive 0.9 micrograms.kg-1.min
      1 of intravenous nitroglycerin (n = 22). The diagnosis of myocardial ischemia was
      based on a review of Holter electrocardiogram (ECG) recordings. There was no
      difference in the incidence of ischemia between groups. Seven control patients
      (30%) and seven nitroglycerin patients (32%) exhibited ECG evidence of ischemia.
      The preponderance of myocardial ischemia occurred during emergence from
      anesthesia (of the 14 patients exhibiting ischemia, 12 did so at emergence).
      There was an acute increase in heart rate at the onset of ischemia in all
      patients exhibiting ischemia with 14 of 18 episodes associated with an increase
      of 20% or greater. The heart rate associated with the onset of ischemia was
      greater in the nitroglycerin-treated patients than in the control group. We also
      found that the occurrence of myocardial ischemia on a preoperative Holter
      recording was strongly predictive of the subsequent occurrence of perioperative
      ischemia. In conclusion, the addition of nitroglycerin to standard anesthetic
      management of these high-risk patients does not measurably reduce perioperative
      ischemia.

PMID- 8466006
TI  - Direct or modified Seldinger guide wire-directed technique for arterial catheter
      insertion.
AB  - Percutaneous radial artery cannulation is widely used for direct continuous
      arterial blood pressure measurement and sampling of arterial blood. We compared
      the success rate of arterial catheter placement in patients undergoing
      aortocoronary bypass operations using the direct and the modified Seldinger
      techniques. The effects of gender and quality of the pulse were also
      investigated. Our study group consisted of 42 female and 96 male patients. The
      overall success rate with the guide wire was 82% compared with that of the direct
      method of 65% (P = 0.02). The success rate for arterial cannulation in male
      patients was high whether direct cannulation or a guide wire was used. In female
      patients, on the other hand, the failure rate with the direct technique was high
      (57%) and was significantly lower (14%) when the guide wire was used (P < 0.001).
      We conclude that the success rate for cannulation is high in male patients, and
      patients with a bounding pulse regardless of the use of the direct or guide-wire
      techniques. The guide wire is recommended as the initial technique for
      cannulating the radial artery of female patients. In patients with a thready
      pulse, no significant advantage could be obtained by using a guide wire, but in
      salvaging an arterial line the guide wire is efficacious.

PMID- 8466008
TI  - Actions of volatile anesthetics on ischemic and nonischemic Purkinje fibers in
      the canine heart: regional action potential characteristics.
AB  - The effects of halothane, isoflurane, and enflurane on proximal (false tendon)
      and distal (apical) Purkinje fibers were measured in vitro in infarcted canine
      hearts to assess their effects on action potentials of fibers located within the
      nonischemic and ischemic regions, respectively. High- and low-dose anesthetic
      effects were evaluated in three groups of eight preparations and compared to
      changes occurring at identical times in eight infarcted control preparations.
      Under control conditions in all groups, the action potential duration at 90%
      repolarization (APD90, mean +/- SEM) of ischemic distal fibers (396 +/- 9 ms) was
      longer (P < or = 0.01) than that of nonischemic proximal fibers (344 +/- 5 ms)
      and the ischemic fibers exhibited (P < or = 0.05) reduced maximum diastolic
      potential, amplitude, and Vmax relative to nonischemic fibers. Halothane (0.25
      and 0.6 mM), isoflurane (0.4 and 0.8 mM), and enflurane (0.8 and 1.6 mM) produced
      dose-dependent decreases of nonischemic fiber APD90 with less decrease (P < or =
      0.01) of ischemic fiber APD90 and thereby accentuated (P < or = 0.05) regional
      differences of APD90 at high dose. The decreases of nonischemic fiber APD90 were
      greater (P < or = 0.01) for 0.8 mM (2.9 minimum alveolar anesthetic concentration
      [MAC]) isoflurane (-95 +/- 5 ms) and 1.6 mM (2.5 MAC) enflurane (-79 +/- 12 ms)
      than for 0.6 mM (2.2 MAC) halothane (-41 +/- 3 ms). Isoflurane increased the
      pathologic difference (ischemic > nonischemic) between the repolarization times
      (APD90) of Purkinje fibers in the infarcted heart more (P < or = 0.05) than
      halothane.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466007
TI  - Actions of halothane and isoflurane on Purkinje fibers in the infarcted canine
      heart: conduction, regional refractoriness, and reentry.
AB  - The actions of halothane (HAL) and isoflurane (ISO) on conduction and regional
      refractoriness were studied in infarcted canine hearts to compare their effects
      on reentry in vitro. In two anesthetic groups of 8 hearts, high and low dose
      effects were assessed using action potentials recorded from Purkinje fibers
      located in the nonischemic and ischemic regions. An extrastimulus technique was
      used to determine the relationship between delay of conduction of premature
      impulses into the more refractory ischemic region and induction of reentrant
      responses. At high doses (HAL 0.60 mM and ISO 0.64 mM, approximately 2.3 minimum
      alveolar anesthetic concentration [MAC]) both anesthetics decreased (P < or =
      0.05) the effective refractory period for direct intracellular stimulation of
      nonischemic fibers (local ERP, initial control: 294 +/- 8 ms); the decrease with
      HAL (-29 +/- 6 ms) was smaller (P < or = 0.05) than with ISO (-50 +/- 7 ms). HAL
      and ISO also decreased (P < or = 0.05) the coupling interval of the earliest
      premature impulse which conducted into the infarct (system effective refractory
      period [SERP], control: 301 +/- 7 ms) by -31 +/- 11 and -44 +/- 8 ms,
      respectively. In contrast, the functional refractory period (FRP) in the ischemic
      region (control:354 +/- 4 ms) was increased by HAL (26 +/- 8 ms; P < or = 0.05)
      but decreased by ISO (-14 +/- 4 ms, P < or = 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466009
TI  - Halothane and the reperfusion injury in the intact animal model.
AB  - We studied the effect of halothane on regional myocardial function during acute
      ischemia and reperfusion in an open-chest pig model. Anesthesia was induced with
      thiopental and fentanyl and maintained with an intravenous (IV) infusion of
      pentobarbital and fentanyl. Regional myocardial function was studied with
      microsonometers placed in the subendocardium supplied by the left anterior
      descending coronary (LAD) and circumflex coronary artery (LX). Systolic function
      was evaluated with reference to the end-systolic pressure-length relationship
      (ESPLR) and regional systolic shortening. Diastolic dysfunction was studied with
      postsystolic shortening (PSS). Ischemia was induced with 15 min of total
      occlusion of the LAD artery, and thereafter reperfusion was allowed for 120 min.
      Five groups were studied: one group received only pentobarbital and fentanyl (n =
      10); the other groups received halothane 0.2% (n = 5), 0.4% (n = 7), 0.6% (n =
      5), and 0.8% (n = 5). The pentobarbital and fentanyl infusion was adjusted in the
      halothane groups in an effort to maintain arterial blood pressure and heart rate
      within specified limits (when possible). Results indicate that regional
      dysfunction during acute ischemia was equal among all the groups. However, on
      reperfusion, halothane significantly reduced the incidence of ventricular
      arrhythmias. Halothane (0.6% and 0.8%) was associated with less regional
      postischemic systolic dysfunction during reperfusion when compared to the other
      groups. Hearts subjected to 0.6% and 0.8% halothane also were less stiff at the
      end of systole (i.e., the extrapolated ventricular volume at zero ventricular
      pressure was less) after 120 min reperfusion compared to animals receiving less
      halothane. However, diastolic dysfunction was equal among the groups during
      reperfusion. We conclude that, in this model, administration of halothane is
      associated with improved recovery of regional systolic function and potentially
      beneficial pressure-length relations at the end of systole after acute severe
      myocardial ischemia and reperfusion. Furthermore, administration of halothane was
      associated with fewer reperfusion arrhythmias compared to animals not receiving
      halothane.

PMID- 8466010
TI  - Progesterone-mediated potentiation of spinal sufentanil in rats.
AB  - Pregnancy is associated with an increased sensitivity to both general and local
      anesthetics. The exact reason is uncertain, but increased concentrations of
      progesterone and endogenous opiates have been implicated. Therefore, we tested
      the ability of intrathecally administered progesterone to produce analgesia and
      to potentiate the effects of spinal sufentanil. Female rats had intrathecal
      catheters implanted for drug administration, and analgesia was measured using the
      tail flick assay or hemostat clamp test. Animals were pretreated first with 10
      micrograms, 20 micrograms, or 40 micrograms of intrathecal progesterone (n = 5,
      for each dose) and then given a minimally analgesic dose of sufentanil.
      Pretreatment with progesterone potentiated sufentanil's effect and resulted in
      almost complete analgesia. In contrast, in animals not pretreated with
      progesterone, the same dose of sufentanil resulted in minimal analgesia (n = 15).
      Intrathecal progesterone alone had no analgesic effects. No behavioral or motor
      effects were noted after progesterone treatment. Cerebral spinal fluid
      progesterone levels were within physiologic range. Furthermore, 100 micrograms of
      progesterone administered intramuscularly did not potentiate sufentanil
      analgesia. A major progesterone metabolite, 5 alpha-pregnane-3 alpha-ol-20-one, 5
      micrograms, 10 micrograms, or 20 micrograms (n = 5, for each dose), also
      potentiated sufentanil analgesia when administered intrathecally. In contrast, a
      stereoisomer, 5 beta-pregnane-3 beta-ol-20-one failed to show potentiation.
      Finally, two drugs that block gamma-aminobutyric acid-mediated increases in
      chloride ion conductance, picrotoxin and bicuculline, each blocked progesterone
      mediated potentiation of sufentanil analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466011
TI  - Influence of sensor site location on pulse oximetry kinetics in children.
AB  - A pulse oximeter sensor is used to monitor changes in arterial hemoglobin oxygen
      saturation (SpO2) in anesthetized pediatric patients. The authors compared the
      kinetics of desaturation and resaturation measured by sensors placed over central
      (tongue, cheek) and peripheral (finger, toe) vascular beds in children with
      congenital heart disease. Desaturation time was defined as the time which elapsed
      between the onset of apnea and a 4% decrease in SpO2 from baseline. The
      desaturation times averaged 24 +/- 12 s, 56 +/- 34 s, and 58 +/- 28 s for the
      cheek, finger, and toe, respectively (n = 40; P < 0.0001 for cheek versus finger
      or toe). Resaturation time was defined as the interval between the resumption of
      ventilation and a 4% increase in SpO2 above the nadir. Resaturation times
      averaged 12 +/- 8 s for the cheek, 40 +/- 36 s for the finger, and 47 +/- 25 s
      for the toe (n = 40; P < 0.0001 for cheek versus finger or toe). A comparison of
      the kinetics at two central sensor sites, cheek and tongue, respectively,
      revealed no significant differences in desaturation times (20 +/- 10 s vs 21 +/-
      9 s) or resaturation times (10 +/- 6 s vs 7 +/- 3 s) (n = 13). The authors
      conclude that both desaturation and resaturation are detected earlier by
      centrally placed sensors.

PMID- 8466012
TI  - Anesthetic management of patients undergoing bilateral unifocalization.
AB  - We report on the anesthetic management of eight patients undergoing
      unifocalization for pulmonary atresia and ventricular septal defect with major
      aortopulmonary collateral arteries. Unifocalization was performed separately on
      the right and left lungs in the lateral decubitus position. During
      unifocalization, pulmonary blood flow to the nondependent lung is interrupted and
      arterial oxygenation is dependent solely on the blood flow to the dependent lung.
      Thus, PaO2 and SaO2 decreased significantly and PaCO2 increased significantly
      during unifocalization, as compared with before and after unifocalization. When
      these values are compared between first and second stage of unifocalization, SaO2
      during second stage was lower than during first stage. Although PaO2, PaCO2, and
      pH during second stage tended to be worse than during first stage, the
      differences did not reach statistical significance. During unifocalization,
      especially in second stage, to prevent deterioration of these arterial gas
      variables, pulmonary blood flow had to be increased by frequent administration of
      catecholamine. In addition, bicarbonate infusion was also used to prevent
      progressive metabolic acidosis due to hypoxia during unifocalization. Because
      anticoagulant therapy was required during unifocalization, airway bleeding was a
      common complication.

PMID- 8466013
TI  - Propofol infusion and the incidence of emesis in pediatric outpatient strabismus
      surgery.
AB  - A prospective, randomized, double-blind study was conducted to examine the effect
      of a propofol infusion on the incidence of postoperative emesis in children
      undergoing outpatient strabismus surgery. Seventy-eight children, aged 3-12 yr,
      were allocated randomly to receive either nitrous oxide and halothane or nitrous
      oxide and a propofol infusion for the maintenance of anesthesia. The overall
      incidence of vomiting during the first 24 h was 64% in those receiving halothane
      and 41% in those receiving the propofol infusion; this difference was
      statistically significant (P < 0.05). In children who received no opioids
      postoperatively, the incidence of vomiting in the first 24 h was 71% in the
      halothane group and 24% in the propofol group; this difference was also
      significant (P = 0.001). We conclude that propofol was effective in reducing the
      incidence of postoperative emesis in pediatric outpatient strabismus surgery.

PMID- 8466014
TI  - Factors influencing deep vein thrombosis following total hip arthroplasty under
      epidural anesthesia.
AB  - To determine intraoperative factors which may influence deep vein thrombosis
      rate, we studied surgeries performed by one surgeon on 441 consecutive patients
      undergoing primary total hip arthroplasty under epidural anesthesia. Operative
      limb venography was performed on the fourth or fifth postoperative day in 381
      patients, who received 650 mg of aspirin daily as the only postoperative
      thromboprophylaxis. Of 381 (15%) patients, 58 had a positive venogram; 13 (3%)
      had proximal thrombi. Of 178 patients (9.5%) with surgery lasting less than 70
      min, 17 developed deep vein thrombosis whereas 41 of 203 patients (20.3%) with
      surgery lasting more than 70 min developed deep vein thrombosis (P < 0.05).
      Corresponding proximal deep vein thrombosis rates increased from 1.7% to 4.9%.
      Deep vein thrombosis was observed in 12.5% of patients receiving intravenous low
      dose epinephrine, 10.3% receiving intravenous sodium nitroprusside, 14.5%
      receiving both low-dose epinephrine and sodium nitroprusside concurrently, and
      25% receiving intravenous fluid alone. Proximal deep vein thrombosis rates were
      2.4%, 0%, 1.45%, and 9.3% in these groups, respectively. These data suggest that
      the intraoperative management of both surgery and anesthesia influence rates of
      deep vein thrombosis following total hip arthroplasty.

PMID- 8466015
TI  - Norepinephrine prolongs tetracaine spinal anesthesia in surgical patients: a
      preliminary study.
AB  - We conducted a double-blinded examination of the effects of norepinephrine as a
      vasoconstrictor on the onset and duration of tetracaine spinal anesthesia in 80
      surgical patients. The patients were randomly allocated to four groups (n = 20 in
      each group). Each patient received 10 mg of tetracaine in a volume of 2.0 mL
      which contained either 0 micrograms/mL, 5 micrograms/mL, 10 micrograms/mL, or 15
      micrograms/mL of norepinephrine. The onset of spinal anesthesia was determined by
      the time to reach Th-10 level as well as by the time required to obtain the
      highest level of sensory analgesia. The time for two-segment regression and full
      motor recovery were defined as the duration of spinal anesthesia. The time to
      reach Th-10, the highest analgesia level, and the time to obtain the highest
      analgesia level did not differ among the groups. Two-segment regression was
      prolonged significantly by 175%, 103%, and 106% as compared with the plain
      tetracaine group, in 5 micrograms/mL, 10 micrograms/mL, and 15 micrograms/mL of
      norepinephrine groups, respectively. Motor recovery also was extended
      significantly by 111%, 152%, and 121% as compared with the plain tetracaine
      group, in 5 micrograms/mL, 10 micrograms/mL, and 15 micrograms/mL of
      norepinephrine groups, respectively. There were no differences in the changes of
      arterial blood pressure and heart rate associated with the addition of
      norepinephrine among the groups. We conclude that norepinephrine provides a
      clinically meaningful prolongation of the duration of tetracaine spinal
      anesthesia.

PMID- 8466016
TI  - Subarachnoid local anesthetic block does not affect morphine absorption from
      paired intramuscular and subcutaneous injection sites in the elderly patient.
AB  - Morphine absorption from subcutaneous and intramuscular injection sites is
      dependent on local skin and muscle blood flow. Normally, drug absorption from
      intramuscular and subcutaneous injections at the same anatomical site is
      comparable, but spinal anesthesia alters muscle and skin blood flow in the
      blocked area. This study measured morphine absorption from pairs of intramuscular
      and subcutaneous injection sites at vastus lateralis and deltoid following a
      single dose of morphine sulfate in the presence of spinal anesthesia. Differences
      between the maximum concentration achieved after injection (Cmax) and the time at
      which this occurred (Tmax) were not significant when absorption for each "same
      site" pair of injections was compared, but Tmax after intramuscular injection at
      vastus lateralis was significantly longer than that observed following either
      intramuscular or subcutaneous injection at the deltoid (P < 0.05 for both
      comparisons). Cmax/Tmax ratios and the area under concentration time curve (AUC)
      also were analyzed, but there were no statistically significant differences among
      any of the four groups.

PMID- 8466017
TI  - Effect of gentle massage on regression of sensory analgesia during epidural
      block.
AB  - We investigated the effect of gentle epigastric massage on the regression of the
      sensory analgesia of epidural block. Sixteen patients, who underwent minor
      obstetric or gynecologic surgery under epidural block with lidocaine, were
      divided into two groups. Group A was the control group. Group B received gentle
      massage of the epigastric area for 30 min. The proximal extent of sensory
      analgesia before massage and 0 and 30 min after the massage was T9 +/- 1, T10 +/-
      1, and T10 +/- 1 in group A, and T9 +/- 1, T11 +/- 1 and L1 +/- 1 in group B
      (mean +/- SD), respectively. The regression of sensory analgesia in group B was
      significantly (P < 0.001) faster than in group A 30 min after the massage. We
      conclude that peripheral sensory stimulation as weak as gentle massage may
      initiate a series of indirect mechanisms that lead to accelerated regression of
      sensory analgesia.

PMID- 8466018
TI  - Dose-response effect of intrathecal alfentanil on canine lower urinary tract
      dynamics.
AB  - The effect of intrathecal (IT) administration of three different doses (1, 2.5,
      and 5 micrograms/kg) of alfentanil on lower urinary tract dynamics was examined
      by urodynamic studies, cystometrograms (CMG), and urethral pressure profiles
      (UPP) in seven anesthetized dogs. Simultaneous serum drug concentrations were
      determined by specific radioimmunoassay for time-response analysis. A significant
      dose-dependent relaxation of urethral musculature expressed by a reduction in UPP
      values of 41.5% and 38.4% (P < 0.03) was noted 30 min after 5 and 2.5
      micrograms/kg IT alfentanil, respectively, whereas the decrease of 13.4-22% in
      mean CMG values was not significant. All changes in UPP and CMG returned to
      baseline values by 60 min. The pharmacokinetics of alfentanil from the
      cerebrospinal fluid to the systemic circulation were linear, i.e., dose
      independent with maximal serum concentrations of 0.6, 1.4, and 3.5 ng/mL 10 min
      after the three respective IT doses. The low serum alfentanil concentrations and
      the lack of time correlation between the peak values and the changes in urinary
      tract activity, point to a spinally mediated mechanism. The short-lived effect of
      IT alfentanil on lower urinary tract dynamics and the relaxation of the bladder
      neck allow for unobstructed micturition pathways and may avoid urinary retention.

PMID- 8466020
TI  - The utility of tracheal temperature monitoring.
AB  - Tracheal temperature--the temperature of the tracheal wall--is believed to
      reflect the core temperature. The trachea reacts quickly to temperature changes
      because it is surrounded by various large arteries and veins. Using the blood
      temperature from the cardiopulmonary bypass (CPB) and the jugular vein
      temperature as standards for core temperature, we evaluated the utility of
      monitoring the tracheal temperature during cardiac surgery. The tracheal
      temperature was measured by a thermistor which was attached to the anterior inner
      surface of the cuff of a tracheal tube. The tracheal temperature had correlation
      coefficients more than 0.99 with both blood temperature from the CPB (r = 0.993,
      P < 0.001) and jugular vein temperature (r = 0.993, P < 0.001) during CPB.
      Because the blood from the CPB draining into the ascending aorta and the jugular
      vein temperature might reflect the hypothalamic temperature directly, the
      tracheal temperature, which correlates with both of these quite closely, may
      reflect the core value directly. The monitoring of the tracheal temperature is
      not only valuable in monitoring the core value, but is also convenient during
      general anesthesia.

PMID- 8466019
TI  - Loss of hypoxic ventilatory response following bilateral neck dissection.
AB  - Modified radical neck or combined radical and modified radical neck surgery is
      performed for treatment of head and neck cancer. Because of the extensive nature
      of the surgery, including dissection around the carotid vessels, we prospectively
      evaluated hypoxic ventilatory responses preoperatively and postoperatively in
      five patients. The change in ventilation to percent desaturation varied between 
      0.22 and -0.60 L/min per percent desaturation in the five study patients. In the
      postoperative evaluation, two of five patients showed flattened responses
      compared with the preoperative measurements due to denervation of their carotid
      bodies. Two patients showed increased responses due to loss of upper airway
      resistance from tracheostomy. We conclude that after bilateral neck dissection
      for cancer surgery some patients may lose their hypoxic ventilatory responses due
      to carotid body denervation.

PMID- 8466021
TI  - Can an anesthesia machine flush valve provide for effective jet ventilation?
AB  - Transtracheal jet ventilation (TTJV) using a percutaneously inserted intravenous
      (IV) catheter for the patient who cannot be ventilated or tracheally intubated
      or, using a jet stylet for changing endotracheal tubes (ETT) in patients for whom
      subsequent ventilation and/or tracheal reintubation may be difficult, are
      extremely valuable therapeutic options. The jet ventilation system must have a
      sufficiently high pressure-oxygen source to drive oxygen through noncompliant
      tubing and through relatively small IV catheters and/or jet stylets in order to
      achieve adequate ventilation and oxygenation. There is no evidence that using the
      common gas outlet of an anesthesia machine by activating the flush valve can
      provide enough flow (V) and tidal volume (VT) for effective jet ventilation. This
      in vitro study utilized a mechanical lung model that had a varying lung
      compliance [Cset (10-100 mL/cm H2O)] to determine the VT (measured by integrating
      a pneumotachograph flow signal) and corresponding minute ventilation (VE) through
      14-, 16-, and 18-gauge IV catheters and small, medium, and large jet stylets. The
      flow of O2 was generated by activating the flush valve of Drager Narkomed 2 and
      2A and Ohmeda Modulus II and II Plus anesthesia machines at an
      inspiratory:expiratory (I:E) ratio = 1:1 (unit of time = 1 s). We found that the
      largest VT and resultant VE were consistently obtained by activating the flush
      valve of the Ohmeda Modulus II and Drager Narkomed 2 anesthesia machines. The
      smallest VT and VE were produced using the Ohmeda Modulus II Plus anesthesia
      machine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466022
TI  - Vancomycin does not enhance hypotension under anesthesia.
AB  - The rapid administration of vancomycin is associated with flushing and
      hypotension, a consequence of histamine release. The manufacturer discourages
      administering vancomycin to anesthetized patients, stating that vancomycin
      aggravates the hypotensive effects of anesthetics. To test this, we randomly
      assigned 36 adults (ASA classes I through III) to one of two groups: preinduction
      (Preind, n = 19) and postinduction (Postind, n = 17). Both groups received two
      different infusions: vancomycin (1 g/250 mL normal saline) and saline (250 mL
      normal saline) over 30-60 min. The Preind group received vancomycin before
      anesthesia was induced and saline was administered immediately after anesthesia
      was induced; for the Postind group, this order was reversed. This was done in a
      double-blind fashion. The anesthetic induction was standardized by the
      intravenous administration of thiopental and vecuronium and anesthetic
      maintenance by inhalation of nitrous oxide and enflurane. End-tidal enflurane,
      heart rate (HR), and blood pressure (BP) were measured every 3 min. Independent
      (unpaired) t-test was used in data analysis. The groups did not differ
      significantly. We conclude that vancomycin infusion may be given under anesthesia
      without significant adverse hemodynamic consequences if administered over a 30-60
      min period of time.

PMID- 8466023
TI  - A-3665, a new short-acting opioid: a comparison with alfentanil.
AB  - A-3665 is a new short-acting synthetic opioid of the piperidine class. We
      conducted a double-blind, escalating dose comparison of A-3665 to alfentanil and
      placebo. Analgesic efficacy was assessed after the administration of A-3665 in
      increasing intravenous doses (0.25, 0.5, 1, 2, 4, 8, 16, 32, and 64
      micrograms/kg) to nine groups of volunteers. At the lower doses (0.25, 0.5, 1,
      and 2 micrograms/kg), five volunteers were in each group; four received A-3665
      and one received placebo in a double-blind manner. There were nine volunteers in
      each of the next three groups; four received A-3665 (4, 8, or 16 micrograms/kg),
      four received alfentanil (4, 8, or 16 micrograms/kg), and one received placebo.
      At the 32 micrograms/kg and 64 micrograms/kg dose levels, five subjects each were
      to be enrolled (four to receive A-3665 and one to receive placebo); however, the
      study was terminated after two subjects in the 64 micrograms/kg group had
      significant respiratory depression. Both drugs caused potent analgesia, compared
      with placebo, with peak effect occurring 3 min after injection. There was no
      significant difference in analgesic potency of A-3665 and alfentanil as measured
      by tolerance to tibial pressure at 3 min. At the dose of 16 micrograms/kg, both
      drugs significantly increased pain tolerance to tibial pressure compared with
      placebo at 3 min, but alfentanil continued to display significant analgesic
      effect versus placebo and versus A-3665 at 6, 11, and 15 min after injection. A
      3665 caused significant respiratory depression at doses of 32 micrograms/kg and
      64 micrograms/kg, but alfentanil did not induce significant respiratory
      depression at the doses tested.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466024
TI  - Inhibitory effects of propofol on cytochrome P450 activities in rat hepatic
      microsomes.
AB  - The effects of propofol on cytochrome P450 activity in rat hepatic microsomes
      were evaluated to determine the potential influence of this anesthetic on the
      metabolism of coadministered agents. In microsomes from untreated and isoniazid
      treated rats, propofol was a weak inhibitor of enflurane metabolism, inhibiting
      activity only at 0.35 mM propofol. In contrast, toluene, a related compound,
      effectively impaired enflurane defluorination in microsomes from untreated, and
      isoniazid- and phenobarbital-treated rats at concentrations as low as 0.025 mM.
      Propofol, in contrast to toluene, was an effective inhibitor of benzphetamine
      demethylation where it inhibited this activity at propofol concentrations as low
      as 0.025 mM in microsomes from phenobarbital-treated rats. In microsomes from
      phenobarbital-treated rats, propofol potently inhibited the metabolism of
      aniline. Sixty-four percent inhibition was achieved at 0.03 mM propofol, whereas
      toluene had no effect at 1 mM. These data demonstrate that propofol does not
      effectively inhibit enflurane metabolism performed by the isoniazid-inducible
      cytochrome P450IIE1 but effectively impairs activities of the phenobarbital
      inducible cytochrome P450 isozymes.

PMID- 8466025
TI  - Propofol attenuates the myogenic response of vascular smooth muscle.
AB  - The myogenic response is the tendency of certain vessels, most notably small
      arteries and arterioles, to constrict in response to an increase in intravascular
      pressure. The effects of propofol on the myogenic response of the isolated
      pressurized rabbit ear artery were studied in segments preconstricted either with
      norepinephrine or 5-hydroxytryptamine and subjected to pressure increases from 60
      to 100 mm Hg applied either rapidly (jumps over 500 ms) or slowly (ramps over 120
      s). In the control experiments the preconstricted vessels initially dilated, then
      rapidly returned toward their initial diameter. In response to pressure ramps,
      vessels slowly dilated, but closely retained their resting diameter.
      Administration of propofol (1.6 x 10(-4) to 1.6 x 10(-3) M) resulted in dilation
      of the constricted vessels. With pressure jumps vessels had a reduced capacity to
      recover their initial diameters, and with pressure ramps vessels dilated to
      greater diameters. When the concentration of vasoconstrictor was increased to
      antagonize the propofol-induced dilation the myogenicity was not restored. This
      attenuation of myogenicity, distinct from the drug's vasodilator effect may
      represent a further mechanism by which anesthetic agents can affect
      cardiovascular function.

PMID- 8466026
TI  - Evaluation of STAT-CRIT hematocrit determination in comparison to Coulter and
      centrifuge: the effects of isotonic hemodilution and albumin administration.
AB  - The accuracy of the STAT-CRIT hematocrit (hct) was compared to Coulter and
      centrifuge methods in this study of the interrelationship between non-red cell
      blood constituents and accuracy of conductivity-based hct measurements. In the
      first part of the study, blood samples from 31 patients undergoing elective
      cardiac procedures were analyzed at three times: before induction of anesthesia
      (Time 1), during the rewarming period of cardiopulmonary bypass (CPB) (Time 2),
      and after transfusion of all cell-saver blood available after termination of CPB
      (Time 3). Laboratory evaluation included hct using the Stat-Crit, Coulter, and
      centrifuge methods, and sodium (Na), potassium (K), chloride (Cl), white blood
      cell count, total protein (TP), and albumin. In the second part of the study,
      patients were randomized to receive either 5% albumin (n = 14) or isotonic
      crystalloid (n = 14) after termination of CPB to determine the effect of protein
      colloid replacement on conductivity-based hct measurements. Blood samples were
      obtained before and after fluid volume replacement for multivariate analysis.
      Correlation of Coulter hct (absolute) with microhematocrit by centrifuge at all
      times (n = 93) was 0.95 (R2) with a bias and precision of -0.26 +/- 1.7%. Blood
      variables having the most significant effect on the Coulter-Stat-Crit difference
      (bias) were protein, Cl, and Na. Single regression analysis indicated that a 1
      g/dL decrease in TP resulted in an absolute decrease in the hct reading by 1 hct%
      units. A 10-mmol/L change in either Cl or Na concentration resulted in a change
      in Stat-Crit accuracy of 3.5% and 2.5%, respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466027
TI  - Bronchospirometry and separate measurement of occlusion pressure before and after
      lung resection using a double-lumen endotracheal tube.
AB  - To assess the distribution of ventilation to each lung, we measured ventilation
      and maximum negative airway pressure during occluded inspiratory effort (Pmax) of
      the individual lungs in eight male patients immediately before and after right
      upper lobectomy using a double-lumen endotracheal tube at a constant depth of
      enflurane anesthesia (end-tidal concentration 1.7%). Compared with the breathing
      pattern observed immediately before surgery, minute ventilation, Pmax, and
      respiratory frequency significantly increased immediately after the surgery,
      whereas tidal volume was unchanged. Bronchospirometry revealed that tidal volumes
      on the nonoperated side significantly increased after the operation. In contrast,
      tidal volumes on the operated side significantly decreased after the operation
      and were associated with significantly smaller Pmax obtained from unilateral
      airway than those of the nonoperated side postoperatively. These results indicate
      that there are considerable differences in ventilatory function between the lungs
      on the operated side and nonoperated side. The lung on the nonoperated side can
      partially compensate for the impaired ventilatory function on the operated side.

PMID- 8466028
TI  - Costs of anesthesia.

PMID- 8466029
TI  - Cerebral blood flow and metabolism during cardiopulmonary bypass.
AB  - Although much has been learned about cerebral physiology during CPB in the past
      decade, the role of alterations in CBF and CMRO2 during CPB and the unfortunately
      common occurrence of neuropsychologic injury still is understood incompletely. It
      is apparent that during CPB temperature, anesthetic depth, CMRO2, and PaCO2 are
      the major factors that effect CBF. The systemic pressure, pump flow, and flow
      character (pulsatile versus nonpulsatile) have little influence on CBF within the
      bounds of usual clinical practice. Although cerebral autoregulation is
      characteristically preserved during CPB, untreated hypertension, profound
      hypothermia, pH-stat blood gas management, diabetes, and certain neurologic
      disorders may impair this important link between cerebral blood flow nutrient
      supply and metabolic demand (Figure 5). During stable moderate hypothermic CPB
      with alpha-stat management of arterial blood gases, hypothermia is the most
      important factor altering cerebral metabolic parameters. Autoregulation is intact
      and CBF follows cerebral metabolism. Despite wide variations in perfusion flow
      and systemic arterial pressure, CBF is unchanged. Populations of patients have
      been identified with altered cerebral autoregulation. To what degree the
      impairment of cerebral autoregulation contributes to postoperative
      neuropsychologic dysfunction is unknown. It must be emphasized that not the
      absolute level of CBF, but the appropriateness of oxygen delivery to demand is
      paramount. However, the assumption that the control of cerebral oxygen and
      nutrient supply and demand will prevent neurologic injury during CPB is
      simplistic. A better understanding of CBF, CMRO2, autoregulation and mechanism(s)
      of cerebral injury during CPB has lead to a scientific basis for many of the
      decisions made regarding extracorporeal perfusion.

PMID- 8466030
TI  - Prolonged neuromuscular block after mivacurium in a patient with end-stage renal
      disease.

PMID- 8466031
TI  - Depression of neuromuscular function in a patient during desflurane anesthesia.

PMID- 8466032
TI  - Complete airway obstruction during arthroscopic shoulder surgery.

PMID- 8466033
TI  - Anesthetic management of the patient with a bronchogenic cyst: a review of 24
      cases.

PMID- 8466034
TI  - Anesthetic considerations in patients with mitochondrial dysfunction.

PMID- 8466035
TI  - Coronary artery bypass grafting in a patient with multiple intracranial aneurysms
      and recent subarachnoid hemorrhage.

PMID- 8466036
TI  - Profound hypothermic circulatory arrest for noncardiac surgery via the closed
      chest technique.

PMID- 8466037
TI  - Cauda equina syndrome: a consequence of lumbar disk protrusion or continuous
      subarachnoid analgesia?

PMID- 8466038
TI  - Another iatrogenic cause of profound hypotension following cardiopulmonary
      bypass.

PMID- 8466039
TI  - Decimal dermatomes?

PMID- 8466040
TI  - Superior laryngeal nerve block as a supplement to total intravenous anesthesia
      for rigid laser bronchoscopy in a patient with myasthenic syndrome: risk of
      aspiration?

PMID- 8466041
TI  - Intranasal midazolam for rapidly sedating an adult patient.

PMID- 8466042
TI  - Oral midazolam in children: the effect at time and adjunct therapy.

PMID- 8466043
TI  - Migration of an epidural catheter related to flexion and extension of the spine.

PMID- 8466044
TI  - Gastric pH and stomach contents.

PMID- 8466045
TI  - Heart block in children.

PMID- 8466046
TI  - Not all breathing circuits are "circuits".

PMID- 8466047
TI  - Transdermal nicotine patch and general anesthesia.

PMID- 8466048
TI  - Evaluation of the change in your editorial policy.

PMID- 8466049
TI  - A lethal complication of internal jugular vein catheterization.

PMID- 8466050
TI  - "Migration" of an epidural catheter?

PMID- 8466051
TI  - Calculated risk of human immunodeficiency virus infection in anesthesiologists.

PMID- 8466052
TI  - Risk of HIV infection.

PMID- 8466053
TI  - Use of transcutaneous nerve stimulation to assist interscalene block.

PMID- 8466054
TI  - Throw away the chapstick.

PMID- 8466055
TI  - Oxygen flow reduction due to dust particle blockage of the oxygen filter.

PMID- 8466056
TI  - Rate-responsive pacemakers and extracorporeal shock wave lithotripsy: a dangerous
      combination?

PMID- 8466057
TI  - Calculating local anesthetic dose for infant spinal: body weight versus spinal
      length.

PMID- 8466058
TI  - Elective use in pediatric anesthesia of intraosseous infusion: proceed only with
      extreme caution.

PMID- 8466059
TI  - Neuromuscular stimulator causes changes in electrocardiograph tracing.

PMID- 8466060
TI  - Propofol sedation for pediatric MRI.

PMID- 8466061
TI  - Fentanyl-induced rigidity and unconsciousness in human volunteers. Incidence,
      duration, and plasma concentrations.
AB  - BACKGROUND: Muscle rigidity frequently accompanies induction of anesthesia with
      opioids. The authors sought to determine whether unconsciousness and amnesia
      occur when humans develop rigidity and apnea after intravenous fentanyl (without
      other concomitant anesthetics). METHODS: The incidence and duration of rigidity
      and level of consciousness were evaluated and associated plasma concentrations of
      fentanyl were measured in 12 healthy adult male volunteers given only intravenous
      fentanyl. Fentanyl was infused at a rate of 150 micrograms/min until a total of
      15 micrograms/kg had been administered. Arterial blood samples for fentanyl assay
      were drawn and responsiveness, heart rate (HR), and systolic and diastolic
      arterial blood pressures were determined at frequent intervals during and after
      infusion. If rigidity was accompanied by an Spo2 < 90%, positive pressure
      ventilation with 100% O2 with a mask was instituted until spontaneous ventilation
      resumed. RESULTS: The incidence of muscular rigidity was 50% (6/12). All subjects
      who developed rigidity were apneic, unresponsive, and had no recall of commands
      to breathe or of positive pressure ventilation. Subjects not developing rigidity
      remained awake and responsive. No subject developing rigidity required
      neuromuscular blockade to allow positive pressure ventilation and adequate
      oxygenation (Spo2 > 90%). When rigidity occurred, it started 3 +/- 0.9 (range 1
      4) min after the peak plasma fentanyl concentration and lasted for 11.5 +/- 5.8
      (range 7-23) min. Rigidity started at a plasma fentanyl concentration of 21.5 +/-
      4.4 (range 16-28) ng/ml and ended at 6.9 +/- 1.5 (range 5.2-8.7) ng/ml. Baseline
      HR was less in the subjects who subsequently developed rigidity (56.7 +/- 7.8 vs.
      67.2 +/- 7.8 P = 0.04). No differences in fentanyl plasma concentrations or
      predicted effect site concentrations for rigidity were detected between subjects
      who developed rigidity and those who did not. CONCLUSIONS: These findings support
      the hypothesis that unconsciousness occurs in the unstimulated subject during
      fentanyl-induced apnea and rigidity.

PMID- 8466062
TI  - The effect of flumazenil on midazolam-induced depression of the ventilatory
      response to hypoxia during isohypercarbia.
AB  - BACKGROUND: While flumazenil reverses benzodiazepine-induced sedation, its
      ability to antagonize the ventilatory depressant effects of benzodiazepines has
      not been fully established. A randomized, double-blind study was conducted to
      determine whether flumazenil effectively reverses midazolam-induced depression of
      the hypoxic ventilatory response. METHODS: Twelve healthy male volunteers
      received intravenous midazolam 0.12 +/- 0.01 mg.kg-1 followed by either
      flumazenil 1.0 mg or placebo. Hypoxic ventilatory response was measured using an
      isocapnic rebreathing technique: as Spo2 decreased to 70% VE and tidal volume
      were continuously recorded. Hypoxic response determinations were performed before
      and after midazolam, as well as 3, 30, 60, 120, and 180 min after flumazenil or
      placebo. RESULTS: After midazolam, the slope of the hypoxic ventilatory response
      curve (VE vs. SpO2) decreased to 0.59 +/- 0.05 (means +/- SE) times its
      premidazolam baseline; likewise, at Spo2 = 90%, minute ventilation (VE90) and
      tidal volume (TV90) decreased to 0.70 +/- 0.04 and 0.62 +/- 0.03 times baseline,
      respectively. Three minutes after flumazenil, the slope increased to 1.10 +/-
      0.13 times baseline (P < 0.05 vs. postmidazolam), while following placebo, it was
      only 0.81 +/- 0.09 times baseline (P = NS vs. postmidazolam, P < 0.05 between
      treatments). VE90 and TV90, after flumazenil, increased to 1.45 +/- 0.15 and 1.27
      +/- 0.09 times baseline, respectively (P < 0.05 vs. postmidazolam); these
      increases were significantly greater than the corresponding changes observed
      after placebo (P < 0.05 between treatments). CONCLUSIONS: It was concluded that,
      after sedation with midazolam, flumazenil causes a greater increase in hypoxic
      ventilatory response during isohypercarbic conditions than does placebo, and may,
      therefore, be useful in the treatment of midazolam-induced ventilatory
      depression.

PMID- 8466063
TI  - Assessment of ketorolac as an adjuvant to fentanyl patient-controlled epidural
      analgesia after radical retropubic prostatectomy.
AB  - BACKGROUND: Opioids, although effective postoperative analgesics, are associated
      with undesirable side effects. In an attempt to determine whether adjuvant,
      nonopioid medication would permit a reduction of the amount of fentanyl required
      for postoperative analgesia, the efficacy of ketorolac, an injectable
      nonsteroidal antiinflammatory drug, was studied as an adjuvant to fentanyl
      patient-controlled epidural analgesia (PCEA) for postoperative pain management
      following radical retropublic prostatectomy. METHODS: Forty patients were
      randomized into two groups to receive fentanyl PCEA and either ketorolac 30 mg
      intramuscularly every 6 h after an initial dose of 60 mg (n = 20) or placebo (n =
      20) for 72 h. Visual analogue scale pain scores (0-100 mm; 0 mm = no pain; 100 mm
      = worst pain), sedation, fentanyl usage, gastrointestinal function,
      complications, blood loss, and temperature were assessed four times each day.
      RESULTS: Visual analogue scale (VAS) pain scores at rest were lower in the
      ketorolac group during the first 4 h (P < 0.01), but were similar thereafter.
      Global VAS pain scores with activity were lower in the ketorolac group on
      postoperative day 1 (23 +/- 4 vs. 39 +/- 6; P < 0.05) and postoperative day 2 (17
      +/- 3 vs. 29 +/- 4; P < 0.05). Bladder spasm pain occurred less frequently in the
      ketorolac group (1 vs. 9 patients; P < 0.05). Fentanyl usage was less in the
      ketorolac group throughout the study (33 +/- 3 vs. 50 +/- 6 micrograms/h, 0-24 h;
      20 +/- 2 vs. 36 +/- 6 micrograms/h, 24-48 h; 12 +/- 2 vs. 24 +/- 6 micrograms/h,
      48-72 h; P < 0.05). Sedation scores and side effects were similar, except on
      postoperative day 3 when nausea was less frequent in the ketorolac group (0 vs. 6
      patients; P < 0.05). Recovery of gastrointestinal function occurred sooner in the
      ketorolac group as determined by first bowel sounds (26 +/- 3 vs. 38 +/- 4 h; P <
      0.05), first clear liquids (51 +/- 2 vs. 65 +/- 3 h; P < 0.01), and first regular
      meal (95 +/- 4 vs. 110 +/- 4 h; P < 0.05). There was no significant difference in
      blood loss, transfusion requirement, hematocrit, platelet count, or temperature.
      There was high overall satisfaction in both groups, but fewer patients in the
      ketorolac group rated pain with walking as usually or always painful (1 vs. 9
      patients; P < 0.05). CONCLUSIONS: Ketorolac is a beneficial adjuvant to fentanyl
      PCEA for postoperative pain management after radical retropubic prostatectomy.

PMID- 8466064
TI  - Continuous intravenous infusion of rocuronium (ORG 9426) in patients receiving
      balanced, enflurane, or isoflurane anesthesia.
AB  - BACKGROUND: Rocuronium (ORG 9426) is a new nondepolarizing neuromuscular blocking
      agent with a rapid onset and an intermediate duration of action. This study
      obtains the infusion requirements of rocuronium in 30 patients in whom anesthesia
      was maintained with barbiturate-nitrous oxide-opioid, nitrous oxide and
      enflurane, or nitrous oxide and isoflurane. METHODS: For all 30 patients,
      anesthesia was induced with intravenous thiopental and fentanyl, followed by 0.45
      mg/kg rocuronium. Patients were randomly allocated to receive either: 1) nitrous
      oxide in 40% oxygen supplemented with fentanyl, thiopental, and droperidol
      (balanced anesthesia), 2) 1.25 MAC enflurane-nitrous oxide, or 3) 1.25 MAC
      isoflurane-nitrous oxide. Once blockade had recovered to 95% depression of twitch
      height, muscle relaxation was maintained by continuous infusion of rocuronium,
      adjusted to maintain mechanical twitch response at 95% depression. RESULTS: At 90
      and 120 min, the enflurane and isoflurane groups had lower infusion requirements
      than those receiving barbiturate-nitrous oxide-opioid anesthesia (P < 0.02), but
      these did not differ significantly between the two volatile agents. Final
      infusion requirements (mean +/- SD) were 9.8 +/- 3.7, 5.9 +/- 3.1, and 6.1 +/-
      2.7 micrograms.kg-1.min-1 for the groups receiving barbiturate-nitrous oxide
      opioid, enflurane, and isoflurane anesthesia, respectively. Spontaneous recovery
      began soon after termination of the infusion; in all patients, twitch tension
      equaled 10% of control within 5 min. CONCLUSIONS: The infusion requirements to
      maintain 95% twitch depression approximated 10 micrograms.kg-1.min-1 during
      barbiturate-nitrous oxide-opioid anesthesia. These requirements were reduced by
      40% during anesthesia involving enflurane or isoflurane.

PMID- 8466065
TI  - The effect of cricoid pressure on preventing gastric insufflation in infants and
      children.
AB  - BACKGROUND: The use of cricoid pressure for the possible prevention of
      regurgitation of gastric contents during induction of anesthesia in both adults
      and children has been recommended. However, equally important is the technique in
      possibly preventing insufflation of gas into the stomach. This study was designed
      to determine the efficacy of cricoid pressure application in preventing gastric
      gas insufflation in pediatric patients and to determine the airway pressure at
      which gas entered the stomach (pop-off point). METHODS: Fifty-nine patients, 2
      weeks to 8 yr of age, physical status 1-4, scheduled for elective surgery,
      received an inhalational induction of anesthesia with halothane, N2O, and O2. A
      single observer used a stethoscope to auscultate over the upper abdomen for any
      air entry. In study I (without paralysis), the proximal airway pressure was
      slowly increased by gradually closing the pop-off valve on the anesthesia machine
      until gas was heard entering the stomach (pop-off point) or until the peak
      inspiratory pressure (PIP) reached 40 cm H2O. Thereafter, the pressurization
      procedure was repeated three times, altering the application and removal of
      cricoid pressure. The same patients were then paralyzed (study II), and the
      stomach evacuated before commencing an identical pressurization sequence with and
      without cricoid pressure. RESULTS: Appropriately applied cricoid pressure was
      100% effective in preventing gas insufflation into the stomach of all children up
      to 40 cm H2O PIP with and without paralysis. In addition, paralysis significantly
      decreased the median pop-off point in any given patient. CONCLUSIONS: Appropriate
      application of cricoid pressure prevents gastric gas insufflation during airway
      management via mask up to 40 cm H2O PIP in infants and children. An additional
      benefit of cricoid pressure occurs in paralyzed patients in whom gastric
      insufflation occurs at lower inflation pressures.

PMID- 8466066
TI  - Propofol infusion for maintenance of anesthesia in morbidly obese patients
      receiving nitrous oxide. A clinical and pharmacokinetic study.
AB  - BACKGROUND: The pharmacokinetic and pharmacodynamic properties of propofol
      indicate that this may be an appropriate agent for induction and maintenance of
      anesthesia in obese patients. This study was designed to assess the rates of
      recovery and the pharmacokinetics of propofol infusions in morbidly obese
      patients. METHODS: Anesthesia was induced and maintained using a stepwise
      infusion regimen of propofol in eight morbidly obese patients. The patients'
      lungs were ventilated with nitrous oxide:oxygen (66:34%). Pharmacokinetic
      parameters were calculated from iterative blood sampling during the propofol
      infusion and during 8 h after its completion. RESULTS: Results were compared with
      those from a concurrent study of propofol pharmacokinetics in nonobese adults.
      The initial volume of distribution of propofol was not modified in obese
      patients. Total body clearance increase was correlated to body weight (R = 0.76,
      25.4 +/- 6.5 ml.kg-1.min-1, mean +/- SD). Volume of distribution at steady state
      was also correlated to body weight (R = 0.61, 1.63 +/- 0.54 l.kg-1, mean +/- SD).
      Propofol concentration at the time of eye opening in response to verbal command
      was 0.94 +/- 0.26 mg.l-1. CONCLUSIONS: Results from this study confirm the
      absence of propofol accumulation in morbidly obese patients when the current
      dosing scheme is used. Dosing schemes expressed in mg.kg-1 are the same as those
      in normal patients.

PMID- 8466067
TI  - Postoperative pulmonary complications. Epidural analgesia using bupivacaine and
      opioids versus parenteral opioids.
AB  - BACKGROUND: Different types of analgesia have been proposed for the prevention of
      postoperative respiratory complications. The aim of this prospective, double
      blind randomized study was to compare the impact of epidural bupivacaine and
      opioids versus parenteral opioids on respiratory complications in patients who
      had undergone major abdominal surgery. METHODS: One hundred fifty-three patients
      undergoing abdominal surgery for cancer were randomly allocated to receive either
      general anesthesia with intravenous fentanyl and postoperative analgesia with
      subcutaneous morphine (SC group) or general anesthesia combined with epidural
      bupivacaine and epidural bupivacaine plus morphine for postoperative pain relief
      (EP group). Analgesia was tested on a visual analog pain scale. Pulmonary
      complications were evaluated according to clinical complications, chest
      radiographs, arterial blood gas analysis, and pulmonary function tests. The
      evaluation was carried out on the day before the operation and on the first 5
      postoperative days. Particular attention also was paid to the episodes of
      arterial hypotension and hemoglobin oxygen desaturation during the 1st
      postoperative night. RESULTS: Pain relief was significantly better in the EP
      group than in the SC group (P < 0.05) especially during recovery and on the 1st
      and 2nd postoperative days. In the EP group, vital capacity decreased less on the
      1st postoperative day (P < 0.05) and arterial oxygen tension was greater in the
      recovery room (P < 0.05). However, no statistically significant difference was
      observed between the SC and EP groups in the incidence of clinical pulmonary
      complications (31% and 27%, respectively) and radiographic chest abnormalities
      (52% and 46%, respectively). The EP group recovered intestinal function earlier
      (P < 0.05), but significantly more patients in this group had episodes of
      systolic hypotension (21% vs. 8%; P < 0.05) during the 1st postoperative night.
      The length of the hospital stay was similar in both groups of treatment.
      CONCLUSIONS: Epidural analgesia with a combination of local anesthetic and opioid
      improves patient comfort. However, this type of analgesia does not decrease the
      incidence of postoperative pulmonary complications, does not reduce the length of
      the hospital stay, and carries the risk of complications from episodic systemic
      hypotension.

PMID- 8466068
TI  - Insulin decreases the serum potassium concentration during the anhepatic stage of
      liver transplantation.
AB  - BACKGROUND: Severe hyperkalemia is a serious problem during orthotopic liver
      transplantation. The effectiveness of insulin in decreasing serum potassium
      concentration during the anhepatic stage of orthotopic liver transplantation was
      investigated. METHODS: Forty patients with serum potassium concentrations greater
      than 4.0 mM/L at the onset of the anhepatic stage were randomized into two
      groups. Control group patients (n = 20) received no treatment, and treatment
      group patients (n = 20) received an intravenous bolus of regular insulin (20 u)
      10 min into the anhepatic stage, followed by a glucose infusion (500 ml 5%
      dextrose in water) over 15 min. RESULTS: In the control group, the potassium
      concentration did not change, whereas in the treatment group, it decreased from
      4.70 +/- 0.54 to 4.18 +/- 0.63 mM/L (mean +/- SD) within 15 min and to 3.57 +/-
      0.55 mM/L 60 min after therapy. The potassium concentration was less in the
      treatment group than in the control group within 30 min of treatment (3.97 +/-
      0.52 vs. 4.49 +/- 0.43 mM/L, respectively; P < 0.05). The potassium concentration
      increased similarly 30 s after graft reperfusion in both groups of patients, but
      was less in the treatment group (5.91 +/- 1.63 vs. 7.37 +/- 1.67 mM/L,
      respectively; P < 0.05). The potassium concentration returned to prereperfusion
      levels within 5 min after graft reperfusion. CONCLUSIONS: In patients undergoing
      orthotopic liver transplantation, the administration of insulin rapidly decreases
      serum potassium concentration, even in the absence of the liver, suggesting an
      important contribution by extrahepatic tissues in the insulin-stimulated uptake
      of potassium.

PMID- 8466069
TI  - Approximate entropy of heart rate as a correlate of postoperative ventricular
      dysfunction.
AB  - BACKGROUND: Instantaneous changes in the heart rate, i.e., heart rate variation,
      traditionally have been quantified by the standard deviation of a series of
      intervals between successive heart beats. Approximate entropy provides another
      measure of variability by calculating the logarithmic likelihood that patterns
      that are similar remain similar on the next incremental comparisons. Approximate
      entropy is a nonnegative number that will distinguish data sets by their amount
      of regularity, with larger numbers indicating more randomness. We hypothesized
      that a decrease in the approximate entropy of heart rate would be associated with
      postoperative ventricular dysfunction (e.g., myocardial infarction, unstable
      angina, congestive heart failure, prolonged inotropic support). METHODS: Twenty
      three high-risk noncardiac patients were continuously monitored by ambulatory
      electrocardiographic recorders from the evening before surgery up to 80 h during
      the postoperative period: 9 demonstrated postoperative ventricular dysfunction,
      and 14 had an uncomplicated postoperative course. Hourly approximate entropy
      average values were calculated. RESULTS: Approximate entropy was high (> 0.7) in
      all but two patients preoperatively. Postoperative approximate entropy <0.55 had
      a sensitivity of 88% and a specificity of 71% for being associated with
      postoperative ventricular dysfunction; preoperative approximate entropy values
      were not significantly different between the two groups. CONCLUSIONS: These
      results suggest that changes in approximate entropy can distinguish between
      patients who sustained poor outcome and those who had an uncomplicated course.

PMID- 8466070
TI  - Inhibition of interferon stimulation of natural killer cell activity in mice
      anesthetized with halothane or isoflurane.
AB  - BACKGROUND: Basal cytotoxic activity of NK cells, a subtype of lymphocytes
      involved in the nonspecific immune response to viruses, tumors, and some
      bacteria, is altered in the postoperative period. The current study examines the
      effects of halothane and isoflurane on interferon-induced stimulation of NK cell
      cytotoxicity in vivo and in vitro. METHODS: Mice were exposed to either
      anesthetic on days 10, 5, 1, or -1 relative to interferon treatment on day 0. NK
      cytotoxicity was assessed 24 h later. Similarly, splenic mononuclear cells
      containing NK cells were treated with interferon, before or after in vitro
      exposure with either halothane or isoflurane, and cytotoxicity was determined.
      RESULTS: In vivo, isoflurane or halothane inhibited subsequent interferon-induced
      NK cell stimulation (> 90% and 67%, respectively). No inhibition occurred if
      interferon was given before anesthetic exposure. Significant inhibition of
      interferon-induced NK cell stimulation could be observed 11 days after
      anesthesia. In vitro, both anesthetics inhibited the subsequent stimulation of NK
      cytotoxicity by interferon, however, cytotoxicity of NK cells treated with
      interferon before anesthetic exposure was comparable to untreated interferon
      stimulated NK cells. CONCLUSIONS: Halothane and isoflurane inhibit interferon
      stimulation of NK cytotoxicity in naive (unstimulated) NK cells of the splenic
      mononuclear cell pool without affecting the cytotoxicity of previously stimulated
      (interferon) NK cells. This could occur directly by preventing the NK cell from
      responding or indirectly by altering other cells in the splenic mononuclear cell
      pool (T cells, macrophages), which then inhibit NK cell induction.

PMID- 8466071
TI  - Anesthetic potency (MAC) is independent of forebrain structures in the rat.
AB  - BACKGROUND: The ability of general anesthetics to suppress somatomotor responses
      to surgical incision and other noxious stimuli is of particular clinical
      relevance. When the blockade is due to inhaled agents, this effect can be
      quantified as the minimum alveolar concentration (MAC), i.e., that concentration
      that blocks movement evoked by a noxious stimulus (ED50). METHODS: To identify
      the neural structures that subtend this somatomotor response, we anesthetized 14
      rats with isoflurane in oxygen and performed bilateral parietal-temporal
      craniotomies. In each rat, MAC was repeatedly tested using tail-clamping and
      Dixon's up-down concentration technique. After determination of baseline MAC,
      seven rats underwent aspiration decerebration, after which MAC was repeatedly
      measured. RESULTS: In the control group (N = 7), MAC (mean +/- SD) remained
      constant at 1.30 +/- 0.25% for more than 6 h. In the seven rats that underwent
      aspiration decerebration, baseline MAC was 1.26 +/- 0.14%. These seven rats with
      histologically validated precollicular decerebration demonstrated no change in
      MAC relative to control rats, as much as 11 h after decerebration (P = 0.14).
      CONCLUSIONS: These findings suggest that the anesthetic-induced unresponsiveness
      to noxious stimuli measured by MAC testing does not depend on cortical or
      forebrain structures in the rat.

PMID- 8466072
TI  - The effects of ketamine on the excitation and inhibition of dorsal horn WDR
      neuronal activity induced by bradykinin injection into the femoral artery in cats
      after spinal cord transection.
AB  - BACKGROUND: It is now well established that wide dynamic range neurons (WDR) can
      possess widespread cutaneous inhibitory receptive fields, as well as excitatory
      receptive fields, in specific regions of the body. The ability of ketamine to
      depress the excitatory responses of spinal WDR neurons indicates that the
      analgesia produced by this agent may be a result, in part, of this spinal action.
      The primary purpose of this study was to investigate the effects of ketamine on
      the WDR propriospinal inhibitory mechanism that is induced by a bradykinin (BK)
      injection as a noxious test stimuli. METHODS: In decerebrate, spinal cord
      transected cats (L1-L2), the effects of a low (0.5 mg.kg-1, intravenous) and a
      high (10 mg.kg-1, intravenous) dose of ketamine on the neuronal activity of
      spinal dorsal horn WDR neurons evoked by femoral artery injection of BK (10
      micrograms) was examined. Extracellular activity was recorded from single WDR
      neurons that responded to noxious and innocuous stimuli applied to the cutaneous
      receptive fields on the foot pads of the left hind paw. RESULTS: After
      ipsilateral BK administration, the activity of the WDR neurons was found to be
      increased (excited) in all ten neurons that were examined. In contrast, the
      activity of these neurons was found to be decreased (inhibited) in five of these
      ten neurons after BK administration into the contralateral femoral artery. The 10
      mg.kg-1 dose of ketamine significantly suppressed the excitatory activity
      observed in all 15 of the WDR neurons examined. A comparison of the effects
      produced by the 0.5-mg.kg-1 and the 10-mg.kg-1 intravenous doses reveals that the
      amount of suppression was dose-related. In addition, the inhibitory WDR neuronal
      activity induced by contralateral BK injection was also significantly reduced by
      both the 0.5- and the 10-mg.kg-1 doses of ketamine. CONCLUSIONS: These results
      indicate that this reduction of excitatory and inhibitory responses of WDR
      neurons after noxious stimulation is likely to be the fundamental basis for the
      spinal cord component of ketamine-induced analgesia.

PMID- 8466073
TI  - High-dose droperidol protects against experimental coronary thrombosis in dogs
      and pigs and attenuates aggregation of porcine platelets and Ca2+ mobilization in
      human platelets.
AB  - BACKGROUND: Activation of platelets after contact with thrombogenic substrates
      may be an early factor leading to coronary artery thrombosis and myocardial
      infarction. Haloperidol, a butyrophenone, possesses weak in vitro platelet
      inhibitory activity. Experiments were designed to determine whether droperidol, a
      butyrophenone adjunct to anesthesia, protected against experimental coronary
      thrombosis in intravenously anesthetized open-chest dogs and pigs, attenuated ex
      vivo porcine platelet aggregation, and inhibited agonist-induced increases in
      [Ca2+]i in human platelets. METHODS: In dogs and pigs, a lesion consisting of
      deendothelialization, deep vessel wall injury, and critical stenosis was created
      in the proximal circumflex arteries, resulting in coronary thrombus formation
      accompanied by decreased circumflex artery blood flow. Embolization of the
      thrombus restored flow, but the cycle then repeated, resulting in repetitive
      cyclical flow reductions (CFRs). These were measured using an electromagnetic
      flow probe. RESULTS: In dogs, droperidol 0.2 mg/kg intravenous rapidly abolished
      CFRs in all ten animals, with frequency decreasing from 0.22 +/- 0.01 cycles/min
      to 0. Droperidol 0.8 mg/kg intravenous rapidly abolished CFRs in seven of eight
      pigs, with frequency decreasing from 0.15 +/- 0.01 to 0.02 cycles/min (P <
      0.005). In both species, additional doses of droperidol were effective against
      CFRs augmented with intravenous epinephrine, a catecholamine that stimulates
      thrombosis. Ex vivo platelet aggregation studies were performed in platelet-rich
      plasma obtained from pigs before and after droperidol 0.8 mg/kg intravenous.
      Pretreatment with the drug resulted in marked inhibition of aggregation evoked by
      collagen, modest attenuation of that elicited by adenosine diphosphate (ADP), but
      no effect on that evoked by arachidonic acid. In human platelets, apparent
      [Ca2+]i was estimated using the fluorescent indicator indo-1 and flow cytometry.
      Droperidol 10(-7), 10(-6), and 10(-5)M had a dose-dependent inhibitory effect on
      the amplitude of increases in [Ca2+]i evoked by 10(-5)M serotonin (plus 10(-7)M
      epinephrine). The higher droperidol concentration decreased the response to as
      much as 30% of control (P < 0.001). Droperidol lacked effect on Ca2+ mobilization
      elicited with 10(-6)M ADP. CONCLUSIONS: The results from three experimental
      models indicate that droperidol attenuates experimental coronary thrombosis in
      animals and suggest that this inhibition may result, in part, from a direct
      droperidol depressant effect on platelet activation and aggregation.

PMID- 8466074
TI  - Pentobarbital-morphine anesthetic interactions in terms of intensity of noxious
      stimulation required for arousal.
AB  - BACKGROUND: Previous reports suggest that the outcome (synergism, antagonism,
      summation) of opioid-barbiturate interactions may depend on the depth of
      anesthesia. One aim of the present study was to determine whether pentobarbital,
      alone and in combination with morphine, blocks awakening caused by noxious
      stimulation in a dose-related manner: the more intense the noxious stimulation,
      the more pentobarbital is required to suppress the response. A second aim of the
      study was to determine whether the pentobarbital-morphine anesthetic interaction
      depends on the depth of anesthesia measured in terms of intensity of noxious
      stimulation required for behavioral arousal (recovery of the righting reflex).
      METHODS: Experiments were performed on rats, with the measure of anesthetic
      effect being suppression of the righting reflex. The noxious stimulus was
      pressure on the tail at four levels of intensity: 0.0, 0.25, 2.5, and 3.3 kg,
      generated with an Analgesy-Meter. Pentobarbital and morphine were injected
      intravenously via chronically implanted catheters. Dose-response curves for
      pentobarbital given alone and in combination with morphine were determined (by
      probit analysis) separately for each of the pressure levels. RESULTS:
      Pentobarbital, alone and in combination with morphine, blocked awakening caused
      by noxious stimulation of different intensities in a dose-related fashion so that
      more anesthetic was required to block awakening with more intense stimulation.
      The pentobarbital ED50 values were: 12.0, 19.5, 22.7, and 24.3 mg/kg for 0.0,
      0.25, 2.5, and 3.3 kg pressure, respectively. The addition of morphine (1 mg/kg)
      reduced the pentobarbital ED50 values for 0.0, 0.25, and 2.5 kg pressure by 34%
      (P < 0.0001), 39% (P < 0.0001), and 21% (P < 0.005), respectively. No change was
      seen in the pentobarbital ED50 value at the maximal (3.3 kg) pressure level.
      CONCLUSIONS: The results suggest that the depth of anesthesia can be measured in
      terms of intensity of noxious stimulation required for arousal and that the
      outcome of barbiturate-opioid anesthetic interaction depends on the depth of
      anesthesia.

PMID- 8466075
TI  - Inhibition of dopamine transport in rat brain synaptosomes by volatile
      anesthetics.
AB  - BACKGROUND: Volatile anesthetics may depress transmission by altering synaptic
      concentrations of neurotransmitter. Microdialysis studies have found an increase
      in brain extracellular dopamine concentration on exposure to volatile
      anesthetics. We investigated the possibility that synaptosomal dopamine transport
      is reversibly inhibited by the halothane and isoflurane. METHODS: Rat brain
      synaptosomes were incubated with 5 nM 3H-DA and increasing concentrations of
      anesthetic in Teflon-sealed microvials. Cocaine (100 microM) was used to quantify
      non-specific binding/uptake. Uptake was stopped by vacuum filtration and washing;
      label incorporation into synaptosomes was determined by liquid scintillation
      counting. 3H-DA release from preloaded synaptosomes also was studied in the
      presence of the anesthetic to allow distinction between uptake inhibition and
      release stimulation in the synaptosomes. RESULTS: Both halothane and isoflurane
      inhibited the specific 3H-DA uptake in a concentration-dependent fashion with an
      IC50 of 0.72 +/- 0.14 mM for halothane and 2.24 +/- 0.85 mM for isoflurane. No
      stereoselectivity of isoflurane's action on Dopamine (DA) uptake was observed.
      The inhibition produced by halothane and isoflurane was kinetically characterized
      as noncompetitive, but full reversal was demonstrated after removal of the
      anesthetic from the incubation mixture. The anesthetics did not stimulate 3H-DA
      release from preloaded synaptosomes. CONCLUSIONS: These results demonstrate
      volatile anesthetic-induced inhibition of the dopamine transporter in this
      preparation of synaptosomes. The calculated IC50S suggest this inhibition occurs
      with clinically relevant concentrations of halothane but not with isoflurane. The
      results are consistent with and may explain the increase in extracellular
      dopamine concentrations demonstrated by microdialysis.

PMID- 8466076
TI  - Neostigmine produces bradycardia in a heart transplant patient.

PMID- 8466077
TI  - The failure of capnography to properly assess endotracheal tube location.

PMID- 8466078
TI  - Gadolinium-enhanced magnetic resonance imaging and autopsy findings in a patient
      with cauda equina syndrome.

PMID- 8466079
TI  - Lidocaine toxicity treated with low-dose propofol.

PMID- 8466080
TI  - Response to surgical stress following thoracic epidural anesthesia.

PMID- 8466081
TI  - Response to surgical stress following thoracic epidural anesthesia.

PMID- 8466082
TI  - A newly designed curved needle for percutaneous cannulation of the internal
      jugular vein.

PMID- 8466083
TI  - Potency versus onset of neuromuscular blocking agents.

PMID- 8466084
TI  - Use of neuromuscular relaxants in a child with an abnormal anatomy.

PMID- 8466085
TI  - Is it really free?

PMID- 8466087
TI  - Pharmacology of clonidine.

PMID- 8466086
TI  - Does diabetes reduce local anesthetic requirement?

PMID- 8466088
TI  - Preoperative epidural fentanyl, neuroplasticity, and postoperative pain.

PMID- 8466089
TI  - Evaluation of responses to pneumococcal vaccine.

PMID- 8466090
TI  - Immunosuppressive therapy for autoimmune diseases.

PMID- 8466091
TI  - Refractory wheezing and shortness of breath in a 34-year-old woman.

PMID- 8466092
TI  - Evaluation of postimmunization pneumococcal titers in children with recurrent
      infections and normal levels of immunoglobulin.
AB  - Seven children were evaluated who had recurrent sinusitis, acute otitis media,
      pneumonia, and mastoiditis. All children had normal or near normal levels of IgG,
      IgA, and IgM. One child displayed a poor antibody response following tetanus and
      diphtheria immunization. Another child was noted to be atopic as determined by
      allergy skin tests. A polyvalent pneumococcal vaccine was administered to all
      children after 24 months of age, with the average age of administration being 33
      months. Titers were obtained 3 to 6 weeks following immunization and were
      evaluated to 12 serotypes using radioimmunoassay. All seven patients failed to
      mount an adequate response to immunization and were treated with a course of
      intravenous gammaglobulin. Five of seven children showed a distinct improvement
      in clinical course. Children with recurrent infections and normal levels of IgG
      may have a depressed ability to respond to pneumococcal antigen. Evaluation of
      their response to pneumococcal vaccine can be used as a marker to determine their
      ability to make antibody specific responses to multiple infectious agents. The
      failure to make a specific antibody response may be one factor in the
      susceptibility of these patients to recurrent infections.

PMID- 8466093
TI  - Antibody levels and response to pneumococcal vaccine in steroid-dependent asthma.
AB  - Immunization with pneumococcal vaccine is recommended for patients with chronic
      respiratory diseases, and is also used to evaluate antibody responses to
      polysaccharide antigens. We determined the effect of chronic prednisone treatment
      on immunoglobulin levels, pneumococcal antibody levels, and on the serologic
      response to pneumococcal vaccination. We studied 14 adult steroid-dependent
      asthmatics receiving daily or alternate day prednisone, 10 to 35 mg, and 14 age
      matched, nonsteroid dependent asthmatic patients. Immunoglobulin levels were
      within the normal range in all patients. There was no difference in the pre
      immunization antipneumococcal polysaccharide antibody levels against serotypes 3,
      7F, 9N, and 14 between steroid-dependent and nonsteroid-dependent asthmatic
      patients. All patients had increases in antipneumococcal antibody levels 4 weeks
      after pneumococcal immunization. Mean post-immunization pneumococcal antibody
      titers were similar in steroid-dependent and nonsteroid-dependent asthmatic
      patients. All patients either had or developed levels > or = 300 ng Ab N/mL
      against one or more pneumococcal serotypes. We conclude that chronic prednisone
      treatment in steroid-dependent asthmatic adults does not significantly affect
      immunoglobulin levels, pneumococcal antibody levels, or specific antibody
      responses to pneumococcal immunization.

PMID- 8466094
TI  - Efficacy of laser-acupuncture in the prevention of exercise-induced asthma.
AB  - Many asthmatic patients are reluctant to follow the medication schedule
      prescribed for them and turn to alternative treatment methods. The results of
      this study indicate that one such method, laser acupuncture, does not prevent
      exercise-induced asthma.

PMID- 8466095
TI  - Comparison of the acceptability of the Ventolin metered-dose inhaler and the
      Bricanyl Turbuhaler.
AB  - One hundred fifty-nine asthmatic patients aged 19 to 76 years completed an open
      crossover-designed study comparing the acceptability of the Bricanyl Turbuhaler
      (BTH) and the Ventolin metered-dose inhaler (VMDI). The doses given were presumed
      to be equiactive. Each treatment period lasted for 14 days. Patients registered
      morning and evening peak expiratory flow rate (PEFR) before and five minutes
      after medication. Asthma symptoms as well as adverse events were registered on
      diary cards. After each study period a questionnaire containing acceptability
      questions was completed. At the end of the study the patients indicated their
      preference for one of the two treatments. The two treatments were equal
      concerning bronchodilation and asthma symptoms. There was an overall preference
      for the Bricanyl Turbuhaler.

PMID- 8466096
TI  - Effects of cetirizine versus terfenadine in seasonal allergic rhinitis.
AB  - The purpose of this study was to compare the efficacy and safety of cetirizine,
      10 mg, once daily in the morning to terfenadine, 60 mg, BID in the treatment of
      seasonal allergic rhinitis. The multicenter, single-blind, parallel study
      involved 160 patients, who were all included in the safety and efficacy analysis.
      The results of the study showed that both cetirizine, 10 mg, QD and terfenadine,
      60 mg, BID used for 1 week are safe and effective in the management of allergic
      rhinitis. By repeated measures analysis, cetirizine improved symptoms more than
      terfenadine for the treatment period of days four to seven. Standard Cochran
      Mantel-Haenszel statistics test showed the relative degree of patient
      satisfaction to be higher in the cetirizine group.

PMID- 8466097
TI  - Dose-response study of inhaled salmeterol in asthmatic patients with 24-hour
      spirometry and Holter monitoring.
AB  - Salmeterol is a new long-acting beta 2-selective adrenoceptor agonist. In this
      double-blind, 6-way crossover study, four single doses of salmeterol by metered
      dose inhaler (12.5, 25, 50, 100 micrograms) were compared with albuterol aerosol
      200 micrograms and placebo in 24 patients with moderate asthma with 24-hour
      pulmonary function testing and Holter monitoring. Salmeterol was an effective
      bronchodilator at each dose evaluated and demonstrated a greater increase in FEV1
      above baseline, a slightly slower onset and a longer duration of bronchodilation
      than albuterol. Median durations of bronchodilation were 9.0, 15.6, 13.4, and
      18.4 hours with increasing doses of salmeterol in comparison to 4.2 hours for
      albuterol. Holter monitoring showed (1) a mean maximum heart rate 2 to 5 bpm
      higher after salmeterol 50 and 100 micrograms compared with placebo and (2)
      supraventricular premature beats (> 30 per hour or > 100 per 24 hours) more often
      in the salmeterol 100-micrograms group (13% to 17% of patients) than in the
      placebo (4%), albuterol (4% to 8%), or other salmeterol groups (4% to 9%). These
      differences were not statistically significant. Tremor and palpitations were the
      most frequently reported drug-related adverse events and their frequencies
      increased with increasing doses of salmeterol. This study demonstrated that
      single doses of salmeterol given by metered dose inhaler over an 8-fold range
      possess substantial, long-lasting bronchodilator activity.

PMID- 8466098
TI  - Cerebral lateralization and histamine skin test asymmetries in humans.
AB  - Although asymmetries exist in both cerebral and somatic systems, their
      relationship is not well understood. One hypothesis suggests that some processes
      determining cerebral hemispheric dominance also affect immune systems. We
      employed histamine, a final common mediator for the immediate hypersensitivity
      immune response, to examine the relationship of skin response to cerebral
      lateralization (ie, left versus right brain dominance). Histamine skin wheal
      responses on the left and right forearms were measured using computerized
      planimetry in 176 consecutive patients undergoing allergy skin testing. Cerebral
      lateralization was determined by personal and family handedness via
      questionnaires. Subjects were classified as right handed (RH) with only RH
      relatives, RH with non-RH relatives, or non-RH (ie, left-handed or ambidextrous).
      Left/right arm asymmetries in wheal area were demonstrated and were related to
      cerebral dominance, but could not be explained by simple arm use. Right-handed
      subjects with only RH relatives had greater wheal size on the right arm, RH
      subjects with non-RH relatives had no significant left/right difference in wheal
      size, and non-RH subjects had greater wheal size on the left arm. Further, gender
      differences in these asymmetries appeared to be present for subjects with mixed
      cerebral dominance. The results suggest an association between process affecting
      cerebral and somatic asymmetries, and offer new insight into brain/body
      interactions.

PMID- 8466099
TI  - Allergic bronchopulmonary aspergillosis in patients with and without evidence of
      bronchiectasis.
AB  - Allergic bronchopulmonary aspergillosis (ABPA) may complicate 1% to 2% of all
      cases of chronic asthma. Twenty-eight patients fulfilling the diagnostic criteria
      for ABPA but without evidence of proximal bronchiectasis [ABPA-S (seropositive)]
      were identified over a 12-year period and classified by stage. The majority of
      patients were in remission but all had chronic asthma. Serum anti-Aspergillus
      fumigatus (Af) IgG was lower in ABPA-S (n = 28) versus ABPA-CB (central
      bronchiectasis) (n = 58) at the time of initial presentation (IgG-Af index 3.62
      versus 7.80, t = 3.46, P < or = .001). Serum IgG1-Af was significantly lower in
      ABPA-S as compared with ABPA-CB (t = 2.37, P = .011), as was serum IgG2-Af (t =
      1.91, P = .031) and serum IgG4-Af (t = 1.78, P = .041). There were trends toward
      lower concentrations of total serum IgE, serum anti-Af-IgE, and anti-Af-IgA in
      ABPA-S. Eleven patients with ABPA-S were evaluated closely for a total of 63
      patient-years and only four exacerbations with pulmonary infiltrates were
      identified. No patient in either group was observed to progress to end-stage or
      irreversible lung disease when early recognition and treatment were instituted.
      We conclude that ABPA-S represents the earliest stage or apparently a less
      aggressive form of ABPA.

PMID- 8466100
TI  - The value of screening for risk of exercise-induced asthma in high school
      athletes.
AB  - Exercise challenges were performed on 166 middle and high school student athletes
      (aged 12 to 18 years) to evaluate undiagnosed exercise-induced asthma (EIA).
      Seventy-three percent were male, 70% were white, and 30% were black. All students
      completed a questionnaire and were briefly interviewed to elicit risk factors for
      EIA. Resting spirometry, exercise treadmill provocation, and postexercise
      spirometry at 1, 10, 20, and 30 minutes were performed. Twenty-two students had
      reductions in FEV1 > or = 15% from baseline; 15 of these had FEV1 reductions > or
      = 20%. Of students considered at risk for EIA by history or baseline spirometry
      (N = 48, 29%) eight (17%) demonstrated EIA after exercise. Of students with no
      risk factors (N = 118, 71%), 14 (12%) demonstrated EIA after exercise, but would
      not have been identified without exercise challenge. The overall incidence of EIA
      was 12%, a rate that is consistent with previous studies of college and Olympic
      athletes. Sixty-four percent of students identified with EIA were not considered
      at risk by routine screening methods. History and spirometry alone may not be
      adequate as screening tools for EIA in adolescents.

PMID- 8466101
TI  - Expression of interleukin-6 in association with rat lung reimplantation and
      allograft rejection.
AB  - Organ transplantation has become a therapeutic option for the replacement of
      malfunctioning tissues and organs. Since the advent of the first combined heart
      lung transplant in 1981, there has been a rapid growth in the popularity of lung
      transplantation for a number of end-stage pulmonary disorders. Interestingly,
      these lung transplant patients experience more complications of acute and chronic
      allograft rejection compared with recipients of other solid organs. These
      episodes of rejection are related to a complex series of events that depend on
      the interaction of many cells and soluble mediators leading to cellular and
      tissue injury. The histopathology of lung allograft rejection has been actively
      studied and is associated with the sequestration of activated mononuclear
      phagocytes, T and B lymphocytes. These cells secrete a number of soluble
      mediators, that is, cytokines, that participate in the evolution of the immune
      response via autocrine, paracrine, or endocrine mechanisms. The interaction of
      cytokines with their targets leads to cellular activation, proliferation, and
      differentiation. In this study, we postulated that interleukin-6 (IL-6) may have
      a central role in the pathogenesis of acute lung allograft rejection. To test
      this hypothesis, we employed an unmodified RT1-incompatible rat lung allograft
      model and assessed the time course and major tissue compartment(s) of IL-6
      production during the evolution of lung allograft rejection. The expression and
      production of IL-6 during the pathogenesis of lung allograft rejection was
      measured at the whole-animal, organ, cellular, and molecular levels. The
      expression of IL-6 was found to be bimodal in character, initially related to the
      reimplantation response and finally to the maximal allograft rejection.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466102
TI  - Histochemical evidence for induction of arachidonate 15-lipoxygenase in airway
      disease.
AB  - We have previously described the distribution of the arachidonate 15-lipoxygenase
      in lung tissue obtained from healthy human subjects. In the present study, we
      have utilized the same immunohistochemical methodology to examine the expression
      of 15-lipoxygenase in bronchial biopsy tissue from subjects with airway disease.
      Immunohistochemistry of bronchial tissue using two antibodies against distinct
      epitopes of the 15-lipoxygenase and indirect biotin-avidin-peroxidase detection
      demonstrated that, in contrast to airway tissue from normal subjects (n = 10) in
      which 15-lipoxygenase antigen was confined to the uppermost airways (nose and
      trachea) and was almost undetectable in bronchi, the bronchial tissue obtained
      from subjects with asthma (n = 7) or chronic bronchitis (n = 7) exhibited
      markedly positive immunostaining of mucosal epithelial cells with both anti-15
      lipoxygenase antibodies. Specificity of 15-lipoxygenase immunostaining was
      verified by antigen competition experiments and by the lack of immunostaining
      with preimmune serum or control anti-5-lipoxygenase antibodies. The increased
      levels of 15-lipoxygenase antigen in the bronchial epithelial cells of asthmatic
      and bronchitic subjects compared with the same cell population in normal subjects
      coupled with the previous findings of increased 15-lipoxygenase activity in
      asthmatic airways suggest that epithelial 15-lipoxygenase is induced by airway
      inflammatory disease.

PMID- 8466103
TI  - Continuous venous air embolism in patients receiving positive end-expiratory
      pressure.
AB  - The occurrence of venous air embolism in critically ill patients can cause
      profound cardiopulmonary compromise. Recognized causes include aspiration through
      an indwelling catheter and pneumothorax. We report three patients in whom we
      found continuous air embolism in the inferior vena cava that persisted for days.
      The bubbles appeared to arise from splanchnic veins, and they were associated
      with barotrauma and positive airway pressure. In the two survivors, the bubbling
      ceased when the ARDS resolved and airway pressures were decreased. We suspect
      that venous air embolism is not an uncommon occurrence in critically ill patients
      receiving high positive airway pressure.

PMID- 8466104
TI  - HIV-1 and the lung. Infectivity, pathogenic mechanisms, and cellular immune
      responses taking place in the lower respiratory tract.

PMID- 8466105
TI  - Noninvasive ventilation. Does it work, for whom, and how?

PMID- 8466106
TI  - Guidelines for the evaluation of impairment/disability in patients with asthma.
      American Thoracic Society. Medical Section of the American Lung Association.

PMID- 8466107
TI  - Assessment of new sterilizing drugs for treating pulmonary tuberculosis by
      culture at 2 months.

PMID- 8466108
TI  - Plasma elastin peptide level, a diagnostic test for chronic obstructive lung
      disease?

PMID- 8466109
TI  - Erythromycin reduces neutrophils and neutrophil-derived elastolytic-like activity
      in the lower respiratory tract of bronchiolitis patients.

PMID- 8466110
TI  - New concepts in the formation of pulmonary edema.

PMID- 8466111
TI  - Recovery of pulmonary function in farmer's lung. A five-year follow-up study.
AB  - The recovery of pulmonary function in farmer's lung (FL) was studied during a 5
      yr follow-up in 101 patients (20 men and 81 women, mean age 47 yr). At the
      initial evaluation all patients had the first diagnosed attack of FL. Spirometry,
      measurement of pulmonary diffusing capacity, and arterial blood gas analysis were
      done at the time of the diagnosis and 1, 3, 6, 12, and 24 months thereafter. The
      last follow-up measurements were made 4 to 6 yr after the initial evaluation.
      Mean FVC improved significantly for up to 1 yr. In mean DLCO there was
      improvement for up to 2 yr. Mean PaO2 rose to its maximum within 1 month of the
      initial examination and did not change significantly thereafter. No patient had
      diagnosed asthma at the time of the diagnosis of FL, but asthma was later
      diagnosed in 7 patients during the follow-up. In conclusion, the pulmonary
      function of FL patients improved for up to 2 yr after the initial acute episode.
      In general, PaO2 improved most rapidly; the improvement in FVC was slower, and
      the recovery of DLCO took the longest time.

PMID- 8466112
TI  - Important deficits of lung function in three modern colliery populations.
      Relations with dust exposure.
AB  - To determine whether dust-related "clinically important" deficits of lung
      function still occur in British coal miners we have analyzed the relationship
      between lifetime cumulative exposure to respirable dust and risk of defined
      functional deficits in a population of miners who were examined between 1981 and
      1986. The study group consisted of a sample of men who had worked at any one of
      three collieries (South Wales, Yorkshire, and North East England) between 1970,
      when new dust standards were introduced, and date of medical survey. There were
      1,671 men studied, including men who had left the collieries. "Clinically
      important" deficits of FEV1 from predicted values derived in this population were
      defined by comparisons with questionnaire data on exercise tolerance limited by
      breathlessness. The mean FEV1 of men in the South Wales colliery, for example,
      who said they had to stop for breath when walking at their own pace on level
      ground was 942 ml less than the predicted value for nonsmokers after taking age
      and stature into account. Individual cumulative exposures to respirable dust were
      calculated from a long-term program of measurements of dust concentrations and
      occupational records commencing in 1953. In the three colliery populations, 24,
      24, and 12% in South Wales, Yorkshire, and the North East, respectively, had FEV1
      deficits that were at least as severe as the average deficit associated with the
      severe grade of exertional dyspnea described above. In all collieries deficits
      were more common in smokers than in nonsmokers, and more common in men who had
      left the industry than in men still within it.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466113
TI  - The pulmonary response of white and black adults to six concentrations of ozone.
AB  - Many early studies of respiratory responsiveness to ozone (O3) were done on
      healthy, young, white males. The purpose of this study was to determine whether
      gender or race differences in O3 response exist among white and black, males and
      females, and to develop concentration-response curves for each of the gender-race
      groups. Three hundred seventy-two subjects (n > 90 in each gender-race group),
      ages 18 to 35 yr, were exposed once for 2.33 h to 0.0 (purified air), 0.12, 0.18,
      0.24, 0.30, or 0.40 ppm O3. Each exposure was preceded by baseline pulmonary
      function tests and a symptom questionnaire. The first 2 h of exposure included
      alternating 15-min periods of rest and exercise on a motorized treadmill
      producing a minute ventilation (VE) of 25 L/min/m2 body surface area (BSA). After
      exposure, subjects completed a set of pulmonary function tests and a symptom
      questionnaire. Lung function and symptom responses were expressed as percent
      change from baseline and analyzed using a nonparametric two factor analysis of
      variance. Three primary variables were analyzed: FEV1, specific airway resistance
      (SRaw), and cough. Statistical analysis demonstrated no significant differences
      in response to O3 among the individual gender-race groups. For the group as a
      whole, changes in the variables FEV1, SRaw, and cough were first noted at 0.12,
      0.18, and 0.18 ppm O3, respectively. Adjusted for exercise difference,
      concentration-response curves for FEV1 and cough among white males were
      consistent with previous reports (1).

PMID- 8466114
TI  - Lung function, pre- and post-natal smoke exposure, and wheezing in the first year
      of life.
AB  - The relationship between initial level of lung function and subsequent wheezing,
      lower respiratory illness (LRI) was studied in 97 infants in whom the first
      measurement of pulmonary function (PFT) was made before 6 months of age.
      Occurrence of LRI was evaluated by standardized questionnaires at each well-baby
      visit, biweekly telephone calls to mothers, and review of all visits to
      physicians. Infant PFT was assessed by partial expiratory flow-volume curves and
      helium-dilution measurement of functional residual capacity (FRC). Maternal,
      prenatal smoking was assessed by urine cotinine and standard questionnaires.
      Infants who developed an LRI during the first year of life had lower preillness
      length-corrected forced expiratory flow at FRC (VFRC) than those who did not
      experience an LRI (males, 2.06 +/- 0.20 versus 2.32 +/- 0.29 ml/s/cm; females,
      2.38 +/- 0.20 versus 2.91 +/- 0.26 ml/s/cm). Similar results were observed with
      FRC-corrected VFRC. No differences were observed for FRC. Differences in lung
      function were greatest in female infants whose mothers did not smoke during
      pregnancy (VFRC 2.67 +/- 0.25 versus 3.49 +/- 0.26 ml/s/cm for those with and
      without LRI, respectively; p = 0.03). History of maternal wheezing was more
      common in infants who experience an LRI, independent of maternal smoking. The
      results were not influenced by exposure to nonmaternal sources of environmental
      tobacco smoke in the postnatal period. Regression analyses that included data for
      multiple measurements of VFRC over the first year and took account of duration of
      follow-up demonstrated that lower levels of VFRC were associated with an
      increased frequency of LRI, especially in female infants.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8466115
TI  - Predictors of individual differences in acute response to ozone exposure.
AB  - The purpose of this study was to identify personal characteristics that predict
      individual differences in acute FEV1 response to ozone exposure. Response and
      predictor data were collected on 290 white male volunteers 18 to 32 yr of age who
      were each exposed to one of six concentrations of ozone between 0.0 and 0.40 part
      per million. The sample was divided into an exploratory sample of 96 and a
      confirmatory sample of 194 subjects. Exploratory analysis indicated that ozone,
      age, and several other variables explained a significant proportion of the
      variance in response. In the confirmatory sample, only age and ozone
      concentration predicted FEV1 decrement. For the combined sample ozone explained
      31% of the variance, with age accounting for an additional 4%. The model
      predicted a decreasing response with increasing age for all nonzero ozone
      concentrations. For exposure to 0.40 ppm, the model predicts decrements in FEV1
      of 1.07 and 0.47 L for 18- and 30-yr-old subjects, respectively. We concluded
      that for white male subjects age was a significant predictor of response, with
      older subjects being less responsive to ozone. Furthermore, we demonstrated that
      exploratory analysis without control of type I statistical error rates may result
      in apparent findings that cannot be replicated.

PMID- 8466117
TI  - Measuring quality of life in asthma.
AB  - The aim of this study was to evaluate the measurement properties of an Asthma
      Quality of Life Questionnaire. The study design was an 8-wk unblinded single
      cohort with assessments at 0, 4, and 8 wk. Thirty-nine adults with symptomatic
      asthma and a wide range of airway responsiveness and medication requirements were
      enrolled from previous studies and through notices in the local media. Those with
      inadequately controlled asthma were offered an inhaled steroid (budesonide).
      Asthma Quality of Life Questionnaire, spirometry, a clinical asthma control
      questionnaire, medication requirements, airway responsiveness to methacholine,
      the Sickness Impact Profile, and the Rand questionnaire were recorded at each
      visit. Patients kept daily diaries of peak flow rates and medications. The Asthma
      Quality of Life Questionnaire was able to detect changes in patients who
      responded to treatment or who had natural fluctuations in their asthma (p <
      0.001) and to differentiate these patients from those who remained stable (p <
      0.001). The Questionnaire was reproducible in patients who were stable
      (intraclass correlation coefficient = 0.92). There were significant longitudinal
      and cross-sectional correlations between asthma quality of life and other
      measures of both clinical asthma and generic quality of life. We conclude that
      the Asthma Quality of Life Questionnaire has good measurement properties and that
      it is valid as both an evaluative and a discriminative instrument. It measures
      the component of asthma most important to patients, and it should be considered
      for inclusion in all asthma studies.

PMID- 8466116
TI  - Particulate air pollution and hospital emergency room visits for asthma in
      Seattle.
AB  - Recent studies have associated short-term exposure to respirable particulate
      matter (PM10) exposure with peak flow decrements, increased symptoms of
      respiratory irritation, increased use of asthma medications, and increased
      hospitalization for asthma. Increased mortality from chronic respiratory disease
      has also been reported. To help confirm whether PM10 exposure is a risk factor
      for the exacerbation of asthma, we compiled daily records of asthma emergency
      room visits from eight hospitals in the Seattle area. In Poisson regressions
      controlling for weather, season, time trends, age, hospital, and day of the week,
      the daily counts of emergency room visits for persons under age 65 were
      significantly associated with PM10 exposure on the previous day. The mean of the
      previous 4 days' PM10 was a better predictor (p < 0.005). The relative risk for a
      30 micrograms/m3 increase in PM10 was 1.12 (95% confidence interval 1.20 to
      1.04). Daily PM10 concentrations never exceeded 70% of the current ambient air
      quality standards during the period. The consistency of investigations of the
      health effects of PM10 suggest that increased attention should be given to the
      control of particulate matter air pollution.

PMID- 8466118
TI  - Intrinsic positive end-expiratory pressure in ambulatory patients with airways
      obstruction.
AB  - In patients with severe expiratory airflow limitation, dynamic hyperinflation
      often occurs when inspiratory efforts are initiated at a thoracic volume above
      the relaxation point of the respiratory system. The result is intrinsic positive
      end-expiratory alveolar pressure (PEEPi). To determine whether PEEPi occurs in
      ambulatory patients, we measured alveolar pressure (Palv) noninvasively during
      tidal breathing in 8 normal subjects, 15 asthmatic subjects, and 19 patients with
      COPD, using a body plethysmographic technique that includes computerized
      corrections for nonlinear pneumotachometer output and for plethysmograph leakage.
      In all 8 normal subjects, 9 asthmatic subjects, and 3 COPD patients, Palv
      descended smoothly to zero at end expiration. In contrast, among each of the
      remaining 22 patients, there was an abrupt change in slope of the Palv tracing
      near end expiration, identifying the onset of the next inspiratory effort and
      indicating the presence of PEEPi, ranging from 0.2 to 9.5 cm H2O. PEEPi was
      significantly correlated with FRC (% of predicted); PEEPi = (0.040 x %FRC) -
      3.65, r = 0.73, p < 0.001, and with the reciprocal of FEV1 (% of predicted),
      PEEPi = (138/%FEV1) - 1.34, r = 0.69, p < 0.001. PEEPi could be elicited in
      normal subjects by severe expiratory resistive loading but not by the increased
      expiratory muscle activity occurring during an MVV maneuver. We conclude that
      PEEPi is common in patients with airways obstruction, even without overt
      ventilatory failure, and that its severity is generally in proportion to the
      severity of the hyperinflation and the airways obstruction.

PMID- 8466119
TI  - Assessment of diaphragm function using mouth pressure twitches in chronic
      obstructive pulmonary disease patients.
AB  - The relative invasiveness of the balloon catheter technique in measuring twitch
      transdiaphragmatic pressure (Pdit) limits its clinical use. By phrenic
      stimulation we obtained swings in mouth pressure (Pmt) in six COPD patients (age
      50 to 72, FEV1 18 to 48% of predicted) at relaxed FRC (rFRC) and during graded
      inspiratory efforts (IE; twitch occlusion, TO). At rFRC, Pmt was damped and time
      lagged relative to the esophageal pressure twitch (Pes(t)), as if pressure had
      equilibrated through an RC system. Pmt was not correlated with Pdit. Conversely,
      Pmt and Pes(t) were always well matched during IE [Pmt = 0.971 (SEM +/- 0.028)
      Pes(t), r > 0.89], possibly in relation to a decrease in upper airway compliance
      or more uniform pleural pressure swings. Pmt decreased with the level of
      voluntary diaphragmatic contraction (Pdivol) in proportion to Pdit, reflecting a
      progressive increase in the level of diaphragm activation. During IE, Pmt was
      closely related to the voluntary mouth pressure in five subjects but not in the
      remaining subject, indicating intersubject variability in the level of
      diaphragmatic recruitment relative to other inspiratory muscles. We submit that
      measuring Pm during inspiratory efforts upon which bilateral phrenic stimulation
      is superimposed offers a relatively simple method for the assessment of diaphragm
      activation, potentially applicable in the clinical field.

PMID- 8466120
TI  - Effect of pressure and timing of contraction on human rib cage muscle fatigue.
AB  - Breathing against inspiratory loads can be accomplished with different degrees of
      coupling between the diaphragm and the other muscles attached to the rib cage
      (RCM). Thus, the electromyographic signs of fatigue develop separately in each
      muscle group. While breathing with diaphragm emphasis, the occurrence of
      diaphragmatic fatigue was found to be related to the tension-time index TTdi (=
      Pdi/Pdimax x Ti/Ttot). Above the critical range of 0.15 to 0.18, the endurance of
      the diaphragm is less than 1 h and it is inversely related to the TTdi value.
      However, in most loaded breathing conditions, the spontaneous pattern of
      breathing is characterized by predominant activation of RCM. The tension-time
      conditions at which fatigue develops during breathing with RCM emphasis are not
      known. We assessed the critical tension-time value in four normal subjects
      breathing with RCM emphasis against inspiratory threshold loads. RCM predominance
      was achieved by developing negative abdominal pressure swings during inspiration,
      and it was characterized by the tension-time index TTrc (Ppl/Pplmax x Tl/Ttot),
      where Ppl is pleural pressure developed under this condition. Above a critical
      TTrc value of 0.30, endurance time was inversely related to TTrc, and it resulted
      from failure of the RCM rather than of the diaphragm. We conclude that the
      critical threshold, as assessed by TTrc, is higher for breathing patterns with
      RCM emphasis than previously described by TTdi for diaphragm emphasis. However,
      when predominantly recruited, as in breathing patterns commonly adopted in loaded
      conditions, the RCM fatigue earlier than the diaphragm.

PMID- 8466121
TI  - Respiratory and peripheral muscle function in cystic fibrosis.
AB  - Respiratory muscle strength (RMS) and endurance are often preserved in cystic
      fibrosis (CF) despite malnutrition, chronic airflow limitation, and
      hyperinflation. Inspiratory muscle function may be relatively preserved due to a
      selective "training stimulus" from chronic lung disease. Respiratory and
      peripheral muscle function were evaluated in 14 stable CF patients and 16 healthy
      control subjects. RMS was measured using static maximal pressures performed at
      FRC. Respiratory fatigue (RF) was assessed using 18 repeated static efforts (10 s
      on/5 s off) over 4.5 min. Peripheral function was evaluated by leg strength (LS)
      and leg fatigue (LF) measured during sprint efforts on an isokinetic cycle
      ergometer. Despite a lower weight (mean +/- SD, 94 +/- 9.6% ideal wt for CF
      patients versus 107 +/- 14.6% for controls) and elevated residual volume (RV)/TLC
      ratio (38 +/- 13.0 versus 22 +/- 5.3), the CF group maintained RMS (inspiratory
      96 +/- 23.2 versus 114 +/- 33.2; expiratory 105 +/- 28.3 versus 123 +/- 40.9 cm
      H2O) but had decreased LS (590 +/- 201.7 versus 813 +/- 167.1 W). There were no
      differences between the groups with respect to RF or LF. For the control group,
      inspiratory and expiratory RMS correlated with LS (p < 0.01) and lean body mass
      (p < 0.01). For the CF group, while expiratory RMS (p < 0.05) and LS (p < 0.01)
      correlated with lean body mass and each other (p < 0.01), inspiratory RMS was
      independent of lean body mass and LS (p > 0.1). Female CF patients appeared to
      have a better preservation of inspiratory RMS than males with CF.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466122
TI  - Maximum voluntary ventilation. Spirometric determinants in chronic obstructive
      pulmonary disease patients and normal subjects.
AB  - The 12-s maximum voluntary ventilation (MVV) provides an estimate of the
      ventilatory reserves available to meet the physiologic demands of exercise.
      Earlier studies established a general relationship between MVV and FEV1. We
      hypothesized that the resting maximum inspiratory flow rate (MIFR) also serves as
      a clinically useful predictor of the MVV. A total of 105 subjects, 45 women and
      60 men (age 57 +/- 5 yr, mean +/- SD), with expiratory impairment categories of
      severe (n = 26), moderate (n = 22), mild (n = 18), and normal (n = 39) based on
      FEV1 (percentage of predicted), comprised the study samples. The ratio MVV/FEV1
      averaged 41 +/- 7 overall. The FEV1 correlated with MVV in normal subjects (p <
      0.05, r2 = 0.642) and patients (p < 0.05, r2 = 0.787) better than MIFR (p < 0.05,
      r2 > or = 0.480). MIFR joined with FEV1 in multiple linear regression to
      significantly improve the description of MVV:MVV L/min = 30.77FEV1 (L) + 5.94MIFR
      (L/s) - 4.77 (n = 105; p < 0.05, r2 = 0.849). The 95% confidence limits for MVV
      varied from 90 to 110% of predicted from the equation for this sample. The
      factors sex and impairment category did not reduce the unexplained variability in
      MVV after inclusion of FEV1 and MIFR as covariates in ANOVA (p > 0.05). Addition
      of MIFR to the model with FEV1 produced greater improvement in r2 than PImax. We
      conclude that MIFR, although secondary in importance to FEV1, is a significant
      determinant of MVV in patients with COPD and normal subjects.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8466123
TI  - Theophylline delays skeletal muscle fatigue during progressive exercise.
AB  - In this study, 31P nuclear magnetic resonance spectroscopy (NMRS) was used to
      examine the effect of theophylline on human forearm muscle metabolism during
      progressive exercise. Six healthy men (37 +/- 14 yr of age) were assigned to
      either a control (CTRL) group (n = 3), or a theophylline treatment (THEO) group
      (n = 3). Each subject performed two dynamic wrist flexion exercise tests to
      fatigue, with at least 72 h separating each trial. The THEO group repeated the
      protocol after receiving 300 mg of sustained-release theophylline every 12 h. 31P
      spectra were acquired every 36 s throughout exercise, and the relative
      contributions of the phosphate metabolites and pH were determined. Power output
      at the onset, or threshold of intracellular acidosis (IT), was identified for
      each subject from changes in phosphocreatine (PCr) metabolism and pH. Power at
      maximal exercise and at the IT was found to be reproducible in the CTRL group.
      After theophylline administration, the maximal power attained by the THEO group
      increased significantly by 19% (p < 0.05), from 2.25 +/- 0.2 to 2.68 +/- 0.15 W.
      A similar trend occurred in the onset of the IT, which was also prolonged by 19%,
      from 1.33 +/- 0.18 to 1.58 +/- 0.22 W. Therapeutic concentrations of theophylline
      significantly increased the endurance of the forearm musculature, apparently by
      delaying the onset of intracellular metabolic acidosis. These findings suggest an
      enhancement of oxidative capacity of the muscle.

PMID- 8466124
TI  - Influence of non-REM sleep on inspiratory muscle activity and lung volume in
      asthmatic patients.
AB  - To determine the effect of non-REM (NREM) sleep on inspiratory muscle
      electromyographic (EMG) activity in asthmatic patients and the subsequent effect
      of such changes on FRC, 12 asthmatic patients with nocturnal worsening were
      monitored overnight in a horizontal volume-displacement body plethysmograph.
      During studies FRC was monitored using the single inspiratory occlusion
      technique, whereas EMG activities of the diaphragm (DI), intercostal (IC), and
      sternocleidomastoid (SCM) muscles were monitored using surface electrodes. FRC
      decreased progressively, from 3.63 +/- 0.27 L while awake prior to "lights out"
      to 3.15 +/- 0.27 L after 60 min of NREM sleep (p < 0.005). With awakening at the
      end of the study FRC increased to 4.69 +/- 0.48 L (p < 0.01). Onset of NREM sleep
      was also associated with significant (p < 0.05) reductions in EMG tonic
      activities of all three inspiratory muscles. These levels of tonic activity
      returned and were further augmented (p < 0.001) with awakening at the conclusion
      of the study. Linear relationships were demonstrated between sleep-state
      dependent changes in FRC and EMG tonic activity for each of the three inspiratory
      muscles (r = 0.98, 0.93, and 0.97 for DI, IC, and SCM, respectively, p < 0.01).
      NREM sleep did not significantly alter mean inspiratory phasic activities of
      these muscles, although there was considerable heterogeneity between individual
      subjects in the effects of NREM sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466125
TI  - Objective measurement of patterns of nasal CPAP use by patients with obstructive
      sleep apnea.
AB  - Obstruction of the upper airway during sleep (OSAS) is widely treated by having
      patients self-administer nasal continuous positive airway pressure (CPAP). To
      obtain objective evidence of the patterns of CPAP use, information was gathered
      from two urban sites on 35 OSAS patients who were prescribed CPAP for a total of
      3,743 days. Patients were given CPAP machines that contained a microprocessor and
      monitor that measured actual pressure at the mask for every minute of each 24-h
      day for an average of 106 days per patient. They were not aware of the monitor
      inside the CPAP machines. Monitor output was compared with patients' diagnostic
      status, pretreatment clinical and demographic characteristics, and follow-up self
      reports of CPAP use, problems, side effects, and aspects of daytime fatigue and
      sleepiness. Patients attempted to use CPAP an average of 66 +/- 37% of the days
      monitored. When CPAP was used, the mean duration of use was 4.88 +/- 1.97 h.
      However, patients' reports of the duration of CPAP use overestimated actual use
      by 69 +/- 110 min (p < 0.002). Both frequency and duration of CPAP use in the
      first month reliably predicted use in the third month (p < 0.0001). Although the
      majority (60%) of patients claimed to use CPAP nightly, only 16 of 35 (46%) met
      criteria for regular use, defined by at least 4 h of CPAP administered on 70% of
      the days monitored. Relative to less regular users, these 16 patients had more
      years of education (p = 0.05), and were more likely to work in professional
      occupations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466127
TI  - Do nasal ciliary changes reflect bronchial changes? An ultrastructural study.
AB  - Ciliary dyskinesia is characterized by recurrent respiratory tract infections
      secondary to abnormal ciliary structure and function. The diagnosis of ciliary
      dyskinesia is based on the detection of axonemal ultrastructural abnormalities
      (AUA) is respiratory mucosa samples. In most cases, the diagnosis of AUA is made
      on samples obtained from nasal ciliated cells with little discomfort to the
      patient. However, no studies have been performed in the same patient to confirm
      whether nasal samples reflect bronchial ciliary changes. To answer this question
      and to determine whether it is necessary to sample bronchial cells for the
      diagnosis of ciliary dyskinesia, we investigated 12 patients (between the age of
      5 and 63 yr) with chronic sputum production. The presence of situs inversus,
      bronchiectasis, chronic sinusitis, and sterility was investigated to determine an
      inherited disorder. Two groups were established: Group 1 = six patients with an
      inherited disorder and Group 2 = six patients without evidence of an inherited
      disorder. Samples were obtained by brushing or biopsy of nasal and bronchial
      mucosa and were processed for transmission electron microscopy. In Group 1, the
      mean AUA was 65.2 +/- 11.4%. The following predominant axonemal defects were
      found: absence of dynein arms (DA) (four patients), central complex abnormalities
      (CC) (one patient), and various AUA (one patient). Nasal and bronchial samples
      correlated significantly for total AUA (r' = 1, p < 0.01) and for outer DA
      defects (r' = 0.96, p < 0.05). A good but not significant correlation was found
      for inner DA (r' = 0.83) and peripheral microtubule (PM) defects (r' = 0.71). In
      Group 2, the mean AUA was 9.6 +/- 2.3%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466126
TI  - IL-5 is the predominant eosinophil-active cytokine in the antigen-induced
      pulmonary late-phase reaction.
AB  - The mechanism of airway eosinophilia during antigen-induced inflammation was
      investigated by measurement of eosinophil-active cytokines utilizing an
      eosinophil survival assay. In the first study, 4 patients with allergic rhinitis
      underwent segmental bronchoprovocation (SBP) with low, medium, and high doses of
      ragweed extract instilled into different bronchial subsegments; bronchoalveolar
      lavage (BAL) fluids were collected from each segment 12 min and 48 h after
      challenge. Eosinophil granule proteins and eosinophil survival activity were
      significantly elevated in the 48-h (late-phase) BAL fluids from these segments.
      Correlations were observed between the concentrations of eosinophil granule
      proteins and eosinophil survival activity (rs = 0.717 to 0.880, p < 0.001) in BAL
      fluids. Eosinophil survival activity was completely neutralized by anti-IL-5
      monoclonal antibody in five of the seven 48-h samples tested representing three
      of the 4 patients. In the two remaining samples, eosinophil survival activity was
      only partially neutralized by either anti-IL-5 antibody or anti-granulocyte
      macrophage colony-stimulating factor (GM-CSF) but was completely neutralized by
      anti-IL-5 and anti-GM-CSF in combination. Subsequently, in the second study, 10
      patients with allergic rhinitis were challenged by SBP with ragweed extract.
      Eosinophil survival activity was significantly elevated in the 48-h BAL fluids;
      this activity was partially neutralized by anti-IL-5 antibody about (48%) and
      completely neutralized by the combination of anti-IL-5 and anti-GM-CSF
      antibodies. These findings suggest that the eosinophil survival activity in the
      late inflammatory lesions following SBP with allergen is mainly associated with
      IL-5, with small contributions from GM-CSF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466128
TI  - Pressure and flow changes in the pulmonary circulation in exercising sheep:
      evidence for elevated microvascular pressure.
AB  - The purpose of this study was to measure hemodynamic and transvascular filtration
      changes in the lung during strenuous exercise in sheep. The specific goals were
      (1) to determine the nature of the reduction in pulmonary arterial pressure (Ppa)
      after its initial peak rise with onset of exercise; (2) to use a pulmonary artery
      catheter distal wedge technique ("microwedge") to better assess longitudinal
      changes in resistance in the pulmonary circulation with exercise; and (3) to
      compare lung lymph flow and protein concentration changes at comparable estimated
      microvascular pressure (Pmv) (mean Ppa - mean left atrial pressure) (Pla) x 0.4 +
      mean Pla) during exercise versus passive left atrial hypertension to determine
      whether exercise causes a higher than expected lymph flow. We found that cardiac
      output rises quickly and thereafter remains constant with constant-rate exercise,
      and, thus, the secondary reduction in Ppa was due to vasodilation and/or
      recruitment. The microwedge pressure rose more than did Pla, suggesting that
      actual Pmv was probably higher than that estimated. With hypoxia, most of the
      change in pulmonary vascular resistance was in upstream vessels (arteries and
      capillaries), as was most of the exercise-induced vasodilation. Lymph flow rose
      more quickly and was much higher during brief exercise than during left atrial
      hypertension at a comparable calculated Pmv, and lymph protein content decreased
      more quickly. The data point to a Pmv with strenuous exercise that is higher than
      expected.

PMID- 8466129
TI  - Pulmonary hypertensive response to rabbit blood components in goats: role of
      thromboxane.
AB  - Transfusion of small quantities of heterologous blood may cause severe pulmonary
      hypertensive response in certain species. To determine the responsible component
      in the donor blood and the main mediator, we studied the responses of goats to
      small quantities of rabbit blood components and observed the effects of several
      pharmacologic agents on these responses. In anesthetized goats, a bolus injection
      of 0.004 ml/kg rabbit blood caused the pulmonary arterial pressure to increase
      from 25.3 +/- 2.8 to 57.1 +/- 11.6 cm H2O within 45 to 90 s, and the aortic
      thromboxane concentration rose from 44 +/- 38 to 238 +/- 104 pg/ml. Pulmonary
      vascular resistance increased more than 4-fold, whereas systemic vascular
      resistance increased moderately (50%). The erythrocyte stroma, mainly cell
      membranes, caused similar responses; other blood components were all ineffective.
      By blocking the production of thromboxane, indomethacin and U63557A (thromboxane
      synthetase inhibitor) abolished nearly all of the hemodynamic responses to rabbit
      blood. Isoproterenol also largely attenuated the responses to rabbit blood by
      blocking thromboxane production without interfering with the responses to the
      thromboxane mimic U46619. Nitrendipine (calcium-channel blocker) equally
      attenuated rabbit blood and U46619-induced hemodynamic responses but did not
      block thromboxane production. Chlorpheniramine (H1-receptor antagonist) partially
      blocked the hemodynamic responses to rabbit blood without affecting thromboxane
      production or U46619-induced responses. We conclude that the erythrocyte membrane
      is the responsible component in the donor blood and thromboxane is the
      predominant mediator. The main action of isoproterenol is to reduce thromboxane
      production and histamine participates by possible interaction with cyclooxygenase
      products.

PMID- 8466130
TI  - A study of monokine release and natural killer activity in the bronchoalveolar
      lavage of subjects with farmer's lung.
AB  - We examined the interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF alpha)
      releasability of alveolar macrophages and the natural killer (NK) cell activity
      in the bronchoalveolar lavage (BAL) cells of 11 patients with Farmer's lung at
      different stages of the disease. Although there were some variations in the
      levels of monokine release, macrophages of patients with acute disease secreted
      significantly higher spontaneous levels of TNF alpha than did a nonfarming
      control group (p = 0.0002). Conversely, TNF alpha release stimulated by bacterial
      lipopolysaccharide (LPS) was similar in patients with acute disease when compared
      with that in normal control subjects. IL-1 was also spontaneously secreted in
      significantly greater amounts by patients with acute Farmer's lung than by
      subjects in a control group (p = 0.0001). However, LPS-induced IL-1 release was
      significantly diminished in BAL macrophages from patients with acute
      manifestations of the disease when compared with that in control subjects (p =
      0.001). Treating hypersensitivity pneumonitis with corticosteroids or by contact
      avoidance resulted in very significant decrease in spontaneous and LPS-stimulated
      IL-1 production by BAL macrophages (p = 0.0001 and p = 0.03, respectively), as
      well as in a decrease in spontaneous TNF alpha release that was also significant
      (p = 0.01). In addition, BAL cells of patients in the acute phase had a
      significant NK cell activity (mean +/- SEM of 18.33 +/- 2.65%). Treatment of
      these patients resulted in an increase in NK cell activity (mean of 40.17 +/-
      7.86%), which was significantly different from values of patients with acute
      disease (p = 0.037).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466131
TI  - Clinical significance of borderline quantitative protected brush specimen culture
      results.
AB  - In patients with clinical suspicion of pneumonia, quantitative cultures of
      protected brushing specimens (PBS) yielding > or = 10(3) CFU/ml of at least one
      microorganism have been found useful for differentiating airway colonization and
      lung infection, especially in mechanically ventilated patients. The amount of
      secretions collected by protected catheter brushing is small and difficult to
      determine accurately. Thus, the clinical significance of PBS cultures yielding
      organisms in concentrations > or = 10(2) but < 10(3) CFU/ml, in the absence of
      active antimicrobial treatment, is unknown. The 34 consecutive results of PBS
      cultures yielding organisms in concentrations > or = 10(2) but < 10(3) CFU/ml in
      30 patients under mechanical ventilation or weaned for < or = 4 days were
      prospectively studied. No patients were receiving agents active on the organism
      recovered. In 5 cases, the diagnosis of pneumonia was ruled out by recovery
      without treatment (n = 4) or negative postmortem lung cultures (n = 1). A second
      PBS was cultured in 29 episodes (2.7 +/- 1.8 days after the first PBS). In 12
      instances (Group 1), cultures of the second PBS yielded > or = 10(3) CFU/ml of
      the same organism as that found in the first PBS (S. pneumoniae, 1; S. aureus, 1;
      H. influenzae, 1; E. coli, 1; P. aeruginosa, 4; and A. baumannii, 4), and these
      patients were therefore treated with appropriate antibiotics. A total of 17
      patients had a negative repeat PBS culture (no growth or trivial concentrations)
      and were considered free of pneumonia and given no antibiotic treatment for this
      episode.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466132
TI  - Specificity of endotracheal aspiration, protected specimen brush, and
      bronchoalveolar lavage in mechanically ventilated patients.
AB  - The specificity of the different techniques used to diagnose ventilator
      associated pneumonia is still a matter of controversy. To investigate the
      specificity of endotracheal aspiration (EA), protected specimen brush (PSB), and
      bronchoalveolar lavage (BAL) quantitative cultures, we studied 27 consecutive
      mechanically ventilated (MV) patients (> 72 h) without clinical or radiographic
      evidence of pulmonary infection. Comparing different thresholds for quantitative
      cultures (from 10(3) through 10(6) CFU/ml), the lowest rate of false positive
      results was obtained using 10(6) for EA, 10(5) for PSB, and 10(6) for BAL. Using
      10(6) CFU/ml for EA, 10(4) CFU/ml for PSB, and 10(5) CFU/ml for BAL as cutoff
      points, we obtained the following specificities: 85, 85, and 78% for the three
      techniques, respectively. A bacterial index of 8 was the best threshold to get a
      low percentage of false positive results for all techniques except for EA (0% for
      PSB and 12% for BAL). There were reasonable qualitative agreements (PSB versus EA
      = 58%; BAL versus EA = 69%; and PSB versus BAL = 62%) and poor quantitative
      correlations between concomitantly isolated microorganisms from the three types
      of samples. Quantitative cultures of EA, PSB, and BAL may show a considerable
      percentage of false positive results at the respective cutoff points usually
      accepted. Increasing the thresholds for quantitative cultures, albeit loosing
      sensitivity, may rule out better the absence of pulmonary infection in MV
      patients.

PMID- 8466133
TI  - Quantitative bacillary response to treatment in HIV-associated pulmonary
      tuberculosis.
AB  - A group of 122 patients with culture-proven pulmonary tuberculosis were recruited
      to examine the concentrations of Mycobacterium tuberculosis in sputum and the
      relationship to HIV-1 antibody status. They were followed for up to 28 days from
      the start of antituberculous chemotherapy to assess the early bacillary response
      to two chemotherapeutic regimens. Of 67 treated with streptomycin, thiacetazone,
      and isoniazid 17 were HIV positive, and subsequently 55, of whom 20 were HIV
      positive, were treated with streptomycin, rifampin, isoniazid, and pyrazinamide.
      The mean initial concentration of M. tuberculosis in the sputum of the HIV
      negative patients was significantly higher than in HIV-positive patients (6.95
      and 6.34 log colony-forming units respectively; p = 0.019). The HIV-positive
      patients had less radiologic evidence of disease and significantly fewer zones of
      lung affected with cavities. The response to treatment was similar, but with HIV
      positive patients more likely to become culture negative by 28 days. The
      differences that exist between HIV-positive and HIV-negative patients are minor,
      and standard regimens are at least as effective in HIV-positive patients in the
      first month of treatment.

PMID- 8466134
TI  - Intrapleural streptokinase in experimental empyema.
AB  - Intrapleural streptokinase has been used in multiloculated empyemas to enhance
      pleural space drainage, presumably by causing fibrinolysis of the interlocular
      septae. We evaluated the efficacy and safety of daily administration of 10,000 U
      intrapleural streptokinase or equal volumes of saline to enhance resolution of
      experimental empyema in the rabbit pleural space. Seventy-two hours after
      intrapleural turpentine, 10(8) colony-forming units each of Escherichia coli,
      Peptostreptococcus anaerobius, and Bacteroides fragilis were injected into the
      sterile pleural effusion of all animals. Immediately after bacterial inoculation,
      and daily for 3 days, animals received 10,000 U streptokinase or saline
      intrapleurally. Animals that achieved a pleural fluid pH < 7.30 and either
      glucose < 50 mg/dl or LDH > 500 IU/L were included for data analysis. At Day 4
      after bacterial inoculation, the streptokinase-treated empyemic rabbits had more
      pleural fluid (18.8 +/- 5.1 ml) (mean +/- SEM) than did saline-treated control
      animals (4.8 +/- 1.7 ml) (p = 0.015), fewer interpleural adhesions (8.2 +/- 2.7)
      than did saline-treated control animals (25.1 +/- 3.6) (p = 0.002), and
      comparable amounts of visceral and parietal pleural plaque than did saline
      treated control animals (p = NS). No evidence of systemic fibrinolysis was
      observed at 1 h after intrapleural streptokinase administration. We conclude that
      intrapleural streptokinase decreases interpleural adhesion numbers but fails to
      reduce the amount of pleural plaque observed in experimental empyema in rabbits.
      The increases in pleural fluid volume observed after streptokinase administration
      may be due to mechanisms other than fibrinolytic activity.

PMID- 8466135
TI  - Inflammatory cell populations in the airways and parenchyma after antigen
      challenge in the rat.
AB  - We examined the effects of sensitization and antigen challenge on the cellular
      populations retrieved from the large airways (LA) (generations zero to 5
      approximately) and small airways and parenchyma (S/P) of the rat. Male Brown
      Norway rats, 7 to 8 wk of age, were either actively sensitized to ovalbumin (n =
      24) or sham-sensitized to saline (n = 9), and, 14 days later, they were
      anesthetized with urethane, intubated endotracheally, and challenged. Aerosols of
      ovalbumin (5% wt/vol in saline for 5 min) or saline were administered to 12 and
      six rats, respectively, and measurements of pulmonary resistance (RL) were made
      for 8 h. The early airway response (ER) was calculated as the highest value of RL
      in the first hour after challenge, and the late response (LR) was calculated as
      an increase in RL to greater than 200% of the baseline value in the 4- to 8-h
      period after challenge. Rats were killed by exsanguination, LA were separated
      from S/P, and cells were isolated after tissue mincing and digestion with
      collagenase. Total and differential cell counts and lymphocyte subsets were
      determined. Antigen challenge significantly increased the cellular yield (mostly
      neutrophils) from the LA and S/P. Animals with a LR had a lower total cellular
      yield from the LA and S/P than did animals without a LR. The animals with a LR
      also had a lower yield of eosinophils and lymphocytes from the S/P than did
      animals challenged with saline alone. Cellular yields were not lower in the
      animals with an isolated ER after antigen challenge.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466136
TI  - Collagen and elastin in human pulmonary emphysema.
AB  - Studies of collagen and elastin in pulmonary emphysema have been controversial.
      The problems involve methodologic differences; often whole lungs have been
      sampled and the types of emphysema have not been classified. Quantification of
      collagen and elastin is important since the increase in collagen supports the
      inflammatory-repair hypothesis of emphysema, which has been recently revived. On
      the other hand, loss of elastin supports the protease-antiprotease hypothesis.
      Accordingly, we measured collagen (hydroxy-proline) and elastin (desmosine) in
      147 small samples of human lungs removed for cancer. The amount and type of
      collagen were also assessed histochemically in tissue blocks adjacent to the
      tissue used for the biochemical analysis. We found that collagen in the
      homogenates was increased only in irregular airspace enlargement, but
      histochemically, collagen was consistently increased in centriacinar, distal
      acinar, and irregular air-space enlargement sections. Elastin was decreased in
      all grades of panacinar air-space enlargement and also in severe centriacinar air
      space enlargement. Our data support both the protease-antiprotease imbalance
      hypothesis in panacinar and the inflammatory-repair hypothesis in centriacinar,
      distal acinar, and irregular air-space enlargement.

PMID- 8466137
TI  - The effect of human eosinophil granule major basic protein on airway
      responsiveness in the rat in vivo. A comparison with polycations.
AB  - Major basic protein (MBP) is a highly cationic protein found in the granules of
      eosinophils. It has been postulated that MBP may participate in the pathogenesis
      of airway hyperresponsiveness exhibited by asthmatic patients. Accordingly, we
      used a rat model to investigate the effect of human MBP instillation on airway
      responsiveness and the possible role of cationic charge in the determination of
      this effect. Dose-response characteristics to inhaled methacholine (MDRC) were
      determined at baseline, and the animals were allowed to recover. Then animals in
      the experimental group received 100 micrograms of purified human MBP via direct
      instillation into the trachea. One hour after instillation, the MDRC were again
      assessed. Control animals received (in lieu of MBP) buffer from the void volume
      pool of the same chromatography column used to purify the MBP. One hour after
      instillation of MBP there was a significant increase in airway responsiveness to
      inhaled methacholine, whereas control animals exhibited no increase in airway
      responsiveness. Some animals from the MBP group were restudied 48 h after MBP
      instillation, by which time airway responsiveness had returned to baseline level.
      The effect of the polycations poly-L-arginine and poly-L-lysine on airway
      responsiveness was also examined. As with MBP, airway responsiveness to inhaled
      methacholine increased 1 h after the instillation of either polycation. In
      addition, acetylation of the charged groups on poly-L-lysine resulted in a loss
      of this effect. Histologic examination of the airways failed to reveal airway
      epithelial shedding 1 h after MBP or polycation instillation.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8466138
TI  - Experimental hydrostatic pulmonary edema in rabbit lungs. Morphology.
AB  - To study the accumulation and distribution of edema fluid and the associated
      changes in alveolar microarchitecture, edema was induced in excised rabbit lungs
      perfused with 6% albumin solution. The lungs, including the edema fluid, were
      then fixed by vascular perfusion with glutaraldehyde, osmium tetroxide, and
      uranyl acetate. Tissue samples were analyzed by light microscopy and transmission
      and scanning electron microscopy. We found (1) fixation was successful in that
      the albumin in the edema fluid formed coherent webs indicating the location and
      arrangement of the extravascular fluid accumulations; (2) regardless of the
      filtration pressure (about 29 mm Hg in one set of experiments and about 14 mm Hg
      in the other), an apical to basal gradient of fluid accumulation was found. This
      gradient was absent in lungs held in the inverse position, suggesting that the
      regional distribution of pulmonary edema is not simply gravity dependent. At the
      same lung height, there was a remarkable inhomogeneity of interstitial and
      alveolar edema. (3) Both the inhomogeneous distribution of fluid and the
      resulting changes in surface tension affected the entire alveolar architecture.
      (4) Within interstitial and alveolar spaces, there were striking inequalities in
      the density of the proteinaceous fluid pools that suggest local differences in
      the sieving properties of the barriers, that is, in the reflection coefficients
      for albumin. In conclusion, our findings suggest that the formation of pulmonary
      edema cannot be explained solely by uniform membrane models for fluid exchange.

PMID- 8466139
TI  - Experimental hydrostatic pulmonary edema in rabbit lungs. Barrier lesions.
AB  - In excised rabbit lungs perfused with a 6% albumin solution, hydrostatic
      pulmonary edema was induced by moderate (about 14 mm Hg) and high increases
      (about 29 mm Hg) of capillary transmural pressure. Thereafter, lung tissue and
      proteinaceous edema fluid were fixed by vascular perfusion and analyzed by
      electron microscopy for possible lesions of the blood-gas barrier. The following
      observations appear noteworthy: (1) There were distinct and numerous lesions of
      the epithelial cell layer. In high-pressure edema, frank disruptions on the thin
      and thick sides of the blood-gas barrier were prominent. In moderate pressure
      edema epithelial blebs were more conspicuous. (2) In contrast, endothelial
      lesions were rare in both high- and moderate-pressure experiments. (3) Epithelial
      Type I cells revealed an enormous plasticity as illustrated by the formation of
      large epithelial blebs. (4) Although the entire microvasculature was subjected to
      high pressures, barrier lesions were exclusively seen in regions with alveolar
      edema. These findings suggest that barrier leaks play a role in both hydrostatic
      and permeability lung edema and that the differences between both types of edema
      rather reflects the type and extent of injury to the alveolar epithelial barrier
      and the associated inflammatory reaction.

PMID- 8466140
TI  - The role of clinical biochemistry departments in developing a research
      infrastructure.

PMID- 8466141
TI  - Would DNA repair assessment benefit patient management?

PMID- 8466142
TI  - Laboratory diagnosis of phaeochromocytoma: which analytes should we measure?
AB  - There is a diversity of advice in the literature as to which biochemical assays
      are best suited to the investigation of patients with a suspected
      phaeochromocytoma. The challenge for the clinical laboratory is to select those
      assays which detect all phaeochromocytomas, whilst having the lowest incidence of
      false positive diagnoses. We compared the sensitivity and specificity of a wide
      range of assays currently used for the biochemical diagnosis of phaeochromocytoma
      using either specific gas chromatographic-mass spectrometric (GC/MS) or high
      performance liquid chromatography-electrochemical detection (HPLC/ED) techniques.
      Noradrenaline (NA), adrenaline (ADR), dopamine (DA), 3,4-dihydroxyphenylglycol
      (DHPG), hydroxymethoxymandelic acid (HMMA), normetanephrine (NMET) and
      metanephrine (MET) were measured in 24 h urine specimens from 20 patients with
      histologically proven phaeochromocytoma and a large group of patients referred
      for investigation but subsequently found not to have a phaeochromocytoma. Because
      phaeochromocytomas are a heterogeneous group of hormone secreting tumours, no
      single analyte could achieve 100% sensitivity; 100% sensitivity was achieved only
      when the combination of both NA and ADR or NMET and MET was used. DA, DHPG and
      HMMA all had poor sensitivities. HMMA had a sensitivity of 70% when using the
      upper 95% confidence level (48 mumol/24 h) of the non-tumour patients as the cut
      off. By lowering the cut-off to 35 mumol/24 h the sensitivity could be increased
      to 100% but at the expense of the specificity which was decreased from 98 to 92%.
      On the basis of this study we recommend the specific measurement of either NA and
      ADR or NMET and MET as the most suitable analytes for the detection of
      phaeochromocytoma, and further that, due to its poor specificity, HMMA be
      abandoned as a suitable analyte.

PMID- 8466143
TI  - Estimation of sulphoconjugated catecholamine concentrations in plasma by high
      performance liquid chromatography.
AB  - Free and sulphoconjugated catecholamine (CA) concentrations were measured in
      plasma using a fully automated and sensitive analyser equipped with a three
      column system of high-performance liquid chromatography (HPLC). Although the free
      dopamine (DA) concentration has been below the detection limit of HPLC analysers
      thus far available, this new CA analyser can measure as little as 0.03 nmol/L.
      For the estimation of sulphoconjugated CA, we performed enzymatic deconjugation
      with arylsulphatase prior to HPLC analysis. The difference between free and total
      concentrations represents that of sulphoconjugated CA. The intraassay coefficient
      variation was less than 2.2% for free noradrenaline (NA) and adrenaline (A),
      12.62% for free DA, and less than 4.3% for total A, and DA. These assays of free
      and sulphoconjugated CA are simple and can be performed routinely by a suitably
      equipped laboratory.

PMID- 8466144
TI  - Identification of sources of lead exposure among children in Arar, Saudi Arabia.
AB  - The concentrations of lead and the isotopic ratios of lead, 206Pb:207Pb, were
      measured by inductively coupled plasma-mass spectrometry in environmental
      specimens, cosmetics and traditional remedies. The ratios were compared with
      those found in blood samples of Saudi children who had increased concentrations
      of total blood lead. The isotopic ratios in the blood specimens (1.144 +/- 0.027)
      were not significantly different from those determined in cosmetics and remedies
      (1.152 +/- 0.031) and indicated that these were the likely sources of exposure
      rather than the lead contained in petrol which had an isotopic ratio of 1.207.

PMID- 8466145
TI  - Predicting the probability of helper T cell immunodominant sites through
      discriminant analysis.
AB  - Bayesian discriminant analysis is used to predict whether or not a given protein
      segment will activate helper T cells. The predictor variables are drawn from the
      products of frequencies of amino acid residues. The model's predictive validity
      compares favourably with that of alternative modelling strategies, suggesting
      that this approach merits further investigation.

PMID- 8466146
TI  - Analysis of apolipoprotein size distribution by electroimmunoblotting from non
      denaturing composite gels.
AB  - An exponential gradient gel with 0-35% acrylamide and 0.5% agarose was developed
      for electrophoresis of intact lipoproteins with subsequent electroimmunoblotting.
      The system resolved in a single gel lipoprotein-associated proteins of sizes from
      'free' apoproteins to VLDL. Reproducibility between gels was good (coefficient of
      variation < 8%). Examination of the effect of mild glutaraldehyde fixation on
      immunodetection showed variable results (lack of effect on apos (a), AII, and
      AIV; inhibition of apoB; enhancement of apos AI and E). The composite gel system
      described here will simplify analysis of apolipoprotein distributions in both
      health and disease and therefore will likely be useful in future clinical
      applications.

PMID- 8466147
TI  - An evaluation of the measurement of drugs of abuse by commercial and in-house
      horizontal thin layer chromatography.
AB  - We have compared an in-house horizontal thin layer chromatography (TLC) method
      with a commercial TLC screening kit (Toxi-Lab) to find the most suitable method
      for screening urine for opioid drugs. The in-house TLC procedure is cheaper and
      more efficient than the commercial TLC method and is ideal as a confirmatory
      method when used in conjunction with other established laboratory methods. The in
      house TLC method is useful for one-off requests and is able to differentiate
      between small quantities (0.1-0.5 mg/L) of the different, commonly abused opioids
      and their metabolites, which means that it is well suited for use at a local Drug
      Addiction Unit as a routine screening service.

PMID- 8466148
TI  - Glycohaemoglobin: comparison of 12 analytical methods, applied to lyophilized
      haemolysates by 101 laboratories in an external quality assurance programme.
AB  - Stable lyophilized ethylenediaminetetra-acetic acid (EDTA)-blood haemolysates
      were applied in an external quality assurance programme (SKZL, The Netherlands)
      for glycohaemoglobin assays in 101 laboratories using 12 methods. The mean
      intralaboratory day-to-day coefficient of variation (CV), calculated from the
      assay of 12 unidentified pairs over a period of 1 year, was 5.2% (range: 0.2
      28.7). Forty-seven per cent of laboratories did not meet the criterion of CV <
      5%, whereas 68% did not meet the clinically more desirable 3.3-3.6%. Linearity,
      as derived from the analysis of five combinations of two haemolysates with low
      and high glycohaemoglobin percentages over 6 months, was excellent (mean
      correlation coefficient 0.9953; range: 0.9188-0.9999). Analysis of two samples
      with high and low glycohaemoglobin percentages gave mean interlaboratory
      coefficients of variation of 10% for one method performed by several laboratories
      and 22% for all methods performed by all laboratories. It is concluded that the
      majority of laboratories do not meet the clinically desirable intralaboratory
      precision and that an unacceptably high interlaboratory precision exists.

PMID- 8466149
TI  - A robust procedure for the automated measurement of total serum bilirubin using
      potassium ferricyanide.
AB  - Bilirubin is oxidized to biliverdin by 1.0 mmol/L potassium ferricyanide in the
      presence of caffeine. The absorbance decline at 480 nm with blanking at 660 nm is
      proportional to bilirubin concentration. The assay is linear up to 1000 mumol/L
      and is suitable for the measurement of bilirubin in adult and neonatal patients.
      The assay is accurate and precise and is not significantly affected by haemolysis
      up to 5.0 g/L haemoglobin. Reagents and calibration are stable for at least 3
      months.

PMID- 8466150
TI  - Urinary growth hormone excretion as measured by a sensitive
      immunochemiluminometric assay.
AB  - A sensitive immunochemiluminometric assay with a detection limit of 1.1 microU/L
      was developed for the measurement of urinary growth hormone (UGH). The assay was
      shown to be specific and precise. There was a good correlation between serum
      growth hormone (GH) and UGH concentrations in 20 patients with acromegaly and six
      volunteers following an intravenous injection of recombinant GH. We concluded
      therefore that UGH measurements appear to provide a satisfactory index of GH
      secretion. The use of the assay in the investigation of growth disorders was
      assessed. We studied 11 pre-pubertal children, six of normal stature, and five of
      short stature, over a 6-month period. Sequential fortnightly measurements of UGH
      were carried out and height velocity was determined. The children of short
      stature grew at a slower rate and excreted less GH than the children of normal
      stature. However, we observed considerable within-individual variability in GH
      excretion in both groups (CV 22-98%). We therefore recommend that sequential UGH
      analyses should be carried out and the results interpreted in conjunction with
      growth measurements. However, further investigations into the renal handling of
      GH are needed to establish optimum sampling regimes.

PMID- 8466151
TI  - Comparison of a commercial enzymic kit for urinary oxalate analysis with a high
      performance liquid chromatographic method.
AB  - A new commercial enzymic kit for urinary oxalate determination has been adapted
      for use on a centrifugal analyser. It has been evaluated and compared with an
      established high performance liquid chromatographic (HPLC) procedure developed in
      our laboratory. Mean recovery of oxalate from urine samples augmented with oxalic
      acid exceeded 97% by both methods. The precision of the HPLC method was superior
      to that of the enzymic kit but both methods gave between batch precision values
      better than CV 12% at low (less than 100 mumol/L) oxalate concentrations and
      better than CV 7% at higher concentrations (greater than 270 mumol/L). Urinary
      oxalate values obtained with the new enzymic procedure correlated more closely
      with HPLC values (r = 0.84) than did values previously obtained using the
      forerunner of the kit (r = 0.62) which was known to be susceptible to ascorbate
      interference. No significant interference from ascorbic acid or from high urinary
      calcium concentrations could be demonstrated using either the improved kit or the
      HPLC procedure. Its easy adaptation to automated analysers available in most
      laboratories, coupled to its acceptable analytical performance render the enzymic
      kit a reasonable alternative to HPLC or other more complex procedures for urinary
      oxalate analysis.

PMID- 8466152
TI  - Bone-derived serum enzymes and bone density in perimenopausal Caucasian women.
AB  - Serum levels of bone-origin alkaline phosphatase and of tartrate-resistant acid
      phosphatase were measured in Caucasian women aged 41-69 years who had volunteered
      for bone densitometry. Bone alkaline phosphatase and tartrate-resistant acid
      phosphatase were inversely correlated with vertebral bone density and with
      femoral neck bone density. Bone alkaline phosphatase and acid phosphatase were
      also significantly correlated, consistent with the concept of 'coupling' between
      osteoblast and osteoclast activity.

PMID- 8466153
TI  - Insulin and proinsulin-like molecules in motor neurone disease.

PMID- 8466154
TI  - Serum glycated albumin concentrations during pregnancy.

PMID- 8466155
TI  - Thin layer chromatographic identification of thromboxane B2 in serum, and
      platelet rich plasma stimulated by arachidonic acid and collagen.

PMID- 8466156
TI  - Monitoring erythropoietin therapy for anaemia of chronic renal failure by serum
      erythropoietin assays.

PMID- 8466157
TI  - Alpha-fucosidase as a marker of genetic deletion in ovarian carcinoma.

PMID- 8466158
TI  - A simple method for measuring neopterin in serum using HPLC.

PMID- 8466159
TI  - Keep the lid on it: artefactual hypernatraemia in samples from paediatric
      patients.

PMID- 8466160
TI  - Storage of plasma in primary plasma separator tubes.

PMID- 8466161
TI  - Inhibition of the urease reaction by boric acid.

PMID- 8466162
TI  - Hyponatraemia and hypouricaemia.

PMID- 8466163
TI  - Elevated levels of maternal serum inhibin immunoreactivity in second trimester
      pregnancies affected by Down's syndrome.

PMID- 8466164
TI  - Interaction between bovine control materials and the ferene iron method.

PMID- 8466165
TI  - Europium labelled time-resolved fluoroimmunoassay for urine albumin.

PMID- 8466166
TI  - Hyperammonaemia--an important cause of encephalopathy: three case reports.

PMID- 8466167
TI  - Seminal fluid contamination of urine.

PMID- 8466168
TI  - Cardiac action potentials, membrane currents, and some personal reminiscences.

PMID- 8466169
TI  - Aldosterone action.

PMID- 8466170
TI  - The insulin-like growth factors.
AB  - The recent availability of reagents to study the IGFs, their receptors, and
      binding proteins has led to an explosive growth in the study of IGF physiology.
      However, most studies to date have been descriptive, and studies delineating
      mechanisms of action are limited. It is apparent that most organ systems
      synthesize several components of the IGF system necessary for IGF to function in
      an autocrine or paracrine fashion and that regulation of this system occurs at
      the local level. However, the relative importance of locally produced IGF vs
      circulating IGF remains unclear. The mechanisms by which the IGFBPs modulate IGF
      activity are crucial to understanding this system, and identification of specific
      roles for each of these proteins will be required. Of critical importance is the
      identity of the intracellular signal transduction system by which the IGF
      receptor mediates the effects of the IGFs, and the delineation of mechanisms by
      which the IGFBPs interact with the receptor at the cellular level. It is also of
      interest to determine what role, if any, the IGF-II receptor plays in mediating
      the growth-promoting effects of the IGFs. The ubiquitous distribution of the
      IGFs, IGFBPs, and IGF receptors indicates that they may play a role in the
      regulation of coordinate growth among several tissues and cell types.
      Understanding the mechanisms by which these components interact to coordinate
      growth responses between different cell types should greatly enhance our
      understanding of normal growth and development.

PMID- 8466171
TI  - Mechanical factors in lung liquid distribution.

PMID- 8466172
TI  - Temporal organization: reflections of a Darwinian clock-watcher.

PMID- 8466173
TI  - Gene transfection of lung cells in vitro and in vivo.

PMID- 8466175
TI  - Neutrophil-endothelial cell interactions in the lung.
AB  - The large marginated pool of neutrophils normally present in the pulmonary
      circulation provides a unique opportunity to study the relationship between
      neutrophils and endothelial cells in situ. Unlike other organs in which
      neutrophil density in the vascular space is low, adequate numbers of cells are
      readily available in the lung to assess such important characteristics as
      distribution, density, size, volume, and immunocytochemical and cytochemical
      characteristics. To take advantage of such a large marginated pool, morphologic
      techniques should be more universally applied in studies of neutrophil-mediated
      tissue injury. From the data presented, it seems clear that factors governing
      neutrophil-endothelial cell interactions may differ in the lung compared to
      systemic vascular beds. We have suggested that this difference may be related to
      the unique characteristics of the lung with regard to anatomy and blood flow
      rather than site-specific differences in endothelial cells. With the discovery of
      specialized proteins involved in cell adhesion and the increasing availability of
      appropriate antibodies to adhesion proteins, unprecedented opportunities exist to
      address these questions. It is an exciting time to study neutrophil-endothelial
      cell interactions in the lung.

PMID- 8466176
TI  - Endothelin peptides and the kidney.

PMID- 8466174
TI  - Interrelationship of pleural and pulmonary interstitial liquid.
AB  - When the lung interstitium fills with liquid, lung interstitial liquid may flow
      across the visceral pleura into the pleural space. This route of interstitial
      liquid flow does not apparently depend on the type of edema because it is used
      equally in both hydrostatic and increased permeability edema. The route of flow
      depends mostly on the quantity and location of extravascular lung water. In
      experimental studies of hydrostatic and increased permeability edema, pleural
      effusion develops when extravascular lung water has reached a certain level for a
      certain amount of time. The necessary level of edema appears to be greater than
      5.0 g/g dry lung, whether in hydrostatic edema [5.2-6.2 g/g dry lung (14); 5.0
      6.5 g/g dry lung (4)] or in increased permeability edema due either to ANTU [5.1
      9.3 g/g dry lung (45)], oleic-acid [6.5-8.0 g/g dry lung (58)], or alveolar P.
      aeruginosa [5.4-6.7 g/g dry lung (J. Wiener-Kronish, unpublished observations)].
      The amount of lung edema necessary for pleural effusion formation is similar to
      the amount of edema Bhattacharya and co-workers found to be associated with the
      steep rise in subpleural pressure (7). The time before appearance of pleural
      effusion appears to be approximately 2 hr after the development of lung edema,
      whether the effusion results from hydrostatic edema (14) or increased
      permeability edema due to ANTU (48) or oleic acid (58). This delay may be
      necessary for the interstitial liquid to accumulate and the interstitial pressure
      to increase in the subpleural tissues to the point that liquid flows across the
      visceral pleura at a rate greater than the rate at which the parietal lymphatics
      can clear it. Consequences of a pleural route of edema clearance are several.
      Pleural effusion that develops in the course of lung edema represents lung
      interstitial edema and can be sampled in lieu of sampling lung lymph. Indeed,
      pleural liquid may be a better sample of lung interstitial liquid than is
      alveolar edema liquid. The flow of lung interstitial liquid to the pleural space
      can protect against the development of alveolar edema by transferring excess
      liquid from the lung interstitium to the pleural space, where the effects on lung
      function are relatively minor. Obliteration of the pleural space may either lower
      the threshold for development of alveolar edema in the adjacent lungs, or slow
      the clearance of established edema; with chronic edema, other routes of clearance
      would likely adapt to compensate for the loss of the pleural clearance route.

PMID- 8466177
TI  - Function and regulation of collecting duct intercalated cells.

PMID- 8466179
TI  - Synchronization of cortical activity and its putative role in information
      processing and learning.

PMID- 8466178
TI  - Role of growth factors in regulation of renal growth.
AB  - It is clear that a number of growth factors are synthesized within the adult and
      the developing kidney. Compelling evidence exists that several of these agents
      orchestrate the nephrogenic process. A growing body of data supports roles for
      one or more of these agents in the adult kidney as regulators of renal function,
      growth, and repair processes. Growth factor expression may be the cause of
      glomerulosclerosis in one or more pathophysiological states. Our knowledge of the
      sites of growth factor synthesis and actions in the kidney and of the mechanisms
      by which growth factor synthesis is regulated and actions are exerted is
      rudimentary. Expansion of this knowledge base is likely to result in a greater
      understanding of renal disease mechanisms and thereby generate strategies by
      which kidney damage can be halted, prevented, or reversed.

PMID- 8466180
TI  - The mechanism of expression of long-term enhancement of hippocampal synapses:
      current issues and theoretical implications.

PMID- 8466181
TI  - Structural changes accompanying memory storage.

PMID- 8466182
TI  - Comparative aspects of muscle capillary supply.

PMID- 8466183
TI  - Contraction dynamics and power output of skeletal muscle.

PMID- 8466184
TI  - Limits to maximal performance.
AB  - Body size fundamentally affects maximal locomotor performance in mammals.
      Comparisons of performances of different-sized animals yield different results if
      made using relative, rather than absolute scales. Absolute speed may be a
      reasonable way to evaluate the locomotor performance of an animal that must
      escape predators in real time. However, comparisons of metabolic power in animals
      of different size can only be made meaningfully on a mass-specific basis.
      Numerous factors associated with the mechanics, energetics, and storage of
      elastic energy during locomotion change with body size, which results in
      allometric relationships that make the energetic cost of locomotion (alpha Mb
      0.3) more expensive for small mammals than for large mammals. Small mammals have
      lower enzymatic capacities for anaerobic glycolysis (alpha Mb0.15) and higher
      specific aerobic capacities (alpha Mb-0.13) than large mammals. However, the
      energetic cost of transport increases more than aerobic power as mammals get
      smaller. The higher ratio of cost to available power in small mammals may explain
      why they run more slowly than large mammals, as a rule. Maximum aerobic capacity
      is allometrically related to body size. Limits to VO2max can be imposed by
      mitochondrial oxidative capacity, as in goats, or by the O2 transport system, as
      in humans and horses. No single step in the O2 transport system can limit the
      flux of O2 by itself; however, in an average non-athletic species of mammal, any
      of the steps in the system might appear to be the weakest link. In highly aerobic
      athletic species, and possibly elite athletic individuals of other species (e.g.
      humans), the malleable elements of the O2 transport system may develop to the
      point that their O2 transport capacities approach that of the least malleable
      element in the system, the lung. VO2max is very high in such individuals, and
      appears to be limited by simultaneous failure of all components of the O2
      transport system.

PMID- 8466185
TI  - Control of cardiac gene expression by mechanical stress.

PMID- 8466186
TI  - The intestinal Na+/glucose cotransporter.

PMID- 8466187
TI  - Facilitated glucose transporters in epithelial cells.
AB  - The molecular cloning of facilitated sugar transporters has led to the
      identification of a family of transport molecules having similar functions, but
      possessing specific kinetic and regulatory properties. These transporter isoforms
      are characterized by different primary structures, specific tissue localization,
      and polarized expression within the same epithelial cells. The use of Xenopus
      oocytes for the functional expression of different members of this transporter
      family has been of considerable value in defining the kinetic properties and
      sugar specificities of the different isoforms. The expression of chimeric or
      variously mutated transporters should, in the near future, permit the
      determination of the structural basis for their kinetic properties and sugar
      specificities. cDNA probes and antipeptide antibodies specific for each isoform
      are now being used to determine their specific regulation during development and
      in different states of altered glucose homeostasis. The variety of molecular
      forms implicated in the apparently simple task of sugar uptake or transepithelial
      transport has been surprising. With the available molecular tools now in hand, it
      will be possible to study these mechanisms in much greater detail.

PMID- 8466188
TI  - Formal approaches to understanding biological oscillators.
AB  - In this brief review, we have attempted to illustrate the utility of our
      qualitative scheme proposed in 1984 (27). This scheme provides a means of
      summarizing information concerning oscillating systems by identifying system
      variables and parameters and the interactions between variables. Moreover, the
      qualitative scheme can be employed to deduce the form of system differential
      equations. This second step then clearly shows the rate constants that must be
      deduced through experimentation for the construction of explicit mathematical
      models.

PMID- 8466189
TI  - Genetic analysis of circadian clocks.

PMID- 8466190
TI  - Molecular approaches to understanding circadian oscillations.

PMID- 8466191
TI  - Controlling cell chemistry with caged compounds.

PMID- 8466192
TI  - Transcriptional regulation during cardiac growth and development.

PMID- 8466193
TI  - Multimode light microscopy and the dynamics of molecules, cells, and tissues.

PMID- 8466195
TI  - AORN supports HIV testing, counseling.

PMID- 8466194
TI  - Transgenic mice in cardiovascular research.

PMID- 8466196
TI  - Let's put our fear of HIV in proper perspective.

PMID- 8466197
TI  - Anesthesia personnel.

PMID- 8466198
TI  - Sterile technique.

PMID- 8466199
TI  - Cervical spine injury. Perioperative patient care.

PMID- 8466200
TI  - Ultrasonic surgical aspiration. An expanding method for patient treatment.

PMID- 8466201
TI  - Perioperative nursing in Uganda. Improvisation, creativity.

PMID- 8466202
TI  - Assert yourself. Effective communication for nurses.

PMID- 8466203
TI  - Preoperative teaching strategy. Videotapes for home viewing.

PMID- 8466204
TI  - Employee recognition. A working model to enhance job satisfaction.

PMID- 8466205
TI  - The holding room. A preoperative advantage.

PMID- 8466206
TI  - Labor budgeting. Automating the manual system.

PMID- 8466207
TI  - Stressors of providing care to the elderly.

PMID- 8466208
TI  - Do-not-resuscitate orders in the operating room.
AB  - Surgery offers patients the chance to improve the quality and longevity of their
      lives, but surgery and anesthesia are not without risks. Patients should have the
      opportunity to make informed choices about the risks they take with respect to
      their health care. Perioperative nurses must be knowledgeable about advance
      directives and the implications they have for surgical care, and they must
      support patient autonomy by respecting the choices and decisions patients make
      about their care.

PMID- 8466209
TI  - Legal implications of perioperative documentation.

PMID- 8466210
TI  - Proposed recommended practices. Environmental responsibility in the practice
      setting. Association of Operating Room Nurses.

PMID- 8466211
TI  - Recommended practices. Monitoring the patient receiving i.v. conscious sedation.
      Association of Operating Room Nurses.

PMID- 8466212
TI  - A pilot study of iontophoretic cisplatin chemotherapy of basal and squamous cell
      carcinomas of the skin.

PMID- 8466213
TI  - Peripheral blood mononuclear cells in patients with nonleukemic cutaneous T-cell
      lymphoma. Reduced proliferation and preferential secretion of a T helper-2-like
      cytokine pattern on stimulation.
AB  - BACKGROUND AND DESIGN: Since patients with cutaneous T-cell lymphoma (CTCL)
      demonstrate several immunologic abnormalities such as elevated serum
      immunoglobulin levels or reduced natural killer cell activity, we analyzed
      functional properties of the peripheral blood mononuclear cells in patients with
      nonleukemic CTCL and healthy donors. RESULTS: After priming with
      phytohemagglutinin for 3 days, a reduced proliferation in the presence of
      interleukin 2 and interleukin 4 was found. Limiting dilution technique revealed a
      diminished number of peripheral blood mononuclear cells from patients with CTCL
      that were capable of proliferating on interleukin 2 but not on interleukin 4
      stimulation. Phytohemagglutinin induced a significantly higher release of
      interleukin 4 (mean +/- SD, 196 +/- 149.8 pg/mL [n = 19] vs 76.4 +/- 16.4 pg/mL
      [n = 248]) and a significantly lower secretion of interferon-gamma (24.9 +/- 30.7
      U/mL [n = 17] vs 47.5 +/- 43.5 U/mL [n = 18]) in the peripheral blood mononuclear
      cells of patients with CTCL compared with the peripheral blood mononuclear cells
      of healthy donors (P < or = .02, U test). CONCLUSION: These functional
      characteristics can be explained by an imbalanced T helper-1/T helper-2 system
      and allow speculations concerning clinical features such as elevated
      immunoglobulin serum levels and reduced cytotoxic activity in patients with CTCL.

PMID- 8466214
TI  - Sneddon's syndrome. A long-term follow-up of 21 patients.
AB  - BACKGROUND AND DESIGN: Twenty-one patients with histologically proven Sneddon's
      syndrome were followed up in a retrospective study. We report on their detailed
      clinical courses and extensive follow-up examinations. RESULTS: Incidence is
      estimated at four cases per million population per year. Nonspecific prodromal
      symptoms (headache, dizziness) frequently (80%) precede livedo racemosa for 3.5
      and (multi)focal neurological symptoms of fully developed disease for 9 years
      followed by progressive cognitive impairment (60%) 10 years later. Involvement of
      fundi, peripheral nerves, heart, and kidneys is frequent (50% to 70%) yet usually
      asymptomatic. Some symptoms prove irreversible (livedo racemosa, multifocal
      cerebral lesions on imaging, or creatinine clearance), whereas other symptoms
      tend to resolve after days to years (many focal neurological symptoms, some
      electrocardiographic changes, or hypertension). Mortality is calculated at 9.5%
      within an average observation time of 6.2 years. Laboratory findings, including
      antiphospholipid antibodies, are normal except for elevated erythrocyte
      sedimentation rates and complement consumption at times of disease progression
      and increased cholesterol levels parallel to disease extent. Skin biopsy
      specimens reveal inflammatory findings ("endothelitis") of small- to medium-sized
      arteries followed by subendothelial proliferation and fibrosis. Hypertension is
      the only risk factor significantly associated with a more severe course of the
      disease; no medication proved effective. CONCLUSIONS: Sneddon's syndrome is an
      often unrecognized, slowly progressive, systemic disease with evidence of
      vasculitic origin.

PMID- 8466215
TI  - Confocal laser scanning microscopic and immunoelectron microscopic studies of the
      anatomical distribution of fibrillar IgA deposits in dermatitis herpetiformis.
AB  - BACKGROUND AND DESIGN: The fibrillar immunofluorescent pattern of IgA deposition
      in dermatitis herpetiformis is considered by most authorities to be a variant of
      the granular IgA pattern. It has been hypothesized that the fibrillar vs the
      granular pattern is related to longitudinal vs transverse sectioning of affected
      dermal microfibril bundles. However, direct evidence for this possibility has yet
      to be presented. Confocal laser scanning microscopy and immunoelectron microscopy
      were performed to determine the anatomical distribution of fibrillar IgA
      deposits, using skin specimens from a patient with typical fibrillar IgA
      deposition. OBSERVATIONS: Confocal laser scanning microscopy showed numerous
      fibrils stained with anti-IgA extending from the dermoepidermal junction to a
      depth of 50 to 110 microns in the dermis. They crossed each other at various
      angles to form a three-dimensional network. Immunoelectron microscopy
      demonstrated a diffuse dispersion of immune deposits on the surface of
      microfibrils of dermal microfibril bundles, with sporadic distribution of small
      aggregates, 0.1 to 0.3 micron in diameter. CONCLUSIONS: To our knowledge, this is
      the first article to present evidence for the actual distribution of fibrillar
      IgA. Insofar as the present case is concerned, the distribution of fibrillar IgA
      is greatly at variance with that indicated in previous reports on granular IgA.
      However, studies on more cases should be conducted to determine whether this is a
      distinctive feature of the fibrillar type of IgA deposition.

PMID- 8466216
TI  - Angiokeratoma corporis diffusum with glycopeptiduria due to deficient lysosomal
      alpha-N-acetylgalactosaminidase activity. Clinical, morphologic, and biochemical
      studies.
AB  - BACKGROUND: Angiokeratoma corporis diffusum is a prominent cutaneous feature of
      certain lysosomal storage diseases. In this article, the clinical, morphologic,
      and biochemical features of a new, adult-onset lysosomal disease with
      angiokeratoma are described. OBSERVATIONS: A 46-year-old Japanese woman had
      diffuse angiokeratoma, mild intellectual impairment, and peripheral neuroaxonal
      degeneration. The angiokeratoma first appeared on her lower torso when she was 28
      years old, and then it became diffusely distributed. Histopathologically, the
      telangiectasia had localized hyperkeratosis; ultrastructural examination revealed
      clear cytoplasmic vacuoles in all dermal cells, particularly in vascular and
      lymphatic endothelial cells and in eccrine sweat gland cells. The lysosomal
      pathologic features and increased urinary excretion of O-linked glycopeptides
      suggested the deficiency of a specific glycosidase. Enzyme analyses revealed less
      than 2% of normal alpha-N-acetylgalactosaminidase activity and the absence of
      immunodetectable enzyme protein. Her two unaffected children had half-normal
      alpha-N-acetylgalactosaminidase levels, consistent with the autosomal recessive
      inheritance of the enzymatic defect. CONCLUSIONS: Since this enzyme deficiency
      was previously identified in patients with an infantile form of inherited
      neuroaxonal dystrophy, the occurrence of the enzymopathy in the 46-year-old
      proband described herein represents an adult-onset form of alpha-N
      acetylgalactosaminidase deficiency. This newly recognized entity should be
      considered in the differential diagnosis of angiokeratoma corporis diffusum.

PMID- 8466217
TI  - Cutaneous T-cell recruitment in toxic epidermal necrolysis. Further evidence of
      CD8+ lymphocyte involvement.
AB  - BACKGROUND: Toxic epidermal necrolysis (TEN) is a life-threatening disease with
      severe mucocutaneous shedding. Although it is widely accepted that immune
      mechanisms are at play, the pathophysiology of TEN is still unknown. We studied
      the blister fluid inflammatory cells in three drug-related cases to further
      define the suspected T-cell involvement in TEN. OBSERVATIONS: A peripheral blood
      lymphopenia, especially of CD4+ T lymphocytes, was associated with a high
      lymphocytic cellularity of the blister fluid. In two cases, immunophenotyping of
      blister fluid lymphocytes showed a predominance of the CD8 phenotype.
      Furthermore, using two-color flow cytometry in one patient, we could show the
      predominance of CD8+ CD29+ lymphocytes and CD45RA- negative cells. CONCLUSIONS:
      Our findings point to a cutaneous recruitment of antigen-primed and cytotoxic T
      cells in TEN, further supporting the involvement of CD8+ lymphocytes in TEN
      pathogenesis and its immune mediation.

PMID- 8466218
TI  - Erythema induratum of Bazin. Evidence of T-lymphocyte hyperresponsiveness to
      purified protein derivative of tuberculin: report of two cases and treatment.
AB  - BACKGROUND AND DESIGN: Erythema induratum of Bazin, a chronic form of nodular
      vasculitis, may be associated with chronic infections by Mycobacterium
      tuberculosis. However, the true origin of the disease is a subject of speculation
      and remains elusive. Two female patients (58 years old and 33 years old) with a
      minimum 10-year history of chronic tender ulcerating nodules on the lower aspects
      of the legs were studied both clinically and in the response of their peripheral
      T cells to purified protein derivative of tuberculin. RESULTS: Both patients with
      no previous history of tuberculosis had strongly positive skin test results at a
      Mantoux 10(-4) dilution (1 unit of purified protein derivative). In response to
      full-course triple-agent (isoniazid, rifampicin, and ethambutol) chemotherapy, a
      complete remission of clinical symptoms was seen in both cases and no relapse
      occurred after discontinuation of therapy. A marked increase in peripheral T
      lymphocyte response to purified protein derivative was found before onset of and
      during successful therapy. CONCLUSIONS: The present clinical observations
      together with the pronounced cellular response to purified protein derivative
      suggest a tuberculous origin of erythema induratum of Bazin.

PMID- 8466219
TI  - Desipramine-induced blue-gray photosensitive pigmentation.
AB  - BACKGROUND: Blue-gray pigmentation of the skin can be elicited by several
      medications. We report the first case (to our knowledge) of desipramine-induced
      photosensitive blue-gray pigmentation. OBSERVATIONS: Diffuse blue-gray
      pigmentation on sun-exposed surfaces was noted in a healthy 48-year-old woman who
      had been taking desipramine hydrochloride for 8 years. Ultrastructural studies
      demonstrated the presence of melanin and homogeneous electron-dense material in
      the dermis. CONCLUSIONS: We conclude that tricyclic antidepressant agents
      represent another class of medications responsible for blue-gray cutaneous
      pigmentation.

PMID- 8466220
TI  - Intralesional steroid injection after nerve block anesthesia in the treatment of
      orofacial granulomatosis.
AB  - BACKGROUND: The facial disfigurement produced by orofacial granulomatosis causes
      enormous embarrassment. None of the many therapies recommended is reliably
      successful. Oral corticosteroids cause significant side effects and repeated
      injections of small quantities of triamcinolone are painful. We have injected
      large volumes of triamcinolone after numbing the lips using nerve block
      anesthesia. OBSERVATIONS: Nine patients (six males and three females, aged 10 to
      47 years) with orofacial granulomatosis were investigated. No evidence of an
      allergic cause was found using patch or contact urticaria tests. Eating chocolate
      produced lip swelling in one man, and his lip shrank in size after avoiding this
      for 12 months. Five patients, aged 10 to 24 years, were treated with high-volume
      intralesional triamcinolone injections (3 to 10 mL of 10 mg/mL) after first
      numbing the lips using infraorbital nerve branch and mental nerve block. After 6
      weeks, the lip size returned to normal in four patients and was reduced in a
      fifth. One patient was injected on four occasions over a 2-year period; in four
      other patients treated once, lip size remained reduced for over 10 months.
      CONCLUSION: Intralesional triamcinolone reduces lip swelling in patients with
      orofacial granulomatosis. Numbing the lips by nerve block anesthesia before
      triamcinolone injection enables adequate volumes and repeated injections to be
      given painlessly.

PMID- 8466221
TI  - The biology of skin grafts. Skin grafts as pharmacologic agents.
AB  - BACKGROUND: Skin grafting is commonly used to treat nonhealing wounds. However,
      how skin grafts help to heal wounds is not entirely known. Why epithelium from
      grafted skin is able to migrate and cover these wounds, while epithelium at the
      edge of nonhealing wounds is unable to, is a long unanswered biologic question.
      OBSERVATIONS: The recent use of cultured epithelial allografts has rekindled
      interest in the biology of skin grafts. Replaced, even in chronic wounds, by
      recipient epithelium, cultured epithelial allografts appear to work by providing
      a potent stimulus to healing imparted by the graft itself. Based on this, we have
      reassessed how skin autografts help to heal wounds and hypothesize that, in a
      similar fashion, autografts may work not only by replacing tissue but also by
      providing a stimulus for healing. CONCLUSIONS: We suggest that skin grafts may
      work not only as tissue replacement but as pharmacologic agents that provide a
      stimulus for healing. We believe that, someday, it may be possible to augment the
      stimulatory properties of donor skin to speed healing of the recipient wound.

PMID- 8466222
TI  - Dermatology in Japan.

PMID- 8466223
TI  - The immunopathogenesis of cutaneous T-cell lymphoma. Abnormal cytokine production
      by Sezary T cells.

PMID- 8466224
TI  - An anemic woman with sparse telangiectases. Osler-Weber-Rendu disease.

PMID- 8466225
TI  - Erythematous plaques on the eyelids. Discoid lupus erythematosus (DLE).

PMID- 8466226
TI  - An ulcerated plaque in a gay man. Cutaneous cryptococcosis.

PMID- 8466227
TI  - Hemorrhagic Darier's disease.

PMID- 8466228
TI  - Acute undifferentiated myeloblastic leukemia revealed by specific hemorrhagic
      bullous lesions.

PMID- 8466229
TI  - Pentoxifylline suppresses allergic patch test reactions in humans.

PMID- 8466230
TI  - Alopecia totalis and topical mustine.

PMID- 8466231
TI  - Rupia syphilitica.

PMID- 8466232
TI  - Ectodermal dysplasia in Cape Verdian families.

PMID- 8466233
TI  - Alcohol abuse in adolescence: an update.

PMID- 8466234
TI  - Androgen insensitivity syndrome.

PMID- 8466235
TI  - An update on Laron syndrome.

PMID- 8466236
TI  - Operation for gastro-oesophageal reflux associated with severe mental
      retardation.
AB  - One hundred and seventy six children with severe mental retardation underwent a
      fundoplication for considerable gastro-oesophageal reflux. There were six 'early'
      (3%) deaths and five 'late' deaths. Major complications developed in 17 (10%)
      children whereas 86 (49%) had 'minor' complications. A revision operation was
      required in 27 patients. Overall 142 (81%) children achieved a good result. In
      spite of the high complication rate and the need for a secondary operation in 15%
      of the patients, the quality of life for these children and their parents and
      carers is greatly improved by antireflux surgery.

PMID- 8466237
TI  - Treatment of croup with nebulised steroid (budesonide): a double blind, placebo
      controlled study.
AB  - The aim of this prospective, randomised, double blind study was to evaluate
      whether nebulised local steroid treatment is effective in the treatment of croup.
      Thirty six infants and children (0.4-4.9 years of age) admitted to hospital with
      moderate to severe croup were allocated to receive either 2 mg nebulised
      budesonide (20 children) or saline (16 children). Disease severity was assessed
      by a clinical total croup score based on stridor, cough, retractions, dyspnoea,
      and cyanosis. In addition the overall clinical impression was evaluated (0-100).
      Two hours after treatment there was a significant improvement in the total croup
      score in the group treated with budesonide (8 to 4.5), but not in the group
      treated with saline (8 to 8). Furthermore, the overall clinical impression
      assessment score decreased significantly (50 to 25) in the group treated with
      budesonide, whereas it remained constant in the placebo group (60 to 62). The
      total croup score and overall clinical severity were significantly better in the
      group treated with budesonide than in the placebo group. No side effects were
      observed. The results indicate that nebulised budesonide can be used as a safe
      and effective alternative treatment in children and infants with moderate to
      severe croup.

PMID- 8466238
TI  - Treatment of severe steroid dependent preschool asthma with nebulised budesonide
      suspension.
AB  - The steroid sparing effect of nebulised budesonide suspension was assessed in a
      double blind placebo controlled parallel group study of 36 preschool children
      with severe asthma who were dependent on treatment with oral steroids. Nebulised
      budesonide suspension significantly reduced the requirement for treatment with
      oral steroids, and produced a marked improvement in overall health as scored on a
      visual analogue scale during the clinic visits. This study shows a significant
      step forward in the prophylactic treatment of asthma in children under the age of
      3 years, in whom the efficacy of many other nebulised treatments has been
      questioned.

PMID- 8466239
TI  - Cardiac rhabdomyomas and their association with tuberous sclerosis.
AB  - A search for children presenting with signs or symptoms of cardiac rhabdomyomas
      was made through members of the paediatric section of the British Cardiac Society
      in order to establish their birth incidence, presenting features, clinical
      course, and the frequency of a concurrent diagnosis of tuberous sclerosis.
      Fifteen children were identified and 12 had tuberous sclerosis (80%). Heart
      failure was the presentation in six, five of whom died; six presented because of
      a murmur and three because of arrhythmias. The prevalence of echocardiographic
      evidence of cardiac rhabdomyomas in a population of patients with tuberous
      sclerosis was established. Twenty individuals had echocardiography and eight had
      echodensities consistent with cardiac rhabdomyomas. It is concluded that the
      minimum birth incidence for children presenting because of the effects of cardiac
      rhabdomyomas is 1/326,000 and a minimum of 80% have tuberous sclerosis. In a
      population of patients with tuberous sclerosis a minimum of 60% under 18 years
      have cardiac rhabdomyomas.

PMID- 8466240
TI  - Protein restriction in chronic renal failure.
AB  - The aim of the study was to investigate the effect of a protein restricted diet
      on renal function and growth of children with chronic renal failure. In a
      multicentre prospective study 56 children (aged 2-18 years) with chronic renal
      failure were randomly assigned to the protein restricted (0.8-1.1 g/kg/day) or
      the control group. All children were followed up by the same paediatrician and
      dietitian. After a follow up period of three years there was no significant
      difference in glomerular filtration rate between children on a protein restricted
      diet and children of the control group. There was no significant difference in
      weight with respect to height and height SD score between the protein restricted
      and the control group. Compliance with the protein restricted diet, as indicated
      by the prospective diet diaries and the serum urea:creatinine ratio, was good.
      This study shows that children with chronic renal failure do not benefit from a
      protein restricted diet.

PMID- 8466241
TI  - Creatinine related reference ranges for urinary homovanillic acid and
      vanillylmandelic acid at 6 months of age.
AB  - The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA),
      and creatinine in the urine of 6 month old babies has been studied and reference
      ranges in the form of centiles constructed for HVA and VMA against creatinine.
      Over 10,000 urine samples were collected from babies in four health districts in
      the north of England. HVA and VMA concentration, either independently or when
      divided by creatinine concentration, were dependent upon the absolute
      concentration of creatinine in the sample. After adjustment for creatinine
      significant differences in the mean concentration of HVA were found between
      sexes. No such differences were found for VMA. HVA and VMA were also found to be
      age dependent. Centiles were constructed using a procedure which makes no
      distributional assumptions about the data. The net effect of utilising these
      centiles was to increase the predictive value of a positive screening test from
      20% to 40% without any increase in the false negative rate.

PMID- 8466242
TI  - Evaluation and audit in a paediatric disability service.
AB  - Parental and professional responses to questionnaires evaluating a paediatric
      disability service are reported and the viability of auditing structural,
      process, and outcome aspects of clinical practice are discussed. Expectations of
      waiting time to first appointment (met for only 52% of consumers) illustrate
      structural issues. Process issues are reflected in consumer reactions to outreach
      work (for example, 94% of parents and 84% of professionals found this
      supportive). Outcome measures such as consumer satisfaction with the service (76%
      of consumers reported being 'very satisfied' and 20% 'fairly satisfied') suggest
      that service aims are being met. Good concurrence of service aims with consumer
      needs is indicated by parental reasons for referral (for example, 75% for
      diagnostic help, 73% for a better understanding of the disorder, 88% for
      practical help), referrers' reasons (for example, 55% for a second diagnostic
      opinion, 45% due to lack of local expertise), and reports from most other
      professionals involved with the case that a similar service was not provided
      locally.

PMID- 8466243
TI  - Rapid diagnosis of malignancy using flow cytometry.
AB  - The rapid and accurate diagnosis of childhood malignancy is important both in the
      planning of appropriate treatment and in relieving the inevitable family anxiety.
      The use of flow cytometry to analyse monoclonal antibody coated single cell
      suspensions is widely accepted as having increased the speed and accuracy of
      diagnosis in leukaemias, though its use in solid tumour diagnosis is not widely
      reported. Ten cases of childhood malignancy in whom the diagnosis was initially
      made by flow cytometry and subsequently confirmed histologically are described.
      The technique has a number of advantages. Only a small sample is required as the
      analysis is carried out on a single cell suspension, the method is rapid, a
      diagnosis being reached within three hours of receipt of the sample, and
      information is obtained on cell lineage and stage of differentiation. Diagnostic
      accuracy is good when compared with histological results.

PMID- 8466244
TI  - Lack of lipolytic response in infants after endotracheal intubation.
AB  - The sympathoadrenal response to endotracheal intubation was investigated in nine
      infants 2-4 months old and in eight adults 23-45 years old at the start of
      inguinal hernia operations. In both infants and adults, heart rate and diastolic
      blood pressure increased significantly immediately after intubation. In both
      groups, moreover, there was a mean (SD) reduction in microvascular blood flow in
      the abdominal skin (infants -21 (14)%, adults -14 (7)%) and in the adipose tissue
      (infants -7 (4)%, adults -5 (4)%). However, the plasma glycerol concentration did
      not increase in the infants whereas it increased in the adults by 50 (12)%. In
      conclusion, infants and adults showed similar circulatory reactions during
      endotracheal intubation but the markedly increased lipolysis rate observed in
      adults was not seen in the infants. This may indicate that catecholamine induced
      lipolysis in vivo as well as in vitro is poor during infancy.

PMID- 8466245
TI  - Unusual cyclosporin related neurological complications in recipients of liver
      transplants.
AB  - In a series of 256 recipients of paediatric liver transplants, from 1984 to 1990,
      four patients presented with sudden onset seizures not explained by conventional
      work-up. None had a family or personal history of seizures. Infectious causes
      were excluded. There were no glucose or electrolyte disturbances. Seizures were
      not induced by systemic or intracranial hypertension. One child out of four had
      transient white matter and cortex focal lesions on computed tomography of the
      brain. One to 10 days before seizures all four children presented with
      supratherapeutic concentrations of serum cyclosporin that were determined by a
      non-specific method that measured the parent compound plus its metabolites. The
      supratherapeutic concentrations were not found with the specific method measuring
      cyclosporin alone. It is concluded that these seizures may correspond to a toxic
      effect of cyclosporin, probably due to one or several metabolites, as suggested
      by the discrepancy between specific and non-specific methods of determination.

PMID- 8466246
TI  - Cerebral aspergilloma in a child with autosomal recessive chronic granulomatous
      disease.
AB  - A 2 year old girl presented with epilepsy 16 months after being diagnosed as
      having autosomal recessive chronic granulomatous disease. Computed tomography
      showed a cerebral mass which was surgically removed and proved histologically to
      be an aspergilloma. This case illustrates the application of molecular diagnostic
      techniques to the diagnosis of chronic granulomatous disease. The occurrence of,
      and unusual reaction to, cerebral aspergillus infection indicates the need to
      consider this possibility in the differential diagnosis of mass lesions in
      chronic granulomatous disease. Furthermore, it is clear that autosomal recessive
      chronic granulomatous disease cannot be considered to be a clinically mild form
      that is exempt from major neurological complications.

PMID- 8466247
TI  - Rhizomelic chondrodysplasia punctata with isolated DHAP-AT deficiency.
AB  - An infant with the characteristic phenotype of classical rhizomelic
      chondrodysplasia punctata was found to have an isolated deficiency of the
      peroxisomal enzyme acyl CoA dihydroxyacetone phosphate acyltransferase (DHAP-AT).
      All other peroxisomal functions measured were found to be normal. Previously
      described in one other case report, this confirms the existence of another
      distinct form of peroxisomal disorder characterised biochemically by a deficiency
      in de novo plasmalogen biosynthesis only.

PMID- 8466248
TI  - Nasal dermoids: the significance of a midline punctum.
AB  - Nasal dermoids are rare and their diagnosis is often delayed until complications
      occur. Signs such as a midline nasal punctum may be noted at birth but the
      significance of this finding frequently passes unrecognised. The cases are
      reported of two patients which illustrate the typical presentation of these
      lesions and their subsequent management is discussed.

PMID- 8466249
TI  - From cot death to infant triggered ventilation.

PMID- 8466250
TI  - Recommendations on the dietary management of phenylketonuria. Report of Medical
      Research Council Working Party on Phenylketonuria.

PMID- 8466251
TI  - Physical education and the national curriculum.

PMID- 8466252
TI  - Atopy, bronchial responsiveness, and symptoms in wheezy 3 year olds.

PMID- 8466253
TI  - Serum IgG titres against Pseudomonas aeruginosa.

PMID- 8466254
TI  - Audit of screening for congenital hypothyroidism.

PMID- 8466255
TI  - Is hearing really assessed after bacterial meningitis.

PMID- 8466256
TI  - Near fatal haemorrhage from the superior sagittal sinus in Adams-Oliver syndrome.

PMID- 8466257
TI  - Rett syndrome and the 4th metatarsal.

PMID- 8466258
TI  - How does exogenous surfactant work?

PMID- 8466259
TI  - Neonatal blood glucose concentrations: metabolic effects of intravenous glucagon
      and intragastric medium chain triglyceride.
AB  - Neonatal hypoglycaemia is a common clinical problem and the traditional treatment
      for the condition is intravenous glucose administration. The glycaemic effects of
      two additional treatments were investigated, in a randomised trial, in 23
      neonates who were receiving intravenous glucose as treatment for hypoglycaemia.
      Eleven infants received an intravenous bolus dose of glucagon (200 micrograms/kg)
      and 12 infants received intragastric medium chain triglyceride (MCT) (5 ml/kg).
      Blood concentrations of glucose and intermediary metabolites were measured before
      and one hour after treatment, and, using stable isotope infusion, glucose
      production rates were calculated. After glucagon, there was a mean rise in blood
      glucose concentration of 1.6 mmol/l and in the glucose production rate of 2.6
      mg/kg/min. After MCT, there was a small mean rise in blood glucose concentration
      of 0.4 mmol/l, but the effect of MCT on glucose production rate was variable.
      Intravenous bolus glucagon administration exerted a glycaemic effect which was
      associated with an increase in glucose production rate. The use of glucagon, as
      an alternative treatment to intravenous glucose, should be investigated further.

PMID- 8466260
TI  - Metabolic adaptation in small for gestational age infants.
AB  - Hypoglycaemia has long been recognised as a feature of the failure of metabolic
      adaptation in infants who are small for gestational age (SGA). This study
      examined the process of metabolic adaptation by measuring, longitudinally, the
      concentrations of metabolic fuels and substrates in 33 SGA infants in the first
      postnatal week, and relating these to cross sectional data in 218 infants of
      appropriate weight for gestational age (AGA). SGA term infants had higher mean
      blood lactate concentrations than AGA term infants at delivery (2.98 v 2.10
      mmol/l) and in the first few postnatal hours (3.05 v 1.91 mmol/l). Subsequently,
      although there were no differences in blood glucose concentrations, SGA term
      infants had lower mean ketone body concentrations (for example day 2: 0.07 v 0.41
      mmol/l), and failed to mount a ketogenic response to low blood glucose
      concentrations. At birth, SGA preterm infants had lower mean blood glucose
      concentrations than AGA preterm infants (3.17 v 4.16 mmol/l), but there were few
      postnatal metabolic differences between the two groups. Mean blood glucose
      concentrations did not differ between AGA and SGA preterm infants. For variables
      that differed between the groups, multiple regression analysis suggested that
      both the degree and asymmetry of growth retardation were related to the severity
      of the metabolic abnormalities. These data suggest that, although there are early
      metabolic differences between SGA and AGA infants, it is possible that current
      clinical management is effective in preventing subsequent hypoglycaemia. This is
      important because of the failure of SGA infants to mount a ketogenic response.

PMID- 8466261
TI  - Hormonal and metabolic response to hypoglycaemia in small for gestational age
      infants.
AB  - Little is known of the ability of hypoglycaemic infants who are small for
      gestational age (SGA) to mount the coordinated hormonal and metabolic
      counterregulatory response that is seen in healthy older subjects during
      glycopenia. This response was studied in 22 SGA infants (birth weight < 10th
      centile) by measuring the blood concentrations of glucose, intermediary
      metabolites, and glucoregulatory hormones. Plasma non-esterified fatty acid and
      blood ketone body concentrations were low, even when blood glucose concentrations
      were low. Plasma insulin and glucagon varied widely (< 1.0-53.1 mU/l and 16.6
      87.1 pmol/l, respectively). Concentrations of noradrenaline and glucagon were
      raised, but cortisol and adrenaline were lower than those found in hypoglycaemic
      adults. There was no relationship between the concentration of any hormone and
      blood glucose concentration. We postulate that hypoglycaemia and the failure to
      mobilise alternative fuels in some SGA infants is secondary both to a poorly
      coordinated counterregulatory hormone response and to a peripheral insensitivity
      to the actions of the hormones. Those infants, who fail to mount a
      counterregulatory response, should be identified by accurate and reliable blood
      glucose monitoring, and an adequate exogenous supply of energy, either enteral or
      parenteral, should be ensured.

PMID- 8466262
TI  - The role of pancreatic insulin secretion in neonatal glucoregulation. I. Healthy
      term and preterm infants.
AB  - The glucoregulatory role of insulin in adult subjects is undisputed. However,
      less is known about the secretion of insulin and its actions in the neonatal
      period, either for healthy subjects, or for those at risk of disordered blood
      glucose homoeostasis. The relationships between blood glucose and plasma
      immunoreactive insulin concentrations were therefore examined in 52 healthy
      children (aged 1 month-10 years), 67 appropriate birth weight for gestational age
      (AGA) term infants, and 39 AGA preterm neonates. In children and AGA neonates,
      plasma immunoreactive insulin concentration was positively related to blood
      glucose concentration. However, although both groups of neonates had
      significantly lower blood glucose concentrations than children, plasma
      immunoreactive insulin concentrations were significantly higher in both term and
      preterm neonates, when compared with children. The variation in plasma
      immunoreactive insulin concentrations was greater for neonates than for children.
      These data suggest, that compared with older subjects, plasma immunoreactive
      insulin concentrations are high in newborn babies and that neonatal pancreatic
      insulin secretion is less closely linked to circulating blood glucose
      concentrations. There are important implications for the interpretation of
      studies in hypoglycaemic and hyperglycaemic neonates.

PMID- 8466263
TI  - The role of pancreatic insulin secretion in neonatal glucoregulation. II. Infants
      with disordered blood glucose homoeostasis.
AB  - Some neonates, such as those who are preterm or small for dates, become
      hypoglycaemic or hyperglycaemic. These disorders represent a failure of neonatal
      metabolic adaptation, but the underlying mechanisms are unclear. Data from
      studies of hypoglycaemic and hyperglycaemic infants were reviewed in the light of
      new data from studies of healthy neonates. Data from 28 neonates, who had
      disordered blood glucose homoeostasis, were analysed to determine the
      interrelationships between circulating concentrations of glucose, intermediary
      metabolites, glucagon and insulin, and glucose production rates. Blood glucose
      concentrations ranged from 2.5 to 26.1 mmol/l, and glucose production rates from
      0 to 19.2 mg/kg/min. Blood glucose concentrations were positively related to
      intravenous glucose infusion rates and to glucose production rates. A negative
      relationship existed between plasma glucagon and blood glucose concentrations,
      but there was a wide variation in plasma insulin levels at all blood glucose
      concentrations. No relationship between either plasma insulin or glucagon
      concentration and glucose production rate was shown. It is concluded that in
      neonates with disordered blood glucose homoeostasis, blood glucose concentration
      is influenced by the rate of administration of glucose, with less precise
      internal control mechanisms than older subjects. This emphasises the importance
      of blood glucose monitoring and careful prescribing of exogenous glucose by
      clinicians caring for such infants.

PMID- 8466264
TI  - Outcome at 8 years for children with birth weights of 1250 g or less.
AB  - The educational, motor, and behavioural performance of a hospital based cohort of
      51 children aged 8 years with birth weights of 1250 g or less is reported, as
      part of a longitudinal study. Compared with age, race and sex matched classmates,
      who were examined at school at the same visit, the very low birthweight (VLBW)
      group performed less well on the basic mathematics test A, the Schonell spelling
      test, and the test of motor impairment. Reading performance was also poorer in
      this group. Twenty three (45%) VLBW children were having difficulty with one or
      more school subjects compared with 11 (19%) controls, and 15 (26%) had
      difficulties in two or more areas, compared with three (5%) controls. Parents of
      VLBW children reported a similar frequency of behavioural problems to controls
      but teachers identified characteristics typical of emotional disorders and
      overactivity more frequently among the VLBW group. Motor testing at 6 years of
      age was the best predictor of school problems at 8 years, correctly identifying
      15/16 children with multiple problems with a low (33%) positive predictive value
      but a high (98%) negative predictive value. Children with birth weights of 1250 g
      or less and no major impairment have a high frequency of learning difficulties
      that become more apparent with advancing age. Such problems may be predicted at
      an earlier age by detailed motor testing.

PMID- 8466265
TI  - Double blind trial of recombinant human erythropoietin in preterm infants.
AB  - Twenty four infants between 27 and 33 weeks' gestation were recruited into a
      double blind study to investigate the use of recombinant human erythropoietin (r
      HuEpo) for the prevention of anaemia of prematurity. Between 50 and 150 U of r
      HuEpo (n = 16) or placebo was administered subcutaneously twice a week from 7
      days of age until discharge. There was a significant increase in the reticulocyte
      count in infants receiving r-HuEpo sustained from the second week of treatment
      until discharge compared with placebo. There was a reduction in the number of
      transfusions required in the r-HuEpo group with only 47% requiring a transfusion
      compared with 87% in the placebo group. During treatment with r-HuEpo there was a
      significant rise in the red cell folate concentration, a significant fall in the
      ferritin concentration, and a significantly higher percentage of haemoglobin F at
      discharge suggesting active erythropoiesis. The study provides strong evidence
      for the efficacy of r-HuEpo in stimulating erythropoiesis and reducing the
      requirement for transfusions for anaemia of prematurity.

PMID- 8466266
TI  - Relationship between vitamin K dependent coagulation factors and anticoagulants
      (protein C and protein S) in neonatal vitamin K deficiency.
AB  - To determine the relationship between vitamin K dependent coagulation factors and
      natural anticoagulants, namely protein C and protein S, in various degrees of
      vitamin K deficiency, plasma values for clotting activity, protein induced by
      vitamin K absence (PIVKA-II), protein C antigen, gamma-carboxy protein C antigen,
      and protein S antigen including total and free fractions and activity of protein
      C were measured in 66 full term and healthy breast fed neonates who did not
      receive vitamin K supplement at birth. The 66 neonates were divided into a
      control group (17 cases) and a low group (49 cases) according to their values for
      clotting activity--that is, > or = 20% or < 20% during the first six days of life
      -and vitamin K was immediately given when the neonates showed values < 20%. In
      the low group clotting activity gamma-carboxy protein C, free protein S, and
      protein C activity was significantly decreased to a minimum on day 2 or 3, and
      increased in parallel after vitamin K administration. Furthermore, they were
      positively correlated with one another and inversely cor-correlated with the
      PIVKA-II concentrations. These findings suggest that simultaneous gamma
      carboxylation of coagulation factors and proteins C and S acts to maintain both
      coagulation and anticoagulation activities in parallel at various concentrations
      of vitamin K. The breast milk intake in the group with low values of clotting
      activity was significantly lower than that in the control group during the first
      three days of life.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466267
TI  - Pulmonary artery pressure changes in the very low birthweight infant developing
      chronic lung disease.
AB  - Pulmonary artery pressure may be estimated non-invasively in the premature
      newborn infant because of its negative correlation with the time to peak
      velocity:right ventricular ejection time (TPV:RVET) ratio calculated from the
      pulmonary artery Doppler waveform. We studied 54 very low birthweight infants on
      days 1, 2, 3, 7, 14, 21, and 28 after birth. Thirty four infants developed
      chronic lung disease (CLD). Twenty did not and acted as controls. After
      correcting the TPV:RVET ratio for heart rate (TPV:RVET(c)), during the first 14
      days the TPV:RVET(c) ratio rose progressively in both groups suggesting a fall in
      pulmonary artery pressure. This occurred at a significantly slower rate in the
      CLD group. From days 14 to 28 there was a significant fall in the ratio in the
      CLD group only, suggesting an increase in pulmonary artery pressure. Using CLD as
      the end point, a TPV:RVET(c) ratio < 0.54 on day 7 had a predictive value of 78%
      (sensitivity 73%, specificity 65%). This rose to a predictive value of 97%
      (sensitivity 88%, specificity 95%) on day 28. The non-invasive assessment of
      pulmonary artery pressure may be useful in the early clinical management of the
      very low birthweight infant at risk of developing CLD.

PMID- 8466268
TI  - Long term trigger ventilation in neonatal respiratory distress syndrome.
AB  - Experience of using an SLE 2000 neonatal trigger ventilator as the sole means of
      ventilation in 68 infants with respiratory distress syndrome was reviewed. No
      death or complication was seen in 22 infants with a birth weight above 1500 g.
      Forty five infants under 1500 g birth weight including 18 infants between 23 and
      28 weeks' gestation were trigger ventilated throughout. Six infants died, four of
      whom were under 28 weeks' gestation. Two infants under 1500 g birth weight
      sustained a pneumothorax while being ventilated. Nine of 61 infants (15%) had
      radiological evidence of pulmonary interstitial emphysema, which was mild in
      seven infants. Intraventricular haemorrhage occurred in 10 babies under 1500 g,
      four of these being grade III or IV. Twenty two (48%) of the babies under 1500 g
      required added oxygen at 28 days. The preliminary clinical experience of this
      trigger ventilator suggests that it is capable of providing respiratory support
      from birth to extubation in even the most immature infants with respiratory
      distress syndrome. A controlled clinical trial is now required to compare the
      safety and efficacy of patient triggered ventilation with conventional neonatal
      ventilation.

PMID- 8466269
TI  - Factors associated with respiration induced variability in cerebral blood flow
      velocity.
AB  - A consecutive cohort of 73 very low birthweight infants was studied to determine
      the presence or absence of beat to beat variability in the velocity of blood flow
      in the cerebral circulation and its relation with respiration. One minute epochs
      of information included recordings of cerebral blood flow velocity estimated with
      Doppler ultrasound, blood pressure, spontaneous respiratory activity, and
      ventilator cycling. Fourier transformation was used to resolve the frequencies
      present within the one minute epochs and to classify the cerebral blood flow
      velocity as showing the presence or absence of any respiratory associated
      variability. A total of 249 recordings was made on days 1, 2, 3, and 7. Forty
      seven infants showed respiratory variability in cerebral blood flow velocity on
      97 occasions, usually during the first day of life. The infants with respiratory
      associated variability were of lower gestational age and when the respiratory
      associated variability was present they were more likely to be ventilated and
      receiving higher inspired oxygen; these associations were shown to be independent
      of gestational age. There was no significant independent association with brain
      injury, cerebral blood flow velocity (cm/s), or blood pressure (mm Hg). The
      findings suggest that artificial ventilation may entrain normal respiratory
      associated variability in the cerebral circulation but do not provide evidence
      that it is harmful.

PMID- 8466270
TI  - Development of bowel habit in preterm infants.
AB  - The bowel habits in 844 preterm infants were observed during the first 56 days
      after birth. Delay in the passage of meconium beyond the second day occurred in
      32%, and there was an inverse relation between gestational age and the day of
      first bowel action. Thereafter the increase in frequency of stools passed each
      day was related directly to the volume of milk ingested. Unfed infants had a
      modal defecation rate of one stool each day. For each 50 ml/kg increase in the
      volume of milk ingested the infants showed a further increase of one stool passed
      each day. Infants fed with human milk passed a greater number and softer stools
      than those who received cows' milk formula. In the absence of milk feeds an
      intrinsic pattern of large bowel motor activity, present as early as 25 weeks'
      gestation, ensures a defecation rate of one stool each day. The effect of enteral
      nutrition on this inherent motility is governed by the volume and composition of
      milk feeds, independently of gestational age.

PMID- 8466271
TI  - Influence of place of delivery on outcome in babies with gastroschisis.
AB  - In order to determine whether the elective delivery of babies with gastroschisis
      confers advantages in outcome, the case-notes of all babies referred to Bristol
      with gastroschisis over a 10 year period were reviewed. Various factors were
      compared between babies born in Bristol and those born elsewhere in the South
      West region. One neonate from the outborn group died after transfer to Bristol
      but otherwise there was no evidence that transfer and elective delivery in
      Bristol conferred any advantage. The important of effective resuscitation of
      outborn babies before transfer is emphasised and guidelines for resuscitation
      given.

PMID- 8466272
TI  - Resuscitation with intraosseous lines in neonatal units.

PMID- 8466273
TI  - Should we look after babies less than 800 g?

PMID- 8466274
TI  - The effectiveness and side effects of dexamethasone in preterm infants with
      bronchopulmonary dysplasia.

PMID- 8466275
TI  - Dr Ramazzini (1633-1714) and the occupational diseases of midwives and wet
      nurses.

PMID- 8466276
TI  - Metabolic acidosis in premature babies.

PMID- 8466277
TI  - Traumatic neonatal intracranial bleeding and stroke.

PMID- 8466278
TI  - Brain uptake of amino acids in intravenously fed preterm infants.

PMID- 8466279
TI  - Lymphokine profiles in contact sensitivity induced by dinitrofluorobenzene and
      tolerance induced by dinitrothiocyanobenzene.
AB  - We determined the lymphokines involved in the immune response to epicutaneously
      applied dinitrofluorobenzene (DNFB), a sensitizer, and dinitrothiocyanobenzene
      (DNTB), a tolerogen. Hapten-dependent T-cell proliferation and production of
      interleukin-2, interleukin-3 and interleukin-4 by lymph node cells (LNC) in mice
      painted with these cross-reactive haptens were measured by specific lymphokine
      assays. Proliferation of LNC in tolerized animals was lower than in sensitized
      mice. LNC from DNTB-treated mice produced lower amounts of interleukin-2,
      interleukin-3 and interleukin-4 than cells from DNFB-painted mice. These results
      may explain hapten-specific tolerance induced by DNTB which results in deficient
      production of both type 1 T-helper cell (Th1) and type 2 T-helper cell (Th2)
      lymphokines in response to hapten re-exposure. Deficient interleukin-4 production
      by cells from tolerized mice was corrected by the addition of exogenous
      interleukin-2. The suppressor function of adoptively transferred T cells from
      animals tolerized with dinitrothiocyanobenzene may be related to a shift in the
      balance of Th1 and Th2 lymphokines in favour of the latter, since recipient T
      cells might provide the source of interleukin-2 that induces interleukin-4
      production by donor T cells.

PMID- 8466280
TI  - Effects of tumor necrosis factor-alpha on connective tissue metabolism in normal
      and scleroderma fibroblast cultures.
AB  - Recent studies have demonstrated that tumor necrosis factor-alpha (TNF-alpha)
      selectively decreases production of collagens I and III, the major types of
      collagen in the dermis, and increases production of collagenase in cultured
      dermal fibroblasts. The effects of TNF-alpha on collagens I, III and VI,
      fibronectin and collagenase gene expression by fibroblasts derived from normal
      individuals and patients with systemic sclerosis (SSc) were studied. SSc is
      characterized by excessive accumulation of collagen in the skin and in certain
      organs. TNF-alpha inhibited collagen production and mRNA levels of collagens I
      and III and of fibronectin, and stimulated collagenase activity and collagenase
      mRNA levels in SSs fibroblasts. Levels of mRNA for alpha 1 (VI) and alpha 3 (VI)
      collagen and for beta-actin were unaltered in SSc fibroblasts incubated with TNF
      alpha. Similar results were observed for mRNA levels in normal fibroblasts
      incubated with TNF-alpha. These results suggest that TNF-alpha could be expected
      to be beneficial in the treatment of SSc. In addition, our results indicated that
      collagen-VI expression is regulated independently from expression of collagens I
      and III, and expression of fibronectin and collagens I and III are regulated in
      parallel in fibroblasts treated with TNF-alpha.

PMID- 8466281
TI  - Growth and differentiation stimuli induce different and distinct increases in
      intracellular free calcium in human keratinocytes.
AB  - The effect of growth and differentiation stimuli on intracellular free calcium
      ([Ca2+]i) in cultured human keratinocytes was investigated using micro
      spectrofluorimetric techniques and the calcium-sensitive dye FURA-2. The mean
      [Ca2+]i of keratinocytes in 70 microM calcium medium was 104 +/- 3 nM (mean +/-
      SEM), significantly lower than the transformed keratinocyte line SVK14 (128 +/- 2
      nM). When cultured in 2.0 mM calcium medium the [Ca2+]i increased in both normal
      and transformed keratinocytes to 135 +/- 4 nM and 180 +/- 4 nM, respectively.
      Keratinocytes grew more slowly in the absence of EGF, but [Ca2+]i was unaltered.
      Stimulation with EGF (10 ng/ml) induced, over 4 min, a large transient rise in
      [Ca2+]i up to 230 nm, due to an influx of extracellular calcium. Heterogeneity of
      keratinocytes was observed with 46% (n = 13) responding, but confluent or
      differentiated keratinocytes did not respond. TGF--beta (1 ng/ml) reduced cell
      growth without inducing differentiation and was not associated with any change in
      [Ca2+]i. The phorbol ester TPA (50 nM) induced irreversible growth arrest and
      terminal differentiation and increased the [Ca2+]i from 102 +/- 2 nM to 126 +/- 3
      nM at 2 h, an effect similar to that of 2 mM extracellular calcium. Addition of
      500 nM TPA was associated with a rise in [Ca2+]i, over several minutes to a
      plateau of 200-300 nM, due to release from internal stores and an influx of
      extracellular calcium. In normal human keratinocytes an increase in [Ca2+]i
      appears to be an early event in differentiation, whether induced by calcium or
      TPA, but not during growth inhibition without differentiation.

PMID- 8466282
TI  - Adrenal androgen abnormalities in women with late onset and persistent acne.
AB  - Androgens are an essential prerequisite for the development of acne. The present
      study was undertaken to characterize the androgen status of women with late onset
      and persistent acne only and, using the dexamethasone (dex) suppression test, to
      identify the source(s) of the androgen excess. We measured serum levels of total
      testosterone (T), free testosterone (FT), androstenedione (delta 4A),
      dihydrotestosterone (DHT), dehydroepiandrosterone sulphate (DHEA-S) and sex
      hormone binding globulin (SHBG) in 34 healthy control subjects, in 34 women with
      mild acne and in 29 women with moderate or severe acne. Serum FT, DHT and DHEA-S
      levels in patients of both acne groups were significantly higher than those in
      the control subjects. The other hormone levels showed no significant differences
      between patients and control subjects, and there were no significant differences
      between the two acne groups in any of the androgen levels. In order to evaluate
      the ovarian and adrenal contributions to serum androgens in the acne patients,
      the serum levels of delta 4A, T, DHT and DHEA-S were measured prior to and
      following 2 weeks of dex therapy. Following the dex test, the DHT and T of
      adrenal origin were significantly higher in the acne patients than in the control
      subjects. These results suggest that, in acne patients, hyperandrogenaemia is
      likely to develop as a result of adrenal androgen excess. In addition, since
      abnormally high androgen levels are frequently seen in late onset and persist
      acne, it seems that this condition is likely to be a sign of hyperandrogenism.

PMID- 8466283
TI  - Racial differences in the in vivo percutaneous absorption of some organic
      compounds: a comparison between black, Caucasian and Asian subjects.
AB  - Individual differences exist between patients, and, for topical therapy,
      differences in skin due to race may be a consideration. Pharmacological response
      depends upon the percutaneous absorption and the inherent activity of the
      chemical once absorbed into the biological system. Our objective was to determine
      the in vivo percutaneous absorption of three test chemicals in human subjects
      with Asian (A), black (B) and Caucasian (C) ethnic skin. Following a 30 min
      topical application on the upper outer arm of 1 mumol/cm2 14C-labeled chemical,
      percutaneous absorption was determined by both urinary excretion and the
      stripping technique. Amounts absorbed were: for benzoic acid 1.43 +/- 0.27% (SD)
      (A), 1.07 +/- 0.18% (B), 1.2 +/- 0.19% (C); for caffeine 1.06 +/- 0.17% (A), 1.01
      +/- 0.19% (B) and 0.96 +/- 0.12% (C); for acetylsalicylic acid 1.8 +/- 0.31% (A),
      1.59 +/- 0.31% (B) and 2.12 +/- 0.36% (C). No statistical difference (P > 0.05)
      was found in percutaneous absorption of benzoic acid, caffeine or acetylsalicylic
      acid between Asian, black and Caucasian subjects.

PMID- 8466284
TI  - Organ culture of human hair follicles in serum-free medium.
AB  - Human hair follicles were cultured in serum-free media at 31 degrees C in an
      atmosphere containing 95% O2 and 5% CO2. Results showed that the length of the
      cultured hair increased time dependently for 96 h. Histological findings revealed
      that the hair germinative cells maintained their normal morphology throughout the
      96 h culture period. DNA synthesis in the hair bulb also increased time
      dependently for 96 h. Autoradiographs of 3H-thymidine-labelled follicles
      indicated that they were localized in the germinative cells below Auber's
      critical line. The effects of minoxidil sulphate on DNA synthesis in this culture
      system were concentration dependent. Minoxidil sulphate at concentrations of 10(
      10), 10(-9) and 10(-8) M significantly increased DNA synthesis compared with DNA
      synthesis in the control medium. Autoradiographs of the follicles cultured in 10(
      10) M minoxidil sulphate showed that 3H-thymidine localized primarily in the
      germinative cells below Auber's critical line. These results suggest that this
      organ culture system may be useful for studying DNA synthesis by hair germinative
      cells in serum-free media.

PMID- 8466285
TI  - Bound lipids liberated by alkaline hydrolysis after exhaustive extraction of
      pulverized clavus.
AB  - In the present study, covalently bound lipids were found in clavus material and
      their lipid classes were determined by high-performance thin-layer chromatography
      (HPTLC). Clavus material, pulverized completely in a Mikro-Dismembrator II, was
      exhaustively extracted three times with chloroform/methanol (2:1, 1:1 and 1:2
      v/v) at 80 degrees C for 1 h each time and this sequence of extractions was
      repeated to obtain the unbound lipid-free residue which was saponified and then
      extracted with chloroform. The extract proved to comprise several bands of lipids
      covalently bound through an ester-like linkage. These were identified as free
      fatty acids, cholesterol, ceramides and glucocerebrosides by HPTLC. However,
      omega-hydroxy fatty acids were not detected in the lipids. To analyse the fatty
      acids amide-linked to the bound ceramides, the latter were isolated by
      preparative HPTLC and subjected to mild acid hydrolysis. Since the bound
      ceramides constituted neither omega-hydroxy fatty acids nor alpha-hydroxy fatty
      acids, they were not identified as hydroxyl-acylsphingosines.

PMID- 8466286
TI  - Casein kinase III activity in psoriasis.

PMID- 8466287
TI  - The relative contribution of individual polychlorinated biphenyls (PCBs),
      polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-p-furans
      (PCDFs) to toxic equivalent values derived for bulked human adipose tissue
      samples from Wales, United Kingdom.
AB  - Five bulked human adipose tissue samples were analyzed for individual
      polychlorinated biphenyl (PCB) congeners (including selected non-ortho
      substituted compounds) and polychlorinated dibenzo-p-dioxins and furans
      (PCDD/Fs). Mean sigma PCB and sigma PCDD/F (tetra-through octachlorinated
      homologues) concentrations were 0.75 microgram/g and 1.22 ng/g adipose tissue
      respectively. Both the congener patterns and levels detected were similar to
      those reported by laboratories in other industrialised countries. Each sample
      comprised of tissue taken from donors within a given locality. However, no
      obvious relationships were apparent between sampling area, absolute
      concentrations and congener pattern of PCBs and PCDD/Fs. The contribution of
      individual PCDD/F and non-ortho-(o), mono-o-, and di-o-substituted PCB congeners
      to the total calculated toxic equivalent values (sigma TEQ) was assessed for each
      sample. The main contributions to the sigma TEQ were the mono-o-substituted PCB
      congeners #118 (TEQ = 42.5 pg/g of lipid), #156 (TEQ = 24.8 pg/g) and #105 (TEQ =
      20.7 pg/g), followed by 1,2,3,6,7,8-HxCDD (TEQ = 18.2 pg/g), 2,3,4,7,8-P5CDF (TEQ
      = 12 pg/g), 1,2,3,7,8-P5CDD (TEQ = 11.5 pg/g), and the non-o-substituted PCB
      congener #126 (TEQ = 11.3 pg/g). Collectively, these compounds accounted for 80%
      of the sigma TEQ values. Based on the TEFs proposed by Safe (1990), the overall
      TEQs calculated for the monitored PCBs, were twice those due to sigma PCDD/Fs.

PMID- 8466288
TI  - In vitro effects of N-nitrosoatrazine on chromosome breakage.
AB  - Exposing human lymphocyte cultures to concentrations of N-nitrosoatrazine (NNAT)
      as low as 0.0001 microgram/ml results in significant elevations in chromosome
      breakage as well as an increased mitotic index. In contrast, 1,000-10,000-fold
      greater concentrations of nitrates, nitrites, and/or atrazine was required to
      produce comparable chromosome damage and, in those cases where the mitotic index
      was affected, it was decreased. Simultaneous administration of nitrates or
      nitrites with atrazine caused less chromosome damage than low concentrations of
      NNAT without affecting the mitotic index, illustrating that metabolic conversion
      of contaminants with minimal genotoxicity can give rise to compounds such as NNAT
      which are even more genotoxic.

PMID- 8466289
TI  - The effect of industrial pollution on mercury levels in water, soil, and sludge
      in the coastal area of Motril, southeast Spain.
AB  - The total concentration of mercury was determined in samples of water, soil and
      sludge from the Mediterranean coastal area of Southeast Spain (Motril), where Hg
      contamination is produced primarily by a local paper mill. Samples were taken at
      surface level in a 5 Km radius from the factory. The total Hg concentrations
      varied from 0.117 to 0.760 microgram/g in soil and sludge, and from ND to 2.088
      micrograms/L in water. A negative correlation was observed between the distance
      of the sampling station from the mill and the concentration of Hg in the soil and
      sludge samples. Similarly, an increase in Hg concentration was observed in the
      freshwater and wastewater after passing close to the factory.

PMID- 8466291
TI  - Coplanar polychlorinated biphenyl congener levels and patterns and the
      identification of separate populations of harbor seals (Phoca vitulina) in
      Denmark.
AB  - Blubber samples from 21 harbor seals (Phoca vitulina), found dead on Danish
      beaches during the morbilli virus epidemic in 1988, have been analyzed for toxic
      coplanar chlorinated biphenyl (CB) congeners. The 21 samples consist of seven
      samples from 1-2-year-old animals (both males and females) from each of three
      geographical separate locations: The Limfjord, the Kattegat, and the Wadden Sea.
      The level of the CBs, defined as the sum of all the measured CB congeners, were
      highest in the samples from the Wadden Sea and lowest in the Limfjord samples.
      The quotient between highest level and lowest level was 4. Toxic equivalency
      factors given by Safe (1990) was used for calculation of the contribution to
      dioxin-like toxicity from the coplanar CB congeners, and the result was compared
      to literature data on polychlorinated dibenzo-p-dioxins and -dibenzofurans in
      harbor seal. CB congeners CB-118, CB-156, CB-157, and CB-105 were major
      contributors to sigma TEQ in all samples. The patterns of polychlorinated
      biphenyl congeners in harbor seals from the three locations were compared by
      principal component analysis. The two first principal components could separate
      the samples in groups corresponding to each of the three geographical locations.
      The geographical and biological variations were estimated from the data. It was
      shown, that the geographical variation was the largest. Possible reasons behind
      the geographical variation in CB congener patterns are discussed.

PMID- 8466290
TI  - The growth response of the green alga Chlorella vulgaris to combined divalent
      cation exposure.
AB  - Using the growth response of the green alga Chlorella vulgaris as a model system,
      the effects of combinations of the environmentally active cations Cd, Co, and Cu
      were evaluated. The 96-h static EC50 for these cations to C. vulgaris were,
      respectively, 0.89 microM, 9.0 microM, and 2.8 microM, yielding a toxicity series
      such that Cd > Cu > Co. The cation combinations of Cd + Cu, and Cu + Co acted
      synergistically, while Cd + Co, and the tri-metallic combination Cd + Cu + Co
      resulted in antagonistic interactions. Examination of these toxic combinations at
      24, 48, 72, and 96 h indicate that the cellular response is not a uniform one.
      Failure of energy dispersive X-ray spectrophotometric analysis to demonstrate any
      intracellular incorporation of these cations (except for a weak cytoplasmic Cu
      peak at the 8.0 KEV position) suggests that the toxic actions of these cations at
      EC50 concentrations are exerted at the level of the plasma membrane.

PMID- 8466292
TI  - Effects of air pollution on passerine birds and small mammals.
AB  - The effects produced by emissions from coal-fired power plants, including mainly
      SO2, NOx and particulates, on natural populations and caged specimens of birds
      and small mammals were studied. The field-captured species used to evaluate these
      effects were passerine birds: Parus major (coal tit) and Emberiza cia (rock
      bunting), and the rodent Apodemus sylvaticus (wood mouse). In parallel to this
      study on animals captured in the field, we used other animals, Mus musculus
      (house mouse) and Carduelis carduelis (goldfinch) which were placed in cages near
      the source of pollution. Some of the animals were killed and their tracheas were
      removed and prepared for conventional optic studies (1000x) and electron
      microscopy (TEM and SEM). The results show that atmospheric air pollutants from
      coal-fired power plants produce alterations in the tracheal epithelium. In
      passerine birds, an increase in the mucus which covers the tracheal epithelium,
      shortening of the cilia, and increase in the number of secretory granules and
      vesicles were observed. In mammals, variation of the uniformity of the
      pseudostratified epithelium with a wide stratum of mucus, shortening of the
      cilia, and increase in the number of secretory granules were observed.

PMID- 8466293
TI  - Effects of organic fertilizers on aldicarb soil biodegradation in sugar beet
      crops.
AB  - In the present work, the influences of several organic fertilizer treatment
      regimens were compared as to their slowing down effect on aldicarb soil
      metabolism in a sugar beet crop. The organic fertilizers treatment schemes had
      been repeatedly applied in the past 30 years, according to a 3-year rotation
      cycle. The following organic fertilizers treatment regimens--which are the main
      ones used in the agronomy practice--were compared: Treatment 1: no organic
      fertilizer at all; treatment 2: 40 tons cow manure ha-1; treatment 3: 40 tons pig
      slurry ha-1 + green manure + crop wastes; treatment 4: green manure + crop
      wastes; treatment 5: straw cereal wastes alone. A sugar beet crop was sown in
      April 1991, 1 kg aldicarb ha-1 being applied in granulates in the sowing furrow.
      During the 2.9 first crop months, the soil half-lives of the sum of the
      insecticide S(-)+SO(-)+SO2-aldicarb in the sowing line in the 0-25 cm surface
      soil layer were 21.6, 44.4, 39.6, 35.7, and 30.3 days in the treatments 1, 2, 3,
      4, and 5 treated plots, respectively. The organic fertilizers soil treatments
      thus increased the persistence of the total insecticide compounds soil
      concentrations, and probably also the insecticide protection efficiencies.
      Comparison of the results obtained here with the ones previously obtained with
      other crop trials, herbicides and soil insecticides, suggests that the soil
      organic matter is the most efficient to slow down the insecticides soil
      biodegradation, compared to the old humus originating from the organic
      fertilizers treatments made more than one year ago.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466294
TI  - Family pesticide use and childhood brain cancer.
AB  - The relationship between family pesticide use and childhood brain cancer was
      examined in a case-control study. Telephone interviews were conducted from June
      1989 through March 1990 with the natural mothers of 45 childhood brain cancer
      cases, 85 friend controls, and 108 cancer controls. In comparisons to friend
      controls, significant positive associations were observed for use of pesticides
      to control nuisance pests in the home, no-pest-strips in the home, pesticides to
      control termites, Kwell shampoo, flea collars on pets, diazinon in the garden or
      orchard, and herbicides to control weeds in the yard. In comparisons to cancer
      controls, significant positive associations were observed for use of pesticide
      bombs in the home, pesticides to control termites, flea collars on pets,
      insecticides in the garden or orchard, carbaryl in the garden or orchard, and
      herbicides to control weeds in the yard. In general, positive associations in
      comparisons to one control group were supported by elevated odds ratios in
      comparisons to the other control group. Several potentially important
      associations were identified in this study. However, small sample sizes,
      potential recall bias, multiple comparisons, and lack of detailed exposure
      verification require further research to confirm these findings.

PMID- 8466295
TI  - Factors affecting inter-individual variation in human plasma cholinesterase
      activity: body weight, height, sex, genetic polymorphism and age.
AB  - The influence of body weight, height, age and sex on plasma cholinesterase
      activity (ChE) in 650 males and 437 females with ChE-1 phenotype U (genotype
      ChEuChEu or ChEuChEs) or UA (genotype ChEuChEa) was studied in a multiple
      regression model. ChE was not influenced by age (p > 0.01), but, like other liver
      synthesized plasma enzymes, highly (p < 0.001) influenced by body weight and
      height. In a logarithmic scale ChE followed a linear model (R = 0.535, p < 0.001)
      with randomly distributed residuals, InChE = 3.286-0.308 x ChE-1 phenotype-0.104
      x sex + 0.00765 x weight - 0.00723 x height (U = 1, UA = 2; male = 1, female = 2;
      kg; cm). A simplified model based on body-mass index (BMI = weight divided by
      squared height, kg/m2), InCHE = 2.016-0.308 x ChE-1 phenotype - 0.091 x sex +
      0.0230 x BMI, showed the same goodness-of-fit (R = 0.533). In a non-logarithmic
      scale both multiple regression models failed to fit cases with high ChE activity.
      A model for a 'standardized' plasma ChE in which the effects of ChE-1 phenotype,
      sex, body weight and height are eliminated, is proposed to compare ChE in
      unmatched population groups when using this enzyme activity as a biomarker in
      environmental or occupational medicine.

PMID- 8466296
TI  - Measurements of year-long exposure to tree nursery workers using multiple
      pesticides.
AB  - A year-long nurseryworker pesticide exposure study was designed to measure and
      evaluate the exposure occurring to workers who had the potential for simultaneous
      exposure to multiple pesticides. This four-State study was conducted in five
      nurseries (four USDA Forest Service and one State) involved in conifer seedling
      production. Primary comparisons were made among nursery workers in the Pacific
      northwest and south central United States. Worker exposure was assessed by using
      patches attached to clothing, handrinse samples and urine excreted from
      potentially exposed workers. In addition, dislodgeable residue in rinsate from a
      water wash of pesticide-treated seedlings was also evaluated. Four different
      groups of field workers, designated as applicators, weeders, scouts and packers,
      were included. The pesticide absorbed dose, assessed by urine analysis of
      pesticide metabolites and the deposition of pesticide on patches attached to the
      clothing of field workers, was monitored as they performed their duties under
      normal conditions (e.g., typical clothing, pesticide application). Monitoring was
      performed for the 14 different pesticides which were used in these nurseries.
      Seven pesticides were studied in more detail using biological monitoring. For
      these compounds, metabolites known to be excreted in the urine of exposed humans
      or other mammals were used to estimate the dose of pesticide absorbed by the
      exposed workers. The highest percentage of positive samples came from
      dislodgeable residue samples (8.3%) followed by patch samples (3.2%), handrinse
      (2.9%), and urine samples (1.3%). To summarize the conclusions from the urinary
      excretion data, 12 of the 73 nursery workers in the study received a low absorbed
      dose of pesticide. Biological monitoring revealed that three pesticides (benomyl,
      bifenox and carbaryl) were found in the urine of some of the workers. Of the
      3,134 urine samples analyzed there were 42 positive; 11 urine samples were
      positive for benomyl, while bifenox was responsible for 13 positives and carbaryl
      accounted for the remaining 18. The 12-week continuous monitoring of urine showed
      that metabolites of these materials were rapidly excreted; thus, no build-up in
      the body is anticipated. Margins of Safety (MOS) calculations were made to
      provide an assessment of the significance of the exposure. Based on the low
      frequency of positive urine samples in the study, the low levels of metabolites
      when they were found, their apparent rapid excretion rate and the No Observed
      Effect Level (NOEL) data, furnished from other sources, nursery worker exposure
      to pesticides in these conifer nurseries is below health threatening levels.

PMID- 8466298
TI  - Toxicological assessment of biodegraded pentachlorophenol: Microtox and fish
      embryos.
AB  - A Gram-negative bacterium, Pseudomonas sp. strain SR3, was isolated from soil at
      a former wood treatment plant in north central Florida. The ability of this
      bacterium to degrade pentachlorophenol (PCP) was confirmed by growing cells in a
      basal salts medium in which PCP was the only source of carbon and energy.
      Degradation from a measured concentration of 39-40 micrograms PCP/ml to 0.0006
      micrograms PCP/ml was observed within 120 h of incubation in the presence of PCP
      induced cells of Pseudomonas sp. strain SR3. The initial cell density in these
      cultures was 6 x 10(6) cfu/ml. Microtox 5 min EC50 toxicity tests revealed that
      aqueous solutions of PCP, measured concentrations 39-40 micrograms/ml were toxic
      but that final biodegraded samples, 0.0006 micrograms PCP/ml were nontoxic.
      However, bioassays with embryonic inland silversides, Menidia beryllina, showed
      that the biodegraded samples were embryotoxic or teratogenic. Water containing
      added PCP at concentrations up to 30 times higher than measured in the final
      biodegraded samples was less toxic/teratogenic. These results indicate that while
      biodegradation of PCP was nearly complete, intermediate metabolites of the
      degradation process or undegraded impurities in PCP were toxic or teratogenic.
      Thus, the M. beryllina bioassay allows extremely sensitive assessment of toxicity
      associated with biodegraded environmental pollutants and may be a useful
      criterion for determining whether bioremediated water or soil is safe for
      discharge back into the environment.

PMID- 8466297
TI  - The reproductive effects of dietary heptachlor in mink (Mustela vison).
AB  - Adult female mink were fed diets containing 0 (control), 6.25, 12.5, and 25 ppm
      (micrograms/g) technical grade heptachlor prior to and throughout the
      reproductive period (181 days) to evaluate the effects of heptachlor consumption
      on reproduction and offspring viability and to assess the extent of placental and
      mammary transfer of heptachlor epoxide to mink offspring. Feeding 12.5 and 25 ppm
      resulted in significant reductions in feed consumption and body weights of female
      mink. Mortality was 0, 8, 67, and 100% for the control, 6.25, 12.5, and 25 ppm
      groups, respectively. All females in the 25 ppm group died within 88 days. Mink
      fed the two higher heptachlor diets displayed clinical signs indicative of
      central nervous system involvement just prior to death. Females were mated with
      males on the same dietary treatments. Whelping success rates were 67, 83, 27, and
      0% for the control, 6.25, 12.5, and 25 ppm groups, respectively. High mortality
      in the 12.5 and 25 ppm groups accounted for the lack of reproductive success.
      Gestation length, litter size and birth weight of kits were not significantly
      affected by adult female consumption of 6.25 ppm heptachlor while kits helped by
      females on the 12.5 ppm diet weighed significantly less than control kits at
      birth. Survival of kits in the 12.5 ppm group from birth to three weeks of age
      was also adversely affected. At three and six weeks of age, kit body weights in
      both the 6.25 and 12.5 ppm groups were significantly less than body weights in
      control kits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466299
TI  - Oxidative stress in fish cells: in vitro studies.
AB  - Bluegill sunfish BF-2 fibroblasts were used in the neutral red (NR) cytotoxicity
      assay to discern the toxicities of hydrogen peroxide (H2O2) and paraquat as
      indicated by their abilities to induce oxidative stress. The toxicity of H2O2 was
      markedly enhanced in BF-2 cells treated with the glutathione depleting agents,
      buthionine sulfoximine (BSO), maleic acid, and chlorodinitrobenzene; similar
      treatments did not sensitize the BF-2 cells to paraquat, a redox cycling
      xenobiotic. BSO treated BF-2 cells, however, were sensitized to nitrofurantoin,
      also a redox cycling chemical. Diethyldithiocarbamate, an inhibitor of superoxide
      dismutase, only weakly enhanced the sensitivity of the BF-2 cells to H2O2 and
      paraquat. 1,10-Phenanthroline, a chelator of Fe2+, reduced the cytotoxicity of
      H2O2 and paraquat, presumably by preventing hydroxyl radical formation in the
      Fenton reaction. Quin 2 AM, an intracellular chelator of Ca2+, markedly lessened
      the toxicity of H2O2, but not of paraquat; EGTA, an extracellular chelator of
      Ca2+, had no effect on the toxicity of H2O2 or paraquat. Apparently, perturbation
      of intracellular Ca2+ homeostasis is involved in H2O2 toxicity. For comparative
      purposes, some studies were performed with fathead minnow FHM epithelioid cells,
      BALB/c mouse 3T3 fibroblasts, and human HepG2 hepatoma cells. The BF-2
      fibroblast/NR cytotoxicity red assay was shown to be a suitable model to study
      oxidative stress in fish.

PMID- 8466300
TI  - Cadmium, copper and lead in wild rice from central Canada.
AB  - Samples of wild rice grains available for sale in Manitoba, Canada contained <
      0.01-6.2 micrograms/g cadmium, < 0.01-6.7 micrograms/g lead, and 1.6-14.4
      micrograms/g copper. Rice originating from Saskatchewan and northern Manitoba
      contained significantly higher copper concentrations than samples from Ontario
      and southeastern Manitoba. Larger and heavier grains contained higher lead
      concentrations per unit weight. Mean content of all three metals per individual
      grain was exponentially correlated with grain size and weight. Total soluble
      carbohydrate and soluble protein concentrations were negatively correlated with
      copper concentrations.

PMID- 8466301
TI  - Levels of environmental pollutants in flounder (Platichthys flesus L.) and cod
      (Gadus morhua L.) caught in the waterway of Glomma, Norway. II. Mercury and
      arsenic.
AB  - The present study is a survey on mercury and arsenic pollution in two sedentary
      fish species stationed in or close to the Glomma estuary in the Hvaler
      archipelago, Norway. Mercury and arsenic were determined individually in 80
      flounder (Platichthys flesus L.) and 100 cod (Gadus morhua L.). The fish were
      caught at five different localities near or in the relatively polluted Glomma
      estuary. There were significantly higher mercury and arsenic concentrations in
      fillets of flounder than in fillets of cod (wet weight), 0.15 vs. 0.08 mg/kg and
      5.2 vs. 4.1 mg/kg, respectively. Seasonal variation in mercury concentration was
      only found in flounder, with a significantly higher level in spring than in
      autumn. A significant increase in mercury content with increasing age was found
      for both species. For cod, a significantly higher arsenic level was found on the
      outer stations as compared to the inner stations, while arsenic levels in
      flounder was less dependent on sampling site.

PMID- 8466302
TI  - Effects of fasting on distribution and excretion of lead following long-term lead
      exposure in rats.
AB  - Lead was given to rats through drinking water containing 100 ppm lead acetate for
      20 days. Delta-aminolevulinic acid dehydratase (ALAD) activity in erythrocytes
      was significantly lower (p < 0.05) at 20 days after Pb treatment. Erythrocytic
      ALAD activity was significantly lower (p < 0.05) in fasted rats than in fed rats
      with or without Pb pretreatment. Serum glutamic pyruvic transaminase and glutamic
      oxaloacetic transaminase activities after 6 days of fasting were significantly
      higher (p < 0.05) in Pb pretreated rats than in other groups (Pb nontreated fed
      and fasted rats, and Pb pretreated fed rats). Long periods of fasting strongly
      enhanced these serum-enzymes elevations induced by lead. Maximum Pb
      concentrations and total amount in feces increased in rats fasted for 3 days
      regardless of Pb pretreatment. On the other hand, total amount of Pb in feces of
      rats fasted for 6 days were not significantly different from the other groups
      because their fecal volume decreased to about 1% of fed rats. The Pb
      concentrations of liver, kidney, spleen, and femur increased significantly in Pb
      pretreated rats compared to in controls, but there were no significant
      differences between the fed and fasted rats.

PMID- 8466304
TI  - Ileal pouch-anal anastomosis for ulcerative colitis associated with primary
      sclerosing cholangitis.

PMID- 8466303
TI  - Effects of diethylene glycol monomethyl ether on pregnancy and postnatal
      development in rats.
AB  - The effects of oral treatment of Wistar rats with diethylene glycol monomethyl
      ether (diEGME) were examined. In a preliminary dose-finding study with non
      pregnant rats, diEGME treatment at doses up to 4,000 mg/kg/day on 11 consecutive
      days decreased relative weights of thymus and pituitary gland, white and red
      blood cell counts, hemoglobin concentrations and hematocrit levels. In pregnant
      rats, treatment at doses of > 3,000 mg/kg/day (over gestation days 7-17) caused
      total resorption of all litters. In teratology and postnatal studies, pregnant
      rats were treated with diEGME at doses of 0, 200, 600, and 1,800 mg/kg/day from
      day 7 through 17 of gestation. At 200 mg/kg, there were no adverse effects on
      either dams, fetuses, or neonates. At 600 mg/kg, dams were not affected, but
      fetal body weights were decreased, and fetal thymus and ossification were
      adversely affected. At 1,800 mg/kg, maternal thymus weights and food consumption
      were decreased, and visceral malformations of the cardiovascular system were seen
      in 28.0% of the fetuses. Only 6.3% of the pups delivered by dams treated with
      1,800 mg/kg of diEGME survived for 4 days after birth. Thus, diEGME was
      teratogenic in Wistar rats, but the spectrum differed from that in Sprague-Dawley
      rats. In addition to teratogenicity, diEGME had significant adverse effects on
      postnatal development. The most sensitive organ to diEGME was the thymus in both
      dams and fetuses.

PMID- 8466305
TI  - Complications and risk factors after ileal pouch-anal anastomosis for ulcerative
      colitis associated with primary sclerosing cholangitis.
AB  - OBJECTIVE: This study determined predictive factors for postoperative
      complications and outcome after ileal pouch-anal anastomosis in patients with
      ulcerative colitis and primary sclerosing cholangitis. SUMMARY BACKGROUND DATA:
      Patients with ulcerative colitis and primary sclerosing cholangitis treated by
      colectomy and ileostomy are at high risk of troublesome bleeding from peristomal
      varices. METHODS: Postoperative complications and outcome were assessed in 40
      patients with ulcerative colitis and sclerosing cholangitis who received an ileal
      pouch-anal anastomosis between January 1981 and February 1990. RESULTS: Immediate
      postoperative and remote ileoanal anastomosis-related complications were high but
      related directly to the severity of liver disease. No patient had perianastomotic
      anal bleeding. CONCLUSIONS: In patients with both ulcerative colitis and primary
      sclerosing cholangitis, ileal pouch-anal anastomosis is safe and is not
      associated with perianastomotic bleeding.

PMID- 8466306
TI  - Early and long-term effects of colectomy and endorectal pullthrough on bile acid
      profile.
AB  - OBJECTIVE: Although total colectomy with mucosal proctectomy and endorectal
      pullthrough affects two sites critical to the enterohepatic circulation of bile
      acids, little information is available regarding the manner in which normal
      digestive physiology is altered by these procedures. This study defines the early
      and long-term effects of colectomy and endorectal pullthrough on bile acid
      profile and the long-term effects on biliary lipid metabolism. SUMMARY BACKGROUND
      DATA: Specific changes in bile acid absorption have been reported in patients
      after ileal resection. Recent studies from our laboratory indicate that in the
      early postoperative period, colectomy with endorectal pullthrough causes a
      significant decrease in gallbladder bile concentrations of total bile acids,
      cholesterol, phospholipids, and calcium. The observation by several authors that
      the pouch undergoes morphologic and perhaps functional adaptation suggest that
      these changes may be transient and perhaps reversible. METHODS: These studies
      were done in an awake, unanesthetized canine model that allows periodic sampling
      of gallbladder bile without creation of an external biliary fistula and its
      associated sequelae. Animals were ultimately randomly assigned to either
      laparotomy and gallbladder cannulation (N = 6), or gallbladder cannulation with
      total colectomy and ileorectal anastomosis (N = 7), or biliary cannulation,
      colectomy, mucosal proctectomy and endorectal pullthrough with ileal reservoir (N
      = 5). RESULTS: Six weeks after operation, colectomy and ileorectal anastomosis
      were associated with a significant alteration in the relative composition of bile
      acids in gallbladder bile. These early changes were manifested by a significant
      (p < 0.05) increase in taurocholic acid and a concomitant decrease in
      taurodeoxycholic acid. These changes became even more pronounced in the
      ileorectal anastomosis group 12 weeks after colectomy and ileorectostomy.
      Although similar changes in the relative concentrations of individual bile acids
      occurred in the 6-week endorectal animals, bile acid profile was restored to
      normal by 12 weeks. CONCLUSIONS: Colectomy with ileorectal anastomosis leads to
      early and significant changes in bile acid profile, which persist and become even
      more pronounced with time. In contrast, the construction of an ileal reservoir
      after colectomy facilitates restoration of a normal bile acid profile. We propose
      that these alterations in bile acid metabolism result from adaptation of the
      ileal reservoir as its mucosa assumes functional characteristics of normal colon.

PMID- 8466307
TI  - Nissen fundoplication for reflux esophagitis. Long-term clinical and endoscopic
      results in 109 of 127 consecutive patients.
AB  - OBJECTIVE: This study evaluates the clinical and endoscopic long-term results of
      Nissen fundoplication in reflux esophagitis. SUMMARY BACKGROUND DATA: Nissen
      fundoplication has been reported to give good results in the treatment of
      gastroesophageal reflux with success rates up to 78-97%. Most of the previous
      studies on long-term results of fundoplication have, however, been based on
      interviews with only sporadic endoscopic examinations. METHODS: Of 127 patients
      consecutively treated with Nissen fundoplication for reflux esophagitis, 109 were
      available for follow-up after a median of 77 months. Upper gastrointestinal
      endoscopy was done in 105 cases, and all the patients with reflux symptoms or
      abnormal endoscopic observations were referred to esophageal 24-hour pH
      monitoring and manometry. RESULTS: No symptoms of gastroesophageal reflux were
      reported by 73 of the 109 patients, but dysphagia was present in 47. Endoscopy
      showed defective fundic wrap in 24 patients. Objective evidence of reflux was
      found in 24 patients (endoscopic esophagitis in 18 and pathologic 24-hour pH
      score without esophagitis in 6). Esophagitis was found in 14 of the 24 patients
      with defective wrap, but in only 4 of the 81 with infact wrap. CONCLUSIONS:
      Nissen fundoplication alleviated symptoms of gastroesophageal reflux and cured
      esophagitis in great majority of cases. The main determinant of outcome was the
      state of the fundic wrap.

PMID- 8466308
TI  - Peptic ulcer surgery in patients with liver cirrhosis.
AB  - OBJECTIVE: This study identified risk factors of surgical treatment for
      gastroduodenal ulcer disease in patients with liver cirrhosis. SUMMARY BACKGROUND
      DATA: Liver cirrhosis is frequently associated with complicated peptic ulcer
      disease. Surgery in liver cirrhotics has a high mortality and morbidity
      especially when abdominal operations are performed. METHODS: Sixty-nine patients
      undergoing surgery for gastroduodenal ulcer disease between 1972 and 1991 were
      studied, retrospectively. RESULTS: Ninety percent of patients required emergency
      surgery for bleeding ulcer (n = 45) or perforation (n = 17). Mortality was 29%
      for elective patients (n = 7), 35% for patients with perforation and 64% for
      patients with bleeding. Overall mortality of 69 patients was 54%. Only 15 of 69
      patients (22%) had an uncomplicated postoperative course. Postoperative bleeding,
      septic complications, and renal failure were the most frequent postoperative
      complications. Bleeding and multiple organ failure were the leading causes of
      death in 70% of patients. A univariate analysis determined preoperative
      hemoglobin < 12 g/L (p < 0.05), systolic blood pressure < 100 mm Hg (p < 0.025),
      prothrombin time < 60% (p < 0.05) and the presence of portal hypertension (p <
      0.01) as prognostic factors. No significant correlation with survival could be
      established for excretory liver function (serum bilirubin) and partial
      thromboplastin time. CONCLUSIONS: To improve treatment results it is recommended
      (1) to substitute blood products (particularly coagulation factors) early and in
      sufficient quantities, (2) to diligently search for and to treat septic foci and
      administer antibiotics in a nonrestrictive manner, and (3) to restrict the
      operative procedure to the treatment required for control of the ulcer
      complication.

PMID- 8466310
TI  - Fetal wound healing. The ontogeny of scar formation in the non-human primate.
AB  - OBJECTIVE: This study determined how scar formation develops in a non-human
      primate model of fetal skin repair. SUMMARY BACKGROUND DATA: A transition from
      healing scarlessly to healing with scar formation characterizes skin repair in
      rat and sheep fetuses. New knowledge of the regulatory processes occurring in the
      fetal wound at the initial stages of scar formation may provide insights into the
      early mechanisms of scar formation. METHODS: Full-thickness wounds were made in
      fetal rhesus monkey lips from 75 through 114 days gestation (n = 6, term = 165
      days). Wounds were harvested at 14 days postwounding and processed for histology
      (hematoxylin & eosin, Masson's trichrome) as well as immunohistochemistry (human
      type I or type III collagen). RESULTS: Wounds healed with complete restoration of
      normal tissue architecture in the 75-day gestation fetus. However in the 85-100
      day gestation fetuses, wounds healed with an absence of hair follicles and
      sebaceous glands, but the dermal collagen pattern remained reticular and similar
      to that in unwounded dermis. At 107 days, a thin scar was present in the wound,
      thereby demonstrating a transition to scar formation between 100 and 107 days
      gestation (early 3rd trimester) in the non-human primate. CONCLUSIONS: In the non
      human primate fetus, a transition from scarless repair to adult-type repair with
      scar formation occurs in the early third trimester. These data provide insight
      into the transition process; the ontogeny of scar formation is characterized
      initially by wounds healing without the presence of epidermal appendages but with
      a normal reticular dermal collagen pattern, which we term the "transition wound."

PMID- 8466309
TI  - Carcinoid tumors of the appendix.
AB  - OBJECTIVE: A retrospective study of 41 patients with histologically confirmed
      diagnosis of appendix carcinoid tumors was undertaken by reviewing the surgical
      records at Massachusetts General Hospital. METHODS: There were 8 male and 33
      female patients (mean age 32 years). Twenty-two patients (54%) presented with
      signs and symptoms suggestive of acute appendicitis. In 19 patients (46%) the
      lesions were discovered incidentally. The tumors were located in 32 patients at
      the tip, in 6 patients in the middle third, and in 3 patients at the base of the
      appendix. The tumor was less than 1 cm in diameter in 32 patients, between 1 and
      2 cm in 7 patients, and was bigger than 2 cm in 2 patients. In 29 patients, the
      depth of tumor penetration was confined to the submucosa or to the muscle layers
      of the appendix, and in 8 patients the serosa was involved. In 4 patients,
      evidence of tumor extension into the meso-appendicular fat was present, including
      one patient with a tumor bigger than 2 cm and local lymph-node metastases. Forty
      patients underwent appendectomy alone. One patient with a tumor size bigger than
      2 cm in diameter with positive lymph nodes in the mesoappendix underwent
      secondary right hemicolectomy. Complete follow-up was achieved in 35 patients,
      and all patients remained free of tumor recurrence. CONCLUSIONS: The authors
      conclude that appendiceal carcinoids are rare and most often are asymptomatic.
      Tumors of less than 1 cm are adequately managed by appendectomy alone. The
      appropriate treatment for tumors of 1 to 2 cm continues to be controversial.
      Right hemicolectomy is recommended for all tumors larger than 2 cm, whereas
      preference for an aggressive approach should be given in young patients.

PMID- 8466311
TI  - Collagen synthesis in intact skin is suppressed during wound healing.
AB  - OBJECTIVE: Simultaneous monitoring of total collagen synthesis as well as
      synthesis in intact skin and in the wound to verify the higher priority of wound
      healing after surgery. SUMMARY BACKGROUND DATA: Synthesis of acute phase proteins
      is stimulated by surgical trauma. At the same time, production of albumin is
      inhibited and there is a net catabolism of skeletal muscle proteins. Similarly,
      the authors have found a transient inhibition of total collagen synthesis after
      surgery. The authors hypothesized a lower priority in synthesis of structural and
      peripheral collagen for the benefit of wound healing. METHODS: The concentrations
      of the carboxyterminal propeptide of type I procollagen (PICP) and the
      aminoterminal propeptide of type III procollagen (PIIINP) were measured in
      suction blister fluid of intact skin and in wound fluid in ten surgical patients.
      PICP and PIIINP concentrations in serum were also measured. Specific
      radioimmunoassays were used. RESULTS: In peripheral skin, the median preoperative
      concentrations of PICP and PIIINP were 228 and 140 micrograms/L, respectively. On
      postoperative days 1, 2, 4 and 7, the median concentration of PICP was 145 (p =
      0.01, Wilcoxon signed rank sum test), 102 (0.02), 159 (0.03), and 152 (0.06)
      micrograms/L, respectively. The postoperative medians of PIIINP were 68 (p =
      0.17), 76 (0.04), 66 (0.06), and 56 (0.03) micrograms/L, respectively. At the
      same time, collagen synthesis in the wound increased dramatically from the second
      day on. After an initial decrease, propeptide concentrations in serum gradually
      increased from the fourth day on. CONCLUSIONS: Collagen synthesis is regulated
      for the benefit of the wound during the acute phase response.

PMID- 8466312
TI  - Physiologic study of bile salt and lipid secretion in rats after liver
      transplantation.
AB  - OBJECTIVE: This experiment determined the effects of liver transplantation on
      bile salt kinetics and biliary lipid secretion. SUMMARY BACKGROUND DATA:
      Depression of bile secretion in the three main components and bile cholesterol
      supersaturation with a high incidence of cholesterol stone formation have been
      documented in patients with end stage liver diseases after transplantation.
      However, physiologic changes of bile salt and lipid secretion in recipients
      remain unclear. METHODS: The study was done using a rat liver transplant model
      with 1 and 6 hours of donor liver cold preservation in saline. A chronic common
      bile duct fistula and a duodenal cannula were established for bile collection and
      the sample biochemical study for 6 days. RESULTS: Altered bile salt kinetics in
      liver grafted rats included depressed bile flow for 1-3 hours after the
      revascularization, decreased bile salt concentration and outputs, reduced bile
      salt basal synthesis rate, and reduced bile salt pool size during the early
      postoperative period. Phospholipid concentration and secretion rate depressed for
      1-3 days without altered cholesterol level. The uncoupling change of the
      cholesterol and the other bile components resulted in an increased lithogenic
      indices in bile on days 2 and 3. CONCLUSION: Alterations of bile composition and
      bile salt kinetics occur in liver transplanted rats. The changes may result from
      injuries of the liver microcirculation and parenchymal cells caused by cold
      preservation. The study of bile secretion is helpful for evaluation of the
      initial graft function. The changed ratio of three bile components may be
      important for cholesterol stone formation in the liver transplant recipient.

PMID- 8466313
TI  - Growth hormone after abdominal surgery attenuated forearm glutamine, alanine, 3
      methylhistidine, and total amino acid efflux in patients receiving total
      parenteral nutrition.
AB  - OBJECTIVE: The study clarified the effects of growth hormone treatment on forearm
      amino acid efflux in patients with full nutritional support after
      gastrointestinal surgery. SUMMARY BACKGROUND DATA: Growth hormone attenuates net
      nitrogen loss after surgical trauma. An increase in net protein synthesis has
      been described, whereas the results regarding protein breakdown have been
      conflicting. METHODS: Elective patients undergoing abdominal surgery were double
      blindly randomized to treatment with recombinant human growth hormone (GH, n = 9)
      24 IU or placebo (PL, n = 10) the first 5 postoperative days. All received
      parenteral nutrition (nitrogen = 5.7 +/- .1 g/m2, energy = 1018 +/- 12 kcal/m2
      (125 +/- .7% of BMR) and epidural analgesia. Amino acid plasma levels and forearm
      fluxes were measured. RESULTS: The second postoperative day, growth hormone
      abolished forearm efflux of total amino acid nitrogen (GH: 170 +/- 117, PL: -785
      +/- 192 nmol/100 mL/min, p = .0007) due to reduced losses of both essential and
      nonessential amino acids. Glutamine release was abolished (13 +/- 15 vs. -137 +/-
      43 nmol/100 mL/min, p = .007) and alanine release attenuated (-61 +/- 17 vs. -211
      +/- 51 nmol/100 mL/min, p = .01). 3-Methyl-histidine release was attenuated (-.20
      +/- .11 vs. -.62 +/- .09 nmol/100 mL/min, p = .04). Growth hormone also induced
      decreased venous plasma amino acid levels. CONCLUSIONS: When given after
      gastrointestinal surgery in patients treated with total parenteral nutrition,
      growth hormone treatment abolished glutamine, 3-methylhistidine, and total amino
      acid nitrogen loss from forearm tissue. Alanine loss from forearm tissue was
      attenuated.

PMID- 8466315
TI  - Pseudocoarctation of the aorta presenting as a mediastinal mass with dysphagia.
AB  - Pseudocoarctation is an uncommon anomaly thought to be caused by congenital
      elongation and kinking of the aorta. We report a case of pseudocoarctation of the
      aorta presenting as a superior mediastinal mass causing dysphagia. Aortography
      and echocardiography revealed dilatation of the aorta and an aneurysm below the
      level of the pseudocoarctation. The patient underwent operative repair of the
      pseudocoarctation and associated aneurysm with good symptomatic relief. Review of
      the literature and experience with this case demonstrate that pseudocoarctation
      of the aorta cannot necessarily be regarded as a benign condition. Surgical
      treatment is recommended for all symptomatic patients and for those with
      associated aneurysm formation.

PMID- 8466314
TI  - Double-orifice mitral and tricuspid valves in association with the Raghib
      complex.
AB  - A 19-year-old woman presented clinically with a left to right pretricuspid shunt.
      Echocardiography revealed a large ostium primum defect and a double-orifice
      mitral valve. Operative findings revealed additionally a double-orifice tricuspid
      valve and a left superior vena cava draining to the roof of the left atrium. The
      atrioventricular valves were competent. The primum defect was patched and the
      left superior vena cava was rerouted.

PMID- 8466316
TI  - Successful resection of a recurrent leiomyosarcoma of the pulmonary trunk.
AB  - We successfully performed a total resection of the pulmonary artery trunk and
      replaced it with an equine pericardial xenograft roll in a patient with a
      recurrent leiomyosarcoma. We believe, based on anatomic and embryologic
      principles, total rather than partial resection of the pulmonary artery trunk
      should be the treatment of choice for primary leiomyosarcomas of the pulmonary
      artery.

PMID- 8466317
TI  - Systolic anterior motion of the mitral valve after mitral valve repair without a
      ring.
AB  - We report a case of systolic anterior motion of the mitral valve after mitral
      reconstruction without a semirigid mitral annular ring. A 56-year-old man with
      mitral regurgitation due to ruptured chordae tendineae underwent mitral valve
      reconstruction by replacement of chordae tendineae, leaflet excision, and suture
      annuloplasty without an annular ring. Postoperatively, left ventricular outflow
      tract obstruction developed and echocardiography revealed systolic anterior
      motion of the mitral valve. These findings disappeared after medication with a
      beta-blocking drug.

PMID- 8466318
TI  - Pyoderma gangrenosum after coronary artery bypass grafting.
AB  - Pyoderma gangrenosum is a rare cutaneous disorder that may complicate recovery
      after a cardiac operation. The lesions appear to represent a necrotizing
      infection; however, they do not respond to surgical debridement and antibiotic
      therapy. The treatment is based on high-dose corticosteroids and concomitant
      treatment of any underlying systemic disease.

PMID- 8466319
TI  - Technique of single-lung transplantation.
AB  - The technique of single-lung transplantation at our institution has evolved as
      our experience has increased over the past 3 1/2 years. This technique is
      described and illustrated. Surgical staples are used to perform recipient
      pneumonectomy and provide free access to the hilar structures for anastomoses.
      The modified, telescoped bronchial anastomosis allows healing while obviating the
      need for omentopexy as seen in our last 30 bronchial anastomoses.

PMID- 8466320
TI  - Pericardial patch repair of left ventricular aneurysm.
AB  - Infectious complications associated with the use of Teflon felt buttresses in
      left ventricular aneurysm repair may result in serious morbidity. Use of an
      autologous pericardial patch is an alternative approach that should be
      considered. The technique, which we have used in 4 patients, is described.

PMID- 8466321
TI  - New cardiac retractor for epicardial electrode insertion via subxiphoid approach.
AB  - A new retractor for the insertion of epicardial screw-in electrodes is described.
      We have found that this instrument can be easily applied to the heart and gives
      excellent exposure for electrode insertion.

PMID- 8466322
TI  - New technique for improving hemostasis in aortic root replacement with composite
      graft.
AB  - By using both aortic annular and supraannular aortic wall tandem suture lines, we
      have, in our experience, markedly improved hemostasis in aortic root replacement
      with composite conduits of two types. Using this technique, 4 of 5 patients
      required 2 units or less of transfused red blood cells. Two patients did not
      receive transfusions. The technique consists of using interrupted mattress
      sutures to anchor the lower part of the valve sewing ring to the aortic annulus.
      The upper part of the sewing ring is then anchored with a running suture line to
      the cut edge of the supraannular aortic wall.

PMID- 8466323
TI  - Total anomalous pulmonary connection: then and now.
AB  - In their classic article "Total anomalous pulmonary venous drainage. Correction
      with cardiopulmonary bypass in 62 patients," Denton A. Cooley, MD, and associates
      defined the proper course of therapy for most patients with this lesion. This
      article was published in 1966 in the Journal of Thoracic and Cardiovascular
      Surgery. The text and illustrations in this signal publication have served as one
      of the guiding features for surgeons attempting operations on patients with these
      lesions since that time. This article reviews that publication and points out the
      marked similarities between the treatment practices at that time and those in use
      today.

PMID- 8466324
TI  - 1980: descending aortic aneurysmectomy without adjuncts to avoid ischemia. 1993
      update.
AB  - Encouraged by reports on the safety of simple aortic cross-clamping for resection
      of descending aortic aneurysm, we began utilizing this technique more liberally
      in 1976. This study was undertaken to examine the results of operation in 36
      patients, equally divided into two distinct groups. In Group 1, either
      extracorporeal circulation or indwelling temporary shunts were employed during
      the period of aortic occlusion. In Group 2, simple aortic cross-clamping was
      utilized to manage the lesion. No adjuncts were used to avoid ischemia in the
      latter group. The only 2 early deaths and two instances of paraplegia occurred in
      Group 1. In general, there were fewer complications in Group 2, with
      approximately two-thirds of the patients experiencing an uneventful postoperative
      course. These differences are considered important since the two groups were
      similar in respect to the extent and nature of the lesions and other factors
      contributing to operative risk.

PMID- 8466325
TI  - Bronchopleural fistula.

PMID- 8466326
TI  - AIDS-related bronchopleural fistula.

PMID- 8466327
TI  - Retrograde versus antegrade cardioplegia: impact on right ventricular function.

PMID- 8466328
TI  - Surveillance of Barrett's esophagus.

PMID- 8466329
TI  - Cavernous hemangioma of the intercostal space.

PMID- 8466330
TI  - Bentall redo.

PMID- 8466331
TI  - Treatment of acute aortic arch dissection.

PMID- 8466332
TI  - The vascular endothelium: friend or foe?

PMID- 8466333
TI  - Deep hypothermic arrest and left thoracotomy for repair of difficult thoracic
      aneurysms.
AB  - Seven patients with complex thoracic aortic aneurysms were operated on using
      profound hypothermia and circulatory arrest through a left thoracotomy. Three
      patients had false aneurysms, 2 had large aneurysms precluding access for
      proximal control, 1 patient had had previous hemiarch replacement, and 1 patient
      had a thoracoabdominal aneurysm. All patients were cooled on partial
      cardiopulmonary bypass until the electroencephalogram was isoelectric
      (approximately 15 degrees C rectal temperature). Circulatory arrest times ranged
      from 7 to 56 minutes (median, 34 minutes). There was one death due to cardiac
      failure, and paraplegia developed in 1 patient. The 6 survivors are otherwise
      well at a median of 12 months postoperatively. Hypothermia and circulatory arrest
      is an invaluable technique for the treatment of complex aortic aneurysms
      requiring left thoracotomy for resection. The techniques employed are described
      and the indications for their use are discussed.

PMID- 8466334
TI  - Myocardial performance after contusion with concurrent hypovolemia.
AB  - Myocardial contusion may present as a benign nonclinical event or a life
      threatening emergency. Although cardiac output is recognized to be decreased with
      major contusion, the contribution of hypovolemic shock to myocardial dysfunction
      is unclear. This study was designed to evaluate the relationship between
      myocardial contusion and hypovolemic shock. After Sprague-Dawley rats were
      anesthetized, contusions were administered at either 80 psi or 120 psi. Half of
      each group then underwent hypovolemic shock. After 24 hours of recovery, cardiac
      hemodynamics were studied in each subgroup using the Neely-Langendorff apparatus.
      Isoenzymes and histology were evaluated as well. The data showed that rats
      undergoing hypovolemic shock in each subgroup had a significant decrease in
      cardiac output when compared with their controls. This decrease was more
      pronounced in the 120-psi group. Cardiac isoenzyme levels were elevated in all
      groups. Microscopic evaluations showed contusion in the controls and necrosis in
      the shock groups. Patients whose injuries are compatible with myocardial
      contusion and hypovolemic shock should be resuscitated quickly and evaluated for
      myocardial dysfunction secondary to infarction.

PMID- 8466335
TI  - Sternal resection and reconstruction.
AB  - Twenty-one patients underwent sternal resection and reconstruction. Surgical
      indications included sternal infection in 9 patients, recurrent breast cancer in
      6, metastatic carcinoma from an unknown primary in 2, pectus excavatum in 2, and
      osteogenic sarcoma and eosinophilic granuloma in 1 each. Management included
      partial sternectomy in 10 patients (group 1) and complete sternectomy in 11
      (group 2). Chest wall reconstruction was by various flaps and mesh repairs. Blood
      transfusions averaged 2 units in group 1 versus 5.5 units in group 2 (p = 0.02).
      Average number of days until extubation was 2.6 in group 1 versus 7.3 in group 2
      (p = 0.04). Average number of intensive care unit days was 4.4 for group 1 versus
      9.4 for group 2 (p = 0.03). The number of days until discharge was 14 days for
      group 1 versus 20 days for group 2. Complications occurred in 40% of group 1 and
      82% of group 2 patients. Overall mortality was 9.5%. Sternal resection and
      reconstruction, particularly complete sternal resections, are a major undertaking
      with substantial morbidity. Using a multidisciplinary approach (cardiothoracic,
      plastic and reconstructive, critical care medicine, and infectious disease) and
      aggressive pulmonary support, acceptable cosmetic and functional results are
      possible.

PMID- 8466336
TI  - Surgical management of pulmonary infections in chronic granulomatous disease of
      childhood.
AB  - Chronic granulomatous disease of childhood is an inheritable disorder of
      phagocytic cell respiratory burst resulting in recurrent, life-threatening,
      catalase-positive infections. The lung is the most common site of infection, and
      pulmonary disease is the primary cause of death in greater than 50% of children
      with chronic granulomatous disease. Still, the role of surgery in management of
      this disease remains undefined. Between 1974 and 1990, 19 patients with chronic
      granulomatous disease required 31 thoracic interventions at our institution.
      Patients ranged in age from 2.5 to 27 years (mean age, 15 years). Seventeen of 19
      patients (89%) had had previous pulmonary infections. Patients presented as toxic
      (temperature > 38.5 degrees C, chest pain, and cough) in 22 instances before the
      31 procedures. Aggressive surgical intervention for diagnosis and extirpation of
      localized infections was undertaken with lobectomy/pneumonectomy with or without
      other procedures (5), bisegmentectomy (2), segmentectomy with or without other
      procedures (5), or wedge with or without other procedures (13). In five
      instances, an empyema was drained; a chest tube for a sterile collection was
      placed in one instance. There was one intraoperative death, and 3 patients died
      22 to 600 days postoperatively with overwhelming sepsis. The mean hospitalization
      was 101 days (range, 24 to 600 days). Wound complications occurred in 5 patients,
      requiring 17 separate anesthetic debridements. A change in therapy was dictated
      by the results of the procedure in 23 of 31 instances (74%). Thoracic surgeons
      must be aware of this rare cause of immunosuppression in these children and, due
      to the unusual nature of the pulmonary infections, should follow an aggressive
      approach in their diagnosis and management.

PMID- 8466337
TI  - Pulmonary artery sleeve resection for abutting left upper lobe lesions.
AB  - Because the left upper lobe bronchus overlies the left pulmonary artery (PA), T2
      3 lesions, N0-1 disease, or rarely inflammation may involve this vessel,
      necessitating lobectomy with partial PA resection or pneumonectomy with sacrifice
      of the lower lobe. In 486 operations performed for left upper lobe lesions
      between 1966 and 1992 (wedge, 111; segmentectomy, 131; lobectomy, 155;
      pneumonectomy, 89), isolated PA encroachment was caused by bronchogenic carcinoma
      (32), invasive aspergillosis (2), or organized pneumonitis (1) and occurred in 9%
      (32/360) of malignant left upper lobe tumors and 2% (3/126) of benign lesions.
      Initially (1966 through 1979), PA involvement was the indication for 30% (18/60)
      of left pneumonectomies. Later (1980 through 1990), tangential resection of the
      PA was attempted in 11, 5 ending up with pneumonectomy. Overall, 35 of 244
      patients undergoing major left upper lobe resection (lobectomy or pneumonectomy)
      had PA encroachment. Recently, we have performed, selectively in patients with
      restricted lung function, six left upper lobectomies with sleeve resection of the
      PA. Paneled saphenous vein interposition was used (3) or 18-mm
      polytetrafluorethylene tube prostheses (3). All patients survived, 1 later
      requiring completion pneumonectomy for bronchostenosis after wedge bronchoplasty.
      Two have since died of metastases or pulmonary insufficiency; the remainder
      (average follow-up, 17 months) are asymptomatic with lower lobe function in 3
      confirmed by differential ventilation-perfusion scans and pulmonary angiography.

PMID- 8466338
TI  - Allograft replacement of the aortic valve versus the miniroot and valve.
AB  - Between February 1986 and April 1992, 27 patients ranging in age from 8 to 65
      years (median, 18 years) underwent allograft replacement of the aortic valve with
      one death (operative mortality, 3.7%). The indications for operation were aortic
      regurgitation in 14 patients, aortic stenosis in 7, aortic stenosis/regurgitation
      in 4, and endocarditis in 2. Associated lesions included annuloectasia in 4
      patients (1 with Marfan's syndrome), sinus of Valsalva aneurysm in 3, coronary
      artery disease in 4, and ventricular septal defect in 2. The freehand technique
      was used in 12 patients and the miniroot replacement in 15 patients. The
      postoperative transvalvular gradient was 17 mm Hg in freehand valves and 7 mm Hg
      in the miniroot valves. Initial postoperative study showed no or trivial aortic
      regurgitation in all 26 survivors except 1 freehand patient who had mild aortic
      regurgitation. At late study up to 6 years postoperatively all 10 of our
      available freehand patients showed progressive regurgitation, and it was severe
      in 4 patients. By contrast only half of the miniroot patients showed progressive
      regurgitation, and in none was it severe. Allograft replacement of the aortic
      valve can be done in children and adults with low mortality rate, short hospital
      stay, and excellent early function. Subsequent follow-up studies suggest that the
      miniroot replacements are superior to the freehand valves with lower
      transvalvular gradients, less valvular regurgitation, and delayed progression of
      valvular regurgitation.

PMID- 8466339
TI  - Mitral valve repair using a flexible and adjustable annuloplasty ring.
AB  - Initial experience with a new flexible and adjustable mitral annuloplasty ring is
      described. Used in conjunction with standard techniques of mitral valve repair,
      this ring was implanted in 21 consecutive patients undergoing elective operation
      for mitral regurgitation. Satisfactory valve repair was feasible in 20 of these
      patients. Once the ring was sewn in place, adjustment of the ring to reduce or
      eliminate residual regurgitation was beneficial in 9 patients. Excellent results
      were achieved as determined by intraoperative transesophageal echocardiography.
      Comparable late results were found in all but 1 patient up to 1 year after
      repair. This patient required mitral valve replacement 6 months after repair due
      to failure of papillary muscle reconstruction. The BiFlex ring has the merits of
      a flexible prosthesis with the advantage of easy adjustment once secured in
      place.

PMID- 8466340
TI  - Replacement of the transverse aortic arch for type A acute aortic dissection.
AB  - Surgical treatment of acute aortic dissection involving the segment of transverse
      aortic arch is difficult and often associated with a high mortality and
      morbidity. The high mortality and morbidity are primarily related to anatomic
      features and techniques of cerebral protection employed during the period of
      aortic branch occlusion needed for reconstruction. This study reports our
      experience of 20 consecutive cases of acute type A aortic dissection treated by
      repair or replacement of the transverse aortic arch during emergency operation.
      Ages of the patients ranged from 56 to 76 years. All patients were referred to us
      within 2 weeks of onset (mean time, 58 hours). Selective cerebral perfusion or
      deep hypothermia with complete circulatory arrest was employed during the period
      of aortic branch occlusion. Duration of cerebral perfusion, circulatory arrest,
      myocardial ischemia, and cardiopulmonary bypass averaged 106 minutes, 32 minutes,
      127 minutes, and 248 minutes, respectively. There were three operative deaths.
      All three dissections were ruptured ones, and the patients died of hemorrhage,
      deep coma, or multiple organ failure. One patient died of infection 3 months
      after operation. The remaining patients are alive and well without any detectable
      neurological deficit 1 month to 4 years postoperatively. This experience
      emphasizes that repair or replacement of acute type A aortic dissection involving
      the aortic arch can be performed safely by adequate selection of patients,
      supportive measures, and operative methods.

PMID- 8466341
TI  - Tracheoesophageal fistulas.
AB  - Tracheoesophageal fistula is an uncommon clinical problem, and can be either
      congenital or acquired in origin. In this report, we present our experience in
      the management of 41 patients with tracheoesophageal fistula (28 male, 13 female;
      age ranging from 8 to 69 years) who were seen during the period spanning 1968 to
      1989 at the National Research Center of Surgery, Moscow. During this time frame
      fewer malignant and correspondingly more posttraumatic and postoperative fistulas
      were observed. The most common clinical findings were cough associated with
      eating, production of sputum mixed with food, and weight loss with profound
      weakness. In the vast majority of patients, diagnosis was made using radiologic
      contrast studies, with endoscopic assessment being occasionally necessary. We
      classify our surgical approaches as "radical" (the isolation and ablation of the
      communication), "conditionally radical" (implying creation of a neoesophagus or
      thoracoplasty with muscle flap obliteration of the fistula and associated chronic
      empyema cavity), or "palliative" (usually entailing gastrostomy alone). Of the 32
      patients undergoing surgical treatment in this series, 21 underwent radical or
      conditionally radical procedures; there was no operative mortality, and long-term
      follow-up shows that 19 of the 20 long-term survivors report satisfactory, good,
      or excellent status. This report summarizes the indications, timing, technique,
      and results of the various surgical approaches, and also delineates measures for
      the prevention of postoperative tracheoesophageal fistula.

PMID- 8466342
TI  - High-risk cardiac operation: a viable alternative to heart transplantation.
AB  - To determine if high-risk heart operation with circulatory support standby is an
      acceptable alternative to direct heart transplantation, we reviewed 21 patients
      who were accepted as heart transplant candidates but offered a heart operation
      because of the availability of circulatory support. Preoperative left ventricular
      ejection fraction was 0.25 +/- 0.08 (mean +/- standard deviation), and New York
      Heart Association functional class was 3.4 +/- 0.7. The patients underwent 16
      bypass graft operations, 4 mitral and 2 aortic valve replacements, and 4
      defibrillator implantations (combined procedures in 5 patients). An intraaortic
      balloon pump was placed in 12 patients. One patient required biventricular assist
      device support but was weaned in 11 days. Twenty patients were discharged 14.8 +/
      11.5 days postoperatively. One patient died 15 days postoperatively of
      amiodarone-induced respiratory failure, and 1 died suddenly 2 months
      postoperatively. At 10.5 +/- 6 months postoperatively, 19 patients (90%) are
      alive. Mean functional class is 1.9 +/- 0.9. None of the patients has undergone
      transplantation, but 2 are awaiting donor organs. We conclude that in selected
      heart transplant candidates high-risk heart operation is a viable alternative to
      direct heart transplantation.

PMID- 8466343
TI  - Exercise coronary flow reserve of bilateral internal thoracic artery bypass
      grafts.
AB  - We attempted to quantify the exercise coronary flow reserve in 20 patients with
      bilateral internal thoracic artery grafts to the left coronary arteries (group I)
      who had complete revascularization. The coronary sinus blood flow was measured by
      the continuous thermodilution method both at rest and during exercise (50 W for 8
      to 9 minutes) approximately 1 month after the operation. These results were
      compared with 30 patients treated with an internal thoracic artery and saphenous
      vein grafts to the left coronary arteries (group II) and 9 patients with
      saphenous vein grafts alone to the left coronary arteries (group III). There were
      no differences among the three groups in age, sex, number of vessels involved,
      heart rate, double products, left ventricular (LV) end-diastolic pressure, LV
      ejection fraction, LV end-diastolic volume, or LV mass at the time of study. None
      of the 59 patients in the study had abnormally enlarged LV end-diastolic volume
      or increased LV mass. The postoperative coronary sinus blood flow per 100 grams
      of LV mass at rest was similar among the three groups (73.0 +/- 28.4 mL/min per
      100 g LV mass in group I, 73.4 +/- 31.1 mL/min per 100 g LV mass in group II, and
      75.9 +/- 28.5 mL/min per 100 g LV mass in group III [not significant]) and
      significantly (p < 0.01) increased by exercise, although the differences between
      groups during exercise were not significant (158.9 +/- 45.9, 153.5 +/- 72.1, and
      148.3 +/- 60.0 mL/min per 100 g LV mass, respectively [not
      significant]).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466344
TI  - Long-term complications of implantable cardioverter defibrillator lead systems.
AB  - Over a period of 8.5 years in 255 patients with full-system implantable
      cardioverter defibrillators, lead-specific complications requiring reoperation
      developed in 32 patients. A total of 36 leads were affected. Lead fracture was
      the cause of failure in half of these patients. Refinement and improvement in
      structural designs of these leads, use of endocardial leads, and attention to
      technical details during implantation should decrease the incidence of these
      complications.

PMID- 8466345
TI  - Effects of cardiomyoplasty on biventricular function in canine chronic heart
      failure.
AB  - Dynamic cardiomyoplasty, the use of skeletal muscle to assist the heart, is a new
      therapy for the treatment of heart failure. However, the effects of
      cardiomyoplasty on biventricular function and the synchrony of ventricular
      contraction are not fully known. We assessed the efficacy of latissimus dorsi
      muscle (LDM) dynamic cardiomyoplasty in a chronic model of biventricular failure.
      Five dogs received doxorubicin (1 mg.kg-1.wk-1) for up to 12 weeks to induce
      heart failure and then underwent a biventricular cardiomyoplasty. After
      operation, the muscle was progressively stimulated according to an established
      protocol. When training was complete (10 weeks), radionuclide ventriculographic
      and catheterization data were obtained. Peak left ventricular (LV) systolic
      pressure and its first derivative were unchanged, whereas LV end-diastolic
      pressure decreased slightly with LDM assistance (11.0 +/- 1.6 to 9.6 +/- 1.5 mm
      Hg; p < 0.05). Right ventricular (RV) systolic pressure increased significantly
      with LDM assistance from 21 +/- 2 to 26 +/- 3 mm Hg (p < 0.05), whereas its first
      derivative and RV end-diastolic pressure were unchanged. Dynamic cardiomyoplasty
      significantly improved LV ejection fraction from 0.18 +/- 0.07 without LDM
      assistance to 0.31 +/- 0.05 with LDM assistance (p < 0.05); similarly RV ejection
      fraction increased from 0.32 +/- 0.07 to 0.45 +/- 0.06 with LDM assistance (p <
      0.05). The temporal sequence of LV wall motion was assessed by phase analysis of
      the radionuclide ventriculograms. With skeletal muscle assistance, standard
      deviation ("spread") decreased from 31.6 +/- 17.4 to 20.0 +/- 15.4 degrees (p <
      0.06), whereas skewness ("symmetry") was unchanged. Dynamic cardiomyoplasty
      improved both LV and RV ejection fractions without increasing diastolic
      pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466346
TI  - Improvement of cardiac function impaired by repeated ischemic arrests in isolated
      rat hearts.
AB  - We investigated the effects of coenzyme Q10 and verapamil, either alone or in
      combination, on cardiac function impaired by repeated ischemic arrests and
      reperfusion in the isolated rat heart. In the group with a single ischemic
      arrest, the aortic flow, cardiac output, stroke volume, coronary flow, and heart
      rate recovered well (72% to 100% of the prearrest values). In the repeated-arrest
      group, the recovery of aortic flow (24%), cardiac output (30%), stroke volume
      (40%), or coronary flow (63%) was much poorer than that in the single-arrest
      group. Pretreatment with coenzyme Q10 given intraperitoneally improved aortic
      flow, cardiac output, stroke volume, coronary flow, and heart rate. The addition
      of verapamil to the reperfusion solution also protected the cardiac function with
      a decrease in heart rate. However, combination therapy with coenzyme Q10 and
      verapamil further increased the recoveries of aortic flow, cardiac output, stroke
      volume, and coronary flow to 57%, 61%, 77%, and 84%, respectively, which were
      better than the values after treatment with coenzyme Q10 or verapamil alone. We,
      therefore, suggest that treatment with coenzyme Q10 or verapamil, alone or in
      combination, in addition to St. Thomas' Hospital solution effectively protects
      cardiac function impaired by repeated ischemic arrests and reperfusion.

PMID- 8466347
TI  - A model to predict survival at time of postcardiotomy intraaortic balloon pump
      insertion.
AB  - To facilitate timely application of new forms of cardiac support to patients at
      highest risk after cardiotomy despite conventional support with the intraaortic
      balloon pump, an accurate prediction of survival must be available at the time of
      weaning from cardiopulmonary bypass. We, therefore, acquired 240 demographic,
      disease, and perioperative characteristics of 322 patients (mortality rate,
      48.4%) who required IABP support to separate from bypass. Four variables
      available before or within 10 minutes of the first attempt at weaning from bypass
      significantly predicted mortality by stepwise logistic regression: complete heart
      block as demonstrated by need for temporary pacing at weaning (p < 0.001),
      advanced age (p < 0.002), preoperative blood urea nitrogen concentration (p =
      0.036), and female sex (p = 0.048). An equation generated by the logistic model
      predicted a 72.2% survival rate in the 25% of patients at least risk (actual
      survival rate, 71.6%); in the 25% at greatest risk, death was predicted in 73.0%,
      and the actual mortality rate was 74.1%. The equation was then prospectively
      applied to 330 intraaortic balloon pump-supported patients managed at another
      institution. The overall mortality rate there was 41.2%; in the 25% at least
      risk, predicted survival rate was 70.5% (actual survival rate, 77.1%), and in the
      25% at greatest risk, predicted mortality rate was 75.7% (actual mortality rate,
      62.7%). Thus, retrospectively at one institution and prospectively at another,
      the equation generated by this model based only on data available at the time of
      weaning from bypass was able to define one subgroup of patients 2.6 to 2.7 times
      as likely to die as another subgroup from within similar cohorts.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466348
TI  - Balloon aortic valvuloplasty as a bridge to aortic valve replacement in
      critically ill patients.
AB  - This report highlights our experience in 5 patients with severe aortic stenosis
      and multiple organ failure undergoing balloon aortic valvuloplasty as a bridge to
      conventional aortic valve replacement. Balloon aortic valvuloplasty successfully
      stabilized the condition of these patients, improved organ function, and
      decreased their baseline risk profile. Elective aortic valve replacement was then
      performed without complications. Short-term palliation with balloon aortic
      valvuloplasty should be considered as a bridge to aortic valve replacement in
      selected patients with critical aortic stenosis and multiple organ failure.

PMID- 8466349
TI  - Heparin-coated circuits reduce the inflammatory response to cardiopulmonary
      bypass.
AB  - Cardiopulmonary bypass generates a systemic inflammatory response including the
      activation of the complement cascade and leukocytes contributing to postoperative
      morbidity. To evaluate whether the use of heparin-coated extracorporeal circuits
      could reduce these activation processes, we performed a study on 30 patients
      undergoing coronary artery bypass grafting who were randomly perfused with a
      heparin-coated circuit (Duraflo II, n = 15) or with a similar noncoated circuit
      (control, n = 15). Standardized systemic heparinization was applied for every
      patient before cardiopulmonary bypass. The use of heparin-coated circuits
      resulted in a reduction of systemic leukocyte activation during cardiopulmonary
      bypass reflected by reduced elastase release (p < 0.05) and tumor necrosis factor
      generation (p < 0.05) manifest after release of the aortic cross-clamp. In
      addition, blood samples taken from both the right and left atria after
      reperfusion revealed that the elastase release from the pulmonary
      microcirculation was absent in the Duraflo II group in contrast to the control
      group (p < 0.05). The pattern of complement activation, likely initiating this
      inflammatory reaction, was modified by heparin coating in two different aspects.
      There was a significant reduction of C3a generation after protamine
      administration in patients perfused with heparin-coated circuits, and there was a
      decrease of complement hemolytic capacity in pooled human serum incubated with
      heparin-coated tubing. These observations suggest that heparin coating might bind
      some of the complement components from the classic pathway, thereby reducing the
      inflammatory response to cardiopulmonary bypass.

PMID- 8466350
TI  - Effect of vascular clamp on endothelial integrity of the internal mammary artery.
AB  - The preservation of endothelial integrity is essential for maintaining patency of
      vascular grafts. The internal mammary artery flow is often interrupted with the
      application of a soft vascular clamp to achieve a bloodless field during the
      anastomosis. We investigated the effect of the vascular clamp on the internal
      mammary artery endothelium using the scanning electron and light microscope. The
      endothelium was examined before and at 15 and 30 minutes after clamping in both
      the pedicled and the skeletonized arteries. Endothelial integrity was breached by
      clamping with early evidence of platelet adhesion to the damaged areas. The
      severity of the endothelial damage was related to the clamp time, but there was
      no difference in the degree of damage between the pedicled and the skeletonized
      arteries. We conclude that the vascular clamp causes injury to the internal
      mammary artery endothelium and may be implicated in early postoperative graft
      failure.

PMID- 8466351
TI  - Operative creation of left to right cardiac shunts: pulmonary functional
      sequelae.
AB  - The creation of left to right cardiac shunts in neonates is frequently
      complicated by pulmonary morbidity in the immediate postoperative course. To
      elucidate the pattern, severity, and cause of lung dysfunction, pulmonary
      function testing was performed preoperatively and 1, 3, and 7 days
      postoperatively on 7 neonates undergoing Blalock-Taussig shunting. Pulmonary
      mechanics (compliance, conductance) were determined with esophageal manometry and
      pneumotachography, and functional residual capacity was measured by the helium
      dilution technique. The infants had pulmonary function preoperatively that was
      similar to that of healthy term neonatal controls. Significant decreases in
      compliance, conductance, and functional residual capacity were found on the first
      postoperative day (57%, 21%, and 53% of predicted, respectively). Alterations in
      conductance were more severe than those in compliance, but both were low through
      postoperative day 3. Functional residual capacity was the least affected
      parameter and recovered by postoperative day 3. All parameters were normal by
      postoperative day 7. These data indicate that shunting is associated with
      pulmonary morbidity through the third postoperative day that affects the airways
      more than the lung parenchyma. Pulmonary function studies of these infants may
      clarify the etiology of pulmonary dysfunction and have an impact on therapeutic
      strategies used in neonates undergoing cardiac operations.

PMID- 8466352
TI  - Systolic and diastolic function of both ventricles after prolonged cardioplegic
      arrest.
AB  - The current technique of donor heart preservation for transplantation is known to
      cause myocardial dysfunction. We have investigated the effect of 2, 4, and 8
      hours of global ischemia at 4 degrees C with a single infusion of St. Thomas'
      Hospital cardioplegic solution on the recovery of right and left ventricular
      function in the blood-perfused, isolated pig heart. Two hours of ischemia caused
      significant deterioration in both left (p < 0.05) and right (p < 0.01)
      ventricular diastolic function as assessed by ventricular compliance and
      stiffness (reduction in left and right ventricular compliances, 19.3% +/- 14.8%
      and 13.3% +/- 3.5%, respectively) but had no significant effect on systolic
      function as evaluated by the slope value of the systolic pressure-volume
      relationship (peak elastance). Four hours of ischemia resulted in further
      reduction in ventricular compliance (left ventricle, p < 0.001; right ventricle,
      p < 0.05) and also caused left ventricular systolic dysfunction (p < 0.05). Eight
      hours of ischemia caused approximately 50% reduction in left ventricular (p <
      0.01) and right ventricular (p < 0.05) compliance and left ventricular elastance
      (p < 0.001). Coronary vascular resistance at the end of 2 hours of reperfusion
      after preservation was significantly elevated as compared with the control value
      in all three groups. There was no correlation between the percentage increase in
      coronary vascular resistance and the percentage reduction in left or right
      ventricular diastolic function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466353
TI  - Impairment of vascular endothelial function by high-potassium storage solutions.
AB  - High-potassium cold storage solutions are currently used to preserve myocardial
      function during heart transplantation. However, the effects of high potassium
      concentration on vascular endothelial function are not well known. We therefore
      tested vascular rings for endothelial-dependent and endothelial-independent
      relaxation during storage in normokalemic, normothermic buffers and then in
      buffers supplemented with 10 to 110 mmol/L KCl. Maximal endothelial-dependent
      relaxation was significantly reduced at all high potassium concentrations.
      Endothelial-independent relaxation was impaired only with 80 and 110 mmol/L KCl
      buffers. Both endothelial-dependent relaxation and endothelial-independent
      relaxation returned to normal values after washout of excess potassium.
      Similarly, endothelial-dependent relaxation and endothelial-independent
      relaxation were assessed in rings after 24 hours of hypothermic storage in
      normokalemic Krebs buffer, and in buffers containing 20 and 110 mmol/L KCl.
      Maximal endothelial-dependent relaxation was significantly reduced after
      preservation in the high-potassium solutions, whereas endothelial-independent
      relaxation was not impaired. We conclude that there is significant impairment of
      endothelial function after cold storage in a high-potassium buffer. Inadequate
      washout of potassium during normothermic conditions may lead to further
      functional impairment of vascular responsiveness. A low-potassium storage medium
      is recommended for improved vascular protection.

PMID- 8466354
TI  - New experimental technique to study blood cardioplegia in the isolated, perfused
      rat heart.
AB  - Blood cardioplegia has been extensively studied clinically and in the large
      animal experimental model. We describe here a modification of the original
      Langendorff technique to study continuous warm blood cardioplegia in the
      isolated, perfused rat heart. The excised heart is mounted on the perfusion
      apparatus and perfused with Krebs-Henseleit buffer. Prearrest hemodynamics are
      recorded. The shed blood in the mediastinal cavity (8 to 12 mL) is collected,
      filtered, and reconstituted into cardioplegic solution (hematocrit, 0.20; K+, 15
      mmol/L). Hearts are arrested and maintained at 37 degrees C by continuous
      recirculation of blood cardioplegia for 1 hour. The blood cardioplegia system
      consists of a Silastic tubing oxygenator, peristaltic pump, and two filters (40
      microns pore size). The heart is reperfused with Krebs-Henseleit solution, and
      postarrest hemodynamics are recorded. Percentage recovery of peak left
      ventricular pressure, heart rate, and coronary flow were 98.5 +/- 3.1, 102 +/-
      4.2, and 98.5 +/- 4.5 (mean +/- standard error of the mean; n = 6), respectively.
      Myocardial oxygen consumption during arrest was 57 microL.min-1.g-1 dry wt, which
      is 10% of the myocardial oxygen consumption of a beating heart in in-vivo and ex
      vivo models. These results suggest the feasibility of studying blood cardioplegia
      in the isolated, perfused rat heart model under controlled conditions. Continuous
      warm blood cardioplegic arrest provided excellent myocardial protection for 1
      hour in this model.

PMID- 8466355
TI  - Trans-ventricular septal defect approach for resection of accessory mitral valve
      tissue.
AB  - Accessory mitral valve tissue is a rare cause of left ventricular outflow tract
      obstruction, which can be difficult to recognize. Surgical resection by the
      conventional transaortic approach with or without left atriotomy is extremely
      difficult in infants with a small aorta. When a ventricular septal defect is
      present, it may be the best way to approach the accessory mitral valve tissue,
      because the ventricular septal defect is located just in front of it. Five
      infants underwent resection of accessory mitral valve tissue together with repair
      of other intracardiac malformations. In 3 infants, resection of accessory mitral
      valve tissue was easily performed through the ventricular septal defect, which
      required enlargement in 2 patients.

PMID- 8466356
TI  - Perfluorochemical reperfusion yields improved myocardial recovery after global
      ischemia.
AB  - Reperfusion injury remains a limiting factor in extending ischemic storage time
      for human heart transplantation. In this study, initial myocardial reperfusion
      with an oxygenated perfluorochemical (Fluosol) was investigated as a means of
      limiting such injury. Neonatal piglet hearts were arrested with crystalloid
      cardioplegia, excised, and stored for 12 hours in saline solution at 0 degrees C.
      Initial reperfusion (10 minutes) was either with whole blood (n = 6), unmodified
      perfluorochemical (n = 8), or aspartate/glutamate-enriched perfluorochemical
      cardioplegia (n = 6), and was followed by an additional 40 minutes of whole blood
      perfusion. Functional evaluation was then completed, and left ventricular biopsy
      specimens were taken. A control group (n = 7) was evaluated without an
      intervening period of ischemia. At a left ventricular end-diastolic pressure of 9
      mm Hg, hearts stored in whole blood cardioplegia developed a left-ventricular
      stroke work index of 3.8 +/- 2.3 x 10(3) erg/g (mean +/- standard error of the
      mean). Under the same conditions, perfluorochemical-reperfused hearts achieved a
      stroke work index of 14.6 +/- 1.3 x 10(3) erg/g, significantly greater than that
      of the whole blood group (p < 0.001). Stroke work index for hearts reperfused
      with aspartate/glutamate-enriched perfluorochemical cardioplegia was 19.8 +/- 1.6
      x 10(3) erg/g, significantly increased over that of the nonenriched
      perfluorochemical group (p < 0.01) and not different from values obtained in
      controls (19.2 +/- 0.8 x 10(3) erg/g).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466357
TI  - Aortic arch thrombosis in the neonate.
AB  - Two cases of neonatal aortic arch thrombosis are reported. One patient, who had
      ascending aortic thrombosis, died preoperatively. The other had reoperation and
      is alive and well at 6 months' follow-up. No obvious cause was found.

PMID- 8466358
TI  - Isolated bilateral ostial coronary artery stenoses.
AB  - Isolated coronary ostial narrowing is rare and most often attributed to
      atherosclerotic disease of the aorta. A man with isolated, bilateral stenoses of
      the coronary ostia is presented, who also had severe peripheral vascular disease.
      A review of previous reports concerning coronary ostial disease is presented.

PMID- 8466359
TI  - Successful surgical management of an aortic arch aneurysm with acute aorto
      pulmonary fistula.
AB  - Aortic arch aneurysm with acute aorto-pulmonary fistula is usually a postmortem
      diagnosis. Few reports of successful surgical management are noted. Despite the
      many advances in cardiac surgery over the last 30 years, the observed mortality
      rate for surgical correction has been very high. Early diagnosis and prompt
      surgical intervention using profound hypothermia and total circulatory arrest are
      essential to successful outcome.

PMID- 8466360
TI  - Pulmonary lymphangiomyomatosis causing bilateral pneumothorax during pregnancy.
AB  - A 32-year-old woman, 12 weeks pregnant, presented with bilateral spontaneous
      pneumothorax that did not heal with tube thoracostomy. At right and left
      thoracotomy, lymphangiomyomatosis of the lung was found and treated by
      pleurodesis. Lymphangiomyomatosis has been infrequently reported in the surgical
      literature, even though it may befall the thoracic surgeon to establish the
      diagnosis and aid in treatment.

PMID- 8466361
TI  - [An analysis of the antihypertensive properties of 3-nitropropionic acid, a
      compound from plants in the genus Astragalus].
AB  - 3-Nitropropionic acid (NPA), a compound obtained from Astragalus species,
      elicited a dose-dependent relaxation of precontracted rabbit aortic rings. The
      remotion of endothelium or the presence of atropine, propranolol or
      brompheniramine did not modify the vasodilator effect of NPA but methylene blue
      clearly inhibited it. On the other hand the acute i.v. administration of NPA in
      normotensive rats or the chronic oral administration of NPA in renal hypertensive
      dogs, provoked both a decrease in blood pressure and bradycardia. Finally, NPA
      elicited negative inotropic and chronotropic effects in guinea pig isolated
      auricles, which were not blocked by atropine and it inhibited the increase in
      contractile force and heart rate elicited by isoproterenol. The present results
      indicate that NPA has vasodilator and antihypertensive properties. The arterial
      relaxation elicited by NPA was inhibited with methylene blue suggesting that it
      is a consequence of guanylate cyclase stimulation. The hypotensive effect was
      independent of the animal species or route of administration used. The
      bradycardia seen in rats and dogs and the negative chronotropic and inotropic
      effects observed in isolated auricles suggest that the hypotensive effect of NPA
      is a mixture of vasodilator and cardiodepressor actions. NPA cardiac effects may
      be related with inhibition of beta-adrenergic mediated responses.

PMID- 8466362
TI  - [A comparative study between surgical section and radiofrequency ablation of the
      anomalous pathways in the WPW syndrome].
AB  - Radiofrequency catheter ablation is an effective alternative to medical therapy
      to patient with Wolff Parkinson White syndrome (WPW). The purpose of this study
      is to compare our results in 70 patients with WPW that underwent either surgery
      or ablation procedure with radiofrequency energy. Of this number of patients the
      surgical procedure was successful in 82%; complications were present in 15% and
      mortality in 8%. Average hospitalization was 6 to 10 days and cost from 2 to 10
      thousand of new pesos. On the other hand, of 44 patients that underwent
      radiofrequency ablation, in 80% the procedure was finally successful with
      recurrence of 9% and no mortality. The hospitalization period was one day, the
      cost run from 500 to 2 thousand of new pesos in our institution. These results
      demonstrate the efficacy of the radiofrequency energy ablation in the treatment
      of WPW. This procedure is safe and less expensive than surgery.

PMID- 8466363
TI  - [The radiofrequency ablation of accessory pathways. The initial experience in
      Mexico].
AB  - Thirteen patients with paroxysmal supraventricular tachycardia (SVT) due to an
      accessory pathway were submitted to an electrophysiological study and
      radiofrequency ablation of the Kent bundle. There were 9 males and 4 females. The
      mean age was 22 years. Other than their SVT, none had any structural heart
      disease. Ten of them had Wolff-Parkinson-White syndrome, and three had concealed
      accessory pathways. Two different types of radiofrequency devices were used: one
      generating damped sinusoid waves, and two other generators producing pure
      continuous sinusoid waves. With the first type, two attempts were made: one
      patient with a concealed pathway and one with overt preexcitation. The successful
      ablation was not achieved because this wave type is 100 times more powerful, it
      desiccates the tissue, and thus does not produce the right kind of lesion. The
      other eleven patients were divided in three groups: I) With left overt
      preexcitation (7 pts) II) Concealed left Kent bundles (2 pts) III) Right Kent
      bundles. Ablation was 100% successful in group I, while in the other two groups,
      only one patient of each was successfully ablated. The overall successful rate of
      these 3 groups was 81.8%. Of the two patients that could not be treated, one had
      an anterior septal Kent bundle and the other had a concealed left Kent bundle. We
      believe that catheter ablation is a very promising therapeutic procedure for
      patients with SVT, besides being a extraordinary instrument that will enable us
      to be able to understand further clinical electrophysiology.

PMID- 8466364
TI  - [The radiofrequency and the elimination of accessory atrioventricular pathways.
      The factors related to successful transcatheter ablation].
AB  - Some factors related with successful radiofrequency catheter ablation were
      retrospectively analyzed from the initial patients with WPW syndrome that
      underwent this therapy. They were 21 patients, and success rate with
      radiofrequency therapy was 73%. Conventional conduction intervals were obtained
      from catheter ablation electrograms. Only ventricular activation around Delta
      wave onset, and earliest retrograde atrial activation were statistically
      significant for successful ablation (P < 0.05 both). Inadvertent interruption of
      AV-His bundle was produced ablating a septal accessory pathway, and no mortality
      procedure-related was observed. We conclude that radiofrequency catheter ablation
      of accessory pathways represents nowadays, an effective solution in patients with
      symptomatic arrhythmias, besides its high success rate and low risks, but
      different mapping criteria should be considered to attain an efficient
      elimination of atrioventricular accessory-pathways.

PMID- 8466365
TI  - [The radiofrequency ablation of accessory pathways in 100 consecutive patients
      with supraventricular tachycardias].
AB  - The purpose of this study is to describe the results and the complications of
      radiofrequency catheter ablation, of accessory pathways in 100 consecutive
      patients. We had one patient with two pathways. Of the 101 accessory pathways, 56
      were overt and 45 concealed. Only 19 patients have had a previous
      electrophysiology study, in the others, the study and the ablation were performed
      simultaneously. The location of the accessory pathways were as follows: 61
      pathways in the free wall of the left ventricle, 4 in the free wall of the right
      ventricle, 25 in the left posteroseptal region, 9 in the right posteroseptal
      region and 2 in the right anteroseptal area. The time required for the diagnostic
      component of the electrophysiology study, the ablation procedure and the
      fluoroscopic time was recorded for each patient. Ninety-one of 101 accessory AV
      connections were successfully ablated (90%). Our success rate for the initial
      attempt was 87%. We had the opportunity to do a second attempt in only 4 out of
      14 patients. The mean time of the procedure, including the electrophysiology test
      and the ablation was 95.6 %/-55.3 minutes. We have had a recurrence of 9% and 4%
      of non fatal complications. Radiofrequency catheter ablation can be performed
      safely and with a high success rate.

PMID- 8466366
TI  - [Coronary angioplasty in patients not accepted for surgical treatment. The
      initial experience of the Ignacio Chavez Instituto Nacional de Cardiologia].
AB  - Coronary angioplasty has shown its efficacy in "high-risk" patients for surgical
      treatment (severe left ventricular failure, serious pulmonary or systemic
      disease). We studied a subgroup with multivessel coronary heart disease treated
      with coronary angioplasty because they were no candidates for surgery due to
      unsuitable coronary anatomy. Revascularization rate was determined in each
      patient as revascularization percentage obtained, compared with all the
      technically suitable lesions for coronary angioplasty. Ten patients (mean age 63
      years) were studied, eight of them had unstable angina. Overall, 44 lesions were
      considered technically suitable for angioplasty and thirty-five could be dilated,
      technical success rate was 88% (31/35 lesions) and revascularization rate was 71%
      (31/44 lesions). Primary success rate was achieved in nine patients. Clinical
      follow-up varied from two to thirteen months (mean 7.8 months); eight patients
      have remained asymptomatic (class I of NYHA), another patient had stable angina
      and the other one had sudden death six months after the procedure. In conclusion,
      we demonstrated a high success rate in a short and long term with coronary
      angioplasty in a subgroup of patients with multivascular coronary heart disease
      that had been rejected for surgery due to unsuitable coronary anatomy.

PMID- 8466367
TI  - [The treatment of infectious endocarditis. Cefotaxime versus "traditional"
      medical management].
AB  - We performed an open study to compare efficacy and renal toxicity of cephotaxime
      versus the usual beta lactam plus aminoglucoside treatment of infectious
      endocarditis. Twenty cases were studied, 10 treated with cephotaxime 4 g/day per
      21 days and aminoglucoside for only 10 days. Comparison group received a
      combination of different beta lactam antibiotic plus aminoglucoside for 21 to 50
      days, these patients were under care of nonparticipant physicians. Although
      cephotaxime treatment was as good as conventional antimicrobial scheme for
      control of infectious endocarditis, the treatment cost increases, and there is
      only marginal benefit in regard renal toxicity.

PMID- 8466368
TI  - [Percutaneous transvenous mitral commissurotomy with a Medi-tech balloon
      catheter: the initial experience and midterm follow-up].
AB  - From Jan-21-91 to Jan-8-92 we performed percutaneous transvenous mitral
      commissurotomy (PTCM) with a Medi-tech balloon catheter (MBC) in 41 patients
      bearing mitral stenosis simple o predominant. We utilized an anterograde
      transseptal approach in order to access the mitral valve, the procedure failed in
      5 patients, in 30 of them we used double MBC and single MBC were utilized in 6
      patients. Both left ventriculogram and hemodynamic parameters were taken before
      and after PTCM. Posterior to PTCM an important decrease appeared in the mitral
      transvalvular gradient from 20.6 +/- 2.7 to 2.4 +/- 1.7 mmHg (p < 0.0001) and an
      average pressure of pulmonary artery of 46.2 +/- 9.8 to 23.9 +/- 6 mmHg (p <
      0.0001), and also the pulmonary arterial resistance from 1178.1 to 557.1 dinas/cm
      5/seg. There was an important concomitant increase in mitral valvular area from
      0.84 +/- 0.11 to 2.38 +/- 0.08 cm2 (p < 0.0001) and in cardiac rate from 2.7 +/-
      0.7 to 2.9 +/- 0.52 L/min (p < 0.001). COMPLICATIONS: Two female patients
      developed cardiac tamponade, one of them the procedure was successful, and for
      the other it was decided to submit her to valvular replacement. Mitral
      insufficiency was present in three patients; GI/IV in two of them and GII/IV
      angiographic in one. Another patient presented cerebral thromboembolism with
      complete recovery within 15 days. Short left to right shunt was detected only in
      8 patients being 1.2/1 in 6 of them, 1.3/1 in one and 1.4/1 in other patient.
      Thirty three uncomplicated were dismissed within a maximum of 48 hours after
      procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466369
TI  - [An overview of nuclear magnetic resonance in the study of the heart and major
      vessels].

PMID- 8466370
TI  - [The cardiovascular effects of cocaine (I)].

PMID- 8466371
TI  - [Radiofrequency ablation, a new technic in the treatment of tachyarrhythmias].

PMID- 8466373
TI  - Morning vs afternoon exertion. Both are safe, but which is safer?

PMID- 8466372
TI  - [Interventional cardiology in Aguascalientes. The first 2 years of experience].

PMID- 8466374
TI  - Approaches to asthma management. Realities and recommendations.
AB  - As asthma prevalence continues to increase, so does its impact on public health
      and on health care systems. Despite the prescription of more antiasthma
      medications than ever before, morbidity and mortality associated with asthma
      continue to increase. The focus of asthma therapy is changing, with a greater
      emphasis on control of the inflammatory rather than the bronchoconstrictive
      component. Several sets of guidelines recently developed by groups of asthma
      specialists clearly reflect this new focus. While such recommendations are
      intended to help physicians more accurately diagnose asthma by severity and
      better manage its symptoms, uniformity in both areas is lacking. Disparities are
      seen not only among physicians overall but also among primary care physicians
      compared with subspecialists. New survey data help to illustrate how reality--the
      clinical approaches of these physician subgroups--differs from current
      recommendations. Physicians who treat patients with asthma may find that their
      approaches are in agreement with those of their peers. Nonetheless, they may also
      find that they deviate from guidelines that could improve clinical outcome for a
      substantial number of patients with asthma.

PMID- 8466375
TI  - Should patients with heart disease exercise in the morning or afternoon?
AB  - OBJECTIVE: To compare the cardiovascular risk of exercise in the morning and
      afternoon in patients with established heart disease. DESIGN: Retrospective
      cohort study. PATIENTS: Patients with established heart disease referred for
      participation in a comprehensive cardiac rehabilitation program. INTERVENTION:
      Supervised, submaximal exercise (1 hour three times per week) performed either in
      the morning (7:30 AM) or the afternoon (3 PM). MAIN OUTCOME: Documented cardiac
      events that occurred while patients were exercising in the rehabilitation
      programs. RESULTS: There were five cardiac events in 168,111 patient-hours of
      exercise in the morning, with an incidence of 3.0 +/- 1.3 events per 100,000
      patient-hours. There were two events during the 84,491 patient-hours of exercise
      in the afternoon, for an incidence of 2.4 +/- 1.5 events per 100,000 patient
      hours (not significant). The risk ratio of cardiac events during exercise in the
      morning compared with the afternoon was 1.27 (95% confidence interval, 0.25 to
      6.55). CONCLUSION: In patients with coronary artery disease, the incidence of
      cardiac events is low during regular, submaximal exercise whether performed in
      the morning or the afternoon.

PMID- 8466376
TI  - The use of an indwelling Teflon catheter for subcutaneous heparin administration
      during pregnancy. A randomized crossover study.
AB  - BACKGROUND: The use of subcutaneous heparin, the therapy of choice for women
      requiring anticoagulant prophylaxis during pregnancy, is problematic because of
      the discomfort produced by repeated injections. An indwelling subcutaneous Teflon
      catheter that can be left in place for 1 week recently became available for use
      as an entry port for parenteral therapy. Since the use of this catheter has the
      potential to overcome some of the problems of long-term heparin therapy, we
      decided to compare this Teflon catheter with twice-daily subcutaneous injections
      in women requiring heparin during pregnancy. METHODS: In a randomized, multiple
      crossover study, patients alternated every 2 weeks between having heparin
      administered through the indwelling Teflon catheter and receiving heparin via
      subcutaneous injections. After each 4-week cycle, patients completed a
      questionnaire designed to determine their preferred method of heparin
      administration. The side effects, doses, and anticoagulant activity of heparin
      with the two delivery systems were also compared. RESULTS: Twelve patients
      completed one to five 4-week cycles of heparin therapy. Ten of the patients
      selected the Teflon catheter as the preferred route of heparin administration (P
      = .04) and 11 patients reported that the catheter caused less pain and bruising
      than twice-daily subcutaneous injections (P < .01). Five patients developed
      urticarial reactions at the sites of heparin injections. These reactions tended
      to be more severe when the Teflon catheter was used, and two women discontinued
      using the catheter after the first cycle because of this complication. There were
      no differences in heparin dose requirements or achieved activated partial
      thromboplastin times between the two routes of heparin administration.
      CONCLUSIONS: Most pregnant women in our study preferred to have subcutaneous
      heparin administered through an indwelling Teflon catheter rather than by twice
      daily injections. Heparin given through the Teflon catheter was bioavailable and
      caused less local bruising than twice-daily injections. Urticarial reactions to
      heparin tended to be more severe with the use of the Teflon catheter and resulted
      in the discontinuation of the device's use in two of 12 patients.

PMID- 8466377
TI  - Weight loss intervention in phase 1 of the Trials of Hypertension Prevention. The
      TOHP Collaborative Research Group.
AB  - BACKGROUND: Phase 1 of the Trials of Hypertension Prevention was a collaborative,
      randomized controlled clinical trial designed to determine the feasibility and
      efficacy of selected nonpharmacologic interventions in reducing or preventing an
      increase in diastolic blood pressure. METHODS: Participants aged 30 to 54 years
      who had a high-normal diastolic blood pressure (80 to 89 mm Hg), and were between
      115% and 165% of their desirable body weight, were randomly assigned to either an
      18-month weight loss intervention (n = 308) or a usual-care control condition (N
      = 256). Intervention consisted of 14 weekly group meetings followed by monthly
      maintenance sessions. Intervention participants received training in behavioral
      self-management technique and were asked to make life-style changes aimed at
      achieving a moderate reduction in energy intake and an increase in physical
      activity. RESULTS: The average weight losses in the intervention group at 6, 12,
      and 18 months of follow-up were 6.5, 5.6, and 4.7 kg for men and 3.7, 2.7, and
      1.6 kg for women. The mean (+/- SE) change in diastolic blood pressure for
      intervention participants compared with controls at termination was -2.8 +/- 0.6
      mm Hg for men and -1.1 +/- 0.9 mm Hg for women. For systolic blood pressure, the
      corresponding change was -3.1 +/- 0.7 mm Hg for men and -2.0 +/- 1.3 mm Hg for
      women. Blood pressure reductions were greater for those who lost larger amounts
      of weight. Sex-related differences in blood pressure response were largely due to
      the smaller amount of weight lost by women, and sex differences in weight loss
      could be accounted for by differences in baseline body weight. CONCLUSIONS:
      During an 18-month follow-up period, this weight reduction program was shown to
      be an effective nonpharmacologic intervention for reducing blood pressure in
      overweight adults with high-normal blood pressure.

PMID- 8466378
TI  - The superiority of antimicrosomal over antithyroglobulin antibodies for detecting
      Hashimoto's thyroiditis.
AB  - BACKGROUND: Antimicrosomal (anti-M) and antithyroglobulin (anti-Tg) antibodies
      are commonly measured together to detect Hashimoto's thyroiditis. Since this
      nearly doubles the cost of testing for one antibody, we wished to determine
      whether significant diagnostic loss would occur if the two tests were replaced by
      anti-M alone. METHODS: Both tests were performed in 2030 consecutive patients
      referred by general internists and endocrinologists. RESULTS: With a positive
      result defined as either test being positive at a 1:100 dilution, anti-M was much
      more sensitive than anti-Tg. Anti-M was positive in 99% (823/831) of all patients
      with positive tests, while anti-Tg was positive in 36% (302/831). Anti-M was the
      only positive test in 64% of all patients with positive tests, while anti-Tg was
      the only positive test in 1%. With a cutoff point of 1:400 dilution, the results
      were similar. CONCLUSIONS: Anti-M alone appears sufficient to detect autoimmune
      thyroid disease at about one half the cost of routinely performing both anti-M
      and anti-Tg studies. The widespread practice of performing both tests increases
      the cost without an offsetting diagnostic gain.

PMID- 8466379
TI  - Clinically significant hearing loss in renal allograft recipients treated with
      intravenous erythromycin.
AB  - BACKGROUND: Hearing loss is generally regarded as a rare side effect of
      erythromycin therapy. However, our own clinical experiences in erythromycin
      treated patients led us to suspect that this complication may be more common
      among renal allograft recipients. The purpose of this study was to evaluate the
      incidence, predisposing factors, clinical characteristics, and outcomes of
      erythromycin-induced hearing loss among renal allograft recipients. METHODS: We
      reviewed medical records of renal transplant patients treated for pneumonia with
      intravenous erythromycin lactobionate. Patients were evaluated for the occurrence
      of clinically significant hearing loss (including onset, duration, and
      reversibility), other signs and symptoms of ototoxicity (vertigo and tinnitus),
      daily erythromycin dose and duration of treatment, concurrent ototoxic drug
      therapy, renal and hepatic function, and history of previous otic disease.
      RESULTS: Eleven (32%) of 34 courses of intravenous erythromycin therapy resulted
      in hearing loss. The incidence of hearing loss was 53% (eight of 15 courses) in
      patients treated with 4 g of erythromycin daily compared with 16% (three of 19
      courses) among those receiving 2 g/d (P = .05). In addition, courses of
      erythromycin were longer in those suffering auditory toxicity (9.6 +/- 4.7 days)
      than in nontoxic patients (5.7 +/- 3.6 days) (P < .05). Hepatic and renal
      function did not differ between toxic and nontoxic patients. All episodes of
      erythromycin-induced hearing loss were reversible. CONCLUSIONS: We conclude that
      clinically significant hearing loss occurs in more than 30% of renal allograft
      recipients treated for pneumonia with intravenous erythromycin lactobionate.
      Patients who require prolonged courses of erythromycin and those treated with 4
      g/d are at particular risk for the development of auditory toxicity. With prompt
      recognition and modification of therapy, erythromycin-induced hearing loss
      appears to be completely reversible.

PMID- 8466380
TI  - Thyrotoxicosis followed by hypothyroidism in patients treated with amiodarone. A
      possible consequence of a destructive process in the thyroid.
AB  - Amiodarone is an iodine-rich drug used in the treatment of resistant cardiac
      arrhythmias. Amiodarone-induced thyrotoxicosis (AIT) is well recognized and is
      generally believed to be due to the excess iodine released from the metabolism of
      the drug, although amiodarone-associated thyroiditis has occasionally been
      observed. We report the clinical, laboratory, and therapeutic course of nine
      patients with AIT. The thyrotoxic phase was often followed by mild hypothyroidism
      during and after antithyroid drug or corticosteroid therapy. The thyroid was
      tender to palpation in two patients and a fine-needle aspiration biopsy of the
      thyroid revealed changes consistent with thyroiditis in three patients who
      underwent biopsy. These findings strongly suggest that the etiology of AIT, at
      least in some patients, is due, in part, to drug-induced inflammatory changes in
      the thyroid, as has been reported to occur in lung, bone marrow, and testes.
      Thus, the AIT may be due to excess iodine, drug-induced thyroiditis, or a
      combination of the two. The favorable response of AIT to corticosteroids in
      occasional patients previously reported also suggests that acute thyroiditis was
      probably present.

PMID- 8466381
TI  - Vasospastic angina associated with menses.

PMID- 8466382
TI  - Esophagogastroduodenoscopy for suspected gastrointestinal deposits.

PMID- 8466383
TI  - Anti-atherogenic effect of nuts: is the answer NO?

PMID- 8466384
TI  - Coffee and coronary heart disease.

PMID- 8466385
TI  - Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders
      Interview Schedule-Revised (ADIS-R).
AB  - A large reliability study of DSM-III-R anxiety disorders is reported in which
      outpatients (n = 267) received two independent structured interviews (Anxiety
      Disorders Interview Schedule-Revised). It is the only reliability study to date
      in which the final DSM-III-R criteria are used throughout the study. Reliability
      was assessed for each diagnosis when it was assigned as a principal diagnosis and
      when it was assigned as either a principal or an additional diagnosis. Excellent
      reliability was obtained for current principal diagnoses of simple phobia, social
      phobia, and obsessive-compulsive disorder. Agreement was good for panic disorder
      when all severity levels of agoraphobic avoidance were combined. Reliability was
      fair for generalized anxiety disorder. Remaining diagnostic difficulties,
      particularly in identifying levels of agoraphobic avoidance and in reliably
      diagnosing generalized anxiety disorder, are discussed in the context of changes
      in diagnostic criteria that are under consideration for DSM-IV.

PMID- 8466386
TI  - A twin study of genetic and environmental contributions to liability for
      posttraumatic stress symptoms.
AB  - We studied 4042 Vietnam era veteran monozygotic and dizygotic male twin pairs to
      determine the effects of heredity, shared environment, and unique environment on
      the liability for 15 self-reported posttraumatic stress disorder symptoms
      included in the symptom categories of reexperiencing the trauma, avoidance of
      stimuli related to the trauma, and increased arousal. Quantitative genetic
      analysis reveals that inheritance has a substantial influence on liability for
      all symptoms. Symptoms in the reexperiencing cluster and one symptom in the
      avoidance and numbing cluster are strongly associated with combat exposure, and
      monozygotic pairs are more highly concordant for combat exposure than dizygotic
      pairs. By fitting a bivariate genetic model, we show that there are significant
      genetic influences on symptom liability, even after adjusting for differences in
      combat exposure; genetic factors account for 13% to 30% of the variance in
      liability for symptoms in the reexperiencing cluster, 30% to 34% for symptoms in
      the avoidance cluster, and 28% to 32% for symptoms in the arousal cluster. There
      is no evidence that shared environment contributes to the development of
      posttraumatic stress disorder symptoms.

PMID- 8466387
TI  - Abnormal noradrenergic function in posttraumatic stress disorder.
AB  - To evaluate possible abnormal noradrenergic neuronal regulation in patients with
      posttraumatic stress disorder (PTSD), the behavioral, biochemical, and
      cardiovascular effects of intravenous yohimbine hydrochloride (0.4 mg/kg) were
      determined in 18 healthy male subjects and 20 male patients with PTSD. A subgroup
      of patients with PTSD were observed to experience yohimbine-induced panic attacks
      (70% [14/20]) and flashbacks (40% [8/20]), and they had larger yohimbine-induced
      increases in plasma 3-methoxy-4-hydroxyphenylglycol levels, sitting systolic
      blood pressure, and heart rate than those in healthy subjects. In addition, in
      the patients with PTSD, yohimbine induced significant increases in core PTSD
      symptoms, such as intrusive traumatic thoughts, emotional numbing, and grief.
      These data were consistent with a large body of preclinical data that indicated
      that uncontrollable stress produces substantial increases in noradrenergic
      neuronal function. We discuss the implications of these abnormalities in
      noradrenergic functional regulation in relation to the long-term neurobiological
      sequelae of severe uncontrollable stress and the pathophysiological relationship
      between PTSD and other anxiety disorders, such as panic disorder.

PMID- 8466388
TI  - Effect of innervation on heart rate response to mental stress.
AB  - Heart transplant recipients provide a useful model for study of the autonomic
      control of the cardiovascular response to mental stress. Utilizing the innervated
      native atrial tissue of heart transplant recipients as an internal control
      exposed to the same circulatory milieu as the denervated graft heart was exposed
      to, the effect of innervation on the heart rate response to a mentally stressful
      arithmetic task was examined in eight subjects. Compared with the graft, the
      innervated atrial tissue manifested a larger heart rate increase during the task,
      larger heart rate decrease after the task, and more rapid rate of change in heart
      rate during the task and recovery periods. Thus, cardiac denervation results in a
      chronotropic response to mental arithmetic-induced stress that is blunted and
      more gradual than that of the innervated heart but not completely eliminated. The
      cardiac chronotropic response to mental arithmetic stress is dependent on both
      humoral factors and, predominantly, its direct autonomic innervation.

PMID- 8466389
TI  - Panic attacks during placebo procedures in the laboratory. Physiology and
      symptomatology.
AB  - Heart rate, respiratory measurements, and Acute Panic Inventory symptoms of 17
      patients with panic disorder who experienced panic attacks during a placebo
      infusion (situationally provoked panic) were analyzed and compared with similar
      data from a group of 19 patients with panic disorder who panicked during lactate
      infusion. Previously, it was shown that the group with lactate-induced panic
      attacks exhibited increased minute ventilation compared with normal control
      subjects and nonpanicking patients with panic disorder during lactate infusion.
      The group with situationally provoked panic attacks exhibited significant
      increases in both heart rate and minute ventilation immediately preceding the
      onset of the panic attack. The increase in minute ventilation appeared to be
      caused more by increase in tidal volume than in respiratory frequency. The
      increase in heart rate in the group with situationally provoked panic attacks was
      very similar to that seen in the group with lactate-induced panic attacks, but
      the group with situationally provoked panic attacks appeared to have somewhat
      greater increase in minute ventilation than the group with lactate-induced panic
      attacks. This suggests that the metabolic alkalosis produced by lactate infusion
      might actually blunt the full expression of panic-associated respiratory
      stimulation. These data validate the belief that significant cardiorespiratory
      stimulation occurring during panic attacks in the laboratory is not simply
      secondary to the intrinsic physiologic effects of panic-inducing substances such
      as lactate, yohimbine, and carbon dioxide.

PMID- 8466390
TI  - A direct interview family study of social phobia.
AB  - Risks for DSM-III-R anxiety and affective disorders and "subdisorder"
      (nonimpairing) irrational social fears, among directly interviewed first-degree
      relatives (n = 83) of probands who met criteria for social phobia but for no
      other lifetime anxiety disorder diagnosis, were contrasted to risks for disorder
      among similarly evaluated relatives (n = 231) of never mentally ill controls.
      Relatives of social phobia probands had a significantly increased risk for social
      phobia (16% vs 5%, relative risk = 3.12) but not for other anxiety disorders.
      These results suggest a familial contribution to the development of some cases of
      social phobia. The specificity of the pattern of intergenerational transmission
      is consistent with the current nosologic distinction between social phobia and
      other anxiety disorders.

PMID- 8466391
TI  - Psychobiologic mechanisms of posttraumatic stress disorder.

PMID- 8466393
TI  - The professional historical error.

PMID- 8466392
TI  - False suffocation alarms, spontaneous panics, and related conditions. An
      integrative hypothesis.
AB  - A carbon dioxide hypersensitivity theory of panic has been posited. We
      hypothesize more broadly that a physiologic misinterpretation by a suffocation
      monitor misfires an evolved suffocation alarm system. This produces sudden
      respiratory distress followed swiftly by a brief hyperventilation, panic, and the
      urge to flee. Carbon dioxide hypersensitivity is seen as due to the deranged
      suffocation alarm monitor. If other indicators of potential suffocation provoke
      panic this theoretical extension is supported. We broadly pursue this theory by
      examining Ondine's curse as the physiologic and pharmacologic converse of panic
      disorder, splitting panic in terms of symptomatology and challenge studies,
      reevaluating the role of hyperventilation, and reinterpreting the contagiousness
      of sighing and yawning, as well as mass hysteria. Further, the phenomena of panic
      during relaxation and sleep, late luteal phase dysphoric disorder, pregnancy,
      childbirth, pulmonary disease, separation anxiety, and treatment are used to test
      and illuminate the suffocation false alarm theory.

PMID- 8466394
TI  - The psychological impact of the Gulf War: a study of acute stress in Israeli
      evacuees.

PMID- 8466395
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry: introduction.

PMID- 8466396
TI  - Matrix effects on proficiency testing materials. Impact on accuracy of
      cholesterol measurement in laboratories in the nation's largest hospital system.
AB  - The objective of this collaborative study with the Department of Veterans Affairs
      (VA), College of American Pathologists (CAP), and the Centers for Disease Control
      and Prevention (CDC) was to quantitate the matrix-induced biases of cholesterol
      measurements on the CAP Comprehensive Chemistry Surveys materials used in
      proficiency testing (PT). A total of 174 VA Medical Centers outpatient clinics
      and clinical laboratories participate in the VA-CDC National Cholesterol
      Standardization and Certification Program. This study was conducted in 112 VA
      laboratories that have been standardized for measuring cholesterol accurately
      (within +/- 3.0% of the CDC reference-method values) using fresh, unfrozen,
      unadulterated human serum samples. Fresh serum samples and 1990 CAP Surveys
      materials were sent by overnight mail, and the laboratories were asked to analyze
      them simultaneously in triplicate in a single analytic batch run. The results
      showed significant matrix-effect biases with the CAP Surveys materials with six
      of the eight major peer groups, despite the fact that accuracy of cholesterol
      measurements was maintained with fresh serum samples. The magnitude and direction
      (positive or negative) of the matrix-effect biases were instrument, reagent, and
      method specific using the following peer groups: du Pont Dimension (-8.9%);
      Beckman CX4, CX5, and CX7 (-5.5%); Kodak Ektachem 400, 500, and 700 (+4.4%);
      Instrumentation Laboratory Monarch (-3.1%); Baxter Paramax (-2.4%); Technicon
      SMAC and RA (+1.3%); Hitachi/BMD 704 through 747 (+0.4%); and Abbott Spectrum (
      0.3%). The CAP PT materials used currently do not behave in a manner identical to
      fresh human serum when measuring cholesterol on many, but not all, analytic
      systems. The observed biases due to "matrix effects" with PT materials will cause
      incorrect conclusions about the accuracy of many laboratory procedures performed
      on fresh patient specimens. This matrix-effect phenomenon will severely hamper
      interlaboratory accuracy transfer, standardization efforts, and monitoring
      performance of a laboratory's testing accuracy with the use of the current survey
      materials used in PT programs. Collaborative efforts are needed to (1) improve PT
      fluids to analytically behave more like fresh, human serum; (2) improve
      instrument design and reagent formulation; and (3) select methods and
      methodologic parameters that are more "robust" and less sensitive to the exact
      character of processed calibrators, quality control, and PT materials.

PMID- 8466397
TI  - Accurate enzyme activity measurements. Two decades of development in the
      commutability of enzyme quality control materials.
AB  - Commercial serum preparations are integral components of both internal and
      external quality control programs for enzyme activity measurements. However,
      properties of these materials may differ significantly from those of clinical
      specimens. Differences from clinical specimens may include the following: species
      origin of the enzyme; isoenzyme form(s); integrity of the molecular species;
      matrix of the solution; processes such as lyophilization; and addition of
      preservatives. There are also significant differences among methods measuring the
      activity of a single enzyme including a diversity of compounds that may serve as
      substrate(s); variable cofactor or metal supplementation; and differences in the
      substrate concentration(s), buffer substances, pH, and temperature. The measured
      response to each of these variations in assay technique may differ among these
      types of specimens. To be acceptable, quality control materials must have
      properties similar to those of clinical specimens. Thus, the concept of
      commutability that we originated and first applied to enzyme activity
      measurements remains useful, and its further application to the problem of
      "matrix effects" is reviewed here. Multivariate display techniques are applied to
      the specific examples of aspartate aminotransferase, alpha-amylase, and alkaline
      phosphatase to judge the commutability of quality control materials for these
      enzymes.

PMID- 8466398
TI  - Matrix effects in blood gas proficiency testing.
AB  - Materials currently used for blood gas proficiency testing are unlike whole blood
      in several obvious respects, which by definition introduces matrix effects as
      possible sources of error that can affect proficiency testing results. Data from
      recent College of American Pathologists surveys are reviewed and aqueous and
      fluorocarbon matrices for PO2 and PCO2 testing are compared. Closely related to
      matrix effects are other sources of error unique to proficiency testing samples,
      such as sample temperature and sample packaging. Proficiency testing programs are
      seriously hampered by not being able to use either whole blood or a better
      surrogate than is currently available. In particular, the use of aqueous
      materials has the potential to penalize participant laboratories unfairly in some
      cases and to turn proficiency testing into a meaningless exercise in others.

PMID- 8466399
TI  - Review of the influence of polypeptide hormone forms on immunoassay results.
AB  - Various forms of the polypeptide hormones that occur in blood, fluids, or tissues
      can differ according to physiologic and pathologic states. Forms include subunits
      of luteinizing hormone, follicle-stimulating hormone, human chorionic
      gonadotropin, and thyroid-stimulating hormone. Hormonal isoforms occur for these
      hormones as well as for prolactin and growth hormone. Variation in hormonal forms
      appears to contribute significantly to the wide variation in immunoassay results
      for these polypeptide hormones. Subunits and isoforms of the polypeptide hormones
      can overreact or underreact in monoclonal antibody assays. The underreaction or
      overreaction can occur with standards, controls, and patient specimens as well as
      with the assay label.

PMID- 8466400
TI  - Matrix effects in therapeutic drug monitoring surveys. Proposed protocol to
      identify error components and quality improvement opportunities.
AB  - Therapeutic drugs are not endogenous compounds. Therefore, differing reactivities
      between proficiency testing and patient samples have potential mechanisms beyond
      those attributable to alterations of the serum protein base, stabilizing
      materials, and other manufacturing components. The therapeutic drug monitoring
      proficiency sample is the ultimate in polypharmacy. Cross-reactivities may be
      uncovered that may or may not occur with any frequency in patient samples. Drugs
      are present in therapeutic drug monitoring proficiency samples in the absence of
      their metabolites, which may alter interactions with the assay systems. The CAP
      Therapeutic Drug Monitoring Resource Committee has contacted manufacturers when a
      specific method yields proficiency test results that differ from all other
      methods and/or the weighed-in target values. Only a few examples have been
      formally evaluated with the "matrix evaluation protocol." The protocol is very
      useful and has identified some matrix effects. A protocol is proposed using
      multiple samples containing survey base material. Data analysis using reciprocal
      plots will identify interference and corroborate calibration or recovery errors
      in the presence of survey base material. Data from 1987 through 1991 surveys for
      lithium and theophylline illustrate this data analysis and show interference from
      other drugs and suggest calibration errors. Weighted-in target values are the
      most rigorous method to provide accurate, transferable patient results and
      convince ourselves and our evaluators that we know what we are measuring. All of
      us need to be committed to improvement of laboratory procedures. I believe
      weighed-in target values are the appropriate and achievable goal for proficiency
      testing the majority of therapeutic drug monitoring analytes. Implementation of
      target values requires diligent and intricate collaboration among laboratorians,
      surveyors, manufacturers, and regulators.

PMID- 8466401
TI  - Accuracy verification and identification of matrix effects. The College of
      American Pathologists' Protocol.
AB  - Proficiency testing using stabilized control materials has been used for decades
      as a means of monitoring and improving performance in the clinical laboratory.
      Often, the commonly used proficiency testing materials exhibit "matrix effects"
      that cause them to behave differently from fresh human specimens in certain
      clinical analytic systems. Because proficiency testing is the primary method in
      which regulatory agencies have chosen to evaluate clinical laboratory
      performance, the College of American Pathologists (CAP) has proposed guidelines
      for investigating the influence of matrix effects on their Survey results. The
      purpose of this investigation was to determine the feasibility, usefulness, and
      potential problems associated with this CAP Matrix Effect Analytical Protocol, in
      which fresh patient specimens and CAP proficiency specimens are analyzed
      simultaneously by a field method and a definitive, reference, or other
      comparative method. The optimal outcome would be that both the fresh human and
      CAP Survey specimens agree closely with the comparative method result. However,
      this was not always the case. Using several different analytic configurations, we
      were able to demonstrate matrix and calibration biases for several of the
      analytes investigated.

PMID- 8466402
TI  - Statistical power in the detection of matrix effects.
AB  - Matrix-induced bias can adversely affect the performance evaluation a clinical
      laboratory receives on proficiency testing results. Therefore, it is vital that
      matrix effects from a matrix-biased system are detected and that laboratories
      using these systems are not falsely penalized on their proficiency testing
      results. The College of American Pathologists has developed an experimental
      protocol to test whether an observed bias is, in fact, due to the proficiency
      testing sample matrix rather than true performance or calibration problems. The
      probability of detecting a matrix effect using this protocol given a matrix
      biased system is defined as statistical power. Five parameters are known to
      affect the probability of detection: (1) size of the bias in the proficiency
      testing material, (2) lack of fit coefficient of variation-natural variation in
      patient samples used to define the relationship between the test and reference
      methods, (3) pure error coefficient of variation-random variation in the test
      method, (4) the number of fresh patient samples, and (5) the number of replicates
      for each sample. The level of significance of the statistical test will also
      affect the probability of detection. Power curves are generated to show the
      effect these five parameters have on the determination of power. With the
      exception of bias, power is most influenced by the components of variance, lack
      of fit (nonlinear), and pure (random) error. Of these two components, the lack of
      fit error, which represents an uncontrollable source of error, is usually more
      influential than pure error, which can be reduced by a larger number of
      replicates. A large increase in power will result from an increase of fresh
      patient samples from 10 to 20, and a moderate increase in power will result from
      an increase of fresh patient samples from 20 to 40; no noticeable increase in
      power is seen with greater than 40 fresh patient samples. Large increases in
      power were observed for increases in the number of replicates per sample from one
      to two, two to three, and three to five. To markedly increase power further, 10
      replicates would have to be assayed.

PMID- 8466403
TI  - Matrix effects and the accuracy of cholesterol analysis.
AB  - We found evidence of bias due to matrix effect in 70% of 37 instrument/reagent
      specific systems analyzing the total cholesterol content of a lyophilized
      proficiency testing material. We used a computational method to remove bias due
      to matrix effect from the proficiency testing database. After correction for
      matrix effect bias and when compared with the reference method, 92% to 93% of
      results for three lyophilized proficiency testing samples analyzed in 1989 and
      1990 met the 1992 National Cholesterol Education Program total error goal of
      8.9%, and 94% to 95% met the Clinical Laboratory Improvement Amendments of 1988
      (CLIA '88) goal of 10%. However, compared with the definitive method for total
      cholesterol, the calibration bias of 41% of 37 peer groups exceeded the 1992
      National Cholesterol Education Program goal for bias of 3%. Because the
      calibration bias of the method is incorporated into the peer group mean, use of
      peer group means as target values to assess result acceptability hinders
      advancement of the state of the art in interlaboratory comparability and the
      clinical effectiveness of laboratory testing. The prevalence of matrix effects
      has prevented successful application of accuracy-based evaluation of cholesterol
      test proficiency. The establishment of predictable recovery, preferably complete
      recovery, of cholesterol from reference materials is an important priority for
      cholesterol test methods. However, adjustment of proficiency testing results to
      remove the average bias due to matrix effects can help assess the actual state of
      the art in cholesterol test accuracy.

PMID- 8466404
TI  - Matrix effects and accuracy assessment. Identifying matrix-sensitive methods from
      real-time proficiency testing data.
AB  - Retrospective proficiency testing data may be used to screen for matrix effect,
      which is suspected when significant methodologic bias is detected. Prioritization
      is centered on those situations where relatively high unacceptability rates are
      associated with high bias. Before attributing high unacceptability rates to
      methodologic bias, factors such as peer grouping strategies, number of
      participants in peer groups, analyte concentration, evaluation limits, and
      interparticipant precision, all of which affect scoring, need to be considered.
      When bias-associated high unacceptability rates are detected, methods are
      candidates for further evaluations to identify the causes of bias, to determine
      if matrix effect is present. Using outputs from the College of American
      Pathologists Survey Management Enhancement Program, we have presented data from
      the 1991 Comprehensive Chemistry Survey to demonstrate methodology to study this
      problem, and have selected examples of method performance in which tabular and
      graphic information contribute to its study. For the analytes studied,
      unacceptability rates tend to be greatest in association with high methodologic
      bias and/or between-participant imprecision relative to external evaluation
      limits, samples at the upper extreme of analyte concentration, low numbers of
      participants in peer groups, grading by comparative method, and concentration
      independent fixed evaluation limits. Specific examples of significant bias that
      is possibly matrix induced are presented for uric acid, glucose, creatinine, and
      total protein.

PMID- 8466405
TI  - Achieving accuracy for routine clinical chemistry methods by using patient
      specimen correlations to assign calibrator values. A means of managing matrix
      effects.
AB  - Accurate results obtained from routine methods used in the clinical laboratory
      can be achieved if the methods are traceable to definitive or reference methods
      or are based on widely accepted methodologic principles. At Eastman Kodak Co
      (Rochester, NY), we assign calibrator values for each method that is available on
      Kodak Ektachem analyzers by correlation to a reference method or a methodologic
      principle using patient specimens. Kodak's Reference Laboratory is responsible
      for maintaining the accuracy and consistency of the reference method or
      methodologic principle by standardizing with National Institute of Standards and
      Technology materials, where available, monitoring performance through statistical
      process control, participating in proficiency testing programs, and following
      procedures consistent with the International Organization for Standardization
      guideline, "General Requirements for the Competence of Calibrations and Testing
      Laboratories (ISO 25). "Patient samples that span the reportable range are run in
      replicate on the reference method or methodologic principle over several days.
      These patient sample results are then used to create a calibration curve based on
      the relationship of concentration to the raw response of the routine method,
      where the same patient samples are also run in replicate on the same day. Each
      day, multiple vials of stable calibrator fluids are included in these tests,
      along with control materials. Each calibrator is assigned a value of equivalent
      concentration (in millimoles per liter) by predicting the concentration that
      would be present at the measured response if the test fluid were a patient
      sample. These are termed supplementary assigned values (SAVs). The same
      calibrators can be used to compensate for matrix effects resulting from changes
      in reagent formulations, by appropriately adjusting the assigned values. For
      example, when a process improvement for Kodak Ektachem clinical chemistry slides
      for phosphorus was introduced, an SAV change of 0.39 mmol/L (1.2 mg/dL) was
      required for one calibrator to maintain accuracy of the patient samples. A
      comparison of patient samples, using the SAVs specific for each formulation, gave
      excellent correlation (in millimoles per liter; r2 = 0.995) by the following
      equation: New Formulation = 1.02 (Old Formulation) -0.016; Sy.x = 0.074. The
      benefits of this approach to calibration include (1) accuracy is traceable to a
      reference method or methodologic principle and, wherever available, to reference
      materials; (2) new calibrator values (SAVs) can be assigned whenever the reagent
      formulation changes to maintain accurate patient results; and (3) if matrix
      effects are present, they will not adversely influence accuracy because
      traceability is based on patient sample comparisons.

PMID- 8466406
TI  - Manufacturer's approach in transferring accuracy to multiple field installations.
AB  - Manufacturers of instrument systems for in vitro diagnostic use are closely
      regulated by the Food and Drug Administration and sell their products to clinical
      laboratories that participate in rigorous quality control and proficiency testing
      programs. In these circumstances, manufacturers must plan and implement
      procedures that will ensure acceptable accuracy and precision from all installed
      systems. This activity starts with the design goals and specifications and
      continues with manufacturing and quality assurance testing, through various
      postsale support services. This article outlines some specific instrumentation
      examples to demonstrate the accomplishment of these objectives.

PMID- 8466407
TI  - Problems in formulating method-insensitive proficiency testing materials.
AB  - Significant problems exist in formulating method-insensitive proficiency
      materials. Many steps are required in processing human plasma, and difficult
      choices are involved in the selection of appropriate materials to be added to the
      processed plasma. Additionally, analytes may vary widely in their recovery from
      method to method. To enhance understanding of the procedures and problems
      involved in the development and manufacture of proficiency materials, a number of
      constituents and their method-specific recoveries are reviewed.

PMID- 8466408
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry. Report of Working Group on Proficiency Test
      Scoring.

PMID- 8466409
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry: report of Working Group on Method Development.

PMID- 8466410
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry. Report of Working Group on Materials
      Development.

PMID- 8466411
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry. Report of Working Group on Proficiency Test
      Programs.

PMID- 8466412
TI  - College of American Pathologists Conference XXIII on matrix effects and accuracy
      assessment in clinical chemistry. Report of Working Group on Accuracy Transfer.

PMID- 8466413
TI  - The detection of problem analytes in a single proficiency test challenge in the
      absence of the Health Care Financing Administration rule violations.
AB  - The Clinical Laboratory Improvement Act of 1988 (CLIA 88) has dramatically
      changed proficiency testing (PT) practices having mandated (1) satisfactory PT
      for certain analytes as a condition of laboratory operation, (2) fixed PT limits
      for many of these "regulated" analytes, and (3) an increased number of PT
      specimens (n = 5) for each testing cycle. For many of these analytes, the fixed
      limits are much broader than the previously employed Standard Deviation Index
      (SDI) criteria. Paradoxically, there may be less incentive to identify and
      evaluate analytically significant outliers to improve the analytical process.
      Previously described "control rules" to evaluate these PT results are unworkable
      as they consider only two or three results. We used Monte Carlo simulations of
      Kodak Ektachem analyzers participating in PT to determine optimal control rules
      for the identification of PT results that are inconsistent with those from other
      laboratories using the same methods. The analysis of three representative
      analytes, potassium, creatine kinase, and iron was simulated with varying
      intrainstrument and interinstrument standard deviations (si and sg, respectively)
      obtained from the College of American Pathologists (Northfield, Ill) Quality
      Assurance Services data and Proficiency Test data, respectively. Analytical
      errors were simulated in each of the analytes and evaluated in terms of multiples
      of the interlaboratory SDI. Simple control rules for detecting systematic and
      random error were evaluated with power function graphs, graphs of probability of
      error detected vs magnitude of error. Based on the simulation results, we
      recommend screening all analytes for the occurrence of two or more observations
      exceeding the same +/- 1 SDI limit. For any analyte satisfying this condition,
      the mean of the observations should be calculated. For analytes with sg/si ratios
      between 1.0 and 1.5, a significant systematic error is signaled by the mean
      exceeding 1.0 SDI. Significant random error is signaled by one observation
      exceeding the +/- 3-SDI limit or the range of the observations exceeding 4 SDIs.
      For analytes with higher sg/si, significant systematic or random error is
      signaled by violation of the screening rule (having at least two observations
      exceeding the same +/- 1 SDI limit). Random error can also be signaled by one
      observation exceeding the +/- 1.5-SDI limit or the range of the observations
      exceeding 3 SDIs. We present a practical approach to the workup of apparent PT
      errors.

PMID- 8466414
TI  - Ethical considerations in rehabilitation medicine.
AB  - As the number of patients with chronic illness or disability grows,
      rehabilitation professionals will face increasingly difficult questions.
      Traditional concepts of medical ethics can help find solutions to some, but not
      all of those questions. Rehabilitation medicine needs an expanded vision of
      informed consent, one that embraces the needs of patients and promotes
      rehabilitation's educational model. To insure that rehabilitation professionals
      use this model appropriately, we need to make certain that their education
      integrates humanistic and caring virtues with medical knowledge and skill.

PMID- 8466415
TI  - Technique to improve chronic motor deficit after stroke.
AB  - The unaffected upper extremity of chronic stroke patients was restrained in a
      sling during waking hours for 14 days; on ten of those days, these patients were
      given six hours of practice in using the impaired upper extremity. An attention
      comparison group received several procedures designed to focus attention on use
      of the impaired upper extremity. The restraint subjects improved on each of the
      laboratory measures of motor function used--in most cases markedly. Extensive
      improvement, from a multi-year plateau of greatly impaired motor function, was
      also noted for the restraint group in the life situation and these gains were
      maintained during a two-year period of follow-up. For the comparison group only
      one measure showed small to moderate improvement, and this was lost during the
      follow-up period; there was essentially no overlap between the individuals of the
      two groups. Thus, prolonged restraint of an unaffected upper extremity and
      practice of functional movements with the impaired limb proved to be an effective
      means of restoring substantial motor function in stroke patients with chronic
      motor impairment identified by the inclusion criteria of this project.

PMID- 8466416
TI  - Patterns of visual spatial inattention and their functional significance in
      stroke patients.
AB  - The relationship between patterns of visual spatial inattention and activities of
      daily living (ADL) performance was investigated in 64 Chinese patients with right
      brain lesions, using the Klein-Bell ADL Scale and the Random Chinese Word
      Cancellation Test. The result showed that patients demonstrating hemi-inattention
      were significantly worse in ADL performance than patients with nonlateralized
      inattention or patients with normal attention, but that the latter two groups did
      not differ from each other. Although ADL performance was also found to be
      significantly related to somatosensation, motor status, and visual factors, after
      controlling the effects of these variables by partial correlation, hemi
      inattention still was highly related to ADL performance. Independence in
      dressing, mobility, and elimination appeared to be more adversely affected by
      hemi-inattention than were bathing/hygiene, eating, and telephone use.

PMID- 8466417
TI  - Traumatic brain injury as a risk factor for behavioral disorders in children.
AB  - The most common behavioral problems that are associated with traumatic brain
      injury in children are the same behaviors that prompt referral to special
      education for behavioral disorder. The purpose of this study was to determine
      whether there is an association between traumatic head injury in children and
      subsequent behavioral disorders for which special educational services are
      provided. A case-control design was used to compare occurrences of prior head
      injury in children receiving special educational services for behavioral
      disorders (cases) to similar occurrences in children in regular education
      (controls). Subjects included 170 case and 197 control students in grades 1
      through 5 in a single large school district during 1988-1989. Data were collected
      by parent questionnaire and school record review. The odds ratio (OR) of a
      history of head injury among children with behavioral disorders relative to
      controls was 3.3 (95% confidence interval [CI] 1.3-8.3); the OR of a history of
      head injury sustained during the preschool years was 8.7 (95% CI 2.5-30.7) in
      cases relative to controls. Mean IQ scores were significantly lower for cases
      injured at two years of age or less in comparison with cases injured later. Full
      scale IQs (+/- SD) were 88 +/- 5 versus 107 +/- 14 (t = 3.5, p = .008),
      performance IQs 91 +/- 9 versus 108 +/- 12 (t = 3.0, p = .012), and verbal IQs 86
      +/- 7 versus 106 +/- 15 (t = 3.2, p = .008). Achievement test results did not
      differ between cases with and those without histories of head injury.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466418
TI  - Performance comparison among children fitted with myoelectric and body-powered
      hands.
AB  - Seventy-six children with unilateral below-elbow amputation were fitted in random
      sequence with a myoelectric (MYO) and a body-powered (BP) prosthetic hand of
      identical size, shape, and glove color. Subjects ranged from six to 17 years,
      nine months and included 67 children with congenital limb deficiency and nine who
      sustained traumatic amputation. After training, each child wore each hand for
      three months. On the form board test requiring only prosthetic use, subjects took
      13.7% longer with the MYO and committed more errors with the MYO, specifically in
      dropping objects and delaying their grasp and release. Object displacement, the
      most common error, occurred nearly as often with BP as MYO. MYO was minimally
      faster on a test of ten practical activities designed for bimanual prehension.
      Card playing was 39.8% faster with BP, whereas donning socks, cutting paper, and
      bandage application were 27.8%, 12.5%, and 10.9% faster with MYO. Performance
      with both hands was rated as decidedly poorer than normal quality. No major
      clinically important differences were found in the comparison of performance.

PMID- 8466419
TI  - Gait parameters of children with spastic diplegia: a comparison of effects of
      posterior and anterior walkers.
AB  - The purpose of this study was to compare the effects of posterior and anterior
      walkers on the gait parameters of five children with spastic diplegic cerebral
      palsy. Computer-based kinematic analysis was used to investigate differences in
      gait. Gait laboratory data indicated that use of the posterior walker (1)
      facilitated more upright posture in these subjects, as seen in decreased trunk
      and hip flexion during stance phase; (2) decreased double stance time; and (3)
      increased walking velocity. According to parent report, both the parents and
      their children preferred the posterior walker. Most parents also reported that
      when using the posterior walker, their children walked more normally with
      increased stability and interacted more easily with other children.

PMID- 8466420
TI  - Rehabilitation approaches to children with osteogenesis imperfecta: a ten-year
      experience.
AB  - Twenty-five children with severe osteogenesis imperfecta were followed and
      treated with physical and occupational therapy for a mean of five years, two
      months, 80% since the first two years of life. According to their highest
      achieved motor skill, they fell into three groups: (A) able to stand in braces,
      (B) able to ambulate short distances without braces, and (C) able to ambulate in
      the community without assistance. Preventable functional impairment is caused in
      group A by shoulder joint and hand contractures and upper extremity weakness,
      group by hip flexion and plantar flexion contractures of the feet, shoulder joint
      contractures, and upper extremity weakness, and group C by poor lower extremity
      joint alignment, impaired balance, and low endurance. Appropriate rehabilitation
      strategies have led to slow, continued functional improvement in the majority of
      patients. Results of the ten-year retrospective study suggest that clinical
      groupings based in part on functional needs will enable the clinician to provide
      optimal rehabilitation services.

PMID- 8466421
TI  - Preprogrammed reactions in individuals with Down syndrome: the effects of
      instruction and predictability of the perturbation.
AB  - Preprogrammed reactions to unexpected loadings and unloadings of an elbow joint
      resisting an extending bias load were studied in subjects with Down syndrome. The
      subjects were instructed to either "let go" or "return back as fast as possible."
      Both predictable and unpredictable perturbation directions were used. Integrated
      electromyograms of the two elbow flexors and two elbow extensors were used to
      characterize the preprogrammed reactions. All the subjects were able to modulate
      their preprogrammed reactions in response to a change in the instruction. They
      were also able to grade the preprogrammed responses corresponding to the
      magnitude of the perturbation. Two basic patterns of modulation were observed,
      "reciprocal" and "coactivation." There were no effects of the predictability of
      the perturbation direction. Reconstructed joint compliant characteristics
      suggested an unchanged gain in the arc of the tonic stretch reflex. We propose
      that there are no abnormalities in the preprogrammed reactions of some
      individuals with Down syndrome. The apparent "clumsiness" of individuals with
      Down syndrome in a changing environment is assumed to reflect an adaptation to
      their impaired decision-making ability. The high variability of motor performance
      in subjects with Down syndrome may result from mixing different strategies for
      solving motor tasks.

PMID- 8466422
TI  - Exercise to improve gait velocity in older persons.
AB  - The effect of 12 weeks of resistance and balance training on strength and gait
      measures in older persons was tested in a randomized control trial. Thirty-one
      residents of two life-care communities volunteered (mean age, 82.1 years). The
      exercise group (E) trained three times per week, performing resistance training
      to fatigue for knee extension, hip abduction, ankle dorsiflexion, hip extension,
      and knee flexion, and postural control exercises. The control group (C) met
      weekly for flexibility exercises performed sitting in a chair. The exercise group
      achieved significant improvements in muscle strength and gait velocity (p < .05).
      Knee extension one maximum repetition increased 32% (24% to 40%, 95% confidence
      interval [CI]), from 55 +/- to 72 +/- 4N.m. Isokinetic knee extension torque
      increased 25% (3% to 47%) from 40 +/- 5 to 50 +/- 5N.m at 120 degrees s-1. Usual
      gait velocity increased 8% (3% to 13%) in E from 1.04 +/- .07 to 1.12 +/- .06m/s.
      There was a trend of improvement in maximal gait speed 4% (0 to 8%) from 1.43 +/-
      0.1 to 1.49 +/- 0.1m/s, p = 0.054. Gait and strength measures in C were
      unchanged. A short-term exercise program that trained strength and balance
      achieved a clinically significant improvement in gait velocity.

PMID- 8466423
TI  - Quadriceps angle and rearfoot motion: relationships in walking.
AB  - The purpose of this study was to describe the relationship between quadriceps
      angle (q-angle) and rearfoot motion in walking. Twenty women were videotaped with
      two cameras, one located behind the subject and one located in front providing
      both front and rear views of the frontal plane. Each subject was required to walk
      at a 1.5 mph pace on a treadmill while five consecutive right footfalls were
      videotaped. After walking, each subject was videotaped in a calibrated stance and
      a chosen stance. Leg length and hip width were measured. Arch index was measured
      to determine arch type of the subject. All subjects were required to walk
      barefoot during testing. All trials were digitized and analyzed using the Peak
      Performance Motion Measurement System. Q-angles and rearfoot angles were
      calculated and averaged over the five trials. The following group means were
      obtained: maximum pronation (MPRO) was -7.88 degrees, total rearfoot motion
      (TRFM) was 8.20 degrees, static rearfoot angle in a chosen stance (SRFCHOS) was 
      3.45 degrees, static rearfoot angle in a calibrated stance (SRFCAL) was -2.40
      degrees, dynamic q-angle at heel strike (DQHS) was 16.13 degrees, dynamic q-angle
      at midstance (DQMS) was 16.00 degrees, static q-angle in a chosen stance (SQCHOS)
      was 18.32 degrees, static q-angle in a calibrated stance (SQCAL) was 17.42
      degrees, hip width (HWIDTH) was 25.66cm, leg length (LLENGTH) was 85.76cm and
      arch index was 0.23cm2. Pearson product moment correlations were calculated
      between each of the variables. All of the q-angle variables, both static and
      dynamic, correlated poorly with rearfoot motion variables.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8466424
TI  - Persistent facial myoclonus: a negative prognostic sign in patients with severe
      brain injury.
AB  - The determination of long-term prognosis is one of the most difficult tasks in
      the management of persons with brain injury (BI). Initial Glasgow Score, duration
      of coma, brain stem reflexes, and pupillary responses are all clinical findings
      that have been related to outcome in BI. We describe another easily observable
      clinical finding, persistent facial myoclonus (PFM), which may provide additional
      information on prognosis after severe BI. We retrospectively reviewed 295
      consecutive admissions to an inpatient brain injury rehabilitation program. Data
      extracted included mechanism of injury, patient demographics, admission and
      discharge Rancho Level (RL), and presence of PFM plus first date of description.
      Of the total admissions, 68 (23%) were RL < or = 2 on admission and of those 68,
      nine (13%) demonstrated PFM. Twenty-seven of 59 patients without PFM advanced to
      RL > 3 but none of those with PFM progressed to RL > 2 (Fisher's exact
      probability = .007). Mean time from injury to PFM description was 10.5 months (SD
      = 11.8, range, 2.5 to 25.0 months) and mean time from description to discharge
      was 7.1 months (SD = 6.6, range, 2.0 to 22.5 months). Four of the nine PFM
      patients had evidence of brain stem injury on computed tomography or magnetic
      resonance imaging scans, a much higher percentage than in the larger population.
      We postulate that patients with PFM after TBI represent a subgroup of patients
      with severe diffuse axonal injury with brain stem lesions.

PMID- 8466425
TI  - Baltimore Therapeutic Equipment work simulator: energy expenditure of work
      activities in cardiac patients.
AB  - The energy expenditure and hemodynamic responses to tasks performed on the
      Baltimore Therapeutic Equipment (BTE) work simulator were evaluated in men with
      coronary artery disease and compared to tasks performed at a laboratory
      workstation in which actual tools and equipment were used. Met units for the BTE
      work simulator and corresponding workstation tasks, respectively, were drill
      press operation, 1.5 +/- 0.1 and 1.5 +/- 0.3Mets; hammering, 2.3 +/- 0.3 and 3.4
      +/- 0.8Mets (p < 0.05); repetitive lifting a 22.7kg weight load, 3.8 +/- 0.6 and
      4.5 +/- 0.9Mets (p < 0.05); mechanic work in a supine position, 2.0 +/- 0.5 and
      1.7 +/- 0.2Mets; sanding wood, 2.0 +/- 0.3 and 2.5 +/- 0.7Mets; sawing wood, 3.2
      +/- 0.6 and 4.3 +/- 0.7Mets (p < 0.05); screwdriving, 2.2 +/- 0.3 and 2.5 +/-
      0.5Mets (p < 0.05); shoveling, 5.45kg load 4.6 +/- 1.0 and 4.2 +/- 0.7Mets;
      sweeping, 1.7 +/- 0.2 and 3.0 +/- 0.4Mets (p < 0.05); and vacuuming, 2.7 +/- 0.7
      and 2.9 +/- 0.5Mets. The results indicate that there is a tendency for the
      metabolic and hemodynamic responses to BTE work simulator tasks to be lower than
      that of the actual activity.

PMID- 8466426
TI  - Active or passive physiotherapy for occupational cervicobrachial disorders? A
      comparison of two treatment methods with a 1-year follow-up.
AB  - In this study 169 female office employees were interviewed and examined to
      determine the occurrence and severity of neck and shoulder symptoms. Forty-seven
      of those with symptoms who fulfilled the criteria taken as indicating need for
      treatment were enrolled in a controlled clinical trial and divided into two
      groups. One group participated in dynamic muscle training of neck and shoulder
      muscles (active physiotherapy). The other patients were treated by means of
      surface heat, massage, and stretching (passive physiotherapy). Pain in the neck
      and shoulder regions disappeared significantly more often just after active
      treatment as compared to passive treatment. Symptoms returned within three months
      in both groups. However, after 12 months, the incidence of headache was
      significantly less in the group that had received active physiotherapy. Maximal
      isometric muscle strength in relation to cervical lateral flexion and extension
      and grip strength and endurance force of shoulder muscles improved significantly
      after active physiotherapy, but only maximal isometric extension force increased
      significantly after passive physiotherapy. Numbers of tender points in neck and
      shoulder muscles decreased significantly after both types of physiotherapy.
      Pressure threshold levels increased but not significantly in both groups during
      treatment.

PMID- 8466427
TI  - Increasing the wearing time of vinyl urinary drainage bags by decontamination
      with bleach.
AB  - The purpose of this study was to determine the safety of 4 week re-use of vinyl
      urinary leg and bed bags in the acute rehabilitation setting when decontaminated
      daily with a dilute bleach (sodium hypochlorite) rinse. Patients requiring
      urinary bags (n = 54) were randomly assigned to Control (C) and Experimental (E)
      groups. C's bags were replaced weekly; E's only after four weeks. Both groups
      received identical daily bag decontamination and weekly urine and bag cultures.
      No significant differences were found between groups with ANCOVA, controlling for
      baseline urine cultures, age, number of days catheterized, and use of
      antibiotics. Thirty different organisms were cultured in urine and bags; when the
      procedure was done daily, all bag cultures showed only minimal contamination (0
      100CFU/mL). Bacterial growth (4.4% of leg bags) > 100CFU/mL was found only when
      the daily decontamination procedure had been omitted. In fact, 57% of leg bags
      and 76.5% of bed bags returned with no growth. We conclude that it is safe and
      cost effective to reuse vinyl urinary leg and bed bags for four weeks.

PMID- 8466428
TI  - Rebox: an adjunct in physical medicine?
AB  - Electrical therapy is used extensively in the treatment of musculoskeletal
      diseases. The best known form is transcutaneous electrical nerve stimulation
      (TENS). Rebox is another apparatus for electrical therapy that operates on much
      lower currents than TENS (0 to 300 microA). The effect of Rebox was tested on
      chronic lateral epicondylitis in 16 patients in a controlled crossover study. We
      found a significant effect of Rebox compared to placebo in respect to all the
      subjective and the objective variables: grip-strength, pain at power-grip and
      lifting a weightload with pronated forearm, and daily impairment.

PMID- 8466429
TI  - The Vannini-Rizzoli orthosis: a unique case of thoracic outlet syndrome.
AB  - The Vannini-Rizzoli boot is a stabilizing orthosis that allows selected spinal
      cord injured patients to stand and ambulate. The body positioning required to
      maintain stability while using these boots can result in an exaggerated "military
      position" of the shoulders, as the patient braces his shoulders posteriorly to
      maintain his center of gravity anterior to the ankle axis. This posture produced
      thoracic outlet compression in this patient. This case emphasizes the need to be
      aware of this clinical complex when working with this orthosis and suggests the
      importance of the patient's functional needs in treatment decisions.

PMID- 8466430
TI  - Drug-induced dysphagia.
AB  - Dysphagia is a problem commonly treated and frequently diagnosed on the
      rehabilitation unit. It can be caused by trauma, injury, or diseases of the
      nervous system and can result in potentially serious and life threatening
      complications. The disruption of normal swallowing has also been reported to
      occur in psychiatric patients treated with psychotropic medication. Relatively
      unappreciated by physicians, and unreported by the rehabilitation patient, drug
      induced dysphagia can likewise result in serious complications. This report
      describes a case of drug-induced dysphagia and aspiration pneumonia during the
      rehabilitation of a traumatically brain injured male who received psychotropic
      medication to control aggressive behavior. The course of his dysphagia was
      followed and documented both clinically and with videofluoroscopic studies.

PMID- 8466432
TI  - The high cost of asthma: a challenge to all GPs.

PMID- 8466431
TI  - Bracing for serratus anterior palsy.

PMID- 8466433
TI  - Dislocations in the upper limb. Traps, tricks and treatment.
AB  - Dislocations in the upper limb are not always straightforward--they are often
      poorly diagnosed and managed. Careful examination to detect the total injury and
      awareness of the pitfalls should ensure that mistakes are avoided.

PMID- 8466434
TI  - Common pitfalls and the treatment of fractures.
AB  - In summary, the management of fractures is not easy. The clinician must be
      familiar with fractures and their management and their potential complications.
      If the problem appears to be outside the scope of a doctors training, it is best
      referred earlier rather than later.

PMID- 8466435
TI  - Stress fractures.
AB  - Stress fractures are now common. They are often missed because the doctor fails
      to keep the possible diagnosis in mind, or believes that a plain X-ray can
      exclude these fractures. A bone scan gives the diagnosis. Treatment is by rest in
      most cases, but stress fractures of the navicular sometimes require surgery.

PMID- 8466436
TI  - Fractures and dislocations of fingers and toes. Principles, tips and pitfalls.
AB  - If each injury is carefully assessed on its merits good outcomes will be
      achieved. If any kind of unusual situation is met advice should be sought early
      rather than late. Balancing competing concepts, especially with regard to
      mobilisation and immobilisation of the injured part, makes treatment of digital
      injuries a challenge to our ingenuity.

PMID- 8466437
TI  - Understanding insomnia.
AB  - Anxiety and depression are common causes of insomnia, but they are not the only
      causes. Neurological disorders such as restless legs syndrome and periodic limb
      movement disorder are also common. A conceptual model of sleep and wakefulness
      helps to explain different kinds of insomnia.

PMID- 8466438
TI  - Helping patients to sleep better without drugs.
AB  - A brief description of the programme to treat insomnia has been presented. Sleep
      Better Without Drugs is a comprehensive integrated programme that includes more
      than 30 elements. One segment of the programme, the nine sleep rules, is
      presented in the Patient Education feature of this issue.

PMID- 8466439
TI  - Morbidity and treatment in general practice in Australia.
AB  - More detailed analysis of this data will continue. It will be combined with other
      more specific studies to provide a more focused view of some aspects of general
      practice. Requests for individual analyses of selected data will be accepted by
      the Family Medicine Research Unit. Contact Helena Britt on (02) 745 2633. The
      Unit has provided Australian Family Physician with 500 copies of the full report
      for distribution to interested practitioners. Such copies can be obtained by
      contacting Mrs Judy Brook, Secretary, Australian Family Physician, 2nd Floor, 70
      Jolimont Street, Jolimont 3002. Fax: (03) 289 1211. Telephone: (03) 654 3000.

PMID- 8466440
TI  - The old painful knee trap.

PMID- 8466441
TI  - Coronary risk factors, knowledge and beliefs in 'blue collar' men attending
      general practice.
AB  - OBJECTIVE: To describe risk factors, dietary knowledge and beliefs in Australian
      born males of low socio-economic status (SES) in relation to coronary heart
      disease. METHODOLOGY: Cross-sectional prevalence survey of 180 (99.7% of 185)
      selected attenders at a community health centre with a high proportion of low SES
      residents in Melbourne. RESULTS: Mean BMI and prevalence of obesity and smoking
      were higher than in national sample; age-weighted serum cholesterol somewhat
      lower. A majority believed that their diets were unhealthy and would continue to
      be so despite high perceived susceptibility to CHD. Seventy-two per cent wanted
      more dietary information and GPs were the most commonly nominated preferred
      source for this information. CONCLUSION: GPs have an important role in targeting
      this 'at risk' group in order to address the knowledge gaps and misconceptions
      identified in the study and to encourage appropriate behaviour and risk factor
      modification.

PMID- 8466442
TI  - Night call to the dead.

PMID- 8466443
TI  - Dr. Paul Nisselle. GPs' defence counsel.

PMID- 8466444
TI  - Marsupialisation technique for Bartholin's cyst.

PMID- 8466445
TI  - Working birthdays.

PMID- 8466446
TI  - The right to know--the need to disclose.
AB  - The High Court judgment states explicitly that your duty to disclose will now be
      measured by a legal standard. Gaudron J states: "... there is simply no occasion
      to consider the practice or practices of medical practitioners in determining
      what information should be supplied ..." Thus the court in dismissing the appeal
      has moved substantially to the American position, which emphasizes the right of
      the patient to make up his or her own mind in the light of the relevant
      circumstances and the right of the patient to know about material risks, "a right
      which in turn arises from the patient's right to decide for himself or herself
      whether or not to submit to the medical treatment proposed". In short, a prudent
      GP, in the light of this High Court judgment, will talk more, and will write down
      what has been said.

PMID- 8466447
TI  - Logistics of participation in clinical trials.
AB  - A decision to participate in a clinical drug trial will require a commitment in
      time and resources from both the doctor and other practice staff. The authors
      explain some of the strategies that can be used to maximise the limited time
      available for such research and minimise unnecessary wastage of scarce resources.

PMID- 8466448
TI  - Identifying the warts in your practice.

PMID- 8466449
TI  - Patient education. Nine rules for better sleep.

PMID- 8466450
TI  - The use of calcium channel blockers in general practice.
AB  - Over the past decade the calcium antagonist drugs, also known as calcium channel
      blockers, have become established for use in a variety of cardiovascular
      diseases. A bewildering (and ever-growing) number of drugs in this class now
      becoming available. This article summarises the important characteristics of the
      calcium antagonists and discusses their practical use in hypertension, angina and
      other conditions in general practice.

PMID- 8466451
TI  - Future access to Medline.

PMID- 8466452
TI  - Laparoscopic ultrasonography.

PMID- 8466453
TI  - Small area analysis of lumbar spine surgery in South Australia.
AB  - The hospital separation records for 1987 in the health planning regions of South
      Australia were reviewed using a selection algorithm to identify all
      hospitalizations involving a lumbar spine surgery (LSS) for low back or leg pain.
      Among 16 health planning regions (two additional regions were excluded from the
      analysis because of the low number of observations) the LSS rate varied almost
      four-fold, from 25 to 92/100,000, with a mean of 55/100,000. The effect of 24
      socioeconomic and health care supply characteristic variables upon observed
      differences in rates were tested. The unemployment rate was the only significant
      variable in the analysis, explaining 11% of the variation in the surgery rates
      for the 16 regions. This finding is in agreement with studies from other
      countries that suggest that characteristics of small areas do not substantially
      predict the rates of elective surgical procedures. The decision-making processes
      of surgeons and their patients remain poorly defined; the contributions to the
      rate of lumbar spine surgery by the health care delivery system, physician
      behaviours or patient expectations are not yet identified.

PMID- 8466454
TI  - Impact of pedestrian injury on inner city trauma services.
AB  - This report describes the epidemiology of pedestrian injury in four inner
      metropolitan local government areas of Sydney. These data were obtained from the
      Roads and Traffic Authority of New South Wales. The spectrum of injury and
      clinical outcome was defined in patients with an Injury Severity Score (ISS) > 15
      admitted from the study area, during a 1 year period, to the four inner
      metropolitan teaching hospitals. The incidence of pedestrian death was 3.3 times
      the state average of 32/10(6)/year. An average of 235 pedestrians, injured in the
      study area, were hospitalized each year during the period 1987-89. On average 24
      pedestrians died each year, seven at the scene and 17 in hospital. Fifty patients
      (ISS > 15) were admitted to the four teaching hospitals during a 1 year period
      1990-91. Forty-five were adults and five children. Multiplicity of injury was
      seen in 68% of patients. The pelvis and lower extremities were involved in 70%,
      the head in 66% and chest in 42%. The hospital mortality rate was 30% with five
      patients dying on the first day from blood loss and nine dying during subsequent
      days from head injury. This study has important implications for trauma service
      development. Successful clinical management of the severely injured pedestrian
      requires close co-operation between pre-hospital and hospital care providers. An
      integrated hospital trauma team response is mandatory to ensure appropriate
      management of what is often a shocked, hypoxic, head-injured patient.

PMID- 8466455
TI  - The management of renal cell carcinoma with inferior vena-caval involvement.
AB  - Seven patients with renal cell carcinoma involving the inferior vena cava
      underwent surgical resection between 1975 and 1991. Pre-operative staging defined
      five patients with stage T3bNoMo disease, one patient with stage T3bN1Mo, and one
      patient with stage T3bNoM1 disease. At operation one patient had tumour thrombus
      filling the right atrium. Two patients had tumour thrombus within the
      intrahepatic vena cava and four infrahepatic tumour thrombus. The mean follow-up
      is 34.4 months (median 40 months). Four patients have been followed for over 4
      years. Three of these patients are survivors, two have remained disease-free
      since their initial surgery. The other patient had a liver resection at 49 months
      for a solitary metastases; he is currently disease free. One patient died at 38
      months from a gastrointestinal haemorrhage. Three patients are 12 months or less
      postoperation. Operative mortality was zero. The mean postoperative hospital stay
      was 14.7 days. Data suggests that 3-10% of renal cell carcinomas will involve the
      inferior vena cava. The small number of patients in this series suggests that
      many patients with renal cell carcinoma involving the inferior vena cava are not
      referred for surgical assessment. These patients are potential surgical
      candidates. Their survival after surgical resection, excluding the group with
      extension of tumour thrombus into the hepatic cava or above, is not reduced when
      compared with other patients with renal carcinoma.

PMID- 8466456
TI  - The role of ERCP and endoscopic sphincterotomy in the era of laparoscopic
      cholecystectomy.
AB  - The advent of laparoscopic cholecystectomy (LC) has led to some controversy
      regarding the best method of managing bile duct calculi. This paper reviews the
      cases of 38 patients who underwent LC and endoscopic retrograde
      cholangiopancreatography (ERCP), from a series of 600 consecutive laparoscopic
      cholecystectomies. Twenty-nine patients had ERCP performed pre-operatively
      because of suspicion of choledocholithiasis. Duct stones were confirmed in eight
      patients. Recent or current jaundice was the best predictor of bile duct stones.
      Nine patients had ERCP done postoperatively because of duct stones seen on
      operative cholangiography. In two patients bile duct cannulation was not possible
      and a third procedure, open duct exploration, was necessary. Techniques in
      laparoscopic management of duct stones are improving and the role of ERCP and
      sphincterotomy should be limited to jaundiced patients or those with proven bile
      duct stones in whom laparoscopic procedures have been unsuccessful.

PMID- 8466457
TI  - Primary cerebral lymphoma: an argument for the use of adjunctive systemic
      chemotherapy.
AB  - Eleven patients with primary cerebral lymphoma were treated at a single
      institution over a 5 year period. Patient characteristics were typical of this
      rare disease. One patient died prior to receiving treatment and of the remaining
      10, all received cranial irradiation and in addition, five received systemic
      cyclophosphamide, adriamycin, vincristine and prednisolone (CHOP) chemotherapy.
      Of the six patients who are alive and disease-free, five received the combined
      modality therapy. The median survival for those patients receiving cranial
      irradiation alone was 18 months and for the combined modalities was 25+ months.
      Combination systemic chemotherapy, in addition to cerebral irradiation, may
      convey a survival benefit in patients with primary cerebral lymphoma but this
      requires further investigation with multicentre, prospective randomized trials.

PMID- 8466458
TI  - Primary central nervous system tumours in Australia: a profile of clinical
      practice from the Australian Brain Tumour Register.
AB  - An epidemiological survey of all primary central nervous system tumours in
      Australia was commenced in 1986. Cases was reported by the treating physician to
      the Australian Brain Tumour Register, located at the Victorian Cancer Registry.
      Ninety-three per cent of tumours were histologically confirmed and 69% were
      reviewed by an independent pathology panel. During the initial 3 years of the
      survey a total of 4577 brain tumours and 266 primary spinal cord tumours were
      reported to the Register. The age standardized rates for malignant tumours of the
      central nervous system, sum to 5.0/100,000 males and 3.4/100,000 females. Twenty
      eight per cent of gliomas were biopsied only. Radiotherapy was administered to
      57% of cerebral gliomas and 2% of these tumours were treated with adjuvant
      chemotherapy. Forty per cent of meningiomas were considered to have had a
      complete tumour resection.

PMID- 8466459
TI  - Laparoscopic management of acute small bowel obstruction.
AB  - Acute small bowel obstruction is commonly due to band adhesions. In the past it
      has had an overall mortality rate of up to 11% for elderly patients. In this
      paper we report three cases of small bowel obstruction, treated by laparoscopic
      division of the causative bands. All patients recovered rapidly and were
      discharged within 5 days of surgery.

PMID- 8466460
TI  - A (more) simple technique for locating the umbilicus in abdominoplasty.
AB  - A method for simply and accurately locating the umbilicus in abdominoplasty is
      described. The method uses a shaped wire and ink.

PMID- 8466461
TI  - The evaluation of the isolated perfused liver as a model for the assessment of
      liver preservation.
AB  - An ex vivo isolated perfused porcine liver model was tested to assess its
      suitability for rapid, reliable and relatively cheap testing of organ
      preservation solutions for liver transplantation. The model consists of a machine
      driven recirculating system incorporating an organ chamber, blood pump and
      membrane oxygenator. Autologous blood was used for perfusion for a period of 2 h
      at a temperature of 37 degrees C. The model was tested with five groups of livers
      which had sustained varying degrees of injury ranging from minimally damaged to
      those known to be incapable of sustaining life when used for liver
      transplantation. The groups of livers were: (i) controls; (ii) preserved in
      University of Wisconsin solution (UW) for 6 h; (iii) preserved in an albumin
      based extracellular fluid (ALB) for 6 h; (iv) preserved in UW for 18 h; and (v)
      preserved in ALB for 18 h. Bile production was found to be a reliable parameter
      of preservation damage. Changes in perfusate levels of aspartate
      aminotransferase, potassium, glucose and calcium also occurred in relationship to
      preservation damage. In contrast, weight gain of the liver, sequestration of the
      white cells and platelets in the liver, urea production and oxygen consumption
      were unreliable predictors of liver damage. Histology of biopsy specimens
      revealed apparently well preserved livers in all cases after preservation but
      before perfusion, but serious abnormalities after perfusion in long preserved
      livers, with features in these suggestive of damage to the sinusoidal
      endothelium. We believe that the model is a worthwhile adjunct to research into
      liver preservation.

PMID- 8466462
TI  - Retention of surgical knowledge base by senior medical students.
AB  - The medical course at the University of Queensland is 6 years in length. After
      studies in basic sciences, the fourth year consists of systematic pathology,
      clinico-pathological correlation and the learning of clinical methods. During the
      fifth year the core surgical knowledge base is taught. The sixth year is spent in
      clinical ward work aimed at problem-orientated consolidation of knowledge and
      skills, and the learning of applied therapeutics. We studied whether the surgical
      knowledge base taught to our fifth year students was retained a year later by the
      same students in their final year. A standardized post-test examination which had
      been presented to the students during their fifth year in 1990 was again
      presented to them during their sixth year in 1991. We found that the surgical
      knowledge base of this group of students remained the same in their final year as
      it had been in their penultimate year. We suggest that to continue testing core
      surgical knowledge once it has proven satisfactory is not productive. These
      students should progress to further clinical studies aimed at improving their
      problem solving ability.

PMID- 8466463
TI  - Carl Langenbuch and the Lazarus Hospital: events and circumstances surrounding
      the first cholecystectomy.
AB  - Carl Langenbuch performed the first cholecystectomy at the Lazarus Hospital in
      Berlin in July 1882. This operation followed scientific experiment, careful
      thought, cadaver dissections and careful patient selection. Langenbuch's career
      was linked with the Lazarus Hospital in Berlin, to which he was appointed as
      Director at the age of 27. The hospital was then 4 years old and in a poor area
      of Berlin, and they grew in reputation together. Going through repeated troubled
      times, this hospital has withstood financial disaster, three wars, an occupation
      and the ambitions of administrators and developers. Treatment for cholecystitis
      before Langenbuch was stone extraction from spontaneous cutaneous biliary fistula
      or skin incision of near-pointing empyema. Cholecystostomy was carried out by
      Bobbs (1867), by Sims (1878), and championed by Kocher (1878) and Tait (1879).
      Langenbuch carried out a cholecystectomy in 1882 and subsequently recommended
      choledochotomy, duodenotomy and sphincterotomy in the management of stones in the
      bile ducts. He carried out one of the earlier major right liver resections in
      1888. Also, he was famous for his sciatic nerve stretching for tabes dorsalis,
      management of gunshot wounds and his dissertations at the German Surgical Society
      before becoming renowned for cholecystectomy. The surgical world owes Langenbuch
      proper acknowledgement for his contribution to hepatobiliary surgery.

PMID- 8466464
TI  - A rare cause of acute aortic occlusion.

PMID- 8466465
TI  - Misdiagnosis of appendicitis in tubally sterilized women.
AB  - Sterilization by tubal occlusive methods has a small but definite incidence of
      failure which is not well recognized among general surgeons. As a result of the
      failure to appreciate the possibility of ectopic pregnancy after tubal ligation,
      right-sided abdominal pain in this patient population is commonly misdiagnosed as
      appendicitis. One such case is presented, and the literature is reviewed and
      discussed.

PMID- 8466466
TI  - Delayed epididymitis following intravesical bacillus Calmette-Guerin
      administration.

PMID- 8466467
TI  - Intra-aortic balloon rupture causing femoral entrapment.
AB  - Rupture of an intra-aortic balloon counterpulsator (IABCP) demands immediate
      removal. We report a case of thrombus formation within a Datascope IABCP
      secondary to IABCP rupture, necessitating surgical exploration for removal. There
      is a disturbing pattern of balloon ruptures with this type of IABCP.

PMID- 8466468
TI  - Neutropenic enterocolitis treated by primary resection with anastomosis in a
      leukaemic patient receiving chemotherapy.
AB  - Neutropenic enterocolitis is a complication of patients receiving chemotherapy
      for malignant disease. It has a characteristic presentation and may lead to gut
      perforation with consequent high mortality. It is best treated by early surgical
      intervention. Considerable mortality is inevitable in these gravely ill patients.

PMID- 8466469
TI  - Right chylothorax following left radical neck dissection.
AB  - The development of a right chylothorax following left radical neck dissection for
      melanoma is reported. Chylothorax following neck dissection is extremely rare,
      with only 12 cases documented in the literature. Seven of these were bilateral
      and three were unilateral (all left-sided); unilateral right chylothorax after
      neck dissection has not been reported previously. Chylothorax is more common
      after intrathoracic surgery or trauma. Regardless of its cause, the condition is
      potentially serious and sometimes fatal. Our patient was successfully managed
      without further surgery. The aetiology and management of chylothorax following
      neck dissection are discussed.

PMID- 8466470
TI  - Development and organizational structure of an acute pain service in a major
      teaching hospital.
AB  - Pain management is an essential part of postoperative care. The present
      availability of multiple modalities of patient controlled and continuous regional
      analgesia requires the reorganization of existing hospital structures to be
      efficacious and safe. This article presents an Acute Pain Service (APS) as a
      model for a reorganized structure. Although anaesthesia based, this service
      requires close co-operation of surgeons, nurses and other paramedical personnel
      to achieve the expected results. Prerequisites of an APS are careful selection of
      suitable techniques as well as the formulation of protocols and standing orders
      for the techniques. Inservice training of involved personnel, dedicated single
      ward trials and introduction of the revised technique for general use are further
      essential steps in its development. The organizational structures proposed
      include selection of the appropriate technique for a patient by the theatre
      anaesthetist, preparation and documentation by the recovery nurse, monitoring and
      ongoing skilled assessment by the ward nurse and ward rounds, advice and 24 h
      availability by anaesthetists.

PMID- 8466471
TI  - What determines whether chromosomes segregate reductionally or equationally in
      meiosis?
AB  - Normal meiosis consists of a single round of DNA replication followed by two
      nuclear divisions. In the 1st division the chromosomes segregate reductionally
      whereas in the 2nd division they segregate equationally (as they do in mitosis).
      In certain yeast mutants, a single-division meiosis takes place, in which some
      chromosomes segregate reductionally while others divide equationally. This
      autonomous segregation behaviour of individual chromosomes on a common spindle is
      determined by the centromeres they carry. The relationship between reductional
      segregation of a pair of chromosomes and their earlier recombinational history is
      also discussed.

PMID- 8466472
TI  - Exploitation of host signal transduction pathways and cytoskeletal functions by
      invasive bacteria.
AB  - Many bacteria that cause disease have the capacity to enter into and live within
      eukaryotic cells such as epithelial cells and macrophages. The mechanisms used by
      these organisms to achieve and maintain this intracellular lifestyle vary
      considerably, but most mechanisms involve subversion and exploitation of host
      cell functions. Entry into non-phagocytic cells involves triggering host signal
      transduction mechanisms to induce rearrangement of the host cytoskeleton, thereby
      facilitating bacterial uptake. Once inside the host cell, intracellular pathogens
      either remain within membrane bound inclusions or escape to the cytoplasm. Those
      living in the cytoplasm can further pirate the host actin system, using actin as
      a mechanism to facilitate movement within and between host cells. Organisms
      remaining within the vacuole have specialized mechanisms for intracellular
      survival and growth which involve additional communication with the host cell.
      Some of the processes involved in the various steps of facultative intracellular
      parasitism are discussed in the context of subverting the host cell cytoskeleton
      and signal transduction pathways for bacterial benefit.

PMID- 8466473
TI  - Bending of DNA by transcription factors.
AB  - An increasing number of transcription factors both from prokaryotic and
      eukaryotic sources are found to bend the DNA upon binding to their recognition
      site. Bending can easily be detected by the anomalous electrophoretic behaviour
      of the DNA-protein complex or by increased cyclization of DNA fragments
      containing the protein-induced bend. Induction of DNA bending by transcription
      factors could regulate transcription in various ways. Bending may bring distantly
      bound transcription factors closer together by facilitating DNA-looping or it
      could mediate the interaction between transcription factors and the general
      transcription machinery by formation of large nucleoprotein structures in which
      the DNA is wrapped around the protein complex. Alternatively, the energy stored
      in a protein-induced bend could be used to favour formation of an open
      transcription complex or to dissociate the RNA polymerase in the transition from
      initiation to elongation. Modification of the bend angles and bending centers,
      caused by homodimerization or heterodimerization of transcription factors, may
      well turn out to be an important way to enlarge the range of interactions
      required for regulation of gene expression.

PMID- 8466474
TI  - RNA editing: exploring one mode with apolipoprotein B mRNA.
AB  - RNA editing is a newly described genetic phenomenon. It encompasses widely
      different molecular mechanisms and events. According to the specific RNA
      modification, RNA editing can be broadly classified into six major types. Type II
      RNA editing occurs in plants and mammals; it consists predominantly in cytidine
      to uridine conversions resulting from deamination/transamination or
      transglycosylation, although in plants other mechanisms have not been excluded.
      Apolipoprotein B mRNA editing is the only well-documented editing phenomenon in
      mammals. It is an intranuclear event that occurs posttranscriptionally,
      coincident with splicing and polyadenylation. Recent observations indicate that
      the tissue- and sequence-specific process is mediated by an enzyme that has
      separate domains for editing and sequence recognition. The presence of
      apolipoprotein B mRNA editing activity in tissues that do not produce the protein
      suggests that other RNAs may be edited and RNA editing may be a genetic
      phenomenon of general biological importance to the cell.

PMID- 8466475
TI  - Interaction of rhodopsin with the G-protein, transducin.
AB  - Rhodopsin, upon activation by light, transduces the photon signal by activation
      of the G-protein, transducin. The well-studied rhodopsin/transducin system serves
      as a model for the understanding of signal transduction by the large class of G
      protein-coupled receptors. The interactive form of rhodopsin, R*, is
      conformationally similar or identical to rhodopsin's photolysis intermediate
      Metarhodopsin II (MII). Formation of MII requires deprotonation of rhodopsin's
      protonated Schiff base which appears to facilitate some opening of the rhodopsin
      structure. This allows a change in conformation at rhodopsin's cytoplasmic
      surface that provides binding sites for transducin. Rhodopsin's 2nd, 3rd and
      putative 4th cytoplasmic loops bind transducin at sites including transducin's 5
      kDa carboxyl-terminal region. Site-specific mutagenesis of rhodopsin is being
      used to distinguish sites on rhodopsin's surface that are important in binding
      transducin from those that function in activating transducin. These observations
      are consistent with and extend studies on the action of other G-protein-coupled
      receptors and their interactions with their respective G proteins.

PMID- 8466476
TI  - Mechanism of action of the Escherichia coli UvrABC nuclease: clues to the damage
      recognition problem.
AB  - During the process of E. coli nucleotide excision repair, DNA damage recognition
      and processing are achieved by the action of the uvrA, uvrB, and uvrC gene
      products. The availability of highly purified proteins has lead to a detailed
      molecular description of E. coli nucleotide excision repair that serves as a
      model for similar processes in eukaryotes. An interesting aspect of this repair
      system is the protein complex's ability to work on a vast array of DNA lesions
      that differ widely in their chemical composition and molecular architecture. Here
      we propose a model for damage recognition in which the UvrB protein serves as the
      component that confers enhanced specificity to a preincision complex. We
      hypothesize that one major determinant for the formation of a stable preincision
      complex appears to be the disruption of base stacking interactions by DNA
      lesions.

PMID- 8466477
TI  - Do specific interactions between transmembrane helices play a part in signalling
      transduction? Exploration with the insulin receptor.

PMID- 8466478
TI  - The pharmacological manipulation of members of the transforming growth factor
      beta family in the chemoprevention of breast cancer.
AB  - The transforming growth factors beta are a family of peptides which are involved
      in the regulation of cell growth and differentiation. It has been suggested that
      the loss of sensitivity to growth inhibition by endogenous TGF-beta may
      contribute to the process of carcinogenesis in epithelial systems. However, many
      breast cancer cells remain sensitive to the growth inhibitory effects of these
      peptides, suggesting that the local induction of TGF-beta could provide a
      pharmacological approach to chemoprevention. Triphenylethylene anti-oestrogens,
      synthetic progestins and retinoids all offer potential as chemopreventative
      agents. A common feature of their mechanism of action is the ability to locally
      increase the production of the transforming growth factors beta.

PMID- 8466479
TI  - Biochemical characterization of a protein inhibitor for DNA ligase I from human
      cells. Regulation/replication/repair/recombination.
AB  - An inhibitor for DNA ligase I has recently been purified from human cells. This
      inhibitor of 55-75 kDa forms a reversible complex with DNA ligase I, but has no
      effect on DNA ligase II and T4 DNA ligase, suggesting that it may play a
      regulatory role for DNA replication and repair. This report shows that the
      inhibitor was sensitive to heating at 52 degrees C and to trypsin treatment,
      indicating that it is a heat-labile protein. The inhibitor affected the ligation
      of double- and single-strand breaks in natural and synthetic DNA, but had no
      effect on the formation of the ligase-AMP complex and on the subsequent reaction
      following the formation of the AMP-DNA complex. These data indicate that the
      major mechanism of action for the inhibitor is the blocking of the second step of
      the reaction, in which the AMP moiety is transferred from the ligase-AMP to DNA.
      The site of interaction for the enzyme is therefore localized in a domain
      associated with the DNA binding or the AMP-transferring function.

PMID- 8466480
TI  - IL-1 beta decreases expression of amyloid precursor protein gene in human glioma
      cells.
AB  - In Alzheimer's disease a small fragment of the amyloid protein precursor (APP),
      called beta 4, is a characteristic component of senile plaques in brains of
      affected patients. Efforts to intervene in Alzheimer's disease include approaches
      by which APP levels can be decreased in brain. The study described here
      demonstrates the expression of APP gene in four cell lines that originated from
      human brain glioblastomas. In one line, HTB 17, APP mRNA level was approximately
      25% the APP mRNA found in human brain and 150% that found in human liver. To
      ascertain whether or not APP expression in HTB 17 cells could be modulated by a
      cytokine associated with the inflammatory response, cells were cultured in the
      presence of IL-1 beta. A significant decrease in APP mRNA accompanied treatment
      of glioma cells with IL-1 beta.

PMID- 8466481
TI  - Dopamine D1 receptor mutagenesis: role of amino acids in agonist and antagonist
      binding.
AB  - We investigated the role of amino acids, by site-directed mutagenesis, in five of
      the seven transmembrane regions of the human dopamine D1 receptor. The results
      demonstrate a role for an aspartic acid (Asp70) in transmembrane 2 mediating the
      sodium ion effect on receptor conformation. Amino acids residues in transmembrane
      3 and 5 are important for optimum dopamine binding to the receptor. Mutant
      receptors involving amino acids in transmembrane 7 suggest that binding sites for
      agonists and antagonists have distinct binding determinants within the dopamine
      D1 receptor.

PMID- 8466482
TI  - Cloning of a variant epidermal growth factor receptor.
AB  - The sequences encoding the full-length epidermal growth factor receptor (EGFR)
      were cloned from a cDNA library prepared from T3M4 cells. A transition (G to A)
      was identified at codon 497 of EGFR cDNA, resulting in the substitution of a
      lysine for an arginine. The same substitution was identified by sequencing cDNA
      derived from 3 of 7 additional human pancreatic cancer cell lines, one
      endometrial cancer cell line, and one lung cancer cell line, but not in A431
      cells. Variant EGFR was always co-expressed with wild-type EGFR. Both sequences
      were present in genomic DNA from two cell lines expressing the variant receptor
      and in DNA from normal (3 of 7 individuals) human lymphocytes. These findings
      indicate that there are two alleles in this region of the EGFR gene, and that
      expression of variant EGFR is a common occurrence in normal and cancerous cells.

PMID- 8466483
TI  - Regulation of the rat class I alcohol dehydrogenase gene by growth hormone.
AB  - Growth hormone (GH) increases the transcription of the rat class I alcohol
      dehydrogenase (ADH) gene. Two transcription factors, the CCAAT/enhancer binding
      protein (C/EBP) and the liver activator protein (LAP), were previously shown to
      bind to the ADH promoter at nucleotide positions -11 to -22 relative to the start
      site of transcription and to activate the ADH promoter in co-transfection
      experiments. In this study, exposure of cultured rat hepatocytes to GH (1
      micrograms/ml) for 4 days increased LAP mRNA, but not C/EBP mRNA, in conjunction
      with an increase in ADH mRNA. GH, in transient transfection experiments of
      primary rat hepatocyte cultures, activated an ADH promoter-reporter gene
      construct containing the C/EBP binding site, but failed to activate a construct
      containing a 4-bp mutation at this site. These results suggest that the effect of
      GH in enhancing ADH promoter activity is mediated by LAP binding to the C/EBP
      site.

PMID- 8466484
TI  - Enzymatic labeling of biologically active envelope glycoprotein gp120 of HIV-1.
AB  - We have found that the envelope glycoprotein gp120 of HIV-1 can be modified
      extensively by enzymatic oxidation of oligosaccharide chains without diminishing
      binding to its natural receptor, CD4. Using affinity purified galactose oxidase,
      over 20 sites per gp120 molecule were converted to chemically reactive aldehydes,
      as measured by 3H-BH4 reduction, while the conformation-dependent CD4 binding
      site remained intact. In contrast, periodate oxidation completely destroyed CD4
      binding while producing fewer sites. Enzymatically labeled, biologically active
      gp120 should facilitate biochemical studies of receptor binding and viral
      inactivation by neutralizing antibodies.

PMID- 8466485
TI  - Endothelin-1 and endothelin receptor mRNA expression in normal and
      atherosclerotic human arteries.
AB  - Endothelin-1 (ET-1) is a potent vasoconstrictor peptide implicated in a number of
      human diseases including atherosclerosis. ET-1 binds to two distinct G protein
      coupled receptors, known as the ETA and ETB receptor subtypes. In this study, we
      have examined ET-1, ETA and ETB mRNA expression levels in human vascular cells
      cultured in vitro and in normal and atherosclerotic human arteries. The results
      indicate that (a) ET-1 mRNA is constitutively expressed by endothelial cells but
      not by smooth muscle cells, (b) endothelial cells express only ETB mRNA but
      smooth muscle cells co-express ETA and ETB mRNA, and (c) in comparison to normal
      aorta, ET-1 mRNA expression is elevated and endothelin receptor mRNA expression
      is repressed in atherosclerotic lesions.

PMID- 8466486
TI  - Purification and characterization of three MEKA-like proteins in liver:
      association of a 94 kDa protein with beta gamma subunits of G-proteins.
AB  - Retinal 32 kDa MEKA protein (rMEKA) exists in the photoreceptor cells and forms a
      complex with beta gamma subunit of transducin. Bovine liver contained three MEKA
      like proteins (94 kDa, 35 kDa-a, 35 kDa-b) which reacted with a rMEKA antibody.
      Each protein was purified as a single band on a SDS-PAGE and used for a
      reconstitution experiment with alpha and beta gamma subunits of cerebral G
      proteins (Go/i). The 94 kDa protein inhibited GTP-binding ability of G alpha by
      forming a complex with beta gamma subunit.

PMID- 8466487
TI  - The monosialoganglioside GM1 induces internalisation and degradation of the CD4
      antigen in U937 cells: evidence for a novel mechanism of CD4 down-modulation in a
      p56lck-negative cell line, which is independent of protein kinase C activation.
AB  - Sialated glycosphingolipids (gangliosides) were recently shown to induce
      internalisation of the CD4 Ag in lymphoid cells and dissociation of p56lck from
      CD4 (Repke et al. (1992) J. Immunol. 149, 2585-2591; Saggioro et al. (1993) J.
      Biol. Chem. 268, 1368-1375). The findings presented in this paper show that GM1
      induces internalisation and the eventual degradation of the CD4 Ag also in the
      monocytic cell line U937. GM1 effects are independent of a possible activation of
      protein kinase C, as enzyme inhibitors which effectively blocked phorbol esters
      effects did not prevent GM1-induced CD4 internalisation and degradation. GM1
      effects were also independent of a possible action on a CD4 associated kinase
      activity as we show that U937 cells lack any CD4-associated kinase activity.

PMID- 8466488
TI  - Evidence for a dual osmoregulatory mechanism in the yeast Saccharomyces
      cerevisiae.
AB  - Osmoadaptation in S. cerevisiae occurs through intracellular accumulation of
      glycerol in response to an increase in osmolarity of the surrounding environment.
      Analysis of ssv1-2, a strain carrying a mutation in a gene required for vacuole
      biogenesis, protein-sorting and osmohomeostasis, shows that the strain is
      terminally inactivated by 1.5 M NaCl within 10 seconds while the isogenic wild
      type maintains slow growth and accumulates glycerol within 18 hours. This study
      provides the first evidence that the vacuole participates in an immediate
      osmoregulatory process permitting survival until the osmoadaptive glycerol
      accumulation allows growth under osmotically unfavorable conditions.

PMID- 8466489
TI  - Detection of beta-thalassemia carrier by direct analysis of beta-globin gene
      lesions.
AB  - DNA was prepared from peripheral blood mononuclear cells of 114 Chinese with low
      erythrocyte mean corpuscular volume and analyzed by allele-specific DNA
      amplification for the presence of mutant alleles in the beta-globin gene that
      account for about 90% of beta-thalassemia in Chinese. A total of 9 mutations of
      the five most frequent mutant alleles were detected in 8 individuals. All mutant
      sequences were confirmed later by DNA sequencing. However, no mutation of these
      mutant alleles was detected in the remaining 106 individuals with low erythrocyte
      mean corpuscular volume including 22 who also had Hb A2 content of 6.0% or more.
      Our results seem to suggest that the presence of beta-thalassemia allele does not
      correlate very well with red blood cell indices and that direct DNA analysis by
      allele-specific DNA amplification is an accurate method to identify beta
      thalassemia heterozygotes.

PMID- 8466490
TI  - Biochemical and immunological characterization of calcium-dependent and 
      independent PKC isoenzymes in renal ischemia.
AB  - The PKC alpha, beta, delta, epsilon and zeta isoenzyme changes in the rat kidney
      cortex have been investigated after temporary occlusion of the renal artery,
      followed by reperfusion for up to 4 h. Increased PKC alpha, delta and epsilon
      immunoreactivity and PKC alpha activity occurred within 60 min of postischemic
      reflow, while PKC beta and zeta were unmodified. Increased PKC beta activity was
      present at later times of reflow (120 min), suggesting that the initial events of
      the regenerative repair response after an ischemic insult implicate the
      activation of specific PKC isoenzymes (alpha, delta, epsilon), playing a role in
      the control of cell proliferation.

PMID- 8466491
TI  - Expression of non-ADP-ribosylatable, diphtheria toxin-resistant elongation factor
      2 in Saccharomyces cerevisiae.
AB  - Eucaryotic elongation factor 2 (EF-2) contains a post-translationally modified
      histidine residue termed diphthamide that is specifically ADP-ribosylated by
      diphtheria toxin (DT) or Pseudomonas exotoxin A. To analyze the potential
      physiological role of ADP-ribosylation of EF-2 by cellular ADP-ribosyl
      transferase, we constructed DT-resistant, non-ADP-ribosylatable Saccharomyces
      cerevisiae EF-2 by site-directed mutagenesis and expressed the mutant EF-2 in
      yeast. Substitution of Arg for Gly(701) in yeast EF-2 conferred complete
      resistance to DT in vivo and in vitro. However, when only non-ribosylatable EF-2
      was expressed in cells using genetic manipulation, the mutated EF-2 did not
      affect vegetative cell growth, mating, sporulation and germination of ascospores.

PMID- 8466492
TI  - Cellular uptake of phosphorothioate oligodeoxynucleotides is negatively affected
      by cell density in a transformed rat tracheal epithelial cell line: implication
      for antisense approaches.
AB  - Antisense oligodeoxynucleotides have been used to specifically inhibit the
      expression of a variety of genes. In the process of testing phosphorothioate
      oligodeoxynucleotides (S-oligos) as specific inhibitors of transforming growth
      factor alpha synthesis, we observed that the efficiency of cellular uptake of S
      oligos was not constant throughout the culture period but decreased as the cell
      densities increased. Our data suggest that the mechanism by which
      oligonucleotides enter cells is negatively affected by increased cell density.
      These results emphasize the importance of determining uptake kinetics before
      designing and interpreting antisense experiments using phosphorothioate
      oligonucleotides.

PMID- 8466493
TI  - Molecular characteristics of uronic-acid-rich protein, a strong inhibitor of
      calcium oxalate crystallization in vitro.
AB  - Uronic-acid-rich protein (UAP) is a new urinary macromolecule which strongly
      inhibits calcium oxalate crystal formation. It is a glycoprotein with a molecular
      weight of about 35,000 Da, and its carbohydrate content is 8.5%. This inhibitor
      is composed of two polypeptidic chains crosslinked by chondroitin sulfate. It
      exhibits partial structural homology with alpha 1-microglobulin. The inhibitory
      activity seems to be supported by peptidic chains as determined by enzymatic
      assay.

PMID- 8466494
TI  - Crosslink formation between DNA and nuclear proteins by in vivo and in vitro
      exposure of cells to dimethylarsinic acid.
AB  - DNA damage induced by arsenics, particularly by dimethylarsinic acid (DMAA), a
      main metabolite of inorganic arsenics in mammals, was investigated. DNA-protein
      crosslinks, similarly to DNA single-strand breaks, were induced in mouse and
      human culture cells by the treatment with DMAA. The crosslinks were sensitive to
      treatment with guanidine and hydroxylamine, suggesting that the DNA linkage sites
      in proteins were serine and threonine residues of H1 histone and of nonhistone
      proteins and that the linkage occurred through a phospho-nitrogen bond. The type
      of crosslinks was different from that induced by X-ray radiation. Of the radicals
      produced in the further metabolic processing of DMAA, the dimethylarsenic peroxyl
      radical rather than the superoxide anion radical is likely responsible for the
      formation of crosslinks, similar to the case of DNA single-strand breaks.

PMID- 8466495
TI  - Identification of 34 apolipoprotein(a) isoforms: differential expression of
      apolipoprotein(a) alleles between American blacks and whites.
AB  - A total of 34 different apo(a) isoforms was identified in a population sample of
      806 American Whites and 701 American Blacks by a high resolution SDS-agarose gel
      electrophoretic method followed by immunoblotting. Among the 1507 individuals
      tested, 79% revealed double-banded phenotypes and 21% single-banded phenotypes.
      The frequencies of the apo(a) isoforms differed between American Blacks and
      Whites (p < 0.001).

PMID- 8466496
TI  - The passive calcium leak in cultured porcine aortic endothelial cells.
AB  - Unidirectional 45Ca fluxes were measured to characterize the calcium-leak pathway
      in cultured endothelial cells of pig aorta. Lanthanum, but not other calcium
      channel blockers such as verapamil and diltiazem, inhibited the passive 45Ca
      uptake. Passive uptake of 45Ca across the plasma membrane increased progressively
      as extracellular pH was raised from 5.2 to 9.2. SK&F 96365, a putative inhibitor
      of receptor-mediated Ca2+ entry, selectively blocked ATP-induced 45Ca uptake. The
      Ca2+ leak pathway may play an important role in endothelial cell Ca2+ homeostasis
      which controls the basal and stimulated release of endothelium-derived relaxing
      factors (i.e., EDRF, prostacyclin) in physiological or pathological situations.

PMID- 8466497
TI  - Role of the collagen-like domain of the human serum mannan-binding protein in the
      activation of complement and the secretion of this lectin.
AB  - Human mannan-binding protein (MBP) is a C-type serum lectin involved in an
      immunoglobulin-independent host defense. Recently, a common defect of immune
      opsonin was found to be associated with very low serum levels of MBP. This
      deficiency was thought to be an effect of a single base substitution in the MBP
      gene, which resulted in the conversion of Gly54 to Asp. In this study, three
      mutant MBPs were expressed in COS-1 cells and the effects of these mutations were
      studied. Gly54Asp-MBP and Gly57Asp-MBP were secreted into the medium almost at
      the same levels as the wild type MBP, but the formation of higher multimers and
      the activation of complement were interfered with significantly. The other
      mutant, in which Leu was inserted into the Gly63-Gln-Gly sequence to restore the
      collagen motif of the Gly-Xaa-Yaa repeat, was secreted at levels similar to that
      of the wild type, formed higher multimers and activated complement in a manner
      not significantly altered from that of the wild type. These results are discussed
      with regard to the molecular basis of patients with opsonic defects.

PMID- 8466498
TI  - Identification of binding domains on the superantigen, toxic shock syndrome-1,
      for class II MHC molecules.
AB  - Toxic shock syndrome toxin-1 (TSST-1) is a member of the staphylococcal
      enterotoxin superantigen family. In order to determine the regions on the TSST-1
      molecule involved in binding to class II MHC, seven overlapping peptides of the
      entire TSST-1 molecule were synthesized and tested for their ability to compete
      with 125I-TSST-1 for binding to class II MHC on murine A20 cells and HLA on Raji
      cells. Peptides corresponding to N-terminal amino acid residues 39 through 68 and
      C-terminal residues 155 through 194 competed with 125I-TSST-1 for binding to
      class II MHC. Also, binding studies with class II MHC beta-chain peptides
      indicate that regions encompassed by I-A beta b(30-60) and I-A beta b(60-90) are
      binding regions for TSST-1. Thus, we have identified binding domains on the TSST
      1 molecule for class II MHC molecule receptors on antigen presenting cells.

PMID- 8466499
TI  - Stimulation of DNA synthesis in hepatocytes by hepatocyte growth factor bound to
      extracellular matrix.
AB  - Hepatocyte growth factor (HGF) purified from human placenta was specifically
      bound to a component in ECM secreted from lung fibroblasts, hepatocytes, and
      nonparenchymal liver cells. HGF was also bound to a component in basement
      membrane matrigel. The rate of DNA synthesis in hepatocytes cultured on the HGF
      bound ECM was 4-7 times that of control hepatocytes. When ECM-coated dishes were
      pretreated with heparinase and heparitinase prior to binding of HGF, the
      stimulation decreased remarkably. A considerable decrease in the stimulation was
      observed following the washing of HGF-bound ECM with 1 M NaCl. We propose, based
      on these observations, that HGF bound to the ECM component present in Disse's
      space functions in regeneration following hepatic injury.

PMID- 8466500
TI  - Catabolism of intact type VI collagen microfibrils: susceptibility to degradation
      by serine proteinases.
AB  - We present the first direct biochemical evidence for the turnover of intact type
      VI collagen microfibrils. Matrix-degrading enzymes of the serine proteinase
      class, including rat mast cell chymases I and II, human mast cell tryptase,
      neutrophil elastase, cathepsin G and trypsin, were able to catabolize intact type
      VI collagen microfibrils isolated from foetal bovine skin and metabolically
      labelled intact type VI collagen immunoprecipitated from fibroblast culture
      medium. By contrast, intact type VI collagen was not degraded by the human matrix
      metalloproteinases, MMP-1, MMP-2, MMP-3 and MMP-9. These data have important
      implications for the stability of type VI collagen in connective tissues and
      highlight the potential role of serine proteinases both in normal type VI
      collagen turnover and in inflammatory conditions characterized by matrix
      degradation.

PMID- 8466501
TI  - Endothelin-1 induces cholestasis which is mediated by an increase in portal
      pressure.
AB  - Endothelin-1 (ET-1) is a potent vasoactive peptide which generally exerts its
      effect on target cells by increasing [Ca++]i. Both vasoconstriction (resulting in
      an increase in perfusion pressure) and increased [Ca++]i are actions of ET-1 that
      may result in cholestasis. Single-pass isolated perfused rat liver (IPRL) were
      used, and [Ca++]i was measured in both populations of hepatocytes and single
      cells. ET-1 (0.1-100 nM) induced a dose-dependent increase in perfusion pressure
      and decrease in bile flow. Perfusion pressure increased by 112% (p < 0.001) and
      bile flow decreased by 17% (p < 0.008) in response to 2 nM ET-1. At this
      concentration of ET-1, but not at higher concentrations, the cholestasis was
      abolished (p > 0.18 vs basal) and the rise in perfusion pressure was decreased
      (by 62%; p < 0.002) by the vasodilator papaverine. This ET-1 concentration also
      had no measurable effect on [Ca++]i in isolated hepatocytes. Taken together these
      findings indicate that ET-1 inhibits bile flow in IPRL and suggests that this
      effect is mediated by vasoconstriction and not by changes in hepatocyte cytosolic
      Ca++.

PMID- 8466502
TI  - Overexpression of a UV-damage recognition protein in a UV-sensitive human colon
      cancer cell line that features multidrug-resistant phenotype.
AB  - We have previously hypothesized that the level of UV-damage recognition protein
      (UVDRP) is a potential indicator of DNA-damage-mediated sensitivity or resistance
      of human cells to UV radiation [Chao, C.C.-K., Biochem. J. 282, 203-207, 1992].
      In this study, we detected a 2-fold increase in the UVDRP binding activity in a
      UV-sensitive multidrug-resistant (MDR) human colon cancer cells compared to the
      parental SW620 cells. However, the MDR cells did not display enhanced DNA repair.
      The data is consistent with the conclusion that DNA excision repair is not the
      sole determinant of cellular sensitivity to genotoxic agents. The results also
      suggest that recognition of damaged DNA may be associated with generating a
      signal which mediates cellular sensitivity to UV radiation.

PMID- 8466503
TI  - Autocrine/paracrine function of parathyroid hormone-related peptide in rat
      osteoblast-like cells.
AB  - Parathyroid hormone-related peptide (PTHrP) may be synthesized in or near its
      target tissues and acts by autocrine and/or paracrine fashions. The rat clonal
      strain of the osteoblast-like cell, ROS 17/2.8-5, can express low levels of PTHrP
      in the cytoplasm; however, the autocrine function of PTHrP in ROS cells has not
      yet been clarified. We created PTHrP expression vectors and transfected them into
      cells in order to elucidate the functional role of PTHrP on their own target
      cells. Sense and antisense rat PTHrP expression vectors (pSV2 neo-ECE-rPLP) were
      transfected into ROS cells independently and cultured for 72 hours. Cells
      overexpressing PTHrP were detected by immunocytochemical analysis and confirmed
      by Northern blot analysis, respectively. These transfected cells demonstrated
      mitogenic activity as determined by BrdU uptake staining. These findings suggest
      the functional role of PTHrP on their own PTHrP expressing cells via an
      autocrine/paracrine fashion. These PTHrP-overexpressing ROS cells provide a model
      in vitro system to clarify the mechanism by which PTHrP acts in an
      autocrine/paracrine fashion.

PMID- 8466504
TI  - Identification and partial characterization of phospholipase D in the human
      amniotic membrane.
AB  - The enzymatic activity of phospholipase D and its characteristics have been
      examined in human amnion tissue. The phospholipase D activity was not Ca(2+)- or
      Mg(2+)-dependent and was activated by unsaturated fatty acids. The optimal pH of
      phospholipase D was 5.5. The phospholipase D activity in amnion tissue was
      highest in the microsomal fraction, and preferentially utilized
      phosphatidylcholine as a substrate. The phospholipase D activity of the
      microsomal fraction of amnion tissue obtained at term before labor onset (34.0 +/
      16.3 nmol/hour/mg protein, mean +/- SD, n = 11) was significantly (p < 0.05)
      higher than the activity in this tissue obtained from women in the mid-trimester
      (15.0 +/- 7.5 nmol/hour/mg protein, n = 9).

PMID- 8466505
TI  - Permanent gases inside healthy and microbially infected cotton fruit during
      development.
AB  - Permanent gases inside developing cotton fruit (Gossypium hirsutum L.) were, by
      weight, 46% nitrogen, 29% oxygen, 4% argon and 20% carbon dioxide, whereas plant
      canopy air assayed at 73% nitrogen, 25% oxygen, 2% argon and 0.3% carbon dioxide.
      Light exposure, fruit age, and mild infection (Erwinia) had no compositional
      effect but aggressive infection (Aspergillus) raised carbon dioxide content to
      31% by weight and correspondingly lowered oxygen to 17%. Respiration with oxygen
      replenishment except during aggressive infection accounted for the fruit gas
      compositions.

PMID- 8466506
TI  - Lipopolysaccharide-induced expression of prostaglandin H synthase-2 in alveolar
      macrophages is inhibited by dexamethasone but not by aspirin.
AB  - Alveolar macrophages cultured with lipopolysaccharide release markedly increased
      amounts of prostanoids upon subsequent stimulation, an effect that is due to
      induction of prostaglandin H synthase-2 (J. Biol. Chem., (1992), 267, 14545
      14550, and Biochem. Biophys. Res. Comm., (1992), 187, 1123-1127). The effects of
      dexamethasone and aspirin on this enhanced formation of thromboxane by stimulated
      lipopolysaccharide-primed alveolar macrophages were investigated. Under
      conditions of maximum inhibition, dexamethasone and aspirin decreased the
      formation of thromboxane by approximately 50% and 80%, respectively. Expression
      of lipopolysaccharide-induced prostaglandin H synthase-2 in dexamethasone-treated
      macrophages was similarly inhibited by about 50%, as determined by Northern blot
      and immunoprecipitation. In contrast, levels of lipopolysaccharide-induced
      prostaglandin H synthase-2 mRNA and protein were not reduced in aspirin-treated
      macrophages. We conclude that inhibition of prostaglandin H synthase-2 expression
      represents a mechanism by which dexamethasone, but not aspirin, may inhibit
      prostanoid formation by alveolar macrophages.

PMID- 8466507
TI  - Differentiation and apoptosis of murine neuroblastoma cells N1E115.
AB  - The mode and the kinetics of differentiation and death of murine N1E115
      neuroblastoma cells induced by dimethyl sulfoxide and other nonspecific factors
      in vitro were investigated. After morphological differentiation neuroblastoma
      cells die by apoptosis which is indicated by characteristic morphological
      features and by internucleosomal DNA fragmentation. Durations of both
      differentiation and apoptosis are dependent on the nature of stimuli used.
      Protein synthesis inhibitor cycloheximide does not prevent differentiation and
      apoptosis of neuroblastoma cells induced by dimethyl sulfoxide and even
      accelerates both processes. The relationship between cell death and
      differentiation is discussed.

PMID- 8466508
TI  - Epidermal growth factor binding and stimulation of inositol trisphosphate
      production in basolateral membranes from dog kidney.
AB  - To ascertain whether epidermal growth factor (EGF) receptors are present in
      proximal tubular basolateral membranes from dog kidney and whether the growth
      factor activates phospholipase C at this site, we measured binding of 125I-EGF in
      isolated membranes and determined whether incubation of the membranes with EGF
      results in generation of inositol trisphosphate. Specific binding of 125I-EGF to
      basolateral membranes was observed that was half-maximally inhibited by
      approximately 7 x 10(-10) M EGF. The specific binding capacity of basolateral
      membranes for EGF averaged 45.9 fmol/mg protein. 125I-EGF was crosslinked to 2
      proteins in basolateral membranes with M(r)s of 170,000 and 150,000. EGF
      stimulated phosphorylation of a 170,000 M(r) protein. Incubation of basolateral
      membranes with EGF stimulated inositol trisphosphate production in a
      concentration-dependent manner. We conclude that EGF activates a phospholipase C
      activity that cleaves phosphatidylinositol 4,5-bisphosphate within the
      basolateral membrane.

PMID- 8466510
TI  - Enzymatic basis for altered ascorbic acid and dehydroascorbic acid levels in
      diabetes.
AB  - Abnormal plasma ascorbic acid (AA) and dehydroascorbic acid (DHAA) levels
      observed in diabetes may be correlated to a deficiency in the recycling of AA.
      Ascorbic acid and DHAA levels are altered in diabetic liver in the present study.
      In addition, a coupling of the hexose monophosphate (HMP) shunt by way of NADPH
      to glutathione reductase and subsequent DHAA reduction is demonstrated. Ascorbic
      acid production was assayed directly and by way of the HMPS pathway. Results
      indicate that AA production from DHAA via the HMPS pathway occurs, and is
      significantly decreased in diabetic liver. Glucose-6-phosphate dehydrogenase
      (G6PDH) activity is shown to be decreased in diabetic liver. Since G6PDH is
      essential in providing NADPH for the reduction of glutathione required for
      subsequent DHAA reduction, its decreased activity is consistent with altered
      levels of AA and DHAA observed in diabetic tissues.

PMID- 8466509
TI  - Molecular cloning of human epimorphin: identification of isoforms and their
      unique properties.
AB  - Epithelial-mesenchymal interactions are crucial for various epithelial tissue
      organizations and epimorphin is one of the important signaling molecules from the
      mesenchyme. The sequence analysis of a human homologue revealed that both of
      primary and predicted secondary structures of epimorphin are highly conserved
      among species and this molecule has some isoforms including a putative soluble
      type. I found that human epimorphins also have a large discrepancy in molecular
      masses as the case of mouse (around 33kD are predicted by the sequences whereas
      two protein bands of 60-70kD and 150kD are detected in the cells), and it can be
      explained, at least in part, by the SDS-resistant complexes formed in the
      microsomal membranes.

PMID- 8466511
TI  - Cleavage arrest in Xenopus embryos injected with a human c-myc gene.
AB  - The c-myc protein has been implicated in cell proliferation and differentiation
      of various cell lines, but its function in early embryos of Xenopus is obscure.
      We introduced the c-myc gene into embryos using a pcDL-SR alpha plasmid with an
      efficient promoter of the gene. It was found that fertilized eggs injected with
      the c-myc gene were arrested at the 4-cell stage within 1 h of the injection,
      when the plasmid that carried c-myc gene but not the plasmid that carried
      defective c-myc gene was injected. These results also suggest that Xenopus
      embryos already have the ability to transcribe an exogenously injected c-myc gene
      at the 4-cell stage.

PMID- 8466512
TI  - A novel disease with deficiency of mitochondrial very-long-chain acyl-CoA
      dehydrogenase.
AB  - Palmitoyl-CoA dehydrogenase activity in skin fibroblasts from seven patients with
      unidentified defects of fatty acid oxidation was measured in the presence and
      absence of antibodies against medium-chain, long-chain, and very-long-chain acyl
      CoA dehydrogenases (VLCAD). Two of the patients, 4-5 month old boys, were found
      to have a novel disease, VLCAD deficiency, as judged from the results of very low
      palmitoyl-CoA dehydrogenase activity and the lack of immunoreactivity toward
      antibody raised to purified VLCAD.

PMID- 8466513
TI  - Two insulin genes are present in the salmon genome.
AB  - According to the accepted hypothesis, polyploid evolution is necessary to achieve
      meaningful gene duplication. Some fish, namely those belonging to the suborder
      Salmonidae, appear to be autotetraploid species that probably originated from a
      diploid ancestor relatively recently and that appear to be progressing toward
      diploidization to various degrees. The Pacific chum salmon (Oncorhynchus keta)
      has almost completed this process of diploidization. Thus, with regard to
      practically any gene product, theory predicts a freshly diploidized,
      autotetraploid species to possess twice the number of gene loci as diploid
      animals. Here we show that the chum salmon genome contains two nonallelic insulin
      genes that are both expressed in chum salmon Brockman bodies. Nucleotide sequence
      analysis reveals structural diversification of this pair of duplicated genes.

PMID- 8466514
TI  - Alboaggregin-B and botrocetin, two snake venom proteins with highly homologous
      amino acid sequences but totally distinct functions on von Willebrand factor
      binding to platelets.
AB  - Alboaggregin-B (AL-B) (Peng et al., Biochemistry (1991) 30, 11529-11536) was
      highly purified from the snake venom of Trimeresurus albolabris and characterized
      structurally and functionally, comparing with botrocetin, another snake venom
      protein recently characterized (Usami et al., Proc. Natl. Acad. Sci. USA (1993)
      90, 928-932). Both the venom proteins are a heterodimer and show a high degree of
      sequence homology to each other and also to C-type lectins. Botrocetin
      specifically binds to von Willebrand factor (vWF), whereas AL-B binds to platelet
      glycoprotein (GP) Ib without affecting the binding of botrocetin to vWF. The
      binding of AL-B to GPIb does not potentiate the platelet aggregation even by
      exogenous fibrinogen, suggesting that AL-B binding to GPIb does not activate
      GPIIb/IIIa complex.

PMID- 8466515
TI  - Voltage-dependent potassium currents in cultured human retinal pigment epithelial
      cells.
AB  - Membrane currents in primary cultures of human retinal pigment epithelial cells
      were studied using the whole-cell configuration of the patch-clamp technique. Two
      types of voltage-dependent whole-cell currents were observed. First, a time- and
      voltage-dependent outward current, which was activated by depolarizing the cell
      to potentials more positive than -30mV, was sensitive to Ba2+ (10mM), 4
      aminopyridine (10mM) and TEA+ (30mM). Tail-current analysis indicated that the
      current was mainly carried by K(+)-ions. Second, hyperpolarization of the cell to
      potentials more negative than -70mV led to a time- and voltage-dependent inward
      current which was blocked by Ba2+ (10mM) and 4-aminopyridine (10mM), but not by
      TEA+ (30mM). In summary, human retinal pigment epithelial cells in primary
      culture express currents which indicate the presence of a delayed rectifier K(+)
      channel and an inward rectifier K(+)-channel.

PMID- 8466516
TI  - Theoretical analysis of amino acid sequence of human dystrophin.
AB  - Human muscular dystrophy, the fatal disease, is caused by the genetic abnormality
      of dystrophin. The question whether dystrophin is an intrinsic membrane protein
      or not was investigated by calculating the average value and the long periodicity
      of hydrophobicity of amino acid sequence. The periodicity was estimated by a
      maximum entropy method of Fourier transformation. The results indicated that a
      fragment from 3101-st to 3200-th residues of dystrophin contains several
      transmembrane helices. The hydropathy plot of this region strongly suggests four
      transmembrane helices, indicating that both ends, N-and C-termini, are located in
      the cytoplasmic sides with firm anchoring into membrane by these helices.

PMID- 8466517
TI  - Evidence for the involvement of G proteins in the modulation of 22Na and 45Ca
      fluxes in myogenic L6 and aortic smooth muscle cells.
AB  - Preincubation of rat skeletal muscle derived L6 myoblasts with 10 mM NaF
      increased, the activity of Na+/H+ exchanger, and the uptake of 45Ca by 2 and 5
      folds, respectively. In cultured vascular smooth muscle cells (CVSMC) of rat
      aorta, NaF increased the activity of Na+,K(+)-pump, Na+/H+ exchanger, passive
      permeability for Na+, and 45Ca uptake by 1.6, 9, 2, and 9 folds, respectively.
      Both, in CVSMC and L6 cells, the effect of NaF on the Na+/H+ exchanger and 45Ca
      uptake were significantly augmented by 20 microM AlCl3. No effect of AlCl3 on the
      NaF dependent changes in ion flux was seen in rat erythrocytes. The results
      suggest that in L6 and CVSMC cells, the Na+/H+ exchanger and Ca++ uptake
      pathway(s) are activated by GTP-binding proteins.

PMID- 8466518
TI  - The structure and characteristics of a fourth allele of polymorphic N
      acetyltransferase gene found in the Japanese population.
AB  - Polymorphic N-acetyltransferase (NAT2), which exists in the human liver and
      metabolizes a wide spectrum of arylamine, is encoded by one gene (NAT2). We have
      identified the mutations of a fourth NAT2 allele (allele 4) which we previously
      found in the Japanese population. Compared with allele 1, which expresses a high
      enzyme activity, allele 4 has 3 nucleotide differences. 2 are missense mutations
      at nucleotide position (nt) 341 and 803. The other is a silent mutation at the
      KpnI site. From the result of expression studies of chimeric gene constructs
      between allele 1 and allele 4 in Chinese hamster ovary cells, nt 341 missense
      mutation of the allele 4 which causes the Ile-114 to Thr change is responsible
      for the low enzyme activity of NAT2 protein.

PMID- 8466519
TI  - Endothelin-1 induces contraction of bile canaliculi in isolated rat hepatocytes.
AB  - To examine the effects of endothelin-1(ET-1) on bile canalicular contractions,
      rat hepatocytes were isolated by a collagenase perfusion technique and cultured
      on p-n-p-vinylbenzenyl-D-lactonamide-coated dishes under serum-free conditions.
      The frequency of bile canalicular contractions was expressed by the percentage of
      the number of bile canaliculi(BC) that contracted compared to the total number of
      BC observed for 10 min. The treatment of the hepatocytes with ET-1 increased the
      frequency of contraction of the BC in a dose-dependent manner up to 2nM, control:
      10.4%; 0.5nM ET-1:31.6%; 1nM ET-1:54.0%; 2nM ET-1:58.0%; 4nM ET-1:58.9%. The
      contraction, once it occurred, lasted for rest of the observation period. We also
      observed a transient increase in the concentration of intracellular Ca in
      cultured hepatocytes upon the addition of ET-1 to the medium. These results
      suggest that ET-1 plays an important role in the mortility of BC in vivo.

PMID- 8466520
TI  - Endothelin-1 is produced and secreted by neonatal rat cardiac myocytes in vitro.
AB  - Production of endothelin-1 in the cultured neonatal rat cardiac myocytes was
      investigated. Studies on the cultured cardiac myocytes with reverse transcription
      polymerase chain reaction followed by Southern hybridization indicated that mRNA
      of ET-1(preproET-1 mRNA) was expressed by cardiac myocytes. ET-1 polypeptide was
      also detected in the cultured cardiac myocytes. Moreover, ET-1 was secreted into
      the culture medium by them. These results suggest that the cardiac myocytes,
      which have been regarded as target cells of ET-1, are able to synthesize and
      secrete ET-1. Furthermore, there may be a possible autocrine mechanism of ET-1 in
      the myocytes of a heart.

PMID- 8466521
TI  - Molecular cloning and characterization of the promoter region of the human c-erbA
      alpha gene.
AB  - The c-erbA alpha gene encodes the alpha type thyroid hormone receptor. This gene
      is expressed in various types of cells, its expression being relatively high in
      the central nervous system. A genomic clone that contains the 5'-terminal portion
      of the human c-erbA alpha gene was isolated. The 615 base pair (bp) 5'-flanking
      sequence of the c-erbA alpha gene showed promoter activity when placed upstream
      of the bacterial chloramphenicol acetyltransferase gene and transfected into HeLa
      cells. Nine transcriptional initiation sites were detected within this sequence
      by S1 nuclease protection analysis. DNA sequence analysis showed that the
      promoter region contains ten putative binding sites for transcriptional factor
      Sp1 in the GC rich region (86%). Three putative cAMP responsive elements (CRE)
      and one putative TPA responsive element (TRE) were identified upstream of the GC
      rich region. The c-erbA alpha promoter sequence also contains a putative binding
      site for the Krox-20 transcriptional factor, which is thought to play a role in
      early development of the mouse central nervous system.

PMID- 8466522
TI  - Endothelin 1 mediates endothelial cell-dependent proliferation of vascular
      pericytes.
AB  - The influence of endothelial cells on the growth of vascular pericytes was
      investigated using human umbilical endothelial cell and bovine retinal pericyte
      co-culture systems. When pericytes were cultured with endothelial cells, the
      number of viable pericytes increased significantly, regardless of the presence or
      absence of physical contact between the two cell types, indicating that
      endothelial cells can induce proliferation of pericytes through certain secreted
      factor(s). Evidence that endothelin 1 mediates this action was obtained:
      endothelin 1 added to the medium was able to substitute for the feeder layer of
      endothelial cells, and an antiserum against endothelin 1 could neutralize the
      ability of endothelial cells to promote pericyte growth. RNA blot analysis
      revealed that pericytes express mRNA for type-A endothelin receptor, a high
      affinity receptor of endothelin 1.

PMID- 8466523
TI  - Nitric oxide stimulates the ADP-ribosylation of actin in human neutrophils.
AB  - ADP-ribosylation is an important post-translational protein modification;
      however, endogenous substrates are poorly characterized. In these studies we
      examined the effects of nitric oxide on the ADP-ribosylation of neutrophil
      proteins. Purified cytosol and plasma membrane were incubated with 32P-NAD (5
      microM, 1 microCi, 30 min) in the presence or absence of nitric oxide. Nitric
      oxide induced the ADP-ribosylation of the 37 kD substrate present only in
      cytosol. Nitric oxide treatment of plasma membrane plus cytosol revealed the ADP
      ribosylation of an additional 43 kD protein. This 43 kD substrate was identified
      as actin by both phalloidin precipitation and immunoblot (2-D) gel using specific
      anti-actin antibodies. The data indicate that nitric oxide stimulates the ADP
      ribosylation of two discrete substrates in fractionated PMN, one of which can be
      identified as actin. NO-induced ADP-ribosylation may contribute to the modulatory
      effect of nitric oxide on neutrophil functions, including F-actin assembly.

PMID- 8466524
TI  - Solution structure of casokefamide.
AB  - Casokefamide (Tyr-D-Ala-Phe-D-Ala-Tyr-NH2) is a synthetic peptide derived from
      the beta-casomorphin sequence, designed to increase the resistance to gastric
      proteases. Casokefamide binds to both mu and delta-opioid receptors, while beta
      casomorphins and its fragments are typical mu-opioid receptor agonists.
      Furthermore, casokefamide can affect gastric acid and pancreatic exocrine
      secretions and also gastrointestinal motility. We have undertaken a
      conformational study on this peptide based on NMR measurements in a DMSOd6/H2O
      cryomixture at 265 K and energy calculations. The predominant conformation is
      characterised by the absence of regular structures and intramolecular hydrogen
      bonds. The conformation of the message domain is reminiscent of the shape of
      several peptidic and non peptidic opiates, with the D-Ala2CH3 group sandwiched
      between Tyr1 and Phe3 aromatic rings.

PMID- 8466525
TI  - Cloning of the rat cyclin-dependent kinase 4 cDNA: implication in proliferation
      dependent expression in rat tissues.
AB  - To identify protein kinases that may regulate fetal growth and differentiation,
      we used an oligonucleotide probe encoding the conserved sequence of
      serine/threonine kinases to screen a fetal lung cDNA library. Several clones were
      isolated and sequenced, one of which encodes the rat homolog of the 34 kilodalton
      cyclin-dependent kinase 4 (p34cdk4). Northern blot analyses of pre- and postnatal
      rat tissues show that rat cdk4 is expressed in a developmentally regulated
      pattern in all tissues examined. The mRNA is also significantly decreased in
      cells that are arrested in the G1 phase of cell cycle. The regulated expression
      of rat cdk4 is consistent with a proliferation-, rather than a differentiation-,
      dependent pattern.

PMID- 8466526
TI  - 1H-detected in vivo 13C NMR spectroscopy and imaging at 2T magnetic field:
      efficient monitoring of 13C-labeled metabolites in the rat brain derived from 1
      13C-glucose.
AB  - Gradient-select hetero-nuclear multiple quantum coherence in nuclear magnetic
      resonance (NMR) an indirect method of detecting nuclei in low sensitivity by 1H
      NMR, was used to observe 13C-enriched metabolites in the rat brain in vivo, with
      a 2 T NMR system. We detected the accumulation of 13C-labeled glucose and its
      metabolites, glutamine and/or glutamate, in less than 5 min. The extension of
      this technique to chemical shift imaging permitted the localization of these
      chemicals in the rat brain. This approach may have various applications for non
      invasive monitoring of 13C-labeled compounds in humans and other animals.

PMID- 8466527
TI  - Geranylgeranylacetone used as an antiulcer agent is a potent inducer of
      differentiation of various human myeloid leukemia cell lines.
AB  - Low concentrations of geranylgeranylacetone (GGA), known as an antiulcer agent
      (Teprenone), induces differentiation of various human myeloid leukemia cell
      lines. The cell lines examined in the present study were myeloblastic ML1,
      histiocytic U937, promyelocytic HL60, and multipotential K562. All of these cell
      lines were induced to differentiate by 20 microM GGA, as measured by NBT
      staining. Neither polyprenylacetones, with more or fewer isoprene units than the
      geranylgeranyl group, nor polyprenylalcohols had no differentiation-inducing
      activity. GGA used in combination with RA or TNF-alpha increased ML1 cell
      differentiation. The present results suggest that GGA may be a useful agent in
      differentiation therapy of leukemia.

PMID- 8466528
TI  - The mouse low density lipoprotein receptor gene: cDNA sequence and exon-intron
      structure.
AB  - The low density lipoprotein (LDL) receptor plays a central role in the
      cholesterol metabolism. The cDNA sequence of the mouse low density lipoprotein
      receptor (Ldlr) gene has been determined and shows 76% homology with the human
      gene. The exon-intron structure has been determined for the 129/J mouse strain.
      The gene is composed of 18 exons and spans a region of 28 kb. In addition, the
      promoter regions of the mouse and human genes are homologous. Northern blot
      analysis revealed an mRNA of approximately 5 kb. The cloning of the Ldlr gene
      will enhance the usefulness of the mouse for the study of cholesterol metabolism
      and, in particular, for carrying out gene targeting experiments.

PMID- 8466529
TI  - Molecular cloning and sequencing of zeta-crystallin/quinone reductase cDNA from
      human liver.
AB  - Zeta-crystallin is an enzyme-crystallin highly expressed in the lens of some
      hystricomorph rodents and camels. It has been shown to have a novel NADPH:
      quinone oxidoreductase activity and is present at enzymatic levels in a variety
      of tissues from various mammals. We report here the cDNA cloning of zeta
      crystallin from a human liver library. One clone with the complete open reading
      frame was obtained. Ten nucleotides of the 5' and 796 of the 3' nontranslated
      regions are present in the clone including two possible polyadenylation signals.
      The deduced amino acid sequence is 328 residues long with a calculated molecular
      mass of 34910 daltons and isoelectric point of 8.73. It shows 84% identity with
      the guinea pig protein.

PMID- 8466530
TI  - Effect of retinoic acid on osteocalcin gene expression in human osteoblasts.
AB  - It is well known that the expression of osteocalcin, the only recognized
      osteoblast-specific protein, is regulated by 1 alpha-25-dihydroxyvitamin D3
      through a distinct vitamin D3 receptor and a cis-acting DNA response element. In
      addition, recent data obtained with plasmid constructs have shown a positive
      interaction between retinoic acid activated receptor(s) and the osteocalcin gene
      promoter. Our studies, carried out on primary cultures of human osteoblasts, have
      demonstrated for the first time the activation of the osteocalcin gene expression
      by retinoic acid. Moreover, a remarkable synergistic effect between the hormonal
      forms of vitamin A and D3 on the synthesis of this bone-specific protein was
      observed.

PMID- 8466531
TI  - Bcl-2 gene is highly expressed during neurogenesis in the central nervous system.
AB  - An analytical method for quantitation of the RNA transcripts of murine bcl-2 gene
      was developed. The PCR products from bcl-2 alpha and bcl-2 beta mRNA were
      fluorometrically analyzed and their specific contents were calculated by the
      internal standard method. Both bcl-2 mRNAs in adult mice were transcribed at the
      highest level in the thymus and at a comparable level in the spleen. Aside from
      the immune system, the brain gave the most abundant levels of the bcl-2 mRNAs.
      The ratios of bcl-2 beta mRNA to bcl-2 alpha mRNA in the thymus and spleen were
      significantly higher than those in other tissues. During development of the
      brain, the bcl-2 alpha and bcl-2 beta mRNA levels were highest on embryonic day
      15, and about two and three times higher than those of adult, respectively. The
      results suggest that the bcl-2 gene functions to regulate development and
      survival of neurons in the central nervous system.

PMID- 8466532
TI  - Specific interaction of guanidine hydrochloride with essential carboxyl group of
      xylanase from alkalothermophilic Bacillus sp.
AB  - Experimental evidence for the specific interaction of guanidine hydrochloride
      with the carboxyl group of xylanase has been presented for the first time.
      Guanidine hydrochloride (0.1 M) inactivated the xylanase from alkalothermophilic
      Bacillus sp. to 50% without affecting the conformation of the protein as
      determined by the fluorometric profile. The kinetic analysis indicated a
      competitive type of inhibition and a requirement of 1.4 molecules of guanidine
      hydrochloride per molecule of the enzyme for inhibition. Maximum inhibition
      occurred at the pH which is optimum for the enzyme activity. The reaction of
      guanidine hydrochloride with the enzyme prior to modification by Woodward's
      Reagent K, a specific inhibitor of the carboxyl group, made it inaccessible for
      modification as indicated by absorbance data at 340 nm. Urea, sodium dodecyl
      sulphate, LiCl, KCl and NaCl at 0.1 M concentration each had negligible effect on
      the enzyme activity.

PMID- 8466533
TI  - Satellite cell myogenesis is highly stimulated by the kinase inhibitor iso-H7:
      comparison with HA1004 and staurosporine effects.
AB  - Differentiation of rat satellite cells, measured by cell fusion into myotubes and
      isozymic conversion of creatine kinase and phosphoglycerate mutase, was shown to
      be highly increased in the presence of 1-(5-isoquinolinylsulfonyl)-3
      methylpiperazine (iso-H7). This substance inhibited both protein kinase C (PKC)
      and cAMP-dependent protein kinase (PKA) activities with similar IC50 between 22
      and 34 microM. Iso-H7, as well as the PKA inhibitor HA1004 increased myogenic
      differentiation without altering the proliferation of satellite cells, whereas
      the proliferation and the differentiation of these cells were inhibited by the
      PKC inhibitor staurosporine. Our results suggest a predominant negative control
      of PKA on satellite cell myogenesis.

PMID- 8466534
TI  - Enhancement of perforin by retinoic acid is mediated by protein kinase C.
AB  - We previously demonstrated that interleukin-2 induced murine lymphokine-activated
      killer cell activity is augmented by retinoic acid. The enhanced cytotoxicity is
      significantly correlated with the increase in PKC. In the present study, we have
      shown that retinoic acid increases the expression of perforin, a potent cytolytic
      mediator, at both protein and mRNA levels. This enhancement can be induced by a
      direct stimulation of PKC signaling pathway, as manipulated by a short term
      incubation of lymphokine-activated killer cells with 12-O-tetradecanoyl-phorbol
      13-acetate and ionomycin, and suppressed by PKC inhibitors. These results suggest
      that PKC plays a regulatory role in the enhancement of the expression of
      cytolytic mediators in retinoic acid-augmented lymphokine-activated killer cells.

PMID- 8466535
TI  - A new method to determine the level of coenzyme Q10 in one drop of human blood
      for biomedical research.
AB  - This method has been designed to determine the levels of CoQ10 in human blood
      which utilizes only one drop of blood (0.05 ml). This method encourages and
      facilitates more frequent monitoring of blood levels of CoQ10, and of clinical
      importance, reveals the presence or absence of compliance. CoQ11 was used as an
      internal standard. The mean recovery of CoQ10 was 96%. The correlation
      coefficient between using 1.0 ml and 0.1 ml of blood and between using 1.0 and
      0.05 ml was 0.997 in the two comparisons. Therefore, it can be accurate to
      monitor the level of CoQ10 in a -"finger-prick"-drop of blood, and at least 24
      such determinations can be conducted in a 2-day period.

PMID- 8466536
TI  - Adrenoleukodystrophy: overlapping deletions point to a gene location in Xq28.
AB  - Adrenoleukodystrophy is a lethal X-linked neurodegenerative disorder which maps
      close to the red/green color pigment gene cluster in Xq28. We have reported a
      broad spectrum of color pigment gene changes in adrenoleukodystrophy patients,
      indicating that the genes may be quite close together. We now have used anonymous
      DNA probes centromeric to the color pigment gene cluster to analyze patients from
      59 adrenoleukodystrophy kindreds. All patients showed normal hybridization using
      probe Fr9, 30 kb centromeric to the color pigment genes. However, using probe
      Fr11, 100 kb further centromeric, we found overlapping deletions in 2 patients.
      We isolated conventional and cosmid genomic clones encompassing 24 kb surrounding
      Fr11; the clones and map derived from this region localize the telomeric ends of
      the two deletions to distinct positions 8 kb apart. These overlapping deletions
      implicate this specific region as a likely site for the ALD gene.

PMID- 8466537
TI  - Molecular cloning of a cDNA encoding the precursor of adenoregulin from frog
      skin. Relationships with the vertebrate defensive peptides, dermaseptins.
AB  - Adenoregulin has recently been isolated from Phyllomedusa skin as a 33 amino acid
      residues peptide which enhanced binding of agonists to the A1 adenosine receptor.
      In order to study the structure of the precursor of adenoregulin we constructed a
      cDNA library from mRNAs extracted from the skin of Phyllomedusa bicolor. We
      detected the complete nucleotide sequence of a cDNA encoding the adenoregulin
      biosynthetic precursor. The deduced sequence of the precursor is 81 amino acids
      long, exhibits a putative signal sequence at the NH2 terminus and contains a
      single copy of the biologically active peptide at the COOH terminus. Structural
      and conformational homologies that are observed between adenoregulin and the
      dermaseptins, antimicrobial peptides exhibiting strong membranolytic activities
      against various pathogenic agents, suggest that adenoregulin is an additional
      member of the growing family of cytotropic antimicrobial peptides that allow
      vertebrate animals to defend themselves against microorganisms. As such, the
      adenosine receptor regulating activity of adenoregulin could be due to its
      ability to interact with and disrupt membranes lipid bilayers.

PMID- 8466538
TI  - Prenatal developmental expression of rat brain 5-HT1A receptor gene followed by
      PCR.
AB  - Expression of the gene encoding the serotonin 5-HT1A receptor was investigated in
      the brain of rats from embryonic day (ED) 10 to postnatal day 18 using PCR. The 5
      HT1A receptor transcripts were first detected as early as ED 12. Their
      concentration increased to a maximum at ED 15 and decreased progressively to very
      low levels just before birth (ED 20). In 18-day-old rats, the brain stem levels
      of 5-HT1A receptor mRNA were higher than at ED 20 but still markedly lower than
      at ED 15. The high rate of expression of the 5-HT1A receptor gene for a limited
      period during the fetal life further supports that this receptor might be
      involved in the trophic action of serotonin during brain maturation.

PMID- 8466539
TI  - Kinetic assay for HIV proteinase subunit dissociation.
AB  - The kinetics and thermodynamics of the monomer--dimer equilibrium for HIV-1
      proteinase are investigated in a concentration jump experiment, at a
      concentration of the substrate that is substantially lower than the Michaelis
      constant. Under these conditions the substrate-induced stabilization of the
      active dimer is suppressed, and the integral rate equation can be obtained in a
      closed form. Both the monomer--dimer bimolecular association rate constant and
      the corresponding equilibrium dissociation constant are obtained directly by
      nonlinear regression analysis of the reaction time-course. In buffers of low
      ionic strength and in the absence of external ligands (substrates and
      inhibitors), the equilibrium dissociation constant at 37 degrees C is 440 +/- 52
      nM, a value significantly higher than previous estimates obtained at a
      comparatively high concentration of substrates.

PMID- 8466540
TI  - Specific binding and uptake of extracellular nicotinamide in human leukemic K-562
      cells.
AB  - Extracellular nicotinamide is well recognized as the primary precursor to the
      cellular synthesis of NAD. NAD is a pivotal molecule in regulating the energy and
      redox potentials of cells via synthesis of ATP and NAD(P)/NAD(P)H ratios. NAD
      turnover in cells is very rapid due to NAD catabolism via ADP-ribosylation
      reactions. These facts suggest that the cellular uptake and transport of
      nicotinamide may not be a passive process but a highly regulated cellular event.
      We have utilized radiometric procedures to characterize the uptake of
      [14C]nicotinamide in human leukemic K-562 cells. At physiologically relevant
      doses of nicotinamide (< 100 microM), the uptake was saturable with a Km of 2.3
      +/- 1.0 microM and a Vmax of about 1.5 +/- 0.5 pmol/10(6) cells/min. Kinetic
      studies revealed that nicotinamide was first taken up intracellularly and then
      immediately converted to NAD and 1-methyl nicotinamide. All of the nicotinamide
      taken up into the cell was bound tightly to plasma membranes (25,000 g pellet)
      with Kd values between 3.2 and 12.7 microM and a Bmax of 1.56 pmol/10(6) cells.
      The specificity of nicotinamide binding was demonstrated by competitive
      inhibition experiments using NAD analogs, nicotinamide derivatives, and agonists
      or antagonists of plasma membrane receptors. We conclude that there is specific
      binding of nicotinamide, followed by intracellular uptake and immediate synthesis
      to NAD.

PMID- 8466541
TI  - Fluvoxamine is a potent inhibitor of cytochrome P4501A2.
AB  - Fluvoxamine is a new antidepressant and selectively inhibits serotonin reuptake
      (SSRI). The present study demonstrates that fluvoxamine is a very potent
      inhibitor of the high-affinity O-deethylation of phenacetin, which is catalysed
      by cytochrome P4501A2 (CYP1A2), in microsomes from three human livers. Thus, the
      apparent inhibitor constant of fluvoxamine, Ki, ranged from 0.12 to 0.24 microM.
      Seven other SSRIs, citalopram, N-desmethylcitalopram, fluoxetine, norfluoxetine,
      paroxetine, sertraline and litoxetin either did not inhibit or were weak
      inhibitors of the O-deethylation of phenacetin. Our findings explain the
      mechanism of the pharmacokinetic interactions between fluvoxamine and drugs that
      are metabolized by CYP1A2, e.g. theophylline and imipramine.

PMID- 8466542
TI  - Hepatic and intrahepatic targeting of an anti-inflammatory agent with human serum
      albumin and neoglycoproteins as carrier molecules.
AB  - The anti-inflammatory agent naproxen (Nap) was covalently coupled to human serum
      albumin (HSA) and to the neoglycoproteins, galactose and mannose terminated HSA,
      to deliver this drug selectively to different cell types of the liver.
      Disposition of Nap20-HSA was studied in rats and compared to that of equivalent
      doses of mixtures of uncoupled drug and protein. The liver to kidney ratios of
      the drug (L/K-Nap) and the protein (L/K-prot.) were increased, indicating an
      improved delivery of both protein and drug to the target site. After injection of
      10 micrograms Nap20-HSA the L/K-prot. was increased 15.0 +/- 0.21-fold as
      measured 1 hr after injection. Even after injection of 5 mg of the conjugate, the
      L/K-prot. was enhanced 5.6 +/- 0.34-fold and the L/K-Nap 4.6 +/- 0.23-fold as
      measured 1 hr after injection. Immunohistochemical staining of liver slices
      revealed that the endothelial cells were the main sites for hepatic uptake.
      Further pharmacokinetic studies of Nap20-HSA in isolated perfused rat livers
      showed a saturable uptake process (Vmax = 2.46 micrograms/min/10.0 g liver and Km
      = 4.27 x 10(-6) M). The uptake in the liver could be inhibited by various
      polyanionic probes, indicating the major involvement of a scavenger receptor
      system in the internalization mechanism of Nap20-HSA. This endothelial uptake via
      the scavenger receptor system is likely to be related to the increased negative
      charge of the Nap-albumin conjugate as was revealed by anion exchange
      chromatography. Studies in the intact organ and in purified liver lysosomal
      lysates indicate that after internalization of Nap20-HSA the conjugate is
      proteolytically degraded leading to the formation of the lysine conjugate of Nap.
      This amino acid conjugate of Nap was shown in a previous study by us to be
      equipotent to Nap itself with regard to prostaglandin-E2 synthesis inhibition. A
      pronounced altered intrahepatic distribution was observed when Nap was coupled to
      lactosaminated and mannosylated HSA (Lact-HSA and Man-HSA, respectively).
      Coupling of Nap to Lact27-HSA and Man10-HSA resulted in a major shift in
      intrahepatic distribution from endothelial cells to the hepatocytes and Kupffer
      cells, respectively. We conclude that conjugation of Nap to HSA itself results in
      a selective delivery to endothelial cells and that the local proteolysis of the
      conjugate produces an active catabolite. Selective delivery to other cell types
      of the liver can be achieved by attaching naproxen to neoglycoproteins with an
      appropriate type and number of sugar groups.

PMID- 8466543
TI  - Inhibition of glutathione S-transferases from rat liver by basic triphenylmethane
      dyes.
AB  - (1) Basic triphenylmethane dyes related to pararosanilin inhibit class alpha
      glutathione S-transferases (GSTs) from rat liver. The inhibitory potency of each
      dye correlates with its octanol-water partition coefficient. Values of Ki
      determined at pH 6.5 ranged from about 1 x 10(-7) M for Ethyl violet to 7 x 10(
      5) M for Methyl green. GST 3-3, a class mu isoenzyme, was an order of magnitude
      less sensitive to inhibition by Ethyl violet. (2) All of the dyes tested were
      bleached to varying degrees by glutathione. The bleaching appears to result from
      the formation of an adduct between the dye and glutathione. At pH 6.5, adduct
      formation is significant only for Malachite green and Methyl green. There is
      kinetic evidence that for these dyes the adduct contributes significantly to the
      overall inhibition. It is probable that at physiological pH, all of the dyes
      would exist to a significant extent in the adduct form. (3) The dyes are excreted
      extensively in the bile, at least partly as the glutathione adduct. The free dye
      is regenerated on standing, it is assumed as a result of removal of glutathione
      by oxidation.

PMID- 8466544
TI  - Effect of malaria infection and endotoxin-induced fever on phenacetin O
      deethylation by rat liver microsomes.
AB  - We have investigated the effect of malaria infection with the rodent parasite
      Plasmodium berghei and fever induced by Escherichia coli endotoxin on the
      metabolism of phenacetin to paracetamol by rat liver microsomes from young (4
      weeks old) male Wistar rats (N = 5 in control and fever groups; N = 10 in malaria
      infected group). Following determination of % parasitaemia, the malaria-infected
      group was divided into a low parasitaemia subgroup (N = 5; mean % parasitaemia =
      9.87 +/- 2.6) and a high parasitaemia subgroup (N = 5; mean % parasitaemia = 36.6
      +/- 8.1). The control group received normal saline. Total microsomal protein was
      not significantly affected by fever or malaria infection while cytochrome P450
      levels were reduced by approximately 50% in the high parasitaemia subgroup, 20%
      in the low parasitaemia subgroup and 20% in the endotoxin-treated group.
      Phenacetin-O-deethylation kinetics were biphasic in both control and malaria
      infected rats, but monophasic in endotoxin-treated rats. Total apparent intrinsic
      clearance (CL(int),total; calculated as Vmax/Km; Vmax is maximum velocity, Km is
      Michaelis constant) of phenacetin was reduced approximately 6-fold in low
      parasitaemia, 30-fold in high parasitaemia and 35-fold in fever. There was a poor
      correlation between CL(int),total and % parasitaemia (r = -0.6). However, log
      CL(int),total correlated inversely with % parasitaemia (r = -0.9), suggesting
      that Cl(int),total decreased exponentially with an increase in % parasitaemia.
      Phenacetin O-deethylation is a marker for cytochrome P4501A2 activity and the
      results of the present study suggest that both malaria infection and fever might
      specifically reduce P4501A2 activity in the rat.

PMID- 8466545
TI  - Effect of malaria infection and endotoxin-induced fever on the metabolism of
      antipyrine and metronidazole in the rat.
AB  - Antipyrine and metronidazole were administered as a cocktail to young (4 weeks
      old) male Wistar rats (N = 12 for each treatment) to investigate the effect of
      malaria infection due to the rodent parasite Plasmodium berghei and Escherichia
      coli endotoxin-induced fever on the metabolism of the two compounds in vivo.
      Control rats received normal saline. Antipyrine and metronidazole clearances were
      estimated from a single saliva sample while the formation clearances of their
      metabolites (in malaria-infected and control rats) were estimated from the
      product of clearance of parent drug and the fraction of the administered dose
      excreted as metabolites in urine in 24 hr. Rats treated with endotoxin produced
      no urine during this period. Malaria infection had no effect on clearance of
      antipyrine or on formation clearance of any of its metabolites. However, the
      clearance of metronidazole was reduced by approximately 20% compared with
      controls as a result of decreased formation of hydroxymetronidazole. Fever
      decreased clearance of both antipyrine and metronidazole by approximately 36% and
      23%, respectively. These results demonstrate that both malaria infection and
      fever can influence P450-dependent drug metabolism and the effects seen appear to
      be isozyme-selective.

PMID- 8466546
TI  - Zonation of acetaminophen metabolism and cytochrome P450 2E1-mediated toxicity
      studied in isolated periportal and perivenous hepatocytes.
AB  - To study the mechanism of centrilobular damage developing in the centrilobular
      region after high doses of acetaminophen (APAP), its metabolism and toxicity were
      compared in periportal and perivenous hepatocytes isolated by
      digitonin/collagenase perfusion. Contrary to earlier reports, based on
      perfusions, no evidence for a periportal dominance of APAP sulfation could be
      observed. Glucuronidation, the dominant pathway of conjugation at high (5 mM)
      APAP concentration, was faster in perivenous cells. During primary culture,
      prolonged exposure (> or = 24 hr) to 5 mM APAP damaged perivenous cells, with a
      higher P450 2E1 level than periportal cells. When cells were isolated from
      ethanol-pretreated rats, to induce P450 2E1 levels specifically in the perivenous
      region, perivenous hepatocytes exhibited enhanced APAP vulnerability and
      extensive glutathione depletion. In contrast, corresponding periportal cells
      retained good viability. Isoniazid, an inhibitor of cytochrome P450 2E1,
      protected cells against APAP toxicity and prevented glutathione depletion.
      Induction of P450 2E1 also caused a 3-fold increase in the covalent binding of
      reactive intermediates from [14C]APAP, and this increase was mainly confined to
      perivenous cells. These results indicate that in rat liver there is only slight
      perivenous zonation of APAP conjugation and suggest that zone-specific APAP
      activation, mediated by the regional expression of ethanol-inducible cytochrome
      P450 2E1, is responsible for the characteristic centrilobular liver damage
      elicited by APAP.

PMID- 8466547
TI  - Role of polymorphic and monomorphic human arylamine N-acetyltransferases in
      determining sulfamethoxazole metabolism.
AB  - Sulfonamides are associated with a variety of adverse reactions, some of which
      have been linked with the classical acetylator phenotypes. Although the slow
      acetylator phenotype has been identified as a risk factor for hypersensitivity
      reactions to sulfamethoxazole (SMX), the disposition of this compound appears not
      to be affected by the acetylation polymorphism in vivo in humans. We therefore
      investigated the acetylation of SMX by monomorphic (NAT1) and polymorphic (NAT2)
      arylamine N-acetyltransferases in humans with the objective of determining their
      role in the metabolism of SMX. SMX was acetylated by both NAT1 and NAT2. Km
      values determined in hepatic cytosol for NAT1- and NAT2-mediated acetylation of
      SMX were 1.2 mM and approximately 5 mM, respectively, at an acetyl coenzyme A
      concentration of 100 microM. Mononuclear leukocytes, which contain only NAT1, had
      a Km value of 1.2 mM. Km values determined with recombinant NAT1 and NAT2
      proteins expressed in Escherichia coli were 1.5 mM and approximately 15 mM,
      respectively. The higher affinity of NAT1 for SMX indicates that acetylation by
      this enzyme will predominate at therapeutic plasma concentrations, in agreement
      with the observed in vivo monomorphic acetylation of SMX. NAT1 may be the primary
      determinant of SMX systemic metabolic clearance. However, in the hepatocyte NAT2
      variation may be an important competitive pathway which influences the extent of
      oxidative metabolism of SMX to its reactive hydroxylamine metabolite. Therefore,
      variation in both monomorphic and polymorphic N-acetyltransferases may play a
      role in determining susceptibility to sulfamethoxazole toxicity.

PMID- 8466548
TI  - Effect of valproate on lipogenesis in neonatal rat brain.
AB  - The effect of valproate on lipogenesis in brain slices from early neonatal rats
      was studied. The rate of lipid synthesis from lactate and 3-hydroxybutyrate, but
      not from glucose, was decreased significantly by 1 mM valproate. Separation by
      high performance liquid chromatography of brain lipids showed that valproate
      inhibited the synthesis of major phospholipids (phosphatidylcholine,
      phosphatidylethanolamine and phosphatidylserine) from lactate and major sterols
      (desmosterol, cholesterol and lanosterol) from lactate and 3-hydroxybutyrate.
      Valproate did not affect sterol synthesis but slightly enhanced phospholipid
      synthesis from glucose. However, the ratio of
      phosphatidylserine/phosphatidylethanolamine synthesis was decreased from lactate,
      glucose and 3-hydroxybutyrate, suggesting that valproate changes phospholipid
      composition of brain structures. These changes may contribute to the
      pharmacological action of the drug.

PMID- 8466549
TI  - Synthetic C5a receptor agonists. Pharmacology, metabolism and in vivo
      cardiovascular and hematologic effects.
AB  - Recent investigations have produced novel compounds that act on the receptor for
      anaphylatoxin C5a. These products are C-terminal analogues of C5a, some of which
      are modified extensively. We have measured the receptor affinities of such
      analogues in a binding assay on human neutrophils (PMNs). We have also
      characterized their pharmacological profiles in vitro on the isolated rabbit
      portal vein and pulmonary artery, on superoxide release by PMNs as well as in
      vivo in the anesthetized rabbit (acute hypotensive and neutropenic effects). The
      metabolic resistance of these analogues was also evaluated in the presence of
      different peptidases. One of these compounds, MePhe-Lys-Pro-D-Cha-Phe-D-Arg,
      behaved as an antagonist on the release of superoxide by neutrophils while
      exerting agonist activity in all other assays. Its partial agonist status was
      documented in a receptor down-regulation experiment on PMNs where its activity
      was compared with those of recombinant C5a and of protamine which behaves as a
      competitive antagonist on these cells. Degradation studies indicated that the
      discrepancy between the affinity of certain analogues in vitro and their potency
      in vivo was probably linked to their metabolic stability.

PMID- 8466550
TI  - Interaction of vanadate and iodate oxyanions with adenylyl cyclase of ciliary
      processes.
AB  - Vanadate (VO3-) was found to activate adenylyl cyclase (AC) in ocular ciliary
      process membrane. This response was additive to that of isoproterenol (ISO) and
      vasoactive intestinal peptide (VIP), but it was potentiative with forskolin (FSK)
      and also with Ca2+/calmodulin activation of AC activity. The potentiated response
      of FSK in the presence of VO3- was due to an increase in Vmax without a change in
      the apparent affinity of FSK or VO3-, and therefore differs from the potentiated
      response of activated G-protein (Gs) and FSK, where the affinity of FSK was
      increased by 1-2 orders of magnitude. Potentiation occurred at low Mg2+ and was
      not observed at free [Mg2+] > 3 mM. Iodate (IO3-) inhibited the FSK, ISO, and VO3
      activations of AC in ciliary process membranes (IC50, 0.3 mM). In vivo topical
      treatment of the rabbit eye with 50 microL of 5% NaIO3 had no effect alone but
      completely blocked the intraocular pressure response to a 50-microL topical dose
      of 1% FSK and partially blocked the response to a 50-microL dose of 0.001% ISO.
      These findings indicate that some AC enzymes may have a binding site for
      oxyanions which can directly regulate enzyme activity.

PMID- 8466551
TI  - Effects of monoamine oxidase inhibitors on the acid metabolites of some trace
      amines and of dopamine in the rat striatum.
AB  - The effects of the administration of selective and non-selective inhibitors of
      monoamine oxidase (MAO) on the concentrations of three trace acid metabolites
      [phenylacetic acid (PAA); m-hydroxyphenylacetic acid (mHPAA); and p
      hydroxyphenylacetic acid (pHPAA)] and of an acid metabolite of dopamine [3,4
      dihydroxyphenylacetic acid (DOPAC)] in the rat striatum were determined.
      Administration of brofaromine (1-100 mg/kg, s.c.) a type AMAO inhibitor, dose
      dependently decreased DOPAC and mHPAA levels. pHPAA levels were decreased by 100
      mg/kg brofaromine, but PAA levels were unaffected. Doses of deprenyl of less than
      100 mg/kg, i.p., had no effect on any of the acids, while 100 mg/kg decreased
      DOPAC, mHPAA and pHPAA but not PAA levels. Clorgyline, pargyline and
      tranylcypromine treatment decreased the levels of DOPAC, mHPAA and pHPAA but not
      PAA. Administration of alpha-monofluoromethyldopa, an inhibitor of aromatic amino
      acid decarboxylase, decreased the levels of all four acids. It was concluded that
      deamination of the respective parent amine by type A MAO is primarily responsible
      for the synthesis of DOPAC and mHPAA, but that another pathway contributes to
      pHPAA synthesis. It appears that either PAA arises predominantly independently
      from the actions of MAO or that is removal via transport or further metabolism
      regulates its concentration.

PMID- 8466552
TI  - Characterization of cannabidiol-mediated cytochrome P450 inactivation.
AB  - Cannibidiol (CBD) has been shown to impair hepatic drug metabolism in several
      animal species and to markedly inhibit mouse hepatic microsomal delta 1
      tetrahydrocannabinol (THC) metabolism by inactivating specific cytochrome P450s
      (P450) belonging to the 2C and 3A subfamilies. Elucidation of the mechanism of
      CBD-mediated P450 inhibition would be clinically very important for predicting
      its effect on metabolism of THC and the many other clinically important drugs
      known to be metabolized by P450s 2C and 3A. CBD-mediated inactivation of mouse
      hepatic microsomal P450s did not decrease hepatic microsomal heme content.
      However, [14C]CBD was found covalently bound to microsomal protein in an
      approximately equimolar ratio to P450 loss. Immunoprecipitation of microsomal
      protein with antibodies raised against either P450 2C or 3A revealed that
      approximately equal amounts of [14C]-CBD were bound to each of these P450s after
      CBD-mediated inactivation. Furthermore, this specific P450 binding was equivalent
      to P450 loss and accounted for nearly all of the microsomal [14C]CBD irreversible
      binding. Although > 80% of the enzyme activities attributed to P450s 2C and 3A
      were inactivated by CBD at the anticonvulsant dose of 120 mg/kg, P450 2C was
      approximately 3-fold more sensitive than P450 3A at the lower CBD doses tested.
      CBD analogs were synthesized in order to elucidate the chemical pathways for CBD
      mediated P450 inactivation in vivo. Oxidations at allylic carbon positions or
      saturation of either the exocyclic double bond or both double bonds of the
      terpene moiety did not markedly affect the inhibitory properties of the analogs.
      Methylation of both phenolic groups of the resorcinol moiety completely blocked
      the P450-inhibitory properties of this analog, revealing the involvement of a
      free hydroxyl group in the inactivation process. Rotation of the resorcinol
      moiety in abnormal-CBD did not impair the inhibitory properties of the analog,
      suggesting that the position of the hydroxyl group relative to the terpene ring
      is unimportant. Further studies are required to fully understand the chemical
      basis of CBD-mediated P450 inactivation.

PMID- 8466553
TI  - Attenuation of myocardial reperfusion injury by reducing intracellular calcium
      overloading with dihydropyridines.
AB  - The effects of three different dihydropyridine (DHP) calcium channel antagonists,
      nisoldipine, nimodipine, and nifedipine, on myocardial ischemic and reperfusion
      injury were studied using isolated rat hearts subjected to ischemia and
      reperfusion. Hearts were perfused with Krebs-Henseleit bicarbonate buffer
      containing 0, 4, 16, 64 and 100 nM concentrations of the above dihydropyridines
      for 15 min. Global ischemia was then induced by terminating the aortic flow for
      30 min at 37 degrees, followed by 30 min of reperfusion. Left ventricular (LV)
      functional (LV developed pressure, its first derivative and coronary flow) and
      biochemical parameters (creatine kinase release) were monitored prior to ischemia
      and during reperfusion. In separate group of hearts, intracellular free Ca2+
      ([Ca2+]i) was monitored with an intracellular calcium analyzer using a
      fluorescent Ca2+ indicator (Fura-2 AM). Tissue Ca2+ was also measured by atomic
      absorption spectroscopy after perfusing the hearts with ion-free cold buffer to
      wash out extracellular Ca2+. Significant recovery of the coronary flow was
      observed in all hearts treated with a high concentration (100 nM) of DHPs
      compared with the control group (P < 0.05), while a lower dose of nisoldipine (16
      nM) and nifedipine (64 nM) also improved the coronary flow effectively. Reduction
      of myocardial creatine kinase release and improvement of the recovery of LV
      developed pressure, dp/dtmax, were achieved by DHPs in a concentration-dependent
      manner. A higher concentration of DHPs also decreased the formation of myocardial
      thiobarbituric acid reactive substances, although these compounds did not possess
      direct free radical scavenging effects in vitro. Tissue Ca2+ content was reduced
      significantly in treated groups. The rise of [Ca2+]i during ischemia and
      reperfusion appeared to be attenuated by these DHPs. The concentration-response
      study of the three DHPs showed the effective concentrations for reducing [Ca2+]i
      to be 16, 64 and 100 nM nisoldipine, nifedipine and nimodipine, respectively, in
      this experimental setting. The above results indicate that pretreatment with DHPs
      can attenuate the myocardial reperfusion injury by modulating Ca2+ overloading
      and decreasing the susceptibility of the membrane to free radical attack.

PMID- 8466554
TI  - The reversal of experimental cyclosporin A nephrotoxicity by thromboxane
      synthetase inhibition.
AB  - The ability of thromboxane synthetase inhibition to reverse acute cyclosporin A
      (CsA)-induced nephrotoxicity in the rat was investigated. CsA administration (50
      mg/kg/day p.o. for 14 days) to male Sprague-Dawley rats caused a significant 50%
      decline in creatinine clearance rates, an increase in N-acetyl-beta-D
      glucosaminidase (NAG) enzymuria and renal tubulointerstitial damage by day 14.
      These changes were associated with a 5-6-fold increase in urinary thromboxane B2
      excretion (from pretreatment values of 28.1 +/- 7.9 to 122.6 +/- 38.9 and 165.8
      +/- 39.0 eta g/24 hr body weight on days 7 and 14, respectively). Excretion rates
      of 6-keto-prostaglandin F1 alpha and prostaglandin E2 were, however, unaffected
      by CsA administration. Co-treatment with a thromboxane synthetase inhibitor (CGS
      12970; 8-[3-methyl-2-(3-pyridyl)-1-indolyl]-octanoic acid) from day 7 (10
      mg/kg/day) normalized thromboxane B2 excretion, resulted in creatine clearance
      rates which were similar to pretreatment values on days 10 and 14, reduced NAG
      enzymuria on day 10 and prevented acute proximal tubular vacuolation. However,
      the severity of chronic CsA nephrotoxicity, namely chronic tubular damage and
      microcalcification at the corticomedullary junction, was not diminished by the
      thromboxane synthetase inhibition. These results demonstrate that (i) elevated
      thromboxane synthesis plays an important role in the development of acute CsA
      nephrotoxicity and (ii) that different and/or additional mechanisms are involved
      in the pathogenesis of chronic nephrotoxicity.

PMID- 8466555
TI  - Aromatic diamidines are reversible inhibitors of porcine kidney diamine oxidase.
AB  - The inhibitory ability of aromatic diamidines has been studied on porcine kidney
      diamine oxidase. The reversibility of drug-protein interactions has been tested
      by means of exhaustive dialysis experiments, showing in all cases a reversible
      binding pattern. Ki values obtained by means of Lineweaver-Burk plots were:
      stilbamidine 12 microM, 2-OH-stilbamide 8.5 microM, phenamidine 4 microM,
      propamidine 8 microM, dibromopropamidine 4.9 microM and amicarbalide 12 microM.

PMID- 8466556
TI  - Audiology for clothing?

PMID- 8466557
TI  - Let's use the right words.

PMID- 8466558
TI  - SPECT over PET?

PMID- 8466559
TI  - The civil right to speech.

PMID- 8466560
TI  - Child care: a challenge for the nineties.

PMID- 8466561
TI  - Activities to encourage speech and language development.

PMID- 8466562
TI  - Reinnervation of the cutaneous part of the free fibula osteocutaneous flap for
      reconstruction of the phallus.

PMID- 8466563
TI  - The cochlear implant and the deaf community.

PMID- 8466564
TI  - Laparoscopic inguinal hernioplasty.

PMID- 8466565
TI  - Valproate versus carbamazepine for seizures.

PMID- 8466566
TI  - Predisposing factors for severe, uncontrolled hypertension in an inner-city
      minority population.

PMID- 8466567
TI  - Suicidal ideation and young adults.

PMID- 8466568
TI  - "Chordal" preservation during mitral valve rereplacement.

PMID- 8466569
TI  - Treatment of atelectasis of the right upper lobe with a J-shaped catheter.

PMID- 8466570
TI  - Age effects of radiation-associated neurotoxicity in children.

PMID- 8466571
TI  - Nitrous oxide and fertility.

PMID- 8466572
TI  - The long-QT syndrome.

PMID- 8466573
TI  - Sex on the brain.

PMID- 8466574
TI  - Monitoring cyclosporine in liver-transplant recipients.

PMID- 8466575
TI  - Critical comparisons of alternative therapies for ectopic pregnancy!

PMID- 8466576
TI  - Detection of streptococcal antigens: arguments for and against testing in primary
      care offices.

PMID- 8466577
TI  - Pap smear provision in general practice.

PMID- 8466578
TI  - Prevalence and risk factors of iron-deficiency in women of Chukotka.
AB  - A study of iron deficiency states (IDS) in Chukotkan native women aged 20-59
      years revealed a relatively high prevalence of 36.4%. The prevalence of anemia
      was 5.6%. Some risk factors of IDS have been defined including frequent
      deliveries, prolonged lactation and also some peculiarities in the nutrition of
      these women.

PMID- 8466579
TI  - The Keewatin Health Assessment Study, NWT, Canada.

PMID- 8466580
TI  - The Chukotka Chronic Diseases Study, Chukotka, Russia.

PMID- 8466582
TI  - Human exposure to environmental hazards in the Arctic.

PMID- 8466581
TI  - The Sante Quebec Cree and Inuit Surveys, Quebec, Canada.

PMID- 8466583
TI  - Plans for the Greenland Health Survey.

PMID- 8466584
TI  - Patterns of patient attendance and dental service utilization in northern
      Labrador 1985-1989.
AB  - The purpose of the present study was to identify patterns of dental patient
      attendance and service utilization using both epidemiological and service record
      data from six satellite clinics in Northern Labrador, Canada, between 1985-1989.
      Baseline attendances were derived for the region from the analysis of 1985-1988
      data, the period prior to the introduction of a non-insured health benefit
      scheme. The results demonstrated that females and persons under the age of 21
      years frequented the dentist the most. The effects of this non-insured health
      benefit scheme introduced in January 1989, was then compared to the baseline
      pattern of attendance. This dental coverage removed all financial barriers for
      dental treatment for a population of Inuit origin in this northern area (or 91%
      of the population). An increase in the uptake of all dental treatments by 10-40%,
      and a doubling of fillings and denture treatments was observed. About 7% more
      patients frequented the dentist in 1989. Attendances of the middle-aged and
      elderly patients increased by 4%. Mean number of appointments per person per year
      increased from the baseline level of 1.8 to 2.5. The largest increase in
      population attendances was observed in Hopedale, while Nain remained the
      community with the best attendance record. No better monthly patterns of
      attendance were identified for 1989 compared to the baseline. Future studies
      should continue to evaluate changes in treatment needs, demands and service
      utilization in the area on a longitudinal basis. There is also a need for more
      literature on patterns of dental attendances in northern areas.

PMID- 8466585
TI  - Temporal changes in superoxide dismutase, glutathione peroxidase, and catalase
      levels in primary and peri-ischemic tissue. Monosialoganglioside (GM1) treatment
      effects.
AB  - Time-dependent changes in levels of the antioxidant enzymes, superoxide dismutase
      (SOD), glutathione peroxidase (GSHPOD), and catalase (CAT) after cortical focal
      ischemia in rat indicate that: (1) primary and peri-ischemic tissues differ in
      both rate and the magnitude of oxyradical-induced ischemic injury, and (2)
      ischemic tissue remains vulnerable to oxyradical damage as long as 72 h after
      ischemia since the antioxidant enzyme levels remain at or below basal levels.
      After 72 h, the increased levels of these enzymes are sufficient to protect
      tissue against oxyradical damage. GM1 ganglioside (10 mg/kg, im) further
      increased the already elevated levels of the enzymes after ischemia, thereby
      indicating the GM1 treatment increases the capacity of ischemic tissue to protect
      against oxyradical injury.

PMID- 8466586
TI  - Regional lipid composition in the rat brain.
AB  - The lipid composition of the brain is of great importance to its metabolism and
      function. Although much research has been done on regional brain lipid
      composition, studies usually suffer from limited brain regions or from limited
      lipids analyzed. We modified a previously described method for the separation of
      brain phospholipids and glycolipids, improving the separation and sensitivity of
      the method. Using this modified method, we measured the lipid composition of the
      frontal and entorhinal cortices, the hippocampus, basal ganglia, cerebellum, and
      medulla oblongata of five rats under nitrous oxide analgesia. Total lipid content
      was highest (p < 0.05) in the medulla oblongata (111.0 +/- 6.0 mg/g wet brain, X
      +/- SD) followed by the hippocampus (72.6 +/- 2.8), cerebellum (62.7 +/- 4.6),
      basal ganglia (62.6 +/- 1.5), frontal cortex (57.7 +/- 2.1), and entorhinal
      cortex (53.3 +/- 1.9). The areas with higher total lipid content (p < 0.05) also
      had higher percentages of cerebrosides (18.6 +/- 2.2 in the medulla oblongata vs
      8.3 +/- 1.2 in the frontal cortex) and 40 to 50% lower levels of
      phosphatidylcholine and phosphatidylinositol. The relation between the ratio of
      cerebrosides plus sulfatides to phosphatidylcholine and the total lipid content
      indicates that differences in brain lipid composition between regions are
      attributable to their relative gray/white matter content.

PMID- 8466587
TI  - Autoradiographic study on dopamine uptake sites and their correlation with
      dopamine levels and their striata from patients with Parkinson disease, Alzheimer
      disease, and neurologically normal controls.
AB  - An autoradiographic study of labeled mazindol binding to presumed dopamine (DA)
      uptake sites in the striatum was done in 7 Parkinson (PD), 6 Alzheimer (AD), 1
      Huntington disease (HD), and 4 neurologically normal cases. Large and significant
      decreases of specific binding were found in PD in both caudate (to 32% of
      control) and putamen (to 16%), with no significant effect in AD or HD.
      Nonspecific binding was a large proportion of total binding in all cases. In the
      12 cases where both binding data and DA levels were available, they showed highly
      significant linear correlations in both caudate and putamen. Autoradiographic
      studies on D1, D2, and muscarinic binding sites in the PD, AD and control striata
      revealed no significant group differences.

PMID- 8466588
TI  - Brain levels of neuropeptide Y in experimental pneumococcal meningitis.
AB  - Neuropeptide Y (NPY), which is found in high concentrations in several regions of
      the brain including nuclei of the brain stem and in nerve fibers surrounding
      cerebral vessels, has been proposed to play a role in regulating cerebral blood
      flow (CBF) and systemic vegetative functions. Since CBF is altered during
      meningitis, we examined whether NPY concentrations changed in various regions of
      the rabbit brain in response to experimental pneumococcal meningitis. Changes
      were most pronounced in the medulla, where NPY concentration increased threefold
      after 48 h of infection. Concomitantly, there was an increase in NPY
      immunoreactive fibers surrounding small vessels in the dorsolateral medulla,
      especially in the nucleus tractus solitarius. These results suggest that NPY may
      play a role in inducing some of the hemodynamic changes seen during pneumococcal
      meningitis.

PMID- 8466589
TI  - Immunohistochemical study of alpha 2 macroglobulin receptor in Alzheimer and
      control postmortem human brain.
AB  - Localization of the alpha 2 macroglobulin receptor (alpha 2MR) was studied in
      postmortem human brain tissue of Alzheimer disease (AD) and age-matched control
      cases with a monoclonal antibody (A2MR alpha 2) to the receptor. In control cases
      alpha 2MR was detected in neurons, glia, and some capillaries. Neuronal staining
      was most conspicuous in the hippocampus and entorhinal cortex. In AD, alpha 2MR
      immunoreactivity was enhanced. The staining intensity of some neurons was
      increased, as was the number of positive glial cells. In addition, senile
      plaques, tangles, and dystrophic neurites were strongly stained. These results
      suggest that alpha 2MR is involved in AD pathology.

PMID- 8466590
TI  - Urinary excretion of MHPG and normetanephrine in attention deficit hyperactivity
      disorder.
AB  - Twenty-four-hour excretion (expressed per gram of creatinine) of the
      norepinephrine metabolites 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and
      normetanephrine (NME) was measured in children with attention deficit
      hyperactivity disorder (ADHD) and in normal subjects matched for age and
      education. In contrast to findings with Tourette syndrome patients, in the ADHD
      patients there was no significant difference in excretion of MHPG and NME from
      control values.

PMID- 8466591
TI  - Hypoxia induces different responses of striatal high- and low- affinity dopamine
      uptake sites.
AB  - The dopamine (DA) uptake over a concentration range from 0.03 to 100 microM was
      studied in S1 fractions of the rat striatum prepared from control rats and those
      exposed for 14 h to hypobaric hypoxia. The uptake exhibited non-Michaelis-Menten
      kinetics, which were evaluated by applying an equation assuming two transport
      sites. The high-affinity uptake site was characterized by an apparent Michaelis
      Menten constant of 0.47 microM and an apparent maximal transport rate of 113
      pmol/mg protein/30 s. The respective constants of the low-affinity uptake site
      were 52.8 microM and 1490 pmol/mg protein/30 s. One hour after hypoxia kinetic
      constants of the high-affinity uptake were unchanged but the maximal transport
      rate of the low-affinity uptake was increased by 50%. The elevated low-affinity
      uptake capacity may represent a means of adaptation to hypoxia allowing a faster
      removal of high extracellular concentrations of DA.

PMID- 8466592
TI  - The interaction of insulin and angiotensin II on the regulation of human
      neuroblastoma cell growth.
AB  - This laboratory has previously reported that angiotensin II is a growth factor
      for human SH-SY5Y neuroblastoma cells, and that a variety of converting enzyme
      inhibitors and angiotensin II antagonists reduce thymidine incorporation into the
      DNA of these cells. In the present study, insulin, at 5 micrograms/mL, was found
      to stimulate thymidine incorporation in SH-SY5Y cells. The insulin effect was
      only partially inhibited by the converting enzyme inhibitors enalapril,
      quinapril, and quinaprilat, whereas it was markedly or totally blunted by the
      angiotensin II antagonists DuP753 and PD123177. In additional studies, IGF-1 (50
      ng/mL) significantly stimulated thymidine incorporation into these cells in a
      fashion indistinguishable from that of insulin. Taken together, these studies are
      consistent with the suggestion that insulin at high concentrations and IGF at low
      concentrations enhance the proliferative response of these cells to angiotensin
      II. The differential effects of converting enzyme inhibition and angiotensin II
      antagonism on cell proliferation could be explained if converting enzyme
      inhibition results in low, but effective, levels of angiotensin II in the culture
      medium, whereas the angiotensin II antagonists effectively block angiotensin II
      at its receptor. Finally, in this system, both the AT1 receptor blocking agent
      DuP 753 and the AT2 receptor blocking agent PD123177 appear to be effective.

PMID- 8466593
TI  - Accumulation of exogenous polyamines in gerbil brain after ischemia.
AB  - Regionally selective delayed neuronal degeneration is a characteristic sequel of
      cerebral ischemia. Recent evidence indicates that changes in brain polyamine
      metabolism may be critical for nerve cell survival after ischemia. Within hours
      after ischemia, intracellular putrescine levels are greatly increased and remain
      elevated for days, whereas only minor changes are noted in the levels of the
      polyamines spermine and spermidine. In contrast, the extracellular levels of all
      polyamines are low after ischemia. Injections of polyamines following ischemia,
      however, can protect neurons in the gerbil brain from delayed cell death, with
      spermine being the most potent of the polyamines. In the present study,
      therefore, we sought to determine if increased polyamine uptake occurs in the
      brain after ischemia. In the hippocampal slice preparation, temperature-dependent
      uptake was unique for spermine, but not for spermidine or putrescine. Uptake of
      [14C]spermine was transiently increased after ischemia, peaking at 150% of
      control by 12-13 h and subsiding by 24 h. Intravenous injections of
      [3H]spermidine resulted in a postischemic accumulation of this polyamine
      throughout the forebrain parenchyma. We conclude that: 1. Active cellular uptake
      of spermine is transiently increased early after ischemia; 2. A nonspecific
      accumulation of exogenous polyamines occurs early after ischemia probably owing
      to a compromised blood-brain barrier, and 3. The findings indicate that exogenous
      polyamines can exert their effect directly in the brain after ischemia.

PMID- 8466594
TI  - Polyamines in rat brain extracellular space after ischemia.
AB  - This article reports measurements of extracellular polyamines in rat brain.
      Microdialysis probes were implanted in the striatum and microperfusion samples
      were collected before, during, and after transient (20 min) global ischemia.
      Polyamine levels in microperfusates were measured by reverse-phase high
      performance liquid chromatography after precolumn derivatization. No significant
      changes in extracellular polyamines were detected for up to 3 h following
      ischemia. We conclude that extracellular levels of polyamines (1) are comparable
      to the low levels in other extracellular compartments, and (2) do not change
      during the initial period of reperfusion, the period most critical for neuron
      survival after ischemia.

PMID- 8466595
TI  - Detailed characterization of the biological activities of recombinant human nerve
      growth factor expressed in Chinese hamster ovary cells.
AB  - The biological activities of recombinant human nerve growth factor (rhNGF)
      produced by Chinese hamster ovary (CHO) cells that were transfected with human
      NGF gene were investigated in vitro and in vivo. rhNGF showed the same
      immunoreactivity as mouse NGF (mNGF) in a highly sensitive two-site enzyme
      immunoassay system employing mouse monoclonal antibody against mouse beta-NGF
      (MAb 27/21) for both the primary and the secondary antibodies. In PC12 cells,
      rhNGF promoted neurite extension and induced acetylcholinesterase (AChE) with the
      same potency as mNGF, showing an ED50 of 10-20 ng/mL. In fetal rat septal neurons
      cultured on a feeder layer of astroglial cells, rhNGF promoted survival and
      neurite extension as well as an increase in choline acetyltransferase (ChAT)
      activity and acetylcholine (ACh) content. At a maximal effective concentration of
      30 ng/mL, rhNGF promoted a 1.4-, 2.8-, and 4-fold increase in surviving cell
      number, ACh content, and ChAT activity, respectively. rhNGF was five times more
      potent than mNGF for the increase in ChAT activity and ACh content showing an
      ED50 of 0.5 ng/mL, although the maximal response was the same for the two NGFs.
      Transection of the fimbria-fornix resulted in a loss of AChE-positive cells in
      the medial septum (MS) and vertical limb of the diagonal band of Broca (VDB). The
      administration of rhNGF or mNGF (3 or 30 micrograms in gel form) attenuated the
      loss of AChE-positive cells; rhNGF was as potent as or even more potent than
      mNGF. Radio frequency lesion of the basal forebrain (BF) including the nucleus
      basalis magnocellularis (NBM) resulted in severe impairment of memory and/or
      learning in passive avoidance and Morris' water maze tasks. Repeated injection of
      rhNGF (5 micrograms x 5 over 2 wk) into the lateral ventricle ameliorated the
      behavioral impairment in the water maze task but not in passive avoidance. rhNGF
      treatment increased ChAT activity in the frontal cortex and even in other
      subregions of the cerebral cortex where ChAT activity was not decreased by BF
      lesion. These results indicate that human NGF can be measured in an enzyme
      immunoassay system using monoclonal antibody against mNGF (MAb 27/21) and that
      rhNGF has potent biological activity, comparable to or greater than mNGF, both in
      vitro and in vivo.

PMID- 8466597
TI  - The nature of public health after reform.
AB  - Many of the pressures now building to reform the American health care system can
      be traced to an unfortunate fragmentation of the health professions, notably
      between medicine and public health. Medicine has advanced strikingly in its
      curative potential in recent decades, but for that very reason has fallen prey to
      hubris, as technology has outpaced overall strategies of care. Public health
      offers counterbalance to this effect in that it stresses a population-based
      perspective on medical care and underscores the importance of prevention in any
      rational, comprehensive system devoted to the health of the public. Critical
      elements that must be factored into any major restructuring of the present costly
      health care arrangements include provision for universal access, enhancement of
      preventive and primary care capabilities, and education of the public about their
      health status and its maintenance in such ways that they can become informed
      collaborators in their overall care. Enhanced appreciation of behavioral
      cofactors in the etiology of many diseases will play an important role in that
      education of the public, but it must be achieved in ways that are nonjudgmental
      lest it be counterproductive to the overall goals of prevention and compassionate
      care.

PMID- 8466596
TI  - PC12 cells release stimulatory factors after transfection with beta/A4-C-terminal
      DNA of the Alzheimer amyloid precursor protein.
AB  - The beta/A4 region of the amyloid precursor protein (APP) accumulates in brains
      of victims of Alzheimer disease (AD) where it is a major component of senile
      plaques. We examined the pathophysiological consequences of overexpression of the
      beta/A4-C-terminal DNA in PC12 cells. Serum-free conditioned media (SFCM) from
      positive transfectants stimulated control PC12 cells to extend neurites and
      increase in size. Unlike the factor that affected cell size, neurite lengthening
      activity was significantly decreased after immunoabsorption with anti-beta/A4
      monoclonal antibodies (MAb) and changes in pH. The data support the view that
      among the consequences of beta/A4-C-terminal DNA overexpression in PC12 cells is
      the release of factors that stimulate nontransfected cells to undergo
      morphological transformations that include differentiation to a neuronal
      phenotype. It is hypothesized that similar activities that may contribute to the
      molecular pathophysiology of the disorder may be present in the AD brain.

PMID- 8466598
TI  - Beyond multiple-choice questions and essays: the need for a new way to assess
      clinical competence.
AB  - This essay reviews the influence that research on psychological processes in
      clinical reasoning has had upon the characteristics and formats of licensing
      examinations such as the new United States Medical Licensing Examination (USMLE)
      and its predecessors, emphasizes the implications of such research for the
      assessment of clinical competence at all levels of medical education, and
      proposes a challenging new direction for educational research that could make
      clinical assessment more effective. Specifically, (1) factors are discussed that
      support the continued judicious use of multiple-choice questions (MCQs); and (2)
      emphasis is given to the need to assess the clinician's ability to analyze
      controversial clinical situations, where no single answer is agreed upon as "most
      nearly correct," for even though essay questions and oral examinations are better
      suited than MCQs to assess such questions, they have been replaced by MCQs
      largely because of problems of consistency in grading, breadth of domain
      sampling, and cost. Because of these limits on essays and oral examinations, a
      program of educational research is advocated to develop a test format that can
      effectively assess the clinician's abilities to deliberate among alternatives, to
      recognize the role of values and preferences in decisions, and to weigh risks and
      benefits. Just how much this new tool could be used for national certification
      and licensing examinations would have to be determined, but it is important that
      some component be included to signal to educators and new physicians that medical
      practice is, at least in part, concerned with matters for which final answers are
      not available.

PMID- 8466600
TI  - Elements of an effective medical school curriculum committee.

PMID- 8466599
TI  - Ethics in a short white coat: the ethical dilemmas that medical students
      confront.
AB  - Many existing ethics curricula fail to address the subtle yet critical ethical
      issues that medical students confront daily. The authors report on the kinds of
      dilemmas students face as clinical clerks, using cases that students submitted in
      1991-92 during an innovative and well-received ethics class given at a tertiary
      care hospital as part of the internal medicine clerkship. Analysis of these cases
      reveals that many dilemmas are intimately tied to the student's unique role on
      the medical health care team. Recurring themes included the student's pursuit of
      experience, differing degrees of knowledge and ignorance among team members, and
      dealing with disagreement within the hierarchical authority structure of the
      medical team. The authors conclude that some components of ethical education must
      be participant-driven and developmentally stage-specific, focusing more attention
      on the kinds of ethical decisions made by medical students as opposed to those
      made by residents or practicing physicians.

PMID- 8466601
TI  - Saying what you mean and meaning what you say: coupling biomedical terminology
      and knowledge.

PMID- 8466602
TI  - Managed competition.

PMID- 8466603
TI  - Academic medical centers have a major role in preventing violence.

PMID- 8466605
TI  - Medical students' well-being: a necessary component of reform.

PMID- 8466604
TI  - Is declining class size related to the shortage of family medicine practitioners?

PMID- 8466606
TI  - Chief residents' career motives and perceived constraints.

PMID- 8466607
TI  - A method for selecting a site for a rural residency program.

PMID- 8466608
TI  - The effect of training on the management of asthma by family physicians.

PMID- 8466609
TI  - Fostering a new relationship between departments of medicine and teaching
      hospitals.

PMID- 8466610
TI  - The declining interest of medical school graduates in generalist specialties:
      students' abandonment of earlier inclinations.

PMID- 8466611
TI  - Influence of longitudinal primary care training on medical students' specialty
      choices.
AB  - BACKGROUND: At the University of South Florida College of Medicine, a program
      designed to give students four years of primary care training began in 1983. As
      of 1992, six classes that included program participants had graduated. The
      present study examined the effect of the program on the participants' choices of
      specialty by comparing their choices with those of other graduates. METHOD: Each
      year program volunteers were solicited from a class size of about 96 freshmen. Of
      the 201 volunteers from the classes of 1987-1992, 93 were randomly selected to
      participate in the program. The participants received primary care education one
      half-day per week in a community-based clinical setting. The specialty choices of
      the 543 graduates from 1987-1992 were determined from the National Resident
      Matching Program and were divided into primary care (family practice, internal
      medicine, pediatrics); surgery, obstetrics-gynecology, and psychiatry; and other
      (high-technology specialties). Comparisons were made (1) between volunteers and
      nonvolunteers and (2) between volunteers who were participants and those who were
      not. The Z-test was used, with alpha set at .01. RESULTS: Significantly more
      volunteers--with no difference between participants and nonparticipants--matched
      with primary care specialties, and more volunteers were women. Significantly more
      nonvolunteers matched with high-technology specialties--again, no difference
      between participants and nonparticipants. CONCLUSION: The program did not seem to
      influence the students' specialty choices, because students interested in
      participating--regardless of whether they actually participated--were more likely
      to match with primary care specialties and were more likely to be women.

PMID- 8466613
TI  - Further psychometric evaluations of a class-ranking model as a predictor of
      graduates' clinical competence in the first year of residency.
AB  - PURPOSE: To investigate further the psychometrics of a class-ranking model in
      which a weight of one-third was assigned to performance measures in basic
      sciences and a weight of two-thirds to ratings on six core clerkships. METHOD:
      The first part of the study involved 215 graduates of Jefferson Medical College
      who--based on the ranking model--had been in the top and bottom quarters of the
      classes of 1991 and 1992. Six faculty, who did not know the graduates' ranks but
      were familiar with their performances and characteristics, were asked to judge
      the graduates' potential to become competent physicians. The graduates' ranks
      according to the model were then compared with the ratings they received from the
      faculty. The second part of the study investigated whether there was a linear
      relationship between class ranks and ratings of postgraduate competence, by using
      directors' ratings of the data-gathering skills of 598 graduates (1986-1990) at
      the end of their first year of residency. RESULTS: A concordance rate of 85% was
      obtained between the graduates' ranks and the ratings they received from the
      medical school faculty, which supports the criterion-related validity of the
      ranking model. In addition, class ranks were linearly related to ratings of
      postgraduate competence. However, women and graduates who had been low achievers
      in medical school were less likely to have given permission for collecting
      postgraduate ratings, which led to range restriction and a possible
      underestimation of the validity of the model. CONCLUSION: The psychometric
      evidence supports the class-ranking model, but other schools should exercise
      caution in employing the model until they accumulate evidence from data obtained
      from their own students.

PMID- 8466612
TI  - Medical students' clinical self-assessments: comparisons with external measures
      of performance and the students' self-assessments of overall performance and
      effort.
AB  - PURPOSE: To find predictors of students' initial self-assessments of their
      clinical performances, the predictive value of their self-assessments, and
      factors that relate to their final self-assessments. METHOD: Of the 142 third
      year students at the University of Michigan Hospital in 1988-89, 137 (96%)
      completed a self-assessment questionnaire on the first day of their internal
      medicine clerkship and a slightly expanded questionnaire on the last day. The
      questionnaires asked the students to use Likert-type scales to rate their
      abilities regarding clinical skills, use of knowledge in the clinical setting,
      and discharge of patient care responsibilities. Also collected were data on the
      students' performances as measured externally: college grade-point averages;
      standardized examinations taken before, during, and after the clerkship; and
      ratings given the students by the faculty and residents with whom they worked in
      the clerkship. Pearson product-moment correlations were then calculated between
      the students' self-assessment ratings and their scores on the external measures
      of performance. RESULTS: Weak to absent correlations were found between prior
      performance measures and initial self-assessments. The lower-performing students,
      as measured by college grade-point averages and Medical College Admission Test
      scores, tended to rate their performances higher than did their peers at initial
      self-assessment. IN contrast, the higher-performing students rated themselves
      lower than would be warranted given their prior performances. There were
      significant increases in the initial self-assessments as the year progressed and
      the students entered the clerkship after having had more experience. The
      correlations between the students' final self-assessments and the ratings by
      faculty and residents were generally weak. The strongest (.267, p < or = .001)
      concerned the students' medical knowledge. In addition, there was a moderate
      correlation (.413, p < or = .001) between the students' self-assessments of how
      hard they had worked and their self-assessments of overall performance.
      CONCLUSION: The findings in this study were similar to those of previous studies
      in that they showed relatively poor agreement between external measures of
      students' performances and students' self-assessments of their performances.

PMID- 8466614
TI  - Comparing clerkship sites in a community-based medical school by evaluating
      students' undergraduate and postgraduate performances.
AB  - BACKGROUND: Studies have generally found clinical training sites within the same
      clerkship to be comparable regarding students' performances--by using
      undergraduate measures in individual clerkships at medical schools with
      university hospitals. The present study examined performance comparability among
      sites within two clerkships in a community-based medical school and used both
      undergraduate and postgraduate measures. METHOD: The participants were the 349
      graduates from the classes of 1988-1991 at Wright State University School of
      Medicine who took an internal medicine clerkship (332 of the graduates, in five
      principal combinations of sites) and a general surgery clerkship (349 at six
      sites). The undergraduate measures were final percent scores for the clerkships
      and subtest and total scores on the National Board of Medical Examiners (NBME)
      Part II examination. The postgraduate measures were supervisors' ratings from the
      first year of residency (210 graduates) and total score on the NBME Part III
      (212). Univariate analysis of variance and Tukey's multiple-range test were used
      for the comparisons. RESULTS: The only statistically significant difference among
      sites was for the medicine clerkship and involved only one undergraduate measure,
      the clerkship score (and the differences were slight, less than four percentage
      points). CONCLUSION: Virtually no differences in the students' performances on
      the undergraduate and postgraduate measures were found among sites for the two
      clerkships.

PMID- 8466615
TI  - Effects of student gender and standardized-patient gender in a single case using
      a male and a female standardized patient.
AB  - BACKGROUND: In previous studies assessing the effects of student gender,
      standardized-patient (SP) gender, and their interaction on multiple-station
      examinations of clinical competence, SP gender was confounded with cases, that
      is, male SPs were used for some cases and female SPs for others. The authors
      conducted two studies to investigate the effects of gender on a single case by
      using a male SP and a female SP for the same case. METHOD: Both studies involved
      one SP case in a comprehensive clinical evaluation used to assess fourth-year
      students at the end of a required ambulatory care clerkship at Saint Louis
      University School of Medicine in 1990-91 and 1991-92. In Study 1, 45 students in
      four rotations saw the same male SP; 42 students in three other rotations saw the
      same female SP. In Study 2, 69 students in six rotations were randomly assigned
      either the male SP (28) or the female SP (41) within the same rotation. For each
      study, to determine the interaction of student gender and SP gender as well as
      their main effects, analyses of variance were performed on the students' history
      taking and physical examination scores and communication skills ratings. RESULTS:
      Neither study showed a significant interaction of student gender and SP gender on
      history taking, physical examinations, or communication skills. CONCLUSION: The
      findings of both studies suggest that the interaction between student gender and
      SP gender, unconfounded by case content, had no effect on the students' scores
      and ratings.

PMID- 8466616
TI  - Critical thinking in preclinical course examinations.
AB  - PURPOSE: To examine the relationship between preclinical medical school course
      examinations and critical-thinking skills by correlating examination results with
      the Watson-Glaser Critical Thinking Appraisal (WGCTA), an 80-item critical
      thinking inventory. METHOD: The 196 students in the class of 1993 at the
      University of Texas Southwestern Medical Center at Dallas Southwestern Medical
      School were given the WGCTA during the second half of their freshman year. A
      composite WGCTA score and five subtest scores were calculated for each student.
      The course examinations were 25 tests, each with a majority of multiple-choice
      items, from courses given during the first two years of the school curriculum.
      The students' undergraduate grade-point average (GPAs), medical school GPAs, and
      Medical College Admission Test (MCAT) scores were also included in the analysis.
      Pearson product-moment correlations were calculated between the students' WGCTA
      scores and their examination scores, MCAT scores, and GPAs. RESULTS: Sixteen of
      the examinations--in the behavioral sciences, psychiatry, ethics, pathology,
      introduction to clinical medicine, genetics, endocrinology, and cell biology--had
      significant positive correlations with the WGCTA, as did MCAT scores and first
      year GPAs. Correlations were more robust with the WGCTA subscales for
      interpretation (18 examinations), evaluation of arguments (15), and deduction
      (13), and less robust with the subscales for inference (7) and recognition of
      assumptions (3). CONCLUSIONS: The results suggest that objective multiple-choice
      examinations can at least partially reflect critical-thinking skills.

PMID- 8466617
TI  - A twelve-year profile of students' SAT scores, GPAs, and MCAT scores from a small
      university's premedical program.
AB  - PURPOSE: To determine whether significant correlations existed among quantitative
      and qualitative predictors of students' academic success and quantitative
      outcomes of such success over a 12-year period in a small university's premedical
      program. METHOD: A database was assembled from information on the 199 graduates
      who earned BS degrees in biology from Barry University's School of Natural and
      Health Sciences from 1980 through 1991. The quantitative variables were year of
      BS degree, total score on the Scholastic Aptitude Test (SAT), various measures of
      undergraduate grade-point averages (GPAs), and total score on the Medical College
      Admission Test (MCAT); and the qualitative variables were minority (54% of the
      students) or majority status and transfer (about one-third of the students) or
      nontransfer status. The statistical methods were multiple analysis of variance
      and stepwise multiple regression. RESULTS: Statistically significant positive
      correlations were found among SAT total scores, final GPAs, biology GPAs versus
      nonbiology GPAs, and MCAT total scores. These correlations held for transfer
      versus nontransfer students and for minority versus majority students. Over the
      12-year period there were significant fluctuations in mean MCAT scores.
      CONCLUSION: The students' SAT scores and GPAs proved to be statistically reliable
      predictors of MCAT scores, but the minority or majority status and the transfer
      or nontransfer status of the students were statistically insignificant.

PMID- 8466618
TI  - A continuous quality improvement cycle for teaching the identification of
      psychosocial problems to general internal medicine residents.
AB  - PURPOSE: To study a continuous quality improvement (CQI) cycle intended to
      enhance general internal medicine residents' identification of psychosocial
      problems in an ambulatory-care setting. METHOD: From 1986 through 1990, the
      authors compared two groups of comprehensive examinations of patients by 34
      residents at the University of Vermont College of Medicine before and after the
      implementation of a CQI cycle. After data on the first group of 17 residents'
      examinations of patients had been retrospectively audited by a clinical social
      worker, the CQI cycle was developed for the next group of 17 residents'
      examinations to reinforce the importance of psychosocial problems in primary care
      and the use of diagnostic case-finding instruments, flow sheets, and real-time
      feedback from social workers to the residents on their performances, according to
      accepted predefined specifications. The t-test was then used to measure the
      difference in the residents' performances between the two groups of examinations.
      RESULTS: The CQI intervention resulted in a statistically significant (p < .05)
      improvement in performance: an increased rate of residents' identifications of
      patients with psychosocial problems, from 72% (36 of 50 patients) to 85% (140 of
      165 patients). CONCLUSION: That the CQI cycle resulted in improved performance
      suggests that an effective psychosocial training program for residents in
      ambulatory primary-care general internal medicine can be organized around CQI and
      a problem-oriented system of care.

PMID- 8466619
TI  - Colorado's decentralized medical education to increase the number of graduates
      practicing primary care in rural areas.

PMID- 8466620
TI  - Comparing the teaching of physical diagnosis in a primary care setting and a
      hospital setting.

PMID- 8466621
TI  - Participants' perceptions versus actuality in achieving the goals of problem
      based learning.

PMID- 8466622
TI  - A simple ambulatory-care experience and students' residency choices and attitudes
      toward general internal medicine.

PMID- 8466623
TI  - A brief measure of psychological androgyny for use in predicting physicians'
      decision making.

PMID- 8466624
TI  - Using active participation in a consensus conference to enhance its influence on
      physicians' clinical behavior.

PMID- 8466625
TI  - Proteoglycans on endothelial cells present adhesion-inducing cytokines to
      leukocytes.
AB  - Leukocyte recruitment from the blood circulation into tissue is essential for
      effective immune responses, and is, consequently, carefully regulated. In this
      article Yoshiya Tanaka and co-workers describe a model in which proteoglycans on
      the luminal surface of endothelium capture pro-adhesive cytokines. These
      cytokines provide the adhesion-inducing signal to particular leukocyte subsets
      which initiates their transmigration.

PMID- 8466626
TI  - Sequence homologies between hsp60 and autoantigens.
AB  - The human heat shock protein (hsp) 60 shares sequence homology with a wide range
      of autoantigens including those of insulin dependent diabetes mellitus,
      Hashimoto's thyroiditis, glomerulonephritis, scleroderma, pemphigoid, rheumatoid
      arthritis, multiple sclerosis, chronic active hepatitis, primary biliary
      cirrhosis and Addison's disease. Here we show the extent of this homology and
      suggest that it contributes to autoimmunity through cross-reactivity between
      hsp60 and tissue-specific proteins containing similar epitope motifs. Differences
      between individuals in MHC class II may influence the selection of a particular
      hsp60 epitope and the corresponding target antigen that gives rise to an
      autoimmune disease.

PMID- 8466627
TI  - What is an idiotype?
AB  - Idiotypy is an important concept with significant practical implications for the
      manipulation of B- and T-cell clones. However, this potential depends on a
      correct identification of idiotypy and the development of appropriate reagents.
      Current knowledge of the structure and polymorphism within the Ig loci reveals
      that several idiotypic paradigms are based on isotypic or allotypic structures
      rather than supposed crossreactive idiotypes.

PMID- 8466628
TI  - Apoptosis.
AB  - Cell death can be accidental or programmed in a multicellular organism. Evidence
      supports the proposition that there is a 'suicide program' inherent in vertebrate
      cells which can be activated when the cell's death is desirable for the good of
      the rest of the community. The morphology of such death is usually that of
      apoptosis, rather than of necrosis. Here, John Cohen describes the changes of
      apoptosis, and discusses progress on the identification of regulatory mechanisms
      and genes.

PMID- 8466629
TI  - The tale of T cells.
AB  - The discovery of the thymus was perhaps the major milestone of contemporary
      immunology. Here Anthony Davies reflects on the events surrounding this discovery
      and puts into perspective the significance of those experiments today.

PMID- 8466630
TI  - Of furphys, and facts that are fugacious.

PMID- 8466631
TI  - Janus-faced tumor-associated macrophages.

PMID- 8466632
TI  - Antigen presentation by intestinal epithelial cells.

PMID- 8466633
TI  - Cell adhesion in the immune system.
AB  - Cell adhesion molecules have an important role to play in many facets of the
      immune system. At a recent meeting their role in leukocyte migration,
      inflammation, cancer metastasis and lymphocyte development was discussed.

PMID- 8466635
TI  - Immunologic infertility: a basic review.
AB  - Antisperm antibodies interfere with the human reproductive events and once they
      have been produced, antisperm antibodies bind to the spermatic surface and affect
      both the transport of spermatozoa and the interactions between the gametes. The
      formation of antisperm antibodies has still not been completely explained and the
      antigen map of the spermatic surface has not been yet established. The antibody
      levels in the serum generally do not reflect the immunoglobulin present in the
      secretions of reproductive tract and in the immunologic screening of the
      infertile couple we need of direct analysis of antisperm antibodies on the
      spermatic surfaces. We have many diagnostic procedures but actually very few
      therapeutic options: to improve the last question, a better understanding of the
      phenomena that lead to fertilization is imperative.

PMID- 8466634
TI  - [Correlational study between lymphocyte IgE markers: membrane CD23 (mCD23) and
      soluble CD23 (sCD23) in an atopic population].
AB  - IgE has two types of receptors: high affinity RFc sigma I and low affinity RFc
      sigma II. The latter may be studied by flow cytometry by the membrane marker CD23
      (mCD23), expressed on B and T cells, monocytes, macrophages, Langerhans cells,
      eosinophils and platelets. Soluble CD23 (sCD23) corresponds with the
      extracellular C terminal domain of mCD23. The aim of the study was to search for
      a correlation between the levels of mCD23 and sCD23, comparatively with IgE,
      eosinophils, eosinophil cationic protein (ECP) and to the cytokines IL2, IL4 and
      IL6. 78 patients took part in the study, divided into two groups: Group 1 =
      atopics (n = 61); Group 2 = controls (n = 17). The majority presented with
      rhinitis, asthma, atopic dermatitis isolated or associated. The results showed a
      highly significant correlation between mCD23 and sCD23 compared with the control
      group. There was also a statistically significant increase for mCD23, sCD23,
      cytokines IL2, IL4 and IL6, mediator ECP in parallel with eosinophils and total
      IgE. This study confirms amongst other things the rise in IL4 in atopy and the
      correlation between the level of ECP and that of eosinophils, and that there is
      an overall correlation between mCD23 and sCD23.

PMID- 8466636
TI  - [Vitamins and immunity].
AB  - Nutritional status conditions immunity in man whom malnutrition is often
      associated with diminished immunocompetence and increased susceptibility to
      infection. Among micronutrients, vitamins A, C, E and carotenoids notably have
      special influence: they provide good cellular and tissular physiological
      behaviour; they also protect tissues against reactive oxygen species, and enhance
      immune response.

PMID- 8466637
TI  - [Apropos of 2 cases of latex allergy with isolated ocular expression].
AB  - We present here two cases of latex allergy with ocular manifestations due to the
      use of condoms and the manipulation of rubber bands. In both cases the in vivo
      (prick tests) and the in vitro (RAST) testing were positive. In one of these two
      cases, the immunological tests performed in tears showed a local synthesis of
      latex specific IgE.

PMID- 8466638
TI  - [Pharmacologic study of the glucocorticoid activity of flunisolide compared with
      other steroids in the rat].
AB  - Flunisolide (FLU), beclomethasone dipropionate (BDP) and its pulmonary
      metabolites beclomethasone monopropionate (BMP) and beclomethasone (B) were
      studied in rat for: their relative binding affinity (RBA) for the 5 classes of
      steroid receptors, their in vitro glucocorticoid activity on rat thymocytes,
      their in vivo glucocorticoid activity by oral route. These compounds displayed a
      strong RBA for rat lung, thymus and liver glucocorticoid receptors (FLU > or =
      BMP > BDP > or = B). They were also shown to have a moderate RBA for both
      mineralocorticoid and progestin receptors, while being devoid of any binding to
      androgen and oestrogen receptors. On rat thymocytes FLU exhibited the highest
      glucocorticoid activity (FLU > B > or = BMP > BDP). In rat oral FLU displayed a
      strong glucocorticoid activity with a slight first-pass metabolism as opposed to
      what has been reported in human.

PMID- 8466639
TI  - [Teldane update. Interview with Dr. Alfred Sabbah, chief of the immuno
      allergology laboratory of the C.H.U. d'Angers. Interview by Dr. Pierre Ceddaha].

PMID- 8466640
TI  - Dual effects of cytokines in regulation of MHC-unrestricted cell mediated
      cytotoxicity.
AB  - Natural killer (NK) cells probably function as an early defense line against
      viruses, due to their ability to kill virus-infected cells without resorting to
      clonal proliferation of memory cells. NK cells are also capable of killing tumor
      cells. In both cases the killing is major histocompatibility complex (MHC)
      unrestricted. NK cells exhibit spontaneous activity but they are positively
      regulated by interferon (IFN) or indirectly by such IFN-inducers as viruses,
      bacterial products, poly (rl):(rC), and mitogens. Interleukin-2 (IL-2) has the
      ability to enhance NK activity in addition to its ability to generate lymphokine
      activated killer (LAK) cell activity. Recently, it was documented that other
      cytokines (e.g., IL-1, tumor necrosis factor (TNF), IL-6, and IL-12) are also
      involved in induction or enhancement of the cytotoxic activity of NK cells.
      Besides their "positive" regulation of NK activity, cytokines (in some cases the
      same cytokines) often act as "negative signals" for NK-mediated cytotoxicity. If
      NK susceptible target cells are exposed to IFN prior to NK cells, their
      sensitivity to NK activity is often markedly diminished. The mechanism by which
      IFNs (IFN-alpha, -beta and -gamma) affect the sensitivity of target cells to NK
      activity remains unknown, but it is clear that this function is not shared by
      other cell-mediated killing processes. The protective effect induced by IFN
      against NK activity is dependent on new mRNA and protein synthesis and can be
      abolished when target cells are incubated with combination of IFN and metabolic
      inhibitors or by chemotherapeutic purine or pyrimidine analogs. Class I MHC
      antigens have a central role in cell to cell interactions in the immune system.
      Because IFN has the ability to induce/increase class I MHC antigen expression, it
      has been suggested that class I MHC antigens act as "negative signals" of NK
      mediated cytotoxicity. Although many studies support this hypothesis, others
      present evidence for a lack of involvement of class I MHC antigens in mediating
      sensitivity to NK activity. Other cytokines have been tested for their ability to
      affect the sensitivity of target cells to NK activity, as well as their ability
      to enhance the cytotoxic activity of NK effector cells. Lymphotoxin (TNF-beta)
      increases target cell susceptibility to NK activity. On the other hand, IL-1, IL
      2, IL-6, and TNF reduce the sensitivity of target cells to NK lysis, at least in
      some systems.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8466641
TI  - The role of mast cells in inflammatory responses in the lung.
AB  - Human lung mast cells (HLMC), by virtue of their anatomic localization and
      release of potent chemical mediators, are well suited to produce characteristic
      pathophysiological inflammatory reactions in the lung. Much has been learned
      about the nature of these cells over the past 10 years, following the development
      of techniques to disperse them from lung tissue and ultimately purify them to
      near homogeneity. Recent work focusing on the origin, ultrastructure,
      proliferation, differentiation, heterogeneity, biochemistry of release,
      mediators, and pharmacological control of HLMC secretion is reviewed. Current
      knowledge of HLMC involvement in asthma and interstitial lung diseases,
      characterized by fibrosis, is summarized with an emphasis on potential areas of
      therapeutic intervention.

PMID- 8466642
TI  - Heat shock proteins in immune responses.
AB  - The assembly of functional MHC-I and MHC-II complexes is rapid, specific, and
      efficient. Recent advances in the area of antigen processing and presentation
      suggest that members of the heat shock protein (hsp) family facilitate the
      molecular events in the assembly process. Furthermore, hsps themselves have been
      shown to be the dominant antigens of a variety of pathogens as well as serving as
      targets of the immune system in healthy individuals. Hsps may play a fundamental
      role in immune responses, serving as an early warning to the host's immune system
      during the onset of infection.

PMID- 8466643
TI  - A bipartite activation domain is responsible for the activity of transcription
      factor HNF1/LFB1 in cells of hepatic and nonhepatic origin.
AB  - HNF1/LFB1 is a transcription factor that controls the expression of several liver
      specific genes. Previous in vitro experiments allowed us to identify two
      different regions in the carboxy-terminal portion of the protein responsible for
      most of the transcription activation potential: the first, ADI, between amino
      acids 546 and 628 and the second, ADII, between amino acids 281 and 318. To
      characterize the molecular anatomy of HNF1/LFB1 better, we have analyzed its
      trans-activating properties in vivo. Several HNF1/LFB1 deletion mutants were
      tested for their ability to induce transcription from HNF1/LFB1-dependent
      synthetic promoters in cells of hepatic and nonhepatic origin. These last
      recipient cells provide an HNF1/LFB1-deficient environment that is useful for a
      precise quantification of the recombinant protein. Our results confirm the
      importance of ADI and indicate that no activating property can be assigned to
      ADII in vivo. Moreover, a novel glutamine/proline-rich activation domain (ADIII)
      has been identified between amino acids 440 and 506. These findings are confirmed
      by domain-swapping experiments, carried out with the heterologous GAL4 DNA
      binding domain, which also show that the activity of each individual activation
      domain is influenced by combining adjacent HNF1/LFB1 sequences. The data
      presented indicate that HNF1/LFB1 transcription activating potential relies on a
      complex structure and also provide important clues to understanding the different
      functions exerted by transcription factors of this family.

PMID- 8466644
TI  - 5' structure and expression of human glucose-6-phosphate dehydrogenase mRNA.
AB  - The human glucose-6-phosphate (G6PD) cDNAs cloned from normal and carcinoma cells
      can encode 545-amino-acid residues starting from the first in-frame chain
      initiation codon. However, it was reported that the G6PD mRNAs of carcinoma cell
      lines were shorter and could encode only 515-amino-acid residues (Martini et al.,
      1986). We demonstrated the existence of two major G6PD mRNAs in normal
      reticulocytes, lymphoblasts, and hepatocytes by the primer extension analysis.
      The longer mRNA has a cap site at approx. nucleotide -166 and can encode 545
      amino-acid residues, whereas the shorter mRNA has a cap site at approx.
      nucleotide -66, and encodes 515-amino-acid residues. These two naturally existing
      mRNAs (cDNAs) and an artificially truncated mRNA, which can encode the carboxy
      terminal 479-amino-acid residues of the subunit, were expressed in the in vitro
      reticulocyte and wheat germ systems and in the in vivo E. coli system. All three
      species of mRNA (cDNA) were efficiently translated and produced proteins with the
      expected molecular sizes. The peptide with 515 residues formed the catalytically
      active enzyme, but the 545-residue protein and the 479-residue protein were
      catalytically inactive. The larger 545-residue protein may correspond to the
      larger G6PD precursor observed in the rat. The extended amino-terminal region
      encoded by the larger mRNA contains the -Arg-Gly-Gly-Arg-Arg-Arg-Arg-sequence,
      which is conserved in the nucleotide-binding protamine family.

PMID- 8466645
TI  - Cytogenetic evidence of involvement of chromosome regions 15q12 and 12q15 in
      conditions with associated overgrowth.
AB  - Syndromes with associated overgrowth are poorly understood. Besides their mode of
      inheritance, nothing is known regarding the basic genetic alterations that lead
      to their abnormal phenotypic manifestations. The chromosome localization of the
      genes involved remains unknown for this group of syndromes, with the only
      exception being the Wiedemann-Beckwith syndrome.

PMID- 8466646
TI  - Induction of O6-methylguanine-DNA-methyltransferase and N3-methyladenine-DNA
      glycosylase in human cells exposed to DNA-damaging agents.
AB  - The inducibility of two DNA repair proteins, the O6-methylguanine-DNA
      methyltransferase (MGMT) and the N3-methyladenine-DNA-glycosylase (ANPG), was
      studied by measuring the protein activities and the transcription of the MGMT and
      ANPG genes in a human hepatoma cell line (LICH cells). The two protein activities
      are enhanced after treatment with a variety of DNA-damaging agents. They are
      maximum 72 hr after the inducing treatments and remain elevated for about 120 hr.
      This induction is abolished when the cells are grown in the presence of protein
      or RNA synthesis inhibitors. Northern blot analysis shows that the DNA-damaging
      agents increase to different extents the transcription of the MGMT or ANPG genes.
      The transferase activity is also increased by DNA damage in a human glioblastoma
      cell line (T98G cells), but is not significantly modified in human normal
      fibroblasts, suggesting that this repair activity enhancement might occur
      preferentially in transformed cells, as we have previously shown for cells of rat
      origin. Therefore, these increased repair activities may play an important role
      in removing the lethal N3-methyladenine residues, the promutagenic O6
      methylguanine lesions, and the potentially lethal chloroethyl adducts formed by
      the nitrosoureas used in cancer chemotherapy more efficiently from the cellular
      DNA.

PMID- 8466647
TI  - Characterization of multiple transcription initiation sites of the ovine insulin
      like growth factor-I gene and expression profiles of three alternatively spliced
      transcripts.
AB  - Alternative splicing of ovine insulin-like growth factor-I (IGF-I) transcripts
      generates three different mRNAs. Class 1 and class 2 transcripts contain exons 1
      and 2 spliced to exon 3, respectively. A novel IGF-I mRNA containing exon W is
      spliced to exon 3 and has been located upstream of exon 1. No in-frame methionine
      codon was present in exon W and therefore translation is proposed to initiate at
      the methionine codon present in exon 3. Using primer extension, transcription
      initiation sites were found 179, 336, and 368 nucleotides upstream of exon 1 and
      86, 96, 131, and approximately 850 nucleotides upstream of exon 2. The locations
      of these transcription initiation sites are well conserved among mammalian and
      avian IGF-I genes. Expression of exon 1-, 2-, and W-specific transcripts was
      examined in brain, heart, kidney, liver, lung, skeletal muscle, and spleen from
      adult ewes or 75-day fetal lambs using a reverse transcriptase-polymerase chain
      reaction assay. Exon 1 transcripts were the most abundant and found in all fetal
      and adult tissues. Exon 2 transcripts were found in all tissues and were
      generally expressed the highest in adult liver. Exon W transcripts were also
      found to be expressed in all tissues examined. Thus, the three alternatively
      spliced ovine IGF-I transcripts were expressed in a variety of fetal and adult
      tissues.

PMID- 8466648
TI  - Structure of the rat catechol-O-methyltransferase gene: separate promoters are
      used to produce mRNAs for soluble and membrane-bound forms of the enzyme.
AB  - The enzyme catechol-O-methyltransferase (COMT) catalyzes the inactivation of
      catechol-containing molecules by methylation. The cDNAs for the rat and human
      COMT have recently been cloned and recombinant proteins expressed in prokaryotic
      and eukaryotic cells. We describe here the structure of the rat COMT gene and its
      5'-flanking sequences. The gene spans at least 13 kb and is composed of 5 exons,
      the first one noncoding. The two ATG codons for the initiation of translation of
      the membrane-bound (MB-COMT) and soluble (S-COMT) forms of the enzyme reside in
      the second exon. The gene expresses two mRNA species of 1.6 kb and 1.9 kb that
      have different tissue distributions. The expression of the transcripts is
      regulated by at least two promoters, P1 and P2. The P1 promoter expresses the
      shorter transcript in a tissue-specific manner and is located between the ATG
      codons in the coding region of the longer transcript. The P2 promoter is
      constitutive and responsible for the expression of the longer transcript. The
      shorter 1.6-kb mRNA (S-mRNA) produces only the S-COMT polypeptide, whereas the
      longer 1.9-kb mRNA (MB-mRNA) is able to direct synthesis of both forms of the
      COMT enzyme.

PMID- 8466649
TI  - Characterization of the DNA-binding properties of the early growth response-1
      (Egr-1) transcription factor: evidence for modulation by a redox mechanism.
AB  - The binding of the transcription factor early growth response-1 (Egr-1) to its
      specific DNA-binding sequence GCGGGGGCG occurs through the interaction of three
      zinc finger motifs. DNA binding by Egr-1 can be modified by alteration of
      reduction-oxidation (redox) state. Using gel retardation assays, we show that
      binding of Egr-1 protein is specific and is dependent on the presence of reducing
      agents in a dose-dependent manner. The zinc finger region is the domain subject
      to conformation changes by redox. Oxidized or metal-free Egr-1 does not bind.
      Nuclear extracts of several cell types contain a heat-sensitive factor(s) that
      induces the ability of Egr-1 protein to bind to DNA in otherwise suboptimal
      conditions containing insufficient reducing agent. This inducing activity may be
      replaced by Ref-1, a protein identified and characterized by Curran and co
      workers (Xanthoudakis and Curran, 1992). The possibility arises that the
      transcription-regulating activity of Egr-1 may be regulated by the redox state in
      the cell via factors such as Ref-1 that modulate its DNA-binding activity.

PMID- 8466651
TI  - [Opinions of Honduran adults about street children].
AB  - The purpose of this study was to determine the beliefs parents of working
      children and business people have about two types of street children, those who
      work on the street and those who are abandoned and live on the street. In 1991
      forty-nine parents of working children and 49 business people from Tegucigalpa
      were administered a questionnaire listing 36 beliefs about the lifestyles of
      abandoned and working children and causes of children adopting these ways of
      life. Among parents of working children, education was significantly lower and
      mothers were more likely to be single women than in the business people sample.
      There were many beliefs about the lifestyles of street children on which both
      groups agreed, but parents of working children held the youngsters more
      accountable for choosing to work or live in the street. Parents also seemed to be
      more aware of the health risks to both types of street children than business
      people who felt working children were at less risk than abandoned children.
      Business people perceived abandoned children to be victims of single parenthood
      and solvent abuse. A deeper exploration of the views held by families of street
      children may assist those seeking to help them.

PMID- 8466650
TI  - Mapping of a sequence essential for the nuclear transport of the Xenopus
      ribosomal transcription factor xUBF using a simple coupled translation-transport
      and acid extraction approach.
AB  - The amino acid sequences directing the nuclear transport of the RNA polymerase I
      transcription factor xUBF have been studied by a novel combination of in oocyte
      coupled translation-nuclear transport and selective HCl extraction. Synthetic
      mRNA was used to direct the translation of labeled xUBF and its mutants in
      microinjected oocytes. After manual dissection of nuclei and cytoplasm, labeled
      xUBF and mutants were isolated essentially pure by HCl extraction. Using deletion
      mutations, a sequence essential, but not necessarily sufficient, for nuclear
      transport was mapped to a 29-amino-acid segment lying between the most carboxy
      terminal putative HMG-box DNA-binding domain, HMG-box 5, and the highly acidic
      carboxy-terminal domain. It was shown that deletion of only 5 amino acids from
      this segment eliminated xUBF transport, and it could be deduced that at least 11
      of the 29 amino acids were essential for nuclear transport. The segment of xUBF
      necessary for nuclear transport contains a sequence conforming to the bipartite
      nuclear transport motif consensus, but this sequence in itself was insufficient
      for nuclear transport.

PMID- 8466652
TI  - [Relations between health and development].
AB  - The relationship between the health of a population and the state of development
      of a society is complex and varies over time. Throughout history, improved health
      has been one of the main benefits of development. This benefit results partly
      from an increase in income and partly from scientific progress in the fight
      against disease and disability. This second factor is increasingly important
      compared to simple economic growth. Reciprocally, health could be expected to
      have a favorable effect on development, although this effect is more difficult to
      detect. Nevertheless, health can be considered part of a society's capital stock,
      as long as the essential differences between this type of capital and physical
      capital are recognized. These differences, in turn, provide an insight into the
      health services market and, in particular, into the tendency to spend more and
      more resources on health. It is necessary to respect the intrinsic value of human
      capital, rather than focusing strictly on the economic productivity that may be
      derived from it, in order to prevent discrimination against children, the
      elderly, the poor, or the disabled.

PMID- 8466653
TI  - [The painful reality of street children].

PMID- 8466654
TI  - Neonatal exogenous testosterone modifies sex difference in radial arm and Morris
      water maze performance in prepubescent and adult rats.
AB  - To study the involvement of testosterone in the development of spatial abilities,
      testosterone propionate (TP) was administered to male and female rats during the
      first week after birth. As adults, these rats were trained and tested on the
      radial arm maze (RAM) or the Morris water maze (MWM). Sex and neonatal TP
      treatment influenced number of trials to criterion, accuracy, and the use of an
      adjacent-arm strategy on the RAM, as well as the speed with which the rats
      learned the location of a hidden platform in the MWM. On both RAM and MWM,
      control males performed better than control females, but TP treatment reversed
      this pattern, producing better maze performance in females and worse in males.
      Neonatal TP effects on MWM performance were also examined in 21-day-old male and
      female rats. Performance paralleled that of the adults in all but the
      testosterone-treated male group, which did not differ from control males. The
      results of this study provide support for the hypothesis that circulating
      testosterone during brain development may play a role in the development of
      spatial memory, and suggest that, in the rat, both the sex difference and
      testosterone influence are present early in life.

PMID- 8466655
TI  - Three independent factors characterize spontaneous rat motor activity.
AB  - A scaling approach was introduced recently to assess sequential and geometrical
      aspects of animal behavior. This study describes the relationship between
      different measures of unconditioned motor activity of rats. Specifically, the
      amount of motor activity was assessed using both a traditional photobeam break
      measure, counts, and the temporal scaling exponent, alpha, which describes the
      ratio of fast to slow behavioral micro-events. The sequential characteristics of
      the behavior were assessed by the dynamical entropy, h, describing the degree of
      unpredictability of future movements. The geometrical characteristics of rat
      motor activity were quantified by the spatial scaling exponent, d. Exploratory
      activity was measured by counting rearings and holepoking responses. A factor
      analysis of these measures was conducted based on results from 137 drug-naive
      animals that were tested for 1 h in the Behavioral Pattern Monitor. Three
      independent factors account for 77% of the variance. These factors can be
      described as the 'amount of activity', 'sequential response organization', and
      'exploratory activity'. The factor loadings support the initial hypothesis that
      the geometrical structure of rat motor activity, i.e. the spatial scaling
      exponent d, varies independently from the amount of activity, i.e. counts. In
      addition, the distribution of these measures did not deviate significantly from
      normality suggesting that the z-scores of these variables, which have been used
      previously in the d-alpha plane description, are able to indicate significant
      changes of behavior. These results suggest that unconditioned motor activity is
      influenced by at least three independent factors. The independent assessment of
      these factors may contribute significantly to the understanding of the neural
      substrates involved in the organization of unconditioned behavior.

PMID- 8466656
TI  - Tetrahydroaminoacridine attenuates dizocilpine-induced behavioural changes.
AB  - The acetylcholinesterase inhibitor tetrahydroaminoacridine (THA) is known to
      interact with neurotransmitter systems other than the cholinergic, e.g. several
      studies have shown interaction of THA with the N-methyl-D-aspartate (NMDA)
      receptor subtype of the glutamatergic system. We therefore investigated whether
      behavioral changes in rats, caused by the non-competitive NMDA-antagonist
      dizocilpine, were altered by THA. Spontaneous locomotion was measured in an open
      field and learning behaviour was evaluated in a spatial learning task in the 8
      arm radial maze. Hyperactivity in the open field caused by 0.08 mg/kg i.p.
      dizocilpine was reversed by 5 mg/kg i.p. THA. Hyperactivity caused by 0.16 mg/kg
      i.p. dizocilpine was reversed by two THA doses (2.5 mg/kg, 5 mg/kg i.p.). A
      dizocilpine-induced acquisition deficit in the 8-arm radial maze was attenuated
      by THA (2.5 mg/kg) on the 6th and 7th day of testing. The effects of THA are
      discussed with reference to a possible functional glutamate agonism.

PMID- 8466657
TI  - Age-dependent effects of hippocampal muscarinic receptor blockade on memory-based
      learning in the developing rat.
AB  - The effects of ventral intrahippocampal injections of atropine sulfate on
      patterned single alternation (PSA), a discrimination task that requires intact
      short-to-intermediate-term memory, were examined in the developing rat at 16-17
      and 28-32 days of age. Atropine treatment disrupted simple acquisition in some 16
      to 17-day-old pups by interfering with approach to the goal, but did not
      eliminate PSA at either 8- or 15-s intertrial intervals when approach was normal.
      In the older rats, atropine treatment delayed the onset and reduced the magnitude
      of PSA, indicating a reduced memory-based discrimination. These results provide
      additional support for an increasing role of muscarinic receptors in learning and
      memory as this system matures in the developing rat, and suggest different
      mechanisms for PSA at the two ages.

PMID- 8466658
TI  - Development of hippocampal specialisation in a food-storing bird.
AB  - Previous studies demonstrated that amongst food-storing passerine birds the
      hippocampal region (dorso-medial cortex) is enlarged relative to the rest of the
      telencephalon. It has been hypothesised that this hippocampal specialisation is
      related to the spatial memory requirements of retrieving large numbers of stored
      items. Here we compare the development of the hippocampus in a food-storing and a
      non-storing corvid, the adults of which differ in relative hippocampal volume.
      The volume, cell density and number of cells in the hippocampal region of
      nestling (5-25 days post hatching) and adult (> 320 days old) magpies Pica pica
      (food-storing) and jackdaws Corvus monedula (non-storing) were measured. In both
      species the volume of the hippocampus increases with the volume of the rest of
      the telencephalon during the nestling growth phase. The relative volume of the
      hippocampus in 5- to 25-day-old nestlings of the two species does not differ
      significantly. In the food-storing magpie, the relative volume of the adult
      hippocampus is significantly larger than that of nestlings, whilst in the
      jackdaw, adults and nestlings do not differ. The density of neurons declines with
      increasing age and this effect is more marked in jackdaws than in magpies. Neuron
      number did not change significantly with age, but is significantly greater in
      adult magpies than in adult jackdaws. These results are discussed in relation to
      the possibility that changes in hippocampal volume and cell number are related to
      the use of spatial memory in retrieving stored food.

PMID- 8466659
TI  - Functional comparison of neuronal properties in the primate posterior hippocampus
      and parahippocampus (area TF/TH) during different behavioural paradigms involving
      memory and selective attention.
AB  - Monkeys were trained on a delayed match-to-sample (DMS) task. In addition a
      standardized behavioural trial was performed which involved an experimenter
      approaching the animal in certain sequence and presenting edible or other objects
      ('raisin trial'). Neuronal activity of 617 units was recorded in the posterior
      parahippocampus (PH) and in the posterior hippocampus (H). In many cases, we
      compared the activity of the same neuron in different tasks. 32.7% of the 455 PH
      neurons and 28.5% of the 130 H cells responded during the presentation of the
      visual stimuli in the DMS task. These responses were only mildly influenced by
      the physical dimensions of the visual stimulus, but often depended on the context
      in which the stimuli were presented. There was no differential response to the
      second stimulus that clearly depended on the nature of the first stimulus. 6.2%
      of the PH units, but none in H, responded in relation to the reward. 4.4% of the
      PH neurons, but none in H, showed a mild response during the interstimulus
      interval. 38.1% of 215 PH neurons and 37.8% of 45 H cells responded during one or
      more phases of the raisin trial. These responses were not related to the physical
      dimensions of the sensory stimuli. 210 PH and 41 H units were investigated during
      the DMS task as well as during the raisin trial. 18.1% (PH) and 12.2% (H) of the
      units responded during the DMS task, but not during the raisin trial; 17.1% (PH)
      and 36.6% (H) responded vice versa. A response in both trials was found in 17.1%
      of the PH neurons, but in none of the H cells. There were also other PH unit
      types showing responses during different aspects of the DMS task and even in
      other control paradigms, while no such overlap was encountered in H. Our results
      suggest a function of H and PH in the evaluation of the behavioural significance
      of sensory information. It may be this aspect which leads to anterograde memory
      disturbances after lesion of these areas. Since representation of neuronal
      information was found to be more specific in H, a possible function as an
      'evaluation index' is discussed.

PMID- 8466660
TI  - Delayed response learning to auditory stimuli is impaired in cage-reared cats.
AB  - Four normal and eight cage-reared cats were used. Four of the cage-reared cats
      were visually deprived in the first 6 months of life. The cats were trained on a
      three-choice delayed response task to auditory stimuli. All normal cats mastered
      a 1-min delay and two cats even a 6-min delay. In contrast, two cage-reared cats
      failed to cope even with a 5-s delay, four cats with a 15-s delay and the
      remaining two cats with a 1-min delay. No significant difference was found
      between the non-deprived and the deprived cage-reared cats. The deficits was
      analogous to that shown by cage-reared cats during delayed response, visual
      learning. Thus, cage-rearing strongly impairs delayed responding to at least two
      different sensory modalities.

PMID- 8466661
TI  - Effects of locus coeruleus lesions on vigilance and attentive behaviour in cat.
AB  - Previous data have suggested that in the cat, expectancy behaviour (waiting for a
      target to appear) and associated electrocortical, focal, synchronized activity
      ('mu' rhythms) are modulated by a noradrenergic system possibly originating from
      the locus coeruleus (LC). To test the latter hypothesis, we have examined the
      behavioural and ECoG changes induced after bilateral LC lesions. Our results
      demonstrated that destruction of the anterior 3/4th of the LC (A6 noradrenergic
      cell group) resulted in a considerable increase of mu rhythms and expectancy
      behaviour, without episodes of drowsiness that normally occur. Destruction of the
      posterior fourth of LC (A4 noradrenergic group) only increased the duration of
      slow sleep. Extending the A6 lesion to include the dorsal ascending noradrenergic
      bundle also increased the expectancy behaviour and mu rhythms. Finally, when the
      nucleus subcoeruleus was also involved, the duration of slow sleep and the
      frequency of paradoxical sleep episodes increased. These findings indicate that
      the LC exerts an inhibitory effect on structures involved in the induction and
      persistence of expectancy behaviour with accompanying mu rhythms.

PMID- 8466662
TI  - P-3-BSA, but not P-11-BSA, implants in the VTA rapidly facilitate receptivity in
      hamsters after progesterone priming to the VMH.
AB  - Recent evidence suggests that progesterone (P) may have behaviorally relevant
      actions on neuronal membranes in the ventral midbrain. In the present
      experiments, we exploited the rapid time course predicted for non-genomic actions
      of steroid hormones. Ovariectomized hamsters were implanted with chronic guide
      cannulae, one aimed above the ventromedial hypothalamus (VMH) and the other over
      the contralateral ventral tegmental area (VTA). The following week animals were
      estrogen-primed (10 micrograms estradiol benzoate) and pre-tested for sexual
      receptivity 2 h after a P or P conjugated to the macromolecule bovine serum
      albumin (P-3-BSA) containing tube was applied to the VMH. P-3-BSA binds well to
      neuronal membranes, but does not penetrate them because of the large size of the
      BSA molecule. After the pre-test, the opposite hormone-containing insert was
      applied to the VTA and hamsters were tested again for sexual receptivity 5 min
      after this implantation. The following week, the contents of the tubes were
      reversed. Receptivity only occurred when P was applied to the VMH and 2 h later P
      3-BSA was applied to the VTA; the reverse treatment was ineffective. These data
      indicate that P is capable of rapidly facilitating receptivity by actions on cell
      membranes in the VTA if P has been applied to the hypothalamus 2 h earlier.
      Progesterone conjugated to BSA at carbon 11 (P-11-BSA) was ineffective compared
      to P-3-BSA using the same paradigm. This suggests that the mechanism which
      responds to P in the ventral midbrain may require the 11 region.

PMID- 8466663
TI  - Event-related potentials in macaque monkey during passive and attentional
      processing of faces in a priming paradigm.
AB  - Epidural event-related potentials (ERPs) were recorded in monkeys using a priming
      (S1-S2) paradigm. One juvenile and 2 young adult macaque monkeys (Macaca
      fascicularis) viewed tachistoscopically presented pairs of faces in four possible
      combinations: human-human, monkey-monkey, monkey-human, human-monkey. Faces were
      presented upright to untrained subjects. Subsequently, one adult monkey was
      trained to associate the occurrence of a monkey-monkey pair of faces with juice
      reward. In a separate control experiment, the same stimuli were presented upside
      down. In both the upright and inverted conditions, adult monkey ERPs exhibited a
      P1-N1-P2 complex of peaks in the 400 ms following stimulus presentation. However,
      only upright faces elicited a prominent, widely distributed negativity (N4) in
      the 400-800 ms interval and a long-duration negativity (LDN) in the last 400 ms
      of the 1,400-ms epoch. N4 was earlier in latency, larger in amplitude, and larger
      over left hemisphere in response to monkey faces compared to human faces. It was
      also sensitive to the preceding or priming stimulus, exhibiting larger amplitudes
      when S1 matched S2 than when it did not. Trained monkey waveforms differed from
      untrained monkey responses in terms of the appearance of an N2-P3 complex. P3 was
      bilaterally symmetrical, larger in magnitude, and delayed in latency in response
      to monkey faces. The differences in components in the two conditions suggest that
      monkey ERPs can distinguish between passive and attentional processing of faces.
      N4 appears to reflect the recognition of conspecifics, is sensitive to priming,
      and occurs primarily over left hemisphere. Rewarded presentation of faces results
      in P3-like components that may reflect the novelty, meaningfulness, or active
      nature of the response. The differences in distribution between P3 and N4 suggest
      that they do not share the same neural sources.

PMID- 8466664
TI  - Recovery of a temporally based visual discrimination after visual cortex lesion
      in the rat.
AB  - In Expt. 1, rats were conditioned to emit a shock avoidance response when the
      pulse rate of a light was increased. Then, after bilateral visual cortex lesions,
      the rats were given 10, 20, or 40 days recovery before relearning the
      discrimination. While all rats were able to relearn the discrimination response,
      lesion rats had a performance deficit after all recovery periods. Expt. 2
      compared the effects of postoperative visual pulse rate training to those of
      auditory pulse rate training on relearning of the photic pulse-rate
      discrimination 10 days after visual decortication. Recovery of discrimination
      responding was better after auditory pulse rate training than after visual
      training. These data suggest that visual cortex lesions in the rat disrupt
      perceptual or associational functions involving the temporal features of a visual
      stimulus. In addition, generalization of relational properties during cross-modal
      training through multimodal CNS structures appears to enhance recovery of
      behavior after brain insult.

PMID- 8466665
TI  - Stopping behavior: constraints on exploration in rats (Rattus norvegicus).
AB  - In the absence of an obvious reference place, rat locomotor behavior in a novel
      environment appears haphazard. In previous work, one or two places termed home
      bases, were shown to stand out from all the other places in the environment in
      terms of the behaviors performed in them and in terms of their behavioral
      stability. We use home base location as a reference place for rat movement in
      locale space, by defining an excursion as a trip starting at a home base and
      ending at the next stop at a home base. We then establish the uniform
      distribution as an appropriate model for the number of stops per excursion. This
      way we show that there is an intrinsic upper bound on the number of times a rat
      stops during an excursion. As a rat leaves the home base, home base attraction
      increases with every additional stop performed by it, first slowly and then fast.
      This cumulative process of attraction may be concluded after each stop, as long
      as the number of stops does not exceed an intrinsic upper bound; once the upper
      bound is reached, the rat concludes that excursion and returns to base. The
      session's upper bound does not increase with the size of the explored area.

PMID- 8466666
TI  - The predictive value for performance speed of preparatory changes in neuronal
      activity of the monkey motor and premotor cortex.
AB  - Three monkeys were trained in a precued reaction time (RT) paradigm. An initial
      preparatory signal (PS) provided complete, partial or no information about
      direction and extent of a wrist flexion/extension movement which was executed
      after the second, response signal (RS). A PS providing information about
      direction shortened the RT much more than a PS indicating movement extent. The
      activity of 464 task-related neurons was recorded in the primary motor (MI) and
      premotor (PM) cortex. Not only the timing and amplitude of mean activity changes
      were analyzed, but also trial-by-trial correlation analyses between RT and
      discharge frequency during the PS-RS interval were conducted. Correlations were
      stronger in the condition of information about direction than in conditions of
      information about extent or no information. Considering directionally selective
      neurons, correlations were stronger when the neuron's preferred direction than
      the opposite direction was precued. Correlation distributions were similar for MI
      and PM. Correlations were negative when preparatory activity increased during the
      PS-RS interval, and positive when activity decreased. Correlation analyses
      between behavioral performance and neuronal activity can thus be considered as a
      powerful tool to obtain a deeper insight into the functional mechanism of motor
      preparation.

PMID- 8466667
TI  - The effects of V4 lesions on the visual abilities of macaques: hue discrimination
      and colour constancy.
AB  - Monkeys with lesions of cortical visual area V4 were compared with unoperated
      monkeys in three experiments. In Expt. 1 they were tested for the reacquisition
      of a pre-operatively learned hue discrimination task. In Expt. 2, as a test of
      colour constancy, the monkeys were required to perform previously overlearned
      colour discrimination tasks when the amounts of red, green and blue light in the
      illuminant were changed. In Expt. 3 the animals were compared on the post
      operative acquisition of hue, greyness and saturation discrimination tasks. The
      results of Expt. 1 showed that monkeys with V4 lesions can regain their pre
      operative levels of performance on hue discrimination tasks. Expt. 2 showed that
      monkeys with V4 lesions have a colour constancy deficit. Expt. 3 reinforced the
      finding that the animals with V4 lesions could learn to perform fine hue
      discriminations but that their final, asymptotic performance was not as reliable
      as that of normal animals. The wavelength discrimination data are discussed
      within the context of recent electrophysiological findings that V4 is involved in
      selective attention to visual stimuli and the constancy data are interpreted as
      evidence that V4 is important for defining colour constancy thresholds but not
      for constructing the perceptual categories underlying constant colour perception.

PMID- 8466668
TI  - Regional distribution of functions in dorsolateral prefrontal cortex of the the
      monkey.
AB  - Single-cell responses were obtained from 352 neurons in dorsolateral prefrontal
      cortex (Walker's areas 9 and 46) of three monkeys. The neurons were classified
      functionally according to their responsiveness to visual, auditory and
      somatosensory stimulation, and to correlation of their activity with spontaneous
      eye or limb movements. A comparison between the distribution of different
      functions and known modality-specific anatomical connections to various sectors
      of this area showed a good correspondence. On average somatosensory and motor
      neurons were located more ventrally than the remaining ones, and were
      concentrated to the middle third of the inferior bank of principal sulcus and
      adjacent inferior convexity, where a number of somatosensory projections overlap.
      Oculomotor neurons were found caudally in both banks of principal sulcus and in a
      narrow band on the dorsal convexity, coinciding with the projection fields of
      areas 7a and 7ip of posterior parietal cortex, superior colliculus, and
      paramedian pontine tegmentum. Other functions were scatteredly distributed.
      Visual neurons which preferred moving to stationary stimuli were located more
      caudally and dorsally than other visual neurons. The present study shows that a
      parcellation of dorsolateral prefrontal cortex proposed on the basis of
      anatomical connectivity is also functionally evident.

PMID- 8466669
TI  - Lesions of the frontal eye field impair pursuit eye movements, but preserve the
      predictions driving them.
AB  - Visually guided eye movements are driven by a mix of current signals (e.g. visual
      motion) and prior experience (predictive strategies). Previously, large ablations
      of the frontal eye field (FEF) impaired visually guided smooth pursuit. This
      study examined if the pursuit decrement could be laid to a selective loss in
      predictive signals. Normal monkeys demonstrated some of the same predictive eye
      movements documented in humans. They pursued periodic visual targets with near
      zero phase lag. When such targets suddenly disappeared, the monkeys continued
      smooth pursuit without visual guidance for several reaction times. These epochs
      of 'blind pursuit' achieved a peak velocity proportional to the prior target
      frequency just experienced by the monkey. With predictable step-ramp targets
      smooth eye movements sometimes preceded target motion (anticipatory pursuit).
      Reaction time to begin pursuit was influenced by the target velocity of prior
      trials. Small unilateral ablations of 'low threshold' FEF showed smooth pursuit
      if the fundus of the arcuate sulcus was thoroughly removed. On the step-ramp
      targets the slowing was evident in both the initial 100 ms and subsequent
      portions of pursuit. During sine pursuit blind epochs were more slowed by surgery
      than were visually guided epochs of pursuit. Ipsilateral anticipatory pursuit was
      abolished in one subject, but not in the other subject with pursuit deficits.
      Otherwise, pursuit after surgery continued to display the influence of predictive
      strategies. The average phase lag of periodic pursuit remained much less than the
      pursuit system's reaction time. Blind epochs persisted after the periodic target
      disappeared, albeit with a lower peak velocity. Reaction time to begin pursuit of
      step-ramp targets remained a function of the monkey's experience on prior trials.
      It is argued that the FEF pursuit deficits do not reflect the loss of visual
      motion signals or the loss of some 'cognitive' signal such as a prediction about
      the target's motion, but rather can be explained as a motor deficit.

PMID- 8466670
TI  - Statistical mechanical approach for predicting the transition to non-B DNA
      structures in supercoiled DNA.
AB  - Supercoiling causes global twist of DNA structure and the supercoiled state has
      wide influence on conformational transition. A statistical mechanical approach
      was made for prediction of the transition probability to non-B DNA structures
      under torsional stress. A conditional partition function was defined as the sum
      over all possible states of the DNA sequence with basepair 1 and basepair n being
      in B-form helix and a recurrence formula was developed which expressed the
      partition function for basepair n with those for less number of pairs. This new
      definition permits a quick enumeration of every configuration of secondary
      structures. Energetic parameters of all conformations concerned, involving B
      form, interior loop, cruciform and Z-form, were included in the equation. The
      probability of transition to each non-B conformation could be derived from these
      conditional partition functions. For treatment of effects of superhelicity,
      supercoiling energy was considered, and a twist of each conformation was
      determined to minimize the supercoiling energy. As the twist itself affects the
      transition probability, the whole scheme of equations was solved by
      renormalization technique. The present method permits a simultaneous treatment of
      several types of conformations under a common torsional stress. A set of
      energetic parameters of DNA secondary structures has been chosen for calculation.
      Some DNA sequences were submitted to the calculation, and all the sequences that
      we submitted gave stable convergence. Some of them have been investigated the
      critical supercoil density for the transition to non-B DNA structures. Even
      though the reliability of the set of parameters was not enough, the prediction of
      secondary structure transition showed good agreement with reported observation.
      Hence, the present algorithm can estimate the probability of local conformational
      change of DNA under a given supercoil density, and also be employed to predict
      some specific sequences in which conformational change is sensitive to
      superhelicity.

PMID- 8466671
TI  - An elastic model for in-plane deformations of small DNA rings.
AB  - In-plane deformations of an elastic ring are analyzed as a model for structural
      distortions of small covalently-closed DNA rings with little or no writhe. The
      static conformation of an unconstrained elastic ring is a geometric circle, but
      thermal fluctuations away from the circle are found to be significant. An elastic
      ring confined in a cylindrical pore of rigid radius less than the radius of the
      free ring is studied as a model for a small DNA ring in a tight resolving gel.
      The model is extended to include deformability of the pore. Larger rings are
      relatively more deformed in the pore than smaller ones. This result may be
      pertinent to the observation that at constant linking number the mobility of
      small DNA rings in a resolving gel decreases as the number of base pairs
      increases.

PMID- 8466672
TI  - Binding site for ethidium cation in the major groove of B-form DNA.
AB  - Molecular modeling of the system composed of ethidium cation initially
      intercalated through the major and minor grooves of the B-DNA form of 5'GCATGC3'
      into the central AT pairs, with the phenyl group oriented either toward or away
      from the helical axis, led upon energy minimization to intercalation complexes
      only when the phenyl group was initially oriented away from the helical axis. For
      the other two cases, energy minimization led to extrusion of the ethidium from
      the helix to form unanticipated outside-bound complexes stabilized by specific
      hydrogen bonds. It is suggested that outside-bound major groove complexes
      involving the GXXXG sequence may play important roles in the reaction mechanism
      of ethidium intercalation and in its action as a drug.

PMID- 8466673
TI  - Conformational isomerizations of poly(dA-dT) are dramatically influenced by a
      substitution of a minor amount of adenine by purine or amino2purine.
AB  - We have synthesized poly(dA,dPu-dT) and poly(dA,n2dPu-dT) containing,
      respectively, 5.7% of purine and 7.4% of amino2purine in place of adenine to
      demonstrate that these apparently negligible perturbations of the primary
      structure have dramatic consequences for the polynucleotide conformational
      isomerizations. The replacement of adenine by amino2purine, preserving the number
      of hydrogen bonds between the complementary bases, has a stronger effect on the
      polynucleotide conformational isomerizations than the replacement with purine
      that is bound only by a single hydrogen bond to thymine. Nevertheless,
      poly(dA,dPu-dT) forms a more thermostable duplex than poly(dA,n2dPu-dT).
      Furthermore the few amino2purines in poly(dA,n2dPu-dT) inhibit its isomerization
      into X-DNA, stabilize but modify A-DNA and stabilize Z-DNA. Kinetics of the B-Z
      transition of poly(dA,n2dPu-dT) is fast to indicate that the amino groups in the
      double helix minor groove substantially decrease the kinetic barrier between B-
      and Z-DNA. On the other hand, the replacement of adenine by purine destabilizes
      both Z-DNA and A-DNA, and the destabilization of X-DNA is weaker than with
      amino2purine. A-form and B-form perhaps coexist in poly(dA,dPu-dT) at high
      concentrations of ethanol.

PMID- 8466674
TI  - Investigation of solution structure of d(GAATTTAAATTC)2 by 1H NMR, molecular
      dynamics, mechanics, refinement by back-calculation of the NOESY spectrum and
      analysis of this structure using X-ray data.
AB  - 1H NMR spectroscopy, restrained molecular mechanics and dynamics and refinements
      after back-calculation of the NOESY spectrum have been performed to study the
      structure of the d(GAATTTAAATTC)2 duplex and to determine whether it is bent or
      not. It is found that the duplex adopts a B-type conformation; all sugar
      conformations belong to the C2' endo region and purines have a larger
      pseudorotation angle as compared to pyrimidines. The cross-strand AH2(n)-AH1' (m
      + 1) distance (where (n) and (m) are complementary residues), crucial for an
      anomalous A/T tract structure, is large on the TA step and gradually decreases at
      the 3' and 5' ends of the TTTAAA tract and follows the rules proposed previously
      [Chuprina, V.P., Lipanov, A.A., Fedoroff, O.Yu, Kim, S.G., Kintanar, A., and
      Reid, B.R., Proc. Natl. Acad. Sci. U.S.A. 88, 9087 (1991)]. The changes in this
      distance correlate with those in the T1 value for AH2 protons which we measured
      for several oligonucleotide sequences. A total number of about 250 interproton
      distance constraints were determined from NOESY spectra and were used for
      structure determination by molecular mechanics, dynamics and refinement by back
      calculations. It is shown that these data are not enough to determine whether the
      duplex is bent or not. The whole family of B-type conformations including bent
      and straight structures fit well with the available NMR data. In principle,
      additional non-NMR data could be used in order to reduce the number of the
      allowable structures. The refinement of the structures with additional different
      non-NMR constraints (used as a driving force) on P-P or H1'-H1' minor groove
      width distances in the TA region shows a very good correlation between these
      distances and the angle of bending of the dodecamer. The more the minor groove
      width increases in the TA region the more the duplex is bent at the major groove
      of this region. On the other hand, there is also a very good correlation between
      P-P, H1'-H1' and AH2-H1' cross-strand distances as follows from analysis of X-ray
      B-type structures. These two correlations, together with the increased AH2-H1'
      cross-strand NMR distance in the TA region of the dodecamer indicate that the
      duplex should be characterized by a wider minor groove in the TA region and be
      bent in the major groove in this region.

PMID- 8466675
TI  - Quantum chemical and molecular mechanics studies on the binding of stereoisomers
      of the oligopeptide antibiotics amidinomycin and noformycin to the minor groove
      of B-DNA.
AB  - Ab initio calculations (Hartree-Fock) using the 6-31G basis set have been
      performed on two chiral oligopeptide antitumor antibiotics amidinomycin 5 and
      noformycin 6. The latter are DNA minor groove binding agents related to the A.T
      recognizing netropsin 4 and distamycin 3 but, unlike the latter, bear
      stereocenters (two for 5 and one for 6) that may be expected to affect binding to
      the B-DNA receptor. Geometry optimized conformations, energies and distribution
      of electrostatic charges within the molecules were derived. The rotational
      barrier for bond C3-C6 in 6 was calculated to be ca. 6 kcal.mole-1 and the dipole
      moment for 6 was 7.69D and for 5 was 5.58D. The ab initio derived parameters of
      the geometry optimized conformations of the different possible stereoisomeric
      forms of 5 and 6 were used to interpret their different interactions with the
      minor groove of DNA at both A.T and G.C sequences and the results were compared
      with molecular mechanics calculations. The order of binding of the four
      stereoisomers of 5 at the preferred (A.T)n sequences by both ab initio and
      molecular mechanics calculations is 1S,3R > RR > RS > SS. The predicted energy
      differences for complexation with DNA of the other stereoisomers from that of
      1S,3R are: RR (4.2%); RS (6.7%) and SS (21.5%). In the case of noformycin the 4R
      structure binds more effectively than the enantiomer. Considerations of phasing
      in the computed distances between hydrogen bond donating sites in the DNA-bound
      antibiotics provide further insight into the binding processes. In the complexes
      of noformycin 6 the N-N1-N4 and N1-N5 distances (9.05 and 9.15 A respectively for
      4R-6 and 9.23 and 9.26 A respectively for 4S-6) are close to the optimum value of
      9.1 A for effective binding. In the case of amidinomycin 5 the best agreement
      with the optimum value occurs with the strongest binding diastereomer 1S,3R (N1
      N3 = 8.91, N1-N4 = 9.41 A). The unexpected result, consistent in both ab initio
      and molecular mechanics treatments, is that, in contrast to the cases of
      kikumycin 1 and anthelvencin 2, the natural 3S configuration of 5 and 4S of 6 do
      not confer maximal binding efficiency. This suggests that biogenetic factors in
      the generation of the oligopeptide antibiotics lead to maximum DNA binding in the
      cases of kikumycin and anthelvencin but not in the cases of amidinomycin and
      noformycin.

PMID- 8466676
TI  - Stereochemistry of 2'-5' linked nucleic acids: crystal and molecular structure of
      ammonium adenylyl-2',5'-adenosine tetrahydrate: a core fragment of 2'-5' oligo
      A's produced by interferon induced adenylate synthetase.
AB  - The preponderance of 3'-5' phosphodiester links in nucleic acids is well known.
      Albeit less prevalent, the 2'-5' links are specifically utilised in the formation
      of 'lariat' in group II introns and in the msDNA-RNA junction in myxobacterium.
      As a sequel to our earlier study on cytidylyl-2',5'-adenosine we have now
      obtained the crystal structure of adenylyl-2',5'-adenosine (A2'p5'A) at atomic
      resolution. This dinucleoside monophosphate crystallizes in the orthorhombic
      space group P2(1)2(1)2(1) with a = 7.956(3) A, b = 12.212(3) A and c = 36.654(3)
      A. CuK alpha intensity data were collected on a diffractometer. The structure was
      sloved by direct methods and refined by full matrix least squares methods to R =
      10.8%. The 2' terminal adenine is in the commonly observed anti (chi 2 = 161
      degrees) conformation and the 5' terminal base has a syn (chi 1 = 55 degrees)
      conformation more often seen in purine nucleotides. A noteworthy feature of
      A2'p5'A is the intranucleotide hydrogen bond between N3 and O5' atoms of the 5'
      adenine base. The two furanose rings in A2'p5'A show different conformations -
      C2' endo, C3' endo puckering for the 5' and 2' ends respectively. In this
      structure too there is a stacking of the purine base on the ribose O4' just as in
      other 2'-5' dinucleoside structures, a feature characteristically seen in the
      left handed Z DNA. In having syn, anti conformation about the glycosyl bonds, C2'
      endo, C3' endo mixed sugar puckering and N3-O5' intramolecular hydrogen bond
      A2'p5'A resembles its 3'-5' analogue and several other 2'-5' dinucleoside
      monophosphate structures solved so far. Striking similarities between the 2'-5'
      dinucleoside monophosphate structures suggest that the conformation of the 5'-end
      nucleoside dictates the conformation of the 2' end nucleoside. Also, the 2'-5'
      dimers do not favour formation of miniature classical double helical structures
      like the 3'-5' dimers. It is conceivable, 2-5(A) could be using the
      stereochemical features of A2'p5'A which accounts for its higher activity.

PMID- 8466677
TI  - Characterization of gamma-radiation induced decomposition products of thymidine
      containing dinucleoside monophosphates by nuclear magnetic resonance
      spectroscopy.
AB  - To study the chemical and biochemical influence of loss of base aromaticity,
      dinucleoside monophosphates containing cis-5R,6S-thymidine glycol (Tg) and 5R and
      5S 5,6-dihydrothymidine (Th) were prepared from d-ApT and d-TpA by KMnO4
      oxidation and rhodium-catalysed hydrogenation, respectively. One and two
      dimensional 1H NMR techniques were used to characterize the solution conformation
      of each of the modified dinucleoside monophosphates for comparison with the
      unmodified compounds. Coupling constant data show that all sugar moieties adopt a
      predominantly 2'-endo conformation. Estimates of proton-proton distances from two
      dimensional NOE experiments reveal that most of the glycosidic bonds prefer the
      anti conformation. Analysis of the C5'-C4' (gamma) torsion angle of the
      hydroxymethyl group using 3JH4'H5' and 3JH4'H5" data indicate that these
      modifications to thymine have little effect on the gamma conformer populations.
      Although, in general, additions at C5 and C6 of thymine in d-ApT and d-TpA
      profoundly distort the pyrimidine, they do not otherwise significantly alter the
      conformation of these compounds relative to the unsubstituted dinucleoside
      monophosphates. The one exception is the thymine glycol of d-TgpA, which appears
      to have a higher syn population than the parent compound.

PMID- 8466678
TI  - Mutations induced by 1-nitrosopyrene and related compounds during DNA replication
      in human cells and induction of homologous recombination by these compounds.
AB  - The transformation of normal human cells into cancer cells is a multistep
      process. Evidence suggests that a minimum of five independent steps (changes) are
      required for the development of certain kinds of human cancer, as well as for
      malignant transformation of human cells in culture. Mutations are one of the
      mechanisms involved in bringing about such changes. A single DNA base
      substitution mutation can activate an oncogene or inactivate a tumor suppressor
      gene. Because the action of tumor suppressor genes is to prevent cells from
      becoming malignant, the activity of both copies of such genes must be eliminated
      before suppression is lifted. Homologous mitotic recombination between a mutant
      tumor suppressor gene allele and its non-mutant allele is one mechanism for
      accomplishing this. The present study was designed to investigate the mechanisms
      by which certain carcinogenic compounds found in diesel exhaust particles and
      structurally-related N-substituted aryl carcinogens induce such base substitution
      mutations and homologous recombination events in mammalian cells in culture,
      including human cells. The system we employed to determine rapidly the kinds of
      mutations induced by these compounds, as well as the location of the point
      mutations in the target gene, involved a circular DNA molecule (plasmid) carrying
      a small target gene, supF. The target gene was exposed in vitro to radiolabeled
      compounds and then was allowed to replicate in human cells where the mutations
      were formed. The sites of mutation induction were compared with the sites of
      stable binding of the carcinogens to the DNA (adducts). The system used to
      determine whether these agents could induce homologous recombination consisted of
      a thymidine kinase-deficient mouse L cell line with a recombination substrate
      stably integrated into the genome. To determine whether or not excision repair
      was involved in the mechanism by which carcinogens induced recombination, the
      recombination substrate was introduced into an excision repair-proficient human
      cell line and two repair-deficient human cell lines. These cell lines were then
      compared for the frequency of recombination induced by the agents. All four N
      substituted aryl compounds tested in the supF mutagenesis assay produced mainly
      base substitutions involving guanosine-cytosine (G.C)* base pairs, primarily G.C-
      >thymidine-adenine (T.A) transversions. However, 1,6-dinitropyrene adducts,
      formed by exposing the plasmids to 1-nitro-6-nitrosopyrene in the presence of a
      reducing agent, also induced a significant proportion (17%) of single G.C base
      pair deletions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8466679
TI  - The safety of Bacille Calmette-Guerin vaccination in HIV infection and AIDS.

PMID- 8466680
TI  - HIV wasting syndrome in the United States.
AB  - OBJECTIVE: To describe the characteristics of individuals > or = 13 years of age
      with HIV wasting syndrome in the United States and US territories. DESIGN:
      Retrospective review of national AIDS case surveillance data. METHODS: Data for
      the 147,225 individuals with AIDS reported to the Centers for Disease Control
      from 1 September 1987 to 31 August 1991 were reviewed. The frequency of HIV
      wasting syndrome and its association with demographic and exposure category
      variables and with other AIDS-indicator diseases were assessed. RESULTS: A total
      of 10,525 (7.1%) had wasting syndrome as the only AIDS-indicator condition, and
      15,726 (10.7%) had wasting syndrome plus at least one other AIDS-indicator
      condition. Patients with wasting syndrome as the only AIDS diagnosis were more
      likely to be female, to be black or Hispanic, and to have a mode of HIV exposure
      reported as injecting drug use, heterosexual contact, or transfusion/hemophilia.
      The proportion of AIDS patients reported with wasting syndrome varied by
      geographic distribution, ranging from 11% in the northeastern United States to
      47% in Puerto Rico. The association between HIV wasting syndrome and Hispanic
      ethnicity was due to the much higher prevalence of wasting syndrome reported in
      Puerto Rican AIDS patients. The other AIDS-indicator conditions most strongly
      associated with wasting syndrome were isosporiasis, pulmonary candidiasis,
      esophageal candidiasis, HIV encephalopathy, chronic mucocutaneous herpes simplex,
      and coccidioidomycosis. CONCLUSIONS: The association between HIV wasting syndrome
      and injecting drug use, and the significant racial/ethnic and geographic
      differences in prevalence of this AIDS diagnosis may reflect differences in
      diagnostic and reporting practices and/or access to medical care.

PMID- 8466681
TI  - Clinical correlates of in vitro HIV-1 resistance ot zidovudine. Results of the
      Multicentre Canadian AZT Trial.
AB  - OBJECTIVE: To describe the rate of development of in vitro HIV resistance to
      zidovudine (ZDV) and its prognostic implications within the Multicentre Canadian
      AZT Trial (MCAT). METHODS: HIV-infected subjects in Centers for Disease Control
      (CDC) stages IIB, III and IVC-2 with CD4 cell counts > 270 x 10(6)/l were treated
      with ZDV as part of a dose-range study. Participating volunteers underwent
      prospective clinical and laboratory evaluations at regular intervals. Viral
      cultures and sensitivity testing were performed every 12 weeks in a predefined
      subset of 50 volunteers. An isolate was designated ZDV-resistant if it had a
      median inhibitory concentration (IC50) for ZDV at least 50-fold higher than that
      of virus isolated from the same subject before initiation of antiviral
      chemotherapy. The relationship between resistance and subsequent disease
      progression was studied using the Mantel and Byar method, for which, at each
      instance of disease progression, 2 x 2 tables classifying progression versus
      resistance status were constructed. The observed number of progressions was
      compared with that expected under the null hypothesis using Mantel-Haenszel
      methods adjusted for baseline CD4:CD8 ratio. RESULTS: The Kaplan-Meier estimate
      for the cumulative development of in vitro resistance was 64% [95% confidence
      interval (CI), 41-78] at 180 weeks. Baseline CD4:CD8 ratio was negatively
      associated (P = 0.10) with the subsequent development of resistance (proportional
      hazard, 0.44; 95% CI, 0.17-1.10). After adjusting for baseline CD4:CD8 ratio, the
      numbers of observed and expected progressions following the development of
      resistance were 15 and 7.6, respectively (P = 0.008). A similar relative risk of
      progression between resistant and non-resistant states was found in the two
      CD4:CD8 strata; observed and expected progressions were 4 and 2.3 and 11 and 5.2
      in the high and low CD4:CD8 strata, respectively. CONCLUSIONS: In vitro
      resistance to ZDV developed in 64% of subjects after 180 weeks of ZDV therapy.
      Lower CD4:CD8 ratio at baseline was associated with faster development of
      resistance. In addition, the development of resistance was found to be a marker
      of subsequent disease progression. This association persisted after adjustment
      for baseline CD4:CD8 ratio. Whether in vitro resistance to ZDV is merely a
      surrogate marker or a determinant of disease progression remains to be
      established.

PMID- 8466682
TI  - Comparison of two dose regimens of zidovudine in an open, randomized, multicentre
      study for severe HIV-related thrombocytopenia.
AB  - OBJECTIVE: To compare the effect of two dose regimens of zidovudine in the
      treatment of severe HIV-related thrombocytopenia (TP). DESIGN: Eighty-four
      patients with severe HIV-related TP and platelet counts < 50 x 10(9)/l were
      enrolled in an open study at six centres. Patients were randomized into two
      groups to receive zidovudine (group A, 500 mg per day; group B, 1000 mg per day)
      for 6 months. METHODS: Platelet counts were determined monthly and patients
      categorized as complete responders (CR; platelets > 100 x 10(9)/l), partial
      responders (PR; platelets > 50 to < 100 x 10(9)/l), or failures (F; platelets to
      < 50 x 10(9)/l). CD4+ and CD8+ lymphocytes, HIV antigenaemia, beta 2
      microglobulin, white blood cells, mean cell volume and haemoglobin were also
      determined. RESULTS: Seventy-one patients (35 and 36 in groups A and B,
      respectively) completed the study; 11.4% of group A patients were CR and 45.7%
      PR; 38.9% of group B were CR and 33.3% PR. Increase in mean platelet counts was
      dose-related, more rapid in the higher dose group and remained significantly
      higher after 6 months of treatment (56.4 x 10(9)/l in group A versus 98.2 x
      10(9)/l in group B; P < 0.01). CONCLUSIONS: The results confirm the efficacy of
      zidovudine in the treatment of severe HIV-related TP. The average for CR and PR
      in the two groups was 64.8%; the higher dose of zidovudine was more effective at
      increasing platelet counts.

PMID- 8466683
TI  - Intestinal parasites and HIV infection in Tanzanian children with chronic
      diarrhea.
AB  - OBJECTIVE: To determine whether specific intestinal parasites are associated with
      HIV infection in Tanzanian children with chronic diarrhea. DESIGN: A prospective,
      cross-sectional study. SETTING: Muhimbili University College of Health Sciences,
      Dar es Salaam, Tanzania. SUBJECTS: All children aged 15 months to 5 years
      admitted with chronic diarrhea, and age-matched controls. METHODS: Standardized
      history, physical examination, HIV serology, and stool parasitology were
      evaluated for all subjects. We compared three groups: HIV-infected and non-HIV
      infected children with chronic diarrhea and controls without diarrhea. MAIN
      OUTCOME MEASURES: Fecal parasites and nutritional status. RESULTS: Chronic
      diarrhea accounted for one-quarter of all cases of diarrheal disease in the
      defined age range, and children with chronic diarrhea were severely malnourished.
      Forty per cent of subjects with chronic diarrhea were HIV-seropositive. Although
      intestinal parasites were detected in approximately 50% of all three groups,
      diarrheagenic parasites were detected in up to 40% of children with chronic
      diarrhea. Blastocystis hominis was detected only in HIV-infected patients.
      CONCLUSIONS: HIV infection was common in children with chronic diarrhea, and
      parasitic agents of diarrhea may be important in children with chronic diarrhea
      both with and without HIV infection in this setting. B. hominis was more frequent
      in HIV-infected children. The immunocompromising effects of severe malnutrition
      may have diminished the difference between HIV-infected and non-HIV-infected
      children.

PMID- 8466684
TI  - Elevated plasma levels of vasoactive intestinal peptide in AIDS patients with
      refractory idiopathic diarrhoea. Effects of treatment with octreotide.
AB  - OBJECTIVE: To evaluate plasma levels of vasoactive intestinal peptide (VIP) in
      AIDS patients with refractory idiopathic diarrhoea, and to assess the role of
      treatment with octreotide. PATIENTS: Three AIDS patients were evaluated for
      severe watery diarrhoea of 2-6 months' duration, which was complicated by weight
      loss, weakness, and fluid and electrolyte abnormalities. They had not shown a
      significant response to several regimens of empirical antimicrobial chemotherapy,
      or symptomatic antidiarrhoeal treatment. METHODS: A complete diagnostic
      examination, including repeated microbiological evaluation and radiological,
      ultrasonographic, endoscopic and histological examination, was performed. Plasma
      levels of VIP were determined by radioimmunoassay and compared with
      concentrations in a group of healthy subjects. RESULTS: Since no clinically
      significant results were obtained from standard diagnostic evaluation and
      empirical therapeutical attempts, idiopathic refractory diarrhoea was diagnosed.
      Plasma concentrations of VIP were moderately elevated in all three subjects
      examined, with levels of 11.5, 17.5 and 9.5 pmol/l (values < 8.8 pmol/l in the
      control group). One patient received 50-100 micrograms octreotide three times
      daily subcutaneously for 6 months, resulting in complete resolution of diarrhoea
      and significant improvement in body weight and quality of life, together with a
      reduction in VIP concentration to within normal values. CONCLUSIONS: Although the
      somatostatin analogue octreotide has been used successfully in the management of
      both infectious and non-infectious AIDS-related diarrhoea, gastrointestinal
      neuroendocrine function and circulating humoral mediators of diarrhoea have not
      hitherto been investigated extensively in HIV-infected subjects. Our data on the
      association of idiopathic secretory diarrhoea and elevated plasma VIP levels
      provide a possible pathophysiological rationale for identifying AIDS patients
      whose refractory diarrhoea may be more responsive to octreotide treatment.

PMID- 8466685
TI  - Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral
      blood smears.
AB  - OBJECTIVE: To compare the clinical and laboratory features of visceral
      leishmaniasis (kala-azar) in HIV-infected and non-infected subjects, and to
      determine the presence of Leishmania amastigotes in circulating leukocytes using
      peripheral blood smears. PATIENTS: Twenty-eight HIV-infected and six HIV-negative
      adult patients diagnosed as having kala-azar presenting at one institution over a
      7-year period. METHODS: Retrospective review of clinical charts and re
      examination of peripheral blood smears. RESULTS: There were no significant
      differences in the clinical presentation and laboratory features of HIV-positive
      and HIV-negative patients. However, Leishmania amastigotes were observed in
      circulating leukocytes in eight out of the 17 available peripheral blood smears
      (15 from HIV-infected patients). All eight individuals presenting with Leishmania
      in peripheral blood leukocytes were HIV-positive. CONCLUSIONS: Direct
      visualization of Leishmania amastigotes in leukocytes on peripheral blood smears
      enabled the diagnosis of kala-azar in a high proportion [eight out of 15 (53%)]
      of our HIV-infected patients.

PMID- 8466686
TI  - The treatment-free incubation period of AIDS in a cohort of homosexual men.
AB  - OBJECTIVE: The treatment-free incubation period distribution was estimated from
      data obtained from a cohort of homo/bisexual men in Amsterdam. DESIGN:
      Participants in a cohort study that started in Amsterdam at the end of 1984 were
      seen at 3- or 6-monthly intervals. The analysis excluded time since the start of
      zidovudine treatment (given to 27 individuals) and no cohort member received
      primary Pneumocystis carinii pneumonia prophylaxis (i.e., before AIDS diagnosis)
      before February 1990. METHODS: Both HIV-positive (n = 269) and HIV-seroconverted
      (n = 79) homosexual men were included in this study. Of these, 68 developed AIDS
      before February 1990. The unobserved dates of seroconversion were obtained by
      multiple imputation. The incubation period distribution was estimated from these
      data by direct Kaplan-Meier analysis and by using parametric Weibull and gamma
      distributions (including a parameter describing the probability of never
      progressing to AIDS). Our results are compared with published estimates of
      progression to AIDS from other homo/bisexual cohort studies. RESULTS: Both the
      Weibull and the gamma distributions provide equally good empirical descriptions
      of the incubation period distribution for up to 7 years postseroconversion, but
      the estimated gamma distribution (median, 9.2; mean, 10.2; percentage AIDS at 7
      years, 33%) should be preferred beyond that time, due to a slowing of the hazard
      rate. There is insufficient information to be able to estimate accurately the
      probability of never progressing to AIDS. CONCLUSIONS: The time-dependent pattern
      of HIV incidence should be considered in the analysis of prevalent cohort
      studies. Our results are in agreement with other homo/bisexual cohort studies,
      and will be valuable for future comparison with and understanding of the
      epidemiological consequences of clinical treatment that delays the onset of AIDS.

PMID- 8466687
TI  - Three-year neuropsychological follow-up in a selected group of HIV-infected
      homosexual/bisexual men.
AB  - OBJECTIVE: To evaluate changes in cognition in a selected group of asymptomatic
      homosexual/bisexual men over a 3-year period. PATIENTS AND METHODS: Sixty HIV
      infected (Centers for Disease Control stage II) subjects and 60 controls
      (individually matched for age and years in education) were administered
      neuropsychological tests evaluating attention, language, memory, logic and visuo
      motor abilities. None of the patients had a history of alcohol or drug abuse, and
      all received the baseline cognitive evaluation within 18-24 months of
      seroconversion. RESULTS: The HIV-infected subjects differed from controls in only
      one of the six memory tests (P < 0.01). Follow-up evaluation after 18 and 36
      months (available for 51 and 36 subjects, respectively) demonstrated a
      significant deterioration in visuo-motor ability (P < 0.01) only in subjects who
      had progressed to AIDS, without signs or symptoms of central nervous system
      involvement. CONCLUSIONS: The data suggest that cognitive alterations in
      asymptomatic stages of HIV infection are in most subjects minor and do not
      develop. Percentage rates of CD4 lymphocyte decline appear to be significantly
      related to deterioration in visuo-motor abilities.

PMID- 8466688
TI  - Evaluation of a cognitive-behavioural intervention for HIV prevention among
      injecting drug users.
AB  - OBJECTIVE: To evaluate the effectiveness of relapse prevention (RP) and brief
      intervention (BI) in reducing HIV risk-taking behaviours among injecting drug
      users (IDU) enrolled in methadone programmes. The hypotheses tested were: (1)
      that a six-session RP programme would be more effective in reducing HIV risk
      taking behaviours than a one-session BI and a non-intervention control condition
      (C); and (2) that BI would be more effective in reducing HIV risk-taking
      behaviours than C. DESIGN: Clients of methadone programmes were randomly assigned
      to either RP, BI, or C. Follow-up occurred 6 months after pre-intervention
      assessment and was conducted by independent research assistants who were not
      aware of subjects' group allocations. SETTING: Confidential assessment interviews
      and interventions generally took place at the methadone unit treating the
      subject. PARTICIPANTS: Ninety-five IDU enrolled in methadone programmes. Study
      entry criteria were: injection of any drug in the 6 months before the day of pre
      intervention assessment; literacy in English; agreement to HIV-antibody testing
      for research purposes; and no known diagnosis of a serious mental illness. Eighty
      subjects were contacted successfully for a 6-month follow-up. INTERVENTIONS: The
      RP intervention was a six-session programme. Each 60-90 min session was conducted
      individually. The BI was a one-session motivational interview lasting 60-90 min,
      accompanied by a self-help booklet. MAIN OUTCOME MEASURES: All subjects were
      administered the Drug Use Scale and HIV Risk-Taking Behaviour Scale of the Opiate
      Treatment Index and consented to the collection of a capillary blood sample for
      HIV-antibody testing at pre-intervention assessment and follow-up. At follow-up,
      the Highest HIV Risk-Taking Behaviour Scale, collateral reports from subjects'
      sexual partners pertaining to the previous month and urinalysis results for the
      month before follow-up were collected. RESULTS: Compliance with interventions was
      good. Correspondence of self-reports with urinalysis and collateral reports was
      satisfactory. There were no significant differences between groups in risk-taking
      behaviours during the month before follow-up. However, there was evidence of a
      lower rate of needle-risk behaviour (sharing and cleaning) during the heaviest
      risk-taking month since pre-intervention assessment in the group given RP. There
      were no indications that BI was of greater benefit than the usual methadone
      treatment and neither intervention appeared to reduce sexual risk behaviour.
      CONCLUSIONS: The results are cautiously interpreted as showing that individual RP
      programmes decrease the level of needle-risk behaviour during relapse episodes,
      but further research is required to replicate this finding.

PMID- 8466689
TI  - Sustaining safe sex: a longitudinal study of a sample of homosexual men.
AB  - OBJECTIVE: TO assess the maintenance of safe sexual practice. (We use the term
      'safe' sex throughout the paper, since 'safe' is the term adopted by the
      Australian National Committee on AIDS). DESIGN: Maintenance was assessed by
      comparing sexual behaviour with both regular and casual partners reported in a
      1986/1987 survey (time 1) with behaviour reported in a second survey in 1991
      (time 2). METHOD: The 145 homosexually active participants were a non-clinical
      sample recruited in 1986/1987 by advertisement and followed-up in 1991. A
      structured questionnaire was administered at both times. Items included questions
      about the nature of the men's sexual relationships and their sexual practices.
      RESULTS: Our findings indicate that the majority of men had sustained safe sex
      practices. HIV prevention strategies adopted included condom use, avoidance of
      anal intercourse and negotiated safety (i.e., the negotiated practice of
      unprotected anal intercourse within regular partnerships of concordant
      serostatus). CONCLUSIONS: Negotiated safety is not the same as relapse.

PMID- 8466690
TI  - The effectiveness of condom use in heterosexual prostitution in The Netherlands.
AB  - OBJECTIVES: To assess the extent to which condoms are used effectively in
      commercial heterosexual intercourse. Data on the number of condoms that had
      broken or slipped off, the sexual technique during which this had occurred and
      the perceived cause of failure were collected. The use of non-water-soluble
      lubricants and non-fortified condoms during anal intercourse, and the demand for
      a greater variety of condom sizes were also examined. SUBJECTS AND METHODS: One
      hundred and twenty-seven female prostitutes and 91 male clients from different
      parts of The Netherlands were interviewed face-to-face between July 1990 and
      March 1991. RESULTS: Of those who used condoms during vaginal intercourse, 49% of
      the prostitutes had experienced condom breakage in the previous 6 months, and 16%
      of the clients in the previous 12 months. The breakage rate was 0.8% for
      prostitutes and 1.5% for clients. Condom quality was seldom reported as the
      cause; breakage was generally attributed to human factors, such as rough or
      prolonged intercourse, incorrect handling of the condom or the use of
      insufficient lubricant. Prostitutes also identified penis size as a cause.
      Condoms slipping off before or after ejaculation was reported less frequently
      than breakage. Thirteen per cent of clients and 36% of prostitutes expressed a
      need for either smaller or larger condoms. Of the prostitutes, 9% used oil or
      vaseline as a lubricant. CONCLUSIONS: In view of the low rate of condom failure
      in heterosexual prostitution in The Netherlands, the potential spread of HIV by
      this means is small. The use of a greater variety of condom sizes may further
      reduce the failure rate. Few prostitutes remain ignorant about the adverse
      effects of oil-based lubricants on condoms.

PMID- 8466691
TI  - The effects of post-test counselling on condom use among prostitutes in The
      Gambia.
AB  - OBJECTIVES: To determine the effect of counselling on condom use by prostitutes.
      DESIGN: Cohort study. SETTING: Field-based study in The Gambia. PARTICIPANTS:
      Thirty-one (12 HIV-positive and 19 HIV-negative) prostitutes. INTERVENTIONS: Post
      test HIV counselling. MAIN OUTCOME MEASURES: Levels of condom use. RESULTS:
      Overall, counselling had no effect on condom use. CONCLUSIONS: Scarce resources
      should be directed towards providing condoms in bars rather than counselling.

PMID- 8466692
TI  - Estimating the seroincidence of HIV-1 in the general adult population in Kigali,
      Rwanda.
AB  - OBJECTIVE: To estimate the seroincidence of HIV-1 infection in the general adult
      population of Kigali, Rwanda. DESIGN: Repeated standardized cross-sectional
      studies. SETTING: Two urban prenatal clinics. PATIENTS: A total of 4486
      consecutive pregnant women consulting in 1989 and 1990. MAIN OUTCOME MEASURES:
      Prevalence of HIV-1 antibodies. RESULTS: HIV seropositivity increased by 3-5%
      annually over this period, indicating that it has not reached a plateau in this
      sentinel population. The percentage infection rates, calculated using two
      complementary methods, were 26.2-30.7% in 1990. Extrapolating these results to
      the general population of Kigali, we estimate that 2300-3800 new infections in
      young women and 3600-6100 new infections in young men occur annually among the
      total population of 350,000 in Kigali. CONCLUSIONS: A new HIV infection occurred
      in an adult every 50-90 min, on average, in Kigali during 1989-1990, while every
      6-7 h a baby with maternally acquired HIV infection was born. Our HIV
      surveillance system, which is based on prenatal sentinel posts, is a useful tool
      for monitoring the progression of the HIV epidemic in Kigali.

PMID- 8466693
TI  - Safer sex maintenance among gay men: are we moving in the right direction?

PMID- 8466694
TI  - Safer sex among gay men: what is the ultimate goal?

PMID- 8466695
TI  - HIV seropositivity of blood donations in Spain: a 4-year surveillance (1988
      1991). The HIV Blood Donations Study Group.

PMID- 8466696
TI  - Concurrent partners and the results of the Uganda Rakai project.

PMID- 8466697
TI  - Recurrent Kawasaki disease associated with co-infection with parvovirus B19 and
      HIV-1.

PMID- 8466698
TI  - Zidovudine-responsive pure red cell aplasia as initial manifestation of HIV
      infection.

PMID- 8466699
TI  - Antibodies to natural killer cells in HIV-infected patients.

PMID- 8466700
TI  - Spermicides: anti-HIV activity and cytotoxicity in vitro.

PMID- 8466701
TI  - Survival of HIV-infected Brazilians: a model based on the World Health
      Organization staging system.

PMID- 8466702
TI  - Statistics from the World Health Organization.

PMID- 8466703
TI  - A comparison of two tests for the assessment of blood pressure responses to
      sodium.
AB  - In order to assess the congruity of two different methods for the
      characterization of blood pressure responsivity to alterations in sodium and
      extracellular fluid volume balance, we studied 40 normotensive and hypertensive
      humans. All subjects were initially studied with a protocol of rapid sodium and
      volume expansion induced by intravenous administration of 0.9% saline (2 L over 4
      h) followed by a day of sodium and volume depletion achieved by a low (10 mmol)
      sodium diet and three 40 mg oral doses of furosemide. Subsequently the subjects
      underwent a dietary protocol consisting of 5 days of a high (> or = 200 mmol/da)
      sodium diet followed by 7 days of a low (< or = 15 mmol/day) sodium diet. Blood
      pressure measurements as well as urinary sodium, potassium, and creatinine
      excretion measurements were made daily in both studies. A significant (P < .01)
      correlation was observed between the blood pressure responses to the separate
      techniques in the same individual. However, not all subjects responded in a
      similar qualitative fashion to the two maneuvers. The discrepancy was more
      frequent among subjects having a salt-resistant response to the rapid protocol.
      The renin response to sodium and volume depletion induced by the low sodium diet
      and furosemide correlated significantly (P < .001) with the subsequent blood
      pressure response to the low sodium diet. Subjects defined as salt-sensitive
      differed from the salt-resistant group by more sluggish renal adaptation to
      dietary sodium restriction. These findings demonstrate the congruity of two
      different approaches for the assessment of salt responsivity of blood pressure in
      humans.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466704
TI  - Nephrosclerosis in three cohorts of black and white men born 1925 to 1944, 1934
      to 1953, and 1943 to 1962.
AB  - The prevailing levels of blood pressure among black and white men of ages 25 to
      54 years were examined by two independent approaches in this study. Data on blood
      pressure obtained in national health surveys (National Health and Nutrition
      Examination Surveys, NHANES) do not show any appreciable upward or downward trend
      between 1960 and 1980 in men of these ages. The histologic examination of kidney
      samples obtained from coroner's autopsies offers an indirect way of estimating
      the levels of blood pressure that prevail in populations because of statistical
      relationships between nephrosclerosis and blood pressure. Samples of kidney
      tissues archived in New Orleans from 1968 to 1986 were evaluated by quantitative
      morphometry for the severity of the renovasculopathies that accompany high blood
      pressure. The outcome showed no significant secular trend among black and white
      men, confirming blood pressure survey findings that show no change in the
      hypertensive status of the population. The black-white difference in incipient
      signs of hypertension was seen to be well-established by ages 25 to 34 years in
      all cohorts of New Orleans subjects, as well as in the NHANES survey data. These
      result suggest that the adolescent and young adult ages are especially important
      in establishing the black-white difference in hypertension.

PMID- 8466705
TI  - Verapamil prevents the acute hypertensive response to intracerebroventricular
      cadmium in conscious normotensive rats.
AB  - Cadmium, a trace element from natural and industrial sources, may contribute to
      the pathogenesis of arterial hypertension. We evaluated the effect induced by
      acute intracerebroventricular (icv) administration of cadmium on mean blood
      pressure of normotensive conscious rats. Intracerebroventricular cadmium (1 to 10
      micrograms) produced a dose-dependent, sustained increase in mean blood pressure.
      The hypertensive response to icv cadmium was significantly (P < .01) prevented by
      icv pretreatment with verapamil (10 to 100 micrograms). A preventive effect was
      exerted also by icv nifedipine (100 micrograms); however, this result was
      attributable, at least in part, to the antihypertensive action of the vehicle,
      polyethylene glycol. The hypertensive response to icv cadmium was blunted by icv
      administration of 10 ng clonidine, 10 micrograms vasopressin antagonist, or 10
      micrograms bradykinin antagonist (P < .05), but it was not altered by icv
      enalaprilat (100 micrograms). These results indicate that brain calcium channels
      play a role in the hypertensive action induced by icv cadmium. Accumulation of
      cadmium in the brain caused by prolonged exposure to this heavy metal might lead
      to chronic arterial hypertension.

PMID- 8466706
TI  - Evaluation of orthostatic hypotension using power spectral analysis.
AB  - To evaluate the pathogenesis of orthostatic hypotension, we studied the autonomic
      regulation system by measuring heart rate variability during 60 degrees passive
      head-up tilt using power spectral analysis in 21 patients with orthostatic
      hypotension (mean age 62 +/- 2 years, five with histories of cerebrovascular
      accidents, five with Parkinsonism, five with diabetes mellitus, three with
      pheochromocytoma, and three with unknown causes) and 15 normal healthy subjects
      as a control (mean age 63 +/- 2 years). We also assessed plasma epinephrine and
      norepinephrine response to tilt. During tilt, control subjects showed an increase
      in heart rate with no change in blood pressure. Spectral analysis of heart rate
      variability demonstrated increases in the low frequency band (LFB, mainly
      sympathetic) and low frequency band/high frequency band ratio (LFB/HFB, sympatho
      vagal balance). All patients with orthostatic hypotension showed a significant
      reduction in blood pressure with an increase in heart rate. In patients with
      histories of cerebrovascular accidents and with Parkinsonism, LFB and the LFB/HFB
      ratio did not increase. However, in other patients with orthostatic hypotension,
      LFB and the LFB/HFB ratio increased during tilt. Norepinephrine increased in
      control subjects and in patients with diabetes mellitus, pheochromocytoma, and
      unknown causes. In contrast, patients with histories of cerebrovascular accidents
      and patients with Parkinsonism showed no increase in norepinephrine. Epinephrine
      responses paralleled those of norepinephrine, but the changes were not
      significant. Thus, neurological response to tilt is not uniform in patients with
      orthostatic hypotension. Patients with histories of cerebrovascular accidents and
      patients with Parkinsonism may have impaired function of central neural
      mechanisms controlling blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466707
TI  - Effect of antihypertensive treatment on daytime and nighttime power spectral
      analysis of heart rate.
AB  - Power spectral analysis of heart rate may provide useful information about
      cardiac neural activity. The aim of this study was to evaluate cardiac
      sympathetic and parasympathetic activity, as assessed by power spectral analysis
      of heart rate, in hypertensive patients before and after antihypertensive
      treatment. In 14 hypertensive patients and in 7 normotensive subjects 24 h Holter
      electrocardiogram monitoring was performed under basal conditions and after 6
      months of treatment with nifedipine (n = 7) or enalapril (n = 7). Sequences of
      512 RR intervals were taken for the evaluation of power spectral analysis
      (autoregressive method); absolute and normalized power spectral density of the
      peak at 0.10 Hz (low frequency peak: LF) and at 0.25 Hz (high frequency peak:
      HF), as well as their ratio (index of sympatovagal interaction: SVI) were
      calculated. Under basal conditions SVI was significantly decreased from daytime
      to nighttime in normotensives, while no change was observed in hypertensive
      patients. In all hypertensive patients a reduction of SVI during nighttime in
      respect to basal values was observed after treatment. SVI during nighttime was
      significantly reduced with both nifedipine and enalapril, while SVI during
      daytime was slightly increased during nifedipine treatment, and significantly
      reduced during enalapril treatment. Systolic and diastolic arterial pressure as
      well as left ventricular mass index were significantly reduced with both
      treatments. In conclusion, long term treatment with nifedipine or enalapril seems
      to be able to restore an impaired daytime to nighttime SVI modulation in
      hypertensive patients, even considering the potential limitations of power
      spectral analysis of heart rate.

PMID- 8466708
TI  - Determinants of platelet intracellular free calcium in essential hypertension and
      effect of stimulation by arginine vasopressin.
AB  - The aim of this study was to determine platelet intracellular free calcium with
      respect to age, sex, race, and agonist stimulation in patients with essential
      hypertension compared with normotensive subjects. Intracellular free calcium was
      measured, using Fura-2-AM, in 42 normotensive and 52 patients with untreated
      essential hypertension. Of these, 22 pairs were age, sex, and race matched. The
      intracellular free calcium response to agonist stimulation was measured in the
      presence of 1 mumol/L arginine vasopressin (AVP). Intracellular calcium was
      significantly raised in patients with hypertension in both the matched and
      unmatched groups with values (means +/- SEM) in the matched group of 68.4 +/- 2.6
      nmol/L for the hypertensives and 60.2 +/- 2.1 nmol/L for the normotensives (n =
      22; P < or = .02) and in the unmatched group of 63.3 +/- 1.8 nmol/L (n = 52) and
      57.6 +/- 1.4 nmol/L (n = 42, P < or = .02), respectively. There was no sex
      difference but intracellular calcium was significantly lower in black
      hypertensives compared with white hypertensives (P < .005). A significant
      correlation with blood pressure was only observed in the combined normotensive
      and hypertensive group (r = 0.23; P = .030). There was no significant correlation
      with age in any group (even when excluding the black individuals), but in the
      hypertensive group there was a significant correlation with serum cholesterol (r
      = 0.34, P = .02; n = 46).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466709
TI  - Increased inositol 1,4,5-trisphosphate binding capacity in vascular smooth muscle
      of spontaneously hypertensive rats.
AB  - High intracellular levels of free calcium (Ca2+) are found in cells of
      hypertensive patients, and these levels have been correlated with increased blood
      pressure. In the present study, we characterized inositol 1,4,5-trisphosphate
      (InsP3) receptors in aorta and heart microsomes of Long-Evans rats. We also
      studied this receptor in some organs of spontaneously hypertensive rats (SHR) to
      clarify the role this important component of the mechanism of Ca2+ regulation has
      in hypertension. Microsomal fractions were prepared from aorta, heart, adrenal
      cortex (organs directly involved in the regulation of blood pressure), and
      cerebellum (control organ, not directly involved) of 14-week-old SHR and Wistar
      Kyoto (WKY) rats. InsP3, receptors were studied in each microsomal fraction by a
      radioligand binding method with [3H]InsP3. The properties of InsP3 binding sites
      in each tissue were consistent with those of well-characterized InsP3 receptors:
      1) InsP3 binding was specific and saturable, 2) InsP3 binding increased upon pH
      elevation, 3) InsP3 binding was inhibited by heparin, and 4) InsP3 had a higher
      binding affinity than InsP4. No significant difference of binding affinity or of
      maximal binding capacity between WKY and SHR was observed in microsomes from
      heart, adrenal cortex, and cerebellum. It is interesting that InsP3 binding
      capacity of SHR aorta microsomes was significantly higher (1.6 fold) than that of
      WKY aorta microsomes. These results suggest that increased InsP3 receptor
      activity in vascular smooth muscle of SHR may contribute to the elevation of
      blood pressure. Further studies are needed to assess the significance of this
      observation as regards the mobilization of intracellular Ca2+.

PMID- 8466710
TI  - Environmental determinants of urinary kallikrein excretion.
AB  - Decreased urinary kallikrein excretion has been shown to be related to
      hypertension. Kallikrein levels also have been shown to be determined primarily
      by genes, with 51% of the total variance being due to a single gene. However,
      there exists strong spouse-spouse correlation, indicating that common environment
      plays a significant role. This study used 69 pairs of monozygous twins to
      investigate possible dietary, biochemical, and anthropometric determinants of
      kallikrein that could result in this high spouse correlation. Urinary sodium and
      potassium excretion differences were significantly related to kallikrein
      differences, with urinary potassium having the strongest relationship (r = 0.46,
      P = .0001). Urinary pH (r = 0.23, P = .03) and systolic blood pressure (r = 
      0.25, P = .03) differences were associated with urinary kallikrein excretion
      differences independently of urinary potassium. Information on nutrients was
      obtained from a dietary food frequency questionnaire that ascertains usual intake
      over the last 5 years. Kallikrein differences between monozygous twins were not
      explained by differences in nutrient intake as measured by this questionnaire.
      Therefore, urinary potassium and pH probably represent the more acute effects of
      recent dietary sodium and potassium intake on urinary kallikrein levels. Urinary
      potassium, pH, and systolic blood pressure differences explained 34% of the
      difference in kallikrein levels between monozygous twins. The significant
      difference in systolic blood pressure between twins, even after controlling for
      electrolyte excretion differences suggests an additional unmeasured environmental
      variable that is associated with decreased kallikrein excretion and elevated
      blood pressure.

PMID- 8466711
TI  - Chronic parathyroid hormone administration reverses the antihypertensive effect
      of calcium loading in young spontaneously hypertensive rats.
AB  - To investigate the role of parathyroid hormone (PTH) in the development of
      hypertension, the long-term administration of human PTH (hPTH) was performed in 7
      week-old male spontaneously hypertensive rats maintained on a standard calcium
      diet (1.1% calcium) or a high calcium diet (2.8% calcium). The hPTH was infused
      subcutaneously at 0.9 U/h over 2 weeks using a minipump. Two weeks after minipump
      implantation, rat PTH (rPTH) and 1,25-dihydroxy vitamin D (1,25-D) levels were
      measured and the pressor response to norepinephrine (NE) was examined. Calcium
      loading both attenuated the development of hypertension and reduced the pressor
      response to norepinephrine. Chronic hPTH administration accelerated the
      development of hypertension and increased the pressor response to norepinephrine
      in rats fed a high calcium diet, but did not affect either parameter in rats fed
      a standard calcium diet. The serum concentrations of rat PTH and 1,25-D were
      significantly lower in rats fed a high calcium diet than in those fed a standard
      calcium diet (rat PTH: 351 +/- 16 v 430 +/- 1 pmol/L; 1,25-D: 125 +/- 19 v 206 +/
      31 pg/mL). Chronic administration of hPTH increased the serum 1,25-D
      concentration in rats fed a high calcium diet (186 +/- 35 pg/mL), but did not
      affect that of rats fed a standard calcium diet (165 +/- 16 pg/mL). It is
      concluded that PTH prevented the antihypertensive effect of calcium loading in
      young SHR, perhaps by enhancing blood pressure reactivity through causing an
      increase of 1,25-D.

PMID- 8466712
TI  - Involvement of nitric oxide in the blastogenic response deficiency in splenocytes
      from spontaneously hypertensive rats.
AB  - It has been shown that spontaneously hypertensive rats (SHR) exhibit some
      abnormalities in their immune system. These include a reduced delayed
      hypersensitivity response, a reduction in the number of rosette-forming cells and
      a decreased lymphocyte blastogenic response. In this study, we further
      investigated the blastogenic responses of splenocytes, thymocytes, and T-enriched
      lymphocytes from SHR. In SHR splenocytes, the blastogenic responses to
      concanavalin A (Con A), phytohemagglutinin (PHA), interleukin-2 (IL-2), and
      phorbol 12,13-dibutyrate (PDB) plus ionomycin were significantly reduced compared
      with those from Wistar-Kyoto rats (WKY). In SHR thymocytes and T-enriched
      lymphocytes, the blastogenic responses to these activators were the same as in
      WKY rats. The IL-2 production by SHR splenocytes was similar to that of WKY. To
      elucidate the possible mechanism responsible for the blastogenic defects in SHR
      splenocytes, the involvement of the nitric oxide (NO) synthetic pathway was
      studied. The inhibition of NO synthesis by NG-monomethyl-L-arginine (L-NMMA)
      corrected the defect in SHR splenocytes. L-NMMA had no effect on the splenocytes,
      thymocytes, or macrophage-depleted splenocytes from WKY or on thymocytes or
      macrophage-depleted splenocytes from SHR. The removal of macrophages from SHR
      splenocytes also corrected the blastogenic defect in these cells. Furthermore,
      the NO synthesis in Con A stimulated SHR splenocyte culture medium was
      statistically significantly higher than that in WKY. These results suggested that
      overproduction of nitric oxide by SHR macrophages may be responsible for the SHR
      splenocyte blastogenic defect.

PMID- 8466713
TI  - A new approach for evaluating circadian blood pressure levels and variability
      from 24 h ambulatory blood pressure profiles.
AB  - In 24 h blood pressure monitoring the severity of arterial hypertension is
      generally classified on the basis of the arithmetic mean of the diastolic blood
      pressure between 6 AM and 10 PM. In the present study Fourier analysis was used
      for evaluation of circadian blood pressure level and variability. A common
      reference profile was calculated on the basis of a group of 50 normotensive
      profiles. This reference profile is characterized by the fact that the sum of the
      squares of the distances between the individual profiles and the reference
      profile is a minimum. The individual 24 h profiles of 103 patients with untreated
      arterial hypertension were also each described by a Fourier series and were then
      compared with the normotensive reference profile. The comparison was made not
      only with respect to the absolute pressure over 24 h but also with respect to the
      circadian fluctuations in blood pressure. Our results show that the Fourier
      analysis of 24 h blood pressure profiles presented here can be used for more
      precise evaluation of 24 h blood pressure profiles.

PMID- 8466714
TI  - Short- and long-term goals in the treatment of hypertension. Symposium
      proceedings. Madrid.

PMID- 8466715
TI  - Effects of isradipine and nifedipine retard in hypertensive patients with type II
      diabetes mellitus.
AB  - Twenty patients were randomized to receive either 2.5 mg isradipine twice daily
      or 20 mg nifedipine retard once daily for 6 months. After 2 weeks of placebo wash
      out, evaluations were carried out every 4 weeks. These evaluations included
      assessment of blood pressure, lipid profile, hemoglobin A1 sigma glucagon, C
      peptide, and insulin requirements. Both isradipine and nifedipine retard lowered
      systolic and diastolic blood pressures to normal values (P < .001). However,
      isradipine was accompanied by a decrease in heart rate (P < .005). Neither drug
      modified hemoglobin A1c or the glycemic profile. The endogenous insulin-secretion
      response decreased in both treatment groups (P < .05). In conclusion, isradipine
      and nifedipine retard are efficacious in the treatment of hypertension in
      patients with type II diabetes mellitus, and neither treatment produces
      modification of metabolic control.

PMID- 8466716
TI  - Antihypertensive efficacy, safety, and tolerability of isradipine in hypertensive
      patients with diabetes.
AB  - The aim of this study was to investigate the efficacy, tolerability, and safety
      of isradipine in hypertensive diabetic patients. Twenty-eight patients (14 men
      and 14 women), of whom 15 had type II (non-insulin-dependent) and 13 had type I
      (insulin-dependent) diabetes mellitus, received isradipine for 6 months. A
      significant reduction was observed in both systolic and diastolic blood pressures
      (P < .00005). There were no significant differences between the type I and type
      II diabetes patients; metabolic control remained stable. Moderate or slight
      headaches were reported by four patients. In conclusion, the overall efficacy of
      isradipine and its tolerability were found to be very good.

PMID- 8466717
TI  - Antihypertensive effect of the calcium antagonist isradipine and lipid profile.
AB  - The hypothesis that plasma lipids may modulate the antihypertensive effect of the
      calcium antagonist isradipine was tested in 85 patients who had essential
      hypertension. Significant linear correlations were found between the
      antihypertensive effect of isradipine and plasma levels of total cholesterol and
      high-density lipoprotein (HDL2 or HDL3) in normotriglyceridemic (n = 63), but not
      in hypertriglyceridemic (n = 22), patients. From this, we conclude that normal
      levels of plasma lipids may modulate the function of calcium channels and their
      interaction with calcium antagonists.

PMID- 8466718
TI  - Transplacental passage of isradipine in the treatment of pregnancy-induced
      hypertension.
AB  - The aim of this study was to assess the concentration of isradipine in maternal
      and fetal plasma, and in amniotic fluid under steady-state conditions. Eight
      women were treated with 5-mg isradipine tablets twice daily and eight women were
      given slow-release isradipine capsules (SRO) twice daily for hypertension in
      pregnancy. Blood and amniotic fluid sampling for analysis of drug concentration
      was performed at delivery. In the isradipine tablet group, maternal and fetal
      plasma levels were 788 +/- 701 pg/mL (mean +/- SD) and 270 +/- 90 pg/mL,
      respectively. The corresponding levels in the SRO-treated group were 463 +/- 217
      pg/mL and 185 +/- 95 pg/mL, respectively. In the amniotic fluid, the
      concentration was 74 +/- 42 pg/mL in the tablet group and 45 +/- 14 pg/mL in the
      SRO group. Therefore, isradipine passes the placental barrier, but its
      concentration is considerably lower in the fetal compartments.

PMID- 8466719
TI  - Parenteral isradipine reduces blood pressure in hypertensive crisis.
AB  - The efficacy and tolerability of an infusion of isradipine, a calcium antagonist
      of the dihydropyridine type, were tested in patients in hypertensive crisis. Ten
      patients with symptomatic and significant elevations in blood pressure were
      infused for 12 h with isradipine at 1.2, 2.4, 4.8, and 7.2 micrograms/kg/h (3 h
      of each infusion level). No untoward effects or adverse reactions were noted. No
      alterations were observed on electrocardiographic tracings, and blood pressure
      was significantly reduced only at doses of 7.2 micrograms/kg/h. Thus, isradipine
      as an infusion is useful and safe for hypertensive crisis, starting at a rate of
      7.2 micrograms/kg/h. Higher doses may yet prove to be safe, well tolerated, and
      even more efficacious.

PMID- 8466721
TI  - Short- and long-term perspectives of antihypertensive therapy. An introduction.
AB  - Randomized trials of antihypertensive therapy are relatively short in duration (3
      to 5 years) and, when based on monitoring of the mortal and morbid events
      occurring during this period of time, represent short-term perspectives of
      antihypertensive therapy. In cases of mild-to-moderate hypertension, however, the
      goal of antihypertensive therapy is not the prevention of impending events but,
      rather, the avoidance or retardation of cardiovascular lesions. These long-term
      perspectives can only be explored by randomized trials that monitor surrogate
      endpoints (for example, left ventricular hypertrophy or atherosclerotic plaque
      development). In the future, more and more antihypertensive drugs will be tested
      to assess their ability to interfere with both cardiovascular disease and
      cardiovascular events.

PMID- 8466720
TI  - Left ventricular function and regression of left ventricular hypertrophy in
      essential hypertension.
AB  - Although left ventricular hypertrophy (LVH) is an adaptive response to the
      increased load imposed on the heart in patients with hypertension, it ultimately
      is itself a major risk factor for cardiovascular disease. The influence of LVH on
      left ventricular function and on the coronary circulation, and the occurrence of
      serious ventricular arrhythmias are the major mechanisms of this increased risk.
      There is no doubt that regression of LVH occurs, but there are clear differences
      in this respect among antihypertensive drugs: angiotensin-converting enzyme (ACE)
      inhibitors and calcium antagonists produce the best response. Whether regression
      of LVH also causes an improvement in left ventricular function is unclear;
      various studies using the same drugs have yielded contradictory results.
      Furthermore, it has yet to be determined whether regression of LVH has a positive
      influence on the long-term prognosis in such patients; the results of the
      European Multicenter Study OvA will help in shedding more light on this important
      question.

PMID- 8466722
TI  - Hemodynamic changes in elderly hypertensive patients.
AB  - Hypertension in the elderly is characterized by a disproportionate increase of
      systolic blood pressure over diastolic blood pressure. Subsequently, in this
      category of patients, the increase in pulse pressure predominates over the
      increase in mean arterial pressure, thus highlighting the role of arterial
      changes in this pattern of hemodynamics. In the presence of normal or reduced
      cardiac function, the disproportionate increase in systolic pressure is the
      result of a combination of increases of both arterial stiffness and wave
      reflections. The former is primarily due to central aortic structural changes
      with a small contribution by modifications of the smooth muscle tone of the
      central large arteries. The latter is secondary to the geometric modifications of
      the arterial system associated with age that are responsible for the increase in
      wave reflections within the thoracic aorta as a consequence of increases in pulse
      wave velocity and in reflection points closer to the heart.

PMID- 8466723
TI  - Calcium antagonists and atherosclerosis. The Multicenter Isradipine/Diuretic
      Atherosclerosis Study.
AB  - The Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) is a double
      blind, randomized, controlled clinical trial comparing the effects of isradipine
      and hydrochlorothiazide on the progression or regression of early carotid
      atherosclerosis in 883 hypertensive patients. Assessment of the outcome is by B
      mode ultrasonographic measurement of early lesions (as reflected by intimal
      medial wall thickening) at baseline and semiannually over 36 months. At baseline,
      the participants' mean age was 58.5 years. The study population was 78.6% male
      and 72.4% white. The average resting systolic and diastolic blood pressures were
      149.8 and 96.5 mm Hg, respectively. Mean total serum cholesterol and low-density
      lipoprotein (LDL)-cholesterol levels were 216.2 mg/dL and 146.6 mg/dL,
      respectively. Risk factors for coronary artery disease were balanced at baseline
      between the two study groups. The mean maximum intimal-medial thickness at
      baseline (measured in the near and far walls of three segments for both carotid
      arteries) was 1.17 +/- 0.20 mm; the mean intimal-medial thickness of the single
      thickest lesion was 2.11 +/- 0.51 mm. Cross-sectional analyses show that intimal
      medial thickness correlates independently with male gender, age, number of
      cigarettes smoked per day, levels of LDL cholesterol, systolic blood pressure,
      and white blood cell count. The MIDAS endpoint results will be available in 1993.

PMID- 8466724
TI  - Differential effects of antihypertensive agents in experimental and human
      atherosclerosis.
AB  - The association between hypertension and atherosclerosis is complex,
      incorporating endothelial dysfunction, abnormalities of insulin and lipid
      metabolism, altered vascular biology, and impaired arterial compliance. Results
      of experimental and human studies suggest that there is heterogeneity in the
      manifestations of disease and responses to therapy among different animal
      species, vascular territories, and individual patients. Antihypertensive therapy
      requires the careful selection of specific agents that reduce blood pressure and
      preferentially and positively modulate the synergistic interaction of the many
      facets of disease, with the goal of preventing or regressing atherosclerosis.
      Angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, and alpha
      blockers appear to hold the greatest promise in this regard.

PMID- 8466725
TI  - A multicenter comparison of isradipine and felodipine in the treatment of mild-to
      moderate hypertension. The Physician's Study Group.
AB  - The objective of this study was to compare the tolerability of isradipine and
      felodipine in patients with mild-to-moderate hypertension. Following a 4-week
      placebo run-in, 143 patients entered a 12-week double-blind multicenter study.
      Patients were randomized to receive either isradipine (n = 72) or felodipine (n =
      71) at a dose of 2.5 mg twice daily. Dose-doubling and the addition of enalapril
      (2.5 mg once daily) was permitted if diastolic blood pressure (DBP) was > 90 mm
      Hg at weeks 4 and 8, respectively. Isradipine reduced blood pressure from 165/104
      +/- 13/6 mm Hg at baseline to 144/88 +/- 13/8 mm Hg at week 12 (P < .001) whereas
      felodipine reduced blood pressure from 171/104 +/- 17/6 mm Hg at baseline to
      150/92 +/- 19/9 mm Hg at week 12 (P < .001). Similar incidences of headache,
      flushing, dizziness and tachycardia were reported in both groups. However, the
      incidence of ankle edema was significantly lower in the isradipine group (14% v
      30%) (P = .028). It is concluded that isradipine represents a practical
      improvement over felodipine in the treatment of hypertension.

PMID- 8466726
TI  - Isradipine in the treatment of mild-to-moderate hypertension. The Austrian
      Multicenter Isradipine cum Spirapril Study (AMICUS).
AB  - The objective of this study was to assess the safety and efficacy of 1.25 to 2.5
      mg of isradipine twice daily in patients with mild-to-moderate hypertension, as
      seen in general practice. A total of 595 patients were treated for 6 months with
      an initial dose of isradipine at 1.25 mg twice daily. This dose was doubled if
      normotension (diastolic blood pressure [DBP] < or = 90 mm Hg) was not achieved
      after 4 weeks of treatment (n = 327). If, after 8 weeks, blood pressure was still
      not normalized, either the angiotensin-converting enzyme (ACE) inhibitor
      spirapril at 3 mg (n = 58) or the beta-blocker pindolol at 5 mg (n = 54) was
      added to the treatment. After 24 weeks, the mean blood pressure decrease with
      isradipine at 1.25 mg twice daily was 28.5/19.0 mm Hg for systolic blood pressure
      (SBP)/DBP and, with 2.5 mg isradipine twice daily, 28.4/18.5 mm Hg. There was no
      relevant change in heart rate. The overall normalization rate for all 595
      patients was 78.2%. Side-effects that were considered related or possibly related
      to treatment were reported in 73 patients (12.3%). Treatment with isradipine plus
      either spirapril or pindolol was discontinued in 32 patients (5.4%) because of
      side-effects related, or possibly related, to the study treatment. Blood pressure
      was also self-recorded in a subgroup of 45 patients. The self-recorded values
      were 11/6 mm Hg (SBP/DBP) lower than the respective causal readings at the start
      of active treatment. However, this difference disappeared completely after 8
      weeks of treatment.

PMID- 8466727
TI  - Efficacy, safety, and tolerability of isradipine in hypertension as used in
      general practice in a developing country (Pakistan).
AB  - This open-label trial of isradipine was carried out in 3422 outpatients by 893
      general practitioners to assess the efficacy, safety, and tolerability of
      isradipine as monotherapy in mild-to-moderate hypertension. Patients received 2.5
      mg isradipine twice daily as monotherapy for 6 weeks following a placebo wash-out
      period of 1 week. After 6 weeks of active treatment, diastolic blood pressure was
      significantly reduced from 106 +/- 7.7 to 89.4 +/- 8.0 mm Hg (P < .001). Systolic
      blood pressure also decreased significantly, from 166.8 +/- 19.6 to 141.8 +/-
      15.7 mm Hg (P < .001). Blood pressure was normalized in 75.68% of the patients. A
      total of 629 patients (19%) reported adverse events, 79 (2.3%) of whom withdrew
      from the study for this reason. The most common side-effects were headache
      (8.7%), palpitations/tachycardia (3.8%), vertigo (2.89%) and flushing (1.00%). In
      conclusion, 2.5 mg isradipine twice daily is a safe, effective, and well
      tolerated form of monotherapy in the treatment of hypertension in general
      practice in a developing country (Pakistan).

PMID- 8466728
TI  - A multicenter, double-blind, randomized, placebo-controlled study of isradipine
      and methyldopa as monotherapy or in combination with captopril in the treatment
      of hypertension. The LOMIR-MCT-IH Research Group.
AB  - This multicenter, double-blind, randomized trial of 1 year's duration compared
      the safety and efficacy of isradipine, methyldopa, and placebo in 368 men, aged
      40 to 65 years, with mild-to-moderate essential hypertension. Initial treatment
      with isradipine (1.25 mg twice daily), methyldopa (250 mg twice daily), or
      placebo was started after a wash-out and single-blind placebo period. If
      normotension [diastolic blood pressure (DBP) < 95 mm Hg] was not achieved, doses
      were doubled. If the maximum dose as monotherapy did not result in normotension,
      captopril (25 mg or, if necessary, 50 mg, once daily) was added to the treatments
      of the three patient groups. Despite the marked placebo effect during the first 2
      weeks of treatment, monotherapy with isradipine resulted in a higher rate of
      normalization (more than 64%) compared with 50% in the methyldopa group and 36%
      in the placebo group. Adding captopril to the treatments of non-responders
      increased the rate of normalization to 90% in the isradipine group, 84% in the
      methyldopa group, and 75% in the placebo group. Twenty-one patients dropped-out
      and 70 patients discontinued the study, the majority because of a lack of
      efficacy and adverse reactions. The most common adverse reactions reported were
      cardiovascular and gastrointestinal complaints, headaches, and sleep and sexual
      disorders, mostly by patients taking methyldopa. Isradipine was well tolerated
      and the side-effects were minimal. These results indicate that isradipine is
      superior to methyldopa and, whether as monotherapy or in combination with
      captopril, highly effective and well tolerated in the treatment of mild-to
      moderate hypertension.

PMID- 8466729
TI  - A review of the short-term benefits of antihypertensive treatment with emphasis
      on stroke.
AB  - Hypertension is the major underlying risk factor for stroke, and the risk of
      stroke increases proportionally to the rise in blood pressure. In the elderly,
      systolic hypertension increases the risk of stroke. Stroke in hypertensive
      patients may be due to Charcot-Bouchard aneurysm, to atherosclerosis of the
      extracranial and major cerebral arteries, or to embolism as a result of cardiac
      disease. Reduction of blood pressure greatly reduces the risk of stroke in
      severe, mild-to-moderate, and isolated systolic hypertension. The reduction in
      stroke risk occurs up to a year after the onset of treatment and appears to
      persist thereafter. The use of dihydropyridine calcium antagonists may confer
      further benefits in addition to those related to blood pressure reduction as
      these agents block the influx of calcium into ischemic brain cells, thereby
      limiting the extent of the infarction. However, although these effects have been
      impressive in experimental models, there is as yet no convincing evidence of this
      effect in clinical studies.

PMID- 8466730
TI  - Reexamining the quality of life of hypertensive patients. A new self-structured
      measure.
AB  - This study included the introduction of a new, qualitative, self-structured
      measure of quality of life (QOL) after meta-analysis had shown that prestructured
      quantitative measures yielded insignificant results. This study compared the pre-
      and post-treatment evaluations of 268 men with mild hypertension, aged 40 to 65
      years, who were randomly allocated to three treatment groups (methyldopa,
      isradipine, and placebo) with that of 155 normotensive subjects. It was found
      that the study participants defined QOL qualitatively differently from the way it
      was defined by physicians. Normotensive subjects showed a better QOL status in
      most prestructured measures whereas the patients taking isradipine showed better
      results on evaluation of the current level of their self-defined domains. The
      combined quantitative and qualitative approach to measuring QOL may help to
      clarify this important aspect of medical research, both conceptually and
      methodologically.

PMID- 8466731
TI  - Antihypertensive effect of isradipine on ambulatory and casual blood pressure.
AB  - The antihypertensive effect of isradipine was studied in 35 mild-to-moderate
      hypertensive patients (mean age 57 years) using casual and ambulatory 24-h blood
      pressure measurement. After the placebo phase, oral treatment was started with
      1.25 mg isradipine twice daily for 4 weeks, which was increased to 2.5 mg twice
      daily if blood pressure was not normalized [in one patient, the new angiotensin
      converting enzyme (ACE) inhibitor spirapril was added at a dose of 3 mg daily
      after 4 weeks]. The active-treatment period lasted 24 weeks. At the end of
      therapy, casual blood pressure decreased significantly (P < .001) from 174/103 to
      151/86 mm Hg, and mean ambulatory blood pressure from 145/88 to 139/84 mm Hg (P <
      .05). The total number of hypertensive systolic and diastolic blood pressure
      values also decreased. When patients were divided into normotensives and
      hypertensives according to their initial ambulatory blood pressure, no effect of
      treatment was detected in the normotensive group. Casual blood pressure was
      higher than the 24-h ambulatory pressure.

PMID- 8466732
TI  - Bioequivalence of a slow-release and a non-retard formulation of isradipine.
AB  - Pharmacokinetic studies were carried out in 48 healthy male volunteers to
      determine the pharmacokinetic properties of a new modified-release formulation of
      isradipine (SRO) and to compare these with the pharmacokinetic properties of the
      nonretard form of isradipine (NR). Studies were carried out in the fasting state
      and also following a light meal. The time required to reach maximum plasma
      concentration (tmax) was extended from approximately 1.5 h with NR to 5 to 7 h
      with SRO, and the maximum plasma concentration [Cp(tmax)] was reduced by around
      50%. The bioavailability of SRO was increased by less than 20% compared with the
      same daily dose given as NR, indicating that the two forms are bioequivalent and
      that no adjustment in the total daily dose of isradipine is necessary when
      switching from one form to the other. Administration with a light meal altered
      the pharmacokinetic parameters by less than 20% compared with administration
      without food.

PMID- 8466733
TI  - Isradipine: a slow-release formulation given once daily controls blood pressure
      for 24 h.
AB  - A total of 190 patients (mean age 57 years; range 21 to 89 years), with a supine
      diastolic blood pressure (sDBP) of 100 to 120 mm Hg after a 3-week placebo phase,
      entered a double-blind parallel-group study to receive placebo (n = 62), or slow
      release isradipine (SRO) at 2.5 mg (n = 64) or 5 mg (n = 64) once daily for 4
      weeks. Blood pressure was always measured between 23.5 and 24.5 h after the
      previous drug administration. Before and after the 4-week treatment period, blood
      pressure profiles were recorded from measurements taken immediately before drug
      administration ('trough') and repeated at 2, 4, 6, and 8 h after administration.
      A 'peak:trough' ratio was assessed from the data of 156 patients who completed
      the 4 weeks of active treatment, and for whom blood pressure profiles were
      available both before and after treatment. A supine DBP of < or = 90 mm Hg at
      trough was achieved by 28%, 35%, and 47% of patients receiving placebo, 2.5 mg,
      and 5 mg SRO, respectively. If patients who achieved a reduction in sDBP of at
      least 10 mm Hg are included, the total response rate becomes 42%, 66%, and 61% in
      the three treatment groups, respectively. The reduction in sDBP immediately
      before drug administration (trough effect) was 37% of the 'peak' effect (6 h
      after administration) with the 2.5-mg dose and 74% with the 5-mg dose. Adverse
      events were reported by 14.5%, 9.4%, and 17.2% of patients taking placebo and SRO
      at 2.5 mg and 5 mg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466734
TI  - Efficacy of slow-release oral isradipine in moderate-to-severe hypertension with
      add-on spirapril.
AB  - The new slow-release oral formulation (SRO) of isradipine, a dihydropyridine
      calcium antagonist, was evaluated in 57 patients who had moderate-to-severe
      hypertension following a 2-week wash-out period and a 2-week placebo period. The
      angiotensin-converting enzyme (ACE) inhibitor spirapril, at a dose of 6 mg/day,
      was added to the treatment of those not responding to 5 mg/day isradipine SRO
      alone. After 4 weeks of active treatment, isradipine alone normalized blood
      pressure (diastolic blood pressure < or = 90 mm Hg) in 38 (66.6%) patients
      whereas a further 4 weeks of treatment with the combination of isradipine and
      spirapril led to normalization in 14 of the 19 (73.7%) patients with partial or
      nil blood pressure responses. Side-effects were mild and transient and were
      observed in nine patients (15.8%). Isradipine SRO is an effective and well
      tolerated antihypertensive agent and combination with spirapril appears to
      enhance its efficacy without an increase in side-effects.

PMID- 8466735
TI  - A comparative study of isradipine SRO and enalapril in black patients with mild
      to-moderate hypertension.
AB  - Fifty-two black men who had supine diastolic blood pressures (DBP) above 95 mm Hg
      at the end of a 2-week placebo wash-out period were randomized to receive either
      isradipine SRO at 2.5 mg/day or enalapril at 10 mg/day for 8 weeks. After 4
      weeks, the dosages were doubled if DBP remained above 90 mm Hg. Reductions in
      blood pressure were comparable in both groups. Mean supine DBP was reduced from
      100.6 to 93.9 mm Hg in the isradipine-treated group, and from 103.9 to 98.2 mm Hg
      in the enalapril-treated group. At the end of the study, 24/27 patients were
      taking 5 mg isradipine SRO once daily, and 20/25 patients were taking 20 mg
      enalapril once daily. There were no serious adverse events. The results of this
      study indicated that monotherapy with isradipine SRO at the recommended initial
      dosage of 5 mg once daily is appropriate in black patients with hypertension.
      This was, however, not the case with enalapril at 10 mg once daily. The
      concurrent administration of a diuretic with enalapril may be more appropriate.

PMID- 8466736
TI  - Regression of left ventricular hypertrophy with isradipine antihypertensive
      therapy.
AB  - To assess left ventricular (LV) structural and functional changes, 45
      hypertensive patients were studied by echocardiography after 2 weeks of placebo
      and 6 months of isradipine monotherapy. Although LV cavity size did not change,
      LV wall thickness decreased dramatically (P < .0001), producing a significant
      decrease in LV mass index (from 158 g/m2 to 136 g/m2; P < .0001). In addition, LV
      fractional shortening (FS) did not change (1.2%; P = NS) whereas the cardiac
      index increased (6.4%; P = .0007) due to a modest tachycardia accompanied by a
      reduction in total peripheral resistance (-22.1%; P < .0001). The magnitude of
      the reduction of LV mass was related to the degree of FS increase (r = -0.70; P <
      .0001), an indication of beneficial LV remodeling. It can be concluded that
      isradipine antihypertensive therapy leads to regression of LV hypertrophy without
      depression of LV pump function.

PMID- 8466737
TI  - Regression of left ventricular hypertrophy with isradipine in previously
      untreated hypertensive patients.
AB  - The regression of left ventricular hypertrophy (LVH) is considered a desirable
      goal of antihypertensive treatment. Isradipine was used as first-line
      antihypertensive treatment in 15 patients who had mild-to-moderate hypertension
      and LVH, and who were studied before and after 6 months of treatment. Left
      ventricular mass and function were assessed by Doppler echocardiography. Systolic
      and diastolic blood pressure were reduced from 161 +/- 14 mm Hg and 103 +/- 3 mm
      Hg to 136 +/- 8 mm Hg and 87 +/- 6 mm Hg, respectively (P < .001). The
      interventricular septal thickness was reduced by 11.9% (P < .001), posterior wall
      thickness by 11.1% (P < .001), left ventricular end-diastolic diameter by 2%, and
      left ventricular mass index by 17% (P < .02). In conclusion, 6 months of
      antihypertensive treatment of mild-to-moderate hypertension with isradipine
      achieves a significant regression (17%) of LVH.

PMID- 8466738
TI  - Reversal of left ventricular hypertrophy with isradipine induces diminution of
      cardiac arrhythmias.
AB  - The left ventricular hypertrophy (LVH) of hypertension is often associated with
      ventricular arrhythmias, which may increase the risk of cardiovascular mortality.
      Our study was therefore designed to assess whether pharmacological reversal of
      LVH was associated with the diminution of LV ectopic beats. The antihypertensive
      agent selected for the study was the dihydropyridine calcium antagonist
      isradipine (2.5 to 5.0 mg/day orally), which induces rapid regression of LVH. A
      marked temporal association was observed between regression of LV mass and
      reductions in the total number of ventricular extrasystoles and in paired beats.
      Furthermore, there was a diminution of the complexity of the form of ventricular
      ectopic beats during antihypertensive treatment. No changes in serum electrolytes
      were documented to account for this control of cardiac arrhythmias. We conclude
      that the reversal of LVH obtained with isradipine is accompanied by control of
      the ventricular arrhythmias in hypertensive patients. It is possible that this
      cardioprotective action may be associated non-specifically with the reduction in
      LV mass, although a drug- or class-specific action cannot be ruled out.

PMID- 8466739
TI  - Clinical value of ambulatory blood pressure monitoring.
AB  - Although office blood pressure measurement may be predictive of cardiovascular
      complications, it still has several limitations: first, the accuracy of its
      predictions is limited; second, the stress reaction it causes may lead to an
      overestimation of the need for treatment and to an underestimation of the
      therapeutic response in some patients; and third, because of this 'white-coat'
      reaction and the wide variation in blood pressure over 24 h, office blood
      pressure can only be an approximate reflection of 24-h average blood pressure
      values both during and in the absence of treatment. The alternative method of
      ambulatory blood pressure monitoring may represent a valuable approach in the
      clinical management of hypertension. Values derived by this method are largely
      devoid of the consequences of the 'white-coat' reaction and are more closely
      correlated to the organ damage associated with hypertension than those derived
      from office blood pressure measurement. However, longitudinal studies are needed
      to demonstrate whether ambulatory blood pressure monitoring is truly
      prognostically superior to the traditional method, and to determine precisely
      which are the blood pressure values within the 24-h period on which to base the
      diagnosis of hypertension to assess more accurately the efficacy of
      antihypertensive treatment. However, there is the suggestion that optimal blood
      pressure control probably consists of an even reduction of both daytime and night
      time values, and that the wide variations in blood pressure that occur throughout
      24 h should probably also be reduced and maintained on a long-term basis.

PMID- 8466740
TI  - Effect of short-term antihypertensive therapy on left ventricular wall tension. A
      double-blind comparison of isradipine and nifedipine.
AB  - The comparative efficacy of the calcium antagonists isradipine and nifedipine in
      reducing left ventricular peak systolic wall tension was assessed in 25 patients
      with essential hypertension (20 men, 5 women; mean age: 49 years). After 2 weeks
      of treatment with either isradipine (2.5 mg twice daily) or slow-release
      nifedipine (20 mg twice daily), blood pressure was similarly reduced in both
      groups of patients whereas the thickness of the interventricular septum and left
      ventricular free wall did not change. Echocardiographic end-diastolic volume of
      the left ventricle showed no change whereas end-systolic volume significantly
      decreased with isradipine, but not with nifedipine retard. This led to a
      significant reduction in peak systolic wall tension in the isradipine group, but
      not in the nifedipine group. In conclusion, antihypertensive treatment with
      isradipine produces a reduction in peak systolic wall tension which is not seen
      with nifedipine, probably because of its negative inotropic effect.

PMID- 8466741
TI  - Beneficial effect of isradipine on the development of left ventricular
      hypertrophy in mild hypertension.
AB  - The objective of this study was to analyze the long-term hemodynamic effects of
      the calcium antagonist isradipine in mild hypertension compared with those of the
      beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the
      development of cardiac hypertrophy. Ten male patients with mild essential
      hypertension were entered into a double-blind crossover study. Examinations were
      carried out after 2 weeks of placebo run-in, and after 6 and 12 months of active
      treatment. Mean resting blood pressure was reduced from 115 +/- 12 mm Hg to 106
      +/- 12 mm Hg with atenolol, and to 107 +/- 8 mm Hg with isradipine. The increase
      in the product of heart rate times blood pressure was significantly greater
      during isradipine treatment, as was the maximum exercise capacity. Left
      ventricular mass was increased from 228 +/- 36 g to 305 +/- 68 g with atenolol
      whereas it remained unchanged with isradipine (254 +/- 55 g). The results
      indicate that antihypertensive treatment with isradipine as monotherapy may
      prevent the development of left ventricular hypertrophy whereas treatment with
      atenolol as monotherapy does not appear to offer this possibility.

PMID- 8466742
TI  - Treatment of hypertension with calcium antagonists and aspirin. Effects on 24-h
      platelet activity.
AB  - The effects of calcium antagonists on platelets, and the effects of aspirin on
      the antihypertensive efficacy of calcium antagonists and on the 24-h platelet
      activity profile were investigated in a double-blind study. Patients with
      essential hypertension were treated for 8 weeks with either nitrendipine (10 mg
      once daily) or isradipine (2.5 mg once daily). Aspirin (100 mg once daily) was
      added to both treatments for a further 8 weeks. Measurements were taken after
      placebo, after 8 weeks of active treatment, and after 8 weeks of treatment plus
      aspirin. Plasma levels of beta-thromboglobulin (beta-TG) and platelet aggregation
      (PA) were measured six times over 24 h. Isradipine and nitrendipine significantly
      lowered systolic and diastolic blood pressure. The addition of aspirin had no
      effect on blood pressure. Platelet activity before treatment exhibited circadian
      variations with the lowest values of beta-TG and PA at 0530 h and the steepest
      increases between 0530 and 0900 h. Although both calcium antagonists decreased
      beta-TG levels (P < .05), the effect with isradipine was more pronounced than
      that with nitrendipine (P < .05). Aspirin added to nitrendipine produced a
      significant decrease in beta-TG levels whereas isradipine plus aspirin was
      accompanied by a partial increase in beta-TG. It is concluded that hypertensive
      patients exhibit circadian increases in platelet activity that can be prevented
      by either isradipine alone or by treatment with nitrendipine plus aspirin.
      Chronic aspirin intake at a daily dose of 100 mg does not affect calcium
      antagonist antihypertensive efficacy.

PMID- 8466743
TI  - Minimally invasive surgery in otorhinolaryngology.
AB  - Otorhinolaryngology has always strived to improve the diagnostic and therapeutic
      possibilities of managing afflicted organs by developing technically and
      conceptually new and advanced treatment techniques. The endeavor to develop
      methods with minimized patient discomfort during interventional surgery in the
      head and neck region was an essential motive which gave rise to the discipline of
      ENT medicine. Since fairly recently, the term "minimally invasive surgery" has
      become firmly established in the domain of general surgery. The possibility for
      replacing a substantial number of routine operations by endoscopic procedures
      with low levels of discomfort for the patient and shorter periods of
      hospitalization has given the term "minimally invasive" even further wide-ranging
      significance. The present review endeavors to provide an assessment of the
      current state-of-the-art in otorhinolaryngology, giving special attention to the
      historical development and pathophysiological fundamentals of this field.

PMID- 8466744
TI  - Modern imaging techniques and ultrasound-guided aspiration cytology for the
      assessment of neck node metastases: a prospective comparative study.
AB  - Although palpation has proved to be an unreliable staging procedure, the
      indications for and the implications of more reliable radiologic staging methods
      for the neck in patients with a primary squamous cell carcinoma of the head and
      neck remain controversial. Only a very accurate imaging technique can replace
      neck dissection in clinical NO disease. This study compares the value of
      palpation with computed tomography (CT), magnetic resonance imaging (MRI) and
      ultrasound (US) with or without guided aspiration cytology for neck node staging.
      One hundred and thirty-two patients with squamous cell carcinoma of the head and
      neck were examined radiologically before undergoing a total of 180 neck
      dissections as part of their treatment. CT, US and MRI proved to be significantly
      more accurate than palpation for cervical lymph node staging. The accuracy of US
      guided aspiration cytology was significantly better than of any other technique
      used in this study. Modern imaging techniques are essential for appropriate
      assessment of neck node metastases. In view of advances in the accuracy of
      contemporary imaging, the need for elective treatment of the neck requires
      reappraisal.

PMID- 8466745
TI  - Vascular patterns of the saccule of the rat: a microcorrosion cast study.
AB  - A scanning electron microscope study of corrosion cast preparations of the
      vessels of the saccule was carried out in adult rats. This method shows the
      microvasculature of the saccule in the three-dimensional model. As a result of
      this technique we have been able to demonstrate a particular microvasculature of
      the saccule in the rat's inner ear. The main blood supply of the saccule consists
      of the arterioles coming from the vestibulocochlear artery entering the anterior
      margin of the macula sacculi. A few branches of the anterior vestibular artery
      enter the macula sacculi from the superior margin. The saccular vein drains the
      venous blood from a dense capillary area underneath the striola to the posterior
      vestibular vein which eventually ends in the vein of the cochlear aqueduct.

PMID- 8466746
TI  - The effects of low-frequency ultrasound on the inner ear: an electrophysiological
      study using the guinea pig cochlea.
AB  - By examining 218 albino guinea pigs, electrophysiological methods were used to
      investigate the effects of low frequency ultrasound at moderate sound pressure
      levels after long-term exposure to the inner ear. From 10 kHz to 28 kHz, low
      frequency ultrasound below 100 dB SPL induced significant changes in cochlear
      microphonics, elevated thresholds and decreased maximum output voltage of action
      potentials and decreased absolute values of negative potentials of the
      endocochlear potentials.

PMID- 8466747
TI  - Influenza A modification of endotoxin-induced otitis media with effusion in the
      guinea pig.
AB  - A total of 120 Hartley strain guinea pigs were used to investigate the possible
      role of influenza A in endotoxin-induced otitis media with effusion.
      Intratympanic inoculation of 0.2 ml physiologic saline solution containing 10(4)
      plaque-forming units (PFU)/ml of influenza A suspension or 100 ng/ml
      lipopolysaccharide failed to induce either middle ear effusions or mucociliary
      pathologies in the tubotympanum. In contrast, intratympanic inoculation 100 ng/ml
      endotoxin resulted in prolonged mucociliary dysfunction and middle ear effusions
      when 0.2 ml 10(4) PFU/ml of influenza A was inoculated in the tympanic cavity.
      The inference is drawn that an influenza A infection might predispose the middle
      ear to endotoxin-induced otitis media with effusion.

PMID- 8466748
TI  - Preclinical detection of initial vestibulocochlear abnormalities in a patient
      with multiple sclerosis.
AB  - A 49-year-old woman presented with a third-degree continuous spontaneous
      nystagmus to the left which was followed by a sudden, almost complete deafness of
      her left ear. These symptoms were established as the sole initial presenting
      manifestations of multiple sclerosis (MS). Magnetic resonance imaging
      demonstrated a lesion within the left eight nerve root-entry zone and multiple
      small central lesions beneath the lateral ventricles. Pure-tone audiometry
      returned to normalcy after 2 weeks and speech discrimination was 100% after 10
      weeks. Auditory brainstem responses (ABRs) showed abnormal parameters during a 10
      month follow-up period after the acute hearing loss. Furthermore,
      desynchronization in ABR testing could be demonstrated 2 days before onset of
      hearing loss, which was interpreted as a prodromal ABR sign of the incipient MS
      attack.

PMID- 8466749
TI  - The cochlear glomeruli in the modiolus of the guinea pig.
AB  - The cochlear glomeruli were studied in guinea pigs using scanning electron
      microscopy of vascular corrosion casts and transmission electron microscopy of
      tissue sections. Two types of coiled vessels forming the cochlear glomeruli were
      found in the bony wall of the modiolus. First, upper glomeruli were seen situated
      in the bony wall next to the scala vestibuli; second, lower glomeruli were
      located in the osseous spiral lamina just above the spiral ganglion. Upper
      glomeruli gave rise to radiating arterioles which supplied capillaries of the
      stria the spiral lamina and limbus. Unlike the main supplying arteries, smooth
      muscle cells were not present in the walls of the arterioles forming the
      glomeruli and a peculiar layer of lamellar pericytes was found. The arterioles
      were strikingly longer than their parent vessels and no autonomic nerves were
      found in close spatial relationship. Hence, these findings indicate that the
      cochlear glomeruli serve as efficient devices for reducing cochlear blood
      pressure.

PMID- 8466750
TI  - The effect of nimodipine on salicylate ototoxicity in the rat as revealed by the
      auditory evoked brain-stem response.
AB  - Experiments have been performed to investigate the ototoxic effects of sodium
      salicylate administration in anaesthetised rats as recorded by the auditory
      evoked brain-stem response (AEBR). Sodium salicylate (300 mg kg-1 i.p.) produced
      time-dependent increases in hearing threshold and decreases in the four principle
      peaks of the AEBR. Maximum responses were obtained at 4 h post-administration and
      were highly significant (P < 0.001). In a further series of experiments
      nimodipine, a calcium channel antagonist which has been suggested as a potential
      therapy for tinnitus, was administered at a dose of 2 mg kg-1 s.c. at the same
      time as sodium salicylate. This had no effect on the changes in hearing
      threshold. However, it did reduce the decrease in latencies of three of the four
      peaks of the AEBR, such that only the decrease in latency of the first peak was
      significantly different when compared to the pre-injection control latency (P <
      0.01). We believe that these findings show specific neurophysiological correlates
      of salicylate ototoxicity. Since salicylate intoxication is used as the method
      for inducing tinnitus in animal models, the changes in the AEBR may provide an
      objective measure by which potential therapeutic intervention may be tested.

PMID- 8466751
TI  - A critical analysis of human immunodeficiency virus transmission using human
      cartilage allografts.
AB  - Allogeneic cartilage represents an important source of tissue for reconstructive
      surgery in the head and neck. The use of allografts is now being discussed
      because of the possible transmission of the human immunodeficiency virus (HIV).
      The receptor for HIV in most cell types is the CD-4 molecule. Since cartilage is
      a popular homograft source, the purpose of this study was to investigate the
      presence of CD-4 molecules on cartilage tissue as detected with an
      immunoperoxidase staining and immunofluorescence flow cytometric analysis using a
      monoclonal antibody. Our results indicate clearly the absence of the HIV receptor
      on human cartilage tissue. We have concluded therefore that normal cartilage
      tissue cannot be infected by HIV, at least not through a CD-4-dependent
      mechanism.

PMID- 8466752
TI  - Chondrosarcoma of the nasal septum: surgical considerations on Le Fort I
      osteotomy.
AB  - A case of chondrosarcoma of the nasal septum extending into the entire
      nasopharynx sphenoid sinus and skull base is presented. These cartilaginous
      tumors are rate in the head and neck, with only 28 reported in the nasal septum.
      They arise in tissues known to be formed of cartilage, and in the present case
      tumour presumably originated from the perpendicular lamina of the septum. The
      treatment of choice is wide surgical excision, which requires an adequate
      approach for gaining the widest possible exposure of tumor. Surgical
      considerations are discussed.

PMID- 8466753
TI  - Transcriptional regulation of vascular endothelial growth factor gene expression
      in ovarian bovine granulosa cells.
AB  - The expression of vascular endothelial growth factor (VEGF) in cultured bovine
      granulosa cells has been studied. As shown by northern blot analysis, granulosa
      cells express the VEGF gene. Analysis of the VEGF transcripts by the polymerase
      chain reaction technique shows that granulosa cells express predominantly the
      smallest VEGF coding forms (VEGF121 and VEGF164). Since in the promoter region of
      the VEGF gene there are four potential AP-1 sites and two potential AP-2 sites we
      have studied if TPA and forskolin could regulate VEGF gene expression. TPA
      induces VEGF transcription in a time- and dose-dependent fashion. Maximal VEGF
      mRNA levels are detected 6 h after TPA treatment. Induction apparently requires
      de novo protein synthesis since it does not occur when translation is inhibited
      by cycloheximide. Forskolin, a naturally occurring diterpene that activates
      adenylylcyclase, also increases VEGF mRNA content in a time-dependent manner.
      Induction does not require de novo protein synthesis and, in contrast to TPA,
      induction is strongly potentiated by cycloheximide. Luteotrophic hormone, a known
      activator of adenylylcyclase, also induces VEGF transcription. These results
      imply that granulosa cells may be a source of VEGF which could play a role in the
      angiogenic process associated with ovulation and corpus luteum formation.

PMID- 8466754
TI  - Midkine (MK), a retinoic acid (RA)-inducible gene product, produced in E. coli
      acts on neuronal and HL60 leukemia cells.
AB  - We have shown previously that (i) retinoic acid (RA), an anti-neoplastic agent,
      activates the midkine (MK) gene in mammalian embryonic carcinoma cells, and that
      (ii) the MK of 118 amino acids, purified from L cells, induces neurite outgrowth
      of mammalian embryonic brain cells. In this paper, we describe an unconventional
      strategy for the purification of a fully active MK from E. coli with a high
      yield. The MK was overproduced in E. coli as a glutathione S-transferase (GST)
      fusion protein. The MK fusion protein extracted from the bacterial inclusion
      bodies with guanidine-HCl was renatured, refolded slowly and cleaved by thrombin
      at the site where the GST links to the MK. The purified free MK, like RA, induced
      neurite outgrowth from central neurons of the mouse spinal cord, and suppressed
      the growth of human HL60 leukemia cells in vitro. Unlike RA, however, the MK did
      not induce granulocytic differentiation of HL60 cells. Furthermore, the MK
      supported the survival of an NGF-insensitive sensory neuron subpopulation(s) from
      chicken embryo dorsal root ganglion. Thus, the actions of the MK and leukemia
      inhibitory factor (LIF) are surprisingly similar. There is no sequence similarity
      between MK and LIF, however, and unlike MK, LIF production does not appear to be
      RA-inducible.

PMID- 8466755
TI  - Translation of the placenta growth factor mRNA is severely affected by a small
      open reading frame localized in the 5' untranslated region.
AB  - The recently identified placenta growth factor gene (PIGF) code for a protein
      related to the vascular permeability factor (VPF). We present evidence indicating
      that expressing of this gene could be regulated at the post-transcriptional
      level. The region upstream to the coding region of PIGF mRNA contains a small
      open reading frame (ORF), potentially coding for a peptide of 15 amino acids. The
      translation of different constructs in reticulocyte and wheat germ lysates as
      well as in COS-1 and CV-1 cells indicates that this short region is a
      translational inhibitory element since mutations in its two potential initiator
      codons increase PIGF synthesis in vivo. Using RNAse protection assay, we
      demonstrate that the PIGF mRNAs obtained from human term placenta and JEG
      choriocarcinoma cell line have a complete 5' untranslated region and,
      consequently, also the above mentioned small ORF. Finally, the analysis of a
      bovine PIGF genomic clone reveals that this small ORF is strongly conserved with
      respect to both putative peptide sequences and distance from the PIGF coding
      region.

PMID- 8466756
TI  - Vitamin D3 and calcipotriol enhance the secretion of transforming growth factor
      beta 1 and -beta 2 in cultured murine keratinocytes.
AB  - Vitamin D3 and its analogue calcipotriol (MC 903) inhibit the proliferation of
      cultured keratinocytes and induce their differentiation. Since TGF beta s are
      very potent inhibitors of keratinocyte growth we studied the effects of vitamin
      D3 and calcipotriol on the secretion of TGF beta in cultured murine
      keratinocytes. Vitamin D3 and calcipotriol (10(-6)-10(-9) M) inhibited the DNA
      synthesis of mouse keratinocytes by 50-80% in a time and dose-dependent manner as
      measured by [3H]-thymidine incorporation. Analysis of the conditioned medium of
      the keratinocytes indicated that the cells secreted into their medium activity
      that inhibited the growth of indicator Mv1Lu mink lung epithelial cells.
      Neutralizing antibodies against TGF beta 1 and TGF beta 2 decreased, and when
      used together, prevented the observed growth inhibition of the indicator cells.
      Heat treatment of the conditioned medium, which activates latent forms of TGF
      beta, revealed higher levels of growth inhibitory activity in the medium from
      vitamin D3 and calcipotriol treated than from control cultures indicating that a
      fraction of TGF beta was in a latent form. Active TGF beta was, however, detected
      considerably more in vitamin D3 and calcipotriol treated cultures than in control
      cultures. Immunoblotting analysis of the medium revealed enhanced secretion of
      TGF beta protein. These results indicate that enhanced TGF beta 1 and TGF beta 2
      secretion and activity is associated with vitamin D3-mediated growth inhibition
      of cultured keratinocytes.

PMID- 8466757
TI  - A model for the interaction of the GM-CSF, IL-3 and IL-5 receptors with their
      ligands.
AB  - The high affinity receptors for GM-CSF, IL-3 and IL-5 are heterodimers consisting
      of a ligand-specific alpha chain and a common beta chain. These proteins are
      members of a family of proteins known as the "cytokine receptor family" which is
      characterized by the presence of a 200-residue ligand-binding module. The GM-CSF,
      IL-3 and IL-5 receptor alpha chains constitute a distinct subgroup and share
      features not found in other members of the cytokine receptor family, features
      which we propose to be important for their interaction with the common beta chain
      and for their binding of the structurally-related ligands. The growth hormone
      receptor is a well-characterized member of the cytokine receptor family. Based on
      the structure of the complex between growth hormone and its receptor, we have
      proposed sites of contact between the GM-CSF, IL-3 and IL-5 receptors and their
      cognate ligands.

PMID- 8466758
TI  - Starting again--a comparison study of a group rehabilitation program for cancer
      patients.
AB  - The effects of a seven-week (11 two-hour sessions) group post-treatment
      rehabilitation program ('Starting again') for cancer patients were assessed. The
      program emphasised physical training, information, and training of coping skills.
      Thirty participants were matched to thirty patients, not wanting to participate
      (comparison group) and compared in a longitudinal study: before and after the
      program, and three, six and twelve months after program completion. Program
      participants had a significantly heavier burden of physical and psychological
      symptoms at entry than did patients who chose not to participate. More
      participants reported change of their life-style and habits after the cancer
      diagnosis than did the comparison group. In comparison with non-participants,
      participants were more satisfied with information during the entire follow-up,
      improved more from pre- to post measurement with respect to physical strength and
      increased their physical training and social activities more.

PMID- 8466759
TI  - Protein tyrosine kinase in colorectal adenoma.
AB  - To determine whether protein tyrosine kinase (PTK) could be utilized as a
      biological indicator of colonic tumorigenesis, we examined the PTK activity in
      the cytosolic and particulate fractions of homogenates from 25 adenomas (polyps)
      and from adjacent normal mucosa. The particulate fraction PTK activity in the
      colorectal adenomas was significantly higher than in the normal mucosa. The
      adenomas were then analyzed according to size, histological type (tubular and
      tubulovillous), and degree of dysplasia (mild, moderate and severe). The average
      particulate fraction PTK activity ratio (adenoma/normal mucosa) of tubulovillous
      adenomas or adenomas with moderate to severe dysplasia was significantly elevated
      in comparison with that of tubular adenomas or adenomas with mild dysplasia. The
      particulate PTK activity ratio increased significantly with increasing adenoma
      size, while the cytosolic ratio did not. The cytosolic PTK activity ratio in
      tubulovillous adenomas or adenomas with severe dysplasia decreased significantly
      with increasing size. These findings suggest that colonic carcinogenesis might be
      associated with alterations in the cellular level of PTK activity and that the
      PTK activity ratio (adenoma/normal mucosa) in the particulate and/or cytosolic
      fractions may possibly correlate with the risk of malignant transformation.

PMID- 8466760
TI  - Urinary excretion of 6-hydroxymethylpterin in brain tumours.
AB  - The urinary 6-hydroxymethylpterin(Pt-6-CH2OH) excretion was determined in 87
      patients with brain tumours and in 50 control patients. The Pt-6-CH2OH levels
      were significantly elevated in all patients with tumours. No difference was
      observed when malignant tumours were compared with benign neoplasms. Following
      therapy, the Pt-6-CH2OH levels were partially reduced when compared with control
      patients and their pre-operative values.

PMID- 8466761
TI  - Breast cancer 2000 BC to 2000 AD--time for a paradigm shift?
AB  - In this paper I trace the history of the development of the treatment of breast
      cancer over a 4000-year period. I point out that there have basically been three
      paradigms within which we have studied and developed treatment for this disease.
      Clinical trials over the last twenty years as an expression of the scientific
      method in action, have demonstrated the limited success of the contemporary
      paradigm with its therapeutic sequelae of breast conserving surgery and adjuvant
      systemic therapy. At the same time a critical review of the natural history of
      breast cancer and the results of current treatments suggest logical
      inconsistencies in the model. I have therefore constructed a novel paradigm which
      better fits the available information by suggesting that metastases are not only
      a result of cellular transmission of breast cancer but sub-cellular transmission
      using the mechanism of in vivo transfection. Although this may sound far fetched,
      there are a series of remarkable studies in the literature which supports this
      conceptual revolution. This is surely a fertile field for research and the
      therapeutic consequences would be obvious. They might suggest that more
      aggressive adjuvant systemic chemotherapy based on the conventional model is
      unlikely to achieve any additional benefit, whereas therapy based on anti-viral
      drugs might produce the next therapeutic advance. It is not the intention of this
      article to persuade readers that the alternative paradigm is true but merely to
      open minds to the study of history and scientific philosophy to ensure that we do
      not repeat the errors of the past.

PMID- 8466762
TI  - Treatment of relapsing anal carcinoma.
AB  - Between 1983 and 1989, a total of 94 patients were admitted to the Norwegian
      Radium Hospital for primary squamous cell carcinoma (including 'basaloid' and
      'cloacogenic' carcinomas) of the anal canal. Seven patients with evident distant
      metastases received chemotherapy, while without known distant metastases received
      combined chemo- and radiotherapy. Of the latter patients, 17 developed distant
      metastases and 11 local recurrence later on. Patients with distant metastases had
      a median survival of 12 months (range 3-54 months) following start of
      chemotherapy (cisplatin + 5-FU or mitomycin C + 5-FU). An abdominoperineal
      resection was performed on 9 of the 11 patients with local relapse. Of these, 6
      patients were alive without evident disease after 3 years of observation.

PMID- 8466763
TI  - Megestrol acetate in cancer patients with anorexia and weight loss. A Hellenic Co
      operative Oncology Group (HeCOG) study.
AB  - Fifty-two patients with hormone-independent cancer, who complained of anorexia
      and of weight loss with at least 10%, received megestrol acetate (MA), 480 mg
      daily, during 1-21 weeks. Of the 41 patients treated during 4 weeks or longer, 38
      experienced weight gain. Monthly subjective evaluation of six parameters using a
      linear analog self-assessment (LASA) form showed a significant improvement in the
      patient's rating of appetite, mood, nausea and vomiting, and quality of life; the
      tumor was progressive in 21, stable in 11 and it regressed in only 9 of these
      patients. No toxicity was observed; one case of death due to a congestive heart
      failure remains unexplained. MA at the dose used is a powerful appetite
      stimulant; it contributes to weight increase and might improve the subjective
      appreciation of quality of life. MA at lower doses should be compared in a
      prospective trial to the dose used in this study.

PMID- 8466764
TI  - Reduction of cisplatinum-induced renal toxicity in mice by
      tetrahydroindazolonecarboxylic acid (HIDA) [corrected].
AB  - The ability of tetrahydroindazolone carboxylic acid (HIDA) to reduce the toxicity
      of cis-diamminedichloroplatinum (cis-DDP) in CDF1 mice was investigated. Toxicity
      was assessed both in terms of mouse lethality occurring within 14 days after
      treatment and kidney damage estimated by measurement of plasma urea. The levels
      of plasma urea were found to increase from day 2 after intraperitoneal (i.p.)
      injection of cis-DDP, reaching a peak at day 5. This increase was also cis-DDP
      dose dependent. An i.p. injection of HIDA reduced kidney damage only when given
      2.5 h prior to cis-DDP and at HIDA doses of 100 mg/kg or larger. The protection
      ratio for this reduction was 1.10. HIDA also decreased mouse lethality from cis
      DDP, resulting in a PR of 1.41. This protective effect of HIDA on cis-DDP
      toxicity may eventually have a clinical application.

PMID- 8466765
TI  - A new theoretical formula for fractionated radiotherapy based on a saturable
      cellular repair mechanism.
AB  - Recently we have published a new model of survival cellular response to radiation
      based on the existence of a saturable cellular repair mechanism. In the present
      paper we extend the predictions of this model of calculating the change in total
      dose necessary to achieve an equal response in a tissue when the dose per
      fraction in a radiotherapy fractionation schedule is varied. The model provides a
      new explanation of the difference between late and early radiation reactions.
      Results obtained from the model for different tissues and standard fractionation
      schedules are approximately equal to those obtained by the L.Q. (linear
      quadratic) model. The model is compatible with in vitro survival curves that are
      straight at high doses.

PMID- 8466766
TI  - Radiation therapy of para-aortic lymph nodes in cancer of the uterine cervix.
AB  - From 1965 to 1986, 173 patients with gynaecological cancer received para-aortic
      radiation treatment using a biaxial-four-segmental-rotating field technique.
      Seventy-five patients with cervical cancer and proven lymph node involvement were
      eligible for analysis. Crude survival and disease-free survival in 37 patients
      with FIGO III and 15 patients with FIGO IVA, receiving initial para-aortic
      treatment were compared with the corresponding data from patients in whom para
      aortic treatment was secondary applied when para-aortic metastases became
      clinically symptomatic. Five-year survival rates of 37.5% (FIGO III) and 27.3%
      (FIGO IVA) were encouraging as none of the patients in the secondary group
      survived for more than 16 months. The number of complications induced by the
      described method of survived for more than 16 months. The number of complications
      induced by the described method of para-aortic irradiation appears to be
      substantially lower than with other methods using equal doses. Five cases of
      severe but not life-threatening side-effects were observed among 173 treated
      patients.

PMID- 8466767
TI  - Radiotherapy compared to chemotherapy as initial treatment of angiocentric
      centrofacial lymphoma (polymorphic reticulosis).
AB  - Polymorphic reticulosis has recently been characterized as an angiocentric
      lymphoproliferative disorder of the peripheral T-lymphocytes. However, its
      treatment is still a matter of controversy. In order to study efficacy and
      toxicity of the primary treatment, we reviewed clinical features and therapeutic
      results in 29 patients seen at the Instituto Nacional de Cancerologia de Mexico.
      Nineteen patients received primary local irradiation and 10 patients primary
      combination chemotherapy. In the radiotherapy group, 14 (74%) patients achieved
      complete response, but only 4 (40%) did so in the primary chemotherapy group.
      Five patients in the latter group died of treatment-related complications. The 5
      year actuarial survival rate was 70% in the irradiation group, while the 1-year
      survival rate was only 15% in the chemotherapy group. These data strongly suggest
      that, in polymorphic reticulosis, initial chemotherapy may be very toxic.

PMID- 8466768
TI  - Backscatter radiation at tissue-titanium interfaces. Biological effects from
      diagnostic 65 kVp x-rays.
AB  - The induced secondary electrons from a metal surface by diagnostic x-rays are
      thought to contribute to cell damage near the tissue-metal boundaries of metal
      implants. Titanium implants are becoming increasingly more popular for tissue
      reconstructions and it is rather often desirable to take radiographs of the
      operated area. In this study we compared the biological effects of radiation on
      cultured mammalian test cells grown on titanium plates with the radiation effects
      on cells that were grown on plastic control plates. In order to study the acute
      radiation effects on cell growth it was necessary to work with rather high
      radiation doses (0.7-5 Gy). Photon energies, suitable for diagnostic radiography
      in odontology, 65 kV, were applied. We found that the cells grown on titanium
      plates were, in terms of the applied dose in the surrounding culture medium, more
      sensitive to the irradiations than the cells growing on plastic plates. The
      survival curve for the cells on titanium had a steeper slope, showed no shoulder
      in the low-dose region and looked like curves normally obtained for high LET
      radiation. It was not possible to resolve to what degree the titanium-dependent
      changes were due to an increased dose near the titanium surface or to a change in
      the radiobiological effectiveness. Although there was a significant decrease in
      cellular survival near the metal, postoperative intraoral radiography after
      titanium implantations need not be excluded. The maximal doses given in
      odontological x-ray examinations are less than 1 mGy and, if the results in this
      study are applied, the biological effects near the titanium implant will
      correspond to biological effects in soft tissue of doses less than 20 mGy which
      is lower than the doses that give acute effects. The risk of acute healing
      disturbances are significant only at much higher radiation doses.

PMID- 8466769
TI  - Influence of the timing of a concomitant boost during fractionated irradiation of
      rat rhabdomyosarcoma R1H.
AB  - Rhabdomyosarcomas R1H of the rat (WAG/Rij) were treated using fractionation
      schedules including a boost. The total dose was 60 Gy. Overall treatment time was
      6 weeks. Four different boost schedules were applied: a single dose boost (12.15
      Gy) at the last day of treatment, a single dose boost (12.15 Gy) at the first day
      of treatment, a schedule including the boost in 7 fractions during the first
      week, and a schedule including the boost in 10 fractions during the first week of
      treatment. A standard schedule with 30 fractions of 2 Gy without a boost was used
      for comparison. Initially accelerated schedules, i.e. those with a boost at start
      of treatment, revealed higher effect on tumour parenchyma as monitored by local
      control rate and net growth delay. This could be due to a decrease of radio
      sensitivity, that is, an increase of the hypoxic fraction of clonogenic tumour
      cells during fractionated irradiation.

PMID- 8466770
TI  - Liver cirrhosis and serum neuron-specific enolase.

PMID- 8466771
TI  - Discontinuous accelerated fractionation in the treatment of advanced head and
      neck neoplasms--a preliminary report.

PMID- 8466772
TI  - Cancer incidence among male salaried employees at a smeltery in northern Sweden.
AB  - This study focuses on mortality and cancer incidence among the male salaried
      employees at a copper smeltery in northern Sweden, where previously an increased
      lung cancer risk had been demonstrated among blue-collar workers, with all
      likelihood due to arsenic exposure. During the period 1928-1979 there has been
      1,255 male salaried employees and 6,334 male blue-collar workers. Three cohorts
      were formed; those who had worked only as salaried employees, those who had
      worked only as blue-collar workers and those had worked in both job categories.
      The mortality among the entire group of salaried employees was comparatively
      lower than that of Sweden as a whole. The incidence of lung cancer was highest
      among those who had worked in both job categories, most of them former blue
      collar workers. The trends in lung cancer incidence among the blue-collar workers
      along and among those who had had both types of jobs showed the same pattern,
      with a peak in the 1970s. The decrease in this trend started earlier among the
      salaried employees. When job category and employment cohort were analyzed
      together the highest risk was confirmed for those having been employed in both
      job categories.

PMID- 8466773
TI  - Stress in undergraduate medical education: 'the mask of relaxed brilliance'.

PMID- 8466774
TI  - General practice in deprived areas: problems and solutions.

PMID- 8466775
TI  - Patient access to records: expectations of hospital doctors and experiences of
      cancer patients.
AB  - The aim of this study was to examine cancer patients' reactions to the offer of
      access to their medical records, hospital doctors' preconceptions of patient
      access to medical records and the reality of access to records for both parties.
      Semistructured interviews were conducted with 32 patients and 21 hospital
      doctors. Hospital doctors were also shown letters from their department to the
      general practitioner and asked about any changes they would have made as a result
      of knowing about patient access to records. The results showed that most patients
      were able to judge for themselves if they wanted access or not and that patients
      who chose to look at their records found access to their records helpful and
      reassuring even if the news was bad. Doctors expected access to records to be
      harmful to patients but would not have wished to amend many of the letters they
      had written. Patient access to records can be a safe and useful adjunct to good
      patient care.

PMID- 8466776
TI  - Knowledge and perceptions of a domiciliary hospice service among general
      practitioners and community nurses.
AB  - Within a single district health authority all the general practitioners and
      community registered general nurses were asked to complete a questionnaire
      regarding awareness and perceptions of a domiciliary hospice service. Responses
      were received from 127 doctors (71%) and 58 nurses (80%). Awareness of resources
      offered by the domiciliary hospice service was high, especially among the 102
      respondents with access to the service. Eighty per cent or more of general
      practitioners and community nurses were satisfied with the amount of information
      received concerning changes in the patient's condition and who was involved in
      the care process. However, 33% of nurses agreed that it was difficult to know who
      had overall responsibility for the patient's care and 28% of nurses felt that
      their own contribution was under-rated. These findings were reinforced by a
      number of written statements submitted by the nurses. There was a desire
      expressed by both general practitioners and community nurses for more educational
      input from the domiciliary service. Overall, assistance from the service was
      welcomed and its special skills acknowledged. In the future planning of a
      comprehensive hospice service the differing needs expressed by doctors and nurses
      should be taken into account.

PMID- 8466777
TI  - Management of joint and soft tissue injuries in three general practices: value of
      on-site physiotherapy.
AB  - A prospective study was undertaken to determine the potential benefits in patient
      management and cost effectiveness of physiotherapists employed by general
      practitioners compared with direct hospital access and access via consultants.
      The study involved 401 patients from three rural general practices in south
      Cheshire and north Staffordshire and took place over six months. On-site
      physiotherapy in general practice premises resulted in higher referral rates to
      the physiotherapist compared with the practice using direct hospital access or
      the practice with access via consultants. Both on site and direct access
      physiotherapy were associated with fewer prescriptions and lower overall
      prescribing costs per patient than access to physiotherapy via consultants. There
      was less time lost from work and normal duties for patients attending the
      practice with on site physiotherapy compared with those attending the practice
      which required referral via hospital consultants. Access to physiotherapy via
      hospital specialists resulted in considerably longer delays than on site
      physiotherapy and greatly increased the financial costs for the patient.
      Physiotherapy in general practice premises is a cost effective way of dealing
      with joint and soft tissue complaints. Direct access to the physiotherapy
      department within hospitals results in longer delays but provides a satisfactory
      service. There is little to recommend the utilization of hospital consultants as
      a means of access to physiotherapy.

PMID- 8466778
TI  - Care of diabetic patients in hospital clinics and general practice clinics: a
      study in Dudley.
AB  - A five year retrospective casenote review was undertaken of 452 patients
      attending 11 different general practice diabetic clinics, and 506 patients
      attending a diabetic clinic at hospital A and 210 patients attending a diabetic
      clinic at hospital B. The populations attending the clinics, the degree of
      glycaemic control achieved and the monitoring for the development of diabetic
      complications were investigated. Insulin dependent patients comprised 57.9% of
      patients attending the diabetic clinic at hospital A, 35.7% at hospital B and
      25.0% of patients attending the diabetic clinics at general practices. Of these
      55.6%, 37.3% and 30.1% respectively received multiple daily insulin injections.
      Hospital A had a higher proportion of patients under 40 years old than hospital B
      or the general practice clinics. The ages of diabetic patients attending the
      general practice diabetic clinics were broadly similar to those attending
      hospital B. Significantly more general practice patients, both insulin and non
      insulin dependent, had a mean blood glucose level of less than 11 mmol l-1
      compared with patients attending clinics at hospitals A and B (P < 0.001).
      Glycosylated haemoglobin levels did not differ between patients attending
      hospital A and the general practice clinics. More non-insulin dependent and
      insulin dependent diabetic patients attending the general practice clinics and
      hospital A had been monitored satisfactorily for diabetic retinopathy (general
      practice clinic 68.8% and 39.7% respectively, hospital A 61.7% and 43.5%) than at
      hospital B (43.0% and 19.4%). Referral rates among all groups for
      ophthalmological assessment were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466779
TI  - Creating a death register for general practice.
AB  - General practitioners complete approximately 26% of death certificates themselves
      but have considerable difficulty obtaining prompt and accurate information about
      their other patients who die. A random survey of district health authorities in
      England revealed that all were able to compile death lists but none included
      general practitioner details. This paper reviews the flow of information on
      patient deaths and describes a project to assess the feasibility of providing
      Newcastle general practitioners with comprehensive death registers. With the
      collaboration of the family health services authority and the district health
      authority, and with data from the regional perinatal mortality survey the
      creation each week of complete lists of patient deaths, broken down by general
      practitioner, is feasible. Death registers allow general practitioners to
      undertake audit of the quality of death certification and of the care of the
      recently deceased, and to improve the continuing care of the bereaved.

PMID- 8466781
TI  - James Mackenzie Lecture 1992. The Indians' revenge.

PMID- 8466780
TI  - Efficacy of physiotherapy for musculoskeletal disorders: what can we learn from
      research?
AB  - In order to summarize the available clinical evidence for the efficacy of
      physiotherapy, 400 randomized clinical trials were identified from the
      literature. Studies were found by using bibliographic databases, citation
      tracking, and correspondence with researchers in the field. Focusing on disorders
      of the musculoskeletal system, a number of criterion based meta-analyses were
      performed on 180 trials in order to summarize the available evidence. For each
      randomized clinical trial in each meta-analysis a methodological score was
      calculated using a set of explicit criteria and weighting factors applied by two
      or three independent reviewers who were blinded as to the outcomes, the journal
      and the authors of the publication. In each meta-analysis the randomized clinical
      trials were ordered hierarchically depending on their score for methodological
      quality. Meta-analyses were performed for spinal manipulation, exercise therapy,
      traction, ultrasound, and laser therapy, and for disorders of the back, neck,
      shoulder and knee. In general, the methodological quality of the studies appeared
      to be low, and the efficacy of physiotherapy was shown to be convincing for only
      a few indications and treatments. On the other hand, because of the prevalence of
      serious methodological flaws, it cannot be concluded that physiotherapy has no
      effect.

PMID- 8466782
TI  - Apparent food allergy.

PMID- 8466783
TI  - Ambulatory blood pressure measurement.

PMID- 8466784
TI  - Community care of patients receiving antipsychotic medication by depot injection.

PMID- 8466786
TI  - [Tax tips for nurses].

PMID- 8466785
TI  - Emergency contraception.

PMID- 8466787
TI  - [Norwegian Nurses Association with large-scale campaign: we must entice career
      minded youths to the nursing profession].

PMID- 8466788
TI  - [Student guidance clarified. Interview by Kjell Arne Bakke].

PMID- 8466790
TI  - [Sceptical about cooperation in revenue policy].

PMID- 8466789
TI  - [First aid 30,000 feet high. Interview by Siv Barstad].

PMID- 8466791
TI  - [Pat on the shoulder, less in union's fund. Interview by Bjorn Arild Ostby].

PMID- 8466792
TI  - [Nursing under a different sky--Saudi Arabia].

PMID- 8466794
TI  - [To Uganda with knowledge. Interview by Kjell Arne Bakke].

PMID- 8466793
TI  - [Asia: front-line country in the HIV epidemic].

PMID- 8466795
TI  - [The entire family in childbed].

PMID- 8466796
TI  - [Professional nurses have a lot of responsibility and many possibilities].

PMID- 8466797
TI  - [Special hospital stifles guest patients' arrangement. Unfair to patients].

PMID- 8466798
TI  - [Special hospital stifles guest patients' arrangement. Sunnaas struggles.
      Interview by Siv Barstad].

PMID- 8466799
TI  - [Special hospital stifles guest patients' arrangement. Everybody has enough of
      it].

PMID- 8466800
TI  - Analysis of enterotoxin production by Bacillus cereus from dairy products, food
      poisoning incidents and non-gastrointestinal infections.
AB  - Of 85 strains of Bacillus cereus isolated in Norway from dairy products, 59% were
      found to be enterotoxigenic, and 15% were psychrotrophic. Six of the isolates
      (7%) were identified as potential psychrotrophic food-poisoning strains as they
      were both enterotoxigenic and exhibited good growth at 6 degrees C. Enterotoxin
      production was detected using the Western immunoblot technique, and a
      commercially available reversed passive latex agglutination (RPLA) assay (Unipath
      BCET-RPLA TD950). Both methods gave essentially the same results. In a separate
      study, the Western immunoblot and RPLA assays were used in a conjunction with the
      in vivo vascular permeability reaction (VPR) assay to determine enterotoxin
      production among 25 isolates of Bacillus cereus referred to the PHLS Food Hygiene
      Laboratory from incidents of diarrhoeal- and emetic-syndrome food poisoning and
      non-gastrointestinal infections. Eighty-four percent of these isolates were found
      to be enterotoxigenic by the Western immunoblot and the RPLA assays, and these
      results were in good agreement with those obtained by the VPR assay. In both
      studies, the BCET-RPLA kit proved to be a simple and reliable means for
      determining enterotoxin production by strains of Bacillus cereus.

PMID- 8466801
TI  - Detection of Salmonella in animal protein by Rappaport-Vassiliadis broth using
      indirect impediometry.
AB  - Indirect impedance methodology for the detection of Salmonella was investigated
      using a rapid automated bacterial impedance technique (RABIT) system. Four
      commercially available Rappaport-Vassiliadis (RV) enrichment broths were
      evaluated for their sensitivity and selectivity in detecting Salmonella using
      this technique. The RV from Lab M and Oxoid (new) gave the shortest detection
      times and showed good correlation between Salmonella numbers and detection times.
      Using Lab M medium, the indirect impedance technique could distinguish between
      Salmonella spp. and the closely related genera, Proteus and Citrobacter. The
      impedance technique showed recoveries of Salmonella from processed animal protein
      and raw meats equivalent to, or better than, those obtained with RV used in a
      conventional Salmonella isolation procedure.

PMID- 8466802
TI  - Effect of three preservatives on the growth of Bacillus cereus, Vero
      cytotoxigenic Escherichia coli and Staphylococcus aureus, on plates with
      gradients of pH and sodium chloride concentration.
AB  - The effect of temperature, pH, sodium chloride concentration and a preservative
      (sodium benzoate, sodium nitrite or potassium sorbate) on the growth of three
      foodborne bacterial pathogens (Bacillus cereus, Vero cytotoxigenic Escherichia
      coli and Staphylococcus aureus) was studied using gradient gel plates. Growth,
      expressed in optical density units, was recorded using image analysis techniques,
      and was expressed as three-dimensional grids. These gave a visual indication of
      the effects of any three of the environmental factors on bacterial proliferation.
      Sorbate was completely effective against E. coli at all temperature/pH/NaCl
      combinations, and was the most effective preservative tested against B. cereus.
      Increase in the acidity and/or the NaCl concentration improved the effect of all
      the preservatives, except nitrite when used against St. aureus. Nitrite was the
      least effective preservative, particularly against St. aureus. At < 25 degrees C,
      sorbate was more effective than benzoate against St. aureus when used with higher
      concentrations of NaCl. At 35 degrees C benzoate was the most effective
      preservative against St. aureus, especially when used at pH < 6.

PMID- 8466803
TI  - Effects of gluconodeltalactone and Lactobacillus plantarum on the production of
      histamine and tyramine in fermented sausages.
AB  - Fermented sausages were made experimentally with addition of 0.3% (w/w)
      gluconodeltalactone (GDL) or a starter culture of Lactobacillus plantarum, unable
      to produce histamine or tyramine. Controls were produced without GDL and starter
      culture. During 15 days preparation and storage periods, number of bacteria and
      lactobacilli, pH, and levels of histamine, tyrosine and tyramine were monitored,
      and organoleptic evaluations were carried out. Maximal histamine levels were
      19.41 micrograms/g of dry matter in the GDL-added sausages, 18.64 micrograms/g in
      the control, and 17.20 micrograms/g in the starter sausages. Maximal tyramine
      levels were 1249.16 micrograms/g in the GDL sausages, 1101.16 micrograms/g in the
      control, and 906.35 micrograms/g in the starter sausages. Sausages produced with
      GDL proved less acceptable in organoleptic evaluation due to an unpleasant sour
      flavour.

PMID- 8466804
TI  - Inhibition of the growth of yeasts in fermented salads.
AB  - Salads composed of vegetables and/or meat in an oil-in-water emulsion were
      prepared by fermentation for 7 h at 42 degrees C or 45 degrees C with strains of
      Lactobacillus spp. Their stability towards spoilage yeasts was studied using
      Saccharomyces cerevisiae, Saccharomyces exiguus and Torulaspora delbrueckii,
      isolated from salads, as well as Pichia membranaefaciens and Zygosaccharomyces
      bailii. Salads fermented with good lactic starters usually had pH values of < or
      = 4.2 and lactic acid concentrations of 0.28 to 0.43% (w/w). High numbers of
      spoilage yeasts (and production of large volumes of CO2) were not attained in
      these salads, provided the initial concentration of spoilage yeasts was
      sufficiently low (< or = 100 CFU/g). Inhibition of spoilage yeasts in lactic
      fermented salads is probably due to lactic acid, the low storage temperature and
      the low residual oxygen concentration.

PMID- 8466805
TI  - Flow cytometric detection of wild yeast in lager breweries.
AB  - A flow cytometric method for detection of wild yeast infections in breweries is
      reported. It is based on selective enrichment in Malt extract Yeast extract
      Glucose Peptone broth (MYGP) at 37 degrees C and in MYGP with 200 ppm CuSO4 at 25
      degrees C, staining with a fluorochrome precursor and flow cytometry. In
      experiments with several types of wild yeast isolated from breweries and two
      different strains of lager yeast it has been possible to detect one wild yeast
      per 10(6) culture yeast after 48-72 h of incubation and, in some cases, after 24
      h.

PMID- 8466806
TI  - Survey of the physiological properties of the most frequent yeasts associated
      with commercial chilled foods.
AB  - A comparative analysis of the initial and final population of yeasts, lactic acid
      bacteria and psychrotrophic bacteria, in a number of chilled foods, varying in
      ingredients, physico-chemical characters and origin, gave evidence that yeasts
      could play a significant role in the spoilage. The yeast populations appeared to
      be unexpectedly uniform and comprised principally strains of Yarrowia lipolytica,
      Debaryomyces hansenii and Pichia membranaefaciens. A survey of 62 isolates,
      comprising physiological characteristics such as growth temperatures, proteolytic
      and lipolytic activities, hydrophobicity, aw and preservative tolerance, in
      addition to organic acid production, indicated that these dominant species have
      very few common characters and that they are endowed with a spoilage potential
      probably linked to different physiological properties. The isolates of Y.
      lipolytica exhibited the strongest proteolytic and lipolytic activities and a
      pronounced hydrophobicity while D. hansenii isolates were characterized by a high
      growth rate at low temperature and at intermediate aw. P. membranaefaciens
      isolates showed a remarkable tolerance to acetic acid as a sole selective factor.
      A hypothesis of separate growth loci, in multicomponent or polyphasic food
      systems, was formulated.

PMID- 8466807
TI  - A 48 kilodalton enterotoxin-related protein from Clostridium perfringens
      vegetative and sporulating cells.
AB  - Sporulating and vegetative cell extracts of enterotoxin-positive and enterotoxin
      negative strains of Clostridium perfringens were examined by Western blotting
      using enterotoxin antiserum. A 48-kDa enterotoxin-related protein was found in
      vegetative and sporulating cell extracts of both toxin types. The results
      question previous reports about the ability of vegetative cells and presumptive
      enterotoxin-negative strains of this organism to produce enterotoxin, a protein
      with a molecular weight of 34 kDa.

PMID- 8466808
TI  - Microbial ecology of fresh pork stored under modified atmosphere at -1, 4.4 and
      10 degrees C.
AB  - The prevalent bacteria on fresh pork packaged in modified atmosphere with
      elevated CO2 were determined by selection of representative colonies from the
      greatest dilution of meat samples. The pork samples were stored in two packaging
      films of different oxygen permeability at three storage temperatures. Strains
      were classified and those identified as lactic acid bacteria were screened for
      production of inhibitory substances. The types of bacteria isolated from samples
      stored in the two packaging films were similar. Storage temperature influenced
      the type of bacteria that dominated the microbial population. At 10 degrees C the
      prevalent microflora consisted of aeromonads, Enterobacteriaceae and lactic acid
      bacteria but at 4.4 and -1 degrees C, aeromonads, Brochothrix thermosphacta and
      lactic acid bacteria dominated. Listeriae were detected as part of the prevalent
      microflora on samples stored at -1 degree C, but not on samples stored at 4.4 or
      10 degrees C. Species of lactic acid bacteria dominating the microflora were
      influenced by growth medium. The majority of isolates taken from Plate Count agar
      were carnobacteria whereas those from Lactobacilli MRS agar were homofermentative
      lactic acid bacteria. Of the 538 lactic acid bacteria isolates screened for
      production of inhibitory substances, 162 strains showed deferred inhibition
      toward a range of lactic acid bacteria and nonlactic acid bacteria indicator
      strains.

PMID- 8466809
TI  - A model of food-borne Listeria monocytogenes infection in the Sprague-Dawley rat
      using gastric inoculation: development and effect of gastric acidity on infective
      dose.
AB  - Recent epidemiological evidence suggests that Listeria monocytogenes (LM) is a
      food-borne pathogen in humans. A model of LM infection was developed using the
      Sprague-Dawley (SD) rat to study the interaction of LM with gastrointestinal
      epithelium as the first step in the pathogenesis of invasive listeriosis.
      Conventionally raised, juvenile female SD rats were given 10(2)-10(9) virulent L.
      monocytogenes, serotype 4b or nonpathogenic Listeria species. Only rats given
      virulent LM developed dose-dependent invasive infection of the liver and spleen.
      Light and electron microscopic studies suggested attachment to and invasion of
      the gastrointestinal mucosa by virulent LM. Because the development of invasive
      listeriosis in humans has been epidemiologically associated with a decrease in
      gastric acidity, the effect of decreasing gastric acidity on dose-dependent
      infection was studied. Rats were pretreated with cimetidine (50 mg/kg) by
      intraperitoneal injection prior to oral inoculation of 10(2)-10(9) virulent L.
      monocytogenes. Cimetidine significantly lowered the infective dose of virulent L.
      monocytogenes (P < 0.05). This oral model should allow further study of host and
      organism-specific virulence factors mediating the gastrointestinal phase of
      invasive LM infection, an increasingly important public health problem.

PMID- 8466810
TI  - Effect of low-dose irradiation on growth of and toxin production by
      Staphylococcus aureus and Bacillus cereus in roast beef and gravy.
AB  - The effect of irradiation (2 kGy) on growth of and toxin production by
      Staphylococcus aureus and Bacillus cereus in roast beef and gravy during storage
      at abuse temperatures (15 and 22 degrees C) was assessed by inoculation studies.
      Irradiation resulted in a 3-4 log10 reduction in numbers of both pathogens.
      Whenever B. cereus and S. aureus numbers reached 10(6) and 10(7) cfu/g,
      respectively, during storage their toxins were detectable. As the time taken to
      attain these levels was longer in irradiated than in unirradiated samples, toxin
      production by both pathogens was delayed by irradiation. When samples initially
      containing low levels (10(2)/g) of S. aureus were irradiated no toxin was
      produced during subsequent storage at 15 or 22 degrees C. Diarrhoeal toxin
      produced by B. cereus was detected after 2 days at 22 degrees C, but not at 15
      degrees C, in samples containing 10(2) cells/g prior to irradiation. When higher
      numbers (10(6)/g) of either pathogen were present prior to irradiation, toxins
      were produced by both pathogens at 22 degrees C, but not at 15 degrees C.
      Microbial competition had an effect on the growth of B. cereus and S. aureus
      after irradiation when a low initial inoculum was applied. However, when a higher
      inoculum was used the pathogens outnumbered their competitors and competition
      effects were less important. It was concluded that low-dose irradiation would
      improve the microbiological safety of roast beef and gravy.

PMID- 8466811
TI  - An improved medium for distinguishing between homofermentative and
      heterofermentative lactic acid bacteria.
AB  - An improved solid medium for differentiating between homofermentative and
      heterofermentative lactic acid bacteria is proposed. It was developed to support
      the growth of wine strains unable to grow in other media. However, it can be
      employed as a general medium for the lactic acid bacteria that utilize fructose.

PMID- 8466812
TI  - Within and between sample comparisons of Gompertz parameters for Salmonella
      enteritidis and aerobic plate counts in chicken stored in air and modified
      atmosphere.
AB  - The objective of this work was to compare between and within sample differences
      in aerobic plate counts (APC) and Salmonella in chicken held at abusive
      temperatures under air and modified atmosphere (MA). Three independent samples
      and three subsamples of ground raw chicken meat were inoculated with a nalidixic
      acid-resistant Salmonella enteritidis var. Rochester, packaged in barrier films
      containing air or 75% CO2, 20% N2, and 5% O2, and stored at 13 and 27 degrees C
      for 120 h. Samples were quantitatively enumerated for APC and S. enteritidis
      colony forming units (cfu/g). Gompertz function parameters for microbial growth
      in each sample and subsample were statistically compared in order to determine if
      within sample variation was different to between sample variation. At 13 degrees
      C, APC organisms averaged 1.27 log units lower in the MA compared to air while
      Salmonella counts averaged 1.44 log units higher. At 27 degrees C APC averaged
      0.46 log units lower in the MA compared to air while Salmonella averaged 0.30 log
      units lower. The data fit the Gompertz function such that no systematic
      deviations from the curves were detected and the confidence bands were relatively
      narrow. Except for initial microbial load, there were no significant differences
      in variance of Gompertz parameters between the subsamples and the independent
      samples. This indicates that samples from different chickens with the same
      initial APC can be expected to be as similar in growth patterns and final counts
      as subsamples from the same chicken.

PMID- 8466813
TI  - Yeasts associated with Vienna sausage packaging.
AB  - A total of 123 representative yeast isolates from a previous study of a Vienna
      sausage processing plant were identified according to conventional methods and
      long-chain fatty acid analyses. The most prevalent isolates belonged to the
      genera Candida and Debaryomyces. Other genera encountered were Rhodotorula,
      Yarrowia, Pichia, Galactomyces, Cryptococcus, Trichosporon and Torulaspora.

PMID- 8466814
TI  - Development and evaluation of a novel sterilizer with rotary vibrators.
AB  - A novel steam-air sterilizer with rotary vibrators was developed with the aim of
      promoting heat transfer and the effective sterilization of foods. To evaluate the
      effects of the sterilizer, experiments to examine heat transfer and sterilization
      tests were carried out. In the experiments to examine heat transfer, heat
      penetration factors of sterilizer with vibration, j and fh values, were 1.70 and
      1.50, respectively, while those of sterilizer without vibration were 1.83 and
      2.32, respectively. In the sterilization with vibration, no surviving cells were
      detected after 3 min, whereas 7 min were required for sterilization without
      vibration. The rate of the amino carbonyl reaction was repressed by heat
      treatment with vibration.

PMID- 8466815
TI  - Microbial flora of frozen tail meat from captive Nile crocodiles (Crocodylus
      niloticus).
AB  - Frozen tail meat samples from nine Nile crocodiles (Crocodylus niloticus) were
      evaluated for microbial numbers and types. Microbial analyses yielded a mean
      aerobic plate count (APC, 30 degrees C) of 4.86 log cfu/g, a mean coliform count
      (TC, 37 degrees C) of 3.77 log cfu/g and a mean faecal coliform count (FC, 44
      degrees C) of 3.40 log cfu/g. Salmonella was isolated from three samples, and
      beta-haemolytic streptococci from two samples. Yersinia, Aeromonas,
      Staphylococcus aureus and Bacillus cereus were not isolated. Typical bacterial
      genera recovered included Flavobacterium, Pseudomonas, Acinetobacter,
      Enterobacter, Moraxella, Micrococcus, Staphylococcus and Streptococcus.

PMID- 8466816
TI  - Novel mechanism for the CAMP reaction between Listeria monocytogenes and
      Corynebacterium equi.
AB  - The synergistic hemolytic reaction between Listeria monocytogenes, Staphylococcus
      aureus and Corynebacterium equi on blood agar plates was explored using a
      modified test-tube assay. A synergistic lysis of sheep red blood cells was
      observed with L. monocytogenes and either S. aureus or C. equi, using crude
      extracts. Synergism was also found with L. monocytogenes and purified cholesterol
      oxidase from Pseudomonas fluorescens and Brevibacterium brevi. Crude extracts of
      S. aureus sensitized sheep red blood cells to subsequent lysis with either L.
      monocytogenes or C. equi. The interaction between L. monocytogenes and C. equi
      apparently did not involve a pre-sensitization step; simultaneous exposure of
      sheep red blood cells to the two extracts was required. A number of strains of L.
      monocytogenes gave positive synergistic reactions with cholesterol oxidase,
      suggesting that this reaction may be more useful than the CAMP test with C. equi
      for identifying L. monocytogenes. These results suggest that a novel synergistic
      reaction may be taking place, possibly involving the listeriolysin O, or one or
      both of the phospholipases from L. monocytogenes.

PMID- 8466817
TI  - Accident & emergency nursing: why are we waiting?

PMID- 8466818
TI  - Health and safety: assessing the risks.

PMID- 8466819
TI  - Avoiding the risk of needlestick injuries.
AB  - It is dangerous not to recap used needles, yet it can be equally dangerous to
      recap them. For each of us in the health sector, the prevention of needlestick
      injury (NSI) should be an everyday objective. This article discusses the risks
      associated with NSIs and examines whether current recommendations are being
      ignored.

PMID- 8466820
TI  - Farewell to a special nurse.

PMID- 8466821
TI  - Meeting the health needs of gypsies.

PMID- 8466822
TI  - Ethics: nursing care of gay and lesbian patients.
AB  - Work currently being undertaken by the Royal College of Nursing's Lesbian and Gay
      Nursing Issues Working Party has revealed evidence of prejudice towards, and
      discrimination against, lesbian and gay patients by members of the nursing and
      medical professions. In addition, there are instances when the specific nursing
      needs of this population have not been met due to lack of knowledge on the part
      of practitioners. Lesbians and gay men who have mental health problems are
      particularly vulnerable to abuse from homophobic health care workers. Lesbian and
      gay teenagers are even more vulnerable, and they run the added risk of being
      labelled mentally ill because of behaviour which is considered socially
      undesirable. This article discusses the research evidence and highlights the need
      for further investigation into providing appropriate and acceptable services to
      these patients.

PMID- 8466823
TI  - Nursing, HIV & AIDS: AVERT funded project.
AB  - October 1991 saw the start of a two-year national investigation into the nursing
      care and treatment of people with HIV/AIDS. The project is based in the Daphne
      Heald Research Unit at the Royal College of Nursing and is funded by the AIDS
      Education and Research Trust (AVERT). The aim is to gather information on current
      approaches to nursing care and treatment at a number of centres around the
      country, and to identify some of the main issues that are important to nurses
      undertaking this work. This article is based on preliminary reading and
      discussions with nurses, and makes some general points about the nursing
      profession's response to HIV/AIDS.

PMID- 8466824
TI  - Alternative therapies: a new holistic science.

PMID- 8466825
TI  - Uninhibited introductions.

PMID- 8466826
TI  - Standards of care: whistle down the drain.

PMID- 8466827
TI  - Information technology: what will computers do for me?

PMID- 8466829
TI  - HIV surveys should be treated with caution.

PMID- 8466828
TI  - NHS reforms: stop corporate blandishment.

PMID- 8466830
TI  - Tributes flood in for Richard Wells--'a very special man'.

PMID- 8466831
TI  - Occupational stress in head teachers: a national UK study.
AB  - This study assessed occupational stress amongst 2,638 head teachers of primary
      and secondary schools, together with principals/directors of further and higher
      education establishments, throughout the United Kingdom. Data were collected on
      personal/job demographics, sources of job stress, mental health, job satisfaction
      and coping strategies. These data were analysed by SPSS-X, producing univariate,
      bivariate and multivariate techniques. It was found that as we moved from the
      further/higher education level to secondary to primary sectors, the levels of job
      dissatisfaction and mental ill health rose. In addition, it was found that, with
      the exception of primary schools, female head teachers in secondary and FHE seem
      to be suffering significantly greater job dissatisfaction than their male
      counterparts, although this does not translate itself into mental ill health.
      Male head teachers, on the other hand, seem to suffer more mental ill health than
      their female counterparts. And finally, the two main sources of occupational
      stress that appear in many of the multivariate analyses as predictors of job
      dissatisfaction and mental ill health are 'work overload' and 'handling
      relationships with staff'. The implications of all these findings are discussed
      in detail.

PMID- 8466832
TI  - Effective use of pictures as extra stimulus prompts.
AB  - Past research on learning single words in the presence of pictures has suggested
      that the pictures can function as a blocking element which inhibits the
      development of an association between the written word and its spoken response.
      The purpose of this study was to investigate whether the extra stimulus pictorial
      prompts can be arranged in a different manner which does not inhibit the learning
      of the words. Three presentation techniques were investigated using samples (N =
      12) of kindergarten children: matching, matching with the fading of the pictorial
      stimulus prompts, and feedback cueing. The results showed that, in general, the
      best learning occurred in the absence of the pictorial prompts, that is, when the
      words were presented alone. In the case of the feedback cueing condition,
      however, this technique neutralised the blocking effect of the pictures and the
      performance was as good as the word-alone condition.

PMID- 8466833
TI  - What do inventories of students' learning processes really measure? A theoretical
      review and clarification.
AB  - Research into student learning has been based on two main theoretical sources:
      information processing (IP), and contextually based work on students' approaches
      to learning (SAL). The cross-fertilisation has been valuable, but it has led to
      ambiguities and misunderstandings, evident in the recent literature, about
      constructs, methodology, and of particular concern here, the development and
      interpretation of inventories of learning/study processes. The basic issue
      revolves around a conception of student learning as taking place within-the
      student, as IP models appear to assume, or within-the-teaching/learning-context,
      as the SAL tradition emphasises. It is suggested that student learning is best
      construed within a teaching/learning context that functions as an 'open system',
      a model that brings some clarity to the use and interpretation of study process
      inventories, and that locates their value in yielding functionally useful data to
      researchers, teachers, and staff developers.

PMID- 8466834
TI  - A critique of research on cognition and cognitive processes.
AB  - In this article it is pointed out that there exists a methodological
      contradiction in most research on cognition and cognitive processes, which makes
      such research invalid in the strongest meaning of the term. When the aim is to
      study cognitive processes very often the researcher uses attributes of the
      learning material to be the standard or the template against which any outcome of
      the subjects can be analysed and made the ground for inferences about cognition
      and cognitive processes. This way of doing research is considered to be based on
      false theoretical assumptions and also proven invalid by a number of empirical
      studies. It is suggested in the article that the researcher must distinguish
      between an educational and a cognitive perspective and avoid mixing them in order
      to carry out successfully research on cognitive processes.

PMID- 8466835
TI  - Relations between children's playground and classroom behaviour.
AB  - In this within-subjects design field experiment children's behaviour in the
      playground was charted as a function of gender and time in the classroom
      immediately preceding playtime. Playground behaviour was also related to post
      recess classroom behaviour. Twenty-three 9-year-old children were observed for 14
      weeks. Classroom behaviour (i.e., task relevant behaviour on standardised seat
      work immediately before and after playtime) and playground behaviour (i.e.,
      social and non-social exercise and sedentary behaviour) were observed. Time in
      classroom before playtime was manipulated so that there was a shorter and a
      longer confinement period. Results indicated that children were less attentive to
      seat work as a function of time and that longer confinement resulted in more
      exercise for boys and more social sedentary behaviour for girls. Social behaviour
      at playtime and post-playtime attention to seat work were significantly related.
      Results are discussed in terms of Novelty Theory.

PMID- 8466836
TI  - Vygotsky and Papert: social-cognitive interactions within Logo environments.
AB  - The purpose of this study was to examine the effects of co-operative and
      individualised Logo environments on creativity and interpersonal relationships
      regarding academic recognition and social acceptance. Participants were 83
      students who studied in three eighth grade classrooms: one was exposed to a co
      operative Logo environment (N = 30), the other to an individualised Logo
      environment (N = 24), and the third served as a non-treatment control group (N =
      29). Results showed that students in the cooperative Logo environment
      outperformed their counterparts in the other two groups on certain measures of
      creativity (figurative-originality, verbal-flexibility, and verbal-originality).
      In addition, the co-operative Logo group developed more positive interpersonal
      relationships than the students in the other two settings. The results are
      discussed from three perspectives: the social-cognitive approach emphasising the
      roles of co-operation and metacognition in developing advanced thinking skills;
      the educational-technology viewpoint demonstrating the potential use of
      computers; and the pedagogical view pointing out the implications of the study to
      school situations and heterogeneous classrooms.

PMID- 8466837
TI  - Tooth and nail syndrome: genetic, clinical and dermatoglyphic findings: case
      report.

PMID- 8466839
TI  - Pediatric dentistry a metaphor for life: the third option.

PMID- 8466838
TI  - Anomalies associated with hypodontia of the permanent lateral incisor and second
      premolar.
AB  - Apart from the molars the most commonly congenitally absent tooth is the second
      premolar followed by the permanent lateral incisor. From a total of 5127
      patients, congenital absence of the permanent lateral incisor occurred with a
      frequency of 2.2 per cent and absence of the second premolar with a frequency of
      3.4 per cent. In association with hypodontia of these teeth other dental
      anomalies were observed. Absence of other teeth was observed as the most likely
      associated dental anomaly. Other anomalies recorded included disturbances in
      spacing of the dentition, and problems associated with tooth eruption and
      exfoliation.

PMID- 8466840
TI  - Improving profitability in a fee for service pediatric dental private practice
      through internal marketing.
AB  - To maximize your internal marketing, emphasize quality, services, and services
      added in your office. Your increased understanding of the needs and wants of your
      patients will be financially rewarding and gratifying.

PMID- 8466841
TI  - Children's behavior in emergency and non-emergency dental situations.
AB  - This study evaluated children's behavior during emergency and non-emergency
      visits to the dentist. Three methods were used to evaluate behavior: 1) the
      Palmar Sweat Index, 2) the Taylor Manifest Anxiety Scale, and 3) the Frankl
      Behavior Scale. Forty children, 6-12 years of age, were seen in a pediatric
      dental clinic. All children had no previous dental experiences. Twenty patients
      were seen for new patient examinations and twenty patients had emergency
      examinations and treatment. This study showed that children exhibit equal levels
      of stress whether for a screening appointment or an emergency visit. The Palmar
      Sweat Index has the potential of being a viable evaluation for detecting non
      verbally expressed anxiety.

PMID- 8466842
TI  - An investigation of accessory foramina in furcation areas of human primary
      molars: Part 1. SEM observations of frequency, size and location of accessory
      foramina in the internal and external furcation areas.
AB  - Although the existence of accessory foramina in the furcation area and roots of
      permanent teeth has been demonstrated, the presence of accessory foramina in
      furcation areas of primary molars is less certain. This investigation was
      conducted to determine the presence or absence of accessory foramina in the
      furcation areas of human primary molars using the scanning electron microscope
      (SEM). Twenty extracted, carious and noncarious human primary molars were placed
      in fixative and then mounted in a hard tissue cutting machine: ten teeth were cut
      transversely 2.0mm coronal to the floor of the pulpal chamber and ten teeth were
      cut transversely 2.0mm apical to the external furcation. Both the internal and
      external furcation surfaces of these sectioned molars were debrided with sodium
      hypochlorite/hydrogen peroxide solutions to remove organic materials, which might
      obscure visibility of possible foramina and then rinsed in water and dried. The
      tissues were then prepared for and examined by SEM. Twenty percent of the molars
      examined by SEM on the internal furcation surface and 50% of the molars examined
      by SEM on the external furcation surface demonstrated accessory foramina.

PMID- 8466844
TI  - Chemical analysis of a dens invaginatus by SEM microanalyses.
AB  - A patient with a supernumerary right maxillary lateral incisor with dens
      invaginatus presented. After extraction, the invaginated area of the tooth as
      well as another of similar ages but with normal hard tissues, were prepared for
      scanning electron microscopic observation. Outer and invaginated enamels were
      identified the latter showing more density. Chemical analysis by the scanning
      microanalyses revealed differences in mineral contents between: a) the external
      and cut surface of the outer and the invaginated enamel, and b) the external and
      cut surface of the normal tooth. The outer and invaginated enamels are quite
      different concerning the quantity and quality of minerals, the latter having no
      magnesium at all. Magnesium was also non existent in the dentin.

PMID- 8466843
TI  - An investigation of accessory canals in furcation areas of human primary molars:
      Part 2. Latex perfusion studies of the internal and external furcation areas to
      demonstrate accessory canals.
AB  - Four classes of accessory canals: "true," "blind," "looping" and "enclosed"
      canals have been suggested to exist in furcation areas of primary teeth. Although
      the existence of accessory canals in the furcation areas and roots of permanent
      teeth has been demonstrated, their presence in furcation areas of primary teeth
      is uncertain. This investigation was conducted to determine the presence or
      absence of accessory canals in the furcation areas of human primary molars using
      a variety of latex perfusion techniques. Twenty extracted, noncarious human
      primary molars were placed in fixative and then sectioned on a hard tissue
      cutting machine: ten teeth were cut transversely 2.0 mm coronal to the floor of
      the pulpal chamber and ten teeth were cut transversely 2.0 mm apical to the
      external furcation area. The internal and external furcation surfaces of these
      sectioned molars were debrided with sodium hypochlorite/hydrogen peroxide
      solutions, rinsed in water and dried to remove organic materials, which might
      obscure the existence of possible canals. Twenty of these extracted teeth were
      examined by SEM to detect the possible presence of accessory foramina in the
      internal and external furcation areas (Part 1). Twenty percent of the molars
      examined by SEM on the IFA and 50 percent of the molars examined by SEM on the
      EFA exhibited accessory foramina. Twenty molars were perfused with low viscosity
      latex using vacuum [negative] pressure (10 molars) and positive pressure (10
      molars) to detect the possible existence of the patency and the extent of such
      accessory canals in the internal and external furcation areas (Part 2).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466845
TI  - Effect of fluoridated gels on a light-cured glass ionomer cement: an SEM study.
AB  - This SEM study evaluated the micromorphological effect of a 1.23% acidulated
      phosphate fluoride gel (Oral-B) (APF) and a neutral 1.1% sodium fluoride gel
      (Thera-Flur) (Colgate-Hoyt) on the surface of a light-cured glass ionomer cement
      (Fuji II LC) with or without a protective surface glazing. Glass ionomer (GI)
      cylinders (area 6.69 mm) were prepared and divided into six groups of 10
      specimens each: Group 1: GI; Group 2: GI + APF gel for 4 minutes; Group 3: GI +
      glaze; Group 4: GI, glaze, APF for 4 minutes; Group 5: GI, neutral fluoride for 4
      minutes; Group 6: GI, glaze, neutral fluoride for 4 minutes. The glass ionomer
      was handled according to manufacturer's instructions, except for the groups using
      the glaze after light-curing the GI. The glaze resin (Ketac-Glaze) was painted
      with a brush over the GI surface and cured with visible light (Demetron) for 30
      seconds. The fluoride gels were left in contact with the surface for 4 minutes,
      rinsed and dried. All specimens were then mounted on aluminum stubs, coated and
      evaluated under the SEM. The results indicated that the APF gel etches the GI
      surface considerably and that the glaze protects the GI from the APF gel. The
      neutral fluoride gel had no significant effect on the GI surface with or without
      the glaze application.

PMID- 8466846
TI  - Incidence of malocclusion in asthmatic children.
AB  - This study examined the relationship of a compromised airway in asthmatic
      children, i.e. mouthbreathing, and the effect that the airway compromise has on
      occlusal and facial characteristic. The study consisted of sixty-four children of
      both sexes, ranging in age from three to sixteen years. Thirty-two subjects were
      from the pulmonary and allergy clinic of the Floating Hospital, New England
      Medical Center, who were present for follow-up and/or treatment of asthma. Thirty
      two randomly selected children were selected from the pediatric clinic in Tufts
      University School of Dental Medicine to serve as controls. The two groups were
      equally balanced according to age, sex and race. A statistically significant
      relationship was found between the frequency of crossbites and the frequency of
      mouth breathing. Additionally, a statistically significant relationship was found
      between the frequency of crossbites and the facial type in the experimental
      group. The frequency of crossbites appears to be related to abnormal facial
      types.

PMID- 8466847
TI  - Supernumerary teeth removal and orthodontic tooth repositioning: a case report.
AB  - A case is presented of a 12-year-old, black male, who had a full permanent
      dentition except for retaining the two maxillary primary central incisors. A
      radiographic examination revealed the presence of two supernumerary teeth
      interfering with the eruption of the permanent central incisors. Space was
      orthodontically created for the permanent central incisors, the primary central
      incisors and supernumerary teeth were removed, and the permanent central incisors
      were orthodontically brought into proper alignment.

PMID- 8466848
TI  - Papillon Lefevre syndrome: treatment of two cases with a clinical microbiological
      and histopathological investigation.
AB  - Papillon Lefevre syndrome is presented in the cases of two female patients of the
      ages of 7 and 9, who exhibited all typical symptoms of the disease.
      Microbiological and histopathological studies were done and treatment provided.
      Actinobacillus actinomycetemcomitans, which is suspected as a pathogenic factor
      in the disease was identified as well as some other gram negative microorganisms
      and an antibiogram was performed in which amoxycillin plus clavulanic acid was
      most effective. Histopathological investigation also confirmed the presence of
      gram negative bacteria. Granular cell infiltration was predominant in the surface
      epithelium. Prosthetic appliances were provided for the patients after mechanical
      and chemical plaque control. In addition to this, antibiotics (amoxycillin plus
      clavulanic acid) were prescribed every six months. No tooth loss was observed in
      both patients after more than two years follow-up period. At the moment only one
      patient is under review and because she is uncooperative, mild periodontal
      inflammation is still present around the teeth which erupted before the
      antibiotic regime, but not in the other teeth.

PMID- 8466849
TI  - Tumor cell proliferation and motility estimates are prognostic factors in
      malignant melanoma.
AB  - Metastatic spread of solid tumors depends on a complex metastatic cascade.
      Metastatic tumor cells must therefore express a variety of biological properties
      including the ability to proliferate and the ability to migrate. In the present
      study, the prognostic significance of both parameters was investigated in 184
      cases of malignant melanoma of the skin. Proliferative activity was assessed by
      mitotic counts, the degree of cell motility was estimated by comparing the
      histological pattern of the tumor with patterns obtained by computer simulations
      with predefined values of cell motility. Follow up of surviving patients was at
      least 5 years. Statistical analysis was done using classification and regression
      tree (CART) analysis combining mitotic counts and motility estimates. As far as
      overall survival was concerned, mitotic counts were the most significant variable
      separating one group of patients with mitotic counts < 17/mm2 and a 5-year
      survival rate of 82% and a group with mitotic counts > or = 17/mm2 and a 5-year
      survival rate of 52%. Within the group with low mitotic counts, motility
      estimates found a subgroup of patients with a coefficient of motility > or = 126,
      which had a 5-year survival rate of 55% similar to those patients with high
      mitotic counts. Corresponding results were obtained in the assessment of
      metastasis-free interval. The data show that not only proliferation as assessed
      by mitotic counts, but also estimates of tumor cell motility based on image
      analysis and computer simulations provide prognostic information in primary
      malignant melanoma of the skin.

PMID- 8466850
TI  - A constant flux system using the 'magnetic cell separator' (MACS) for highly
      efficient T-cell depletion.
AB  - A method for highly efficient T-cell depletion using a 'Magnetic Cell Separator'
      (MACS) is described. T-lymphocytes were depleted from peripheral blood samples of
      37 patients with chronic lymphocytic leukemia (CLL). The flow speed in the MACS
      column was adjusted by a syringe-driver allowing a constant flow speed of about
      100 microliters/min. The mean content of T-cells after depletion was 0.17% (S.D.
      +/- 0.27). The effectiveness of depletion was calculated to a mean 93.7%. There
      was no correlation between the proportion of CD3-positive cells before and after
      depletion.

PMID- 8466851
TI  - Detection of false DNA aneuploidy and false DNA multiploidy in flow cytometric
      DNA analysis.
AB  - Although false DNA aneuploid peaks have previously been described in normal
      tissue, criteria for distinguishing them from 'true' near-diploid peaks have not
      been established. Normal thyroid (n = 4) and kidney (n = 1) tissue were allowed
      to autolyze over a fixed period of time and DNA content was analyzed by flow
      cytometry (FCM). Autolysis was associated with the development of distinct
      separate G0/G1 peaks which had low DNA indices (1.09-1.18) and showed decreased
      forward light scatter (FSC) when compared to fresh tissue. Using DNA content and
      FSC measurements similar false DNA aneuploid peaks were identified in 29/94
      surgical specimens. These cases included both benign and malignant lesions from
      thyroid (n = 63) with the remaining 31 neoplastic cases being from breast (16),
      lymphoma (8), sarcoma (4), lung (2) and uterine (1) tissue. In addition, false
      DNA multiploidy was identified. None of these cases showed histological evidence
      of necrosis. In a parallel comparison study using image cytometry (ICM) on the
      thyroid nodules, the presence of false DNA aneuploidy was supported.
      Investigators should routinely employ quality control criteria to identify
      possible cases of false DNA aneuploidy when measuring DNA content using FCM.

PMID- 8466852
TI  - Spectral analysis of cervical cells using the discrete Fourier transform.
AB  - This paper contains results from a preliminary study of spectral analysis
      techniques applied to the classification of cervical cells from routinely
      prepared Papanicolaou cervical smears. Experiments were conducted using a subset
      of 110 normals and 110 dyskaryotic single cell images randomly selected from a
      larger cell image data base. An assessment was made of the contribution of
      different regions within a cell image to the frequency spectrum. Three image sets
      were used, the original image itself plus two derived from it. In the first
      derived set, only nuclear size and shape were used. In the second set nuclear
      morphology and texture were included. Nuclear masking was performed using an
      interactive segmentation procedure. The discrete Fourier transform was applied to
      each image in the three image sets and classification experiments were performed
      using 80 features derived from the frequency spectra. An optimum set of features
      was selected for each experiment by canonical analysis. Good classification
      results were obtained when features extracted solely from nuclear shape were
      used. The inclusion of information relating to nuclear texture improved the
      results. However, inclusion of the extra nuclear region degraded the classifier's
      ability to discriminate between cell groups.

PMID- 8466853
TI  - Enhanced expression of the human multidrug resistance 1 gene in response to UV
      light irradiation.
AB  - The multidrug resistance 1 (MDR1) gene encodes a M(r) 170,000 membrane
      glycoprotein termed P-glycoprotein, which catalyzes the energy-dependent efflux
      of multiple anticancer agents. We investigated the activation of the MDR1 gene
      promoter by UV light irradiation in human cancer KB cells after both transient
      and stable transfection assays of the MDR1 promoter fused to the chloramphenicol
      acetyltransferase (CAT) gene. Following exposure to UV irradiation, CAT gene
      expression was about 20-fold increased. A series of promoter dissection analyses
      showed that two elements extending from -136 to -76 of the 5' flanking sequence
      and from +1 to +121 of the sequence downstream from the initiation site were
      required for the stress induction of MDR1 promoter activity. Gel shift assays
      showed that the specific DNA binding activities of the transacting protein to the
      MDR1 promoter were augmented in nuclear extracts from the cells treated with UV
      irradiation. A DNA sequence, an inverted CCAAT box, was identified that
      specifically bound to this protein, and mutation of this sequence abolished the
      binding of this protein. Two guanines in the inverted CCAAT box were found to be
      critical, as methylation of these guanines abrogated the binding. Nuclear run-on
      assay demonstrated that the transcription level was increased about 5-fold. These
      results suggest that the activation of the MDR1 promoter may result from
      transcriptional rather than posttranscriptional events. These studies will
      provide the basis for understanding the regulatory mechanism for appearance of
      the drug-resistant phenotype during cancer chemotherapy.

PMID- 8466854
TI  - Phorbol ester-induced monocytic differentiation is associated with G2 delay and
      down-regulation of cdc25 expression.
AB  - Treatment of human U-937 myeloid leukemia cells with 12-O-tetradecanoylphorbol-13
      acetate (TPA) is associated with growth arrest and induction of monocytic
      differentiation. The present results demonstrate that exposure of G1- or S phase
      enriched U-937 cells to TPA was associated with delayed transition through G2-M
      and then exit from the cell cycle in the subsequent G0-G1 phase. In contrast, G2
      M cells treated with TPA progressed through G1-S, were delayed in the next G2-M
      phase, and then entered a nonproliferative G0-G1 state. The effects of TPA on
      expression of cell cycle control genes demonstrated down-regulation of the cdc25
      mitotic inducer during S-G2 progression. In order to investigate the role of
      cdc25 in the control of cell cycle progression, U-937 cells were stably
      transfected with an antisense cdc25 construct under control of a metallothionein
      inducible promoter. Expression of this construct in G1 phase cells was associated
      with a significant delay in transition through S and G2-M phase. Similar results
      were obtained when G1 phase cells were incubated with a 14-base pair antisense
      cdc25 oligomer. Taken together, these results indicate that the cdc25 gene
      product is functionally associated with S-G2 transition of proliferating myeloid
      leukemia cells and that down-regulation of this gene by TPA is associated with G2
      M delay.

PMID- 8466855
TI  - Predominant expression of nPKC eta, a Ca(2+)-independent isoform of protein
      kinase C in epithelial tissues, in association with epithelial differentiation.
AB  - Of the nine known members of the protein kinase C (PKC) family, we found that
      novel (n-) PKC eta, a newly isolated Ca(2+)-independent isoform, was expressed at
      the highest level in the epidermis of mouse skin and epithelia of the digestive
      and respiratory tracts including the tongue, esophagus, forestomach, glandular
      stomach, intestine, colon, trachea, and bronchus. Expression of nPKC eta mRNA in
      these epithelial tissues was 3-10 times that in the brain and was especially high
      in squamous epithelium. Two other PKC isoforms, conventional (c-) PKC alpha and
      nPKC delta, were also expressed in these epithelial tissues, but no cPKC gamma
      was detected. In situ hybridization and immunohistochemical analyses demonstrated
      the localization of nPKC eta in suprabasal layers of the skin, tongue, esophagus,
      and forestomach. In the intestine, it was expressed in the epithelial cells of
      villi, but not of crypts. In the lung, only bronchial epithelium expressed nPKC
      eta. The localization of nPKC eta in differentiating or differentiated epithelial
      cells, rather than in proliferating basal cells, suggests the involvement of nPKC
      eta in epithelial differentiation.

PMID- 8466856
TI  - Altered growth and spontaneous transformation of cells cultured from v-jun
      transgenic mice recapitulate wound-induced multistage tumorigenesis.
AB  - H-2K/v-jun transgenic mice develop sarcomas at sites of wounding via a multistep
      process characterized by discrete pathological stages. To study this progression
      in vitro, cells from different stages of tumorigenesis were cultured and examined
      for their growth properties. The results show that whereas transgenic fibroblasts
      do not manifest enhanced proliferative potential in vivo in the absence of
      wounding, they do show obvious proliferative advantage relative to nontransgenic
      fibroblasts in vitro, including the capacity for indefinite growth. In addition,
      relative to nontransgenic fibroblasts, transgenic cells show altered sensitivity
      to platelet-derived growth factor and tumor necrosis factor alpha, both of which
      are known to be mobilized during wounding. No obvious differences in growth
      potential are observed between transgenic fibroblasts and cells cultured from
      wound-induced premalignant lesions, and confluent cultures of both cell
      populations give rise to spontaneous foci of transformed myogenic and nonmyogenic
      cells that resemble those of late-stage malignant wound sarcomas. Relative to
      transgenic fibroblast cultures, however, premalignant lesion cultures segregate
      transformed cells at a greater frequency and after shorter intervals of in vitro
      growth. The results suggest that wound-induced multistage tumorigenesis can be
      recapitulated in vitro and that cells cultured from different stages of
      tumorigenesis retain biological properties that reflect the pathological stage
      from which they are derived.

PMID- 8466857
TI  - Transforming growth factor beta 1 can induce estrogen-independent tumorigenicity
      of human breast cancer cells in athymic mice.
AB  - We have examined the effect of transforming growth factor beta 1 (TGF-beta 1)
      overexpression in human breast cancer cell tumorigenicity in athymic mice.
      Estrogen-dependent MCF-7 cells were stably transfected with pSVTGF beta 1. A
      clone was isolated which overexpressed TGF-beta 1 mRNA and secreted > 10-fold
      more TGF-beta activity into the tissue culture medium. Similar to the parent
      line, the MCF-7/TGF-beta 1 cells were relatively insensitive to exogenous TGF
      beta 1 and exhibited low levels of TGF-beta receptors. Clonogenicity in soft
      agarose, doubling time, morphology, and sensitivity to 17 beta-estradiol and the
      antiestrogen tamoxifen were not altered in the transfected cells. Inoculation
      s.c. of MCF-7/TGF-beta 1 cells in ovariectomized nude mice resulted in 100% tumor
      formation which was totally abrogated by i.p. administration of the neutralizing
      anti-TGF-beta 2G7 IgG2B. The parent cells formed tumors only after estrogen
      supplementation. By immunohistochemistry, higher levels of TGF-beta 1 protein
      were detected in MCF-7/TGF-beta 1 tumors than in estrogen-induced parent MCF-7
      tumors. Administration of 1 microgram TGF-beta 1 i.p. daily for 3 weeks after
      tumor cell inoculation transiently supported estrogen-independent growth of
      parent MCF-7 tumors in castrated nude mice. These data indicate that
      overexpression of TGF-beta 1 in human breast cancer cells can contribute to their
      escape from hormone dependence.

PMID- 8466858
TI  - Regulation of fat and muscle development by transforming growth factor alpha in
      transgenic mice and in cultured cells.
AB  - Transgenic mice overexpressing transforming growth factor alpha (TGF-alpha) under
      control of the metallothionein promoter had, on average, 20% reductions in body
      and carcass weights compared to nontransgenic littermates. This loss resulted
      from significant decreases in the comparative weights of bone, muscle, and
      especially fat. Transgenic epididymal fat pads were reduced by 40-80%, and total
      body fat content by 50%, relative to control animals. Distal hindlimb muscle
      weights were 20% below normal, and other skeletal muscles were visibly smaller in
      size. Weight reductions were accompanied by decreases in the cellularity of
      transgenic fat pads and muscles and by decreases in the number and area of
      striated muscle fibers. These findings were not obviously attributable to
      differences in metabolic rates since transgenic and control mice displayed
      similar levels of energy expenditure per unit lean body mass. The effects of TGF
      alpha on the development of these tissues could be mimicked in culture for fat
      but not muscle. Thus, TGF-alpha did not inhibit the differentiation of the mouse
      skeletal myoblast cell line C2C12 as evidenced by the expression of muscle
      specific actin and fusion to form multinucleated myotubes. However, TGF-alpha
      repressed the differentiation of the preadipocyte cell line 3T3-F442A in a dose
      dependent and reversible manner as judged by morphological conversion and
      diminished expression of mRNAs encoding the adipocyte-specific markers adipsin
      and glycerophosphate dehydrogenase. This repression, which occurred without
      marked stimulation of proliferation, was incomplete even in the presence of high
      concentrations of growth factor. Despite its effects on adipose development,
      introduction of the metallothionein-TGF-alpha transgene into the ob/ob genetic
      background did not suppress the marked obesity characteristic of this mutation.
      Finally, endogenous TGF-alpha epidermal growth factor receptor mRNAs were
      detected in normal adipose tissue, suggesting that regulation of adipogenesis by
      this growth factor may be physiological.

PMID- 8466859
TI  - Glucocorticoids reversibly arrest rat hepatoma cell growth by inducing an early
      G1 block in cell cycle progression.
AB  - We have previously documented that glucocorticoids suppress the proliferation of
      BDS1 hepatoma cells, a rat epithelial tumor cell line derived from minimal
      deviation Reuber H35 hepatoma cells. Flow cytometry demonstrated that, after
      treatment with the synthetic glucocorticoid dexamethasone, the growth of an
      asynchronous population of BDS1 cells was arrested within one cell cycle which
      resulted in an accumulation of cells with a G1-G0-like DNA content. Consistent
      with a glucocorticoid-induced block early in the G1 phase of the cell cycle,
      propidium iodide flow cytometry revealed that addition of dexamethasone up to 2 h
      after release from contact inhibition prevented BDS1 hepatoma cells from entering
      S phase, whereas dexamethasone treatment after 2 h had no effect on the entry of
      cells into S phase. Moreover, dexamethasone treatment did not prevent BDS1 cells
      from entering S phase after release from synchronization at the G1-S boundary by
      a double thymidine block. Analysis of DNA content, [3H]-thymidine incorporation,
      and autoradiography of [3H]-thymidine-labeled nuclei revealed that, after release
      from dexamethasone, BDS1 cells synchronously reinitiated cell cycle progression
      and entered S phase 8 h after hormone withdrawal. Northern blot analysis
      demonstrated that the level of transcripts encoding the G1 marker genes CYL-1 and
      CYL-2 G1 cyclins peaked 4 h after dexamethasone withdrawal. Dexamethasone induced
      a 20-fold increase in the level of c-jun mRNA which was reversed after hormone
      withdrawal, whereas expression of c-fos transcripts remained at a low level
      during the time course of hormone treatment and withdrawal. Transient
      transfections with a collagenase-chloramphenicol acetyltransferase reporter gene
      showed that dexamethasone inhibited 12-O-tetradecanoylphorbol-13-acetate
      inducible, but not basal, AP-1 transcription factor activity. Our results
      demonstrate that glucocorticoids reversibly induce an early G1 block in cell
      cycle progression of an epithelial tumor cell line that occurs with a coordinate
      elevation in the expression of c-jun transcripts.

PMID- 8466860
TI  - Schwann cell lineage-specific neu (erbB-2) gene expression in the developing rat
      nervous system.
AB  - Initiation of oncogenesis in the immature peripheral nervous system (PNS) of rats
      by the DNA-reactive carcinogen N-ethyl-N-nitrosourea (EtNU) involves a specific
      T:A-->A:T transversion mutation at nucleotide 2012 of the neu (erbB-2) receptor
      tyrosine kinase gene in cells of the Schwann cell lineage. Although this mutation
      is invariably detected in the resulting malignant schwannomas, it is not found in
      EtNU-induced tumors of the central nervous system (CNS). We have evaluated
      expression of the neu gene in the PNS and CNS as a function of developmental
      stage. Cellular levels of neu mRNA and gp185neu were analyzed in the trigeminal
      and sciatic nerve and in brain, using a quantitative reverse transcription
      polymerase chain reaction, in situ hybridization, immunocytochemistry, and
      fluorescence-activated cell sorting. In the PNS, expression of the neu gene is
      restricted to cells of the Schwann cell lineage and markedly exceeds expression
      in the CNS from prenatal day 20 onward. In trigeminal Schwann cells, neu mRNA is
      most abundant (2.8 x 10(7) copies/micrograms of RNA) on postnatal day 1,
      coincident with both the end of maximum mitotic activity and the "developmental
      window" of highest sensitivity to malignant transformation by EtNU. The
      subsequent decrease of neu gene expression is accompanied by decreasing
      proliferative activity and the onset of myelination. The level of neu gene
      expression may thus be critical to proliferation versus differentiation decisions
      in the Schwann cell lineage. EtNU-induced mutation of the neu gene in
      proliferative Schwann cell precursors expressing gp185neu may abrogate their
      responsiveness to extracellular and/or intrinsic controls, resulting in sustained
      proliferative activity and malignant conversion.

PMID- 8466861
TI  - Interaction of a human Fc gamma RIIb1 (CD32) isoform with murine and human IgG
      subclasses.
AB  - A group of Fc receptor molecules, classified CD32, recognize the Fc moiety of IgG
      with low affinity. We report the isolation and identification of different hFc
      gamma RIIb cDNA clones, amongst which are cDNA clones encoding hFc gamma RIIb1
      and hFc gamma RIIb2. Two hFc gamma RIIb1 encoding cDNA clones (pIP9 and pIP14)
      were isolated, which differed by three nucleotides, probably because of allelic
      variation. The nucleotide differences result in one amino acid change between the
      allelic hFc gamma RIIb1 variants. This substitution is located at amino acid
      position 11 of the cytoplasmic tail; a tyrosine in hFc gamma RIIb1 (clone pIP9)
      was replaced by an aspartic acid in clone pIP14 (encoding hFc gamma RIIb1*). A
      complication in studying ligand specificity of Fc receptors is the potential co
      expression of different classes, subclasses, or polymorphic forms of FcR on the
      same cell. We therefore used murine fibroblasts transfected with cDNA clone
      pIP14, encoding a hFc gamma RIIb1* isoform, as our model system. These
      fibroblasts were found to interact with erythrocytes sensitized with mIgG2a and
      mIgG2b in rosetting assays performed at 4 and 37 degrees C. Interestingly, hFc
      gamma RIIb1* transfectants bound mIgG1 sensitized erythrocytes only weakly at 4
      degrees C, whereas profound binding was observed at 37 degrees C. The ligand
      specificity for human (h) IgG isotypes was found to be hlgG3 > or = hlgG1 > hlgG4
      > hlgG2, as determined at 4 degrees C with hlgG dimeric complexes. However, when
      assayed at 37 degrees C, the binding of hlgG2 dimers increased significantly.
      Next, we evaluated whether these transfectants were capable of supporting anti
      CD3 induced T cell proliferation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466862
TI  - Cortical neurons selectively inhibit MHC class II induction in astrocytes but not
      in microglial cells.
AB  - Astrocytes have been shown to act as potent accessory cells for MHC class II
      restricted T cell responses in vitro after treatment with interferon-gamma. In
      contrast, even under conditions of severe central nervous system (CNS)
      inflammation, they seem to express little, if any, class II molecules in vivo.
      Thus the role of astroglial cells as accessory cells in immune responses in the
      CNS remains to be determined. We have studied neuron--glia interactions with
      respect to induction of MHC class II molecules. Surprisingly, in a co-culture
      system, viable neurons inhibited the induction of class II restriction elements
      on astrocytes. This effect was only observed when neurons had contact to
      astrocytes; neuron derived soluble factors alone were insufficient. Most
      interestingly, the suppressive effect of neurons on class II inducibility
      operated specifically on astrocytes, while microglial cells were left unaffected.

PMID- 8466863
TI  - Low frequencies of somatic mutation in two expressed V kappa genes: unequal
      distribution of mutation in 5' and 3' flanking regions.
AB  - Somatic mutation of antibody variable region genes is a hallmark of secondary
      responses. Most often the coexpressed VH and V kappa genes of a B cell mutate at
      nearly equal rates. We have previously identified hybridomas from two B cell
      clones that exhibited > 10-fold lower frequency of mutation in their expressed V
      kappa 12 or V kappa 1A genes relative to their coexpressed VH genes. To gain
      insight into the mechanism(s) responsible for this low frequency V kappa
      mutation, we determined the frequency of mutation in non-coding flanking DNA from
      multiple members of each clone. We find a low frequency of mutation in the 5'
      (4/700) and 3' (1/670) non-coding regions of the expressed V kappa 1A genes
      consistent with the low frequency of coding region mutation. In contrast, the
      distribution and frequency of mutation surrounding the expressed V kappa 12.37
      gene are unusual. Among the six members of this clone there are 31 mutations 3'
      (31/2100 bp) and no mutations 5' (0/2010 bp) of the V kappa exon. This V kappa
      exon has acquired mutations that are intermediate in number to its flanking
      regions and are significantly skewed in distribution to the 3' end. None of the
      31 3' mutations are shared by two or more members of this clone, indicating that
      they all occurred late in clonal expansion. These results raise the possibility
      that some V kappa genes may lack functional cis-regulatory elements which direct
      V kappa coding region mutation.

PMID- 8466864
TI  - The human I alpha 1 and I alpha 2 germline promoter elements: proximal positive
      and distal negative elements may regulate the tissue specific expression of C
      alpha 1 and C alpha 2 germline transcripts.
AB  - Treatment of human splenic B lymphocytes with the mitogen Branhamella catarrhalis
      (BC) and transforming growth factor-beta 1 (TGF-beta 1) induces expression of
      germline Ig C alpha transcripts and class switching to this isotype. To further
      characterize the molecular mechanism by which TGF-beta 1 and mitogenic signals
      regulate the expression of unrearranged C alpha 1 and C alpha 2 genes, we have
      characterized the promoter elements that are responsible for the transcriptional
      activation of their corresponding germline genes using transient expression
      assays. We report here that both in the I alpha 1 and the I alpha 2 regions,
      maximal phorbol myristate acetate (PMA) and TGF-beta 1 responsiveness of the
      promoters can be conferred by 327 bp spanning the transcription initiation sites
      and a previously identified phylogenetically conserved region. The expression of
      these 327 bp segments is not restricted to the B cell lineage since they are also
      active in the erythroleukemia cell line K562 as well as the B cell lines Raji and
      DG75. Mutational analyses have demonstrated the importance of sequences within
      the 327 bp segment that contain a putative cyclic AMP responsive element binding
      protein (CREB) binding site for TGF-beta 1 and PMA responsiveness and putative PU
      1 and Sp1 binding sites for basal promoter activity. Upstream distal elements
      that could negatively modulate the expression of the I alpha 1 and I alpha 2
      promoters, particularly in non-B cells, have been identified. Three such elements
      were mapped between positions -352 to -243, -627 to -516, and upstream of
      position -731 respectively. The influence of these elements presumably
      contributes to the B cell specific expression of the I alpha 1 and I alpha 2
      promoters. The I alpha 1 and I alpha 2 promoters were found to be functionally
      indistinguishable from each other with respect to their basal level of
      expression, and their responsiveness to TGF-beta 1.

PMID- 8466865
TI  - Effects of isotype and Fc region on in vitro function of a mouse/human chimeric
      CD4 antibody.
AB  - Murine CD4 mAbs have shown potential for the treatment of allograft rejection and
      autoimmune disorders including rheumatoid arthritis. Clinical usefulness of the
      murine mAbs has been limited by immunogenicity and a short circulating half-life.
      Mouse/human chimeric antibodies have been constructed, composed of the variable
      region of M-T412 (a murine G2a mAb specific for the human CD4 molecule) and human
      G1 (cM-T412 G1) or G4 (cM-T412 G4) Fc regions. F(ab')2 and F(ab) fragments of the
      murine G2a and chimeric G1 mAbs were generated by enzymatic digestion. The
      chimeric mAbs and all fragments retained the avidity and specificity of the
      murine M-T412 and were evaluated in in vitro assays measuring Ig production by
      pokeweed mitogen (PWM)-stimulated peripheral blood mononuclear cells (PBMC), sIL
      2R produced by phytohemagglutinin-stimulated PBMC, and proliferation in response
      to tetanus toxoid, CD3 mAb plus IL-2, and mixed lymphocyte response (MLR). When
      PBMC were stimulated with tetanus toxoid, 10 ng/ml of cM-T412 G1 inhibited
      proliferation by 90%, while neither the cM-T412 G4, M-T412 G2a, nor any mAb
      fragment produced > 65% inhibition, even at 1000-fold higher concentrations. A
      similar pattern of inhibition was observed in MLR assays. In contrast, the
      F(ab')2 fragment of the cM-T412 G1 was as effective as the whole antibody in
      inhibiting PWM-stimulated IgM synthesis and PBMC proliferation in response to
      stimulation by a CD3 mAb plus IL-2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466866
TI  - IL-4 regulates the morphology, cytoskeleton, and proliferation of human umbilical
      vein endothelial cells: relationship between vimentin and CD23.
AB  - Many of the vascular endothelial changes associated with inflammation can be
      induced in vitro by the cytokines tumour necrosis factor, IL-1, and IFN gamma. On
      the other hand, although IL-4 is a powerful mediator of leucocyte function, its
      influence on endothelial cells has not yet been fully determined. In this study
      the effect of IL-4 on human umbilical vein endothelial cells has been
      investigated. It is shown that IL-4 stimulates DNA synthesis over the first 24 h
      in culture, followed by dramatic alterations in endothelial cell morphology in
      which the cobblestone appearance of cells grown to confluence in medium changes
      to a monolayer composed of islands of tightly packed polygonal cells. The
      morphological changes induced by IL-4 were accompanied by a reorganization of the
      intracellular vimentin matrix from a diffuse pattern to a perinuclear
      concentration observed by staining with vimentin antibodies. Similar patterns of
      vimentin staining were also observed with an antibody to the low affinity IgE
      receptor (CD23) normally associated with IL-4 activation of B lymphocytes. Our
      results suggest that this represents cross reactivity between CD23 and vimentin
      rather than the appearance of CD23 in endothelial cells. Amino acid sequence
      comparison between CD23 and vimentin indicated significant homology between these
      two molecules, including a leucine zipper-like motif. Our results suggest that IL
      4 may be an important regulator of endothelial cell morphology and function in
      inflammation.

PMID- 8466867
TI  - B-lineage cells in mu-transgenic scid mice proliferate in response to IL-7 but
      fail to show evidence of immunoglobulin light chain gene rearrangement.
AB  - The severe combined immunodeficiency (scid) mouse mutation impairs the
      recombination of Ig and TCR genes. Mice homozygous for this mutation (scid mice)
      lack pre-B, B, and T lymphocytes. Earlier we introduced a functionally rearranged
      mu-heavy chain gene into the scid mouse genome and found that this resulted in
      the development of pre-B cells in the bone marrow of these mice; however, sIgM+ B
      cells were not detected. We have now investigated the growth properties and
      rearrangement status of Ig genes in early B-lineage cells arising in mu
      transgenic scid mice. We find that the presence of a functional mu-transgene
      allows pro-B cells from these mice to proliferate in short-term culture with IL
      7. Nevertheless, rearrangements of Ig light chain genes are not detected in the
      bone marrow of such mice. Furthermore, the frequency of rearrangement detected at
      the endogenous Ig heavy chain locus in scid pro-B and pre-B cells is reduced
      relative to that in wild-type cells.

PMID- 8466868
TI  - Complications and long-term results of the Nissen fundoplication.
AB  - The Nissen fundoplication is the operative therapy of choice in children with
      symptomatic gastroesophageal reflux. In recent years several reports on specific
      complications of the Nissen fundoplication have been published. This report
      summarizes the complications in 45 patients on whom a Nissen fundoplication was
      performed in our clinic between 1979 and 1989. 18 patients (40%) showed early or
      late complications. In 10 patients (22%) reoperation was necessary. However, at
      follow-up with a mean period of 4 1/2 years after surgery, 36 patients (92%)
      showed good results without any residual symptoms. The Nissen fundoplication had
      in our hands a rather high rate of complications. However, late results were
      excellent and our healing rate (92%) was higher than reported in other series
      with different techniques.

PMID- 8466869
TI  - Pancreaticobiliary long common channel syndrome and congenital anomalous
      dilatation of the choledochal duct--study of 46 patients.
AB  - Retrospectively evaluated clinical, radiological and anatomical findings of 46
      patients with tubular or cystic dilated choledochal ducts indicate the following
      conclusion: Pathological stricture of the sphincter of Oddi system, including a
      hypertrophic and spastic portion of the sphincter choledochus inferior, called
      "narrow segment", raises the pressure in the choledochal duct to pathological
      levels and consequently causes a dilatation of the duct during a specific
      embryonic phase. Such a pathological sphincter of Oddi system develops if a long
      common channel persists as the result of a disturbance in the development of the
      distal choledochal and pancreatic duct. This statement contradicts the classical
      conception which assumes that a reflux of pancreatic juice into the choledochal
      duct causes ductal dilatation. Authors who are in favor of this conception
      propose that pancreatic juice causes weakness of the ductal wall, which may be
      dilated in the embryonic period. However, the findings of the series evaluated
      here show that dilatation of the duct may also originate without any reflux of
      pancreatic juice into the choledochal duct if a "narrow segment" exists above the
      junction of the pancreatic and choledochal ducts. For this reason, pancreatic
      juice reflux cannot be the condition sine qua non in the development of
      choledochal duct dilatation. Similarly the pathologic junction angulation can
      only be an optional factor in this autogenetic anomaly. With regard to a
      pathological sphincter of Oddi system the question arises whether a partial or
      complete myotomy of the muscular sphincter may be able to remedy the dilatation
      and avoid resection of the choledochal duct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466870
TI  - Cystic fibrosis and portal hypertension interest of partial splenectomy.
AB  - Extra pulmonary complications can be major in patients suffering of cystic
      fibrosis who survive long enough without pulmonary problems. Hepatic cirrhosis is
      often present and is responsible for portal hypertension with splenomegaly,
      hypersplenism and esophageal varices. In six patients we have performed a partial
      splenectomy with conservation of the upper pole of the spleen vascularized by
      gastrosplenic omentum and its vessels. The post-operative complications (3 scar
      ruptures but no pulmonary decompensation) are not very important considering the
      benefits: Normal spleen according to clinical, ultrasonic examination and
      scintigraphy Correction of hypersplenism Diminution of esophageal varices
      Stability of hepatic functions. With a post-operative follow-up between 2.5 and 7
      years, none of the patients had an increased risk of infection. This technique
      allows a good survival for those patients waiting for pulmonary transplantation.

PMID- 8466871
TI  - Use of the appendix to provide urinary continence.
AB  - We describe a technique used to provide urinary continence to a group of
      teenagers with neuropathic bladders. The technique gives continence to a urinary
      reservoir by utilising the appendix as a continent catheterisable conduit. Of the
      first five patients to have this procedure performed in this institute, four
      became fully continent. We feel that this procedure can be of great benefit to
      both children and adults with urinary incontinence.

PMID- 8466872
TI  - The relative proportions of type I and type II muscle fibers in the external
      sphincter ani muscle at different ages and stages of development--observations on
      the development of continence.
AB  - The external sphincter ani muscles were partially or completely removed from 11
      fetuses, 3 infants, 2 children and 12 adults, none of whom had had anorectal
      disease and all of whom had died of diseases not affecting the anorectal organ of
      continence. Muscle fiber-typing was carried out. In the fetuses ages 26-40 weeks,
      we found a predominance of Type II (rapid) fibers. With increasing gestational
      age Type II fibers started to diminish along with a simultaneous increase in Type
      I (slow) fibers. At the same time, stromal restructuring took place. Three
      infants, ages 1, 2 and 10 months, showed further increases of Type I fibers,
      until finally, in the two older children studied (5 and 8 years), there was a
      predominance of Type I fibers. This persisted in adults between ages 56 to 70,
      but after age 70 Type I fibers diminished, so that the ratio of slow to rapid
      fibers in the 78 to 81 year-old group was 3:2. This study shows that in contrast
      to other skeletal muscles the fiber distribution in the external sphincter ani
      muscle is not established from the beginning, but is the result of a
      developmental process. The predominance of Type II (twitching) fibers explains
      the state of reflex continence of the young infant. With increasing maturation of
      tonic Type I fibers, an additional voluntary component to continence is made
      possible with the help of the supporting pelvic musculature. This maturation is
      determined by the increasing strain on the pelvic floor as the child learns to
      sit and walk.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466873
TI  - Ligation of the patent ductus arteriosus in premature infants--indications and
      procedures.
AB  - Premature newborns with patent ductus arteriosus can be managed by prostaglandin
      inhibition, but this medical treatment carries a high risk of renal failure, and
      other complications such as necrotizing enterocolitis and hematologic disorders
      have been described. Echocardiography gives an early confirmation of shunt and
      surgical treatment may be proposed. The aortic arch anatomy in the premature
      infant may not be as simple to determine as the anatomy of an older child. In the
      premature infant the use of a clip for patent ductus arterious closure seems the
      best technique, avoiding circular dissection of the ductus. We report our
      experience of 68 cases operated upon.

PMID- 8466874
TI  - The treatment of duplication thumbs in children. About a series of 32 patients.
AB  - 29 children with 32 duplicated thumbs were followed up. Wassel's classification
      was used: type I (3 cases), type II (8 cases), type IV (16 cases), type V (3
      cases), type VII (2 cases). There were no type III or VI cases. Seven cases were
      not operated on (minor abnormalities, refusal by the parents). Simple surgical
      ablation was performed in 12 cases, ablation with reconstruction in 10 cases,
      ablation with pollicisation in one case, ablation with longitudinal osteotomy in
      one case. Finally, Bilhaut's technique was performed in one case. 16 cases had a
      good result, 9 cases were disappointing with one case of stiffness, one step
      deformity, one protrusion of the metacarpal head and particularly 6 cases with
      joint instability. This latter complication is the most frequently encountered in
      various series and the authors emphasize the surgical precautions to avoid its
      occurrence.

PMID- 8466875
TI  - Investigations on mechanism of Salter-1-fractures of the greater trochanter.
AB  - This study aims at clarifying why the apophysis of the greater trochanter very
      rarely separates, in contrast to other apophyses of the hip region. The
      inclination and area measurement of the greater trochanteric growth plate and the
      mode of insertion of the muscles on the apophysis were analyzed on the basis of
      16 anatomic femoral specimens from newborn to children of 14 years of age. The
      physiological muscle cross section Q of the muscles inserting at the greater
      trochanter was determined on 6 specimens. In a cross-sectional radiological
      study, carried out on 1350 hip joints of healthy children, the inclination of the
      greater trochanter growth plate was measured. The anatomical and radiological
      findings show that the nearly plane-shaped greater trochanter growth plate
      remains inclined at a 50 degree angle to the horizontal body line and is loaded
      from a diagonally craniolateral direction throughout the total growth period. The
      lateral surface of the apophysis is covered by a fibrous connection which joins
      the insertion areas of the gluteus medius, minimus and vastus lateralis muscles.
      The vastus lateralis muscle is intimately bound to the vastus intermedius muscle
      by fibrous tissue. According to the results of the physiological muscle cross
      sections these four muscle groups can form a counteracting muscle sling, which
      transforms the traction forces at the surface of the greater trochanter into
      pressure forces in line with a tension band effect.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466876
TI  - Jugular phlebectasia in children.
AB  - Jugular phlebectasia is a congenital dilatation of jugular vein which appears as
      a soft, compressible mass in the neck only during straining or crying. It should
      be differentiated from laryngocele, cysts and tumors of neck which may also
      appear during straining. Comparable ultrasonography (US) and computerized
      tomography (CT) are diagnostic methods to distinguish the pathology. Four
      children with jugular phlebectasia diagnosed by venography, US and CT are
      reported. Surgical excision of the dilated segment was performed in each case.
      The inevitability of surgical intervention is discussed.

PMID- 8466877
TI  - Lipid secreting breast carcinoma in childhood: a case report.
AB  - A ten-year-old girl was admitted to our hospital with a mass in the left breast
      after a local recurrence following a resection done in a district hospital three
      months earlier. A modified radical mastectomy with axillary lymph node dissection
      was performed in our department. Histological examination revealed a lipid
      secreting carcinoma (lipid-rich carcinoma) of the breast. To our knowledge she is
      the first case in childhood in the literature and is therefore reported.

PMID- 8466878
TI  - Traumatic rupture of the thoracic aorta in childhood with special reference to
      the therapeutic strategy.
AB  - Acute traumatic tear of the thoracic aorta is extremely rare in childhood. Based
      upon our own experience with two children, the essential diagnostic and
      therapeutic measures are discussed with special reference to timing of surgery.
      Aortic disruption must be suspected in a child who sustains severe blunt chest
      injury and develops an abnormally wide mediastinum. Definite diagnosis is
      established by aortography or computed tomography. The appropriate therapeutic
      approach is determined by the clinical symptomatology and particularly by the
      severity of concomitant lesions. In the absence of a significant hemothorax and
      if no difference in pulse amplitude between upper and lower extremities is
      evident, the risk of free aortic rupture with intrathoracic exsanguination is
      presumed to be rather low if the patient reaches the hospital alive. In that
      situation, the continuity of the injured aorta is maintained by the adventitia
      and surrounding mediastinal structures. Therefore, these patients may derive the
      best benefit from an initially conservative management including pharmacological
      intervention to reduce the risk of free aortic rupture. This concept is
      particularly indicated if aortic disruption is associated with severe concomitant
      injury such as intraabdominal or intracranial lesions. Such injuries preclude
      safe aortic repair immediately after establishment of diagnosis. Delay of aortic
      repair until recovery from associated major injury allows heparinization and the
      use of a pump oxygenator, which is regarded as the most effective method to
      prevent spinal cord ischemia and to reduce the risk of paraplegia.

PMID- 8466879
TI  - Gastrointestinal manifestations of neurofibromatosis in childhood.
AB  - Von Recklinghausen's neurofibromatosis (VRN) is a familial disorder characterised
      by a generalized neuroectodermal dysplasia--symptomatic involvement of the
      gastrointestinal tract is rare. We report on our experience with two children who
      had proven gastrointestinal neurofibromas and highlight the need for careful
      assessment in children with VRN who develop abdominal pain.

PMID- 8466880
TI  - Intestinal hemorrhage three years after incidental appendectomy by total
      inversion.
AB  - A late hemorrhagic complication of incidental appendectomy by entire inversion is
      reported in a liver transplant child. The use of proper surgical technique for
      inversion appendectomy is emphasized, including total devascularization of the
      appendix before inverting it.

PMID- 8466881
TI  - Lung growth and maturation in the rat model of experimentally induced congenital
      diaphragmatic hernia.
AB  - This paper explores whether, in addition to the previously described lung
      hypoplasia with arteriolar hypermuscularization present in the nitrofen-induced
      foetal rat model of congenital diaphragmatic hernia (CDH), there are changes in
      the respiratory exchange epithelium, consistent with the hypothesis that abnormal
      surfactant production and/or release could account in part for the respiratory
      insufficiency in this condition. Foetal lungs from nitrofen-treated rats were
      obtained on the 21st day of gestation, weighed and processed for light and
      electron-microscopic studies and compared to controls of the same age. Tissues
      from 29 control and 26 CDH foetuses were examined. In addition, lungs from 19
      foetuses born to nitrofen-treated dams but without CDH were also studied. The
      lungs from CDH animals were hypoplastic by weight in comparison with control ones
      and so were those from treated foetuses without CDH. Airway branching was
      arrested in CDH at the pseudo-glandular stage of development, corresponding to
      the 16th day of gestation and the very narrow air spaces were lined by generally
      mature type II pneumocytes rich in glycogen and lamellar bodies corresponding to
      the 19th day of gestation. This pattern was in contrast to that of the control
      foetuses which had a normal terminal sac pattern with flat type I pneumocyte
      lining corresponding to their gestational age. Nitrofentreated animals without
      CDH had intermediate patterns. These findings support the hypothesis that the
      surfactant-producing system has the same lesions in this experimental model as in
      other less-affordable ones, like the foetal lamb one. Further studies on the
      contribution of this factor to the altered respiratory physiology in CDH using
      this model are warranted.

PMID- 8466882
TI  - Relation of hemostatic risk factors to other risk factors for coronary heart
      disease and to sex hormones in men.
AB  - The present study was carried out to explore the possible relation of plasma
      plasminogen activator inhibitor-1 (PAI-1), fibrinogen, and factor VII levels to
      other risk factors for coronary heart disease (CHD) and to serum sex hormone
      levels. The study group comprised 48 apparently healthy men. To avoid the
      confounding factor of obesity, correlations were determined in the 30 men in this
      group with a body mass index (BMI) < 26.4, after controlling for age. PAI-1
      correlated with testosterone, estradiol/testosterone, and free
      testosterone/testosterone (FT/T), and fibrinogen correlated with FT/T. All three
      hemostatic factors correlated with glucose and with the ratio of cholesterol/high
      density lipoprotein cholesterol, while PAI-1 correlated with diastolic blood
      pressure. To test the effect of obesity, correlations were determined in the
      entire group of 48 men, which included 18 subjects with a BMI > 26.4. All three
      hemostatic factors correlated with BMI in this group after controlling for age;
      however, on controlling for testosterone, only PAI-1 correlated with BMI.
      Fibrinogen correlated with age in both groups after controlling for testosterone
      or BMI. These correlations support the hypothesis that PAI-1, fibrinogen, and
      factor VII are related to other risk factors for CHD and that an alteration in
      the sex hormone milieu may be the underlying factor linking them.

PMID- 8466883
TI  - Ultrasonic-pathological comparison of the human arterial wall. Verification of
      intima-media thickness.
AB  - Recent intravascular ultrasound experience challenges the accuracy of ultrasonic
      measurement of arterial wall thickness. We reevaluated the correlation between
      histological and sonographic measurements of intima-media thickness using
      standard transcutaneous vascular technology. Carotid and femoral arterial
      segments were imaged before and after fixation using a 7-MHz linear-array
      vascular transducer. Log compression and beam orientation were varied. Mean
      intima, media, and adventitia thicknesses were measured and compared with
      corresponding histological tunica. Tissue processing caused 2.5% shrinkage.
      Intraobserver reading error was 0.7% for histology and 5.4% for sonography.
      Ultrasound overestimated the thickness of the intima and adventitia and
      underestimated the thickness of the media. For combined intima-media thickness,
      the differences between histology and imaging were insignificant, averaging 4%
      for the carotid artery and 9% for the femoral artery in the far-wall projection.
      In the near-wall projection, sonographic intima-media thickness was 20% less than
      that determined histologically. We conclude that ultrasonography is limited
      mainly by axial resolution in quantifying the dimensions of individual arterial
      tunica but is capable of accurately measuring far-wall intima-media thickness.

PMID- 8466884
TI  - Visceral fat loss measured by magnetic resonance imaging in relation to changes
      in serum lipid levels of obese men and women.
AB  - The effect of weight reduction on serum lipids in relation to visceral fat
      accumulation was studied in 78 healthy obese subjects (40 premenopausal women and
      38 men) aged 27-51 years and with an initial body mass index of 30.7 +/- 2.2
      kg/m2 (mean +/- SD). The subjects received a 4.2 MJ/day energy-deficit diet for
      13 weeks. Magnetic resonance imaging was used to assess abdominal fat areas
      before and after weight loss. Weight reductions of 12.6 +/- 3.2 kg in men and
      11.7 +/- 3.8 kg in women resulted in larger reductions in the fasting serum
      levels of total cholesterol (p < 0.05), low density lipoprotein cholesterol (p =
      0.06), and triglycerides (p < 0.01) and a larger increase in the high density
      lipoprotein cholesterol/low density lipoprotein cholesterol ratio (p = 0.05) in
      men compared with women. Men also lost more visceral fat (p < 0.0001), whereas
      the reductions in the total and subcutaneous abdominal fat depots were similar.
      In women, visceral fat loss was significantly related with an increase of the
      high density lipoprotein cholesterol level, independent of the degree of total
      fat loss. In men, however, no significant correlations were observed between
      changes in visceral fat and any of the serum lipids. Comparisons of average
      changes in obese men and women suggest that visceral fat loss is associated with
      an improvement of the serum lipid profile. However, correlation analysis does not
      support a critical role of visceral fat in determining serum lipid concentrations
      on an individual level, except for an improvement of the high density lipoprotein
      cholesterol level with visceral fat loss in obese women.

PMID- 8466885
TI  - The low HDL cholesterol/high triglyceride trait.
AB  - In 748 probands and 3,283 first-degree relatives from the Collaborative Lipid
      Research Clinics (LRC) Family Study, our specific aim was to examine the degree
      to which low (bottom decile) high density lipoprotein cholesterol (HDL-C,
      hypoalpha) and high (top decile) triglyceride (TG, hyperTG) levels occur
      conjointly (CT) and the extent to which these characteristics were shared within
      families. To control for family size and permit a comparison with the proband
      percentages, mean familial percentages of HDL-C/TG abnormalities were calculated.
      Concurrent low HDL-C and high TG levels were present in 2.7% of the probands, a
      value that was enriched to 12.7% (p = 0.003) of their associated first-degree
      relatives. If the proband had a low HDL-C value, 7.7% (p = 0.013) of relatives
      had CT. Familial (proband and at least one first-degree family member share the
      same lipoprotein/lipid phenotype) hypoalpha was observed in 2.4% of families
      while familial hyperTG was observed in 4.1%. Familial CT was seen in
      approximately 0.7%. If the proband had CT, 80% of their families had at least one
      other first-degree member with an HDL-C/TG abnormality, whereas the corresponding
      percentage for families associated with probands with only hypoalpha was 64% and
      for those with hyperTG alone, 54%. A broadly shared environmental factor cannot
      easily explain the familial association of hypoalpha, hyperTG, and CT. In
      probands with low HDL-C values alone or the conjoint low-HDL-C/high-TG trait,
      family screening is extremely valuable because low HDL-C/high TG is enriched in
      the respective family members, a conjoined trait closely associated with
      increased coronary heart disease risk.

PMID- 8466886
TI  - Circulating lipid hydroperoxide levels in human hyperhomocysteinemia. Relevance
      to development of arteriosclerosis.
AB  - Elevated circulating homocyst(e)ine is a risk factor for occlusive vascular
      disease. We explored whether elevated plasma homocyst(e)ine is associated with
      increased plasma lipid hydroperoxides that might trigger vascular disease. We
      obtained plasma containing high levels of homocyst(e)ine from four patients with
      a homozygous deficiency of cystathionine beta-synthase activity and also from
      four heterozygotes with a deficiency of this enzyme after an oral methionine
      load. The mean plasma non-protein-bound homocyst(e)ine level in all subjects was
      more than 11-fold higher than the mean normal fasting value. Levels of high
      density lipoprotein (HDL) cholesteryl ester hydroperoxides (CEOOH), normalized
      against the concentration of free cholesterol in HDL, were not elevated in our
      subjects (mean +/- SD, 0.0091 +/- 0.0061) compared with values for 14 fasting
      healthy donors (0.0164 +/- 0.0086). An inverse dependency was observed between
      plasma total homocyst(e)ine and HDL CEOOH (r = -0.78, p = 0.023). Also, the
      ubiquinol-10/ubiquinone-10 ratio in HDL, which is expected to fall during
      oxidative stress, increased with plasma homocyst(e)ine. Since HDL contains the
      majority of detectable plasma lipid hydroperoxides, of which CEOOHs are the most
      abundant, our data suggest that an elevated plasma homocyst(e)ine level does not
      enhance oxidative stress, increase the levels of lipid hydroperoxides in plasma,
      or generate vascular damage by this mechanism.

PMID- 8466887
TI  - Endogenous sex hormones and ischemic heart disease in men. The Caerphilly
      prospective study.
AB  - Numerous case-control studies have suggested that elevated levels of endogenous
      estrogen and low levels of testosterone are associated with ischemic heart
      disease (IHD) in men. These findings were tested in the Caerphilly study of 2,512
      men from the general population who were aged 45-59 years at baseline and were
      followed for 5 years. Some 153 men experienced a new episode of IHD (fatal and
      nonfatal) during the period of follow-up. Baseline values of estradiol were
      marginally higher in subjects who developed IHD than in those who did not, but
      the difference was not statistically significant. Plasma values of testosterone
      were similar in the two groups. Among quintiles of the distribution of the
      hormone values, the incidence of IHD was similar in the case of estradiol; there
      was also no clear trend in the case of testosterone. These findings provide no
      support for the suggestion that plasma estradiol or testosterone are primary risk
      factors for IHD, although the associations between plasma testosterone and other
      probable risk markers (triglycerides, insulin, body mass index, and high density
      lipoprotein cholesterol) indicate the possibility that testosterone may play an
      indirect role in the pathogenesis of IHD.

PMID- 8466888
TI  - Increased postprandial lipemia in Apo A-IMilano carriers.
AB  - Plasma lipid/lipoprotein changes were monitored after a fat load (65 g fat per
      square meter body surface area) in six carriers of the apolipoprotein A-IMilano
      (A-IM) variant and six age- and sex-matched control subjects. The magnitude of
      postprandial lipemia, calculated as the area under the curve (AUC) described by
      plasma triglyceride (TG) level versus time, was threefold higher in the A-IM
      carriers; however, after correction for the different baseline TG levels, it was
      similar to control subjects. Moreover, the magnitude of postprandial lipemia was
      positively correlated with baseline TG in both A-IM carriers (r = 0.77) and
      control subjects (r = 0.80), indicating that fasting TGs are a major determinant
      of postprandial response in all subjects. Postprandial lipemia was also inversely
      correlated with high density lipoprotein (HDL) and HDL2 cholesterol in both
      groups (A-IM, r = -0.81 and -0.79; control subjects, r = -0.87 and -0.94).
      Different from those in control subjects, the plasma apo A-I levels in the A-IM
      carriers decreased progressively while apo B increased up to 4 hours but
      decreased thereafter. Postprandial rises of low density lipoprotein TG but not of
      HDL-TG AUC were significantly higher in the A-IM carriers, even after
      normalization for the different fasting concentrations. These data show that the
      low plasma HDL levels of A-IM carriers, which are secondary to a primary
      structural alteration of the major HDL apolipoprotein, are associated with
      elevated fasting and postprandial TG levels and an anomalous postprandial
      redistribution of TG among lipoprotein classes.

PMID- 8466889
TI  - Binding of 111In-labeled LDL to platelets of normolipemic volunteers and patients
      with heterozygous familial hypercholesterolemia.
AB  - Low density lipoproteins (LDLs) were isolated by ultracentrifugation and
      radiolabeled with 111In. The in vitro binding of these radiolabels onto platelets
      of normolipemic volunteers (n = 15) and patients (n = 36) with heterozygous
      familial hypercholesterolemia (FH) was investigated. Binding was saturable and
      indicated high-affinity binding sites capable of binding 1,757 +/- 289 ng protein
      of 111In-LDL per 10(9) platelets (dissociation constant [Kd], 6 +/- 3 micrograms
      protein/mL) in healthy volunteers and significantly (p < 0.001) lower amounts in
      the FH patients (mean, 633 +/- 341 ng protein/10(9) platelets; Kd, 10 +/- 5
      micrograms protein/mL). The capacity of native LDL to displace bound 111In-LDL by
      half amounted to 10 +/- 4 micrograms protein/mL in volunteers and 22 +/- 8
      micrograms protein/mL in FH patients (p < 0.001). Treatment with gemfibrozil
      alone or in combination with cholestyramine in 10 patients resulted in increased
      111In-LDL binding by platelets (470 +/- 307 [mean +/- SD] ng protein/10(9)
      platelets before therapy, 948 +/- 650 ng protein/10(9) platelets after 2 months
      of therapy [p < 0.01], and 1,272 +/- 701 ng protein/10(9) platelets after 6
      months of therapy [p < 0.01]). Significant correlations between 111In-LDL binding
      capacity and apolipoprotein B (r = -0.83, p < 0.001) and LDL cholesterol (r = 
      0.80, p < 0.000) concentrations were found. Patients with clinically manifested
      atherosclerosis (p < 0.01) and those with diabetes mellitus (p < 0.05) had
      significantly lower platelet LDL binding sites. The findings demonstrate 111In
      lipoprotein-specific binding sites on human platelets.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466890
TI  - Occlusive arterial thrombosis in cynomolgus monkeys with varying plasma
      concentrations of lipoprotein(a).
AB  - Lipoprotein(a) (Lp[a]) is a newly recognized risk factor for the development of
      coronary heart disease and stroke in human beings; however, the mechanisms by
      which Lp(a) increases the risk of coronary heart disease remain unclear. The
      purpose of this study was to examine the effects of Lp(a) on the occurrence of
      occlusive arterial thrombosis. Occlusive arterial thrombus formation was examined
      in 18 cynomolgus monkeys with high plasma Lp(a) concentrations (> 35 mg/dL, n =
      6), intermediate Lp(a) concentrations (20-25 mg/dL, n = 6), and low Lp(a)
      concentrations (< 12 mg/dL, n = 6). A Goldblatt clamp was positioned around the
      left common carotid artery to produce a stenotic segment, and the artery was
      pinch-injured with needle holders. A 20-MHz Doppler velocity crystal, placed
      distal to the stenosis/injury site, was used to detect cyclic flow reductions
      (indicative of transient thrombosis) or permanent cessation of flow velocity
      (indicative of more stable occlusive thrombosis). All monkeys with high Lp(a)
      concentrations developed permanent cessation of flow, whereas only one of six
      arteries from low-Lp(a) monkeys developed permanent cessation of flow (p < 0.05).
      Arteries from monkeys with intermediate Lp(a) concentrations developed pronounced
      cyclic reductions of flow but did not progress to permanent cessation of flow.
      There were no differences in plasma von Willebrand factor activity among the
      three groups. Immunohistochemical analysis of the damaged arterial segments
      indicated incorporation of Lp(a) into the adventitia, media, and intima of
      arteries from monkeys with low and high plasma Lp(a) concentrations, as well as
      the presence of an occlusive thrombus in arteries that developed permanent
      cessation of flow.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466891
TI  - Lower-extremity arterial disease in older hypertensive adults.
AB  - Lower-extremity arterial disease (LEAD) is common in older adults, particularly
      those with systolic hypertension. In a subgroup of 1,775 participants of the
      Systolic Hypertension in the Elderly Program, LEAD was assessed noninvasively by
      the ratio of the ankle to arm blood pressure, the ankle-arm index (AAI). LEAD was
      defined as an AAI of < or = 0.9 in either leg. The prevalence of LEAD was 25% in
      white men, 38% in black men, 23% in white women, and 41% in black women. About
      half of those with LEAD had mild disease (AAI, 0.8-0.9), and only 1-3% had a
      positive Rose questionnaire for intermittent claudication. The prevalence
      increased with age (p < 0.01) and was consistently higher in blacks than whites
      (p < 0.01), although there were no significant differences between men and women.
      Even in the absence of risk factors such as smoking and diabetes, blacks had a
      higher prevalence of LEAD than whites. Associations of LEAD with cardiovascular
      risk factors (high density lipoprotein cholesterol, systolic blood pressure, and
      smoking) appeared to be similar in blacks and whites, although relations were not
      always statistically significant in subgroups stratified by race and sex.
      Independent factors associated with the presence of LEAD included age, black
      race, smoking, diabetes mellitus, history of myocardial infarction or angina,
      systolic blood pressure, lower high density lipoprotein cholesterol, and body
      mass index. LEAD is common in older men and women with systolic hypertension,
      particularly blacks. However, very few have symptoms of claudication.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8466892
TI  - HMG CoA reductase inhibitors. In vivo effects on carotid intimal thickening in
      normocholesterolemic rabbits.
AB  - The in vivo activity of different 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA)
      reductase inhibitors (vastatins) on neointimal formation induced by insertion of
      a flexible collar around one carotid artery of normocholesterolemic rabbits was
      investigated. The contralateral carotid artery served as a sham control.
      Pravastatin, lovastatin, simvastatin, and fluvastatin were given mixed with food
      at daily doses of 20 mg/kg body wt for 2 weeks starting on the day of collar
      placement. The treatment with vastatins did not modify rabbit plasma cholesterol
      concentrations. The neointimal formation was assessed by measuring the cross
      sectional thickness of intimal and medial tissues of fixed arteries with light
      microscopy. Fourteen days after collar placement, intimal hyperplasia (mostly
      cellular) was pronounced in treated carotid arteries. The intimal/medial (I/M)
      tissue ratio was 12-fold higher in treated arteries than in arteries without the
      collar (0.36 +/- 0.04 versus 0.03 +/- 0.02). Animals treated with lovastatin (n =
      12), simvastatin (n = 12), and fluvastatin (n = 12) showed significantly less
      neointimal formation; I/M tissue ratios were 0.24 +/- 0.03, 0.20 +/- 0.03, and
      0.17 +/- 0.03, respectively. The inhibition elicited by pravastatin (n = 12, 0.32
      +/- 0.03) did not reach statistical significance. alpha-Actin antibody
      immunofluorescence analysis of serial sections revealed that cells present in the
      hyperplastic intima were mostly myocytes. Rates of intimal myocyte proliferation
      were also measured by incorporation of 5-bromo-2'-deoxyuridine, a thymidine
      analogue, into replicating DNA. Immunofluorescence analysis showed that 5-bromo
      2'-deoxyuridine was actively incorporated into intimal myocytes after
      ++reinsertion of the collar, with a labeling index (percent of labeled myocytes)
      of 2.15 after 14 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466893
TI  - Two patterns of LDL metabolism in normotriglyceridemic patients with
      hypoalphalipoproteinemia.
AB  - The objective of this study was to determine whether normotriglyceridemic
      patients with low levels of high density lipoprotein (HDL) cholesterol have
      concomitant defects in the metabolism of low density lipoproteins (LDLs). To
      address this question, measurements of turnover rates of apolipoprotein A-I (apo
      A-I) and LDL apolipoprotein B (apo B) were made in 36 middle-aged men with low
      HDL cholesterol (< 40 mg/dL), normal triglyceride (< 250 mg/dL), and normal total
      cholesterol (< or = 90th percentile) levels. Similar measurements were made in
      eight hypertriglyceridemic men having low HDL levels. For control, turnover rates
      of LDL apo B were measured in 24 healthy, normolipidemic men, and apo A-I
      kinetics were determined in 20 other healthy men with normal HDL cholesterol
      levels. In all patients with low HDL levels, fractional catabolic rates (FCRs)
      for apo A-I were increased compared with control subjects; in contrast, input
      rates for apo A-I in low-HDL patients were similar to control.
      Hypertriglyceridemic patients had significantly higher FCRs for LDL (0.463 +/-
      0.040 pool/day, [mean +/- SEM]) than control subjects (0.328 +/- 0.008 pool/day,
      p < 0.001). In normolipidemic patients having low HDL, a bimodal pattern of LDL
      apo B kinetics was observed. For 23 low-HDL patients, FCRs for LDL apo B averaged
      0.450 +/- 0.017 pool/day and were significantly higher than control values.
      Additionally, in these patients, levels of very low density lipoprotein plus
      intermediate density lipoprotein (VLDL+IDL) cholesterol and VLDL+IDL apo B were
      higher than in control subjects (54 +/- 3 versus 32 +/- 3 mg/dL and 25 +/- 2
      versus 18 +/- 1 mg/dL, respectively). The remaining 13 low-HDL patients had lower
      and essentially normal FCRs for LDL (0.300 +/- 0.009 pool/day); these patients
      also had relatively low levels of cholesterol and apo B in VLDL+IDL. Thus, two
      patterns of LDL kinetics were present in normotriglyceridemic patients with low
      HDL levels. One pattern was indistinguishable from that typically present in
      patients with hypertriglyceridemia, whereas the other was similar to normal
      control subjects. These two patterns of LDL-apo B kinetics may reflect different
      mechanisms for the causation of low HDL cholesterol concentrations.

PMID- 8466894
TI  - Effect of dietary antioxidant combinations in humans. Protection of LDL by
      vitamin E but not by beta-carotene.
AB  - Experimental and epidemiological evidence supports the hypothesis that oxidation
      of low density lipoprotein (LDL) appears to be important in mediating the
      atherogenicity of LDL. To test this hypothesis in humans, it will be necessary to
      perform intervention studies in large populations. We performed two studies to
      assess the effectiveness of supplementation with beta-carotene and vitamin E,
      used alone and in combination with each other, and with vitamin C, to protect LDL
      from oxidation. In phase 1, after a placebo period, eight subjects were given
      beta-carotene (60 mg/day) for 3 months, then beta-carotene plus vitamin E (1,600
      mg/day) for another 3 months, and then beta-carotene plus vitamin E plus vitamin
      C (2 g/day) for 3 months. During phase 2, beta-carotene and vitamin C were
      discontinued, and subjects took only vitamin E for 5 months. During each period,
      LDL samples were isolated, and measurements of susceptibility to oxidation were
      performed. beta-Carotene levels in LDL increased nearly 20-fold, but LDL
      susceptibility to oxidation did not change. Addition of vitamin E increased LDL
      vitamin E levels nearly 2.5-fold, and this decreased LDL oxidation 30-40%. During
      the vitamin C supplementation period, plasma levels of beta-carotene and vitamin
      E rose, but only beta-carotene increased in LDL. However, the susceptibility of
      LDL to oxidation in this period was not decreased further. During phase 2, when
      subjects took only vitamin E, LDL susceptibility to oxidation was decreased by
      50% as measured by thiobarbituric acid-reactive substances, conjugated dienes,
      and lipid peroxide formation as well as by macrophage degradation. Thus, long
      term supplementation with large doses of vitamin E alone, but not beta-carotene,
      conferred increased protection to LDL in in vitro assays of oxidation. These data
      should be useful in planning therapeutic strategies to test the antioxidant
      hypothesis in humans.

PMID- 8466895
TI  - Comparison of supplementation of RRR-alpha-tocopherol and racemic alpha
      tocopherol in humans. Effects on lipid levels and lipoprotein susceptibility to
      oxidation.
AB  - It has been suggested that alpha-tocopherol, a safe and effective antioxidant, be
      used in clinical trials to evaluate the ability of antioxidant therapy to inhibit
      atherosclerosis. Recent reports, however, have raised the possibility that there
      may be greater enrichment of plasma low density lipoprotein (LDL) in alpha
      tocopherol resulting from the use of the naturally occurring RRR-alpha-tocopherol
      isomer compared with the other isomers present in the synthetic racemic form of
      alpha-tocopherol. Therefore, we fed equal dosages (1,600 mg/day) of the two forms
      of vitamin E to 16 men and women for 8 weeks and compared the effects of this
      supplementation on the susceptibility of isolated lipoproteins to oxidation.
      Neither form of vitamin E had appreciable effects on lipid or lipoprotein levels.
      alpha-Tocopherol levels in LDL increased at a similar rate in both groups and
      were nearly twofold higher than baseline levels by the end of the study. The
      susceptibility of LDL to oxidation was measured by formation of conjugated
      dienes, lipid peroxides, and thiobarbituric acid-reactive substances, as well as
      by macrophage degradation of LDL exposed to oxidizing conditions in vitro. The
      susceptibility of LDL to oxidation was decreased in both vitamin E groups
      compared with the baseline value, and this reduction occurred to a similar extent
      in both vitamin E-supplemented groups. alpha-Tocopherol levels in LDL also
      strongly correlated with all measures of LDL oxidation. This study demonstrates
      that, at this dosage, supplementation with either the natural or synthetic form
      of alpha-tocopherol provided equal antioxidant protection to LDL.

PMID- 8466896
TI  - Effect of intramolecular cross-links on the enthalpy and quaternary structure of
      the intermediates of oxygenation of human hemoglobin.
AB  - We have reported [Bucci, E., Fronticelli, C., & Grycznski, Z. (1991) Biochemistry
      30, 3195-3199] that in human and bovine hemoglobins the release of heat at the
      subsequent steps of oxygenation is not constant. This is especially evident in
      the binding of the third O2 molecule, which is an endothermic event. This
      phenomenon was attributed to peculiar conformations of the intermediates of
      oxygenation, not included in the fundamental R/T transition of the system. To
      test this hypothesis, we have explored the effect of conformational constraints
      on the thermodynamics of the intermediates of oxygenation. The assumption was
      that intramolecular constraints would stabilize the intermediates into
      conformations similar to the R and T forms reducing the variability of their
      enthalpies. We have analyzed the temperature dependence of the oxygen binding
      isotherms of human hemoglobin cross-linked either between the beta 82 or between
      the alpha 99 lysines by bis(3,5-dibromosalicyl)fumarate. The measurements were
      perfomred at pH 9.0 in 0.1 M borate buffer in order to avoid thermal effects due
      to oxygen-linked binding of anions and protons. The data were analyzed singularly
      by local procedures and simultaneously using global procedures. The two cross
      links had opposite effects. The cross-link between the beta-subunits decreased
      while that between the alpha-subunits increased the endothermic behavior of the
      third step of oxygenation. Also, the cross-link between the beta-subunits
      increased the fractional amount of the triligated species at intermediate stages
      of oxygenation, while that between the alpha-subunits decreased this quantity to
      hardly detectable values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466897
TI  - Association of the A subunits of recombinant placental factor XIII with the
      native carrier B subunits from human plasma.
AB  - Interactions of a recombinant human placental protein (rA2) expressed in yeast
      and considered to be identical to the catalytic A2 subunits of factor XIII, the
      fibrin stabilizing factor zymogen, were examined with the native carrier subunits
      (B2) of the factor isolated from human plasma. Nondenaturing electrophoresis and
      HPLC gel-filtration experiments showed a tight binding of rA2 to B2 for forming
      an ensemble similar to that of plasma factor XIII (A2B2). In the presence of
      excess B2, however, some higher ordered oligomers (rA2Bn, where n > 2) were also
      seen in electrophoresis. The same technique revealed a microheterogeneity in the
      rA2 preparation; nevertheless, all isoforms could bind to B2. By employing an
      ELISA procedure for measuring free B2 in mixtures with rA2, an apparent binding
      constant of 4 x 10(7) M-1 was derived for the association of rA2 with B2.
      Fluorescence depolarization was used to monitor the heterologous association of
      rA2 with fluorescein-labeled B2F as well as the dissociation of the rA2B2F
      structure. The former was characterized by an increase, and the latter by a
      decrease, in the fluorescence anisotropy of the system. Binding of rA2 to B2F (pH
      7.5, mu = 0.315, 37 degrees C) was not influenced by low concentrations of Ca2+
      (< or = 30 mM), and rA2B2F proved to be quite stable under these conditions. Much
      higher concentrations of Ca2+, as well as higher ionic strengths, were required
      to dissociate this assembly. By contrast, release of B2F from the thrombin
      modified rA2'B2F occurred rapidly in the presence of low concentrations of Ca2+
      at low ionic strength.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466898
TI  - Kinetics of bisulfite-induced cytosine deamination in single-stranded DNA.
AB  - The rate of bisulfite-induced deamination of cytosine to uracil in single
      stranded (ss) DNA at physiological temperature and pH was monitored by a
      sensitive genetic assay. The assay is based on reversion of a mutation in the
      lacZ alpha gene of bacteriophage M13mp2 and employs ung- (NR9404) and ung+
      (MC1061) bacterial strains which are isogenic except for uracil glycosylase
      activity. For ss DNA incubated with 1-50 mM bisulfite and transfected into an ung
      cell strain, the reversion frequency increased linearly with time of incubation
      and with concentration of bisulfite. Of 54 revertants sequenced, all were C-->T
      transitions. Reduction in reversion frequency upon transfecting ss DNA into ung+
      cells indicated that the majority of mutations were occurring via a uracil
      intermediate. Assuming that all revertants arose via uracil, the pseudo-first
      order rate constant for deamination in 10 mM sodium bisulfite and 10 mM Hepes
      NaOH, pH 7.4, at 37 degrees C as measured by transfecting into an ung- cell
      strain was 3.5 x 10(-10) s-1, as compared to a spontaneous background rate
      constant of 0.6 x 10(-10) s-1 in buffer alone.

PMID- 8466899
TI  - Inhibitor binding to the Phe53Trp mutant of HIV-1 protease promotes
      conformational changes detectable by spectrofluorometry.
AB  - HIV-1 protease contains two identical, conformationally mobile loops, known as
      flaps, which form in part the binding pockets for substrates and inhibitors. We
      have constructed a site-specific mutant of the protease in which residues Phe-53
      and Phe-153 at the end of the flaps have been mutated to Trp residues, in order
      to incorporate a specific fluorescent probe to monitor conformational changes
      upon the binding of an inhibitor. The Phe53Trp (F53W) mutant of HIV-1 protease
      was expressed in Escherichia coli and purified from bacterial lysates. Analysis
      of the purified mutant protease demonstrated that its kinetic properties were
      highly similar to those of the wild-type protease. While binding of a potent
      peptide-analogue inhibitor (Ki = 9 nM) to the wild-type enzyme led to no change
      in protein fluorescence, a 5-8% increase in fluorescence was observed with the
      F53W mutant, indicating an enhancement of the Trp fluorescence due to flap
      movement upon inhibitor binding. Investigation of the kinetics of the F53W
      protease-inhibitor binding by stopped-flow spectrofluorometry revealed a rapid
      increase in protein fluorescence upon formation of the enzyme-inhibitor complex.
      These data were consistent with a one-step mechanistic model of inhibitor binding
      in which flap movement was concomitant with inhibitor binding, from which
      respective rate constants of association and dissociation of 2.5 x 10(6) M-1 s-1
      and 0.023 s-1 were obtained.

PMID- 8466900
TI  - Transcription termination factor rho: the site of bicyclomycin inhibition in
      Escherichia coli.
AB  - Bicyclomycin is a novel, commercially important antibiotic. Information
      concerning the site of bicyclomycin inhibition in Escherichia coli has been
      obtained by the production of bicyclomycin resistant mutants by UV irradiation.
      Selection by growth in the presence of bicyclomycin of a plasmid clone library
      generated from a highly resistant mutant in recipient antibiotic-sensitive host
      cells (E. coli strain W3350) has led to the characterization of three different
      plasmids that confer drug resistance, which contained the gene encoding the
      transcription termination factor, rho. These mutant rho genes contained single
      base changes at nucleotide positions 656, 796, and 1009. Preliminary mechanistic
      information has been obtained by monitoring the polyC-dependent ATPase activity
      of rho in the absence and presence of bicyclomycin and dihydrobicyclomycin.
      Addition of bicyclomycin to aqueous solutions containing rho and ATP led to a
      decrease in the release of inorganic phosphate with an I50 value of 60-70 microM
      bicyclomycin. This inhibition is comparable to the drug concentration needed to
      inhibit bacterial growth on plates. No loss of activity was observed when a
      similar concentration of dihydrobicyclomycin was used in place of bicyclomycin,
      while use of 10-fold higher concentrations of this derivative led to partial rho
      inhibition. PolyC-dependent ATPase activity from partially purified rho isolated
      from the mutant BCMr108 was not inhibited by bicyclomycin at concentrations (200
      microM) found to completely inhibit wild-type rho. These cumulative findings are
      consistent with the notion that bicyclomycin expresses its activity by
      interfering with the polyC-dependent ATPase activity of rho.

PMID- 8466901
TI  - Effect of thymine tract length on the structure and stability of model telomeric
      sequences.
AB  - DNA from the telomeres at the ends of eukaryotic chromosomes contains a stretch
      of simple tandemly repeated sequences in which clusters of G residues alternate
      with clusters of T/A sequences along one DNA strand. Model telomeric G-clusters
      form four-stranded structures in Na+ or K+, stabilized by Hoogsteen pairing
      between G bases. DNA containing a single copy of the G-cluster can self-associate
      to form tetramers, with a parallel-stranded, right-handed helical structure. Two
      copies of the 3'-terminal G strand form a folded-back hairpin that dimerizes to
      create an antiparallel quadruplex structure. We show here that the tetrameric
      structure is strongly influenced by the T residue flanking either side of the G
      cluster. The parallel tetraplex formed by single copies of the sequences dTnG4 is
      most stable for n = 1 and least stable for n = 8, the longest tract we have
      studied. At least two thymine residues are required to allow formation of
      antiparallel folded-back hairpin dimers from two-copy oligomers of sequence
      d(TnG4)2 in Na+; additional T's destabilize this structure. In K+, the
      predominant structure formed is the four-stranded parallel tetramer in all cases.
      Kinetic analysis indicates that the quadruplex structure formed by Oxytricha
      telomeric DNA overhangs in the presence of Na+ arises by dimerization of two
      Hoogsteen base-paired hairpins, with a relatively low energy barrier.

PMID- 8466902
TI  - Important 2'-hydroxyl groups within the core of a group I intron.
AB  - The catalytic activity of a group I intron is dependent on a core structure, much
      of which is not exposed to solvent. In order to study the structure of the core,
      an efficient bimolecular reaction has been developed: the 5'-component is a
      molecule of about 300 bases which contains the 5'-splice-site and terminates in
      the loop established by P8, and the 3'-component is a 24 base long
      oligoribonucleotide which includes the 3'-regions of the P8 and P7 helices with
      their joining region, J8/7. J8/7 is thought to play several roles including
      binding the helix containing the 5'-splice-site. P7 forms a major portion of the
      guanosine binding site required for splicing. We have modified the bimolecular
      system to make it amenable to kinetic analysis and have used it to study the role
      of the ribose sugars in the oligomer. Multiple deoxyribonucleotide substitution
      in the J8/7 region completely blocked 5'-splice-site cleavage even though the Kd
      was only reduced about 5-fold. This supports the idea that the ribose phosphate
      backbone in J8/7 plays a key role in catalysis. Individual substitutions at G303
      and A306 reduced the rate of catalysis 5-10-fold. The G303 substitution blocked
      GTP-independent hydrolysis of the 5'-splice-site. The region spanning the
      junction of P8 and J8/7 was also highly sensitive to multiple deoxyribonucleotide
      substitution; however, only in the case of C298 did an individual substitution
      have any effect on cleavage. Deoxyribonucleotide substitution in the 3'-section
      of P7 was less severe, although kcat/Km in low GTP was down 70-fold.

PMID- 8466903
TI  - Sources of hydrogen abstraction by activated neocarzinostatin chromophore.
AB  - Activation of the enediyne neocarzinostatin chromophore (NCS-Chrom) by thiol
      addition at C-12 generates a diradical species with radical centers at C-2 and C
      6, which abstract hydrogens from deoxyribose in the minor groove of DNA. Since
      hydrogen abstraction from DNA accounts for only part of the hydrogen incorporated
      at these sites, it is important to determine the other possible sources. At low
      concentration of thiol, a condition resembling that during NCS-Chrom-induced DNA
      damage, the major non-DNA hydrogen donation source was found to be the carbon
      bound hydrogen of the aqueous methanol solvent, rather than the expected sulfur
      bound hydrogen of the thiol. Further, experiments with the gamma-L-glutamyl-DL
      cysteinylglycine labeled with deuterium on the alpha- or beta-carbons to the
      sulfur showed small amounts of internal transfer of hydrogen into C-2 of the drug
      from the naturally occurring L,L diastereomer only. Quantitation of the hydrogen
      transfer was accomplished by separation of the L,DL diastereomeric mixtures of
      the thiol-NCS-Chrom adducts. In all, these various hydrogen donation sources can
      account for at least 70-80% of the hydrogen incorporated at C-2 of the drug under
      DNA damage conditions. Selective quenching of the radical at C-2 could account
      for the predominance of single-stranded over double-stranded DNA lesions.

PMID- 8466904
TI  - Exclusive production of bistranded DNA damage by calicheamicin.
AB  - Bistranded DNA damage produced by the enediyne antitumor antibiotic calicheamicin
      (CAL) was examined in plasmid DNA and in a model site for CAL-mediated DNA damage
      containing the sequence AGGA.TCCT. CAL was observed to produce bistranded DNA
      damage to the virtual exclusion of single-strand (SS) lesions. Without expression
      of drug-induced abasic sites as strand breaks, CAL activated by 10 mM glutathione
      produced equal numbers of DS and SS breaks in plasmid DNA. However, cleavage of
      drug-induced abasic sites with hydrazine and putrescine resulted in a dramatic
      increase in the appearance of bistranded damage, with ratios of DS to SS breaks
      of approximately 6:1 and approximately 24:1, respectively. A similar bias for DS
      lesions was noted in CAL-mediated damage in the AGGA.TCCT model sequence, in
      which evidence for a 4'-hydroxylated abasic site was observed on the AGGA strand.
      These model DNA systems revealed three important features of the bistranded
      damage produced by CAL. First, the major lesion produced by CAL is a bistranded
      lesion consisting of an abasic site on one strand and a direct strand break on
      the other. Second, 3'-phosphoglycolate residues resulting from CAL-induced C4'
      hydrogen abstraction at the C of AGGATC were restricted to bistranded lesions.
      This unusual behavior of the C4'-chemistry of both CAL and the related
      neocarzinostatin (NCS) is consistent with an intermediate in the partitioning
      that is dependent on bistranded lesions. Finally, 4-hydroxythiophenol activated
      CAL to produce a ratio of DS to SS lesions of approximately 10:1, as opposed to
      the approximately 1:30 ratio noted previously for NCS.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8466905
TI  - Identification of a compact DNA-binding domain in the gene 5 protein of Pf1
      bacteriophage.
AB  - The structure of the gene 5 protein of filamentous bacteriophage Pf1 and its
      interaction with viral DNA have been investigated by a series of limited
      proteolysis experiments. The ability of purified proteolytic fragments of the Pf1
      gene 5 protein to bind oligonucleotides and polynucleotides was monitored by gel
      retardation and fluorescence. The results show the presence of a compact DNA
      binding "core" domain consisting of residues 1-112 of the protein, which is
      protected from proteolysis in the nucleoprotein complex. Digestion of the free
      gene 5 protein with subtilisin produces a smaller fragment (residues 7-102) which
      can no longer bind DNA. Although the N-terminal "core" domain shows full DNA
      binding activity by fluorescence, the gel retardation experiments suggest reduced
      kinetic stability of this domain in complexes with oligonucleotides, resulting
      from the removal of residues 113-144 from the C-terminus of the protein. The
      sequence of the C-terminal 32 amino acid residues is unusual, with a high
      proportion of alanine, glutamine, and proline residues which may be related to
      the role of this sequence in stabilizing the complex.

PMID- 8466906
TI  - Differential scanning calorimetry of the irreversible denaturation of Escherichia
      coli glucosamine-6-phosphate deaminase.
AB  - The thermal denaturation of Escherichia coli glucosamine-6-phosphate deaminase
      (G6PD) at neutral pH was studied by means of differential scanning calorimetry
      (DSC). In the concentration range 0.6-7.3 mg mL-1, the denaturation of this
      hexameric enzyme was completely irreversible as judged by the absence of any
      endotherm on rescanning of previously scanned samples. However, the study of the
      effect of scanning rate on DSC curves indicated that the denaturation of G6PD is,
      most likely, a complex process which includes transitions in equilibrium as well
      as an irreversible step; in addition, it was found that application of the
      equilibrium formalism to the analysis of calorimetric data seems to be justified
      in this case, provided that scanning rates used are above 0.75 K min-1. The
      calorimetric and van't Hoff enthalpies for G6PD were 1260 +/- 118 and 160 +/- 27
      kcal mol-1, respectively, indicating the presence of intermediates in the
      process. Accordingly, the DSC curves were adequately fitted to a model including
      six two-state sequential transitions. The observed protein-concentration
      dependence of the temperature at the maximum heat capacity, Tm, for each of the
      individual transitions suggests that G6PD dissociates to dimers in two
      consecutive steps. Using a model that includes dissociation explicitly, we
      calculated the thermodynamic parameters for each step. From this data, the
      enthalpy and free energy for the disruption of one dimer-dimer contact were
      roughly estimated, at pH 7.1 and 51 degrees C, as 57 and 2.1 kcal mol-1,
      respectively.

PMID- 8466907
TI  - Conformational dynamics of cytochrome P-450cam as monitored by photoacoustic
      calorimetry.
AB  - Conformational transitions of cytochrome P-450cam following the dissociation of
      CO from the ferrous heme were investigated by using photoacoustic calorimetry.
      The effect of substrate association on the acoustic signal was also examined.
      Results show that the conformational dynamics of cytochrome P-450cam substrate
      free protein occur faster than 10 ns, which is the time scale of the instrument
      response. The enthalpy and volume change for the dissociation reaction are 2.2
      kcal mol-1 and 1.8 mL mol-1, respectively. Upon addition of camphor, the reaction
      is markedly slowed. An intermediate is formed whose lifetime is 130 ns at 17
      degrees C. The overall enthalpy and volume changes are -15.9 kcal mol-1 and 10.3
      mL mol-1, respectively. These results, together with published transient Raman
      spectra [Wells, A. V., Pusheng, L., Champion, P. M., Martinis, S. A., & Sligar,
      S. G. (1992) Biochemistry 31, 4384-4393] suggest that camphor leaves the heme
      pocket concomitant with the photoinduced expulsion of CO into the solvent and
      induces a considerable conformational change in the protein.

PMID- 8466908
TI  - Pathway of disulfide-coupled unfolding and refolding of bovine alpha-lactalbumin.
AB  - alpha-Lactalbumin's four disulfide bonds have been used to probe the nature of
      its native, molten globule, and unfolded states. The Ca2+ concentration could be
      used to vary the stability of the native state because it binds a single calcium
      ion with high affinity. In the Ca(2+)-bound native state, the Cys6-120 and Cys28
      111 disulfides were reduced sequentially, reflecting their relative
      accessibilities. The native disulfides do not stabilize the native conformation
      as much as in other proteins, nor was the unfolding process as cooperative. After
      two disulfides were reduced, only part of the protein molecule appeared to remain
      folded. In the absence of Ca2+, the native state was much less stable, and a
      molten globule-type conformation tended to be adopted. Formation of disulfide
      bonds in the reduced protein was initially noncooperative and nonspecific. The
      molten globule state increased the rate at which disulfides were formed, by
      tending to keep close in space cysteine residues that are distant in the
      sequence. A large number of nonnative disulfide pairings were preferred, and the
      disulfides were not stabilized to any great extent. The alpha-lactalbumin molten
      globule seems to be stabilized by nonspecific interactions and without a well
      defined topology. The native protein was regenerated only when Ca2+ bound to and
      stabilized the three-disulfide intermediate lacking the Cys6-120 disulfide, which
      then rapidly formed the fourth disulfide bond. The rate-limiting intramolecular
      steps were rearrangement of disulfide bonds to native combinations in species
      with two and three disulfide bonds.

PMID- 8466909
TI  - Structural characterization of the disulfide folding intermediates of bovine
      alpha-lactalbumin.
AB  - Specific three- and two-disulfide intermediates that accumulate transiently
      during reduction of the disulfide bonds of Ca(2+)-bound bovine alpha-lactalbumin
      have been trapped, isolated, and characterized. The three-disulfide intermediate
      was shown to lack the Cys6-120 disulfide bond, confirming the observations of
      others. The newly-recognized two-disulfide form has been shown to lack the Cys6
      120 and Cys28-111 native disulfide bonds. The remaining native disulfide bonds in
      the two partially reduced derivatives of alpha-lactalbumin are stable only when
      the proteins are in a Ca(2+)-bound state. Otherwise, they adopt an equilibrium
      between molten globule and unfolded conformations, and rapid thiol-disulfide
      interchange occurs, at a rate as high as when the proteins are fully unfolded in
      8 M urea, to generate distinct mixtures of rearranged products. Urea gradient
      electrophoresis, circular dichroism, fluorescence, and ANS binding have been
      combined to give a detailed structural picture of alpha-lactalbumin, its
      derivatives with native and with nonnative disulfide bonds, and the fully reduced
      protein. The native structure of alpha-lactalbumin appears to be split by
      selective disulfide bond cleavage into at least one subdomain, which retains the
      Ca(2+)-binding site. The alpha-lactalbumin molten globule state is shown largely
      to result from nonspecific hydrophobic collapse, to be devoid of cooperative or
      specific tertiary interactions, and not to be stabilized substantially by the
      native or rearranged disulfide bonds.

PMID- 8466910
TI  - Time-resolved and equilibrium measurements of the effects of poly(ethylene
      glycol) on small unilamellar phospholipid vesicles.
AB  - The effects of poly(ethylene glycol) (PEG) on sonicated unilamellar vesicles made
      of phosphatidylcholine have been examined. Stopped-flow and equilibrium data are
      presented for vesicle aggregation, vesicle leakage, lipid mixing, and aqueous
      contents mixing. Vesicle aggregation is detected as a monoexponential increase in
      light scattering, for PEG concentrations between 5 and 10%. In the region between
      10-15% and 23-27% PEG, under our experimental conditions, the increase in light
      scattering follows a more complex biexponential kinetics, and, under these
      conditions, vesicle aggregation is accompanied by lipid mixing, a combination of
      events denoted as "close apposition". Above 23-27% PEG, the increase in light
      scattering is accompanied by fast lipid mixing, and also mixing of aqueous
      contents, all this being indicative of vesicle fusion; in addition, leakage
      occurs under these circumstances. Fusion takes place at high PEG concentrations,
      as indicated above, without any dilution step. From a methodological point of
      view, the Tb/DPA assay is shown to be more appropriate than the ANTS/DPX method
      for leakage and fusion studies in the presence of PEG.

PMID- 8466911
TI  - Contribution of hydrogen bonding to lipid-lipid interactions in membranes and the
      role of lipid order: effects of cholesterol, increased phospholipid unsaturation,
      and ethanol.
AB  - It is proposed that increased phospholipid unsaturation in membranes and
      perturbation by agents such as ethanol weaken interlipid hydrogen bonding
      involving water and that the process is independent of effects on lipid order. To
      investigate this, the rates of phospholipid desorption, as a measure of the
      strength of interlipid interactions, from "donor" lipid vesicles was determined.
      This was accomplished using (7-nitrobenzo-2-oxa-1,3-diazole-4-yl)aminohexanoate
      (C6-NBD) labeled phospholipids, the rate of desorption being followed from
      changes in fluorescence with time. The rates of desorption of the NBD
      phospholipids from phosphatidylcholine (PC) donor vesicles was in the order
      phosphatidylcholine (PC) > phosphatidylserine (PS) > phosphatidylethanolamine
      (PE), the slower rates in the PS and PE reflecting direct interlipid hydrogen
      bonding. For PC, the interlipid hydrogen bonding was restricted to the "hydration
      layer", the network of hydrogen-bonded water molecules extending between
      phospholipid head groups. The rate of C6-NBD-PC desorption was elevated with
      higher levels of donor PC sn-2 unsaturation, due the increased head group spacing
      weakening the lipid-lipid interactions that occur via the hydration layer.
      Ethanol also increased the rate of NBD-phospholipid desorption from donor PC
      vesicles in the order PC > PS > PE, showing that PC interactions, here limited to
      the weaker hydrogen-bonded water molecule network, were more susceptible compared
      to stronger, direct interlipid hydrogen bonds involving PE and PS. The relative
      magnitude of the ethanol-induced increase in the desorption rate was amplified
      with higher levels of donor lipid sn-2 unsaturation. Cholesterol had little
      effect on the rate of phospholipid desorption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466912
TI  - Physical properties of recombinant apolipoprotein(a) and its association with LDL
      to form an LP(a)-like complex.
AB  - Recombinant apolipoprotein(a) has been studied by hydrodynamic techniques and
      electron microscopy. Recombinant apo(a) was primarily a monomer in solution with
      an s0(20,w) of 9.3 S, a D20,w of 2.29 ficks, and a molecular weight of 325,000
      from sedimentation equilibrium and 318,000 from combining the sedimentation and
      diffusion coefficients. A small amount, approximately 10%, of the recombinant
      apo(a) was present as a high molecular weight aggregate. The Stokes radius of the
      monomer, determined either from the diffusion coefficient or by combining the
      sedimentation equilibrium data with the sedimentation velocity data, was 94 A.
      The frictional ratio was 2.2, suggesting a highly asymmetric or random coil
      structure. In the electron microscope, recombinant apolipoprotein(a) was
      visualized as a long, highly flexible chain of domains forming large, open coiled
      structures on the EM grid with contour lengths of about 800 A. Addition of 6
      aminohexanoic acid at 50 mM, a concentration which should saturate the weak
      lysine binding sites, did not alter the sedimentation behavior. In vivo,
      apolipoprotein(a) is associated tightly with LDL to form a highly atherogenic
      lipoprotein, Lp(a). A single molecule of recombinant apo(a) also associated
      tightly with LDL to yield a 13.3-S Lp(a)-like complex. This complex dissociated
      upon the addition of 50 mM 6-aminohexanoic acid. A novel sucrose gradient
      centrifugation technique was employed to determine a dissociation constant for
      the reversible equilibrium between recombinant apo(a) and LDL; at physiological
      ionic strength the dissociation constant was 0.3 nM. Raising the salt
      concentration to 5 M NaBr caused the dissociation constant to increase to 500
      nM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466913
TI  - Differential effects of the reversible thiol-reactive agents arsenite and methyl
      methanethiosulfonate on steroid binding by the glucocorticoid receptor.
AB  - The hormone binding domain of the glucocorticoid receptor contains a unique
      vicinally spaced dithiol, and when it is bound by arsenite under conditions that
      are specific for reaction with vicinally spaced dithiols versus monothiols,
      steroid binding activity is eliminated [Simons, S. S., Jr., Chakraborti, P. K., &
      Cavanaugh, A. H. (1990) J. Biol. Chem. 265, 1938-1945]. The vicinally spaced
      dithiol lies in a region of the receptor that appears to be a contact site for
      hsp90, which is required for the high-affinity steroid binding conformation of
      the glucocorticoid receptor [Dalman, F. C., Scherrer, L. C., Taylor, L. P., Akil,
      H., & Pratt, W. B. (1991) J. Biol. Chem. 266, 3482-3490]. As part of a long-term
      project to develop a vicinal dithiol-specific agent that will permit studies of
      ligand-induced conformational changes in this region of the receptor, we have
      examined here the differential effects of two reversible thiol-reactive agents,
      arsenite and MMTS. At low concentration, arsenite inactivates the steroid binding
      activity of the unliganded receptor in a vicinal dithiol-specific manner, whereas
      dissociation of steroid from untransformed, transformed, or DNA-bound transformed
      receptors occurs only at concentrations typical of monothiol interactions. MMTS
      produces a unique bimodal effect on the steroid binding capacity of the
      unliganded receptor at pH 9 that is pH-dependent and becomes essentially unimodal
      at physiological pH. Whereas arsenite disrupts the dexamethasone-receptor complex
      more readily than the triamcinolone acetonide-receptor complex, MMTS has the
      opposite effect. During treatment for 1 h at 0 degree C, neither reagent causes
      dissociation of hsp90 from the receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466914
TI  - Proteolytic release of cell surface proteins during differentiation of
      Trypanosoma brucei.
AB  - The surface of the bloodstream forms of Trypanosoma brucei is covered by the
      abundant glycosylphosphatidylinositol-anchored variant surface protein (mfVSG).
      During differentiation of bloodstream forms to the insect-stage or procyclic
      forms, the mfVSG is replaced by another glycoprotein, designated procyclic acidic
      repetitive protein (PARP) or procyclin. Shortly after differentiation is
      triggered in vitro, a cell-associated fragment of mfVSG can be detected which is
      subsequently released into the culture medium. In the case of the mfVSG of the
      variant clone MITat 1.4 (470 amino acid residues), fragmentation occurs close to
      the COOH-terminus (Gln433 or Thr434) as shown by NH2-terminal sequencing,
      metabolic labeling experiments, and molecular weight determinations by laser
      desorption/ionization mass spectrometry. Two invariant surface glycoproteins,
      which are anchored in the membrane by hydrophobic sequences close to their COOH
      termini, are lost from the surface with similar kinetics as mfVSG. The data
      suggest that trypanosomes synthesize or activate a developmentally-regulated
      proteinase which degrades the glycoproteins at the surface, at the membrane
      lining the flagellar pocket, and/or in an early endocytic compartment.

PMID- 8466915
TI  - Biosynthesis of lipoic acid: characterization of the lipoic acid auxotrophs
      Escherichia coli W1485-lip2 and JRG33-lip9.
AB  - The abilities of the Escherichia coli lipoic acid auxotrophs W1485-lip2 and JRG33
      lip9 to grow on succinate medium in the presence of octanoate, 8
      mercaptooctanoate, or 6-mercaptooctanoate have been determined. Both organisms
      are mutated in lipA. Neither organism can use octanoate or 6-mercaptooctanoate
      for production of lipoate, but the lip2 allele can use 8-mercaptooctanoate.
      Chromosomal DNA from the auxotrophs was amplified by PCR using primers derived
      from the DNA sequence of wild-type lipA and then sequenced. Both mutants contain
      single G/C to A/T mutations in lipA, resulting in conversion of Ser307 into Phe
      in W1485-lip2 and Glu195 into Lys in JRG33-lip9. These results support the
      hypothesis that lipA is involved in the sulfur insertion step(s) of lipoate
      biosynthesis and indicate that it is possible to selectively block formation of
      the C8-S bond through suitable mutation in lipA.

PMID- 8466916
TI  - A reexamination of the folding mechanism of dihydrofolate reductase from
      Escherichia coli: verification and refinement of a four-channel model.
AB  - The mechanism of folding of dihydrofolate reductase from Escherichia coli was
      reinvestigated by studying the unfolding and refolding kinetics using absorbance
      and fluorescence spectroscopies. The original kinetic model proposed that folding
      involved a series of native, intermediate, and unfolded forms which
      interconverted through four independent channels linked by slow cis/trans
      isomerization reactions at Xaa-Pro peptide bonds [Touchette, N. A., Perry, K. M.,
      & Matthews, C. R. (1986) Biochemistry 25, 5445]. Recently, alternative sequential
      models have been proposed [Frieden, C. (1990) Proc. Natl. Acad. Sci. U.S.A. 87,
      4413; Kuwajima et al. (1991) Biochemistry 30, 7693] which challenge the original
      proposal. Stopped-flow studies of the intrinsic tryptophan fluorescence
      demonstrated the presence of three (and tentatively four) kinetic phases in
      unfolding which correlated well with four phases previously observed in refolding
      experiments. By monitoring the binding of the inhibitor methotrexate during
      folding at varying relative concentrations of inhibitor to protein, it was found
      that the selective loss of the slow-folding phases at substoichiometric levels
      could only be explained by a four-channel folding model. Double-jump experiments
      (native-->unfolded-->native) showed that the four refolding channels are
      populated within 20 s at 15 degrees C and are not likely to be due to proline
      isomerization. Reverse double-jump experiments (unfolded-->native-->unfolded)
      demonstrated that interconversions between native conformers are more rapid than
      originally proposed. Interestingly, the majority of the protein folds through a
      channel to a native conformer that is minimally populated at equilibrium. This
      implies that although the folding of dihydrofolate reductase is ultimately under
      thermodynamic control, kinetic factors contribute to the transient populations of
      native species during folding.

PMID- 8466917
TI  - Three-state analysis of sperm whale apomyoglobin folding.
AB  - We give a quantitative description of the urea- and acid-induced transitions of
      apomyoglobin at 0 degree C and 2 mM sodium citrate. Our data consist of two
      series of unfolding curves: (1) acid-induced unfolding carried out in the
      presence of various concentrations of urea and (2) urea-induced unfolding at
      various pH values. A three-state equation is derived which relates the stability
      of three different conformations of apomyoglobin (native [N], unfolded [U], and
      intermediate [I]) as a function of urea and of pH. This equation fits our data
      reasonably well. The parameters which give the best fit have both thermodynamic
      and structural implications for N, I, and U. Specifically, I is closer in Gibbs
      energy to U than to N, indicating that side-chain packing results in much of the
      stability of native protein structure. The equilibria between N and I and between
      I and U are equally sensitive to urea, suggesting that much of the surface of I
      is inaccessible to solvent. The acid-induced transition in which N unfolds can be
      described as the result of titration of approximately two histidines with low
      pKaS in N. Under physiological conditions (neutral pH, no urea) I is the most
      stable non-native conformation.

PMID- 8466918
TI  - Study of a fatty acid binding site of interphotoreceptor retinoid-binding protein
      using fluorescent fatty acids.
AB  - Interphotoreceptor retinoid-binding protein (IRBP) is a 140-kDa glycolipoprotein
      which constitutes about 70% of the soluble protein of the retinal
      interphotoreceptor matrix. Much is known concerning its role in the transport of
      retinoids between photoreceptor cells and pigment epithelium but little is known
      about its interactions with lipids. Here we have examined the physicochemical
      characteristics of a fatty acid binding site of IRBP using a set of fluorescent
      fatty acid analogs with an anthracene moiety attached at different positions
      along the hydrocarbon chain. The results show that fatty acids are bound in a
      hydrophobic environment as indicated by a blue shift in fluorescence maxima and
      by a increase in quantum yield of the bound ligand. There is a single specific
      fatty acid binding site for each molecule of IRBP with an apparent Kd = 3.6 x 10(
      7) M. There is a nonradiative energy transfer from tryptophan residues to bound
      ligand. The interactions of IRBP and bound fatty acid are sensitive to
      denaturation by increasing concentrations of urea as judged by changes in
      nonradiative energy transfer efficiency and the quantum yield of bound probe.
      Quantum yields of bound fatty acid analogs varied with position of the
      fluorophore along the hydrocarbon chain and had the lowest values for the
      fluorophore located at the midpoint. Probing of the microenvironment of bound
      fluorophore with a quencher indicated a highly structured binding site.

PMID- 8466920
TI  - Solution conformation of a deoxynucleotide containing tandem G.A mismatched base
      pairs and 3'-overhanging ends in d(GTGAACTT)2.

PMID- 8466919
TI  - Fluorophore environments in membrane-bound probes: a red edge excitation shift
      study.
AB  - A shift in the wavelength of maximum fluorescence emission toward higher
      wavelengths, caused by a shift in the excitation wavelength toward the red edge
      of the absorption band, is termed the Red Edge Excitation Shift (REES). This
      effect is mostly observed with polar fluorophores in motionally restricted media
      such as very viscous solutions or condensed phases. In this paper, we report the
      red edge excitation shift of a membrane-bound phospholipid molecule whose
      headgroup is covalently labeled with a 7-nitrobenz-2-oxa-1,3-diazol-4-yl (NBD)
      moiety. When incorporated into model membranes of dioleoyl-sn-glycero-3
      phosphocholine (DOPC), the NBD-labeled phospholipid (NBD-PE), exhibits a red edge
      excitation shift of 10 nm. In addition, fluorescence polarization of NBD-PE in
      membranes shows both excitation and emission wavelength dependence. The nonpolar
      membrane probe 1,6-diphenyl-1,3,5-hexatriene (DPH) does not show red edge
      excitation shift in model membranes. The lifetime of NBD-PE in DOPC vesicles was
      found to be dependent on both excitation and emission wavelengths. These
      wavelength-dependent lifetimes are correlated to the reorientation of solvent
      dipoles around the excited-state dipole of the NBD moiety in the membrane. The
      magnitude of the red shift in the emission maximum for NBD-PE was found to be
      independent of temperature, between 12 and 54 degrees C, and of the physical
      state (gel or fluid) of the membrane. Taken together, these observations are
      indicative of the motional restriction experienced by this fluorophore in the
      membrane. Red edge excitation shift promises to be a powerful tool in probing
      membrane organization and dynamics.

PMID- 8466921
TI  - Release of protein 4.1-rich vesicles from diamide-treated erythrocytes under
      hydrostatic pressure.
AB  - The effect of cross-linking of membrane proteins on vesiculation under high
      pressure (2.0 kbar) of human erythrocytes was examined. To get the large
      molecular weight aggregates characterized by cross-linking of cytoskeletal
      proteins with integral ones, the erythrocytes were pretreated with diamide under
      pressure (1.0 kbar) where no vesiculation occurs. Vesicles released at 2.0 kbar
      from such erythrocytes contained protein 4.1 as major membrane protein. Upon
      reduction of cross-linking by dithiothreitol prior to vesiculation, the released
      vesicles contained membrane proteins similar to intact cells. On the other hand,
      in the erythrocyte pretreated with diamide at atmospheric pressure, no such large
      molecular weight aggregate was observed and the membrane protein composition of
      the vesicles released from the cells at 2.0 kbar was also similar to that of
      intact cells. These results suggest that the membrane protein composition of
      released vesicles is much affected by the properties of cross-linking of membrane
      proteins in erythrocytes.

PMID- 8466922
TI  - Monitoring of unbound protein in vesicle suspensions with off-null ellipsometry.
AB  - In studies on the binding of proteins to small unilamellar phospholipid vesicles
      (SUV), the concentration of unbound protein usually remains unknown, because the
      vesicles cannot be separated from the bulk solution. In the present study, this
      limitation was overcome by addition of a supported planar phospholipid bilayer to
      the cuvette containing a vesicle suspension. Ellipsometric measurement of the
      protein adsorption velocities on this bilayer allowed determination of the
      concentrations of unbound protein. At high protein concentrations the adsorption
      is rapidly completed and the usual null-ellipsometry is too slow to obtain well
      defined initial adsorption rates. Therefore, an off-null technique was developed,
      allowing measurement of the adsorbed protein mass at time intervals of 20 ms.
      Binding of prothrombin and coagulation factor Xa was measured in SUV suspensions
      prepared from a 20% dioleoylphosphatidylserine (DOPS) and 80%
      dioleoylphosphatidylcholine (DOPC) phospholipid mixture. For prothrombin, a
      dissociation constant Kd = 140 +/- 27 nM (mean +/- S.E.) and maximal surface
      concentration gamma max = (8.9 +/- 0.8) x 10(-3) mole of protein per mole of
      lipid, were obtained. For factor Xa, these values were Kd = 49.6 +/- 6.3 nM and
      gamma max = (23.0 +/- 1.4) x 10(-3) mole of protein per mole of lipid. These
      binding parameters are similar to those obtained earlier for planar bilayers.
      Apparently, the binding of factor Xa and prothrombin is not dependent on surface
      curvature.

PMID- 8466923
TI  - Purification and functional reconstitution of the 2-oxoglutarate/malate
      translocator from spinach chloroplasts.
AB  - The chloroplast 2-oxoglutarate/malate translocator was solubilized from envelope
      membranes by the detergent n-dodecyl beta-D-maltoside and purified to apparent
      homogeneity by anion-exchange chromatography followed by gel permeation
      chromatography. During the purification procedure, the activity of the
      translocator was monitored by functional reconstitution into phospholipid
      vesicles. The purified translocator protein has an apparent molecular mass of
      about 45,000 as revealed by SDS-PAGE. Based on the specific reconstituted
      transport activity, the purification was about 31-fold with an overall yield of
      identical to 50%. The substrate specificity of the purified translocator closely
      resembles that described for the native transport system in intact chloroplasts.

PMID- 8466924
TI  - Bactericidal catechins damage the lipid bilayer.
AB  - The mode of antibacterial action of, the green tea (Camellia sinensis) extracts,
      (-)-epigallocatechin gallate (EGCg) and (-)-epicatechin (EC) was investigated.
      Strong bactericidal EGCg caused leakage of 5,6-carboxyfluorescein from
      phosphatidylcholine liposomes (PC), but EC with very weak bactericidal activity
      caused little damage to the membrane. Phosphatidylserine and dicetyl phosphate
      partially protected the membrane from EGCg-mediated damage when reconstituted
      into the liposome membrane with PC. EGCg, but not EC, caused strong aggregation
      and NPN-fluorescence quenching of PC-liposomes and these actions were markedly
      lowered in the presence of negatively charged lipids. These results show that
      bactericidal catechins primarily act on and damage bacterial membranes. The
      observation that Gram-negative bacteria are more resistant to bactericidal
      catechins than Gram-positive bacteria can be explained to some extent by the
      presence of negatively charged lipopolysaccharide.

PMID- 8466925
TI  - Effect of fenvalerate, a pyrethroid insecticide on membrane fluidity.
AB  - Fenvalerate is a commonly used pyrethroid insecticide, used to control a wide
      range of pests. We have studied its interaction with the membrane using
      fluorescence polarization and differential scanning calorimetry (DSC) techniques.
      Fenvalerate was found to decrease the DPH fluorescence polarization value of
      synaptosomal and microsomal membrane, implicating that it makes the membrane more
      fluid. At different concentrations of fenvalerate, the activation energy of the
      probe molecule in the membrane also changes revealed from the change in slope of
      the Arrhenius plot. At higher concentrations the insecticide slowly saturates the
      membrane. The effects of fenvalerate on model membrane were also studied with
      liposomes reconstituted with dipalmitoylphosphatidylcholine (DPPC). Fenvalerate
      decreased the phase transition temperature (Tm) of DPPC by 1.5 C degrees at 40
      microM concentration, but there was no effect on the cooperativity of the
      transition as interpreted from the DSC thermogram. From the change in the
      thermogram profile with fenvalerate it has been interpreted that it localizes in
      the acyl chain region of the lipid, possibly between C10 and C16 region and
      weakens the acyl chain packing. Fenvalerate was also found to interact with DPPC
      liposomes containing cholesterol to fluidize it.

PMID- 8466926
TI  - The effect of general anesthetics on the dynamics of phosphatidylcholine
      acetylcholine receptor interactions in reconstituted vesicles.
AB  - The interaction of general anesthetics at the lipid/protein interface of the
      nicotinic acetylcholine receptor reconstituted in dioleoylphosphatidylcholine
      bilayers at various lipid/protein ratios has been studied using the electron spin
      resonance spectra of phosphatidylcholine spin-labeled at the fourteenth acyl
      carbon (14-PCSL). In addition to the bilayer spectrum, the spin label reported a
      more motionally restricted environment whose contribution increased with
      increasing protein/lipid ratio. Exchange between these two environments occurred
      at a rate of approx. 6 x 10(7) s-1. The motionally restricted, protein-associated
      14-PCSL had a rotational correlation time of about 10-20 ns, an order of
      magnitude slower than when in the bilayer. Addition of 1-hexanol (up to 16 mM) to
      the reconstituted receptor perturbed the acyl chains of the bulk lipid phase, but
      the motional properties of the lipid acyl chains at the protein/lipid interface
      near the membrane center were not significantly perturbed on the EPR motional
      time-scale. Similarly, anesthetics that were less effective at perturbing the
      bilayer, such as pentobarbital (up to 2 mM) and isoflurane (7 mM), did not
      perturb the lipid/protein interface on the conventional EPR motional time scale.

PMID- 8466927
TI  - A microscopic model for lipid/protein bilayers with critical mixing.
AB  - A statistical mechanical lattice model is proposed to describe the phase diagram
      of phospholipid bilayers with small transmembrane proteins or polypeptides. The
      model is based on the extended Pink-Green-Chapman model (Zhang et al. (1992)
      Phys. Rev. A 45, 7560-7567) for pure lipid bilayers which undergo a first-order
      gel-fluid phase transition. The interaction between the lipid bilayer and the
      protein or polypeptide is modelled using the concept of hydrophobic matching. The
      phase diagram has been derived by computer-simulation techniques which fully
      account for thermal density fluctuations and which operate on the level of the
      free-energy thereby permitting an accurate identification of the phase
      boundaries. The calculations predict a closed loop of gel-fluid coexistence with
      a lower critical mixing point. Specific-heat traces across the phase diagram are
      also presented. The theoretical results for the phase diagram, the specific-heat
      function, and the transition enthalpy are related to recent experimental
      measurements on phospholipid bilayers mixed with synthetic transmembrane
      amphiphilic polypeptides or with gramicidin A.

PMID- 8466928
TI  - Use of irreversible electrical breakdown of lipid bilayers for the study of
      interaction of membranes with surface active molecules.
AB  - Lipid bilayers were formed in the presence of different macromolecules and high
      electrical fields were used to induce mechanical rupture of the membranes. The
      kinetics of pore formation during irreversible breakdown was studied as a
      function of the macromolecules. We observed that macromolecules having a strong
      binding affinity to the membrane alter the time course of pore formation
      significantly. We propose this method as a simple test for adsorption of
      macromolecules to membranes.

PMID- 8466929
TI  - Effect of the biochemical state of the Ca-ATPase protein of scallop sarcoplasmic
      reticulum on its interaction with trans-parinaric acid.
AB  - The polyene fluorescent probe trans-parinaric acid (tPA) was used to compare
      lipid-protein interactions in the scallop fragmented sarcoplasmic reticulum (FSR)
      between biochemical states where the Ca-ATPase molecules were arranged
      differently in the membrane and had different tertiary conformations. The state
      of the bulk lipid phase was examined over the temperature range -3 to +32 degrees
      C by exciting the tPA directly at 320 nm. The state of the system close to the Ca
      ATPase protein was followed over the same temperature range by indirectly
      exciting the tPA through resonance energy transfer from the Ca-ATPase protein,
      with approximately one twenty-fifth the quantum yield of the directly excited
      probe. Raising the tPA/lipid ratio in the membrane to high levels (approx. 1:9),
      caused the quantum yield of indirectly excited tPA to reach a maximum, which may
      reflect saturation of the annular lipid phase with the probe, or contribution to
      the fluorescence from indirectly excited tPA bound directly to the protein. In
      the presence of 0.1 M KCl, a thermal perturbation was observed at approx. 7
      degrees C using indirect excitation when the Ca(2+)-binding sites on the Ca
      ATPase were occupied, and the subunits were disorganized. This transition was not
      detected in the presence of 0.1 M KCl and EGTA, when the Ca(2+)-binding sites
      were empty, and the Ca-ATPase subunits were organized in dimeric arrays. The
      transition seen with the E1(Ca2+)2 form of the membrane may involve an event at
      the protein/lipid interface, or a change in the environment of tPA bound to the
      Ca-ATPase. The temperature at which the perturbation occurs is close to that of a
      discontinuity in the Arrhenius plot of the Ca-ATPase enzyme activity determined
      in the presence of 0.1 M KCl (Kalabokis, V.N. and Hardwicke, P.M.D. (1988) J.
      Biol. Chem. 263, 15184-15188). No perturbation was observed in the bulk
      properties of the lipid component of the membrane in either the E1(Ca2+)2 or E2
      states.

PMID- 8466930
TI  - Antimicrobial specificity and hemolytic activity of cyclized basic amphiphilic
      beta-structural model peptides and their interactions with phospholipid bilayers.
AB  - We synthesized a series of cyclic antiparallel beta-sheet model peptides with
      various ring sizes, which were designed on the basis of a cyclic beta-structural
      antibiotic, gramicidin S (GS); cyclo(Val-Orn-Leu-D-Phe-Pro)2, and investigated in
      terms of their antimicrobial activity and specificity against Gram-positive and
      Gram-negative bacteria and lytic activity for human erythrocytes. In our
      planning, in order to compare the peptides with GS, D-Phe-Pro sequence forming
      beta-turn in GS molecule remained unaltered and repeating sequences of
      alternately hydrophobic (Leu)-hydrophilic (Orn) residue were introduced into the
      beta-structural parts. CD study in acidic liposomes as well as leakage study of
      carboxyfluorescein encapsulated in phospholipid vesicles indicated that the
      peptides strongly interacted with lipid bilayers by taking an amphiphilic beta
      structure. Antimicrobial study showed that although GS is active only against
      Gram-positive bacteria, the antimicrobial spectra of the model peptides
      transformed gradually to be active against Gram-negative ones and finally only
      against Gram-negative bacteria whose repeating sequences increased. It should be
      noted that the designed cyclic model peptides show antibacterial activity but
      accompany no hemolysis. This indicates that an appropriate hydrophobicity
      together with a proper orientation of hydrophilic (cationic) and hydrophobic
      groups in cyclic beta-structural molecules can hold antimicrobial activity
      against both types of bacteria without damaging eukaryotic cells.

PMID- 8466931
TI  - Self-assembling properties of synthetic peptidic lipids.
AB  - Novel peptidic lipids were synthesized by the coupling of a linear oligopeptide
      as the hydrophilic moiety with a glutamic acid dialkylamide as the hydrophobic
      moiety. Their self-assembling properties were investigated. The critical
      aggregate concentrations (CAC) for the peptidic lipids with a double dodecyl
      group were in the range of 1.0 x 10(-5)-3.8 x 10(-5) M. The phase transition
      parameters and the aggregation morphologies in aqueous dispersion were largely
      dependent on the number and nature of the constitutive amino acid residues. Dark
      field optical microscopy demonstrated that the present peptidic lipids can form
      four types of stable morphologies in water, i.e., tubular structures, twisted
      ribbons, vesicles, and amorphous crystals.

PMID- 8466932
TI  - Magnetically induced orientation of phosphatidylcholine membranes.
AB  - Lipid bilayers prepared from natural phospholipids orient in magnetic fields with
      the long axis of the lipid molecules perpendicular to the magnetic field. This
      magnetically induced orientation was studied at high (11.7 Tesla (T)), mid (9.36
      T), and low (4.68 T) magnetic field strengths using lipid aggregates prepared
      from natural and synthetic phosphatidylcholine analogs. Phosphatidylcholine
      analogs containing saturated diacylated chains (12 to 16 carbons/chain) exhibited
      extensive orientation of the lipid when bilayer formation occurred by gentle
      hydration conditions. Gentle hydration involved incubating dried
      phosphatidylcholine C above the main phase transition (Tm); brief shaking or
      swirling by hand was occasionally needed to completely disperse the lipids. The
      method of bilayer formation significantly influenced the amount of lipid that
      orients in magnetic fields. Thus the supramolecular structures (and %
      orientation) above Tm in an 11.7 T field of dimyristoylphosphatidylcholine (DMPC)
      bilayers are SUV (0%), LUV (approximately 15%), SPLV (approximately 40%),
      vortexed-MLV (approximately 60%) and non-vortexed MLV (approximately 90%). Single
      layered vesicles prepared by the REV method exhibited orientation at 11.7 T
      similar to LUV prepared by freeze thaw cycles. Aqueous dispersions of eggPC
      prepared by gentle hydration exhibit approximately 40% orientation at 11.7 T
      which decreased to approximately 30% orientation if 30% cholesterol is added to
      the membrane. Magnetic orientation of bilayers thus appears to be a general
      phenomenon for both saturated and unsaturated natural phospholipids either with
      or without cholesterol in the membrane.

PMID- 8466933
TI  - Localization of Cys-344 on the (Ca(2+)-Mg(2+)-ATPase of sarcoplasmic reticulum
      using resonance energy transfer.
AB  - 4-Bromomethyl-6,7-dimethoxy-coumarin labels the (Ca(2+)-Mg(2+)-ATPase of skeletal
      muscle sarcoplasmic reticulum at Cys-344. Resonance energy transfer has been used
      to measure the distance between this site and Lys-515 labelled with fluorescein
      isothiocyanate as about 37 A. The height of Cys-344 above the phospholipid/water
      interface has been measured by resonance energy transfer for the ATPase
      reconstituted into bilayers containing fluorescein-labelled
      phosphatidylethanolamine; the height was found to be about 45 A. None of these
      distances was found to alter on changing pH, or on addition of Mg2+, Ca2+ or
      vanadate. Quenching of the fluorescence of the coumarin-labelled ATPase with KI
      suggested that the fluorophore is not fully exposed on the ATPase.

PMID- 8466934
TI  - Plasma dependent pH sensitivity of liposomes containing sulfatide.
AB  - In this study we investigated the possibility to define relatively plasma-stable
      liposomal preparations in which the sensitivity to moderate drops of pH (i.e.,
      from 7.4 to 6.8) would be induced by the presence of plasma itself. The liposome
      stability was monitored by determining the release of entrapped 5,6
      carboxyfluorescein (CF). Using small unilamellar vesicles composed of egg
      phosphatidylcholine (EPC) and bovine brain sulfatide (CS) (4:1, molar ratio), the
      amount of CF released at pH 6.8 in the presence of 50% plasma was 3-fold that at
      pH 7.4, whereas no significant differences in the amount of CF released were
      observed when the same liposomes were incubated in buffer at pH 7.4 and 6.8,
      respectively. The increase in plasma induced leakage as a consequence of a drop
      in the pH medium, seems to specifically depend on the presence of sulfatide
      molecule in the bilayer since neither the acidic cholesterol 3-sulfate nor
      galactocerebroside, are able to induce pH sensitivity in EPC liposomes. Of all
      the plasma components considered (VLDL, LDL, HDL, protein fraction), VLDL seemed
      preferentially involved in the pH sensitivity induced by CS since they promoted
      an almost complete release of CF from EPC/CS small unilamellar vesicles. Thus,
      these liposomes are potentially a useful tool for a specific drug delivery to
      those pathological tissues such as tumors, inflammation sites and ischemic areas
      in which it is known that a lowering of the pH can occur.

PMID- 8466935
TI  - Tension-stabilized pores in giant vesicles: determination of pore size and pore
      line tension.
AB  - We present the first observations of giant, long-existing, stabilized pores in
      vesicle membranes. Using a new experimental technique for studying the electro
      permeabilization of lipid membranes, giant liposomes (from 25 to 56 microns in
      diameter) were subjected to single, square, electric pulses (duration 150
      microseconds and electric field strength from 63 to 126 kV/m). The liposomes were
      held by a micropipet and small membrane tensions were created by controlling the
      pipet suction pressure. The liposomes were loaded with media having different
      refractive index from the outside solution, and, under these conditions, the
      formation of pores in the pressurized liposome could be visualized by the jet of
      inside solution that flowed out from the membrane pore. By adjusting the membrane
      tension, pores were kept open, and pore lifetimes could be varied from tenths of
      a second to several seconds. The pore size was determined from the volumetric
      flow in the pore region and the measured pressure differences across the bilayer.
      It was clear from the experiments that only one pore remained opened after the
      pulse. The estimated pore radii were on the order of one micrometer. The pores
      were in a quasi-stationary state and when they closed they did so spontaneously
      in a quick process (in milliseconds). The isotropic membrane tension was
      determined for the same measurements and from determinations of both pore size
      and dynamic membrane tension the pore line tension was found. The line tension of
      the pore region was determined for two lipid compositions, stearoyl
      oleoylphosphatidylcholine and stearoyl-oleoylphosphatidylcholine with 50 mol%
      cholesterol, and the obtained values for single bilayers were (0.92 +/- 0.07) x
      10(-11) N and (3.05 +/- 0.12) x 10(-11) N, respectively.

PMID- 8466936
TI  - Evidence that liver microsomes of human neonates desaturate essential fatty
      acids.
AB  - delta 6- and delta 5-Desaturation of essential fatty acids of n-6 and n-3 series
      are required for the biosynthesis of polyunsaturated fatty acids (PUFAs), which
      are precursors of eicosanoids and constituents of membrane phospholipids. This
      pathway could be of special importance during the perinatal period, when PUFAs
      accretion in the central nervous system is very active. However, experimental
      evidence of delta 6- and delta 5-desaturase activities in man is very scarce, and
      no data are available for newborns. We report the delta 6- and delta 5-desaturase
      activities detected in human liver microsomes from three neonates who died from
      associated malformations. Radiochemical assays of delta 6- and delta 5-desaturase
      activities performed with reverse phase HPLC analysis of the products in the n-6
      series ranged from 4.8-13.6 to 3.2-16.4 pmol substrate converted.min-1.mg-1
      microsomal proteins, respectively. In the n-3 series delta 6-desaturase activity
      ranged from 5.3 to 12.8 pmol.min-1.mg-1. The relationships between enzyme
      activities and substrate concentrations suggest excess substrate inhibition for n
      6 and not for n-3 fatty acids. These results demonstrate significant delta 6- and
      delta 5-desaturase activities in human liver of neonates, but this activity was
      lower than previously reported in adult humans and in mammals, especially
      rodents.

PMID- 8466937
TI  - Phase behavior of mixtures of DPPC and POPG.
AB  - The phase relation of dipalmitoylphosphatidylcholine (DPPC) and 1-palmitoyl-2
      oleoyl-phosphatidylglycerol (POPG) has been determined by measurement of the
      endothermic transitions of mixtures of DPPC and POPG in 100 mM NaCl, 50 mM PIPES
      (pH 7.0). With the use of differential scanning calorimetry, the gel-liquid
      crystalline phase transitions of pure POPG and DPPC were estimated to be 274 K
      and 315.8 K, respectively. With mixtures, there was considerable broadening of
      the endotherms, but there was no evidence of immiscibility. At high and low mole
      fractions of DPPC, the observed transition regions are not different from that
      calculated assuming ideal behavior. However in the central region of the phase
      diagram, there were deviations from both the ideal liquidus and solidus curves.
      The chemical shift anisotropy of the 13C-labelled carbonyl carbon of pure DPPC
      was determined as a function of temperature. At 298 K, a broad peak
      characteristic of axially symmetric motional averaging of the shielding tensor
      was observed. At a temperature of 300 K, a narrow peak at 173 ppm was
      superimposed upon the broad peak. The magnitude of the narrow resonance increased
      with temperature over the range of 300 to 315 K with the spectrum obtained at the
      latter point almost completely devoid of any broad features. Spectra obtained
      with a 9:1 mole ratio of DPPC/POPG was very similar to that obtained with pure
      DPPC. However, with increasing amounts of POPG, both the temperature at which the
      narrow resonance appeared and the temperature at which only a narrow resonance
      was observed were reduced. Over the range of 0 to 50 mol % POPG, there was no
      major change in the width or shape of the spectra which contained only a broad or
      narrow resonance. Also for mol % of POPG of 20% and less, there was agreement
      between the temperature at which only the narrow component was observed and the
      completion of the main phase transition based on the DSC scans. However, at the
      two higher mol % of 33 and 50%, the temperature at which only the narrow
      component was observed was lower than the temperature established for the
      completion of the main phase transition.

PMID- 8466938
TI  - Lipids and oxidised lipids in human atheroma and normal aorta.
AB  - Lipids and oxidised lipids were analysed by GC and GC-MS in samples of human
      atheroma (necrotic gruel from the interior of advanced atherosclerotic plaques in
      the aorta) and human normal aorta (lesion-free intima plus inner media) from
      necropsy subjects. Cholest-5-en-3 beta,26-diol and cholest-5-en-3 beta,7 beta
      diol were detected in all the atheroma samples examined but not in significant
      amounts in normal aorta. In atheroma, cholest-5-en-3 beta,26-diol was
      approximately proportional to cholesterol. Several isomeric hydroxy
      octadecadienoic acids were detected in atheroma, and, in smaller amounts, in
      normal aorta. Many of the components of atheroma showed a high degree of cross
      correlation on linear regression analysis, whilst cross-correlations were
      somewhat weaker for normal aorta. Atheroma showed a vast accumulation of lipid,
      especially cholesterol, in comparison to normal aorta. The atheroma samples
      contained a larger proportion of linoleate relative to oleate than the normal
      aorta. Levels of fatty acids relative to cholesterol were lower for atheroma than
      for normal aorta. The chemical composition of atheroma appeared unrelated to the
      age of the subject, whereas age-related increases in linoleate, oleate and
      cholesterol content were seen in the samples of normal aorta.

PMID- 8466939
TI  - Effects of differentiation on the phospholipid and phospholipid fatty acid
      composition of N1E-115 neuroblastoma cells.
AB  - The effects of differentiation on the phospholipid and phospholipid fatty acid
      composition of N1E-115 neuroblastoma cells were determined. The cellular lipids
      were extracted on days 0, 3 and 7, following the addition of 1.2%
      dimethylsulfoxide to induce cellular differentiation. Proportions of ethanolamine
      glycerophospholipids (EtnGpl), phosphatidylinositol (PtdIns) and sphingomyelin
      (CerPCho) were significantly elevated following differentiation. The mole
      percentage of choline glycerophospholipids (ChoGpl) decreased with
      differentiation. The plasmalogens, both choline and ethanolamine, increased by
      1.3- and 2.3-fold, respectively, during differentiation. The fatty acid
      composition of the phospholipid classes was also altered. PtdIns and ChoGpl had
      decreased proportions of polyenoic fatty acids, while these proportions were
      increased in EtnGpl. Both ChoGpl and EtnGpl had increased n-3/n-6 series fatty
      acid ratios, but this ratio was decreased in PtdIns. The mole percentage of
      arachidonic acid was significantly decreased in both PtdIns and ChoGpl, but
      elevated in EtnGpl and may be a result of the increase in ethanolamine
      plasmalogen. Thus, differentiation did not increase the overall mole percentage
      of polyenoic FA in the cells nor increase the n-6 series fatty acid proportions.
      We speculate plasmalogens may have a role in the differentiation process or in
      maintaining the cell in the differentiated state.

PMID- 8466940
TI  - Occurrence of two nonmethylene-interrupted delta 5 polyunsaturated fatty acids in
      a delta 6-desaturase-defective mutant of the fungus Mortierella alpina 1S-4.
AB  - Two non-methylene-interrupted fatty acids, 5(Z),11(Z),14(Z)-eicosatrienoic acid
      (20:3 delta 5) and 5(Z),11(Z),14(Z),17(Z)-eicosatetraenoic acid (20: 4 delta 5),
      were found in a delta 6-desaturase-defective mutant of Mortierella alpina 1S-4.
      20: 4 delta 5 was detected only when growth was at a temperature lower than 24
      degrees C or in a culture medium supplemented with either alpha-linolenic acid or
      11(Z),14(Z),17(Z)-eicosatrienoic acid. 20: 3 delta 5 was found when growth was at
      12-28 degrees C. The amount of 20: 3 delta 5 was greatest (27 mg g-1 dry mycelia)
      when growth was at 20 degrees C, and it accounted for about 7 wt% of the total
      fatty acids of the mycelia. The optimum temperature for the accumulation of 20:4
      delta 5 was 12 degrees C; there was 6.4 mg 20: 4 delta 5/g dry mycelia. Most of
      these two fatty acids (more than 75 mol%) was in the triacylglycerol fraction.

PMID- 8466941
TI  - Fatty acid composition of lecithin is a key factor in bile metastability in
      supersaturated model bile systems.
AB  - We studied the effect of fatty acid saturation of biliary lecithin on bile
      metastability, determined by nucleation time, using model bile solutions with
      identical lipid compositions except for the lecithin species (total lipid
      concentration, 9 g/dl; cholesterol, 12 mM; lecithin, 31 mM, bile salts, 116 mM).
      Gel permeation chromatographic studies revealed that nonmicellar cholesterol
      distribution was inversely related to the degree of unsaturation of the lecithin
      species. Differential interference contrast microscopy and cholesterol crystal
      growth assay showed that a lower degree of saturation of the lecithin species was
      associated with a faster nucleation time and crystal growth rate. These results
      suggest that vesicular lecithin containing more unsaturated fatty acyl chains
      binds less tightly to cholesterol as compared with lecithin containing
      predominantly saturated fatty acids and that the biliary lecithin species
      modulates cholesterol crystal nucleation in bile. Also, the high ratio of
      cholesterol to lecithin (more than 1.0) was found in the crystal forming model
      biles, although the vesicle aggregation was not always observed prior to the
      cholesterol crystal formation. These findings indicated that there are different
      processes in cholesterol crystal nucleation, with or without vesicle aggregation,
      and that such processes depend, in part, on lecithin species in vesicles.

PMID- 8466942
TI  - Formation of prostanoids and hydroxy fatty acids by stimulated peritoneal mast
      cells: role of the dietary fat type in rat.
AB  - To study the influence of membrane fatty acid composition on the formation of
      prostanoids and hydroxy fatty acids by rat peritoneal mast cells (MC), animals
      were fed three different types of fatty acids: mackerel oil (MO), abundant in n-3
      fatty acids; sunflower seed oil (SO), rich in linoleic acid; and hydrogenated
      coconut oil (HCO), mainly containing saturated fatty acids. The presence of n-3
      fatty acids in the diet resulted in the incorporation of 20:5(n-3), 22:5(n-3) and
      22:6(n-3) in MC phospholipids. A decrease of arachidonic acid, 20:4(n-6), was
      observed in MC-phospholipids of the MO-fed animals. Furthermore, increasing the
      relative amounts of 18:2(n-6) in the diet (SO group) led to an increased
      incorporation of linoleic acid, 18:2(n-6) in MC phospholipids when compared to
      both other dietary groups. The changes in MC phospholipid fatty acid composition
      were (partly) reflected in the formation of prostanoids and hydroxy fatty acids
      upon stimulation with the calcium ionophore A23187. The decrease in arachidonic
      acid content in MC phospholipids of MO-fed rats resulted in a decreased formation
      of PGD2 when compared to both other groups. Also, the increased amounts of 18:2(n
      6) in MC phospholipids of SO-fed rats resulted in an increased formation of 9-
      and 13-HODE upon stimulation. The results show that modifications in the fatty
      acid composition of the diet influences MC membrane fatty acid composition which
      ultimately results in changes in prostanoid and hydroxy fatty acid synthesis by
      MC upon stimulation with the calcium ionophore A23187.

PMID- 8466943
TI  - Stimulation of acyl-CoA:cholesterol acyltransferase activity by brefeldin A in
      macrophage J774 cells.
AB  - Brefeldin A (BFA), an inhibitor of secretory pathway, enhances incorporation of
      radiolabeled cholesterol and oleate into cholesteryl esters in cultured cells
      [12]. We studied the mechanism for this effect of BFA in the macrophage J774.
      When incubated with 2.7 microM BFA in the absence of lipoproteins, J774 cells
      synthesized and accumulated 1.5- to 4-fold more cholesteryl esters than did cells
      which received no BFA. BFA caused neither an elevation of cholesterol synthesis,
      inhibition of its secretion nor changes in cholesterol transport to plasma
      membrane, esterification of plasma membrane cholesterol and cholesteryl ester
      hydrolysis. Acyl-CoA:cholesterol acyltransferase (ACAT) activity in microsomes
      from BFA-treated cells was 1.5- to 1.8-fold higher than that from control cells.
      The effect of BFA was diminished by treatment with low temperature, which is
      known to abolish BFA effect on Golgi formation.

PMID- 8466944
TI  - Intestinal perfusion of beta-carotene in the ferret raises retinoic acid level in
      portal blood.
AB  - To determine whether beta-carotene (beta-C) can serve as a source of intestinally
      derived retinoic acid (RA), either 15,15'-[14C]beta-C or unlabeled beta-C was
      perfused through 30 cm jejunal segments of ferrets in vivo. Portal vein blood was
      sampled periodically via an indwelling catheter. RA was identified in portal
      blood by comparing retention times in HPLC, by UV absorption, and by
      derivatization (methylation) and subsequent GC-MS analysis. The RA concentration
      in the portal blood increased 3-fold with perfusion of beta-C (P < 0.05), and
      remained at 18 nmol/L during the perfusion of beta-C. The single peak of RA in
      HPLC was shown to consist of four separate peaks by GC-MS, which may be cis-trans
      isomers of RA. The concentration of RA in portal blood returned to the initial
      level (5 nmol/L) after a 2 h period of intestinal perfusion with 5% dextrose.
      Retinyl ester concentration in portal blood did not change before or after the
      perfusion, whereas retinol decreased significantly during the perfusion of beta
      C. This study clearly indicates that a considerable quantity and number of polar
      metabolites, including RA, are formed from beta-C in the ferret intestine which
      are transported via the portal vein to the liver.

PMID- 8466945
TI  - Arachidonic acid metabolism of rat peritoneal macrophages after passive
      sensitization and allergen challenge.
AB  - The aim of our work was to evaluate the effect of passive sensitization of rat
      peritoneal macrophages (treatment of cells by an anti-ovalbumin IgE-rich serum)
      on arachidonic acid (AA) metabolism and the impact of specific antigen
      (ovalbumin) on this process. Compared to a control treatment without serum, the
      atopic serum and a serum without IgE, used on [3H]AA-labeled macrophages,
      increased cyclooxygenase and lipoxygenase eicosanoid production. Sera, used prior
      to [3H]AA incorporation, induced a decrease of 3H-labeled membrane phospholipids
      and an increase of lipoxygenase metabolites in the [3H]AA incorporation medium.
      To establish if the serum-induced catabolism of AA differed according to whether
      it was externally added to the culture medium or incorporated into membrane
      phospholipids, we studied the eicosanoid secretion of [3H]AA-prelabeled
      macrophages, treated by the serum and incubated with [14C]AA. It was confirmed
      that phospholipid-incorporated AA was catabolised following the cyclooxygenase
      and lipoxygenase pathways and external AA preferentially following the
      lipoxygenase pathway. The allergen increased the eicosanoid formation of
      passively sensitized macrophages but not that of cells treated by the serum
      without IgE. Our data suggest that changes occurring in passive sensitization, on
      AA mobilization from membrane phospholipids and on AA catabolism, induced by the
      serum, are independent of IgE and must be taken into consideration on
      interpreting the allergen effect.

PMID- 8466946
TI  - The hypocholesterolemic effect of sulfur-substituted fatty acid analogues in rats
      fed a high carbohydrate diet.
AB  - Sulfur-substituted fatty acid analogues have been administered to rats fed a high
      carbohydrate diet, and the effect on plasma and hepatic lipid metabolism was
      investigated. Two of the analogues studied, 3-thiadicarboxylic acid and
      tetradecylthioacetic acid, reduced the plasma cholesterol level significantly,
      whereas the effect on plasma triacylglycerol level was only marginal. 3
      Thiadicarboxylic acid was the most potent, decreasing the cholesterol level
      faster and at a lower dose than tetradecylthioacetic acid. The relative effects
      on plasma cholesterol and triacylglycerol levels were different from what have
      been observed in rats fed a conventional pellet diet. Tetradecylthiopropionic
      acid had no hypocholesterolemic effect. The activities of three lipogenic
      enzymes: ATP-citrate lyase, acetyl-CoA carboxylase and fatty acid synthase was
      measured. The two hypocholesterolemic analogues reduced the activities of these
      enzymes in a coordinated manner. The enzyme activities was found to correlate
      with the the plasma cholesterol level, indicating a coordinated regulation of
      these enzymes and cholesterol synthesis or secretion. The effect on two enzymes
      involved in cholesterol metabolism was also studied. The activity of acyl
      CoA:cholesterol acyltransferase (ACAT) was reduced by the two hypocholesterolemic
      analogues, in contrast to the rate-limiting enzyme in cholesterol biosynthesis,
      HMG-CoA reductase, which tended to increase. The cholesterol lowering effect of 3
      thiadicarboxylic acid and tetradecylthioacetic acid can probably be ascribed to
      diminished cholesterol synthesis due to a reduced availability of acetyl-CoA. A
      reduction in the esterification of hepatic cholesterol may be a contributing
      factor.

PMID- 8466947
TI  - Stimulation of mycolic acid biosynthesis by incorporation of cis-tetracos-5-enoic
      acid in a cell-wall preparation from Mycobacterium smegmatis.
AB  - Mycolic acids are high molecular weight hydroxy fatty acids which are a
      covalently linked part of the cell wall structure of all mycobacteria and their
      biosynthetic pathways offer potential drug targets. Three good candidates, cis
      tetracos-5-enoic acid and R or S trans-6-methyl-tetracos-4-enoic acids, for the
      key initial intermediates where mycolic acid biosynthesis might diverge from
      other metabolic pathways, were tested as possible substrates. A cell-wall
      preparation from Mycobacterium smegmatis, capable of mycolic acid synthesis, was
      developed to investigate the possible incorporation of these, and other 16 to 24
      carbon acids into mycolic acids. The wall preparations were extracted with hexane
      and suspended in hexane/water (7:1, v/v), and in this low-water assay, only one
      of these acids, cis-tetracos-5-enoic acid, stimulated the incorporation of
      radioactive label from [1-14C]acetate into alpha- and alpha'-mycolic acids. The
      extraction method used did, however, abolish some enzyme activity and mycolic
      acid biosynthesis was not completely restored by cis-tetracos-5-enoate. The two
      methyl-branched acids did not enhance the amount of label in epoxymycolic acids.
      An initial key intermediate in the synthesis of alpha- and alpha'-mycolic acids
      has therefore been positively identified for the first time; intermediates in the
      initial stages of the biosynthesis of oxygenated mycolic acids such as
      epoxymycolates remain to be defined.

PMID- 8466948
TI  - Acylcarnitine formation and fatty acid oxidation in hepatocytes from rats treated
      with tetradecylthioacetic acid (a 3-thia fatty acid).
AB  - In livers of rats fed a single morning dose of 100 mg tetradecylthioacetic acid
      (TTA) total long-chain acyl-CoA increased significantly to 3 times control levels
      within 6 h, then the level declined almost to control value within the next
      morning. Hepatic malonyl-CoA was reduced 75% 6 h after TTA treatment. From 6 to
      24 h malonyl-CoA increased about 10-fold to about 3 times that of controls.
      Paradoxically there was nearly a 2-fold higher oxidation of both [1-14C]palmitic
      acid (0.5 mM) and [1-14C]oleic acid (0.5 mM) in hepatocytes isolated from rats 24
      h after TTA treatment compared to controls. After 6 h, when malonyl-CoA was at a
      minimum in vivo, fatty acid oxidation in cells was not increased. Acylcarnitine
      formation in digitonin permeabilized hepatocytes isolated 24 h after
      administration of TTA was increased both in the absence and in the presence of
      malonyl-CoA. At 24 h peroxisomal palmitoyl-CoA oxidase activity was not
      increased. The results suggest that an increased CPT activity and increased
      acylcarnitine formation in the presence of malonyl-CoA is a delayed response to
      increased acyl-CoA levels. Furthermore, in hepatocytes isolated after 24 h
      incorporation of [1-14C]oleic acid into triacylglycerols was significantly
      reduced. The data show that in hepatocytes isolated from rats 24 h after
      administration of a single dose of TTA, there is a diversion of hepatic acyl-CoA
      from synthesis of triacylglycerols into beta-oxidation in the mitochondria.

PMID- 8466949
TI  - Dependence of the plasma triacylglycerol-lowering effect of fish oil on insulin
      replacement in streptozotocin diabetic rats.
AB  - Streptozotocin diabetic rats, with and without insulin replacement, and sham
      injected controls were fed a high-fat (30% of energy) menhaden oil (MO) or corn
      oil (CO) diet for 2 weeks. After an overnight fast, plasma and livers were
      collected for analysis of insulin, glucose, triacylglycerol, cholesterol and
      glucose-6-phosphate dehydrogenase activity. Streptozotocin treatment resulted in
      decreased plasma insulin and elevated glucose. MO-feeding to insulin-replaced
      diabetic rats resulted in higher insulin and lower glucose levels compared to the
      respective CO-fed rats, suggesting decreased hepatic insulin extraction and
      greater peripheral utilization of glucose with MO. Plasma triacylglycerol and
      cholesterol, and hepatic glucose-6-phosphate dehydrogenase activity were reduced
      in MO-fed vs. CO-fed control rats. These effects of MO were prevented in the
      diabetic rats but were restored by insulin replacement. We conclude from our data
      that the presence of insulin is required to observe at least some of the effects
      of fish oil (FO). To explain our observations we propose that many of the effects
      of FO on hepatic metabolism are mediated by an inhibition of insulin action in
      the liver, thus providing a possible central mechanism for the regulation of
      hepatic lipid metabolism by dietary FO.

PMID- 8466950
TI  - Lysosomal phosphatidylcholine: bis(monoacylglycero)phosphate acyltransferase:
      specificity for the sn-1 fatty acid of the donor and co-purification with
      phospholipase A1.
AB  - Positional specificities in donor and acceptor phospholipids of the lysosomal
      phosphatidylcholine: bis(monoacylglycero)phosphate acyltransferase have been
      determined. Comparison of the transfer of labelled fatty acid from sn-1 [14C]acyl
      and sn-2 [14C]acylphosphatidylcholines by extracts of rat liver lysosomes
      revealed that fatty acids in the sn-1 position were exclusively transferred.
      Degradation of the acylphosphatidylglycerol product by Rhizopus arrhizus lipase,
      highly specific for fatty acids esterified to sn-1 or sn-3 positions, indicated
      that sn-1 or sn-3 rather than sn-2 positions had been acylated. Assays of
      phospholipase A1, phosphatidylcholine: bis(monoacylglycero)phosphate
      acyltransferase, the conversion of lysophosphatidylglycerol to
      bis(monoacylglycero)phosphate and phospholipase A2 were performed at various
      steps in the purification of lysosomal phospholipase A1. After the penultimate
      step of chromatofocusing, there was a 1086-fold increase of phospholipase A1
      specific activity over the homogenate and this was accompanied by a 11 998-fold
      increase of phosphatidylcholine: bis(monoacylglycero)phosphate acyltransferase
      specific activity. A second preparation carried through to the final step of gel
      filtration retained a similar ratio of acyltransferase activity. On the other
      hand, specific activities of phospholipase A2 and of the conversion of
      lysophosphatidylglycerol to bis(monoacylglycero)phosphate increased to the step
      where enzyme was solubilized from lysosomes, but were lost from later steps.
      These findings suggest that phosphatidylcholine: bis(monoacylglycero)phosphate
      acyltransferase is catalyzed by lysosomal phospholipase A1. The site of acylation
      in the bis(monoacylglycero)phosphate acceptor appears to be either sn-1 or sn-3.
      Since the lysosomal extracts did not catalyze the transacylation of
      phosphatidylglycerol, we conclude that the formation of acylphosphatidylglycerol
      in lysosomes requires the sequential acylation of lysophosphatidylglycerol to
      form bis(monoacylglycero)phosphate by an unidentified enzymatic mechanism
      followed by a transacylation of bis(monoacylglycero)phosphate in either sn-1 or
      sn-3 position to form acylphosphatidylglycerol which is catalyzed by
      phospholipase A1.

PMID- 8466951
TI  - A comparative study of low-density lipoprotein interaction with
      glycosaminoglycans.
AB  - The association between low-density lipoprotein (LDL) and a series of well
      characterized dermatan and chondroitin sulfates has been investigated by means of
      the fluorescence anisotropy technique with competition experiments using a
      fluorescein-labeled high LDL-affinity heparin fraction as a reference.
      Preparations of glycosaminoglycan (GAG) with sulfation degrees varying over a
      wide range, as obtained by fractionation or by chemical modification, were chosen
      for this study. The influence of chain length, which had been found sizeable in a
      former study of heparin affinity for LDL, was taken into account with an
      empirical correction of dissociation constants. After this correction, a linear
      relationship was found between the logarithm of dissociation constants and the
      number of sulfate groups per disaccharide unit, ns, both for dermatan and
      chondroitin sulfates, and for heparins. At comparable ns values, however,
      dermatan sulfates and heparins, which contain L-iduronic acid in their backbone,
      show higher LDL-affinity than chondroitin sulfates, which contain only D
      glucuronic acid. Though confirming a non-specific, predominantly electrostatic
      interaction between GAGs and LDL, these results indicate modulation of LDL
      affinity by the polysaccharide backbone.

PMID- 8466952
TI  - A novel member of the lipocalin superfamily: tammar wallaby late-lactation
      protein.
AB  - The finding that tammar wallaby late-lactation protein is linked to beta
      lactoglobulin prompted a search of current GenPeptide and NBRF-PIR protein
      databases for sequence similarities to late-lactation protein. Similarities were
      found to von Ebner's gland protein and other members of the lipocalin superfamily
      of proteins. A conservative replacement of Trp with Tyr suggests that late
      lactation protein may represent an unusual member of this protein superfamily.

PMID- 8466953
TI  - Effect of fluvastatin sodium (XU62-320), a new inhibitor of 3-hydroxy-3
      methylglutaryl coenzyme A reductase, on the induction of low-density lipoprotein
      receptor in HepG2 cells.
AB  - The effect of fluvastatin sodium (XU62-320), a new type of inhibitor of 3-hydroxy
      3-methylglutaryl coenzyme A, on the induction of LDL receptor in the human liver
      derived cell line HepG2 was investigated. Fluvastatin sodium produced marked
      inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and
      induction of LDL receptor on HepG2 cells at a concentration of 0.1-1.0 microM.
      These results suggest that fluvastatin sodium has potential for use as a strong
      plasma cholesterol-lowering drug.

PMID- 8466954
TI  - Strategies for peak-purity assessment in liquid chromatography.
AB  - One of the key requirements for the validation of chromatographic methods is to
      determine the purity of a chromatographic peak. Statistical modelling of the
      chromatographic process suggests that overlapping components are highly probable
      in a chromatogram. Hence extensive efforts have been directed at the development
      of sensitive, reliable and robust methods to assess peak purity. This is
      especially the case in the pharmaceutical industry, where liquid chromatography
      (LC) is widely utilized and the demands on method validation are justifiably
      high. On-line multiwavelength absorptiometric detection is often used to generate
      the additional data required to facilitate peak-purity assessment in LC. This
      approach, using photodiode-array technology, is directly compatible with the
      aqueous-based reversed-phase LC solvents used extensively in drug analysis.
      Consequently, this work highlights many of the peak-purity algorithms, which may
      be applied using LC with diode-array detection. The relative merits of the
      individual techniques are discussed, and a rationale is developed for their
      application.

PMID- 8466955
TI  - Determination of thiol-containing drugs by chemiluminescence-flow injection
      analysis.
AB  - A flow injection analysis procedure with chemiluminescence detection for the
      determination of both thiol-containing drugs and the amino acid cysteine is
      described. Procedures are based on the inhibition by the drugs of the
      chemiluminescence generated in the copper-catalysed oxidation of luminol by
      hydrogen peroxide. The proposed methods were applied to the determination of
      cysteine, N-acetylcysteine, penicillamine, 2-mercaptopropionylglycine and
      thiouracil in pharmaceuticals.

PMID- 8466956
TI  - Analysis of biological fluids using 600 MHz proton NMR spectroscopy: application
      of homonuclear two-dimensional J-resolved spectroscopy to urine and blood plasma
      for spectral simplification and assignment.
AB  - The application of 600 MHz two-dimensional J-resolved 1H NMR spectroscopy (JRES)
      to the analysis of human urine and blood plasma is demonstrated. This method when
      applied at very high field gives a rapid means of simplifying and aiding the
      assignment of highly overlapped resonances of minor metabolites in biofluids.
      Using this approach, mixtures of drug and endogenous metabolites were identified
      in untreated urine samples, the signals of which were extensively overlapped in
      single pulse 600 MHz spectra. For untreated blood plasma samples the JRES
      experiment was also effective for the selective attenuation of signals from the
      plasma proteins thus revealing strong well-resolved signals from the low
      molecular weight components. For the first time it was shown to be possible to
      assign in detail the spectra region from 3 to 4 ppm in blood plasma, including
      the complete assignment of the signals from alpha- and beta-glucose. JRES spectra
      of plasma were much easier to interpret and had a much higher information content
      than equivalent one-dimensional Hahn spin-echo spectra, thus aiding the
      identification of non protein-bound low molecular weight metabolites in plasma.

PMID- 8466957
TI  - Micellar acid-base potentiometric titrations of weak acidic and/or insoluble
      drugs.
AB  - The effect of various surfactants [the cationics cetyl trimethyl ammonium bromide
      (CTAB) and cetyl pyridinium chloride (CPC), the anionic sodium dodecyl sulphate
      (SDS), and the nonionic polysorbate 80 (Tween 80)] on the solubility and
      ionization constant of some sparingly soluble weak acids of pharmaceutical
      interest was studied. Benzoic acid (and its 3-methyl-, 3-nitro-, and 4-tert-butyl
      derivatives), acetylsalicylic acid, naproxen and iopanoic acid were chosen as
      model examples. Precise and accurate acid-base titrations in micellar systems
      were made feasible using a microcomputer-controlled titrator. The response curve,
      response time and potential drift of the glass electrode in the micellar systems
      were examined. The cationics CTAB and CPC were found to increase considerably the
      ionization constant of the weak acids (delta pKa ranged from -0.21 to -3.57),
      while the anionic SDS showed negligible effect and the nonionic Tween 80
      generally decreased the ionization constants. The solubility of the acids in
      aqueous micellar and acidified micellar solutions was studied
      spectrophotometrically and it was found increased in all cases. Acetylsalicylic
      acid, naproxen, benzoic acid and iopanoic acid could be easily determined in raw
      material and some of them in pharmaceutical preparations by direct titration in
      CTAB-micellar system instead of using the traditional non-aqueous or back
      titrimetry. Precisions of 0.3-4.3% RSD and good correlation with the official
      tedious methods were obtained. The interference study of some excipients showed
      that a preliminary test should be carried out before the assay of formulations.

PMID- 8466958
TI  - Pharmacokinetics of cyclosporin A during pregnancy; monitoring of treatment and
      specific assays of cyclosporin, based on five liver transplant patients.
AB  - Very little information is available concerning the pharmacokinetic behaviour and
      monitoring of cyclosporin A (CsA) during pregnancy, notably after liver
      transplant. Monitoring of blood levels of CsA is considered to be one of the best
      tools for evaluation of the efficacy of immunosuppressant treatment. The aim of
      this study was to bring together new information concerning pregnant women
      receiving immunosuppressant treatment with CsA and, in view of the special
      pathophysiological status of such patients, to compare pharmacokinetic profiles
      of changes in blood levels of CsA and of the combination of CsA plus metabolites.
      Specific (CsA-S kit) and a new non-specific (CsA-NS kit) assays of CsA were
      carried out in five hospitalized pregnant patients who had received liver
      transplants between the 6th and the 41st weeks of amenorrhea. The results of five
      cases investigated lead to the following conclusions: (1) The pharmacokinetic
      behaviour of native CsA in the pregnant woman between the 6th and 41st weeks of
      amenorrhea suggests no systemic accumulation nor any radical need for changes in
      dosage schedule as compared with a non-pregnant patient. (2) Monitoring based
      upon simultaneous use of the CsA-NS and CsA-S kits may be a source of analytical
      bias and hence confusion for the physician. (3) Determination of an experimental
      CsA-NS/CsA-S accumulation ratio (based upon analysis of single concentrations or
      processing of AUCs) is of interest only if specific assays involve not only CsA
      itself but also its principal metabolites. (4) Monitoring based upon single
      measurements of residual CsA levels only, is necessary and adequate. Furthermore,
      such an approach is less costly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466959
TI  - Chloroisothiocyanatoquinolines as fluorogenic derivatizing agents for primary and
      secondary amines.
AB  - Two new prechromatographic LC fluorogenic derivatizing agents, 2- and 4-chloro-3
      isothiocyanatoquinoline (4 and 5) have been synthesized and shown to react
      smoothly with primary and secondary amines to produce fluorescent
      thiazoloquinolines. Compounds 4 and 5 hydrolyse in aqueous base and the rates of
      this reaction compared with the rates of derivatizations with amino acids
      indicate that the hydrolysis reaction interferes with derivatization when UV
      detection is used. The kinetics of derivatization with ordinary amines indicate
      that this reaction is quite facile, although less nucleophilic amines, e.g.
      aniline, react slowly. The pKas for first protonations indicate that derivatives
      of 4 would be unprotonated and those of 5 would be protonated with typical RP-LC
      mobile phases. The Stokes shift for protonated derivatives of 5 is nearly 200 nm.
      The excess of unreacted derivatizing reagent interferes with UV detection of some
      analytes; but when fluorescence detection is used this excess produces only a
      small negative peak. With fluorescence detection the sensitivity of this method
      is about 0.8 microM at S/N of 2, and the response of peak height to concentration
      is linear over at least two decades of concentration.

PMID- 8466960
TI  - Microbore liquid chromatography with electrochemical detection for the control of
      phenolic antioxidants in drugs and foods.
AB  - Antioxidants are added to foods and drugs to inhibit their oxidation. As these
      additives are somewhat toxic, it is necessary to control the amount added to any
      food or drug. Liquid chromatography (LC) is a powerful tool for this purpose.
      Many antioxidants are electroactive molecules which enables the advantages of
      electrochemical detection or selectivity and sensitivity to be realized. The
      interest of analysts in microbore LC arises from the low mobile phase volumetric
      flow rates involved, the reduced on-column samples together with reduced
      chromatographic dilution and high efficiency. Coupling of microbore LC with
      electrochemical detection adds another advantage: the decrease of electrode
      ageing. The problem of extra-column band broadening with microbore column is
      discussed in the present communication. A micro LC-electrochemical detection
      system is constructed and tested using catecholamines. The limit of detection
      (LOD) for noradrenaline using a 0.7 mm bore column is found to be 0.1 pg injected
      in 0.2 microliter (0.6 femtomoles). Three phenolic antioxidants are studied: tert
      butyl-p-hydroxyanisole (BHA), di-tert-butyl-hydroxytoluene (BHT) and n-propyl
      gallate (3,4,5-trimethoxybenzoic acid propyl ester). The dynamic range is four
      orders of magnitude with LODs down to 0.1 femtomoles (20 fg injected) with a 0.3
      mm bore column. No electrode response change is observed after 60 injections of 3
      ng BHA over 6 days. Antioxidants are determined in different pharmaceutical
      preparations and foodstuffs (chewing gums, dried potato flakes). The agreement
      between the manufacturer stated concentrations and observed results is found to
      be satisfactory.

PMID- 8466961
TI  - Optimization of the separation of salbutamol and its decomposition products by
      liquid chromatography with diode-array detection.
AB  - A high-performance liquid chromatographic (HPLC) method based on diode-array
      detection is developed and optimized for stability studies on salbutamol. In
      establishing the method, the effects of mobile phase constituents (buffers,
      buffer concentration, pH, modifiers, organic solvents, ion-pair reagents) upon
      the resolution of salbutamol and its degradation products are studied. The
      optimum method involves the use of a LiChrosorb RP-18 column with a one-step
      gradient elution with acetonitrile-sodium dihydrogen phosphate (40 mM)
      triethylamine (5.74 mM) (pH 3.0). The acetonitrile content is increased from 4 to
      9% after 6 min.

PMID- 8466962
TI  - Sensitive determination of 1,1'-ethylidenebis(L-tryptophan) in L-tryptophan by
      gradient HPLC with fluorimetric detection.

PMID- 8466963
TI  - E. P. Pope Memorial Award to Dr. Anthony Gallina.

PMID- 8466964
TI  - Pleuropneumonia in Missouri swine.

PMID- 8466965
TI  - Naturally occurring systemic anaphylactic and anaphylactoid reactions in four
      groups of pigs injected with commercially available bacterins.

PMID- 8466966
TI  - Listerial abortion in a llama.

PMID- 8466967
TI  - Septicemic Enterococcus infection in an adult llama.

PMID- 8466968
TI  - Yersinia pseudotuberculosis bovine abortion.

PMID- 8466969
TI  - Clostridial enteritis in red lories (Eos bornea).

PMID- 8466970
TI  - Small intestinal Chlamydia infection in piglets.

PMID- 8466971
TI  - Multicentric lymphosarcoma in a llama.

PMID- 8466972
TI  - Echinococcus granulosus hydatid cysts in the livers of two horses.

PMID- 8466973
TI  - Vertebral angiosarcoma in a horse.

PMID- 8466974
TI  - Investigation of selenium sources associated with chronic selenosis in horses of
      western Iowa.

PMID- 8466975
TI  - The effect of formalin fixation on the concentration of selenium in porcine
      liver.

PMID- 8466976
TI  - Hepatogenous photosensitization in cattle fed a grass hay.

PMID- 8466977
TI  - Detection of antigenemia by enzyme-linked immunosorbent assay in horses with
      experimental Ehrlichia risticii infection.
AB  - Four horses were inoculated with Ehrlichia risticii contained in either infected
      murine P388 D1 cells or heparinized blood from an infected horse. All 4 horses
      produced serum antibody, plasma antigen, and clinical signs of the disease. An
      enzyme-linked immunosorbent assay was used to detect antibody in the serum and
      was also used in conjunction with an anti-E. risticii monoclonal antibody to
      detect antigenemia. These laboratory and clinical findings were correlated to
      determine the efficiency of the antigen detection method for discerning E.
      risticii infection.

PMID- 8466978
TI  - Detection of humoral antigen and antibody by enzyme-linked immunosorbent assay in
      horses with experimentally induced Ehrlichia equi infection.
AB  - An enzyme-linked immunosorbent assay (ELISA) was used to detect antigen in plasma
      and antibody in serum of 3 horses inoculated with Ehrlichia equi. Clinical signs,
      including rectal temperature, were correlated with the antigen and antibody
      detection. ELISA was very efficient in detection of serum antibody. Antigen
      detection using monoclonal antibodies to E. equi and ELISA should be considered
      as a diagnostic method.

PMID- 8466979
TI  - Detection of Eperythrozoon suis using the polymerase chain reaction.
AB  - Eperythrozoon suis is an extracellular red blood cell parasite that causes
      icteroanemia in acutely ill pigs and a variety of syndromes in chronically
      infected pigs. Current techniques to detect E. suis infection are limited by
      variability of parasitemias and antibody responses in infected animals. The
      polymerase chain reaction (PCR) was investigated to determine its potential as a
      means of detecting E. suis infection in pigs. With DNA samples extracted from
      either purified E. suis organisms or E. suis-infected pig blood, PCR produced an
      amplification product 492 base pairs in length. This amplification product
      hybridized successfully with the fragment of the DNA probe from which the primer
      sequences had been selected. Sensitivity studies indicated that the PCR protocol
      was capable of amplifying total genomic E. suis DNA in quantities as low as 450
      pg. When PCR was used with DNA from blood samples from a splenectomized pig that
      had been infected with E. suis, amplification products were detectable as early
      as 24 hours postinfection. This preliminary analysis indicates that PCR shows
      promise as a means of efficiently detecting E. suis infection in pigs.

PMID- 8466980
TI  - Preliminary characterization of a pleomorphic gram-negative rod associated with
      avian respiratory disease.
AB  - An unidentified, pleomorphic, gram-negative rod (PGNR) bacterium has been
      isolated from domestic fowl with respiratory disease. The PGNR was isolated in 5%
      of turkey accessions and 3% of chicken accessions, primarily from the respiratory
      tract. Preliminary characterization of this organism included reviewing accession
      records, conducting cultural and biochemical tests, and analyzing cellular fatty
      acids. The PGNR was also compared with other bacteria capable of inhabiting the
      avian respiratory system. Biochemical and cellular fatty acid analysis failed to
      identify the organism, however all 14 isolates were similar.

PMID- 8466981
TI  - Reproducibility of a commercial enzyme-linked immunosorbent assay for bovine
      paratuberculosis among eight laboratories.
AB  - Interlaboratory reproducibility of an absorbed enzyme-linked immunosorbent assay
      (ELISA) kit for detection of bovine serum antibodies to Mycobacterium
      paratuberculosis was evaluated. A panel of 30 bovine sera (15 positives and 15
      negatives) was tested in triplicate microtiter wells on each of 2 days at 8
      different laboratories. One laboratory had invalid results because of positive or
      negative serum control optical density (OD) readings beyond the acceptable range
      specified by the kit. The coefficient of variation (CV) for mean OD values was
      influenced by low ODs on test negative sera at 2 laboratories, thus the CVs on
      positive sera were considered a more representative measure of kit
      reproducibility. Between-well CVs averaged 6.7% +/- 2.8% (mean +/- standard
      deviation), and between-day CVs averaged 14.5% +/- 9.8% among the 7 laboratories
      with valid assays on the 15 positive sera. The OD values were converted to
      positive or negative classifications for each assay well, and the results were
      compared. Among 1,392 assays in 7 laboratories, 98.6% were in agreement. Eleven
      of 18 discrepant results were due to a sample that consistently gave OD values
      near the cutoff for a positive test. Exclusion of that serum from the analysis
      resulted in a 99.8% rate of agreement among laboratories. Results indicated that
      the absorbed ELISA kit provided reproducible results within and between
      laboratories.

PMID- 8466982
TI  - Etiology and pathology of equine placentitis.
AB  - Placentas from aborted, stillborn, and premature foals were examined during the
      1988 and 1989 foaling seasons, and 236 of 954 (24.7%) had placentitis.
      Microorganisms associated with placentitis were isolated or demonstrated from 162
      of 236 (68.6%) placentitis cases. Leptospira spp. and a nocardioform actinomycete
      were 2 important, newly emerging bacteria associated with equine placentitis.
      Major pathogens identified in decreasing order were Streptococcus zooepidemicus,
      Leptospira spp., Escherichia coli, a nocardioform actinomycete, fungi,
      Pseudomonas aeruginosa, Streptococcus equisimilis, Enterobacter agglomerans,
      Klebsiella pneumoniae, and alpha-hemolytic Streptococcus. Pathogens were not
      recovered in 64 cases (27.1%) and overgrowth by saprophytic bacteria was recorded
      in 10 cases (4.2%). Twenty-seven cases (16.6%) had mixed bacterial growth and 93
      cases (57.4%) had bacteria cultured from both placenta and fetal organs. The
      majority of the placentitis cases caused by bacteria, with the exception of
      Leptospira spp. and the nocardioform actinomycete, occurred in 2 forms. One was
      acute, focal or diffuse; had an infiltration of neutrophils in the intervillous
      spaces or necrosis of chorionic villi; was associated with bacteremia; and
      frequently occurred in the placenta from fetuses expelled before or at
      midgestation. The other was observed from foals expelled at late gestation, was
      mostly chronic and focal or focally extensive, and occurred mostly at the
      cervical star area. Chronic placentitis was characterized by the presence of 1 or
      a combination of the following lesions: necrosis of chorionic villi, presence of
      eosinophilic amorphous material on the chorion, and infiltration of mononuclear
      inflammatory cells in the intervillous spaces, villous stroma, chorionic stroma,
      vascular layer, and allantois.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8466983
TI  - Bacterial agents detected in a 10-year study of bovine abortions and stillbirths.
AB  - In a 10-year survey started in 1980, specimens from 8,995 bovine abortions and
      stillbirths were submitted to the South Dakota Animal Disease Research and
      Diagnostic Laboratory. Of these, 8,962 were suitable for some type of
      examination. Bacteria were determined to be the cause of 1,299 (14.49%). The 5
      bacteria most commonly associated with bovine abortion or stillbirth were
      Actinomyces pyogenes, 378 (4.22%); Bacillus spp., 321 (3.58%); Listeria spp., 121
      (1.35%); Escherichia coli, 98 (1.09%); and Leptospira interrogans, 79 (0.88%).
      Twelve other genera of bacteria were associated with > or = 10 abortions or
      stillbirths, and 12 more species were associated with < or = 10 abortions or
      stillbirths.

PMID- 8466984
TI  - Experimental equine leukoencephalomalacia, toxic hepatosis, and encephalopathy
      caused by corn naturally contaminated with fumonisins.
AB  - A study to evaluate the effects of dietary fumonisin B1 was conducted using 6
      ponies (4 test and 2 control). A ration naturally contaminated with fumonisin B1
      was fed in 3 phases: 1) 44 ppm fumonisin B1, 2) less than 1 ppm fumonisin B1, and
      3) 88 ppm fumonisin B1. All ponies were monitored daily, weighed weekly, and
      limit fed at a rate of 0.8% body weight plus hay. Feed intake was measured daily,
      and a serum chemistry panel was completed once or twice weekly. Four to 7 days
      after initiation of the trial (Phase 1), all 4 test ponies had decreased feed
      consumption, and selected serum chemistry parameters were markedly elevated. On
      day 9, 1 pony died acutely with mild encephalopathy and hepatic necrosis. Another
      pony, euthanized on day 45, also had mild encephalopathy and hepatic necrosis.
      The remaining 2 test ponies continued the 44 ppm fumonisin B1 diet for 98 days.
      Phase 2 consisted of a diet with < 1 ppm fumonisin B1 for 120 days. During this
      phase, the serum chemistry values of the 2 ponies returned to normal. Following
      Phase 2, the 2 ponies were fed a diet containing 88 ppm fumonisin B1. After 75
      days, 1 animal died of equine leukoencephalomalacia with mild hepatic necrosis.
      On day 78, the remaining pony was euthanized after showing distress; it also had
      leukoencephalomalacia and hepatic lesions.

PMID- 8466987
TI  - Naturally occurring selenosis in Wyoming.
AB  - A review of Wyoming State Veterinary Laboratory records for 1947-1987 revealed no
      substantiated cases of naturally occurring selenosis. However, older reports
      attributed thousands of animal deaths to selenium each year in this area.
      Beginning in August 1988, cases of suspected selenosis and selenium deficiency
      were solicited from veterinarians and producers by announcements in various
      statewide livestock publications. As of August 1991, 4 cases (all horses) of
      naturally occurring selenosis have been confirmed. Clinical signs were most often
      referable to epithelial damage, e.g., hoof lesions and loss of mane and tail.
      None involved neurologic signs. Sources of selenium included native range and
      grass hay.

PMID- 8466985
TI  - Fumonisin toxicity in turkey poults.
AB  - The effects of dietary fumonisin B1 were evaluated in young turkey poults. The
      experimental design consisted of 3 treatments, with 24 female turkey poults
      allotted randomly per treatment. Day-old poults were fed diets containing 0 mg
      (feed control), 100 mg, and 200 mg fumonisin B1/kg feed for 21 days. Body weight
      gains and efficiency of feed conversion decreased linearly with increasing
      dietary fumonisin. Liver, kidney, and pancreas weights increased linearly with
      increasing dietary fumonisin, and spleen and heart weights decreased. Serum
      aspartate aminotransferase levels increased with increasing dietary fumonisin,
      and serum cholesterol; alkaline phosphatase, mean cell volume, and mean cell
      hemoglobin all decreased. Biliary hyperplasia, hypertrophy of Kupffer's cells,
      thymic cortical atrophy, and moderate widening of the proliferating and
      degenerating hypertrophied zones of tibial physes were present in poults fed
      diets containing fumonisin B1. Results indicate that fumonisin B1, from Fusarium
      moniliforme culture material, is toxic in young poults, and the poult appears to
      be more sensitive to fumonisin than the broiler chick.

PMID- 8466986
TI  - Pathogenic studies and antigenic and sequence comparisons of A/equine/Alaska/1/91
      (H3N8) influenza virus.
AB  - An influenza virus, A/equine/Alaska/1/91 (H3N8), was isolated from horses from
      Alaska with an acute respiratory infection. Pathogenic and serologic studies
      revealed that this virus is similar to previously isolated equine H3N8 influenza
      viruses. Antigenic analyses utilizing hemagglutination inhibition and
      neuraminidase inhibition assays indicated an antigenic drift from the prototype
      equine H3N8 influenza virus, A/equine/Miami/1/63. Partial sequence analysis of
      the A/equine/Alaska influenza virus indicated that each of 8 gene sequences are
      of equine origin.

PMID- 8466988
TI  - Equine protozoal myeloencephalitis: antigen analysis of cultured Sarcocystis
      neurona merozoites.
AB  - Antigens of cultured Sarcocystis neurona merozoites were examined using
      immunoblot analysis. Blotted proteins were probed with S. cruzi, S. muris, and S.
      neurona antisera produced in rabbits, S. fayeri (pre- and post-infection) and S.
      neurona (pre- and post-inoculation) sera produced in horses, immune sera from 7
      histologically confirmed cases of equine protozoal myeloencephalitis (EPM), and
      pre-suckle serum from a newborn foal. Eight proteins, 70, 24, 23.5, 22.5, 13, 11,
      10.5, and 10 Kd, were detected only by S. neurona antiserum and/or immune serum
      from EPM-affected horses. Equine sera were titered by the indirect
      immunofluorescent antibody (IFA) method using air-dried, cultured S. neurona
      merozoites. Anti-Sarcocystis IFA titers were found in horses with or without EPM.
      Serum titers did not correspond to the number of specific bands recognized on
      immunoblots.

PMID- 8466990
TI  - Serologic responses to the mallein test for glanders in solipeds.

PMID- 8466989
TI  - Poliomyelomalacia and ganglioneuritis in a horse with paralytic rabies.

PMID- 8466991
TI  - Clostridium difficile associated with typhlocolitis in an adult horse.

PMID- 8466992
TI  - [Physico-chemical compatibility of drugs with enteral nutrition].
AB  - The physical and chemical compatibility of an enteral diet (standard Precitene)
      with a series of liquid preparations included in the hospital's formulary was
      evaluated. These preparations are included in the following groups: vitamins,
      antibiotics and chemotherapeutic drugs, analgesics, antiepileptic drugs,
      neuroleptics, bronchodilators, expectorants, antihistamines, immunosuppressors
      and short chain triglycerides. Phase separation, particle growth pH variation,
      osmolality increase and viscosity increase were studied. The results obtained
      indicate that the majority of the drugs studied are compatible from a physical
      and chemical point of view with the enteral diet used, at least during a 24 hour
      period, with the exception of those drugs which, because of their pH, acidify the
      mixture, causing problems of increased viscosity and particle growth, and of
      those liquid preparations of continuous oleous phase where phase separation is
      unavoidable. Lastly, a series of recommendations are given on cases where joint
      administration of drugs with enteral nutrition is suitable.

PMID- 8466993
TI  - [Nutritional parameters and morbimortality in clinical hospitalization].
AB  - The prevalence of malnutrition in patients admitted to hospital in the region of
      Northwest Murcia and its repercussion on the morbidity rate and length of
      admission are studied. A protocol of nutritional evaluation according to the
      computer programme EDECAN-MED was applied, and the corresponding statistical
      treatment of data and results was done. We find that anthropometric data lack
      predictive value and that deterioration in the values for albumin, basal energy
      expenditure and nutritional prognostic index are associated with increased
      morbidity/mortality and prolongation of the length of hospital stay. The most
      valuable predictive datum of the length of hospital stay was the nutritional
      prognostic index, in spite of it being an index of surgical risk.

PMID- 8466994
TI  - [Control of the biological contamination index in total parenteral nutrition
      (TPN) preparations].
AB  - Possible microbiological contamination of 1,107 mixtures of TPN made up in the
      Pharmacy Department of the General Hospital of Albacete in 1991 are studied. In
      this department, the TPN mixtures are prepared in a horizontal laminar flow
      chamber, under the aseptic conditions included in the literature. When we come to
      evaluate the contamination index of these preparations, we have to take the
      increase in the work load on days before public holidays into account. We observe
      that, when the preparation norms are rigorously followed, no significant
      contamination is produced, even on days when the number of mixtures to be made up
      is higher.

PMID- 8466995
TI  - [Possible mistakes in the interpretation of commercial nitrogenous solutions].

PMID- 8466996
TI  - [Plasma aminogram in critical patients].
AB  - This study of the plasma aminogram was done on 35 patients with a moderate to
      high level of stress and/or sepsis. For the criteria of illness, the SAPS
      (Simplified Acute Physiological Score) was used on their admission to the
      intensive Care Unit, and the diagnosis of sepsis was established according to the
      criteria of Jacobs and Boone. The stress level was calculated according to
      Bistrian. The plasma aminogram was determined with High Resolution Liquid
      Chromatography. The plasma samples were taken while nutrient units containing
      what is considered a standard solution of amino acids were infused. The eight
      essential amino acids (EAA) and 10 non-essential were quantified. The ratio of
      ramified to aromatic amino acids (RAA/AAA) was calculated by Fisher's criteria.
      An increase in AAA (phenylalanine, p < 0.001, and tyrosine, NS) and sulphur
      containing amino acids (methionine, p < 0.001) was found. The RAA were within
      normal ranges (valine) or increased (leucine, p < 0.001 and isoleucine, p <
      0.001). The RAA/AAA ratio was reduced, p < 0.0001. Glycine was increased, p <
      0.0001 and alanine reduced, p < 0.05. Glutamine and glutamic acid were reduced, p
      < 0.0001 and p < 0.01 as was arginine, p < 0.001. No difference was found in the
      total concentration of AA. The results confirm the standard plasma aminogram
      described in situations of metabolic stress and/or sepsis.

PMID- 8466997
TI  - [Nutritional status of patients undergoing digestive surgery].
AB  - A retrospective study of 102 patients, analysing the incidence of malnutrition,
      was done in the Digestive Surgery Department of the Queen Sophia University
      Hospital, Cordoba. Patients were subjected to a protocol of nutritional
      evaluation to find out their nutritional condition and type and degree of
      malnutrition. The high incidence of malnutrition sufferers (> 80%) at the time of
      hospital admission was confirmed, being more noticeable in neoplastic patients.

PMID- 8466998
TI  - [Methods for quality control in parenteral nutrition. III: application of the
      program to therapeutic results].
AB  - Therapeutic results of parenteral nutrition are evaluated by clinical nutritional
      benefits and by its safety with respect to the potential complications related to
      the method of administration and its inherent metabolic complications. In this
      context, a quality control programme was applied retrospectively to 148 patients
      and was evaluated according to the following indicators: a) PN suspension; b) a
      nutritional evaluation on termination of the parenteral nutrition; c) catheters
      inserted; d) mechanical complications; e) septic complications; f) routine
      controls; g) complete controls, and h) biochemical changes. The compliance
      percentages obtained were 92.8, 100, 85.1, 81.4, 84.9, 60.0, 33.1 and 43.8
      respectively. These results allow us to see, for the first time, the profile of
      therapeutic quality in patients with parenteral nutrition. Likewise, it
      constitutes an obligatory methodology of intrahospital reference for continued
      improvement of parenteral nutrition received by patients admitted to this
      hospital.

PMID- 8466999
TI  - Self-employed nursing.

PMID- 8467000
TI  - Profile of a self-employed nurse.

PMID- 8467001
TI  - Making it on her own. Interview by Laura Brown.

PMID- 8467002
TI  - Marketing dilemmas for health care providers.

PMID- 8467003
TI  - Nursing a difficult patient.

PMID- 8467004
TI  - Putting research into practice.

PMID- 8467005
TI  - Pioneering spirit lives on.

PMID- 8467006
TI  - Caring for a chemically-dependent colleague.

PMID- 8467007
TI  - Consent to health care.

PMID- 8467008
TI  - A self-directed approach to health care reform.

PMID- 8467009
TI  - Back injury may end your career.

PMID- 8467010
TI  - Different effect of Intralipid and triacylglycerol rich lipoproteins on the Kodak
      Ektachem serum cholesterol determination.
AB  - We documented the quantitative effects of lipaemia on cholesterol recovery on a
      Kodak Ektachem 700 XRC analyser (Rochester, NY, USA) in comparison with a Hitachi
      717 analyser (Boehringer, Mannheim, Germany). Using the linear ranges of the
      analysers, we compared the effects of adding Intralipid and of adding high
      concentrations of native Very-Low-Density-Lipoproteins and/or chylomicrons. Our
      data demonstrate less than 10% bias for the Kodak cholesterol determination in an
      Intralipid dilution series prepared according to M. R. Glick and coworkers (e.g.
      Clin. Chem. 33 (1987) 1453-1458). However, in a hypertriglyceridaemic dilution
      series (theoretical cholesterol concentrations ranged from 5.2 to 15.5 mmol/l)
      the Kodak cholesterol recovery fraction decreased from 0.88 to 0.58 when the
      triacylglycerol concentration increased from 5.64 mmol/l to 38.35 mmol/l. In
      contrast, the cholesterol recoveries on the Hitachi analyser were complete for
      both approaches. We conclude that the lipaemia effect on the Kodak cholesterol
      determination is not adequately reflected by addition of Intralipid, because the
      Kodak cholesterol determination is more prone to interference by turbidity when
      triacylglycerols are presented as native serum lipoproteins, especially as
      chylomicrons.

PMID- 8467011
TI  - Acetylation phenotypes and biological variation in a French Caucasian population.
AB  - Factors affecting the caffeine acetylation phenotype were investigated in a
      French Caucasian population of 150 unrelated supposedly healthy subjects, aged 18
      to 63 years. This population, including 75 men and 75 women, was used to
      determine whether the acetylation polymorphism is related to environmental
      influences such as smoking habits, intake of alcohol, use of oral contraceptives,
      use of certain drugs. The acetylation phenotype was assessed from the molar ratio
      of two caffeine metabolites: 5-acetylamino-6-formylamino-3-methyluracil/1
      methylxanthine. For values less than 0.85, the subjects were classified as poor
      acetylators (frequency, mean +/- SD: 61.3 +/- 7.9%) in this study. Dose
      recoveries of 5-acetylamino-6-formylamino-3-methyluracil (mean +/- SD) were 1.26
      +/- 0.85% and 3.58 +/- 1.64% in slow and rapid acetylators, respectively. The
      recovery (mean +/- SD) of 1-methylxanthine in the 3 hour-urine was 2.86 +/- 1.51%
      in slow acetylators and 2.36 +/- 1.27% in rapid acetylators. The mean value (and
      SD) of the molar ratio was 0.437 (0.177) and 1.669 (0.651) for slow and rapid
      acetylators. Three other metabolite ratios can also provide an acetylation index:
      5-acetylamino-6-formylamino-3-methyluracil/5-acetylamino-6-formylamino-3 -
      methyluracil + 1-methylxanthine + 1-methyluric acid; 5-acetylamino-6-formylamino
      3-methyluracil/1-methylxanthine + 1-methyluric acid + 1,7-dimethyluric acid; and
      5-acetylamino-6-formylamino-3-methyluracil/1-methylxanthine + 1-methyluric acid +
      1,7-dimethyluric acid + 1,7-dimethylxanthine with a bimodal distribution for the
      former and a trimodal distribution for the two latter ratios, both showing about
      95% concordance with the 5-acetylamino-6-formylamino-3-methyluracil/1
      methylxanthine ratio. Age did not influence the excretion of caffeine and its
      five major metabolites. A marked influence of sex was observed only on the
      unchanged caffeine excretion, and the effect was greater in slow acetylators than
      in rapid acetylators. The 5-acetylamino-6-formylamino-3-methyluracil excretion
      was about three times higher in rapid acetylators than in slow acetylators in
      both sexes.

PMID- 8467012
TI  - Anomalous tumour marker concentrations in renal transplant patients.
AB  - Serial serum determinations of the tumour associated antigens carcinoembryonic
      antigen, tissue polypeptide antigen, CA 19-9, CA 15-3 and CA 125 were performed
      on 70 patients who were undergoing, or had undergone renal transplantation. The
      period of observation ranged from 4 days pre-operative to 708 days post
      operative, although daily monitoring was usually carried out during the first 14
      35 days post-operatively. With the exception of tissue polypeptide antigen, which
      was analysed with an immunoluminometric assay, all analytes were measured with
      the Enzymun-Test System ES-300 using immunoenzymometric assays with colorimetric
      determination. The interassay coefficients of variation were less than 5% for the
      immunoenzymometric assays and 8.7% for tissue polypeptide antigen, all values
      being derived from 20 consecutive assays. Only 8/70 patients with no
      complications showed normal concentrations for all five analytes. 6/79 patients
      showed parallel changes of at least three markers. 7/70 patients had transient
      elevations of at least one marker, whereas 25/70 patients had a continual
      elevation of CA 125, 9/70 CA 19-9 and 1/70 CA 15-3, although no patient showed
      evidence of disease. Two patients, each with 2 rejection episodes, showed daily
      fluctuations up to 100% for all markers, with the exception of carcinoembryonic
      antigen. There was no correlation between elevated tumour markers and
      cytomegalovirus infection.

PMID- 8467013
TI  - Preferential inhibition of LDL oxidation by the all-trans isomer of beta-carotene
      in comparison with 9-cis beta-carotene.
AB  - The synthetic all-trans isomer of beta-carotene was recently shown to possess
      antioxidant properties towards the formation of oxidized low density lipoprotein.
      In the present study, the binding of the all-trans and the 9-cis isomers of beta
      carotene to plasma lipoproteins was investigated, and the effect of these isomers
      on the susceptibility of plasma lipoprotein to lipid peroxidation and on
      macrophage uptake of oxidized LDL were studied. Both the synthetic all-trans
      isomer of beta-carotene and the natural beta-carotene from the algae Dunaliella
      Bardawil [which is composed of the all-trans (70%) and the 9-cis (30%) isomers],
      were found to bind similarly to all plasma lipoproteins, following the incubation
      of beta-carotene with purified lipoproteins or with whole plasma. Incubation of
      the beta-carotene isomers with whole plasma, followed by separation of the
      lipoproteins, revealed substantial carotene binding to very low density
      lipoprotein (VLDL) and to LDL and limited binding to high density lipoprotein
      (HDL). Lipid peroxidation of VLDL and LDL were significantly inhibited by beta
      carotene. The synthetic beta-carotene, however, was twice as effective as the
      Dunaliella beta-carotene in inhibiting LDL lipid peroxidation (following LDL
      incubation with copper ions). Cellular degradation of oxidized lipoproteins
      (mediated via the scavenger receptor) was decreased by 40% and 18%, respectively,
      when they were prepared by incubation in the presence of synthetic or natural
      beta-carotene; the control oxidized LDL was prepared in the absence of beta
      carotene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467014
TI  - Analysis of haemoglobin variants using immobilized pH gradients.
AB  - We present a new method for analysis of haemoglobin variants in immobilized pH
      gradients. The isoelectric fractionation is performed in polyacrylamide gels with
      copolymerized pH gradients between pH 7.0 and 8.0. The common haemoglobin
      variants (HbA, HbF, HbS, HbC, HbE and HbA2) are clearly resolved within this pH
      range. The high resolving power and reproducibility of immobilized pH gradients
      combined with extremely short separation times make this fractionation technique
      superior to all electrokinetic procedures used for haemoglobin analysis. At
      present, isoelectric focusing in immobilized pH gradients is a complementary tool
      for haemoglobin analysis when classical electrophoretic techniques do not provide
      sufficient resolution. We hope that in the future this technique will gain the
      popularity it deserves.

PMID- 8467015
TI  - The competitive edge--think like the opposing side to succeed.

PMID- 8467016
TI  - Laws affect treatment of HIV patients.

PMID- 8467017
TI  - Surgical treatment of patients with lobar holoprosencephaly: a personal note.
AB  - The diagnosis of holoprosencephaly usually implies a poor prognosis and is often
      regarded as a contraindication for surgical correction of associated clefts of
      the lip or palate. Between 1985 and 1991, 4 patients with lobar holoprosencephaly
      were evaluated and studied with computed tomography or magnetic resonance
      imaging. All had cleft palate and 3 had paramedian cleft lip; all 4 exhibited
      some degree of nasal dysplasia. All patients are presently alive, at a mean age
      of 26.6 +/- 2.4 months (mean +/- SD). Three of the children showed normal or near
      normal development, whereas the fourth was severely retarded. Our experience
      suggests that some children with lobar holoprosencephaly have a highly variable
      degree of intellectual development and that long-term survival may be expected.

PMID- 8467018
TI  - Pediatric facial injuries in Tehran: a review of 87 patients.
AB  - Because of the Iraq/Iran conflict pediatric facial injuries were commonly seen in
      Iran. A series of 87 facial injuries were isolated from 1,608 patients with
      different types of facial injuries seen in two university hospitals in Tehran
      during the previous 6 years (1984-1990). Their ages ranged from 20 months to 13
      years. The male-to-female ratio was 16.4:1; the highest incidence was in the
      lower-third region (63.21%; n = 55), and the highest incidence was in the 8- to 9
      year-old age groups. Associated nonfacial injuries, clinical and computed
      tomographic scan findings for head injuries associated with facial injuries,
      treatment, and complications are reported.

PMID- 8467020
TI  - The effect of insulin growth factor-1 on calvarial sutures in a Sprague-Dawley
      rat.
AB  - Early investigations attempting to determine the exact pathogenesis of premature
      closure of the cranial sutures were limited by the untoward sequelae caused by
      surgical procedures in animal models to simulate the development of
      craniosynostosis. In an attempt to create a model for evaluating the effects of
      manipulating the craniofacial sutures without the limitations of associated
      scarring, we conceived an animal prototype dependent on the effects of insulin
      growth factor-1 on the anterior frontal suture in a Sprague-Dawley rat model. The
      experimental group received 2 mg of IGF-1 over a 14-day period via a
      subcutaneously placed osmotic infusion pump, whereas the age-matched control
      group received no treatment. We present our preliminary histological results
      describing the effect of IGF-1 on calvarial sutures.

PMID- 8467019
TI  - Autogenous reconstruction of the temporomandibular joint.
AB  - Recently, the temporomandibular joint has been reconstructed with a variety of
      alloplastic materials; however, functional results are often limited, and long
      term stability of the reconstruction is questionable. In contrast, costochondral
      rib grafting with rigid internal fixation and a temporoparietal fascia flap
      allows complete functional reconstruction of the temporomandibular joint with
      autogenous tissue. Thirteen joint reconstructions in 11 patients were followed
      for up to 7 years and stability of the reconstruction was confirmed. The anterior
      incisal opening improved from a mean of 14 to 31 mm. Normal occlusal
      relationships were either reestablished or preserved. Joint pain was ameliorated.
      The preferred reconstruction of the temporomandibular joint is by autogenous
      tissue for disc and joint replacement. The treatment provides primary therapy in
      total joint reconstruction where tumor, trauma, or failed prosthetic joint
      replacement necessitate complete reconstruction.

PMID- 8467021
TI  - The evolution of the modern human face: Part 1. An anthropological concept.

PMID- 8467022
TI  - Molded polymethylmethacrylate external retention bolsters for soft-tissue support
      following medial canthopexy.

PMID- 8467023
TI  - Osseointegrated implants in cranial bone grafts for mandibular reconstruction.
AB  - Branemark osseointegrated implants were used in combination with a cranial bone
      graft that was harvested from the outer table of the skull in a patient with a
      discontinuity defect of the anterior aspect of the mandible. First, a staged
      procedure allowed reconstruction of the defect. The second stage was placement of
      the Branemark osseointegrated implant fixtures, followed by contouring the
      interior genial area by adding more bone grafts. The initial stabilization was
      done with an adoption plate that was used to stabilize the mandibular fragments
      during the healing phase. This plate was subsequently removed when the
      osseointegrated implants were placed. The patient had a full course of oral
      rehabilitation and a satisfactory final outcome.

PMID- 8467024
TI  - Immediate reconstruction of complex cranioorbital fractures in children.
AB  - Six principles of craniofacial surgery were applied to the treatment of 7
      consecutive pediatric patients who sustained complex cranioorbital fractures.
      These principles are (1) accurate assessment of the deformity, (2) early
      reconstruction, (3) complete exposure of the involved craniofacial skeleton, (4)
      accurate anatomical reduction of the fracture fragments, (5) use of rigid
      internal fixation, and (6) autogenous cranial bone grafting. Patient follow-up
      ranged from 6 to 52 months; evaluation included serial photographs, three
      dimensional computed tomographic imaging, and cephalometric analysis. Application
      of these 6 craniofacial surgical principles provided definitive management in one
      operation, with optimal anatomical and functional reconstruction, and resulted in
      no detectable impairment to subsequent craniofacial growth.

PMID- 8467025
TI  - [Low-dose midazolam reduces the alfentanil demand in elderly but not in young
      patients during extracorporeal shock wave lithotripsy].
AB  - To evaluate whether midazolam has analgesic properties in humans after
      intravenous injection we studied the influence of a subhypnotic dose of midazolam
      (50 micrograms/kg) on the cumulative alfentanil consumption in 53 patients during
      extracorporeal shock wave lithotripsy (ESWL) using a patient-controlled analgesia
      system (PCAS). In a randomised double blind fashion all patients received either
      midazolam or an equal volume of saline (placebo) prior to ESWL. Heart rate and
      arterial blood pressure were measured before and during ESWL. Alfentanil
      consumption was assessed 20 minutes after injection of midazolam or placebo,
      respectively. All patients received oxygen via face mask. In patients older than
      60 years (median: 70 years, range: 61-88 years) pretreatment with midazolam
      resulted in a significantly lower cumulative alfentanil consumption (0.41 vs 0.97
      mg; p = 0.027) compared with patients younger than 60 years after midazolam
      pretreatment (0.84 vs 0.71 mg; p = 0.27). Mean arterial pressure also was
      significantly lower in the former compared with the latter group, while heart
      rate remained unchanged. In contrast, in patients younger than 60 years (median:
      47 years, range: 24-56 years) no significant differences were observed between
      the midazolam and the placebo group. Thus, low dose intravenous midazolam
      pretreatment led to a significant decrease of alfentanil consumption in patients
      beyond 60 years of age. We conclude that subhypnotic doses of midazolam are
      capable of reducing alfentanil demand in elderly but not in younger patients
      during ESWL.

PMID- 8467026
TI  - [N2O-supplemented intravenous anesthesia versus inhalation anesthesia. A
      comparative study of the sympathoadrenergic reaction and postoperative
      vigilance].
AB  - The aim of the present study was a comparison of the intraoperative
      sympathoadrenergic response and the postoperative vigilance of a
      propofol/alfentanil anaesthesia to a conventional isoflurane anaesthesia. 25
      patients were admitted to the study undergoing septorhino surgery. Patients with
      continuous intravenous anaesthesia with propofol/alfentanil combined with nitrous
      oxide showed better haemodynamic conditions without an increase of blood pressure
      and catecholamines under laryngoscopy, intubation and surgical stimulation. In
      contrast to that the patients with isoflurane anesthesia showed a significant
      increase in haemodynamic parameters and capillary bloodflow. The measured plasma
      adrenalin levels showed wide intraindividual fluctuation but no significant
      difference between the groups. The suppression of plasma noradrenaline was more
      pronounced under intravenous anaesthesia. Recovery was significantly faster and
      vigilance significantly better in the patients undergoing intravenous
      anaesthesia. After 30 min patients with i.v. anaesthesia fulfilled all the
      conditions to be transferred to the regular ward; the other group needed more
      than one hour. It can be concluded that continuous i.v. anaesthesia with
      propofol/alfentanil is superior in suppressing the stress response to invasive
      stimuli and provides faster recovery and better postoperative analgesia.

PMID- 8467027
TI  - [Prevention of pneumonia by endotracheal micronebulization of tobramycin].
AB  - In 69 artificially ventilated patients the clinical, bacteriological and
      pharmacological effects of endotracheally administered tobramycin were studied in
      comparison to a control group. In the therapy group, 52% of all specimens were
      sterile, in the control group only 25%. During the first 4 days these changes
      were significant (p < 0.05). In the therapy group the endotracheal colonisation
      with ps. aeruginosa was significantly lower between the 4th and 14th day (p <
      0.05). The incidence of secondary pneumonia was reduced from 42% to 17.5% (not
      significant). Systemic administration of antibiotics, e.g. of aminoglycosides,
      was significantly more often necessary in the control group. No increasing of
      growth of fungi in the upper respiratory tract was observed, but these was a non
      significantly higher incidence mainly of staph. epidermidis. The application of
      80 mg tobramycin four times a day as an aerosol was well tolerated by the
      patients. Under there conditions, tobramycin could not be measured in the serum.
      No allergic reactions, increased respiratory pressures or bronchoconstrictions
      were observed.

PMID- 8467028
TI  - [Hypoxia. Introduction].

PMID- 8467029
TI  - [Hypoxia--a significant problem in intensive medicine].

PMID- 8467030
TI  - [Diagnosis of the O2 management of the O2 status of the blood].

PMID- 8467031
TI  - [Monitoring oxygen transport using pulse oximetry].

PMID- 8467032
TI  - [Measurement of oxygen partial pressure in tissue. Clinical results].

PMID- 8467033
TI  - [Inhalation anesthetics in patients with coronary heart disease: pro].

PMID- 8467034
TI  - [Inhalation anesthetics in patients with coronary heart disease: contra].

PMID- 8467035
TI  - [Historical vignette. Compression hyperemia of the head for the prevention of the
      dreaded poisoning by local anesthetics].

PMID- 8467036
TI  - [Septic-toxic heart failure as a result of a heparin-induced thrombocytopenia
      with "white-clot-syndrome"].
AB  - A patient is presented who developed pulmonary artery embolism and
      thrombocytopenia with various arterial clots several days after an ankle joint
      osteosynthesis, which finally caused the amputation of the right arm.
      Unfractionated heparin was applied for the prevention of postoperative
      thrombosis. Obviously as a consequence of the liberation of toxic metabolites
      from the gangrenous lower arm, the patient developed septic shock which was
      exacerbated by a severe pneumonia caused by methicillin-resistant S. aureus
      bacteria (MRSA). Laboratory investigations showed an antibody (IgG) induced
      thrombopenia mediated by all low molecular weight and unfractionated heparins. By
      eliminating heparin and further treatment with a low molecular weight heparinoid
      (ORG 10,172), platelet count rose sufficiently and thrombotic process ceased
      completely. Septic shock was successfully treated by fluid replacement,
      antibiotics and inotropic substances.

PMID- 8467037
TI  - [Multicultural cooperation in nursing].

PMID- 8467038
TI  - ["I do believe that there is something". Discussions with cancer patients].

PMID- 8467039
TI  - [Postoperative pain therapy with patient-controlled analgesia (PCA)].

PMID- 8467040
TI  - [Pediatric adventure trip into research, knowledge and practice].

PMID- 8467041
TI  - [Nutritional problems in long-term nursing home patients].

PMID- 8467042
TI  - [Refusal to eat by nursing home patients and what nurses aides and geriatric
      nurses make of it].

PMID- 8467043
TI  - [An ethical analysis of double-bind conflicts of nurses who have to feed severely
      demented patients].

PMID- 8467044
TI  - [Attitude of nurses and their interpretation of the behavior of severely demented
      patients during feeding in a patient assignment system].

PMID- 8467045
TI  - [Nursing education and nursing science--experiences in the United States].

PMID- 8467046
TI  - [Stresses on nursing personnel. 2].

PMID- 8467047
TI  - [Multiple sorting technique--an example for its application in nursing research].

PMID- 8467048
TI  - [The conflict between individual and community care: can we see the woods for the
      trees?].

PMID- 8467049
TI  - [The family and community medicine specialty before homologation with the
      European Community].

PMID- 8467051
TI  - [Auditing the performance of the physician facing patient alcohol consumption].
AB  - OBJECTIVE: To assess the Primary Care doctor's performance when faced with
      his/her patients' alcohol consumption. DESIGN: Retrospective evaluation of data
      on procedures by means of explicit normative criteria and implicit check-up of
      those not complying. SETTING: Urban health centre. PATIENTS: A random and
      institutionally based sample, over a week, of patients of both sexes who came for
      a general medical consultation (eleven blocks) without prior appointment.
      RESULTS: 110 clinical histories were evaluated. 60% were not asked about alcohol
      consumption. In the cases of those who were asked, the amount consumed was
      specified. Excessive consumption was recorded in the notes as a health risk
      factor in 87%. A liver profile was requested for 62%. Advice to give up or reduce
      alcohol consumption was given in all cases. CONCLUSIONS: Poor compliance with the
      assessment criteria chosen justifies the implementation of the corrective
      measures proper to quality control methodology. We underline the importance of
      generalizing the implementation of the Programme of Preventive Activities in
      Primary Care and the need to improve health professionals' training and
      motivation on the question.

PMID- 8467050
TI  - [Self-care measures recorded for acute pathology in primary care].
AB  - OBJECTIVE: To quantify and describe the self-treatment existing among users
      requesting a consultation about an illness which had commenced in the previous 15
      days. DESIGN: Observational prospective study. SETTING: Primary care in a semi
      rural environment. Family Medicine Unit in Valls (Tarragona). PATIENTS AND OTHERS
      PARTICIPANTS: The study included all those people who attended the Unit, whose
      illness had begun during the previous 15 days and who were attending with this
      illness for the first time. The following variables were recorded: gender, age,
      symptomatology and whether they had taken self-treatment measures (self
      medication and/or non-pharmacological measures). MEASUREMENTS AND MAIN RESULTS: A
      total of 375 patients were recorded: 59.5% women and 40.5% men. The most common
      symptoms were pain (50.1%) and temperature (15.2%). 69.9% of the patients (CI
      4.75) had treated themselves: there were no significant differences as regards
      age and gender. An analysis shows that 18.7% used nonpharmacological measures;
      75.9% took some drug; and 5.4% used non-pharmacological measures plus a drug. The
      most used pharmacological groups were analgesics and antipyretics (40.9%, p <
      0.001). CONCLUSIONS: Self-treatment is very common in the Primary Care
      environment. Professionals and health planners will have to bear this very much
      in mind, in order both to strengthen its positive implications and correct any
      negative aspects found.

PMID- 8467052
TI  - [The time used by the patient when he/she talks without interruptions].
AB  - OBJECTIVE: To measure the time used by a patient to explain the reason for
      his/her visit to the general practitioner, when he/she is permitted to talk
      freely and without interruption. DESIGN: A descriptive study where only
      previously known patients, who had a new reason for a consultation, were
      considered. SETTINGS: Visits to general practitioners' offices in Slovenia and
      Croatia. PARTICIPANTS: Six general practitioners (two Slovenes and four
      Croatians) who recorded the time spent on 480 consultations. MEASUREMENTS AND
      MAIN RESULTS: The period of time measured was that used by the patients, at the
      beginning of the consultation, to reply to the doctor's question: "What can I do
      for you today?" Average time used by the patients was 28.6 seconds. There was a
      link between the older age group and a longer time period. There were no gender
      differences. CONCLUSIONS: Patients are able to explain calmly and without
      interruptions the reason for their visit. Interruptions by the doctor are
      probably unnecessary and do not save time.

PMID- 8467053
TI  - [The impact on hospital emergency care of the introduction of continuing care
      into the health centers of Logrono].
AB  - OBJECTIVE: To assess the influence in Logrono of the setting-up of "On-going Care
      Points" (OCP's) on the number of visits to specific Emergency services. DESIGN:
      Descriptive study. SETTING: Emergency Service of San Millan hospital, Logrono.
      PATIENTS: All the patients (29,407) seen in the Emergency department of the above
      hospital during the period under study. RESULTS: After the installation of OCP's,
      the demand for hospital care fell from a daily average of 172.63 (SD = 21.35) to
      164.28 (SD = 17.85). This reduction occurred mainly during the OCPs' opening
      hours. On non-working days, during these hours, hospital attendance fell from an
      average of 137.84 (SD = 19.5) to 129.88 (SD = 12.41) (p < 0.05); whereas on
      working days, it fell from an average of 54.09 (SD = 9.05) to 48.62 (SD = 7.54)
      (p < 0.001). CONCLUSIONS: We believe that the setting-up of OCP's has been the
      main reason for the drop in the number of patients seen in the Emergency
      department.

PMID- 8467054
TI  - [Compliance with long-term drug treatment: the prescription as a means of health
      education].
AB  - OBJECTIVE: To examine whether the new prescription form, when it is correctly
      filled in and gives adequate information about the meaning of the treatment
      instructions, provides long-term patients with a higher level of understanding of
      their drugs treatment than the old prescription form. DESIGN: Prospective,
      descriptive study. SETTING: Primary Care level. PATIENTS AND OTHERS PARTICIPANTS:
      Those users of the Health Area undergoing long-term pharmacological treatments
      and supervised by the nursing staff using the Health Centre Medication Card.
      INTERVENTIONS: The 193 users who fulfilled these criteria for inclusion in the
      study were given three questionnaires. The first contained the old prescription
      form; the second, the new prescription form, without the spaces for the treatment
      instructions being filled in; the third, the new form, with the treatment
      instructions filled in and their meaning explained. MEASUREMENTS AND MAIN
      RESULTS: Users were faced with the old prescription form and the new one
      correctly filled in plus explanation. Comparison between the two showed that out
      of 38 cases of error with the old form, 14 (36.84%) increased their understanding
      of the treatment. This was a statistically significant improvement: [Tc] < [Te]
      with an average of (-3.77), with a typical deviation of 1.16 and p < 0.05.
      CONCLUSIONS: The prescription form can be a good way of improving the efficacy of
      staff intervention.

PMID- 8467055
TI  - [The usefulness of the Munich Alcoholism Test (MALT) in the diagnosis of
      alcoholism].

PMID- 8467056
TI  - [The diagnosis and treatment of the most frequent menstrual changes in primary
      care (and II)].

PMID- 8467057
TI  - [The evaluation of an influenza vaccination campaign in a health sector].

PMID- 8467058
TI  - [A case of AIDS in primary care].

PMID- 8467059
TI  - [Pregnancy due to the failure of a hormonal contraceptive method].

PMID- 8467060
TI  - [Risk factors and the cult of the body].

PMID- 8467061
TI  - [PPD and chemoprophylaxis in diabetes].

PMID- 8467062
TI  - The influence of hydration on the conformation of lysozyme studied by solid-state
      13C-NMR spectroscopy.
AB  - 13C proton decoupled cross-polarization magic-angle spinning nmr spectra of
      lysozyme are reported as a function of hydration. Increases in hydration level
      enhance the resolution of the spectra, particularly in the aliphatic region, but
      has no significant effect on either the rotating frame proton spin-lattice
      relaxation time or the cross-relaxation time. The enhancement in spectral
      resolution with hydration is attributed to a decrease in the distribution of
      isotropic chemical shifts, which reflects a decrease in the distribution of
      conformational states sampled by the protein. Changes in the distribution of
      isotropic chemical shifts occur after the addition of water to the charged groups
      as coverage of the polar side chains and peptide groups takes place. The onset of
      this behavior occurs at a hydration level of about 0.1-0.2 g water/g protein and
      is largely complete at about 0.3 g water/g protein, the same hydration range
      where changes in the heat capacity are observed. That hydrogen exchange of buried
      protons can occur at hydration levels significantly lower than those at which
      changes in the distribution of conformational states are first observed suggests
      that some motions that mediate exchange are already present in the dry protein.
      The preservation of efficient dipolar coupling indicates that the conformational
      rearrangements that do occur on hydration are small and do not involve any
      significant overall expansion of free volume or weakening of interactions that
      would increase the reorientational freedom of protein groups.

PMID- 8467063
TI  - Effects of molecular association on structure and dynamics of a collagenous
      peptide.
AB  - Peptide GVKGDKGNPGWPGAPY from the triple-helix domain of type IV collagen
      aggregates in solution at a critical aggregation concentration of 18 mM. This
      molecular self-association process is investigated by 1H- and 13C-nmr
      spectroscopy. As a function of increasing peptide concentration, selective 1H
      resonances are cooperatively chemically shifted by up to 0.04 ppm to apparently
      saturable values at high concentration. Pulsed field gradient nmr was used to
      derive translation diffusion constants that, as the peptide concentration is
      increased, also cooperatively and monotonically decrease to an apparent limiting
      value. An average number of 6 monomer units per aggregate have been estimated
      from diffusion constant and 13C relaxation data. Comparative 1H nuclear
      Overhauser effect spectroscopy (NOESY) spectra accumulated at high and low
      peptide concentrations suggest that average internuclear distances are decreased
      as a result of peptide association. 13C-nmr multiple spin-lattice relaxation and
      13C-[1H] NOE effects on 13C-enriched glycine methylene positions in the peptide
      demonstrate that overall molecular tumbling and backbone internal motions are
      attenuated in the aggregate state. Lowering the solution pD from pD 6 to pD 2
      disrupts the aggregate state, suggesting a role for electrostatic interactions in
      the association process. Based on thermodynamic considerations, hydrophobic
      interactions also probably act to stabilize the aggregate state. These data are
      discussed in terms of an nmr/NOE constrained computer-modeled structure of the
      peptide.

PMID- 8467064
TI  - Dynamic light scattering of aqueous solutions of linear aggregates induced by
      thermal denaturation of ovalbumin.
AB  - Dynamic light scattering measurements were performed on dilute aqueous solutions
      of native ovalbumin (OA) and on those of linear OA aggregates induced by thermal
      denaturation at low ionic strength and neutral pH. The weight-average molecular
      weight MW of four aggregates tested ranged from 1,700,000 to 5,500,000. The
      translational diffusion coefficient D0 of native OA at infinite dilution was
      estimated as 8.70 x 10(-7) cm2/s, which gave 56.0 A as the diameter of the rigid
      spherical particle. The intensity autocorrelation function of linear OA polymers
      was analyzed with the cumulant method to obtain the first cumulant gamma e. The
      dependence of gamma e on the scattering vector q at very low polymer
      concentration was found intermediate between those of a flexible chain and a
      rigid rod. The translational diffusion coefficient Dtr [identical to (gamma
      e/q2)q-->0] was in proportion to M-0.55W, and the magnitude was in good agreement
      with a value calculated from the wormlike cylinder model with values of three
      parameters determined in an earlier study, ML = 1600 A-1, d = 120 A, and Q = 230
      A, where ML, d, and Q are the molecular weight per unit length, diameter, and
      persistence length, respectively. Based on these results, a new model, to be
      called as the dimer model, was proposed to interpret the formation mechanism of
      linear OA polymers induced by thermal denaturation.

PMID- 8467065
TI  - Physicochemical properties of (1-->6)-branched (1-->3)-beta-D-glucans. 1.
      Physical dimensions estimated from hydrodynamic and electron microscopic data.
AB  - The physical dimensions of several (1-->6) branched (1-->3)-beta-D-glucan samples
      obtained from different organisms and their derivatives have been studied by
      electron microscopy, light scattering measurements, viscometry, and gel
      permeation chromatography. The electron micrographs indicate that in most samples
      these biopolymers are adequately described as linear worm-like coils. A sample
      reconstituted from alkaline media appeared as a blend of the linear, circular,
      and aggregated polymer morphologies. The average mass per unit length, ML = Mw/Lw
      for the macroscopically linear samples, was estimated to be 2100 +/- 200 g mol-1
      nm-1. The parameter ML was determined from the contour lengths obtained by
      electron microscopy and the molecular weight by light scattering measurements.
      The observed ML was consistent with the triple-helical structure reported from x
      ray diffraction studies and observed degree of side-chain substitution. From the
      molecular snapshots shown in the electron micrographs, the persistence lengths of
      these beta-D-glucans were determined to be 140 +/- 30 nm. The experimentally
      determined intrinsic viscosities were consistent with these estimates of ML and
      persistence length. Comparison of the molecular weight distributions obtained
      from gel permeation chromatography and those deduced from the electron
      micrographs indicates that number and weight average contour lengths are more
      reliable than z and z + 1 averages.

PMID- 8467066
TI  - Reversible effects of medium dielectric constant on structural transformation of
      beta-lactoglobulin and its retinol binding.
AB  - The secondary structure transformation of beta-lactoglobulin from a predominantly
      beta-structure into a predominantly alpha-helical one, under the influence of
      solvent polarity changes is reversible. Independent of the alcohol used-
      methanol, ethanol, or 2-propanol--the midpoints of the observed structural
      transformation occur around dielectric constant epsilon approximately 60. The
      structural change destroying the hydrophobic core formed by the beta-barrel
      structure leads, at room temperature, to the dissociation of the retinol/beta
      lactoglobulin complex in the neighborhood of dielectric constant epsilon
      approximately 50. However, when the dielectric constant of the medium is raised
      back to epsilon approximately 70 by the decrease of the temperature, both the
      refolding of BLG into a beta-structure and the reassociation of the retinol/beta
      lactoglobulin complex are observed. The esterification of beta-lactoglobulin
      carboxyl groups has two effects: on the one hand it accelerates the beta
      strand<==>alpha-helix transition induced by alcohols. On the other hand, the
      esterification of beta-lactoglobulin strengthens its interaction with retinol as
      it may be deduced from the smaller apparent dissociation constant of
      retinol/methylated beta-lactoglobulin complex. The binding of retinol to modified
      or unmodified beta-lactoglobulin has no influence (stabilizing or destabilizing)
      on the folding changes induced by alcohol.

PMID- 8467067
TI  - Design of peptides: crystal and molecular structure of a 3(10)-helical peptide N
      Boc-L-Phe-dehydro-Phe-L-Val-L-Phe-dehydro-Phe-L-Val-OCH3.
AB  - Highly specific peptide structures can be designed by inserting dehydro residues
      into peptide sequences. The peptide N-Boc-L-Phe-dehydro-Phe-L-Val-L-Phe-dehydro
      Phe-L-Val- OCH3, synthesized by conventional procedures, crystallizes from
      methanol-water mixtures at 4 degrees C in the tetragonal space group P4(3) with
      cell parameters a = b = 13.829 +/- 0.003 A, c = 27.587 +/- 0.008 A, V = 5275.5 +/
      0.2 A3, Z = 4, dm = 1.152 +/- 0.005 g cm-3, dcal = 1.150 +/- 0.005 g cm-3. The
      overall residual factor R = 0.084 for 2342 reflections, with 2 theta max = 140
      degrees using CuK alpha radiation. The backbone torsion angles are theta 1 = 
      171(1) degrees, omega 0 = 168(1) degrees, phi 1 = 77(2) degrees, psi 1 = 41(2)
      degrees, omega 1 = 169(1) degrees, phi 2 = -46(2) degrees, psi 2 = -24(2)
      degrees, omega 2 = 179(1) degrees, phi 3 = -63(2) degrees, psi 3 = 19(2) degrees,
      omega 3 = 171(1) degrees, phi 4 = -67(2) degrees, psi 4 = -8(1) degrees, omega 4
      = 169(1) degrees, phi 5 = -61(1) degrees, psi 5 = -26(1) degrees, omega 5 =
      177(1) degrees, phi 6 = -122(1) degrees, psi 6T = 26(2) degrees. The peptide
      adopts a 3(10)-helical conformation with three intramolecular hydrogen bonds (i +
      3-->i) involving carbonyl oxygen atoms of Phe1, dehydro-Phe2, Val3, and the NH
      groups of Phe4, dehydro-Phe5, and Val6 with distances of 3.01(1), 2.82(1), and
      3.09(2) A, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467068
TI  - beta-Alanine containing peptides: gamma-turns in cyclotetrapeptides.
AB  - In the present paper we describe the synthesis, purification, single-crystal x
      ray analysis, solution conformational characterization, and conformational energy
      calculations of the cyclic tetrapeptide cyclo-(beta-Ala-L-Pro-beta-Ala-L-Val).
      The peptide was synthesized by classical solution methods and the cyclization of
      the free tetrapeptide was accomplished in good yields in diluted methylene
      chloride solution using N,N-dicyclohexyl-carbodiimide. The compound crystallizes
      in the monoclinic space group P2(1) from ethanol with two independent molecules
      in the unit cell. All peptide bonds are trans. The nmr molecular conformation in
      the acetonitrile solution as well as that derived from the molecular dynamic
      simulation in vacuo is quite different from those observed in the solid state and
      is very similar to that previously observed for the parent compound cyclo- (beta
      Ala-L-Pro-beta-Ala-L-Pro).

PMID- 8467069
TI  - The effect of intrinsic curvature on supercoiling: predictions of elasticity
      theory.
AB  - Elasticity theory of naturally curved rods is employed to study the effects of
      intrinsic curvature on the properties of the equilibrium conformations of
      supercoiled DNA. The results stand in sharp contrast to those obtained when the
      molecule is viewed as being straight in its relaxed form. Starting from very
      fundamental principles of the theory, we show that the torsion of an open segment
      with a curved duplex axis can vary when the temperature, and along with it, the
      intrinsic twist is changed. Conversely, an imposed helicity, such as might be
      associated with binding to a histone, can change the intrinsic twist. It is also
      shown that another consequence of the presence of naturally curved sequences is
      that the twist density will, in general, vary with position along the chain in
      all equilibrium states. Then portions of the molecule will be more or less
      susceptible to interaction with other agents sensitive to such a variation.
      Finally, some closed equilibrium global structures uniquely associated with
      intrinsic curvature are discussed.

PMID- 8467070
TI  - Synthesis and conformational analysis of N-glycopeptides. II. CD, molecular
      dynamics, and NMR spectroscopic studies on linear N-glycopeptides.
AB  - The comprehensive structural analysis reported herein of eight N-glycopeptides,
      in three different solvents, is based on quantitative CD experiments, homonuclear
      nuclear Overhauser effect measurements, and molecular dynamics (MD) calculations.
      Although several orientations of the two amide planes attached to the
      carbohydrate pyranose ring are possible, according to NOE, CD data, and MD
      simulations, of all of the glycopeptide models, regardless of the type of the
      carrier peptide, only one dominant conformer population was found. This conformer
      is characterized by a nearly trans orientation of the CH and NH hydrogens of both
      acetamido groups. This finding is in perfect agreement with x-ray
      crystallographic data on the solid state conformation of the 1-N-acetyl- and 1-N
      (beta-aspartyl)-2-acetamido-2-deoxy-beta-D-glucopyranosyla min e. The precise
      identification of this dominant conformer of N-glycopeptides in solution was the
      major question addressed herein by the structural analyses. A "CD additivity"
      experiment was carried out using an equimolar solution of Boc-Pro-Asp-NHCH3 and 1
      N-acetyl-3,4,6- tri-O-acetyl-2-acetamido-2-deoxy-beta-D-glucopyranosylamine at
      ambient temperature in acetonitrile. The CD spectrum obtained from the equimolar
      solution of the above two molecules (the "spectroscopic sum") was identical with
      the CD curve obtained from the algebraic summation of the individually recorded
      CD spectra of the peptide and the carbohydrate moiety ("mathematical sum"). The
      global picture of the CD spectral analyses of the eight parent peptides with the
      eight N-glycopeptides revealed that in trifluoroethanol and acetonitrile, the
      side-chain modification of the Asn models (natural N-glycopeptide analogues) by N
      glycosylation has a significant effect on the conformation of the carrier
      peptide, resulting in a decrease in the original type I beta-turn content.
      Simultaneously, the type II beta-turn conformational percentage increased to
      approximately 20%. Such a conformational ratio change seems to be larger than the
      expected errors arising from the CD analyses, and agrees with the results of MD
      calculations. N-glycosylation of Asn residues causes perturbations, not only
      through the covalent bond, but also through specific hydrogen bonds between the
      backbone and side chain atoms. CD spectroscopy, augmented by efficient CD curve
      deconvolution techniques, has proved to be a useful tool for studying
      multicomponent conformer mixtures of small linear peptides in solution and
      changes of conformational equilibria caused by N-glycosylation.

PMID- 8467071
TI  - Cyanogen as a selective probe for carbonic anhydrase hydrolase activity.
AB  - The salt bridge probe cyanogen (ethanedinitrile, C2N2; N identical to C-C
      identical to N) inhibits the bovine carbonic anhydrase (EC 4.2.1.1.) hydrolase
      activity toward various types of esters without significant effect on its
      hydrolyase activity. Two sets of pyridine derivatives that were isosteric
      substrates for the two activities were differentially affected. Acetazolamide and
      salamide are reversible inhibitors of the enzyme; only salamide affords
      protection of the hydrolase activity against the action of C2N2. Since each is
      known to bind in different positions within the active site, the selective effect
      of salamide may arise from its position covering one CO2 site as well as a site
      important for hydrolase activity. The C2N2 concentration dependence of the time
      course of hydrolase inhibition is consistent with the existence of a high C2N2
      affinity site with slow covalent change and a second site with lower C2N2
      affinity, but higher rate of covalent modification of the enzyme.

PMID- 8467072
TI  - NMR and computer-aided studies of the three interchanging stereoisomers of the
      cyclic hexapeptide cyclo[-Pro1-Gly2-Glu3(OBzl)-Pro4-Phe5-Leu6-]: unexpected
      observation of a cis isomer of a secondary amide peptide bond in the presence of
      two trans proline peptide bonds.
AB  - The cyclic hexapeptide cyclo[-Pro1-Gly2-Glu3(OBzl)-Pro4-Phe5-Leu6-] (1; OBzl:
      benzyl ester) was modeled and synthesized to be used as a chiral site for the
      separation of enantiomers. Total correlation spectroscopy and nuclear Overhauser
      effect spectroscopy spectra of the peptide in CDCl3 showed the presence of three
      stereoisomers. The two dominant stereoisomers 1a and 1b exchanged chemically with
      each other, while the minor stereoisomer 1c exchanged exclusively with the
      stereoisomer 1b. Stereoisomer 1a had two cis proline peptide bonds while
      stereoisomer 1b had all-trans peptide bonds. The stereoisomer 1c had, for
      nonstrained peptides, an unusual cis phenylalanine peptide bond while both
      proline peptide bonds were trans.

PMID- 8467073
TI  - Isolation and characterization of a cDNA encoding NADP(+)-specific isocitrate
      dehydrogenase from soybean (Glycine max).
AB  - A cDNA that encodes an NADP-specific isocitrate dehydrogenase (IDH) was cloned
      from a soybean nodule cDNA library by complementation of an Escherichia coli
      mutant that lacked IDH. DNA sequence analysis showed that the 1583 bp soybean
      cDNA could encode a protein that shares 63.9% amino acid sequence identity with
      the Saccharomyces cerevisiae NADP-IDH and long sequences of identity to an IDH
      from pig. Southern blot analysis suggests that this gene corresponds to a gene
      family made up of no more than two loci. The IDH cDNA hybridized to a 1.7 kb
      soybean mRNA and the relative amount of this transcript in soybean leaves,
      nodules and roots was 1:3.4:7.7. In alfalfa, a 1.7 kb mRNA was also found but the
      ratios for the corresponding tissues were 1:7.4:7.7. IDH activity was detected in
      the complemented E. coli strain and the electrophoretic mobility of this activity
      in nondenaturing polyacrylamide gels was identical to that of an IDH in extracts
      from soybean cotyledons or nodule cytosol. NADP-IDH specific activity in the E.
      coli host strain varied with growth phase; the highest rates (ca. 180 nmol/min
      per mg protein) were observed in late-stationary-phase cells. The enzyme had a
      broad pH optimum of 8.0 to 9.5 and had an absolute metal cofactor requirement,
      preferring Mn2+ below pH 8.0 and Mg2+ above pH 8.0. The Km for isocitrate and
      NADP was 21 microM and 11 microM respectively with Mn2+ as cofactor and 13 microM
      and 12 microM with Mg2+ as cofactor.

PMID- 8467074
TI  - The Rubisco activase (rca) gene is located downstream from rbcS in Anabaena sp.
      strain CA and is detected in other Anabaena/Nostoc strains.
AB  - A gene encoding ribulose 1,5-bisphosphate carboxylase/oxygenase (Rubisco)
      activase (rca) was found downstream from the rbcLrbcS operon in the heterocystous
      cyanobacterium Anabaena sp. strain CA. Two unknown open reading frames were shown
      to be located between rbcS and rca in strain CA and all the genes, rbcLrbcS,
      ORF1, ORF2, and rca were in the same transcriptional orientation. The deduced
      amino acid sequence of the Anabaena Rubisco activase showed both similarities and
      differences to the plant enzyme with considerable differences at the carboxy and
      amino termini. Proposed ATP-binding sites were conserved in the cyanobacterial
      protein. Recombinant cyanobacterial Rubisco activase, however, reacted with
      antisera to spinach Rubisco activase. Hybridization studies, using the Anabaena
      sp. strain CA rca gene as a heterologous probe, detected homologous sequences in
      heterocystous Anabaena/Nostoc strains but not in unicellular or nonheterocystous
      filamentous cyanobacteria, suggestive of a close evolutionary relationship of
      chloroplasts and heterocystous cyanobacteria.

PMID- 8467075
TI  - Sequence analysis of 22 kDa-like alpha-coixin genes and their comparison with
      homologous zein and kafirin genes reveals highly conserved protein structure and
      regulatory elements.
AB  - Several genomic and cDNA clones encoding the 22 kDa-like alpha-coixin, the alpha
      prolamin of Coix seeds, were isolated and sequenced. Three contiguous 22 kDa-like
      alpha-coixin genes designated alpha-3A, alpha-3B and alpha-3C were found in the
      15 kb alpha-3 genomic clone. The alpha-3A and alpha-3C genes presented in-frame
      stop codons at position +652. The two genes with truncated ORFs are flanking the
      alpha-3B gene, suggesting that the three alpha-coixin genes may have arisen by
      tandem duplication and that the stop codon was introduced before the duplication.
      Comparison of the deduced amino acid sequences of alpha-coixin clones with the
      published sequences of 22 kDa alpha-zein and 22 kDa-like alpha-kafirin revealed a
      highly conserved protein structure. The protein consists of an N-terminus,
      containing the signal peptide, followed by ten highly conserved tandem repeats of
      15-20 amino acids flanked by polyglutamines, and a short C-terminus. The
      difference between the 22 kDa-like alpha-prolamins and the 19 kDa alpha-zein lies
      in the fact that the 19 kDa protein is exactly one repeat motif shorter than the
      22 kDa proteins. Several putative regulatory sequences common to the zein and
      kafirin genes were identified within both the 5' and 3' flanking regions of alpha
      3B. Nucleotide sequences that match the consensus TATA, CATC and the ca. -300
      prolamin box are present at conserved positions in alpha-3B relative to zein and
      kafirin genes. Two putative Opaque-2 boxes are present in alpha-3B that occupies
      approximately the same positions as those identified for the 22 kDa alpha-zein
      and alpha-kafirin genes. Southern hybridization, using a fragment of a maize
      Opaque-2 cDNA clone as a probe, confirmed the presence of Opaque-2 homologous
      sequences in the Coix and sorghum genomes. The overall results suggest that the
      structural and regulatory genes involved in the expression of the 22 kDa-like
      alpha-prolamin genes of Coix, sorghum and maize, originated from a common
      ancestor, and that variations were introduced in the structural and regulatory
      sequences after species separation.

PMID- 8467076
TI  - Secondary structure and phylogeny of the chloroplast 23S rRNA gene from the brown
      alga Pylaiella littoralis.
AB  - The entire nucleotide sequence of a 23S rRNA gene from the brown alga Pylaiella
      littoralis (L.) Kjellm has been determined. The predicted length of the 23S rRNA
      is 2948 nucleotides, including the 4.5S rRNA-like region at the 3' end of the
      molecule. The putative transcript has been folded into a secondary structure by
      comparison to existing structure models, and the predicted helical regions were
      inspected by identifying compensatory downstream base changes. The 23S rRNA
      secondary structure presented here has features that are unique to P. littoralis
      (no other chromophyte or red algal 23S rRNA sequences are yet available), but has
      none of the features specific to the chloroplast rRNAs of green plants and green
      algae. The Pylaiella sequence was aligned with analogous plastidial and
      eubacterial gene sequences, and the alignment was used to construct a
      phylogenetic tree. The plastidial sequences formed a coherent cluster closely
      associated with the 23S rRNA of the cyanobacterium Anacystis nidulans. Within the
      plastid group, the P. littoralis sequence was most closely related to that of
      Euglena gracilis confirming earlier analyses based upon 16S rRNA sequences.

PMID- 8467077
TI  - Organization of the genes encoding chalcone synthase in Pisum sativum.
AB  - To analyze the regulation of defense-related genes by signal molecules produced
      by phytopathogens, we isolated genes that encode chalcone synthase (CHS) in Pisum
      sativum. We have obtained seven independent genomic clones that contain at least
      seven classes of CHS genes, identified by the hybridization analysis to CHS cDNA
      and by the restriction mapping analysis. Two of the genomic clones (clone 5 and
      6) each contain two CHS genes in a tandem repeat. The nucleotide sequence
      analysis of CHS genomic clone 5 revealed that PsCHS1 and PsCHS2 were
      corresponding genes of the CHS cDNA clones, pCC6 and pCC2, respectively, as
      reported earlier. Both genes are interrupted by a single intron of 88 nucleotides
      with identical sequences, although exonic sequences and 5'-flanking sequences are
      divergent. Nucleotide sequences of the introns in five other classes of CHS genes
      showed that three classes had an intron of 87 nt with a striking homology to each
      other, but that the intron of the other two classes of CHS genes showed
      heterogeneity both in size and nucleotide sequence. 5'-upstream regions of PsCHS1
      and PsCHS2 did not show sequence homology except the 31 bp identical sequence
      that contains the CCTACC motif resembling the box-1 sequence. Both PsCHS1 and
      PsCHS2 genes are shown to be induced by fungal elicitor by a primer extension
      analysis and a transient transformation analysis using pea protoplasts prepared
      from suspension cultured-cells.

PMID- 8467078
TI  - Transient gene expression of foreign genes in preheated protoplasts: stimulation
      of expression of transfected genes lacking heat shock elements.
AB  - Transfection of preheated petunia protoplasts with several biologically active
      DNA constructs resulted in a significantly higher gene expression than that
      observed in transfected unheated protoplasts. It was observed with supercoiled,
      linearized and single-stranded DNA structures that stimulation of transient gene
      expression in preheated protoplasts was neither dependent on the reporter gene
      nor on the regulatory elements used. Heat treatment at 42 degrees C also
      increased expression in protoplasts transfected with a plasmid bearing the
      tobacco mosaic virus (TMV) translational enhancer, omega. Northern blot analysis
      revealed that heat treatment of protoplasts before the transfection event greatly
      increased the amount of the newly synthesized transcripts. Preheating of
      protoplasts did not affect the transfection efficiency, namely the number of
      transfected cells in the population, nor the amount of DNA in transfected nuclei,
      as was inferred from histochemical staining and Southern blot analysis,
      respectively. The possible mechanism by which heat treatment stimulates transient
      gene expression of genes lacking obvious heat shock elements is offered. The
      relevance of the present findings to transient gene expression in plants in
      general and to viral gene expression in particular is discussed.

PMID- 8467079
TI  - Isolation and characterization of the genes encoding allophycocyanin subunits and
      two linker proteins from Synechocystis 6714.
AB  - Genes encoding the phycobilisome core subunits allophycocyanin alpha and beta and
      a small core linker protein in Synechocystis sp. strain PCC 6714 were cloned and
      sequenced. These genes form an operon, apcABC, with a single transcription start
      site and two possible termination sites, one following apcB and the other
      following apcC. The promoter region, like those of the apcABC operons of other
      cyanobacteria, does not resemble the consensus promoter sequences of Escherichia
      coli. However, the apcABC promoters identified in four strains of cyanobacteria
      have conserved sequences centered at -50 and -10 with respect to the start of
      transcription. The apcE gene, encoding the protein that links the phycobilisome
      core to the thylakoid membrane, was also cloned from Synechocystis 6714 and
      sequenced. It is unlinked to the apcABC operon. As in other Synechocystis
      strains, the LCM polypeptide encoded by the apcE gene contains three repeats of
      the basic phycobiliprotein linker domain. The apcE gene promoter sequence bears
      little resemblance to either the E. coli consensus or the apcABC promoter region,
      but it is similar to the corresponding regions of other cyanobacterial apcE
      genes. In these cases, there are conserved sequences centered at -40 and -10 with
      respect to the transcription start site. These conserved promoter elements from
      the apcABC and apcE genes were also identified in the corresponding 5'-flanking
      regions of eleven transcript starts for cpc genes encoding phycocyanin subunits
      in cyanobacteria and algal chloroplasts. These results suggest that a factor yet
      to be described participates in transcription of phycobiliprotein genes.

PMID- 8467081
TI  - Molecular basis for extensin size heterogeneity in two maize varieties.
AB  - This study concerned the molecular basis for the protein size heterogeneity of
      extensin from two maize (Zea mays L.) varieties. We studied the physical
      properties of extensin, a hydroxyproline-rich glycoprotein (HRGP), from the silk
      and pericarp of Golden X Bantam (GXB) sweet corn and Japanese Hulless (JHL)
      popcorn. Extensin from GXB has a molecular mass of 66 kDa whereas extensins from
      JHL have molecular masses of 76 and 66 kDa. Treatment with anhydrous hydrogen
      fluoride to deglycosylate proteins reduced the size of all extensins by 5 kDa.
      Probing with a 500 bp fragment from a genomic clone of maize extensin identified
      two transcripts (1.9 and 1.5 kb) on northern blots. JHL contained both
      transcripts and GXB contained only the 1.5 kb transcript. The probe also
      hybridized to two larger transcripts (6.2 and 4.5 kb) that were found in both
      varieties. We immunoprecipitated two proteins (66 and 56 kDa) from translated RNA
      isolated from JHL and one protein (56 kDa) from GXB. These results demonstrate
      that these extensins differ in the size of their peptide moiety and not in their
      extent of glycosylation.

PMID- 8467080
TI  - Use of bar as a selectable marker gene and for the production of herbicide
      resistant rice plants from protoplasts.
AB  - We have used the bar gene in combination with the herbicide Basta to select
      transformed rice (Oryza sativa L. cv. Radon) protoplasts for the production of
      herbicide-resistant rice plants. Protoplasts, obtained from regenerable
      suspension cultures established from immature embryo callus, were transformed
      using PEG-mediated DNA uptake. Transformed calli could be selected 2-4 weeks
      after placing the protoplast-derived calli on medium containing the selective
      agent, phosphinothricin (PPT), the active component of Basta. Calli resistant to
      PPT were capable of regenerating plants. Phosphinothricin acetyltransferase (PAT)
      assays confirmed the expression of the bar gene in plants obtained from PPT
      resistant calli. The only exceptions were two plants obtained from the same
      callus that had multiple copies of the bar gene integrated into their genomes.
      The transgenic status of the plants was verified by Southern blot analysis. In
      our system, where the transformation was done via the protoplast method, there
      were very few escapes. The efficiency of co-transformation with a reporter gene
      gusA, was 30%. The T0 plants of Radon were self-fertile. Both the bar and gusA
      genes were transmitted to progeny as confirmed by Southern analysis. Both genes
      were expressed in T1 and T2 progenies. Enzyme analyses on T1 progeny plants also
      showed a gene dose response reflecting their homozygous and heterozygous status.
      The leaves of T0 plants and that of the progeny having the bar gene were
      resistant to application of Basta. Thus, the bar gene has proven to be a useful
      selectable and screenable marker for the transformation of rice plants and for
      the production of herbicide-resistant plants.

PMID- 8467082
TI  - Unusual sequence of group 3 LEA (II) mRNA inducible by dehydration stress in
      wheat.
AB  - A cDNA clone, pMA1949, detects two mRNA species in wheat seedling tissue that are
      late embryogenesis-abundant (LEA) and dehydration stress-inducible. Sequence
      analysis of the pMA1949 clone shows it to be a 991 bp partial cDNA encoding a
      polypeptide of 317 amino acids with homology to two group 3 LEA proteins, carrot
      (DC8) and a soybean protein encoded by pGmPM2 cDNA. Molecular analysis of the
      deduced protein reveals a 33 kDa acidic and extremely hydrophilic protein with
      potential amphiphilic alpha-helical regions. In addition, the protein contains
      eleven similar, contiguous repeats of 11 amino acids, which are separated by 118
      amino acids from two additional and unique repeats of 36 residues each at the
      carboxyl end of the protein. Comparisons of sequences of reported group 3 LEA
      proteins revealed that there are two types, separable by sequence similarity of
      the 11 amino acid repeating motifs and by the presence or absence of a certain
      amino acid stretch at the carboxyl terminus. Based on results from these
      comparisons, we propose a second type of group 3 LEA proteins, called group 3 LEA
      (II).

PMID- 8467083
TI  - Structure of a cyanobacterial gene encoding the 50S ribosomal protein L9.
AB  - The rplI gene encoding the ribosomal protein L9 was found 4 kbp downstream from
      the desA gene, but on the opposite strand, in the genome of the cyanobacterium
      Synechocystis PCC6803. The deduced amino acid sequence is homologous to the
      sequences of the L9 proteins from Escherichia coli and chloroplasts of
      Arabidopsis and pea. The gene is present as a single copy in the chromosome and
      is transcribed as a mRNA of 0.64 kb. An open reading frame of unknown function
      (ORF291) was found in the upstream region of the rplI gene.

PMID- 8467084
TI  - A large DNA repeat of the dispersion pattern common to wheat and rye genomes.
AB  - A Hind III-generated fragment of wheat embryo nuclear DNA has been cloned and
      sequenced. The cloned fragment corresponds to a 1241 bp long, moderately repeated
      (60,000 copies/genome) segment of the genomic DNA. The repeat is AT-rich (67%),
      contains an open reading frame for 151 amino acids and several nucleotide blocks
      resembling the consensus domain of autonomously replicating sequences. Southern
      blot hybridization analyses indicate that the repeat is scattered through the
      wheat genome. A sequence homologous to this repeat occurs also in rye embryo
      nuclear DNA where it shows the same dispersion pattern as that observed for the
      wheat repeat.

PMID- 8467085
TI  - Molecular characterization of salt-stress-associated protein in citrus: protein
      and cDNA sequence homology to mammalian glutathione peroxidases.
AB  - A gene encoding for a citrus salt-stress-associated protein (Cit-SAP) was cloned
      from Citrus sinensis salt-treated cell suspension. The gene, designated csa, was
      isolated from a cDNA expression library. The partial amino acid sequence of the
      protein, as well as that deduced from the nucleotide sequence of csa, revealed a
      considerable homology to mammalian glutathione peroxidase (GP), and to clone
      6P229 from tobacco protoplasts. The increased expression of Cit-SAP in NaCl
      treated cultured citrus cells and in citrus plants irrigated with saline water,
      and its similarity to GP, raise the possibility that one of the effects of salt
      stress in plants may be the increase of the level of free radicals.

PMID- 8467086
TI  - Tissue-specific expression of a plant turgor-responsive gene with amino acid
      sequence homology to transport-facilitating proteins.
AB  - We report the isolation of a turgor-responsive gene of pea, trg-31, whose
      transcription induced within 30 min after the loss of leaf turgor. Structure of
      the coding region and 1.4 kb of 5' untranslated region was determined by DNA
      sequencing. A 3 kb promoter fragment from trg-31 was fused to a beta
      glucuronidase (GUS) reporter gene in pBI101, tobacco leaf disks and mature plants
      analyzed for turgor-responsive induction of GUS mRNA. Significant amino acid
      sequence homology exists between trg-31 and putative transport proteins of
      bovine, Phaseolus, soybean and Escherichia coli membranes.

PMID- 8467087
TI  - Semi-constitutive expression of an Arabidopsis thaliana alpha-tubulin gene.
AB  - In Arabidopsis tissues, the pool of tubulin protein is provided by the expression
      of multiple alpha-tubulin and beta-tubulin genes. Previous evidence suggested
      that the TUA2 alpha-tubulin gene was expressed in all organs of mature plants. We
      now report a more detailed analysis of TUA2 expression during plant development.
      Chimeric genes containing TUA2 5'-flanking DNA fused to the beta-glucuronidase
      (GUS) coding region were used to create transgenic Arabidopsis plants. Second
      generation progeny of regenerated plants were analyzed by histochemical assay to
      localize GUS expression. GUS activity was seen throughout plant development and
      in nearly all tissues. The blue product of GUS activity accumulated to the
      highest levels in tissues with actively dividing and elongating cells. GUS
      activity was not detected in a few plant tissues, suggesting that, though widely
      expressed, the TUA2 promoter is not constitutively active.

PMID- 8467088
TI  - Post-transcriptional transfer of gamma-thio affinity label to RNA in isolated
      parsley nuclei.
AB  - As an alternative to soluble plant transcription systems, we examined the
      reinitiation capacity of isolated parsley nuclei. Nuclear chalcone synthase in
      vitro transcripts were affinity-labelled with gamma-thio-ATP, gamma-thio-GTP or
      beta-thio-ATP, and purified by chromatography on a mercury Sepharose affinity
      column. Primer extension and subsequent PCR amplification of these in vitro
      transcripts revealed gamma-thio-ATP-dependent, but no beta-thio-ATP-dependent,
      signals, although affinity labelling of overall in vitro transcripts still
      occurred with beta-thio-ATP. We conclude that the described plant nuclei
      reinitiated transcription non-specifically and that post-transcriptional transfer
      of the gamma-thio affinity label severely interfered with the detection of
      reinitiated transcripts.

PMID- 8467089
TI  - Sequence of a sugarcane ribulose-1,5-bisphosphate carboxylase/oxygenase small
      subunit gene.

PMID- 8467090
TI  - Interaction of the T cell receptor with bacterial superantigens.
AB  - Bacterial toxin superantigens bind to MHC class II molecules and activate a large
      proportion of T cells through a direct interaction with the T cell receptor
      (TCR). The toxin: TCR interaction involves specific recognition between the beta
      chain variable region and the toxin. Although a complete alpha beta T cell
      receptor is required for activation of T cells, studies using purified soluble T
      cell receptor beta-chain have shown that it alone is sufficient for binding the
      toxin: class II complex. The regions of V beta and enterotoxin involved in the
      recognition have been determined.

PMID- 8467091
TI  - Interactions between staphylococcal superantigens and MHC class II molecules.
AB  - Superantigen binding to MHC class II molecules is a prerequisite for T cell
      stimulation. While the presentation of superantigens is not MHC restricted,
      allelic and isotypic variations in the ability of class II molecules to interact
      and present these superantigens exist. SEs bind to MHC class II molecules outside
      of the peptide binding groove, differences in binding affinities of the toxins
      for class II alleles and isotypes have been shown. In addition, a direct
      interaction between T cell receptor and MHC class II molecules could be
      responsible for these differences. In this review we provide a molecular analysis
      of the interactions of SEs with class II molecules.

PMID- 8467092
TI  - Superantigens of microbial origin.
AB  - Food poisoning associated staphylococcal enterotoxins and other bacterial
      products of diverse origin are now the focus of immunological research. These
      substances have special properties which determine their designation as
      superantigens. They influence T cell functions by controlling their repertoire,
      their cytokines production and their modulation of the immune response. As a
      consequence, superantigens might be at the origin of bacterial and autoimmune
      diseases. In this review we describe mainly the staphylococcal enterotoxins as
      representative members of the superantigen family.

PMID- 8467093
TI  - The CD8 T cell response to staphylococcal enterotoxins.
AB  - Staphylococcal enterotoxins (SE) are superantigens that bind to MHC class II
      molecules and activate T lymphocytes via the T cell receptor (TCR) V beta domain.
      By analogy with T cell responses to conventional peptide antigens, it might be
      predicted that CD4 (MHC class II restricted) cells would respond better to SE
      than CD8 (MHC class I restricted) cells. Here we summarize evidence that in fact
      CD8 cells respond as well as CD4 cells to SE both in vitro and in vivo. These
      findings emphasize the unique character of TCR-superantigen interactions.

PMID- 8467094
TI  - Gamma delta T cell reactivity towards bacterial superantigens.
AB  - Human TCR gamma delta positive T cells can proliferate in response to stimulation
      with staphylococcal enterotoxins (SEs) or mediate lysis of SE pulsed target
      cells. In the small number of studies reported, the proliferative response of
      gamma delta T cells was limited to V gamma 9 negative cells and, in vitro, such
      responses do not require the presence of MHC class II molecules for antigen
      presentation. Proliferative responses have been found after stimulation with SEA,
      SEB and TSST. The cytolytic activity of gamma delta T cells can be mediated by
      two different mechanisms: either gamma delta T cells specifically interact with
      SEA pulsed target cells--this is most likely TCR mediated recognition--or gamma
      delta T cells mediate antibody dependent cellular cytotoxicity (ADCC). This
      latter reactivity depends on Fc-receptor expression by the gamma delta T cell
      clones and the presence of SE specific antibodies during the assay. So far
      cytotoxic gamma delta T cell reactivity has only been found against the highly
      homologous enterotoxins SEA and SEE. Finally, HLA-class II positive gamma delta T
      cell clones can present SE to other SE reactive T cells but appear to be
      relatively resistant to T cell mediated lysis. Taken together, TCR gamma delta
      positive T cells are able to respond to a number of bacterial superantigens and
      may therefore be involved in local immune responses to such antigens. This may be
      especially relevant for those gamma delta T cell subpopulations that are
      preferentially found in the (intestinal) epithelia where exposure to bacterial
      superantigens is likely to occur.

PMID- 8467095
TI  - Staphylococcal superantigens as inducers of signal transduction in MHC class II
      positive cells.
AB  - Staphylococcal superantigens (SEs and TSST-1) interact with and potentially
      activate two of the main subsets of the immune system: T lymphocytes and MHC
      class II-positive cells. Since the interaction of SEs and TSST-1 with MHC class
      II molecules is the first step in triggering immune cells activation, a detailed
      understanding of the nature of this interaction is essential for understanding
      its effect on the immune system and for designing therapeutic strategies for SEs
      and TSST-1-mediated injury. A series of events is induced in MHC class II
      positive cells (B cells, activated T cells, monocytes, and synoviocytes) upon
      engagement with superantigens. Some of these events require monomeric forms of
      superantigens, whereas others are critically dependent on cross-linking of toxin
      bound MHC class II molecules by a biochemical agent (biotin-avidin) or a natural
      physiological one such as the TCR. The ability of superantigens to induce
      polyclonal activation of MHC class II-positive cells may confer to the
      superantigen its capacity to trigger autoimmune diseases.

PMID- 8467096
TI  - Not every superantigen induces tolerance in vivo.
AB  - We have distinguished TSST-1 from SEA and SEB with respect to its in vivo effect
      on T cells, that is, SEA and SEB induce tolerance in treated mice whereas
      injection of TSST-1 does not result in tolerance. Therefore, previous
      observations which relate superantigens to the suppression of reactive V beta TCR
      T cells seem difficult to generalize to all bacterial superantigens. Since the
      effects of superantigens are beginning to be exploited for immunotherapy, the
      differences between TSST-1 and SEB in terms of induction of tolerance suggest
      that all superantigens may not generally be useful in this respect. Each
      superantigen obviously should be studied in vivo in respect to T cell tolerance
      induction.

PMID- 8467097
TI  - Do superantigens play a role in autoimmunity?
AB  - Mycoplasma arthritidis produces a typical soluble superantigen (SAg) which shares
      many characteristics with bacterial toxins and Mouse Mammary Tumor Virus SAg.
      However, this microbe is associated with an autoimmune-like disorder and this
      disease may therefore serve as a model to investigate the potential role of a SAg
      in autoimmune disease pathogenesis.

PMID- 8467098
TI  - Expression of hornet genes encoding venom allergen antigen 5 in insects.
AB  - Antigen 5, also known as Dol m V, is a major allergen found in the venom of the
      baldfaced hornet, Dolichovespula maculata. We have inserted the f10 and f17
      cDNAs, which encode hornet antigen 5 (HA5) forms 2 (Dol m; VB) and 3 (Dol m VA),
      respectively, into the genome of the baculovirus, AcMNPV, to produce the
      recombinant baculovirus gene expression vectors, vEV-HA5f10 and vEV-HA5f17.
      Insect cells infected with either vEV-HA5f10 or vEV-HA5f17 produce and secrete a
      novel protein with an electrophoretic mobility which is similar if not identical
      to authentic mature Dol m V. The gene products also react specifically with a
      polyclonal antiserum raised to Dol m VB as expected. Dol m V gene products were
      not acutely toxic when injected into insect larvae. However, infection of fifth
      instar larvae with vEV-HA5f17 resulted in premature melanization of the larvae
      and lower weight gain than infection with control virus. Thus, the Dol m V gene
      product has a subtle, possibly cytotoxic or biochemical effect on insects. The
      expression systems may prove useful in further structural and functional
      characterization of these proteins.

PMID- 8467099
TI  - Development of recombinant viral insecticides by expression of an insect-specific
      toxin and insect-specific enzyme in nuclear polyhedrosis viruses.
AB  - As supplements to classical chemical insecticides, two approaches to develop
      recombinant baculovirus insecticides are described. In one approach an insect
      specific toxin is expressed leading to a dramatic reduction in time to death. In
      the second approach an insect juvenile hormone esterase is expressed which leads
      to a reduction in feeding. Modifications of the wildtype esterase led to viruses
      which reduced the time to death as effectively as did the toxin-expressing virus.
      In both cases existing recombinant viruses are viewed as leads, and approaches to
      further improvement in the engineered viruses are suggested. Many of these
      approaches are based on analogy with the development of classical synthetic
      insecticides. Using these viruses as examples, the potential utility and
      limitations of recombinant viruses and other biological insecticides are
      discussed.

PMID- 8467100
TI  - Delayed and enhanced biodegradation of soil-applied diphenamid, carbendazim, and
      aldicarb.
AB  - Recent studies have demonstrated that interaction between various agrochemicals
      and soil microorganisms may either slow down or enhance processes of degradation.
      Soil disinfestation is employed for the control of soil-borne pathogens and
      weeds. Soil application of such broad-spectrum biocides, as well as some more
      selective chemicals, has a strong effect on microbial activity, which may result
      in drastic reduction in the rate of degradation of pesticides applied to such
      treated soils. Application of pesticides to previously disinfested soils may
      extend their biological activity, which in the case of herbicides could cause
      phytotoxic damage to the next crop. In contrast, repeated application of the same
      or structurally related pesticides may result in a selective buildup of microbial
      populations capable of degrading the pesticide at much faster rates. Cases of
      accelerated degradation were reported for pesticides belonging to various
      chemical groups. Studies were conducted to evaluate the mechanisms of accelerated
      degradation. For several pesticides it has been shown that soil fungi are
      involved in their normal degradation, but not in their accelerated degradation.
      The shift in the rate of degradation of pesticides such as diphenamid, benomyl,
      and S-ethyl dipropylthiocarbamate, in soils that have acquired accelerated
      degradation, seems to be associated with the buildup of populations of bacterial
      degraders. Moreover, it has been shown that for the herbicide diphenamide,
      accelerated degradation is apparently linked to the induction of an oxidative
      demethylation process in soil bacteria, which might be analogous to the
      development of resistance in pests. Contrary to studies demonstrating accelerated
      degradation of the systemic insecticide aldicarb and accumulation of aldicarb
      sulfoxide in non-history soils, our work has shown that repeated application of
      this carbamate at several locations in Israel over a 10-year period did not
      induce accelerated degradation. It should be pointed out that in the Israeli
      soils there was only minimal formation of aldicarb sulfoxide. These studies were
      performed in soils with a pH ranging from 7.8 to 8.3, which is higher than the pH
      reported for soils where accelerated degradation was detected.

PMID- 8467101
TI  - Temperature rise in tumor tissue during high-dose-rate photoradiation.
AB  - The bioheat transfer equation and optical diffusion theory are used to develop a
      mathematical model for describing the thermal field in a spherical tumor and its
      surrounding normal tissue resulting from photoradiation. Analytical solutions to
      the model equations are presented for determining both the steady-state and
      transient temperature profiles. The effect of the optical and thermal properties
      of the surrounding normal tissue on the thermal field generated within the tumor
      is explored.

PMID- 8467102
TI  - Mathematical study of periodic breathing as an instability of the respiratory
      system.
AB  - A theoretical study of respiratory stability, based on a simple CO2 model of the
      respiratory system, investigates each component of respiration: the plant system
      and the central and peripheral controller systems. Analysis of the dynamic
      properties of the plant leads to a simplified respiratory model for the study of
      the influence of the central and peripheral controller components on stability.
      It is shown that the central component is not involved in respiratory instability
      phenomena such as periodic breathing whereas the peripheral component plays a
      major role. The explicit analytical index of stability obtained allows definition
      of the conditions of occurrence of periodic breathing in terms of the fundamental
      respiratory parameters. Moreover, this index can be used to evaluate the
      influence of various respiratory parameters on the stability of respiration.

PMID- 8467103
TI  - Mathematical description and computer simulation of retinal cometlike
      afterimages: a modified neural equation with stability analysis.
AB  - A mathematical model for the spatiotemporal description of a well-known
      psychophysical phenomenon, the cometlike afterimage effect (CLAIE), is presented.
      The CLAIE occurs when a bright circular light spot moves slowly in the peripheral
      human retina. Under these conditions, the leading edge of the dot looks circular,
      but the trailing edge becomes elongated like a comet's tail whose length
      increases with speed and luminance, and the illusion is more prominent for
      photopic backgrounds. This cometlike motion smear is described on the basis of
      the temporal responsiveness and adaptation of rods. The model is an extension of
      an existing neural model of M. N. Oguztoreli et al., with an additional term that
      allows prolonged saturation and long decay time following exposure to intense
      stimuli, and these effects are held responsible for the cometlike smear. The
      model predicts the response of photoreceptors through a nonlinear ordinary
      integrodifferential equation, which includes known biophysical terms for response
      dynamics, adaptation, saturation, and kinetics of intermediate components of the
      phototransduction process. The introduction of a saturation coefficient into the
      neural equation makes it possible to distinguish the different saturation
      thresholds of the rod-and-cone system. Numerical determination of the stationary
      solutions and complete linear stability analysis of the improved neural equation
      are given for a neuron of second order, and some computational results are
      presented for phase flows around different singular points in the phase field. A
      computer simulation based on the improved neural equation is presented for
      modeling the development and features of the CLAIE as a function of the speed and
      luminance of the stimulus and the background intensity. The computational results
      agree well with the psychophysical findings relating to the CLAIE.

PMID- 8467104
TI  - Complications of enteral feeding.

PMID- 8467105
TI  - Chronically increased vitamin intake and vitamin status of healthy men.
AB  - The effects of an 8-wk chronically increased vitamin intake on the biochemical
      parameters of vitamin status in 498 healthy men were estimated. A control group
      of 520 volunteers, given a placebo instead of vitamins, was also examined to
      control the changes that occur in biochemical vitamin supply parameters.
      Comparison of the measurements between the groups showed that plasma
      concentrations of folate, vitamin B12, and tocopherol; the urine concentrations
      of thiamine and riboflavin; and the activities of measured vitamin-related
      enzymes increased linearly and independently to the baseline vitamin status by
      the absolute value. Plasma concentrations of ascorbic acid, activity
      coefficients, and urinary excretion of 4-pyridoxic acid increased more in men
      with lower baseline values. The plasma retinol concentration did not change
      despite doubling the vitamin A intake.

PMID- 8467106
TI  - Glucose and fat utilization during intravenous administration of glucose and
      lipid emulsion in non-insulin-dependent diabetic patients.
AB  - To evaluate the clinical significance of substrate competition in the insulin
      resistant state, we measured glucose and lipid utilization in 10 non-insulin
      dependent diabetic patients during an isoglycemic hyperinsulinemic (approximately
      75 and approximately 1500 mU/L) clamp without and with the concomitant infusion
      of Intralipid (0.15 g triglycerides.kg-1 x h-1) and during Intralipid infusion
      only in combination with indirect calorimetry. We found that a lipid emulsion
      does not alter the metabolic clearance rates of glucose at insulinemias of
      approximately 75 mU/L (5.58 +/- 2.56 vs. 6.03 +/- 2.43 ml.kg-1 x min-1) and
      approximately 1500 mU/L (13.55 +/- 3.17 vs. 13.75 +/- 4.36 ml.kg-1 x min-1) and
      it does not change oxidative and nonoxidative glucose disposal rates. Insulin and
      glucose attenuate the Intralipid-induced increase in serum triglycerides, free
      fatty acids, and lipid oxidation. We conclude that, whereas Intralipid infused at
      a standard rate does not decrease glucose utilization under hyperinsulinemic
      conditions, its own removal from the plasma is enhanced by glucose and insulin in
      non-insulin-dependent diabetic patients.

PMID- 8467107
TI  - Long-term serum lipid lowering, behavior modification, and weight loss in obese
      women.
AB  - Reduced calorie intake, changes in the composition of foods ingested, and
      increased physical activity are the usual initial recommended therapies for the
      obesity that often accompanies hypercholesterolemia and other hyperlipidemias.
      Collectively resulting in weight loss, these behavioral changes are known to
      produce short-term (< or = 7- to 9-mo) reductions in serum cholesterol and other
      lipids. In contrast, previous long-term (> or = 1-yr) investigations fail to
      disclose a cholesterol-lowering effect of weight loss, although the subjects in
      these studies were not hypercholesterolemic. The aim of our investigation was to
      examine the long-term changes in serum lipids that occurred in a representative
      cohort of healthy obese (n = 45, body mass index mean +/- SD 39.0 +/- 8.6 kg/m2)
      women after they completed a 15-wk conventional behavior-modification program.
      The serum cholesterol level of this cohort was elevated at baseline (6.18 +/-
      1.41 mM, > or = 75th percentile). At the time of follow-up (17.0 +/- 7.0 mo),
      there were significant decreases in body weight (-16.7 kg, p < 0.001) and
      reductions in serum total (-0.53 mM, p < 0.01) and low-density lipoprotein (-0.35
      mM, p < 0.05) cholesterol. Serum triglyceride levels also decreased significantly
      (-0.38 mM, p < 0.001), and serum high-density lipoprotein levels remained
      unchanged; the ratio of high-density lipoprotein total cholesterol increased
      significantly (p < 0.05) relative to baseline levels. Multiple stepwise
      regression analysis indicated that the best predictor of percentage change in
      each respective lipid was its own baseline level.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8467108
TI  - Parenteral nutrition in hyperemesis gravidarum.
AB  - Hyperemesis gravidarum (HG) is a clinical condition that threatens fetal
      viability and even the mother's life when the severity of symptoms almost
      completely prevents the intake of food. Parenteral nutrition (PN) is a possible
      alternative. We present eight patients with HG. There were 10 PN treatments
      because two of the patients required the treatment twice. There were 9 central
      venous and 1 peripheral treatment delivery. The average age of the patients was
      27.5 yr. Gestational ages varied from 8 to 19 wk. PN treatments were formulated
      as amino acid and glucose solutions (fat emulsions in 2 of the 8 cases) blended
      with vitamins and electrolytes. These treatments lasted 5-16 days. Before PN
      deliveries were initiated, five of the patients presented some degree of protein
      calorie and/or visceral protein malnutrition. All of them showed minor liver
      dysfunction, which did not change during PN. Newborns were term deliveries,
      except for one case of missed abortion. Results show that PN constitutes a
      therapeutic alternative in cases of HG that do not respond to the standard
      treatment of parenteral hydration and antiemetics. In fact, symptoms disappear
      promptly, and no significant complications arise.

PMID- 8467109
TI  - Substrate supply as determinant of O2 extraction in sepsis and nonseptic trauma.
AB  - Metabolic and hemodynamic measurements performed in 72 septic (S) and 40
      nonseptic (NS) surgical patients undergoing total parenteral nutrition were
      analyzed to assess the role of substrate supply as a determinant of O2 extraction
      (O2Ex). In S, O2Ex was inversely related to cardiac index (CI); at any given CI,
      significant increases in O2Ex with simultaneous increases in O2 consumption (VO2)
      were related to increasing doses of amino acids, with a less remarkable effect of
      fat and no effect of glucose dose. In NS, O2Ex was also inversely related to CI;
      however, at any given CI, there was no evident substrate-supply dependency of
      O2Ex, which was more normally related to P50. The increase in VO2 per gram of
      administered amino acids, at any CI and O2 transport index, was 817 ml in S and
      267 ml in NS. These results suggest that the impaired O2Ex and VO2 in S may at
      least partly reflect abnormalities in substrate utilization and that amino acid
      support may have a role in modulating these abnormal O2Ex patterns by providing
      preferential substrate for oxidative metabolism.

PMID- 8467110
TI  - Amino acid imbalance and intracellular protein synthesis.
AB  - The effects of amino acid imbalance, created by decreasing the concentrations of
      specific amino acids in culture media, on intracellular protein synthesis were
      compared with the findings obtained by restricting all amino acids. Protein
      synthesis levels were estimated by measuring the uptake rates of 14C-labeled
      amino acids by cultured rat hepatoma AH109A cells. The inhibitory activity of a
      0.1-fold dilution of valine in DM-160 medium was higher than that resulting from
      the dilution of all amino acids by 0.1-fold. On the other hand, the dilution of
      other essential amino acids was not as effective as the dilution of all amino
      acids, whereas the concurrent dilution of valine and leucine was found to be
      equivalent in effectiveness to the latter. Protein-synthesis levels in 0.3, 0.1,
      0.03, and 0.01 mM valine were maximum at 0.9, 0.3, 0.09, and 0.03 mM leucine,
      respectively. Valine transport into the cell was found to be inversely
      proportional to the extracellular leucine concentration. DL-Norvaline and DL
      norleucine were not effective. Valine-leucine interactions were suggested to be
      involved in intracellular protein synthesis.

PMID- 8467111
TI  - Nutrition behavior of malnourished HIV-infected patients and intensified oral
      nutritional intervention.
AB  - Malnutrition and cachexia are characteristic symptoms of human immunodeficiency
      virus (HIV)-1 infection and AIDS. To identify risk situations that might affect
      nutritional behavior and status and to evaluate the therapeutic effect of an
      intensified oral nutritional intervention, we analyzed 81 consecutively treated
      homosexual HIV-infected outpatients with malnutrition retrospectively and could
      follow the outcome of a nutritional intervention prospectively in 54 of them.
      Nutritional therapy was ineffective for only 5 of the 54 patients; constant
      weight loss could be stopped in 31 of the patients, and 18 patients could even
      gain weight. We suggest intensified oral nutritional intervention should be an
      integral part of the treatment of HIV-infected patients to prevent or treat
      malnutrition.

PMID- 8467112
TI  - Nutrition management in acute renal failure.
AB  - A case report is presented in which a man developed acute renal failure after a
      surgical misadventure. The initial management, postoperative course with the
      manifestation of acute tubular necrosis with oliguria and its physiological
      sequelae, nutrition management in the context of the overall treatment, hospital
      course, and patient's disease are discussed in detail. The rationale for giving
      nutrition support, the general considerations for providing nutrients, and the
      specific nutrition considerations as they pertain to the patient under discussion
      are outlined to provide a comprehensive guide and overview of the nutrition
      management of a patient with acute renal failure.

PMID- 8467113
TI  - Carbohydrate metabolism and requirements for nutritional support: Part I.

PMID- 8467114
TI  - Can O2-extraction pattern be altered in sepsis by substrate availability?

PMID- 8467115
TI  - Dietary L-lysine supplementation: a promising nutritional tool in the prophylaxis
      and treatment of osteoporosis.

PMID- 8467116
TI  - Is normal normal?

PMID- 8467117
TI  - Classic human vitamin C depletion experiments: homeostasis and requirement for
      vitamin C.

PMID- 8467118
TI  - Metabolism of ascorbic-1-14C acid in experimental human scurvy. 1969.

PMID- 8467119
TI  - PUFA 1992. Fifth Scientific Meeting of the Society for Research on
      Polyunsaturated Fatty Acids. November 11-14, 1992, Tokyo, Japan. Abstracts.

PMID- 8467120
TI  - [Sentinel practice data quality. Denominator concepts, spatial and temporal
      frequency patterns. Special issue following the "1st Sentinel-Workshop Hannover"
      on 29 April 1992].

PMID- 8467121
TI  - [Data quality in the MORBUS Sentinel Project--expiratory wheezing in infants].
AB  - Since 1991 the MORBUS project is being conducted to establish and run a sentinel
      network of 100 general and paediatric practices in three regions of Germany. A
      number of health conditions have been and will be monitored consecutively with
      special emphasis on environmentally determined health problems. From March to
      June, 1991, 1054 contacts of 1- and 2-year-old children with expiratory wheezing
      were reported. Quality of these event data was assessed by means of internal
      completeness. Important clinical information was missing in about 10% of all
      cases without evidence for regional differentiations. Data quality by this
      criterion was better in first contact than in re-contact cases (9.7% vs 18.1%
      missing). Questions concerning the parents (allergies, smoking, education) were
      less frequently answered (up to 24% missing) than questions of obvious medical
      relevance to the child. Completeness of parental information varied considerably
      between regions. There was no association between the medical specialty of the
      doctors and the quality of their data. In a longitudinal view, there was a
      slightly positive trend over time in the proportion of clinically incomplete case
      reports at borderline statistical significance (p = 0.057). Apart from these
      minor findings then, there was an overall good consistency of completeness in the
      MORBUS data on expiratory wheezing. By optimizing questionnaires and data
      transmission, it should be possible to increase the data quality even further.

PMID- 8467122
TI  - Numerators and denominators of rates estimated on the basis of physicians'
      practice data.
AB  - The paper discusses selected methodological aspects of numerators and
      denominators derived from medical practice observations. The estimation of rates
      (of incidence or prevalence) on the basis of primary care practice data is apt to
      be influenced by several methodological factors. These are: morbidity of the
      local population, physician workload and expertise, diagnosis coding rules, and
      patient visiting behavior (Anderson, 1984). These factors tend to have an impact
      on the numerator. Vis-a-vis the lack of appropriate population denominators of
      single practices, the question is whether rate estimates may be developed for fee
      for-service systems without population registration of persons with medical
      practices and which use these rates may be put to.

PMID- 8467123
TI  - Quality of care in general practice and a fixed denominator.
AB  - The NHG, the college of general practitioners in the Netherlands, has developed a
      national programme of standard setting in which 25 standards have been published
      since 1989 on quite different subjects. Its ultimate goal is to improve the
      quality of care in general practice. Both health insurance companies and
      governmental organizations are very interested in all the aspects of quality
      assurance and assessment allied with the programme. The fixed denominator for
      general practice in the Dutch health care system is of essential value with
      regard to the selection of topics to be standardized, the evaluation of the
      programme and the investigations into the consequences of the introduction of
      standards. Its role is demonstrated and discussed as a modal example.

PMID- 8467124
TI  - [Estimating the denominator of a sentinel practice using accounting data of the
      federal physicians association].
AB  - In order to interpret the regional and temporal variation in the number of cases
      reported for sentinel topics, rates have to be calculated which relate these
      figures to a common denominator. For this denominator different definitions are
      possible, where this paper focuses on the contact denominator, counting all
      contacts between the patient and the doctor in a specified period of time and a
      specified population (i.e. children between 2 and 3 years of age by sex for the
      first MORBUS topic). One patient may produce different contacts. Due to work load
      considerations contact denominators could not be directly recorded in sentinel
      practices in the MORBUS-project. A method was developed which combined minimal
      denominator information obtained from sentinel practices with routine
      (accounting) data from the doctor's associations, in order to estimate
      denominators with a high degree of precision. Data elements in the accounting
      data base include number of personal patient-doctor-contacts by type of treatment
      (screening/cure/emergency/referral) and insurance status (ordinary member, family
      member, retired) itemized list of actions that were reimbursed through the
      insurance company structural data about the doctor/practice (specialty,
      accreditation date) etc. For a first assessment of the degree of accuracy with
      which denominators can be estimated by such data, a pilot test was scheduled for
      April 1991. Doctors recorded the number of contacts with children between two and
      three years of age (by sex) for one week on a simple checklist. A linear model
      which included specialty, region, number of vouchers per quarter, number of
      infant health assessments and date of accreditation as predictors, was fitted to
      the data.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467125
TI  - Validation of sentinel data.
AB  - The Dutch Sentinel Practice Network, "de Peilstations" started in 1970. The
      purpose of this network is to gain a better insight into the epidemiology of a
      number of illnesses and conditions as they are presented to the general
      practitioner. The network is sponsored by the Ministry of Welfare, Public Health
      and Culture. Value was attached to the distribution of the spotter physicians
      over the country and by degree of urbanisation. The presence of 1% of the
      population of the four provinces groups and the three urbanisation groups has
      been observed in the practices of the spotter physicians. The completeness of the
      registration, the internal and the external validity of the data collected by the
      physicians are discussed.

PMID- 8467126
TI  - [A method for determining the denominator in general practice--results of a pilot
      study].
AB  - In countries with fee for service billing and direct access to specialist care
      the general practitioner does not know key figures of the population he serves.
      As the role of general practice in health-service-research, quality assurance
      activities and the construction of sentinel-networks is becoming more important,
      valid methods to determine the denominator are needed. Results from five
      practices suggest that yearly contact groups should be used as a common
      denominator for general practice in our health care system. For certain groups of
      patients (e. g. the elderly > 60 yrs.) even quarterly contact groups can give
      sufficient information to forecast the yearly contact group.

PMID- 8467127
TI  - [Incidence of findings in pediatric sentinel practices: the Hamburg-Harburg pilot
      project].
AB  - In a one year pilot project in Hamburg, the feasibility of a sentinel practice
      system was tested by paediatricians and the health officials. The items to be
      documented were four symptoms of possible allergic pathogenesis. The mean of
      contacts per practice and week was 42 for rhinitis, 9 for wheeze, 8 for acute
      conjunctivitis and 4 for urticaria. Rhinitis, conjunctivitis and wheeze showed
      clear seasonal trends, but also shortterm peaks running against the seasonal
      trends were detectable. Seasonal covariations between symptoms and environmental
      parameters were strongest between wheeze, temperature and sulfur dioxide
      concentration of the air. But only a part of the wheeze-peaks followed peaks of
      temperature or sulfur dioxide. The implications of the feasibility study results
      for a long-term sentinel system in Hamburg are discussed.

PMID- 8467128
TI  - [Asthma attacks in general practice--epidemiologic markers and seasonal patterns
      in longitudinal observation].
AB  - The continuous registration of asthmatic attacks by the Swiss Sentinel Network
      "Sentinella" since November 1988 has been preceded by a pilot study which tested
      the methods of data collection and analysis. The original aim was (a) to use the
      incidence of asthmatic attacks as a possible indicator for the adverse effects of
      rising concentrations of air pollutants, and (b) to create a set of baseline data
      for future research in this field, i.e. data of asthmatic attacks for
      retrospective analysis of periods with increased levels of air pollution. Here,
      morbidity characteristics and seasonal patterns of asthmatic attacks as
      registered from November 1988 to May 1991, will be presented only. With regard to
      age and sex the data show that more than half of all asthmatic attacks occurred
      in children 0-14 years of age. Males outweigh females by roughly two to one, but
      the distribution becomes more even after adolescence. These results are in
      accordance with the literature (Table 1). Whereas hospital beds
      (hospitalisations) are occupied by a growing number of patients suffering from
      asthma, especially in children hospitals, the referral rate of children with
      asthmatic attacks by primary car physicians has remained relatively steady over
      the past three years (Table 2). Thus, it can be inferred that asthma, while a
      major problem in the hospital, is dealt with successfully by practitioners in the
      primary care setting. This is to the contrary of international trends which show
      an increasing referral rate for asthma. A differential analysis of workload from
      asthmatic attacks for general practitioners, internists and paediatricians is
      directing toward a rising incidence of asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467129
TI  - [The European study for counseling in HIV antibody testing in general practice:
      results of the German project section].
AB  - General practitioners play an important role in counselling for HIV-Tests. There
      is little known yet about the background of the decision process which results in
      doing the HIV-test. The EUROSENTINEL-study on requests for HIV-testing started in
      1990 and is in the meanwhile carried out in 7 sentinel-networks in six european
      countries. In the beginning of 1991 the german part started in 36 practices in
      the north of Hessia. In the first year of the study these 36 practices recorded
      327 consultations about HIV-testing. The initiative to counsel was taken in 64.2%
      by the patient and in 35.8% by the doctor. In male patients the main reasons for
      the consultation were heterosexual contacts and administrative or legal reasons.
      In female patients it were fear of HIV-infection without any risk and
      professional exposure. In 86.2% of patients the consultation was followed by a
      HIV-test. Seven Tests (2.5%) were positive. All HIV-positive patients belonged to
      the classical risk groups. The results are discussed in comparison to those of
      other european networks. It can be concluded that general practitioners play an
      important role in primary prevention of HIV-infection and in counselling people
      who are worried by the AIDS epidemic.

PMID- 8467130
TI  - Organochlorine pesticide residues in black tea, camomile, and linden.

PMID- 8467131
TI  - Microbial abundance and degradation of polycyclic aromatic hydrocarbons in soil.

PMID- 8467132
TI  - Movement of pendimethalin in soil of the south of France.

PMID- 8467133
TI  - Degradation of 14C-glyphosate in Saskatchewan soils.

PMID- 8467134
TI  - Biodegradation of liquid and microencapsulated formulations of alachlor in a clay
      loam soil.

PMID- 8467135
TI  - Chromium, copper, and zinc concentrations in edible vegetables grown in Tarragona
      Province, Spain.

PMID- 8467136
TI  - Biodegradation of anthraquinone dyes by Bacillus subtilis.

PMID- 8467137
TI  - Phthalate esters as potential contaminants during GC analysis of environmental
      samples using electron capture and mass spectrometric detectors.

PMID- 8467138
TI  - Influence of lead on pregnant women in metropolitan Mexico City.

PMID- 8467140
TI  - Cadmium, lead, and zinc concentrations in human fingernails.

PMID- 8467139
TI  - Organochlorine insecticide residues in human breast milk: a survey of lactating
      mothers from a remote area in Papua New Guinea.

PMID- 8467141
TI  - Effect of 2-thiotriazone (TTZ) on hepatic and pulmonary glutathione (GSH)
      concentrations in rats.

PMID- 8467142
TI  - Effects of environmental cadmium pollution in fattening of veal calves.

PMID- 8467143
TI  - Effect of alachlor on the urinary excretion of malondialdehyde, formaldehyde,
      acetaldehyde, and acetone by rats.

PMID- 8467144
TI  - Bioaccumulation and elimination of endosulfan in the fish yellow tetra
      (Hyphessobrycon bifasciatus).

PMID- 8467145
TI  - Bioconcentration and excretion of diazinon by eel.

PMID- 8467146
TI  - Plasma sorbitol dehydrogenase, glutamate dehydrogenase, and alkaline phosphatase
      as potential indicators of liver intoxication in grey mullet (Mugil auratus
      Risso).

PMID- 8467147
TI  - Variable sensitivity of Cyprinus carpio eggs, larvae, and fry to pesticides.

PMID- 8467148
TI  - Effect of copper on the growth of Anacystis nidulans.

PMID- 8467149
TI  - Stage-dependent susceptibility of Bufo arenarum embryos to cadmium.

PMID- 8467150
TI  - Mercury concentrations of walleye (Stizostedion vitreum vitreum) in 34 northern
      Wisconsin lakes.

PMID- 8467152
TI  - Metal concentrations in American lobster and channeled whelk from two dredge
      spoil dump sites in Long Island Sound.

PMID- 8467151
TI  - Heavy metals and polycyclic aromatic hydrocarbons (PAH's) in marine organisms
      from the Ionian Sea (Italy).

PMID- 8467153
TI  - Changes in the blood endotoxin concentration after digestive surgery.
AB  - Blood endotoxin concentrations measured in 57 patients with digestive disorders
      pre- and postoperatively, were found to peak one day after surgery, then
      gradually return to the preoperative level. The plasma endotoxin concentration
      was not significantly different in patients with and without liver cirrhosis
      before surgery, but was significantly higher in the cirrhosis group one day after
      surgery. The preoperative endotoxin concentration did not correlate with the
      white blood count (WBC), platelet count, or routine biochemical liver function
      tests, however, a significant negative correlation was observed between the
      plasma endotoxin and fibronectin concentrations. The ability of plasma to
      inactivate endotoxin was quantified by serial measurements of the endotoxin
      concentration following the addition of a known quantity to each patient's
      plasma. The plasma from normal subjects quickly inactivated endotoxin, but
      inactivation was decreased in the plasma from patients with liver failure.

PMID- 8467154
TI  - Thoracic endoscopic T2-T3 sympathectomy in palmar hyperhidrosis: experience of
      112 cases.
AB  - Palmar hyperhidrosis is a troublesome and embarrassing disorder that causes
      professional, psychological, and social handicaps. Its etiology is unknown,
      although surgical treatment by thoracic sympathectomy is presently believed to be
      the best method of cure. Up to now, numerous methods of sympathectomy, including
      open thoracotomy, as well as posterior and supraclavicular approaches have been
      described. We favor endoscopy at this time due to both its simplicity and its
      resultant short hospital stay. During the period between March 1988 and October
      1990, 112 patients (55 males, 57 females) suffering from palmar hyperhidrosis
      underwent 222 thoracoscopic T2-T3 sympathectomies under general anesthesia in our
      department. The remaining 2 hands had a second operation of unilateral open
      thoracotomy due to pleural adhesion. The patients' ages ranged from 15 to 45
      years. A total of 220 hands became dry while the others showed improvements.
      There were 5 patients who required unilateral chest tube insertion, 2 for post
      thoracotomy drainage and 3 for intrathoracic hemorrhage after thoracoscopic
      pneumonolysis. The average operative time (bilateral) was 30.8 min and hospital
      stay was 2.87 days. Compensatory hyperhidrosis was the major complication. There
      was no mortality. We therefore consider thoracoscopic sympathectomy to be a
      simple, safe, and effective method for treating palmar hyperhidrosis.

PMID- 8467155
TI  - Sequential bypass for multisegmental occlusive disease.
AB  - We evaluated the effectiveness of a sequential bypass for multisegmental
      occlusive disease. Forty-seven multiple bypass grafts were performed on 43
      patients ranging in age from 55 to 83 years (mean: 70 years). The indications for
      operation included incapacitating claudication in 20 limbs, resting pain in 15,
      and nonhealing ulcers in 12. An anatomical arterial bypass was performed on 36
      limbs, consisting of an aorto-femoro-popliteal bypass in 21 limbs, a femoro
      popliteal-posterior tibial bypass in 8, an ilio-femoro-popliteal bypass in 4, an
      ilio-femoro-posterior tibial bypass in 2, and a femoro-popliteal-plantar bypass
      in 1. Similarly, an extra-anatomical arterial bypass was performed on 11 limbs,
      consisting of an axillo-femoro-popliteal bypass in 6, a crossover femoro-femoro
      popliteal bypass in 3, an axillo-femoro-posterior tibial bypass in 1, and a
      crossover femoro-femoro-anterior tibial bypass in 1. The follow-up period ranged
      from 3 to 77 months (mean: 23 months). Twelve graft failures occurred, and 2 of
      them required major amputations. The cumulative graft patency rate was 85% at one
      year and 65% at 3 years. Arterial Doppler examination revealed a mean
      preoperative ankle-brachial index of 0.29 +/- 0.25. The early and late mean
      postoperative ankle-brachial indices, however, increased to 0.97 +/- 0.19 and
      0.84 +/- 0.25, respectively. Midterm results have indicated that such multiple
      sequential bypass grafts are effective.

PMID- 8467156
TI  - Comparison of postoperative results following terminal esophagoproximal
      gastrectomy and esophageal transection for esophageal varices.
AB  - The results of 44 terminal esophagoproximal gastrectomies (TEPG) and 53
      esophageal transections (ET) for esophageal varices, performed during the period
      between January, 1975 and March, 1989, were retrospectively compared. The results
      examined prognosis, recurrence of esophageal varices and late postoperative
      complications. The 5-year survival rates for patients who underwent selective or
      prophylactic surgery were 85.9% following TEPG and 81.6% following ET. However,
      the 10-year survival rate for the former group was significantly lower than that
      for the latter group at 59.3% versus 70.0% (P < 0.05) because of the number of
      deaths due to hemorrhage and liver failure caused by anastomotic ulcers. The
      respective 5-year recurrence rates of varices for the TEPG and ET groups were
      18.4% and 26.4%, respectively, while the 10-year recurrence rate for the former
      group was again significantly lower than that for the latter group at 27.1%
      versus 53.7% (P < 0.01). As for postoperative late complications, reflux
      esophagitis and/or anastomotic ulcers were found twice as frequently after TEPG
      as after ET. Thus, although TEPG was more effective for preventing variceal
      recurrence it left the potential for an anastomotic ulcer to develop, which was
      the dominant cause of death more than 5 years after surgery.

PMID- 8467157
TI  - Extra-anatomic bypass for aorto-iliac occlusive disease in octogenarians.
AB  - Fifteen patients over 80 years of age with aorto-iliac occlusive disease (AIOD)
      underwent surgical revascularization of an ischemic lower extremity by extra
      anatomic bypasses. The mean age at operation was 81.7 years, ranging from 80 to
      86 years. Surgical revascularization of the ischemic lower limbs could safely be
      performed with an extra-anatomic bypass in these patients without any major
      complications. The mean follow-up period was 32.7 months. Eight patients died
      during the follow-up, only one of them died from myo-nephropathic metabolic
      syndrome related to acute graft occlusion. As a long-term result, the cumulative
      survival after 37 months was only 23.9%, while the actual graft patency rate was
      43.8% after 60 months in this series. The survival period with an improved
      quality of life after surgical intervention reached a level of approximately 40%
      of that for the general population. There should be no hesitation over whether to
      carry out surgical intervention for AIOD in patients over 80 years of age,
      because a reasonable extension of life can be obtained by an extra-anatomic
      bypass.

PMID- 8467158
TI  - Effect of lentinan on lymphocyte subsets of peripheral blood, lymph nodes, and
      tumor tissues in patients with gastric cancer.
AB  - The effect of lentinan on lymphocyte subsets of peripheral blood, lymph nodes,
      and tumor tissues in gastric cancer patients was investigated. A 2-mg dose of
      lentinan was administered to 12 patients intravenously twice, the first at 3-9
      days before and the second the day before surgery. The results were then compared
      with a control group without lentinan administration comprising 12 patients.
      Regarding peripheral blood and lymph nodes without metastasis, lymphocyte subsets
      defined with anti-CD3, anti-CD4, anti-CD8, anti-Leu7, and anti-Leu11 were
      analyzed by flow-cytometry. As for tumor tissues, lymphocyte subsets defined with
      anti-CD3, anti-CD4, anti-CD8, anti-Leu11, and anti-M3 were analyzed after
      immunohistochemical staining. There were no significant changes in the lymphocyte
      subsets of peripheral blood between the two groups. In the lymph nodes, the CD4
      cell ratios increased; otherwise in regard to tumor-infiltrating lymphocytes
      (TILs), the number of CD4, Leu11 and LeuM3 cells showed a prominent increase.
      Therefore, lentinan was observed to produce different effects in accordance with
      the subjective organs.

PMID- 8467159
TI  - Rat liver peroxisomal and mitochondrial fatty acid oxidation in sepsis.
AB  - Time course changes in hepatic mitochondrial and peroxisomal fatty acid oxidative
      capacities, as well as changes in the related enzyme activities, were
      investigated in rats with sepsis induced by cecal ligation and puncture.
      Palmitoyl-L-carnitine oxidation was not altered, but carnitine palmitoyl
      transferase (CPT) dependent palmitoyl-CoA (plus L-carnitine) oxidation was
      slightly increased in the liver mitochondria of the septic rats. Hepatic CPT
      activity, being the rate-limiting step of mitochondrial beta-oxidation, was also
      enhanced by sepsis. In contrast, cyanide-insensitive peroxisomal beta-oxidation
      and the carnitine acetyltransferase and catalase activities associated with the
      peroxisomal-enriched fraction were markedly reduced by abdominal sepsis. Cyanide
      insensitive beta-oxidation in control livers showed optimal specificity for
      lauroyl- and myristoyl-CoA and this pattern remained unchanged by sepsis.
      However, oxidation rates were reduced for all acyl-CoA esters tested, being more
      pronounced with longer carbon chain length acyl-CoA substrates. These results
      indicate that in early sepsis, hepatic mitochondrial fatty acid oxidative
      capacity was increased, probably due to enhanced CPT activity, whereas
      peroxisomal beta-oxidation was seriously disturbed along with reduced catalase
      activity.

PMID- 8467160
TI  - Aberrant retrotracheal goiter: report of a case.
AB  - A case of intrathoracic retrotracheal goiter in a 40-year-old woman is herein
      described. A computed tomographic scan, magnetic resonance imaging and
      endoscopical ultrasonography all confirmed the existence of a retrotracheal
      encapsulated lesion, which was suspected to be aberrant mediastinal goiter.
      Radioiodine scintigraphy, however, demonstrated little uptake in the mass. A
      large (7 x 6 x 4 cm), encapsulated adenomatous goiter was then easily removed via
      a right thoracic approach.

PMID- 8467161
TI  - A case of renal cell carcinoma with metastasis to the thyroid gland and
      concomitant early gastric cancer.
AB  - Metastatic lesions from renal cell carcinoma are commonly recognized in the lung
      and bone, however, thyroid metastasis has rarely been reported in the literature.
      We present herein a case of a man with lung and thyroid metastatic tumors from
      renal cell carcinoma. Although making a preoperative diagnosis of thyroid
      metastasis is difficult because there is no established diagnostic criteria, we
      were able to identify this thyroid lesion as a metastatic tumor from renal cell
      carcinoma by the pathological findings. Interestingly, hypercalcemia was
      recognized in this patient whose serum parathyroid hormone (PTH) level was not
      increased. Moreover, this patient also had early gastric cancer simultaneously,
      being a so-called 'double cancer'. After surgical resection of the right kidney
      and stomach, interferon was administered without any efficacy against the
      metastatic lesions of the lung and thyroid gland.

PMID- 8467162
TI  - A case of bilateral obturator hernias: image diagnosis and description of a
      retropubic operative approach.
AB  - A case of bilateral obturator hernias which was diagnosed by ultrasonography (US)
      and computed tomography (CT), and repaired by a retropubic extraperitoneal
      operative approach under spinal anesthesia is reported herein. A 91-year-old
      woman presented with lower abdominal and left groin pain consistent with a
      Howship-Romberg sign. US demonstrated an image of the bowel projecting from the
      small pelvic space to the left thigh with a to-and-fro movement of the bowel
      contents. The definitive diagnosis of an incarcerated left obturator hernia was
      made by CT which also revealed a mass in the right obturator foramen. Surgery was
      performed through a retropubic extraperitoneal approach under spinal anesthesia.
      No necrosis was observed in the incarcerated bowel and resection was not
      necessary. A simple hernial sac was found in the right obturator canal. The
      operation using the retropubic extraperitoneal approach was successful and we
      believe it to be the most effective procedure for obturator hernias which have
      been diagnosed early.

PMID- 8467163
TI  - The solitary cutaneous metastasis of asymptomatic colon cancer to an operative
      scar.
AB  - Although umbilical or cutaneous metastases from asymptomatic internal
      malignancies are occasionally documented, the literature contains no report of a
      solitary cutaneous metastasis to an old operative scar from an asymptomatic
      internal malignancy. A rare case of colonic cancer presenting as a solitary
      subcutaneous metastasis to a lower abdominal scar resulting from an open
      prostatectomy is described in this communication. It was impossible to
      distinguish this subcutaneous metastasis from a pyogenic granuloma caused by
      residual sutures without histological evidence. Thus, a granuloma that persists
      despite repeated treatment may be a possible sign of asymptomatic internal
      malignancy.

PMID- 8467164
TI  - Case report of an anomalous arrangement of the pancreaticobiliary ducts and
      nuclear DNA ploidy analysis.
AB  - Two cases with an anomalous arrangement of the pancreaticobiliary ducts (APBD)
      are reported in order to investigate the mechanism of carcinogenesis of the
      extrahepatic biliary tract from the aspect of DNA ploidy analysis. Highly
      elevated biliary enzymes were found in both cases. Although inflammatory changes
      without any metaplasia or neoplasia were observed histologically, a
      cytofluorometric nuclear DNA ploidy analysis showed an aneuploid low ploidy
      pattern in a histogram of the gall bladder, an aneuploid high ploidy pattern in a
      histogram of the common bile duct in one patient, and a diploidy pattern in the
      gall bladder, an aneuploid low pattern in the common bile duct in another case.
      These results may show that APBD may play a role in the development in DNA ploidy
      abnormality with refluxed pancreatic juice which may induce repeated irritation
      and inflammation. Radical surgery including a complete excision of the
      extrahepatic biliary tract followed by reconstruction may achieve better results
      with regard to undesirable consequences with an abnormal nuclear DNA ploidy
      pattern and decrease the likelihood of developing carcinoma.

PMID- 8467165
TI  - Portal vein calcification: a clinical review of the last 50 years and report of a
      case associated with dysplasminogenemia.
AB  - We report herein a case of a 68-year-old Japanese woman in whom calcification of
      the portal vein was recognized by plain abdominal X-ray radiograph and computed
      tomography (CT) scan when she presented with repeated thrombosis of the portal
      system. Following emergency small bowel resection for intestinal necrosis caused
      by superior mesenteric vein thrombosis, hematological studies revealed the
      association of dysplasminogenemia. A review of 21 cases of portal vein
      calcification reported between 1940 and 1990 revealed the average age to be 53.7
      +/- 10.2 years and the male/female ratio 17:4. Although the majority of cases
      suffered from portal hypertension (81%), only 38% had any evidence of liver
      cirrhosis, while 52% had normal liver function, being comparable to idiopathic
      portal hypertension. The calcified lesions were located in the portal vein in
      100% of cases, the splenic vein in 62%, the superior mesenteric vein in 33%, and
      the inferior mesenteric vein in 0%. The precise etiology of the calcification was
      not elucidated in any of the reviewed cases. The patient reported herein is the
      first reported case of portal vein calcification due to repeated thrombosis of
      the portal system caused by dysplasminogenemia, which could be accounted as a
      cause of idiopathic portal hypertension.

PMID- 8467166
TI  - The coexistence of abdominal aortic aneurysm and early gastric cancer: report of
      three cases.
AB  - The surgical approach for patients with abdominal aortic aneurysm (AAA) and
      coexistent abdominal malignancy remains controversial. We report herein three
      cases of coincident AAA and early gastric cancer, all of whom were treated by a
      two-stage operation and underwent curative surgery for their gastric cancer. The
      principles of our surgical approach are as follows: (1) the lesion which requires
      urgent surgery should be operated on first, and if both lesions show absolute
      indications, a one-stage surgical procedure should then be performed; (2) a two
      stage surgical procedure in which aneurysmectomy is performed first should be
      undertaken when no absolute indications for urgent surgery exist for either
      lesion; (3) a one-stage surgical procedure should only be performed when surgery
      on one lesion makes the other lesion highly dangerous; and (4) in patients with a
      poor prognosis because of far advanced cancer in whom the AAA shows no sign of
      rupturing, only a gastrectomy should be performed.

PMID- 8467167
TI  - Patients with multiple primary gastric cancers tend to develop second primaries
      in organs other than the stomach.
AB  - The multiple occurrence of a single cancer tends to result in the increased
      vulnerability of some other organs to another malignancy. In the present study,
      we examined a total of 1,606 patients with gastric cancer to ascertain whether
      the frequency of second primaries in organs other than the stomach is higher in
      patients with multiple gastric cancers than in those with a single gastric
      cancer. Primary cancers of other organs were present in 87 (5.9%) of 1,474
      patients with single gastric cancer and in 16 (12.1%) of 132 patients with
      multiple gastric cancers. The difference was statistically significant. The most
      frequent site of the occurrence of a second primary was the colo-rectum, followed
      by the urogenital organs, uterus, breast, and lung in descending order of
      frequency. We therefore assume that the occurrence of multiple cancers in the
      stomach is not merely a chance phenomenon but is related to both genetic
      predisposition and environmental factors.

PMID- 8467168
TI  - The usefulness of postoperative continuous epidural morphine in abdominal
      surgery.
AB  - The influence of continuous epidural morphine on the recovery course of
      intestinal activity, urinary function, and ambulation after surgery was studied
      in 40 patients who underwent either gastrectomy for gastric cancer or
      cholecystectomy for cholelithiasis. Compared with a control group of patients
      whose postoperative pain was managed by pentazocine or hydroxyzine as before, the
      length of time before passing flatus or faeces was significantly shortened in the
      morphine groups (P < 0.05). Following gastrectomy, the urinary catheter was able
      to be removed significantly earlier in the morphine group (P < 0.05) although
      there was no statistical difference between both cholecystectomy groups. The
      morphine group experienced no difficulty with postoperative ambulation and
      exercise, although the difference in time before ambulation between the two
      groups was not considered significant. The results of this study led us to
      conclude that the postoperative continuous epidural infusion of morphine would be
      more beneficial following major abdominal surgery than the conventionally used
      methods of administering postoperative analgesia.

PMID- 8467169
TI  - The predictability of clinical antitumor effects using two distinctive in vitro
      chemosensitivity tests: an analysis of true positive cases.
AB  - The results of two types of in vitro chemosensitivity tests, namely, the human
      tumor clonogenic assay (HTCA) and the succinic dehydrogenase inhibition assay
      (SDIA), for solid tumors, including stomach, colorectal and lung cancers, were
      analyzed and their correlation with clinical effects evaluated. The anticancer
      agents employed were mitomycin C (MMC), 5-fluorouracil (5-FU), adriamycin (ADM)
      and cisplatin (DDP). The evaluability rates of the assays were 54.5% for HTCA and
      89.0% for SDIA. Among the 29 cases with evaluable lesions subjected to HTCA,
      there were 4 true positives, 9 false positives, and 16 true negatives, whereas
      among the 32 cases subjected to SDIA, the corresponding numbers were 2, 6, and
      24, respectively. There were no false negatives for either assay, the accuracy of
      prediction for HTCA being 69.0% and for SDIA, 81.3%. The true positives of both
      assays included one complete response (CR) and five partial responses (PR),
      although the eventual outcome was cancer death in all cases. Interestingly, in
      five out of the six true positive cases, the agent involved was either ADM or
      DDP, both the which are usually regarded as "second line" anticancer agents for
      gastrointestinal carcinomas.

PMID- 8467170
TI  - The quality of mass screening for breast cancer by physical examination.
AB  - Mass screening for breast cancer using physical examination alone has been
      carried out since 1983 in Zentsuji, Kagawa Prefecture, Japan. Over a 7-year
      period, breast cancer was detected in 11 of a total 8,271 examinees, the
      detection rate being high at 0.13%. The detected cases included a few early
      staged breast cancers, suggesting that mass screenings are of slight efficacy.
      Seven cases of interval cancer were found by breast self-examination after the
      mass screenings, supporting the value of breast self-examination. A relatively
      large number of interval breast cancers was detected in 1985 and 1986, when the
      rates of required further examination remained under 1%. The sensitivity and
      specificity of this screening were 61.1% and 94.5%, respectively, indicating a
      low sensitivity. These results suggest that the qualitative diagnoses made from
      the first screening by physical examination alone were often revealed to be false
      negatives. Therefore, the existing diagnosis should be employed in the first
      screenings. It is recommended that mammography be introduced to detect breast
      tumors which are nonpalpable or undetectable by physical examination alone.

PMID- 8467171
TI  - The zipper-mesh method for treating delayed generalized peritonitis.
AB  - Recently, many articles have been published related to the "open abdomen" concept
      which is performed particularly on patients with delayed generalized peritonitis.
      Since most arguments still support the effectiveness of this method and the
      results have been mostly favourable, it was decided to use the technique on 14
      patients with peritonitis. Commercial zippers either with or without mesh were
      used on all. Four patients, however, died in the very early postoperative period
      and were excluded from the study. Others were examined as to the operative
      findings, period of delay, concomittant diseases, primary operations, indications
      of the technique, the number and type of the reinterventional procedures, status
      of remote organ failure, expected and realized mortality. Forty laparatomies were
      performed on 10 patients. In addition to obtaining a clean intraperitoneal
      cavity, some additional procedures such as anastomotic repair or
      gastroenterostomy could be done. The mean period of ventilator support was 27 h,
      the ambulation period was 3 days. The start of enteral nutrition early was able
      to be achieved more easily. In the patients whose expected mortality rate was as
      high as 70%-90%, a rate of 40% was established in those ten patients.

PMID- 8467172
TI  - The prognostic significance of DNA ploidy for neuroblastoma.
AB  - Flow cytometric DNA analysis was performed on 45 neuroblastomas in order to
      evaluate the prognostic significance of DNA ploidy. The DNA ploidy was diploid in
      14 and aneuploid in 31 neuroblastomas and did not correlate with the conventional
      prognostic variables such as age, Evans' stage, or the primary site of the tumor.
      The survival of 31 patients with aneuploid tumors was comparable to that of 14
      patients with diploid tumors. On the other hand, DNA aneuploidy was associated
      with a decreased long-term survival in 21 patients older than 24 months of age at
      the time of operation, and in 27 patients with advanced disease at Evans' stage
      III or IV. These results suggest that more intensive and longer-term
      postoperative chemotherapy is necessary for neuroblastoma patients older than 24
      months of age, or for those with advanced disease if they have aneuploid tumors.

PMID- 8467173
TI  - Factors related to the recurrent hyperfunction of autografts after total
      parathyroidectomy in patients with severe secondary hyperparathyroidism.
AB  - Total parathyroidectomy with autotransplantation has been widely accepted as the
      appropriate treatment for patients with hyperparathyroidism due to chronic renal
      failure on long term hemodialysis. However, recurrence has been an enigma and
      therefore, the factors involved in the recurrence of hyperparathyroidism were
      studied in 128 patients followed for more than 2 years after surgical treatment.
      The preoperative serum parathyroid hormone (PTH) concentrations correlated with
      the total weights of the parathyroid glands. When the original autotransplanted
      glands were divided into two groups, being diffuse and nodular, the rate of
      recurrent hyperparathyroidism due to graft hyperfunction was significantly higher
      in the patients who received nodular glands (24%) than in those who received
      diffuse glands (8.4%) (P < 0.05). To investigate whether PTH synthetic activity
      is different in diffuse and nodular glands, the amount of PTH mRNA was studied by
      in situ hybridization. There was no significant difference in the amount of PTH
      mRNA in the cells from either diffuse or nodular glands. These data suggest that
      the recurrence of hyperparathyroidism is not due to enhanced PTH synthetic
      activity of autotransplant grafts but to the abnormal growth rate of the
      transplanted gland.

PMID- 8467174
TI  - Clinical and experimental studies on the role of platelet-activating factor (PAF)
      in the pathogenesis of septic DIC.
AB  - Various toxic factors induced by endotoxin (Et) are thought to be deeply involved
      in the pathogenesis of severe infections. In this study, particular attention was
      paid to the role of the platelet-activating factor (PAF) in these conditions, and
      clinical and experimental studies were conducted on the relationship between PAF
      and the changes observed in the general parameters after surgical infections. In
      the clinical study, changes in the PAF concentration in the blood of seven
      patients with disseminated intravascular coagulation (DIC), five of whom were
      septic and two non-septic, were monitored by gas/mas spectrometry. The mean PAF
      level in the septic DIC group tended to be higher than that in the non-septic DIC
      group. Moreover, in the septic DIC group, the relationship between the increase
      in the PAF level and platelet count was analyzed with the lapse of time and we
      surmised a negative correlation between these parameters. Experimentally, we also
      investigated the role of PAF in Et shock and the effect of an anti-PAF agent and
      protease inhibitor. The Et-induced fall in blood pressure was similarly prevented
      by both the anti-PAF agent and protease inhibitor. However, the decrease in the
      platelet count was more significantly inhibited by the anti-PAF agent than by the
      protease inhibitor, whereas the parameters of the blood coagulation/fibrinolysis
      system were more affected by the protease inhibitor than by the anti-PAF agent.

PMID- 8467175
TI  - K252a, a potent protein kinase inhibitor, improves endotoxic lethality and
      glucose dyshomeostasis.
AB  - To investigate whether the inhibition of protein kinases including protein kinase
      C can antagonize endotoxicosis, the in vivo effects of K252a, a potent inhibitor
      of protein kinases, on endotoxin-induced lethality and glucose dyshomeostasis
      were determined in conscious rats. Sprague-Dawley rats (260-340 g) were divided
      into the following four groups: Group DS, 2.5% dimethyl sulfoxide (DMSO), 6 ml/kg
      iv + 0.9% saline, 2 ml/kg iv; group KS, K252a in 2.5% DMSO, 4 mg/kg iv + 0.9%
      saline; group DE, 2.5% DMSO + endotoxin (E. coli), 15 mg/kg iv; and group KE,
      K252a in 2.5% DMSO + endotoxin. A quarter of DMSO or K252a solution was
      continuously infused over a 15 min period before a bolus injection of either
      saline or endotoxin. The remaining dose was administered over a 180 min period
      after saline or endotoxin. All animals in the DS and KS groups survived for 24
      hrs. K252a significantly improved endotoxic lethality. It attenuated the initial
      hyperglycemia, and late hypoglycemia, hyperlactacidemia, and base deficit after
      endotoxin. However, K252a had no influence on the endotoxic alterations of blood
      pressure, PaCO2 or PaO2. These results suggest that the activations of protein
      kinases, particularly protein kinase C, are involved in the pathogenesis of
      lethal endotoxicosis and sepsis.

PMID- 8467176
TI  - Natural human IgG inhibits the production of tumor necrosis factor-alpha and
      interleukin-1 alpha through the Fc portion.
AB  - The overproduction of cytokines such as the tumor necrosis factor-alpha (TNF
      alpha) and interleukin-1 alpha (IL-1 alpha) may cause further deterioration in
      the already critical condition of patients with shock, sepsis, and acute
      inflammation. The effectiveness of infusion therapy of natural human IgG to such
      patients is suggested to depend partly upon the inhibition of the productivity of
      these cytokines. In this study, we investigated the modulation effects of IgG and
      its fragments on the production of TNF-alpha and IL-1 alpha, on human peripheral
      blood mononuclear cells (PBMC). The production of TNF-alpha and IL-1 alpha was
      found to be dose-dependently inhibited by IgG when stimulated by
      lipopolysaccharide (LPS), phytohemagglutinin (PHA), concanavalin A (Con A), and
      interleukin-2 (IL-2). However, no inhibition was seen when stimulated by
      phorbormyristate acetate (PMA). The F(ab')2 fragment showed enhancing effects on
      cytokine production by LPS, while the Fc fragment showed not as much inhibitory
      effect as whole intact IgG. IgG showed no direct cytotoxic effect on PBMC. These
      data suggest that natural human IgG inhibits TNF-alpha and IL-1 alpha production
      by PBMC through the Fc portion. The results of this study led us to conclude that
      whole intact IgG may be the best form of therapeutic delivery.

PMID- 8467177
TI  - Inflammatory pseudotumor of the spleen: report of a case.
AB  - A case of an inflammatory pseudotumor arising in the spleen of a 60-year-old
      Japanese male is described herein. This benign lesion is extremely rare, with
      only 12 cases, including our own, having been reported in the world literature.
      We preoperatively diagnosed the splenic tumor as a metastasis, due to the
      coexistance of advanced stage carcinoma in the sigmoid colon. However, after
      splenectomy, histopathological examination of the mass revealed an inflammatory
      process. Inflammatory pseudotumors often pose diagnostic difficulties because the
      clinical and radiologic findings are suggestive of malignancy. The clinical and
      pathological features of cases previously reported are reviewed following the
      presentation of this case.

PMID- 8467178
TI  - Small aorta syndrome.
AB  - A 47-year-old female with a 10-year history of bilateral intermittent
      claudication was diagnosed as having small aorta syndrome (SAS) and was
      successfully treated by an aorto-bifemoral bypass with aortic
      thrombendarterectomy. The infra-renal aorta was narrow, being 10 mm in diameter,
      with thrombotic occlusion of the terminal aorta and common iliac arteries. These
      findings were compatible with the features of SAS, however, there were few
      atherosclerotic changes in the abdominal wall and no evidence of any prediposing
      risk factors such as smoking or hyperlipidemia. Computed tomography, in addition
      to arteriography, seemed imperative for making the preoperative diagnosis. SAS is
      not uncommon as an established entity in Western Countries, but in Japan there
      have been few reports to date. The etiology, diagnosis, and management of this
      entity are reviewed following the presentation of this case.

PMID- 8467179
TI  - Juvenile gigantomastia: report of a case.
AB  - Juvenile gigantomastia in a 12-year-old girl was treated by a bilateral reduction
      mammoplasty with free transplantation of the areolae and nipples and the removal
      of 3,980 g of breast tissue. Regrowth of the residual breast tissue has been
      suppressed by the administration of tamoxifen, an antiestrogen drug, since the
      surgery. This case was positive for estrogen receptors (ER) by the dextran-coated
      charcoal method, while tissue staining for ER and estradiol resulted in a darker
      staining of the epithelial contents, especially of fibroadenoma-like nodules,
      using an immunocytochemical assay. It is thus suggested that the etiology of this
      disease might be related to a local hypersensitivity to estrogen.

PMID- 8467180
TI  - Primary neurilemoma of the thyroid gland: report of a case.
AB  - Neurilemoma, like other non-epithelial tumors, seldom occurs in the thyroid
      gland. A 57-year-old man was first referred to our hospital with an asymptomatic
      anterior neck tumor. A solid tumor was detected in the right lobe of the thyroid
      and an enucleation of the thyroid tumor was performed. The tumor was 35 x 33 x 33
      mm in size, and diagnosed as Antoni A type neurilemoma. We were only able to find
      seven previously reported detailed cases of primary neurilemoma of the thyroid
      gland. A review of these cases, however, revealed that neurilemoma tends to
      develop in the right lobe of the thyroid gland. An operation is thus considered
      necessary and an enucleation of the tumor is appropriate.

PMID- 8467181
TI  - Heterotopic pancreas as a rare cause of gastrointestinal hemorrhage in the
      newborn: report of a case.
AB  - We report herein a female infant in whom a heterotopic pancreas in the stomach
      caused gastrointestinal hemorrhage during the newborn period. Endoscopy was
      essential for ruling out other causes of hemorrhage and to follow the patient
      until the time of elective surgery at 6 months of age. Heterotopic pancreas
      should be borne in mind as a rare cause of gastrointestinal hemorrhage in the
      newborn when an unexplained gastrointestinal hemorrhage continues, and the lesion
      was discussed in relation to our experience of upper gastrointestinal endoscopies
      and a review of the literature.

PMID- 8467182
TI  - Hemangioma of the upper arm associated with massive hemorrhage in a neonate.
AB  - A rare case of an ulcerated hemangioma of the upper arm in a neonate is described
      herein. Resection of the huge hemangioma, which occupied the axilla and extended
      down the entire length of the upper arm, was necessary due to massive hemorrhage
      from the ulcer and progressive heart failure caused by the arteriovenous fistula
      in the hemangioma. After complete resection of the hemangioma, extensive defects
      of the skin and subcutaneous tissue were replaced by a skin flap closure
      technique which involved considerable difficulty. However, the arm gradually
      recovered its size and function with good wound healing. The present case
      illustrates that rapid surgical intervention may be required to prevent clinical
      deterioration in such cases.

PMID- 8467183
TI  - A pharmacological analysis of prostaglandin E1 on portal blood flow after partial
      hepatectomy in rats.
AB  - Portal venous flow (PVF) and portal venous pressure (PVP) were examined after the
      jugular or portal injection of Prostaglandin E1 (PGE) in rats partially
      hepatectomized by either 40% or 66%. In the 66% hepatectomized animals, the
      jugular injection of PGE at 5.0 micrograms/kg/min produced an increase in PVF
      concomitant with a fall in systemic arterial pressure (SAP), while PVP remained
      unchanged. The portal injection of PGE at 0.5 micrograms/kg/min increased PVF to
      a level equivalent to that evoked by the jugular injection of 5.0
      micrograms/kg/min PGE, without any change in SAP. PVP was reduced
      synchronistically with an increase in PVF. The PVF response to a portal injection
      of PGE at 0.5 micrograms/kg/min was not reproduced in liver intact rats. These
      results suggest that PGE is potent in increasing PVF in the partially resected
      condition of the liver and that the portal vascular bed is involved in this
      response.

PMID- 8467184
TI  - An experimental study on intestinal vascular lesions: a comparison between the
      effects of arterial and venous occlusion in the acute phase.
AB  - In order to clarify what early ischemic changes are produced by venous
      interruption in the intestine, intestinal vascular lesions caused by peripheral
      venous ligation were compared with those caused by arterial ligation in rabbits.
      With less than 30 min ligation, there were only 4 specimens from a total 13
      without injury following venous ligation, whereas there were 7 from a total 11
      without injury following arterial ligation. After 30 min venous ligation, both
      the mucosal and submucosal layers of all 10 specimens were affected, while
      following arterial ligation, 3 of the 11 specimens showed no histological
      changes. Moreover, in 3 of the remaining 8 specimens from the latter group, the
      injury was confined to within the mucosal layer. Thus, in cases of venous
      interruption, intestinal injury might be evoked earlier with more severe damage
      than in cases of arterial interruption.

PMID- 8467185
TI  - Nurses remain ignorant over HIV/AIDS.

PMID- 8467186
TI  - Practical tips for writers.

PMID- 8467187
TI  - Blood glucose monitoring in the intensive care unit.
AB  - Patients in intensive care units may have high blood glucose levels for a variety
      of reasons. Careful control of blood glucose has a number of advantages. Nurses
      need to be trained in the use of blood glucose meters to obtain accurate results.

PMID- 8467188
TI  - Nursing management of irritable bowel syndrome.
AB  - Irritable bowel syndrome (IBS) affects up to 25% of the population and accounts
      for about 40% of patients referred to consultant gastroenterologists (Nagvi and
      Prout, 1983). Despite this, much of the medical and dietary research is
      conflicting and inconclusive. This article discusses the variety of symptoms and
      treatments associated with IBS and the nursing management of the condition.

PMID- 8467189
TI  - Mouth care and the hospitalized patient.
AB  - Despite its importance, there still appears to be some confusion among nurses
      regarding mouth care and the tools that should be used. This article reviews the
      literature and suggests the best possible approach.

PMID- 8467190
TI  - Intuition and expert clinical practice in nursing.
AB  - The quest for the essence of nursing in the UK continues unabated. Similarly, the
      concept of what constitutes expert clinical practice and the problem of how it
      can be achieved are topical issues. This article considers the notion of a
      developmental process in nursing and the concept of reflective practice, and
      examines the idea of intuition as a key component in the functioning of the
      expert nurse.

PMID- 8467191
TI  - The Bland truth: 1.

PMID- 8467192
TI  - Nurses' role in encouraging organ donation.
AB  - There is currently a shortage of transplantable organs, mainly because the
      relatives of potential organ donors dying in hospital are not routinely offered
      the choice of donating their loved one's organs. Nurses are ideally placed to
      perform this function, and those who have had the courage to approach relatives
      of potential organ donors have found it a worthwhile experience.

PMID- 8467193
TI  - Ethical implications of first aid.
AB  - Nurses have a moral duty to act when faced with emergency situations. Fear of
      legal recourse is no excuse for failing to provide first-aid care. This article
      considers the ethical implications for the nurse, midwife and health visitor at
      the scene of an accident.

PMID- 8467194
TI  - The G grade ward sister: clinical expert and ward manager.
AB  - The role of ward sister is changing and increasingly veering towards a middle
      management role. This article discusses the qualities and skills needed by a ward
      sister if she is to maintain her traditional role as clinical expert while also
      fulfilling her new role as ward manager.

PMID- 8467195
TI  - Influence of chronic alcohol consumption on the development of altered
      hepatocellular foci in rats.
AB  - The effect of chronic alcohol consumption on the development of altered
      hepatocellular foci was examined in 150 male Slc:Wistar rats fed an ethanol
      solution (0, 5 or 20%, w/v) ad libitum instead of drinking water. In the 120th
      week of the treatment period, the liver was examined histopathologically. There
      was no significant difference in the incidence, number and volume fractions of
      altered hepatocellular foci between the 0% and the 5% ethanol groups. In the 20%
      ethanol group, the incidence of altered hepatocellular foci was significantly
      higher than in the 0% ethanol group, and the number and the volume fraction of
      altered hepatocellular foci were significantly greater than in the 0% and the 5%
      ethanol groups. These results indicate that chronic consumption of a large amount
      of alcohol promotes the development of altered hepatocellular foci. However,
      there was no statistically significant difference in the incidence of benign
      liver cell tumours and hepatocellular carcinoma among the three groups.

PMID- 8467196
TI  - Experimental pulmonary hypertension induced by constriction of the pulmonary
      arteries resulting in rupture or extraordinary dilatation of the right ventricle
      after administration of a little amount of Na2EDTA.
AB  - Our earlier studies on the hypocalcemic condition have focused on the
      histological distortion of the organ structure with the removal of the calcium
      ion from the molecular structure of acid mucopolysaccharides (AMPs); resulting in
      the sol-gel diversion of the matrix. Bivalent cationic materials including
      calcium are related not only to function but also to structural alteration of the
      living organism (Yamaguchi et al. 1978, 1981, 1982, 1985, 1991). The ionic shift
      from the structural phase to the functional phase induced a number of
      morphological distortions of the various organs. In the present paper, starting
      our research from a different experimental viewpoint, we decreased the Na2EDTA
      dose used to prevent the conventional typical tetanic shock which sometimes
      results in animal death. We expected this decreased dose to induce mild
      constriction of muscle cells. In our experiment, administration of a small amount
      of Na2EDTA intraperitoneally provoked animal death after 10 days to two weeks
      over a two-month period. In the initial phase of 10 days to two weeks, rupture of
      the right ventricular wall along the septum occurred at an anterior angle with
      moderate right ventricular dilatation and a remarkably thin ventricular wall.
      Characteristic of these cases was elastosis between the medial smooth muscle
      cells of the main pulmonary arteries accompanied by a severe degree of
      constriction. On the other hand, demonstrated in the delayed cases of between
      more than two weeks to two months there was severe dilatation of the right
      ventricular lumina with paper-like thinness of the wall. In these cases, the main
      pulmonary arteries showed rather slight constriction with scarce
      elastosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467197
TI  - Transplantability and MHC antigen expression of tumor mast cells.
AB  - A cloned cell line was established from tumor cells spontaneously developed in a
      coculture of an autoreactive T cell line (1/+ T1) and 30 Gy-irradiated MRL/+
      spleen cells with Con A supernatants. Morphological studies and studies of
      histamine content and modes of histamine release after stimulation with compound
      48/80 revealed that the cell line (MRL-MC3) had mast cell characteristics. MRL
      MC3 was transplantable not only to MRL/+, MRL/lpr and AKR/J (H-2k) mice but also
      to BALB/c and (BALB/c x DBA/2) F1 (H-2d) mice, although the allogeneic mice
      survived twice as long as syngeneic mice after i.v. injection. In addition, after
      i.v. injection, the mast cells infiltrated the livers and spleens of syngeneic
      (MRL/+) mice, however the lymph nodes around the mesenterium to the parapylorus
      in allogeneic (BALB/c) mice. A mast cell line (BALB-MC) was also established from
      a lymph node of MRL-MC3-injected BALB/c mice. Cell surface marker analyses
      revealed clear differences between the BALB-MC and the original MRL-MC3, which
      was positive for the expression of MHC class I antigens (K, D), I-E antigen and c
      abl-encoded (anti-pEX-2 antibody-reactive) proteins, but not for I-A on the cell
      surface. In contrast, BALB-MC showed positive only for the MHC class I antigens
      (K, D) on the surface, and also positive for anti-pEX-2 antibody-reactive
      cytoplasmic proteins, as seen in MRL-MC3. Mast cells obtained from MRL-MC3
      injected MRL/+ mice showed the same staining pattern as MRL-MC3. BALB-MC induced
      shorter survival times (approximately half) in both MRL/+ and BALB/c mice than
      MRL-MC3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467198
TI  - Enhanced effect of chronic stress on pregnancy outcome in Uje:WIST rats by
      prenatal treatment with lithium.
AB  - Female Uje:WIST rats were exposed to lithium (20 mmol LiCl/l drinking water,
      lithium levels about 1 mmol/l serum) for at least three weeks before mating and
      continuously up to the end of gestation. Female F1-offspring were raised without
      further treatment and mated at an age of 90-120 days with untreated males. The
      effect of chronic restraint stress during gestation on pregnancy outcome was
      estimated. Moderate changes (higher frequency of prolonged gestation, decreased
      body mass of the newborn pups) resembled those which were induced by considerably
      longer stress exposure (extended to the premating period) of prenatally untreated
      female Uje:WIST rats. An enhanced stress sensitivity following prenatal lithium
      treatment is discussed.

PMID- 8467199
TI  - Stability of pituitary weight after multiple reproductive cycles.

PMID- 8467200
TI  - The effects of adriamycin on dental proteins formation and mineralization in
      vitro.
AB  - Second maxillary molars of 4-5 days old golden hamsters were exposed for 2 h in
      vitro to 1 mg/L adriamycin, rinsed and subsequently cultured up to 7 days without
      the drug. At days 3, 5 or 7 of culture the synthesis of extracellular tooth
      matrices and their mineralization were examined by measuring the incorporation of
      3H-proline and the uptake of 45Ca and 32PO4 by the explants during a 24 h pulse
      labeling. Compared with unexposed control explants, exposure to adriamycin for
      the first 2 h of culture had no effect on total biosynthesis of proline
      containing matrix proteins. However, at days 3 and 5 of culture it increased the
      quantity of water-soluble enamel matrix proteins (amelogenins). Adriamycin also
      strongly reduced the amount of organically-bound 32P-activity in a fraction
      extractable with guanidine-HC1-EDTA only, allegedly containing a mixture of
      mineral-associated proteins from both enamel and dentin. Since this decrease of
      32P-activity coincided with the formation of osteodentin in the pulp as shown
      previously in histological and electron microscopical studies, it was speculated
      that osteodentin matrix may not contain the highly phosphorylated, dentin
      specific phosphoproteins (DPP). Adriamycin also affected the uptake of 45Ca and
      32PO4. At day 3 these values were slightly higher than control values but lower
      at days 5 and 7. It therefore appears that a 2 h exposure to adriamycin in
      concentrations as low as 1 mg/L causes an acceleration of secretory amelogenesis
      by tooth germs in vitro. It also induces pulp cells to form osteodentin.

PMID- 8467201
TI  - Determination of lead in paired samples of blood and synovial fluid of bovines.
AB  - Exposure of synovial fluid to lead allows the entrance of this metal into the
      systemic circulation. In this study we report lead concentrations measured in
      bovine paired samples of synovial fluid and whole blood withdrawn from the coxo
      femoral joints and jugular vein, respectively. Lead was determined by atomic
      absorption spectrophotometry. This study provides the "normal" values for lead in
      synovial fluid 12.15 +/- 5.41 and blood 3.54 +/- 1.31 micrograms% (mean +/- SD).
      The data distribution fits the GAUSSIAN curve (p < 0.02). The difference of
      concentration between synovial fluid and blood can not be explained only in terms
      of the solubility of lead in both fluids; other factors must be considered.

PMID- 8467202
TI  - Ossification of the vertebral column in the offspring of rats exposed to alcohol,
      acetaldehyde and caffeine.
AB  - The embryopathic effects of alcohol have been widely studied in humans and
      laboratory animals. However, the role of risk factors remains largely unknown.
      Whereas skeletal abnormalities are often present in the offspring of alcoholic
      mothers, these have not been fully documented. This report is concerned
      specifically with the development of the vertebral column in rats exposed in
      utero to ethanol, its primary metabolite acetaldehyde, and caffeine. Our results
      indicate a possible causal association between alcohol abuse and ossification
      anomalies of the vertebral column. Maternal treatment with caffeine accelerated
      ossification in the sacro-caudal vertebrae. Caffeine combined with ethanol only
      moderately affected the development of the centra and arches.

PMID- 8467203
TI  - Lack of tumorigenic activity of 1,1-dimethylhydrazine in Syrian golden hamsters
      treated by subcutaneous injection.
AB  - Syrian golden hamsters were treated throughout their lifespan by weekly
      subcutaneous injections of 1,1-dimethylhydrazine (1,1-DMH) at doses of 0, 8, 17
      and 35 mg/kg body weight. In contrast to our previous study using European
      hamsters, no treatment-related tumors occurred in this study.

PMID- 8467204
TI  - Approaches to epilepsy surgery.
AB  - The different approaches to epilepsy surgery are discussed. Despite considerable
      differences in rationale, patients, and operative technique, there are apparently
      similar outcomes. There are no controlled studies available comparing these
      different techniques.

PMID- 8467205
TI  - History of focal epilepsy and criteria for medical intractability.
AB  - In this article the issues surrounding the definition of medical intractability
      have been discussed. Acceptable seizure control is primarily defined by the
      patient. If in a given living situation the number of seizures a patient is
      having (even if quite small) is interfering to the point that they are willing to
      consider epilepsy surgery as a treatment modality, there is unacceptable seizure
      control. More difficult is the definition of what constitutes an adequate trial
      of anti-epilepsy drugs. A consensus is that patients should have had at least
      trials to toxicity, toxicity as defined by patients' signs or symptoms (and not
      by drug levels), of at least two major anti-epilepsy drugs. Trials of combined
      therapy are not necessary. The natural history of these patients is such that if
      they have not been controlled with adequate trials of drugs within 2 years, they
      are unlikely (< 10% probability) to enter a long-term permanent remission of
      their seizures. These patients are medically intractable.

PMID- 8467206
TI  - Imaging criteria to identify the epileptic focus. Magnetic resonance imaging,
      magnetic resonance spectroscopy, positron emission tomography scanning, and
      single photon emission computed tomography.
AB  - The use of MRI, MRSI, PET, and SPECT scanning for preoperative evaluation of
      patients with epilepsy is reviewed. MRI provides the best anatomic detail and
      contains prognostic information. PET provides useful information in some patients
      for whom MRI findings are absent or contradictory. Interictal SPECT scanning
      lacks sufficient specificity to be of use in the preoperative evaluation of
      refractory patients, whereas ictal SPECT appears to be useful in temporal and
      extratemporal lobe epilepsy. The new technique of MRSI is described.

PMID- 8467207
TI  - Preoperative criteria for identifying eloquent brain. Intracarotid amytal for
      language and memory testing.
AB  - The intracarotid Amytal procedure is a useful method for preoperative assessment
      of language dominance. It is also helpful for assuring that the contralateral
      hemisphere can sustain adequate memory function following temporal lobectomy. The
      methods of language and memory testing using intracarotid Amytal procedure are
      discussed.

PMID- 8467208
TI  - Intraoperative and extraoperative identification of eloquent brain using
      stimulation mapping.
AB  - Intraoperative and extraoperative stimulation mapping provides a reliable
      mechanism for identification of functional cortex in patients who are to undergo
      resective surgery for epilepsy. The techniques available for performing
      stimulation mapping are discussed.

PMID- 8467209
TI  - Surgical anatomy of the temporal lobe.
AB  - The complex functional and anatomic relationships between the structures in and
      around the temporal lobe are central to the problem of intractable partial
      complex seizures. Resecting those areas that are responsible for seizures and
      protecting those that are essential for the normal functioning of the patient are
      the fundamental tasks of the epilepsy surgeon. A thorough understanding of the
      structural and functional anatomy of this region is essential to achieve these
      goals.

PMID- 8467210
TI  - Anatomic temporal lobe resections for temporal lobe epilepsy.
AB  - Temporal lobe epilepsy is not a single clinicopathologic entity but a group of
      syndromes requiring different surgical solutions. Anatomic resections planned for
      the treatment of these syndromes are aimed at pathologic substrates minimizing
      ablation of normal tissue. Most of these procedures involve mesial and lateral
      temporal resections. The syndrome of mesial temporal sclerosis should be treated
      with resection aimed at hippocampus and the PHG, including entorhinal cortex, and
      at part of the amygdala. Improvement in diagnostic methods and refinement of
      anatomic surgical procedures that maximize resection of hippocampus resulted in
      excellent outcome in the treatment of patients with this syndrome. Mass lesions
      in patients with intractable seizures should be resected with some surrounding
      margins, but additional clinical studies will be required to determine the role
      of anatomic resections, including hippocampectomy, in the treatment of these
      patients. Extrahippocampal temporal lobe epilepsy is the most difficult to
      evaluate and treat. Tailored individualized resections based on acute or chronic
      EEG recordings may be required until and if discrete anatomically based syndromes
      can be identified in this patient population.

PMID- 8467211
TI  - Surgery and results of selective amygdala-hippocampectomy in one hundred patients
      with nonlesional limbic epilepsy.

PMID- 8467212
TI  - Temporal lobectomy that spares the amygdala for temporal lobe epilepsy.
AB  - Rationale, surgical techniques, and results in 70 patients with complex partial
      seizures who underwent temporal lobectomy with sparing of the amygdala are
      discussed. Removal of entorhinal cortex may be the common denominator that
      explains the similar results obtained with different types of temporal
      lobectomies for epilepsy.

PMID- 8467213
TI  - The tailored temporal lobectomy.
AB  - The indications, rationale, operative technique, risks, and outcome from the
      tailored temporal lobectomy are reviewed. The tailored lobectomy allows
      intraoperative identification of both electrically active cortex and functionally
      essential cortex, thus permitting maximal resection of epileptic regions without
      damage to Rolandic cortex or essential language cortex. This allows surgical
      strategy to be planned on the basis of preoperative interictal scalp
      electroencephalography recordings, thus lowering hospital costs and avoiding risk
      of implanting intracranial electrodes.

PMID- 8467214
TI  - Extratemporal resective surgery for epilepsy.
AB  - Extratemporal resections were the most common early operations for epilepsy. This
      area is in need of further investigations, however, as relatively little progress
      has been made in management of these cases. The surveys from the Palm Desert
      Conferences on extratemporal resections with at least 1 year follow-up indicate
      that of the 825 patients operated between 1949 and 1984, 43.2% were said to be
      seizure free, 27.8% improved, and 29.1% not improved. Between 1986 and 1990, 768
      patients underwent extratemporal resections, with 44.5% seizure free, 35.7%
      improved, and 19.8% not improved. Thus, there has not been a major improvement in
      the seizure-free outcomes, although more patients are undergoing surgical
      treatment and there are increases in the "improved" category. Moreover, these
      results are worse than those for temporal resections reported by the same
      surveys. As is apparent from this article, extratemporal epilepsies are very
      heterogeneous. The techniques of electrophysiology that have been so successful
      with temporal lobe epilepsy seem to be less so with many extratemporal
      epilepsies, however, suggesting that improved outcomes for those conditions
      especially may depend on new techniques, such as those based on imaging.

PMID- 8467215
TI  - The role of callosal section in surgical treatment of epilepsies.
AB  - Using current microsurgical technique, the procedures of both partial and
      complete corpus callosum section may be performed with minimal morbidity and with
      full assurance of completeness of callosal fiber division. Between 65% and 80% of
      patients have had significant improvement in terms of generalized seizure
      control. These results are similar to those observed at a number of other
      epilepsy centers now performing this surgery, and the benefit is long lasting.
      The neuropsychologic effects of callosal division have now been fairly well
      characterized. Although demonstrable in all patients, these rarely have been
      problematic and in nearly all instances have been outweighed by the benefit in
      terms of seizure control.

PMID- 8467216
TI  - Surgery for epilepsy. Special pediatric considerations.
AB  - Children with epilepsy require special consideration because the nature of their
      seizures is different from those in adults, the effects of intractable epilepsy
      may be more serious in children, and younger children may have greater potential
      for recovery than adults. This article reviews the unique problems and approaches
      to resective surgery for pediatric epilepsy.

PMID- 8467217
TI  - Complications of epilepsy surgery.
AB  - In the treatment of patients with medically intractable epilepsy, neurosurgeons
      are involved in the application of invasive monitoring procedures and definitive
      surgical therapies, including resective and disconnection surgery. Each
      alternative intervention carries with it a unique set of potential adverse
      outcomes or complications, which provides the principal focus of this article.

PMID- 8467218
TI  - Surgical resection of epileptogenic cortex associated with structural lesions.
AB  - In this article we have reviewed the available data for postsurgical seizure
      control in patients with both structural lesions and seizures. There is evidence
      that simple excision alone will control seizures in some patients, whereas others
      require, in addition, seizure surgery with resection of epileptogenic cortex.
      When available studies are reviewed and submitted to meta-analysis, however, we
      have found that more patients are seizure free at 2-year follow-up after seizure
      surgery than after simple excision. Seizure control is one of the many factors
      that influence the choice of surgical approach. Therefore, we do not recommend
      that all patients with structural lesions and seizures disorders undergo seizure
      surgery. Rather, for those patients with a structural lesion in whom seizures are
      medically intractable, our review supports excision of the structural lesion as
      well as resection of the epileptogenic cortex to provide the patient with the
      best opportunity of seizure control.

PMID- 8467219
TI  - Seizure outcome in patients undergoing temporal lobe resections for epilepsy.
AB  - This article reviews the results of surgical treatment of temporal lobe epilepsy
      based on retrospective reviews: more recent surveys from 91 centers on the
      outcomes from the surgical treatment of epilepsy and preliminary data from the
      authors' institution's 5-year retrospective review of nearly 100 surgical
      patients matched to medically treated epileptics. Surgical outcomes from
      resections in other areas, including extratemporal resections, and the efficacy
      of lesionectomy versus epilepsy surgery for structural lesions are detailed
      elsewhere in this issue.

PMID- 8467220
TI  - Resection surgery for epilepsy. Outcome and quality of life.
AB  - Psychosocial problems frequently are more difficult to manage than the seizures.
      Quality of life investigations are important in identifying psychosocial issues
      that impede the benefits of improved or complete seizure control. Three
      categories of quality of life assessment are discussed: professional observation
      and ratings, psychometric assessment, and community-based measures of adaptive
      ability.

PMID- 8467221
TI  - Identification of a methyl jasmonate-responsive domain in the soybean vspB
      promoter.
AB  - Soybean vspB encodes a highly expressed vegetative storage protein-acid
      phosphatase. In soybean, vspB expression is stimulated by methyl jasmonate (MeJA)
      and sugars. The vspB promoter was studied by transforming tobacco with fusions of
      5' noncoding vspB DNA and the gene encoding beta-glucuronidase (GUS). Constructs
      containing 833 bp of vspB 5' DNA showed high expression of GUS in stems, leaf
      veins and trichomes, sepals, and pollen. Sucrose (0.2 M) and MeJA (10(-5) M)
      increased gene expression when applied to leaf tissue. Deletion of the region 
      787 to -520 with respect to the transcription initiation site rendered the vspB
      promoter noninducible by MeJA but still sucrose responsive. This result indicates
      that DNA elements capable of modulating vspB by MeJA can be separated from carbon
      response elements. Further 5' end deletion from -520 to -403 or 3' end deletion
      from -165 to -289 removed DNA sequences involved in carbon modulation of gene
      expression. A DNA domain that mediates the MeJA response was further localized to
      a 50-bp region between -535 and -585. This domain when fused to a cauliflower
      mosaic virus (CaMV) 35S truncated (-88) promoter makes the CaMV promoter
      responsive to MeJA. The MeJA-responsive domain contains a G-box motif (CACGTG)
      and a C-rich sequence. A similar 50-bp DNA region is present in the putative
      promoter of vspA. Related sequences are located in a wound- and MeJA-responsive
      domain of the proteinase inhibitor II gene and a UV-responsive promoter domain of
      chs, the gene encoding chalcone synthase that is also responsive to MeJA.

PMID- 8467222
TI  - Developmental expression and localization of petunia glycine-rich protein 1.
AB  - An anti-petunia glycine-rich protein 1 (ptGRP1) antibody was used for biotin
      streptavidin-alkaline phosphatase localization of this protein. In petunia stem
      and leaves grown under different light conditions, these studies revealed a
      complex pattern of cell localization for this protein. Levels of ptGRP1 were
      shown to decrease with developmental age of the tissue, appearing to correlate
      directly with expansive growth and inversely with lignification. Significantly,
      plants grown under low light (approximately 32 mumol m-2 sec-1 at noon) showed at
      least an eightfold increased level of ptGRP1 protein throughout ptGRP1's
      expression period when compared to plants grown under higher light (approximately
      80 mumol m-2 sec-1 at noon). Evidence also indicated that for one cell type in
      which ptGRP1 is localized, this protein is imported rather than synthesized. In
      addition, confocal microscopy studies suggested that ptGRP1 is deposited at the
      cell wall/membrane interface rather than within the cell wall.

PMID- 8467223
TI  - The patterns of gene expression in the tomato shoot apical meristem.
AB  - In this paper, we describe the synthesis of a cDNA library from the vegetative
      shoot apical meristem and the analysis of clones selected from it. Using in situ
      hybridization, we characterized the patterns of expression of these genes in the
      tomato shoot apical meristem, as well as the patterns obtained from other
      sources. The results from the analysis of 15 cDNAs indicated the following six
      main patterns of gene expression in the shoot apical meristem: overall
      expression, zero expression, expression limited to the epidermis, expression
      excluded from the epidermis, punctate expression, and expression elevated in the
      flanks of the meristem. The patterns observed and the nature and number of the
      genes showing these patterns necessitate a reinterpretation of the models of
      meristem structure and function. In particular, the data suggest a
      compartmentation within the shoot apical meristem based on the spatial expression
      of particular subsets of genes. This paper also reports on the specific and
      precise criteria essential for the correct identification of meristem-specific
      gene expression. The data give new insight into the molecular organization of the
      shoot apical meristem and provide the framework for a detailed dissection of the
      factors controlling this organization.

PMID- 8467224
TI  - Expression of an Atriplex nummularia gene encoding a protein homologous to the
      bacterial molecular chaperone DnaJ.
AB  - DnaJ is a 36-kD heat shock protein that functions together with Dnak (Hsp70) as a
      molecular chaperone in Escherichia coli. We have obtained a cDNA clone from the
      higher plant Atriplex nummularia that encodes a 46.6-kD polypeptide (ANJ1) with
      an overall 35.2% amino acid sequence identity with the E. coli DnaJ. ANJ1 has
      43.4% overall sequence identity with the Saccharomyces cerevisiae cytoplasmic
      DnaJ homolog YDJ1/MAS5. Complementation of the yeast mas5 mutation indicated that
      ANJ1 is a functional homolog of YDJ1/MAS5. The presence of other DnaJ homologs in
      A. nummularia was demonstrated by the detection of proteins that are
      antigenically related to the yeast mitochondrial DnaJ homolog SCJ1 and the yeast
      DnaJ-related protein Sec63. Expression of the ANJ1 gene was compared with that of
      an A. nummularia Hsp70 gene. Expression of both ANJ1 and Hsp70 transcripts was
      coordinately induced by heat shock. However, noncoordinate accumulation of ANJ1
      and Hsp70 mRNAs occurred during the cell growth cycle and in response to NaCl
      stress.

PMID- 8467225
TI  - The enigma of slow viruses. Facts and artefacts.

PMID- 8467226
TI  - Bone marrow transplantation in sickle cell anaemia.
AB  - Sickle cell anaemia is a hereditary disorder commonly seen in the black
      population, due to a point mutation in the beta globin gene. The sickle mutation
      is responsible for an increased rigidity and adherence of the red blood cell
      leading to haemolytic anaemia and vaso-occlusive episodes. Symptoms include
      dactylitis, painful crisis, splenic sequestration and the development of multi
      organ damage and failure. The progressive loss of splenic function increases the
      risk of infections. The morbidity and mortality can be reduced by the maintenance
      of an adequate nutrition, the prevention of infection and the treatment of
      complications. In some patients severely affected, a chronic transfusion program
      has to be instigated to maintain a level of haemoglobin S below 50%. New
      therapeutic strategies include the use of hydroxyurea and maybe, in the future,
      butyrates to increase the level of foetal haemoglobin. Further studies are needed
      to evaluate the benefits of such therapies. Bone marrow transplantation
      represents an attractive therapeutic tool and its role in other
      haemoglobinopathies like thalassaemia is now well demonstrated. As far as sickle
      anaemia is concerned, the first report concerned a child with acute myeloblastic
      leukaemia. The patient is now cured of both the sickle cell anaemia and the
      leukemia. Since April 1986, 21 patients underwent an allogeneic bone marrow
      transplantation for sickle cell anaemia in our department. 20 patients became
      asymptomatic and have an electrophoretic pattern of the haemoglobin similar to
      that of the donor. One patient died of bone marrow transplantation related
      complications.

PMID- 8467227
TI  - Karyotypic analysis in primary myelodysplastic syndromes.
AB  - Cytogenetics has provided new insights into the biology and pathogenesis of
      myelodysplastic syndromes. In patients with refractory anemia, it has provided
      proof of clonality and has helped differentiate chronic myelomonocytic leukemia
      from chronic myeloid leukemia. As a prognostic tool, cytogenetics has been
      predictive of duration of survival and leukemic transformation. However, its role
      as an independent prognostic factor compared with recent prognostic scoring
      systems remains to be determined. New techniques such as fluorescent in situ
      hybridization using chromosome-specific DNA probes may expand the usefulness of
      cytogenetics. The prognostic impact of cytogenetics may not be fully realized
      until more effective treatments become available.

PMID- 8467228
TI  - Multiple myeloma: the biology of malignant plasma cells.
AB  - Multiple myeloma remains a difficult disorder to treat and cures are virtually
      unknown. Most modalities of treatment have been tried on an empirical basis, and
      a greater understanding of the nature of myeloma progenitors may lead to more
      specific therapies. In the past few years interest in the biology of myeloma
      plasma cells has increased and the current state of knowledge is summarised in
      this review. Myeloma clonogenic, or colony, assays have been attempted by many
      groups. Despite this, no direct equivalent is available of the CFU-GM assay for
      granulocyte-macrophage progenitors in normal marrow. No published methods have
      been exported widely to other laboratories. Recently, myeloma plasma cells were
      found to express a wide range of adhesion molecules permitting cell to cell and
      cell to stroma interactions. This finding may explain the difficulty of myeloma
      colony assays, since adhesive clumping must be prevented. The observation that
      interleukin (IL)-6 can stimulate myeloma plasma cells led to further work with
      other cytokines such as IL-3 and GM-CSF. The precise role of IL-6 in the usual
      case of bone marrow myeloma remains unclear however.

PMID- 8467229
TI  - Biology and treatment of multiple myeloma.
AB  - The uniformly fatal plasma cell malignancy, multiple myeloma (MM), currently
      represents 10-15% of hematologic neoplasms in the USA and has been steadily
      increasing in incidence for several decades. Therapeutic alternatives have lagged
      significantly behind insights into the biology and pathogenesis of this entity.
      Traditionally felt to be a neoplasm of fully differentiated plasma cells,
      evidence has been mounting that the self renewing population consist of cells
      derived from a much earlier compartment; perhaps prior to B-cell lineage
      commitment or even at the level of an earlier 'stem cell'. Bcl-2 protein
      overexpression has been almost uniformly seen in both clinical myeloma specimens
      as well as in myeloma cell lines. The failure to consistently identify the
      t(14;18) translocation, normally found in follicular lymphomas and
      characteristically associated with overexpression of bcl-2, implies a unique
      mechanism in MM. A number of cytokines, including TNF alpha, IL-1 and IL-6 have
      been found to play a central role not only in the biology of the malignant clone
      but also in the bony and other systemic manifestations of this disease. Since
      both IL-6 and bcl-2 protein have been shown to prevent programmed cell death,
      this may be the unifying event in MM. Standard therapy for MM has been an
      alkylating agent and corticosteroid. Combination chemotherapy provides more
      prompt palliation but no clear survival advantage. In advanced stages, adriamycin
      may offer some survival advantage. High dose chemotherapy with or without stem
      cell support offers a potentially curative therapeutic approach. New
      interventions directed at the complex cytokine networks pertinent to the
      pathogenesis of MM are an exciting new area of investigation. Identification of
      new prognostic parameters as well as new active agents remains the central theme
      in clinical myeloma research.

PMID- 8467230
TI  - Treatment of early stage Hodgkin's disease.
AB  - Current trends in the treatment of patients with Stages I and II Hodgkin's
      disease are discussed in this review. Recommendations for staging procedures and
      the updated staging classification are described. Long-term results with extended
      field radiation therapy overall and in subgroups of patients are detailed. As
      follow-up and numbers of patients treated with extended field radiation therapy
      have accrued, prognostic factors, predictive of outcome, have emerged. The
      evolution of combined modality treatment with chemotherapy and radiation therapy
      and, more recently, chemotherapy alone for early stage patients is reviewed.
      Discussion is made of recent programs in various centers to reduce toxicity while
      maintaining good results. Long-term potential toxicities are described, and
      recommendations are made for long-term follow-up monitoring.

PMID- 8467231
TI  - Bone marrow transplant for sickle cell disease--the dilemma.
AB  - Sickle cell disease is the family of clinically significant haemoglobin disorders
      which have in common the inheritance of the sickle beta haemoglobin chain gene.
      The homozygous SS condition, also known as sickle cell anaemia, can present a
      varied clinical picture from asymptomatic through to frequent painful vaso
      occlusive crises and even death as a result of complications of the disease. S
      beta zero thalassaemia and the rate haemoglobin SD disease present a similar
      picture to SS, while S beta plus thalassaemia and haemoglobin SC disease
      generally have milder clinical features than SS and present somewhat later in
      life. The present debate about bone marrow transplant (BMT) for sickle cell
      disease, among both physicians and community, relates to SS patients, definition
      and markers of disease severity, the effect of BMT on sickle related organ
      damage, the efficacy of BMT for SS, and its complications, both early and long
      term.

PMID- 8467232
TI  - Hepatic veno-occlusive disease after bone marrow transplant.
AB  - Hepatic veno-occlusive disease (VOD) is a non-thrombotic obliteration of the
      lumina of small intrahepatic veins. VOD has been reported after exposure to a
      wide variety of pathogens. It has been suggested that the chemoradiotherapy used
      as the conditioning regimen for bone marrow transplant (BMT) is now the main
      cause of this disease. However, the pathogenesis of VOD after BMT is probably
      multifactorial. Endothelial injury of sinusoids and small hepatic veins is
      considered to be the initial event in genesis of VOD. This injury is followed by
      deposition of fibrin-related aggregates in the subendothelial zone. These
      aggregates, and the intramural entrapment of fluid and cellular debris, occlude
      progressively the hepatic venous outflow and generate a postsinusoidal
      intrahepatic hypertension. Clinically, VOD is characterized by jaundice, weight
      gain, ascites, painful hepatomegaly and platelet refractoriness developing early
      post transplant, although other posttransplant liver disturbances can produce a
      similar syndrome. VOD diagnosis is usually established by applying the clinical
      criteria proposed by the Seattle and Baltimore groups. When clinical diagnosis of
      VOD is uncertain, a transjugular liver study including a transvenous biopsy and
      measurement of the gradient between wedged and free hepatic venous pressure, is
      recommended in order to establish an accurate diagnosis. According to the
      literature data, the incidence of VOD ranges from 0 to 70% and its mortality from
      20 to 50%. This very wide range is attributable to the different incidence of
      risk factors in the different series and to the differences in applying the
      diagnostic criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467233
TI  - Platelet alpha-granules.
AB  - Platelets contain a vast number of biologically active molecules within
      cytoplasmic granules which are classified according to their respective distinct
      ultrastructures, densities and content. The alpha-granule is a unique secretory
      organelle in that it exhibits further compartmentalization and acquires its
      protein content via two distinct mechanisms: (1) biosynthesis predominantly at
      the megakaryocyte (MK) level (with some vestigial platelet synthesis) (e.g.
      platelet factor 4) and (2) endocytosis and pinocytosis at both the MK and
      circulating platelet levels (e.g. fibrinogen (Fg) and IgG). The currently known
      list of alpha-granular proteins continues to enlarge and includes many adhesive
      proteins (e.g. Fg, von Willebrand factor (vWf) and thrombospodin (TSP)), plasma
      proteins (e.g. IgG and albumin), cellular mitogens (e.g. platelet derived growth
      factor and TGF beta), coagulation factors (e.g. factor V) and protease inhibitors
      (e.g. alpha 2-macroglobulin and alpha 2-antiplasmin). More recently the inner
      lining of the alpha-granule unit membrane has been demonstrated to contain a
      number of physiologically important receptors including glycoprotein IIb/IIIa
      (alpha IIb beta 3) and P-selectin. The alpha-granules originate from small
      precursor granules which can be observed budding from the trans-Golgi network
      within the platelet precursor cell the MK. During MK maturation the alpha
      granules become very prominent and are ultimately packaged into platelets during
      thrombopoiesis. The alpha-granular contents are destined for release during
      platelet activation at sites of vessel wall injury and thus play an important
      role in haemostasis, inflammation, ultimate wound repair and in the pathogenesis
      of atherosclerosis.

PMID- 8467234
TI  - The role of apoptosis (programmed cell death) in haemopoiesis and the immune
      system.
AB  - Apoptosis, or programmed cell death, is a series of controlled sequential events
      resulting in the demise of cells without invoking an inflammatory response. It is
      a naturally occurring process which maintains a cellular balance during both
      animal development and in the mature adult. Although first described 20 years
      ago, there is now renewed interest in this phenomenon, particularly in the light
      of our greater understanding of cellular signalling pathways and their genetic
      control. This is especially pertinent to haemopoiesis and the overall maintenance
      of a functional immune system. This review broadly covers the biochemical events
      of apoptosis and the recognition of apoptotic cells by phagocytes. Reference is
      made to the selective development of T- and B-cells and to the control of
      inflammation. Molecular events in apoptosis are also discussed with special
      reference to aberrant bcl-2 gene expression in follicular B-cell lymphoma and the
      role of other death genes in the control of apoptosis.

PMID- 8467236
TI  - Detection of mRNA encoding an antibacterial-metalloprotein (MPII) by in situ
      hybridization with a cDNA probe generated by polymerase chain reaction in the
      worm Nereis diversicolor.
AB  - Based on partial amino acid sequence of an antibacterial-metalloprotein (MPII)
      consisting of a N-terminal fragment (1-33th) and an 43 amino acids long internal
      fragment, two oligonucleotides primers were synthesized and used to generate a
      cDNA fragment by the PCR method. The specificity of the PCR synthesized 220 bp
      fragment was verified by hybrid-arrest translation and sequencing. In situ
      hybridization performed with this cDNA fragment on Nereis diversicolor whole body
      defined two specific sites of recognition: a cluster of cells floating in the
      coelom and two types of muscles (perineural and oblique). Finally, the
      chronological expression of the MPII was postulated.

PMID- 8467235
TI  - Timely and topologically defined protein synthesis in the peri-implanting mouse
      endometrium revealed by light and electron microscopic radioautography.
AB  - Many efforts have been made to correlate the morphological and biochemical
      evidences with changes on physiological state of the uterus during activation of
      the implantation window. However, the exact mechanism involved in such a
      phenomenon remains to be determined. The present experiment used the
      radioautographic approach to determine whether, chronological and/or topological
      variations of proteins synthesis occur in the peri-implanting endometrium.
      Pregnant mice submitted to ovariectomy, received exogenous supply of nidatory
      estradiol. After 0 to 18 hrs. of time-lapsed estradiol effects, each animal
      received intraperitoneally, 1 hr. pulse 3H-leucine. The uterine fragments
      embedded in epoxy resin, were processed for light and electron microscope
      radioautography. The pattern of 3H-leucine incorporation in the luminal
      epithelium varied according to their relation with the blastocyst present in the
      uterine lumen. The highest incorporation ratio was seen in the epithelium just
      around the conceptus 6 hrs. after estradiol treatment, while in the cells
      localized at interimplantation site no peak of incorporation was seen. At
      ultrastructural level, cell organelles involved in protein synthesis were found
      to be labelled. Accumulation of silver grains occurred at apical portion of the
      epithelial cells showed accumulation of silver grains after 6 hrs. of estradiol
      treatment, but not on cell surface. The endometrial stromal cells localized
      around the blastocyst also showed a peak of 3H-leucine incorporation 6 hrs. after
      estradiol, but not in the cells localized at interimplantation sites. No
      increased labeling was seen on the components of extra-cellular matrix at
      ultrastructural level. The present radioautographic experiment showed that
      epithelial and stromal cells localized in the endometrium of implantation
      chamber, changed their pattern of protein synthesis under nidatory estradiol
      effects. This evidence suggests that the phenomenon of implantation window
      induced by estradiol, is not a systemic response of the whole pregnant
      endometrium. The activation involves only a specific population of the
      endometrial cells localized just around the conceptus.

PMID- 8467237
TI  - Synaptic and non-synaptic immunolocalization of GABA and glutamate acid
      decarboxylase (GAD) in cerebellar cortex of rat.
AB  - The existence of a large number of GABA receptors in the cerebellar molecular
      layer, and the observation of numerous punctate immunoreactive deposits of GABA
      synthesizing enzyme (GAD) throughout this layer, could indicate the existence of
      numerous axon terminals that may be involved in neurotransmission modulated by
      GABA. These axon terminals may be different from those considered classically as
      cerebellar GABAergic axon terminals. Therefore, we have reinvestigated the
      localization of GABA- and GAD-immunoreactivities in the cerebellar cortex of the
      rat with the PAP method, using different antisera obtained from rabbits immunized
      with GABA, baclofen and GAD. The results observed in our investigation have
      demonstrated GABA- and GAD-immunoreactivities in the axon terminals considered
      classically as GABAergic, as well as in others which, until now, have not been
      considered GABAergic. This fact leads us to think that the distribution of GABA
      or molecules structurally similar to GABA is far more extended than previously
      thought in the cerebellum. We have also observed both GABA- and GAD
      immunoreactivities within dendrites and glial cells. These facts suggest us a
      possible extrasynaptic release of GABA.

PMID- 8467238
TI  - Alkaline phosphatase activity at physiological pH: kinetic properties and
      biological significance.
AB  - The activity of rat liver alkaline phosphatase (ALP) was studied at physiological
      pH, using para-nitrophenyl phosphate (pNPP) as substrate. At this pH, the
      purified enzyme had optimal catalytic efficiency and its activity was maximal for
      the very low substrate concentrations. During thermal inactivation of rat liver
      plasma membranes activities, the ratio of the measured residual activities (pH
      10.5/pH 7.5) varied, showing that ALP was not the only plasma membranes pNPP
      hydrolase. Indeed, the proportion of pNPP hydrolase activities attributable to
      ALP in plasma membranes at pH 7.5 was relatively low. Effectively, it was shown
      using bromolevamisole, a potent and specific inhibitor of ALP, that contrary to
      what it was previously reported, ALP was not the major pNPP hydrolase of liver
      plasma membrane.

PMID- 8467239
TI  - A peptide containing the leucine zipper domain specifically inhibits CREB binding
      and transcription.
AB  - Formation of dimers via leucine zippers is an absolute requirement for several
      transcription factors to express their activity. Using circular dichroism
      spectroscopy, it was found that synthetic peptides which mimic the leucine
      zippers from CREB, Jun and Myc are alpha-helices in solution. The CREB leucine
      zipper peptide specifically inhibited the binding of wild type CREB protein and
      transcription from the CRE containing c-fos promoter in vitro. This inhibition is
      most likely caused by competition of the peptide to form complex with CREB
      monomers through leucine zippers.

PMID- 8467240
TI  - Electron microscopic radioautographic study on DNA synthesis in perinatal mouse
      retina.
AB  - For the purpose of comparing the quantitative changes in both labelled and
      unlabelled retinal cells with 3H-thymidine radioautography, normal ddY mice from
      early embryonic stage (E 9.5) to postnatal 2 weeks were utilized as materials.
      About 200 electron microscopic radioautograms were taken from the middle portions
      of retina in the early embryonic stages and from the inner half of outer
      neuroblastic layers of retina of 9 groups of litter mice at the late embryonic
      and postnatal ages, and the enlarged photographs were quantitatively analyzed by
      image analysis. The results showed that the area of nuclei, cytoplasm,
      mitochondria and the number of mitochondria, per retinal cell, decreased from
      early embryonic stages to postnatal ages in both labelled and unlabelled cells (p
      < 0.05). However, no significant changes occurred in the area of ER per retinal
      cell in both labelled and unlabeled cells. Significant differences of the
      ultrastructural changes between labelled and unlabelled cells were not
      statistically detected except the area of nuclei at P 1 and the number of
      mitochondria at P 3.

PMID- 8467241
TI  - Effects of two peroxisome proliferators (ciprofibrate and fenofibrate) on
      peroxisomal membrane proteins and dihydroxyacetone-phosphate acyl-transferase
      activity in rat liver.
AB  - The effects of ciprofibrate and fenofibrate, which are more potent peroxisome
      proliferators than clofibrate, on the activities of dihydroxyacetone-phosphate
      acyl-transferase (DHAP-AT) and glycerol-3-phosphate acyl-transferase (G3P-AT)
      were studied at the two pH optima 5.5 and 7.4 in subcellular fractions of rat
      liver, and in solubilized peroxisomal membranes (PMP) as well. Protein was also
      analyzed by gel electrophoresis. 1) Under the conditions of the specific activity
      of peroxisomal acyl-CoA oxidase (CN(-)-ACO) being increased (8 to 9-fold), there
      was no specific induction of the DHAP-AT activity when measured at pH 5.5 in
      purified peroxisomes and PMP. However, the total activities of DHAP-AT in these
      two fractions were increased by 6 to 11 times, as a result of hepatomegaly and
      peroxisome proliferation. In contrast, they were only slightly enhanced (x 1.1 to
      2.2-fold) when determined at pH 7.4. The magnitude of the effects of a fibrate
      treatment was, therefore, dependent on the pH of the incubation medium. 2)
      Experiments of reversibility of enzyme induction reinforced the finding that the
      peroxisomal DHAP-AT activity is not specifically induced by ciprofibrate and
      fenofibrate. 3) Our results suggest the existence of a peroxisomal G3P-AT, non
      inducible by fibrates, in the rat liver. 4) Induction of peroxisomal membrane
      associated polypeptides with apparent molecular masses of 26- and 36-kDa was
      evidenced in stained electrophoretic gels of protein.

PMID- 8467242
TI  - Light microscopic radioautographic study of DNA synthesis in the kidneys of aging
      mice.
AB  - The change of proliferative activity in mouse kidney cortex cells during
      development and aging was studied by detecting S-phase cells by light microscopic
      radioautography using 3H-thymidine (3H-TDR). Mouse kidney tissues of various
      ages: prenatal 13.5, 15.5 and 19.0 days of gestation, postnatal 1 and 8 days, 1
      and 2 months, and 1 year were used for this experiment. The kidney cortex tissues
      were labelled with 3H-TDR either in vitro or in vivo and they were processed for
      light microscopic radioautography. The labeling indices of the respective cell
      types were calculated. The labeling indices in glomeruli and uriniferous tubules
      in the superficial layer were higher than those in the deep layer of metanephric
      cortex through the developmental stages. However, they decreased rapidly after
      birth and reached low levels (below 4%) from 1 day to 1 year.

PMID- 8467243
TI  - Production of a new monoclonal antibody recognizing alpha-actinin: analysis of
      the changes in subcellular expression in the developing chick heart.
AB  - A new monoclonal antibody that recognizes alpha-actinin in cardiac muscle cells
      was used in a quantitative study (fluorescence activated cell sorting and
      polyacrylamide gel electrophoresis) of the expression of this protein during
      chick embryo development, to determine the changes in cytoplasmic and
      cytoskeletal compartments. alpha-Actinin expression was weak in early stages of
      development (Hamburger and Hamilton stage 18) and increased steadily until
      Hamburger Hamilton stage 40. In all stages, the protein was more abundant in the
      cytoplasmic compartment. The monoclonal antibody cross-reacted with alpha-actinin
      in chicken smooth and striated muscle cells and also showed a faint cross
      reaction with human cardiac muscle alpha-actinin.

PMID- 8467244
TI  - Predictors of toenail selenium levels in men and women.
AB  - Potential predictors of toenail selenium levels were studied in 1211 men and 1248
      women aged 55-69 years. These subjects were randomly selected cohort members
      without prevalent cancer (other than skin) participating in a prospective study
      on diet and cancer in the Netherlands. Information on the considered potential
      predictors (gender, age, smoking, intake of dietary selenium and alcohol,
      Quetelet index) was collected together with toenail specimens in 1986. The
      average toenail selenium concentration was significantly (P < 0.001) lower in men
      than in women: 0.547 +/- 0.126 microgram/g (mean +/- SD) and 0.575 +/- 0.109
      microgram/g, respectively. The gender difference remained significant after
      adjustment for the other variables in multiple regression analyses. Age was not
      associated with toenail selenium levels in men or women. An inverse association
      was observed with current smoking but not with past smoking. The average toenail
      selenium values for male current smokers were 0.513 +/- 0.106 microgram/g (mean
      +/- SD) versus 0.571 +/- 0.133 microgram/g for male never- or ex-smokers (P <
      0.001). For women these values were 0.548 +/- 0.101 and 0.581 +/- 0.109
      microgram/g, respectively (P < 0.001). Dietary selenium intake was positively
      associated with toenail selenium levels in multivariate analyses (P < 0.001), but
      the association was weak (partial r = 0.09). Alcohol intake and Quetelet index
      were not significant independent predictors of toenail selenium. The observed
      associations had similar directions in men and women but were stronger in men.

PMID- 8467245
TI  - Serum pepsinogens in relation to precancerous gastric lesions in a population at
      high risk for gastric cancer.
AB  - Concentrations of serum pepsinogens (PG) I and II were determined for 3252
      randomly selected adults who participated in a population-based gastroscopic
      screening in an area of China with one of the world's highest rates of gastric
      cancer. PG I and II concentrations in both sexes tended to be higher than
      reported in other countries, with levels generally higher among males than
      females. PG I tended to decrease and PG II to increase with age, but the most
      pronounced associations were between PG I:II ratios and gastric histology. Median
      PG I:II ratios monotonically declined from 9.1 to 7.2 to 5.7 to 5.4 to 3.8 among
      those with superficial gastritis, chronic atrophic gastritis, intestinal
      metaplasia, dysplasia, and stomach cancer, respectively. The prevalence of
      dysplasia was nearly 3 times greater among those with PG I:II ratios less than 3
      compared with those whose PG I:II ratios were greater than 10. While average
      levels differed significantly among the histologic groups, the PG I:II ratios
      were neither sensitive nor specific markers of an individual's likelihood of
      advanced gastric lesions in this population.

PMID- 8467246
TI  - Serum anti-Helicobacter pylori IgG antibodies and pepsinogens A and C as
      serological markers of chronic atrophic gastritis.
AB  - This study was designed to test the sensitivity and specificity of serum anti
      Helicobacter pylori IgG antibodies and the ratio of serum pepsinogen A to
      pepsinogen C (PGA:PGC) in detecting chronic atrophic gastritis (CAG) and
      intestinal metaplasia. Parallel gastric biopsies and a serum sample were
      collected from a series of 87 patients aged 20-69 years attending a routine upper
      endoscopy clinic. The seroprevalence (> 10 micrograms IgG/ml) of anti-H. pylori
      antibodies was 42.7%, and of a low PGA:PGC ratio (< 1.5) was 17.7%. A positive H.
      pylori IgG antibody level was more sensitive than the level of PGA:PGC in
      diagnosing CAG (71.4% and 25.0%, respectively), moderate CAG (86.7% and 26.7%,
      respectively), and intestinal metaplasia (90.9% and 50.0%, respectively). Anti-H.
      pylori IgG antibody levels were less specific than PGA:PGC levels in diagnosing
      CAG (90.9% and 93.9%, respectively), moderate CAG (78.3% and 89.1%,
      respectively), and intestinal metaplasia (72.6% and 92.2%, respectively). A
      combination of anti-H. pylori antibodies and a low PGA:PGC ratio for the
      detection of CAG resulted in a specificity of 100%, but the sensitivity was
      21.4%.

PMID- 8467247
TI  - Procollagen type I carboxy-terminal propeptide as a marker of osteoblastic bone
      metastases.
AB  - Collagen type I is the sole collagen type found in bones and tendons.
      Carboxyterminal propeptide, deriving and cleaved from procollagen type I (PICP)
      during collagen synthesis, is delivered into the blood, where it can be measured.
      According to current knowledge, PICP correlates with bone collagen synthesis and
      bone formation rate. Elevated serum levels of PICP in patients with Paget's
      disease, compared with normal subjects and correlated with serum alkaline
      phosphatase (Alk.Ph.), have been previously described. Thus, PICP may be a
      valuable marker of bone formation. PICP, serum Alk.Ph., serum bone Gla protein
      and 24-h urinary hydroxyproline:creatinine ratio have been measured in 47 cancer
      patients: 27 with predominantly osteolytic lesions (5 myeloma, 15 breast, 3 lung,
      2 kidney, 1 bladder, 1 thyroid) and 20 with predominantly osteoblastic lesions
      (18 prostate and 2 breast). The higher levels of PICP were noted in patients with
      osteoblastic or mixed metastases. In the entire group of patients, a
      statistically significant correlation between PICP and bone Gla protein (r =
      0.57; P < 0.001), PICP and Alk.Ph. (r = 0.80; P < 0.001), and bone Gla protein
      and Alk.Ph. (r = 0.44; P < 0.01) was noted. In those patients with osteoblastic
      metastases we observed a significant correlation only between PICP and Alk.Ph. (r
      = 0.62; P < 0.003). During chemotherapy, 13 of 20 patients with osteoblastic
      metastases who achieved objective response or stable disease showed a more rapid
      and significant decrease in PICP with respect to the other bone markers. Serum
      PICP level could be considered a good marker of osteoblastic activity.

PMID- 8467249
TI  - Micronutrient concentrations in paired skin and plasma of patients with actinic
      keratoses: effect of prolonged retinol supplementation.
AB  - Much of our knowledge about the relationship between micronutrients and cancer
      comes from studies in which plasma (serum) micronutrient levels have been
      correlated with cancer incidence; however, the relationship between the
      concentrations of micronutrients in the plasma and in the target tissues has not
      been established. Ninety-three subjects (62 males and 31 females ages 42-86,
      median age 69) with actinic keratoses were recruited for investigation of this
      relationship. The subjects were randomly assigned and received placebo or retinol
      (25,000 IU/day) intervention for 48 to 65 months as part of a skin cancer
      chemoprevention trial. Shortly before the end of the trial, three fasting plasma
      samples and one skin biopsy were obtained from each subject. The concentrations
      of lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, beta
      carotene, cis-beta-carotene, retinol, retinyl palmitate, alpha-tocopherol and
      gamma-tocopherol in the plasma and skin were simultaneously measured using HPLC.
      The profiles of the eleven micronutrients in the plasma and skin were similar.
      Lycopene, beta-carotene and alpha-tocopherol were the predominant micronutrients
      in both plasma and skin, but the ratio of retinyl palmitate to retinol was much
      greater in the skin than plasma. The three fasting plasma concentrations from the
      same subject during a one-month period were very consistent; however, the between
      person variations were very large. The retinol supplementation caused a
      significant increase in the plasma concentrations of retinol, retinyl palmitate,
      lutein and alpha-tocopherol, especially retinyl palmitate as well as the skin
      concentrations of retinol and retinyl palmitate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467248
TI  - A nonsaponification method for the determination of carotenoids, retinoids, and
      tocopherols in solid human tissues.
AB  - There has been an increasing interest in the measurement of carotenoids,
      retinoids, and tocopherols in human tissues because some of these micronutrients
      have been shown to have chemopreventive activity. Since clinical tissue samples
      obtained for analysis are usually small in quantity, a sensitive analytical
      procedure that can simultaneously measure all the micronutrients of interest in
      one small piece of human tissue is necessary. Moreover, some solid tissues, such
      as skin, are very difficult to homogenize unless they are first saponified in
      alcoholic KOH, but the saponification often causes substantial destruction of
      some micronutrients. Thus, a nonsaponification procedure using collagenase to
      facilitate homogenization was developed. Solid tissues are first incubated in a
      collagenase solution, homogenized, then incubated in a protease solution,
      followed by precipitation of tissue proteins and extraction with hexane.
      Collagenase digestion facilitates homogenization, and protease digestion
      increases the extractable amounts of the micronutrients from certain tissue
      samples. In this study, the recovery and precision (coefficient of variation) of
      the new procedure was determined. In addition, the extracted amounts of seven
      carotenoids, two retinoids, and two tocopherols from human skin, cervical/ovarian
      tissue, as well as sarcoma and kidney tumors using the new procedure and a
      commonly applied saponification procedure were compared.

PMID- 8467250
TI  - Impact of an HMO-based intervention to increase mammography utilization.
AB  - A health maintenance organization (HMO)-based program designed to increase breast
      cancer screening was evaluated, focusing on changes in mammography utilization.
      The program consisted of a multistage intervention aimed at women members and
      primary care physicians of the HMO. This report examines the effect of the
      intervention on mammography utilization. The program was evaluated using a
      quasiexperimental design in which a random sample of women aged 50-74 from the
      HMO (intervention) was compared to a similarly aged geographic control group
      selected through random digit dialing. From 1988 to 1990, 450 intervention women
      and 450 control women were sampled (without replacement) each year and surveyed
      about breast cancer screening practices and related knowledge. A clear increase
      in self-reported mammography utilization was associated with the intervention.
      The percentage of women who reported a mammogram in the 12 months prior to the
      survey increased from 41% in 1988 (baseline) to 68% in 1990 among HMO women,
      compared to a change from 39% to 49% among control women. Comparing
      postintervention rates of mammography in HMO versus control women yielded a rate
      ratio (RR) of 1.4. However, this effect was strongly modified by income and race.
      Women with annual incomes of $31,000 or more showed little (whites, RR = 1.2) or
      no (blacks, RR = 1.0) effect of the intervention. Among women with incomes less
      than $31,000, the effect among whites (RR = 1.9) was much stronger than among
      blacks (RR = 1.2).

PMID- 8467252
TI  - Alcohol abstainers: a low-risk group for cancer--a cohort study of Norwegian
      teetotalers.
AB  - Groups with assumed health-protective life-styles have been studied for several
      decades, in search of causes for cancer. We have analyzed cancer incidence, total
      mortality, and cause-specific mortality in Norwegian teetotalers to assess the
      possible health gains from an alcohol-abstaining life-style. A cohort of 5332
      members of the International Organization of Good Templars was followed for 10
      years from 1980. The cancer incidence and the cause-specific mortality of the
      cohort has been compared to that of the total Norwegian population. The
      standardized incidence ratio (SIR) for all cancer sites was 74 [95% confidence
      interval (CI), 64-80] for men and 72 (95% CI, 61-84) for women. For possible
      alcohol-associated cancers, such as cancer of the oral cavity, pharynx,
      esophagus, liver, and larynx, the SIR was 43 (95% CI, 17-88) for both sexes
      combined. For lung cancer the SIR was 57 (95% CI, 37-90) for men and 10 (95% CI,
      0-57) for women. When all alcohol- and tobacco-associated cancers were excluded,
      the SIR for both sexes combined was 79 (95% CI, 69-87). The standardized
      mortality ratio for total mortality was 81 (95% CI, 65-74). This significant
      decrease in total mortality was caused by reduced risks for all major causes of
      death. The study indicates that members of the Norwegian chapter of the
      International Organization of Good Templars are a low-risk group not only
      regarding alcohol- and tobacco-associated cancers, but also regarding all other
      cancers.

PMID- 8467251
TI  - Epidemiology of colorectal adenomatous polyps.

PMID- 8467253
TI  - Dysplastic nevi in relation to superficial spreading melanoma.
AB  - The aim of the present study was to evaluate the frequency with which
      histologically confirmed dysplastic nevi are observed among patients with
      superficial spreading melanoma compared to patients with nodular melanoma. A
      pathology review of 117 new cases of first primary nonfamilial cutaneous melanoma
      identified 61 patients with superficial spreading melanoma and 19 with nodular
      melanoma. Study participants received a physician-conducted skin examination
      which included enumeration of clinically benign and atypical nevi and the
      surgical excision of the clinically most atypical nevus. Patients' dysplastic
      nevus status was established by histological review of the clinically most
      atypical nevus. A comparison based on the tumor subtypes showed that dysplastic
      nevi occur nearly four times more frequently among patients with a prior
      diagnosis of superficial spreading melanoma relative to nodular melanoma (odds
      ratio = 3.6; P = 0.03).

PMID- 8467254
TI  - Competency and the law.

PMID- 8467255
TI  - Six "musts" for quality programs.

PMID- 8467256
TI  - Conducting a computer needs assessment.

PMID- 8467257
TI  - Implementing the Patient Self-Determination Act.

PMID- 8467258
TI  - Restraint/seclusion: an approach to documentation and assessment.

PMID- 8467259
TI  - Strategies to keep a group alive.

PMID- 8467260
TI  - Trends in evaluating quality of care.

PMID- 8467261
TI  - Ten tips for using the AHCPR guidelines.

PMID- 8467263
TI  - Preestablished forms help quality monitoring.

PMID- 8467262
TI  - Finding the facts on computer software.

PMID- 8467264
TI  - JCAHO unveils new standards for orientation, education and training.

PMID- 8467265
TI  - Ten characteristics of true team players.

PMID- 8467266
TI  - Combining staff development and support services for improved outcomes.

PMID- 8467267
TI  - Twenty-five tips from expert preceptors.

PMID- 8467268
TI  - Ethical issues in staff development.

PMID- 8467269
TI  - Tic-tac-toe: a terrific teaching technique.

PMID- 8467270
TI  - The reduction of aggression in people with learning difficulties: a review of
      psychological methods.
AB  - The literature on the reduction of aggression in people with learning
      difficulties is reviewed. The methods of reducing aggression identified were
      predominantly evaluated in staffed settings and with target behaviours more
      frequent than once a day. This contrasts with the findings of a recent survey
      that found the majority of aggressive individuals to live in the community and
      show aggression less than once a day. It is argued that the reasons for this
      disparity are as follows. That it is easier to do a controlled study in staffed
      settings with high-frequency aggression. That it is more difficult to do an
      analysis of the target behaviour if it is low frequency or if the subject is in
      the community; and that the methods that have been traditionally used to reduce
      aggression may not be effective with all subjects in all settings. It is
      suggested that it may be necessary to develop and evaluate a new technology for
      reducing aggression.

PMID- 8467271
TI  - Understanding women's responses to treatment for cervical intra-epithelial
      neoplasia.
AB  - Laser treatment is held to prevent the development of cervical intra-epithelial
      neoplasia, or CIN, into invasive carcinoma of the cervix. Recent work has found
      that such treatment represents a considerable emotional upset in the lives of
      many women. In this study, the impact of treatment was further investigated,
      using a control group to separate the effects of diagnosis from those of
      treatment. The main findings showed that the diagnosis of CIN is traumatic. Women
      experience high levels of intrusive thoughts and avoidance, and in response to
      perceived threats to their health, and existing beliefs about themselves, they
      also experience high levels of anger. An impact of treatment over and above that
      of diagnosis was not found. From the interview data, diagnosis has its traumatic
      impact through women's understanding of CIN's association with cervical cancer, a
      potentially life-threatening disease. Interview data also suggest that body image
      and sexual relationships suffer following diagnosis because of CIN's postulated
      causal relationship to the sexually transmitted wart virus. Fear of the
      progression of CIN to cervical cancer is consistent with the medical model which
      provides the rationale for preventative laser treatment. It is speculated that
      once women are diagnosed as having CIN, the spectre of cancer is raised and their
      anxiety may be such that being monitored and not immediately treated may cause
      them great distress.

PMID- 8467272
TI  - Dieting, dietary restraint and cognitive performance.
AB  - In a volunteer sample of female undergraduates, concerns about eating, body
      weight and body shape were found to increase with the level of self-reported
      dietary restraint. These concerns were greatest, however, in a subsample of
      subjects who were currently dieting to lose weight, and greater than in equally
      restrained but non-dieting subjects. Furthermore, the dieting subjects performed
      less well on a demanding cognitive task than the non-dieting subjects. These
      results show that it is important to distinguish between dietary restraint and
      actual dieting behaviour. They also highlight the need for further research to
      examine the effects of dieting on cognitive functioning.

PMID- 8467273
TI  - Subjective craving for opiates: evaluation of a cue exposure protocol for use
      with detoxified opiate addicts.
AB  - Cue exposure has been advocated as an intervention for reducing relapse rates in
      detoxified addicts, by extinguishing classically conditioned drug effects/craving
      which may have developed. Several studies with alcoholics have found cue exposure
      to be associated with reductions in craving, but no controlled study has yet
      shown such an effect in opiate addicts. The present controlled group design
      evaluates a protocol which draws from experience in the treatment of anxiety and
      requires that each stimulus exposure should be continued until within-session
      habituation has occurred. It also explores whether there is any benefit of using
      a 'cognitive aversion' strategy during cue exposure, based on the social learning
      analysis that craving derives from expectancies of positive drug effects. A total
      of 21 detoxified in-patients were randomized to routine ward treatment plus two
      sessions of either cue exposure (Group E) or cue exposure and cognitive aversion
      (Group E/CA), or to routine treatment alone (Group C). A specially designed
      Craving Test was carried out before and after treatment, to assess change in cue
      elicited reactions. The two treated groups showed significantly greater
      reductions in craving than Group C, but did not differ from each other. The cue
      exposure protocol has therefore been adopted for use in an ongoing clinical
      trial.

PMID- 8467274
TI  - The Spot-the-Word test: a robust estimate of verbal intelligence based on lexical
      decision.
AB  - The development of a test aimed at estimating premorbid intelligence is
      described. The test, Spot-the-Word, involves presenting the subject with pairs of
      items comprising one word and one non-word, and requiring the subject to identify
      the word. Data show that performance correlates highly with verbal intelligence
      as estimated by Mill Hill Vocabulary score and by performance on the National
      Adult Reading Test (NART). Performance does not decline with age, in contrast to
      an associated test of verbal recognition memory. A second study attempted to test
      the effect of intellectual deterioration due to age on Spot-the-Word performance.
      Elderly subjects who had high vocabulary scores scored well on the Spot-the-Word
      regardless of whether fluid intelligence as measured by the AH4 test was well
      preserved, or was low, implying intellectual deterioration. A final study
      collected normative data on a sample of 224 subjects stratified by age and socio
      economic status, with each subject performing two parallel forms of the test, A
      and B, together with the NART. Correlation between the two forms was .884, while
      correlation with NART was .831 for Form A and .859 for Form B, suggesting
      adequate reliability and validity. It is concluded that the test provides a
      potentially useful additional method of estimating premorbid intelligence.

PMID- 8467275
TI  - Reduced cognitive inhibition in obsessive-compulsive disorder.
AB  - On a semantic negative priming task designed to investigate putative inhibitory
      mechanisms of selective attention, obsessive-compulsive disordered (OCD) subjects
      were distinguished from all other sub-categories of anxiety disorder (OAD). OCD
      subjects failed to show any priming effects in the repetition priming condition
      and exhibited facilitation in the semantic priming condition (i.e. shorter
      reaction times to previously ignored stimuli). OAD subjects demonstrated negative
      priming (i.e. longer reaction times to previously ignored stimuli) in both
      experimental conditions. These results are interpreted in terms of reduced
      cognitive inhibition in OCD and the implications of this hypothesis are
      discussed. Parallels are also drawn with previous studies regarding the results
      of high schizotypes and schizophrenic subjects using negative priming tasks.

PMID- 8467276
TI  - Correlates of everyday memory among residents of Part III homes.
AB  - Performance on the Rivermead Behavioural Memory Test (RBMT) of 43 residents of
      Part III homes was compared with performance on Raven's Coloured Progressive
      matrices and the National Adult Reading Test (NART). Health, medication, selfcare
      and social activity were also measured. Results show that although Raven's score
      was the best predictor of memory test performance, it had a high refusal rate.
      Age was not a significant predictor of overall memory test score but results were
      complicated by age of entry into Part III, with older people performing better on
      some items. Medication, in particular drugs acting on the central nervous system,
      enhanced performance on some items.

PMID- 8467277
TI  - The relationship between Beck's concepts of sociotropy and autonomy and the NEO
      Personality Inventory.
AB  - Beck (1983) proposed that two personality dimensions, sociotropy and autonomy,
      represent vulnerability factors for depression. This study assesses the relations
      between sociotropy/autonomy (Sociotropy/Autonomy scale) and five personality
      dimensions, i.e. neuroticism, extraversion, openness to experience,
      agreeableness, and conscientiousness (NEO-Personality Inventory). Sociotropy was
      related positively to neuroticism and negatively to openness to experience.
      Autonomy was positively associated with conscientiousness.

PMID- 8467278
TI  - Deriving principal component IQ scores from the WAIS-R.

PMID- 8467279
TI  - Health beliefs, locus of control, emotional control and women's cancer screening
      behaviour.
AB  - Improvements in women's cancer-screening behaviours can lead to a reduction in
      the incidence of breast and cervical cancer. This paper considers the utility of
      three social psychological models as predictors of such behaviours. Almost 400
      women throughout Northern Ireland completed a questionnaire designed to measure
      the extent of their cancer-screening behaviour, their health beliefs about
      cancer, their health locus of control and their emotional control. It was found
      that several components of the health belief model and of locus of control were
      predictors of the behaviours. The most important predictor of breast self
      examination was confidence in how to practise BSE while the most important
      predictor of attendance for cervical smears was lack of fear of the consequences
      of the investigation. The findings are discussed with reference to attempts to
      promote these practices.

PMID- 8467280
TI  - BMT in experimental autoimmune diseases.

PMID- 8467281
TI  - Is there an effective therapy for chronic graft-versus-host disease?

PMID- 8467282
TI  - Physiological mechanisms in BMT and haemopoiesis--revisited.

PMID- 8467283
TI  - Pulmonary thromboembolism in leukaemic children undergoing bone marrow
      transplantation.
AB  - Of 67 leukaemic children transplanted in our BMT unit 3 presented with severe
      acute respiratory syndrome associated with pulmonary thromboembolism (PTE) as
      diagnosed by scintiscan and/or angiography in the first month after BMT.
      Intervention with continuous positive pressure ventilation, urokinase (loading
      dose, then continuous infusion for 12-18 h) and heparin (continuous infusion for
      an average of 10 days) has been carried out successfully in two cases. In
      conclusion, when evaluating patients undergoing BMT and developing early
      pulmonary complications, PTE must be considered. The pathogenesis of PTE is still
      difficult to ascertain but urokinase therapy may reduce early morbidity.

PMID- 8467284
TI  - Haemolytic uraemic syndrome and renal dysfunction following BEAC (BCNU,
      etoposide, ara-C, cyclophosphamide) +/- TBI and autologous BMT for malignant
      lymphomas.
AB  - Twenty-four patients autografted for malignant lymphoma have been followed. All
      were conditioned with BEAC (BCNU, etoposide, ara-C, cyclophosphamide), in 10
      patients combined with total body irradiation (TBI) 7.5 Gy. Within 1 month of
      ABMT, a capillary leak syndrome was seen in four patients (one death) and
      isolated pericarditis in one. Nineteen patients survive disease-free at > or = 6
      months, median (range) 24 (11-48) months. In 15 of 19 patients, a decrease in
      glomerular filtration rate (GFR) of > 20% was observed, 6 (6-24) months after
      ABMT. In six of these patients (five treated with TBI), the renal dysfunction was
      still progressing 11-36 months after ABMT. Five patients (four conditioned with
      TBI) developed a haemolytic uraemic syndrome (HUS) with Coombs negative
      haemolytic anaemia, platelet consumption and renal impairment, with onset 3-6
      months after ABMT. Haemolysis and platelet consumption, but not renal impairment,
      were reversible in all patients. One death from HUS was seen. Because of the
      adverse effects described we have abandoned the combination of BEAC with TBI.

PMID- 8467285
TI  - Prognostic importance of histological and immunopathological assessment of skin
      and rectal biopsies in patients with GVHD.
AB  - Skin and rectal biopsies from patients with GVHD were examined histologically and
      immunopathologically before and after treatment for the disease. The patients
      were divided into two groups: those showing a good response to treatment and
      those showing a poor or no response. The aims of the study were to assess the
      possibility of predicting the response to treatment and to compare good and poor
      responders after treatment. The results show that there are no features on either
      skin or rectal biopsy that could identify those patients with early GVHD who
      would respond to treatment. Following treatment with steroids there was no change
      histologically in the grading of the skin biopsy whereas the rectal biopsy showed
      improvement in six of nine good responders and no improvement in the poor
      responders. There was an increase in infiltrating lymphocytes in both the skin
      and rectum of patients showing a poor response and this is most likely due to the
      ongoing immune reaction. The pre-treatment biopsy did not show any features that
      would predict this development and was therefore of no prognostic value. However,
      examination of skin and rectal biopsies may aid in determining whether patients
      are responding to the treatment given for GVHD.

PMID- 8467286
TI  - Use of granulocyte-macrophage colony-stimulating factor and erythropoietin in
      combination after autologous marrow transplantation.
AB  - The toxicities and possible utility of the combination of recombinant human
      granulocyte-macrophage colony-stimulating factor (rhGM-CSF) and recombinant human
      erythropoietin (rHuEPO) given after autologous BMT were evaluated in this pilot
      trial. Eighteen patients received the combination and were compared with six
      concurrent control and 65 historical control patients treated with rhGM-CSF
      alone. Patients treated with the combination tended to have more rapid recovery
      to an absolute neutrophil count of 500 x 10(6)/l (median = 12.5 vs 18 days for
      concurrent and 19 days for historical control patients). There was no apparent
      impact on red cell transfusion requirements, platelet recovery or duration of
      hospitalization. Patients treated in the current study with rhGM-CSF plus either
      rHuEPO or with placebo had a higher incidence of rash than seen in our historical
      experience using rhGM-CSF. This difference may reflect changes in the source of
      rhGM-CSF or in the infusion schedule. Erythropoietin can be combined safely with
      rhGM-CSF after autologous transplantation. Larger controlled trials will be
      necessary to detect possible therapeutic effects.

PMID- 8467287
TI  - Parafollicular hair bulge in human GVHD: a stem cell-rich primary target.
AB  - We sought to determine the frequency of parafollicular hair bulge involvement in
      human GVHD of the skin. The parafollicular bulge was recently shown by Murphy to
      be a target of GVHD in the minor histoincompatible mouse GVHD model. We sought a
      crude estimate of this frequency by studying 541 skin biopsy reports from a 5
      month period at our bone marrow transplant center. We selected 170 slides for
      review on the basis of a prior histological diagnosis of GVHD. Of these 41 had
      potentially evaluable pilar units and were recut. Three cases were considered
      unevaluable but the remaining 38 cases all showed positive evidence of
      involvement of the parafollicular hair bulge. The data confirm that the
      parafollicular hair bulge is involved with very high frequency in acute GVHD in
      humans.

PMID- 8467288
TI  - Consequences of cryopreserving first remission autologous marrow for use after
      relapse in patients with acute myeloid leukemia.
AB  - Ninety-eight patients with AML had marrow harvested and cryopreserved at a median
      of 6 months (range 1-36 months) after achieving first CR with the intent of
      performing an ABMT at the first sign of relapse. Thirty-three of the 98 patients
      have not relapsed and 32 survive at a median of 64 months (range 10-105 months)
      after marrow storage. Sixty-five of the 98 patients relapsed at a median of 7
      months (range 1-53 months) after marrow storage. The survival at 2 and 4 years
      for the 65 patients who relapsed was 22% and 8% respectively. Sixteen of 24
      patients treated initially with chemotherapy were ultimately transplanted and two
      are surviving 21 and 41 months following ABMT and allogeneic marrow transplant
      respectively. There were no survivors among the eight patients treated with
      chemotherapy who were not transplanted. Thirty-eight of the 65 patients who
      relapsed proceeded directly to ABMT without attempts at remission induction, and
      eight survive disease-free 15-114 months following ABMT. One of the first 17
      patients treated with cyclophosphamide and total body irradiation survives
      without relapse. The probabilities of relapse-free survival, non-relapse
      mortality, and relapse for the 17 most recent patients prepared with busulfan
      containing regimens were 41%, 39% and 32% respectively. Surviving patients had
      longer first remissions (p = 0.08) and lower peripheral blood blast counts at the
      time of transplant (p = 0.02) when compared with patients who died. These data
      suggest that ABMT in untreated first relapse is a reasonable approach for the
      treatment of patients with AML who relapse.

PMID- 8467289
TI  - Treatment of experimental allergic encephalomyelitis in rats with total body
      irradiation and syngeneic BMT.
AB  - Experimental allergic encephalomyelitis (EAE) was induced in Buffalo rats by
      immunization with syngeneic spinal cord homogenate in complete adjuvant. EAE, an
      autoimmune disease of the central nervous system (CNS), is regarded as a model
      for multiple sclerosis. When severe paresis had developed, rats were treated with
      high-dose total body irradiation (TBI) and transplanted with syngeneic BM from
      healthy donors. Nine Gy TBI followed by syngeneic BMT greatly accelerated
      recovery of paresis compared with untreated controls. In 6-33% of the treated
      animals a relapse of EAE was observed shortly after treatment. Reimmunization 20
      days after treatment, resulted in a relapse in 12-44% of the rats. Employing the
      maximally tolerated dose of TBI (10 Gy) did not significantly alter the incidence
      of spontaneous or induced relapses. Furthermore, it was shown that irradiation of
      the CNS only was not sufficient for the induction of complete regression of
      paresis. The origin of the cells responsible for these relapses is discussed, as
      is the importance of reimmunization in evaluating the effect of treatment of
      experimental autoimmune disease.

PMID- 8467290
TI  - Graft failure following neutrophil-specific alloantigen mismatched allogeneic
      BMT.
AB  - We report a case of unexplained graft failure in a 33-year-old man who received
      an allogeneic bone marrow graft that contained a donor-recipient mismatch
      involving the highly immunogenic NA1 neutrophil-specific alloantigen system.
      Laboratory and clinical data suggest that an alloimmune process related to the
      neutrophil alloantigen mismatch played a role in the development of the graft
      failure.

PMID- 8467291
TI  - Successful allogeneic bone marrow transplantation in juvenile CML: conditioning
      or graft-versus-leukaemia effect?
AB  - Allogeneic BMT is the treatment of choice for juvenile CML (JCML). This has been
      successful following conditioning with cyclophosphamide (120 mg/kg) and total
      body irradiation (TBI) (10-15.75 Gy). However, busulphan (16 mg/kg) and
      cyclophosphamide (200 mg/kg) (Bu/Cy) conditioning has been reported to be
      insufficient to eradicate the malignant clone in JCML. We report successful BMT
      and eradication of the disease at 18 months follow-up in a child 15 months old at
      presentation, who was conditioned with busulphan 20 mg/kg and cyclophosphamide
      200 mg/kg, with the addition of splenic irradiation. Despite using higher than
      conventional doses of busulphan, pharmacokinetic analysis revealed very low
      busulphan peak levels and rapid excretion. As a possible consequence, only
      partial chimerism was achieved, but full engraftment ensued following the
      discontinuation of cyclosporin A, rebound donor lymphocytosis and the onset of
      acute GVHD. We suggest that host resistance to engraftment and tumour elimination
      was overcome by removing a suppressive effect on donor lymphocytes, allowing a
      graft-versus-leukaemia effect.

PMID- 8467292
TI  - Folinic acid rescue after methotrexate.

PMID- 8467293
TI  - Thalidomide as therapy for intestinal chronic GVHD.

PMID- 8467294
TI  - Comparison of psychologic and physiologic functioning between patients with
      masticatory muscle pain and matched controls.
AB  - This study explored the physiologic and psychologic distinctions between
      masticatory muscle pain patients and age and sex-matched normal controls.
      Subjects completed several standardized psychologic tests. They then underwent a
      laboratory stress profile evaluation to obtain physiologic measures (EMG, heart
      rate, systolic and diastolic blood pressure) under conditions of rest, mental
      stress, and relaxation. The pain patients reported greater anxiety, especially
      cognitive symptoms, and feelings of muscle tension than did the controls. Under
      stress, pain patients had higher heart rates and systolic blood pressure than the
      controls. Electromyogram activity in the masseter regions was not significantly
      different between the pain and control group. The results are discussed in terms
      of the likely mechanisms that might account for the observed differences between
      masticatory pain patients and normal subjects.

PMID- 8467295
TI  - Temporomandibular joint pain assessment.
AB  - The aim of this study was to evaluate pain characteristics of patients with
      temporomandibular joint-related pain and propose a rationale for the assessment
      of pain and its impact on patients with temporomandibular disorders. Based on
      anamnestic information, the 88 patients in the sample were classified according
      to pain grade: (1) acute/subacute nonrecurrent or recurrent pain, n = 41 (46.6%);
      (2) persistently recurring pain in relatively high frequency, or nonsevere
      persistent pain, n = 32 (36.4%); (3) persistent and impairing pain, n = 8 (9.1%);
      (4) persistent and disabling pain, n = 7 (7.9%); and (5) persistent and
      handicapping pain, n = 0. Regarding TMJ pain provoked during the clinical
      examination, there was a significant difference among diagnostic subgroups,
      subgroups with different pain intensity levels, and pain grade subgroups, but no
      significant differences could be found based on the duration of the pain
      symptoms. Subgroups also did not significantly differ in scores on the Multi
      dimensional Pain Inventory and the General Health Questionnaire. Based on the
      results of the study, the assessment of nonchronic TMJ pain may generally be
      limited to an accurate description of the pain complaint and thorough clinical
      assessment. Multidimensional assessment may be useful when the TMJ pain persists
      or is persistently recurring. Depending on individual circumstances, additional
      assessment procedures may prove to be useful. A general strategy for pain
      assessment in temporomandibular disorders is proposed.

PMID- 8467296
TI  - Craniomandibular disorders in the geriatric patient.
AB  - This paper represents a general review of basic age-related changes that take
      place in the craniomandibular apparatus and the most frequently presenting
      conditions associated with craniomandibular disorders (CMD) in the elderly. The
      evaluation of geriatric patients with signs or symptoms of CMD must consider (1)
      normal age-related changes in the craniomandibular apparatus and their impact on
      both normal function and responses to stress; (2) the role of dentition status
      and dental prosthesis in CMD; and (3) the contribution of malignant disease,
      psoriasis, arthritic conditions, pseudogout, granulomatous vascular conditions,
      and metaplastic involvement of tissue to the pathosis of CMD. The clinician must
      also be aware of various effects of psychologic, sociologic, and biologic aspects
      of aging on the development of headache and atypical facial pain as components of
      CMD in the geriatric patient.

PMID- 8467297
TI  - Characterization of 86 bruxing patients with long-term study of their management
      with occlusal devices and other forms of therapy.
AB  - Of 353 patients screened, 86 answered positively to questions designed to
      identify bruxers. The bruxing patient profile revealed that 100% had working
      excursive interferences, 78% had balancing excursive interferences, and 95.4% had
      a premature contact into maximum intercuspation. Most of the bruxing patients had
      a chief complaint that related to pain, and 89.6% of the patients had a
      craniomandibular disorder. The patients were initially managed with an anterior
      deprogrammer and were later managed with other occlusal devices as signs and
      symptoms dictated. Definitive treatment was determined by the patient's
      maxillomandibular relationship.

PMID- 8467298
TI  - Clinical follow-up with different disc positions.
AB  - A clinical follow-up of 45 previously symptomatic patients with arthrographically
      diagnosed TMJ disc positions was performed at least 1 year (average, 4 years 4
      months) after treatment. The patients were divided into three groups according to
      disc position: (1) superior disc position, n = 5; (2) anterior disc displacement
      with reduction, n = 17; and (3) anterior disc displacement without reduction, n =
      23. Ninety-two percent of the patient were treated conservatively. Seventy
      percent of the patients reported being symptom-free or improved. The frequency of
      joint clicking did not change considerably, but the amount of crepitating sounds
      increased markedly. No difference was found regarding treatment outcome between
      the anterior disc displacement groups with and without reduction.

PMID- 8467299
TI  - Reproducibility of the condylar reference position.
AB  - The reproducibility of the condylar reference position was examined at the pont
      of unstrained hinging movement of the mandible in subjects with TMJ symptoms and
      in asymptomatic subjects. Three different operators performed the procedure to
      detect interoperator variability. Each operator made five registrations using
      computerized axiography in the electronic mandibular position indicator mode.
      Data were evaluated by an analysis of variance using three factors: (1)
      repetitions of the single operator, (2) data from symptomatic versus asymptomatic
      patients, and (3) values of different operators. The results showed that none of
      these factors had a significant influence on reproducibility of the condylar
      reference position. High reproducibility was obtained in both symptomatic and
      asymptomatic groups. Measured values remained within +/- 0.1 mm in 58.6% and
      within +/- 0.2 mm in 24.3% of the registrations.

PMID- 8467300
TI  - Thermographic characterization of the asymptomatic temporomandibular joint.
AB  - This study used electronic thermography, an alternative diagnostic imaging
      modality, to assess the thermal image characteristics of the normal TMJ in 30
      asymptomatic subjects. Assessments made included: thermal pattern recognition and
      symmetry, absolute temperature measurements and differences in absolute
      temperature measurements, and mean temperature measurements and differences in
      five anatomic zones. Results indicated the presence of a common thermal TMJ
      pattern in two thirds of patients, with variations from this pattern in the
      remaining patients. All TMJ thermal patterns demonstrated marked thermal
      symmetry, with delta T < 0.2 degrees C in the region of the TMJ and related
      regions of the face. This consistent symmetry demonstrated in normal subjects
      suggests that substantial thermal asymmetry may prove to be a reliable indicator
      of TMJ disease.

PMID- 8467301
TI  - Changes in subjective symptoms of craniomandibular disorders in children and
      adolescents during a 10-year period.
AB  - An epidemiologic sample of 293 subjects in three age groups, now 17, 21, and 25
      years of age, were followed longitudinally with respect to symptoms of
      craniomandibular dysfunction during a 10-year period. Reports of one or more such
      symptoms increased in all three age groups during the 10 years. At the follow-up,
      1 in 3 individuals in all three groups had noticed such symptoms occasionally and
      10% had them frequently. Reports of oral parafunctions such as bruxing and
      clenching also increased, while other parafunctions such as nail, lip, cheek, and
      tongue biting increased from the age of 7 to 11 but then decreased with age.
      Despite the high incidence of subjective symptoms of craniomandibular disorders,
      only a few subjects had had any kind of functional treatment performed during the
      10-year period, and only 7 had an actual demand for treatment at present.

PMID- 8467303
TI  - Activity of anterior temporalis and masseter muscles during deliberate unilateral
      mastication.
AB  - The reproducibility of electromyographic parameters descriptive of deliberate
      unilateral chewing (activity, timing, curve symmetry) was investigated in normal
      asymptomatic volunteers. The best time for the initiation of muscle activity was
      also examined, with the future aim of staging TMJ internal derangements. The
      results suggest that activity is the most reliable variable, indicating that it
      may be helpful in describing muscle incoordination. When time was used in
      conjunction with another variable, overall reproducibility decreased.

PMID- 8467302
TI  - Management of craniomandibular disorders. Part 1: A craniocervical dysfunction
      index.
AB  - A craniocervical dysfunction index has been developed (based on the Helkimo
      Dysfunction Index) to comprehensively assess craniocervical dysfunction and to
      objectively monitor the management of patients who present with these clinical
      problems. The close functional interrelationship of temporomandibular joints, jaw
      muscles, and cervical joints and muscles is reviewed, and a mechanism is proposed
      to explain dysfunctional relationships between these structures. This is the
      first of three papers stemming from a clinical study that investigated
      craniomandibular disorders and assessed the effect of routine dental management
      on craniomandibular and craniocervical dysfunction.

PMID- 8467304
TI  - Cold chain study: danger of freezing vaccines.

PMID- 8467305
TI  - Pharmacochemistry Meeting. Aspects of Metabolism Weesp, The Netherlands, 11
      December 1992. Abstracts.

PMID- 8467306
TI  - Pharmaceutical and Biomedical Analysis Meeting. Tilburg, The Netherlands, 27
      November 1992. Abstracts.

PMID- 8467307
TI  - Urinary dopamine and sodium excretion in spontaneously hypertensive rats.
AB  - We measured urinary dopamine in spontaneously hypertensive rats (SHR) and
      normotensive Wistar-Kyoto rats (WKY) before (days 0-6) and during high-salt diet,
      in the absence (days 6-10) and presence (days 10-14) of added L-dopa (2 mg/kg/day
      by gavage). Urinary excretion of sodium (UNaV) increased 20-fold during intake of
      chow containing 8% NaCl in both strains. Systolic blood pressure (SBP) of SHR
      increased slightly (9 +/- 4 mmHg; p < 0.05) on the high-salt diet, whereas SBP
      did not change in WKY. Urinary dopamine excretion was not different between
      strains in the basal state, and was as great or greater in SHR than WKY during
      high-salt intake with and without added L-dopa. SBP was unaffected by L-dopa
      administration and UNaV did not increase or differ between strains despite higher
      urinary dopamine excretion in SHR. We conclude that renal dopamine formation in
      vivo is not diminished in SHR, compared with WKY, on normal or high-salt diets,
      and that elevation of renal dopamine formation secondary to L-dopa administration
      is not associated with reductions in SBP or altered UNaV in these rats.

PMID- 8467308
TI  - Evaluation of a structured treatment and teaching programme on hypertension in
      general practice.
AB  - OBJECTIVE: Evaluation of a structured hypertension treatment and teaching
      programme in general practice. DESIGN: Prospective controlled trial; follow-up
      period 18 months. SETTING: 10 primary health care practices. PRACTICES AND
      PATIENTS: From each practice 20 patients (30 to 60 years old, mean of the last
      two blood pressure measurements at or above 160 and/or 95 mmHg) were randomly
      selected; in 5 practices these patients were to participate in the treatment and
      teaching programme; in the remaining 5 practices hypertension care was continued
      without the availability of such a programme (controls). INTERVENTION: Structured
      treatment and teaching programme based upon four group sessions for patients
      mainly conducted by paramedical personnel. MAIN OUTCOME MEASURES: Blood pressure,
      body weight, prescription of antihypertensive drugs - as documented in the
      patient's records. MAIN RESULTS: Of the 100 control patients 26 and of the 100
      intervention patients 14 were lost to observation; 46 patients had agreed to
      participate in the programme. The mean number of prescribed antihypertensive
      agents per patient decreased in the intervention group (1.8 +/- 1.3 at baseline,
      vs 1.2 +/- 1.2 at follow-up) compared to the control group (1.6 +/- 1.3 vs 1.8 +/
      1.6); difference 0.8 (95% CI 0.4 to 1.1), p < 0.0001. In the control group 9%
      and in the intervention group 33% of patients had documented reductions of body
      weight (p < 0.0001). Blood pressure decreased in the intervention group (162 +/-
      14/100 +/- 7 mmHg at baseline, vs 154 +/- 16/95 +/- 9 mmHg at follow-up) compared
      to the control group (161 +/- 13/98 +/- 7 mmHg vs 158 +/- 18/96 +/- 11 mmHg);
      differences for systolic blood pressure 5 (95% CI 0 to 10) mmHg, p = 0.071; for
      diastolic blood pressure 4 (1 to 7) mmHg, p = 0.018. CONCLUSIONS: The
      introduction of a structured hypertension treatment and teaching programme in
      general practice may lead to significant improvements of hypertension care.

PMID- 8467309
TI  - Ca2+ ATPase activity in essential and renal hypertension.
AB  - In 15 patients with essential hypertension, 16 patients with renal hypertension
      and in 12 healthy subjects Ca2+ ATPase activity was determined in red blood cells
      both in the basal state and after maximal stimulation with calmodulin. Normal
      subjects showed a basal and maximal activity of 7.1 +/- 3.6 and 16.0 +/- 2.3 pmol
      phosphate/min.10(6) RBC, respectively. Renal hypertensives had a similar basal
      Ca2+ ATPase activity (5.4 +/- 4.1 pmol phosphate/min.10(6) RBC) and a lowered
      maximal Ca2+ ATPase activity (9.8 +/- 5.4 pmol phosphate/min.10(6) RBC, p <
      0.05). In essential hypertensives basal and maximal Ca2+ ATPase activity was 9.0
      +/- 5.3 and 35.4 +/- 14.4 pmol phosphate/min.10(6) RBC, respectively, the latter
      being significantly increased (p < 0.01). This finding, which is in contrast to
      earlier results indicating a lowered Ca2+ ATPase activity in essential
      hypertension, may be explained as a consequence of an increased Ca2+ influx in
      essential hypertension. A lowered Ca2+ ATPase activity does not seem to be
      involved in the pathogenesis of essential hypertension.

PMID- 8467310
TI  - The effects of synthetic alpha-human atrial natriuretic peptide (alpha-hANP) on
      the overall baroreflex system in anesthetized mongrel dogs.
AB  - The effects of alpha-hANP (0.3 micrograms/kg body weight/min) on the baroreflex
      system were studied in anesthetized dogs according to three different protocols.
      In the first protocol, the effects of alpha-hANP on an open-loop gain (G(AP)) of
      the overall baroreflex system and a gain (GHR) of the baroreflex heart rate
      control system during quick mild hemorrhage and blood infusion were studied.
      G(AP) was decreased from 7.6 +/- 0.6 to 2.8 +/- 0.5 by alpha-hANP with
      hemorrhage. G(AP) decreased 7.4 +/- 0.8 to 2.9 +/- 0.4 by alpha-hANP with blood
      infusion. G(AP) was restored nearly to the control levels one hour after alpha
      hANP administration. GHR did not change by alpha-hANP administration. In the
      second and third protocol, a site of action of alpha-hANP was analysed. alpha
      hANP inhibited the responses of systemic vascular resistance to quick mild
      hemorrhage and blood infusion, but did not affect the responses of cardiac output
      to quick mild hemorrhage and blood infusion in the second protocol. After carotid
      sinus denervation and vagotomy, alpha-hANP inhibited an arterial pressure
      responses to phenylephrine and nitroglycerin bolus injection in the third
      protocol. These findings suggest that alpha-hANP has mainly an effect on the
      peripheral vascular system to decrease its responsiveness, resulting in a
      decrease in G(AP).

PMID- 8467311
TI  - Acute and chronic effects of losartan (DuP 753) on blood pressure and vascular
      reactivity in normotensive rats.
AB  - The effects of in vivo treatment with the nonpeptide subtype 1 angiotensin II
      receptor antagonist, losartan, on blood pressure and vascular reactivity in
      normotensive male Sprague-Dawley rats were studied. Initial acute experiments
      demonstrated that blood pressure was significantly decreased six hours following
      a single injection of losartan (10 mg/kg, sc), but returned to control levels by
      24 hours post-injection. Pressor responses to angiotensin II (0.1 ug/kg, iv) in
      these rats were significantly attenuated 2 and 24 hours following losartan
      injection. For chronic studies, rats were injected once daily for 21 days with
      either the same dose of losartan or saline vehicle. Blood pressure and pressor
      responses to angiotensin II were assessed at the end of the 21 day treatment
      period. A significant decrease in blood pressure was observed in chronic losartan
      treated rats 6 hours after the last injection on day 21; however, as in the acute
      studies, blood pressure had returned to control values by 24 hours post
      injection. Although blood pressure had returned to normal, pressor responses to
      angiotensin II were significantly attenuated in chronic losartan treated rats 24
      hours after the last injection. Following the in vivo studies, aortae and tail
      arteries were removed for experiments on vascular reactivity. Acute and chronic
      losartan treatment had no effect on KCl and norepinephrine reactivity.
      Endothelial-dependent and independent relaxation responses were also unaltered. A
      significant decrease in the maximal contractile response to angiotensin II was
      observed in aorta from acute and chronic losartan treated rats. Electrical
      stimulation-induced responses were unaltered in tail arteries from rats acutely
      treated with losartan but were potentiated in rats chronically treated with
      losartan. Exogenously applied angiotensin II, in concentrations which did not
      elicit contractile responses, potentiated electrical stimulation-induced
      responses of tail arteries from control rats but did not influence responses in
      arteries from acute and chronic losartan treated rats. These results demonstrate
      that losartan has significant blood pressure lowering effects in normotensive
      rats. Interestingly, although blood pressure returns to normal by 24 hours post
      injection, pressor responses to angiotensin II remain attenuated in acute and
      chronic losartan treated rats. Finally, losartan treatment results in specific
      alterations in vascular reactivity associated with the actions of angiotensin II.

PMID- 8467312
TI  - The acute effect of nicardipine on the renin-angiotensin-aldosterone system in
      salt-sensitive essential hypertension.
AB  - To determine the role of the renin-angiotensin-aldosterone (RAA) system in the
      acute effect of calcium channel blockers, we examined the acute effect of 40 mg
      nicardipine in 21 essential hypertensive patients. Nine patients whose mean blood
      pressure (MBP) decreased more than 5% at 2 hours after 20 mg furosemide i.v. were
      classified as salt-sensitive (SS); the remainder as salt-resistant (SR). The
      percentage decrease of MBP with nicardipine was not different between the two
      subgroups (12.4 +/- 2.5% for SS, and 17.7 +/- 4.1% for SR). The percentage
      decrease of MBP correlated with the pretreatment MBP (r = 0.67, p < 0.001), but
      not with the basal plasma renin activity (PRA), plasma aldosterone concentration
      (PAC), or natriuretic response. A significant increase of heart rate was noted in
      SR (31.2%) but not in SS (6.5%), and was associated with a higher increase of PRA
      in SR (90.7%) than in SS (25.5%). A correlation between the increase of PRA and
      the percentage increase of heart rate was noted (r = 0.77 p < 0.001). Decrease of
      PAC was observed in SS but not in SR until the third hour. The 3-hour sodium
      excretion was slightly greater in SR than in SS (59.9 +/- 9.1 vs. 35.1 +/- 3.0
      mEq; p < 0.05). In summary, the acute hypotensive effect of nicardipine is
      dependent upon the vascular tone regardless of the status of the RAA system. An
      increase in PRA by nicardipine resulting from a baroreflex mechanism may
      counteract the inhibitory effect of aldosterone secretion by nicardipine. The
      unchanged PRA in SS is due to their blunted baroreflex control of heart rate.
      Mechanisms other than the change in the RAA system by nicardipine may account for
      the acute natriuretic effect.

PMID- 8467313
TI  - Hemodynamic effects on thrombogenesis and platelet aggregation in spontaneously
      hypertensive rats.
AB  - The present study was conducted to investigate the effect of hypertension on the
      formation of arterial thrombus in the rat femoral artery. The time required to
      establish the thrombus following endothelial injury in spontaneously hypertensive
      rats (SHR) was extremely prolonged. Pretreatment with prazosin which lowered the
      blood pressure near the level in normotensive Wistar Kyoto (WKY) rats,
      significantly shortened the thrombogenesis time, but it was still longer than
      that in WKY rats. Platelet aggregation in response to collagen with washed
      platelets and whole blood was reduced in SHR with and without hypotensive
      treatment, in comparison with that in WKY rats. Prazosin did not affect the
      platelet aggregability. Therefore, the decreased platelet aggregation was
      considered to be responsible for the delayed thrombus formation in hypotensively
      treated SHR. These results suggested that high blood pressure, mainly, interferes
      with the establishment of thrombus directly. Hypoaggregability of platelets is
      likely to be partly involved in the prolongation of thrombogenesis in SHR.

PMID- 8467315
TI  - Salivary electrolytes in treated hypertensives at low or normal sodium diet.
AB  - The aim of this study was to investigate possible abnormalities in salivary
      electrolytes in hypertensives treated with ace-inhibitors (ACE-I) or calcium
      antagonists (Ca-ANT) at low or normal sodium intake. Hypertensives treated with
      ACE-I (n.14) or Ca-ANT (n.22) and 13 normotensives were studied during normal or
      restricted Na intake. Na, K, Ca, Mg and Cl were determined in saliva samples
      collected by using a standardized adsorption procedure (SALIVETTE). Na intake was
      evaluated by determination of the 24-hr urinary Na excretion. Similar
      concentrations of Na, K, Ca, and Cl were found in normotensives and in
      hypertensives treated with ACEI or Ca-ANT both at low or normal Na diet.
      Magnesium in saliva appeared reduced in ACEI-treated hypertensives (0.28 +/- 0.06
      mmol/l) in comparison to the similar values of normotensives (0.53 +/- 0.05) and
      Ca-ANT treated hypertensives (0.54 +/- 0.07). In normotensives and in treated
      hypertensives lowering of Na intake did not change the salivary content of Ca, Mg
      and Cl but produced in saliva a reduction of Na associated to a rise in K.
      Salivary Na/K ratio was significantly correlated with 24 hr urinary Na excretion
      in normotensives (r = 0.77; p < 0.05) and in hypertensives treated with ACE-I (r
      = 0.74; p < 0.05) or Ca-ANT (r = 0.62; p < 0.05). The low salivary magnesium in
      ACE-I-HT may have a role in the occasional ACEI-dependent dysgeusia. Salivary
      Na/K ratio may be used as a rough index of Na intake in treated hypertensives.

PMID- 8467314
TI  - Renal responses to acute volume expansion in young spontaneously hypertensive
      rats.
AB  - The renal responses to acute volume expansion (VE) were measured from intact and
      denervated kidneys in 5 week old spontaneously hypertensive rats (SHR). Urine
      flow and sodium excretion were measured before, during and after VE from
      innervated and denervated kidneys in anesthetized (Inactin--0.1 g/kg, ip) age and
      sex matched SHR and normotensive Wistar Kyoto (WKY) rats. Mean arterial pressure
      was 23 mm Hg higher in SHR than in WKY. During VE the increment in urinary flow
      rate and sodium excretion from both innervated and denervated kidneys were
      greater in SHR than WKY. In another group of SHR, renal perfusion pressure was
      maintained at a level similar to the arterial pressure in the WKY group (84 mm
      Hg). When renal perfusion pressure was controlled at the lower level in the SHR
      there was no longer the increase in diuresis and natriuresis in response to acute
      VE. Examining differences within a strain, the SHR demonstrate a greater increase
      in diuresis and natriuresis in response to VE in the absence of renal nerves,
      unlike the WKY. In conclusion, these results suggest that there is a greater
      diuresis and natriuresis in the young SHR due to increased renal perfusion
      pressure and the renal nerves produce a greater retention of water and sodium in
      SHR compared to WKY.

PMID- 8467316
TI  - Diuretic and natriuretic responses to ANF in the presence and absence of renal
      nerves in DOCA-salt hypertensive rats.
AB  - To determine if renal nerves contributes in the renal response to atrial
      natriuretic factor (ANF) in DOCA-salt hypertensive rats, diuretic and natriuretic
      responses to ANF were measured in Inactin (0.1 g/kg, i.p) anesthetized rats with
      unilateral renal denervation. Rats were assigned to either a control group (108
      +/- 6 mmHg), or one of two DOCA-salt groups (injected with deoxycorticosterone
      acetate, DOCA, 25 mg/week, and given 0.9% saline to drink for 4 weeks); a) DOCA
      salt group (137 +/- 6 mmHg) and b) DOCA-salt-BPC group (with blood pressure
      controlled at the level of the femoral artery (102 +/- 3 mmHg) by an occluder on
      the abdominal aorta proximal to the right renal artery). Urine flow and sodium
      excretion in response to ANF infusion (0.3 micrograms/min/kg) were measured from
      intact and denervated kidneys of control and DOCA-salt treated rats. ANF infusion
      produced a significant increase in diuresis and natriuresis in all three groups
      of rats. Urine flow and sodium excretion in response to ANF were significantly
      less in the intact kidney but not the denervated kidneys of the DOCA-salt rats
      compared to control rats. These results indicate that renal nerves contribute to
      the blunted renal responses to ANF in DOCA-salt rats. Renal responses also were
      significantly smaller in both intact and denervated kidneys of DOCA-salt-BPC rats
      (in which arterial pressure was reduced) compared to DOCA-salt rats. Overall,
      these results indicate that both renal nerves and arterial pressure determine the
      natriuretic and diuretic actions of ANF in DOCA-salt hypertensive rats.

PMID- 8467317
TI  - Evaluation of the reproducibility and accuracy of ambulatory blood pressure
      monitoring using the Takeda TM-2420 automated blood pressure monitor.
AB  - The reproducibility of ambulatory blood pressure measurements was assessed in
      eight normotensive subjects who underwent three separate days of recording, using
      Takeda Medical TM-2420 (TM-2420) blood pressure monitors. The coefficients of
      variation of mean 24 hour systolic and diastolic blood pressure were 2.1% and
      2.8% respectively. The corresponding values for systolic and diastolic blood
      pressure variability, were 19% and 14% respectively. Measurement intervals of
      greater than 30 minutes significantly reduced the reproducibility of mean day
      interval systolic measurements. The bias of the TM-2420 systolic and diastolic
      blood pressure measurements compared to standard sphygmomanometer measurement
      were 0 +/- 7 mmHg and 1 +/- 6 mmHg respectively. Ambulatory blood pressure
      monitoring provides reproducible estimates of mean systolic and diastolic blood
      pressure, however, blood pressure variability is poorly reproducible.

PMID- 8467318
TI  - Renin and renin inhibition in anephric man.
AB  - Renin activity appears to be present in low concentrations in the plasma of
      anephric humans but could be artifactual secondary to inadvertent activation of
      prorenin during specimen collection and handling or from a renin-like enzyme. We
      studied the effects of specimen collection, storage, different assay conditions,
      trypsin activation, and the renin inhibitor EMD 56133 (E Merck, Darmstadt) on
      plasma renin activity (PRA) in anephric man. PRA was detectable in all seven
      bilaterally nephrectomized (BNX) patients (0.2 +/- 0.1 ng AI/ml/hr, range 0.1
      0.7) but was significantly lower than normals (2.4 +/- 0.3 ng AI/ml/hr, range 1.5
      3.1, p = 0.001). PRA was not different in BNX whether blood samples were
      collected on ice or at room temperature and assayed immediately or whether
      samples were frozen and assayed several days later. Prolonged cold storage of
      samples and five freeze-thaw cycles over six to seven months did not
      significantly increase PRA in normals or anephrics. However, deliberate repeated
      freezing and thawing over the period of a single day increased PRA 4.1-fold in
      BNX and 1.6-fold in normals. Renin-like activity was also detected in BNX
      individuals using renin concentration determinations with either excess human or
      sheep angiotensinogen. The inhibition of renin activity (IC-50% = 3.16 x 10(-9)
      molar) by EMD 56133 was not different between BNX and normals. Thus, active renin
      is present in the plasma of anephric humans and does not result from the
      inadvertent activation of prorenin due to sample handling. Although the source of
      PRA in BNX is unknown, the enzyme appears functionally normal as evidenced by the
      dose-response to a single renin inhibitor.

PMID- 8467319
TI  - Central neural mechanism contributing to attenuation of angiotensin II-induced
      hypertension in rats on dietary calcium supplementation.
AB  - The effect of dietary calcium (Ca) supplementation on blood pressure (BP) and the
      central nervous system (CNS) mechanism underlying this effect were studied in
      angiotensin II (Ang II)-induced hypertensive rats. The effects of dietary Ca
      (0.5, 2, 4%) on systolic blood pressure (SBP), ionized Ca concentration (Ca++) in
      cerebrospinal fluid (CSF) and central norepinephrine (NE) turnover were
      investigated in male Wistar rats receiving subcutaneous infusion of Ang II (100
      ng/min). Central NE turnover was studied by measuring 3-methoxy-4
      hydroxyphenylglycol (MHPG) concentration in CSF with multiple electrode liquid
      chromatography. Ang II significantly increased SBP, and dietary Ca dose
      dependently attenuated the increase. SBP inversely correlated with Ca++ and MHPG
      in CSF. Intracerebroventricular injection of CaCl2 more markedly reduced BP in
      Ang II-treated rats than that in control rats. These results suggest that
      modulation of central NE turnover possibly caused by the increase in CNS Ca++ is
      involved in the anti-hypertensive mechanism of dietary Ca supplementation in Ang
      II-induced hypertensive rats.

PMID- 8467320
TI  - A renin-secreting tumour with severe hypertension and cardiovascular disease: a
      diagnostic and therapeutic challenge.
AB  - A case of renin-secreting juxtaglomerular cell tumour which presented with a
      severe hypertensive crisis and did not respond to angiotensin converting enzyme
      inhibitors but was promptly controlled by intravenous labetalol is reported. The
      diagnostic difficulties which can be encountered in such cases and the usefulness
      of the different diagnostic tests, including renal vein renin measurement, are
      discussed.

PMID- 8467321
TI  - Atrial natriuretic factor response to acute volume expansion in borderline
      hypertension. Role of ACE-inhibition and changes in peripheral venous tone.
AB  - Abnormalities in the response of atrial natriuretic factor (ANF) to volume
      expansion have been reported in hypertensive-prone animals and men as well as in
      hypertensive patients undergoing ACE-inhibition. To investigate some of the
      mechanisms affecting ANF release in borderline hypertensive patients (BHT) we
      have studied 16 subjects by assessing their neuro-humoral and hemodynamic
      response to a two-hour isotonic i.v. NaCl infusion carried out during short-term
      administration of either placebo or captopril. ACE-inhibition increased baseline
      venous distensibility (VV30:1.4 vs 1.6 ml/100 ml; p < .05) and reduced the prompt
      (45') ANF response to saline loading (10.3 +/- 13 vs 42.7 +/- 15%; p < .05))
      without affecting the overall ANF release (120':92 +/- 25 vs 65.8 +/- 20%; NS)).
      A significant pressor increase in response to NaCl loading was observed
      exclusively after ACE-inhibition (SBP: 5.2 +/- 2 vs 2.4 +/- 1%; p < .05--DBP: 7.1
      +/- 3 vs 2 +/- 3%; p < .025) and occurred along with a peripheral arterial and
      venous constriction and with an increase in plasma levels of an endogeneous
      Na+/K+ATPase inhibitor (8.8 +/- 4 vs -2 +/- 4%; p < .05). We conclude that the
      ANF response to saline infusion is delayed by ACE-inhibition in borderline
      hypertensives. The abnormalities observed in ANF response could follow the
      changes in peripheral venous distensibility and contribute to the pressor and
      neuro-humoral derangements described in borderline hypertensives during volume
      expansion.

PMID- 8467322
TI  - Arterial pressure, plasma renin activity, atrial natriuretic factor, and sodium
      excretion during induced hyper- and hypoinsulinemia in therapy-resistant
      hypertensives.
AB  - We investigated whether short-term changes in serum insulin would effect a
      reduction of arterial pressure in subjects with therapy-resistant essential
      hypertension. Six patients were examined twice with a 3 week's interval in a
      single-blind cross-over design with euglycemic insulin clamps (A and B). A
      reduction of endogenous serum insulin was achieved by continuous infusion of 50
      microgram octreoid (a somatostatin analogue) per hour. During clamp A low dose
      insulin infusion (5 mU/m2/min) was given, whereas during clamp B insulin was
      infused at a rate of 60 mU/m2/min. Preceding each clamp a standard drug therapy
      was given for one week (50 mg atenolol+ 30 mg furosemide per day). During clamp A
      plasma insulin was reduced from 21.4 +/- 7.5 to 10.8 +/- 1.2 mU/l (p < 0.01)
      whereas plasma insulin rose during clamp B from 20.0 +/- 7.5 to 99.0 +/- 17.2
      mU/l (p < 0.001). The mean arterial blood pressure did not decrease during clamp
      A (low dose insulin infusion). There was an increased natriuresis during the high
      insulin clamp (70 vs. 38 mmol, p = 0.13), but no difference in arterial pressure
      between the clamps. The results do not support the notion that high insulin
      levels contribute to hypertension in therapy resistant hypertensive patients by
      any direct and immediate mechanism.

PMID- 8467323
TI  - Heritability estimates of blood pressure in genetically selected White Carneau
      pigeons.
AB  - Seven White Carneau (WC) pigeon families of the high blood pressure (HBP) line
      with 51 offspring and six families of the low blood pressure (LBP) line with 57
      offspring were used to estimate heritability of the blood pressure trait. Pigeons
      from the HBP line had significantly higher systolic blood pressures than the LBP
      line at ages 1 through 6 months. No significant effect of age on blood pressure
      was observed in either the HBP line or the LBP line. Systolic, diastolic and mean
      arterial pressures were 155 +/- 6.4 and 122 +/- 5.7 and 139 +/- 6.1,
      respectively, for male parents and 163 +/- 9.3 and 125 +/- 7.1 and 143 +/- 8.3,
      respectively for female parents. The mid-parent mean averaged across pairs was
      159 +/- 7.3 and 123 +/- 5.9, and 141 +/- 6.6, for systolic, diastolic, and mean
      arterial pressures, respectively. The average systolic, diastolic, and mean
      arterial pressures for offspring were 159 +/- 5.9, 132 +/- 5.5, and 147 +/- 5.6,
      respectively. Blood pressure measurements did not differ greatly between the
      offspring and the mid-parent mean, indicating that offspring inherit blood
      pressure levels similar to those of their parents. Mean heart rates were 189 +/-
      12.2, 202 +/- 14.2 and 197 +/- 9.9 for the male parents, female parents and
      offspring, respectively. Heritability estimated by the regression of offspring on
      the mid-parent mean was 0.55 +/- 0.18, 0.69 +/- 0.19 and 0.61 +/- 0.18, 0.82 +/-
      0.19 for systolic, diastolic and mean arterial pressure and heart rate,
      respectively. The results suggest that genetic factors play a significant role in
      influencing blood pressure in WC pigeons.

PMID- 8467325
TI  - Effects of nisoldipine on hypertension and glomerulosclerosis in Cohen diabetic
      rat with Goldblatt hypertension.
AB  - Nisoldipine treatment for five months prevented a rise in blood pressure in Cohen
      diabetic rats with Goldblatt hypertension, compared to a significant elevation in
      untreated controls. Blood creatinine and urea also decreased significantly in the
      treated animals, and renal lesions were less severe. The prevalence of
      glomerulosclerosis, however, remained unaltered in both the treated and control
      groups. These findings indicate that increased blood pressure aggravates renal
      changes, while reducing it eliminates the aggravation.

PMID- 8467324
TI  - Atrial natriuretic factor and changes in the aldosterone response to angiotensin
      II in sodium depleted dogs.
AB  - The effects of physiological shifts in plasma atrial natriuretic factor (ANF)
      concentrations on angiotensin II/aldosterone relationships during changes in
      sodium status were assessed in 6 conscious beagle dogs. Incremental infusions of
      angiotensin II (3, 9 and 27ng/kg/min) were administered on three occasions. The
      animals were studied in sodium replete and deplete states and on a third
      occasion, again while sodium deplete, with a background constant low-dose
      infusion of ANF (1.5pmol/kg/min) sufficient to enhance the low endogenous plasma
      ANF values observed in sodium depletion to match those observed in the sodium
      replete state. Sodium depletion caused a leftward shift and steepened the slope
      of the relationship between achieved arterial angiotensin II concentrations and
      the plasma aldosterone response. This effect was significantly attenuated
      (approximately 50%) by the low dose ANF infusions which tended to flatten the
      slope of the angiotensin II/aldosterone curve (ns) and shifted it significantly
      to the right (p < 0.05). These data suggest subtle shifts in endogenous levels of
      plasma ANF, accompanying changes in sodium status, are a major contributor to the
      associated alterations in angiotensin II/aldosterone relationships. Low dose ANF
      also significantly reduced the effect of angiotensin II on arterial pressures but
      did not alter natriuresis.

PMID- 8467326
TI  - Muscarinic receptors in the aortae of normo- and hypertensive rats: a binding
      study.
AB  - The muscarinic receptors in the aorta of the normo- and hypertensive rats were
      characterised with tritiated acetylcholine (3H-ACh) and various muscarinic
      receptor antagonists. The binding of 3H-ACh to the endothelial membranes of the
      normotensive Wistar Kyoto rats (WKY) and the spontaneously hypertensive rats
      (SHR) was displaceable by nanomolar range of scopolamine but only by micromolar
      range of atropine and homatropine. The reverse was observed with the muscle
      binding sites, i.e. the 3H-ACh was displaceable by nanomolar range of atropine
      and homatropine but only by micromolar range of scopolamine. Pirenzepine and 4
      diphenyl-acetoxy-N-methyl-piperidine metobromide (4-DAMP) displaced the binding
      of 3H-ACh from both tissues in the nano to micromolar range, with the
      displacement from the endothelial binding sites occurring at lower concentration
      range of the ligands. The apparent IC50 values of both compounds for the smooth
      muscle were 9 and 16 times greater than those for the endothelial binding sites
      respectively. When saturated with guanylyl-imididiphosphate (GppNHp), conversion
      of high to low-affinity binding site occurred in both tissues of the WKY but only
      in the smooth muscle of the SHR. GppNHp had no apparent effect on the binding of
      3H-ACh to the endothelial binding sites confirming that the high-affinity site
      for 3H-ACh was missing in the endothelium of the SHR.

PMID- 8467327
TI  - The effects of PEG-interleukin-2 and interleukin-2 on essential hypertension and
      cellular immune function in the spontaneously hypertensive rat.
AB  - The effects of recombinant human interleukin-2 covalently linked to polyethylene
      glycol (PEG-IL-2) or interleukin-2 (IL-2) on hypertension and in vitro suppressor
      T cell function in the spontaneously hypertensive rats (SHR) were investigated.
      Male young prehypertensive (4 weeks old) SHRs and adult (10 weeks old) SHRs with
      established hypertension were injected with low (5,000 units (u)/kg) or high
      (50,000-100,000 u/kg) dose of PEG-IL-2 or IL-2 as a single bolus or repeated
      injections. Systolic blood pressure was measured twice weekly using the tail-cuff
      technique. Systolic blood pressure in the PEG-IL-2 or IL-2 treated animals,
      irrespective of age, dose, or route of injection, did not differ significantly
      from that measured in vehicle-treated controls over a 10 week period. Mean
      arterial pressure measured by intra-arterial catheter was 159 +/- 7 mm Hg 10
      weeks after treatment with repeated injections of 5,000 u/kg of PEG-IL-2 and 158
      +/- 9 mm Hg in vehicle-treated controls. All rats injected with IL-2 had IL-2
      specific IgG antibody in their sera. None of the PEG-IL-2 treated rats had any
      detectable anti-IL-2 antibodies in their sera. Thus, PEG-IL-2 showed far less
      immunogenicity than IL-2. Suppressor T (Ts) cells generated from adult SHR spleen
      cells failed to suppress pokeweed mitogen (PWM)-driven immunoglobulin G (IgG)
      synthesis. PEG-IL-2 or IL-2 supplementation both in vitro and in vivo restored
      the ability of adult SHR to generate Ts cells able to inhibit IgG synthesis. Our
      data suggest that PEG-IL-2 or IL-2 administration does correct a prominent
      defective Ts cell activity found in adult SHR, but that correction of this immune
      abnormality is not attended by an attenuation of hypertension.

PMID- 8467328
TI  - The effects of imagery on emotions, immune function, and cancer outcome.

PMID- 8467329
TI  - Responses of existing women's organizations to the women's movement of the 1970s-
      competition or cooperation.

PMID- 8467330
TI  - The relationship between quadriceps angle and anterior knee pain syndrome.
AB  - Anterior knee pain syndrome (AKPS) represents a significant challenge for
      patients and for clinicians. The purposes of this study were: 1) to determine the
      reliability of the Q-angle measurement, 2) to quantify Q-angle changes that occur
      with knee flexion, and 3) to determine if subjects with AKPS (N = 52) have a
      significantly different Q-angle than subjects without AKPS (N = 50). With the
      knee in an extended position, intratester Q-angle intraclass correlation
      coefficients (ICC) ranged from .84 to .90, and standard error of measurement
      (SEM) values ranged from 2.01 to 2.23 degrees. Intertester Q-angle ICC was .83,
      and the SEM was 2.49 degrees. With the knee flexed, the intratester ICC was .83
      for both testers, and SEM values ranged from 0.68 to 2.45 degrees. Intertester
      ICC and SEM were .65 and 3.50 degrees, respectively. No significant difference
      was found in intratester Q-angle values between the extended and flexed knee
      positions (p > 0.05). No significant difference in Q-angle was found between
      asymptomatic subjects (11.1 +/- 5.5 degrees) and symptomatic subjects (12.4 +/-
      5.1 degrees) (p = 0.07). Increased Q-angles were not responsible for AKPS in this
      group of patients. Other factors were hypothesized to be responsible for their
      symptoms.

PMID- 8467331
TI  - The stretch-shortening cycle of the quadriceps femoris muscle group measured by
      isokinetic dynamometry.
AB  - The ability to measure the stretch-shortening cycle of isolated muscle groups has
      been limited. The purpose of this study was to measure the stretch-shortening
      cycle of the quadriceps femoris muscle group. Twenty-four volunteer subjects, 12
      men and 12 women, participated in one test session; five men and five women also
      participated in a retest session; to examine the reliability of the test. A
      concentric contraction of the left quadriceps was measured for peak torque and
      time to peak torque on a Biodex isokinetic dynamometer under three conditions: 1)
      passive stretch before a concentric contraction, 2) isometric preload before a
      concentric contraction, and 3) eccentric preload before a concentric contraction.
      Conditions 2 and 3 showed a significant increase in peak torque production
      compared to condition 1 (p < 0.01). A significant difference was found for all
      three conditions between the men and women, with the men producing greatest peak
      torques. Conditions 2 and 3 also showed a significantly decreased time to peak
      torque compared with condition 1 (p < 0.01). The testing protocol was found to
      have high reliability. This testing protocol could be used to further study the
      stretch-shortening cycle in the quadriceps femoris muscle group.

PMID- 8467332
TI  - The effect of foot orthotics and gait velocity on lower limb kinematics and
      temporal events of stance.
AB  - Research on foot orthotics is primarily restricted to their effect on the lower
      limb during running. Research is limited, however, on the potential of foot
      orthotics to control the mechanics of the foot during walking. The purpose of
      this study was to examine the interactive effect of foot orthotics and two
      walking speeds on the angular changes at the rearfoot, ankle, and knee, and
      temporal events during stance. Ten subjects demonstrating a minimum of 3 degrees
      of calcaneal eversion in relaxed standing participated in the project. All
      subjects routinely wore functional orthotics that were used during testing in
      conjunction with personal athletic shoes. Individuals were tested with and
      without the orthotics while walking on a treadmill at 2 and 3 mph. A four-camera
      motion analysis system was used to capture three-dimensional motion at 60 frames
      per second. Angle plots illustrated changes in joint motion at the knee, ankle,
      and rearfoot. Temporal data for heel strike, heel rise, and toe off of the foot
      during the stance were calculated. A two-factor repeated analysis of variance was
      used to determine the main and interactive effects of the orthotic and speed on
      the dependent variables. When walking with the orthotic, there was a significant
      reduction in the degree of pronation throughout stance as well as an increase in
      the duration of stance time as measured from heel strike to heel rise. The
      orthotic did not significantly reduce the velocity of pronation during the first
      20% of stance. There was a speed effect for peak dorsiflexion and knee
      flexion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467333
TI  - The effects of pad placement and angular velocity on tibial displacement during
      isokinetic exercise.
AB  - The purpose of this study was to compare the effects of proximal single
      resistance pad placement (PSPP) and distal single pad placement (DSPP) on tibial
      displacement during isokinetic exercise on anterior cruciate ligament (ACL)
      deficient knees. This study is important to the clinician because it documents
      tibial displacement during open chain isokinetic knee extension exercise at
      various isokinetic speeds. In addition, this study documents the range of motion
      where the greatest amount of anterior tibial displacement occurs. The anterior
      displacement of the tibia was recorded by a computerized knee laxity testing
      device during isokinetic exercise. Data were collected from 12 ACL-deficient
      knees. Each subject was tested on an OSI Knee Signature System for quantifiable
      tibial displacement during a Lachman's test, anterior drawer test, and active vs.
      passive knee extension. Following this, each subject was tested on a Biodex
      isokinetic dynamometer at isokinetic velocities of 60, 180, and 300 degrees/sec
      with the computerized knee laxity testing device in place. Pad placement
      consisted of distal single pad placement, which is 1 inch proximal to the medial
      malleolus, and proximal single pad placement, which is 3 inches proximal to the
      DSPP location. The testing procedure was standardized, and peak torque was
      monitored to ensure consistent maximal effort throughout the study. The results
      indicated that PSPP resulted in less anterior tibial displacement at all three
      test speeds. The peak anterior tibial displacement occurred in a range from 30 to
      15 degrees of knee flexion at both pad placements and all three test
      speeds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467334
TI  - The effect of isokinetic exercise on the relationship between blood lactate and
      muscle fatigue.
AB  - Exercise velocity may be an important variable in determining the amount of blood
      lactate accumulation during isokinetic exercise. The purpose of this study was to
      measure the effects of velocity-specific isokinetic exercise on blood lactate,
      muscle fatigue index, and rating of perceived exertion and to examine the
      relationship between blood lactate and muscle fatigue index. Ten experienced
      recreational weight trainers, aged 20-40 years, took part in a repeated measures
      design consisting of three separate treatments (constant angular velocity at 30,
      120, and 300 degrees/sec performed at maximal effort for 1 minute by the right
      knee flexors and extensors). Rating of perceived exertion, blood lactate, and
      muscle fatigue index were measured in response to each treatment. Rating of
      perceived exertion was equal across all three speeds. Muscle fatigue and blood
      lactate increased significantly as the velocity of exercise increased. There was
      also a positive correlation coefficient (r = .82, < or = 0.01) between muscle
      fatigue index and blood lactate. The data suggested that the magnitude of muscle
      fatigue index and blood lactate responses are strongly dependent on the velocity
      of movement utilized during maximal isokinetic exercise, and there is a
      relationship between muscle fatigue index and blood lactate.

PMID- 8467335
TI  - Athletic trainer utilization in sports medicine clinics.
AB  - Increased use of athletic trainers in sports medicine clinics has created a need
      for information related to actual and ideal use of these professionals in these
      settings. The purposes of this study were to 1) describe the characteristics of
      sports medicine clinics and their personnel, 2) determine whether there were
      differences between opinions of certified athletic trainers (ATCs), physical
      therapists (PTs), and professionals with dual credentials (PT/ATCs) about the
      ideal role of the ATC in sports medicine clinics, and 3) determine whether there
      were differences in actual usage of ATCs between states with and without athletic
      training laws. Subjects included 46 PTs, 43 PT/ATCs, and 73 ATCs from six
      different states. A questionnaire ascertained opinions about ideal ATC
      utilization and about current practice of ATCs with respect to 28 different
      clinical procedures. For 27 of the 28 procedures, there were significant
      differences of opinion about ideal ATC utilization between individuals with the
      three credentials. No significant differences in actual athletic trainer use in
      sports medicine clinics were found between states with and without athletic
      training laws.

PMID- 8467337
TI  - Mechanical power and muscle action during forward and backward running.
AB  - Recently, there has been increasing interest in using backward running (BR) as an
      exercise and rehabilitation tool. To date, no study has been performed that
      combined electromyography (EMG) and joint kinetics to study BR. The purpose of
      this study was to compare selected EMG and kinetic parameters in the stance phase
      of forward running (FR) and backward running (BR). The sagittal plane of the
      right knee was analyzed during three trials of FR and BR in six male subjects.
      Four 60-Hz video cameras collected motion data, and a link segment model of the
      right lower extremity was established. Force plate and EMG data were collected at
      1000 Hz and synchronized with the video data. The knee muscle peak (+) and peak (
      ) mechanical power and total (+) and total (-) mechanical work were calculated.
      Electromyography signals were captured from the right lower extremity on the
      rectus femoris, vastus lateralis, vastus medialis, biceps femoris, gastrocnemius,
      and tibialis anterior muscles. Statistical analysis indicated that significantly
      less (p < 0.05) peak (+) and (-) power and total (+) work occurred at the knee
      during BR than during FR. Significant differences (p < .05) in muscle firing
      patterns between conditions were observed. Muscle action of the vastus lateralis
      (VL) and vastus medialis oblique (VMO) was largely eccentric and concentric
      during FR and isometric and concentric during BR. Backward running appears to be
      a good method for achieving isometric and concentric muscle action of the VMO and
      VL and may be useful in clinical conditions that require an increase in knee
      extensor strength.

PMID- 8467336
TI  - Lower extremity muscular flexibility in long distance runners.
AB  - Muscle tightness is often considered to be a predisposing factor in muscle
      injuries. The purpose of this study was to assess the muscle flexibility of the
      hamstrings, rectus femoris, iliopsoas, gastrocnemius, and soleus muscles in long
      distance runners. Range of motion measurements of five movements, including hip
      flexion with knee extended, hip extension with knee flexed, hip extension with
      knee extended, ankle dorsiflexion with knee extended, and ankle dorsiflexion with
      knee flexed, were evaluated to determine muscle tightness. Twenty runners and 20
      nonrunners volunteered for the study. Each group consisted of 10 males and 10
      females. The observed means were compared between runners and nonrunners, males
      and females, plus the dominant and nondominant leg using a three-way analysis of
      variance. The runners were found to have tighter hamstrings (p < .05), and soleus
      (p < .05) muscles than nonrunners. There was no significant difference in rectus
      femoris and iliopsoas muscle tightness in runners compared with nonrunners. In
      addition, the males had tighter hamstring muscles than the females in both
      runners and nonrunners (p < .05). The hamstring muscles of the dominant leg were
      tighter than the hamstrings of the nondominant leg in all subjects (p < .05). In
      conclusion, long distance runners appear to have posterior muscle tightness in
      the lower extremity.

PMID- 8467338
TI  - Development of a computer-assisted method for the collection, organization, and
      use of patient health history information in physical therapy.
AB  - Screening a patient's general health prior to instituting physical therapy
      management is generally acknowledged as important. However, neither the specific
      content nor the optimal method of performing this part of patient examination has
      received much attention. One method that uses a computerized information
      management system to assemble relevant clinical literature and to guide the
      collection, organization, and use of patient health history data in clinical
      decision-making is described. The philosophy and rationale for performance of
      general health screenings by physical therapists, justification for the use of
      computers in the screening process, and the development and application of one
      type of computer-assisted health history screening system for physical therapy
      are presented.

PMID- 8467339
TI  - Performing arts medicine: the musical athlete.
AB  - Musicians and dancers in the performing arts place abnormal stresses on their
      musculoskeletal systems, resulting in overuse injuries. The purpose of this paper
      is to address the factors contributing to musculoskeletal injuries sustained by
      musicians. Recommendations for evaluative procedures, treatment, and education in
      dealing with the needs of this population are discussed.

PMID- 8467340
TI  - The effects of immediate continuous passive motion on pain during the
      inflammatory phase of soft tissue healing following anterior cruciate ligament
      reconstruction.
AB  - Continuous passive motion (CPM) may have potential application as a physical
      modality in decreasing acute pain. The purpose of this study was to examine the
      effects of CPM immediately following an arthroscopically-assisted anterior
      cruciate ligament (ACL) reconstruction utilizing bone-patella-bone autograft on
      acute pain during the inflammatory phase of soft tissue healing. Acute pain was
      measured by assessing the amount of pain medication (amount of narcotic delivered
      from the patient-controlled analgesia (PCA) pump during the first postoperative
      24 hours and the total intake of oral medication during the second and third
      postoperative days), the need for pain medication (number of times the patient
      pushed the PCA button during the first postoperative 24 hours), and perceived
      pain (graphic pain scale measuring antalgic sensation). Thirty patients (15-45
      years old) participated in this study. The patients were prospectively randomized
      into two groups, CPM and non-CPM. Both groups followed an identical postoperative
      rehabilitation program except for the CPM groups using a CPM device. The design
      of this study included the collection of data during the inflammatory phase of
      soft tissue healing. The results indicated that the initiation of CPM immediately
      following an ACL reconstruction had a significant (p < .05) effect on decreasing
      the amount of medication consumed by the patient and a significant (p < .05)
      decrease in the patient's need for medication during the inflammatory phase.
      There was no statistical significance in the level of perceived pain between the
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467341
TI  - A comparison of two different methods to treat hip pain in runners.
AB  - Little or no research has been performed on the physical therapy treatment of hip
      pain. The purpose of this study was to compare two different treatments for hip
      pain. Twenty runners who had primary hip pain and sacroiliac joint dysfunction,
      without evidence of arthritic changes, were randomly assigned to two groups. One
      group received a mobilization technique to the involved hip, while the other was
      treated with a manipulative technique known to affect sacroiliac joint
      dysfunction. The subjects were evaluated by using a pain questionnaire and the
      Faber test to determine the response of the hip joint to treatment. Data were
      analyzed with the Mann-Whitney U statistic for perceived pain response and with
      the Chi-square statistic with Yates correction for the Faber test. Results showed
      a significant difference in perceived pain response, as well as reproduction of
      pain with the Faber test, between the two groups. The results suggest that a
      manipulative technique designed to reduce sacroiliac joint dysfunction is an
      effective method to reduce hip pain. Physical therapists should evaluate the
      sacroiliac joint in patients with hip pain.

PMID- 8467342
TI  - Effects of electrical and electromagnetic stimulation after anterior cruciate
      ligament reconstruction.
AB  - A need exists to develop new methods of neuromuscular electrical stimulation
      (NMES) that are both effective and relatively pain-free. The purpose of this
      pilot study was to determine the effects of both NMES and a new method of
      electromagnetic (NMES/PEMF) stimulation for reducing girth loss and for reducing
      pain and muscle weakness of the knee extensor muscles in patients during the
      first 6 weeks after reconstructive surgery of the anterior cruciate ligament
      (ACL). Seventeen patients receiving ACL reconstructive surgery participated as a
      control group (N = 3), as an NMES group (N = 7), and with combined NMES and
      magnetic field stimulation (NMES/PEMF) (N = 7). Patients receiving NMES/PEMF
      rated each type of stimulation for perceived pain and were measured for their
      torque. Torque results revealed a mean decrease of 13.1% for NMES/PEMF patients.
      The mean percent of thigh girth decreased 8.3% for controls, 0.5% for NMES, and
      2.3% for NMES/PEMF patients. The NMES/PEMF patients rated NMES as causing about
      twice the pain intensity as NMES/PEMF during treatments. As a result of this
      data, the authors conclude that both NMES and NMES/PEMF are effective in reducing
      girth loss and that NMES/PEMF is less painful than NMES alone in treating
      patients after ACL reconstruction.

PMID- 8467343
TI  - Clinical evaluation of the BackMate lower lumbar rehabilitation system: results
      of a preliminary study.
AB  - Back pain profoundly affects daily activities and quality-of-life parameters. It
      was the intent of the present study to evaluate a procedure of stretching and
      strengthening the lower back musculature with the aid of a pelvic stabilization
      device, the BackMate, for the treatment of lower back pain. Subjects suffering
      from chronic back pain (> 3 months in duration) were studied. The treatment
      program consisted of three therapy sessions per week for 3 weeks. Sitting time,
      walking distance, and lower back pain, parameters reported by the subjects,
      significantly improved regardless of age and sex of the subjects. Similarly,
      objective parameters, including forward bend, straight leg raise, and hamstring
      flexibility, significantly improved. This preliminary experience suggests that
      stretching and strengthening procedures performed with the aid of a pelvic
      stabilization device may prove to be a significant addition to current clinical
      treatment procedures for lower back pain.

PMID- 8467344
TI  - Retro runner with ischial tuberosity enthesopathy.
AB  - In reviewing the literature, no studies were found reporting the use of retro
      running on flat and hilly terrain, which elicited enthesopathy (stress reaction)
      at the ischial tuberosity. Therefore, this case study of an atypical enthesopathy
      condition warrants careful scrutiny in order to generate future research. This
      case study describes the clinical management of a female runner with bilateral
      patellofemoral pain who self-initiated a program of backward running and
      stationary bicycling after reading an article about retro running in a runners'
      magazine. She subsequently developed ischial tuberosity enthesopathy verified by
      scintigraphy (bone scan). Her symptoms gradually resolved with physical therapy
      intervention. Eventually, she was able to forward jog 2 miles on flat surfaces
      without complaint of pain but did not resume retro running. This case not only
      suggests the need for further research in retro running kinetics and kinematics
      but highlights the proactive role health professionals must assume in injury
      prevention.

PMID- 8467345
TI  - HDL-cholesterol: exercise formula. Results of long-term (6-year) strenuous
      swimming exercise in a middle-aged male with paraplegia.
AB  - Paraplegic individuals are at increased risk for developing heart disease because
      of low HDL-cholesterol levels. Exercise has been identified as an important
      factor in raising the HDL-cholesterol level. This case study documents the
      effects of long-term (6-year) strenuous exercise (2940 kcal/wk) on lipid markers
      in a 41-year-old white male with paraplegia. An additional 21 mg of HDL
      cholesterol (84% increase) were observed in a paraplegic individual who swam 2100
      kcal/week for 6 years. Througout this study, serial blood samples were analyzed
      for total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. An
      initial low HDL-cholesterol of 25 mg/dl was measured in the subject. This case
      study continued for 72 months to determine the long-term effects on various blood
      lipid fractions of swimming an additional 2.5 hours/week. HDL-cholesterol slowly
      increased over the duration of the study. After 12 months of swimming the HDL
      fraction had increased from 25 mg/dl to 31 mg/dl. After 24 months and at the end
      of 72 months of swimming, the HDL fraction had risen to 43 mg/dl and 46 mg/dl,
      respectively. The estimated long-term energy cost for each additional 1 mg/dl of
      HDL-cholesterol above the pre-exercise HDL value was 100 kcal/week in this
      subject. Long-term strenuous swimming exercise has been successfully incorporated
      into the lifestyle of a paraplegic individual. Significant reduction in known
      coronary risk factors followed a marked increase in the HDL-cholesterol level.

PMID- 8467346
TI  - Physiopharmacological interactions between stress hormones and central
      serotonergic systems.
AB  - The present review tries to delineate some mechanisms through which the
      sympathetic nervous system (SNS) and the hypothalamo-pituitary-adrenal (HPA)
      interact with central serotonergic systems. The recent progress in 5
      hydroxytryptamine (5-HT) receptor pharmacology has helped to define the means by
      which central serotonergic activity may alter the respective activities of the
      SNS (sympathetic nerves and adrenomedulla) and of the HPA axis. These
      pharmacological findings have also helped to characterize the differential
      effects of central 5-HT upon different branches of the SNS and the numerous sites
      at which 5-HT exerts stimulatory influences upon the HPA axis. Although relevant
      to stress-related neuroendocrinology, the extent to which these interactions are
      involved in the antidepressant/anxiolytic properties of some serotonergic agents
      still remains to be clarified. Beside these findings, there is also abundant
      evidence for a tight control of central serotonergic systems by stress hormones.
      Activation of the SNS increases, by numerous means, central availability of
      tryptophan, whereas glucocorticoids exert differential actions upon the intra-
      and the extraneuronal regulation of 5-HT function. Actually, a significant number
      of these mechanisms is involved in the maintenance of homeostasis during
      stressful events, thereby conferring to these mechanisms a key role in adaptation
      processes.

PMID- 8467347
TI  - Long-term potentiation as synaptic dialogue.
AB  - We have proposed a testable model of the physiological and biochemical events
      underlying LTP that offers the following novel features. (1) The focus is not on
      a single mechanism or synaptic site, but rather on the integration and
      interaction of mechanisms occurring on both sides of the synapse, (2) beta PKC
      plays a critical presynaptic role in LTP, while gamma PKC functions
      postsynaptically. (3) These stages can be ordered in a time-delimited sequence of
      post- then presynaptic molecular events based on the period of effectiveness of
      inhibitor compounds. (4) The distinction is made between the time when kinase
      activation occurs and the time when the potentiated response requiring this
      kinase activation is observed.

PMID- 8467348
TI  - Ascorbic acid in the brain.
AB  - Ascorbic acid is highly concentrated in the central nervous system. Measurement
      of the extracellular concentration of ascorbate in animals, mainly by the
      technique of voltammetry in vivo, has demonstrated fluctuation in release from
      neuropil, both spontaneously and in response to physical stimulation of the
      animal and to certain drugs. Although in the adrenal medulla ascorbate is co
      released with catecholamines, release of ascorbate from brain cells is associated
      principally with the activity of glutamatergic neurones, mainly by glutamate
      ascorbate heteroexchange across cell membranes of neurones or glia. This
      phenomenon is discussed in relation to a possible role of ascorbate as a
      neuromodulator or neuroprotective agent in the brain.

PMID- 8467349
TI  - The neuropharmacological and neurochemical basis of place learning in the Morris
      water maze.
AB  - The Morris water maze (MWM) offers several advantages over other methods of
      studying the neurochemical basis of learning and memory, particularly with
      respect to its ability to dissociate deficits in memory formation from deficits
      in sensory, motor, motivational and retrieval processes. The contributions of
      nearly all of the major neurotransmitter systems have been investigated and
      consistent patterns have emerged. Normal function in glutamatergic and
      cholinergic systems is necessary for spatial learning, as blockade of NMDA
      receptors and cholinergic hypofunction prevents spatial learning but does not
      impair recall. Peptides such as adrenal and sex hormones and somatostatin may
      also be necessary for spatial learning. In contrast, activity in either GABAergic
      or opioidergic systems impairs spatial learning, though by quite different means.
      GABAergic activity prevents memory function, whereas opioidergic activity reduces
      motivation. Normal monoaminergic activity is necessary for normal performance in
      the MWM, but not for spatial learning per se. However, noradrenergic and
      serotonergic systems may enhance cholinergic-mediated mnemonic processes. Further
      research into the relative contributions of different receptor subtypes as well
      as interactions between neurochemical systems should provide significant advances
      in our understanding of the neural basis of learning and memory in mammals.

PMID- 8467350
TI  - Sexual dimorphism in the vomeronasal pathway and sex differences in reproductive
      behaviors.
AB  - Several years ago we hypothesized that the vomeronasal system (VNS), a complex
      neural network involved in the control of reproductive behavior, might be
      sexually dimorphic. This hypothesis sprung from several facts; (a) the existence
      of steroid receptors in the VNS; (b) sexual dimorphism was already described in
      some structures that receive vomeronasal input, such as the medial preoptic area,
      the ventromedial hypothalamic nucleus, the ventral region of the premammillary
      nucleus and the medial amygdaloid nucleus; and (c) the vomeronasal organ, which
      is the receptor organ of the VNS, was also sexually dimorphic. After that point,
      the accessory olfactory bulb (AOB), the bed nucleus of the accessory olfactory
      tract (BAOT) and the bed nucleus of the stria terminalis were found to be
      sexually dimorphic. The aim of the present review is to show the experimental
      facts that confirm our earlier hypothesis and, consequently, to present the
      existence of a sexually dimorphic multisynaptic pathway for the first time in
      mammals. Sexual dimorphism in the VNS might provide a comprehensive approach to
      understanding the neural bases of sexually dimorphic reproductive behavior and it
      is suggested here that the greater number of neurons which male rats present in
      relation to females in most VNS structures might contribute to the inhibition of
      the expression of feminine copulatory behavior (lordosis) and maternal behavior
      in males. In addition, the mechanisms that control the development of sexual
      dimorphism in the VNS are discussed. The discussion takes into account the two
      patterns of sexual dimorphism found in the rat brain. Estrogens seem to promote
      the development of sexual dimorphism in both male and female rats. However, an
      inhibitory role of androgens might be necessary to hypothesize when males or
      females present a lower number of neurons and/or volume than the opposite sex.
      There are experimental data supporting this hypothesis in the female, since
      dihydrotestosterone seems to facilitate neuronal death in VNS structures, such as
      the AOB and the BAOT, in which females present a lower number of neurons and
      volume than male rats. Finally, since the lateral division of the bed nucleus of
      the stria terminalis, which belongs to the main olfactory system (MOS), is
      sexually dimorphic and presents anatomical relationships with some VNS structures
      the MOS might be sexually dimorphic.

PMID- 8467351
TI  - Possible action of cyclopiazonic acid on myocardial sarcoplasmic reticulum:
      inotropic effects on neonatal and adult rat heart.
AB  - Cyclopiazonic acid (CPA), a mycotoxin from Aspergillus and Penicillium, has been
      described as a highly selective inhibitor of Ca(2+)-ATPase in the sarcoplasmic
      reticulum (SR) in skeletal and smooth muscles but no reports at present deal with
      the effect of CPA in cardiac muscle. In the present study, we examined the
      inotropic effect of CPA on adult and neonatal rat myocardia, the contractions of
      which are known to be highly dependent on Ca(2+)-release from the sarcoplasmic
      reticulum and transsarcolemmal Ca(2+)-influx, respectively. CPA (30 microM)
      produced a negative inotropic effect in adult preparations, accompanied by marked
      prolongation of the contraction duration. In contrast, CPA had minimum effects on
      neonatal myocardium. Thus we have demonstrated that CPA exerts negative inotropic
      effects on adult myocardium probably through inhibition of SR function.

PMID- 8467352
TI  - Anti-inflammatory actions of an N-terminal peptide from human lipocortin 1.
AB  - An acetylated polypeptide corresponding to residues 2-26 of human lipocortin 1
      was synthesized and the anti-inflammatory activity assessed in three models of
      acute inflammation in rat and mouse. In the carrageenin rat paw oedema test, the
      peptide produced a maximal inhibition of approximately 41% at the 3 h time point
      with a 10 micrograms dose. When rat paw oedema was induced by the injection of
      venom phospholipase A2, the peptide produced a significant inhibition (31%) at
      the top dose of 20 micrograms per paw. In the mouse air-pouch model, systemic
      treatment with the peptide produced a dramatic reduction in cytokine-induced
      leukocyte migration with an ID50 of approximately 40 micrograms per mouse. The N
      terminal peptide 2-26 shares the actions of lipocortin 1 in these acute models of
      inflammation.

PMID- 8467353
TI  - Active secretion of the fluoroquinolone ciprofloxacin by human intestinal
      epithelial Caco-2 cell layers.
AB  - The bidirectional transepithelial fluxes of ciprofloxacin, an antibacterial
      fluoroquinolone, across the human intestinal epithelial Caco-2 cell-line show
      marked asymmetry. Basal-to-apical flux of ciprofloxacin (10 microM) exceeds
      apical-to-basal flux indicating net secretion. Net ciprofloxacin secretion is
      abolished by azide/2-deoxy-D-glucose treatment, displays saturation kinetics (Km
      = 0.89 +/- 0.23 mM, Vmax 44.3 +/- 4.9 nmol cm-2.h) and competition by other
      fluoroquinolones. A specific, active secretion in Caco-2 epithelia may explain
      the transintestinal elimination of ciprofloxacin observed in pharmacokinetic
      studies in man.

PMID- 8467354
TI  - Striatal dopamine release in vivo following neurotoxic doses of methamphetamine
      and effect of the neuroprotective drugs, chlormethiazole and dizocilpine.
AB  - 1. Administration to rats of methamphetamine (15 mg kg-1, i.p.) every 2 h to a
      total of 4 doses resulted in a neurotoxic loss of striatal dopamine of 36% and of
      5-hydroxytryptamine (5-HT) in the cortex (43%) and hippocampus (47%) 3 days
      later. 2. Administration of chlormethiazole (50 mg kg-1, i.p.) 15 min before each
      dose of methamphetamine provided complete protection against the neurotoxic loss
      of monoamines while administration of dizocilpine (1 mg kg-1, i.p.) using the
      same dose schedule provided substantial protection. 3. Measurement of dopamine
      release in the striatum by in vivo microdialysis revealed that methamphetamine
      produced an approximate 7000% increase in dopamine release after the first
      injection. The enhanced release response was somewhat diminished after the third
      injection but still around 4000% above baseline. Dizocilpine (1 mg kg-1, i.p.)
      did not alter this response but chlormethiazole (50 mg kg-1, i.p.) attenuated the
      methamphetamine-induced release by approximately 40%. 4. Dizocilpine pretreatment
      did not influence the decrease in the dialysate concentration of the dopamine
      metabolites dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA)
      produced by administration of methamphetamine while chlormethiazole pretreatment
      decreased the dialysate concentration of these metabolites still further. 5. The
      concentration of dopamine in the dialysate during basal conditions increased
      modestly during the course of the experiment. This increase did not occur in
      chlormethiazole-treated rats. HVA concentrations were unaltered by
      chlormethiazole administration. 6. Chlormethiazole (100-1000 microM) did not
      alter methamphetamine (100 microM) or K+ (35 mM)-evoked release of endogenous
      dopamine from striatal prisms in vitro. 7. Several NMDA antagonists prevent
      methamphetamine-induced neurotoxicity; however chlormethiazole is not an NMDA
      antagonist. Inhibition of striatal dopamine function prevents methamphetamine
      induced toxicity of both dopamine and 5-HT pathways. Therefore the attenuation of
      the enhanced dopamine release which occurs in animals given chlormethiazole may
      be associated with the protective action of this drug against methamphetamine
      induced neurotoxicity.

PMID- 8467355
TI  - Mediation of the antidepressant-like effect of 8-OH-DPAT in mice by postsynaptic
      5-HT1A receptors.
AB  - 1. The 5-hydroxytryptamine (5-HT)1A agonist 8-hydroxy-2-(dipropylamino)tetralin
      (8-OH-DPAT) has been evaluated in a mouse model for detecting potential
      antidepressants (Porsolt test). The effects of various receptor antagonists,
      lesions of brain monoaminergic neurones and chronic drug treatments on this 8-OH
      DPAT-induced response have also been determined. 2. 8-OH-DPAT (0.3-10.0 mg kg-1,
      s.c.) dose-dependently increased the mobility of mice in the Porsolt test. Other
      selective 5-HT1A receptor ligands (0.3-30 mg kg-1, s.c.) either mimicked the 8-OH
      DPAT response (ipsapirone, at 10 and 30 mg kg-1, s.c.) or were inactive
      (buspirone and gepirone). However, each of these compounds (< or = 100 mg kg-1,
      p.o.) inhibited the response to 8-OH-DPAT (3 mg kg-1, s.c.) when given
      concurrently. 3. The putative 5-HT1A antagonists, spiroxatrine (1-30 mg kg-1,
      p.o.), (+/-)-pindolol (30 mg kg-1, p.o.) and methiothepin (3-10 mg kg-1, p.o.),
      each attenuated the 8-OH-DPAT (3 mg kg-1, s.c.)-induced increase in mobility. 4.
      The dopamine D1 receptor antagonist, SCH 23390 (3-10 mg kg-1, p.o.), weakly
      reversed the 8-OH-DPAT response. Antagonists at 5-HTlc/5-HT2 receptors
      (ketanserin; 0.1-3.0 mg kg-1, p.o.),5-HT3 receptors (ondansetron; 0.03-10mg kg-1,
      p.o.), at-adrenoceptors (prazosin; 1-3mgkg-1, p.o.),alpha2 -adrenoceptors
      (idazoxan; 3-30mg kg-1, p.o.), alpha 1-adrenoceptors (metoprolol; 1-30mgkg-1,
      p.o.),beta 2-adrenoceptors (ICI 118,551; 1-30 mg kg-1, p.o.), dopamine D2
      receptors (sulpiride; 10-300mg kg-',p.o.) and opiate receptors (naloxone; 3-100
      mg kg-', p.o.) had no effect on the 8-OH-DPAT response.5. Selective destruction
      of 5-HT neurones with 5,7-dihydroxytryptamine or inhibition of 5-HT synthesis
      with p-chlorophenylalanine did not change the 8-OH-DPAT response in the Porsolt
      test. This response was also unaltered by pretreatment with the noradrenergic
      neurotoxin, DSP-4.6. Administration of 8-OH-DPAT (3 mg kg-1, s.c.) twice-daily
      for 10 days attenuated the hypothermia,but not the increased mobility, induced by
      8-OH-DPAT (3 mg kg-1, s.c.). Similarly, repeated administration of amitriptyline
      (3-30 mg kg-1), desipramine (3-30 mg kg-1) or dothiepin (10-100 mg kg-1) also
      attenuated the former, but not the latter, response.7. We conclude that 8-OH-DPAT
      produces an antidepressant-like effect in the Porsolt test which is mediated via
      postsynaptic 5-HT1A receptors.

PMID- 8467356
TI  - Comparison of the regional haemodynamic effects of the AT1-receptor antagonists,
      losartan and EXP 3174, in water-deprived Brattleboro rats.
AB  - 1. Two separate groups (n = 8) of Brattleboro rats, chronically instrumented for
      the measurement of regional haemodynamics, underwent a 2-stage experimental
      protocol. Initially, animals had their drinking water removed and cardiovascular
      recordings were made every 30 min for the following 6 h. Then animals received
      either the AT1-receptor antagonist, losartan (3 mg kg-1, i.v., n = 8), or an
      initially equi-hypotensive dose of its active metabolite, EXP 3174 (1 mg kg-1,
      i.v., n = 8), and the resultant cardiovascular changes were monitored for a
      further 2 h. A third group of Brattleboro rats (n = 8) was water-deprived for 8 h
      to serve as a time control. 2. In all 3 groups of animals, mesenteric and
      hindquarters vasoconstriction (beginning approximately 30 and 120 min,
      respectively, after water was removed) occurred much earlier than changes in
      blood pressure, since increases in blood pressure were significant only after 5-6
      h of water deprivation; renal perfusion was largely unchanged. The observation of
      a differential onset of haemodynamic changes (i.e. mesenteric > hindquarters >>
      renal) extends our previous findings, in which measurements were made only at the
      end of a 14 h period of water-deprivation. 3. When given after 6 h of water
      deprivation, losartan and EXP 3174 produced directionally similar, but temporally
      disparate, haemodynamic effects. EXP 3174 caused a depressor response associated
      with marked renal, mesenteric and hindquarters vasodilatations which were well
      maintained over 2 h. Losartan evoked similar changes to EXP 3174 in the first 5
      min, but in contrast to EXP 3174, blood pressure showed some recovery and all 3
      vascular conductance values returned to baseline (i.e. pre-drug)levels over the
      following 10-20 min. Thereafter, hypotension and renal, mesenteric and
      hindquarters vasodilatation again occurred, and these changes were maintained for
      the rest of the 2 h. However,compared with losartan, EXP 3174 caused
      significantly greater mesenteric and hindquarters vasodilatation,even at times
      when both compounds lowered blood pressure to the same extent.4. The biphasic
      cardiovascular response caused by losartan is consistent with the conversion of
      the parent compound to EXP 3174. Whether or not the enhanced vasodilator effect
      of EXP 3174 over losartan is related to pharmacodynamic differences (i.e.,
      noncompetitive versus competitive antagonism,respectively), and/or to differences
      in the amount of EXP 3174 generated from losartan is not known at present.

PMID- 8467357
TI  - The regulation of aortic endothelial cells by purines and pyrimidines involves co
      existing P2y-purinoceptors and nucleotide receptors linked to phospholipase C.
AB  - 1. We have examined the phospholipase C responses in bovine aortic endothelial
      cells to purines (ATP, ADP and analogues) and the pyrimidine, uridine
      triphosphate (UTP). 2. The cells responded to purines in a manner consistent with
      the presence of P2y purinoceptors; both 2-methylthioadenosine 5'-triphosphate
      (2MeSATP) and adenosine 5'-0-(2-thiodiphosphate) (ADP beta S) were potent
      agonists (EC50 0.41 microM and 0.85 microM respectively) while beta, gamma
      methylene ATP at 300 microM was not. 3. The cells also responded to UTP. The
      maximal response to UTP was less than that for either 2MeSATP and ADP beta S
      while adenosine 5'-0-(3-thiotriphosphate) (ATP gamma S) gave the largest maximal
      response. 4. The concentration-effect curve to UTP was additive in the presence
      of either 2MeSATP or ADP beta S. However, the concentration-effect curves to ATP
      gamma S reached the same maximum in the presence or absence of UTP. 5. Suramin,
      at concentrations between 10 microM and 100 microM was a competitive antagonist
      for the response to ADP beta S and 2MeSATP but not the response to UTP. 6. The
      results show that there are two separate, co-existing, receptor populations: P2y
      purinoceptors (responding to purines) and nucleotide receptors (responding to
      both purines and pyrimidines). We conclude that purines such as ATP/ADP may
      regulate aortic endothelial cells by interacting with two phospholipase C-linked
      receptors.

PMID- 8467358
TI  - Role of leukotrienes in airway hyperresponsiveness in guinea-pigs.
AB  - 1. Repeated aerosolization of leukotriene C4 (LTC4) to guinea-pigs produced
      leftward shift in their pulmonary resistance (RL) dose-response curves to inhaled
      acetylcholine (ACh) without increasing the maximum responses. 2. Repeated LTC4
      aerosolization did not increase airway eosinophils. 3. The 5-lipoxygenase
      activating protein (FLAP) inhibitor, MK-886, prevented the leftward shift in RL
      dose-response curves to ACh following repeated antigen challenge in guinea-pigs.
      4. MK-886 did not inhibit the increased maximal RL produced by repeated antigen
      challenge, nor inhibit the airway eosinophilia induced by repeated antigen
      challenge. 5. Our findings suggest that leukotrienes may account for the leftward
      shift in pulmonary resistance responses caused by antigen but do not cause the
      airway eosinophilia nor enhanced maximum broncho-constrictor response to antigen.

PMID- 8467359
TI  - Reversal by suramin of neuromuscular block produced by pancuronium in the
      anaesthetized rat.
AB  - 1. Rats were anaesthetized with sodium pentobarbitone and maximal twitches of a
      tibialis anterior muscle were evoked by stimulation of the motor nerve. 2.
      Suramin, injected intravenously in a series of cumulative bolus doses, each 15 mg
      kg-1, completely reversed a 90% depression of twitches maintained by a continuous
      intravenous infusion of pancuronium. The cumulated dose necessary to restore
      twitches to 50% of their control amplitude was 35 mg kg-1. Suramin did not modify
      a similar degree of block produced by suxamethonium, nor did it affect the
      amplitude of control maximal twitches, even in cumulative doses up to 150 mg kg
      1. 3. The effects of bolus doses of suramin (85 mg kg-1), neostigmine (0.03 mg kg
      1) and 4-aminopyridine (1.2 mg kg-1), calculated to restore pancuronium-blocked
      twitches to 95% of control amplitude, were compared. Suramin produced the most
      rapid reversal (1.1 +/- 0.5 min), but its duration of action was the shortest
      (9.4 +/- 1.6 min). Suramin was without effect on heart rate or blood pressure in
      the doses used. 4. The results showed that suramin reversed neuromuscular block
      produced by nondepolarizing blocking drug, pancuronium, but was without effect on
      a block produced by the depolarizing blocking drug, suxamethonium. Its short
      duration of action suggests that suramin would probably not be of value
      clinically as a reversal agent. However, it is possible that it might serve as a
      starter compound for the synthesis and development of a new class of reversal
      agents for use in anaesthetic practice.

PMID- 8467360
TI  - Effects of analogues of adenine nucleotides on increases in intracellular calcium
      mediated by P2T-purinoceptors on human blood platelets.
AB  - 1. By use of a number of analogues of adenine nucleotides, the structure-activity
      relationships of the human platelet receptor for adenosine 5'-diphosphate (ADP)
      mediating increases in intracellular calcium were investigated, and compared with
      the known structure-activity relationships for induction by ADP of platelet
      aggregation. 2. ADP, 2-methylthioadenosine 5'-diphosphate (2-methylthio-ADP),
      adenosine 5'-O-(1-thiodiphosphate) (ADP-alpha-S) and adenosine 5'-O-(2
      thiodiphosphate) (ADP-beta-S) each induced increases in intracellular calcium in
      a manner similar to their reported ability to induce human platelet aggregation.
      The effects of these agonists were antagonized by ATP, with a pA2 value in each
      case consistent with the inhibition by ATP of ADP-induced aggregation. In the
      case of ADP, the inhibition by ATP of increases in intracellular calcium was
      shown to be competitive by Schild analysis. 3. Of the analogues tested as
      inhibitors of the effect of ADP on intracellular calcium, 2-chloroadenosine 5'
      triphosphate (2-chloro-ATP), adenosine 5'-O-(1-thiotriphosphate) (ATP-alpha-S),
      P1, P5-diadenosine pentaphosphate (Ap5A) and adenylyl 5'-(beta,gamma
      methylene)diphosphonate (AMPPCP) were apparently competitive antagonists,
      although only one concentration of each antagonist was used. There was a good
      correlation between the pA2 values found here for these antagonists including
      ATP, and their pA2 values reported for inhibition of ADP-induced aggregation.
      Adenosine 5'-(alpha, beta-methylene)triphosphate (AMPCPP) and uridine 5'
      triphosphate (UTP) (100 microM) were only very weak inhibitors of the effect of
      ADP on intracellular calcium, and this is consistent with their weak actions as
      inhibitors of aggregation. 2-Methylthioadenosine 5'-triphosphate (2-methylthio
      ATP) (50 microM) non-competitively inhibited the effect of ADP on intracellular
      calcium, in a very similar way to its inhibition of ADP-induced aggregation.4.
      The good correspondence found for these analogues between their effect on
      intracellular calcium and on aggregation confirms that there is a causal
      relationship between these actions of ADP, and that they are mediated by the same
      receptor on platelets. These findings cast further doubt on the use of the
      affinity reagent 5'-fluorosulphonylbenzoyladenosine (FSBA) as an antagonist and
      label for the ADP receptor, as this compound has been reported to inhibit
      aggregation but not ADP-induced increases in intracellular calcium.

PMID- 8467361
TI  - Characterization and ontogeny of P1-purinoceptors on rat vas deferens.
AB  - 1. The P1-purinoceptors which mediate the inhibition by adenosine of nerve
      mediated contraction of the rat vas deferens have been investigated by use of the
      agonists N6-cyclopentyladenosine (CPA) and 5'-N-ethylcarboxamidoadenosine (NECA)
      and the A1-selective antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX). The
      ontogeny of the responses to adenosine and to the two co-transmitters which
      induce the contractions in this tissue, adenosine 5'-triphosphate (ATP) and
      noradrenaline (NA), have also been studied. 2. The order of potency for the
      adenosine agonists in inhibiting the nerve-mediated contractions was CPA = NECA >
      adenosine. Micromolar concentrations of DPCPX were required to antagonize the
      inhibition by adenosine and NECA of nerve-mediated responses, whereas the
      inhibitory effect of CPA was antagonized by nanomolar concentrations of the
      antagonist. 3. NECA and adenosine inhibited contractions induced by ATP (10
      microM) or by NA (10 microM), NECA being at least ten fold more potent than
      adenosine, whereas CPA was inactive. Micromolar concentrations of DPCPX were
      required to antagonize the effect of adenosine on the contractions induced by ATP
      (10 microM). 4. Nerve-stimulated contractions could be observed in neonatal
      tissues from day 15 and increased with age, and could be inhibited by adenosine
      from this time, the potency of adenosine decreasing with age. Responses to ATP
      also appeared at day 15 and increased with age up to day 25, while responses to
      NA were present from day 10 (the earliest day tested) and decreased with age. 5.
      These results show that the rat vas deferens contains both prejunctional Al
      receptors and postjunctional A2-receptors, and that adenosine acts on the latter
      populations to inhibit nerve-mediated contractions.The high potency of adenosine
      in the neonate and the parallel development of responses to ATP and to nerve
      mediated contractions support suggestions that purinergic responses may be
      particularly important in neonatal tissues.

PMID- 8467362
TI  - The effect of NG-nitro-L-arginine methyl ester upon basal blood flow and
      endothelium-dependent vasodilatation in the dog hindlimb.
AB  - 1. The role played by the endothelium-derived relaxing factor (EDRF), nitric
      oxide (NO) in the regulation of blood flow to the skeletal muscle vasculature of
      the dog skinned hindlimb has been determined by examining the effects of the NO
      synthase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME) upon (i) basal
      iliac artery blood flow, (ii) vasodilator responses to endothelium-dependent and 
      independent agonists and (iii) reactive hyperaemic responses to arterial
      occlusion. 2. L-NAME (0.1-3 mg min-1) infused directly into the iliac artery dose
      dependently reduced basal iliac artery blood flow by a maximum of 48.6 +/- 6.9%
      (n = 4) and also increased mean systemic arterial blood pressure by 25.6 +/- 5.0
      mmHg (n = 4) (at 3 mg min-1 L-NAME). 3. Over the same dose range, L-NAME also
      inhibited the peak vasodilator responses to intra-arterially administered,
      submaximal bolus doses of the endothelium-dependent agonists, bradykinin (3-300
      ng) and acetylcholine (30-300 ng) by approximately 40%. In contrast, peak
      vasodilator responses to the endothelium-independent agonists, sodium azide (3-30
      micrograms) and adenosine (0.3-1 mg), and peak reactive hyperaemic responses to
      arterial occlusion (60 s) were largely unaffected by L-NAME. 4. The dose-related
      effects of L-NAME on basal iliac artery blood flow, mean systemic arterial blood
      pressure and endothelium-dependent vasodilator responses were significantly
      attenuated by pretreatment with L-arginine (100 mg min-1) followed by co-infusion
      of L-arginine (100 mg min-1) with L-NAME. 5. In conclusion, these data suggest
      that NO plays some role in regulating basal blood flow and in mediating the
      vasodilator responses to the endothelium-dependent agonists bradykinin and
      acetylcholine in the skeletal muscle vasculature of the dog hindlimb. The
      substantial component (~60%) of the peak vasodilator responses to bradykinin and
      acetylcholine, unaffected by L-NAME, may be independent of NO, or be mediated by
      an alternative EDRF-dependent but L-NAME-insensitive mechanism.

PMID- 8467363
TI  - Differential effects of captopril on regional haemodynamic responses to
      angiotensin I and bradykinin in conscious rats.
AB  - 1. Conscious, Long Evans rats were chronically instrumented with pulsed Doppler
      flow probes and intravascular catheters to allow regional haemodynamic (coeliac,
      mesenteric and hindquarters vascular beds) responses to i.v. bradykinin to be
      assessed in the absence and presence of captopril and of ganglion blockade (with
      mecamylamine). 2. Bradykinin (3 nmol kg-1, i.v. bolus) had no effect on mean
      arterial blood pressure, although it caused hyperaemic vasodilatation in the
      coeliac, mesenteric and hindquarters vascular beds. Following administration of
      captopril at a dose (28 nmol kg-1) which had no effect on responses to
      angiotensin I, the hypotensive and coeliac and mesenteric vasodilator responses
      to bradykinin were enhanced. However, there was a temporal dissociation between
      these events indicating that changes in cardiac output must have been
      contributing to the changes in mean arterial blood pressure. 3. Captopril at a
      higher dose (280 nmol kg-1) caused reversible inhibition of the pressor and
      coeliac and mesenteric vasoconstrictor effects of angiotensin I, but the
      inhibition of the mesenteric vascular responses was significantly less than that
      of the coeliac vascular responses. Under the same conditions, the mesenteric
      vasodilator effects of bradykinin were less enhanced than the coeliac vasodilator
      effects, consistent with greater inhibition of angiotensin-converting enzyme
      (i.e., kininase II) in the coeliac than in the mesenteric vascular bed. But,
      since the hypotensive action of bradykinin was markedly enhanced in these
      circumstances, the possibility existed that baroreflex responses influenced the
      haemodynamic effects of bradykinin. However, assessment of the haemodynamic
      changes following bradykinin administration(bolus or infusion) in the presence of
      ganglion blockade showed that only the hindquarters vasodilator response to
      bradykinin was enhanced, while the coeliac and mesenteric vasodilator responses
      were diminished. Thus, additional factors must have been influencing the latter
      responses.4. The results show that inhibition of angiotensin-converting enzyme
      (kininase II) can have differential effects on the regional haemodynamic
      responses to angiotensin I and bradykinin. The results provide a striking
      illustration of our previous assertion that the measurement of arterial blood
      pressure alone cannot provide sufficient information to allow interpretation
      either of the effects of vasoactive substances,or of the influence of drugs
      thereupon.

PMID- 8467364
TI  - Mediation via different receptors of the vasoconstrictor effects of endothelins
      and sarafotoxins in the systemic circulation and renal vasculature of the
      anaesthetized rat.
AB  - 1. Using endothelin-1 (ET-1), endothelin-3 (ET-3), sarafotoxin 6b (SX6b) and
      sarafotoxin 6c (SX6c) as agonists and BQ-123 as a selective ETA receptor
      antagonist, we have examined the endothelin receptor subtypes mediating the
      systemic pressor and renal vasoconstrictor effects of the ET/SX family of
      peptides. 2. In anaesthetized rats, bolus intravenous injections of ET-1, ET-3,
      SX6b or SX6c (0.1, 0.25 and 0.50 nmol kg-1) produced initial transient depressor
      responses followed by sustained and dose-dependent increases in mean arterial
      pressure (MAP) with the following rank order of potency: SX6b > ET-1 >> SX6c > ET
      3. In contrast, in the renal vasculature these peptides caused equipotent dose
      dependent falls in renal blood flow (RBF) (ET-1 = ET-3 = SX6b = SX6c). 3. BQ-123
      (1 mg kg-1, i.v. bolus) significantly reduced the systemic pressor effects of all
      the peptides but was largely ineffective against the renal vasoconstrictions. 4.
      These results indicate that although the systemic pressor effects of the ET/SX
      peptides are mediated via ETA receptors, the vasoconstriction in the kidney in
      vivo may be mediated predominantly via ETB-like receptors. This may be of
      therapeutic relevance, for an ETA-receptor-selective antagonist could offer only
      poor protection of the renal circulation from the deleterious effects of
      endogenously produced members of this peptide family.

PMID- 8467365
TI  - Amelioration by the Ca2+ antagonist, nimodipine of an existing neuropathy in the
      streptozotocin-induced, diabetic rat.
AB  - 1. Neuropathy is a frequently diagnosed complication in diabetic patients but an
      effective treatment does not exist. 2. The development of neuropathy in
      streptozotocin-induced diabetic rats was monitored by measuring the motor and
      sensory nerve conduction velocity in the sciatic nerve. 3. A significant decrease
      in sensory and motor nerve conduction velocity was apparent in young, 14-week-old
      diabetic rats as compared to non-diabetic, age-matched controls 4 weeks after the
      induction of diabetes with streptozotocin. 4. Intraperitoneal treatment with the
      Ca2+ channel blocker, nimodipine, from week 4 onwards, in a dosage of 10 mg kg-1
      or 20 mg kg-1 intraperitoneally per 48 h, resulted in a significant increase in
      sensory and motor nerve conduction velocity whereas treatment with 5 mg kg-1
      intraperitoneally per 48 h was not effective. 5. One-year-old, adult, diabetic
      rats treated with nimodipine 20 mg kg-1 (treatment started again 4 weeks after
      induction of diabetes mellitus) also showed an increase of both sensory and motor
      nerve conduction velocity as compared to diabetic rats treated with placebo. 6.
      It is concluded that nimodipine ameliorates existing experimental diabetic
      neuropathy in streptozotocin-induced diabetic rats in both young and adult
      animals.

PMID- 8467366
TI  - Effects of the central analgesic tramadol on the uptake and release of
      noradrenaline and dopamine in vitro.
AB  - 1. The centrally acting analgesic, tramadol, has low affinity for opioid
      receptors and therefore presumably other mechanisms of analgesic action.
      Neurotransmitter release and uptake experiments were used to characterize the
      effects of tramadol on the central noradrenergic and dopaminergic systems. 2.
      Tramadol inhibited the uptake of [3H]-noradrenaline into purified rat
      hypothalamic synaptosomes with an IC50 of 2.8 microM; the (-)-enantiomer was
      about ten times more potent than the (+)-enantiomer. Results with the principal
      metabolite O-desmethyltramadol were very similar. Inhibition of dopamine uptake
      into purified rabbit caudate nucleus synaptosomes was very weak with 62%
      inhibition of 100 microM. 3. Rat occipital cortex slices were preincubated with
      [3H]-noradrenaline and rabbit caudate nucleus slices with [3H]-dopamine, then
      superfused and stimulated electrically. Tramadol, 1 and 10 microM, enhanced the
      stimulation-evoked [3H]-noradrenaline overflow by 25 and 69%, respectively; the (
      )-enantiomer was more potent than the racemate or the (+)-enantiomer. Tramadol,
      10 microM, had no effect on dopamine release. 4. The effects of tramadol on the
      stimulation-evoked [3H]-noradrenaline release were abolished when uptake sites
      were already blocked by a high concentration of cocaine. 5. The metabolite O
      desmethyltramadol showed a slight facilitation of the stimulation-evoked
      noradrenaline release; the effect was more pronounced in the presence of a high
      concentration of naloxone. In the presence of cocaine, inhibition of the release
      was observed similar to the effect of morphine but less potent. 6. The results
      show that tramadol blocks noradrenaline uptake with selectivity as compared to
      dopamine uptake. The interaction with the noradrenaline transporter is
      stereoselective. The principal metabolite O-desmethyltramadol shows in addition
      to noradrenaline uptake inhibition, opioid inhibition of noradrenaline release.

PMID- 8467367
TI  - Effects of carbamazepine and baclofen on 4-aminopyridine-induced epileptic
      activity in rat hippocampal slices.
AB  - 1. Rat transverse hippocampal slices exposed to 100 microM 4-aminopyridine (4-AP)
      generate spontaneous epileptic discharges ranging in duration from short 50 ms
      'interictal' bursts to long 0.5-2 s 'polyspike' activity. 2. Here we compared the
      effects of the commonly used anticonvulsant, carbamazepine (40 microM) and the
      antispastic drug, baclofen (2 microM) on the various types of burst. 3.
      Carbamazepine completely abolished long bursts whilst leaving shorter bursts
      intact. This is consistent with its known anticonvulsant properties. 4. Baclofen
      greatly reduced the frequency of short bursts but did not block the long bursts.
      Rather, they became significantly more prolonged, indicating that baclofen does
      not have an anticonvulsant action, and may be proconvulsant. 5. These results
      conflict with conclusions based on studies using models that exhibited only
      interictal bursts, and emphasize the need to use experimental epilepsies which
      generate several types of epileptic discharge to evaluate the effects of putative
      anticonvulsant drugs. 6. The present findings suggest that GABAB receptors play a
      role in the transition of benign interictal bursts to longer polyspike activity
      which could develop into seizures in the whole animal.

PMID- 8467368
TI  - Imagery ability and source monitoring: implications for eyewitness memory.
AB  - The present study investigated the effect of self-reported vividness of visual
      imagery on the ability to discriminate between memories derived from two external
      sources of information. Subjects were shown a film of a crime and were then given
      a written description of the event which included information not seen in the
      film. In a source monitoring task, high and low imagers were found to be equally
      proficient in recognizing items as previously presented, but high imagers were
      poorer at discriminating the source of items based on the written description.
      This finding is considered in terms of possible encoding and retrieval
      differences resulting from imagery vividness. The role of vivid visual imagery as
      a variable underpinning confusions in eyewitness testimony is discussed.

PMID- 8467369
TI  - Latent inhibition and recall/recognition of irrelevant stimuli as a function of
      pre-exposure duration in high and low psychotic-prone normal subjects.
AB  - Learning to ignore non-relevant stimuli (coloured geometric shapes) was evaluated
      in high and low psychotic-prone normal subjects in two experiments. In the first,
      subjects were tested in a latent inhibition paradigm in a 2 x 2 x 3 factorial
      design (high vs. low psychotic proneness, as measured by MMPI subscales; pre
      exposure of the stimuli such that they were non-relevant before the test but
      relevant in the test vs. absence of such pre-exposure; three levels of pre
      exposure duration: 3-, 6- and 15-min). Low psychotic-prone subjects showed the
      latent inhibition effect (poorer learning as a result of pre-exposure to the non
      relevant stimuli as compared to no pre-exposure) at 6- and 15-min durations, but
      not at 3-min. High psychotic-prone subjects failed to show latent inhibition at 3
      and 6-min durations, but did show the effect at 15-min. The second experiment
      employed a 2 x 3 design (high vs. low psychotic proneness; three levels of pre
      exposure duration of the same stimuli used in Expt 1). High psychotic-prone
      normal subjects recalled and recognized more previously non-relevant stimuli than
      low psychotic-prone subjects, particularly after 6-min pre-exposure to those
      stimuli. The data of the two experiments suggest that the attenuation of latent
      inhibition in high psychotic-prone subjects as compared to low psychotic-prone
      subjects is a result of the increased attention to non-relevant information.

PMID- 8467370
TI  - On what intelligence is.
AB  - Despite much controversy over the exact definition of intelligence, most
      researchers agree that it is a concept labelled by a word, or even several
      related concepts labelled by a word. The present study applies recent theorizing
      about the nature of concepts in general to clarify the notion (or notions) of
      intelligence. This theorizing defines a concept as a person's unique and
      individual information about a category and a category as a set of things in the
      world. An example of a concept/category pair is 'dog', with the category being
      the set of all dogs and an individual's concept of dog being his or her personal
      knowledge of dogs. This knowledge can be used to place things in or out of the
      category. Different individuals may have somewhat different knowledge about the
      same category and a single word may label several different concept/category
      pairs. A concept of intelligence thus consists of information about a general
      category labelled by the word 'intelligence'. This study analyses three major
      concept/category pairs of 'intelligence': (1) Spearman's g; (2) intelligence as a
      property of behaviour; and (3) intelligence as a set of abilities. Each concept
      contains different information, refers to a different category, and should be
      used in different ways. Several recurrent issues, such as whether the word
      'intelligence' refers to a thing and what things are intelligent (e.g. animals,
      computers), can be resolved by considering each issue in relation to these
      concept/category pairs. For instance, the word 'intelligence' refers to a thing
      only if one uses the g concept. Similarly, only humans are intelligent according
      to the g concept but animals and computers may be considered intelligent if the
      other concepts are applied. Recent theorizing on the nature of concepts can be
      used to clarify other important psychological notions.

PMID- 8467371
TI  - Recognition and recall of visual area.
AB  - When visual areas are recalled the ratio of two areas is compressed relative to
      both the actual and perceived values (e.g. Kemp, 1988). Experiment 1 replicated
      this effect with a simple two-region figure, and Expt 2 showed a significant
      increase in area compression to occur between 2 min and 1 week when subjects were
      asked to recognize the two-region figure from a set of nine figures with
      different area ratios. Area compression was also found in Expt 3 where a
      different figure was used. Experiment 4 found that varying the texture of the
      smaller region of a two-region figure had no significant effect on area
      compression, and in Expt 5 subjects choose a figure in which the area was
      expanded but the texture was unchanged over one in which the texture was expanded
      with the area. Experiment 6 showed that compression of remembered areas seen in a
      photograph did not depend on recalled distance. In conclusion, area compression
      appears to arise from a gradual transformation of remembered area that does not
      resemble a zooming process.

PMID- 8467372
TI  - Potency in groups: articulating a construct.
AB  - This paper examines potency, defined as the collective belief in a group that it
      can be effective, and its role in determining group effectiveness. The paper
      illustrates the construct and reviews its origins. The distinctiveness of potency
      from efficacy and from other collective and motivational constructs is described.
      The measurement of potency is also examined. The paper concludes with a
      presentation of a conceptual framework for understanding the determinants of
      potency and with a discussion of future theory, research and practice.

PMID- 8467373
TI  - Hemisphericity and top-down processing of language.
AB  - This study investigated the impact of contextual prompts (priming words and
      sentences) on the classical finding of superior performance with right visual
      field stimulation in a lexical decision task. Subjects were presented with
      prompts of varying lengths (one, three, or six words). The prompts were followed
      by a target stimulus (word/nonword) to the right or the left visual field.
      Subjects were required to respond whether the target was a word or a nonword. The
      major purpose of the study was to determine the extent of right visual field
      (RVF) superiority, reflecting left hemisphere superiority, in language processing
      when target stimuli are preceded by semantically meaningful prompts. The results
      showed that increasing the number of priming words congruent with the target
      (creating a meaningful context) increased the advantage of the RVF over the left
      visual field presentation in lexical decision. Thus, even with an available
      strategy provided by congruent priming stimuli, RVF superiority in lexical
      decision is retained and even increased.

PMID- 8467374
TI  - "Auditory neglect after right frontal lobe and right pulvinar thalamic lesions":
      comments on Hugdahl, Wester, and Asbjornsen (1991) and some preliminary findings.
AB  - We take issue with the claim recently made in this journal that extinction of
      left ear input during dichotic, but not monaural, stimulus presentation
      demonstrates "auditory attentional neglect" (Hugdahl, Wester, & Asbjornsen,
      1991). We also report on a patient suffering from unilateral visual neglect, who
      shows extinction under dichotic, but not monaural, conditions of stimulus
      presentation but this is not confined to one ear. Although this patient denies
      hearing both of two dichotically presented words, he recognizes the extinguished
      stimulus when given a forced-choice recognition task.

PMID- 8467376
TI  - Pragmatic language skills after closed head injury: ability to meet the
      informational needs of the listener.
AB  - Two closed-head-injured subjects and 12 non-brain-damaged controls explained a
      novel procedure to a blindfolded third person. Their productions were transcribed
      and scored by nine judges on ratings scales based on Grice's maxims of quantity
      and manner. The two closed-head injury (CHI) productions were significantly
      inferior to the controls, both being rated as disorganized, confusing, and
      ineffective. While one subject's production was considered overly repetitive, the
      other had too little detail. In order to specify, more exactly, the nature of the
      deficits, a cohesion analysis and an analysis of informational content were
      performed. The cohesion analysis suggested that the CHI productions were
      generally similar to the controls. The informational analysis was more revealing.
      Judgements of detail and repetitiveness were reflected in the number of new and
      repeated propositions. Errors in sequencing and inclusion of irrelevant
      propositions contributed to the disorganized and confusing nature of the texts.
      The results were interpreted within the framework of frontal lobe deficits in
      monitoring and regulation of performance.

PMID- 8467375
TI  - Dissociation of cortical and single unit activity in spoken and signed languages.
AB  - Based on stroke and other lesion data, the cortical organization of sign language
      has been shown to be in the verbal language-dominant hemisphere. However, finer
      detail of the cortical organization of sign language is not readily available.
      Intraoperative cortical mapping of spoken and American Sign Language (ASL) was
      performed in a hearing patient proficient in ASL undergoing an awake operation
      for intractable epilepsy. We found the dissociation of essential cortical
      language sites for spoken and signed languages, the relationship of these sites
      to the interpretation of ASL, and the importance of the anterior temporal lobe in
      the language-dominant hemisphere for proper ASL handshapes. Single unit
      recordings in the anterior temporal lobe, at a site later identified to be
      important in handshape formation, showed sustained activity during naming with
      superimposed increases in activity during overt speech.

PMID- 8467377
TI  - A personal case history of transient anomia.
AB  - The article presents a first-person account of a transient anomia or word-finding
      deficit; the assumption is that such an account, reported by someone with a
      professional background in memory, cognition, and language processes, may shed
      additional light on the nature of an anomic episode and on the subjective
      experience of memory and language disruption due to brain-related abnormalities.
      During the 45-min episode, I was unable to retrieve and use specific content
      words and terms ("data," "experiment," "printout") in overt speech. I was
      completely conscious of these target concepts, although not of their names, and
      was aware of my inability to find the words. Neither word finding for "everyday"
      words nor ongoing thought processes were particularly disrupted. The nature and
      quality of my thoughts during the episode indicate no loss of awareness of
      circumstances or "presence of mind," but no genuine awareness of the seriousness
      of the episode. I briefly consider the implications of my experience and the
      similarities to another published case history.

PMID- 8467378
TI  - "Virtual N400" and slow wave topography to auditory sentence incongruence.
AB  - In a simple auditory sentence paradigm, two ERP components were found to be
      sensitive to violations of sentence congruence: a "virtual N400" and the Slow
      Wave (SW). Unlike previous studies, the N400 was found to occur very early (peak
      latency of 250 msec) and have a short duration (196-287 msec), while maintaining
      the previously described slightly asymmetric right central-parietal negative
      topography. Because of the early latency, this component was referred to as a
      "virtual N400." The SW (418-530 msec) was also enhanced and topographically
      shifted to incongruent sentence terminal words. Its topography consisted of a
      symmetric frontal minimum and posterior maximum. Although the difference map was
      also symmetric, a t value map of the congruence effect was maximal over the left
      posterior temporal area. The very early latency of the "virtual N400" and its
      decreased duration were produced by a paradigm that allowed for very early
      recognition of a semantic violation, even before the spoken word was complete. It
      is postulated that the "virtual N400" indexes word recognition. Semantic
      processing in indexed by the "virtual N400" as well, but the left posterior
      temporal asymmetry in the t maps of the Slow Wave may be of even greater import.

PMID- 8467379
TI  - Semantic processing in the right hemisphere may contribute to drawing inferences
      from discourse.
AB  - After listening to multiple-episode stories that promoted coherence inferences,
      right hemisphere-damaged patients answered Inference questions about the stories
      less accurately than Explicit questions, whereas normal elderly subjects answered
      both question types equally well. In addition, while subjects listened to the
      stories they made lexical decisions to tests words that were related to the
      promoted inferences or were unrelated to the stories. Right hemisphere-damaged
      patients responded more slowly to inference-related words than to unrelated
      words, whereas normal elderly subjects responded more quickly to interference
      related words than to unrelated words. Furthermore, the episode boundaries did
      not affect either group's accuracy on Inference questions, and the boundaries
      equally affected both groups' lexical decision latencies, suggesting that the
      patients' inferencing deficit was not due to an impairment in organizing the
      mental substructures used to represent discourse. These results suggest that the
      right hemisphere-damaged patients lacked activation of semantic information
      necessary for drawing coherence inferences.

PMID- 8467381
TI  - Long-term changes in the neuromuscular synapses of a crayfish motoneuron produced
      by calcium influx.
AB  - Previous in vivo studies of crustacean neuromuscular synapses have shown that a
      chronic increase in the impulse activity of a previously 'inactive' motoneuron
      produces a reduction in initial transmitter release and greater resistance to
      synaptic fatigue. To explore the mechanisms of this synaptic change, we have
      developed an in vitro procedure for examining this activity-dependent reduction
      in initial transmitter release. We report that depolarization selectively applied
      to the proximal region of the neuron (cell body or axon) of a phasic motoneuron
      produces a reduction in initial transmitter release from the motor terminals.
      This synaptic change is observed 4-5 h after the beginning of depolarization.
      Proximal depolarization decreases initial transmitter release without reducing
      the capacity of the terminals to release transmitter during repetitive
      stimulation. Application of a calcium channel blocker during conditioning
      prevents the reduction in initial transmitter release. These results demonstrate
      that prolonged calcium influx produce a long-term reduction in initial
      transmitter release, and that calcium influx in distant regions of the motoneuron
      can influence transmitter release from motor terminals. The relationship of these
      findings to previously reported activity-dependent synaptic changes is discussed.

PMID- 8467380
TI  - The developmental pattern of rabbit brain insulin and insulin-like growth factor
      receptor expression.
AB  - To examine the effect of development on rabbit brain insulin and insulin-like
      growth factor (IGF) receptor expression, we characterized and quantitated
      receptor mRNAs by Northern blot analysis and affinity-labeled ligand bound
      receptors by SDS-PAGE and autoradiography. At various stages of development
      ranging from 23 to 30 day gestational (term approximately 31 days), 1 to 10 day
      postnatal ages and the adult, no change in the whole brain insulin receptor mRNA
      (7.0, 6.0 and 5.5 kb) and affinity-labeled receptor protein (approximately 125
      kDa) levels was observed. The IGF-I receptor mRNA (11.5, 6.5 and 4.5 kb) and
      affinity-labeled receptor (approximately 125 kDa) protein levels declined during
      the neonatal stages of development. In the case of the IGF-II receptor, while the
      mRNA levels (9.0 and 4.5 kb) remained constant, the corresponding affinity
      labeled receptor protein (approximately 230 kDa) declined with maturation. We
      conclude that a differential regulation of brain insulin, IGF-I and IGF-II
      receptor expression occurs during development.

PMID- 8467382
TI  - Destruction of the locus coeruleus decreases physical signs of opiate withdrawal.
AB  - The purpose of the present study was to investigate the role of the locus
      coeruleus in the development of opiate dependence. Two groups of rats each were
      subjected to either a electrolytic lesion of the locus coeruleus or a sham
      lesion. All animals were implanted with an intracerebroventricular (i.c.v.)
      cannula, and made physically dependent by subcutaneous insertion of two 75-mg
      morphine (base) pellets. Abstinence was precipitated by i.c.v. administration of
      methylnaloxonium (31-1,000 ng) 72 h after pellet implantation. Methylnaloxonium
      administered intracerebroventricularly induced a withdrawal syndrome
      characterized by the appearance of teeth chattering, mastication, rearing, wet
      dog shakes, jumping, piloerection, hyperactivity, ptosis and eye twitch.
      Withdrawal observed in the electrolytic lesion groups was less severe than in
      sham group. The presence of mastication, rearing, piloerection, hyperactivity,
      ptosis and eye twitch was significantly lower. These results support the
      hypothesis that the locus coeruleus has an important role in the expression of
      the physical signs of opiate dependence.

PMID- 8467383
TI  - Distribution of thyrotropin-releasing hormone binding sites: autoradiographic
      study in infant and adult human hippocampal formation.
AB  - The rostrocaudal distribution of thyrotropin-releasing hormone (TRH) binding
      sites was studied in the human hippocampus. Cryostat sections of the right and
      left hippocampi from 6 infants (2 h to 5 months of age) and 11 adults (24 to 92
      years) were subjected to in vitro quantitative autoradiography using [3H]MeTRH as
      a ligand. A single class of high affinity [3H]MeTRH binding sites with an
      apparent dissociation constant in the nanomolar range has been shown both in the
      infant and the adult. The maximal number of these sites was higher in the infant.
      No significant difference was observed between the general patterns of the right
      and the left hippocampi when taking postmortem delay and age as parameters. The
      highest concentrations of [3H]MeTRH binding sites were localized in the uncinate
      gyrus, the uncal subiculum and in the whole length of the molecular layer of the
      dentate gyrus. The lowest densities were present in the ventral subiculum. The
      major difference observed between the infant and the adult appeared in the
      molecular layer of the dentate gyrus where the densities were two-fold higher in
      infants (189 +/- 6 versus 88 +/- 2 fmol/mg of tissue). The only marked difference
      in the distribution was localized in the caudal part of the body where no
      specific labeling was found in the presubiculum of the infant.

PMID- 8467384
TI  - Membrane-bound choline-O-acetyltransferase in rat hippocampal tissue is anchored
      by glycosyl-phosphatidylinositol.
AB  - In an earlier study, we presented evidence to suggest that some of the
      particulate choline-O-acetyltransferase (ChAT) in rat hippocampal tissue might be
      linked to membranes by a glycosyl-phosphatidylinositol (GPI) anchor. In the
      present report, we attempted to determine if any of this GPI-anchored ChAT might
      be intracellular. Internalization of phosphatidylinositol-specific phospholipase
      C (PI-PLC) from Bacillus thuringiensis into rat hippocampal synaptosomes by the
      DMSO (dimethyl sulfoxide) freeze/thawing procedure caused an increase in
      cytosolic and a decrease in membrane-bound ChAT. Incubation of a plasma membrane
      enriched subcellular fraction at 16 degrees C relative to 4 degrees C led to a
      conversion of the membrane-bound, amphiphilic ChAT into hydrophilic ChAT. This
      conversion was blocked by zinc, an inhibitor of GPI-PLC. The cytosolic fraction
      of ChAT immunoreacted on western blots with an antibody directed against the
      cross-reacting determinant (CRD) of the GPI anchor. We suggest that some of the
      membrane-bound ChAT in rat hippocampal tissue is GPI-anchored intracellularly;
      also, that an endogenous GPI-PLC-like enzyme acts to release it into the cytosol.

PMID- 8467385
TI  - Transient increase in endogenous basic fibroblast growth factor in neurons of
      ischemic rat brains.
AB  - An antiserum against basic fibroblast growth factor (bFGF) was shown to recognize
      an 18-kDa protein (possibly bFGF) in crude neocortical extracts by immunoblot and
      used to investigate the changes of bFGF immunoreactivity in neurons and
      astrocytes of the cerebral cortex of rats 1-21 days after unilateral occlusion of
      the middle cerebral artery (MCA). The mildly ischemic neocortex exhibited no
      signs of cell loss or degeneration in Nissl-stained sections 1-14 days after MCA
      occlusion, but it contained pyramidal cell bodies and processes with more intense
      bFGF immunoreactivity than did the control neocortex. bFGF immunoreactivity in
      the ischemic hemisphere gradually declined in intensity and by 21 days after MCA
      occlusion, it had reached the control level. On the other hand, there were many
      bFGF immunoreactive astrocytes in the primary olfactory cortex on the side of
      infarction. These findings suggest that MCA occlusion causes an increase in bFGF
      content not only in astrocytes but also in neurons, depending on the severity of
      the ischemic insult in individual cortical regions. The transient augmentation of
      bFGF expression or accumulation in mildly ischemic pyramidal neurons but not in
      astrocytes is in line with previous studies suggesting the neurotrophism of
      exogenously applied bFGF.

PMID- 8467386
TI  - Glucocorticoid and mineralocorticoid receptors in rat neocortical and hippocampal
      brain cells in culture: characterization and regulatory studies.
AB  - Glucocorticoid and mineralocorticoid binding sites were characterized in cell
      cultures derived from neocortical and hippocampal brain tissue from fetal (E18)
      rats. Specific and saturable binding was detected in living cells with a
      sensitive whole cell binding method using [3H]dexamethasone ([3H]DEX) and
      [3H]aldosterone ([3H]ALDO) (in the presence of RU 28362, a selective
      glucocorticoid receptor (GR) agonist) as ligands for the measurement of
      glucocorticoid and mineralocorticoid receptors (MRs), respectively. Specific
      corticosteroid binding was demonstrated as early as day 4 in culture in
      neocortical cells, with a time-dependent increase in binding sites during further
      culturing time. At 7-9 days in vitro, Scatchard analysis of [3H]DEX binding
      revealed a maximum binding capacity (Bmax) of 83.4 +/- 5.0 fmol/mg protein and a
      binding affinity (Kd) of 3.6 +/- 0.4 nM in neocortical brain cells. Competition
      binding studies with [3H]DEX demonstrated a glucocorticoid specificity of
      receptor sites (relative binding affinity: RU 28362 = DEX > PROG > ALDO). Similar
      binding characteristics were demonstrated for GRs in cultures derived from fetal
      hippocampal tissue (Bmax 49.1 +/- 5.8 fmol/mg protein, Kd 3.5 +/- 0.2 nM).
      Analysis of MRs with [3H]ALDO (+RU 28362) revealed specific and saturable binding
      in hippocampal cultures, with a Bmax of 8.0 +/- 0.5 fmol/mg protein and a Kd of
      0.2 +/- 0.1 nM. Competition studies with [3H]ALDO showed a mineralocorticoid-like
      pattern of receptor binding (relative binding affinity: CORT = ALDO > PROG >
      DEX). In addition, small numbers of MRs were detectable in cortex-derived
      cultures (Bmax: 3.7 +/- 0.8 fmol/mg protein, Kd: 0.3 +/- 0.2 nM).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8467387
TI  - Microinjection of a corticotropin-releasing factor antagonist into the central
      nucleus of the amygdala reverses anxiogenic-like effects of ethanol withdrawal.
AB  - Previous studies have shown that spontaneous exploration of the Elevated Plus
      Maze provides a sensitive measure of 'anxiety' induced by pharmacological or
      behavioral stressors. In particular, the percent time spent exploring the open
      arms of the plus maze is decreased during ethanol withdrawal, and this effect is
      antagonized by intracerebroventricular administration of 25 micrograms of alpha
      helical CRF, a corticotropin-releasing factor antagonist (H.A. Baldwin et al.,
      Psychopharmacology, 103 (1991) 227-232). The present study was designed to
      examine the effect of alpha-helical CRF infusion within the central nucleus of
      the amygdala during ethanol withdrawal. Rats were made dependent on ethanol by
      maintenance on an ethanol-containing liquid diet for 16 days, withdrawn from
      ethanol and tested on the elevated plus maze at 8 h post-ethanol access. In
      comparison with pair-fed control rats, ethanol withdrawn subjects spent
      significantly less percent time exploring the open arms of the plus maze. This
      decrease in open arm exploration was antagonized by administration of alpha
      helical CRF (250 ng) bilaterally into the central nucleus of the amygdala, but
      not by intracerebroventricular administration of 250 ng of alpha-helical CRF. The
      ability of intra-amygdala alpha-helical CRF to antagonize decreased open arm
      exploration is unlikely to be due to changes in motor activity, since general
      activity on the maze was reduced in all EtOH withdrawal groups. These results
      suggest that the central nucleus of the amygdala may be an effective site for
      endogenous CRF systems to mediate anxious behavior associated with ethanol
      withdrawal.

PMID- 8467388
TI  - Nerve growth factor and a fibroblast growth factor-like neurotrophic activity in
      cerebrospinal fluid of brain injured human patients.
AB  - We report here the presence of nerve growth factor (NGF) in the cerebrospinal
      fluid (CSF) of some brain-injured human patients soon after injury. The NGF was
      quantified against a recombinant human NGF standard in a two-site enzyme-linked
      immunoabsorbent assay using antibodies against murine B NGF. None of the samples
      collected more than 2 days after injury contained detectable levels of NGF. When
      the CSF was assayed for the ability to promote neurite outgrowth from PC12 cells,
      neurite outgrowth was reduced, but not completely blocked, by antibodies to B
      NGF, suggesting that there were other biologically active factors present.
      Fibroblast growth factor (FGF) also promotes neurite outgrowth in PC12 cells. In
      an initial screening for the presence of FGF, we employed PC12 cells and NR119
      cells, PC12 variants in which recombinant human B NGF, but not recombinant human
      basic FGF, promotes neurite outgrowth. CSF from brain injury patients promoted
      greater neurite outgrowth from PC12 cells than from NR119 cells, suggesting that
      some of the biological activity associated with the injury CSF may be due a FGF.
      This possibility is further supported by the observation that the biological
      activity of the injury CSF significantly reduced by batch absorption with heparin
      Sepharose, suggesting the presence of a heparin binding neurotrophic factor.
      Neurotrophic factors appear in CSF as a consequence of diverse types of brain
      injury, including head trauma, intracerebral hemorrhage and subarachnoid
      hemorrhage. The appearance of these factors may reflect important common elements
      in the complex series of cellular changes occurring in response to acute brain
      injury.

PMID- 8467389
TI  - Reversible tetracaine block of rat periaqueductal gray (PAG) decreases baseline
      tail-flick latency and prevents analgesic effects of met-enkephalin injections in
      nucleus paragigantocellularis (PGC).
AB  - One micrograms of tetracaine in the rat periaqueductal gray (PAG) produced a
      decline in baseline tail-flick latencies (hyperalgesia) from about 5 to 3.5 s
      over the course of 9 min, after which the latencies increased to about 4.5 s. One
      micrograms of Met-enkephalin in PGC caused an expected increase in latencies
      (analgesia) from about 4.25 to 6.2 s in 9 min, with recovery to 4.7 s after 15
      min post-injection. Giving the preceding 2 nanoinjections simultaneously led to
      an essentially total block of the PGC analgesia. A control injection in PAG
      simultaneous with a Met-enkephalin injection in PGC did not block the latter's
      analgesic effect. Single control (artificial cerebrospinal fluid) injections in
      PAG or PGC were without effect. The hyperalgesic effect of PAG tetracaine
      supports the involvement of PAG in normally occurring, tonic descending pain
      inhibition. The block of PGC met-enkephalin analgesia by distant injection of
      tetracaine in PAG supports the necessity of PAG integrity for PGC analgesic
      function.

PMID- 8467390
TI  - Differential distribution of the alternative forms of the
      sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase, SERCA2b and SERCA2a, in the
      avian brain.
AB  - Cellular distribution of the two forms of SERCA2 was examined in adult chicken
      brain. Four regions of the brain were analyzed with three immunological reagents:
      a monoclonal antibody that recognizes both forms of SERCA2, and two antisera
      which are specific for the two alternative forms, SERCA2b or SERCA2a. Cerebellar
      Purkinje cells express predominantly SERCA2b but also low levels of SERCA2a, as
      has been reported for mammals. The nucleus isthmo-opticus, nucleus
      magnocellularis cochlearis, and nucleus laminaris all express high levels of
      SERCA2 but with different ratios of SERCA2b and SERCA2a. These
      immunohistochemical results were supported by in situ hybridization analysis.
      Therefore, it appears that regions within the brain have specific requirements
      for the two forms of SERCA2. This suggests functional significance for the
      alternative forms SERCA2b and SERCA2a, and possible functions are discussed.

PMID- 8467391
TI  - Ratification of broiler carcase condemnations in poultry meat inspection.
AB  - 1. In the years 1985 to 1989 decisions (approvals and condemnations) made by
      poultry meat inspectors were examined by the individual reinspection of 26,815
      broiler carcases. 2. The extent of agreement between inspection and revision
      ranged between 83.2 and 86.2%. 3. Agreement between inspectors and revisors was
      higher for the category of approved birds than for the condemned category. 4.
      Differences in the criteria used to assess the birds were observed. 5. The
      conclusion was drawn that findings in meat inspection require further discussion
      to reach an agreed standard.

PMID- 8467392
TI  - Artificial light sources and their influence on physical activity and energy
      expenditure of laying hens.
AB  - 1. The influence of fluorescent and incandescent artificial lighting in a 16L:8D
      day/night schedule on number and intensity of movements, and on total, resting
      and activity-related energy expenditure was investigated. 2. Fluorescent light
      showed the same positive correlation between light intensity and physical
      activity at all activity levels as was found previously for incandescent light.
      3. Light-dependent physical activity under fluorescent light was higher than
      under incandescent light at illuminances of 5 lux and above, indicating the
      fowl's ability to perceive qualitative light differences. 4. Total and activity
      related energy expenditure were positively associated with illuminance; resting
      energy expenditure was not influenced. 5. Total, resting and activity-related
      energy expenditure were not statistically significantly different between light
      sources. 6. The results are discussed in relationship to Teichmuller's concept of
      adequate lighting and the characteristics of the fowl's visual system.

PMID- 8467393
TI  - Improvement of dietary protein utilisation in chicks by medium chain
      triglyceride.
AB  - 1. To improve the influence of variation of ME intake, an experiment was carried
      out using equalized feeding to investigate the comparative effects on protein and
      energy utilisation in chicks of diets containing medium chain triglyceride (MCT)
      and long chain triglyceride (LCT). Experimental diets were given at 3 different
      food intakes, namely, 100, 120 or 147 g/bird/10 d. The diets contained MCT or LCT
      on an isoenergetic basis. Maize oil and caprylic acid triglyceride respectively,
      were used as LCT and MCT sources. 2. Body weight gain and food efficiency of
      chicks significantly increased with the supplement of dietary MCT compared with
      dietary LCT at all food intakes. Protein retention and the efficiency of protein
      utilisation (protein retained/protein intake) at all food intakes also
      significantly increased with dietary MCT, while body fat and fat retention were
      significantly reduced. Chicks fed the LCT-supplemented diet, on the other hand,
      had a lower protein retention, but significantly higher fat retention. The value
      for energy retention and the efficiency of energy utilisation (energy retained/ME
      intake) were not significantly different between MCT- and LCT-supplemented diets.
      3. It was concluded that supplementing MCT to the chick diet would improve body
      weight gain and protein utilisation while regulating fat deposition compared to
      the LCT supplemented diet, under equalized feeding conditions.

PMID- 8467394
TI  - Effects of feeding deoxynivalenol-contaminated oats on reproduction performance
      in White Leghorn hens.
AB  - 1. The effect of feeding trichothecene-contaminated diets with graded
      concentrations of deoxynivalenol ranging from 120 to 4900 micrograms/kg to groups
      of laying hens was investigated. 2. Food intake, weight gain and egg production
      were not affected by mycotoxin administration. No significant differences were
      found between groups. 3. The overall results from the hatching tests did not
      reveal any significant differences in fertility, hatchability or perinatal
      mortality, which could be explained by the mycotoxin content in the diets. 4.
      Body weight at hatching and viability of the chicks were not affected by the
      mycotoxin concentrations in the diets. 5. The incidence of chick developmental
      anomalies was increased in the mycotoxin-administered groups compared to
      controls. Minor malformations were the dominating anomalies and included
      unwithdrawn yolk sac and delayed ossification. The most frequent major
      malformations were cloacal atresia and cardiac anomalies.

PMID- 8467395
TI  - Effect of pyridoxine on the distribution of chloramphenicol and its residues in
      the chicken.
AB  - 1. Chickens were given either a single dose of chloramphenicol (50 mg/kg body
      weight per os) or a dose of chloramphenicol together with pyridoxine (25 mg/kg
      per os) given 1 h before or 4 h afterwards. 2. Concentrations of chloramphenicol
      were determined in samples of serum and the rates of distribution and elimination
      extrapolated. Concentrations of chloramphenicol in muscle, liver and kidney were
      also determined. 3. Serum concentrations of chloramphenicol were lower in
      chickens given both pyridoxine and chloramphenicol compared with those given only
      chloramphenicol. 4. Differences were most pronounced during the post-absorptive
      phase. The rates of disappearance of chloramphenicol residues from tissues were
      enhanced by pyridoxine. 5. The biological half life of chloramphenicol and area
      under the concentration-time curve were both reduced by the concurrent
      administration of pyridoxine. 6. Availability of pyridoxine may be a rate
      limiting factor in the biotransformation of xenobiotics, though its
      indiscriminate use could cause failure of antibiotic therapy.

PMID- 8467396
TI  - Effects of a beta-adrenergic agonist (clenbuterol) on performance, carcase
      composition, hepatic microsomal mixed function oxidase and antibody production in
      female broilers treated with or without corticosterone.
AB  - 1. Beta-adrenergic agonist (Clenbuterol, 0.33 mg/kg) and corticosterone (10
      mg/kg) were incorporated into a diet based on maize and soybean meal. Their
      effects on performance, carcase composition, hepatic microsomal mixed function
      oxidase and antibody production were investigated in female broilers. 2. Dietary
      corticosterone reduced the titre to sheep red blood cells, while it was unchanged
      by clenbuterol. 3. Clenbuterol exerted a promoting effect on gain-to-food ratio,
      carcase protein and hepatic microsomal cytochrome P-450 content. 4. Addition of
      clenbuterol to the corticosterone-containing diet prevented the increase in
      abdominal fat weight and uric acid excretion induced by corticosterone, but did
      not affect total fat mass. 5. The results showed that clenbuterol reduced
      abdominal rather than carcase fat and prevented protein degradation in the body
      when chicks were treated with corticosterone. Clenbuterol also influenced the
      content of cytochrome P-450, but not the humoral immunity.

PMID- 8467397
TI  - Effect of cold stress on performance and immune responses of Bedouin and White
      Leghorn hens.
AB  - 1. Bedouin chickens are kept in deserts mainly for eggs and are well adapted to
      arid conditions. However, deserts are also characterised by relatively cold
      winter nights. As a consequence of cold stress there is an involution of lymphoid
      organs and a depression of immunological function. We compared the performance
      and immunological responses of Bedouin and White Leghorn hens kept in outdoor
      pens in the Negev Desert during the winter. 2. Initial mean body mass was similar
      for the two breeds: 1525 g for Bedouin hens and 1542 g for White Leghorn hens.
      White Leghorns lost 7.74 g/d, compared with 0.60 g/d for Bedouin hens and
      produced 0.36 eggs/d, compared with 0.54 eggs/day for Bedouin hens. 3. The
      heterophil/lymphocyte ratio for Bedouin hens was 0.28, which was lower than the
      0.44 for White Leghorn hens. Phagocytic index was higher in Bedouin hens than in
      White Leghorns. Furthermore, wattle index measured 24, 48 and 72 h after PHA
      injections and anti-SRBC antibody titres determined 10 d after challenge were
      also higher in Bedouin hens than in White Leghorns. 4. We concluded that the
      Bedouin hens were less stressed by the cold than were the White Leghorn hens.

PMID- 8467398
TI  - Comparison of the rates of proliferation of adipocyte precursor cells derived
      from two lines of chicken which differ in their rates of adipose tissue
      development.
AB  - 1. Putative adipocyte precursor cells were isolated from the white adipose tissue
      of young broiler and layer chickens and cultured in vitro. 2. The cells from both
      sources were shown to have the characteristics of adipocyte precursor cells. On
      reaching confluence, lipoprotein lipase activity was induced and the cells from
      both strains accumulated large amounts of lipid in the presence of chicken serum.
      3. Measurement of cell number over time in culture and calculation of cell
      doubling times showed that cells from broilers proliferated at a faster rate than
      those derived from layer-strain chickens. This was the case whether primary or
      secondary cell cultures were used. Primary cultures of broiler cells had a
      doubling time of 22 h versus 39 h for layer cells. 4. The contribution of such a
      difference in proliferative rate to the differential rate of adipose tissue
      growth between broiler and layer strains observed in vivo is discussed.

PMID- 8467399
TI  - Pharmacokinetic profile and tissue distribution of monensin in broiler chickens.
AB  - 1. The pharmacokinetics of monensin, including half-life, apparent volume of
      distribution, total body clearance, systemic bioavailability and tissue residues
      were determined in broiler chickens. The drug was given by intracrop and
      intravenous routes in a single dose of 40 mg/kg body weight. 2. Following
      intravenous injection the kinetic disposition of monensin followed a two
      compartments open model with absorption half life of 0.59 h, volume of
      distribution of 4.11 l/kg and total body clearance of 28.36 ml/kg/min. The
      highest serum concentrations of monensin were reached 0.5 h after intracrop
      dosage with an absorption half-life of 0.27 h and an elimination half life of
      2.11 h. The systemic bioavailability was 65.1% after intracrop administration.
      Serum protein-binding tendency of monensin calculated in vitro was 22.8%. 3.
      Monensin concentrations in the serum and tissues of chickens after a single
      intracrop dose of pure monensin (40 mg/kg body weight) were higher than those
      after feeding a supplemented monensin premix (120 mg/kg) for 2 weeks. Monensin
      residues were detected in tested body tissues, collected 2, 4, 6 and 8 h after
      oral administration. The highest concentration was found in the liver. In
      addition, monensin residues were detected only in liver, kidney and fat 24 h
      after the last oral dose. No monensin residues could be detected in tissues after
      48 h, except in liver which cleared completely by 72 h.

PMID- 8467400
TI  - Further studies of linkage and mappings of the loci of genes in group 3 on
      chromosome 1 of the domestic fowl.
AB  - 1. Evidence is presented to confirm the placing of the extended black E-locus in
      linkage Group 3 on chromosome 1, E being linked with peacomb P by 43 map units. P
      has been shown to be linked with dark-brown columbian Db and sleepy-eye se by 32
      and 45 map units, respectively, se being independent of E. 2. Evidence is also
      presented to demonstrate independence of E and Db; hence, Db and se have their
      loci on the same side of P, the gene order being E-P-Db-se, thus contradicting
      published mappings which place P between Db and se. 3. An investigation into the
      deductive relationships on which published mappings are based led to the
      conclusion that insufficient evidence existed for the inclusion of the sub-group
      comprising blood group Ea-P, naked neck Na, silky feathering h and flightless Fl
      as part of Group 3. 4. Furthermore, it appears only 4 genes in Group 3 have
      actually had their loci mapped; blue egg O, P, the eumelanin extension charcoal
      cha and the feather growth restrictor tardy t. 5. No evidence appears to have
      been presented to establish on which arm of chromosome 1 any of the other genes
      in Group 3 have their loci. A revised map of chromosome 1 and a schematic
      arrangement to demonstrate the relative linkage distances of the loci of the
      unmapped genes in Group 3 are presented and explained.

PMID- 8467402
TI  - Photoperiod and seasonal influences on the growth of turkey hens.
AB  - 1. The influence of photoperiod and time of year on the growth of hen turkeys was
      investigated. 2. Photoperiod treatments consisted of computer simulations of day
      lengths which occur naturally in the spring and autumn of the year. Both
      photoperiod treatments were given to hens in the autumn and spring. 3. Data were
      collected for growth evaluations at 2- to 4-week intervals to 16 weeks of age. No
      significant season X photoperiod interactions occurred. 4. The spring trial
      resulted in greater body weights and better food conversions (food/gain) than the
      autumn trial. 5. Simulated autumn daylengths resulted in greater body weights and
      improved food efficiency at 16 weeks of age compared with simulated spring
      daylengths. 6. The pattern of growth (period changes) was influenced by season,
      but not photoperiod. 7. Season and photoperiod both have important and
      independent influences on the growth of the turkey hen.

PMID- 8467401
TI  - Feeding behaviour in chickens given diets containing medium chain triglyceride.
AB  - 1. The effect of dietary medium chain triglyceride (MCT) on short-term food
      intake was compared with the effect of long chain triglyceride (LCT) in chickens.
      Maize oil was used as the LCT while glyceryl tricaprylate (C 8) and glyceryl
      tricaprate (C 10) were used as MCT. Cumulative food intake was determined during
      the 6 h after the start of feeding. 2. Chicks were given diets containing 200 g C
      8/kg diet, 200 g C 10/kg diet or 200 g LCT/kg diet in experiment 1. As early as
      30 min after feeding, cumulative food intake in both MCT-supplemented diets
      decreased significantly compared with the diet containing LCT. 3. To determine if
      endogenous cholecystokinin (CCK) was responsible for the decrease in food intake
      caused by MCT, birds were injected with the CCK-A receptor antagonist devazepide
      (DVZ, 1 mg/kg BW) before diet presentation. DVZ had no effect on food intake with
      either LCT- or MCT-supplemented diets. 4. In experiment 3, chicks were given a
      choice between either diets containing LCT and C 8, LCT and C 10, or C 8 and C 10
      to confirm whether or not the palatability of the diets was influenced by the
      dietary fat sources. There was no difference in food intake between C 8 and C 10
      supplemented diets. However, chicks preferred the LCT-supplemented diet compared
      with either of the diets containing MCT.

PMID- 8467403
TI  - Distribution and characteristics of mast cells in the chick ovary.
AB  - 1. Distribution and characteristics of mast cells have been studied in the
      ovaries of 5 and 17 week old chickens. 2. Mast cells were mainly present in the
      stroma, hilum and theca of normal and atretic follicles. No significant age
      related differences in percentage distribution of mast cells were observed in the
      stroma and hilar regions of the ovary. However, the percentage of mast cells
      associated with follicles in both age groups was significantly less compared to
      stromal and hilar regions. 3. The number of mast cells present in the theca of
      normal and atretic follicles of stage 301 to 500 microns increased significantly
      compared to the preceding stages in 17-week old chicken ovaries. Moreover, the
      number of mast cells associated with the follicles of this stage in 17-week old
      chick ovaries was also higher compared to 5-week old chicken ovaries. 4. The mast
      cells showing variable shapes were divided into two types: compact and
      degranulating. More degranulating mast cells were observed in the 17-week old
      chicken ovary compared to those observed at 5-weeks.

PMID- 8467404
TI  - Someone's precious child.

PMID- 8467405
TI  - Spine and femur BMD by DXA in patients with varying severity spinal osteoporosis.
AB  - Bone mineral density (BMD) at the lumbar spine, femoral neck, trochanteric
      region, and Ward's triangle was measured using dual-energy X-ray absorptiometry
      (DXA) in 118 women with osteoporotic vertebral collapse (average age 65 years),
      divided into four groups according to numbers and SD of vertebral deformation
      below norms: group 1: -3SD deformations only; group 2: one -4SD deformation;
      group 3: two-four -4SD deformations; and group 4: 5 or more -4SD deformations.
      There were no significant differences between the groups. Results were compared
      with those from 80 premenopausal (average age 32 years, range 20-40 years) and
      109 postmenopausal normal women (average age 64, range 60-70 years). Mean BMD in
      osteoporotic group 1 was lower than premenopausal normal women by 32% at the
      lumbar spine, 31% femoral neck, 30% trochanteric region, and 44% at Ward's
      triangle, and postmenopausal controls by 17% lumbar spine, 16% femoral neck, 17%
      trochanter, and 14% Ward's triangle. There was a clear trend to reduction in mean
      BMD between osteoporotic groups 1 and 4 at all four measured sites with
      significant differences at the spine of 0.102 g/cm2 (P < 0.01) and Ward's
      triangle 0.059 g/cm2 (P < 0.01). When compared with premenopausal controls, there
      was a reduction in mean BMD between osteoporotic groups 1 and 4 of 10% at the
      lumbar spine, 7% femoral neck, 8% trochanteric region, and 13% Ward's triangle.
      Receiver operating characteristic analysis showed no significant differences in
      diagnostic sensitivities among the four measured sites for vertebral fractures.
      We conclude from this cross-sectional data that the majority of bone loss in
      spinal osteoporosis occurs before the onset of fractures.

PMID- 8467406
TI  - Fracture of the distal forearm as a forecaster of subsequent hip fracture: a
      population-based cohort study with 24 years of follow-up.
AB  - OBJECTIVE: To determine the long-term risk of hip fracture following fracture of
      the distal forearm. DESIGN: Registry-based cohort study comparing patients with a
      fracture of the distal forearm with a population-based cohort. FRACTURE COHORT:
      All women and men above 40 years of age with a radiologically verified fracture
      of the distal forearm during a 5-year period, 1968-1972, in all 1,126 women and
      212 men. CONTROL COHORT: An equal number of population-based, age- and sex
      matched control persons selected from a population register. MEASUREMENTS: All
      cohort members were followed up individually through record linkage until the
      first hip fracture, emigration, death, or the end of 1991. The cohort members
      contributed a total of 40,832 person-years of observation, and altogether 365
      cases of hip fractures were observed. RESULTS: Both women and men with a fracture
      of the distal forearm ran an increased risk of sustaining a subsequent hip
      fracture. The overall relative hazard for the women was 1.54 and for men 2.27.
      The increased risk in the women was independent of age at inclusion, but that in
      the men was more pronounced in the younger age groups. CONCLUSIONS: Patients with
      a fracture of the distal forearm run an increased risk of sustaining a subsequent
      hip fracture. They therefore appear to constitute a group in which appropriate
      prophylactic measures against osteoporosis and fractures should be considered.

PMID- 8467407
TI  - Videodensitometry of osteons in females with femoral neck fractures.
AB  - The medial femoral cortices of 10 females with femoral neck fractures and 10 age
      matched female autopsy cases were studied using computer-assisted
      videodensitometry. Radiographic mineral density was determined using the
      calibration method described by Martin et al. [20]. Measurements were made of
      porosity, osteon and haversian canal dimensions, and of interstitial and osteon
      mineral density across the cortical wall of the orthopedic calcar region. There
      were no differences between the fracture and nonfracture groups in the overall
      mean mineral density of the bone averaged over the microstructure, excluding pore
      space, or in the interstitial bone mineral density. The porosity in the fracture
      group was greater than in the autopsy group, especially in the periosteal region,
      where the porosity was 2.4 times greater and where there were also 27% fewer
      osteons per unit area than in the autopsy group (P < 0.05). Mean osteon mineral
      density was 2.5% higher in the fracture group (P < 0.05) compared with the
      autopsy group in the endosteal region, and 4% higher in the periosteal region.
      Osteon and haversian canal areas were also larger in the fracture group,
      especially in the middle region of the cortical wall (17% and 23%, respectively,
      P < 0.05).

PMID- 8467408
TI  - Distribution of fluoride in cortical bone of human rib.
AB  - We describe a detailed study of fluoride distribution with age in the human
      cortical rib bone. Human ribs were obtained from 110 subjects (M:68, F;42) aged
      20-93 years. The fluoride distribution from the periosteal to endosteal surfaces
      of the ribs was determined by sampling each specimen using an abrasive micro
      sampling technique, and the samples were analyzed using the fluoride electrode,
      as described by Weatherell et al. [1]. The concentration of fluoride was highest
      in the periosteal region, decreased gradually towards the interior of the tissue
      where the concentration of fluoride tended toward the plateau, and then rose
      again towards the endosteal surface. Patterns of fluoride distribution changed
      with age, and the difference between periosteal and endosteal fluoride levels
      increased with age. Although average fluoride concentrations increased with age
      in both sexes, there was a significant difference between males and females at
      the age of about 55 years (P < 0.05).

PMID- 8467409
TI  - Humeral skeletal development and plasma constituent changes in fetuses of ewes
      maintained on a low calcium diet from 60 days of gestation.
AB  - The objective of this study was to evaluate the effects of a long-term, low
      calcium diet on fetal calcium metabolism and fetal skeleton development in ewes.
      Eleven pregnant sheep were assigned to two groups, fed either a diet low in
      calcium (0.26% total dry matter) or normal in calcium (0.8% total dry matter) for
      2 months, starting at 60 days gestational age. The ewes fed the low calcium diet
      showed lower plasma levels of calcium and higher plasma levels of hydroxyproline,
      parathyroid hormone, and 1,25(OH)2D compared with the ewes fed the normal calcium
      diet. There were no differences in these variables between the two groups of
      fetuses. These observations suggest that the plasma components of calcium
      homeostasis measured in the fetal lamb in the present study are independent of
      the ewe and are not significantly affected by the presence of lowered maternal
      calcium for many weeks during pregnancy. Despite the ability of the fetus of the
      ewe on the low calcium diet to maintain relatively normal circulating plasma
      components of calcium homeostasis, long-term maternal hypocalcemia delayed fetal
      skeletal ossification as shown by histological examination of the fetal humerus.
      The fetal humerus from low calcium-fed ewes showed a lower proportion of bone
      versus cartilage (45.6 +/- 5.9 versus 57.4 +/- 4.6%, mean +/- SD) lower ash
      content (15.4 +/- 1.5 versus 17.4 +/- 1.0%), and lower specific gravity (1.19 +/-
      0.2 versus 1.22 +/- 0.02) (P < 0.05) than the humerus from fetuses of normal
      calcium-fed ewes. This study shows that the long-term calcium intake of the ewe
      does affect fetal skeletal development, despite a lack of observable effects on
      fetal plasma concentrations of calcium or known calcium regulating hormones such
      as 1,25(OH)2D or parathyroid hormone.

PMID- 8467410
TI  - Insulin enhances the growth of cartilage in organ and tissue cultures of mouse
      neonatal mandibular condyle.
AB  - Condylar cartilages were cultured in the form of organ cultures on top of
      collagen sponges in medium containing 2% fetal calf serum and were treated with
      3.5-350 nM insulin for 6 days. Doses of 175 nM of insulin caused a marked
      increase (+96%) in DNA synthesis and in proteoglycan production (+74%), features
      that manifested themselves structurally by a 60% increase in overall size of the
      cultured explants. Using a tissue culture system comprised of cartilage
      progenitor cells, insulin was found to enhance the differentiation of the
      progenitor cells so that by 6 days in culture an appreciable nodule of
      differentiated chondrocytes developed. The latter was surrounded by perichondrial
      cells whereas the extracellular matrix within the newly formed, insulin-induced,
      nodule reacted positively for cartilage-specific antigens (type II collagen and
      bone sialoprotein). It is suggested that insulin induces a direct stimulatory
      effect on progenitor cell proliferation, cartilage differentiation, and
      extracellular matrix deposition.

PMID- 8467411
TI  - Impaired duodenal response to short-term dietary calcium restriction in
      adolescent spontaneously hypertensive rats.
AB  - The response pattern of plasma calcitriol level and related intestinal adaptation
      to short-term moderate calcium (Ca) restriction was examined in adolescent male,
      spontaneously hypertensive rats (SHR) and normotensive WKY control rats. Twelve
      week-old SHR and WKY fed a low (0.1%) Ca diet for 3, 6, or 12 days were compared
      with rats of either strain fed a normal (1.0%) Ca diet. Plasma calcitriol
      response was measured and duodenal adaptation to Ca restriction was investigated
      by evaluating active Ca transport, calbindin-D9K (CaBP9K) protein, CaBP9K mRNA,
      and alkaline phosphatase activity (ALP). Under the normal Ca diet, no significant
      difference between strains was observed for all five parameters. In response to
      the low Ca diet, the SHR and WKY showed a similar increase (nearly 50%) in plasma
      calcitriol, starting at day 3 of this diet. However, only the WKY displayed the
      expected duodenal adaptation: active Ca transport increased at day 6 and CaBP9K
      as well as ALP increased at day 3 of the low Ca diet. The stimulation of the
      latter three parameters was maintained until day 12 of Ca restriction. Moreover,
      CaBP9K mRNA was increased in WKY after 3 days of Ca restriction. In contrast, the
      SHR had either no or only a minor increase of duodenal parameters in response to
      Ca restriction. Finally, a significant and positive correlation between Ca
      transport and plasma calcitriol and between Ca transport and CaBP9K was found in
      WKY but not in SHR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467412
TI  - Scanning electron microscopy of final enamel formation in rat mandibular incisors
      following single injections of 1-hydroxyethylidene-1,1-bisphosphonate.
AB  - A single, high dose of 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) results in
      three different types of lesions along the enamel surface of the rat incisor, one
      of which is seen as a "bright band" crossing the final enamel surface in the
      scanning electron microscope (SEM). The present study presents the structural
      surface features of final enamel formation and its subsequent maturation in
      normal and HEBP-exposed rats. The position of the bright band is examined in
      relation to where the Tomes processes pits disappear (DTPP), where the boundary
      between "light" and "dark" enamel (LDB) as seen by SEM is located, and in
      particular, where the so-called opaque boundary (OB) is positioned. Groups of
      rats were given a subcutaneous dose of 0, 5, or 10 mg P/kg body wt of HEBP and
      killed at intervals of either 12 hours or 2 or 9 days. The mandibular incisors
      were processed for SEM after enzymatic digestion of enamel organ remains. Enamel
      surface nodules, 100-300 nm in diameter and composed of smaller units, were
      evident at the start of final enamel formation which was defined as the area from
      DTPP to LDB. With increasing maturation, the nodules merged to form a smooth
      surface. In HEBP-treated animals, growth and merging of these surface nodules
      became arrested at the time of injection resulting in an irreversible "porous"
      stage corresponding to that part of the surface enamel. This area--the bright
      band--developed corresponding to the start of the area of final enamel formation
      and was subsequently carried incisally during the eruption of the
      incisor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467413
TI  - Detection of collagenase mRNA in odontoclasts of bovine root-resorbing tissue by
      in situ hybridization.
AB  - The odontoclast, which is morphologically similar to osteoclast, is thought to
      play a major role in root resorption of deciduous teeth. High collagenolytic
      activity has been detected in the root resorbing tissue. In order to identify
      collagenase-producing cells and the role of collagenase in root resorption of
      deciduous tooth, in situ hybridization of collagenase mRNA in bovine root
      resorbing tissue sections was performed using a digoxigenin-labeled,
      nonradioactive RNA probe. Collagenase mRNA expression was clearly observed in
      odontoclasts in addition to the macrophages, fibroblasts, odontoblasts, and
      cementoblasts. Multinuclear odontoclasts showed intense tartrate-resistant acid
      phosphatase (TRAP) activity. We also examined interleukin-1 (IL-1) mRNA
      expression in the root-resorbing tissue by in situ hybridization. IL-1
      transcripts were found to be expressed in odontoclasts, fibroblasts, and
      macrophages suggesting that IL-1 might be an important factor for promoting root
      resorption. These results suggest that the collagenase produced by odontoclasts
      may play a key role in dentin collagen degradation in root resorption.

PMID- 8467414
TI  - Biochemical markers of nutrition in osteoporosis.
AB  - Thirty-six women with vertebral osteoporosis showed significantly decreased
      levels of biochemical markers of nutrition, transferrin (P < 0.001), prealbumin
      (P < 0.001), retinol binding-protein (P < 0.001), and fibronectin (P < 0.001),
      compared with 40 healthy women of similar age. Multiple regression analysis
      showed a significant (R2 = 0.509; P = 0.0068) correlation between bone mineral
      content and biochemical markers of nutrition in the osteoporotic patients but not
      in the control group. These data suggest that postmenopausal osteoporosis may be
      associated with a nutritional deficiency.

PMID- 8467415
TI  - Antigen-specific recognition by class I major histocompatibility complex
      restricted T cells and activation of CD8+ memory cytotoxic T cells.

PMID- 8467416
TI  - A review of the microbiological quality of bottled water sold in Canada. Part 2.
      The need for more stringent standards and regulations.

PMID- 8467417
TI  - Purification and partial characterization of a bacteriocin isolated from
      Bacteroides ovatus H47.
AB  - A new intracellular bacteriocin isolated from a human fecal strain of Bacteroides
      ovatus was partially purified through ammonium sulfate precipitation, ion
      exchange chromatography, gel filtration, and preparative polyacrylamide gel
      electrophoresis (PAGE). The bacteriocin is stable at a pH range of 3-10, at 60
      degrees C for 24 h, and at -70 degrees C for 6 months. It is inactivated by
      proteolytic enzymes. The molecular weight, estimated by sodium dodecyl sulfate-
      PAGE, is 78 kDa. Fifty strains of the Bacteroides fragilis group were isolated
      from fecal samples, and 41 of the isolates were shown to produce an antagonistic
      substance against at least 1 indicator strain. Iso-, auto-, and hetero
      antagonisms were observed.

PMID- 8467418
TI  - 1,3,5-Trihydroxybenzene biodegradation by Rhodococcus sp. BPG-8.
AB  - The metabolic pathway used by Rhodococcus sp. BPG-8 isolated from oil-rich soil
      in Newfoundland for the degradation of 1,3,5-trihydroxybenzene (phloroglucinol)
      as a sole source of carbon and energy was determined. Culture filtrates of cells
      grown on phloroglucinol detected 1,2,3,5-tetrahydroxybenzene when extracted and
      analyzed using gas chromatography--mass spectrometry, thin-layer chromatography,
      and ultraviolet spectrophotometry. Nonaromatics were either derivatized with 2,4
      dinitrophenylhydrazine and compared against authentic standards by the above
      methods, or detected by chemical and enzymatic methods. Extracts of cells grown
      on phloroglucinol contained phloroglucinol hydroxylase activity, and a
      dioxygenase that carried out ortho-cleavage of 1,2,3,5-tetrahydroxybenzene. The
      extract also showed inducible activity for further metabolism of acetopyruvate
      leading to accumulation of formate in the supernatant. A tentative degradative
      pathway for phloroglucinol by Rhodococcus sp. BPG--8 is proposed.

PMID- 8467419
TI  - Measurement of the intracellular pH of Propionibacterium acnes: comparison
      between the fluorescent probe BCECF and 31P-NMR spectroscopy.
AB  - The intracellular pH of the Gram-positive skin bacterium Propionibacterium acnes
      was determined using the pH-sensitive fluorescent probe 2',7'-bis-(2
      carboxyethyl)-5-(and-6)carboxyfluorescein (BCECF). The probe was introduced into
      the bacteria using the membrane-permeable acetoxymethyl ester BCECF-AM. The
      intracellular pH of the bacteria was determined by establishing a relation
      between the fluorescence ratio 505/450 and pH using the ionophore nigericin. To
      verify the intracellular pH determined using BCECF, the results were compared
      with those obtained using 31P-NMR spectroscopy. The effects of different external
      pH values and glucose addition upon the intracellular pH were examined using
      BCECF and 31P-NMR. Good correlation was obtained between the two techniques.
      Propionibacterium acnes maintained a pH gradient, inside alkaline, in the
      external pH range 5.0-7.4, which inverted when the pH was > 7.5. At external pH >
      or equal to 8.5, the intracellular pH was close to the external pH. Glucose
      exposure did not affect the intracellular pH. Rapid, transient intracellular
      acidification and alkalinization brought about using NaHCO3 and NH4Cl,
      respectively, could be detected using BCECF. A limitation encountered when using
      BCECF was BCECF leakage, which could significantly affect the results if not
      taken into account.

PMID- 8467420
TI  - Purification and properties of mercuric reductase from Yersinia enterocolitica
      138A14.
AB  - A mercuric ion-reducing flavoprotein was purified from Yersinia enterocolitica
      138A14 using dye matrix affinity chromatography. The purified enzyme had a
      characteristic absorption spectrum similar to those of flavin compounds, and FAD
      was detected as a part of the purified enzyme by thin-layer chromatography.
      Freshly purified preparations of the enzyme showed a single band on SDS
      polyacrylamide gel electrophoresis with a molecular weight of 70,000. The
      isolated enzyme had a molecular weight of about 200,000 as determined by gel
      filtration and disc gel electrophoresis. These results suggest an apparently
      trimeric structure of the enzyme. Dithiothreitol treatment disrupted the trimer
      into a dimeric structure of 140,000. Along with ageing, as well as limited
      proteolytic digestion, the enzyme evolved to give a dimeric molecule of 105,000
      composed of two identical subunits of 52,000. The combination of the purified
      enzyme with HgCl2, or unexpectedly with merthiolate, oxidised the NADPH, which
      was followed spectrophotometrically. The Km for HgCl2 was dependent on the
      concentration of exogenous thiol compounds. A comparison of physical properties
      as well as kinetic characteristics indicated that the enzyme from Y.
      enterocolitica 138A14 is similar to mercuric reductases isolated from other
      mercury-resistant bacteria.

PMID- 8467421
TI  - Degradation of acrylamide by immobilized cells of a Pseudomonas sp. and
      Xanthomonas maltophilia.
AB  - Two bacterial isolates capable of utilizing acrylamide as the sole source of
      carbon and nitrogen were isolated from herbicide-contaminated soil samples and
      identified as Pseudomonas sp. and Xanthomonas maltophilia. Batch cultures of
      Pseudomonas sp. and X. maltophilia completely degraded 62.8 mM acrylamide to
      acrylic acid and ammonia in 24 and 48 h, respectively. Pseudomonas sp. and X.
      maltophilia, when immobilized in calcium alginate, markedly increased the rate of
      degradation of acrylamide over batch cultures. Cells of the isolates immobilized
      in calcium alginate degraded acrylamide to acrylic acid and ammonia in less than
      6 h. Initial metabolism of acrylamide by immobilized cells of Pseudomonas sp.
      followed by inoculation with nonimmobilized cells after 6 h totally removed
      acrylamide and its metabolites in 72 h. A similar procedure with X. maltophilia
      resulted in the total metabolism of acrylamide in 96 h. An inducible,
      intracellular amidase was responsible for the hydrolysis of acrylamide to acrylic
      acid and ammonia. The specific activity of Pseudomonas sp. amidase was higher
      than the specific activity of X. maltophilia amidase.

PMID- 8467422
TI  - Levels of small molecules in dormant spores of Sporosarcina species and
      comparison with levels in spores of Bacillus and Clostridium species.
AB  - Dormant spores of Sporosarcina halophila and Sporosarcina ureae contained no
      detectable ATP, significant levels of ADP, even higher levels of AMP, and a large
      pool of 3-phosphoglyceric acid, similar to what is found in dormant spores of
      Bacillus and Clostridium species. Sporosarcina halophila and S. ureae spores also
      contained significant pools of free amino acids, in particular glutamic acid, as
      in the case with spores of Bacillus but not Clostridium species. Levels of
      monovalent and divalent inorganic cations were comparable in spores of
      Sporosarcina, Clostridium, and Bacillus species, and cation levels in spores of
      the slight halophile S. halophila were similar to those in S. ureae spores. These
      data suggest that levels of small molecules are generally similar in spores of
      all Gram-positive organisms, and further suggest that these levels reflect
      fundamental and conserved features of the sporulation process and dormant spores
      in these organisms. The data are also consistent with the proposed close
      evolutionary relationship between Bacillus and Sporosarcina species.

PMID- 8467423
TI  - Instability of the production of avermectins, sporulation, and pigmentation in
      Streptomyces avermitilis.
AB  - Production of avermectins, sporulation ability, and colony pigmentation were
      followed in Streptomyces avermitilis C-18/6 cultures during serial transfer (for
      eight subcultures) in four different liquid media. These phenotypes were found to
      be unstable and independent of each other. A procedure was established whereby
      depressed avermectin production could be reversed but the degree of reversion was
      dependent on the history of the isolate, i.e., the type of medium used. The
      presence of isoleucine as the sole N source caused an immediate loss of
      avermectin production and this could not be reversed.

PMID- 8467424
TI  - Epidemiology of multiple sclerosis: a critical overview.
AB  - The decisive conclusions to be drawn from the available epidemiological data,
      mostly geography and prevalence, of MS are: (1) a north-south (as well as west
      east in the United States) gradient exists independent of genetic/racial factors;
      (2) major differences in prevalence occur in the absence of latitude differences;
      (3) individuals from the same ethnic derivation have either similar prevalence
      rates or very different prevalence rates in widely separated geographical areas
      and (4) specific resistant isolates are shown to exist regardless of latitude.
      Existing information leads to the almost inescapable conclusion that the
      epidemiology of MS cannot be explained by any single known environmental or
      genetic factor(s) in isolation. A combination of a heterogeneous distribution of
      both genetic and environmental factors appears to be required to explain the
      available data on MS.

PMID- 8467425
TI  - Penfield Lecture. A quarter century's experience with intraoperative nerve action
      potential recording.
AB  - The rationale, basic considerations, and technique of intraoperative nerve action
      potential (NAP) recording have been reviewed. Experience using this technique in
      several thousand patients over a 25 year period has been summarized. The most
      frequent serious nerve injury is one that leaves it in continuity. Resection of
      such a lesion that is regenerating does the patient a great disservice as does
      exploration without repair of one with little or no potential for useful
      spontaneous recovery. The frequency of lesions in continuity as well as the
      difficulties in evaluating them in the early months by electromyography let alone
      by surgical inspection has led to the development of intraoperative NAP
      recording. Where neurolysis was based on a recordable NAP across a lesion in
      continuity, 93% recovered good function. Where resection of the lesion was based
      on absence of an NAP, the injury was, without exception, neurotmetic and/or one
      with poor potential for useful recovery without repair. Some lesions had an NAP
      across their lesion but a portion of the cross-sectional area appeared more
      seriously injured. By use of NAP recordings, a split repair was done and usually
      with good results.

PMID- 8467426
TI  - Focal cerebral ischemia in rats: effect of hemodilution with alpha-alpha cross
      linked hemoglobin on brain injury and edema.
AB  - The effect of hemodilution, with alpha-alpha cross-linked hemoglobin (DCLHb), on
      brain injury and edema was assessed after temporary middle cerebral artery
      occlusion in rats. Injury was analyzed with 2,3,5-triphenyltetrazolium chloride
      (TTC) stain and edema by microgravimety. Part A: DCLHb was given to maintain one
      of the following hematocrits (Hct) and normotension: 1) 45/Hct, 2) 30/Hct, 3)
      16/Hct, or 4) 9/Hct. Brain injury (% of ischemic hemisphere, mean +/- SD) was
      less in the 30/Hct group (31 +/- 4) versus the 45/Hct group (42 +/- 5); and in
      the 16/Hct (20 +/- 3) and 9/Hct (19 +/- 4) groups versus the 45/Hct and 30/Hct
      groups. Edema was less in the hemodiluted groups versus the 45/Hct group. Part B:
      DCLHb was given to maintain one of the following hematocrits and hyper (HTN)-or
      normotension (Norm): 1) 45/Norm, 2) 30/Norm, 3) 30/HTN, 4) 16/Norm, or 5) 16/HTN.
      In hematocrit matched groups hypertension decreased brain injury (30/HTN-24 +/- 2
      < 30/Norm-34 +/- 4; and 16/HTN-17 +/- 3 < 16/Norm-24 +/- 4). Edema was not
      effected by hypertension. These results suggest that hemodilution with DCLHb
      decreases focal ischemic injury, and is most effective when given in a manner
      that induces hypertension.

PMID- 8467427
TI  - Failure of iron chelators to protect against cerebral infarction in hypoxia
      ischemia.
AB  - In this study the ability of iron chelators to attenuate hypoxic-ischemic brain
      damage was assessed in hyperglycemic rats that were exposed to 1% carbon monoxide
      and right carotid occlusion. The animals received deferoxamine (50 mg/kg),
      manganese-deferoxamine (50 mg/kg) or vehicle i.p. 0.5 h prior to hypoxemic
      ischemic exposure and at 0.5, 3 and 24 h post-exposure; with subsequent
      histological examination of the brain at 7 days recovery. The area of cerebral
      infarction was measured at three levels using video imaging methods. The mean
      percentage of total hemisphere that was infarcted in the three groups was:
      vehicle--28.5 +/- 5.0; deferoxamine--31.7 +/- 12.1; and manganese deferoxamine-
      30.6 +/- 6.8 (p-n.s.). The results as obtained in this preliminary study indicate
      that aggressive pre- and post-treatment with iron chelators has no ability to
      attenuate cerebral infarction in this model.

PMID- 8467428
TI  - Single-blind study of dystrophin staining in carriers of Duchenne muscular
      dystrophy.
AB  - A single-blind study of dystrophin staining in skeletal muscle was performed in
      13 biopsies from carriers of Duchenne Muscular Dystrophy (DMD) and controls. The
      results indicate that immunohistochemical analysis of dystrophin staining is a
      valuable diagnostic test for DMD carriers when DNA for testing is unavailable
      from critical family members or is uninformative, when creatine kinase (CK)
      values are conflicting or when CK values must be used in isolation.

PMID- 8467429
TI  - Detection of Lewy bodies in Trisomy 21 (Down's syndrome).
AB  - The presence of cortical senile plaques and neurofibrillary tangles sufficient to
      warrant a neuropathological diagnosis of Alzheimer's disease is well established
      in middle-aged individuals with Trisomy 21 (Down's syndrome). In contrast a
      relationship between Down's syndrome and Lewy bodies, one of the major
      neuropathological features of Parkinson's disease, has not been previously
      reported. In a clinico-neuropathological survey of 23 cases of Down's Syndrome,
      two patients, aged 50 and 56 years respectively, were found to have Lewy body
      formation in the substantia nigra in addition to cortical Alzheimer-type
      pathology. Neither case showed significant substantia nigra neuron loss although
      locus coeruleus loss was present in both. Since substantia nigra Lewy bodies are
      a characteristic neurohistological feature of idiopathic Parkinson's disease,
      their occurrence in cases of Down's syndrome with evidence of Alzheimer-type
      pathology supports an aetiopathological connection between Parkinson's disease,
      Alzheimer's disease, and Down's syndrome; and suggests that common pathogenic
      mechanisms may underlie aspects of neuronal degeneration in these three
      disorders, some of which may relate to aberrant chromosome 21 expression.

PMID- 8467430
TI  - A double-blind cross-over trial of amantadine hydrochloride in Friedreich's
      ataxia.
AB  - We performed a double-blind cross-over study with amantadine hydrochloride in 12
      patients with Friedreich's disease and 2 with autosomal dominant cerebellar
      ataxia. Patients were randomly assigned to a placebo-amantadine or amantadine
      placebo sequence. The interval between the treatments was two weeks. Patients
      were graded according to a functional ataxia scoring scale and videotaped in
      basal conditions and 90 min after a single oral dose of 100 mg amantadine or
      placebo. Three evaluators independently scored the videotapes. Statistical
      analysis showed no significant effect of amantadine in Friedreich's disease.

PMID- 8467431
TI  - Cervical disc herniation presenting with chest wall pain.
AB  - This report highlights the clinical features of two patients who presented with
      severe neuropathic chest wall pain caused by herniated C6-7 disc, and speculates
      on the pathophysiology of this syndrome. Worsening of symptoms with neck movement
      helped localize the process as cervical spine rather than plexus in origin. Both
      patients had herniated C6-7 disc material compressing the spinal cord and C7
      nerve root, and neurological symptoms resolved promptly following surgery.
      Neuropathic chest wall pain should alert the clinician to consider the diagnosis
      of cervical disc herniation and prompt definitive imaging of the cervical spine
      by myelography or magnetic resonance imaging (MRI).

PMID- 8467432
TI  - Horner's syndrome secondary to angiogram negative, subadventitial carotid artery
      dissection.
AB  - A 59-year-old man presented with the acute onset of paresthesias and pain in the
      left neck, face, and forehead. On subsequent investigation he was found to have a
      subadventitial type of carotid artery dissection, producing an ipsilateral
      Horner's syndrome with normal carotid angiography. MRI imaging of the neck
      structures, using fat saturation technique, showed the subadventitial dissection,
      sparing the vessel lumen. MRI offers a non-invasive method of diagnosis and
      follow-up for carotid artery dissection.

PMID- 8467433
TI  - Epineurial peptides: a role in neuropathic pain?
AB  - Neuropathic pain is not well understood. Although central dorsal horn remodelling
      is likely important in maintaining chronic neuropathic pain, afferent activity
      from injured nerves or ganglia may initiate these changes. It is suggested, in
      this review that the peripheral nerve trunk is capable of sustaining a "flare"
      response as observed in injured skin and other tissues. The injury response may
      be associated with local vasodilatation, plasma extravasation and the generation
      of painful local afferent activity sustained by locally originating peptidergic
      fibers (nervi nervorum). These fibers contain substance P, calcitonin gene
      related peptide and other peptides that have been linked to nociceptive
      transmission. Manipulation of the local injury response of the nerve trunk by
      pharmacologic means may provide one strategy in the treatment of neuropathic
      pain.

PMID- 8467435
TI  - Epidemiology of pathological gambling in Edmonton.
AB  - Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were
      identified when 7,214 randomly selected household residents of Edmonton were
      interviewed by trained lay interviewers using the Diagnostic Interview Schedule.
      The lifelong prevalence of pathological gambling was 0.42% (ratio of males to
      females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates
      of comorbidity with other psychiatric disorders. They were likely to have made
      suicide attempts (13.3%), to have been convicted of offences (26.7%), to be
      spouse and child abusers (23.3% and 16.7% respectively) and to have spent long
      periods unemployed (40%). In addition, 80% had trouble at home or work because of
      gambling, and 60% borrowed or stole to gamble.

PMID- 8467434
TI  - The reduction of violence in a chronic psychiatric inpatient group: a social
      technique.
AB  - A group of 72 chronic psychiatric inpatients comprised of the most violent and
      the least violent patients on a long term unit were studied prospectively for one
      year. The impact of increasing the doctor-patient contact in the second six
      months on the frequency of violent episodes was studied. The contact was brief
      and structured. Changes in staff, medication and the number of family visits were
      not found to be significant. The increased in contact seemed to have been highly
      significant. Violent episodes were reduced by 82% and had completely ceased by
      the last month of the study.

PMID- 8467436
TI  - Dimenhydrinate abuse among adolescents.
AB  - Dimenhydrinate may be a relatively common yet unrecognized substance of abuse
      among adolescents. Abuse of this drug may present as a psychiatric syndrome,
      particularly depression. Three cases are presented which illustrate this
      relationship. A review of the literature is presented and suggestions are made
      for identifying adolescents who abuse dimenhydrinate.

PMID- 8467437
TI  - [Influence of mass media on mental health].
AB  - The author summarizes different research findings which have evaluated the
      influence of the media on the mental health of children, adolescents and adults.
      After this review of the literature, strategies are proposed to improve the
      promotion of mental health in the media. Also the importance of collaboration
      between health professionals and broadcasters in this process is highlighted.
      Concrete examples are reported such as the communication programs which have been
      developed by the Quebec Mental Illness Foundation and the Quebec Psychiatrists'
      Association.

PMID- 8467438
TI  - Changes to the Criminal Code provisions for mentally disordered offenders and
      their implications for Canadian psychiatry.
AB  - Bill C-30, implemented in February 1992, made a number of significant changes to
      the Criminal Code provisions concerning the assessment, treatment and disposition
      of mentally disordered persons charged with a crime, including persons considered
      to be unfit to stand trial or pleading insanity. The changes deal mainly with
      procedural law and the civil rights of persons being assessed or held in custody,
      and put limits on where, how long and for what purpose persons may be detained.
      The new law abolishes the automatic, indeterminate detention of persons found
      unfit to stand trial or not criminally responsible on account of mental disorder.
      The changes may mean that the forensic psychiatric route is now a more
      "attractive option" for defendants. The new law may create administrative
      problems for clinicians by leading to increased requests for psychiatric
      assessments while at the same time constraining the assessment process.

PMID- 8467439
TI  - [Cardiovascular pathology and panic disorder].
AB  - The relationship between anxiety and cardiovascular function and symptoms has
      long been of interest, culminating in the recent emphasis on the modulation of
      cardiovascular response in patients with panic disorder. The relationship between
      panic disorder and mitral valve prolapse remains controversial. Panic disorder
      appears to be significantly associated with increased incidence of cardiovascular
      morbidity. The detection and treatment of panic disorder in patients with
      cardiovascular risk or diseases could have an important impact on prognosis and
      quality of life of the patients.

PMID- 8467440
TI  - Treatment of rapid cycling bipolar disorder with combination therapy of valproate
      and lithium.
AB  - Over the past two decades there has been a great deal of interest in the use of
      anticonvulsants to treat a variety of primary psychiatric disorders. Valproate,
      one such anticonvulsant, has been found to be effective in the treatment of acute
      mania, mixed states and rapid cycling disorders. This paper presents the results
      of an open study with combination therapy of valproate and lithium in a series of
      nine patients (mean age = 50 years). These patients had previously been treated
      with various psychotropic agents, including a combination of carbamazepine and
      lithium. All but one patient showed marked or moderate improvement in their
      condition. Of particular interest was the observation that in three patients
      there was evidence of augmentation between valproate and lithium during the
      depressed phase of their illness. There was significant improvement in their
      depression within 24 to 48 hours of the addition of lithium to valproate. The
      combination therapy was very well-tolerated. It is concluded that valproate and
      lithium combination therapy provides a safe and effective alternative for the
      treatment of rapid cycling variant of bipolar illness.

PMID- 8467441
TI  - A checklist for evaluating the usefulness of rating scales.
AB  - Rating scales of various sorts are very useful for both clinical and research
      purposes. However, they vary greatly regarding their reliability, validity, and
      utility. This article provides a guide for people who need to evaluate scales,
      either to incorporate them into their own research or clinical activities, or to
      determine if the results of studies which use scales are meaningful. The
      different types of reliability and validity are discussed and guidelines are
      offered to evaluate how well these were assessed. Finally, other aspects of
      scales which can affect their usefulness, such as completion time, training, and
      scoring ease, are discussed.

PMID- 8467442
TI  - Phantom limb in schizophrenia and the central hypothesis.

PMID- 8467444
TI  - Therapy of the absurd.

PMID- 8467443
TI  - Pimozide-responsive monosymptomatic hypochondriacal psychosis in an adolescent.

PMID- 8467445
TI  - Depression versus dementia.

PMID- 8467446
TI  - Benzodiazepines and the ear--tinnitus, hallucinations and schizophrenia.

PMID- 8467447
TI  - Training psychiatric residents to work with primary care physicians: results of a
      national survey.
AB  - To assess the preparation of residents in psychiatry for working with family
      physicians, a questionnaire was sent to the directors of Canada's 16 psychiatry
      residency programs. The results of the study are presented with recommendations
      for improving this aspect of training.

PMID- 8467448
TI  - Tarasoff in the Canadian context: Wenden and the duty to protect.
AB  - The precedent-setting 1976 US court decision of Tarasoff v. Regents of the
      University of California established a "duty to protect" whereby psychotherapists
      are held responsible to protect the potential victims of their clients' violent
      behaviour. The purpose of this article is to review and discuss this duty in the
      context of Canadian law and the 1991 Alberta court decision of Wenden v. Trikha,
      Royal Alexandra Hospital and Yaltho. The current Canadian interpretation of the
      duty to protect and guidelines for avoiding such liability are presented.

PMID- 8467449
TI  - Geriatric psychiatry: training guidelines and their application. Section on
      Geriatric Psychiatry of the Canadian Psychiatric Association.
AB  - Geriatric psychiatry is now a mandatory part of psychiatric residency education
      in Canada. Educational requirements in geriatric psychiatry were updated by the
      Royal College of Physicians and Surgeons of Canada in 1988, and guidelines were
      developed in more detail in 1989 by the Section on Geriatric Psychiatry of the
      Canadian Psychiatric Association (CPA). These guidelines are presented here
      together with a survey, conducted in the fall of 1991, of all 16 Canadian
      psychiatry residency programs. Thirteen of the training centres now require
      residents to have a formal rotation in geriatric psychiatry, generally three
      months in length. Residents are exposed to elderly patients in other services,
      such as consultation/liaison, but these services may not include formal teaching
      in geriatric psychiatry. Most programs have a seminar series in geriatric
      psychiatry and have training guidelines similar to those of the CPA. However, it
      is not clear how closely these are being followed, since it was felt in almost
      one-third of all programs that there was an insufficient number of teachers to
      fulfill the training requirements. In addition, a number of training directors
      felt that the objectives were too comprehensive to be met in the three month
      period. Earlier studies in the field are reviewed, implications of the current
      findings are discussed, and suggestions are made for further research.

PMID- 8467450
TI  - [A crisis intervention service in an outpatient psychiatric clinic of a general
      hospital: function and clientele].
AB  - The authors describe an external crisis intervention service in a general
      hospital. This service is intended for a clientele presenting acute mental health
      problems, referred, in the majority of cases, from the emergency department. They
      present demographic data, diagnostic data, data on the factors precipitating the
      crises and data which can be used to qualify and quantify the clientele. In
      addition, they describe the therapeutic approach and the treatment philosophy,
      the number of follow-up sessions, and the guidance provided to the clientele
      after follow-up. Finally, the authors suggest prerequisites considered essential
      to the effective operation of a crisis intervention module in an external
      psychiatric clinic.

PMID- 8467451
TI  - Carcinoma of the parotid gland. Analysis of treatment results and patterns of
      failure after combined surgery and radiation therapy.
AB  - BACKGROUND: The authors retrospectively studied 62 patients with malignant
      parotid tumors, treated by combined surgery and radiation therapy between 1975
      and 1989. No patients were lost to follow-up, and all living patients were
      interviewed. The median follow-up time was 66 months. RESULTS: Among the 62
      patients, there were five isolated local failures. Distant failure was observed
      in 11 patients. Neck failure was uncommon except in patients with advanced neck
      disease on presentation. The actuarial 5-year and 10-year local control rates
      were 95% and 84%, respectively. The corresponding actuarial disease-free survival
      (DFS) rates were 77% and 65%, respectively. Patients with larger tumors,
      recurrent disease, or involvement of the facial nerve tended to have lower DFS
      rates. No statistically significant differences were observed for patients
      treated with once-daily versus twice-daily radiation therapy fractionation
      schemes. CONCLUSIONS: Treatment was well tolerated, and severe treatment sequelae
      were uncommon. In summary, surgery in combination with radiation therapy is
      highly efficacious in controlling malignant tumors of the parotid gland.

PMID- 8467452
TI  - Carboplatin and etoposide in advanced colorectal carcinoma. A phase II study.
AB  - BACKGROUND: For advanced colorectal carcinoma, 5-fluorouracil (5-FU)-leucovorin
      is the best therapy available. To improve results, a variety of drugs were added,
      including cisplatin (CDDP), sometimes with controversial results. The combination
      of CDDP and etoposide (VP-16) has shown synergistic activity in other settings.
      Although VP-16 alone is considered rather inactive in colorectal carcinoma, the
      authors believed it was appropriate to evaluate the combination of VP-16 and
      carboplatin (CBDCA) in this disease because the newer platinum analogue CBDCA has
      more limited side effects than the parent compound. METHODS: Twenty-eight
      patients with advanced colorectal carcinoma were treated with CBDCA (200 mg/m2,
      days 1-3) and VP-16 (100 mg/m2, days 1-5). Cycles were repeated every 4 weeks.
      All patients received at least two cycles (median, six cycles; range, two to
      eight cycles). RESULTS: There were three complete responses and four partial
      responses. The median duration of response was 35 weeks (range, 25-84 weeks). The
      median time to tumor progression was 23 weeks (range, 9-84 weeks). The median
      survival time was 49 weeks (range, 9-151+ weeks). Toxic effects generally were
      assessed as mild, with no Grade 4 (Eastern Cooperative Oncology Group
      classification) toxic effects observed during this study. CONCLUSIONS: Response
      rate and toxic effects observed during this study warrant additional studies
      comparing this regimen with 5-FU-based regimens in advanced colorectal carcinoma.

PMID- 8467453
TI  - Analysis of the results of combined therapy for maxillary carcinoma.
AB  - BACKGROUND: Maxillary sinus carcinomas usually are locally advanced. A wide
      variety of modalities, including surgery, radiation therapy, and intraarterial
      chemotherapy, alone or in combination, have been used. However, there is still
      much controversy with regard to the optimum treatment. METHODS: From 1972 to
      1986, 108 patients with squamous cell carcinoma of the maxillary sinus were
      treated at the Department of Radiology, University of Tokyo Hospital. From 1972
      to 1974 (the first period), the treatment consisted of operation for reduction of
      tumor volume, daily cleaning of the maxillary antrum, 20 Gy of postoperative
      radiation therapy, and intraarterial infusion of 1500 mg of 5-fluorouracil (5-FU)
      and 3000 mg of 5-bromodeoxyuridine (BUdR). From 1975 to 1979 (the second period),
      the radiation dose was reduced to 10 Gy, and intraarterial infusion of 5-FU and
      BUdR was not performed. Surgery for reduction of tumor volume and daily cleaning
      of the antrum played a major role in this period. From 1980 to 1982 (the third
      period), daily cleaning of the antrum was not performed. Instead, the dose of
      radiation was increased to 50-60 Gy. From 1983 to 1986 (the fourth period), more
      extensive surgery to resect the tumor en bloc was introduced. The radiation dose
      was increased to 70 Gy. Intraarterial infusion of 3750 mg of 5-FU and 120 mg of
      cisplatin also was administered. RESULTS: The 5-year survival rate was 46% in the
      first period, 24% in the second period, 7.2% in the third period, and 53% in the
      fourth period. In the third period, there were more cases in which death resulted
      from a cause other than local failure, such as distant metastasis, pneumonia, or
      secondary primary cancer. Since 1984, we planned treatment with computed
      tomography (CT) and used the linear accelerator with a multileaf collimator to
      treat patients with an irregular field of irradiation. These have made it
      possible to administer radiation therapy in doses as high as 70 Gy without severe
      complications and improve the survival rate, especially for T4 disease.
      CONCLUSIONS: Radiation plays an important role in sterilizing malignant cells
      that cannot be removed by operation. The dose of radiation should be determined
      according to the volume of residual tumor. Careful treatment planning is required
      to irradiate the tumor adequately and reduce complications.

PMID- 8467454
TI  - Malignant melanoma in different ethnic groups in Israel. Incidence and biologic
      behavior.
AB  - BACKGROUND: The Jewish population of Israel is divided into two ethnic groups:
      Ashkenazic Jews (AJ) who immigrated from Europe and are fair-skinned, and
      Sephardic Jews (SJ) who immigrated from the Orient and Africa and who are dark
      skinned. The biologic behavior of malignant melanoma (MM) in these two groups has
      not been investigated. METHODS: Three hundred forty-eight of 380 patients with
      MM, who could be accurately grouped ethnically, constitute this study group. The
      gender, site and depth of primary tumor, metastatic involvement and survival
      analysis, including univariate analysis for level of invasion, were examined.
      RESULTS: Of 348 patients with MM, 285 were AJ and 63 were SJ. The female:male
      ratio was 2:1 and 0.9:1, for AJ and SJ, respectively (P < 0.05). Lesion site
      distribution was similar. The lesions were more invasive in SJ, 53% Clark level 4
      5 versus 41% in AJ (P < 0.05). The 5-year survival was worse in SJ relative to AJ
      -50% versus 71% for female patients and 30% versus 62% for male patients--but did
      not reach statistical significance (NS). The actuarial 10-year survival showed
      poorer survival for female SJ: 27% versus 67% in female AJ (P < 0.05) and male
      SJ; 32% versus 65% in male AJ (P < 0.01). For all stage I MM, the actuarial 10
      year survival was in male patients 32% versus 79% (P < 0.05), and in female
      patients, 27% versus 72% (P < 0.05) in SJ and AJ, respectively. For the more
      invasive lesions (Clark levels 4 and 5), the actuarial 10-year survival was for
      male patients 19% versus 75% (P < 0.05) and for female patients, 65% versus 67%
      (NS) in SJ and AJ, respectively. CONCLUSIONS: The dark-skinned SJ tend to have MM
      less than the fair-skinned AJ, but once MM occurs in SJ, it appears to have a
      more virulent nature.

PMID- 8467455
TI  - Primary peritoneal carcinoma after prophylactic oophorectomy in women with a
      family history of ovarian cancer. A report of the Gilda Radner Familial Ovarian
      Cancer Registry.
AB  - BACKGROUND: According to previous reports, primary peritoneal carcinoma
      indistinguishable from primary ovarian adenocarcinoma had developed in five women
      with a history of familial ovarian cancer who had undergone prophylactic
      oophorectomy. METHODS: The records from the Gilda Radner Familial Ovarian Cancer
      Registry were reviewed for instances of prophylactic oophorectomy and cases of
      primary peritoneal carcinoma occurring after prophylactic oophorectomy. RESULTS:
      From 1981 through July 1992, the Gilda Radner Familial Ovarian Cancer Registry
      accessioned 931 families (a total of 2221 cases of familial ovarian cancer).
      Currently, 324 women in these families have undergone prophylactic oophorectomy
      as a preventive measure against the subsequent development of ovarian cancer.
      Primary peritoneal carcinoma indistinguishable histologically from primary
      ovarian adenocarcinoma has developed in six of these women 1-27 years after
      prophylactic oophorectomy. CONCLUSIONS: Based on this finding and other reports
      of such primary peritoneal carcinoma, a prospective international study is
      planned. This study will compare the incidence of peritoneal carcinoma in first-
      or second-degree relatives who underwent prophylactic oophorectomy because of a
      family history of ovarian cancer with that of those who did not undergo
      prophylactic oophorectomy.

PMID- 8467456
TI  - Variation in body fat distribution and breast cancer risk in the families of
      patients with breast cancer and control families.
AB  - BACKGROUND: The pattern of body fat distribution in women has been correlated
      with the risk of developing breast and endometrial cancer. The authors determined
      whether body fat distribution varied between first-degree relatives of patients
      with breast cancer and in cancer-free families by comparing the body fat
      distribution of first-degree relatives of patients with breast cancer with age
      and Quetelet Index-matched controls. METHODS: Fifty-six first-degree relatives of
      newly diagnosed patients with breast cancer were compared with 56 controls (non
      cancer family members) matched for age and Quetelet Index and were studied for
      variation in body fat distribution. Anthropometric measurements were taken for
      the abdomen, thigh, suprailiac, subscapular, biceps, and triceps skinfold
      thickness; waist and hip circumference; weight; and height. The distribution of
      body measurements and derived ratios in both case and control family members were
      compared using the Student t test. RESULTS: A significant variation in body fat
      distribution occurred among first-degree relatives in breast cancer and control
      families. In families with a history of breast cancer, first-degree family
      members were found to have significantly greater waist:hip ratio (P < 0.001)
      compared with controls without family history matched for age and Quetelet Index.
      Other variables indicating upper body fat localization, such as abdomen and
      suprailiac skinfold were significantly greater in family members of patients with
      breast cancer compared with controls. CONCLUSIONS: A marked variation occurred in
      body fat localization among first-degree relatives of patients with breast cancer
      and in cancer-free families. This finding implies a variation in breast cancer
      risk in these families. Identifying family members with upper body fat
      distribution in breast cancer families would allow targeting of these individuals
      for energetic screening and risk factor reduction interventions.

PMID- 8467457
TI  - Enhancement of progesterone receptor levels by interferons in AE-7 endometrial
      cancer cells.
AB  - BACKGROUND: Interferon (IFN) has been reported to increase hormone receptor
      expression in breast cancer cells and to sensitize them to antiproliferative
      hormones. Endometrial cancer cells with high progesterone receptor (PR) level
      respond better to progesterone therapy than cells with either low or absent PR
      level. The effect of four different interferons (alpha and beta, both natural [n]
      and recombinant [r]) on cell proliferation and steroid receptor levels was
      investigated in the PR positive AE-7 human endometrial cancer cell line over a
      period of 12 days. METHODS: Cells were exposed to 10,100 and 1000 IU/ml of each
      IFN either for 3 days or continuously for 12 days. Hormone receptors were
      determined by the monoclonal enzyme immunoassay. Chemosensitivity was evaluated
      with the adenosine triphosphate-cell viability assay. RESULTS: AE-7 has a low
      level of estrogen receptors, which was not significantly affected by IFN
      exposure. The four IFN showed significantly enhanced PR levels over 12 days in
      both the 3-day and continuous-exposure experiments. No significant difference of
      PR enhancement was observed between 3 days and continuous exposure to IFN. This
      increase of receptors did not appear to be dose related. IFN enhanced PR level to
      a maximum level of about two times control cells. IFN did not produce significant
      cytotoxicity. Antiproliferative activity was observed with nIFN beta and rIFN
      beta at 1000 IU/ml dose in continuous-exposure experiments, which showed survival
      values of 79% and 69% respectively, compared with control at day 12. CONCLUSIONS:
      These preliminary data on PR expression modulation support other studies, which
      have shown that IFN modulate hormone receptor expression and, therefore, may play
      a role in the treatment of endometrial cancer.

PMID- 8467458
TI  - Uveal metastasis from prostate carcinoma.
AB  - BACKGROUND: Although breast and lung cancers account for most metastatic tumors
      to the uvea, prostate carcinoma metastatic to the uvea is relatively rare.
      METHODS: The authors reviewed 379 consecutive patients with uveal metastasis
      referred to the Ocular Oncology Service at the Wills Eye Hospital to determine
      the frequency of prostate carcinoma as the primary neoplasm. RESULTS: Of 379
      consecutive patients with uveal metastasis, the primary tumor was prostate
      carcinoma in 7 (2% of all patients, 5% of male patients). The mean age at ocular
      diagnosis was 66 years. In six patients (85%) a prior history of prostate
      carcinoma was known and the prior history of prostate carcinoma was known and the
      mean time interval between the diagnosis of the primary tumor and the uveal
      metastasis was 28 months. All seven patients were found to have active or
      regressed metastases elsewhere. The choroid was involved in six patients (85%)
      and the iris in one (15%). Ocular treatment included external-beam radiation
      therapy in five patients (70%) and episcleral radioactive plaque in two (30%).
      After a total mean follow-up of 84 months (range, 44-140 months) from the
      diagnosis of prostate carcinoma, two patients were still alive and five patients
      have died (mean, 6 months after diagnosis of uveal metastasis). CONCLUSIONS:
      Prostate carcinoma can metastasize to the uvea and the presence of uveal
      metastasis is associated with a shorter survival time compared with metastasis to
      other sites.

PMID- 8467459
TI  - DNA heterogeneity in prostatic adenocarcinoma. A DNA flow cytometric mapping
      study with whole organ sections of prostate.
AB  - BACKGROUND: The degree of DNA heterogeneity varies between tumors arising at
      different sites. The presence of a significant degree of variability within a
      given tumor may result in problems in the interpretation of DNA flow cytometric
      findings. This study evaluated the degree of DNA heterogeneity in prostatic
      adenocarcinoma. METHODS: A total of 122 3-mm punch biopsy specimens were
      evaluated from single representative whole organ sections from nine cases of
      prostate cancer (range, 4-18 samples per case; mean, 12 samples; median, 14
      samples). Individual punch biopsy specimens were graded and reviewed to confirm
      the presence of carcinoma and processed for DNA ploidy analysis. RESULTS:
      Assessable histograms, defined as having a coefficient of variation of the
      diploid G0/G1 peak of 7.5% or less, were available for 111 (91%) of the samples.
      Of the nine cases studied, five (56%) showed heterogeneity in the DNA pattern
      (diploid plus aneuploid, n = 1; diploid plus tetraploid, n = 2; and diploid plus
      tetraploid plus aneuploid, n = 2). All four cases having a homogeneous DNA
      content were DNA diploid in all samples. In those cases with a heterogeneous
      pattern, the areas having abnormal DNA patterns could not be predicted by
      histologic pattern or grade. CONCLUSIONS: From this study, the authors conclude
      that a significant degree of DNA heterogeneity exists within individual cases of
      prostatic adenocarcinoma, and this may be an important confounding factor in DNA
      ploidy studies.

PMID- 8467460
TI  - Common expression of parathyroid hormone-related protein and no correlation of
      calcium level in renal cell carcinomas.
AB  - BACKGROUND: Parathyroid hormone-related protein (PTHrP) is the predominant cause
      of humoral hypercalcemia of malignancy (HHM). METHODS: Using a PTHrP-specific
      monoclonal antibody (MoAb), 4B3, the authors investigated the immunohistochemical
      localization of PTHrP in formalin-fixed and paraffin-embedded sections of normal
      human kidney tissues and tissues from 42 human renal cell carcinomas obtained at
      operation or autopsy. RESULTS: In normal renal tissues, the distal tubules and
      collecting ducts showed positive immunostaining. PTHrP was detected in 40 of 42
      renal cell carcinoma tissues (95%). Histopathologically, the granular cell
      subtypes of renal cell carcinomas tended to be more strongly positive than the
      clear cell subtypes. There was no significant correlation between the level of
      immunostaining and each patient's serum calcium level. CONCLUSION: PTHrP was
      commonly observed in renal cell carcinomas, and no significant correlation was
      seen between the intensity of PTHrP staining and the serum calcium level.

PMID- 8467462
TI  - Bone tumors other than osteosarcoma after retinoblastoma.
AB  - BACKGROUND: The most frequent second malignant neoplasm after retinoblastoma is
      osteosarcoma, which may be associated with radiation therapy or arise de novo in
      patients with bilateral retinoblastoma. METHODS: Clinical, pathologic, and
      diagnostic imaging findings in two patients with Ewing sarcoma (ES) and one with
      peripheral neuroepithelioma (PN) are presented. RESULTS: Second malignant
      neoplasms located in the extremities or pelvis were seen 12-18 years after
      initial diagnosis of unilateral (two patients) or bilateral (one patient)
      retinoblastoma. The patients with unilateral retinoblastoma were treated by
      enucleation only; the other received ocular radiation therapy and chemotherapy.
      To the knowledge of the authors, this is the first documentation of round blue
      cell tumor after unilateral retinoblastoma. CONCLUSIONS: ES and PN should be
      included in the differential diagnosis of malignant neoplasms occurring after
      treatment of unilateral or bilateral retinoblastoma.

PMID- 8467461
TI  - Effect of surgery on peripheral blood lymphocyte locomotion through type I
      collagen.
AB  - BACKGROUND: Locomotion of peripheral blood lymphocytes (PBL) through peritumoral
      matrix is obligatory for tumor cell killing. The authors investigated the effect
      of surgery on lymphocyte locomotion and compared it with the effect on natural
      killer cell cytotoxicity (NKCC). METHODS: PBL from 12 patients with cancer were
      assessed for locomotion in Type I rat-tail collagen. Preoperative and
      postoperative locomotion (after 20 hours of incubation) and NKCC were estimated.
      RESULTS: Locomotion of lymphocytes through collagen increased significantly after
      operation in 6 of 12 patients, whereas only 1 of 12 had a decrease (P < 0.001).
      Short-term (20-hour incubation) exposure of the locomotory HSB cell line to
      patient plasma samples did not affect their migration. NKCC, as estimated against
      K562 target cells with the use of the 51Cr-release assay, decreased 5-50% after
      operation in 9 of 12 patients (P = 0.006). No correlation could be demonstrated
      between the changes in locomotion and NKCC (regression analyses), nor were
      identifiable clinical factors associated with these changes. CONCLUSIONS:
      Locomotion of PBL through collagen increases after operation in patients with
      cancer, whereas possibly independent factors may decrease postoperative NKCC.

PMID- 8467464
TI  - Determinants of home versus hospital terminal care for patients with gynecologic
      cancer.
AB  - BACKGROUND: This study reviewed all patients managed by the Gynecologic Oncology
      service of a tertiary care facility (n = 468) whose deaths occurred between 1980
      and 1990 to ascertain the site of death and potential factors affecting whether
      patients died at home or in a hospital. METHODS: Gynecologic Oncology Tumor
      Registry data were analyzed for patient diagnosis, age at diagnosis, age at
      death, marital status, insurance coverage, and year of death in relation to
      location of death. RESULTS: This study found that 78% of patients died in the
      hospital, and 22% died at home. The mean terminal hospital stay was 15 days. The
      variables examined in this study could only accurately predict location of death
      in 59% of the cases. Examination of the variable year of death, however,
      demonstrated that the likelihood of death in the hospital generally increased
      from 1980 to 1990, despite introduction of diagnosis related groups and
      aggressive efforts by caregivers to facilitate and encourage death at home.
      CONCLUSIONS: Philosophical and economic considerations to the contrary, a
      significant majority of terminal patients with gynecologic cancers will die in a
      hospital, thus extensively utilizing our limited health resources.

PMID- 8467463
TI  - Intensive alternating drug pairs for treatment of high-risk childhood acute
      lymphoblastic leukemia. A Pediatric Oncology Group pilot study.
AB  - BACKGROUND: To prevent drug resistance, the authors designed a protocol that
      featured early intensive rotating drug pairs as part of the therapy for acute
      lymphoblastic leukemia (ALL). METHODS: After prednisone, vincristine,
      asparaginase, and daunorubicin induction, 12 intensive treatments (ABACABACABAC)
      were given in 30 weeks: A--intermediate-dose methotrexate (IDMTX) plus
      intermediate-dose mercaptopurine (MP); B--cytosine arabinoside (AC) plus
      daunorubicin (DNR); C--AC plus teniposide (VM-26). Triple intrathecal
      chemotherapy (AC, MTX, and hydrocortisone) was given for central nervous system
      (CNS) prophylaxis. Continuation therapy consisted of weekly MTX and daily MP
      until 2.5 years of continuous complete remission had been achieved. RESULTS:
      Seventy-four children (age range, 1-19 years) at high risk of relapse were
      treated. Of 55 with B-lineage (early pre-B, pre-B) ALL, 24 have failed (2
      induction failures, 2 deaths from infection, and 20 relapses). The event-free
      survival (EFS) rate at 4 years was 55.5% (standard error [SE] +/- 7.7%). Of 19
      patients with T-cell ALL, 12 have failed (2 induction failures and 10 relapses).
      The EFS rate at 4 years was 32.6% (SE +/- 26.8%). Toxicities were significantly
      more common after AC and DNR or AC and VM-26 than IDMTX and MP. There were no
      toxicity-related deaths during intensive treatments. CONCLUSION: Early intensive
      rotating therapy is tolerable and warrants consideration for additional trials of
      patients with high-risk, B-lineage ALL.

PMID- 8467465
TI  - Angiosarcoma of the breast after lumpectomy and radiation therapy for
      adenocarcinoma.

PMID- 8467466
TI  - Osteosarcoma in a 26-month-old girl.

PMID- 8467467
TI  - Colon cancer survival in Finland.

PMID- 8467468
TI  - Abnormalities of chromosome 22 in human brain tumors determined by combined
      cytogenetic and molecular genetic approaches.
AB  - Southern blot hybridization studies were performed on a panel of 130 blood/tumor
      samples from brain neoplasms including all major histologic subtypes: 50
      meningiomas, 18 neurinomas, 56 gliomas, and six others. To detect abnormalities
      involving chromosome 22, polymorphic probes were used to analyze eight loci
      located in this chromosome: D22S9, IGLV, D22S20, D22S32, MB, PDGF-B, D22S80, and
      D22S171. Loss of heterozygosity (LOH) was observed in 40 cases including
      monosomy, terminal, and interstitial deletions, which suggest the location of
      recessive tumor genes in certain chromosome 22 subregions (22q11.3-q12 in
      neurinomas and meningiomas, and 22q13 in malignant gliomas). Cytogenetic studies
      were performed in parallel on the same tumors, in most instances corroborating
      the presence of abnormalities for chromosome 22. Nevertheless, discrepancies
      between the cytogenetic and molecular findings were observed in several cases,
      suggesting that the use of both methodologies in combination might provide key
      information on the incidence and extent of the abnormalities involving chromosome
      22 in human brain tumors.

PMID- 8467469
TI  - Cytogenetic studies in three xenografted nasopharyngeal carcinomas.
AB  - Cytogenetics results of three xenografted nasopharyngeal carcinomas (NPC) are
      reported. One (C15) was almost diploid and had only an isochromosome 1q, trisomy
      2, and loss of chromosome X. The two other tumors, C17 and C19, were hypodiploid
      and had complex karyotypes with some variations. Nonrandom structural
      abnormalities of chromosomes 1, 3, 8, and 17 were observed. A correlation between
      a del(17)(p11-12) observed in C17 and loss of both alleles of p53 recently shown
      in this tumor is emphasized.

PMID- 8467470
TI  - Chromosome 9 anomalies as the primary clonal alteration in a case of squamous
      cell carcinoma of the epiglottis.
AB  - We present the cytogenetic characterization of a short-term culture of a primary
      squamous cell carcinoma of the epiglottis from a 67-year-old male patient who was
      admitted to this hospital for treatment. This patient had a history of chronic
      exposure to tobacco and alcohol, environmental carcinogens known to be related to
      the etiology of the disease. The tumor karyotype showed three distinct clones: 1)
      cells with chromosome 9 anomalies; 2) cells with chromosome 9 and other clonal
      structural anomalies involving chromosomes 1, 11, 14, and 17; and 3) cells whose
      chromosomes were partially or totally pulverized. The anomalies on chromosome 9
      were homozygous inversion (p12q13), deletions at regions q22, q34.1, and p13, and
      i(9q) formation. Structural clonal anomalies on other chromosomes included
      translocations, deletions, and isochromosome formation. The presence of a
      chromosome 9 anomaly alone or in conjunction with other anomalies suggests that
      this aberration may be a nonrandom primary event in the progression of squamous
      cell carcinoma of the head and neck.

PMID- 8467471
TI  - Involvement of 22q12 in a neurofibrosarcoma in neurofibromatosis type 1.
AB  - We describe the cytogenetic and molecular genetic findings in a neurofibrosarcoma
      arising in a patient affected by neurofibromatosis type 1. Multiple chromosomal
      rearrangements were found but only a few of them were identified as clonal
      abnormalities, including a deletion of chromosome 22, which at the molecular
      level proved to be interstitial, mainly involving the 22q12 region. Loss of
      heterozygosity for markers D22S32 and MB was observed. These findings are in
      agreement with previous data which suggest a possible involvement of a gene
      located at 22q11-q13.1 during the neoplastic development of some
      neurofibromatosis type 1-associated tumors.

PMID- 8467472
TI  - Cytogenetic analysis of six bronchial carcinoids.
AB  - Short-term cultures from four typical and two atypical primary bronchial
      carcinoids were cytogenetically analyzed. A lung metastasis from one of the
      atypical carcinoids was also analyzed. Of the four typical carcinoids, two had
      normal chromosome complements, while the other two had the karyotypes 46,X, -X,
      +7/47,XX, +7/47,XX, +X/46,XX and 47,XX, +7/46,XX. Both atypical carcinoids had
      chromosome abnormalities. One had the karyotype 45-46,X, 
      X,del(1)(q32),add(17)(p13), +add(19)(p13), -22, +r/47,XX, +X. The second
      carcinoid had the karyotype 78-81,XXY, +Y, +1,t(2;8)(q21;q24), +3, +4, +del(4)
      (q25), +5, +6,der(6)t(6;6)(q21;p21)x2, +7, +7, -10,add(14)(p11-13), +19, -21, +1
      4mar. The metastasis from this carcinoid had the same aberrations, except that
      the del(4)(q25) had been lost and one to two markers had been gained.

PMID- 8467473
TI  - Trisomy 14 in hematologic diseases. Another non-random abnormality within myeloid
      proliferative disorders.
AB  - Two cases of myelodysplastic syndrome (MDS) and a case of acute nonlymphoblastic
      leukemia (ANLL) with a trisomy 14 are presented. The series of results derived
      from our cases, and those previously reported, strongly suggest that this anomaly
      may be another nonrandom change, confined within myeloid disorders and associated
      with patients' advanced age, marked tendency to bone marrow dysplastic features,
      normal platelet values, and not unfavorable prognosis.

PMID- 8467474
TI  - Rhabdomyosarcoma. A cytogenetically interesting case report.
AB  - Chromosomal analysis was performed on the tumor tissue in a case of ocular
      rhabdomyosarcoma. Cytogenetic analysis revealed multiple clonal abnormalities.
      Derivative(5)t(1;5)(q21;q35) and t(2;11) (q21;q23) were present in all the
      metaphases analyzed (100%). Translocation(1;19)(q21;q13) was observed in 61% of
      the metaphases. Other clonal abnormalities present included
      +i(6p)(85%),i(17q)(38%),18q+(57%), 4p+ (38%), loss of the Y chromosome (33%), and
      presence of double minutes (12.8%).

PMID- 8467475
TI  - Cytogenetic analysis of posterior uveal melanoma.
AB  - Cytogenetic analysis was performed on short-term cultures of primary tumor
      samples from seven patients with posterior uveal melanoma. Informative data were
      obtained from four patients, all of whom had a near-diploid chromosomal number
      and clonal chromosomal alterations. Analysis of one patient's tumor revealed
      monosomy 3 as the only cytogenetically distinguishable aberration. Trisomies of
      chromosome 8 and i(8)(q10) were detected in two other patients in combination
      with monosomy of chromosome 3. The fourth patient's karyotype displayed two
      different translocations. One translocation, der(6)t(6;8)(q12;q13.1), resulted in
      the over-representation of 8q13.1-->qter and a partial monosomy of 6q12-->qter;
      the other translocation, der(9)t(6;9)(p12;p23), produced a partial trisomy of
      6p12-->pter and a partial monosomy of 9p23-->pter. These results support the view
      that the recurring pattern of chromosomal rearrangements in ocular melanoma is
      unique from that associated with cutaneous malignant melanoma. Furthermore, these
      results help confirm that chromosomes 3, 6, and 8 are nonrandomly altered in
      ocular melanoma.

PMID- 8467476
TI  - Karyotypic analysis of CCRF-CEM and drug-resistant cell lines with stable and
      unstable ploidy.
AB  - Karyotypic studies were performed on methotrexate (MTX)- and vincristine (VCR)
      resistant cell lines derived from the human T-cell leukemia CCRF-CEM cell line.
      We noted karyotypic selection and additional chromosome change associated with
      acquisition of drug-resistance. Furthermore, we observed that both the parental
      and MTX-resistant sublines, CEM/MTX R1-3, had a tendency to ploidy change.
      Karyotypic studies of malignant cells have shown that polyploidy is frequently a
      consequence of a single sporadic event, followed by growth and selection of the
      polyploid clone [1]. In this study, however, various karyotypic clones were
      identified with near- and pseudotetraploid karyotypes that appeared to be derived
      from different near- and pseudodiploid sidelines. Polyploidy was invariably
      associated with loss of at least two of the four chromosomes 8 whether the
      pseudodiploid sideline from which it was derived carried one or both chromosomes
      8. In contrast, neither polyploid clones nor loss of chromosome 8 was noted in
      the CEM/VCR R cells.

PMID- 8467477
TI  - Sister chromatid exchange in Waldenstrom's macroglobulinemia.
AB  - Results on sister chromatid exchange (SCE) frequency and interchromosomal
      distribution in bone marrow and peripheral blood cultures from patients with
      Waldenstrom's macroglobulinemia are reported. PHA-stimulated bone marrow cultures
      showed increased SCE frequencies in all 12 patients examined. The increase was
      particularly high in two cases (17.07 and 16.77 SCE/cell, respectively) and, in
      one of them, a very high SCE level was found in PHA-stimulated peripheral blood
      culture (40.81 SCE/cell). In LPS-stimulated cultures, increased SCE levels were
      observed in some patients. Comparison between SCE frequency in bone marrow cell
      cultures with either mitogen showed a significant increase in PHA-stimulated
      cultures. Analysis of the interchromosomal SCE distribution revealed significant
      differences with respect to the control values; however, these differences were
      variable in the different patients. In pooled data of PHA-stimulated bone marrow
      cultures, there were differences between expected and observed SCEs in
      chromosomes 1 and 2 and in B, E, F, and G chromosome groups. Results of cell
      cycle modifications are also reported.

PMID- 8467478
TI  - Acute lymphoblastic leukemia with trisomy 21 constitutional mosaicism.
AB  - Acute lymphoblastic leukemia was diagnosed in an 11-year-old girl with mild signs
      of Down's syndrome. She was known since birth to have a constitutional mosaicism
      (46,XX/47,XX,+21c). At initial diagnosis of acute leukemia, additional chromosome
      changes were found in bone marrow blasts: hyperdiploidy > 50, with a structural
      abnormality. She was treated with a standard chemotherapeutic protocol, and has
      remained in complete remission for more than 3 years. The constitutional
      mosaicism evolved toward normalization year after year in the blood and under the
      effect of chemotherapy in the bone marrow.

PMID- 8467479
TI  - FISH: a useful technique in the verification of clonality of random chromosome
      abnormalities.
AB  - Random chromosome abnormality is an important issue in clinical cytogenetics,
      especially in cancer cytogenetics. The significance of random abnormalities needs
      to be well defined. In the present study, ten patients with malignant hematologic
      disorders were analyzed by classical cytogenetic techniques and fluorescence in
      situ hybridization (FISH) procedures. Cytogenetic studies showed all ten patients
      to have a single cell with trisomy, i.e., +8, +8 (5 cases), +12, +15, +18, +20,
      and +21, respectively. FISH necessitated revision of the cytogenetic diagnosis
      and confirmed the clonality of these "random" abnormalities.

PMID- 8467480
TI  - Derivative (11)t(7;11)(q11;q24) in a child with acute megakaryoblastic leukemia.
AB  - We document the clinical, morphologic, and cytogenetic findings in a 2 1/2-year
      old patient with acute megakaryoblastic leukemia. Cytogenetic analysis of
      peripheral blood leukemic cells revealed the presence of a
      der(11)t(7;11)(q11;q24). Chromosome 7 involvement is observed in nearly half of
      all cases of megakaryoblastic leukemias, however, the type of abnormality differs
      widely from one case to another. The der(11)t(7;11)(q11;q24) described here is
      the first reported to our knowledge.

PMID- 8467481
TI  - A new pericentric inv(8) in acute nonlymphocytic leukemia.
AB  - Chromosome studies were carried out on unstimulated bone marrow cells from a
      patient with a diagnosis of acute nonlymphocytic leukemia (FAB M6 ANLL).
      Cytogenetic analysis revealed a mosaic chromosome pattern
      46,XX/46,XX,inv(8)(p21q24). This pericentric inversion has not been previously
      described in ANLL. Because, fragile sites, zinc finger gene loci, and the MYC
      protooncogene have been localized to band 8q24, a putative role for these sites
      and genes could be considered.

PMID- 8467482
TI  - Interstitial deletion of 9q in a case of acute myeloid leukemia (FAB M6)

PMID- 8467483
TI  - Transcriptionally active chimeric gene derived from the fusion of the AML gene
      and a novel gene on chromosome 8 in t(8;21) leukemic cells.

PMID- 8467484
TI  - Transgenic mouse model for synergistic effects of nuclear oncogenes and growth
      factors in tumorigenesis: interaction of c-myc and transforming growth factor
      alpha in hepatic oncogenesis.
AB  - Double transgenic mice bearing fusion genes consisting of mouse albumin
      enhancer/promoter-mouse c-myc complementary DNA and mouse metallothionein 1
      promoter-human transforming growth factor alpha complementary DNA were generated
      to investigate the interaction of these genes in hepatic oncogenesis and to
      provide a general paradigm for characterizing the interaction of nuclear
      oncogenes and growth factors in tumorigenesis. Coexpression of c-myc and
      transforming growth factor alpha as transgenes in the mouse liver resulted in a
      tremendous acceleration of neoplastic development in this organ as compared to
      expression of either of these transgenes alone. The two distinct cellular
      reactions that occurred in the liver of the double transgenic mice prior to the
      appearance of liver tumors were dysplastic and apoptotic changes in the existing
      hepatocytes followed by emergence of multiple focal lesions composed of both
      hyperplastic and dysplastic cell populations. These observations suggest that the
      interaction of c-myc and transforming growth factor alpha, and possibly other
      combinations of nuclear oncogenes and growth factors, during development of
      hepatic neoplasia contributes to the selection and expansion of the preneoplastic
      cell populations which consequently increases the probability of malignant
      conversion.

PMID- 8467485
TI  - Immunohistochemical localization of parathyroid hormone-related protein in human
      prostate cancer.
AB  - Parathyroid hormone-related protein (PTHrP) is produced by a variety of malignant
      tumors and has been implicated as a major cause of humoral hypercalcemia of
      malignancy. Expression of PTHrP in prostate cancer tissue was studied
      immunohistochemically using 33 radical prostatectomy specimens from patients with
      clinically localized carcinoma of the prostate. None of these patients
      demonstrated hypercalcemia prior to the surgery. Acetone-methyl benzoate-xylene
      processed, paraffin-embedded tissues were stained with a validated mouse
      monoclonal antibody to an amino acid fragment, PTHrP(109-141), using the
      streptavidin-peroxidase enzyme conjugate method. All cases (33 of 33; 100%)
      studied demonstrated some degree of immunoreactivity throughout the cytoplasm of
      the tumor cells, but immunostaining was absent from inflammatory and stromal
      cells. The intensity of the staining appeared to directly correlate with
      increasing tumor grade. The widespread immunohistochemical localization of PTHrP
      in carcinoma of the prostate suggests that PTHrP may play some local role in the
      growth of transformed cells in the prostate. Furthermore, overexpression of PTHrP
      may be a possible marker to evaluate the malignant potential of carcinoma of the
      prostate.

PMID- 8467486
TI  - In vivo inhibition of insulin-like growth factor I gene expression by tamoxifen.
AB  - Tamoxifen, a partial antagonist to the estrogen receptor, is widely used in the
      treatment of breast cancer and is currently being evaluated as a breast cancer
      preventative agent in large-scale clinical trials. Recent clinical research has
      demonstrated that tamoxifen administration is associated with a reduction of
      serum insulin-like growth factor I (IGF-I) concentration. We demonstrate here
      that tamoxifen, when administered in an in vivo experimental system previously
      used to demonstrate its cytostatic effect on breast cancer cell proliferation,
      inhibits the expression of the IGF-I gene in common target organs for breast
      cancer metastasis. Furthermore, while our prior experimental studies have
      demonstrated an inhibitory effect of tamoxifen on growth hormone output, we show
      here for the first time that the suppression of IGF-I gene expression associated
      with tamoxifen administration is in part a consequence of a pituitary-independent
      action of the drug. Because IGF-I is a potent mitogen for breast cancer cells,
      this newly described activity of tamoxifen may contribute to its antineoplastic
      properties, particularly with regard to inhibition of metastasis seen both in
      animal models and clinically.

PMID- 8467487
TI  - Ribozyme-mediated modulation of human O6-methylguanine-DNA methyltransferase
      expression.
AB  - A synthetic oligonucleotide containing ribozyme sequences targeted to the 5'
      region of the human O6-methylguanine-DNA methyltransferase (MGMT) mRNA has been
      constructed. This ribozyme demonstrates cleavage activity in vitro in the
      presence of Mg2+. To determine whether this ribozyme can function in vivo, HeLa
      CCL2 cells were transfected with a mammalian expression vector containing the
      ribozyme sequence. Following selection and expansion of individual transfectants,
      a stable clone was isolated that lacks both MGMT mRNA and protein. Molecular
      analysis of this cell line indicates that in vivo cleavage of MGMT mRNA is
      responsible for the lack of MGMT activity.

PMID- 8467488
TI  - Activation of the Abelson tyrosine kinase activity is associated with suppression
      of apoptosis in hemopoietic cells.
AB  - A chromosomal translocation uniquely associated with chronic myeloid leukemia
      leads to the formation of a chimeric gene, bcr-abl, on the Philadelphia
      chromosome. The BRC-ABL protein displays an uncontrolled tyrosine kinase activity
      similar to that seen with the transforming oncogene of the Abelson murine
      leukemia (ABL) virus (v-abl). An interleukin 3 dependent cell line, IC.DP, has
      been transfected with a gene encoding a temperature sensitive v-ABL. In the
      absence of interleukin 3 at the restrictive temperature for ABL tyrosine kinase
      activity IC.DP cells died via apoptosis. At the permissive temperature ABL
      tyrosine kinase activity promoted IC.DP cell survival but not proliferation. ABL
      therefore can specifically suppress apoptosis.

PMID- 8467489
TI  - A structural role for metal ions in the "wild-type" conformation of the tumor
      suppressor protein p53.
AB  - In human tumors, many different point mutations of the p53 gene knock out
      suppressor function and induce the p53 polypeptide to adopt an immunologically
      distinct, "mutant" conformation. Here we show that exposure to the metal chelator
      1,10-phenanthroline induces wild-type p53 to adopt the mutant conformation and
      that this process is reversible. Conversion to mutant phenotype also occurs after
      exposure to (a) an organic mercurial reagent targeting cysteinyl residues and (b)
      low concentrations of mercury or cadmium. We propose that binding of metal ions,
      most probably zinc, to conserved cysteinyl residues stabilizes the tertiary
      structure of wild-type p53.

PMID- 8467490
TI  - Prevention of orthotopic human lung cancer growth by intratracheal instillation
      of a retroviral antisense K-ras construct.
AB  - An orthotopic human lung cancer model in nu/nu mice was used to study the effect
      of an antisense K-ras (AS-K-ras) retroviral construct on tumor growth in vivo. A
      2-kilobase genomic AS-K-ras DNA fragment linked to a beta-actin promoter was
      cloned into the LNSX retroviral vector. The recombinant construct was packaged
      into GP+envAm12 cells and titers greater than 10(6) colony-forming units/ml were
      obtained. Irradiated (350 cGy) nu/nu mice were first inoculated intratracheally
      with 10(5) H460a human large cell lung carcinoma cells which have a codon 61
      mutation of the K-ras oncogene. Three days later they received intratracheal
      instillation of viral supernatant (5 x 10(6) colony-forming units/ml) from either
      LNSX, LNSX-AS-K-ras, LNSX-sense-K-ras producer cells, or medium daily for 3 days.
      At autopsy, 30 days after tumor cell inoculation, 90% of the control mice had
      tumors whereas 87% of mice treated with the LNSX-AS-K-ras viral supernatant were
      free of tumors. The efficacy of the viral supernatant was dose dependent.
      Intratracheal administration of retroviral LNSX-AS-K-ras supernatant prevents the
      growth of human lung cancer cells implanted orthotopically in nu/nu mice.

PMID- 8467491
TI  - Analysis of the expression of MRP, the gene for a new putative transmembrane drug
      transporter, in human multidrug resistant lung cancer cell lines.
AB  - Human cells can become multidrug resistant (MDR) by an increase in the activity
      of the MDR1 P-glycoprotein or by other, as yet unknown mechanisms, referred to as
      non-P-glycoprotein mediated MDR (non-Pgp MDR). S. P. C. Cole et al. [Science
      (Washington DC), 258: 1650-1654, 1992] recently reported that in two cell lines
      non-Pgp MDR was associated with the overexpression of a new putative membrane
      transporter gene, MRP. Using an RNase protection assay we have analyzed the
      expression of MRP in non-Pgp MDR sublines of the human lung cancer cell lines SW
      1573 (non-small cell lung cancer) and GLC4 (small cell lung cancer). In all of
      ten SW-1573 derived lines examined the MRP mRNA level was equal to that in the
      parental line, whereas MRP was 25-fold overexpressed in a resistant subline of
      GLC4. We conclude that overexpression of MRP cannot account for all forms of non
      Pgp MDR.

PMID- 8467492
TI  - Identification of a putative tumor marker in breast and colon cancer.
AB  - Application of a recently developed phospholipid saponification procedure to
      malignant colon or breast tissue produces an unidentified phosphodiester
      resonance in the 31P nuclear magnetic resonance spectrum which appears to
      correlate with malignancy. Glycerol phosphodiesters were prepared from a
      malignant breast tumor by a Folch extraction of the tissue followed by
      saponification of the resulting phospholipids. These compounds were separated by
      ion exchange chromatography and the compound responsible for this new resonance
      was isolated and identified as glycerol 2-phosphoglycerol by high resolution
      nuclear magnetic resonance spectroscopy. Confirmation of this structure was
      achieved by chemical synthesis of glycerol 2-phosphoglycerol. Attempts to isolate
      the phospholipid responsible for this resonance showed that it is not derived
      from a new class of phospholipids but is most likely an artifact of the new
      saponification procedure used. Glycerol 2-phosphoglycerol is formed via glycerol
      2,3-(cyclic) phosphate derived from phosphatidylcholine followed by reaction with
      glycerol. Malignant tissue is more prone to produce this compound than is
      nonmalignant tissue and the differences between these tissue types may be a form
      of phosphatidylcholine that is present in higher concentrations in malignant
      tumor membranes than in those of normal tissue.

PMID- 8467493
TI  - Entry of protein toxins in polarized epithelial cells.
AB  - The action of a number of toxins used in the formation of immunotoxins was
      studied in polarized cells. Diphtheria toxin inhibited protein synthesis most
      efficiently when added to the basolateral side of the kidney cells, MDCK-I, MDBK
      and Pt K2, and the colon carcinoma cell Caco-2. Similar findings were made with
      Pseudomonas aeruginosa exotoxin A in MDCK-I, Pt K2, and Caco-2 cells, and with
      modeccin and volkensin in MDCK-I cells. In accordance with the toxicity data,
      diphtheria toxin bound specifically to the basolateral side of MDCK-I cells but
      not to the apical side. On the other hand, in the trophoblastic BeWo cell line
      there was little or no difference in the toxic effect of P. aeruginosa exotoxin A
      and modeccin added to the two sides. The plant toxins ricin and abrin and the
      bacterial Shigella toxin inhibited protein synthesis approximately equally well
      in all cell lines tested whether they were added apically or basolaterally. The
      results indicate that protein toxins are able to enter cells from both the apical
      and basolateral sides provided receptors are present. The consequences for the
      preparation of immunotoxins are discussed.

PMID- 8467494
TI  - Chromatophoromas and chromatophore hyperplasia in Pacific rockfish (Sebastes
      spp.).
AB  - Pacific rockfish from Cordell Bank, off central California (United States), were
      collected and histologically examined from 1985 to 1990. Hyperplastic and
      neoplastic cutaneous lesions, involving dermal chromatophores, were observed in
      five species; yellowtail rockfish (Sebastes flavidus), bocaccio (S. paucispinis),
      olive rockfish (S. serranoides), widow rockfish (S. entomelas), and chilipepper
      rockfish (S. goodei). Yearly prevalences were highest in S. paucispinis (29-38%).
      Prevalence was initially low in S. flavidus, but increased more than 3-fold from
      1985 (7.5%) to 1990 (25%). The majority of lesions were black, but white, yellow,
      orange, red, and mixed-color variants were also seen. Lesions were found in skin,
      fins, lips, gingiva, tongue, urogenital papilla, conjunctiva, and cornea of the
      eye. Flat lesions were consistent with melanophore (black), xanthophore (yellow
      or orange), and erythrophore (red) hyperplasia. Neoplastic lesions included
      melanophoromas, amelanotic melanophoromas, xanthophoromas, erythrophoromas, and
      mixed chromatophoromas. Although etiology has not been determined, interest is
      currently focused on potential exposure to chemical and radioactive carcinogens
      from the Farallon Island Radioactive Waste Dump, 30 km to the south.

PMID- 8467495
TI  - Loss of differentiation control in transformed 3T3 T proadipocytes.
AB  - Nontransformed 3T3 T mesenchymal/proadipocyte stem cells can be readily induced
      to differentiate, yet previous work has shown that 3T3 T cells that are
      spontaneously or virally transformed not only lose their normal growth control
      mechanisms but also lose the ability to differentiate. Loss of growth control can
      be due to autocrine mechanisms in some transformed cells, but the mechanisms
      involved in disrupting differentiation control are poorly understood. Our goal is
      to further define the growth and differentiation defects that arise in
      neoplastically transformed cells and the mechanisms underlying those defects. For
      example, exogenous transforming growth factor beta and tumor necrosis factor,
      both of which are secreted aberrantly by some tumor cells, are known inhibitors
      of different steps of the normal 3T3 T adipocyte differentiation process,
      suggesting a potential role as autocrine factors in disrupting differentiation of
      transformed 3T3 T cells. In the current study we transformed 3T3 T cells in vitro
      with chemical or UV irradiation treatment in order to determine if the
      acquisition of the transformed phenotype after these treatments is also
      associated with loss of differentiation control as it is with spontaneously or
      virally transformed cells. Four chemically and two UV-treated 3T3 T cell lines
      were isolated from type III foci and all have been found to be tumorigenic in
      syngeneic animals and to have lost the ability to differentiate. Relative to the
      parental cell line the differentiation abilities of the transformed clones ranged
      from 0 to less than 5%. In this regard, we also analyzed the normal and aberrant
      expression of three growth factors and differentiation inhibitors in transformed
      cells. Both transforming growth factor alpha and beta were found to be expressed
      in non-transformed 3T3 T cells as determined by Northern blot analyses. In
      addition, both were found to be down-regulated during differentiation of 3T3 T
      cells. Transformed/differentiation-defective 3T3 T cells expressed varied levels
      of transforming growth factor alpha and beta. Three of the new transformed clones
      expressed particularly high levels of transforming growth factor alpha. Very low
      levels of tumor necrosis factor expression were found in the normal cells and the
      transformed cells appeared to express tumor necrosis factor at similar levels. In
      contrast, none of the transformed cells expressed any of the differentiation
      specific genes tested (lipoprotein lipase, glycerol-3-phosphate dehydrogenase,
      etc.). Even a transformed clone which could undergo growth arrest but not
      morphological differentiation expressed no differentiation-specific genes.
      Together, these data suggest that neoplastic transformation in general disrupts
      differentiation control.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8467496
TI  - Accumulation of p53 protein in human esophageal precancerous lesions: a possible
      early biomarker for carcinogenesis.
AB  - The level of p53 protein was determined immunohistochemically in normal tissues
      and tissues with different severities of lesions (basal cell hyperplasia,
      dysplasia, carcinoma in situ, and carcinoma) from surgically resected human
      esophagi and esophageal biopsies of symptom-free subjects. The samples were from
      an area with high esophageal cancer incidence in northern China (Linxian and
      Huixian in the Henan province). Tissue sections were incubated with p53
      antibodies for immunostaining. Conventional hematoxylin and eosin stain was also
      used. In surgically resected esophageal specimens, elevated p53 protein levels
      were found in the cell nuclei in tissues with precancerous and cancerous lesions.
      From basal cell hyperplasia to dysplasia to carcinoma in situ, the p53
      immunostain-positive cells increased in number, and their distribution had
      roughly the same pattern as that of the proliferating cells. However, positive
      stain was not observed in the dividing basal cells of the normal epithelium of
      the surgically resected tissues. A similar pattern of immunostaining was observed
      in the abnormal tissues of the biopsy samples from the symptom-free subjects. An
      intriguing observation is that some p53 immunostain-positive cells were observed
      in 3 of 6 cases of histologically normal epithelia of biopsy samples. Only the
      papillary immunostaining pattern was observed in these three "normal" cases.
      Although the molecular basis for such positive stain remains to be investigated,
      it is possible that p53 protein accumulation occurs early in the pathogenesis of
      esophageal cancer and that p53 mutation is closely associated with the initiation
      of this cancer. The accumulation of p53 protein may be a promising early
      biomarker for identifying high-risk subjects for esophageal cancer.

PMID- 8467497
TI  - Clinical value of determination of urokinase-type plasminogen activator antigen
      in plasma for detection of colorectal cancer: comparison with circulating tumor
      associated antigens CA 19-9 and carcinoembryonic antigen.
AB  - We determined urokinase-type plasminogen activator antigen (u-PA),
      gastrointestinal cancer-associated antigen (CA 19-9), and carcinoembryonic
      antigen (CEA) in the plasma of patients with colorectal cancer at the time of
      clinical tumor detection and in a group of patients with Crohn's disease and
      analyzed the specificity of these tumor markers. u-PA, CA 19-9, and CEA were
      indicative for colorectal cancer in 75.5%, 51.5%, and 51.5% of tumor patients,
      respectively, with a specificity of 79.3%, 94%, and 97.5%. Sensitivity increased
      when two or all three markers were determined in identical blood samples, whereby
      a combination of u-PA and CEA exhibited the highest sensitivity value (90.9%) as
      compared to the combinations of u-PA and CA 19-9 or CA 19-9 and CEA. The use of
      all 3 markers did not lead to further increased sensitivity. False negative
      results were obtained in 3 of 32 cancer patients (9.1%, using one of 3 markers as
      indicative for malignant disease). These results indicate the benefit of
      multiparametric tumor marker analyses including u-PA antigen for the diagnosis of
      colorectal cancer.

PMID- 8467498
TI  - Phase I and pharmacological study of the pulmonary cytotoxin 4-ipomeanol on a
      single dose schedule in lung cancer patients: hepatotoxicity is dose limiting in
      humans.
AB  - 4-Ipomeanol (IPO), a naturally occurring pulmonary toxin, is the first cytotoxic
      agent to undergo clinical development based on a biochemical-biological rationale
      as an antineoplastic agent targeted specifically against lung cancer. This
      rationale is based on preclinical observations that metabolic activation and
      intracellular binding of IPO, as well as cytotoxicity, occurred selectively in
      tissues and cancers derived from tissues that are rich in specific P450 mixed
      function oxidase enzymes. Although tissues capable of activating IPO to cytotoxic
      intermediates in vitro include liver, lung, and kidney, IPO has been demonstrated
      in rodents and dogs to undergo in situ activation, bind covalently, and induce
      cytotoxicity preferentially in lung tissue at doses not similarly affecting liver
      or kidneys. Although the drug was devoid of antitumor activity in the
      conventional murine preclinical screening models, cytotoxic activity was observed
      in human lung cancers in vitro and in human lung cancer xenografts in vivo,
      adding to the rationale for clinical development. Somewhat unexpectantly,
      hepatocellular toxicity was the dose-limiting principal toxicity of IPO
      administered as a 30-min infusion every 3 weeks to patients with lung cancer. In
      this study, 55 patients received 254 courses at doses almost spanning 3 orders of
      magnitude, 6.5 to 1612 mg/m2. Transient and isolated elevations in hepatocellular
      enzymes, predominantly alanine aminotransferase, occurred in the majority of
      courses of IPO at 1032 mg/m2, which is the recommended IPO dose for subsequent
      phase II trials. At higher doses, hepatocellular toxicity was more severe and was
      often associated with right upper quadrant pain and severe malaise. Toxic effects
      were also noted in other tissues capable of activating IPO, including possible
      nephrotoxicity in a patient treated with one course of IPO at 154 mg/m2 and
      severe, reversible pulmonary toxicity in another patient who received nine
      courses of IPO at doses ranging from 202 to 826 mg/m2. Although individual plasma
      drug disposition curves were well described by a two-compartment first order
      elimination model, The relationship between IPO dose and area under the
      disposition curve was curvilinear, suggesting saturable elimination kinetics. At
      the maximum tolerated dose, the mean half-lives (lambda 1 and lambda 2) were 6.7
      and 114.5 min, respectively. Renal excretion of parent compound accounted for
      less than 2% of the administered dose of IPO. An unidentified metabolite was
      detected in the plasma of patients treated at higher doses. No objective
      antitumor responses were observed; however, stable disease persisted for at least
      eight courses in 27% of patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8467499
TI  - Glucocorticoids coordinately disrupt a transforming growth factor alpha autocrine
      loop and suppress the growth of 13762NF-derived Con8 rat mammary adenocarcinoma
      cells.
AB  - We have demonstrated previously that the synthetic glucocorticoid dexamethasone
      suppresses the growth of Con8 rat mammary tumor cells, which are derived from the
      13762NF transplantable, hormone-responsive rat mammary adenocarcinoma.
      Dexamethasone inhibited [3H]thymidine incorporation into Con8 cells at high cell
      density under both serum and serum-free conditions. Fractionation in nonreducing
      sodium dodecyl sulfate-polyacrylamide gels of proteins secreted from
      dexamethasone-treated and untreated Con8 mammary tumor cells revealed two size
      classes of glucocorticoid inhibited mitogenic activities; a larger M(r) 27,000
      33,000 and a smaller M(r) 5,000-12,000 activity. Both size classes of mitogens
      restimulated the growth of glucocorticoid-suppressed Con8 cells suggesting that
      they can act in an autocrine fashion. The smaller mitogen was identified as
      transforming growth factor alpha (TGF-alpha) since this activity competed with
      125I-epidermal growth factor (EGF) for EGF receptor binding and was selectively
      immunodepleted with monoclonal TGF-alpha antibodies but not with EGF antibodies.
      Western blots and radioreceptor assay of Con8-secreted proteins revealed that
      glucocorticoids inhibited the production of a M(r) 5500 immunoreactive TGF-alpha
      protein by 10-fold. Consistent with a steroid effect on the level of TGF-alpha
      production, rather than on its activity, the specific mitogenic activities of the
      TGF-alpha s secreted by dexamethasone-treated and untreated Con8 cells were
      identical to that of recombinant human TGF-alpha. Treatment of intact cells with
      suramin, which dissociates ligand-receptor complexes, revealed that the EGF
      receptor-mediated mitogenic response is functional in both glucocorticoid-treated
      and untreated cells. Taken together, our results demonstrate that glucocorticoids
      suppress Con8 mammary tumor cell growth and disrupt a potential TGF-alpha
      autocrine loop which results in a dramatic reduction in the level of
      extracellular TGF-alpha.

PMID- 8467500
TI  - Overexpression of transforming growth factor alpha overrides the glucocorticoid
      mediated suppression of Con8 mammary tumor cell growth in vitro and in vivo.
AB  - In a preceding paper (D. B. Alexander et al., Cancer Res., 53: 1808-1815, 1993),
      we demonstrated that the in vitro glucocorticoid inhibition of Con8 mammary tumor
      cell growth is accompanied by the disruption of a transforming growth factor
      alpha (TGF-alpha) autocrine loop. This growth suppression response functions in
      vivo since proliferation of Con8-derived tumors was inhibited in rats treated
      with the synthetic glucocorticoid, dexamethasone. The effect of dexamethasone on
      Con8-derived tumor growth was reversible in that tumors rapidly grew at the site
      of inoculation after discontinuing injections of dexamethasone. To test the in
      vivo relationship between the glucocorticoid growth suppression response and the
      TGF-alpha autocrine loop, Con8 cells were transfected with a TGF-alpha expression
      vector and single cell-derived neomycin-resistant subclones were recovered.
      [3H]Thymidine incorporation of cultured monolayers of transfected Con8 mammary
      cells and measurement of tumor diameters in rats revealed that dexamethasone
      failed to suppress the in vitro proliferation or in vivo tumor growth of Con8
      derived cells producing high constitutive levels of secreted TGF-alpha. In
      contrast, both the in vivo and in vitro growth of Con8 cells transfected with
      vector controls were fully suppressible by glucocorticoids. Consistent with our
      in vitro observations, these results demonstrate that the regulation of TGF-alpha
      production plays a key role in the in vivo glucocorticoid suppression of Con8
      derived mammary tumor growth.

PMID- 8467501
TI  - Ovarian cancers express and process progastrin.
AB  - Gastrin synthesis in ovarian tumors has been described in a few isolated cases
      associated with the Zollinger-Ellison syndrome. Consequently, ovarian gastrin
      synthesis has been considered exceptional. In order to evaluate whether
      expression of gastrin in ovarian tumors indeed is rare, we examined the
      expression and processing of progastrin in 16 malignant and 5 benign ovarian
      tumors and 4 normal postmenopausal ovaria. Using a library of sequence specific
      radioimmunoassays, cleavage by processing-like enzymes, and gel chromatography,
      we found that one-half of the malignant tumors expressed significant
      concentrations of amidated gastrins [6.7 +/- 2.7 (SEM) pmol/g; range, 1.4-20.0
      pmol/g, n = 7]. The concentrations of glycine-extended gastrins and progastrins
      were low (0.25 +/- 0.03 and 1.4 +/- 0.4 pmol/g, respectively) but higher than in
      controls and benign tumors. Chromatography showed that the majority of the
      bioactive gastrins was unsulfated gastrin-17. The other half of the malignant
      tumors expressed glycine-extended gastrins and progastrins (0.2 +/- 0.03 and 0.6
      +/- 0.1 pmol/g; n = 9), but the amidation of the peptides was impaired (0.1 +/-
      0.03 pmol/g). Low concentrations of glycine-extended gastrins and progastrins
      were detected in the normal ovarian tissues (0.2 +/- 0.05 pmol/g tissue and 0.2
      +/- 0.06 pmol/g, respectively, n = 4) and in the benign tumors (0.1 +/- 0.02
      pmol/g and 0.5 +/- 0.03 pmol/g; n = 5). Amidated gastrins were undetectable,
      except in low amounts in a single benign tumor (0.2 pmol/g tissue). The results
      show that postmenopausal ovaria and neoplastic ovarian tissues express the
      gastrin gene at peptide level. The synthesis and processing of progastrin
      increase considerably in malignant tumors.

PMID- 8467502
TI  - Modulation of both cisplatin nephrotoxicity and drug resistance in murine bladder
      tumor by controlling metallothionein synthesis.
AB  - The role of metallothionein (MT) in cisplatin (cis-DDP) resistance and renal
      toxicity was investigated in C3H mice inoculated with mouse bladder tumor (MBT
      2). C3H mice were inoculated s.c. with 1 x 10(6) MBT-2 cells/mouse on day 0. Mice
      were given injections of proparglyglycine (PPG) (500 mumol/kg s.c.) once a day
      for 3 days from day 7 to day 9 and with ZnSO4 (200 mumol/kg s.c.) once a day for
      2 days from day 8 to day 9. cis-DDP (50 mumol/kg i.p.) was administered 10 days
      after MBT-2 cell inoculation. Since MT contents in the tumor and kidneys were
      significantly increased by administration of ZnSO4, both the antitumor activity
      of cis-DDP and its renal toxicity were reduced. However, coadministration of PPG
      reduced MT induction in tumor without affecting the level of renal MT. As a
      result, PPG could clearly overcome the MT-mediated cis-DDP resistance of tumors
      without compromising the protective effect exerted by renal MT on nephrotoxicity
      of the drug. It was suggested, therefore, that PPG may be a promising adjunct in
      cancer chemotherapy to overcome the drug resistance of tumors caused by the
      elevated level of MT.

PMID- 8467503
TI  - Protection of bone marrow stromal cells from the toxic effects of
      cyclophosphamide in vivo and of ASTA-Z 7557 and etoposide in vitro by ammonium
      trichloro(dioxyethylene-O-O')tellurate (AS101).
AB  - The immunomodulator AS101 has previously been shown to protect mice from lethal
      and sublethal doses of cyclophosphamide (CYP). AS101 was also shown to protect BM
      granulocyte-macrophage colony-forming cells from the toxic effects of ASTA-Z
      7557. In the present study we examined the ability of AS101 to protect functional
      properties of BM stromal cells from the toxic effects of CYP in vivo or ASTA-Z in
      vitro. The functional properties of stromal cells from CYP-injected mice were
      tested with respect to stromal cell number and viability as reflected by the
      number of colony-forming unit fibroblasts, the ability of established stromal
      layers to secrete colony-stimulating factor and interleukin 6, as well as the
      capacity to support hemopoietic cells. All of these parameters were tested from
      day 1 to day 7 after CYP treatment. We demonstrate that all stromal functions are
      severely damaged following CYP treatment. Pretreatment of mice with 10 micrograms
      AS101 24 h before injection of 250 mg/kg CYP resulted in a significant
      amelioration of stromal cell functions as early as 24 h following CYP treatment.
      In addition we show that prior incubation of BM cells with AS101 protects the
      development of stromal colony-forming unit fibroblasts from the toxic effects of
      ASTA-Z, a potent derivative of CYP, and etoposide, a derivative of
      podophyllotoxin. These results strongly suggest the usefulness of AS101 in
      counteracting chemotherapy-induced BM microenvironmental suppression and the
      important role of the compound as an adjunct treatment of cancer when used in
      combination with CYP. The data also suggest the effectiveness of AS101 in purging
      bone marrow when used concomitantly with ASTA-Z or etoposide.

PMID- 8467504
TI  - Apoptosis induced by anthracycline antibiotics in P388 parent and multidrug
      resistant cells.
AB  - The effect of the topoisomerase II inhibitor doxorubicin and its non-cross
      resistant analogue annamycin on DNA degradation and programmed cell death was
      examined in murine leukemia P388 cells. P388 parental cells exposed to various
      concentrations of doxorubicin and annamycin for 24 h displayed dose-dependent DNA
      cleavage: at 1 microM, both doxorubicin and annamycin were effective in inducing
      DNA breakdown, but at 10 microM, the effect was markedly decreased or totally
      absent. In multidrug-resistant P388/Dox cells, doxorubicin did not cause DNA
      cleavage, while 10 microM annamycin had a significant effect. By agarose gel
      analysis, drug-induced DNA fragmentation showed the characteristic pattern of
      internucleosomal ladder. Morphologically, P388 cells treated with 1 microM
      doxorubicin or annamycin for 24 h showed a reduction in cell volume and
      condensation of nuclear structures. Similar changes were observed in P388/Dox
      cells exposed to 10 microM annamycin for 24 h but not in cells exposed to 10
      microM doxorubicin. Time course studies demonstrated that DNA fragmentation was
      detected 12 h after incubation with 1 microM doxorubicin or annamycin, while loss
      of membrane integrity appeared at 24 h, thus indicating that DNA degradation was
      a preceding event. DNA fragmentation caused by doxorubicin and annamycin was
      inhibited by the RNA synthesis inhibitor actinomycin D, the protein synthesis
      inhibitor cycloheximide, and the endonuclease inhibitor aurintricarboxylic acid.
      Drug-induced cell death was partially prevented by cycloheximide and
      aurintricarboxylic acid, thus suggesting that the apoptotic process caused by
      these drugs requires gene expression, synthesis of new proteins, and activation
      of endogenous nucleases. In contrast, DNA cleavage was not affected by incubating
      cells with 1 mM ethylene glycol-bis(2-aminoethyl ether)-N,N,N',N'-tetraacetic
      acid, thus indicating that intracellular calcium depletion does not affect
      anthracycline-induced apoptosis. The results obtained demonstrate that the cell
      killing effect of anthracyclines is mediated, at least in part, by the induction
      of apoptosis.

PMID- 8467505
TI  - Constitutive expression of human Bcl-2 modulates nitrogen mustard and
      camptothecin induced apoptosis.
AB  - Bcl-2 is a novel protooncogene which prolongs cell survival and suppresses
      apoptosis. We examined whether constitutive expression of transfected human bcl-2
      conferred resistance to two different DNA damaging drugs, nitrogen mustard (HN2)
      and camptothecin (CPT) in a murine, IL-3 dependent cell line (FL5.12). HN2
      treatment produced 2-fold less cell death and DNA degradation in cells
      overexpressing bcl-2 relative to control cells transfected with a construct
      bearing only the neoR gene. DNA degradation was characterized by oligonucleosomal
      length fragments indicating that programmed cell death or apoptosis had occurred.
      Equimolar HN2 produced similar extents of interstrand cross-link formation and
      repair in each cell line. Cell cycle characteristics were similar for both cell
      lines following equimolar HN2 treatment, exhibiting a brief S phase delay
      followed by a longer G2 arrest. Time course studies indicated that DNA
      fragmentation occurred following peak G2 arrest in control cells and 12 h later
      in bcl-2 transfected cells. Equimolar CPT exposure also induced 2-fold less death
      and apoptotic DNA fragmentation in bcl-2 transfected compared to control cells.
      DNA single strand break formation and resealing kinetics were comparable in both
      cell lines following equimolar CPT treatment. CPT caused similar cell cycle
      perturbations in both cell lines, with a brief S phase block detectable 12 h
      after an equimolar drug dose. Kinetic studies showed apoptosis occurred following
      maximal S phase arrest in control and 12 h later in bcl-2 transfected cells. By
      contrast, IL-3 withdrawal produced rapid and extensive DNA degradation and
      apoptosis in controls 24 h postwithdrawal, and this process was inhibited 3-4
      fold in bcl-2 transfectants. Cell cycle analysis showed both cell lines arrested
      in G0/G1 following IL-3 removal. In summary, bcl-2 transfection affords a 2-fold
      protection from HN2 and CPT cytotoxicity and decreases drug induced apoptosis in
      FL5.12 cells, despite the different mechanisms of action and cell cycle effects
      of each agent. Bcl-2 overexpression appears to represent a novel drug resistance
      mechanism of potential clinical significance.

PMID- 8467506
TI  - Inhibition of protein tyrosine phosphatase by the antitumor agent gallium
      nitrate.
AB  - Protein tyrosine phosphatases (PTPases) play an important role in regulating cell
      growth and transformation. We report that the antitumor agent gallium nitrate is
      a potent inhibitor (concentration producing 50% inhibition, 2-6 microM) of
      detergent-solubilized cellular membrane PTPase from Jurkat human T-cell leukemia
      cells and HT-29 human colon cancer cells. This is the first report of a
      selective, small molecule drug inhibitor of PTPase. Gallium nitrate did not
      inhibit CD45, a PTPase found in the membranes of hemopoietic lineage cells such
      as Jurkat cells. Studies with gallium nitrate and a series of gallium-containing
      analogues revealed no correlation between growth-inhibitory activity in Jurkat
      and HT-29 cells and the ability to inhibit detergent-solubilized PTPase. Gallium
      nitrate and most of the gallium analogues penetrate poorly into cells. In
      contrast, a gallium-hydrogen peroxide complex inhibits DNA synthesis in Jurkat
      cells and induces the accumulation of phosphotyrosines on multiple intracellular
      proteins in this cell line. Gallium-hydrogen peroxide complex and gallium nitrate
      have similar inhibitory activity toward detergent-soluble PTPase. This is a new
      mechanism of action for gallium nitrate but it is not known if the inhibition of
      PTPase is related to the antitumor activity of gallium nitrate.

PMID- 8467507
TI  - Yeast cells can enter a quiescent state through G1, S, G2, or M phase of the cell
      cycle.
AB  - We have examined the ability of the yeasts Schizosaccharomyces pombe and
      Saccharomyces cerevisiae to enter a quiescent state through G1, S, G2, or M phase
      of the cell cycle. We monitored entry to a quiescent state by measuring two well
      known properties of quiescent cells, i.e., long-term viability and a dramatic
      increase in resistance to thermal heat shock relative to cycling cells. For this
      purpose, we made use of yeast cell division cycle (cdc) mutants with which we
      could arrest most of the cells in culture at specific points in the cell cycle.
      We find that these eukaryotes can enter a reversible quiescent state at any of
      the points in the cell cycle we examined if the cells are exposed to starvation
      conditions (starvation normally signals cells to leave the cell cycle). These
      findings indicate that mechanisms involved in entry to and exit from a quiescent
      state can operate not only in G1 phase (leading to G0 arrested cells) but can
      also operate in S, G2, and M phases of the cell cycle. These findings may be
      important for clinical oncology in cases where tumor cells escape the cytotoxic
      effects of chemotherapeutic agents. It may be that escape from the effect of
      these drugs is due to tumor cells entering quiescent states at points in the cell
      cycle other than G1 phase. Perhaps different chemotherapeutic strategies may be
      required to kill tumor cells reentering the cell cycle from other than G1.

PMID- 8467508
TI  - Human myelomonocytic cell line THP-1 produces a novel growth-promoting factor
      with a wide target cell spectrum.
AB  - Conditioned medium from a human myelomonocytic cell line THP-1 promoted the
      growth of a wide variety of cell types, i.e., human and mouse myeloid cells (HL
      60, U937, K562, and M1), mouse T-cells (EL-4), human B cells (Daudi and Raji),
      mouse mastocytoma cells (IC-2), human melanoma cells (A375-C6), mouse transformed
      fibroblast cells (L929), human lung fibroblast cells (TIG-1), and mouse bone
      marrow fibroblast/stromal-like cells. The growth-promoting activity was acid
      labile. The activity was resistant to 50 degrees C for 5 min but completely lost
      in 5 min at 70 degrees C. The activity was resistant to treatment with trypsin
      but sensitive to chymotrypsin alpha, Pronase E, and proteinase K, indicating the
      proteinous nature of this activity. The activity was lost by dithiothreitol and 2
      mercaptoethanol. Molecular weight (M(r) 50,000-70,000) was estimated by gel
      filtration-high performance liquid chromatography. After the sequential anion
      exchange, hydrophobic, and hydroxylapatite high performance liquid
      chromatography, the partially purified factor exhibited the same target cell
      spectrum as the conditioned medium.

PMID- 8467509
TI  - An anticancer drug-sensitive murine erythroleukemia clone: implications for the
      mechanism of action of antineoplastic drugs.
AB  - The mechanism(s) by which anticancer drugs kill tumor cells remains obscure. The
      studies reported here were undertaken with the view that the mechanism may be
      understood in part through an analysis of anticancer drug-sensitive clones. We
      have isolated a murine (Friend) erythroleukemia clone in which drug sensitivity
      was correlated with increased differentiation, suggesting that anticancer drug
      induced cell death may be based on differentiation or a differentiation-dependent
      mechanism. In addition, this clone showed a high propensity for constitutive
      differentiation and frequent appearance of large multinucleate cells.
      Morphologically similar large aberrant cells were observed after the treatment of
      parental (745A) cells with Adriamycin (or bleomycin). We attribute these
      morphological defects occurring in clone 3-1 or in the parental cell line after
      anticancer drug treatment to a defective or inhibited cell cycle function. We
      suggest that the putative cell cycle defect in clone 3-1 is coupled to the
      increased drug-induced differentiation and resulting cell death. From a broader
      perspective, the studies reported here suggest that the search for and design of
      new anticancer drugs be directed at agents that modulate differentiation
      functions.

PMID- 8467510
TI  - Altered messenger RNA and unique mutational profiles of p53 and Rb in human
      esophageal carcinomas.
AB  - Seventy-nine esophageal carcinoma patients were studied for genetic abnormalities
      in the p53 and Rb tumor suppressor genes. Single-strand conformation polymorphism
      analysis and DNA sequencing were used to detect p53 point mutations, Northern
      blotting was used to examine abnormal expression of p53 and Rb, and polymerase
      chain reaction and Southern blotting were used to analyze allelic loss. Twenty
      five cases were analyzed by DNA sequencing to detect mutations in p53. Fourteen
      samples contained mutations within exons 5 through 9 of p53; seven had missense
      mutations giving rise to single amino acid substitutions. The remaining seven
      (50%) contained nonsense mutations leading to premature termination, five due to
      single base pair substitutions, and two that were the result of frameshift
      mutations. In other human tumors, p53 mutations are predominantly missense
      mutations, but our data as well as those from other groups show that nonsense
      mutations are common in human esophageal cancer. All but one of the
      constitutionally heterozygous samples containing mutations also manifested loss
      of the normal p53 allele; the one exception without allelic loss contained a
      silent mutation, which should not have had any affect on the p53 protein product.
      In addition, Northern blotting analysis revealed abnormalities (altered
      transcript size or mRNA levels) in 5 of 7 cases involving p53 and in 2 of 7 cases
      analyzed for Rb. Thirty-four cases were informative for allelic loss studies of
      both p53 and Rb; of these, 25 (74%) lost heterozygosity of p53, Rb, or both. When
      point mutations and mRNA expression abnormalities were also considered, 33 of 45
      (73%) tumors informative for allelic loss assays of both genes as well as for
      mRNA or point mutation studies showed one or more abnormalities in p53 or Rb. Our
      results strongly suggest that a unique profile of molecular alterations involving
      p53 and Rb characterizes human esophageal cancer and that these specific genetic
      lesions are important in the development and/or progression of most human
      esophageal carcinomas.

PMID- 8467511
TI  - Deletion of 1p36 as a primary chromosomal aberration in intestinal tumorigenesis.
AB  - Cytogenetic analysis of short-term cultures from benign intestinal tumors
      revealed clonal chromosome aberrations in five colorectal adenomas, one adenoma
      of the papilla Vateri, and one hyperplastic polyp of the rectum. One adenoma had
      numerical aberrations only, but in all other tumors structural rearrangements
      were found that led to loss of genetic material from 1p. In three of the cases,
      the deletion was restricted to the 1p36 band; the rest had lost larger 1p
      segments. The rearrangement of chromosome 1 was the sole karyotypic anomaly in
      three adenomas, all with mild or moderate dysplasia, and in the hyperplastic
      polyp. Both adenomas that had additional aberrations beyond the 1p loss showed
      severe dysplasia. We conclude that cytogenetically detectable loss of genetic
      information from 1p36 is an early, seemingly primary, premalignant event in
      intestinal tumorigenesis. The fact that the adenomas with 1p- as the sole change
      showed only mild or moderate dysplasia and that the del(1p) was found also in the
      hyperplastic polyp suggests that this aberration is more related to the induction
      of hyperproliferation than to differentiation disturbances in the intestinal
      mucosa.

PMID- 8467512
TI  - Mutation of the Ki-ras protooncogene in human endometrial hyperplasia and
      carcinoma.
AB  - Previous studies have demonstrated that some human endometrial carcinomas contain
      an activating point mutation in codon 12 of the Ki-ras protooncogene. To examine
      the hypothesis that this mutation may occur at an earlier stage of neoplastic
      progression in the endometrium, we analyzed 89 samples of premalignant
      endometrial hyperplasia and an additional 84 samples of endometrial carcinoma for
      point mutations of Ki-ras codon 12. Mutations were found in all three types of
      endometrial hyperplasia, simple, complex, and atypical, with no clear evidence of
      a differential distribution in any particular type. Furthermore, the overall
      incidence of Ki-ras mutations in the hyperplasia specimens (16%) was similar to
      the incidence detected in carcinomas (18%), indicating that ras mutation may
      represent an early event in a subset of endometrial carcinomas. When the tissue
      samples were segregated as to country of origin, the frequency of this mutation
      was approximately 2-fold higher in hyperplasia and carcinoma samples from Japan
      than from the United States, where the incidence, clinicopathological
      characteristics, and risk factors for endometrial carcinoma differ dramatically.
      There was no apparent correlation, however, between ras mutation and any
      pathological, histological, or clinical parameter examined, except survival. The
      presence of a ras mutation was inversely associated with death from disease,
      suggesting that this molecular feature may characterize a subset of endometrial
      carcinomas with a good prognosis.

PMID- 8467513
TI  - Detection of DNA strand breaks in individual apoptotic cells by the in situ
      terminal deoxynucleotidyl transferase and nick translation assays.
AB  - DNA strand breaks which occur in HL-60 cells as a result of activation of
      endonuclease during apoptosis induced by cell treatment with the DNA
      topoisomerase I inhibitor camptothecin and topoisomerase II inhibitors
      teniposide, 4'-(9-acridinylamino)-3-methanesulfon-m-anisidide, and fostriecin
      were labeled in situ, in individual fixed and permeabilized cells, with
      biotinylated dUTP (detected by fluoresceinated avidin), using the terminal
      deoxynucleotidyl transferase or nick translation assays. During the early stage
      of apoptosis, prior to nuclear fragmentation, the breaks were predominantly
      localized at the nuclear periphery, close to the nuclear envelope. In more
      advanced stages, all cellular DNA, then localized within the cell as dense,
      homogeneous granules of a variety of sizes, was strongly labeled, indicating
      extensive and more uniform distribution of breaks throughout genomic DNA.
      Bivariate analysis of the incorporated biotinylated dUTP and cellular DNA content
      by flow cytometry made it possible to estimate the kinetics of the labeling
      reaction and relate DNA breaks to cell position in the cycle. The kinetics of
      biotinylated dUTP incorporation was faster, and the distinction of cells with DNA
      breaks was more pronounced, using the terminal transferase rather than the nick
      translation assay. Camptothecin, teniposide, and 4'-(9-acridinylamino)-3
      methanesulfon-m-anisidide induced DNA breaks preferentially in S-phase cells,
      having little effect on cells in the G1 phase of the cycle. In contrast,
      fostriecin affected cells indiscriminately, in all phases of the cell cycle. The
      method of detection of DNA strand breaks (3'-hydroxyl termini) in individual
      cells offers several advantages and can be applied to clinical material (tumor
      biopsies) to study the induction of apoptosis in tumors during treatment, as a
      possible prognostic marker. The protein-associated DNA breaks in the "cleavable"
      DNA-topoisomerase complexes, which are the primary lesions induced by the
      inhibitors and precede apoptosis, were not detectable by the present methods.

PMID- 8467514
TI  - Radiation-enhanced expression of major histocompatibility complex class I antigen
      H-2Db in B16 melanoma cells.
AB  - Exposure of eukaryotic cells to ionizing radiation induces several cellular
      responses including DNA repair, arrest of DNA synthesis, and increased synthesis
      of specific cellular proteins. We derived from the murine melanoma cell line B16
      F10 a clonal isolate (M1) that was exposed to a total dose of 5000 cGy in 25
      fractions, according to a protocol that reflects the standard for current
      radiotherapeutic regimens. We measured, by flow cytometry of fluorescence-stained
      cells, the surface expression of the two major histocompatibility complex class I
      antigens H-2Db and H-2Kb in irradiated M1 cells and untreated M1 controls. We
      found that after 2000 cGy, expression of H-2Db antigen was enhanced in irradiated
      cells versus controls. Radiation-induced expression of H-2Db antigen appeared to
      be selective, since no up-regulation of the H-2Kb antigen was detectable, and
      persisted for at least 5 weeks following the last irradiation. Enhanced H-2Db
      antigen expression correlated with increased steady-state levels of H-2Db mRNA in
      irradiated cells. These results are consistent with the notion that enhanced
      expression of major histocompatibility complex class I antigens is part of a long
      lasting stress response elicited in cells by radiation.

PMID- 8467515
TI  - Differential diagnosis of oral mucosal ulcerations.

PMID- 8467516
TI  - The immediate chairside splint.

PMID- 8467517
TI  - A multidisciplinary approach for localized juvenile periodontitis: a case report.

PMID- 8467518
TI  - Acupuncture anesthesia/analgesia for pain and anxiety control in dental practice.
      Part I: Theory and application.

PMID- 8467519
TI  - The fascinating story of maxillofacial prosthetics.

PMID- 8467520
TI  - Oral amalgam tattoos: a diagnostic study.

PMID- 8467521
TI  - Indirect resin restoration-a proper technique to ensure success.

PMID- 8467522
TI  - Multiple hamartoma syndrome (Cowden's disease): a case report.

PMID- 8467523
TI  - Divergent neural beta tubulin from the Antarctic fish Notothenia coriiceps
      neglecta: potential sequence contributions to cold adaptation of microtubule
      assembly.
AB  - The cytoplasmic microtubules of the cold-adapted Antarctic fishes, unlike those
      of homeotherms and temperate poikilotherms, assemble and function at body
      temperatures in the range -1.8 to +2 degrees C. To determine whether alterations
      to the primary sequence of beta tubulin may contribute to enhancement of
      microtubule assembly at cold temperatures, we have cloned and sequenced a 1.8
      kilobase neural beta-chain cDNA, Ncn beta 1, from an Antarctic rockcod,
      Notothenia coriiceps neglecta. Based on nucleotide sequence homology, Ncn beta 1
      probably corresponds to a class-II beta-tubulin gene. The 446-residue beta chain
      encoded by Ncn beta 1 is closely related (sequence homology approximately 95%)
      both to the neural class-I/II isotypes and to the neural/testicular class-IV
      variants of higher vertebrates, but the sequence of its carboxy-terminal isotype
      defining region (residues 431-446) has diverged markedly (> or = 25% change
      relative to the I/II/IV referents). Furthermore, the Ncn beta 1 polypeptide
      contains six unique amino-acid substitutions (five conservative, one
      nonconservative) not found in other vertebrate brain isotypes, and the carboxy
      terminal region possesses a unique tyrosine inserted at position 442. We conclude
      that Ncn beta 1 encodes a class-II beta tubulin that contains sequence
      modifications, located largely in its interdimer contact domain, that may
      contribute to cold adaptation of microtubule assembly.

PMID- 8467524
TI  - Microtubule-associated motility in cytoplasmic extracts of sea urchin eggs.
AB  - We have developed a method for producing sea urchin egg cytoplasmic extracts
      which support substantial microtubule-associated motility, particularly minus end
      directed motility characteristic of cytoplasmic dynein. Particles translocated
      along microtubules and axonemes predominantly in the minus end direction;
      microtubules and axonemes glided across the coverslip surface only in the plus
      end direction (as expected for a minus-end directed motor bound to the coverslip
      surface); and microtubules crosslinked into bundles in an antiparallel
      orientation. Velocities of particle and microtubule translocation were in the
      range of 0.5-1.8 microns/sec. Vanadate at 10 microM inhibited all gliding of the
      microtubules and axonemes, yet bidirectional particle transport persisted.
      Vanadate at concentrations of 25 microM and higher inhibited nearly all
      microtubule-based motility in the preparation and produced parallel bundling of
      the microtubules. Motility was slowed but not stopped in the presence of 5 mM AMP
      PNP. Usually when a particle bound to a microtubule wall, it moved to the
      microtubule minus end. These particles often remained attached to the minus end.
      When a microtubule plus end in the shortening phase of dynamic instability
      reached a stationary particle on the microtubule, sometimes normal minus end
      directed motility was activated, or at other times the particle remained attached
      to the shortening plus end.

PMID- 8467525
TI  - Myosin-I in mammalian liver.
AB  - Myosin-I refers to a class of proteins with a molecular weight of approximately
      110-kDa, which have characteristics of conventional myosin but are unable to form
      filaments. Previous studies have implicated myosin-I in motile cellular processes
      including cell migration and phagocytosis. Although the first example of myosin-I
      in higher eukaryotes was the intestinal 110K-calmodulin complex, which forms in
      microvilli the lateral links connecting the core bundle of actin filaments to the
      membrane, myosin-I has now been shown to be a component of rat kidney and to be
      present in bovine adrenal gland and brain. We have now purified and characterized
      two polypeptides from rat liver which have several characteristics of the
      intestinal 110K-calmodulin complex. Both liver polypeptides are solubilized with
      ATP and co-elute on gel filtration with calmodulin. The polypeptides, of 110-kDa
      and 130-kDa, bind calmodulin in 1 mM EGTA. Both polypeptides bind to F-actin in
      an ATP reversible fashion, and crosslink actin filaments. The purified
      polypeptides possess an actin-activated Mg(2+)-ATPase activity typical of brush
      border myosin-I. A polyclonal antiserum directed against the chicken intestinal
      110-kDa polypeptide recognizes both rat liver polypeptides, whereas another serum
      recognizes the 130-kDa but not the 110-kDa rat liver polypeptide. Controlled
      proteolysis of the purified polypeptides with alpha-chymotrypsin indicates that
      the two polypeptides are distinct but related. Immunofluorescence microscopy on
      isolated hepatocytes shows distribution of myosin-I to be vesicular, distributed
      throughout the cytoplasm, but more concentrated near the nucleus. These data
      contribute new evidence by several functional criteria that multiple myosin-I
      molecules are present in higher organisms and may coexist in a single cell type.

PMID- 8467526
TI  - Molecular neurobiology of olfaction.
AB  - Odor discrimination is mediated via dendritic cilia of olfactory receptor
      neurons. Odorants traverse the aqueous mucous interphase that lines the surface
      of the olfactory neuroepithelium and interact with odorant receptors, which are
      members of the superfamily of G-protein-linked receptors. These interactions
      trigger synthesis of second messengers, including cyclic AMP and inositol
      triphosphate. Cyclic AMP opens a cation channel to elicit the generator current,
      which depolarizes the cell and, ultimately, leads to action potentials. Inositol
      triphosphate opens a calcium channel in the ciliary plasma membrane. Calcium
      entering through both this channel and the cyclic nucleotide-gated channel
      modulates the response to odorants by amplifying the generation of cyclic AMP
      after binding to calmodulin. Calcium also is essential for desensitization of
      olfactory receptor neurons. Differential expression of odorant receptors of
      diverse ligand specificities by different olfactory neurons ensures that the
      structures and concentrations of odorants that reach the chemosensory surface are
      encoded as distinct patterns of neuronal activity, which are relayed to the brain
      where they take shape as characteristic odor sensations.

PMID- 8467527
TI  - The growth and signalling defects of the ggs1 (fdp1/byp1) deletion mutant on
      glucose are suppressed by a deletion of the gene encoding hexokinase PII.
AB  - Yeast cells defective in the GGS1 (FDP1/BYP1) gene are unable to adapt to
      fermentative metabolism. When glucose is added to derepressed ggs1 cells, growth
      is arrested due to an overloading of glycolysis with sugar phosphates which
      eventually leads to a depletion of phosphate in the cytosol. Ggs1 mutants lack
      all glucose-induced regulatory effects investigated so far. We reduced hexokinase
      activity in ggs1 strains by deleting the gene HXK2 encoding hexokinase PII. The
      double mutant ggs1 delta, hxk2 delta grew on glucose. This is in agreement with
      the idea that an inability of the ggs1 mutants to regulate the initiation of
      glycolysis causes the growth deficiency. However, the ggs1 delta, hxk2 delta
      double mutant still displayed a high level of glucose-6-phosphate as well as the
      rapid appearance of free intracellular glucose. This is consistent with our
      previous model suggesting an involvement of GGS1 in transport-associated sugar
      phosphorylation. Glucose induction of pyruvate decarboxylase, glucose-induced
      cAMP-signalling, glucose-induced inactivation of fructose-1,6-bisphosphatase, and
      glucose-induced activation of the potassium transport system, all deficient in
      ggs1 mutants, were restored by the deletion of HXK2. However, both the ggs1 delta
      and the ggs1 delta, hk2 delta mutant lack detectable trehalose and trehalose-6
      phosphate synthase activity. Trehalose is undetectable even in ggs1 delta strains
      with strongly reduced activity of protein kinase A which normally causes a very
      high trehalose content. These data fit with the recent cloning of GGS1 as a
      subunit of the trehalose-6-phosphate synthase/phosphatase complex.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8467528
TI  - Recombination initiated by double-strand breaks.
AB  - The HO endonuclease was used to introduce a site-specific double-strand break
      (DSB) in an interval designed to monitor mitotic recombination. The interval
      included the trp1 and his3 genes inserted into chromosome III of S. cerevisiae
      between the CRY1 and MAT loci. Mitotic recombination was monitored in a diploid
      carrying heteroalleles of trp1 and his3. The normal recognition sites for the HO
      endonuclease were mutated at the MAT alleles and a synthetic recognition site for
      HO endonuclease was placed between trp1 and his3 on one of the chromosomes. HO
      induced cleavage resulted in efficient recombination in this interval. Most of
      the data can be explained by double-strand gap repair in which the cut chromosome
      acts as the recipient. However, analysis of some of the recombinants indicates
      that regions of heteroduplex were generated flanking the site of the cut, and
      that some recombinants were the result of the cut chromosome acting as the
      genetic donor.

PMID- 8467529
TI  - Interaction between mitochondrial DNA and mitochondrial plasmids in Claviceps
      purpurea: analysis of plasmid-homologous sequences upstream of the lrRNA-gene.
AB  - Homology of two linear, mitochondrial (mt) Claviceps purpurea plasmids, pClK1 and
      pClT5, to the upstream region of the large ribosomal RNA gene in the mtDNA of
      three strains (W3, T5 and K) has been investigated in detail to explore the
      widespread phenomenon of homology between mt plasmids and mtDNA in C. purpurea.
      Sequence comparison indicates that recombination between free plasmids and mtDNA
      is the cause of the observed homology. The process is similar to the integration
      of the structurally related adenoviruses into the mammalian genome. As in other
      fungi, palindromic sequences seem to be involved in this mitochondrial
      recombination process.

PMID- 8467530
TI  - Isolation, sequencing, and characterization of crp-5, a gene encoding a
      Neurospora ribosomal protein.
AB  - A Neurospora crassa cytoplasmic ribosomal protein gene, crp-5, has been isolated
      and characterized. The cDNA was isolated by a differential screening of a cDNA
      library for glucose-inducible genes. The cDNA was subsequently used to identify
      and isolate crp-5 genomic sequences. Computer analysis of the DNA sequences
      showed that they contain an open reading frame which encodes a protein homologous
      to the rat ribosomal protein S26. The crp-5 mRNA levels are regulated in a carbon
      source-dependent manner. The organization of the gene and the region upstream of
      the coding sequences are discussed.

PMID- 8467531
TI  - Transfer of genetic information from the mycoparasite Parasitella parasitica to
      its host Absidia glauca.
AB  - The infection of the model organism Absidia glauca by P. parasitica is
      accompanied by the fusion of both mycelia. By two lines of evidence we were able
      to show that this process is associated with the transfer of genes. First,
      auxotrophically labelled A. glauca mutants are efficiently complemented as a
      consequence of transfer of the parasite's genetic material. Second, for a plasmid
      coded dominant marker (neomycin resistance), which is expressed in either
      organism, we proved the presence of plasmid DNA in recombinant recipients by
      molecular analysis at the DNA level. We propose the term para-recombinants for
      describing recombinant inter-generic chimaerae, which are generated as a
      consequence of mycoparasitism.

PMID- 8467532
TI  - Messenger RNA intron in the nuclear 18s ribosomal RNA gene of deuteromycetes.
AB  - Introns within messenger RNA genes have characteristic border sequences and a
      conserved region near the 3' end of the intron. All are involved in splicing to
      produce the mature mRNA. Introns in ribosomal RNA genes have less well-defined
      borders and contain no internal conservation. We report here mRNA-type introns
      located near the 3' end of the 18s rRNA genes of the deuteromycetes Phialophora
      americana and Cenococcum geophilum. Inserted sequences of various sizes have also
      been located at the same point in several other deuteromycete species.

PMID- 8467533
TI  - Gibberella pulicaris transformants: state of transforming DNA during asexual and
      sexual growth.
AB  - A genetically fertile, trichothecene-producing plant pathogen, Gibberella
      pulicaris (Fusarium sambucinum), was transformed with three different vectors:
      cosHyg1, pUCH1, and pDH25. All three vectors carry hph (encoding hygromycin B
      phosphotransferase) as the selectable marker. Transformation frequency was 0.03
      transformants per mumg of DNA for pDH25 and 0.5 for pUCH1 or cosHyg1. The vector
      DNA sequences integrated at different sites into the fungal genome. Transformants
      were classified into three types based upon distinctive integration patterns:
      type A contained a single, intact copy of the vector at one site per genome; type
      B contained multiple tandem copies or a combination of single and multiple tandem
      copies at one or more sites per genome; type C contained a partial vector copy at
      one site per genome. While the transformants with cosHyg1 and pUCH1 were type A
      or B, type C was unique to pDH25 transformants. Type A and C transformants were
      both meiotically and mitotically stable. However, type B multiple inserts were
      unstable in mitosis and meiosis since: (1) multiple tandem copies were deleted;
      (2) rearrangements occurred during premeiosis; and (3) inserts in one of the type
      B transformants became methylated during premeiosis. Differential expression of
      transforming sequences between spore germination and mycelial growth was also
      observed among type B transformants. The ability to transform G. pulicaris with
      the resulting varied features of integration patterns and the behavior of
      transforming DNA during mitosis and meiosis provides a means to isolate,
      manipulate, and study cloned genes in this mycotoxin-producing plant pathogen.

PMID- 8467534
TI  - Isolation and transformation of uracil auxotrophs of the lignin-degrading
      basidiomycete Phanerochaete chrysosporium.
AB  - Uracil auxotrophs of Phanerochaete chrysosporium were isolated using 5
      fluoroorotate resistance as a selection scheme. The ura3 auxotrophs deficient in
      orotidylate decarboxylase and ura5 auxotrophs deficient in orotate phosphoribosyl
      transferase were characterized by enzyme assays and complementation tests. The
      ura5 auxotrophs were transformed to prototrophy with the ura5 gene from the
      ascomycete Podospora anserina. The ura3 auxotrophs were transformed to
      prototrophy with the ura3 gene from the basidiomycete Schizophyllum commune. The
      P. chrysosporium ura3 gene was isolated from a lambda EMBL3 genomic library using
      the S. commune ura3 gene as a probe. A 6.6-kb fragment incorporating the ura3
      gene was subcloned into Bluescript SK+(pURA3.1) and used to transform P.
      chrysosporium ura3 auxotrophic strains. The pURA3.1 insert was mapped for
      restriction sites and the approximate location of the ura3 gene within the insert
      was determined. Double auxotrophic strains were transformed with either of two
      marker genes and the resulting single auxotrophic strains were crossed to
      demonstrate genetic recombination between two nuclei of identical genetic
      background.

PMID- 8467535
TI  - Uniparental inheritance of the mitochondrial gene cytochrome b in Plasmodium
      falciparum.
AB  - The inheritance of an extrachromosomal 6-kb element has been examined in the
      human malaria parasite Plasmodium falciparum. A single base pair difference in
      the cytochrome b gene from the 6-kb element of two different cloned lines of the
      parasite was identified, and used as a marker in a cross in the mosquito stage of
      the life cycle. Analysis of 59 individual hybrid oocysts resulting from this
      cross clearly demonstrated that inheritance of the cytochrome b gene was
      uniparental. This observation makes it possible to investigate the inheritance
      and evolution of cytoplasmic traits, including certain forms of drug resistance,
      in natural populations of this parasite.

PMID- 8467536
TI  - A region of heterogeneity adjacent to the 5s ribosomal RNA gene of cereal rusts.

PMID- 8467537
TI  - Genomic organization of a cellulase gene family in Phanerochaete chrysosporium.

PMID- 8467538
TI  - Tracheal intubation and laryngoscope design.

PMID- 8467539
TI  - Perioperative cardiovascular complications associated with blunt thoracic trauma.
AB  - The purpose of this study was to examine the frequency and importance of
      intraoperative mortality, arrhythmias and hypotension in the presence of thoracic
      trauma and to determine the effect of myocardial contusion on these perioperative
      complications. Over a two-year period patients with evidence of blunt thoracic
      injury who required surgery within 24 hr of admission were studied. The
      anaesthetist filled in a questionnaire on intraoperative events. Patients were
      also studied for the presence of myocardial injury with radionuclide angiography
      (RNA), at autopsy or at thoracotomy. Two hundred and one patients were studied.
      The intraoperative and overall mortality was 7.9% and 22.9% respectively. Of the
      operating room survivors the incidence of intraoperative arrhythmias and
      hypotension was 3.8% and 26.5% respectively. Only 5.9% of patients had a
      suspected or confirmed myocardial contusion. Patients were divided into two
      groups, those without myocardial injury were designated Group I, while those with
      myocardial contusion were designated Group II. The Group II patients had a
      greater severity of injury and intraoperative mortality (54.4%) than those in
      Group I (4.6%) P < 0.05. Intraoperative deaths were attributed to, with one
      exception, non-cardiac causes. There were no differences in the incidences of
      arrhythmias and hypotension between patients with-or without myocardial injury
      surviving the operating room. All patients with blunt thoracic injury may develop
      intraoperative arrhythmias or hypotension.

PMID- 8467540
TI  - Intubating conditions and haemodynamic changes following thiopentone or propofol
      for early tracheal intubation.
AB  - Intubating conditions and haemodynamic changes were studied 30 sec after a fixed
      induction dose of thiopentone or propofol in patients scheduled for elective
      surgery. The hypnotic agent was preceded by the administration of papaveretum 10
      mg three minutes before induction and alcuronium 0.2 mg.kg-1 at induction. Ease
      of intubation was graded and the study conducted in a randomised double-blind
      fashion. In the thiopentone group (n = 30) intubation was very easy in 73%
      compared with 79% in the propofol group (n = 29). In two patients in the propofol
      group the tracheas were moderately difficult to intubate but there were no failed
      intubations in either group. No patients recalled the intubation period on
      subsequent postoperative questioning. The immediate post-induction average
      systolic pressure in the thiopentone group decreased by 0.7% (range 15.9%
      increase to 25.3% decrease) whilst the post-intubation systolic pressure
      increased by 6.3% (range - 31.5% increase to 24.2% decrease). In the propofol
      group there was a decrease in systolic pressure after induction (average 14.4%;
      range 15.5% increase to 41.4% decrease, P < 0.05) but the subsequent pressor
      response to intubation was markedly attenuated compared with baseline (average
      systolic pressure decreased 15.5% (range 22.4% increase to 42.7% decrease)).
      Following intubation and maintenance, ventilation with nitrous oxide 70% and
      halothane 1% the systolic pressure decreased markedly in both groups with a
      greater reduction in the propofol group (P < 0.05). Compared with baseline there
      were increases (P < 0.0001) in heart rate in both groups from induction of
      anaesthesia to the end of study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467541
TI  - Ventilatory requirements during laparoscopic cholecystectomy.
AB  - The purpose of this clinical study was to determine: (1) the increase in minute
      ventilation required to maintain preinsufflation arterial carbon dioxide tension
      (PaCO2) during laparoscopic cholecystectomy, and (2) whether end-tidal PCO2
      (PETCO2) can be used as an index of PaCO2 and, therefore, of the adequacy of
      minute ventilation during the pneumoperitoneum. We measured PaCO2, PETCO2,
      expired minute volume (Vexp) standardized for body surface area (SA), airway and
      intra-abdominal pressure (P(aw), Pabd) during general anaesthesia for
      laparoscopic cholecystectomy just before and 30 min after the creation of a CO2
      pneumoperitoneum in 28 healthy (ASA class 1 and 2) consenting adults. They were
      in the reverse Trendlenburg position (20 degrees) with a 5 degrees lateral tilt.
      Expired minute volume was increased from 3.75 (SEM +/- 0.12) to 4.19 (0.15) L.min
      1 x m-2 to maintain PaCO2 close to control levels: 38.9 (0.8) vs 40.1 (0.6) mmHg
      5.19 (0.1) vs 5.35 (0.08) kPa). In most of the patients (23/28), PETCO2 was less
      than 41 mmHg with a correlation between PaCO2 and PETCO2. In ten of these
      patients, (Pa-PET)CO2 was greater than the normal range. In 5/28, (Pa-PET)CO2 was
      negative. The "driving pressure" (P(aw)-Pabd) increased from 8.7 (1.0) to 10.4
      (1.1) cm H2O, without any correlation between the increase in P(aw)-Pabd and that
      in Vexp. The results indicate the need for extra ventilatory requirement during
      laparoscopy and that PETCO2 is an imperfect index of PaCO2 under these
      circumstances.

PMID- 8467542
TI  - Patient-controlled epidural analgesia in labour: varying bolus dose and lockout
      interval.
AB  - This double-blind prospective study was designed to determine the best dose
      variables for patient-controlled epidural analgesia (PCEA) and to compare bolus
      only PCEA with continuous infusion epidural analgesia (CIEA) during the first
      stage of labour. Five groups of parturients self-administered 0.125% bupivacaine
      with 1:400,000 epinephrine and fentanyl 2.5 micrograms.ml-1 using PCA pumps
      programmed as follows: Group A, 2 ml bolus/10 min lockout interval (LI); Group B,
      3 ml bolus/15 min LI; Group C, 4 ml bolus/20 min LI; Group D, 6 ml bolus/30 min
      LI; Group E, 8 ml.hr-1 continuous infusion. Hourly assessments included: VAS
      scores for pain and satisfaction, sensory and motor block, bupivacaine and
      fentanyl consumption. Blood samples were collected at birth for maternal and
      fetal fentanyl concentrations. Data from 68 patients showed no differences among
      groups in pain relief or maternal satisfaction. Most patients received excellent
      analgesia and those requiring extra epidural supplements were evenly distributed
      across groups. There was higher consumption of bupivacaine and fentanyl in Group
      E than in any of the other four groups: bupivacaine mg.hr-1, mean (SD), 9.4 (2.7)
      in Group E vs 5.2 (1.7) in Groups A-D inclusive (P < 0.0001); fentanyl
      microgram.hr-1, 19.6 (4.6) in group E vs 12.6 (7.5) in Groups A-D inclusive (P <
      0.05). Motor block was minimal, whereas sensory levels were higher at the 3- and
      4-hour assessments in Groups D and E than in all other groups (P < 0.05). Plasma
      fentanyl concentrations were < 0.5 ng.ml-1 in all samples and no sequelae from
      fentanyl were observed, apart from mild pruritus.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8467543
TI  - Gastric pH and volume after oral fluids in the postpartum patient.
AB  - The aim of this study was to investigate the relationship between preoperative
      oral fluids and gastric pH and volume in women undergoing sterilization between
      one and five days postpartum. Fifty postpartum patients received 150 ml water
      approximately two to three hours before surgery while 50 postpartum and 50 non
      pregnant women were fasted from midnight. After induction of anaesthesia, gastric
      contents were aspirated using a Salem sump tube and the gastric pH and volume
      were measured. There were no differences in intragastric pH and volume, median
      (range), among the postpartum fasted group, 1.19 (0.74-4.57), 22 (1-78) ml,
      postpartum water group 1.18 (0.70-6.4), 25.5 (3-66) ml and the non-pregnant group
      1.27 (0.51-6.63), 25 (3-69) ml. There was no correlation between postpartum
      interval, 60 (12-120) hr, and intragastric pH or volume. It is concluded that
      oral water may be given safely two to three hours preoperatively to patients more
      than one day postpartum. Intragastric volume and acidity were not increased and
      the findings in postpartum patients were similar to those found in non-pregnant
      patients.

PMID- 8467544
TI  - Blood transfusion in total hip arthroplasty: guidelines to eliminate
      overtransfusion.
AB  - This study was designed to evaluate the effect of transfusion guidelines on
      perioperative blood usage with a view to identifying a protocol for transfusion
      therapy in our hospital. Eighty consecutive patients with normal haemoglobin
      concentrations presenting for total hip arthroplasty were studied. The maximum
      allowable blood loss (MABL) was calculated for each patient using the formula of
      Kallos et al. Blood loss up to this value was replaced with Haemaccel. When the
      MABL was reached, a haematocrit (Hct) was performed and blood was given if the
      Hct was less than 30 in men and 27 in women. Otherwise replacement was with
      Haemaccel. All postoperative complications, duration of hospital stay, and
      physiotherapy compliance assessments were recorded. A discharge Hct > 36% was the
      criterion for overtransfusion. The results were compared with findings from a
      retrospective group before the introduction of these guidelines. Analysis of the
      data demonstrated a reduction in the frequency of transfusion (97% vs 32% P <
      0.05), the volume transfused (2.7 vs 1.3 units P < 0.05), and the incidence of
      overtransfusion (45% vs 5% P < 0.05) between the two groups of patients. There
      was no difference between the groups in complication rate, duration of hospital
      stay or physiotherapy scoring. We conclude that the introduction of guidelines
      for transfusion in total hip arthroplasty patients has produced a marked
      reduction in blood usage in our hospital without detrimental effect.

PMID- 8467546
TI  - Delayed ischaemia of the hand necessitating amputation after radial artery
      cannulation.
AB  - We present a case of ischaemic hand injury in a patient, who had 95% occlusion of
      both the ulnar and radial arteries, after atraumatic placement of a left radial
      artery catheter. The presence of cigarette burns on the dorsum of the hand was
      highly suggestive of vascular compromise. There were no signs of vascular
      compromise after placement of the arterial line which was removed 24 hr later.
      Ten days after placement the patient complained of pain with ensuing ischaemic
      changes resulting in necrosis of the finger tips and eventual amputation of the
      hand. We recommend using other sites of arterial access such as axillary or
      superficial temporal artery in patients with severe peripheral vascular disease.

PMID- 8467547
TI  - Modification of intravenous lidocaine-induced convulsions by epinephrine in rats.
AB  - We studied intravenous lidocaine-induced convulsions in rats to determine whether
      added epinephrine influences the provocation of lidocaine toxicity. Wistar rats
      (200-250 g) were divided into three groups of ten, depending on the concentration
      of epinephrine added to lidocaine. Group 1: plain 1.5% lidocaine; Group 2: 1.5%
      lidocaine with 1:200,000 epinephrine; Group 3: 1.5% lidocaine with 1:100,000
      epinephrine. After surgical preparation and recovery from anaesthesia, all rats
      received a continuous i.v. infusion of lidocaine (15 mg.ml-1) at a rate of 4.0
      mg.kg-1 x min-1 until generalized convulsions occurred. The epinephrine-treated
      animals developed acute hypertension after one minute of lidocaine infusion (105
      +/- 2 to 141 +/- 2 mmHg in Group 2 and 103 +/- 2 to 151 +/- 2 mmHg in Group 3).
      The PaO2 values in the epinephrine groups at the onset of convulsions were
      decreased significantly (88.3 +/- 1.0 to 84.0 +/- 1.5 mmHg in Group 2 P < 0.05
      and 86.9 +/- 1.2 to 78.1 +/- 2.4 mmHg in Group 3 P < 0.01). However, these values
      were still within physiological ranges. Serum potassium concentrations in all
      groups were decreased P < 0.05, (4.24 +/- 0.09 to 3.52 +/- 0.12 mEq.L-1 in Group
      1, 4.02 +/- 0.09 to 3.63 +/- 0.17 mEq.L-1 in Group 2, and 4.15 +/- 0.10 to 3.69
      +/- 0.17 mEq.L-1 in Group 3).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467548
TI  - Comparison of the direct effects of sevoflurane, isoflurane and halothane on
      isolated canine coronary arteries.
AB  - We have demonstrated previously, using dog epicardial arteries of different
      sizes, that isoflurane, like adenosine, is preferentially a small coronary artery
      dilator, whereas halothane, like nitroglycerin, is a large artery dilator. The
      present study was designed to compare the direct effects of sevoflurane with
      those of isoflurane and halothane. Proximal large coronary arteries with an outer
      diameter (o.d.) of 2.5-3.2 mm and distal small arteries of 0.6-0.9 mm o.d. were
      isolated from dogs and then cut into vascular rings. They were precontracted with
      KCl (20 mM), and their relaxant responses to anaesthetics were compared relative
      to the maximal responses induced by papaverine. Sevoflurane, halothane and
      isoflurane (1-3 human MAC) induced dose-dependent relaxation of these arteries.
      The relaxant response to sevoflurane did not differ between large and small
      arteries. However, the relaxant response of the large arteries to halothane (1.5
      2.3%) was greater than that of small arteries (P < 0.01) and the response of
      small arteries to isoflurane (3.5%) was greater than that of large arteries (P <
      0.05). In large arteries, the potency of the relaxant effect at equivalent human
      MAC could be ranked as halothane > or = sevoflurane > isoflurane, and, in small
      epicardial arteries as isoflurane > sevoflurane >> halothane. We conclude that,
      unlike isoflurane, sevoflurane is not a preferential dilator of small coronary
      arteries.

PMID- 8467545
TI  - Potassium and anaesthesia.
AB  - Potassium is the principle intracellular ion, and its concentration and gradients
      greatly influence the electrical activity of excitable membranes. Because
      anaesthesia is so intimately involved with electrically active cells, potassium
      concentrations in surgical patients have received considerable attention in
      diagnostic and therapeutic applications. With the ongoing evolution in the
      indications for potassium, it is important to review the role of potassium in
      cellular activity, in storage and regulation, in diseases that alter potassium
      homeostasis, and in the therapeutic implications of perioperative alterations of
      potassium concentration. A rational approach to abnormal potassium values and the
      use of potassium in the operating room is sought, based on a physiological
      understanding of risks and benefits.

PMID- 8467549
TI  - An analysis of laryngoscope blade shape and design: new criteria for laryngoscope
      evaluation.
AB  - Laryngoscope blade design has tended to be relatively arbitrary and so far
      scientific analysis has not allowed useful comparisons between blade shapes. A
      new theoretical method of analysing laryngoscope blades is introduced and uses
      the depth of insertion profiles of two angular measurements. One represents
      eyeline displacement and the other the forward space that the blade occupies at
      the level of the mandible. Photographs of straight and curved blades were studied
      on Cartesian graphs with the tip T, at the origin and handle fittings parallel to
      the x-axis of the graph. Then, IT is any line from the origin to the incisor
      surface and represents a point of contact with the upper incisors for a given
      depth of blade insertion. Angle EIT (eyeline displacement) is to a tangent from I
      along the lower lingual surface of the blade. Point M is on the upper lingual
      surface of the blade, at right angles to IT, 1/3 of the distance from I along IT.
      Angle MIT (forward space) may be positive or negative depending on whether M is
      in front of or behind IT. The angles EIT, MIT and their additive combination are
      used in blade analysis. Negative MIT compensates for eyeline displacement as
      Macintosh size 3 and 4 blades have better combination scores than Miller size 3.
      All three are superior to the straight Soper size 3 blade. The Macintosh size 1
      and 2 blades are quite different from the larger Macintosh blades. This
      theoretical basis for blade analysis is consistent with commonly expressed
      clinical opinions and may influence blade design in the future.

PMID- 8467550
TI  - Computerized photo-plethysmography of the finger.
AB  - A microcomputer system for studying photo-plethysmography of the finger (PPF) was
      designed and applied to 50 non-premedicated healthy boys (one to ten years old)
      undergoing general anaesthesia (halothane in 70% N2O, with mechanical
      ventilation) for outpatient inguinal hernia repair. The purpose of this study was
      to assess the accuracy of computerized estimations of the photo-plethysmographic
      (arterial waves) amplitude and to evaluate whether or not PPF allows
      discrimination between two different surgical stimuli (skin incision, and
      manipulation of the spermatic cord). When anaesthesia was stable for at least
      five minutes (end-tidal halothane = 1.25-1.5%; PETCO2 = 32-38 mmHg; SpO2 > or =
      98%; rectal temperature = 36.3-37 degrees C; ambient operating room temperature =
      20-21 degrees C), and immediately before the skin incision, computerized
      estimations of the photo-plethysmographic (arterial waves) amplitudes (PPA) were
      recorded and saved for later comparison with direct (manual) measurements of the
      plethysmographic tracing, using an arbitrary scale of 0-255 units. Also, the
      values of PPA, systolic blood pressure, and pulse rate recorded immediately
      before the skin incision were later compared with the maximum changes in these
      same values recorded 30-90 sec after skin incision, and 30-90 sec after
      manipulation (traction+dissection) of the spermatic cord. Six boys (three to ten
      years old) stayed quiet enough, during induction of anaesthesia by mask, to allow
      regression analysis of PPA, systolic blood pressure, and pulse rate (Y) on end
      tidal halothane/70% N2O (X). Computerized estimations tended to give a higher
      reading, by between 0.2 to 0.8 units, than direct measurements.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8467551
TI  - Difficult laryngoscopy made easy with a "BURP".
AB  - Displacement of the larynx by backward, upward and rightward pressure on the
      thyroid cartilage or "BURP" may improve visualization of the glottis in some
      cases of difficult direct laryngoscopy. In a patient with the Treacher-Collins
      syndrome in whom conventional laryngoscopy had proved impossible and tracheal
      intubation extremely difficult, this manoeuvre exposed the entire glottis and
      made tracheal intubation under direct vision easy. In a patient with protruding
      upper incisors and a prominent premaxilla which precluded a view of the glottis
      by conventional laryngoscopy, "BURP" again revealed the glottic opening and
      simplified the placement of an endotracheal tube. This experience suggests that
      "BURP" be considered as a potential aid in the management of difficult direct
      laryngoscopy.

PMID- 8467552
TI  - Plasma sufentanil concentration after intranasal administration to paediatric
      outpatients.

PMID- 8467553
TI  - Management of failed oral fibreoptic intubation with laryngeal mask airway
      insertion under topical anaesthesia.

PMID- 8467554
TI  - Patient recruitment for clinical research.

PMID- 8467555
TI  - Rheumatoid arthritis: how well do the theories fit the evidence?
AB  - In this brief review, inspired partly by a symposium at the autumn meeting of the
      British Society for Immunology, 1992, varying hypotheses concerning the
      etiopathogenesis of rheumatoid arthritis (RA) are explored and tested against
      current evidence. Immunogenetic considerations, whilst of interest, have not
      aided our understanding of the development of this disease. The association with
      restricted HLA-DR beta chain hypervariable sequences does not hold true with all
      cases of RA (but may be related to disease severity) and studies of T cell
      receptor (TCR) beta chain usage fail to show consistent oligoclonality of
      infiltrating T cells in the synovial compartment. Etiologies based on triggering
      by bacteria are also considered: homologies between the 'shared epitope'
      sequences of HLA-DR1 and DR4 beta chains, Escherichia coli dnaJ and Proteus
      haemolysin do not indicate any feasible mechanisms for the development of RA, and
      cannot explain the many cases in which such DR sequences do not occur, though new
      data from man and animals enhance interest in the role of bowel flora. Finally,
      the striking parallels between slow bacterial infections and RA, in terms of
      immunogenetics, pathology, IgG glycosylation abnormalities and autoimmune
      manifestations, are put forward as circumstantial evidence that such bacterial
      infections may underly, or trigger, this serious disease.

PMID- 8467556
TI  - Increased expression of interferon-gamma in hyperplastic lymph nodes from HIV
      infected patients.
AB  - Polyclonal B cell activation is characteristic of HIV infection and occurs in the
      presence of severe CD4+ lymphocyte depletion. In contrast, CD4+ lymphocytes are
      the dominant T cell in the reactive lymphoid tissues of patients not infected
      with HIV. In this study, lymph node biopsies from eight HIV-infected patients
      with persistent generalized lymphadenopathy syndrome (PGL) were assessed for IL-1
      beta, IL-2, IL-4, IL-6, IL-10, interferon-gamma (IFN-gamma) and tumour necrosis
      factor-beta (TNF-beta) gene expression using the polymerase chain reaction (PCR).
      The cytokine gene expression of two cases of reactive adenopathy in patients not
      infected with HIV was assessed for comparison. IFN-gamma was expressed much more
      strongly in the PGL samples than in control reactive lymphoid tissues, whereas
      the other cytokines were expressed to a similar extent in both types of tissues.
      IFN-gamma may have an important role in maintaining the adenopathy of HIV
      infected patients. Expression of cytokines such as IL-2, IL-4 and IL-10 in HIV
      nodes may be adequate to allow the recruitment of naive B cells to the reactive
      process.

PMID- 8467557
TI  - IL-4 and interferon-gamma production in children with atopic disease.
AB  - In vitro studies have implicated reciprocal roles for IL-4 and interferon-gamma
      (IFN-gamma) in the regulation of IgE production. As elevated IgE is a major
      feature of atopic disease, an important question is whether an imbalance of IL-4
      and IFN-gamma is present in vivo. The production of IL-4 and IFN-gamma in
      phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cell cultures
      from atopic children was examined to determine if there is an increased
      production of IL-4 and/or a reduced production of IFN-gamma. Highly atopic
      children with IgE > 600 U/ml produced significantly more IL-4 and less IFN-gamma
      in vitro than age-matched non-atopic controls. Production of IL-4 and IFN-gamma
      in mildly atopic children was equivalent to controls. These findings indicate
      that highly atopic children have an imbalance of IL-4 and IFN-gamma production
      and that the degree of imbalance relates to severity of the atopic state. The
      ratio of in vitro IL-4: IFN-gamma production correlated positively with serum
      IgE, which suggests that the balance of these two cytokines is a factor in the
      regulation of IgE, in vivo. It remains to be determined whether this imbalance of
      IL-4 and IFN-gamma in the highly atopic children is the cause or result of the
      disease process.

PMID- 8467558
TI  - Abnormalities of the IgA immune system in members of unrelated pedigrees from
      patients with IgA nephropathy.
AB  - In the last few years many investigators have reported the recurrence of primary
      IgA nephropathy (IgAN) or the presence of persistent microhaematuria and/or
      proteinuria in family members of patients with IgAN. Our study was undertaken to
      investigate the relevance of abnormalities in the regulation of the IgA and IgM
      immune system in microhaematuric and asymptomatic family members of IgAN
      patients. Fifty-four out of 120 members of nine unrelated pedigrees were examined
      by urinalysis; polymeric IgA (pIgA), IgA rheumatoid factor (IgARF), IgA1-IgG
      immune complexes (IgA 1-IgG IC) and IgA 1-IgM IC, and other immunoglobulins were
      measured in serum samples. Moreover, we studied the production of
      immunoglobulins, pIgA and IgARF by peripheral blood mononuclear cells (PBMC) in
      basal conditions and after pokeweed mitogen (PWM) stimulation. Our data
      demonstrate that persistent microhaematuria was present in 24% of relatives. High
      serum levels of IgA, mainly pIgA and IgARF, IgA 1-IgG IC and IgA 1-IgM IC
      occurred in 66% of relatives. Abnormal spontaneous production of IgA by PBMC and
      after PWM stimulation was present in 64% of family members. Interestingly, high
      serum levels of IgM and abnormal production of this immunoglobulin by PBMC were
      observed in relatives. However, the immunological abnormalities did not correlate
      in any way with the presence of urinary abnormalities such as microhaematuria,
      which was most likely determined by an underlying glomerular alteration.

PMID- 8467559
TI  - Increased spontaneous secretion of rheumatoid factor by intestinal lamina propria
      mononuclear cells from Crohn's disease but not ulcerative colitis patients.
AB  - Increased levels of rheumatoid factors (RF) have been observed in the serum of
      Crohn's disease but not ulcerative colitis patients, and have been proposed to
      relate to an increased state of intestinal lymphocyte activation. We have
      therefore examined the spontaneous in vitro secretion of RF by intestinal lamina
      propria mononuclear cells (MNC) isolated from specimens from control and
      inflammatory bowel disease (Crohn's disease, ulcerative colitis) patients. Normal
      intestinal lamina propria MNC spontaneously secrete rheumatoid factors of
      different isotypes during 14 days of in vitro culture (9.7 ng/ml IgA RF, 11.6
      ng/ml IgM RF and 64.6 ng/ml IgA anti-Fc (IgG)). In matched studies intestinal MNC
      isolated from normal large bowel exhibited significantly greater levels of RF
      synthesis and secretion in vitro than normal small bowel intestinal MNC. A large
      increase in spontaneous RF secretion was observed from Crohn's disease intestinal
      MNC (21.4 ng/ml IgA RF, 21.4 ng/ml IgM RF, and 108.15 ng/ml IgA anti-Fc (IgG)),
      when compared with normal controls. The amount of RF secreted was dependent on
      the amount of inflammatory activity of the bowel specimens, from which the MNC
      were isolated (198.3 ng/ml of IgA anti-Fc(IgG) from involved versus 50.0 ng/ml
      from matched non-involved tissue). Ulcerative colitis MNC released decreased
      amounts of RF (7.1 ng/ml IgA RF, 6.2 ng/ml IgM RF, and 42.3 ng/ml IgA anti
      Fc(IgG)). These observations using isolated intestinal MNC may explain the
      findings of RF changes in the sera of inflammatory bowel disease patients. Our
      observations support the hypothesis of a heightened state of activation in normal
      intestinal lamina propria MNC, which is further increased in active Crohn's
      disease. The dissimilarities observed between Crohn's disease and ulcerative
      colitis may indicate fundamental differences in disease pathophysiology and will
      lead to further studies exploring intestinal immunoregulatory properties of RF.

PMID- 8467560
TI  - Lower antibody response to tetanus toxoid associated with higher auto-anti
      idiotypic antibody in old compared with young humans.
AB  - The production of anti-tetanus toxoid (TT) antibody and anti-anti-TT (auto-anti
      Id) antibody has been measured in three young and three old persons. Both
      antibodies were measured using ELISA. We found that: (i) the anti-TT response of
      old subjects was lower than that of young subjects, (ii) serum auto-anti-Id
      antibody concentration was higher in old compared with young humans before
      boosting with TT, and (iii) anti-TT antibodies from different humans shared Id
      cross-reactivity when tested with a rabbit anti-Id antibody. Thus, the serum anti
      TT antibody response to boosting was inversely correlated with the serum level of
      auto-anti-Id. This conclusion is consistent with the view that the higher level
      of auto-anti-antibody in older subjects contributes to their impaired antibody
      response to TT.

PMID- 8467561
TI  - Augmentation by transferrin of IL-2-inducible killer activity and perforin
      production of human CD8+ T cells.
AB  - The effects of human transferrin (Tf) on lymphokine (IL-2)-activated killer (LAK)
      induction from blood lymphocytes of healthy donors was examined. LAK cells were
      induced by 6-day incubation in medium with recombinant human IL-2 of lymphocytes,
      and their cytotoxic activity was assessed by measuring 51Cr release from NK
      resistant Daudi cells. Tf alone did not induce any LAK activity, but in
      combination with IL-2, it augmented LAK induction dose- and time-dependently.
      This augmenting effect was completely abolished by pretreatment with anti-Tf
      antiserum. Tf augmented the proliferative response of lymphocytes to IL-2 and
      their expressions of receptors for IL-2 and Tf. CD8+ T cells were isolated from
      purified blood lymphocytes using antibody-bound magnetic beads. Addition of Tf to
      cultures of CD8+ cells resulted in significant augmentation of killer cell
      induction and perforin (PFP) production after 4 days stimulation with IL-2. These
      results indicate that Tf is important in generation of IL-2-inducible killer
      properties and PFP activity of human CD8+ T cells.

PMID- 8467562
TI  - Cytokines involved in the progression of multiple myeloma.
AB  - We have investigated which of the cytokines that are relevant in the in vitro
      growth of multiple myeloma (MM) malignant plasma cells are actually produced in
      vivo by MM patients. To this end, we have measured the levels of IL-1 beta, IL-3,
      IL-4, IL-6, IL-7, IL-8 and tumour necrosis factor-alpha (TNF-alpha) both in sera
      and in the supernatant of bone marrow (BM) stromal cell cultures from patients
      with MM and monoclonal gammopathy of undetermined significance (MGUS). The
      significance of our findings is three-fold. First, IL-6 and IL-8 are produced by
      MM BM stromal cells, while IL-1 beta, TNF-alpha, IL-4 and IL-7 are not. Second,
      IL-3 is the only cytokine consistently raised in serum samples: we have also
      detected low levels of serum IL-6 in a minority of cases, usually in advanced
      stage of the disease. Third, MM BM stromal cells are active IL-6 and IL-8
      producers, while both normal and MGUS BM stromal cells are low producers, thus
      suggesting that in the BM of MM a number of environmental cells, that would
      normally be quiescent, are instead activated and that, in MM, activated BM
      stromal cells play an active role in supporting the progressive expansion of the
      B cell clone.

PMID- 8467563
TI  - Similar frequency of autoantibodies against 70-kD class heat-shock proteins in
      healthy subjects and systemic lupus erythematosus patients.
AB  - Stress or heat-shock proteins may be involved in the initiation and perpetuation
      of autoimmune diseases. In order to investigate a possible role of autoantibodies
      against the 70-kD family of heat-shock proteins in systemic lupus erythematosus
      (SLE), sera of SLE patients and healthy subjects were tested for the presence of
      IgG and IgM antibodies to 70-kD class proteins. These proteins were purified by
      affinity chromatography on ATP-agarose and used in Western blotting studies. The
      data obtained revealed that antibodies to the 72-kD and the 73-kD heat-shock
      proteins occurred with similar frequencies both in healthy subjects and SLE
      patients. Thus, approximately 20% of the sera in each group contained IgG
      antibodies, and IgM antibodies were detected in about 30% of the sera tested.
      Moreover, in SLE patients no association between the occurrence and titre of
      these antibodies and disease activity was found. These data suggest that
      antibodies to the 70-kD class heat-shock proteins are naturally occurring and
      argue therefore against an involvement of these antibodies in the pathogenesis of
      SLE.

PMID- 8467564
TI  - Interactions of anti-DNA antibodies with Z-DNA.
AB  - Systemic lupus erythematosus (SLE) sera, two classes of serum lipoproteins, and
      IgG antibodies from SLE and normal sera were tested for their reactivity with a Z
      DNA polymer, Br-poly (dG-dC). In all cases preferential binding to Z-DNA over B
      DNA was observed. This interaction, for the most part, could be inhibited by the
      negatively charged phospholipid, cardiolipin, which suggests that most of the
      anti-Z-DNA activity associated with sera arises from relatively non-specific
      ionic interactions between proteins and polyanionic molecules. An assay has been
      described that can eliminate proteins cross-reactive with negatively charged
      phospholipids.

PMID- 8467565
TI  - Significance of thyroglobulin antibodies cross-reactive with thyroperoxidase
      (TGPO antibodies) in individual patients and immunized mice.
AB  - Thyroglobulin (TG) and thyroperoxidase (TPO), both involved in thyroid hormone
      synthesis, represent major autoantigens in thyroid autoimmune disease. Despite
      numerous studies, the emergence, pathophysiological significance and role of
      autoantibodies to TG and TPO remain elusive. The recent identification of a new
      category of thyroid-specific autoantibody interacting with both TG and TPO (TGPO
      autoantibodies) offers a new opportunity in the study of thyroid autoimmunity. To
      gain a better insight into the significance of these TGPO autoantibodies,
      measurement in individual samples appeared necessary. The unique property of TGPO
      autoantibodies, simultaneous binding to TG and TPO, was used to set up a sandwich
      method which combined coated TG and radio-iodinated TPO. This method was found to
      be strictly specific for TGPO autoantibodies and sensitive enough to assay TGPO
      autoantibodies in serum. In humans, TGPO autoantibodies were found in most of the
      sera with high TG and TPO autoantibody titres, but not in sera negative for TG
      autoantibodies, whatever the TPO autoantibody titre. Furthermore, high TGPO
      autoantibody titres were found in sera strongly cytotoxic for cultured porcine
      thyroid cells. However, significant correlation of TGPO autoantibody titre was
      observed neither with TG and TPO autoantibody titres (n = 48) nor with complement
      dependent cytotoxicity (n = 50). TGPO antibody assay was also performed in
      individual plasma of CBA/J mice immunized with either human TG (n = 6) or human
      TPO (n = 6). Immunization with TG induced high levels of not only TG but also
      TGPO antibodies, which exhibited a strong reactivity for TPO and whose binding to
      TG and TPO was fully inhibited by TG. In contrast, immunization with TPO induced
      high levels of only specific TPO antibodies accompanied by low levels of specific
      TG antibodies. In this case TGPO antibodies were not detected. Of note, TG- and
      TPO-immunized mice mounted an immune response against their own TG, but did not
      exhibit histological signs of thyroiditis. Large panels of TG and TPO MoAbs were
      also investigated with this method: 18/25 TG MoAbs and only 1/13 TPO MoAbs were
      found cross-reactive. Taken together, these data provide evidence that TGPO
      antibodies are effectively present in individual patients and TG-immunized mice,
      are different from specific TG and TPO antibodies, and may derive from natural B
      cell repertoire by autoimmune processes involving TG and not TPO.

PMID- 8467566
TI  - Characterization of cytokine production in infectious mononucleosis studied at a
      single-cell level in tonsil and peripheral blood.
AB  - Cytokine profile and production was studied at a single-cell level in cells
      obtained from 14 patients with acute infectious mononucleosis (IM), with less
      than 7 days of symptomatic disease, by use of cytokine-specific MoAbs and
      indirect immunofluorescence technique. In producer cells, all the studied
      cytokines, except IL-1, accumulated in the Golgi system, which resulted in a
      characteristic morphology of the staining. Less than one in a thousand
      mononuclear cells obtained directly from IM blood and stained within 2 h of
      sampling produced IL-2, interferon-gamma (IFN-gamma), IL-4, IL-5, IL-6, IL-10, GM
      CSF, tumour necrosis factor-alpha (TNF-alpha) or TNF-beta, spontaneously.
      However, these cells were induced to cytokine synthesis by T cell receptor
      ligation in vitro using immobilized anti-CD3 MoAbs for 2-3 h restimulation under
      conditions which did not activate normal cells. By this approach 168 +/- 120
      cells/10,000 peripheral blood mononuclear cells produced IFN-gamma as compared
      with 10 +/- 8 cells/10,000 non-stimulated cultured cells obtained from IM
      patients (P < 0.001) and 1/10,000 cells obtained from healthy controls,
      respectively. No induced production of IL-2, IL-3, IL-4, IL-5, IL-10, GM-CSF or
      TNF-beta was detected in IM cells obtained from peripheral blood by this
      restimulation. In contrast, a spontaneous cytokine production was evident in
      tonsil material obtained from four IM patients tonsilectomized because of
      respiratory obstruction. From this site 160 +/- 40 cells/10,000 cells produced IL
      2, 40 +/- 30 cells IL-6, 30 +/- 30 cells TNF-beta and 35 +/- 25 cells IFN-gamma,
      respectively. No such spontaneous IL-2, IL-6, TNF-beta or IFN-gamma production
      was evident in control cells obtained from patients tonsilectomized because of
      chronic tonsil hyperplasia.

PMID- 8467567
TI  - Autoantibodies in malaria, tuberculosis and hepatitis B in a west African
      population.
AB  - Following reports of associations between autoantibodies and living in the
      tropics, we have studied the seroprevalence and nature of anti-nuclear
      antibodies, anti-cardiolipin antibodies, antibodies to extractable nuclear
      antigens and anti-neutrophilic cytoplasmic antibodies in 351 West Africans with
      malaria, tuberculosis or hepatitis B, or in good health. Amongst healthy West
      Africans we found a seroprevalence of 7% for anti-nuclear antibodies with several
      staining patterns, and of 30.3% for anti-cardiolipin antibodies. Among patients
      with tuberculosis and malaria there was twice that frequency of anti-nuclear
      antibodies (predominantly speckled in pattern), and anti-neutrophil cytoplasmic
      antibodies (predominantly IgM) were demonstrated in a few cases. A possible
      association between IgG anti-cardiolipin antibodies and tuberculosis was observed
      (P < 0.05), but antibodies to double-stranded DNA were not elevated and no
      antibodies to extractable nuclear antigens were found in any of the patients or
      healthy individuals studied. Our findings suggest the need for caution in the
      interpretation of autoantibody tests in subjects from or living in the tropics,
      as well as in patients with tropical infections.

PMID- 8467568
TI  - An immunohistochemical analysis of onchocercal nodules: evidence for an
      interaction between macrophage MRP8/MRP14 and adult Onchocerca volvulus.
AB  - We have used a panel of MoAbs to investigate the phenotype of macrophages and
      other leucocytes infiltrating onchocercal nodules. Nodules were removed from
      individuals at the end of the second year of a community-based, placebo
      controlled trial of annual ivermectin chemotherapy in northern Nigeria. No
      significant differences were seen in the distribution and phenotype of leucocytes
      in nodules from ivermectin- and placebo-treated individuals. Live adult worms
      were only seen in nine of the 21 nodules examined. Three regions were clearly
      discernible within nodules containing both live and dead worms; an outer
      fibrovascular capsule (zone A), an inner adult worm bundle with surrounding
      hyaline extracellular matrix interspersed with solitary cells (zone B), and a
      dense cellular infiltrate surrounding and in contact with a variable proportion
      of the worm (zone C). Macrophages were the predominant cell type in all zones of
      the nodule. Those in zone B were distinguished by their dendritic morphology and
      strong reactivity with MoAbs directed against class II molecules, FcRI (CD64) and
      CD68, whereas macrophages in zone C were larger, more heterogeneous in shape, and
      were distinguished by strong reactivity with MoAbs directed against CR4 (CD11c,
      CD18) and MRP8/MRP14, and with MoAb24. T cells were found primarily in zones A
      and C, whilst eosinophils were found in only six nodules. A unique staining
      pattern was seen using MoAbs reacting with the calcium-binding protein
      MRP8/MRP14. Most macrophages in zones A and B were negative; however, where the
      occasional positive macrophage was seen in zone B, MRP8/MRP14 was also found
      around the cell and on the neighbouring worm surface, giving the impression that
      MRP8/MRP14 was being secreted onto the adult worm. Macrophages in zone C were
      also MRP8/MRP14-positive, and often the whole infiltrate was surrounded with
      extracellular MRP8/MRP14, with greatest concentration seen adjacent to the worm.
      MRP8/MRP14 was not identified on the surface of microfilariae (MF) within the
      same nodules. Since MRP8/MRP14 was seen on the adult worm in the absence of a
      leucocytic infiltrate, it may have an early role to play in the immune response
      to Onchocerca volvulus.

PMID- 8467569
TI  - The angiotensin-converting enzyme inhibitor, perindopril, prevents cardiac
      hypertrophy in low-renin hypertensive rats.
AB  - 1. To examine whether an angiotensin-converting enzyme (ACE) inhibitor prevents
      left ventricular (LV) hypertrophy even in low-renin hypertension, we studied the
      effect of the administration of perindopril on cardiac hypertrophy induced by
      partial renal ablation in hypertensive rats. 2. Rats that had undergone partial
      nephrectomy were randomly divided into four groups that received the following as
      drinking water: Group A, tap water; Group B, 1% sodium chloride (NaCl); Group C,
      NaCl + perindopril 3 mg/kg per day; and Group D, NaCl + perindopril 1 mg/kg per
      day. Plasma renin activity (PRA), angiotensin-II (AII) concentration and cardiac
      tissue AII were measured. 3. Supplementation of NaCl following nephrectomy
      increased the blood pressure and cardiac weight compared with rats that had
      undergone nephrectomy alone (P < 0.05). Treatment with perindopril (3 mg/kg per
      day) did not affect the blood pressure and plasma AII but inhibited the increase
      of cardiac weight (P < 0.05). Left ventricular AII was decreased in cases of
      reduced renal mass hypertension, but was not changed by treatment with
      perindopril. 4. These results demonstrate that perindopril may be able to prevent
      LV hypertrophy even in low-renin hypertension, which was not mediated by a
      reduction of blood pressure or suppression of the circulating and cardiac renin
      angiotensin systems. Other mechanisms of ACE inhibitors may contribute to the
      cardioprotective effects.

PMID- 8467570
TI  - The inhibition of nitric oxide-mediated relaxations in rat aorta and anococcygeus
      muscle by diphenylene iodonium.
AB  - 1. The effects of diphenylene iodonium (DPI), an inhibitor of reduced
      nicotinamide adenine dinucleotide phosphate-dependent oxidases (which generate
      superoxide anions), were studied on nitric oxide (NO)-mediated responses in
      isolated preparations of the rat aorta and anococcygeus muscle. 2. In aortic
      rings, the endothelium-dependent relaxant action of acetylcholine was reduced by
      DPI (0.3-10 mumol/L) in a concentration-dependent manner and abolished by the NO
      synthase (NOS) inhibitor L-nitro-NG-arginine methylester (L-NAME; 100 mumol/L).
      Relaxations induced by sodium nitroprusside (SNP) or NO were not affected by DPI
      or L-NAME. 3. In anococcygeus muscles, DPI (0.3-10 mumol/L) as well as L-NAME (5
      100 mumol/L) produced concentration-dependent reductions of relaxations produced
      by nitrergic nerve stimulation. Relaxations induced by NO and SNP were not
      affected by either DPI or L-NAME. L-Arginine (1 mmol/L) prevented the reduction
      of nitrergic relaxations by L-NAME but not by DPI. 4. Contractions of
      anococcygeus muscles elicited by exogenous noradrenaline (1 mumol/L) were not
      affected or were inhibited by DPI (0.3-10 mumol/L), but the contractions elicited
      by noradrenergic nerve stimulation were significantly enhanced by DPI and L-NAME.
      When noradrenergic contractions had already been maximally enhanced by L-NAME
      (100 mumol/L), DPI produced no further enhancement. L-Arginine (1 mmol/L)
      prevented the enhancement of noradrenergic contractions by L-NAME but not by DPI.
      5. The efflux of radioactivity induced by field stimulation from anococcygeus
      muscles previously incubated with [3H]-noradrenaline was not affected by either
      DPI or L-NAME.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467571
TI  - Circadian variations of blood pressure and pulse rate in essential hypertensives
      with diabetes mellitus.
AB  - 1. The circadian variations of blood pressure and pulse rate in essential
      hypertensives either with or without diabetes mellitus were studied. 2. Diabetic
      patients with orthostatic hypotension showed an increase in variability of blood
      pressure and a decrease in that of pulse rate when assessed by coefficient of
      variation. Cosinor analysis showed no significant circadian rhythm in both blood
      pressure and pulse rate in these patients. 3. There were no differences in the
      circadian variations of blood pressure and pulse rate between essential
      hypertensives with and without diabetes mellitus unless orthostatic hypotension
      was present. 4. These results suggest that diabetes mellitus per se does not have
      any effects on the circadian variations of blood pressure and pulse rate in
      essential hypertensives unless autonomic neuropathy is present.

PMID- 8467572
TI  - Decreased norepinephrine content in the medulla oblongata in severely
      hypertensive rats.
AB  - 1. To clarify possible abnormalities in catecholamines in the medulla oblongata
      in relation to severe hypertension, the authors measured changes in catecholamine
      levels in the medulla oblongata of malignant stroke-prone spontaneously
      hypertensive rats (M-SHRSP). Effects of the adrenal medullae and peripheral
      nerves were ruled out by adrenal demedullation and chemical sympathectomy. 2. The
      level of norepinephrine in the medulla oblongata was significantly lower in
      untreated M-SHRSP than in untreated WKY (control) rats at 10 weeks of age.
      Further, it was significantly lower in treated M-SHRSP than in the treated WKY
      group at both 6 and 10 weeks of age. The level of epinephrine in 6 week old
      treated M-SHRSP was significantly higher than that in age-matched treated WKY,
      but no other differences were observed in terms of epinephrine content. There
      were no age- or treatment-related differences in dopamine levels in the medullar
      oblongata. 3. Since norepinephrine has an inhibitory effect on blood pressure
      elevation in the nucleus tractus solitarii (NTS) in the medulla oblongata, the
      suppression of negative feedback due to a decrease in the activity of inhibitory
      neurons in the medulla oblongata appears to be involved in the development and
      progression of severe hypertension in M-SHRSP.

PMID- 8467573
TI  - Biliary hyperpressure in rat extrahepatic cholestasis alters horseradish
      peroxidase biliary excretion.
AB  - 1. The authors investigated the effect of two extrahepatic cholestasis models
      (one by bile duct ligation and the other by choledocho-jugular fistula) on the
      hepatic clearance of horseradish peroxidase in male Sprague-Dawley rats divided
      into four groups. 2. In groups A (n = 5 rats) and B (n = 5), bile duct ligation
      was performed, while a choledocho-jugular fistula was created in groups C (n = 5)
      and D (n = 7). A 10 mg intravenous bolus of horseradish peroxidase was injected
      after 24 h (groups A and C), 48 h (groups B and D) or 1 h (Group E; five sham
      operated rats). Serum and bile samples were then serially collected for 2 h. 3.
      In all groups, serum horseradish peroxidase levels increased soon after injection
      and then rapidly decreased, the curves being similar. Biliary excretion increased
      for 30 min and then slowly decreased. The highest horseradish peroxidase biliary
      concentrations and outputs were found in Group B followed by Group A; both groups
      had significantly higher levels than Group E. No difference was found between
      horseradish peroxidase biliary excretion of groups C and D and that of sham
      operated rats. 4. When each group was considered separately, sampling times
      correlated with the corresponding ratios of bile/plasma HRP. Significant
      differences were found between the relative slopes of groups A, B and E, but not
      between those of groups C, D and E. 5. In conclusion, bile duct obstruction
      greatly affects the plasma-bile transfer of fluid phase markers, such as
      horseradish peroxidase, while single retention, caused by choledocho-jugular
      fistula, has no influence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467574
TI  - A study on the role of cholinergic and gamma amino butyric acid systems in the
      anti-nociceptive effect of gossypin.
AB  - 1. The participation of cholinergic and gamma amino butyric acid (GABA)
      neurotransmitter systems in the anti-nociceptive effect of gossypin was
      investigated using pharmacological tools. 2. Physostigmine potentiated its anti
      nociceptive response while atropine failed to modify it significantly. 3. THIP
      (4,5,6,7-tetra hydroisoxazolo (5,4-C) pyridin-3-ol) and gossypin treatment
      produced an additive response while bicuculline attenuated the anti-nociceptive
      response of gossypin. Similar observations were recorded for morphine. 4. It is
      suggested that cholinergic and GABAergic systems play a role in gossypin-induced
      anti-nociception.

PMID- 8467575
TI  - Novel microscopy using fibre optic confocal imaging and its suitability for
      subsurface blood vessel imaging in vivo.

PMID- 8467576
TI  - Differences in the expression of spondyloarthropathy: a comparison between
      ankylosing spondylitis and psoriatic arthritis.
AB  - The aim of the study was to compare the spondyloarthropathy of ankylosing
      spondylitis (AS) to that of psoriatic arthritis (PsA). Forty patients with AS and
      66 patients with PsA underwent a complete assessment according to a standard
      protocol, including radiographic evaluation and HLA typing. A logistic regression
      analysis was performed controlling for age, arthritis duration, and sex. A higher
      frequency of inflammatory neck and back pain and stiffness (p < 0.0002),
      limitation of back movements (p < 0.0006), grade 4 sacroiliitis (p = 0.007), and
      syndesmophytes (p = 0.005) was noted in AS, while peripheral arthritis was more
      common and more severe in patients with PsA (p = 0.002). A lower frequency of HLA
      B17 (p = 0.02), and a higher frequency of HLA B27 (p = 0.0001), and Cw2 (p <
      0.01) was found in AS compared to PsA. Thus, there are clinical, radiologic, and
      genetic differences in disease expression of the SA of AS and PsA, supporting
      their classification as distinct entities.

PMID- 8467577
TI  - Uptake of ferritin by isolated rat hepatocytes. Effect of metabolic inhibitors
      and iron.
AB  - To further characterize the hepatic endocytic pathway of ferritin, the effects of
      inhibitors of intracellular dissociation of ligands (monensin 15 microM,
      chloroquine 400 microM), intracellular proteolysis (leupeptin 100 microM) and
      iron loading on the endocytosis of 125I-rat liver ferritin were studied in
      isolated rat hepatocytes. Cell associated radioactivity at 37 degrees C was
      decreased by 27% with chloroquine and 18% with monensin after 4 h. Cell
      associated radioactivity increased by 38% with leupeptin at 37 degrees C. Acid
      soluble radioactivity in the extracellular medium was significantly decreased at
      4 h in the leupeptin group, which suggests that leupeptin inhibited the lysosomal
      degradation of the 125I-ferritin resulting in intracellular accumulation of
      ligand rather than increased uptake of ferritin. Iron loading of cells (5.4-fold
      increase in intracellular iron) did not significantly alter the binding or
      accumulation of 125I-ferritin. The characteristics of the endocytic pathway for
      ferritin are more similar to the asialoglycoprotein receptor than the transferrin
      receptor, and the hepatic uptake of ferritin is unaffected in this study by
      increasing the intracellular iron concentration.

PMID- 8467578
TI  - Middle cerebral artery blood flow velocity in the newborn following delivery.
AB  - Ninety-five normally grown term and preterm newborns were examined to determine
      the means and prediction limits of cerebral blood flow velocity following
      delivery and to examine the relationship of systemic blood pressure to cerebral
      blood flow velocity. Doppler blood flow velocity was observed during the four
      days following delivery. Continuous measures of blood pressure and heart rate
      were recorded concurrently. Mean peak systolic and end diastolic blood flow
      velocity immediately following delivery was 43.2 and 9.3 cm/sec for term newborn,
      and 31.8 and 3.3 cm/sec for preterm newborn. During the 24 h following delivery
      there was no change of peak systolic blood flow velocity but a two to three fold
      increase of end diastolic blood flow velocity in the term and preterm newborn.
      The reference limits for peak systolic and end diastolic blood flow velocity
      provide criteria to define abnormal increases and decreases of blood flow
      velocity. During the 24 h following delivery, increasing diastolic blood pressure
      was associated with increasing end diastolic blood flow velocity independent of
      birth weight and time following delivery. Also there was a significant
      correlation between systemic pressure pulsatile index and middle cerebral artery
      blood flow velocity pulsatile index. Thus systemic blood pressure pulsatility
      must be recognized as distinct from other intracerebral influences on cerebral
      blood flow velocity regulation in the newborn.

PMID- 8467579
TI  - Bacteremic community-acquired pneumonia due to viridans group streptococci.
AB  - We studied 1118 patients with community-acquired pneumonia who were admitted to
      our hospital over an 8-y period. Seventy-six of the 1118 patients were bacteremic
      and 7 (9.2%) of these had blood cultures positive for various viridans
      streptococci. Four had polymicrobial bacteremia (S. mitis, S. sanguis 1, S.
      sanguis II; S. mitis, S. sanguis II; S. MG; S. sanguis II, Neisseria sp; S.
      intermedius, S. aureus). For 3 of the 7, viridans streptococci were the only
      agents implicated in the etiology of the pneumonia. These patients were
      classified as definite viridans streptococcal pneumonia; the remaining 2 were
      probably and 2 were possibly due to these micro-organisms. The 5 males and 2
      females had a mean age of 61.8 y. The mortality rate was 28%. All were febrile
      and had elevated white blood cell counts. The 5 who had arterial blood gas
      measurements performed were hypoxemic pO2 34-68 torr. The chest radiographs were
      not distinctive--a segmental alveolar opacity was the most common abnormality. We
      conclude that viridans streptococci rarely cause bacteremic community-acquired
      pneumonia. There are no distinctive clinical or radiographic features of this
      type of pneumonia.

PMID- 8467580
TI  - The absorption and bioactivity of bacterially synthesized menaquinones.
AB  - After optimizing conditions for maximal production of menaquinones (MK), S.
      aureus and B. vulgatus were grown in batches, harvested and extracted for
      qualitative and quantitative MK content utilizing HPLC (high performance liquid
      chromatography) until a total of 6 mg was available. Five normal healthy male
      volunteers were placed on a vitamin K1 deficient diet (< or = 25 micrograms/day)
      and were subsequently warfarinized to maintain a prothrombin time (PT) 1.5-2
      times control. Following stabilization of daily warfarin dosage 1 mg doses of the
      extracted MK were orally administered. As a control, the same volunteers were
      later warfarinized but no MK was given. Within 24 h of MK administration the
      prothrombin time (PT) decreased (mean +/- SEM) 3.6 +/- 1.0 s (p < 0.005) and the
      Factor VII level increased 0.36 +/- 0.3 u/ml (p < 0.005) vs a PT increase of 1.0
      +/- 1.0 s (p > 0.1) and a Factor VII level increase of 0.03 +/- 0.1 u/ml (p >
      0.1) in the control phase. Within 48 h of MK administration the PT was normal in
      all subjects but remained > or = 1.5 times control in the control phase. These
      data demonstrate for the first time the absorption and bioactivity of bacterially
      synthesized vitamin K in humans.

PMID- 8467581
TI  - Parathyroid hormone: regulation of synthesis and secretion.
AB  - Calcium homeostasis is essential for survival and is primarily achieved through
      the actions of parathyroid hormone. Parathyroid hormone secretion and synthesis
      are primarily regulated by serum calcium levels, although other factors such as
      vitamin D and neurotransmitters play a role. This review is intended to provide
      the reader with up to date information on the current state of basic cell
      regulation research into parathyroid function. While some mention of disease
      states is made, the focus of this review is on the calcium regulation of
      parathyroid hormone secretion at the molecular level. Individual sections will
      discuss calcium-sensing, signal transduction by calcium and other secretagogues,
      regulation of parathyroid hormone synthesis, and strategies of regulation of
      parathyroid hormone secretion by calcium. Particular emphasis is given to the
      calcium-stimulated degradation of parathyroid hormone within the parathyroid as
      one of the major pathways by which circulating levels of bioactive hormone are
      controlled.

PMID- 8467582
TI  - Are contemporary methods for somatic gene therapy suitable for clinical
      applications?
AB  - Clinical trials involving the introduction of recombinant genes into human
      subjects began in 1989 after a decade of earnest debate concerning the technical,
      social, and ethical implications of somatic gene therapy. The initial trials
      involved the introduction of recombinant genes into peripheral blood lymphocytes
      to study the characteristics of tumor infiltrating lymphocytes, enhance
      immunotherapy for cancer, and treat severe combined immunodeficiency due to
      adenosine deaminase deficiency. Additional clinical trials involving the
      introduction of genes into bone marrow, hepatocytes, and tumor cells are
      underway. Are these clinical trials premature? This article reviews basic methods
      for somatic gene therapy and the clinical trials which have been proposed or
      performed to date. This clinical experience suggests that gene therapy can be
      performed in select clinical trials safely and with public acceptance. Clinical
      trials have provided essential data concerning the feasibility and safety of gene
      transfer in human subjects. These trials have also brought a clinical focus to
      the assessment of technologies currently being used in experimental models. While
      there will certainly be significant advances in somatic gene therapy in the
      future, existing methods may be employed fairly in clinical trials.

PMID- 8467584
TI  - Brachial plexus injury. Postgraduate Boerhaave course. Leiden, March 25-26, 1993.

PMID- 8467583
TI  - Ferguson's BCG research--Canada's first randomized clinical trial?

PMID- 8467585
TI  - Brachial plexus injuries.

PMID- 8467586
TI  - Peripheral nerve lesions: the neuropharmacological outlook.
AB  - A review is presented of compounds with trophic effects on the peripheral nervous
      system. A distinction should be made between three types of effect: enhancement
      of neurone survival, stimulation of regeneration and induction or stimulation of
      collateral sprouting. On the basis of data currently available, laminin and
      insulin-like growth factor I are the most promising substances for regeneration
      of peripheral nerve lesions. Future investigations of laminin should provide an
      answer to the query whether local administration facilitates sprouts to cross the
      gap between proximal and distal nerve stumps. Further experiments are required on
      effects of systemic administration of IGF-I in animal models of peripheral nerve
      lesions before investigations can be initiated in man.

PMID- 8467587
TI  - Functional recovery after ventral root avulsion and implantation in the spinal
      cord.
AB  - This survey describes experiments performed in rats, cats and monkeys aiming at
      the management of motor deficits after ventral root rupture or avulsion from the
      spinal cord as seen in brachial plexus lesions. After intramedullary implantation
      of the ruptured or avulsed ventral root, neurophysiological data show that alpha
      and probably also gamma motoneurons are capable of producing new axons which
      regrow for a considerable distance in the spinal cord before entering the
      implanted root. Intracellular physiological experiments demonstrate that new
      axons can conduct action potentials and elicit muscle responses. The neurons are
      reconnected in segmental spinal cord activity and respond to impulses in sensory
      fibres. In primates, implantation of avulsed ventral roots in the brachial plexus
      resulted in functional restitution. It is concluded that intraspinal implantation
      of avulsed ventral roots significantly promotes motor recovery in the muscles
      supplied by the lesioned spinal cord segments. These studies indicate the
      possibility of surgical treatment of ventral root avulsion injuries in brachial
      plexus lesions in man.

PMID- 8467588
TI  - Reimplantation of ventral rootlets into the cervical spinal cord after their
      avulsion: an anterior surgical approach.
AB  - Root avulsions from the cervical spinal cord due to traction injuries are beyond
      repair up to the present day. An anterior surgical approach has been developed in
      cats for reimplantation of the ventral rootlets into the site of avulsion. The
      consecutive surgical steps towards exposure of the ventral surface of the
      cervical cord are given in detail. The morphological relations during the
      operative procedure are explained in the text and by illustrations. In this study
      the surgery related mortality rate was 16% and the overall mortality rate
      amounted to 21%. Loss of blood, initially a major problem, was coped with by
      increasing technical experience and the infusion of plasma expanding fluid. In 2
      animals with survival times of 209 and 293 days respectively, many ventral horn
      motoneurons were found HRP-positive after retrograde HRP transport through the
      site of reimplantation. The findings provide evidence that the axonal continuity
      between reimplanted ventral roots and their motoneurons may be restored.

PMID- 8467589
TI  - The topographical anatomy of the brachial plexus.
AB  - The anatomy of the shoulder region is discussed focusing on the course of the
      brachial plexus. Magnetic resonance imaging enables one to visualize the
      topographical anatomy of this area.

PMID- 8467590
TI  - The dorsoscapular nerve in traumatic brachial plexus lesions.
AB  - The origin and course of the nerval innervation of the levator scapulae and
      rhomboid muscles was studied in four human cadavers. Special attention was given
      to surgical anatomy. The levator scapulae muscle receives two small segmental
      nerves from C3 and C4, respectively. The rhomboid muscle receives two segmental
      nerves, one from C4 and the other from C5. Moreover, in a series of 137 patients
      with a traumatic brachial plexus lesion, the linkage between levator scapulae and
      rhomboid muscle function impairment and site of the brachial plexus lesion was
      studied. Paresis of one or both of these muscles was noted in 13 cases. It was
      concluded that the rhomboid muscle may function on a single C4 nerve supply
      without any loss of strength. Arguments are put forward to support the relevance
      of rhomboid muscle testing in the assessment of brachial plexus lesions.

PMID- 8467591
TI  - Mechanisms of brachial plexus lesions.
AB  - The main causes of brachial plexus palsies are traction, due to extreme
      movements, and heavy impact. In downward traction of the arm and forcible
      widening of the shoulder-neck angle the lesion will occur in the upper roots and
      trunk. Forcible upward traction will cause avulsion of T1 and C8. The most
      violent trauma will result in a lesion at all levels. Rupture of the cords and/or
      individual infraclavicular nerves will be produced by traction and/or forcible
      widening of the scapulohumeral angle. Vascular structures are subjected to the
      same mechanism and injuries of these structures give information about the site
      and severity of nerve lesions; fractures of the skull, cervical spine, clavicle,
      first rib or arm yield further data on the mechanism of trauma that has produced
      the brachial plexus palsy. Heavy impact or crush lesions are caused by direct
      trauma to the (supra)clavicular region and are nearly always associated with
      fracture of the clavicle.

PMID- 8467592
TI  - A rostrocaudal somatotopic organization in the brachial dorsal root ganglia of
      neonatal rats.
AB  - A rostrocaudal somatotopic organization in the rat lumbar dorsal root ganglia
      (DRGs) during development has been demonstrated. The present study shows that
      such a rostrocaudal somatotopic organization also exists in the brachial DRGs of
      neonatal rats. WGA-HRP or WGA-HRP/HRP injections into the forepaw of neonatal
      rats gave rise to completely and partially labeled DRGs. Partial labeling always
      concerned the caudal or rostral halves of the rostral-most or caudal-most labeled
      DRGs, respectively. Labeling of forelimb nerves (cutaneous branch of the
      musculocutaneous nerve, median and ulnar nerve) in neonatal rats also resulted in
      whole labeled DRGs and labeled rostral or caudal halves of DRGs. Accordingly,
      just as was found for the hind limb nerves, the position of the somata of the
      sensory neurons of forelimb nerves can be restricted to the rostral or caudal
      half of a DRG. Moreover, it was observed that the rostrocaudal organization in
      the brachial DRGs is maintained in the spinal nerves. Application of tracer to
      the cut end of intercostal nerves in neonatal rats produced labeling of one whole
      thoracic DRG. It is therefore possible that the rostrocaudal organization in the
      brachial and lumbar DRGs is a consequence of the formation of the plexuses. In
      one instance a subdivision in the labeling pattern of a midthoracic DRG was
      noticed after a WGA-HRP injection into the thoracic wall of a neonatal rat. The
      whole thoracic DRG was labeled except the dorsorostral corner. This indicates
      that during development, some kind of somatotopic organization may exist also in
      the thoracic DRG.

PMID- 8467594
TI  - The tensile testing machine applied in the study of human nerve rupture: a
      preliminary study.
AB  - A tensile testing machine was used to provoke lesions of fixed and unfixed
      brachial plexus nerves. The forces and mechanical work were measured before and
      during rupture. Fixed nerves resist continued tensile forces better than unfixed
      nerves do. Increasing the speed of the tensile forces results in a decrease of
      the extension a brachial plexus nerve can withstand. The mechanical work needed
      to start rupture is equal to the mechanical work used to complete rupture of the
      nerve.

PMID- 8467593
TI  - Brachial plexus injury in multitraumatized patients.
AB  - The majority of patients presenting with a brachial plexus traction injury suffer
      from multisystem trauma. The consequences are discussed. Occlusion of the
      axillary artery is an associated lesion which rarely produces ischaemia of the
      upper limb. Repair may preferentially be carried out together with elective
      plexus reconstructive surgery.

PMID- 8467595
TI  - Neuroradiological investigations in cervical root avulsion.
AB  - Cervical myelography in combination with CT myelography is not fully reliable to
      demonstrate a partial or complete cervical root avulsion. MRI scanning can
      demonstrate large traumatic meningoceles or additional lesions, such as
      intramedullary or extradural haematomas, but not a root avulsion. In experimental
      conditions MR microscopy enables visualization of the avulsed root separated from
      the spinal cord. The anterior funiculus shows transverse tracts left behind by
      the avulsion at the original site of the motor fibres. However, the small bore of
      the current high field magnets and the very long acquisition time makes this
      method, as yet, unsuitable for application in man.

PMID- 8467596
TI  - Ultrastructural study on avulsion effects of the cat cervical moto-axonal
      pathways in the spinal cord.
AB  - After selective avulsion of the ventral root cervical 7 (C7) from the adult cat
      spinal cord, the intraspinal trajectories of the torn axons in the white matter
      were studied at different survival times. Two phases could be discerned: an early
      phase which showed changes that occurred up to 14 days after avulsion and a
      second phase from day 30 onwards. Two days postoperatively, considerably swollen,
      empty myelin sheaths occurred, which remained present up to 14 days after
      avulsion. A primary increase in the number of glial cells (microglia) was noted
      on days 2 and 4 after avulsion. Ultrastructurally, unmyelinated and myelinated
      terminal clubs were found 8 and 14 days after avulsion. These clubs were
      characterized as cones of growth, related to axonal regeneration. A second glial
      increase was present after 30 days. At that time, the entire moto-axonal pathway
      clearly showed a degeneration pattern. This finding was light microscopically
      confirmed by an increase of GFAP-positive astrocytes. During the first 30 days, a
      front of small calibre myelinated axons, starting at the transition zone of the
      grey and white matter traversed halfway through the moto-axonal pathway. However,
      on days 60 and 90 no further shift of the front had occurred.

PMID- 8467597
TI  - Computer assisted diagnosis and treatment planning of brachial plexus injuries.
AB  - PLEXUS is a computer program which has been developed to provide recommendations
      for diagnosis and treatment planning of brachial plexus injuries. This computer
      program is meant for neurologists, neurosurgeons and orthopaedic surgeons who are
      not experienced in the field of brachial plexus injuries. The system detects the
      locations and severity of brachial plexus lesions. PLEXUS also indicates whether
      the patient may be referred to a specialist centre for nerve surgery. In order to
      determine whether the advice given by the system is of expert quality, a study of
      its recommendations is being carried out in cooperation with four international
      brachial plexus experts. To investigate if the system does indeed have the
      capability to assist physicians in the area of brachial plexus injuries, it is
      being tested clinically in four hospitals in The Netherlands.

PMID- 8467598
TI  - Lesions found when operating traction injuries of the brachial plexus.
AB  - Traumatic traction injuries occurring mostly during road traffic accidents
      frequently cause severe lesions of the brachial plexus. 108 patients with such
      lesions were surgically explored in the last 5 years by one surgeon. By contrast,
      101 patients with other lesions to the brachial plexus or various injuries to
      neighbouring nerves were operated on during the same period. Among the former,
      root avulsions were found in 73 patients, 33 presenting with 4 or all roots
      avulsed. In 14 of these patients the subclavian artery was ruptured. Out of 17
      patients with infraclavicular distal plexus lesions 7 presented with a rupture of
      the axillary artery. The severity of the lesions to nerves and vessels in the
      shoulder girdle region seems to have increased over the past 10 years. The
      different injury patterns seen at operation are presented.

PMID- 8467599
TI  - Surgical repair of brachial plexus injury.
AB  - This preliminary report surveys the authors' experience in the treatment of 66
      patients with brachial plexus traction injuries. The results of nerve
      reconstructive surgery obtained in 44 patients with a follow-up of at least 2
      years were disappointing; on average, 10% of upper limb function was added. The
      role of several factors involved in this type of injury and the major draw-backs
      of treatment are discussed in combination with future possibilities. Current
      techniques of neurotizations are presented in one case.

PMID- 8467600
TI  - Obstetric brachial plexus lesions and their neurosurgical treatment.
AB  - The present series of 655 brachial plexus lesions includes 240 obstetric palsies.
      The results of neurophysiological and radiological examinations in these cases
      are often disappointing in regard to the evaluation of the severity of the
      lesion. Timing for surgery was according to the criterium of Gilbert: lack of
      clinical signs of recovery of the biceps at the end of the third month. Intra-
      and/or extraplexal neurotizations were performed in 94 children. Although only 28
      children operated upon have been followed up for at least 2 years, some tentative
      conclusions may be drawn. A good to very good result was achieved in 10 children
      with an upper plexus lesion, born in cephalic presentation. In breech
      presentation cases, often associated with root avulsion, and in (sub)total
      lesions, the final result was much less.

PMID- 8467601
TI  - Perineurial cells are the first to traverse gaps of peripheral nerves in silicone
      tubes.
AB  - Silicon tubes were used to study the outgrowth and differentiation of the
      perineurium around the cord bridging the gap between the proximal and distal
      stumps of the transected sciatic nerve of rats. The sequence of events was
      investigated at time intervals 3, 7, 12, 18, and 21 days after surgery. Although
      similar tubulation systems have been used to investigate various aspects of
      peripheral nerve fibre regeneration, the present study shows for the first time
      with electron microscopic and immunocytochemical methods that a primitive
      perineurium bridges the gap as the initial cellular element. This perineurium
      develops from outgrowing fibroblasts as early as 7 days post surgery, forming a
      tube which is used as a guiding structure for subsequent cellular elements. The
      proximal and distal perineurial tubes join between 12 and 18 days after surgery
      thus representing the first connection between the proximal and distal nerve
      stumps. Blood vessels, Schwann cells, and axons appear to follow in this
      sequence.

PMID- 8467602
TI  - Nerve growth factor and regeneration of peripheral nervous system.
AB  - Nerve growth factor, a well-known neurotrophic factor, supports the survival,
      differentiation and maintenance of sensory and sympathetic neurons during
      embryonic development and in the adult. This paper summarises the data on its
      involvement in peripheral nerve regeneration.

PMID- 8467603
TI  - Muscle transpositions in the shoulder and upper arm for sequelae of brachial
      plexus palsy.
AB  - Permanent deficiency in abduction and external rotation of the arm seen after
      brachial plexus injury may be corrected by a levator scapulae transposition onto
      the supraspinatus, while the teres major, associated or not with latissimus
      dorsi, is transferred onto the infraspinatus muscle. Transposed in a bipolar
      manner, the latissimus may compensate the deltoid muscle. Associated measures
      have to be carried out in children with deformities caused by obstetrical palsy.
      A paralysed serratus anterior is best compensated by a transfer of the pectoralis
      major together with pectoralis minor muscle.

PMID- 8467604
TI  - Musculo-tendinous transfers of the hand and forearm.
AB  - The concept of providing a more equitable distribution of forces acting upon a
      disabled limb is the basis of tendon transfers. The musculo-tendinous transfer is
      usually performed by moving the insertion, thereby altering the direction of the
      unit in an attempt to replace a lost function. In order to obtain a successful
      result basic principles have to be followed. The transferred muscle must have
      enough strength, should have approximately the same amplitude as the muscle whose
      function it is replacing and should have a straight line of pull from the origin
      to the new insertion or distally from the newly created pulley. Furthermore, the
      nerve and blood supply should remain intact during the actual transfer. In the
      event of scarred tissue or poorly mobilized joints treatment should first deal
      with these problems before tendon transfer is carried out. After careful
      assessment of the patient's disability a plan of operation can be conceived on
      the basis of the extent of functional loss balanced against the muscle force
      available for transfer. Essential for forearm and hand function are wrist
      extension and finger flexion as well as thumb and intrinsic function. The loss of
      these functions may be compensated for by a variety of motors. The choice is made
      on the basis of the available possibilities and the demands of the patient. To
      obtain optimal postoperative results physiotherapy of the hand and a well
      motivated patient are necessary.

PMID- 8467605
TI  - Respiration-related activity in the biceps brachii muscle after intercostal
      musculocutaneous nerve transfer.
AB  - Needle EMG and polygraphic recordings of respiration and biceps activity were
      obtained in 7 patients who had undergone intercostal to musculocutaneous nerve
      transfer because of severe traumatic injury to the brachial plexus. EMG activity
      during expiration and inspiration was assessed during quiet breathing, deep
      breathing, and during sustained inspiration and expiration, and compared to the
      clinical strength of the biceps muscle. Biceps activity was consistently found
      during both expiration and inspiration, and in either case separately related to
      the flexion force levels. Initially this relationship appeared equally strong for
      both phases. With time, control over flexion changes from a completely
      respiratory-driven control to a conscious volitional control; however,
      involuntary effects of respiration always remained present in polygraphic
      recordings. Theoretical explanations for the change in control are put forward.

PMID- 8467606
TI  - XIIIth European Workshop for Rheumatology Research. Brighton, UK, 28-30 January
      1993. Abstracts.

PMID- 8467607
TI  - The occurrence of fibromyalgia-like syndromes in a general female population.
AB  - In an epidemiological survey of females aged 20-49 years in Arendal, Norway, 217
      persons with musculoskeletal pain were examined for the presence of fibromyalgia
      as defined by the ACR criteria of 1990. Forty females with fibromyalgia were
      found whereas 129 females had chronic musculoskeletal pain of more than three
      months duration but failed to meet the criteria. Two females suffered from
      nonrheumatic disorders which could explain their musculoskeletal pain. Forty-six
      females had pain of less than three months duration. Somewhat surprising, the
      presence of tender points and symptoms regarded as typical of fibromyalgia were
      rather frequently observed among the females who failed to satisfy the ACR 1990
      criteria. No other diseases were found which could explain their complaints or
      clinical findings. The presence of fibromyalgia-like syndromes is suggested, and
      the classification and nature of such syndromes are discussed.

PMID- 8467608
TI  - Association of anti-cardiolipin antibodies with vascular thrombosis and
      neurological manifestation of Behcets disease.
AB  - We have studied 44 patients with Behcet's Disease (BD) to look for any
      correlation of arterial and venous thrombosis or central nervous system (CNS)
      manifestations with anti-cardiolipin antibodies (ACLA). Twenty patients were
      positive for ACLA by MELISA method. Ten patients had IgG antibody, four had IgM
      and six had both IgG and IgM. Of these patients, 11 had a history of vascular
      thrombosis and thrombophlebitis and nine had CNS manifestations. The association
      of ACLA with vascular thrombosis or CNS manifestation of Behcet's disease was
      statistically not significant.

PMID- 8467609
TI  - Complement split product C3d as an indicator of disease activity in systemic
      lupus erythematosus.
AB  - In order to investigate, if complement levels can be used as an indicator of
      clinical activity in systemic lupus erythematosus (SLE), levels of C3, C4, CH50,
      and C3d were measured in 79 patients, 41 with inactive, 31 with moderately active
      and 7 with severely active disease. Our study shows that C3d, and particularly
      the C3d/C3 ratio, provide sensitive markers for disease activity in SLE. Since
      C3d is a direct measurement of complement turnover, it reflects complement
      activation better than C3, C4 and CH50.

PMID- 8467610
TI  - Protrusio acetabuli in juvenile rheumatoid arthritis.
AB  - Acetabular protrusion (PA) as measured by a line crossing method was studied in
      73 patients with juvenile rheumatoid arthritis (JRA) and its frequency found to
      be 12% (9/73), presenting bilaterally in 5 cases and unilaterally in 4. All
      patients had some other forms of radiological damage and the presence of PA was
      predominantly observed in the JRA group with greater age at onset (8 vs 4.2
      years; p < 0.001) and lower frequency of extraarticular manifestations (22% vs
      72%; p < 0.01). There was no correlation with type of JRA onset, course of
      disease, sex, disease duration, seropositivity for rheumatoid factor, and prior
      steroid intake.

PMID- 8467611
TI  - Connection of atopic disease in Japanese patients with juvenile dermatomyositis
      based on serum IgE levels.
AB  - Serum IgE levels of 22 patients with juvenile dermatomyositis (JDMS), 44 normal
      children, and 43 patients with adult dermatomyositis were compared. The geometric
      mean of serum IgE levels was significantly higher in the juvenile patients when
      compared with normal children (p < 0.01) and adult patients (p < 0.01). Of the 22
      patients with JDMS, 11 (50%) had elevated serum IgE levels accompanied by atopic
      disease. Dermatomyositis was accompanied by atopic dermatitis (AD) in 9 (41%) of
      these 22 patients, a high prevalence when compared with reports among the general
      population. Following the appearance of muscular symptoms in JDMS patients with
      AD, the ratio of OKT4 to OKT8 cells rose due to a reduction in the percentage of
      OKT8-positive cells, along with further elevations in serum IgE levels and
      intractable cutaneous manifestations of dermatomyositis. All this may be a result
      of an interaction between the immuno-mechanism of this disease and that of AD. We
      suspect that, in general, children with impaired cell-mediated immunity,
      presenting with such symptoms as AD, may have a higher tendency for developing
      JDMS.

PMID- 8467612
TI  - Estimating lumbar bone mineral density from routine radiographs of the lumbar
      spine.
AB  - To evaluate the information content of lateral lumbar films with respect to bone
      mineral content, we compared reading criteria with values obtained by
      quantitative computed tomography (CT) of L1 at baseline and after 5 years. The
      highest correlations with mineral content were found for the criteria "overall
      assessment of the vertebra", "vertebral bone density versus soft tissue", and
      "amount of trabeculations". These three reading criteria yielded higher
      correlations with CT scores in subjects with lower body mass index. Changes in
      mineral content over the 5-year period could not be read adequately, the average
      difference representing only a loss of about 10% in the study subjects. We
      conclude that a rough estimate of bone density can be obtained from lateral
      radiographs which, in the presence of eventual risk factors for osteoporosis, may
      serve as an additional indication to timely bone densitometry with methods which
      allow precise short-term follow-up measurements.

PMID- 8467613
TI  - Capillaritis: a manifestation of rheumatoid disease.
AB  - We present seven cases of capillaritis arising in patients with rheumatoid
      arthritis and suggest that it is primarily related to disease activity and not
      drugs. In the majority, the rash resolved spontaneously with the use of a topical
      steroid to treat the symptom of itch.

PMID- 8467615
TI  - Elevated anticardiolipin antibodies in a patient with vibration-white-finger,
      valvular heart disease and psoriatic arthritis.
AB  - We describe a case of irreversible severe vibration-white-finger (VWF) occurring
      in a male who used a compression-hammer daily at work for a 20-year period. Infra
      red thermography following either a cold provocation or a vibratory stress was a
      sensitive objective method of documenting the condition. Persistent elevation of
      IgG anticardiolipin antibodies (aCL) was found in his serum and may be a marker
      of endothelial damage associated with either VWF or the patient's coincidental
      valvular heart disease.

PMID- 8467614
TI  - The influence of fast and vegetarian diet on parameters of nutritional status in
      patients with rheumatoid arthritis.
AB  - Nutritional status was studied over a period of 13 months in 34 patients with
      rheumatoid arthritis (RA). Seventeen patients fasted for 7-10 days, were then
      transferred to a gluten-free vegan diet for 3.5 months and finally to a
      lactovegetarian diet for 9 months. The remaining 17 patients followed a "normal"
      diet. After one month, the values for body mass index (BMI) and triceps skinfold
      thickness (TSF) were significantly reduced in the diet group compared with the
      values at inclusion (p < 0.001), whereas upper arm muscle area (UAMA) was not
      significantly reduced. Evaluation of the whole study course revealed a
      significantly lower BMI (p = 0.04) and TSF (p < 0.01) in the diet group compared
      with the control group. The concentration of insulin-like growth factor 1 (IGF1)
      was significantly reduced in the diet group after one month compared with the
      value at inclusion (p = 0.01), but the overall difference between the two groups
      was not significant. There were no overall significant differences with regard to
      VAMA, concentration of serum albumin, haemoglobin, ferritin, zinc and copper
      between the two groups. Thus fast, followed by diet manipulations for one year,
      had a minor impact on nutritional status in patients with RA.

PMID- 8467616
TI  - Progressive systemic sclerosis and IgA deficiency in a young man.
AB  - A 21-year-old man presented with an IgA deficiency and symptoms reminiscent of a
      systemic lupus erythematosus. After 7 years systemic sclerosis developed
      involving the lungs, oesophagus, central nervous system and reproductive system.
      Connective tissue disease and its relationship to IgA deficiency will be
      discussed.

PMID- 8467617
TI  - Systemic sclerosis following anti-androgenic treatment for prostatic
      adenocarcinoma.
AB  - We describe a male patient who developed systemic sclerosis following
      orchiectomy, radiotherapy and anti-androgenic treatment for prostatic
      adenocarcinoma. This case appears interesting as it further supports the
      possibility of a relationship between neoplasia and systemic sclerosis. The
      concurrence of scleroderma and iatrogenic hypoandrogenism suggests that hormonal
      influences may also play a role in the pathogenesis of this connective tissue
      disorder.

PMID- 8467619
TI  - Synovial sarcoma manifesting as a single joint flare in rheumatoid arthritis.
AB  - A 69-year-old female recently diagnosed as suffering from rheumatoid arthritis
      presented with a general flare-up of disease including a swollen left ankle.
      Investigation revealed the swelling to be due to a synovial sarcoma. This unusual
      cause should be considered in all cases of local joint flares in rheumatoid
      arthritis.

PMID- 8467618
TI  - Eosinophilic fasciitis in association with chronic vasculitic-like leg
      ulcerations.
AB  - Vasculitic lesions are not generally associated with eosinophilic fasciitis.
      Eosinophilic fasciitis is reported to be a syndrome distinct from progressive
      systemic sclerosis (PSS). More recent studies, however, note overlapping features
      in the clinical, pathologic, and laboratory findings of eosinophilic fasciitis
      and scleroderma. We report a typical presentation of eosinophilic fasciitis that
      developed vasculitic-like leg ulcerations as seen in scleroderma.

PMID- 8467620
TI  - Lymphoma developing in a patient with rheumatoid arthritis taking methotrexate.
AB  - We report one case of non-Hodgkin lymphoma in a patient, with a 30-year history
      of rheumatoid arthritis, taking low dose methotrexate weekly over a 10-month
      period. The mild immunosuppression that occurs with methotrexate therapy probably
      places patients with rheumatoid arthritis at added risk of developing
      lymphoproliferative diseases, but coincidence cannot be excluded.

PMID- 8467621
TI  - Evaluation of Abbott TestPack RSV for the diagnosis of respiratory syncytial
      virus infections.
AB  - Abbott TestPack RSV, a 20-minute enzyme immunoassay, is available for the rapid
      diagnosis of respiratory syncytial virus (RSV) infections. We have compared
      TestPack with a "gold standard" method of virus isolation in traditional tube
      cultures and shell vials to determine the sensitivity and specificity of this
      rapid method. Respiratory specimens were collected prospectively from 402
      children and assayed by the rapid antigen detection method and isolation in
      culture. Virus was isolated by inoculation of specimen in a total of eight tubes
      and 2-3 shell vials. Isolation of RSV was confirmed by characteristic cytopathic
      effect and immunofluorescence using monoclonal antibodies to RSV. Of the 402
      specimens tested, there were only 18 discrepant results (seven TestPack-positive,
      culture-negative, and 11 TestPack-negative, culture-positive specimens). The
      sensitivity of TestPack RSV versus culture was 93.6% (162 of 173) and the
      specificity was 97.0% (222 of 229). Using a very rigorous culture system, we have
      obtained high values for the sensitivity and specificity of TestPack RSV. This
      assay is an excellent method for the rapid diagnosis of RSV infections in young
      children.

PMID- 8467622
TI  - Species identification and determination of high-level aminoglycoside resistance
      among enterococci. Comparison study of sterile body fluid isolates, 1985-1991.
AB  - Enterococcus spp. have become the third most common cause of nosocomial
      infections. High-level aminoglycoside resistance (HLR), an important clinical
      concern, has been associated with some species of the enterococci. We evaluated
      the Vitek and API 20S systems for species identification and the Vitek for the
      detection of HLR. Enterococci from nosocomial infections (208 strains) at the
      University of Iowa Hospital (1985-1991) were tested by Vitek, API 20S, and
      reference methods. The error rate for species identification was 6.7% for the API
      20S and 5.8% for the Vitek Gram-positive identification (GPI) cards. Both systems
      tended to incorrectly identify other enterococcal species as Enterococcus
      faecium. HLR was found in Enterococcus faecalis and E. faecium isolates only. The
      highest rates of HLR to streptomycin alone (17.9%) and with gentamicin (13.5%)
      was observed among E. faecalis strains, and to gentamicin alone (7.3%) was found
      among E. faecium isolates. No apparent differences in HLR rates were found from
      year-to-year over the 7-year enterococcus sample interval. Susceptibility errors
      for Vitek were among the streptomycin tests only. Our results demonstrated
      acceptable performance by the Vitek cards for enterococcal species identification
      and the detection of HLR. API 20S also provided an acceptable ability to speciate
      the enterococci within its data base, however, both systems must be improved by
      adding other clinical important Enterococcus species.

PMID- 8467624
TI  - Endovascular infection and septic arthritis caused by Gemella morbillorum.
AB  - Streptococcus morbillorum was transferred to the genus Gemella in 1988.
      Infections caused by G. morbillorum are unusual. We report a case of endovascular
      infection and presumptive septic arthritis caused by G. morbillorum. Previous
      cases of infection caused by G. morbillorum and G. haemolysans are reviewed.

PMID- 8467623
TI  - Comparison of oral cefpodoxime proxetil and cefaclor in the treatment of skin and
      soft tissue infections.
AB  - This multicenter, randomized, double-blind study was designed to compare the
      safety and efficacy of cefpodoxime proxetil and cefaclor in the treatment of skin
      and soft tissue infections. Patients were aged > or = 12 years with acute (< or =
      7 days duration), single-site skin or skin-structure infections. The 7- to 10-day
      treatment regimens were cefpodoxime proxetil (400 mg cefpodoxime) orally with
      food twice a day with cefaclor-matched placebo (orally, fasting, three times a
      day); or cefaclor (Ceclor; 500 mg anhydrous equivalent) orally, fasting, three
      times a day, with cefpodoxime-matched placebo (orally with food twice a day).
      Clinical progress and cultures were evaluated upon admission to the study; on
      study days 7-10 and 15-18; and 2-3 weeks after treatment. Cefpodoxime had lower
      minimum inhibitory concentrations against the majority of Staphylococcus species
      than did cefaclor. Both treatments were highly effective (99% pathogen
      eradication and 86% cure rate). These high eradication rates were not unexpected
      in this study of minor infections in which patients with resistant pathogens were
      excluded. Cefaclor had a higher failure rate [2 (4%) of 57], than did cefpodoxime
      [2 (1%) of 139; p not significant]. Most patients in both groups completed
      treatment as planned: 185 (74%) of 249 cefpodoxime-treated patients and 91 (75%)
      of 122 cefaclor-treated patients. Both treatments were well tolerated and
      considered safe and effective in the treatment of skin and skin structure
      infections. However, the twice-a-day dosing regimen for cefpodoxime proxetil
      compared with the three-times-a-day regimen for cefaclor may result in better
      patient compliance.

PMID- 8467625
TI  - In vitro activity of rifaximin, a topical rifamycin derivative, against Chlamydia
      trachomatis.
AB  - Rifaximin is a rifamycin derivative that possesses in vitro activity against a
      wide range of bacteria. Its antimicrobial spectrum plus poor intestinal
      absorption have led to consideration of this compound as a topical agent. We
      evaluated its in vitro activity against clinical and laboratory strains of
      Chlamydia trachomatis and found that rifaximin exhibits minimum inhibitory
      concentrations (MICs) at concentrations that would be greatly exceeded in a
      topical preparation.

PMID- 8467627
TI  - Impact of intervention on the frequency with which leaky urine specimens are
      received in the laboratory.
AB  - Prior to intervention, 4.5% of urine specimens received for culturing in the
      University of Massachusetts Medical Center clinical microbiology laboratory were
      noted to have leaked during transport. After an extensive educational program was
      conducted aimed at alerting physician, nursing, and clerical personnel about the
      problem, a policy was adopted in which physicians were notified by telephone when
      the laboratory received leaky specimens. The specimens, however, were processed.
      Leakage rates dropped to 1.7%. A second round of intervention in which leaky
      urine specimens were not processed was then implemented. No additional decrease
      in the rate of receipt of leaky urine specimen was noted (that is, 1.9%). One
      year later, having adopted a policy of not processing leaky urine specimens, the
      rate of leaky specimens remained at 1.9%. The clinical microbiology laboratory
      can effectively intervene regarding problems of specimens that have leaked during
      transport to the laboratory.

PMID- 8467626
TI  - Increased resistance to quinolone in Catalonia, Spain.
AB  - From 1989 to 1991, the level of resistance to ciprofloxacin in our hospital
      increased from 0.47% to 6.7% in opportunistic Enterobacteriaceae, from 9.9% to
      16% in Pseudomonas aeruginosa and from 8.27% to 31.8% in Campylobacter jejuni
      coli. We also observed an increase in quinolone consumption from 1.1 in 1989 to
      1.5 defined daily doses per 1000 inhabitants per day in 1991.

PMID- 8467628
TI  - Prevalence of enterococcal high-level aminoglycoside resistance in Japan.
      Comparative detection by three methods.
AB  - A total of 250 strains of enterococci isolated in Kumamoto University Hospital,
      Japan, during the period from January to March 1992 were tested for high-level
      aminoglycoside resistance. Brain-heart infusion (BHI) agar plates supplemented
      with 1000 micrograms/ml of gentamicin or 2000 micrograms/ml of streptomycin
      detected 164 (66%) isolates resistant to either gentamicin or streptomycin alone,
      or both, and consisted of 107 (43%) resistant to gentamicin and 96 (38%)
      resistant to streptomycin. The Vitek Gram-Positive Susceptibility card (GPS-TA)
      revealed high correlations with those by agar screens, the results indicating a
      sensitivity of 100% and 99% to gentamicin and streptomycin, respectively, and
      100% specificity to both. Also, the microdilution tests of the National Committee
      for Clinical Laboratory Standards (NCCLS) showed 100% and 92% sensitivity to
      gentamicin and streptomycin, respectively, and no false resistance (100%
      specificity) when compared with the results by agar screens.

PMID- 8467629
TI  - Molecular technology for hospital epidemiology.
AB  - Hospital-acquired infections in the United States contribute to approximately
      80,000 deaths per year, with an associated cost of > $4 billion. Some of these
      infections are associated with outbreaks and clusters occurring within the
      hospital. The hospital infection control team must respond quickly and decisively
      to recognize and curtail these outbreaks, but their response often depends on
      critical laboratory data that characterize or "fingerprint" suspected microbial
      isolates. This presentation summarizes the simple, easily performed tests and the
      more molecular approaches that a hospital laboratory may take in support of
      infection control efforts. In addition to phenotypic data, such as biotype and
      antibiograms, hospitals that elect to incorporate molecular protocols should
      limit their first experiences to plasmid analysis and plasmid restriction
      endonuclease profiles.

PMID- 8467630
TI  - Use of probes and amplification techniques for the diagnosis and prognosis of
      human immunodeficiency virus (HIV-1) infections.
AB  - The recent development of nucleic acid amplification methodologies has markedly
      improved our ability to detect very low levels of specific nucleic acids.
      Amplification techniques have been combined with product detection systems that
      are designed for high throughput and are automatable. These developments are
      drastically changing the face of infectious disease diagnostics and changing the
      character of prognostic indicators in certain diseases. The polymerase chain
      reaction (PCR) has been used extensively for diagnosis of human immunodeficiency
      virus (HIV-1) infections, and recent developments have indicated that
      quantitative reverse-transcriptase PCR for viral RNA has prognostic value. Self
      sustained sequence replication amplification for detection of viral RNA appears
      comparable to plasma culture for diagnosis of pediatric infections. The ligase
      chain reaction is still in developmental stages, but holds promise for specific
      purposes.

PMID- 8467631
TI  - Use of molecular diagnostics in sexually transmitted diseases. Critical
      assessment.
AB  - This review describes and assesses the use of molecular assays for the diagnosis
      of sexually transmitted diseases (STDs). Specifically, data from literature on
      currently available commercial systems as well as that of imminently to be
      released assay formats are presented. The focus is on evaluations of two
      molecular diagnostic techniques--hybridization and amplification for the direct
      detection of Chlamydia trachomatis and Neisseria gonorrhoeae (gonococci, GC)--the
      use of urine as a specimen for the diagnosis of these pathogens in humans, a
      confirmatory probe assay for GC, and finally the description of a hybridization
      assay for pathogens significant in vaginitis and bacterial vaginosis. Although
      viral pathogens are a significant part of the STD problem, and molecular
      techniques have been described for their identification, they are not being
      discussed here. With the exception of the Virapap DNA hybridization assay for
      human papillomavirus (Digene Diagnostic, Silver Spring, MD), suitable molecular
      clinical laboratory assays for viral detection have not been developed for
      genital samples.

PMID- 8467632
TI  - A comparison of the API Uriscreen with the Vitek Urine Identification-3 and the
      leukocyte esterase or nitrite strip as a screening test for bacteriuria.
AB  - The API Uriscreen is a rapid urine-screening test based on the detection of
      catalase activity present in somatic cells and in many of the bacteria commonly
      causing urinary tract infections. Of 487 routine, outpatient urine specimens
      processed by conventional quantitative culture, API Uriscreen, Vitek UID-3 panel,
      and a leukocyte esterase-nitrite strip, 142 had no growth. Of 336 urine specimens
      with > or = 10(3) colony-forming units (CFU)/ml, 79 were considered to be
      indicative of possible or probable urinary tract infection (Cumitech 2A). The
      sensitivity and specificity of the API Uriscreen for the detection of bacteriuria
      at > or = 10(5) CFU/ml were 62% and 85%, those of the leukocyte esterase-nitrite
      strip was 61% and 82%, those of the Vitek UID-3 panel were 91% and 66%. When
      bacteriurias were classified into possibly or probably indicative of urinary
      tract infection, the sensitivity and specificity of the API Uriscreen at > or =
      10(5) CFU/ml were 87% and 78%, those of the leukocyte esterase-nitrite were 84%
      and 76%, those of the Vitek UID-3 were 93% and 55%. In this study, we consider
      the API Uriscreen did not have significant advantages over the leukocyte esterase
      nitrite strip.

PMID- 8467633
TI  - Use of chemiluminescent DNA probes in the rapid detection of oxacillin resistance
      in clinically isolated strains of Staphylococcus aureus.
AB  - Chemiluminescent DNA probes (AccuProbe, species specific; and FlashTrack,
      bacterial generic) were used to determine oxacillin resistance in Staphylococcus
      aureus. Ribosomal RNA was measured at designated intervals in the presence and
      absence of antibiotic. A total of 48 (AccuProbe assay) and 24 (FlashTrack) S.
      aureus isolates with known oxacillin susceptibility patterns were inoculated into
      Bactec 6A bottles both with and without 4 micrograms/ml oxacillin and incubated
      at 35 degrees C for 4 h. Aliquots were removed at 0 and 4 h, and pellets of
      bacteria were obtained via selective centrifugation. Probe assay counts (relative
      light units, RLUs) were performed. Of 21 oxacillin-resistant S. aureus (ORSA)
      strains, 20 showed a > 5-fold RLU increase during the incubation period (Accu
      Probe assay): 25 of 27 oxacillin-susceptible strains demonstrated a < or = 4-fold
      increase. AccuProbe test sensitivity and specificity were 95% and 92%,
      respectively. With the generic FlashTrack probe assay, all nine ORSA isolates
      showed a > or = 4- to 10-fold increase in RLUs, and all 15 oxacillin-susceptible
      strains showed a < or = 4-fold increase in RLUs during the 4-h incubation. The
      FlashTrack test sensitivity and specificity were both 100%. Probe assays were
      completed within 5 h. This study suggests that rapid and reliable determination
      of oxacillin resistance in S. aureus clinical isolates can be accomplished using
      commercially available DNA probes.

PMID- 8467634
TI  - The application of fractal dimension to temporomandibular joint sounds.
AB  - Researchers have attempted to use mathematical analysis of the sounds produced by
      symptomatic temporomandibular joints (TMJ) as a diagnostic modality. However,
      previous studies have generally concluded that such analyses have little
      diagnostic utility. Previous studies using Fourier transforms and visual
      inspection were of limited success. This paper reports the results of a
      preliminary retrospective study using fractal analysis to analyze sounds produced
      by symptomatic temporomandibular joints previously diagnosed using other clinical
      modalities as having internal derangements with reducing discs. Multiple
      mandibular opening and closing cycles were recorded in four subjects. The study
      revealed that fractal analysis produced a high degree of reproducibility within,
      and similarity across subjects. The fractual dimension associated with joints
      having this pathology was found to be 1.266, revealing that fractal analysis
      shows promise as a noninvasive method for diagnosing interarticular TMJ
      pathology.

PMID- 8467635
TI  - A mimetic-based frequency domain technique for automatic generation of EEG
      reports.
AB  - This paper describes a novel mimetic technique of using frequency domain approach
      and digital filters for automatic generation of EEG reports. Digitized EEG data
      files, transported on a cartridge, have been used for the analysis. The signals
      are filtered for alpha, beta, theta, and delta bands with digital bandpass
      filters of fourth-order, cascaded, Butterworth, infinite impulse response (IIR)
      type. The maximum amplitude, mean frequency, continuity index and degree of
      asymmetry have been computed for a given EEG frequency band. Finally, searches
      for the presence of artifacts (eye movement or muscle artifacts) in the EEG
      records have been made.

PMID- 8467636
TI  - A computer program in QuickBasic for the selection of tests for the
      identification of Helicobacter pylori.
AB  - Reliable microbiological tests are needed for the identification of bacteria. A
      program has been written in QuickBasic to identify such tests by using a formula
      that is based on Gyllenberg's Sum of C(i) and Gyllenberg's Rank R(i). A total of
      139 papers on a newly isolated bacterium, Helicobacter pylori, was used as data
      source for the coding of test results into an input file. The program outputs a
      list that aids in the determination of suitable tests for the identification of
      H. pylori. These tests chosen by the formula were found to be correctly
      identified as supported by later publications on the bacterium.

PMID- 8467637
TI  - Mathematical modeling of time-dependent oxygen transport in rat peripheral nerve.
AB  - We modeled time-dependent transport of oxygen in peripheral nerve. Simulation
      began with a steady-state oxygen tension field determined by capillary diameter
      and length, intercapillary distance, blood-flow velocity, oxygen consumption
      rate, and arterial oxygen tension. One of these parameters was assumed to change
      rapidly to new constant value, producing time-varying oxygen tensions. A
      monoexponential or biexponential function characterized the oxygen tension time
      variation. Rate constants of the slower exponential ranged from 0.017 sec-1 to
      0.46 sec-1, implying minimal time lag in response of peripheral nerve oxygen
      tensions to alterations in blood flow, arterial blood oxygenation, or metabolic
      demands.

PMID- 8467638
TI  - Computer simulation of normal and pathological copper metabolism in man.
AB  - A digital computer simulation of copper metabolism was used to simulate human
      copper metabolism. The simulation agrees well with the normal data extant.
      Wilson's disease (hepatolenticular degeneration) and Menkes' disease (steely-hair
      syndrome) were simulated. Simulation of the unavailability of accumulated liver
      copper simulated Wilson's disease if it was assumed that the increased urinary
      excretion was due to induction of an enzymic mechanism for enhanced excretion.
      This would be consistent with the genetic defect causing only the sequestering of
      unavailable copper in the liver. Other genetic defects need not be present.
      Menkes' disease is also a genetic disease affecting the newborn. It was simulated
      successfully as a defect in absorption of copper from the gastrointestinal tract.

PMID- 8467639
TI  - A computer simulation study on the effects of input function measurement noise in
      tracer kinetic modeling with positron emission tomography (PET).
AB  - Tracer kinetic modeling with positron emission tomography (PET) requires
      measurements of the time-activity curves in both plasma (PTAC) and tissue (TTAC)
      to estimate physiological parameters, i.e. to fit the parameters of certain
      compartmental models using PTAC and TTAC as the model input and output functions,
      respectively. However, the estimation usually ignores the measurement noise in
      plasma tracer activity curves. The accuracy and reliability of the physiological
      parameters estimated by ignoring such noise are not well understood. In this
      paper, effects of noise in [18F] 2-fluoro-2-deoxy-D-glucose (FDG) tracer plasma
      concentration measurements on estimation of local cerebral metabolic rates of
      glucose (LCMRGlc) with PET is investigated systematically. The PTAC modeling
      approach used in this paper also provides a realistic means to filter out the
      noise and to improve the physiological parameter accuracy, which can be
      potentially used in model-based non-invasive measurements of PTAC.

PMID- 8467640
TI  - Bioassay from two parabolas.
AB  - The paper deals with potency ratio estimation of parallel curve analytic dilution
      assays in case log dose-response relationship could be reasonably described by a
      parabola. It comprises: (1) testing the adequacy and validity of the quadratic
      model by the analysis of variance; and (2) estimation of the relative potency of
      an unknown in relation to a standard preparation, its standard deviation and
      fiducial limits for its true value. The method is applicable whenever successive
      doses of an unknown are a constant multiple of a standard in randomized blocks or
      completely randomized design. The method can be generalized to polynomial models
      of higher order.

PMID- 8467641
TI  - Nonparametric estimation of potency ratio for dilution assays.
AB  - The paper considers the estimation of the potency of an unknown test preparation
      in relation to a standard in a dilution assay. The method utilizes the Mantel
      Haenszel one degree of freedom chi-square approach to test consistency of the
      observed potency ratio with a range of alternative potency ratios. The method is
      nonparametric as it does not require any distributional assumptions. However, it
      requires the doses employed to be equally spaced logarithmically. The dose
      response curve is also required to be monotone over the dose range used.

PMID- 8467642
TI  - The effect of starting time on dexamethasone suppression test results in horses.
AB  - This study was conducted to investigate the effect of starting time on
      dexamethasone suppression test results in horses. Eight adult horses were used
      throughout the trial. Baseline cortisol levels were established by collecting
      cortisol levels twice daily, at 8:00 A.M. and 8:00 P.M. for 4 consecutive days.
      Morning baseline cortisol levels were 46.3 +/- 5.94 ng/ml, and evening baseline
      cortisol levels were 32.8 +/- 5.59 ng/ml. Although lower, the evening cortisol
      levels were not statistically different (P = 0.154) from the morning levels.
      Dexamethasone suppression tests initiated at either 9:00 A.M. or 9:00 P.M. were
      performed by collected a control blood sample, administering either 0.044 mg/kg
      dexamethasone or its vehicle intravenously and then collecting additional blood
      samples at 6, 12, 24, 36, and 48 hr after treatment. Mean cortisol levels at hr
      0, 6, 12, 24, 36, and 48 after a dexamethasone injection given at 9:00 A.M. were
      55.6 +/- 3.08, 6.4 +/- 2.05, 0.73 +/- 0.48, 11.0 +/- 5.82, 12.6 +/- 4.30, and
      40.5 +/- 5.38 ng/ml respectively. Mean cortisol levels at hr 0, 6, 12, 24, 36,
      and 48 hr after a dexamethasone injection given at 9:00 P.M. were 45.0 +/- 6.03,
      4.5 +/- 1.28, 0.20 +/- 0.12, 4.5 +/- 2.49, 23.4 +/- 5.88, and 29.5 +/- 6.61 ng/ml
      respectively. There was no statistical difference in cortisol values between A.M.
      and P.M. initiated tests at any hour post dexamethasone administration. There was
      no decrease in cortisol level after administration of dexamethasone vehicle.

PMID- 8467643
TI  - Lack of effects of indomethacin on estradiol feedback control of luteinizing
      hormone in ovariectomized ewes.
AB  - We tested the hypothesis that indomethacin, a potent inhibitor of prostaglandin
      synthesis, would modify estradiol's effects on tonic and surge concentrations of
      LH in chronically ovariectomized ewes during the anestrous season. Ewes (n = 21)
      were assigned randomly to one of four treatments: Vehicle+Blank (n = 5);
      Indomethacin+Blank (n = 6); Vehicle+Estradiol (n = 5); or Indomethacin+Estradiol
      (n = 5). On d=0 (hr = 0), ewes began to receive i.m. injections of either
      indomethacin (4 mg/kg body weight) or corn oil every 8 hr for 9 d. Blood samples
      were collected every 12 min for 6 hr beginning at -6 hr, +18 hr, and on day 8
      (relative to initial injections of indomethacin or vehicle) to assess tonic
      patterns of secretion of LH. At +24 hr, ewes received blank- or estradiol
      containing Silastic implants and were bled hourly for 48 hr. On day 9, ewes
      received 50 micrograms of GnRH i.v. and were bled hourly for 8 hr. Serum samples
      were assayed for LH. Indomethacin had no effect on the following parameters of LH
      secretion: 1) mean concentrations (ng/ml; 8.4 +/- .7 vs 8.9 +/- .8; P > .1), 2)
      pulse frequency/6 hr (4.5 +/- .4 vs 4.1 +/- .4; P > .1) or 3) pulse amplitude
      (ng/ml; 15.3 +/- 1.1 vs 14.9 +/- 1.2; P > 1). Estradiol elicited a surge of LH
      which began 18.9 +/- 1.7 hr after implant insertion, reached a mean peak
      concentration of 95.3 +/- 20.1 ng/ml, and did not differ with respect to
      indomethacin treatment (P > .1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467644
TI  - Basis of norgestomet action as a progestogen in cattle.
AB  - Norgestomet is the progestational component present in Syncro-Mate-B, which is
      used to synchronize estrus in cattle. In post-partum cows, luteal phases
      anticipated to be short following first ovulation are of normal length when cows
      are pretreated with norgestomet. Because Syncro-Mate-B is used experimentally as
      a progestogen to affect uterine function, these studies were conducted to
      investigate how norgestomet acts at the level of the uterus. Receptor binding
      assays and a sensitive estrogen bioassay in tissue culture were used to address
      the possibility that some effects of norgestomet might be mediated through
      interaction of this compound with steroid hormone receptors other than the
      progesterone receptor (rP). The source of receptors was high-speed cytosol,
      prepared from bovine uterine endometrium, which was obtained from cyclic cows.
      Results of single-point and complete competition analyses comparing norgestomet
      and progesterone indicated that norgestomet competed even more effectively than
      did progesterone for specific binding of [3H]progesterone to rP. Results of
      similar studies, which compared the abilities of norgestomet and
      diethylstilbestrol to compete with [3H]estradiol for binding by uterine
      endometrial estrogen receptors (rE), provided no evidence for norgestomet
      competitive binding to rE. In MCF-7 breast cancer cell bioassays, norgestomet
      showed weak estrogenic activity, but only at concentrations greater than 1
      micromolar. Finally, norgestomet did not compete with [3H]triamcinolone acetonide
      when present in an 100-fold excess, and only competed with [3H]dexamethasone for
      binding by endometrial glucocorticoid receptors (rG) when present in the
      micromolar range. We conclude that, at the concentrations used in synchronizing
      estrus, norgestomet interacts with bovine endometrium as a progestogen and that
      its biological actions occur through binding of this compound to rP present in
      target tissues.

PMID- 8467645
TI  - Determination of the percentage of free cortisol in plasma in the dog by
      ultrafiltration/dialysis.
AB  - The current methods for measurement of free cortisol are hampered by
      methodological drawbacks including large sample requirement, length of the
      procedure, and overestimation or underestimation of free cortisol. We report a
      technique combining ultrafiltration and dialysis, which could largely overcome
      these drawbacks, for measurement of the per cent free cortisol in plasma in the
      dog. This is a modification of the method of Hammond et al. for the determination
      of sex steroids in man. We found a good positive correlation (rs = 0.87) with
      equilibrium dialysis, which is considered the golden standard in free cortisol
      measurements. The 2.5th and 97.5th percentiles of values of free cortisol
      measured in plasma of 40 healthy household dogs were 5-20 nmol/l or 5.1-11.7% of
      the total cortisol concentration.

PMID- 8467646
TI  - Endogenous growth hormone controls high plasma levels of 3,3',5-triiodothyronine
      (T3) in growing chickens by decreasing the T3-degrading type III deiodinase
      activity.
AB  - The influence of endogenous GH levels on peripheral monodeiodination activity has
      been investigated in growing chickens at the age of 4 weeks, when they normally
      show no T3 increase after GH injection. Injection of anti-GH serum decreased
      plasma T3 and increased plasma T4. Three d and 1 week after hypophysectomy,
      plasma T3 was also markedly decreased, while T4 was only slightly affected,
      hepatic 5'D-I activity showed a transient decrease, but 5D-III activity was
      highly increased, as were the number of hepatic GH receptor sites. Injection of
      GH in hypophysectomized chickens decreased 5D-III activity and increased plasma
      T3. GH receptor-deficient dwarf chickens had decreased plasma T3 and increased
      plasma T4 and hepatic 5'D-I and 5D-III activities compared to their normally
      growing siblings. GH administration could only affect T3 and 5D-III in the non
      dwarf siblings, which showed higher basal 5D-III activity compared to the non
      responsive age-matched chickens of the Hisex strain used in the other
      experiments. It can be concluded that endogenous GH is an important factor in the
      control of plasma T3 levels in growing chickens due to its influence on the
      activity of the T3-degrading type III deiodinase. The effectiveness of exogenous
      GH administration to acutely increase plasma T3 probably depends on the balance
      between the injected dose and the endogenous GH concentration, the hepatic GH
      receptor availability and the hepatic type III deiodinase level.

PMID- 8467647
TI  - Concentration of bovine placental lactogen in dairy and beef cows across
      gestation.
AB  - The concentration of bovine placental lactogen (bPL) was determined in five dairy
      heifers and five beef cows across gestation. Blood samples were collected
      beginning at day 45 post insemination and once every two weeks until two d
      postpartum. Concentrations of bPL in maternal serum ranged from undetectable (<
      .25 ng/ml) to 2.93 ng/ml and there were no significant differences between dairy
      and beef animals. Peak concentrations were observed at day 215 of gestation and
      remained high until just prior to parturition. These results suggest that bPL
      concentrations follow a pattern similar to that in other species that produce
      placental lactogen.

PMID- 8467648
TI  - Effects of season and estradiol on concentrations of histamine within discrete
      brain regions of ovariectomized ewes.
AB  - Histamine has been implicated as a neuromodulator of secretion of gonadotropins
      in several species. Concentrations of histamine were analyzed within discrete
      brain regions and endocrine tissues to help determine whether this amine has the
      potential to exert a similar function in ewes expected to have dramatically
      different serum concentrations of LH. Following collection of blood samples at 12
      min intervals for 4-hr, ovariectomized (OVX) and OVX-estradiol treated (OVX-E)
      ewes were slaughtered during the breeding and anestrous seasons (five
      animals/group). Concentrations of LH were depressed by treatment with estradiol
      (E; P < .01), but to a greater extent (P < .05) during the anestrous season
      compared to the breeding season. Concentrations of histamine in tissues (ng/mg)
      differed (P < .01) between the breeding and anestrous seasons, in the medial
      thalamus (39.2 +/- 14.1 vs 109.9 +/- 13.0), posterior pituitary gland (247.6 +/-
      50.7 vs 23.0 +/- 9.1) and midbrain tegmentum (10.4 +/- 5.6 vs 50.7 +/- 3.9).
      Estradiol containing implants decreased (P < .05) concentrations of histamine in
      the midbrain tegmentum (20.3 +/- 7.1 vs 37.7 +/- 7.8) and posterior pituitary
      gland (87.3 +/- 24.0 vs 258.2 +2- 67.5) compared to non-estradiol treated
      controls. Histamine concentrations in the pineal and anterior pituitary glands
      and brain regions; stalk-median eminence, medial basal hypothalamus, preoptic
      area, cerebellum, parietal neocortex, were not (P > .05) affected solely by
      either season or E. An interaction between effects of season and estradiol on
      concentrations of histamine occurred (P < .05) in the posterior pituitary gland
      and the preoptic area.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467649
TI  - [Asking about 'nursing and medicine'].

PMID- 8467650
TI  - [An introduction to Nightingale's nursing].

PMID- 8467653
TI  - [A trial in educational development of the general clinical nursing theory].

PMID- 8467652
TI  - [The Center for Nursing Research in the University of Michigan].

PMID- 8467654
TI  - [Case study reports. 20. (Society for the Study of Scientific Nursing)].

PMID- 8467651
TI  - [Building up the science of welfare care].

PMID- 8467655
TI  - [What is psychiatry?].

PMID- 8467656
TI  - [Beginning course of English medical terminology based on analytical method].

PMID- 8467657
TI  - [Searching for logic of children's recognition].

PMID- 8467658
TI  - [The world of Hildegard von Bingen].

PMID- 8467659
TI  - Tubular cell and matrix changes in renal cystic disease.

PMID- 8467660
TI  - Potential role of colchicine in the prevention of cast nephropathy from Bence
      Jones proteins.

PMID- 8467661
TI  - Urinary excretion of glycosaminoglycans and albumin in experimental diabetes.

PMID- 8467662
TI  - Response of glomerular filtration rate to protein load in diabetic patients
      varies according to severity of proteinuria.

PMID- 8467663
TI  - Terminal parts of the membrane recycling process in rat kidney proximal tubule
      cells.

PMID- 8467664
TI  - Tubular proteinuria in diabetic children. A 3-year follow-up study.

PMID- 8467665
TI  - Microalbuminuria is linked with abnormalities favoring atherosclerosis in type 2
      diabetics.

PMID- 8467667
TI  - Extravasation of plasma proteins into the renal interstitium contributes to the
      pathophysiology of diabetic nephropathy.

PMID- 8467666
TI  - Protein charge permselectivity in type 2 and type 1 diabetes.

PMID- 8467668
TI  - Urinary protein excretion in normal individuals: diurnal changes, influence of
      orthostasis and relationship to the renin-angiotensin system.

PMID- 8467669
TI  - Differentiation between renal and postrenal type of hematuria and proteinuria
      measuring urinary apolipoprotein A1 excretion.

PMID- 8467670
TI  - Comparison of SDS-PAGE and immunoblotting with polyclonal and monoclonal
      antihuman albumin sera for the detection of urinary polymers of albumin.

PMID- 8467671
TI  - An immunoassay method for the determination of rat retinol-binding protein in
      serum and urine.

PMID- 8467673
TI  - Renal fibronectin excretion as a marker for renal environmental toxins.

PMID- 8467672
TI  - Urinary endopeptidase 24.11 as a new marker of proximal tubular injury.
      Preliminary study in kidney transplant recipients.

PMID- 8467674
TI  - Hyperoxaluria, enzymuria and nephrolithiasis.

PMID- 8467675
TI  - Protease inhibitory activity in serum and urine following extracorporeal shock
      wave lithotripsy.

PMID- 8467676
TI  - Possible role of altered polyamine metabolism in gentamicin toxicity in OK cells.

PMID- 8467677
TI  - Immunohistochemical study of epidermal growth factor in the rat kidney after
      gentamicin-induced tubular injury.

PMID- 8467678
TI  - Proteinuria and progression of chronic adriamycin nephropathy.

PMID- 8467679
TI  - Use of renal epithelial cell lines for testing cellular toxicity.

PMID- 8467680
TI  - The functional effects of contrast media on the isolated perfused rat kidney.

PMID- 8467681
TI  - Renal effects and nephrotoxicity of contrast media in renal patients.

PMID- 8467683
TI  - Role of reactive oxygen species in the development of glomerular injury.

PMID- 8467682
TI  - Contrast media nephrotoxicity: urinary protein and enzyme pattern in patients
      with or without saline infusion during digital subtracting angiography.

PMID- 8467684
TI  - Structure-affinity relationship of different drugs at the contraluminal transport
      system for organic cations in proximal tubules of rat kidneys.

PMID- 8467685
TI  - Effects of endothelin on coagulation, prostaglandins and hemodynamics.

PMID- 8467686
TI  - Circadian rhythms of atrial natriuretic peptide and blood pressure are
      consistently blunted in chronic renal failure.

PMID- 8467687
TI  - Renal response to colloid volume expansion in patients with solitary kidneys or
      mesangial glomerulonephritis.

PMID- 8467688
TI  - The renal catabolic pathways of cytokines.

PMID- 8467689
TI  - Endosomes degrade insulin.

PMID- 8467690
TI  - The renal handling of protein 1 (Clara cell protein): effect of age, sex and
      renal dysfunction.

PMID- 8467691
TI  - Development of an enzyme-linked immunosorbent assay for protein 1.

PMID- 8467692
TI  - Increased kidney accumulation of 131I-lysozyme in the uninephrectomized rat.

PMID- 8467693
TI  - Tubular reabsorption of proteins is a selective process. Evidence from selected
      nephrotoxicity models.

PMID- 8467694
TI  - Low-molecular-weight proteins as carriers for renal drug targeting.

PMID- 8467695
TI  - An unusual case of bovine twin dystocia.

PMID- 8467696
TI  - Serum chemistry and lipid profiles in neonatal beagle puppies fed homemade milk
      replacer formulas.
AB  - Milk replacer formulas based on cow's milk and egg yolks are frequently
      recommended for use in neonatal puppies. These formulas are lower in protein,
      kilocalories, calcium, and phosphorus than bitch's milk. In addition, the
      cholesterol content is greater than bitch's milk. The effect of feeding these
      formulas on serum chemistry profiles, lipid profiles, and alkaline phosphatase
      isoenzyme profiles of 5-week-old beagle puppies was studied. Three groups of
      beagle puppies were fed bitch's milk (control) (n = 18), a homemade milk-egg-oil
      formula (Formula 1) (n = 18), or a homemade milk-egg-oil formula supplemented
      with additional calcium and phosphorous (Formula 2) (n = 18). Concentrations of
      serum urea nitrogen, albumin, and total CO2 were lower (P < 0.05), and
      concentrations of serum phosphorus, globulins, sodium, chloride, and cholesterol
      were higher (P < 0.05) in formula-fed puppies than bitch-fed puppies. Serum
      potassium concentration was lower in the puppies fed Formula 1 than in the
      control puppies (P < 0.05), and serum potassium concentration in the puppies fed
      Formula 2 was not significantly different from that in puppies fed Formula 1 or
      the control puppies. Total triglyceride (TG) and high density lipoprotein2
      cholesterol (HDL2) concentrations were similar in all three groups of puppies but
      the combined high density lipoprotein1 (HDL1) plus low density lipoprotein (LDL)
      cholesterol fraction was higher (P < 0.05) in the formula-fed puppies and
      accounted for the majority of the increase in cholesterol. There were no
      differences (P < 0.05) in total serum alkaline phosphatase (ALP) or bone-derived
      ALP (BALP) concentrations among the groups, however there was a higher (P < 0.05)
      serum concentration of liver-derived ALP (LALP) in the Formula 1-fed puppies.
      Feeding homemade egg and cow's milk-based puppy replacement formulas is not
      recommended for long term use.

PMID- 8467697
TI  - Telazol and xylazine anesthesia in sheep.
AB  - The analgesic and anesthetic effects of Telazol (13.2 mg/kg, IV) and xylazine
      (0.11 mg/kg, IV)-Telazol (13.2 mg/kg, IV) were evaluated in 6 sheep. Anesthesia
      was characterized by muscle relaxation and profound analgesia with both regimens,
      muscle relaxation appeared to be better in sheep receiving xylazine-Telazol. The
      duration of analgesia was significantly longer in sheep receiving xylazine
      Telazol (101.7 +/- 26 minutes) than in sheep receiving Telazol alone (41.6 +/- 15
      minutes). Changes in heart rate and respiration rate were transient with both
      regimens. Apnea occurred in 2 sheep immediately after xylazine-Telazol
      administration, requiring assisted ventilation, but both sheep resumed
      spontaneous breathing within 2 minutes. Arterial blood pressure decreased
      significantly at 45 and 60 minutes after xylazine-Telazol injection. Arousal to
      standing was smooth, but gradual with no significant difference between the two
      drug regimens. In conclusion, xylazine-Telazol combination produced better muscle
      relaxation and longer duration of anesthesia than Telazol alone. The adverse
      effects induced by xylazine-Telazol were similar to that of Telazol.

PMID- 8467698
TI  - Conservative management of femoral diaphyseal fractures in four foals.
AB  - Femoral fractures in young horses can occur as a result of severe trauma and
      generally have a poor prognosis despite treatment. Four young horses with femoral
      diaphyseal fractures were managed with conservative treatment consisting of
      prolonged rest, analgesics, hind limb support, and corrective farriery. A
      favorable outcome in the form of pasture soundness with potential for limited
      athletic usefulness was obtained in 3 out of the 4 cases. This report supports
      the use of conservative treatment of selected diaphyseal femoral fractures in
      young horses.

PMID- 8467699
TI  - Neuroaxonal dystrophy in a Jack Russell terrier pup resembling human infantile
      neuroaxonal dystrophy.
AB  - A 9-week-old Jack Russell terrier with progressive ataxia had histopathological
      lesions consistent with neuroaxonal dystrophy. Gross observation revealed absence
      of the septum pellucidum, hypoplasia of the corpus callosum and marked bilateral
      hydrocephalus. Light microscopy of the CNS revealed extensive axonal swellings
      principally in the gray matter of the brain stem where the sensory nuclei were
      most affected. Ultrastructurally, spheroids were identified as axonal terminals
      and probably dystrophic boutons; they were characterized by accumulations of
      membrane bound bodies. Clinical and morphological findings are similar to those
      identified in human infantile neuroaxonal dystrophy (Seitelberger's disease).

PMID- 8467700
TI  - Clostridium septicum septicemia in a neonatal foal with hemorrhagic enteritis.
AB  - Clostridium septicum was isolated by anaerobic culture of blood collected from a
      3-day-old foal with hemorrhagic enteritis and signs suggestive of septicemia. The
      foal responded well to treatment with intravenous fluids, antibiotics, plasma,
      and oral gastrointestinal protectants. One month after apparent complete recovery
      from the septicemia and hemorrhagic enteritis, the foal was euthanized during an
      acute episode of colic that was caused by severe, strangulating intestinal
      adhesions, thought to have formed as a result of peritonitis secondary to the
      hemorrhagic enteritis. The value of anaerobic culture of blood in foals with
      signs suggestive of septicemia is emphasized by the case presented here, as is
      the importance of evaluating the presence and extent of peritoneal inflammation
      in foals with hemorrhagic enteritis. To our knowledge, Clostridium septicum has
      not previously been reported to cause septicemia in neonatal foals.

PMID- 8467701
TI  - Evaluation of ketamine-xylazine in Syrian hamsters.
AB  - Few parenteral anesthetics are safe and effective in the Syrian hamster. This
      study evaluated the anesthetic efficacy and potential for tissue damage of
      ketamine-xylazine (KX). Two dosage levels were administered intraperitoneally.
      Ketamine at 50 mg/kg combined with 10 mg/kg xylazine did not produce a
      consistent, reliable level of immobilization or anesthesia. Ketamine at 150 mg/kg
      combined with 10 mg/kg xylazine administered IP produced an adequate level of
      anesthesia without tissue damage for most procedures, but supplementation with
      lidocaine was necessary for peritoneal incision. Careful positioning of male
      hamsters for IP injection is imperative to prevent inadvertent injection into the
      testes with subsequent tissue damage.

PMID- 8467702
TI  - Early-onset leukopenia and severe thrombocytopenia following doxorubicin
      chemotherapy for tonsillar squamous cell carcinoma in a dog.
AB  - Doxorubicin is reported to cause myelosuppression, with a white blood cell count
      nadir occurring between day 7 and day 10. Thrombocytopenia is less severe and
      occurs between days 3 and 8. This report presents an early onset of leukopenia
      (day 5) and a severe thrombocytopenia (4000 platelets/microliter) (day 6)
      associated with doxorubicin administration for treatment of recurrent tonsillar
      squamous cell carcinoma in a dog.

PMID- 8467704
TI  - The new veterinary medical teaching hospital at the College of Veterinary
      Medicine Cornell University.

PMID- 8467703
TI  - Trichophytobezoar as a cause of transverse colon obstruction in a foal.
AB  - A 5-week-old belgian colt was examined for colic of 12 hours duration after
      several episodes of diarrhea. Physical examination revealed signs of abdominal
      pain, mild dehydration and normal auscultable borborygmi in all abdominal
      quadrants. Distention of the cecum, large colon and small intestinal was evident
      on abdominal radiographs. The foal was treated medically as the owners declined
      surgery. The colt was euthanized because of continued deterioration and failure
      to respond to medical therapy. Post-mortem exam revealed the presence of a
      trichophytobezoar obstructing the distal part of the transverse colon.

PMID- 8467706
TI  - Deleted and normal chromosome 10 homologs from a patient with Hirschsprung
      disease isolated in two cell hybrids through enrichment by immunomagnetic
      selection.
AB  - A cytogenetically detectable deletion, del(10) (q11.2-->q21.2), was observed in a
      patient with total colonic aganglionosis with small bowel involvement (TCSA), a
      variant of Hirschsprung disease (HSCR). A similar deletion is present in another
      TCSA patient (S.M. Huson, personal communication). To reveal cytogenetically
      undetectable deletions of chromosome 10 in further patients, we developed a
      strategy for mapping chromosome 10 DNA markers with respect to the observed
      deletions. To this end, the two chromosome 10 homologs (deleted and normal) were
      segregated in two distinct somatic cell hybrids obtained after fusion of the
      patient's fibroblasts with a Chinese hamster ovary cell line (YH21). Hybrid cells
      containing chromosome 10 were selected for the expression of the gene coding for
      the beta subunit of the fibronectin receptor (FNRB), which maps to 10p11.2, using
      a monoclonal antibody against FNRB. Hybrid 185.O contains the deleted chromosome,
      whereas hybrid 179.Q contains the nondeleted one. Southern blot and PCR analysis
      of DNA from these two hybrids mapped the markers RBP3H4, RET, D10S15, D10S5,
      D10S22, and D10S88 inside the deletion and D10S170, CDC2, EGR2, and D10S19
      outside the deletion. MEN2A and MEN2B have recently been mapped within the
      centromeric region closely linked to RBP3 and D10S15 (which are located inside
      the deletion) and cosegregate with HSCR in at least two different pedigrees.
      Since HSCR, MEN2A, and MEN2B represent defects of neural crest cell development,
      we hypothesize that they originate from mutations in different genes clustered in
      the centromeric region of 10q.

PMID- 8467705
TI  - Aspergillosis granuloma in the mediastinum of a non-immunocompromised horse.
AB  - A National Show Horse with a mediastinal granuloma was presented with clinical
      signs which included fever, nasal discharge and cough. The mediastinal mass was
      identified radiographically and ultrasonographically. A presumptive diagnosis of
      aspergillosis was made following isolation of Aspergillus spp. from both
      transtracheal aspirate and bronchoalveolar lavage fluid samples and agar gel
      immunodiffusion (AGID) identification of serum antibody to Aspergillus spp. The
      diagnosis was confirmed by histopathologic examination of the mediastinal mass
      obtained at necropsy examination.

PMID- 8467707
TI  - Regional mapping of the Rowett nude gene (RONU) to rat chromosome 10q24-->q32 by
      localizing linked SYB2 and GH loci.
AB  - The Rowett nude gene (RONU) has been mapped on rat chromosome (Chr) 10 by linkage
      analysis using (ACI x F344/N-RONU/RONU)F1 x F344/N-RONU/RONU backcross progeny.
      The gene order on the chromosome was RR92- (16.1 cM) - RR24 - (17.9 cM) - MYHSE
      (myosin heavy chain, embryonic) - (1.0 cM) - SYB2 (synaptobrevin 2) - (1.0 cM) -
      SHBG (sex hormone-binding globulin) - (4.0 cM) - RONU (Rowett nude) - (29.0 cM) -
      AEP (anion exchange protein), PPY (pancreatic polypeptide) - (3.0 cM) - ACE
      (angiotensin I converting enzyme), GH (growth hormone). The RONU locus was
      localized to 10q24-->q32 by fluorescence in situ hybridization of the closely
      linked SYB2 and loosely linked GH loci on the opposite side. Conserved linkage of
      homologous loci mapped to rat Chr 10 and mouse Chr 11 supports the hypothesis
      that the RONU locus is a rat homolog of the mouse nu locus.

PMID- 8467709
TI  - Assignment of the human UDP glucuronosyltransferase gene (UGT1A1) to chromosome
      region 2q37.
AB  - UDP glucuronosyltransferases (UGTs) comprise a multigene family of drug
      metabolizing enzymes. The sub-family of UGTs that conjugate bilirubin and
      phenolic compounds with glucuronic acid has been termed UGT1A1. In man, UGT1A1
      isoforms are encoded by a single gene, UGT1A1. Protein isoforms encoded by UGT1A1
      originate by alternative splicing. In the present study, we used the cDNA of
      UGT1A1*4, a bilirubin-conjugating isoform, to localize the UGT1A1 locus in the
      human genome. The UGT1A1 gene was assigned by in situ hybridization to chromosome
      region 2q37.

PMID- 8467708
TI  - The human gene for the zona pellucida glycoprotein ZP3 and a second polymorphic
      locus are located on chromosome 7.
AB  - Southern blot analysis of genomic DNA and gene-cloning experiments have recently
      shown that the human ZP3 gene is not a single-copy gene. The human genome harbors
      sequences encoding a protein of 424 amino acids and, in addition, a polymorphic
      locus with the potential to give rise to a probably nonfunctional polypeptide of
      372 residues. In this report it is shown, by screening of a panel of human x
      hamster hybrid cell lines, that both the ZP3 and ZP3P loci are located on human
      chromosome 7.

PMID- 8467710
TI  - Linkage map of 10 polymorphic markers on rat chromosome 2.
AB  - Analysis of F2 intercross progeny of inbred F344/N x LEW/N rats led to the
      assignment of 10 polymorphic PCR-typable markers to rat chromosome 2. The markers
      form a single linkage group covering 47.9 cM with the following order: D2N1R
      D2N28-FGG (gamma fibrinogen)-PKLR (liver and RBC pyruvate kinase)-ATP1A1 (the
      alpha-1 polypeptide of Na+/K+ transporting ATPase)-HSD3B (hydroxy-delta-5-steroid
      dehydrogenase)-D2N2R-D2N91-CAMKI (calmodulin-dependent protein kinase II)-D2N35.
      All but two of the markers (D2N1R and D2N2R) were detected using specific PCR
      primers flanking dinucleotide repeats. Sequences with dinucleotide repeats
      associated with five genes (FGG, PKLR, ATP1A1, HSD3B, and CAMKI) were identified
      in GenBank, and primers were designed to flank these repeats. The PCR primer
      pairs for three anonymous markers (D2N28, D2N91, and D2N35) were identified by
      sequencing cloned LEW/N rat genomic DNA containing (CA)n.(GT)n repeats. D2N1R and
      D2N2R were identified by PCR amplification of genomic DNA with single,
      nonspecific 10-base oligonucleotide primers. All of the markers were codominant
      except for D2N1R, D2N2R, and CAMKI, which only amplified from F344/N homozygous
      and heterozygous rat DNA. The seven codominant markers were highly polymorphic in
      10 other inbred rat strains (SHR/N, WKY/N, MNR/N, MR/N, LOU/MN, BN/SsN, BUF/N,
      WBB1/N, WBB2/N, and ACI/N), suggesting that they will be useful for general
      mapping studies among these strains. Comparative gene mapping analysis indicated
      that a portion of the mapped region of rat chromosome 2 exhibits synteny
      conservation with regions of human chromosome 1 and mouse Chromosome 3.

PMID- 8467711
TI  - Strand-specific FISH reveals orientation of chromosome 18 alphoid DNA.
AB  - A method is described for making in situ hybridization strand specific. Through
      the use of a synthetic DNA probe of a repetitive sequence in the centromeric
      region of chromosome 18, it is shown that the repeats exist in a head-to-tail
      tandem array. The method should be useful for studies of the molecular
      organization and mapping of chromosomes.

PMID- 8467712
TI  - Ribosomal RNA genes are interspersed throughout a heterochromatic chromosome arm
      in Atlantic salmon.
AB  - The ribosomal RNA genes (rDNA) have been mapped by fluorescent in situ
      hybridization (FISH) using four rDNA probes (rDNA/FISH) to Atlantic salmon
      chromosomes. Signals appeared over the whole heterochromatic chromosome arm
      displaying the secondary constriction and satellites. The size polymorphism of
      this sort arm, revealed by C-banding, was confirmed by rDNA/FISH, supporting
      large interindividual differences in the number of rDNA copies. Conventional
      techniques for the detection of nucleolar organizer regions are discussed, and
      their results are compared with those of rDNA/FISH.

PMID- 8467713
TI  - Comparison of highly repeated DNA sequences in some Lemuridae and taxonomic
      implications.
AB  - Highly repeated DNA sequences of Eulemur fulvus mayottensis, E. coronatus, Lemur
      catta, and Hapalemur griseus griseus have been identified and compared. Sequence
      analysis of highly repeated DNA fragments isolated from L. catta and Hapalemur
      showed a high percentage of similarity (nearly 95%), as did fragments isolated
      from the two very close Eulemur species, whereas comparison of the DNA fragments
      isolated from the two Eulemur species and the L. catta/Hapalemur group showed a
      very low percentage (approximately 40%) of identity, as might be expected for
      distant species. These results confirm our previous data, obtained by Southern
      blot hybridization techniques on the same species, and strongly support the
      existence of a common trunk between L. catta and Hapalemur, but different from
      the leading to the Eulemur species.

PMID- 8467714
TI  - An X-Y homologous pairing segment in tree shrews (Tupaia).
AB  - High-resolution early replication banding of tupaia metaphase chromosomes
      revealed a synchronous early replicating segment in the short-arm telomeric
      regions of the active and inactive X chromosomes and in the long-arm telomeric
      region of the Y chromosome. Hybridization with the human-derived pseudoautosomal
      probe 113F (STIR) showed that this repeat is conserved and specifically localized
      within these synchronously early replicating segments of the X short arm and the
      Y long arm of all three tupaia species (Tupaia belangeri, T. chinensis, and T.
      glis) investigated. Moreover, meiotic studies demonstrated that a synaptonemal
      complex is formed at one telomeric end of the XY bivalent during the pachytene
      stage of meiosis in a male T. glis specimen. Thus, apart from the mouse, the
      tupaias are the first nonprimate mammals for which cytogenetic and molecular
      evidence is provided that their highly heteromorphic X and Y chromosomes share a
      conserved homologous segment in the telomeric position, a location that is
      compatible with pairing and crossing-over in male meiosis. Taken together, these
      observations strongly, albeit indirectly, suggest that this chromosome segment at
      the tip of a sex-chromosome arm might behave pseudoautosomally.

PMID- 8467715
TI  - Refined physical mapping of chromosome 16-specific low-abundance repetitive DNA
      sequences.
AB  - Repetitive DNA sequences have been implicated in the origin of several disease
      phenotypes, including fragile X syndrome, myotonic dystrophy, and spinal bulbar
      atrophy. In addition, a complex family of chromosome 16-specific low-abundance
      repetitive (CH16LAR) DNA sequences have been mapped by fluorescence in situ
      hybridization to regions of chromosome 16 that undergo breakage/rearrangement in
      acute nonlymphocytic leukemia (ANLL) cells. It has been hypothesized that these
      repetitive sequences are causally related to the chromosome rearrangements found
      in ANLL. Here, we further refine the mapping of CH16LAR sequences with respect to
      the ANLL inversion breakpoints, using a panel of somatic cell hybrids containing
      51 different chromosome 16 breakpoints. These studies indicate that CH16LAR
      sequences at 16p13 are in close proximity to the ANLL short-arm breakpoint
      region. However, the region containing the highest density of CH16LAR sequences
      on the long arm appears to be distal to the region where the ANLL long-arm
      breakpoint has been mapped. These studies further show that CH16LAR sequences map
      in close proximity to FRA16D and FRA16A.

PMID- 8467717
TI  - The role of esophageal motility in gastroesophageal reflux disease: technique and
      clinical results of ambulatory 24-hour mano/-pH-metry.
AB  - The interplay between esophageal motility and gastroesophageal reflux (GER) was
      investigated with a new ambulatory system of 24-h monitoring of intraesophageal
      pressures and pH (MP24). The technique allows for simultaneous digital recordings
      and off-line data analysis. Both computer-aided and visual analyses were used,
      and algorithms for intercorrelation of mano- and pH-metry were developed. In a
      group of normal volunteers the physiological response of esophageal motility on
      GER was defined. In unselected patients suffering from GER disease, the
      esophageal motility prior to and during GER events were analyzed. In healthy
      people, most GER episodes occurred spontaneously and were cleared from the distal
      esophagus by peristaltic contractions. In GER patients, reflux episodes were
      often preceded by irregular contractions; during GER, esophageal motility was
      less often peristaltic compared with controls. Therefore, we conclude that MP24
      gives relevant information in GER disease which might help in selecting patients
      for medical or surgical therapy.

PMID- 8467716
TI  - Clinical use of ambulatory 24-hour esophageal motility monitoring in patients
      with primary esophageal motor disorders.
AB  - The development of miniaturized electronic pressure transducers and portable
      digital data recorders with large storage capacity has made ambulatory monitoring
      of esophageal motor function over an entire circadian cycle possible. Broad
      clinical application of this new technology in a large number of asymptomatic
      normal volunteers and patients with symptoms suggestive of a primary esophageal
      motor disorder provides new insights into esophageal motor function under a
      variety of physiologic conditions in health and disease. These studies suggest
      that ambulatory esophageal motility monitoring allows for a more precise
      classification of esophageal motor disorders than standard manometry and can
      identify abnormal esophageal motor patterns associated with nonobstructive
      dysphagia or noncardiac chest pain. Ambulatory esophageal motility monitoring
      performed in combination with pH monitoring is currently the most physiologic way
      to assess esophageal function and has potential to improve diagnosis and
      management of patients with esophageal motor disorders. Ambulatory 24-h
      esophageal motility monitoring should become the gold standard for assessing
      motor function of the esophageal body.

PMID- 8467718
TI  - pH monitoring: the gold standard in detection of gastrointestinal reflux disease?
AB  - Gastroesophageal reflux disease (GERD) is one of the most frequent benign
      diseases of the gastrointestinal tract and in some cases the diagnosis may be
      very difficult. There are many diagnostic procedures but none of them could prove
      or definitely exclude the disease. The 24-h pH-monitoring is the "gold standard"
      for detection of gastroesophageal reflux and in many patients the reflux
      correlates with the GERD. The evaluation of a diagnostic method has to be done in
      a similar manner to the evaluation of therapeutic study (phase 1 to phase 4). For
      the definition of the "gold standard" for detection of a special diagnosis (e.g.,
      the gastresophageal reflux disease), the results of phase 3 studies for different
      methods had to be compared. The method with the best values for sensitivity and
      specificity is yet to be discovered. Until now, pH monitoring has been the gold
      standard for the diagnosis of GERD. However, there are many problems connected
      with using this method in clinical practice.

PMID- 8467719
TI  - pH monitoring: is it the gold standard for the detection of gastroesophageal
      reflux disease?
AB  - Ambulatory, long term (24-h) intraluminal esophageal pH monitoring is the "gold
      standard" for detection and quantification of gastroesophageal reflux. Is it,
      however, the "gold standard" for the diagnosis of gastroesophageal reflux disease
      (GERD)? The answer depends in part on how GERD is defined. Is it to be defined on
      the basis of symptoms, inflammatory changes in the esophageal mucosa, extent of
      the exposure of the esophagus to acid or some combination of these factors? Since
      the correlation between acid exposure of the esophageal mucosa and either
      symptoms or histologic changes is poor at best, it seems there must be factors in
      addition to acid exposure that determine the severity of symptoms and histologic
      damage. One such is the resistance of the individual patient's mucosa to injury
      by acid exposure. In view of the above, it is not surprising that no specific
      value for acid exposure of the esophagus can be equated with the diagnosis of
      GERD. The addition of the symptom index, the frequency with which symptoms
      coincide with reflux episodes, has done little to increase the sensitivity and
      specificity of pH recording in the diagnosis of GERD. Another variable only
      occasionally considered is the day to day variation in the frequency and duration
      of acid reflux. Finally, intraesophageal pH recording measures only the intensity
      of acid exposure but we have no clinical measure of mucosa resistance to acid
      induced injury, the other factor contributing to the pathogenesis of GERD.

PMID- 8467722
TI  - Swallowing therapy in patients with neurological disorders causing
      cricopharyngeal dysfunction.
AB  - The results of swallowing therapy in 28 patients with neurological disorders
      causing cricopharyngeal (CP) dysfunction are reported. Variables described
      include the type of swallowing disorder, type and degree of aspiration, and
      therapeutic strategies. Patients were monitored by cineradiography before,
      during, and after therapy. Success of therapy was defined by progress in type,
      ease and safety of feeding, and range of diet. As an example, a case of an
      unusually severe disorder of a CP opening subsequent to brainstem
      meningoencephalitis is described. The bedside clinical evaluation,
      otolaryngologic findings, and radiographic studies helped determine an
      individualized program of swallowing therapy. Therapy goals, direct and indirect
      therapeutic strategies, and the treatment outcome are presented. Ninety percent
      of patients with CP dysfunction improved with swallowing therapy, 65% by
      objective and 25% by subjective criteria. We conclude that in neurological
      patients with CP, dysfunction can effectively be treated with swallowing therapy
      and that surgical approaches to CP dysfunction should be deferred pending the
      outcome of conservative management.

PMID- 8467723
TI  - Swallowing therapy with neurologic patients: results of direct and indirect
      therapy methods in 66 patients suffering from neurological disorders.
AB  - The results of direct and indirect therapy methods applied to 66 patients
      suffering from neurological disorders are presented. Variables considered were
      age, time since lesion, localization of central nervous system lesion, type of
      swallowing disorder (defined according to swallowing phase, type of aspiration
      and degree of aspiration), cognitive deficits (memory, planning/problem-solving,
      and attention deficits), and duration of therapy. Success of therapy was defined
      by progress in type, ease, and safety of feeding and by range of diet.
      Therapeutic outcome was correlated with the above-listed variables. The findings
      suggest that swallowing therapy is effective for patients with neurological
      disorders.

PMID- 8467720
TI  - Medical treatment of esophageal motility disorders.
AB  - Swallowing is a complex mechanism that is based on the coordinated interplay of
      tongue, pharynx, and esophagus. Disturbances of this interplay or disorders of
      one or several of these components lead to dysphagia, non-cardiac chest pain, or
      regurgitation. The major esophageal motility disorders include achalasia, diffuse
      esophageal spasm, hypercontractile esophagus ("nutcracker esophagus"), and
      hypocontractile esophagus ("scleroderma esophagus"). Other esophageal diseases
      such as hypopharyngeal (Zenker's) diverticula or gastroesophageal reflux disease
      also may be sequelae of primary esophageal motility disorder. Finally, a
      substantial group of patients referred for evaluation of possible esophageal
      motor disorders have milder degrees of dysmotility--referred to as nonspecific
      esophageal motor disorder--that are of unclear clinical significance. Medical
      treatment of esophageal motility disorders involves the uses of agents that
      either reduce (anti-cholinergic agents, nitrates, calcium antagonists) or enhance
      (prokinetic agents) esophageal contractility. Despite the beneficial effect of
      the various drugs on esophageal motility parameters, the clinical benefit of
      medical treatment is often disappointing. From clinical and epidemiological
      studies there is some evidence for a "psychological" component in the
      pathogenesis or perception of esophageal symptoms. Further understanding of
      esophageal pathophysiology, as well as development of new receptor selective
      drugs, might increase our chances of successful treatment of esophageal motility
      disorders.

PMID- 8467721
TI  - The surgical management of motility disorders.
AB  - Surgical treatment is either the therapy of choice or a facultative procedure in
      various types of esophageal motility disorders. In achalasia, cardiomyotomy,
      frequently combined with fundoplasty, achieves good or excellent results in > 80%
      of cases, and is, therefore, advised in cases when pneumostatic dilatation fails.
      Diverticulectomy and myotomy of the upper or lower esophageal sphincter are
      proven procedures to treat cervical and epiphrenic diverticula, leading to
      good/excellent results or at least an improvement in more than 95%. If,
      exceptionally, parabronchial diverticula require therapy, they should be excised
      transthoracically. Cervical myotomy is indicated in cases of cervical achalasia,
      when sufficient pharyngeal propulsion is preserved. In systemic diseases like
      scleroderma reflux induced complications may require surgical intervention in
      medically intractable cases. In these rather few cases, subtotal gastrectomy with
      a Roux-en-Y anastomosis is advised. In patients suffering from diffuse esophageal
      spasm or symptomatic "nutcracker" esophagus, extended esophageal myotomy can
      relieve symptoms. If a clear diagnosis is provided, about 75% of patients will
      have an improvement of symptoms.

PMID- 8467724
TI  - Drug-induced dysphagia.
AB  - Dysphagia describes the disability or problems in swallowing a wet or dry bolus
      properly and is normally associated with an impaired transport of the bolus.
      Dysphagia can be accompanied by a pain sensation in the chest mostly caused by
      impaction of the food bolus in the esophagus. Odynophagia describes only the
      status of painful swallowing without an impairment of the swallow and transport
      function. Drug-induced dysphagia can be caused in two different ways. First as a
      normal drug side effect of the pharmacological action of the drug or as a
      complication of the therapeutic action of the drug. The normal drug side effect
      is most likely in drugs that affect smooth or striated muscle function or the
      sensitivity of the mucosa. The drug effect on smooth muscle function that causes
      dysphagia can be inhibitory or excitatory. Dysphagia is a common clinical symptom
      in patients with reduced perception of the pharyngeal mucosa which leads to an
      subjective impairment of swallowing. Dysphagia caused by a complication of the
      therapeutic action of a drug includes viral or fungal esophagitis in patients
      treated with immunosuppressive drugs or cancer therapeutic agents, or antibiotics
      and immunological reactions to certain drugs such as erythema exsudativa
      multiforme or Stevens-Johnson syndrome. Second, drug-induced dysphagia can be due
      to medication-induced esophageal injury (MIEI). In most cases this mucosal injury
      appears to be the direct result of prolonged contact of a potentially caustic
      drug with the esophageal mucosa. This form of medication-induced esophagitis is
      most likely to be found in elderly patients and patients with esophageal motility
      disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467726
TI  - Art and science of history taking in the patient with difficulty swallowing.
AB  - History taking is the first step in the evaluation of a patient. An analysis of
      the information obtained provides the basis for the choice and order of
      diagnostic tests. In addition, it provides the clinician with the necessary
      information to determine the relevance of "abnormal tests" to the patient's
      problem. Dysphagia is a reliable symptom that indicates an abnormality in the
      swallowing mechanism. The history should contain a detailed description of the
      symptoms associated with dysphagia from the onset. Especially relevant are
      questions to determine if dysphagia is experienced every day or intermittently,
      with solid food or liquids or both, as well as presence and timing of associated
      symptoms such as, choking, coughing and regurgitation, changes in speech,
      heartburn and chest pain. It is clinically useful to divide swallowing into three
      phases: oral, pharyngeal and esophageal. Oral dysphagia is usually due to a
      neurologic disorder, decreased salivary flow or painful oropharyngeal lesions.
      Pharyngeal dysphagia is most frequently caused by neuromuscular disorders and
      less frequently by a Zenker's diverticulum, neoplasm or a mucosal web. Esophageal
      dysphagia is caused by a structural narrowing, such as produced by a peptic
      stricture, neoplasm or a Schatzki's ring or by a primary motility abnormality,
      such as achalasia or diffuse esophageal spasm or by motility abnormalities
      produced by inflammation caused by gastroesophageal reflux, medication-induced
      esophageal ulceration or infectious esophagitis.

PMID- 8467725
TI  - Wylie J. Dodds, M.D.: a memorial "going funded".

PMID- 8467727
TI  - Coordination of peristalsis in pharynx and esophagus.
AB  - When a swallowed liquid bolus is followed from mouth to stomach in man by
      contrast studies or manometry, it traverses its course without hesitation even
      though the bolus is propelled by striated muscle contraction in the first part of
      its journey and smooth muscle in the latter part. The striated muscle is
      innervated by excitatory cholinergic nicotinic cranial nerves whereas the smooth
      muscle of the esophagus is innervated by the enteric nervous system (ENS) through
      excitatory and inhibitory nerves. These differences can be demonstrated by
      observing the inhibitory effects of curare and atropine, the first blocking
      nicotinic receptors and the second muscarinic receptors. Early students of
      esophageal motility recognized that peristalsis could be initiated in two ways.
      The first is initiated by a swallow and is called primary peristalsis and the
      second called secondary peristalsis is initiated by distension of the esophagus.
      It was proposed that primary peristalsis was initiated by a single sensory input
      activated by the bolus entering the pharynx which in turn activated a motor
      program in the brain stem. Secondary peristalsis was believed to be stimulated by
      multiple afferent impulses arriving from the esophagus as the bolus passed down
      the esophagus. More recent studies using manometric techniques have suggested
      that the only difference between primary and secondary peristalsis is the
      afferent stimuli and the effector mechanism is the same. Subsequent studies of
      carefully timed, paired swallows, transection of vagus nerves and esophagus, and
      single nerve recordings suggest that the answer lies between the two extremes
      noted above.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467729
TI  - Commentary on the determination of the evaluation of dysphagia.

PMID- 8467730
TI  - Dysphagia in dermatologic disease.
AB  - Disorders of the oral cavity, pharynx, and esophagus may be found in some
      dermatologic diseases. The connective tissue diseases especially may be
      accompanied by dysphagia. Furthermore, some rare inflammatory and bullous
      dermatologic diseases can lead to esophageal disorders. Finally, some infectious
      and malignant diseases occurring in human immunodeficiency virus (HIV)-infected
      patients cause dysphagia (Table 1). The following discussion presents a
      comprehensive review of these diseases and their typical esophageal dysfunction.

PMID- 8467728
TI  - The gastroenterologist's approach to dysphagia.
AB  - In the gastroenterological diagnostic armamentarium, dysphagia is considered as
      an important symptom for diseases of the esophagus. Concerning the history of
      illness, symptoms such as retrosternal pain and heartburn are often associated
      with gastroesophageal reflux disease. Morphological changes of the mucosa can be
      diagnosed by flexible endoscopy and radiographic examinations. Investigation with
      24-h pH monitoring, manometry, and pharmacological tests is necessary for the
      diagnosis of functional disorders. Additionally, dysphagia can be associated with
      multiple internal diseases, including muscular diseases such as dermatomyositis,
      progressive systemic sclerosis, as well as lupus erythematosus. Difficulties in
      swallowing associated with hypo- and hyperthyroidism can also be interpreted as
      muscular lesions. Metabolic disorders such as alcoholism, and diabetes mellitus
      can be the cause of dysphagia. Increasing importance in the differential
      diagnosis of dysphagia is attached to infections of the upper GI tract.
      Especially in immunocompromised patients, infections of Candida albicans,
      mycobacterias, herpes, varicella zoster, and cytomegaloviruses can produce
      dysphagia and odynophagia. The differential diagnosis of the "angina-like chest
      pain" has to differentiate between cardiac disease and a noncardiac genesis.
      Therefore, besides the cardiac diagnostic investigation, endoscopy, radiography,
      and manometry are often indicated.

PMID- 8467731
TI  - The value of endoscopy and endosonography in the diagnosis of the dysphagic
      patient.
AB  - The value of endoscopy in dysphagia is limited in the diagnosis of motility
      disorders and small structures, webs, and hiatal hernias. Endoscopy is of special
      use for the clarification of an organic cause of dysphagia. Intraluminal tumors
      can be seen and in a high percentage of cases be definitely diagnosed by taking
      biopsies; a malignant degeneration in Barrett's esophagus is detectable by
      endoscopy in 89.1% of cases. Gastroesophageal reflux disease can be diagnosed on
      endoscopy as it leads to an endoscopically visible inflammatory reaction;
      however, normal findings on endoscopy cannot exclude reflux disease. Endoscopy is
      the method of choice in the diagnosis of nonreflux esophagitis, especially
      Candida and viral esophagitis. A further advantage of endoscopy is the fact that
      a microscopic diagnosis can be obtained and endoscopic treatment can be performed
      simultaneously. Submucosal or extramural lesions can be missed by endoscopy.
      Endosonography, the combination of endoscopy and ultrasonography (EUS) yields
      additional information in diagnosing submucosal and extramural lesions of the
      esophagus which is missed by other imaging procedures. One of the main advantages
      of EUS is the detection of small and submucosal lesions. The most important
      indication is the local staging of esophageal carcinomas; the accuracy of
      endosonography in determining the depth of infiltration ranges between 79% and
      92%. The detection of paraesophageal lymph nodes is successful in 60%-82%,
      although EUS cannot differentiate benign from malignant lymph nodes. Submucosal
      tumors can be visualized by endosonography and their size, echopattern, and the
      layers of origin can be determined with high accuracy. Further indications for
      EUS are the exclusion of focal lesions in achalasia or peptic strictures.

PMID- 8467732
TI  - The place of esophageal manometry in the diagnosis of dysphagia.
AB  - Esophageal manometry allows to quantify intraluminal pressure changes as the
      basis of normal or abnormal esophageal motility. It is a complementary diagnostic
      procedure which should only be performed after endoscopic and fluoroscopic
      examinations and may be helpful in the detection of various motility disorders
      like diffuse esophageal spasm, nutcracker esophagus and vigorous achalasia.
      Manometry is recommendable for therapy control after medical and surgical
      therapy, and mandatory prior to surgical reflux therapy.

PMID- 8467733
TI  - [Intra-individual variations in triglyceride and total cholesterol levels in
      serum in mixed hyperlipidemia].
AB  - Swings in serum concentrations of total cholesterol and triglycerides were
      assessed retrospectively in 12 of 60 patients with mixed hyperlipidaemia (ten
      men, two women; mean age 44 [38-55] years). A second disease as a cause of the
      hyperlipidaemia had been excluded. Despite clinical stability and unchanged drug
      therapy the fasting values of triglycerides, measured enzymatically, in a minimum
      of four different samples (over several months) differed by more than 5 mmol/l, a
      mean of 16.6 (5-41.9) mmol/l. The lowest values were 2.7 (1.3-7.5) mmol/l, the
      highest 17.9 (6.4-44.6) mmol/l. Total cholesterol concentrations varied around
      5.5 (1.6-31.7) mmol/l, minimal values 5.7 (4.2-8.9) mmol/l, maximal ones 12.0
      (6.9-37.4) mmol/l. Six of the twelve patients consumed more than 60 g alcohol
      daily. The cause of the marked variations between individual samples is
      uncertain. Marked swings in triglyceride and total cholesterol concentrations are
      likely in mixed hyperlipidaemia. It is, therefore, essential to measure these
      concentrations repeatedly to assess correctly the diagnosis and treatment.

PMID- 8467734
TI  - [Acute plasma cell leukemia. Clinical course during high-dose melphalan therapy].
AB  - A 29-year-old woman, with a slightly elevated temperature for 3 weeks, increasing
      dyspnoea at rest, markedly reduced general condition and in heart failure, was
      found to have a leucocytosis of 100,000/microliters, anaemia (haemoglobin 6.3
      g/dl) and thrombocytopenia (41,000/microliters). There were 62% plasma cells in
      the blood smear. Immunoelectrophoresis of serum and urine revealed kappa-light
      chains and immunocytology demonstrated IgG-kappa. There was no radiological
      evidence of osteolysis, while ultrasound examination showed multiple abdominal
      lymphomas and marked hepatosplenomegaly. Bone marrow smear showed a 90%
      infiltration of plasma cells. High-dosage melphalan treatment (single intravenous
      injection of 140 mg/m2) resulted in complete remission after myelodepression over
      several weeks. Two extramedullary recurrences 5 and 12 months after the diagnosis
      had been made were successfully treated with high-dosage melphalan, but it was
      associated with severe and long-lasting myelodepression. Septicaemia with renal
      and hepatic failure developed and the patient died 6 weeks after the third course
      of high-dosage melphalan, 14 months after the diagnosis.

PMID- 8467735
TI  - [Mediastinal chloroma with right heart involvement. Unusual cause of a superior
      vena cava syndrome].
AB  - For four months a 28-year-old man had been suffering from a sensation of pressure
      in his head when lying down, swelling of the face, exertional dyspnoea and weight
      gain of 9 kg. Biochemical tests and chest radiograph were unremarkable.
      Echocardiography revealed a 3 x 5 cm mass in the right atrium, extending into the
      superior vena cava whose lumen was narrowed to a few millimetres. Computed
      tomography and magnetic resonance imaging were suggestive of a malignant tumour.
      Bone marrow biopsy as well as transvascular and mediastinoscopically obtained
      biopsies failed to provide a pathological diagnosis. Exploratory thoracotomy
      uncovered a nonresectable chloroma surrounding both venae cavae. It had
      penetrated into the right and left atria, as well as the pulmonary veins. A Gore
      tex bypass was placed between the innominate vein and right atrial appendage. The
      tumour was identified as a local manifestation of acute myeloid leukaemia.
      Treatment with idarubicin (12 mg/m2 daily for 3 days) and adriamycin (1.5 mg/m2
      daily for 4 days) followed by radiotherapy with 35 Gy achieved partial remission
      and 15 months after onset of treatment the patient is in a good general
      condition.

PMID- 8467736
TI  - [Symptoms and diagnosis of Lyme borreliosis].

PMID- 8467739
TI  - [Gastric lymphoma following chromium or nickel exposure?].

PMID- 8467738
TI  - [What are the facts in the treatment of diabetic nephropathy?].

PMID- 8467737
TI  - [McLeod syndrome].

PMID- 8467740
TI  - [Calcium replacement in hemotherapy].

PMID- 8467741
TI  - [Intramuscular injection of vaccines].

PMID- 8467742
TI  - [Differential diagnosis of hypereosinophilia syndrome].

PMID- 8467743
TI  - [Mercury sensitization in amalgam fillings. Assessment from a dermatologic
      viewpoint].
AB  - Epicutaneous tests were performed on 88 patients (27 men, 61 women; mean age 36.8
      [18-68] years) thought to have an allergy against amalgam or mercury. In addition
      their oral mucosa was assessed clinically. The epicutaneous test was positive for
      mercury sensitization in seven patients, five of them reporting oral mucosa
      symptoms. Such symptoms also occurred, although less frequently, in non
      sensitized patients (30 of 81). In three sensitized patients there was evidence
      of perioral dermatitis which in two of them cleared up after removal of the
      amalgam fillings. Two further patients had no further complaints, such as burning
      sensation on the oral mucosa, recurrent aphthous ulcers or gingivitis, after
      removal of amalgam fillings. In one patient each peroral eczema and diarrhoea
      aggravated after amalgam fillings had been taken out. These observations indicate
      that responses to mercury allergy are not uniform and show considerable
      individual variations. There is no reason to advise against or prohibit the use
      of amalgam fillings. Their substitutions by other materials may well bring about
      other types of allergy.

PMID- 8467745
TI  - [Rothmund-Thomson syndrome].
AB  - One year after a normal birth a girl developed large, flat and net-like
      telangiectasias and erythema with hyper- and depigmentation (poikiloderma), at
      first in the face and later on the limbs, sparing the trunk. There was increased
      light sensitivity of the affected areas. At 3 years and 8 months of age her
      height was diminished (3rd percentile; height 104 cm, weight 15 kg) and she had a
      deep nasal root and bradydactylia. These cutaneous and extracutaneous
      abnormalities correspond to the spectrum of Rothmund-Thomson syndrome which has a
      wide clinical heterogeneity. The family history for this condition was negative.

PMID- 8467744
TI  - [Severe hemoptysis in pulmonary vasculitis].
AB  - A 27-year-old man, in good health but a moderate smoker, suddenly had two
      episodes of haemoptysis. Routine clinical examination was unremarkable.
      Erythrocyte sedimentation rate was increased to 34 mm/h. The chest radiography
      showed ill-defined, contrast-poor infiltrations bilaterally, as well as left
      hilar enlargement. Lung scintigraphy and pulmonary arteriogram suggested
      pulmonary embolism, possible from a "pelvic vein spur", i.e. an intimal
      proliferation due to crossing of the common iliac artery over the pelvic vein. He
      was placed on oral anticoagulants. Three months later he had another severe
      haemoptysis, providing the indication for an exploratory thoracotomy. This
      revealed the left pulmonary artery wall to have inflammatory changes with
      aneurysmal dilatation. The aneurysm was plicated. Histological examination
      demonstrated chronic vasculitis as seen in Behcet's syndrome, a diagnosis
      confirmed by the findings of ulcers of the oral mucosa and the presence of HLA B5
      allo-antigens. Immunosuppressive treatment was given with prednisone (1 mg/kg),
      azathioprine (2.5 mg/kg) and ciclosporin (5 mg/kg). Over the next 12 months there
      has been only one further haemoptysis.

PMID- 8467746
TI  - [Therapy of Lyme borreliosis].

PMID- 8467747
TI  - [Circadian incidence of cardiovascular incidents and hypertension upon
      awakening].

PMID- 8467749
TI  - [Thrombocytopenia following Varicella zoster infection].

PMID- 8467748
TI  - [Azathioprine in Crohn disease].

PMID- 8467750
TI  - [Penicillin-resistant pneumococci in the German Federal Republic].

PMID- 8467751
TI  - [Prognosis of legasthenia].

PMID- 8467752
TI  - [Analgetic irradiation of degenerative-inflammatory skeletal diseases. Benefits
      and risks].
AB  - Between 1980 and 1991, ionizing radiation was applied for analgesic purposes to
      181 patients (97 men, 84 women, mean age 54 [29-81] years) with degenerative
      inflammatory skeletal disease. The long-term effects were evaluated by
      questionnaire. Radiation of 2.5 to 6.0 Gy achieved lasting pain relief in 21 of
      30 patients (70%) with arthritis of the shoulder or humeroscapular periarthritis,
      15 of 21 (71%) with arthritis of the hip, in 12 of 15 (80%) with heel spurs or
      Achilles tendon bursitis and 10 of 11 (91%) with epicondylitis. Pain relief
      lasted for longer than two years in 41 of the 77 patients (53%). There were no
      side effects at the stated dosage. According to dose measurements the theoretical
      risk of malignant tumour induction is 20-40/million radiated patients and thus
      four orders of magnitude below the spontaneous malignant tumour incidence rate.
      The genetic risk is even lower. Ionizing radiation of degenerative-inflammatory
      diseases is thus an effective form of treatment with few side effects.

PMID- 8467753
TI  - [Stent implantation in solitary aneurysm of the common iliac artery].
AB  - A 56-year-old man had intermittent claudication in the right leg for 11 months,
      gradually worsening of late. Digital subtraction angiography demonstrated an
      aneurysm, 8 x 2.5 cm, of the right common iliac artery and 70% stenosis of the
      right external iliac artery. As the patient refused full surgical intervention
      the aneurysm was treated by the insertion of two exactly adjoining wall stents
      (diameter 9 mm, length 7 cm), and the arterial stenosis was balloon-dilated. One
      month after stent implantation the aneurysm had thrombosed outside of the stent
      and the stent lumen was being perfused normally. 6 months later the local
      findings were identically. The patient remained symptom-free. --The case
      illustrates that management of circumscribed aneurysms by stent implantation
      could well be an alternative to surgical treatment, as long as the stent can
      prevent enlargement and rupture of the aneurysm.

PMID- 8467754
TI  - [Endobracyesophagus. Pathogenesis, epidemiology and malignant degeneration].

PMID- 8467755
TI  - [Post-traumatic splenectomy].

PMID- 8467756
TI  - ["Tumorous" overgrown gastrostomy tube].

PMID- 8467757
TI  - Nutrition and lung structure and function.

PMID- 8467758
TI  - Effect of a synthetic leukocyte elastase inhibitor on thrombin-induced pulmonary
      edema in the rat.
AB  - The effect of a synthetic leukocyte elastase inhibitor on thrombin-induced
      pulmonary edema was studied in rats. The chloromethylketone human neutrophil
      elastase inhibitor, ICI 200,355, blunted rat leukocyte elastase activity in rat
      lung tissue. Administration of thrombin produced a significant increase (p < .01)
      in lung weight. The wet weight to dry weight ratio (WW/DW) and relative water
      contents were also significantly elevated (p < .01). Pretreatment with ICI
      200,355 (200 micrograms/kg h-1) resulted in significant reductions (p < .05) in
      lung weight and a tendency to decrease WW/DW and water content compared with
      animals given thrombin alone. It is possible that the elastase inhibitor
      effectively reduced the rate of thrombin-induced pulmonary edema by attenuation
      of increased vascular permeability.

PMID- 8467759
TI  - Lung antioxidant enzymes and cardiopulmonary responses in young rats exposed to
      hyperoxia and treated intratracheally with PEG catalase and superoxide dismutase.
AB  - The 27-day-old rat exposed to 100% oxygen (O2) for 8 days will have predictable
      lung vascular and parenchymal changes at 60 days of age. Using this model, the
      goals of this study are (1) to measure the lung antioxidant enzyme activities
      serially following intratracheal PEG antioxidant therapy during the 8-day O2
      exposure; and (2) to assess chronic cardiopulmonary changes in the O2-exposed
      rats treated with PEG-CAT and/or PEG-CuZn SOD given intraperitoneally (IP) and/or
      intratracheally (IT). The study encompassed 202 male rats exposed to room air or
      oxygen. CuZn SOD doses were 300 U IT and 2000 U IP. The CAT dose was 500 or 4000
      U IT and 10,000 U IP. At 60 days of age, the right ventricular systolic pressure
      (RVP), RV weight, % acinar wall arterial thickness, and parenchymal air space
      were significantly increased in O2-exposed rats compared to RA rats. The RVP, RV
      weight, and parenchymal changes were prevented by daily IT PEG-CAT 4000 U + CuZn
      SOD 300 U but the increased small artery muscularization was not. Three hours
      after the initial dose of IT PEG-CAT 4000 U, lung CAT activity was more than
      doubled and remained constant throughout the 8-day daily treatment course. This
      dose of CAT depressed the induction response to O2 of CuZn and MnSOD. It is
      concluded that daily intratracheal administration of PEG-CAT 4000 U + CuZn SOD
      300 U can significantly ameliorate some of the chronic parenchymal and vascular
      lung O2 toxic changes. However, it appears that high-dose exogenous PEG-CAT
      suppresses the endogenous enzyme induction to hyperoxia of both CuZn and Mn-SOD.

PMID- 8467760
TI  - Pulmonary epithelial cell proliferation in primary culture of alveolar type II
      cells.
AB  - A small subpopulation of pulmonary epithelial cells (PE) proliferates in low
      density primary culture of alveolar type II cells and forms colonies of cells
      that could be passaged for several generations and that in some respects maintain
      a differentiated phenotype of the alveolar type II cells. At this time it is not
      known if these cells are some form of progenitor epithelial cells or type II
      cells that are not fully differentiated in vitro. The proliferation of the PE
      cells was dependent on serum, alveolar macrophage-conditioned medium, and insulin
      being included in the culture medium. Under these conditions, approximately 0.5
      1.0% of the seeded cells that adhered to the culture dishes were capable of
      forming colonies. Efficiency of colony formation increased to 5-10% in subsequent
      passages. PE cells maintained a high level (> 40%) of saturated
      phosphatidylcholine (PC) as a percentage of total PC throughout the culture
      period (> 28 days). However, the saturated PC content was not constant throughout
      the long-term culture period and the subsequent passages (41.3% at 29 days and
      37.3% in the 3rd passage). These cells also contained numerous lamellar bodies
      and were able to bind the Maclura pomifera lectin. PE cells also expressed
      cytokeratin No. 19, as well as alkaline phosphatase activity, both possible
      markers for differentiated type II cells. However, PE cell synthesized low levels
      of Pg (approximately 2%), were squamous, and tended to form multiple strata,
      unlike the cuboidal type II cells in vivo. The cells did not exhibit
      immunocytochemically demonstrable surfactant-associated protein A (SP-A).
      Additional factors and culture requirements may be necessary for complete
      maturation of cultured PE cells. This was demonstrated by culturing PE cells on
      EHS matrix. Aggregates of cells surrounding a central lumen were formed after a
      few hours in culture and were maintained for 20 days. The cells contained
      lamellar bodies and some intercellular junctions. PE cells can be regarded as a
      highly selected subpopulation of pulmonary epithelial cells that concomitantly
      maintain proliferation and aspects of differentiated alveolar type II cells in
      long-term culture.

PMID- 8467761
TI  - Pulmonary air-space enlargement induced by intratracheal instillment of
      hyaluronidase and concomitant exposure to 60% oxygen.
AB  - Although emphysema is generally characterized by damage to pulmonary elastic
      fibers, the causes of such injury appear to be complex and are not entirely
      explained by a singular imbalance between elastases and their inhibitors. Other
      factors could compromise elastic fiber integrity. To test the validity of this
      argument, hamsters were instilled intratracheally with a nonelastolytic enzyme,
      hyaluronidase (which reduces lung hexuronic acid content by 21% after 24 h), then
      exposed to an otherwise nontoxic concentration of oxygen (60%) for 4 days.
      Additional groups were given (1) hyaluronidase and room air, (2) saline and 60%
      oxygen, and (3) saline and room air. Treatment with both hyaluronidase and 60%
      oxygen resulted in a significant increase in air-space enlargement at 4 days
      (67.1 vs. 57.9 microns for saline/room air controls; p < .05), which was
      accompanied by only minimal inflammatory changes, as determined by both light
      microscopy and lavage cytology. Animals receiving either hyaluronidase or 60%
      oxygen alone showed no significant increases in air-space size compared to those
      given saline and exposed to room air. While the mechanisms responsible for these
      results are unclear, the marked increase in radiolabeling of lung elastin cross
      links (desmosine and isodesmosine) in animals receiving both hyaluronidase and
      60% oxygen (429 vs. 168 cpm/g dry lung for saline/room air controls; p < .05), as
      well as a significant decrease in total lung desmosine and isodesmosine (32.5 vs.
      37.7 micrograms/lung for saline/room air controls; p < .05), suggests that
      elastic fiber damage is a potential factor. Moreover, only those animals
      receiving both hyaluronidase and 60% oxygen showed a significant rise in cell
      free elastase activity in lavage fluids compared to saline/room air controls
      (83.3 vs. 48.3 ng; p < .05). On the basis of these findings, it is concluded that
      while elastic fiber damage may be a common pathway in emphysema, the factors that
      initiate the disease may be more varied than previously suspected and not always
      related to the balance between elastases and their inhibitors.

PMID- 8467762
TI  - Administration of bromodeoxyuridine in early postnatal rats results in lung
      changes at maturity.
AB  - The purpose of this study was to examine how lungs in early postnatal animals
      that are administered bromodeoxyuridine (BrdU), a thymidine analog known to be a
      cytogenetically toxic agent, change in adult life. BrdU was injected (1 mg/g body
      weight) intraperitoneally in suckling rats on day 6 after birth.
      Immunohistochemical studies revealed that BrdU was incorporated in alveolar
      cells, and infrequently in the mesothelium, endothelium, and bronchiolar
      epithelium. The number (per high-power field) of alveolar cells incorporating
      BrdU was 8.76 +/- 0.50 in the interstitium and 1.66 +/- 0.25 in the epithelium.
      The animals were sacrificed at 2 and 8 weeks and 12 months of age. Control
      animals were treated the same as the BrdU-treated animals except for the
      injection of BrdU. Body weight, body size (nose-tail length), and lung weight
      were identical between BrdU-treated animals and control animals at all
      experimental periods. The histopathology and physiology of these lungs were
      studied. At 2 weeks of age, the BrdU-treated animals appeared morphologically and
      functionally similar to control animals. At 8 weeks and 12 months of age, the
      lungs in the BrdU-treated animals showed abnormal enlargement of the airspace,
      few alveoli, and less complexity in pulmonary architecture with or without
      increased lung compliance. These findings suggest that lung injured
      cytogenetically in early postnatal life may develop functional and structural
      abnormalities in later life.

PMID- 8467763
TI  - Role of protein synthesis and CD11/CD18 adhesion complex in neutrophil emigration
      into the lung.
AB  - The mechanism of neutrophil (PMN) emigration into the lung may be stimulus
      dependent. This study examined PMN emigration in the lung induced by
      intratracheal instillation of lipopolysaccharide (LPS), Streptococcus pneumoniae
      (S. pneu) organisms, supernatant from S. pneu incubated with alveolar macrophages
      (AM phi), Escherichia coli (E. coli) organisms, or phorbol myristate acetate
      (PMA). Rabbits were pretreated with either the CD18 monoclonal antibody (MAb)
      60.3, the protein synthesis inhibitor cycloheximide (Cx), or, in one case, both.
      Animals were then given one of the above stimuli to elicit PMN emigration. Four
      hours after the stimulus was instilled, animals were killed and total and
      differential cell counts were performed on bronchoalveolar lavage (BAL) fluid.
      PMN emigration in response to PMA was virtually abolished by MAb 60.3, but was
      not significantly inhibited by Cx. Emigration induced by LPS was inhibited by 80%
      by either MAb 60.3 or Cx, and greater than 94% when MAb 60.3 and Cx were given
      simultaneously. Emigration in response to E. coli organisms was 80% inhibited by
      MAb 60.3. Emigration induced by S. pneu was approximately 50% inhibited by MAb
      60.3, but was greater than 90% blocked by Cx. The MAb 60.3 had approximately the
      same effect on PMN emigration toward the supernatant from co-incubation of AM phi
      with S. pneu as it did toward live S. pneu. It is concluded that the mechanism of
      PMN emigration into the lung is stimulus-dependent. The CD18-dependent mechanism
      is responsible for the majority of the emigration in response to PMA, E. coli
      LPS, and E. coli organisms. S. pneu and supernatant from S. pneu + AM phi produce
      a CD18-independent pathway. These data suggest the requirement for de novo
      protein synthesis for PMN emigration in response to LPS and S. pneu, but not for
      PMA-induced emigration.

PMID- 8467764
TI  - Clearance of 99mTc-labeled albumin from lungs in anesthetized guinea pigs.
AB  - Gamma imaging was used to measure the rate of clearance of aerosolized 99mTc
      human serum albumin (HSA) from the lungs of control guinea pigs and guinea pigs
      that received increased lung inflation or lung injury. Anesthetized guinea pigs
      were ventilated for 6 min with an aerosol of HSA and the radioactivity in the
      chest was monitored for 2 h with a gamma camera to determine whether the
      clearance rate would be a reliable assessment of lung epithelial permeability.
      Increased lung volumes were effected by application of 5 or 7 cm H2O positive end
      expired pressure (5-PEEP and 7-PEEP, respectively). Lung injury was induced
      either by intravenous oleic acid (OA, 27-73 microliters/kg) or inhalation of
      nitrogen dioxide (NO2, 80-100 ppm) for 2 h. Postmortem extravascular lung water
      volume (EVLW) provided an assessment of the degree of lung injury. Tracer
      clearance rates in animals receiving 5 or 7 cm H2O PEEP were not significantly
      different from controls (K = 0.15 +/- 0.05 and 0.24 +/- 0.10 vs 0.12 +/-
      0.03%/min, respectively, p > .05). Animals exposed to NO2 had faster tracer
      clearance rates (K = 0.33 +/- 0.21%/min, p < .05) and higher EVLW (5.8 +/- 3.0 vs
      3.7 +/- 0.2 mL/g dry lung, p < .05) than controls. Clearance rates of HSA from
      the lungs of NO2-exposed guinea pigs correlated well with injury as assessed by
      EVLW (r = .93, p < .01). Clearance rates of HSA and EVLW in animals receiving
      oleic acid were significantly higher than controls and the group receiving 5 cm
      H2O PEEP (K = 0.58 +/- 0.41%/min, EVLW = 8.1 +/- 0.8 mL/g dry lung tissue, p <
      .05), but there was no correlation between these parameters in this injury model.
      It is concluded that imaging of the disappearance of radiolabeled HSA in the
      guinea pig can be a useful index of lung epithelial permeability, but this
      technique is limited to certain models of lung injury.

PMID- 8467765
TI  - Cellular and cytokine profiles in spontaneous regression phase of
      hypersensitivity pneumonitis.
AB  - The phase of spontaneous regression of hypersensitivity pneumonitis was evaluated
      using a mouse model. C57BL/6 mice were instilled intranasally with 150 micrograms
      of the thermophilic actinomycete Faeni rectivirgula 3 days a week so as to
      establish a mouse model of farmer's lungs. It was shown that instillation of mice
      for a period of more than 6 weeks was associated with a significant decrease in
      the lung inflammation, suggestive of the so-called spontaneous regression phase
      seen in this pathology. Indeed, the lung index was seen to decrease after more
      than 6 weeks of treatment (2.2 after 6 weeks vs. 1.7 at 12 weeks, p < .01). There
      was also a significant decrease in lung hydroxyproline levels in animals given 12
      weeks of treatment (175 micrograms/lung) compared to 6-week-treated animals (212
      micrograms/lung, p < .05). Treated mice did not show a significant decrease in
      the alveolitis after 9 weeks of treatment. Also, there was no evidence that there
      was a decrease in bronchoalveolar lavage macrophage or T lymphocyte activity in
      mice given more than 9 weeks of F. rectivirgula treatment, as judged by O2-
      release and antigen-driven proliferation. Conversely, it was shown that NK cell
      activity in the lung digest of mice given 9 to 12 weeks of instillation was
      significantly higher than that seen in mice given 6 weeks of treatment. Analysis
      of the lung cell cytokine profile seen after ConA mitogenesis showed that after 6
      weeks of F. rectivirgula treatments, nonparenchymal cells secreted high levels of
      tumor necrosis factor alpha (TNF alpha) and granulocyte macrophage colony
      stimulating-factor (GM-CSF), whereas similar cells from the lungs of mice given 9
      12 weeks of treatment secreted larger amounts of interferon-gamma (IFN gamma) and
      interleukin-2 (IL-2). Overall, these results suggest that the spontaneous
      regression phase is associated with changes in NK cell activity and lung cell
      lymphokine profile.

PMID- 8467766
TI  - Elastase causes secretory discharge in bronchi of hamsters with elastase-induced
      secretory cell metaplasia.
AB  - A single intratracheal instillation of human neutrophil elastase (HNE) into
      hamsters causes granule discharge from bronchial secretory cells followed by
      marked accumulation of granules, visible by light microscopy at 21 days and
      persisting through 18 months. To determine whether persistence of this secretory
      cell metaplasia (SCM) is due to inability of the metaplastic secretory cells to
      secrete their granules, hamsters having HNE-induced SCM were challenged with the
      potent secretagogue HNE. Four groups of 10 hamsters each received 300 micrograms
      HNE intratracheally. Twenty-one days later, hamsters were intratracheally treated
      with HNE or saline; the groups were designated HNE-HNE and HNE-SAL, respectively.
      Hamsters were killed 2 h or 21 days following the second treatment. Using light
      microscopy, nucleated epithelial cells were counted in plastic sections of the
      left main intrapulmonary bronchus. Cells were classified as ciliated (C), basal
      (B), indeterminate (IN), or secretory. Secretory cells were subcategorized as S0
      (0 granules), S1 (1-4 granules), S2 (> or = 5 granules with intervening
      cytoplasm), and S3 (abundant granules completely filling the cytoplasm). At 2 h,
      S3 cell frequency in the HNE-HNE group was 13.0 +/- 2.2 (% mean +/- SE),
      significantly lower than in the 2 h HNE-SAL group (31.1 +/- 4.5). Concomitantly,
      higher cell frequencies were seen in the other secretory categories of the HNE
      HNE group compared to the HNE-SAL group; S2 17.1 +/- 1.9 compared to 9.4 +/- 1.9,
      S1 2.4 +/- 0.4 compared to 1.1 +/- 0.5, and S0 2.4 +/- 0.5 compared to 1.1 +/-
      0.5, respectively. The S3 cell frequency of the 21-day HNE-HNE group was 25.4 +/-
      4.7, increased significantly compared to the 2 h HNE-HNE group; this change was
      concomitant with significant decrease in the frequency of the S0 secretory cells.
      Cell frequencies of C, B, and IN were not affected by treatment or time. It is
      concluded that metaplastic secretory cells discharge their granules in response
      to HNE; SCM returns to its original state after HNE rechallenge; persistent SCM
      is not due to the inability of metaplastic secretory cells to discharge their
      granules.

PMID- 8467767
TI  - Recognition of Pneumocystis carinii in foals with respiratory distress.
AB  - Five 3-month-old foals presenting with fever and respiratory disease were found
      to have pulmonary abscesses with patchy to diffuse alveolar and interstitial
      pneumonia on post-mortem examination. All affected foals had evidence of
      Rhodococcus equi infection and had few to abundant Pneumocystis carinii cysts in
      the sections of affected lung. Of the 5 foals examined radiographically, 3 had a
      distinct reticulonodular (miliary) pattern which may aid in the ante-mortem
      diagnosis of P. carinii pneumonia (PCP). Leukocyte counts of foals with PCP were
      significantly greater than in the control group of foals with uncomplicated
      bacterial pneumonia. Foals with PCP tended to be more tachypnoeic than the
      control foals and 4 of the 5 PCP+ foals appeared dyspnoeic before death. The ante
      mortem recognition of PCP may be expedited by bronchoalveolar lavage and
      successful treatment of foals with PCP may require the administration of adequate
      levels of potentiated sulphonamides.

PMID- 8467769
TI  - Clinical evaluation of an infusion of xylazine, guaifenesin and ketamine for
      maintenance of anaesthesia in horses.
AB  - General anaesthesia was maintained in 40 horses by the continuous intravenous
      infusion of a mixture of 500 ml 10% guaifenesin solution, 1 g ketamine and 500 mg
      xylazine. The median duration of infusion was 65 mins (interquartile range 51-95
      mins). Anaesthesia was characterised by active palpebral reflexes, variable
      degrees of nystagmus and occasional swallowing. Swallowing was considered to be
      undesirable in horses undergoing laryngeal surgery, but the infusion produced
      satisfactory conditions for all other surgical procedures performed. Arterial
      blood pressure was well maintained in all cases (median mean arterial blood
      pressure = 85 mmHg after 30 mins anaesthesia). Heart rate and PaCO2 were
      significantly lower, whilst PaO2 was significantly higher in the infusion group
      than in a group of paired control horses which were anaesthetised with halothane.
      Recovery from anaesthesia was good (Grades 1-2) in 33 horses. Median times to
      sternal recumbency and to standing were 24 and 38 mins respectively. The infusion
      caused a significant fall in packed cell volume, haemoglobin concentration and
      red blood cell count (P < 0.01) and a significant rise in plasma glucose
      concentration (P < 0.01). These variables returned to pre-infusion values within
      24 h.

PMID- 8467768
TI  - Effect of surgical removal of endometrial cups on concentrations of chorionic
      gonadotrophin and subsequent fertility in the mare.
AB  - Seven pregnant mares underwent general anaesthesia, laparotomy, hysterotomy and
      removal of a 50-day conceptus. Eversion of the uterine horn through the
      hysterotomy site allowed direct visualisation and electrosurgical removal of
      endometrial cup tissue from 5 randomly selected mares (Nos 1-5), while cup tissue
      in 2 mares (Nos 6 and 7) was left intact. Two pregnant mares served as unoperated
      controls (Nos 8 and 9). Efforts to re-establish pregnancy were initiated 20 days
      after surgery. Serum samples collected before surgery and during the post
      operative period were analysed for concentration of horse chorionic gonadotrophin
      (CG) by radioimmunoassay. Mean (+/- sd) weight and area of removed tissue was
      9.91 +/- 4.6 g and 22.4 +/- 5.9 cm2, respectively. Concentrations of CG ranging
      from 3440 to 21,220 ng/ml were highest at the time of cup removal (50 days) and
      declined thereafter. Peak concentrations of CG at the time of surgery were not
      linearly correlated (r = -0.59) with mass of excised cup tissue. Individual CG
      half-life values for Mares 1-5 ranged from 5.4 to 8.8 days (mean 7.1 +/- 1.2
      days). Peak CG concentrations occurred 68 days after conception with a rate of
      disappearance (half-time) of 13.4 +/- 0.4 days in Mares 6 and 7 and at 74 and 78
      days after conception with a half-time of 14.0 +/- 5.7 days in Mares 8 and 9.
      Mares 1-5 exhibited behavioural oestrus and ovulation 30-44 days after surgery.
      Pregnancy occurred in 3 mares within 41 days after surgery and was associated
      with concentrations of CG below 200 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467770
TI  - An immunohistological study of MHC class II expression and T lymphocytes in the
      endometrium of the mare.
AB  - The distribution of T lymphocytes and of cells bearing MHC Class II antigens in
      the endometrium of the mare was studied using an avidin-biotin-peroxidase
      staining method. The cells within the endometrium which expressed MHC Class II
      were macrophages, lymphocytes, monocytes, dendritic cells, epithelial cells and
      endothelial cells. MHC Class II expression increased significantly (P < 0.05) in
      the luminal epithelium and tended (P = 0.0573) to increase in the subepithelial
      layers during oestrus. Numbers of T lymphocytes did not differ between oestrus
      and dioestrus. MHC Class II expression and T lymphocyte numbers were not
      significantly different in samples collected on Day 14 of dioestrus and on Day 14
      of pregnancy. The presence of endometritis greatly increased MHC Class II
      expression and T lymphocyte numbers within the endometrium.

PMID- 8467772
TI  - Ground reaction force patterns of Dutch warmblood horses at normal trot.
AB  - This study was undertaken to establish limb loading patterns of sound horses at
      the trot, to provide a data base against which results for lame horses could be
      compared. Ground reaction force (GRF) data were collected from 20 clinically
      sound Dutch Warmblood horses. The data from at least 5 stance phases of each limb
      were averaged after standardisation to the animal's body mass and to the stance
      phase duration and resulted in 'representative' GRF data. The symmetry in the
      vertical GRF peak amplitudes, impulses and the stance phase duration comparing
      left and right limbs exceeded 97%. By averaging the 'representative' GRF of the
      20 horses a 'standard' GRF pattern of the Dutch Warmblood horse at the trot was
      constructed. The GRF patterns at the trot, compared with those at the walk,
      showed only one vertical force peak in forelimbs and hindlimbs (11.59 N/kg and
      10.21 N/kg, respectively). The retardatory and propulsory forces were distributed
      over the forelimbs and hindlimbs in such a way that the forelimbs contributed
      more to retardation (peak forces 1.13 and 0.79 N/kg), and the hindlimbs more to
      propulsion (-0.84 and -1.17 N/kg, respectively).

PMID- 8467771
TI  - Communication of the ulnaris lateralis bursa with the equine elbow joint and
      evaluation of caudal arthrocentesis.
AB  - Elbows from cadaver limbs were evaluated to determine the presence of a
      communication between the ulnaris lateralis bursa (ULB) and the joint and the
      extent of the bursa. Thirty-two pairs of joints were studied: 12 pairs were
      frozen, then transversely sectioned and 20 pairs were injected with methyl
      methacrylate. The 12 frozen-section pairs revealed a communication between the
      ULB and the elbow joint in 9/24 joints (37.5%) and a true bursa (absence of
      communication) in 15/24 joints (62.5%). The mean bursal length in adult horses
      was 3.8 cm. There was no significant difference in the length of the bursa or
      presence of bursa-joint communication between the right and left limbs. In the
      acrylic specimens a communication between the ULB and the joint was found in
      19/40 specimens (47.5%). There was no significant correlation between age or sex
      and frequency of communication. There was a significantly greater prevalence of
      communications present in Quarter Horse than in non-Quarter Horse (P < 0.05)
      joints. A communication between the ULB and the joint is not always present, and
      therefore injection of the elbow joint via the ULB may be unreliable.

PMID- 8467773
TI  - Flunixin meglumine blocks frusemide-induced bronchodilation in horses with
      chronic obstructive pulmonary disease.
AB  - Six horses that developed acute airway obstruction (heaves) when housed in a barn
      and fed poor-quality hay were studied. Airway obstruction was verified by a
      maximal change in pleural pressure during tidal breathing (delta Pplmax) of at
      least 15 cmH2O. Frusemide (1.0 mg/kg bwt) or an equivalent volume of vehicle was
      then administered intravenously (iv) and lung function was measured 15, 30, 60,
      120, 180, 240 and 300 mins after drug administration. The effect of frusemide on
      lung function was also studied after treatment of horses with the cyclooxygenase
      inhibitor flunixin meglumine (1.1 mg/kg every 8 h for 2 days before the
      experiment). Frusemide significantly reduced the delta Pplmax beginning 15 mins
      after drug administration. This effect persisted for 5 h. The reduction in delta
      Pplmax was due partly to an increase in dynamic compliance and partly to a
      decrease in pulmonary resistance. Tidal volume and respiratory frequency were
      unaffected by frusemide. Vehicle had no effect on lung function. Flunixin
      meglumine abolished the effect of frusemide on airway calibre but did not prevent
      diuresis. These results indicate that the effect of frusemide on airways of
      horses with heaves persists for at least 5 h, is mediated through prostanoids,
      and is not a result of diuresis.

PMID- 8467774
TI  - Muscle characteristics in standardbreds of different ages and sexes.
AB  - Biopsy samples were taken from the middle gluteal muscle in 107 health
      Standardbred horses. The horses were separated according to sex and divided into
      4 age groups (1, 2, 3 and 4-6 years). The proportion of Type I fibres increased
      with age (from 16 to 20%), irrespective of sex. The proportions of Type IIA and
      IIB fibres varied with age and differed between stallions and mares. Type IIA
      fibres increased in mares from 37 to 47% and in stallions from 40 to 48% and Type
      IIB fibres decreased from 49 to 34% in mares, and from 43 to 30% in stallions.
      Mares and stallions did not differ in enzyme activities, which changed with age.
      The activity of citrate synthase increased from 30 to 62 mmol/kg/min and that of
      lactate dehydrogenase decreased from 1,930 to 1,565 mmol/kg/min. The relative
      area of each fibre type was measured in biopsy samples from 7 mares and 7
      stallions aged 1 year and 7 mares and 11 stallions aged 4-6 years. The relative
      areas of Type IIA and IIB fibres changed with age and differed between sexes. The
      relative area of Type IIA fibres increased in mares from 30 to 35% and in
      stallions from 33 to 47% and that of Type IIB fibres decreased in mares from 63
      to 54% and in stallions from 55 to 38% between the ages of 1 and 4-6
      years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467775
TI  - Factors influencing the outcome of equine anaesthesia: a review of 1,314 cases.
AB  - Patient data, physiological variables and recovery quality were extracted from
      1,314 records of equine anaesthetics covering a 7-year period and analysed
      retrospectively. Better recovery quality was significantly associated with
      shorter duration of anaesthesia, longer recovery times, less invasive surgery, a
      lower pulse rate at induction and higher pulse and respiratory rates during
      anaesthesia. Nineteen animals suffered serious anaesthetic-related problems (1.4%
      incidence) and 9 died (0.68% incidence). Clinical treatment of hypotension during
      anaesthesia significantly reduced the hypotensive index but did not significantly
      alter the recovery quality or incidence of post-anaesthetic myopathy. The
      severity of the myopathy was, however, markedly reduced in the animals treated
      for hypotension.

PMID- 8467776
TI  - Failure of hydroxyprogesterone caproate to maintain pregnancy in ovariectomised
      mares.

PMID- 8467777
TI  - Recurrent diarrhoea in aged ponies associated with larval cyathostomiasis.

PMID- 8467778
TI  - Sterility associated with an XO karyotype in a miniature horse mare.

PMID- 8467779
TI  - Localised subcutaneous cryptococcal granuloma in a horse.

PMID- 8467780
TI  - Factors associated with the risk of developing sarcoid tumours in horses.

PMID- 8467781
TI  - Comparison of two surgical methods for treatment of crib-biting in horses.

PMID- 8467782
TI  - Comparison of two surgical methods for treatment of crib-biting in horses.

PMID- 8467783
TI  - 'Frozen' evolution of equine influenza viruses?

PMID- 8467784
TI  - Immunodeficiency and serious pneumonia in foals: the plot thickens.

PMID- 8467785
TI  - Progesterone and the pregnant mare: unanswered chestnuts.

PMID- 8467786
TI  - A comparison of responses to analgesia of the navicular bursa and intra-articular
      analgesia of the distal interphalangeal joint in 59 horses.
AB  - Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa
      was performed independently in the lame or lamer forelimb of 59 horses, in which
      lameness was significantly improved by perineural analgesia of either the palmar
      digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was
      detected. Lameness was improved by analgesia of the DIP joint but there was no
      response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness
      was improved by analgesia of the navicular bursa but intra-articular analgesia
      resulted in no change. Forty-one horses responded both to analgesia of the
      navicular bursa and intra-articular analgesia of the DIP joint. Synovial fluid
      was retrieved from all DIP joints but from only one navicular bursa. It is
      suggested that a positive response to analgesia of the DIP joint does not
      necessarily imply that pain arises from the joint per se, but a positive response
      to intra-bursal analgesia probably reflects pathology of the bursa per se, the
      navicular bone and/or supporting ligaments and/or the DDFT. Radiographic
      abnormalities of the navicular bone in the lame or lamer limb were detected in 35
      horses, all of which showed some response to analgesia of the navicular bursa. In
      25 of these horses (71%) changes were only identifiable in the palmaroproximal
      palmarodistal oblique views.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467787
TI  - Growth phase dependence of the activation of a bacterial gene for carotenoid
      synthesis by blue light.
AB  - Myxococcus xanthus responds to blue light by producing carotenoid pigments. A
      mutation at a gene named carC is known to block the metabolism of phytoene, a
      carotenoid precursor, and this gene has now been cloned and sequenced. We show
      here that gene carC, which is homologous to phytoene dehydrogenase genes from
      other organisms, is tightly regulated by light through a mechanism that operates
      only when the cells have reached the stationary phase or are starved of a carbon
      source. A genetic element that mediates the effect of the growth phase has been
      identified. Gene carC is integrated with another unlinked carotenogenic gene in a
      single 'light regulon' controlled by common trans-acting genetic elements. A
      potential -35 site for the binding of sigma factors has been found upstream of
      the carC transcriptional start. However, the -10 region shows no similarity with
      analogous sites at promoters of other Gram-negative bacteria.

PMID- 8467788
TI  - Excess capacity of H(+)-ATPase and inverse respiratory control in Escherichia
      coli.
AB  - With succinate as free-energy source, Escherichia coli generating virtually all
      ATP by oxidative phosphorylation might be expected heavily to tax its ATP
      generating capacity. To examine this the H(+)-ATPase (ATP synthase) was modulated
      over a 30-fold range. Decreasing the amount of H(+)-ATPase reduced the growth
      rate much less than proportionally; the H(+)-ATPase controlled growth rate by <
      10%. This lack of control reflected excess capacity: the rate of ATP synthesis
      per H(+)-ATPase (the turnover number) increased by 60% when the number of enzymes
      was decreased by 40%. At 15% H(+)-ATPase, the enzyme became limiting and its
      turnover was increased even further, due to an increased driving force caused by
      a reduction in the total flux through the enzymes. At smaller reductions of [H(+)
      ATPase] the total flux was not reduced, revealing a second cause for increased
      turnover number through increased membrane potential: respiration was increased,
      showing that in E.coli, respiration and ATP synthesis are, in part, inversely
      coupled. Indeed, growth yield per O2 decreased, suggesting significant leakage or
      slip at the high respiration rates and membrane potential found at low H(+)
      ATPase concentrations, and explaining that growth yield may be increased by
      activating the H(+)-ATPase.

PMID- 8467789
TI  - Two crystal structures for cathepsin D: the lysosomal targeting signal and active
      site.
AB  - Two crystal structures are described for the lysosomal aspartic protease
      cathepsin D (EC 3.4.23.5). The molecular replacement method was used with X-ray
      diffraction data to 3 A resolution to produce structures for human spleen
      cathepsin D and for bovine liver cathepsin D complexed with the 6-peptide
      inhibitor pepstatin A. The lysosomal targeting region of cathepsin D defined by
      previous expression studies [Barnaski et al. (1990) Cell, 63, 281-219] is located
      in well defined electron density on the surface of the molecules. This region
      includes the putative binding site of the cis-Golgi phosphotransferase which is
      responsible for the initial sorting step for soluble proteins destined for
      lysosomes by phosphorylating the carbohydrates on these molecules. Carbohydrate
      density is visible at both expected positions on the cathepsin D molecules and,
      at the best defined position, four sugar residues extend towards the lysosomal
      targeting region. The active site of the protease and the active site cleft
      substrate binding subsites are described using the pepstatin inhibited structure.
      The model geometry for human cathepsin D has rms deviations from ideal of bonds
      and angles of 0.013 A and 3.2 degrees respectively. For bovine cathepsin D the
      corresponding figures are 0.014 A and 3.3 degrees. The crystallographic residuals
      (R factors) are 16.1% and 15.8% for the human and inhibited bovine cathepsin D
      models respectively. The free R factors, calculated with 10% of the data reserved
      for testing the models and not used for refinement, are 25.1% and 24.1%
      respectively.

PMID- 8467790
TI  - The portal protein of bacteriophage SPP1: a DNA pump with 13-fold symmetry.
AB  - Electron microscopy in combination with image processing is a powerful method for
      obtaining structural information on non-crystallized biological macromolecules at
      the 10-50 A resolution level. The processing of noisy microscopical images
      requires advanced data processing methodologies in which one must carefully avoid
      the introduction of any form of bias into the data set. Using a novel
      multivariate statistical approach to the analysis of symmetry, we studied the
      structure of the bacteriophage SPP1 portal protein oligomer. This portal
      structure, ubiquitous in icosahedral bacteriophages which package dsDNA, is
      located at the site of symmetry mismatch between a 5-fold vertex of the
      icosahedral shell and the 6-fold symmetric (helical) tail. From previous studies
      such 'head-to-tail connector' structures were generally accepted to be
      homododecamers assembled in a 12-fold symmetric ring around a central channel.
      Using a new analysis methodology we have found that the phage SPP1 portal
      structure exhibits 13-fold cyclical symmetry: a new point group organization for
      oligomeric proteins. A model for the DNA packaging mechanism by 13-fold symmetric
      portal protein assemblies is presented which attributes a coherent functional
      meaning to their unusual symmetry.

PMID- 8467791
TI  - Structure of the HMG box motif in the B-domain of HMG1.
AB  - The conserved, abundant chromosomal protein HMG1 consists of two highly
      homologous, folded, basic DNA-binding domains, each of approximately 80 amino
      acid residues, and an acidic C-terminal tail. Each folded domain represents an
      'HMG box', a sequence motif recently recognized in certain sequence-specific DNA
      binding proteins and which also occurs in abundant HMG1-like proteins that bind
      to DNA without sequence specificity. The HMG box is defined by a set of highly
      conserved residues (most distinctively aromatic and basic) and appears to define
      a novel DNA-binding structural motif. We have expressed the HMG box region of the
      B-domain of rat HMG1 (residues 88-164 of the intact protein) in Escherichia coli
      and we describe here the determination of its structure by 2D 1H-NMR
      spectroscopy. There are three alpha-helices (residues 13-29, 34-48 and 50-74),
      which together account for approximately 75% of the total residues and contain
      many of the conserved basic and aromatic residues. Strikingly, the molecule is L
      shaped, the angle of approximately 80 degrees between the two arms being defined
      by a cluster of conserved, predominantly aromatic, residues. The distinctive
      shape of the HMG box motif, which is distinct from hitherto characterized DNA
      binding motifs, may be significant in relation to its recognition of four-way DNA
      junctions.

PMID- 8467792
TI  - The NF-M transcription factor is related to C/EBP beta and plays a role in signal
      transduction, differentiation and leukemogenesis of avian myelomonocytic cells.
AB  - Retroviral oncogenes encode nuclear regulators of gene expression or signal
      transduction molecules, such as protein kinases, which stimulate the activity of
      cellular transcription factors. Here we describe the cloning of NF-M, a myeloid
      specific transcription factor related to C/EBP beta, which is a target of
      activated protein kinases. NF-M stimulates the expression of the gene encoding
      cMGF, a myeloid cell-specific growth factor, creating an autocrine growth loop
      crucial to oncogene transformation of myeloid cells. The NF-M protein bound
      directly to the cMGF gene promoter and activated its transcription, even in
      erythroid cells where the promoter is usually inactive. In addition, a truncated,
      dominant-negative form of NF-M inhibited cMGF expression in macrophages,
      indicating that NF-M is required for the normal activation of the gene. When
      multipotent hematopoietic progenitor cells were stimulated to differentiate, NF-M
      expression was induced at a very early stage, suggesting that the transcription
      factor plays a role in lineage commitment. The stimulation of transformed
      myelomonocytic cells or of normal peripheral blood macrophages with kinases or
      LPS or TPA respectively, led to the rapid redistribution of NF-M protein from the
      cell bodies to the nucleus, consistent with the notion that NF-M was directly
      affected by such treatments. Our data indicate that NF-M plays a key role in
      myelomonocytic differentiation, in signal transduction during macrophage
      activation and in the development of myelogenous leukemia.

PMID- 8467793
TI  - Influence of the v-Myb transactivation domain on the oncoprotein's transformation
      specificity.
AB  - The v-myb-containing viruses AMV and E26 induce the proliferation of
      myelomonocytic cells. The E26 Myb protein, by virtue of its fusion to Ets, is
      also able to transform multipotent haematopoietic cells (MEPs). We have examined
      the biological effects of substituting the v-Myb transactivation domain with the
      strong acidic activator domain from the C-terminus of the HSV-1 VP16 protein. In
      the absence of Ets, deletion of the transactivation domain destroyed the ability
      of v-Myb to stimulate transcription and to transform cells, whilst the
      substitution of the VP16 transactivation domain into v-Myb resulted in a greatly
      enhanced transactivation potential and altered TATA box binding protein (TBP)
      binding properties. In spite of these functional differences, the v-Myb VP16
      protein regained the ability to transform myeloid cells with the same
      characteristics as wild type v-Myb. A construct encoding v-Myb VP16 fused to v
      Ets was still capable of inducing leukaemia and of transforming both myeloid
      cells and MEPs in vitro, although the latter cells exhibited an altered
      phenotype. Our results demonstrate that the transformation of myeloid cells by v
      Myb is largely independent of the type and potency of the transactivation domain
      it contains, whereas transformation of MEPs by the Myb-Ets fusion protein has
      more stringent transactivation requirements of Myb.

PMID- 8467794
TI  - Cloned transcription factor MTF-1 activates the mouse metallothionein I promoter.
AB  - Metallothioneins (MTs) are small cysteine-rich proteins whose structure is
      conserved from fungi to man. MTs strongly bind heavy metals, notably zinc, copper
      and cadmium. Upon exposure of cells to heavy metal and other adverse treatments,
      MT gene transcription is strongly enhanced. Metal induction is mediated by
      several copies of a 15 bp consensus sequence (metal-responsive element, MRE)
      present in the promoter region of MT genes. We and others have demonstrated the
      presence of an MRE-binding factor in HeLa cell nuclear extracts. We found that
      this factor, termed MTF-1 (MRE-binding transcription factor) is
      inactivated/reactivated in vitro by zinc withdrawal/addition. Here we report that
      the amounts of MTF-1-DNA complexes are elevated several-fold in zinc-treated
      cells, as measured by bandshift assay. We have also cloned the cDNA of mouse MTF
      1, a 72.5 kDa protein. MTF-1 contains six zinc fingers and separate
      transcriptional activation domains with high contents of acidic and proline
      residues. Ectopic expression of MTF-1 in primate or rodent cells strongly
      enhances transcription of a reporter gene that is driven by four consensus MREd
      sites, or by the complete mouse MT-I promoter, even at normal zinc levels.

PMID- 8467795
TI  - Clustered organization of homologous KRAB zinc-finger genes with enhanced
      expression in human T lymphoid cells.
AB  - KRAB zinc-finger proteins (KRAB-ZFPs) constitute a large subfamily of ZFPs of the
      Kruppel C2H2 type. KRAB (Kruppel-associated box) is an evolutionarily conserved
      protein domain found N-terminally with respect to the finger repeats. We report
      here the characterization of a particular subgroup of highly related human KRAB
      ZFPs. ZNF91 is one representative of this subgroup and contains 35 contiguous
      finger repeats at its C-terminus. Three mRNA isoforms with sequence identity to
      ZNF91 were isolated by the polymerase chain reaction. These encode proteins with
      a KRAB domain present, partially deleted or absent. Five genomic fragments were
      characterized, each encoding part of a gene: the ZNF91 gene or one of four
      distinct, related KRAB-ZFP genes. All exhibit a common exon/intron organization
      with the variant zinc finger repeats organized in a single exon and the KRAB
      domain encoded by two separate exons. This positioning of introns supports the
      hypothesis that the mRNA isoforms encoding polypeptides with variability in the
      KRAB domain could arise by alternative splicing. By in situ chromosomal mapping
      studies and by analysis of fragments from a human genomic yeast artificial
      chromosome library containing KRAB-ZFP genes, we show that these genes occur in
      clusters; in particular, a gene complex containing over 40 genes has been
      identified in chromosomal region 19p12-p13.1. These ZNF91-related genes probably
      arose late during evolution since no homologous genes are detected in the mouse
      and rat genomes. Although the transcription of members of this KRAB-ZFP gene
      subgroup is detectable in all human tissues, their expression is significantly
      higher in human T lymphoid cells.

PMID- 8467796
TI  - GAL4 is regulated by a glucose-responsive functional domain.
AB  - The Saccharomyces cerevisiae transcriptional activator GAL4 is regulated by the
      presence of available carbon sources. Galactose induces activity by inhibiting
      the negative regulator GAL80, while glucose, the preferred carbon source,
      antagonizes GAL4 function by several mechanisms. In the present study we present
      evidence that one mechanisms for inhibition of GAL transcription by glucose
      involves direct inhibition of the GAL4 protein. We demonstrate that a large,
      previously uncharacterized, central region of GAL4 contains at least three
      'inhibitory domains' and a 'glucose response domain' (GRD). Deletion of the
      entire central region eliminates direct inhibition of GAL4 by glucose, and
      furthermore, fusion of the central region to a heterologous transcriptional
      activator confers inhibition by glucose. The central region inhibitory domains
      constitutively inhibit transcriptional activation when the GRD is absent. Direct
      inhibition of GAL4 activity can be detected within 30 min following glucose
      addition and may represent an early mechanism promoting a switch from galactose
      to glucose utilization. A model for the regulatory role of the central region is
      presented, involving interaction with an additional protein that inhibits GAL4
      activity when glucose is present.

PMID- 8467798
TI  - The control in cis of the position and the amount of the ARG4 meiotic double
      strand break of Saccharomyces cerevisiae.
AB  - During meiosis, a transient DNA double-strand break (DSB) occurs in the promoter
      region (positions -200/-185) of the Saccharomyces cerevisiae ARG4 gene and is a
      likely intermediate in the initiation of meiotic gene conversion events in this
      region. We report here a functional analysis of the ARG4 DSB based on the study
      of various deletions in this chromosomal region. We have identified several cis
      acting elements located within the -465/+3 region of the ARG4 promoter that
      control the formation of this DSB. The -465/-317 region includes a transcription
      terminator and is necessary for a normal amount of ARG4 DSB, but not for its
      positioning. The -316/-140 region can be replaced by an unrelated DNA sequence
      where a meiotic DSB then occurs, suggesting that the site of DSB is not sequence
      specific, but is positioned at a fixed distance from the adjacent -139/+3 region.
      Also, in all strains constructed, the amount of meiotic DSB is correlated with
      the frequency of gene conversion in ARG4, which provides a strong argument for
      the initiation of gene conversion by a DSB in this region of the yeast genome.

PMID- 8467797
TI  - Functional conservation of vertebrate seven-up related genes in neurogenesis and
      eye development.
AB  - Several members of the steroid receptor superfamily, including the transcription
      factor COUP, are closely related to the Drosophila gene seven-up (svp) which is
      required for the development of the embryonic central nervous system (CNS) and
      specific photoreceptor cells of the eye. We have identified and characterized two
      zebrafish (Brachydanio rerio) members of this subfamily of orphan nuclear
      receptors. While one of them (svp[44]) is the zebrafish cognate of COUP, the
      second (svp[46]) seems to be a novel member of the COUP/svp group. The proteins
      encoded by both genes contain highly conserved DNA-binding and putative ligand
      binding domains, indicating close similarities in target sequence recognition and
      ligand binding. Analysis of the spatial distribution of their transcripts in
      whole-mount embryos revealed that the CNS is a major site of expression for both
      genes. At early embryonic stages, both genes are expressed in domains
      corresponding to specific rhombomere primordia in the hindbrain. This suggests an
      involvement in hindbrain segmentation and/or rhombomere specification. Moreover,
      transcripts derived from both genes are detected within distinct areas of the eye
      rudiments, suggesting roles in eye patterning and/or cell differentiation. In the
      case of the svp[44] gene, expression is also observed within specific parts of
      the midbrain, diencephalon and telencephalon. These results represent the first
      evidence that at least some of the nervous system and eye-specific functions of
      Drosophila svp are conserved in vertebrates.

PMID- 8467799
TI  - Conserved features in the mode of replication of eukaryotic ribosomal RNA genes.
AB  - It was previously shown that a 1.5 kb fragment located in the non-transcribed
      spacer (NTS) is the earliest replicating region of pea (Pisum sativum) rDNA in
      synchronized root cells. In the present report the structure of this region was
      characterized. It contains a cluster of four 11 bp near matches to the
      Saccharomyces cerevisiae ARS consensus sequence (ACS). These near matches are
      embedded in an A+T rich domain located upstream from the transcription initiation
      site. We identified and mapped an intrinsic DNA bending locus 5' to the cluster
      of near matches. Several eukaryotic origins including the ARS from the budding
      yeast show very similar structural features. This observation strengthens the
      notion that pea rDNA replication initiates at or near this region. Replication of
      the entire pea rDNA repeat was analysed by two-dimensional (2D) agarose gel
      electrophoresis. The results obtained indicate that only a small fraction of the
      potential origins is used in each replication round. Forks moving in the
      direction opposite to rRNA transcription are stalled at a polar replication fork
      barrier (RFB), which mapped near the 3' end of the transcription unit.
      Consequently, most of pea rDNA appears to replicate in a unidirectional manner.
      These results show that the strategy used to replicate pea and yeast rRNA genes
      is very similar, suggesting that it has been conserved and might be common to
      most eukaryotes.

PMID- 8467800
TI  - A methyl jasmonate-induced shift in the length of the 5' untranslated region
      impairs translation of the plastid rbcL transcript in barley.
AB  - The plant growth substance (-)-jasmonic acid methyl ester (methyl jasmonate,
      JaMe) affects plastid gene expression at the protein and mRNA levels when applied
      exogenously to detached leaf segments of Hordeum vulgare L. cv. Salome.
      Translation of the large subunits of ribulose-1,5-bisphosphate
      carboxylase/oxygenase (LSU, rbcL gene products) and of the 65 and 68 kDa proteins
      of photosystem I (psaA and psaB gene products, respectively) ceased, whereas
      synthesis of the 32 kDa photosystem II protein (D1, psbA gene product) continued
      in JaMe-treated leaf tissues. These changes were not caused by corresponding
      alterations in transcript abundances. The loss of LSU protein synthesis,
      occurring within 24 h of JaMe treatment, correlated with a decline in the in
      vitro-translatable rbcL mRNA, but contrasted with an almost constant transcript
      level. The 5' ends of the rbcL transcripts shifted from '-59' in freshly
      harvested or water-treated leaves to '-94' in JaMe-treated leaf tissues.
      Transcripts ending at these positions presumably arise from alternative
      processing of the primary transcript ending at position '-316'. The '-94'
      transcript contains, within the 5' untranslated region, a 35-base motif with
      remarkable complementarity to the extreme 3' terminal part of the 16S rRNA,
      involved in intramolecular base pairing within the ribosome and can associate
      with 30S but not 70S complexes in organello, suggesting that intermolecular base
      pairing impairs translation initiation, probably by competing for ribosome
      binding at the Shine-Dalgarno sequence. In contrast, transcripts ending at '-59'
      lack the 5' terminal 'extra' sequence and are active in terms of translation
      initiation.

PMID- 8467801
TI  - Related chromosome binding sites for zeste, suppressors of zeste and Polycomb
      group proteins in Drosophila and their dependence on Enhancer of zeste function.
AB  - Polycomb group genes are necessary for maintaining homeotic genes repressed in
      appropriate parts of the body plan. Some of these genes, e.g. Psc, Su(z)2 and
      E(z), are also modifiers of the zeste-white interaction. The products of Psc and
      Su(z)2 were immunohistochemically detected at 80-90 sites on polytene
      chromosomes. The chromosomal binding sites of these two proteins were compared
      with those of zeste protein and two other Polycomb group proteins, Polycomb and
      polyhomeotic. The five proteins co-localize at a large number of sites,
      suggesting that they frequently act together on target genes. In larvae carrying
      a temperature sensitive mutation in another Polycomb group gene, E(z), the Su(z)2
      and Psc products become dissociated from chromatin at non-permissive temperatures
      from most but not all sites, while the binding of the zeste protein is
      unaffected. The polytene chromosomes in these mutant larvae acquire a decondensed
      appearance, frequently losing characteristic constrictions. These results suggest
      that the binding of at least some Polycomb group proteins requires interactions
      with other members of the group and, although zeste can bind independently, its
      repressive effect on white involves the presence of at least some of the Polycomb
      group proteins.

PMID- 8467802
TI  - Implications of novel guide RNA features for the mechanism of RNA editing in
      Crithidia fasciculata.
AB  - We have determined the relative steady state concentration of the two Crithidia
      fasciculata guide (g)RNAs involved in editing the two domains of mRNAs for NADH
      dehydrogenase (ND) subunit 7. We found that, although there was an 8-fold
      difference between the molar ratio of these two gRNAs relative to the (pre)-mRNA,
      the two domains are edited with a very similar frequency (around 50%). Also, for
      the editing of a given domain, many gRNA species exist with the same 5' end but
      with a different 3' uridylation site. Approximately 20% of these short gRNAs do
      not contain the information required for editing a complete domain, which may
      explain the high incidence of partially edited RNAs. Remarkably, genomically
      encoded Us are missing from two sites of a few of the gRNAs involved in editing
      apocytochrome b RNA. We speculate that these species are created by editing-like
      events. Both the short and complete forms of the ND7 gRNAs are found in chimeric
      molecules, in which the gRNA is covalently linked via its 3'-terminus to an
      editing site of pre-edited ND7 RNA. Some features of the chimeric molecules are
      at odds with current models of RNA editing: (i) U residues are completely absent
      from the connecting sequence of a number of these molecules, (ii) the ND7 gRNAs
      are frequently hooked up to the wrong editing domain of ND7 RNA, although other
      gRNAs are not found at these positions and (iii) in some chimeric molecules the
      gRNA appears to be linked to the 5' end of pre-edited RNA.

PMID- 8467803
TI  - An actin-binding function contributes to transformation by the Bcr-Abl
      oncoprotein of Philadelphia chromosome-positive human leukemias.
AB  - In Philadelphia chromosome-positive human leukemias, which include chronic
      myelogenous leukemia and some acute lymphocytic leukemias, the c-abl proto
      oncogene on chromosome 9 becomes fused to the bcr gene on chromosome 22, and Bcr
      Abl fusion proteins are produced. The Bcr sequences activate the Abl tyrosine
      kinase which is required for the transforming function of Bcr-Abl. The Bcr
      sequences also enhance an F-actin-binding activity associated with c-Abl. Here,
      we show that binding of c-Abl and Bcr-Abl proteins to actin filaments in vivo and
      in vitro is mediated by an evolutionarily conserved domain at the C-terminal end
      of c-Abl. The c-Abl F-actin-binding domain contains a consensus motif found in
      several other actin-crosslinking proteins. Mutations in the consensus motif are
      shown to abolish binding to F-actin. Bcr-Abl proteins unable to associate with F
      actin have a reduced ability to transform Rat-1 fibroblasts and to abrogate the
      requirement for interleukin-3 in the lymphoblastoid cell line Ba/F3. In
      transformed cells, Bcr-Abl induces a redistribution of F-actin into punctate,
      juxtanuclear aggregates. The binding to actin filaments has important
      implications for the pathogenic and physiological functions of the Bcr-Abl and c
      Abl proteins.

PMID- 8467804
TI  - Regulated expression of human CD4 rescues helper T cell development in mice
      lacking expression of endogenous CD4.
AB  - During T cell development, precursor thymocytes that co-express the CD4 and CD8
      glycoproteins give rise to mature progeny expressing one of these molecules to
      the exclusion of the other. Continued expression of only CD4 is the hallmark of
      mature helper T cells, whereas cytotoxic T cells express CD8 and extinguish CD4.
      The differentiation program that generates the two T cell subsets is likely to be
      intimately tied to regulation of expression of these cell surface molecules. We
      now describe the use of a murine CD4 enhancer in the generation of transgenic
      mice expressing physiologic levels of human CD4. The transgene is appropriately
      regulated during T cell development and includes the necessary cis-acting
      sequences for extinguishing expression in the CD8 lineage. Furthermore, in mice
      whose endogenous CD4 gene is inactivated, the transgenic human CD4 mediates
      rescue of the CD4 lineage and restoration of normal helper cell functions. The
      generation of these mice exemplifies a general approach for developing reliable
      animal models for the human immune system.

PMID- 8467805
TI  - Programmed cell death by bcl-2-dependent and independent mechanisms in B lymphoma
      cells.
AB  - Programmed cell death (PCD) or apoptosis is a common form of cellular demise
      during embryogenesis, tumorigenesis and clonal selection in the immune system.
      The bcl-2 proto-oncogene has been recently implicated as a potential
      physiological regulator of the PCD pathway. Gene transfer studies have shown that
      overexpression of bcl-2 blocks apoptosis mediated by several stimuli in cultured
      cell lines and promotes the survival of B and T lymphocytes in transgenic mice.
      However, it remains unclear whether under normal conditions bcl-2 is responsible
      for controlling cell death. We have investigated the role of bcl-2 in the
      antimembrane IgM (mIgM)-induced apoptotic death of WEHI-231 B cell lymphoma, a
      model that mimics clonal deletion of immature B cells by antigen. Signalling of
      mIgM receptors triggered downregulation of both bcl-2 RNA and protein, and
      induced apoptosis in WEHI-231 B cells. This effect appeared to be specific since
      (i) the levels of beta 2-microglobulin and beta-actin RNA remain unchanged and
      (ii) signalling of the apoptosis-resistant B cell lymphoma line BAL-17 with anti
      mu was not associated with downregulation of bcl-2 RNA. However, stable
      expression of bcl-2 by transfection did not rescue WEHI-231 B cells from
      apoptosis, yet WEHI-231 cells overexpressing bcl-2 were more resistant to
      programmed cell death induced by heat-shock.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467806
TI  - Insect immunity. Two 17 bp repeats nesting a kappa B-related sequence confer
      inducibility to the diptericin gene and bind a polypeptide in bacteria-challenged
      Drosophila.
AB  - The Drosophila diptericin gene codes for a 9 kDa antibacterial peptide and is
      rapidly and transiently expressed in larvae and adults after bacterial challenge.
      It is also induced in a tumorous Drosophila blood cell line by the addition of
      lipopolysaccharide (LPS). The promoter of this gene contains two 17 bp repeats
      located closely upstream of the TATA-box and harbouring a decameric kappa B
      related sequence. This study reports that the replacement of the two 17 bp
      repeats by random sequences abolishes bacteria inducibility in transgenic fly
      lines. In transfected tumorous blood cells, the replacement of both or either of
      the 17 bp motifs reduces dramatically LPS inducibility, whereas multiple copies
      significantly increase the level of transcriptional activation by LPS challenge.
      A specific DNA-protein binding activity is evidenced in cytoplasmic and nuclear
      extracts of induced blood cells and fat body. It is absent in controls. It is
      proposed that induction of the diptericin gene mediated by the two 17 bp repeats
      occurs via a mechanism similar to that of mammalian NF-kappa B.

PMID- 8467807
TI  - Apidaecin multipeptide precursor structure: a putative mechanism for
      amplification of the insect antibacterial response.
AB  - Apidaecins are the most prominent components of the honeybee humoral defense
      against microbial invasion. Our analysis of cDNA clones indicated that up to 12
      of these short peptides (2 kDa) can be generated by processing of single
      precursor proteins; different isoforms are hereby linked in one promolecule.
      Assembly of the multipeptide precursors and the putative three-step maturation
      are strongly reminiscent of yeast alpha-mating factor. Bioactive apidaecins are
      flanked by the two 'processing' sequences, EAEPEAEP (or variants) and RR; joined
      together, they form a single unit that is repeated numerous times. The number of
      such repeats is variable and was reflected in the observed diversity of
      transcript lengths. Each such transcript is likely to be encoded by a different
      gene, forming a tight gene cluster. While transcriptional activation upon
      bacterial challenge is not exceptionally fast, the multigene and multipeptide
      precursor nature of the apidaecin genetic information allows for amplification of
      the response, resulting in a real overproduction of peptide antibiotic. Enhanced
      efficiency of the 'immune' response to bacterial infection through such a
      mechanism is, to our knowledge, unique among insects.

PMID- 8467808
TI  - A conserved region of the MSP-1 surface protein of Plasmodium falciparum contains
      a recognition sequence for erythrocyte spectrin.
AB  - The major surface protein MSP-1 of Plasmodium falciparum blood-stage malaria
      parasites contains notably conserved sequence blocks with unknown function. The
      recombinant protein 190L, which represents such a block, exhibits a high affinity
      for red blood cell membranes. We demonstrate that both 190L and native MSP-1
      protein bind to the inner red blood cell membrane skeleton protein spectrin. By
      using overlapping peptides covering the 190L molecule, we show that the spectrin
      contact site of 190L is included in a linear sequence of 30 amino acid residues.
      Association of 190L with naturally occurring spectrin deficient red blood cells
      is drastically reduced. In the same cells parasite invasion is normal, but the
      intracellular parasite development arrests late in the trophozoite stage. A
      similar situation arises when synthetic peptides covering the spectrin
      recognition sequence of 190L are added to P.falciparum cultures. These data and
      the cellular localization of MSP-1 suggest the possibility that MSP-1 associates
      with spectrin under natural conditions.

PMID- 8467809
TI  - Evidence for the induction of casein kinase II in bovine lymphocytes transformed
      by the intracellular protozoan parasite Theileria parva.
AB  - Theileria parva is an obligate, intracellular, parasitic protozoan that causes
      East Coast fever, an acute leukemia-like disease of cattle. T. parva and the
      related parasite, Theileria annulata, are unique among protozoa in that their
      intralymphocytic stages induce transformation of bovid lymphocytes. Comparison of
      in vitro protein kinase activities between uninfected IL-2-dependent T
      lymphoblasts and T. parva-infected lymphocytes revealed a 4.7- to 12-fold
      increase in total phosphorylation and the induction of a group of Theileria
      infection-specific phosphoproteins. The enzyme that phosphorylates these
      substrates is a serine/threonine kinase with substrate and effector specificities
      of casein kinase (CK) II. Northern blot analyses revealed a 3.9- to 6.0-fold
      increase in CKII alpha mRNA in the infected cells relative to the controls.
      Furthermore, a marked increase of CKII antigen was observed on Western blots of
      materials prepared from the infected cell lines. The antibovine CKII antibody
      used in these studies immunoprecipitated a protein kinase that phosphorylated
      casein in a reaction that was inhibited by low (nM) quantities of heparin. Our
      data show marked increases of bovine CKII at the transcriptional, translational
      and functional levels in T. parva-infected lymphocytes, relative to quiescent
      cells or IL-2-dependent parental lymphoblasts. Bovine CKII thus appears to be
      constitutively activated in these cells and we propose that this kinase may be an
      important element in the signal-transducing pathways activated by Theileria in
      bovid lymphocytes and perhaps in some leukemic cells.

PMID- 8467811
TI  - Functional significance of a family of protein kinases encoded at the shaggy
      locus in Drosophila.
AB  - The characterization of the structurally complex gene shaggy is presented. This
      gene encodes multiple proteins with putative serine/threonine kinase activity
      thought to be involved in signal transduction mechanisms that take place during
      several patterning events throughout Drosophila development. The gene comprises
      two transcription units that give rise to 10 transcripts and five different
      proteins with a common kinase catalytic domain and overlapping patterns of
      expression during development. Mutational analysis of shaggy defines a single
      complementation group, lethality of which is associated with the loss of two
      major shaggy proteins. These studies allow the first definition of a true null
      allele. Two proteins may fulfill maternal requirements. Phenotypes of flies
      expressing individual shaggy proteins revealed that although there is some
      redundancy between the different forms they do not all carry out identical
      functions in vivo. However, under experimental conditions, a single form of the
      protein was able to carry out all known requirements. This protein probably also
      functions as part of a signal transduction cascade in the imaginal
      neuroepithelium, where cells have to choose between epidermal and neural fates.

PMID- 8467810
TI  - Depletion of casein kinase II by antisense oligonucleotide prevents
      neuritogenesis in neuroblastoma cells.
AB  - Casein kinase II is a multifunctional protein kinase which has been implicated in
      the regulation of cell growth and differentiation. This enzyme is much more
      abundant in neurons than in any other cell type. The treatment of neuroblastoma
      cells with an antisense oligodeoxyribonucleotide which specifically results in
      the depletion of casein kinase II catalytic subunits blocks neuritogenesis.
      Accordingly, this enzyme may perform an essential role during neurite growth in
      developing neurons. Casein kinase II depletion induced by antisense
      oligodeoxyribonucleotide is accompanied by a site-specific dephosphorylation of
      microtubule-associated protein MAP1B (also referred to as MAP5, MAP1.X or
      MAP1.2), which is paralleled by a release of MAP1B from microtubules. We
      therefore propose that phosphorylation by casein kinase II may be required for
      the proper MAP1B functioning in the promotion of the assembly of microtubules
      which constitute the cytoskeletal scaffolding of growing axon-like neurites.

PMID- 8467812
TI  - Structure-function analysis of human IL-6 receptor: dissociation of amino acid
      residues required for IL-6-binding and for IL-6 signal transduction through
      gp130.
AB  - Here, we report the analysis of the structure-function relationship of the
      extracellular region of human interleukin 6 receptor (IL-6R). Upon binding of IL
      6, IL-6R becomes associated extracellularly with a non-IL-6-binding but signal
      transducing molecule, gp130, and the IL-6 signal is generated. In this region,
      the cytokine receptor family domain, but not the immunoglobulin-like domain, was
      responsible both for IL-6 binding and for signal transduction through gp130.
      Because a soluble, extracellular portion of IL-6R (sIL-6R) could bind IL-6 and
      mediate IL-6 functions through gp130, amino acid substitutions were introduced
      into sIL-6R by site-directed mutagenesis. The results, together with the
      previously proposed tertiary structure model, suggested that the amino acid
      residues critical for IL-6 binding have a tendency to be distributed to the hinge
      region between the two 'barrel'-like fibronectin type III modules and to the same
      side of these two 'barrels'. Amino acid residues, of which substitutions barely
      affected the IL-6-binding but did abolish the IL-6 signalling capability of sIL
      6R, were identified and found to be located mainly in the membrane proximal half
      of the second barrel. sIL-6R mutants carrying such substitutions lacked the
      capacity to associate with gp130 in the presence of IL-6.

PMID- 8467813
TI  - The internalization signal and the phosphorylation site of transferrin receptor
      are distinct from the main basolateral sorting information.
AB  - Wild-type human transferrin receptor (hTfR), like endogenous canine receptor, is
      expressed almost exclusively (97%) at the basolateral membrane of transfected
      Madin-Darbey canine kidney (MDCK) cells. We investigated the role of two distinct
      features of the hTfR cytoplasmic domain, namely the endocytic signal and the
      unique phosphorylation site, in polarized cell surface delivery. Basolateral
      location was not altered by point mutation of Ser24-->Ala24, indicating that
      phosphorylation is not involved in vectorial sorting of hTfR. The steady state
      distribution of hTfR was partially affected by a deletion of 36 cytoplasmic
      residues encompassing the internalization sequence. However, 80% of the receptors
      were still basolateral. As assessed by pulse-chase experiments in combination
      with biotinylation, newly synthesized wild-type and deletion mutant receptors
      were directly sorted to the domain of their steady state residency. Although both
      receptors could bind human transferrin, endocytosis of the deletion mutant was
      strongly impaired at either surface. These data indicate that the predominant
      basolateral targeting signal of hTfR is independent of the internalization
      sequence.

PMID- 8467815
TI  - Environmental Mutagen Society. 24th annual scientific meeting. Norfolk, Virginia,
      April 17-22, 1993. Abstracts.

PMID- 8467814
TI  - Characterization of the fission yeast mcs2 cyclin and its associated protein
      kinase activity.
AB  - We have previously described the isolation of mcs2-75, a mutation obtained as an
      allele-specific suppressor of a dominant allele of cdc2. mcs2 was cloned and
      determined to be an essential gene, the product of which shares homology with the
      cyclin family of proteins. In contrast to the behavior of some, but not all
      cyclins, the mcs2 protein is constant in its abundance and localization
      throughout the cell cycle. A kinase activity that co-precipitates with mcs2 can
      be detected when myelin basic protein (MBP) is provided as an exogenous
      substrate. This kinase activity is constant throughout the cell cycle. mcs2 does
      not appear to associate with the cdc2 protein kinase or an antigenically related
      kinase. Finally, a protein kinase termed csk1 (cyclin suppressing kinase) was
      isolated as a high copy suppressor of an mcs2 mutation. csk1 is not essential,
      however, the level of kinase activity that co-precipitates with mcs2 is reduced
      approximately 3-fold in strains harboring a csk1 null allele. Therefore, csk1 may
      encode a protein kinase physically associated with mcs2 or alternatively may
      function as an upstream activator of the mcs2-associated kinase.

PMID- 8467816
TI  - Muscle rearrangement in patients with hemiparesis after stroke: an
      electrophysiological and morphological study.
AB  - Skeletal muscle changes were evaluated in patients suffering from hemiparesis
      after stroke. Concentric needle EMG and single fiber EMG of the paretic
      gastrocnemius medialis muscle were performed. Maximal amplitude of H, T and M
      responses in calf muscles of both the affected and the unaffected sides were
      determined by usual electrophysiological techniques. Muscle biopsy of the lateral
      gastrocnemius muscle of the affected side was performed to determine the
      distribution of fiber types and fiber sizes. Fibrillation activity and positive
      sharp waves occurred in paretic muscles in patients with more recent hemiparesis
      while the duration of motor unit potentials was prolonged in patients with long
      lasting disease. The H/M ratio was increased on the paretic side. The percentage
      of type 1 fibers was augmented in most patients with normal mean diameter and low
      atrophy factor. The percentage of type 2 fibers was reduced with decreased mean
      diameters and with a high atrophy factor. Such changes may be related to
      inactivity or transsynaptic degeneration of type 2 motoneurons as a consequence
      of the interruption of the corticospinal tract. Increased percentage of type 1
      fibers may be due to a collateral reinnervation process or a motor unit type
      transformation.

PMID- 8467817
TI  - Myasthenia gravis and invasive thymoma. A 20-year experience.
AB  - Over the last 20 years, 15 patients with myasthenia gravis and invasive thymoma
      have been treated in our department. Eight of these patients underwent either
      nontotal excision or were not operated on due to massive invasion, while 7
      underwent total excision. These 15 cases represent 6.2% of the 242 myasthenic
      patients treated during this period. Six of the 8 nontotal excision cases died,
      and 2 of the 7 total excision cases succumbed. The prognosis of total excision
      cases was better than that of nontotal excision cases. The overall 5-year
      survival rate was 73%, and the 10-year survival rate 20%. Total excision of the
      thymoma, if possible, and high doses of corticosteroids and combination
      chemotherapy for the remaining tumor seem to be the treatments of choice.

PMID- 8467818
TI  - Protein analyses in cerebrospinal fluid. I. Influence of concentration gradients
      for proteins on cerebrospinal fluid/serum albumin ratio.
AB  - Concentration gradients in lumbar cerebrospinal fluid (CSF) for albumin and IgG
      were studied in 8 healthy individuals and 44 neuropsychiatric patients by serial
      sampling of 6 successive portions of CSF, each containing 4 ml, in all 24 ml.
      Significant and identical decreases between the first (0-4th ml) and the last
      (21st-24th ml) portions were found for CSF-albumin (21% decrease, p < 0.0001) and
      CSF-IgG (21% decrease, p < 0.0001). Therefore, the CSF/serum albumin ratio also
      showed a significant gradient with a 21% decrease (p < 0.0001), while no
      gradients were found to the IgG index. These results imply that analyses of
      proteins in the CSF should be performed on a standardized volume of CSF,
      preferably the first 12 ml, to allow comparisons of scientific results between
      various patient groups and controls and between different laboratories and to
      increase the validity of protein analyses in clinical practice.

PMID- 8467819
TI  - Protein analysis in cerebrospinal fluid. II. Reference values derived from
      healthy individuals 18-88 years of age.
AB  - Analyses of the cerebrospinal fluid (CSF) to determine the blood-CSF barrier
      function and to detect intrathecal IgG production are used in the diagnosis of
      neurological and psychiatric diseases. Therefore, accurate reference values for
      these parameters are of utmost importance. However, current reference values are
      based on 'reference groups' consisting of patients with psychiatric and/or
      neurological symptoms but without positive clinical findings and on groups of
      young students. The present study presents reference values for CSF proteins in a
      large sample (n = 105) of healthy individuals, with a large age-span (18-88 years
      of age). The parameter for the determination of the blood CSF barrier function,
      the CSF/serum (CSF/S) albumin ratio, was found to show an increasing variability
      in individuals over 45 years of age, suggesting a less stable blood-CSF barrier
      function than in younger individuals. The upper reference limit for the CSF/S
      albumin ratio was 6.8 for individuals under 45 years of age and 10.2 for
      individuals over 45 years of age. The IgG index, a dimensionless quotient for the
      determination of intrathecal IgG production, showed only a minor correlation with
      age and had an upper reference limit of 0.63.

PMID- 8467820
TI  - Protein analysis in cerebrospinal fluid. III. Relation to blood-cerebrospinal
      fluid barrier function for formulas for quantitative determination of intrathecal
      IgG production.
AB  - To examine the possible influence of the blood-CSF barrier function on
      mathematical formulas for estimating intrathecal IgG production (IgG index,
      Tourtellotte's formula [TOURT], Schuller and Sagar's formula [Schull], and Reiber
      and Felgenhauer's formula [IgG(loc)]), we analysed serum and CSF samples from 105
      healthy individuals, aged 18-88 years, and 816 consecutive patients without
      oligoclonal IgG bands (OCBs) in the CSF, aged 18-91 years. In healthy individuals
      there was no significant correlation between the CSF/serum (S) albumin ratio
      (i.e. blood-CSF barrier function) and the IgG index, a dimensionless quotient for
      determining intrathecal IgG production, and only a small correlation (r = -0.08,
      p < 0.05) in patients without OCBs. However, significant dependence on the blood
      CSF barrier function was found, in both healthy individuals and patients without
      OCBs, for the formulas determining intrathecal IgG production in milligrams (per
      litre CSF or per day), i.e. for TOURT, SCHULL and IgG(loc). Therefore, we propose
      a new formula for the quantitative determination of intrathecal IgG production in
      mg/l, the IGGPROD, which is calculated as: CSF-IgG -[(0.51 x CSF-Alb x S-IgG)/S
      Alb]. IGGPROD is an empirical formula, based on findings in 105 healthy
      individuals 18-88 years of age, and does not depend on the blood CSF barrier
      function.

PMID- 8467821
TI  - Dopamine receptor SPET imaging in Parkinson's disease: a [123I]-IBZM and [99mTc]
      HM-PAO study.
AB  - Single photon emission tomography (SPET) with the novel ligand [123I]-IBZM was
      used to image central dopamine D2 receptors in Parkinson's disease (PD) patients.
      The aim was to assess basal ganglia (BG) receptor densities in relation to the
      response to L-dopa therapy. To better characterize the clinical potential of
      [123I]-IBZM SPET, each patient underwent a second study with the regional
      perfusion tracer [99mTc]-HM-PAO. Tracer activity ratios were calculated for
      caudate and putamen with mean activity over the cerebellar hemispheres as
      internal standard. In PD patients we found a significant decline of mean caudate
      [123I]-IBZM activity, as compared with age-matched control subjects. However,
      when patients were grouped according to their therapeutic behavior, the [123I]
      IBZM uptake in BG ganglia regions of the PD patient group with a poor and
      fluctuating response to L-dopa was significantly reduced from mean values of
      patients with a sustained response to L-dopa therapy. [99mTc]-HM-PAO caudate and
      putamen uptake indexes in PD were similar to control values, even in patients
      with deteriorated therapeutic response. Our results indicate that BG D2 receptor
      alterations in PD may contribute to the altered response to L-dopa.

PMID- 8467822
TI  - Incidence of nervous system Borrelia burgdorferi infection in patients with
      lumboradicular syndrome.
AB  - We investigated 103 consecutive patients primarily admitted to our Department of
      Neurosurgery (36 women, age: median 44, range 21-79; 67 men, age: 47, range 19
      77) suffering from low back pain radiating into one or both legs. Neurological
      examination combined with computer tomography and lumbar myelography revealed
      lumbar-disc herniation in 74, vertebrostenosis in 10 and relapsed disc herniation
      in 9 patients. In 9 patients the diagnosis of pseudoradicular syndrome was
      established without definite neuroradiological morphological evidence. Two
      patients were diagnosed as having polyneuropathy, and 1 patient suffered from a
      nervus ischiadicus lesion due to a gluteal abscess. CSF of all patients was
      examined according to a fixed routine schedule (cells, protein, sugar,
      immunoglobulins, IgG index). Antibodies to Borrelia burgdorferi were found in the
      serum and CSF of 5.8%, and in the serum alone of 2% of patients. Intrathecally
      produced specific antibodies were detected in 3 patients (2.9%) with
      neuroradiological evidence of disc or spinal-canal disease, indicating the
      coexistence of previous CNS infection by B. burgdorferi with lumbar-disc
      herniation. None of the patients showed CSF pleocytosis; thus, in no case was
      acute radiculitis due to B. burgdorferi infection diagnosed.

PMID- 8467823
TI  - Markers of activated T lymphocytes and T cell receptor gamma/delta+ in patients
      with multiple sclerosis.
AB  - We studied interferon-gamma (IFN-gamma), alpha-tumor necrosis factor (alpha-TNF)
      and granulocyte macrophage colony-stimulating factor (GM-CSF) in the
      cerebrospinal fluid and serum of 18 patients with multiple sclerosis (MS) and 10
      subjects with other neurological diseases (OND). We also studied the
      cerebrospinal-fluid CD 69 expression, and T cells with T cell receptor (TcR)
      gamma/delta+. We found an increase of IFN-gamma (14.0 +/- 3.5 U/ml) and GM-CSF
      (8.0 +/- 3.4 pg/ml) levels in the cerebrospinal fluid of MS patients compared to
      the OND group (p < 0.005 and p < 0.01, respectively). The frequency of detectable
      cerebrospinal-fluid and serum alpha-TNF was similar in patients with MS and with
      OND. The cerebrospinal-fluid CD69 expression in lymphocytes was significantly
      higher in MS patients (15.0 +/- 9.9%) than in the control group (3.7 +/- 6.2%; p
      < 0.005). Comparable serum levels of IFN-gamma and GM-CSF were detected in
      patients with MS and in OND subjects. No significant difference in the incidence
      of TcR gamma/delta+ in the cerebrospinal fluid was found between the two groups.
      These results indicate an activation of T lymphocytes and macrophages in patients
      with MS. Our data do not suggest a role for an increased incidence of TcR
      gamma/delta+. However, we cannot rule out the possibility that these T cells
      could be present at the plaque site of MS patients.

PMID- 8467824
TI  - Guillain-Barre syndrome after herpes zoster infection: a report of 2 cases.
AB  - We report 2 patients with Guillain-Barre syndrome following infection with the
      varicella-zoster virus. Evidence from neurophysiological studies is provided and
      the literature is reviewed on the association between these conditions.

PMID- 8467825
TI  - Atypical manifestations of tuberculous meningitis.
AB  - We describe 2 patients with tuberculous meningitis who exhibited unusual changes
      of their cerebrospinal fluid (CSF) which led to confusion in their management.
      Patient 1 was a 25-year-old man who displayed persistent polymorphonuclear
      dominant pleocytosis in his CSF. Autopsy revealed marked hypoplasia of the thymus
      and T cell areas of the lymph nodes, consistent with the Nezelof syndrome, as
      well as disseminated tuberculosis. Patient 2 was a 39-year-old woman who
      demonstrated, during appropriate antituberculous chemotherapy, an atypical
      exacerbation consisting of prolonged fever, polymorphonuclear dominant
      pleocytosis in her CSF and multiple cerebral infarcts. The neurological
      abnormalities in the patient underwent marked improvement following oral
      prednisolone therapy.

PMID- 8467826
TI  - Regional cerebral blood flow in multiple sclerosis measured by single photon
      emission tomography with technetium-99m hexamethylpropyleneamine oxime.
AB  - The regional cerebral blood flow (rCBF) in 19 patients with multiple sclerosis
      (MS), 10 with a relapsing remitting course and 9 with a progressive course, was
      examined by single photon emission computed tomography (SPECT) using technetium
      99m hexamethylpropyleneamine oxime ([99mTc]-d,l-HM-PAO) as flow tracer. Nine age
      matched volunteers served as controls. Low rCBF in the frontal grey matter
      correlated with neurological disability (p < 0.01), low frontal grey and white
      matter perfusion correlated with impaired cognitive functions (p < 0.02), and low
      rCBF in the occipital regions correlated with impaired visual functions (p <
      0.03) in the MS population. A relationship was also found between reduced
      parietal white matter perfusion and the duration of the disease (p < 0.005).
      Patients with progressive MS had significantly reduced rCBF in the frontal grey
      matter compared with relapsing remitting MS patients and controls (p < 0.05). No
      other rCBF differences were found. As a diagnostic tool in MS, SPECT-[99mTc]-d,l
      HM-PAO was found to be insensitive.

PMID- 8467827
TI  - Bezafibrate-induced myopathy: no evidence for defects in muscle metabolism.
AB  - A 58-year-old man with chronic renal failure developed severe muscle pain and
      tenderness 1 week after starting bezafibrate 400 mg daily. Serum creatine kinase
      was 32,280 U/l. Muscle biopsy revealed scattered necrotic fibers and mild type 2b
      atrophy. Muscle total and free carnitine were at the upper limits of the normal
      range. Biochemical investigations of muscle homogenate showed normal carnitine
      pelmityl transferase (CPT) as well as normal individual glycolytic and
      mitochondrial enzyme activities. Withdrawal of the drug was followed by rapid
      clinical improvement. Our study casts doubt on the hypothesis that bezafibrate is
      able to affect muscle metabolic pathways. It is likely that the drug acts on
      cholesterol constituents of the muscle membrane, producing discontinuities of the
      sarcolemma and initiating cell necrosis.

PMID- 8467828
TI  - Decreased interhemispheric EEG coherence during sleep in agenesis of the corpus
      callosum.
AB  - Inter- and intrahemispheric EEG coherence was studied in 4 subjects with agenesis
      of the corpus callosum (ACC) and in 4 matched controls through different states
      of the sleep/wakefulness cycle. Interhemispheric coherence was calculated between
      homologous prefrontal, frontal, central, parietal and occipital electrode pairs
      whereas intrahemispheric coherence was calculated between all adjacent,
      unihemispheric electrode pairs. EEG samples were recorded from stage 2, stages 3
      + 4 and stage REM sleep and the eyes closed waking state. Interhemispheric
      coherence measures indicated lower values for ACC subjects than for control
      subjects for most brain regions; the occipital cortex was least affected. These
      results further validate the interhemispheric coherence function as a measure of
      activity in the corpus callosum and suggest that occipital measures may index
      activity localized in the posterior commissure. Intrahemispheric coherence
      measures indicated very few differences between the two groups, a result
      consistent with the suggestion that there is no specialized intrahemispheric
      compensation in ACC.

PMID- 8467829
TI  - Successful nonoperative treatment of tuberculous spinal epidural abscess with
      cord compression: the role of magnetic resonance imaging.
AB  - A patient is described with a tuberculous spinal epidural abscess and signs of
      cord compression, who was successful treated without surgery. Magnetic resonance
      imaging, in addition to its role as a diagnostic tool, was helpful in monitoring
      the resolution of inflammation.

PMID- 8467830
TI  - Left tuberothalamic artery territory infarction: neuropsychological and MRI
      features.
AB  - We examined a 29-year-old woman who had language disturbances and memory
      impairment after a left thalamic infarction. MRI showed injury that was limited
      to the tuberothalamic artery territory. Beside reduced voice volume and verbal
      memory trouble, she presented with aspontaneity, loss of psychic self-activation
      and affective drive. Considering thalamic lesions, this loss of psychic self
      activation or 'athymhormie' was found in a left thalamic infarct and could not be
      considered as an exclusive characteristic of bithalamic infarctions. The
      disappearance of the neurobehavioral disturbances within 15 days after the onset
      of the troubles was associated with the decreasing of the mass lesion found by
      MRI.

PMID- 8467831
TI  - Retinal periphlebitis in multiple sclerosis: a marker of disease activity?
AB  - This study was performed in order to verify the prevalence of retinal
      periphlebitis and other ocular changes in a well-defined population of multiple
      sclerosis (MS) patients, and to correlate the presence of these features with
      some clinical variables which characterize the disease. 110 MS-affected subjects
      were submitted to a standard ophthalmologic examination including a
      biomicroscopical evaluation of the fundus oculi. The prevalence of retinal
      sheathing in MS patients was found to be nearly 36%. It is significantly higher
      in patients evaluated in an active phase of the disease than in those examined in
      a stationary phase.

PMID- 8467832
TI  - Dynamic strength in Parkinson's disease. Quantitative measurements following
      withdrawal of medication.
AB  - This study examined the influence of pharmacological treatment on muscle strength
      in Parkinson's disease (PD). Twelve patients, 7 men and 5 women, were tested with
      modified Cybex II equipment. Peak torques in isometric, concentric and eccentric
      contraction at 30, 120 and 180 degrees/s in ankle dorsiflexors were recorded
      before and after the withdrawal of medication. EMG were recorded during
      contraction. Clinical assessment was done according to Webster's and Hoehn and
      Yahr's rating scales. Clinical scores were significantly increased (p < 0.05).
      Peak torques in isometric, concentric and eccentric contraction (p < 0.05)
      decreased at almost all velocities after withdrawal of medication. Correlations
      were found between changes in clinical score and strength. Strength production in
      PD was influenced by medication, and the results correlated with changes in
      clinical ratings. Strength measurement may be used in the evaluation of
      pharmacological therapy.

PMID- 8467833
TI  - Ophthalmoplegia, hemiparesis and cheiro-oral syndrome in basilar artery migraine.
AB  - A patient with migraine developed ophthalmoplegia, hemiparesis and cheiro-oral
      syndrome on the left side. T2-weighted MRI showed infarcts in the tegmentum of
      bilateral midbrains and right pons but no lesion in the cerebral or cerebellar
      hemisphere. Infarction in the tegmentum of brainstem secondary to the involvement
      of perforating arteries has not been reported in basilar artery migraine until
      now.

PMID- 8467834
TI  - Clinically asymptomatic xeroderma pigmentosum neurological disease in an adult:
      evidence for a neurodegeneration in later life caused by defective DNA repair.
AB  - Xeroderma pigmentosum is a genetically heterogeneous disease caused by DNA repair
      defects resulting in skin cancer and, in some patients, a primary neuronal
      degeneration which has in all previous reports become symptomatic prior to age 21
      years. A 47-year-old xeroderma pigmentosum patient is described who, although
      neurologically asymptomatic, has sensorineural hearing loss together with
      clinical signs and electrophysiologic evidence of a developing peripheral
      neuropathy. This case suggests that defective DNA repair may cause
      neurodegeneration in adults as well as in children.

PMID- 8467835
TI  - Benign intracranial hypertension associated with HIV infection.
AB  - We report the case of a 24-year-old woman with HIV-seropositivity, who developed
      a clinical picture of pseudotumor cerebri, an association not previously
      described. The patient improved with the use of acetazolamide. We suggest the
      possible existence of this disorder in HIV-infected patients with persistent
      headaches, visual deficits and/or extraocular muscle palsies.

PMID- 8467836
TI  - Bilateral neuropsychological deficits in unilateral paramedian thalamic
      infarction.
AB  - The neuropsychological deficits in 5 patients with chronic and MRI-proven
      unilateral infarctions in the perfusion territory of the paramedian thalamic
      arteries were studied. All patients showed deficits pointing to a dysfunction of
      frontotemporal hemispheric structures on the side of the thalamic lesion.
      However, 4 patients revealed additionally neuropsychological deficits pointing to
      a dysfunction of frontotemporal hemispheric structures overlying the nonaffected
      thalamus. The contralateral deficits showed (in 4 patients) signs of temporal and
      (in 3 patients) frontal lobe dysfunction. It is suggested that the bilaterality
      of the neuropsychological deficits results from additional contralateral thalamic
      lesions not detected by MRI and/or from bilateral cortical hypometabolism.

PMID- 8467837
TI  - Effectiveness of botulinum toxin in the treatment of spasmodic torticollis.
AB  - Thirty-two patients with spasmodic torticollis were assessed quantitatively for
      posture deformity, tremor and range of neck movement, and qualitatively for pain
      and global subjective disability. All patients were then treated with
      intramuscular botulinum toxin injections into appropriate neck muscles. Fifty
      three treatments were administered using dosages of toxin in the range of 50-100
      U per muscle. The maximum dose administered at a single sitting was 280 U. The
      progress of the patients was assessed during an 18-month period. Seventy-five
      percent of patients showed documented improvement in both subjective and
      objective parameters and were considered treatment successes. Pain improved in
      65%, posture in 65%, tremor in 50% and range in 46%. The side effects that
      occurred were transient and included fatigue, dysphagia, neck weakness,
      hoarseness and local pain. This study demonstrates that treatment with botulinum
      toxin is of significant benefit for the majority of patients with spasmodic
      torticollis.

PMID- 8467838
TI  - Glycogenosis type V (McArdle's disease) with hyperuricemia. A case report and
      clinical investigation.
AB  - A 28-year-old male with glycogenosis type V associated with continuous
      hyperuricemia during mild daily activities is reported. An aerobic exercise test
      using a bicycle ergometer revealed that purine metabolites, i.e., ammonia,
      inosine, hypoxanthine and xanthine, were transiently increased by the exercise
      and that a subsequent increment in uric acid continued until the following day.
      The accelerated purine degradation by the muscle exercise was thus shown to be
      able to cause the overt hyperuricemia in a patient with glycogenosis type V.
      Therapeutic use of fructose for glycogenosis was disappointing due to fructose
      induced hyperuricemia. A search for myogenic hyperuricemia is essential for
      therapeutic trials.

PMID- 8467839
TI  - Clinical spectrum of McArdle disease: three cases with unusual expression.
AB  - Three cases of myophosphorylase deficiency with unusual clinical expression are
      presented. The 1st had clinical characteristics suggesting a mild congenital
      myopathy, and the patient never experienced cramps or myalgias. The 2nd had a
      slowly progressive myopathy without cramps or myoglobinuria which was detected by
      chance. The 3rd presented with myoglobinuria and acute renal failure, unrelated
      to a triggering effort, and with permanent weakness and wasting. In all cases,
      muscle biopsy demonstrated a vacuolar myopathy with free glycogen increase and
      absence of myophosphorylase activity, confirmed by biochemical assays. The cases
      confirm the wide clinical spectrum of McArdle disease.

PMID- 8467840
TI  - Rabies encephalitis mimicking the electrophysiological pattern of brain death. A
      case report.
AB  - A 48-year-old woman was referred from Zaire with suspected rabies encephalitis.
      Survival was 34 days after the onset of symptoms and the diagnosis of rabies was
      ultimately proven after brain autopsy. Serial neurophysiological investigations,
      including EEG and multimodality evoked potentials and radiological examinations
      (cerebral magnetic resonance imaging and computed tomodensitometry) were
      performed. Whereas the clinical findings and EEG were compatible with brain death
      at the end of the course, this diagnosis could be definitely ruled out by
      multimodality evoked potentials, magnetic resonance imaging and autopsy. The
      validity of multimodality evoked potentials is discussed in this particular
      setting.

PMID- 8467841
TI  - Trigeminal sensory symptoms due to midbrain lesions.
AB  - Three patients with midbrain lesion are described who showed trigeminal sensory
      symptoms in the contralateral side. Two with ischemic stroke showed partial
      oculomotor paresis while the third with probable vascular malformation had
      trochlear palsy. Considering their clinical manifestations and magnetic resonance
      findings, their sensory changes are believed to be caused by the involvement of
      the crossed trigeminothalamic fibers near the ocular motor nuclei.

PMID- 8467842
TI  - Is parkinsonian arm tremor a resting tremor?
AB  - Arm tremor in Parkinson's disease occurs during rest which has been explained by
      a specific tremulous mechanism activated during rest. During action or posture
      maintenance, the tremor may persist or recur, but with reduced amplitude. We
      present 2 patients with idiopathic Parkinson's disease who showed persisting arm
      tremor which was most marked during action rather than during rest. The patterns
      of upper limb tremor were investigated during rest, maintenance of fixed posture,
      and slow movement, using an advanced computerized movement-monitoring system
      (Coda 3). Four parkinsonian patients showing tremor under all conditions were
      studied, comparing 2 patients whose tremor was most marked during rest with 2
      whose tremor was most marked during action. All showed intermediate amplitudes
      during posture maintenance. Patterns of tremor frequency were very similar
      between patients, irrespective of amplitude characteristics. These features
      suggest that tremors in all patients originate in a single, complex mechanism
      which may involve both central and peripheral mechanisms.

PMID- 8467843
TI  - Soluble class I antigen secretion by peripheral blood lymphocytes in multiple
      sclerosis.
AB  - We have quantified the soluble class I antigen (sHLA) secretion by peripheral
      blood lymphocytes of 26 multiple sclerosis (MS) patients. Thirteen of them were
      in a stable phase of the disease, 6 on relapse and 7 suffered from a progressive
      MS. sHLA secretion was reduced in the presence or absence of phytohemagglutinin
      in patients with either active or stable MS, being normal after stimulation with
      a monoclonal antibody anti-CD3. In MS patients, lymphocyte proliferation and
      immunoglobulin secretion were found to be similar to those of 29 healthy blood
      donors who comprised the group of controls. These results reflect systemic
      anomalies in the cell activation process in MS, which seem to be independent of
      the disease activity. Whether these alterations are specific to MS or are common
      to other inflammatory CNS diseases remains to be elucidated.

PMID- 8467844
TI  - Brain stem magnetic resonance imaging and evoked potential studies of symptomatic
      multiple sclerosis patients.
AB  - In this study we evaluated the sensitivity of neuroradiological and
      neurophysiological tests for detecting brain stem (BS) lesions in multiple
      sclerosis patients, since the recent introduction of the gradient motion
      rephasing technique has markedly increased the image quality of magnetic
      resonance imaging (MRI). From 50 MS patients (33 women and 17 men; mean age 35.9
      +/- 8.3 years; mean duration of the disease 7.2 +/- 4.1 years) with clinical
      signs of BS involvement, brain MRI, BS auditory evoked potentials (BAEPs), and
      left and right median somatosensory evoked potentials (mSEPs) were obtained. BS
      MRI lesions were detected in 41 patients (82%); in 14 cases they were located in
      the medulla oblongata, in 55 in the pons, and in 24 in the midbrain. Single
      lesions were present in 20 patients, while two or more BS lesions were
      demonstrated in 21 patients; 30 patients had at least one lesion located close to
      the inner or the outer cerebrospinal fluid border. BAEPs were abnormal in 19 of
      the 50 patients (38%), and BS components of mSEPs were abnormal in 15 of 46
      (33%). With combined use of these neurophysiological techniques, BS abnormalities
      were revealed in 24 patients (48%). Only 1 patient had neurophysiological BS
      abnormalities and normal MRI. Moreover, there was a good correlation (74%)
      between the clinical and MRI BS findings in the 23 patients with signs referable
      to focal neurological BS lesions. The concordances considering clinical and
      evoked potential reports were positive, but less marked.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8467845
TI  - Recurrent polyradiculoneuropathy with hyperthyroidism.
AB  - A 30-year-old woman, who had had two episodes of distal dominant sensorimotor
      disorders in the extremities, developed again sensorimotor involvement in the
      distal portion of all limbs. She was also found to have hyperhidrosis,
      tachycardia and goiter. Neurological and endocrinological examinations led to a
      diagnosis of coexistence of recurrent polyradiculoneuropathy and hyperthyroidism.
      Treatment with thiamazole resulted in improvement of the neurological features as
      well as of hyperthyroidism. The relationship between polyradiculoneuropathy and
      hyperthyroidism is discussed.

PMID- 8467846
TI  - Creutzfeldt-Jakob disease. Report of a case of the panencephalopathic type and
      experiences of a teaching hospital in Taiwan.
AB  - We report a case of the unusual panencephalopathic type of Creutzfeldt-Jakob
      disease (CJD) in Taiwan. This 59-year-old woman presented in 1983 with typical
      clinical manifestations of CJD and died 16 months later. Postmortem examination
      revealed severe neuronal loss, spongiosis and gliosis extensively in cerebral
      cortex and striatum as well as in the white matter. We also report 6 other CJD
      patients seen from 1983 to 1991 at Veterans General Hospital-Taipei.

PMID- 8467847
TI  - Persistent chorea after recurrent hypoglycemia. A case report.
AB  - In a 72-year-old woman with a 33-year history of diabetes mellitus bilateral
      chorea had occurred after a series of hypoglycemic comas at the age of 58. The
      choreiform movements remained untreated, persisted more than 10 years and inspite
      of intermittent exaggeration were tolerated by the patient. Except for the
      hyperkinetic movements, neurological examination of this patient was otherwise
      normal as was cranial computer tomography.

PMID- 8467848
TI  - Recurrent oligodendroglioma diagnosed with 11C-L-methionine and PET: a case
      report.
AB  - A benign oligodendroglioma was removed in a young patient who had temporal
      epileptic seizures. He then became free of any fit until 15 months after the
      operation, when he developed seizures progressively less controlled by therapy.
      All investigations were normal (including CT scan and MRI) except a PET study
      which showed a high uptake of 11C-L-methionine in the area of the previous tumor.
      The second operation revealed that this area was indeed a tumor recurrence. We
      briefly discuss the potential usefulness of PET for the follow-up of low grade
      gliomas.

PMID- 8467849
TI  - Elevated velocity of prostacyclin degradation in blood as a possible risk factor
      in patients with cerebrovascular disorders.
AB  - Blood and plasma from 193 patients at risk of cerebrovascular disorders and 87
      patients with brain infarction were tested to study prostacyclin (PGI2)
      degradation. It has been reported that patients at risk for cerebrovascular
      disorders and especially with brain infarction have an enhanced velocity of PGI2
      degradation. The increase in velocity was more marked in blood than in plasma. A
      direct relation between this enhancement and the manifestation of intravascular
      platelet activation was observed. These data suggest that elevated PGI2
      degradation might be a risk factor for thromboembolic events in patients with
      cerebrovascular disorders.

PMID- 8467850
TI  - Increased density in the middle cerebral artery by nonenhanced computed
      tomography. Prognostic value in acute cerebral infarction.
AB  - In order to consider the prognostic value of hyperdensity of the middle cerebral
      artery (MCA), we studied retrospectively the medical records of 80 consecutive
      patients with the diagnosis of ischemic stroke who underwent a non-enhanced
      computed tomography no longer than 24 h after the onset of the symptoms. To
      determine the mortality and disability, a follow-up of 30 days was obtained.
      Mortality does not differ significantly in acute ischemic stroke patients with
      and without increased density of MCA. When disability, calculated with the Rankin
      scale, is considered, the two groups are different since patients with
      hyperdensity of the middle cerebral artery (MCA) have a significantly worse
      outcome. The two groups do not differ for age, sex, the presence of atrial
      fibrillation, hypertension, diabetes, myocardial infarction and/or angina, and
      these factors do not influence the prognosis being equally present in the dead
      and in the survivors. In the multivariate discriminant analysis with stepwise
      variable selection, the dense MCA sign was significantly correlated either to
      mortality or to disability, along with atrial fibrillation, age and diabetes. We
      conclude that the dense MCA sign can be a useful prognostic factor in the early
      phase of ischemic stroke.

PMID- 8467851
TI  - Moyamoya-like disease with inflammation.
AB  - A 29-year-old Caucasian male died from massive cerebral infarction due to
      unilateral occlusion of the terminal internal carotid artery. The carotid
      occlusion was secondary to subendothelial fibrous tissue proliferation which was
      associated with a considerable mononuclear cell infiltration of the carotid wall,
      characterised as T cells by immunoperoxidase methods. Angiography showed vascular
      network at the base of the brain compatible with Moyamoya disease. We suggest
      that the pathogenesis of Moyamoya-like disease in our patient involved a T-cell
      mediated attack to a vascular antigen.

PMID- 8467852
TI  - Hemorrhagic and ischemic cerebrovascular complications of active infective
      endocarditis of native valve.
AB  - Cerebrovascular events complicate the management of infective endocarditis. The
      purpose of this study is to analyze clinical features of cerebrovascular
      complications in infective endocarditis and to establish the appropriate time
      schedule of chemotherapy and cardiosurgical intervention. We studied the clinical
      data of 123 patients with active infective endocarditis of native valves
      retrospectively. Thirty-three patients (18 males and 15 females, age 17-57 years)
      had cerebrovascular complications such as cerebral ischemia (n = 22) or
      intracranial hemorrhage (n = 11). The majority of complications (21 ischemic and
      13 hemorrhagic episodes) occurred prior to or within 1 month after chemotherapy.
      Fatal neurological deterioration developed after cardiac surgery in 2 patients.
      Both of them needed emergency cardiac surgery, because of worsening hemodynamic
      state, which was performed within 5 days after cerebral embolic events. The
      remaining patients undertaking cardiac surgery did all survive; in whom there
      were chemotherapeutic intervals of 11 days after ischemic events or of 23 days
      after hemorrhagic events. These medical records suggest that early cardiosurgical
      intervention, if necessary, needs at least 2-3 weeks of preceding chemotherapy.
      In cases undergoing more than 1 month of chemotherapy, cerebrovascular
      complications may be well managed by medical treatment alone.

PMID- 8467853
TI  - Development of palilalia after stereotaxic thalamotomy in Parkinson's disease.

PMID- 8467854
TI  - Profile of ucb L059, a novel anticonvulsant drug, in models of partial and
      generalized epilepsy in mice and rats.
AB  - The novel anticonvulsant drug ucb L059 ((S)-alpha-ethyl-2-oxo-1
      pyrrolidineacetamide) was evaluated in several rodent models of partial and
      generalized seizures. Ucb L059 (27-108 mg/kg i.p.) increased the thresholds for
      tonic electroconvulsions and myoclonic and clonic seizures induced by timed i.v.
      infusion of pentylenetetrazol (PTZ), but was ineffective in the traditional
      maximal electroshock seizure and s.c. PTZ seizure tests in mice and rats in doses
      up to 500 mg/kg. The anticonvulsant potency of ucb L059 in seizure threshold
      tests was similar to that of standard drugs, such as valproate. In amygdala
      kindled rats, ucb L059 exerted potent anticonvulsant activity against both focal
      and secondarily generalized seizures at doses of 13-108 mg/kg. The adverse
      effects of ucb L059 were quantitated in the open field and in standard tests for
      motor impairment, such as the rotarod and chimney tests. Ucb L059 exerted only
      minimal effects on behaviour, e.g. slight hyperactivity, and did not impair
      muscle activity in the rotarod test in doses up to 1700 mg/kg i.p. The data
      indicate that ucb L059 is an interesting new anticonvulsant agent with a broad
      spectrum of activity and high therapeutic index.

PMID- 8467855
TI  - Inhibition of platelet-activating factor-induced leukocyte adhesion in vivo by a
      leumedin.
AB  - Leumedins are a class of amino acid derivatives which have been reported to exert
      anti-inflammatory properties through a mechanism related to their ability to
      inhibit the expression of adhesion molecules on leukocytes. In the present study,
      the ability of an orally active leumedin (NPC 17923) to inhibit leukocyte
      adherence stimulated by platelet-activating factor was examined using an in vivo
      intravital microscopy preparation of mesenteric venules in the rat. Oral
      pretreatment with NPC 17923 (100 mg/kg) markedly increased the ratio of white
      blood cell velocity to red blood cell velocity, indicating that less force was
      required to displace a white blood cell from the vascular endothelium. NPC 17923
      also significantly inhibited the adherence of white blood cells to the
      endothelium during the superfusion with platelet-activating factor. While not
      significantly affecting vessel diameter under basal conditions, vessels were
      significantly larger in NPC 17923-pretreated rats during the superfusion with
      platelet-activating factor. These results are consistent with the hypothesis that
      the anti-inflammatory properties of leumedins are at least in part due to effects
      on leukocyte adherence, but may also be in part attributable to effects on
      vascular tone.

PMID- 8467856
TI  - Angiotensin II-induced tachyphylaxis in aortas of normo- and hypertensive rats:
      changes in receptor affinity.
AB  - Angiotensin II-induced tachyphylaxis was found to be associated with changes in
      agonist affinity (Ka) and EC50 values, as assessed by using Furchgott's equation
      derived for the determination of full agonist affinity. The diminished affinity
      during tachyphylaxis was observed in aorta ring preparations from both Wistar
      Kyoto and spontaneously hypertensive rats. Noradrenaline (10(-9) M) reduced the
      increase in the Ka value during tachyphylaxis in both strains. The results
      suggest that tachyphylaxis occurs at the level of the receptor, resulting in
      changes in the affinity of the ligand for the receptor and in the coupling
      efficiency of the receptor system. The results also support the probable role of
      modulators acting on allosteric receptor sites.

PMID- 8467857
TI  - Poststatin, a novel inhibitor of bradykinin-degrading enzymes in rat urine.
AB  - Incubation of bradykinin with rat urine resulted in the successive degradation of
      bradykinin to bradykinin-(1-8), bradykinin-(1-7) and bradykinin-(1-6). In
      contrast, in rat plasma, bradykinin was degraded via either bradykinin-(1-8) or
      bradykinin-(1-7) to bradykinin-(1-5). Phosphoramidon (1 mM) partially inhibited
      the degradation of bradykinin by rat urine, as well as the conversion of
      bradykinin-(1-7) to bradykinin-(1-6). D,L-2-Mercaptomethyl-3
      guanidinoethylthiopropanoic acid (1 mM) and captopril (1 mM) did not have a
      significant effect on any of the degradation steps in rat urine. In contrast, all
      of the degradation steps in urine, namely, from bradykinin to bradykinin-(1-8),
      from bradykinin-(1-8) to bradykinin-(1-7) and from bradykinin-(1-7) to bradykinin
      (1-6), were markedly inhibited by poststatin (1 mM), even though this compound
      was reported originally to be a novel inhibitor of post-proline cleaving enzyme.
      Poststatin (1 mM) did not inhibit the degradation of bradykinin in rat plasma.
      These results indicate that poststatin is an effective inhibitor of kinin
      degrading enzyme in rat urine.

PMID- 8467858
TI  - Morphine and diffuse noxious inhibitory controls in the rat: effects of lesions
      of the rostral ventromedial medulla.
AB  - The aim of this study was to investigate whether the rostral ventromedial medulla
      (RVM) participates in the lifting of diffuse noxious inhibitory controls (DNIC)
      by systemic morphine. The effects of morphine (1 mg/kg i.v.) on DNIC were
      compared in sham-operated rats and animals with electrolytic lesions of the RVM
      performed one or three weeks earlier. The C-fibre-evoked responses of spinal
      dorsal horn convergent neurones were similar in the sham-operated and lesioned
      animals. DNIC acting on these responses were also similar in these groups. DNIC
      were similarly reduced naloxone reversibly following morphine injections in sham
      operated animals and animals tested one week after lesioning of the RVM. In
      contrast, DNIC were not significantly altered by morphine in animals tested three
      weeks after lesioning. The lesions were similar in both groups of animals. This
      time-dependent attenuation of the effects of morphine indicates that the RVM is
      not directly involved in the reduction of DNIC induced by systemic morphine.
      However, it is suggested that lesions in this region can induce a reorganization
      of brainstem opioidergic systems.

PMID- 8467859
TI  - Antidiuretic activity and release of factor VIII by vasopressin analogues.
AB  - Vasopressin and in particular its structural analogue dDAVP (1-deamino-8-D
      arginine vasopressin) can increase plasma concentrations of Factor VIII and
      tissue plasminogen activator (tPA) in some species of animals and in humans. For
      this reason dDAVP is used therapeutically in the treatment of bleeding episodes
      in patients suffering from haemophilia A and Von Willebrand's disease. However,
      the high antidiuretic activity of dDAVP constitutes and unwanted effect in this
      context. In the present study, a large number of analogues of vasopressin were
      designed, synthesized and tested in monkeys with the aim of producing compounds
      in which the Factor VIII-releasing activity was selectively isolated from the
      vasopressor and antidiuretic actions of the peptide. The results indicate that it
      is possible to separate these biological activities; however, none of the
      analogues tested so far possessed Factor VIII potencies comparable to that of
      dDAVP.

PMID- 8467860
TI  - Potentiation of dark onset feeding in obese mice (genotype ob/ob) following
      central injection of norepinephrine and clonidine.
AB  - Central monoaminergic neurotransmitters have been implicated in the control of
      food intake in different animal species but it remains unclear whether these same
      neurochemical systems effectively regulate feeding behaviour in the genetically
      obese (ob/ob) mouse. Neuropharmacological studies have demonstrated, for example,
      that microinjection of norepinephrine can elicit a reliable feeding response in
      the rat, particularly at dark onset. The present study was therefore designed to
      examine the impact of central injection of norepinephrine (20-160 nmol) and
      clonidine (5-80 nmol), an alpha 2-adrenoceptor agonist, on food intake in ob/ob
      mice and lean (+/?) controls. Presatiated obese and lean mice were injected with
      norepinephrine or clonidine immediately prior to the onset of the dark cycle.
      Food intake (kcal) was measured 1 h postinjection. Obese mice ingested more food
      than lean mice under baseline saline conditions. Injection of norepinephrine and
      clonidine increased eating in both phenotypes, although the ob/ob showed an
      enhanced feeding response to norepinephrine and clonidine administration.
      Intracerebroventricular pretreatment with the alpha 2-adrenoceptor antagonist
      yohimbine (12.5-50 nmol) significantly attenuated the increase in food intake
      observed in response to central injection of norepinephrine (40 nmol) and
      clonidine (10 nmol). However, the alpha 1-adrenoceptor antagonist corynanthine
      (15-60 nmol) or the beta-adrenoceptor antagonist propranolol (25-100 nmol) failed
      to alter noradrenergic feeding. These results suggest that modification of
      central alpha 2-noradrenergic function can alter natural feeding in mice, and
      that the ob/ob is particularly sensitive to this effect.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8467861
TI  - Catecholamine uptake inhibitors elevate 6-hydroxydopamine in brain after
      administration of 6-hydroxydopa.
AB  - Desipramine and nomifensine, two norepinephrine uptake blockers, elevated by 63
      248% the levels of 6-hydroxydopamine found in the frontal cortex at 1-4 h after
      administration of 6-OH-DOPA. Nomifensine also elevated 6-hydroxydopamine by 83%
      in the striatum at 4 h. These results nullify prior suggestions in the literature
      that 6-OH-DOPA is decarboxylated to 6-hydroxydopamine mainly outside of
      catecholamine nerve terminals and that 6-hydroxydopamine subsequently gains
      access to nerve terminals via the axonal membrane transport system for
      catecholamines.

PMID- 8467862
TI  - Activation of neuropeptide Y1 and neuropeptide Y2 receptors by substituted and
      truncated neuropeptide Y analogs: identification of signal epitopes.
AB  - Neuropeptide Y (NPY-(1-36)) acts on Y1 and Y2 receptors at the sympathetic
      neuroeffector junction. Various truncated NPY analogs were tested in the isolated
      guinea-pig caval vein where NPY is a vasoconstrictor (Y1 receptors) and in
      isolated rat vas deferens, by monitoring the suppression of electrically evoked
      contractions (Y2 receptors). The aim of this study was to define which parts of
      the NPY-(1-36) molecule were required to activate these receptors. NPY-(1-36),
      [Pro34]NPY and [Glu16,Ser18,Ala22,Leu28,31]NPY (ESALL-NPY), the latter being an
      analog with increased alpha-helicity in the 14-31 region, evoked vasoconstriction
      with similar potency and efficacy. Cyclic as well as linear NPY analogs having
      the 4 to 7 N-terminal amino acid residues linked to the 9 to 19 C-terminal
      residues by an 8-aminooctanoic acid (Aoc) residue were 25-50 times less potent
      than NPY-(1-36) itself. In the cyclic analogs, a disulfide bond was introduced to
      bring the N- and C-termini close together. Linear Aoc-2-27-NPY was virtually
      inactive. The Y1 receptor needs an intact N-terminal end of NPY in order to
      become fully activated. The requirements for the C-terminus are less stringent,
      since substitutions in this part of the molecule resulted in fully active
      analogs. The central portion of the molecule may impose steric constraints on the
      N- and C-terminal ends, thereby facilitating Y1 receptor activation, but it does
      not seem to be essential for receptor recognition. NPY-(2-36) and NPY-(5-36) were
      only slightly less potent than the parent molecule in suppressing electrically
      evoked twitches in the vas deferens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467863
TI  - Effects of long-term d-fenfluramine treatment on energy metabolism in rats.
AB  - The effects of chronic intragastric administration of the anorectic agent d
      fenfluramine on energy metabolism and nutrient concentrations were investigated
      at rest and during swimming. Rats were provided with permanent cannulas for blood
      sampling and intragastric administration of d-fenfluramine or saline. Energy
      expenditure and nutrient and hormone concentrations were determined. Under
      baseline conditions, d-fenfluramine increased carbohydrate utilization (14.2 vs.
      7.0 mg/kg.min) and decreased fat oxidation (2.8 vs. 5.5 mg/kg.min). Plasma free
      fatty acid concentration was decreased (0.29 vs. 0.55 mmol/l) and lactate and
      insulin concentrations were increased after d-fenfluramine treatment (0.64 vs.
      0.37 mmol/l and 61 vs. 33 mU/l, respectively). The shift in nutrient utilization
      also occurred during swimming. The exercise-induced increase in blood glucose was
      reduced after d-fenfluramine (+0.8 vs. +2.0 mmol/l). During swimming, free fatty
      acid, lactate and insulin concentrations were similar in the two groups. It is
      hypothesized that chronic d-fenfluramine treatment increases in the oxidation of
      carbohydrates and decreases the oxidation of fat as a result of a decrease in the
      transport of fatty acids over the mitochondrial membrane.

PMID- 8467864
TI  - Inhibition of cytokine production and endothelial expression of adhesion antigens
      by 5'-methylthioadenosine.
AB  - We investigated the activity of endogenous nucleoside 5'-deoxy-5'
      methylthioadenosine (MTA) on both the production of inflammatory cytokines and
      the cytokine-dependent endothelial expression of adhesion molecules. The compound
      inhibited the production of tumor necrosis factor (but not interleukin-1) in
      lipopolysaccharide-activated macrophages. In addition, MTA selectively inhibited
      the expression of intercellular adhesion molecule-1 in endothelial cells
      activated with interleukin-1. This effect was paralleled by a reduction in
      endothelial adhesiveness for polymorphonuclear leukocytes. These data suggest
      that MTA might have anti-inflammatory activity.

PMID- 8467865
TI  - Delayed administration of basic fibroblast growth factor protects against N
      methyl-D-aspartate neurotoxicity in neonatal rats.
AB  - Neuroprotective effects of basic fibroblast growth factor (bFGF) (200 mu/kg i.p.)
      were examined at different time points following intrastriatal injection of N
      methyl-D-aspartate (NMDA) in seven-day-old rats. When administered 0.5 h before
      intrastriatal NMDA injection, 200 micrograms/kg of bFGF significantly reduced
      NMDA-induced lesion by 47% as compared with vehicle treatment. Posttreatment with
      the same dose of bFGF at 0, 0.5 or 1 h after NMDA injection also significantly
      reduced those lesions by 45, 35 or 26%, respectively, while no neuroprotective
      effects was observed when administered at 2 or 4 h after NMDA injection.

PMID- 8467866
TI  - Opposite effects of mesencephalic microinjections of cholecystokinin octapeptide
      and neurotensin-(1-13) on brain stimulation reward.
AB  - Changes in operant responding for brain stimulation reward were studied before
      and after a microinjection of 1 nmol of sulphated cholecystokinin octapeptide,
      neurotensin or saline into the ventral tegmental area. Neurotensin produced a
      significant and long lasting decrease in the stimulation frequency required to
      produce a half-maximal rate of responding; cholecystokinin had the opposite
      effect, attenuating the rewarding efficacy the stimulation during the first 30
      min post-injection. It is suggested that the opposite effects of the peptides on
      reward are due to their differential modulatory effects on a subpopulation of
      mesencephalic dopamine neurones.

PMID- 8467867
TI  - Testosterone is required for the stimulatory effects of 8-OH-DPAT on sexual
      behavior in castrated male rats.
AB  - The stimulatory effects of 8-OH-DPAT (8-hydroxy-2-(di-n-propylamino)tetralin) on
      male sexual behavior in the absence and presence of testosterone were
      investigated. Male rats (n = 12) were castrated and tested for sexual behavior
      (15 min, with an estrous female) up to 1 year after castration. Castration caused
      an abrupt decrease (50%) in the number of intromissions before first ejaculation,
      and the number remained stable for about 8 weeks. Between 8-12 weeks after
      castration, when ejaculation frequency was low, 0.2 or 0.4 mg/kg 8-OH-DPAT had no
      effect on ejaculation frequency, but significantly decreased the number of
      intromissions before first ejaculation. In weeks 17-18 after castration, 0.4
      mg/kg 8-OH-DPAT no longer affected copulatory behavior. A 5-mm testosterone
      filled Silastic capsule (implanted at week 19 after castration) resulted in
      subnormal plasma testosterone levels (mean 4.4 nmol/l) and did not fully restore
      male copulatory behavior. Administration of 8-OH-DPAT (0.2 and 0.4 mg/kg) was
      followed by an increase in ejaculation frequency and a decrease in ejaculation
      latency. Five months later, when plasma testosterone levels were very low (mean
      0.6 nmol/l), 8-OH-DPAT (0.4 mg/kg) significantly increased the mean number of
      intromissions and ejaculations and decreased the number of intromissions before
      first ejaculation, intromission latency and ejaculation latency (borderline). The
      present results suggest that testosterone is required for the activating effects
      of 8-OH-DPAT on sexual behavior in castrated male rats, tested 17-52 weeks after
      castration.

PMID- 8467868
TI  - Activation of the ATP-sensitive K+ channel by decavanadate in guinea-pig
      ventricular myocytes.
AB  - To evaluate the effects of decavanadate on the ATP-sensitive K+ (KATP) channel,
      we applied the inside-out membrane patch-clamp technique to ventricular myocytes
      isolated from guinea-pig hearts. Decavanadate increased the probability of the
      KATP channel being open in a dose-dependent manner over the range of 0.1 to 5 mM
      in the presence of 0.3 mM ATP. Half-maximal activation occurred at 540 microM
      decavanadate and a Hill coefficient of 1.3 was obtained when the Hill equation
      was used to fit the dose-dependent activation for the channel by decavanadate.
      The half-maximum inhibition for the channel by ATP (K1/2) in the presence of 2 mM
      Mg2+ was 19 and 74 microM in its absence. In the presence of decavanadate, both
      curves shifted toward the higher concentration of ATP without a change in
      steepness of the slope (Hill coefficient = 2). The effect of decavanadate could
      be expressed by a model in which its binding prevents ATP binding from closing
      the channel. The estimated dissociation constant of decavanadate was 1.5 microM
      in the presence and 22.8 microM in the absence of Mg2+. Decavanadate reactivated
      the rundown channel in the absence of Mg2+ and ATP. Neither the single channel
      slope conductance nor the mean open and closed lifetime within the bursts of
      channel openings were affected by decavanadate. We conclude that internal Mg2+ is
      not required for the modulation produced by decavanadate, but this ion influences
      the channel and changes the dissociation constant of both ATP and decavanadate to
      the channel.

PMID- 8467869
TI  - Role of prostacyclin in acetylcholine release from myenteric plexus of guinea-pig
      ileum.
AB  - The roles of metabolites of arachidonic acid in spontaneous and agonist-induced
      acetylcholine release from a longitudinal muscle preparation with myenteric
      plexus of guinea-pig ileum were studied. Indomethacin significantly decreased
      both spontaneous acetylcholine release and its release induced by nicotine and
      substance P. We had found that prostaglandin E2 (PGE2) partly reversed this
      inhibition. We now found that a stable prostacyclin analog, OP-41483 at 100 nM,
      completely reversed the inhibition of acetylcholine release by indomethacin. On
      the other hand, PGD2, PGF2 alpha and ONO-11113, a thromboxane A2 analog, did not
      have any significant effect on the inhibition by indomethacin. OP-41483 had no
      effect on acetylcholine release induced by nicotine or substance P in the absence
      of indomethacin. To confirm the modulatory role of endogenous prostaglandins on
      acetylcholine release, we also studied the release of 6-keto-PGF1 alpha, a
      metabolite of prostacyclin, and PGE2 from longitudinal muscle preparations. The
      preparations released appreciable amounts of 6-keto-PGF1 alpha continuously
      during the experiments. Indomethacin inhibited release, while nicotine did not
      affect it so significantly. Our results suggest that endogenous prostacyclin
      modulates acetylcholine release from cholinergic nerve terminals in the myenteric
      plexus of guinea-pig ileum.

PMID- 8467870
TI  - Big endothelin-1 and big endothelin-3 are constrictor agents in the
      microvasculature: evidence for the local phosphoramidon-sensitive conversion of
      big endothelin-1.
AB  - The effect of local administration of big endothelin-1 (1-38, big ET-1) has been
      investigated on blood flow in the skin of anaesthetised rats, measured by 133Xe
      clearance. The local effects of big ET-1 and big endothelin-3 (1-41, big ET-3)
      have also been determined on microvessel diameter by intravital microscopy of the
      cheek pouch of anaesthetised hamsters. Big ET-1 (i.d.) caused a dose-dependent
      decrease in skin blood flow and was 10 times less potent than endothelin-1 (ET
      1). Phosphoramidon (30 nmol/site i.d.) did not effect blood flow but when
      coinjected selectively attenuated the effect of big ET-1 (1 and 3 pmol/site, P <
      0.05). In the cheek pouch big ET-1 (100 pmol) induced an intense and long-lasting
      arteriolar constriction. Phosphoramidon (100 nmol) abolished constriction to big
      ET-1 (100 pmol) but not to ET-1 (10 pmol). The modest constriction induced by big
      ET-3 (300 pmol) was not inhibited by phosphoramidon (100 nmol). Results suggest
      that a phosphoramidon-sensitive endothelin-converting enzyme situated close to
      microvascular vessels is important in the conversion of big ET-1. The mechanism
      for activity of big ET-3 in the microcirculation is unclear.

PMID- 8467871
TI  - The sigma receptor ligand 1,3-di-(2-tolyl)guanidine in animal models of
      schizophrenia.
AB  - The behavioral effects of the selective sigma ligand 1,3-di(2-tolyl)guanidine
      (DTG) were studied in rats. In the radial 8-arm maze, DTG (2, 4 and 8 mg/kg i.p.)
      reduced the number of arm entries in the spontaneous alternation task. In animals
      receiving 4 mg/kg DTG, the percentage of 135 degrees angles between consecutive
      arm entries decreased. In the open field, equipped with a holeboard, DTG (8
      mg/kg) reduced the number of line crossings, rearings and head dips. Sniffing,
      measured in an experimental chamber, was also reduced. DTG prolonged the time
      that the animals were inactive. In combination with DL-amphetamine (4 mg/kg) or
      dizocilpine (0.16 mg/kg), DTG (8 mg/kg) decreased--but did not antagonize--the
      induced enhancement of locomotion and sniffing. These results demonstrate motor
      depressant effects of DTG on locomotion, rearing and sniffing. Since antagonists
      of sigma binding sites are known to produce opposite effects, we conclude that
      DTG--in behavioral terms--acts like an antagonist at sigma binding sites.

PMID- 8467872
TI  - Effects of the Ca2+ chelators EGTA and EDTA on ethanol- or stress-induced gastric
      mucosal lesions and gastric secretion.
AB  - Ca2+ modulates gastric function and dysfunction as well as the release of
      cysteine proteases and metalloproteinases which have been implicated in the
      pathogenesis of gastric mucosal lesions. We thus tested the hypothesis that
      pretreatment with the Ca2+ chelators, ethylene diamine tetraacetic acid (EDTA)
      and ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA)
      might reduce the experimental gastric mucosal damage induced by restraint cold
      stress or 1.0 ml of 75% ethanol. Other rats were prepared with chronic indwelling
      gastric cannulas and the effects of EDTA and EGTA on conscious basal gastric acid
      output were assessed. In addition, rats were pretreated with EGTA or EDTA prior
      to pylorus ligation and their effects on acid and pepsin output assessed. Both
      EDTA and EGTA reduced significantly the extent of ethanol-induced gastric mucosal
      damage as well as the degree of stress-induced gastric lesions. To further
      characterize the mechanism of Ca2+ chelator protection against ethanol-induced
      gastric lesions, some rats were vagotomized or adrenalectomized prior to
      treatment with EGTA or EDTA, followed by ethanol or stress. Both adrenalectomy
      and vagotomy abolished gastroprotection by EGTA and slightly reduced that induced
      by EDTA in both models of experimental gastric mucosal injury. Both EDTA and EGTA
      reduced significantly basal gastric acid output, an effect which persisted for at
      least 2 h following their administration. Both compounds also decreased
      significantly acid and pepsin output in pylorus-ligated rats. We conclude that
      Ca2+ chelators attenuate both acid-dependent and acid-independent gastric
      lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467873
TI  - Suppression by ethanol of pressor response caused by the inhibition of nitric
      oxide synthesis.
AB  - The effects of ethanol on mean arterial pressure (MAP) and heart rate (HR)
      responses to the nitric oxide synthase inhibitor, NG-nitro-L-arginine, and to
      angiotensin II and noradrenaline were studied in rats. I.V. bolus injections of
      NG-nitro-L-arginine dose dependently increased MAP in vehicle-pretreated rats,
      with a maximum increase of 56 +/- 7 mm Hg and an ED50 of 3.8 +/- 0.4 mg/kg,
      respectively. I.v. infusions of ethanol dose dependently reduced maximum MAP
      response to NG-nitro-L-arginine, with a Ki of 96 +/- 8 mg/kg per min but did not
      alter the ED50. Ethanol (48 mg/kg per min) did not modify the MAP response to
      i.v. bolus injections of angiotensin II (0.02-1.28 micrograms/kg) or
      noradrenaline (0.25-16 micrograms/kg). However, ethanol attenuated the reflex HR
      responses of NG-nitro-L-arginine and angiotensin II but not that of
      noradrenaline. The results demonstrate that ethanol selectively but non
      competitively inhibits the MAP response to NG-nitro-L-arginine, suggesting an
      interaction between ethanol and the L-arginine/nitric oxide pathway.

PMID- 8467874
TI  - The interaction of selective and non-selective antagonists with pre- and
      postjunctional muscarinic receptor subtypes in the guinea pig trachea.
AB  - Muscarinic receptor antagonists were used to study prejunctional M2 and
      postjunctional M3 receptors in the isolated guinea pig trachea. The effects of
      four M2-selective muscarinic receptor antagonists (gallamine, methoctramine, AQ
      RA 741 and AF-DX 116) were studied on twitch contractions, elicited by electrical
      field stimulation, of tracheal ring preparations. M1-selective (pirenzepine, (+)-
      and (-)-telenzepine), M3-selective (4-DAMP-methobromide and UH-AH 371) and non
      selective (atropine and ipratropium) muscarinic receptor antagonists were also
      used. The clear potentiation of the twitch contractions and the subsequent strong
      inhibition observed with M2-selective antagonists demonstrate antagonism at
      prejunctional M2 and postjunctional M3 muscarinic receptors, respectively. The
      maximal potentiation correlated well with the M2/M3-selectivity known from
      binding experiments: gallamine > methoctramine > AQ-RA 741 > AF-DX 116. Strong
      correlations were also found between the pEC20 values for potentiation of the
      twitch response and the pKi values for bovine cardiac M2 muscarinic receptors and
      between the pIC50 values for inhibition of the twitch response and the pA2 values
      for M3 muscarinic receptors as determined on non-stimulated methacholine
      contracted tracheal smooth muscle preparations. Thus, study of the effects of a
      wide concentration range of putative M2-selective muscarinic receptor antagonists
      on the twitch contractions of single tracheal rings induced by low-intensity
      electrical field stimulation yields information about M2/M3 receptor selectivity
      and about prejunctional M2 and postjunctional M3 receptor affinity within the
      same experiment.

PMID- 8467875
TI  - Protective actions of 21-aminosteroids and MK-801 on hypoxia-induced
      electrophysiological changes in rat hippocampal slices.
AB  - The effects of the 21-aminosteroids, U-74500A and U-78517F (drugs endowed with
      lipid peroxidation inhibitor properties) were tested on hypoxia-induced
      functional failure in rat hippocampal slices. For comparison, the effects of the
      non-competitive N-methyl-D-aspartate antagonist, dizocilpine (MK-801) were
      studied. Perfusion of slices with 50 microM of MK-801 or with 50-100 microM of U
      78517F, but not with 100-200 microM of U-74500A, significantly (P < 0.01)
      increased the incidence of reappearance of the CA1 population spikes after
      reoxygenation in rat hippocampal slices subjected to a 45-min hypoxic period
      followed by a 45-min reoxygenation period. Perfusion of slices with 12.5 microM
      of MK-801 plus 12.5 microM of U-78517F significantly (P < 0.05) increased the
      incidence of reappearance of the CA1 population spikes after reoxygenation with
      respect to perfusion of slices with 12.5 microM of U-78517F alone or with 12.5
      microM of MK-801 alone. The results show that 21-aminosteroids have protective
      effects against hypoxia-induced functional failure in rat hippocampal slices. In
      addition, the data show that, under the same experimental conditions, the NMDA
      receptor antagonist, MK-801, was also able to improve hypoxia-induced functional
      failure. On the whole, the results suggest that the hypoxia-induced functional
      electrical failure might depend on both release of excitatory amino acids and
      oxygen free-radical-mediated membrane lipid peroxidation.

PMID- 8467876
TI  - The novel 5-HT4 receptor antagonist DAU 6285 antagonizes 5-hydroxytryptamine
      induced tachycardia in pigs.
AB  - The 5-HT4 receptor antagonist action of DAU 6285 was investigated in vivo in
      anesthetized pigs. DAU 6285 (0.3-3 mg/kg i.v.) dose dependently antagonized 5
      hydroxytryptamine (5-HT)-induced tachycardiac responses. In contrast, the 5-HT3
      receptor antagonist, ondansetron (0.3-3 mg/kg i.v.) did not influence the
      tachycardia induced by 5-HT. These results indicate that DAU 6285 is a potent
      antagonist of 5-HT4 receptor-mediated responses in vivo.

PMID- 8467877
TI  - Cyclosporine A induces endothelin-1 release from cultured rat vascular smooth
      muscle cells.
AB  - Since vascular smooth muscle cells in culture are capable of secreting endothelin
      1 (ET-1), we investigated the effect of cyclosporine A on ET-1 release from rat
      vascular smooth muscle cells. Cyclosporine A 10 microM significantly (P < 0.05)
      enhanced the secretion of ET-1 at 2, 8, 24 and 48 h (6.5 +/- 0.5, 11 +/- 0.7, 19
      +/- 0.5, 37 +/- 1.6 fmol/10(6) cells, respectively) compared with vehicle (4.7 +/
      0.3, 8.1 +/- 0.6, 15 +/- 0.4, 27 +/- 2.0 fmol/10(6) cells, respectively). The
      cyclosporine-induced synthesis of ET-1 by vascular smooth muscle cell may
      participate in the pathogenesis of cyclosporine-induced vasoconstriction and
      vasculopathy via an autocrine regulatory mechanism.

PMID- 8467878
TI  - Interleukin-1 alpha and tumour necrosis factor inhibit rat gastric fundus
      motility in vitro.
AB  - In this study, the effects of tumour necrosis factor (TNF) and interleukins 1
      alpha and 6 (IL-1 alpha and IL-6) on rat gastric fundus motility were
      investigated in vitro. IL-1 alpha and TNF induced rapid dose-dependent inhibition
      of stomach motility, with maximal relaxation equal to that induced by 100 microM
      papaverin, and respective EC50s of 20 and 450 pg/ml. IL-6 had no effect on
      gastric motility up to a 3 ng/ml concentration.

PMID- 8467879
TI  - Disinhibition of hippocampal pyramidal cells during the transition into theta
      rhythm.
AB  - The activity of hippocampal complex-spike cells (presumed pyramidal cells) and
      theta cells (presumed interneurons) was examined during transitions from non
      theta electroencephalogram (EEG) states to theta EEG states in freely moving and
      sleeping rats. Theta cell firing rates were significantly depressed in a 1-s
      period centered on the EEG transition relative to the surrounding 1-s periods
      (normalized rates +/- SEM): 1.05 +/- 0.02 for the "non-theta" period, 0.59 +/-
      0.03 for the "transition" period, and 1.36 +/- 0.04 for the "theta" period (n =
      26 cells). Conversely, complex-spike cell firing was significantly increased
      during the transition period: 0.51 +/- 0.11 for the "non-theta" period, 2.24 +/-
      0.19 for the "transition" period, and 0.24 +/- 0.04 for the "theta" period (n =
      27 cells). This diametrically altered activity indicates that theta cells must be
      actively inhibited during the transition. The increased activity in complex-spike
      cells during the transition may be simply a release from inhibitory control by
      interneurons. The pattern of theta cell inhibition together with increased
      complex-spike cell activity appears to be a general property of transitions into
      the theta EEG state, irrespective of behavior. It is suggested that increased
      activity in septal afferents (GA-BAergic cell activity greater than cholinergic
      cell activity) initially inhibits hippocampal interneurons. The inhibition is not
      sustained because of an activity-dependent decrease in the potency of the
      septointerneuronal inhibition, leaving the rhythmic excitatory (cholinergic)
      septointerneuronal inputs, together with principal cell inputs, to increase
      interneuron firing rates.

PMID- 8467881
TI  - Motion sensitive cells in the macaque superior temporal polysensory area. I. Lack
      of response to the sight of the animal's own limb movement.
AB  - An animal's own behaviour can give rise to sensory stimulation that is very
      similar to stimulation of completely external origin. Much of this self-induced
      stimulation has little informative value to the animal and may even interfere
      with the processing of externally induced stimulation. We have measured responses
      of visual movement sensitive neurons in the anterior part of the dorsal superior
      temporal sulcus of monkeys to stimulation caused by the animal's own active
      movements. These cells responded to any stimuli moved by the experimenter, but
      gave no response to the sight of animal's own limb movements. The cells remained
      responsive to external stimulation, however, while the monkey's own hand was
      moving in view. Responses to self-induced movements were recovered if the monkey
      introduced a novel object in its hand into view. Various possible neural
      mechanisms for explaining the results are discussed, and it is suggested that the
      studied neurons belong to a system that detects unexpected and hence
      behaviourally relevant sensory events.

PMID- 8467880
TI  - The effect of fasciculus cuneatus lesions on finger positioning and long-latency
      reflexes in monkeys.
AB  - Previous studies have reported abnormalities in fine hand and finger movements
      following interruption of the fasciculus cuneatus (FC) in primates. We report
      here that many of these deficits could be caused by an inability to actively
      regulate the position of the finger. Three macaques were trained to maintain the
      index finger in one position against constant or changing loads. Periodically,
      torque pulses were used to elicit reflexes in finger muscles. Following
      unilateral FC lesions, the monkeys failed to adjust finger position during the
      trials, and the normal M2 long-latency response was absent in the finger muscles.
      Performance on the task was impaired only in monkeys with complete lesions that
      included the deep ventral portion of the FC. These results suggest that afferent
      fibers in the FC regulate finger position, and do so partly through reflexive
      mechanisms. When the FC is interrupted, the inability to control finger position
      disturbs fine motor activities.

PMID- 8467882
TI  - Gain and threshold of the jaw-jerk reflex in man during isometric contraction.
AB  - The control of mandibular posture has been related to the activity of the
      anterior temporal muscles, whereas the masseter muscles have been viewed mainly
      as force producers. However, these groups of muscles, especially in the deep
      layers, are highly endowed with muscle spindles, so that a difference in function
      should imply a difference in the reflex sensitivity. By studying the jaw-jerk
      reflex by means of bipolar surface electromyogram, the reflex sensitivity was
      determined from relationships between reflex amplitude and jaw displacement from
      both groups of muscles in eight subjects. At a constant level of background
      muscle activity, and hence with a constant excitability of the alpha motoneurons,
      the reflex sensitivity can be determined from these relationships in terms of
      gain and threshold. In order to account for differences in thickness of the soft
      tissues overlying the various muscles studied, the reflex amplitude was
      normalized with respect to the level of maximal voluntary contraction (MVC). In
      experiments where the inter-electrode distance was 18 mm over both groups of
      muscles, the reflex gain of the anterior temporal muscles was larger than that of
      the masseter muscles (P < 0.05). The threshold value did not differ significantly
      from zero for either group of muscles. Normalization of the reflex amplitude with
      respect to MVC can be carried out correctly only if the reflexly activated muscle
      fibres are distributed uniformly within the muscle. In order to gain an insight
      into this distribution, control experiments were performed with three subjects in
      which the inter-electrode distance was varied, thus influencing the depth in the
      muscle from which active muscle fibres were recorded. The reflex gain of the
      masseter muscle with an inter-electrode distance of 22 mm, which records from
      deeper layers of the muscle as well as superficial ones, was larger than with a
      distance of 11 mm (P < 0.01-0.10 in the various subjects). No such differences
      were found for the anterior temporal muscle. It was concluded that the afferents
      of the spindles in the jaw-elevator muscles do not project uniformly upon the
      motoneurons, but involve mainly fibres in the deeper layers of the muscle. The
      difference in gain found between the masseter and the anterior temporal muscles
      with the same inter-electrode distance of 18 mm is likely to be due to a larger
      distance of the reflexly activated muscle fibres in the masseter muscle with
      respect to the electrodes rather than to a difference in reflex sensitivity
      between the muscles.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8467883
TI  - Jaw-jerk reflex activity in relation to various clenching tasks in man.
AB  - In order to investigate whether the mandibular stretch (jaw-jerk) reflex is
      modulated in a task-dependent manner, jaw-jerk reflexes were elicited in eight
      subjects during clenching with unilateral and bilateral tooth support,
      respectively. The reflexes were examined in the electromyographic (EMG) activity
      recorded by means of surface electrodes and were elicited by means of small
      transient jaw displacements at a constant value of 80 microns. Low levels of
      background EMG were applied ranging from 1 to 30% maximal voluntary contraction
      (MVC) as controlled by means of visual feedback. Linear relationships were
      observed between reflex amplitude and level of background EMG. The slope in these
      relationships served as a measure of reflex gain. For the masseter as well as the
      anterior temporal muscles, the reflex gain, averaged over both sides, was larger
      during clenching with unilateral tooth support than with bilateral tooth support
      (P < 0.05). Furthermore, the gain was larger on the side without tooth support
      during unilateral clenching and larger on the side without visual feedback of
      elevator muscle activity during bilateral clenching. It can be concluded that the
      jaw-jerk reflex is modulated to subserve the stabilization of the mandible, with
      the reflex sensitivity being larger the more that alternative stabilizing factors
      such as mechanical tooth contact, visual feedback and feedback from periodontal
      pressure receptors around the teeth are lacking. The reflex modulation may be of
      functional importance in stabilizing the mandible during its movement in the
      chewing process, as the food is predominantly placed unilaterally between the
      antagonistic teeth during individual chewing cycles.

PMID- 8467884
TI  - The visual guidance of catching.
AB  - In order to explore the nature and amount of information in the optic array used
      by subjects required to carry out one-handed catching actions, the optical
      expansion pattern (using a deflating ball) and the duration of viewing time
      (using liquid crystal spectacles) of the ball were varied. Subjects were required
      to catch luminous balls (two of constant physical size and one of changing
      physical size during approach) attached to a pendulum in a totally dark room,
      while the liquid spectacles were closed at 0, 100, 200 or 300 ms before hand-ball
      contact. The results confirmed previous findings that the timing of the catching
      action is based on retinal expansion information and that conclusion was
      strengthened when an additional dependent variable (time of the maximal opening
      velocity of the grasp) was used. Further, for the viewing time duration
      manipulations, the time of the maximal closing velocity of the hand was later,
      while no effect was found on the time of the maximal opening velocity, when the
      last 300 ms of the trajectory of the ball was occluded. Adjustments to the
      catching action in response to the different ball sizes under the 0 ms condition
      differed significantly from the adjustments under the 300 ms condition. Both
      findings point to the importance of relative optical expansion information,
      available between 300 and 200 ms before ball-hand contact, in maintaining a
      (relatively) continuous perception-action coupling in the act of catching.

PMID- 8467885
TI  - Selective adaptation of internally triggered saccades made to visual targets.
AB  - We examined whether internally triggered saccades made to a nonjumping target (I
      saccades) could be adapted independently from externally triggered saccades
      induced by a jumping target (E-saccades). Five subjects made I-saccades between
      two fixed targets, one placed straight ahead and the other one positioned at an
      eccentricity of 17.5 degrees. The peripheral target was displaced to an
      eccentricity of 8.75 degrees during the saccadic movements toward this target.
      Amplitudes of the I-saccades made from the central to the peripheral target
      before and after adaptation were compared with each other. Saccadic amplitudes
      after adaptation were between 10% and 42% smaller than those before adaptation. E
      saccades induced by a single target which jumped from straight ahead to the same
      peripheral target position as was used for the I-saccades were also measured
      before and after the adaptation of I-saccades. Amplitudes of E-saccades before
      and after adaptation were hardly different from each other except in one subject.
      The mean decreases in amplitude of the two types of saccades, averaged over all
      subjects, were 21% for I-saccades and 5% for E-saccades. These results show that
      I-saccades can be adapted to changed visual conditions while E-saccades remain
      unadapted. We conclude from this finding that I-saccades and E-saccades are
      generated by at least partially different neural mechanisms.

PMID- 8467886
TI  - Common processing constraints for visuomotor and visual mental rotations.
AB  - Naive human subjects were tested in three different tasks: (1) a visuomotor
      mental rotation task, in which the subjects were instructed to move a cursor at a
      given angle from a stimulus direction; (2) a visual mental rotation task, in
      which the subjects had to decide whether a displayed letter was normal or mirror
      image regardless of its orientation in the plane of presentation; and (3) a
      visuomotor memory scanning task, in which a list of two to five stimuli
      directions were presented sequentially and then one of the stimuli (test
      stimulus), except the last one, was presented again. Subjects were instructed to
      move a cursor in the direction of the stimulus that followed the test stimulus in
      the previous sequence. The processing rate of each subject in each task was
      estimated using the linear relation between the response time and the angle
      (mental rotation tasks) or the list length (memory scanning task). We found that
      the processing rates in the mental rotation tasks were significantly correlated
      but that neither correlated significantly with the processing rate in the memory
      scanning task. These results suggest that visuomotor and visual mental rotations
      share common processing constraints that cannot be ascribed to general mental
      processing performances.

PMID- 8467887
TI  - Stimulation of human somatosensory cortex: tactile and body displacement
      perceptions in medial regions.
AB  - We examined the somatosensory perceptions evoked by stimulation of rolandic and
      parietal brain regions in 40 epileptic patients undergoing a presurgical
      investigation with intracerebral electrodes. Bipolar stimulation trains were
      delivered in an incremental sequence at medial and/or lateral contact pairs of
      stereotaxically implanted, multi-contact electrodes, while monitoring stimulus
      after discharge propagation with electrodes in frontal and temporal lobes.
      Rolandic stimulation evoked contralateral sensations, whereas sensations from
      either side were evoked in the opercular region. Stimulation of lateral posterior
      parietal cortex evoked only few sensations and these were restricted to the
      supramarginal gyrus. Contralateral sensations were evoked in the posterior
      cingulate gyrus, whereas ipsilateral sensations were evoked in the vicinity of
      the cingulate sulcus. Complex proprioceptive sensations in the form of bilateral
      feelings of levitation were elicited in a medial parietal region around the
      subparietal sulcus and not at any other site. These perceptions were not
      accompanied by any movement, tactile, or vestibular sensations, suggesting that
      the human sub-parietal sulcus region is linked to the proprioceptive processing
      system.

PMID- 8467888
TI  - Dependence of elbow viscoelastic behavior on speed and loading in voluntary
      movements.
AB  - The objective of this study was to characterize the mechanical behavior of the
      elbow joint during voluntary movement, for different speeds of movement and under
      different loading conditions. Torque pulses of 50 ms duration were applied at
      movement onset and at peak velocity on random trials. The displacement away from
      the unperturbed trajectory was used as an indicator of the relative compliance of
      the elbow under different conditions. We found that both the displacement and the
      time taken to return to the unperturbed trajectory decreased if the overall speed
      of the movement increased or if a viscous resistive load was added, implying
      lower joint compliance. It was possible to account qualitatively for differences
      in mechanical behavior from observed muscle activation patterns.

PMID- 8467889
TI  - Postexercise depression of motor evoked potentials: a measure of central nervous
      system fatigue.
AB  - Fatigue of voluntary muscular effort is a complex and multifaceted phenomenon.
      Fatigue of peripheral nervous system components, including the contractile
      apparatus and the neuromuscular junction, has been well studied. Central nervous
      system components also fatigue, but studies have lagged for want of objective
      methods. Transcranial magnetic stimulation is a relatively new technique that can
      be used to assess central nervous system excitability from the motor cortex to
      the alpha-motoneuron. In six normal volunteers, including four of the
      investigators, the amplitudes of motor evoked potentials elicited by transcranial
      magnetic stimulation were transiently decreased after exercise, indicating
      fatigue of motor pathways in the central nervous system. The decrease in
      amplitude was associated with a feeling of fatigue. The mechanism of this
      phenomenon is apparently decreased efficiency in the generation of the motor
      command in the motor cortex.

PMID- 8467890
TI  - Fusimotor effects of midbrain stimulation on jaw muscle spindles of the
      anaesthetized cat.
AB  - The effects of electrical stimulation within the midbrain on fusimotor output to
      the jaw elevator muscles were studied in anaesthetized cats. Muscle spindle
      afferents recorded in the mesencephalic trigeminal nucleus were categorised as
      primary or secondary by their responses to succinylcholine during sinusoidal or
      ramp-and-hold stretches. Changes in their stretch responses during midbrain
      stimulation were then assessed by changes in bias and in dynamic sensitivity.
      Problems were encountered in interpreting changes in sine wave stretch responses
      of primary afferents, in some of which a very small change in firing pattern
      produced large changes in estimates of the response amplitude. Sine wave testing
      also sometimes over-estimated static effects and under-estimated dynamic effects
      relative to ramp responses. On other occasions a small amount of static fusimotor
      activity caused a marked increase in sine response amplitude, which could be
      wrongly interpreted as a dynamic effect. Consequently, ramp responses only were
      used for diagnosing fusimotor changes. The most effective region for producing
      pure dynamic fusimotor excitation was directly rostral to the red nucleus,
      extending dorsally and ventrally approximately in the course of the retroflex
      bundle. Stimulation of regions caudal and dorso-caudal to the red nucleus,
      previously designated as the mesencephalic area for dynamic fusimotor control of
      leg muscles, gave static or mixed static and dynamic effects on jaw spindles. The
      use of midbrain stimulation to identify fusimotor neurones of jaw muscles as
      static or dynamic would be most reliable with stimulation just rostral to the red
      nucleus and would require spindle afferent behaviour to be monitored at the same
      time with ramp stretches.

PMID- 8467891
TI  - Behavioral state dependence of homo- and hetero-synaptic modulation of dentate
      gyrus excitability.
AB  - The effects of two different waking behavioral states on the modulation of
      perforant, path-evoked population spikes were studied following prestimulation of
      either the perforant path itself, the dentate gyrus commissural/association
      pathway, or the medial septum. The intermediate-latency, post-inhibitory
      'rebound' of the population spike, which normally follows short-latency,
      perforant path or commissure-induced inhibition, was substantially increased
      during forced locomotion on a treadmill, compared with quiet wakefulness. There
      was no effect of these behavioral states either on the short-latency inhibitory
      phase itself or on the average magnitude of the unconditioned population spike.
      The short-latency, GABA-mediated disinhibitory effect of medial septal
      prestimulation was slightly reduced by walking, as might be expected from the
      increased feedforward excitatory drive on hippocampal interneurons that occurs
      during walking. Septal prestimulation during walking also led to a large,
      intermediate-latency spike facilitation that was completely absent during the
      quiet, awake state. Lesions of the medial septum attenuated the effects of
      behavioral state on the post-inhibitory facilitation from both perforant path and
      commissural stimulation. Atropine reduced the walking-induced increase in
      intermediate-latency facilitation, but had no effect in the still condition. We
      conclude that, during walking, electrical stimulation within the hippocampal
      formation or septum leads to a delayed increase in dentate gyrus excitability
      that is probably mediated polysynaptically through the medial septum or fibers
      passing through it. This state dependency is not due to tonic suppression of the
      inhibitory systems within the dentate gyrus itself.

PMID- 8467892
TI  - Orientation sensitive elements in the corticofugal influence on centre-surround
      interactions in the dorsal lateral geniculate nucleus.
AB  - In a previous study, we have shown that the corticofugal projection to the dLGN
      enhances inhibitory mechanisms underlying length tuning. This suggests that the
      inhibitory influences deriving from the corticofugal feedback should exhibit
      characteristics that reflect the response properties of orientation-tuned layer
      VI cells. Here we report data obtained from experiments using a bipartite visual
      stimulus, with an inner section over the dLGN cell receptive field centre and an
      outer section extending beyond it. For both X and Y cells there was a modulation
      of the strength of the surround antagonism of centre responses that was dependent
      on the orientation alignment of contours in the two components of the stimulus.
      Layer VI cells showed maximal responses when the two components were aligned to
      the same orientation; dLGN cells showed a minimal response. Varying the
      orientation alignment of the inner and outer components of the stimulus in a
      randomised, interleaved fashion showed that bringing the stimulus into alignment
      resulted in a 24.28% increase in the surround antagonism of the centre response.
      Blocking cortical activity showed this effect of alignment to be strongly
      dependent on corticofugal feedback. This effect of orientation alignment appears
      to apply for any absolute orientation of the alignment condition and supports the
      view that an entire subset of cortical orientation columns generate the feedback
      influencing any given dLGN cell. This mechanism makes dLGN cells sensitive to the
      orientation domain discontinuities in elongated contours moving across their
      receptive field.

PMID- 8467893
TI  - Critical timing of sensorimotor cortex lesions for the recovery of motor skills
      in the developing cat.
AB  - Forelimb movements and motor skills were studied in adult cats in order to
      determine the effect of brain damage inflicted at different postnatal ages. The
      unilateral lesion included the cortical areas from which the pyramidal tract
      originates in cat: areas 4 and 6 corresponding to the motor cortex; areas 3, 2
      and 1 corresponding to the primary somatosensory cortex; and part of area 2 prae
      insularis corresponding to the secondary somatosensory cortex. Forelimb
      performance of a food-retrieving task requiring proximal as well as distal
      muscles was assessed by comparing the limb contralateral to the damaged
      hemisphere (affected limb) with the limb contralateral to the intact hemisphere
      (non-affected limb) that appeared to perform the task as well as both limbs of
      control animals. In simple task-related movements, all operated animals were
      rapidly able to achieve the goal with the affected limb, whatever the age at
      lesion. In complex tasks, the ability to achieve the goal with the affected limb
      decreased with increasing age at lesion. Recovery of distal skills, i.e. grasping
      and wrist rotation, did not occur in animals operated on after the 23rd postnatal
      day (PND), and recovery of proximal skills, i.e. amplitude and precision of the
      reaching movement, did not occur in animals operated on after the 45th PND. The
      critical time for the recovery of distal skills lies somewhere between the 23rd
      and 30th PND, whereas for the recovery of proximal skills it lies somewhere
      between the 45th and 60th PND. These critical dates for the recovery of motor
      skills support the Kennard doctrine. Different critical times for proximal and
      distal skills may be explained in terms of different stages of sensorimotor
      development in kitten. It is hypothesised that recovery only occurs if brain
      damage is inflicted before maturation of the nervous system underlying a given
      motor skill.

PMID- 8467894
TI  - Modulation of the development of light-initiated asymmetry in chick thalamofugal
      visual projections by oestradiol.
AB  - Thalamofugal visual projections of light-incubated chicks are organised
      asymmetrically. This asymmetry, which is generated by light stimulation of the
      embryo during the final days of incubation, is sexually dimorphic, being more
      pronounced in males than in females. We have shown that the development of the
      asymmetry can be prevented by elevating circulating levels of 17 beta-oestradiol
      in the embryo prior to hatching. Light-incubated male chicks were treated 5 days
      prior to hatching with either one of two doses of 17 beta-oestradiol (1.5 mg or
      2.5 mg in a 0.1 ml solution of 10% ethanol in olive oil) or the vehicle only.
      After hatching the retrogradely labelling fluorescent dyes True Blue and
      Fluorogold were injected into the left and right side of the hyperstriatal region
      of the forebrain, consequently labelling the cell bodies of thalamic neurons
      which project to this region. Although a pronounced asymmetry was present in the
      control group, it was not present in both of the 17 beta-oestradiol-treated
      groups. These results suggest that the asymmetrical development of thalamofugal
      visual projections in response to lateralised light stimulation of the embryo is
      dependent on circulating levels of steroid hormones, and that compared to the
      male, the lesser degree of asymmetry found in thalamofugal projections of
      untreated females may be related to the higher levels of circulating oestradiol
      present in females prior to hatching.

PMID- 8467895
TI  - Trypanosoma cruzi: characterization of two recombinant antigens with potential
      application in the diagnosis of Chagas' disease.
AB  - A genomic library of Trypanosoma cruzi, constructed in the vector lambda gt11,
      was screened with a hyperimmune rabbit antiserum against tissue culture
      trypomastigotes. Two clones, B12 and B13, containing inserts of 350 and 600 bp,
      respectively, were isolated. Sequencing data indicated that both clones present a
      pattern of tandemly repeated nucleotide units of 60 bp for B12 and 36 bp for B13.
      Southern blot analysis suggests that both corresponding genes exist as a single
      copy. The inserts of both recombinants were subcloned in the vector pMSgt11, in
      phase with the lacZ gene. Recombinant proteins were affinity purified on pAPTG
      agarose columns and employed to immunize rabbits, as well as to immunoselect
      human chagasic antibodies. By Western blot, antibodies to B12 reacted with bands
      of 230 kDa in trypomastigotes and 200 kDa in epimastigotes, while those to B13
      identified bands of 140 and 116 kDa in trypomastigotes and epimastigotes.
      Immunoprecipitation of radioiodinated parasites revealed that the 140-kDa antigen
      recognized by antibodies to B13 is located on the membrane of trypomastigotes but
      not epimastigotes. The potential application of either recombinant antigen in the
      serological diagnosis of Chagas' disease was evaluated initially by RIA. It was
      observed that B13 presents a very good performance with sensitivity of 97%. For
      B12, the corresponding value was 82%. The reactivity to B13 was also evaluated by
      ELISA tests run in parallel with conventional serological reactions for Chagas'
      disease. Analysis of 209 serum samples indicates that B13 presents similar or
      even better performance in relation to the use of total epimastigote antigens,
      making it a promising candidate for the diagnosis of Chagas' disease.

PMID- 8467896
TI  - Schistosoma mansoni: membranes from adult worms reversibly perturb shape, volume,
      and membrane organization of intact human red blood cells.
AB  - Adult forms of Schistosoma mansoni ingest host (human) red blood cells (RBCs). To
      elucidate potential mechanisms by which contact with adult parasites perturbs RBC
      membranes, we studied the effects of the membrane fraction of isolated
      schistosomes on RBC shape, volume, potassium ion content, and phospholipid and
      transmembrane protein lateral mobility. S. mansoni-treated RBCs exhibited rapid
      but spontaneously reversible shape change from discocytes to spheroechinocytes,
      reversible decrease in cell volume, and rapid loss of intracellular potassium
      ions. Treated RBCs also showed rapid but spontaneously reversible immobilization
      of membrane phospholipids and of band 3, the major transmembrane protein. These
      data suggest that components of adult S. mansoni membranes can perturb host RBC
      volume and membrane organization. In the absence of RBC lysis, RBC metabolic and
      repair mechanisms can reverse these effects.

PMID- 8467897
TI  - IgE antibody responses in bronchoalveolar spaces of rats infected with
      Nippostrongylus brasiliensis.
AB  - IgE levels in the bronchoalveolar lavage fluids (BALF) of rats increased
      significantly following infection with Nippostrongylus brasiliensis. This
      increase corresponded with a concurrent increase in serum IgE levels. However, a
      comparison of IgE to albumin ratio in both BALF and serum suggested local
      accumulation and/or production of IgE in the bronchoalveolar spaces rather than
      leakage from serum. Subsequent analysis of BALF showed presence of heat-labile
      PCA activity with highest anti-worm titer (1:64) on Days 11-16 postinfection
      (pi). Secondary infection resulted in up to a fourfold increase in PCA activity
      compared to primary infection. Immunoblot analysis showed that these parasite
      specific IgE antibodies in BALF recognized many proteins of adult worms ranging
      from 16-290 kDa. IgE antibodies in serum and BALF showed similarities in their
      reactivities toward adult worm antigens. However, the IgE antibody reactivities
      to different antigens varied significantly among different days pi. Depletion of
      IgG from BALF and serum resulted in more intense binding by IgE antibodies to
      antigens than when IgG was not depleted. Concurrent with the elevated levels of
      IgE antibodies, there was a significant increase in the levels of histamine in
      BALF, suggesting activation of mast cells. Thus, following N. brasiliensis
      infection there is an abundance of parasite-specific IgE antibodies in the lower
      respiratory tract and IgE-mediated pathways of inflammation appeared to be
      activated in the lungs.

PMID- 8467898
TI  - Plasmodium falciparum: stage-specific ribosomal RNA as a potential target for
      monitoring parasite development in Anopheles stephensi.
AB  - The transcriptional switch of Plasmodium falciparum ribosomal RNA A gene to the C
      gene was demonstrated during the developmental transition from the vertebrate
      blood stage to the invertebrate sporozoite stage. Expression of the sporozoite
      specific C gene in infected mosquitoes was not detected until Day 10
      postinfectious blood meal, the time of mature oocyst formation on the midgut. As
      a potential target for monitoring malaria parasite development in mosquitoes,
      oligonucleotide probes based on sequences of small subunit ribosomal RNA were
      evaluated for specificity and sensitivity by filter blot hybridization against
      different species and stages of malaria parasites. Probes PfC02 and PfA02 were
      selected as the most sensitive for sporozoite and blood stage parasites,
      respectively. Filter blot hybridization using probe PfC02 resulted in sensitivity
      comparable with microscopic dissection in single mosquitoes, detecting mosquitoes
      with an average of 1.2 oocysts per gut or as few as 800 salivary gland
      sporozoites.

PMID- 8467899
TI  - Leishmania mexicana amazonensis: effect of heat shock on the spliced leader RNA
      and its ribonucleoprotein particle SL RNP.
AB  - Trypanosomatid parasites of the genus Leishmania experience a temperature shift
      from 22-38 degrees C to 33-37 degrees C while being transmitted from the
      invertebrate vector to the mammalian host. Expression of many protein-coding
      genes in protozoan parasites that cycle between two hosts have been shown to be
      thermosensitive, and temperature changes most probably serve as a major
      regulatory factor during stage differentiation. We present here our studies on
      effects of physiological temperature shift on the steady-state and nascent
      synthesis of the spliced leader SL RNA, as well as on its small RNP particle, SL
      RNP. Northern blot analysis showed no significant changes in the steady-state
      level of SL RNA at elevated temperatures. Neither were any alterations detected
      at the two different temperatures in nascent transcription of the SL RNA gene,
      examined in cells made permeable by treatment with lysolecithin. Fractionation of
      cell extracts on Cs2SO4 gradients indicated that temperature elevation led to
      changes in SL RNP particles. Alterations in these particles upon heat shock were
      also observed by separation on polyacrylamide gels, but only in the presence of
      urea, indicating that the differences caused by elevation of temperature were
      revealed exclusively under stringent fractionation conditions.

PMID- 8467900
TI  - Eimeria tenella: characterization of a 5S ribosomal RNA repeat unit and its use
      as a species-specific probe.
AB  - The oocysts of Eimeria tenella, one of the most pathogenic of several species
      causing chicken coccidiosis, are difficult to distinguish microscopically from
      several other infective Eimeria species. One copy of a gene coding for 5S
      ribosomal RNA has been cloned from E. tenella and sequenced. A coding region of
      120 nucleotides and an intergenic region of 608 nucleotides together make up a 5S
      rRNA repeat unit, of which there are many copies tandemly repeated in the genome.
      The intergenic region is species-specific and sequences derived from it can be
      used for species identification by polymerase chain reaction (PCR). The PCR
      procedure described here is particularly sensitive, with fewer than 10 oocysts
      sufficing to give a positive result. This method may also be useful for the
      identification by PCR of other cyst-forming parasites.

PMID- 8467901
TI  - Plasmodium falciparum: in vitro studies of the pharmacodynamic properties of
      drugs used for the treatment of severe malaria.
AB  - The speed and stage specificity of antimalarial drug action on the metabolic
      activities of cultured Plasmodium falciparum were studied for chloroquine (CQ),
      quinine (QN), artemisinin (AR), and sodium artelinate (SA). CQ had the most rapid
      onset of action on [3H]hypoxanthine and [3H]isoleucine uptake, reaching 50% of
      its maximum effect in 1.8 hr compared with 3.5-7.4 hr for the other three drugs.
      In contrast there was a lag time of 1-4 hr before AR and SA had a measurable
      inhibitory effect, although after this delay antimalarial action was very rapid.
      Parasite glycolysis was relatively drug resistant; the inhibition of lactate
      production was < 60% of that for [3H]hypoxanthine and [3H]isoleucine uptake. The
      susceptibility of P. falciparum changed markedly as the parasite matured. Maximum
      drug effects occurred at the late ring and early trophozoite stage, which
      corresponds to the time at which the most rapid increases in synthetic and
      glycolytic activities occur. Mature schizonts and young rings were relatively
      unaffected by the antimalarial drugs. Young rings were particularly resistant to
      QN. Schizonts multiplied successfully in the presence of relatively high
      concentrations of all four drugs. The two artemisinin compounds had the broadest
      time window of action and may be particularly suitable for the treatment of
      severe malaria.

PMID- 8467902
TI  - Trypanosoma brucei: unusual expression-site-associated gene homologies in a
      metacyclic VSG gene expression site.

PMID- 8467903
TI  - Unique reaction of a barley peroxidase with hydrogen peroxide.
AB  - The reaction of barley peroxidase BP 1 with H2O2 is markedly different from that
      of other peroxidases. Saturation kinetics and a strong pH dependence over the
      accessible pH range from 3.09 to 5.08 are observed. At pH 3.8, native BP 1 has
      maxima at 401, 498 and 635 nm, cpd 1 at 403 nm, and cpd II at 407 and 521 nm with
      a shoulder at 553 nm. Both cpds I and II appear to be incompletely formed.
      Isosbestic points between native BP 1 and cpd I occur at 365 and 416 nm, while an
      isosbestic point in the Soret region between cpd I and cpd II has been observed
      at 410 nm. Between cpd II and a not yet identified intermediate isosbestic points
      have been observed at 408, 455 and 526 nm.

PMID- 8467904
TI  - Over-expression of protein kinase C-alpha enhances platelet-derived growth factor
      and phorbol ester- but not calcium ionophore-induced formation of prostaglandins
      in NIH 3T3 fibroblasts.
AB  - Over-expression of human protein kinase C-alpha in murine NIH 3T3 fibroblasts is
      associated with an increased platelet-derived growth factor- and phorbol ester
      mediated formation of prostaglandins, whereas the calcium ionophore-induced
      release of arachidonic acid metabolites is unaffected; however, the differences
      of arachidonic acid and prostaglandin formation are much more pronounced with
      platelet-derived growth factor than with phorbol ester. Platelet-derived growth
      factor induces an identical elevation of intracellular free calcium in control
      and protein kinase C-alpha over-expressing cells: the phorbol ester has no effect
      on intracellular free calcium in both cell lines. These results demonstrate that
      protein kinase C-alpha may couple to arachidonic acid cascade in NIH 3T3
      fibroblasts.

PMID- 8467905
TI  - The two Staphylococcal bi-component toxins, leukocidin and gamma-hemolysin, share
      one component in common.
AB  - Staphylococcal bi-component toxins, leukocidin and gamma-hemolysin, consist of
      two protein components, i.e. F and S for leukocidin and H gamma I and H gamma II
      for gamma-hemolysin. In this study we purified H gamma I and H gamma II to
      homogeneity from the culture medium of Staphylococcus aureus RIMD 310925 and
      compared their properties with those of F and S purified from the same source.
      The N-terminal 59- and C-terminal 2-residue amino acid sequences, apparent
      molecular mass, and isoelectric point of purified H gamma I were the same as
      those of F. In an Ouchterlony double diffusion test a fused line without spur was
      formed between F and H gamma I using either anti-F or anti-H gamma I antibodies.
      A synergistic action of F and H gamma II caused hemolysis of human red blood
      cells, and H gamma I acted synergistically with S to exhibit leukocidin activity.
      We conclude that the two toxins share one protein component (F = H gamma I) in
      common and leukocidin- and gamma-hemolysin-specific activities are determined by
      S and H gamma II, respectively. It is also reported that the N-terminal 58
      residue sequence of H gamma II is 72% similar to the corresponding sequence of S.

PMID- 8467906
TI  - Mercury inhibition at the donor side of photosystem II is reversed by chloride.
AB  - Mercury is an environmental contaminant that strongly inhibits photosynthetic
      electron transport, photosystem II being the most sensitive target. We
      investigated in greater detail the effect of mercury using photosystem II
      submembrane fractions of higher plants. Oxygen evolution was strongly inhibited
      and variable chlorophyll fluorescence was severely quenched by mercury. Chloride,
      an inorganic cofactor known to be essential for the optimal function of
      photosystem II, significantly reversed the inhibitory effect of mercury. However,
      calcium, another essential cofactor, showed no reversal capacity. It is concluded
      that on the donor side of PSII, mercury exerts its action by perturbing chloride
      binding and/or function. Considering the exceptional affinity of mercury for
      sulfhydryl groups of proteins, the results suggest the implication of cystein
      residue(s) in maintaining structural and functional integrity of photosystem II.

PMID- 8467907
TI  - The choline transporter is the major site of control of choline oxidation in
      isolated rat liver mitochondria.
AB  - The degree of control exerted by the mitochondrial choline transporter over the
      oxidation pathway was measured in isolated rat liver mitochondria. Choline
      transporter activity was titrated with hemicholinium-3, a known competitive
      inhibitor of the transporter. It was shown that the rate of betaine efflux from
      mitochondria was an accurate measure of choline oxidation. The relative rate of
      choline oxidation was measured as a function of the relative degree of inhibition
      of the transporter. The resulting data gave a flux control coefficient over
      choline oxidation of 0.9 for the choline transporter. It is concluded that the
      choline transporter is the major site for control of choline oxidation in
      isolated rat liver mitochondria.

PMID- 8467908
TI  - Phosphorylation of ribosomal proteins by the vaccinia virus B1R protein kinase.
AB  - Two proteins of the 40S ribosomal subunit were shown to be phosphorylated in
      vitro by a vaccinia virus-encoded serine/threonine protein kinase. These were
      identified by two-dimensional gel electrophoresis as ribosomal proteins Sa and S2
      and were shown by phosphoamino acid analysis to both be phosphorylated on serine
      and threonine residues. The three phosphorylated forms of S2 produced by the B1R
      protein kinase in vitro matched the phosphorylated forms of S2 previously
      observed in cells infected with vaccinia virus. These data strongly suggest that
      this enzyme is responsible for the phosphorylation of S2 and Sa which occurs
      early during vaccinia virus infection.

PMID- 8467909
TI  - AT(D)PMg-induced dissociation of the alpha 3 beta 3 complex of the F1-ATPase from
      a thermophilic Bacillus PS3 into alpha 1 beta 1 heterodimers is prevented by
      mutation beta (Y341C).
AB  - AT(D)PMg induces dissociation of the alpha 3 beta 3 complex of F1-ATPase from a
      thermophilic Bacillus strain. PS3, into the alpha 1 beta 1 heterodimers [(1991)
      Biochim. Biophys. Acta 1056, 279-284] but the location of the AT(D)PMg binding
      site responsible is not known. From the analysis of AT(D)PMg binding properties
      of the isolated mutant beta subunit, beta(Y341C), and the stability of the alpha
      3 beta(Y341C)3 complex in the presence of AT(D)PMg, we conclude that binding of
      AT(D)PMg to the Tyr-341 site of the beta subunit(s) in the alpha 3 beta 3 complex
      triggers the dissociation of the alpha 3 beta 3 complex into the alpha 1 beta 1
      heterodimers.

PMID- 8467910
TI  - A1F-B, a novel CCAAT-binding transcription activator that interacts with the
      aldolase B promoter.
AB  - We describe here a 70 kDa transcription factor A1F-B, which preferentially binds
      to an element encompassing a CCAAT motif on the rat aldolase B promoter.
      Comparison of binding specificities, relative molecular masses, and subunit
      compositions with those of other known CCAAT-binding factors indicated that A1F-B
      is a novel member of CCAAT-binding factors.

PMID- 8467911
TI  - A thioredoxin-independent fully active NADP-malate dehydrogenase obtained by site
      directed mutagenesis.
AB  - A triple cysteine mutant of sorghum leaf NADP-malate dehydrogenase has been
      constructed by site-directed mutagenesis, combining the previously obtained
      mutation of the two N-terminal cysteines with the mutation of the most internal
      of the two C-terminal cysteines. The construct, over-expressed in E. coli,
      yielded an always active, dithiol-insensitive enzyme. It can be concluded that
      the dithiol activation of the unmodified enzyme involves a maximum of two
      different disulfides per subunit, and that none of the mutated cysteines is
      implicated in catalysis.

PMID- 8467912
TI  - Molecular cloning of a cDNA encoding calmodulin from Neurospora crassa.
AB  - A full-length cDNA encoding Neurospora crassa calmodulin was isolated from a
      lambda ZAP II cDNA expression library. The open reading frame encodes a protein
      of 148 amino acid residues with a calculated M(r) of 16,865 Da. Using site
      directed mutagenesis, the complete cDNA was ligated into a trc promoter-regulated
      bacterial expression vector to allow expression of N. crassa calmodulin in E.
      coli. The expressed protein was found to be identical to the native protein on
      the basis of some of its biochemical properties. Finally, Southern analysis of
      restriction digests of genomic DNA indicates that calmodulin is encoded by a
      single-copy gene.

PMID- 8467913
TI  - Identification of an actin binding region in aldolase.
AB  - Fragmentation of the actin binding glycolytic enzyme, aldolase, with cyanogen
      bromide yields an 18K actin binding fragment which corresponds to residues 1-164
      of the aldolase sequence. Within this fragment there is a region of sequence
      (residues 32-52) which is highly homologous to a region of sequence near the C
      terminus of actin itself and which is also found in the actin binding domains of
      a number of other actin binding proteins. A synthetic peptide corresponding to
      the aldolase sequence 32-52 encompassing this region of homology binds to F-actin
      and specifically competes with native aldolase for binding to this cytoskeletal
      protein.

PMID- 8467914
TI  - Termination of right handed helices in proteins by residues in left handed
      helical conformations.
AB  - An analysis of 636 helical segments, ranging in length from 4 to 32 residues,
      from 123 independent protein crystal structures reveals that helix termination by
      residues in left handed (alpha 1) helical conformations is a common occurrence.
      Gly and Asn residues are the most frequent alpha L helix terminators, with the
      former having a very high propensity to adopt such conformations. The alpha R
      alpha R-alpha R-alpha L segment at the C termini of protein helices often
      possesses a 6--> 1 (pi-type) hydrogen bond between the CO of residue i and the NH
      of residue i + 5 with residue i + 4 occurring in the alpha L conformation. A
      stereochemical analysis of 216 examples shows that in 62 cases the 6-->1 hydrogen
      bond is absent. The present analysis provides a quantitative measure of the
      propensity of the 20 amino acids to adopt alpha L helix terminating
      conformations.

PMID- 8467915
TI  - Stereo-specific inhibition of sea urchin envelysin (hatching enzyme) by a
      synthetic autoinhibitor peptide with a cysteine-switch consensus sequence.
AB  - Inhibition of envelysin, a metalloproteinase which dissolves the fertilization
      envelope of sea urchin embryo, was studied using a synthetic autoinhibitor
      peptide. Ac-Pro-Arg-Cys-Gly-Val-Pro-Asp-Val-NH2, with a 'cysteine-switch'
      consensus sequence. Although its effect is reversible, the hatching of sea urchin
      embryos was effectively delayed by 0.5 mM of the peptide. When alpha 1-proteinase
      inhibitor was used as the substrate, envelysin was inhibited by the autoinhibitor
      and an Ala6 analogue, but not by a D-Cys3 analogue. However, envelysin was weakly
      inhibited by both D- and L-cysteines to the same extent. Snake venom alpha
      protease exhibited cleavage and inhibition behavior similar to envelysin with a
      little weaker stereo-specificity. The results suggest that the coordination of
      the autoinhibitor Cys residue with the envelysin active site Zn is established
      only after the amino acid residues on both sides of the Cys residue get into an
      appropriate interaction with the catalytic site residues, and that the precise
      orientation of the cysteine SH group is essential. By contrast, thermolysin was
      weakly inhibited by the three peptide non-stereo-specifically. Furthermore,
      thermolysin cleaved the autoinhibitor at the Cys3 Gly4 bond when incubated
      without substrate.

PMID- 8467917
TI  - Shared governance: participatory management.

PMID- 8467916
TI  - Cloning, expression and characterization of human kininogen domain 3.
AB  - The internal domain 3 of the heavy chain of human kininogen, a cysteine
      proteinase inhibitor, was amplified by a polymerase chain reaction from the
      kininogen cDNA clone phKG36. The DNA fragment was expressed in Escherichia coli
      using the ompA expression vector pASK40 and the resulting protein was isolated
      from periplasm, purified by S-carboxymethylpapain affinity- and ion-exchange
      chromatography. The recombinant human kininogen domain 3 is 92% pure, reacts with
      anti-kininogen antibodies and is actively inhibitory. The expected amino acid
      sequence of ANSM-[G253-S377] kininogen was confirmed; the inhibitor has a
      molecular mass of 14,396 Da and an isoelectric point of 6.0 (pH). The determined
      Ki values of the complexes with papain and cathepsin L are similar to those
      measured previously with proteolytically liberated kininogen domain 3, and those
      of single-domain cystatins, like chicken egg white cystatin. However, recombinant
      kininogen domain 3 is a weak inhibitor of cathepsin B (Ki = 63 nM) as it has been
      found for native L-kininogen (Ki = 340 nM).

PMID- 8467918
TI  - Is it time for self-assessment?

PMID- 8467919
TI  - Small group training in breast screening using volunteer leaders.

PMID- 8467920
TI  - Health status of women in Florida.

PMID- 8467921
TI  - The contraceptive decision: update on methods/considerations.

PMID- 8467922
TI  - Report of Institute of Member Collective Bargaining.

PMID- 8467923
TI  - Job sharing among camp nurses.

PMID- 8467924
TI  - The paradigm shift from traditional obstetrics to single room maternity care.

PMID- 8467925
TI  - Ethical concerns affecting Florida nurses: survey results from FNA Convention.

PMID- 8467926
TI  - [Thyroid and growth factors].
AB  - Although TSH is the major regulator of thyroid growth and function, the role of
      TSH in thyroid cell growth in vitro is controversial. Recent studies have shown
      that a number of growth factors, cytokines, vitamins, hormones and other reagents
      including iodide, lithium or retinoids modulate proliferation of cultured thyroid
      cells. Insulin-like growth factors (IGFs) stimulate growth of thyroid cells from
      a variety of species and also enhance expression of differentiated functions
      stimulated by TSH. Epidermal growth factor (EGF), fibroblast growth factor (FGF),
      and Transforming growth factor (TGF)-alpha are also mitogens to thyroid cells,
      but they are inhibitory to differentiated functions. In contrast, TGF-beta is a
      potent inhibitor to thyroid cell growth and functions. Indirect evidence suggests
      that these growth factors are involved in growth regulation of normal and
      neoplastic thyroid cell growth in autocrine/paracrine manner.

PMID- 8467927
TI  - [Structure and function of the thyroid hormone receptor].
AB  - Cloning of the thyroid hormone receptor and its identification as a cellular
      counterpart of the viral oncogene v-erbA was a major breakthrough in the study of
      thyroid hormone action. However, contrary to our initial expectations, many
      astonishing findings which have accumulated since the receptor cloning,
      especially the presence of two receptor types, made the elucidation of the
      thyroid hormone action extremely complicated. In this paper, we mainly did a
      phylogenic comparison of the amino acid sequence between alpha- and beta-type
      receptor from Xenopus laevis to humans, hoping to obtain some clue to clarify the
      functional differences between these receptors. There are several consistent
      amino acid differences between alpha- and beta-receptor through species in the
      DNA binding domain, one of which is non-conservative and is located in the
      portion supposed to be critical to the protein-protein interaction. We believe
      that clarification of the physiological significance of the presence of two
      receptor types will facilitate the study of thyroid hormone action.

PMID- 8467928
TI  - [A rare case of primary aldosteronism due to bilateral functioning adrenocortical
      adenomas].
AB  - A 43-year-old man was admitted to our hospital in January, 1991 for further
      examination of polydipsia, polyuria and hypertension. He had had a personal
      history of hypertension since 1976 and of diabetes mellitus since 1982. Physical
      examination and routine laboratory studies showed that the patient was
      characterized by asymptomatic hypertension in the presence of hypokalemia and
      increased urinary potassium excretion. Plasma aldosterone concentrations (PAC)
      were elevated and plasma renin activity (PRA) was suppressed, resulting in a
      considerable increase in the ratio of PAC to PRA. PAC was not normally suppressed
      by saline infusion (2 1/2h, iv). PRA remained suppressed and PAC did not rise
      after stimulation with iv injection of furosemide (40 mg) in combination with
      walking for 60 min. PAC was increased in response to ACTH injection (0.25 mg, iv)
      but not suppressed by dexamethasone administration (2 and 8 mg/day, po). PAC did
      not rise after iv infusion of angiotensin II (20 ng/kg/min for 30 min). Venous
      sampling showed that PAC was considerably elevated in the bilateral adrenal vein.
      CT and MRI demonstrated tumor mass in the bilateral adrenal gland and the
      remaining normal portion in the left adrenal gland. Scintigraphic imaging with
      133I-aldosterol during dexamethasone suppression provided bilateral uptake in the
      adrenals. Oral administration of spironolactone (375 mg/day) suppressed blood
      pressure and elevated PRA and serum potassium. Elevated PCA and PRA levels as
      well as hypertension were corrected by right-total and left-subtotal
      adrenalectomy performed in March, 1991. However, impaired glucose tolerance was
      not changed after surgery, and plasma glucose levels were well controlled with a
      small dose of insulin (9U/day). Pathological studies revealed adrenocortical
      adenoma cells of clear cell type with spironolactone bodies in the bilateral
      adrenal tumors. These findings indicate that this is a very rare case of primary
      aldosteronism due to bilateral functioning adrenocortical adenomas, which is
      accompanied by diabetes mellitus.

PMID- 8467929
TI  - [Free fatty acid responses to growth hormone (GH)-releasing factor and the GH-GH
      receptor axis].
AB  - The functional assessment of GH receptor has been previously performed by GH
      induced somatomedin (SM) generation test. There is a specific GH receptor on
      adipocytes, and GH induces lipolysis with an increment of plasma free fatty acid
      (FFA). In this report, we examined GH and FFA responses to GRF loading tests and
      GH-binding protein, which reflects the tissue GH-receptor concentration, in 30
      short children, and we evaluated the lipolysis mediated by GH and GH-receptor
      axis. Following GRF administration, there was a definite increase in plasma FFA
      levels, which mainly consisted of palmitic acid and oleic acid on HPLC analysis.
      In the group of GH high responders, peak GH levels more than 30 ng/ml, the
      increments of FFA were apparently more than those in the GH low responders, peak
      GH levels less than 30 ng/ml. There was a significant correlation between the
      integrated GH secretion and the integrated FFA net-increments. In the GH low
      responders, the integrated FFA net-increments significantly correlated with their
      serum GH-binding protein activities. The net increments of FFA were also
      correlated with basal SM-C levels. In a case of GH-resistant dwarfism, in which
      GH-binding protein activity was markedly reduced, the patient's GH secretion to
      GRF as high as 51 ng/ml did not induce any increment of FFA levels. These results
      suggest that FFA responses to GRF loading depend on the integrated GH secretion
      and tissue GH-receptor content. FFA measurements in GRF test samples may be a
      simple and useful method for the functional assessment of GH and GH-receptor
      axis.

PMID- 8467930
TI  - [The effect of alacepril on insulin sensitivity in patients with essential
      hypertension].
AB  - The aim of this study was to determine the effect of angiotensin-converting
      enzyme inhibitor, alacepril, on insulin sensitivity in patients with essential
      hypertension (EHT). Ten patients (5 men and 5 women) with EHT (3 with mild
      diabetes and 2 with borderline glucose tolerance) participated. We measured
      insulin sensitivity using the two-hour euglycemic-hyperinsulinemic clamp
      technique and plasma glucose and insulin responses to a 75 g oral glucose
      tolerance test (75 g OGTT) before and after 6-8 weeks of treatment with alacepril
      (dose, 50 mg/day). Glucose infusion rate (GIR) during the last 30 min of the
      clamp study increased from 5.83 +/- 0.70 to 6.59 +/- 0.65 mg per kilogram of body
      weight per minute (P < 0.05) after treatment with alacepril. The insulin
      sensitivity index, which was calculated by dividing the GIR by the mean insulin
      concentration during the same period of the clamp, also increased from 5.91 +/-
      0.66 to 7.20 +/- 0.90 (P < 0.05) after treatment with alacepril. Plasma glucose
      responses to a 75 g OGTT were changed from diabetic pattern to borderline pattern
      in two patients and from borderline pattern to normal pattern in one patient
      after treatment with alacepril. Body weight did not significantly change
      throughout the study in any of the patients studied. Our study demonstrated that
      alacepril significantly improves insulin sensitivity in patients with EHT.

PMID- 8467931
TI  - A new theory of relativity?

PMID- 8467932
TI  - Outpatient colchicine poisoning.
AB  - The clinical effectiveness of colchicine for acute gouty attacks is well
      documented. Its toxicity and low therapeutic index have also been previously
      described. The following case report, although nonfatal, illustrates the toxicity
      of colchicine and the dangers of inadequate doctor-patient communication
      involving highly toxic medications.

PMID- 8467933
TI  - Advising and stimulating health education in schools, 1965-1993.

PMID- 8467934
TI  - Tricky business: discharging a physician-employee.

PMID- 8467935
TI  - Screening for lung cancer: it's still not worthwhile.

PMID- 8467936
TI  - A physical therapist responds.

PMID- 8467937
TI  - Job dissatisfaction: dentistry's taboo topic.

PMID- 8467938
TI  - Prepare a cash budget to meet your goals.

PMID- 8467939
TI  - Marketing your practice.

PMID- 8467940
TI  - Interest-rate shock.

PMID- 8467941
TI  - Properly handling reference requests.

PMID- 8467942
TI  - Every 'nook and cranny' is put to use.

PMID- 8467943
TI  - Thinking about the unthinkable.

PMID- 8467944
TI  - Intraoral video enhances presentations.

PMID- 8467945
TI  - Conservative crown build-out using hybrid composite materials.

PMID- 8467946
TI  - Enamel microabrasion technique.

PMID- 8467947
TI  - Success secrets of mandibular anesthesia.

PMID- 8467948
TI  - Composite choices expand.

PMID- 8467949
TI  - Nucleoside transport in parasites--current status and methodological aspects.

PMID- 8467950
TI  - Purification and partial characterization of 200 kDa oncofetal antigen from
      radiation induced murine lymphocytic lymphoma.
AB  - 1. A 200 kDa glycoprotein (gp200) oncofetal antigen was purified from solubilized
      membranes of a radiation-induced murine lymphocytic lymphoma cell line (XR11-5T),
      grown in syngeneic RFM mice, by successive gel chromatography of the active
      fraction on lentil lectin agarose, Q- and S-Sepharose and Superose-12 using an
      FPLC system. 2. A murine monoclonal antibody 115, produced by the syngeneic
      immunization of adult male C57BL/6N mice with 12-day mouse fetal cells, was used
      in a slot blot antibody assay to follow up the active fractions. 3. The purified
      glycoprotein has a pI of 5.4. 4. Treatment of radiolabeled gp200 with
      neuraminidase caused a slight reduction in size due to the removal of sialic acid
      groups and a shift in pI to 6.3. 5. Treatment of gp200 with different
      glycosidases shows that gp200 is susceptible to N- and O-glycanase but not to
      endoglycosaminidase H. 6. On extraction of gp200 with Triton X-114 it partitions
      exclusively into the detergent-rich fraction consistent with being an integral
      membrane protein.

PMID- 8467951
TI  - Interaction of N-methyl-anthraniloyl-labelled porcine apolipoprotein A-I with
      porcine lecithin: cholesterol acyltransferase: an energy transfer study.
AB  - 1. To investigate whether a direct protein-protein interaction between apoA-I and
      lecithin:cholesterol acyltransferase (LCAT) is necessary for the activation of
      the enzyme, apoA-I was labelled with N-methylisatoic anhydride at lysine
      residues. The intermolecular resonance energy transfer from tryptophan residues
      of LCAT (donor) to N-methyl-anthraniloyl (NMA)-labelled apoA-I (NMA-apoA-I)
      (acceptor) was used as a sensitive fluorescence method for studying molecular
      interactions. 2. In the absence of lipids no fluorescence energy transfer was
      measurable. 3. Fluorescence energy transfer occurred from LCAT to NMA-apoA-I in
      the presence of liposomes with phospholipid/cholesterol ratios ranging from 5:1
      to 18:1 and regardless whether only 1 or up to 5 NMA-apoA-I molecules resided at
      the liposome surface. 4. This indicates a preferred binding of the enzyme
      directly to or in spatial proximity to the activator protein NMA-apoA-I even if
      enough space at the liposome surface is available to allow LCAT binding at a
      distance, where no energy transfer is measurable.

PMID- 8467952
TI  - Regulation of horse-liver glutathione reductase.
AB  - 1. The enzyme was rapidly inactivated by NAD(P)H, GSH, dithionite or borohydride,
      while activity increased in the presence of NAD(P)+ or GSSG. NADH was more
      efficient for inactivation than NADPH. Redox inactivation required neutral or
      alkaline pH, was maximal at pH 8.5, and depended on the presence of metal
      cations. 2. GSSG and dithiothreitol fully protected the enzyme from inactivation
      at concentrations stoichiometric with NAD(P)H. Ten-fold higher ferricyanide or
      GSH concentrations were required to obtain partial protection. NAD+ or NADP+ were
      quite ineffective. 3. GSSG fully reactivated the inactive enzyme at 38 degrees C
      and neutral to acidic pH (5.5-7.5). Reactivation by dithiothreitol was
      accomplished in short periods of time at pH 8.5 although the activity was
      progressively lost afterwards. Ferricyanide and GSH also reactivated the enzyme
      to different extents.

PMID- 8467953
TI  - Induction of prothrombin biosynthesis and inhibition of gamma carboxylase
      activity in experimental models of liver regeneration and fibrosis.
AB  - 1. When acute liver damage is induced in rats treated with CCl4, both prothrombin
      biosynthesis and gamma carboxylase activity decreases, originating a prolongation
      of prothrombin time in plasma. 2. Then, during the regenerative process,
      prothrombin biosynthesis increases higher than normal, but gamma carboxylase
      activity remain decreased. In this case, prolongation of prothrombin time occurs
      in spite of high levels of descarboxylated prothrombin in plasma. 3. An increase
      of descarboxylated prothrombin in plasma is also detected in the CCl4-liver
      fibrosis model.

PMID- 8467954
TI  - Association of cytosolic lipids with fatty acid synthase from lactating mammary
      gland.
AB  - 1. Membrane-free cytosol contained over 4% of both the total lipids and
      phospholipids present in homogenates of lactating rat mammary gland, and much of
      this lipid was associated with a high molecular weight complex isolated from
      cytosol by gel exclusion chromatography or by density gradient centrifugation. 2.
      This complex principally consisted of polypeptides with apparent molecular
      weights of 220 and 116 kDa. Lipids associated with this complex were transferred
      to endoplasmic reticulum and to intracellular lipid droplet precursors of milk
      lipid globules upon incubation in a cell-free system. 3. This lipoprotein complex
      was abundant in cytosol from lactating mammary gland, but was diminished in
      amount in cytosol from involuted mammary glands. The 220 kDa constituent of this
      complex was identified as the monomer of fatty acid synthase. 4. These results
      suggest that fatty acid synthase complex in lactating mammary gland may function
      in transfer of lipids necessary for formation or growth of lipid droplet
      precursors of milk lipid globules.

PMID- 8467956
TI  - Distribution of serine esterase activity in the lymphoid system of C57BL/6 mice,
      effect of aging on the enzymatic activity.
AB  - 1. The activity of serine esterase (SE) was investigated in the lymphoid system
      of C57BL/6 mice. SE activity increased in the lymphoid tissues with their content
      of mature T-lymphocytes, except that high levels were also observed in various
      populations of bone marrow cells. 2. The maturation of T-lymphocytes in the
      thymus was accompanied by an increase in their SE activity. 3. Experiments on the
      influence of age on SE activity showed that while thymocytes were not affected, a
      three-fold increase in activity occurs in spleen lymphocytes between the ages of
      26 and 78 wk.

PMID- 8467955
TI  - Degradation of bone matrix proteins by osteoclast cathepsins.
AB  - 1. The degradation of the bone matrix proteins osteocalcin, osteonectin and alpha
      2HS-glycoprotein by human cathepsins B and L and human osteoclastoma cathepsins
      has been investigated. 2. Intermediate degradation products (M(r) > 12 kDa) were
      not observed during the digestion of alpha 2HS-glycoprotein and osteonectin by
      cathepsins B and L although they were observed with some of the osteoclastoma
      cathepsins. Most of the osteoclastoma cathepsins were capable of degrading these
      two proteins to small peptides at comparable rates. 3. Each cathepsin produced a
      different pattern of osteocalcin degradation products. 4. The extensive range of
      non-collagenous proteins in bone matrix may necessitate the production by
      osteoclasts of cathepsins with different specificities during bone resorption.

PMID- 8467957
TI  - PLA2 activity in rat liver nuclei.
AB  - 1. Subcellular fractions of rat liver were assayed for PLA2 activity. 2. The PLA2
      assay measures the release of [3H]oleic acid from phospholipids, using labeled E.
      coli as substrate. 3. Nuclear fractions contained PLA2 activity, which was Ca2+
      dependent and could not be explained from mitochondria, microsomal or plasma
      membrane contamination. 4. The Vmax value of nuclear PLA2 is 0.30 +/- 0.04 pmol
      oleic acid/min/mg protein; its Km value is 0.86 +/- 0.12 microM, similar to that
      of mitochondrial PLA2. 5. We conclude that rat liver nuclei contain PLA2
      activity.

PMID- 8467958
TI  - Strong sequence patterns in eukaryotic promoter regions: potential implications
      for DNA structure.
AB  - 1. Analysis of eukaryotic sequences reveals recurring trends in upstream regions.
      Oligomers composed of (G/C)n and (A/T)m blocks are preferentially flanked by
      (G/C)2 doublets on their 3' rather than on their 5' ends, that is
      (G/C)n(A/T)m(G/C)2 > (G/C)n+2(A/T)m. 2. These trends are stronger for larger n
      and smaller m. Additional trends are outlined below. 3. The trends are correlated
      with DNA structural parameters, in particular with twist and roll angles. 4.
      Generally, the trends hold if the base pair step joining the 5' (G/C)2 doublet to
      the (G/C)n (A/T)m oligomer is not undertwisted and is not strongly rolled into
      the major groove. 5. Other DNA parameters crucial for DNA-protein interactions
      are discussed as well.

PMID- 8467959
TI  - Purification and properties of a beta-1,4-xylanase from a cellulolytic extreme
      thermophile expressed in Escherichia coli.
AB  - 1. An endoxylanase (EC 3.2.1.8) was purified from an Escherichia coli strain
      carrying a xylanase gene from the extreme thermophile "Caldocellum
      saccharolyticum" strain Tp8T6.3.3.1. It was found to have an M(r) of 42,000 and
      an isoelectric point of approx. 5.0. 2. The enzyme showed optimum activity at pH
      5.0-7.7 and had an activation energy of 44 kJ mol-1. It was stable at room
      temperature at pH 4.5-11.5 in the presence of 0.5 mg ml-1 bovine serum albumin.
      The half-life of the enzyme at 75 degrees C was 20 min at pH 6.0 in the presence
      of 0.5 mg ml-1 bovine serum albumin. 3. The xylanase had highest activity on oat
      spelts xylan, releasing xylobiose and some xylotriose. The Km for oat spelts
      xylan was 0.021% (w/v) at pH 6.0. 4. The enzyme had high activity on sugar cane
      bagasse hemicelluloses A and B, lower activity on larchwood xylan and also
      hydrolysed carboxymethylcellulose, 4-methylumbelliferyl beta-D-cellobioside and p
      nitrophenyl beta-D-cellobioside, but could not hydrolyse xylobiose. 5. It showed
      transferase activity on p-nitrophenyl beta-D-xylopyranoside. Xylose did not
      inhibit the enzyme.

PMID- 8467960
TI  - Effects of hyperthyroidism on glucose, glutamine and ketone-body metabolism in
      the gut of the rat.
AB  - 1. The metabolism of glucose, glutamine and ketone-bodies was studied in the
      small intestine of rats after 5 days of hyperthyroidism. 2. Portal-drained
      visceral bloodflow increased by 20.1% (P < 0.05) in hyperthyroid rats and was
      accompanied by a decrease in the arteriovenous concentration difference of
      glutamine (25.7%, P < 0.05), glutamate (22.0%, P < 0.05), alanine (20.9%, P <
      0.05) and ammonia (20.6%, P < 0.05) and an increase in that of glucose (27.2%, P
      < 0.05), lactate (28.9%, P < 0.05) and ketone-bodies (163.2%, P < 0.001). 3. The
      gut of hyperthyroid rats showed increased rates of extraction of glucose, lactate
      and ketone-bodies. 4. Enterocytes isolated from hyperthyroid rats showed
      increased rates of utilization of glucose and ketone-bodies but that of glutamine
      were decreased. 5. The maximal activities of hexokinase, 6-phosphofructokinase,
      pyruvate kinase, citrate synthase and oxoglutarate dehydrogenase were increased
      (by 13.7-36.2%) in intestinal mucosal scrapings of hyperthyroid rats, whereas the
      activity of glutaminase was decreased (22.1-31.4%). 6. It is concluded that
      hyperthyroidism increases the rates of utilization of glucose and ketone-bodies
      but decreases that of glutamine (both in vivo and in vitro) by the epithelial
      cells of the small intestine.

PMID- 8467961
TI  - Postpartum factors related to mother's attraction to newborn infant odors.
AB  - Hedonic responses to a variety of infant (general body, urine, and feces) and
      noninfant (lotion, cheese, and spice) odorants were compared in four groups of
      subjects: new mothers, mothers a 1-month postpartum, and female and male
      nonparents. Using standard scaling procedures, subjects rated each of the
      odorants twice on a scale from extremely unpleasant (-20.5) to extremely pleasant
      (+20.5). In addition, all subjects completed a set of attitude questionnaires,
      and mothers also answered a childbirth questionnaire and were observed while
      feeding their infants.

PMID- 8467962
TI  - Ultrasonic vocalization responses of rat pups to acute separation and contact
      comfort do not depend on maternal thermal cues.
AB  - In order to assess the importance of maternal thermal cues in controlling the
      acute USV responses of rat pups to contact with her body (the contact comfort
      response) and to separation from her, we drastically altered maternal temperature
      by inducing severe hypothermia so that maternal rectal and flank temperatures
      averaged more than 20 degrees C below normal and 10 degrees C below ambient
      levels during testing. Isolated 12- to 13-day-old pups showed reductions in USV
      when these cold dams were presented and brisk USV accelerations when the cold
      dams were removed from the test chamber. These responses closely resembled those
      of other pups tested with warm (36 degrees C) anesthetized dams. No significant
      differences were found in pups' USV contact comfort responses to cold and warm
      dams. For acute separation, prior maternal thermal properties and other factors
      were found to modulate the relative intensity of the marked USV increase elicited
      by this event.

PMID- 8467964
TI  - American Society for Biochemistry and Molecular Biology and Division of
      Biological Chemistry--American Chemical Society. Joint Meeting. San Diego,
      California, May 30-June 3, 1993. Abstracts.

PMID- 8467963
TI  - Salt appetite consequent on sodium depletion in the suckling rat pup.
AB  - The ontogeny of the behavioral ability to compensate for sodium deficit was
      studied in the rat. The experiments showed that: 1) Before weaning age, sodium
      depleted pups will increase their avidity for 3% NaCl solution; 2) the ability to
      select and drink a salt solution in response to a sodium deficit continues to
      evolve between 17-24 days of age, and that pups at these ages will modify their
      intake of salt and water as do adult rats when rectifying plasma osmolality; 3)
      The increased appetite for sodium is evident even when depleted preweanlings are
      dehydrated and provided with solid NaCl tablets to lick, showing that sodium
      appetite and hydrational status are already dissociated at this age; and finally,
      4) sodium depletion first induces an increase in intake of orally infused 3% NaCl
      solution in 12-day-old pups. The picture of the development of salt appetite in
      the suckling rat that these findings present is of a precocious competence to
      meet a challenge to sodium homeostasis. In this respect salt appetite emerges in
      parallel to the other ingestive behaviors.

PMID- 8467965
TI  - [A multivariate prospective study of prognostic factors in 200 operated
      epidermoid cancers of the esophagus. Definition of patients for whom surgical
      resection was of benefit].
AB  - From 1982 to 1991, 200 patients with squamous-cell esophageal cancers underwent
      operation. Sixteen prognostic parameters were prospectively collected and
      analyzed. The main aim of this study was to define the best preoperative criteria
      for selection for curative surgery and which patients would benefit most from
      radical resection. Squamous-cell head and neck carcinoma was associated in 43.5%
      of cases. Of these, 24% preceded the esophageal carcinoma while 19.5% were
      synchronous. Resection was curative (i.e. grossly complete) in 144 cases,
      palliative (leaving gross tumor behind) in 25 cases, and judged impossible in 31
      cases. Twenty-one patients died during their hospitalization. Five-year survival,
      according to the Kaplan-Meier method, was 18 +/- 3.6% for all patients, and 27 +/
      4.8% for patients undergoing curative resection (including postoperative
      mortality). Palliative resections or invasion of adjacent organs, but not
      resection with positive lymph nodes, was thought to be synonymous with
      incurability. Multivariate analysis showed that the two principal statistically
      significant characteristics were the stage as determined by roentgenological and
      endoscopic evaluation (P = 0.003) (clearly assessable during initial work-up) and
      type of resection (complete or not) (P = 0.04). Tumor diameter, as determined on
      CT-scan (< or > than 30 mm), was at the limit of statistical significance (P =
      0.09). A second multivariate analysis of prognostic factors was conducted in 128
      patients undergoing resection with curative intent and who survived the initial
      postoperative period. Roentgenologic/endoscopic staging alone emerged as being
      statistically significant (P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467966
TI  - [Cancer of the esophagus: survival increases and indications become clear].

PMID- 8467967
TI  - [Electronic sectorial ultrasound endoscopy in benign and malignant tumoral
      pathology of the stomach. Results in 30 patients].
AB  - From October 1991 to July 1992, endoscopic ultrasound examination (EUS) was
      performed preoperatively in 30 patients with gastrointestinal disease with a new
      forward-view fiber optic gastroscope with a 5 and 7.5 MHz curved-array linear
      transducer mounted directly behind the lens. Before EUS examination, endoscopy
      with biopsy had established the diagnosis of gastric disease in 22 cases: 16
      adenocarcinoma, 4 lymphoma, 1 carcinoid tumor and 1 gastric metastasis of a
      chorionic tumor. In the 8 other cases, endoscopic diagnosis with non productive
      biopsy was gastric ulcer (1 case), submucosal tumor (5 cases), and large fold
      gastritis (2 cases). EUS established a correct diagnosis in 6 of these 8 cases (2
      leiomyoma, 1 lipoma, 1 lymphoma, 2 gastric linitis). Correct preoperative TN
      staging was accomplished by EUS in 83.3% and correct preoperative staging for N
      was accomplished by EUS in 90%. This study shows that EUS a curved-array
      transducer is useful in preoperative TN staging of gastric tumors.

PMID- 8467968
TI  - [Etiologies of a moderate and prolonged elevation of serum activity of
      transaminases: the end of "transaminitis"?].

PMID- 8467969
TI  - [Contribution of liver biopsy and serology of hepatitis C virus to the diagnosis
      of a moderate and prolonged elevation of aminotransferases].
AB  - The aim of this study was to evaluate the diagnostic usefulness of percutaneous
      liver biopsy and screening for hepatitis C virus antibodies with 1st and 2nd
      generation ELISA in asymptomatic blood donors with persistent (> 1 year) and
      moderate elevation (> 1.5 times the upper limit of normal) of serum alanine
      aminotransferase. The diagnosis was established from clinical, biological and
      ultrasound data before biopsies were obtained, then compared to the histological
      diagnosis. Thirty one of 56 blood donors who satisfied the preceding criteria
      accepted liver biopsy and were subsequently included in the study. An accurate
      diagnosis was proposed before biopsy in 20 cases. This was in agreement with the
      histological results in 19 cases but in 2 of these, unexpected lobular hepatitis
      was associated with the expected steatosis. Positive hepatitis C virus tests
      corresponded to chronic hepatitis in all cases (n = 5). No accurate diagnosis
      could be proposed in the 11 remaining cases owing to the lack of evidence of any
      etiology (n = 4) or because several potential etiologies were possible for the
      same subject (n = 7). Histological diagnoses were: isolated steatosis (n = 12),
      steatosis associated with lobular hepatitis (n = 7) or with chronic persistent
      hepatitis (n = 1), chronic active (n = 2) or chronic persistent hepatitis (n =
      3), alcoholic hepatitis (n = 2), hemochromatosis (n = 1), and normal liver (n =
      3). Liver biopsy is essential to the accurate etiological diagnosis of persistent
      and moderate elevation of aminotransferases despite hepatitis virus C tests which
      are associated with the correct diagnosis of chronic hepatitis in 16% of
      cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8467970
TI  - Exertional gastroesophageal pH-metry: a new provocative physiological test in the
      diagnosis of chest pain.
AB  - With the aim of determining the value of physical exercise as a provocative test
      for chest pain associated with gastroesophageal reflux, 67 patients presenting
      non-cardiac chest pain (normal coronary angiograms and no functional coronary
      artery alterations) with different characteristics (group A: at rest; group B:
      exertional or mixed-type) underwent exercise tests during 24-hour
      gastroesophageal pH-metry associated with electrocardiographic (EKG) monitoring.
      Thirty-four patients in group A (73.4%), and 12 in group B (57%) showed
      pathological reflux on 24-hour gastroesophageal pH-metry. Twelve patients in
      group A (25%) and 6 in group B (28.5%) (total ratio: 26.8%) presented positive
      responses to exercise, with concomitant occurrence of gastroesophageal reflux,
      typical pain, without EKG ischemic signals. Exertional pH-metry allowed to reach
      diagnostic certitude in 10 (14.9%) of 67 patients, 9 presenting 24-hour pH-metry
      results that only suggested "possible" diagnosis, and 1 without either
      pathological reflux or pain during prolonged monitoring: all these patients
      belonged to group A. The repetition of the test showed total reproducibility of
      the results, with "fixed thresholds" of exercise in 11 of 18 subjects (61.1%).
      These data suggest the usefulness of grouping different diagnostics (24-hour EKG,
      pH-metry and exertional test) to increase diagnostic certitude, mainly in
      patients with primary angina. Exertional pH-metry shows to be an efficacious
      provocative test, and the only based on a physiological stimulus.

PMID- 8467971
TI  - [A case of chylous ascites associated with exudative enteropathy complicating
      chronic pancreatitis of alcoholic origin].
AB  - Chylous ascites is mainly due to malignant abdominal disease or cirrhosis. We
      report the case of chylous ascites associated with protein losing enteropathy
      caused by fibrotic compression of abdominal lymphatic vessels and superior
      mesenteric vein complicating alcohol-related chronic pancreatitis. This is the
      second case published in the literature.

PMID- 8467972
TI  - [Angiomyolipomas of the liver. Diagnostic and therapeutic aspects in 4 cases and
      review of the literature].
AB  - In four cases, angiomyolipoma of the liver was discovered incidentally by
      ultrasound investigation. Based on a review of 26 other previously reported cases
      and as was borne out in our series, the diagnosis is suggested by the
      demonstration of fatty material on CT-scan and confirmed by needle aspiration
      biopsy. Magnetic resonance may be contributive as well.

PMID- 8467973
TI  - [Multiple microcystic cystadenomas of the pancreas without organic association.
      Apropos of a case].

PMID- 8467974
TI  - [Toxic megacolon caused by loperamide-myorelaxants combination].

PMID- 8467975
TI  - [Tracheal stenosis and hemorrhagic rectocolitis].

PMID- 8467976
TI  - [Diarrhea induced by Cyclo 3 fort and lymphocytic colitis].

PMID- 8467977
TI  - [Ulcerative colitis: secondary to the ingestion of lysine acetylsalicylate?].

PMID- 8467978
TI  - [Combined radiological and endoscopic treatment of intrahepatic lithiasis. Value
      of intra-corporeal lithotripsy by pulsed laser].

PMID- 8467979
TI  - [Projectile in the common bile duct: a rare cause of cholestatic jaundice].

PMID- 8467980
TI  - [Treatment of and survival after epidermoid cancer of the esophagus in the
      department of Finistere between 1984 and 1988 (716 cases)].
AB  - The incidence of esophageal cancer in the French county of Finistere is among the
      highest in France (26.7/10(5) for males). The authors analyzed the survival rates
      for squamous cell carcinomas from data of the Finistere tumor registry in order
      to describe different prognostic groups of patients using the multivariate Cox
      model. From 1984 to 1988, 716 patients with esophageal squamous cell carcinomas
      were registered in an overall population of 828,000 residents: 675 males and 41
      females. Survival was calculated using the actuarial method. Six hundred and
      seventy five patients died before the point date (31 Dec 1989). Only one patient
      was lost to follow-up. The actuarial survival rates of all patients were 89 +/-
      1% at 3 months, 68 +/- 2% at 6 months, 37 +/- 2% at one year, 12 +/- 1% at 3
      years and 6 +/- 1% at 5 years; median survival was 9.1 +/- 0.4 months. Survival
      was significantly related to cancer size, tumor extension and surgical
      contraindications. In the Cox model, age, cancer size, surgical
      contraindications, year of diagnosis were independent prognostic predictors.
      There was a significant increase in survival rates after 1986: median survival
      was 8.1 +/- 0.4 months between 1984 and 1986 and 10.1 +/- 0.5 months between 1987
      and 1988. Patients treated by curative resection had higher actuarial survival
      rates (median survival 22.5 +/- 4.1 months) than patients who underwent
      palliative resection (median survival 11.3 +/- 1.2 months). In patients with
      cancer managed surgically, the prognostic predictors were tumor size, curative vs
      palliative surgical resection and association with chemotherapy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8467981
TI  - [Toxic pollutants and fertility disorders. Solvents and pesticides].
AB  - It is demonstrated by means of extensive reference studies, as well as own
      results, that organic solvents and pesticides can be accountable for
      intoxications and various complications during pregnancy (e.g. abortion,
      stillbirth, intrauterine growth retardation). An initial stimulation of the
      adrenal cortex (hyperandrogenaemia) can result in partial insufficiency of the
      adrenal cortex with symptoms like alopecia and feeling of sickness. Consequences
      can be hypo- and hyperthyroidism. The immunological system is affected (e.g.
      abortion, susceptibility to infections). Neurovegetative and neuropsychological
      concomitant symptoms are numerous. Toxic contaminants affect men at different
      levels of the semen producing organs (e.g. oligospermia, azoospermia).
      Indications regarding diagnosis of toxic substances related illnesses as well as
      therapeutic and prophylactic potentialities are presented.

PMID- 8467982
TI  - [Ambulatory surgery].

PMID- 8467983
TI  - [Combined surgical and radiotherapeutic treatment of pelvic wall recurrences:
      report of experiences after 3 years].
AB  - CORT has been developed to treat recurrent gynaecological malignancies
      infiltrating the pelvic wall unilaterally. The surgical part consists of: (i)
      staging laparotomy/lymphadenectomy, (ii) maximum tumour resection at the pelvic
      wall and exenteration of infiltrated central pelvic organs, (iii) implantation of
      guiding tubes on the residual tumour/tumour bed on the pelvic wall, (iv) pelvic
      wall plasty with muscle, musculocutaneous and omentum flaps, (v) operative
      reconstruction of bowel, bladder and perineo-vulvo-vaginal functions. Radiation
      is performed as interstitial high dose rate brachytherapy through the implanted
      tubes. Patients without prior pelvic irradiation receive in addition, whole
      pelvis teletherapy. CORT has been evaluated in a prospective phase I and II trial
      at the University of Mainz. Within a 3-year period, 21 patients with pelvic wall
      recurrences from various gynaecological primary tumours were treated. Seventeen
      patients had been irradiated as (part of) the previous therapy with a median
      total mid-pelvic dose of 65 Gy (range 40-100 Gy). There was no operative
      mortality. Five patients developed complications necessitating surgical
      intervention. One patient died from fatal thromboembolism 6 months after CORT
      without evidence of tumour progression. In 14 patients, local tumour control has
      been achieved. After a median follow-up period of 27 months (range 6-38 months)
      Kaplan-Meier life table analysis revealed an actuarial survival probability of
      55% (recurrence-free 49%). We conclude from these preliminary results, that the
      CORT procedure for the treatment of pelvic wall recurrences is feasible and may
      lead to encouraging therapeutic success in selected patients, whose situation had
      been hopeless so far.

PMID- 8467984
TI  - [EGF receptor and EGF-like activity as prognostic factors in cervix cancer].
AB  - The binding of the Epidermal Growth Factor (EGF) and the amount of EGF-like
      activity (EGF-A) was analysed in 75 cervical carcinomas and possible clinical
      implications were tested. EGF-A was significantly increased in patients with
      metastases to the pelvic and/or para-aortic lymph nodes. The EGF-receptor (EGF-R)
      capacity was inversely related to the histological grade (p < 0.05) and was
      reduced in highly differentiated tumours. In stage I and II disease, the clinical
      outcome was significantly reduced, if the receptor capacity or the level of EGF-A
      was increased (> 100 fmol/mg protein and > 0.5 ng/mg protein, respectively). The
      measurement of EGF-R capacity and EGF-A provides new and additional information
      for the prediction of the prognosis in cervical cancer.

PMID- 8467985
TI  - [The current status of prenatal diagnosis of myelomeningocele--results of a
      questionnaire].
AB  - Questionnaires were sent to 1000 parents of children with myelomeningocele in
      order to get a better knowledge of the present state of prenatal diagnosis of
      this disease. 566 parents answered; 488 responders, in whom the pregnancy took
      place 1982 and later, were evaluated in detail. 85% of the parents reported
      having been checked by ultrasound 2 times and more during pregnancy: however,
      only 27% of the myelomeningoceles were detected before delivery. 83% were
      diagnosed between the 30th and 40th week of pregnancy. The rate of discovery rose
      from 0% and 37% between 1982 and 1990. As a consequence of this result, one
      should make every effort by using ultrasound and alpha-foetoprotein-screening to
      verify or to exclude a myelomeningocele in an early phase of pregnancy. The
      delivery should take place in a specialised centre, and the knowledge of life
      expectancy and life quality of these patients should be improved, for the
      obstetricians as well as for the parents.

PMID- 8467986
TI  - ["Facing"--a preliminary parameter in diagnosis of fetal skeletal abnormalities].
AB  - Four cases with abnormalities of foetal faces are demonstrated--thanatophoric
      dwarfism, cheilognathopalotoschisis, osteogenesis imperfecta, achondrogenesis
      (Type I). A relationship to skeletal dysplasia was shown. We think, that the
      representation of foetal faces and their profile plays an important part in
      second trimester ultrasound screening between 18 and 22 weeks of gestational age.

PMID- 8467987
TI  - [Regular exercise therapy in disorders of carbohydrate metabolism in pregnancy-
      results of a prospective, randomized longitudinal study].
AB  - Regular exercise has long been known as an adjunct in the therapy of diabetes
      mellitus. There are, however, only few reports on the impact of this therapy
      during pregnancy. This study aims at presenting an exercise programme for
      patients with insulin-requiring gestational diabetes (GDM) and its short-term and
      long-term effects on carbohydrate metabolism, on the foetus and on the course of
      pregnancy. Between the 26th and 32nd week of gestation, 41 pregnant subjects were
      randomised into either an exercise and diet group (EXE) or an Insulin and diet
      group (INS). The EXE patients (N = 21) trained three times per week at 50%
      VO2max. For 3 x 15 minutes on a recumbent bicycle ergometer throughout pregnancy
      with blood glucose monitoring before and after exercise). Blood glucose
      metabolism was followed by daily home monitoring and weekly fasting blood glucose
      sampling (FBG). The FBG results were comparable in the study and the control
      group (< 105 mg/dl); the maternal and foetal complications did not differ
      significantly between the two groups. The glycaemic parameters indicate a
      persistent decrease in blood glucose and an increase in insulin sensitivity
      induced by regular physical activity. We conclude, that such a medically
      supervised exercise programme can be safely conducted in women with GDM resulting
      in normoglycaemia for the mother and thus preventing insulin therapy.

PMID- 8467988
TI  - [Maternal and fetal morbidity and mortality in premature abruptio placentae--a
      retrospective analysis].
AB  - The frequency of abruptio placentae has nearly tripled in our clinic since 1974
      and now stands at 1.4% of all deliveries. In a retrospective analysis it was
      investigated whether improved diagnostic and therapeutic methods have decreased
      the morbidity and mortality of this severe obstetrical complication. During 3
      stages of observation--1974-1979, 1980-1985 and 1986-6/1990--we registered 123
      cases. The division into time intervals was based on the introduction of
      sensitive ultrasonic methods in 1980 and the vaginal scan in 1986. Important risk
      factors of abruptio placentae were found to be bleeding in pregnancy (32%),
      previous curettages (38%), premature labour (29%), and pre-eclampsia (14%). The
      diagnostic sensitivity of sonography rose from 40% in the first to 78% in the
      third interval of observation. The rate of vaginal deliveries decreased from 15%
      to 2%. Simultaneously, the perinatal mortality decreased, despite increasing
      foetal prematurity, from 30% to 2%. The improvement in foetal outcome could be
      demonstrated by 1- and 5-minute Apgar score values. During the entire period, we
      lost one mother with abruptio placentae complicated by fulminant lung embolism
      intra operationem. The frequency of serious stages of abruptio placentae (Page 2
      3) decreased from 69% to 33%. While 54% of the mothers developed shock (shock
      index > or = 1) during delivery in the first observation period, this figure was
      finally only 10.5%. At the same time the frequency of coagulation disorders
      decreased from 31% to 4%.

PMID- 8467989
TI  - [Histiocytosis X (Langerhans cell granulomatosis) of the vulva].
AB  - Isolated histiocytosis X (Langerhans cell granulomatosis) of the vulva is
      extremely rare. In most reported cases, vulval disease is associated with
      multitopic organ involvement. We report here on the second case in the world of
      isolated histiocytosis X of the vulva. The diagnosis could be established by
      immunohistochemical demonstration of anti-S 100 protein + Langerhans cells. The
      patient received a local radiation therapy of 10 gy and responded excellently.

PMID- 8467990
TI  - [Hereditary prolonged QT interval (Romano Ward syndrome) in obstetric
      management].
AB  - In the Romano-Ward syndrome, an inherited form of abnormally prolonged QT
      duration is a matter for concern. The frequency-corrected QTc value in the ECG
      amounts to more than 0.44 s. Persons suffering from Romano-Ward syndrome are
      vitally endangered by attacks of arrhythmia, syncope and cardiac arrest which are
      triggered or aggravated by stress or certain drugs. In obstetrical anaesthesia,
      attention should be paid to the foetus, which, due to the genetic dominance, will
      have a 50% probability of suffering from the disorder. A 28-year-old para I was
      admitted with cervical dilation on her predetermined date of delivery. Romano
      Ward syndrome had been diagnosed 10 years earlier. The patient had been free of
      complaints and had received no treatment. Due to cephalopelvic disproportion and
      the cardiac syndrome, a primary Caesarean section was performed. The QTc values
      were pathologically prolonged (0.47 s; 0.48-0.63 s) during the pre- and
      intraoperative period. Haemodynamic irregularities did not occur in the
      perioperative period. The newborn was vital (3.830 g; 50 cm; Apgar scores
      10/10/10; umbilical cord pH 7.29). Directly postpartum isolated supraventricular
      extra systoles occurred, and the QTc duration increased to 0.51 s.

PMID- 8467991
TI  - [Rudolf Kaltenbach. On the 150th anniversary of his birth and 100th anniversary
      of his death].

PMID- 8467992
TI  - Non-specific hole formation in the Escherichia coli inner membrane by lambda S
      proteins in independent of cellular secY and secA functions and of the proportion
      of membrane acidic phospholipids.
AB  - Formation of the lesion in the Escherichia coli inner membrane caused by lambda
      lysis protein S was examined by electron microscopy. We also show that
      macromolecules exceeding the size of the lambda R transglycosylase can pass
      through the S-dependent hole and that assembly of the S-dependent hole is
      independent of the proportion of acidic phospholipids in the inner membrane and
      of components of the cellular transport machinery.

PMID- 8467993
TI  - Purification of a fibroblast-inhibitory factor from Actinobacillus
      actinomycetemcomitans Y4.
AB  - A factor showing inhibitory activity against human gingival fibroblasts was
      extracted from the cytosol fraction of Actinobacillus actinomycetemocimitans Y4.
      The activity markedly inhibited the proliferation of human gingival fibroblasts,
      but had no effect on cell viability or gross morphology. No such activity was
      found in cytosol fractions from either Porphyromonas gingivalis 381 or
      Escherichia coli HB101. The extract from A. actinomycetemocomitans Y4 was then
      purified by anion-exchange chromatography, hydroxyapatite chromatography and gel
      filtration chromatography to give a single band on SDS-PAGE with an apparent
      molecular mass of 65 kDa. The purification ratio was 183-fold with a recovery
      rate of 5% compared with the crude extract (starting material) when the activity
      was assessed by direct cell counts.

PMID- 8467994
TI  - Heme b (protoheme IX) is a precursor of heme a and heme d in Bacillus subtilis.
AB  - Bacillus subtilis can synthesise cytochromes containing a-, b-, c- and d-type
      heme. The biosynthetic pathways of these heme prosthetic groups were investigated
      by using strains blocked in uroporphyrinogen III synthesis from porphobilinogen
      or in heme b (protoheme IX) synthesis from uroporphyrinogen III. The results
      strongly suggest that heme a and heme d are both synthesised from heme b
      (protoheme IX). They also indicate that B. subtilis contains a novel
      ferrochelatase involved in the synthesis of siroheme.

PMID- 8467995
TI  - Alternate interactions of the D-galactose-specific yeast lectin Kb-CWL I with
      sensitive yeast strains.
AB  - In vitro growth assays with a purified D-galactose-specific lectin Kb-CWL I
      extracted from Kluyveromyces bulgaricus showed marked antifungal effects on 9 of
      12 test strains belonging to the genera Kluyveromyces, Saccharomyces, Pichia,
      Candida, Rhodotorula and Schizosaccharomyces. The inhibition of growth was
      proportional to the lectin concentration (0.04 and 0.08 mg ml-1) in the culture
      medium. Under the test conditions, K. bulgaricus, K. lactis and S. bayanus were
      consistently agglutinated without growth inhibition. D-Galactose, the inhibitory
      sugar of the cell aggregation activity, did not abolish the antifungal effects of
      the lectin Kb-CWL I on other yeast strains tested. In C. albicans and C.
      tropicalis, the lectin influenced the dimorphism of these strains and stimulated
      germ tube formation.

PMID- 8467997
TI  - Microbial desulfurization of dibenzothiophene: a sulfur-specific pathway.
AB  - Rhodococcus rhodochrous strain IGTS8 metabolizes dibenzothiophene, a model
      compound for organic sulfur in fossil fuels, in a sulfur-specific manner. Two
      routes of desulfurization have been identified. Under growth conditions, the
      intermediates are dibenzothiophene sulfoxide, dibenzothiophene sulfone, 2'
      hydroxybiphenyl-2-sulfonate, and 2,2'-dihydroxybiphenyl. Stationary phase cells
      produce 2-hydroxybiphenyl as the desulfurized product and use the 2'
      hydroxybiphenyl-2-sulfinate, rather than the sulfonate, as the key intermediate.

PMID- 8467996
TI  - A yeast gene for trehalose-6-phosphate synthase and its complementation of an
      Escherichia coli otsA mutant.
AB  - A Saccharomyces cerevisiae gene for trehalose-6-phosphate synthase (TPS1) was
      sequenced. The gene appeared to code for a protein of 495 amino acid residues,
      giving the protein a molecular mass of 56 kDa. The TPS1 gene was able to restore
      both osmotolerance and trehalose accumulation during salt stress in an
      Escherichia coli strain mutated in the otsA gene encoding trehalose-6-phosphate
      synthase. Complementation studies with E. coli galU mutants showed that the TPS1
      encoded trehalose-6-phosphate synthase is UDP-glucose-dependent. Sequence
      analysis and data base searches showed that TPS1 is allelic to GGS1, byp1, cif1
      and fdp1. A possible gene for trehalose-6-phosphate synthase in Methanobacterium
      thermoautotrophicum was identified.

PMID- 8467998
TI  - Screening of thermotolerant yeasts as producers of superoxide dismutase.
AB  - A screening procedure for highly thermostable yeast superoxide dismutase was
      developed. Growth yields at various temperatures were estimated for ten
      mesophilic and thermotolerant strains, belonging to the genera Saccharomyces,
      Kluyveromyces and Pichia. Higher yields at 45 degrees C were obtained for K.
      lactis 90-3 and 90-4. A correlation between the ability to grow at higher
      temperature and the thermostability of the superoxide dismutase enzyme
      synthesized was observed. A comparison of the operational stability of the
      superoxide dismutase of all tested strains suggests that the enzyme of K. lactis
      strains was more thermostable than that of the other tested microorganisms.

PMID- 8467999
TI  - Production and characterisation of a Legionella pneumophila specific monoclonal
      antibody.
AB  - To better define the antigenic structure of the outer cell membranes of
      Legionellae, a panel of 6 monoclonal antibodies was raised against partially
      purified outer membranes of Legionella pneumophila serogroup 1, Corby strain.
      This study describes the purification and characterization of one of these
      monoclonal antibodies reacting with a 135-kDa protein, which was shown to be
      common to all 14 serogroups of Legionella pneumophila. It shows no cross
      reactivity with 20 other Legionella species, or 9 other Gram-negative species
      tested by SDS-PAGE and Western blotting procedures. The epitope would appear to
      be predominantly surface exposed and, from preliminary detergent extraction
      studies, not peptidoglycan-associated.

PMID- 8468000
TI  - Cloning and partial sequence of transferrin-binding protein 2 of Neisseria
      meningitidis using a novel method: twin N-terminal PCR.
AB  - The genes encoding transferrin-binding proteins (TBPs) 1 and 2 of Neisseria
      meningitidis and N. gonorrhoeae were used as model loci in a novel method of
      cloning (twin N-terminal polymerase chain reaction; TNT-PCR) involving
      amplification between the 5' ends of two genes. Primers were based on N-terminal
      amino-acid sequences. A 2.1-kb product amplified from N. meningitidis strain SD
      (B15 P1.16) was cloned into a plasmid vector and partially sequenced. Translated
      sequence immediately downstream of the primer at both ends of this product
      correlated to the additional known N-terminal amino acids of TBP-1 and 2. The
      protein encoded by the cloned sequence reacted with TBP-2-specific antiserum. The
      size of products generated in TNT-PCR correlated exactly with the different sized
      TBP-2 produced by 10 strains of the Neisseria spp. examined, indicating
      successful cloning of the gene for TBP-2 and showing it to be adjacent to and
      preceding TBP-1 on the chromosome for both N. meningitidis and N. gonorrhoeae.

PMID- 8468001
TI  - Identification of Streptococcus mutans antigen D as the HPr component of the
      sugar-phosphotransferase transport system.
AB  - Extraction of Streptococcus mutans with the detergents HECAMEG and lauroyl
      sarcosinate preferentially extracted antigen D, previously identified as a low
      molecular mass wall-associated protein. Western blotting with specific antisera
      was used to demonstrate that this antigen is the HPr component of the sugar
      phosphotransferase transport system. Non-denaturing electrophoresis indicated
      that HECAMEG selectively extracted only one of the two forms of HPr. It is
      suggested that this form of HPr may have a specific cell surface location.

PMID- 8468002
TI  - Temperature-sensitive amber suppression of ompF'-'lacZ fused gene expression in a
      supE mutant of Escherichia coli K12.
AB  - In an ompF'-'lacZ fusion system carried by the open reading frame vector pORF1 in
      a supE mutant of Escherichia coli K12, read-through of an amber codon was
      decreased at temperatures higher than 40 degrees C. This effect of temperature
      was dependent on the nucleotide sequence surrounding the amber codon, which was
      inserted into a site between the ompF and lacZ cistrons. Upon a temperature shift
      up from 30 to 42 degrees C, beta-galactosidase synthesis directed by this fusion
      showed a transient arrest.

PMID- 8468003
TI  - Surface hydrophobic and hydrophilic protein alterations in Candida albicans.
AB  - Cell surface hydrophobicity influences pathogenesis of Candida albicans. Previous
      studies suggested that stationary-phase hydrophilic and hydrophobic cells,
      obtained by growth at 37 and 23 degrees C, respectively, may have similar
      hydrophobic proteins. However, whether hydrophilic and hydrophobic surface
      proteins differ during the growth cycle at 37 degrees C is unknown. Freeze
      fracture analysis revealed surface fibrillar layer differences between
      hydrophobic late-lag and hydrophilic stationary-phase yeast cells grown at 37
      degrees C. Hydrophilic protein differences were also observed between these
      populations. However, similar hydrophobic proteins were detected among the late
      lag and stationary phase cells grown at 37 degrees C and hydrophobic stationary
      phase cells grown at 23 degrees C. These results suggest that hydrophobic
      proteins remain constant but hydrophilic proteins vary during growth. Thus,
      conversion from surface hydrophilicity to hydrophobicity by C. albicans may only
      require alterations in the hydrophilic fibrillar protein components.

PMID- 8468004
TI  - Effect of the anti-microtubule compound tubulozole on Leishmania protozoan
      parasites in vitro.
AB  - For the cis and trans stereoisomers of the synthetic anti-microtubule compound
      tubulozole, at micromolar concentrations, tubulozole-C is cytotoxic to mammalian
      cells whereas tubulozole-T is not. The effect of tubulozoles on the parasitic
      protozoan Leishmania was tested. For the promastigote stage of L. mexicana
      amazonensis, both isomers inhibited parasite growth. For the amastigote stage of
      L. mexicana amazonensis and L. major, within murine J774 macrophage line as host
      cells in vitro, tubulozole-T reduced the infective index. Despite the observation
      of macrophage cytotoxicity of tubulozole-T, this compound may be a potentially
      useful and novel anti-leishmanial drug.

PMID- 8468005
TI  - Expression of the Escherichia coli ftsZ gene: trials and tribulations of gene
      fusion studies.
AB  - The ftsZ gene of Escherichia coli, which codes for an essential cell division
      protein, is subjected to multiple regulation, as shown in part with studies using
      an ftsZ::lacZ operon fusion located on phage lambda JFL100. Using this same
      fusion, we sought to isolate regulatory mutants overexpressing ftsZ by selecting
      mutants able to grow on lactose. One Lac+ mutant was obtained which overexpressed
      the ftsZ::lacZ fusion 70-fold. The mutation responsible for the overexpression
      lies in a new gene, cot, located near 56 min on the E. coli genetic map. The cot
      mutation probably affects the transcription of a chromosomal open reading frame,
      ORF1, lying downstream of the bioA gene and adjacent to the ftzZ::lacZ fusion of
      the lambda JFL100 prophage integrated at att lambda. Using an ftsZ84(Ts) strain,
      in which there was a double selection for overexpression of both ftsZ::lacZ and
      ftsZ+, no Lac+Tr mutants were obtained from 3.6 x 10(10) bacteria; the
      introduction of a mutL allele, increasing spontaneous base substitution mutation
      rates 75-fold, did not permit us to isolate such a mutant. We conclude that Lac+
      ftsZ-constitutive mutations cannot be obtained in lambda JFL100 lysogens by a
      single base substitution.

PMID- 8468006
TI  - Studies of linkage in populations. X. Altitude and autosomal gene arrangements in
      Drosophila robusta.
AB  - Data are presented concerning the gene arrangements in the second and third
      chromosomes of Drosophila robusta in eight altitudinal transects. A consistent
      change is the increase in the arrangement 2L-3, particularly in the linkage
      combination 2L-3.2R, with increasing altitude. The reciprocal decrease with
      increasing altitude affects several different 2-left arrangements, most
      consistently 2L-1. The arrangements of 2-right show no significant variation with
      altitude, and those of 3-right do so only in a few samples of the two northern
      transects studied, none in any of the southern ones. These results confirm
      previous evidence for the significant role of the arrangements of the left arm of
      the second chromosome in the adaptations of this species to altitude and suggest
      further that interactions of linked arrangements are involved in these
      adaptations. The data also indicate that the factors responsible for the
      altitudinal adaptations of this species are in many cases not the same ones that
      are responsible for variations in its gene arrangements with latitude.

PMID- 8468007
TI  - Continuity after a stroke: implications of life-course disruption in old age.
AB  - Life-course disruption caused by a stroke and subsequent attempts on the part of
      stoke victims to restore continuity was explored through qualitative research
      with a sample of 216 persons. This research suggests: 1) that theory in
      gerontology could be deepened by framing continuity to include discontinuous
      experience in late life; and 2) that research on what elderly persons themselves
      make of continuity--how they perpetuate it or recreate it and the obstacles they
      perceive in doing so--may inform our understanding of the experience of old age
      and lead to applications in the practice of gerontology that address the
      disruption illness poses for people's lives.

PMID- 8468008
TI  - Adopting a disability approach to home care services for older adults.
AB  - The disability and aging communities differ significantly in their perceptions,
      definitions, and values about the independence and autonomy of disabled
      individuals. These viewpoints are reflected in the different services and goals
      of personal assistance provided to older and younger disabled persons. We explore
      the applicability of the disability approach to personal assistance for older
      persons and offer ethical, practice-oriented, and political arguments for the
      aging community to adopt this approach. We also review past efforts toward
      achieving a "unified agenda" between the aging and disability communities and
      outline possible future initiatives.

PMID- 8468009
TI  - Changes in the use of personal assistance and special equipment from 1982 to
      1989: results from the 1982 and 1989 NLTCS.
AB  - Analysis of data from the 1982, 1984 and 1989 National Long-term Care Surveys
      suggests that long-term care use is changing. Between 1982 and 1989, equipment
      use by persons with light physical impairment, or to supplement personal
      assistance for the severely disabled, increased. Over this same period, there was
      a decline in the use of personal assistance as the sole modality to deal with
      chronic impairments. Since equipment costs are nonrecurrent, whereas personal
      assistance costs are recurrent, this finding has implications for long-term care
      policy.

PMID- 8468010
TI  - The cost-effectiveness of community services in a frail elderly population.
AB  - We use an integrated model incorporating simple principles of decision analysis
      and marginal cost analysis to discuss cost-effectiveness of community long-term
      care services as a substitute for nursing home care. By taking individuals as the
      unit of analysis and analyzing different types of community services separately,
      the model defines the targeting issue precisely and permits key policy parameters
      to be estimated empirically. When applied to data from the National Long Term
      Care Channeling Demonstration, 41% of those screened into the control group were
      found to have some potential for net long-term care cost reduction through
      program services.

PMID- 8468011
TI  - State units and convergence models: needs assessment revisited.
AB  - Based on a comprehensive survey of state and territorial units on aging, this
      article reexamines and evaluates the needs assessment process in place in social
      service agencies. Although most agencies reported multiple sources of planning
      data, serious limitations in the representativeness of selected data sets were
      still apparent. We outline a convergence model of needs assessment that utilizes
      a long-range planning perspective for the development of planning models.

PMID- 8468012
TI  - Falls in dementia patients.
AB  - We analyzed the number and nature of falls in a nursing home for elderly patients
      with dementia. Staff reported 1,343 falls over a 2-year period in 240 patients, a
      rate of about 4 falls per person year. The risk of falling was especially high
      shortly after admission and after transfer to another ward, increased with
      severity of the dementia and physical impairment, and decreased for very severely
      demented or physically handicapped patients. Men had twice the risk of falling of
      women. Most incidents were relatively harmless, but 33 fractures were reported.
      The most common causes for falls were "inadequate (use of) materials, stumbling,
      or slipping" (17%) and "gait and equilibrium disturbances" (16%).

PMID- 8468013
TI  - The perspective of the patient with Alzheimer's disease: a neglected dimension of
      dementia research.
AB  - The patient perspective has been largely ignored in studies of Alzheimer's
      disease. The person with dementia is often relegated to the status of object
      rather than legitimate contributor to the research process and much can be gained
      from a systematic study of patients' views regarding their illness and care. We
      examine the status of dementia patients in three research areas and identify
      research challenges and opportunities that may substantially increase our
      understanding of dementia.

PMID- 8468015
TI  - Volunteerism by elders: past trends and future prospects.
AB  - A number of surveys indicate a rise in the percentage of elders involved in
      volunteer work over the past 25 years. This article identifies cultural,
      demographic, and programmatic factors that have contributed to this increase.
      After describing some current policies and programs, it identifies strategies for
      sustaining and expanding volunteerism by elders in the future.

PMID- 8468014
TI  - Amenity retirement migration process: a model and preliminary evidence.
AB  - A heuristic model of the retirement migration process was developed and explored
      using survey data from 586 migrants to western North Carolina. Five distinct
      subgroups were investigated: those who went from part- to full-time residency;
      those who thought about not migrating; individuals who migrated, remained in the
      labor force for a short period, and then retired; people who made two retirement
      migrations; and destination-selecting versus destination-specific migrants.

PMID- 8468016
TI  - The effects of caregiving on women's Social Security benefits.
AB  - Using data from the Social Security Administration's 1982 New Beneficiary Survey,
      we tested a life-course model that suggests that early- and late-life caregiving
      reduce monthly Social Security benefits of newly retired women workers. Each
      child raised was associated with a loss of $8 to $16 dollars in the 1983 Social
      Security primary insurance amounts (PIAs). The 1983 PIAs of women leaving their
      last jobs to care for others were $127 lower than the PIAs of women who left
      because of the availability of Social Security benefits, to receive a pension, or
      because they wanted to retire. Leaving work to care for others exerted a stronger
      depressing effect on the Social Security benefits of women with low- and moderate
      as opposed to high-earnings histories.

PMID- 8468017
TI  - A meta-analytic review of interventions for caregiver distress: recommendations
      for future research.
AB  - This review summarizes articles from 1980 to 1990 on psychosocial interventions
      and respite care for caregivers. The review was limited to controlled studies
      that attempted to change emotional distress in caregivers. Cumulatively, they
      suggest that individual psychosocial interventions and respite programs are
      moderately effective; psychosocial interventions with groups are less so.

PMID- 8468018
TI  - Depressive symptoms in family caregivers of long-stay patients.
AB  - Factors contributing to depressive symptoms in a group of 67 family caregivers of
      hospitalized "long-stay" patients were investigated. Levels of depressive
      symptoms were quite high and were related to level of patient dependency,
      caregiver's health, feeling too many demands were being made on the caregiver,
      feeling torn between the patient's needs and the caregiver's own needs, not
      getting enough rest, amount of time spent in caregiving activities, feeling
      someone else could take over caregiving if necessary, and perceptions of staff.
      The factors contributing to depressive symptoms differed among spouses, children
      and other caregivers, but for all the strongest contributor was experiencing
      difficulty with staff.

PMID- 8468019
TI  - A task-specific typology of intergenerational family structure in later life.
AB  - We tested a typology of intergenerational social support structure with data from
      910 dyads of older adults and their primary child helpers. Logistic regression
      was used to identify variables that differentiate dyads with distinct support
      configurations. Household support provided to elderly parents was more sensitive
      to physical and social deficits and geographic distance, whereas social-emotional
      support was more sensitive to norms and personal affinity.

PMID- 8468020
TI  - Using an imaginary scrapbook for neurolinguistic programming in the aftermath of
      a clinical depression: a case history.
AB  - We employed neurolinguistic programming (NLP) principles to develop a positive
      self-identity in an elderly male patient in England recovering from clinical
      depression. This novel technique encouraged recall of intrinsically rewarding
      past experiences. Each experience was conceptualized in an image and compiled
      chronologically in an imaginary book, providing continuity to what were chaotic
      and fragmented recollections during the immediate postdepressive stage. The
      patient's anxiety and depression were alleviated and his own functional goals
      largely realized.

PMID- 8468021
TI  - A center on ethics in long-term care.
AB  - Long-term care institutions are beginning to grapple with ethical issues on a
      regular basis. This has encouraged facilities to develop new mechanisms to deal
      with these issues. Described is a tripartite program that incorporates direct
      service, education, and research in ethics.

PMID- 8468022
TI  - Cytostatic effects of horseradish and thyroid peroxidase derived free radicals.
AB  - An otherwise noncytostatic flux of H2O2 from glucose and glucose oxidase became
      cytostatic to cultured Chinese Hamster Ovary (CHO) cells when horseradish or
      thyroid peroxidase was added to the culture medium. Electron spin resonance (ESR)
      measurements showed that one or more factors present in the culture medium
      promote the one-electron oxidation of a reduced nitroxide or glutathione in an
      H2O2/peroxidase-dependent process. Moreover, a reduced nitroxide conferred
      significant protection against the cytostatic effect of H2O2/peroxidase.
      Cytostatic effects were not only seen in the presence of the active
      H2O2/peroxidase system, but also in media which had been preexposed to
      H2O2/peroxidase but no longer contained an active H2O2 generating system. It is
      suggested that peroxidases oxidize one or more factors in tissue culture media to
      free radicals, which react with nearby components of cells or form toxic
      products, causing growth inhibition. If similar free radical precursors are
      present in tissue fluids, some of the toxicity of H2O2 in vivo may be due to
      peroxidase-mediated endogenous free radical generation.

PMID- 8468023
TI  - Diphenylamine: an unusual antioxidant.
AB  - Diphenylamine (DPA) has been utilized as an antioxidant in studies of lipid
      peroxidation. Using peroxidizing red blood cell (RBC) membranes, we find that DPA
      actually promotes lipid hydroperoxide (LOOH) formation and oxygen consumption
      while markedly inhibiting generation of thiobarbituric acid reactive substances
      (TBARS). As a consequence, DPA increases the prelytic RBC K leak that results
      from peroxidative stress and potentiates a known nonprelytic but LOOH-dependent K
      leak pathway in RBC. In contrast, DPA abolishes formation of cyclooxygenase
      dependent conversion products of arachidonate. DPA is almost as efficient as BHT
      in inhibiting peroxyl radical mediated destruction of phycoerythrin fluorescence.
      Study of DPA analogues shows that the antioxidant effect of DPA lies in its
      secondary amine function. Presumably, this results in intermediate formation of a
      nitrogen-based radical so that redox cycling of this aromatic amine stimulates
      further peroxidation. This dramatically illustrates the hazard of relying solely
      on TBARS measurements for assessment of peroxidation.

PMID- 8468024
TI  - Lipid hydroperoxides potentiate mesenteric artery vasoconstrictor responses.
AB  - The aim of this study was to investigate the effects of lipid and organic
      hydroperoxides on vasomotor activity of isolated rat superior mesenteric
      arteries. Hydroperoxides did not elicit measurable responses in unstimulated
      (quiescent) mesenteric arteries. Contractile responses to potassium, however,
      were significantly potentiated by 13-(s)-hydroperoxylinoleic acid (range 3-54
      microM). Potentiation of potassium responses by linoleic acid (18:2) and
      linolenic acid (18:3) was increased by pretreatment of the fatty acids with
      lipoxygenase (p < .01). Lipoxygenase alone had no contractile effects.
      Lipoxygenase-treated 18:2, tert-butyl hydroperoxide, and hydrogen peroxide
      augmented contractile responses to phenylephrine, but to a lesser degree than
      corresponding augmentation of potassium responses. Contractile responses to
      lipoxygenase-treated 18:3 were blunted by vitamin E (p < .02) and by nitroblue
      tetrazolium (p < .02), whereas catalase and mannitol had no effects, implicating
      lipid free radicals in the contractile response. Responses to lipid
      hydroperoxides were not significantly altered by prostaglandin inhibitors.
      Endothelial cell denudation significantly enhanced the contractile responses
      elicited by 13-(s)-hydroperoxylinoleic acid (p < .05), indicating that lipid
      hydroperoxides enhance agonist-induced contractions by a direct effect on the
      smooth muscle. These results support a hypothesized link between lipid
      peroxidation and development of altered vascular function. They further suggest
      that the vascular endothelium may play an important role in regulation of
      vasomotor responses to lipid hydroperoxides.

PMID- 8468025
TI  - Antioxidant enzyme activities in IDD-prone and IDD-resistant mice: a comparative
      study.
AB  - Insulin-dependent diabetes (IDD) in the nonobese diabetic (NOD) mouse is believed
      to result from the specific autoimmune destruction of pancreatic beta cells. The
      frequency of diabetes in the NOD mouse is sex-dependent, with approximately 90%
      of females and 40% of males developing clinical diabetes by 40 weeks of age.
      Recently, attention has focused on determining possible mechanisms for beta cell
      destruction. One potential mechanism is the toxic effect of free oxygen radicals
      produced as a result of the influx of inflammatory cells into the pancreas. A
      deficiency in available antioxidant enzymes could form a basis for diabetes
      susceptibility. To test the feasibility of this idea, we have compared the
      activities of superoxide dismutase, catalase, glutathione peroxidase, and
      glutathione reductase in isolated islets, pancreas, and other tissues of age- and
      sex-matched NOD, BALB/c, C57BL/10, and B10.GD mice. Enzyme profiles revealed that
      female NOD mice do not differ significantly in antioxidant enzyme activity from
      females of the other inbred strains. However, antioxidant enzyme activity in
      females was generally lower than in males regardless of mouse strain. While
      isolated islet cells exhibited somewhat lower levels of enzyme activity than
      other tissues, the islets of NOD mice proved to be no more deficient than those
      of BALB/c mice. Therefore, it is unlikely that any toxic effect of free oxygen
      radicals on the beta cells of NOD mice results directly or solely from an
      antioxidant enzyme deficiency. Nevertheless, one possible explanation for the
      lower incidence of diabetes in NOD males versus females may be the inherently
      higher male antioxidant enzyme activities.

PMID- 8468026
TI  - Evidence that the large loss of glutathione observed in ischemia/reperfusion of
      the small intestine is not due to oxidation to glutathione disulfide.
AB  - Reperfusion injury following ischemia is thought to be the consequence of
      reactive oxygen species possibly generated either by xanthine oxidase activity or
      by processes associated with neutrophil activation in the affected organ or
      tissue. The conversion of xanthine dehydrogenase to the oxidase as well as the
      interactions between endothelium and neutrophils in the margination and
      activation of the latter are all considered to be results of conditions resulting
      from the ischemic episode. Determination of the redox status of glutathione in an
      ischemic/reperfused organ is frequently employed as an indicator of oxidative
      stress created by the production of oxygen free radicals during the reperfusion
      period. In this procedure, the ratio of oxidized glutathione (GSSG) to total
      glutathione (GSH + GSSG) is utilized to demonstrate the proportion of glutathione
      oxidized during reperfusion. We determined this ratio in the rat small intestine
      during ischemia and reperfusion and found that while the ratio of GSSG/(GSH +
      GSSG) does increase, this increase was the result of GSH disappearance rather
      than an increase in GSSG, and that essentially all of this loss occurred during
      the ischemic episode. We demonstrated that no oxidation of GSH occurred that was
      attributable to reperfusion per se; nor was there an increase of GSSG during this
      reoxygenation period.

PMID- 8468027
TI  - Free radicals and calcium homeostasis: relevance to malignant hyperthermia?
AB  - The regulation of intracellular free calcium ions (Ca2+) in skeletal muscle at
      rest and during contraction depends on mechanisms such as Na(+)-Ca2+ exchangers,
      Ca(2+)-ATPases, and the voltage-sensitive ryanodine receptor. The susceptibility
      of these regulatory mechanisms to free-radical-mediated damage may be increased
      because of their location within the lipid membranes of sarcolemma, sarcoplasmic
      reticulum, and mitochondrion with resultant uncontrolled increases in myoplasmic
      Ca2+ concentration and cell death. The potentially fatal pharmacogenetic
      disorder, malignant hyperthermia (MH), is characterised by muscle rigidity,
      arrhythmias, lactic acidosis, and a rapid rise in body temperature. The sequence
      of events responsible for the MH syndrome remains uncertain, but it has been
      variously ascribed to faults in many of the Ca2+ regulatory mechanisms. In swine
      the condition is associated with a specific mutation in the ryanodine receptor,
      whereas in humans the syndrome is genetically heterogenous. Free-radical-mediated
      peroxidation of membrane lipids and proteins also results in the rapid efflux of
      Ca2+ from organelles, and the detection of products of free radical reactions in
      tissue from MH-susceptible individuals using electron spin resonance spectroscopy
      provides evidence for the involvement of free radicals in the MH syndrome.

PMID- 8468028
TI  - Ozone exposure inhibits cardiac protein synthesis in the mouse.
AB  - Ozone is a major environmental oxidant pollutant. Following ozone inhalation,
      there are a number of marked pulmonary responses depending on the extent and
      duration of exposure. Recently it has been established that ozone exposure may
      also result in cardiac injury. In this study we show that exposure of mice to 800
      ppb ozone for as little as 6 h results in a 16% decrease in cardiac protein
      synthesis rates (p < .02). The fall in protein synthesis is due primarily to a
      reduced rate of ribosomal efficiency (40%) in the hearts of ozone-exposed mice.
      This change in cardiac protein metabolism is accompanied by increased levels of
      two markers of tissue injury: edema and protein carbonyl content. It is unlikely,
      however, that these observations represent a direct action of ozone on the heart,
      but rather an indirect effect, possibly mediated by lipid peroxidation products
      generated in the lung.

PMID- 8468029
TI  - [Perioperative preventive use of antibiotics].

PMID- 8468030
TI  - Significance of animal studies for perinatal research.
AB  - Only recently has it been possible to access human fetuses to obtain blood
      samples in utero, and to monitor circulatory dynamics by ultrasound. Most of our
      knowledge of fetal physiology and metabolism has been derived from animal
      studies. Using techniques of chronic implantation of intravascular catheters and
      specialized methods for measuring organ blood flow, cardiac output, and vascular
      pressures, much has been learned about normal fetal vascular physiology and its
      responses to stress. In addition, it has been possible to simulate abnormal
      morphology and to examine its effects on fetal function. Caution should be
      exercised in directly relating information obtained from animal studies to the
      human fetus. Differences in maturity at the time of birth, and in morphology,
      such as relative brain to body weight, must be taken into consideration.

PMID- 8468031
TI  - Umbilical artery flow velocity waveform analysis and assessment of fetal
      oxygenation.
AB  - Assessment of the fetal condition is an important but also difficult problem.
      During the last decades a number of new fetal monitoring techniques have been
      introduced into clinical practice without proper evaluation regarding its value
      for clinical practice beforehand. The last fetal monitoring technique introduced
      into clinical practice in such a way is the assessment of the fetal condition
      with umbilical artery flow velocity waveform analyses. Although in cases with
      zeroflow or reverse flow during diastole the complication rate is high, it is not
      possible to assess the fetal oxygenation by means of recording the umbilical
      artery pulsatility index and its changes. Moreover no adequate treatment of fetal
      hypoxia is yet available, except termination of pregnancy. It is important in
      this context to realize that prematurity in itself is still the most powerful
      determining factor for the further development of the child.

PMID- 8468032
TI  - [Clinical etiologies in fetal hypoxia in pregnancy].

PMID- 8468033
TI  - Uterine contractions and their possible influence on fetal oxygenation.
AB  - There is now ample evidence that during uterine contractions the utero-placental
      blood flow diminishes leading to a temporary decrease of fetal oxygenation.
      Although the fetus lives at a body temperature of 38 degrees Celsius, the
      adaptive mechanisms seem to be well attuned to sustain this relative oxygen
      deprived situation during pregnancy and also during labour. Nevertheless in
      clinical obstetrical practice the fetus can dy in utero or survive with
      neurologic handicaps. This is a rare event in term low risk babies with a
      bodyweight appropriate for gestational age (AGA) in contrast to obstetrical
      pathology that can jeopardize especially infants small for gestational age (SGA).

PMID- 8468034
TI  - [The fetal cardiovascular reaction to acute and chronic hypoxia].

PMID- 8468035
TI  - [Circulation and energy supply to the fetal brain in hypoxia: relation to early
      childhood brain damage].

PMID- 8468036
TI  - [Effects of fetal hypoxia on later life. Late prognosis of asphyxia neonatorum].

PMID- 8468037
TI  - [The significance of perinatal data for perinatal research].

PMID- 8468038
TI  - [Importance of technical advances for CTG monitoring in the near future].

PMID- 8468039
TI  - [Physiologic and biochemical mechanisms of O2 supply of the fetus].

PMID- 8468040
TI  - Identification and partial characterization of a candidate gene for X-linked
      retinopathies using a lateral approach.
AB  - Using library to library cross-screening we have identified a number of genomic
      clones that harbor X-linked sequences expressed in the human choroid/retina. We
      describe the characterization of one of these, designated XEH.8 (DXS542), which
      is localized to Xp11.3-q12. Isolation, partial sequencing, and Northern analysis
      of the cognate cDNA (XEH.8c), has shown that the cDNA has some homology to the
      dystrophin gene and hybridizes to a 10-kb mRNA present in the choroid and retina
      but not in fibroblasts. This expressed sequence maps to the same region of the X
      chromosome as several known X-linked ophthalmic diseases, including Norrie
      disease, retinitis pigmentosa 2, congenital night blindness and Aland Island eye
      disease.

PMID- 8468041
TI  - Key features of cereal genome organization as revealed by the use of cytosine
      methylation-sensitive restriction endonucleases.
AB  - Unlike mammalian genomes, cereal (Gramineae) genomes exhibit little suppression
      of CpG dinucleotides. In cereal genomes, however, most of the numerous potential
      recognition sites for CpG methylation-sensitive restriction enzymes are
      methylated. Analysis of cereal genomic libraries and of regions flanking genes
      indicates that unmethylated NotI sites are useful landmarks for regions
      containing genes/single-copy sequences. Studies of a rye chromosome arm indicate
      that its pericentromeric region has a reduced density of unmethylated NotI (and
      MluI) sites and therefore of genes. Unmethylated MluI and NruI sites are
      distributed nonrandomly in the genomes of wheat, barley, and rice. Analysis of
      the genomic blocks defined by these sites in wheat and barley indicates that they
      are most likely to have arisen by amplification. These observations form the
      basis of a proposed model for the organization and evolution of the wheat,
      barley, and rice genomes.

PMID- 8468042
TI  - Novel sequences conserved on the human and mouse X chromosomes.
AB  - We have cloned and mapped 28 single-copy probes from a pool of cosmids derived
      from the human X chromosome. Four of the probes detected strongly conserved
      sequences in murine DNA; all have been localized to the proximal region of the
      human X chromosome short arm. Comparative mapping of these sequences in the mouse
      genome demonstrates that, while X linkage is conserved, this region of the human
      X chromosome is not maintained as a contiguous segment on the mouse X chromosome.
      The mapping of one novel conserved sequence between Plp and Pdha1 on the mouse X
      chromosome defines a previously unknown region of homology. The mapping of
      another probe that detects a novel sequence family (DXF34) close to the X
      chromosome centromere in both species suggests that a block of pericentromeric
      material is conserved between the X chromosomes of man and mouse.

PMID- 8468043
TI  - Isolation and mapping of human chromosome 21 cosmids using a probe for RTVL-H
      retrovirus-like elements.
AB  - We have explored the usefulness of a cloned low-repetitive DNA element, termed
      RTVL-H, for the region-specific isolation of DNA cosmids from chromosome 21.
      Hybridization of the RTVL-H element as a probe to genomic Southern blots of DNAs
      from a chromosome 21-specific somatic cell hybrid panel demonstrated the presence
      of at least seven RTVL-H-related sequences in defined regions dispersed over the
      chromosome. Some of the RTVL-H sequences detected by using the chromosome 21
      specific somatic cell hybrid panel were subsequently isolated from a chromosome
      21-specific cosmid library and mapped using somatic cell hybrids. In general,
      close correspondence was found between mapping results obtained using the
      consensus RTVL-H probe on the chromosome 21-specific somatic cell hybrid panel
      and the more precise mapping obtained using cosmids. The results demonstrate that
      sequences such as the RTVL-H element can be used for isolating region-specific
      sequences.

PMID- 8468044
TI  - Deletion mapping and a highly reduced radiation hybrid in the Xp22.3-p22.2
      region.
AB  - The human Xp22.3-p22.2 region contains several known disease genes as well as
      distinctive families of low copy repetitive sequences. In this study, we have
      developed new tools to more finely map this area. We have characterized a mapping
      panel of various cell lines and hybrids with different molecular breakpoints as
      defined by previously mapped reference markers from this region. The panel
      subdivides this area into nine distinct regions from DXS41 through the
      pseudoautosomal boundary. We have also identified a radiation-reduced somatic
      cell hybrid, Z4-7, that contains DXS31, DXS452, STS, DXS143, and DXS85, but not
      PABX, DXS16, or other single-copy probes from proximal Xp and Xq. A phage library
      was constructed from Z4-7 and over 80,000 plaques were screened with total human
      DNA. More than 100 positive clones were identified as potential new markers in
      this region. Nine of these have been mapped to the hybrid panel, and unique
      subclones have been isolated from three of these markers. The panel has also
      allowed us to map several other DNA markers, genes (AMG, OA1), and repetitive
      elements of the DXF22S and DXF30S sequence families relative to the various
      breakpoints.

PMID- 8468045
TI  - Molecular characterization and mapping of murine genes encoding three members of
      the stefin family of cysteine proteinase inhibitors.
AB  - Stefins or Type 1 cystatins belong to a large, evolutionarily conserved protein
      superfamily, the members of which inhibit the papain-like cysteine proteinases.
      We report here on the molecular cloning and chromosomal localization of three
      newly identified members of the murine stefin gene family. These genes,
      designated herein as mouse stefins 1, 2, and 3, were isolated on the basis of
      their relatively increased expression in moth-eaten viable compared to normal
      congenic mouse bone marrow cells. The open reading frames of the stefin cDNAs
      encode proteins of approximately 11.5 kDa that show between 50 and 92% identity
      to sequences of stefins isolated from various other species. Data from Southern
      analysis suggest that the murine stefin gene family encompasses at least 6 and
      possibly 10-20 members, all of which appear to be clustered in the genome.
      Analysis of interspecific backcross mice indicates that the genes encoding the
      three mouse stefins all map to mouse chromosome 16, a localization that is
      consistent with the recent assignment of the human stefin A gene to a region of
      conserved homology between human chromosome 3q and the proximal region of mouse
      chromosome 16.

PMID- 8468046
TI  - Human lymphocyte-specific pp52 gene is a member of a highly conserved dispersed
      family.
AB  - For a better understanding of genes that potentially function in B lymphocyte
      cell signaling, we isolated the human genomic counterpart of the murine pp52 or
      LSP1 gene. We unexpectedly found that the human pp52 gene is one of four closely
      related loci. Representative cosmids from each of the four family members were
      isolated and chromosomally localized by fluorescence in situ hybridization.
      Nucleotide sequence was obtained from an exon common to each locus and
      demonstrated very close similarity among all four loci. Two of the four loci
      harbored dysfunctional frameshift mutations or premature translation stop sites.
      The exon of one locus was flanked by an 80-bp perfect inverted repeat, suggesting
      that it may have originated through a looped intermediate DNA structure. Through
      a series of cDNA hybridization studies and nucleotide sequence analyses we were
      able to unambiguously link the lymphocyte-expressed gene to the locus mapped to
      chromosome 11p15.5. This same chromosomal band has been involved in tumor-related
      chromosomal translocations found in chronic lymphocytic leukemia.

PMID- 8468047
TI  - High-resolution chromosomal localization of the human calcitonin/CGRP/IAPP gene
      family members.
AB  - We report the high-resolution localization of the human calcitonin/CGRP genes,
      CALCA, CALCB, and the pseudogene CALCP, to a 220-kb SacII fragment on chromosome
      11p15.2-p15.1, using prometaphase fluorescence in situ hybridization (FISH), two
      color interphase FISH, and pulsed-field gel electrophoresis analysis. The related
      islet amyloid polypeptide (IAPP) gene was assigned to human chromosome 12p12.3
      p12.1. The results support an evolutionary relationship between the
      calcitonin/CGRP genes and the IAPP gene and between parts of human chromosomes 11
      and 12.

PMID- 8468048
TI  - Molecular cloning of the b subunit of mouse coagulation factor XIII and
      assignment of the gene to chromosome 1: close evolutionary relationship to
      complement factor H.
AB  - The b subunit of human coagulation factor XIII (FXIII-b) is composed of 10 short
      consensus repeats (SCRs) characteristic of the regulatory proteins of complement
      activation system. A full-length cDNA clone of mouse FXIII-b was isolated and the
      entire sequence was determined. The predicted amino acid sequence showed 77.5%
      homology with human FXIII-b, although mouse FXIII-b contained seven extra amino
      acid residues at the carboxyl terminal. The strong reactivity of the translation
      product of this clone with rabbit anti-human FXIII-b antiserum confirmed that it
      encodes a mouse counterpart of the human FXIII-b. By in situ hybridization and
      mapping studies using 66 interspecific backcross mice, the mouse FXIII-b gene
      (designated F13b) was shown to be located on distal chromosome 1 closely linked
      to Cfh, extending a conserved linkage group between human and mouse chromosome 1.
      In addition, a significant structural similarity between FXIII-b and complement
      factor H is described.

PMID- 8468049
TI  - Molecular dissection of an extrachromosomal amplicon reveals a circular structure
      consisting of an imperfect inverted duplication.
AB  - A mouse fibroblast line, B-1/50, with a 4300-fold amplification of the adenosine
      deaminase gene locus (Yeung et al., 1983, J. Biol. Chem. 258: 8338-8345), was
      shown by in situ hybridization to harbor the amplified sequences on variously
      sized extrachromosomal elements. We show here that the smallest circle is
      approximately 500 kb. We describe a facile screening technique for identifying
      cosmid and yeast artificial chromosome (YAC) clones derived from the amplicon. A
      closed molecular map was generated by arranging the cosmids and YACs into a
      contig spanning over 250 kb of the adenosine deaminase gene locus. YACs from the
      two ends of this contig were shown to delimit a 250-kb inverted duplication. Long
      range mapping of a SalI partial digest of B-1/50 DNA is also consistent with the
      interpretation that the 500-kb adenosine deaminase amplicon in B-1/50 cells is an
      inverted duplication. The finding that this amplicon is the only or predominant
      structure containing amplified sequences in the B-1/50 cell line suggests that
      such structures are not inherently prone to high frequency rearrangement, even
      when present at such high copy number. This study provides the first molecular
      description of the structure of an episome involved in mammalian gene
      amplification. The implications of this finding for models of gene amplification
      and episome formation are discussed.

PMID- 8468050
TI  - Physical mapping and YAC contig analysis of the region surrounding Xist on the
      mouse X chromosome.
AB  - The Xist sequence has been proposed as a potential candidate for the X
      inactivation center based both on its localization within the candidate region
      for the X-inactivation center in man and mouse and on its unique pattern of
      expression from the inactive X chromosome. We have cloned 550 kb of DNA
      surrounding the mouse Xist sequence in contiguously overlapping YAC clones and
      have developed a long-range restriction map that spans almost 1 Mb of this region
      and includes this YAC contig. The detailed restriction map we have established
      provides a framework for the identification of expressed sequences other than
      Xist that may equally exhibit unusual expression characteristics associated with
      X inactivation. The presence of possible structural or methylation differences
      within this region between the active and inactive X chromosomes has been
      investigated through comparative analysis of male and female genomic DNA, and we
      report here the identification of certain CpG-containing restriction sites around
      Xist that have an interesting differential methylation status on the inactive and
      active X chromosomes.

PMID- 8468051
TI  - Physical mapping of 2000 kb of the mouse X chromosome in the vicinity of the Xist
      locus.
AB  - A physical map encompassing approximately 2.0 megabases (Mb) in the region of the
      mouse X-inactivation center has been constructed. The map extends from the Gjb-1
      locus to the Xist locus and demonstrates the order of probes inseparable by
      genetic analysis. The deduced locus order is as follows: Gjb-1, Ccg-1, DXCrc171,
      Rps4, Phka, DXCrc177, DXCrc318, Xist. Detailed physical mapping in the region
      between the Phka and Xist loci indicates the position of CpG-rich islands
      associated with the 5' end of genes. The DXCrc177 and DXCrc318 loci, both defined
      by probes derived from linking clones, are associated with CpG-rich islands. The
      map provides a framework for the isolation of underlying sequences in the mouse X
      inactivation center region.

PMID- 8468052
TI  - A 37-kb fragment common to the pericentromeric region of human chromosomes 13 and
      21 and to the ancestral inactive centromere of chromosome 2.
AB  - A YAC clone from a chromosome 21-specific partial library was localized by in
      situ hybridization to the pericentromeric region of chromosomes 13 and 21 and to
      the long arm of chromosome 2, where an ancestral inactive centromere is present.
      Restriction mapping of the insert showed that it may contain tandemly repeated
      DNA. Probes for alpha-satellite and satellite II and III failed to hybridize with
      the cloned DNA. Shotgun subcloning might reveal a sequence that seems to be
      specific for chromosome 21. Alu-PCR was performed to generate probes from the YAC
      clone to map it more precisely, using a somatic hybrid containing only human
      chromosome 21. The inter-Alu sequences thus isolated were found to be clustered
      in an approximately 37-kb-long fragment common to chromosome 2, 13, and 21, which
      might be involved in the centromeric function of these chromosomes.

PMID- 8468053
TI  - Structural organization of the human isovaleryl-CoA dehydrogenase gene.
AB  - Isovaleryl-CoA dehydrogenase (IVD) catalyzes the third step in leucine
      catabolism. The genetic deficiency of IVD causes isovaleric acidemia. The
      functional IVD gene spans approximately 15 kb and consists of 12 exons and 11
      introns, with the exon size ranging from 52 to 728 bp. The poly(A) addition site
      begins 21 nucleotides downstream of this signal. The 5'-flanking region contained
      typical promoter elements such as TATA and CAT boxes in addition to other
      putative regulatory sequences. The transcription start site appeared to be
      located 344 bp upstream of the initiator methionine codon. The GC content in this
      region is very high. In Northern blot analysis, the IVD cDNA probe hybridized to
      three RNA species of sizes 2.1, 3.6, and 4.8 kb, respectively. The 2.1-kb band
      corresponds to the size of IVD cDNA. The results from experiments using an IVD
      specific oligomer and stringent washes with 3.0 M tetramethylammonium chloride
      suggested that high GC content may have caused hybridization of the probe to the
      3.6- and 4.8-kb species.

PMID- 8468054
TI  - Isolation and characterization of a human pseudogene for the regulatory subunit
      RI alpha of cAMP-dependent protein kinases and its sublocalization on chromosome
      1.
AB  - Using a human cDNA (complementary DNA) encoding the regulatory subunit RI alpha
      of cAMP-dependent protein kinases (PKA) as a probe, a pseudogene for this PKA
      isoform was isolated from a human genomic library. The human RI alpha pseudogene
      was 89% similar to the open reading frame of the expressed human RI alpha at the
      nucleotide level. Several stop codons were found, indicating that the pseudogene
      does not encode a functional protein. The pseudogene also contained several
      frameshift mutations, small deletions, and insertions. No introns were found in
      the region corresponding to the open reading frame of the expressed RI alpha
      cDNA. Specific oligonucleotides for the RI alpha gene and pseudogene were
      constructed and used as primers in polymerase chain reaction (PCR) to amplify
      human DNA from healthy blood donors. Probing of the PCR products using
      oligonucleotides specific for the RI alpha gene and RI alpha pseudogene,
      respectively, showed the presence of both genes in the human genome. When DNA
      extracted from various somatic cell hybrids was amplified, it was shown that the
      RI alpha gene was located on human chromosome 17, whereas the RI alpha pseudogene
      was located in the p21-p31 region on chromosome 1. This is the first report
      describing a pseudogene for a subunit of cAMP-dependent protein kinases from any
      species.

PMID- 8468055
TI  - Isolation and characterization of the mouse thrombospondin 3 (Thbs3) gene.
AB  - The DNA sequence of the coding region of the mouse thrombospondin (TSP) 3 gene
      has been determined by analysis of both genomic and cDNA clones. Like TSP1 and
      TSP2, TSP3 has a homologous COOH-terminal domain and seven type III (Ca(2+)
      binding) repeats. However, TSP3 contains four, rather than three, type II repeats
      and lacks the type I (TSP or properdin) repeats and procollagen homology
      characteristic of TSP1 and TSP2. In addition, the NH2-terminal domain of TSP3
      differs markedly, both in sequence and in exon/intron structure, from that in
      TSP1 or TSP2. The gene is located on mouse chromosome 3, bands E3-F1, immediately
      upstream from the Muc1 (episialin) gene and is expressed in the developing mouse
      in a pattern that also differs from that of TSP1 or TSP2. Based on its structure,
      we suggest that TSP3 may play both a unique role in cell-matrix interactions and
      perform functions that overlap with those of TSP1 and TSP2.

PMID- 8468056
TI  - The human mast cell chymase gene (CMA1): mapping to the cathepsin G/granzyme gene
      cluster and lineage-restricted expression.
AB  - Genes encoding T-cell-receptor alpha/delta chains, neutrophil cathepsin G, and
      lymphocyte CGL/granzymes are closely linked on chromosomal band 14q11.2. The
      current work identifies the human mast cell chymase gene (CMA1) as the fourth
      protease in this cluster and maps the gene to within 150 kb of the cathepsin G
      gene. The gene order is centromere-T cell receptor alpha/delta-CGL-1/granzyme B
      CGL-2/granzyme H-cathepsin G-chymase. Chymase and cathepsin G genes are shown to
      be cotranscribed in the human mast cell line HMC-1 and in U-937 cells. Other
      cells transcribe cathepsin G or CGL/granzyme genes, but not chymase genes,
      suggesting a capacity for independent regulation. Comparison of the 5' flank of
      the chymase gene with those of cathepsin G and CGL/granzymes reveals little
      overall homology. Only short regions of the 5' flanks of the human and murine
      chymase gene sequenced to date are similar, suggesting that they are more
      distantly related than human and rodent CGL-1/granzyme B, the flanks of which are
      highly homologous. The expression patterns and clustering of genes provide
      possible clues to the presence of locus control regions that orchestrate lineage
      restricted expression of leukocyte and mast cell proteases.

PMID- 8468057
TI  - A novel zinc finger cDNA with a polymorphic pentanucleotide repeat (ATTTT)n maps
      on human chromosome 19p.
AB  - To isolate genes that contain zinc finger motifs, a human brain cDNA library was
      screened with an oligonucleotide complementary to the conserved "linker" sequence
      between adjacent zinc fingers. The insert of one positive clone of 1226
      nucleotides contained a novel open reading frame (ZNF121) with 9 zinc finger
      motifs; in addition, 10 repeats of the pentanucleotide sequence (ATTTT) were
      found 223 nucleotides after a stop codon and were followed by an Alu repeat. A
      sequence-tagged site of 172 nucleotides containing this repeat was defined by two
      oligonucleotide primers, mapped to chromosome 19 using commercially available
      mapping panels of hybrid cell lines, and designated D19S204. The pentanucleotide
      repeat was polymorphic in the members of CEPH families, with 7 alleles ranging in
      size from 147 to 197 nucleotides. The observed heterozygosity in unrelated CEPH
      parents was 58% (46 of 79). Genotypes from 34 informative CEPH families were used
      to perform linkage analyses with other polymorphic markers contained in the CEPH
      V5 database; strong linkage was found with markers on the short arm of chromosome
      19. The zinc finger cDNA described here maps in an area where other zinc finger
      sequences and multiple cosmid clones containing zinc fingers have been previously
      localized. The ease of scoring these polymorphic alleles indicates that
      pentanucleotide repeat polymorphisms may be a particularly useful class of DNA
      markers for linkage studies.

PMID- 8468058
TI  - A contiguous physical map of the pericentromeric region of chromosome 21q between
      D21Z1 and D21S13E.
AB  - We constructed a long range restriction map of the pericentromeric 21q region
      between the centromere, identified by the alphoid DNA sequence D21Z1, and
      D21S13E. The physical map showed the order and intermarker distances of five new
      loci, including two for which highly informative dinucleotide repeat
      polymorphisms were identified. The total distance between D21Z1 and D21S13E was
      2400 kb. Comparison of genetic and physical distances indicated that there is
      about 400 to 500 kb per centimorgan that is not significantly different from the
      average 470 kb per centimorgan for the whole of chromosome 21q. Our physical
      mapping results do not indicate suppression of recombination in pericentromeric
      21q.

PMID- 8468059
TI  - Characterization of the apolipoprotein AI and CIII genes in the domestic pig.
AB  - The apolipoproteins (apo) AI and CIII are important constituents of triglyceride
      rich lipoproteins and high-density lipoproteins. In humans, apo AI is believed to
      play an important protective role in the pathogenesis of arteriosclerosis,
      whereas apo CIII might be involved in the development of hypertriglyceridemia.
      Both human genes are located within a gene cluster on chromosome 11. Although the
      domestic pig has been widely used as an animal model in arteriosclerosis and
      lipid research, the porcine apolipoproteins genes are poorly characterized. In
      this report, the complete nucleotide sequences of the porcine apo AI and CIII
      genes are presented and we demonstrate, for the first time, apo CIII expression
      in the pig. Both genes are composed of four exons and three introns and resemble
      closely their human counterparts with regard to the transcriptional start sites,
      exon sizes, intron sizes, exon-intron borders, and the size of the intergenic
      region. The predicted pig apo AI is a protein of 241 amino acids, which is 2
      amino acids shorter than human apo AI. The protein sequence was found to be very
      homologous to apo AI sequences in other mammalian species. Apo AI expression was
      detected on the mRNA level in porcine liver and intestine. The apo CIII gene
      encodes a protein with 73 amino acids, which is 6 amino acids shorter than human
      apo CIII. In contrast to the three isoforms of apo CIII found in humans, only one
      major isoform was detected in the pig. Presumably this isoform is unglycosylated.
      In addition to apo CIII expression in the liver and the intestine, a truncated
      form of apo CIII mRNA was also found in porcine kidney. Our studies demonstrate
      the presence of an apo CIII gene, an apo CIII mRNA, and an apo CIII protein in
      the pig and, therefore, exclude a hypothesized apo CIII deficiency in these
      animals.

PMID- 8468060
TI  - A human chromosome 11 NotI end clone library.
AB  - A NotI end clone library has been constructed from a human-hamster hybrid cell
      line containing only human chromosome 11. Fifty-one NotI clones were chosen to
      characterize the library. The majority of NotI clones hybridize to small 15- to
      200-kb fragments and have proven to be valuable for chromosome 11 physical
      mapping by detecting fragments not previously recognized by random probes. These
      NotI end clones have been used to isolate corresponding NotI linking cosmids
      which were then used to identify adjacent NotI fragments on pulsed-field gels.
      The clones were mapped using fluorescence in situ hybridization and a somatic
      cell hybrid panel. Although these clones were localized over the entirety of
      chromosome 11, a nonrandom distribution was observed. Northern blot analysis
      indicated that 57% (17/30) of the NotI clones examined detected poly(A)+
      transcripts in HeLa cell RNA.

PMID- 8468061
TI  - An experimentally derived data set constructed for testing large-scale DNA
      sequence assembly algorithms.
AB  - A data set consisting of DNA sequences from a large-scale shotgun DNA cloning and
      sequencing project has been collected and posted for public release. The purpose
      is to propose a standard genomic DNA sequencing data set by which various
      algorithms and implementations can be tested. This set of data is divided into
      two subsets, one containing raw DNA sequence data (1023 clones) and the other
      consisting of the corresponding partially refined or edited DNA sequence data
      (820 clones). Suggested criteria or guidelines for this data refinement are
      presented so that algorithms for preprocessing and screening raw sequences may be
      developed. Development of such preprocessing, screening, aligning, and assembling
      algorithms will expedite large-scale DNA sequencing projects so that the complete
      unambiguous consensus DNA sequences will be made available to the general
      research community in a quicker manner. Smaller scale routine DNA sequencing
      projects will also be greatly aided by such computational efforts.

PMID- 8468062
TI  - Reassignment of the human ARH9 RAS-related gene to chromosome 1p13-p21.
AB  - The human ARH9 gene (originally rhoC), a member of the RAS gene superfamily, was
      initially isolated on the basis of cross-hybridization with a RAS-related cDNA
      from the marine snail Aplysia. The ARH9 gene locus was previously assigned to the
      telomeric region of chromosome 5q by isotopic chromosomal in situ hybridization
      and Southern analysis of somatic cell hybrid DNAs; the gene was noted to
      cosegregate with the CSF1 gene locus in human-rodent somatic cell hybrids
      carrying partial chromosomes 5, together with other human chromosomes. With the
      recent reassignment of the human CSF1 locus to chromosome 1, region p13-p21, it
      seemed important to reexamine the localization of the ARH9 gene, since it
      segregates 100% concordantly with the CSF1 locus in hybrid cells. Results of our
      investigation demonstrate that the ARH9 locus is also present in hybrids
      retaining chromosome 1, but not 5. Using hybrids carrying partial 1p, we mapped
      the ARH9 locus relative to other 1p loci, localizing the gene to the region 1p13
      p31. Fluorescence in situ hybridization to metaphase chromosomes with a genomic
      ARH9 clone refined the gene's localization to chromosome 1, bands p13-p21.

PMID- 8468063
TI  - A set of STS assays targeting the chromosome 22 physical framework markers.
AB  - The widespread use of the sequence-tagged site (STS) as a quick, efficient, and
      reproducible assay for comparing physical and genetic map information promises to
      facilitate greatly long-range goals of the mapping of the human genome. We have
      designed 21 STS assays for loci on human chromosome 22. These assays primarily
      tag the physical framework markers of the long arm of 22, but additional assays
      have been designed from known genes and loci in the neurofibromatosis 2 (NF2)
      region. The availability of these assays will make these loci available to the
      research community without physical transfer of materials and will serve as start
      points for further efforts to physically map chromosome 22 with yeast artificial
      chromosome clones.

PMID- 8468064
TI  - Assignment of the cysteinyl-tRNA synthetase gene (CARS) to 11p15.5.

PMID- 8468065
TI  - The human cell cycle gene CDC25B is located at 20p13.

PMID- 8468066
TI  - Regional localization of the CCAAT displacement protein gene (CUTL1) to 7q22 by
      analysis of somatic cell hybrids.

PMID- 8468067
TI  - Assignment of the human glutamate receptor gene GLUR5 to 21q22 by screening a
      chromosome 21 YAC library.

PMID- 8468068
TI  - Correction for apparent prolongation of mean transit time resulting from response
      time in a thermodilution system.
AB  - We investigated a method of correcting an apparent prolongation in the measured
      mean transit time (MTT), resulting from the response time of the thermodilution
      system. We measured the mean response times (MRT) for five commercially available
      thermistor-tipped catheters by recording their step function response curves. MRT
      is the sum of the time from the point of step change to the point of the first
      detection of change in temperature (latency time) plus the time from the first
      detection to the point of 63.2% of full response (time constant). By using a flow
      loop model filled with saline through a mixing chamber, we recorded pairs of
      thermodilution curves simultaneously with pairs of catheters, and studied the
      influence of MRT on MTT over the constant flow rates of 1-6 L/min. The difference
      in MRT's (delta MRT, second) between a pair of thermodilution systems correlated
      with the difference in MTT's (delta MTT, second) between a corresponding pair of
      thermodilution curves, yielding an equation: delta MTT = 1.07 delta MRT = 0.04 (n
      = 72, r = 0.95), delta MTT/delta MRT = 1.02 +/- 0.18 (mean +/- SD). We conclude
      that an apparent prolongation of MTT due to response time is removable by
      subtracting MRT from measured MTT.

PMID- 8468069
TI  - Temperature dependence of reflectance and transmittance of the artery exposed to
      air during laser irradiation.
AB  - Reflectance, transmittance, and temperature of the arterial wall exposed to air
      are measured during laser irradiation for different heating dynamics. Temperature
      dependence of the reflectance and transmittance is then deduced. Our results show
      a competing effect between temperature and dehydration, resulting in a distinct
      minimum of transmittance and maximum of reflectance. As a consequence, a direct
      correlation of reflectance and transmittance with temperature is only possible
      for a specific dynamics.

PMID- 8468070
TI  - Analytical study of temperature oscillations in living tissues.
AB  - A nonlinear, time-delay differential equation is postulated as a possible
      structure to describe the temperature dynamics at a point inside living tissue.
      The presented analysis explains how this differential equation can lead to four
      different temperature response types that have been previously observed in vivo.

PMID- 8468071
TI  - An RF concentrating method using inductive aperture-type applicators.
AB  - A method for concentrating em energy of a low frequency in hyperthermia is
      proposed. The phantom together with boli are placed between a pair of inductive
      aperture-type applicators. The calculated results show that the method can heat
      the deep portion of the phantom without overheating the fat layers excessively.

PMID- 8468072
TI  - Accelerometer type cardiac transducer for detection of low-level heart sounds.
AB  - New applications in phonocardiography require transducers with high sensitivity,
      low noise, and extended frequency range. This paper compares several different
      cardiac transducers and describes the development of a low-mass, accelerometer
      type cardiac transducer which fulfills these objectives. The accelerometer weighs
      approximately 5 g and has a theoretical sensitivity of 125 mV/g in the frequency
      range 200-800 Hz. The basic design allows for easy modification of sensitivity
      and resonant frequency. This transducer has been effective in detecting sounds
      associated with turbulent blood flow in partially occluded coronary arteries.

PMID- 8468073
TI  - Using compound electrodes in electrical impedance tomography.
AB  - In electrical impedance tomography, we inject currents and measure voltages to
      estimate an object's resistivity distribution. The electrode configuration
      affects measured voltage data because the electrode-skin contact impedance is
      high and varies with electrode location. We developed a compound electrode which
      is composed of two electrodes: a large outer electrode to inject current and a
      small inner electrode to sense voltage. We used these compound electrodes to
      measure voltages from a physical phantom. We showed that the measured voltages
      from the compound electrodes are smaller in amplitude than those from
      conventional electrodes. This demonstrates that the compound electrode can
      minimize contact impedance voltage drop from the measured data. We used a finite
      element model for the compound electrode and incorporated the model into the
      regularized Newton-Raphson reconstruction algorithm. We performed a sensitivity
      study and showed that the reconstructed resistivity distributions are less
      dependent on the unknown contact resistance values for a compound electrode than
      a conventional electrode and that the use of a compound electrode results in
      improved images for the reconstruction algorithm.

PMID- 8468074
TI  - Modeling the neuron-microtransducer junction: from extracellular to patch
      recording.
AB  - This paper is devoted to a detailed characterization of the neuron-to
      microtransducer junction, based on the equivalent electric-circuit approach. As a
      result, recording of action potentials can be simulated with the general-purpose
      network-analysis program SPICE. Both noble-metal microelectrodes and insulated
      gate FET's are considered. The responses of such devices are characterized as
      functions of several parameters, e.g., sealing impedance, density of ionic
      currents in the cell membrane, and spatial discontinuities of the adhesion
      process. It is shown that the various signal shapes reported in the literature
      can be reproduced and interpreted in terms of time derivatives of the action
      potential. In this way, the shape of any experimental signal can be interpreted
      on the basis of a specific sealing condition. Possible future improvements in
      microtransducer design, based on the proposed approach, are also suggested.

PMID- 8468075
TI  - Effects of local variations in skull and scalp thickness on EEG's and MEG's.
AB  - Many studies have been performed on the effects of various features of head
      geometry on electroencephalograms (EEG's) and magnetoencephalograms (MEG's) and
      on the accuracy with which electrical sources in the brain can be localized using
      these measurements. However, to date no studies have been performed of the
      effects of local variations in skull and scalp thickness. This paper presents a
      computer modeling study of the effects of such local variations. The results
      obtained in this study indicate that local variations in skull and scalp
      thickness have effects on EEG's and MEG's which range from a simple intuitive
      effect to complex effects which depend on such factors as source depth and
      orientation, the geometry of the variation in skull and scalp thickness, etc.
      These results also indicate that local variations in skull and scalp thickness
      cause EEG localization errors which are generally much less than 1 cm and MEG
      localization errors which are even smaller. These results also indicate that
      multichannel and single-channel MEG measurements will produce localization errors
      of approximately the same amplitude when there is a bump on the external surface
      of the head but that multichannel measurements will produce significantly smaller
      localization errors than single-channel measurements when a depression is present
      in that surface.

PMID- 8468076
TI  - A simulation of cardiac action currents having curl.
AB  - A digital simulation of a two dimensional cardiac slice has been performed. It is
      stimulated at the center and an action potential propagates outward. An
      anisotropic bidomain model is used in which fast sodium physiology connects the
      intracellular and extracellular domains. For cases in which the inner asymmetry
      (expressed as longitudinal versus transverse electrical conductivity) is greater
      than the outer asymmetry, a current flow pattern is observed for which there is
      nonzero curl. Such a result explains recent observations of nonzero Bz magnetic
      field detected above a slab of tissue in the x-y plane. The current loop
      producing this field consists of outer domain current in the longitudinal
      direction flowing around in space to return at the AP location in the transverse
      direction in the outer domain and then completing the loop in the longitudinal
      direction by passing distally through the AP in the inner domain where resistance
      is extremely low.

PMID- 8468077
TI  - Single-trial processing of event-related potentials using outlier information.
AB  - A new approach to extracting single-trial event-related information is described
      in this paper. This approach, called the outlier processing method (OPM), is
      based on the concept that event-related information is contained in EEG time
      series outliers. In particular, the OPM has been effective in extracting motor
      related information from single-trial EEG. An investigation into the viability of
      the OPM was carried out on single-trial EEG data from four subjects. The EEG was
      collected under two conditions: an active task in which the subject performed a
      skilled thumb movement and an idle task in which the subject remained alert but
      did not carry out any motor activity. The results of this investigation
      demonstrated that consistent single-trial motor related information can be
      successfully extracted using the OPM.

PMID- 8468078
TI  - A time domain approach for the fluctuation analysis of heart rate related to
      instantaneous lung volume.
AB  - This paper presents a time domain technique for estimating transfer
      characteristics from fluctuations of instantaneous lung volume (ILV) to heart
      rate (HR). An effective procedure for estimating the impulse response of HR to
      ILV is proposed. Pre- and post-processing procedures, including prefiltering of
      the HR signal, preenhancement of the high frequency content of the ILV signal,
      and post-filtering of the estimated impulse response, together with a random
      breathing technique, are shown to effectively reduce spurious transfer gain so as
      to get a stable estimate of the impulse response. Analysis of the data collected
      from fourteen healthy male subjects in various conditions revealed that there are
      three components in the impulse response: fast positive, delayed slow negative,
      and oscillatory. The effects of the autonomic blocking agents propranolol and
      atropine on these transfer characteristics are also described.

PMID- 8468079
TI  - On the efficacy of linear system analysis of renal autoregulation in rats.
AB  - In order to assess the linearity of the mechanisms subserving renal blood flow
      autoregulation, broad-band arterial pressure fluctuations at three different
      power levels were induced experimentally and the resulting renal blood flow
      responses were recorded. Linear system analysis methods were applied in both the
      time and frequency domain. In the frequency domain, spectral estimates employing
      FFT, autoregressive moving average (ARMA) and moving average (MA) methods were
      used; only the MA model showed two vascular control mechanisms active at 0.02
      0.05 Hz and 0.1-0.18 Hz consistent with previous experimental findings [Holstein
      Rathlou et al., Amer. J. Physiol., vol. 258, 1990.]. In the time domain, impulse
      response functions obtained from the MA model indicated likewise the presence of
      these two vascular control mechanisms, but the ARMA model failed to show any
      vascular control mechanism at 0.02-0.05 Hz. The residuals (i.e., model prediction
      errors) of the MA model were smaller than the ARMA model for all levels of
      arterial pressure forcings. The observed low coherence values and the significant
      model residuals in the 0.02-0.05 Hz frequency range suggest that the
      tubuloglomerular feedback (TGF) active in this frequency range is a nonlinear
      vascular control mechanism. In addition, experimental results suggest that the
      operation of the TGF mechanism is more evident at low/moderate pressure
      fluctuations and becomes overwhelmed when the arterial pressure forcing is too
      high.

PMID- 8468080
TI  - A new strategy for multifunction myoelectric control.
AB  - This paper describes a novel approach to the control of a multifunction
      prosthesis based on the classification of myoelectric patterns. It is shown that
      the myoelectric signal exhibits a deterministic structure during the initial
      phase of a muscle contraction. Features are extracted from several time segments
      of the myoelectric signal to preserve pattern structure. These features are then
      classified using an artificial neural network. The control signals are derived
      from natural contraction patterns which can be produced reliably with little
      subject training. The new control scheme increases the number of functions which
      can be controlled by a single channel of myoelectric signal but does so in a way
      which does not increase the effort required by the amputee. Results are presented
      to support this approach.

PMID- 8468081
TI  - Seat support surface optimization using force feedback.
AB  - The development, implementation and evaluation of an algorithm designed to find
      optimal seat support surfaces is presented. The algorithm has been developed and
      implemented on an active contour measurement device. The device consists of an
      array of positioning elements equipped with force sensors for feedback. With a
      patient seated on the array, the algorithm is designed to find a seat contour
      that optimally satisfies given performance criteria. The performance criteria are
      based on measured stiffness of the soft tissues. A theoretical development of the
      algorithm is presented along with the modifications made to the algorithm during
      implementation. The results from several tests using man-made test bodies and a
      prototype contour gage are presented to verify the algorithm's performance.

PMID- 8468082
TI  - The regenerative potential of plaque-induced peri-implant bone defects treated by
      a submerged membrane technique: an experimental study.
AB  - The aim of the present study was to experimentally induce peri-implant bone
      defects around three different types of implants by plaque accumulation and to
      determine whether new bone formation can occur on previously contaminated dental
      implants. Dental implants were placed into the mandibles of beagle dogs. Gross
      plaque accumulation around the implants was undisturbed for 3 months, which
      resulted in circumferential peri-implant bone defects. Bony defects surrounding
      the hydroxyapatite implants were significantly greater than those around the
      titanium implants. Surgical treatment consisted of granulation tissue removal,
      preparation of the implant surface, and the placement of an e-PTFE membrane over
      each test implant. Before the flap was closed to cover the implants, perforations
      were made into the cancellous bone. Each control implant received identical
      treatment, but without placement of a membrane. Surgical exposure after an
      uneventful submerged healing period showed evidence of closure of the peri
      implant bone defects. Corresponding histologic examination of 2-month sections
      demonstrated large amounts of rapidly formed lamellar bone beneath the membrane.
      Some areas of the previously contaminated implant surface showed evidence of "re
      osseointegration." These preliminary results support the hypothesis that plaque
      induced peri-implant bone defects can be successfully treated by a submerged
      membrane technique in the dog model.

PMID- 8468083
TI  - The biomechanics of force distribution in implant-supported prostheses.
AB  - Force distribution with natural teeth depends on micromovement induced by the
      periodontal ligament. The location and cusp inclination of the tooth
      qualitatively alter the force pattern. Osseointegrated implants do not have
      micromovement associated with force distribution. Force distribution to the
      osseointegrated implant interface is completely different than with natural
      teeth. Alterations in tooth location and cusp inclination are suggested to limit
      implant overload. Force distribution in splinted natural teeth and
      osseointegrated prostheses are compared. The mechanism of interface force
      distribution and the consequences of poor interface fit are interrelated. The
      differential mobility of splinted natural teeth affects diagnosis and treatment.
      However, combining natural teeth with an osseointegrated prosthesis requires new
      design principles.

PMID- 8468084
TI  - Surface analysis of four dental implant systems.
AB  - Dental implants obtained from four suppliers were analyzed by electron
      spectroscopy for chemical analysis and scanning electron microscopy. Three of the
      implants were delivered in a sterilized condition, while the fourth implant was
      delivered in a plasma-sprayed condition. The covering oxide layer consisted
      mainly of TiO2. Divalent and trivalent states of titanium were also detected,
      showing that TiO and Ti2O3 layers occurred. The thickness of the oxide formed on
      the plasma-sprayed implant was 3.4 nm. The oxide thicknesses of the sterilized
      implants were 4.6 +/- 0.4 nm. The surfaces of all samples were covered with
      organic contaminants. A strong fluorine signal was obtained from one sample,
      indicating that the supplier etches the implants in hydrofluoric acid. Calcium
      and zinc were found on the surfaces of all samples from one supplier, while
      calcium and silicon were found on the surfaces of the implants from another
      supplier. It is suggested that inorganic contaminants should be avoided because
      these species can possibly provoke the dissolution of titanium.

PMID- 8468085
TI  - Effect of hyperbaric oxygen therapy on osseointegration of titanium implants in
      irradiated bone: a preliminary report.
AB  - Four patients who had undergone combined surgical and radiotherapeutic treatment
      for maxillofacial cancer had osseointegrated titanium implants placed in the bone
      of the treated region at various intervals after irradiation. Preoperatively and
      postoperatively, hyperbaric oxygen therapy was administered to the patients at
      the level of 2 or 3 atmosphere absolute (ATA). Of the 21 fixtures placed, one was
      lost because of lack of osseointegration, rendering the survival rate 92.3%.
      Hyperbaric oxygen therapy seemed to be a viable method to improve the survival
      rate of fixtures in irradiated bone tissue.

PMID- 8468086
TI  - Bone grafts and Branemark implants in the treatment of the severely resorbed
      maxilla: a 2-year longitudinal study.
AB  - A combination of horseshoe-shaped iliac bone grafts and Branemark implants was
      used in 30 patients with severely resorbed maxillary alveolar ridges. All
      patients were followed clinically for 2 years and evaluated with regard to
      prosthesis stability, fixture survival, wound healing complications, and soft
      tissue conditions. Surgery was performed by the same oral surgeons using
      identical procedures, and the prosthetic treatment was performed by the same
      prosthodontist. The development group included the first 10 patients and the
      routine group included the following 20. Fixture survival in the development
      group was 54.4%, whereas 88.3% of the fixtures in the routine group have survived
      after 2 years. The average fixture survival in the study was 77.4%. Three
      patients in the development group lost all fixtures, primarily the result of
      trauma to the grafted region. With respect to the difficult situation many of
      these patients experienced, the survival rate should be considered most
      acceptable.

PMID- 8468087
TI  - Implant-supported fixed prosthesis treatment of a patient with Sjogren's
      syndrome: a clinical report.
AB  - Many completely and partially edentulous patients experience advanced xerostomia
      and have considerable difficulty wearing tissue-supported prostheses. A
      conservative, maximum bone preservation approach to immediate implant placement
      is presented. The surgical and prosthetic considerations for treating a patient
      with Sjogren's syndrome are reviewed and discussed.

PMID- 8468088
TI  - Effects of drill cooling and bone structure on IMZ implant fixation.
AB  - Alternating use of the original method of internal drill cooling with manual
      external cooling, one IMZ implant was placed in the diaphysis (compact bone) and
      metaphysis (spongy bone) of the left distal tibia in each of six sheep. After
      polyfluorochrome sequential labeling, two animals survived for 4, 8, and 16 weeks
      without functional loading of the implants. The drill holes and bone-implant
      reactions were evaluated in undecalcified ground sections and microradiographs,
      using computer-aided histomorphometry. At least 30% of all drill holes were
      incongruent, but up to 25% of the implant surfaces had primary bone contacts.
      Four weeks after implantation, distinct differences in the bone reactions could
      be determined between the experimental conditions. After both cooling methods,
      osteoclastic resorption had extended up to 0.5 mm into peri-implant compact bone
      and up to 0.18 mm into spongy bone. Based on the percentage of newly formed bone
      to-implant contacts, external cooling proved superior at all superficial drill
      hole levels in compact bone and in all spongy bone beds, while internal cooling
      was only better at the deeper drill hole levels in compact bone. After 8 and 16
      weeks, peri-implant bone remodeling led to further increased new bone-implant
      contacts, irrespective of incongruent drill holes or cooling methods. At all time
      periods, abraded titanium particles were observed within interfacial foreign body
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468089
TI  - Failures in the osseointegration of endosseous implants.
AB  - A total of 68 patients, 26 men and 42 women, aged 21 to 86 years, were treated
      with 204 endosseous implants (TPS, ITI, Bonefit, or Biolox) from 1985 to 1990.
      They were examined at their latest recall visit approximately 22.5 months after
      surgery, the range varying greatly between the implant systems used (from 4 to 60
      months). Fourteen implants were lost during the observation period because of
      failures in osseointegration. There were no statistically significant differences
      in success rates between the implant systems during the observation period. The
      Periotest values, however, differed between the Bonefit and ITI implants in
      maxillae (P < .001) and mandibles (P < .01), and between successful and failed
      TPS implants (P < .001, unpaired t test). In four of the failures, all ITI
      implants, the prosthetic restorations (fixed dentures and single crowns) had been
      lost. All other failures were treated by using the previous complete denture.
      Possible causes of failure included advanced age and poor general health of the
      patient, complications in the surgical procedures, and compromised oral hygiene.

PMID- 8468090
TI  - Prosthodontic restoration with dental implants and an intraoral cranial bone
      onlay graft: a case report.
AB  - In 1988, a 54-year-old edentulous patient received a cranial bone onlay graft
      with the immediate placement of five dental implants. Treatment procedures and
      early results of restoration are described.

PMID- 8468091
TI  - Infection in the male reproductive tract. Impact, diagnosis and treatment in
      relation to male infertility.
AB  - The following are the conclusions that can be derived from a review of the
      literature regarding the role of infection in the aetiology of male infertility.
      (i) Temporary inflammatory episodes in the male reproductive tract which are self
      limiting are probably common. (ii) Caution should be exercised in the use of
      leukospermia or bacteriospermia as parameters for glandular infection. (iii)
      There is a need for alternative techniques for detecting non-symptomatic deep
      pelvic infections in the male; one technique of great promise is rectal
      ultrasound. (iv) Rectal ultrasound indicates that a large number of men with poor
      sperm quality have a non-symptomatic, chronic prostatovesiculitis. (v) Increasing
      evidence implicates Chlamydia trachomatis as being a major cause of chronic non
      bacterial prostatitis. (vi) An important aspect of chlamydial infections in men
      may be that the male accessory sex glands may function as reservoirs for the
      organism, increasing the probability of infection in the female. (vii) Ureaplasma
      urealyticum may also play an important aetiological role in male infertility but
      its significance is confounded by its acknowledged function as a commensal in the
      reproductive tract. (viii) One of the manifestations of male reproductive tract
      infection is the induction of sperm autoantibodies. (ix) There is a need for more
      systematic controlled studies of the effects of antibiotic treatment on sperm
      quality with different preparations for extended periods using patient groups in
      which a glandular infection has been verified, e.g. by rectal ultrasonography.

PMID- 8468092
TI  - The influence of sperm density on the motility characteristics of washed human
      spermatozoa.
AB  - To study the effects of sperm density on the results of computer-assisted semen
      analysis (CASA), 10 washed semen samples were diluted and measured with the
      CellTrak/S CASA system in a concentration range of 10-180 x 10(6) spermatozoa/ml.
      All sperm motility parameters were influenced to some extent by sperm density.
      The motility percentage was influenced significantly in 5 samples (P < 0.005),
      the straight line velocity in all samples (P < 0.0005 in 7 samples), the
      curvilinear velocity in 3 samples (P < 0.005), the linearity in 9 samples (P <
      0.0005 in 6 samples) and the lateral head displacement in 9 samples (P < 0.005 in
      6 samples). In general, the CellTrak/S data are influenced significantly if sperm
      density exceeds 50 x 10(6) spermatozoa/ml. The influence of sperm density on the
      motility parameters can be explained both by the accuracy of the CASA system and
      by actual changes in the motility of the spermatozoa. In the light of other
      published studies, it is concluded that sperm motility measurements with CASA
      systems should be assessed using 25-50 x 10(6) spermatozoa/ml, especially in
      studies concerning lateral head displacement and the linearity, as in sperm
      hyperactivation studies.

PMID- 8468093
TI  - Enhancement of testosterone secretion by normal adult human Leydig cells by co
      culture with enriched preparations of normal adult human Sertoli cells.
AB  - An in-vitro method was developed to study Sertoli-Leydig cell interactions in
      man, using testes removed at the time kidneys were removed for transplantation
      from 6 young adult men (aged 17-45 years) after cerebral death. After collagenase
      digestion of testicular tissue, Leydig cells were purified on discontinuous
      Percoll gradients. Two fractions of Leydig cells, 'L2' and 'L3' which differed in
      their buoyant density (1.05 g < L2 < 1.06 g and 1.06 g < L3 < 1.08 g), were
      obtained. The Sertoli cell-enriched preparation was obtained from seminiferous
      tubular fragments after sequential treatment with glycine buffer to remove
      peritubular-myoid cells, a second collagenase digestion, mechanical fragmentation
      and washes to remove germ cells. Purified Leydig cells were then cultured either
      alone or together with Sertoli cells in culture dishes coated with collagen,
      fibronectin and laminin in a chemically defined medium without serum. The
      influence of co-culture on basal testosterone secretion was examined in 3
      successive 48 h periods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468094
TI  - Contents of fructose, citric acid, acid phosphatase, proteins and electrolytes in
      secretions of the accessory sex glands of the male golden hamster.
AB  - Secretions were collected from the ampullary gland, dorsolateral prostate,
      ventral prostate, coagulating glands and seminal vesicles of male golden hamsters
      aged 15-20 weeks. The concentrations of total protein, citric acid, fructose,
      acid phosphatase, chloride, sodium, potassium, calcium, magnesium and zinc were
      determined. The ampullary gland secreted predominantly citric acid, sodium and
      acid phosphatase. Zinc was secreted only by the prostatic complex, with the
      largest quantity coming from the coagulating gland. The highest concentrations of
      potassium, calcium and magnesium were found in secretions of the ventral
      prostate. The coagulating gland and dorsolateral prostate were the principal
      contributors to total protein. The hamster appears to be more related to the
      mouse than to the rat in terms of the secretory functions of its accessory sex
      glands.

PMID- 8468095
TI  - Immuno-competent cells in the murine epididymis following infection with
      Escherichia coli.
AB  - Epididymitis was induced by retrograde injection of Escherichia coli into the vas
      deferens of 28 mice. A group of 28 saline-injected animals served as controls. On
      Days 1, 3, 7 and 28, groups of seven animals were killed. Bacterial culture was
      performed. Leucocyte numbers and distribution were determined in epididymides. In
      infected mice, E. coli were isolated from all epididymides on Days 1 and 3, but
      only from five of seven epididymides on Days 7 and 28. One week after infection,
      the total number of macrophages rose from about 10 to 28%. Significantly
      increased macrophage percentages were also found in animals killed 28 days after
      infection. A simultaneous increase in MHC class II positive cells was seen on Day
      7. A total of 20% of the cells expressed MHC class II in infected epididymides
      (normal = 6%). A similar increase was found on Day 28 after infection. Most of
      the macrophages and MHC class II positive cells were located in the interstitium,
      fewer in the peritubular layer and nearly none in the epithelium. The main
      increase in these cells occurred in the interstitium and, to a lesser but
      significant extent, in the peritubular area. T-helper and T-suppressor/cytotoxic
      lymphocytes reached peak values on Day 28. The increase in T-lymphocytes and
      simultaneous appearance of plasma cells followed the increase in numbers of
      macrophages and MHC class II positive cells. They were located mainly in the
      interstitium. A sequential increase in leucocyte subsets and negative culture
      results for E. coli were observed on Days 7 and 28 (2/7 on each day). The
      inflammatory process was restricted to the interstitium.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8468096
TI  - Effects of high altitudes on finger cooling test in Japanese and Tibetans at
      Qinghai Plateau.
AB  - The influences of both hypobaric hypoxia and cold on peripheral circulation were
      studied using the finger cooling test (measurement of the decrease in finger
      temperature, measured at the dorsal surface of the finger, during immersion of
      the hand in 0 degrees C water for 20 min) at Qinghai Plateau. The same test was
      carried out at simulated altitudes in a 25 degrees C climatic chamber to separate
      the hypobaric hypoxia influence from that of cold. In Japanese subjects at
      Qinghai Plateau there was a significant difference between finger skin
      temperatures (FSTs) during 20 min of 0 degrees C water immersion at altitudes of
      2260 m and 4860 m by ANOVA. Mean finger skin temperature during the 20-min
      immersion (5-20 min, MST) measured at 4860 m was significantly lower than that at
      2260 m. In Tibetan subjects, there was also a significant difference between FSTs
      at 2260 m and at 4860 m by ANOVA. MST at 4860 m tended to be lower than that at
      2260 m. In the 25 degrees C climatic chamber, there was a significant difference
      between FSTs of Japanese expedition members at 2000 m and at 4000 m by ANOVA. MST
      was higher at 4000 m than at 2000 m, contrary to the data obtained in Qinghai. In
      conclusion, the higher skin temperature in response to local cold immersion,
      which would have been caused by stronger hypobaric hypoxia, must have been masked
      by the lower ambient temperature.

PMID- 8468097
TI  - Respiratory changes due to extreme cold in the Arctic environment.
AB  - Effects of acute exposure and acclimatisation to cold stress on respiratory
      functions were investigated in healthy tropical Indian men (n = 10). Initial
      baseline recordings were carried out at Delhi and thereafter serially thrice at
      the arctic region and once on return to Delhi. For comparison the respiratory
      functions were also evaluated on Russian migrants (RM; n = 7) and Russian natives
      (RN; n = 6). The respiratory functions were evaluated using standard methodology
      on a Vitalograph: In Indians, there was an initial decrease in lung vital
      capacity (VC), forced vital capacity (FVC), forced expiratory volume 1st s
      (FEV1), peak expiratory flow rate (PEFR) and maximum voluntary ventilation (MVV)
      on acute exposure to cold stress, followed by gradual recovery during
      acclimatisation for 4 weeks and a further significant improvement after 9 weeks
      of stay at the arctic region. On return to India all the parameters reached near
      baseline values except for MVV which remained slightly elevated. RM and RN showed
      similar respiratory functions at the beginning of acute cold exposure at the
      arctic zone. RN showed an improvement after 10 weeks of stay whereas RM did not
      show much change. The respiratory responses during acute cold exposure are
      similar to those of initial altitude responses.

PMID- 8468098
TI  - Seasonal adaptation of thermal and metabolic responses in men wearing different
      clothing at 10 degrees C.
AB  - Thermoregulatory responses at ambient temperatures of 20 and 10 degrees C in six
      male subjects wearing two different kinds of clothing were compared between
      summer and winter. The two different kinds of clothing were one insulating the
      upper half of the body lightly and the lower half of the body heavily (clothing
      A, the weight in the upper and lower halves of the body being, respectively, 489
      g and 1278 g) and the other insulating the upper half of the body heavily and the
      lower half of the body lightly (clothing B: 1212 g and 559 g). The major findings
      are summarized as follow. (i) Rectal temperature was kept significantly higher in
      clothing B than in clothing A both in summer and winter. (ii) The fall of rectal
      temperature was significantly greater in summer than in winter in both types of
      clothing. (iii) Mean skin temperatures and skin temperatures in the face, chest,
      thigh and leg were significantly lower at Ta of 10 degrees C in summer than in
      winter in clothing A, while skin temperatures in the face and thigh were also
      significantly lower at Ta of 10 degrees C in summer than in winter in clothing B.
      (iv) Metabolic heat production was higher in summer than in winter at 20 and 10
      degrees C in both types of clothing. (v) The subjects felt cooler and colder to
      Ta of 10 degrees C in summer than in winter in both types of clothing. These
      different responses occurring between summer and winter are discussed mainly in
      terms of total conductance and dry heat loss.

PMID- 8468099
TI  - Intraocular pressure (IOP) in relation to four levels of daily geomagnetic and
      extreme yearly solar activity.
AB  - The link between geomagnetic field activity (GMA), solar activity and intraocular
      pressure (IOP) in healthy individuals was investigated. The IOP of 485 patients
      (970 eyes) was recorded over three nonconsecutive years (1979, 1986, 1989) which
      were characterized by maximal solar activity (1979, 1989) or minimal solar
      activity (1986). The measurements were also correlated with four categories of
      GMA activity: quiet (level I0), unsettled (II0), active (III0), and stormy (IV0).
      Participants were also differentiated by age and sex. We found that IOP was
      lowest on days of level IV0 (stromy) GMA. The drop in IOP concomitant with a
      decrease in GMA level was more significant during periods of low solar activity
      and in persons over 65 years of age. There was a trend towards higher IOP values
      on days of levels II0 and IV0 GMA in years of high solar activity. Differences
      between the sexes and among individuals younger than 65 years were not
      significant. Our results show an interesting aspect of environmental influence on
      the healthy population.

PMID- 8468100
TI  - Myocardial infarct death, the population at risk, and temperature habituation.
AB  - Daily myocardial infarct deaths from Brisbane, 29 degrees 28' S, and Montreal, 45
      degrees 30' N, were used to derive a "pool of susceptible individuals". Pool size
      had no effect on the minimum death temperature but large pools increased the
      value of the acceleration temperature in Brisbane and the maximum death
      temperature in Montreal. Moderately sized pools in Montreal appeared to produce
      reduced death rates in cold conditions from both cold avoidance and habituation.
      A generalized relationship between temperature and myocardial infarct death is
      postulated.

PMID- 8468101
TI  - Photoperiod, temperature, and regional patterns of conceptions in the USA.
AB  - Twenty-two years of monthly values of birth data for the USA, 1967 through 1988,
      were analyzed by visual inspection. The data were transformed to remove the
      influence of length of month and of linear trend, and the values were lagged 9
      months to approximate the time of conception. Then, 11-year monthly averages were
      obtained and plotted as standard scores. Thus two 11-year sets of data were
      independently analyzed, providing the opportunity of replication. Four distinct
      temporal patterns were found, differing in month of occurrence of the initial
      trough and peak and the relative sizes of the two troughs; these characteristics
      of the temporal pattern change systematically with latitude in the eastern and
      midwestern states. Data from two other continents, the United Kingdom and
      Australia, also were analyzed using the same method and found to exhibit a
      temporal pattern during the year similar to the northern states of the USA. Two
      biologically relevant variables, temperature and photoperiod, were considered as
      possible controllers and regulators of the annual rhythmicity. Comparisons of the
      trends in conceptions with these environmental variables, and inspections of the
      temperatures and photoperiods at which peaks and troughs in conceptions were
      found, indicated that these environmental variables could not account for the
      annual rhythmicity in conceptions.

PMID- 8468103
TI  - Hypnotizability and facets of openness.
AB  - Absorption, a correlate of hypnotizability, is related to a broader dimension of
      openness to experience, one construal of the "Big Five" structure of personality.
      But openness itself is very heterogeneous, and some of its facets may be
      unrelated to hypnotizability. A total of 651 subjects completed a questionnaire
      measuring three different aspects of openness--absorption, intellectance, and
      liberalism--before receiving the Harvard Group Scale of Hypnotic Susceptibility,
      Form A. The three dimensions were only modestly related to each other, and only
      absorption was significantly related to hypnotizability. Adding intellectance and
      liberalism to absorption did not enhance the prediction of hypnotizability. The
      results indicate that the various facets of openness are rather different from
      each other and that the "Big Five" structure may need to be expanded. Absorption
      and hypnosis share a kind of imaginative involvement that is not necessarily part
      of other kinds of openness, such as intellectance and liberalism.

PMID- 8468102
TI  - Effect of running training on uncoupling protein mRNA expression in rat brown
      adipose tissue.
AB  - The effect was investigated of endurance training on the expression of uncoupling
      protein (UCP) mRNA in brown adipose tissue (BAT) of rats. The exercised rats were
      trained on a rodent treadmill for 5 days per week and a total of 9 weeks. After
      the training programme, a marked decrease in BAT mass was found in terms of
      weight or weight per unit body weight; there was a corresponding decrease in DNA
      content and a downward trend in RNA and glycogen levels. The UCP mRNA was present
      at a markedly decreased level in BAT of trained animals. In consideration of the
      reduced levels of mRNAs for hormone-sensitive lipase and acyl-CoA synthetase, the
      brown adipose tissue investigated appeared to be in a relatively atrophied and
      thermogenically quiescent state.

PMID- 8468104
TI  - Direct versus indirect suggestions: a conceptual and methodological review.
AB  - The article reviews the literature on the effects of direct versus indirect
      hypnotic suggestions. A conceptual and methodological analysis of direct versus
      indirect suggestions is also provided. Three conclusions follow from the review:
      (a) Contrary to views of Ericksonian hypnotists, suggestion style has little
      effect on objective responding to hypnotic test items; (b) studies of clinical-
      and laboratory-induced pain and other measures of subjective experience have
      yielded contradictory results--however, the best controlled studies have not
      indicated that indirect suggestions are superior to direct suggestions; and (c)
      there is insufficient evidence to conclude that hypnotizability level and
      suggestion wording interact, such that low hypnotizable subjects are particularly
      responsive to indirect suggestions. Methodological and conceptual problems in
      defining and studying hypnotic communications, the lack of rigorous experimental
      controls, and research issues and directions are highlighted.

PMID- 8468105
TI  - Response expectancy as a mediator of hypnotizability modification: a brief
      communication.
AB  - The role of response expectancy in bringing about increases in hypnotic
      susceptibility by use of the Carleton Skill Training Program (CSTP) was assessed
      with 27 subjects selected for their low hypnotizability scores. Subjects were
      randomly assigned to one of two conditions: 13 received the CSTP to increase
      their hypnotic susceptibility, and 14 received no training. In addition to
      assessing hypnotizability, hypnotic response expectancies were assessed before
      and after training. With pretreatment hypnotizability controlled, subjects in the
      training group scored significantly higher than control subjects on all self
      report measures of hypnotizability but not on a measure of observed behavioral
      response. Changes in response expectancy were found to be highly correlated with
      changes in hypnotizability. With changes in expectancy controlled, no significant
      differences between the trained and control groups were found.

PMID- 8468106
TI  - Hypnotic susceptibility and the endogenous eyeblink: a brief communication.
AB  - This study investigated the relationship between hypnotic susceptibility,
      hypnotic state, and the endogenous eyeblink with 36 undergraduates, who were
      assigned to four independent groups (waking-low, hypnotized-low, waking-high, and
      hypnotized-high susceptibles) on the basis of combined cutoff scores on both the
      Creative Imagination Scale and the Stanford Hypnotic Clinical Scale for Adults.
      The auditory vigilance task required subjects to discriminate between 200 ms and
      300 ms tones over a 35-minute period. Hypnotic depth was controlled across trials
      using the Long Stanford Scale of Hypnotic Depth. As predicted, high-susceptible
      subjects had a significantly lower blink rate than low-susceptible subjects. The
      predicted interaction between susceptibility and hypnotic state was also
      confirmed. High-susceptible subjects showed a significant decrease in blinking
      for the hypnotized condition, whereas low-susceptible subjects did not. The need
      for replication with more adequate measures of susceptibility is discussed.

PMID- 8468107
TI  - Hypnosis and attention deficits after closed head injury.
AB  - In a controlled study of patients attending a concussion clinic because of
      ongoing postconcussion symptoms, attention deficits were recorded in the head
      injured group for the aspects of alertness, assessed by the Continuous
      Performance Test (CPT), and processing capacity, assessed by a version of the
      Paced Auditory Serial Addition Test (PASAT). Selective attention was intact.
      Hypnotizability was assessed by the Harvard Group Scale of Hypnotic
      Susceptibility, Form A (HGSHS:A), with normal means and standard deviations found
      in both the concussed and control groups. There was a significant correlation,
      however, between HGSHS:A scores and PASAT scores in the concussed group only. The
      results of this preliminary study suggest that slower processing capacity after a
      closed head injury may predict higher hypnotizability and that hypnosis could be
      an appropriate rehabilitation technique for these patients who present with
      postconcussion symptoms.

PMID- 8468108
TI  - Iron protein succinylate in the treatment of iron deficiency: controlled, double
      blind, multicenter clinical trial on over 1,000 patients.
AB  - A prospective, controlled, double-blind, double-dummy, multicenter clinical trial
      was made to assess the efficacy and tolerability of iron-protein-succinylate (ITF
      282) in comparison with a well known iron preparation in the treatment of iron
      deficiency or iron deficient anemia. One thousand and ninety-five patients
      affected with iron deficiency or overt iron deficient anemia were randomized to
      receive either two ITF 282 tablets/day (60 mg iron each) or a commercially
      available ferrous sulphate controlled release tablet (one tablet containing 105
      mg iron/day). Five hundred and forty-nine patients received ITF 282; 546 patients
      were treated with ferrous sulphate. Both treatments lasted 60 days. The treatment
      outcome was checked by evaluating special hematology, symptomatology, safety
      hematology and hematochemistry. After two months of treatment, the normalization
      of the main hematologic parameters in both groups was detected. Although in the
      first month the reference treatment appears to provide somewhat faster results,
      at the end of the observation, the values of hematocrit, hemoglobin and ferritin
      were greater in the ITF 282 group, indicating a more progressive and steady
      therapeutic effect. The overall clinical rating was significantly in favor of ITF
      282, with 78.9% of favorable results vs 67.6%. By dividing the patient population
      according to pathological conditions (iron deficiency or overt anemia), or
      according to the etiopathogenesis of the iron deficiency (increased requirement,
      or increased loss in adults and in the elderly), separate analyses on the
      treatment outcome were made (and have been included). The general tolerability,
      although favorable with both treatments, was significantly more favorable with
      ITF 282. With this medication, 63 patients (11.5%) complained of 69 adverse
      reactions (25 heartburn, 19 constipation, 25 abdominal pain) vs 141 events
      reported by 127 patients (26.3%) with the reference medication (33 heartburn, 31
      epigastric pain, 23 constipation, 32 abdominal pain, 8 skin rash, 14 nausea).
      These observations confirm that, although the most modern preparations of ferrous
      sulphate exhibit a relatively low frequency of adverse events of limited clinical
      concern, it is nevertheless possible to decrease both the prevalence and the
      duration of such events without prejudice for the clinical efficacy, with the use
      of more "physiological" preparations in which the iron is reversibly bound to a
      protein carrier, thus effectively removing one of the main obstacles to the
      correct compliance with treatments that must be administered for prolonged
      periods of time.

PMID- 8468109
TI  - Effect of hydroxyzine and meperidine on arterial blood gases in patients with
      chronic obstructive pulmonary disease.
AB  - Hydroxyzine is frequently used to tranquilize chronic obstructive pulmonary
      disease patients, who may be concomitantly receiving narcotic analgesics.
      Therefore, its effect alone and in combination with meperidine on arterial blood
      gases and ventilation at rest were evaluated in 44 patient volunteers, who gave
      informed consent. Hydroxyzine, 1.5 mg/kg i.v. caused no significant decrease in
      PaO2 and pH, no increase in PaCO2 at 5, 10, 20, 30 and 60 min post-infusion (n =
      13, mean age = 63.4 years). Meperidine, 1.5 mg/kg i.v. caused a significant (p <
      0.001) reduction in PaO2 for 20 min with concomitant increase in PaCO2 (n = 14;
      mean age = 49.4 years). The combination of the same doses of hydroxyzine with
      meperidine i.v. caused no greater decrease in PaO2 or in pH or increase in PaCO2
      than did meperidine alone (n = 17; mean age = 52.6 years), indicating no greater
      ventilatory depression with the combination than with meperidine alone. The lack
      of significant pH decreases at 30 and 60 min further corroborates no potentiation
      of meperidine by hydroxyzine. In conclusion, hydroxyzine, even when given through
      the i.v. route in excess of the maximum i.m. therapeutic dose, caused no changes
      in PaO2, PaCO2 or pH in chronic obstructive pulmonary disease patients.
      Therefore, its i.m. administration resulting in lower blood levels than i.v., is
      not likely to cause ventilatory depression. Furthermore, hydroxyzine caused no
      potentiation of the ventilatory depression induced by meperidine, hence
      hydroxyzine may be safely employed in combination with meperidine.

PMID- 8468110
TI  - The antimicrobial actions of taurolin and other preparations on the pathogenic
      spectrum in dentoalveolar infections.
AB  - Bacteriological specimens from a total of 64 patients with six common, highly
      relevant clinical indications were collected for an in vitro investigation. By
      means of standard microbiological methods, 149 species of organism were
      differentiated, and their relative sensitivity to Taurolin, a broad spectrum
      chemotherapeutic and antitoxin, as well as 5 conventional finished
      pharmaceuticals were tested in agar diffusion tests. Taurolin, which was tested
      in 3 different galenic formulations, produced practically identical, but
      considerably wider zones of inhibition than all other compared products. In
      contrast to other substances which exhibited a failure rate of up to 24.8%, no
      gaps in the activity spectrum in the form of the lack of inhibition zone
      formation were observed.

PMID- 8468111
TI  - Heparin-induced transaminase elevations: a prospective study.
AB  - An intensive and prospective surveillance study of 54 patients hospitalized in
      the Internal Medicine Unit of Clinical Hospital of the Catholic University of
      Chile, who required heparin in the period between June and December of 1991 was
      done. The aim of the work was to characterize and study the incidence of the
      adverse reactions associated with heparin therapy, with special emphasis on
      abnormal serum transaminase elevation. Abnormal transaminase elevation was
      defined as a rise over 20% of the serum transaminase baseline value. For
      determining the serum transaminase level, a UV spectrophotometric method was
      used. The incidence of the adverse drug reactions (ADR) was 24.1% (13 ADR), 8 of
      which (14.8%) were related with heparin therapy. Three of them (5.5%)
      corresponded to alanine transaminase (ALAT) increase and five (9.3%) to aspartate
      transaminase (ASAT) elevation. By means of global introspection method, 3 cases
      of ALAT increases were defined as probable and 6 as possible, while 5 ASAT
      increases were estimated as probable and 14 as possible. All of them were of slow
      onset, did not require treatment and hospital stay was not prolonged. Two
      patients' characteristics--age and sex--were associated with the development of
      heparin-induced abnormal alanine transaminase concentrations. The younger male
      patients showed a greater frequency of heparin-induced ALAT elevation. However,
      this association was not observed with the heparin-induced ASAT increase. These
      reactions were dose-dependent. Patients with heparin-induced ALAT elevation
      received a dose of 154,220 IU +/- 72,970 IU in comparison to patients without
      that adverse reaction who received 96,210 IU +/- 40,340 IU. This difference was
      statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468112
TI  - Comparison of fluorescence polarisation immunoassay (FPIA) and high performance
      liquid chromatography (HPLC) methods for the measurement of flecainide in human
      plasma.
AB  - The precision and accuracy of HPLC and FPIA for the measurement of flecainide
      plasma levels were compared below, in and above the therapeutic range (200-1,000
      ng/ml). Following a calibration crossover study, five standard plasma solutions
      of varying flecainide concentrations (SPS) and 99 flecainide containing plasma
      samples of 24 in-patients (IPS) were analyzed with both methods. The results show
      that within the range of approximately 500-1,500 ng/ml, the two methods did not
      differ in either precision (expressed as coefficient of variation, CV) or
      accuracy (expressed as relative error, RE). Close to the lower limit and below
      the therapeutic range however, HPLC provided greater precision and accuracy than
      FPIA.

PMID- 8468113
TI  - Flomoxef, a new oxacephem antibiotic, does not cause hemostatic defects.
AB  - Antibiotics of the beta-lactam class may cause coagulation defects and bleeding.
      It has been suggested that N-methyltetrazolethiol (NMTT), a common side chain
      group at the 3'-position of the cephem or 1-oxacephem frame, could be responsible
      for the hypoprothrombinemic effect of the antibiotics and that it could inhibit
      the liver vitamin K-epoxide reductase activity. Flomoxef (6315-S) is a new
      oxacephem antibiotic which differs from latamoxef because it has [1-(2
      hydroxethyl)-1H-tetrazol-5-yl] thiomethyl (HTT) as a side chain at the 3'
      position of cephem group instead of NMTT and an extensive modification of 7 beta
      acylamino side chain. The present study was carried out to study its effects on
      vitamin K-dependent blood coagulation parameters in human volunteers. Ten adult
      patients (6 men and 4 women), suffering from chronic bronchitis, entered into the
      study. Each patient received ten 1 g i.m. injections of flomoxef at 12-hourly
      intervals. Apparently, the treatment with this oxacephem antibiotic had no
      significant effect. PT, PTT and fibrinogen remained in the normal range in all
      patients and factors II+VII+X, protein C, protein S and AT III were not depleted.
      The trend was similar both in men and women. Based on the results of the present
      study, we conclude that flomoxef is an antibiotic that does not exhibit an effect
      on blood coagulation, even in males.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468114
TI  - Comparison of the efficacy and safety of amikacin once or twice-a-day in the
      treatment of severe gram-negative infections in the elderly.
AB  - The aim of this study was to compare the efficacy and safety of amikacin given
      either as single injection or as two injections within 12-h interval in the
      treatment of severe gram-negative infections in elderly patients. Thirty-nine non
      selected consecutive patients of a general internal medicine facility were
      randomized to receive the same total daily dose of amikacin either as a single
      dose (19 patients) or divided into two doses injected at 12-h interval (20
      patients). Amikacin was used alone or in combination with metronidazole,
      clindamycin, fosfomycin or a beta-lactam. Clinical and bacteriological responses
      were satisfactory and comparable in the two groups. There was no difference
      between the once/day and the twice-a-day groups with respect to drug dosage,
      duration of therapy and concomitant treatment. Only one patient (BID group)
      showed a rise of serum creatinine during the observation period. Amikacin alone
      or in combination can be regarded as an efficacious and safe antibiotic in the
      treatment of severe gram-negative infections in elderly patients, whether the
      daily dose is administered in a single infusion or in a BID interval.

PMID- 8468115
TI  - Effects of SK&F 105685, a novel anti-arthritic agent, on immune function in the
      dog.
AB  - SK&F 105685 (N,N-dimethyl-8,8-dipropyl-2-azaspiro[4,5]decane-2-propanamine+ ++
      dihydrochloride) is a novel azaspirane with beneficial activity in animal models
      of autoimmune disease such as adjuvant-induced arthritis and experimental
      encephalomyelitis in the Lewis rat and lupus-like disease in the MRL mouse. The
      activity of SK&F 105685 in these models is associated with the induction of non
      specific suppressor cell (SC) activity as defined by the ability of cells from
      drug-treated animals to inhibit the proliferative response of lymphocytes from
      control animals to concanavalin A. To evaluate the immunotoxicologic potential of
      SK&F 105685, the effect on immune function of one month of dosing with 1
      mg/kg/day of SK&F 105685 was examined in the dog. Differential blood cell counts
      and ex vivo immune function assays were performed using blood collected before
      dosing on days 1 (baseline), 15 and 29, of the study. Immune function assays were
      performed on spleen cells on day 30. Under the conditions of the study, SK&F
      105685 displayed pharmacological activity as demonstrated by the induction of
      splenic SC activity. The drug did not affect the total number or relative
      percentages of the various white blood cell types present in peripheral blood and
      did not cause generalized immunosuppression. The ability of peripheral blood
      lymphocytes or spleen cells to produce IL-2 or proliferate in response to
      mitogenic stimulation was not affected by drug treatment. SK&F 105685 also failed
      to affect the candidacidal activity of polymorphonuclear leucocytes and spleen
      cells indicating that it is unlikely to compromise nonspecific resistance to
      infection. SK&F 105685 however, was able to inhibit the generation of a specific
      in vitro antibody response to sheep red blood cells (SRBC) by splenocytes from
      treated animals. Inhibition of the anti-SRBC antibody response was also observed
      upon addition of the drug to normal spleen cells. Addition of the drug at
      different time points during the culture period indicated that SK&F 105685 was
      interfering with an event(s) occurring during the first 72 h of culture. Taken
      together, these results suggest that, in a therapeutic setting, SK&F 105685 is
      unlikely to compromise the immune status of the host as it can down-regulate a
      specific immune response without causing generalized immunosuppression.

PMID- 8468116
TI  - Combined treatments with interferon (alpha,beta) plus PGA1 to control early
      infection with HTLV-I in primary cord blood-derived mononuclear cells.
AB  - Interferon (IFN) alpha and beta can activate an antiviral and immunomodulating
      response in primary cord blood-derived mononuclear cells (CBMC) exposed to
      infection with Human T-cell Leukemia Virus type I (HTLV-I), resulting in partial
      inhibition of early infection in vitro. On the other hand, PGA1, a PGE1-derived
      cyclopentenone prostaglandin, can inhibit in vitro the proliferation of virus
      infected CBMC, preventing the emergence of the potentially transformed clone. In
      order to achieve a complete control of HTLV-I infection in this experimental
      model, we evaluated whether the antiviral activity of IFNs and the
      antiproliferative activity of PGA1 could be preserved in a combination therapy
      scheme. Recipient CBMC were treated with IFN alpha or beta (1000 IU/ml) at the
      onset of the co-culture with lethally irradiated virus-donor MT-2 cells, followed
      by multiple treatments with PGA1 (4 micrograms/ml every 4 days, starting on day
      0) for 6 weeks post infection (p.i.). In PGA1-treated co-cultures the percentage
      of virus-positive CBMC was constantly doubled during culture time as well as the
      amount of viral transcripts and p19 virus core protein production were increased.
      The antiviral effects of IFNs, resulting in about a 50% reduction of the
      percentage of virus-positive CBMC and consequently in a partial inhibition of
      virus expression (HTLV-I transcription and p19 production) until 4 weeks p.i.,
      were suppressed by multiple PGA1 treatments. However, the antiproliferative
      effect of PGA1 was enforced in IFN-treated co-cultures, leading to earlier
      control of proliferation of virus-infected cells. Interestingly, infection of
      CBMC with HTLV-I was associated with persistent expression of 70 kDa heat shock
      protein (HSP70), for at least 4 weeks p.i. IFNs and PGA1 showed antagonistic
      effects on HSP70 production in infected CBMC. In fact, production of HSP70 was
      suppressed (or prevented) in IFN-treated co-cultures, tested 2 and 4 weeks p.i.
      The fact that the expression of HSP70 is apparently suppressed (or prevented) by
      IFN treatment is surprising, since expression of this protein family has been
      associated with antiviral immunity. PGA1 could totally reverse the IFN-mediated
      suppression of HSP70 expression in these co-cultures. It is presently unclear
      whether HSP70 expression is directly involved in the control of proliferation
      exerted by PGA1 against virus-infected CBMC or is an epiphenomenon associated
      with inhibition of cell growth.

PMID- 8468117
TI  - Pharmacokinetics of an immunomodulator peptidoglycan monomer in mice after
      intravenous administration.
AB  - A 14C labeled low molecular weight immunomodulator, peptidoglycan monomer (14C
      PGM), was injected intravenously (i.v.) into mice. At various time intervals
      thereafter (15 min-6 h), radioactivity in the urine, whole blood, plasma,
      kidneys, liver, spleen, lungs, intestines and the brain of the mice was
      determined. Shortly after injection, 14C-PGM was very rapidly excreted from the
      organism, so that 1 h following administration, 80% of the radioactivity was
      found in the urine (62% as unchanged PGM and the rest as the metabolites
      pentapeptide and disaccharide). At the same time, around 2% of the injected
      material was found in the blood. Six hours after injection, equal quantities were
      found in the intestines, liver and blood (0.5%), slightly less in the kidneys,
      lungs and spleen (0.2-0.3%) and the least quantity in the brain (0.04%). However,
      the dynamics of retention in the organs was evidently different. In the kidneys,
      lungs and spleen, radioactivity steadily decreased over the studied period. In
      the liver following an initial decrease, radioactivity remained the same 3 and 6
      h after injection. On the other hand, in the intestines and brain PGM seemed to
      accumulate rather than disappear following i.v. administration. This fact should
      be considered when explaining different biological activities of low molecular
      weight bacterial peptidoglycans.

PMID- 8468118
TI  - Murine systemic autoimmune disease induced by mercuric chloride (HgCl2): Hg
      specific helper T-cells react to antigen stored in macrophages.
AB  - The adoptive transfer popliteal lymph node assay (PLNA) was used to demonstrate
      Hg-specific T-cell responses of mice that were continuously treated with HgCl2 by
      a regimen known to induce a systemic autoimmune disease in H-2s (murine
      histocompatibility complex, haplotype s) mice, but not H-2d mice. We found that
      spleen cells of B10.S and A.SW donors (both H-2s) responded anamnestically to
      HgCl2 by inducing a significant increase in cellularity in the draining PLN of
      the recipient: In contrast, spleen cells of HgCl2-treated DBA/2 (H-2d) donors
      failed to induce an increase in PLN cellularity, and spleen cells of B10.D2/n (H
      2d) donors induced no changes or even diminished PLN cellularity upon re
      encounter with HgCl2. Kinetic studies showed that spleen cells of B10.S donors
      were stimulatory from day 3 until day 14 of donor HgCl2 treatment and, when
      purified splenic T-cells were tested, still on day 28, the last point in time
      tested. The Hg-specific T-cells prepared from HgCl2-treated B10.S mice not only
      induced an increased cellularity, but also B-cell activation to antibody
      secretion in the draining PLN of the recipient. Moreover, the Hg-specific donor T
      cells transferred could specifically be restimulated by killed peritoneal cells
      obtained from the same donors or from syngeneic donors previously treated with
      HgCl2. Interestingly, when killed peritoneal cells were injected as antigen the
      amount of Hg required for T-cell restimulation was only 1/40 of that required
      when free HgCl2 was used. Taken together, these results show that an HgCl2
      treatment schedule designed to induce systemic autoimmune disease primes Hg
      specific T-helper (Th) cells and generates immunogenic material in peritoneal
      cells to which the T-cells react. The possible contribution to the pathogenesis
      of HgCl2-induced auto-immune disease of these Hg-specific T-cells and the
      autoreactive T-cells reported in the literature is discussed.

PMID- 8468119
TI  - Comparative effects of tetrandrine and berbamine on guineapig airway
      microvascular leakage induced by platelet-activating factor and other allergic
      mediators.
AB  - The bisbenzylisoquinoline analogues, tetrandrine and berbamine, were investigated
      for their effects on guineapig airway microvascular leakage, an animal model of
      asthma and allergic inflammation. Significant inhibition of microvascular leakage
      by tetrandrine was observed with all four allergic mediators used in these
      experiments. By contrast, berbamine was able to suppress microvascular leakage
      induced by platelet-activating factor and bradykinin, but not by leukotriene D4
      or histamine. These results indicate that tetrandrine has broad-spectrum
      inhibitory activity on allergic mediators, and may have value for the therapy of
      diseases in which these mediators have a role in pathogenesis.

PMID- 8468120
TI  - Cytotoxic effect of ricin A-chain conjugates containing monoclonal antibodies
      against human erythroid cells.
AB  - Selective elimination of human erythroblastoid cells by the conjugate of the A
      chain of a plant toxin ricin (RA) and monoclonal antibody (MAb) HAE9 (IgM)
      directed against human erythroblast antigen (Ag-Eb) has been demonstrated. In
      comparative experiments, MAb HAE3 (IgM) against human glycophorin-A was used. On
      average, the conjugates obtained contained two A-chain molecules and one antibody
      molecule. Efficiency of cytotoxic action of native ricin and conjugates was
      compared both with the amount of binding sites on the surface of K562 cells and
      the internalization rate of these proteins. The association constants of the
      proteins proved to be almost the same (ka = 10(8) M-1). The ID50 values were 1.1
      x 10(-11), 3.2 x 10(-10) and 3.1 x 10(-9) M for ricin, HAE9/RA and HAE3/RA,
      respectively. Ammonium chloride at a concentration of 10 mM increases the
      cytotoxic effect of the HAE9/RA conjugate approximately 10 times and does not
      change the activity of the HAE3/RA conjugate.

PMID- 8468121
TI  - Enhancement of various non-specific immune effector functions in mice by local
      injection of aclacinomycin A adsorbed onto activated carbon particles (ACR-CH).
AB  - Local injections of aclacinomycin A adsorbed onto activated carbon particles (ACR
      CH) augmented the cytotoxic activities of regional lymph node cells for 7 days.
      In contrast NK-activity was only slightly augmented by injections of
      aclacinomycin A (ACR) solution or activated carbon suspension. The effects were
      found in lymphocytes from all regions tested. NK-activity could only be detected
      when both adherent and non-adherent cells were present. The cell number of L3T4+
      cells in each type of lymph node tested increased, and subset analysis of the
      lymphocyte subpopulations revealed an increase in the ratio of L3T4+/Lyt2+ cells,
      suggesting that the ACR-CH selectively increased and stimulated L3T4+ cells.
      Enhanced capacity of lymph node cells to produce cytokines, tumor necrosis factor
      (TNF) and interleukin-1 (IL-1) upon restimulation (with LPS) in vitro in the ACR
      CH treated group was found. From these results, it appears that the new dosage
      form of aclacinomycin A, ACR-CH, with superior therapeutic efficacy against lymph
      node metastases, can also enhance the immune response of regional lymph node
      cells. The findings reported here will be valuable in the establishment of novel
      chemoimmunotherapeutic protocols using ACR-CH.

PMID- 8468122
TI  - Cyclophosphamide blocks both antigen-specific and polyclonal immunoglobulin
      responses in experimental visceral leishmaniasis.
AB  - Cyclophosphamide (Cy) has been shown to modulate antibody responses in a wide
      range of diseases both in humans and experimental animals. Our results in Syrian
      hamsters infected with Leishmania donovani have shown that Cy blocks specific and
      polyclonal antibody production both in vivo and in vitro. This effect was
      achieved by weekly 100 mg/kg doses and also by a 300 mg/kg single dose. Although
      Cy provokes a significant decrease in B-cell numbers in infected animals, this
      cannot explain the suppression of antibody production since a 50% decrease in B
      cells of only-infected hamsters did not reproduce the same effect in in vitro
      assays. Also, this suppression was not reversed either by elimination of adherent
      cells or by the presence of indomethacin. These data suggest that Cy affects T
      cell populations involved in the control of antibody production by B-cells.

PMID- 8468123
TI  - Comparison of dideoxynucleoside drugs (DDI and zidovudine) and induction of
      hematopoietic toxicity using normal human bone marrow cells in vitro.
AB  - The drug zidovudine (AZT), a synthetic thymidine analog, has been used in the
      treatment of acquired immunodeficiency syndrome (AIDS). Clinical use of
      zidovudine has induced hematopoietic toxicity manifested by anemia, neutropenia
      and on occasion thrombocytopenia. Such toxicity has stimulated the development of
      alternative dideoxynucleoside drugs capable of exerting anti-viral potency while
      minimizing the risk for inducing organ toxicities. One such alternative
      dideoxynucleoside drug is 2',3'-dideoxyinosine (ddI). Recent therapeutic anti
      viral strategy, now undergoing clinical trial, is the evaluation of combined
      zidovudine ddI treatment. Unfortunately a complete assessment of their potential
      toxicity using this drug regimen has not been thoroughly examined. We report here
      the results of studies comparing the toxicity profile of zidovudine versus ddI on
      their ability to influence several classes of hematopoietic progenitor stem
      cells, e.g. granulocyte--macrophage (CFU-GM), megakaryocyte (CFU-Meg) and
      erythroid (CFU-E/BFU-E) following in vitro co-culture with normal human bone
      marrow. Since the main clinical toxicity associated with zidovudine in vivo is
      the development of anemia, additional in vitro studies compared the dose
      escalation effect of erythropoietin in the presence of combined zidovudine and
      ddI. CFU-GM, CFU-Meg, CFU-E and BFU-E were all reduced (P < 0.05) following
      incubation with either zidovudine or ddI thus determining their ID50
      concentrations for these classes of hematopoietic progenitors; however, the
      extent of toxicity associated with ddI was lower than what was observed with
      zidovudine. More importantly, dose-escalation of erythropoietin was effective in
      reversing the inhibition observed for ddI on erythroid progenitors CFU-E and BFU
      E (P < 0.05), an effect not reported with zidovudine in vitro.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8468124
TI  - Expression of activation markers on peripheral-blood lymphocytes following oral
      administration of Bacillus subtilis spores.
AB  - This study was undertaken to assess the capability of Bacillus subtilis spores to
      modify the peripheral-blood lymphocyte (PBL) subsets or determine the de novo
      expression of activation markers. The data we obtained show that spores of B.
      subtilis are able to increase the expression of certain cell activation markers
      and that such activation is dose-dependent. In fact, doses of 2 x 10(9) spores
      did not give rise to changes in any of the parameters evaluated, while doses of 6
      x 10(9) increased the HLA-DR antigen expression on T-lymphocytes. At the highest
      dosage used (12 x 10(9), B. subtilis spores caused the appearance of cells
      bearing the CD25 and CD71 activation markers. Therefore, such cell activation
      markers may prove useful for monitoring the activity of B. subtilis spores, and
      possibly of other immunomodulating agents, in the course of clinical research.

PMID- 8468125
TI  - Three sibling species within Contracaecum osculatum (Nematoda, Ascaridida,
      Ascaridoidea) from the Atlantic Arctic-Boreal region: reproductive isolation and
      host preferences.
AB  - Genetic variation within and between population samples from 22 locations of the
      Atlantic Arctic-Boreal region, including 1657 specimens morphologically assigned
      to Contracaecum osculatum, was electrophoretically analysed at 17 loci. Highly
      significant deviations from the Hardy-Weinberg equilibrium were found at various
      loci in several samples, owing to the existence of three distinct gene pools
      within C. osculatum (sensu lato) from the study area. These gene pools correspond
      to three biological species (provisionally designated A, B and C), characterized
      by distinct genotypes at several diagnostic loci. Reproductive isolation between
      C.osculatum A, B and C is confirmed by the lack of F1, recombinant, or backcross
      genotypes in sympatric areas, despite the occurrence of multiple infections. Mean
      heterozygosity per locus is on average 0.11 in species A, 0.10 in B and 0.07 in
      C. High levels of gene flow were found within each of the three species, the
      values of Nm (number of migrant individuals) ranging from 3.41 (C. osculatum C)
      to 5.77 (C. osculatum A). Average Nei's genetic distance is 0.46 between A and B,
      0.50 between A and C and 0.77 between B and C. From these values, times of
      evolutionary divergence from 2 to 4 million years can be estimated. Genetic
      relationships among populations and species of the C. osculatum complex are
      illustrated by principal component analysis. The role of both geographical
      isolation and host preferences in the speciation of C. osculatum (sensu lato) is
      discussed. A morphological distinction of the three species has not yet been
      possible (sibling species). However, there is evidence that the name C. osculatum
      (sensu stricto) should be used for species C, which shows a geographical
      distribution and definitive host corresponding to the neotype of C. osculatum
      (sensu stricto). Finally, a comparison is made between the members of the C.
      osculatum complex from the Atlantic Arctic-Boreal region and those of the
      Pseudoterranova decipiens complex from the same area, as to: (i) times of
      evolutionary divergence, (ii) geographical distribution, and (iii) host
      preferences.

PMID- 8468126
TI  - Does the duration of antigen retention in draining lymphoid tissue following GI
      nematode infection determine the 'responder phenotype' of the host?

PMID- 8468127
TI  - Topical treatment of cutaneous leishmaniasis in Belize: in vitro and in vivo
      studies with Leishmania mexicana.
AB  - Strains of Leishmania mexicana isolated from Belizian patients were found to be
      highly susceptible to paromomycin sulphate (PR) treatment. This drug at 100
      micrograms ml-1 destroyed 85-99.5% of in vitro cultivated Leishmania
      promastigotes within 4 days of exposure to the drug. Leishmania promastigotes
      inoculated into the base of the tail of Balb/c mice caused the development of
      local lesions several weeks after infection. These lesions were totally cleared
      of parasites after 20 days of topical treatment with PR ointment, comprised of
      15% paromomycin sulphate and 12% methylbenzethonium chloride in soft white
      paraffin. Similar results were also obtained with L. braziliensis infections.
      Isoenzyme analysis was found to be the method of choice for parasite strain
      identification. Excreted factor serotyping was only partially effective and
      promastigote agglutination gave negative results.

PMID- 8468128
TI  - Lipids in the broodsac of Leucochloridium variae (Digenea, Leucochloridiidae) and
      its snail host Succinea ovalis.
AB  - Thin-layer chromatographic analysis was used to examine lipophilic pigments and
      neutral lipids in the broodsac of Leucochloridium variae and in the tissues of
      its snail host, Succinea ovalis. Beta-carotene and lutein were not detected in
      either the parasite or the host on a C-18 reversed phase layer developed in a
      solvent system of petroleum ether-acetonitrile-methanol (2:4:4). This
      chromatographic system was able to detect 10 ng of a beta-carotene standard and
      100 ng of a lutein standard. The Mangold solvent system on a silica gel plate
      showed the presence of triacylglycerols, free sterols, and sterol esters as the
      major neutral lipids in both snail and parasite tissues. As seen in a previous
      sporocyst-snail relationship, the qualitative neutral lipid profiles of both host
      and parasite are similar.

PMID- 8468129
TI  - The Bo-RBC-SCID mouse model for evaluating the efficacy of anti-theilerial drugs.
AB  - We have previously developed a mouse model which allowed the proliferation of
      Theileria sergenti in severe combined immunodeficiency (SCID) mice with
      circulating bovine erythrocytes (Bo-RBC). In the present study, this model was
      utilized to test the efficacy of anti-theilerial drugs. Bo-RBC-SCID mice were
      created by giving periodic transfusions of T. sergenti-free Bo-RBC, and
      subsequently infecting with T. sergenti. Three anti-protozoal compounds,
      Pamaquine (Yamanouchi Pharmaceutical Co. Ltd), Ganaseg (Japan CIBA-GEIGY Ltd) and
      Buparvaquone (Coopers Animal Health Ltd), were subcutaneously administered into
      the mice at doses recommended for cattle therapy. Blood examinations demonstrated
      that all three drugs significantly reduced the level of parasitemia although
      Ganaseg was effective only at a dose five times higher than that recommended for
      cattle therapy. Administration of the drugs neither caused any sign of acute
      toxicity nor changed the rate of Bo-RBC in the SCID mice's circulating blood
      cells. The results indicate that the Bo-RBC-SCID mouse model may offer a useful
      in vivo system for evaluating the efficacy of anti-protozoal drugs against T.
      sergenti.

PMID- 8468130
TI  - Identification and purification of Cooperia oncophora-specific antigens to
      improve serological diagnosis.
AB  - Cooperia oncophora total adult extracts were examined by Western blotting with
      sera from C. oncophora- and O. ostertagi-infected calves to determine species
      specific antigens. It was shown that two antigens with apparent molecular weights
      of 14.2 and 14.9 kDa were only recognized by calves which received a Cooperia
      infection and not by Ostertagia mono-infected calves or parasite-naive animals.
      The partial purification of these two antigens was achieved by gel filtration and
      ion-exchange chromatography. An enzyme-linked immunosorbent assay (ELISA) was
      developed based on the fractions containing these two antigens and no cross
      reactivity could be noticed with serum from Ostertagia mono-infected calves. In
      contrast, the ELISA with total worm extracts showed strong cross-reactivity with
      heterologous serum. It was concluded that the 14.2 and 14.9 kDa Cooperia adult
      antigens have diagnostic potential, at least to differentiate C. oncophora and O.
      ostertagi.

PMID- 8468131
TI  - Identification of a Babesia bovis gene with homology to the small subunit
      ribosomal RNA gene from the 35-kilobase circular DNA of Plasmodium falciparum.
AB  - Isolation of a 552-base pair (bp) fragment of a putative extrachromosomal small
      subunit ribosomal RNA (SSrRNA) gene from Babesia bovis was achieved using the
      polymerase chain reaction (PCR) followed by cloning and sequencing of the PCR
      product. The sequences of the oligonucleotide primers used for the PCR were
      derived from selected known sequences in the organellar SSrRNA gene which is
      encoded within the 35-kilobase (kb) circular DNA from Plasmodium falciparum.
      Comparison of the sequence of the 552-bp fragment from B. bovis with gene
      sequences from other organisms showed 71% identity with the organellar SSrRNA
      gene from P. falciparum and up to 65% identity with the plastid SSrRNA gene
      sequences from various other organisms. We conclude that the 552-bp fragment
      amplified by PCR from B. bovis is possibly derived from an organellar genome of
      this parasite.

PMID- 8468132
TI  - Analysis of the 18S ribosomal RNA gene of Strongyloides stercoralis.
AB  - The entire 1766 bases of the 18S rRNA gene of Strongyloides stercoralis have been
      sequenced. The gene has a 38% G+C content. Although it is similar in length to
      the 18S rRNA gene of Caenorhabditis elegans, the only other completely sequenced
      nematode 18S rRNA gene, it is only 69% identical. Closely related helminths will
      need to be sequenced in order to delineate sequences specific for the diagnosis
      of strongyloidiasis.

PMID- 8468133
TI  - Sibling species within Macropostrongyloides baylisi (Nematoda: Strongyloidea)
      from macropodid marsupials.
AB  - Macropostrongyloides baylisi from four different species or subspecies of host
      were analysed electrophoretically at 27 enzyme loci. The results revealed the
      existence of two species, one in Macropus giganteus and the other in M. robustus
      robustus, M.r. erubescens and M.r. parryi, that had fixed genetic differences at
      33% of loci. Populations of nematodes from two subspecies of M. robustus, M.r.
      robustus from Queensland and M.r. erubescens from South Australia, had fixed
      genetic differences at two (7.4%) of 27 loci and were considered to belong to the
      same species. No fixed genetic differences were detected between nematodes from
      M. parryi and M.r. robustus. A discriminant function analysis of morphological
      data assigned 96% of specimens to groups defined on the basis of the host species
      or subspecies from which they were obtained. This separation of Ma. baylisi into
      host-specific groups did not, however, totally correlate with the electrophoretic
      data. The species of M. baylisi in M. giganteus was genetically more distinct
      from the sibling species in M. robustus/M. parryi than to a related but
      morphologically dissimilar nematode, Ma. yamagutii from M. fuliginosus. This
      suggests an evolutionary parallel between host and parasite at the genetic level
      which is not reflected by morphological differences.

PMID- 8468134
TI  - Oxygen affinities of metronidazole-resistant and -sensitive stocks of Giardia
      intestinalis.
AB  - The common protozoon, Giardia intestinalis, parasitizes the upper small intestine
      of man, and is often refractory to treatment by metronidazole. Defective oxygen
      scavenging mechanisms have been implicated as a cause of metronidazole resistance
      of another flagellate Trichomonas vaginalis, where metronidazole is also the most
      common drug treatment. Oxygen consumption of six clinical isolates of G.
      intestinalis and one line selected for resistance to metronidazole was measured
      over 0-50 microM-O2 using an oxygen electrode open for gas exchange. At > 30
      microM-O2, inhibition of respiration was demonstrated in all seven stocks.
      Apparent oxygen affinities (KmO2) were found to range from 0.5 to 5.2 microM-O2;
      however, isolates from patients who failed to respond to treatment with
      metronidazole did not have measurably defective O2-scavenging capabilities
      compared with metronidazole-sensitive isolates. These strains did, however, show
      elevated NADPH-oxidase activities compared with metronidazole-sensitive strains.
      Results indicate that biochemical mechanisms of drug resistance in G.
      intestinalis may be quite different from those operating in T. vaginalis.

PMID- 8468135
TI  - Identification of host-protective antigens of Taenia ovis oncospheres.
AB  - Sheep were fully protected against challenge infection following immunization
      with a homogenate of T. ovis oncospheres. Ultracentrifugation of sonicated
      oncospheres either alone or in the presence of a range of detergents did not
      reduce the immunogenicity of the extracts. Solubilization of oncosphere extracts
      in non-ionic detergents or sodium dodecyl sulphate (SDS) enabled analysis of host
      protective antigens by isoelectric focusing (IEF) and electrophoresis in
      polyacrylamide gels (SDS-PAGE), respectively. Immunoblotting analysis of
      oncosphere antigens with immune sheep sera identified predominantly two groups of
      antigens with relative mobilities of 31-34 kDa and 47-52 kDa with a common
      isoelectric point of 5.8. The immunogenicity of these antigens was confirmed in
      vaccination trials using appropriate fractions cut from SDS-PAGE gels and agarose
      IEF gels. Affinity-purified antibodies prepared against the candidate antigens
      were used to select the corresponding recombinant DNA-derived polypeptides, one
      of which was subsequently found to be host-protective.

PMID- 8468136
TI  - Lymphokine production by mesenteric lymph node cells from BALB/C mice during
      Hymenolepis nana infection.
AB  - Mesenteric lymph node cells (MLNC) prepared from BALB/c mice during infection
      with Hymenolepis nana proliferated extensively when cultured in the presence of
      soluble egg antigen, as assessed by measuring 3H-thymidine incorporation.
      Analysis of Hymenolepis-specific proliferative cells in MLNC by using monoclonal
      antibody specific for mouse T lymphocyte surface antigens revealed that the
      proliferative response of MLNC was mediated by Thy-1.2+, L3T4+ cells, that is,
      helper T cells. Supernatant of MLNC cultured with egg antigen contained large
      amounts of interleukin-2 and interferon-gamma, but only low levels of interleukin
      5. The titer of these cytokines did not correlate with the interval between oral
      infection and collection of MLNC. These results strongly indicate that the Th1
      subtype of helper T lymphocytes respond well to stimulation of H. nana egg
      antigen and suggest that acute inflammatory responses are involved in host
      protective immunity to H. nana.

PMID- 8468137
TI  - The effects of changes in the definitive host environment on the metabolism of
      Hymenolepis diminuta during growth and maturation.
AB  - Flexibility in the metabolism of Hymenolepis diminuta is associated with changing
      intrinsic requirements during maturation but is also influenced by extrinsic
      factors, that is, by the nature of the host environment. End-products of
      carbohydrate metabolism and enzyme activities in worm extracts were used as
      indicators of metabolic regulation in H. diminuta recovered at various times
      postinfection. The predominant end-product from 6-day-old worms is lactate,
      generated by cytosolic glycolysis. As the cestode matures in the host, lactate
      production by the whole worm decreases and greater amounts of the mitochondrial
      end-products, succinate and acetate, are detected. A stable, dichotomous carbon
      flow to lactate, succinate and acetate is observed from 12 days post-infection. A
      metabolic gradient along the length of individual strobila is also evident. It
      extends from glycolysis, in the anterior region, to mitochondrial dismutation in
      the posterior region. The transition from cytosolic to mitochondrial pathways
      during maturation and along the strobilus is delayed or suppressed in worms
      recovered from immunosensitized hosts. Four host environments were compared:
      unsensitized rats, rats immunosensitized with a primary infection of H. diminuta,
      rats immunosensitized with a primary infection of Nippostrongylus brasiliensis
      and mice concurrently infected with Heligmosomoides polygyrus. The specific
      activities of PK and PEPCK in whole worm extracts were similar in 10-, 21- and 35
      day-old worms and did not differ in worms isolated from different host
      environments. However, the PEPCK/PK ratio is high in worms that utilize
      mitochondrial pathways and low in worms that produce predominantly lactate. LDH
      activity is high in lactate producers. It is concluded that the pattern of
      metabolism in H. diminuta is influenced by many effectors in the host
      environment.

PMID- 8468138
TI  - Virus-like particles in a monogenean (Platyhelminthes) parasitic in a marine
      fish.
AB  - In Microcotyle sp., a gill parasite in the marine fish Abudefduf analogus near
      Dakar, Senegal, various organs were studied by transmission electron microscopy.
      One of the six worms studied contained virus-like particles located only in the
      outer layer and in the cytons (deep cell bodies) of the tegument. The tegument
      ultrastructure is described for both healthy and infected monogeneans. The outer
      layer of the tegument, 2-5 microns thick, does not have microvilli. The virus
      like particles are cytoplasmic, about 70 nm in diameter with a single-layered
      capsid-like structure 10-12 nm thick, and have an icosahedral symmetry. They
      originate from viroplasms and accumulate in paracrystalline arrays up to 1 micron
      in size. By their ultrastructural characteristics, these virus-like particles are
      related to the Reoviridae or, more probably, the Birnaviridae. This is the third
      report of viruses in monogeneans, and the first in a polyopisthocotylean
      monogenean. It is hypothesized that monogeneans could act as vectors of viral
      diseases among their host fishes.

PMID- 8468139
TI  - Proliferation of Theileria annulata and Theileria parva macroschizont-infected
      bovine cells in scid mice.
AB  - Theileria annulata and Theileria parva macroschizont-infected bovine cells formed
      tumours at the inoculation site when injected subcutaneously into C.B.-17 scid
      mice. T. annulata tumours showed more vigorous growth than T. parva tumours. The
      tumours did not regress and infected cells spread to other tissues.
      Intraperitoneal injection of high doses of T. annulata-infected cells resulted in
      the development of ascites: the infected cells colonized abdominal organs, in
      particular mesenteric tissue. Low doses of cells did not establish when
      administered by this route. Evidence for a role for macrophages in controlling
      proliferation of Theileria-infected cells was provided by finding (i) that
      uninfected bovine cells did not survive for as long in the peritoneal cavities of
      scid mice as in Balb/c mice: (ii) peritoneal macrophages both proliferated in
      vivo in the presence of infected cells and were activated as assessed by
      production of interleukin-1. Evidence against a role for NK cells was provided by
      (i) the failure of an in vivo assay for allogeneic lymphocyte cytotoxicity to
      reveal any activity against bovine cells in the lungs or liver, i.e. the sites
      usually associated with NK cell cytotoxicity, and (ii) the lack of correlation
      between tumour regression and NK cell activity in the spleens of mice with
      chronic T. annulata tumours.

PMID- 8468140
TI  - The effect of cobalt-60 irradiation on the infectivity of Toxoplasma gondii.
AB  - Toxoplasma gondii cysts in the tissues of experimentally infected mice and pigs
      were irradiated with cobalt-60 at various doses and used to infect mice and
      kittens. Loss of parasite infectivity was confirmed following irradiation whereas
      control animals inoculated with non-irradiated infected tissues became infected.
      Experiments were repeated to calculate the minimal effective dose (MED) of
      irradiation to eradicate parasite infectivity. The MED for the Chinese NT strain
      and the American ME-49 and TS-2 strains of T. gondii cysts in mouse and pig
      tissues was approximately 0.6 kGy. The infectivity for mice of NT strain
      bradyzoites irradiated at a dose of 0.45 kGy was reduced 10,000-fold. Such
      irradiation may be valuable in practical operations to control T. gondii in pork
      products.

PMID- 8468141
TI  - Phosphorus metabolites of liver from mice infected with Hymenolepis microstoma.
AB  - 31P NMR in vivo spectra of mouse livers infected with Hymenolepis microstoma for
      130 or 265 days showed modifications in phosphorus-containing metabolite ratios
      when compared to those of normal liver. After 130 days of infection the
      metabolite ratio of inorganic phosphate (Pi)/beta ATP significantly increased
      whereas that of phosphocreatine (PCr)/beta ATP significantly decreased. In older,
      265 day infections, the increase in Pi/beta ATP and decrease in PCr/beta ATP
      persisted. Changes in the group infected for 130 days were accompanied by lowered
      pH. Analysis of liver extracts from mice with 130-day-old. H. microstoma revealed
      significantly lower concentrations of Pi, ATP and ADP compounds. In those from
      mice infected for 265 days the concentration of Pi remained low whereas
      concentrations of ATP and ADP increased to levels in between those of controls
      and the 130-day-old infection. In addition, levels of phosphorylethanolamine (PE)
      and of an unknown metabolite significantly increased in this latter group. Worm
      extracts contained high levels of glycerophosphorylcholine (GPC), Pi, fructose
      1,6-diphosphate (FDP), PE, diphosphodiesters (DPDE), phosphorylcholine (PC) and
      glycerolphosphorylethanolamine (GPE) in order of declining concentrations,
      respectively.

PMID- 8468142
TI  - [The quality of the basic cause of death in the Statistical Bulletin of
      Mortality. Spain, 1985].

PMID- 8468143
TI  - [Intravenous drug addiction and the risk of HIV infection in Madrid in 1990].
AB  - As part of a multicenter WHO study on HIV infection among drug injectors, 472
      intravenous drug users (IDUs) were interviewed, 240 recruited in the streets and
      232 at drug treatment centers. The objectives of the study were to assess the
      prevalence of HIV infection among IDUs of Madrid, to identify factors associated
      with risk reduction behaviors, such as the use of sterile syringes and condoms.
      Chi-square and logistic regression were used to test for differences and to
      estimate odds ratios. Prevalence of HIV infection among IDUs in Madrid was 50%
      (53% among those recruited in the street and 38% among those recruited at
      treatment centers). Forty five per cent of those interviewed were still sharing
      syringes. Out of the 315 sexually active subjects, only 22% reported using
      condoms always or almost always. These results suggest that a range of
      interventions should be implemented to promote change towards healthier
      behaviors, including syringe-exchange programs, methadone maintenance treatments
      and pre- and post-test counseling in those agencies which care for this
      population.

PMID- 8468145
TI  - [Barriers to verbal communication and consumer satisfaction with consultations in
      general medicine].
AB  - With the objective of knowing the barriers to verbal communication experienced by
      general practice users, and their satisfaction with the information received, a
      sample of 1553 adults (> 14 years old), users of the Basque Health Service
      general practice services, was interviewed. A questionnaire of 13 questions,
      administered after the consultation, was employed. The most frequently
      experienced barrier was the lack of written information, that affected to a 77.7%
      of those interviewed. This percentage is greater (p < 0.005) among those visiting
      traditional doctors (81.9%), than among those enrolled with primary care teams
      (72.4%) or rural doctors (70.0%). Those who were given written information left
      out the consultation more satisfied than the others (p < 0.001). The provision of
      written information seems to be related to the user's satisfaction. It is advised
      to modify the doctors' attitude towards the communicative process with their
      patients.

PMID- 8468144
TI  - [Inequalities in health: perinatal and infant mortality in Spain].
AB  - The interregional variation coefficient (VC) has been considered as an accurate
      measure of the dispersion of regional infant, neonatal, postneonatal and
      perinatal mortality rates. Thus, trends of annual VC have been analyzed, for each
      rate, from 1940 to 1986, to identify the evolution in time of the regional
      differences with respect to these mortality rates. None of the four mortality
      rates showed a decreasing trend in their respective VCs. This may indicate that
      interregional differences do not change along time. The postneonatal mortality
      rate has been shown to have the highest VCs during the study period (ranging from
      23 to 40%), with an independent evolution with respect to neonatal mortality
      rate, probably because the factors that influence both rates are clearly
      different.

PMID- 8468146
TI  - [Consumer satisfaction with 2 models of primary care in operation in Andalucia].
AB  - A study was completed to investigate if any differences are observed in user
      satisfaction with health care centres, polyclinics and solo-practice, furthermore
      to identify user, organizational characteristics and doctors as variables that
      relate to user satisfaction in health care. A sample of users was chosen from the
      Andalusian cities of Granada, Malaga and Sevilla with an alpha = 5%, beta = 10%
      and d = 11%. The variables were collected trough the use of three questionnaires.
      Greater satisfaction was found between health care centre users than with
      polyclinics and solo-practice, with values being 62.4, 58.2 and 60.6 with a p <
      0.001. The variables more strongly associated with user satisfaction in health
      care centres are those related with doctors and organization characteristics.
      Therefore several are capable of improvement in order to increase user
      satisfaction. On the contrary in polyclinics and solo-practice the most
      influential variables are those related with the user characteristics, which are
      not modifiable by the health services intervention.

PMID- 8468147
TI  - Controlling the HIV epidemic among drug injectors.

PMID- 8468148
TI  - Attitudes toward primary care are changing.

PMID- 8468149
TI  - UI hospitals touches every part of Iowa.

PMID- 8468150
TI  - Understanding the problems of the elderly.

PMID- 8468151
TI  - Training for Iowa physicians.

PMID- 8468152
TI  - UI researches environmental health risks.

PMID- 8468153
TI  - Cocaine abuse in a high risk obstetrical population.

PMID- 8468155
TI  - National Scientific Medical Meeting. The Royal College of Physicians of Ireland.
      18-20 March 1993. Abstracts.

PMID- 8468154
TI  - Hospital ethics committees.

PMID- 8468156
TI  - Properties of the purified elongation factor 2 in the thermoacidophilic
      archaebacterium Sulfolobus solfataricus.
AB  - The elongation factor 2 (aEF-2) has been purified to homogeneity from the extreme
      thermoacidophilic archaebacterium Sulfolobus solfataricus. It is the only target
      protein which is ADP-ribosylated by diphtheria toxin in presence of NAD and this
      modification abolishes its property to support poly(Phe) synthesis in vitro. The
      factor is constituted by a single polypeptide chain with a relative molecular
      mass of 78,000 and an isoelectric point of 5.9. aEF-2 is resistant to heat
      denaturation as shown by the fact that its capability to be ADP-ribosylated was
      only 10% reduced after 4 h treatment at 80 degrees C. Its amino acid composition
      does not reveal significant differences with that of analogous factors in other
      sources; nevertheless, the deviation function indicates that aEF-2 is related to
      Sulfolobus acidocaldarius and eukaryotes EF-2 more than to eubacterial EF-G or
      other archaebacterial EF-2.

PMID- 8468157
TI  - Different outcomes of pregnancy in women with essential thrombocytosis.

PMID- 8468158
TI  - A new design of pyloromyotom for pyloromyotomy in infants--a modification of the
      Benson spreader.

PMID- 8468159
TI  - Urine osmolality in nursery school children in a hot climate.

PMID- 8468160
TI  - Helicobacter pylori and peptic ulcer disease.

PMID- 8468161
TI  - The importance of drinking.

PMID- 8468162
TI  - The role of high-dose chemotherapy with autologous bone marrow support in breast
      cancer: state of the art.

PMID- 8468163
TI  - Janusz Korczak.

PMID- 8468164
TI  - Paracetamol overdosage in Jerusalem 1984-89".

PMID- 8468165
TI  - Sixth autoimmunity meeting--Georg Wick day. 23 March 1992, Tel-Hashomer, Israel.
      Proceedings.

PMID- 8468166
TI  - Altered immunoendocrine dialogue in autoimmune disease.
AB  - Autoimmune diseases have a multifactorial pathogenesis including essential
      genetic and nonessential modulatory factors. Among the essential factors, not
      only should genes coding for an abnormal reactivity of the immune system be
      considered, but we have, in addition, provided experimental evidence for the
      existence of genes responsible for a susceptibility of the target organ/structure
      for the autoimmune attack. Only when both sets of essential genes are present
      does an autoimmune disease develop at all. The modulatory factors then determine
      the final outcome in each case. The present contribution discusses the
      immunomodulating role of glucocorticoid and sex steroids focussing on the Obese
      Strain (OS) of chickens, a model for Hashimoto thyroiditis.

PMID- 8468167
TI  - Pathogenic natural autoantibodies.

PMID- 8468168
TI  - Immune response genes and autoimmune diseases.

PMID- 8468169
TI  - Human CD5+ B cells and autoimmunity.

PMID- 8468170
TI  - Immunotherapeutic approach to rheumatoid arthritis with anti-idiotypic antibodies
      to HLA-DR4.

PMID- 8468171
TI  - Cytokines, interleukin-3 and autoimmunity.

PMID- 8468172
TI  - Analysis of the T cell receptor V gene usage in multiple sclerosis and human
      autoimmune thyroiditis.

PMID- 8468173
TI  - Do natural autoantibodies play a role in physiologic red blood cell
      sequestration?

PMID- 8468174
TI  - The use of ultrasound in children with pain around the hip and thigh.
AB  - The use of ultrasound in the evaluation of effusion of the hip is well
      established. We performed ultrasound examinations on 87 children who presented
      with a limp and with pain in the hip region. We confirm the diagnostic value of
      ultrasound in detecting an effusion in the hip. Furthermore, ultrasound
      examination revealed effusion in two cases (psoas myositis), an unexpected
      effusion in the contralateral hip in two cases, and the cause of the pain in
      eight cases without effusion.

PMID- 8468175
TI  - Assessment of uterine and umbilical artery velocimetry during latent and active
      phases of normal labor.
AB  - Twenty healthy parturients in active labor were monitored with continuous wave
      Doppler to assess changes in uterine and umbilical velocity waveforms. Each case
      served as its own control. Tracings of fetal heart rate monitoring were normal in
      all patients. The analysis of the waveforms included the peak systolic/end
      diastolic ratio for the umbilical circulation (umbilical artery), and the
      systolic minus diastolic velocity divided by systolic velocity (resistance index)
      was used as an indication of downstream resistance in the uterine arteries.
      Recordings from umbilical, left and right uterine arteries were obtained during
      various stages of progression of labor as indicated by Friedman's curve. In
      latent phase labor with intact membranes, as well as in three consecutive
      measurements throughout active phase labor until delivery, umbilical artery
      systolic/end-diastolic ratios, before, during and after contraction did not
      change--2.2 +/- 0.5, 2.3 +/- 0.6, 2.2 +/- 0.3 and 2.5 +/- 0.7 (NS). No changes in
      the resistance to flow in the left and right uterine arteries were recorded
      during both latent and active phases of labor--0.53 +/- 0.09, 0.52 +/- 0.1, 0.5
      +/- 0.07, 0.56 +/- 0.07 (NS) and 0.59 +/- 0.1, 0.57 +/- 0.1, 0.56 +/- 0.1, 0.59
      +/- 0.08 (NS), respectively. These results suggest stability of the fetal
      cardiovascular system ensuring continuous constant gas exchange process during
      labor, enabling most term fetuses to tolerate labor to a degree where minimal if
      any metabolic changes occur.

PMID- 8468176
TI  - Early severe dehydration in young breast-fed newborn infants.
AB  - Six breast-fed infants living in a dry desert climate area presented at ages 4-11
      days with severe dehydration. In all cases, dehydration was associated with
      inadequate breast milk production by the mothers. In contrast to earlier reports
      on dehydration in breast-fed infants, five of the mothers were from a low
      socioeconomic background and three were multiparas, including two mothers who had
      previous experience with breast-feeding. In two infants severe bacterial
      infections were documented. Two mothers had small retracted nipples. As in
      earlier reported instances, sodium concentration in breast milk was elevated in
      all five mothers in whom it was measured, and three babies had severe
      hypernatremia. Successful relactation was achieved in three cases with a decrease
      in the milk sodium concentration. These data demonstrate that severe dehydration
      in breast-fed infants may occur as early as the first week of life and may affect
      even infants of experienced multiparous mothers who are well motivated for breast
      feeding. It seems that hypernatremia in these infants is secondary to poor fluid
      intake and increased insensible water loss rather than to elevated milk sodium,
      since there was no direct correlation between milk sodium concentration and serum
      sodium levels. Following fluid resuscitation, relactation can be achieved in
      motivated mothers.

PMID- 8468177
TI  - A centralized intravenous additive system in an Israeli government hospital.
AB  - The pharmacy of the Barzilai Medical Center initiated a centralized method for
      preparation of the sterile i.v. antibiotic dilutions used in the hospital that
      has proven to be beneficial to the patient and cost-effective to the hospital.
      With this system, all small-volume bags containing antibiotic dilutions-
      constituting 58.5% of all the sterile dilutions used in the Medical Center--are
      prepared centrally in the pharmacy of the hospital rather than in the various
      wards. Since the method requires professional supervision, it leads to an
      improvement in the quality of patient care. The solutions are prepared under
      sterile conditions, and care is taken to ensure their stability as well as to
      prevent incompatibilities between the antibiotics and the diluents. In addition
      to the direct benefit to the patient there has been a saving of approximately NIS
      200,000/year resulting from the decrease in the number of minibags, syringes and
      needles, personnel time and wastage.

PMID- 8468178
TI  - 14C-urea breath test--a simple, noninvasive method for the detection of
      Helicobacter pylori infection.

PMID- 8468179
TI  - The relationship between estrogen/progesterone ratio and term human parturition.

PMID- 8468180
TI  - Pulmonary balloon dilation for valvular and arterial stenosis.
AB  - The use of balloon catheters to dilate obstructed vascular lesions represents one
      of the major advances in cardiology and dates back to 1964 when Dotter and
      Judkins reported their experience in dilating arteriosclerotic obstructive
      lesions. Since that time, the technique of balloon dilation has been used
      extensively for coronary and peripheral vascular lesions but also has been
      applied to such diverse cardiac lesions as pulmonic stenosis, mitral stenosis,
      aortic stenosis, aortic coarctation, superior vena caval and pulmonary venous
      obstructions. Balloon dilation has been used for both valvular and arterial
      pulmonary stenosis. The purpose of this study is to report on our initial
      experience in Hawaii with balloon dilation of valvular pulmonic stenosis and also
      with dilation of peripheral pulmonary artery stenosis due to congenital causes
      and as a residual postoperative lesion.

PMID- 8468181
TI  - Quality improvement: how does it differ from quality assurance?
AB  - Quality improvement? How does it differ from Quality assurance? The "Total
      Quality Management" movement which has been so successful in improving the
      quality of manufactured products in Japan and more recently in the United States
      has arrived in American service industries, including health care. Although a
      minority of health care institutions has adopted the Continuous Quality
      Improvement (CQI) or Total Quality Management (TQM) philosophy and techniques on
      their own, the new Joint Commission on Accreditation of Health Care Organizations
      (JCAHO) standards to be phased in over the next 3 years require all accredited
      hospitals to "adopt the new philosophy".

PMID- 8468182
TI  - Vaginal birth after cesarean section in Hawaii. Experience at Kapiolani Medical
      Center for Women and Children.
AB  - Medical records at Kapiolani Medical Center for Women and Children were reviewed
      for cases that had a trial of labor subsequent to prior cesarean section during
      the period January 1990 to July 1991. All cases were > or = delivered 36 weeks'
      gestation. During the 19-month period, 356/483 or 73.5% cases with a trial of
      labor had successful vaginal births after previous cesarean sections (VBAC). The
      majority of the others that did not were due to failure of progression in labor.
      The incidence of scar separation was 5/483 (1.04%). There were 5/483 neonates
      with Apgar scores of < or = 6 at 5 minutes, giving a perinatal morbidity rate of
      1.04%. There were no maternal deaths. Oxytocin induction resulted in successful
      VBAC in 30/47 (63.8%) cases. This study concludes that a trial of labor for
      vaginal birth after cesarean section is well established at our institution. In
      addition, the rates of successful VBAC, its complications and outcomes, are
      comparable to national averages.

PMID- 8468183
TI  - Cross-cultural dream use in Hawaii.
AB  - Cultural variations in the narrative content of dreams have been reported in many
      studies. This basic cultural difference in dream language and representations has
      been used to support psychoanalytic theories of dreaming, especially that of the
      Jungian-based schools. Others have postulated that such variations reflect the
      cultural differences that each individual experiences during waking life. This
      "continuity" hypothesis proposes that a high correlation exists between an
      individual's waking life and his or her dream content. The biologic framework of
      dreams, sleep/dream-state physiology, is cross-culturally consistent, and the
      incidence of dream related pathology also is remarkedly similar between differing
      cultures.

PMID- 8468184
TI  - Differentiation of silver-enhanced mercury and gold in tissue sections of rat
      dorsal root ganglia.
AB  - Autometallography was used in conjunction with light and electron microscopy to
      detect traces of gold and mercury in the dorsal root ganglia of rats treated with
      sodium aurothiomalate and mercuric chloride. In order to differentiate between
      gold and mercury in tissue sections, the gold accumulations were removed by
      potassium cyanide, leaving mercury sulphides/selenides as the only possible
      catalysts for autometallographic development. With this technique, it is now
      possible to differentiate between all tissue metals capable of initiating the
      autometallographic process, i.e. gold, vesicular zinc, and sulphides and
      selenides of mercury and silver.

PMID- 8468185
TI  - The effects of storage on the retention of enzyme activity in cryostat sections.
      A quantitative histochemical study on rat liver.
AB  - The effect of storage of unfixed cryostat sections from rat liver for 4 h, 24 h,
      3 days and 7 days at -25 degrees C was studied on the activities of lactate
      dehydrogenase, glucose-6-phosphate dehydrogenase, xanthine oxidoreductase,
      glutamate dehydrogenase, succinate dehydrogenase (all demonstrated with
      tetrazolium salt procedures), glucose-6-phosphatase (cerium-diaminobenzidine
      method), 5'-nucleotidase (lead salt method), dipeptidyl peptidase II, acid
      phosphatase (both simultaneous azo coupling methods), D-amino acid oxidase
      (cerium-diaminobenzidine-cobalt-hydrogen peroxide procedure) and catalase
      (diaminobenzidine method). The effect of drying of the cryostat sections at room
      temperature for 5 and 60 min was investigated as well. The enzyme activities were
      quantified by cytophotometric measurements of test and control reactions. The
      test minus control reaction was taken as a measure for specific enzyme activity.
      It was found that the activities of all the enzymes investigated, with one
      exception, were affected neither by storage of the cryostat sections at -25
      degrees C for up to 7 days, nor by drying of the sections at room temperature for
      up to 60 min. The exception was xanthine oxidoreductase, whose activity was
      reduced by 20% after 5 min drying of sections or after 4 h storage. Therefore,
      only incubations for xanthine oxidoreductase activity have to be performed
      immediately after cutting cryostat sections, whereas for the other enzymes a
      considerable margin appears to exist.

PMID- 8468186
TI  - Immunohistochemical detection of strain-specific major histocompatibility complex
      class I antigens in paraffin-embedded rat osteochondral tissue.
AB  - An immunohistochemical method using formalin-fixed, paraffin wax-embedded
      sections is described for detecting strain-specific major histocompatibility
      complex class I antigens in knee-joint tissue from DA and Lewis strains of rat.
      The fixed osteochondral tissues were additionally decalcified in formic acid
      before processing for paraffin wax embedding. For immunohistochemistry, two
      monoclonal antibodies, one specific for DA class I allele RT1Aa and the other for
      Lewis class I allele RT1A1, were used together with the avidin-biotin
      immunoperoxidase procedure. It was necessary to use strain-specific normal rat
      serum as a diluent for the antibodies to suppress cross-strain recognition. DA
      specific antibody stained positively only on DA rat sections, not on Lewis rat
      sections, and Lewis-specific antibody stained positively only on Lewis rat
      sections, and not on DA. Positive staining was localized in the bone marrow,
      osteochondral cells and endothelium. We propose that the use of a decalcification
      medium may have enhanced the immunoreactivity of the tissue. The method described
      can be used on sections of allografts from the two strains of rat to assess
      morphologically the extent of cellular replacement of the graft by the host's
      cells.

PMID- 8468187
TI  - Fate of degenerating lactotrophs in rat pituitary gland after interruption of
      lactation: a histochemical and immunocytochemical study.
AB  - In the pituitary gland of pregnant and lactating rats a striking proliferation of
      lactotrophs occurs to meet the increased demands for prolactin. Following
      interruption of lactation the redundant lactotrophs undergo a massive
      degeneration until pre-pregnant proportions are re-established.
      Immunocytochemical detection of prolactin allows the recognition of degenerating
      lactotrophs until advanced stages of degeneration and leads to the conclusion
      that this process is autolytic in nature. Histochemistry of acid phosphatase
      reveals a remarkable accumulation of this enzyme in Golgi cisternae and
      lysosomes. At later stages of degeneration the acid phosphatase spreads
      throughout the entire cell. The presence of increased numbers of necrotic cells
      appears to activate phagocytosis of stellate cells and, to a lesser extent, of
      follicular cells. Stellate cells responsible for the secondary processing of cell
      residues are isolated cells characterized by a prominent oval nucleus and an
      electron-lucent cytoplasm with scarce organelles and extensive cytoplasmic
      processes. They appear as scavenger cells engulfing cell remnants and debris.
      Immunocytochemistry of S-100 protein discloses differential staining of two types
      of cell, one forming clusters of 2-4 cells with faint immunoreactivity, while the
      other type consists of isolated cells with a stellate profile and stronger
      labelling to S-100 protein.

PMID- 8468188
TI  - A monoclonal antibody distinguishes growth cartilage from other types of
      cartilage: a new probe for osteogenic cartilage.
AB  - Monoclonal antibodies (mAbs) were raised by injection of a homogenate of cultured
      growth cartilage (GC) cells from young rabbit ribs. These mAbs were examined by
      immunohistochemical staining for their reactivity to paraffin sections of rabbit
      tissues. The results showed that an mAb reacted preferentially with late
      hypertrophic and calcified costal GC zones. The mAb also reacted with
      hypertrophic GC adjacent to bone that existed in sternum and femur, but not to
      other cartilages, including resting cartilage, articular cartilage, auricular
      cartilage, nasal cartilage, tracheal cartilage and meniscus cartilage, or with
      other tissues, including tendon, skin, muscles, lung, liver, heart, thymus,
      spleen, eye and gut. It reacted with a wider area of the GC zone when the
      sections were decalcified, although its reactivity with the extended area was
      much less intensive than that with late hypertrophic and calcified GC zones. On
      treatment of the sections with bacterial collagenase, neither the reactive area
      nor its intensity were changed, while when treated with trypsin the reactivity
      was lost. These results suggest the existence of a certain molecule which
      distinguishes GC (osteogenic cartilage) from other (non-osteogenic) cartilage.
      This mAb is a useful probe for distinguishing osteogenic cartilage from non
      osteogenic cartilage, and for studying differentiation steps of cartilage cells
      in endochondral bone formation. The mAb can also be used as a probe for clinical
      and stored specimens because it reacts with decalcified and paraffin-embedded
      human specimens.

PMID- 8468189
TI  - Histochemistry of carbohydrates as performed by physical development procedures.
AB  - The histochemistry of carbohydrates demonstrated by means of physical development
      procedures has been reviewed in terms of the use and reliability of the
      procedures, physical developers, practice of the procedures, a fundamental series
      of light and electron microscopic methods and certain other promising aspects of
      this area of histochemistry. A line of fundamental light- and electron
      microscopic histochemical methods for carbohydrates using physical development
      procedures such as periodic acid-thiocarbohydrazide-silver protein-physical
      development (PA-TCH-SP-PD), high- or low-iron diamine (HID or LID)-TCH-SP-PD and
      lectin-gold (LT-G)-PD and related methods has been found to be more efficient,
      compared with those without physical development procedures. Since a series of
      other promising histochemical methods for carbohydrates using physical
      development procedures have been derived or are now being introduced, these
      procedures could be regarded as an unusually potent vehicle for effectively
      advancing carbohydrate histochemistry in both light and electron microscopy.

PMID- 8468191
TI  - Molecular heterogeneity of the actin filament cytoskeleton associated with
      microvilli of photoreceptors, Muller's glial cells and pigment epithelial cells
      of the retina.
AB  - The present study addressed the question as to whether the four different actin
      associated proteins that are associated with the actin core bundle in intestinal
      microvilli (i.e. villin, fimbrin, myosin I and ezrin) are essential components of
      all microvilli of the body. The retina provides an excellent example of a tissue
      supplied with three different sets of microvilli, namely those of Muller's glial
      cells (Muller baskets), photoreceptors (calycal processes), and pigment
      epithelial cells. The main outcome of this study is that none of these microvilli
      contain all four actin-associated proteins present in intestinal microvilli.
      Muller cell microvilli contain villin, ezrin and myosin I (95 kDa isoform) but
      not fimbrin. Calycal processes of photoreceptors contain fimbrin but not villin,
      myosin I and ezrin. Finally, microvilli of pigment epithelial cells are positive
      for ezrin but not for villin, fimbrin and myosin I. Because of limited cross
      reactivities of the antibodies to myosin I and ezrin, the myosin I data refer to
      the chicken retina whereas the findings with anti-ezrin were obtained with the
      rat retina. A further outcome of this study is that the actin filament core
      bundles in microvilli of chicken pigment epithelial cells are presumed to contain
      a crosslinking protein, which is not immunologically related to either villin,
      fimbrin or myosin I of the intestinal brush border.

PMID- 8468190
TI  - The versatility of microvascular pericytes: from mesenchyme to smooth muscle?

PMID- 8468192
TI  - Carbonic anhydrase isoenzymes II and I are present in the zona glomerulosa cells
      of the human adrenal gland.
AB  - Human carbonic anhydrase isoenzymes I and II (HCA I and II) were purified from
      human erythrocytes by inhibitor affinity chromatography and ion-exchange
      chromatography. These isoenzymes were then located in the human adrenal gland
      using specific polyclonal antisera raised in rabbits and specific detection by
      immunohistochemical techniques. Both HCA II and I were located in the zona
      glomerulosa cells, although the staining for HCA I was faint. The cells of the
      zona fasciculata and the zona reticularis failed to stain with either antiserum.
      Control stainings with preimmune or anti-HCA VI sera were negative. The presence
      of HCA II and I in the zona glomerulosa cells may be linked to regulation of the
      biosynthesis or secretion of mineralocorticoids.

PMID- 8468193
TI  - Quantitative X-ray microanalysis of adrenal medullary cells of young adult and
      aged rats after glutaraldehyde fixation and potassium dichromate treatment.
AB  - X-ray microanalysis has been used to detect chromium in the histochemical
      reaction product resulting from the reaction of noradrenaline with glutaraldehyde
      during fixation of the rat adrenal medulla and subsequent treatment with
      potassium dichromate. In unstained ultrathin sections, noradrenaline cells can be
      identified by their content of highly electron-dense storage granules, which
      enables individual granules to be analysed quantitatively to assess the amount of
      bound chromium within them. In young adult (4-month-old) rats the mean chromium
      content of noradrenaline-containing adrenal medullary granules was 443.6 +/- 50.7
      mM/kg dry weight. In aged (24-month-old) animals the mean chromium content was
      267.0 +/- 64.0 mM/kg dry weight which was significantly (P < 0.01) lower then the
      value for the young adult rats. Some noradrenaline cells contained granule
      populations, which were markedly less electron dense than those in the young
      adults and this is reflected in the ranges of chromium values recorded between
      individual cells in the 24-month-old animals. There were also noradrenaline cells
      in the medulla of the aged animals, which contained highly electron-dense
      granules but these did not contain as much bound chromium as the highest values
      recorded in the young adult animals. The results are discussed in the context of
      the growth of the rat adrenal medulla throughout the lifespan and with respect to
      the effects of age on the integrity of storage granules.

PMID- 8468194
TI  - Gamma-aminobutyric acid-immunoreactive neurons in the rat trigeminal nuclei.
AB  - The distribution of GABAergic neurons in the rat trigeminal nuclei was studied
      using a highly specific monoclonal antibody (mAb3A12) to gamma-aminobutyric acid
      (GABA). Immunopositive cells were relatively abundant in the marginal and
      gelatinosa beds of the caudal part of the trigeminal spinal tract nucleus, and in
      the dorsomedial areas of the oral subnucleus and the principal nucleus. A high
      density of GABA-immunoreactive somata was also found in the rostral part of the
      oral subnucleus and in the adjacent parvicellular reticular formation as well as
      in the supratrigeminal and intertrigeminal regions. Thus, the distribution of the
      GABAergic cells showed a relatively high density in areas related to the
      convergence of sensory stimuli, and in zones that contain interneurons inhibiting
      masticatory motoneurons. The results suggest, therefore, that GABA might play an
      important role both in discriminative sensory processing and in reflex modulation
      of the orofacial region.

PMID- 8468195
TI  - Simultaneous histochemical demonstration of capillaries and muscle fibre types.
AB  - Immunohistochemical staining of fibronectin is proposed as a good method for
      demonstrating capillaries in skeletal muscle tissue. The reaction superimposed on
      the histochemical reaction for myofibrillar ATPase enables simultaneous
      demonstration of fibre typing and capillary supply on the same tissue section.
      The method is quick and makes possible automated image analysis.

PMID- 8468196
TI  - Flat bed scanner in the quantitative assay of 35SO4-incorporation by X-ray film
      autoradiography of intervertebral disc sections.
AB  - A rapid quantitation of proteoglycan synthesis distribution in intervertebral
      disc and endplates is described. Tissue blocks of disc (C7-Th1) in the
      midsagittal plane from ten female beagles were incubated in the presence of 35SO4
      and prepared as histological slides. For comparison, sulphate incorporation rates
      in the C5-C6 discs were assayed by liquid scintillation. Autoradiographic film
      exposed against the labelled sections was developed and digitized for image
      analysis using a 256 grey level flat bed table scanner connected to a
      microcomputer. The film density versus dpm (disintegrations per minute)
      calibration was performed using a set of 35SO4-labelled glycosaminoglycan
      standards applied on the same film. Since section thickness, dpm calibration of
      the film density and the specific activity of sulphate in the medium were known,
      the incorporations per tissue volume could be calculated. The average
      incorporation rates of the anterior and posterior annulus fibrosus, nucleus
      pulposus and vertebral endplates were 5.2 +/- 0.9, 5.2 +/- 0.8, 4.5 +/- 0.6 and
      4.1 +/- 0.8 pmol/mm3 per h (+/- SE, n = 10), respectively and closely
      corresponded to those obtained by liquid scintillation. This method offers a
      convenient and reproducible way to measure the rate of proteoglycan synthesis in
      large tissue sections but also in thin cartilaginous tissues such as the
      vertebral endplate.

PMID- 8468197
TI  - The use of sodium sulphide-fixed brain tissue for immunocytochemical staining of
      activated microglia and reactive astrocytes.
AB  - The use of sodium sulphide-perfused material for the immunocytochemical
      demonstration of microglia and astrocytes is described. An
      intracerebroventricular injection of kainic acid (KA) was used to induce neuronal
      degeneration and subsequent axonal sprouting in the hippocampus. Animals under
      deep anaesthesia were killed by perfusion with either 4% paraformaldehyde alone
      or with 1% sodium sulphide followed by 4% paraformaldehyde solution. Microglial
      cells were identified with OX-42, a monoclonal antibody towards CR3 complement
      receptors, and astrocytes with a polyclonal antibody to glial fibrillary acidic
      protein (GFAP). The present study reveals a marked enhancement in the
      immunoreactivity of activated microglial cells in sodium sulphide perfused
      tissues compared to those observed in tissues fixed in paraformaldehyde alone.
      GFAP immunoreactivity of the astrocytes was not compromised by the use of sodium
      sulphide. The results clearly show the suitability of sodium sulphide perfused
      tissues for immunocytochemical procedures and should provide a useful tool for
      investigation of the role of neuroglial cells in axonal sprouting.

PMID- 8468199
TI  - Comments on withdrawal of penicillin/streptomycin combinations.

PMID- 8468198
TI  - Galactose-binding lectins as markers of pregnancy-related glycoproteins.
AB  - Protein extracts from pregnant mouse endometria were compared with those obtained
      from non-pregnant and pseudopregnant mice to detect early pregnancy-specific
      galactose-rich glycoproteins. Gradient gel electrophoresis combined with lectin
      overlay and lectin histochemistry were used to identify Ricinus communis I (RCA
      I), R. communis II (RCA-II) and Cytisus scoparius (CSA) lectin binding
      glycoproteins. Using this approach, galactose-rich glycoproteins were identified
      that were maximally expressed in the estrus phase of non-pregnant endometria and
      also those that had peak expression in pregnancy. Lectin histochemistry revealed
      pregnancy related changes in three portions of mouse endometrium: endometrial
      glands, luminal epithelium and its basement membrane. Two major glycoproteins
      (RCA-I reactive 64 kDa and RCA-II reactive 35 kDa) were specifically expressed in
      peri-implantation endometrium on days 3 and 4 of pregnancy. The appearance of
      these glycoproteins during the period of the implantation window in mouse
      suggests that they could serve as markers of uterine receptivity to the
      implanting blastocyst.

PMID- 8468200
TI  - Women in leadership roles.

PMID- 8468201
TI  - Viewpoints on borreliosis.

PMID- 8468202
TI  - Concern for all immunosuppressed clients.

PMID- 8468203
TI  - "Spay or pay"--is mandatory sterilization the answer to pet overpopulation
      problem?

PMID- 8468204
TI  - 1991 US veterinary practice revenue and expenses.

PMID- 8468205
TI  - An idea whose time has come: veterinarians in humane society administration.

PMID- 8468206
TI  - Survey of state veterinarians and state veterinary diagnostic laboratories for
      selenium deficiency and toxicosis in animals.
AB  - Surveys were performed in which the state veterinarian and the major state
      veterinary diagnostic laboratories in every state were asked about selenium (Se)
      deficiency and toxicosis in livestock and wildlife in their state. Selenium
      deficiency diseases were diagnosed in 46 states and were reported to be an
      important livestock problem in regions of 37 states; deficiencies were diagnosed
      in wildlife in 10 states. Natural Se toxicosis was a rare problem, with only 7
      states reporting naturally developing Se toxicosis. Oversupplementation with Se
      was reported as a cause of toxicosis in 15 states. Toxicoses in aquatic
      environments were reported from 4 states; in all cases, high-Se content in the
      water had resulted from agricultural irrigation or natural rainfall causing
      leaching of Se from high-Se soils. Current amounts of supplemental Se that can be
      fed to our major food-producing animals are being reviewed by the FDA because of
      speculation of potential environmental problems caused by Se supplementation in
      animals. Amounts of supplemental Se allowed in the western United States (states
      west of and including North Dakota, South Dakota, Nebraska, Kansas, Oklahoma, and
      Texas) are proposed by the FDA to have more potential for environmental Se
      enrichment and toxicosis. This premise was not supported by our data. Selenium
      supplementation in domestic livestock was not involved in wildlife toxicosis
      found by these surveys.

PMID- 8468207
TI  - Difficult dermatologic diagnosis.

PMID- 8468208
TI  - Randomized field trial to determine the effects of oral selenium supplementation
      on milk production and reproductive performance of Holstein heifers.
AB  - A field trial was conducted to measure differences in performance between
      selenium-supplemented and nonsupplemented heifers on a 1,200-cow California
      dairy. One hundred seventeen 19- to 27-month-old Holstein heifers were randomly
      assigned to treatment (n = 59) and control (n = 58) groups. A federally approved,
      commercially available, sustained-release intraruminal selenium bolus was
      administered to each heifer in the treatment group. Blood samples were taken from
      treated and control animals to assess selenium values before and after bolus
      administration and again after introduction to the milking ration. Production
      data were obtained from an on-farm computerized record system for each heifer
      during her first lactation. Mean blood selenium concentrations in treated heifers
      were higher than those in control heifers from posttreatment day 30 until after
      calving. Data analyzed in midlactation and late lactation indicated no
      significant differences between treated and control groups in somatic cell count,
      days not pregnant, total milk produced, or times bred.

PMID- 8468209
TI  - The gentle cow as scapegoat for world hunger?

PMID- 8468210
TI  - The human side of veterinary medicine. The tough job of talking about risk.

PMID- 8468211
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. New developments
      in small animal population control.

PMID- 8468212
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. One generation
      away from humanity.

PMID- 8468213
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. Working with
      breeders on solutions to pet overpopulation.

PMID- 8468214
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. Early-age
      neutering of dogs and cats.

PMID- 8468215
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. Veterinary
      practitioners' role in pet overpopulation.

PMID- 8468216
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. The pet owner and
      breeder's perspective on overpopulation.

PMID- 8468217
TI  - Animal welfare forum: overpopulation of unwanted dogs and cats. Role of breeding
      regulation laws in solving the dog and cat overpopulation problem.

PMID- 8468218
TI  - Genetic study of hyperkalemic periodic paralysis in horses.
AB  - Four Quarter Horses (1 stallion, 3 mares) with hyperkalemic periodic paralysis
      were mated to unaffected horses to determine the genetic basis of the disease.
      The affected stallion was bred to 11 unaffected mares (4 Quarter Horses, 1
      Arabian, 2 Standardbreds, and 4 Thoroughbreds). The 3 affected mares were bred to
      an unaffected Quarter Horse stallion. Of the 15 offspring obtained from these
      matings, 9 were affected with hyperkalemic periodic paralysis, and 6 were
      unaffected, consistent with an autosomal dominant mode of inheritance. Diagnosis
      was established by results of oral administration of potassium chloride and
      demonstration of characteristic clinical signs accompanied by hyperkalemia. Oral
      administration of potassium chloride resulted in marked increases in plasma
      potassium concentrations in affected and unaffected foals, although hyperkalemia
      was associated with clinical signs of hyperkalemic periodic paralysis in the
      affected foals. Evaluation of blood samples from affected and unaffected
      offspring revealed no linkage with erythrocyte and serum markers at 24 loci.

PMID- 8468220
TI  - Vaporizer in circle for delivery of isoflurane to dogs.
AB  - An in-circuit vaporizer for delivery of isoflurane was evaluated. The isoflurane
      concentration within an isolated circle breathing circuit was determined for 1
      hour in 6 in-the-circuit vaporizers with the wicks removed. A mechanical
      ventilator and artificial lung were connected to the circuit. Isoflurane
      concentration increased as vaporizer setting increased, and delivered
      concentration (%) at 60 minutes (mean +/- SEM) ranged from 0.46 +/- 0.10 at tap
      setting 1 to 3.67 +/- 0.30 at setting 5. Temperature of the isoflurane did not
      change. Cardiovascular and respiratory function were maintained within a
      clinically acceptable range in 6 dogs anesthetized with thiamylal and maintained
      with 1.87% end-tidal isoflurane delivered from the in-circuit vaporizer during
      spontaneous ventilation, controlled ventilation, and closed-circuit anesthesia.
      The range of vaporizer tap settings (mean +/- SEM) was lower during closed-system
      anesthesia (2.5 +/- 0.1 to 3.5 +/- 0.6) and during controlled ventilation (2.6 +/
      0.2 to 3.3 +/- 0.2) than during semi-closed system anesthesia (5.4 +/- 0.3 to
      6.8 +/- 0.4). The in-circuit vaporizer was used to deliver isoflurane to 36 dogs
      anesthetized for a variety of surgical and medical procedures. Ventilation was
      spontaneous, assisted, and in 1 instance, controlled. Cardiovascular function,
      respiratory function, and recovery times were within clinically acceptable
      ranges. The initial vaporizer tap setting (mean +/- SEM) was 8.2 +/- 0.4, and
      this corresponded to an end-tidal isoflurane concentration of 3.5 +/- 0.6. The
      range of vaporizer settings during the maintenance phase (mean +/- SEM) was 2.8
      +/- 0.5 to 4.6 +/- 1.9.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468219
TI  - Within-herd and between-herd variation in diagnosis of clinical mastitis in
      cattle.
AB  - In a set of data on farmer-observed clinical mastitis in cattle, all milk samples
      were scored with regard to milk color and milk texture (presence of flakes and
      viscosity). During a 1-year period, 1,106 milk samples were collected from 125
      farms with a bulk milk somatic cell count < 150,000 cells/ml. The overall
      variation, the between-herd variation, and the within-herd variation of the
      scores were evaluated and compared with each other. Differences between farmers
      were found for the scores on the visual characteristics per sample. However,
      these differences were not related to the reported number of cases of clinical
      mastitis per year. It was concluded that the diagnostic capability of farmers
      whose herds had low somatic cell counts did not have a negative influence on the
      validity of farmer-observed clinical mastitis incidence. However, care should be
      taken in herds with a low frequency of cases.

PMID- 8468221
TI  - Effect of total ablation of the external acoustic meatus and bulla osteotomy on
      auditory function in dogs.
AB  - Seven dogs with end-stage bilateral otitis externa were evaluated for auditory
      function before and after bilateral total ear canal ablation and lateral bulla
      osteotomy. Evaluations were performed by owner questionnaire and by recording
      brainstem auditory-evoked responses. Prior to surgery, all dogs could hear a loud
      voice or noise, however, only 3 dogs responded to a voice spoken at a normal
      level. Of the 14 ears tested electrodiagnostically, only 1 did not have a
      response, using air-conducted or bone-conducted stimuli. After surgery, 2 dogs
      responded to a normal voice, but all 7 responded to loud voices or noise. Three
      ears that had recordable brainstem auditory-evoked responses to air-conducted
      stimulation prior to surgery, failed to respond after surgery. Ears that
      responded to bone-conducted stimulation prior to surgery also responded after
      surgery.

PMID- 8468223
TI  - Use of metyrapone to treat pituitary-dependent hyperadrenocorticism in a cat with
      large cutaneous wounds.
AB  - Metyrapone, a drug that inhibits cortisol production, was used to lower plasma
      cortisol concentration and alleviate skin lesions caused by pituitary-dependent
      hyper-adrenocorticism in a cat. Plasma cortisol concentration was documented by
      ACTH stimulation test results. During metyrapone treatment, alopecia, thin skin,
      and large cutaneous wounds resolved. Metyrapone was administered orally at a
      dosage of 65 mg/kg of body weight, every 12 hours. Metyrapone may be used in
      conjunction with surgery in the management of pituitary-dependent
      hyperadrenocorticism in cats.

PMID- 8468222
TI  - Salmonella choleraesuis pneumonia in a cat without signs of gastrointestinal
      tract disease.
AB  - Primary Salmonella choleraesuis pneumonia without enteric manifestations was
      diagnosed in an 8-year-old cat. The diagnosis was based on culture of the
      organism from bronchial brushings. Pathogens were not isolated from multiple
      fecal samples. The cat initially responded to treatment with sulfamethoxazole
      trimethoprim, but relapsed after the owner discontinued treatment because of
      difficulty in administration. Treatment with ampicillin, followed by amoxicillin,
      resulted in complete resolution of all pulmonary infiltrates. Possible mechanisms
      of Salmonella infection in this cat included nosocomial infection from a
      nonclinical carrier, as well as Salmonella bacteremia initiated during a dental
      procedure performed prior to the onset of clinical signs of pneumonia.

PMID- 8468224
TI  - Severe cardiomegaly secondary to anemia in a kitten.
AB  - Severe anemia in a weanling kitten resulted in volume overload hypertrophy of the
      heart and signs of congestive heart failure. A 6-week-old moribund kitten was
      admitted to the hospital with a PCV of 3%. The anemia was determined to have
      resulted from severe flea infestation and iron deficiency. Supportive therapy
      consisted of flea removal, blood transfusions, and oral nutritional support. On
      day 3 of hospitalization, the kitten had signs of depression and became
      tachypneic. Auscultation revealed a systolic murmur, gallop rhythm, and crackles
      over the ventral lung fields. Thoracic radiography revealed pulmonary edema and
      massive cardiomegaly. Echocardiographic evaluation revealed dilatation of all
      cardiac chambers. The addition of furosemide to the kitten's treatment protocol
      resulted in resolution of the pulmonary edema. On follow-up examination 1 month
      later, the kitten had mild residual cardiomegaly and the anemia had resolved.
      Anemia is a well-known sequela to severe flea infestation in young animals. A
      less commonly reported, but potentially life-threatening, sequela to anemia may
      include the development of volume overload hypertrophy of the heart and
      congestive heart failure.

PMID- 8468225
TI  - Acquired arteriovenous fistula secondary to castration in a dog.
AB  - A 6-year-old castrated male Basset Hound was examined because of a 1-year history
      of a pulsating mass in the right inguinal region. The pulsatile mass was
      diagnosed as an arteriovenous fistula by physical examination and angiography.
      Surgical exploration revealed that the right testicular artery and vein, the
      artery of the ductus deferens, and the cremasteric artery were involved in the
      fistula. The fistula was believed to have developed secondary to castration
      performed at 6 months of age. The mass and associated vessels were completely
      excised and signs of recurrence were not observed 13 months after surgery.

PMID- 8468226
TI  - Primary mesenchymal or mixed-cell-origin lung tumors in four dogs.
AB  - Primary lung tumors of mesenchymal or mixed cell origin were diagnosed in 4 dogs
      with clinical and radiographic abnormalities indicating an intrathoracic mass.
      Each dog had 1 large intrapulmonary lesion, and 1 dog also had nodules scattered
      throughout all lung lobes. Two dogs were euthanatized; 1 had a biphasic pulmonary
      blastoma; and the other had a pulmonary chondroblastic osteosarcoma with
      intrapulmonary metastases. The masses in the other 2 dogs were hamartomas
      (lipomatous in 1, microcystic in the other), which were resected. Both dogs
      survived more than 1 year after surgery. Primary lung tumors are uncommon in dogs
      and are generally malignant (adenocarcinomas or carcinomas). Tumors of connective
      tissue or mixed cell origin are rare, but the outcome is potentially good after
      surgical removal.

PMID- 8468227
TI  - Spiral colon intussusception in a three-year-old bull.
AB  - Intussusception of the spiral colon was diagnosed in a 3-year-old Charolais bull.
      Necropsy revealed the intussusception to involve approximately 40 cm of the first
      centripetal gyrus of the spiral loop, beginning 70 cm distal to the ileocolic
      junction. Predisposing lesions were not noticed in the mesentery or lumen of the
      affected intestine; however, the involved intestine was necrotic. Surgical
      resection of the lesion was not attempted because of the compromised nature of
      the involved large intestine and because of the inability to exteriorize the
      region in the standing animal.

PMID- 8468228
TI  - Intermittent antimicrobial infusion for management of a septic distal
      interphalangeal joint in a horse.
AB  - A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region
      of the foot, which penetrated the navicular bursa and distal interphalangeal
      joint, 7 days prior to examination. A street-nail procedure was performed to
      debride the tract and provide drainage of the navicular bursa and distal
      interphalangeal joint. An indwelling lavage system was placed through the dorsal
      aspect of the joint and antimicrobials were infused intermittently to supply a
      high local concentration of drug and to frequently lavage the distal
      interphalangeal joint and navicular bursa.

PMID- 8468229
TI  - Echinocytosis in horses: 54 cases (1990).
AB  - Retrospective review of CBC and serum chemical data from 124 horses admitted to
      the veterinary teaching hospital over a 9-month period (Feb 1, 1990 to Oct 31,
      1990) indicated that 54 horses had echinocytosis (prevalence = 44%). In horses
      with echinocytosis, the most frequent diagnosis was colitis (23 horses; 43%).
      Odds ratios (measure of association) were calculated to determine the association
      of echinocytosis with specific hematologic and biochemical abnormalities. When
      evaluated in a multivariate model, low serum sodium concentration (< 136 mEq/L)
      was the only variable significantly associated with the incidence of
      echinocytosis. Within the group of 54 horses with echinocytosis, hyponatremia (35
      horses; 65%), hypochloremia (35 horses; 65%), low total carbon dioxide
      concentration (35 horses; 65%), hypoosmolality (30 horses; 55%), and hypocalcemia
      (22 horses; 41%) were the most common biochemical abnormalities. It was concluded
      that hyponatremia was associated with increased incidence of echinocytosis. It
      was suggested that systemic electrolyte depletion might be involved in the
      induction of echinocyte formation.

PMID- 8468230
TI  - Digit amputation in cattle: 85 cases (1971-1990).
AB  - Medical records of 83 cattle, which had 1 or more digit amputations performed at
      Kansas State University and The Ohio State University veterinary hospitals
      between 1971 and 1990, were reviewed. Signalment, duration of lameness, prior
      treatment, digit involved, and pathologic condition were evaluated. Owners were
      contacted with regard to the animal's duration in the herd after amputation and
      reason for exiting the herd, level of production attained, and degree of
      lameness. The animal was judged to have a good, fair, or poor recovery on the
      basis of this information. Septic arthritis of the distal interphalangeal joint
      and resulting complications were the problems most frequently treated by digit
      amputation. Fifty-one percent of cattle undergoing digit amputation attained
      preamputation production levels for a minimum of 24 months. Approximately 30% of
      cattle undergoing digit amputation were culled for lameness, usually within 7
      months of surgery. Cattle remaining in the herd more than 12 months after
      amputation were unlikely to be culled for lameness, indicating that long-term
      breakdown of supporting structures was uncommon. Likelihood of a good recovery
      decreased from 71.4% in cattle weighing < or = 341 kg to 27.3% in cattle weighing
      > or = 682 kg. Cattle undergoing amputation of a rear medial digit were more
      likely to recover well than those undergoing amputation of either front digit.
      The most frequently performed amputation was that of a rear lateral digit, but it
      was associated with the poorest recovery, possibly because of the
      disproportionate amount of stress placed on this digit. Cattle used for dairy and
      beef production had approximately equal chances of a good recovery from digit
      amputation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468231
TI  - Bordetella bronchiseptica pneumonia in a koala.
AB  - A 3-year-old male koala (Phascolarctos cinereus) was evaluated because of severe
      acute respiratory distress. Despite medical treatment, the koala died. Gross and
      histologic lesions consistent with acute bacterial pneumonia were identified at
      necropsy and Bordetella bronchiseptica was isolated from pulmonary tissue. There
      are 2 prior reports from Australia of fatal B bronchiseptica pneumonia in captive
      koalas.

PMID- 8468232
TI  - Immobilization and anesthesia of two hand-reared zebras.
AB  - This report describes our experiences with 2 drug combinations that were used
      safely and effectively to immobilize and anesthetize 2 hand-reared zebras. Zebras
      were sedated with xylazine hydrochloride or detomidine. The latter is more potent
      and of more use in healthy, vigorous animals. Anesthesia was induced with
      thiamylal/guaifenesin or tiletamine/zolazepam. The latter is more convenient
      because a quick, simple IV injection will preclude the necessity for physical
      restraint required to administer a large volume of guaifenesin/thiobarbiturate
      combination. Tracheal intubation was easily accomplished with either induction
      regimen, and inhalation anesthetic was used for longer periods of anesthesia.

PMID- 8468233
TI  - What is your diagnosis? Lysis of the left zygomatic process and the squamous
      portion of the left temporal bone.

PMID- 8468234
TI  - What is your diagnosis? Mass in the cranial mediastinum.

PMID- 8468235
TI  - Pepticinnamins, new farnesyl-protein transferase inhibitors produced by an
      actinomycete. I. Producing strain, fermentation, isolation and biological
      activity.
AB  - Pepticinnamins A, B, C, D, E and F, a family of farnesyl-protein transferase
      (FPT) inhibitors were isolated from the fermentation broth of Streptomyces sp. OH
      4652. These inhibitors were purified from whole broth by extraction with
      chloroform, followed by silica gel column chromatography, Sephadex LH-20
      chromatography and reverse phase HPLC. Among these, pepticinnamin C showed the
      most potent inhibition (IC50-100 nM).

PMID- 8468236
TI  - Pepticinnamins, new farnesyl-protein transferase inhibitors produced by an
      actinomycete. II. Structural elucidation of pepticinnamin E.
AB  - Structure of novel farnesyl transferase inhibitor, pepticinnamin E, is elucidated
      by NMR study. Pepticinnamin E is composed of five amino acids and o
      pentenylcinnamic acid, having a molecular weight of 907. C-terminal glycylserine
      of the compounds is in the cyclized diketopiperazine form.

PMID- 8468237
TI  - Novel antimycin antibiotics, urauchimycins A and B, produced by marine
      actinomycete.
AB  - Two novel antimycin antibiotics, urauchimycins A and B, were isolated from a
      fermentation broth of a Streptomyces sp. Ni-80. The strain was isolated from an
      unidentified sponge. Their chemical structures were determined by 2D NMR
      analysis. They are the first antimycin antibiotics which possess a branched side
      chain moiety. They exhibited inhibitory activity against morphological
      differentiation of Candida albicans.

PMID- 8468238
TI  - Mer-WF3010, a new member of the papulacandin family. I. Fermentation, isolation
      and characterization.
AB  - Mer-WF3010, a new member of the papulacandin family, was isolated from the
      mycelia of Phialophora cyclaminis Mer-WF3010 (FERM P-11475). The molecular
      formula of Mer-WF3010 was determined as C45H60O16.

PMID- 8468239
TI  - AB023, novel polyene antibiotics. I. Taxonomy of the producing organism,
      fermentation and antifungal activity.
AB  - AB023 is a complex of polyene antibiotics produced by an actinomycete, SD581,
      which was isolated from a Kenyan soil sample. The two main components, pentaene
      antibiotics AB023a and AB023b, have antifungal activity against some
      phytopathogenic fungi, particularly against Botrytis cinerea (MIC of 5
      micrograms/ml).

PMID- 8468240
TI  - AB023, novel polyene antibiotics. II. Isolation and structure determination.
AB  - AB023, a complex of new polyene antibiotics, was isolated from a soil
      Streptomyces strain. The two main components, pentaene antibiotics AB023a and
      AB023b, were separated and purified by preparative chromatographic methods and
      their structures were determined by extensive NMR and mass spectrometric studies.

PMID- 8468241
TI  - BMS-181184, a new pradimicin derivative. Screening, taxonomy, directed
      biosynthesis, isolation and characterization.
AB  - BMS-181184 is a new semisynthetic pradimicin derivative with a broad-spectrum
      antifungal activity. In a search for actinomycetes producing BMS-181184, 4
      strains of Actinomadura sp. isolated from soil samples were found to produce the
      antibiotic under conditions of directed biosynthesis. Among them, Actinomadura
      sp. AB1236 proved most useful in the production of BMS-181184 when fermented in a
      medium containing D-serine and D-cycloserine. A minor product isolated from the
      broth of strain AB1236 was identified as the dexylosyl analog of BMS-181184,
      which was also obtained by acid hydrolysis of BMS-181184.

PMID- 8468242
TI  - Three novel polyether antibiotics X-14889A, C, and D from a streptomycete.
      Taxonomy of the producing organism, fermentation production and biological
      properties of the antibiotics.
AB  - Antibiotic X-14889A, C, and D are novel polyether antibiotics related to
      lysocellin and antibiotic X-14873A. They are produced by a streptomycete isolated
      from a soil of Wisconsin. The antibiotic X-14889C is active against Gram-positive
      bacteria and exhibits ionophore property.

PMID- 8468243
TI  - Isolation and characterization of four polyether antibiotics, X-14889A, B, C, and
      D, closely related to lysocellin and the ferensimycins.
AB  - Streptomyces sp. X-14889 (NRRL 15517) has been found to produce a number of novel
      polyether antibiotics and an orange pigment. One of the antibiotics, X-14889B (3)
      was identified as ferensimycin A, which in turn is an isomer of the well-studied
      polyether antibiotic, lysocellin (1). Of the three other antibiotics, X-14889C
      (4) is a lower homolog of ferensimycin A and antibiotics X-14889A (2) and D (5)
      which are respectively the descarboxy and anhydro-descarboxy forms of this same
      molecule. The latter compound, X-14889D is of interest as it contains an ether
      bridge across the terminal tetrahydrofuranyl ring in an analogous relationship to
      that reported earlier for antibiotics X-14873A (6) and G.

PMID- 8468244
TI  - Ferrocins, new iron-containing peptide antibiotics produced by bacteria.
      Isolation, characterization and structure elucidation.
AB  - Novel iron-containing peptide antibiotics, ferrocins A, B, C and D, have been
      isolated from the culture filtrate of Pseudomonas fluorescens YK-310. These
      antibiotics were purified by butanol extraction, followed by column
      chromatography using adsorption resin, silica gel and preparative reverse-phase
      HPLC. The structures of ferrocins were elucidated using spectroscopic and
      degradative methods. Ferrocins contain three hydroxamate moieties per ferric ion
      which forms an octahedral iron complex.

PMID- 8468245
TI  - Synthesis of the metabolite N-hydroxy-desferrioxamine B.
AB  - N-Hydroxy-desferrioxamine B (5), a postulated metabolite of the microbial product
      desferrioxamine B (1), has been prepared by reduction of the intermediate oxime 6
      with sodium cyanoborohydride. The oxime was obtained by selective oxidation of
      desferrioxamine B with hydrogen peroxide and a catalytic amount of sodium
      tungstate dihydrate. The iron complex derived from 5 enabled definite proof of
      the structure of one of four metabolites of desferrioxamine B found in urine
      samples of patients treated with this drug.

PMID- 8468246
TI  - Syntheses of the potent inhibitors of neuraminidase, N-(1,2-dihydroxypropyl)
      derivatives of siastatin B and its 4-deoxy analogs.

PMID- 8468247
TI  - Structures of enzymatically modified products of arbekacin by methicillin
      resistant. Staphylococcus aureus.
AB  - Only a limited number of strains of methicillin-resistant Staphylococcus aureus
      (MRSA) moderately resistant to arbekacin (ABK) have been isolated clinically.
      Three inactivated products of ABK have been obtained by reaction with excess
      amounts of a crude enzyme preparation extracted from an ABK-resistant MRSA strain
      (MIC, 25 micrograms/ml). The 2"-O-phosphate was the major product together with
      small amounts of the 6'-N-acetate and the double modification product. The
      structures of these modification products were determined by MS and NMR spectral
      analyses.

PMID- 8468248
TI  - Orally active cephalosporins. III. Synthesis and structure-activity relationships
      of new 3-heterocyclicthiomethylthio-7 beta-[(Z)- 2-(2-aminothiazol-4-yl)-2
      hydroxyiminoacetamido]-3-cephem-4 -carboxylic acids.
AB  - 3-Heterocyclicthiomethylthio-7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-
      hydroxyiminoacetamido]-3-cephem-4-carboxylic acids (2) were synthesized. Their
      antibacterial activity and oral absorbability were much influenced by the
      structure of heteroaromatic moiety in the side chain at the 3-position of a
      cephem nucleus. In this cephalosporin series, 3
      thiadiazolylthiomethylthiocephalosporins (2k, 2l and 2m) exhibited potent
      antibacterial activity against both Gram-positive and Gram-negative bacteria,
      whereas 3-(2-methyl-1,2,3-triazol-4-yl)thiomethylthiocephalosporin (2b) and 3
      (pyridin-2-yl)thiomethylthiocephalosporin (2n) showed better oral absorption in
      mice than the other cephalosporins prepared. The structure-activity relationships
      of 2 are presented.

PMID- 8468249
TI  - Synthesis and structure-activity relationships of some 6 beta-acrylamido
      penicillins.
AB  - Syntheses are described for penicillins (4b approximately 4i, 5a and 5b) which
      possess a 6 beta-(2-heteroaryl-3-substituted)-propenamido side-chain of fixed
      geometry. In vitro results for these compounds against a range of Gram-positive
      and Gram-negative bacteria showed in most cases good stability against both
      penicillinase and TEM-1 beta-lactamase; analogues (4b approximately 4i) bearing a
      2-(2-aminothiazol-4-yl) unit showed the best intrinsic activity, the cyclohexyl
      compound (4b) being the most promising. The 1-acetoxyethyl ester (6) of 4b was
      also prepared; in experimental animal studies the in vivo properties of this
      compound compared favourably with cefuroxime axetil and are reported together
      with selected in vivo data for the other compounds.

PMID- 8468250
TI  - Secondary metabolites by chemical screening. 21. Clonostachydiol, a novel
      anthelmintic macrodiolide from the fungus Clonostachys cylindrospora (strain FH-A
      6607).

PMID- 8468251
TI  - Metabolic products of microorganisms. 264. Exfoliamycin and related metabolites,
      new naphthoquinone antibiotics from Streptomyces exfoliatus.

PMID- 8468252
TI  - Elaiophylin as a rumen fermentation efficiency enhancer.

PMID- 8468253
TI  - Mer-WF3010, a new member of the papulacandin family. II. Structure determination.

PMID- 8468254
TI  - FK037, a new parenteral cephalosporin with a broad antibacterial spectrum:
      synthesis and antibacterial activity.

PMID- 8468255
TI  - Stereoselective synthesis of BRL 56173, a bicyclic acrylic penicillin highly
      stable to beta-lactamases.

PMID- 8468256
TI  - Methods for Escherichia coli identification in food, water and clinical samples
      based on beta-glucuronidase detection.

PMID- 8468258
TI  - The effect of the olive phenolic compound, oleuropein, on growth and enterotoxin
      B production by Staphylococcus aureus.
AB  - The presence of low concentrations (0.1% w/v) of oleuropein, a phenolic compound
      extracted from olives, delayed the growth of Staphylococcus aureus in NZ amine A
      and brain heart infusion media modified by the addition of growth factors and
      glucose (NZA+ and BHI+), as indicated by changes in conductance, whilst higher
      concentrations (0.4-0.6% w/v) inhibited growth completely. Intermediate
      concentrations of oleuropein (0.2%) prevented growth in BHI+ but allowed growth
      to occur in NZA+ despite an extended lag phase (30 h). Concentrations of
      oleuropein > 0.2% inhibited growth and production of enterotoxin B in both types
      of media. Lower levels (0.1%) did not affect the final viable count and
      production of toxin in BHI+ but decreased the number of viable organisms and
      reduced the toxin production in NZA+ by eightfold. An increase in the
      concentration of oleuropein resulted in a decrease in the amount of glucose
      assimilated and consequently the amount of lactate produced. In addition,
      oleuropein prevented the secretion of a number of exoproteins. Addition of
      oleuropein during the exponential phase appeared to have no effect on the growth
      of Staph. aureus in NZA+.

PMID- 8468257
TI  - Alternative antigens reduce cross-reactions in an ELISA for the detection of
      Salmonella enteritidis in poultry.
AB  - Two alternative antigens for the use in detection of antibodies to salmonellas
      were investigated: firstly, lipopolysaccharide (LPS) from members of the D2
      group, having antigens O: 9, 46, and flagella antigens. Whereas LPS from the D2
      group did not discriminate sufficiently with control sera, flagella antigens
      reacted specifically with antibodies directed to serotype specific H antigens.
      When flagella antigens were used to screen sera from birds of commercial flocks,
      however, cross-reactivity between flagella antigens was observed. When both LPS
      and flagella antigens were used to screen sera from chickens infected with
      Salmonella enteritidis, the sera gave higher titres with flagella antigens during
      the early stages of infection, and titres with flagella antigens dropped earlier
      after infection had ended than titres with lipopolysaccharide.

PMID- 8468259
TI  - Use of the polymerase chain reaction and 16S rRNA sequences for the rapid
      detection of Brochothrix spp. in foods.
AB  - Oligonucleotide primers were designed against rRNA sequences to give a DNA-based
      PCR assay for the rapid identification/detection of Brochothrix spp. The PCR
      products could be confirmed by hybridization to an internal oligonucleotide
      probe. The method successfully and sensitively detected/identified these
      organisms in pure cultures but was of limited value as a detection method because
      the detection sensitivity, in relation to conventional plate counts, varied and
      the assay sensitivity was reduced in the presence of staphylococci. Furthermore,
      sensitivity was also lost when the assay was applied directly to meat samples.
      However, a separation step using a lectin (from Agaricus bisporus) immobilized on
      magnetic beads prior to the PCR assay, allowed the direct detection of low
      numbers (> 10(2) cfu g-1) of Brochothrix in meat samples within a working day.

PMID- 8468260
TI  - Separation of bacteria using agglutinins isolated from invertebrates.
AB  - The agglutination of a selection of Gram-positive and Gram-negative bacteria by
      the haemolymph and coelomic fluid from several invertebrates was studied. The
      haemolymph from Lumbricus terrestris and Limulus polyphemus caused the strongest
      agglutination of most of the bacteria studied. When the agglutinating fraction of
      Lim. Polyphemus was liganded to magnetic microspheres 53% of the cells in pure
      cultures of Listeria monocytogenes C200, 15% of Salmonella enteritidis 37782, 92%
      of Staphylococcus aureus NCDO 949, 19% of Escherichia coli E4936/76 and 65% of E.
      coli W2-2 were adsorbed to the beads. The immobilized haemolymph from Lumb.
      terrestris adsorbed 42% of Salm. enteritidis 37782, 64% of E. coli 4936/76 and
      27% of Staph. aureus NCDO 1499 cells and the coelomic fluid from Haemopsis
      sanguisuga adsorbed 42, 48 and 50% of these cultures respectively. With
      immobilized Haem. sanguisuga agglutinins, 21-27% of Staph. aureus NCDO 2044 cells
      were recovered from full-fat pasteurized milk and 20-51% from braising steak.
      Immobilized Lim. polyphemus agglutinins recovered 17-34% of Staph. aureus cells
      from raw egg. The potential of agglutinins isolated from invertebrates for
      enhancing rapid microbiological assays of foods is discussed.

PMID- 8468261
TI  - Adhesion of Lactobacillus acidophilus to avian intestinal epithelial cells
      mediated by the crystalline bacterial cell surface layer (S-layer).
AB  - Lactobacillus acidophilus was isolated from washed and homogenized walls of the
      crop and caecum of an adult fowl. A strain that adhered well in the Fuller
      adhesion test was subcultured until colonies on Lactobacillus Selective agar
      changed from rough to smooth. This coincided with a change from aggregate to
      planktonic growth in liquid medium and a marked loss of ability to adhere.
      ultrastructure of cells from both types of culture was studied by electron
      microscopy. An S-layer formed the outermost part of the cell wall in the strongly
      adherent strain, whereas this layer was covered with polymerized material or was
      absent in strains that lacked the ability to adhere, or those with reduced
      adherence.

PMID- 8468262
TI  - Molecular characterization of Lactobacillus curvatus and Lact. sake isolated from
      sauerkraut and their application in sausage fermentations.
AB  - Lactobacillus curvatus and Lact. sake are best adapted to meat fermentations and
      dominate the flora during the whole process. In fermenting sauerkraut,
      Leuconostoc mesenteroides subsp. mesenteroides is the major organism only during
      the early phase. In this environment Lact. curvatus and Lact. sake provide up to
      50% of the microbial flora especially of the later phase, depending on the
      process conditions. Strains of Lact. curvatus and Lact. sake isolated from
      fermenting sauerkraut were identified by hybridization with species specific 23S
      rRNA-targeted oligonucleotide probes and further characterized. In 59 of 72
      strains, plasmid DNA was detected. Small cryptic plasmids of 20 strains were
      found to be homologous with pLc2, a 2.6 kb plasmid from Lact. curvatus LTH683,
      which was originally isolated from meat. The ability to compete was investigated
      in fermenting sausages of two strains each of Lact. curvatus and Lact. sake
      isolated from sauerkraut. One strain each of Lact. curvatus and Lact. sake was
      found to outnumber the meat-borne flora and govern the process.

PMID- 8468263
TI  - Digoxigenin-labelled inv- and ail-probes for the detection and identification of
      pathogenic Yersinia enterocolitica in clinical specimens and naturally
      contaminated pig samples.
AB  - A non-radioactive colony hybridization method was developed for the rapid
      detection of Yersinia enterocolitica in primary isolates and for differentiation
      between pathogenic and non-pathogenic strains. The method is based on,
      respectively, the presence of the inv-locus in all Yersinia spp. and the presence
      of the ail-gene in pathogenic Y. enterocolitica only. Hybridization results with
      ail-probes of 132 strains of Y. enterocolitica were in good agreement with
      pathogenicity phenotypes as indicated by a tissue culture invasion (TCI) assay
      and by serotyping. All TCI+ strains and only two TCI- strains were positive by
      hybridization with ail. Hybridization results with inv- or ail-probes of 150
      primary isolates of human, animal or slaughterhouse origin were compared with
      those of conventional methods to detect and identify Y. enterocolitica. All
      samples that were positive for Yersinia spp. by cultivation (four of 66) or were
      positive for pathogenic Y. enterocolitica by cultivation and serotyping (six of
      84) were also positive by hybridization with, respectively, the inv- or ail
      probe. In three slaughterhouse swab samples, in which Yersinia spp. were not
      detected by cultivation (2%), strong positive hybridization signals were obtained
      with the inv- and/or ail-probe. Four other swab samples which were negative by
      cultivation produced weak positive signals by hybridization with inv- and/or ail
      probes. These results indicate that the method can be used for (1) the
      identification of pathogenic Y. enterocolitica isolates and (2) the detection of
      Yersinia spp. in primary isolates of naturally contaminated samples.

PMID- 8468264
TI  - Numerical taxonomy of Lactobacillus spp. associated with healthy and diseased
      mucosa of the human intestines.
AB  - Two-hundred and fifty Lactobacillus strains isolated from healthy and diseased
      mucosa of human intestines of 75 individuals and 49 reference strains were
      phenotypically classified using 49 unit characters. Data were processed by the
      Jaccard (SJ) and Simple Matching (SSM) coefficients, and unweighted pair group
      algorithm with arithmetic averages. Seventeen major clusters were defined at the
      76% SJ-similarity level which approximately correspond to the SSM-level of 91%.
      Seven clusters could be identified: Lactobacillus plantarum (isolates recovered
      from 5% of the patients), Lact. casei subsp. rhamnosus (17% of the patients),
      Lact. casei subsp. pseudoplantarum (5% of the patients), Leuconostoc
      mesenteroides subsp. mesenteroides (3% of the patients), Lact. buchneri (4% of
      patients), Lact. reuteri (4% of the patients) and Lact. salivarius subsp.
      salivarius (9% of the patients). Unassigned clusters 1 and 3 both contained
      homofermentative Lactobacillus strains. Cluster 1 included the type strains of
      Lact. crispatus, Lact. acidophilus, Lact. jensenii and Lact. gasseri, and cluster
      3, the type strains of Lact. delbrueckii subsp. lactis, Lact. agilis and Lact.
      casei subsp. tolerans. Clusters 1 and 3 were found in 15% and 25% of the
      patients, respectively. Unassigned clusters 2, 6, 7, 8 and 10 contained
      homofermentative Lactobacillus strains but no reference strains. Clusters 11, 12,
      15 and 17 were made up of heterofermentative Lactobacillus strains but no
      reference strains. Phenotypical characteristics of the clusters are given. No
      obvious trends in species (cluster) composition between different intestinal
      locations could be noted. Most clusters contained isolates from both diseased and
      healthy mucosa. Exceptions were cluster 15 and cluster 17 which only included
      isolates from healthy mucosa, and cluster 11 which only included isolates from
      diseased mucosa. Cluster 15 was isolated in 12% of the patients, and cluster 11
      in 8%.

PMID- 8468265
TI  - Laboratory study of several enrichment broths for the detection of Salmonella
      spp. particularly in relation to water samples.
AB  - The selectivity and efficiency of several enrichment broths used for the the
      detection of salmonellas were comparatively evaluated under laboratory and
      environmental conditions. Media with selenite were less efficient in their
      inhibition of the growth of Gram-positive micro-organisms. Salmonellas grew
      slowly in tetrathionate broth and in media containing brilliant green. These
      media inhibited the growth of Salmonella typhi, which grew only in media
      containing selenite. The results obtained in the experiments with stressed
      salmonellas indicate that the media selenite F, selenite F with novobiocin,
      selenite cystine and Rappaport-Vassiliadis (RV/43), in conjunction with the
      double agar layer technique, showed an optimal efficiency for the detection of
      stressed salmonellas. When natural samples (freshwater and seawater) were used to
      evaluate the media, however, those containing malachite green, whether or not
      supplemented with sodium novobiocin, enhanced the recovery of salmonellas.

PMID- 8468266
TI  - Safety studies of modified hemoglobin as an oxygen-carrying blood substitute.

PMID- 8468268
TI  - Therapy-related second malignancies. Proceedings of a symposium. Boston, January
      1992.

PMID- 8468267
TI  - The biology of alkylating-agent cellular injury.
AB  - Alkylating agents, such as nitrogen mustard, cyclophosphamide, and the
      nitrosoureas, have been used to treat many malignancies for more than 30 years.
      It is now clear that they are not only cytotoxic but also mutagenic and
      carcinogenic. The initial alkylation event, monoadduct formation on ring
      nitrogens or extra-cyclic oxygens of nucleotide bases, can result in chromosomal
      loss or single base mutation, both of which can lead to malignant transformation.
      The bone marrow is particularly sensitive to these events, and acute myelogenous
      leukemia is the most common malignancy caused by alkylating agents. Mechanisms of
      genetic damage and mutagenesis are discussed.

PMID- 8468269
TI  - Cellular, molecular, and carcinogenic effects of radiation.
AB  - (1) The biologic effects of ionizing radiation at the cellular and molecular
      levels differ from those of many chemical agents. Radiation is a classic
      genotoxic agent. The important DNA lesion with respect to its cytotoxic and
      mutagenic effects appears to be the DNA double strand break, whereas
      chemotherapeutic alkylating agents induce primarily base damage from adduct
      formation and cross-linking. Radiation-induced mutations result primarily from
      large-scale structural changes in DNA as a result of mechanisms such as
      chromosomal deletions, rearrangements, and homologous recombination, rather than
      point mutation as generally observed with alkylating agents. Finally, radiation
      is highly cytotoxic; a significantly increased frequency of specific gene
      mutations is usually observed only following doses that produce significant cell
      killing. (2) Radiation may not be a very potent inducer of second malignant
      tumors, at least in most cases. This prediction is derived from the localized
      nature of the exposure during clinical radiotherapy, in which the dose to normal
      tissues is minimized, and from the fact that radiation tends to be cytotoxic
      rather than mutagenic. The very high doses employed in curative radiotherapy may
      thus kill potentially transformed cells in the field. An exception to this
      general prediction may be Hodgkin's disease, in which a relatively large volume
      of tissue is treated with lower total radiation doses. (3) We have a firm
      scientific basis on which to predict the carcinogenic effects of radiation at
      many tissue sites, owing to extensive quantitative epidemiologic data in human
      populations. Unlike for chemical agents, radiation can be easily detected, and
      the absorbed dose to critical tissues is precisely measured. Thus, we know about
      the sensitivity of many target tissues to radiation-induced cancer. (4) A number
      of factors can modify the carcinogenic effects of radiation. It is likely that
      important interactive effects will occur between radiation and chemotherapeutic
      alkylating agents, which may depend upon the timing and order of the treatments
      as well as the particular agent(s) employed. (5) Genetic predisposition to
      radiation-induced cancer may be a confounding factor in the prediction of its
      effects in any given individual.

PMID- 8468270
TI  - Mutagenesis after therapy for Hodgkin's disease.
AB  - Therapy for Hodgkin's disease has been associated with a significant increase in
      risk for second cancers. To begin an investigation of the association of therapy
      induced genetic damage with this risk, somatic mutations at the hypoxanthine
      phosphoribosyltransferase locus were measured in lymphocytes from patients
      previously treated for Hodgkin's disease. The results demonstrate that a subset
      of patients have persistently elevated mutation frequencies, perhaps suggesting
      that these individuals are among those at significant risk of second cancer
      development.

PMID- 8468271
TI  - Acute leukemia after the treatment of Hodgkin's disease.
AB  - The risk of developing a secondary acute leukemia or myelodysplastic syndrome
      after the treatment of Hodgkin's disease is discussed on the basis of the results
      reported from large series with prolonged follow-up. It appears that the risk
      mainly depends upon the treatment strategy and certain host-related factors such
      as older age. Radiation therapy used alone is associated with the lowest risk,
      combination mechlorethamine, vincristine, procarbazine, and prednisone (MOPP)
      chemotherapy plus irradiation with the highest risk, and the risk of MOPP
      chemotherapy alone being in between the two. Splenectomy and probably splenic
      irradiation may also add to the risk. In long-term, surviving patients
      continuously free of Hodgkin's disease, the cumulative probability of second
      leukemia is low, with a high risk period which can be limited to the 10 years
      following the end of curative therapy. Finally, the impact of secondary leukemia
      on long-term survival is limited and far less than that of second tumors.

PMID- 8468272
TI  - Solid second cancers following Hodgkin's disease.
AB  - Patients treated for Hodgkin's disease with radiation therapy, chemotherapy, or
      both, are often cured with potential lives ahead of them. It is now obvious,
      however, that many of these patients will develop solid tumors in the years after
      their successful treatment for Hodgkin's disease. These tumors include non
      Hodgkin's lymphomas, lung cancers, sarcomas, and gastrointestinal malignancies,
      as well as other solid tumors. Understanding the epidemiology of the development
      of these solid tumors should allow us to design therapies in the future that
      diminish the risk of developing these second cancers.

PMID- 8468273
TI  - Second tumors after treatment of childhood malignancies.
AB  - The occurrence of a second malignancy represents a serious complication of
      childhood cancer. With the introduction of more intensive multiagent therapy for
      childhood cancers, not only are a greater proportion of children surviving their
      initial cancer, but also they now may be at greater risk for developing a second
      malignancy. The larger studies indicate that the cumulative incidence of second
      cancers may be as high as 12% at 20 years following the initial cancer. The most
      consistent finding of the larger studies is that the elevated risk of a second
      cancer remains relatively constant over time, but the absolute risk increases
      substantially as the length of follow-up increases. There are treatment-related
      risk factors, such as solid tumors within irradiated fields and secondary
      leukemias following alkylating therapy. Retinoblastoma represents one example of
      the role of genetic predisposition in second cancers. It is imperative that
      survivors of childhood cancer be closely followed to determine the occurrence of
      second cancers, particularly those that may occur many years following the
      original childhood cancer. Research needs to be directed toward the
      identification of treatment, as well as genetic and life style risk factors.
      Intervention, through modifications of treatment protocols and implementation of
      preventive programs, may have a future role in reducing the occurrence of second
      cancers.

PMID- 8468274
TI  - Risk factors for the development of secondary malignancies after marrow
      transplantation.
AB  - Bone marrow transplantation is associated with several risk factors that may
      predispose patients to the development of a new malignancy post-transplant.
      Several types of malignancies, including lymphoproliferative disorders, new
      leukemias, and solid tumors have been observed. Risk factors include treatment of
      acute graft-versus-host disease with monoclonal or polyclonal antibodies, total
      body irradiation, HLA nonidentity, and T-cell depletion. It is currently unknown
      whether longer follow-up will show a further increase or decline in the incidence
      of secondary tumors.

PMID- 8468275
TI  - Tumors after renal and cardiac transplantation.
AB  - Organ transplant recipients treated with immunosuppressive therapy are prone to
      develop malignancies particularly squamous cell carcinomas of the skin, non
      Hodgkin's lymphomas, Kaposi's sarcomas, carcinomas of the vulva and perineum, in
      situ carcinomas of the uterine cervix, renal carcinomas, hepatomas, and various
      sarcomas. The earliest tumors to appear are the Kaposi's sarcoma at an average of
      21 months after transplantation, and the latest are carcinomas of the vulva and
      perineum, at an average of 112 months after transplantation. The tumors that
      develop in cardiac allograft recipients compared with renal transplant recipients
      are predominantly non-Hodgkin's lymphomas and more rarely, skin, uterine cervical
      and vulvar tumors. Major factors accounting for these differences are the
      intensity of immunosuppressive therapy given to the cardiac patients and the much
      longer follow-up of the renal allograft recipients.

PMID- 8468276
TI  - Treatment of therapy-related acute myelogenous leukemia and myelodysplastic
      syndromes.
AB  - The number of cases of therapy-related acute myelogenous leukemia and
      myelodysplastic syndromes has risen with the advances of successful combination
      chemotherapy. Unfortunately, the therapy-related diseases are difficult to treat.
      Aggressive induction chemotherapy can induce a complete remission, but the
      remission duration is short. Differentiating agents, hormonal agents, and growth
      factors have all been disappointing. Allogeneic bone marrow transplantation
      remains the only curative approach.

PMID- 8468277
TI  - Gene to ultrastructure: the case of the flagellar basal body.

PMID- 8468278
TI  - Highly selective binding of nascent polypeptides by an Escherichia coli chaperone
      protein in vivo.
AB  - Chaperone proteins bind to newly synthesized polypeptides and assist in various
      assembly reactions. The Escherichia coli chaperone protein SecB binds precursors
      of exported proteins and assists in export. In vitro, SecB can bind to many
      unfolded proteins. In this report, we demonstrate that SecB binding in vivo is
      highly selective; the major polypeptides that are bound by SecB are nascent
      precursors of the exported proteins maltose-binding protein (MBP), LamB, OmpF,
      and OmpA. These results support the hypothesis that the primary physiological
      function of SecB is to stimulate protein export. By interacting with nascent
      polypeptides, SecB probably stimulates their cotranslational association with the
      membrane-bound protein translocation apparatus.

PMID- 8468279
TI  - Unipolar localization and ATPase activity of IcsA, a Shigella flexneri protein
      involved in intracellular movement.
AB  - Shigella flexneri uses elements of the host cell cytoskeleton to move within
      cells and from cell to cell. IcsA, an S. flexneri protein involved in this
      movement, was purified and studied in vitro. IcsA bound the radiolabelled ATP
      analog 3'(2')-O-(4-benzoyl)benzoyl-ATP and hydrolyzed ATP. In addition, the
      surface localization of IcsA on both extracellular and intracellular shigellae
      was unipolar. Further, in HeLa cells infected with shigellae, IcsA antiserum
      labelled the actin tail throughout its length, thereby suggesting that IcsA
      interacts with elements within the tail. Localization of IcsA within the tail at
      a distance from the bacterium would require its secretion; we demonstrate here
      that in vitro IcsA is secreted into the culture supernatant in a cleaved form.

PMID- 8468280
TI  - Genetic construction and functional analysis of hybrid polyketide synthases
      containing heterologous acyl carrier proteins.
AB  - The gene that encodes the acyl carrier protein (ACP) of the actinorhodin
      polyketide synthase (PKS) of Streptomyces coelicolor A3(2) was replaced with
      homologs from the granaticin, oxytetracycline, tetracenomycin, and putative
      frenolicin polyketide synthase gene clusters. All of the replacements led to
      expression of functional synthases, and the recombinants synthesized aromatic
      polyketides similar in chromatographic properties to actinorhodin or to shunt
      products produced by mutants defective in the actinorhodin pathway. Some regions
      within the ACP were also shown to be interchangeable and allow production of a
      functional hybrid ACP. Structural analysis of the most abundant polyketide
      product of one of the recombinants by electrospray mass spectrometry suggested
      that it is identical to mutactin, a previously characterized shunt product of an
      actVII mutant (deficient in cyclase and dehydrase activities). Quantitative
      differences in the product profiles of strains that express the various hybrid
      synthases were observed. These can be explained, at least in part, by differences
      in ribosome-binding sites upstream of each ACP gene, implying either that the ACP
      concentration in some strains is rate limiting to overall PKS activity or that
      the level of ACP expression also influences the expression of another enzyme(s)
      encoded by a downstream gene(s) in the same operon as the actinorhodin ACP gene.
      These results reaffirm the idea that construction of hybrid polyketide synthases
      will be a useful approach for dissecting the molecular basis of the specificity
      of PKS-catalyzed reactions. However, they also point to the need for reducing the
      chemical complexity of the approach by minimizing the diversity of polyketide
      products synthesized in strains that produce recombinant polyketide synthases.

PMID- 8468281
TI  - Energy flux and osmoregulation of Saccharomyces cerevisiae grown in chemostats
      under NaCl stress.
AB  - The energetics and accumulation of solutes in Saccharomyces cerevisiae were
      investigated for cells grown aerobically in a chemostat under NaCl stress and
      glucose limitation. Changed energy requirements in relation to external salinity
      were examined by energy balance determinations performed by substrate and product
      analyses, with the latter including heat measurements by microcalorimetry. In
      both 0 and 0.9 M NaCl cultures, the catabolism was entirely respiratory at the
      lowest dilution rates tested but shifted to a mixed respiratory-fermentative
      metabolism at higher dilution rates. This shift occurred at a considerably lower
      dilution rate for salt-grown cells. The intracellular solute concentrations, as
      calculated on the basis of intracellular soluble space determinations, showed
      that the internal Na+ concentration increased from about 0.02 molal in basal
      medium to about 0.18 molal in 0.9 M NaCl medium, while intracellular K+ was
      maintained around 0.29 molal despite the variation in external salinity. The
      intracellular glycerol concentration increased from below 0.05 molal at low
      salinity to about 1.2 molal at 0.9 M NaCl. The concentrations of the internal
      solutes, however, changed insignificantly with growth rate and energy metabolism.
      The additional maintenance energy expenditure for growth at 0.9 M NaCl was,
      depending on the growth rate, 14 to 31% of the total energy requirement for
      growth at 0 M NaCl. Including the energy conserved in glycerol, the total
      additional energy demand for growth at 0.9 M NaCl corresponded to 28 to 51% of
      the energy required for growth at 0 M NaCl.

PMID- 8468282
TI  - Characterization of the Escherichia coli F factor traY gene product and its
      binding sites.
AB  - The traY gene product (TraYp) from the Escherichia coli F factor has previously
      been purified and shown to bind a DNA fragment containing the F plasmid oriT
      region (E. E. Lahue and S. W. Matson, J. Bacteriol. 172:1385-1391, 1990). To
      determine the precise nucleotide sequence bound by TraYp, DNase I footprinting
      was performed. The TraYp-binding site is near, but not coincident with, the site
      that is nicked to initiate conjugative DNA transfer. In addition, a second TraYp
      binding site, which is coincident with the mRNA start site at the traYI promoter,
      is described. The Kd for each binding site was determined by a gel mobility shift
      assay. TraYp exhibits a fivefold higher affinity for the oriT binding site
      compared with the traYI promoter binding site. Hydrodynamic studies were
      performed to show that TraYp is a monomer in solution under the conditions used
      in DNA binding assays. Early genetic experiments implicated the traY gene product
      in the site- and strand-specific endonuclease activity that nicks at oriT (R.
      Everett and N. Willetts, J. Mol. Biol. 136:129-150, 1980; S. McIntire and N.
      Willetts, Mol. Gen. Genet. 178:165-172, 1980). As this activity has recently been
      ascribed to helicase I, it was of interest to see whether TraYp had any effect on
      this reaction. Addition of TraYp to nicking reactions catalyzed by helicase I
      showed no effect on the rate or efficiency of oriT nicking. Roles for TraYp in
      conjugative DNA transfer and a possible mode of binding to DNA are discussed.

PMID- 8468283
TI  - Mechanism of adverse conditions causing lack of flagella in Escherichia coli.
AB  - Escherichia coli lacks flagella when grown in tryptone broth in the presence of
      various adverse conditions (C. Li, C. J. Louise, W. Shi, and J. Adler, J.
      Bacteriol. 175:2229-2235, 1993). Now, the synthesis, rather than the degradation,
      of flagellin was shown to be inhibited. Studies of transcriptional fusions of
      flagellar operons to the lacZ gene revealed that transcription of the flagellar
      genes was reduced in cells grown under these adverse conditions. Increasing gene
      dosage of the flhD operon by a plasmid partially suppressed the nonflagellation
      caused by some adverse conditions. The signal which shuts off the synthesis of
      flagella under adverse conditions remains to be discovered. This shutting-off
      process does not result from catabolite repression or from signals from the
      chemotaxis system.

PMID- 8468284
TI  - Plasmolysis bays in Escherichia coli: are they related to development and
      positioning of division sites?
AB  - Plasmolysis bays, induced in Escherichia coli by hypertonic treatment, are
      flanked by zones of adhesion between the plasma membrane and the cell wall. To
      test the proposition of Cook et al. (W. R. Cook, F. Joseleau-Petit, T. J.
      MacAlister, and L. I. Rothfield, Proc. Natl. Acad. Sci. USA 84:7144-7148, 1987)
      that these zones, called periseptal annuli, play a role in determining the
      division site, we analyzed the positions of these zones by phase-contrast and
      electron microscopy. In situ treatment of cells grown in agar showed that the
      youngest cell pole was the most susceptible to plasmolysis, whereas the
      constriction site was resistant. Lateral bays occurred only at some distance from
      a polar bay or a resistant constriction site. Orienting cells with their most
      prominently plasmolyzed polar bay in one direction showed that the lateral bays
      were always displaced away from the polar bay at about half the distance to the
      other cell pole. If no poles were plasmolyzed, lateral bays occurred either in
      the centers of nonconstricting cells or at the 1/4 or 3/4 position of cell length
      in constricting cells. The asymmetric positions of lateral plasmolysis bays,
      caused by their abrupt displacement in the presence of polar bays or constriction
      sites, does not confirm the periseptal annulus model (Cook et al.), which
      predicts a gradual and symmetric change in the position of lateral bays with
      increasing cell length. Our analysis indicates that plasmolysis bays have no
      relation to the development and positioning of the future division site.

PMID- 8468285
TI  - Relevance of charged groups for the integrity of the S-layer from Bacillus
      coagulans E38-66 and for molecular interactions.
AB  - In this paper, the importance of charged amino and carboxyl groups for the
      integrity of the cell surface layer (S-layer) lattice from Bacillus coagulans E38
      66 and for the self-assembly of the isolated subunits was investigated.
      Amidination of the free amino groups which preserved their positive net charge
      had no influence on both. On the other hand, acetylation and succinylation, which
      converted the amino groups into either neutral or negatively charged groups, and
      amidation of carboxyl groups were accompanied by the disintegration or at least
      by the loss of the regular structure of the S-layer lattice. Treatment of S-layer
      monolayers with the zero-length cross-linker carbodiimide led to the introduction
      of peptide bonds between activated carboxyl groups and amino groups from adjacent
      subunits. This clearly indicated that in the native S-layer lattice the charged
      groups are located closely enough for direct electrostatic interactions. Under
      disrupting conditions in which the S-layer polypeptide chains were unfolded, 58%
      of the Asx and Glx residues could be amidated, indicating that they occur in the
      free carboxylic acid form. As derived from chemical modification of monolayer
      self-assembly products, about 90% of the lysine and 70% of the aspartic and
      glutamic acid residues are aligned on the surface of the S-layer protein domains.
      This corresponded to 45 amino groups and to 63 carboxyl groups per S-layer
      subunit. Labelling experiments with macromolecules with different sizes and
      charges and adsorption studies with ion-exchange particles revealed a surplus of
      free carboxyl groups on the inner and on the outer faces of the S-layer lattice.
      Since the carboxyl groups on the outer S-layer face were accessible only for
      protein molecules significantly smaller then the S-layer protomers or for
      positively charged, thin polymer chains extending from the surface of ion
      exchange beads, the negatively charged sites must be located within indentations
      of the corrugated S-layer protein network. This was in contrast to the carboxyl
      groups on the inner S-layer face, which were found to be exposed on elevations of
      the S-layer protein domains (D. Pum, M. Sara, and U.B. Sleytr, J. Bacteriol.
      171:5296-5303, 1989).

PMID- 8468286
TI  - A mutation of Escherichia coli SecA protein that partially compensates for the
      absence of SecB.
AB  - The Escherichia coli SecB protein is a cytosolic chaperone protein that is
      required for rapid export of a subset of exported proteins. To aid in elucidation
      of the activities of SecB that contribute to rapid export kinetics, mutations
      that partially suppressed the export defect caused by the absence of SecB were
      selected. One of these mutations improves protein export in the absence of SecB
      and is the result of a duplication of SecA coding sequences, leading to the
      synthesis of a large, in-frame fusion protein. Unexpectedly, this mutation
      conferred a second phenotype. The secA mutation exacerbated the defective protein
      export caused by point mutations in the signal sequence of pre-maltose-binding
      protein. One explanation for these results is that the mutant SecA protein has
      sustained a duplication of its binding site(s) for exported protein precursors so
      that the mutant SecA is altered in its interaction with precursor molecules.

PMID- 8468287
TI  - Cloning and nucleotide sequence of the Myxococcus xanthus lon gene:
      indispensability of lon for vegetative growth.
AB  - The lon gene of Escherichia coli is known to encode protease La, an ATP-dependent
      protease associated with cellular protein degradation. A lon gene homolog from
      Myxococcus xanthus, a soil bacterium which differentiates to form fruiting bodies
      upon nutrient starvation, was cloned and characterized by use of the lon gene of
      E. coli as a probe. The nucleotide sequence of the M. xanthus lon gene was
      determined. It contains an open reading frame that encodes a 92-kDa protein
      consisting of 817 amino acid residues. The deduced amino acid sequence of the M.
      xanthus lon gene product showed 60 and 56% identity with those of the E. coli and
      Bacillus brevis lon gene products, respectively. Analysis of an M. xanthus strain
      carrying a lon-lacZ operon fusion suggested that the lon gene is similarly
      expressed during vegetative growth and development in M. xanthus. In contrast to
      that of E. coli, the M. xanthus lon gene was shown to be essential for cell
      growth, since a null mutant could not be isolated.

PMID- 8468288
TI  - Construction of a Pseudomonas hybrid strain that mineralizes 2,4,6
      trinitrotoluene.
AB  - A bacterium, Pseudomonas sp. strain C1S1, able to grow on 2,4,6-trinitrotoluene
      (TNT), 2,4- and 2,6-dinitrotoluene, and 2-nitrotoluene as N sources, was
      isolated. The bacterium grew at 30 degrees C with fructose as a C source and
      accumulated nitrite. Through batch culture enrichment, we isolated a derivative
      strain, called Pseudomonas sp. clone A, which grew faster on TNT and did not
      accumulate nitrite in the culture medium. Use of TNT by these two strains as an N
      source involved the successive removal of nitro groups to yield 2,4- and 2,6
      dinitrotoluene, 2-nitrotoluene, and toluene. Transfer of the Pseudomonas putida
      TOL plasmid pWW0-Km to Pseudomonas sp. clone A allowed the transconjugant
      bacteria to grow on TNT as the sole C and N source. All bacteria in this study,
      in addition to removing nitro groups from TNT, reduced nitro groups on the
      aromatic ring via hydroxylamine to amino derivatives. Azoxy dimers probably
      resulting from the condensation of partially reduced TNT derivatives were also
      found.

PMID- 8468289
TI  - Relationships between C4 dicarboxylic acid transport and chemotaxis in Rhizobium
      meliloti.
AB  - The relationship between chemotaxis and transport of C4 dicarboxylic acids was
      analyzed with Rhizobium meliloti dct mutants defective in one or all of the genes
      required for dicarboxylic acid transport. Succinate, malate, and fumarate were
      moderately potent chemoattractants for wild-type R. meliloti and appeared to
      share a common chemoreceptor. While dicarboxylate transport is inducible, taxis
      to succinate was shown to be constitutive. Mutations in the dctA and dctB genes
      both resulted in the reduction, but not elimination, of chemotactic responses to
      succinate, indicating that transport via DctA or chemosensing via DctB is not
      essential for C4 dicarboxylate taxis, although they appear to contribute to it.
      Mutations in dctD and rpoN genes did not affect taxis to succinate. Aspartate,
      which is also transported by the dicarboxylate transport system, elicited strong
      chemotactic responses via a chemoreceptor distinct from the succinate-malate
      fumarate receptor. Taxis to aspartate was unaltered in dctA and dctB mutants but
      was considerably reduced in both dctD and rpoN mutants, indicating that aspartate
      taxis is strongly dependent on elements responsible for transcriptional
      activation of dctA. Methylation and methanol release experiments failed to show a
      significant increase in methyl esterification of R. meliloti proteins in response
      to any of the attractants tested.

PMID- 8468290
TI  - Expression of the Rhodobacter sphaeroides hemA and hemT genes, encoding two 5
      aminolevulinic acid synthase isozymes.
AB  - The nucleotide sequences of the Rhodobacter sphaeroides hemA and hemT genes,
      encoding 5-aminolevulinic acid (ALA) synthase isozymes, were determined. ALA
      synthase catalyzes the condensation of glycine and succinyl coenzyme A, the first
      and rate-limiting step in tetrapyrrole biosynthesis. The hemA and hemT structural
      gene sequences were 65% identical to each other, and the deduced HemA and HemT
      polypeptide sequences were 53% identical, with an additional 16% of aligned amino
      acids being similar. HemA and HemT were homologous to all characterized ALA
      synthases, including two human ALA synthase isozymes. In addition, they were
      evolutionarily related to 7-keto-8-aminopelargonic acid synthetase (BioF) and 2
      amino-3-ketobutyrate coenzyme A ligase (Kbl), enzymes which catalyze similar
      reactions. Two hemA transcripts were identified, both expressed under
      photosynthetic conditions at levels approximately three times higher than those
      found under aerobic conditions. A single transcriptional start point was
      identified for both transcripts, and a consensus sequence at this location
      indicated that an Fnr-like protein may be involved in the transcriptional
      regulation of hemA. Transcription of hemT was not detected in wild-type cells
      under the physiological growth conditions tested. In a mutant strain in which the
      hemA gene had been inactivated, however, hemT was expressed. In this mutant, hemT
      transcripts were characterized by Northern (RNA) hybridization, primer extension,
      and ribonuclease protection techniques. A small open reading frame of unknown
      function was identified upstream of, and transcribed in the same direction as,
      hemA.

PMID- 8468291
TI  - 5-Aminolevulinic acid availability and control of spectral complex formation in
      hemA and hemT mutants of Rhodobacter sphaeroides.
AB  - In the photosynthetic bacterium Rhodobacter sphaeroides, two genes, hemA and
      hemT, each encode a distinct 5-aminolevulinic acid (ALA) synthase isozyme (E. L.
      Neidle and S. Kaplan, J. Bacteriol. 175:2292-2303, 1993). This enzyme catalyzes
      the first and rate-limiting step in a branched pathway for tetrapyrrole
      formation, leading to the biosynthesis of hemes, bacteriochlorophylls, and
      corrinoids. In an attempt to determine the functions of hemA and hemT, mutant
      strains were constructed with specific chromosomal disruptions. These chromosomal
      disruption allowed hemA and hemT to be precisely localized on the larger and
      smaller of two R. sphaeroides chromosomes, respectively. Mutants carrying a
      single hemA or hemT disruption grew well without the addition of ALA, whereas a
      mutant, HemAT1, in which hemA and hemT had both been inactivated required
      exogenous ALA for growth. The growth rates, ALA synthase enzyme levels, and the
      amounts of bacteriochlorophyll-containing intracytoplasmic membrane spectral
      complexes of all strains were compared. Under photosynthetic growth conditions,
      the levels of bacteriochlorophyll, carotenoids, and B800-850 and B875 light
      harvesting complexes were significantly lower in the Hem mutants than in the wild
      type. In the mutant strains, available bacteriochlorophyll appeared to be
      preferentially targeted to the B875 light-harvesting complex relative to the B800
      850 complex. In strain HemAT1, the amount of B800-850 complex varied with the
      concentration of ALA added to the growth medium, and under conditions of ALA
      limitation, no B800-850 complexes could be detected. In the Hem mutants, there
      were aberrant transcript levels corresponding to the puc and puf operons encoding
      structural polypeptides of the B800-850 and B875 complexes. These results suggest
      that hemA and hemT expression is coupled to the genetic control of the R.
      sphaeroides photosynthetic apparatus.

PMID- 8468292
TI  - AppppA-binding protein E89 is the Escherichia coli heat shock protein ClpB.
AB  - Dinucleotide AppppA (5',5'''-P1,P4-diadenosine tetraphosphate) is rapidly
      synthesized in Escherichia coli cells during heat shock. apaH mutants lack AppppN
      hydrolase activity and, therefore, contain constitutively levels of AppppA, which
      affect several cellular processes. However, the precise role of AppppA remains
      undetermined. Photo-crosslinking experiments with radioactively labelled azido
      AppppA have shown that a number of proteins, including heat shock proteins DnaK
      and GroEL, specifically bind to AppppA. Several other unidentified proteins (C40,
      C45, and E89) also bind strongly to AppppA. In this work, we have identified the
      AppppA-binding protein E89 as heat shock protein ClpB. In addition, since ClpB
      belongs to a family of proteins implicated in proteolysis, we have examined the
      effects of apaH mutants on protein degradation. Constitutively elevated levels of
      AppppA stimulate lon-independent proteolysis only in heat-shocked cells. We also
      show that overproduction of ClpB from a plasmid rescues apaH mutants from
      sensitivity to killing by heat.

PMID- 8468293
TI  - Mutational analysis of segmental stabilization of transcripts from the Zymomonas
      mobilis gap-pgk operon.
AB  - In Zymomonas mobilis, the genes encoding glyceraldehyde-3-phosphate dehydrogenase
      and phosphoglycerate kinase are transcribed together from the gap-pgk operon.
      However, higher levels of the former enzyme are present in the cytoplasm because
      of increased stability of a 5' segment containing the gap coding region. This
      segment is bounded by an upstream untranslated region which can be folded into
      many stem-loop structures and a prominent intercistronic stem-loop. Mutations
      eliminating a proposed stem-loop in the untranslated region or the intercistronic
      stem-loop resulted in a decrease in the stability and pool size of the 5' gap
      segment. Site-specific mutations in the unpaired regions of both of these stems
      also altered the message pools. Elimination of the intercistronic stem appeared
      to reduce the endonucleolytic cleavage within the pgk coding region, increasing
      the stability and abundance of the full-length message. DNA encoding the
      prominent stem-loop at the 3' end of the message was shown to be a
      transcriptional terminator both in Z. mobilis and in Escherichia coli. This third
      stem-loop region (part of the transcriptional terminator) was required to
      stabilize the full-length gap-pgk message.

PMID- 8468294
TI  - Regulation of sigma B levels and activity in Bacillus subtilis.
AB  - The sigB operon of Bacillus subtilis encodes sigma B plus three additional
      proteins (RsbV, RsbW, and RsbX) that regulate sigma B activity. Using an anti
      sigma B monoclonal antibody to monitor the levels of sigma B protein, PSPAC to
      control the expression of the sigB operon, and a ctc-lacZ reporter system to
      monitor sigma B activity, we observed that the rsbV and rsbW products control
      sigma B activity at the ctc promoter independently of their effects on sigma B
      levels. In contrast, RsbX was found to have no effect on expression of ctc when
      the sigB operon was controlled by PSPAC. The data are consistent with RsbV and
      RsbW being regulators of sigma B activity and RsbX acting primarily as a negative
      regulator of sigB operon expression. Evidence that stationary-phase induction of
      the sigma B-dependent ctc promoter is accomplished by a reduction in RsbW
      dependent inhibition of sigma B activity is also presented. In addition, Western
      blot (immunoblot) analyses of sigB operon expression demonstrated that sigma B
      accumulation is coupled to the synthesis of its primary inhibitor (RsbW). This
      finding is consistent with RsbW and sigma B being present within the cell in
      equivalent amounts, a circumstance that would permit RsbW to directly influence
      sigma B activity by a direct protein-protein interaction.

PMID- 8468295
TI  - Genetic evidence that promoter P2 is the physiologically significant promoter for
      the pyrBI operon of Escherichia coli K-12.
AB  - The pyrBI operon of Escherichia coli K-12 encodes the two nonidentical subunits
      of the pyrimidine biosynthetic enzyme aspartate transcarbamylase (ATCase).
      Expression of this operon is negatively regulated by pyrimidine availability
      primarily through UTP-sensitive transcriptional attenuation and, to a lesser
      extent, at the level of transcriptional initiation. Previous studies indicated
      that the pyrBI operon was transcribed from tandem sigma 70 promoters designated
      P1 and P2, with the large majority of transcription initiated at the more
      downstream promoter P2. To more clearly define the roles of these promoters,
      mutations that severely impair or inactivate individual promoters were
      constructed in the chromosomal pyrBI operon, and their effects on ATCase
      synthesis were measured. In cells grown under conditions of either pyrimidine
      excess or pyrimidine limitation, more than 99% of all ATCase synthesis was
      directed by transcripts initiated at promoter P2, indicating that it is the only
      physiologically significant pyrBI promoter. However, mutations that effectively
      inactivate promoter P1 caused a 15% reduction in ATCase levels, apparently by
      inhibiting transcription from promoter P2 by an unknown mechanism. Support for
      this explanation was provided by the demonstration that little, if any,
      transcriptional initiation occurred at promoter P1 in a transcriptional fusion
      vector whereas a high level of transcription was initiated at promoter P2 in an
      equivalent construction. Our results also provide evidence for pyrimidine
      mediated regulation of transcriptional initiation at promoter P2 over a
      severalfold range and show that cells can grow reasonably well with very low
      levels of ATCase, apparently because of changes in the concentration of
      allosteric effectors that increase the specific activity of the enzyme.

PMID- 8468296
TI  - Structures of genes nasA and nasB, encoding assimilatory nitrate and nitrite
      reductases in Klebsiella pneumoniae M5al.
AB  - Klebsiella pneumoniae can use nitrate and nitrite as sole nitrogen sources during
      aerobic growth. Assimilatory nitrate and nitrite reductases convert nitrate
      through nitrite to ammonium. We report here the molecular cloning of the nasA and
      nasB genes, which encode assimilatory nitrate and nitrite reductase,
      respectively. These genes are tightly linked and probably form a nasBA operon. In
      vivo protein expression and DNA sequence analysis revealed that the nasA and nasB
      genes encode 92- and 104-kDa proteins, respectively. The NASA polypeptide is
      homologous to other prokaryotic molybdoenzymes, and the NASB polypeptide is
      homologous to eukaryotic and prokaryotic NADH-nitrite reductases. The narL gene
      product positively regulates expression of the structural genes for respiratory
      nitrate reductase, narGHJI. Surprisingly, we found that the nasBA operon is
      tightly linked to the narL-narGHJI region in K. pneumoniae, even though the
      nitrate assimilatory and respiratory enzymes serve different physiological
      functions.

PMID- 8468298
TI  - Choline transport activity in Staphylococcus aureus induced by osmotic stress and
      low phosphate concentrations.
AB  - Uptake of [14C]choline upon hyperosmotic stress of exponential-phase
      Staphylococcus aureus cultures in a complex medium occurred after a delay of 2.5
      to 3.5 h. This uptake could be prevented by chloramphenicol, suggesting that it
      occurred via an inducible transport system. Radioactivity from [14C]choline was
      accumulated as [14C]glycine betaine. However, neither choline nor glycine betaine
      could act as the major carbon and energy source for the organism, suggesting that
      choline was not metabolized beyond glycine betaine. Assay of choline transport
      activity in cells grown under different conditions in defined media revealed that
      osmotic stress was mainly responsible for the induction, but choline gave a
      further increase in induction. The system was not induced in anaerobically grown
      cells. Choline transport activity was repressed by glycine betaine and proline
      betaine, suggesting that these compounds are corepressors. Choline transport
      activity was not induced in cells osmotically stressed by 1 M potassium phosphate
      or 0.5 M sodium phosphate, but was induced in cells grown in low-phosphate medium
      in the absence of osmotic stress. This suggests that there is a connection
      between the phosphate and osmotic stress regulons. Choline transport was energy
      and Na+ dependent and had a Km of 46 microM and a maximum rate of transport
      (Vmax) of 54 nmol/min/mg (dry weight). The results of competition studies
      suggested that N-methyl and an alcohol group or aldehyde groups at the ends of
      the molecule were important in its recognition by the system. Glycine betaine was
      not a highly effective competitor, suggesting that its transport system and the
      choline transport system were distinct from each other. Choline transport was
      highly susceptible to a variety of inhibitors, which may be related to the
      greater dependence on respiratory metabolism of cells grown in the presence of
      high NaC1 concentrations.

PMID- 8468297
TI  - Sites and gene products involved in lambdoid phage DNA packaging.
AB  - 21 is a temperate lambdoid coliphage, and the genes that encode the head proteins
      of lambda and 21 are descended from a common ancestral bacteriophage. The
      sequencing of terminase genes 1 and 2 of 21 was completed, along with that of a
      segment at the right end of 21 DNA that includes the R4 sequence. The R4
      sequence, a site that is likely involved in termination of DNA packaging, was
      found to be very similar to the R4 sequences of lambda and phi 80, suggesting
      that R4 is a recognition site that is not phage specific. DNA packaging by 21 is
      dependent on a host protein, integration host factor. A series of mutations in
      gene 1 (her mutations), which allow integration host factor-independent DNA
      packaging by 21, were found to be missense changes that affect predicted alpha
      helixes in gp1. gp2, the large terminase subunit, is predicted to contain an ATP
      binding domain and, perhaps, a second domain important for the cos-cutting
      activity of terminase. orf1, an open reading frame analogous in position to FI, a
      lambda gene involved in DNA packaging, shares some sequence identity with FI.
      orf1 was inactivated with nonsense and insertion mutations; these mutations were
      found not to affect phage growth. 21 was also not able to complement a lambda FI
      mutant.

PMID- 8468299
TI  - The Rhodobacter capsulatus chlorin reductase-encoding locus, bchA, consists of
      three genes, bchX, bchY, and bchZ.
AB  - The bchA locus of Rhodobacter capsulatus codes for the chlorin reductase enzyme
      in the bacteriochlorophyll synthesis pathway. Previous work has suggested that
      this locus might encompass a single gene. We have sequenced the bchA locus and
      found it to contain three coding segments, which we designate bchX, bchY, and
      bchZ. Each coding segment contains its own translational initiation sequence and
      follows codon utilization patterns consistent with those of previously published
      R. capsulatus genes. When various regions of the bchA locus and flanking
      sequences were subcloned into an expression vector and expressed in Escherichia
      coli, the three coding segments were all expressed as separate peptides. Finally,
      conservation of amino acid sequences between bchX and a subunit of the
      protochlorophyllide reductase (bchL, 34% identity) and the nitrogenase Fe protein
      (nifH, 30 to 37% identity) suggests structural and mechanistic commonalities
      among all three proteins.

PMID- 8468301
TI  - Sequence of the gene coding for ammonia monooxygenase in Nitrosomonas europaea.
AB  - Nitrosomonas europaea, a chemolithotrophic bacterium, was found to contain two
      copies of the gene coding for the presumed active site polypeptide of ammonia
      monooxygenase, the 32-kDa acetylene-binding polypeptide. One copy of this gene
      was cloned, and its complete nucleotide sequence is presented. Immediately
      downstream of this gene, in the same operon, is the gene for a 40-kDa polypeptide
      that copurifies with the ammonia monooxygenase acetylene-binding polypeptide. The
      sequence of the first 692 nucleotides of this structural gene, coding for about
      two-thirds of the protein, is presented. These sequences are the first sequences
      of protein-encoding genes from an ammonia-oxidizing autotrophic nitrifying
      bacterium. The two protein sequences are not homologous with the sequences of any
      other monooxygenase. From radioactive labelling of ammonia monooxygenase with
      [14C]acetylene it was determined that there are 23 nmol of ammonia monooxygenase
      per g of cells. The kcat of ammonia monooxygenase for NH3 in vivo was calculated
      to be 20 s-1.

PMID- 8468300
TI  - Structure, function, and regulation of the kilB locus of promiscuous plasmid RK2.
AB  - The kil-kor regulon of the self-transmissible, broad-host-range plasmid RK2 is a
      unique network with eight coregulated operons. Among the genes encoded by the kil
      kor regulon are trfA, which encodes the replication initiator, and several kil
      loci (kilA, kilB, kilC, and kilE), each of which is lethal to the host cell in
      the absence of appropriate negative regulatory elements encoded by the korA,
      korB, korC, and korE determinants. We have proposed that the functions of the kil
      loci are related to RK2 maintenance or host range. Here, we report the nucleotide
      sequence of a 2.44-kb region that includes the lethal kilB determinant. We
      identified the first three genes of the kilB operon (designated klbA, klbB, and
      klbC), and we determined by deletion analysis that the host-lethal phenotype
      requires klbB. The predicted amino acid sequence of the 34,995-Da klbA product
      reveals a potential ATP-binding fold. The klbB product is predicted to be a
      membrane protein with a molecular mass of 15,012 Da with homology to the RK2 KlaC
      membrane protein encoded by the kilA operon. The amino acid sequence of the
      12,085-Da klbC product contains a perfect match to the leucine zipper motif
      common to eukaryotic regulatory proteins. Primer extension analysis revealed
      unambiguously that transcription of the kilB operon begins 46 nucleotides
      upstream of klbA. No transcription was initiated from the sequence previously
      presumed by other investigators to be the kilB promoter. The abundance of kilB
      transcripts is reduced in the presence of KorB, consistent with the prediction
      that KorB acts at the level of transcription. A degenerate KorB-binding site that
      contains a perfect half-palindrome overlaps the kilB promoter, but this site is
      insufficient for regulation by KorB. The region containing a KorB-binding site
      located 183 bp upstream of the transcriptional start is required for regulation
      by KorB, indicating that KorB acts at a distance to regulate transcription of
      kilB. Our studies with the mutant plasmid pRP101, a transfer-defective derivative
      of the RK2-like plasmid RP4, demonstrated that the kilB operon includes the
      conjugal transfer and surface exclusion genes of the Tra2 region. Nucleotide
      sequence analysis revealed that the transposon Tn7 insertion in pRP101 is located
      in the klbC gene, and complementation analysis showed that this mutation has a
      strong polar effect on the expression of genes for conjugal transfer and surface
      exclusion located several kilobases downstream. A klbA mutant was constructed and
      found to be both transfer defective and complementable, thus, demonstrating a
      requirement was constructed and found to be both transfer defective and
      complementable, thus demonstrating a requirement for klbA product in plasmid
      transmissibility. These results have demonstrated a role for the kilB operon in
      conjugal transfer. The kil-kor regulon of RK2 is the only known example of
      plasmid-mediated coregulation of replication and transfer.

PMID- 8468302
TI  - Expression of gonococcal transferrin-binding protein 1 causes Escherichia coli to
      bind human transferrin.
AB  - The gene for gonococcal transferrin-binding protein 1 (TBP1) was cloned behind an
      inducible promoter in Escherichia coli. The resultant strain was capable of
      binding human transferrin with the same specificity as that of the gonococcus. E.
      coli expressing TBP1 did not internalize transferrin-bound iron or grow on
      transferrin as a sole iron source.

PMID- 8468303
TI  - Role of the recA-related gene adjacent to the recA gene in Pseudomonas
      aeruginosa.
AB  - The region adjacent to the 3' end of the recA gene is indispensable for normal
      cell division in a rec-2 strain of Pseudomonas aeruginosa when the recA gene is
      highly expressed. A putative protein encoded by this region may play a regulatory
      role(s) in recA function.

PMID- 8468304
TI  - The Ada protein is a class I transcription factor of Escherichia coli.
AB  - The methylated Ada protein of Escherichia coli, a regulatory protein for the
      adaptive response, binds to a target DNA from positions -62 to -31 upstream of
      the ada gene and facilitates the binding of RNA polymerase to the promoter.
      Mutant RNA polymerases consisting of C-terminal-deleted alpha subunits are
      virtually inactive in response to activation by the Ada protein. Thus, we
      conclude that the Ada protein is a class I transcription factor which requires
      the C-terminal region of the RNA polymerase alpha subunit for transcription
      activation.

PMID- 8468305
TI  - The dilution rate affects the outer membrane protein and lipopolysaccharide
      composition of Haemophilus influenzae type b grown under iron limitation.
AB  - When Haemophilus influenzae type b was grown under iron limitation in continuous
      culture, the dilution rate affected the outer membrane protein and
      lipopolysaccharide composition. Investigations of the effect of the reduced
      availability of iron or other environmental parameters on these surface
      components should be controlled for growth rate.

PMID- 8468306
TI  - Effects of amino acid substitutions in the promoter -10 binding region of the
      sigma A factor on growth of Bacillus subtilis.
AB  - On the bases of structural and functional information about the Bacillus subtilis
      sigma A protein and the techniques of site-directed mutagenesis, we constructed a
      B. subtilis sigA mutant (DB1005) which grows normally at 37 degrees C but is
      sensitive to higher temperatures. DNA sequencing analyses revealed that DB1005
      has Ile-198-->Ala and Ile-202-->Ala amino acid substitutions in the alpha-helix
      of the 2.4 region of the sigma A protein. Western blotting (immunoblotting)
      revealed that this mutant sigma A protein is stable at both 37 and 49 degrees C.
      These results suggest that Ile-198 and Ile-202 separately or in combination are
      critical for the sigma A protein to be functional at the restrictive temperature.

PMID- 8468307
TI  - Cloning and sequence determination of the valS gene, encoding valyl-tRNA
      synthetase in Lactobacillus casei.
AB  - The DNA sequence of the valS gene from Lactobacillus casei and the predicted
      amino acid sequence of its valyl-tRNA synthetase product have been determined. An
      open reading frame coding for a protein of 901 amino acids was found. A clone
      containing the intact L. casei valS gene functionally complemented the
      temperature-sensitive growth of the valS mutant strain 236c of Escherichia coli.
      The valS gene and the downstream folylpolyglutamate synthetase gene are
      transcribed in the same direction but are separated by a putative transcription
      terminator.

PMID- 8468308
TI  - Negative symptoms and emotional blunting in schizophrenic patients.
AB  - BACKGROUND: Emotional blunting and negative symptoms were explored as
      interchangeable concepts in evaluating schizophrenic patients. METHOD: We
      evaluated 115 consecutively admitted patients who had DSM-III-R schizophrenia. We
      performed a principal component analysis of Abrams and Taylor's Scale for
      Emotional Blunting (SEB) and Andreasen's Scale for the Assessment of Negative
      Symptoms (SANS) and correlated the subscales derived by factor analyses with
      demographic and clinical variables. RESULTS: Both scales contained subscales
      corresponding to poverty of affect and speech and inappropriate affect. The SEB
      also included an indifference subscale, whereas the SANS included avolition
      anhedonia, asociality, and blocking subscales. Poor premorbid functioning was
      most strongly associated with poverty of affect and speech. Inappropriate affect
      and anhedonia-avolition-asociality were moderately correlated with poor response
      to treatment. CONCLUSION: Negative symptoms and emotional blunting are similar
      concepts, but they are not interchangeable. Flatness and inappropriateness appear
      to be different affective dimensions with different clinical correlations.
      Inappropriate affect, inattention, and blocking should not be considered negative
      symptoms.

PMID- 8468309
TI  - Possible effects of smoke-free inpatient units on psychiatric diagnosis and
      treatment.
AB  - BACKGROUND: The author undertook to review the effects of abstinence from smoking
      and how those effects might influence the diagnosis and treatment of psychiatric
      disorders when patients are required to temporarily refrain from smoking (e.g.,
      on inpatient wards) or when patients decide to stop smoking permanently. METHOD:
      Computerized data bases and reference lists of existing articles were searched
      for prior publications from three areas: (1) the association of smoking and
      psychiatric disorders, (2) the effects of nicotine withdrawal, and (3) the role
      of nicotine in psychiatric disorders. RESULTS: Withdrawal-induced increases in
      anxiety, depression, insomnia, irritability, restlessness, and weight and
      decreases in heart rate could affect the ability to evaluate alcohol/drug
      withdrawal, anxiety disorders, etc. Withdrawal effects could mimic medication
      side effects or increase the blood levels of several psychiatric medications.
      Whether these effects occur frequently or are of clinical magnitude has not been
      tested in studies of psychiatric patients. CONCLUSION: Psychiatrists should
      consider the effects of abstinence from smoking when diagnosing and treating
      patients who enter smoke-free inpatient units or who stop smoking during
      outpatient treatment.

PMID- 8468311
TI  - Ciprofloxacin-induced catatonia.

PMID- 8468310
TI  - Titration of serotonin reuptake blockers.

PMID- 8468312
TI  - Venlafaxine: a new dimension in antidepressant pharmacotherapy.

PMID- 8468313
TI  - Alcohol, drugs, and psychiatric comorbidity among homeless women: an
      epidemiologic study.
AB  - BACKGROUND: Very little is known about the mental health of homeless women. The
      present study is one of the first to focus on psychiatric diagnosis and
      comorbidity in a population of homeless women systematically interviewed with a
      structured instrument. METHOD: Three hundred homeless women randomly selected
      from St. Louis shelters were interviewed using the Diagnostic Interview Schedule
      (DIS). RESULTS: The population of homeless women in St. Louis is predominantly
      young adult, single, and black; most have young children and average nearly a
      high school education. Schizophrenia and bipolar affective disorder account for
      only a small portion of the mental illness in these women. Nearly one in three
      has a history of substance abuse, with drug abuse being more prevalent than
      alcoholism. One third of the sample met lifetime criteria for posttraumatic
      stress disorder. One fourth of the women have received inpatient psychiatric
      care, and the majority with a nonsubstance Axis I diagnosis have received some
      mental health treatment. CONCLUSION: Although major mental illness is
      overrepresented among these homeless women, the majority do not suffer from major
      mental illness. Despite the severity of the stressors these women face, the large
      numbers escaping psychiatric disorders speak to their resilience and to the
      likelihood that important factors other than mental illness contribute to their
      homelessness. Future studies to examine positive outcomes and investigate
      protective factors might provide a valuable source of information on coping with
      the stresses associated with homelessness and point to more effective
      interventions.

PMID- 8468314
TI  - Relationship of past depressive episodes to symptom severity and treatment
      response in panic disorder with agoraphobia.
AB  - BACKGROUND: Many investigators have reported that panic disorder (PD) patients
      with comorbid major depression (MD) have more severe symptoms and a poorer
      response to treatment than patients with PD alone. It is not known if this is due
      to a distinct and more serious underlying disorder in these patients or simply a
      result of the simultaneous presence of the two disorders. METHOD: Nondepressed
      patients presenting for treatment of panic disorder with agoraphobia (PDA) were
      studied before treatment (N = 180) and after 4 weeks of treatment with adinazolam
      sustained release (N = 89) or placebo (N = 91). Twenty-nine percent (N = 53) of
      the patients had a past history of MD. Symptom severity and treatment outcome
      were compared in patients with primary, secondary, single, recurrent, or no past
      MD. RESULTS: There were no consistent differences in symptom severity or
      treatment outcome in patients with a past history of primary, secondary, or
      single episode MD compared with patients with no history of MD. However, a small
      number of patients with history of recurrent MD exhibited consistently greater
      symptom severity and poorer response to treatment than patients with no history
      of MD. CONCLUSION: The greater severity and worse outcome of comorbid PD and MD
      observed in earlier studies are more likely due to the simultaneous presence of
      the two disorders than to a more serious and enduring underlying disorder.
      However, our results suggest that recurrent MD may indicate a more serious
      condition in patients with PDA. This possibility warrants further study.

PMID- 8468315
TI  - Direct demonstration of the essential role of the intramolecular high-mannose
      oligosaccharide chains in the folding and assembly of soybean (glycine max)
      lectin polypeptides.
AB  - We investigated the role of the intramolecular high-mannose oligosaccharide
      chains in the folding and assembly of soybean lectin polypeptides. Soybean
      lectin, dissociated into subunits and completely denatured in 6 M guanidine
      hydrochloride, was quantitatively reconstituted to the active tetrameric
      structure by simple dilution. However, neither the activity nor the tetrameric
      structure was regained in the presence of 100 microM of an asparagine-linked
      oligosaccharide, Man9GlcNAc2Asn, having the same structure as that of the sugar
      chains of soybean lectin. Besides, the same concentration of this glycopeptide
      even dissociated, although only gradually, the native lectin into subunits. On
      the other hand, the deglycosylated subunits had no ability to regain the activity
      or the tetrameric structure. The present study provided for the first time direct
      evidence of the essential role of the intramolecular high-mannose oligosaccharide
      chains in the proper folding and assembly of glycopolypeptides.

PMID- 8468316
TI  - Identification of the specific labile sites in the 180 kDa catalytic polypeptide
      of the Drosophila melanogaster DNA polymerase alpha-primase complex.
AB  - The immunoaffinity-purified DNA polymerase alpha-primase complex from Drosophila
      melanogaster Kc cells contains three high molecular weight polypeptides besides
      the 180 kDa catalytic polypeptide. These polypeptides are immunologically cross
      reactive with the 180 kDa polypeptide. When the immunoaffinity-purified complex
      was kept at 4 degrees C for about four weeks, the amounts of the three
      polypeptides increased, while the 180 kDa polypeptide completely disappeared.
      Sodium bisulfite inhibited the decrease in the 180 kDa polypeptide. The N
      terminal amino acid sequences of all the polypeptides were all assigned to ones
      present in a portion close to the N-terminus of the 180 kDa polypeptide. The N
      terminal residue of all the three polypeptides was Ser. The cleavage sites were
      Phe130-Ser131, Thr180-Ser181, and Phe237-Ser238. These results show that the
      three polypeptides are cleavage products of the 180 kDa catalytic polypeptide,
      the cleavage occurring at specific labile sites including a Ser residue. The
      amino acid residues at the sites are quite different from those (Lys-Lys) in the
      human 180 kDa catalytic polypeptide.

PMID- 8468317
TI  - Examination of processing of the rat liver mitochondrial F1-ATPase beta subunit
      precursor protein by high-resolution 2D-gel electrophoresis.
AB  - We report the one-step processing of the rat liver beta-F1-ATPase precursor
      protein, as examined by high resolution 2D-gel electrophoresis. Proteolytic
      cleavage of the positively charged mitochondrial targeting signal of the
      precursor promotes decreases in both the molecular weight (approximately 3 kDa)
      and the isoelectric point (approximate 0.2 pH unit) of the protein. The results
      obtained illustrate the usefulness of this technique, since it takes advantage of
      both results of the maturation process, for molecular characterization of the
      processing of mitochondrial precursor proteins.

PMID- 8468318
TI  - Identification and functional expression of a new member of the mammalian Kex2
      like processing endoprotease family: its striking structural similarity to PACE4.
AB  - We used the polymerase chain reaction to identify a mouse cDNA which represented
      a new member of a growing class of mammalian endoproteases homologous to the
      yeast Kex2 protease involved in the processing of precursor proteins. This cDNA
      encoded a 915-residue protein, designated as PC6, containing a subtilisin-like
      catalytic domain closely related to those of other Kex2-like members (furin, PC2,
      PC1/3, PC4, and PACE4). It exhibited striking sequence similarity to PACE4 and
      contained similar protein domains, such as the COOH-terminal Cys-rich region.
      Northern blot analysis revealed that PC6 mRNA, as with furin and PACE4 mRNAs, was
      expressed in various tissues and cell lines, with the highest level in the
      intestine. Transfection experiments revealed that PC6 was capable of cleaving
      precursors at dibasic sites. These observations suggest that PC6 is a candidate
      for a processing endoprotease responsible for the maturation of gastrointestinal
      peptides.

PMID- 8468319
TI  - Stereochemistry of intermediates in the conversion of 3 alpha,7 alpha,12 alpha
      trihydroxy-5 beta-cholestanoic acid to cholic acid by rat liver peroxisomes.
AB  - We have investigated the stereochemistry of the side chain of the intermediates,
      3 alpha, 7 alpha,12 alpha-trihydroxy-5 beta-cholest-24-enoic acid and 3 alpha,7
      alpha,12 alpha,24-tetrahydroxy-5 beta-cholestanoic acid, in the conversion of 3
      alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid to cholic acid by rat
      liver peroxisomes. The intermediates formed were converted to the p-bromophenacyl
      ester derivatives and analyzed by reversed-phase high-performance liquid
      chromatography. Only the (24E) form of the two isomers of the delta 24
      unsaturated acid and the (24R,25S) form of the four isomers at C-24 and C-25 of
      the 24-hydroxy acid were found to be formed stereospecifically from either (25R)-
      or (25S)-3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid. Formation
      of the other isomers of the alpha beta-unsaturated bile acid or the beta-hydroxy
      bile acid was not detected. The findings support the proposed pathway for the
      side-chain cleavage in cholic acid biosynthesis, which is thought to be similar
      to that of peroxisomal fatty acid beta-oxidation.

PMID- 8468321
TI  - cDNA and genomic structures of arrowhead proteinase inhibitors.
AB  - Arrowhead double-headed proteinase inhibitors A and B consist of 150 amino acid
      residues with three disulfide bonds. Based on their primary structures, three
      cDNA fragments of the inhibitors were amplified in vitro by the PCR method using
      a constructed arrowhead cDNA library as a template. With the overlapping
      sequences, the full-length cDNA sequences of the inhibitors were then
      ascertained. The open reading frame encodes a pre-inhibitor, including a 24
      residue signal peptide. The deduced amino acid sequences are consistent in
      principle with those determined by primary structure analysis, except that there
      are seven extra residues in the C-terminal part of the inhibitors, which might be
      cleaved off by proteinase post-processing immediately after protein synthesis. It
      is worth pointing out that cDNAs of both inhibitors A and B contain an 87 bp
      intron in the AAG codon of residue Lys-97. According to the elucidated cDNA
      sequences, the structural genes of inhibitors A and B were amplified using the
      total cDNA or genomic DNA of arrowhead as a PCR template. It was indicated that
      both the cDNA and genomic structures of inhibitors A and B have the same
      sequences.

PMID- 8468320
TI  - Three forms of rat CYP11B genes: 11 beta-hydroxylase gene, aldosterone synthase
      gene, and a novel gene.
AB  - We isolated three genomic clones of rat P-450(11 beta) genes (CYP11B). Two of
      them corresponded to 11 beta-hydroxylase gene (CYP11B1) and aldosterone synthase
      gene (CYP11B2), respectively. The third one was a novel gene resembling both
      CYP11B1 and CYP11B2, and was named CYP11B3 gene (CYP11B3). CYP11B2 and CYP11B3
      are located tandemly in the genome in the same direction approximately 24 kb
      apart. These three genes were highly homologous in their amino acid coding
      regions, with 88% (CYP11B1 to CYP11B2), 89% (CYP11B2 to CYP11B3), 96% (CYP11B1 to
      CYP11B3) nucleotide identity. The numbers and the locations of the exons of these
      three genes also exactly corresponded to each other. However, the nucleotide
      sequences of the 5' upstream regions of CYP11B1 and CYP11B2 were significantly
      different, suggesting different transcriptional regulations. CYP11B3 had almost
      the same sequence as CYP11B1 gene in the 5' upstream region. A putative Ad4 site,
      a cis-acting element present in the promoter regions of all the steroidogenic P
      450s so far reported [Morohashi, K., Honda, S., Inomata, Y., Handa, H., Omura, T.
      (1992) J. Biol. Chem. 267, 17913-17919], was found in the promoter regions of
      both CYP11B1 and CYP11B2. Gel retardation analysis showed the binding of Ad4BP
      purified from bovine adrenal cortex to these two Ad4 sites. We analyzed the
      relative abundance of the mRNAs corresponding to these three genes by the
      generation of RT-PCR libraries from rat adrenal total RNAs.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8468322
TI  - Arrangement of the disulfide bridges in a blood coagulation factor IX/factor X
      binding protein from the venom of Trimeresurus flavoviridis.
AB  - Blood coagulation factor IX/factor X-binding protein (IX/X-bp) is a two-chain
      anticoagulant protein that was isolated from the venom of Trimeresurus
      flavoviridis. The amino acid sequence of IX/X-bp is homologous to the sequences
      of C-type lectin-like proteins, such as asialoglycoprotein receptor, tetranectin,
      and the low-affinity Fc epsilon receptor of immunoglobulin E. The amino acid
      composition and amino acid sequence of cystine-containing peptides, formed as a
      result of enzymatic digestion of CNBr-generated fragments of IX/X-bp, were
      analyzed to determine the location of the seven disulfide bridges in the protein.
      Three disulfide bridges in the A chain link Cys2 to Cys13, Cys30 to Cys127, and
      Cys102 to Cys119. Three disulfide bridges in the A chain link Cys2 to Cys13,
      Cys30 to Cys119, and Cys96 to Cys111. An interchain disulfide bond links Cys79 of
      the A chain and Cys75 of the B chain. The intrachain disulfide-bonding patterns
      of both the A and B chains of IX/X-bp are similar to those found in other C-type
      lectin-like proteins. We discuss in this report the sequence homology between
      IX/X-bp and other two-chain, C-type lectin-like proteins that have been isolated
      from snake venoms and we compare the S-S bonding patterns of proteins that are
      homologous to IX/X-bp.

PMID- 8468323
TI  - A complementary DNA for an ascidian embryonic nuclear antigen Hgv2 encodes a
      protein closely related to the amphibian histone-binding protein N1.
AB  - We have isolated and sequenced a cDNA clone encoding an ascidian embryonic
      nuclear protein, Hgv2. An insert about 2 kb long covered almost the entire length
      of 2.3-kb Hgv2 mRNA. The amino acid sequence of Hgv2 deduced from the cDNA
      sequence showed that this protein is related to the amphibian karyophilic histone
      binding protein N1, which is thought to be involved in nucleosome assembly.
      Homology between these two proteins is evident from their extremely similar amino
      acid compositions and hydropathy profiles. In addition, Hgv2 protein has
      sequences strikingly similar to the nuclear targeting signal of N1. This is
      therefore the first report of molecular cloning of a homologue of N1 in non
      amphibian species. Putative histone-binding domains of N1 are composed of two
      acidic residue-rich clusters. Hgv2 polypeptide contains two highly acidic
      regions, but amino acid sequences of the regions are not conserved. Since Hgv2
      protein exists in nuclei of every embryonic cell but disappears from nuclei of
      metamorphosed juvenile tissues, this protein may function as a nucleosome
      assembly factor during rapid embryonic cell divisions.

PMID- 8468324
TI  - Fluorescent molecular rotor binding to actin.
AB  - 1-(2-Hydroxyethyl)-6-[(2,2-dicyano)vinyl]-2,3,4-trihydroquinoli ne (DCQ) is a
      fluorescent dye and its fluorescence yield is determined by a freedom of
      intramolecular rotation. When DCQ was added to an actin solution, its
      fluorescence intensity increased as the actin molecule transformed from G-actin
      to F-actin. This fluorescence intensity increase was induced both by the higher
      binding constant of the dye to F-actin than to G-actin and by the higher
      fluorescence yield of the dye bound to F-actin than to G-actin. DCQ bound more
      strongly to Mg(2+)-F-actin than to Ca(2+)-F-actin, resulting in higher
      fluorescence intensity of DCQ-Mg(2+)-F-actin solution than of DCQ-Ca(2+)-F-actin
      solution. DCQ did not distinguish Mg(2+)-G-actin and Ca(2+)-G-actin. Thus, DCQ is
      a good probe for polymerization of actin and polymorphism of F-actin.

PMID- 8468325
TI  - Tissue-specific and developmentally regulated expression of the genes encoding
      adenylate kinase isozymes.
AB  - Adenylate kinase (AK) is known to play an important role in homeostasis of
      adenine nucleotide metabolism. We isolated cDNAs for rat AK isozymes (AK1, AK2,
      and AK3), determined their mRNAs in rat tissues by Northern blot analysis, and
      measured the isozyme activities. Tissue-dependent activities of AK1 and AK2
      paralleled the contents of mRNAs. Tissues with high AK1 levels showed low AK2
      levels and vice versa, suggesting that tissue-specific expressions of the AK1 and
      AK2 genes are inversely regulated. AK3 mRNA was detected in most tissues
      examined, suggesting that AK3 gene expression is constitutive. We further
      examined developmental changes in mRNAs and enzyme activities of AK isozymes in
      rat skeletal muscle and liver. In the skeletal muscle, AK1 and AK3 activities
      started to increase at around the weaning period. AK1 mRNA accumulated at the
      prenatal stage and further increased during development, while AK3 mRNA was at
      high levels during the fetal stage and remained fairly constant during
      development. In the liver, AK2 and AK3 activities started to increase after birth
      and were further elevated during growth, whereas their mRNAs were present at
      relatively high levels throughout development. The physiological meanings of the
      tissue-specific expression of the AK isozyme genes are discussed.

PMID- 8468326
TI  - Inhibition of aspartate chemotaxis of Escherichia coli by site-directed
      sulfhydryl modification of the receptor.
AB  - Thr-154 of the chemoreceptor Tar in Escherichia coli is important for aspartate
      sensing. Taking advantage of the fact that Tar has no Cys residues, we have
      further investigated the role of Thr-154 by replacing it with Cys in order to
      subject it to SH modification. Tar-T154C retained the abilities of aspartate
      sensing and repellent sensing. However, when cells with Tar-T154C were treated
      with an SH-modifying reagent, 5,5'-dithiobis-2-nitrobenzoic acid (DTNB), they
      specifically lost the ability to sense aspartate; the ability was restored by the
      reducing reagent, 1,4-dithiothreitol. DTNB showed no detectable effect on the
      function of wild-type Tar or serine-replaced Tar, Tar-T154S. Thus, DTNB modifies
      Cys-154 of Tar-T154C in intact cells and causes a specific defect in the
      aspartate-sensing ability of Tar. The addition of 1 mM or higher concentrations
      of aspartate resulted in protection of Cys-154 from the modification; serine had
      no effect in this regard. These results that not only is Thr-154 important for
      aspartate sensing but also, it may be located at the actual aspartate-binding
      site.

PMID- 8468327
TI  - Functional analysis of cDNAs for two types of human heme oxygenase and evidence
      for their separate regulation.
AB  - We cloned a cDNA coding for a putative human heme oxygenase isozyme, designated
      type 2 (HO-2), and analyzed its function by transient expression assays. HeLa
      cells transfected with either HO-2 cDNAs or a cDNA coding for authentic heme
      oxygenase (HO-1) expressed the activity of heme oxygenase, although no activity
      was detected in the mock transfected cells. Using specific anti-HO-1 antibody, we
      showed that expression of a HO-1 cDNA resulted in the increase in its protein
      levels, but HO-1 protein was not detectable in the cells expressing HO-2 cDNAs.
      We thus confirmed the functional identity of HO-1 and HO-2. Then, we analyzed
      their expression in an erythroid cell line, YN-1-0-A. Treatment with hemin or by
      heat shock (42 degrees C) led to a remarkable increase in the HO-1 mRNA levels,
      while HO-2 mRNA expression was not induced at all, suggesting that they are under
      separate regulation.

PMID- 8468328
TI  - Cleavage specificity and inhibition profile of proteasome isolated from the
      cytosol of Xenopus oocyte.
AB  - The specificity of action of the proteasome purified from the cytosol of Xenopus
      oocyte was investigated using oxidized insulin B chain as the substrate. HPLC
      analyses of the produced peptides followed by amino acid analyses showed that it
      cleaved four peptide bonds, Leu6-Cya7, Glu13-Ala14, Leu15-Tyr16, and Leu17-Val18,
      of the peptide. Cleavage at Leu6-Cya7 was found to be specific to the Xenopus
      enzyme. The enzyme did not cleave Gln4-His5 and Cya19-Gly20, which are commonly
      hydrolyzed by proteasomes from rat and mouse liver, and human erythrocyte. In
      contrast to previous results obtained with the mammalian proteasome, the cleavage
      by the Xenopus enzyme was inhibited selectively by chymostatin. These results
      demonstrate distinct species difference in cleavage specificity and inhibition
      profile among proteasomes of different origins.

PMID- 8468329
TI  - Purification and characterization of two isoforms of serine proteinase from the
      microsomal membranes of rat liver.
AB  - An extensive purification of microsomal serine proteinase was achieved from rat
      liver microsome membranes solubilized with 1% sodium cholate by a series of
      column chromatographic steps on hydroxylapatite, DEAE-cellulose, and benzamidine
      Sepharose 6B, and polyacrylamide gel electrophoresis (PAGE). In the final step of
      PAGE, the enzyme was separated into two fractions with slightly different
      mobilities, designated microsomal serine proteinases 1 (MSP1) and 2 (MSP2). The
      former was purified about 8,000-fold to apparent homogeneity, and the latter was
      purified about 800-fold, starting from the sample which had been spontaneously
      activated after elution from the hydroxylapatite column. Both enzyme fractions
      showed essentially the same properties, including molecular weight,
      susceptibility to various proteinase inhibitors and metal ions, specificity of
      action toward protein substrates with special preference for a basic protein
      histone as well as toward synthetic substrates, and pH dependence of activity
      toward a synthetic substrate and two neuropeptides. Taken together with the same
      behavior on a series of chromatographic steps, the two isoforms are thought to be
      essentially the same enzyme. Further, the detailed kinetic studies of the enzyme
      activity, especially of MSP1, toward various synthetic and naturally occurring
      peptide substrates showed that it was highly specific for basic amino acid pairs,
      strictly hydrolyzing at the COOH side of arginine residue. These results are
      consistent with those obtained previously with a partially purified enzyme and
      establish more definitely and in detail the specificity as well as other
      molecular and enzymatic properties of the enzyme.

PMID- 8468331
TI  - Antibodies raised against the adenosine receptor agonist, 5'-N
      ethylcarboxamidoadenosine (NECA).
AB  - Antisera against the non-selective adenosine receptor agonist 5'-N
      ethylcarboxamido-adenosine (NECA) have been raised by immunizing rabbits with
      NECA-coupled bovine serum albumin. The antisera which bind [3H]NECA with high
      affinity were purified by affinity chromatography using NECA-coupled Sepharose as
      the affinity gel without significant changes in [3H]NECA-binding properties. The
      order of the affinity for various adenosine receptor ligands of the purified or
      unpurified antisera was 5'-N-cyclopropylcarboxamidoadenosine > or = NECA > 2',5'
      dideoxyadenosine > 2-chloroadenosine > theophylline > isobutylmethylxanthine >
      (R)-N6-phenylisopropyladenosine = N6-cyclohexyl- adenosine. This specificity was
      found to be similar to that of the non-receptor NECA-binding sites, which had
      been found in various tissues such as human placentas and mouse P815 mastocytoma
      cells, rather than to that of adenosine receptors. These anti-NECA antibodies
      will be useful as immunochemical agents in the search for endogenous ligand(s) to
      the non-receptor NECA-binding sites.

PMID- 8468330
TI  - Isolation of N omega-phosphoarginine hydrolase from rat liver and its physical
      properties.
AB  - N omega-Phosphoarginine hydrolase from rat liver cytosol was purified to apparent
      homogeneity on SDS-PAGE, by employing column chromatographies on Sephadex G-75,
      DEAE-cellulose, QAE-Toyopearl, and glutathione-2-pyridyl-disulfide-Superose. One
      milligram protein of the final preparation released 4 mumol/min of inorganic
      phosphate from N omega-phosphoarginine. The molecular mass on SDS-PAGE, the
      Stokes' radius and the sedimentation coefficient were estimated to be 17.3 kDa,
      1.63 nm, and 2.0 s, respectively, indicating that this enzyme consists of a
      single peptide. The stability of the enzyme to heat depended on the buffers
      employed and treatment of the enzyme preparation in 50 mM Tris-HCl, pH 7.0 at 50
      degrees C, reduced the hydrolytic activity with a decay constant of 0.099 per
      min.

PMID- 8468332
TI  - Ganglioside distribution in the liver of inbred strains of rats and the cancerous
      liver of LEC rats.
AB  - The gangliosides in the livers of various inbred strains of rats and hepatoma of
      LEC rats were purified and analyzed by thin-layer chromatography. The patterns of
      ganglioside distribution in these rat livers were classified into three
      phenotypes depending on the strain, that is, a-type (ACI, LEA, LEW, BUF), b-type
      (WKAH, SHR/SP), and LEC type, which are characterized by dominance of a- or b
      series of gangliosides, or a variation of a-type, respectively. A sex difference
      was also recognized in the molar ratio of GM3 which was much higher in males (60
      75%) than in females (33-56%) except in LEC rats. In addition, the content of a
      series gangliosides was lower and the content of b-series gangliosides was higher
      in a-type male rats than in a-type female rats. The opposite was true in b-type
      rats. LEC rats were an exception, characterized by no sex difference and a quite
      low content of b-series gangliosides. The LEC rat is a mutant strain that
      spontaneously develops fulminant hepatitis around 14 to 20 weeks of age and
      hepatoma at 1 to 1.5 years old. The gangliosides of the hepatoma were
      characterized by the appearance of the newly synthesized gangliosides, fucosyl
      GM1 and alpha-galactosyl alpha-fucosyl GM1 (BGM1). In particular, BGM1
      ganglioside accumulated in the hepatoma of female rats.

PMID- 8468333
TI  - The complete amino acid sequence of a Kunitz family trypsin inhibitor from seeds
      of Acacia confusa.
AB  - The complete amino acid sequence of a Kunitz-type two-chain trypsin inhibitor was
      determined for the first time. The sequence of the inhibitor from Acacia confusa
      (ACTI) was determined by analysis of peptides obtained from the reduced and S
      carboxymethylated protein by digestion with endopeptidase Lys-C, endopeptidase
      Arg-C, and V8 endopeptidase. ACTI is comprised of two chains, namely A and B
      chains linked by the disulfide bridge between Cys(133) and Cys(141), and the
      inhibitor consists of 175 amino acid residues, 136 residues in the A-chain and 39
      residues in the B-chain. The N-terminal amino acid sequence of ACTI shows
      extensive homology to the trypsin inhibitors from Acacia elata and Albizzia
      julibrissin, while the whole amino acid sequence of ACTI has a high degree of
      homology to the other Kunitz-type trypsin inhibitors from soybeans, winged bean
      seeds [Psophocarpus tetragonolobus (L) DC.], and seeds of Erythrina species.

PMID- 8468334
TI  - Hydrolysis of cholesteryl oleate liquid crystals by hormone-sensitive lipase.
AB  - Cholesteryl oleate liquid crystals were prepared by sonication as a model of
      lipid droplets accumulated in foam cells derived from macrophages. These liquid
      crystals were spherical and showed an anisotropic cross image. Hormone-sensitive
      lipase from bovine adipose tissue hydrolyzed these liquid crystals optimally at
      pH 6.8. The Km for the liquid crystals was about 8 times that for vesicles or
      emulsified cholesteryl oleate. The Vmax for the liquid crystals was the same as
      that for the emulsified substrate and 6 times that for the vesicle substrate.
      Phospholipid inhibited cholesteryl oleate hydrolysis in a concentration-dependent
      fashion, phosphatidylserine being especially inhibitory. The effect of
      phospholipids on the activity changed upon their incorporation into the
      cholesteryl oleate liquid crystals, phosphatidylethanolamine increasing the
      activity to about twice that of the control. These results suggest that hormone
      sensitive lipase hydrolyzes cholesteryl oleate liquid crystals as a model of
      endogenous lipid droplets and its activities are affected by phospholipids.

PMID- 8468336
TI  - A method for measuring mechanical work and work efficiency during human
      activities.
AB  - A major limitation in understanding human energy balance is the ability to
      accurately quantify the amount of physical activity or work performed by human
      subjects. We describe the development and validation of a force platform (2.5 x
      2.5 m) system for measuring external mechanical work performed by human subjects.
      The force platform system was constructed inside a whole-room indirect
      calorimeter, thus, allowing simultaneous measurement of the energy expenditure
      associated with physical activity. We demonstrated the accuracy of the system for
      measuring work performed using a solenoid (32 kg) to deliver controlled amounts
      of energy to the platform. In tests with human subjects we demonstrated that the
      system can accurately and reproducibly measure work performed, energy expenditure
      associated with work performed, and work efficiency (work performed divided by
      energy expenditure). Overall, we obtained high correlations (an average of 0.932
      for 33 subjects), between mechanical work performed and energy expenditure. We
      believe this mechanical work-energy expenditure system will be useful in
      determining the importance of individual differences in amount and cost of
      physical activity in the regulation of body weight and in development of obesity.

PMID- 8468335
TI  - The effect of temperature, stress and microstructure on the creep of compact
      bovine bone.
AB  - Creep tests of 117 compact bovine bone specimens were conducted at three
      temperatures (25, 37, and 43 degrees C), with applied stresses between 71 and 115
      MPa. Following testing, the amount of secondary haversian bone in the gage region
      of the specimens was estimated. The resulting steady-state creep rates (epsilon)
      were fit to an Arrhenius (e-Qc/RT) model (where Qc is the activation energy for
      the mechanism(s) controlling creep, R is the gas constant, and T is the absolute
      temperature) of the type used to describe the classic steady-state creep behavior
      of metals, ceramics, and metamorphic rocks. The empirical model developed was
      epsilon = 5.6 x 10(-9) e4.6F sigma 5.2 e-5330/T, where epsilon is the estimated
      mean steady-state creep rate, F is the volume fraction of secondary haversian
      bone, sigma is the applied stress, and T is the absolute temperature. There was a
      positive, significant association between the estimated mean steady-state creep
      rate and F, sigma, and T. Qc was determined to be 44.3 kJ mol-1, a reasonable
      value when compared to activation energies for creep in ceramics. It is
      hypothesized that permanent deformation during creep of compact bovine bone is
      primarily due to damage mechanisms associated with dislocations in the
      hydroxyapatite mineral lattice structure.

PMID- 8468337
TI  - Kinematics of jaw movements during chewing at different frequencies.
AB  - The three-dimensional jaw movement trajectory and its velocity profile were
      investigated to provide information regarding the motor control of chewing. This
      was done on a cycle-by-cycle basis across three voluntarily guided chewing
      frequencies to test the lack of invariance at the velocity level and the evidence
      for a cost function. The data revealed that an increase in chewing frequencies
      resulted in a significant reduction of the three-dimensional path, being
      significantly higher in opening than closing. The ratio of peak speed/three
      dimensional distance, a kinematic index of stiffness, increased with increase in
      chewing frequency; higher stiffness being associated with faster chewing, the
      stiffness being significantly higher in opening than in closing. The ratio of
      peak velocity to mean velocity decreased as a function of increase in chewing
      frequency only at the highest frequency and this decrease again was different in
      opening than in closing. The results demonstrated that the velocity profile of
      chewing movements, like that of speech movements, lacked invariance. Rather than
      minimizing one cost function, the system used an efficient trade-off between
      time, space and effort, based on the objective of movements.

PMID- 8468338
TI  - Evaluation of finite element analysis for prediction of the strength reduction
      due to metastatic lesions in the femoral neck.
AB  - Between 30 and 70% of almost one million new cancer patients diagnosed each year
      will develop osseous metastases. Clinicians are faced with the difficult task of
      determining which patients require prophylactic stabilization to prevent
      pathologic fracture. The objective of this study was to test the ability of
      macroscopic finite element models to predict the fracture strength of the
      proximal femur with a lesion in the femoral neck. Drill hole defects in human
      cadaver femora were used to simulate lesions that penetrate one cortex of the
      femoral neck. Based on the first of two series of in vitro experiments, the
      fracture strength of a femur with a lesion that penetrates either the inferior
      medial or superior-lateral cortex of the neck is approximately 45% less than the
      fracture strength of the paired intact femur; based on the second series, the
      fracture strength with the inferior-medial lesion is approximately 20% less than
      the fracture strength with the superior-lateral lesion. A series of three
      dimensional finite element models were used to predict the fracture strength for
      anterior and posterior lesions, as well as the inferior-medial and posterior
      lateral lesions tested in vitro. Based on a direct comparison of the strengths
      predicted by the finite element models to the measured in vitro fracture
      strengths, the finite element models performed poorly. In particular, the
      application of an anisotropic strength criterion to the stresses predicted by the
      models resulted in a considerable underestimation of the percentage reduction in
      the in vitro fracture strength. This may reflect a fundamental inability of a
      linear, macroscopic continuum-based analysis to predict accurately the fracture
      strength of a bone structure as complex as the proximal femur. However, despite
      this lack of agreement in absolute fracture strength, the general trends for gait
      and stair ascent loading for the inferior-medial and superior-lateral lesions
      were consistent with the in vitro data. The greatest reduction in strength was
      predicted for the inferior-medial lesion, followed by the anterior lesion and
      then the superior-lateral lesion, and the least reduction in strength was
      predicted for the posterior lesion. Most importantly, the predicted strength
      ratio varied considerably as a function of the applied loads. Any metastatic
      lesions of the femoral neck may be especially sensitive to some particular
      activity, making it difficult to determine precisely the risk of fracture.

PMID- 8468339
TI  - Absolute angle measurement using the earth-field-referenced hall effect sensors.
AB  - A miniaturized absolute angle sensor utilizing Hall generators referenced to the
      Earth's ambient magnetic field has been developed. The sensor has three
      dimensional angular sensitivity which allows the output to be self-normalized
      resulting in high immunity to both B-field and temperature induced errors. The
      individual Hall generator elements were operated with a final sensitivity of 4.07
      V G-1. The Earth's field, magnitude 0.486 G with a surface declination angle of
      58.2 degrees (San Diego, California), was used as the excitation/reference field.
      Bandwidth limiting, low-noise design, and active/passive thermal compensation
      techniques were employed resulting in a sensor bandwidth of DC to 100 Hz with a
      maximum signal-to-noise ratio of 44.5 dB. The maximum angular resolution of the
      sensor was measured to be +/- 0.27 degrees. Temperature induced error was
      measured to be less than 2% from 25 degrees C to 40 degrees C. The measurement of
      shoulder joint rotation was used as the test case application for the sensor with
      excellent agreement between theoretical and experimental performance.

PMID- 8468340
TI  - A technique for the tensile testing of demineralised bone.
AB  - The purpose of this study was to devise a method for the tensile testing of the
      organic component of demineralised bone. It was hoped that the method could be
      applied to determine whether an observed reduction in the strength of bone in
      copper-deficient rats could be attributed to a reduction in the cross-linking of
      collagen. Tensile testing of a fully demineralised specimen proved impossible to
      perform because of the difficulty in gripping the material, which tended to slide
      out of its holding clamps. The technique devised involved the demineralisation of
      only the diaphysis of the bone, leaving the bone ends intact. This enabled the
      bone to be gripped firmly at both ends in an Instron tensile testing machine.
      Elongation under loading of the demineralised diaphysis was measured by the
      Instron and a video recording was made of the elongation of the central portion.
      The strain was found to be uniform. Tensile strength was found to correlate with
      copper levels in the liver (r = 0.54, p < 0.05), although no significant
      differences were found between the strength, the stiffness, or the strain to
      failure for bone from the copper-deficient animals and bone from the normal
      controls. The test method itself should be useful in other studies in which the
      tensile properties of the organic phase of bone need to be measured.

PMID- 8468341
TI  - A static dynamometer measuring multidirectional torques exerted simultaneously at
      the hip and knee.
AB  - The function of a static dynamometer measuring torques exerted simultaneously in
      the different anatomical planes of the hip (flexion-extension, abduction
      adduction and internal-external rotation) and knee (flexion-extension) is
      described. Muscular torques were calculated in real time using a desktop computer
      from measurements of orthogonal forces applied at two locations and the lever arm
      values measured in each subject. The reliability of the force transducers was
      explored by examining their output, using calibrated weights, on three different
      days. The results were identical over this period of time, indicating that the
      transducers are highly reliable. A mechanical simulator of a lower limb was
      constructed to generate specific or combined torques of known values at the hip
      and knee. The torques measured by the dynamometer were found to be highly
      concordant with the known torques applied by the simulator, indicating that the
      torque measurements were valid. The usefulness of the dynamometer is demonstrated
      by evaluating the activity of the rectus femoris and biceps femoris muscles
      during static efforts exerted in various directions at the hip. In addition, the
      mechanical action of biarticular muscles at the hip was evaluated by
      quantification of hip torques during efforts exerted at the knee. From these
      results, it has been concluded that the present biarticular and multidirectional
      dynamometer is a valid, reliable and precise instrument that may prove to be
      useful in evaluating the muscular function of the lower limb.

PMID- 8468342
TI  - Abstracts of NACOB II. The 2nd North American Congress on Biomechanics.

PMID- 8468343
TI  - Association of individual hnRNP proteins and snRNPs with nascent transcripts.
AB  - As they are transcribed, RNA polymerase II transcripts (hnRNAs or pre-mRNAs)
      associate with hnRNP proteins and snRNP particles, and the processing of pre-mRNA
      occurs within these ribonucleoprotein complexes. To better understand the
      relationship between hnRNP proteins and snRNP particles and their roles in mRNA
      formation, we have visualized them as they associate with nascent transcripts on
      the polytene chromosomes of Drosophila melanogaster salivary glands. Simultaneous
      pairwise detection of the abundant hnRNP proteins hrp36, hrp40, and hrp48 by
      direct double-label immunofluorescence microscopy reveals all of these proteins
      are bound to most transcripts, but their relative amounts on different
      transcripts are not fixed. Numerous differences in the relative amounts of snRNP
      particles and hnRNP proteins on nascent transcripts are also observed. These
      observations directly demonstrate that individual hnRNP proteins and snRNP
      particles are differentially associated with nascent transcripts and suggest that
      different pre-mRNAs bind different combinations of these factors to form
      transcript-specific, rather than a single type of, hnRNA-hnRNP-snRNP complexes.
      The distinct and specific constellation of hnRNP proteins and snRNP particles
      that assembles on different pre-mRNAs is likely to affect the fate and pathway of
      processing of these transcripts.

PMID- 8468344
TI  - A cytoplasmically anchored nuclear protein interferes specifically with the
      import of nuclear proteins but not U1 snRNA.
AB  - A cytoplasmically anchored mutant SV40 T antigen, FS T antigen, was shown
      previously to interfere specifically with the nuclear import of a heterologous
      nuclear protein, adenovirus 5 fiber protein, in cultured monkey cells (Schneider,
      J., C. Schindewolf, K. van Zee, and E. Fanning. 1988. Cell. 54:117-125; van Zee,
      K., F. Appel, and E. Fanning. 1991. Mol. Cell. Biol. 11:5137-5146). In this
      report, we demonstrate that FS T antigen also interferes with the nuclear import
      of adenovirus E1A and a peptide-albumin conjugate bearing multiple copies of the
      T antigen nuclear localization signal, but not with the import of U1 snRNA. A
      kinetic analysis indicates that nuclear import of the albumin-peptide conjugate
      is inhibited only when high intracellular concentrations of FS T antigen are
      reached. After microinjection into the cytoplasm of cultured cells, purified FS T
      antigen protein does not accumulate at the nuclear periphery, but rather is
      distributed in a punctate pattern throughout the cytoplasm. These data support a
      model in which cytoplasmic anchoring of FS T antigen enables the mutant protein
      to sequester and titrate out a cellular factor which is required for nuclear
      protein but not U1 snRNA import.

PMID- 8468345
TI  - Unusual nuclear structures in meiotic prophase of fission yeast: a cytological
      analysis.
AB  - Earlier results from sectioned nuclei indicating that Schizosaccharomyces pombe
      does not develop a classical tripartite synaptonemal complex (SC) during meiotic
      prophase are confirmed by spreading of whole nuclei. The linear elements
      appearing during prophase I resemble the axial cores (SC precursors) of other
      organisms. The number of linear elements in haploid, diploid, and tetraploid
      strains is always higher than the chromosome number, implying that they are not
      formed continuously along the chromosomes. Time course experiments reveal that
      the elements appear after DNA replication and form networks and bundles. Later
      they separate and approximately 24 individual elements with a total length of 34
      microns are observed before degradation and meiotic divisions. Parallel staining
      of DNA reveals changes in nuclear shape during meiotic prophase. Strains with a
      mei4 mutation are blocked at a late prophase stage. In serial sections we
      additionally observed a constant arrangement of the spindle pole body, the
      nucleolus, and the presumptive centromere cluster. Thus, S. pombe manages to
      recombine and segregate its chromosomes without SC. This might correlate with the
      absence of crossover interference. We propose a mechanism for chromosome pairing
      with initial recognition of the homologs at the centromeres and suggest functions
      of the linear elements in preparation of the chromosomes for meiosis I
      disjunction. With the spreading technique combined genetic, molecular, and
      cytological approaches become feasible in S. pombe. This provides an opportunity
      to study essential meiotic functions in the absence of SCs which may help to
      clarify the significance of the SC and its components for meiotic chromosome
      structure and function.

PMID- 8468346
TI  - A novel tau transcript in cultured human neuroblastoma cells expressing nuclear
      tau.
AB  - We previously reported the presence of the microtubule-associated protein, tau in
      the nuclei of primate cells in culture. The present study confirms the existence
      of nuclear tau in two human neuroblastoma cells lines by indirect
      immunofluorescence and Western blot using mAbs to tau. Northern blot analysis of
      poly A+ mRNA detects a novel 2-kb tau transcript coexpressed with the 6-kb
      message in cultured human cells and human frontal cortex. PCR and cDNA sequencing
      demonstrate that the 2-kb message contains the entire tau coding region.
      Furthermore, actinomycin D transcription inhibition experiments indicate that the
      2-kb message is not derived from the 6-kb message, but instead arises from the
      original tau transcript. One of the human neuroblastoma cell lines examined
      contains both nuclear and cytoplasmic tau as assayed by both Western blot and
      indirect immunofluorescence. Northern blot analysis of this cell line indicates
      that copious amounts of the 2-kb message are present while little of the 6-kb
      transcript is obvious. Immunofluorescence analysis of this cell line demonstrates
      that the cytoplasmic tau is not localized to microtubules. Together, these
      results indicate that the 2-kb tau message in humans may specify tau for non
      microtubule functions in both the cytoplasm and the nucleus. We hypothesize that
      this is accomplished via a message targeting mechanism mediated by the
      untranslated regions of the tau messages.

PMID- 8468347
TI  - The rubella virus E2 and E1 spike glycoproteins are targeted to the Golgi
      complex.
AB  - Rubella virus (RV) has been reported to bud from intracellular membranes in
      certain cell types. In this study the intracellular site of targeting of RV
      envelope E2 and E1 glycoproteins has been investigated in three different cell
      types (CHO, BHK-21 and Vero cells) transfected with a cDNA encoding the two
      glycoproteins. By indirect immunofluorescence, E2 and E1 were localized to the
      Golgi region of all three cell types, and their distribution was disrupted by
      treatment with BFA or nocodazole. Immunogold labeling demonstrated that E2 and E1
      were localized to Golgi cisternae and indicated that the glycoproteins were
      distributed across the Golgi stack. Analysis of immunoprecipitates obtained from
      stably transfected CHO cells revealed that E2 and E1 become endo H resistant and
      undergo sialylation without being transported to the cell surface. Transport of
      RV glycoproteins to the Golgi complex was relatively slow (t1/2 = 60-90 min).
      Coprecipitation experiments indicated that E2 and E1 form a heterodimer in the
      RER. E1 was found to fold much more slowly than E2, suggesting that the delay in
      transport of the heterodimer to the Golgi may be due to the slow maturation of E1
      in the ER. These results indicate that RV glycoproteins behave as integral
      membrane proteins of the Golgi complex and thus provide a useful model to study
      targeting and turnover of type I membrane proteins in this organelle.

PMID- 8468348
TI  - Study of the synthesis and secretion of normal and artificial mutants of murine
      amyloid precursor protein (APP): cleavage of APP occurs in a late compartment of
      the default secretion pathway.
AB  - Amyloid precursor protein (APP) secretase plays a pivotal role in the processing
      of APP since its activity precludes the formation of amyloid peptide in
      Alzheimer's Disease. The identity and the subcellular localization of this enzyme
      are at this moment unknown. It is also unclear how APP escapes the activity of
      this enzyme when amyloid is formed. We have previously shown that APP-secretase
      activity is not inhibited by exogenously added proteinase inhibitors of different
      specificity (De Strooper, B., F. Van Leuven, and H. Van Den Berghe. 1992. FEBS
      (Fed. Eur. Biochem. Soc.) Lett. 308:50-53). We show here that the primary amine
      methylamine inhibits the secretion of APP into the medium. Furthermore, we show
      that a truncated form of APP, devoid of the cytoplasmic domain, is more
      efficiently cleaved and secreted than wild-type APP, which together with the
      methylamine block, shows that APP-secretase is located in a late compartment of
      the default constitutional secretion pathway. The sorting signals in the
      cytoplasmic domain of APP are therefore important in the deviation of APP from
      the secretase pathway. Finally we show that mutation of Arg609 to Asp in
      combination with Lys612 to Glu makes APP a less efficiently cleaved substrate for
      APP-secretase. The results are discussed in the context of recent findings on the
      targeting of APP and a parallel is drawn with some lysosomal glycoproteins that
      follow similar pathways.

PMID- 8468349
TI  - Retrieval of transmembrane proteins to the endoplasmic reticulum.
AB  - A COOH-terminal double lysine motif maintains type I transmembrane proteins in
      the ER. Proteins tagged with this motif, eg., CD8/E19 and CD4/E19, rapidly
      receive post-translational modifications characteristic of the intermediate
      compartment and partially colocalized to this organelle. These proteins also
      received modifications characteristic of the Golgi but much more slowly. Lectin
      staining localized these Golgi modified proteins to ER indicating that this motif
      is a retrieval signal. Differences in the subcellular distribution and rate of
      post-translational modification of CD8 maintained in the ER by sequences derived
      from a variety of ER resident proteins suggested that the efficiency of retrieval
      was dependent on the sequence context of the double lysine motif and that
      retrieval may be initiated from multiple positions along the exocytotic pathway.

PMID- 8468350
TI  - Apical polarization of N-CAM in retinal pigment epithelium is dependent on
      contact with the neural retina.
AB  - The retinal pigment epithelium (RPE) is unique among epithelia in that its apical
      surface does not face a lumen, but, instead, is specialized for interaction with
      the neural retina. The molecules involved in the interaction of the RPE with the
      neural retina are not known. We show here that the neural cell adhesion molecule
      (N-CAM) is found both on the apical surface of RPE in situ and on the outer
      segments of photoreceptors, fulfilling an important requisite for an adhesion
      role between both structures. Strikingly, culture of RPE results in rapid
      redistribution of N-CAM to the basolateral surface. This is not due to an isoform
      shift, since the N-CAM expressed by cultured cells (140 kD) is the same as that
      expressed by RPE in vivo. Rather, the reversed polarity of N-CAM appears to
      result from the disruption of the contact between the RPE and the photoreceptors
      of the neural retina. We suggest that N-CAM in RPE and photoreceptors participate
      in these interactions.

PMID- 8468351
TI  - Cross-linking of IgG receptors inhibits membrane immunoglobulin-stimulated
      calcium influx in B lymphocytes.
AB  - By cross-linking membrane immunoglobulins (mIg), the antigenic stimulation of B
      lymphocytes induces an increase in intracellular free calcium levels ([Ca2+]i)
      because of a combination of release from intracellular stores and transmembrane
      influx. It has been suggested that both events are linked, as in a number of
      other cases of receptor-induced increase in [Ca2+]i. Conversely, in B
      lymphocytes, type II receptors for the Fc fragment of IgG (Fc gamma RII) inhibit
      mIg-mediated signaling. Thus, we have investigated at the level of single cells
      if these receptors could act on specific phases of mIg Ca2+ signaling.
      Lipopolysaccharide-activated murine B splenocytes and B lymphoma cells
      transfected with intact or truncated Fc gamma RII-cDNA were used to determine the
      domains of Fc gamma RII implicated in the inhibition of the Ca2+ signal. [Ca2+]i
      was measured in single fura-2-loaded cells by microfluorometry. The phases of
      release from intracellular stores and of transmembrane influx were discriminated
      by using manganese, which quenches fura-2, in the external medium as a tracer for
      bivalent cation entry. The role of membrane potential was studied by recording
      [Ca2+]i in cells voltage-clamped using the perforated patch-clamp method. Cross
      linking of mIgM or mIgG with F(ab')2 fragments of anti-Ig antibodies induced a
      sustained rise in [Ca2+]i due to an extremely fast and transitory release of Ca2+
      from intracellular stores and a long lasting transmembrane Ca2+ influx. The phase
      of influx, but not that of release, was inhibited by membrane depolarization. The
      increase in [Ca2+]i occurred after a delay inversely related to the dose of
      ligand. Co-cross-linking mIgs and Fc gamma RII with intact anti-Ig antibodies
      only triggered transitory release of Ca2+ from intracellular stores but no Ca2+
      influx, even when the cell was voltage-clamped at negative membrane potentials.
      These transitory Ca2+ rises had similar amplitudes and delays to those induced by
      cross-linking mIgs alone. Thus, our data show that Fc gamma RII does not mediate
      an overall inhibition of mIg signaling but specifically affects transmembrane
      Ca2+ influx without affecting the release of Ca2+ from intracellular stores.
      Furthermore, this inhibition is not mediated by cell depolarization. Thus, Fc
      gamma RII represents a tool to dissociate physiologically the phases of release
      and transmembrane influx of Ca2+ triggered through antigen receptors.

PMID- 8468352
TI  - Dynamics of the neuronal intermediate filaments.
AB  - We have analyzed the dynamics of neuronal intermediate filaments in living
      neurons by using the method of photobleaching of fluorescently-labeled
      neurofilament L protein and immunoelectron microscopy of incorporation sites of
      biotinylated neurofilament L protein. Low-light-level imaging and photobleaching
      of growing axons of mouse sensory neurons did not affect the rate of either
      axonal growth or the addition of intermediate filament structures at the axon
      terminal, suggesting that any perturbations caused by these optical methods would
      be minimal. After laser photobleaching, recovery of fluorescence did occur slowly
      with a recovery half-time of 40 min. Furthermore, we observed a more rapid
      fluorescence recovery in growing axons than in quiescent ones, indicating a
      growth-dependent regulation of the turnover rate. Incorporation sites of biotin
      labeled neurofilament L protein were localized as numerous discrete sites along
      the axon, and they slowly elongated to become continuous arrays 24 h after
      injection. Collectively, these results indicate that neuronal intermediate
      filaments in growing axons turn over within the small area of the axoplasm
      possibly by the mechanism of lateral and segmental incorporation of new subunits.

PMID- 8468353
TI  - Neurofilament deficiency in quail caused by nonsense mutation in neurofilament-L
      gene.
AB  - The existence of a neurofilament-deficient mutant of Japanese quail was recently
      documented (Yamasaki, H., C. Itakura, and M. Mizutani. 1991. Acta Neuropathol.
      82:427-434), but the genetic events leading to the neurofilament deficiency have
      yet to be determined. Our molecular biological analyses revealed that the
      expression of neurofilament-L (NF-L) gene was specifically repressed in neurons
      of this mutant. To search for mutation(s) responsible for the shutdown of this
      gene expression, we cloned and sequenced the NF-L genes in the wild-type and
      mutant quails. It is eventually found that the NF-L gene in the mutant includes a
      nonsense mutation at the deduced amino acid residue 114, indicating that the
      mutant is incapable of producing even a trace amount of polymerization-competent
      NF-L protein at any situation. The identification of this nonsense mutation
      provides us with a solid basis on which molecular mechanisms underlying the
      alteration in the neuronal cytoskeletal architecture in the mutant should be
      interpreted.

PMID- 8468354
TI  - Carbohydrate recognition in the peripheral nervous system: a calcium-dependent
      membrane binding site for HNK-1 reactive glycolipids potentially involved in
      Schwann cell adhesion.
AB  - The carbohydrate determinants recognized by the HNK-1 antibody are potential cell
      cell recognition ligands in the peripheral nervous system (PNS). The HNK-1
      reactive sulfoglucuronylneolacto (SGNL) glycolipids specifically support Schwann
      cell adhesion, suggesting the presence of a cell surface receptor specific for
      SGNL-oligosaccharides. We directly probed PNS membranes for receptors
      complementary to SGNL determinants using a synthetic radioligand consisting of
      radioiodinated serum albumin derivatized with multiple SGNL-oligosaccharides. A
      high-affinity, saturable, calcium-dependent binding site for this ligand was
      found in PNS myelin membranes. Binding activity was carbohydrate-specific (most
      potently inhibited by SGNL-lipids compared to other glycolipids) and PNS-specific
      (absent from comparable central nervous system membranes). The SGNL-specific
      binding activity on PNS membranes reported here may be involved in peripheral
      myelination or myelin stabilization.

PMID- 8468356
TI  - Inhibition of fibronectin binding and fibronectin-mediated cell adhesion to
      collagen by a peptide from the second type I repeat of thrombospondin.
AB  - The platelet and extracellular matrix glycoprotein thrombospondin interacts with
      various types of cells as both a positive and negative modulator of cell
      adhesion, motility, and proliferation. These effects may be mediated by binding
      of thrombospondin to cell surface receptors or indirectly by binding to other
      extracellular matrix components. The role of peptide sequences from the type I
      repeats of thrombospondin in its interaction with fibronectin were investigated.
      Fibronectin bound specifically to the peptide Gly-Gly-Trp-Ser-His-Trp from the
      second type I repeat of thrombospondin but not to the corresponding peptides from
      the first or third repeats or flanking sequences from the second repeat. The two
      Trp residues and the His residue were essential for binding, and the two Gly
      residues enhanced the affinity of binding. Binding of the peptide and intact
      thrombospondin to fibronectin were inhibited by the gelatin-binding domain of
      fibronectin. The peptide specifically inhibited binding of fibronectin to gelatin
      or type I collagen and inhibited fibronectin-mediated adhesion of breast
      carcinoma and melanoma cells to gelatin or type I collagen substrates but not
      direct adhesion of the cells to fibronectin, which was inhibited by the peptide
      Gly-Arg-Gly-Asp-Ser. Thus, the fibronectin-binding thrombospondin peptide Gly-Gly
      Trp-Ser-His-Trp is a selective inhibitor of fibronectin-mediated interactions of
      cells with collagen in the extracellular matrix.

PMID- 8468355
TI  - Effect of nerve growth factor and fibroblast growth factor on PC12 cells:
      inhibition by orthovanadate.
AB  - Sodium orthovanadate, an inhibitor of protein tyrosine phosphatases, causes
      increased levels of tyrosine phosphorylation and blocks, at noncytotoxic
      concentrations, the differentiative response of rat pheochromocytoma (PC12) cells
      to beta-nerve growth factor (beta NGF) and basic fibroblast growth factor (bFGF)
      in a reversible manner. It also prevents growth factor-induced neurite
      proliferation in primed cells and causes the retraction of previously formed
      neurites, even in the presence of beta NGF or bFGF. It is equally effective in
      blocking neurite proliferation by 8-Br-cAMP. Zinc chloride and ammonium
      molybdate, two other inhibitors of tyrosine phosphatases, also cause parallel
      decreases in neurite proliferation. Orthovanadate generally reduces the
      transcription of immediate early response genes (TIS 8 and c-fos) and secondary
      response genes (ornithine decarboxylase (ODC), acetyl-cholinesterase (AChE) and
      SCG 10) induced by beta NGF, bFGF, EGF, and PMA, albeit in a variable fashion.
      There was no observed effect on the kinetics of expression as judged by TIS 8
      induction by beta NGF and protein kinase C (PKC) downregulation did not change
      the levels of inhibition by orthovanadate seen in control cells. Orthovanadate
      does not affect the production of diacylglycerol induced by beta NGF or bFGF.
      These observations are consistent with the view that growth factor stimulation of
      differentiation in PC12 cells involves at least one other PKC independent
      pathway, and that cAMP and PMA (and their active analogs) activate tyrosine
      kinases (albeit probably secondarily), which are at least partially responsible
      for their actions. Although the exact site(s) of action of orthovanadate that
      lead to the inhibition of growth factor-induced neurite proliferation are
      unknown, the results presented suggest that it prolongs tyrosine phosphorylations
      by nonreceptor tyrosine kinases that act downstream from the receptor kinases.

PMID- 8468357
TI  - Long-term culture of disaggregated rat osteoclasts: inhibition of bone resorption
      and reduction of osteoclast-like cell number by calcitonin and PTHrP[107-139].
AB  - The isolated osteoclast bone resorption assay has proved to be a useful means of
      examining the response of mammalian and avian osteoclasts to a variety of
      stimuli. The assay has traditionally been performed over a period of 24 hours. By
      extending the duration of the osteoclast bone resorption assay, we have been able
      to assess the long-term effects of carboxyl-terminal parathyroid hormone-related
      protein (hPTHrP[107-139]), salmon calcitonin (sCT) and hPTH[1-34] on bone
      resorption and TRACP-positive osteoclast-like cell number. We found that, in
      control cultures over a period of up to 144 hours, the osteoclast-like cells not
      only remained viable but their numbers also increased. The number of
      mononucleated and multinucleated osteoclast-like cells doubled in the first 48
      hours before stabilizing over the remainder of the incubation period. Osteoblasts
      also proliferated, resulting in a resorption response to hPTH[1-34] being evident
      from 48 hours onward. hPTHrP]107-139] persistently inhibited basal and PTH
      stimulated bone resorption for at least 96-144 hours, whereas "escape" from the
      inhibitory effect of sCT was seen after 48-72 hours. Decreased numbers of both
      mononucleated and multinucleated TRACP-positive osteoclast-like cells were seen
      by 48 hours in cultures treated with sCT. In contrast, hPTHrP[107-139] reduced
      the number of mononuclear TRACP-positive cells with only a late effect on
      multinucleated cells. Furthermore, the increased number of osteoclast-like cells
      seen in response to hPTH[1-34] was inhibited by carboxyl-terminal PTHrP. In
      summary, this study indicates that the extended bone resorption assay system is a
      complex one where both osteoclastic resorption and osteoclast maturation are
      evident. Using this system, we have shown that hPTHrP[107-139] acts as a potent
      long-term inhibitor of osteoclastic bone resorption, without evidence of escape
      from its effect. Its action to reduce the number of mononucleated osteoclast-like
      cells suggests that it affects several aspects of osteoclast activity.

PMID- 8468358
TI  - Dissociation of early and late markers of murine myeloid differentiation by
      interferon-gamma and interleukin-6.
AB  - Murine myeloid leukemia M1 cells undergo terminal differentiation to mature
      macrophages after stimulation with interleukin-6 (IL-6). This process can be
      monitored by measuring the expression of early markers such as the high affinity
      receptor for monomeric IgG2a (Fc gamma RI) and Ia antigen followed by late
      markers such as lysozyme production and finally morphological changes from blast
      cells to mature macrophages. The same early markers that are expressed on M1
      cells after induction with IL-6 are also expressed on monocytic cells after
      activation with interferon-gamma (IFN gamma). We used IL-6 and IFN gamma to
      investigate whether the early stages of M1 cell differentiation could be
      accomplished without commitment of the cells to terminal differentiation.
      Cytofluorometry shows that the expression of the same early differentiation
      markers (Fc gamma RI and Ia antigen) that are inducible by IL-6 on M1 cells can
      be induced by IFN gamma as well. However, stimulation with IFN gamma, in contrast
      to IL-6, does not induce the late differentiation markers such as lysozyme
      production, phagocytic activity, and morphological changes. Northern analysis
      supports these findings in that expression of Fc gamma RI mRNA is induced by
      either cytokine, whereas expression of mRNA for lysozyme is inducible by IL-6
      only. Nuclear run-on analysis reveals that the changes in steady state mRNA
      levels of both Fc gamma RI and lysozyme are regulated by a transcriptional
      mechanism. These data suggest that early stages in the process of myeloid
      differentiation can be separately induced by IFN gamma and thus are independent
      from the later events induced by IL-6.

PMID- 8468359
TI  - Adhesiveness and proliferation of epithelial cells are differentially modulated
      by activation and inhibition of protein kinase C in a substratum-dependent
      manner.
AB  - In the present study, we have examined the regulation of attachment, onset of
      proliferation and the subsequent growth, in vitro, of chick retinal pigmented
      epithelial (RPE) cells as a function of the nature of the substratum and of
      either the activation or inhibition of protein kinase C (PKC). The RPE cells have
      an adhesive preference for protein carpets which contain laminin. This preference
      disappears gradually with time in culture. The adhesion of RPE cells to
      fibronectin is shown to be a receptor-mediated process which involves the RGD
      recognition signal. This study also demonstrates that a PKC activator, 12-O
      tetradecanoyl-phorbol-13-acetate (TPA), affects RPE cell adhesion in a substratum
      dependent manner. Exposure of RPE cells to TPA lowers the cell attachment
      efficacy to ECM protein substrata but does not affect cell attachment to plastic.
      The onset of cell proliferation is accelerated by TPA on all of the substrata
      tested. The minimal duration of an effective TPA pulse exerting a long-lasting
      influence on RPE cell proliferation is between 1.5 and 3.5 hr. Stimulation of
      cell proliferation by TPA in long-term cultures is independent of the nature of
      the growth substratum. The acceleration of the onset of cell proliferation by TPA
      is sensitive to 1-(5-isoquinolinesulfonyl)-2-methylpiperazine (H7), an inhibitor
      of conventional PKC, and thus appears to be dependent on the activation of
      conventional PKC. H7 also affects cell-cell contacts, causing an alteration in
      the shape ("squaring") of RPE cells packed into large colonies. Conversely, the
      effects of TPA on both the attachment and the long-term proliferation of RPE
      cells are not dependent a conventional PKC isotype, since H7 cannot abolish the
      influence of TPA on either process. We conclude that the effect of TPA on long
      term proliferation of RPE cells is either dependent on a novel PKC isotype or
      independent of PKC.

PMID- 8468360
TI  - Modulation of transforming growth factor-beta 1 stimulated elastin and collagen
      production and proliferation in porcine vascular smooth muscle cells and skin
      fibroblasts by basic fibroblast growth factor, transforming growth factor-alpha,
      and insulin-like growth factor-I.
AB  - During tissue repair and development, matrix accumulation is modulated as
      multiple signals impinge on target cells. We have investigated the effects of
      combinations of the mitogenic cytokines, basic fibroblast growth factor (bFGF),
      transforming growth factor alpha (TGF-alpha), and insulin-like growth factor-1
      (IGF-1) with transforming growth factor-beta 1 (TGF-beta 1) with respect to the
      production of two matrix components, elastin and type I collagen. Using specific
      enzyme-linked immunoassays for detection of secreted precursors in both vascular
      smooth muscle cells and skin fibroblasts from the domestic pig, production of
      these two fibrous proteins was shown to be strongly stimulated by TGF-beta 1. In
      the smooth muscle cell, both bFGF and TGF-alpha were potent antagonists of TGF
      beta 1-mediated matrix production, whereas IGF-1 was only weakly additive with
      respect to elastin production. Antagonism was also evident to a lesser extent in
      skin fibroblasts. Reduced responsiveness to TGF-beta 1 did not appear to be due
      to a switch to a proliferative state, since TGF-beta 1 itself acted as a mitogen
      in confluent SMC, and TGF-alpha was only a weak mitogen in confluent fibroblast
      cultures. Although a predominant effect of TGF-beta is matrix accumulation, these
      findings suggest that this property will be significantly modified by the
      cytokine context.

PMID- 8468361
TI  - Expression and function of gingival fibroblast C1q receptors are upregulated by
      interleukin-1 beta and transforming growth factor-beta.
AB  - In injury and inflammation, complement (C) component C1q, in addition to its
      central role in initiation of classical pathway of complement activation,
      modulates diverse cellular functions by binding to specific cell surface
      receptors. Interaction of substrate-bound C1q with receptors for the collagen
      like domain of C1q (C1qRC) of human gingival fibroblasts (HGF) promotes cell
      attachment. We investigated modulation of the adhesive function and expression of
      C1qRC by interleukin-1 beta (IL-1 beta) and transforming growth factor-beta (TGF
      beta). Confluent fibroblast monolayers were incubated under standard culture
      conditions with or without cytokines. C1qRC function was measured by attachment
      assays. IL-1 beta and TGF-beta increased fibroblast adhesion to C1q to 146% and
      131% of controls, respectively. Cytokine enhancement of HGF adhesion was
      concentration-dependent, saturable (20 ng/ml IL-1 beta; 1 ng/ml TGF-beta) and
      time-dependent (IL-1 beta 12-hr peak; TGF-beta 24-hr peak). Effect of IL-1 beta
      and TGF-beta on C1qRC expression was assessed by flow cytometry measurements of
      fluorescence intensity of cells stained with C1q and FITC anti-C1q antibody, and
      by binding studies with 125I-C1q. Cells treated with cytokines displayed a two-
      to four-fold increased fluorescence of cell-bound C1q compared to controls.
      Binding studies indicated the increased fluorescence correlated with increase in
      number of C1qRC in both IL-1 beta (4.7 x 10(6)/cell) and TGF-beta (3.9 x
      10(6)/cell)-treated cells, compared to control (3.0 x 10(6)/cell), but had no
      effect on binding affinity. Rates of internalization of receptor-bound C1q were
      similar in cytokine-treated cells and controls. We propose from these data that
      IL-1 beta and TGF-beta have the ability to upregulate C1qRC expression, and this
      effect contributes to increased adhesion of HGF to substrate-bound C1q.

PMID- 8468362
TI  - Epidermal growth factor receptors lose ligand binding ability as WI-38 cells
      progress from short-term to long-term quiescence.
AB  - WI-38 cells, density arrested for short periods of time, can be stimulated to re
      enter the cell cycle by epidermal growth factor (EGF) alone. However, cells
      density arrested for longer periods have a prolonged prereplicative phase when
      serum stimulated and cannot be stimulated by EGF alone. Radio-ligand binding
      studies performed on WI-38 cells showed that actively growing cells bind [125I]EG
      at relatively low levels that increase to a maximum as the cells become contact
      inhibited. As the cells enter a state of deeper quiescence, EGF binding falls to
      one-third to one-fifth the short-term growth arrested levels, remaining constant
      thereafter. The EGF-receptor complexes internalize more slowly in long-term
      growth arrested cells, and the rate of ligand association to the receptor is
      lower than short-term growth arrested cells. The amount of EGF receptor protein
      in lysates of equal numbers of both short- and long-term quiescent cells remains
      the same. These results suggest that the failure of long-term growth arrested
      cells to respond to EGF is not due to dramatic changes in the amount of receptor
      protein during prolonged quiescence but more likely to an alteration in the
      ability of these receptors to bind ligand and/or activate the EGF signal
      transduction pathway.

PMID- 8468363
TI  - Effects of growth factors on cell cycle arrest in dolichyl phosphate-depleted
      cultures.
AB  - Previously we showed that CHO cell growth is arrested in the G1 or G0 phase
      within 24 h after the biosynthesis of mevalonic acid is blocked. The growth
      limiting factor under these conditions appeared to be dolichyl phosphate or one
      of its glycosylated derivatives with consequent decrease in the synthesis of N
      linked glycoproteins (Doyle, J.W., and A.A. Kandutsch, 1988, J. Cell Physiol.
      137:133-140; Kabakoff, B., J.W. Doyle, and A.A. Kandutsch, 1990, Arch. Biochem.
      Biophys. 276:382-389). We show herein that cell surface glycoproteins are
      depleted in the inhibited cultures and that growth arrest is delayed when
      supraphysiological concentrations of insulin, insulin-like growth factor-1 (IGF
      1) and bFGF are added to the culture medium. Apparently an elevated level of a
      growth factor increases the length of time during which a threshold level of
      occupied receptor is maintained as the number of glycosylated receptor molecules
      declines. The results support the idea that cellular levels of dolichyl phosphate
      and its derivatives may limit cell division by controlling the numbers of
      functional receptors for growth factors and of other glycoproteins on the cell
      surface.

PMID- 8468364
TI  - Mutant cell line demonstrating a block in insulin and insulin-like growth factor
      type 1 (IGF-1) induced mitogenesis.
AB  - Recently, we have isolated a Chinese hamster cell variant (IV-A1-j) resistant to
      an insulin-diphtheria-A chain toxic conjugate (Leckett and Germinario:
      Cytotechnology [in press]. This cell line exhibited a decreased level of insulin
      binding, but normal growth in serum-containing medium when compared to the
      parental cell line (V-79). In this paper we further demonstrate that while IV-A1
      j cells are capable of growing in serum-containing medium, they are insensitive
      to the mitogenic actions of either insulin or IGF-1. In contrast, epidermal
      growth factor (EGF) and/or alpha-thrombin (THR) generate a mitogenic effect in IV
      A1-j cells comparable to that observed in the parental V-79 cells. The
      combination of EGF and/or THR with either insulin or IGF-1 results in an increase
      in V-79 cell growth above EGF and/or THR alone. On the other hand, insulin or IGF
      1 in the presence of other mitogens did not stimulate further growth in IV-A1-j
      cells. While insulin binding was lower in IV-A1-j cells, internalization of 125I
      insulin was not different in the two cell types. Additionally, insulin-stimulated
      glycogen synthesis and protein synthesis were not different in the two cell
      types. These observations are consistent with insulin and IGF-1 sharing a
      mitogenic signalling pathway in Chinese hamster fibroblasts and that this pathway
      is distinct from other growth factor signalling pathways. The fact that this
      pathway is defective in the IV-A1-j cell line indicates the potential usefulness
      of these cells in identifying a key step(s) in the insulin (IGF-1) mitogenic
      pathway.

PMID- 8468365
TI  - Heparin-like glycosaminoglycans participate in binding of a human trophoblastic
      cell line (JAR) to a human uterine epithelial cell line (RL95).
AB  - In vitro studies in our laboratory have indicated that heparan sulfate
      proteoglycans (HSPGs) play an important role in murine embryo implantation. In
      order to investigate the potential function of HSPGs in human implantation, two
      human cell lines (RL95 and JAR) were used to model uterine epithelium and
      embryonal trophectoderm, respectively. A heterologous cell-cell adhesion assay
      was developed to determine if binding of JAR cells to RL95 cells was heparan
      sulfate-dependent. Labeled, single cell suspensions of JAR cells attached to
      confluent monolayers of RL95 cells in a dose- and time-dependent manner. Heparin
      like glycosaminoglycans and JAR cell proteoglycans competitively inhibited JAR
      cell adhesion to RL95 cells by 50% or more. A panel of chemically modified
      heparins were used to demonstrate that O-sulfation and amino group substitution
      were critical for inhibition of cell-cell adhesion. Treatment with chlorate, an
      inhibitor of ATP-sulfurylase, resulted in a 56% reduction in cell-cell binding
      compared to untreated controls. Heparinase and chondroitinase ABC markedly
      inhibited JAR-RL95 binding, while chondroitinase AC had no significant effect.
      These observations indicated that HSPGs as well as dermatan sulfate-containing
      proteoglycans participated in cell-cell binding. Collectively, these results
      indicate that initial binding interactions between JAR and RL95 cells is mediated
      by cell surface glycosaminoglycans (GAGs) with heparin-like properties (i.e.,
      heparan sulfate and dermatan sulfate). These observations are consistent with an
      important role for HS and heparin-like GAGs as well as their corresponding
      binding sites in early stages of human trophoblast-uterine epithelial cell
      binding.

PMID- 8468366
TI  - Regulation of malic enzyme gene expression by nutrients, hormones, and growth
      factors in fetal hepatocyte primary cultures.
AB  - The culture of fetal hepatocytes for 64 h in medium supplemented with 5 mM
      glucose, T3, insulin, and dexamethasone resulted in the coordinate precocious
      expression of malic enzyme mRNA, protein, and specific activity. T3 was the main
      inducer; meanwhile, insulin exerted a small synergistic effect when added with
      T3. Dexamethasone had a potentiation effect on the T3 response of malic enzyme
      mRNA expression regardless of the presence of insulin. This effect of
      dexamethasone on T3 response of malic enzyme mRNA expression was time (64 h) and
      glucose dependent. Glucagon, and to a greater degree dibutyryl-cAMP, repressed
      malic enzyme mRNA as well as protein expression by T3 and dexamethasone, in the
      absence of insulin. Glucose and other carbon sources such as lactate-pyruvate or
      dihydroxyacetone induced the abundance of malic enzyme mRNA in the absence of
      hormones. Insulin and T3 produced a high accumulation of malic enzyme mRNA in
      lactate-pyruvate medium, this effect being decreased by dexamethasone. EGF
      suppressed the induction produced by T3 and dexamethasone on malic enzyme mRNA,
      while the expression of beta-actin mRNA remained essentially unmodified.

PMID- 8468367
TI  - Synergistic effects of cytokine and hyperthermia on cytotoxicity in HT-29 cells
      are not mediated by alteration of induced protein levels.
AB  - In this study, we investigated the mechanism of synergistic effects of cytokine
      and hyperthermia on cytotoxicity in HT-29. When cells were heated at 42 degrees C
      in the presence of recombinant human tumor necrosis factor (rhTNF-alpha),
      recombinant interferon-gamma (rhIFN-gamma), or in a combination of both, a
      synergistic increase in the cytotoxic effects of the respective drugs was
      observed. We hypothesized that alteration of cytokine or heat-induced
      polypeptides synthesis was responsible for a synergistic interaction between heat
      and cytokine. Five heat shock proteins (HSPs, M(r) 110,000, 100,000, 90,000,
      70,000, and 28,000) were preferentially synthesized during chronic heating at 42
      degrees C. In contrast, the synthesis of two proteins (M(r) 60,000 and 29,000)
      was induced by treatment with rhIFN-gamma (1,000 U/ml). Although the combination
      of chronic hyperthermia (42 degrees C) with TNF-alpha, IFN-gamma, or TNF-alpha +
      IFN-gamma increased cytotoxicity, alteration/induction of polypeptides was not
      correlated with the synergistical cytotoxic effects of cytokine and heat. Thus,
      the synergistic effects of cytokine and hyperthermia are not mediated through an
      induction of polypeptides.

PMID- 8468368
TI  - Role of Ca2+ in stimulation of DNA synthesis by epidermal growth factor and tumor
      promoters in cultured rat hepatocytes.
AB  - This study examines the effects of extracellular Ca2+ concentrations, [Ca2+]o,
      and of treatments known to modulate intracellular Ca2+ levels on the extent and
      timing of DNA synthesis in primary cultures of adult rat hepatocytes. In cultures
      exposed to insulin and EGF, the extent of DNA synthesis between 40 h and 70 h in
      culture was independent of [Ca2+]o in the range 25-1,800 microM, although the
      peak of DNA synthesis occurred 5-10 h earlier with 1.2 mM Ca2+ than with 25
      microM Ca2+. Complete removal of extracellular Ca2+ using EGTA blocked DNA
      synthesis if Ca2+ was removed on the second day after EGF addition but not if
      Ca2+ was absent only on day 1. Treatment of cultures in 1.2 mM Ca(2+)-containing
      media with Ca(2+)-ionophore A23187 or with thapsigargin, agents expected to raise
      cytosolic [Ca2+], failed to augment the stimulation of DNA synthesis by EGF.
      These observations suggest that hepatocytes may have a permissive requirement for
      [Ca2+]o > 0 at least late in the sequence of events leading from growth factor
      stimulation to DNA synthesis. However, sustained elevation of cytosolic [Ca2+]
      does not appear to be important as an early signalling event either in mediating
      or augmenting EGF action in hepatocytes. The ability of liver tumor promoters
      alpha-hexachlorocyclohexane or DDT to stimulate DNA synthesis in combination with
      EGF was independent of [Ca2+]o. By contrast, the skin tumor-promoting phorbol
      ester, TPA, or liver tumor promoter, phenobarbital, were without effect or
      inhibitory at low [Ca2+]o but in combination with EGF, stimulated DNA synthesis
      at [Ca2+]o > 0.4 mM, suggesting that Ca2+ may have some role in mediating or
      modulating the stimulatory effects of these agents.

PMID- 8468369
TI  - Regulation of chicken Hsp70 and Hsp90 family gene expression by transforming
      growth factor-beta 1.
AB  - Transforming growth factor-beta 1 (TGF beta) is a regulator of protein synthesis
      in cultured chicken embryo cells (CEC). Preceding a gradual increase in overall
      protein synthesis, members of the Hsp70 family (Hsp70, Hsc70, and Grp78) and the
      Hsp90 family (90-2 and 90-3) of molecular chaperones are induced rapidly and
      represent a new class of TGF beta-inducible proteins (I.M. Takenaka and L.E.
      Hightower, J. Cell. Physiol., 152:568-577, 1992). Herein, 32P-labeled cDNA probes
      encoding Hsc70 and Hsp90 were used to show that levels of the corresponding mRNAs
      increased as a fraction of total RNA and in polysomes within five hours of
      treatment of CEC with TGF beta. This cytokine did not increase rates of hsc70 and
      hsp90 gene transcription as measured by run-on transcription assays of isolated
      nuclei. However, the Hsp RNA inductions were inhibited by dactinomycin,
      indicating a requirement for newly synthesized RNA. Both Hsc70 and Hsp90 mRNAs
      had relatively short half-lives, measured by Northern blot analyses of
      dactinomycin chases, which were not altered substantially in TGF beta-treated
      cells. In contrast, Hsp mRNA half-lives increased in heat shocked CEC exposed to
      dactinomycin during recovery, revealing a difference in regulation of these genes
      in stressed cells compared with TGF beta-treated cells. Our results support the
      conclusion that hsc70 and hsp90 gene expression is regulated
      posttranscriptionally in TGF beta-treated CEC, and the mechanism likely involves
      a nuclear event such as increasing the half-lives of nuclear RNA transcripts,
      processing, or transport into the cytoplasm.

PMID- 8468370
TI  - Mechanical stimulation of skeletal muscle generates lipid-related second
      messengers by phospholipase activation.
AB  - Repetitive mechanical stimulation of cultured avian skeletal muscle increases the
      synthesis of prostaglandins (PG) E2 and F2 alpha which regulate protein turnover
      rates and muscle cell growth. These stretch-induced PG increases are reduced in
      low extracellular calcium medium and by specific phospholipase inhibitors.
      Mechanical stimulation increases the breakdown rate of 3H-arachidonic acid
      labelled phospholipids, releasing free 3H-arachidonic acid, the rate-limiting
      precursor of PG synthesis. Mechanical stimulation also increases 3H-arachidonic
      acid labelled diacylglycerol formation and intracellular levels of inositol
      phosphates from myo-[2-3H]inositol labelled phospholipids. Phospholipase A2
      (PLA2), phosphatidylinositol-specific phospholipase C (PLC), and phospholipase D
      (PLD) are all activated by stretch. The stretch-induced increases in PG
      production, 3H-arachidonic acid labelled phospholipid breakdown, and 3H
      arachidonic acid labelled diacylglycerol formation occur independently of
      cellular electrical activity (tetrodotoxin insensitive) whereas the formation of
      inositol phosphates from myo-[2-3H]inositol labelled phospholipids is dependent
      on cellular electrical activity. These results indicate that mechanical
      stimulation increases the lipid-related second messengers arachidonic acid,
      diacylglycerol, and PG through activation of specific phospholipases such as PLA2
      and PLD, but not by activation of phosphatidylinositol-specific PLC.

PMID- 8468371
TI  - Effects of epidermal growth factor, estrogen, and progestin on DNA synthesis in
      mammary cells in vivo are determined by the developmental state of the gland.
AB  - Estrogen (E), progesterone (P), and epidermal growth factor (EGF) are involved in
      the growth and development of the normal mammary gland. While studies have been
      carried out to investigate the in vivo effects of EGF in the immature mammary
      gland, nothing is known about the growth effects of EGF or its potential
      interactions with E and/or P in the adult mammary gland. The present studies were
      undertaken to investigate the effects of EGF, E, and P on mammary cell
      proliferation in immature, peripubertal vs. adult, sexually mature mice. We have
      found that EGF promotes epithelial and stromal cell proliferation in both the
      immature and adult mammary glands. In the immature gland, the end bud epithelium
      is most responsive to the proliferative effects of EGF and there is no apparent
      interaction between EGF, E, and/or P. In contrast, in the mature gland EGF adds
      to the proliferative effects of E+P in the ductal epithelium resulting in more
      extensive ductal sidebranching. Thus these results demonstrate that the
      developmental state of the mammary gland determines the nature and extent of the
      interactions between EGF, E, and P in growth and development.

PMID- 8468372
TI  - Cell density, negative proliferation control, and phosphorylation of
      retinoblastoma protein.
AB  - Cell density negative control (CDNC) of normal human fibroblast proliferation
      occurs after stimulation by mitogens with different signal transduction
      mechanism. Delayed exposure to agents that interfere with CDNC, such as double
      stranded RNA and vanadate, reveals the existence of a biochemical event, involved
      in CDNC, that occurs 5-8 hr after the beginning of mitogenic stimulation. This is
      earlier than the point of "mitogenic commitment," defined by the duration of
      mitogen exposure required for cell cycle entry (8-18 hr). Phosphorylation of the
      retinoblastoma gene product (pRB) begins 8-10 hr after mitogen stimulation and is
      nearly complete at 18 hr, just as the first cells enter S-phase. CDNC prevents
      pRB phosphorylation. Interferon beta delays pRB phosphorylation by up to 20 hr
      but has little effect on the timing of mitogenic commitment. Thus mitogenic
      commitment is located in time between CDNC and pRB phosphorylation. When agents
      that cause a release from CDNC are applied to dense, negatively controlled
      cultures after 18 hr of EGF stimulation, pRB phosphorylation occurs 6-8 hr after
      release. This suggests that the negatively controlled cells process the mitogenic
      signal but accumulate at a restriction point. The relatively early timing of CDNC
      related events in the prereplicative phase raises the possibility that pRB
      phosphorylation is a consequence rather than a prerequisite for release from cell
      density negative control.

PMID- 8468373
TI  - Ca2+ dependence of inositol 1,4,5-trisphosphate-induced Ca2+ release in renal
      epithelial LLC-PK1 cells.
AB  - We have studied arginine vasopressin (AVP)-, thapsigargin- and inositol 1,4,5
      trisphosphate (InsP3)-mediated Ca2+ release in renal epithelial LLC-PK1 cells.
      AVP-induced changes in the intracellular free calcium concentration ([Ca2+]i)
      were studied in indo-1 loaded single cells by confocal laser cytometry. AVP
      mediated Ca2+ mobilization was also observed in the absence of extracellular
      Ca2+, but was completely abolished after depletion of the intracellular Ca2+
      stores by 2 microM thapsigargin. Using 45Ca2+ fluxes in saponin-permeabilized
      cell monolayers, we have analysed how InsP3 affected the Ca2+ content of non
      mitochondrial Ca2+ pools in different loading and release conditions. Less than
      10% of the Ca2+ was taken up in a thapsigargin-insensitive pool when loading was
      performed in a medium containing 0.1 microM Ca2+. The thapsigargin-insensitive
      compartment amounted to 35% in the presence of 110 microM Ca2+, but Ca2+
      sequestered in this pool could not be released by InsP3. The thapsigargin
      sensitive Ca2+ pool, in contrast, was nearly completely InsP3 sensitive. A
      submaximal [InsP3], however, released only a fraction of the sequestered Ca2+.
      This fraction was dependent on the cytosolic as well as on the luminal [Ca2+].
      The cytosolic free [Ca2+] affected the InsP3-induced Ca2+ release in a biphasic
      way. Maximal sensitivity toward InsP3 was found at a free cytosolic [Ca2+]
      between 0.1 and 0.5 microM, whereas higher cytosolic [Ca2+] decreased the InsP3
      sensitivity. Other divalent cations or La3+ did not provoke similar inhibitory
      effects on InsP3-induced Ca2+ release. The luminal free [Ca2+] was manipulated by
      varying the time of incubation of Ca(2+)-loaded cells in an EGTA-containing
      medium. Reduction of the Ca2+ content to one-third of its initial value resulted
      in a fivefold decrease in the InsP3 sensitivity of the Ca2+ release.

PMID- 8468374
TI  - Improved assay for the quantification of 11-dehydrothromboxane B2 by gas
      chromatography-mass spectrometry.
AB  - Endogenous thromboxane production is best assessed by the measurement of its
      excreted metabolites, of which 11-dehydrothromboxane B2 (11-dehydro-TxB2) is most
      abundant. Gas chromatographic-mass spectrometric assays have been developed for
      this compound but suffer from the presence of co-eluting impurities which make
      the measurement of 11-dehydro-TxB2 difficult. Furthermore, these assays are often
      time-consuming. We now report a modified assay for the measurement of this
      compound employing gas chromatography-mass spectrometry which alleviates the
      problem of co-eluting impurities primarily through modification of extraction and
      chromatographic methods. Furthermore, the time to complete the assay is
      significantly shortened. It is adaptable to both urine and plasma. Precision of
      the assay is +/- 7% and accuracy is 90%. The lower limit of sensitivity in urine
      is approximately 20 pg/mg creatinine. Normal levels of urinary excretion of this
      metabolite were found to be 370 +/- 137 pg/mg creatinine (mean +/- 1 S.D.) and
      normal plasma levels were found to be 1.5 +/- 0.4 pg/ml (mean +/- 1 S.D.).
      Urinary excretion of 11-dehydro-TxB2 is markedly altered in situations associated
      with abnormalities in thromboxane generation when quantified using this assay.
      Thus, this assay provides a sensitive and accurate method to assess endogenous
      thromboxane production and to further explore the role of this compound in human
      disease.

PMID- 8468375
TI  - Determination of tryptophan in human serum by high-performance liquid
      chromatography with pre-column fluorescence derivatization using phenylglyoxal.
AB  - A high-performance liquid chromatographic method based on pre-column fluorescence
      derivatization with phenylglyoxal is described for the sensitive and selective
      quantification of total (free plus albumin-bound) and free tryptophan in serum.
      Serum was deproteinized with perchloric acid for total tryptophan and by
      ultrafiltration for free tryptophan, and then subjected to fluorescence
      derivatization. The reaction mixture was separated on a reversed-phase column by
      isocratic elution and the tryptophan derivative was then detected by fluorimetry.
      The method was at least ten-fold more sensitive than other conventional
      chromatographic methods with no derivatization. The lower limit of determination
      (signal-to-noise ratio = 3) for endogenous tryptophan in human serum was 72
      nmol/l, which corresponds to 200 fmol on-column.

PMID- 8468376
TI  - Use of guanidine hydrochloride and ammonium sulfate in comprehensive in-line
      sorption enrichment of xenobiotics in biological fluids by high-performance
      liquid chromatography.
AB  - A novel approach has been developed for direct injection of physiological fluids
      on an in-line extraction pre-column followed by column switching in order to
      introduce the adsorbed xenobiotic onto the analytical column. The physiological
      fluid is pre-treated with guanidinium solution in water (200 microliters of fluid
      plus 300 microliters of a reagent containing 8.05 M guanidinium and 1.02 M
      ammonium sulfate) in order to denature protein binding sites and to serve as a
      universal solvent for a divergent range of polar to non-polar xenobiotics in a
      hydrophilic medium. A 0.5 M ammonium sulfate solution (500 microliters) is used
      as a pre- and post-flush reagent for the extraction pre-column (30 mm x 2.1 mm
      I.D.). The pre-flush reagent prepares the sorbent environment of the C18 pre
      column for the hydrophobic retention of analytes. The post-flush reagent flushes
      non-retained sample proteins and salts to waste prior to switching the pre-column
      in-line with the analytical column. Universal chromatographic conditions for the
      analytical phase allows elution of a range of polar to non-polar xenobiotics
      within 20 min from an end-capped C8 silica analytical column (250 mm x 4.6 mm
      I.D.). This is effected by a linear gradient from a binary system consisting of
      solvent A (0.05 M KH2PO4) and solvent B (acetonitrile-isopropanol, 80:20, v/v).

PMID- 8468377
TI  - Analyses of volatile C2 haloethanes and haloethenes in tissues: sample
      preparation and extraction.
AB  - A tissue extraction procedure was developed which minimized loss of readily
      volatilizable compounds for subsequent quantification by headspace gas
      chromatography, and evaluated for perchloroethylene (PER), 1,1,1-trichloroethane,
      1,1,2,2-tetrachloroethane, and 1,1,2-trichloroethylene. Of the procedures
      evaluated, joint isooctane and saline tissue homogenization had the most
      efficient recovery, ranging from 73 to 104% for the four halocarbons from seven
      different rat tissues. PER concentrations were also determined in tissues of rats
      following in vivo halocarbon administration. Recovery did not appear to be tissue
      dependent, but did vary somewhat with test chemical, with the least volatile,
      most lipophilic compounds exhibiting the highest recovery.

PMID- 8468378
TI  - Determination of nicotine and two major metabolites in serum by solid-phase
      extraction and high-performance liquid chromatography, and high-performance
      liquid chromatography-particle beam mass spectrometry.
AB  - A rapid and selective assay of nicotine, cotinine and trans-3'-hydroxycotinine in
      human serum, based on high-performance liquid chromatography with UV detection
      has been developed. The compounds were subjected to solid-phase extraction, using
      Extrelut 1 cartridges. Recoveries were ca. 95% for nicotine, 90% for cotinine and
      50-55% for trans-3'-hydroxycotinine. The limit of quantitation observed with this
      method was 10 ng/ml for nicotine and 5 ng/ml for each of the metabolites. The
      compounds were also identified using high-performance liquid chromatography with
      particle beam mass spectrometry, to confirm their presence in human serum.

PMID- 8468379
TI  - Direct high-performance liquid chromatographic determination in urine of the
      enantiomers of propranolol and its major basic metabolite 4-hydroxypropranolol.
AB  - A method is described for quantitation of underivatized enantiomers of
      propranolol and its major basic metabolite, 4-hydroxypropranolol, in urine
      samples by high-performance liquid chromatography with fluorescence detection,
      using a cellulose tris(3,5-dimethylphenylcarbamate) chiral stationary phase. This
      method was found to be precise and accurate for the measurement of propranolol
      and 4-hydroxypropranolol concentrations in urine from pharmacokinetic
      investigations. This method represents the first assay for direct determination
      of 4-hydroxypropranolol enantiomers. The ability to easily measure 4
      hydroxypropranolol enantiomers is valuable because the stereoselective
      disposition of propranolol is primarily due to stereoselective metabolism in the
      pathway responsible for generation of 4-hydroxypropranolol.

PMID- 8468380
TI  - Achiral and chiral high-performance liquid chromatographic determination of
      tramadol and its major metabolites in urine after oral administration of racemic
      tramadol.
AB  - A reversed-phase high-performance liquid chromatographic method for the
      simultaneous determination of tramadol and its major metabolites O
      demethyltramadol and N-demethyltramadol in urine has been developed. The
      determination of the enantiomeric ratios of the three compounds was achieved
      using a Chiralpak AD column and a Chiralcel OD column, respectively. After oral
      administration of racemic tramadol to five healthy volunteers, inter-individual
      differences of the excreted amounts and the enantiomeric ratios of the compounds
      were observed.

PMID- 8468381
TI  - Stereoselective high-performance liquid chromatographic assay for the
      determination of sotalol enantiomers in biological fluids.
AB  - A high-performance liquid chromatographic (HPLC) assay for determination of
      sotalol enantiomers in biological fluids was developed to assess the
      stereoselective disposition of the drug in man. Following extraction at pH 9.0
      with a mixture of chloroform-isopropanol (3:1, v/v), the organic phase was
      evaporated to dryness and the residue derivatized with (-)-methyl chloroformate.
      Diastereoisomeric derivatives were resolved by HPLC (C8 column) with fluorescence
      detection (lambda ex = 235 nm and lambda em = 300 nm). Retention times of l- and
      d-sotalol derivatives were 13 and 15 min while that of the internal standard, S-(
      )-atenolol, was 12.3 min. The detection limit of each enantiomer was 12.5 ng/ml
      using 1 ml of plasma or urine. Intra-day and inter-day coefficients of variation
      were less than 10% for each enantiomer in the range 0.125-2.5 micrograms/ml in
      plasma and 0.25-2.5 micrograms/ml in urine.

PMID- 8468382
TI  - Improved detection limits for screening of diuretics by coupled liquid
      chromatography and ultraviolet-visible spectrophotometry.
AB  - Experimental conditions have been studied in order to improve the sensitivity for
      the analysis of diuretics and probenecid in urine samples by high-performance
      liquid chromatography with ultraviolet detection. Sample clean-up and
      chromatographic parameters have been optimized to obtain a suitable sensitivity
      for the detection or quantification of each diuretic using an HP-Hypersil ODS-C18
      column (5 microns, 250 mm x 4 mm I.D.), taking into account the pharmacological
      properties of each compound. The reliability of this method was tested by
      analysing urine samples after a minimum single-dose administration of
      chlorthalidone and probenecid.

PMID- 8468383
TI  - Determination of dapoxetine, an investigational agent with the potential for
      treating depression, and its mono- and di-desmethyl metabolites in human plasma
      using column-switching high-performance liquid chromatography.
AB  - A column-switching high-performance liquid chromatographic (HPLC) method is
      described for the determination of dapoxetine and its mono- and di-desmethyl
      metabolites in human plasma. The analytes, including an internal standard, were
      extracted from plasma at basic pH with hexane-ethyl acetate. The organic extract
      was evaporated to dryness and the residue reconstituted with acetonitrile. The
      analytes were separated from late-eluting endogenous substances on a Zorbax RX-C8
      pre-column. The front-cut fraction containing the analytes was further separated
      on a second RX-C8 column. The analytes were detected by their native
      fluorescence, using excitation and emission wavelengths of 230 and 330 nm,
      respectively. The limit of quantitation was determined to be 20 ng/ml, and the
      response was linear from 20 to 200 ng/ml. The method has been successfully
      applied to human plasma samples in a Phase I study.

PMID- 8468384
TI  - Sensitive high-performance liquid chromatographic determination of 2,2'-[(2
      aminoethyl)imino]diethanol bis(butylcarbamate) and its metabolites in human serum
      following pre-column derivatization with o-phthalaldehyde and stabilization of
      the derivatives.
AB  - A high-performance liquid chromatographic method for the sensitive determination
      of 2,2'-[(2-aminoethyl)imino]diethanol bis(butylcarbamate) (I) and its
      metabolites in human serum has been developed. The method was based on a pre
      column derivatization with o-phthalaldehyde. The derivatives were stabilized at
      least for 24 h at 4 degrees C by using N-acetyl-L-cysteine as a thiol and by
      eliminating the excess o-phthalaldehyde in the reaction mixture by solvent
      extraction and the addition of an ammonium salt after the reaction. The
      recoveries and reproducibilities in human serum spiked with I and its two
      metabolites were satisfactory, and the responses were linear over a wide range of
      analyte concentrations. The detection limits of I and its metabolites, II and
      III, in serum were 0.5, 4 and 2 ng/ml, respectively, at a signal-to-noise ratio
      of 5. The method was satisfactorily applied to the clinical study of I.

PMID- 8468385
TI  - Simultaneous high-performance liquid chromatographic assay of droperidol and
      flunitrazepam in human plasma. Application to haemodilution blood samples
      collected during clinical anaesthesia.
AB  - A simultaneous assay for droperidol and flunitrazepam by high-performance liquid
      chromatography has been developed and applied to blood samples collected during
      an acute normovolemic haemodilution under general anaesthesia. Haemodilution
      blood samples were stored at +4 degrees C to be transfused, if required, to a
      patient during the post-surgical phase. A C18 Supelclean cartridge was used for
      solid-phase extraction, and the recoveries were 74% and 89%, respectively, for
      droperidol and flunitrazepam. Compounds were chromatographed on a C18 Novapak
      column at 250 nm, with a mobile phase of acetonitrile-10 mM ammonium acetate
      buffer (pH 6.7) (45:55, v/v). Nitrazepam was used as the internal standard. For
      both drugs, the assay was linear up to 500 micrograms/l, and the detection limits
      were 20 and 10 micrograms/l for droperidol and flunitrazepam, respectively, and
      their observed levels in haemodilution samples were 93 +/- 82 micrograms/l and 76
      +/- 107 micrograms/l, respectively. Some of the values for flunitrazepam were
      higher than the minimal efficient concentration, defined as the plasma level
      observed at the time of the patient wakening from anaesthesia (12 +/- 4
      micrograms/l). According to our results, haemodilution sampling can be performed
      before induction of anaesthesia. When the blood is collected after the
      anaesthetic induction, it seems necessary to determine levels of the two drugs in
      haemodilution samples to avoid side-effects.

PMID- 8468386
TI  - Assay of deoxy-deazapurines in DNA by 3'-phosphorylation and two-dimensional thin
      layer chromatography.
AB  - Deoxy-deazapurines (deaza-dNMPs) are incorporated into cellular DNA after
      administration of anti-neoplastic, anti-viral, or anti-parasitic chemotherapy.
      Deaza-dNMPs are stable purine analogues and can be detected via 32P-labeling cold
      DNA. Assay of analogue incorporation and normal base composition is carried out
      by radiolabeling DNA with all four deoxynucleotides (dNMPs) through nick
      translation. 3'-Monophosphate digest radiolabels representative dNMPs and deaza
      dNMPs. Separation occurs in two-dimensional polyethyleneimine-cellulose thin
      layer chromatography, which resolves all dNMPs. The technique was applied to
      human placental and calf thymus DNA, control and altered calf thymus DNA with
      cold stoichiometric replacement of deaza-dNMPs to include deoxy-deazaadenosine,
      deoxy-deazaguanosine, and deoxy-deazainosine. Scintillation detection and
      densitometry both accurately reflect dNMP content. This technique easily and
      quickly quantifies the low-molecular-mass deaza-dNMP analogues in DNA. Deaza-dNMP
      uptake into DNA may reflect clinical chemotherapeutic efficacy and host toxicity.
      The assay may therefore serve as an early biochemical dosimeter of drug effect
      and resistance.

PMID- 8468387
TI  - Determination of 3-methylflavone-8-carboxylic acid, the main metabolite of
      flavoxate, in human urine by capillary electrophoresis with direct injection.
AB  - The effects of tetraalkylammonium salts and sodium dodecyl sulphate on the
      migration behaviour of human urinary components and other negatively charged or
      neutral solutes were investigated. The sulphate acted mainly on hydrophobic and
      positively charged substances, whereas the ammonium salts acted mainly on
      negatively charged solutes. By choosing the components of the eluent carefully,
      the free and conjugate forms of 3-methylflavone-8-carboxylic acid (MFA) in human
      urine, the major metabolites of flavoxate, could be simultaneously determined
      without pretreatment, using fenprofen as an internal standard. The calibration
      curve of MFA was linear in the range 1-50 micrograms/ml and the detection limit
      was 0.2 microgram/ml, which covered the urine levels encountered in
      pharmacokinetic studies. The intra-day and inter-day precisions of the method,
      expressed as the relative standard deviation, were less than 2 and 3%,
      respectively. This method was successfully applied to an excretion study of MFA
      in eight healthy volunteers, and the results were in agreement with data in the
      literature obtained by gas chromatography.

PMID- 8468388
TI  - Improved thin-layer chromatographic separation of 32P-postlabeled DNA adducts.
AB  - DNA adducts represent the putative initiating event in the chemical
      carcinogenesis process. 32P-Postlabeling is one of several assays which have been
      developed for the sensitive detection of DNA adducts. An integral part of the 32P
      postlabeling assay is the separation of adducted nucleotides by multidirectional,
      multisolvent, anion-exchange polyethyleneimine-cellulose thin-layer
      chromatography. Standard since the introduction of this assay has been the use of
      high-salt, high-urea solvents for the resolution of adducts during the D3 and D4
      phases of the chromatography. Urea solvents are able to separate adducts
      resulting from a number of chemicals, however, they are time-consuming, retain a
      lot of background noise, may push adducts into inadequately resolved diagonal
      radioactive zones, and may not separate adducts of similar structure. In this
      study we introduce the use of a dilute ammonium hydroxide solvent for D4
      chromatography and compare it to other standard solvents such as lithium chloride
      Tris.HCl-urea, sodium phosphate-Tris.HCl-urea, and isopropanol-4 M ammonium
      hydroxide for adduct separation, resolution, recovery, retention of background
      noise, and chromatography development time. We found that 0.2 M ammonium
      hydroxide worked well for the recovery, separation, and resolution of a wide
      array of adducts derived from highly lipophilic polycyclic aromatic hydrocarbons
      and aromatic amines. In addition, this solvent required much less time (< 1/4) as
      compared to the other solvents and more importantly allowed the separation of
      adducts which otherwise comigrated and were not visible when using the other
      three D4 solvents.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468389
TI  - Determination of nicotine and its main metabolites in urine by high-performance
      liquid chromatography.
AB  - Nicotine and its main metabolites (cotinine, trans-3'-hydroxycotinine, trans-3'
      hydroxycotinine glucuronide, nicotine-1'-N-oxide and 3-pyridylcarbinol) were
      analysed in urine after liquid-liquid extraction by high-performance liquid
      chromatography using norephedrine as internal standard, ultraviolet detection at
      260 nm and scanning ultraviolet spectra with a photodiode-array detector. The
      conjugated trans-3'-hydroxycotinine was determined after enzymatic hydrolysis.
      Specific determination of 3-pyridylcarbinol was also carried out. Owing to its
      good selectivity, sensitivity and reproducibility, the method was applied to the
      analysis of urine samples from smokers and non-smokers. The results obtained
      suggest that the urinary markers used to assess active smoking or exposure to
      environmental tobacco smoke must be not only nicotine and cotinine, but also
      their main free and conjugated metabolites.

PMID- 8468390
TI  - High-performance liquid chromatographic assay for two rifamycin-derived
      hypocholesterolemic agents in liver and biological fluids.
AB  - CGP 43371 (compound I), a mono-pivaloyl oxazole derivative of a 3-piperazino
      rifamycin, has been in clinical trials as a potential hypocholesterolemic agent.
      A reversed-phase high-performance liquid chromatographic (HPLC) assay was
      developed using a C18 column and a gradient solvent system of methanol-0.1 M
      sodium acetate, pH 4.5, at a flow-rate of 1 ml/min. The compound and internal
      standard (rifampicin) were detected by their ultraviolet absorption at 254 nm.
      Isolation of the compounds from plasma and liver homogenates was accomplished by
      precipitation of proteins with acetonitrile, followed by evaporation under
      nitrogen and reconstitution in methanol. Bile, lymph and urine were injected onto
      the HPLC column without pretreatment. Calibration curves were linear (r > 0.999)
      over the concentration range 0.25-20.0 micrograms/ml. The assay procedure was
      also applicable to other rifamycin derivatives and was able to distinguish
      between molecular species containing small differences in functionality.

PMID- 8468391
TI  - Determination of boldine in plasma by high-performance liquid chromatography.
AB  - A sensitive method for the determination of boldine in blood plasma is described.
      The procedure involves a direct pH-buffered chloroform extraction of boldine from
      blood plasma, followed by its assay under isocratic conditions by HPLC with UV
      detection. The extraction recovery is excellent, and sensitivity and precision of
      the method are very high, when applied to plasma samples containing
      pharmacologically relevant concentrations of boldine.

PMID- 8468392
TI  - Immunoaffinity isolation of the sulfate conjugate of 4'-hydroxypropranolol from
      plasma.
AB  - Selective extraction of sulfate conjugates of basic drugs from biological
      matrices has been difficult because of their highly polar nature. Immunoaffinity
      isolation may be the best solution to this analytical problem. This was tested
      for a model compound, the metabolite 4'-hydroxypropranolol sulfate (HOPS), which
      was effectively extracted from plasma by a column containing antibodies to the
      parent drug propranolol. The specificity was very high, giving little
      interference from the biological material in subsequent high-performance liquid
      chromatographic analysis with fluorometric detection. The method for HOPS was
      highly reproducible and provided a sensitivity of 1 ng/ml plasma. The technique
      was applied to measurements of HOPS in plasma after therapeutic doses of
      propranolol as well as to the individual enantiomers after chiral derivatization.

PMID- 8468393
TI  - Rapid and sensitive pre-column extraction high-performance liquid chromatographic
      assay for propofol in biological fluids.
AB  - A completely automated high-performance liquid chromatographic system is
      described for the determination of the phenolic anaesthetic propofol. The method
      is based on pre-column extraction in a closed system allowing direct injection of
      biological samples without any sample pretreatment. The assay is sensitive (limit
      of quantification is 5 ng/ml serum), reliable (the variability within a series is
      2%) and rapid (results are available after 6 min).

PMID- 8468394
TI  - Assay of artelinic acid in serum by high-performance liquid chromatography.
AB  - A simple and rapid high-performance liquid chromatographic method with UV
      detection for the determination in serum of the antimalarial artelinic acid is
      described. Artelinic acid is a water-soluble semi-synthetic derivative of
      artemisinin (or Qinghaosu), which is the parent compound of a completely new
      class of antimalarials with great potential value. Calibration curves of
      artelinic acid in serum from 0.5 to 50 micrograms/ml were found to be linear, and
      the extraction recovery was ca. 70% from rabbit serum and 45% from bovine and
      human serum. The detection limit of the method was 50 ng/ml when 250 microliters
      of serum were processed. Spiked samples (rabbit serum) proved to be stable for at
      least 43 days on storage at -20 degrees C. The method has been used for the
      analysis of ca. 400 samples in a pharmacokinetic study. About 50 samples can be
      processed in half a day.

PMID- 8468395
TI  - Methodological commentary on the analysis of metrifonate and dichlorvos in
      biological samples.

PMID- 8468396
TI  - 1993 International Chromatography Guide.

PMID- 8468397
TI  - Embryonic development of rat sympathetic preganglionic neurons: possible
      migratory substrates.
AB  - Spinal somatic and autonomic (sympathetic preganglionic) motor neurons are
      generated synchronously and, subsequently, migrate from the ventricular zone
      together to form a common primitive motor column. However, these two subsets of
      motor neurons ultimately express several phenotypic differences, including somal
      size, peripheral targets, and spinal cord locations. While somatic motor neurons
      remain ventrally, autonomic motor neurons (AMNs) move both dorsally and medially
      between embryonic days 14 and 18, when they approximate their final locations in
      spinal cord. The goal of the present investigation was to determine the potential
      guidance substrates available to AMNs during these movements. The dorsal
      translocation was studied in developing upper thoracic spinal cord, because, at
      this level, the majority of AMNs are located dorsolaterally. Sections were double
      labeled by ChAT (choline acetyltransferase) and SNAP/TAG-1 (stage-specific
      neurite associated protein/transiently expressed axonal surface glycoprotein)
      immunocytochemistry to visualize motor neurons and the axons of early forming
      circumferential interneurons, respectively. Results showed that during the
      developmental stage when AMNs translocated dorsally, SNAP/TAG-1 immunoreactive
      lateral circumferential axons were physically located along the borders of the
      AMN region, as well as among its constituent cells. These findings indicate that
      lateral circumferential axons, as well as the SNAP/TAG-1 molecules contained upon
      their surfaces, are in the correct spatial and temporal position to serve as
      guidance substrates for AMNs. The medial translocation was studied in developing
      lower thoracic-upper lumbar spinal cord, because, at this level, more than half
      of the AMNs are medially located. Sections were double-labeled by ChAT and
      vimentin immunocytochemistry to visualize motor neurons and radial glial fibers,
      respectively. Observations on consecutive developmental days of the medial
      translocation revealed that AMNs were aligned with parallel arrays of radial
      glial fibers. Thus, the glial processes could serve as guides for the AMN medial
      movement. Future experimental analyses will examine whether circumferential axons
      and radial glial fibers are in fact functioning as migratory guides during AMN
      development, and, if so, whether specific surface molecules on these guides
      trigger the subsequent differentiation of AMNs.

PMID- 8468398
TI  - Axonal regeneration is associated with glial migration: comparison between the
      injured optic nerves of fish and rats.
AB  - The central nervous systems of mammals and fish differ significantly in their
      ability to regenerate. Central nervous system axons in the fish readily
      regenerate after injury, while in mammals they begin to elongate but their growth
      is aborted at the site of injury, an area previously shown to contain no glial
      cells. In the present study we compared the ability of glial cells to migrate and
      thus to repopulate the injured area in fish and rats, and used light and electron
      microscopy in an attempt to correlate such migration with the ability of axons to
      traverse this area. One week after the optic nerve was crushed, both axonal and
      glial responses to injury were similar in fish and rat. In both species glial
      cells were absent in the injured area (indicated by the disappearance of glial
      fibrillary acidic protein and vimentin immunoreactive cells from the site of
      injury in rat and fish, respectively), while at the same time axonal growth,
      indicated by expression of the growth-associated protein GAP-43, was restricted
      to the proximal part of the nerve. In fish, 2 weeks after the crush, GAP-43
      staining (i.e., growing axons) was seen at the site of injury, in association
      with migrating vimentin-positive glial cells. One week later the site of injury
      in the fish optic nerve was repopulated by vimentin-positive glial cells, and GAP
      43-positive axons had already traversed the site of injury and reached the distal
      part of the nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468399
TI  - First appearance, distribution, and origin of macrophages in the early
      development of the avian central nervous system.
AB  - A phagocytic cell system of hemopoietic origin exists in the early avian embryo
      (Cuadros, Coltey, Nieto, and Martin: Development 115:157-168, '92). In this study
      we investigated the presence of cells belonging to this system in the central
      nervous system (CNS) of chick and quail embryos by using both histochemical
      staining for acid phosphatase and immunolabelling with antibodies recognizing
      cells of quail hemangioblastic lineage. The origin of these cells was traced in
      interspecific chick-quail yolk sac chimeras. Hemopoietic cells were detected
      within the CNS from developmental stage HH15 on, and steadily increased in number
      at subsequent stages. Analysis of yolk sac chimeras revealed that most of these
      cells were of yolk sac origin, although some hemopoietic cells of intramebryonic
      origin were also found in the CNS. Immunocytochemical, histochemical, and
      ultrastructural characterization allowed us to identify hemopoietic cells in the
      CNS as macrophages. These cells were consistently found in the brain vesicles and
      spinal cord, appearing (1) between undifferentiated neuroepithelial cells at
      dorsal levels of the CNS; (2) in areas of cell death; (3) in the marginal layer
      in close relationship with developing axons; (4) in large extracellular spaces in
      the subventricular layer; (5) on vascular buds growing through the marginal and
      subventricular layers; and (6) in the ventricular lumen. Macrophages in different
      locations varied in morphology and ultrastructure, suggesting that in addition to
      their involvement in phagocytosis, they play a role in other processes in the
      developing CNS, such as axonal growth and vascular development. The first
      macrophages migrate to the CNS independently of its vascularization, apparently
      traversing the pial basal lamina to reach the nervous parenchyma. Other
      macrophages may enter the CNS together with vascular buds at subsequent stages
      during CNS vascularization.

PMID- 8468400
TI  - Cerebellar nuclear projections from the basilar pontine nuclei and nucleus
      reticularis tegmenti pontis as demonstrated with PHA-L tracing in the rat.
AB  - Small iontophoretic placements of the orthogradely transported axonal tracer
      Phaseolus vulgaris leucoagglutinin (PHA-L) were made in portions of the basilar
      pontine nuclei (BPN) or nucleus reticularis tegmenti pontis (NRTP) to determine
      if these cell groups provide projections to the cerebellar nuclei (CN) in the rat
      and if so, to visualize the morphology of the axons and terminals and illustrate
      any topographical organization in this system. Axons that originated from BPN or
      NRTP neurons and contained PHA-L were visualized by an immunohistochemical
      procedure that involved sequential incubation of tissue sections with goat anti
      PHA-L antibody, biotinylated rabbit anti-goat immunoglobulin, and a biotin-avidin
      peroxidase conjugate. Following injections of PHA-L restricted to ventral and
      medial portions of the BPN, labeled fibers were observed in the brachium pontis,
      the white matter dorsal to the CN, and to a lesser extent, in the white matter of
      the parafloccular stalk. Labeled preterminal axons entered the CN and gave rise
      to beaded axons that arborized primarily within dorsal portions of the lateral,
      interposed, and medial cerebellar nuclei. Injections of PHA-L restricted to
      either lateral portions of the BPN or ventrolateral regions of NRTP produced
      labeled fibers in the cerebellum that most frequently involved the parafloccular
      stalk and ventral portions of the CN. In contrast, dorsomedial NRTP injections
      resulted in the presence of labeled fibers both in the dorsal cerebellar white
      matter and the parafloccular stalk as well as dorsal and ventral portions of the
      CN. With the exception of the rostral and medial territory of interpositus
      anterior which received very sparse input, all portions of each CN subdivision
      seemed to exhibit some degree of terminal labeling. The density of labeled axon
      terminals in the CN appeared to be somewhat greater in the NRTP-injected cases
      compared to BPN-injected animals. These observations indicate that in the rat,
      both the BPN and NRTP contain neurons whose axons distribute to the CN. It is
      likely that most of the axons which project to the CN are collaterals of fibers
      that continue into the cerebellar cortex as mossy fibers but confirmation of this
      point must await further investigation. In light of the extensive projections
      from the cerebral cortex to the BPN and NRTP, this axonal system provides the
      cerebral cortex with a relatively direct route of access to the CN via one
      synapse in the BPN or NRTP.

PMID- 8468401
TI  - Heterogeneity and selectivity of the degeneration of cholinergic neurons in the
      basal forebrain of patients with Alzheimer's disease.
AB  - Cholinergic neurons were studied by immunohistochemistry, with an antiserum
      against choline acetyltransferase (ChAT), in the basal forebrain (Ch1 to Ch4) of
      four patients with Alzheimer's disease (AD) and four control subjects. ChAT
      positive cell bodies were mapped and counted in Ch1 (medial septal nucleus), Ch2
      (vertical nucleus of the diagonal band), Ch3 (horizontal nucleus of the diagonal
      band) and Ch4 (nucleus basalis of Meynert). Compared to controls, the number of
      cholinergic neurons in AD patients was reduced by 50% on average. The
      interindividual variations in cholinergic cell loss were high, neuronal loss
      ranging from moderate (27%) to severe (63%). Despite the small number of brains
      studied, a significant correlation was found between the cholinergic cell loss
      and the degree of intellectual impairment. To determine the selectivity of
      cholinergic neuronal loss in the basal forebrain of AD patients, NPY
      immunoreactive neurons were also investigated. The number of NPY-positive cell
      bodies was the same in controls and AD patients. The results (1) confirm
      cholinergic neuron degeneration in the basal forebrain in AD and the relative
      sparing of these neurons in some patients, (2) indicate that degeneration of
      cholinergic neurons in the basal forebrain contributes to intellectual decline,
      and (3) show that, in AD, such cholinergic cell loss is selective, since NPY
      positive neurons are preserved in the basal forebrain.

PMID- 8468402
TI  - Immunocytochemical localization of atrial natriuretic factor (ANF)-like peptides
      in the brain and heart of the treefrog Hyla japonica: effect of weightlessness on
      the distribution of immunoreactive neurons and cardiocytes.
AB  - The localization of atrial-natriuretic factor (ANF)-like immunoreactivity was
      investigated in the brain and heart of the treefrog Hyla japonica by the indirect
      immunofluorescence technique. Concurrently, the effect of weightlessness on the
      distribution of ANF-containing neurons and cardiocytes was studied in frogs that
      were sent into space for 9 days on the space station "MIR." In control animals,
      the amygdala contained the most prominent group of ANF-immunoreactive cells and
      fibers. ANF-positive neurons and nerve processes were also detected in other
      areas of the telencephalon such as the nucleus olfactorius, the pallium mediale,
      and the striatum. In "space frogs," the intensity of labeling of the amygdala and
      nucleus olfactorius was similar to that seen in control animals. In contrast, the
      pallium and the striatum of "space frogs" were totally devoid of positive cell
      bodies. In the diencephalon, of all animals, numerous ANF-immunoreactive
      perikarya and fibers were seen in the hypothalamus, the anterior thalamus, the
      infundibulum, and the median eminence. ANF-positive cell bodies were also noted
      in the lateral forebrain bundle of control frogs but were absent in "space
      frogs." The major difference between control and "space frogs" was observed in
      the posterior nuclei of the thalamus. In "space frogs," the nucleus
      posterocentralis thalami and the nucleus posterolateralis thalami exhibited large
      ANF-immunoreactive perikarya, while, in control frogs, these nuclei only
      contained scarce positive nerve fibers. In the mesencephalon, ANF-positive cell
      bodies and nerve processes were seen in the nucleus tegmenti mesencephali, the
      interpeduncular nucleus, and the nucleus cerebelli of all animals. However,
      stained perikarya were only observed in the nucleus reticularis isthmi of control
      frogs. In the heart, atrial cardiocytes exhibited intense ANF-like
      immunoreactivity. ANF-positive myocytes were also detected in the subpericardial
      region of the ventricle. The density and distribution of the staining were
      identical in the heart of control and "space frogs." These data support the
      concept that prolonged exposure to microgravity affects biosynthesis and/or
      release of ANF-related peptides in discrete regions of the amphibian brain.

PMID- 8468403
TI  - Synaptophysin immunohistochemistry reveals inside-out pattern of early
      synaptogenesis in ferret cerebral cortex.
AB  - Synaptogenesis in the ferret cerebral cortex was examined from the day of birth
      to adulthood with an antibody against synaptophysin at the light and electron
      microscopic levels. Due to the premature birth of ferrets, the generation of
      cells destined to the upper cortical layers and their subsequent migration to
      their final positions in the cortical plate are largely postnatal events.
      Throughout the newborn ferret cerebral cortex, a high amount of synaptophysin
      immunoreactivity was present within the marginal zone and subplate region.
      Staining was also conspicuous within the forming cortical plate. The typical
      layering pattern of synaptophysin immunoreactivity in the developing cortical
      plate correlated with the migration pattern of cortical neurons. The synaptic
      density was lowest directly below the marginal zone, where the youngest neurons
      just stopped their migration. Below this zone, the density of the synaptic
      staining increased gradually toward lower (and older) cortical plate layers. As
      the cortex expanded, the synaptophysin immunoreactivity pattern closely followed
      the expansion, suggesting that synapses were formed in a given layer shortly
      after the cells migrating to this layer reached their final position. As soon as
      cell migration had finished, the entire cortical plate contained dense
      synaptophysin immunoreactivity, in a pattern similar to that observed in the
      adult animal. During cortical development, a rostrocaudal and a laterodorsal
      gradient of synaptogenesis was observed. At any given time, rostral and lateral
      regions of the cerebral cortex were more advanced in their development than
      caudal and dorsal regions. Electron microscopic examination of synaptophysin
      immunoreactivity in the developing cerebral cortex of ferrets confirmed that
      labeling was solely associated with synaptic vesicles. These vesicles were
      typically, but not exclusively, confined to synaptic boutons. Especially around
      the end of the first postnatal week, long fiber profiles loaded with synaptic
      vesicles were occasionally detected. As some of these fibers also showed en
      passant synapses along their course, we concluded that synaptic vesicle labeling
      may be reliably used to study synaptogenesis at the light microscopic level. A
      systematic analysis of samples from postnatal days 0 and 7 corroborated this
      conclusion, showing that synaptic profile distribution completely matched the
      distribution of synaptophysin immunoreactivity seen in the light microscope. In
      conclusion, synaptogenesis begins as soon as migratory cells reach their final
      position in the cortical plate. As long as cell migration continues,
      synaptogenesis is under the constraints of neurogenesis, following its gradients.

PMID- 8468404
TI  - Chronic peripheral nerve section results in a rearrangement of the central axonal
      arborizations of axotomized A beta primary afferent neurons in the rat spinal
      cord.
AB  - In order to investigate the reorganization of the neuropil of the dorsal horn
      following peripheral nerve injury, the central terminal arborizations of 35 A
      beta primary afferent neurons, chronically injured by a cut and ligation of the
      sural nerve 6-12 weeks previously, were studied by the intra-axonal injection of
      horseradish peroxidase. Their morphology was compared to 13 intact sural nerve
      hair follicle afferents. Following axotomy, three kinds of morphological
      abnormalities were observed in the collateral arbors of the 26 afferents that
      were hair follicle-like. Atrophy with thin stem axons and reduced terminal branch
      patterns with few boutons was seen in 5 afferents. Sprouting of bouton-containing
      terminals into lamina I and IIo was found in 8 afferents. Finally, abnormal
      arborization patterns in the deeper laminae were observed in 29% of the
      collateral arbors. Changes included the loss in some arbors of a flame-shaped
      appearance, which is characteristic of hair follicle afferents, atypical
      branching patterns and ventrally directed axons producing wider and deeper
      arbors, compared to normal. Axotomy also caused a disruption of the normal
      somatotopic organization of sural nerve A beta afferents. This disruption
      manifested as a variability in the normally mediolaterally restricted terminal
      sheet, with a consequent loss of the strict somatotopic register in the
      rostrocaudal direction. Damage to the peripheral axon of A beta primary afferents
      induces a structural reorganization of their central terminals in the dorsal horn
      of the spinal cord, which may modify sensory input to the central nervous system.

PMID- 8468405
TI  - Deafferentation-induced terminal field expansion of myelinated saphenous
      afferents in the adult rat dorsal horn and the nucleus gracilis following pronase
      injection of the sciatic nerve.
AB  - We have previously demonstrated sprouting of small diameter saphenous afferents,
      labelled with wheat germ agglutinin conjugated with horseradish peroxidase (WGA
      HRP) and (HRP), into the sciatic territory of the adult rat superficial dorsal
      horn following destruction of sciatic afferents by injection of the sciatic nerve
      with pronase (a combination of proteolytic enzymes). In the present experiments,
      we examined the response of myelinated saphenous axons, which terminate in lamina
      I and the deep dorsal horn (laminae III-V) under the same conditions, with the
      tracer B subunit of cholera toxin conjugated to HRP (B-HRP) which specifically
      labels myelinated primary afferents when injected into a peripheral somatic
      nerve. We also examined changes in the nucleus gracilis, another site of sciatic
      degeneration and a target of saphenous afferents. Four months after injection of
      the pronase, the area of label determined by measurement of the width of the
      saphenous territory in lamina III was expanded by 24% on the pronase side. Since
      there was also expansion throughout the deep dorsal horn, the area measured by
      tracing the labelled region in transverse sections was actually twice that of the
      control side, and the intensity of labelling within the traced area increased by
      18%. There was no change in grey matter area due to the lesion. The traced area
      of labelling in the nucleus gracilis increased by 40%, and increased in intensity
      by 17%. The substantia gelatinosa is not normally supplied by B-HRP-labelled
      afferents, and there was no expansion of these sprouted saphenous afferents into
      the gelatinosa. These results indicate that myelinated afferents can sprout as
      vigorously in lamina I and the deep dorsal horn as the small diameter afferents
      do in the substantia gelatinosa; that there is no invasion of the substantia
      gelatinosa by the myelinated afferents at least as long as the small diameter
      afferents also have the opportunity to sprout; and that primary afferents have
      the potential to sprout at more than one site of termination, i.e., both the
      dorsal horn and the dorsal column nuclei.

PMID- 8468406
TI  - Chiasmatic course of temporal retinal axons in the developing ferret.
AB  - Recent studies on the distribution of optic axons in the mature visual pathways,
      as well as on the genesis of their ganglion cells of origin, suggest that the
      time of axonal arrival at the optic chiasm determines the side of the brain to
      which a temporal retinal axon will project. The present study has examined this
      issue directly in fetal ferrets, by determining the projection of the temporal
      retina at different developmental stages. Fetuses of known gestational age were
      fixed with paraformaldehyde and subsequently implanted with crystals of the
      carbocyanine dye, DiI, into either the temporal retina, or into one optic tract.
      The lipophilic diffusion of the dye within the plasma membrane of the axons
      revealed the course of temporal retinal fibers through the fetal chiasm, as well
      as the distribution of ganglion cells across the two retinae projecting to one
      optic tract. During early fetal stages, the temporal retina extends axons
      preferentially into the ipsilateral optic tract: the early retinal projection
      shows a classical partial decussation pattern. During later fetal stages,
      temporal retinal axons can be traced into both optic tracts, and the distribution
      of cells with crossed and uncrossed optic axons in the temporal retina is
      overlapping. These results indicate that the mature decussation patterns of
      retinal ganglion cell classes are not primarily the consequence of regressive
      phenomena such as cell death; rather, they are formed as axons navigate the
      chiasmatic region during development. The differences in decussation pattern
      between cell classes arise from the fact that the mechanisms producing the
      segregation of nasal and temporal retinal axons at the chiasm must change as
      development proceeds.

PMID- 8468407
TI  - Geometry of the representation of the visual field on the superior colliculus of
      the wallaby (Macropus eugenii). I. Normal projection.
AB  - In 13 wallabies (Macropus eugenii, the tammar), microelectrode recordings of the
      activity of units in the superficial layers of the superior colliculus in
      response to a flashing light spot were used to make a map of the spatial location
      of their receptive fields. This article describes the projection of a normal eye
      to the contralateral colliculus. Ten of the 13 animals had one rotated eye and
      these projections are analysed in the accompanying paper (James et al., this
      issue). Units responded briskly to the stimulus at light on and off and had
      receptive fields about 5 degrees across. The centres of receptive fields from a
      regular array of recording points on the colliculus were plotted with a perimeter
      and fitted to a flattened representation of the colliculus according to a spline
      technique. The visual field of each colliculus extends from 25 degrees
      ipsilateral to the vertical meridian to 120 degrees temporal contralaterally. The
      lines of isoazimuth are regularly spaced and parallel and run mediolaterally on
      the colliculus. The horizon is represented by a line running rostrocaudally and
      the parallels are more widely spaced near the horizon and become compressed in
      the superior and inferior fields. The variation of areal magnification factor
      fits the distribution of density of retinal ganglion cells very well. Anisotropy
      of the projection means that the increased ganglion cell density of the retinal
      visual streak is entirely accommodated by magnification in the vertical
      direction, while the magnification of the azimuthal projection is equal over the
      whole field. No responses were recorded from the ipsilateral eye even though
      anatomically there is a direct retinal ipsilateral projection.

PMID- 8468408
TI  - Geometry of the projection of the visual field onto the superior colliculus of
      the wallaby (Macropus eugenii). II. Stability of the projection after prolonged
      rearing with rotational squint.
AB  - At about the time of eye opening, one eye of seven tammar wallaby pouch young was
      surgically rotated about the optic axis by approximately 90 degrees. In adulthood
      the projection of the visual field through the rotated eye onto the contralateral
      superior colliculus was mapped electrophysiologically. Although apparently
      distorted, the projection could be coherently re-rotated mathematically to a
      reasonable copy of the normal projection from the opposite eye of the same
      animal, including details such as regional variations of the magnification
      factor. The same was true of three adult animals in which the eye rotation was
      done after anaesthesia immediately before the electrophysiological mapping. In
      animals in which the visual field seen through one eye, the other being normal,
      was rotated for the entire period of visual experience, there was no sign of
      compensation or rearrangement of the topographic map. Retinocollicular synaptic
      connections appear unmoved by such discordant visual experience.

PMID- 8468409
TI  - Adrenalectomy-induced granule cell degeneration in the rat hippocampal dentate
      gyrus: characterization of an in vivo model of controlled neuronal death.
AB  - The recent discovery that adrenalectomy results in hippocampal granule cell loss
      suggested that this phenomenon might be useful as a model of selective,
      experimentally controlled neuronal death possibly relevant to neurodegenerative
      disorders. This study was designed to provide a detailed qualitative anatomical
      description of the phenomenon and to determine whether adrenalectomy-induced
      dentate granule cell degeneration constitutes a reliable model of selective
      neuronal death. Silver impregnation staining revealed that granule cell
      degeneration begins immediately after adrenalectomy and continues for months in
      both sexes, in young and older adults, and in all strains tested. In one group of
      77 adrenalectomized rats, 82% exhibited silver-impregnated granule cells. This
      phenomenon is extraordinarily selective in that no neurons other than dentate
      granule cells degenerated after adrenalectomy. There was considerable variability
      among animals in the number of cells degenerating at a given time-point or in the
      degree of ultimate cell loss. In the most extreme cases, virtually complete
      granule cell loss was present throughout approximately 80% of the dentate gyrus.
      Nissl staining revealed that degenerating granule cells exhibited coalescing of
      nuclear chromatin into multiple nuclear bodies and pyknosis without accompanying
      glial swelling. This morphology is distinct from the necrosis caused by other
      neurotoxic insults and is the subject of the ultrastructural companion paper
      identifying this type of cell death as apoptosis. Taken together, these results
      indicate that adrenalectomy reliably initiates an immediate, highly selective,
      and long-continuing process of hippocampal granule cell degeneration that
      exhibits morphological features characteristic of apoptosis, rather than
      necrosis. The possibility that this apoptotic cell death involves a biochemical
      cascade relevant to programmed cell death and/or neurodegenerative diseases
      suggests that this model may be valuable for studies of neuronal death and its
      prevention. Some practical guidelines for use of this model are described.

PMID- 8468410
TI  - Electron microscopic analysis of adrenalectomy-induced hippocampal granule cell
      degeneration in the rat: apoptosis in the adult central nervous system.
AB  - As described in the preceding paper, adrenalectomy triggers hippocampal granule
      cell degeneration that begins within days after adrenalectomy, continues for
      months, and is the only apparent cell death anywhere within the brain. At the
      light microscopic level, granule cell degeneration is characterized by coalescing
      of nuclear chromatin into numerous spherical bodies. Since the morphology at the
      light microscopic level resembled the nuclear morphology characteristic of
      "apoptosis" rather than "necrosis," we undertook this ultrastructural study to
      determine if adrenalectomy induces the morphological features characteristic of
      apoptosis. Electron microscopy revealed coalescing of nuclear chromatin,
      compaction of cytoplasm, and the budding-off of cytoplasmic bodies that were
      engulfed by glia. Mitochondria, the Golgi apparatus, and rough endoplasmic
      reticulum appeared relatively normal early in the process of granule cell
      degeneration when nuclear changes were prominent. Presynaptic terminals
      innervating degenerating granule cells appeared normal. Electron-dense
      degeneration of granule cell axon terminals in association with normal
      postsynaptic elements of CA3 pyramidal cells highlighted the extraordinary
      selectivity of adrenalectomy-induced granule cell death. Ten weeks after
      adrenalectomy, astrocytes were filled with abnormally abundant glial fibrils and
      neuronal debris. This "apoptotic" morphology produced by adrenalectomy was
      clearly distinct from the "necrotic" granule cell morphology produced by
      intrahippocampal injection of the neurotoxin volkensin. These results indicate
      that, in a manner possibly analogous to castration-induced prostate cell death,
      loss of adrenal hormone triggers a process in dentate granule cells that causes
      the morphological changes characteristic of "apoptosis." Thus, adrenal steroids
      may be obligatory growth factors for dentate granule cells and their loss may
      initiate a selective process in the mature brain that is unique or that may
      normally occur only in the developing brain.

PMID- 8468411
TI  - Organum vasculosum laminae terminalis (OVLT) in rabbit and rat: topographic
      studies.
AB  - The microcirculation and fine structure of the rabbit and rat organum vasculosum
      laminae terminalis (OVLT) were examined by light microscopy and scanning and
      transmission electron microscopy. In both animals, the microcirculation is
      composed of a superficial and a deep vascular bed but the system is more complex
      and extensive in the rabbit. This was particularly true of the deep vascular bed.
      In the rabbit, the deep bed is composed of fenestrated capillaries, which are
      arranged in glomerular tufts surrounded by very wide perivascular spaces (PVS).
      In contrast, the deep vascular bed of the rat OVLT usually consists of only one
      or two small vessels. These are either fenestrated and surrounded by a PVS or
      lined by continuous endothelium with only a few fenestrae and without a dilated
      PVS. A corresponding difference was seen in the contours of the ventricular
      surface. It is much more irregular in the rabbit than in the rat and numerous
      bulges reflect the underlying vascular tufts and pockets of PVS in the rabbit.
      Supraependymal cells are present in both species and two sizes of them occur in
      the rabbit. The results demonstrate that the microcirculation of the OVLT is more
      elaborate and more highly developed in the rabbit than in the rat. We suggest
      that this might result in a different neurohemal microenvironment and,
      ultimately, in functional differences.

PMID- 8468412
TI  - Neuroanatomical distribution and binding properties of saxitoxin sites in the rat
      and turtle CNS.
AB  - Since saxitoxin (STX) binds to voltage-sensitive sodium channels and blocks their
      function, it has been widely used in the study of these channels. There is,
      however, limited information on STX binding properties and the neuroanatomical
      distribution of the Na+ channel as a function of brain region in the rat and in
      lower vertebrates such as the turtle. In the present study, we used a broad range
      of 3H-STX concentration (up to 64 nM) to examine saturation profiles and density
      distribution in both adult rat and turtle brains. We found that (1) STX sites do
      not vary greatly in affinity (most Kds = 2 to 5 nM) in various regions of the
      adult rat brain; (2) STX binding distribution was very heterogeneous in the rat
      with much higher density in the cortex, hippocampus, amygdala, and cerebellum
      than in the brainstem and spinal cord; (3) STX sites are mostly localized in
      layers made mostly of neurons with low density in white matter; and (4) turtle
      brain STX sites had similar binding properties, but its brain had much fewer STX
      sites than the rat, especially in the cerebellum and rostral areas such as the
      cortex. We conclude that (a) adult brain sodium channels have similar STX binding
      affinity in spite of the existence of multiple sodium channel subtypes; (b) the
      brainstem is very different from rostral brain areas in channel density; and (c)
      the turtle brain has a much lower sodium channel density than the rat brain.

PMID- 8468413
TI  - Quantitative synaptology of functionally different types of cat medial
      gastrocnemius alpha-motoneurons.
AB  - The aim of this ultrastructural investigation was to study quantitatively the
      synaptology of the cell bodies and dendrites of cat medial gastrocnemius (MG)
      alpha-motoneurons of functionally different types. In electrophysiologically
      classified and intracellularly HRP-labelled MG alpha-motoneurons of the FF (fast
      twitch, fatigable), FR (fast twitch, fatigue resistant) and S (slow twitch, very
      fatigue resistant) types, the synaptic covering of the soma as well as that of
      dendritic segments located within 100 microns and at 300, 700, and 1,000 microns
      distance, respectively from the soma, was analyzed. The synaptic boutons were
      classified into the L-(apposition length > 4 microns) and S-types (< 4 microns)
      with spherical synaptic vesicles, and the F-type with flat or pleomorphic
      synaptic vesicles. The length of apposition towards the motoneuron membrane was
      measured for each bouton profile. Approximately 1,000 boutons contacted the soma
      and a similar number of boutons contacted the proximal dendrites within 50
      microns from the soma. The number of dendritic boutons was larger at the 300
      microns distance than at the 100 and 700 microns distances. The three types of
      motoneurons showed similar values for percentage synaptic covering and synaptic
      packing density in the proximal dendrites, while in the most distal dendritic
      regions the S motoneurons had more than 50% higher values for percentage
      covering, packing density and total number of boutons. The S motoneurons also
      exhibited a larger preponderance of F-type boutons on the soma. The ratio between
      the F- and S-types of boutons decreased somatofugally along the dendrites in the
      type FF and FR motoneurons, while in the S motoneurons it remained fairly
      constant.

PMID- 8468414
TI  - The cutaneous histopathology of chemotherapeutic reactions.
AB  - The histological diagnosis of chemotherapy-induced cutaneous reactions is a
      difficult problem for the dermatopathologist. The initial effort should be
      directed towards obtaining as much clinical history as possible since the
      provided information is often incomplete and clinical correlation is usually
      required. The biopsy should be examined in a systematic fashion to assess the
      presence of damage to specific cutaneous structures. A recommended approach is to
      initially examine the epidermis and then proceed to hair follicles, eccrine sweat
      glands, vessels and dermis. The degree and pattern of damage will usually
      indicate whether or not a cytotoxic reaction is present. The intensity, pattern,
      and components of the inflammatory response should be assessed since they provide
      clues to whether a hypersensitivity reaction or immunomodulating chemotherapeutic
      reaction is present. In addition to the possibility of a chemotherapeutic
      reaction, the dermatopathologist must also consider the possibility of an
      infection since the host is usually immunocompromised and must also exclude the
      presence of a residual malignancy. After examination of the biopsy specimen and
      determination of the pathologic process or precesses, the observed findings
      should be correlated with the clinical history before rendering an
      interpretation.

PMID- 8468415
TI  - Plexiform and other unusual variants of palisaded encapsulated neuroma.
AB  - Palisaded, encapsulated neuroma (PEN) has been described as a predominantly
      solitary, nodular tumor; plexiform or multinodular growth patterns have not been
      reported in detail. We reviewed 55 PEN in order to evaluate: 1) the predominant
      growth patterns; 2) features that may indicate previous trauma; and 3)
      association with acne-like changes. Sixteen cases (29%) had growth patterns other
      than the solitary, nodular type. These patterns were: a) plexiform (7/16), b)
      multinodular (5/16), and c) fungating (4/16). Other unusual features included
      evidence of trauma, i.e., fibrosis, myxoid change, chronic inflammation (5/16),
      partially incomplete capsule (6/16), and association with acne-like features
      (13/16). These results suggest that: 1) plexiform or multinodular growth patterns
      occur relatively often in PEN; 2) some changes indicate a possible histogenetic
      relation to traumatic neuroma, probably via secondary traumatization; 3) a high
      frequency of association with acne-like changes which could imply, but does not
      prove, an acne-induced histogenesis; and 4) the differential diagnosis of
      cutaneous plexiform lesions should include PEN.

PMID- 8468416
TI  - Trichilemmal carcinoma: review of 8 cases.
AB  - Clinical and histological data from 8 trichilemmal carcinomas are reviewed. The
      tumors occurred mainly on sun-exposed skin of the face of elderly people as small
      solitary, frequently ulcerated nodules. Histologically, they consisted of
      multilobulate, infiltrative growths, connected to the epidermis and pilosebaceous
      structures and showing features reminiscent of the outer root sheath of the hair
      follicle. The presence of lobules of clear, glycogen-rich cells with peripheral
      palisading, hyaline basement membranes, trichilemmal keratinization, and abortive
      follicular sheaths and the absence of ductal or acinar differentiation allow
      distinction from other clear cell tumors of the skin. Although the histological
      picture suggests a high-grade malignant neoplasm, trichilemmal carcinoma has an
      indolent course. No recurrence or metastases have been observed.

PMID- 8468417
TI  - Further validation of the prognostic model for stage I malignant melanoma based
      on tumor progression.
AB  - Prediction of long-term survival for clinical stage I malignant melanoma and
      guidance of therapy has long relied upon assessment of tumor thickness. This
      parameter is a strong, but not infallible predictor of prognosis. Clark et al.
      have developed a prognostic model based upon the concept of tumor progression and
      the evaluation of six readily assessable clinical and histologic attributes. They
      report the most accurate prediction of long-term survival of any prognostic
      method available for melanoma (100% accurate for radial-growth-phase and 84.1%
      accurate for vertical-growth-phase melanomas). This model was developed and
      validated via study of a patient population which largely resided in the
      northeastern portion of the United States. We report additional validation of
      this model using a data base of 55 patients from a different geographic location
      (North Carolina) and have observed virtual identity in the accuracy of predicting
      8-year survival for radial-growth-phase (100%) and vertical-growth-phase (85.1%)
      melanomas. Twenty per cent of these cases were randomly selected and subjected to
      re-evaluation for prognosis with extremely good precision obtained in the
      prognostic prediction.

PMID- 8468418
TI  - Immunelectron microscopic localization of cathepsin B in human exocrine glands.
AB  - The distribution of the lysosomal enzymes cathepsin B, lysozyme, chymotrypsin,
      and neutrophil elastase was examined in eccrine, apocrine, and sebaceous glands
      using a postembedding immunogold labeling procedure. Various amounts of cathepsin
      B were detected in all glands. Lysozyme, however, was detected in apocrine glands
      only. The other two lysosomal enzymes were not detectable immunologically. In
      apocrine and eccrine glands, anti-cathepsin B antibody labeled all secretory
      granules. In sebaceous glands, only the peripheral layer of cells showed
      immunological activity for cathepsin B. In apocrine glands, granules containing
      remnants of cristae were more intensively labeled than those lacking cristae
      which supports the assumption that both granules are derived from mitochondria by
      acquiring lysosomal enzymes. The enzymes convert mitochondria to granules with
      cristae and finally to granules without cristae. Thus the difference in
      morphology is part of a spectrum of the degradation of mitochondria to granules.

PMID- 8468419
TI  - Nodular fasciitis of the dermis.
AB  - We describe the second reported patient with nodular fasciitis involving the
      dermis. Our case was morphologically a typical example of nodular fasciitis, but
      was distinctive by its cutaneous location and recurrence. As in the first
      reported case, the unexpected dermal involvement caused diagnostic difficulty,
      despite a typical histology.

PMID- 8468420
TI  - Basal cell carcinoma with monster cells.
AB  - A case of basal cell carcinoma with "monster cells" is reported. Clinically, the
      lesion presented as a red nodule on the forearm of a 58-year-old male. The
      histologic picture was striking, with large, "monstrous" nuclei scattered
      throughout a well defined nodule. Basal cell carcinoma with monster cells appears
      to represent a histologic variant of nodular basal cell carcinoma. The prognostic
      significance of the monster cells remains to be established.

PMID- 8468421
TI  - Intravascular immunoglobulin crystalloids in monoclonal cryoglubulinemia
      associated dermatitis: ultrastructural findings.
AB  - A 46-year-old woman developed polyarthritis, purpuric skin rashes, nasal septal
      perforation and marginal furrowing of corneas in 1980. Monoclonal IgG, kappa
      cryoglobulinemia was found in the patient's serum. No underlying
      lymphoproliferative disorder has been found in ten years since her original
      diagnosis. In 1991, she developed palpable purpura on both lower extremities with
      subsequent necrosis and ulceration. A skin biopsy revealed fibrin thrombi within
      capillaries in the papillary dermis, and immunofluorescence studies showed IgG
      and light chain kappa within the fibrin thrombi. An electron microscopy study
      showed intravascular immunoglobulin crystalloid structures with a mean diameter
      of 80.3A degrees (8.03 nm), mixed with fibrin and red blood cells. The exclusive
      vascular location of these crystalloids may have implication in the pathogenesis
      of skin lesions.

PMID- 8468422
TI  - Apocrine nevus: light microscopic, immunohistochemical and ultrastructural
      studies of a case.
AB  - The apocrine nevus (AN) is a rare tumor occurring in the upper chest and the
      axilla. We report a case of a AN in a 33-year-old female occurring unilaterally.
      The presenting complaint related to tenderness and swelling in the right axilla.
      The initial impression was hidradenitis suppurativa. The gross specimen revealed
      the presence of irregular thickening just beneath the dermal subcutaneous
      interface. Microscopically the lesion was composed of mature apocrine glands with
      apical snouts. The glands were arranged in lobules divided by thin fibrous septa.
      Immunohistochemical studies revealed the following profile in the glandular
      epithelium: positive low molecular weight cytokeratin, epithelial membrane
      antigen, and gross cystic disease fluid protein reactivity and negative high
      molecular cytokeratin and S-100 protein reactivity. Carcinoembryonic antigen
      reactivity was found in the duct epithelium. Ultrastructural studies revealed
      cells lining the lumen of the glands with a concentration of granules in the
      apical region and light and dark granules. These findings support the previously
      described light microscopic observations and provide unreported ultrastructural
      studies in this rare tumor.

PMID- 8468423
TI  - Myxoid change in decidualized scar endometriosis mimicking malignancy.
AB  - A case of cesarean scar endometriosis with massive decidualization is presented.
      The 25-year-old patient had an extensive, ulcerated lesion that mimicked
      malignancy microscopically due to myxoid change with alveolar patterns
      reminiscent of some soft tissue sarcomas, signet ring-like cells similar to mucin
      producing carcinoma, and pseudoinfiltration of the fascia. The myxoid tissue was
      positive for acid mucopolysaccharides but negative with PAS. Decidual cells were
      vimentin positive and keratin negative. No atypia or mitoses were seen. The
      pseudoinfiltrative aspect was due to abundant extracellular matrix that separated
      the fascicles of the fascial tissue. There was a metaplastic decidual "proximity
      effect" in the surrounding, unaffected dermis, which may be responsible for the
      expansile features of the lesion. This case exemplifies the differential
      diagnosis of myxoid endometriosis with malignant conditions of the skin.

PMID- 8468424
TI  - Vascular variant of palisaded encapsulated neuroma.

PMID- 8468426
TI  - Parallel lives, deaths, questions.

PMID- 8468425
TI  - Plaque-like dermal fibromatosis/dermatomyofibroma.

PMID- 8468427
TI  - Peripheral effects of sex steroids: implications for patient management.
AB  - Sex steroids--estrogens, progesterone, and testosterone and other androgens--have
      effects on the anatomy and physiology of many nonreproductive organ systems.
      These changes can influence the sex ratio of certain diseases. They also affect
      the "normal range" for certain parameters, and data from men often do not apply
      to normal female physiology. Sex steroids also affect the response to certain
      toxins, pharmacologic agents, and other therapies. Replacement sex steroid
      therapy and oral contraceptives may affect these processes differently than
      natural hormones do. The normal monthly changes of female hormones can also
      affect the severity of many conditions and may change the response to therapy in
      certain conditions, such as asthma or control of diabetes. This paper reviews the
      data on the effects of sex hormones on normal and pathologic human physiology and
      examines the therapeutic implications of these findings.

PMID- 8468428
TI  - Women in surgery.

PMID- 8468429
TI  - Perceptions of the gender fairness of the medical education environment.
AB  - Many medical institutions are making an effort to create "gender-fair"
      environments. Perceptions of the current state of the environment may have
      implications for progress toward this goal. We surveyed faculty, housestaff, and
      medical students at the University of Virginia School of Medicine (UVASOM) to
      determine their perceptions of the status of women at that institution. The
      results showed that women perceived their environment as significantly more
      inequitable and sexist than their male counterparts did. Women faculty perceived
      significantly more inequity and sexism than women housestaff or students.
      Comments from both women and men at UVASOM focused on the need to eliminate
      discrimination of all kinds and to recruit more women faculty as leaders,
      mentors, and role models. The UVASOM is now implementing recommendations that
      should significantly reduce the discrepancy in perceptions of its environment.

PMID- 8468430
TI  - War crimes of the 90s: rape as a strategy.

PMID- 8468431
TI  - RIMAs in subtypes of depression: focus on moclobemide. Third International
      Symposium, Vienna, 29-31 March 1992.

PMID- 8468432
TI  - RIMA--a new concept in the treatment of depression with moclobemide.
AB  - Moclobemide, a specific reversible inhibitor of monoamine oxidase that shows a
      preference for the A isoenzyme, has been developed as a new antidepressive agent.
      Unlike earlier generation monoamine oxidase inhibitors, moclobemide is devoid of
      any clinically significant tyramine interaction, thus making dietary restrictions
      during therapy unnecessary. In comparative trials, moclobemide has been found to
      be superior to placebo and similar to imipramine, clomipramine, and amitriptyline
      in clinical efficacy. Long-term trials involving moclobemide therapy for up to
      one year have indicated that antidepressant efficacy can be maintained for this
      period. Tolerance is good and is significantly better than for tricyclic
      antidepressants. In addition, unlike the tricyclic antidepressants, overdoses of
      moclobemide do not appear to be life-threatening.

PMID- 8468434
TI  - The role of moclobemide in endogenous depression: a survey of recent data.
AB  - Earlier studies demonstrated that moclobemide has good efficacy as an
      antidepressant. Its efficacy was comparable to reference antidepressants, both in
      endogenous and non-endogenous depression. A meta-analysis was performed of recent
      data from more than 2000 patients who had participated in double-blind trials
      with moclobemide and comparison drugs. Based on HAMD-17 baseline scores, the
      sample was divided into three groups according to the severity of depression. In
      all three, moclobemide was as effective as comparison drugs, both in endogenous
      and non-endogenous depression. The antidepressant efficacy of both moclobemide
      and reference drugs was more pronounced in endogenous than in non-endogenous
      depression, whatever the severity.

PMID- 8468433
TI  - Moclobemide--placebo-controlled trials.
AB  - In this paper, three placebo-controlled trials of moclobemide, and four three-way
      comparison trials of moclobemide, placebo and one of the standard tricyclic
      antidepressants, imipramine, clomipramine, or amitriptyline, are reviewed. The
      results of the placebo-controlled trials indicate that about twice as many of the
      patients receiving moclobemide showed a marked improvement during a four-week
      treatment period, as compared with patients receiving placebo. Of the three-way
      trials, two studies indicated that the efficacy of moclobemide was significantly
      greater than that of placebo and similar to that of other antidepressants
      (imipramine or amitriptyline). Tolerance of moclobemide was good and better than
      that of the tricyclic antidepressants. In the other three-way comparison trials,
      the differences in efficacy between the placebo, moclobemide, and the tricyclic
      antidepressant were not significant.

PMID- 8468435
TI  - Moclobemide versus imipramine in depressed out-patients: a double-blind multi
      centre study.
AB  - One hundred and twenty seven patients with major depressive episode were included
      in a double-blind, four-week, prospective, randomized, multi-centre parallel
      group trial comparing moclobemide and imipramine. The dose of moclobemide was 150
      525 mg/day and that of imipramine 50-175 mg/day; the mean daily doses during the
      last week of treatment were 307 mg and 100 mg of moclobemide and imipramine,
      respectively. The decrease of the total scores of the Hamilton Depression Scale
      (HDRS) as well as the Overall Assessment of Efficacy by the Investigators showed
      significant amelioration of depression in both treatment groups (p < 0.001). No
      significant differences were found between the moclobemide and imipramine groups
      with regard to treatment outcome. The onset of the antidepressant activity was
      faster in the moclobemide group as measured by the Assessment of the
      Investigators. This difference was not observed when the therapeutic index
      figures calculated on the basis of the changes in the HDRS scores were
      scrutinized. Treatment-emergent side effects were somewhat more frequent during
      imipramine than during moclobemide treatment. Nevertheless, a total of only four
      patients discontinued the trial prematurely because of poor tolerability.
      Imipramine-treated patients reported more anticholinergic side effects, whereas
      tiredness and headache were observed more frequently in the moclobemide-treated
      patients. Restlessness, nervousness and sleep disturbances were noted with equal
      incidence in both patient groups.

PMID- 8468436
TI  - A comparison study of moclobemide and doxepin in major depression with special
      reference to effects on sexual dysfunction.
AB  - A double-blind parallel-group comparison study of moclobemide versus doxepin in
      237 patients with major depression confirmed that moclobemide was equal in
      efficacy and better tolerated than doxepin. It was less sedating and caused fewer
      anticholinergic adverse events as measured by the UKU side-effect rating scale.
      Unexpectedly, moclobemide therapy more often than doxepin resulted in increased
      sexual desire. An exploratory analysis of UKU-measured symptoms of impaired
      sexual function prior to commencement of the study revealed that moclobemide more
      often than doxepin led to an improvement of reduced libido and impaired erection,
      ejaculation and orgasm. This finding is compatible with the assumption that there
      is a greater likelihood that the anticholinergic reuptake inhibitor doxepin has a
      higher risk of impairing sexual function than the non-anticholinergic RIMA
      moclobemide. A single case report of moclobemide-induced sexual hyperarousal
      supports the alternative assumption that moclobemide has a specific sexually
      stimulative effect in depression.

PMID- 8468437
TI  - A double-blind comparison of moclobemide and fluoxetine in the treatment of
      depressive disorders.
AB  - Moclobemide and fluoxetine were tested in a six-week trial involving 122 patients
      with major depressive illness. Patients initially received moclobemide, 150 mg
      three times daily, or fluoxetine 20 mg/day, but during weeks 3, 4, 5 and 6 the
      doses could be altered, giving a range of 300-600 mg/day for moclobemide or 20-40
      mg/day for fluoxetine. No dietary restrictions were imposed on the patients. The
      trial was completed by 49 patients receiving moclobemide, and 43 patients
      receiving fluoxetine. The efficacies of these two agents, as determined on the
      Hamilton Depression Rating Scale and from Clinical Global Assessments, were found
      not to differ significantly. The frequencies of occurrence of adverse reactions
      were also similar, but sedation, nausea and vomiting were reported more
      frequently with fluoxetine, and insomnia was experienced with moclobemide.
      Tolerance of both drugs was judged to be high.

PMID- 8468438
TI  - A randomized, double-blind, multi-centre, parallel-group study comparing the
      tolerability and efficacy of moclobemide and dothiepin hydrochloride in depressed
      patients in general practice.
AB  - A randomized, double-blind, multi-centre, parallel-group study compared the
      tolerability and efficacy of 450 mg of moclobemide and 75-150 mg of dothiepin in
      the management of depressed patients in general practice. Patients who fulfilled
      the DSM-III-R criteria for major depressive disorder and who scored 13 or more on
      the Hamilton Depression Rating Scale were admitted. The trial lasted six weeks.
      The dose of moclobemide was 150 mg three times daily and that of dothiepin was 75
      mg daily for the first two weeks and 150 mg thereafter. Assessments were made at
      baseline and after one, three and six weeks using the HDRS, the Zung SRS and the
      CGI. Adverse events and vital signs were monitored at each visit, and laboratory
      screening tests performed at the beginning and end of the study. Sixty-four
      general practitioners from four centres recruited 345 patients: 175 received
      dothiepin and 170 moclobemide; 265 completed six weeks of treatment. Thirty-eight
      dothiepin-treated patients (22%) and 42 who received moclobemide (25%) dropped
      out, most commonly because they experienced adverse events. More patients on
      dothiepin (24) than on moclobemide (16) dropped out for this reason; the
      incidence of adverse events was 10% higher in the dothiepin-treated group and of
      "side effects" more than 10% higher, the latter difference being statistically
      significant. Both treatments resulted in significant improvement; this was
      greater in the dothiepin-treated group and the difference was statistically
      significant, although clinically small.

PMID- 8468439
TI  - An update of recent moclobemide interaction data.
AB  - The classical monoamine oxidase inhibitors (MAOIs) are believed to have serious
      risks because of interactions with other drugs and foodstuffs, although not with
      a sound scientific basis in all cases. However, moclobemide, a selective
      reversible inhibitor of MAO-A, has a low propensity for producing drug
      interactions. Interaction studies have been carried out in healthy volunteers in
      an attempt to answer some relevant practical questions related to therapy with
      moclobemide. In combination with therapeutic doses of either fluvoxamine or
      fluoxetine, moclobemide did not provide any indication of a serotoninergic
      syndrome, so that no wash-out period is needed when switching from a selective
      serotonin re-uptake inhibitor to moclobemide or vice versa. Since concomitant
      treatment with moclobemide and selegiline had a supra-additive effect on the
      sensitivity to intravenously administered tyramine, that combination therapy
      should only be considered when accompanied by dietary restrictions. Concomitant
      treatment with moclobemide and levodopa/benserazide, however, was well tolerated.
      When oral ephedrine was added to steady-state moclobemide treatment, the
      cardiovascular effects of the former were increased to about the same extent as
      for oral tyramine, i.e. a potentiation of 2-4.

PMID- 8468440
TI  - Effect of moclobemide on the psychophysiology of sleep/wake cycles: a
      neuroelectrophysiological study of depressed patients administered with
      moclobemide.
AB  - The effects of moclobemide, 450 mg/day, on sleep were investigated in 12 patients
      with major depression. The study was carried out over six weeks, divided into
      three periods: (1) treatment for one week with placebo and measurement to obtain
      baseline values; (2) treatment with moclobemide for four weeks; and (3) one week
      withdrawal period. Polygraphic sleep recording, all-night sleep-EEG spectral
      analysis, and diurnal EEG vigilance mapping were used to determine the effects of
      this antidepressant. An activating effect was observed, most marked during the
      early phase of treatment. The most noticeable effects were on REM sleep,
      affecting polysomnographic and spectral sleep EEG parameters. A REM sleep
      habituation phenomenon was observed, and a slight REM sleep rebound effect
      occurred early during withdrawal. The observed neuroelectrophysiological changes
      appear to be specific for moclobemide and differ from those brought about by
      other antidepressants.

PMID- 8468441
TI  - The costs of depression.
AB  - Depression is one of the commonest conditions seen by general practitioners.
      Conventional treatments are typically drug based, and usually involve one of the
      tricyclic preparations. The evaluation of new treatments requires an
      understanding of the costs and benefits of existing alternatives, to provide a
      comparative framework for general practitioners and others concerned with the
      treatment and management of depressed patients. This paper presents estimates of
      the direct costs associated with the treatment of patients in England and Wales.
      These amount to some 420 million pounds annually. Pharmaceutical costs represent
      a relatively small proportion of this total. Substantial indirect costs are
      generated through lost productivity, and these may exceed 3 billion pounds.

PMID- 8468442
TI  - Recurrent brief depression, dysthymia and melancholia. Workshop report.

PMID- 8468443
TI  - Therapy-resistant depression. Workshop report.

PMID- 8468444
TI  - Syndromal subgroups of depression. Workshop report.

PMID- 8468445
TI  - Depression in medical illness. Workshop report.

PMID- 8468446
TI  - Cytochemical evidence for the presence of phospholipids in epithelial tight
      junction strands.
AB  - Previous freeze-fracture experiments using either glutaraldehyde-fixed and
      cryoprotected specimens or unfixed rapid-frozen samples led to the proposal that
      cylindrical strands of the tight junction (TJ) observed in freeze-fracture
      preparations are inverted cylindrical micelles made up of membrane lipids and,
      possibly, membrane proteins. However, no one has yet been able to directly label
      the structural fibrils of the TJ. To test the hypothesis that TJ strands observed
      on freeze-fracture preparations are composed at least partially of lipids, we
      have combined the phospholipase A2-gold and the fracture-label techniques for
      localization of phospholipids. Phospholipase A2, purified from bee venom, was
      adsorbed on gold particles and used for specific labeling of its substrate.
      Phospholipase A2-colloidal gold (PLA2-CG) complex was applied to freeze-fractured
      preparations of rat exocrine pancreatic cells and testicular Sertoli cells, both
      of which are known to have extensive TJ complexes on their plasma membranes.
      Fracture-label replicas of exocrine pancreatic cells revealed specific
      association of gold particles with TJ fibrils on the protoplasmic fracture-face
      of the plasma membrane. The majority of these gold particles were observed either
      directly on the top of the TJ fibrils or adjacent to these cylindrical
      structures. A high density of PLA2-CG labeling was also observed over the
      complementary exoplasmic fracture-face of the TJ complex. This intimate
      association of PLA2-CG labeling with the TJ is particularly evident in the
      Sertoli cell plasma membrane, where rows of gold particles were observed to be
      superimposed on parallel arrays of cylindrical strands of the TJ complex. The
      present findings provide direct cytochemical evidence to support the hypothesis
      that cylindrical TJ strands observed in freeze-fracture preparations contain
      phospholipids.

PMID- 8468447
TI  - A histochemical procedure for light microscopic demonstration of xanthine oxidase
      activity in unfixed cryostat sections using cerium ions and a semipermeable
      membrane technique.
AB  - Xanthine oxidoreductase exists in two functionally distinct forms. Under normal
      conditions, the larger part of the enzyme occurs as an NAD(+)-dependent
      dehydrogenase form which produces NADH and urate. The dehydrogenase can be
      transformed under various (patho)physiological conditions to an oxygen-dependent
      oxidase form which produces oxygen radicals and/or hydrogen peroxide and urate.
      Tetrazolium salts are used to demonstrate the total activity of both the
      dehydrogenase and the oxidase form of the enzyme. We have developed a procedure
      to detect the oxidase form only in unfixed cryostat sections with the use of
      cerium on the basis of the semipermeable membrane technique. The incubation
      medium contained hypoxanthine as substrate, cerium ions, and sodium azide to
      inhibit catalase and peroxidase activity. In a second-step reaction,
      diaminobenzidine was polymerized in the presence of cobalt ions by decomposition
      of cerium perhydroxide. Large amounts of final reaction product were found in
      milk droplets in the acini of lactating bovine mammary gland, whereas milk
      secreting epithelial cells contained hardly any final reaction product. In rat
      duodenum, enzyme activity was found in the cytoplasm of enterocytes and goblet
      cells but not in the mucus. Control reactions performed in the absence of
      substrate or in the presence of substrate and allopurinol, a specific inhibitor
      of xanthine oxidase, were completely negative in both tissues, with the exception
      of polymorphonuclear leukocytes in the lamina propria of duodenum. The positive
      nonspecific reaction in these cells was caused by myeloperoxidase activity. We
      conclude that the present method is specific for the detection of xanthine
      oxidase activity. Moreover, conversion of the dehydrogenase form into the oxidase
      form can be prevented by omission of chemical fixation of the tissue in the
      present procedure.

PMID- 8468448
TI  - Immunocytochemical localization of androgen receptor with polyclonal antibody in
      paraffin-embedded human tissues.
AB  - We investigated the immunohistochemical localization of androgen receptor (AR)
      using a polyclonal antibody for 55 KD recombinant human AR in human tissues fixed
      with 4% paraformaldehyde solution and embedded in paraffin. Immunoreactive AR was
      restricted to the nuclei of various tissues. Among the well-known androgen target
      organs, secretory cells and basal cells of the prostate, spermatogonia,
      spermatocytes, Sertoli cells and Leydig cells of the testis, epithelial cells of
      the rete testis, fibroblasts in the whole organ, squamous cells, sweat gland and
      hair follicle cells of the skin, and hepatocytes of the liver were positive for
      AR. In addition, smooth muscle cells of the prostate, uterus, urinary bladder,
      gastrointestinal tract, arteries, and arterioles were strongly immunoreactive for
      AR. Cardiac muscle and striated muscle of psoas were positive for AR. Acinar
      cells, ductal cells, and myoepithelial cells of the breast, endocervical and
      endometrial cells of the uterus, cyto- and syncytiotrophoblast of the chorionic
      villi, and tubules of the kidney were also positive for AR. Most FSH, LH, and
      some GH endocrine cells in the anterior and posterior lobes of the pituitary
      gland, follicular cells of the thyroid gland, and adrenocortical cells were
      positive for AR. Cells immunoreactive for AR were ubiquitously distributed
      throughout the entire body. The present study demonstrated the diversity of
      androgen effects on many target tissues.

PMID- 8468449
TI  - Rapid expression of collagen type X gene of non-hypertrophic chondrocytes in the
      grafted chick periosteum demonstrated by in situ hybridization.
AB  - We investigated the spatiotemporal localization of collagen Type I, II, and X
      mRNAs in the subcutaneously grafted chick periosteum by in situ hybridization.
      Five days after transplantation, we noted three types of histological findings in
      the grated tissue. (a) Developing trabecular bone exhibited proliferation of
      spindle-shaped fibroblastic cells and polygonal osteoblasts with moderate signals
      for collagen Type I mRNA. (b) Developing cartilage contained ovoid chondrocytes
      with a moderate level of both collagen Type I and II mRNAs. Differentiating
      chondrocytes with increased collagen Type X mRNA developed during the course of
      endochondral ossification. (c) An atypical mass of cartilage weakly stained with
      alcian blue was composed of a large number of non-hypertrophic chondrocytes
      exhibiting high signals for collagen Type X mRNA. At Day 9, we observed the
      typical histological features of both membranous and endochondral ossification.
      However, sparsely distributed chondrocytes with high signals for collagen Type X
      mRNA were also demonstrated in osteoid and/or woven bone. The phenotype of
      chondrocytes showing rapid expression of collagen Type X gene derived from
      grafted periosteum seems to participate in the important role of endochondral
      bone formation in the early stage of fracture repair.

PMID- 8468450
TI  - Measurement of metabolic events in the avian epiphyseal growth cartilage using a
      bioluminescence technique.
AB  - We developed a technique to map the distribution of selected metabolites in the
      growth cartilage in situ using luciferase-NAD(P)H:FMN oxidoreductase. Chick
      tibial epiphyses were freeze-trapped, sectioned, and freeze-dried. For evaluating
      lactate, luciferase was suspended in a buffer containing polyvinylalcohol,
      gelatin, NAD, FMN, and lactic dehydrogenase (LDH). The buffer was frozen into a
      layer 800 microns thick and placed in contact with the tissue section. The
      temperature of the frozen reagent mixture was then allowed to increase; the
      emitted light was focused through a photographic lens and collected on film. We
      found that lactate was synthesized by cells in all regions of the growth plate.
      The highest concentration of the metabolite was observed in the calcified
      hypertrophic region. Substantial levels of lactate were also present in articular
      cartilage. By modifying the composition of the buffer solution, we were able to
      map the distribution of glucose and glucose-6-phosphate and the activity of LDH.
      Maximal levels of each of the three components were present in hypertrophic
      cartilage. Chemical analysis of the tissue section confirmed the luminographic
      studies and provided further evidence that there was reliance on glycolytic
      metabolism in terminally differentiated chondrocytes. Use of enzyme couples
      similar to those described above should permit the technique to be used to study
      most, if not all, of the major metabolic components of cartilage.

PMID- 8468451
TI  - Detection of nerve growth factor mRNA in rodent salivary glands with digoxigenin-
      and 33P-labeled oligonucleotides: effects of castration and sympathectomy.
AB  - Nerve growth factor (NGF) is a protein highly expressed in the male mouse
      submandibular gland. We have applied a non-radioactive in situ hybridization
      method using digoxigenin-labeled NGF oligonucleotides, and have found the highest
      amounts of NGF mRNA in the secretory striated ducts of the male mouse
      submandibular gland. Scattered strongly positive cells were found in male mouse
      sublingual glands. Weakly labeled cells were seen in female mouse and in male rat
      submandibular gland striated duct cells. Using 33P as an alternative to 32P and
      35S, we demonstrated a 1.3 KB NGF mRNA in salivary glands of male mice by
      Northern blot hybridization. Using 33P we detected NGF mRNA in male mouse
      submandibular glands by in situ hybridization but with a signal that, compared
      with the non-radioactive method, had a very low resolution. Castration of male
      mice almost abolished both the 1.3 KB NGF mRNA seen with Northern blots and the
      NGF mRNA labeling in submandibular glands 4 weeks after the operation, whereas
      levels were increased 6 hr and 2 days after sympathectomy. We conclude that
      hybridization with digoxigenin-labeled NGF oligonucleotides is a good tool to
      study the expression and regulation of NGF mRNA in male mouse submandibular
      glands.

PMID- 8468452
TI  - Antibodies raised against a peptide corresponding to a Gs alpha domain reveal a
      vimentin-associated protein.
AB  - In an attempt to localize the guanine nucleotide binding protein Gs alpha by
      immunocytochemistry, we synthetized peptides corresponding to several stretches
      of residues deduced from the published cDNA sequence of Gs alpha and raised
      antibodies against them. Among the peptides, one corresponding to residues 367
      381 elicited antibodies that immunocytochemically detected, at the optical level,
      what appeared to be vimentin in several cells and tissues. Studies at the
      ultrastructural level confirmed this observation and also showed weak staining of
      some areas of plasma membranes of glial and nerve cells. Analysis by Western
      blots of rat brain subcellular fractions indicated that: (a) the protein stained
      by the anti-peptide antibodies was associated with the cytoskeleton; and (b) it
      was not vimentin but a protein of higher molecular weight, 65 KD. We accordingly
      suggest that the Gs alpha-derived peptide elicited two types of antibodies, one
      recognizing Gs alpha in fixed tissues, the other recognizing an epitope located
      in a vimentin-associated protein. This study emphasizes the caution that is
      needed when conclusions are drawn on the basis of immunocytochemical studies
      using antipeptide antibodies.

PMID- 8468453
TI  - A comparison of the detection sensitivity of lymphocyte membrane antigens using
      fluorescein and phosphor immunoconjugates.
AB  - In this study we compared the sensitivity of immunocytochemical procedures, using
      conventional and time-resolved fluorescent dyes, in a model system consisting of
      paraformaldehyde-fixed human lymphocytes. The lymphocytes were stained for the
      presence of the CD4 epitope by indirect immunofluorescence using FITC as label or
      by using time-resolved luminescent immunophosphors. These immunophosphors were
      primarily developed for use under time-resolved fluorescence conditions, but they
      are also very well suited for use in conventional fluorescence microscopes. The
      differently labeled cells were first examined visually with a conventional
      fluorescence microscope in a double-blind study. The fluorescence was also
      measured with a CCD camera mounted on a specially constructed time-resolved
      fluorescence microscope which allows the suppression of the fast decaying
      fluorescence, thereby permitting visualization of the specific, slowing decaying
      luminescence of the phosphor label. With this microscope FITC and immunophosphor
      labeled lymphocytes were compared under normal conditions (i.e., continuous
      excitation) and under conditions of time-resolved registration. Conventional
      fluorescence microscopy revealed a better sensitivity in favor of the phosphor
      conjugates. This difference became more prominent when the preparations were
      quantitatively assessed with the CCD-time-resolved microscope. Time-resolved
      microscopy permitted a suppression of fast decaying fluorescence better than 1 to
      10(6).

PMID- 8468454
TI  - Quantitative immunohistochemical evaluation by image analysis of metallothionein
      in copper-loaded rat kidney.
AB  - Kidneys of copper-loaded rats were investigated immunohistochemically with a
      directly peroxidase-conjugated monoclonal antibody against metallothionein (MT).
      By means of an image analyzing system the area and the staining intensity of MT
      immunoreactivity in the proximal convoluted tubule (PCT) cells were determined.
      In the present study we compared the data obtained by image analysis with
      analytically determined tissue copper and MT concentrations of rats fed a high
      copper diet (1 g/kg) for 16 weeks and sacrificed sequentially during this period.
      Our results provide evidence that the area of MT immunoreactivity correlates
      significantly with tissue copper and MT concentrations. Both the copper and MT
      concentrations in kidney rose to a maximum at 8 weeks and remained constant
      thereafter. The observed rise in the staining intensity of MT in PCT cells to a
      maximum at 6 weeks, which subsequently declined, suggests a continuing
      redistribution of copper and MT in the kidneys even after a maximum of
      concentration copper and MT is reached in the tissue.

PMID- 8468455
TI  - The histochemical profiles of fast fiber types IIB, IID, and IIA in skeletal
      muscles of mouse, rat, and rabbit.
AB  - This study characterized histochemically three fast fiber types (IIB, IID, IIA)
      in skeletal muscles of mouse, rat, and rabbit, with special reference to fiber
      types IIB and IID. The results are complemented by biochemical analyses of myosin
      heavy chain composition in these muscles. Fiber type delineation is based on
      various methods for mATPase staining with pre-incubations and assays under
      different conditions. In rat and mouse, IIB and IID fibers can be best
      distinguished according to their different mATPase stabilities towards
      formaldehyde and alkaline pH. In rabbit, the method of Matoba and Gollnick using
      acid pre-incubation provided best and most reproducible results. In addition to
      their different mATPase stabilities, the three fast fiber types differ with
      regard to their oxidative capacities and cross-sectional fiber areas in the three
      species. In general, Type IIB fibers are the largest and least oxidative, Type
      IIA fibers the smallest and most oxidative, and Type IID fibers intermediate. In
      rabbit, Type IID fibers are the predominant fast fiber population in extensor
      digitorum longus, psoas, and tibialis anterior muscles. As judged from
      histochemistry, these muscles of rabbit do not contain pure Type IIB fibers. This
      is in accordance with biochemical results that show the HCIId to form the
      majority of the myosin heavy chain complement expressed in these muscles. On the
      other hand, IIB fibers are numerous in rabbit adductor magnus, gastrocnemius, and
      vastus lateralis muscles. Similarly, appreciable amounts of myosin heavy chain
      HCIIb are found in the three latter muscles of rabbit.

PMID- 8468456
TI  - Monitoring of two allergens, Bet v I and profilin, in dry and rehydrated birch
      pollen by immunogold electron microscopy and immunoblotting.
AB  - Dry and rehydrated birch pollen grains were anhydrously fixed and double
      immunogold-labeled for the presence of two allergens, Bet v I major allergen (17
      KD) and profilin (14 KD). In dry pollen grains, both allergens are found
      exclusively inside the cytoplasm. In pollen grains rehydrated for 1 min, the
      cytoplasm is partially devoid of the two allergens, whereas the pollen wall and
      the germination aperture are specifically labeled. Pollen grains rehydrated for 5
      min are largely free of the two allergens. In immunoblot experiments, both
      allergens could be detected in the aqueous supernatants of rehydrated pollen
      samples within 5 min. The results obtained by both methods show the high
      solubility of both proteins. This makes them readily available to the immune
      system and characterizes them as potent allergens. Moreover, the solubilization
      of profilin might indicate a dissociation of the profilin-actin complex at the
      very first stage of pollen germination, which could favor formation of the
      cytoskeleton and pollen tube growth.

PMID- 8468457
TI  - Location of a membrane-bound carbonic anhydrase isoenzyme (CA IV) in the human
      male reproductive tract.
AB  - We studied the location of a membrane-bound carbonic anhydrase (CA IV) in the
      human male reproductive tract using a specific antiserum to human CA IV in
      conjunction with immunoblotting, immunoperoxidase, and immunofluorescence
      techniques. The microvilli and apical plasma membrane of the epithelial cells and
      the subepithelial smooth muscle layer of the epididymis, ductus deferens, and
      ampulla of the ductus deferens showed specific staining for CA IV. The epithelial
      cells of the prostate and seminal vesicle failed to stain for CA IV, however,
      whereas the subepithelial smooth muscle layer showed positive staining. No
      specific staining for CA II was seen in the epithelium of the epididymal duct or
      the proximal ductus deferens. The presence of CA IV in the epididymis was
      confirmed by immunoblotting, which revealed 35 KD and 33 KD polypeptides. The
      results show that the microvilli and the apical plasma membrane of the lining
      epithelium of the epididymal duct, ductus deferens, and ampulla of the ductus
      deferens contain the membrane-bound carbonic anhydrase isoenzyme IV. The presence
      of the enzyme in the epithelium of the epididymis and ductus deferens is probably
      linked to the acidification of the epididymal fluid that prevents premature sperm
      activation. Its physiological role in the smooth muscle cells remains to be
      elucidated.

PMID- 8468458
TI  - Immunohistochemical detection of human brown adipose tissue uncoupling protein in
      an autopsy series.
AB  - We used an immunohistochemical method for the inner mitochondrial membrane
      uncoupling protein (UCP) to examine whether human brown adipose tissue UCP could
      be detected by an anti-rat UCP antibody. Samples of human brown adipose tissue
      were obtained at medicolegal autopsies. Fat tissue was excised from around the
      common carotid arteries and in the subscapular region and from around the
      thoracic aorta. The subjects were either known alcohol consumers, in which
      thermogenically active brown adipose tissue (BAT) is often found, or victims of
      sudden infant death syndrome (SID). UCP was detected in all the cases examined,
      even when the post-mortem time from death to autopsy reached several days, but
      the intensity of the immunostaining was variable. Intense staining was observed
      in three cases with a post-mortem time under 24 hr, but in the SID cases a strong
      positive staining was seen even with a post-mortem delay of 4 days. These results
      show that an anti-rat UCP antibody can be used for immunohistochemical detection
      of UCP in human brown adipose tissue and that it provides a useful method for
      distinguishing between white and brown fat in paraffin-embedded samples. It can
      be used to detect UCP in the BAT of obese and diabetic individuals and probably
      also in the histopathological diagnosis of brown adipose tissue lipoma, known as
      hibernoma.

PMID- 8468459
TI  - A simple and reliable method for correlative light and electron microscopic
      studies.
AB  - We describe in detail a simple method for flat-embedding that can be subsequently
      used in correlative light and electron microscopic studies. The method can be
      applied to any material suitable for electron microscopy and is especially useful
      for study of the synaptology and ultrastructural characteristics of
      immunocytochemically or morphologically identified neurons or their processes. We
      present here an example to show how accurately one can delineate the fine details
      of a complex axonal arborization impregnated with the Golgi method in the mouse
      cerebral cortex. Golgi-impregnated sections to be studied at the electron
      microscopic level are osmicated, dehydrated, infiltrated with Araldite resin,
      flat-embedded, and identified cells or processes photographed. Serial semi-thin
      sections (1-2 microns thick) are then cut with an ultramicrotome, examined with
      the light microscope, and the elements rephotographed. Selected semi-thin
      sections are then resectioned on the ultramicrotome at 60-70 nm and examined
      electron microscopically. This method allows the systematic and accurate
      localization of stained cells and processes throughout the successive steps of
      the procedure.

PMID- 8468460
TI  - Effect of transforming growth factor-beta on early and late activation events in
      human T cells.
AB  - Transforming growth factors-beta (TGF-beta) modulate immune responses by
      inhibiting the proliferation of normal T lymphocytes. To examine the mechanism(s)
      of this inhibition, we studied the effect of TGF-beta 1 on selected events
      associated with the initiation and progression of the T lymphocyte cell cycle.
      Human peripheral blood T cells were stimulated with anti-CD3 mAb, PHA, PMA, or
      ionomycin, alone or in combination. TGF-beta 1 (0.5 to 10 ng/ml) partially
      inhibited the tyrosine phosphorylation of a 100-kDa protein, but not the calcium
      influx when cells were stimulated via TCR. Nuclear transcription of early
      activation genes (c-fos, c-jun, and c-myc) as determined by nuclear run-off
      assays, and steady state mRNA levels and/or protein products of intermediate
      activation genes (IL-2, IL-2R alpha, IL-2R beta, and transferrin receptor) were
      not affected by TGF-beta 1. Total cellular RNA synthesis and cell size after T
      cell stimulation were also not affected by TGF-beta 1. However, TGF-beta 1
      inhibited the IL-2-dependent proliferation of Con A lymphoblasts by -50%. This
      inhibition was associated with the down-regulation of IL-2-mediated tyrosine
      phosphorylation of proteins of 120, 100, 85, 75, and 50 kDa. TGF-beta 1 also
      inhibited the IL-2-dependent phosphorylation of the retinoblastoma susceptibility
      gene product, which plays an important role in cell cycle progression. These
      results suggest that TGF-beta 1 inhibits T cell proliferation by down-regulating
      predominantly IL-2-mediated proliferative signals.

PMID- 8468461
TI  - Separation of T helper 1 clone cytolysis from proliferation and lymphokine
      production using analog peptides.
AB  - In this report, we investigate the activation of Th1 clones using altered TCR
      ligand. By changing the immunogenic peptide, cytolytic function can be separated
      from proliferative and lymphokine responses. These three responses were examined
      and dissected in two Th1 clones using analogs of the murine hemoglobin [Hb(64
      76)] peptide. This analysis was focused on amino acids in the immunogenic peptide
      that were possible T cell contact residues. Typically, several amino acids were
      identified as critical contact residues for a Th1 proliferative response. An
      examination of lymphokine production (IFN-gamma or IL-3) revealed the same
      pattern of response to the analog peptides indicating that the proliferative and
      lymphokine responses were directly related. However, for cytolysis, fewer amino
      acid residues were identified as critical contact residues for effector function.
      Thus, some altered peptide ligands allowed the disassociation of the cytolytic
      function from the proliferative and lymphokine responses in Th1 clones. To extend
      these findings, the activation of T cell hybridomas created from the Th1 clones
      were similarly examined using the altered TCR ligands. The lymphokine response
      (IL-2) of the T cell hybridomas identified the same critical amino acids as did
      the cytolytic response of the Th1 clones. Thus, analog peptides partially
      activated the Th1 clones such that cytolysis occurred independent from
      proliferative and lymphokine responses.

PMID- 8468462
TI  - Costimulation of peripheral blood T cell activation by human endothelial cells.
      Enhanced IL-2 transcription correlates with increased c-fos synthesis and
      increased Fos content of AP-1.
AB  - Endothelial cells (EC) act as APC for resting PBL in vitro, and may have
      important roles in vivo in the pathogenesis of allograft rejection and delayed
      hypersensitivity. We previously reported that human umbilical vein EC provide
      costimulatory signals to PHA-stimulated PBL via CD2:lymphocyte function
      associated Ag-3 and an unidentified ligand pair, resulting in a three- to eight
      fold enhancement of IL-2 production. The physiologic relevance of this increase
      was demonstrated by the proliferative advantage provided by EC to PBL
      suboptimally stimulated with mAb OKT3. We now report that EC costimulation causes
      increased levels of IL-2 mRNA as a result of increased IL-2 transcription in PBL.
      We therefore examined the effects of EC on T cell nuclear factors known to
      regulate IL-2 transcription, including c-jun and c-fos-two components of the
      transcription factor AP-1, NFAT, and others. PBL constitutively express c-jun
      transcripts, and the level of c-jun mRNA is not altered by PHA activation in the
      absence or presence of EC. In contrast, c-fos mRNA is absent from resting T cells
      and is induced on PHA activation. EC alone do not induce c-fos mRNA but augment
      the level of c-fos mRNA in PHA-activated T cells by 3- to 10-fold. This effect is
      largely independent of the CD2:lymphocyte function-associated Ag-3 pathway. Gel
      shift analysis reveals the constitutive presence of nuclear factors in resting
      PBL that bind to the proximal AP-1 site of the IL-2 promoter and that contain
      immunoreactive c-Jun but not c-Fos protein. In contrast, AP-1 from PHA-activated
      cells contains c-Jun and low levels of c-Fos. Strikingly, costimulation with EC
      results in a dramatic increase (up to 15-fold) in the c-Fos content of AP-1.
      Levels of other nuclear factors involved in IL-2 regulation were not altered by
      EC, although NFAT-DNA complexes migrated at a slightly different mobility. In
      summary, our data suggest that changes in the composition of transcription factor
      AP-1 is a key molecular mechanism for increasing IL-2 transcription and may
      underlie the phenomenon of costimulation by EC.

PMID- 8468463
TI  - Limited usage of T cell receptor V beta genes by allopeptide-specific T cells.
AB  - T cell reactivity to alloantigens results from direct and indirect recognition of
      allogeneic MHC molecules and/or peptides. Although direct recognition is not self
      MHC restricted, indirect recognition, the result of alloantigen processing and
      presentation by host APC, is restricted by the self (responder) MHC molecule to
      which the allopeptide has bound. We have studied the MHC restriction and TCR
      usage in T cell alloreactivity to a synthetic peptide corresponding to amino acid
      residues 21-42 of the DR beta 1*0101 molecule. T cell lines were developed by in
      vitro immunization of T cells from three responders carrying the DR beta 1*1101
      allele with this peptide. In all three responders, reactivity to peptide 21-42
      was restricted by the DR11 molecule. A limited usage of V beta genes was found in
      these T cell lines, all of which shared the expression of V beta 13.2. Because
      indirect recognition of allopeptide may play an important role in chronic,
      antibody-mediated allograft rejection, study of the TCR gene usage may contribute
      to the development of specific immunosuppression therapy.

PMID- 8468464
TI  - Invariant chain retains MHC class II molecules in the endocytic pathway.
AB  - During exocytosis of MHC class II, the class II alpha beta heterodimer associates
      with a third polypeptide termed invariant chain (Ii). Class II and Ii are
      coordinately processed and transported until proteolytic cleavage of Ii in an
      acidic compartment immediately before class II surface expression. Although the
      lysosomotropic agent chloroquine (CQ) prevents dissociation of class II/Ii within
      the cell, the ultimate fate of these complexes has not been determined. We
      considered two alternative possibilities. If Ii encodes an intracellular
      retention signal, then persistent association of Ii with class II could lead to
      intracellular accumulation of class II/Ii complexes. Alternatively, if Ii does
      not block further transport of class II, then CQ treatment should result in
      aberrant expression of class II/Ii complexes at the cell surface. Ltk- and EL4
      cells transfected with I-A(d) alone or I-A(d) plus Ii were treated with CQ and
      examined for changes in surface class II and Ii expression. Anti-Ii mAb surface
      staining did not increase with prolonged CQ treatment, but a dramatic decrease in
      surface class II staining was observed. This decrease in class II was observed
      both with genomic Ii and p31 cDNA transfectants and was rapidly reversed upon
      drug removal. Accumulation of Ii and class II within treated cells was directly
      observed by intracellular staining. Similar effects on MHC surface expression
      were observed with the lysosomotropic agents primaquine and NH4Cl and the
      cysteine protease inhibitor leupeptin. Ii-negative cells treated in parallel
      displayed no effect of the lysosomotropic agents or leupeptin on class II surface
      staining. These results indicate that dissociation of Ii from newly synthesized
      class II is required for transport of the alpha beta dimer to the cell surface,
      and suggest that Ii serves to retain class II molecules in a post-Golgi endocytic
      compartment.

PMID- 8468465
TI  - Modulation of the intracellular Ca2+ and inositol trisphosphate concentrations in
      murine T lymphocytes by the glycosylphosphatidylinositol-anchored protein sgp-60.
AB  - Stimulation of T lymphocytes via the TCR/CD3 complex initiates a series of
      intracellular biochemical events. Among the earliest cellular responses are the
      stimulation of the turnover of phosphatidylinositol and an increase in the
      intracellular Ca2+ concentration. The significance of these second messengers for
      distal cellular responses such as lymphokine production or cell proliferation is
      not understood. We have previously shown that hamster mAb to the murine
      glycosylphosphatidylinositol-anchored protein sgp-60 can inhibit IL-2 production,
      IL-2R expression, and cell proliferation, events normally observed after
      stimulation of T cells with an antibody to the TCR/CD3 complex or with the lectin
      Con A. We now show that the anti-sgp-60 mAb inhibits the activation-induced
      increase in intracellular Ca2+ concentration. Additional analysis demonstrates
      that the mAb interferes with the release of Ca2+ from intracellular stores and
      with the generation of inositol 1,4,5-trisphosphate. Our findings suggest a role
      for this glycosylphosphatidylinositol-anchored protein in the generation of
      second messengers in signal transduction through the TCR/CD3 complex in murine T
      lymphocytes.

PMID- 8468466
TI  - IL-10 inhibits T cell-independent but not T cell-dependent responses in vitro.
AB  - Lymphokines play a key role in T cell-independent (TI) Ag-induced responses. We
      recently showed that IL-10 potently inhibits Ig production stimulated by TI-2 Ag
      + IL-5. In view of our recent findings that the B cell activator can determine
      the effect lymphokines will have on Ig production and on isotype selection, we
      analyzed the effect of IL-10 on Ig production induced by other TI antigens and T
      cell-dependent Ag. These data demonstrate that IL-10 inhibited IL-5-induced Ig
      production stimulated by TI-1 and by TI-2 Ag, but had no effect on an in vitro T
      cell-dependent Ag-specific anti-SRBC-induced response or on a T cell-induced
      polyclonal response mediated by anti-CD3-activated T cell clones. IL-10 inhibited
      IgM, IgG1, IgG2a, and IgG3 secretion by B cells costimulated by LPS or anti-delta
      dextran. IL-10 did not interfere with induction of class II MHC Ag expression or
      cell enlargement that was stimulated by LPS or anti-delta-dextran and had no
      detrimental effect on cell viability. IL-4 reversed the IL-10-mediated inhibition
      of IgG1 and IgM secretion stimulated by anti-delta-dextran or LPS-activated cells
      in the presence of IL-5. A 72 h, but not 24 h, exposure to IL-4 at initiation of
      culture with anti-delta-dextran + IL-5 + IL-10 was necessary to reverse the IL-10
      mediated inhibition of IgM secretion. Our data suggest that IL-10 can selectively
      inhibit TI Ag-induced responses when other T cell-derived stimulatory lymphokines
      are not present and further emphasize the specific role of the B cell activator
      in influencing the responsiveness of B cells to lymphokines.

PMID- 8468467
TI  - Staphylococcus aureus Wood 46 strain activates human B cells without affecting
      DNA synthesis or tyrosine phosphorylation.
AB  - Induction of Ig secretion in human tonsilar B cell by protein A-deficient
      Staphylococcus aureus WOOD 46 strain (SAW) was examined. SAW induced as much Ig
      secretion as protein A-rich S. aureus Cowan I strain (SAC) when IL-2 was present
      in the culture. Activated and resting B cells are separated by Percoll gradient
      to determine whether SAW stimulates either resting or activated B cells. In
      resting B cells, SAW plus IL-2 induced IgM secretion significantly, but neither
      IL-2 nor SAW alone induced IgM secretion. In activated B cells, however, IL-2
      induced IgM secretion by itself and SAW plus IL-2 did not induce additional IgM
      secretion. These results suggest that SAW activates small resting B cells rather
      than preactivated B cells. Subsequently, mechanisms of B cell activation by SAW
      and SAC were compared. SAW did not induce [3H]-TdR incorporation through day 1 to
      5, and the number of viable cells was not increased by SAW stimulation. Moreover,
      SAW did not induce significant tyrosine phosphorylation at any concentration
      tested, when tyrosine phosphorylation of B cells was examined. However, SAC
      induced both [3H]-TdR incorporation and tyrosine phosphorylation of B cell
      efficiently. In further experiments, induction of IL-2R and IgM mRNA expressions
      were examined. SAW by itself induced IL-2R and IgM mRNA expressions without
      affecting expression of membrane-type IgM mRNA. These results show that SAW
      activates human B cells in quite a different manner from SAC by up-regulating the
      expression of secretory type IgM mRNA without affecting cell proliferation nor
      tyrosine phosphorylation, proposing a distinct B cell activation model from SAC.

PMID- 8468468
TI  - Selective inhibition of T cell activation by an inhibitor of S-adenosyl-L
      homocysteine hydrolase.
AB  - Defects in the enzymes involved in the pathway of S-adenosylmethionine (AdoMet)
      metabolism, or inhibition of those enzymes, results in profound immunodeficiency.
      We have examined MDL 28,842, a novel irreversible inhibitor of S-adenosyl-L
      homocysteine hydrolase (AdoHcyase), an enzyme involved in AdoMet metabolism, to
      determine its effect on the immune system and to investigate its potential as an
      immunosuppressive agent. The stimulation of human mononuclear cell proliferation
      in vitro with Con A, a T cell mitogen, and PWM, a T-dependent B cell mitogen,
      were inhibited by MDL 28,842. The 50% inhibitory concentration for both were 0.33
      microM. In murine spleen cells, MDL 28,842 was a potent, nontoxic, inhibitor of
      Con A-stimulated T cell proliferation (IC50 = 0.19 microM) but did not affect LPS
      induced B cell proliferation. This selective suppression was also observed when
      enriched murine T and B cells were stimulated with mitogens, although S-adenosyl
      L-homocysteine (AdoHcy), the substrate of AdoHcyase, was similarly elevated in
      both populations. In addition to proliferation in response to a number of
      stimuli, IL-2 production and the expression of IL-2R by mitogen-stimulated T
      cells were inhibited by MDL 28,842. These results suggest a direct effect of MDL
      28,842 on T cells. In vivo, the antibody response to a T cell-dependent Ag, OVA,
      was inhibited by MDL 28,842. The response of splenic T cells from these animals
      to OVA in vitro were similarly depressed compared with controls. The results
      demonstrate that MDL 28,842 is a potent nontoxic immunosuppressive agent, which
      has selectivity for T cells and therefore may be useful in the treatment of T
      cell-mediated disorders, such as autoimmune disease and tissue transplantation.

PMID- 8468469
TI  - Inhibition of murine T cell activation by cholera toxin B subunit is not mediated
      through the phosphatidylinositol second messenger system.
AB  - Although cholera toxin B subunit is a potent mucosal immunogen in vivo, its
      predominant effect in vitro is inhibition of T cell and B cell activation. We
      reported earlier that this inhibition was not mediated through activation of
      adenylate cyclase and increases in intracellular cAMP. There is increasing
      evidence that T cell activation is initiated through the phosphatidyl inositol
      second messenger system in which phosphatidyl inositol bisphosphate is hydrolyzed
      by phospholipase C, producing inositol trisphosphate (IP3) and diacylglycerol.
      IP3 increases cytosolic calcium and diacylglycerol binds, translocates, and
      activates protein kinase C (PKC). These signals lead to a complex series of
      events eventuating in activation of a number of genes important in cell
      proliferation. In this study, we asked whether the mechanism of T cell inhibition
      by B subunit of cholera toxin (CT-B) was due to interference with the
      phosphatidyl inositol second messenger system. We found that substitution of
      ionomycin and PMA for IP3 and diacylglycerol, respectively, in culture induced T
      cell proliferation but only if both were present simultaneously. Such
      proliferation was inhibited by CT-B even if added hours after the start of
      culture. An assay for cytosolic PKC activity demonstrated that PMA translocation
      of PKC from cytosol to membrane was not inhibited by CT-B, indicating that CT-B
      does not inhibit activation of PKC. There was no inhibition of Con A-stimulated T
      cell phosphoinositol turnover. Moreover, Con A added to Fura-2 AM-loaded cells
      caused a rapid rise in cytosolic calcium, which CT-B preincubation did not alter.
      These results indicate that CT-B did not inhibit IP3 generation or action. We
      next looked at expression of genes involved in T cell proliferation. CT-B
      inhibited the production of IL-2 by mitogen-activated T cells; Northern analysis
      showed that this inhibition was associated with decreased levels of IL-2 mRNA.
      Expression of IL-2R and of transferrin receptors was only modestly reduced.
      Despite the presence of IL-2R on the T cells exposed to CT-B, the addition of
      exogenous IL-2 to the cultures did not reverse the CT-B-induced T cell
      inhibition. We conclude that the T cell inhibition by CT-B is not mediated by
      interference with the activation of the phosphatidylinositol second messenger
      system but occurs at a later stage of T cell activation.

PMID- 8468470
TI  - A protein of the AP-1 family is a component of nuclear factor of activated T
      cells.
AB  - Nuclear factor of activated T cells (NF-AT) is a transcriptional activator
      involved in the induction of IL-2 gene expression. The response element for NF-AT
      is a sequence localized between -285/-254 in the IL-2 regulatory region. The
      composition of NF-AT protein is still not fully elucidated. We demonstrate that,
      in normal human T cells, an AP-1 protein is a component of the NF-AT protein
      complex. This was evidenced by the ability of the AP-1 site to compete with the
      NF-AT site for binding to NF-AT and by the capacity of immobilized anti-Jun and
      anti-Fos antibodies to deplete NF-AT-binding activity from nuclear extracts of
      activated T cells. There was no detectable binding of in vitro translated Jun/Fos
      heterodimer (AP-1) to the NF-AT sequence, and the NF-AT sequence was unable to
      inhibit the binding of Jun/Fos to the AP-1 sequence. The presence of an AP-1
      protein in the NF-AT protein complex may regulate NF-AT-binding activity through
      protein-protein interaction.

PMID- 8468471
TI  - Genomic composition and allelic polymorphisms influence V beta usage by the
      Mycoplasma arthritidis superantigen.
AB  - The Mycoplasma arthritidis superantigen (MAM) is produced by an organism that
      causes systemic disease in rodents leading to chronic proliferative arthritis.
      MAM is a typical superantigen that requires presentation to T cells by MHC
      molecules without processing and T cell recognition of MAM occurs through the V
      beta chains of the TCR. Several major findings are presented here. First,
      different MAM-MHC class II isotype complexes may engage different sets of V beta
      TCR. Thus, activation of V beta 6- and V beta 8.3-bearing T cells is more
      dependent upon the I-E molecule of the murine H-2 MHC than is activation of cells
      bearing the V beta 5.1, 8.1, and 8.2 TCR. Secondly, both genomic composition and
      allelic polymorphisms at the V beta chain segment of the TCR exert profound
      effects upon the pattern of V beta that are used by MAM. Thus, in V beta b
      haplotype mice, MAM engages V beta 5.1, 6, and the V beta 8 family of TCR whereas
      in V beta a (C57BR) and V beta c (RIIIS) haplotype mice that lack various
      combinations of these V beta, activation of cells bearing V beta 1, 3.1, 7, and
      16 can be demonstrated. These differences in V beta usage by MAM appear to be
      caused by both differences in the avidity of MAM for the various V beta s and to
      structural allelic polymorphisms in these V beta. Clonal expansion of specific V
      beta in vivo after injection of MAM is also dependent upon the genomic
      composition of the mice, because expansion of the V beta 8 TCR seen in V beta b
      haplotype mice (B10.RIII) whereas marked expansion of V beta 6 is seen in V beta
      a mice (C57BR). In as much as these TCR have been implicated in a number of
      experimental autoimmune diseases, MAM may represent an ideal model to evaluate
      the role of superantigens in the triggering of autoimmune disease.

PMID- 8468472
TI  - Regulation of MHC class I and beta 2-microglobulin gene expression in human
      neuronal cells. Factor binding to conserved cis-acting regulatory sequences
      correlates with expression of the genes.
AB  - MHC class I molecules are coexpressed with beta 2-microglobulin (beta 2-M) on
      many somatic cells. However, these proteins are normally not present on cells of
      the central nervous system (CNS). Cells derived from human neuroblastomas were
      used as a model for investigating the molecular basis for the paucity of MHC
      class I and beta 2-M gene expression in neural cells and for the induction of
      these genes by two cytokines, IFN-gamma, and TNF-alpha. These cytokines
      independently increased MHC class I and beta 2-M cell surface expression on the
      neuroblastoma cell lines. IFN-gamma or TNF-alpha also increased MHC class I and
      beta 2-M steady-state RNA levels and the expression of MHC class I and beta 2-M
      CAT reporter constructs transiently transfected into the neuroblastoma cell
      lines, indicating that the cytokines acted by increasing the transcription of
      these genes. MHC class I and beta 2-M genes share two conserved regulatory
      elements, an NF kappa B-like site and the IFN consensus sequence, that act as a
      constitutive enhancer and an IFN-responsive element, respectively. Low MHC class
      I and beta 2-M gene expression in these cells was accounted for by undetectable
      to low factor binding activity specific for the above regulatory elements of
      these genes. TNF-alpha increased factor binding activity specific for the NF
      kappa B-like elements and IFN-gamma increased factor binding activity specific
      for the IFN consensus sequence elements of the MHC class I and beta 2-M genes,
      but not vice versa. Taken together, our results indicated that IFN-gamma and TNF
      alpha increased MHC class I and beta 2-M gene expression in the neuroblastoma
      cell lines by inducing factor binding to the regulatory elements present in both
      genes.

PMID- 8468473
TI  - Endogenous Ig production in mu transgenic mice. I. Allelic exclusion at the level
      of expression.
AB  - Our findings indicate that allelic exclusion is maintained in B cells that
      successfully rearrange and express and endogenous H chain gene, despite carrying
      a functionally rearranged H chain transgene (17.2.25 mu a). Cloned hybridomas
      having a functionally rearranged endogenous H chain gene as well as the transgene
      produce only endogenous gene products. Some of these hybridoma cultures, upon
      continuous growth, will secrete transgene as well as endogenous gene products.
      However, the two H chain polypeptides appear to be made by different cells. In
      each of three cases of such "double producer" lines examined, further subcloning
      at this time reveals two types of clones: those that secrete only transgene and
      those that secrete only endogenous H chains. The clones producing transgene
      product have lost the functionally rearranged endogenous H chain genes, whereas
      the clones producing endogenous gene products still contain both transgene and
      endogenous functionally rearranged H chain genes. These results indicate that
      hybridomas expressing endogenous Ig have transgene copies that are potentially
      functional but are reversibly silenced by an unknown mechanism and suggest that
      inhibition of transgene expression may be mediated by endogenous Ig gene
      expression.

PMID- 8468474
TI  - Endogenous Ig production in mu transgenic mice. II. Anti-Ig reactivity and
      apparent double allotype expression.
AB  - In 17.2.25 mu transgenic mice (M54, M95), many of the expressed Ig, whether
      encoded by the transgene or endogenous H chain genes, react with Ig. IgM
      antibodies encoded by the 17.2.25 mu transgene transfected into J558L myeloma
      cells are also Ig reactive. In addition, anti-Ig reactivity was manifested by
      antibodies of the IgM, IgG, and IgA isotypes from the transgenic mice, suggesting
      that this characteristic reactivity is associated with VH and VL domains of these
      antibodies. These antibodies bind the (Fab')2 fragment of mouse IgG1 mAb known to
      be directed against C mu allotypic determinants. This finding could account for
      the so called "double producer" B cells found in mu transgenic mice and
      previously identified in serologic assays conducted with two different anti-mu
      allotypic reagents. In transgenic mice, a high frequency of the antibodies
      encoded by the transgene or endogenous H chain genes react with polyclonal and
      monoclonal antiidiotypic antibodies raised against the 17.2.25 Id. The idiotypic
      and/or antiidiotypic reactivity displayed by antibodies derived from these
      transgenic mice is similar to that of antibodies expressed by neonatal B cells of
      normal mice. Thus, our data suggest that transgene expression can play an
      important role in shaping the endogenous repertoire of antibody specificities.

PMID- 8468475
TI  - Unexpected effects of the IL-2 receptor alpha subunit on high affinity IL-2
      receptor assembly and function detected with a mutant IL-2 analog.
AB  - Binding of IL-2 to the high affinity IL-2R results in the formation of a stable
      complex consisting of IL-2 and at least three distinct, noncovalently associated
      receptor subunits: IL-2R alpha (p55), IL-2R beta (p70-75), and IL-2R gamma (p64).
      Ligand binding also stimulates the rapid endocytosis of this receptor complex. To
      gain further insight into the function of the various subunits of the
      multicomponent high affinity IL-2R complex, we have carried out binding,
      internalization, and proliferation assays using an IL-2 analog designated F42A
      that contains a single Phe for Ala amino acid substitution at position 42. This
      mutation markedly reduces the intrinsic affinity of the resultant IL-2 analog for
      the low affinity IL-2R alpha subunit although having little or no effect on
      binding to the IL-2R beta (or IL-2R beta/gamma) intermediate affinity receptor.
      We have confirmed that F42A does not bind to the IL-2R alpha chain when expressed
      alone on MT-1 cells or in the presence of the large or small excess of IL-2R beta
      chains present on either YT-1 cells or forskolin-induced YT-1 cells,
      respectively. However, although F42A does not interact with the large number of
      low affinity IL-2R alpha chains present on HUT 102B2 cells, this ligand does bind
      to the small number of IL-2R beta chains present on these cells with at least 10
      fold higher than expected affinity. These findings indicate that excess IL-2R
      alpha chains may exert positive effects on binding perhaps by changing the
      conformation of IL-2R beta. In F42A-stimulated internalization assays on
      forskolin-induced YT-1 cells, the IL-2R alpha chain is consistently endocytosed
      together with the IL-2R beta subunit indicating that IL-2R alpha is stably
      associated with the F42A-IL-2R beta complex even though the alpha-subunit
      contributes little if any affinity to the F42A binding reaction. In proliferation
      assays on mouse IL-3-dependent pro-B BA/F3 cells stably coexpressing transfected
      human IL-2R alpha and IL-2R beta subunits (but a mouse IL-2R gamma subunit), F42A
      proved to be a more effective agonist of growth than wild-type IL-2. These
      results suggest that the interaction between wild-type IL-2 but not F42A and the
      IL-2R alpha subunit in this mixed species high affinity receptor complex may
      induce an unfavorable receptor conformation leading to diminished rather than
      enhanced growth signal transduction.

PMID- 8468476
TI  - Transcriptional analysis of inhibition of lipopolysaccharide response by anti
      IgM.
AB  - Murine splenic B cells, when stimulated with LPS, show a generalized enhancement
      of gene transcription. In addition to this general increase, there is a specific
      increase in microseconds mRNA production and differentiation to high rate IgM
      secretion. Anti-mu added concomitantly with LPS at the start of culture has been
      demonstrated to inhibit the LPS-induced increase in microseconds mRNA production
      without affecting the proliferative capacity of the cells. By "run-on" analysis
      of nascent transcription, we have shown that the effect of anti-mu is mediated by
      the abrogation of the up-regulation of transcription of the mu-gene induced by
      LPS. Furthermore, by assessing the site of transcription termination, it is
      possible to infer that alterations in 3'-end processing induced by LPS are also
      inhibited. We have also found that CAT3 gene activity driven by a number of
      promoter/enhancers with diverse regulatory motifs are inhibited by anti-mu. These
      results suggest that the effect of anti-mu cannot be restricted to interactions
      with a single regulatory element. Therefore, cross-linking of surface IgM may
      affect a number of genes involved in differentiation to Ig secretion.

PMID- 8468477
TI  - Characterization of the alpha subunit of the IFN-alpha receptor. Evidence of N-
      and O-linked glycosylation and association with other surface proteins.
AB  - We studied the association of the alpha subunit of the (IFN-alpha-receptor) to
      other receptor components in the human H-929 and U-266 myeloma cell lines.
      Immunoprecipitation performed with the IFNaR3 mAb showed that two proteins with
      molecular masses of 205 and 145 kDa are co-precipitated with the alpha subunit.
      These complexes may not bind IFN-alpha as shown by studies using the
      heterobifunctional cross-linking reagent Denny-Jaffe and by partial cleavage of
      the homobifunctional cross-linker dithio succinimidyl propionate. These studies
      also provided evidence that at least two subunits with molecular mass of 130 kDa
      (alpha subunit) and 110 kDa (including 20 kDa corresponding to IFN-alpha)
      contribute to the formation of the IFN-alpha-receptor complex. To further
      characterize the alpha subunit of the IFN-alpha-receptor, immunoprecipitates
      using the mAb IFNaR3 were sequentially treated with N-glycanase, neuraminidase
      and O-glycanase. These studies showed that the alpha subunit is heavily
      glycosylated and has a protein precursor with a molecular mass of 68 kDa. Binding
      studies provided evidence for high and low affinity binding sites for IFN-alpha
      2. Affinity cross-linking experiments under low and high affinity conditions
      suggest that the high affinity binding site of the IFN-alpha-receptor is formed
      by a complex containing the alpha subunit, whereas the 110-kDa subunit may bind
      IFN-alpha 2 under low affinity conditions.

PMID- 8468478
TI  - Mice treated with a leumedin or antibody to Mac-1 to inhibit leukocyte
      sequestration survive endotoxin challenge.
AB  - Endotoxin challenge causes metabolic dysfunction mediated by TNF, and
      sequestration of leukocytes. NPC 15669, N-carboxy-L-leucine, N-[2,7
      dimethylfluoren-9-yl)methyl] ester, inhibits leukocyte recruitment into
      inflammatory lesions in animals, and inhibits endotoxin-induced neutropenia and
      lymphopenia in mice. This study was carried out to determine whether the ability
      of NPC 15669 to inhibit leukocyte sequestration is sufficient to promote survival
      after endotoxin challenge. To inhibit leukocyte sequestration directly, mice were
      treated with anti-CD11a (LFA-1) or anti-CD11b (Mac-1) before endotoxin challenge.
      Anti-CD11b partly inhibited neutropenia and lymphopenia in response to challenge
      with LPS, but anti--CD11a had little effect on leukopenia. At doses of 100 and
      1000 micrograms/kg, anti-CD11b increased survival to endotoxin challenge from 0
      to 20 and 40%, respectively, whereas anti-CD11a was without effect. These
      observations, coupled with the finding that NPC 15669 does not inhibit endotoxin
      induced TNF release suggest that inhibition of leukocyte sequestration can
      increase survival after endotoxin challenge, and that NPC 15669 or antibodies to
      Mac-1 may represent effective therapies for gram-negative sepsis and shock.

PMID- 8468479
TI  - Effects of cytokines on multiplication of Toxoplasma gondii in microglial cells.
AB  - Microglia may play a role in host defense against Toxoplasma gondii in the
      central nervous system. In our study, the antitoxoplasma activity of murine
      microglia was investigated. T. gondii multiplied readily in cultured microglial
      cells, and activation of these cells with IFN-gamma plus LPS suppressed (p <
      0.01) intracellular growth of this parasite. This antitoxoplasma defense of
      activated microglia was significantly blocked by neutralizing antibodies against
      TNF-alpha and transforming growth factor-beta, suggesting that these cytokines
      play a role in the inhibitory process. Consistent with this hypothesis,
      activation of microglia with IFN-gamma plus TNF-alpha or transforming growth
      factor-beta inhibited, in a dose-dependent manner, T. gondii multiplication.
      Treatment with pentoxifylline or dexamethasone, drugs that suppress production of
      TNF-alpha, prevented (p < 0.01) the microglia from exerting an anti-T. gondii
      effect. These findings suggest that the host defense function of microglia
      against T. gondii is dependent primarily on the activating properties of IFN
      gamma and TNF-alpha, and that agents that interfere with cytokine-mediated
      activation may promote the pathogenesis of this infection.

PMID- 8468480
TI  - Different appearance of gamma delta T cells during salmonellosis between Ityr and
      Itys mice.
AB  - Ity gene, which is believed to be a single gene on proximal mouse chromosome 1,
      determines susceptibility to Salmonella infection. We have recently demonstrated
      that the gamma delta T cells specific for purified protein derivative appear at
      the early stage after infection with Salmonella choleraesuis strain 31N-1
      (avirulent strain) in mice. In the present study, we compared the appearance of
      the gamma delta T cells in Ityr and Itys mice after infection with S.
      choleraesuis in an attempt to elucidate the role of the gamma delta T cells in
      the in vivo effect of the Ity locus on murine salmonellosis. The numbers of gamma
      delta T cells in the peritoneal cavity and liver were significantly larger in
      DBA/2 (Ityr) mice than those in BALB/c (Itys) mice after infection with a
      sublethal dose of S. choleraesuis. C.D2 Ityr mice, which are BALB/c mice with
      Ityr allele, also showed a significant increase in the number of the gamma delta
      T cells at the early stage after infection. Similar results in different
      appearances of the gamma delta T cells could be obtained between BALB/c and DBA/2
      mice after infection with Mycobacterium bovis, bacillus Calmette-Guerin. The
      peritoneal adherent cells of DBA/2 mice infected with S. choleraesuis, which
      expressed a large amount of heat shock/stress protein (hsp) homologous to the
      mycobacterial 65-kDa hsp, induced significantly higher level of expansion of the
      peritoneal gamma delta T cells in normal mice in vivo and in vitro than did those
      of BALB/c mice infected with S. choleraesuis, which expressed a lesser amount of
      the hsp. These results suggest that the Ity locus may be closely related to the
      expression of hsp by macrophages after infection with Salmonella, which in turn
      stimulate the gamma delta T cells in the host during an early phase of
      salmonellosis.

PMID- 8468481
TI  - A primary intestinal helminthic infection rapidly induces a gut-associated
      elevation of Th2-associated cytokines and IL-3.
AB  - The immune response that is characteristic of parasitic helminth infections
      includes components associated with immediate-type hypersensitivity: elevated
      serum IgE, eosinophilia, and intestinal mast cell hyperplasia. In infection with
      the parasitic nematode, Heligmosomoides polygyrus, IL-4 mediates protective
      immunity, suggesting the presence of a host-protective Th2 response. In this
      investigation, we examined early stages of immune responsiveness to H. polygyrus
      infection to determine whether and at what stage a specific Th2-like pattern
      first appears. Using a quantitative reverse transcriptase-polymerase chain
      reaction assay, we analyzed changes in IL-2, IFN-gamma, IL-3, IL-4, IL-5, IL-6,
      IL-9, and IL-10 gene expression in the spleen, mesenteric lymph node, and Peyer's
      patch at various time points after infection. Our results demonstrate a highly
      specific and reproducible pattern of cytokine gene expression that remains
      localized to the enteric region. By 6 h after infection, IL-5 and IL-9 mRNA were
      elevated in the Peyer's patch and IL-3 was elevated by 12 to 24 h after
      infection. IL-4 RNA became elevated by 4 to 6 days after infection, but little
      change was observed in IFN-gamma, IL-2, or IL-10 mRNA levels. The early increases
      in IL-3, IL-5, and IL-9 gene expression after infection were probably T cell
      independent, inasmuch as they were observed in Peyer's patches of congenitally
      athymic mice and anti-CD4, anti-CD8 mAb-treated conventional mice. However,
      treatment with these mAb considerably decreased cytokine gene expression 6 days
      after infection, and 8 days after infection, increased IL-4 gene expression in
      mesenteric lymph node cells was restricted to the CD4+ population. Thus, H.
      polygyrus infection induces cytokine gene expression that is restricted to some
      Th2-associated cytokines, is initiated by a T-independent response, and
      culminates in a T-dependent response.

PMID- 8468483
TI  - Expression of the leukocyte common antigen CD45 by endothelium.
AB  - The CD45 family of Ag expressed by leukocytes play a key role in lymphocyte
      activation. In this study, we identify both a restricted pattern of expression of
      CD45 Ag by human endothelial cells and differences in m.w. of endothelial CD45
      compared with lymphocyte CD45. Initially, immunoperoxidase staining of
      endothelial cells in culture revealed the presence of the CD45RO isoform provided
      the endothelial cells had been stimulated by IL-1 for several days. No other
      isoform of CD45 was detected by immunoperoxidase staining of endothelium.
      Leukocyte common antibodies, reputed to detect all isoforms of CD45, did not
      detect endothelial CD45RO. A polymerase chain reaction method was then used to
      demonstrate that the message for the CD45RO isoform was constitutively present,
      with increased levels after IL-1 stimulation. Western blot confirmed the presence
      of the RO isoform. No other CD45 isoform was detected, either by PCR
      amplification for message or by Western blot. There were clear differences
      between lymphocyte and endothelial CD45. The RO isoform expressed by endothelium
      has an estimated M(r) of 235,000 in contrast to lymphocyte RO that, on our gels,
      has an estimated M(r) of 190,000. Given the large surface area of endothelium
      (approximately 1 km2 in the human), the close apposition of lymphocytes and
      endothelium in immunologic tissues such as lymph nodes, and the pivotal role CD45
      plays in activation, expression of CD45RO by endothelium may have important
      implications in lymphocyte-endothelial interactions. This is most likely to occur
      in endothelium after a few days of IL-1 stimulation, e.g., at sites of chronic
      inflammation, or in the draining lymph node of an inflammatory focus.

PMID- 8468482
TI  - Integrin alpha E beta 7 mediates adhesion of T lymphocytes to epithelial cells.
AB  - Intestinal intraepithelial lymphocytes (iIEL) are a distinct subpopulation of T
      lymphocytes diffusely distributed in the epithelium. Because > 95% of these iIEL
      express the integrin alpha E beta 7, we reasoned that this integrin might mediate
      the localization of iIEL to the epithelium. We report that cultured iIEL bound to
      mucosal epithelial cells derived from either breast or intestine. This binding
      was dependent on the presence of divalent cations, and was blocked by mAb
      specific for two integrins, alpha E beta 7 and alpha L beta 2. After TGF-beta 1
      treatment, cultured iIEL cell lines expressed alpha E beta 7 at levels similar to
      those found on iIEL in vivo. Under these conditions this integrin appeared to
      predominate in mediating the adhesion of iIEL to epithelial cells. Although alpha
      L beta 2 blocked the adhesion of iIEL to both endothelial and epithelial cells,
      alpha E beta 7 blocked binding only to epithelial cells suggesting that the
      ligand for alpha E beta 7 is not expressed on IL-1 beta-treated cultured
      endothelial cells. iIEL did not readily bind to the apical surface of confluent
      polarized epithelial cell monolayers. However, iIEL did bind to these cells when
      tight junctions were disrupted, a treatment that allows redistribution of
      proteins compartmentalized to the basolateral surface. This binding was also
      blocked by mAb to alpha E beta 7. In addition, in vitro coculture of iIEL with
      polarized epithelial cells resulted in basolateral localization of the iIEL.
      Thus, it is likely that expression of the alpha E beta 7 ligand is restricted to
      the basolateral membrane of polarized epithelial cells. Because alpha E beta 7
      appears to be a predominant integrin on freshly isolated iIEL, we hypothesized
      that alpha E beta 7-mediated adhesion may be particularly important in cell-to
      cell interactions between T cells and epithelial cells in vivo.

PMID- 8468484
TI  - Enhancement of antigen-induced bronchoconstriction after intravascular complement
      activation with cobra venom factor. Reversal by granulocyte depletion.
AB  - Our previous studies have demonstrated that activation of the C system with cobra
      venom factor (CVF) in a passively sensitized guinea pig results in an enhanced
      bronchoconstrictor response to Ag but not to other constrictor agents. Thus, our
      immediate goal was to determine the mechanism of the CVF-induced enhancement of
      the Ag-induced bronchoconstriction. Isolated airways from sensitized guinea pigs
      that had been treated with CVF responded normally to Ag. Because such a system
      lacks the normal circulating cell populations, we hypothesized that the CVF
      induced enhancement of the Ag-induced bronchoconstriction was dependent on the
      presence of circulating white blood cells or platelets. Guinea pigs were depleted
      of circulating granulocytes, platelets, or both using specific antisera and the
      effect on the CVF-induced enhancement of the Ag-induced bronchoconstriction was
      determined. We found that CVF treatment did not result in an enhanced Ag-induced
      bronchoconstriction in guinea pigs depleted of either granulocytes or both
      granulocytes and platelets. However, the enhanced response was still apparent in
      guinea pigs depleted of just platelets. We investigated the effects of CVF itself
      and found that CVF treatment did not alter the number, or percentages, of
      different cell populations in the bronchoalveolar lavage, did not alter the
      protein or albumin content of the lavage fluid or the wet:dry ratio of the lung.
      In addition, CVF did not cause an increase in airway microvascular permeability
      as assessed by leakage of Evans blue. However, CVF did substantially increase
      granulocytes sequestered in the lung as measured by increased myeloperoxidase
      content. Thus, C activation by CVF results in an increase in neutrophils in the
      lung and an enhanced Ag-induced bronchoconstriction dependent on the presence of
      circulating granulocytes. These studies suggest that C activation and/or
      retention of granulocytes in the lung may be important in determining the
      severity of an Ag-induced bronchoconstriction.

PMID- 8468485
TI  - Cytokines and dexamethasone modulation of IL-1 receptors on human neutrophils in
      vitro.
AB  - Modulation of IL-1R on human neutrophils was investigated after in vitro
      treatment of cells with human recombinant (hr) granulocyte (G)-CSF, hrgranulocyte
      macrophage (GM)-CSF, hrCSF-1, hrIL-1 alpha, hrIL-2, hrIL-3, hrIL-4, hrIL-5, hrIL
      6, hrIL-7, transforming growth factor-beta 1, or hrTNF-alpha. At 4 degrees C,
      125I-IL-1 binding was competed by IL-1 but not by other cytokines tested. At 37
      degrees C, GM-CSF, TNF-alpha, and IL-1 decreased 125I-IL-1 binding in a dose
      dependent manner. Kinetic studies showed that GM-CSF reduced > 45% IL-1 binding
      within 15 min but later (8 h) produced a > 2-fold increase. In contrast, TNF
      decreased > 85% IL-1 binding within 15 min with a recovery of > 80% relative to
      that of control after 24 h. Scatchard analysis revealed that TNF or GM-CSF down
      modulation of IL-1 binding was due to a decrease of IL-1R number. Further studies
      showed that dexamethasone and GM-CSF (or G-CSF) synergistically increased IL-1
      binding after 8 h. This synergistic modulation was a cytokine dose- and time
      dependent process, and was due to an increase in IL-1R numbers rather than a
      change in binding affinity. In addition, human bone marrow neutrophils, cord
      blood neutrophils, and several human hematopoietic cell lines (HL-60, U-937, and
      AML-193) responded to dexamethasone and GM-CSF (or G-CSF) with a superadditive
      increase in IL-1 binding. Because mammalian systems respond to bacterial
      endotoxins with secretion of TNF, IL-1, glucocorticoids, G-CSF and GM-CSF, our
      results shed additional light on this highly regulated cytokine network and
      revealed a novel role for GM-CSF.

PMID- 8468486
TI  - Effect of docosahexaenoic acid on the generation of platelet-activating factor by
      eosinophilic leukemia cells, Eol-1.
AB  - Human eosinophilic leukemia (Eol-1) cells were examined for their ability to
      generate platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3
      phosphocholine) (PAF) and the effect of supplementation of docosa-hexaenoic acid
      (C22:6n-3) (DHA) on the PAF synthesis was explored in relation to the fatty acid
      composition of phospholipids and the liberation of arachidonic acid (C20:4n-6
      AA). Although undifferentiated cells did not produce PAF, the exposure of IFN
      gamma differentiated Eol-1 to generate PAF in response to the Ca-ionophore. In
      addition, the IFN-gamma-treated cells acquired the ability to release free fatty
      acids, approximately 55% of which was found to be AA. When DHA was supplemented
      into the culture of Eol-1 for 24 h, PAF production decreased by 40 to 50% at
      concentrations of 3 to 10 microM. On the other hand, supplementation of 10 microM
      eicosapentaenoic acid (C20:5n-3) did not significantly decrease PAF production.
      With the supplementation of 10 microM DHA, DHA levels in phospholipid subclasses,
      including alkylacylglycerophosphocholine, were greatly increased with concurrent
      decreases in other unsaturated fatty acids. In these cells, the liberation of AA
      in response to an ionophore was decreased by 55%. Even when DHA was enriched in
      phospholipids, DHA release in response to ionophore stimulation was almost
      negligible, indicating that the DHA moiety of phospholipids is not susceptible to
      the action of phospholipase A2. Furthermore, DHA supplementation appeared to
      attenuate phospholipase A2 reaction by some unknown mechanism because the
      decrease in AA release was much more than that for the AA level in phospholipids.
      Acetyl-CoA:1-alkylGPC acetyltransferase activity of stimulated cell lysate was
      also reduced by DHA supplementation but the reduction was much less when compared
      with that of PAF synthesis or AA release. These results implicated that
      enrichment of DHA attenuates enzymic reactions for PAF synthesis, mainly the
      initial reaction catalyzed by AA-specific phospholipase, and thereby reduces PAF
      synthesis in Eol-1.

PMID- 8468487
TI  - Agonist-dependent phosphorylation of N-formylpeptide and activation peptide from
      the fifth component of C (C5a) chemoattractant receptors in differentiated HL60
      cells.
AB  - Attenuation of signaling is a key step in controlling the cytotoxic potential of
      leukocyte responses to chemotactic factors. Antipeptide antibodies, directed
      against the N-formyl chemotactic peptide receptor (FPR) and the activation
      peptide from the fifth component of C (C5a) anaphylatoxin receptor (C5aR) of
      human neutrophils, were used to analyze the ability of these receptors to be
      phosphorylated. Our data show that, in granulocyte-like differentiated HL-60
      cells, both FPR and C5aR undergo an agonist dose-dependent phosphorylation that
      reaches completion in less than 2 to 3 min, consistent with the rate and the dose
      dependent attenuation of signaling in phagocytes. Therefore, phosphorylation
      might be one of the possible mechanisms involved in the desensitization process
      of FPR and C5aR. Addition of either C5a or the protein kinase C activator (PMA)
      did not appear to induce the phosphorylation of FPR in the absence of FMLP or to
      modulate the phosphorylation of the latter at low concentrations of agonist. In
      contrast, although FMLP at a saturating concentration barely stimulated the
      phosphorylation of unoccupied C5aR, it markedly potentiated C5aR phosphorylation
      in cells exposed to low concentrations of C5a. Moreover, PMA was able to induce
      C5aR phosphorylation in the absence of agonist, indicating that protein kinase C
      or protein kinase C-activated kinase(s) could be involved in the phosphorylation
      of C5aR. Pretreatment of cells with staurosporine, a potent but nonspecific
      inhibitor of protein kinase C, resulted in the partial inhibition of both FPR and
      C5aR phosphorylation induced by saturating concentrations of agonist, suggesting
      that a kinase different from protein kinase C might be mainly responsible for the
      phosphorylation of these chemotactic receptors.

PMID- 8468488
TI  - Effects of exogenous eicosapentaenoic acid on generation of leukotriene C4 and
      leukotriene C5 by calcium ionophore-activated human eosinophils in vitro.
AB  - Exogenous eicosapentaenoic acid (EPA) has been compared with exogenous
      arachidonic acid (AA) for its ability to modulate the oxidative metabolism of
      membrane-derived arachidonic acid by the 5-lipoxygenase pathway in ionophore
      activated human eosinophils, and for its suitability as a parallel substrate in
      this pathway. Products were quantitated by specific RIA and tetraene and pentaene
      leukotrienes (LT) were separated by reverse-phase HPLC. Eosinophils were
      preincubated with control buffer, exogenous EPA or AA and stimulated optimally
      with 10 microM calcium ionophore (A23187) for 15 min. Mean generation of LTC4 in
      the absence of fatty acid was 6.0 = 1.1 ng/10(6) eosinophils (mean = SEM, n = 5).
      In the presence of EPA, the amount of LTC4 generated rose to peak at 16.5 +/- 1.9
      ng/10(6) eosinophils at 10 micrograms/ml EPA and then fell to 8.3 +/- 3.1
      ng/10(6) cells at 40 micrograms/ml EPA. The EPA derivative, LTC5 was first
      detectable at 5 micrograms/ml EPA with 4.8 +/- 1.2 ng/10(6) cells and gradually
      rose with increasing dose of EPA to be maximal at 40 micrograms/ml with 12.7 +/-
      2.2 ng/10(6) cells. Identity of the LTC5 was confirmed by an identical retention
      time to synthetic LTC5 standard, immunoreactivity to a specific antibody against
      LTC4 and LTC5 and a typical UV absorbance spectrum. When eosinophils were
      preincubated with AA and similarly stimulated, LTC4 generation gradually
      increased from a baseline of 6.7 +/- 0.7 ng/10(6) cells in the absence of fatty
      acid to reach a maximum of 12.9 +/- 0.8 ng/10(6) cells at 40 micrograms/ml of AA.
      Total LTC generation was nearly twofold more with cells incubated with EPA than
      with cells incubated with AA (p < 0.05). Thus, EPA does not suppress LTC
      generation from eosinophils but stimulates it at lower doses and is a substrate
      for LTC5 generation.

PMID- 8468489
TI  - Transforming growth factor-beta mediates IL-1-dependent induction of IL-1
      receptor antagonist.
AB  - Transforming growth factor-beta (TGF-beta) is a potent immunomodulatory molecule
      that promotes inflammation through recruitment of monocytes and induction of IL-1
      and other cytokines. These proinflammatory processes may be modulated by the
      ability of TGF-beta to induce de novo synthesis and secretion of an IL-1 receptor
      antagonist (IL-1ra) that binds to and blocks IL-1 receptors. In this study, we
      show that the addition of TGF-beta to human peripheral blood monocytes induced
      the sequential transcription of the 1.8-kb mRNA for IL-1 beta and for IL-1ra. The
      expression of detectable mRNA and synthesis of IL-1 beta peptide routinely
      preceded that for IL-1ra, suggesting possible dependency of IL-1ra generation on
      IL-1 beta. Antibody to IL-1 blocked TGF-beta induction of IL-1ra mRNA expression
      demonstrating an unique IL-1-dependent induction of its own antagonist.
      Confirmatory evidence that IL-1 participates in the generation of IL-1ra was
      obtained when exogenously added IL-1 induced and, IL-1 receptor antagonist
      blocked, IL-1ra transcription. Thus, these data suggest that TGF-beta, after
      release at a site of inflammation, induces synthesis of IL-1 that participates in
      the initial cytokine cascade central to an inflammatory response, and then
      triggers the generation of its own natural inhibitor by autocrine or paracrine
      pathways. This TGF-beta-induced IL-1-dependent induction of IL-1ra may provide a
      negative feedback loop, thereby promoting the resolution of an inflammatory
      response.

PMID- 8468490
TI  - Monoclonal Ig L chain and L chain V domain fragment crystallization in myeloma
      associated Fanconi's syndrome.
AB  - Monoclonal free L chains secreted in immunoproliferative disorders are frequently
      involved in renal complications, including a specific proximal tubule impairment,
      the Fanconi's syndrome, which is generally featured by intracellular
      crystallization of L chain-related material. In a patient with myeloma-associated
      Fanconi's syndrome, hexagonal crystals (most surrounded by smooth membranes) were
      found in kidney proximal tubular cells and bone marrow plasma cells and
      phagocytes. The sequence of the patient's monoclonal kappa-chain was deduced from
      that of identical kappa-cDNA clones from the tumoral plasma cells. Small protein
      enriched gel filtration fractions from urine yielded crystals morphologically
      similar and with the same 60 A periodicity on electron micrographs as those found
      in the cells. N-terminal sequencing and mass spectrometry studies showed that the
      crystals contained a 107-amino acid fragment (with a C-terminal lysine)
      corresponding to the V domain together with a low proportion of the entire kappa
      chain. In vitro trypsin and pepsin treatment of the native entire kappa-chain
      yielded a homogeneous V domain fragment which, contrary to other monoclonal kappa
      chains, was completely resistant to further proteolytic attack. The patient's
      kappa-chain also displayed an unusual self-reactivity, as demonstrated by a
      Western blot technique. The peculiar proneness of the V domain to resist
      proteolysis and to form crystals might prevent the normal cell catabolism of the
      L chain and lead to crystallization and renal impairment.

PMID- 8468491
TI  - Comparison of HLA class II genes in Caucasoid, Chinese, and Japanese patients
      with primary Sjogren's syndrome.
AB  - To better define the genetic factors that predispose to primary Sjogren's
      syndrome (SS), we have used polymerase chain reaction in combination with
      oligonucleotide probe hybridization and DNA sequencing to analyze HLA-DRB1, 
      DQA1, -DQB1, and -DPB1 alleles in Caucasoid (California), Japanese (Tokyo), and
      Chinese (Shanghai and Beijing) SS patients. In comparison to local controls in
      each region, we found: 1) increased frequency of the predicted haplotype HLA
      DRB1*0301-DRB3*0101-DQA1*0501-DQB1*0201 in Caucasoid patients (p < 0.001); 2)
      increased frequency of the predicted haplotype HLA-DRB1*0405-DRB4*0101-DQA1*0301
      DQB1*0401 in Japanese patients (p < 0.05); 3) increased frequency of the
      predicted haplotype DRB1*0803-DQA1*0103-DQB1*0601 in Chinese patients (p < 0.05);
      and 4) no statistically significant association with DPB1 alleles in any group,
      although an increased number of Caucasoid and Japanese SS patients possessed
      DPB1*0301. Comparison of DNA sequences for the three disease-associated
      haplotypes in these ethnic groups revealed a shared region of predicted amino
      acids from positions 58 to 69 in the first domain of HLA-DQB1. These results
      extend previous studies by demonstrating that no single class II allele was
      associated with 1 degree SS in the different ethnic groups. However, a shared
      amino acid motif in the DQB1 first domain was present in each disease-associated
      haplotype.

PMID- 8468492
TI  - Engraftment and activity of anti-CD3-activated human peripheral blood lymphocytes
      transferred into mice with severe combined immune deficiency.
AB  - Human PBL (huPBL) were activated with anti-CD3 mAb in vitro and then were
      transferred into mice with severe combined immune deficiency (SCID) to determine
      the effect of activation on engraftment and to determine if the engrafted human
      cells could provide antitumor effects in mice. Some mice were also treated with
      human rIL-2 after huPBL transfer. Mice were analyzed 6 to 8 wk after cell
      transfer and the number of human cells in the peripheral lymphoid organs was
      determined. Mice receiving anti-CD3-activated huPBL demonstrated a significant
      increase in the incidence of human T cell engraftment in the periphery as
      assessed by flow cytometry. Human cells were also detected in the murine thymus
      after anti-CD3 stimulation indicating that human T cells can migrate to the
      murine thymus provided that they are activated before the transfer. The transfer
      of anti-CD3-activated huPBL also resulted in an xenogeneic graft-vs-host reaction
      manifested primarily by proliferation of murine splenic hemopoietic cells. When
      SCID mice received the human colon carcinoma HT29, the concurrent transfer of
      anti-CD3-activated human cells resulted in a significant increase in survival.
      However, the human cells displayed low cytolytic activity toward human tumor
      targets when they were recovered from the lymphoid organs of the SCID recipients.
      Supernatants from the anti-CD3-activated cells were able to inhibit the growth of
      HT29 in vitro, partly because of the presence of IFN-gamma, suggesting that the
      human T cells are producing cytokines in vivo that have antitumor effects. Thus,
      the use of anti-CD3-activated huPBL in SCID mice may be of value for optimizing
      human cell engraftment in the human/mouse lymphoid chimeras and may be used to
      evaluate potential anti-neoplastic therapies that employ human effector cells.

PMID- 8468493
TI  - Serum-IgE-facilitated allergen presentation in atopic disease.
AB  - The occurrence of facilitated Ag presentation (FAP) was investigated in atopic
      disease using an in vitro model in which the ability of CD23-expressing EBV-B
      cells was tested to present Der p II, a major allergen of housedust mite
      Dermatophagoides pteronyssinus, to cells of autologous Der p II-specific CD4+ T
      lymphocyte clones. Purified Der p II protein was immune complexed with Ig by
      preincubation in sera from atopic patients containing Der p II-specific IgE.
      Incubation of EBV-B cells with these complexes before using the cells as APC
      results in proliferation of the Der p II-specific T cells at a 1000-fold lower
      Der p II concentration than required for T cell activation by presentation of
      uncomplexed Der p II. FAP is not evident using sera from allergic and nonallergic
      control donors not containing Der p II-specific IgE. FAP is mediated by IgE and
      not by IgG, because it can be blocked completely by preincubating the serum from
      atopics with polyclonal anti-IgE and not with polyclonal anti-IgG. After pulsing
      EBV-B with precomplexed Der p II at 4 degrees C, FAP is as strong as after
      incubation at 37 degrees C, suggesting that FAP is the result of facilitated
      trapping of IgE-complexed allergen. CD23 was involved in facilitated trapping of
      the complexes, because FAP is blocked by preincubation of EBV-B with anti-CD23.
      In contrast to FAP of Der p II, which was mediated by all Der p II-specific sera
      tested, only one of four sera containing cat allergen-specific IgE was
      appropriate to mediate FAP to cat allergen-specific T cell clones. Inasmuch as
      FAP enables functional presentation of allergen in vivo at doses as low as
      several nanograms, FAP may contribute to the continuing of chronic allergic
      reactions in response to minute doses of aeroallergens, especially housedust mite
      allergens, in the environment.

PMID- 8468494
TI  - [Treatment of experimental invasive pulmonary aspergillosis in rats with
      liposomal amphotericin B].
AB  - Liposomal amphotericin B was evaluated for toxicity, pharmacokinetic properties
      and therapeutic efficacy in invasive pulmonary aspergillosis in Sprague-Dawley
      rats. The protective effect of liposomes against the toxicity induced by repeated
      amphotericin B infusions was observed in a survival study of rats, thereby
      allowing higher dosages to be administered. Pharmacokinetic studies showed that
      liposomes led to high levels of amphotericin B in the spleen and liver. Drug
      levels in the lung were higher at ten minutes after intravenous injection of
      liposomal amphotericin B at 20 mg/kg than of free amphotericin B at 1.5 mg/kg.
      Efficacy was assessed in rats treated with cortisone acetate, fed a low-protein
      diet and infected transtracheally with 8 x 10(4) Aspergillus fumigatus spores to
      cause fetal pneumonia and pulmonary bleeding. Dosages of 20 or 4 mg/kg of
      liposomal amphotericin B, or 1.5 mg/kg of free amphotericin B were administered
      intravenously to rats once daily for 8 days. Control rats received saline. Twenty
      mg/kg of liposomal amphotericin B was as effective on survival rate as 1.5 mg/kg
      of free amphotericin B. However, 4 mg/kg of liposomal amphotericin B was less
      effective than 1.5 mg/kg of free amphotericin B, prolonging the mean survival
      time of rats treated with saline, which showed elevation of galactomannan antigen
      titers of Aspergillus fumigatus in sera and invasive proliferation or mycelia
      with bleeding in histopathological sections of the lung. We conclude that
      liposomal amphotericin B reduces toxicity of the drug, thereby increasing the
      concentration of the drug in the lung by high-dose administration, but decreases
      the efficacy of the drug in experimental pulmonary aspergillosis.

PMID- 8468495
TI  - [Sporadic case of hemolytic uremic syndrome associated with verotoxin producing
      Escherichia coli O2:K1:H7].
AB  - Cases of enterohaemorrhagic Escherichia coli (EHEC) are being increasingly
      reported in Japan. Bacteriological isolation of EHEC has been a constant problem
      because the organism is shed for a short duration after onset on illness and
      generally during the prodromal stages. In order to ease the diagnosis of EHEC
      infections in this country, we have developed a LPS-based solid phase enzyme
      linked immunosorbent assay for serological diagnosis of the infection. Adequate
      knowledge on the prevalence of EHEC serogroups in Japan is mandatory for the
      success of such a diagnostic test. O157 is currently the prominent serogroup
      associated with EHEC infections in Japan followed by O111, O26 and O128 in that
      order of prevalence. In February 1992, a 1 year-old infant developed hemolytic
      uremic syndrome (HUS) 15 days later the prodrome of watery diarrhoea. Stool
      sample obtained on day 15 was cultured for detection of EHEC. Ten colonies of E.
      coli picked from MacConkey agar plate were examined by the polymerase chain
      reaction (PCR) using primers specific for both verotoxins (VT1 and VT2). Of the
      10 colonies, only one was positive for the VT2 gene. The strain was confirmed to
      be cytotoxic on cultured Vero cells. The strain agglutinated with antisera of E.
      coli O2, K1 and with H7 serogroups. As of date, none of such strains of O2:K1:H7
      EHEC has been reported in Japan. The patient's sera was found to be positive for
      antibodies against LPS from the homologous isolate as well as against VT2. The
      patient recovered uneventfully from HUS 40 days after the onset of the disease
      and was discharged from the hospital.

PMID- 8468496
TI  - [Epidemiology of sporadic pediatric enteritis patients due to verotoxin-producing
      Escherichia coli].
AB  - We tried to isolate verotoxin-producing Escherichia coli (VTEC) from 323 sporadic
      pediatric enteritis patients who came to three clinics in the Fukuoka area. We
      used the sorbitol-MacConkey medium for the isolation of VTEC O157:H7. For non
      O157 VTEC strains we used the V1/PECS method. VT/PECS method was applied. VTEC
      strains were isolated from three patients (0.9%). None of the patients were
      seriously, ill or developed the hemolytic uremic syndrome. The three patients
      were all seen in the summer season, July and August. O157:H7 strains were
      isolated from two patients, and O145:NM from one. This study showed that sporadic
      enteritis cases due to VTEC exist in the Fukuoka area. In the future a rapid and
      easy method for the detection of VT or VTEC should be developed and
      commercialized to proceed with epidemiological studies of VTEC infections
      throughout Japan.

PMID- 8468497
TI  - [Biological characters of the clinically isolated strains of Escherichia coli
      O157:H7 in Canada].
AB  - Biological characters of enterohemorrhagic Escherichia coli (EHEC) strains
      isolated from food poisoning cases in Canada, 1987-1988 were examined in
      comparison with that isolated in Saitama, 1990. The Saitama strain was found to
      belong to biotype I, and biotypes I and II were found in Canada. Most of the
      strains including the Saitama strain were found to have siderophilins suggesting
      their advantageous growth in vivo. An enteroinvasive strain with 140 megadalton
      (Md) plasmid and two colicinogenic strains with 4.8 Md plasmids were detected.
      All strains were found to have 60 Md plasmids. This plasmid might be specific for
      this serotype. A few strains were resistant to streptomycin (SM) and/or
      tetracycline (TC), and a strain transferred its SM-TC resistances by conjugation.
      Many strains including the Saitama strain were found to produce vero cytotoxin
      (VT) types 1 and 2 (VT1 and VT2). A few type 2 and untypable toxin producing
      strains were also detected. VT titers produced by untypable toxin producing
      strains were over 10 times lower than those by other strains. High annealing
      temperature for PCR amplification of VT1 gene and a variety of annealing
      temperatures of VT2 gene suggested that the nucleotide sequences for VT1 gene
      were well preserved, but that those for VT2 might have some mutations.

PMID- 8468498
TI  - [Differences in susceptibility of Helicobacter pylori to macrolide and other
      antibiotics in tests using blood agar and albumin agar].
AB  - Minimum inhibitory concentrations (MICs) of penicillin G, cefazolin,
      tetracycline, chloramphenicol, four aminoglycosides, and seven macrolides against
      Helicobacter pylori strains were determined on Brucella agar supplemented with
      bovine serum albumin fraction V (albumin agar) and compared with those on blood
      agar. MICs of the macrolides against H. pylori determined on albumin agar were
      markedly lower than those found with blood agar. The susceptibilities of 26 H.
      pylori strains to the macrolides were estimated from the MIC50 values determined
      on blood agar and albumin agar, which were 0.39 and < or = 0.05 micrograms/ml for
      erythromycin, midecamycin and rokitamycin, 3.13 and 0.10 micrograms/ml for
      clindamycin, 1.56 and < or = 0.05 micrograms/ml for josamycin, 1.56 and 0.10
      micrograms/ml for kitasamycin, and 0.10 and < or = 0.05 micrograms/ml for
      roxithromycin, respectively. However, the MICs of other antibiotics against H.
      pylori and of all antibiotics against two reference Campylobacter strains
      differed minimally between values obtained on blood agar and albumin agar.

PMID- 8468499
TI  - [Study of local immune response in mice with an impaired chemotaxis of
      neutrophils--in Pseudomonas aeruginosa induced experimental urinary tract
      infection].
AB  - Experimental ascending urinary tract infection was induced by transurethral
      instillation of Pseudomonas aeruginosa in mice whose neutrophilic chemotactic
      activity was suppressed by administration of colchicine, and we investigated the
      time course fluctuation of local immune response at the infected sites in terms
      of immune response cells as compared with that in normal mice. In comparison with
      that in normal mice, a significant suppression was noted in the chemotactic
      activity of the peritoneal exudating neutrophils when colchicine at a dose of
      0.02 mg/mouse was administrated a total of 4 times, namely, 1, 3 and 5 days, and
      6 hours before infection (the day of assessment). When experimental ascending
      urinary tract infection was induced by P. aeruginosa, markedly increased
      susceptibility to bacterial infection was noted in mice with an impaired
      chemotaxis of neutrophils (impaired neutrophilic chemotaxis group) as compared
      with that in normal mice (control group). Apparent infiltration of neutrophils
      was recognized one day after infection in the control group by the time course
      observation of the immune response cells at the sites of infection while hardly
      any infiltration was observed in the impaired neutrophilic chemotaxis group one
      day after infection. In other words, the cellular infiltration into an infected
      site was conceivably obstructed when the chemotactic activity was impaired. On
      the other hand, macrophages in the impaired neutrophilic chemotaxis group
      demonstrated marked infiltration as compared with that in the control group one
      day after infection, and such infiltration remained on the same higher level
      thereafter. As for T and B cells, an increased ratio was noted in helper T cells
      and early infiltration in IgG positive B cells 3 days after infection and onward
      when compared with the control group. It was therefore suggested that other
      immune response cells compensated for the infiltration of neutrophils when their
      chemotactic activity was obstructed, and that these cells on the whole possibly
      responded toward the preservation of their protective mechanism against
      infection.

PMID- 8468500
TI  - Chronic melioidosis: a report of the first case in Japan.
AB  - A 41-year-old Japanese male with uncontrolled diabetes mellitus and alcoholic
      liver dysfunction developed melioidosis after his business trip to Indonesia and
      Singapore in 1988. His disease started with spiked fever on the following day
      after extraction of a tooth, and a liver abscess developed, followed by abscesses
      in the spleen and in the subphrenic space. In spite of splenectomy and intensive
      antimicrobial treatments for three months, he developed parotitis, prostatitis,
      and abscess of the right submandibular gland at 5 to 16-month interval.
      Pseudomonas pseudomallei was isolated from the blood and pus from each abscess.
      The lung was not involved. At present, he has returned to work, with continued
      intravenous instillation of imipenem/cilastatin.

PMID- 8468501
TI  - [A case of Legionnaires' disease due to aspiration of hot spring water and
      isolation of Legionella pneumophila from hot spring water].
AB  - We report a case of fulminant pneumonia that was due to aspiration of
      contaminated hot spring water and was not affected by beta-lactam antibiotics. We
      suspected that the patient had Legionnaires' disease and treated the clinical
      symptoms with erythromycin. Legionellaceae could not be isolated from sputum or
      lung biopsy material, but an elevated titer to Legionella pneumophila serogroup 4
      was found by indirect immunofluorescence test. We diagnosed the patent as having
      Legionnaires' disease with improved clinical symptoms. Furthermore, we went to
      the hot spring that he visited and tried to isolate Legionellaceae. Hot spring
      water was collected from the bathroom and water, hot water, and shower water from
      the guest-room. After using a low-pH method, samples were cultured on BCYE alpha
      medium. Serogroups are classified by agglutination method with immune rabbit
      serum. As a result, we successfully isolated Legionella pneumophila serogroup 4
      from hot spring water (42 degrees C) from the bath. No bacteria could be isolated
      from the other samples. Therefore, we believe that this case of Legionnaires'
      disease was caused by aspiration of contaminated hot spring water. The infection
      route of Legionnaires' disease is unclear. There are no previous reports of
      isolation of Legionellaceae from Japanese hot springs. This case would provide
      important information when considering the infection route of Legionnaires'
      disease in Japan.

PMID- 8468502
TI  - [Prevalence of HIV infection among stable female partners of seropositive men].
AB  - Prevalence of HIV transmission to female sexual partners of seropositive men is
      not known yet. In order to know the condition in Japan, 11 HIV-seropositive men
      (25-42 years old; mean +/- SD, 32.5 +/- 6.0) and their stable female partners (24
      42 years old; mean +/- SD, 31.3 +/- 6.0) were analyzed. Seropositive men
      consisted of seven hemophiliacs including a hemophiliac with intravenous drug
      abuse, three men who acquired HIV infection through heterosexual contact, and a
      man with intravenous drug abuse. Six of them were asymptomatic carriers, two had
      AIDS-related complex, and three had AIDS. All of the female partners had no risk
      factors other than sexual contact with their stable, seropositive male partners,
      except one who used to inject intravenous drug. Four of 11 female partners (36%)
      were found to be infected with HIV. All of the male partners of infected females
      had AIDS or AIDS-related complex, and had CD4 counts fewer than 100
      cells/microliters. Asymptomatic carriers and men with CD4 counts more than 200
      cells/microliters did not transmit HIV to their partners: rate of transmission of
      HIV by symptomatic men was significantly higher than that by asymptomatic men (p
      < 0.01), and the rate by men with CD4 counts fewer than 100 cells/microliters was
      also significantly higher than that by men with larger CD4 counts (p < 0.01). HIV
      p24 antigen was measured in 10 of 11 seropositive men. The antigen was positive
      in four men, and negative in six.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468504
TI  - Guide to the use of hyperthermic equipment. 1. Capacitively-coupled heating.

PMID- 8468503
TI  - Role of cellular membranes in hyperthermia: some observations and theories
      reviewed.
AB  - We have re-examined critically the evidence for and against the involvement of
      membranes in determining the response of cells to acute and chronic heat stress.
      Although frequently dismissed by many in the past, we believe that the bulk of
      evidence presented supports the view that physical and compositional alterations
      of membrane lipid components, both during and subsequent to heat exposure may, at
      least in part, account for cell adaptation, malfunction and lethality. Our
      primary goal in this review is to generate renewed interest in testing the
      validity of this hypothesis.

PMID- 8468505
TI  - Modification of human tumour and normal tissue pH during hyperthermic and
      normothermic antiblastic regional isolation perfusion for malignant melanoma: a
      pilot study.
AB  - Human tumour and normal tissue pH were investigated during hyperthermic and
      normothermic antiblastic regional isolation perfusion and the effects of vascular
      occlusion, artificially induced hypoxia, hyperglycaemia, haemoglobin level of the
      perfusate and hyperthermia on tumour and normal tissue pH were evaluated. A pilot
      study was performed on 10 patients, with locally inoperable recurrent and primary
      malignant melanoma of the leg. The treatment consisted of a regional isolation
      perfusion with hyperthermia (120 min at 42-43 degrees C), at femoral level,
      followed by a normothermic regional isolation perfusion with Melphalan (60 min at
      37-38 degrees C), at iliacal level, 7-10 can be distinguished: (1) first
      ischaemic anoxia period; (2) extracorporeal circulation, during which the leg is
      heated to the desired temperature, after which either hyperthermia or Melphalan
      is applied; (3) second ischaemic anoxia period. During the anoxia periods the
      large vessels that supply the leg are temporarily clamped and the effects on
      tissue pH can be investigated. During extracorporeal circulation, high-dose
      glucose can be administered to the isolated leg, to acutely decrease tumour
      tissue pH. Such a decrease is expected to sensitize tumours to hyperthermia, when
      applied immediately prior to or during heating. At the beginning of the treatment
      the mean tumour pH was significantly lower than normal tissue pH (7.14, with a
      mean tumour volume of 39.2 cm3, and 7.38, respectively; p < 0.01). During the
      perfusions with hyperthermia and Melphalan, tissue pH decreased by -0.41 units
      and -0.20 for tumour, and -0.11 units for normal tissue, respectively (all
      statistically significant). The two anoxia periods accounted for approximately
      half of the net decrease. During these periods tumour pH appeared to decrease
      more selectively, although there was great variation. The other investigated
      modalities, such as hyperglycaemia and hyperthermia, also decreased tissue pH,
      but to a lesser extent. However, a combination of more than one modality caused a
      larger decrease than a single one, but no preference for tumour could be
      detected. Before the second perfusion mean tumour pH was significantly increased
      by 0.14 units, and was no longer significantly different from normal tissue pH in
      the course of the regional isolation perfusion. This could be the reflection of
      the reduced tumour volume (by 30%, n.s.). Similar pH changes occurred during this
      Melphalan perfusion, but they were less pronounced since the total treatment time
      was shorter. Summarizing, tumour pH can be decreased more than normal tissue pH
      in the course of the regional isolation perfusion. In particular, vascular
      occlusion appeared to be tumour pH selective.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8468506
TI  - Problems associated with CT-guided catheter insertions.
AB  - From October 1987 to August 1991 a total of 141 closed-tip catheters were
      inserted into deep-seated or half-deep-seated tumours in 95 treatment areas. Most
      of the catheters (n = 79) were implanted in the pelvic region. In 139 punctures
      no clinical evidence of bleeding was seen. A transient blood loss was evident in
      only two patients. In addition, no nerve injury was observed. The problems with
      141 implanted catheters were evaluated. Nineteen catheters (13%) were lost during
      the treatment series. In five displacement of the catheters was verified by
      repeat CT scans during the whole treatment. Eight catheters had to be removed due
      to infection. In two patients with advanced disease who were receiving a
      combination of chemotherapy and hyperthermia a strong inflammatory response was
      evident. Another patient developed an acute pancreatitis after catheter
      insertion. No metastasis in the invasive tracks has been seen in the follow-up
      period. In conclusion the insertion of closed-tip catheters by CT guidance is a
      sure and well-tolerated method. There were a few problems only with the implanted
      catheters throughout the whole treatment series.

PMID- 8468507
TI  - Pre-clinical evaluation of a microwave planar array applicator for superficial
      hyperthermia.
AB  - Multi-element hyperthermia applicators have an advantage over single-aperture
      devices in that the power deposition pattern across the applicator surface may be
      adjusted to improve the resultant temperature distribution. This capability can
      be used to compensate for irregular tumour geometry as well as heterogeneity of
      thermal and power absorption parameters within the tissue. This paper evaluates
      the first commercially available microwave system of this type designed for
      superficial hyperthermia. The applicator (16-element planar array, 915 MHz, 15.2
      x 15.2 cm footprint) was evaluated by the following: (1) measuring absolute SAR
      distributions in muscle-equivalent liquid phantom with an intervening 1 cm thick
      layer of fat phantom by scanning a calibrated E-field sensor, and (2) power
      output measurements using calorimetric methods. The SAR distributions measured
      for each individual aperture exhibited significant irregularities and differing
      power deposition patterns. A priori knowledge of these different power deposition
      characteristics was used to provide appropriate illumination schemes which could
      be used as initial starting points for producing clinically useful power
      deposition patterns. Measurements of these composite patterns demonstrate the
      adjustable nature and flexibility of the heating capabilities of this applicator,
      which includes 50% iso-SAR coverage that can be extended to the applicator
      perimeter. This clearly illustrates the clinical utility and potential advantages
      of this system over single-aperture devices for superficial hyperthermia.

PMID- 8468508
TI  - Changes in electrical impedance of skeletal muscle measured during hyperthermia.
AB  - The electrical impedance of rat skeletal muscle was measured from 100 Hz to 40
      MHz during the application of typical hyperthermia heating regimens. Trials were
      performed employing freshly excised tissue heated to target temperatures from
      39.5 to 50 degrees C. Abrupt and rapid decreases in the low-frequency beta
      dispersion occurred very shortly after reaching hyperthermia temperatures. These
      rapid decreases continued at a rate and to an extent dependent upon the target
      temperature, and then, as heating continued, abruptly changed to a much slower
      rate which continued indefinitely. The initial rapid changes were associated with
      microscopically observed muscle fibre rounding and radial shrinkage, with
      accompanying increasing interstitial oedema. The subsequent slow changes were
      associated with a slow histolysis. The time- and temperature-dependence of the
      rapid resistivity changes evidenced similarities to typical hyperthermia endpoint
      responses. An Arrhenius analysis of the rate of the resistivity changes yielded a
      break at 43 degrees C, with activation energies of 36.1 and 58.3 kcal/mol above
      and below this break. Preliminary in vivo impedance data displayed qualitative
      similarities to the excised tissue findings.

PMID- 8468509
TI  - Small cylindrical ultrasound sources for induction of hyperthermia via body
      cavities or interstitial implants.
AB  - In this study, small (outside diameter 1 mm) cylindrical ultrasound sources were
      investigated for induction of hyperthermia in tumours. These ultrasound
      transducers could be placed in small-diameter body cavities, or they could be
      used interstitially in brachytherapy catheters. The ultrasound field measurements
      showed that the field is fairly uniform as a function of the length of the
      applicator except at the ends where sharp peaks were located. However, there were
      significant field variations as a function of rotation angle around the
      transducers. The degree of these non-uniformities varied from transducer to
      transducer, and also as a function of frequency. The temperature measurements in
      vitro perfused kidneys showed that therapeutic temperature elevations could be
      induced in perfused tissues. The radial extent of the therapeutic zone could be
      increased by circulating water around the applicators, thus avoiding high
      temperatures on the applicator surface. It was also shown that some control over
      the temperature distribution along the length of the applicator could be achieved
      by using a two-element applicator. An array of four applicators implanted in a
      square pattern with the spacing of 25 mm between the catheters, was able to heat
      the tissue volume inside of the implant. The results showed that these small
      ultrasound applicators may offer significant improvement over existing techniques
      by increasing the penetration depth and the control over the power deposition
      pattern.

PMID- 8468510
TI  - Synergism between alkylating agent and cis-platin with moderate local
      hyperthermia: the effect of multidrug chemotherapy in an animal system.
AB  - The combined effect of multidrug chemotherapy given in combination with
      hyperthermia was investigated using early-generation isotransplants of a
      spontaneous fibrosarcoma, FSa-II in C3Hf/Sed mice. Combinations of various types
      of chemotherapeutic agents, including alkylating agents, cyclophosphamide (CY)
      and 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU); antibiotics, bleomycin (BLM) and
      mitomycin C (MMC); an antimetabolite, 5-fluorouracil (5FU); and a platinum
      complex, cis-diamminedichloroplatinum(II) (cDDP), were examined using the tumour
      growth (TG) time assay. Simultaneously, the effect of glucose on the response to
      thermochemotherapy was investigated. Graded doses of the multidrugs were given
      i.p. immediately before hyperthermia with or without a glucose dose of 5 g/kg
      given i.p. 60 min before hyperthermia. Hyperthermia was given by immersing the
      tumour-bearing murine feet into a water bath set at 41.5 +/- 0.05 degrees C for
      60 min. Dose-response curves were obtained between the TG time and drug dose. The
      thermal enhancement ratio (TER) was expressed as a ratio of the slope of the dose
      response curve obtained at 41.5 degrees C to that obtained at room temperature.
      To evaluate normal tissue damage, the number of white blood cells (WBC) was
      counted from a day before treatment to the 21st day after treatment. A
      substantial thermal enhancement of the anti-tumour effect was observed in all
      five multidrug regimens tested. Glucose administered prior to thermochemotherapy
      further enhanced the antitumour effect. The TER was largest for the combination
      of CY+cDDP (TER was 5 without glucose). The second largest TER was obtained for a
      combination of CY+cDDP+MMC (TER was 4.1 without glucose and 6.5 with glucose).
      The antitumour effects of these two combinations were synergistic at a test
      elevated temperature only. No synergistic effect was found at room temperature
      for any of the drug combinations tested. The smaller TERs were observed in the
      treatment regimens that included 5FU. In general, a decrease in the number of WBC
      following multidrug chemotherapy was slightly less than that following the
      individual drugs.

PMID- 8468511
TI  - Tumour pH drop after cryotreatment and enhancement of hyperthermia antitumour
      effect.
AB  - Our previous study demonstrated a selective drop of pH, PO2 and blood flow in
      tumours under induced hyperglycaemia that enhanced the antitumour effect of
      hyperthermia. However, there are contraindications restricting the use of
      hyperglycaemia. Cryotreatment, as a method of altering tumour microphysiology
      similar to hyperglycaemia, was investigated. Guerin carcinoma pH was measured
      after cryotreatment (-15 to -20 degrees C at the tumour and normal tissue
      boundary; -110 to -120 degrees C at the cryoinstrument tip). It was determined
      that tumour pH immediately after complete tumour thawing (10 degrees C) was 6.08
      (range 5.5-6.3), by 2 h it was 6.34 (range 6.2-6.4), by 4 h it was 6.42 (range
      6.1-6.8) and by 24 h it was 6.54 (range 6.3-6.6). Complete tumour regression (%)
      and survival of rats with both the tumour regrowth and the partial tumour
      regression (days) after a single treatment were as follows: control -zero, 28 +/-
      4; hyperthermia (2450 MHz, 43 degrees C, 60 min) -zero, 30 +/- 3; cryotreatment 
      14, 35 +/- 5; cryotreatment+hyperthermia -41, 46 +/- 5. It is planned to use
      combined cryotreatment+hyperthermia in a clinical trial for certain accessible
      tumours.

PMID- 8468512
TI  - A comparison of the effect of hyperthermia on DNA polymerase in hamster and human
      glioma cells.
AB  - The hyperthermia response of two human glioma cells lines (87MG and 373MG) was
      compared to the CHO cell line for cell killing and DNA polymerase inactivation.
      Glioma cells were found to be more thermally resistant than CHO cells over a
      temperature range of 41-46 degrees C. Inactivation of polymerase alpha and beta
      by hyperthermia was also more resistant in glioma cells than in CHO cells. The
      relative order of resistance for both killing and polymerase inactivation was
      373MG > 87MG > CHO. While polymerase inactivation correlated with cell killing at
      high thermal doses, such correlation at low doses was absent; i.e. thermal
      killing was characterized by survival curves with shoulders while polymerase
      inactivation was not. Thus at low thermal doses the mechanism of thermal cell
      killing is probably not related to the degree of polymerase inactivation.
      Arrhenius analysis of the survival data showed that the inactivation energy for
      the glioma cells was 133-135 kcal/mol. The inactivation energies of alpha and
      beta polymerase were also evaluated and were 102-104 and 140-146 kcal/mol,
      respectively. Further analysis of the temperature-time relationship of
      hyperthermia treatment resulting in 50% cell kill showed the degree of polymerase
      beta inactivation to be a good indicator of thermal dose.

PMID- 8468514
TI  - [Interaction of DNA with nuclear skeletal structures].

PMID- 8468513
TI  - Abnormal rheological response of erythrocytes caused by nitroimidazoles and
      hyperthermia.
AB  - The aim of the present study was to investigate the response of erythrocytes to
      hyperthermia in combined treatment with nitroimidazoles. The efficiency of
      nitroimidazoles and physical agents on the rheological response of erythrocytes
      was measured by the viscosimetric-diffractometric method in a continuous osmotic
      gradient with constant shear stress of 100 dyn/cm2. We found that three newly
      synthesized dinitro- or nitroimidazole derivatives caused oxidative damage of
      erythrocytes in aerobic conditions. Nitroimidazole structure-dependent decrease
      of erythrocyte deformability was accompanied by oxidation of haemoglobin and
      depletion of reduced glutathione, lipid peroxidation and alteration of membrane
      structure indicated by a decrease of the ANS fluorescence intensity and increased
      production of MDA. Heat treatment per se (from 42 to 45 degrees C) only slightly
      decreased the erythrocyte deformability, but markedly enhanced the structure
      dependent effect of nitroimidazoles. Erythrocytes heated at 45 degrees C with
      dinitroimidazole derivative III lost their deformability without haemolysis.
      Dithiothreitol used in combination with nitroimidazoles during a heating period
      to 43.5 degrees C protected cell deformability entirely, indicating an important
      role for disulphide bond formation in membrane proteins submitted to oxidative
      stress and hyperthermia.

PMID- 8468515
TI  - [Processing enzymes for precursors of biologically active peptides and proteins:
      Kex2-like endoproteases in higher eukaryotes].

PMID- 8468516
TI  - [Transcription factor C/EBP family].

PMID- 8468517
TI  - [Evaluation of universities by their accomplishment on life science].

PMID- 8468518
TI  - [Estrogen synthetase (P-450 . aromatase) as a regulatory factor concerning sexual
      differentiation of brain and sexual behavior--physiological functions and
      regulation of gene expression of aromatase].

PMID- 8468519
TI  - [Role of polyamines in cell proliferation and differentiation].

PMID- 8468520
TI  - Absorption, lipoprotein transport, and regulation of plasma concentrations of
      vitamin E in humans.

PMID- 8468521
TI  - Clofibrate elevates enzyme activities of the tricarboxylic acid cycle in rat
      liver.
AB  - Activities of the tricarboxylic acid cycle enzymes were measured in subcellular
      fractions of liver from rats that had been fed clofibrate for 3 weeks. Large
      changes in these activities per gram tissue were found in the large particle
      fraction, which also showed an increase in total protein concentration of 76%
      under clofibrate treatment. The three regulatory enzymes of the cycle, namely
      citrate synthase, NAD(+)-linked isocitrate dehydrogenase, and 2-oxoglutarate
      dehydrogenase were significantly enhanced by 24% (P < 0.02), 54% (P < 0.02), and
      153% (P < 0.005), respectively. Fumarase and malate dehydrogenase rose by 71% (P
      < 0.005) and 95% (P < 0.02), whereas succinate dehydrogenase remained unchanged.
      Enhancement of the citrate synthase, NAD-isocitrate dehydrogenase, and 2
      oxoglutarate dehydrogenase may play a role in decreasing intracellular
      availability of acetyl-CoA for lipid metabolism.

PMID- 8468522
TI  - Carbohydrate composition of protein and lipid components in sialic acid-rich and 
      poor low density lipoproteins from subjects with and without coronary artery
      disease.
AB  - Low density lipoprotein (LDL) from patients with coronary heart disease (CHD)
      caused 78-286% increase in accumulation of cholesterol in human aortic
      subendothelial cells compared to 2-17% caused by LDL from normal subjects. Ricin
      Sepharose affinity chromatography was used to separate LDL into two subfractions,
      one sialic acid-rich (SAR) and the other sialic acid-poor (SAP). SAP-LDL from CHD
      patients caused 156-307% increase in accumulation of cellular cholesterol,
      whereas SAR-LDL from these patients caused only 14-21% increase. SAP-LDL from
      normal healthy subjects caused 50-86% increased accumulation, whereas their SAR
      LDL induced only 2-12% increase. Carbohydrate analysis of SAP-LDL protein
      isolated from four CHD patients revealed mean values of 59, 25, 61, and 11 nmoles
      of N-acetyl glucosamine, galactose, mannose, and sialic acid per mg protein,
      respectively. Mean values for SAR-LDL protein from these patients were 59, 31,
      77, and 24 nmol/mg protein, respectively. Analysis of SAP-LDL protein from four
      normal healthy subjects indicated respective mean values of 58, 29, 72, and 22
      nmol/mg, whereas SAR-LDL protein from normals contained 59, 29, 72, and 29
      nmol/mg. The carbohydrate content of LDL lipids represents about 25% of the total
      carbohydrate present in the lipoprotein. The mean values for SAP-LDL lipids from
      four CHD patients were about 2, 2, 18, 18, and 2 nmol/mg protein for N-acetyl
      galactosamine, N-acetyl glucosamine, galactose, glucose, and sialic acid,
      respectively. The mean values for SAR-LDL lipids from these patients were 3, 4,
      34, 41, and 5 nmol/mg, respectively. Analysis of SAP-LDL lipids from four normal
      healthy subjects indicated respective mean values of 4, 6, 30, 31, and 3 nmol/mg,
      whereas SAR-LDL lipids from these subjects contained 6, 9, 41, 46, and 7 nmol/mg.
      These results suggest that the different biological properties of SAR-LDL and SAP
      LDL are related to their different carbohydrate compositions.

PMID- 8468523
TI  - Pharmacologic consequences of cholesterol absorption inhibition: alteration in
      cholesterol metabolism and reduction in plasma cholesterol concentration induced
      by the synthetic saponin beta-tigogenin cellobioside (CP-88818; tiqueside).
AB  - Natural and synthetic saponins inhibit cholesterol absorption and reduce plasma
      cholesterol levels in experimental animals and are therefore of potential
      pharmacologic utility in the treatment of hypercholesterolemia. To determine the
      effects of this class of compounds on cholesterol absorption and metabolism, we
      evaluated the effects of the synthetic saponin, beta-tigogenin cellobioside
      (tiqueside; CP-88818), on male golden Syrian hamsters. When administered as
      either a single oral bolus or as a dietary supplement for up to 2 weeks,
      tiqueside inhibited cholesterol absorption in a dose-dependent manner in both the
      presence and absence of dietary cholesterol. Administration of tiqueside to chow
      fed hamsters as a 0.2% dietary supplement (150 mg/kg per day) for 4 days resulted
      in a 68% decrease in intestinal cholesterol absorption with no change in either
      bile absorption or cholesterol 7 alpha-hydroxylase activity, suggesting that
      tiqueside inhibits cholesterol absorption without interfering with enterohepatic
      bile acid recirculation. Under these conditions, hepatic cholesterol levels were
      also reduced in a dose-dependent manner. Hepatic cholesterol reduction was highly
      correlated with cholesterol absorption inhibition, and induced compensatory
      increases in both hepatic HMG-CoA reductase activity and hepatic low density
      lipoprotein (LDL) receptor levels. Compensatory increases in intestinal HMG-CoA
      reductase activity were also noted after tiqueside administration, and are
      consistent with a luminal mechanism for tiqueside action. As a consequence of
      these changes to cholesterol metabolism, tiqueside administration induced plasma
      cholesterol reductions that were highly correlated with both hepatic cholesterol
      reduction and cholesterol absorption inhibition. Tiqueside also produced
      comparable plasma cholesterol lowering in a variety of other species fed either
      cholesterol-free diets (hamster, rat, mouse, dog) or cholesterol-containing diets
      (hamster, rat, rabbit, mouse, cynomolgus monkey, rhesus monkey, SEA quail)
      indicating the ubiquity of tiqueside action. For all species evaluated except the
      dog, the reduction in plasma cholesterol was due primarily to a reduction in
      circulating non-HDL cholesterol levels with little or no change in HDL
      cholesterol levels. Taken together, these results indicate that inhibition of
      cholesterol absorption by tiqueside produces profound effects on cholesterol
      metabolism without affecting bile acid metabolism, and that these changes lead to
      reductions primarily in plasma non-HDL cholesterol concentrations. The synthetic
      saponin, tiqueside, may thus represent a prototypical form of therapy for the
      treatment of hypercholesterolemia.

PMID- 8468525
TI  - Long-term fatty acid modification of endothelial cells: implications for
      arachidonic acid distribution in phospholipid classes.
AB  - Human umbilical vein endothelial cells were cultured in various fatty acid
      modified media until equilibrium conditions were reached (7-8 days). The effects
      on the fatty acid composition of phospholipid classes and on the metabolism of
      arachidonic acid (20:4(n-6)) were studied. The results showed that in every
      phospholipid class large changes in fatty acid composition, including 20:4(n-6)
      content, were induced by long-term modification with unsaturated as well as
      saturated fatty acids. However, the mean levels of saturated and unsaturated
      fatty acids per phospholipid class remained relatively constant, except for cells
      modified with oleic acid, which showed an increase in monounsaturated fatty acids
      at the expense of both saturated and polyunsaturated fatty acids. The rate of
      incorporation of radiolabeled 20:4(n-6) in endothelial lipids was not influenced
      by long-term fatty acid modification. Cells modified with 20:4(n-6) (having a
      high 20:4(n-6) content) tended to "store" excess 20:4(n-6) as the elongated
      product 22:4(n-6) mainly in phosphatidylserine and ethanolamine phospholipids. On
      the other hand, endothelial cells modified with 20:5(n-3) (having a low 20:4(n-6)
      content) differed typically from other fatty acid-modified cells by a relatively
      high level and high incorporation rate of 20:4(n-6) in phosphatidylinositol, with
      a low extent of elongation. These results indicate extensive homeostatic control
      of membrane unsaturation in each phospholipid class and economical control of
      20:4(n-6) content in all modified endothelial cells, irrespective of a
      considerable variation of 20:4(n-6) levels in cellular lipids. Moreover, the
      observed maintenance of a critical level of 20:4(n-6) in phosphatidylinositol,
      when 20:4(n-6) supply was strongly decreased, may be important for maintaining
      proper signal transduction upon endothelial cell stimulation.

PMID- 8468524
TI  - Lipoprotein lipase synthesis and secretion: effects of concentration and type of
      fatty acids in adipocyte cell culture.
AB  - Fatty acids (FA) were added to differentiating chick adipocytes to study their
      effects on the synthesis and secretion of avian lipoprotein lipase (LPL). Oleate
      (18:1n-9), eicosapentaenoate (EPA, 20:5n-3), and linoleate (18:2n-6) were
      complexed to fatty acid-free bovine serum albumin (BSA) and separately added to
      cells in RMPI-1640 media containing 0.5% delipidated hen serum. LPL secretion in
      the presence of 10 U/ml heparin was used as a means of estimating LPL synthesis.
      FA from 50 microM to 165 microM depressed LPL secretion for cells exposed to
      20:5n-3 and 18:2n-6. The decrease in adipocyte LPL secretion was only observed
      with chronic administration of FA. In other experiments, the rate of LPL
      synthesis was estimated by incorporation of radiolabel (Tran 35S-label) in cells
      exposed to 50 microM FA. Total radioactivity incorporated into LPL, expressed as
      a percentage of total trichloroacetic acid (TCA)-precipitable radioactivity, was
      not affected in cells fed 18:1n-9 but was significantly decreased for cells fed
      20:5n-3 (45%) or 18:2n-6 (67%) relative to controls given equimolar BSA (33
      microM). Abundance of LPL message in similarly treated cells also decreased for
      cells incubated with 20:5n-3 or 18:2n-6 (35%) relative to controls and 18:1n-9
      treated cells. A decrease in adipocyte LPL secretion was also observed with
      administration of lipoprotein (d < 1.006 g/ml) enriched in n-3 and n-6 fatty
      acids. LPL secretion of cells incubated with n-3 enriched lipoprotein at 50
      microM and 75 microM triglyceride fatty acid equivalents was significantly
      greater than that of cells incubated with n-6-enriched lipoprotein.
      Interestingly, at the same concentrations of triglyceride fatty acids,
      lipoproteins enriched with n-9 fatty acids had no effect on LPL secretion
      relative to controls. These studies document that in cultured avian adipocytes,
      LPL secretion, synthesis, and level of message are decreased by chronic
      administration of n-3 and n-6 fatty acids. In contrast, in adipocytes
      supplemented with oleic acid there was no effect on LPL synthesis and secretion.

PMID- 8468526
TI  - Metabolism of sulfonate analogs of ursodeoxycholic acid and their effects on
      biliary bile acid composition in hamsters.
AB  - The metabolism of sodium 3 alpha,7 beta-dihydroxy-5 beta-cholane-24-sulfonate and
      sodium 3 alpha,7 beta-dihydroxy-24-nor-5 beta-cholane-23-sulfonate was studied in
      hamsters. In bile fistula animals these sulfonate analogs of ursodeoxycholic acid
      were absorbed mainly from the terminal ileum and secreted rapidly into the bile
      without biotransformation or conjugation. After oral administration, the
      sulfonate analogs were excreted in the feces at the same rate as chenodeoxycholic
      acid and its metabolic products. The intestinal microorganisms transformed
      chenodeoxycholic acid largely into lithocholic acid; the sulfonate analogs were
      completely resistant to biotransformation. After a 2-week feeding period, the
      sulfonate analogs of ursodeoxycholic acid accounted for 24.0% and 16.9% of total
      biliary bile acids. These sulfonates did not affect the proportions of the
      natural bile acids in the bile, and the ratio of glycine-conjugated bile acids to
      taurine-conjugated bile acids was not altered by feeding the sulfonates. In
      contrast, when ursodeoxycholic acid was fed, the proportions of the natural bile
      acids and the glycine/taurine ratio were changed. These results suggest that the
      sulfonate analogs had no profound effect on endogenous bile acid metabolism and
      did not cause a depletion of the hepatic taurine pool during enterohepatic
      circulation. The sulfonates had no effect on intestinal cholesterol absorption
      and serum cholesterol levels.

PMID- 8468527
TI  - Cholesteryl ester transfer protein and high density lipoprotein responses to
      cholesterol feeding in men: relationship to apolipoprotein E genotype.
AB  - The apolipoprotein (apo) E isoform is an important determinant of the plasma
      lipoprotein distribution of apoE and of the metabolism of apoE-containing
      lipoproteins. We have determined the effects of apoE genotype on the plasma
      lipoprotein response to cholesterol feeding in 30 young normal male subjects (5
      E3/2, 11 E3/3, 14 E4/3) under rigorously controlled dietary conditions. Two
      diets, differing only in cholesterol content (low cholesterol (LC): 80 mg
      cholesterol/1000 kcal and high cholesterol (HC): 320 mg cholesterol/1000 kcal),
      were compared using a random crossover design. At the end of the HC as compared
      to the LC period, total cholesterol (TC), low density lipoprotein cholesterol
      (LDL-C), high density lipoprotein cholesterol (HDL-C), and HDL2-C increased by an
      average of 15%, 21%, 7%, and 23%, respectively, for the three genotype groups
      combined (P < 0.001 for each). The LDL-C response to dietary cholesterol did not
      differ among the apoE genotypes. However, the increase in HDL-C varied
      significantly according to the apoE genotype (E3/2: 0 change, E3/3: +4%, E4/3:
      +12%; P < 0.05). The plasma cholesteryl ester transfer protein (CETP) response to
      cholesterol feeding also differed amongst the three apoE genotype groups (E3/2:
      +37%, E3/3: +18%, E4/3: +9%) (P < 0.05). ApoE genotype has significant and
      opposite effects on plasma CETP and HDL-C responses to dietary cholesterol in
      men.

PMID- 8468528
TI  - Preferential association of apolipoprotein E Leiden with very low density
      lipoproteins of human plasma.
AB  - Apolipoprotein (apo) E Leiden is a rare variant of human apoE characterized by
      defective receptor binding and associated with dominant transmission of type III
      hyperlipoproteinemia. In heterozygotes, apoE Leiden is present in higher
      concentrations in both total plasma and very low density lipoproteins (VLDL) than
      the other apoE allele product. In the present study we analyzed cell expression
      and plasma lipoprotein association of apoE Leiden to determine whether the
      unequal concentration of the two apoE allele products could be explained by
      differences in secretion rate from the hepatocyte or by preferential association
      with VLDL. We transfected the rat hepatoma cell line McA-RH7777 with apoE Leiden
      or normal human apoE3, and studied their secretion and media distribution. In
      pulse-chase experiments, the secretion of apoE Leiden was comparable to that of
      both human apoE3 and rat endogenous apoE, approaching 100% in 90 min. In similar
      transfection experiments, secreted apoE Leiden was significantly less
      glycosylated than normal apoE3 (21.7% vs. 36.6%, P < 0.005, n = 4), a finding
      also noted for apoE Leiden in human plasma. In in vitro incubation experiments,
      apoE Leiden showed a markedly higher preference for VLDL of normolipidemic human
      plasma when compared to both apoE3 (2.6-fold, P < 0.001) and apoE4 (1.6-fold, P <
      0.001). These results suggest that the accumulation of apoE Leiden in VLDL
      derives from a high affinity of the mutant protein for the VLDL. This enrichment
      in defective apoE probably exacerbates impairment of VLDL removal from the
      circulation, thus contributing to the dominant transmission of type III
      hyperlipoproteinemia.

PMID- 8468529
TI  - Hepatic lipase treatment of chylomicron remnants increases exposure of
      apolipoprotein E.
AB  - The consequences of hepatic lipase treatment of chylomicron remnants were
      studied. Rats were fed corn oil to induce production and secretion of
      chylomicrons and were then injected with polyclonal antiserum raised against
      hepatic lipase to specifically and quantitatively inhibit hepatic lipase activity
      in vivo. A fraction enriched in chylomicron remnants was isolated from rat plasma
      by a brief centrifugation step that preferentially isolates triglyceride-rich
      apolipoprotein (apo) B-48-containing lipoproteins. The chylomicron remnants were
      then treated with hepatic lipase in vitro, or incubated under identical
      conditions in the absence of enzyme (control incubations). Hepatic lipase-treated
      and control chylomicron remnants were isolated by a second brief centrifugation
      step using discontinuous salt gradients. Control lipoproteins were collected from
      one discrete band at d < 1.02 g/ml. Hepatic lipase-treated chylomicron remnants
      formed two discrete bands and were collected at two densities: d < 1.02 g/ml and
      1.02 < d < 1.04 g/ml. The buoyant (d < 1.02 g/ml) subfraction of hepatic lipase
      treated chylomicron remnants was depleted of 62% of the total phospholipid when
      compared to control d < 1.02 g/ml lipoproteins. The dense (1.02 < d < 1.04 g/ml)
      subfraction of hepatic lipase-treated chylomicron remnants was depleted of 65% of
      particle phospholipid content and 90% of particle triglyceride content when
      compared to control d < 1.02 g/ml lipoproteins. The dense (1.02 < d < 1.04 g/ml)
      subfraction of hepatic lipase-treated chylomicron remnants showed 5- to 7-fold
      greater immunoreactivity of apoE when compared to control lipoproteins in
      competitive displacement immunoassays. These data suggest that extensive
      hydrolysis of chylomicron remnant phospholipid and triglyceride leads to the
      formation of a dense remnant particle that contains highly exposed apoE. This
      increased exposure of apoE may be the key to the previously observed increased
      degradation of chylomicron remnants treated with hepatic lipase because more
      exposed apoE may bind better to cell surface lipoprotein receptors. Furthermore,
      the data imply that hepatic lipase cleaves chylomicron remnant phospholipid and
      triglyceride in a sequential fashion; hydrolytic intermediates depleted only of
      phospholipid precede the formation of a smaller dense remnant particle depleted
      of phospholipid and triglyceride.

PMID- 8468530
TI  - Exclusive localization in peroxisomes of dihydroxyacetone phosphate
      acyltransferase and alkyl-dihydroxyacetone phosphate synthase in rat liver.
AB  - Dihydroxyacetone phosphate acyl transferase (DHAP-AT), alkyl dihydroxyacetone
      phosphate synthase (alkyl-DHAP-synthase), and glycerol-3-phosphate
      acyltransferase (GPAT) activities were investigated under optimal assay
      conditions using highly purified organelle preparations. The data presented
      clearly indicate that GPAT activity was mainly localized in mitochondria and
      microsomes, whereas DHAP-AT and alkyl-DHAP-synthase activities were exclusively
      localized in peroxisomes. A small fraction of the total DHAP-AT and alkyl-DHAP
      synthase activities observed in purified mitochondrial preparations was due to
      the presence of intact peroxisomes. DHAP-AT and alkyl-DHAP-synthase activities
      were very low in purified microsomes (< 1% compared to peroxisomes) and these
      activities are thought to be due to sedimentation of peroxisomal fragments
      (generated during homogenization of liver and processing of liver homogenate)
      with microsomes. The results indicate that the dihydroxyacetone phosphate pathway
      does not contribute to the synthesis of glycerolipids other than ether lipids in
      rat liver. The ether bond formation occurs exclusively in peroxisomes, and all
      the biosynthetic reactions for plasmalogen synthesis may also be operating within
      peroxisomes in rat liver.

PMID- 8468531
TI  - Lethal damage to endothelial cells by oxidized low density lipoprotein: role of
      selenoperoxidases in cytoprotection against lipid hydroperoxide- and iron
      mediated reactions.
AB  - Oxidized low density lipoprotein (LDLox) is believed to be an important
      contributor to endothelial cytodamage and atherogenesis. The purpose of this
      study was to examine the role of glutathione (GSH) and GSH-dependent
      selenoperoxidases in cytoprotection against the damaging effects of LDLox. When
      irradiated in the presence of a phthalocyanine sensitizing dye, human LDL
      accumulated chromatographically detectable and iodometrically measurable lipid
      hydroperoxides (LOOHs). Photogenerated LDLox caused lethal damage to bovine
      aortic endothelial (BAE) cells in vitro, as determined by lactate dehydrogenase
      release and inhibition of thiazolyl blue reduction. When depleted of GSH by
      buthionine sulfoximine treatment, BAE cells became more sensitive to LDLox. Cells
      grown in 2% serum/DME-HAM's F-12 medium without added selenium [Se(-) cells]
      exhibited far lower GSH-peroxidase and phospholipid hydroperoxide GSH-peroxidase
      activities than selenium-supplemented controls [Se(+) cells], and were much more
      sensitive to oxidative injury induced by t-butyl hydroperoxide, liposomal
      cholesterol hydroperoxides, and LDLox. Preincubation of LDLox with GSH and
      Ebselen (a selenoperoxidase mimetic) resulted in a dramatic reduction in both
      LOOH content and cytotoxicity. Moreover, treating Se(-) cells themselves with
      Ebselen substantially restored their resistance to LDLox-induced damage. LDLox
      toxicity to Se(-) cells was strongly inhibited by desferrioxamine and stimulated
      by ferric-8-hydroxyquinoline (a lipophilic chelate), indicating that iron is an
      active participant in oxidative damage. These results demonstrate that the GSH
      dependent selenoperoxidase(s) play(s) an important role in cellular defense
      against oxidized low density lipoprotein, presumably by detoxifying lipid
      hydroperoxides and thereby preventing their iron-catalyzed decomposition to
      damaging free radical intermediates.

PMID- 8468532
TI  - Unique lipids of primate spermatozoa: desmosterol and docosahexaenoic acid.
AB  - Spermatozoa represent a tissue readily accessible for study after various
      exogenous perturbations. To characterize the lipid composition of monkey sperm
      and to establish a baseline from which dietary or pharmaceutical influences may
      then be evaluated, we collected semen samples from five rhesus monkeys by
      electroejaculation and analyzed the sperm for sterols, fatty acid composition,
      and the molecular species of the ethanolamine glycerophospholipids. Two sterols
      were identified: cholesterol, 41%, and desmosterol, 59% of total sterols.
      Desmosterol was found only in the free form. Cholesterol existed in three
      different forms: free, 60%; esterified, 20%; and sulfated, 20%. Docosahexaenoic
      acid (22:6, DHA) was almost the only n-3 fatty acid in sperm phospholipids, 24%
      of the total fatty acids. DHA was present mainly in phosphatidylcholine and
      phosphatidylethanolamine. Oleic and palmitic acids were the predominant
      monounsaturated and saturated fatty acids. The ethanolamine glycerophospholipids
      were separated into three subclasses: diacyl 49%, alkenylacyl 43%, and alkylacyl
      8%. Thirteen molecular species were identified and quantified. The sn-1 position
      of these molecular species contained exclusively 16:0, 18:0, or 18:1. The sn-2
      position contained n-3, n-6, and n-9, as well as saturated fatty acids. The
      molecular species having n-3 fatty acids in the sn-2 position contributed 43, 73,
      and 100% of the total in the diacyl, alkenylacyl, and alkylacyl subclasses,
      respectively. The presence of the unusual sterol, desmosterol, a cholesterol
      precursor not found in measurable quantities in any other tissue suggests an
      important functional and structural role for desmosterol in spermatozoa. The
      other unique lipids, cholesterol sulfate and the n-3 docosahexaenoic acid, may
      also have a significant role in the function of spermatozoa.

PMID- 8468533
TI  - Four new mutations in the apolipoprotein B gene causing hypobetalipoproteinemia,
      including two different frameshift mutations that yield truncated apolipoprotein
      B proteins of identical length.
AB  - Familial hypobetalipoproteinemia can be caused by mutations in the apolipoprotein
      (apo)B gene that interfere with the translation of a full-length apoB molecule.
      Frequently, a truncated apoB molecule can be detected in the plasma lipoproteins
      of affected subjects. In this report, we characterize four different apoB gene
      mutations causing hypobetalipoproteinemia that are associated with the synthesis
      of truncated apoB proteins. Two of the mutations are nonsense mutations caused by
      single nucleotide substitutions; these mutations are associated with the
      production of apoB-32.5 (1473 amino acids) and apoB-82 (3733 amino acids). The
      other two mutations are single nucleotide deletions (of apoB cDNA nucleotides
      7295 and 7359, respectively). The altered reading frames created by these
      different frameshift mutations terminated with the same stop codon, and both
      therefore yielded a truncated protein of identical size: apoB-52.8 (2395 amino
      acids). The two apoB-52.8 proteins differ, however, in the number of novel
      carboxyl-terminal amino acids introduced by the frameshift. The buoyant density
      of lipoproteins containing the truncated apoBs was inversely related to the
      length of the truncated apoB. ApoB-32.5 was present only in high density
      lipoproteins (HDL) and the d > 1.21 g/ml fraction, whereas apoB-82 was present
      almost exclusively in very low density lipoproteins (VLDL). ApoB-52.8 was present
      primarily in VLDL, intermediate density lipoproteins (IDL), and low density
      lipoproteins (LDL); trace amounts were observed in the HDL.

PMID- 8468534
TI  - Intracellular maturation of apolipoprotein[a] and assembly of lipoprotein[a] in
      primary baboon hepatocytes.
AB  - The glycoprotein apolipoprotein[a] (apo[a]) is present in plasma at highly
      variable concentrations and appears as a number of genetically determined size
      isoforms (400-800 kDa), disulfide linked to apoB-100 in low density lipoprotein
      to produce lipoprotein [a](Lp[a]). Apo[a] is synthesized by the liver, but the
      site of association of apo[a] and apoB and factors that regulate its production
      are unknown. To examine the morphogenesis of the Lp[a] particle, baboon
      hepatocytes expressing a single, low molecular weight isoform of apo[a] were
      labeled with [35S]cysteine and methionine, and apo[a] was analyzed by
      immunoprecipitation and SDS-PAGE. Steady-state labeling revealed two molecular
      weight forms of apo[a] inside the cell. Only the large form was recovered from
      the culture medium. Pulse-chase studies and endoglycosidase treatment revealed
      that the lower molecular weight form of apo[a] represented a precursor with a
      prolonged residence time in the endoplasmic reticulum or an early Golgi
      compartment, after which it was processed to the mature form. A proportion of the
      mature form of apo[a] was rapidly secreted after synthesis, whereas the remainder
      had a prolonged residence time in a late Golgi compartment. In all experiments,
      apoB co-precipitated with apo[a] from the culture medium, but not from cell
      lysates. Density gradient ultracentrifugation and immunoblot analysis revealed
      that the majority of apo[a] was secreted into the medium in a free form,
      suggesting that the association between apo[a] and apoB occurred after secretion.
      Regulation of the movement of apo[a] between intracellular compartments may be
      one mechanism by which the plasma levels of Lp[a] are influenced.

PMID- 8468535
TI  - Half-sib mating structures.
AB  - All ways in which all matings in a population can be between half-sibs under a
      generalization of regular systems of inbreeding are characterized for both finite
      and infinite populations. A model of random half-sib mating is developed and
      analyzed, and the asymptotic configuration of populations subject to it is
      described. The classical model of half-sib mating which ensues from the standard
      definition of regular systems of inbreeding is only one of many ways a population
      can propagate by half-sib mating, and a wide range of genetic identity is
      possible dependent on which half-sib mating structure governs a population.

PMID- 8468536
TI  - Entropy and convergence in dynamics and demography.
AB  - Demographic dynamics is formally equivalent to the dynamics of a Markov chain, as
      is true of some nonlinear dynamical systems. Convergence to demographic
      equilibrium can be studied in terms of convergence in the Markov chain.
      Tuljapurkar (1982) showed that population entropy (Kolmogorov-Sinai entropy)
      provides information on the rate of this convergence. This paper begins by
      considering finite state Markov chains, providing elementary proofs of the
      relationship between convergence rate and entropy, and discusses in detail the
      uses and limitations of entropy as a convergence measure; these results also
      apply to Markovian dynamical systems. Next, new qualitative and quantitative
      arguments are used to discuss the demographic meaning of entropy. An exact
      relationship is established giving population entropy in terms of the eigenvalues
      of the Leslie matrix characteristic equation. Finally, the significance of
      imprimitive and periodic limits is discussed in relation to population entropy.

PMID- 8468537
TI  - A parameter identification problem arising from a model of canalicular bile
      formation.
AB  - We develop a simple mathematical model for bile formation and analyze some
      features of the model that suggest the design for future physiological
      experiments. The mathematical model results in a boundary value problem for a
      system of functional differential equations depending on several physical
      parameters. From the observability of the boundary values we can identify, both
      qualitatively and quantitatively, some of these physical parameters. This
      identification then suggests physical experiments from which one could infer some
      of the bile transport phenomena that are not, at present, directly observable.
      The mathematical parameter identification problem is solved by converting the
      boundary value problem to a transition time problem for a quadratic system of
      ordinary differential equations on the plane where we are able to employ some
      special properties of quadratic systems in order to obtain a solution.

PMID- 8468538
TI  - DNA damage in non-proliferating cells subjected to ionizing irradiation at high
      or low dose rates.
AB  - Ionizing radiation damage to the genome of a non-cycling mammalian cell is
      analyzed using continuous time Markov chains. Immediate damage induced by the
      radiation is modeled as a batch Poisson arrival process of DNA double strand
      breaks (DSBs). Different kinds of radiation, for example gamma rays or alpha
      particles, have different batch probabilities. Enzymatic modulation of the
      immediate damage is modeled as a Markov process similar to the processes
      described by the master equation of stochastic chemical kinetics. An illustrative
      example is the restitution/complete exchange model, which postulates that
      radiation induced DSBs can subsequently either undergo enzymatically mediated
      repair (restitution) or can participate pairwise in chromosome exchanges, some of
      which make irremediable lesions such as dicentric chromosome aberrations. One may
      have rapid irradiation followed by enzymatic DSB processing or have prolonged
      irradiation with both DSB arrival and enzymatic DSB processing continuing
      throughout the irradiation period. A complete solution of the Markov chain is
      known for the case that the exchange rate constant is negligible so that no
      irremediable chromosome lesions are produced and DSBs are the only damage to the
      genome. Using PDEs for generating functions, a perturbation calculation is made
      assuming the exchange rate constant is small compared to the repair rate
      constant. Some non-perturbative results applicable to very prolonged irradiation
      are also obtained using matrix methods: Perron-Frobenius theory, variational
      methods and numerical approximations of eigenvalues. Applications to experimental
      results on expected values, variances and statistical distributions of DNA
      lesions are briefly outlined. Continuous time Markov chain models are the most
      systematic of those current radiation damage models which treat DSB-DSB
      interactions within the cell nucleus as homogeneous (e.g. ignore diffusion
      limitations). They contain most other homogeneous models as special cases,
      limiting cases or approximations. However, applying the continuous time Markov
      chain models to studying spatial dependence of DSB interactions, which is
      generally believed to be very important in some situations, presents
      difficulties.

PMID- 8468539
TI  - Control of intrinsic buccal muscles by motoneurons B11, B15, and B16 in Aplysia
      californica.
AB  - To further define the control of intrinsic buccal muscles by identified
      motoneurons B11, B15, and B16 in Aplysia californica, we made physiological
      recordings from semi-intact and isolated preparations of the buccal ganglia and
      buccal mass. B15 and B16 were previously known to innervate muscle 15 (also
      called the accessory radula closer muscle). We show here that these motoneurons
      also innervate other buccal muscles ipsilateral to their cell bodies; for
      example, B15 reliably innervates and can cause contraction in intrinsic muscle
      I4. Likewise, B11 appears to innervate all of the intrinsic buccal muscles, but
      elicits contractions only in I4. The form and time course of synaptic plasticity
      displayed by these motoneurons is common to all the muscles they innervate. No
      evidence for electrical coupling between fibers of adjacent muscles could be
      obtained, suggesting that all recorded innervation is direct. Like B15 and B16
      (Cohen et al., '78), B11 neuromuscular synapses appear to be cholinergic, since
      they are reversibly antagonized by hexamethonium and d-tubocurarine
      (acetylcholine [ACh] receptor antagonists). In addition, direct application of
      ACh elicits depolarizing responses and contractions in I4 which are also blocked
      by hexamethonium. Application of glutamate and GABA do not elicit depolarizations
      or contractions in I4 or I5. We conclude that these motoneurons control radula
      position through complex synaptic actions on multiple intrinsic buccal muscles,
      using ACh as their conventional transmitter.

PMID- 8468540
TI  - Prolactin and interrenal hormone balance in adult specimens of Xenopus laevis
      exposed to hyperosmotic stress for up to one week.
AB  - Adult female specimens of Xenopus laevis were exposed to diluted artificial
      seawater for up to 1 week. Statistically significant increases were observed in
      serum levels of aldosterone and corticosterone, concomitant with a drop in levels
      of prolactin (PRL) receptors in the cell membranes of the epidermis and kidney,
      which can be taken as an indicator of the levels of circulating PRL. The changes
      in hormone levels were detected after 1 day, being followed by a gradual
      restoration of the initial mean levels of these hormones when the exposure to
      hyperosmotic stress was extended for up to 2 or 7 days. Comparison of the above
      results with those previously obtained in Xenopus after longer exposure (15 days)
      to brackish water substantiates the necessity of recording possible initial
      fluctuations, as well as any changes that occur over the course of longer
      exposure during which time adaptation to environmental changes are likely to take
      place. The reverse responses, which may be not independent of one another, in
      terms of levels of corticoids and PRL in the animals exposed to hyperosmotic
      stress, are discussed. A survey of the literature suggests that, in Xenopus, as
      in the case of other less strictly water-dwelling amphibians, PRL is one of the
      hormones required for life in fresh water.

PMID- 8468541
TI  - Stage-related production of 21-hydroxylated progestins by the dogfish (Squalus
      acanthias) testis.
AB  - Using shark (Squalus acanthias) testicular microsomes and [3H]progesterone
      ([3H]P) and [3H]17 alpha-hydroxyprogesterone ([3H]17 alpha-P) as substrates, two
      major products of 21-hydroxylase action were identified; respectively, 21-hydroxy
      4-pregnen-3-one (11-deoxycorticosterone, DOC) and 17 alpha,21-dihydroxy-4-pregnen
      3-one (11-deoxycortisol,S). Additional products of 17 alpha-hydroxylase/C-17,20
      lyase action were detected: 17 alpha-hydroxyprogesterone (17 alpha P),
      testosterone (T), and androstenedione (AE). When microsomes derived from tissues
      in premeiotic (PrM), meiotic (M), and postmeiotic (PoM) stages of spermatogenesis
      were compared, maturation-related increases were observed with both 21
      hydroxylase (3- to 20-fold) and 17 alpha-hydroxylase (2- to 6-fold). With [3H]P
      as tracer, the half-maximal substrate concentrations (Km = 0.2-1.0 microM) and
      maximal reaction velocities (Vmax = 9-25 pmol/mg protein/min) were similar for
      both enzymes when assayed in the same preparation, suggesting they compete for
      available substrate. Also, the presence of 1- or 10-fold molar excess radioinert
      DOC reduced conversion of [3H]P to 17 alpha-hydroxylated products. [3H]DOC itself
      was a substrate of 17 alpha-hydroxylation but not C-17,20-lyase action.
      Expression of 21-hydroxylase and 17 alpha-hydroxylase activities in cultured
      spermatocysts (intact germ cell/Sertoli cell units) was confirmed by detection of
      immunoreactive 17 alpha,20 beta,21-trihydroxy-4-pregnen-3-one (20 beta-S),S,17
      alpha,20 beta-dihydroxy-4-pregnen-3-one (17 alpha,20 beta-P), DOC, P and T in
      spent media. 20 beta-S and S secretion increased and 17 alpha,20 beta-P decreased
      progressively with stage of maturation, but DOC was similar in all stages. P
      secretion was maximal and T lowest in M-stage spermatocysts, but when DOC (0.1
      microM) was added to PrM or PoM spermatocysts, T output decreased. Taken
      together, the data suggest that 21-hydroxylating pathways, via direct and
      indirect mechanisms, affect accumulation of bioactive steroids (P and T)
      differentially by stage of spermatogenic development. Whether 21-hydroxylated
      progestins produced in shark testis have paracrine or endocrine actions in their
      own right remains to be investigated.

PMID- 8468542
TI  - Basal, diurnal, and stress-induced levels of glucose and glucocorticoids in
      captive bats.
AB  - Plasma levels of glucocorticoids and glucose were measured in three species of
      fruit bats (Chiroptera) sampled from captive populations. Three species of Old
      World bats (Pteropus vampyrus, P. Hypomelanus, and Rousettus aegyptiacus) had
      plasma levels of glucose that were within the normal mammalian range (80-100
      mg/dl), with no difference between males and females. All animals had detectable
      levels of one or both of the major glucocorticoids (cortisol and corticosterone)
      found in mammals. Steroid levels were highest in P. hypomelanus (cortisol: 1,269
      +/- 207 ng/ml; corticosterone; 590 +/- 154 ng/ml) and lowest in R. aegyptiacus
      (corticosterone: 36 +/- 4 ng/ml; cortisol not determined). Diurnal changes in
      these steroids and the effects of handling and restraint stress were further
      investigated in P. hypomelanus. Experimental animals were captured in their roost
      quarters, bled once by venupuncture within 3 min, placed singly into a small
      holding chamber for 50-60 min, and bled again. This procedure was performed at
      four different times over the course of 24 h with different groups of animals.
      Glucose was at a minimum just before and a maximum just after the period of food
      presentation. Cortisol levels remained relatively constant throughout the day
      roosting period and significantly declined to their lowest level in the period
      following food presentation. As expected, the effects of handling and isolation
      caused a significant increase in both plasma cortisol and glucose levels. When
      individual P. hypomelanus were subjected to 3 h restraint stress in small plastic
      wire-mesh restraining devices, cortisol levels rose approximately 800% by 2 h,
      with the first significant increase at 20 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468543
TI  - Eggshell formation in Bdelloura candida, an ectoparasitic turbellarian of the
      horseshoe crab Limulus polyphemus.
AB  - The marine triclad Bdelloura candida (Turbellaria) episodically deposits stalked
      eggshells onto the gill lamellae of the horseshoe crab Limulus polyphemus.
      Ultrastructural and biochemical analyses indicate that the eggshells consist of
      primary inner and secondary outer layers. Protein of the primary layer is rich in
      glycine, aspartate/asparagine, serine, and 3,4-dihydroxyphenylalanine (Dopa). In
      this regard it resembles the eggshell compositions of other members of the phylum
      Platyhelminthes. The primary layer appears to be derived from precursors produced
      in the vitelline cells of the flatworm. Each egg-laying episode consumes all of
      the precursor-containing vitelline cells. A Dopa-containing protein, vitelline
      protein 1 (Vp1), has been isolated from B. candida and resembles the primary
      eggshell layer in its composition. Vp1 has an apparent molecular weight of 34.4
      and an acidic pI. Dopa-containing proteins are presumed to be directly involved
      in the cross-linking reactions that accompany quinone-tanning. The secondary
      outer layer of the eggshell may serve to adhere the eggshell to the gill. Its
      amino acid composition is unlike that of the primary eggshell and nothing is
      known about its precursors.

PMID- 8468544
TI  - Pheromonal regulation of the mouse estrous cycle by a heterogenotypic male.
AB  - The role of male pheromones in estrous cyclicity was studied in mice selected for
      different reproductive traits. When females are exposed to males of their own
      strain, estrous cycles are highly regular in females selected for increased
      embryo survival (line E). In contrast, cycle regularity is reduced by exposure of
      line E females to males from a strain characterized by irregular estrous cycles
      (line CN-). To investigate the inhibition of estrous cyclicity and the role of
      androgen in this phenomenon, line E females were housed in the olfactory presence
      of E males and later rehoused with one of the following: intact or castrated
      males of line E (homogenotypic condition) or line CN-heterogenotypic condition)
      or castrated CN- males provided with testosterone replacement. A final exposure
      to homogenotypic (line E) males was provided. Estrous cyclicity was decreased
      when line E females were rehoused with intact or castrated CN- males. Metestrus
      was prolonged by intact CN- males, whereas diestrus was prolonged in the presence
      of castrated CN- males. Androgen treatment did not enable castrated CN- males to
      prolong metestrus. These results demonstrate that: 1) heterogenotypic pheromones
      inhibit estrous cyclicity in line E; and 2) the inhibitory influence of line CN-
      males on line E estrous cyclicity is mediated by factors in addition to or other
      than testosterone.

PMID- 8468545
TI  - Spawning in the zebra mussel (Dreissena polymorpha): activation by internal or
      external application of serotonin.
AB  - The zebra mussel, Dreissena polymorpha, was recently introduced accidentally into
      the Great Lakes and, due in part to its prodigious reproductive capacity, is
      spreading rapidly in temperate fresh waters of North America. The present studies
      examine some of the mechanisms that regulate spawning in this animal. In August
      and September 1990 and in May 1991 injection of serotonin (5-hydroxytryptamine, 5
      HT) induced ripe male, but not female, zebra mussels to spawn. During mid-summer
      1991, 5-HT induced spawning in both males and females, and 5-HT could produce
      spawning responses by either injection or external application. External pH over
      a broad range (6.0 to 9.1) had no effect on spawning, neither inhibiting
      induction of spawning by 5-HT nor significantly eliciting spawning itself. With
      external application, 10(-3) M and 10(-4) M 5-HT caused spawning, but 10(-5) M
      and 10(-6) M did not. Cyproheptadine, a 5-HT receptor antagonist, reduced the
      response of both males and females by more than half. Spawning in response to 5
      HT was blocked at 4 degrees C, but not at 12 degrees C, 20 degrees C, or 27
      degrees C. For male zebra mussels morphological criteria for judging gonadal
      maturity were well-correlated with probability of spawning in response to 5-HT.
      For females, the likelihood of spawning in response to 5-HT was not tightly
      coupled to morphological maturity of the gonad, with many morphologically ripe
      females failing to spawn and some apparently immature animals releasing oocytes.
      Prior spawning reduced subsequent responsiveness and intensity of spawning of
      animals to 5-HT. These experiments support a role for 5-HT in regulating
      reproduction in zebra mussels and help define conditions by which zebra mussel
      spawning may be stimulated or inhibited.

PMID- 8468546
TI  - Similar responses to pharmacological agents of 1,2-OAG-induced compaction-like
      adhesion of two-cell mouse embryo to physiological compaction.
AB  - A comparison was made of responses to pharmacological agents between cell
      adhesion induced by an activator of Ca(2+)-phospholipid-dependent protein kinase
      (PKC) and physiological compaction in mouse embryos. An activator of PKC, 1
      oleoyl-2-acetyl-sn-glycerol (1,2-OAG) induced the compaction-like adhesion of
      cells in two-cell embryos within 5-10 min and the adhesion lasted during the
      course of treatment for 1 h. W-7 and W-5 (calmodulin antagonists) and
      cytochalasin B and cytochalasin D (inhibitors of the polymerization of
      microfilaments) each completely interfered with the 1,2-OAG-induced adhesion of
      cells. Two-cell embryos having once shown evidence of cell adhesion in response
      to 1,2-OAG were decompacted when they were transferred to a medium that contained
      1,2-OAG and any one of the agents described above. Colchicine and colcemid
      (inhibitors of the polymerization of microtubules) and tunicamycin (an inhibitor
      of N-linked protein glycosylation) each had no effect on the 1,2-OAG-induced
      adhesion of cells. In Ca(2+)-free medium, treatment with 1,2-OAG failed to induce
      any cell adhesion. These results are very similar to those reported for
      physiological compaction at the late eight-cell stage. Thus, the compaction-like
      adhesion of cells in mouse embryos at the two-cell stage appears to be a
      calmodulin-dependent process, requiring assembled microfilaments and
      extracellular Ca2+ ions but not microtubules or N-linked glycoproteins as is the
      case for the physiological compaction.

PMID- 8468547
TI  - Nightly increase in visual sensitivity correlated with bioluminescent flashing
      activity in the firefly Photuris versicolor (Coleoptera:Lampyridae).
AB  - Changes in visual sensitivity as a function of time-of-day were studied in the
      firefly Photuris versicolor. The electroretinograms (ERGs) elicited by photic
      stimuli of constant intensity and duration were recorded over long periods (18-52
      h) while the insect was in constant darkness. The amplitudes of the ERGs elicited
      by the standard flash were small and remained constant during the daytime hours
      and increased on average sixfold during the evening hours, reaching a maximum at
      the onset of darkness and remaining at that high level until the morning hours.
      The amplitude of the standard response again was reduced in the morning hours to
      a daytime low value which again persisted until the following evening (Fig. 1).
      In addition, a series of flashes of varying intensity were administered
      periodically and logV/logI curves as a function of time-of-day were obtained.
      Compared to the daytime logV/logI curves, the nighttime curves were shifted about
      4 log units towards the left on the intensity axis (Fig. 2). This period of high
      visual sensitivity was correlated with the species' flashing activity period,
      which occurs during the night hours (Fig. 1).

PMID- 8468548
TI  - Maize stripe virus RNA5 is of negative polarity and encodes a highly basic
      protein.
AB  - The entire 1317 nucleotide sequence of the maize stripe virus (MStV) RNA5 was
      determined. Only one open reading frame (ORF) was identified and was found in the
      viral complementary RNA (vcRNA). This ORF appears to encode a protein of M(r)
      44237, hereafter referred to as NS5 delta. In vitro translation of transcripts
      representing nearly full-length RNA5 vcRNA yielded products of the predicted
      size, as well as some smaller, less prominent products. No products were
      identified from transcripts of viral polarity. RNA hybridization analyses of MStV
      infected Zea mays revealed RNAs corresponding only to full-length RNA5, but both
      positive and negative polarity RNAs were abundant. Analysis of the NS5 amino acid
      sequence revealed that it is extremely basic, containing 21% arginine and lysine.
      Database comparisons showed that NS5 had no significant similarity to other
      protein sequences.

PMID- 8468549
TI  - Sequence analysis of the parsnip yellow fleck virus polyprotein: evidence of
      affinities with picornaviruses.
AB  - The 9.9 kb monopartite ssRNA genome of parsnip yellow fleck virus (PYFV) encodes
      a polyprotein from which the functional proteins are assumed to arise by
      proteolytic cleavage. The 22.5K, 26K and 31K particle proteins were mapped in the
      polyprotein by determining their N-terminal amino acid sequences, and were found
      to begin at amino acid positions 395, 589 and 811, respectively. There could be
      polypeptide(s) of up to 43K on the N-terminal side of the particle protein
      sequences. A region within the 26K particle protein has sequence similarity to
      the VP3 particle protein of picornaviruses. Three other regions in the PYFV
      polyprotein have sequence similarity to regions thought to have RNA polymerase,
      NTP-binding and protease functions in the polyproteins of picornaviruses,
      comoviruses and nepoviruses. Despite these similarities in sequence and in genome
      organization to viruses in the picorna-like supergroup, PYFV is distinct from all
      other plant and animal viruses described. This justifies placing it in a separate
      plant virus genus for which the name 'sequivirus' has been proposed.

PMID- 8468550
TI  - Functional domains of the p10 protein of Autographa californica nuclear
      polyhedrosis virus.
AB  - Distinct functional domains in the Autographa californica nuclear polyhedrosis
      virus p10 protein were identified by analysis of p10 mutants. When up to 15 amino
      acids from the carboxy terminus were deleted, truncated p10 proteins were found
      in both the nucleus and the cytoplasm of infected cells, but formed no fibrillar
      structures. This suggested that the positively charged carboxy terminus is not
      required for nuclear or cytoplasmic localization of p10 protein, but is involved
      in protein-protein interactions leading to assembly of the p10 protein into
      fibrillar structures. Absence of the p10 protein prevented the release of
      polyhedra from infected cells, caused by impaired nuclear disintegration. This
      function of the p10 protein appears to be located between amino acid residues 52
      and 79. The amino-terminal half of the p10 protein has already been implicated in
      the self-aggregation of this protein. Thus fibrillar structure formation, nuclear
      disintegration and intermolecular p10 protein interactions seem to be three
      separate functions of the p10 protein and these functions are located in distinct
      domains of the protein. The mutants expressing truncated p10 proteins were
      impaired in electron-dense spacer formation but polyhedron envelopes were still
      formed. This result suggested that the formation of electron-dense spacers is not
      a prerequisite for the formation of polyhedron envelopes.

PMID- 8468551
TI  - Selective effects on adenovirus late gene expression of deleting the E1b 55K
      protein.
AB  - The E1b gene of human adenovirus 5 (Ad5) encodes a 55K product previously shown
      to be required for the efficient accumulation of mRNAs derived from the major
      late primary transcript in the cytoplasm of infected cells. This finding is
      extended here to include the transcripts from other viral promoters activated
      during the late phase of infection. Conversely, accumulation of mRNA derived from
      the major late promoter at early times is not dependent on this E1b function.
      Cytoplasmic levels of the various differentially spliced products of the major
      late unit are not equally dependent on the E1b 55K protein. Rather, the longest
      mRNA species within each 3'-coterminal family shows the greatest dependence.
      These findings support a model in which the Ad5 E1b 55K protein acts to
      facilitate the movement of mature viral mRNA away from the nuclear matrix of the
      infected cell.

PMID- 8468552
TI  - Role of phosphorylation near the amino terminus of adenovirus type 5 early region
      1A proteins.
AB  - Human adenovirus early region 1A (E1A) proteins act as transcriptional regulators
      and function in the control of DNA synthesis and cell transformation. Little is
      known about how these viral products are functionally regulated. E1A proteins of
      adenovirus serotype 5 (Ad5) are phosphorylated at several serine residues and
      previous studies had indicated that both Ser-89 and Ser-219 are substrates for
      one or more of the cdc2 family of cell cycle kinases. A second residue near the
      amino terminus, Ser-96, may also be a site. Although phosphorylation of Ser-89
      causes a major shift in gel mobility, the effect on E1A biological activity is
      unclear. In the present studies we have shown by mutational analysis that
      phosphorylation at Ser-89 also regulates phosphorylation at Ser-96, suggesting
      that the gel mobility shift is the result of multiple phosphorylation events.
      Phosphorylation at Ser-89 did not seem to affect E1A-mediated repression of the
      simian virus 40 enhancer or trans-activation of the E3 promoter significantly,
      but it did appear to have a modest but significant effect on transformation of
      primary baby rat kidney cells.

PMID- 8468553
TI  - Molecular cloning and expression in Escherichia coli of the glycoprotein gene of
      VHS virus, and immunization of rainbow trout with the recombinant protein.
AB  - The gene encoding the envelope glycoprotein of a recent Danish isolate of a
      salmonid rhabdovirus, viral haemorrhagic septicaemia virus (VHSV) has been cloned
      and sequenced at the cDNA level. When compared with the deduced sequence of a
      French isolate of VHSV, it was noted that there were 13 amino acid substitutions
      in the Danish virus. Amino acid homologies with the glycoprotein of a North
      American salmonid rhabdovirus (infectious haematopoietic necrosis virus) indicate
      a high degree of structural similarity between the two fish rhabdovirus
      glycoproteins. Results from partial enzymatic deglycosylation of the viral
      protein indicate that all four NXT/S sites found in the sequence are N
      glycosylated in the virus. The glycoprotein, without the N-terminal leader
      sequence and C-terminal hydrophobic anchor segment, was expressed in Escherichia
      coli as a factor Xa protease-cleavable fusion protein. The purified and renatured
      viral part of the recombinant protein was able to elicit VHSV-specific antibodies
      and neutralizing antibody activity in serum when injected into rainbow trout.

PMID- 8468554
TI  - Characterization of morbilliviruses isolated from dolphins and porpoises in
      Europe.
AB  - A previously unidentified morbillivirus was isolated from two harbour porpoises
      (Phocoena phocoena) that had died in the Dutch Waddensea (North Sea) in 1990.
      This porpoise morbillivirus (PMV) and a dolphin morbillivirus (DMV), which had
      recently caused a heavy mortality in Mediterranean striped dolphins (Stenella
      coeruleoalba), were compared antigenically with other members of the genus
      Morbillivirus, including the newly recognized phocine distemper virus type 1. DMV
      and PMV proved to be similar but distinct morbillivurses, closely related to
      rinderpest virus and peste-des-petitsruminants virus. Cell cultures of cetacean,
      pinniped, ruminant and canine origin showed a different pattern of susceptibility
      to DMV and PMV infection. Ruminants and dogs proved to be susceptible to
      experimental infection with DMV and PMV, which both caused a transient leukopenia
      most pronounced in the ruminants. Pre-exposure of dogs to DMV and PMV protected
      them from developing CDV viraemia and clinical signs upon challenge infection
      with virulent CDV. A serological survey among stranded animals of different
      cetacean species in Europe indicated that infections with DMV- and PMV-like
      morbilliviruses are not uncommon among these aquatic mammals.

PMID- 8468555
TI  - The role of gp55 N-glycosylation in pathogenesis of Friend spleen focus-forming
      virus.
AB  - The product of the envelope gene (gp55) of Friend spleen focus-forming virus is
      responsible for the acute form of erythroleukaemia caused by this virus. In order
      to investigate the role that the four known N-linked carbohydrate side-chains of
      gp55 play in pathogenesis, we have inactivated the four N-glycosylation signals
      by mutating the asparagine residues of these four sites into serine. When
      glycosylation sites 1 and/or 2 were altered, the viruses remained fully
      pathogenic. However, mutation at either of glycosylation sites 3 or 4 rendered
      the virus apathogenic, independent of mutations at other sites. Furthermore, when
      site 3 was changed, a new product appeared which seemed to have acquired a
      carbohydrate chain at a position normally not glycosylated, presumably at
      position Asn378.

PMID- 8468556
TI  - Mutational analysis of Moloney murine leukaemia virus surface protein gp70.
AB  - Ten mutations were generated in the env gene of Moloney murine leukaemia virus
      DNA. The mutations were made by site-directed mutagenesis to alter basic amino
      acids (lysine or arginine) in the surface glycoprotein gp70. Mutants were
      investigated following transfection into NIH/3T3 cells. All 10 mutants released
      virion particles into the medium, suggesting that none of the mutations affected
      overall viral gene expression or virion budding. Two mutants were positive in XC
      plaque assay, reverse transcriptase assay and re-infection experiments, showing
      that these mutations occurred in parts of the molecule not essential for
      infection. Three mutants were negative in both the XC plaque assay and re
      infection experiments, suggesting that they make non-infectious virus particles.
      The results indicate a defect in the early phase of infection, perhaps in
      receptor binding or in the fusion of virion and host membranes. The other
      mutations resulted in reduced infectivity of released virion particles.

PMID- 8468557
TI  - In vitro non-productive infection of purified natural killer cells by the BRU
      isolate of the human immunodeficiency virus type 1.
AB  - Highly purified natural killer (NK) cell lines and clones, displaying the typical
      phenotype, morphology and function and obtained from healthy blood donors, were
      infected in vitro with the BRU isolate of human immunodeficiency virus type 1
      (HIV-1). There was no significant increase in reverse transcriptase activity and
      levels of p24 antigen in the supernatants, but positive staining was observed
      using an immunogold technique with polyclonal anti-HIV-1 antibodies. When
      infected NK cells were co-cultivated with autologous non-infected CD4+ mitogen
      activated cells, significant levels of reverse transcriptase activity and p24
      antigen in supernatants were detected. Giant syncytial cells and a high number of
      mature virion particles were also evident. When NK cell lines or clones from HIV
      1-infected patients were studied, neither the presence of p24 antigen nor reverse
      transcriptase activity was detected in the supernatants after stimulation with
      mitogens, cytokines or co-culture with allogeneic CD4+ mitogen-activated cells.
      PCR studies did not detect HIV-1 genes in freshly purified NK cells, cell lines
      or clones from infected patients. Taken together these results suggest that (i)
      normal NK cells can be infected in vitro by the HIV-1 BRU isolate in a non
      productive fashion, (ii) PCR with NK cell DNA of HIV-1-infected patients
      indicates that in vivo few of these cells, if any, are infected by HIV-1 and
      (iii) the mechanisms responsible for the impairment of NK cell function during
      HIV-1 infection remain to be determined and are probably not related to a direct
      cytopathic effect of the virus.

PMID- 8468558
TI  - Class I major histocompatibility complex-restricted cytotoxic T cell responses to
      vaccinia virus in humans.
AB  - Cytotoxic T lymphocyte (CTL) responses to vaccinia virus (VV) were studied in
      human subjects receiving smallpox vaccine by dermal scarification. After in vitro
      restimulation with VV, peripheral blood mononuclear cells (PBMCs) from three of
      six vaccinated subjects killed virus-infected target cells. VV-specific, HLA
      restricted CTL activity was mediated primarily by CD8+ cells, although low levels
      of lytic activity by CD4+ cells were observed in some experiments. Two of the
      three responders had no history of exposure to VV prior to vaccination, whereas
      all three non-responders were vaccinated against smallpox during childhood. PBMCs
      from an additional three subjects who had received smallpox vaccine at least 20
      years previously were negative for CTL activity. These data suggest that the
      duration of memory CTL populations against VV in the peripheral blood is limited,
      and that pre-existing immunity to VV may interfere with boosting of the CTL
      response upon revaccination.

PMID- 8468559
TI  - Nucleotide sequence and possible ambisense coding strategy of rice stripe virus
      RNA segment 2.
AB  - The complete nucleotide sequence (3514 nucleotides) of RNA segment 2 of rice
      stripe virus (RSV), the prototype member of tenuivirus group, was determined. In
      the virus-sense RNA an open reading frame (ORF) is present which encodes a 199
      amino acid protein of M(r) 22,762. Another long ORF encoding an 834 amino acid
      protein with M(r) 94,047 (94K) exists in the virus-complementary RNA. Between
      these two ORFs, there is a long non-coding intergenic region of 299 nucleotides.
      The sequence suggests that RNA 2 has an ambisense coding strategy as found for
      RSV RNAs 3 and 4. The putative 94K protein carries stretches with an amino acid
      sequence showing weak similarity to parts of the membrane glycoproteins of Punta
      Toro and Uukuniemi phleboviruses of the family Bunyaviridae, suggesting a
      possible distinct evolutionary relationship between the animal phleboviruses and
      the plant tenuiviruses.

PMID- 8468560
TI  - The putative zinc finger of a caulimovirus is essential for infectivity but does
      not influence gene expression.
AB  - Plant pararetroviruses, such as caulimoviruses, and animal retroviruses have in
      common the presence of a highly conserved arrangement of cysteines and a
      histidine in the precursor of the capsid protein. The composition of these amino
      acids resembles a zinc finger element, a structure that is common to a class of
      eukaryotic proteins that regulate gene expression. The role of the putative zinc
      finger in the life-cycle of caulimoviruses was investigated by introducing
      specific mutations in the coat protein coding region of a cloned and infectious
      form of figwort mosaic virus, a caulimovirus. This mutated viral genome, which no
      longer encoded the conserved cysteine and histidine residues, was not infectious
      in plants. Transient expression assays in protoplasts showed that expression of a
      reporter gene inserted at different places in the genome was not detectably
      influenced by the coat protein or its putative zinc finger. It appears that the
      zinc finger-like element of caulimoviruses is not involved in the regulation of
      gene expression. These observations support a model which predicts a function of
      the zinc finger in specific recognition and packaging of viral RNA into virions
      prior to reverse transcription.

PMID- 8468561
TI  - Production of infectious in vitro transcripts from a full-length clover yellow
      mosaic virus cDNA clone.
AB  - A full-length cDNA copy of clover yellow mosaic virus (CYMV) RNA was constructed
      from two smaller cDNA clones. In vitro transcription of linearized plasmid with
      T7 RNA polymerase produced genomic-sized RNA. These transcripts caused symptoms
      typical of CYMV infection when used to inoculate both a systemic host (Vicia
      faba) and a local lesion host (Gomphrena globosa). Electron microscopy of
      extracts from individual local lesions revealed virus particles identical to
      native CYMV. Increasing the length of the poly(A) tail from 23 residues to 80 or
      to 135 residues increased the infectivity rate from 12% to 17% or to 35% that of
      native CYMV RNA, respectively.

PMID- 8468562
TI  - The nucleotide sequence of the M RNA segment of tomato spotted wilt virus, a
      bunyavirus with two ambisense RNA segments.

PMID- 8468563
TI  - Comparative study of the isolation of human immunodeficiency virus from the lung
      and peripheral blood of AIDS patients.
AB  - HIV-1 proviral DNA was detected by the polymerase chain reaction (PCR) in
      leucocytes from the peripheral blood (PBL) and bronchoalveolar lavage (BAL) of
      100% and 72%, respectively, of HIV-1 seropositive patients. Infective virus
      isolated by cocultivation was recovered from the PBL and BAL of 50% and 59% of
      individuals, respectively. Isolation of HIV-1 was more readily made from the lung
      of individuals undergoing Pneumocystis carinii pneumonia (PCP) than from patients
      with non-PCP lung infections. The concomitant infection of lung cells with
      cytomegalovirus did not affect the isolation rate of HIV-1 from the lung. HIV-1
      was isolated from BAL of 23 out of 36 (64%) individuals receiving no antiviral
      chemotherapy and from 13 out of 24 (54%) patients who were receiving AZT.

PMID- 8468564
TI  - Delayed clearance of HBV-DNA detected by PCR in the absence of viral replication.
AB  - The polymerase chain reaction (PCR) was used to study the in vivo persistence and
      clearance of HBV-DNA in the serum of a monkey (Macaca mulatta) known to be
      naturally resistant to the HBV infection. Total infectious plasma, virus pellet,
      and viral DNA were inoculated into 3 different monkeys. Degradation of infectious
      particles and clearance of HBV-DNA were analyzed by detecting HBV-DNA sequences
      in serial dilutions of serum by dot blot hybridization and PCR. Semi-quantitation
      was carried out by comparison with minimal positive dilutions of known HBV-DNA.
      The presence of hepatitis B surface antigen (HB-sAg) and hepatitis B e antigen
      (HBeAg) in serum was also investigated. PCR assays were found positive in serial
      samples of the 3 monkeys, and passively transmitted viral DNA remained detectable
      for 3 months after inoculation. HBsAg and HBeAg were detectable for 3 weeks and 2
      weeks, respectively, in a monkey inoculated with total infectious plasma. Semi
      quantitation of HBV viremia showed that the amount of virus detected 1 day after
      injection was markedly decreased and persisted at a low level, showing a rapid
      and important sequestration of viral particles. Since replication can be excluded
      in these monkeys, the data show that HBV-DNA sequences can remain detectable at a
      low level in the serum for long periods. It is thus conceivable that PCR may also
      detect the HBV genome, eventually degraded in vivo, and a weakly positive result
      does not always mean ongoing viral replication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468565
TI  - Polymerase chain reaction-based detection of hepatitis D virus genome in patients
      infected with human immunodeficiency virus.
AB  - The polymerase chain reaction (PCR) was used to detect hepatitis D (HD) viremia
      in patients infected with the human immunodeficiency virus (HIV). Nineteen (9%)
      of 206 such patients, unselected for liver disease or HBV infection, were found
      prospectively to be infected by HDV. Thirty-one anti-HIV-positive patients were
      studied by means of PCR, and the results were analyzed according to HDV and
      hepatitis B virus (HBV) serological status. HDV-PCR was positive in 5 patients.
      Two had detectable serum HDV antigen. Four patients had anti-HD IgM and IgG
      antibodies. All these patients were HBs antigen-positive, and 3 were HBV-DNA
      positive. All the other patients were HDV-PCR-negative. Statistical analysis
      suggested more extensive liver damage and immunological impairment in HDV-PCR
      positive patients. In this unselected HIV-infected population, HDV-RNA detection
      by PCR was restricted to HDV infected patients in whom 5/19 were positive. This
      test permitted direct diagnosis of HDV viremia and will be useful for monitoring
      HDV infection.

PMID- 8468566
TI  - Small virus-like particles bud from the cell membranes of normal as well as HIV
      infected human lymphoid cells.
AB  - Electron microscopy (EM) of cell sections showed cell associated virus-like
      particles (VLP), 50-60 nm in diameter, budding from the membrane of human
      lymphoid cells in culture. The particles had an envelope continuous with the cell
      membrane and a dense core that almost filled the particle. Particles 70-80 nm in
      diameter with prominent external spikes were found in the culture medium by
      negative staining (medium-associated VLP). Cell-associated VLP were also present
      in cord lymphocytes, both on initial separation and after culture with or without
      foetal calf serum, and therefore were considered to be endogenous to the cells
      and were not bovine diarrhoea virus. VLP were observed in most of the lymphoid
      cell lines examined. VLP were also found less frequently in established human
      tumour and nontumour cell lines. Both cell-associated and medium-associated VLP
      were also present in HIV infected cell cultures, and they could be distinguished
      from HIV by their characteristic morphology and smaller size. It was not
      determined whether the 2 types of particle represented the same entity, or
      whether they were defective virus particles or a cellular secretory product.

PMID- 8468567
TI  - Incidence of HTLV-I/II infection in seronegative high-risk individuals.
AB  - The frequency of human T-cell lymphotropic virus types I and II (HTLV-I/II)
      polymerase chain reaction (PCR) reactivity was studied in two groups of high-risk
      individuals in Amsterdam: hard drug users and heterosexual outpatients of the
      sexual transmitted diseases (STD) clinic. Both groups were seronegative as
      determined by enzyme-linked immunosorbent assay (ELISA), Western blot (WB), and
      radioimmuno-precipitation assay (RIPA). Detection of HTLV-I and HTLV-II in
      peripheral blood mononuclear cells (MNC) was performed by PCR, using primer sets
      indicative for the pol and tax genes. In the hard drug users group (n = 25) no
      evidence of HTLV-I/II infection was found whereas in the STD group (n = 21) one
      individual was identified with HTLV-II proviral DNA. Positive reactions in PCR
      were confirmed only for three seropositive controls after in vitro culture of MNC
      but not for the PCR-positive, seronegative individual. Virus production in vitro
      could not be detected by a sensitive HTLV-I antigen capture assay for viral
      p24gag proteins after in vitro T-cell stimulation of MNC, either from PCR
      positive or PCR-seronegative individuals. This suggests again a low viral
      production rate. It is concluded that infection with HTLV-II can be detected
      among high-risk seronegative individuals.

PMID- 8468568
TI  - Critical review of Aedes aegypti control programs in the Caribbean and selected
      neighboring countries.
AB  - In recent years the region of the Americas has experienced increasing dengue
      activity with circulation of multiple virus serotypes. Associated with this trend
      has been the occurrence of sporadic dengue hemorrhagic fever (DHF) cases and of
      DHF epidemics in both the Caribbean and Latin America. High vector infestation
      levels persist even though most countries in the Caribbean conduct national Aedes
      aegypti control programs and despite the fact that in some instances,
      expenditures exceed US$5 per capita per annum. This paper critically reviews the
      resources and vector control strategies employed in the region and in selected
      neighboring countries. Reasons for the lack of progress include continued
      overreliance on eradication-style larviciding routines and the passive role of
      communities in addressing the problem. A policy of health promotion aimed at
      improving environmental health practices at the household and community levels
      has been endorsed by the governments of the region but as yet has not been widely
      adopted.

PMID- 8468569
TI  - Effect of the insect growth regulator methoprene on the ovipositional behavior of
      Aedes aegypti and Culex quinquefasciatus.
AB  - Laboratory and field tests were conducted to determine the attractiveness of the
      insect growth regulator methoprene to ovipositing mosquitoes when presented at
      concentrations used in mosquito control programs. Laboratory experiments
      indicated that ovipositing Culex quinquefasciatus and Aedes aegypti were not
      attracted to methoprene. In field experiments, Culex stigmatosoma and Cx.
      quinquefasciatus larval dip counts in experimental ponds treated with methoprene
      briquets were not significantly different from untreated control ponds. Water
      taken from these methoprene-treated ponds was not attractive when compared with
      water taken from untreated ponds to ovipositing Cx. quinquefasciatus in
      laboratory experiments. These studies provide strong evidence that methoprene is
      not attractive to ovipositing mosquitoes at concentrations within the range of
      field applications.

PMID- 8468570
TI  - Role of Anopheles culicifacies s.l. and An. pulcherrimus in malaria transmission
      in Ghassreghand (Baluchistan), Iran.
AB  - A 2-site immunoradiometric assay (IRMA) was performed on the head and thorax of
      Anopheles culicifacies s.l. and An. pulcherrimus females, the 2 most common
      anopheline species in the District of Ghassreghand (Baluchistan, Iran), collected
      during the 2 peak malaria transmission seasons (May and September-October 1991).
      Positive IRMA results revealed the 2 species as potential vectors of malaria in
      this highly endemic district. This finding serves as the first report on natural
      infection of An. pulcherrimus in Iran and is the second on natural infection of
      An. culicifacies since the previous report of 1959.

PMID- 8468571
TI  - Anopheles culicifacies complex: cytogenetic characterization of Rameshwaram
      island populations.
AB  - Anopheles culicifacies sensu lato collected from Rameshwaram island, Tamil Nadu
      state, India was identified as species B based on the diagnostic inversion
      karyotype Xab 2g1+h1 as observed in polytene chromosomes. Among male mitotic
      karyotypes made from larval neurogonial cells, two types were observed: one with
      an acrocentric Y-chromosome and the other with a sub-metacentric Y-chromosome,
      both had sub-metacentric X and metacentric autosomes. The Rameshwaram population
      is identical to species B in its genetic relationship with species A and C as
      determined by experimental hybridizations (sterile and fertile male hybrids,
      respectively).

PMID- 8468572
TI  - A comparison of Teflon slides and the Army Insecticide Measuring System for
      sampling aerosol clouds.
AB  - The effects of method of droplet analysis, reader of Teflon slides and distance
      on mass median diameter of a Cythion aerosol cloud were examined in the
      calibration of an Army Insecticide Measuring System (AIMS). There were no
      significant differences in results among readers and between the AIMS and
      readers. There were slight but statistically significant differences between
      readers of Teflon slides and between the methods of analysis. Data supports the
      manufacturer's recommendation that, for the AIMS, the distance at which an
      aerosol generator air blast is between 3 and 7 m3 s-1 must be determined.

PMID- 8468573
TI  - Factors affecting the acquisition of Plagiorchis noblei (Trematoda:
      Plagiorchiidae) cercariae by black fly (Diptera: Simuliidae) larvae and the
      effect of metacercariae on host survival.
AB  - Larvae of 4 species of black flies, Prosimulium mixtum, Simulium vittatum, S.
      decorum and Stegopterna mutata, were exposed in the laboratory to cercariae of
      the digenean Plagiorchis noblei in flowing water. Prevalence and intensity of
      infection of all species varied directly with exposure intensity and decreased
      with increasing water velocity; prevalence increased with larval size. Infection
      levels for P. mixtum were higher than for the 3 other species. Mortality among
      infected larvae of all species was 3 times that of controls. Exposure of black
      fly larvae to P. noblei cercariae may adversely affect their survival.

PMID- 8468574
TI  - Dynamics of population densities and vegetation associations of Anopheles
      albimanus larvae in a coastal area of southern Chiapas, Mexico.
AB  - Spatial and seasonal variations on Anopheles albimanus larval densities and their
      plant associations were investigated in larval habitats in southern Mexico
      between April 1989 and May 1990. Thirty-four plant groups were dominant in larval
      habitats. Dense larval populations were associated with 3 genera of plants,
      Cynodon, Echinocloa and Fimbristylis and no larvae were found in habitats with
      Salvinia and Rhizophora. Low significant positive or negative associations were
      documented with the other 12 plant genera. Larval habitats were classified
      according to the morphology of their dominant plants. Higher larval densities
      were observed in the groups characterized by relatively short emergent
      vegetation. The distribution of habitat-types within 5 identified vegetation
      units showed a significantly dependent relationship. For the entire study period,
      highest larval densities were detected in flooded pasture/grassland vegetation
      units. For all vegetation units, higher larval densities were found when the
      dominant plant type covered between 25-50% of the breeding site. The integration
      of data from habitat-types into vegetation units did not result in loss of
      information.

PMID- 8468575
TI  - Metaphase karyotypes of Anopheles of Thailand and Southeast Asia: I. The Hyrcanus
      Group.
AB  - Metaphase karyotypes of 6 species of the Hyrcanus Species Group of the subgenus
      Anopheles show constitutive heterochromatin variation in X and Y chromosomes.
      Anopheles peditaeniatus exhibits the most extensive variation in the size and
      shape of heterochromatic sex chromosomes, with 3 types of X and 5 types of Y
      chromosomes. Anopheles nitidus shows the least variation, with only 2 types of X
      chromosomes. Anopheles sinensis and An. crawfordi each have 2 forms of metaphase
      karyotype in the heterochromatin of the Y chromosome. It is not known whether the
      2 forms of metaphase karyotype in these 2 species represent inter- or
      intraspecific differences. The 2 forms of heterochromatic sex chromosomes
      observed in An. argyropus and An. nigerrimus may suggest the existence of sibling
      species complexes within each of these species.

PMID- 8468576
TI  - Experimental infection of Anopheles gambiae s.s., Anopheles freeborni and
      Anopheles stephensi with Plasmodium malariae and Plasmodium brasilianum.
AB  - Susceptibility to infection of 2 strains of Anopheles gambiae s.s., An. freeborni
      and An. stephensi, was determined for 2 closely related malaria parasites,
      Plasmodium malariae and P. brasilianum. Neither strain of An. gambiae supported
      development of oocyst densities as great as the other 2 anopheline mosquitoes.
      The ZAN strain of An. gambiae s.s. from Zanzibar was more susceptible to
      infection with the strain of P. malariae from Uganda than the G-3 strain of An.
      gambiae s.s. from The Gambia. All species and strains of mosquitoes supported
      complete development to the presence of sporozoites in the salivary glands.

PMID- 8468577
TI  - Effect of controlled burning on survival of floodwater Aedes eggs in Kenya.
AB  - The effect of controlled burning on the survival of Aedes mosquito eggs was
      evaluated in 2 distinct dambo habitats. In a dambo dominated by grasses, egg
      survival was 3.3% after burning compared with 43.8% in a similar dambo that was
      not burned. In a dambo dominated by sedges, egg survival was 0.7% after burning
      compared with 28.5% in a similar dambo that was not burned. Mortality of mosquito
      eggs appeared to be caused by high temperatures associated with the fire and not
      elapsed time since egg survival did not decrease with time after burning. The
      potential for burning to control the mosquito vectors of Rift Valley fever virus
      is discussed.

PMID- 8468578
TI  - Reducing the overwintering ability of Aedes albopictus by male release.
AB  - Eggs of temperate Aedes albopictus populations are cold hardy and can diapause,
      but tropical populations are not cold hardy and cannot diapause. Heterozygotes
      possess intermediate diapause and cold hardiness. Males of a tropical strain from
      Malaysia with a distinctive genetic marker were released into an existing
      temperate population in East St. Louis, Illinois. Subsequent egg samples from the
      release site had genetic marker frequency of up to 24%. Reduced cold hardiness
      and decreased diapause incidence were also observed in the release site
      population. No such changes occurred at a nearby control site. The rank order of
      overwintering survival of eggs at the release site was: Aedes triseriatus >
      temperate Ae. albopictus > hybrid temperate/tropical Ae. albopictus > tropical
      Ae. albopictus. Eggs collected from the release population the next summer showed
      total absence of the genetic marker; presumably carriers were removed by the
      winter.

PMID- 8468580
TI  - Assessment of Aedes sierrensis as a vector of canine heartworm in Utah using a
      new technique for determining the infectivity rate.
AB  - Both Aedes sierrensis and Dirofilaria immitis have recently become established in
      Utah. We evaluated the vector potential of this Aedes sierrensis strain using a
      new technique for detecting Dirofilaria immitis in individual mosquitoes.
      Survival of Aedes sierrensis females after bloodfeeding did not differ from that
      of Ae. triseriatus but infective Ae. sierrensis produced significantly more L3
      nematodes. This observation and epidemiological data support the hypothesis that
      Ae. sierrensis is the vector of canine heartworm in Utah. Infectivity was
      determined by counting infective-stage parasites that migrated into the medium
      after individual mosquitoes were decapitated or crushed in the wells of tissue
      culture plates. Complete recovery of infective-stage nematodes was attained in 60
      74% of the mosquitoes and 77-93% of all L3 were collected with this technique.
      There were few false negatives. High recovery rates (mean = 89%) were also
      obtained for mosquitoes treated en masse.

PMID- 8468579
TI  - Larvicidal and chemosterilant activity of Annona squamosa alkaloids against
      Anopheles stephensi.
AB  - Alkaloids isolated from Annona squamosa have shown larvicidal growth-regulating
      and chemosterilant activities against Anopheles stephensi at concentrations of 50
      to 200 ppm. Adults exposed as larvae to different treatments showed reduced
      fecundity and fertility in females. Mortality in the larvae, pupae and adults
      produced about a 52-92% decrease in the laboratory experiment. The total
      developmental period was slightly reduced from the control. Treatment with the
      alkaloids had a significant effect on the mortality, emergence and reproductive
      physiology of An. stephensi.

PMID- 8468581
TI  - Malathion aerosol cloud behavior in a Coastal Plains pine flatwoods.
AB  - The study examines malathion aerosol cloud behavior in a North Florida pine
      flatwoods. Droplet mass median diameters (MMD) decreased over distance in both
      open and pine flatwoods. A sharp decrease in number of aerosol droplets per cm2
      occurred between 3.1 and 15.2 m and a gradual decline in droplets per cm2
      occurred beyond 15.2 m in both treatment areas. There were no interactions
      between habitat and distance in regard to MMD or droplets per cm2. Analysis of
      variance models accounted for 82% of the variability in the MMD data and 79% of
      the variability in the number of droplets per cm2.

PMID- 8468582
TI  - Carbon dioxide anesthesia in phlebotomine sand flies (Diptera: Psychodidae): CO2
      effect upon two laboratory colonies.
AB  - Gravid females of 2 sand fly species, Phlebotomus papatasi and P. perniciosus,
      were exposed to carbon dioxide anesthesia for 5, 10 and 20 minutes. Recovery
      time, mortality at 0 min and 24 h, percentage of females laying eggs, time to
      oviposition, and egg productivity for each exposure time were registered.
      Survival, fecundity and oviposition time in the 2 species were not adversely
      affected by the short period of CO2 anesthesia routinely used in the sand fly
      colony maintenance.

PMID- 8468583
TI  - Functional imaging in relation to parkinsonian syndromes.
AB  - Parkinsonism is a feature not only of Parkinson's disease but also of many other
      diseases affecting basal ganglia function. Functional imaging (PET and SPECT) can
      demonstrate the various resting patterns of disruption of regional cerebral blood
      flow, metabolism, and neuropharmacology associated with different parkinsonian
      disorders. 18F-dopa PET also has the potential to detect subclinical dysfunction
      of dopaminergic terminals in at-risk subjects. Finally, functional imaging can
      help us understand the nature of the networks involved in performing different
      motor tasks, and can reveal how these networks malfunction in the presence of
      bradykinesia or parkinsonian tremor.

PMID- 8468584
TI  - Inverse correlation between disappearance of intrathecally injected 111In-DTPA
      from CSF with CSF protein content and CSF-to-serum albumin ratio.
AB  - By means of cerebrospinal fluid (CSF) scintigraphy with 111In-DTPA injected
      following lumbar puncture in 18 patients after meningitis (12), with traumatic
      head injury (4), cholesteatoma (1) or a communicating hydrocephalus (1) the
      hypothesis of whether slow movement of CSF may contribute to the elevation of CSF
      protein and albumin content in neurological diseases other than spinal block was
      tested. The ratios of the count rates over the head (geometric mean of anterior
      and posterior view) at 23-25 h to 4-6 h after 111In-DTPA application (C24 h/C5 h)
      and the ratio 47-49 h to 23-25 h after injection (C48 h/24 h) were taken as
      measures of the velocity of 111In-DTPA disappearance from CSF. Both the CSF
      protein content and the CSF-to-serum albumin ratio correlated with C24 h/C5 h and
      C48 h/C24 h. Assuming log-linear elimination between 24 and 48 h the elimination
      half-life of 111In-DTPA was estimated to be 12.4-131.1 h (median = 31.7 h). It
      was concluded that slow CSF kinetics probably are involved in the elevation of
      CSF protein content in several neurological diseases.

PMID- 8468585
TI  - Reduction in cortical 5-HT3 binding sites following a unilateral 6
      hydroxydopamine lesion of the medial forebrain bundle in rats.
AB  - Serotonergic mechanisms have been implicated in pathophysiology of Parkinson's
      disease, an illness where the dopamine deficiency represents the prime
      biochemical deficit. Present interest centres on the possible involvement of
      serotonergic receptors in modulating dopamine transmission. In this paper the
      binding of the selective 5-HT3 antagonist [3H]GR 65630 was studied in rats with a
      unilateral 6-hydroxydopamine lesion of the medial forebrain bundle. The maximal
      density of specific [3H]GR 65630 binding was reduced in homogenates of entorhinal
      (17.1%, P < 0.05) and prefrontal cortex (27.5%, P < 0.05) on the lesioned side of
      the rat brain compared to the control tissues. An increase in affinity for [3H]GR
      65630 binding was also found in homogenates of prefrontal cortex (33.8%, P <
      0.05). No changes in the characteristics of [3H]GR 65630 binding to homogenates
      from the amygdala and hippocampus were observed. These data suggest that altered
      dopamine function may affect serotonergic mechanisms in the cortex in Parkinson's
      disease.

PMID- 8468586
TI  - Chronic progressive spinocerebellar syndrome associated with antibodies to human
      T-lymphotropic virus type I: clinico-virological and magnetic resonance imaging
      studies.
AB  - The relationship between HTLV-I infection and the development of spinocerebellar
      degeneration (SCD) in adulthood was studied. The frequency of anti-HTLV-I
      antibodies among patients with SCD (8 of 43, 19%) was found to be higher than the
      seroprevalence rate in the northern part of Kyushu island (6%). All HTLV-I
      carriers with SCD showed chronic progressive cerebellar ataxia as a predominant
      feature and cerebellar atrophy was evident in 6 of 8 patients on magnetic
      resonance imaging (MRI) of the brain. However, SCD patients with anti-HTLV-I
      antibodies showed a significantly higher frequency of cerebral white matter
      lesions on brain MRI (6 of 8) and pyramidal tract signs in lower extremities (6
      of 8) than did those without the antibodies (35%, P < 0.05 and 26%, P < 0.01,
      respectively). Moreover, the HTLV-I carriers with SCD exceeded 14 HTLV-I carriers
      having neither SCD nor HTLV-I-associated myelopathy (HAM)/tropical spastic
      paraparesis (TSP) (21%, P < 0.05), and 59 HTLV-I seronegative patients without
      brain disorders (19%, P < 0.001) in the frequency of white matter lesions. On the
      other hand, the HTLV-I carriers with SCD were distinct to the HAM/TSP patients in
      the predominance of cerebellar involvement. Therefore, the peculiar features of
      cerebellar, pyramidal and white matter involvement in the HTLV-I-seropositive SCD
      patients as well as the increased frequency of HTLV-I infection among SCD
      patients suggest that this syndrome may be a distinct subtype of HTLV-I
      associated neurologic diseases.

PMID- 8468587
TI  - Intrathecal synthesis of interleukin-2 and soluble IL-2 receptor in asymptomatic
      HIV-1 seropositive individuals. Correlation with local production of specific IgM
      and IgG antibodies.
AB  - The relationship between the interleukin-2 (IL-2) system and the humoral response
      against human immunodeficiency virus type-I (HIV-1) is important in understanding
      the immune reaction before the development of AIDS. Levels of IL-2 and soluble IL
      2 receptor (sIL-2R) in serum and cerebrospinal fluid (CSF) samples from 31
      asymptomatic HIV-1 seropositive individuals were measured and correlated with
      levels of anti-1 IgG and IgM antibodies. High IL-2 levels were detected in the
      CSF of 20 (65%) subjects, 18 (90%) of whom had evidence of intrathecal synthesis
      of HIV-1-specific IgM antibodies. Similarly, IgG antibodies were detected in 10
      subjects who had elevated IL-2 levels in the CSF. Moreover, intrathecal levels of
      IL-2 and sIL-2R correlated with intrathecal synthesis of both IgG and IgM
      antibodies. Local release of IL-2 seems to play an important role in the
      initiation of the antibody response against HIV-1 in early stages of infection
      and may be utilised in devising effective therapeutic strategies.

PMID- 8468588
TI  - Copper-zinc superoxide dismutase activity in red blood cells and serum in
      demented patients and in aging.
AB  - The activity of the enzyme copper-zinc superoxide dismutase (Cu-Zn SOD) has been
      investigated in serum and red blood cells (RBC) homogenate obtained from demented
      patients with associated vascular lesions (VD), demented patients with probable
      Alzheimer's disease (DAT) and healthy controls (CG) of the same age. The increase
      in SOD activity was statistically significant (P < 0.01) in RBCs homogenate of
      DAT and VD patients, when compared to controls, but no differences appear between
      the two diseases groups. Additionally, a statistically significant increase in
      SOD activity (P < 0.01) in DAT patients above 70 years as compared to those 50-70
      years old, and a relation between SOD and age were found. No changes in SOD
      activity with age in healthy controls nor in vascular dementia group were
      detected. A statistically significant increase in Circulating SOD activity (P <
      0.01) was observed in vascular patients compared to controls. The observed
      increase in DAT Circulating SOD activity (against CG) was not significant. The
      increased levels of Cu-Zn SOD, probably represent a general alteration of the
      oxidative processes characteristic of these dementias and suggest that the enzyme
      might be used as a marker.

PMID- 8468589
TI  - Determination of serum and brain concentrations of neuroprotective and non
      neuroprotective doses of MK-801.
AB  - We developed a sensitive and reliable gas chromatographic (GC) technique for the
      quantitative analysis of MK-801 in brain and serum and applied the technique to
      investigate tissue concentrations of neuroprotective and non-neuroprotective
      doses of MK-801 in a neonatal rat model of hypoxic-ischemia. Brain concentrations
      of MK-801 were a linear function of dose over 4 orders of magnitude. After
      administration of a neuroprotective dose of MK-801 (29.6 mumol/kg) to control
      rats, both serum and brain concentrations rose rapidly to approximately 300 nM
      and approximately 2000 nM, respectively, within 30 min. Approximately 60% of
      serum and 90% of brain MK-801 were bound leaving the free concentrations in both
      blood and brain at approximately 100-200 nM. After hypoxic-ischemia, serum MK-801
      concentrations were not different from controls but brain concentrations were
      lowered by 32%. Free brain concentrations of MK-801 after hypoxic-ischemic were
      124 nM after 29.6 mumol/kg while after 8.9 mumol/kg (the non-neuroprotective
      dose) they were 39 nM. In view of the slow kinetics of MK-801 channel blockade,
      which never reaches equilibrium during the current experiment, this difference in
      concentration would be expected to result in an 80-fold (or greater) difference
      in the current flux through NMDA receptor-operated ion-channels as the rate of
      NMDA receptor-operated ion-channel blockade is concentration dependent.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8468590
TI  - Evoked potential measures of auditory cortical function and auditory
      comprehension in aphasia.
AB  - This study investigated the relation between severity of auditory comprehension
      impairment in aphasia and the functional integrity of the posterior superior
      temporal region as evaluated by middle- and long-latency auditory evoked
      potentials and dipole source analysis. AEPs were studied in 20 stroke patients
      and in age-matched controls. AEPs and language data were collected 1 year or more
      post onset, and were compared to performance early after onset. Patients were
      differentiated in a group with severe and a group with moderate to recovered
      auditory comprehension impairment. Significant asymmetries of auditory evoked
      dipole source potentials were more frequent in the severely impaired group.
      However, a severe auditory comprehension deficit was not incompatible with normal
      AEPs. The results confirm the importance of the posterior superior temporal
      region for auditory language comprehension, but the correlation between AEP
      asymmetry and auditory comprehension seems due to the close spatial relation of
      AEP generating substrate and posterior language area rather than to partial
      overlap. Dipole source analysis of AEPs proved to be a valuable method for the
      assessment of interhemispheric asymmetries, enhancing the sensitivity of AEPs to
      unilateral damage of auditory cortex.

PMID- 8468591
TI  - Antibody-dependent cell-mediated cytotoxicity (ADCC) in Parkinson's disease.
AB  - The possible role of a non-specific cell-mediated immune reaction in the
      pathogenesis of Parkinson's disease (PD) is discussed. It was found that the
      killer cell activity of PD patients below 60 years of age was significantly lower
      than in the older age groups or in the age-matched control group. On the other
      hand, it was also found that the killer cell activity of PD patients with severe
      symptoms (Hoehn-Yahr's IV, V stage) was significantly higher than that of the
      milder cases. These results support the hypothesis that an ADCC reaction-
      mediated by the killer cells--may play a role in the pathogenesis of PD.

PMID- 8468592
TI  - Lewy body-like inclusions in Onuf's nucleus from two cases of sporadic
      amyotrophic lateral sclerosis.
AB  - Lewy body-like inclusions in Onuf's neurons from two sporadic cases with
      amyotrophic lateral sclerosis (ALS) were reported. These inclusions in Onuf's
      neurons as well as those found in the anterior horn cells were immunostained with
      an anti-ubiquitin antibody. Neuropathological examination of these two cases
      revealed neuronal loss and associated gliosis in the anterior horn of the spinal
      cord and hypoglossal nuclei, and degeneration of the corticospinal tract. In
      addition to Lewy body-like inclusions, ubiquitinated skein-like inclusions,
      Bunina bodies, or both were observed in the cytoplasm of the remaining neurons in
      the anterior horn of the spinal cord, and, to a lesser degree, in Onuf's nucleus.
      Spheroids and cord-like thickening of cell processes were also found in the
      anterior horn of the spinal cord. Histometrical study of Onuf's nucleus revealed
      atrophy and loss of Onuf's neurons from Case 1 with a long clinical course.
      Similar cases of motor neuron disease with or without tract degeneration have
      been reported, but the presence of Lewy body-like inclusions in Onuf's nucleus is
      reported here for the first time. It is suggested that Onuf's nucleus is more or
      less involved in the degenerative process characteristic of ALS.

PMID- 8468593
TI  - Electrophysiological study of dorsal column function in streptozocin-induced
      diabetic rats: comparison with 2,5-hexanedione intoxication.
AB  - Dorsal column function and peripheral motor and sensory conduction velocities
      (MCV, SCV) were evaluated in experimental diabetic rats and compared with those
      in 2,5-hexanedione (2,5-HD) intoxicated rats. Hyperglycemia was induced by a
      single injection of streptozocin, and electrophysiological studies were performed
      4 and 12 weeks after the injection. For 8 weeks 2,5-HD was administered daily by
      drinking water to make the 2,5-HD neuropathy rats. Age-matched rats were used as
      control. In diabetic rats, gracile surface potentials evoked by electrical
      stimulation of the lumbosacral trunk remained normal during the experimental
      period, whereas the N and P waves of the evoked potentials were suppressed and
      the duration of the N wave was prolonged in the 2,5-HD rats. In 4-week diabetic
      rats, the antidromic compound action potentials of the gracile tract recorded at
      the most proximal site of lumbosacral trunk were normal. In 12-week diabetic
      rats, the gracile tract conduction velocity (GTCV) was decreased, although the
      duration of these potentials was normal. By contrast, the GTCV was decreased and
      the duration was markedly prolonged in 2,5-HD rats. These findings might indicate
      that temporal dispersion of incoming volleys in the gracile tract is increased in
      2,5-HD rats, but not in diabetic rats. These results suggest that diabetic
      myelopathy exists that but the magnitude and progression of this condition are
      quite different from those of 2,5-HD intoxication, typical dying-back-type
      neuropathy and that the dorsal column is less vulnerable than the peripheral
      nerve in diabetes mellitus.

PMID- 8468594
TI  - Cerebrotendinous xanthomatosis: pathophysiological study on bone metabolism.
AB  - A condition of osteopenia in some cerebrotendinous xanthomatosis (CTX) patients
      led us to investigate bone metabolism in 8 patients belonging to 5 families.
      Serum calcium, phosphate and vitamin D metabolites were in the normal range; a
      reduction in total body density and impairment of intestinal radiocalcium
      absorption were found in the majority of our patients.

PMID- 8468595
TI  - Regulation of membrane-mediated chronic muscle degeneration in dystrophic
      hamsters by calcium-channel blockers: diltiazem, nifedipine and verapamil.
AB  - Membrane-mediated excessive intracellular calcium accumulation (EICA) is a
      fundamental pathogenetic event associated with chronic muscle degeneration in
      patients with Duchenne muscular dystrophy (DMD), and in animals with hereditary
      muscular dystrophy (HMD). Because of potential Ca(2+)-channel blocking
      properties, we investigated the relative efficacies of chronic diltiazem (DTZM)
      (50 mg/kg/d), nifedipine (NFDN) (6 mg/kg/d), and verapamil (VPML) (25 mg/kg/d)
      therapies in reducing EICA and improving dystrophic pathobiology beginning in 30
      day-old male BIO-14.6 strain dystrophic hamsters (DH). Each agent, and sterile
      distilled water as vehicle control, was given in a single daily oral dose for 180
      days to four groups each of DH and BIO-F1B strain normal hamsters (NH). Plasma
      [Ca] and [Mg]; plasma aldolase (ALD), creatine kinase (CK), and lactate
      dehydrogenase (LDH) activities; relative cardiac hypertrophy and relative soleus
      hypertrophy; tissue [Ca] and [Mg] of the heart and rectus femoris muscle,
      histology of rectus femoris, and overall mortality rate were quantitated. Muscle
      Mg was not modified in DH, or by any of these agents. NFDN produced significant
      edema in the soleus and myocardium. During the 6-month therapeutic trial, 45% DH
      and 18% NH died on VPML, 27% DH and 9% NH on NFDN, and 20% DH controls on
      distilled water, but none on DTZM; suggesting that DTZM treated DH lived longer
      than DH controls. Relative efficacy in regulating EICA in both the cardiac and
      skeletal muscles; plasma ALD, CK, and LDH; and improving associated dystrophic
      pathobiology was found to be DTZM >>> NFDN > VPML. DTZM appears to be the most
      effective and safest agent in mitigating EICA in cardiac and skeletal muscles,
      efflux of intracellular enzymes, histopathology of dystrophic muscle with
      sporadic necrosis, and chronic muscle degeneration in DH with HMD. DTZM therapy
      also halted the high morbidity and mortality associated with the dystrophic
      pathobiology inherent in DH.

PMID- 8468596
TI  - Manifesting heterozygotes in McArdle's disease: clinical, morphological and
      biochemical studies in a family.
AB  - We report a family with McArdle's disease with several affected individuals in
      two generations. This unusual pedigree for an autosomal recessive disease is
      explained by the existence of manifesting heterozygotes in the maternal line. The
      presence of symptoms in heterozygotes seems to be due to a decrease in
      myophosphorylase activity below a critical threshold, ranging between 30% and 45%
      of normal mean value. The occurrence of several manifesting heterozygotes in the
      maternal line only can be explained by compound heterozygosity of a defective
      allele and a pseudodeficient allele for myophosphorylase, or by a genetic factor
      which regulates the phenotypic expression of the gene.

PMID- 8468597
TI  - Paul C. Bucy. 1904-1992.

PMID- 8468598
TI  - Decompressive lumbar laminectomy for spinal stenosis.
AB  - A total of 258 consecutive decompressive lumbar laminectomies performed on 244
      individuals presenting with spinal stenosis were analyzed retrospectively. Spinal
      fusion was avoided in all but two patients. Outcome in terms of pain relief and
      return to normal activity was evaluated in two stages, one derived from patient
      charts and having a relatively short-term follow-up time (mean 8.4 months) and a
      second derived from patient responses to a questionnaire (which also scored for
      satisfaction with the results of surgery), which had a longer follow-up time
      (mean 4.7 years). More than 20 clinical and operative parameters were analyzed.
      Overall, a high degree of success (93% pain relief, 95% return to normal
      activity) was achieved in the short term, which was supported by the longer-term
      follow-up data (64% pain relief, 56% activity return, 75% satisfaction). The
      following factors were not significantly correlated with outcome: patient age;
      sex; worker's compensation or no-fault insurance status; employed versus not
      employed; a history of back surgery prior to the laminectomy studied; existence
      of degenerative spondylolisthesis or scoliosis; complete versus incomplete
      myelographic block; or the level of the lumbar spine undergoing surgery. The
      major conclusions arising from these data are: 1) for all age groups through at
      least the eighth decade of life, decompressive lumbar laminectomy is a relatively
      safe operation having a high medium-to-long-term success rate; 2) lumbar
      instability following laminectomy is rare, even in individuals presenting prior
      to surgery with degenerative instability conditions; and 3) lumbar fusion in
      addition to the decompressive laminectomy procedure is rarely required for
      degenerative spinal stenosis.

PMID- 8468599
TI  - Halifax interlaminar clamp for posterior cervical fusion: a long-term follow-up
      review.
AB  - Fifty consecutive patients requiring posterior cervical fusion for various
      pathologies were treated with Halifax interlaminar clamps for internal spinal
      fixation. Fusion involved the C1-2 level in 17 cases, the C1-3 level in one, and
      the lower cervical area (C2-7) in 32. No patient was lost to follow-up review,
      which varied from 6 to 40 months (average 21 months). Fusion failed in five
      patients, three at the C1-2 level, one at the C1-3 level, and one at the C2-3
      level. Screw loosening was the cause of failure in four patients, and in one the
      arch of C-1 fractured. No other complications occurred. Because of the lack of
      complications, avoidance of the hazards of sublaminar instrumentation, and an
      excellent fusion rate, this technique is highly recommended for posterior
      cervical fusion in the lower cervical spine. Atlantoaxial arthrodesis was
      achieved in only 14 (82%) of 17 patients, however, which might be due to the
      higher mobility at this multiaxial level. Improved results in this region may be
      possible by using a new modified interlaminar clamp, by performing adequate bone
      fusions, and by postoperative external halo immobilization in high-risk patients.

PMID- 8468600
TI  - Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve
      repair in the hand.
AB  - In 17 patients acetylcholinesterase activity was used to differentiate between
      sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven
      patients received follow-up evaluation 1 to 11 years after surgery, and at that
      time clinical and electroneurographic examinations were performed to evaluate the
      techniques. Clinical examination showed that four patients had regained on
      average 71.9% of hand function after median nerve repair, one patient had
      regained 83.6% of hand function after ulnar nerve repair, four patients had
      regained on average 53.3% of hand function after median and ulnar nerve repair,
      and two patients had regained on average 43.5% of hand function after median and
      partial ulnar nerve repair. The contribution of the ulnar nerve to reinnervation
      of the thenar muscles was 68.5%, whereas the median nerve did not contribute to
      reinnervation of the hypothenar muscles. Distal latencies for the median nerve
      showed a delay of 36% of the upper limit of normal value, and those for the ulnar
      nerve revealed a delay of 21.5%. This study demonstrated that sensory/motor
      differentiated nerve repair of the median and ulnar nerves is possible and can be
      proven electroneurographically.

PMID- 8468601
TI  - The surgical treatment of painful traumatic neuromas.
AB  - Pain following suspected nerve injury was comprehensively evaluated with detailed
      examination including history, neurological evaluation, electrodiagnostic
      studies, quantitative sensory testing, thermography, anesthetic agents, and
      sympathetic nerve blocks. Forty-two surgically treated patients fell into four
      discrete groups: Group 1 patients had distal sensory neuromas treated by excision
      of the neuroma and reimplantation of the proximal nerve into muscle or bone
      marrow; Group 2 patients had suspected distal sensory neuromas in which the
      involved nerve was sectioned proximal to the injury site and reimplanted; Group 3
      patients had proximal in-continuity neuromas of major sensorimotor nerves treated
      by external neurolysis; and Group 4 patients had proximal major sensorimotor
      nerve injuries at points of anatomical entrapment treated by external neurolysis
      and transposition, if possible. Patient follow-up monitoring from 2 to 32 months
      (average 11 months) was possible in 40 (95%) of 42 patients. Surgical success was
      defined as 50% or greater improvement in pain using the Visual Analog Scale or
      pain relief subjectively rated as either good or excellent, without postoperative
      narcotic usage. Overall, 16 (40%) of 40 patients met those criteria. Success
      rates varied as follows: 44% in 18 Group 1 patients, 40% in 10 Group 2 patients,
      0% in five Group 3 patients, and 57% in seven Group 4 patients. Twelve (30%) of
      40 patients were employed both pre- and postoperatively. It is concluded that: 1)
      neuroma excision, neurectomy, and nerve release for injury-related pain of
      peripheral nerve origin yield substantial subjective improvement in a minority of
      patients; 2) external neurolysis of proximal mixed nerves is ineffective in
      relieving pain; 3) surgically proving the existence of a neuroma with confirmed
      excision may be preferable; 4) traumatic neuroma pain is only partly due to a
      peripheral source; 5) demographic and neurological variables do not predict
      success; 6) the presence of a discrete nerve syndrome and mechanical hyperalgesia
      modestly predict pain relief; 7) ongoing litigation is the strongest predictor of
      failure; and 8) change in work status is not a likely outcome.

PMID- 8468602
TI  - Repair of facial nerve after removal of cerebellopontine angle tumors: a
      comparative study.
AB  - The results of repair of 18 facial nerves were examined by means of a modified
      House-Brackmann grading system. Six were repaired by end-to-end anastomosis and
      12 by nerve graft. The reliability of the simplified House-Brackmann grading
      system was also assessed, using the kappa statistic to analyze the agreement
      between pairs of observers who examined the function of 40 nerves in 37 patients.
      Facial nerves studied had been either preserved, repaired or grafted, or divided
      and treated by faciohypoglossal nerve anastomosis. One nerve was not treated. The
      grading system proved to be somewhat unreliable, with complete agreement between
      observers in only 25% of cases. Facial nerve repair produced a fair return of
      function in just under two-thirds of the cases. The ability of an examiner
      ignorant of the patient's history to assess from the end result how the nerve had
      been managed was also estimated. Observers showed little ability to decide
      correctly on the previous treatment of the nerve when the patient showed moderate
      dysfunction postoperatively. The implications of these findings for grading
      systems and for management of the facial nerve in acoustic nerve tumor surgery
      are discussed.

PMID- 8468603
TI  - Referral bias in aneurysmal subarachnoid hemorrhage.
AB  - The objective of this study was to assess the effect of referral bias on survival
      in patients with subarachnoid hemorrhage (SAH). The characteristics of 49
      patients with aneurysmal SAH from a single community were compared with those of
      328 patients referred from outside the community, all treated in the same medical
      care setting. In addition, referral patients who received surgery were compared
      by differential survival analysis with those still awaiting surgery at Days 1 to
      3, Days 4 to 10, and Days 11 to 15. There was a dramatic difference in the 30-day
      survival rate between referral patients (83%) and community patients (59%), but
      most of the difference had occurred by the 2nd day after SAH. In the referral
      patients, the variables present at first medical attention that were found to
      have an independent effect on survival were clinical grade, presence of coma,
      number of days from SAH to referral, diastolic blood pressure, and patient age.
      There was a higher survival rate at 1 year for patients who were surgically
      treated compared with those awaiting surgery for each of the three time periods.
      Patients who underwent early surgical treatment had a 1-year survival rate almost
      identical to that of patients with late surgery. Referral patients had a better
      early survival rate than did community patients because the referral group did
      not include patients who died and some who were in poor clinical condition before
      the opportunity for referral. The differential survival analysis described
      provides a new method for estimating survival for treated and untreated patients
      with SAH.

PMID- 8468604
TI  - Hemispherectomy for intractable seizures: long-term results in 17 patients
      followed for up to 38 years.
AB  - Seventeen patients who underwent hemispherectomy for intractable epilepsy between
      1950 and 1971 were reviewed to evaluate outcome for seizure control and the
      development of late complications. Sixteen had complete resection and in one the
      frontal pole was preserved. The follow-up period was 19 to 38 years (mean 28
      years). One patient was lost to follow-up review 10 years after surgery. Three
      patients had died but none of the deaths were related to the surgery or to
      epilepsy. Ten patients had no postoperative complications, and three developed
      late complications: two had elevated intracranial pressure with enlargement of
      the remaining lateral ventricle after 13 and 16 years, and one had recurrent
      bleeding into the cerebrospinal fluid after 6 years. All were treated surgically
      and have since remained well. Eight patients (47%) had no seizures after surgery
      and eight (47%) were almost seizure-free. It is concluded that classical
      hemispherectomy is an effective operation for control of some types of epilepsy.
      The late complications, which occurred in 17% of the cases in this series, can be
      successfully treated. This series presents the longest follow-up results after
      hemispherectomy reported to date.

PMID- 8468605
TI  - Intracranial chordomas: a clinicopathological and prognostic study of 51 cases.
AB  - Fifty-one patients with intracranial chordomas who were surgically treated
      between 1960 and 1984 were studied. Median patient age was 46 years, and 73%
      presented with diplopia or headache. Nineteen tumors were classified as the
      "chondroid" type. The extent of surgical removal was a biopsy in 11 patients and
      subtotal removal or greater in 40. Thirty-nine patients received postoperative
      radiation therapy. At the time of analysis, 17 patients were alive, and the
      estimated 5- and 10-year survival rates were 51% and 35%, respectively, for the
      group of 51 patients. Univariate analysis showed that: 1) patients undergoing
      resection lived longer (the 5-year survival rate was 36% for the 11 biopsy
      patients compared with 55% for the 40 patients who had resection; 2) patients who
      underwent postoperative radiotherapy tended to have longer disease-free survival
      times; and 3) overall and disease-free survival data were the same for patients
      with chondroid tumors and those with typical chordomas. Multivariate analysis
      showed that: 1) age was the factor most strongly associated with longer overall
      and disease-free survival; 2) diplopia was associated with longer survival; and
      3) tumoral mitotic activity tended to be associated with shorter disease-free
      survival. One tumor metastasized to the cervical cord, and two tumors underwent
      anaplastic transformation. These data suggest that the prognosis in patients with
      chordomas is unfavorable, young age is the single factor most strongly associated
      with longer survival, surgical resection is beneficial, and postoperative
      radiotherapy may prolong disease-free survival.

PMID- 8468606
TI  - High recurrence rate following aspiration of colloid cysts in the third
      ventricle.
AB  - Sixteen patients treated between 1969 and 1989 for a colloid cyst of the foramen
      of Monro by stereotactically guided aspiration (not stereotactic extirpation)
      were evaluated to assess the long-term outcome of the procedure. Thirteen of
      these patients required reoperation due to an acute comatose state, failure to
      achieve permanent reduction of the cyst, or symptomatic hydrocephalus. Of these
      13, six were treated twice and two were treated three times by stereotactic
      aspiration. Five patients underwent microsurgical extirpation and three had a
      shunt placed following a failed aspiration. Failure of the first procedure was
      detected within the first 2 months after treatment in eight patients and after
      more than 6 years in seven. Following stereotactic aspiration, three patients
      experienced a temporary memory deficit and confusion and one patient suffered a
      central pain syndrome. Eleven of the 26 procedures were followed by a recurrence
      6 to 15 years after treatment; seven recurrent cysts were detected after more
      than 8 years. Of the patients with recurrences, three did not undergo repeat
      surgery but showed an increase in cyst size at the latest follow-up examination.
      It is suggested that radical removal by open or stereotactically guided
      microsurgery is the method of choice since stereotactic aspiration fails to offer
      a radical or permanent treatment for colloid cysts of the third ventricle.

PMID- 8468607
TI  - Resection, biopsy, and survival in malignant glial neoplasms. A retrospective
      study of clinical parameters, therapy, and outcome.
AB  - Between July, 1984, and October, 1988, 263 patients (163 male, 100 female), aged
      from 4 to 83 years (mean 52 years), with malignant brain gliomas underwent
      surgical procedures: stereotactic biopsy in 160 and resection in 103 patients.
      There were 170 grade IV astrocytomas, 17 grade IV mixed oligoastrocytomas, 44
      grade III astrocytomas, 22 grade III mixed oligoastrocytomas, and 10 malignant
      oligodendrogliomas. Overall median survival time was 30.1 weeks for grade IV
      gliomas, 87.7 weeks for grade III gliomas, and 171.3 weeks for malignant
      oligodendrogliomas. Multivariate analysis in 218 newly diagnosed cases revealed
      that the variables most strongly correlated with survival time were: tumor grade,
      patient age, seizures as a first symptom, a Karnofsky Performance Scale score of
      less than 70%, tumor resection, and a radiation therapy dose greater than 50 Gy.
      The proportions of patients receiving tumor resection versus biopsy in each of
      these prognosis factor groups were similar. Since most of the 22 patients with
      midline and brain-stem tumors were treated with biopsy alone, these were
      excluded. Considering 196 newly diagnosed patients with cortical and subcortical
      tumors, grade IV glioma patients undergoing resection of the contrast-enhancing
      mass (as evidenced on computerized tomography and magnetic resonance imaging) and
      postoperative external beam radiation therapy lived longer than those undergoing
      biopsy only and radiation therapy (median survival time 50.6 weeks and 33.0
      weeks, respectively; Smirnov test, p = 0.0380). However, survival in patients
      with resected grade III gliomas was no better than in those with biopsied grade
      III lesions (p = 0.746). The authors conclude that, in selected grade IV gliomas,
      resection of the contrast-enhancing mass followed by radiation therapy is
      associated with longer survival times than radiation therapy after biopsy alone.

PMID- 8468608
TI  - Comparative study of transcranial color duplex sonography and transcranial
      Doppler sonography in adults.
AB  - To determine whether the frequency shift recorded in basal cerebral arteries
      corresponds to "true" flow velocities, a prospective comparative study of
      transcranial color duplex sonography (TCCD) and transcranial Doppler sonography
      (TCD) was performed. A 2.0-MHz transducer of a computerized TCCD system and a TCD
      device were used. The middle cerebral artery (MCA) and anterior cerebral artery
      (ACA) were examined by TCCD in 49 healthy volunteers (mean age 35 +/- 12 years).
      In 45 of the same volunteers a comparative TCD examination was possible. The
      studies were carried out blindly by different examiners at separate appointments.
      Peak systolic flow velocity, end-diastolic maximum flow velocity, time-averaged
      maximum flow velocity, and the pulsatility index were measured by both
      techniques. Additionally, for TCCD, time-averaged flow velocity was assessed, the
      resistance index and a spectral broadening index were calculated, and the energy
      output required for reliable measurement was analyzed. The TCCD signals were
      recorded in 98% of both MCA's and ACA's; with TCD, signals were recorded in 98%
      of MCA's and 87% of ACA's. Although in both vessels the angle-corrected peak
      systolic and time-averaged maximum velocities were approximately 10% to 15%
      higher in TCCD than in TCD measurements, correlation of flow velocities between
      both techniques was significant (p < 0.0001); differences between sides and age
      dependency of flow velocities corresponded as well. In a reproducibility study,
      TCCD was repeated in 27 subjects by a third examiner with significant correlation
      (p < 0.0001) of both TCCD examinations. It is concluded that the advantage of
      TCCD is associated more with a qualitative aspect than a quantitative one. The
      additional visual dimension of TCCD can open new diagnostic possibilities in
      cerebrovascular disorders.

PMID- 8468609
TI  - Optical imaging of bipolar cortical stimulation.
AB  - In order to better understand the degree of cortical activation that occurs
      during bipolar surface stimulation, the authors stimulated monkey visual cortex
      while monitoring the degree of activation with optical imaging. Optical imaging
      of intrinsic signals in monkey visual cortex during visual stimulation resulted
      in functional maps of ocular dominance and orientation selectivity. After
      functional maps of ocular dominance and orientation preference were obtained,
      bipolar surface stimulation was applied to activate just the cortical areas
      around the bipolar electrodes. Graded responses to changes in the stimulation
      intensity and duration were found. These findings demonstrate the reliability of
      bipolar cortical surface stimulation in localizing functional regions of cortex.
      The area of activation, at least in the region around the bipolar stimulating
      electrodes, did not appear to activate nearby ocular dominance columns or
      orientation patches. Intraoperative bipolar surface stimulation continues to be a
      consistently reliable technique for localizing rolandic cortex and essential
      language sites.

PMID- 8468610
TI  - Observations on the blood and perineurial permeability barriers of surviving
      nerve allografts in immunodeficient and immunosuppressed rats.
AB  - The authors investigate whether there are any permeability changes in the
      endoneurial blood-nerve barrier and the perineurium-nerve barrier of surviving
      nerve allografts. In a normal nerve, the blood-nerve barrier regulates the
      passage of substances from endoneurial blood vessels into the endoneurium,
      whereas the perineurium-nerve barrier protects the endoneurium from agents that
      escape from permeable epineurial vessels and accumulate around the nerve. Nerves
      from ACI rats were transplanted into immunologically deficient nude rats or
      normal Fischer rats immunosuppressed with cyclosporin A. None of the nerve
      allografts was rejected. The blood-nerve barrier of nerve allografts at 2 and 6
      weeks postoperatively was permeable to intravenously injected horseradish
      peroxidase, which spread into endoneurial tissue. Electron microscopy revealed
      that horseradish peroxidase escaped from endoneurial vessels through
      intercellular junctions between endothelial cells. At 24 weeks, the blood-nerve
      barrier of nerve allografts had recovered and the endoneurial vessels, like those
      in normal nerves, were impermeable to horseradish peroxidase. The perineurium
      nerve barrier of nerve allografts remained impermeable to horseradish peroxidase
      at all times. Axons were grouped into numerous minifascicles at nerve anastomosis
      zones at 24 weeks. Each nerve fascicle was surrounded by an impermeable
      perineurium. These results demonstrate that regenerated axons in long-term
      surviving nerve allografts and at anastomosis zones are protected by permeability
      barriers. It is concluded that permeability barriers of nerve allografts are not
      permanently altered by a foreign environment (grafts to nude rats) even when
      immunosuppression with cyclosporin A is required to prevent allograft rejection
      (grafts to Fischer rats).

PMID- 8468611
TI  - Temporal profile and significance of metabolic failure and trophic changes in the
      canine cerebral arteries during chronic vasospasm after subarachnoid hemorrhage.
AB  - To investigate the pathogenetic significance of metabolic failure observed in
      spastic cerebral arteries after subarachnoid hemorrhage (SAH), the temporal
      profile of alterations in the arterial content of high-energy phosphates was
      studied. A canine model of double hemorrhage was used. Constriction of the
      basilar artery was measured angiographically on Days 3, 5, 7, and 14 after SAH in
      separate groups of animals. Adenosine triphosphate (ATP), adenosine diphosphate
      (ADP), adenosine monophosphate (AMP), guanosine triphosphate (GTP), guanosine
      diphosphate, creatine phosphate (CrP), and creatine (Cr) levels in the arteries
      were assayed using high-performance liquid chromatography. A time-dependent
      development of angiographic spasm was confirmed. A mild vasospasm was seen in the
      group studied 3 days after SAH, progressed in the Day 5 group, remained
      comparably severe in the Day 7 group, and resolved partially in the Day 14 group.
      The content of high-energy phosphates (ATP, GTP, and CrP) declined rapidly over
      the course of the study, and a significant reduction in ATP, GTP, and CrP was
      observed in the Day 3 group. Levels of ATP and CrP decreased further in the Day 5
      and 7 groups. The decrement in GTP was completed in the early phase; a
      significant reduction took place in the Day 3 group, with no progression
      thereafter and no recovery through Day 14. Total adenylate (ATP + ADP + AMP) and
      total creatine (Cr + CrP) content diminished markedly over the course of the
      study. These results indicate that metabolic failure and trophic disturbance in
      the cerebral artery occurs with a rapid onset following SAH and progresses in
      close association with the development of vasospasm, suggesting a significant
      causal relationship with the pathogenesis.

PMID- 8468612
TI  - Intractable hiccups: treatment by microvascular decompression of the vagus nerve.
      Case Report.
AB  - Idiopathic hiccups are usually managed with pharyngeal stimulation or a plethora
      of pharmacological agents. Hiccups that persist and prove intractable to these
      medical measures are treated by crush or ablation of the phrenic nerve, which
      denervates the major respiratory muscle. This is the first reported case of
      nondestructive microvascular decompression of the vagus nerve for the treatment
      of intractable idiopathic hiccups. The success of microvascular decompression has
      been documented with other conditions, such as trigeminal neuralgia and
      hemifacial spasm, that are characterized by hyperactive dysfunctional
      neurovascular contact. The vagus nerve was separated from the posterior inferior
      cerebellar artery by inserting a Teflon pledget between the nerve and vessel
      which eliminated the neurovascular contact. One year after the initial surgery,
      the hiccups recurred. The Teflon pledget had fallen out of place and the nerve
      was once again in contact with the artery. Once the contact was eliminated by
      wrapping the artery with a tuft of Teflon, the hiccups stopped. The patient has
      remained free of hiccups for 3 years. It is concluded that patients with
      intractable idiopathic hiccups who fail medical therapy should be considered for
      microvascular decompression of the vagus nerve.

PMID- 8468613
TI  - Bovine thrombin-induced inhibitor of factor V and bleeding risk in postoperative
      neurosurgical patients. Report of three cases.
AB  - Three patients are reported who developed topical bovine thrombin-induced
      antibodies to clotting factor V following neurosurgical procedures. In each
      patient the coagulopathy occurred within 8 to 13 days following exposure to
      topical bovine thrombin at surgery. Two of the three had previously been exposed
      to bovine thrombin during cardiothoracic surgery. The three patients were
      identified by detection of a prolonged prothrombin time, ranging from 20.5 to
      39.8 seconds. The patient with the highest factor V level (0.12 U/ml) experienced
      gastrointestinal bleeding, which ceased when the factor V level increased to more
      than 0.20 U/ml. One patient required a ventriculostomy. In that case the
      prothrombin time and factor V level failed to improve following administration of
      vitamin K, 10 units of fresh frozen plasma, and platelet transfusions; the factor
      V level temporarily increased from 0.03 to 0.32 U/ml following a 2-day course of
      intravenous gamma globulin (1 gm/kg/day). Plasmapheresis has also been reported
      to be transient benefit in the treatment of this coagulopathy. In most patients
      the factor V level rises and the prothrombin time improves toward normal within 3
      to 6 weeks following surgical exposure. The individuals identified likely
      represent only a fraction of the patients who develop the coagulopathy. The
      latter either do not bleed or are not sufficiently challenged in the
      postoperative period for the bleeding risk to be tested. It is concluded that
      bovine thrombin-induced coagulopathy may occur following surgical exposure to
      topical bovine thrombin and may result in both postoperative morbidity and
      mortality in a subset of patients.

PMID- 8468614
TI  - Lumbosacral neurenteric cyst in an infant. Case report.
AB  - The case of a combined intra- and extraspinal neurenteric cyst in an infant is
      reported. This case is unique because an intraspinal cyst was not suspected
      clinically until large numbers of squamous epithelial cells were obtained at
      lumbar puncture performed as part of a workup for a septic entity. The cyst
      extended from an intradural location ventral to the conus medullaris at L-1
      through a ventrolateral defect in the S-4 vertebral body to communicate with a
      large presacral component. The entire cystic cavity was lined by stratified
      squamous epithelium. The possible pathogenesis of this lesion is discussed.

PMID- 8468615
TI  - Acute obstructive hydrocephalus caused by a migrating intraventricular calculus.
      Case report.
AB  - A 10-year-old boy presented with acute obstructive hydrocephalus caused by the
      impaction of a calculus on the cerebral aqueduct. The calculus migrated from the
      third ventricle to the fourth ventricle after ventricular drainage and right
      ventriculoperitoneal shunt placement had been performed. The nature and origin of
      the calculus could not be determined, although its release from the choroid
      plexus in the lateral ventricle is highly possible.

PMID- 8468616
TI  - Encapsulated intracerebral hematomas: a defined entity. Case report.
AB  - Encapsulated intracerebral hematoma is an interesting and not widely appreciated
      entity. It can be defined as an intraparenchymal hematoma found in normotensive
      patients, usually caused by histologically confirmed vascular malformations,
      characterized by a gradual clinical onset, and presenting a well-defined capsule
      at operation. One case is presented and 25 previously reported cases are
      reviewed, all reflecting the above-mentioned characteristics. The hematomas
      reviewed here occurred in relatively young patients with a mean age of 35 years
      and a clear male predominance (19 males, seven females). A ring of contrast
      enhancement around a lesion of variable density, usually with mass effect and
      perifocal edema, is the most relevant feature on computerized tomography.
      Findings on magnetic resonance images are described for the first time in the
      reported case. A vascular malformation was the most frequent cause found on
      histological examination (12 of the 26 total cases). No proven cause was found in
      the remaining 14 cases, although a small vascular malformation, destroyed or
      thrombosed after rupturing and bleeding, is the most likely etiology in these
      patients.

PMID- 8468617
TI  - Improved transdural exposure and temporary occlusion of the petrous internal
      carotid artery for cavernous sinus surgery. Technical note.
AB  - Safe surgery for vascular and neoplastic lesions involving the cavernous sinus
      requires adequate proximal control of the cavernous internal carotid artery
      (ICA). Classically, control of the cavernous ICA has necessitated dissection and
      isolation of the cervical vessels. The authors describe an alternative method for
      obtaining vascular control via transdural exposure of the petrous ICA and the use
      of the Fogarty balloon embolectomy catheter inserted extra-arterially into the
      carotid canal to provide temporary occlusion. This method is particularly well
      suited for proximal ICA occlusion during short-segment petrous-to-paraclinoid ICA
      bypass procedures as it eliminates the need for a temporary proximal ICA aneurysm
      clip and increases the available working space for completion of the anastomosis.

PMID- 8468618
TI  - Treatment of head injuries in the American Civil War.
AB  - At the time of the American Civil War (1861-1865), a great deal was known about
      closed head injury and gunshot wounds to the head. Compression was differentiated
      from concussion, but localization of lesions was not precise. Ether and
      especially chloroform were used to provide anesthesia. Failure to understand how
      to prevent infection discouraged physicians from aggressive surgery. Manuals
      written to educate inexperienced doctors at the onset of the war provide an
      overview of the advice given by senior surgeons. The Union experiences in the
      treatment of head injury in the Civil War were discussed in the three surgical
      volumes of The Medical and Surgical History of the War of the Rebellion. Wounds
      were divided into incised and puncture wounds, blunt injuries, and gunshot
      wounds, which were analyzed separately. Because the patients were not stratified
      by severity of injury and because there was no neuroimaging, it is difficult to
      understand the clinical problems and the effectiveness of surgery. Almost
      immediately after the war, increased knowledge about cerebral localization and
      the development of antisepsis (and then asepsis) permitted the development of
      modern neurosurgery.

PMID- 8468619
TI  - Perfusion pressure and risk of AVM hemorrhage.

PMID- 8468620
TI  - Cervical spondyloptosis.

PMID- 8468622
TI  - Distal catheter lengthening.

PMID- 8468621
TI  - Distal catheter lengthening.

PMID- 8468623
TI  - Knowledge-based design of removable partial dentures using direct manipulation
      and critiquing.
AB  - A knowledge-based system for designing removable partial dentures is described in
      which graphical representations of denture components are manipulated directly by
      the user to build the required denture design. The arch form of individual
      patients may be depicted by linear movement and rotation of the icons
      representing teeth. The size, shape and position of many denture components are
      determined dynamically to conform to the shape of abutment teeth and to the
      juxtaposition of other elements. Expert clinical knowledge is used to analyse the
      developing design and suggest alternate approaches.

PMID- 8468624
TI  - A system for assessing the severity and progression of occlusal tooth wear.
AB  - This study represents an attempt to introduce a system for the longitudinal
      evaluation of the severity and the rate of progression of tooth wear. The
      material comprised a selected group of 10 males and 10 females, examined twice
      within an 18-month period. The subjects were predisposed to advanced occlusal
      wear and had a mean age of 32 years within the range of 16-56 years. Evaluation
      of occlusal wear was performed on a tooth-by-tooth basis, on study casts, using
      two ordinal scales, one for assessing the severity, and the other the progression
      of occlusal wear. The reliability of the scales was assessed by percentage inter
      observer concordances. The sample exhibited higher occlusal wear scores in the
      incisor and canine regions compared to the posterior region. It was found that
      the overall progression in an 18-month follow-up period was slow. The inter
      observer concordance in the evaluation of the severity of wear was 88%, and 91%
      in the progression of wear. Within the limitations of the described system, the
      scales may be utilized for determining the severity of occlusal wear and the rate
      of its deterioration in an individual's dentition. From a clinical standpoint,
      the need for future treatment may be based on such a evaluation of the
      progression of wear.

PMID- 8468625
TI  - Dual-cure luting composites: Part I: Filler particle distribution.
AB  - Fourteen dual-cure luting composites were analyzed for their filler particle
      shape, predominant and maximum filler size, and filler weight in function of
      their clinical use. Polished surfaces were etched with an argon ion beam and
      studied by means of scanning electron microscopy. The type of filler particles,
      either inorganic or prepolymerized, could clearly be recognized. Their shapes
      were angular, rounded or spherical, depending on the product. The maximum filler
      size varied extremely from less than 1 micron to 250 microns. A particle-size
      distribution analyser disclosed a bell-shaped filler-size distribution. The
      predominant filler size for all the products was much smaller than the maximum
      filler size. The filler weight varied from 36 to 77%. After ion etching, some
      products showed small areas with a low degree of filler loading. A classification
      of the luting composites based on the maximum filler size is proposed. Since the
      particle size varies widely within the group of products analyzed, a standard
      specification for luting composites is urgently needed.

PMID- 8468626
TI  - A comparison of three finite element models of an edentulous mandible provided
      with implants.
AB  - The stress distribution in an edentulous mandible provided with two implants in
      the interforaminal region was calculated by means of three different finite
      element models. The implants were connected with a bar or remained solitary. The
      first model was a three-dimensional representation of the entire mandible, the
      second model of the interforaminal region of this same mandible, whilst the third
      model was a two-dimensional representation of the interforaminal region. The
      differences in stress distribution around the connected implants and the solitary
      implants between these three models were analysed. It can be concluded that for a
      parameter study the stress distribution around the dental implants following from
      a three-dimensional finite element model of only the interforaminal region of an
      edentulous mandible can be used. For such studies therefore, benefit can be
      gained from the advantages of reduced modelling and calculation time.

PMID- 8468627
TI  - Comminution of two artificial test foods by dentate and edentulous subjects.
AB  - An experimental artificial test food with low fracture strength (Optocal) was
      compared with Optosil with respect to the comminution during mastication by
      complete denture wearers and subjects with natural dentitions. The comminution of
      both test foods revealed large differences between the denture wearers and the
      dentate subjects. These differences were larger with Optosil than with Optocal.
      The differences in comminution between Optocal and Optosil were larger in the
      denture wearers than in the dentate subjects. The differences in comminution
      between the denture wearers and the dentate subjects as well as the differences
      in comminution between Optocal and Optosil within each group were largely
      established in less than 20 chewing strokes. The results indicate that
      differences in selection contributed substantially to the differences in
      comminution. Since Optocal appeared to be much easier to chew than Optosil, it
      may be preferred to Optosil for measuring masticatory performance in complete
      denture wearers.

PMID- 8468629
TI  - Parameters of tooth mobility in cases of normal function and functional disorders
      of the masticatory system.
AB  - Tooth mobility was measured mechano-electronically with the aid of quasi-static
      and dynamic methods in 309 patients comprising 2650 teeth being periodontally
      healthy. Besides, clinical and roentgenographic findings were ascertained to
      relate functional features to each periodontium. In general the result was that
      teeth loaded excessively show increased mobility parameters compared to those
      loaded normally. However, the mobility of teeth loaded poorly or deficiently was
      even greater compared to teeth stressed excessively. Moreover, follow-up studies
      showed that tooth mobility decreases after removal of functional disorders of the
      masticatory system or an immobilisation of splinted teeth. An experimental trauma
      of the periodontal ligament also brings on an increased tooth mobility which
      decreases to the original values some days after the trial.

PMID- 8468628
TI  - Initial flow of tissue conditioners--influence of composition and structure on
      gelation.
AB  - The effects of the molecular weight of polymer powders, the ethyl alcohol content
      of the liquids, the type of plasticizer and the polymer powder/liquid ratio on
      viscoelastic properties during gelation of tissue conditioners were studied with
      an oscillating rheometer. The results showed that: (i) The gelation time
      decreased exponentially with increases in molecular weight of the polymer powder
      and with powder/liquid ratio. There were linear relationships between the log of
      gelation time, and both the molecular weight of the polymer powder and the
      powder/liquid ratio. (ii) In general, gelation time decreased exponentially with
      increases in ethyl alcohol content. However, the relationship between the log of
      the gelation time and ethyl alcohol content fitted a second-order polynomial.
      (iii) The type of plasticizer affected gelation time. The order of gelation times
      was: benzyl benzoate < dibutyl phthalate < butyl phthalyl butyl glycolate. The
      initial flow of tissue conditioners could be controlled over a wide range by
      varying the molecular weight of the polymer powders, the ethyl alcohol content,
      the powder/liquid ratio and the type of plasticizer.

PMID- 8468630
TI  - Longitudinal study on torque around the sagittal axis in lower distal-extension
      removable partial dentures.
AB  - The purpose of this study was to examine the longitudinal changes of torque
      around the sagittal axis in lower distal-extension removable partial dentures.
      The torque transmitted from the denture base to retainers was measured on several
      separate occasions from the insertion of new dentures to about 2 months after it.
      The maximal mean value of torque (Max.MT) was calculated from the magnitude of
      all chewing strokes of the minimum of the interocclusal distance. The integration
      values of torque (I) and time (T) from initiation of chewing to swallowing were
      obtained and then the average value of torque (Ave.T) was calculated (Ave.T =
      I/T). Subjects could be divided into two groups. Max.MT and Ave.T were almost
      constant in one group while they were remarkably decreased in another. After 1
      month of insertion of new dentures the value of both groups was within the range
      of less than 3 x 10(-3) kgm (1 kgm = 9.8 Nm) of Max.MT and less than 1 x 10(-3)
      kgm ss-1 of Ave.T.

PMID- 8468631
TI  - Enamel surface roughness analysis after laser ablation and acid-etching.
AB  - Laser-roughened enamel surfaces have been shown to provide for greater acid
      resistance and enhanced restorative material/enamel bond strength. Extracted
      tooth enamel was irradiated with several lasers: CO2/Nd:YAG (CW), CO2 (RSP),
      Nd:YAG (CW), Nd:YAG (Q-switched), Argon (CW), and Ar:F excimer. Additional teeth
      were acid-etched. Energy densities were standardized at 25.47 J/cm2 for all
      mediums. Surface profile analyses were conducted with a profilometer to determine
      the amount of enamel surface roughness. The acid-etched samples exhibited both a
      greater amount of surface roughness and a qualitatively different type of enamel
      surface morphology than the laser-treated specimens. Independent use of the CO2
      and Nd:YAG beams exhibited a moderate amount of roughness, while the coaxial
      CO2/Nd:YAG beam displayed surface roughness approaching that of the acid-etch
      samples. Different laser mediums produce enamel surface morphologies that are
      characteristic of a variety of inherent lasing parameters.

PMID- 8468632
TI  - A method for the estimation of traces of chlorhexidine in water.
AB  - A simple method of estimating traces of chlorhexidine in water using bromothymol
      blue is described. The procedure involves the extraction of the
      chlorhexidine/bromothymol blue complex into carbon tetrachloride from a buffered
      neutral solution and measurement of the absorbances of the extracts in a
      spectrophotometer. The extracted complex has good colour stability, and the
      method is accurate, reproducible, and very sensitive, with concentrations of
      chlorhexidine down to 0.05 micrograms ml-1 measurable.

PMID- 8468633
TI  - Geometrical interpretation for abnormal facial behaviour with possible correction
      of angle S-N-A and S-N-B.
AB  - The orientation of the sella nasion (SN) line in lateral skull radiographs is
      important for accurate assessment of antero-posterior and vertical facial
      relationship. Lateral skull radiographs of a random sample were traced and
      digitized to produce a mean shape template of the sample, with the craniofacial
      centroid line (CFC) used as a base for superimposition of the sample. A
      geometrical triangle was formed using the sella nasion line, craniofacial
      centroid line and the mandibular plane as the sides of the triangle. Simple
      geometric calculations were done to re-orient both the mandibular plane and sella
      nasion line in cases with balanced clinical profiles, while the S-N-A and S-N-B
      measurements indicate otherwise.

PMID- 8468634
TI  - Health care costs in a declining America.

PMID- 8468635
TI  - Intestinal transplantation in the child: experimental and clinical studies.

PMID- 8468636
TI  - Efficacy of pediatric trauma care: results of a population-based study.
AB  - To determine concordance between regional outcome and national norms with respect
      to pediatric injury diagnosis, severity, and mortality in a state lacking a well
      organized trauma system, we compared summary data from all pediatric trauma
      related hospital discharge abstracts compiled by the [New York State Department
      of Health] Statewide Planning and Research Cooperative [Mandatory Hospital
      Reporting] System (SPARCS), with comparable data from pediatric trauma centers
      participating in the National Pediatric Trauma Registry (NPTR), for similar
      epochs in the late 1980s. Analysis was based on 14,234 cases from SPARCS and
      17,098 cases from NPTR. Data were grouped by principal anatomic diagnosis (ICD-9
      CM N-code) and injury severity score (ISS), for each of which incidence and
      mortality were calculated, both individually and collectively, then compared item
      by item for sources of variance. Overall, the two data sets showed the expected
      discordance, with NPTR being skewed toward more complex and severe injury.
      However, when analyzed cell by cell, a striking degree of concordance emerged in
      both incidence and mortality for injuries of comparable severity in all but a few
      selected subsets. Isolated skeletal injuries were treated less frequently in
      pediatric trauma centers, and combined system injuries to the skeleton, brain,
      and internal organs were treated more frequently in pediatric trauma centers.
      However, while the fatality rates were similar between SPARCS and NPTR for most
      diagnoses, given comparable ISS, survival was some ten times greater in pediatric
      trauma centers for patients with either brain or internal injuries--the leading
      causes of pediatric injury mortality--and for skeletal injuries, when the
      injuries sustained were of moderately great severity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8468637
TI  - Does handgun legislation change firearm fatalities?
AB  - When comparing firearm fatalities for children under 16 years of age before and
      after handgun legislation enactment in Maryland, firearm fatalities increased
      overall. A decrease in accidental deaths in the home perhaps reflects a response
      to public education and awareness. More aggressive handgun legislation is
      imperative to reverse this public health trend.

PMID- 8468638
TI  - The effect of hypotension and hypoxia on children with severe head injuries.
AB  - Survival of children (< 17 years) with severe head injuries (Glascow Coma Scale
      [GCS] score < 8) has been shown to be better than that of adults. The addition of
      hypotension (HT) or hypoxia (H) has a deleterious effect on outcome in adults but
      no information is currently available about their effects in children. Over a 5
      year period, 58 children with GCS scores < 8 were admitted and prospectively
      evaluated at this institution. Patients were divided into two groups on the basis
      of systolic blood pressure (SBP) and arterial blood gasses. Patients exhibiting
      HT, defined as a SBP < 90 mm Hg, and patients demonstrating H with a PaO2 < 60 mm
      Hg were compared with normoxic, normotensive children. Survival was increased
      fourfold in patients with neither H nor HT as compared with children with either
      H or HT (P < .001). To validate these observations we reviewed the data from the
      National Pediatric Trauma Registry for similar patients and included our cohort
      in the analysis. In total, 509 children had sufficient data for analysis and were
      studied. Hypoxia alone was not associated with increased mortality in
      normotensive patients (P = .34). Hypotension significantly increased mortality in
      these children even without concomitant H (P < .00001). If both HT and H were
      found together, mortality was only slightly increased over those children with HT
      alone (P = .056). These data confirm that HT with or without H causes
      significantly increased mortality in head-injured children to those levels
      normally found in adults (P = .9), alleviating any age-related protective
      mechanisms normally afforded.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468639
TI  - Successful repair of major retrohepatic vascular injuries without the use of
      shunt or sternotomy.
AB  - Injury to the retrohepatic veins and vena cava secondary to blunt abdominal
      trauma is often fatal. The purpose of this report is to describe the successful
      isolation and repair of retrohepatic vascular injuries without the use of median
      sternotomy or vena caval shunt. Two children with both hepatic vein and
      retrohepatic caval injuries from blunt trauma were treated by the following
      surgical approach: (1) bilateral subcostal incision with vertical midline
      extension; (2) packing of the liver and volume resuscitation with the Rapid
      Infusion System prior to vascular isolation; (3) isolation of the
      intrapericardial vena cava through a transdiaphragmatic pericardial window; (4)
      control of the suprarenal vena cava and porta hepatis; and (5) repair of vein
      lacerations with vascular occlusion and continuous saline irrigation for improved
      visualization despite continued venous bleeding. This approach was tolerated and
      allowed successful repair without shunting in these patients despite an average
      weight of 14 kg and the loss of 3 L and 23 L of blood, respectively. We attribute
      the success of this technique to rapid control of hemorrhage and volume
      resuscitation. This success suggests that the routine use of shunt or sternotomy
      is not necessary in these devastating injuries.

PMID- 8468640
TI  - Does the current health care environment contribute to increased morbidity and
      mortality of acute appendicitis in children?
AB  - To determine whether the current "gatekeeper" controls on health care lead to an
      increase in treatment delay and morbidity of acute appendicitis in children, we
      reviewed the experience with this disease at a large children's hospital over a
      10-year period. One hundred seven consecutive children 18 years and younger
      operated on for acute appendicitis from July 1, 1988 to June 30, 1990 were
      compared with 119 children with the same diagnosis from July 1, 1978 to June 30,
      1980. Age, sex, race, antecedent illnesses, initial physician contact and
      diagnosis, time to referral and operation, pathology, morbidity, and length of
      stay were reviewed. The two groups were comparable in terms of age, sex, race,
      antecedent illnesses, and negative appendectomy rate. More patients in the recent
      group were initially seen in an emergency room or urgent care setting than in the
      previous group (62.2% v 48.5%, P = .07). The accuracy of the initial diagnosis
      was significantly lower in the more recent group (P = .05). No change existed
      between the groups in the time to a physician; however, a significant (P = .04)
      difference existed in the time to surgeon (41.2 hours in the earlier group v 56.4
      hours in the recent group). No significant difference existed between the groups
      in time from surgeon to operation. Although not statistically significant, the
      morbidity rate was increased in the recent group (13.3% v 6.5%, P =
      .17).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468641
TI  - Blood clearance and organ localization of Candida albicans and E coli following
      dual infection in rats.
AB  - Immunosuppressed prematures, cancer patients, and transplant recipients are
      susceptible to bacterial or fungal sepsis or both. This report evaluates whether
      the ability of the reticuloendothelial system (RES) to remove blood-borne viable
      radiolabeled 35S Escherichia coli and 3H-Leucine Candida albicans is adversely
      affected by a dual intravenous challenge of these organisms. Male Sprague Dawley
      rats (n = 150) weighing 175 to 180 g were placed in 5 experimental groups (n =
      30). Group I received intravenous (IV) C albicans (10(7)/mL), group II received E
      coli (10(9)/mL), group III received a dual injection of C albicans and E coli,
      group IV received Candida 1 hour prior to E coli, and group V received E coli 1
      hour prior to fungi. At 1, 4, and 24 hours, tissue samples (50 to 100 mg) of
      liver, spleen, kidneys, and lungs were processed for liquid scintillation
      counting. Organ distribution of bacteria and fungi was calculated and expressed
      as mean percent +/- SD of labeled organisms. The liver trapped 72% +/- 10% and
      the lungs 1.1% +/- 0.3% of E coli (group II) (P < .001). The organ distribution
      of Candida (group I), however, was similar in liver and lungs (42.5% +/- 10% and
      41.4% +/- 6.4%, respectively). Liver localization of E coli was unaffected by
      simultaneous or staggered fungal injection (groups III, 4, and V). Lung
      distribution of E coli following dual injection (group III) was significantly
      higher than controls (group II) (3.6% +/- 0.7% v 1.1% +/- 0.3%; P <
      .001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468642
TI  - The effect of endotoxin on the neonatal erythrocyte.
AB  - Intestinal ischemia is considered a major factor in the development of
      necrotizing enterocolitis (NEC). Despite this, the majority of affected infants
      lack documentation of clinical events associated with obvious gut hypoperfusion.
      Recent evidence in adults suggests that endotoxin may impair flow in the
      microcirculation through alterations in erythrocyte deformability. As the gut
      serves as a semipermeable reservoir of endotoxin in the stressed neonate, such
      localized activity may result in intestinal ischemia at the microcirculatory
      level through alterations in the red cell membrane. This study evaluates the role
      of endotoxin on neonatal erythrocyte membrane viscosity. Paired anticoagulated
      whole blood specimens were obtained from the umbilical cord of 10 neonates at
      delivery. Samples were incubated with either 2 micrograms/mL of E coli endotoxin
      (LPS) or an equal volume of saline (control). Following incubation, erythrocytes
      were isolated, washed, and incorporated with the fluorescent membrane probe TMA
      DPH. Membrane viscosity was assessed by spectroscopic analysis of the fluorescent
      emissions induced by excitation of the probe at 365 nm. Results were calculated
      as anisotropy and analyzed for differences by ANOVA. Endotoxin resulted in a
      significant increase in red cell membrane viscosity as compared to control (LPS
      291.2 +/- 5.1 v Control 271.7 +/- 3.3, P < .01). As the effects of endotoxin are
      known to be primarily the result of white blood cell (WBC) activation, this study
      was repeated in an additional 10 neonates in whom WBCs were removed prior to
      endotoxin/saline incubation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468643
TI  - Nosocomial infection in pediatric surgical patients: a study of 608 infants and
      children.
AB  - We studied nosocomial infection in a group of 608 pediatric surgical patients
      over a 14-month period. All inpatients and outpatients who received an operation
      with an incision by the pediatric general surgical service were entered into the
      study. Demographic, nutritional, clinical, and laboratory data were collected.
      Surveillance was conducted for wound infection, septicemia, infections of the
      respiratory tract, urinary tract, and abdomen, and infectious diarrhea. A total
      of 676 operative procedures was performed. Nosocomial infection occurred in 38 of
      the 608 patients (6.2%). A total of 53 infectious complications was tabulated.
      The number and percent risk per operation were wound 17 (2.5%), septicemia 14
      (2.1%), pulmonary 10 (1.5%), urinary tract 5 (0.7%), abdominal 5 (0.7%), diarrhea
      2 (0.3%). Broviac catheter sepsis occurred in 7 of 61 lines (11.5%). The highest
      overall occurrence of infection was in the infant group (1 mo to 1 yr), (13/161,
      8.1%). The probability of septicemia was highest in neonates (4.2%) compared with
      infants (3.1%) or older children (1.2%) (P < .05). The most common isolates were
      Staphylococcus epidermidis (10/17) from septic patients, and gram-negative
      enteric bacteria (27/50) from organ and wound infections. Infection was
      associated with impaired nutrition, multiple disease processes, and multiple
      operations. The risk of nosocomial infection in this population was comparable to
      that reported in adult surgical patients. These baseline data may aid the
      development of strategies to lower infection risk in children.

PMID- 8468644
TI  - Does the fibrin coat around a central venous catheter influence catheter-related
      sepsis?
AB  - The purpose of this study was to determine whether the fibrin sheath that
      develops around an intravenous silicone catheter influences catheter-related
      sepsis. A rat model with a central intravenous silicone catheter was used.
      Staphylococcus aureus, dose 1 x 10(7) colony forming units (cfu), were injected
      via the tail vein, either immediately after catheter insertion (group 1, n = 23)
      or after the catheter had been in situ for at least 7 days (group 2, n = 22).
      Blood cultures were done on at 24 hours and 7 days. Animals were killed on day 7
      and the catheter was removed for culture (Maki and broth) and scanning
      electronmicroscopy (SEM). The was no significant difference (P > .05) between the
      number of positive blood cultures in groups 1 and 2 at 24 hours (16 v 9) and 7
      days (12 v 6). In group 1 there were significantly more positive catheter
      cultures by both methods (23 v 16 in group 2; P < .05) and more cfu/per
      centimeter catheter (group 1 mean, 520, range, 197 to 600; group 2 mean 195,
      range 9 to 600; P < .001). In group 1, 12 animals had catheter sepsis compared
      with 5 in group 2 (P = NS). On SEM a fibrinous sheath was identified on all
      catheters removed on day 7 but not on 5 catheters inserted and removed after 10
      minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468645
TI  - Prospective analysis of urokinase in the treatment of catheter sepsis in
      pediatric hematology-oncology patients.
AB  - Use of right atrial catheters (RACs) in children with cancer improves the comfort
      and efficacy of therapy. However, catheter-related infections are responsible for
      significant morbidity leading to the removal of approximately 20% of implanted
      RACs. Sepsis has been linked to thrombus and fibrin sheath formation within the
      RAC. Gram-negative and fungal infections appear to be particularly resistant to
      antibiotic therapy alone and most of these infections have required catheter
      removal. Urokinase has been effectively used for reopening thrombus occluded
      RACs. Theoretically, thrombolytic agents could improve the treatment of catheter
      related infections by removing luminal sites of bacterial/fungal colonization. We
      prospectively monitored the use of urokinase and antibiotics for catheter-related
      sepsis in our pediatric hematology/oncology population from 1985 to 1991. Sepsis
      episodes were treated with 2 doses of urokinase and antibiotics (10 to 42 days)
      infused through the RAC. One to 2 mL of urokinase (5,000 U/mL) was instilled in
      the RAC for 1 hour, then removed and repeated 24 hours later. During the study,
      224 RACs were placed in 177 children. RACs were in place for a total of 71,134
      days (median, 274 days). There were 67 blood culture-positive sepsis episodes
      occurring in 50 RACs. Fifty-nine sepsis episodes were treated with urokinase and
      antibiotics and all responded by clearance of organisms from the blood. Three
      patients (5.1% of urokinase treated) had recurrent sepsis with the same organism
      within 2 months, were considered treatment failures and had RACs removed. Only 1
      of 16 episodes of multiple organism/Candida sepsis led to RAC removal due to
      inability to cure the infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468646
TI  - Laparoscopic Nissen fundoplication in childhood.
AB  - An obese, 10-year-old boy presented with symptoms of pain and apnea due to
      gastroesophageal reflux that was unresponsive to medication. A laparoscopic
      Nissen fundoplication was performed, and the child was discharged from the
      hospital within 36 hours of the operation. The rationale and technique of a
      laparoscopic Nissen fundoplication for symptomatic gastroesophageal reflux in
      childhood is described.

PMID- 8468647
TI  - The effects of ischemia and reperfusion on intestinal motility.
AB  - The interdigestive migrating motor complex (MMC) has been demonstrated to be a
      reliable indicator of intestinal motility and function. The effects of low
      perfusion on the MMC have never been studied. Fourteen newborn Yorkshire piglets
      (5 to 18 days old, weighing 2.9 +/- 0.4 kg) underwent celiotomy under general
      anesthesia with placement of four jejunal electrodes (50 cm apart) as well as a
      superior mesenteric artery (SMA) Doppler flow probe and a pericardial catheter.
      Group 1 (n = 5) had operation alone. Group 2 (n = 9) had nonocclusive mesenteric
      ischemia induced by reversible cardiac tamponade for 5 hours between
      postoperative days 6 to 12. All subjects had MMC phase III electrical activity,
      cycling time, and propagation velocity recorded daily. In group 2 MMCs were
      recorded prior to and during ischemia, and during reperfusion. Group 2 animals
      had 75% +/- 4% decrease in SMA flow during the tamponade period. During the
      ischemic period, the MMC cycling time (CT) increased from 67 +/- 10 (mean +/-
      SEM) to 98 +/- 12 minutes (P < .05) and MMC propagation velocity (PV) decreased
      to 4.2 +/- 2.2 from a baseline value of 10.5 +/- 1.5 cm/min (P < .05). During
      reperfusion CT and PV values were not significantly different from baseline. The
      validity of this model is confirmed by the comparable baseline recordings in
      groups 1 and 2, and by the return of MMC to baseline values within 4 to 7 hours
      of reperfusion, as seen in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468648
TI  - Elevation of circulating intestinal fatty acid binding protein in a luminal
      contents-initiated model of NEC.
AB  - Necrotizing enterocolitis (NEC) continues to produce significant morbidity and
      mortality, due in part to the difficulty in detecting its initial manifestations
      at a stage when compromised intestine may potentially be salvaged. We have
      previously reported our findings that intestinal fatty acid binding protein (I
      FABP) is a sensitive biochemical marker for early intestinal mucosal injury due
      to mesenteric ischemia. In this study we evaluated the potential of serum I-FABP
      as a marker for incipient NEC in a nonischemic model of NEC in the rat.
      Intraluminal instillation of a solution of casein (10 mg/mL) and calcium
      gluconate (50 mg/mL) in saline acidified to pH 4.0 with propionic acid resulted
      in a rapid and prolonged increase in serum I-FABP from a baseline of < or = 4.0
      ng/mL to 171 +/- 40 ng/mL. Instillation of the same electrolyte solution with
      either casein or propionic acid alone resulted in a less dramatic elevation of
      serum I-FABP to 19 +/- 4 ng/mL and 76 +/- 30 ng/mL, respectively. In both cases
      baseline values of < or = 4.0 ng/mL were reached within 60 minutes. In control
      animals, which received saline alone, serum I-FABP was undetectable throughout
      the experiment. Simultaneously, we found that serum hexosaminidase, a putative
      biochemical marker for intestinal ischemia and NEC, was unchanged in all groups.
      Light microscopy of the intestinal specimens obtained three hours after
      instillation of casein and organic acid demonstrated superficial villus necrosis
      and villus blunting, but no areas of transmural necrosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8468649
TI  - Thoracic neuroblastoma: a Pediatric Oncology Group study.
AB  - Ninety-six patients with thoracic neuroblastoma were studied in a prospective
      fashion. Median age at presentation was 0.9 years. Forty-eight percent of the
      patients presented with stage A disease, 20% stage B, 13% stage C, 17% stage D,
      and 2% stage DS. Seventy-five patients have been followed for greater than 4
      years. A posterior mediastinal mass was diagnosed on incidental chest
      roentgenograms performed for nontumor-related symptoms in 49% of the cases.
      Sixteen percent of the cases presented with neurological symptoms and 14% of the
      patients presented with acute respiratory distress. Urinary catecholamines were
      elevated in 76% of the cases. Complete surgical resection was carried out in 47%
      of the cases, while incomplete resection or biopsy was performed in 45%. No
      operation was performed in 3 patients. Minor surgical complications occurred in
      20% of the patients, and 3% of the patients had significant perioperative
      complications. One patient died as a complication of therapy. Overall actuarial
      survival was 88% at 4 years. This study confirms the favorable outcome in
      children with mediastinal neuroblastoma. The basic biology of thoracic
      neuroblastomas seems to differ from that of other sites in that the majority of
      patients present at a younger age with localized disease or regional lymph node
      metastases, and have an improved survival even after correcting for age and
      stage. While complete excision is recommended, if possible, radical surgical
      procedures are not indicated since an excellent prognosis is associated with
      combined modality therapy.

PMID- 8468650
TI  - Rectal mucosectomy: a definitive approach to extensive hemangiomas of the rectum.
AB  - Major rectal bleeding may occur in children and adults who have extensive
      hemangiomatous involvement of the pelvis and rectosigmoid colon, as in the
      Kleppel-Trenaunay syndrome (KTS). Conventional surgical techniques such as bowel
      resection and colostomy have often been associated with large blood loss and/or
      incontinence. We have used a new approach to this problem utilizing rectal
      mucosectomy to eliminate the bleeding rectal mucosa and to preserve anal
      function. Four patients born with KTS eventually developed major rectal bleeding
      and were successfully corrected by this surgical approach. Two were females and
      two males. Ages ranged from 4 to 25 years at the time of surgery. The patients
      developed rectal bleeding leading to chronic anemia during the first decade of
      life. Rectal bleeding gradually increased requiring multiple transfusions (2 to
      20 units) prior to surgery. Patient 1 underwent resection of the rectosigmoid
      colon, with rectal mucosectomy and endorectal coloanal anastomosis. The Nd:YAG
      laser was used on 3 occasions on the distal remaining rectal mucosa. Patients 2,
      3, and 4 underwent sigmoid resection, transanal rectal mucosectomy, and a
      coloanal anastomosis, with minor YAG laser therapy in one patient. Blood loss
      during surgery was minimal. Follow-up ranged from 1.5 to 4 years. All have
      excellent sphincter control with no incontinence. No strictures or sepsis
      occurred following surgery. Rectal bleeding was eliminated in all 4 patients.
      This sphincter-saving approach should be considered in patients with extensive
      hemangiomas of the rectosigmoid colon because of its remarkable effectiveness and
      safety.

PMID- 8468651
TI  - Improved survival in biliary atresia patients in the present era of liver
      transplantation.
AB  - Therapy for patients with biliary atresia (BA) has become controversial, with
      orthotopic liver transplantation (OLTx) suggested in place of portoenterostomy.
      This is based on the unpredictable success of portoenterostomy, and the increased
      difficulty of the OLTx procedure following prior extensive liver surgery. The
      survival rate reported here for infants transplanted after unsuccessful
      portoenterostomy does not support this approach. OLTx was undertaken in 37
      patients when end-stage liver failure followed primary portoenterostomy.
      Recipient age ranged from 6 months to 14 years (median, 13 months), and weight
      ranged from 5 to 45 kg (median, 8 kg) at the time of OLTx. Reduced-size
      allografts were used as the primary allograft in 25 patients (23 left lobe), and
      12 received whole-organ allografts. Retransplantation was required in 5 patients,
      each received a reduced-size allograft. There was no increased incidence of
      vascular complications, primary nonfunction, irreversible rejection, intestinal
      perforation, biliary complications, sepsis, or lymphoma comparing the BA patients
      with all other non-BA patients who had undergone OLTx (all P = .16). There was no
      statistically significant difference in mean operative blood loss between BA
      patients (EBL = 1.99 BV) and non-BA patients (1.50 BV) (P = .14). Actuarial
      survival for the series of BA patients was 89% at 1 year, and 80% at 2 years.
      Following the introduction of reduced-size allografts, donor organs were selected
      for use with a priority on donor stability. The actuarial survival for BA
      patients during this time has improved to 96% at 1 year, and 91% at 2
      years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468652
TI  - The influence of portoenterostomy with stoma on morbidity in pediatric patients
      with biliary atresia undergoing orthotopic liver transplantation.
AB  - A portoenterostomy (PE) procedure for extrahepatic biliary atresia (EHBA) is
      sometimes performed with a stoma in an attempt to reduce the incidence of acute
      cholangitis. The purpose of this study was to determine if the presence of a
      stoma increased the complication rate of patients undergoing orthotopic liver
      transplantation (OLT) for EHBA. The medical records of 42 consecutive patients
      with EHBA who underwent primary OLT between October 1988 and October 1991 were
      retrospectively reviewed. Three patients were excluded, since their grafts were
      lost within 3 days of OLT. The remaining 39 patients were divided into three
      groups: no PE (n = 7), PE without stoma (n = 23), and PE with stoma (n = 9). The
      mean age of the whole group was 19.62 +/- 24.37 months, with a range of 5 to 132
      months. Mean weight was 9.62 kg, with a range of 4.2 to 41 kg. Survival at 3 and
      12 months as well as number of retransplantations were similar among the three
      groups. However, at the time of OLT increased morbidity was observed, consisting
      of increased operative time and number of reoperations, whether or not the stoma
      had been closed prior to OLT.

PMID- 8468653
TI  - Hepatobiliary dysfunction during total parenteral nutrition is caused by
      infusate, not the route of administration.
AB  - Cholestatic jaundice is the major complication of total parenteral nutrition
      (TPN). Both the intravenous (IV) route of nutrition and the enteral fast have
      been implicated as causes of TPN-associated cholestasis (TPN-AC). The purpose of
      this study was to determine whether TPN-AC is caused by the TPN solution itself
      or the IV route of administration and enteral fast. Prepubescent rabbits (n = 24)
      were divided into four groups: CONTROL, fed standard lab chow; TPN, received a
      standard hyperalimentation solution of dextrose, Aminosyn, and lipids via the
      jugular vein; ENT, received the same hyperalimentation solution via a
      duodenostomy tube; and OSM, received a polymeric formula (Osmolite) via a
      duodenostomy tube. After 14 days on these diets, we measured bile flow, bile acid
      excretion, sulfobromophthalein (BSP) excretion, plasma amino acid profile, serum
      liver enzymes, and liver histology. Statistical analysis was by analysis of
      variance. Hyperalimentation solution significantly depressed hepatobiliary
      function, whether it was given IV or by gut. Bile flow in both the TPN (36.4
      microL/kg/min) and ENT (46.2) groups was significantly less than CONTROL (84.5)
      or OSM (62.9). Hepatic secretory function, measured by excretion of the
      cholephilic dye BSP, was depressed in both TPN and ENT (57% and 55% of IV dose
      excreted in bile over 60 minutes, respectively) compared with CONTROL (84%) or
      OSM (71%). Serum liver enzymes were normal in all groups. Histological injury
      similar to TPN-AC in humans (portal inflammation and hepatocyte degeneration) was
      seen in both groups receiving the hyperalimentation solution.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8468654
TI  - Side-to-side lienorenal shunt without splenectomy in noncirrhotic portal
      hypertension in children.
AB  - Noncirrhotic portal hypertension is a common cause of upper gastrointestinal
      bleeding in infants, children, and adolescents in India. More than one major
      bleeding episode, severe hypersplenism, presence of fundal varices, rare blood
      group, remoteness from the hospital, and patient noncompliance to sclerotherapy
      formed the main indications for shunt surgery. One hundred four cases of
      noncirrhotic portal hypertension (age range, 18 months to 20 years) underwent
      side-to-side lienorenal shunt (SSLR) without splenectomy in a period of 15 years.
      Splenic veins varying in diameter from 4 to 18 mm and in length from 3 to 4 cm
      were skeletonized through the root of transverse mesocolon and a shunt of at
      least 1.5 cm in diameter was constructed. At a mean follow-up of 54 months, 87%
      of shunts were patent, 13% of shunts were blocked, and 2% were inadequate. Ten
      percent of the children had rebled, all of whom had a blocked shunt. Growth and
      development was normal and no patients developed encephalopathy. There was a good
      correlation between shunt patency on splenoportography and endoscopic
      disappearance of varices, reduction in the size of spleen and splenic pulp
      pressure, and improvement of hypersplenism.

PMID- 8468655
TI  - Children with mucopolysaccharidosis: perioperative care, morbidity, mortality,
      and new findings.
AB  - The perioperative care, morbidity, and mortality in 30 patients with
      mucopolysaccharidosis (MPS) are presented. They underwent a detailed preoperative
      assessment and were anesthetized 141 times. An intravenous induction technique
      was used in most patients. It was easier to see the vocal cords, during
      laryngoscopy, in children with Hurler syndrome (HS) when they were younger (23 v
      41 months, P < or = .01) and smaller (12 v 15 kg, P < or = .05). Preoperative
      obstructive breathing was associated with a significantly higher incidence of
      postextubation obstruction (P < or = .05). A total of 28 children underwent bone
      marrow transplantation (BMT); this reversed upper airway obstruction and also
      reversed intracranial hypertension. In children with HS, the incidence of
      odontoid dysplasia was 94%; 38% demonstrated anterior C1-C2 subluxation. Head and
      neck manipulation was limited in children with cervical spine defects. None of
      the 30 patients experienced spinal cord morbidity. One child suffered an
      intraoperative stroke; another, pulmonary edema. Severe and extensive coronary
      obstruction was responsible for 2 intraoperative deaths. Coronary angiography
      underestimated coronary artery disease.

PMID- 8468656
TI  - Early use of cisplatin is safe after partial hepatectomy.
AB  - Although cisplatin is widely used in the treatment of liver tumors, little
      information is available concerning its effect on liver regeneration. This report
      evaluates the effect of cisplatin on liver regeneration after hepatectomy (HPx).
      One hundred sixty male Sprague-Dawley rats were placed into five experimental
      groups following 70% hepatectomy. Group I (untreated controls, n = 32) received
      0.9% saline intraperitoneally (IP); group II (n = 31), cisplatin 4 mg/kg IP;
      group III (n = 36), cisplatin 10 mg/kg IP; group IV (n = 34), cisplatin 20 mg/kg
      IP; and group V (n = 27), doxorubicin 6 mg/kg intravenously (IV). Five additional
      sham groups underwent celiotomy without hepatectomy (n = 106) followed by the
      above treatment protocols. Liver regeneration was evaluated by liver weight, DNA
      incorporation measured by tritiated thymidine (3H-TdR), and quantitative image
      analysis (QIA) of hepatic nuclei at 18, 24, 36, 48, and 72 hours, and 5 days
      postoperatively. 3H-TdR incorporation peaked at 36 hours and was similar in
      hepatectomized controls group I (404 +/- 110 counts per minute [CPM]/mg liver
      weight) and cisplatin-treated rats (groups II to IV) (P > .05, ANOVA). All sham
      groups were similar to controls. QIA of feulgen-stained touch preps identified
      polyploid, stem line, and proliferating nuclei in both controls and treated
      groups. At 36 hours, QIA showed differences in mitotic status of sham, control,
      and adriamycin-treated HPx rats, consistent with 3H-TdR incorporation. In
      contrast, although cisplatin-treated rats receiving 4 mg/kg showed proliferating
      nuclei, QIA demonstrated decreasing hepatocyte proliferation with higher doses of
      cisplatin (10 mg/kg, and 20 mg/kg).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468657
TI  - Combined preoperative and postoperative immunotherapy for murine C1300
      neuroblastoma.
AB  - Preoperative treatment of murine C1300-neuroblastoma (C1300) with triple
      immunotherapy using low-dose cyclophosphamide (CY), retinyl palmitate (RP), and
      interleukin-2 (IL2), followed by tumor resection leads to significant initial
      tumor control and prolonged survival. However, because long-term tumor recurrence
      is 67%, the efficacy of continued postoperative immunotherapy is now evaluated.
      Thirty-two A/J mice with 1 cm subcutaneous C1300 tumors were treated for 13 days
      with CY-100 mg/kg, intraperitoneally (IP), on day 2 of treatment then 25 mg/kg on
      day 9, RP-2500 IU IP 2 x/week, and IL2 1.6 x 10(5) U IP BID on days 4 to 9 and 11
      to 13. On day 14, mice were divided into five treatment groups: (1) OP (operated
      tumor resection, n = 6); (2) OP+CY (resection and postoperative CY, n = 7); (3)
      OP+CY+RP (resection and postoperative CY+RP, n = 7); (4) OP+CY+RP+IL2 (resection
      and postoperative CY+RP+IL2, n = 7); and (5) CY+RP+IL2 (continued CY+RP+IL2 with
      no resection, n = 5). Survival and postoperative tumor recurrence were followed
      for 60 days. The cure rates were group 1 33% (2/6), group 2 43% (3/7), group 3
      29% (2/7), group 4 71% (5/7), and group 5 20% (1/5). After surgery, tumors that
      recurred did so in 8 to 22 days, with no statistical difference noted between
      groups. MHC class I antigenic expression of tumors resected on day 14 and
      recurrent tumors was determined with monoclonal antibodies and flow cytometry. In
      tumors resected on day 14, class I expression measured by mean fluorescence, was
      374.8 +/- 27.40.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468658
TI  - Biology of fetal repair: the presence of bacteria in fetal wounds induces an
      adult-like healing response.
AB  - The minimal acute inflammatory response to tissue injury is one of the most
      dramatic differences between fetal and adult wound healing. Considering the
      prominent role of inflammation in adult tissue repair, this study tested the
      hypothesis that the minimal fetal inflammatory response to tissue injury plays a
      central role in the "scarless" fetal repair process. Sponge implants were treated
      with lethally irradiated or live bacteria and placed subcutaneously in fetal
      rabbits to test the ability of the fetus to mount an acute inflammatory response
      to bacterial antigens present at the wound site and to analyze the effects of
      this inflammatory response on fetal fibroplasia and neovascularization. After
      harvest, these implants were examined histologically for inflammation, fibroblast
      infiltration, collagen deposition, and neovascularization, and collagen
      deposition was measured using hydroxyproline quantitation by high-performance
      liquid chromatography. Bacteria-treated implants showed dose-dependent acute
      inflammatory responses and significant increases in collagen deposition compared
      with control sponges. Implants containing live bacteria demonstrated maximal
      fibroplasia and neovascularization. These findings suggest that, despite
      neutropenia and immaturity of the fetal immune system, the fetus is capable of
      mounting an acute inflammatory response to avirulent bacteria present at the
      wound site. Fetal inflammatory cells which respond to this bacterial stimulus
      appear capable of initiating an adult-like healing response. Thus, by failing to
      provide a bacterial stimulus for leukocyte recruitment at the site of tissue
      injury, the sterile fetal environment appears to play a role in effecting
      "scarless" fetal wound healing.

PMID- 8468659
TI  - Transverse mucosal preputial flap for repair of severe hypospadias and isolated
      chordee without hypospadias: a 350-case experience.
AB  - Three hundred patients with hypospadias and 50 patients with isolated chordee
      without hypospadias were operated on and followed by the same surgeon. A very low
      postoperative urethrocutaneous fistula rate (4.8%) was related to complete
      cutaneous coverage of the neourethra. The incidence of stenosis, noted in 8% of
      the cases, has progressively decreased with improvement of technical details and
      with growing experience. A total of 75% of the patients were corrected with a
      single operative procedure. Good disponibility of penile skin rendered a second
      intervention always easy.

PMID- 8468660
TI  - Mullerian inhibiting substance in the diagnosis and management of intersex and
      gonadal abnormalities.
AB  - Mullerian inhibiting substance (MIS), a gonadal hormone important in sexual
      differentiation, is high (10 to 70 ng/mL) in human male serum postnatally for
      several years before declining during the peripubertal period, but is
      undetectable in female serum until the onset of puberty. The sexually dimorphic
      secretion of MIS suggested possibilities for its use in several clinical
      settings. Thirty-one patients with intersex and gonadal anomalies from 17
      institutions were therefore evaluated between 1989 and 1992 with an MIS enzyme
      linked immunosorbent assay (ELISA). Serum MIS levels correlated with the presence
      of testicular tissue in two patients with suspected anorchia, five patients with
      male pseudohermaphroditism, and eight other intersex patients with undescended
      testes, dysgenetic gonads, or ovotestes. In these latter patients, serial MIS
      values were also helpful to confirm complete removal of gonadal tissue
      postoperatively. MIS may be a more sensitive marker for the presence of
      testicular tissue than serum testosterone levels, both before and after the
      neonatal androgen surge, and, consequently, may obviate the need for human
      chorionic gonadotropin stimulation in the evaluation of certain intersex
      disorders. In values were useful in differentiating the underlying etiology of
      the disorder. Four patients with undetectable levels have presumptive MIS gene
      mutations, while 7 others with MIS values of 2 to 45 ng/mL may have bioinactive
      hormone of MIS receptor defects. Finally, two young girls with ovarian granulosa
      cell tumors had elevated MIS values that fell from 18 to 2 ng/mL and from 6.5 to
      1 ng/mL during postoperative follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468661
TI  - Congenital bronchobiliary fistula: management of the involved hepatic segment.
AB  - We present three children with congenital bronchobiliary fistula (CBBF). The
      first infant underwent resection of the fistula at age 3 weeks and was reported
      as a success. She returned 7 years later with bilious expectoration for which a
      second thoracotomy was performed. One year thereafter a bile collection in the
      right chest required open drainage. Subsequently, the left hepatic lobe was
      resected. The second child was initially diagnosed as suffering from
      gastroesophageal reflux. He underwent a fundoplication and a gastrostomy at age 9
      months. Persistence of bilious sputum led to the diagnosis of CBBF at age 23
      months. The fistula was excised through a right thoracotomy. The distal end was
      injected demonstrating an arborization involving the entire left hepatic lobe.
      Since there was no communication with the remaining biliary tree or the
      intestine, a left hepatectomy was performed. The third child was reported in a
      communication focusing on the diagnosis of CBBF by hepatobiliary scintigraphy.
      Her history is almost identical to the second patient. However, instead of a
      hepatectomy, she underwent a Roux-en-Y drainage of the fistula. The three
      children had uneventful recoveries and are well. We believe that an abnormal
      biliary tract should be studied by contrast injection. If no decompressing
      communication with the normal biliary ducts or the duodenum can be demonstrated,
      the involved hepatic segment should be resected or internally drained. Children
      who underwent simple fistula excision must have close long-term follow-up.

PMID- 8468662
TI  - The natural history of congenital diaphragmatic hernia and pulmonary hypoplasia
      in the embryo.
AB  - Up to now, descriptions of the natural history of congenital diaphragmatic hernia
      (CDH) associated with pulmonary hypoplasia (PH) are based exclusively on
      observations made in the fetal period. However, nothing is known about the events
      that take place in an embryo with CDH. Recently, an animal model of CDH and PH
      has been established in rat embryos to study the embryology and natural history
      of this lesion. We exposed 36 pregnant Sprague-Dawley rats to a single dose of
      100 mg nitrofen on day 11 of pregnancy. A total of 356 staged embryos and fetuses
      from day 13 to day 21 were studied by light and scanning electronmicroscopy. The
      litters of 9 untreated rats (124 normal age-matched embryos and fetuses) served
      as controls. The abnormal development of the diaphragmatic anlage was first seen
      in embryos aged 13 to 14 days. A defect appeared in the dorsal part of the
      diaphragm, normally on the right side. The liver grew through this defect early
      on. Gut was found in an intrathoracic position only in the very late stages (day
      21/22) and newborns. Compared to controls, lungs of nitrofen-embryos with CDH
      were smaller, depending on the size of liver found in the thoracic cavity.
      Histologically, compression of lung was absent at these stages. Most authors
      speculate that CDH results because the pleuroperitoneal canals fail to close at
      the end of the embryonic period (ie, week 8 to 10 in human development) leading
      to a defect in the dorsolateral region of the diaphragm. However, contradictory
      to this assumption, our findings indicate that diaphragmatic defects develop in
      early embryonic life.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468663
TI  - Pathophysiology of congenital diaphragmatic hernia. IV: Renal hyperplasia is
      associated with pulmonary hypoplasia.
AB  - The hypothesis of this article is that growth of the fetal lung is stimulated by
      a pulmonary growth factor (PGF) produced by the kidneys, which is modulated by a
      feedback signal from the lungs, a pulmonary-derived renotropin (PDR). In the
      fetus with pulmonary hypoplasia (PH), the lungs may maximally stimulate this
      feedback loop to release more PDR, resulting in continual stimulation of the
      kidneys and renal enlargement. If such a schema plays a role in the
      pathophysiology of PH, newborn infants with congenital diaphragmatic hernia (CDH)
      or chronic amniotic fluid leak (CAFL) should have enlarged kidneys. To
      investigate this hypothesis, we created models of CDH in fetal lambs and CAFL in
      fetal rabbits, and then analyzed lung (Lu) and kidney (K) growth. When compared
      to controls, newborn CDH lambs had significantly smaller lungs and larger
      kidneys. The lungs were hypoplastic as defined by either decreased lung
      weight/body weight (LuW/BW), lung DNA/body weight (Lu DNA/BW), or lung total
      protein/body weight (LuTP/BW) (P < .01). Renal hyperplasia was confirmed by
      KW/BW, K DNA/BW (P < .01), and KTP/BW (P < .05). An inverse relationship between
      lung size and kidney size could be described by the equation KW/BW = 1.04 - 0.12
      LuW/BW (r = -.75). The CAFL model in newborn rabbits produced severe
      oligohydramnios when compared with controls (P < .01). This resulted in fetuses
      with smaller lungs and larger kidneys as compared with those of controls. The
      lungs were significantly smaller and more hypoplastic than controls when compared
      by LuW (P < .01), LuW/BW (P < .01), Lu DNA/BW (P < .05), and Lu TP/BW (P <
      .01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468664
TI  - Biochemical immaturity of lungs in congenital diaphragmatic hernia.
AB  - Neonates with congenital diaphragmatic hernia (CDH) continue to have unacceptably
      high mortality rates. To better understand the associated pulmonary pathology we
      measured biochemical parameters of lung maturity in neonatal rats with or without
      congenital diaphragmatic hernia created by maternal feeding of a single dose of
      nitrofen on day 9.5 or day 11.5 of gestation. Lungs from neonatal rats with large
      CDH (n = 9, 5 right-sided, 4 left-sided) had a significantly lower lung weight (P
      = .0001), lung weight/body weight ratio (P = .0001), disaturated
      phosphatidylcholine (DSPC) per microgram DNA (P < .005), total DSPC (P = .0001),
      total DNA (P < .05), protein per microgram DNA (P < .05), and total protein
      content (P < .005) when compared with lungs from the litter mates without
      congenital diaphragmatic hernia (n = 10). The lungs of rats with hernia also had
      significantly higher DNA concentrations (P < .05) and glycogen concentrations (P
      < .05). These data demonstrate that lungs in neonatal rats with large CDH are
      biochemically immature. Treatment directed toward correcting the pulmonary
      biochemical immaturity of affected fetuses before birth may improve the prognosis
      for these babies.

PMID- 8468665
TI  - Altered diaphragm function modifies neonatal lung growth: biologic morphometric
      assessment.
AB  - Thoracic volume relationships supported by the diaphragm are important mechanical
      components of neonatal lung growth. Alterations modify regional lung growth. We
      used stereologic morphometry to study effects of altered diaphragm function on
      alveolar growth in neonatal pigs. Nine piglets (1 mo) were divided into three
      groups: unilateral phrenectomy, noncompliant patch replacement of diaphragm, and
      sham. Seven days later lungs were fixed in situ with 2.5% glutaraldehyde by
      airway installation at 20 cm H2O. Five 1-mm cubes were cut from lung
      corresponding to apex/RUQ(A), base/RLQ(B), apex/LUQ(C), and base/LLQ(D) and
      prepared for light microscopy (n = 25/quad/animal). Stereologic morphometry
      involved point counting for air volume density and point intersect to determine
      the surface area density of the alveolar spaces. Results were analyzed for
      variance and by Tukey range testing. Variance of air volume % between groups
      quadrants B, C, D had decreased air volume % in phrenectomy group compared with
      patch and sham group (P < .05). Variance of air volume % within groups, for
      phrenectomy group A (81.5%), is different from all others (B = 70.6%, C = 75.5%,
      D = 66.7%); C is different from D (P < .05). For patch and sham group, D (P =
      74.8%, S = 80.7%) is different from A (P = 84.1%, S = 86.6%) and C (P = 86.2%, S
      = 84.4%). Variance of surface area density between groups--quadrant D had
      increased surface area density % in phrenectomy group compared to sham group (P <
      .05). Variance of surface area density % within groups, for phrenectomy group, A
      (37.9 mm-1) is different from D (55.7 mm-1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468666
TI  - Intratracheal pulmonary ventilation and congenital diaphragmatic hernia: a report
      of two cases.
AB  - Previous studies from our institution have shown that neonates with congenital
      diaphragmatic hernia (CDH), whose best postductal PaO2 (BPDPO2) was less than 100
      mm Hg while on maximal conventional mechanical ventilation (CMV), had a mortality
      exceeding 90%. When combined with extracorporeal membrane oxygenation (ECMO), the
      mortality rose to 100% in those infants who developed hypercarbia following
      decannulation. Historically, those patients have required increasing ventilator
      support, leading to iatrogenic lung damage, and eventual death. Intratracheal
      pulmonary ventilation (ITPV) using the reverse thrust catheter (RTC) developed by
      Kolobow incorporates a continuous flow of humidified gas through a reverse
      Venturi catheter positioned at the distal end of the endotracheal tube. In animal
      studies, ITPV was shown to result in a reduced physiological dead-space (VD), to
      facilitate expiration, and to enhance CO2 elimination. In our current study, we
      have applied ITPV in two neonates with CDH who could not be weaned from ECMO
      because of uncontrollable hypercapnia, and who met above criteria for 100%
      mortality. In both cases, ITPV restored normal PaCO2 at low peak inspiratory
      pressure (PIP) with a substantial decrease in VD. We believe ITPV is suited to
      ventilating newborns with CDH in whom barotrauma is known to be common. Beyond
      its present use, ITPV may be useful to ventilate children with other forms of
      respiratory failure, and should be so considered along with other now available
      methods of mechanical pulmonary ventilation.

PMID- 8468667
TI  - Lung injury produced by moderate lung overinflation in rats.
AB  - In models using both intact animals and isolated lungs of rats, rabbits, lambs,
      and dogs, application of high airway pressure and resultant lung overdistension
      has been shown to cause lung injury. Under pathological conditions, the more
      normal portions of the lung may be subjected to relative overdistension when
      supranormal airway pressures are used. A small animal model of lung
      overdistension is presented here to demonstrate that lung injury can be caused by
      moderate lung overdistension. Rats were anesthetized with Ketamine and
      pentobarbital. A tracheostomy was performed and arterial and central venous
      catheters placed. The animal was placed in a plethysmograph and an infant
      ventilator was used to provide mechanical ventilation. In the first experiment,
      animals in group A (n = 6, control) were ventilated at tidal volume (TV) of 5
      mL/kg for 5 hours. Animals in group B (n = 6) were ventilated at TV 15 mL/kg for
      60 minutes and then were returned TV of 5 mL/kg for the remainder of the
      experiment. Animals in group C (n = 5) were ventilated at TV 20 mL/kg for 60
      minutes and then returned to TV 5 mL/kg. Static lung compliance and arterial
      blood gasses were measured. Wet and dry lung weight were obtained after
      sacrifice. In the second experiment, animals in group D (n = 4, control) were
      ventilated at TV 5 mL/kg for 240 minutes and killed. Animals in group E (n = 4)
      were ventilated at TV 20 mL/kg for 60 minutes, returned to TV 5 mL/kg, and killed
      at 240 minutes. Fluorescein-labeled albumin was administered to each animal prior
      to mechanical ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468668
TI  - A test of the social support deterioration model in the context of natural
      disaster.
AB  - This prospective longitudinal study examined stress-mediating potentials of 3
      types of social support: social embeddedness, perceived support from nonkin, and
      perceived support from kin. As participants in a statewide panel study, 222 older
      adults were interviewed once before and twice after a severe flood. It was
      hypothesized that disaster exposure (stress) would influence depression directly
      and indirectly, through deterioration of social support. LISREL analyses
      indicated that postdisaster declines in social embeddedness and nonkin support
      mediated the immediate and delayed impact of disaster stress. No evidence was
      found for the mediational role of kin support. Findings are in accord with
      conceptualizations of social support as an entity reflecting dynamic transactions
      among individuals, their social networks, and environmental pressures.

PMID- 8468669
TI  - Perceiver self-presentational goals as moderators of expectancy influences:
      ingratiation and the disconfirmation of negative expectancies.
AB  - Self-fulfilling prophecy processes enable people to confirm their negative
      expectancies for others. The perceiver goal of ingratiation was hypothesized to
      alter this behavioral dynamic and thus lead perceivers to disconfirm their
      negative expectancies. In an interview setting, we manipulated interviewer Ss'
      expectancies and interaction goals. As anticipated, "no goal" interviewers were
      relatively cold and challenging toward their negative-expectancy applicants; as a
      result, these applicants performed somewhat less favorably, consistent with
      interviewer expectancies. In contrast, "liking goal" interviewers were relatively
      warm and unthreatening toward their negative-expectancy applicants; as a result,
      these applicants performed favorably, disconfirming interviewer expectancies.
      These data support a framework in which perceiver self-presentation goals are
      conceptualized to moderate the expectancy-confirmation process.

PMID- 8468670
TI  - Self-esteem, mood, and self-evaluation: changes in mood and the way you see you.
AB  - Three studies found that self-esteem moderates the relation between mood and self
      evaluation. In Study 1, a standard mood-induction procedure was used to induce
      positive, negative, or neutral moods in low self-esteem (LSE) Ss and high self
      esteem Ss. Afterward, Ss evaluated their specific qualities and characteristics
      (e.g., How smart are you? How kind are you?). Both self-esteem groups evaluated
      themselves favorably in a positive mood, but LSE Ss were more apt to lower their
      self-evaluations in a negative mood. Study 2 found a similar, though weaker
      pattern using a noncognitive, musical mood induction; Study 3 found that these
      effects occur with variations in naturally occurring mood over a 6-week period.
      The authors suggest that the tendency for LSE people to respond to negative moods
      with self-depreciation contributes to psychological distress.

PMID- 8468671
TI  - Marital satisfaction, depression, and attributions: a longitudinal analysis.
AB  - This study examined the longitudinal relation between causal attributions and
      marital satisfaction and tested rival hypotheses that might account for any
      longitudinal association found between these variables. Data on attributions for
      negative partner behaviors, marital satisfaction, depression, and self-esteem
      were provided by 130 couples at 2 points separated by 12 months. To the extent
      that spouses made nonbenign attributions for negative partner behavior, their
      marital satisfaction was lower a year later. This finding was not due to
      depression, self-esteem, or initial level of marital satisfaction, and also
      emerged when persons reporting chronic individual or marital disorder were
      removed. Results support a possible causal relation between attributions and
      marital satisfaction.

PMID- 8468672
TI  - Stability of babyfaceness and attractiveness across the life span.
AB  - Differential, structural, and absolute stability of babyfaceness and
      attractiveness at 5 ages were investigated. Attractiveness had differential
      stability across the life span. Babyfaceness had differential stability from
      childhood through the 30s for males and through adolescence for females.
      Consistent with sexual dimorphisms in facial maturation, males had less
      differential stability in babyfaceness from childhood to puberty than females.
      Structural stability of facial appearance, as reflected in the relationship
      between babyfaceness and attractiveness across the life span, was low, with these
      qualities positively related for females in childhood and for both sexes in their
      30s and 50s but unrelated in puberty and adolescence. Absolute stability of
      babyfaceness and attractiveness was also low, with mean levels decreasing across
      the life span. Contrary to cultural stereotypes, age-related decreases in
      attractiveness were equal for male and female Ss.

PMID- 8468673
TI  - Behavioral manifestations of personality: an ecological approach to judgmental
      accuracy.
AB  - The present study concerns connections between personality traits, the behaviors
      by which they are manifest, and the behaviors by which they are judged. One
      hundred forty undergraduate Ss were videotaped in 2 social interactions, and 62
      behaviors were coded from each tape. Separately, personality descriptions were
      obtained from knowledgeable informants. A pair of "strangers" viewed each
      videotape then also provided personality descriptions. Other Ss rated the
      diagnosticity of the 62 behaviors for each of the Big Five personality traits.
      The diagnosticity ratings predicted how behavioral cues would be used by
      strangers and were closely related to their actual relevance as indexed by their
      correlations with informants' judgments. These findings speak to the general
      accuracy of personality judgments, the development of methods to improve
      accuracy, and the value of reintegrating traditionally separate concerns of
      personality and social psychology.

PMID- 8468674
TI  - Changes in and stability of hostile characteristics: results from a 4-year
      longitudinal study of children.
AB  - Changes in and stability of hostility characteristics and their relationship to
      age, sex, and family support were examined among 108 10-18-year-olds in a 4-year
      longitudinal study. Clinical ratings of Structured Interview potential for
      hostility, self-reported Minnesota Multiphasic Personality Inventory-derived
      hostile attitudes, and perceptions of family support were obtained at study entry
      and at follow-up when subjects were ages 15-21. Results showed relative stability
      of hostility rankings across 4 years, with males being more hostile than females.
      Both sexes increased in hostility over time, with the greatest increase in Ss who
      perceived low family support at follow-up and whose parents perceived high family
      support at study entry. Results are consistent with notions that early signs of
      hostility are risk factors for later development of coronary disease and that
      family environment influences development of hostility.

PMID- 8468675
TI  - Prediction of drug distribution in distribution dialysis and in vivo from binding
      to tissues and blood.
AB  - Relationships between the binding and the distribution of drugs have been studied
      in vitro and compared with in vivo data. By use of a standardized technique of
      distribution dialysis, 10 model drugs were allowed to be distributed among blood
      and homogenates of seven tissues. The drugs represented a variety of distinct
      molecules with different lipophilicities, ionization constants, and binding
      characteristics. The tissue/blood drug concentration ratios were below unity for
      salicylic acid and phenylbutazone, at about unity for antipyrine (phenazone) and
      morphine, and above unity for two barbiturates and four basic lipophilic drugs.
      The binding of the 10 drugs to blood and homogenates of seven tissues was
      determined by use of conventional equilibrium dialysis and experimental
      conditions identical to those used in distribution dialysis. From these binding
      values (free fractions), the theoretical concentration ratios were calculated.
      There was a good correlation between the calculated values and those determined
      by distribution dialysis. Thus, the distribution of drugs in the in vitro model
      of distribution dialysis clearly is the result of binding competition and is
      predictable from binding values. The correlation between distribution in vitro
      (or calculated from binding values) and distribution in vivo, on the basis of
      literature data, indicated a reasonable agreement for antipyrine and the acidic
      lipophilic drugs used, as well as for the basic lipophilic drugs, with respect to
      the brain, muscle, and adipose tissue. However, the distribution of the latter
      drugs in the lungs, liver, and kidneys was grossly underestimated.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8468676
TI  - Automated drug dissolution monitor that uses a UV-visible diode array
      spectrophotometer.
AB  - A method for performing multicomponent analysis in drug dissolution testing
      without chromatographic separation is presented. Aliquots from dissolution
      vessels are automatically transferred to a UV-visible diode array
      spectrophotometer, spectra are measured, and the aliquots are returned to the
      testing vessels. A full-spectrum calibration method based on principal-component
      regression is used to simultaneously determine the concentrations of active
      ingredients and to account for interferences due to excipients in a tablet
      formulation. The system was evaluated with two commercial pharmaceutical
      formularies; the first contained pseudoephedrine hydrochloride and
      chlorpheniramine maleate, whereas the second was a mixture of phenylpropanolamine
      hydrochloride and chlorpheniramine maleate. The selections of standard mixtures
      for calibration and validation were based on a factorial design.

PMID- 8468677
TI  - Quantitative structure-activity relationships for substituted aminotetralin
      analogues. I: Inhibition of norepinephrine uptake.
AB  - Quantitative structure-activity relationships of 57 substituted aminotetralin
      analogues, an overview of their syntheses, and their pharmacological activity are
      described in this study. Lipophilic substituents at R3 as well as the overall
      lipophilicity of the molecule contribute toward increasing the inhibitory
      potency. An ethyl group is preferred, and a group larger than a propyl is not
      desirable as a nitrogen substituent. Among the ring substituents examined, an
      hydroxy group at the R6 position and either an unsubstituted R9 position or a
      methoxy substituent at the R9 position increase the inhibitory potency, whereas a
      methoxy group at the R7 position decreases inhibitory potency.

PMID- 8468678
TI  - Hydrolysis of saturated soybean phosphatidylcholine in aqueous liposome
      dispersions.
AB  - Hydrolysis kinetics of saturated soybean phosphatidylcholine (PC) were
      investigated as a function of pH, temperature, buffer concentration, buffer
      species, and ionic strength in aqueous liposome dispersions. A high-performance
      liquid chromatography method was used to separate PC and the hydrolysis products.
      Hydrolysis of PC followed pseudo first-order kinetics. Hydrolysis of fatty acid
      esters at sn-1 and sn-2 positions initially resulted in the formation of 2-acyl
      lyso-phosphatidylcholine and 1-acyl lyso-phosphatidylcholine; because of acyl
      migration, the most stable isomer of lyso-phosphatidylcholine, 1-acyl lyso
      phosphatidylcholine, was formed predominantly. General acid-base catalysis was
      observed for acetate and Tris ions. The pH profiles at 40 and 70 degrees C for a
      buffer concentration of 0.05 M showed a minimum hydrolysis rate at about pH 6.5.
      The relationship between the observed rate constant and temperature could be
      described adequately by the Arrhenius equation below and above the phase
      transition temperature of saturated soybean PC (52 degrees C).

PMID- 8468679
TI  - High-performance liquid chromatographic method for assay of otilonium bromide,
      diazepam, and related compounds in finished pharmaceutical forms.
AB  - A rapid, simple, stability-indicating assay procedure for otilonium bromide, a
      smooth muscle relaxant agent, and diazepam in composite tablet analysis was
      developed with high-performance liquid chromatography. The tablet matrix was
      dissolved with water, and drugs were extracted with acetonitrile containing an
      internal standard. An aliquot was centrifuged and chromatographed on a 5-microns,
      reversed-phase column with 0.5 M sodium acetate trihydrate buffer containing 5 mM
      1-heptanesulfonic acid monohydrate sodium salt:methanol (30:70; v/v; adjusted to
      pH 6.0 with glacial acetic acid) as the mobile phase. The selectivity of the
      chromatographic system was demonstrated by resolving both compounds from various
      potential degradation products of each compound. The method is linear,
      quantitative, and reproducible.

PMID- 8468680
TI  - Photodegradation of benzydamine: phototoxicity of an isolated photoproduct on
      erythrocytes.
AB  - Benzydamine hydrochloride (Tantum, 1) is a photoallergic and phototoxic anti
      inflammatory and analgesic agent. This drug is photolabile under aerobic and
      anaerobic conditions. Irradiation of a methanol solution of benzydamine under
      oxygen or argon at 300 nm affords 5-hydroxybenzydamine (2) and 2-beta
      dimethylaminopropyl-1-benzylindalolin-3-one (3) as the main isolated and
      spectroscopically identified photoproducts. A radical intermediate was evidenced
      by thiobarbituric acid that was used as a radical sonde, as well as by the
      dimerization of cysteine. Erythrocyte lysis photosensitized by 1, 2, and 3 was
      investigated.

PMID- 8468681
TI  - Transmucosal delivery of methionine enkephalin. I: Solution stability and
      kinetics of degradation in various rabbit mucosa extracts.
AB  - To evaluate the feasibility of transmucosal delivery of methionine enkephalin
      (Tyr-Gly-Gly-Phe-Met; Met-Enk), it is important to first investigate its
      physicochemical and enzymatic stability. The kinetics of degradation of Met-Enk
      in aqueous solution was determined at pH 2.01-9.84 and 37-45 degrees C by high
      performance liquid chromatography. The first-order rate constant (k) was
      calculated, and the log k-pH profile showed that Met-Enk is most stable at pH
      approximately 5.0. Various mucosae excised from rabbit were mounted on Valia
      Chien permeation cells and exposed to isotonic phosphate buffer at physiologic
      pHs. Mucosal and serosal extracts were collected from the donor and receptor
      solutions, respectively. The degradation of Met-Enk in the extracts followed
      first-order kinetics, but no significant difference in the degradation rates was
      observed between mucosal and serosal extracts, regardless of the type of mucosa
      used. Degradation was most rapid in the extracts of rectal mucosa, followed by
      vaginal and nasal mucosae. The major metabolites were Des-Tyr-Met-Enk and
      Tyrosine (Tyr), indicating the enzymatic hydrolysis by aminopeptidases. However,
      the data also suggested that dipeptidyl peptidase and dipeptidyl carboxypeptidase
      could play some roles in the degradation of Met-Enk. The degradation pathways of
      Met-Enk were further explored by concomitantly determining the formation of
      smaller metabolites of primary hydrolytic fragments of Met-Enk in the mucosal
      extracts.

PMID- 8468682
TI  - In vitro release of testosterone from suppository bases and in vivo absorption
      studies in human males.
AB  - Diffusion rates of testosterone from various suppository bases with and without
      surfactants were determined. In a limited study, selected suppository
      formulations were evaluated for efficiency of rectal absorption of testosterone
      in three male volunteers ranging in age from 25 to 30 years. Significant
      reductions in the ratios of urinary metabolites to free testosterone were
      observed with polyethylene glycol 1000, esterified (C10-C18) fatty acids, and
      theobroma oil-based samples.

PMID- 8468683
TI  - Epithelial transport of drugs in cell culture. VIII: Effects of sodium dodecyl
      sulfate on cell membrane and tight junction permeability in human intestinal
      epithelial (Caco-2) cells.
AB  - This study demonstrates how the common pharmaceutical wetting agent sodium
      dodecyl sulfate (SDS) increases the absorption of drugs and peptides across the
      human intestinal epithelium. First, an assay that could follow the reversible and
      irreversible time-dependent effects of SDS on the permeability of Caco-2 cell
      monolayers with high reproducibility was developed. SDS (0.40 mM) exposure for 20
      min resulted in reversible absorption enhancement of mannitol (M(r), 182 g/mol),
      1-deamino-8-D-arginine-vasopressin (M(r), 1071 g/mol), and polyethylene glycol
      (M(r), 4000 g/mol). A longer (2 h) exposure to SDS resulted in irreversible
      absorption enhancement. Second, transepithelial electrical resistance
      measurements (TEER) together with fluorescence and transmission electron
      microscopy were used to study the effects of SDS on epithelial integrity, cell
      membranes, intracellular calcium concentration, cytoskeleton, and tight
      junctions. The effect of SDS (0.40 mM) on epithelial integrity was immediate. A
      significant decrease in transepithelial electrical resistance measurements was
      obtained with 1 min after exposure to SDS that was concomitant with increases in
      the permeability of the apical cell membranes and intracellular calcium
      concentration. SDS shortened the microvilli of the cells and produced apical (but
      not basolateral) membrane wounds, actin disbandment, disorganization of the
      terminal web, and structural separation of the tight junctions. The absorption
      enhancement was not reduced after repair of the apical cell membranes, indicating
      that SDS enhances drug and peptide absorption across the intestinal epithelium by
      the paracellular pathway.

PMID- 8468684
TI  - Reduction of erythrocyte membrane permeability and protein binding of low
      molecular-weight drugs following glycoside derivitization.
AB  - The permeability of glycosides (salicin, arbutin, glycyrritin, p-nitrophenyl-beta
      D-glucopyranoside, p-nitrophenyl-beta-D-galactopyranoside, p-nitrophenyl-beta-D
      lactopyranoside, and p-nitrophenyl-beta-D-maltopyranoside) and their aglycons
      through human erythrocyte membrane was investigated. The transport rate of the
      glycosides through human erythrocyte membrane was slower than that of their
      aglycons. Glycosides with a disaccharide did not permeate the erythrocyte
      membrane; this observation suggests that the introduction of disaccharide to
      drugs gives rise to a significant decrease in the leakage of drugs through the
      erythrocyte membrane. The derivatives of glycosides encapsulated in erythrocytes
      were not released from these erythrocytes into the outer medium. The transport
      capacity of the glycosides was not influenced by the kind of suspending medium,
      but that of the aglycons was influenced by the medium. The glycosides bound to
      human serum albumin more weakly than their aglycons. Particularly, the glycosides
      were more difficult to displace from 7-anilinocoumarin-4-acetic acid (site III
      drug) than their aglycons, except for glycyrritin.

PMID- 8468685
TI  - Barrier function of human skin and human reconstructed epidermis.
AB  - The present study compares the stratum corneum of human skin and human
      reconstructed epidermis by histological examination as well as by estimation of
      water permeability. Measurement of the percutaneous absorption of benzoic acid,
      testosterone, and hydrocortisone revealed that under the same experimental
      conditions the reconstructed epidermis on de-epidermized dermis exhibits a
      barrier function with qualitative properties similar to that of normal skin:
      water and benzoic acid penetrate more rapidly than testosterone and
      hydrocortisone. Quantitatively, however, reconstructed epidermis is more
      permeable than normal human skin. This points to an impaired barrier function of
      the epidermis reconstructed in vitro.

PMID- 8468687
TI  - Prediction of skin permeabilities of diclofenac and propranolol from theoretical
      partition coefficients determined from cohesion parameters.
AB  - The cohesion parameters of diclofenac and propranolol were determined
      experimentally. The theoretical partition coefficient (Ps,v) was calculated from
      the activity coefficient (gamma) and the cohesion parameters of the solvent
      (delta 1 = delta v), solute (delta 2), and skin (delta s). By using the extended
      Hildebrand solubility equation, the potential energy of solute-solvent
      interaction in a given solution was considered to have the gamma value derived
      from solubility data of diclofenac and propranolol in ethanol-aqueous buffer.
      Values for experimental permeability coefficients (Kp), which were determined
      from flux and solubility, were compared with values for the respective Ps,v. For
      a solvent that consists of ethanol-aqueous buffer exhibiting cohesion parameters
      in the range of delta v = 18-24 (cal/cm3)1/2, the fluxes increased and the Kp
      decreased because of the similarity in cohesion parameters of these solvents to
      the solute. The difference between Ps,v and experimental Kp suggests that ethanol
      in the solvent affects the membrane and diclofenac and propranolol penetrate
      through the membrane, possibly solvated by ethanol.

PMID- 8468686
TI  - Synthesis and hypolipidemic activity of 4-substituted 1-acyl-1,2,4-triazolidine
      3,5-diones in rodents.
AB  - A series of 4-substituted 1-acyl-1,2,4-triazolidine-3,5-diones demonstrated
      potent activity in CF1 mice when administered intraperitoneally at 20 mg/kg/day,
      lowering both serum cholesterol and triglyceride levels significantly. The 4-(4
      chlorophenyl)-substituted compounds demonstrated better hypolipidemic activity in
      rodents than 4-methoxy-, 4-nitro-, and 4-t-butylphenyl substitutions. Aryl and
      alkyl substitutions rather than benzoyl substitutions at position 4 demonstrated
      good hypocholesterolemic activity. Selected compounds were examined for the mode
      of action in rats in which serum cholesterol and triglyceride levels were reduced
      after administration of 20 mg/kg/day orally; tissue lipids were reduced after 14
      days of administration, and bile and fecal lipids were increased by 44-250%.
      Serum lipoprotein levels were also modulated by the agents, with cholesterol
      levels in very low density lipoprotein and low density lipoprotein fractions
      being reduced by 2-57%. Cholesterol levels in the high density lipoprotein
      fraction were elevated by 94-341%. Activities of mouse hepatic enzymes were
      suppressed by the agents in a manner that suggested that the compounds interfere
      with de novo synthesis of lipids.

PMID- 8468688
TI  - Influence of albumin on the distribution and elimination kinetics of diclofenac
      in the isolated perfused rat liver: analysis by the impulse-response technique
      and the dispersion model.
AB  - The impulse-response technique was used to investigate the influence of changes
      in the perfusate concentration of human serum albumin (HSA; 1.5-25 g/L) on the
      distribution and elimination kinetics of [14C]diclofenac in the isolated perfused
      rat liver. Output data were analyzed by a linear systems approach in combination
      with the axial dispersion model of hepatic elimination. This stochastic model is
      characterized by a dimensionless parameter (the dispersion number, DN) that
      quantifies the relative spreading of a substance as it passes through the liver.
      The two-compartment form of the axial dispersion model, which assumes that the
      radial transfer of a substance between the vascular and cellular spaces proceeds
      at a finite rate, was used to describe the output profiles for diclofenac,
      thereby providing estimates for DN and the first-order rate constants for the
      transfer of drug between the vascular and cellular compartments (k12 and k21) and
      its sequestration from the cellular compartment (kel). With a change in perfusate
      HSA concentration, the only one of these parameters to alter significantly
      (analysis of variance, p < 0.05) was the uptake rate constant (k12), which
      increased from 0.091 +/- 0.016 (mean +/- standard deviation) to 0.79 +/- 0.09 s-1
      as HSA decreased from 25 to 1.5 g/L. Most of this change could be accounted for
      by an increase in the fraction of diclofenac unbound in perfusate, from 0.0030 to
      0.0407 as HSA decreased from 25 to 1.5 g/L.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468689
TI  - Nonlinear pharmacokinetics and protein binding of tiaprofenic acid in female
      Lewis rats.

PMID- 8468690
TI  - Comments concerning "Solvent effects on chemical processes. I: Solubility of
      aromatic and heterocyclic compounds in binary aqueous-organic solvents".

PMID- 8468691
TI  - Transport of L-tryptophan across the rat nasal mucosa.

PMID- 8468692
TI  - Reduction of plantar pressure with the rigid relief orthosis.
AB  - The rigid relief orthosis was developed to protect vulnerable sites on the
      plantar surface of the insensitive foot against reulceration by providing both a
      nonyielding relief under the healed lesion site and a total contact fit.
      Clinically, the rigid relief orthosis has been effective in protecting the foot
      against the trauma induced by the repetitive mechanical stress of walking. This
      study used both the Hercules and F-Scan pressure transducer systems to measure
      pressure at the first metatarsal head in three orthotic treatments. Both
      measurement systems recorded significant reductions in pressure at the first
      metatarsal head with the rigid relief orthosis, establishing a quantitative
      rationale explaining its clinical effectiveness. Significant pressure differences
      were also recorded at the secondary sites of the heel, midfoot, and third
      metatarsal head.

PMID- 8468693
TI  - Current concepts in bone healing. Review of the literature.
AB  - Bone healing is a process of reconstitution of tissue. With the development of
      rigid internal fixation, primary bone healing has exhibited certain histologic
      characteristics not previously seen. The authors discuss the histologic,
      biochemical, and physiologic processes seen in primary and secondary bone healing
      following fracture or osteotomy.

PMID- 8468694
TI  - Anatomical basis for congenital deformities of the lower extremities. Part II.
      The knee and leg.
AB  - The congenital etiology of many malformations of the lower extremities is
      undisputed. This study uses cryomicrotomy of the knees and legs of midterm
      fetuses to establish the best anatomical representations of lower extremity
      parts, as they are developing, in a partially microscopic form. Adequate
      treatment plans of congenital defects require a knowledge of the normal status of
      development, and this investigation provides these data in a unique way. A
      comprehensive review of current therapeutic philosophies is related to
      morphology, which is discussed in light of the various congenital abnormalities
      of the knee and leg.

PMID- 8468695
TI  - Orthotic survey. Preliminary results.
AB  - A nationwide survey of patient satisfaction and effectiveness with prescription
      foot orthoses was conducted. Five hundred twenty patients were fitted with foot
      orthoses and evaluated for 14 weeks. The survey was not confined to a single
      medical condition. The level of patient satisfaction and the final fit of the
      custom-fitted orthoses were excellent. Effectiveness of the orthoses in the
      patient population ranged from 62.5% of the cases having the chief complaint
      completely resolved to 4.7% unresolved. Orthoses reduced or delayed the need for
      surgery in general and for hallux valgus and hammer toe specifically. Although
      several conclusions can be drawn on the basis of these survey results, this study
      highlights the need for a more detailed study and research into the prescription
      of orthoses to improve clinical practice, patient quality of life, cost
      effectiveness, and the design and manufacture of orthoses.

PMID- 8468696
TI  - Pathophysiology of diabetic neuropathy.
AB  - Angiopathy, immunopathy, and neuropathy are the key components responsible for
      diabetic foot complications. The authors report on the current theories of
      metabolic and structural causes of diabetic neuropathy.

PMID- 8468697
TI  - Cuboid stress fracture. A case report.
AB  - Because a stress fracture is rare and easily missed on an x-ray, it might go
      undetected. If a patient presents with an activity related injury to the midfoot
      and x-rays are negative, a computed tomography scan can be helpful in diagnosing
      a cuboid stress fracture. Also, computed tomography scans graphically show the
      fracture location and size, in addition to tracking progressive bone changes
      during the healing process.

PMID- 8468698
TI  - Neurologic disorders affecting the lower extremities in HIV infection.

PMID- 8468699
TI  - Ataxic gait. Complication of chicken pox.

PMID- 8468700
TI  - Heterotopic finger transfer in ulnar ray deficiency associated with contralateral
      postaxial polydactyly: a case report.

PMID- 8468701
TI  - Intraoperative histopathologic nerve examination in brachial plexus injury.
AB  - A new method of indirect intraoperative evaluation of axonal quality in a
      proximal nerve stump by immediate observation of the myelin sheath is presented.
      Using this method in 18 cases of brachial plexus injuries, the proximal stumps of
      particular roots or trunks were classified as unfavorable, favorable, or fair.
      This histologic grading was compared to the clinical result obtained after
      surgical repair of these nerves in the corresponding territory. In three cases,
      the proximal stump of the brachial plexus root was sacrificed because of an
      unfavorable grade, and a nerve transfer was performed: the results were useful in
      two cases and "academic" in one case. Among 12 cases with favorable histologic
      grades, nine were associated with useful function and three were "academic".
      Among three cases with a fair histologic grade, two were associated with an
      "academic" result and one was useful in a nine-year-old child. Retrospective
      comparison with classic examination after axon staining showed that
      intraoperative histopathologic grading was somewhat too optimistic in six cases
      and was relevant in 12 cases. This method may be helpful in choosing proper
      methods for brachial plexus repair. A normal or almost normal histopathologic
      condition in the proximal stump of the nerve is mandatory for obtaining a useful
      clinical result after repair.

PMID- 8468702
TI  - Microsurgical replantation of the avulsed scalp: report of six cases.
AB  - This article reports the successful microsurgical replantation of six scalps
      avulsed for over 3 to 11 hr, after trauma and before repair, including five total
      and one partial avulsion. The authors believe that one key to successful
      replantation is effective vessel anastomoses. In the reported series, three
      scalps were reconstructed with two superficial temporal vessels and in five
      cases, with a 1:1 ratio between arteries and veins. The partially avulsed scalp
      was replanted successfully with only one artery and one vein. The management of
      postoperative complications is discussed.

PMID- 8468703
TI  - The structural basis of Felice Fontana's spiral bands and their relationship to
      nerve injury.
AB  - In 1779, Felice Fontana, using a six-power hand-held magnifying lens, described
      what appeared to be spiral bands surrounding the peripheral nerve. He
      hypothesized that these bands were due to an optical illusion related to the
      underlying undulations of the individual nerve fibers, which he was the first to
      observe with an early microscope. The present study examines the historical basis
      of Fontana's work, confirms with intrafascicular dissection that the bands are an
      illusion created by unstretched nerve fibers, and relates their clinical
      disappearance to current concepts of the pathophysiology of chronic nerve
      compression and nerve injury.

PMID- 8468704
TI  - Direct muscle neurotization recovers gastrocnemius muscle function.
AB  - This case report describes a devastating injury in which a distal motor nerve had
      been avulsed from the muscle belly and was not available for reconstruction. This
      otherwise irreparable posterior tibial nerve injury was successfully treated by
      direct neurotization of the muscle belly. The patient did have one small, intact,
      muscular branch to the medial gastrocnemius muscle; however, electrodiagnostic
      and clinical examination and recovery pattern suggested the neurotization
      procedure was responsible for the functional recovery. In the rare situation
      where no distal nerve is available, and tendon transfers or arthrodesis are
      inappropriate, direct muscle neurotization can be considered as a salvage
      technique.

PMID- 8468705
TI  - Direct muscle neurotization.
AB  - The results of experimental research, as well as of a large clinical series (n =
      51) of direct muscle neurotization, have been encouraging enough to warrant
      extending the indications for the procedure to patients in whom traditional
      repair by direct nerve suture or nerve graft is impossible, because of the lack
      of a distal nerve segment, or because of destruction of the neural portion of one
      or more muscle groups. Prerequisites include a satisfactory volume of muscle with
      sufficient vascularity and adequate postoperative joint and muscle
      immobilization.

PMID- 8468706
TI  - Microsurgical reconstruction in limb-salvage procedures: comparison between
      primary and secondary reconstruction.
AB  - Limb-salvaging procedures after malignant tumor resection in the extremities were
      performed in 22 cases, utilizing microsurgical tissue transplantation. Five
      patients had soft-tissue tumors and 17 had bone tumors. Thirteen cases were
      primarily and nine were secondarily reconstructed. The advantages and
      disadvantages of both primary and secondary reconstructions were compared: as to
      technical difficulty, primary reconstruction was much easier. Chemotherapy was
      necessary just before and/or after reconstruction in eight of 13 cases of primary
      reconstruction. Delayed union or non-union occurred more frequently in patients
      who required chemotherapy, but eventual union was achieved in all cases by adding
      a conventional bone graft. As for oncologic and functional status, there was no
      difference in oncological status between the primary and secondary groups, but
      the primary reconstructions showed better functional results. Although
      individualized treatment is of utmost importance when utilizing microsurgical
      reconstruction to save limbs, primary reconstruction can be done most
      successfully when there is a wide surgical margin after tumor resection and when
      attention is paid to the avoidance of such complications as delayed union or non
      union.

PMID- 8468707
TI  - Gender differences in factors associated with hypoactive sexual desire.
AB  - Several factors have been identified as playing an etiological role in hypoactive
      sexual desire. It has been assumed that these factors appear equally among men
      and women, however, there is little empirical validation for this. An
      investigation of 69 men and women was undertaken to explore whether certain
      medical, psychological, sexual, and/or interpersonal factors were more likely to
      present in men versus women. Significant differences were found with regard to
      age, psychological distress, relationship satisfaction, level of stress, and the
      duration of another sexual dysfunction. Implications for a refined understanding
      of hypoactive sexual desire and for treatment are discussed.

PMID- 8468708
TI  - The female androgen deficiency syndrome.
AB  - We evaluated the sexual functioning of 11 women who developed demonstrable
      androgen deficiencies after undergoing chemotherapy with cytotoxic agents and/or
      bilateral salpingo-oophorectomies for a variety of medical conditions. For
      comparison, we evaluated the sexual status of 11 subjects with comparable
      medical, menopausal, marital, and sexual histories, whose levels of circulating
      testosterone were within normal limits. The results of this clinical study
      confirm and extend the observations originally made by Waxenberg and his
      colleagues in 1959, that testosterone deficiency in women produces a marked
      decrease in libido and sexual responsiveness. Our findings further indicate that
      the female androgen deficiency syndrome is often indistinguishable from
      psychogenic desire disorders on clinical grounds alone.

PMID- 8468709
TI  - A comparative study using orgasm consistency training in the treatment of women
      reporting hypoactive sexual desire.
AB  - In an experimental study, a standard group intervention for treating women with
      hypoactive sexual desire was compared to a standard group intervention plus
      orgasm consistency training. Specificity of sexual change following treatment was
      assessed in 39 women with hypoactive sexual desire disorder who completed either
      treatment. Following treatment, women in both groups reported significantly
      positive sexual changes on two of the four measures of sexual behavior. Compared
      with the women receiving only standard treatment, the women who also received
      orgasm consistency training reported greater sexual arousal and sexual
      assertiveness at posttreatment and at three-month and six-month follow-up
      evaluations and greater sexual satisfaction at the six-month follow-up.
      Implications for these findings, study limitations, and future research
      directions are explored.

PMID- 8468710
TI  - Sexual functioning in HIV+ and HIV- injected drug-using women.
AB  - As part of a natural history study of HIV disease in injected drug users, 38 HIV
      positive (HIV+) asymptomatic or low-symptomatic women and 37 HIV negative (HIV-)
      women, mostly of minority inner-city background, underwent a comprehensive survey
      of sexual functioning. At study baseline, the sample as a whole showed a
      relatively high prevalence of problems in all major phases of the sexual response
      cycle and in vaginismus and vaginal pain. Statistically significant group
      differences indicate higher rates of problems in sexual functioning in HIV+ women
      even at an early stage of disease progression.

PMID- 8468711
TI  - The she-male phenomenon and the concept of partial autogynephilia.
AB  - The term autogynephilia denotes a male's propensity to be sexually aroused by the
      thought or image of himself with female attributes. Some autogynephiles imagine
      themselves, in their sexual fantasies, as complete women. Others, here called
      partial autogynephiles, imagine themselves with a mixture of male and female
      anatomic features, usually women's breasts and men's genitals. Partial
      autogynephiles evince a particular sexual interest in those individuals known in
      the vernacular as she-males. These are men, often involved in prostitution or
      pornography, who have undergone breast augmentation while maintaining their male
      genitals. Partial autogynephiles appear less likely to pursue surgical sex
      reassignment than gender-dysphoric men whose erotic self-image includes a vagina.
      Some patients with a persistent desire for women's breasts but no or conflicted
      desires to live as women full-time or undergo vaginoplasty may be pacified with
      mildly feminizing doses of estrogenic hormones.

PMID- 8468712
TI  - Patterns of exposure to sexually explicit material among sex offenders, child
      molesters, and controls.
AB  - The Meese Commission Report claimed exposure to sexually explicit material leads
      to sex offenses and recommended examining developmental patterns and pornography
      experiences of offenders. This second phase of our study examines developmental
      patterns and sexually explicit material experiences of sex offenders, a subgroup
      of child molesters, and controls. Results indicate sex offenders (but not the
      child molester subgroup) began masturbating at a significantly younger age than
      controls. Sexually explicit material was used during the first masturbatory
      experience of 33.3% of sex offenders and 14% of controls. Child molesters were
      significantly older than controls when exposed to sexually explicit material.
      Frequency of adult use of sexually explicit material does not differ
      significantly among groups.

PMID- 8468713
TI  - Suramin: here to stay!?

PMID- 8468714
TI  - Pesticide residues and breast cancer: the harvest of a silent spring?

PMID- 8468715
TI  - The Delaney clause: too much of a good thing?

PMID- 8468716
TI  - IARC publishes western Europe cancer maps.

PMID- 8468717
TI  - Optimal timing of breast cancer surgery: findings revive debate.

PMID- 8468718
TI  - Pro-tobacco group attempts to discredit EPA's announcement.

PMID- 8468719
TI  - Suramin, an active drug for prostate cancer: interim observations in a phase I
      trial.
AB  - BACKGROUND: Previous studies indicate that suramin may be an active agent for
      treatment of solid tumors. The clinical use of suramin is complicated by a broad
      spectrum of toxic effects and complex pharmacology. Studies have suggested that
      the dose-limiting neurotoxicity of this agent is closely related to sustained
      plasma drug concentrations of 350 micrograms/mL or more. PURPOSE: This phase I
      clinical trial in patients with solid tumors was designed to determine whether
      plasma concentrations resulting in both antitumor activity and manageable
      toxicity could be achieved with short, intermittent infusions of suramin.
      METHODS: Thirty-seven patients, including 33 with metastatic, hormone-refractory
      prostate cancer, collectively received 43 courses of suramin designed to maintain
      a plasma concentration range of 200-300, 175-275, or 150-250 micrograms/mL.
      Patients received a test dose of 200 mg and an initial loading dose of 1000 mg/m2
      on day 1 of therapy. Subsequent suramin doses and schedules were individually
      determined using a strategy of adaptive control with feedback, which used a
      maximum a posteriori Bayesian algorithm to estimate individual pharmacokinetic
      parameters. Patients were treated until dose-limiting toxicity or progressive
      disease developed. RESULTS: Thirty-five of the 37 study patients and 31 of the 33
      with prostate cancer were assessable for toxicity and response. Treatment was
      discontinued in 28 patients because of dose-limiting toxicity consisting of a
      syndrome of malaise, fatigue, and lethargy; recurrent reduction in creatinine
      clearance of 50% or more; or axonal neuropathy. Evidence of major antitumor
      activity was observed in patients with prostate cancer treated at all three
      plasma drug concentrations. Measurable responses (one complete response and five
      partial responses) were noted in six of 12 patients with measurable disease.
      Twenty-four (77%) of 31 patients had a reduction in prostate-specific antigen of
      50% or more, and 17 (55%) of 31 had a reduction of 75% or more. Twenty (83%) of
      24 patients reported reduction in pain. CONCLUSIONS: Suramin can be safely
      administered as an intermittent bolus injection by use of adaptive control with
      feedback to control plasma drug concentrations; toxicity is significant but
      manageable and reversible. Suramin is active against hormone-refractory prostate
      cancer. IMPLICATIONS: Future trials should address the role and necessary extent
      of therapeutic drug monitoring; the optimal plasma drug concentration range and
      duration of therapy; and the activity of suramin in combination with other
      agents, in earlier stages of prostate cancer, and in other tumor types.

PMID- 8468720
TI  - Prospective randomized trial of high-dose interleukin-2 alone or in conjunction
      with lymphokine-activated killer cells for the treatment of patients with
      advanced cancer.
AB  - BACKGROUND: Treatment using interleukin-2 (IL-2) alone or in conjunction with
      lymphokine-activated killer (LAK) cells has been shown to mediate disease
      regression in selected patients with advanced cancer. PURPOSE: This prospective
      randomized trial was designed to determine whether the administration of LAK
      cells in conjunction with high-dose IL-2 alters response and survival rates,
      compared with those for IL-2 alone, in patients with advanced cancer. METHODS:
      The 181 patients who had metastatic cancer that had failed to respond to standard
      therapy or who had disease for which no effective therapy existed received
      treatment with high-dose IL-2 alone or with LAK cells plus IL-2. Both treatment
      groups were to receive the same dose of IL-2 administered according to the same
      schedule. IL-2 doses were omitted depending on the tolerance of the patient. Of
      the 181 patients, 97 had renal cell cancer and 54 had melanoma. RESULTS: Median
      potential follow-up was 63.2 months. There were 10 complete responses among the
      85 assessable patients who received IL-2 plus LAK cells, compared with four among
      the 79 who received IL-2 alone. There were 14 and 12 partial responses,
      respectively. Complete response continues in seven patients at 50-66 months. The
      36-month actuarial survival with IL-2 plus LAK cells was 31%, compared with 17%
      with IL-2 alone (two-sided P value [P2] = .089). A trend toward improved survival
      was seen for patients with melanoma who received IL-2 plus LAK cells, compared
      with those who received IL-2 alone (24-month survival: 32% versus 15%; 48-month
      survival: 18% versus 4%; P2 = .064 [corrected]). None of 26 patients with
      melanoma who received IL-2 alone are alive; five of 28 who received IL-2 plus LAK
      cells are alive, and three continue in complete response. No difference in
      survival was seen in patients with renal cell cancer in the two treatment groups.
      There were six treatment-related deaths (3.3%); three were due to myocardial
      infarction. Other toxic effects resolved by discontinuation of IL-2. Many toxic
      effects were related to increased vascular permeability induced by IL-2.
      CONCLUSIONS: Some patients with metastatic cancer have prolonged remission when
      they are treated with high-dose IL-2 alone or in conjunction with LAK cells. Our
      results suggest a trend toward increased survival when IL-2 is given with LAK
      cells in patients with melanoma, but no trend was observed for patients with
      renal cell cancer. IMPLICATIONS: As these studies continue, efforts are underway
      to develop improved immunotherapies using tumor-infiltrating lymphocytes (TIL)
      and gene-modified TIL.

PMID- 8468721
TI  - Acute lung injury following treatment with high-dose cyclophosphamide, cisplatin,
      and carmustine: pharmacodynamic evaluation of carmustine.
AB  - BACKGROUND: Therapy with high-dose cyclophosphamide, cisplatin, and carmustine
      (BCNU) plus autologous bone marrow transplantation has been extensively studied
      as treatment for patients with stage II or III breast cancer who have a 70% or
      greater risk of developing metastatic disease. This therapy is being used in a
      cooperative intergroup phase III clinical trial. In the cyclophosphamide
      cisplatin-BCNU regimen, cyclophosphamide and BCNU, but not cisplatin, have been
      reported to cause acute lung injury, suggesting that either cyclophosphamide or
      BCNU may contribute to this injury. PURPOSE: The purpose of this study was to
      analyze clinical and pharmacokinetic data from our ongoing phase II trials and to
      determine whether there is an association between BCNU pharmacokinetics and acute
      lung injury following cyclophosphamide-cisplatin-BCNU therapy. METHODS: We
      performed a retrospective study of 38 patients treated following induction
      therapy or relapse, 29 with stage II-IV breast cancer and nine with intermediate
      and high-grade stage III-IV non-Hodgkin's lymphoma. These patients received
      therapy with cyclophosphamide at a dose of 1875 mg/m2 daily as a 1-hour
      intravenous infusion for 3 days, cisplatin at 55 mg/m2 per day as a 72-hour
      continuous intravenous infusion, and BCNU at 600 mg/m2 as a 2-hour infusion
      immediately following completion of the cisplatin infusion. Data from analysis of
      blood samples were used to calculate pharmacokinetic parameters for BCNU, and
      acute lung injury was determined on the basis of pulmonary function test results
      and histologic examination of lung biopsy specimens. RESULTS: Our analysis showed
      that 20 (53%) of the 38 patients developed pulmonary injury following treatment.
      Twelve (60%) of the 20 had values for area under the curve (AUC) for BCNU
      concentration x time that exceeded 600 (micrograms/mL) x minute, whereas only two
      (11%) of the 18 without pulmonary injury had values above this level (P < .03).
      Thus, 12 (86%) of 14 patients with BCNU AUC greater than 600 (micrograms/mL) x
      minute developed lung injury. CONCLUSIONS: These results suggest that BCNU
      exposure greater than 600 (micrograms/mL) x minute is associated with increased
      risk of acute lung injury after cyclophosphamide-cisplatin-BCNU therapy and may
      be a major cause of pulmonary drug injury following this regimen. IMPLICATIONS:
      Strategies aimed at more uniform drug exposure or selective neutralization of
      chlorethylisocyanate, one of the two major hydrolysis products of BCNU, might
      reduce the incidence of acute lung injury following this regimen without major
      compromise of antitumor effect.

PMID- 8468722
TI  - Blood levels of organochlorine residues and risk of breast cancer.
AB  - BACKGROUND: Organochlorines such as DDT [2,2-bis(p-chlorophenyl)-1,1,1
      trichloroethane] and PCBs (polychlorinated biphenyls), which have been used
      extensively as insecticides and as fluid insulators of electrical components,
      respectively, are known to be persistent environmental contaminants and animal
      carcinogens. These agents have been found in human tissue due to their
      inefficient metabolism and their solubility in lipids, which lead to lifelong
      sequestration in adipose tissue. Their association with human cancer occurrence,
      however, has been explored only marginally, with most studies having 20 or fewer
      cases. PURPOSE: This blinded study was designed to determine whether exposure to
      PCBs and to DDE [1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene], the major
      metabolite of DDT, is associated with breast cancer risk in women. METHODS: We
      analyzed sera from the stored blood specimens of 14,290 participants enrolled
      between 1985 and 1991 in the New York University Women's Health Study, a
      prospective cohort study of hormones, diet, and cancer. Cohort members who
      developed breast cancer were included as case patients in our nested case-control
      study. DDE and PCBs were measured by gas chromatography in the sera of 58 women
      with a diagnosis of breast cancer 1-6 months after they entered the cohort and in
      171 matched control subjects from the same study population who did not develop
      cancer. RESULTS: Mean levels of DDE and PCBs were higher for breast cancer case
      patients than for control subjects, but paired differences were statistically
      significant only for DDE (P = .031). After adjustment for first-degree family
      history of breast cancer, lifetime lactation, and age at first full-term
      pregnancy, conditional logistic regression analysis showed a fourfold increase in
      relative risk of breast cancer for an elevation of serum DDE concentrations from
      2.0 ng/mL (10th percentile) to 19.1 ng/mL (90th percentile). For PCBs, the
      relative risk for a change in serum levels from 3.9 ng/mL (10th percentile) to
      10.6 ng/mL (90th percentile) was less than twofold, a nonsignificant association
      that was further reduced after adjustment for DDE. CONCLUSION: In this population
      of New York City women, breast cancer was strongly associated with DDE in serum
      but not with PCBs. IMPLICATIONS: These findings suggest that environmental
      chemical contamination with organochlorine residues may be an important etiologic
      factor in breast cancer. Given the widespread dissemination of organochlorine
      insecticides in the environment and the food chain, the implications are far
      reaching for public health intervention worldwide.

PMID- 8468723
TI  - Psychological impact of screening for familial ovarian cancer.
AB  - BACKGROUND: Psychological distress following false-positive results could
      constitute a substantial disadvantage of cancer screening. PURPOSE: The purpose
      of this prospective study was to evaluate the psychological impact of true
      negative and false-positive results in a high-risk group of women in a screening
      program to detect early familial ovarian cancer by ovarian ultrasound scan. The
      influence of coping style was also assessed. METHODS: Of 500 women who contacted
      the nationally advertised screening program, 302 received the scan and
      participated in the study. Before the screening, they were mailed a questionnaire
      concerning psychological state, coping style, and anxiety about risk of cancer.
      Transabdominal ultrasonography and transvaginal ultrasonography with color
      Doppler imaging were used to detect persistent ovarian lesions and changes in
      volume. Women were informed of any abnormality immediately and asked to return
      for another scan after 6 weeks. Those with a persistent ovarian mass were
      referred for hysterectomy and bilateral oophorectomy. The questionnaire was used
      to reassess psychological distress after the first ultrasound scan, after re
      scanning, and after surgery. RESULTS: The first scan showed negative results for
      233 of the 302 women; 69 (23%) had abnormalities in ovarian morphology. Sixty
      four of the 69 had a second scan, with negative results for 32 and equivocal
      results for 12; 20 had surgery because the results of both scans were positive.
      None of the patients in the screening program were found to have ovarian cancer.
      After the first scan, psychological distress and worries about cancer were
      significantly reduced (P < .001) in the women who had negative results. Responses
      to positive results depended on the baseline coping style and the clinician's
      appraisal of malignancy potential at the time of the scan. Women who had
      information-seeking coping styles and those who were referred for surgery had
      higher levels of distress than other women. At follow-up, the anxiety scores of
      women who had positive results on both scans but negative results at surgery had
      returned to baseline levels. CONCLUSIONS: The findings suggest that false
      positive results in screening are associated with increased distress in the short
      term, but these adverse effects do not appear to be severe or persistent. Women
      who had surgery appeared to welcome the certainty that they could never develop
      ovarian cancer. IMPLICATIONS: The issue of continued surveillance needs to be
      addressed, since many women expressed the desire to have the scan repeated
      regularly.

PMID- 8468724
TI  - Pentostatin in prolymphocytic leukemia: phase II trial of the European
      Organization for Research and Treatment of Cancer Leukemia Cooperative Study
      Group.
AB  - BACKGROUND: B-cell prolymphocytic leukemias or T-cell prolymphocytic leukemias
      are aggressive variants of chronic lymphoid leukemias. The small studies
      conducted to date have shown median survival durations of approximately 3 years
      for patients who have B-cell prolymphocytic leukemia and 7.5 months for those who
      have T-cell prolymphocytic leukemia, compared with about 8 years for patients who
      have chronic lymphocytic leukemia. In chronic lymphocytic leukemia, chemotherapy
      consisting of alkylating agents such as cyclophosphamide and chlorambucil
      combined with prednisone has achieved overall response rates of 50% to 70%, but
      this regimen has resulted in response rates of less than 25% in prolymphocytic
      leukemia. Pentostatin (2'-deoxycoformycin; DCF) is a purine analogue that has
      shown activity in treatment of chronic lymphoid malignancies. PURPOSE: This
      prospective phase II trial by the Leukemia Cooperative Group of the European
      Organization for Research and Treatment of Cancer was performed to assess the
      activity and toxicity of DCF in prolymphocytic leukemia. METHODS: Twenty patients
      with B-cell or T-cell prolymphocytic leukemia were given DCF at a dosage of 4
      mg/m2 intravenously once a week for 3 weeks, then every other week for three
      doses. Patients who had at least partial response received maintenance therapy
      once a month for a maximum of 6 months. Fourteen patients had B-cell
      prolymphocytic leukemia, and six had T-cell prolymphocytic leukemia, as evidenced
      by morphologic and immunologic criteria; three were previously untreated, eight
      had been given one or two chemotherapeutic regimens, and nine had been given more
      than two. RESULTS: One patient died of an unknown cause during the first 6 weeks
      of treatment, and one died of disseminated toxoplasmosis during the period of
      maintenance therapy, 5 months after achieving partial remission. Nine (45%
      response rate) of the 20 patients achieved partial remission, including seven
      (50%) of 14 with B-cell prolymphocytic leukemia and two (33%) of six with T-cell
      prolymphocytic leukemia. The median duration of response was 9 months (range, 2
      30 months); for patients with B-cell prolymphocytic leukemia, the median
      remission duration was 12 months. No complete remission was observed. Toxic
      effects included nausea and vomiting (30%), infections (30%), and transient
      increase in liver enzymes (35%) and in creatinine (20%) levels. Eight patients
      experienced thrombocytopenia, the major hematologic toxic effect; four had grade
      3 or 4 toxic effects. CONCLUSION: DCF is active in prolymphocytic leukemia, even
      as salvage therapy in patients who had received multiple prior chemotherapeutic
      regimens. IMPLICATIONS: Trials using DCF or other purine analogues alone or in
      combination with standard chemotherapeutic agents in front-line or salvage
      therapy are warranted to improve the prognosis of patients with prolymphocytic
      leukemia.

PMID- 8468725
TI  - Effect of high-protein diet on pyrimidine synthesis and response to PALA in mouse
      tissues.
AB  - BACKGROUND: High-protein diets have been found to protect mice from the lethal
      effects of cytotoxic pyrimidine analogues and to reduce the toxicity of the
      antipyrimidine fluorouracil (5-FU), but the biochemical explanation for these
      effects is not known. PALA potentiates the chemotherapeutic efficacy of 5-FU, and
      each of the two agents can produce dose-limiting intestinal toxic effects. We
      have shown that intraperitoneal infusion of ammonium chloride stimulates
      intestinal de novo pyrimidine synthesis. This stimulation with excess ammonia,
      which can also result from high-protein intake, is dependent on the presence of
      carbamoyl phosphate synthetase I, an enzyme in the liver and intestine but not in
      most tumors. These findings suggest that a high-protein diet can stimulate
      pyrimidine synthesis in the liver and intestine but leave it unchanged in tumor
      tissue. PURPOSE: The purpose of this study was to determine whether varying
      dietary protein causes pharmacologically relevant and preferential changes in de
      novo pyrimidine synthesis. METHODS: Mice were fed diets containing 18%, 35%, or
      50% casein. Dietary effects on de novo pyrimidine synthesis were measured in the
      intestine, liver, and B16 mouse melanoma in mice treated with PALA and in
      untreated mice. De novo synthesis was measured by infusion of [15N]alanine into
      intact animals, determination of 15N incorporation into uracil by use of gas
      chromatography-mass spectrometry, and calculation of the fraction of the uracil
      nucleotide pool formed by de novo synthesis. RESULTS: In mice on a 50% casein
      diet (high protein), de novo pyrimidine synthesis increased substantially in the
      liver and intestine, compared with synthesis in mice receiving 18% casein.
      Increase in pyrimidine synthesis in B16 tumor tissue was negligible. The high
      protein diet protected the intestine and liver from depletion of uracil
      nucleotide pools by PALA, and toxicity in tumor-free animals was reduced, as
      determined by mortality after PALA treatment. Sensitivity of the B16 tumor to the
      biochemical and cytotoxic effects of PALA was not diminished. CONCLUSIONS: We
      propose that the basis for these effects of a high-protein diet is the generation
      of excess carbamoyl phosphate in tissues containing carbamoyl phosphate
      synthetase I. This carbamoyl phosphate can stimulate de novo pyrimidine synthesis
      and compete with drugs that interact with enzymes of the de novo pathway, thereby
      selectively protecting the liver and intestine. IMPLICATIONS: These data provide
      a biochemical explanation for reported effects of high-protein diet on toxicity
      of antipyrimidines like 5-FU. Studies are underway to determine if stimulation of
      pyrimidine synthesis by excess ammonia improves therapy with 5-FU alone or
      combined with PALA.

PMID- 8468726
TI  - Reversal by interleukin-2 of alopecia universalis, mucocutaneous candidiasis, and
      sexual impotence in a patient with malignant thymoma.

PMID- 8468727
TI  - Reduction in vasomotor symptoms from tamoxifen over time.

PMID- 8468728
TI  - Factor VIII-related antigen.

PMID- 8468729
TI  - The gastro-intestinal absorption of griseofulvin can be enhanced by encapsulation
      into liposomes.
AB  - Liposomes are microscopic structures consisting of one or more lipid bilayers
      enclosing a definite aqueous space. They are widely used as a drug carrier and
      for the delivery of drugs through membranes. Drugs can be encapsulated into the
      inner water phase or lipidic wall, depending on their own hydro- or
      lipophilicity. The characteristics of the vesicles is fusion with cells and
      natural endocytosis uptake. We applied the properties of liposomes to overcome
      the poor gastro-intestinal (GI) absorption of griseofulvin and compared results
      with the traditional dosage form. In this experiment, the maximum plasma
      concentration obtained from griseofulvin liposomes was about 2.6 times than that
      from griseofulvin suspension. We used the lipids to prepare liposomes that
      consisted of phosphatidycholine, cholesterol, and dicetylphosphate in the molar
      ratio, 1:1.6:0.2, which is similar to the membrane composition of red blood
      cells. We examined some factors affecting the encapsulation ratin (E.R.%) and
      physicochemical properties of liposomes. When the lipid-to-griseofulvin weight
      ratio approached 38:1, the encapsulation ratio reached 94%. The different
      lipid/aqueous ratio (19/1 48/1 96/1) appeared to have little effect on E.R.
      value. The stability of griseofulvin liposomes in terms of leakage of
      griseofulvin was negligible over a period of 18 days at 4 degrees C. The
      sedimentation of vesicles bearing negative charges exhibited the best
      flocculation state. The plasma level-time profile of griseofulvin obtained from
      ingestion of liposomal dosage form showed itself to be significantly higher
      (P<0.01) Cmax, AUC, Ka, and t1/2 than that from suspension.

PMID- 8468730
TI  - Total ankle replacement: preliminary report of 3 cases.
AB  - Total Ankle Replacement has been quite limited used currently and ankle
      arthrodesis is still the treatment of choice for most disabling arthritic disease
      of the ankle because of the generally poor long term results of ankle
      replacement. In spite of its popularity, ankle arthrodesis has many
      disadvantages, including long immobilization, high pseudoarthrosis rate, and load
      shift with increased stress on the neighboring joints of ankle. Total ankle
      replacement may be tried on some selected cases, such as on older patients or on
      patients with bilateral ankle lesions, multiple joints involved arthritis, such
      as rheumatoid arthritis etc. This paper reports three ankle replacements with a
      two year follow up, and they all have encouraging short term results. In the
      future, the development of a more effective ankle replacement seems to be likely.
      But at the present time, only carefully choosing the available prosthesis and
      strictly selecting the indicated patient can make the total ankle replacement
      acceptable.

PMID- 8468731
TI  - [A radiographic survey of root resorption in pulpless primary teeth].
AB  - The goal of this article is to survey the relation between root resorption types
      and sex, age, pulpless source, tooth position of pulpless primary central
      incisors. Healthy children with pulpless primary maxillary central incisors were
      systematically selected from the Kaohsiung Medical College Hospital Pedodontic
      Department. After a complete recording of age (3-6y/o), Sex (male, female),
      pulpless source (caries, trauma), and tooth position (#51, #61), the bisecting
      angle technique was used to take periapical X-ray film of pulpless primary
      maxillary central incisors. A total of 112 pulpless primary central incisors was
      collected and classified into 5 types: Type I--mild resorption Type II--end
      cutting resorption Type III--semi-circumferential resorption Type IV-
      circumferential resorption Type V--irregular resorption 15 teeth (13.4%) were
      classified as type I, 27 teeth (24.1%) classified as type II, 35 teeth (31.2%) as
      type III, 30 teeth (26.8%) as type IV, and 5 teeth (4.5%) classified as type V.
      Chi-square analysis between root resorption types and sex, age, pulpless source,
      tooth position were performed, and two results were noted: (1) There are no
      relation between root resorption types and sex, age, tooth position. (2) There is
      a close relation between root resorption type and pulpless source. The pulpless
      teeth caused by caries tend to be resorbed as type III and type IV; on the other
      hand, the pulpless teeth caused by a traumatic source tend to behave like type I
      and type II.

PMID- 8468732
TI  - [A study of patient severity classification and nursing hours].
AB  - The purpose of this study utilizing the patient classification system was to
      investigate the distribution of categories of patient severity in medical
      departments in relation to the nursing hours required for each patient according
      to the severity of illness. In addition, Work distribution among nursing
      personnel and evaluation for the feasibility of this program were also
      considered. As per a proto-type index, patient severity was recorded by the
      observer; a factor-type nursing requirement table was designed by the nursing
      personnel. There were 621 samples collected from sub-specialized medical
      departments. Snapshot observations were taken to survey the allocation of nursing
      care time. The total of 88 samples of nursing personnel data were analyzed. The
      results showed that most categories of patient severity were distributed among B
      II, B III, C III, C IV while the average nursing hours required daily fluctuated
      between 1.21-10.38 hours. Because of the few samples in A III, B IV, C II, the
      average nursing hours among three categories were no significance in statistics,
      and other categories were significant. The researcher may use the nursing hour
      model as an approach to determine ideal nursing manpower.

PMID- 8468733
TI  - Giant ectopic pelvic spleen: report of a case and review of the literature.
AB  - We report a case of giant ectopic pelvic spleen combined with an accessory spleen
      and confirmed by liver-spleen scan, angiography, magnetic resonance imaging, and
      surgical findings. In various reviews of the literature, no ectopic pelvic spleen
      larger than this one has been reported.

PMID- 8468734
TI  - The effect of adjuvant chemotherapy for nasopharyngeal carcinoma: a preliminary
      report.
AB  - In the past, radiation therapy was the main treatment modality in nasopharyngeal
      cancer, but recently, combined induction chemotherapy has become a trend. In this
      study patients with NPC were divided into two groups. In Group I, 46 cases were
      treated with chemotherapy (Cisplatin + 5-Fu) and radiation. In Group II, 49 cases
      were given radiation only. The side effects of chemotherapy were tolerable except
      for 2 dropouts due to intractable vomiting and semi-coma respectively. Only 17
      cases got leukopenia and one case was graded I in BUN evaluation. All of the
      cases were within normal limits in the platelet and creatinine evaluation. Nine
      cases acquired hyponatremia. The response rate was 72.7% in the primary site
      which included 22.7% of the complete response and 50.0% of the partial response
      with a 80.0% response rate in neck site, which included 56.7% of complete
      response and 23.3% of partial response. But after the consecutive radiation, the
      differences of response rate did not show any significance between the two
      groups. The difference in the response rate between non-keratinizing and
      undifferentiated carcinoma were significant.

PMID- 8468735
TI  - Canadian Society of Otolaryngology--Head and Neck Surgery. 47th annual meeting.
      Victoria, British Columbia, 7-12 May 1993. Abstracts.

PMID- 8468736
TI  - Prenatal sonographic findings of trisomy 18: review of 47 cases.
AB  - Prenatal sonographic findings were reviewed in 47 consecutive fetuses with
      trisomy 18. One or more abnormalities, excluding choroid plexus cysts, were found
      in 39 fetuses (83%), including 21 of 29 (72%) fetuses examined between 14 and 24
      weeks and all 18 (100%) fetuses examined after 24 weeks. Abnormalities most
      frequently detected before 24 weeks included cystic hygromas, nuchal thickening,
      and meningomyelocele. Intrauterine growth retardation, cardiac defects, and an
      enlarged cisterna magna were detected more frequently after 24 weeks than before
      24 weeks (P < 0.05). Intrauterine growth retardation was the single most common
      abnormality, detected in 51% of all fetuses and 89% of fetuses examined after 24
      weeks. Choroid plexus cysts were identified in 25% (12 of 47) of fetuses,
      including 11 of 29 (38%) fetuses seen before 24 weeks. Additional abnormalities
      were identified in 10 of 12 (83%) fetuses with choroid plexus cysts; one of the
      two remaining fetuses showed clenched hands and a cardiac anomaly at autopsy, and
      the other showed unusually large, multiple choroid plexus cysts. Awareness of the
      type of anomalies and the usual menstrual age of diagnosis in fetuses with
      trisomy 18 should improve patient counseling and prenatal detection of fetuses
      considered at risk for this disorder.

PMID- 8468737
TI  - Isolated tubal torsion: clinical and ultrasonographic correlation.

PMID- 8468738
TI  - Neonatal small bowel obstruction due to Meckel diverticulitis: diagnosis by
      ultrasonography.

PMID- 8468739
TI  - Skeletal muscle sonography: a correlative study of echogenicity and morphology.
AB  - In skeletal muscle sonography high echogenicities have proved to be of diagnostic
      value. The following study examines whether these echointensities are caused
      mainly by interstitial fat or fibrosis. Consequently, the echogenicities of 86
      muscles, their diameters, and the thickness of subcutaneous fat layers
      superficial to these muscles were measured and compared for content of fat and
      connective tissue, which were assessed by morphometry and biochemical testing in
      the corresponding muscle biopsy samples. The results indicate that fat
      replacement constitutes the main cause of increased muscle echogenicity, whereas
      intramuscular fibrosis did not significantly affect the muscles' echogenicity.

PMID- 8468740
TI  - Duplex sonography of mammary tumors: a prospective study of 75 patients.
AB  - Seventy-five breast neoplasms have been examined with duplex sonography to
      establish the optimal threshold value of systolic peak flow velocity to
      differentiate benign from malignant tumors. It could be shown that a systolic
      peak flow of > or = 0.2 m/s (Doppler angle corrected to 0 degrees) provides the
      best relationship between sensitivity and specificity concerning characterization
      of tumors. However, the data we obtained indicate that only positive findings are
      potentially reliable. Negative sonographic results should not be used to conclude
      a lesion is benign. Additionally, a new algorithm for breast tumors in which
      duplex sonography is an integral part is discussed.

PMID- 8468741
TI  - Prospects for ultrasonic spectroscopy and spectral imaging of abdominal tissues.
AB  - A system for the digitization and frequency spectral analysis of radiofrequency
      data for ultrasonic waveforms backscattered from abdominal tissues is described.
      Studies of phantoms meant to simulate abdominal tissues of differing scattering
      characteristics indicated that frequency spectral differences due to differences
      in the frequency dependence of backscattering were seen with 5 MHz probes, but
      not with a 3.5 MHz probe. Studies of a phantom with a simulated lesion of altered
      scattering characteristics indicated potential for improved lesion detection and
      characterization, using custom circuitry developed for variable bandwidth
      filtering of received ultrasonic beams. The techniques discussed have potential
      for improved diagnosis of diffuse and focal abdominal abnormalities over that
      obtained with conventional ultrasonic imaging.

PMID- 8468742
TI  - Work in progress CAVUS: transcaval ultrasonography of abdominal organs.
      Preliminary results.
AB  - Endoluminal sonography using tiny transducers (20 MHz) has found wide application
      in various fields of investigation. We have applied the same technology to the
      assessment of abdominal organs using the transcaval route (CAVUS). Normal vessels
      and both normal and dilated bile ducts were displayed. Although the procedure is
      simple and safe, and the images produced are excellent, to be useful clinically,
      microtransducers (6 or 7 MHz) will have to be developed. This technique holds
      much promise, and further miniaturization will allow greatly expanded use of
      endoluminal approaches.

PMID- 8468743
TI  - Fetal syphilis: correlation of sonographic findings and rabbit infectivity
      testing of amniotic fluid.
AB  - Fetal syphilis is the presumed diagnosis when the sonographic findings of fetal
      hydrops are found in the presence of maternal syphilis. In the absence of fetal
      hydrops, the diagnosis of fetal infection is difficult. We hypothesized that
      intra-amniotic infection would be accompanied by anatomic placental and fetal
      abnormalities that could be detected by ultrasonography. Rabbit infectivity
      testing (RIT), intratesticular inoculation of rabbits with amniotic fluid, can be
      used to confirm intra-amniotic infection with Treponema pallidum. Twenty-one
      gravidas with untreated early (primary, secondary, and early latent) syphilis
      underwent sonography and amniocentesis for RIT at 24 weeks of gestation or later.
      Antenatal sonographic findings were compared to their amniotic fluid RIT results.
      Hepatomegaly was significantly (P < 0.01) associated with amniotic fluid
      infection detected by RIT. Antenatal detection of hepatomegaly, which is probably
      the initial sonographic manifestation of hydrops fetalis, may ultimately identify
      the fetus affected with congenital syphilis.

PMID- 8468744
TI  - What constitutes an expert witness?

PMID- 8468746
TI  - Survey suggests rise in health habit complacency.

PMID- 8468745
TI  - Clinicians' forensic interpretations of fatal gunshot wounds often miss the mark.

PMID- 8468747
TI  - Vaccine Program Advisory Committee sticks Secretary Lee with plan to fix
      vaccination system.

PMID- 8468748
TI  - FDA lifts ban on women in early drug tests, will require companies to look for
      gender differences.

PMID- 8468749
TI  - From the Centers for Disease Control and Prevention. False-positive serologic
      tests for human T-cell lymphotropic virus type I among blood donors following
      influenza vaccination, 1992.

PMID- 8468750
TI  - The cardiac risks of noncardiac surgery.

PMID- 8468751
TI  - The cardiac risks of noncardiac surgery.

PMID- 8468752
TI  - Echocardiography for diagnosis and management of rheumatic fever.

PMID- 8468753
TI  - Children from Romania: testing for tuberculosis.

PMID- 8468754
TI  - Health access America's coverage of detoxification.

PMID- 8468755
TI  - Beauty parlor stroke syndrome: report of five cases.

PMID- 8468756
TI  - Don Perlis and Jonathan: the Augenblick says phenylketonuria.

PMID- 8468757
TI  - Clostridium difficile colitis: causes, cures.

PMID- 8468758
TI  - Hip fractures and fluoridation.

PMID- 8468759
TI  - Clostridium difficile colitis: causes, cures.

PMID- 8468760
TI  - Clostridium difficile colitis: causes, cures.

PMID- 8468761
TI  - The treatment of Clostridium difficile colitis.

PMID- 8468762
TI  - The changing in-hospital mortality of women undergoing percutaneous transluminal
      coronary angioplasty.
AB  - OBJECTIVE: To compare in-hospital mortality among women and men undergoing
      percutaneous transluminal coronary angioplasty (PTCA) and determine whether
      mortality differences have changed recently. DESIGN: A retrospective cohort
      study. SETTING: Tertiary referral institution. PATIENTS: Consecutive series of
      3557 patients (27% women) who underwent 4071 PTCA procedures. Two cohorts were
      analyzed: patients treated between 1979 and 1987 (n = 1970) and those treated
      between 1988 and 1990 (n = 2101). MAIN OUTCOME MEASURES: In-hospital and
      periprocedural mortality. RESULTS: Women were older than men (P < .001) and more
      had class III or IV angina (P < .001), unstable angina (P < .001), angina at rest
      (P < .001), cardiac failure (P < .001), and diabetes mellitus, hypertension, and
      hypercholesterolemia (P < .001). The PTCA was successful in 85% of women and 86%
      of men with an in-hospital mortality rate of 4.2% and 2.7%, respectively (P =
      .005). No significant change in mortality occurred in men between the early
      (2.2%) and late (3.1%) eras in contrast to a significant increase among women,
      2.9% to 5.4% (P = .04). Periprocedural mortalities for women and men between 1979
      and 1987 were 1.0% and 1.2% (P = not significant) and between 1988 and 1990 were
      2.9% and 1.4% (P = .02), respectively. The multivariate odds ratio of in-hospital
      mortality for women vs men was 1.51 (95% confidence interval, 1.00 to 2.29; P =
      .05), although six other baseline variables were more powerful predictors of in
      hospital mortality. Accounting for body surface area resulted in no significant
      association between gender and in-hospital mortality. Periprocedural mortality
      was not independently associated with gender. CONCLUSIONS: In-hospital mortality
      among women has increased in recent years, but their higher mortality compared
      with men is related more to the severity of their underlying disease rather than
      gender alone.

PMID- 8468763
TI  - Breast cancer in mothers prescribed diethylstilbestrol in pregnancy. Further
      follow-up.
AB  - OBJECTIVE: Further assessment of the long-term risk of breast cancer associated
      with diethylstilbestrol (DES) during pregnancy. DESIGN: Follow-up continuation
      through June 1, 1989, of a historical cohort of DES-exposed and unexposed mothers
      ascertained by review of obstetric records. PARTICIPANTS: Totals of 3029 each of
      DES-exposed and unexposed mothers who had delivered live babies at four centers
      in the United States during 1940 through 1960. Questionnaires were returned for
      92.6% of the DES-exposed and 88.8% of the unexposed women. MAIN OUTCOME MEASURES:
      Breast cancer incidence and mortality assessed from returned questionnaires and
      review of medical records and death certificates. MAIN RESULTS: The relative rate
      of breast cancer associated with DES exposure, after adjustment for demographic
      and reproductive variables, was 1.35 (95% confidence interval, 1.05 to 1.74). For
      30 years or more following exposure, the relative rate was not appreciably higher
      (relative rate, 1.33; 95% confidence interval, 0.95 to 1.87) than that in earlier
      periods. Surveillance and increased detection seemed unlikely explanations for
      the increased risk, since DES-exposed women had excesses of both large and small
      breast cancers and the two cohorts reported similar breast cancer detection
      practices. A history of miscarriage before first term delivery was not associated
      with breast cancer occurrence. CONCLUSION: Exposure to DES during pregnancy is
      associated with a modest but statistically significant increased risk of breast
      cancer. Contrary to prior indications, the risk does not appear to increase
      greatly over time. The findings are sufficient to exclude the possibility of a
      doubling of risk for the period of 30 or more years following exposure.

PMID- 8468764
TI  - Medical interviewing and interpersonal skills teaching in US medical schools.
      Progress, problems, and promise.
AB  - OBJECTIVE: To assess educational practices, problems, and needs in the teaching
      of medical interviewing and interpersonal skills. DESIGN: Questionnaires sent to
      curricular deans and introductory course leaders at all US medical schools in
      1991. RESULTS: Of 130 programs, 114 deans (88%) and 92 course directors (71%)
      responded. Respondents indicated some advances since a similar survey in 1977:
      Virtually all medical schools now offer teaching in medical interviewing and
      interpersonal skills. More faculty from a greater variety of disciplines are
      involved in this teaching. Most programs feature observation and feedback of
      students' interviews with patients, and use a variety of effective teaching
      methods, including simulated patients and role-playing, both little used in 1977.
      The majority of schools address students' personal growth through discussion or
      support groups. However, there are problems. Most schools lack a faculty
      development process. About half of the introductory courses on medical
      interviewing take place within physical diagnosis courses, often, it appears,
      without systematic observation, feedback, and evaluation of student skills. Many
      programs do not explicitly incorporate certain educational principles into their
      course designs. As in 1977, there appears to be little coordination or sequencing
      of teaching interpersonal skills throughout the curriculum in most medical
      schools. Most deans identified significant barriers to improving teaching.
      CONCLUSIONS: While a number of educational advances have occurred there is still
      great variation in the quality and intensity of courses offered in US medical
      schools. However, the pace of progress bodes well for the future.

PMID- 8468765
TI  - Side effects of glucocorticoid treatment. Experience of the Optic Neuritis
      Treatment Trial.
AB  - OBJECTIVE: To determine the incidence of side effects from short-term
      glucocorticoid therapy prescribed for treatment of optic neuritis in the Optic
      Neuritis Treatment Trial. DESIGN: Randomized, placebo-controlled, multicenter
      clinical trial. SETTING: Fifteen university- or hospital-based centers throughout
      the United States. PATIENTS: A total of 457 patients between the ages of 18 and
      46 years with acute demyelinative optic neuritis were studied. INTERVENTIONS: (1)
      Intravenous methylprednisolone (250 mg every 6 hours) for 3 days while
      hospitalized followed by oral prednisone (1 mg/kg per day) for 11 days; (2) oral
      prednisone (1 mg/kg per day) for 14 days; and (3) oral placebo for 14 days. Each
      regimen was followed by a short taper. RESULTS: Only two patients experienced
      major side effects, psychotic depression in one and acute pancreatitis in the
      other. Both of these patients were from the intravenous methylprednisolone group
      and both of the side effects resolved without sequelae. Patients in both groups
      receiving active drugs more often reported sleep disturbances, mood change,
      stomach upset, and facial flushing and gained more weight during the treatment
      period than patients in the placebo group (P < .001 for each comparison).
      CONCLUSIONS: Although minor side effects are common, short-term glucocorticoid
      therapy in young, healthy adults is relatively safe. Because of the infrequency
      of serious side effects, outpatient administration of high-dose intravenous
      glucocorticoids may be feasible.

PMID- 8468766
TI  - Fraternity hazing revisited through a drawing by George Bellows.

PMID- 8468767
TI  - Court-ordered reimbursement for unproven medical technology. Circumventing
      technology assessment.
AB  - OBJECTIVE--Because we found examples where courts of law ruled against insurance
      carriers that had been sued for reimbursement for unproven medical procedures, we
      conducted a case study to determine the reasoning behind these decisions that run
      counter to accepted medical science. Such actions circumvent health technology
      assessment and could contribute to escalating health care costs and poorer
      quality health care. DATA SOURCES--A literature search identified 17 cases
      between 1980 and 1989 in which an insurance company was sued to reimburse a
      patient who had received an unproven or questionable health technology; 14 of
      these suits were decided in favor of the plaintiff, and the insurance company was
      ordered to pay. Discussed in this article are six of these cases, two involving
      Laetrile (amygdalin), two involving immunoaugmentative therapy, and two involving
      thermography, technologies that had previously been assessed as not safe, not
      effective, or inadequately evaluated. DATA SYNTHESIS AND CONCLUSIONS--The
      circumstances determining how the courts arrive at these "unscientific" decisions
      fall into three general categories: (1) for legal reasons, the insurance contract
      is interpreted in favor of the insured; (2) the reluctance and/or inability,
      legal or otherwise, of the courts to use published scientific literature; and (3)
      the use of adversarial "expert" witnesses with potential conflicts of interest.
      To address this situation, we first urge the legal and insurance industries to
      cooperate in improving the contract language and process in a way that would be
      both legally and scientifically appropriate. Second, we encourage the courts to
      use and foster the use of published peer-reviewed scientific material as evidence
      whenever possible. Third, we recommend that the courts choose their own unbiased
      expert witnesses to interpret scientific material.

PMID- 8468768
TI  - Regional effects and mechanism of positive end-expiratory pressure in early adult
      respiratory distress syndrome.
AB  - OBJECTIVE: To test the hypothesis that positive end-expiratory pressure (PEEP)
      prevents the collapse of a given lung region when it is equal to or greater than
      the hydrostatic pressure superimposed (SPL) to that region. DESIGN: Intervention
      study with sequential levels of PEEP applied in random order to a cohort of
      patients with adult respiratory distress syndrome (ARDS). SETTING: Referral
      center for ARDS in a university hospital. PATIENTS: Ten ARDS patients (with
      Murray scores > 2.5). INTERVENTION: Basal computed tomographic (CT) section taken
      at 0, 2, 4, 5, 6, 8, 10, 12, 14, 15, and 20 cm H2O PEEP. MAIN OUTCOME MEASURES:
      Basal lung CT sections were divided into 10 equal levels from the ventral to
      dorsal surfaces. In each level SPL was measured from density and height. The
      inflation of the level was measured as the gas/tissue ratio (g/t); g/t changes
      with PEEP were defined as the g/t-P curve. The slope of the g/t-P curve was
      defined as level compliance (ie, the ratio of change in the g/t of the level to
      the change in pressure). A linear g/t-P curve was the criterion to detect
      inflation without recruitment (ie, new pulmonary units opening at a given
      pressure). A biphasic g/t-P curve (change of compliance after an inflection
      point) was the criterion to detect recruitment. Pflex was defined as the pressure
      at which the inflection point occurred. RESULTS: The SPL increased from level 1
      (ventral) to level 10 (dorsal) (r = .91; P < .01). The number of linear g/t-P
      curves decreased from level 1 to level 10 (r = .98; P < .01), while the number of
      biphasic g/t-P curves increased (r = .95; P < .01). The Pflex increased from
      level 1 to 10 (r = .97; P < .01) and Pflex was similar to SPL (Pflex = 1.05 + 0.9
      SPL; r = .75; P < .01). CONCLUSIONS: The increased SPL causes compression
      atelectasis; this is prevented when PEEP to a given lung region is equal to or
      greater than the SPL.

PMID- 8468769
TI  - Ventilatory management of respiratory failure in asthma.

PMID- 8468770
TI  - Futility and avoidance. Medical professionals in the treatment of obesity.

PMID- 8468771
TI  - The ARDS lung. New insights from computed tomography.

PMID- 8468772
TI  - Albert Bruce Sabin.

PMID- 8468773
TI  - [Effects of isoflurane, sevoflurane and enflurane on median nerve somatosensory
      evoked potentials in humans].
AB  - Median nerve somatosensory evoked potentials (SEPs) were recorded over neck (N13)
      and scalp (N20) in 18 neurologically normal subjects anesthetized with
      isoflurane, sevoflurane or enflurane for abdominal or lower limb surgery. SEP
      recordings were made at 0.5, 1.0 and 1.5 MAC of each volatile agent without
      nitrous oxide. These three agents did not change N13 latency and amplitude.
      Increasing concentrations of isoflurane and sevoflurane were associated with
      graded reductions in N20 amplitude and increases in N20 latency and N13-N20
      interpeak latency. During enflurane anesthesia N20 amplitude was smaller than
      that at increased in dose related manner. At 1.0 MAC of enflurane N20 amplitude
      was smaller than that at 0.5 MAC, but further decrease was not produced at 1.5
      MAC. The data suggest that effects of sevoflurane on SEPs were more similar to
      those of isoflurane than those of enflurane.

PMID- 8468774
TI  - [A graphic presentation of the anesthesiologist's action pattern].
AB  - The action patterns of anesthesiologists are different among individuals. We have
      developed a graphic presentation system for anesthesiologists' action patterns
      using computer graphics. The resulting representation is called "thought map".
      Data were obtained from 6 anesthesiologists (4 certified instructors and 2 new
      doctors) with a time interval of 2 years, regarding the use of 3 drugs
      (enflurane, sevoflurane and isoflurane). The "maps" were compared among
      individuals, dates and drugs. The following results were obtained: 1) significant
      differences existed among individuals, 2) during the 2-year time interval, 2 new
      drugs were introduced and the practice pattern alterations were seen in the maps,
      3) for the 2 new anesthesiologists, the maps show the process of professional
      knowledge acquisition. We propose an index ("immovable rate"), denoting the
      proportion of the map where concentration of the drug didn't change. This index
      is to be used for evaluating human thinking.

PMID- 8468775
TI  - [Excessive nitrous oxide exhalation by postoperative patients in the recovery
      room].
AB  - Expired nitrous oxide from patients in the recovery room is considered to be the
      major source of air pollution. We measured expired concentrations of nitrous
      oxide in three patients and three volunteers. After only 5 minute inhalation of
      50% nitrous oxide, it took over 2 hours for exhaled N2O concentration to decrease
      to 25 ppm in volunteers and after 30 minute inhalation, it took over 4 hours. The
      patients inhaled 50% nitrous oxide for 60, 165, 150 minutes, respectively and all
      patients expired nitrous oxide, the concentrations of which exceed 100 ppm over 3
      hours. As to the patient who inhaled nitrous oxide for 150 minutes, expired
      nitrous oxide over 25 ppm was detected 10 hours after the end of anesthesia, and
      it was 4 ppm even after 20 hours. Any personnel including anesthesiologists and
      nurses working in the operating room can be exposed to high concentrations of
      nitrous oxide exceeding the permissible limit of 25 ppm, whenever they take care
      closely of their patients. We do not have any effective measures to protect us
      from this kind of air pollution except employing total intravenous anesthesia.

PMID- 8468776
TI  - [Effects of sevoflurane on left ventricular diastolic function using
      transesophageal echocardiography].
AB  - The effects of sevoflurane on left ventricular diastolic filling were evaluated
      using transesophageal Doppler echocardiography in 10 normal subjects. The time
      velocity integral of early filling decreased significantly with sevoflurane 1 MAC
      (7.73 +/- 2.05 to 6.82 +/- 1.90 cm), suggesting impaired left ventricular
      relaxation. Abnormal left ventricular relaxation results in compensatory
      increment of peak velocity and time-velocity integral during atrial filling, both
      of which were significantly decreased by sevoflurane in this study (35.5 +/- 6.6
      to 29.1 +/- 4.8 cm.sec-1, 3.22 +/- 0.65 to 2.73 +/- 0.67 cm, respectively).
      Although the ratio of early peak velocity to late filling velocity was unchanged,
      it appears that left ventricular diastolic function including active relaxation,
      passive compliance, atrial contraction, and elastic recoil was impaired by
      sevoflurane 1 MAC.

PMID- 8468777
TI  - [Changes in heart rate during and after enflurane-nitrous oxide anesthesia].
AB  - Changes in heart rate of 21 patients who received enflurane-nitrous oxide
      anesthesia were studied. They had no cardiac, pulmonary, nervous system and
      endocrine diseases. We measured coefficient of variation of R-R intervals (CV)
      and power spectrum of heart rate fluctuation in 6 periods, (1) control phase (the
      day before operation), (2) during operation under enflurane-nitrous oxide
      anesthesia, (3) ten minutes after endotracheal extubation, (4) sixty minutes
      after arrival in the recovery room, (5) the next morning and (6) the next
      evening. The patients who were 15-25 years old, showed larger value of CV and
      larger power of low frequency component (0.03-0.1 Hz, LFC) as well as high
      frequency component (0.2-0.45 Hz, HFC) compared with patients who were 40-50
      years old during control phase. They showed a significant decrease of CV, LFC and
      HFC in period (2), (3) and (4) but not in (5) and (6). These evidences show that
      autonomic nervous system is impared after enflurane-nitrous oxide anesthesia
      until the next morning.

PMID- 8468778
TI  - [The plasma concentration of buprenorphine during its continuous epidural
      infusion after catheterization at different vertebral levels].
AB  - We investigated 27 patients undergoing elective surgery under epidural
      anesthesia. The plasma concentration of buprenorphine during its continuous
      epidural administration was measured by the radioimmunoassay method. We also
      performed a retrospective study on supplemental analgesics necessary for 48 hours
      after surgeries. The plasma concentration of buprenorphine was found to be stable
      at 300 pg.ml-1 during its continuous epidural infusion. The frequencies of
      administration of supplemental analgesics were 3.3 times with catheterization at
      upper thoracic vertebral level, 2. 1 times at lower thoracic vertebral level and
      1.7 time at upper lumbar vertebral level. We conclude that analgesia with the
      continuous epidural administration of buprenorphine is satisfactory at low plasma
      concentration and is superior, considering the necessity of supplemental
      analgesics to other methods of systemic administration. It is estimated that the
      epidural distribution volume at lower thoracic and upper lumbar vertebral level
      is twice the volume at upper thoracic level from plasma buprenorphine
      concentration.

PMID- 8468779
TI  - [The effects of hemodilution on cerebral hemodynamics and oxygen consumption
      during nonpulsatile hypothermic cardiopulmonary bypass].
AB  - The effects of hemodilution on cerebral hemodynamics and oxygen consumption
      during nonpulsatile hypothermic cardiopulmonary bypass (CPB) were investigated in
      16 patients undergoing elective open heart surgery under CPB. They were divided
      into 2 groups; high (25%) (H) and low hematocrit (15%) (L) groups according to
      the hematocrit values during CPB. Simultaneous measurements of blood flow
      velocity in the middle cerebral artery (VMCA) and oxygen tension in the jugular
      venous bulb (PjvbO2) were performed at prebypass, bypass, and post bypass
      periods. There were no significant differences in nasopharyngeal temperature
      (NPT), cerebral perfusion pressure, pump flow rate, and PaCO2 between the two
      groups at any period. VMCA changed in correlation with NPT in both groups, and
      VMCA in the L group was faster than that in the H group at any period. PjvbO2
      increased during aortic cross clamp, and decreased on rewarming in both groups.
      However, there were no significant differences in VMCA and PjvbO2 between the two
      groups at any period. These findings suggest that increased cerebral blood flow
      may compensate the decreased oxygen content due to the hemodilution during CPB.
      Therefore, the profound hemodilution up to 15% of hematocrit is considered to be
      a safe technique during CPB.

PMID- 8468780
TI  - [Arterial blood ketone body ratio and systemic hemodynamics in patients with
      acute hepatic blood flow occlusion].
AB  - This study was undertaken in order to clarify the influence of acute hepatic
      blood flow occlusion on arterial blood ketone body ratio (AKBR) and systemic
      hemodynamics. Ten patients for hepatectomy were divided into two groups. Group I
      was composed of five patients who had clamping of total hepatic blood flow
      (Pringle's method), and Group II was composed also of five patients who had
      clamping of the right hepatic artery and portal vein during operation. Ten
      minutes after clamping blood flow, AKBR decreased significantly in both groups,
      and a marked reduction in AKBR was observed in group I. During occlusion, cardiac
      output was reduced significantly, and immediately after declamping, mean arterial
      blood pressure and systemic vascular resistance index (SVRI) decreased
      significantly. These changes in hemodynamics in group I were larger than those of
      the other group. A larger reduction in AKBR was observed during occlusion, and
      the greater change in SVRI appeared after declamping blood flow. These findings
      suggest that in the cases with hepatic blood flow occlusion, especially total
      occlusion, a special attention should be paid to mitochondrial liver dysfunction
      and hemodynamic changes associated with acute hepatic blood occlusion.

PMID- 8468781
TI  - [The significance of arterial redox potential measurement by Vincent's method in
      evaluating the hemorrhagic shock state of rabbits].
AB  - Previously we suggested that the arterial redox potential (ARp) is one of the
      most reliable indicators to evaluate the severity and outcome of the acutely-ill
      patients. In this study we attempted to clarify which redox system, intracellular
      or extracellular, is mainly represented by redox potentials measured from
      arterial blood in the hemorrhagic shock state rabbits. The arterial
      pyruvate/lactate, acetoacetate/beta-hydroxybutyrate and oxidized
      glutathione/reduced glutathione (GSSG/GSH) ratios were measured in hemorrhagic
      shock rabbits, and correlations between ARp and each of these factors were
      analyzed. The best correlation was found between ARp and P/L ratio. This
      indicates that ARp well reflects the cytosolic redox state, i.e. cytosolic
      [NAD+]/[NADH], and also [ATP]/[ADP][Pi] theoretically. The ARp is a valuable
      index in evaluating the shock state and can be easily measured with Vincent's
      method.

PMID- 8468782
TI  - [Blood gas changes during hypotensive anesthesia induced by prostaglandin E1].
AB  - The influence of prostaglandin E1 (PGE1) on PaO2 at doses that produced slight
      hypotension was evaluated in 176 patients scheduled for surgery. When systolic
      blood pressure was stabilized after induction of anesthesia, PGE1 infusion was
      started until 20% reduction of systolic blood pressure was achieved. Arterial
      blood gases were analyzed before infusion of PGE1 and 30 min after the completion
      of this hypotensive level respectively. The reductions in both PaO2 [from 177 +/-
      64 mmHg to 164 +/- 65 mmHg (mean +/- SD) (P < 0.01)] and PaO2/FIO2 [from 486.5 +/
      144.4 to 437.6 +/- 121.6 (P < 0.01)] were observed with PGE1 infusion of 0.079
      +/- 0.068 micrograms.kg-1.min-1. The results of this study show that PaO2
      decreases during induced hypotension with PGE1 infusion, but this decrease is not
      clinically significant.

PMID- 8468783
TI  - [Blood gas changes during laparoscopic cholecystectomy--comparative study of N2O
      pneumoperitoneum and CO2 pneumoperitoneum].
AB  - During laparoscopic cholecystectomy by alternative insufflation of nitrous oxide
      and carbon dioxide, the changes of blood gas tensions were measured and analyzed
      in 12 patients. During N2O insufflation, PaO2 decreased by about 25 mmHg and
      PaCO2 was unaltered compared with the values before pneumoperitoneum. While
      during CO2 insufflation, PaO2 decreased by about 13 mmHg and PaCO2 increased by
      about 6 mmHg. We considered that decrease in PaO2 during N2O insufflation was
      associated with not only uneven ventilation/blood flow ratios but also with the
      reduction in the alveolar O2 tension caused by the diffusion of N2O absorbed from
      the peritoneum. PaCO2 increases during CO2 insufflation because CO2 is absorbed
      from the peritoneum, and is not excreted entirely through the lungs.

PMID- 8468784
TI  - [Plasma potassium concentrations during N2O-enflurane anesthesia in patients on
      chronic hemodialysis].
AB  - Plasma potassium concentrations during anesthesia with N2O and enflurane in O2
      were measured in 12 patients on chronic hemodialysis (HD) who underwent HD for
      about 2 hours just before anesthesia. Pre-HD and pre-anesthetic plasma potassium
      concentrations were 5.0 +/- 0.2 and 4.3 +/- 0.2 mEq.l-1, respectively. The
      potassium levels decreased slightly following induction of anesthesia, but
      increased significantly during and after surgery; and at the end of anesthesia
      the levels were similar to those measured just before HD. None of the patients
      developed acidosis, hypoxia or hypercapnia. Based on our results, we consider
      that plasma potassium levels should be measured frequently during surgery in
      patients who have high potassium levels just before HD and are subjected to HD
      just before anesthesia, because hyperkalemia may occur.

PMID- 8468785
TI  - [Reduction of the amount of perioperative blood transfusion by autotransfusion
      techniques in valvular heart surgery].
AB  - We used autotransfusion in valvular heart surgery and evaluated its effect on
      perioperative homologous blood requirements. Methods of autotransfusion we used
      were intraoperative blood salvage using Cell Saver 4 and retransfusion (IAT),
      postoperative autotransfusion of shed mediastinal blood (PAT), and hemodilutional
      autotransfusion (HAT). The patients undergoing valvular heart operations were
      divided into three groups; group 1 (control group), group 2 (using IAT and PAT
      group), and group 3 (using IAT, PAT, and HAT group). Perioperative homologous
      blood requirements significantly decreased in group 3 compared to group 1 and
      group 2. Operations without homologous blood transfusion significantly increased
      in number in group 3 compared with group 1. In conclusion, autotransfusions
      described above were useful blood conservation techniques in valvular heart
      surgery.

PMID- 8468786
TI  - [An application of multiple logistic regression analysis to an outcome study on
      surgery for patients with femoral neck fracture].
AB  - Sixty five patients with femoral neck fracture were examined to find any risk
      factor for their postoperative complications. Here, postoperative complications
      included cardiac catastrophe, pulmonary embolism, central nervous system
      accident, and respiratory failure requiring mechanical ventilation during the
      period of one week after operation. Multiple logistic regression analysis was
      used to predict these factors. Explanatory variables were selected based on the
      clinical judgement. Those variable are age, sex, preoperative underlying cardiac
      disease, preoperative underlying respiratory complications, the use of cement for
      the procedure, and anesthetic technique. The analysis revealed that the sex was
      the only variable that was considered significant based on the P value less than
      0.05. However, multi-colinearity between variables was suspected to exist based
      on the correlation matrix analysis which may indicate that the factor is not, in
      fact, significant. In short, further study will be required to find any
      significant variables or risk factors to predict the outcome of untoward events.

PMID- 8468787
TI  - [Perioperative pulmonary thromboembolism. A clinical study].
AB  - Pulmonary embolism (PE) is a major catastrophe during postoperative period. We
      had six patients who developed PE after surgery and one during anesthesia and
      surgery. Severe arterial hypoxemia (PaO2 41 +/- 14 mmHg) occurred in all six
      postoperative patients, but not in a patient who developed PE under anesthesia.
      In 3 patients with pulmonary artery catheter in place, pulmonary arterial
      pressure (PAP) increased significantly during the embolic events. PAP tended to
      decrease before the apparent improvement of PaO2 in each patient. This suggests
      that increases in anastomotic bronchial blood flow occurred following the events.
      In a patient who developed PE under enflurane-N2O-O2 anesthesia, neither
      hypoxemia nor hypotension occurred despite significant increase in PAP. All
      patients received heparin and urokinase intravenously, which caused persistent
      bleeding in two patients. It remains for further investigations to study the
      mechanisms of serious hypoxemia in postoperative patients with PE as well as
      those of favorably maintained pulmonary oxygenation in a patient with PE under
      general anesthesia.

PMID- 8468788
TI  - [The anesthetic management of Arnold-Chiari malformation with spinal cord
      injury].
AB  - A rare case of spinal cord injury at C3 level associated with Arnold-Chiari
      malformation is reported. A 33 year old male was admitted with a complaint of
      walking difficulty. MRI revealed cerebellar herniation, and a plain X-ray showed
      spinous process adhesion of C2-3 and slight scoliosis. Percent vital capacity was
      reduced to 69%, and blood cell count showed a slight anemia. The patient was
      anesthetized for an orthopedic surgery with pethidine 70 mg, thiamylal 200 mg,
      60% nitrous oxide, 40% oxide, and 0.5-1.2% isoflurane. There was a mild decrease
      in arterial blood pressure during surgical procedures, but this could be easily
      treated by fluid therapy, and there was no episode of autonomic hyperreflexia.
      Postoperative course of the patient was uneventful, except a transient pneumonia
      and urinary tract infection. The key in the anesthetic management of Arnold
      Chiari malformation with spinal cord injury is the control of intracranial
      pressure, care for respiratory dysfunction and the prevention of infection as
      well as autonomic hyperreflexia.

PMID- 8468789
TI  - [Accidental subdural catheterization discovered after postoperative respiratory
      depression].
AB  - A 65-year-old man scheduled for gastrectomy was anesthetized with nitrous oxide
      combined with continuous epidural lidocaine. At the end of the operation,
      morphine 2 mg diluted in 0.25% bupivacaine 5 ml was injected through the epidural
      catheter. Seventy minutes later, the patient developed life-threatening
      respiratory depression which was antagonized by naloxone. The patient requested
      no analgesic during the first 26 postoperative hours. The respiratory depression
      in this patient was assumed to be caused by epidural morphine. Then subdural
      catheterization was confirmed radiologically. This was discovered to have
      resulted from migration of the epidural catheter into the subdural space.
      Subdural injection of morphine may have resulted in higher cerebrospinal fluid
      levels than the levels obtained after epidural injection. Subdural
      catheterization is a complication of epidural anesthesia that probably occurs
      more frequently than previously recognized. In postoperative patients receiving
      epidural morphine, their respiratory status should be monitored closely for
      hours.

PMID- 8468790
TI  - [Beneficial effect of bromocriptine in a patient with malignant syndrome and
      hepatic dysfunctions].
AB  - A 39 year-old male, diagnosed as meningoencephalitis, was admitted because of the
      development of malignant syndrome. This syndrome appeared to have resulted from
      anti-psychotic drugs given to relieve excitement and insomnia. As he had hepatic
      dysfunctions, we could not administer dantrolene further. Therefore, we gave
      bromocriptine to ameliorate the symptoms such as muscle rigidity or hemodynamic
      perturbations. Thereafter, the patient gradually became stable in hemodynamics
      and in other symptoms. In addition, a further deterioration in hepatic functions
      did not occur with administration of bromocriptine. The case suggests that in
      patients with malignant syndrome associated with hepatic dysfunctions,
      bromocriptine could be a first choice as a pharmacological treatment of the
      syndrome.

PMID- 8468791
TI  - [A case report of total intravenous anesthesia for renal transplantation].
AB  - A 20-year-old female patient with chronic renal failure received renal
      transplantation under total intravenous anesthesia with droperidol, fentanyl and
      ketamine. Anesthesia was induced with droperidol 12.5 mg, fentanyl 100
      micrograms, ketamine 100 mg and vecuronium bromide 5 mg, and maintained with
      fentanyl and ketamine. Ketamine was given continuously at a rate of 2.0 mg.kg-1.h
      1. After the renal artery and vein of the donor kidney were anastomosed with the
      patient's internal iliac artery and vein, the urine output of 7.7 ml.min-1 was
      obtained. The patient recovered from anesthesia smoothly and her postoperative
      course was uneventful. Although plasma epinephrine, cortisol and ADH levels
      showed significant changes during anesthesia mainly due to surgical stress, they
      returned to normal values after the end of operation. We conclude that this
      method of anesthesia would be a choice for renal transplantation.

PMID- 8468792
TI  - [Removal of a bronchial foreign body in a child using the laryngeal mask].
AB  - The laryngeal mask (LM) was employed for the removal of a bronchial foreign body
      (screw) in a 2-year-old boy weighing 16 kg since the 6.0 mm external diameter
      fiberoptic bronchoscope (FBS) for extraction forceps could not be used under
      tracheal intubation. Anesthesia was induced with sevoflurane in 100% oxygen.
      After injection of fentanyl 25 micrograms and vecuronium 2 mg, a gastric tube and
      a size 2 LM were inserted. Throughout the extraction procedure by the FBS in the
      left main bronchus, the boy had one lung ventilated manually. The airway pressure
      was kept under 15 cmH2O to avoid gas leakage around the cuff and gastric
      inflation. Oxygen saturation of 100% with pulse oximetry and PETCO2 of 35 to 45
      mmHg with capnometry were maintained. The foreign body was extracted by biopsy
      forceps. A Fogarty catheter was not effective because the balloon tip was broken
      by the screw. The LM does not prevent regurgitation and does not provide adequate
      ventilation under increased airway pressure, but it facilitates the use of a
      larger size FBS equipped with a variety of extraction forceps. Therefore, it
      seems to be a useful device for the removal of bronchial foreign bodies in
      children.

PMID- 8468794
TI  - [Cerebral blood flow velocity and electroencephalogram for the evaluation of
      intraoperative brain function during intrathoracic hyperthermia].
AB  - It is well known that progressive hyperthermia exerts fatal damage on the human
      body. However, there have been few reports on the brain function or the means to
      provide adequate monitoring during hyperthermia. The purpose of this study was to
      introduce two new devices, the Life Scan electroencephalogram (EEG) Monitor
      (Neurometrics) and the TC2-64 (EME) transcranial Doppler sonography (TCD), both
      for monitoring brain function during hyperthermia. The Life Scan uses aperiodic
      analysis, which 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 Life Scan 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 hyperthermia. After the induction of modified neuroleptanesthesia
      (fentanyl and midazolam), AE was maintained at 11 Hz. With an increase in body
      temperature, AE gradually showed a trend toward a slow wave, though the slowing
      of EEG was interrupted when the patient awoke to slight stimulation. Therefore,
      it is speculated that the slowing of EEG in this case was caused by fentanyl. The
      mean cerebral blood flow velocity increased slightly from 28 to 32 cm.sec-1 by
      hyperthermia. It is concluded that the adoption of EEG and TCD was useful in
      determining the intraoperative cerebral function during hyperthermia.

PMID- 8468793
TI  - [An emergency operation for a Jehovah's Witness with ruptured thoracic saccular
      aneurysm].
AB  - A 49-year-old male "Jehovah's Witness" was transferred to our hospital with
      hypotension, abdominal pain, and abdominal distension, and a diagnosis of
      ruptured thoracic saccular aneurysm was made. He and his family insisted on
      having an emergency operation for his ruptured aneurysm without blood
      transfusion. After an intensive discussion among the patient, his family,
      surgeons, and the director of the hospital, we performed the operation without
      blood transfusion. The operation using cardiopulmonary bypass took about five
      hours under enflurane anesthesia, but he died of circulatory collapse fifteen
      hours after the end of operation. As there may be various opinions concerning how
      we should take care of Jehovah's Witness patients, we have to manage them case by
      case.

PMID- 8468796
TI  - [Proceedings of the 79th annual meeting of the Japanese Society of
      Gastroenterology. Kyoto, March 29-31, 1993. Abstracts].

PMID- 8468795
TI  - [A newly devised endotracheal tube for patients with narrowed trachea].
AB  - A 27 year old female patient with pulmonary adenoid cystic cancer was planned for
      emergency tracheotomy for hemoptysis and severe dyspnea. Six month previously she
      had a silicon tube (5.5 mm-ID, 40 mm in length) placed in her trachea, because of
      severe tracheal stenosis. Airway management by endotracheal intubation was deemed
      necessary during the tracheotomy. However, because of her tracheal narrowing, it
      was not possible to insert a usual endotracheal tube for adult. First, we made a
      4.0 mm-ID endotracheal tube without cuff 12 cm in length (TUBE 1), and a 5.5 mm
      ID tube 18 cm in length (TUBE 2). We inserted the TUBE 1 into the TUBE 2, and
      glued them with Aron-Alpha, making it 25 cm long. We could perform tracheotomy by
      intubating and wedging this tube into silicon tube.

PMID- 8468797
TI  - [Evaluation of coronary artery disease by 99mTc-PPN1011: comparison with 201Tl
      imaging and ventricular function].
AB  - To evaluate clinical value of 99mTc-1,2-bis[bis (2
      ethoxyethyl)phosphino]ethane(99mTc-PPN1011) imaging for assessing coronary artery
      disease (CAD), 99mTc-PPN1011 SPECT imaging at post-exercise and at rest was
      compared with 201Tl SPECT imaging at post-exercise and 3 hours in 24 patients
      with CAD. The sensitivities for detecting CAD were 100% (21/21) by 99mTc-PPN1011
      SPECT and 95% (20/21) by 201Tl SPECT. The sensitivities for detecting stenosed
      coronary arteries (> or = 75% stenosis) were similar between 99mTc-PPN1011 (68%)
      and 201Tl (66%). The similar specificity values were obtained by 99mTc-PPN1011
      (80%) and 201Tl (77%). The patterns of abnormality (normal, ischemia and scar)
      were concordant between 99mTc-PPN1011 and 201Tl images in 20 of the 24 cases
      (83%) and 106 of the 120 segments (88%). In the simultaneous analysis of cardiac
      function by first pass radionuclide angiography with 99mTc-PPN1011, there was
      good correlation between left ventricular ejection fraction and perfusion score
      at rest (r = 0.70) and exercise (r = 0.80). The degrees of abnormality between
      perfusion and wall motion were similar in 56 of 66 segments (85%) at rest and 52
      of 66 segments (79%) at exercise. We conclude that this agent is promising for
      the diagnosis and evaluation of coronary artery disease.

PMID- 8468798
TI  - [Assessment of myocardial perfusion abnormality and hibernating myocardium by
      gated blood pool and exercise-stress thallium tomographies after successful
      coronary angioplasty].
AB  - Cardiac function and myocardial perfusion were assessed by exercise-stress
      thallium SPECT and resting gated blood pool SPECT techniques before and after 47
      successful coronary angioplasties. Thallium perfusion was analyzed visually and
      quantitatively in stress and resting studies. Left ventricular ejection fraction
      (LVEF) and peak filling rate (PFR) were calculated and regional wall motion was
      scored by amplitude and phase images in radionuclide planar and tomographic
      imagings. The thallium redistribution in delayed or resting SPECTs was more
      sensitive (87%) for detecting myocardial ischemia compared to symptoms (36%) and
      ECG changes (60%). An exercise capacity, LVEF, PFR, and the scores of perfusion
      and regional wall motion were improved significantly after coronary angioplasty.
      Stress thallium and gated blood pool SPECTs showed the improvements of myocardial
      perfusion in 159 (79%) of 201 segments and regional wall motion in 47 (51%) of 92
      segments, respectively. These results suggest that the combined use of stress
      thallium SPECT, gated blood pool planar and SPECT techniques can contribute not
      only to the assessment of the efficacy of coronary angioplasty but also to
      detecting the mismatching of myocardial perfusion and contraction ("myocardial
      hibernation") in infarct-related myocardial lesions.

PMID- 8468799
TI  - [Regional cerebral blood flow in diabetic patients].
AB  - N-isopropyl-p-123I-iodoamphetamine (IMP) was used to quantify the regional
      cerebral blood flow (r-CBF) in 11 diabetic patients (average age; 67.9 years) and
      12 non-diabetic subjects (average age; 67.4 years), none of whom had CVD
      (Cerebrovascular disease) on CT studies. A reference sampling method by
      continuous arterial blood sampling was used to quantify r-CBF. There were no
      significant differences in physiological or laboratory data between diabetic and
      non-diabetic groups except for fasting plasma glucose and HbA1C levels. The
      average of r-CBF in each region of cerebrum and cerebellum was significantly
      lower in diabetic group than that in the control group (p < 0.01). These
      observations show that r-CBF of diabetic patients is reduced, even in the absence
      of findings of CVD on a CT study.

PMID- 8468801
TI  - [Role of 99mTc-labeled RBC SPECT in the diagnosis of hepatic hemangioma-
      comparison with US, CT and angiography].
AB  - The roles of planar imaging and SPECT with 99mTc-labeled RBC, US, Dynamic CT and
      angiography in the diagnosis of hepatic hemangioma were evaluated. The study
      group consisted of 18 patients with a total of 40 hemangiomas and 13 patients
      with a total of 21 non-hemangiomas. Among these patients, 5 patients with a total
      of 8 hemangiomas and 10 patients with a total of 14 non-hemangiomas were
      diagnosed by operation and biopsy. In all 40 hemangiomas, sensitivity for planar
      imaging was 35%, SPECT 50%, US 53%, Dynamic CT 82% and angiography 81%,
      respectively. When the tumor size was greater than 2.2 cm by SPECT and 2.8 cm by
      planar imaging, their sensitivity for both methods was 100%. Specificity for
      planar imaging was 100%, SPECT 95%, US 81%, Dynamic CT 100% and angiography 83%,
      respectively. One patient with hepatocellular carcinoma diagnosed by angiography
      showed increased uptake on SPECT. Because of the highest accuracy for SPECT in
      hemangioma greater than 2.0 cm, SPECT should be considered to be the method of
      choice for noninvasive diagnosis of hemangioma.

PMID- 8468800
TI  - [Left ventricular hemodynamics in patients with sick sinus syndrome: analysis by
      99mTc-RBC cardiac pool scintigraphy with forward and backward multiple gated
      method (FBMG)].
AB  - The left ventricular (LV) systolic and diastolic functions in 31 patients with
      sick sinus syndrome (types I and II) were analyzed using LV time activity curves
      obtained by a 99mTc-RBC cardiac pool scintigraphy-forward and backward multiple
      gated study (FBMG) and compared with those in controls. On A-V sequential pacing
      (rate, 70 bpm; A-V delay, 150 msec), LV-peak ejection rate (PER) and peak filling
      rate (PFR) were significantly decreased compared to those in normal controls. As
      pacing rate was increased, PFR decreased significantly in patients in whom PER
      was decreased. The etiology of disturbed LV systolic and diastolic functions in
      patients with sick sinus syndrome remains unknown. No patient had significant
      organic coronary artery disease or other cardiac disorder. On the other hand, the
      frequency of vasospastic angina was higher in this group than in the controls. We
      suspect that sick sinus syndrome and vasospastic angina probably share a common
      pathophysiology. In patients with sick sinus syndrome, LV systolic and diastolic
      functions are impaired at rest and during A-V sequential pacing.

PMID- 8468802
TI  - [Phase I clinical study of 99mTc-MAG3].
AB  - A phase I study was performed in three normal volunteers to evaluate the safety
      and biodistribution of 99mTc-MAG3 which was developed as a renal scintigraphic
      and renographic dynamic function agent. There was no significant adverse
      reaction, change in vital signs and clinical laboratory data by the injection of
      99mTc-MAG3. Therefore it is assumed that the safety of the agent is high.
      Clearance of injected 99mTc-MAG3 from blood was rapid and the agent was excreted
      into urine. Immediately after administration of the agent, renal dynamic
      scintigraphy was performed and provided better quality of images and renograms.
      Peak time in the renogram was about 3 min post injection and residual count rate
      to the peak count at 20 min after injection was 19.3%. Cumulative urinary
      excretion during the first 30 min and 3 hr expressed in %Dose was 77.1 +/- 3.5%
      and 94.1 +/- 2.7%, respectively. Radiation dose estimates calculated with MIRD
      method, in the highest organ, bladder, is 5.78 mGy/200 MBq, which seems to be
      within permissible range for routine examination in nuclear medicine. It is
      concluded that 99mTc-MAG3 is a safe and promising radiopharmaceutical in
      diagnosis of renal dynamic function.

PMID- 8468803
TI  - [A study of crossed cerebellar diaschisis on 123I-IMP SPECT images and its
      redistribution phenomenon].
AB  - Crossed cerebellar diaschisis (CCD) is interpreted as a functional deactivation,
      presumably caused by a loss of excitatory or inhibitory afferent inputs on the
      corticopontocerebellar pathway and others. A redistribution phenomenon (RD) is
      usually observed in the contralateral cerebellum with CCD on delayed images of
      123I-IMP SPECT. This phenomenon was analyzed in a view point of rCBF measurement
      in 24 patients with brain tumor, infarction and so forth. Regional CBF was
      measured by the microsphere method with 123I-IMP and a delayed-to-early counts
      ratio (D/E ratio) was used. As a result, there was no relation between rCBF and
      the D/E ratio in the cerebellum, which means that RD is occurred by other factors
      except for rCBF in the cerebellum. Regional CBF and the D/E ratio in the
      contralateral and ipsilateral cerebellum was 46.3 ml/100 g/min, 1.01 and 57.0
      ml/100 g/min, 0.86, respectively. These results mean that the high activity of
      IMP gradually decreased in the ipsilateral cerebellum, while, the low activity in
      the contralateral cerebellum was almost stable, and the difference of both
      activity reduced after 5 hours and RD was observed on the delayed image. The data
      indicate that retention mechanism of IMP and vascular permeability are not
      affected in the cerebellum with CCD.

PMID- 8468804
TI  - [A case of Down's syndrome with progressive dementia of Alzheimer type].
AB  - A rare case of Down's syndrome complicated with progressive dementia of Alzheimer
      type in a 41-year-old man was reported. On 123I-IMP SPECT, the patient revealed
      symmetrical bilateral temporo-parietal hypoperfusion. This finding seemed to
      support the developing dementia of Alzheimer type on the basis of clinical
      manifestations. 123I-IMP SPECT seemed to be useful for early diagnosis of
      Alzheimer-like change in a natural course of Down's syndrome.

PMID- 8468805
TI  - [Lymphoscintigraphy with 99mTc-DTPA-HSA in the diagnosis of protein-losing
      gastroenteropathy].
AB  - We evaluated the diagnostic capability of technetium-99m-diethylene triamine
      pentaacetic acid-human serum albumin (99mTc-DTPA-HSA) lymphoscintigrapy in a
      patient with protein-losing gastroenteropathy. 99mTc-DTPA-HSA (total 740 MBq) was
      injected subcutaneously into the digital webs of the both feet. With a gamma
      camera, whole-body and abdominal lymphoscintigrams were obtained after the
      injection of the radioisotope: early images and delayed images taken 5-15 min and
      50-60 min, respectively, after the injection. A few days later, the dynamic
      lymphoscintigraphy was also performed. Lymph fluid leakage into the small bowel
      and the sites of the leakage were detected. It was concluded that
      lymphoscintigraphy with 99mTc-DTPA-HSA was a useful diagnostic tool in patients
      with protein-losing gastroenteropathy.

PMID- 8468806
TI  - [Crosstalks onto photopeak windows of 99mTc and other radionuclide (201Tl, 123I
      or 111In) in simultaneous acquisitions using a scinticamera--a fundamental study
      through phantom experiments].
AB  - In simultaneous acquisitions of both 99mTc and other radionuclide, there are
      crosstalks onto those photopeak windows. Therefore, to quantify the organ uptake
      in scintigraphic imaging, it is important to correct the crosstalk counts. The
      purpose of this study is to estimate the crosstalk fractions onto each photopeak
      window from other radionuclide. Those crosstalk fractions were determined from
      pulse height spectra, which were measured by inputting signals from a
      scinticamera into a multi-channel (2048 ch) pulse height analyzer. Four types of
      collimators, which are HR (high resolution), AP (all purpose) for low energy, ME
      (medium energy) and HE (high energy), as well as cuboid phantoms (10 x 10 x 10
      cm3) were used in this experiment. The crosstalk fractions have a tendency to
      show small increases at the window width of 10 to 20%, excepting at 30%, a small
      change for the source thickness from 1 to 7 cm, and the least with the ME
      collimator. The crosstalk fractions using the ME-collimator were obtained as
      follows, when the source thickness and the window width were 5 cm and 15%,
      respectively. 99mTc and 201Tl: 9.4% onto 201Tl window and 7.3% onto 99mTc window,
      99mTc and 123I: 36.1% onto 99mTc window and 14.8% onto 123I window, 99mTc and
      111In: 32.6% onto 99mTc window and 6.1% onto 111In window.

PMID- 8468807
TI  - [Clinical application of 99mTc-DTPA-galactosyl serum albumin in hepatobiliary
      disease].
AB  - A clinical study with 99mTc-DTPA-galactosyl serum albumin (99mTc-GSA) was
      performed in 10 patients with hepatobiliary disease. In this study, scintigraphic
      data and images with 99mTc-GSA were compared with several serological liver
      function tests, the hepatic blood perfusion index and image quality using 99mTc
      DTPA-human serum albumin (99mTc-HSA). Dynamic and serial hepatic images were
      obtained over a 20 min period after 99mTc-GSA injection, and time activity curves
      from the heart and liver were generated. The blood clearance index (HH15), and
      the hepatic uptake index (LHL15) were calculated from each curve of the heart and
      liver, respectively. In addition, using two compartment fitting, the blood
      clearance (KH1, KH2) index was calculated, and using exponential fitting, the
      hepatic uptake index (KL) was calculated. The mean HH15 in LC group and non-LC
      group was 0.81 +/- 0.05, 0.64 +/- 0.10, respectively. The mean LHL15 in LC group
      and non-LC group was 0.79 +/- 0.04, 0.91 +/- 0.06, respectively. There were
      significant differences between non-LC group and LC group in HH15, and LHL15, KH1
      and KL. There were also significant correlations of KH1 with HH15, and KL with
      LHL15. Parameters of 99mTc-GSA showed significant correlations with various liver
      functions. 99mTc-GSA scintigraphy showed clearer liver images in hepatobiliary
      diseases than 99mTc-HSA. These results suggest that 99mTc-GSA scintigraphy is
      useful in estimating preserved liver function and hepatic morphology.

PMID- 8468808
TI  - [The indications for the use of gallium-67 scintigraphy].
AB  - 67Ga citrate scanning has been widely used for imaging a variety of neoplasms and
      inflammatory lesions. In this review, indications and limitations of 67Ga
      scanning were briefly discussed, and four diseases, that is, sarcoidosis,
      malignant melanoma, malignant lymphoma and opportunistic infection in patients
      with AIDS, were mentioned as the indications for 67Ga scanning in the clinical
      evaluation. Especially 67Ga scanning is helpful in the early detection and
      differential diagnosis of opportunistic infections in AIDS patients. I am
      convinced that 67Ga scanning will continue to be used for the future in view of
      its rich experience, simplicity and safety, although the exact role of 67Ga
      scanning should be defined.

PMID- 8468809
TI  - [Serum and urinary neopterin levels in sarcoidosis].
AB  - Serum and urinary neopterin levels were determined by high pressure liquid
      chromatography in 26 patients with pulmonary sarcoidosis and 12 healthy controls.
      Neopterin levels were significantly higher in sarcoidosis patients than in the
      controls. Neopterin levels differed from serum angiotensin converting enzyme
      (ACE) activities and were significantly higher in radiologic stage 1 and 2 than
      in radiologic stage 0 in patients not receiving prednisolone. No significant
      correlation was found between neopterin level and serum ACE activity. On the
      other hand, a significant correlation was found between neopterin level and serum
      adenosine deaminase activity. We believe that serum and urinary neopterin levels
      may be a more clinically valuable method of assessing pulmonary sarcoidosis than
      serum ACE activity.

PMID- 8468810
TI  - [A case of pulmonary actinomycosis that was difficult to distinguish from
      pulmonary carcinoma].
AB  - A 45-year-old male was admitted with chief complaint of hemoptysis. Prior to
      admission, a tumor in the S3 segment of the right lung had been detected by chest
      radiography. Despite a detailed examination after admission, no definite
      diagnosis was made, and right upper lobectomy was performed. Histopathological
      examination of the surgically resected tissue led to the diagnosis of pulmonary
      actinomycosis. In Japan, 52 cases of this condition were reported between 1964
      and 1991. This paper discusses the epidemiology, diagnosis and diagnostic imaging
      of the condition, with reference to the literature.

PMID- 8468811
TI  - [A case of idiopathic chylothorax].
AB  - A 29-year-old female was admitted to our hospital because of right pleural
      effusion. Chyle was obtained by thoracocentesis. She received conservative
      therapy, however, the pleural effusion did not decrease. Thoracic duct ligation
      was performed, and improvement of the chylothorax was observed. Because there was
      no underlying disease to cause chylothorax, the diagnosis of idiopathic
      chylothorax was made. Idiopathic chylothorax is a rare disease and only 24 cases
      have been reported in Japan.

PMID- 8468812
TI  - [A case of chylothorax resulting from malignant lymphoma--pathogenesis of
      chylothorax: a new concept].
AB  - We report a case of chylothorax in a 51-year-old male with non-Hodgkin's
      lymphoma. Combination chemotherapy reduced the size of mediastinal lymph nodes
      dramatically, but retroperitoneal lymph nodes remained almost the same, and
      chylothorax subsequently developed. Lymphangiogram showed reticular spread of
      contrast material from the thoracic duct downwards but not above the diaphragm.
      These findings suggest that an obstruction of the infra-diaphragmatic but not the
      supra-diaphragmatic thoracic duct caused development of collateral lymphatic
      channels penetrating the diaphragm into the thoracic cavity, with subsequent
      formation of chylothorax.

PMID- 8468813
TI  - [A case of intrapulmonary lymph node with silicotic nodules in a patient with
      idiopathic interstitial pneumonia].
AB  - A 61-year-old man was admitted to our hospital on October 8, 1991 because of
      abnormal shadows on chest X-ray at annual checkup at his company. Chest X-ray and
      CT on admission showed diffuse reticular shadows in bilateral lower lung fields
      and a nodular opacity approximately 10 mm in diameter in the right lower lung.
      Since transbronchial lung biopsy was not diagnostic, an open lung biopsy was
      performed on October 28, 1991. The lung specimens showed diffuse pulmonary
      fibrosis compatible with usual interstitial pneumonia and an intrapulmonary lymph
      node containing silicotic nodules. Only 29 cases (including the present case) of
      intrapulmonary lymph nodes have been reported. Although the causes of
      intrapulmonary lymph nodes are not clear, smoking is considered to play an
      important role in the development of pulmonary lymphoid tissue. In our case, the
      intrapulmonary lymph node contained silicotic nodules. Only several case have
      been reported to have silicotic nodules in the lymph nodes. As suggested by
      Kradin, they may be induced by relatively low levels of exposure to dust. Our
      case also had pulmonary fibrosis (IIP), and is the first reported case of
      intrapulmonary lymph node associated with IIP. Although it is difficult to
      determine these two diseases occurred coincidently or not, it is possible that a
      low level of dust exposure may have contributed to both silicotic nodules in the
      lymph node and IIP.

PMID- 8468815
TI  - [A case of plasma cell granuloma which resolved after steroid treatment].
AB  - A 65-year-old man with a history of a common cold two months earlier was referred
      to our division for further evaluation of an abnormality on chest X-ray film.
      Transbronchial lung biopsy findings revealed an inflammatory pseudotumor, a
      plasma cell granuloma (PCG). The pulmonary nodule disappeared completely six
      weeks after steroid therapy. To our knowledge, all PCG cases to date have been
      surgically resected. Therefore, this case of PCG diagnosed by transbronchial lung
      biopsy and successfully treated nonsurgically with steroid therapy is worthy of
      note.

PMID- 8468814
TI  - [Bronchial hyperresponsiveness to histamine induced by intravenous administration
      of 9 alpha,11 beta-prostaglandin F2 (9 alpha,11 beta-PGF2) in guinea pigs].
AB  - The effects of intravenous administration of 9 alpha,11 beta-PGF2, a stable
      metabolite of prostaglandin D2 (PGD2), on bronchial smooth muscle in guinea pigs
      were investigated by measurement of dynamic compliance and dynamic respiratory
      resistance using a formula to exclude the effects of differences in airway wall
      thickness. With this formula, the ratio of bronchial smooth muscle constriction
      by histamine can be estimated as an index of bronchial hyperresponsiveness to
      histamine. Administration of 9 alpha,11 beta-PGF2 induced airway wall edema. The
      ratio of bronchial smooth muscle constriction by histamine was significantly
      enhanced by the administration of 9 alpha,11 beta-PGF2a. TXA2 antagonists, ONO-NT
      128 and ONO-8809, inhibited the effect of 9 alpha,11 beta-PGF2 administration.
      These results suggest that 9 alpha,11 beta-PGF2 act as important mediators
      affecting bronchial hyperresponsiveness, and TXA2 may play a role in 9 alpha,11
      beta-PGF2-induced airway wall edema and bronchial hyperresponsiveness to
      histamine.

PMID- 8468816
TI  - [Experimental epithelioid cell granuloma formation in Lewis rats induced by
      injection of cell wall fragments derived from alpha-streptococcus--etiologic
      relationship between bacterial cell wall and sarcoid granuloma].
AB  - We observed the presence of epithelioid granulomas in follicles near lacunae in
      the tonsils from patients with active sarcoidosis. Bacteria isolated in these
      tissues were mostly alpha-streptococci. The present study was undertaken to
      determine whether alpha-streptococcus can induce granuloma formation.
      Streptococcal cell wall (SCW) fragments were injected into the foot pads of
      female Lewis rats. Epithelioid granulomas were abundantly formed in popliteal
      lymph nodes when SCW aqueous suspension was injected four times. SCW antigens
      were detected in macrophages in the granuloma but not in epithelioid cells, by
      immunoperoxidase method. These findings suggest that macrophages transform into
      epithelioid cells after phagocytosis and digestion of SCW, and that components of
      bacterial cell wall such as SCW may induce the granuloma formation in
      sarcoidosis.

PMID- 8468817
TI  - [Bulky mediastinal malignant lymphoma].
AB  - The efficacy of treatment of 19 patients with malignant lymphoma presenting with
      mediastinal tumor was evaluated. They included 7 patients with Hodgkin's disease
      and 12 with non-Hodgkin's lymphoma (NHL). Numbers of patients with stage I, II,
      III and IV disease according to Ann-Arbor's classification were 6, 4, 3 and 6,
      respectively. Stage I patients were treated with CHOP therapy after radiotherapy
      (RT). Stage II and III patients were treated with RT after COP-BLAM chemotherapy.
      Stage IV patients were treated with COP-BLAM III regimen. Complete remission was
      achieved in 16 of 19 patients (84.2%), and partial remission in 2 (10.5%). All
      patients with Hodgkin's disease and 9 (75%) with NHL attained complete remission.
      All patients in stage I to III and 3 (50%) in stage IV achieved complete
      remission. Overall median survival was 66 months. The incidence of bone marrow
      involvement and bulky mass was significantly different between stage I.II and
      stage III.IV patients (p < 0.05). These results indicate that combination
      treatment with RT and chemotherapy with regimens including adriamycin was
      effective in patients with malignant lymphoma presenting with mediastinal tumor,
      especially in those without bone marrow infiltration and bulky mass.

PMID- 8468818
TI  - [A new technique for evaluating the respiratory tract--digital subtraction
      bronchography (DSBG)].
AB  - Bronchography is essential for evaluation of morphological changes in the
      bronchial tree. However, conventional bronchography using Propyliodone (Dionosil)
      is extremely invasive, especially to those with pulmonary infections. In the
      present study, we developed a new less invasive method of bronchography with the
      aid of digital subtraction technique (DSBG), and evaluated its clinical benefits.
      Bronchography was performed by injecting contrast medium (Iopamidol: Iopamiron
      300) via the lumen of the bronchoscope (Olympus Type 20), and image processing of
      the respiratory tract was performed using digital subtraction technique. From
      1991 to 1992, DSBG was performed in 15 cases (8 bronchiectasis, 1 diffuse
      panbronchiolitis, 1 lung cancer, 1 pulmonary emphysema, and 4 others). DSBG
      clearly demonstrated the morphological changes of large and segmental bronchial
      lesions in cases of bronchiectasis and lung cancer, as well as conventional
      bronchography using Dionosil. In addition, it was possible to image the
      morphological changes of bronchiolar lesions in diffuse panbronchiolitis and
      pulmonary emphysema to the same detail as obtained using classical selective
      alveolo-bronchography (SAB). Since DSBG can provide enhanced images the bronchial
      tree without being affected by cardiac and respiratory movements, we could obtain
      detailed information on bronchial and/or bronchiolar lesions. With respect to
      side effects, Iopamiron was quickly drained and/or absorbed within 2 hours after
      injection. Pulmonary infection and bronchial bleeding, which are well known
      primary complications of classical bronchography using Dionosil, were not
      observed. We conclude that 1) DSBG is useful new technique for examining
      morphological changes of the respiratory tract, and 2) DSBG is less invasive than
      conventional bronchography.

PMID- 8468819
TI  - [Airway hyperreactivity test by measurement of specific airway conductance during
      quiet breathing].
AB  - In asthmatic patients, the threshold for specific airway conductance during quiet
      breathing (sGawqt) in the airway hypersensitivity test was determined using our
      newly developed pressure corrected flow type body plethysmograph and compared
      with that measured by means of respiratory resistance (Grs) Astograph in relation
      to the following parameters: 1) Dmin, an index of airway sensitivity (accumulated
      methacholine concentration at the time of onset of linear decrease in the dose
      response curve), 2) SsGawqt and SGrs, indicators of airway sensitivity (slope
      when the value begins to decrease) and 3) PD35 (accumulated methacholine
      concentration when the valve has decreased to 35% of the initial value). Although
      no significantly difference was observed in SsGawqt and SGrs, significantly lower
      values of Dmin and PD35, indexes of airway sensitivity, were obtained with sGawqt
      method as compared to Astograph. These findings may indicate that the airway
      hypersensitivity test using our body plethysmography technique can be performed
      using a smaller amount of inhaled methacholine with less patient burden as
      compared to Astograph.

PMID- 8468820
TI  - [Effects of various doses of endotoxin on physiological and hematological
      parameters in conscious guinea pigs].
AB  - We investigated the effects of various doses (0.2 to 2000 micrograms/kg) of
      endotoxin on physiological and hematological parameters in our guinea pig model.
      Bronchoalveolar lavage (BAL) and lung tissue sampling were performed 6 hours
      after endotoxin injection. Lung damage was assessed by measuring wet to dry lung
      weight ratio (W/D), lung tissue to plasma accumulation of 125I-albumin (AL:
      albumin leakage) and BAL fluid to plasma accumulation of 125I-albumin (BALL:
      bronchoalveolar lavage leakage). Changes in peripheral cell counts were estimated
      at times 0, 1, 2, 4 and 6 hours after endotoxin injection. Pulmonary cell
      accumulation was determined by counting the number of cells in BAL fluid and
      tissue samples fixed for light microscopic examination. Increased W/D and AL were
      observed only in the high dose endotoxin treatment groups (200 and 2000
      micrograms/kg), while BALL increased even in the low dose endotoxin treatment
      groups (2 micrograms/kg). Decreases in peripheral neutrophil counts at one hour
      were observed in all endotoxin treated groups. Increase in BAL fluid neutrophils
      was seen in the 20, 200, and 2000 micrograms/kg groups, while neutrophil
      accumulation assessed by light microscope was observed in all endotoxin treated
      groups. We conclude that different amounts of endotoxin are required to affect
      different parameters of lung injury.

PMID- 8468821
TI  - [Clinical features and prognosis of Churg-Strauss syndrome].
AB  - We studied the clinical features and prognosis of 11 patients with Churg-Strauss
      syndrome (CSS). Subjects included 1 man and 10 women with a mean age of 56.3
      years. All subjects had a history of bronchial asthma prior to the onset of CSS.
      It was noted that the age of onset of bronchial asthma was high, and most of the
      patients had suffered from frequent and severe asthmatic attacks during the
      periods preceding the vasculitis. Skin tests and IgE RAST revealed that less than
      half of the subjects were atopic. Therefore it is considered that asthmatics with
      late onset and severe symptoms have a high risk for CSS, and poor control of
      asthmatic symptoms may contribute to the onset of the vasculitis. Eleven of 12
      cases including 1 patient with a relapse were treated with PSL alone (9 cases) or
      PSL plus cyclophosphamide (2 cases). Three patients died of heart failure or
      central nerve involvement. Vasculitis was ameliorated in the other cases (75%).
      Seven patients received maintenance therapy with low-dose of PSL (5 cases) or
      cyclophosphamide (2 case). None suffered from relapse of vasculitis during
      maintenance therapy. Discontinuation of therapy in five cases resulted in a
      relapse in only one case 62 months after the cessation of low-dose PSL. Although
      maintenance therapy appears to be useful in some CSS patients, the significance
      and indications for maintenance therapy should be further clarified.

PMID- 8468822
TI  - [A case of lung adenocarcinoma with high CT number, high calcium concentration
      but no calcification].
AB  - A 36-year-old woman with lung adenocarcinoma is reported. Chest X-ray film showed
      a high CT number, but no calcified lesion was detected. Histologic examination
      demonstrated no bone formation, calcification, or psammoma bodies. Calcium
      staining with Kossa method was negative. An elementary analysis with penetrating
      type electron microscopy and energy dispersion type analyzer showed high calcium
      concentration in the tumor. It was thought that the tumor showed a high CT number
      because of masked soluble calcium.

PMID- 8468823
TI  - [A case of primary pulmonary lymphoma associated with Sjogren syndrome and IgM
      monoclonal gammopathy confirmed by DNA rearrangement].
AB  - A 70-year-old man was admitted for evaluation of an abnormal shadow on his chest
      X-ray film, consisting of a mass containing an air bronchogram. He was also found
      to have a monoclonal gammopathy (IgM kappa type) and Sjogren syndrome. Open lung
      biopsy was performed with the suspicion of primary pulmonary lymphoma or
      pseudolymphoma. Southern blot analysis of the tissue revealed clonal
      rearrangements of immunoglobulin gene, supporting the diagnosis of B-cell
      lymphoma. Using conventional immunoperoxidase staining (PAP) method, the
      monoclonality in the tissue specimen is sometimes quite difficult to prove.
      Southern blot analysis, however, gives more accurate and reliable results. The
      analysis of immunoglobulin gene rearrangements is quite useful in determining the
      presence or absence of monoclonality in a specimen in cases of suspected
      lymphoproliferative disease such as primary pulmonary lymphoma and
      pseudolymphoma. We strongly recommend the use of Southern blot analysis in making
      the diagnosis of lymphoproliferative disease.

PMID- 8468824
TI  - [Extension of functional limitation for surgery of lung cancer by unilateral
      pulmonary arterial occlusion test].
AB  - We performed unilateral pulmonary arterial occlusion test to determine the
      indication for lung resection functionally, and investigated 32 cases whose total
      pulmonary vascular resistance was over 700 dyne.sec.cm-5/M2. Thirteen out of 32
      cases underwent surgery. There was no difference in lung function tests between
      surgical and non-surgical cases. Nine out of 12 cases whose pulmonary vascular
      resistance was less than 800 dyne by unilateral pulmonary arterial occlusion test
      underwent surgery, and none of these cases died within 3 months after surgery. In
      non-surgical cases, two were aged patients and one had chronic renal failure.
      Four out of 20 cases whose total pulmonary vascular resistance was over 800 dyne
      underwent surgery. Two cases that underwent surgery died within 3 months after
      surgery. These results suggest that the functional limitation of lung resection
      can be extended from 700 dyne.sec.cm-5/M2 to 800 dyne.sec.cm-5/M2 total pulmonary
      vascular resistance by application of unilateral pulmonary arterial occlusion
      test.

PMID- 8468825
TI  - [A case of chest wall abscess due to Salmonella newport].
AB  - A 18-year-old female with a history of precordial pain was admitted. There was a
      mass (3.5 x 2.5 cm) in the right inframammary region which was suspected to be
      chest wall tumor on the basis of CT scan and Ga scintigraphy findings.
      Exploratory surgery, consisting of total resection of the tumor without removing
      the ribs, was performed and revealed an abscess. Culture of pus from the abscess
      grew Salmonella newport (0 antigen 8, H antigen eh; 1.2). Focal infection with
      Salmonellosis is discussed. Surgical treatment is necessary in addition to
      chemotherapy.

PMID- 8468826
TI  - [A case of multiple broncholithiasis caused by mucus retention].
AB  - The patient was a 57-year-old male with long-standing bronchiectasis who
      developed severe respiratory failure and died in 1991. Autopsy revealed multiple
      broncholithiasis in both lungs, but no calcified lymph nodes in the hilar region.
      Since histological examination of the broncholiths showed only stratified
      structures but no tissue structure, most likely cause was considered to be
      calcification of mucus in the bronchi. Analysis of the stone components revealed
      78% calcium and 22% protein. This patient represents a case of multiple
      broncholithiasis caused by mucus retention, which is thought to be very rare.

PMID- 8468827
TI  - [A case of pulmonary arteriovenous fistulas (PAVF) treated with detachable
      balloon embolotherapy].
AB  - A case of pulmonary arteriovenous fistulas (PAVF) treated with detachable balloon
      embolotherapy is reported. A 31-year-old man was admitted to hospital because of
      polycythemia and hypoxemia. He had a history of dyspnea on exertion and transient
      cerebral ischemic attacks (TIA). Chest roentgenogram revealed a peripheral
      lobulated lesion in the right upper lung field and a coin lesion in the left lung
      field connected by dilated blood vessels to each hilus. Pulmonary angiography and
      right heart catheterization was performed. Four PAVFs were observed in bilateral
      lung field, and the intrapulmonary shunt ratio was 25.8%. Because the patient was
      symptomatic, we embolized each PAVF with a detachable balloon without
      complications. After embolotherapy, there was improvement in his symptoms.
      hypoxemia and shunt ratio. Recent reviews have highlighted the need to consider
      embolotherapy for bilateral multiple PAVF. We conclude that embolotherapy with
      detachable balloon is a very useful procedure for treatment of bilateral multiple
      PAVF.

PMID- 8468828
TI  - [A case of neurinoma combined with testicular feminization syndrome].
AB  - A 23-year-old female was admitted to our hospital because of a mediastinal tumor.
      She complained of primary amenorrhea, and abdominal echosonography was therefore
      performed, revealing the absence of a uterus. Chromosome analysis revealed a 46
      XY genotype, indicating the patient to be a male, not a female. Left renal
      venography demonstrated residual blood vessels originating in the Mullerian
      ducts. Thoracotomy and laparotomy were performed, and the mediastinal tumor and
      bilateral testes were resected. Postoperative pathology revealed that the
      mediastinal tumor was a neurinoma. There was no spermatogenesis, but hyperplasia
      of Sertoli cells in the testes was seen. Neither the neurinoma nor the testes
      were malignant. Bioassay of the testes showed no androgen receptors, leading to
      the diagnosis of testicular feminization syndrome with the complete form of
      androgen insensitivity. There have been many reports of an association between
      testicular feminization syndrome and malignant tumors of the testes, but few
      reports of an association between testicular feminization syndrome and benign
      tumors such as neurinoma. Accordingly, the present case was considered to be
      unusual and worth reporting.

PMID- 8468829
TI  - [A case of pulmonary embolism probably induced by long term use of oral
      contraceptive].
AB  - We present a 53-year-old female with pulmonary embolism (PE), who had been taking
      oral contraceptive for 13 years. She was admitted to our hospital with upper
      abdominal pain and was found to be in shock. The diagnosis of PE was made from
      chest X-ray examination, electrocardiogram and pulmonary angiography. Pulmonary
      hypertension was observed on right heart catheterization, and an anticoagulant
      was administered. Multiple defects of the right pulmonary artery were detected on
      lung perfusion scan, and there were no significant findings on leg phlebogram.
      Home oxygen therapy was effective for the treatment of pulmonary hypertension and
      chronic hypoxemia which still persisted after her recovery from the acute stage.
      We are concerned that wide spread use of oral contraceptives will increase the
      incidence of PE in the near future in this country. We conclude that
      contraceptive users should be warned of their higher risk of PE, and that they
      should visit a clinic for examination.

PMID- 8468830
TI  - [Comparison of typical and atypical bronchoplasty for bronchogenic carcinoma].
AB  - One-hundred and twenty-eight patients who underwent bronchoplasty for
      bronchogenic carcinoma from 1969 to 1990 were retrospectively analyzed. Ninety
      six patients had upper sleeve lobectomy or upper lobectomy with wedge
      bronchoplasty (typical procedure) and 32 underwent bronchoplasty with lobectomy
      other than upper lobes (atypical bronchoplasty). The two groups were
      statistically similar in preoperative characteristics including sex, age, cell
      types and stages. In typical group, right upper sleeve lobectomy was performed in
      48 patients, left upper sleeve lobectomy in 27, right upper lobectomy with wedge
      bronchoplasty in 11, left upper lobectomy with wedge bronchoplasty in 7 and
      sleeve bronchoplasty alone in 2. In atypical group, right middle and lower
      lobectomy with sleeve bronchoplasty in 10 patients, left lower sleeve lobectomy
      in 5, right lower lobectomy with wedge bronchoplasty in 4 and others in 13.
      Postoperative mortality was 5.2% in the typical group and 9.4% in the atypical
      group. Postoperative respiratory complications occurred in 16 patients (50%) in
      the patients with the atypical group and in 33 (34.7%) in those with typical
      group. Three years and 5 years survival rates in the typical group were 46 and
      40% and those in the atypical group, 27 and 18%. However, there was no
      statistical difference in survival between the two groups. In conclusion,
      atypical bronchoplasty is useful for preserving the lung parenchyma, but, careful
      perioperative management and surgical technique of bronchoplasty are mandatory.

PMID- 8468831
TI  - [A right internal thoracic artery graft to the left anterior descending artery].
AB  - From 1987 to 1991, 48 patients received a right internal thoracic artery (RITA)
      to the left anterior descending artery (LAD). No operative death occurred, but
      two patients (4.2%) died during hospitalization due to graft versus host disease,
      and congestive heart failure. Graft patency of the RITA was 100%. After a 17.2
      month mean follow-up, the 4 year actuarial survival rate (including all causes of
      death) was 85.3%, and the 4 year cumulative cardiac event free rate (including
      all cardiac deaths, myocardial infarction, reoperation, and PTCA) was 87.6%. The
      length of the RITA graft to the LAD, 15.6 +/- 1.1 cm, was significantly longer
      than that of the left internal thoracic artery (LITA) to the LAD, 12.9 +/- 1.1
      cm. However, the flow of the RITA-LAD graft, 42.3 +/- 21.1 ml/min, was same as
      the flow of the LITA to the LAD, 42.1 +/- 19.6 ml/min. These findings justify
      wider use of the RITA to the LAD as a second arterial graft.

PMID- 8468832
TI  - [Measurement of cardiac output by Doppler echocardiography: clinical validation
      in pediatric patients after open heart surgery].
AB  - We compared the cardiac output obtained by pulsed Doppler echocardiography (COPW)
      with simultaneous thermodilution measurements (COTD) in 13 children for 33 times
      after open heart surgery. Good correlation (r = 0.84, slope = 1.15) of cardiac
      output was obtained when direct measurements of aortic diameter during operation
      were used in the calculations. Cardiac output was overestimated (r = 0.89, slope
      = 1.42) when 2 DE measurements of aortic diameter were used. Nineteen
      measurements of 8 VSD patients revealed good correlation (r = 0.89, slope 0.85)
      using direct measurement of aortic diameter, whereas 14 measurements of TOF
      patients showed somewhat overestimation of cardiac output (r = 0.90, slope =
      1.31). In serial determinations, percent change change in COPW well correlated
      with COTD (r = 0.75, slope = 1.08). We conclude that accurate cardiac output can
      be obtained by pulsed Doppler echocardiography after pediatric cardiac surgery by
      measuring aortic diameter directly in operation room. Accuracy in percent change
      in cardiac output proved that COPW is useful especially in hemodynamically
      unstable patients after pediatric cardiac surgery.

PMID- 8468833
TI  - [Thoracoscopic treatment of bronchogenic cyst].
AB  - A central bronchogenic cyst was excised thoracoscopically from a 44-year-old
      woman in whom a tumor had been pointed out in the left upper posterior
      mediastinum at a screening examination. Since the tumor was diagnosed to be
      benign, only conservative follow-up was undertaken, but the patient consulted our
      department desiring active therapy. On the basis of the chest CT and MRI findings
      a bronchogenic cyst was diagnosed. Under general anesthesia and mechanical
      ventilation of one lung, the thoracoscope was inserted into the thoracic cavity
      revealing in the left upper posterior mediastinum a cyst which was excised
      thoracoscopically. While coagulation was performed gingerly with an electric
      scalpel, the tumor was detached sharply and bluntly with a pair of scissors. The
      postoperative course was uneventful with little wound pain or scar formation.
      Hitherto bronchogenic cysts have been treated by resection after thoracotomy.
      Although this is an easy procedure, a relatively large operative scar is left and
      considerable wound pain may develop. In contrast, thoracoscopic treatment is
      characterized by minimal surgical invasiveness, little postoperative wound pain,
      and small scars. These advantages suggest that this technique may be indicated
      for benign mediastinal tumors, particularly cysts.

PMID- 8468834
TI  - [Thoracoscopic partial resection of the lung for peripheral lung tumor].
AB  - We report a thoracoscopic partial resection of the lung for the peripheral lung
      tumor in a 66-year-old woman. Her chest roentgenogram and computed tomographic
      scan showed a single tumor 1.9 cm in diameter within the periphery of the right
      lower lobe. A solitary metastatic lung tumor of colon cancer, which was resected
      one year ago, was suspected. Partial resection of the lung involving this tumor
      was performed using the MULTIFIRE ENDO GIA 30 disposable surgical stapler under
      thoracoscopy. There was neither air leak nor bleeding at the resection line.
      Pathological examination of the tumor revealed benign localized pleural
      mesothelioma. Her postoperative course was uneventful and she was discharged from
      the hospital on the eighth postoperative day. Thoracoscopic pulmonary resection
      using EndoGIA is a safe technique for a peripheral lung tumor.

PMID- 8468835
TI  - [Bullectomy utilizing EndoGIA under thoracoscopic guidance].
AB  - We report 5 cases of pneumothorax successfully treated with an endoscopic GIA
      stapling device (EndoGIA) under thoracoscopic guidance. There were no
      complications such as air leak or bleeding, and patients were discharged 2 to 7
      days after operation. Surgical procedure utilizing EndoGIA has been proved to
      have advantages such as less pain, early return to normal activity and more
      cosmetic incision.

PMID- 8468836
TI  - [The partial resection of lung with MULTIFIRE ENDO GIA 30 under the
      thoracoscopy].
AB  - MULTIFIRE ENDO GIA 30 was a newly auto suture developed by US surgical c.o., A 27
      year-old man was admitted for right spontaneous pneumothorax in our hospital. We
      performed the partial resection of lung with this new auto suture under the
      thoracoscopy. Condition of patient after operation was very good, and he could
      discharge in short hospitalization. We concluded that this new auto suture was
      entirely reversible and safety.

PMID- 8468837
TI  - [Palliative management of left atrioventricular valve atresia with normal aortic
      valve].
AB  - We present three cases of the left atrioventricular valve atresia (LAVVA) with
      normal aortic valve. All cases showed [S,D,D] and had concordant AV connection.
      First case had two functional ventricles with multiple VSD and ventriculo
      arterial connection was normal. Interatrial communication was maintained through
      ASD and the infant underwent pulmonary arterial banding (PAB). Four years later,
      the patient underwent Blalock-Hanlon (B-H) procedure for an inadequate ASD.
      Second case showed the univentricular heart of right ventricle with double
      outlet. In this case, PFO was restrictive and the infant underwent B-H procedure.
      Ten days after initial palliation, patient underwent PAB. Third case showed the
      univentricular heart of left ventricle and transposed great arteries. This
      patient had also the coarctation of the aorta. B-H procedure, PAB and subclavian
      flap aortoplasty were performed simultaneously by bilateral thoracotomy. All
      patients have done well, with normal growth and development at the time of their
      last outpatient evaluation at 10 year, 9 months and 9 months after surgery
      respectively.

PMID- 8468838
TI  - [Clinical use of an expanded polytetrafluoroethylene sheets (GORE-TEX SHEETS) as
      a pericardial substitute after aorto coronary bypass grafting].
AB  - Reoperation after cardiovascular surgical procedures are often accompanied by the
      possibility of injuring the heart the great vessels, and extracardiac grafts
      during resternotomy. To reduce the risk associated with resternotomy and to
      facilitate dissection of intrapericardial adhesion, we have used GORE-TEX SHEET
      as pericardial substitute since January, 1989. In case GORE-TEX SHEET are
      implanted in the mediastinum, prolongation of the foreign body reaction,
      mediastinitis, increasing postoperative hemorrhage should be in mind. In this
      study, the biocompatibility of GORE-TEX SHEET was examined clinically. The
      following postoperative indices such as duration of fever, change of the WBC
      counts, WBC fraction, CRP, mediastinal hemorrhage are evaluated. These results
      showed no statistical significance between GORE-TEX SHEET group and autologous
      pericardial group by the randomized study. We recommend use of GORE-TEX SHEET as
      a pericardial substitute in cases of major cardiovascular operation using median
      sternotomy.

PMID- 8468839
TI  - [Blood purification after aorto-coronary bypass grafting for dialysis patients].
AB  - Four dialysis patients received aorto-coronary bypass grafting (CABG) at Fukuyama
      cardiovascular hospital from April 1989 to March 1992. We employed continuous
      ambulatory peritoneal dialysis (CAPD) in two cases, hemodialysis with
      extracorporeal ultrafiltration method (ECUM + HD) in one case and
      hemodiafiltration with continuous veno-venous hemofiltration (CVVHF + HDF) in one
      case for perioperative management. In each cases, intermittent HD was undergone
      during 4 days before operation. Intraoperatively, HD was used together with
      extracorporeal circulation. Blood pressure in the postoperative course changed
      more frequently in CAPD cases than ECUM + HD or CVVHF + HDF case. Especially,
      CVVHF + HDF stabilized the movement of circulation and kept balance of serum BUN,
      Cr after the operation (BUN; 27.2 +/- 6.3, Cr; 5.0 +/- 0.6). We concluded that
      CVVHF + HDF would be the most favorable method to maintain the fluid balance
      stably for the uremic patients after CABG.

PMID- 8468840
TI  - [An operative case of aortic valve regurgitation due to blunt trauma to the
      chest].
AB  - While a 70-year-old man was riding a motorcycle, he was hit by car on his chest
      on October 19, 1990. Medical check-up at the emergency room of another hospital
      was negative. However, he fell in to dyspnea on the night of next day which
      progressed to develop signs of orthopnea. He revisited the hospital where he was
      found to have aortic regurgitation and subsequent congestive heart failure after
      medical examination including echocardiography and was referred to our hospital 7
      days after the accident. He was operated upon the following day. On opening the
      pericardium, about 100 ml of reddish black fluid was accumulated. The appearance
      of the heart was normal except for black discoloration of the epicardial fat pad
      at the base of the aorta. Opening the ascending aorta transversely, the right
      coronary cusp was found to be perforated. The aortic valve was considered
      preferable to replace than to repair. The aortic valve was replaced with a St.
      Jude Medical valve. His recovery was uneventful and he has been well thereafter.

PMID- 8468841
TI  - [Acute cardiac tamponade in nonpenetrating injury of proximal aorta: report of a
      case].
AB  - A 21-year-old male admitted to the emergency room with multiple traumatic
      injuries and shock. Although a chest X-ray showed normal in size of cardiac
      shadow, echocardiography confirmed cardiac tamponade. A median sternotomy was
      performed and the pericardial space was evacuated of 600 ml of blood and blood
      clots. Minor bleeding was identified in the proximal aorta, and complete
      hemostasis was achieved with manual compression and fibrin glue sealing. One
      month follow-up showed no pseudoaneurysm formation.

PMID- 8468842
TI  - [Primary chylopericardium with skeletal lymphoangiomatosis: a case report].
AB  - A 5-year-old girl admitted to our hospital complaining cardiomegaly due to
      pericardial fluid and punched-out area in the humerus. Analysis of pericardial
      fluid confirmed primary chylopericardium and the findings in the humerus
      suggested skeletal lymphoangiomatosis. Despite medical treatments, pericardial
      fluid didn't decrease. Therefore, she underwent ligation and resection of
      thoracic duct. She recovered uneventfully without reaccumulation of the
      pericardial effusion. In addition, skeletal survey resulted in lymangiomatosis.

PMID- 8468843
TI  - [Anomalous origin of the left coronary artery from the pulmonary artery: a case
      report in an adult].
AB  - A 37-year-old female with anomalous origin of the left coronary artery from the
      pulmonary artery was surgically treated by creation of intrapulmonary aorto
      coronary tunnel. Postoperative cardiac catheterization showed a minimal pulmonary
      stenosis at the baffle. But the remarkable preoperative ST-depression in a
      treadmill exercise test disappeared completely after operation and the normograde
      blood flow of the left coronary artery was detected from the ascending aorta.

PMID- 8468844
TI  - [Direct implantation of the left coronary artery to the ascending aorta in Bland
      White-Garland syndrome].
AB  - A seventeen-year-old male with Bland-White-Garland syndrome underwent direct
      implantation of the left coronary artery to the ascending aorta. Under
      cardiopulmonary bypass, the main pulmonary artery was completely transected and
      the left coronary artery (LCA) was excised with a cuff of the pulmonary artery
      wall. Then the proximal end of LCA was directly anastomosed to the ascending
      aorta. The postoperative course was excellent. It appears that this surgical
      procedure might be the most ideal repair both anatomically and hemodynamically to
      reconstruct the left coronary artery in Bland-White-Garland syndrome.

PMID- 8468845
TI  - [A case report of pulmonary valve blood cyst].
AB  - A six-year-old boy with pulmonary stenosis was hospitalized in order to examine
      the cause of pulmonary stenosis. The right-ventriculography showed a large shadow
      defect in the right ventricular outflow tract. But the echocardiography showed
      the cystic tumor, which was covered with thin wall and had echo-free space in it,
      in the right ventricular outflow tract. We made a diagnosis of pulmonary blood
      cyst. After cardiopulmonary bypass was established, the main pulmonary artery was
      incised longitudinally. There were two blood cysts at the left pulmonary cusp
      which were 1.5 x 1.5 cm and 0.7 x 0.5 cm in size. The cysts were resected and the
      pulmonary cusp was plicated. Histologically, the wall of the cysts was consisted
      thick valvular tissues. No pulmonary valve pressure gradient was detected with
      the echocardiography following the operation.

PMID- 8468846
TI  - [Simultaneous operation of Cabrol's operation and sternal turnover with rectus
      abdominal flap].
AB  - We performed simultaneous operation of sternal turnover and Cabrol operation for
      a 28-year-old man, who had 3rd grade funnel chest and annuloaortic ectasia with
      3rd grade aortic regurgitation. We think when both annuloaortic ectasia and
      funnel chest are indicated for operation, simultaneous operation is to be
      considered and the combination of Cabrol operation and sternal turnover with
      rectus abdominal flap is the best procedure.

PMID- 8468847
TI  - [A case report of combined aortic and mitral regurgitation associated with
      ankylosing spondylitis].
AB  - We reported a case of ankylosing spondylitis which successfully underwent aortic
      valve replacement for combined aortic and mitral regurgitation. A 42-year-old man
      was admitted with symptoms of shortness of breath and anginal pain. He was
      previously diagnosed ankylosing spondylitis by an orthopedician A grade III/VI to
      and fro murmur was audible at the left sternal border. Retrograde aortography
      revealed severe aortic regurgitation and mild mitral regurgitation. Cardiac
      catheterization showed moderately pulmonary hypertension and high pulmonary
      artery wedge pressure. He underwent aortic valve replacement with SJM prosthetic
      valve. His postoperative course was uneventful. In Japan, ankylosing spondylitis
      is rare disease, and cardiac lesions associated with these conditions is seldom
      met to us. The surgical problems and management of these lesions are discussed.

PMID- 8468848
TI  - [Successful repair of partial atrioventricular septal defect in a 70-year-old
      female patient].
AB  - A 70-year-old female with partial atrioventricular septal defect underwent a
      total correction of the anomaly. The patient was in NYHA functional class II.
      Preoperative cardiac catheterization demonstrated a primum-type atrial septal
      defect through which 33% of left to right shunt occurred and a cleft of mitral
      valve causing moderate regurgitation. The operative procedure as our routine for
      this anomaly consisted of suture of mitral septal commissure and closure of
      atrial septal defect with autologous pericardial patch. Postoperative examination
      showed satisfactory competence of mitral valve and improved functional capacity.
      A successful correction for the case aged more than 66 with this anomaly has not
      been reported so far in Japanese literature. We conclude that surgical treatment
      should be basically considered for this anomaly in spite of senility.

PMID- 8468849
TI  - [Quadricuspid aortic valve: a case report and the review of the literature].
AB  - We report a case of rare congenital anomaly of quadricuspid aortic valve and
      coexisting right coronary displacement. A 70-year-old man was admitted to our
      hospital for heart murmur and ECG abnormality. The trans-esophageal
      echocardiography and aortography showed moderate aortic stenosis and
      regurgitation. At the operation, a quadricuspid aortic valve with three equal
      cusps and one smaller cusp that showed marked calcification and displacement of
      right coronary orifice were noted. Successful aortic valve replacement and
      coronary artery bypass grafting were performed and postoperative course was
      uneventful.

PMID- 8468850
TI  - [A case of simultaneous bilateral spontaneous pneumothorax].
AB  - A 18-year-old man was admitted urgently complaining dyspnea, cyanosis and chest
      pain. The chest x-ray film revealed simultaneous bilateral pneumothorax. Chest
      drains were inserted immediately to the both chest cavities. On the 3 rd hospital
      day, radical operation for spontaneous pneumothorax with synchronous bilateral
      thoracotomies were performed through both axillary incision. Postoperative course
      was uneventful. The patient was discharged on the 8 th day after operation.

PMID- 8468851
TI  - [Excellent late results of total circulatory annuloplasty with absorbable suture
      for the repair of mitral regurgitation of atrioventricular septal defects in
      children].
AB  - We treated 15 children with atrioventricular septal defects (6 complete type and
      9 incomplete type) using total circulatory annuloplasty for mitral regurgitation.
      In 14 patients, total circulatory annuloplasty was performed with absorbable
      suture and in one patient with polypropylene suture. Operative death was one
      patient associated with tetralogy of Fallot and another 14 patients survived.
      Preoperative mitral regurgitation was grade 1 in one patient, grade 2 in 6
      patients and grade 3 in 7 patients. After operation mitral regurgitation reduced
      to grade 1 in 13 patients and grade 2 in one patient. In the late results, only
      one patient underwent reoperation for exacerbation of mitral regurgitation. The
      present data suggested that total circulatory annuloplasty with absorbable suture
      was very useful technique for the repair of mitral regurgitation of
      atrioventricular septal defects in children.

PMID- 8468852
TI  - [The value of omental pedicle flap method for postoperative intractable infection
      in the field of thoracic surgery].
AB  - We present a series of 8 consecutive patients who underwent the omental pedicle
      flap method in the field of thoracic surgery. Four of them had empyema with
      bronchopleural fistula and four had mediastinal infection. A pedicle of omentum
      containing the right gastroepiploic artery was passed through a tunnel in the
      diaphragm into the empyema cavity or the mediastinal abscess cavity. All eight
      patients were cured successfully by single-stage procedures. We think this series
      demonstrates the value of omental pedicle flap method which lacks in symptoms due
      to defected organ and offers an excellent therapeutic effect with easy operative
      procedure. And, this method produce a quality of life. Further active application
      of this method can be expected in the management of chest problems.

PMID- 8468853
TI  - [Surgical treatment of metastatic lung tumors].
AB  - From January 1970 to March 1991, 72 operations in 55 patients (31 males and 24
      females) with metastatic lung tumors were performed in our department. Their
      cumulative survival rates was 25.5% at five years. With analysis of the various
      prognostic factors, patients both with solitary metastases and without lymph node
      metastases had a good prognoses. However, even in patients with recurrent lung
      metastatic tumors, long time survival was achieved with reoperation in two
      patients. We concluded that reoperation with or without effective chemotherapies
      was effective in selected patients.

PMID- 8468854
TI  - [A depression of respiratory function following the cardiopulmonary bypass in
      infants and children].
AB  - Fourty-one patients (2-44 month old) underwent the closure of ventricular septal
      defect using moderate-hypothermic cardiopulmonary bypass (CPB). The respiratory
      index (RI) were monitored after CPB, as functional parameters of oxygenation
      capacity. At 15 min after CPB, there was the increased level in RI (2.22 +/-
      0.45; normal value: 0.1-0.37). Thereafter, RI gradually decreased by 90 min after
      CPB (1.22 +/- 0.19), and again increased reaching peak levels by 12 hrs after ICU
      entry (2.56 +/- 0.64). The patients who exceed 1.00 at 15 min after CPB (RI-15)
      remained higher levels in RI compared to less than 1.00 and had the prolonged
      controlled ventilation. The RI-15 correlated with pulmonary-systemic flow ratio
      (Qp/Qs) and pulmonary-left ventricular pressure ratio (PA/LV). There was no
      significant correlation between RI-15 and CPB factors including CPB time,
      dilution rate, rectal temperature, flow and perfusion pressure. These results
      suggest that pulmonary dysfunction following the CPB may not be simply occurred
      by CPB but also involved by preoperative conditions. An increased pulmonary blood
      flow might be one of important and predictive factor for the depression of
      oxygenation following the cardiac surgery in infants and children.

PMID- 8468855
TI  - [Hygienic handling in cardiac surgery].
AB  - Some points regarding the hygienic handling in cardiac surgery are mentioned. The
      sternal infection or mediastinitis is still one of the most important
      complications after cardiac operation especially when ITA is used for CABG. After
      we paid much attention to these points, the postoperative sternal infection has
      decreased obviously.

PMID- 8468856
TI  - [A new design of annulus sizer].
AB  - Reconstruction of the right ventricular outflow tract at the time of total
      correction of tetralogy of Fallot, the pulmonary valve annulus has been sized
      with fingers and Hegar dilators at our institute. But it has not always been
      sized correctly. To preclude such a problem, we designed new annulus sizers which
      have two cylindrical parts and a flexible handle (100 mm). The cylindrical parts
      are 40 mm in length, 8 to 30 mm in diameter, and have three lines marked every 10
      mm from the end. Adjustment of the line to the valve annulus allows for correct
      measurement of the size. Moreover, we consider these sizers to be beneficial for
      annuloplasty of the atrioventricular valve, measurement of the mitral valve area
      after commissurotomy and the inner diameter of arteries.

PMID- 8468857
TI  - [Left main coronary artery stenosis following aortic valve replacement using a
      solid coronary perfusion catheter: report of two cases].
AB  - We experienced two cases of iatrogenic left main coronary artery stenosis (IOCS)
      following double (aortic and mitral) valve replacement (DVR). The solid coronary
      perfusion catheter may attribute IOCS, with grave consequence. There have been no
      IOCS since the time we exchanged a solid catheter for a soft one. One case, she
      was successfully treated percutaneous transluminal coronary angioplasty (PTCA),
      because she developed angina pectoris about 5 years after PTCA. But she developed
      angina pectoris again and angiographically left main coronary was severe
      stenotic. So she was undergone aorto coronary bypass grafting (CABG) to the left
      anterior descending. The other case, he developed angina pectoris about 3 months
      after DVR. He was treated with PTCA. Angiographically left mine coronary artery
      stenosis reduced 50% from 90%. Generally the treatment of IOCS is CABG, but we
      performed PTCA for 2 patients. Because we thought it was very hazardous for us to
      perform them open heart surgery. When it is very hazardous to perform patients
      open heart surgery, they need to be performed PTCA.

PMID- 8468858
TI  - [Medtronic model 6500 temporary myocardial pacing lead: a report of clinical
      assessment until three weeks after cardiac surgery].
AB  - Medtronic model 6500 heart wire as a right ventricular electrode was assessed in
      41 postoperative cases. R-wave amplitude, slew rate, peak-to-peak, output,
      current, and resistance were measured by Medtronic A-V pacing system analyser,
      model 5311, for three weeks after open heart surgery. These parameter changed
      until the 7 th postoperative day, but did not change significantly thereafter.
      Output and current did not exceed beyond 10 V and 20 mA respectively, where there
      is limitations of usually available pacemaker. No complication was encountered.
      These results showed that this heart wire was reliably useful even until 3 weeks
      after open heart surgery.

PMID- 8468860
TI  - [Acute aortic dissection without opacification of the false lumen on the initial
      aortogram: a case report].
AB  - A 50-year-old woman was admitted to the intensive care unit 40 min after the
      onset of severe chest and back pain with consciousness loss. Emergency computed
      tomography and aortography demonstrated an acute type A dissection without
      opacification of the false lumen. The patient was initially treated with
      antihypertensive drugs. Recurrent back pain and bilateral pleural effusion
      appeared 3 days after onset of the pain. Both the right radial and carotid pulses
      were reduced. Emergent operation was performed when computed tomography and
      aortography repeated 5 days after onset of the pain demonstrated the intimal flap
      in the ascending aorta with the opacified false lumen. The site of intimal tear
      in the proximal arch was resected and a 26 mm Dacron graft was inserted during
      deep hypothermia and circulatory arrest. The postoperative course was uneventful.

PMID- 8468859
TI  - [A case of aortic dissection (DeBakey-I) occurring 20 months after aortic valve
      replacement].
AB  - Simple aortic valve replacement was performed in a 59-year-old man whose
      ascending aorta was moderately dilated (45 mm) because he had no characteristics
      of Marfan's syndrome or other connective tissue diseases. However, about 20
      months later, reoperation needed to be performed for aortic dissection of DeBakey
      type I. The pathological findings of the aortic wall obtained at the initial
      operation revealed cystic medial necrosis. The occurrence of aortic dissection
      after aortic valve replacement is uncommon but not rare, especially in patients
      with cystic medial necrosis and/or dilated aortic root. Therefore, in these
      patients, wrapping or replacement of the ascending aorta may be required at the
      same time of aortic valve replacement.

PMID- 8468861
TI  - [Emergent operation of left atrial ball thrombus associated with mitral
      stenosis].
AB  - A 71-year-old woman with old cerebral infarction and arterial obstruction was
      admitted with the diagnosis of a free floating ball thrombus in the left atrium
      associated mitral stenosis. The emergent open heart operation was performed for
      removal of ball thrombus and mitral commissurotomy. The size of ball thrombus was
      4.8 x 4.0 x 3.0 cm. Postoperative course was uneventful.

PMID- 8468862
TI  - [Surgical treatment of aortitis syndrome associated with annuloaortic ectasia and
      the stenotic lesion of the aortic arch vessels].
AB  - A 37-year-old woman was admitted to our hospital for treatment of aortitis
      syndrome. Her aortogram showed critical stenosis of the innominate artery,
      occlusion of other arch vessels, and annuloaortic ectasia (AAE). We performed
      endarterectomy and patch plasty to the innominate artery using a saphenous vein
      graft. Graft replacement of the ascending aorta and AVR (modified Wheat's
      operation) were also performed at one stage. Deep hypothermic cerebral
      circulatory arrest was used as a method for cerebral protection. During
      operation, the lowest rectal temperature was 17 degrees C and the cerebral
      circulatory arrest time was 36 min. The postoperative course has been uneventful.
      In a postoperative aortogram, the innominate artery was well perfused. She has
      been free of complaint and been doing well for 2 years since the operation.

PMID- 8468863
TI  - [A case report of one-staged surgery for annuloaortic ectasia associated with
      atypical coarctation of the aorta].
AB  - A 33-year-old man admitted to our hospital with an episode of chest discomfort
      and dyspnea. UCG, CT, MRI and DSA disclosed an annuloaortic ectasia with grade 3
      aortic regurgitation and atypical coarctation of the aorta. Cabrol operation was
      performed with simultaneous graft bypass using a woven Dacron prosthesis between
      the ascending aorta and the abdominal aorta. The course of the bypass graft was
      arranged to pass behind the rectal muscle without laparotomy and major collateral
      vessels of the thorax could been kept without thoracotomy. There are only 10
      reported cases of annuloaortic ectasia associated with atypical coarctation of
      the aorta in Japan. This is the second successful case report of one-stage
      surgery to the complicated cardiovascular disease.

PMID- 8468864
TI  - [A case of pseudoaneurysm of the thoracic aorta with Behcet's disease].
AB  - A 54-year-old female with incomplete type of Behcet's disease was operated on
      because of impending rupture of the thoracic aneurysm. There was a saccular
      pseudoaneurysm below the left subclavian artery, and a punched out lesion of the
      aorta was recognized. The defect of the aortic wall was closed with a PTFE patch.
      Before and after the operation, we have given prednisolone. The postoperative
      course was uneventful. Two years later, there was no recurrence of pseudoaneurysm
      near the PTFE patch. In many reports, aneurysms of Behcet's disease are saccular
      pseudoaneurysms, and have high incidence of complications about anastomosis
      postoperatively. We need a further follow-up about this patient.

PMID- 8468865
TI  - [A case of giant dumbbell tumor treated by one-stage operation].
AB  - A 39-year-old woman who had been diagnosed as having von Recklinghausen's disease
      came to our hospital due to numbness of the right fingers. A chest roentgenogram
      indicated a mass in the right upper thoracic cavity and MRI showed this mass to
      be a dumbbell shaped tumor connected to the spinal canal. Because we could
      secured the extension and invasion of the tumor by MRI, we could remove the tumor
      by a one-stage operation.

PMID- 8468866
TI  - [A case of angina pectoris and aortic regurgitation combined with thymoma].
AB  - A case of a 72-year-old female with obstruction of LAD, stenosis of RCA, aortic
      regurgitation in moderate degree and an anterior mediastinal mass of 7 cm in
      diameter, is reported. Coronary artery bypass grafting, aortic valve replacement
      and thymectomy were simultaneously performed. On microscopic examination, the
      tumor was diagnosed as a mixed typed thymoma in the first stage of Masaoka's
      classification. She was making satisfactory progress without recurrence, after
      the operation. There was no case has been reported previously in the world in
      which simultaneous operations were performed for angina pectoris, aortic
      regurgitation and thymoma.

PMID- 8468867
TI  - [A case of two-chambered right ventricle associated with severe pulmonary valve
      regurgitation].
AB  - A 40-year-old female was admitted to the hospital with the chief complaints of
      dyspnea on effort. Echocardiography and cardiac catheterization revealed an
      abnormal muscle bundle in the right ventricle which divided right ventricle into
      two chambers with the pressure gradient of 86 mmHg between them. And severe
      regurgitation associated with hypoplastic pulmonary valve and ventricular septal
      defect were noted. We removed the abnormal muscle bundle through the right atrial
      and ventricular approach, and pulmonary valve replacement and VSD closure were
      carried out. We report a case of two-chambered right ventricle with severe
      pulmonary valve regurgitation because of its rarity.

PMID- 8468868
TI  - [A case of myasthenia gravis developing after resection of non-invasive thymoma].
AB  - The patient was a 79-year-old male. On CT of the chest, a mass shadow of the
      anterior mediastinum was found. He did not complain of symptoms, and there were
      no clinical signs of myasthenia gravis (MG) before surgery. The tumor and the
      thymus was completely resected. The pathological diagnosis was non-invasive
      thymoma, and his postoperative course was satisfactory. However, 2 months after
      the operation, the patient complained of ptosis, diplopia, dysphagia, and muscle
      weakness, which deteriorated rapidly. The titer of anti-acetylcholine receptor
      antibody was high at 91.0 nmol/l. By medication of anti-cholinesterase drug and
      predonin, the symptoms of MG improved. After resection of thymoma, postoperative
      follow-up with considering the possibility of postoperative MG is necessary.

PMID- 8468869
TI  - [A surgical case report of severe valvular aortic stenosis with atrial septal
      defect in a 78-year-old female].
AB  - We have experienced open heart surgery of severe valvular aortic stenosis
      associated with atrial septal defect in a 78-year-old female patient. This is the
      oldest case in Japanese literature. Because balloon valvuloplasty can not produce
      improvement in hemodynamic and clinical status, open heart surgery was performed
      as the final decision. The operative procedure consisted of aortic valve
      replacement with a 19 mm St. Jude Medical valve and direct closure of atrial
      septal defect. Postoperative course was excellent. The patient is doing well at
      the two years and three months of follow-up period.

PMID- 8468870
TI  - Septic shock: a review and update for the emergency department clinician.

PMID- 8468871
TI  - Critical pathways in the emergency department.
AB  - The actual development of the CP is an easy undertaking that an experienced
      emergency nurse can accomplish. The important points to remember are as follows:
      (1) include all disciplines that provide patient care in the development of the
      CP, (2) use realistic time frames (i.e., those currently found to be true in the
      emergency department, not those that are perceived to be ideal), (3) thoroughly
      educate the staff about the value of the CP in the emergency department, and,
      finally, (4) make sure that staff members know how to document variances. CPs in
      the emergency department give physicians and nurses common ground on which to
      negotiate patient care management more efficiently and effectively. They are a
      logical way to bring case management into the acute care setting. With the cost
      of ED visits continually rising, patient acuity levels increasing, and resources
      declining, expedient, coordinated, multidisciplinary action is crucial in giving
      total quality care to each patient.

PMID- 8468872
TI  - Implications of the consolidated Omnibus Budget Reconciliation "antidumping"
      legislation for emergency nurses.
AB  - Although the original intent of the law is to protect the indigent, the statute
      applies to any situation in which a patient is denied care or transferred to
      another facility before being medically stabilized. The data thus far indicate
      that financial motives may be only partially responsible for alleged COBRA
      violations and that other health care system issues are involved. Patient
      "dumping" may become better camouflaged against federal and state scrutiny, but
      until these other issues are identified and addressed dumping may continue to
      occur for a variety of reasons. To avoid the appearance of dumping, the emergency
      nurse and physician should meticulously record all aspects of every patient
      transfer. Particular attention should be given to documenting patient stability
      at the time of transfer, the risks versus benefits of the transfer, and the
      communication with and acceptance of the patient by the receiving facility.
      Emergency nurses, directors of nursing, and nursing quality assurance or risk
      managers should all be familiar with the COBRA requirements. For further
      information on the interpretation and application of COBRA, contact your state's
      acute care facility licensing authority or one of the HCFA Regional Offices
      listed in the Appendix.

PMID- 8468873
TI  - Will trauma centers become extinct? A review of factors affecting trauma center
      financial viability.

PMID- 8468874
TI  - The accuracy of the tympanic membrane thermometer in detecting fever in infants
      aged 3 months and younger in the emergency department setting.
AB  - OBJECTIVE: To evaluate the accuracy of fever detection using the tympanic
      membrane thermometer in infants age 3 months and younger in a general ED clinical
      setting. DESIGN: Retrospective analysis of sequential tympanic and rectal
      temperature readings for sensitivity, specificity, and predictive values.
      SUBJECTS: One hundred two infants, aged 3 months and younger, coming to the
      emergency department from January 1991 to July 1991. RESULTS: With fever defined
      as a temperature of 99.6 degrees F or greater by tympanic thermometer or 100.6
      degrees F or greater by rectal thermometer, the tympanic thermometer had an
      overall specificity for fever detection of 88%. Sensitivity was 90% or higher in
      the 2-month-old and younger age groups and 66% in the 3-month-old age group.
      Negative predictive values were 90% and greater and positive predictive values
      ranged from 60% to 66%. CONCLUSION: The tympanic membrane thermometer provided a
      reliable temperature reading in a high percentage of the sample population when
      the infant was afebrile. It was less reliable in detecting the presence of fever
      in this same age group. Febrile temperature readings obtained by the tympanic
      membrane thermometer within this age group may need to be compared with a rectal
      mode reading to accurately determine the presence of fever.

PMID- 8468875
TI  - Blood glucose monitoring at triage.
AB  - OBJECTIVE: To examine the use of a blood glucose monitor (BGM) on nursing and
      medical care, treatment time, and disposition time for patients in an ED triage.
      DESIGN: Experimental design. Individuals assigned to the experimental group had
      their blood glucose tested by finger stick in the triage area. The blood glucose
      level was made known to the triage nurse and/or the nurse caring for the patient
      in the emergency department proper. The investigator observed the nursing care,
      nursing and medical interventions and times. The control group underwent triage
      as usual, with no finger stick. SUBJECTS: Individuals with a history of diabetes
      and at least 18 years old were randomly assigned to the experimental or control
      group. The participants were 30 men and 38 women. RESULTS: Early knowledge of the
      patient's blood glucose level as determined by BGM affected time and
      implementation of nursing care. Three nursing interventions were significantly
      different between the groups: assessment, chi 2(1,N = 68) = 10.15, p < 0.001;
      consult a physician, chi 2(1,N = 68) = 17.58, p < 0.001; and order stat
      laboratory tests, chi 2(1,N = 68) = 13.09 = p < 0.001. The time the nurse
      intervened was significantly less for the experimental (24 minutes) than for the
      control (164.3 minutes) group (t[65] = -7.05, p < 0.001). Medical treatment time
      was significantly less for the experimental group (89.2 minutes) than for the
      control group (165.5 minutes) t[64] = -2.07, p = 0.05). Disposition time did not
      differ between groups. CONCLUSIONS: Data support the use of a BGM as a fast,
      accurate means of obtaining blood glucose levels. The nurses consulted with a
      physician, ordered stat laboratory tests for verification, and assessed the
      experimental patients more frequently than the control patients. Medical
      treatment time was also shorter for the experimental group. A BGM is an important
      source of data with which emergency nurses initiate care, at a fraction (3%) of
      conventional laboratory cost.

PMID- 8468876
TI  - Diagnostic and characteristic signs of illness and injury.

PMID- 8468877
TI  - Recognition and treatment of neuroleptic malignant syndrome.
AB  - NMS remains a serious and unpredictable reaction to central nervous system
      dopamine blockade. Use of the more recent, flexible definition of NMS will ensure
      that patients with this syndrome receive prompt effective diagnosis and
      treatment. Supportive care, discontinuation of the neuroleptic drug, and
      administration of bromocriptine are the keys to appropriate management. For
      patients with hypertension, nifedipine may be a useful alternative or adjunctive
      treatment. Because these patients may not be able to communicate, the role of the
      emergency nurse includes not only administration of supportive and pharmacologic
      care but also reassurance that this frightening disorder is treatable, with
      improvement likely within 1 day.

PMID- 8468878
TI  - Emergency department labor and delivery records.

PMID- 8468879
TI  - Monitoring patients who receive conscious sedation in the emergency department.

PMID- 8468880
TI  - The Americans with Disabilities Act and the role of the registered nurse with a
      disability.

PMID- 8468881
TI  - Self-study packets: an in-service strategy for today's emergency department.
AB  - The self-study program has been a great success. Staff seized the opportunity for
      "hands-on," nonthreatening learning. The fear of asking questions and appearing
      less knowledgeable than peers in a group setting is removed, and new employees
      are grateful for the rapid accessibility of concise reference material. Everyone
      enjoys the freedom of fitting the in-service program into a routine day, rather
      than trying to adapt to a set time. Last, but not least, management reaps to the
      benefit of a program that satisfies the expectations of regulatory agencies and
      is virtually cost-free.

PMID- 8468882
TI  - Calculating continuous medication infusions: the "50 cc method".

PMID- 8468883
TI  - Trauma system problems: using the tools of quality improvement to find solutions.

PMID- 8468884
TI  - A 20-year-old man with neck and chest pain and discomfort with breathing.

PMID- 8468885
TI  - Just like Kathy Haley, Columbus, Ohio. Interview by Marlene Jezierski.

PMID- 8468886
TI  - Words to the wise.

PMID- 8468887
TI  - Journey of a layoff: one emergency department nurse manager's story.

PMID- 8468888
TI  - International update: alternative treatment for common but dangerous
      acetaminophen overdoses.

PMID- 8468889
TI  - The ethics of exclusion and the myth of control.

PMID- 8468890
TI  - A look at our new emergency department. Shadyside Hospital, Pittsburgh,
      Pennsylvania.

PMID- 8468891
TI  - Two licenses for advanced practice nurses? ENA thinks not.

PMID- 8468892
TI  - Increased incidence of neurocysticercosis after contact with immigrants from
      endemic countries.

PMID- 8468893
TI  - Lack of sedation for cardiopulmonary bypass questioned.

PMID- 8468894
TI  - A 43-year-old man with syncopal episode and bradycardia 2 weeks after a motor
      vehicle crash.

PMID- 8468895
TI  - Acute ethylene glycol poisoning.

PMID- 8468896
TI  - Stresses and coping mechanisms: a report of interviews with eleven emergency
      department nurse managers.

PMID- 8468897
TI  - Automated external defibrillators: prehospital use in advanced cardiac life
      support.
AB  - It is evident that AEDs may be used by minimally trained first responders to
      terminate VF safely and rapidly in victims of out-of-hospital cardiac arrest. To
      enhance patient survival of out-of-hospital VF, there must be coordination
      between AED-trained first responders and ACLS providers.

PMID- 8468898
TI  - Comrades in abuse.

PMID- 8468899
TI  - Nonassignment provisions as cost control.

PMID- 8468900
TI  - Is your CPR training up to date?

PMID- 8468901
TI  - Infant cardiorespiratory monitor burn.

PMID- 8468902
TI  - Reflex sympathetic dystrophy.

PMID- 8468903
TI  - Recent-onset temporal lobe seizures caused by an unusual intracerebral mass.

PMID- 8468904
TI  - Alcohol-related mortality in Kansas, 1990.

PMID- 8468905
TI  - More on the Mennonites.

PMID- 8468906
TI  - Case management: are we ready?

PMID- 8468907
TI  - Case management: care across the continuum.

PMID- 8468908
TI  - Collaborative care in the acute care setting.

PMID- 8468909
TI  - Nursing case management in a rural setting.

PMID- 8468910
TI  - Molecular approaches to nephrology: prospects in diagnosis and management. Bari,
      Italy, March 19-22, 1992. Proceedings.

PMID- 8468911
TI  - Angiotensin II as a hypertrophogenic cytokine for proximal tubular cells.

PMID- 8468912
TI  - Gene transfer into the mammalian kidney: first steps towards renal gene therapy.
AB  - In this review we discuss two strategies for successful retrovirally-mediated
      transfer (transduction) of a reporter gene (bacterial beta-galactosidase) into
      the mammalian kidney. Retroviruses only integrate into dividing cells, but the
      adult kidney has a very low cell turnover. One approach used is the rapidly
      dividing metanephros, or precursor of the adult kidney, as a target for proviral
      integration. After infection and microtransplantation of fragments of this tissue
      into the renal cortex of neonatal mice, the implants grew and developed within
      the host kidney and reporter gene expression was located in glomerular and
      interstitial cells. A similar approach has been used by other investigators to
      grow genetically-engineered metanephros in a subcapsular location in the kidney.
      However, access of the gene product to the parenchyma of the kidney may be
      limited using this approach. A second strategy was to induce renal tubular cell
      replication by causing nephrotoxic damage with a folic acid injection. This
      created a 'biological window' in which a specific cell population, that is,
      tubular cells, was targeted for retroviral infection. One to four weeks later
      foci of tubular cells were found to express the reporter gene product. In both
      models, 50 to 90% of the experiments showed evidence of proviral integration as
      judged by the presence of a 559 base-pair DNA fragment amplified by the
      polymerase chain reaction. This persisted for four to seven weeks, the limit of
      the period of observation.

PMID- 8468913
TI  - Prospects for anti-rejection therapies based upon CD8-dependent immunoregulation.
AB  - In this article we propose that anti-rejection immunotherapies for countering
      acute allograft rejection can be designed around manipulation of the cell surface
      phenotype of alloantigen-presenting cells (allo-APCs) in ways that convert them
      from T cell activators to inhibitors. It is further suggested that a class of
      molecules, termed "coinhibitors," can be defined that carry out this APC
      conversion process. Data are summarized indicating that the human lymphoid cell
      surface molecule CD8 has such a trans-coinhibitor function which is in addition
      to the cis-coreceptor and adhesin functions traditionally ascribed to it.
      Antisense and sense gene transfer studies indicate that CD8 on the surface of
      allo-APCs leads to inhibition of allospecific T cell responders. We have explored
      the possibility of using protein, rather than gene, transfer as a therapeutic
      strategy for delivering CD8 to APC surfaces. Two membrane-binding variants of CD8
      have been assembled to show retention of the coinhibitor function of native CD8.
      Immunotherapeutic possibilities associated with these chimeric CD8 polypeptides
      in the clinical context of renal and other organ transplantation are considered.

PMID- 8468914
TI  - Differential in situ expression of cytokine genes in human renal transplantation.

PMID- 8468915
TI  - Analysis of T cell lines from rejecting renal allografts.
AB  - Acute rejection after renal allotransplantation is characterized by the presence
      of a mononuclear cell infiltrate in the interstitium with involvement of tubuli.
      In a previous study on renal histology we showed that tubular damage by graft
      infiltrating cells (GIC) is a sign of clinically significant rejection. We
      cultured proximal tubular epithelial cells (PTEC) and T cells bearing the
      interleukin 2 (IL-2) receptor from biopsies after transplantation. In vitro
      outgrowth of T cells from the biopsy was significantly (P = 0.0014) related to
      histological signs of graft rejection. Of the T cell lines generated from 25
      biopsies, only five lines showed no or low cytotoxicity against donor PTEC. Three
      cell lines were cytotoxic towards donor PTEC, but not against PHA stimulated
      donor splenocytes, suggesting tissue specificity of GIC. Treatment of PTEC with
      interferon (IFN) gamma for 72 hours to upregulate MHC class I and to induce MHC
      class II expression did not necessarily result in an increased susceptibility to
      lysis. However, three PTEC lines displayed an increment of susceptibility to
      lysis after IFN gamma treatment. Analysis of one T cell line from the same graft
      revealed a high percentage of CD4 positive cells, compatible with a class II
      restricted cytotoxicity. This was confirmed by blocking experiments using anti
      CD4, anti-CD8, anti-class I, and anti-class II antibodies. Blocking experiments
      were done with 12 of these 25 lines. Anti-CD3 and anti-CD18 antibodies inhibited
      cytotoxicity in every case, showing that cytotoxicity was T cell
      mediated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468916
TI  - Induction of interleukin-1 during hemodialysis.

PMID- 8468917
TI  - Induction of mRNA for tumor necrosis factor alpha in hemodialysis.

PMID- 8468918
TI  - Influence of hemodialysis on interleukin-6 production and gene expression by
      peripheral blood mononuclear cells.

PMID- 8468919
TI  - Role of platelet activating factor in hemodialysis.
AB  - A complex array of inflammatory mediators are generated as a consequence of blood
      contact with hemodialysis (HD) membranes. Beside complement activation, other
      mediators are involved in cell activation, and are thought possibly to be
      responsible for early and long-term multiple changes in immunity infection,
      hypercatabolism, beta 2-microglobulin generation and hemostatic mechanisms.
      Previous studies from our laboratories have established platelet activating
      factor (PAF) as one of the mediators generated by complement-dependent or
      independent mechanisms of cell interaction with hemodialysis membranes. Recent
      studies on the production of PAF from endotoxin-primed polymorphonuclear
      neutrophils in a closed miniaturized circuit, and on the effect of PAF in
      mediating endotoxin- and cytokine-induced leukocyte adherence to HD membranes,
      highlight so far undescribed new roles of this mediator in biocompatibility.

PMID- 8468920
TI  - Positional cloning approach to the dominant polycystic kidney disease gene, PKD1.
AB  - Positional cloning is a powerful strategy for identifying the site of disease
      producing mutations when the underlying biochemical defect is unknown. The
      approach also offers new methods for the presymptomatic diagnosis of genetic
      disease. Using these methods we have localized the PKD1 gene, mutated in the
      majority of PKD1 families, to a small (500 kb) segment of chromosome 16, band
      p13.3. Virtually all of this interval has been cloned in cosmids and lambda
      bacteriophage. Over 20 sets of non-overlapping cDNA clones have been isolated
      from the region. Sequence and mutational analyses are currently underway. In
      addition, a set of polymorphic clones has been identified for presymptomatic
      diagnosis. Included in this set are several highly variable [CA]n microsatellite
      repeats. These highly informative markers can be rapidly assayed from a small
      amount of genomic DNA using the polymerase chain reaction. Despite these
      advances, presymptomatic diagnosis cannot be established with certainty in many
      families. However, identification of the PKD1 gene itself will eventually allow
      diagnosis by direct detection of mutations.

PMID- 8468921
TI  - Cytokines and mesangial cells.
AB  - Hyperplasia of mesangial cells (MCs) precedes or accompanies progressive
      glomerular scarring, as is seen in chronic glomerulonephritis and diabetic
      glomerulosclerosis. The mechanisms causing in vivo MC proliferation and
      production of extracellular matrix (ECM) are incompletely understood. Cell
      culture studies have demonstrated that MCs produce as well as react to various
      polypeptide cytokines. Thus, MCs have the potential to generate soluble mediators
      which can, in a paracrine fashion, attract and activate inflammatory cells
      (platelets, monocyte-macrophages, granulocytes), for example by IL-6, IL-8, MCP-1
      and GM-CSF, and exert autocrine effects on MCs themselves, such as by promoting
      MC proliferation (by PDGF, IL-1, IL-6) or ECM production (by TGF-beta, IL-1).
      Recent in vitro results have revealed that specific non-soluble ECM components
      (collagen III, IV; laminin) also affect MC behavior with regard to adhesion, cell
      replication, ECM production as well as their response to cytokines. The latter
      effect appears to be mediated by alterations of cytokine receptor expression on
      MCs in the presence of the ECM components. "Cross-talk" between MCs, cytokines,
      ECM and inflammatory cells is likely to be of great importance in the regulation
      of the MC phenotype and may play a prominent role in the initiation and
      progression of glomerular inflammation. First in vivo findings in rats with
      experimental glomerular disease and in kidney biopsies from patients with
      glomerulonephritis have supported this concept by demonstrating abnormal MC
      expression of cytokines, their receptors and ECM proteins. These MC products may
      promote the recruitment and activation of inflammatory cells and perpetuate MC
      proliferation as well as ECM build-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8468922
TI  - Immunogenetic findings in glomerulonephritis.
AB  - In the 19th century, several authors recognized that some renal diseases tend to
      run in families. Alport pointed to the constellation of nephritic urinary
      sediment, hearing loss and progression into renal failure. Today this is
      recognized to result from abnormal basement membrane (BM) collagen synthesis.
      Recently it has been recognized, however, that other forms of glomerulonephritis
      may also run in families. In about 10% of patients with glomerulonephritis one or
      more sibling also suffers from glomerulonephritis. Genetically determined
      derangements of immune regulation may play a role in the genesis of primary
      chronic glomerulonephritis. Potentially associated immunogenetic abnormalities
      include inherited defects of the complement system, increased prevalence of
      certain HLA-types, altered frequencies of polymorphisms in immunoglobulins and
      TCR genes and others. This overview summarizes immunogenetic studies performed in
      patients with glomerulonephritis with special emphasis on patients with mesangial
      IgA GN.

PMID- 8468923
TI  - Effect of cytokines on the cytoskeleton of resident glomerular cells.
AB  - Resident glomerular cells have complex cytoskeletal organizations relevant to
      maintaining functional and structural integrity. The ability of cells to change
      shape, develop coordinate directed movements, replicate and interact with
      contiguous cells or extracellular matrix depends on cytoskeletal functions.
      Several cytokines directly or indirectly change cytoskeletal organization.
      Cytokines may alter cytoskeletal organization in cultured glomerular epithelial
      and mesangial cells and vascular endothelial cells mainly by mechanisms involving
      production of secondary mediators, such as PAF and leukotrienes that stimulate
      cell contraction, or PGE2 and PGI2 that stimulate cell relaxation. Consequent
      assembly and disassembly of microfilaments leads to functional responses of cells
      that may account for the physiopathological changes induced by cytokines in vivo.

PMID- 8468924
TI  - Modulation of renal production of C3 by proinflammatory cytokines.

PMID- 8468925
TI  - Cytokine mRNA expression by cultured rat mesangial cells after contact with
      environmental lectins.
AB  - We previously demonstrated that gliadin, a lectinic component of gluten, induces
      IgA mesangial deposits in orally immunized mice, binds in vitro polymeric IgA and
      cultured rat mesangial cells modulating their arachidonic acid metabolism. We
      investigated the effects of gliadin and other environmental lectins on some
      mesangial cell functions, including synthesis and release of cytokines and lipid
      mediators. Several lectins, particularly gliadin, affected the mRNA expression of
      c-myc and c-fos, two proto-oncogenes involved in the transcriptional enhancement
      of the gene cascade, which are markers of cell growth, differentiation and
      mitosis. Lectins modulated the ability of cultured rat mesangial cells to express
      mRNA for cytokines involved in the inflammation and in the regulation of the
      immune response. TNF-alpha and IL-6 mRNA transcription were enhanced by gliadin
      and other lectins, and TNF release was variably increased. Conversely, IL-1
      production was less affected or slightly depressed. PAF production was not
      detectable while PGE2 was generally reduced and TXB2 enhanced. Gliadin was one of
      the lectins most active on the mesangial cells, and its effects were reversed by
      the addition of N-Acetylglucosamine, a sugar specific for some lectinic bindings,
      suggesting a carbohydrate interaction. The effects of the various lectins were
      distinct and only partially convergent, ruling out an aspecific mesangial cell
      activation. These data suggest that lectins might interfere with mesangial cell
      functions and modify the mesangial cell homeostasis.

PMID- 8468926
TI  - Factors involved in the regulation of mesangial cell proliferation in vitro and
      in vivo.
AB  - One of the central features of many human glomerular diseases is the
      proliferation of the smooth muscle cell-like mesangial cells. While a multitude
      of mitogens for mesangial cells has been proposed on the basis of in vitro
      experiments, the factors involved in the regulation of mesangial cell
      proliferation in vivo remain largely undefined. To investigate the regulation of
      mesangial cell proliferation in vivo we have studied the mesangioproliferative
      glomerulonephritis that is induced by injection of antibody directed against the
      Thy 1.1 antigen on the mesangial cell surface in rats. In this review, we discuss
      the role of three cytokines in the mesangioproliferative response, namely
      platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), and
      transforming growth factor-beta (TGF-beta). All three cytokines are present in
      various inflammatory cells as well as in mesangial cells themselves, thereby
      allowing these factors to exert both paracrine and autocrine regulatory functions
      on mesangial cells. In vivo studies show that PDGF, bFGF and TGF-beta participate
      in either the mesangial cell proliferation or the mesangial matrix expansion that
      follows mesangial cell injury with anti-Thy 1.1 antibody. Based on currently
      available data we propose that bFGF may participate in the initiation, PDGF in
      the maintenance, and TGF-beta in the resolution of mesangial cell proliferation
      in vivo. Further analysis of the mitogens operative in vivo may ultimately result
      in the design of new therapeutic strategies to treat progressive glomerular
      mesangioproliferative diseases.

PMID- 8468927
TI  - Studies by competitive PCR of glomerulosclerosis in growth hormone transgenic
      mice.
AB  - We have shown that the glomerulosclerotic lesions of mice transgenic for bovine
      growth hormone (bGH mice) consisted of a change in the phenotype of glomerular
      collagens and an elevation of the mRNAs for these collagens in whole kidney. The
      purpose of this study was to determine whether these phenotypic and quantitative
      changes were present in the glomeruli. We used the increased sensitivity afforded
      by reverse transcription followed by the polymerase chain reaction (RT-PCR) to
      detect type I collagen mRNA and a quantitative PCR assay to quantitate type IV
      collagen mRNA in microdissected glomeruli. There was a six- to eightfold increase
      in alpha 1IV collagen mRNA in the glomeruli of bGh mice. alpha 1(I) collagen mRNA
      was present in glomeruli of bGH mice, which is consistent with our previous
      findings that the sclerotic mesangium contained type I collagen peptides by
      immunofluorescence microscopy. Normal glomeruli did not contain detectable
      amounts of alpha 1I collagen mRNA. In summary, we found a phenotypic change in
      glomeruli of mice transgenic for bGH consisting of increased type IV collagen
      mRNA levels and the appearance of type I collagen mRNA. Thus, the development of
      glomerulosclerosis appeared to be at least partially regulated at a
      pretranslational level.

PMID- 8468928
TI  - Cytokines, mesangial cell activation and glomerular injury.

PMID- 8468929
TI  - Role of interleukin-6 in the progression of mesangial proliferative
      glomerulonephritis.
AB  - Mesangial proliferative glomerulonephritis (mesPGN) is histologically
      characterized by proliferation of mesangial cells (MC), suggesting the
      involvement of a growth factor for MC in the pathogenesis of mesPGN. We have
      previously shown that interleukin-6 (IL-6) induces proliferation of cultured rat
      mesangial cells, and urine samples from patients with IgA nephropathy contain
      high level of IL-6 activity. We have also demonstrated that transgenic mice
      carrying a human IL-6 genomic gene showed severe mesangial proliferation and
      matrix enlargement. Urinary samples of patients with lupus nephritis as well as
      IgA nephropathy contain significant IL-6 activity. Over a ten month follow-up, a
      positive correlation between the urinary IL-6 and pathological score was
      observed. Hence, measurement of urinary IL-6 can be used as a good indicator for
      monitoring IgA nephropathy and lupus nephritis. Using RT-PCR methods, IL-6 mRNA
      was detected in the glomeruli of renal biopsy specimens obtained from patients
      with IgA nephropathy and lupus nephritis.

PMID- 8468930
TI  - Role of endothelin in glomerular injury.

PMID- 8468931
TI  - The intercrine superfamily and renal disease.

PMID- 8468932
TI  - Platelet-derived growth factor and proliferative glomerulonephritis.

PMID- 8468933
TI  - MHC gene polymorphism in primary IgA nephropathy.

PMID- 8468934
TI  - Glomerulosclerosis in mice transgenic for native or mutated bovine growth hormone
      gene.
AB  - Mice transgenic for bovine growth hormone (bGH) develop an increase in body
      weight and glomerular lesions characterized by a disproportionate increment in
      glomerular volume and progressive mesangial sclerosis. The relationship between
      glomerular size and body growth in bGH mice was further investigated by examining
      mice transgenic for a mutated GH gene (bGH-m11) which failed to enhance body
      growth. The glomeruli in bGH-m11 mice exhibited an increase in size and
      glomerulosclerosis comparable to those found in bGH mice. The levels of alpha 1
      type IV collagen mRNA, as measured by the competitive polymerase chain reaction
      in isolated microdissected glomeruli, were markedly elevated in mice transgenic
      for both bGH and bGH-m11 genes. These data suggest that body growth on one hand,
      and glomerular hypertrophy and sclerosis on the other hand, are mediated by
      different portions of GH or different second messenger signaling systems.

PMID- 8468935
TI  - Expression of 5-lipoxygenase and 5-lipoxygenase activation protein in
      glomerulonephritis.
AB  - The gene transcription of 5-lipoxygenase (5-LO) and 5-lipoxygenase-activating
      protein (FLAP) in renal tissue of patients with IgA nephropathy and mesangial
      proliferative glomerulonephritis were analyzed by amplification of reverse
      transcribed mRNA with polymerase chain reaction (PCR). The level of expression
      was determined by analysis of the PCR products of 5-LO, FLAP, and beta-actin.
      Forty percent of the patients expressed both 5-LO and FLAP. Relative to beta
      actin, FLAP expression (0.42 +/- 0.21) was higher than 5-LO (0.14 +/- 0.10).
      Comparison of clinical data showed that patients who expressed 5-LO and FLAP had
      a lower glomerular filtration rate and an increased level of blood urea nitrogen,
      serum creatinine, and proteinuria. The results suggest arachidonic acid
      metabolism by inflammatory cells in renal tissue may play an important role in
      human glomerulonephritis.

PMID- 8468936
TI  - [The nursing concept in a psychiatric hospital department].

PMID- 8468937
TI  - [Recognizing and supporting abilities].

PMID- 8468938
TI  - [Aggression-promoting structures. How can one counter them?].

PMID- 8468939
TI  - [Elke Felgner, psychiatric nurse].

PMID- 8468940
TI  - [Typically female. Nursing in the 19th century].

PMID- 8468941
TI  - [Shift work and nurses' health].

PMID- 8468942
TI  - [Working times for better quality of work and life].

PMID- 8468943
TI  - [Health establishments in Scandinavia. Report from a study trip by the 1991/92
      nursing seminar of the Bavarian county nursing association].

PMID- 8468944
TI  - [Juridic problems during training. Report from a student seminar].

PMID- 8468945
TI  - [The transfer visit].

PMID- 8468946
TI  - [Pediatric nurse in a boarding school for disabled children].

PMID- 8468947
TI  - [Difficult search for employment. Unemployed nurses].

PMID- 8468948
TI  - [Temporary firms. Position of Parmed Ltd. Legislative conditions basically
      improved].

PMID- 8468949
TI  - [Research and communication: a path to follow].

PMID- 8468950
TI  - [Genetic exploits under the magnifying lens. Predictive medicine: what are the
      stakes?].

PMID- 8468951
TI  - [Early diagnosis. The right to know ... or to ignore].

PMID- 8468952
TI  - [Ethical questions in neonatology. Indispensable: the spirit of discussion].

PMID- 8468953
TI  - [North-South solidarity. Listen to the women].

PMID- 8468954
TI  - [Attention, polluters!].

PMID- 8468956
TI  - [Sudden infant death--a report. "... and did not wake up again"].

PMID- 8468955
TI  - [Transitory dispositions of the CRS. Should they be abolished without an
      alternative?].

PMID- 8468957
TI  - [Discharge planning for new mothers. At home everything is different].

PMID- 8468958
TI  - [A professional trip through Israel. Good health care--self-assured nurses].

PMID- 8468959
TI  - [Execution of the new educational rules: first a position statement].

PMID- 8468960
TI  - [Illness experienced on one's own skin. When the nurse becomes a patient].

PMID- 8468961
TI  - Buyers' guide 1993.

PMID- 8468962
TI  - Liver transplantation in South Carolina.

PMID- 8468963
TI  - Acute renal failure: pathology and prevention.

PMID- 8468964
TI  - Anterior cervical diskectomy and fusion in a community hospital setting.

PMID- 8468965
TI  - Rebuilding a hospital in a developing country.
AB  - The volunteer group had a successful trip overall. The local medical facility
      underwent substantial physical improvements. Sanitation in a limited area was
      augmented. There was a significant measure of "good will" benefit from the
      standpoint of an American venture into a developing nation. The National Guard
      units involved received enhanced training and improved their abilities to deploy.
      On a personal note, those of us who were given the opportunity to travel to and
      work in such an austere location gained a sincere appreciation for the genuine
      blessings of American standards of living.

PMID- 8468966
TI  - "The great American fraud".

PMID- 8468967
TI  - Health education: state of the art.

PMID- 8468968
TI  - Accomplishments in comprehensive school health education.

PMID- 8468969
TI  - Comprehensive school health education: barriers and opportunities.

PMID- 8468970
TI  - Today's education policy environment.

PMID- 8468971
TI  - Health policy reform and comprehensive school health education: the need for an
      effective partnership.
AB  - This article offers a framework for considering how health care reform issues
      will impact the success of any national movement to implement Comprehensive
      School Health Education and the potential role that CSHE proponents can play in
      advocating reforms congruent with CSHE goals. The effectiveness of the CSHE
      movement within this arena will depend largely on its ability to critically self
      diagnose its potential contributions to short-term and long-term positive health
      outcomes, and on its ability to join forces in ensuring that a variety of health,
      educational, and social services are made available in nontraditional sites-
      particularly schools--that are able to reach children and their families. An
      important step will be to expand the availability of Comprehensive School Health
      Education throughout the country: only one-half of all states currently mandate
      Comprehensive School Health Education programs, and implementation is spotty in
      some of these states. Another boost for the potential role of CSHE proponents can
      be found in the Year 2000 health objectives, of which more than one-third of 300
      objectives geared to promoting health and disease prevention are devoted to the
      health behavior of school-age children and youth. Many of these objectives can be
      achieved directly or indirectly in schools, contingent upon appropriate financing
      and the establishment of CSHE goals as priorities at the policymaking level. An
      important factor will be the ability of the CSHE movement to provide its programs
      in the most cost-effective and cost-efficient manner, possibly including
      redeployment of staff and relocating resources as needed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8468972
TI  - Postoperative outcome following thoracotomy in the pediatric oncology patient
      with diminished pulmonary function.
AB  - Surgical resection of pulmonary metastatic disease is often indicated in
      pediatric malignancies. Although several adult studies document increased
      postoperative morbidity in adults with diminished pulmonary function, there is
      little information in the pediatric population or in patients with restrictive
      lung disease. We reviewed the postoperative course following thoracotomy in
      patients with diminished pulmonary function (FVC, FEV1, or TLC less than 80%
      predicted). Thirty-two thoracotomies were performed in 19 patients. The
      preoperative FVC (% predicted) was 68 +/- 3.6 with a postoperative value of 60 +/
      2.4 (P < 0.01). The preoperative FEV1 was 69 +/- 4.2 with a postoperative value
      of 60 +/- 3.8 (P < 0.01). Although there was a significant drop in pulmonary
      function tests (PFTs) following surgery, there was not a significantly greater
      loss when comparing patients with mild, moderate, and severe disease. When
      considering postoperative morbidity, there were 3 events (prolonged oxygen
      requirement, need for postoperative ventilation, or persistent air leak)
      following 20 surgeries in patients with mild preoperative respiratory
      dysfunction, 5 events (including one death) in the 7 patients with moderate
      dysfunction, and 3 events following 5 surgeries in patients with severe
      dysfunction. There was no correlation with a decrease in any specific PFT and the
      occurrence of postoperative morbidity. Our limited review suggests that
      aggressive surgical treatment of metastatic pulmonary disease is tolerated even
      in patients with severe decreases in pulmonary function.

PMID- 8468973
TI  - Alteration of the systemic antitumor activity of melphalan by sodium cyanate in
      MOPC-460D myeloma-bearing BALB/c mice.
AB  - Sodium cyanate is a selective inhibitor of protein synthesis in a variety of
      mammalian tumor cells without a corresponding effect on normal tissue of the
      tumor-bearing animals. In the present study, we investigated the potential role
      of sodium cyanate in the augmentation of the antitumor activity of melphalan in
      MOPC-460D myeloma-bearing BALB/c mice. The simultaneous intraperitoneal injection
      of sodium cyanate, 250 mg/kg, and melphalan, 12 mg/kg, followed by another dose
      of sodium cyanate, 200 mg/kg, administered 18 hours later, resulted in a tumor
      growth inhibition index (TGII) of 207%. In contrast, melphalan or sodium cyanate
      administered separately at the same dose induced a TGII of 133% and 15%,
      respectively, when compared to control animals. Furthermore, a direct comparison
      of the volume of tumor implants in mice treated with the combination of sodium
      cyanate and melphalan vs. those treated with melphalan alone showed a
      statistically significant growth inhibition in favor of the sodium cyanate and
      melphalan combination on days 35, 39, and 42 from initiation of treatment. The
      data presented here suggest that the antitumor activity of melphalan could be
      increased, with moderate toxicity, by the concomitant intraperitoneal
      administration of sodium cyanate in BALB/c mice bearing measurable subcutaneous
      MOPC-460D tumor transplants. This is the first report of an increase in melphalan
      antitumor activity by sodium cyanate at a tumor location distant from the site of
      injection.

PMID- 8468974
TI  - Dependence of the thymidylate synthase inhibition rate on the interval after the
      last administration of tegafur in sigmoid colon cancer patients.
AB  - The thymidylate synthase (TS) inhibition rate was measured after tegafur (FT)
      administration (1.5 g/day, at least 10 days) in 7 sigmoid colon cancer patients.
      The TS inhibition rate decreased as the interval between the time of the last
      administration and the time of the tumor resection increased longer. This study
      provides basic data for considering methods of drug administration and assessment
      of modification, for example, by leucovorin.

PMID- 8468975
TI  - Relationship between age and the time of surgery and prognosis after gastrectomy
      for gastric cancer.
AB  - We did a retrospective study to assess the influence of age on the prognosis in
      1,537 patients with gastric cancer and who underwent gastrectomy. The patients
      were classified into 7 groups by age at the time of surgery, and the relative
      survival rates were calculated after correcting for each patient's sex, age, and
      the operative calendar year, based on the life table data for the general
      Japanese population. The overall prognoses in patients under age 30 and over age
      80 years were poor (for ages under 30 years, 30-39, 40-49, 50-59, 60-69, 70-79,
      and over 80 years, the 5-year survival rates were 32.1%, 55.9%, 54.8%, 54.3%,
      48.6%, 50.8%, and 31.5%, respectively). The poor prognoses in the youngest
      patients could be attributed to a high frequency of aggressive stage of the
      tumor. After curative gastrectomy, although the prognoses were excellent for
      every category in the first and second postoperative year, patients over age 80
      years had a relatively poor prognosis after the third postoperative check-up. The
      poor prognoses in the oldest patients were attributed to the number of deaths due
      to other diseases. We conclude that for the very young or old subjects, age is a
      significant prognostic factor for those treated by gastrectomy for gastric
      cancer.

PMID- 8468976
TI  - Primary osteosarcoma of the breast.

PMID- 8468977
TI  - Colorimetric chemosensitivity testing using sulforhodamine B.
AB  - A colorimetric chemosensitivity test was investigated using sulforhodamine B
      (SRB), which stains protein synthesized by cells, as an end-point marker. Four
      cultured cell lines, 9 human tumor xenografts serially transplanted into nude
      mice, and 14 fresh surgical specimens were subjected to this assay. The optimal
      conditions for the assay were 3-5 x 10(4) cells per well in a 96-microplate, an
      SRB concentration of 4%, and an incubation time of more than 10 minutes. When
      mitomycin C, doxorubicin, cisplatin, and 5-fluorouracil were assessed by the SRB
      assay, the concentration-effect curves revealed a sharp slope between plateaux at
      low and high concentrations, suggesting that this assay has an excellent
      sensitivity which can assess the effect of drugs as "all or none." Although this
      high sensitivity resulted in good reproducibility of the assay for cultured cell
      lines, the predictive rate of the SRB assay for the chemosensitivity of human
      tumor xenografts in vivo was limited to 63.9%. As a result, this SRB assay is
      thought to be useful for evaluating the chemosensitivity of cultured cells as all
      or none, since it can assess directly cellular protein synthesis, which is one of
      the most important parameters of cell renewal, with excellent sensitivity.

PMID- 8468978
TI  - Experimental cancer chemotherapy using a liver metastatic model of human colon
      cancer transplanted into the spleen of severe combined immunodeficient mice.
AB  - We have developed a liver metastatic model of human colon cancer using severe
      combined immunodeficient (SCID) mice. Liver metastases were observed in all the
      SCID mice on day 28 after intrasplenic injection with 5 x 10(6) dissociated tumor
      cells of COL-2-JCK, a human colon cancer strain serially transplanted in nude
      mice. When this model was applied for chemotherapeutic experiments, 5
      fluorouracil (5-FU) demonstrated significant antitumor effects in preventing
      liver metastases, whereas the efficacy of 5-FU was limited in the currently used
      sc-ip chemosensitivity assay in nude mice. When the human LDH-5 isozyme was
      evaluated in the homogenized metastatic liver tissue of SCID mice, a good
      correlation was obtained between the liver tumor weights and LDH-5 isozyme,
      suggesting that it could be a promising quantitative indicator for metastases.
      This model would be useful for further studies on the treatment of liver
      metastases of colon cancer.

PMID- 8468979
TI  - Heterogeneity in early and advanced gastric carcinomas by flow cytometric DNA
      analysis.
AB  - We investigated 230 systematically sampled fresh specimens from 12 early and 26
      advanced gastric cancer patients by DNA flow cytometry for heterogeneity in DNA
      content. Fifty-eight percent of the 12 early gastric cancers were uniformly
      diploid and 42% were uniformly aneuploid. Fifty-four percent of advanced cancers
      were uniformly diploid in superficial layers and 42% were uniformly diploid in
      deep layers, whereas 46% were uniformly aneuploid in superficial layers, and 50%
      were uniformly aneuploid and 8% were heterogeneously aneuploid and diploid in
      deep layers. Both diploid and aneuploid samples were obtained from 15% for
      advanced cancers, but ploidy heterogeneity did not occur in early cancers.
      Heterogeneity for DNA index (more than one aneuploid DNA index) occurred in 46%
      of whole thickness of advanced cancers, in 19% of superficial layers of advanced
      cancers, and in 8% of early cancers. We concluded that DNA ploidy determination
      using superficial layer specimens may be reliable in early gastric cancer but
      must be interpreted with care in advanced cancer.

PMID- 8468980
TI  - Prognostic significance of tumor-host interaction in clinical gastric cancer:
      relationship between DNA ploidy and dendritic cell infiltration.
AB  - DNA ploidy of tumor cells and the degree of infiltration of dendritic cells were
      determined in 93 gastric cancer tissue specimens, and the mechanisms of tumor
      host interaction on the prognosis were investigated. DNA ploidy patterns were
      grouped into low and high ploidy, and the degree of infiltration of dendritic
      cells (DC) was graded into marked and slight infiltration. In the low ploidy
      group, the 5-year survival rates in patients with marked and slight DC
      infiltration were 80.7% and 61.5%, respectively (P < 0.05). In the high ploidy
      group, however, there were no significant differences. In cases of low ploidy,
      the incidence of lymph node metastasis was significantly lower in the marked DC
      infiltration group compared with findings in the slight DC group. Thus, markedly
      infiltrating dendritic cells in gastric cancer tissue may lead to prolongation of
      survival time for patients with a carcinoma of the low ploidy profile, by
      preventing widespread nodal involvement.

PMID- 8468981
TI  - Breast conservation versus mastectomy: patient preferences in a community
      practice in Kentucky.
AB  - Recent studies have indicated a relatively low rate of breast-sparing surgery for
      carcinoma in the Southeastern United States. From 1987 through 1991, 289 patients
      from Eastern and Central Kentucky with breast carcinoma were treated by the
      authors. Despite being fully informed of treatment options of breast cancer, 82%
      of patients with stage II disease or less and no medical contraindications to
      breast conservation preferred mastectomy. Overall, 10% of patients underwent
      breast-sparing surgery, although this figure had risen to 20% by 1991. The most
      frequent reasons for preference of mastectomy were fear and inconvenience of
      radiotherapy and a perception that survival would be diminished if mastectomy was
      not done.

PMID- 8468982
TI  - Oncocytic tumors of salivary gland type: a study with emphasis on nuclear DNA
      ploidy.
AB  - We studied nine cases of oncocytic tumors of salivary gland type in order to
      evaluate their clinico-pathologic profiles and nuclear DNA patterns as criteria
      for the differential diagnosis between benign and malignant forms. The tumors
      were located at the parotid gland, palate, and orbit. The age of the patients
      ranged between 35 and 85 years and the sex ratio (F:M) was 1:0.8. Seven tumors
      were capsulated and had typical cytology: they were composed of polyhedrical
      cells with large, eosinophilic, and granular cytoplasm and dark nucleus. The
      remaining two tumors exhibited malignancy criteria for the oncocytic tumors:
      atypia, pleomorphism, and mitosis. The evaluation of the nuclear DNA content was
      also distinct: benign tumors had a DNA diploid pattern and the malignant
      neoplasms displayed a DNA aneuploid pattern. These observations point to DNA
      nuclear assessment as an additional criterion to discriminate neoplasms with
      divergent clinical behavior and prognosis.

PMID- 8468983
TI  - Preoperative radiation, surgical margins, and local control of extremity sarcomas
      of soft tissues.
AB  - The relationship between status of the surgical margin and local control of soft
      tissue sarcoma of the extremities by preoperative radiation therapy has been
      assessed in 132 consecutive patients from 1974 to 1988. The 5-year actuarial
      local control rate was 94% for all patients; the rates were 97% and 82% for the
      104 tumors with negative margins and the 28 tumors with positive margins,
      respectively. The local control rate was independent of the extent of the
      negative margin. For primary sarcomas, the local control rates were 96%, 97%, and
      100%, respectively, for margins that were negative at < or = 1 mm or > 1 mm, or
      the specimens were negative for tumor; for positive margins the result was 83%.
      The overall local control rate was lower (not significant) for recurrent than for
      primary sarcomas: 88% vs. 94%. On the other hand, when stratifying by margin
      status, no difference was observed in local control results, i.e.: (1) 97% and
      91% for primary and recurrent tumors with negative margins, respectively, and (2)
      83% and 80% for primary and recurrent tumors with positive margins, respectively.
      Local control was not significantly higher in those patients who were treated by
      surgical resection (S), radiation (RT), and re-excision of the previous tumor bed
      than in those whose radiation therapy was started after the biopsy and followed
      by one surgical resection. For primary sarcomas that were resected with negative
      margins the results were: 100% of 15 patients treated by S-RT-S and 96% of 75
      patients treated by RT-S.

PMID- 8468985
TI  - A simple technique for packing the bowel during pelvic operations.

PMID- 8468984
TI  - Staging of carcinoma of the esophagus and cardia: a comparison of different
      staging criteria.
AB  - The third edition [1988] of the Manual for Staging of Cancer of the American
      Joint Committee on Cancer (AJCC) was developed to permit finer discrimination
      between stages than was true of the previous edition [1983]. This study was
      designed to determine whether or not this goal was achieved. Pathologic staging
      of the specimens removed from 265 patients with carcinoma of the esophagus or
      cardia undergoing esophagogastrectomy between 1970 and 1988 was performed
      according to criteria published in the second and third editions and their
      survival data compared. The new staging criteria of the AJCC provides no better
      discrimination of stages according to survival than was true of the earlier
      version, the 5-year survival of stage IIA patients being similar to that of stage
      I patients (37.5 +/- 6.7% vs. 50.8 +/- 17.7%), and the survival of stage IIB
      patients being similar to that of stage III patients (16.2 +/- 8.1% vs. 13.6 +/-
      3.7%). However, depth of wall penetration and extent of lymph node involvement
      were reliable independent predictors of survival. We propose a modified version
      of the Skinner WNM staging plan that provides a modest increase in staging
      fragmentation.

PMID- 8468986
TI  - Preliminary experience with a modified Tenckhoff catheter for intraperitoneal
      chemotherapy.
AB  - This study reports our preliminary experience with a modified Tenckhoff catheter
      for intraperitoneal chemotherapy, primarily designed to be larger, longer, and
      have more perfusion holes. There were 137 catheters implanted in 125 ovarian
      cancer patients from June 1988 to December 1990, among which 116 were actually
      used for intraperitoneal chemotherapy. A total of 559 cycles of intraperitoneal
      chemotherapy was given with a range of 1 to 16 uses per catheter. There were
      seven infections (6.0%), four inflow obstructions (3.4%), three bowel
      perforations (2.6%), and one leakage (0.8%). Among patients with catheter
      infection, three had delayed bowel perforation. Although the incidence of inflow
      obstruction was reduced from 5.5 to 3.4%, the improvement did not reach
      statistical significance. The frequency of delayed bowel perforation and
      infection were similar to the literature experience of other catheters. An unused
      catheter should be removed to avoid this serious complication. Further study is
      needed to evaluate fully the performance of this catheter system.

PMID- 8468987
TI  - Selective use of drains in thyroid surgery.
AB  - In the past, it was generally advised that every patient undergoing thyroid
      surgery have a drain placed because of the fear of post-operative hematoma. In
      the past 9 years, we have performed 400 thyroidectomies. For the first 6 years,
      we drained the operative site in most of thyroid procedures. However, it was
      apparent from our experience that drains had very little effect on the prevention
      of post-operative hematoma or of seroma. As a matter of fact, all four patients
      who required re-exploration in our initial series had drains in place. As a
      result of this experience over the past 3 years, during which time we have
      performed 150 thyroidectomies, we have used drains selectively. The indications
      for draining the thyroid bed have been the presence of a large dead space,
      operation for a large substernal goiter, and subtotal thyroidectomy for either
      large, multinodular goiter or for Graves' disease. Thus, among 150 recent
      thyroidectomies, we have drained only 35, and avoided drains in 115 patients.
      Though this is not a prospective study, we found no difference in the overall
      outcome whether drains were employed or not. Most patients who had no drains were
      ready for discharge within 24-48 hours of surgery. Since it may be difficult to
      perform a randomized prospective trial examining the use of drains in thyroid
      surgery, we propose that drains should be utilized only selectively for thyroid
      surgery.

PMID- 8468988
TI  - Preoperative duplex venous imaging in the assessment of patients with venous
      access.
AB  - Occult or clinically apparent central venous thrombosis frequently complicates
      central venous catheter placement in patients requiring long-term vascular
      access. Thirty-three patients, aged 12-83 years, underwent duplex scanning of the
      internal jugular, axillary, and brachial veins prior to placement of long-term
      venous access catheters. Twenty-seven patients underwent duplex scanning because
      of a prior history of either long-term or short-term central venous access. Of 12
      patients with a history of long-term central venous access, without
      complications, 42% (5/12) had an abnormal duplex scan demonstrating thrombosis.
      Duplex scans on 15 patients having complications associated with central venous
      access demonstrated thrombosis of one or more of the central veins, 46% (7/15).
      Five patients who underwent duplex scanning without a history of a previous
      central venous catheter or other indication were found to have normal central
      veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the
      surgeon was directed to successful venous access in all cases. Normal findings
      were very helpful in confirming that the venous system was normal in selected
      patients. In approximately 40% of patients with a history of venous access,
      catheters were found to have evidence of thrombosis of one or more of the central
      veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the
      surgeon was directed to a successful site for venous access in all cases.

PMID- 8468989
TI  - Adjuvant regional isolated perfusion with melphalan for patients with Clark V
      melanoma of the extremities.
AB  - From 1978 to 1990, 32 patients with Clark V melanoma were treated by wide
      excision of the primary and adjuvant regional isolated perfusion with melphalan.
      M.D. Anderson stage of disease was stage I in 22 and stage IIIb in 10 patients.
      Five-year survival rates were 58% and 27%, respectively. Seven patients developed
      a recurrence in the perfused limb [stage I, 2, stage IIIb, 5 patients (P =
      0.03)], and 4 of 17 patients developed regional lymph node metastases. Of the
      well-known prognostic variables, only ulceration of the primary tumor
      significantly influenced survival (P = 0.03). We did not see any improvement in
      survival rates compared with literature data on nonperfused patients. In the
      absence of data on locoregional recurrence rates in nonperfused Clark V melanoma
      patients, we cannot say whether adjuvant perfusion diminished this risk.
      Therefore, the results of the prospective randomized EORTC/WHO trial in primary
      high-risk extremity melanoma have to be awaited.

PMID- 8468990
TI  - Intraperitoneal cisplatin with sodium thiosulfate protection in rats with
      intestinal anastomoses.
AB  - Intraperitoneal (IP) cisplatin administered at the time of intraabdominal
      malignancies such as gastric cancer may prevent or delay intraabdominal
      recurrence. Perioperative IP cisplatin raises concerns regarding systemic
      toxicity and retardation of wound healing. Systemic cisplatin toxicity may be
      reduced by administering its antidote, sodium thiosulfate (STS). A preclinical
      study of IP cisplatin in rats undergoing a small intestinal anastomosis was
      carried out. All animals that had received only cisplatin died in the
      postoperative period as a consequence of cisplatin toxicity. Tensile strength of
      the intestinal anastomoses was determined on the tenth postoperative day in the
      surviving animals. Animals that had received intravenous (IV) cisplatin with STS
      had significantly lower tensile strengths than both those receiving IP cisplatin
      with STS and STS alone. This study demonstrates the safety of perioperative
      cisplatin with STS protection by the avoidance of systemic toxicity and
      minimizing the cisplatin-related retardation of wound healing.

PMID- 8468991
TI  - Complete disappearance of a leiomyosarcoma of the lower extremity following
      preoperative hyperthermia and intra-arterial doxorubicin.
AB  - Leiomyosarcoma of the extremities is an unusual tumor. Herein we report a unique
      and what we believe is the first case of a patient in whom there was complete
      disappearance of such a tumor following regional hyperthermia and chemotherapy.

PMID- 8468992
TI  - Superior function of a bicuspid over a monocuspid patch for reconstruction of a
      hypoplastic pulmonary root in pigs.
AB  - In an experimental study in pigs, the function of monocuspid and bicuspid patches
      was compared to improve surgical reconstruction of a hypoplastic pulmonary root.
      Segments from glutaraldehyde-treated porcine aortic roots served as monocuspid
      and bicuspid patches. Their leaflets and commissures were marked with radiopaque
      metal clips. Marker movements were recorded at 100 frames/sec. Quantification of
      pulmonary insufficiency, right ventricular stroke volume, as well as pressures in
      the right ventricle, pulmonary artery, and aorta was performed before and after
      patch plasty. The cyclic motion of the leaflets showed a three-phase pattern in
      monocuspid and bicuspid patches: (1) a rapid opening motion with a significantly
      longer distance to be covered in monocuspid patches (7.5 mm in monocuspid versus
      4.9 mm in bicuspid patches); (2) a slow closing motion that was significantly
      greater in monocuspid patches (31.5% of maximal displacement in monocuspid versus
      18.2% and 23.8% in bicuspid patches); (3) a similar rapid closure motion in both
      types of patches. The commissural expansion was less than 6% for monocuspid and
      bicuspid patches and began 10 to 20 msec before valve opening. Considerable
      irregularities in the movement of the different leaflet markers, especially in
      monocuspid patches, indicated leaflet buckling as a result of redundant leaflet
      tissue. There was a significant pulmonary regurgitant fraction only in monocuspid
      patches (19% in monocuspid versus 7% in bicuspid patches) that occurred during
      early diastole. No pressure gradients were observed across either type of patch.
      In monocuspid patches, a greater leaflet displacement during rapid closure was
      correlated with an increased pulmonary insufficiency (r = 0.8875). In conclusion,
      the function of a bicuspid patch is superior to that of a monocuspid patch for
      repair of a hypoplastic pulmonary root and allows the construction of a competent
      and stenosis-free valve mechanism.

PMID- 8468993
TI  - Intraventricular repair for Taussig-Bing anomaly.
AB  - Among 41 patients with Taussig-Bing anomaly who underwent intracardiac repair, 10
      patients were treated by intraventricular rerouting repair. The ages at operation
      ranged form 1 month to 8 years (average 2 years 3 months). Primary repair was
      done in four (average age 2 years 7 months), and repair was done after pulmonary
      artery banding in six patients (average age 2 years 2 months). The relationship
      of the great arteries was side by side in nine patients and oblique in one. After
      extensive resection of the infundibular septum, a distance of 8 to 18 mm from the
      tricuspid ring or chordae to the pulmonary valve was obtained (24% to 71% of
      total circumference for the subaortic route). The subaortic route was created to
      obtain an internal diameter at least equal to that of the aortic route. Tricuspid
      chordal or papillary muscle reattachment was performed in two patients. There
      were no early or late deaths. Follow-up ranged from 1 year 4 months to 22 years 3
      months (average 5 years 8 months), and reoperation was required in one patient
      for residual pulmonary stenosis. The intraoperative pressure gradient between the
      left ventricle and aorta was 0 to 24 mm Hg (average 10.3 mm Hg), and
      postoperative study showed the gradients to be less than 19 mm Hg (n = 8). The
      age at operation, left ventricular-aortic pressure gradient, and postoperative
      tricuspid regurgitation were not significantly affected by the presence of severe
      hypertrophy of the infundibular septum (n = 4). These results indicate that
      intraventricular rerouting may be feasible in most patients who have the Taussig
      Bing anomaly with side-by-side or similar relationships of the great arteries,
      and the age and conal anatomic variations do not appear to be significant
      limiting factors.

PMID- 8468994
TI  - A computer simulation of the plasma leakage through a vascular prosthesis made of
      expanded polytetrafluoroethylene.
AB  - We explored the blood-retaining mechanism of a vascular prosthesis made of
      expanded polytetrafluoroethylene through analysis of its structure and
      physicochemical properties. Plasma leakage through this vascular prosthesis was
      simulated by computer to explore its etiology. These examinations disclosed that
      leakage is dependent upon the inner pressure and the density of fibers. In other
      words, the study revealed that the mean distance between fibers constituting the
      wall of the expanded polytetrafluoroethylene vascular prosthesis is increased by
      tension (that is, inner pressure), resulting in an increased probability of
      leakage. It was additionally found that a thin membrane is formed on the
      polytetrafluoroethylene surface if blood in contact with the surface is dried.
      This membrane was found to reduce the water-repelling property of
      polytetrafluoroethylene and to make it impossible to preserve the inter-fiber
      liquid surface, thus causing leakage through the expanded polytetrafluoroethylene
      vascular prosthesis.

PMID- 8468995
TI  - The effect of coronary reoperation on the survival of patients with stenoses in
      saphenous vein bypass grafts to coronary arteries.
AB  - Does coronary artery reoperation improve the survival of patients with stenoses
      in saphenous vein bypass grafts to coronary arteries? To examine this question,
      we retrospectively reviewed 1117 patients who had coronary bypass grafting and
      then underwent a postoperative coronary angiogram that showed a stenosis (> or =
      20%) of at least one vein graft. Reoperation within 1 month of the postoperative
      angiogram was performed for 394 patients (REOP group) whereas 723 patients (MED
      group) received initial medical treatment (no reoperation or percutaneous
      transluminal coronary angioplasty within 1 year). Compared with the MED group,
      patients in the REOP group were older, more symptomatic, more likely to have left
      main stenosis, and had fewer patent bypass grafts (all p < 0.001). In-hospital
      mortality for the REOP group was 4.3%. Mean postangiogram follow-up of the entire
      group was 73 months. On the basis of the interval between the primary operation
      and the postoperative angiogram, patients were designated as having early (< 5
      years) or late (> or = 5 years) saphenous vein graft stenosis. Univariate and
      multivariate analyses were used to identify factors influencing the survival of
      these subgroups. Reoperation was not identified as a variable improving the
      survival of patients with early vein graft stenoses. For patients with late vein
      graft stenoses, moderate or severe impairment of left ventricular function (p <
      0.0001), advanced age (p < 0.0001), triple-vessel or left main stenosis (p =
      0.0011), and stenosis in a vein graft to the left anterior descending artery (p =
      0.0019) decreased survival, whereas reoperation improved survival (p = 0.0007).
      The improvement in survival with reoperation was particularly strong for patients
      with a stenotic vein graft to the left anterior descending artery. For that
      subset, survival was 84% and 74% for the REOP group versus 76% and 53% for the
      MED group at 2 and 4 years after catheterization, respectively (p = 0.004). For
      patients with stenotic vein grafts to the right coronary artery or circumflex
      coronary artery (or both), survival was 92% and 87% for the REOP group versus 89%
      and 78% for the MED group at 2 and 4 years after catheterization, respectively (p
      = 0.13). Even for patients with class I or II symptoms, reoperation prolonged
      survival (p = 0.002 with multivariate testing). Reoperation improves the survival
      of patients with late vein graft stenoses, particularly those with stenotic
      grafts to the left anterior descending coronary artery.

PMID- 8468996
TI  - Left ventricular function in experimental mitral regurgitation with intact
      chordae tendineae.
AB  - Left ventricular function in mitral regurgitation has typically been studied in
      models that either sever the chordae tendineae or create a ventriculoatrial
      shunt. These methods may have adverse effects on left ventricular function
      independent of the regurgitant lesion. An animal model of chronic mitral
      regurgitation was therefore developed that both preserves annuloventricular
      continuity and avoids the use of external shunts. A circular 0.16 to 0.24 mm/kg
      defect was created in the anterior mitral valve leaflet of weanling sheep under
      direct vision with the aid of cardiopulmonary bypass. Six animals were studied
      preoperatively and immediately postoperatively (acute regurgitation group), and
      20 animals were studied 8.1 +/- 0.2 (mean +/- one standard deviation) months
      postoperatively (chronic regurgitation group). Animals with chronic mitral
      regurgitation were compared with an age- and weight-matched control group that
      was not operated on (n = 7). Volumetric data and ejection fraction were derived
      from digitalized cineangiographic images. Maximal elastance was calculated from
      pressure-volume loops obtained from the simultaneous recording of left
      ventricular pressure by micromanometer-tipped left ventricular catheters, and
      volumes were obtained from digitalized images of epicardial echocardiographic
      recordings. Mitral valve perforation resulted in 3+ to 4+ mitral regurgitation
      and a calculated regurgitant fraction of 37% +/- 7% (mean +/- one standard
      deviation). Acute mitral regurgitation was associated with an increase in left
      ventricular end-diastolic volume from 110 +/- 17 to 121 +/- 23 ml (p < or = 0.05)
      and no change in end-systolic volume. These changes were associated with an
      increase in fractional shortening, from 29% +/- 11% to 40% +/- 10% (p < or =
      0.05), and an increase in velocity of circumferential shortening, from 1.5 +/-
      0.7 to 2.9 +/- 0.7 circ/sec (p < or = 0.05). However, there was no change in
      maximal elastance, a load-independent index of left ventricular function.
      Conversely, animals with chronic mitral regurgitation exhibited an elevated end
      diastolic volume (202 +/- 32 versus 145 +/- 34, p < or = 0.05), an elevated end
      systolic volume (104 +/- 17 versus 63 +/- 20 ml, p < or = 0.05), and a reduced
      ejection fraction (48% +/- 6% versus 57% +/- 9%, p < or = 0.05) compared with
      controls.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8468997
TI  - Long-term results of mitral commissurotomy.
AB  - Between January 1968 and December 1989, 280 patients underwent conservative
      surgical treatment for pure mitral stenosis. Closed commissurotomy was utilized
      in 134 patients, with a mean age of 38 +/- 11 years and a mean valve area of 1.0
      +/- 0.29 cm2. Open commissurotomy was performed in 146 older patients (mean age
      44 +/- 11 years) with a mean valve area of 0.9 +/- 0.3 cm2. The perioperative
      mortality was 3% in closed procedures and 3.4% in open procedures. Surviving
      patients were evaluated by questionnaires or phone interviews, and 129 patients
      were examined by two-dimensional echocardiography with the purpose of analyzing
      long-term results. Follow-up was 95% complete (Grunkemeier-Starr method), with a
      median of 18 years in patients with closed commissurotomy and 6.6 years in
      patients with open commissurotomy. The actuarial survival at 21 years was 60.8%
      (70% confidence limits 55% to 66%) in patients having closed commissurotomies and
      60.6% (70% confidence limits 49% to 71%) at 22 years in patients having open
      commissurotomies. The "effective palliation" rate, defined by clinical and
      echocardiographic criteria, was 47% at 15 years and 15% at 20 years. We conclude
      that mitral commissurotomy is the procedure of choice in pure mitral valve
      stenosis and should be applied early. When performed in patients aged less than
      40 years, a 78% (70% confidence limits 72% to 84%) survival at 18 years and 67%
      "effective palliation" at 15 years were observed. The closed valvotomy results of
      our study support the present trend toward use of percutaneous balloon valvotomy.

PMID- 8468998
TI  - Annuloplasty with flexible or rigid ring does not alter left ventricular systolic
      performance, energetics, or ventricular-arterial coupling in conscious, closed
      chest dogs.
AB  - Eighteen dogs were randomly chosen to undergo mitral annuloplasty with either a
      Carpentier-Edwards rigid ring (n = 6 in each group) or a Duran-Medtronic flexible
      ring or to undergo a sham procedure with an operation, but no ring. Tantalum
      markers were inserted to measure left ventricular volume and geometry. After 1
      and 6 weeks, biplane videofluoroscopic images were obtained during steady-state
      conditions and during vena caval occlusion. Global and regional systolic function
      was assessed with load-insensitive indexes. Comparison of all three groups and
      both times (1 and 6 weeks) showed no significant differences among the three
      groups in global or regional (basal, equatorial, and apical) left ventricular
      systolic performance. Furthermore, neither type of annuloplasty ring
      significantly affected left ventricular pump efficiency, ventricular-arterial
      coupling ratio, or systolic circumferential contraction and rotation of the basal
      left ventricular sites.

PMID- 8468999
TI  - A clinical trial of University of Wisconsin solution for pulmonary preservation.
AB  - Suboptimal pulmonary preservation with modified Euro-Collins solution (9/90 to
      4/91) prompted us to change to University of Wisconsin solution (4/91 to 4/92).
      Between September 1990 and April 1992, 94 patients received 100 pulmonary
      allografts (13 heart-lungs, 45 double lungs, 42 single lungs) that were flushed
      and preserved with either Euro-Collins (n = 30) or University of Wisconsin (n =
      70) solution. Selection of donors and procurement and storage of donor lungs were
      identical. Bilateral single lung transplantation was performed more often in the
      University of Wisconsin group and resulted in a significantly longer graft
      ischemic time (University of Wisconsin group; 303 +/- 62 minutes; Euro-Collins
      group; 260 +/- 62 minutes; p = 0.007, t test). The use of cardiopulmonary bypass
      was not statistically significantly different. Preservation injury identified by
      the radiograph on day 1 was more severe (p = 0.036; Mann-Whitney U test) in the
      Euro-Collins group than in the University of Wisconsin group. In double lung and
      heart-lung recipients gas exchange of the allografts was evaluated by the
      arterial/alveolar oxygen tension ratios at nine intervals during the first 72
      hours. The mean arterial/alveolar oxygen tension ratio was 0.62 +/- 0.26 in the
      University of Wisconsin group and 0.46 +/- 0.23 in the Euro-Collins group, but
      this difference did not reach significance (p = 0.119, analysis of variance).
      Despite the longer ischemic time, pulmonary preservation achieved by University
      of Wisconsin solution appears to be comparable with that achieved by Euro-Collins
      solution.

PMID- 8469000
TI  - A comparison of intracellular solutions for donor heart preservation.
AB  - Numerous solutions have been advocated for the preservation of donor hearts, and
      there has been much interest in universal and intracellular preservation
      solutions. This study compared the effects of Euro-Collins, University of
      Wisconsin, and Bretschneider's solutions with the use of an in vitro human right
      atrial muscle preparation to assess recovery of function after a 24-hour period
      of simulated cardiac arrest. There were no statistically significant differences
      among groups in length, weight, cross-sectional area, initial developed force, or
      resting force of muscles, including those muscles that were contracted in Krebs
      Henseleit solution and served as a control. After the 24-hour arrest period at
      either 4 degrees or 12 degrees C, the solution was changed back to Krebs
      henseleit at 34 degrees C and recovery was assessed over 30 minutes. At 30
      minutes, developed forces for muscles that were cooled to 4 degree C were 58.9%,
      76.6%, and 60.7% of the control for Euro-Collins, University of Wisconsin, and
      Bretschneider's solutions, respectively (p = not significant). For those cooled
      to 12 degrees C, developed forces were 9.5%, 30.5%, and 95.6% of the control for
      Euro-Collins, University of Wisconsin, and Bretschneider's solutions (p =
      0.0001). Bretscheider's solution resulted in greatly improved recovery compared
      with both Euro-Collins and University of Wisconsin solutions (p = 0.005), and
      University of Wisconsin solution was better than Euro-Collins solution (p =
      0.02). Recovery of developed force was affected by temperature for Euro-Collins
      and University of Wisconsin solutions (p = 0.005 and p = 0.001, respectively) but
      not for Bretschneider's solution. Resting force was elevated in muscles that were
      cooled in both Euro-Collins and University of Wisconsin solutions at 12 degrees C
      compared with almost normal values for Bretschneider's solution at either
      temperature (p = 0.07). Bretschneider's solution has a very high buffering
      capacity, which may be beneficial for long-term preservation. In conclusion,
      Bretschneider's solution resulted in the best recovery of human atrial myocardial
      function after a 24-hour preservation period compared with Euro-Collins and
      University of Wisconsin solutions and should be considered for use in donor heart
      transportation. The variability in quality of preservation at different
      temperatures with either Euro-Collins or University of Wisconsin solution make
      them less desirable as preservation solutions because uniform temperatures are
      seldom obtained during donor heart transplantation.

PMID- 8469001
TI  - The sensitivity of transbronchial biopsy for the diagnosis of acute lung
      rejection.
AB  - Transbronchial biopsy has become the procedure of choice for the diagnosis of
      acute lung rejection after transplantation, but the sensitivity of the technique
      in this setting remains unknown. In this study, 14 mongrel dogs underwent left
      lung transplantation, after which triple-drug immunosuppression was given for 5
      days and then all immunosuppression was stopped. All animals had clear chest
      radiographs at this time. Transbronchial biopsy was performed in nine lung
      regions (two to six pieces of lung tissue were obtained per region, with a mean
      of 4.3 pieces per region) before the animals were killed 2 to 4 days later, at
      which time varying degrees of rejection had occurred. Rejection was graded
      histologically on a scale of 0 to 3 (0 = no rejection, 1 = mild rejection, 2 =
      moderate rejection, 3 = severe rejection) in each piece of lung tissue obtained
      at transbronchial biopsy. After the dogs were put to death, the true state of
      lung rejection was determined by histologic examination of the entire lung. We
      calculated the sensitivity of transbronchial biopsy with 95% confidence
      intervals. Five pieces of lung tissue were needed to yield a sensitivity of 92%
      (82%, 100%) to identify mild rejection in the entire lung with transbronchial
      biopsy. Three pieces of lung tissue were needed to yield a sensitivity of 92%
      (84%, 100%) to identify the presence of moderate to severe rejection in the
      entire lung (that is, rejection that requires pulse therapy) on transbronchial
      biopsy. These results indicate that three to five pieces of lung tissue that are
      suitable for diagnostic purposes obtained at transbronchial biopsy are adequate
      for the diagnosis of acute pulmonary rejection after lung transplantation.

PMID- 8469002
TI  - Determinants of myocardial oxygen consumption in fibrillating dog hearts.
      Comparison between normothermia and hypothermia.
AB  - The purpose of the present study was to elucidate the mechanism of the difference
      in myocardial oxygen consumption between heating and fibrillating states during
      normothermia and hypothermia. In five isolated cross-circulated dog hearts, we
      measured left ventricular pressure at several ventricular volumes and myocardial
      oxygen consumption at V0 and V100, at which peak isovolumic pressures were zero
      and approximately 100 mm Hg, respectively, in beating and fibrillating states
      during normothermia and hypothermia (29 degrees C). As a measure of the total
      mechanical energy at V100, we obtained pressure-volume area in the beating state
      and equivalent pressure-volume area for fibrillation. We calculated equivalent
      heart rate as an estimate of the contraction frequency of individual myocytes in
      a fibrillating ventricle from myocardial oxygen consumption at V0 in the beating
      and fibrillating states. During normothermia, myocardial oxygen consumption per
      minute at V0 and V100 and myocardial oxygen consumption for mechanical purposes
      at V100 (myocardial oxygen consumption at V100-myocardial oxygen consumption at
      V0) were significantly higher during fibrillation than in the beating state.
      Equivalent pressure-volume area during fibrillation and pressure-volume area in
      the beating state at V100 were comparable, whereas equivalent heart rate during
      fibrillation was significantly higher than heart rate in the beating state.
      During hypothermia, myocardial oxygen consumption was comparable between beating
      and fibrillating states at V0, although myocardial oxygen consumption at V100 was
      slightly lower during fibrillation than in the beating state. Myocardial oxygen
      consumption for mechanical purposes during fibrillation was half of that in the
      beating state. Equivalent pressure-volume area was significantly smaller than
      pressure-volume area, whereas equivalent heart rate and heart rate were
      comparable. We conclude that during normothermia, higher myocardial oxygen
      consumption during fibrillation than in the beating state at V0 and V100 is
      attributable to the higher contraction frequency. During hypothermia the
      comparable myocardial oxygen consumption values at V0 are attributable to the
      comparable contraction frequencies, whereas slightly lower myocardial oxygen
      consumption during fibrillation at V100 is ascribed to the lower total mechanical
      energy.

PMID- 8469003
TI  - Cardiac-derived thromboxane A2. An initiating mediator of reperfusion injury?
AB  - After crystalloid cardioplegic arrest, cardiac-derived thromboxane A2 may be an
      important initiating mediator of no-reflow and hemodynamic deterioration during
      reperfusion because of its potent vasoactive properties. Although previous
      studies have already documented the increased release of cardiac thromboxane A2
      after ischemia, none have studied the effects of cardiac thromboxane A2 on
      hemodynamics. We therefore tested the ability of cardiac thromboxane A2 to
      mediate deterioration of coronary flow and functional recovery during reperfusion
      after global ischemia. Crystalloid-perfused rat hearts that had undergone
      Langendorff preparation (n = 30) were subjected to 2 hours of global ischemia at
      15 degrees C under cardioplegic protection with (n = 15) or without (n = 15)
      thromboxane A2 receptor antagonist SQ29548. In eight of 15 hearts in each group,
      preischemic and postischemic aortic flow, coronary flow, cardiac output, heart
      rate, and stroke work were determined. In the remaining seven hearts in each
      group, preischemic and postischemic coronary effluent levels of the stable
      hydrolysis product of thromboxane A2 and thromboxane B2 were determined with
      radioimmunoassay through the use of nonrecirculating perfusate. At the completion
      of the experiment, water content was determined by wet weight/dry weight
      calculations. In a separate group (n = 7) preischemic myocardial water content
      was determined. Within the group protected by cardioplegic solution alone,
      postischemic aortic flow, coronary flow, cardiac output, and stroke work were all
      significantly decreased (p < 0.05) compared with preischemic values (aortic flow,
      50.8 +/- 2.7 versus 29.4 +/- 3.3 ml/min; coronary flow, 13.2 +/- 1.3 versus 8.5
      +/- 1.3 ml/min; cardiac output, 64.0 +/- 3.8 versus 38.0 +/- 4.4 ml/min; stroke
      work, 12.5 +/- 0.7 versus 7.1 +/- 0.8 cm H2O.ml). In relation to the group with
      cardioplegic solution alone, postischemic aortic flow, coronary flow, cardiac
      output, and stroke work were all significantly greater (p < 0.05) in the group
      with the receptor antagonist (aortic flow: 49.5 +/- 2.4 versus 29.4 +/- 3.3
      ml/min; coronary flow; 12.4 +/- 1.2 versus 8.5 +/- 1.3 ml/min; cardiac output,
      62.0 +/- 2.8 versus 38.0 +/- 4.4 ml/min; stroke work, 12.6 +/- 0.8 versus 7.1 +/-
      0.8 cm H2O.ml). Overall, postischemic coronary effluent thromboxane B2 levels
      were greater than preischemic values (105.6 +/- 12.4 versus 69.6 +/- 9.8, p <
      0.05) and treatment with the receptor antagonist did not significantly affect
      postischemic thromboxane B2 levels (92.0 +/- 7.3 versus 82.3 +/- 15.5, p = not
      significant). Neither ischemia nor treatment with the receptor antagonist
      significantly affected heart rate.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8469004
TI  - Acute isovolemic hemodilution and blood transfusion. Effects on regional function
      and metabolism in myocardium with compromised coronary blood flow.
AB  - The use of isovolemic hemodilution to prevent adverse side effects of homologous
      blood transfusions has increased. The lowest level of hemoglobin that can be
      tolerated without regional myocardial dysfunction, however, had not been
      precisely defined for left ventricular myocardium with compromised coronary blood
      flow. This level was determined in our study in 19 dogs with critical stenosis of
      the left anterior descending coronary artery during graded isovolemic
      hemodilution. Regional function was assessed by sonomicrometry in the territory
      supplied by the left anterior descending coronary artery, as well as in two
      noncompromised left ventricular areas; oxygen extraction and consumption in the
      left anterior descending coronary artery region were assessed by analysis of
      anterior descending coronary venous oxygen saturation. The median lowest level of
      hemoglobin tolerated without contractile dysfunction of the territory supplied by
      the left anterior descending artery was 7.5 gm/dl, with lower and upper quartiles
      of 6 and 9 gm/dl. In addition to a marked increase in cardiac output and
      transstenotic left anterior descending flow, global cardiac and regional
      myocardial functions were unchanged at a hemoglobin level of 7.5 gm/dl, as
      compared with a control level of hemoglobin of 12.0 +/- 0.4 gm/dl. At a mean
      level of hemoglobin of 6.0 +/- 0.4 gm/dl, marked contractile dysfunction
      developed in the left anterior descending region: Systolic shortening decreased
      from 24.2% +/- 2.1% to 17.9% +/- 1.9% (p < 0.01); postsystolic shortening
      increased from 4.0% +/- 3.0% to 12.2% +/- 3.8% (p < 0.01); and in the left
      anterior descending region, oxygen consumption decreased. The increase of
      arterial level of hemoglobin by only 1.9 +/- 0.2 gm/dl restored contractile
      function in the left anterior descending region, regional oxygen consumption, and
      oxygen extraction across the left anterior descending region. Moderate isovolemic
      hemodilution is relatively well tolerated in left ventricular myocardium with
      compromised coronary blood flow, and hemodilution regional contractile
      dysfunction induced by hemodilution is reversible by minimal blood transfusion.

PMID- 8469005
TI  - Relative risk of aortic and femoral insertion of intraaortic balloon pump after
      coronary artery bypass grafting procedures.
AB  - We compared the preoperative, operative, and postoperative characteristics of
      patients who required balloon pumps after coronary artery bypass graft procedures
      to determine the relative risks of femoral and aortic insertion. The balloon pump
      was inserted into the ascending aorta when femoral insertion was not possible
      because of occlusive disease or small femoral arteries. Femoral insertion was
      performed in 81 patients and aortic insertion in 42 patients. Patients with
      aortic insertion were more likely to be small and female (p < 0.05) and were more
      likely to have carotid bruits and a history of strokes or transient ischemic
      attacks (p < 0.05). Death was more common in the patients with aortic insertion
      (18/42, 42.9%) than in those with femoral insertion (19/81, 23.4%) (p < 0.05), as
      calculated with single regression analysis. Route of insertion was not a
      predictor of operative death, according to multiple regression analysis. Leg
      complications were more common in patients with femoral artery insertion (23/81,
      28.4%) than in those with aortic insertion (0/42, 0.0%) (p < 0.05). No sternal
      complications occurred in either group. New neurologic abnormalities were not
      significantly different between the patients with aortic and femoral insertion.
      Aortic insertion is a safe alternative to femoral insertion of intraaortic
      balloon pumps and is associated with fewer leg complications in small or diseased
      iliac and femoral arteries. The greater mortality rate with aortic insertion is
      related to greater comorbidity rate in these patients.

PMID- 8469006
TI  - Anatomic lobectomy of the lung by means of thoracoscopy. An experimental study.
AB  - We conducted this study in an attempt to investigate whether anatomic lobectomy
      can be performed through a thoracoscope. Twelve lower (seven left and five right)
      and six left upper lobectomies were done in 17 pigs weighing 60 to 90 kg. With
      the use of general anesthesia and one-lung ventilation, a thoracoscope and
      operating instruments were inserted through four or five trocars. First, the
      incomplete fissure was bluntly dissected with specially designed cotton-tipped
      dissectors and divided by an electrocautery spatula or sapphire contact-tip
      neodymium: yttrium aluminum garnet laser probe. The pulmonary artery and its
      branches were similarly dissected. Two ligatures were passed around the vessels
      by endoscopic right-angle clamps and tied by means of an extracorporeal tying
      technique. The vessels were clipped and divided. In two animals, a hidden branch
      of the pulmonary artery was inadvertently cut. Bleeding was readily controlled
      with the dissector until metal clips could be applied. The bronchus was similarly
      dissected and divided and the proximal stump was closed with sutures. The
      pulmonary vein was dissected bluntly by the same technique and divided. The
      excised lobe was placed in a plastic bag and pulled out through one of the trocar
      holes after the hole had been enlarged to 3 cm. Blood loss was minimal. In
      conclusion, anatomic lobectomy of the lung by means of thoracoscopy was feasible
      in the pig.

PMID- 8469007
TI  - The use of "nonanatomic" pulmonary resection in infants with extensive congenital
      adenomatoid malformation of the lung.
AB  - In three infants with extensive congenital adenomatoid malformation of the lung,
      a method of nonanatomic pulmonary resection permitted preservation of small
      superiorly positioned pulmonary remnants. These remnants then demonstrated a
      surprising capacity for expansion, growth, and function during follow-up periods
      of 5 years, 9 months; 7 years, 6 months; and 19 years. Thus far, this small
      experience indicates that this method of management does not appear to entail
      greater short- or long-term risks than the alternative procedure of
      pneumonectomy.

PMID- 8469008
TI  - Lung volumes, mechanics, and perfusion after pulmonary resection in infancy.
AB  - Partial pulmonary resection in early childhood is well tolerated. Although long
      term outcome has been described in several follow-up studies, almost no
      information is available on postoperative lung perfusion. We studied 14 patients
      3 to 20 years (mean, 11.6 years) after they underwent partial pulmonary resection
      at 1 week to 30 months of age (mean, 6.8 months). We examined development,
      pulmonary function, endurance, radiographs and ventilation-perfusion scans. We
      used predicted pulmonary function test values, which were corrected for the
      relative amount of lung removed and called predicted-corrected values. We
      hypothesized that the remaining lung would have altered ventilation-perfusion
      characteristics. We found no abnormalities in the patients' physical development.
      Most children had abnormal regional ventilation, but normal equilibration
      occurred; five patients had gas retention; all had decreased perfusion to the
      area of resection; nine patients showed ventilation-perfusion mismatch
      characterized by dead-space ventilation. Lung volumes were within the predicted
      range in 12 patients. Residual volume and functional residual capacity were
      larger than predicted-corrected values in most patients but residual volume in
      relation to total lung capacity was at or below normal in 6 of 11 and did not
      correlate with the amount of lung removed. Most patients had prolonged expiratory
      flows. We conclude that lung resection in early childhood leads to good
      functional recovery. However, decreased expiratory flows, regional ventilation
      abnormalities, and decreased perfusion suggest dysplastic parenchyma and vascular
      bed in the area of resection.

PMID- 8469009
TI  - Survival of patients with carcinoma of the esophagus treated with combined
      modality therapy.
AB  - Since 1985, 229 cases of carcinoma of the esophagus have been considered for
      entry into a protocol with the use of preoperative chemotherapy and radiation
      therapy followed by surgical intervention as the primary element of treatment.
      One hundred sixty-five patients (93 with adenocarcinoma and 72 with squamous cell
      carcinoma) had esophagogastrectomy. The 5-year survival of the protocol patients
      who underwent resection was 25% for both groups--squamous cell carcinoma and
      adenocarcinoma. Of the protocol patients with squamous cell carcinoma who
      underwent resection, 40% had a sterilized specimen, whereas of those with
      adenocarcinoma, 20% had a sterilized specimen. If the patient had a sterilized
      specimen, the 5-year survival was approximately 60% for adenocarcinoma and 40%
      for squamous cell carcinoma. Those patients with adenocarcinoma and Barrett's
      esophagus had a 5-year survival of 55%. Of the patients who underwent only
      esophagectomy and esophagogastrectomy and had not been entered into the protocol,
      none lived beyond 3 years. The operative mortality rate for those who had
      esophagogastrectomy was 5%. Sixty-four patients completed the radiation therapy
      and chemotherapy but did not undergo surgical procedures because of progressive
      disease or refusal. Of those patients who completed chemotherapy and radiation
      therapy without surgical intervention, 5-year survival was 18% in patients with
      squamous cell carcinoma, whereas no patients with adenocarcinoma survived beyond
      3 years. The finding of a sterilized specimen after esophagectomy is a favorable
      prognostic factor in patients with adenocarcinoma or squamous cell carcinoma. The
      finding that patients with Barrett's esophagus and adenocarcinoma have an
      improved chance for survival is perhaps related to an earlier diagnosis. It is
      clear that some patients with squamous cell carcinoma who did not undergo
      surgical procedures did have a sterilized specimen, because the survival in this
      group approached 20% at 5 years.

PMID- 8469010
TI  - Selective pulmonary vasodilatation with inhaled nitric oxide.

PMID- 8469011
TI  - Reply to invited letter concerning: assessment of myocardial ultrastructure after
      retrograde infusion of cardioplegic solution (J Thorac Cardiovasc Surg 1992;
      104:1745-6)

PMID- 8469012
TI  - Blunt injury of the innominate artery: use of a vascular pericardial flap.

PMID- 8469013
TI  - Treatment of a patient with factor IX deficiency (hemophilia B) with coronary
      bypass surgery.

PMID- 8469014
TI  - Isolated unilateral pulmonary artery agenesis.

PMID- 8469015
TI  - Static and dynamic models of interdisease competition: past and projected
      mortality from amyotrophic lateral sclerosis and multiple sclerosis.
AB  - Longitudinal Gompertzian analysis is an effective method for determining both the
      pure probability of death for a given condition and the size of inherently
      susceptible subpopulations [1]. Gompertzian analysis has been used in this study
      to provide the parameters necessary to construct a stationary population
      lifetable (static model) of mortality for amyotrophic lateral sclerosis (ALS) and
      for multiple sclerosis (MS). The static model demonstrates the relative effect of
      changing general mortality upon the mortality from each specific disease in a
      situation where interdisease competition is continuously changing. In order to
      represent mortality in a real population more closely (where age structure is not
      the result of mortality rates alone) a dynamic model was constructed for both
      conditions using the age distributions of the population of England and Wales.
      The quality of the model was verified by comparison of estimated mortality with
      historical data from the last three decades. The dynamic model has then been used
      to estimate mortality from each condition over the next three decades on the
      basis of population projections made by the Central Statistical Office [2],
      assuming no major change in the factors which lead to either condition. This
      analysis demonstrates both the theoretical applicability and practical
      capabilities of Gompertz-derived mortality models for analysing changing
      mortality patterns.

PMID- 8469016
TI  - Accumulation of cardiac lipofuscin in crab-eating monkeys (Macaca fasicularis):
      the same rate of lipofuscin accumulation in several species of primates.
AB  - Previously, we have reported that the aging process begins at sexual maturation
      (Nakano, M. et al., Mech. Ageing Dev., 52 (1990) 93-106). In this paper, we
      reported the cardiac lipofuscin accumulation of crab-eating monkeys. The first
      appearance of cardiac lipofuscin was around sexual maturation, and the rate of
      accumulation in crab-eating monkey was 0.45. Several primates which have
      different life spans show the same rate of lipofuscin accumulation in the life
      stage. Namely, even in a different life span, the amount of lipofuscin
      accumulation in a given period of life such as puberty, middle age, old age was
      the same. From these results, it is suggested that the amount of lipofuscin
      accumulation is the same in the life span of primates having different life
      spans.

PMID- 8469017
TI  - Aging and mortality: manifestations of increasing informational entropy of the
      genome?
AB  - Information theory has provided insight to the means by which organisms maintain
      life against the inevitable influence of the second law of thermodynamics. The
      low entropy content of genetic information is used to harness the energy that an
      organism in an open system must utilize to maintain its low entropy and life.
      Redundancy lowers informational entropy, enhances meaning and promotes
      complexity. The genome is characterized by large quantities of 'redundant' DNA.
      Longitudinal Gompertzian analysis has shown that 'the rate of loss of vitality'
      (from the Strehler-Mildvan modification of the Gompertz model of aging and
      mortality) has remained constant for general and disease-specific mortality.
      Applying the concepts of information theory to aging and mortality suggests that
      'the rate of loss of vitality' may be synonymous with the rate of degradation of
      redundant genetic information (or alternatively, the rate of increase in
      informational entropy of the genome). This interpretation is consistent with the
      hypothesis that genetic instability of repeated DNA sequences may be
      fundamentally related to the process of aging. Consequently, there may be no
      specific aging or 'death' genes per se, but rather aging and mortality are the
      inevitable natural consequence of increasing informational entropy (decreasing
      redundancy) contained within the genome.

PMID- 8469018
TI  - Age-related changes in homeostasis of inorganic sulfate in male F-344 rats.
AB  - Advanced age is associated with a decline in renal function including decreased
      glomerular filtration rate, renal blood flow and renal tubular secretion.
      Endogenous inorganic sulfate homeostasis is maintained by concentration-dependent
      active renal reabsorption in the proximal tubule. The purpose of this study was
      to determine the effects of advanced age on: (1) the renal mechanisms for
      conserving endogenous inorganic sulfate and (2) the turnover of inorganic
      sulfate. Awake, male Fischer 344 rats age 4-5 months and 22-23 months received
      i.v. acetaminophen, 300 mg/kg, followed 2 h later by i.v. sodium sulfate, 2
      mmol/kg, to lower and raise, respectively, plasma inorganic sulfate in order to
      measure the renal clearance of this anion from plasma at sub- and
      supraphysiologic concentration ranges. Another group of old and young male F-344
      rats received a tracer injection of [35S]sodium sulfate to determine the effect
      of aging on the turnover of the endogenous inorganic sulfate pool. There was no
      statistically significant effect of advanced age on baseline plasma sulfate
      concentration or on the renal clearance of inorganic sulfate from plasma. The
      baseline excretion rate of inorganic sulfate in the senescent animals (0.38 +/-
      0.25 mumol/min/kg, mean +/- S.D., n = 7) was significantly (P < 0.05) lower than
      that observed in the young animals (0.64 +/- 0.19 mumol/min/kg, n = 8). There was
      no difference in the turnover rate constant, as measured by the change in
      specific activity of urinary [35S]sodium sulfate, for the endogenous sulfate pool
      in old and young animals. Following acetaminophen administration, plasma sulfate
      concentrations declined similarly in young and old animals. Under the conditions
      of relative inorganic sulfate depletion, the renal excretion rate of inorganic
      sulfate decreased to zero in 7 of 8 young rats, whereas the old animals continued
      to excrete sulfate anion at an average rate of 23% of the baseline value. Aged
      animals have a defect in active tubular renal reabsorption of sulfate under
      conditions of sulfate depletion. Age-related changes in the total sulfate
      excretion rate may reflect changes in the metabolic fate of endogenous sulfate
      rather than changes in the endogenous production rate of this anion.

PMID- 8469019
TI  - A comparison of methods for estimating mortality parameters from survival data.
AB  - The Gompertz mortality function, Rm = R0e alpha t, is frequently used to describe
      changes in mortality rate (Rm) with time (t). In this paper, four methods for
      determining the best fit values of the two parameters, R0 and alpha, are
      compared. Three of the four methods use the Gompertz mortality function with
      mortality rate estimates derived from survival data to determine the best fit
      values for the two parameters. All three confront problems. The fourth method
      uses the Gompertz survival function, which can be derived from the Gompertz
      mortality function and which allows one to use survival data directly. It thereby
      avoids the problems and generally gives the best estimates for the two
      parameters. The use of the mortality function, with mortality rate estimates,
      confronts four distinct problems. One of these is caused by time intervals when
      zero organisms die. A second is caused by errors produced in estimating mortality
      rates from survival data. If too high a proportion of a population die in a given
      time interval, the mortality rate estimates are too low. A third problem is the
      sensitivity of the mortality-equation-based analyses to values at the end of the
      survival curve, where scatter in mortality values tends to be greater. A final
      problem occurs when time intervals greater than one time unit (day, week, year,
      etc.) are used in the analysis. Such problems with the use of mortality rates to
      estimate parameter values are revealed when the calculated parameters are used to
      produce a survival curve, or when known values of R0 and alpha are used to
      generate survival data. This paper introduces a non-linear regression analysis,
      using a Simplex algorithm to fit parameters R0 and alpha in the Gompertz Survival
      function and concludes that it gives more reliable and consistent results with a
      variety of data than do three methods that use the mortality function.

PMID- 8469020
TI  - Gene expression and aging.
AB  - Considerable amount of data has accumulated during the past few years showing
      several changes in gene expression as a function of age. However, the basic
      mechanism of aging still remains poorly understood. In this review, we have
      mainly analysed the data pertaining to the hypothesis that aging is associated
      with genetic instability and have attempted further to highlight the gaps that
      need to be bridged in order to have a clear picture of the aging phenomenon.
      Extensive investigations employing new and novel approaches are needed in future
      to elucidate the intricately interwoven patterns of molecular control that
      underlie the various aspects of gene expression during aging.

PMID- 8469021
TI  - Compensatory hypertrophy and training effects on the functioning of aging rat m.
      plantaris.
AB  - The influence of age, compensatory hypertrophy and training on isometric
      contraction characteristics of rat m. plantaris were investigated in 5-, 13- and
      25-month-old rats. Each age group was subdivided into Control Not Trained,
      Control Trained, Operated Not Trained and Operated Trained groups. Run training
      was applied. The Operation i.c. denervation of synergists induced a 30%
      compensatory hypertrophy (P < 0.001). Age and training did not significantly
      affect muscle weight. The tetanic force was highest in 13-month-old and lowest in
      25-month-old muscles as was the tetanic force/muscle weight (P < 0.001). Trained
      and hypertrophied muscles had increased tetanic force (P < 0.01), but tetanic
      force/muscle weight was not significantly affected. Twitch contraction time was
      longer in hypertrophied muscles than in controls (P < 0.001). Half relaxation
      time decreased with training (P < 0.05). Resistance to fatigue was increased in
      hypertrophied muscles as compared to controls (P < 0.04) and was lower in 5-month
      old than in 13-month-old muscles, but their fatigue resistance did not differ
      from the 25-month-old muscles. Each age group showed comparable effects of
      training and hypertrophy on the contraction characteristics. These results
      indicate that the force generating capacity of the M. plantaris was optimal in
      the 13-month-old animals compared to the other age groups. Furthermore, our data
      show that aged muscles react in a similar way to increased functional demand as
      muscles of younger age.

PMID- 8469022
TI  - Age-dependent differences of ATP breakdown and ATP-catabolite release in ischemic
      and reperfused hearts.
AB  - The hearts of young (6 months) and aged (24 months) rats, paced at a frequency of
      300 bpm, were perfused by the Langendorff technique and subjected to: 20 min of
      equilibration perfusion, 30 min of global ischemia (95% reduction of the coronary
      flow) and 20 min of reperfusion. The control group was equilibrated for 20 min
      and then aerobically perfused for 50 min. After 20 min of stabilization, ATP and
      ADP levels and the adenine nucleotide pool were significantly higher in young
      than aged hearts (15% increase), but no modifications were found between the two
      age groups after 50 min of aerobic perfusion. Even the energy charge did not
      change under aerobic conditions. At the end of the ischemic period the levels of
      ATP and ADP decreased to a similar extent in young and aged hearts. After 20 min
      of reperfusion the myocardial level of ATP remained lower in comparison to the
      preischemic and control values in both age groups. At the end of the reperfusion
      there was a decrease in energy charge and creatine phosphate levels in the aged
      group in respect to the young group. The concentrations of adenosine,
      hypoxanthine and xanthine in coronary effluents did not change during ischemia
      and reperfusion irrespective of the age of the animals. On the contrary, the
      release of uric acid during ischemia and reperfusion was greater in aged than
      young hearts (90% increase). Moreover, the level of inosine in perfusates during
      the ischemic period was significantly lower in the 24-month-old group (30%
      decrease). These results are in accordance with the increased purine nucleoside
      phosphorylase activity and the decreased hypoxanthine phosphorybosyl-transferase
      activity found in the myocardium of the aged vs. young rats at the end of the
      reperfusion period. These data indicate that in the aged rat hearts, when exposed
      to ischemic and reperfusion conditions, there is a modification of purine
      breakdown which leads to a greater production of uric acid in respect to that
      found in young hearts.

PMID- 8469023
TI  - Evidence for age-dependent impairment of antiviral 2',5'-oligoadenylate
      synthetase/ribonuclease L-system in tissues of rat.
AB  - The 2',5'-oligoadenylate system (2-5A system) has an essential role in the
      establishment of the antiviral state of cells exposed to virus infection. The
      effects of 2-5A are mediated by a 2-5A-dependent ribonuclease (RNase L) which
      cleaves viral RNA. A study of 2-5A metabolism in different tissues of rats of
      different age (newborn: 1-day-old; young adult: 2- to 3-month-old; middle-aged
      adult: 12-month-old; and old: 32- to 33-month-old) revealed that the activities
      of the 2-5A metabolic enzymes alter during aging and development. We demonstrate
      that soluble 2-5A synthetase activity strongly increases after birth, reaching
      maximal levels in young adult and middle-aged adult animals and then
      significantly decreases with age; the age-dependent decrease was found also for
      the nuclear matrix-associated enzyme. In contrast, the activity of 2',3'
      exoribonuclease which inactivates 2-5A increases by 3-fold with age. The decrease
      in 2-5A synthetase activity and increase in 2-5A nuclease activity were found to
      result in a decrease in the cellular 2-5A content with age. The RNase L which is
      activated by 2-5A also changes age-dependently. The amount and activity of this
      enzyme were determined in cross-linking experiments, in nitrocellulose binding
      assays and in the ribosomal RNA cleavage assay. The livers of old rats displayed
      a 5- to 6-fold decrease in RNase L activity compared to the adult animal groups,
      whilst the amount of the enzyme did not change significantly during aging with
      the exception of a drop by 30% in the nuclear matrix fraction. From these results
      we conclude that the antiviral activity of the 2-5A system is impaired in old
      cells with the consequences that virus production cannot be efficiently
      suppressed.

PMID- 8469024
TI  - Lung glutathione reductase induction in aging catalase-depleted frogs correlates
      with early survival throughout the life span.
AB  - A comprehensive experimental study on free radical-related parameters was
      performed in the lung throughout the life span of 220 initially young or old
      frogs. No age related differences were found transversely or longitudinally for
      lung superoxide dismutase, catalase, Se-dependent and -independent glutathione
      peroxidases, glutathione reductase, GSH, GSSG, or GSSG/GSH ratio. Continuous
      catalase depletion with aminotriazole led to glutathione reductase induction in
      the lung after 14.5 months of experimentation. This was accompanied by a great
      increase in survival rate of treated animals in relation to controls (especially
      in the old group). After 26.5 months of experimentation, glutathione reductase
      induction was lost and GSSG/GSH values tended to increase. This was followed by a
      3-month long period of acute decrease in survival rate of treated animals. It is
      suggested that a high antioxidant/prooxidant balance is of protective value
      against causes of early death and can possibly be used in the future (when
      appropriately controlled) to increase the number of healthy years of the normal
      life span.

PMID- 8469025
TI  - Red blood cell age dependent modifications of inositol 1,4,5-trisphosphate.
AB  - The level of inositol 1,4,5-trisphosphate (Ins1,4,5P3) was determined in human
      and rabbit red blood cells of different ages. In human erythrocytes, fractionated
      by discontinuous density gradient centrifugation, Ins1,4,5P3 was 290 nM in the
      0.3% low density (youngest) cells compared to values of 107 nM in the whole red
      blood cell population. A progressive increase in Ins1,4,5P3 was then observed
      during erythrocyte aging from values of 63 nM in mature erythrocytes to 128 nM in
      the oldest cells. Determinations of Ins1,4,5P3 in rabbit erythrocytes provided
      values of 180 nM. Phenylhydrazine was administered to three animals to induce
      reticulocytosis. Ins1,4,5P3 in rabbit reticulocytes was significantly lower than
      in the whole red cell population, remained lower in young red blood cells and
      then increased to normal values during cell maturation. These results provide
      evidence for an increase of Ins1,4,5P3 during red blood cell aging and could
      contribute to explain the age-dependent loss of deformability and of Ca2+
      homeostasis of these cells.

PMID- 8469026
TI  - Pulmonary pentane excretion increases with age in healthy subjects.
AB  - Excessive lipid peroxidation occurs in various diseases. However, even in health
      low levels of lipid peroxidation can be detected by measuring the pulmonary
      excretion of pentane. Lipid peroxidation has been postulated to be one of the
      causes of the ageing process. In order to test whether pentane excretion is
      related to age, we measured breath pentane in 47 healthy subjects (ages 21-79).
      We also measured serum levels of the antioxidants tocopherol, retinol, lycopene,
      beta carotene, ascorbate and zinc. We found that pentane excretion significantly
      (P < 0.05, r = 0.32) increased with age. Of the six antioxidants measured, only
      lycopene decreased significantly (P < 0.05, r = -0.47) with age, however, this
      decline did not statistically correlate with pentane excretion. The remaining
      five antioxidants either remained stable or increased over the age range studied.
      We conclude that lipid peroxidation, as assessed by pentane excretion, increases
      with advancing age but that this increase is independent of dietary antioxidant
      levels.

PMID- 8469027
TI  - Age-related changes in collagen gel contraction by cultured human lung
      fibroblasts resulting in cross-over of contraction curves between young and aged
      cells.
AB  - We examined the effects of population doubling levels on collagen gel contraction
      by human lung fibroblasts (TIG-1). The sizes of gels at day 4 of culture, when
      the number of cells was the same as the initial number, were smaller with young
      cells than with aged cells. Therefore, retractive force had decreased with in
      vitro cellular aging. On the other hand, the lag time until gel contraction began
      became shorter with aging, resulting in the cross-over of contraction curves of
      young and aged cells. Morphological changes, such as pseudopodia protrusion, were
      suppressed in collagen gel. The surrounding collagen fibrils prevented young
      cells from moving more than aged cells. The weakened omnidirectional interaction
      with collagen fibrils on the entire surface of aged cells might result in an
      earlier occurrence of morphological change and, thereby, gel contraction.

PMID- 8469028
TI  - A mathematical model of the effect of aging on bone marrow cells colonizing the
      thymus.
AB  - The process of T cell generation in the thymus involves complex cell-cell
      interactions between the various types of thymic stromal cells, thymocyte
      progenitors, thymocytes at different stages of differentiation and external
      factors. We applied the tool of mathematical modelling to analyze hypotheses and
      direct experiments concerning mechanisms underlying the observed developmental
      inferiority of bone-marrow thymocyte progenitors from old mice. Previous
      experimental data showed that lower cell numbers were obtained from old bone
      marrow-derived thymocyte progenitors, compared to young bone marrow-derived
      progenitors, when colonizing simultaneously the same fetal thymus. In this study,
      simulations based on the mathematical model indicate that the developmental
      inferiority of old bone marrow-derived progenitors cannot be explained by a
      change in a single parameter, such as the observed differences in progenitor
      frequency, an increase in cell cycle duration, a reduction in the fraction of
      proliferating cells in old age, and/or an increase in the rate of cell death. We
      have performed experimental measurements of the fractions of cycling cells. No
      significant difference was found between these fractions in young and old bone
      marrow-derived thymocytes. The difference in developmental patterns of young and
      old bone marrow-derived thymocytes may be due to a combination of more than one
      mechanism, possibly including interactions between competing thymocytes of old
      and young bone marrow origin.

PMID- 8469029
TI  - The in vitro senescence of human T lymphocytes: failure to divide is not
      associated with a loss of cytolytic activity or memory T cell phenotype.
AB  - Normal human T lymphocytes, activated in vitro and cultured in the continuous
      presence of the growth factor interleukin 2 (IL2), have a limited proliferative
      potential. Senescent T cell cultures will not proliferate, even if restimulated
      by the original allogeneic stimulator cells. However, we have now observed that
      such restimulation induces an increase in the percentage of cells expressing the
      55 kDa chain of the IL2 receptor (IL2R alpha, CD25) without any associated
      increase in cell number. A younger culture, which showed a comparable increase in
      CD25, underwent two population doublings in the same time period after
      restimulation. The senescent cultures, (primarily of the CD8+,
      cytotoxic/suppressor, phenotype), were also found to be highly potent and
      specific effector cells in a 51chromium release assay for cytolytic activity.
      Furthermore, senescent cultures maintain the surface phenotype of memory T cells.
      These findings demonstrate that while senescent T cells are unable to proliferate
      in response to restimulation or to IL2, they are able to recognize the foreign
      stimulator cells and to initiate an otherwise normal T cell response. Our results
      lend support to the hypothesis that in vitro senescence is not associated with a
      generalized decline in functional activity in a differentiated cell type, but
      with a specific event which limits cell division. Thus, the long term T
      lymphocyte culture system will be useful for studying the mechanism by which
      proliferation is blocked in these, apparently, post-mitotic cells.

PMID- 8469030
TI  - Effects of wheel running on glucose transporter (GLUT4) concentration in skeletal
      muscle of young adult and old rats.
AB  - We examined the effects of voluntary exercise on glucose transporter
      concentration in skeletal muscle from young adult and old female Long-Evans rats.
      Rats had free access to voluntary running wheels beginning at 4 months of age or
      remained sedentary. Exercising rats ran approximately 7.5, 6.2, 5.6 and 5.3
      km/day during their 6th, 8th, 9th and 10th month of age, respectively. During the
      23rd, 24th and 25th month of age running distance averaged 3.0, 2.8 and 2.4
      km/day, respectively. At 10 and 25 months of age, glucose transporter protein
      concentration was assessed in epitrochlearis and flexor digitorum brevis muscles
      with a polyclonal antibody directed against the GLUT4 transporter isoform. GLUT4
      protein concentration was not altered by the aging process (i.e., comparing 10-
      and 25-month-old rats) in either muscle type. Wheel running increased GLUT4
      protein concentration by 45% in epitrochlearis muscles of 10-month-old rats
      relative to age-matched sedentary controls. The training-induced adaptation in
      GLUT4 protein was no longer present at age 25 months, probably because the
      running distance had declined by 50%. In the flexor digitorum brevis, exercise
      did not alter GLUT4 concentration at either 10 or 25 months, presumably due to
      insufficient recruitment of this muscle during wheel running as assessed by
      measurement of citrate synthase and hexokinase enzyme activities. Wheel running
      induced cardiac and soleus muscle hypertrophy in 10- and 25-month-old rats. In
      summary, voluntary wheel running can induce an increase in skeletal muscle GLUT4
      protein concentration in adult rats. Older rats that run less exhibit cardiac and
      soleus muscle hypertrophy, but do not maintain an elevated GLUT4 protein
      concentration in the epitrochlearis muscle. Aging does not alter GLUT4 protein
      concentration in the epitrochlearis or FDB muscles.

PMID- 8469031
TI  - Stereoselective pharmacokinetics of atenolol in the rat: influence of aging and
      of renal failure.
AB  - The pharmacokinetics of R- and S-atenolol after intravenous administration of
      racemic atenolol were studied in 3-, 12- and 24-month-old rats and in 3-month-old
      rats with renal failure induced by uranyl nitrate. In all age groups, the area
      under the plasma concentration-time curves is higher for R- than for S-atenolol;
      volume of distribution, total clearance and renal clearance are lower for R
      atenolol than for S-atenolol, but the differences are small. In function of age
      there is for both enantiomers a significant increase in AUC, due, at least in
      part, to a decreased renal clearance; the effect of aging is not stereoselective.
      In rats with renal failure, the AUC of both enantiomers increases, due mainly to
      a decrease in renal clearance, but to a lesser degree also to a decrease in
      nonrenal clearance. For both enantiomers, the volume of distribution decreases
      and the half-life increases in the uraemic rats. The total amount of both
      enantiomers excreted in the urine is decreased in the rats with renal failure.
      There are no stereoselective effects of treatment of the rats with uranyl
      nitrate.

PMID- 8469032
TI  - Macrophages suppress lectin-induced proliferation of lymphocytes from aged rats.
AB  - Splenocytes from old rats exhibit a significant reduction in proliferative
      responses to Con A. This defect can be overcome by passing the cells over nylon
      wool, which suggests that nylon wool adherent cells contribute to the reduction
      in proliferation of mixed cell populations from aged rats. To examine the
      potential role of macrophages in this process, thioglycollate-elicited peritoneal
      macrophages were added to Con A-activated spleen cells from young and old rats.
      Addition of as few as 3% macrophages suppressed proliferation of Con-A-activated
      splenocytes and this inhibition was significantly greater if either the
      macrophages or spleen cells were derived from aged rats. Although prostaglandin
      E2 (PG-E2) inhibited the proliferation of splenocytes and nylon-wool enriched
      splenocytes from 3-month-old animals, its suppressive effects were much greater
      on Con A-activated lymphocytes derived from 24-month-old rats. Addition of
      catalase to deplete macrophage-derived H2O2 resulted in greater augmentation of
      Con-A-induced proliferative responses of splenocytes from old rats than those
      from young rats. TGF-beta 2, but not TNF-alpha, also significantly suppressed the
      proliferation of Con A-activated splenocytes to a greater degree in aged than in
      young rats. Since macrophages are known to release PG-E2, H2O2 and TGF-beta 2
      after stimulation with Con A, these data support the idea that T cells within the
      splenocyte population become increasingly susceptible during aging to inhibitory
      products released by macrophages.

PMID- 8469033
TI  - Age-related reduction of reflex bradycardia in conscious rats by
      catecholaminergic nucleus tractus solitarius lesions.
AB  - To determine whether catecholaminergic lesions in the nucleus tractus solitarius
      (NTS) have age-related baroreflex effects, we compared conscious 3-month- and 14
      month-old rats pretreated with either 6-hydroxydopamine (6-OHDA) or vehicle
      injected into the NTS. Body weights fell immediately in both age groups, but
      after 2 weeks the weight loss persisted only in 14-month-old rats. Mean pressures
      and heart rates, though diminished after 3 days, were later elevated slightly in
      3-month- but not in 14-month-old rats. Two weeks after 6-OHDA pretreatment,
      reflex tachycardia was reduced in both age groups, but reflex bradycardia was
      reduced only in 3-month-old and not in 14-month-old rats. Corresponding changes
      in vehicle-treated rats were not significant. Because 6-OHDA induced lesions in
      the NTS inhibited reflex bradycardia selectively at 3 but not at 14 months of
      age, our results suggest that catecholaminergic mechanisms in the NTS for
      regulating reflex bradycardia become impaired with age.

PMID- 8469034
TI  - Longitudinal Gompertzian analysis of non-Hodgkin's lymphoma mortality in the US,
      1979-1988: demonstration of the environmental basis for rising overall mortality.
AB  - Between 1979 and 1988, annual crude non-Hodgkin's lymphoma mortality rates (per
      100,000) in the United States increased from 3.43 to 6.34 among men (an 85%
      increase in only 10 years) and, among women, increased from 2.82 to 5.71 (a 102%
      increase). Age-specific mortality rates for non-Hodgkin's lymphoma from 1979
      through 1988 were subjected to longitudinal Gompertzian analysis, a method that
      may be able to identify and distinguish among genetic, environmental and
      competitive influences upon evolving mortality trends. The results of this
      analysis suggest that the basis for the dramatic rise in non-Hodgkin's lymphoma
      mortality is due to worsening environmental influences. The capability to
      distinguish between environmental and competitive influences upon evolving
      mortality patterns has significant public health policy implications.

PMID- 8469035
TI  - The age-dependent proliferation of rat aortic smooth muscle cells is independent
      of differential splicing of PDGF A-chain mRNA.
AB  - Arterial smooth muscle cells (SMC) from old rats proliferate in vivo (after
      injury) and in vitro more rapidly than smooth muscle cells from young rats. We
      previously observed that SMC from old rats contained more PDGF-like growth factor
      activity than did young SMC. We therefore tested the hypothesis that age-related
      differences in type of PDGF A-chain gene expression might be responsible for the
      difference in growth factor activity, since PDGF B-chain gene is minimally
      expressed both in young and old SMC. Specifically we tested if the old SMC
      predominantly expressed the long form of the A-chain mRNA, leading to autocrine
      stimulation by cell-associated PDGF AA-homodimers. A partial cDNA for the rat
      PDGF A-chain was cloned and sequenced; it is highly conserved compared to the
      human PDGF-A chain and similarly has two forms, a long form containing all exons,
      which tends to remain cell-associated and a short form lacking exon 6, which
      tends to be secreted. Different tissues of both young and old animals express
      different ratios of these two forms of PDGF-A. However, the relative expression
      of the different mRNA forms does not change with age, suggesting that
      differential splicing of PDGF-A and accumulation of cell-associated PDGF A-chain
      does not determine the enhanced growth potential of old rat SMC.

PMID- 8469036
TI  - Changes with ageing in total dolichol and dolichol fractions in Drosophila.
AB  - Since it is unclear how the concentration of dolichol fractions change with
      ageing in mammals, we have examined the changes in another organism, Drosophila.
      Dolichol extracted from Drosophila melanogaster was found to consist of three
      fractions composed of 15, 16 and 17 isoprene units. The total dolichol content of
      female flies maintained at 25 degrees C increased with ageing between 0 and 64
      days of adult age but the change was not significant. The total dolichol content
      of male flies decreased with ageing but the decrease was not significant. The
      relative amounts of the three different dolichol fractions in both male and
      female flies also failed to show any significant ageing-related change. The
      greatest amount of dolichol was found in the 16 isoprene unit fraction
      representing 67.2% of the total dolichol in male flies and 65.4% in female flies.
      Increased dietary dolichol had little or no influence on the life span of
      Drosophila when given either during the developmental or adult stages.

PMID- 8469037
TI  - [Surgical wound infection: the risk factors and a predictive model].
AB  - BACKGROUND: The identification of the factors associated with infection of the
      surgical wound and the groups of patients with greatest risk of developing the
      same may aid in the elaboration of prevention strategies. METHODS: A prospective
      follow up study of a group of 1,143 patients admitted to general and digestive
      surgical departments in the Ramon y Cajal Hospital over a period of 7 months was
      carried out to determine the accumulated incidence of infection of the surgical
      wound and quantify the associated risk factors. A mathematical model was
      developed by logistic multiple regression analysis allowing the identification of
      groups of patients with high risk of infection which were internally evaluated
      posteriorly. RESULTS: Surgically intervened patients (70% of those admitted)
      developed a mean of 11 wound infections out of 100 patients. Five independent
      factors (age, surgical classification, length of intervention, presurgical stay,
      and presence of a central route) were associated to increased risk of infection.
      CONCLUSIONS: The factors associated with surgical wound infection identified in
      this study are related to the degree of wound contamination, the intrinsic risk
      of the patients and quality of health care. The model obtained is more efficient
      than the traditional surgical classification for the identification of groups of
      patients with high risk of infection.

PMID- 8469038
TI  - [A clinical study of the verapamil and captopril combination in hypertensive
      patients uncontrolled by monotherapy. An evaluation by recording the 24-hour
      ambulatory blood pressure].
AB  - BACKGROUND: By measuring ambulatory blood pressure monitoring (ABPM), the
      pharmacologic association of verapamil plus captopril in essential hypertensive
      patients not responding to isolated monotherapy of these drugs was studied since
      a synergism has been described between these two drugs. METHODS: A lineal
      clinical trial with a previous period of selection (PeSe) in which verapamil and
      captopril were administered in two consecutive phases was carried out in 57
      essential hypertensive patients of 52 +/- 19 years of age with those controlling
      their blood pressure (BP) being excluded. Following a lavage phase the remaining
      subjects were included in the experimental period (ExPe) in wash out the
      association of verapamil 120 mg+captopril 25 mg was administered and if the BP
      was not controlled this was increased to 240 mg + 50 mg, respectively. ABPM was
      performed prior to and at the end of the ExPe. RESULTS: Of the 57 patients 21
      were excluded in the SePe due to control or adverse effects. Of the 26
      individuals who passed into the ExPe 20 presented mild-moderate HTA (M-HTA) and 6
      severe HTA (S-HTA). In the M-HTA group, the reduction of BP (in mmHg) was 157 +/-
      15/106 +/- 5 to 147 +/- 12/97 +/- 7 (p < 0.05/p < 0.001), five controlled BP, in
      the remaining subjects the reduction in the following phase was 150 +/- 11/100 +/
      6 at 136 +/- 11/93 +/- 6 (p < 0.01/p < 0.01). In the S-HTA group the BP
      descended in the ExPe from 184 +/- 15/121 +/- 6 to 167 +/- 24/107 +/- 10 (p <
      0.05/p < 0.05). The 24 hour measurement of BP in the ExPe decreased from 140 +/-
      13/96 +/- 8 to 124 +/- 10/86 +/- 7 (p < 0.001/p < 0.001). BP descended
      significantly in all the hours with the exception of the hours 24, 1, 6, 7, and
      5. CONCLUSIONS: The association of verapamil-captopril demonstrates efficacy and
      synergism in hypertensive patients previously uncontrolled by monotherapy of
      these drugs.

PMID- 8469039
TI  - [A multicenter study of infection with human immunodeficiency virus type-2 (HIV
      2) in Spain (1991). The Spanish Group for the Study of HIV-2].
AB  - BACKGROUND: To January 1991 thirteen cases of HIV-2 infection had been reported
      in Spain. Paradoxically, neighboring countries, i.e. France and Portugal, have
      reported more than one thousand cases, and are the most HIV-2 prevalent areas
      outside West Africa. We report the results of a prospective, nationwide study on
      the prevalence of HIV-2 infection conducted in Spain in 1991. In addition, an
      evaluation of testing methodologies is made. METHODS: Sera collected from 8,073
      individuals at high-risk for HIV infection were screened by a combined HIV-1 plus
      HIV-2 ELISA. Reactive samples were further evaluated by three tests, as HIV-1
      Western blot (WB), HIV-2 specific WB, and a synthetic peptide assay immuno-dot
      (Pepti-lav, Pasteur). RESULTS: Fifteen (0.18%) individuals met criteria of HIV-2
      infection in both specific WB and SPA. Four (27%) of them showed reactivity to
      both HIV-1 and HIV-2, and the dual infection was confirmed by polymerase chain
      reaction (PCR) in 2 out of 3 available samples. The SPA showed higher sensitivity
      and specificity than WB in the diagnosis and distinction of HIV-1 and HIV-2
      infections. CONCLUSIONS: To January 1992, 28 cases of HIV-2 infection have been
      described in Spain. All but two were African immigrants. The first cases of HIV-1
      plus HIV-2 coinfection have been identified. In HIV high-risk populations, SPA
      may provide an excellent alternative to WB to confirm ELISA reactive samples.

PMID- 8469040
TI  - [Why surgical wounds become infected].

PMID- 8469041
TI  - [Patients' rights: the practical problems].

PMID- 8469042
TI  - [The lung transplant].

PMID- 8469043
TI  - [The growth hormone and kidney failure: new physiopathological aspects and
      therapeutic possibilities].

PMID- 8469044
TI  - [The advantages of providing the standard error in communicating the results of
      original biomedical studies].

PMID- 8469045
TI  - [The spontaneous cure of acromegaly after pituitary apoplexy: a report of 2
      cases].

PMID- 8469046
TI  - [Typical migraine and thalidomide].

PMID- 8469047
TI  - [Bacterial enteropathogens and antimicrobial resistance in Zamora: the usefulness
      of fluoroquinolones].

PMID- 8469048
TI  - [The attitude of hospital nursing professionals toward drug-addicted patients].

PMID- 8469049
TI  - [The translation of abstracts into English].

PMID- 8469051
TI  - [The company physician is needed and beneficial].

PMID- 8469050
TI  - [Don't let your life go up in smoke. Ban the tobacco advertisement, introduce age
      limit].

PMID- 8469052
TI  - [Defend the territorial responsibility of primary health care workers].

PMID- 8469053
TI  - [The right to designate family physicians--a threat or possibility?].

PMID- 8469054
TI  - [An open letter to the National Board of Health and Welfare about pediatric
      cardiology].

PMID- 8469055
TI  - [To widen or not to mix].

PMID- 8469056
TI  - [Keep the courses of psychotherapy?].

PMID- 8469057
TI  - [The effects of cervical manipulation are not proven].

PMID- 8469058
TI  - [Warm baths and sauna during early pregnancy. It is not sure there is a risk of
      abnormalities].

PMID- 8469059
TI  - [Successful splenectomy in HIV thrombocytopenia].

PMID- 8469060
TI  - [Painful alliance].

PMID- 8469061
TI  - [Warning! Epidural stimulator caused false asystole].

PMID- 8469063
TI  - [The care of drug addicts could be much better].

PMID- 8469062
TI  - [Only few families with handicapped children get help to relieve pressure].

PMID- 8469064
TI  - [Where are the patients committed to treatment by the court?].

PMID- 8469065
TI  - [Politicians and benzodiazepines].

PMID- 8469066
TI  - [The concept of dementia--does it enlighten or confuse?].

PMID- 8469067
TI  - [Be careful with fax!].

PMID- 8469068
TI  - [Allergy. A comment to a consensus statement on a disease group costly to
      society].

PMID- 8469069
TI  - [Post-infection HIV vaccination. More clinical trials are initiated in Sweden].

PMID- 8469071
TI  - [Does health personnel prefer alternative medicine?].

PMID- 8469070
TI  - [The WHO statement on strategies of HIV vaccinations: field trials in developing
      countries should await studies of the effects].

PMID- 8469072
TI  - [Cataract surgery. What is beneficial for the patient?].

PMID- 8469073
TI  - [Cataract surgery. What is the need and who will perform the surgery?].

PMID- 8469074
TI  - [Rehabilitation of patients with coronary disease. A live-in alternative is as
      positive for women as for men].

PMID- 8469075
TI  - [Toxic shock syndrome in a young child. A severe condition caused by a minor
      injury].

PMID- 8469076
TI  - [Injuries are reduced by air bags. But seat belts are still to be used].

PMID- 8469077
TI  - [Occupational conditions of chief surgeons. Does a heavy work schedule interfere
      with sleep and family life?].

PMID- 8469078
TI  - [An old man writes a wish list to the physician. Criticism against the new
      advises on the treatment of hypertension. Recommended treatment of hypertension
      in the elderly].

PMID- 8469079
TI  - [Psychodynamic therapy has had its day].

PMID- 8469080
TI  - [An inquiry on medical teaching. Pedagogic qualifications are important].

PMID- 8469081
TI  - Medications to treat alcoholism?

PMID- 8469082
TI  - Chronic polyarthralgia in adults.
AB  - Rheumatologists often see patients with musculoskeletal complaints who do not
      always have symptoms and findings that fit into recognized syndromes. Twenty-two
      such patients with chronic polyarthralgias, including eight with a positive test
      for ANA (anti-nuclear antibodies), seen over a seven-year period, did not meet
      criteria for classification or diagnosis of any recognized rheumatologic
      syndromes. The mean follow-up since onset of symptoms was 77.5 months (range, 13
      276 months). During this time, none of the patients' conditions evolved into any
      previously recognized syndromes. This report on the study of these 22 patients
      emphasizes the existence of such patients and comments on their prognosis and
      treatment.

PMID- 8469083
TI  - Lyme disease in outdoor workers on Assateague Island: high tick-exposure but low
      disease risk.
AB  - Lyme disease is endemic to the Assateague Island area. Using a questionnaire and
      serosurvey, we examined the extent of tick exposure, compliance with recommended
      Lyme disease personal preventive activities, and risk of the disease in 86
      outdoor workers on Assateague Island before and after the summer of 1989. Despite
      high self-reported tick exposure and relatively long employment durations on the
      island, there was no evidence of current or past infection with Borrelia
      burgdorferi, the causative agent of Lyme disease. Lyme disease knowledge and use
      of several personal strategies were high, but compliance with these preventive
      strategies was not universal. These data suggest that even in this high-risk
      population, intensive educational efforts are necessary to encourage Lyme disease
      preventive behavior, but the current level of compliance may have decreased the
      risk of Lyme disease on the island.

PMID- 8469084
TI  - The residents' computer bulletin board system: results of a 23-month pilot study.
AB  - The Residents' Computer Bulletin Board System (RBBS) originated as an offshoot of
      a research project designed at a 1988 meeting of Baltimore's chief medical
      residents. Beginning on March 1, 1989, RBBS offered electronic mail, bulletins,
      file transfers, newsletters, and data collections to physicians-in-training. It
      operated for 695 days before ResNet, sponsored by the American College of
      Physicians, superseded it. This report details how medical students, residents,
      and fellows used this electronic means of communication and offers some
      conclusions about the elements that future computerized bulletin board systems
      should have to succeed.

PMID- 8469085
TI  - Body stalk deformity in a twin pregnancy: case report and review.
AB  - Body stalk deformity is a variety of the limb-body wall complex (LBMC)--the rare,
      complicated, congenital process believed to result from early rupture of the
      amnion and vascular disruption. Here we report a case of this anomaly in a twin
      pregnancy and describe the prenatal ultrasound findings.

PMID- 8469086
TI  - A brief history and discussion of certain mycotic infections and their importance
      to physicians.
AB  - Mycotic infections are common and their incidence is increasing. They can be
      difficult to distinguish from other infections, particularly tuberculosis, but
      there are numerous clinical clues that can help suggest the presence of systemic
      mycoses. Histoplasma skin tests, serologic tests, and agent isolation can aid in
      the confirmation of a fungal infection. Clinical considerations must be put in
      the proper perspective before a definitive treatment is proposed. Specific
      chemotherapy is often curative.

PMID- 8469087
TI  - Imaging case of the month. Acute cholecystitis.

PMID- 8469088
TI  - The importance of early diabetic retinopathy detection.

PMID- 8469089
TI  - Diagnosis and treatment of depression in late life: summary of the NIH consensus
      statement.

PMID- 8469090
TI  - The Library of the Medical and Chirurgical Faculty of Maryland.

PMID- 8469091
TI  - Medical records that guide and teach. 1968.

PMID- 8469092
TI  - Data communications.

PMID- 8469093
TI  - Improving PC efficiency by accelerating hard drive performance.

PMID- 8469094
TI  - Trends in journalism.

PMID- 8469095
TI  - Lawrence L. Weed and the problem-oriented medical record.

PMID- 8469096
TI  - One man's meat.

PMID- 8469097
TI  - Another man's poison.

PMID- 8469098
TI  - Estimating the number of physicians using computers.

PMID- 8469099
TI  - The medical record: problem or solution?

PMID- 8469100
TI  - Probability and medical decision making: a politically incorrect view.

PMID- 8469101
TI  - A neural network that predicts psychiatric length of stay.
AB  - We developed a neural network to predict length of stay after admission to a
      state psychiatric hospital. The network was trained with data from 1064 cases
      randomly selected over a 3 1/2-year period, and its accuracy was tested against
      actual length-of-stay patterns and predictions made by a team of clinicians 72
      hours after admission. The network performed at least as well as the team of
      clinicians. Successful prediction of length of stay could result in more
      appropriate use of services, more timely initiation of treatment, better resource
      planning, and cost control--highly sought dividends in an era of diminishing
      fiscal resources.

PMID- 8469102
TI  - Computer-based patient education: a progress report.
AB  - Computer-based teaching can help patients make informed decisions and protect
      both patients and physicians from the serious consequences of poor communication.
      This article discusses the benefits of computer-based patient education and its
      role in the emerging field of "patient informatics."

PMID- 8469103
TI  - Novel microsurgical model of experimental vascular neointimal hyperplasia.
AB  - Neointimal hyperplasia is a common finding after trauma to blood vessels and also
      as a primary change in atherosclerosis. In this study we have developed a simple
      model, using microsurgical techniques, for the initiation of neointimal
      hyperplasia in the rat. In 24 Wistar rats, a 2 mm-diameter arteriotomy in the
      aorta was repaired with a "patch" of iliolumbar vein, using eight evenly spaced
      10-0 Ethilon sutures. The patch overlapped the edges of the arteriotomy, and the
      sutures fastened the patch to the subjacent aorta. At 2, 6 and 12 weeks after
      surgery, the venous patch grafts and segments of the adjacent aortae of eight
      rats were removed. One-half of the specimens were analyzed by scanning electron
      microscopy and the other one-half by light microscopy. All patch grafts were
      surgically successful. Endothelial cells regenerated to cover the patch within 2
      weeks of insertion. By 6 weeks after surgery, neointimal hyperplasia, consisting
      predominantly of smooth muscle, had developed in all patches to a thickness that
      was not significantly different from that of the adjacent aorta. These findings
      are consistent with data from other more complex experimental models of
      neointimal hyperplasia in the rat. We consider that this venous patch technique
      is a simple but effective model for the initiation of neointimal hyperplasia in
      the rat and may easily be used to study the experimental effects of various
      injurious or therapeutic agents on neointimal hyperplasia.

PMID- 8469104
TI  - Hemodynamic comparison of microsurgical closures for longitudinal arteriotomies.
AB  - Twenty-four femoral arteries in 12 rats were used to compare longitudinal and
      transverse closures in blood vessels approximately 1 mm in diameter. The closure
      techniques were applied to a simple longitudinal slit, 1 mm long, and to a
      longitudinal defect, 0.5 mm wide and 1 mm long. Comparisons were made of the
      change in pre- and postrepair flow velocities, recorded every 5 min using a 20
      MHz pulsed Doppler velocimeter. Maximum reductions in flow velocity (linearly
      related to volume flow) were 10% and 29% for the longitudinal and transverse
      repairs, respectively, when applied to the longitudinal slit, and 65% and 19%,
      respectively, when applied to the larger arteriotomy. An analysis of variance
      indicates that the differences in the normalization of flow velocities during the
      immediate postrepair period are significant (P < 0.05). We conclude that optimal
      flow normalization is achieved by applying the longitudinal repair to the simple
      slit and the transverse repair to the larger arteriotomy.

PMID- 8469105
TI  - Microvascular transplant of the gastrocnemius muscle in rats.
AB  - The rat gastrocnemius muscle can serve as a vascularized, innervated muscle
      transplant model. To establish the anatomic and technical details of this model,
      we performed ten gastrocnemius transplants and collected data on muscle weight,
      dimension, and vessel caliber from each muscle. The muscle, consisting of medial
      and lateral heads, is supplied by pairs of sural vessels averaging 0.2 mm in
      diameter. These vessels, however, can be taken in continuity with the femoral
      vessels (averaging 1.0-1.6 mm in diameter), which are used for transplantation.
      The muscles weighed an average of 2.8 g, and the average pedicle length was 24
      mm. Eight of ten transplanted muscles were viable with intact circulation at 72
      hr. The gastrocnemius transplant was technically reliable, and the muscle bulk
      and contour could allow biochemical and functional studies. Donor site morbidity
      limits this model to transplantation studies.

PMID- 8469106
TI  - Free skeletal muscle transplantation to an infarction area: an experimental study
      in the dog.
AB  - In plastic surgery, free skeletal muscle flaps are used for treatment of non
      healing injuries like chronic osteitis or radiation ulcers. We wanted to evaluate
      if the neoangiogenesis induced by these flaps can also constitute a method for
      revascularization in ischemic heart disease. In diffuse small vessel coronary
      heart disease, patients are not suitable for bypass surgery because it is
      impossible to create a microanastomosis with the coronary artery. As an
      alternative, a free striated muscle flap, transplanted onto the heart, can
      constitute a source of neovessels. With the induction of extra-intracardial
      collaterals that develop within 4 weeks after transplantation of the flap, a new
      surgical approach may be offered to those patients. Our experimental work was
      performed with 20 dogs. In these, a myocardial infarction of the anterior wall
      was selectively produced using the Judkins-technique (Radiology 89: 815-824,
      1967) for injection of Sephadex-microspheres. Four weeks later a free pectoralis
      muscle flap was transplanted onto the anterior wall of the heart. Arterial blood
      supply was achieved with an anastomosis with the internal mammary artery. The
      venous flow was directed into the right atrium. Four to eight weeks after
      surgery, the patency of the anastomosis was studied by angiography, showing
      patency in almost all surviving animals. Histological examination of the hearts
      revealed a prominent vascular network penetrating into the underlying myocardium.
      Corrosion cast preparations, as well as a postmortem angiography, showed even
      further penetration of the neovessels into the uninjured parts of the myocardium.
      Thus, myocardial revascularization may be achieved by transplantation of a
      skeletal muscle onto the heart.

PMID- 8469107
TI  - Nerve repair using freezing and fibrin glue: immediate histologic improvement of
      axonal coaptation.
AB  - Despite the fine microsurgical techniques available, injuries to peripheral
      nerves are still a surgical problem. Sutures placed in the epineurium or
      perineurium cause compression, brushing, and misdirection of endoneural tissue. A
      technique of nerve repair using freezing to trim the nerve and fibrin glue to
      coat it before thawing is described. The entire surgical repair procedure is
      carried out with the nerve stumps frozen. The observed axonal alignment with this
      technique was much better than that obtained by microsuture alone.

PMID- 8469108
TI  - Development of a mouse intestinal transplantation model.
AB  - We have recently developed a mouse intestinal transplantation model. The proximal
      segment of donor jejunum is transplanted into the recipient in a heterotopic
      position. End-to-side anastomoses are performed between donor aorta and recipient
      aorta and between donor portal vein and recipient inferior vena cava. Mortality
      rates were initially high due to shock, arterial thrombosis, and postoperative
      sepsis. Refinements in surgical techniques reduced these complications, resulting
      in a high rate of success. Important technical factors included (1) minimizing
      ischemic injuries to the graft in both the donor and the recipient, (2) using an
      aortic patch and elliptical aortotomy for anastomosis, (3) administering large
      volumes of crystalloid to maintain normal blood pressure during the donor and
      recipient surgeries, and (4) using broad-spectrum antibiotics as postoperative
      prophylaxis. The mice with isografts had normal intestinal function and histology
      when they were sacrificed 1 month after surgery. This new model of small bowel
      transplantation will be a useful tool to study the immunology of intestinal
      grafting at the molecular level.

PMID- 8469109
TI  - Management of major penetrating glass injuries to the upper extremities in
      children and adolescents.
AB  - Penetrating glass injuries are a common cause of severe neurovascular damage,
      both in adults and in children. Frequently, an innocent skin wound disguises the
      extensive nature of the injuries beneath. Nineteen children and adolescents (ages
      3-16 years) with a mean age of 9 years who sustained upper extremity penetrating
      glass wounds were evaluated retrospectively in order (1) to determine the
      incidence of unappreciated significant neurologic, musculotendonous, or vascular
      injury; (2) to provide indications for intraoperative evaluation under
      anesthesia; and (3) to further define the role of microneurorrhaphy in this
      population. Twelve patients sustained injuries above the elbow and seven patients
      injuries distal to the elbow. Above the elbow, the structures injured in order of
      frequency were the median nerve (75%), the brachial artery (58%), the ulnar nerve
      (50%), the musculocutaneous nerve (33%), sensory nerves of the arm and forearm
      and venae commitantes (42% each), the radial nerve (25%), and the chords of the
      brachial plexus (8%). Distal to the elbow, the ulnar nerve was the most
      frequently involved (71%), followed by the ulnar artery (57%), the flexor carpi
      ulnaris (57%), the superficialis and profundus flexor tendons (43%), the median
      nerve (43%), and the palmaris longus and flexor carpi radialis (14% each). Early
      exploration is critical to successful management. Vascular repairs and or
      microneurorrhaphy were necessary in all cases. A detailed follow-up evaluation to
      assess the results of these repairs was carried out from 4 to 9 years
      postsurgery. There were no clinical problems related to the vascular
      reconstructions. The results of the nerve repairs in this small series of
      children and adolescents were remarkably good.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469110
TI  - Strategies in pathogenesis: mechanistic specificity in the detection of generic
      signals.
AB  - The virulence genes of the plant pathogen Agrobacterium tumefaciens are induced
      by more than 40 low-molecular-weight phenolic compounds. The prevailing opinion
      is that (i) wound-derived phenols produced on breach of the integrity of the cell
      wall act as the initiating signal in a series of events which results in host
      cell transformation, and (ii) a classical membrane receptor, putatively VirA, is
      responsible for the recognition of all such phenolic inducers. Here, we argue
      that the discovery of the subset of inducers that are relatives of the
      dehydrodiconiferyl alcohol glucoside (DCG) growth factors redirects our attention
      to work on the plant wound as a site of cell division, and suggests that we
      further explore the implications of early work on the relationship between
      transformation efficiency and the status of the cell cycle of the host. In
      addition, we argue that the significant structural diversity allowed in the para
      position of the phenol ring of inducers suggests that a receptor-ligand
      interaction based solely on structural recognition is insufficient, but that
      recognition followed by a specific proton transfer event may be sufficient to
      explain vir induction activity. Hence, the specificity of the response of A.
      tumefaciens may be a consequence of the features required for a chemical reaction
      to occur on the receptor surface. Finally, we review affinity labelling studies
      which exploit this phenol detection mechanism and which provide evidence that the
      phenol receptor may be other than VirA, the sensory kinase of the two component
      regulatory system implicated in Agrobacterium virulence.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8469111
TI  - In situ hybridization analysis of developmental stages of Pneumocystis carinii
      that are transcriptionally active for a major surface glycoprotein gene.
AB  - An abundant glycoprotein on the surface of Pneumocystis carinii, termed gpA or
      gp120, is thought to play a role in the interaction of this opportunistic
      pathogen with its host. Using RNA:RNA hybridization techniques, the in situ
      expression of gpA mRNA in developmental forms of the organism was investigated in
      a ferret model of P. carinii pneumonia. The results suggested that the relative
      abundance of gpA-specific mRNA was variable in different developmental stages of
      ferret P. carinii. P. carinii localized along the epithelial lining of alveoli
      were transcriptionally active. Immunocytochemical detection of gpA and Giemsa
      staining suggested that many of these organisms were trophic forms of P. carinii.
      While no detectable gpA mRNA signal was found in the majority of P. carinii
      cysts, a portion of identifiable cysts co-localized with significant levels of
      gpA mRNA signal. Differential staining of the cyst wall with Gomori's methenamine
      silver suggested that the transcriptionally active P. carinii cysts were the
      intermediate or precyst forms of the organism, while the cysts with no detectable
      mRNA signal were either mature or empty (excysted). Alveolar macrophages were
      observed surrounded by transcriptionally active organisms; however, no gpA
      transcriptional activity was detected within macrophages. Taken together, the
      results suggest that transcription of gpA occurs in forms of P. carinii that are
      actively replicating, and in close proximity or contact with, alveolar epithelial
      cells.

PMID- 8469112
TI  - Molecular analysis of a cytotoxin-converting phage, phi CTX, of Pseudomonas
      aeruginosa: structure of the attP-cos-ctx region and integration into the serine
      tRNA gene.
AB  - The Pseudomonas aeruginosa ctx gene encoding cytotoxin is carried by a temperate
      phage phi CTX. The genome of phi CTX is a 35.5 kb double-stranded DNA with
      cohesive ends (cos). It is unique in that the ctx gene and attP site of phi CTX
      exist very close to the respective cohesive ends. In this study, we determined
      the structure of this attP-cos-ctx region. The termini of phi CTX are 21-base 5'
      extended-single-stranded DNAs. The ctx gene is located 361 bp downstream of the
      left end (cosL). The attP core sequence of 30 bp exists only 647 bp apart from
      the right end (cosR). The attP-cos-ctx region contains six kinds of repeats and
      integration host factor-binding sequences and showed sequence-directed static
      bends, suggesting its potential to form a highly ordered structure. In addition,
      phi CTX was found to integrate into the serine tRNA gene which was mapped to the
      43-45 min region on the P. aeruginosa chromosome.

PMID- 8469113
TI  - Deletion analysis of the SUP35 gene of the yeast Saccharomyces cerevisiae reveals
      two non-overlapping functional regions in the encoded protein.
AB  - SUP35 is an omnipotent suppressor gene of Saccharomyces cerevisiae coding for a
      protein consisting of a C-terminal part similar to the elongation factor EF-1
      alpha and a unique N-terminal sequence of 253 amino acids. Twelve truncated
      versions of the SUP35 gene were generated by the deletion of fragments internal
      to the coding sequence. Functional studies of these deletion mutants showed that:
      (i) only the EF-1 alpha-like C-terminal part of the Sup35 protein is essential
      for the cell viability; (ii) overexpression of either the N-terminal part of the
      Sup35 protein or the full-length Sup35 protein decreases translational fidelity,
      resulting in omnipotent suppression and reduced growth of [psi+] strains; (iii)
      expression of the C-terminal part of the Sup35 protein generates an
      antisuppressor phenotype; and (iv) both the N- or C-terminal segments of the
      Sup35 protein can bind to 80S ribosomes. Thus, the data obtained define two
      domains within the Sup35 protein which are responsible for different functions.

PMID- 8469114
TI  - Functional analysis of the cya promoter of Bordetella pertussis.
AB  - The cyaA gene of Bordetella pertussis and of Bordetella bronchiseptica encodes a
      toxin which is a bifunctional protein exhibiting adenylate cyclase and haemolytic
      activities. In Bordetella, virulence factors are synthesized under the control of
      the bvg regulatory locus, in response to environmental signals. In Escherichia
      coli the cyaA gene is not expressed, nor is it activated by bvg indicating that
      the activation of cya by bvg is indirect. To characterize cis-acting regulatory
      regions required for the activation of the cyaA gene we constructed cyaA-lacZY
      fusions containing progressive deletions in the promoter upstream region and
      isolated promoter mutations by chemical and site-directed mutagenesis. Deletion
      analysis shows that a region extending from -569 to -136 bp upstream from the
      start site of transcription is required for transactivation by bvg, suggesting
      that multiple binding sites are involved in the activation of the cyaA promoter.
      No single or double mutations in the promoter upstream region were found which
      conferred inactive or bvg-independent Cya phenotype. A double mutation in
      positions +10 and +13, relative to the transcription start site, rendered the
      promoter bvg-independent and functional in E. coli. The constitutive mutations
      create a new transcription start site, 20 bp downstream from the wild-type site,
      by providing new -10 and -35 elements recognized by RNA polymerase alone.

PMID- 8469115
TI  - The virA promoter is a host-range determinant in Agrobacterium tumefaciens.
AB  - The limited host range (LHR) Agrobacterium tumefaciens strain Ag162 is an isolate
      with a narrow host range. Introduction of the wide host range (WHR) virA gene is
      essential for extending the host range to Kalanchoe daigremontiana. In this
      report we show that the region upstream of the ATG start codon is responsible for
      the LHR phenomenon and that this is probably due to the non-inducibility of the
      LHRvirA promoter. By comparing the characteristics of the LHR and WHR VirA
      receptor proteins, it was found that the LHR VirA protein is able to activate the
      WHR VirG protein in the presence of acetosyringone and that this acetosyringone
      dependent vir-induction is enhanced by the presence of D-glucose, as in the case
      of WHR VirA proteins. These results indicate that the domains, acting as
      receptors for sugars and phenolic signals, must be conserved between the LHR and
      WHR VirA receptor proteins.

PMID- 8469116
TI  - A 55 kDa antigen of Pneumocystis carinii: analysis of the cellular immune
      response and characterization of the gene.
AB  - Rat-derived Pneumocystis carinii contains a major antigen complex of 45-55 kDa.
      The fusion protein of a cDNA encoding the 3' portion of the 55kDa antigen, which
      had previously been shown to be recognized by serum antibodies of exposed
      subjects, was investigated for its ability to stimulate a cellular immune
      response. Rats exposed to P. carinii via the environment exhibited a vigorous
      proliferative response to the antigen whereas unexposed rats did not. The full
      length cDNA for a 55kDa antigen was cloned and found to contain a 1245bp open
      reading frame capable of encoding a 414-amino-acid peptide. The gene encoding
      this protein contained a single 39bp intron and transcribed a 1.45kb RNA message.
      The cloning and characterization of the 55kDa antigen gene will allow production
      of the specific immunological reagents necessary to characterize this molecule
      and study its role in the biology and pathogenesis of P. carinii.

PMID- 8469117
TI  - Cloning and identification of a two-component signal-transducing regulatory
      system from Bacteroides fragilis.
AB  - A DNA fragment was cloned from Bacteroides fragilis that bestowed low-level
      tetracycline resistance to Escherichia coli strains harbouring the cloned
      fragment on a multicopy plasmid. The tetracycline resistance determinant was
      localized to a 4.3kb Bg/II-PstI subfragment of the original clone. DNA sequence
      analysis of this fragment revealed that it contained an operon encoding two
      proteins: one of 519 amino acids, RprX, and a second of 236 amino acids, RprY.
      Protein sequence analysis revealed that the two proteins shared sequence identity
      with a family of multicomponent signal-transducing regulatory proteins identified
      from many diverse bacterial genera. RprX shared identity with the first component
      of the regulatory system, the histidine protein kinase receptor (for example
      EnvZ, PhoR, CheA, and VirA). RprY shared identity with the second member of the
      regulatory protein pair, the regulatory response protein (for example OmpR, PhoB,
      CheY, and VirG). Expression of these proteins from a multicopy plasmid vector in
      E. coli resulted in a decrease in the level of the outer membrane porin protein
      OmpF and an increase in the level of the outer membrane porin protein OmpC. The
      decrease in OmpF levels correlates with, and may be the cause of, the increased
      tetracycline resistance. Regulation of the levels of OmpF and OmpC is normally
      controlled by a multicomponent signal-transducing regulatory pair of proteins,
      EnvZ and OmpR. The effect RprX and RprY have on OmpF expression is mediated at
      the level of transcription. Thus, RprX and RprY may be interfering with the
      normal regulation of OmpF by OmpR and EnvZ.

PMID- 8469118
TI  - Mutagenesis of cellulase EGZ for studying the general protein secretory pathway
      in Erwinia chrysanthemi.
AB  - Extracellular secretion of endoglucanase Z (EGZ) from Erwinia chrysanthemi is
      mediated by the so-called Out general secretion pathway and, presumably, involves
      recognition of EGZ-carried structural information by one or more of the Out
      proteins. Investigating the relationships between structure and secretability of
      EGZ was the purpose of the present work. EGZ is made of two independent domains,
      located at the N- and C-proximal sides, separated by a Ser/Thr-rich region, which
      are responsible for catalysis and cellulose-binding, respectively. The existence
      of a secretion region ('targeting signal') was investigated by studying the
      secretability of modified EGZ derivatives. These resulted from deletion or
      peptide insertion and were designed by using the domain organization cited above
      as a guide. Catalytic and/or cellulose-binding tests showed that all proteins
      exhibited at least a functional EGZ domain while immunoblot analyses confirmed
      that neither the insertions nor the deletions led to grossly misfolded proteins.
      In contrast, all of the proteins lost their secretability in E. chrysanthemi.
      This suggested that at least two secretion motifs existed, one lying within each
      functional domain. The role of the Ser/Thr-rich linker region was subsequently
      tested. Accordingly, two proteins containing a linker region whose length was
      increased by the addition of 8 and 18 additional residues and one protein lacking
      the linker region were studied. All three exhibited endoglucanase activity and
      cellulose-binding ability, confirming the independence of the domains within the
      context of EGZ/polysaccharide interaction. In contrast, none was secreted by E.
      chrysanthemi.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469119
TI  - TraM of plasmid R1 regulates its own expression.
AB  - Regulation of the traM gene, which encodes a factor essential for conjugation of
      resistance plasmid R1, was studied in vivo using translational gene fusion.
      traM"lacZ fusion constructs were transferred to the chromosome via the
      recombinant phage lambda RZ5. The level of beta-galactosidase expressed by the
      lysogens indicates that the traM promoters are very active. Expression of traM
      was diminished five- to sixfold when the single-copy plasmids R1 or R1-19 were
      present in trans. When recombinant plasmids carrying traM were present at higher
      copy numbers, traM expression was reduced as much as 45-fold. The negative effect
      of R1 plasmids on traM expression in trans, which we interpret as autoregulation,
      was observed regardless of whether the plasmids were conjugatively repressed or
      derepressed. Site-specific mutagenesis of the region encoding the N-terminus of
      the TraM protein eliminated the autoregulative effect indicating that the N
      terminal amino acids of the protein are important to its DNA-binding function.
      The autoregulatory behaviour of TraM is allele specific. R1- or P307-encoded TraM
      molecules were found to recognize only the cognate DNA.

PMID- 8469120
TI  - Characterization of a replicon of the moderately promiscuous plasmid, pGSH5000,
      with features of both the mini-replicon of pCU1 and the ori-2 of F.
AB  - The dominant, polA1-independent replicon of pGSH500, rep beta (1.8 kb), consists
      of a cis-acting oriV region of 245 bp; a repB gene that is essential for
      autonomous replication and 18, 30 to 36 bp iterons which constitute the inc/cop
      region. The molecular organization of rep beta resembles that of mini-pCU1
      (IncN). Furthermore, there is a 58% identity between the Rep proteins of these
      replicons. RepB also shows a 31% identity with RepE of mini-F. In addition, an
      80% identity over 200 bp was identified between the cis-acting beta oriV region
      and the equivalent region of ori-2 (mini-F). Replicons with deletions of repB
      could be complemented by Rep (pCU1) and RepE (mini-F) in trans, supporting the
      hypothesis that rep beta is a natural hybrid between a pCU1-like and F-like
      replicon.

PMID- 8469121
TI  - Short-term memory: where do we stand?
AB  - Two empirical challenges to the traditional "modal model" of short-term memory
      are that neither the Brown-Peterson distractor technique nor the recency effect
      in recall is well accommodated by that position. Additionally, the status of
      memory stores as such, has declined in response to proceduralist thinking. At the
      same time, the concept of coding, on which the modal model is silent, is
      increasingly central to memory theory. People need to remember things in the
      short term, but a dedicated store does not need to be the agency.

PMID- 8469122
TI  - The recency effect: implicit learning with explicit retrieval?
AB  - The recency effect in free recall features prominently in 1960s' theorizing about
      short-term memory, but has since been largely ignored. We argue that this stems
      from a preoccupation with the role of recency in the concept of primary memory
      and the neglect of its role in a broader working-memory framework. It is
      suggested that the recency effect reflects the application of an explicit
      retrieval strategy to the residue of implicit learning within a range of
      cognitive systems. When retrieved implicitly, the same residue is assumed to form
      the basis of priming effects. The various criteria for implicit learning
      described by Tulving and Schacter (1990) are successfully applied to the recency
      effect, and a retrieval process is outlined that can account for both long- and
      short-term recency effects. It is suggested that a framework combining recency,
      priming, and implicit learning provides a basis for understanding one of the most
      important features of cognition and memory, namely, that of maintaining
      orientation in time and place.

PMID- 8469123
TI  - Very short-term conceptual memory.
AB  - Short-term memory for conceptual information is largely missing from current
      models of short-term memory. Several phenomena are discussed that give evidence
      for very brief conceptual representations of stimuli. Although these fleeting
      representations do not surface readily with many of the standard methods for
      studying and testing short-term memory, I argue that they are fundamental to
      cognitive processing and to the form that long-term memory takes.

PMID- 8469124
TI  - Activation, attention, and short-term memory.
AB  - The premise of this paper is that the popular term "short-term memory" (STM) is
      vague because it is used to refer to either (1) the set of representations from
      long-term memory currently in a state of heightened activation or (2) the focus
      of attention or content of awareness. A more coherent conception of STM is
      hierarchical, with the focus of attention depicted as a subset of the activated
      portion of long-term memory. Research issues are discussed to illustrate that
      this simple conception of STM leads to testable predictions and useful lines of
      inquiry.

PMID- 8469125
TI  - A multinomial processing tree model for degradation and redintegration in
      immediate recall.
AB  - When items are presented for immediate recall, a verbal trace is formed and
      degrades quickly, becoming useless after about 2 sec. The span for items such as
      digits equals the number of items that can be pronounced in the available time.
      The length of the items affects span by affecting pronunciation rate. Other
      properties, such as phonological similarity and lexicality, can affect span
      without affecting pronunciation rate. These properties change the trace's useful
      lifetime by affecting redintegration. An analogy is drawn between trace
      reconstruction and repair of errors in speech. When a trace is degraded, one
      process attempts to form a phoneme string, and another process attempts to form a
      word. The two processes are autonomous and can be selectively influenced by
      lexicality and phonological similarity. The resulting processing tree models make
      simple predictions that depend on whether or not the influenced processes are
      sequential. The results are illustrated with data from experiments by Besner and
      Davelaar (1982).

PMID- 8469126
TI  - Short-term memory and sentence processing: evidence from neuropsychology.
AB  - Traditional models of memory assume that short-term memory, as measured by memory
      span, plays an important role in linguistic processing and the learning of verbal
      information. Contradicting this view are findings from a brain-damaged patient,
      E.A., who, despite a verbal memory span of about two items, demonstrated normal
      sentence comprehension in a variety of tasks. She was, however, impaired whenever
      verbatim phonological information had to be maintained or learned. These results
      and those from other patients with reduced span suggest that the phonological
      storage capacity that is critical to memory span plays only a limited role in
      language processing, specifically in the maintenance and learning of phonological
      forms. Implications for models of short-term memory are discussed. It is argued
      that short-term memory should be seen as deriving from the processing and
      retentive capacities of language processing modules, with span tasks drawing on
      only a subset of these modules.

PMID- 8469127
TI  - Varieties of working memory as seen in biology and in connectionist/control
      architectures.
AB  - Biological and computational concepts that underlie the nature of working memory
      are briefly reviewed. The conceptualization of working memory has changed
      dramatically in the last 30 years. Current biological work has monitored several
      aspects of memory, including activation decay, sustained activation, long-term
      connection change, and differential structures for episodic (hippocampal
      formation) and procedural learning. Current connectionist modeling has identified
      factors including multiple-region-based processing, control processing as well as
      data storage, tradeoffs between fast- and slow-connection-change learning
      effects, and the speeding of acquisition via multiple levels of learning. The
      need to relate the biological, behavioral, and computational constraints into
      models of working memory is discussed. Finally, conceptualizations of working
      memory must acknowledge the need for human learning systems to be robust enough
      to operate in a dynamic world.

PMID- 8469128
TI  - Short-term memory: a brief commentary.
AB  - Over the years, a metatheoretical view of short-term memory has developed. This
      view, closely related to the "modal" model from the 1960s, is supported by an
      increasing base of neurophysiological data, and a wide variety of empirical
      findings. It treats short-term memory as (1) the temporary, above threshold,
      activation of neural structures (related in not-too-well-specified ways to
      various recency effects); (2) a work space for carrying out virtually all
      cognitive operations involved in human cognition; and (3) the source of capacity
      limitations, accounting for certain memory limitations and most attentional
      limitations. The main problem with this view is the fact that it encompasses
      virtually everything that we are concerned with in human cognition--a successful
      model would almost be a general model of cognition, something the field has not
      yet approached. This situation is not grounds for despair. Progress is being made
      on many fronts, notwithstanding the fact that the most successful models are
      focused on specific task domains. Recent advances include an increasing awareness
      of the necessity for detailed models of short-term retrieval, a theme reflected
      in a number of articles in the present collection.

PMID- 8469129
TI  - Do we know what we've learned from listening to the news?
AB  - This study investigates the relationship between knowledge acquisition and an
      awareness of that knowledge within the context of listening to the news. Subjects
      listened to a recording of a radio news program consisting of regular news items
      as well as editorials, manipulated to be of high or low personal relevance. They
      then completed a surprise memory test and rated their confidence in their
      answers. In contrast to many studies, the results indicated a strong positive
      confidence-accuracy relationship. Confidence ratings were generally a better
      predictor of an individual's performance than were predictions based on item
      difficulty. Whereas subjects reported strong and accurate feelings of knowing,
      they apparently lacked complementary feelings of not knowing. The implications of
      these findings and others are discussed.

PMID- 8469130
TI  - Rhyme decisions to spoken words and nonwords.
AB  - Lexical effects in auditory rhyme-decision performance were examined in three
      experiments. Experiment 1 showed reliable lexical involvement: rhyme-monitoring
      responses to words were faster than rhyme-monitoring responses to nonwords; and
      decisions were faster in response to high-frequency as opposed to low-frequency
      words. Experiments 2 and 3 tested for lexical influences in the rejection of
      three types of nonrhyming item: words, nonwords with rhyming lexical neighbor
      (e.G., jop after the cue rob), and nonwords with no rhyming lexical neighbor
      (e.g., vop after rob). Words were rejected more rapidly than nonwords, and there
      were reliable differences in the speed and accuracy of rejection of the two types
      of nonword. The advantage for words over nonwords was replicated for positive
      rhyme decisions. However, there were no differences in the speed of acceptance,
      as rhymes, of the two types of nonword. The implications of these results for
      interactive and autonomous models of spoken word recognition are discussed. It is
      concluded that the differences in rejection of nonrhyming nonwords are due to the
      operation of a guessing strategy.

PMID- 8469131
TI  - The role of stimulus familiarity in context-dependent recognition.
AB  - Investigations of context-dependent recognition, a phenomenon in which
      recognition is better for items studied and tested with the same rather than
      different context, have shown serious inconsistencies. A simple organization of
      (1) contextual cues, distinguishing between local context (specific cues) and
      global context (general cues), and (2) stimulus familiarity, distinguishing
      between novel and familiar stimuli, reduces much of this variability. In two
      experiments, changes in both local context (descriptive label) and global context
      (environment) were manipulated in order to examine their effects on recognition
      memory for faces that differed in familiarity. Changes in local context impaired
      recognition of both unfamiliar and familiar faces; changes in environmental
      context impaired recognition only of unfamiliar faces. These results are
      consistent with the many failures to find impaired recognition of verbal stimuli
      under changed environmental contexts, and they suggest that stimulus familiarity
      is a critical parameter modulating environmental context effects.

PMID- 8469132
TI  - Processing novel compounds: evidence for interactive meaning activation of
      ambiguous nouns.
AB  - In three experiments, the meaning activation of ambiguous nouns in novel nominal
      compounds was investigated. Ambiguous nouns were unbalanced homographs occurring
      as the second members of the compound. Meaningful interpretations of the
      compounds were based on either the dominant or the subordinate meaning of the
      ambiguous noun. In Experiment 1, visually presented novel compounds serving as
      primes were followed at varying intervals by targets associatively related to
      distinct meanings of the ambiguous noun. In a lexical decision task, facilitation
      effects were found only for targets related to the meaning that was relevant for
      the interpretation of the compound. Experiment 2 showed that interactive
      activation could not be attributed to differences in semantic relatedness between
      the first members of compounds and targets. Experiment 3 demonstrated equal
      intralexical relatedness between members for both types of compounds. It is
      proposed that interactive activation may facilitate the interpretation of the
      novel compound. Compatible meaning aspects of the nouns may become more strongly
      activated, and incompatible meaning aspects may not become activated. The
      selection of meaning aspects relevant for interpretation would thereby be
      simplified.

PMID- 8469133
TI  - Neighborhood effects in visual word recognition: facilitatory or inhibitory?
AB  - In five experiments, in which subjects were to identify a target word as it was
      gradually clarified, we manipulated the target's frequency of occurrence in the
      language and its neighborhood size--the number of words that can be constructed
      from a target word by changing one letter, while preserving letter position. In
      Experiments 1-4, visual identification performance to screen-fragmented words was
      measured. In Experiments 1 and 2, we used the ascending method of limits, whereas
      Experiments 3 and 4 presented a fixed-level fragment. In Experiment 1, there was
      no relation between overall accuracy and neighborhood size for words between
      three and six letters in length. However, more errors of commission (guesses)
      were made for high-neighborhood words and more errors of omission (blanks) were
      made for low-neighborhood words. Letter errors within guesses occurred at serial
      positions having many neighbors, and these positions were also likely to contain
      consonants rather than vowels. In Experiment 2, a small facilitatory effect of
      neighborhood size on both high- and low-frequency words was found. In contrast,
      in Experiments 3 and 4, using the same set of words, inhibitory effects of
      neighborhood size, but only for low-frequency words, were found. Experiment 5,
      using a speeded identification task, showed results parallel to those of
      Experiments 3 and 4. We suggest that whether neighborhood effects are
      facilitatory or inhibitory depends on whether feedback allows subjects to
      disconfirm initial hypotheses that the target is a high-frequency neighbor.

PMID- 8469134
TI  - Infants' eyewitness testimony: effects of postevent information on a prior memory
      representation.
AB  - In eyewitness testimony research, postevent information impairs retention of the
      original event and increases the probability that interpolated information will
      be identified as part of the original event. The present experiments studied
      these effects with 3-month-olds. Infants learned to kick to move a particular
      crib mobile and then were briefly exposed to information about a novel mobile.
      The novel postevent information impaired recognition of the original mobile when
      it immediately followed training but not when it was delayed by 1 day. Like
      adults, infants treated the postevent information as part of the original
      training event, continuing to do so for at least 2 weeks. We propose that
      postevent information displaces conflicting information coactive with it in
      primary memory and creates a new, updated memory token of the event. Once the new
      token leaves primary memory, however, it is protected; only a copy can be
      retrieved and modified in the future.

PMID- 8469135
TI  - Analysis of carotenoids in human and animal tissues.

PMID- 8469136
TI  - Plasma carotenoid levels in anorexia nervosa and in obese patients.

PMID- 8469137
TI  - Psoralen photosensitization and plasma and cutaneous beta-carotene concentrations
      in hairless mice.

PMID- 8469138
TI  - Human metabolism of carotenoid analogs and apocarotenoids.

PMID- 8469139
TI  - Assay for carotenoid 15,15'-dioxygenase in homogenates of rat intestinal mucosal
      scrapings and application to normal and vitamin A-deficient rats.

PMID- 8469140
TI  - Evaluation of carotenoid intake.

PMID- 8469141
TI  - Retinoic acid synthesis from beta-carotene in vitro.

PMID- 8469142
TI  - Uptake and cleavage of beta-carotene by cultures of rat small intestinal cells
      and human lung fibroblasts.

PMID- 8469143
TI  - Enzymatic conversion of all-trans-beta-carotene to retinal.
AB  - Enzymatic conversion of all-trans-beta-carotene to retinal by a partially
      purified enzyme from rabbit, rat, and human neonatal intestinal mucosa has been
      demonstrated. The enzymatic product was characterized based on the following
      evidence. First, the product gave rise to its O-ethyl oxime by treatment with O
      ethylhydroxylamine with an absorption maximum at 363 nm in ethanol characteristic
      of authentic retinal (O-ethyl) oxime. High-performance liquid chromatography of
      this derivative yielded a sharp peak with a retention time of 7.99 min,
      corresponding to the authentic compound. The enzyme blank and boiled enzyme blank
      failed to show any significant HPLC peaks corresponding to retinal (O-ethyl)
      oxime or retinal or retinol. Second, the mass spectrum of the O-ethyl oxime of
      the enzymatic product was identical to that of authentic retinal (O-ethyl) oxime
      (m/z 327, 45%; m+ and m/z 282, 100%, methoxy). Third, the 14C radioactivity
      persisted to constant specific activity even after repeated crystallization of
      the retinal (O-ethyl) oxime isolated from the enzyme reaction with purified beta
      [14C]carotene. Fourth, the enzymatic product exhibited an absorption maximum at
      370 nm in light petroleum characteristic of authentic retinal. Furthermore, it
      was reduced by horse liver alcohol dehydrogenase to retinol with an absorption
      maximum at 326 nm in light petroleum. This retinol was enzymatically esterified
      to retinyl palmitate by rat pancreatic esterase with a retention time of 10 min
      on HPLC, corresponding to authentic retinyl palmitate. Thus, the enzymatic
      product of beta-carotene cleavage by the partially purified intestinal enzyme has
      been unequivocally confirmed to be retinal. Similarly, enzymatic conversion of
      all-trans-beta-carotene to retinal by an intestinal mucosal enzyme from autopsy
      samples of human neonates has also been demonstrated. Based on the observed
      activities among intestinal samples from 12 premature infants, the BCC enzyme
      activity ranged from 3.3 to 1210 pmol/mg mucosal protein/hr. However, the
      observed activities in the human autopsy samples may be markedly underestimated,
      presumably because of marked loss of enzyme activity from the time of death to
      the time of assay. Therefore, the true activity of the enzyme can be assessed
      only after the extent of the loss of its activity on storage of the human samples
      can be accurately measured. Nonetheless, the demonstration of BCC enzyme activity
      in human neonates shows that beta-carotene may be an important source of vitamin
      A nutrition during gestation.

PMID- 8469144
TI  - Evolutionary conservation and structural similarities of carotenoid biosynthesis
      gene products from photosynthetic and nonphotosynthetic organisms.

PMID- 8469145
TI  - Carotenoid absorption in humans.

PMID- 8469146
TI  - Protection by cloned carotenoid genes expressed in Escherichia coli against
      phototoxic molecules activated by near-ultraviolet light.

PMID- 8469147
TI  - Association of carotenoids with human plasma lipoproteins.

PMID- 8469148
TI  - Carotenoid analysis in mutants from Escherichia coli transformed with
      carotenogenic gene cluster and Scenedesmus obliquus mutant C-6D.

PMID- 8469149
TI  - Functional analysis and purification of enzymes for carotenoid biosynthesis
      expressed in photosynthetic bacteria.

PMID- 8469150
TI  - Characteristics of membrane-associated carotenoid-binding proteins in
      cyanobacteria and prochlorophytes.

PMID- 8469151
TI  - Photoregulated carotenoid biosynthetic genes of Neurospora crassa.

PMID- 8469152
TI  - Solubilization, cellular uptake, and activity of beta-carotene and other
      carotenoids as inhibitors of neoplastic transformation in cultured cells.

PMID- 8469153
TI  - Differentiation between central and excentric cleavage of beta-carotene.

PMID- 8469154
TI  - Carotenoid-protein complexes.
AB  - This chapter provides an updated report of carotenoprotein-related research. Very
      few carotenoproteins have been purified; however, their presence in aqueous
      extracts may be indicated by spectroscopic evidence. Carotenoproteins have been
      isolated, purified, and characterized from the ectoderm, exoskeleton, eggs, and
      ovaries of marine invertebrates, especially crustaceans. Water-soluble and
      detergent-soluble carotenoid-protein complexes have also been isolated from the
      cytoplasmic membrane of some cyanobacteria, Mangifera indica, and carrots.
      Recently, we have been able to partially purify a beta-carotene-protein complex
      from fresh livers of rats fed beta-carotene. Studies are currently in progress to
      purify and characterize the protein. This is the first successful isolation of a
      vertebrate carotenoprotein. The isolation of carotenoproteins is generally by
      standard techniques of protein chemistry. Purification, crystallization of the
      complex, and reconstitution of apoprotein and carotenoid components have been
      achieved for some crustacean carotenoproteins. The complex is very sensitive to
      bright light and to temperatures above that of refrigeration. However, it is best
      preserved in solutions of high ionic strength or as a precipitate in strong
      ammonium sulfate solutions.

PMID- 8469155
TI  - Analysis of carotenoids in human plasma and tissues.
AB  - Procedures are described for the extraction and analysis of carotenoid pigments
      from human tissues and plasma. The method allows resolution of many polar
      pigments, including several such compounds more polar than zeaxanthin. While the
      method requires two separate HPLC runs when applied to tissues containing
      significant quantities of triglyceride, the additional information made available
      on the polar carotenoid composition of such samples is substantial.

PMID- 8469156
TI  - Assessing variability in quantitation of carotenoids in human plasma: variance
      component model.

PMID- 8469157
TI  - Philosophies for the design and development of clinical decision-support systems.
AB  - Little significance is attached by medical informatics workers to the many
      practical issues which affect the development of clinical decision-support
      systems. We examine the current state of research in clinical decision-support,
      the characteristics and motivations of developers, and the perceptions of
      intended end-users. Factors which adversely affect the success of systems are
      highlighted and pointers to good practice discussed. We then propose a coherent
      approach to system development, consisting of requirements analysis, software
      design, implementation, testing, evaluation and maintenance.

PMID- 8469158
TI  - Graphical access to medical expert systems: IV. Experiments to determine the role
      of spoken input.
AB  - The goal of our research is to design improved interfaces for medical expert
      systems. Previously, the use of graphical techniques was explored to improve the
      acceptance by clinicians of the user interface. Now that devices that accept
      spoken input are available, we wish to design interfaces that take advantage of
      this potentially more natural modality for interaction. To understand how
      clinicians might want to speak to a medical decision-support system, we carried
      out an experiment that simulated the availability of a spoken interface to the
      ONCOCIN medical expert system. ONCOCIN provides therapy advice for patients on
      complex cancer therapy protocols based on a description of the patient's current
      medical status and laboratory-test values. In the experiment, we had oncologists
      present a clinical case while observing the ONCOCIN flowsheet display. A project
      member listened to the presentation and filled in values for the flowsheet, as
      well as introducing purposeful misunderstandings of the input. The results
      suggest that each individual developed a stereotypical grammar for communicating
      with the program. Our experience with the purposeful miscommunications suggests
      particular ways to tailor requests for repetition based on the part of the
      utterance that was not understood.

PMID- 8469159
TI  - Graphical access to medical expert systems: V. Integration with continuous-speech
      recognition.
AB  - This paper describes three prototypes of computer-based clinical record-keeping
      tools that use a combination of window-based graphics and continuous speech in
      their user interfaces. Although many of today's commercial speech-recognition
      products achieve high rates of accuracy for large grammars (vocabularies of words
      or collections of sentences and phrases), they can only "listen for" (and
      therefore recognize) a limited number of words or phrases at a time. When a
      speech application requires a grammar whose size exceeds a speech-recognition
      product's limits, the application designer must partition the large grammar into
      several smaller ones and develop control mechanisms that permit users to select
      the grammar that contains the words or phrases they wish to utter. Furthermore,
      the user interfaces they design must provide feedback mechanisms that show users
      the scope of the selected grammars. The three prototypes described were designed
      to explore the use of window-based graphics as control and feedback mechanisms
      for continuous-speech recognition in medical applications. Our experiments
      indicate that window-based graphics can be effectively used to provide control
      and feedback for certain classes of speech applications, but they suggest that
      the techniques we describe will not suffice for applications whose grammars are
      very complex.

PMID- 8469160
TI  - Developmental toxicity risk assessment: a rough sets approach.
AB  - A rough-sets approach was applied to a data set consisting of animal study
      results and other compound characteristics to generate local and global
      (certain/possible) sets of rules for prediction of developmental toxicity in
      human subjects. A modified version of the rough-sets approach is proposed to
      allow the construction of an approximate set of rules to use for prediction in a
      manner similar to that of discriminant analysis. The modified rough-sets approach
      is superior in predictability to the original form of rough-sets methodology. In
      comparison to discriminant analysis, modified rough sets (approximate rules)
      appear to be better in overall classification, sensitivity, positive and negative
      predictive values. The findings were supported by applying the modified rough
      sets and discriminant analysis on a test data set generated from the original
      data set by using a resampling plan.

PMID- 8469161
TI  - A genetic algorithm to improve a neural network to predict a patient's response
      to warfarin.
AB  - The ability of neural networks to predict the international normalised ratio
      (INR) for patients treated with Warfarin was investigated. Neural networks were
      obtained by using all the predictor variables in the neural network, or by using
      a genetic algorithm to select an optimal subset of predictor variables in a
      neural network. The use of a genetic algorithm gave a marked and significant
      improvement in the prediction of the INR in two of the three cases investigated.
      The mean error in these cases, typically, reduced from 1.02 +/- 0.29 to 0.28 +/-
      0.25 (paired t-test, t = -4.71, p < 0.001, n = 30). The use of a genetic
      algorithm with Warfarin data offers a significant enhancement of the predictive
      ability of a neural network with Warfarin data, identifies significant predictor
      variables, reduces the size of the neural network and thus the speed at which the
      reduced network can be trained, and reduces the sensitivity of a network to over
      training.

PMID- 8469162
TI  - A new method to assess the difficulty of a medical diagnosis: application to
      electrocardiographic interpretation.
AB  - A new method to assess the relative difficulty of a medical diagnosis and the
      efficacy of a diagnostic procedure is described. The cases within a population
      are classified by N independent interpreters, i.e., medical experts or computer
      programs. The percentages of correctly diagnosed cases by N (unanimity), N-1, N
      2, ..., zero interpreters, respectively, are calculated. These N + 1 percentages
      are presented in a histogram. A cumulative plot is derived from the "unanimity"
      value. The ratio "unanimity value"/"zero value" is proposed as an index of
      diagnostic performance. An application to the CSE database is presented which is
      composed of 1,220 electrocardiographic tracings interpreted by 13 cardiologists
      and 15 computer programs. The cumulative plots, the performance index and Log
      (index) values, established for eight different diagnostic statements, clearly
      show the relative degree of diagnostic difficulty for each of them and the
      particular efficacy of each approach, i.e., electrocardiography versus
      vectorcardiography, and computerized versus human interpretation.

PMID- 8469163
TI  - Semantic analysis of medical records.
AB  - A program (LogStory) is described that was developed for the automatic semantic
      analysis of clinical narratives, stored in a computerized problem-oriented
      medical record (PROMED). The diagnoses were written in a free-text format during
      consultation, and later collected into diagnostic classes, e.g., diseases. A
      lexical parser automatically created dictionaries from the clinical narrative
      associated with each disease. Automatic (fuzzy) set operations were performed on
      the words associated with each class. The manifestations of 16 diseases were
      automatically extracted by pairwise operations on the word sets. The correlation
      between diseases and corresponding signs, symptoms and treatment was highly
      significant (p < 0.001). Applying the difference operation on diseases with
      disjunct sets of clinical findings allowed the recovery of disease-specific
      knowledge. The evolution of a disease was accounted for, and the system was able
      to generalize its findings. The PROMED-LogStory concept enables the processing of
      natural language and may be a powerful tool for knowledge acquisition and
      clinical research.

PMID- 8469164
TI  - Information exchange in a patient-physician encounter. A quantitative approach.
AB  - The efficiency of data acquisition in a patient-physician encounter was
      investigated. In a simulation study, in which 60 family physicians and eight
      internists participated, the patient was replaced by an actor who used a
      structured set of patient data. The simulation model proved to be quite natural;
      data acquisition was primarily influenced by the amount of time available.
      Discerning between overall and diagnostic information, conclusions could be drawn
      on the effectiveness of data acquisition. Under time pressure, physicians tend to
      look for broadly defined symptoms rather than for details of the patient's
      illness. The collection of patient data then has an inquisitive character, having
      implications for the quality of clinical judgement. The physician's capabilities
      in eliciting relevant information from a patient appear to be of crucial
      importance for clinical problem-solving. The present study shows that patient
      physician interviewing is effective insofar it concerns broad descriptions, but
      ineffective in eliciting specific data. If interviewing is laborious and time
      consuming this may, therefore, affect the kind of information to be collected.

PMID- 8469165
TI  - Modelling in-patient bed usage behaviour in a department of geriatric medicine.
AB  - The flow of patients through geriatric hospitals has been previously described in
      terms of acute and long-stay states where the bed occupancy at a census point is
      modelled by a mixed exponential model. Using data for sixteen years the model was
      fitted to successive annual census points, in order to provide a description of
      temporal trends. While the number of acute patients has remained fairly stable
      during the period, the model shows that there has been a decrease in the number
      of long-stay patients. Mean lengths of stay in our geriatric hospital before
      death or discharge have decreased during the study period for both acute and long
      stay patients. Using these fits of the mixed exponential model to census data, a
      method is provided for predicting future turnover of patients. These predictions
      are reasonably good, except when the turnover patterns go through a period of
      flux in which assumption of stability no longer holds. Overall, a methodology is
      presented which relates census analysis to the behaviour of admission cohorts,
      thus producing a means of predicting future behaviour of patients and identifying
      where there is a change in patterns.

PMID- 8469166
TI  - MultiLink--an intermediary system for multi-database access.
AB  - The design and implementation is described of MultiLink, a desktop system for
      direct enduser access to remote bibliographic information. The system is an
      application of a client-server technique based on a campuswide network, with the
      objective to assist end-users to accomplish the information--retrieval process by
      capturing knowledge and expertise for searches in query formulations. MultiLink,
      via intelligent interfaces, allows users to access several dozens of
      bibliographic databases. The application integrates regional, national and
      international resources, and brings library services to the user's desktop level.

PMID- 8469167
TI  - HTLV-1 sequences in lymphocytes of a patient with non-tropical spastic
      tetraparesis and her asymptomatic husband.
AB  - We describe a 65-year-old woman born and living in Northern Italy affected by non
      tropical spastic tetraparesis and her asymptomatic husband presenting HTLV-1
      sequences in their lymphocytes detected by polymerase chain reaction (PCR). We
      discuss the significance of the case and the mechanism involved in HTLV-1
      infection and the relationship with neurological disorders, stressing that this
      case is the first reported in Italy.

PMID- 8469168
TI  - Preliminary data on the establishment of permanent cell lines continuously
      producing HIV-1: factors affecting the transmissibility and adaptability of
      "wild" HIV-1 isolates.
AB  - This study examines some technical aspects of the transmission to and permanent
      adaptability in continuous cell lines of wild HIV-1 isolates. Three cell systems
      (the lymphocytic cell lines Molt-3 and H-9 and the monocytoid cell line U-937)
      and two transmission protocols (cell to cell and cell-free) were used. Two
      different replicative behaviours were observed among isolates efficiently
      transmitted: a) transmissibility but not adaptability (consisting in a limited
      length of viral replication); aa) transmissibility and adaptability (consisting
      in a stable and long term virus production). The second type of replication was
      confined to viruses from patients with severe immunodeficiency. Technical and
      viral factors can affect the rate of transmissibility and adaptability: the
      modality of infection (cell to cell transmission appeared to be the most
      efficient) and the tropism of the virus (some viruses could infect only one T
      cell line).

PMID- 8469169
TI  - The elevation of circulating platelets after IFN-alpha therapy in HIV-1
      seropositive thrombocytopenic patients correlates with increased plasma levels of
      IL-6.
AB  - In this study we evaluated the effect of recombinant interferon-alpha 2b (IFN
      alpha 2b) therapy on the number of circulating platelets and interleukin-6 (IL-6)
      plasma levels in 12 human immunodeficiency virus type 1 (HIV-1) seropositive
      patients, affected by a severe and persistent thrombocytopenia. The levels of IL
      6 in plasma of HIV-1 seropositive thrombocytopenic subjects before IFN-alpha
      therapy were similar (80 +/- 15 pg/ml) to those observed in 15 HIV-1 seropositive
      asymptomatic individuals (75 +/- 12 pg/ml) and 30 HIV-1 seronegative blood donors
      (59.5 +/- 25 pg/ml). On the other hand, IL-6 amounts (148 +/- 36 pg/ml) in plasma
      of HIV-1 seropositive thrombocytopenic subjects were significantly (p < 0.01)
      increased after 5 weeks of IFN-alpha 2b therapy, showing a good correlation (p <
      0.05, chi-square test) with the levels of circulating platelets. Moreover, an
      increased spontaneous IL-6 production by peripheral blood monocytes was observed
      after IFN-alpha 2b therapy in HIV-1 seropositive thrombocytopenic patients. Our
      results suggest that an increased production of IL-6, one of the main factors
      controlling thrombocytopoiesis, may partially explain the ability of IFN-alpha 2b
      therapy, to restore platelet production in a subset of HIV-1 seropositive
      thrombocytopenic individuals.

PMID- 8469171
TI  - Molecular characterization of Yersinia strains isolated from human and
      environmental sources.
AB  - Thirty-seven strains of Yersinia isolated from human and environmental sources
      were investigated for virulence and molecular characteristics. Clinical isolates
      of Y. enterocolitica serotypes 0:3 and 0:9, harbouring the 45 MDa virulence
      plasmid were Ca++ dependent and responded positively to the CV-binding assay. The
      environmental Y. kristensenii strain, although harbouring a 45 MDa plasmid proved
      to be negative for both assays. All the environmental strains showed
      pyrazinamidase activity, while isolates from human sources proved negative. Two
      different plasmid profiles were disclosed: one Y. enterocolitica strain (serotype
      0:7, 8) showed one plasmid of 67 MDa and one plasmid of 1.5 MDa. Eleven human
      isolates of Y. enterocolitica and one environmental strain of Y. krinstensenii
      showed only one plasmid of 45 MDa. Restriction endonuclease analysis of the 45
      MDa plasmids supported the hypothesis that the environmental Y. krinstensenii
      plasmid is unrelated to the family of homologous virulence plasmids of Y.
      enterocolitica.

PMID- 8469170
TI  - Adherence of Borrelia burgdorferi and Borrelia hermsii to mammalian cells in
      vitro.
AB  - This study investigated the ability of Borrelia burgdorferi and Borrelia hermsii
      to attach the surface of several types of in vitro-cultured mammalian cells.
      Borreliae showed different adhesion efficiencies depending on cell type and
      temperature. Temperatures both lower and higher than 33 degrees and 37 degrees C
      respectively, decreased the adhesion of borreliae which preferentially adhere to
      human fibroblast-like cells. The adhesion process, mediated by structures exposed
      onto the surface of the microorganisms, also proved to be sensitive to the
      treatment of mammalian cells with hyaluronidase and sialidase, confirming that
      carbohydrate receptors are involved in the adhesion of borreliae to eukaryotic
      cells.

PMID- 8469172
TI  - Non-transmissible and self-transmissible plasmids conferring drug resistance in
      clinical isolates of Serratia marcescens from hospitals in Riyadh, Saudi Arabia.
AB  - Sixty Serratia marcescens isolates were obtained from patient specimens from
      three different hospitals in the city of Riyadh. These were tested for their
      antibiotic resistance factors using eleven different antibiotics. Their ability
      to transfer antibiotic resistance plasmids to a sensitive E. coli strain (RR1)
      was tested by transformation and conjugation experiments. Agarose gel
      electrophoresis was used to determine the size and number of the R-plasmids.
      Southern blotting was used to assess homologies between antibiotic resistance
      plasmids from different isolates. Among the isolates tested, 36.7% contained
      plasmids, and all these were from strains isolated from two hospitals. No R
      plasmids could be detected among the multiple resistant strains isolated from the
      third hospital. Among the strains that contained plasmids, approximately 63.6%
      transferred multiple antibiotic resistance to E. coli and the rest transferred
      only one antibiotic resistance marker. The majority of strains carrying out the
      plasmids showed similarities in band number and size. In view of the similarities
      this group was denoted the predominant group, and selected for further molecular
      investigations. Restriction endonuclease digests of plasmids from this group gave
      the same restriction pattern which confirmed that they were closely related.
      Hybridization experiments using these plasmids and nick-translated 32p-labelled
      pBR-322 DNA probe, showed that all the large bands (36 kb) are related and
      exhibit homology with pBR-322.

PMID- 8469173
TI  - Inactivation of ribosomes by an inhibitor of protein synthesis from Salmonella
      enteritidis.
AB  - Sonic extracts of Salmonella enteritidis contain a factor which inhibits protein
      synthesis in cell-free systems by irreversibly inactivating ribosomes. The extent
      of the inactivation of ribosomes depends on the system used to assay protein
      synthesis, natural mRNA translation being more strongly inhibited than poly(U)
      translation. The inhibitory power of the Salmonella factor is destroyed by
      trypsin and by 5% mercaptoethanol. Placental RNase inhibitor is unable to protect
      ribosomes from inactivation.

PMID- 8469174
TI  - Human intestinal methanogens and lactulose administration.
AB  - The effect of lactulose on human intestinal methanogenic bacteria in ten subjects
      on lactulose therapy and ten control adults was evaluated. Methanogens were found
      in 90% of the population examined (9 treated subjects and 9 controls). A marked
      variability in methanogen number (ranging from 10(3)-10(10)/gdw) was observed in
      lactulose-treated subjects and in controls. Analysis of variance showed no
      significant difference between the two groups.

PMID- 8469175
TI  - Rapid differentiation of untreated, autoclaved and ozone-treated Cryptosporidium
      parvum oocysts using dielectrophoresis.
AB  - A novel automated dielectrophoretic electrode apparatus and procedure was used to
      differentiate between untreated, autoclaved and ozone treated Cryptosporidium
      parvum oocysts recovered from water. A freeze-frame video technique enabled
      images of oocysts to be captured when they collected at sites above and between
      the electrodes upon application of an electric field. The number of oocysts
      collecting could then be conveniently counted. Varying the frequency of the
      applied electric field allowed the construction of characteristic spectra for
      each sample.

PMID- 8469176
TI  - Antifungal activity of Myxococcus species 1 production, physicochemical and
      biological properties of antibiotics from Myxococcus fulvus S110
      (Myxobacterales).
AB  - Chloroform extracts of the culture supernatant of a strain of Myxococcus fulvus
      isolated from soil were fungistatic and prevented germination of spores of
      Botrytis cinerea. The antibiotics were produced during the exponential phase of
      growth and the effects of altering medium composition are described. The activity
      was fractionated into neutral, acidic and basic fractions. The neutral fraction
      had a molecular weight of 244 and was tentatively identified as 11-phenyl
      undecadiene-2-ol. The acidic fraction was primarily n-hexadecanoic acid. The
      basic fraction contained components [N-(2-phenylethyl)-acetamide, and compounds
      tentatively identified as 1-isoquinoline carbonitrile and substituted quinolines]
      which have not previously been described in the myxobacteria.

PMID- 8469177
TI  - The distribution and properties of some hydrolytic enzymes from Porphyromonas
      gingivalis W50.
AB  - The production, distribution (as cell-bound, extracellular or associated with
      vesicles) and properties of four hydrolytic enzymes from Porphyromonas gingivalis
      were studied. During batch culture, enzymes appeared as cell bound until 72 h
      when extracellular trypsin-like protease and glycylprolyl dipeptidase were found.
      Alkaline phosphatase and N-acetyl-beta-glucosaminidase continued to be mainly
      cell-bound until 96 and 144 h post-inoculation, respectively. The pH optima for
      trypsin-like protease and dipeptidase activities were 7.5 and 8.0, respectively.
      Activity was most stable between pH 6.5 and 9.0 for the trypsin-like protease and
      pH 8.0 for dipeptidase. For phosphatase and N-acetyl-beta-glucosaminidase, double
      peaks of activity occurred at pH 8.0, 10.5 and 6.5, 7.5, respectively.
      Phosphatase was most stable at pH 7.0, whilst N-acetyl-beta-glucosaminidase was
      stable over a wide range of pH from 5.0-10.0. Molecular weight estimation by gel
      filtration gave 170 and 65 kD for trypsin-like protease, 200 and 24 kD for
      glycylprolyl dipeptidase, 125 and 24 kD for phosphatase, and 22 kD for N-acetyl
      beta-glucosaminidase.

PMID- 8469178
TI  - Glucose uptake in the yeast Saccharomyces cerevisiae.
AB  - The glucose uptake of Saccharomyces cerevisiae cells in sporulation medium for 3
      h was higher than that of cells in 5.5 mM glucose medium. This difference might
      be due to the change in cell structure which is necessary for the sporulation
      process. In both types of cells, the glucose uptake activity became higher as the
      glucose concentration of the medium decreased.

PMID- 8469179
TI  - Different immunomodulator regulated patterns of effector-target cell
      interactions: a novel application of microcalorimetry.
AB  - Microcalorimetric studies of target/effector cell interactions are reported.
      Significant changes in the observed thermal profiles are seen upon pre-incubation
      of the effector cells with chemical immunomodulators. The results of these latter
      studies indicate that the microcalorimetric technique can reveal differences in
      the modes of action of different groups of immunomodulators. It is proposed that
      the technique can be used to screen drug activities and, following further
      analytical work, to contribute to an understanding of modes of action.

PMID- 8469181
TI  - 1993 MSMS Directory Issue.

PMID- 8469180
TI  - Identification and growth characteristics of pink pigmented oxidative bacteria,
      Methylobacterium mesophilicum and biovars isolated from chlorinated and raw water
      supplies.
AB  - Pink pigmented bacteria were isolated from a blood bank water purification unit,
      a municipal town water supply (tap water), and an island (untreated) ground water
      source. A total of thirteen strains including two reference strains of pink
      pigmented bacteria were compared in a numerical phenotypic study using 119 binary
      characters. Three clusters were derived, one major cluster of eleven strains was
      subdivided into two sub-clusters on the basis of methanol utilization. Five
      strains were facultative methylotrophs and were classified as Methylobacterium
      mesophilicum biovar 1. The other six strains did not utilize methanol, but on the
      basis of high phenotypic similarity of 83.6% were classified as M. mesophilicum
      biovar 2. The single reference strain comprising cluster 2 Pseudomonas extorquens
      NCIB 9399 was assigned to the genus Methylobacterium and classified as M.
      extorquens. Cluster 3 was the single reference strain Rhizobium CB 376.

PMID- 8469182
TI  - Effective care in midwifery: research, the professions and the public.

PMID- 8469183
TI  - Appropriate midwifery care for the 1990s. Midwifery practice: where we came from-
      where we can go.

PMID- 8469184
TI  - Giving complementary therapy with midwifery care for the 1990s.

PMID- 8469185
TI  - 1990s: commitment to change.

PMID- 8469186
TI  - The team approach to giving midwifery care for the 1990s.

PMID- 8469187
TI  - Carbon monoxide poisoning: from old dogma to new uncertainties.

PMID- 8469188
TI  - Electrical neurostimulation for angina pectoris. Acupuncture and TENS--where east
      meets west.

PMID- 8469189
TI  - Perspectives on tropical health.

PMID- 8469190
TI  - Medical ethics--past and future.

PMID- 8469192
TI  - Homosexually acquired gonorrhoea in Victoria, 1983-1991.
AB  - OBJECTIVE: To identify trends in the rate of gonorrhoea, particularly
      homosexually acquired infection. DESIGN: A retrospective descriptive study of
      records stored in a relational database. Records contain epidemiological,
      demographic and microbiological data of laboratory confirmed cases of gonorrhoea.
      SUBJECTS: Individuals with gonorrhoea diagnosed microbiologically in Victoria and
      from whom isolates were subsequently forwarded to the Microbiological Diagnostic
      Unit, University of Melbourne, for further bacteriological work for the years
      1983-1991. RESULTS: Overall, gonorrhoea is declining in Victoria in the general
      population but has risen sharply in recent years in homosexually active men. An
      increased number of cases of rectal gonorrhoea in men has also been noted. An age
      cohort effect in homosexually active men is only evident for the final year of
      the study. These men do not tend to acquire gonorrhoea abroad and beta-lactamase
      producing gonococci are rarely found in this group. CONCLUSIONS: Gonorrhoea in
      homosexually active men has increased disproportionately to the rate of infection
      in heterosexual men in recent years, despite intensive education and counselling
      aimed at the gay community. Implications for risk of acquisition of other
      sexually transmitted diseases, including the human immunodeficiency virus, are
      evident.

PMID- 8469191
TI  - Recent military experience with malaria chemoprophylaxis.
AB  - OBJECTIVE: To assess the value of various drug regimens for malaria prophylaxis
      under circumstances where dapsone and pyrimethamine (combined as Maloprim) and
      chloroquine, followed by the 14-day primaquine eradication course, were no longer
      effective in protecting military personnel against falciparum and vivax malaria.
      DESIGN, SETTING AND PARTICIPANTS: Various drug regimens given to four groups of
      healthy male members of the Australian Army during training exercises in
      malarious countries. INTERVENTIONS: Four groups of soldiers were given different
      regimens for 3-12 weeks: Group 1--mefloquine (250 mg weekly); Group 2-
      doxycycline (100 mg daily); Group 3--doxycycline (100 mg daily) and primaquine
      (7.5 mg daily); and Group 4--doxycycline (50 mg daily) and chloroquine (300 mg
      weekly). Except in Group 3, each of these regimens was followed by a 7.5 mg dose
      of primaquine three times a day for two weeks. MAIN OUTCOME MEASURES: The
      proportion of participants in the various prophylactic drug groups who developed
      falciparum or vivax malaria during or after the intervention. RESULTS: Group 1:
      40 men receiving mefloquine were all protected against falciparum malaria but
      four (10%) developed vivax malaria. These results were not statistically
      different from those obtained for either falciparum (P = 0.28) or vivax (P =
      0.36) malaria in the control group of 64 men receiving Maloprim and chloroquine.
      Group 2: 60 men receiving doxycycline (no control group) were all protected
      against falciparum malaria but two developed vivax malaria. Group 3: 124 men, of
      whom 55 received doxycycline and 69 primaquine in addition to doxycycline, were
      all protected against falciparum malaria. However, 13 men taking only doxycycline
      developed vivax malaria two to three weeks after prophylaxis, whereas no vivax
      infections were observed in the men taking the drug combination (P = 0.0001).
      Group 4: no malaria infections were observed in 125 men receiving doxycycline and
      chloroquine for 13 weeks, probably because of the low prevalence of malaria in
      the training area. CONCLUSIONS: These studies confirm that doxycycline is very
      effective in preventing falciparum malaria and, for the first time, also suggest
      that doxycycline used in combination with small doses of primaquine may prevent
      (not only suppress) vivax malaria. If further studies confirm these findings, the
      use of such a drug combination would reduce the incidence of both vivax and
      falciparum malaria in returning travellers. For individuals with a high risk of
      exposure to malaria, it would also forestall the need to take the bothersome
      primaquine eradication course.

PMID- 8469193
TI  - Short and medium term outcomes after rollerball endometrial ablation for
      menorrhagia.
AB  - OBJECTIVE: To review prospectively the intraoperative, short and medium term
      outcomes of patients treated by rollerball endometrial ablation during the
      learning curve for this relatively new procedure. PATIENTS AND TECHNIQUES:
      Seventy-seven women with menorrhagia (71 with dysfunctional bleeding; six with
      additional small intramural myomas) underwent hysteroscopic rollerball
      endometrial ablation by coagulation diathermy during 1.5% glycine irrigation,
      after a two-month period of hormonal suppression. OPERATIVE AND SHORT-TERM
      EFFECTS: These were recorded at operation and six-week follow-up. No serious
      short-term complications were recorded. Objective measurement of intraoperative
      blood loss was always less than 20 mL. One woman experienced uterine perforation
      with a narrow cervical dilator which did not interfere with the ablation, and two
      patients had mild postoperative uterine infections. One patient experienced
      persistent postoperative pain. MEDIUM-TERM OUTCOME: This was recorded at each
      visit, or by telephone, and confirmed by questionnaire at one year. Twenty-five
      per cent achieved complete amenorrhoea, 29% staining only, 30% light periods, 10%
      "normal" or erratic periods and 6% were unchanged. Five patients underwent a
      second ablation, and three of these later underwent hysterectomy. Measured
      menstrual blood loss fell from 104 +/- 19 mL (mean +/- standard error of mean) to
      1.7 +/- 1.1 mL at six months in 18 women. Other menstrual symptoms were also
      often dramatically reduced. Of those women with dysmenorrhoea, 33% were cured and
      43% markedly improved; of those with midcycle pain, 28% were cured and 53%
      markedly improved; of those with significant premenstrual symptoms, 13% were
      cured, 47% markedly improved, 11% unchanged, and 6% were worse. CONCLUSIONS: This
      new procedure is a safe and effective treatment for menorrhagia caused by
      dysfunctional uterine bleeding, with impressive ancillary benefits for
      dysmenorrhoea, midcycle pain and premenstrual tension. It is often called
      minimally invasive surgery, but it must be recognised that it is not minor
      surgery.

PMID- 8469194
TI  - Percutaneous ultrasound guided uterine needle biopsy.
AB  - OBJECTIVE: To determine the safety, accuracy and usefulness of percutaneous
      ultrasound guided uterine needle biopsy. SETTING: Transabdominal uterine biopsy
      was performed with an ultrasound directed biopsy gun. The biopsy was performed as
      an outpatient procedure under local anaesthesia. MAIN OUTCOME MEASURES: The
      safety, accuracy and clinical value of the procedure; a comparison of the
      clinical and ultrasound diagnoses with the biopsy and surgical histological
      diagnoses; and the effect of the biopsy result on the choice of treatment by the
      surgeon and patient. RESULTS: There were no complications. Accuracy was validated
      in all seven patients who subsequently had surgical procedures and more extensive
      myometrial histological investigation. Biopsy diagnosis improved clinical
      diagnosis in nine of the ten patients, and altered or assisted in the ultrasound
      diagnosis in eight of the ten patients. Decisions concerning choice of treatment
      by the doctor or patient were assisted by the biopsy result in seven patients.
      CONCLUSION: Percutaneous ultrasound guided uterine needle biopsy is a useful
      procedure in the diagnosis of myometrial disease.

PMID- 8469196
TI  - The burden of tropical diseases.
AB  - More than half the world's population is at risk of the tropical diseases
      malaria, leprosy, schistosomiasis, lymphatic filariasis, onchocerciasis, Chagas
      disease, African trypanosomiasis and leishmaniasis, and half a billion people are
      infected with at least one of these diseases. We present statistic on the
      population at risk and the infected population, and on the major morbidity and
      mortality attributable to each of these diseases. During the next decade the
      prevalence of leprosy, Chagas disease, and onchocerciasis is expected to fall,
      but for the other tropical diseases the epidemiological situation may remain
      stagnant or even worsen.

PMID- 8469195
TI  - Medical ethics--fact or fiction?
AB  - In recent times the ethical behaviour of doctors has come under close scrutiny
      with some unhappy consequences. During the millennia in which medicine has been
      practised much has been written about ethics and nowadays there is no shortage of
      codes and declarations and of ethics committees to tell us what to do. These
      events raise questions about the status of the general principles of ethics and
      of the significance of particular assertions in that field. There is also the
      important question of whether or not there has been, or is, any connection at all
      between utterances about medical ethics and the behaviour of the members of our
      profession. I believe that the ethical problems confronting doctors are becoming
      more complex, and give my two rules of thumb for proper behaviour.

PMID- 8469197
TI  - Superficial mycoses: a practical approach.

PMID- 8469198
TI  - Superficial mycoses: a strategic approach.

PMID- 8469199
TI  - Management of chronic pain.
AB  - The principles of chronic pain management in the elderly are the same as in
      younger people; whenever possible, the cause of the pain should be identified and
      eradicated. However, older people are more likely to suffer pain from incurable
      conditions, and the emotional component of the suffering may be considerable.
      Treatment options include analgesics, opiates, antidepressants and
      anticonvulsants as well as psychological strategies, physical strategies such as
      exercise and transcutaneous electrical nerve stimulation (TENS), and surgery.
      Improvement of function may be a more important treatment goal than relief of
      pain.

PMID- 8469200
TI  - Fragile X syndrome. The most common cause of familial intellectual handicap.

PMID- 8469202
TI  - TENS in refractory angina pectoris. Three case reports.
AB  - OBJECTIVE: To demonstrate the use of transcutaneous electrical nerve stimulation
      (TENS) in the treatment of refractory angina pectoris. CLINICAL FEATURES: Three
      cases are presented. Patient 1 was a 56-year-old man with a 20-year history of
      angina pectoris. Angiography revealed extensive stenoses of coronary arteries. He
      was deemed unsuitable for coronary bypass surgery due to significant distal
      coronary disease. Patient 2 was an 81-year-old woman with angina that responded
      poorly to increasing drug therapy: she also had extensive stenoses but was judged
      unsuitable for surgery. Patient 3 was a 69-year-old man who had previously
      undergone two coronary bypass procedures and presented with unstable rest angina.
      The patient was deemed unsuitable for a third coronary artery bypass operation
      due to distal disease and the small calibre of the intermediate artery.
      INTERVENTION AND OUTCOME: Each patient had TENS added to their treatment regimen
      (one hour twice a day for Patient 1; one hour three times a day for Patients 2
      and 3). Patient 1 experienced a marked reduction in pain which lasted for over a
      year before symptoms of angina again worsened. Patient 2 has experienced no
      further pain of angina except on occasions when her TENS unit was not working or
      she neglected to use it as prescribed. Patient 3 had been free of angina from
      commencement of TENS therapy on review three months later. CONCLUSION: TENS may
      be useful in the treatment of angina pectoris which is refractory to medical
      therapy when the patient is not suitable for revascularisation procedures or
      revascularisation has failed. The mechanism of action is probably a combination
      of analgesia per se and inhibition of sympathetic nervous stimulation of the
      heart.

PMID- 8469201
TI  - Adult T cell leukaemia lymphoma in a non-aboriginal Australian woman with no
      apparent risk factors.
AB  - OBJECTIVE: To present a case of adult T cell leukaemia lymphoma (ATLL) in a non
      Aboriginal Australian woman with no apparent risk factor. CLINICAL FEATURES: A 43
      year-old Australian woman of European descent presented with a febrile illness
      associated with generalised lymphadenopathy and splenomegaly. INVESTIGATIONS:
      There was lymphocytosis in the peripheral blood with a T helper cell phenotype.
      There were also lytic bone lesions with associated hypercalcaemia. HTLV-1
      antibody was detected by agglutination assay and confirmed by western blot test.
      TREATMENT AND OUTCOME: After initial response to CHOP chemotherapy
      (cyclophosphamide, doxorubicin, vincristine, prednisolone), she relapsed and died
      with central nervous system involvement eight months after the initial diagnosis.
      CONCLUSION: To our knowledge this is only the third case of ATLL in a non
      Aboriginal person in Australia.

PMID- 8469203
TI  - Planning bedside teaching--4. Teaching around the patient.

PMID- 8469204
TI  - Magnetic resonance imaging of lesions in the abdomen.

PMID- 8469205
TI  - First aid treatment of jellyfish stings in Australia. Response to a newly
      differentiated species.
AB  - Vinegar has been shown to inhibit neomatocyst discharge in Chironex fleckeri, the
      deadly north Australian box-jellyfish, and application of vinegar has become
      accepted first aid, not only for box-jellyfish stings, but also for stings by
      other Australian jellyfish. However, in a newly differentiated species of
      Physalia in Australian waters, which causes severe envenomation, vinegar was
      found to cause discharge in up to 30% of neomatocysts. In treating these stings,
      the use of vinegar is not recommended as it may increase envenomation. Stings
      from the single-tentacled Physalia utriculus (the "bluebottle") are not severe,
      tentacles with unfired nematocysts rarely adhere to the victim's skin and vinegar
      dousing is not required. Vinegar treatment is therefore an unnecessary step in
      the first aid management of any Physalia sting but remains an essential first aid
      treatment for all cubozoan (box) jellyfish tested to date.

PMID- 8469206
TI  - Chloroquine-resistant Plasmodium vivax: how common?

PMID- 8469207
TI  - Chloroquine-resistant Plasmodium vivax: how common?

PMID- 8469209
TI  - Ambient environment may affect saliva ferning fertility test.

PMID- 8469208
TI  - Development of clinically significant resistance to norfloxacin given for
      Campylobacter diarrhoea.

PMID- 8469210
TI  - Donation and retrieval of cadaveric organs in Australia.

PMID- 8469211
TI  - Are Papanicolaou recalls worthwhile?

PMID- 8469212
TI  - Children's blood lead levels and environmental lead contamination.

PMID- 8469213
TI  - Changes in the Australian diet.

PMID- 8469214
TI  - Reproducibility of coagulation studies in suspected hepatic and pancreatobiliary
      disease.

PMID- 8469215
TI  - Bilateral avascular necrosis of the head of the femur.

PMID- 8469216
TI  - Ethics in aboriginal research.

PMID- 8469217
TI  - Rare tumors in childhood: pathological aspects. Experience of the Kiel Pediatric
      Tumor Registry.
AB  - A wide variety of rare tumors can occur in childhood and adolescence. Tumors can
      be rare in any age group; common tumors of adults can appear in childhood and
      adolescence, and many rare tumors and tumor-like lesions show a predilection for
      younger age groups. Comparatively frequent tumors can present with rare
      histologic features or can occur in rare atypical locations, and, finally,
      seemingly common but, in fact, rare tumors have to be distinguished from truly
      common but rarely recognized tumors. Thus, the spectrum of rare tumors is broad,
      reflecting the fluent reality of life.

PMID- 8469218
TI  - Localized dumbbell neuroblastoma: a study of 25 cases treated between 1982 and
      1987 using the same protocol.
AB  - Among the 108 non-metastatic neuroblastomas treated at the Institut Gustave
      Roussy between 1982 and 1987, 25 dumbbell neuroblastomas were observed.
      Therapeutics included: 1) an initial laminectomy in forms with neurological
      deficit; 2) surgical excision of the primary tumor; 3) preoperative chemotherapy
      in children in which the primary tumor was considered as unresectable at
      diagnosis and postoperative chemotherapy in cases of incomplete resection; and 4)
      radiation therapy on macroscopic residual disease. Fifteen out of 25 (60%)
      presented a neurological deficit. A laminectomy was performed in 14 cases.
      Neurological recovery was good in 4 cases, partial in 4 cases, and absent in 4
      cases. Two patients were worse after the procedure. The event-free survival was
      88%. This high survival rate is linked: 1) to the non-metastatic stage; 2) to a
      high proportion of children under 1 year of age (18/25) (median age = 7 months);
      and 3) to a high proportion of thoracic location (12/25). The high incidence of
      macroscopically incomplete excision (13/25) did not jeopardize the prognosis. Out
      of the 22 survivors, there were 8 cases of major neurological sequellae (36%) and
      5 cases of major orthopedic ones (26%). The coexistence of a serious functional
      prognosis and an excellent vital prognosis for these patients has led us to
      analyse the therapeutic modalities, to reevaluate the necessity of routine
      initial neurosurgical removal by laminectomy and to discuss the use of first line
      chemotherapy.

PMID- 8469219
TI  - Leukemic blasts with markers of four cell lineages in Down's syndrome
      ("megakaryoblastic leukemia").
AB  - Among 16 patients with Down's syndrome (DS) and acute leukemia admitted to our
      department during a ten year period, 6 were diagnosed as acute megakaryoblastic
      leukemia (AMkL). The diagnosis was based on clinical and hematologic criteria,
      confirmed in three patients with the use of monoclonal antibodies (MoAb) specific
      for megakaryocytic antigens. In these three, and in a fourth patient, the
      leukemic blasts were positive for other myeloid, lymphoid and erythroid markers
      in MoAb testing. We suggest that AMkL in DS is a mixed lineage leukemia with
      blasts presenting a variety of cell surface antigens, indicating origin from an
      early progenitor cell with the capability of megakaryocytic differentiation. Of
      the 6 patients with AMkL, 4 treated with standard AML protocols are in complete
      continuing remission (CCR) with observation periods from 57+ to 148+ months.

PMID- 8469220
TI  - Langerhans cell histiocytosis in childhood: results from the Italian Cooperative
      AIEOP-CNR-H.X '83 study.
AB  - Ninety patients with biopsy-proven Langerhans cell histiocytosis (LCH) were
      enrolled from June, 1983, to December, 1988, in the multicenter AIEOP-CNR-H.X.
      '83 study. They were divided into two groups: poor prognosis (PP), comprising 11
      children with organ dysfunction (OD), and good prognosis (GP), made up of 79
      patients without OD. Eighty-four patients were evaluable for treatment results.
      Among GP patients, 16 with a single lesion received only local treatment, while
      59 entered a clinical trial of immunotherapy and/or monochemotherapy with
      vinblastine (VBL). Nonresponders, sequentially received doxorubicin (ADM) and
      then etoposide (VP16). PP patients were treated with 4 week cycles of
      vincristine, ADM, cyclophosphamide, and prednisone for nine courses. The overall
      survival was 92.8% (100% for GP patients and 45.5% for PP patients) at 48 months.
      The complete response (CR) rates for immunotherapy, VBL, ADM, and VP16 were 10%,
      62.9%, 42.8%, and 88.2%, respectively. Two of the 11 PP patients had a CR
      (18.2%), while six died and three are still alive with recurrent disease. The
      overall incidence of disease-related disabilities was 47.7%, while that of
      diabetes insipidus was 20%. Monochemotherapy is probably adequate in GP patients,
      while more effective treatments are needed for PP patients.

PMID- 8469221
TI  - Cytosine-arabinoside, vincristine, and prednisolone in the treatment of children
      with disseminated Langerhans cell histiocytosis with organ dysfunction:
      experience at a single institution.
AB  - Fifty-two pediatric patients with Langerhans cell histiocytosis (LCH) were
      diagnosed at the Emma Kinderziekenhuis (EKZ) in Amsterdam over a 20-year period.
      Eight patients with multiorgan involvement with organ dysfunction and ten
      patients with multi-organ involvement without organ dysfunction received
      chemotherapy containing cytosine-arabinoside, vincristine, and prednisolone as
      part of their treatment. Five of the 8 patients (63%) with organ dysfunction and
      eight of the 10 (80%) without the organ dysfunction who needed chemotherapy
      because of the deteriorating of symptoms despite conventional therapy are
      presently in complete clinical remission. Two of those with organ dysfunction
      have died. Four of the total 18 patients developed diabetes insipidus either as
      an initial symptom or during the course of the disease. These results in both
      groups compare satisfactorily with other chemotherapeutic regimens, and since
      this combination is only mildly toxic, it has been well tolerated. Therefore we
      would recommend wider experience using this regimen in patients with widespread
      LCH with organ dysfunction as well as in patients with disseminated LCH in which
      chemotherapy proved to be necessary.

PMID- 8469222
TI  - Langerhans cell histiocytosis and acute leukemia: unusual association in two
      cases.
AB  - Langerhans cell histiocytosis (LCH) is a non-malignant disorder, whether
      localized or disseminated, and usually has a favourable prognosis. A possible
      relationship between LCH and neoplastic diseases has not been assessed up to now
      even if a few cases have been recorded. We report two new cases of acute leukemia
      in children with LCH. The first child had acute lymphoblastic leukemia after
      untreated LCH; the second developed acute promyelocytic leukemia after LCH
      treated with vinblastine and etoposide. To our knowledge, this is the first case
      of secondary leukemia after exposure to an epipodophyllotoxin derivative in a
      child with benign disease. Cooperative studies of large numbers of LCH patients
      are needed to evaluate a possible association between LCH and acute leukemia, and
      to identify common risk factors or predisposing agents if such be present.

PMID- 8469223
TI  - The treatment of malignant scala posterior tumors in children: II. Preliminary
      result of the pre- and postoperative adjuvant chemotherapy of scala posterior
      tumors.
AB  - Ten children with posterior scala tumor infiltrating the surrounding brain
      substance and/or the brain stem entered in the present study with preoperative
      chemotherapy. In 8 of the 10 cases regression and necrosis of the tumor were seen
      by CT examination after the preoperative therapy. The diameter of the tumor
      decreased on the average by 35.6% (14.0-74.3%). The main side effect was
      granulocytopenia. According to our observation, the preoperative therapy enables
      a more radical surgery in some cases of medulloblastoma and ependymoma. Further
      observations are necessary to confirm these preliminary results.

PMID- 8469225
TI  - Focal nodular hyperplasia of the liver in childhood.

PMID- 8469224
TI  - Phase I trial of trimetrexate in pediatric solid tumors: a Pediatric Oncology
      Group study.
AB  - Trimetrexate (TMTX), a lipophilic antifol, was evaluated in a Pediatric Oncology
      Group (POG) Phase I trial in children with refractory solid tumors. TMTX was
      administered intravenously daily x 5 every three weeks. Starting dose was 6.4
      mg/m2/day. Dose was escalated by 20% until the maximal tolerated dose was
      reached. A total of 75 courses were administered to 26 children. The major
      toxicity was myelosuppression, of which neutropenia and thrombocytopenia were
      most prominent. Rash, mucositis, and transient liver enzyme elevations were
      infrequently seen. Responses were observed in children with brainstem glioma,
      neuroblastoma, and renal cell carcinoma. The recommended Phase II dose using this
      schedule is 9.2-11 mg/m2/day depending on how heavily the patient has been
      treated prior to initiating this therapy.

PMID- 8469226
TI  - Cytogenetic abnormalities in a disseminated medulloblastoma.
AB  - A 3-year-old girl developed central nervous system, bone and bone marrow
      metastases, and hypercalcaemia shortly after presentation with medulloblastoma.
      Cytogenetic studies of the involved bone marrow showed multiple abnormalities
      including iso(17q). This chromosome rearrangement has been reported in other
      cases of recurrent or disseminated medulloblastoma. More studies are required
      relating the karyotypes of medulloblastomas to long-term outcome to determine if
      the presence of iso(17q) is a prognostic factor in this malignancy.

PMID- 8469227
TI  - Comparison of serial PET and MRI scans in a pediatric patient with a brainstem
      glioma.
AB  - Profound clinical deficits may be associated with insults to the brainstem,
      making management of patients with brainstem gliomas very complex. Small changes
      in the radiographic appearance of a brainstem tumor may be associated with
      significant clinical deterioration. Furthermore, both magnetic resonance imaging
      and computed tomography are frequently unable to differentiate between therapy
      related tissue reactions and progressive tumor. Two clinical scenarios
      particularly difficult to resolve include: (1) transient radiographic and
      clinical deterioration following hyperfractionated radiotherapy, and (2) clinical
      deterioration in a patient who has failed initial therapy, but has stable
      radiographic findings following a second therapy. We report a child with a
      pontine glioma whose tumor progression was demonstrated more convincingly with a
      18F-deoxyglucose positron emission scan than with magnetic resonance imaging. PET
      scans may be helpful in confirming that tumor progression is responsible for
      clinical deterioration in a patient whose MRI scans remain stable.

PMID- 8469228
TI  - Cerebral non-Hodgkin's lymphoma discovered when treating Hodgkin's disease.
AB  - Case report of the appearance of a highly malignant cerebral non-Hodgkin's
      lymphoma of a diffuse large cell type, type B, occurring at the immediate onset
      of chemotherapy for a stage IV (mediastino-pulmonary) Hodgkin's disease (nodular
      sclerosis) diagnosed in a 16-year-old boy. The treatment of this cerebral
      lymphoma associated primary chemotherapy with high dose methotrexate, high dose
      aracytine, etoposide, and ifosfamide. The chemotherapy proved to be highly
      efficient, producing complete remission. Thoracic and abdominal irradiation for
      Hodgkin's disease was performed concomitantly with chemotherapy for the non
      Hodgkin's lymphoma. This treatment was followed by 36 Gy of cerebral irradiation.
      Thirty-six months after the discovery of the cerebral non-Hodgkin's lymphoma the
      patient was still disease-free and doing well.

PMID- 8469229
TI  - Immunizations pay off, Hib meningitis cases 'thud'.

PMID- 8469230
TI  - 100 years of caring for health: MNA and public health nursing.

PMID- 8469231
TI  - Transcripts originating in intron 1 of the HSD11 (11 beta-hydroxysteroid
      dehydrogenase) gene encode a truncated polypeptide that is enzymatically
      inactive.
AB  - There is evidence for the presence in the kidney of more than one isoform of 11
      beta-hydroxysteroid dehydrogenase (11HSD), an enzyme that interconverts cortisol
      and cortisone (in rodents, corticosterone and 11-dehydrocorticosterone). A
      specific isoform might arise from transcripts in the kidney that are known to
      originate in intron 1; translation from these transcripts is predicted to
      initiate at the codon that in the full-length rat enzyme encodes Met27. Alignment
      of the full-length rat and human 11HSD sequences with other members of the short
      chain dehydrogenase family suggests that initiation of translation at Met27 might
      yield a functional enzyme, since the amino-termini of most of these enzymes occur
      at equivalent positions. We confirmed that short transcripts are found in the
      kidney and are detectable at lower levels in the liver and lung. In vitro
      transcription and translation of short cDNA demonstrated that the AUG encoding
      Met27 is indeed a functional initiation codon. However, Chinese hamster ovary
      cells transfected with short cDNA in the pCMV4 vector expressed apparently low
      levels of the corresponding truncated polypeptide and had no 11HSD activity.
      Thus, the functional significance of transcripts originating in intron 1 is
      unclear.

PMID- 8469232
TI  - Trophoblast-specific transcription from the mouse placental lactogen-I gene
      promoter.
AB  - We have isolated the gene encoding mouse placental lactogen-I and characterized
      the promoter region of this gene by transient and stable transfection. Promoter
      sequences extending 274 basepairs (bp) up-stream from the start site of
      transcription contain all of the elements necessary for maximal expression upon
      transient transfection into the rat choriocarcinoma Rcho-1 cell line; these Rcho
      1 cultures contain both proliferative trophoblast stem cells and terminally
      differentiated trophoblast giant cells. In stably transfected cell lines,
      expression from this promoter increases as the percentage of differentiated cells
      in the culture increases. In contrast to these results in trophoblast cells, the
      274-bp promoter as well as a promoter region extending 2700 bp up-stream of the
      transcriptional start site are unable to drive transcription in a variety of
      other cell types. Mutational and protein binding analyses indicate that two AP-1
      sites are required for maximal expression in Rcho-1 cells, and that the
      composition of the AP-1 transcription factor may vary as differentiation in the
      cell culture increases. In addition to these two AP-1 sites, at least one other
      element appears to be critical for promoter activity in trophoblast cells.

PMID- 8469233
TI  - The gene encoding the human corticostatin HP-4 precursor contains a recent 86
      base duplication and is located on chromosome 8.
AB  - The human neutrophil-derived cationic peptide HP-4 exhibits corticostatic
      activity on adrenal cells and is an L-type calcium channel agonist at nanomolar
      concentrations. Complementary DNA clones encoding the HP-4 precursor have been
      isolated from a human bone marrow cDNA library by screening with oligonucleotide
      probes. The nucleotide sequence shares about 72% identity with the cDNA encoding
      defensin HP-1, but differs from it, and from other genes of this family
      characterized to date, by an extra 83-base segment. This extra segment is not
      adjacent to an intron and is apparently the result of a recent duplication within
      the coding region corresponding to most of the mature HP-4 peptide. The predicted
      amino acid sequence shows the HP-4 precursor structure to be typical of this
      family of molecules. By analysis of DNA from a pannel of hamster/human hybrid
      cell lines, the HP-4 gene was found to be on chromosome 8, as is the gene for
      human peptide HP-1. Comparison with the few sequences of other
      corticostatin/defensin genes available does not indicate distinct lineages of
      corticostatic and noncorticostatic peptides, since HP-1 and HP-4 cDNA sequences
      share more identity with each other than either shares with cDNAs encoding rabbit
      MCP-1 or MCP-2, or guinea pig GNCP-1.

PMID- 8469234
TI  - Prolactin augments progesterone-dependent uteroglobin gene expression by
      modulating promoter-binding proteins.
AB  - The sequence-specific binding of endometrial nuclear proteins to uteroglobin 200
      (UG200) (-194/+9), the 203-base pair 5'-flanking region of the rabbit uteroglobin
      gene, and UG99 (-170/-85), a subfragment of UG200, was compared with gel shift
      assays. PRL + progesterone treatment of estrous rabbits produced a 6- to 7-fold
      increase in the primary shift compared to progesterone alone. PRL + progesterone
      treatment of long-term ovariectomized rabbits increased the primary shift 60%
      over progesterone alone, which increased the primary shift 30-fold over similarly
      treated estrous rabbits. The primary shift was eliminated when rabbits were
      treated with progesterone + estradiol benzoate (E2Bz). Changes in the steady
      state levels of UG mRNA paralleled changes in the intensity of the primary gel
      shift. Southwestern blotting revealed four proteins from progesterone-dominated
      endometrial nuclei that bind UG200. PRL pretreatment produced a 3- to 12-fold
      increase in each of the proteins. Protein binding was eliminated by E2Bz. A 100
      kilodalton (kDa) protein from progesterone-dominated endometrial nuclei was UV
      cross-linked to UG200 and UG99. An additional protein was detected by each probe
      with long autoradiographic exposure. PRL pretreatment increased the 100-kDa
      protein, whereas covalent attachment of the 100-kDa protein to UG promoter DNA
      was eliminated by E2Bz. UV cross-linking in situ was used to identify the 100-kDa
      protein as responsible for the primary shift. Collectively, these experiments
      provide compelling evidence that PRL augments the progesterone-dependent
      transcription of the UG gene in the uterus by regulating at least one and as many
      as four proteins that bind to the UG promoter.

PMID- 8469235
TI  - High affinity and specificity of dimeric binding of thyroid hormone receptors to
      DNA and their ligand-dependent dissociation.
AB  - The thyroid hormone receptors are ligand-dependent, DNA binding, trans-acting
      transcriptional factors belonging to the erbA-related steroid/thyroid hormone
      receptor superfamily. We report here the high affinity and specificity of dimeric
      DNA binding of human thyroid hormone receptor-alpha 1 (hTR alpha 1) and hTR beta
      1 and the effect of T3 on its DNA binding. Gel mobility shift assay showed that
      hTR alpha 1 and -beta 1 bind to the rat GH-thyroid hormone response element (TRE)
      and rat malic enzyme (rME)-TRE as a monomer, dimer, and oligomer in the absence
      of T3 and bind to an irrelevant DNA sequence from the adenovirus 5 promoter only
      as a monomer. In competition studies using unlabeled TRE, dimer binding was
      displaced by lower concentrations of TRE than was the monomer, indicating that
      the dimeric binding has higher affinity than the monomer binding. These results
      suggest that the formation of dimers of TR increases the specificity and affinity
      for the response element. Surprisingly, T3 disrupted dimer binding and increased
      the intensity of monomer binding to rME-TRE in a dose-dependent manner. This does
      not occur with the rat GH-TRE. We also demonstrate that this disruption of
      dimeric binding by T3 occurred on a TRE formed by a direct repeat and not on a
      palindromic TRE. Furthermore, a mutant hTR beta (Mf), which has no detectable
      ligand-binding activity because of a glycine to arginine substitution at amino
      acid 340 in the hormone-binding domain, does not show dissociation from rME-TRE
      after the addition of T3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469236
TI  - Identification of residues in the estrogen receptor that confer differential
      sensitivity to estrogen and hydroxytamoxifen.
AB  - We have generated mutant mouse estrogen receptors which differ in their
      sensitivity to estrogen and the antiestrogen 4-hydroxytamoxifen. Mutation of the
      glycine at position 525 and the methionine and/or serine at positions 521/522
      virtually abolishes the ability of the receptor to bind estradiol and stimulate
      transcription. In contrast, the mutant receptors retain the partial agonist
      activity exhibited by the wild-type receptor in the presence of 4
      hydroxytamoxifen. The mutations do not affect the expression and DNA-binding
      activity of the receptor, but do abolish the estrogen-induced increase in the
      mobility of the receptor-DNA complex observed with the wild-type receptor. Other
      mutant receptors that were able to bind and stimulate transcription in the
      presence of estradiol also failed to show the agonist-induced increase in the
      mobility of the receptor-DNA complex, suggesting that it is unlikely to reflect
      the formation of a hormone-dependent transcriptional activation function.

PMID- 8469237
TI  - Identification of a hormone-dependent phosphorylation site adjacent to the DNA
      binding domain of the chicken progesterone receptor.
AB  - We have previously identified three phosphorylation sites in chicken progesterone
      receptor (PR) isolated from the cytosol of chicken oviducts. Several lines of
      evidence suggested that there might be additional phosphorylations that occur
      only in the nuclear compartment. We have reexamined the phosphorylation of the PR
      using whole cell extracts and have identified a second hormone-dependent
      phosphorylation site (Ser367) which is located on the amino-terminal side of the
      DNA-binding domain. This site also contains a Ser-Pro consensus sequence, as do
      the three previously reported sites. There are four Ser-Pro sequences in chicken
      PR, and all four are phosphorylated. Two of the sites showed substantial
      phosphorylation in the absence of hormone, with some enhancement in response to
      hormone, whereas two of the sites showed very little phosphorylation in the
      absence of hormone. This suggests either that despite the Ser-Pro consensus
      sequences, the sites are phosphorylated by different enzymes, or that binding
      hormone changes the conformation of the protein sufficiently to expose the two
      hormone-dependent phosphorylation sites.

PMID- 8469238
TI  - Mullerian inhibiting substance requires its N-terminal domain for maintenance of
      biological activity, a novel finding within the transforming growth factor-beta
      superfamily.
AB  - Mullerian inhibiting substance (MIS)/anti-Mullerian hormone is a differentiation
      factor that causes regression of the Mullerian duct in the developing male fetus
      and an apparent sex reversal of the fetal ovary when inappropriately exposed to
      it. The purified product is a 140-kilodalton glycoprotein composed of two
      identical subunits. We show that a C-terminal fragment of MIS, which shares
      homology with transforming growth factor-beta, causes regression of the Mullerian
      duct and inhibits the biosynthesis of aromatase in the fetal ovary. However, both
      activities are enhanced dramatically by addition of the N-terminal portion of
      MIS. Under conditions where potentiation occurs, the N- and C-terminal domains of
      MIS reassociate. These results indicate that the N-terminus of MIS, unlike that
      of the other members of the transforming growth factor-beta family, plays a role
      in maintaining the biological activity of the C-terminus.

PMID- 8469239
TI  - Structural organization and regulation of the gene for the androgen-dependent
      glutathione peroxidase-like protein specific to the mouse epididymis.
AB  - Genomic clones containing the gene for the glutathione peroxidase-like androgen
      regulated murine epididymal protein of 24 kilodaltons (arMEP24) were isolated. A
      9-kilobase DNA fragment was sequenced and found to contain the entire coding
      region of the gene, which is divided into five exons. The exact sizes and
      boundaries of the exon blocks were deduced by comparison with the cDNA sequence.
      One major and four weak transcription initiation sites in the epididymis were
      localized by primer extension. The promoter of the gene does not contain a
      conventional TATA box immediately up-stream of the start site; rather, the
      sequence TATCA occurs at residue -35. Two CAAT boxes in opposite orientation and
      two putative binding sites for the transcription factor Sp1 were identified up
      stream of the TATA-like box. To localize the cis-acting sequences responsible for
      androgen regulation of expression, fragments of the arMEP24 gene promoter region
      were cloned in front of the luciferase (LUC) reporter gene and cotransfected with
      an androgen receptor expression vector into CV-1 cells in a transient assay. LUC
      activities of CV-1 cells grown in the presence of various concentrations of 5
      alpha-dihydrotestosterone were compared to LUC activities of untreated controls.
      The DNA fragment containing up to 200 nucleotides up-stream from the major
      transcription start site was sufficient for the full promoter activity, but not
      for the responsiveness to androgen induction. Depending on the 5 alpha
      dihydrotestosterone concentration, a 2- to 4-fold induction of LUC activity was
      found if a -1797 to -167 arMEP24 gene fragment was used linked to the reporter
      gene driven by either the homologous promoter or the heterologous thymidine
      kinase promoter. Two or three copies of the imperfect palindromic sequence
      TGTTGAgagAGAACA, found at position -896 to -882 in the gene and resembling the
      consensus steroid hormone-responsive element, are able to confer androgen
      regulation to the thymidine kinase promoter independently of their orientation.
      These findings support evidence that transcriptional regulation of the arMEP24
      gene occurs via the sequence TGTTGAgagAGAACA. Homologies found in the sequence up
      stream of the promoter with several putative binding sites for erythroid-specific
      trans-acting regulatory proteins are discussed. Finally, the arMEP24 gene is
      located by in situ hybridization in the [A2-A4] region of mouse chromosome 13.

PMID- 8469240
TI  - Identification and characterization of a GC-rich promoter of the human
      parathyroid hormone-related peptide gene.
AB  - The human PTH-related peptide (PTHrP) gene comprises eight exons spanning more
      than 15 kilobases of genomic DNA. The gene has a highly complex controlling
      region, which contains four alternatively spliced, noncoding exons and at least
      two putative promoters, one 5' of exon 1A (up-stream TATA element) and the other
      5' of exon 2 (down-stream TATA element). To define important cis regulatory
      sequences of this gene, a functional dissection of PTHrP 5'-flanking DNA was
      initiated, using chimeric PTHrP-chloramphenicol acetyltransferase (CAT)
      constructs. This analysis was carried out in PTHrP-negative human renal carcinoma
      cells, so that RNA derived from transfected DNA could be studied without
      interference from endogenous PTHrP sequences. Of the initial series of constructs
      prepared, the most active was a 1.1-kilobase BamHI-HindIII PTHrP-CAT plasmid
      containing 350 basepairs of DNA 5' of exon 1C and extending into exon 3. Analysis
      of transfection products by RNase protection and primer extension revealed that
      this region contains a previously unrecognized promoter of the gene. This element
      is located immediately 5' of exon 1C, is active in transfected cells when cloned
      in isolation up-stream of the CAT gene, and appears to be functional in a number
      of cell lines and tissues on the basis of primer extension analysis. Unlike the
      other two PTHrP gene promoters, this element is GC rich and does not possess
      canonical TATA or CAAT sequences. The human PTHrP gene is one of a handful of
      genes that appear to use both TATA and GC-rich promoter elements.

PMID- 8469241
TI  - Transcriptional activation of the insulin-like growth factor-II gene during
      myoblast differentiation.
AB  - Insulin-like growth factor-II (IGF-II) is a secreted 67-amino acid peptide that
      functions principally as a prenatal growth regulator in mammals. To date, the
      mechanisms involved in the stimulation of IGF-II expression in the embryo and its
      attenuation after birth are unknown. Recent studies have shown that IGF-II mRNA
      and protein are induced during the terminal stages of muscle development in
      vitro, and that IGF-II may act as an autocrine differentiation agent for skeletal
      myoblasts. We now have investigated the regulation of IGF-II gene expression in
      muscle cells. Steady state levels of IGF-II mRNA increased by more than 30-fold
      during terminal differentiation of the C2 mouse myoblast cell line. Transcription
      run-on experiments using isolated muscle cell nuclei and direct analysis of
      nuclear RNA each demonstrated a greater than 10-fold rise in nascent IGF-II mRNA
      during cellular differentiation, and ribonuclease protection experiments showed
      that more than 95% of IGF-II mRNAs initiated in noncoding exon 3, implying that
      transcriptional activation occurs principally through promoter 3, the most 3' of
      the three mouse IGF-II gene promoters. Analysis of chromatin structure around the
      IGF-II gene in C2 cells revealed four major and four minor DNase-I-hypersensitive
      sites, but did not provide insight into the mechanisms of gene activation, since
      all sites were present in proliferating and differentiating cells. Gene transfer
      experiments showed that promoter 3 was at least 50-fold more active than promoter
      1 or 2 in C2 cells, but the functional assessment of nearly 26 kilobases of
      additional DNA within the IGF-II locus by an "enhancer trap" approach did not
      delineate any chromosomal regions capable of mediating differentiation-specific
      gene activation. Our results demonstrate that muscle cells encode mechanisms for
      activating IGF-II gene transcription and suggest that these cells may be
      excellent models for identifying the developmentally regulated factors that
      control IGF-II gene expression.

PMID- 8469242
TI  - The global impact of penicillin: then and now.

PMID- 8469243
TI  - Clinical correlates of pathologic findings: case 1.

PMID- 8469244
TI  - Narrative and medicine.

PMID- 8469245
TI  - Physicians practicing other occupations, especially literature.
AB  - Literature has been the favored nonmedical pursuit of physicians probably because
      the practice of medicine is suffused with narratives, the patient's history being
      one. Arthur Conan Doyle regarded medicine as a "grim romance," Somerset Maugham
      as an opportunity to see "life in the raw," and William Carlos Williams treated
      "the patient as a work of art." These sentiments may be linked to humanistic
      medicine. At some medical schools, literature is taught in the context of and
      integrated with medicine in an attempt to enhance ethics and empathy which were
      explicitly expressed by some physician-writers.

PMID- 8469246
TI  - Prevalence of thyroid autoantibodies in ambulatory elderly women.
AB  - Major improvements in thyroid autoantibody testing have now become widely
      available. Seventy-five elderly ambulatory women from a senior citizens' center
      (mean age 74.5 yrs) were studied to reassess the prevalence of thyroid
      autoantibodies and to demonstrate how such tests related to clinical signs and
      symptoms of thyroid disease. We used the enzyme-linked immunoassay (ELISA)
      technique for the measurement of autoantibodies to thyroglobulin (hTg) and
      thyroid peroxidase (hTPO) (as microsomal antigen), since ELISA systems are
      economical, highly sensitive and specific for population screening.
      Autoantibodies to hTPO (hTPO-Ab) were present in 44% and hTg autoantibodies (hTg
      Ab) in 32% of the study group. Ten women (13.3%) had elevated thyrotropin (TSH)
      levels. An elevated serum TSH was associated with the presence of hTPO-Ab in
      varying concentrations. The mean TSH value of 7.2 microIU/mL in those women with
      hTPO-Ab was significantly higher than the mean of 4.7 microIU/mL found in those
      women without thyroid autoantibodies (p < 0.01). However, additional testing for
      hTg-Ab was of little clinical value. These data indicate the high prevalence of
      thyroid autoimmune disease in the elderly female population. We conclude that
      screening for thyroid dysfunction is best achieved by the measurement of serum
      TSH in all women over the age of 60 years. The measurement of hTPO-Ab, but not
      hTg-Ab, was helpful in confirming the cause of thyroid failure in the elderly
      female population.

PMID- 8469247
TI  - MRI documentation of hemorrhage into post-traumatic subdural hygroma.
AB  - Rapid enlargement of a post-traumatic hygroma was demonstrated by MRI in a
      patient who had sequential studies performed after head injury. The enlargement
      was shown to be due to hemorrhage into the hygroma.

PMID- 8469248
TI  - A case report of neurologic improvement following treatment of paraneoplastic
      cerebellar degeneration.

PMID- 8469249
TI  - Osteoporosis: on the verge of rational effective therapy?

PMID- 8469250
TI  - The pathophysiology and molecular genetics of beta thalassemia.
AB  - Review of the pathophysiology and molecular basis of beta thalassemia reveals
      that an extremely heterogeneous group of molecular defects can give rise to a
      relatively uniform clinical and hematological phenotype that is primarily the
      result of the excess of free alpha-globin chains that accumulate in the face of
      absent or markedly reduced beta-globin chain synthesis. Despite the molecular
      heterogeneity, it has been possible to establish highly accurate and efficient
      DNA-based prenatal diagnosis for beta thalassemia. Important progress is also
      being made in the area of gene therapy for beta thalassemia.

PMID- 8469251
TI  - A comparison of outcomes in men 11 years after heart-valve replacement with a
      mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular
      Heart Disease.
AB  - BACKGROUND: Mechanical heart valves are durable but thrombogenic, and their use
      requires that the patient receive anticoagulants. In contrast, bioprosthetic
      valves are less thrombogenic, but they have limited durability because of tissue
      deterioration. METHODS: To compare the outcomes of patients who receive these two
      types of valves, we randomly assigned 575 men scheduled to undergo aortic-valve
      or mitral-valve replacement to receive either a mechanical or a bioprosthetic
      valve. The primary end points were death from any cause and any valve-related
      complication. RESULTS: During an average follow-up of 11 years, there was no
      difference between the two groups in the probability of death from any cause (11
      year probability for mechanical valves, 0.57; for bioprostheses, 0.62; P = 0.57)
      or in the probability of any valve-related complication (0.65 and 0.69,
      respectively; P = 0.39). There was a much higher rate of structural valve failure
      among patients who received bioprosthetic valves (11-year probability, 0.15 for
      the aortic valves and 0.36 for the mitral valves) than among those who received
      mechanical valves (no valve failures; P < 0.001). However, this difference was
      offset by a higher rate of bleeding complications among patients with mechanical
      valves than among those with bioprosthetic valves (11-year probability, 0.42 and
      0.26, respectively; P < 0.001) and by a greater frequency of peri-prosthetic
      valvular regurgitation among patients with mechanical mitral valves than among
      those with mitral bioprostheses (11-year probability, 0.17 and 0.09,
      respectively; P = 0.05). CONCLUSIONS: After 11 years, the rates of survival and
      freedom from all valve-related complications were similar for patients who
      received mechanical heart valves and those who received bioprosthetic heart
      valves. However, structural failure was observed only with the bioprosthetic
      valves, whereas bleeding complications were more frequent among patients who
      received mechanical valves.

PMID- 8469252
TI  - Male hypogonadism with gynecomastia caused by late-onset deficiency of testicular
      17-ketosteroid reductase.
AB  - BACKGROUND: 17-Ketosteroid reductase deficiency results in male
      pseudohermaphroditism because conversion of the weak androgen androstenedione to
      the more potent androgen testosterone is impaired. If a late-onset form exists,
      hypogonadism and gynecomastia caused by decreased testosterone production and
      increased estrogen production, respectively, would be expected as the major
      clinical manifestations in men. METHODS: We studied 48 male subjects, ranging
      from 14 to 26 years of age, who had idiopathic pubertal gynecomastia. Serum
      concentrations of gonadal and adrenal steroid hormones were measured before and
      after the administration of corticotropin and after the combined administration
      of chorionic gonadotropin and dexamethasone for three days. RESULTS: We
      identified three unrelated subjects (ages, 16, 17, and 26 years) with results
      indicative of a partial deficiency of testicular 17-ketosteroid reductase. The
      three subjects had gynecomastia as well as decreased libido and impotence. Their
      mean (+/- SD) base-line serum androstenedione and estrone concentrations were
      elevated as compared with the levels in the 45 subjects without this enzyme
      deficiency (androstenedione, 380 +/- 70 vs. 110 +/- 70 ng per deciliter [13 +/- 2
      vs. 4 +/- 2 nmol per liter]; estrone, 138 +/- 12 vs. 46 +/- 9 pg per milliliter
      [511 +/- 44 vs. 170 +/- 33 pmol per liter]). After the administration of
      chorionic gonadotropin, the mean serum androstenedione concentration in these
      three subjects was 910 +/- 48 ng per deciliter (32 +/- 2 nmol per liter) and the
      mean serum estrone concentration was 260 +/- 16 pg per milliliter (962 +/- 59
      pmol per liter). The mean serum testosterone concentration at base line was 210
      +/- 80 ng per deciliter (7.4 +/- 2.8 nmol per liter) in the 3 subjects, as
      compared with a value of 410 +/- 12 ng per deciliter (14.4 +/- 0.42 nmol per
      liter) in the 45 other subjects, and it did not increase in response to the
      administration of chorionic gonadotropin. The concentrations of androstenedione
      and estrone in spermatic venous serum were 19 times higher and 73 times higher,
      respectively, than in normal men. The serum concentrations of follicle
      stimulating hormone and luteinizing hormone in these three subjects were
      inappropriately low, suggesting the presence of hypogonadotropic hypogonadism.
      CONCLUSIONS: A late-onset form of testicular 17-ketosteroid reductase deficiency
      can cause gynecomastia and hypogonadism in men.

PMID- 8469253
TI  - Cyclospora species--a new protozoan pathogen of humans.
AB  - BACKGROUND: Organisms referred to as "cyanobacterium-like bodies" have now been
      identified worldwide in the feces of both immunocompetent and immunocompromised
      patients with diarrhea. Organisms with a similar appearance have been isolated
      from Peruvian patients since 1985. From 1988 to 1991 we studied prospectively two
      cohorts of infants and young children infected with this organism. We now attempt
      to identify it. METHODS: Fecal samples were collected weekly from the children
      and examined with the use of acid-fast staining and staining with a monoclonal
      antibody specific for cryptosporidium. Stools positive for cyanobacterium-like
      bodies were preserved in potassium dichromate and exposed to conditions allowing
      coccidian sporulation and excystation. Both unsporulated and sporulated oocysts
      were fixed by freeze-substitution techniques and then examined by electron
      microscopy. RESULTS: Organisms isolated from the feces of Peruvian patients and
      two patients from the United States were identified as belonging to the coccidian
      genus cyclospora, after sporulation and excystation of the oocysts according to
      standard techniques. Complete sporulation occurred within 5 to 13 days in oocysts
      maintained in potassium dichromate at 25 or 32 degrees C. Complete excystation
      resulted in the liberation of two sporozoites from the two sporocysts within each
      oocyst (cryptosporidia have four naked sporozoites within each oocyst). The
      presence of organelles characteristic of coccidian organisms was confirmed by
      electron microscopy. CONCLUSIONS: We have identified organisms of the genus
      cyclospora that are remarkably similar to cryptosporidia in their morphologic
      features and the diarrheal disease that they produce in humans. The complete life
      cycle and epidemiology of this new protozoan parasite remain to be described.

PMID- 8469254
TI  - Management of fever in patients with cancer and treatment-induced neutropenia.

PMID- 8469255
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 18-1993. A 57-year-old man with chronic lymphedema and enlarging
      purple cutaneous nodules of the leg.

PMID- 8469256
TI  - My three valves.

PMID- 8469257
TI  - Physicians' autonomy--the relation between public and professional expectations.

PMID- 8469258
TI  - HIV infection in rural Florida.

PMID- 8469259
TI  - HIV infection in rural Florida.

PMID- 8469260
TI  - HIV infection in rural Florida.

PMID- 8469261
TI  - Central nervous system toxoplasmosis in AIDS.

PMID- 8469262
TI  - Central nervous system toxoplasmosis in AIDS.

PMID- 8469264
TI  - Cryptococcal meningitis after unusual exposures to birds.

PMID- 8469263
TI  - Central nervous system toxoplasmosis in AIDS.

PMID- 8469265
TI  - Complications of gynecologic laparoscopic surgery--a French multicenter
      collaborative study.

PMID- 8469266
TI  - CPAP cyst.

PMID- 8469267
TI  - The Gulf War and infant and child mortality in Iraq.

PMID- 8469269
TI  - Sequential pathological studies in goats infected intratracheally with
      Aspergillus fumigatus.
AB  - Intratracheal inoculation of goats with Aspergillus fumigatus spores resulted in
      the development of characteristic gross and microscopic lesions. The lesions were
      restricted to lungs and there was no dissemination of infection to other tissues
      of the body except liver in one goat 16 days after infection. The experiment was
      continued for 37 days. Gross changes in lungs were observed up to the 24th day
      post-infection. The lesions, in general, included congestion and oedema in the
      first 6 days followed by the development of varying greyish-white nodules in the
      lungs. Microscopic changes consisted of granulomatous reaction with well
      developed granulomas in lungs. Hyphae and conidiophores with fruiting bodies of
      Aspergillus fumigatus could be demonstrated in sections up to 24 days of
      infection. Reisolation of the fungus consistently was achieved up to 24 days. It
      is concluded that intratracheal inoculation of Aspergillus fumigatus spores in
      goats leads to pulmonary aspergillosis up to 24 days.

PMID- 8469268
TI  - Radiographic features of experimental Candida arthritis in rats.
AB  - Sprague-Dawley rats were inoculated intravenously (i.v.) with Candida albicans,
      and limb joints showing signs of Candida-induced arthritis were subjected to
      radiographic and histologic examination. New bone formation and bone resorption
      were morbidly enhanced in bones sampled from the arthritic joints. Sparsely
      distributed needle-shaped calcified deposits began to be formed on bony surfaces
      in parallel with the onset of joint swelling. The calcified deposits gradually
      became denser and then covered the bony surfaces almost entirely, giving rise to
      an exostosis-like profile. In addition to the new bone formation, bone resorption
      was also observed in regions adjacent to the sites of new bone formation, and
      punched-out bone lesions were produced. Eventually, severe deformation of joint
      bones due to new bone formation and bone resorption was evident. Reflecting these
      unusual radiographic changes, abundant osteoblasts and osteoclasts were
      demonstrated histologically in the bones. On the basis of these results, possible
      mechanisms for the induction of arthritis by Candida infection are discussed.

PMID- 8469270
TI  - Experimental candidiasis in Japanese quail: pathological changes.
AB  - Candidiasis was experimentally produced in young Japanese quail by oral
      administration of Candida albicans cells. Lesions were confined to upper
      digestive tract with most characteristic changes occurring on the mucosa of crop.
      No lesions were observed in other tissues of the body. The initial changes in the
      crop were characterized by thickening and yellowish-white necrotic plaques on the
      mucosa. From 10th day onwards, there was marked thickening and corrugations of
      the crop mucosa giving it a typical 'turkish towel' appearance. Varying degree of
      mucosal swelling was also observed in the oesophagus and proventriculus. Two of
      the infected birds also revealed yellowish-white necrotic plaques on the tongue
      at 7th and 10th day post-infection. The prominent microscopic lesions in the crop
      and tongue consisted of hyperkeratosis and parakeratosis with congestion of the
      subepithelial tissues. Varying degree of parakeratosis and epithelial hyperplasia
      coupled with subepithelial oedema and hypertrophy of glands was observed in the
      oesophagus. The proventriculus and small intestine revealed congestion, oedema,
      mild to marked goblet cell hyperplasia and focal epithelial sloughing. Fungal
      elements could be demonstrated in the sections of tongue up to 10 days while in
      crop up to 14 days post-infection. Reisolation of the fungus was consistently
      achieved from the crop of infected birds throughout the duration of the
      experiment.

PMID- 8469271
TI  - AIDS patients are first in line.

PMID- 8469272
TI  - Japan reviews first guidelines for gene therapy trials.

PMID- 8469273
TI  - NIH to support embryo bank for mice and rabbits.

PMID- 8469274
TI  - NIH takes Stewart and Feder off the misconduct beat.

PMID- 8469275
TI  - Promega extends fight with Roche over Taq enzyme.

PMID- 8469276
TI  - DNA testing helps British bring better pig to market.

PMID- 8469277
TI  - Two-way adaptors.

PMID- 8469278
TI  - Cancer. Fusion potential for vaccines.

PMID- 8469279
TI  - Immunology. Tolerance by exhaustion.

PMID- 8469280
TI  - Retroviruses. One and one make four.

PMID- 8469281
TI  - Magnetic compass orientation.

PMID- 8469282
TI  - Instability and decay of the primary structure of DNA.
AB  - Although DNA is the carrier of genetic information, it has limited chemical
      stability. Hydrolysis, oxidation and nonenzymatic methylation of DNA occur at
      significant rates in vivo, and are counteracted by specific DNA repair processes.
      The spontaneous decay of DNA is likely to be a major factor in mutagenesis,
      carcinogenesis and ageing, and also sets limits for the recovery of DNA fragments
      from fossils.

PMID- 8469283
TI  - Erythroid transcription factor NF-E2 is a haematopoietic-specific basic-leucine
      zipper protein.
AB  - Expression of globin genes in developing erythroid cells is controlled by
      upstream locus control regions. Activity of these regions in vivo requires an
      erythroid-specific nuclear factor (NF-E2) that binds AP-1-like recognition sites.
      Its tissue-specific component (p45 NF-E2) has been characterized by complementary
      DNA cloning as a new basic region-leucine zipper protein which dimerizes with a
      ubiquitous partner to form native NF-E2.

PMID- 8469284
TI  - Male-driven evolution of DNA sequences.
AB  - It is commonly believed that the mutation rate is much higher in the human male
      germ line than in the female germ line because the number of germ-cell divisions
      per generation is much larger in males than in females. But direct estimation of
      mutation rates is difficult, relying mainly on sex-linked genetic diseases, so
      the ratio (alpha m) of male to female mutation rates is not clear. It has been
      noted that if alpha m is very large, then the rate of synonymous substitution in
      X-linked genes should be only 2/3 of that in autosomal genes, and comparison of
      human and rodent genes supported this prediction. As the number of X-linked genes
      used in the study was small and the X-linked and autosomal sequences were non
      homologous, and given that the synonymous rate varies among genes, we sequenced
      the last intron (approximately 1 kb) of the Y-linked and X-linked zinc-finger
      protein genes (ZFY and ZFX) in humans, orang-utans, baboons and squirrel monkeys.
      The ratio Y/X of the substitution rate in the Y-linked intron to that in the X
      linked intron is approximately 2.3, which is close to that estimated from
      synonymous rates in the ZFY and ZFX genes and implies alpha m approximately 6.
      This estimate of alpha m supports the view that the evolution of DNA sequences in
      higher primates is male-driven. It is, however, much lower than the previous
      estimate and therefore raises a number of issues.

PMID- 8469285
TI  - Parental-origin-specific epigenetic modification of the mouse H19 gene.
AB  - The H19 gene produces an abundant developmentally regulated transcript of unknown
      function in normal embryos. In the mouse it lies on chromosome 7 and is subject
      to transcriptional regulation by parental imprinting, which results in the
      maternally inherited gene being expressed and the paternally inherited gene being
      repressed. Embryos carrying maternal duplication/paternal deficiency for distal
      chromosome 7 (MatDi7) therefore express a double dose of H19. Here we examine the
      parental-origin-specific epigenetic modifications that may be involved in this
      regulation by comparing CpG methylation and nuclease sensitivity of chromatin in
      MatDi7 embryos with normal littermates. We show that specific sites in the CpG
      island promoter and 5' portion of the gene are methylated only on the paternal
      allele. Furthermore, active maternal alleles in chromatin of MatDi7 embryos are
      more sensitive and accessible to nucleases. Therefore hypermethylation and
      chromatin compaction in the region of the H19 promoter is associated with
      repression of the paternally inherited copy of the gene. Most, but not all, of
      these sites are unmethylated in sperm, with methylation of the paternal promoter
      occurring after fertilization. These results contrast with our findings for the
      closely linked and reciprocally imprinted gene encoding insulin-like growth
      factor II (ref. 4).

PMID- 8469286
TI  - Idiotype/granulocyte-macrophage colony-stimulating factor fusion protein as a
      vaccine for B-cell lymphoma.
AB  - To produce a vaccine against cancer, antigens must be found that are
      preferentially expressed by tumour cells and can induce an immune response
      against the tumour. The variable regions of the immunoglobulin molecules
      expressed on malignant B cells (idiotypes) are tumour-specific, but are weak
      immunogens. To induce an immune response in animals or humans, the idiotypic
      protein has therefore to be chemically coupled to a strongly immunogenic protein
      and mixed with an adjuvant. The resulting response can protect animals from
      subsequent tumour challenge, and cure animals with established tumours in
      combination with chemotherapy. Granulocyte-macrophage colony-stimulating factor
      (GM-CSF) augments antigen presentation in a variety of cells. Here we show that
      by fusing a tumour-derived idiotype to GM-CSF, it can be converted into a strong
      immunogen capable of inducing idiotype-specific antibodies without other carrier
      proteins or adjuvants and of protecting recipient animals from challenge with an
      otherwise lethal dose of tumour cells. This approach may be applicable to the
      design of vaccines for a variety of other diseases.

PMID- 8469287
TI  - Virus persistence in acutely infected immunocompetent mice by exhaustion of
      antiviral cytotoxic effector T  cells.
AB  - Viruses that are non- or poorly cytopathic have developed various strategies to
      avoid elimination by the immune system and to persist in the host. Acute
      infection of adult mice with the noncytopathic lymphocytic choriomeningitis virus
      (LCMV) normally induces a protective cytotoxic T-cell response that also causes
      immunopathology. But some LCMV strains (such as DOCILE (LCMV-D) or Cl-13
      Armstrong (Cl-13)) derived from virus carrier mice tend to persist after acute
      infection of adult mice without causing lethal immunopathological disease.
      Tendency to persist correlates with tropism, rapidity of virus spread and virus
      mutations. We report here that these LCMV isolates may persist because they
      induce most of the specific antiviral CD8+ cytotoxic T cells so completely that
      they all disappear within a few days and therefore neither eliminate the virus
      nor cause lethal immunopathology. The results illustrate that partially and
      sequentially induced (protective) immunity or complete exhaustion of T-cell
      immunity (high zone tolerance) are quantitatively different points on the scale
      of immunity; some viruses exploit the latter possibility to persist in an
      immunocompetent host.

PMID- 8469288
TI  - Thymic dendritic cells and T cells develop simultaneously in the thymus from a
      common precursor population.
AB  - Dendritic cells, a minor cell population in lymphoid tissues, are specialized for
      presentation of antigenic peptides to T lymphocytes. Thymic dendritic cells are
      involved in the deletion of self-reactive T lymphocytes. Although all dendritic
      cells are ultimately of bone-marrow origin, it has not been clear whether thymic
      dendritic cells are produced in the adult thymus from a precursor cell or whether
      they migrate there preformed from the periphery. Recently we isolated from adult
      mouse thymus a population of early T precursors that could still form B
      lymphocytes, but not erythroid or myeloid cells, when transferred intravenously.
      Here we show that these thymic lymphoid precursor cells, as well as bone-marrow
      haematopoietic stem cells, are able to form both dendritic cells and T-cell
      progeny when transferred into an irradiated thymus. Such linked development may
      ensure that developing T cells are negatively selected predominantly by self
      antigens presented on newly formed thymic dendritic cells.

PMID- 8469289
TI  - Mouse microcytic anaemia caused by a defect in the gene encoding the globin
      enhancer-binding protein NF-E2.
AB  - The nuclear DNA-binding protein NF-E2 is thought to mediate the powerful
      erythroid enhancer activity of the alpha- and beta-globin locus control regions
      and participates in the control of genes encoding two enzymes of haem
      biosynthesis (porphobilinogen deaminase and ferrochelatase). The major component
      of NF-E2 is a 45K polypeptide (designated p45 NF-E2) that belongs to the basic
      region-leucine zipper family of transcription factors. This subunit of NF-E2 is
      specifically expressed in haematopoietic progenitor cells and differentiated
      cells of the erythroid, megakaryocyte and mast cell lineages. The gene encoding
      p45 NF-E2 (murine gene Nfe2) has been mapped to mouse chromosome 15 near the
      mutation microcytosis (mk). Homozygous mk mice have severe hypochromic microcytic
      anaemia as a result of decreased globin synthesis and defects in intestinal and
      erythroid iron absorption. Here we investigate whether the mk mutation lies
      within Nfe2 by characterizing the p45 NF-E2 gene and determining its DNA sequence
      in wild-type and mk alleles. The mk allele carries a missense mutation that
      causes substitution of valine by alanine at amino acid 173 of the p45 NF-E2
      protein. Expression of p45 NF-E2 messenger RNA was detected in erythroid tissues
      of normal mice and in the duodenum of normal and severely anaemic beta
      thalassaemic (Hbbd-th3/Hbbd-th3) mice. We propose that the mk mutation results in
      an impaired form of NF-E2 which fails to regulate both globin production and iron
      metabolism properly.

PMID- 8469290
TI  - Projection structure of rhodopsin.
AB  - Light absorption by the visual pigment rhodopsin triggers, through G-protein
      coupling, a cascade of events in the outer segment of the rod cell of the
      vertebrate retina that results in membrane hyperpolarization and nerve
      excitation. Rhodopsin, which contains 348 amino acids, has seven helices that
      cross the disk membrane and its amino terminus is extracellular. A wealth of
      biochemical data is available for rhodopsin: 11-cis retinal is bound to lysine
      296 in helix VII; glutamic acid 113 on helix III is the counterion to the
      protonated Schiff's base; a disulphide bridge, cystine 110-187, connects helix
      III to the second extracellular loop e2 (refs 13, 14); the carboxy terminus has
      two palmitoylated cysteines forming a cytoplasmic loop i4 (ref. 15); three
      intracellular loops i2, i3 and i4 mediate activation of the heterotrimeric G
      protein transducin; glutamic acid 135 and arginine 136 at the cytoplasmic end of
      helix III affect binding of transducin. But to provide a framework to interpret
      these data, not only for rhodopsin but for other G-protein-coupled receptors,
      requires the structure to be determined. Here we present a projection map of
      rhodopsin showing the configuration of the helices.

PMID- 8469291
TI  - Roster. North Carolina Medical Society. 1992-1993. Officers, committees,
      commissions and roster of members. Alphabetical listings and roster by
      specialties within counties.

PMID- 8469292
TI  - [Insurance medicine assessment of provisions and housing adaptation in chronic
      disease].

PMID- 8469293
TI  - [Multiresistant tuberculosis: a hazard for public health?].

PMID- 8469294
TI  - ['Lorenzo's oil'].

PMID- 8469295
TI  - [A new chapter in the history of tuberculosis].

PMID- 8469296
TI  - [Multiresistant tuberculosis: a new form of an old disease].

PMID- 8469297
TI  - [Current regulations for provisions for the handicapped].

PMID- 8469298
TI  - [Extra-intestinal infections caused by Vibrio spp. in The Netherlands].
AB  - Six patients with serious cellulitis or ear infection due to Vibrio vulnificus,
      V. parahaemolyticus or V. alginolyticus are described. Four patients were
      infected during the summer in the Netherlands and two outside the Netherlands.
      Contact with seawater was the most probable source in four patients. In two
      patients the infection, caused by V. vulnificus, was transmitted by eel. This is
      a new way of transmission.

PMID- 8469299
TI  - [Case control study of the relationship between local environmental factors and
      hematopoietic malignancies in young subjects in Aalsmeer].
AB  - In Aalsmeer, a horticultural community near the main international airport in the
      Netherlands, an incidence of haematopoietic malignancies in young people over
      four times the national mean was observed in the period 1980-1985. A population
      based case-control study investigated the association with local environmental
      factors. For each case younger than 40 years of age (n = 14), diagnosed between
      1975 and 1989, four controls, matched for age and gender, were selected via local
      general practitioners. All parents of patients and controls completed a
      questionnaire on their life style, living conditions and health for several years
      preceding each individual diagnosis. Odds ratios (ORs) were calculated, matched
      and--if necessary--stratified for neighbourhood. Increased ORs were recorded for
      intensive use of petroleum products and pesticides, by the patients themselves
      and their fathers (OR petroleum products: 8.0, resp. 9.0; OR pesticides: 6.0,
      resp. 3.2). Most of these increases were statistically significant. Swimming in a
      local pond was also significantly associated with the disease (OR = 5.3); in the
      seventies this pond had been polluted by accidents with petroleum products and
      pesticides. contributed to the increase of the disease: ORs for several indirect
      exposure parameters were all above 2. It can be concluded that the increased
      incidence of childhood haematopoietic malignancies in Aalsmeer may have been
      associated with several specific local environmental factors. However,
      interpretation of the results should take into account that confidence intervals
      were wide, due to the necessarily limited number of cases.

PMID- 8469300
TI  - [Amyloidosis as cause of severe abdominal symptoms in a young Somali immigrant?].
AB  - Extensive deposition of amyloid was detected in the digestive tract of a Somali
      woman aged 20 yr with abdominal pain, diarrhoea and cachexia. Immunohistochemical
      characterisation showed that the amyloid protein involved was of the AA type.
      Elevated levels were also found for serum amyloid A (SAA), an acute-phase protein
      which is the precursor of AA amyloid. The underlying inflammatory disease was
      peritoneal tuberculosis. The normalisation of the SAA levels and the recovery of
      the small intestine during tuberculostatic therapy showed that the tuberculosis
      was the cause of the enteropathy. This case report highlights the importance of
      early detection and effective treatment of the underlying inflammatory disease in
      case of AA amyloidosis.

PMID- 8469301
TI  - [Pneumococci].

PMID- 8469302
TI  - GABAergic control of odor-induced activity in the frog olfactory bulb:
      electrophysiological study with picrotoxin and bicuculline.
AB  - In the olfactory bulb, the first relay of the olfactory pathways, GABA, could be
      largely involved in the information processing since the two main populations of
      interneurons, periglomerular and granular cells, use it as neurotransmitter
      through reciprocal synapses with second-order neurons. This study planned to
      clarify the role of GABAergic inhibition in odor coding and, more precisely, the
      role of glomerular GABAergic inhibition. To do so, we attempted to specifically
      block in vivo GABAA receptors with either picrotoxin or bicuculline. The drug was
      applied at the level of the glomerular layer so that the antagonist could act
      primarily via periglomerular cells. The analysis of the effects of blocking GABAA
      on the coding was studied by recording the second-order neuron responses to odor
      stimuli delivered in a wide concentration range. Under drug treatment, the second
      order neuron properties were deeply changed: response thresholds to odors were
      often lowered and spike bursts were more sustained in frequency and in duration.
      Thus, the GABAergic control on second-order neurons might be carried out by
      limiting the neuron excitability. GABAA antagonists applied in this manner could
      act to suppress the inhibitory effect of either the periglomerular cells or of
      the granule cells, both of which have been shown to contain enzymes for GABA
      production. The placement of the drug suggests to us that the action is primarily
      at the glomerulus. The results are consistent with periglomerular cells exerting
      a tonic inhibition on second-order neurons, an inhibition whose strength would be
      modulated by stimulus intensity. As a result, the amplifying role of glomerular
      convergence might be partly counterbalanced by input inhibition. Nevertheless,
      due to our procedure of drug application, one cannot rule out the possibility
      that the effects observed may partly reflect granular cell blocking. It can be
      concluded that the whole GABAergic inhibition, through GABAA receptors, permits a
      wide dynamic range of intensity coding.

PMID- 8469303
TI  - Effects of inferior olive inactivation and lesion on the activity of medial
      vestibular neurons in the rat.
AB  - In anaesthetized rats, the unitary activity from the medial vestibular nucleus
      had been recorded during horizontal sinusoidal rotation in the absence of visual
      stimulation. In the first series of experiments, the inferior olivary nuclei were
      selectively destroyed by means of 3-acetylpyridine. Unitary activity was recorded
      three to five days or one month after the lesion. A few days after the lesion,
      the average spontaneous activity, as well as the peak-to-peak amplitude of the
      modulation of the medial vestibular neurons during sinusoidal rotation, were
      significantly lower compared to those recorded in intact rats, and to those
      recorded one month after the lesion. In the second series of experiments, during
      reversible cooling of the inferior olive region of one side, in the contralateral
      medial vestibular nuclei 57% of units underwent a clear decrease in firing rate
      accompanied by a decrease in the amplitude of modulation. In rats whose inferior
      olivary nuclei had been destroyed by means of 3-acetylpyridine one month before,
      or whose cerebellum had been removed, there were few units that showed a decrease
      of the firing rate and modulation amplitude on cooling the same olivary region.
      Our experiments show that silencing the activity of the inferior olive causes a
      decrease both in the spontaneous firing rate and in the amplitude of the response
      of the vestibular neurons to natural labyrinthine stimulation. These results
      support the hypothesis that the inferior olive, by changing its firing rate, may
      regulate on-line the gain of reflexes which are under cerebellar control.

PMID- 8469304
TI  - Effects of noradrenaline on the firing rate of vestibular neurons.
AB  - The effects of microiontophoretic noradrenaline on the firing rate of neurons
      located in the vestibular complex have been studied in anaesthetized rats. Eighty
      five per cent of the neurons tested in all the vestibular nuclei modified their
      background firing rate upon noradrenaline application, generally by reducing it
      (86% of them). In few cases inhibitions were followed by a rebound. Responses
      were dose-dependent. No significant difference was found between vestibular
      neurons projecting to the spinal cord and those delivering their fibres to the
      oculomotor complex. Phentolamine, an alpha-adrenergic antagonist, blocked the
      noradrenaline-evoked inhibitions, whereas beta-adrenergic antagonist timolol was
      ineffective or enhanced them. Furthermore, responses were blocked by yohimbine,
      an alpha 2-adrenergic antagonist, and mimicked by clonidine, an alpha 2
      adrenergic agonist, in the majority of neurons. In few cases prazosin, an alpha 1
      adrenergic antagonist, was able to antagonize weak inhibitions and phenylephrine,
      an alpha 1-adrenergic agonist, to evoke an inhibitory effect blocked by prazosin.
      Isoproterenol, a beta-adrenergic agonist was totally ineffective on the neuronal
      firing rate. It is concluded that noradrenaline can modify the level of neuronal
      activity in the vestibular complex by acting mostly, but not exclusively, through
      alpha 2-adrenergic receptors. An influence of noradrenergic systems on the
      vestibular function by a direct action of noradrenaline inside the vestibular
      nuclei is proposed.

PMID- 8469305
TI  - Stable parkinsonian syndrome and uneven loss of striatal dopamine fibres
      following chronic MPTP administration in baboons.
AB  - The progressive degeneration of dopamine neurons observed in idiopathic
      Parkinson's disease was mimicked by injecting low doses of 1-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP) to baboons, on a chronic basis. Five Papio
      papio baboons were treated on two different regimens (chronic intravenous
      administration at weekly intervals for 20-21 months or, daily MPTP treatment for
      five days followed five to six months later by chronic weekly injections for 5
      21.5 months). All animals were assessed for motor symptoms during and after
      neurotoxic treatment. Both regimens invariably resulted in the appearance of a
      progressive and irreversible syndrome characterized by action and resting tremor,
      cogwheel rigidity, postural impairments, hypokinesia and bradykinesia. In some
      animals, symptoms of resting tremor and rigidity initially restricted to one side
      of the body became bilateral within a few months of treatment. Subtle
      abnormalities that may be found in idiopathic Parkinson's disease such as
      alterations of the blink reflex response were also noted. Neuropathological
      examination of caudate nucleus, putamen, substantia nigra and ventral tegmental
      area in brain sections stained for tyrosine hydroxylase showed a typical uneven
      striatal dopamine fibre loss and a neuronal depletion in the dopaminergic
      mesencephalic cell groups that reproduce those observed in idiopathic Parkinson's
      disease. Immunocytochemical observations and behavioural data show that chronic
      rather than acute MPTP injection regimens can replicate most of the
      neuropathological and the clinical features typical of idiopathic Parkinson's
      disease, possibly by increasing the ability of this neurotoxin to target specific
      subpopulations of mesencephalic dopaminergic neurons.

PMID- 8469306
TI  - Dopamine-rich grafts in the neostriatum and/or nucleus accumbens: effects on drug
      induced behaviours and skilled paw-reaching.
AB  - This study compares the behavioural efficiency of dopaminergic mesencephalic
      neurons implanted into the rat neostriatum and/or the nucleus accumbens. The
      dopaminergic mesotelencephalic pathway was unilaterally destroyed by injection of
      6-hydroxydopamine into the medial forebrain bundle at the level of the lateral
      hypothalamus. Three weeks later, embryonic dopaminergic mesencephalic neurons
      were implanted into the denervated neostriatum, or the nucleus accumbens or into
      both locations (double grafts). All animals were tested over a four month period
      for amphetamine- and apomorphine-induced rotation, apomorphine-induced locomotor
      activity, and on a skilled paw reaching task. The characteristic ipsilateral
      rotation induced by amphetamine observed in lesioned animals was significantly
      reduced by neostriatal and double grafts, but persisted in animals with grafts in
      the nucleus accumbens alone. Four months after grafting, an overcompensation of
      rotation was observed for the neostriatal and double grafted animals, which now
      rotated contralaterally, i.e. away from the grafted side. The rotation induced by
      apomorphine in lesioned rats was decreased by neostriatal and double grafts and
      to a lesser extent by grafts implanted into the nucleus accumbens. Apomorphine
      induced locomotor hyperactivity in lesioned animals was ameliorated by the
      nucleus accumbens and by double grafts. In the paw-reaching task, lesioned
      animals showed severe impairment in the use of the contralateral limb, which none
      of the grafts alleviated. Pretreatment with amphetamine had variable effects on
      the paw-reaching task which persisted in subsequent drug-free trials, suggesting
      that a conditioning mechanism may be involved. These findings suggest that the
      simultaneous reinnervation of the neostriatum and the nucleus accumbens by
      dopaminergic transplants is not sufficient to re-establish normal function in
      more complex behavioural tasks.

PMID- 8469307
TI  - Astrocytic messenger RNA responses to striatal deafferentation in male rat.
AB  - This investigation describes the schedule and regional distribution of astrocytic
      responses in striatum following deafferentation by unilateral frontal cortex
      ablation. In the ipsilateral deafferented striatum, glial fibrillary acidic
      protein and clusterin (sulfated glycoprotein-2) messengerRNA showed peak
      elevations by 10 days postlesioning (Northern blots). Vimentin messengerRNA
      responded faster, with a transient elevation by three days postlesioning. The
      messengerRNA for glial fibrillary acidic protein, clusterin and vimentin returned
      toward control levels by 27 days postlesioning. However, the neuronal marker
      growth-associated protein messengerRNA, was decreased at all postlesion times. By
      in situ hybridization, the increased glial fibrillary acidic protein messengerRNA
      and clusterin messengerRNA signals were localized mainly to the dorsal half of
      the ipsilateral deafferented striatum and followed the same schedule as found by
      Northern blots. Glial fibrillary acidic protein messengerRNA was widely diffused
      in the dorsal striatum and was excluded from fascicles of the internal capsule; a
      similar distribution was found for glial fibrillary acidic protein-immunopositive
      astrocytes. While clusterin messengerRNA signal showed a distinct clustering, its
      immunoreactivity appeared as deposits in the deafferented striatal neuropil;
      Western blots confirmed the immunocytochemical results. By in situ hybridization,
      vimentin messengerRNA was mostly localized to the cortical wound cavity dorsal to
      the deafferented striatum and overlapped the distribution of vimentin
      immunopositive cells. These findings suggest a coordination of striatal
      astrocytic messengerRNA responses with the degeneration of corticostriatal
      afferents. We also compared these same parameters with those from published
      reports on the hippocampus after deafferenting lesions. Certain astrocyte
      molecular responses to deafferentation are detected about five days earlier in
      the hippocampus than in the striatum. This different schedule in response to
      decortication may pertain to differences in synaptic remodeling in the
      hippocampus vs striatum.

PMID- 8469308
TI  - Nerve-dependent expression of high polysialic acid neural cell adhesion molecule
      in neurohypophysial astrocytes of adult rats.
AB  - The adult hypothalamo-neurohypophysial system of the rat retains the capacity to
      express highly polysialylated isoforms of neural cell adhesion molecule normally
      expressed in developing tissues. Here we report that the expression of these
      isoforms in neurohypophysial astrocytes (pituicytes) may be regulated by
      neurosecretory cells. In the intact neurohypophysis a strong and homogeneously
      distributed immunostaining for the "embryonic", highly sialylated form of neural
      cell adhesion molecules was detected by light-microscopic immunocytochemistry. By
      electron-microscopy, both neurosecretory axons and pituicytes were immunoreactive
      for this isoform. However, in contrast to the rather uniform staining on nerve
      fibres, polysialic acid immunolabelling on glial surfaces was uneven:
      immunostaining could be observed on glial surfaces facing neuronal elements, but
      not at contact sites between pituicytes. In addition, most glial and neuronal
      elements were heavily and evenly labelled with the polyclonal antibody
      recognizing "total" neural cell adhesion molecule. Surgical transection of the
      hypophysial stalk, a procedure that eliminates descending neurosecretory axons
      from the neurohypophysis, resulted in the complete disappearance of polysialic
      immunoreactivity from the neurohypophysis. The electron-microscopic analysis
      confirmed that cell surfaces of pituicytes lacked this immunoreactivity after the
      lesion. When residual neurosecretory axons were observed following an incomplete
      lesion, immunoreactivity on axons and glial processes was maintained. Transection
      did not affect the distribution of "total" neural cell adhesion molecule. We
      postulate that the presence of neurosecretory axons in the neurohypophysis is
      necessary to maintain the capacity of pituicytes to express immunoreactivity for
      the polysialylated isoforms of neural cell adhesion molecule but not the neural
      cell adhesion molecule itself since immunoreactivity for "total" neural cell
      adhesion molecule was unaltered after hypophysial stalk transection.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8469309
TI  - Persistent degenerative state of non-pyramidal neurons in the CA1 region of the
      gerbil hippocampus following transient forebrain ischemia.
AB  - Morphological changes in the neurons of the gerbil hippocampus following 5 min of
      forebrain ischemia were examined using light and electron microscopy. Although
      non-pyramidal neurons in the CA1 region of the hippocampus survived through the
      full length of the observation period, up to six weeks after ischemia, they
      consistently demonstrated degenerative changes distinct from those of the well
      known "delayed neuronal death" of CA1 pyramidal cells. When examined with the
      light microscope, CA1 non-pyramidal neurons were found to be shrunken and their
      nuclei and cytoplasm were hyperchromatic between seven days and six weeks after
      ischemia. When examined with the electron microscope, postischemic non-pyramidal
      neurons were found to have markedly electron-dense profiles; their cytoplasm
      contained numerous free ribosomes and heterogeneous smaller granular substances,
      the latter also filling the nuclei. However, there was no loss of ribosomes from
      the rough endoplasmic reticulum, and mitochondrial cristae were preserved,
      suggesting that these neurons were viable. CA1 non-pyramidal neurons were studied
      immunohistochemically using three types of monoclonal antibodies, one each
      against parvalbumin, a nonphosphorylated epitope on the 168,000 mol. wt and
      200,000 mol. wt subunits of neurofilament proteins, and microtubule-associated
      protein 2. CA1 non-pyramidal neurons lost immunoreactivity to these neuron
      specific substances six weeks after ischemia, suggesting that these degenerating
      cells lacked certain types of normal neuronal activity. We conclude that non
      pyramidal neurons in the hippocampal CA1 region survive transient ischemia but
      undergo degenerative changes following complete loss of CA1 pyramidal cells.
      These changes may be due to depletion of presumptive target-derived trophic
      factors within the non-pyramidal neurons.

PMID- 8469310
TI  - Differential regional and cellular distribution of beta-amyloid precursor protein
      messenger RNAs containing and lacking the Kunitz protease inhibitor domain in the
      brain of human, rat and mouse.
AB  - The beta-amyloid precursor protein is the precursor of the main component of
      senile plaques (the beta-amyloid peptide or beta/A4) found in the brain of aged
      humans and, in higher amounts, in the brain of Alzheimer's disease and Down's
      syndrome subjects. Four different forms of beta-amyloid precursor protein
      messenger RNAs have been described in humans and rodents: beta-amyloid precursor
      protein 695, beta-amyloid precursor protein 714, beta-amyloid precursor protein
      751 and beta-amyloid precursor protein 770 messenger RNAs (numbers corresponding
      to the number of encoded amino acids). The two latter forms are characterized by
      containing in their sequence a region with high homology to the Kunitz family of
      serine protease inhibitors. We have used oligonucleotide probes to study the
      distribution of the different messenger RNAs encoding each of the four beta
      amyloid precursor proteins by in situ hybridization histochemistry in human, rat
      and mouse brain. We found that beta-amyloid precursor protein 695, beta-amyloid
      precursor protein 714 and beta-amyloid precursor protein 751 messenger RNAs were
      widely distributed in the human, rat and mouse brain and that their distribution
      was roughly similar in most brain areas in these three species. The distribution
      of beta-amyloid precursor protein 770 messenger RNA was not so wide and differed
      among the three species studied. beta-amyloid precursor protein 751 and 770
      messenger RNAs were the only forms present at significant levels in rodent
      choroid plexus and meninges, while beta-amyloid precursor protein messenger RNA
      isoforms containing and lacking the Kunitz domain were detected in the human
      choroid plexus. We also observed that the relative levels of beta-amyloid
      precursor protein 751 and 770 messenger RNAs in the rat cerebral white matter as
      well as in the mouse and human striatum were higher than those of the beta
      amyloid precursor protein messenger RNAs lacking the Kunitz domain. While the
      most abundant beta-amyloid precursor protein messenger RNAs in the brain of all
      three species under study were, in descending order, beta-amyloid precursor
      protein 695 and beta-amyloid precursor protein 751 messenger RNAs, the least
      abundant form was not the same for all species: in human it was beta-amyloid
      precursor protein 714 messenger RNA and in rat and mouse brain it was beta
      amyloid precursor protein 770 messenger RNA. Our results show differences both
      inter- and intraspecies of the relative abundance and distribution of four beta
      amyloid precursor protein messenger RNAs in rat, mouse and human brain.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8469311
TI  - Primate nucleus basalis of Meynert p75NGFR-containing cholinergic neurons are
      protected from retrograde degeneration by the ganglioside GM1.
AB  - The effects of unilateral devascularizing lesions of the neocortex in primates
      (Cercopithecus aethiops) on the immunoreactivity of choline acetyltransferase and
      the low-affinity nerve growth factor receptor (p75NGFR) were investigated in cell
      bodies of the nucleus basalis of Meynert. Choline acetyltransferase enzymatic
      activity was measured in the dissected ipsi- and contralateral nucleus basalis of
      Meynert as well as in the remaining cortex adjacent to the lesion. Cortically
      lesioned animals displayed a shrinkage of p75NGFR-immunoreactive cholinergic cell
      bodies in only the intermediate portion of the nucleus basalis of Meynert as well
      as a depletion of choline acetyltransferase activity in this cellular complex. In
      contrast, cortically lesioned monkeys treated with monosialoganglioside did not
      reveal a significant loss of choline acetyltransferase activity or shrinkage of
      nucleus basalis of Meynert cholinergic neurons, but rather a modest hypertrophy.
      These results are discussed in relation to a possible use of putative trophic
      agents in the repair of the damaged central nervous system.

PMID- 8469312
TI  - Age-related cognitive decline and electroencephalogram slowing in Down's syndrome
      as a model of Alzheimer's disease.
AB  - We studied quantitative electroencephalogram and neuropsychological performance
      in an aging series of 31 patients with Down's syndrome and compared the findings
      with those of 36 patients with probable Alzheimer's disease and age-matched
      controls. We found an age-related decline of cortical functions and slowing of
      the electroencephalogram in Down's syndrome patients aged from 20 to 60 years.
      Slowing of the electroencephalogram, i.e. the decrease of the peak frequency, was
      significantly related to Mini-Mental status scores, and visual, praxic and speech
      functions, as well as memory in the Down patients, similar to the Alzheimer
      patients. Similar correlations were not demonstrated for young or elderly
      controls. This study provides neuropsychological and electrophysiological data to
      suggest that studying Down's syndrome patients of different ages can serve as a
      model for progression of Alzheimer's disease.

PMID- 8469313
TI  - Oxytocin and vasopressin release within the supraoptic and paraventricular nuclei
      of pregnant, parturient and lactating rats: a microdialysis study.
AB  - The release of the nonapeptides oxytocin and vasopressin within the hypothalamic
      supraoptic and paraventricular nuclei was measured in 30-min microdialysates in
      conscious female rats in the last three days of pregnancy, during parturition,
      immediately after parturition and during suckling, all in the same rats, and in
      virgin controls. Nonapeptide release within the supraoptic and paraventricular
      nuclei was unchanged during late pregnancy compared to virgin rats, but
      intranuclear oxytocin and not vasopressin release was elevated during parturition
      (relative to late pregnancy, supraoptic nucleus: to 254%, paraventricular
      nucleus: to 300%; P < 0.01) and during suckling also on days 8-10 of lactation
      (relative to pre-suckling, supraoptic nucleus: to 407%, paraventricular nucleus:
      to 275%; P < 0.02). Suckling-induced release of oxytocin was significantly
      reduced using Ca(2+)-free, EDTA-containing (10(-4) M) microdialysis fluid and
      further stimulated by high K(+)- (56 mM), veratridine-containing (50 microM)
      microdialysis fluid. The opioid antagonist naloxone whether given by subcutaneous
      injection (5 mg/kg) or directly into the supraoptic nucleus by microdialysis (5 x
      10(-6) M) or microinjection (1.5 microliters, 10(-6) M) did not further enhance
      oxytocin release within either the supraoptic or paraventricular nuclei during
      parturition. In contrast to the selective release of oxytocin within the
      supraoptic and paraventricular nuclei during parturition and suckling, direct
      osmotic stimulation of the nuclei by microdialysing hypertonic medium (artificial
      cerebrospinal fluid; 1 M NaCl) increased intranuclear release of both oxytocin
      and vasopressin which was further enhanced after replacement of hypertonic with
      isotonic fluid. This rebound phenomenon served to confirm the precise location of
      the microdialysis probe ante mortem and the ability of the nuclei to adequately
      respond to the osmotic stimulus at the end of the experiment. The study has shown
      that oxytocin is released in the supraoptic and paraventricular nuclei during
      parturition as well as in lactation unrestrained by endogenous opioids during
      parturition. This intranuclear release of oxytocin may act by local positive
      feedback stimulation of oxytocin neurons to excite further oxytocin release in
      the brain and into blood during both parturition and lactation.

PMID- 8469314
TI  - Oxytocin neuron activation and Fos expression: a quantitative immunocytochemical
      analysis of the effect of lactation, parturition, osmotic and cardiovascular
      stimulation.
AB  - As c-fos expression is generally thought to be linked to neuronal activation, we
      compared Fos immunoreactivity in identified oxytocinergic and vasopressinergic
      neurons of female rats under various conditions known to elicit particular
      patterns of electrophysiological and secretory activity in these neurons. In
      suckled lactating animals, Fos immunoreactivity was visible only in rare
      oxytocinergic and vasopressinergic neurons of the paraventricular and supraoptic
      nuclei, even after interruption of suckling for 18-72 h. On the other hand, many
      Fos-positive cells were visible in the nuclei of parturient rats; they involved
      about 25% of supraoptic oxytocinergic elements. Even more Fos-positive elements
      were visible in the nuclei of lactating rats that had also undergone 24 h water
      deprivation or haemorrhage. This involved about 75% vasopressinergic neurons and
      25% oxytocinergic neurons of the supraoptic nucleus. Fos immunoreactivity was
      particularly conspicuous in oxytocin neurons of the anterior commissural nucleus
      after haemorrhage. After water deprivation or haemorrhage, Fos-positive
      oxytocinergic neurons in the supraoptic nucleus were significantly more numerous
      in virgin rats than in lactating rats. Our observations show that suckling,
      although a most potent stimulus for oxytocin neuron activation and oxytocin
      release, is inefficient in inducing Fos synthesis in magnocellular neurons, even
      after a period of interruption. On the other hand, parturition, water deprivation
      and haemorrhage were more potent stimuli for both neurosecretory systems.
      However, under each type of stimulation, only part of the neuronal populations
      within each nucleus were Fos-positive, suggesting that different stimulus
      specific pathways are involved in these regulations. In so far as electrical
      activity is one possible mechanism for c-fos expression, comparison of the
      patterns of c-fos activation with the known electrophysiological behaviour of
      hypothalamic magnocellular neurons suggests that Fos synthesis in these neurons
      is linked to the number of action potentials generated over a period of time,
      more than to the pattern of electrical activity, whatever the physiological
      impact of this pattern. Furthermore, within a group of neurons, the heterogeneity
      of the response in terms of Fos synthesis may be correlated to the variability of
      the electrophysiological response within this group.

PMID- 8469315
TI  - Interferon beta in multiple sclerosis.

PMID- 8469316
TI  - Clinical neuromythology X. Faithful fashion: survival status of the brain
      transplant cure for parkinsonism.

PMID- 8469317
TI  - Medicare hospital utilization review for ischemic cerebrovascular disease.

PMID- 8469318
TI  - Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I.
      Clinical results of a multicenter, randomized, double-blind, placebo-controlled
      trial. The IFNB Multiple Sclerosis Study Group.
AB  - We report a multicenter, randomized, double-blind, placebo-controlled trial of
      interferon beta-1b (IFNB) in 372 ambulatory patients with relapsing-remitting
      multiple sclerosis (MS). Entry criteria included an Expanded Disability Status
      Scale (EDSS) score of 0 to 5.5 and at least two exacerbations in the previous 2
      years. One-third of the patients received placebo, one-third 1.6 million
      international units (MIU) of IFNB, and one-third 8 MIU of IFNB, self-administered
      by subcutaneous injections every other day. The primary end points were
      differences in exacerbation rates and proportion of patients remaining
      exacerbation-free. The annual exacerbation rate for patients receiving placebo
      was 1.27; for 1.6 MIU IFNB, 1.17; and for 8 MIU IFNB, 0.84 after 2 years.
      Exacerbation rates were significantly lower in both treatment groups compared
      with the placebo group (8 MIU versus placebo, p = 0.0001; 1.6 MIU versus placebo,
      p = 0.0101; and 8 MIU versus 1.6 MIU, p = 0.0086), suggesting a dosage effect.
      The reduction in exacerbation severity in the 8 MIU group was attributable to a
      twofold reduction in the frequency of moderate and severe attacks. More patients
      in the 8 MIU group (n = 36) were exacerbation-free at 2 years compared with the
      placebo group (n = 18; p = 0.007). EDSS scores changed little from baseline in
      both the placebo and treatment arms. Accordingly, a significant change in
      disability could not be discerned in this trial. Finally, in serial MRIs, MS
      activity was significantly less in the high-dose IFNB group.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8469319
TI  - Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II.
      MRI analysis results of a multicenter, randomized, double-blind, placebo
      controlled trial. UBC MS/MRI Study Group and the IFNB Multiple Sclerosis Study
      Group.
AB  - We performed yearly MRI analyses on 327 of the total 372 patients in a
      multicenter, randomized, double-blind, placebo-controlled trial of interferon
      beta-1b (IFNB). Clinical results are presented in the preceding companion paper.
      Baseline MRI characteristics were the same in all treatment groups. Fifty-two
      patients at one center formed a cohort for frequent MRIs (one every 6 weeks) for
      analysis of disease activity. The MRI results support the clinical results in
      showing a significant reduction in disease activity as measured by numbers of
      active scans (median 80% reduction, p = 0.0082) and appearance of new lesions. In
      addition, there was an equally significant reduction in MRI-detected burden of
      disease in the treatment as compared with placebo groups (mean group difference
      of 23%, p = 0.001). These results demonstrate that IFNB has made a significant
      impact on the natural history of MS in these patients.

PMID- 8469320
TI  - Levodopa, melanoma, and Parkinson's disease.
AB  - Previous reports and the Physicians' Desk Reference caution against the use of
      levodopa in Parkinson's disease (PD) patients with melanoma. A critical review of
      the literature reveals only anecdotal evidence to support a link between levodopa
      and melanoma. In fact, levodopa has an antitumor effect on melanoma. We report
      nine patients with PD and melanoma who were treated with levodopa/carbidopa
      (L/C). Current evidence suggests that L/C can be used safely in PD patients with
      a history of melanoma.

PMID- 8469321
TI  - Clinical experience with controlled-release carbidopa/levodopa in Parkinson's
      disease.
AB  - We converted 158 Parkinson's disease (PD) patients on stable doses of standard
      carbidopa/levodopa (Std-L) to controlled-release carbidopa/levodopa (L-CR). Of
      the 141 patients who completed the study, 103 (73%) preferred L-CR, 26 (18.5%)
      preferred Std-L, and 12 (8.5%) had no preference. One hundred fourteen patients
      elected to continue L-CR, and we performed the primary data analysis on this
      group. Following conversion to L-CR, patients reported an increase in length of
      benefit from each dose and an increased "kick-in" time. There was a decrease in
      the total number of doses, "off" periods, sleep interruptions per night, dose
      failures, and sleep disturbances. Conversion to L-CR resulted in a significant
      increase in total levodopa dose. There was no significant change in the
      dyskinesias. However, early-morning dystonia resolved in eight of 14 patients.
      Our findings suggest that L-CR is particularly effective in decreasing motor
      fluctuations, reducing nocturnal problems, and minimizing levodopa dose failures
      in PD.

PMID- 8469322
TI  - Magnetic resonance imaging in childhood intractable partial epilepsies:
      pathologic correlations.
AB  - We conducted a retrospective single-blind study assessing the value of MRI in 44
      children surgically treated for partial epilepsy, and correlated the MRI findings
      with the pathology in all cases. MRI revealed abnormalities in concordance with
      the clinical and electroencephalographic data in 84% of patients. Developmental
      neuronal migration pathology was present in 25% of patients and was relatively
      more common in the sensorimotor cortex. There was hippocampal sclerosis in 50% of
      patients with temporal lobe resection; however, only two of the 10 children with
      hippocampal sclerosis were below the age of 12 years. Similarly, ganglio-glial
      tumors were more common than astrocytomas in children below age 12. These results
      indicate that MRI is sensitive in the detection of pathologic abnormalities in
      most pediatric candidates for epilepsy surgery, and that the distribution and
      type of pathology appear to be age related in this population.

PMID- 8469323
TI  - Felbamate monotherapy for partial-onset seizures: an active-control trial.
AB  - We evaluated felbamate (FBM) monotherapy in 111 patients with uncontrolled
      partial-onset seizures in a multicenter, double-blind, parallel-group trial.
      During the 56-day baseline period, patients had at least eight partial-onset
      seizures and received one standard antiepileptic drug (AED) at a therapeutic
      level; a second AED was allowed if at a subtherapeutic level. Patients received
      either FBM 3,600 mg/d or valproate (VPA) 15 mg/kg/d. The baseline AED at
      therapeutic levels was discontinued by one-third decrements on study days 1, 14,
      and 28 and the sub-therapeutic AED, if any, was discontinued completely on study
      day 1. Study endpoints were completion of 112 study days or fulfilling one or
      more escape criteria. Criteria for escape relative to baseline were (1) twofold
      increase in monthly seizure frequency, (2) twofold increase in highest 2-day
      seizure frequency, (3) single generalized tonic-clonic seizure (GTC) if none
      occurred during baseline, or (4) significant prolongation of GTCs. The primary
      efficacy variable was the number of patients in each treatment group who met
      escape criteria. Thirty-seven patients on VPA and 18 on FBM met escape criteria
      (p < 0.001). Even when we considered FBM dropouts to have fulfilled escape
      criteria and VPA dropouts to have completed the 112-day trial, the treatment
      difference remained statistically significant (p = 0.039) in favor of FBM.
      Adverse experiences with FBM were all mild or moderate in severity. The frequency
      of adverse experiences was much lower during monotherapy. FBM monotherapy was
      effective in the treatment of partial-onset seizures with or without secondarily
      generalized seizures and demonstrated a favorable safety profile.

PMID- 8469324
TI  - Felbamate: a double-blind controlled trial in patients undergoing presurgical
      evaluation of partial seizures.
AB  - We studied the efficacy and safety of felbamate, an investigational antiepileptic
      drug, in a unique, double-blind, placebo-controlled trial. Sixty-four patients
      with refractory partial-onset seizures who completed a routine evaluation for
      epilepsy surgery met seizure frequency entry criteria. Each patient received
      felbamate or placebo in addition to the anticonvulsant regimen present at the
      conclusion of the presurgical evaluation. The treatment phase consisted of an 8
      day inpatient period and a 21-day outpatient period. The efficacy variable was
      time to fourth seizure. The difference in time to fourth seizure was
      statistically significant (p = 0.028) in favor of felbamate. Eighty-eight percent
      of the patients in the placebo group had a fourth seizure during the treatment
      phase compared with 46% of the patients in the felbamate group (p = 0.001).
      Adverse experiences with felbamate were generally mild or moderate in severity.
      This trial demonstrated the ability of felbamate to quickly and safely reduce the
      occurrence of frequent partial-onset seizures and maintain effective seizure
      control following reductions in the dosages of standard antiepileptic drugs.

PMID- 8469325
TI  - T2 relaxation time in patients with Parkinson's disease.
AB  - Postmortem studies of patients with Parkinson's disease (PD) reveal an increase
      in iron concentration in the substantia nigra. Iron content in the brain is
      associated with decreased signal intensity on T2-weighted MRI. We measured in
      vivo the T2 relaxation time in 30 PD patients and 33 healthy volunteer subjects,
      using a 1.5-T whole-body MRI system. In comparison with healthy controls, T2
      values in PD patients were reduced in the following brain regions: substantia
      nigra, caudate nucleus, and putamen. Due to the overlap between patients and
      control subjects, we could not differentiate, in a given patient, healthy from
      diseased state on the basis of T2 relaxation time. Our findings support the
      notion of increased iron deposition in the substantia nigra of patients with PD.
      However, the shortening of T2 values in the substantia nigra did not correlate
      with disease duration nor with clinical severity.

PMID- 8469326
TI  - Sleep state and the risk of seizure recurrence following a first unprovoked
      seizure in childhood.
AB  - In a prospective study, we have followed 347 children identified at the time of a
      first unprovoked seizure for a mean of 46 months. To date, 135 (39%) have
      experienced a seizure recurrence. In this study, we analyzed recurrence risk as a
      function of whether the child was asleep or awake at the time of the first
      seizure. The cumulative recurrence risks for children whose first seizure
      occurred in sleep was 28% at 0.5 years, 39% at 1 year, 53% at 2 years, and 55% at
      4 years, compared with recurrence risks of 18%, 23%, 30%, and 35% at the same
      intervals in children whose first seizure occurred while awake (p < 0.001). The
      association of a first seizure during sleep with an increased recurrence risk was
      present primarily in children with idiopathic seizures. It occurred in both those
      with a normal and an abnormal EEG. On multivariable analysis, sleep state,
      etiology, and the EEG were statistically significant predictors of recurrence
      risk. In children who experienced a seizure recurrence, the recurrences occurred
      in the same sleep state in 73% of the cases (p < 0.0001). This was also true of
      subsequent recurrences. We conclude that the occurrence of a first seizure in
      sleep is associated with an increased risk of recurrence. Subsequent seizures, if
      they do occur, usually occur in the same sleep state as the initial seizure.

PMID- 8469327
TI  - Material-specific memory in the intracarotid amobarbital procedure.
AB  - We examined material-specific memory in 45 left hemisphere language dominant
      patients with temporal complex partial seizures (24 right, 21 left) during the
      intracarotid amobarbital procedure (IAP) by showing eight cards displaying two
      line drawings of common objects, two printed words, one colored shape, one math
      expression, one face, and one abstract shape following amobarbital injection
      (mean = 109.9 mg). We assessed delayed recall and recognition following clearing.
      Patients with right foci recognized significantly fewer verbally mediated stimuli
      (words, object drawings, colored shape) with left than with right injection.
      Patients with left foci recognized a nonverbal stimulus (abstract shape) more
      poorly following right versus left injection. Discriminant function analysis
      lateralized 85% of the sample from memory predictors, upheld to 81% on
      crossvalidation. Material-specific memory remains intact in the hemisphere
      contralateral to a seizure focus, but wider representation may occur for stimuli
      normally dominant for the hemisphere with the seizure focus. The IAP
      significantly lateralizes a seizure focus with use of both types of stimuli.

PMID- 8469328
TI  - Clinical course of spontaneous subarachnoid hemorrhage: a population-based study
      in King County, Washington.
AB  - Over 2 years, we identified 171 patients in King County, Washington, experiencing
      an incident subarachnoid hemorrhage and characterized their clinical course and
      outcome. Most (65%) were women and most (68%) were under age sixty-five. Only
      five died without medical attention. The remaining 166 patients were hospitalized
      and had CTs of the head. Of these, 103 underwent aneurysm surgery, 40 developed
      acute hydrocephalus, 32 had symptomatic vasospasm, and 30 re-bled. Sixty-eight
      percent (68%) survived to 1 month after the bleed and 62% to 1 year. Independent
      predictors of good recovery by 1 month after the bleed included youth, a high
      score on the admission Glasgow Coma Scale, and absence of blood on the first CT.
      In this population-based series, at 1 month after the bleed, approximately one
      third of patients were dead, one-third had neurologic deficits, and one-third
      were doing well.

PMID- 8469329
TI  - MRI volumetric measurement of amygdala and hippocampus in temporal lobe epilepsy.
AB  - We performed MRI volumetric measurements of the amygdala (AM), the hippocampal
      formation (HF), and the anterior temporal lobe in a group of 30 patients with
      intractable temporal lobe epilepsy (TLE) and in seven patients with extratemporal
      lobe foci. Measurements were analyzed with a semiautomated software program and
      the results compared with those of normal controls and correlated with the
      findings of all other investigations. In particular, we compared the results with
      the lateralization of epileptic abnormalities in the EEG. Volumetric studies of
      AM and HF showed lateralization of measurable atrophy consistent with that
      derived from extracranial and intracranial EEG examinations. The HF volumes were
      more sensitive and provided a lateralization in 87%. Combined measurements of AM
      and HF showed lateralization in 93%, always congruent with the results of EEG
      lateralization. This slight but important additional improvement in
      discrimination justifies using AM measurements in MRI volumetric studies of
      mesial temporal structures. Volumetric studies combined with other currently
      employed noninvasive techniques may diminish the need for invasive methods of
      investigation in patients with TLE.

PMID- 8469330
TI  - Facial asymmetry, hippocampal pathology, and remote symptomatic seizures: a
      temporal lobe epileptic syndrome.
AB  - We performed a prospective study of neuroimaging studies and temporal lobe
      pathology in 13 patients with facial asymmetry and intractable partial epilepsy
      of temporal lobe origin. The 13 patients, derived from 50 consecutive patients
      with nonlesional medically refractory partial epilepsy, were deemed appropriate
      candidates for an anterior temporal lobectomy. The facial weakness occurred
      exclusively, or was most prominent, during emotional expression, ie, spontaneous
      smiling. The temporal lobe of seizure origin, demonstrated by ictal long-term EEG
      monitoring, was always contralateral to the side of weakness. All 13 patients had
      a history of early childhood neurologic disease, eg, complex febrile seizure or
      bacterial meningitis. Hippocampal formation atrophy was present in all the
      epileptic temporal lobes by MRI-based volume studies. Twelve of the 13 patients
      subsequently received an anterior temporal lobectomy, and mesial temporal
      sclerosis was present in all the surgically excised temporal lobes. Ten of the 12
      patients have been seizure-free during short-term follow-up. Facial asymmetry may
      occur in patients with partial epilepsy related to remote symptomatic seizures
      and mesial temporal sclerosis.

PMID- 8469331
TI  - Brain infarction severity differs according to cardiac or arterial embolic
      source.
AB  - We compared clinical and radiologic features between 246 cardiac embolism (EMB)
      and 66 arterial embolic (tandem arterial pathology [TAP]) patients selected from
      the 1,273 patients with cerebral infarction in the Stroke Data Bank. Diagnostic
      definitions accounted for the increased frequency of cardiac disease among
      patients with EMB compared with TAP (78.4% versus 29.3%), while transient
      ischemic attacks (32.3% versus 13.1%) and carotid artery bruit (15.1% versus
      3.3%) were more prevalent in TAP than in EMB. Multiple logistic regression
      differentiated TAP and EMB further. The probability of a TAP diagnosis was
      increased by the CT finding of a superficial infarct alone (odds ratio [OR] =
      4.6; 95% CI = 1.5 to 13.7) or by a higher admission hematocrit. The probability
      of EMB was greater in patients with an initial decreased consciousness (OR =
      39.2; 95% CI = 4.0 to 381.3) or with an abnormal first CT (OR = 3.2; 95% CI = 1.2
      to 8.6). These findings indicate that the two infarct subtypes differ in the
      location and extent of the cortical infarction, which argues for a smaller
      particle size, with smaller and more distal infarction in embolism from an
      arterial source compared with cardiogenic embolism.

PMID- 8469332
TI  - Selective dorsolateral frontal lobe dysfunction associated with diencephalic
      amnesia.
AB  - We report three cases with unilateral thalamic ischemic lesions that resulted in
      lasting material-specific memory impairments and concomitant selective frontal
      lobe-related cognitive deficits. In two cases the lesions were limited to the
      left thalamus, and in the third the right thalamus was involved. These deficits
      were associated with ipsilateral diencephalic, striatal, and dorsolateral
      prefrontal hypoperfusion. The damage implicated the ventral anterior nucleus, the
      mamillothalamic tract, and the rostroventral internal medullary lamina. These
      findings suggest that medial thalamic damage involving the ventral and rostral
      sector of the dorsal thalamus will concurrently affect functionally and neurally
      distinct limbodiencephalic pathways and diencephalic connections with the frontal
      cortex. A review of the neuropsychological and neuroimaging findings from
      previously reported cases with vascular lesions of the thalamus further supports
      this contention. The presence of frontal lobe-related cognitive deficits, though
      not obligatorily related to the memory problems, may contribute to some aspects
      of the memory deficits and affect the nature of the memory disorder observed in
      some cases with diencephalic amnesia.

PMID- 8469333
TI  - Cerebral venous thrombosis in paroxysmal nocturnal hemoglobinuria: report of two
      cases.
AB  - We report the clinical, radiologic, and postmortem findings in two patients with
      paroxysmal nocturnal hemoglobinuria (PNH) who developed cerebral venous
      thromboses (CVTs). In contrast with those in most published cases, our patients
      did not have focal neurologic signs. Antemortem diagnosis of CVT had been made by
      MR cerebral venograms. We conclude that (1) PNH should be considered in any
      patient with stroke associated with iron deficiency anemia, hemolysis,
      hemoglobinuria, or hemosiderinuria; (2) PNH should be in the differential
      diagnosis of CVT; (3) the latter could present without focal neurologic signs;
      and (4) MR cerebral venography may be a reliable diagnostic alternative to
      cerebral angiography when CVT is suspected.

PMID- 8469334
TI  - Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing
      chronic intracranial EEG monitoring and outcome of surgical treatment.
AB  - We retrospectively studied 12 consecutive patients with gelastic seizures and
      hypothalamic hamartomas who, because of intractable epilepsy, underwent chronic
      intracranial EEG monitoring or epilepsy surgery. All patients had medically
      refractory seizures that included laughter as an ictal behavior (gelastic
      seizures). The hypothalamic hamartomas were identified with neuroimaging studies
      (12 of 12) and by pathologic verification (four of 12). Associated clinical
      features included behavioral disorders (n = 5), developmental delay (n = 4), and
      precocious puberty (n = 2). Interictal extracranial EEG predominantly showed bi
      hemispheric epileptiform changes suggesting a secondary generalized epileptic
      disorder. Intracranial EEG recordings, performed in eight patients, indicated the
      apparent focal onset of seizure activity (anterior temporal lobe [n = 7] and
      frontal lobe [n = 1]). None of the seven patients who underwent a focal cortical
      resection, however, experienced a significant reduction in seizure tendency. An
      anterior corpus callosotomy, performed in two patients with symptomatic
      generalized epilepsy, resulted in a worthwhile reduction in drop attacks. Results
      of this study may modify the surgical strategies in patients with gelastic
      seizures and hypothalamic hamartomas.

PMID- 8469335
TI  - The natural history of amyotrophic lateral sclerosis and the use of natural
      history controls in therapeutic trials.
AB  - We analyzed the natural history of amyotrophic lateral sclerosis in 277 patients.
      Our goal was to develop a better understanding of the clinical disease and thus
      improve the design of therapeutic trials. The Tufts Quantitative Neuromuscular
      Exam (TQNE) was used as the primary assessment instrument. Our analysis suggested
      that although more observations are desirable, six monthly TQNEs were adequate to
      establish the rate of disease progression. We observed a spectrum of
      deterioration rates without definable subgroups. The striking linearity of
      deterioration was confirmed. We found a high correlation between deterioration
      rates in arm and leg strength for individual patients, but a wide range between
      different patients. Sex and the age at clinical onset did not affect the
      deterioration rate. As compared with patients without a positive family history,
      those with other affected family members had a slower loss in arm but not leg
      strength. We propose that natural history controls can be used effectively in the
      design of ALS therapeutic trials.

PMID- 8469336
TI  - The fatigue of rapid repetitive movements.
AB  - Normal subjects (n = 7) performed rapid voluntary isometric contractions of the
      adductor pollicis and the tibialis anterior. Within the first minute of this low
      intensity exercise, the speed of tension development slowed, accompanied by a
      prolongation in EMG burst duration. In contrast, electrically evoked contractions
      either became more rapid (twitch) or did not change (tetanus), suggesting a
      fatigue of central origin. 31P NMR measurements of high-energy phosphates showed
      that the relationship between the fall of maximum force and changes of phosphates
      and pH was similar to that produced by other high-intensity fatiguing exercise
      protocols. Thus, rapid movements produce fatigue through two major mechanisms.
      First, there is slowing of the speed of tension development which appears
      secondary to central fatigue. Second, the decline of muscle force is primarily
      attributable to changes in muscle pH or inorganic phosphate, which usually occurs
      only after high-intensity (but non-rapid) exercise.

PMID- 8469337
TI  - Ventrolateral and dorsomedial somatosensory association cortex damage produces
      distinct somesthetic syndromes in humans.
AB  - Five somatosensory cortices have distinctive somatotopic representations,
      cytoarchitecture, and connectivity: primary somatosensory cortex (SI),
      ventrolateral association cortices (SII, SIII, and SIV), and dorsomedial
      association cortex (supplementary sensory area). Patients with focal lesions of
      ventrolateral (n = 5) and dorsomedial (n = 6) somatosensory association cortices
      (SACs) and hemiparetic (n = 8) and neurologically normal control patients (n =
      14) underwent detailed somesthetic testing that encompassed basic, intermediate,
      and complex (tactile object recognition) somesthetic functions. Dorsomedial
      lesions acutely caused severe disruption of somesthetic processing and severe
      apraxia when the area of damage was extensive and involved anterior and posterior
      cortices. In contrast, ventrolateral lesions caused tactile agnosia. Chronically,
      sensorimotor function following dorsomedial damage improved considerably. Tactile
      agnosia following ventrolateral damage, however, was readily detectable for years
      following onset. Functional differences between ventrolateral and dorsomedial
      SACs may reflect parallel processing in dual somatosensory systems.

PMID- 8469339
TI  - Brain magnetic resonance imaging in coronary artery bypass grafts: a pre- and
      postoperative assessment.
AB  - We undertook a study to determine (1) the frequency and prognostic significance
      of preexisting MRI brain abnormalities in patients undergoing coronary artery
      bypass grafts (CABG) and (2) whether MRI can detect surgery-related brain damage
      in 31 neurologically asymptomatic CABG patients (mean age, 61.0 +/- 6.6 years).
      MRIs were performed within 7 days before and 8 to 17 days after surgery. When we
      compared the preoperative images with those of 31 age- and risk factor-matched
      neurologically asymptomatic controls free of cardiac disease (mean age, 60.3 +/-
      6.1 years), higher rates of thromboembolic infarcts (16% versus 0%), lacunes
      (58.1% versus 32.3%), and brainstem lesions (22.6% versus 3.8%) were noted.
      Subjective rating demonstrated significantly larger ventricles in patients than
      in controls (p = 0.002). CABG candidates also had significantly increased
      ventricular-to-intracranial cavity ratios (VICR) as determined by
      semiquantitative volumetric measurements (6.9 +/- 2.5% versus 4.9 +/- 1.6%; p =
      0.0004). Eleven patients had postsurgical complications, with eight having
      symptoms consistent with diffuse encephalopathy. The only MRI finding that
      separated encephalopathic from complication-free patients was ventricular size
      (VICR 9.0 +/- 2.5% versus 4.9 +/- 1.6%; p = 0.006). This difference remained
      statistically significant after adjustment for the effects of age (p = 0.04).
      Postoperative MRI consistently failed to demonstrate surgery-related brain damage
      responsible for the encephalopathy.

PMID- 8469338
TI  - HLA-DPB1 allele associates with early-onset myasthenia gravis in Japan.
AB  - We investigated the HLA-DPB1 allele in 43 unrelated Japanese patients with
      myasthenia gravis (MG) using digestion of polymerase chain reaction (PCR)
      amplified DNA with allele-specific restriction endonucleases (PCR-RFLP method).
      We found a higher frequency of the DPB1*0201 allele in female patients whose ages
      at onset were less than 30 years (83.3%) than in controls (35.6%). The study also
      included serologic typing of HLA-A, -B, -C, and -DR antigens in 72 patients with
      MG, and confirmed previous results demonstrating a strong association of HLA-DR53
      with early onset of MG in females. These results indicate that both the DPB1*0201
      allele and DR53 play key roles in the disease process of MG in early-onset
      females, and that the genetic background of Japanese females with early-onset MG
      is different from that of other patients with MG.

PMID- 8469340
TI  - Auditory system degeneration in Alzheimer's disease.
AB  - We observed a highly topographically specific and consistent pattern of
      degeneration in the auditory system of Alzheimer's disease (AD) patients. Senile
      plaques (SP) and neurofibrillary tangles (NFT) were distributed throughout the
      ventral nucleus of the medial geniculate body (MGB) and the central nucleus of
      the inferior colliculus (IC) in nine of nine AD patients. Adjacent nuclei within
      the MGB and IC were consistently spared. NFT and SP were also present in the
      primary auditory and the auditory association cortices. In all control tissues,
      there were neither SP nor NFT in any of the above sites. The cochlear nuclei were
      normal in tissues from both AD and control patients. The ventral nucleus of the
      MGB is the major thalamic relay station for auditory function and receives fibers
      from neurons of the central nucleus of the IC, with projections arranged
      tonotopically in a laminar pattern corresponding to a gradient of high-to-low
      frequency ranges. The degenerative changes distributed throughout these nuclei
      suggest that neuronal loss may include all frequency ranges in AD. In contrast,
      the clinical features of presbycusis in elderly patients include only high
      frequency loss due to lesions peripherally in the cochlea or auditory nerves,
      rather than in the central auditory nuclei. These histologic changes in the
      brains of AD patients may provide an additional basis for altered cognitive
      function due to primary sensory deafferentation.

PMID- 8469341
TI  - Polyglucosan body disease simulating amyotrophic lateral sclerosis.
AB  - We describe two patients with polyglucosan body disease (PBD) with the clinical
      features of atypical amyotrophic lateral sclerosis (ALS). Patient 1 was demented,
      and patient 2, of Ashkenazi background, was incontinent of urine. Autopsy of
      patient 1 revealed diffuse CNS accumulations of polyglucosan bodies (PB)
      localized primarily in neuronal and astrocytic processes and rarely in neuronal
      perikarya. PB were present in peripheral nerve and myocardium. Brancher enzyme
      analysis of nerve and muscle was normal. Patient 2's sural nerve biopsy showed
      PB. Brancher activity was markedly reduced in nerve but not in leukocytes.
      Previous reports have shown reduced leukocyte brancher activity in Ashkenazi
      patients with PBD. Clinically, pathologically, and biochemically, PBD is
      heterogeneous and may include patients presenting with ALS. Cases in which
      typical pathologic features of PBD are combined with findings of rare PB in
      neural perikarya may represent a pathologic variant of PBD. Brancher enzyme
      activity may be normal or only mildly reduced in leukocytes in Ashkenazi patients
      with PBD, implying genetic heterogeneity.

PMID- 8469342
TI  - Kennedy's disease: a clinicopathologic correlation with mutations in the androgen
      receptor gene.
AB  - We confirmed a mutation of the androgen receptor gene as the cause for Kennedy's
      disease, also called "X-linked recessive spinal and bulbar muscular atrophy" or
      "bulbospinal neuronopathy." The mutation is characterized by an increased size of
      a polymorphic tandem CAG repeat within the first exon of the gene. The study
      population consisted of 17 patients from seven families (five distinct kinships
      and two isolated cases). Two patients were as yet asymptomatic and had normal
      examinations. Four carrier females showed the mutant as well as the normal
      allele; none showed clinical features of Kennedy's disease. There was no large
      expansion of the mutation observed in three generations of one family. Phenotypic
      expression between and within families was variable and not related to the size
      of the mutation. This contrasts with the gene mutations found in myotonic
      dystrophy and fragile X syndrome, where increased severity of disease correlates
      with the number of tandem triplet repeats. The findings reported here appear to
      explain the failure to find genetic anticipation in Kennedy's disease. The DNA
      test for Kennedy's disease can now be used for definitive diagnosis and carrier
      detection. In addition, mutation analysis allows early detection, which has
      implications for potential treatment.

PMID- 8469343
TI  - Duchenne muscular dystrophy: deficiency of dystrophin-associated proteins in the
      sarcolemma.
AB  - Dystrophin, the protein product of the Duchenne muscular dystrophy (DMD) gene, is
      a major component of the subsarcolemmal cytoskeleton and exists in a large
      oligomeric complex tightly associated with several sarcolemmal glycoproteins
      which provide a linkage to the extracellular matrix protein, laminin. In the
      present study, we investigated the status of the dystrophin-associated proteins
      in the skeletal muscle from 17 DMD patients of various ages. The results revealed
      a dramatic reduction in all of the dystrophin-associated proteins in the
      sarcolemma of DMD muscle compared with normal muscle and muscle from a variety of
      other neuromuscular diseases. This abnormality was common in all 17 DMD patients,
      irrespective of age. Our results indicate that the absence of dystrophin leads to
      the loss in all of the dystrophin-associated proteins, which renders DMD muscle
      fibers susceptible to necrosis. The analysis of dystrophin-associated proteins is
      important in the assessment of experimental therapies that attempt to replace
      dystrophin in DMD muscle.

PMID- 8469344
TI  - Altered brain development in Turner's syndrome: an event-related potential study.
AB  - We compared event-related brain potentials (ERPs) and reaction time (RT) measures
      from untreated young (prepubertal and peripubertal; ages 9 to 14) and old
      (postpubertal; ages 15 to 20) Turner's syndrome (TS) subjects with those from
      normal age-matched controls. Comparisons among groups permitted the assessment of
      the relative roles of congenital and maturational brain alterations as possible
      bases of the cognitive deficits in TS. All subjects were presented with series of
      auditory stimuli, and they either counted one of the two stimuli or made rapid
      discriminative button presses to both. The results indicated that, whereas the
      ERPs in young TS females were essentially the same as those in their age-matched
      controls, the ERPs in old TS females more closely resembled those in both young
      groups than those in their age-matched controls. Specifically, a late (400 to 900
      msec) frontal negative slow wave (Nc) in the old TS subjects failed to show the
      normal maturational course in which the amplitude and duration of this component
      steadily decreases with age. Except for slightly greater amounts of N1 amplitude
      in the young TS group, the latencies, amplitudes, and scalp distributions of the
      other ERP components (N1, P2, N2, P300) were all the same at all ages in the TS
      subjects and their controls. Behaviorally, both TS groups had longer RTs than
      their controls but, consistent with the ERP results, they did not make more
      errors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469346
TI  - Myopathy in the elderly: evaluation of the histopathologic spectrum and the
      accuracy of clinical diagnosis.
AB  - We undertook a retrospective clinicopathologic study to ascertain the spectrum of
      histopathologic muscle biopsy changes in the elderly thought to have a myopathy,
      and to determine the accuracy of clinical diagnosis of myopathy in the elderly
      compared with a younger control population. We compared muscle histology and case
      histories, as well as EMG and creatine kinase (CK) data, obtained over 10 years
      from 77 consecutive patients aged 65 years or older (75 +/- 6, mean +/- SD; group
      1) with those from 104 patients aged 30 to 50 years (group 2). Prominent
      myopathic features were present in 42% (group 1) versus 51% (group 2) of all
      biopsies. Neurogenic changes (17% versus 9%, p < 0.04) and type II fiber atrophy
      (22% versus 6%, p < 0.0005) were more common in the elderly, whereas normal
      findings tended to be less frequent (19% versus 35%). In at least 68% of patients
      in both groups with the histologic diagnosis of myopathy, either the CK was
      elevated or the EMG was consistent with that diagnosis. Our study indicates that
      (1) the spectrum of histopathologic changes in the two groups differs because of
      a higher frequency of neurogenic change and type II atrophy in the elderly, and
      (2) the accuracy of clinical diagnosis of myopathy in the elderly approximates
      that in a younger population.

PMID- 8469345
TI  - The prevalence by staged severity of various types of diabetic neuropathy,
      retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic
      Neuropathy Study.
AB  - The magnitude of the health problem from diabetic neuropathies remains
      inadequately estimated due to the lack of prospective population-based studies
      employing standardized and validated assessments of the type and stage of
      neuropathy as compared with background frequency. All Rochester, Minnesota,
      residents with diabetes mellitus on January 1, 1986, were invited to participate
      in a cross-sectional and longitudinal study of diabetic neuropathies (and also of
      other microvascular and macrovascular complications). Of 64,573 inhabitants on
      January 1, 1986 in Rochester, 870 (1.3%) had clinically recognized diabetes
      mellitus (National Diabetes Data Group criteria), of whom 380 were enrolled in
      the Rochester Diabetic Neuropathy Study. Of these, 102 (26.8%) had insulin
      dependent diabetes mellitus (IDDM), and 278 (73.2%) had non-insulin-dependent
      diabetes mellitus (NIDDM). Approximately 10% of diabetic patients had neurologic
      deficits attributable to nondiabetic causes. Sixty-six percent of IDDM patients
      had some form of neuropathy; the frequencies of individual types were as follows:
      polyneuropathy, 54%; carpal tunnel syndrome, asymptomatic, 22%, and symptomatic,
      11%; visceral autonomic neuropathy, 7%, and other varieties, 3%. Among NIDDM
      patients, 59% had various neuropathies; the individual percentages were 45%, 29%,
      6%, 5%, and 3%. Symptomatic degrees of polyneuropathy occurred in only 15% of
      IDDM and 13% of NIDDM patients. The more severe stage of polyneuropathy, to the
      point that patients were unable to walk on their heels and also had distal
      sensory and autonomic deficits (stage 2b) occurred even less frequently--6% of
      IDDM and 1% of NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469347
TI  - Prognostic significance of the onset mode in parkinsonism.
AB  - Early recognition of the prognosis in parkinsonism is important for both the
      management and studies aimed at preventing progression of disease. Less favorable
      prognosis is reported in early-onset postural instability and gait difficulty
      (PIGD) than in the tremor-onset cases, but the reasons for this are unknown. In
      70 autopsy-verified cases, 11 (15.7%) had PIGD, and 34 (49%) had tremor onset.
      Improvement on levodopa was more common in the tremor-than the PIGD-onset cases
      (p < 0.05). The majority of tremor-onset cases had Lewy body disease, while the
      majority of PIGD-onset cases had other forms of pathology. Survival was shorter
      in the PIGD- than the tremor-onset cases (p < 0.05).

PMID- 8469348
TI  - Long-term safety of azathioprine therapy in multiple sclerosis.
AB  - We compared the frequency of malignancies in 207 multiple sclerosis patients
      (mean age 35.75 years, SD 10.60) who took 2.0 mg/kg azathioprine daily (mean
      duration 4.16 years; SD 2.38) and in 247 nontreated patients (mean age 35.44
      years; SD 11.94). Five malignancies were diagnosed in the azathioprine group
      compared with seven in the control group. The age-adjusted occurrence rate was
      3.62/1,000 person-years (95% CI, 1.17 to 8.43) in the treated and 4.24/1,000
      person-years (95% CI, 1.70 to 8.73) in the nontreated group; the age-adjusted
      relative risk of developing a tumor was 0.85.

PMID- 8469349
TI  - Longitudinal experience with botulinum toxin injections for treatment of
      blepharospasm and cervical dystonia.
AB  - We performed a longitudinal analysis of the effects of repeat botulinum toxin
      (BTX) injections in 42 patients with blepharospasm (BL) and 115 patients with
      cervical dystonia (CD) who received BTX injections between 1984 and 1992 in at
      least five separate treatment sessions. Although the BL patients were
      significantly older (59.8 years) than the CD patients (50.6 years; p < 0.001),
      there were no other demographic differences between the two groups. While the
      total dose per treatment session and the peak effect rating remained the same,
      the duration of benefit increased and the number of complications decreased
      during the course of treatment. We concluded that chronic treatment with BTX in
      patients with BL and CD is not associated with any decline in benefit, and that
      efficacy may improve slightly with repeat treatments.

PMID- 8469350
TI  - Contrast agent overdose causing brain retention of contrast, seizures and
      parkinsonism.
AB  - A patient received an overdose of intravascular contrast medium and experienced
      protracted seizures associated with radiographic evidence of prolonged retention
      of the contrast agent in the cerebral cortex, basal ganglia, and thalami. This is
      only the second report and the first survivor of a similar neurologic syndrome
      occurring in a patient after contrast agent overdose. After the seizures
      resolved, there was a transient period of parkinsonism probably due to the toxic
      effect of contrast on the basal ganglia.

PMID- 8469351
TI  - Broad A bands of striated muscle in Leber's congenital amaurosis: a new
      congenital myopathy?
AB  - A 2-year-old boy with Leber's congenital amaurosis, hypotonia, depressed myotatic
      reflexes, and delayed motor development had numerous foci of broadened or smeared
      A bands, loss of distinct I bands, and near-normal Z lines in biopsied muscle.
      The thick filaments in these lesions appeared misaligned, suggesting an
      abnormality of the M line or of the structural protein connectin. This unique
      alteration represents the first described morphologic abnormality of muscle in a
      patient with Leber's congenital amaurosis.

PMID- 8469352
TI  - Guillain-Barre syndrome (GBS) with bilateral optic neuritis and central white
      matter disease.
AB  - A patient with acute Guillain-Barre syndrome (GBS), recovering following
      plasmapheresis, developed bilateral optic neuritis with extensive CNS white
      matter lesions on MRI. This illness was associated with Mycoplasma pneumoniae
      infection. The rare association of GBS with CNS disease raises a possibility of a
      shared pathogenic CNS and PNS epitope in these cases.

PMID- 8469353
TI  - Fulminant rhabdomyolysis in a patient with dermatomyositis.

PMID- 8469354
TI  - Dropped head syndrome.

PMID- 8469355
TI  - Dropped head syndrome.

PMID- 8469357
TI  - Secondary syringomyelia.

PMID- 8469356
TI  - ECT-induced status.

PMID- 8469358
TI  - [Evaluation of the endometrium by vaginal ultrasonography].
AB  - A group of 131 women aged between 35 and 70 years old were examined using endo
      vaginal ultrasonography. Of the patients examined, 45 had been in menopause for
      at least 2 years and 86 were pre-menopause. 48.9% of the post-menopause patients
      reported loss of blood and 69.8% of pre-menopause patients reported alterations
      in the menstrual cycle. Ultrasonography was performed using an endo-vaginal 5 MHz
      (Ansaldo 600) probe with the patient in a dorsosacral position. During the course
      of ultrasonography the appearance of the endometrium, in particular its
      thickness, dyshomogeneity and, in pre-menopause women, its correspondence with
      the stage of the ovarian cycle, were examined. Taking these parameters into
      account, the type of endometrial echo patterns were classified, separating the
      cases into pre- and post-menopause groups. Of the women in menopause, 22
      underwent curettage due to symptoms, independently of endometrial thickness which
      was over 4 mm in 50% of cases, 3 women underwent curettage following
      ultrasonographic indications, whereas the remaining 20 underwent hysterectomy due
      to other pathologies. Of the pre-menopausal group, 10 underwent curettage
      following ultrasonographic indications and 42 due to symptoms; the remaining
      patients underwent hysterectomy due to pathologies not related to the
      endometrium. A clearly defined role of endovaginal ultrasonography in the
      diagnosis of endometrial pathologies emerges if ultrasonographic findings are
      correlated with histological ones. In the group of post-menopausal women (45),
      all those cases which were histologically classified as endometrial carcinoma (4)
      were associated with an endometrial thickness over or equal to 4 mm.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8469359
TI  - [Endometrial adenocarcinoma during the fertile age].
AB  - Adenocarcinoma of the endometrium in patients 45 years old or younger accounts
      for 3-8% of all endometrial cancers diagnosed. Ten women of age = 45 years
      treated for endometrial cancer stage I in our Clinic of Obstetrics and
      Gynaecology from December 1979 to December 1988. Two cases were nulliparae, none
      of the 10 patients had Polycystic ovary syndrome and only was obese. In 80% of
      these cases the presenting symptom was abnormal vaginal bleeding and one patient
      had coexisting ovarian neoplasia (endometrioid carcinoma). Atypical endometrial
      hyperplasia was diagnosed in only one case. None of the patients had metastases
      or capillary like spaces invasion. Our policy was to treat these patients by
      hysterectomy (Piver 1 or 2), bilateral salpingo-oophorectomy and selective pelvic
      lymphadenectomy. One patient received adjuvant postoperative radiation therapy
      (49.5 Gy). One women was submitted two years later to radical mastectomy for
      ductal carcinoma of the breast. Endometrial adenocarcinoma in premenopausal women
      is generally of favourable histotype, at early stage and low grade, with
      excellent prognosis. The problem of quality of life is therefore of utmost
      importance. After surgical castration 4 of our patients experienced discomfort
      and excessive weight gain. The implications of long-term estrogen deprivation in
      younger patients must be seriously considered against as the change of ovarian
      conservation of hormonal replacement therapy.

PMID- 8469360
TI  - [Splenectomy in cytoreductive surgery in ovarian cancer].
AB  - During the course of surgery for the treatment of ovarian cancer, splenectomy is
      rarely performed since this tumour rarely infiltrates the parenchyma although it
      spreads around the spleen. Surgery is significant if surgical efforts
      successfully reduce tumour volume to less than one centimetre in diameter.
      Perisplenic involvement is frequent, even if not always massive and infiltrating,
      in relation both to biological aggressiveness and clinical and instrumental
      diagnostic delay. Between January '81 and December '91 a total of 16
      splenectomies were performed during the course of surgery relating to 311 (5.1%)
      patients suffering from mullerian ovarian carcinoma at the 3rd and 4th stage. Of
      these, 7 were performed during the first operation and 9 during the course of a
      second-look. The mean age of patients was 56 with a range of 33-71 years. Massive
      hilar infiltration was found in 14 cases, in 7 together with contemporary
      capsular infiltration. Parenchymal infiltration was present in 3 cases; one
      splenectomy was performed following an iatrogenic complication during the
      mobilization of the left colic flexure, necessary for the creation of the colon
      rectal anastomosis. Splenectomy was always well tolerated in an overall
      assessment of surgery and was without severe local complications. The most
      frequent complications were pleural (7/16) with reactive effusion and
      bronchopulmonary with basal dystelectasia (3 cases) and bronchopneumonic foci (4
      cases). A silent hematoma in a splenic site was revealed using ultrasonography in
      3 cases but resolved spontaneously without requiring drainage.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8469361
TI  - [Epidemiologic study of cervico-vaginal pathology in IUD users].
AB  - 1800 intrauterine contraceptive device users, during a period of more than
      thirteen years, and 1800 control non-users were examined clinically,
      cytologically and histopathologically for cervical pathological lesions. There
      was an increase, but not statistically significant, in the incidence of
      metaplasia, dyskariosis or mild dysplasia. There was no difference in neoplastic
      lesions.

PMID- 8469362
TI  - [Screening for ovarian carcinoma].
AB  - Approximately 1 in 70 women in the USA will develop ovarian cancer in their
      lifetime. As the incidence of ovarian cancer is higher than that of cervical
      cancer, an effective screening program is indicated from a medical point of view.
      This article examines the reduction in ovarian cancer mortality that might be
      achieved if we can develop a screening test for the detection of this disease
      during its preclinical phase. Until recently the only potential screening test
      for ovarian cancer was vaginal examination. With pelvic examination small ovarian
      lesions are often missed. Ultrasound examination of the ovaries is a much more
      reliable method for examining the ovary than gynecologic palpation. The
      combination of serum CA125 measurement with ultrasound examination offers the
      most specific and sensitive method for the early detection of ovarian cancer.
      Question concerning the optimal population to screen remain unanswered. If a
      screening protocol for ovarian cancer is available, demonstration that it results
      in a reduction in mortality in the screened population will be required. This
      will only be obtained by performing a large population based, randomised
      controlled study. Therefore, a simple and reliable screening test for the early
      detection of ovarian cancer is still urgently required.

PMID- 8469363
TI  - [Pregnancy in HIV positive women: psycho-emotional aspects. Study of 16 cases].
AB  - The aim of this study was to analyse the day-to-day life of HIV-positive women
      during pregnancy and to assess the emotions deriving from their relations with
      the baby during the first few months of life. The study was carried out on a
      group of 16 HIV-positive women aged between 19 and 37 years old (mean age 27.3
      years) who underwent a guided interview using a questionnaire. The questionnaire,
      which was mainly based on questions requiring a free answer, focused on four main
      areas: 1) the woman's reaction to HIV-positive status; 2) the influence of HIV
      positive status on relations with her partner and surroundings; 3) the
      interaction between pregnancy and the HIV-positive status; 4) the relation
      between mother and children after birth and during the first few months of life.
      56.25% of the women interviewed had become infected by intravenous drug
      injection, 25% through heterosexual relationships and 12.5% through blood
      transfusions. The cause was unspecified in 6.25%. The women had been aware of
      their HIV-positive status for between one and four years. Their reactions to HIV
      positive status were predominantly denial, condemnation, and depression
      accompanied by a sense of death, anxiety and of being different. Relations
      between couples were influenced in a variety of ways by the new situation: 4
      women reported a diminished frequency of sexual relations, one women reported
      reduced libido, 10 women did not notice changes in sexual relations and one woman
      did not reply.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469364
TI  - [Erythrocyte zinc-protoporphyrin content in pregnancy].
AB  - The assessment of iron deficiency represents a major aspect of routine laboratory
      chemico-clinical analysis, but the results provided by traditional hemato
      clinical tests (sideremia, transferrinemia, mean cell volume and red blood cell
      levels) may not prove conclusive. During pregnancy iron deficiency is common and
      it would be extremely valuable to obtain a precise method of evaluating anemia.
      The assay of erythrocytic zincoprotoporphyrin (ZNPP) offers further diagnostic
      possibilities. This study aimed to evaluate the behaviour of ZNPP and other
      common laboratory indices in pregnant and non-pregnant women in order to assess
      the value of assaying ZNPP levels. Some common parameters for the study of
      sideropenic anemia were determined using the methods employed in our laboratory:
      mean cell volume (MCV), hemoglobin (Hb), sideremia (Fe), ferrinemia and ZNPP in
      women of child-bearing age. The tests were prescribed for preventive tests prior
      to the administration of oral contraceptives and/or in pregnant women undergoing
      control tests. No tests were made to ascertain professional or environmental
      exposure to lead or its derivatives. Precision was evaluated by calculating the
      coefficient of variation (CV) for repeated tests. If a detailed analysis is made
      of the behaviour of some parameters during pregnancy it can be seen that there is
      a progressive diminution of sideremia and ferritin, accompanied by increased
      levels of ZNPP. The potentially most characteristic parameters are ferritin and
      ZNPP which do not have a Gaussian distribution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469365
TI  - [Circumference of the fetal stomach. Echographic study in 100 normal
      pregnancies].
AB  - Fetal stomach circumference were measured sonographically in 100 fetuses with
      gestational ages ranging from 16 to 40 weeks. Normograms of the mean +/- 2SD for
      circumference of the fetal stomach were generated throughout pregnancy. A high
      degree of correlation was observed between gestational age and stomach
      circumference (r = 0.963). These data provide a method by which variations from
      the norm can be assessed, and offer potential prenatal diagnosis of a variety of
      gastrointestinal lesions.

PMID- 8469366
TI  - [Continuous subcutaneous administration of terbutaline in the therapy of
      threatening premature labour].
AB  - The purpose of this study was to evaluate the tocolytic efficacy of terbutaline,
      administered subcutaneously in a low-dose continuous infusion, and intermittent
      high-dose boluses. The population study consisted of 13 women admitted with the
      diagnosis of Threatened Preterm Labour. Before starting chronic infusion by
      terbutaline, patients received 48 hour of therapy with intravenous MgSO4 for
      acute tocolysis. Therapy with microinfusor was continued until the 37th week of
      gestation or until labor. The mean gestational age at the beginning of therapy
      was 25.6 +/- 3.5 and pregnancies were prolonged an average of 65.5 +/- 29 days.
      In any case uterine activity was diminished by terbutaline therapy in all
      patients. Patient tolerance was excellent and there were no significant
      complications due to the therapy.

PMID- 8469367
TI  - [Decapeptyl 3.57mg in the therapy of the fibromatous uterus. Authors'
      contribution].
AB  - Thirty women in their reproductive age who were diagnosed for leiomyomata uteri
      were treated for 6 months with Triptorelin slow release, 3.75 mg, every 28 days,
      i.m. The results obtained were highly satisfactory and were confirmed by
      ultrasound scanning and clinical examination. The drug was extremely well
      tolerated by patients and the side-effects reported never required the
      interruption of treatment.

PMID- 8469368
TI  - [Intraepithelial cervical lesions: colpo-microcolposcopic diagnosis].
AB  - Integration of colposcopy and microcolposcopy allows to perform a complete study
      of eso- endo-cervix, for a diagnostic and topographic evaluation of cervical
      intraepithelial lesion. We have endoscopically studied 172 patients with
      histologically demonstrated CIN. In 218 cases (74.4%) the microcolposcopical
      evaluation corresponded to the histological diagnosis. These data confirm the
      methodological effectiveness of microcolposcopy and recommend it as helpful mean
      for cervical pathology investigation. However we believe that histological
      evaluation is necessary for a correct staging of the lesion. According to our
      experience indications for microcolposcopy are: 1) identification of endocervical
      lesion and squamo-columnar junction, when colposcopically not evident; 2)
      possibility of performing a "tailored" conization; 3) study of endocervix after
      conization.

PMID- 8469369
TI  - Growth factor modulation of surface ganglioside expression in cloned neoplastic
      glia.
AB  - Cloned neoplastic astrocytes from a human glioma-derived cell line (IPSB-18) were
      grown in fetal calf serum (FCS)-supplemented culture medium in the presence of
      three growth factors. Basic fibroblast growth factor (bFGF), epidermal growth
      factor (EGF) but not platelet-derived growth factor (PDGF) induced an increase in
      the number of cells positive for the ganglioside-recognizing monoclonal antibody,
      A2B5. No such growth factor-mediated induction could be detected in cells
      maintained in plasma-derived serum (PDS)-supplemented medium. Small molecules,
      removed from PDS during dialysis, may, therefore, act synergistically with growth
      factors in the control of ganglioside synthesis.

PMID- 8469370
TI  - Corticotropin-releasing factor suppresses the afterhyperpolarization in
      cerebellar Purkinje neurons.
AB  - Corticotropin-releasing factor (CRF) is present in climbing fibers and their
      terminations on Purkinje neurons. To determine whether CRF may have a
      postsynaptic action in this pathway, CRF effects on the electrophysiological
      properties of cultured cerebellar Purkinje neurons were studied. CRF produced a
      dose-dependent reduction of the amplitude of the afterhyperpolarization (AHP)
      which follows a current-induced spike train. The effect of CRF on the AHP was
      specific in that CRF did not significantly alter input resistance, membrane
      potential, amplitude of the depolarizing-off response produced at the termination
      of a hyperpolarizing current pulse, or the number of depolarization-induced
      simple spikes. Suppression of the AHP by CRF may be one mechanism by which CRF
      regulates the response of Purkinje neurons to other transmitters in the climbing
      fiber pathway or in other inputs to Purkinje neurons.

PMID- 8469372
TI  - Nicotinic acetylcholine receptor in dissociated rat nucleus tractus solitarii
      neurons.
AB  - The ACh-activated response of the acutely dissociated neuron from the rat nucleus
      tractus solitarii (NTS) was investigated using conventional and perforated-patch
      techniques. In the present preparation, ACh and nicotine evoked inward transient
      currents in approximately 30% of NTS neurons tested. The ACh-activated inward
      current reversed the direction near 0 mV and was inhibited by D-tubocurarine in a
      dose-dependent manner. In contrast, muscarine resulted in no detectable changes
      in the NTS neurons. Some populations of the NTS had nicotinic but no muscarinic
      acetylcholine receptors.

PMID- 8469371
TI  - Glycine sensor in the hepato-portal system and their reflex effects on pancreatic
      efferents in the rat.
AB  - We earlier reported the existence of vagal arginine, alanine, and leucine sensors
      in the liver which modulate amino acid-induced pancreatic hormone secretion. To
      determine the possible existence of glycine sensors in the liver and their reflex
      effects, afferent discharges from the hepatic branch and efferent discharges from
      the pancreatic branch of the vagus nerve were recorded. Intraportal
      administration of 0.1, 1, and 10 mM of L-glycine solution (0.1 ml) depressed the
      afferent discharge rate of the hepatic branch of the nerve in a dose-dependent
      manner, and increased the efferent discharge rate of the pancreatic vagal branch.
      The results suggest the existence of glycine sensors in the hepato-portal system
      that exert reflex regulation on the pancreatic vagus nerve activity.

PMID- 8469373
TI  - Neuropeptide Y stimulates DNA synthesis in vascular smooth muscle cells.
AB  - Neuropeptide Y (NPY) stimulated DNA synthesis in porcine aortic smooth muscle
      cells in a concentration-dependent manner. [Leu31, Pro34]NPY, a Y1-specific
      agonist, was several hundred times more potent than NPY(13-36), which
      preferentially bound to Y2 receptors, for stimulating DNA synthesis. On the other
      hand, human pancreatic polypeptide had no effect. The potency of NPY and related
      peptides for stimulating DNA synthesis paralleled their potency for increasing
      the cytosolic free Ca2+ concentration in the cells. Pertussis toxin treatment
      completely blocked both effects of the peptides. Thus, NPY may induce Ca2+
      mobilization and stimulation of DNA synthesis in vascular smooth muscle cells via
      Y1 receptors whose signal transduction system involves pertussis toxin-sensitive
      GTP-binding protein(s).

PMID- 8469374
TI  - Region specific expression of furin mRNA in the rat brain.
AB  - The distribution of furin mRNA was examined in the rat central nervous system.
      Northern blot analysis reveals the presence of a 4.4 kb band in all brain tissues
      examined. In situ hybridization analysis of frozen rat brain sections using a
      radioactively labeled antisense cRNA probe to rat furin demonstrated moderate to
      low levels of expression in both neuronal and non-neuronal tissue in all areas
      examined. Interestingly, higher levels of furin were expressed in selective
      regions which include the ventricles (the choroid plexus and ependymal cells),
      the islands of Calleja, the hippocampus and the pineal gland. the ubiquitous
      localization of furin in the brain is consistent with its postulated role as a
      vital convertase important in the processing of proproteins negotiating the
      constitutive pathway of secretion. However, the higher expression of furin mRNA
      in distinct brain areas suggests a more active role in the processing of
      proproteins synthesized in these tissues.

PMID- 8469375
TI  - Failure of 2'-deoxycoformycin to protect against transient forebrain ischemia in
      rat.
AB  - We determined whether 2'-deoxycoformycin (DCF), a potent highly specific
      inhibitor of adenosine deaminase (ADA), protected against transient forebrain
      ischemic neuronal injury in rat. Anesthetized male Sprague-Dawley rats received
      i.p. injections of either saline, 0.5 mg/kg or 5 mg/kg DCF 2 h before undergoing
      a 10-min forebrain ischemic insult induced by bilateral carotid artery occlusion
      with concomitant hypotension. Rat brain sections taken 7 days post-ischemia
      showed damage mostly in the CA1 region of the hippocampus. Quantification of
      neuronal injury showed no significant differences between saline- or DCF-treated
      rats. These results indicate that, contrary to previous reports, DCF does not
      protect against the neuronal damage that follows forebrain ischemia in rat.

PMID- 8469376
TI  - Basket-like interneurones in layer II of the entorhinal cortex exhibit a powerful
      NMDA-mediated synaptic excitation.
AB  - Spiny stellate neurones of layer II of the entorhinal cortex (EC) provide the
      perforant path input to the dentate gyrus. Previous studies have shown that
      synaptic responses of these neurones are dominated by GABAergic inhibition. The
      present study describes intracellular recordings from 'fast-spiking'
      interneurones in layer II which may be the basis of the synaptic inhibition.
      Lucifer yellow fills of fast-spiking cells revealed neurones with a widespread
      axonal arborization forming basket-like complexes around unlabelled cells in
      layer II. Synaptic activation of the fast-spiking cells evoked long duration
      excitations which were mediated largely by NMDA receptors. A fast AMPA/kainate
      EPSP was also detectable. These neurones have morphological and physiological
      properties which make them well-suited to exert a widespread inhibitory control
      over the efferent output of layer II to the dentate gyrus.

PMID- 8469377
TI  - Role of nitric oxide in the coupling of cerebral blood flow to neuronal
      activation in rats.
AB  - We tested the hypothesis that nitric oxide (NO) is a mediator in the coupling of
      cerebral blood flow to neuronal activation. The production of NO was blocked in
      anesthetized rats with the NO-synthase inhibitor N omega-nitro-L-arginine (L-NA).
      In controls, vibrissae stimulation for 60 s led to a fast (< or = 2 s), 17%
      increase in regional cerebral blood flow (rCBF) in the contralateral
      somatosensory cortex. Systemical (10 mg/kg) as well as topical (10(-3) M)
      application of L-NA reduced the response to stimulation by approximately 50%.
      Systemical application primarily attenuated the early component of the response,
      whereas topical application led to an attenuation throughout the whole 60-s
      stimulation interval. We conclude that NO is involved in rCBF coupling to
      neuronal activation.

PMID- 8469378
TI  - Nerve growth factor and its receptor are differentially modified by chronic
      naltrexone treatment during rat brain development.
AB  - In order to examine the relationship between the action of opioid
      neurotransmitters and growth factors in the regulation of brain development, we
      have studied the long-term effect of the opiate antagonist naltrexone (NTX) on
      the content of nerve growth factor (NGF) in cortex, hippocampus, septum and
      neostriatum, and on NGF receptor (NGFRs) levels in cortical membranes. 50 mg/kg
      NTX treatment induced a decrease in the number of 125I-NGF high-affinity binding
      sites, without detectable changes in NGF levels. However, low doses of NTX (1
      mg/kg) produced no differences in 125I-NGF binding sites, but induced a decrease
      in NGF levels in hippocampus, septum and neostriatum. These results suggest that
      NGF and NGFRs could be involved in the trophic effects of opioids during brain
      development.

PMID- 8469379
TI  - Inward potassium rectifier current in type I vestibular hair cells isolated from
      guinea pig.
AB  - Large inward current activated by hyperpolarization was studied using whole cell
      patch clamp technique in type I vestibular hair cells of guinea pig. Near the
      resting membrane potential, at an holding potential of -60 mV (HP -60), this
      current increased with hyperpolarizing steps and showed time-dependent decay for
      steps below -80 mV. This current was progressively inactivated at more negative
      holding potential and was totally abolished at HP -90 mV. The underlying
      conductance was a K+ conductance as indicated by: (i) its dependence on the
      external potassium concentration; (ii) its tail currents, which reversed at about
      -90 mV in solutions with a normal gradient for K+ ions. Pharmacological studies
      revealed that external application of 4-aminopyridine (5 mM) reversibly blocked
      (95%) the total inward current, while external application of tetraethylammonium
      (10 mM) or cesium (2 mM) did not significantly affect the amplitude of this
      current. This potassium inward rectifier current could contribute to restoration
      of the resting membrane potential during negative stimulations.

PMID- 8469380
TI  - Reduction in pineal N-acetyltransferase activity and pineal and serum melatonin
      levels in rats after their exposure to red light at night.
AB  - Pineal gland N-acetyltransferase (NAT) activity and pineal and serum levels of
      melatonin declined linearly in albino rats exposed to different irradiances (low,
      170 microW/cm2; moderate, 420 microW/cm2; high, 1040 microW/cm2) red light during
      the middle of the night. High intensity red light (1040 microW/cm2) was as
      effective as white light (670 microW/cm2) in suppressing pineal NAT activity and
      pineal and serum melatonin levels. The lowered melatonin levels and the reduction
      in NAT activity following exposure to red light suggest that red light cannot be
      regarded as 'safe' light when studying circadian melatonin production in the
      albino rat, at least at the intensities used in this experiment.

PMID- 8469381
TI  - Anatomy of the turtle cerebellorubral circuit studied in vitro using neurobiotin
      and biocytin.
AB  - We have combined the rapid anterograde and retrograde transport of neurobiotin
      and biocytin with the extended viability of the isolated turtle brainstem
      cerebellum to conduct in vitro studies of the chelonian cerebellorubral circuit.
      Tracers were pressure injected in 15-25 nl quantities and the optimal transport
      time was 16 h. Tissue sections were incubated with avidin-biotin-HRP complex and
      reacted with DAB. Retrogradely labeled soma, dendrites and axons, and
      anterogradely labeled axons and to a lesser extent terminals were visible with
      both tracers. Red nucleus injections resulted in dense retrograde label in the
      contralateral lateral cerebellar nucleus and a heavily labeled contralateral
      rubrospinal tract. Cerebellar nucleus injections revealed light retrograde and
      dense terminal label in the contralateral red nucleus, together with retrograde
      label in a cell cluster in the ipsilateral ventrolateral medullary reticular
      formation, an area we identify as the lateral reticular nucleus. Injections into
      this medullary region resulted in heavy mossy fiber input to the ipsilateral
      cerebellum and moderate retrograde label in the contralateral red nucleus. These
      results identify prominent recurrent projections between the lateral cerebellar
      nucleus, red nucleus and lateral reticular nucleus, in addition to revealing
      other features of the cerebellorubral circuit.

PMID- 8469382
TI  - Reduced membrane-associated protein kinase C(beta) immunoreactivity in the
      hippocampus of reserpinized rat brain.
AB  - Protein kinase C(beta) immunoreactivity was determined in the membrane and
      cytosol fractions of the hippocampus, frontal cortex and cerebellum after
      repetitive, intraperitoneal administration of reserpine. A marked decrease in the
      immunoreactivity was observed in the membrane of the hippocampus, while no
      significant change was found in any other subfractions of the frontal cortex or
      cerebellum. These findings suggest a novel mechanism regulating the distribution
      of protein kinase C. The topographical selectivity in the present study may
      indicate the importance of the alteration of protein kinase C in the
      pathophysiological mechanism in Alzheimer's disease.

PMID- 8469383
TI  - Increases in brain polyamine concentrations in chemical kindling and single
      convulsion induced by pentylenetetrazol in rats.
AB  - Concentrations of the polyamines, putrescine, spermidine and spermine were
      investigated in rat brains, in which chemical kindling or single convulsion had
      been induced by intraperitoneal injection of pentylenetetrazol (PTZ). A single
      injection of 60 mg/kg of PTZ produced tonic-clonic convulsion and increased the
      putrescine concentration 8 h after the injection. At lower doses of PTZ (10 and
      30 mg/kg), neither marked behavioral seizure nor significant change in any
      polyamine concentration was observed. On the other hand, repeated injections of
      30 mg/kg of PTZ eventually resulted in intense motor seizures (PTZ kindling) and
      increased the concentrations of all three polyamines. The most marked increase
      was detected in putrescine 1-48 h after the intense seizures. The increase in
      putrescine was clearly higher in PTZ kindling than in single convulsion. These
      results suggest that increases in polyamine concentrations are involved in
      neuronal excitability in the epileptic brain.

PMID- 8469384
TI  - Circulating immune complexes in sera from patients with Alzheimer's disease,
      multi-infarct dementia and Down's syndrome.
AB  - Recent data suggest that immunological mechanisms may be implicated in the
      pathogenesis of Alzheimer's disease (AD). We tested the presence of circulating
      immune complexes (CIC) in the sera from dementia and Down's syndrome (DS)
      patients and age-matched controls using two methods: Clq-binding Elisa (ClqB
      Elisa) and conglutinin-binding Elisa (KgB-Elisa). The probable AD and multi
      infarct dementia (MID) patients had more frequently CIC in their sera as compared
      to elderly non-demented subjects (Chi-square; P < 0.05). The highest frequency of
      positive findings was detected for 10 DS patients (8 KgB-Elisa and 7 ClqB-Elisa
      positive) whereas only 1 of 10 young controls showed ClqB-positivity. In the AD
      patients the cognitive decline as assessed by the Mini-Mental Status test
      correlated significantly with CIC values. The study supports the view that
      systemic autoimmune mechanisms may be involved, at least partly, in dementing
      processes.

PMID- 8469385
TI  - Tight junction complexity in the retinal pigment epithelium of the chicken during
      development.
AB  - In the avascular retina of birds, the pigment epithelium (RPE) is the main site
      of the blood-retina barrier. Tight junctions (TJs) connect the pigment epithelial
      cells and represent the structural substrate of the barrier function. We
      investigated, by means of the quantitative freeze-fracturing technique, the TJs
      of the chicken RPE during development and compared them with the TJs of choroid
      capillary endothelial cells which are known to be fenestrated. The association of
      TJs with the protoplasmic membrane leaflet (P-face) is more pronounced in the RPE
      than in the choroid vessels. Between embryonic day 15 (E15) and E19, we observed
      a significant increase in the TJ complexity in the RPE, but not in the choroid
      vessels. The increase coincides with the morphological and functional maturation
      of the chicken retina suggesting that complex P-face-associated TJs in the RPE
      are necessary for the formation of an effective blood-retina barrier.

PMID- 8469386
TI  - Three openings of the blood-brain barrier produced by forebrain ischemia in the
      rat.
AB  - A sensitive radiotracer method was used to explore the time course and regional
      pattern of blood-brain barrier (BBB) opening that occurs in a rat forebrain
      ischemia model that mimics temporary cardiac arrest. Immediately following 10 min
      of ischemia, transfer constants (Ki) for blood to brain permeation of [3H]sucrose
      were augmented severalfold, indicating widespread BBB opening. After 6 h, a
      delayed intensification of opening was evident in striatum and hippocampus,
      regions known to undergo selective, delayed neuronal death. There was generalized
      BBB recovery by 24 h except in experiments that involved prolonged ischemia (25
      min) or concomitant brain hyperthermia (41 degrees C, 10 min). These protocols
      evoked a third opening; a marked upward increment in Ki and % H2O developed in
      neocortex between 6 and 24 h post-ischemia. Pharmacological or other
      manipulations of these temporal and regional patterns of altered transfer
      constants may aid understanding of the interplay between microvascular damage,
      edema, and neuronal death following brain ischemia.

PMID- 8469387
TI  - Extension of optic nerve fibers on genetically modified cells producing brain
      derived neurotrophic factor.
AB  - Since brain-derived neurotrophic factor (BDNF) promotes the survival of retinal
      ganglion cells (RGCs), we transfected a rat BDNF cDNA into rat fibroblasts, and
      retinal fragments of rat embryos were cultured on cell monolayers of these cells.
      Retinal fragments showed enhanced neurite extension on BDNF-transfected cells
      compared with that on control cells. The degree of the neurite extension,
      however, decreased depending upon the embryonic stages. These results suggest
      that fibroblasts genetically modified to produce BDNF might be a promoter of
      neurite extension by RGCs, but this does not apply to the RGCs of late embryonic
      stages.

PMID- 8469388
TI  - Does frontal-plane asymmetry in compensatory postural responses represent
      preparation for stepping?
AB  - The bilateral symmetry of feet-in-place responses to postural perturbations in
      the anterior-posterior direction has not been well studied. This paper presents
      evidence that right- and left-leg responses that appear to be approximately
      symmetrical in the sagittal plane may actually involve an asymmetry in the
      frontal plane, namely, a lateral weight shift. Comparison with trials where
      subjects stepped suggests that these lateral weight shifts represent early
      preparations for stepping responses that are aborted before the foot is actually
      lifted. Thus, it would seem that compensatory stepping involves a sequence of
      discrete modifiable stages, rather than a single immutable motor program.
      Moreover, postural responses that appear to be similar in the sagittal plane may
      actually be seen to involve quite different postural strategies, i.e. in terms of
      preparation for stepping, when viewed in the frontal plane.

PMID- 8469389
TI  - Regional differences in the ontogeny of 5-hydroxytryptamine-1C binding sites in
      rat brain and spinal cord.
AB  - Developmental profiles of [3H]mesulergine-labelled central 5-HT1c binding sites
      differed regionally in the rat during the first 5 weeks postnatal. At birth,
      cortical 5-HT1c sites were 24-32% of adult levels and increased significantly by
      14-21 days. In brainstem, the majority of 5-HT1c sites were already present at
      birth and increased further by 10 days, which was earlier than in other regions.
      A pattern of increasing binding site density was also found in hippocampus,
      diencephalon, and spinal cord. Cerebellar 5-HT1c sites remained at low levels
      throughout. A mature pattern of regional differences was apparent by 21-28 days
      with a new rank order: cortex, diencephalon > spinal cord, brainstem, hippocampus
      > cerebellum. These trends were seen whether Bmax was expressed according to
      brain weight or protein concentration. The regional contrast in the ontogeny of 5
      HT1c binding sites may be relevant to the proposed role of 5-HT as a growth
      factor in brain development.

PMID- 8469390
TI  - L-arginine and nicotinamide adenine dinucleotide phosphate alter dark voltage and
      accelerate light response recovery in isolated retinal rods of the frog (Rana
      temporaria).
AB  - Effects of intracellularly applied L-arginine and nicotinamide adenine
      dinucleotide phosphate (NADPH) on the dark voltage and light responses of retinal
      rods were studied by means of the whole-cell patch-clamp technique. In this mode
      an exchange of substances by diffusion between cytosol and pipette medium occurs
      (Pflugers Arch., 411 (1988) 204-211). In retinal rods a loss of nucleotides is
      reflected by a hyperpolarization of the dark voltage and by a prolongation of the
      light responses (Vis. Neurosci., 2 (1989) 101-108). Intracellular application of
      L-arginine prevented the prolongation of the light responses and NADPH
      accelerated the light response recovery and in addition depolarized the
      photoreceptor cells. The effects were similar to those observed before upon
      application of the nitric oxide (NO)-releasing substance sodium nitroprusside
      (Vis. Neurosci., 9 (1992) 205-209). It is therefore assumed that the observed
      effects are linked to the NO-synthase and to an activation of a guanylate cyclase
      by NO. It is concluded that the level of NADPH in photoreceptor cells may affect
      the metabolic flux of guanosine 3',5'-cyclic monophosphate (cGMP).

PMID- 8469391
TI  - Mechanisms underlying post-inspiratory depolarization in post-inspiratory neurons
      of the cat.
AB  - The mechanism of the post-inspiratory depolarization in bulbar post-inspiratory
      neurons was investigated in decerebrate cats with a coaxial multibarrelled
      microelectrode technique. Iontophoresed tetrodotoxin eliminated a dominant part
      of the post-inspiratory depolarization and left a small depolarization to occur.
      This residual potential was increased with depolarization. When depolarization
      exceeded a potential of average -63 mV, there appeared a large bell-shaped
      depolarization that was suppressed by iontophoresed cadmium. These results
      suggest that the post-inspiratory depolarization in this neuron is formed by the
      cooperation between excitatory synaptic potentials and voltage-dependent Ca2+
      currents.

PMID- 8469392
TI  - Ultrastructural changes in the presynaptic region of outer hair cells after
      acoustic stimulation.
AB  - Protection against noise trauma results by sound-conditioning animals to a low
      level, long-term acoustic stimulus prior to a damaging exposure. It is known that
      the outer hair cells are selectively protected by sound-conditioning. The aim of
      the present study was to determine if the intrinsic properties of the outer hair
      cell had been modified by sound-conditioning. A stimulus-related increase in the
      vesicle content in the presynaptic region was found. It is suggested that the
      outer hair cells are involved in sound conditioning and that changes in the
      presynaptic region can be one correlate to the protection against noise trauma by
      sound-conditioning.

PMID- 8469393
TI  - Altered distribution of synaptic densities at aberrant synapses in the chick
      cochlear nucleus.
AB  - The role of axon-target cell interactions in shaping the prevalence and
      distribution of synaptic densities was studied in an experimentally-induced
      aberrant functional projection from the chick cochlear nucleus (nuc.
      magnocellularis, NM) to the contralateral NM. Contact with an abnormal target
      appears to induce in the aberrant axons a pattern of presynaptic densities
      resembling that in normal cochlear nerve endings in NM. NM axon terminals induced
      similar numbers of postsynaptic densities (PSDs) per unit length of membrane
      apposition in both their normal and abnormal targets but the longer membrane
      apposition in the highly invaginated aberrant terminal in NM results in a
      significantly greater amount of postsynaptic density per ending. These auditory
      neurons thus appear able to adjust a variety of features to permit assembly and
      maintenance of a novel functional synapse.

PMID- 8469394
TI  - Muscarinic receptor-mediated induction of Fos protein in rat brain.
AB  - Recent studies have shown that the centrally active muscarinic agonist
      pilocarpine induces c-fos mRNA in rat cortex. Here we describe the localization
      of muscarinic receptor-induced FOS protein, within the rat central nervous system
      (CNS), following administration of pilocarpine (25 mg/kg). High levels of FOS
      induction were apparent in many forebrain structures including the primary
      olfactory (piriform) cortex, nucleus accumbens, amygdala, hippocampus, neocortex
      and supra-optic nucleus of the hypothalamus. Within the neocortex FOS induction
      followed a laminar distribution being highest in layers 4 and 6 with lower
      induction seen in layers 2 and 5. Other areas showing FOS induction included the
      striatum, septum, inferior colliculus, thalamus, hypothalamus and several
      brainstem nuclei. Both atropine (10 mg/kg) and pirenzepine (100 mg/kg) reduced
      FOS induction suggesting that a pirenzepine-sensitive muscarinic receptor was
      involved. The possible significance of muscarinic-mediated FOS induction, to
      cholinergic kindling and the cholinergic hypothesis of learning and memory, is
      discussed.

PMID- 8469395
TI  - Amphetamine-induced release of diadenosine polyphosphates--Ap4A and Ap5A--from
      caudate putamen of conscious rat.
AB  - The release of diadenosine polyphosphates--diadenosine tetraphosphate (Ap4A) and
      diadenosine pentaphosphate (Ap5A)--was measured by intracerebral push-pull
      perfusion in conscious rats after systemic amphetamine injection. Samples were
      collected from the caudate putamen, and nucleotide compounds were analyzed by
      HPLC. The presence of Ap4A and Ap5A was demonstrated by their retention times and
      phosphodiesterase digestion. Dinucleotides were not detectable before amphetamine
      injection (5 mg/kg). The maximal levels were reached 20 min after the injection
      with values of 12.9 +/- 0.9 and 11.5 +/- 0.9 pmol/fraction for Ap4A and Ap5A,
      respectively. A slow and progressive decrease in their concentration followed.
      This study shows for the first time the amphetamine-induced release of
      diadenosine polyphosphates in conscious rats, and a role for Ap4A and Ap5A in the
      central nervous system is therefore suggested.

PMID- 8469396
TI  - Palmitate transport through the blood-retina and blood-brain barrier of rat
      visual system during aging.
AB  - The permeability-surface area product (PA) of [1-14C]palmitate at the blood
      retina (BRB) and blood-brain barrier (BBB) was determined after short carotid
      perfusion in male Sprague-Dawley rats at 4, 14 and 28 months of age. For the
      retina, optic nerve and tract, lateral geniculate body, visual and parietal
      cortex, there was no significant difference among mean PAs in any age group. For
      superior colliculus, frontal cortex, striatum, hippocampus and olfactory bulb, a
      slight but significant increase of PA values was observed between young (4-month
      old) and senescent (28-month-old) rats. Our results indicate that aging does not
      affect influx into retina and other structures of rat visual system of the
      palmitate, a metabolic substrate for which carrier-mediated transport across the
      BRB and BBB has not been demonstrated.

PMID- 8469397
TI  - Activation of high-threshold motor units in man by transcranial magnetic
      stimulation.
AB  - Motor units (MUs) with low voluntary recruitment thresholds are the first to be
      activated by transcranial magnetic stimulation. It is not clear, however, if high
      threshold MUs can also be activated and if they contribute to motor evoked
      potentials (MEPs). We therefore studied 11 high-threshold motor units in the
      first dorsal interosseous muscle of 11 healthy subjects. Voluntary recruitment
      thresholds ranged from 22 to 41% (29.5 +/- 5.6%; mean +/- S.D.) of maximal muscle
      force. When MUs were driven at their recruitment thresholds, transcranial
      magnetic stimuli were applied to the vertex. Peri-stimulus time histograms of MU
      discharges were constructed. All MUs studied revealed a period of increased
      firing probability at 19-27 ms after the stimulus (primary peak). Stimulus
      intensities were lower by 10-57% of the maximal stimulator output than required
      to produce near maximal MEPs in conventional surface EMG recordings in the same
      subjects. We conclude that high-threshold MUs can be activated by transcranial
      magnetic stimulation and that they contribute to conventionally recorded MEPs.

PMID- 8469398
TI  - Both splicing variants of the dopamine D2 receptor mRNA are up-regulated by
      antipsychotic drugs.
AB  - We have investigated the effects of antipsychotic drugs on the expression of the
      two dopamine D2 receptor splicing variants using multiprobe oligonucleotide
      solution hybridisation. Both long and short mRNA variants were increased in
      abundance by approximately 2-fold by both haloperidol and loxapine after 32 days
      drug administration.

PMID- 8469399
TI  - A novel silent variant at codon 711 and a variant at codon 708 of the APP
      sequence detected in Spanish Alzheimer and control cases.
AB  - Pathogenic mutations have been identified in exons 16 and 17 of the beta-amyloid
      precursor protein (APP) gene in some cases of early onset Alzheimer's disease.
      Screening of these exons in a number of familial and sporadic cases of
      Alzheimer's disease in Spain, resulted in the identification of a novel silent
      variant at codon 711 whose relevance to the AD pathogenesis remains unclear. The
      708 variant was also detected in one of normal controls.

PMID- 8469400
TI  - Coupling of muscarinic receptors to GTP proteins in postmortem human brain-
      alterations in Alzheimer's disease.
AB  - The coupling of muscarinic agonist receptors to guanine nucleotide-binding (G)
      proteins was investigated in the frontal, temporal cortices and thalamus of
      control and Alzheimer brains by using carbachol in competition experiments with
      [3H]QNB. In the presence of GppNHp, the carbachol/[3H]QNB competition binding
      data showed a 6-fold increase in the high-affinity muscarinic agonist coefficient
      (Ki high) in the thalami of control brains and a significantly increased
      proportion of low-affinity agonist binding sites (Bmax low) in the temporal
      cortices of control brains, while no significant effect of GppNHp was observed in
      Alzheimer brains. The results suggest a disturbance of the muscarinic receptor-G
      protein coupling in Alzheimer's disease.

PMID- 8469401
TI  - Evidence that removal of capsaicin accelerates desensitization on the tongue.
AB  - It has previously been shown that repeated presentations of a moderate
      concentration of capsaicin could either sensitize or desensitize the tongue,
      depending upon the temporal pattern of stimulation. Only when stimulation was
      halted for 5 min or longer did sensitization begin to give way to
      desensitization. The apparent necessity of a hiatus in stimulation led to the
      hypothesis that desensitization involved an inability to re-excite quiescent
      fibers rather than a progressive suppression of stimulated fibers. This
      hypothesis was tested in the present study by measuring the perceptual response
      to a non-desensitizing irritant, zingerone, when it was presented at the rate of
      l/min following a series of capsaicin conditioning stimuli. After an initial,
      brief period of cross-hyper-sensitization, cross-desensitization developed at a
      rate equivalent to that observed when no stimulus was presented. Thus, the
      results disproved the hypothesis that desensitization cannot occur if capsaicin
      sensitive fibers continue to be stimulated, and suggested that after an initial
      period of excitation, the removal of capsaicin accelerates the desensitization
      process. This seeming paradox is discussed in terms of the neural mechanisms that
      may underlie capsaicin desensitization.

PMID- 8469402
TI  - MPTP neurotoxicity to cerebellar Purkinje cells in mice.
AB  - The pyridine derivative 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is
      recognized as a crucial neurotoxin which destroys nigrostriatal dopamine cells,
      thereby inducing neurological signs relevant to idiopathic Parkinson's disease.
      In the present study, we have revealed MPTP neurotoxicity to cerebellar Purkinje
      cells in mice. Systemic MPTP injections to mice resulted in a substantial loss of
      Purkinje cells in a dose-dependent fashion. The MPTP-induced Purkinje cell loss
      occurred markedly in the crus I and II ansiform lobules and the paraflocculus.
      Such a neurotoxic effect was largely prevented by the monoamine oxidase B
      inhibitors pargyline and deprenyl, and the dopamine uptake inhibitors mazindol
      and benztropine.

PMID- 8469403
TI  - Detection of dynamic changes in cerebral oxygenation coupled to neuronal function
      during mental work in man.
AB  - Changes in the oxygenation state of brain hemoglobin during mental work were
      monitored in real time (time resolution: 1 s) using near-infrared
      spectrophotometry in 14 healthy volunteers. In a younger group (age range 22-30
      years, n = 12), the subjects finding difficulty in solving a problem were
      accompanied by significant increases in both oxygenated hemoglobin and total
      hemoglobin, while the subjects making a correct answer without difficulty showed
      no significant changes in hemoglobin oxygenation. When compared with those
      younger subjects, observations on the older subject demonstrated a decrease in
      oxygenated hemoglobin and a reciprocal increase in deoxygenated hemoglobin,
      unaccompanied by changes in total hemoglobin.

PMID- 8469404
TI  - MK-801 increases endogenous acetylcholine release in the rat parietal cortex: a
      study using brain microdialysis.
AB  - Glutaminergic and cholinergic neuronal interactions were investigated by using
      the brain microdialysis method in freely-moving rats. Acute administration of (+)
      10,11-dihydro-5-methyl-5H-dibenzo[a,d]cyclohepten-5, 10-imine hydrogen maleate
      (MK-801) increased dose-dependently the extracellular acetylcholine (ACh) level
      in the rat parietal cortex. Significant increases in the extracellular ACh level
      were observed at doses of 0.4 and 0.5 mg/kg of MK-801, compared with the saline
      treated group. The increase of extracellular ACh level was eliminated by infusion
      of 10(-2) M N-methyl-D-aspartate (NMDA). These results suggest that the
      glutaminergic neuronal system regulates functions of the cholinergic neuronal
      system.

PMID- 8469405
TI  - Early postnatal undernutrition impairs protein kinase C-dependent phosphorylation
      in rat brain synaptosomes.
AB  - Undernutrition in rat pups was established by restricting feeding time daily.
      Protein kinase C-dependent phosphorylation in vitro was studied by incubating the
      mitochondrial-synaptosomal membrane fractions from adult, 18-day-old control and
      undernourished rats with gamma-[32P]ATP in presence of Ca2+ and
      phosphatidylserine. In adult and 18-day-old control rats, an increased
      phosphorylation of three major proteins (49, 53, 84 kDa) were detected in
      presence of calcium and phosphatidylserine. However, in 18-day-old undernourished
      rats, calcium/phosphatidylserine activated phosphorylation was found to be
      significantly impaired with only a slightly increased labelling detected in the
      49 kDa protein.

PMID- 8469406
TI  - Effects of hepatic vagotomy on suppression of water intake induced by hepatic
      portal infusion of water in water-deprived rats.
AB  - We investigated the effects of hepatic vagotomy on the suppression of water
      intake induced by hepatic portal infusion of water by 24-h water-deprived rats.
      In sham-operated rats, water intake of the portal infusion group was
      significantly less than that of the jugular infusion group during and after the
      infusion of deionized water for 3.5 h at a rate of 52 microliters/min. This
      result reconfirmed our previous findings. On the other hand, in hepatic
      vagotomized rats, the suppression during the portal infusion of water was not
      observed, but the suppression after portal infusion was observed. It is concluded
      that the suppression, at least during the portal infusion of water, was mediated
      by hepatoportal osmo-receptive (or sodium-receptive) afferent signals contained
      in the hepatic branch of the vagus nerve.

PMID- 8469407
TI  - Injections of fluid or septal cell suspension grafts into the dentate gyrus of
      rats induce granule cell degeneration.
AB  - This study was originally aimed at investigating the effects of intragyral cell
      suspension grafts which had been enriched in basic fibroblast growth factor
      (bFGF) before being implanted into the rat hippocampus denervated by aspiration
      of the septohippocampal pathways. Whether treated with vehicle alone, vehicle +
      bFGF, cell suspension with or without bFGF, and irrespective of the surgical
      treatment (sham-operation, lesions or lesions + grafts), we unexpectedly found
      approximately 80% of the rats to show morphological alterations in the dentate
      gyrus (20 weeks post-grafting). These alterations consisted of loss of a part of
      the granule cells; this loss was most often located in the dorsal leaf of the
      dentate gyrus. Also, in the close vicinity of the degeneration area, we found
      severe shrinkage of the molecular layer and disappearance of the typical laminae
      pattern of acetylcholinesterase distribution. These observations confirm previous
      findings which showed that fluid injections into the dentate gyrus, a widely used
      technique for intracerebral administration of drugs, trophic factors or neural
      grafts, may induce undesirable granule cell necrosis.

PMID- 8469408
TI  - The time course and location of cerebral evoked activity associated with the
      processing of colour stimuli in man.
AB  - Area V4 has been located in man in the region of the fusiform gyrus on the
      inferior surface of the occipital lobe. Using multiple dipole source analysis on
      multichannel EEG recordings of visual evoked potentials to coloured 'Mondrian'
      stimuli in man, we have confirmed that activity is consistently seen in this area
      regardless of the retinal area stimulated and have obtained new information
      concerning its time course. Three different localized centres of activity follow
      the visual stimulus, with peak latencies of 90, 110 and 160 ms, and arising
      respectively in the region of visual areas V1, V2/V3 and V4. The time course and
      character of the V4 dipole activity to a colourless black-and-white Mondrian is
      indistinguishable from that to the coloured Mondrian, supporting the evidence
      that the cells of V4 are not exclusively concerned with colour processing.

PMID- 8469409
TI  - Electrical stimulation of the ventroposterolateral thalamic nucleus (VPL) reduces
      mechanical allodynia in a rat model of neuropathic pain.
AB  - The effect of electrical stimulation of the ventroposterolateral (VPL) thalamic
      nucleus on mechanical allodynia in the unrestrained awake rat was investigated.
      In 7 rats, a monopolar stimulation and recording electrode was implanted in the
      VPL thalamic representation area of the hindpaw. Exact target localisation was
      performed by means of thalamic evoked potentials induced by stimulating the
      contralateral tibial nerve. A peripheral mononeuropathy was induced by partly
      ligating the right sciatic nerve. Sensitivity of the hindpaws to mechanical
      stimulation was assessed with a set of von Frey hairs. One to 4 weeks after nerve
      ligation, all rats showed allodynia to mechanical stimulation and signs of
      spontaneous pain. Electrical stimulation of the contralateral VPL thalamic
      nucleus abolished the mechanical allodynia observed at the nerve ligated side.
      The effect of VPL stimulation outlasted the stimulation period by 15 min. No
      effect on the withdrawal thresholds at the control (sham operated) side was
      observed. These animals data support the clinical reports that stimulation of the
      sensory thalamus may alleviate pain of neuropathic origin.

PMID- 8469410
TI  - Effects of propentofylline, a NGF synthesis stimulator, on alterations in
      muscarinic cholinergic receptors induced by basal forebrain lesion in rats.
AB  - Basal forebrain (BF) lesions induced by ibotenic acid produced increases in the
      Bmax and Kd values of [3H]QNB binding sites in the frontal cortex, parietal
      cortex, and hippocampus. Twenty-eight-day successive administration of
      propentofylline (10 and 25 mg/kg, p.o.) significantly reduced the Kd values of
      [3H]QNB binding sites, to the levels of those in a sham group, in a dose
      dependent manner. Moreover, propentofylline (25 mg/kg, p.o.) significantly
      reduced the Bmax value of [3H]QNB binding sites compared with that in a vehicle
      treated BF-lesioned group. These results suggest that successive administration
      of propentofylline ameliorates changes in muscarinic cholinergic receptors
      through improving presynaptic cholinergic dysfunction.

PMID- 8469412
TI  - Dimethylsulfoxide (DMSO) blocks conduction in peripheral nerve C fibers: a
      possible mechanism of analgesia.
AB  - Dimethylsulfoxide (DMSO) is readily absorbed through skin, and relieves
      musculoskeletal pain when applied topically to painful areas. We studied the
      effects of DMSO on C-type nerve fibers, which mediate pain sensation. DMSO was
      applied directly to exposed cat sural nerves. C fiber conduction velocity was
      slowed by DMSO, even in low concentrations (5-7% v/v). Higher concentrations
      completely blocked C fiber conduction, with a minimum blocking concentration of
      9%. Onset of nerve block was almost immediate with 15% DMSO or higher
      concentrations. C fiber blockade may account for analgesia with DMSO.

PMID- 8469411
TI  - Distribution of calcitonin gene-related peptide immunoreactive nerve fibers in
      the human submandibular gland.
AB  - The indirect immunofluorescence technique was used to study the distribution of
      calcitonin gene-related peptide (CGRP) in human submandibular gland. A relatively
      low number of thin varicose fibers with intense immunofluorescence for CGRP was
      seen in samples from seven glands. These CGRP-immunoreactive (CGRP-IR) nerve
      fibers were mainly seen around or in close contact with intra- and interlobular
      blood vessels. Some CGRP-IR nerve fibers were also found in association with
      intra- and interlobular salivary ducts and a few around the submandibular acini.
      By visual estimation there was no difference in the density of CGRP-IR nerve
      fibers between specimens of recurrent duct obstruction and laryngeal carcinoma.
      The present results show that the distribution of CGRP-IR nerve fibers in the
      stroma and in the glandular secretory elements of the human submandibular gland
      is quite similar to that seen in the rat and the ferret, which have been reported
      earlier. Furthermore, the regional distribution of CGRP-IR fibers in the human
      submandibular gland suggests that CGRP has a physiological role in the regulation
      of salivary gland function in human salivary glands, e.g. blood flow and
      secretion.

PMID- 8469413
TI  - Cellular localization of angiotensin type 1 receptor and angiotensinogen mRNAs in
      the subfornical organ of the rat brain.
AB  - The cellular localization of angiotensin type 1 receptor (AT 1) and
      angiotensinogen mRNA expression in the subfornical organ (SFO) of the rat brain
      has been studied by means of non-radioactive in situ hybridization combined with
      immunocytochemistry for glial fibrillary acidic protein (GFAP) and Neutral red
      staining. The AT 1 receptor mRNA expression is shown to be within putative nerve
      cells without any association with the glial fibrillary acidic protein (GFAP)
      immunoreactive (IR) cells. In contrast the angiotensinogen cRNA expression is
      associated predominantly with GFAP-IR cells. The results demonstrate that a
      neuronal AT 1 receptor mediates the actions of circulating angiotensin II on the
      SFO and that the angiotensinogen mRNA is predominantly expressed in the SFO
      astroglial cells.

PMID- 8469414
TI  - Diagnostic significance of skin immunolabelling with antibody against native
      cerebral amyloid in Alzheimer's disease.
AB  - Skin taken from patients with Alzheimer's disease (AD) and control patient groups
      were immunolabelled using antisera against either purified native cerebral beta
      protein or synthetic beta peptide. Native amyloid antiserum frequently labelled
      vascular walls in AD skin but rarely in control skin. Semi-quantitative analysis
      of the positive vessels showed a significant difference between the two groups.
      Sweat glands and dermal nerves were labelled in both groups. However, synthetic
      beta peptide antiserum showed no significant difference. Vascular wall labelling
      in skin with native amyloid antiserum is useful in the differential diagnosis of
      AD.

PMID- 8469415
TI  - Increased regional cerebral blood flow in inferior occipital cortex and
      cerebellum of early blind humans.
AB  - Cerebral flow indices were measured in 7 early blind and 13 sighted persons
      twice, during a task of passive and of active touch. In the blind, inferior
      occipital and cerebellar indices were higher. But they were not significantly
      modified by the kind of tactile task.

PMID- 8469416
TI  - Spinal cord localization of the motoneurons innervating the sacrococcygeus dorsi
      lateralis muscle and their noradrenergic nerve terminals in rats.
AB  - We examined in the present study the spinal cord localization of motoneurons
      innervating the caudal portion of the sacrococcygeus dorsi lateralis (SCDL)
      muscle and their noradrenergic nerve terminals in Sprague-Dawley rats, using
      horseradish peroxidase (HRP) and dopamine-beta-hydroxylase (DBH) double-labeling
      techniques. Retrogradely HRP-labeled motoneurons innervating the caudal part of
      the SCDL muscle were located ipsilaterally in the ventromedial aspect of the
      ventral horn (lamina IX) in spinal segments of S2-S4. These cells were polygonal
      in shape, with an average soma diameter of 37.0 +/- 1.1 microns (mean +/- S.E.M.,
      n = 95) and amounted to 33.6 +/- 5.7 (n = 7) in the horizontal plane. Of note was
      the presence of abundant DBH-positive nerve terminals arborizing on the soma and
      dendrites of HRP-labeled motoneurons. These results provided anatomical evidence
      to further support our previous findings that the coerulospinal noradrenergic
      neurotransmission is involved in the mediation of fentanyl-induced muscular
      rigidity.

PMID- 8469417
TI  - The tonotopic representation in the auditory cortex of the guinea pig with
      optical recording.
AB  - We examined spatio-temporal characteristics of the tonotopic representation in
      the auditory cortex of the anesthetized guinea pig with a multichannel optical
      method using voltage-sensitive dye. The response latencies increased, and the
      response field in the cortex became small when the stimulus intensity levels were
      decreased. Low frequencies were represented rostrally and high frequencies
      caudally. The two fields responding to different frequencies at higher intensity
      levels gradually overlapped as time after stimulus onset increased, though these
      response field did not overlap at the beginning of the response. These findings
      indicate that tonotopic representation varies dynamically with time after
      stimulus onset.

PMID- 8469418
TI  - Ontogeny is different for explicit and implicit memory in humans.
AB  - This study was aimed to clarify in how far ontogenetic development is different
      for declarative/explicit compared to procedural/implicit learning. These two
      memory subsystems are differentially affected in a number of pathological
      conditions. Sixty-one children between the age of 5 and 10 years were tested on a
      verbal story recall and non-verbal pictorial recall task, representing explicit
      memory. To test for implicit memory, a motor mirror tracking task and a non-motor
      tower-of-hanoi puzzle were used. Both explicit memory tasks showed a clear
      developmental profile with an increase in the number of recalled items for
      immediate, late and delayed recall with adult values not reached before the age
      of 9-10 years. In contrast, there were no age differences for both implicit
      memory tasks. The study demonstrates that explicit and implicit memory follow
      different maturational trends and further corroborate the notion of two different
      memory systems.

PMID- 8469419
TI  - Adenosine A1 receptors in human hippocampus: inhibition of [3H]8-cyclopentyl-1,3
      dipropylxanthine binding by antagonist drugs.
AB  - Adenosine A1 receptors were visualized in human hippocampus using [3H]8
      cyclopentyl-1,3-dipropylxanthine (DPCPX) as a radioactive ligand probe. The
      receptor antagonists caffeine, the xanthine derivative KFM 19 and the
      carbamazepine analogue oxcarbazepine displaced [3H]DPCPX binding homogeneously
      without any marked difference between the individual layers in the investigated
      hippocampal subregions (n = 4). Ki's in the individual layers were in a range
      between 8.5 +/- 6.5 microM and 18.9 +/- 16.0 microM for caffeine and 11.5 +/- 2.8
      nM and 18.1 +/- 14.1 nM for KFM 19. Ki's could not be calculated for
      oxcarbazepine as the IC50's were greater than 100 microM with estimated IC25's
      varying between 51.2 +/- 53.3 microM and 179.9 +/- 89.9 microM. Antagonism of
      endogenous adenosine at A1 receptors may thus explain part of the clinical
      effects of caffeine in humans and possibly exclusively the behavioral effects of
      KFM 19 in non-human primates.

PMID- 8469420
TI  - Influence of interleukin-1 and tumor necrosis factor alpha on the growth of
      microglial cells in primary cultures of mouse cerebral cortex: involvement of
      colony-stimulating factor 1.
AB  - The influence of monokines and CNS-derived colony-stimulating factors (CSF) on
      the growth of microglia has been studied in mixed glial primary cultures stemming
      from mouse embryos. We observed that spontaneous growth of microglial cells in
      the presence of astrocytes is blocked by adding anti-colony-stimulating factor 1
      (CSF-1) antibodies to the cultures. Both interleukin-1 (IL-1) and tumor necrosis
      factor-alpha(TNF alpha) strongly increased the number of microglial cells in
      mixed glial cultures and this effect was prevented by anti-CSF-1 antibodies. In
      contrast, anti-interleukin-3 (IL-3) or anti-granulocyte-macrophage colony
      stimulating factor (GM-CSF) antibodies did not significantly affect the in vitro
      growth of microglia. These results provide functional significance to astrocytic
      productions of CSF-1 and their modulations by IL-1 or TNF alpha.

PMID- 8469421
TI  - Heart beat fluctuation during fictive locomotion in decerebrate cats: locomotor
      cardiac coupling of central origin.
AB  - Fictive locomotion was evoked by stimulation of the mesencephalic locomotor
      region (MLR) in immobilized, vagotomized and decerebrate cats. The coherence
      between heart beat fluctuation and efferent discharges of the hindlimb nerve was
      used to evaluate the strength of the coupling between the cardiac and locomotor
      rhythms during MLR-elicited fictive locomotion. This study demonstrated that
      there was a locomotor-cardiac coupling of central origin.

PMID- 8469422
TI  - Possible mutual excitatory couplings between inspiratory neurons in caudal
      ventrolateral medulla of brainstem-spinal cord preparation isolated from newborn
      rat.
AB  - In in vitro brainstem-spinal cord preparations, projection of inspiratory neurons
      in the caudal ventrolateral medulla (CVL) was examined electrophysiologically,
      and connectivity between bilateral inspiratory neurons in the CVL was analyzed by
      pulse-cross correlation (PCC) analysis. CVL inspiratory neurons were found to
      project to the contralateral CVL and/or mainly ipsilateral spinal cord. PCC
      analysis revealed significant peaks with different latency on both sides of time
      zero in 3 of 8 pairs. Results were consistent with mono- or oligo-synaptic
      excitatory connections between bilateral inspiratory neurons in the CVL.

PMID- 8469423
TI  - Localization of mRNA encoding the indolamine synthesizing enzyme, hydroxyindole-O
      methyltransferase, in chicken pineal gland and retina by in situ hybridization.
AB  - Hydroxyindole-O-methyltransferase (HIOMT) is the enzyme that catalyzes the final
      step in the synthesis of the hormone melatonin. We have examined the localization
      of expression of the mRNA encoding HIOMT by in situ hybridization in the 3-day
      old and adult chicken retina and pineal gland. The riboprobe utilized for this
      study was transcribed from the complete coding region of HIOMT cDNA synthesized
      from retina RNA and amplified by polymerase chain reaction (PCR). High levels of
      HIOMT mRNA were present in the pinealocytes of the pineal gland. In the retina,
      the hybridization signal was localized to the photoreceptors. The retinal
      photoreceptors of the 3-day-old chick displayed a much lower level of
      hybridization than did the photoreceptors of the adult chicken. This study
      strongly suggests that the photoreceptors are the sites of melatonin synthesis in
      the retina.

PMID- 8469424
TI  - The neuronal nuclear antigen recognized by the human anti-Ri autoantibody is
      expressed in central but not peripheral nervous system neurons.
AB  - Anti-Ri is a human autoantibody that recognizes a neuronal nuclear antigen (Ri).
      Biotinylated IgG from serum of two patients with high titers of anti-Ri
      antibodies was used to study the distribution of the Ri antigen in a panel of
      normal human tissues. the expression of the Ri antigen was evaluated by an avidin
      biotin peroxidase technique and confirmed by immunoblotting. The Ri antigen was
      restricted to the neurons of the central nervous system (CNS) and some pituitary
      cells. Most neurons in dorsal root, Gasserian and sympathetic ganglia, and
      myenteric plexus were negative or, a few of them, very weakly positive. The
      functional implication of the different expression of the Ri antigen between
      neurons of the central and peripheral nervous system is presently unknown.

PMID- 8469425
TI  - The ability of humans to localise noxious stimuli.
AB  - We have investigated the ability of humans to localise noxious stimuli on the
      dorsum of the hand. Pin-prick (non-penetrating needle prick), noxious heat (round
      1 cm2 copper probe heated to 50 degrees C), mustard oil (100% applied topically
      in a small cotton ball, diameter 5 mm) and histamine (iontophoresis of 20 mC
      delivered to an area of 75 mm2) were applied to skin with intact innervation and
      during a differential nerve compression block of the superficial radial nerve
      when only C-fibres were conducting. The mean mislocalisation (+/- S.E.M.; n = 8)
      of all stimuli was 9.5 +/- 0.8 mm with normal nerve conduction and 8.9 +/- 1.2
      during the differential nerve block. There was no significant difference between
      the noxious submodalities. By contrast, when nerve conduction was intact, purely
      tactile stimulation (7 mN von Frey hair) was significantly better localised
      having a mean error of 5.5 +/- 0.4 mm. We conclude that focal stimuli evoking
      itch or pain can be localised with high precision which is only marginally worse
      than for tactile stimuli. This suggests the existence of a somatotopical
      representation for noxious inputs in the brain similar to that found for tactile
      stimuli.

PMID- 8469426
TI  - Repeated seizures cause a generalized increase in excitability in the
      hippocampus.
AB  - Changes in excitability within the hippocampus were examined by recording in CA3
      and in CA1 or the dentate gyrus and stimulating in the angular bundle (fiber
      bundle connecting the entorhinal cortex with the dentate gyrus) before and after
      36 electrographic seizures in urethane anesthetized rats. The responses recorded
      in CA3 or CA1 to stimulation of the angular bundle every 30 s were unchanged
      after repeated seizures, while the responses in the dentate gyrus were augmented.
      When the angular bundle was stimulated every 200 ms, population spikes appeared
      in CA3 and CA1, with CA1 producing multiple population spikes before CA3. The
      results indicate that after repeated seizures there is a general enhancement of
      excitability throughout the hippocampus.

PMID- 8469427
TI  - Cerebrovascular NADPH diaphorase-containing nerve fibers in the rat.
AB  - Recently, neuronal nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase
      has been elucidated to be the nitric oxide synthase (NOS) per se. In order to
      examine the existence and distribution of cerebrovascular nerve fibers containing
      these substances, NADPH-diaphorase histochemistry was applied to the cerebral
      blood vessels and the cranial ganglia known to innervate the cerebral vessels in
      the rat. Numerous nerve fibers with varicosities forming plexuses were observed
      in the circle of Willis and its branches. In addition, thick nerve bundles were
      seen to run along the wall of the internal ethmoidal artery. NADPH-diaphorase
      reaction was prominent in neurons of the sphenopalatine, otic and internal
      carotid ganglia. This study demonstrated, for the first time, the NADPH
      diaphorase-containing nerve fibers in the cerebral vessels and ganglion cells in
      the parasympathetic and sensory ganglia known to innervate the cerebral vessels.

PMID- 8469428
TI  - Regulation of serotonin-induced calcium uptake in Spisula oocytes by tricyclic
      antidepressants.
AB  - The effect of tricyclic antidepressants on 5-hydroxytryptamine (serotonin or 5
      HT)-induced maturation and Ca2+ uptake in Spisula oocytes was determined. The
      drugs at a concentration of 20 microM completely blocked germinal vesicle
      breakdown and 45Ca2+ uptake by Spisula oocytes. The order of effectiveness of the
      antidepressants were imipramine > desipramine > clomipramine. The present
      findings suggest that the action of tricyclic antidepressants is to regulate Ca2+
      uptake into 5-HT-responsive cells.

PMID- 8469429
TI  - Degeneration of rat thalamic reticular neurons following intrathalamic domoic
      acid injection.
AB  - Domoic acid (DA), an analog of kainic acid, produces attentional deficits in
      humans who have ingested shell fish contaminated with this excitotoxin. The
      thalamic reticular nucleus (RT), by virtue of its location, connections and
      intrinsic properties, has been implicated in attentional processes. This study
      demonstrated the vulnerability of RT neurons following intrathalamic DA
      injections in rats. Lesions were characterized by almost total neuronal loss
      throughout the RT and sparing of adjacent populations of relay neurons in the VL
      and VPL. Los of RT neurons may underlie some types of attentional deficits
      observed in humans following DA poisoning.

PMID- 8469430
TI  - Human astrocytes and cytokines: tumor necrosis factor alpha and interferon gamma
      do not promote astrocytic proliferation.
AB  - Astrocyte cell cultures were established from human fetal brains and exposed to
      human recombinant tumor necrosis factor alpha (TNF alpha) and human recombinant
      interferon gamma (IFN gamma), and the proliferative response was assessed by
      bromodeoxyuridine-immunostaining technique. TNF alpha showed an inhibitory
      activity, while IFN gamma induced a slight increase in the number of astrocytes
      undergoing cell division. However, in both experiments differences were not
      statistically significant. Previous studies have demonstrated that TNF alpha and
      IFN gamma are potent mitogens for adult astrocytes in both in vivo and in vitro
      conditions. Our results suggest that in developing brain the immunomodulatory
      activity of cytokines, TNF alpha and IFN gamma, is different from that observed
      in adult brain.

PMID- 8469431
TI  - Facilitation of [3H]-ACh release by forskolin depends on A2-adenosine receptor
      activation.
AB  - The effect of forskolin (FSK) on [3H]-acetylcholine release ([3H]-ACh) from the
      phrenic motor nerve terminals, and its modification by adenosine deaminase (ADA),
      by the A2-adenosine receptor agonist 2-[p-(2-carboxyethyl)phenethylamino]-5'-N
      ethylcarboxamide adenosine (CGS 21680C), by the A1-adenosine receptor agonist R
      N6-phenylisopropyl adenosine (R-PIA), by the A2-antagonist N-(2-(dimethylamino)
      ethyl)-N-methyl-4-(2,3,6,7-tetrahydro-2,6-dioxo-1,3 -dipropyl-1H-purine-8-yl)
      benzene sulphonamide (PD 115,199), and by the A1-antagonist 1,3-dipropyl-8
      cyclopentylxanthine (DPCPX) were studied on the rat phrenic-hemidiaphragm
      preparation. It is concluded that the excitatory effect of FSK on evoked [3H]-ACh
      release depends on tonic A2-adenosine receptor activation.

PMID- 8469432
TI  - Differential effects of dentate kindling on working and reference spatial memory
      in the rat.
AB  - An 8-arm radial maze was used to examine the effects of dentate kindling on the
      performance of a task which requires both working (short-term) and reference
      (long-term) memory. During the 4-week post-operative training period, control and
      experimental rats performed both components of the task equally well. Performance
      of the reference memory component, but not the working memory component of the
      task was significantly impaired during kindling stimulation. The impairment in
      reference memory appeared to be primarily due to the elicitation of
      afterdischarges, since the disruption in maze performance was evident in the pre
      convulsive stages of kindling. Following the cessation of kindling stimulation, a
      gradual recovery in reference memory performance was observed. Dentate kindling
      may provide a useful model for the study of long-term memory deficits associated
      with temporal lobe epilepsy.

PMID- 8469433
TI  - High-dose ketamine does not induce c-Fos protein expression in rat hippocampus.
AB  - The effects of high-dose ketamine on the c-fos protein (c-Fos) expression were
      investigated in rat by an immunohistochemical technique. The administration of
      100 mg/kg ketamine i.p. induced seizure-like activity (limbic seizure). No c-Fos
      immunoreactivity was observed in hippocampus, piriform cortex and amygdala, while
      it was observed in neocortex and thalamus. These findings disagree with the
      reports that ketamine depresses the neuronal function of the neocortex and
      thalamus, while it stimulates the limbic system.

PMID- 8469434
TI  - Induction of c-Fos-like protein in the lateral habenular nucleus by persistent
      noxious peripheral stimulation.
AB  - Persistent noxious peripheral stimulation by formalin injection into the
      unilateral hindpad of anaesthetized rats induced c-Fos-like protein
      immunoreactivity (c-Fos-LI) in neurons within the lateral habenular nucleus (LHb)
      bilaterally. Formalin injection after the transection of spinal cords also
      induced c-Fos-LI in many neurons within the LHb, though the number of labeled
      cells changed depending on the post-transection period. These results suggest
      that the LHb modulates nociceptive information, but that it receives nociceptive
      information via extraspinal pathways as well as intraspinal ascending noxious
      pathways.

PMID- 8469435
TI  - Sex differences in the anteroventral periventricular nucleus of the preoptic area
      and in the related effects of androgen in prenatal rats.
AB  - The density of cells in the anteroventral periventricular nucleus (AVPv) of the
      preoptic area of female rats was greater than that of males on day 21 of
      gestation. It appears that this difference between the sexes is caused by the
      action of androgen since the density of cells in the AVPv of female fetuses fell
      to the density in males when the mother received injections of testosterone
      propionate (TP) on days 14-18 of gestation. Pycnotic cells were more frequently
      found in oil-treated control males and TP-treated female fetuses than in control
      female fetuses. This result suggests that the prenatal injections of TP enhanced
      the rate of degeneration of the cells in the AVPv.

PMID- 8469436
TI  - Autoradiographic demonstration of an increase in muscarinic cholinergic receptors
      in cerebellar granule cells treated with tetrahydroaminoacridine.
AB  - The neurotrophic and neurosurviving effects of 9-amino-1,2,3,4-tetrahydroacridine
      (THA), a putative antidementia agent, were studied in cultured granule cells
      using biochemical and morphological methods. The addition of 30 microM THA to
      cultures grown in 15 mM K(+)-containing media markedly increased cell survival
      and enhanced [3H]N-methylscopolamine binding to muscarinic cholinergic receptors
      (mAChRs). Furthermore, receptor autoradiographic studies revealed that neuronal
      cells were labelled over both cell bodies and fibers by the [3H]receptor ligand.
      These observations provide direct evidence that THA promotes the expression of
      mAChR binding sites in differentiating cerebellar granule cells.

PMID- 8469437
TI  - Differential fatty acid release from CA1 and CA3 regions of rat hippocampal
      slices under hypoxia and hypoglycemia.
AB  - Rat hippocampal slices were subjected to hypoxia and/or hypoglycemia for 10 min,
      and free fatty acids released in CA1 and CA3 regions were separately analyzed.
      Fatty acid accumulation in CA1 was not so significant under hypoglycemia, but
      very prominent under hypoxia. Free fatty acid levels in CA3 were much less than
      those in CA1 even under hypoxia plus hypoglycemia. This observation seems to be
      consistent with the selective vulnerability of CA1 neurons seen in in vivo
      ischemia. The decreasing order of accumulation of free fatty acid species in CA1
      was C16:0 > C18:0 > C18:1 > C20:4 > C22:6. The increment fold as compared to
      control level was decreasing as follows: C22:6, 28 times; C20:4, 13 times, C18:1,
      10 times; C18:0 = C16:0, 3 times. The present experimental conditions using
      hippocampal slices provided a good in vitro model to prove the selective hypoxic
      damages of the CA1 subfield in terms of free fatty acid release in association
      with the membrane degradation.

PMID- 8469438
TI  - Hormonal influence on the permeability of the blood-brain barrier: effect of an
      analog of adrenocorticotropic hormone, beta 1-24 corticotrophin.
AB  - Regional unidirectional transport of alpha-aminoisobutyric acid (AIB) (mol. wt.:
      104) and sucrose (mol wt.: 342) which have a low permeability across the intact
      endothelium was investigated in brain of rats either treated with synacthene: an
      analog of ACTH, tetracosactide retard (beta-1-24 corticotrophin) or in brain of
      placebo-treated controls. Three days treatment with synacthene, reduced the rate
      of influx of AIB and sucrose in most of the brain regions studied especially in
      thalamus, hypothalamus, cortex, and caudate nucleus without affecting the
      vascular compartment. The brainstem, cerebellum and white matter were less
      affected. These experimental findings may suggest that ACTH exhibits significant
      influence on hormonal regulation of blood-brain barrier permeability. Thereby
      such a regulation may involve the entry of polar compounds into the CNS and may
      influence the central effects of diffusion-limited drugs.

PMID- 8469439
TI  - Alterations of glial fibrillary acidic protein mRNA level in the aging brain and
      in senile dementia of the Alzheimer type.
AB  - The GFAP mRNA levels were compared to the density of the senile plaques (SP) in
      postmortem brain samples of 8 cases, either non-demented or affected by senile
      dementia of the Alzheimer type. In the frontal neocortex, the GFAP mRNA level is
      not affected, even if SP are present. In the temporal neocortex, a positive
      correlation between GFAP mRNA level and SP density was highly significant. This
      shows that in this area, astrocytes are altered at transcriptional or post
      transcriptional levels, or both. The different responses of this astrogliosis
      marker in each area may be related to the loss of specific neurotransmitter
      system.

PMID- 8469440
TI  - Lamellated receptors in the skin of the hagfish, Myxine glutinosa.
AB  - The adult hagfish, Myxine glutinosa, does not exhibit a lateral line system. The
      hypodermal layer of the dorsal head and body skin contains a prominent receptor
      system--lamellated corpuscles--arranged in a segmental pattern close to the body
      fascia. The topography and the structural organization of the lamellated
      receptors are described at the light- and electronmicroscopical levels. Spinal
      nerves supply the lamellated receptor organs. A mechanoreceptive function and
      evolutionary aspects are discussed.

PMID- 8469441
TI  - Antinociceptive activity of salmon calcitonin: electrophysiological correlates in
      a rat chronic pain model.
AB  - Experimental and clinical evidence testifies to an antinociceptive action of
      salmon calcitonin (sCT), administered in different ways, on the central nervous
      system. These studies were performed almost exclusively in acute pain models. The
      purpose of the present study was to investigate the effects of sCT, injected
      directly into the lateral cerebral ventriculi, on the firing of single
      nociceptive thalamic neurons, detected by electrophysiological techniques in an
      experimental model of prolonged or chronic pain, such as rats rendered arthritic
      by injection of Freund's adjuvant into the left hindfoot. The noxious test
      stimuli used were either extension or flexion of the ankle or mild lateral
      pressure on the heel. With increasing doses of sCT (5, 10, 20, 40 micrograms, 5
      microliters/i.c.v.) it was possible to observe correspondingly increasing
      inhibitory and long-lasting effects on the evoked firing, with a significant dose
      effect relationship. In agreement with electrophysiological findings, preliminary
      data, obtained with a patch clamp technique, on depression of calcium fluxes
      through neuronal membrane, induced by sCT, oriented the attention to a direct
      action of sCT on CNS.

PMID- 8469443
TI  - Detection of thyrotrophin releasing hormone in rat brain in vivo using novel
      antibody microprobes: effects of amphetamine.
AB  - Antibody microprobes of novel design were used to monitor thyrotrophin releasing
      hormone (TRH) in rat brain before and after-parenteral administration of
      amphetamine. Specific antibodies to TRH were bound to the outside of glass
      microprobes by adsorption to a surface of activated charcoal embedded in
      epoxylite resin. In male Wistar rats anaesthetised with chloral hydrate a series
      of antibody microprobes were implanted in forebrain. Amphetamine (10 mg/kg i.p.)
      caused a highly significant decrease in the binding of 125I-TRH to microprobes,
      indicating an increase in extracellular TRH localised in the lateral septum.
      There was also evidence of TRH release in the septo-hypothalamic nucleus. Neither
      saline, nor amphetamine at 2 mg/kg were able to evoke changes in the release of
      TRH at any sites.

PMID- 8469442
TI  - Adenosine 5'-triphosphate release from the normoxic and hypoxic in vivo rat
      cerebral cortex.
AB  - The release of adenine nucleotides and adenosine from the in vivo rat cerebral
      cortex has been measured in the presence of DL-alpha-glycerophosphate (10(-2) M),
      an inhibitor of non-specific phosphatases. In normoxic brains, the superfusate
      concentrations of adenosine and its nucleotides (in nM) were: adenosine 38.9 +/-
      10.9; AMP 13.9 +/- 1.6; ADP 12.4 +/- 2.3; ATP 17.7 +/- 2.1. During 10 min
      episodes of hypoxia (8% oxygen inhalation) superfusate levels of adenosine
      doubled, but the release of nucleotides was unaltered. These findings indicate
      that extracellular levels of ATP in the cerebral cortex are in the range at which
      this compound dilates cerebral blood vessels, and that ATP may be an endogenous
      regulator of regional cerebral blood flow. The absence of any increase in
      nucleotide levels during hypoxic episodes implies that adenosine is released into
      the extracellular space as the nucleoside, and not as a nucleotide which would
      then be hydrolyzed to adenosine.

PMID- 8469444
TI  - Managing a multisystem interactive video laboratory.

PMID- 8469445
TI  - Nationwide computerized NCLEX, April, 1994! Will you be ready?

PMID- 8469446
TI  - Optimizing use of a hospital computer lab.

PMID- 8469447
TI  - Perceptions, concerns and needs that influence technology integration.

PMID- 8469448
TI  - Mutation and overexpression of p53 in early-stage epithelial ovarian cancer.
AB  - OBJECTIVE: To investigate whether mutation and overexpression of p53 is a feature
      of early-stage ovarian cancers. METHODS: Because early-stage ovarian cancers are
      relatively uncommon, we adapted p53 immunostaining and DNA sequencing methods for
      use in paraffin-embedded tissue blocks. Early-stage ovarian cancers from 52
      patients treated at Duke University between 1980-1991 were analyzed. RESULTS:
      Immunostaining for p53 consistent with overexpression was seen in 29% of early
      stage (I/II) ovarian cancers overall. The incidence of p53 overexpression was
      lower in cancers confined to the ovaries (stage IA/IB) (15%) than in cancers that
      had spread outside the ovaries (stage IC/II) (44%) (P = .03). Although p53
      overexpression was seen more frequently in large tumors (diameter greater than 10
      cm) and in tumors with "high-risk" features (stage IC or II, or grade 3), these
      relationships were not statistically significant. Recurrent disease developed in
      35% of the patients in this series, but there was no relationship between p53
      overexpression and recurrence rate or survival. The presence of point mutations
      in the p53 gene was confirmed by DNA sequencing in eight cancers that
      overexpressed p53. CONCLUSION: Mutation and overexpression of p53 are less
      frequent in early-stage ovarian cancers than in advanced-stage cases. P53
      overexpression is not associated with adverse outcome in early-stage ovarian
      cancer.

PMID- 8469449
TI  - Profiles of women age 30-39 and age less than 30 with epithelial ovarian cancer.
AB  - OBJECTIVE: To study a group of women diagnosed with epithelial ovarian cancer at
      a young age (less than 40). METHODS: Tumor registry data were analyzed with
      respect to age at diagnosis, stage, grade, frequency of nulligravidity, and
      family history of breast or ovarian cancer. Frequencies were analyzed using
      contingency tables, and survival distributions were analyzed according to the
      method of Kaplan and Meier. Multivariate survival analysis was performed with the
      Cox method. RESULTS: We found significantly higher frequencies of low-grade
      tumors (90 versus 37%; P = .0003, chi 2 test) and early-stage tumors (45 versus
      17%; P = .03, Fisher exact test) in women less than 30 at the time of diagnosis
      (very young patients) than in those between 30-39. We also found a significant (P
      = .017, Breslow statistic) survival advantage for the very young women.
      Multivariate analysis demonstrated tumor grade as the independent variable for
      survival. CONCLUSION: These findings support the concept of a preclinical phase
      of epithelial carcinoma and show that young women may derive substantial benefit
      from ovarian cancer screening programs.

PMID- 8469450
TI  - Endometrial changes in postmenopausal breast cancer patients receiving tamoxifen.
AB  - OBJECTIVE: To assess the estrogenic effect of tamoxifen and associated pathologic
      changes of the endometrium in postmenopausal breast cancer patients. METHODS: The
      endometrium of 103 gynecologically asymptomatic postmenopausal breast cancer
      patients was examined. Fifty-one had been treated with tamoxifen and 52 had not
      received any hormonal treatment. The two groups were similar in age, parity, age
      at menopause, and body mass index. RESULTS: Compared with the control subjects,
      the tamoxifen patients had a thicker endometrium (mean +/- standard deviation
      10.4 +/- 5.0 versus 4.2 +/- 2.7 mm; P = .0001) and larger uterine volume (45 +/-
      27 versus 25 +/- 11 cm3; P = .001), as determined by transvaginal sonography.
      Hysteroscopy showed an atrophic endometrium in 28% of the patients in the
      tamoxifen group, as compared with 87% of the control patients (P = .0001).
      Endometrial polyps were more frequent in the tamoxifen group (36 versus 10%; P =
      .004), which included one patient with atypical hyperplasia, one with adenomatous
      hyperplasia, and one with endometrial adenocarcinoma; two controls had
      endometrial adenocarcinoma. CONCLUSION: The results provide evidence for an
      estrogenic effect of long-term tamoxifen treatment on the postmenopausal uterus
      and show it to be associated with an increased occurrence of polyps.

PMID- 8469451
TI  - Natural killer cell activity in endometriosis: correlation between serum
      estradiol levels and cytotoxicity.
AB  - OBJECTIVE: To evaluate the correlation between natural killer cell activity and
      serum estradiol (E2) levels in patients with different stages of endometriosis.
      METHODS: Natural killer cell activity of peripheral blood lymphocytes and serum
      E2 levels were evaluated in 73 women who underwent laparoscopy for pelvic pain,
      infertility, and benign adnexal masses. RESULTS: The 33 patients (45%) with
      endometriosis showed a significant decrease in natural killer cell activity in
      relationship to an increase in disease stage (correlation coefficient r = -0.83,
      P < .001). A significant inverse relationship was observed between cytotoxicity
      and serum E2 levels (correlation coefficient r = -0.89, P < .001). CONCLUSION:
      The relationship between natural killer cell activity and serum E2 levels
      suggests that an immunoendocrine interaction plays an important role in the
      progression of endometriosis.

PMID- 8469452
TI  - Bone density is compromised in amenorrheic women despite return of menses: a 2
      year study.
AB  - OBJECTIVE: To determine the effects of estrogen deprivation on bone mass in young
      women in whom large bone mass increases are known to occur. METHODS: Over 2
      years, nine amenorrheic and 21 normal women were studied, classified into
      exercising (dancers) and sedentary subjects. An integrated estrogen exposure
      score was used to determine estrogen response during the 2 years of study. Bone
      mineral density was measured by single and dual photon absorptiometry in the
      spine, wrist, and foot (metatarsus). RESULTS: Hypoestrogenism was present in all
      amenorrheic women in the first year, and mean estrogen exposure scores were lower
      in these subjects during the 2 years. Mean spine, wrist, and metatarsal bone
      mineral density measurements were lower in the amenorrheic women and remained
      below the levels in controls, despite changing clinical indices and return of
      menses in some of the subjects. Amenorrheic dancers showed the greatest increase
      in spine bone mineral density, gaining 9.65% in the first year, 4.49% in the
      second, and an increase of 14.43% (P < .05) over the total period. Their bone
      mineral density values, however, remained significantly below those of normal
      controls during the duration of the study. The most significant gains were seen
      in two subjects with weight gain and return of irregular periods (three periods
      in 12 months). CONCLUSION: Young amenorrheic exercising women appear to increase
      bone mass before the return of normal menses; however, bone mass remained below
      control values during 2 years of study, possibly because of long-term adolescent
      hypoestrogenism.

PMID- 8469453
TI  - Prenatal diagnosis of congenital heart disease and fetal karyotyping.
AB  - OBJECTIVE: To determine the incidence of aneuploidy among fetuses with congenital
      heart disease diagnosed in utero. METHODS: From June 1988 through December 1991,
      502 fetuses at risk for congenital heart disease underwent fetal
      echocardiography. Fetal karyotyping was performed whenever a cardiac anomaly was
      diagnosed. Autopsy reports, postnatal echocardiograms, and angiograms were
      obtained to confirm the diagnosis. RESULTS: Congenital heart disease was found in
      31 of 469 fetuses with complete follow-up. Fifteen of these 31 fetuses (48%) were
      found to have an abnormal karyotype: five of 17 (29.4%) with isolated cardiac
      anomalies and ten of 14 (71.4%) with cardiac and extracardiac anomalies. Detected
      chromosomal abnormalities included six trisomy 21, four trisomy 18, four trisomy
      13, and one triploidy 69,XXX. Atrioventricular septal defects and ventricular
      septal defects were the cardiac malformations most often associated with abnormal
      karyotypes (77 and 71%, respectively). CONCLUSIONS: The risk of aneuploidy
      associated with fetal cardiac anomalies is much greater than that associated with
      elevated maternal age; therefore, fetal karyotyping should be offered whenever a
      cardiac defect is diagnosed. Advanced gestational age should not represent a
      deterrent, because the discovery of a lethal trisomy in a fetus with a cardiac
      malformation can affect dramatically the prognosis and the obstetric and neonatal
      management. We believe that a screening view such as the four-chamber view should
      now be included routinely in obstetric ultrasound examinations.

PMID- 8469454
TI  - The difference between septated and nonseptated nuchal cystic hygroma in the
      early second trimester.
AB  - OBJECTIVE: To compare nonseptated and septated cystic hygromas in terms of
      morphologic appearance and prognosis. METHODS: During a 5-year period, 125 cases
      of nonseptated cystic hygroma were detected by transvaginal sonography among 7582
      sonographic fetal scans (1.6%) in the first and early second trimesters. Twenty
      five cases of septated cystic hygroma were detected in the same population. Fetal
      karyotype abnormalities; sonographic, morphologic, and histologic appearance; and
      pregnancy outcome were compared between the groups. RESULTS: Whereas 98% of the
      nonseptated cystic hygromas were transient, only 44% of the 25 septated cystic
      hygromas were transient. Six of the 106 cases of nonseptated cystic hygroma that
      underwent karyotyping were dyskaryotic (5.7%), compared with a 72% (18 of 25)
      aneuploidy rate in the septated cystic hygromas. Only two cases of hydrops
      fetalis (1.7%) occurred among the nonseptated cystic hygromas, versus 40% (ten of
      25) in the septated cystic hygromas. Fifteen percent of the nonseptated cystic
      hygromas had associated anomalies (17 of 115) versus 52% (13 of 25) in the
      septated counterpart. As compared with the septated group, the nonseptated cystic
      hygromas had a different sonographic, morphologic, and histologic appearance. The
      live-birth rate was 94% (108 of 115) in the nonseptated cystic hygromas, versus
      only 12% in the septated group. CONCLUSIONS: This study confirms our previous
      suggestion that nonseptated cystic hygromas differ from septated lesions, not
      only in location and morphologic appearance, but also in prognosis.

PMID- 8469455
TI  - Obstetric correlates of neonatal retinal hemorrhage.
AB  - OBJECTIVE: To determine whether maternal or fetal factors, other than vacuum
      assisted delivery, play a role in neonatal retinal hemorrhage, and whether
      correlates are similar in retinal hemorrhage after spontaneous vaginal delivery.
      METHODS: A cross-section of assisted deliveries at an urban hospital (n = 156)
      over 7 months were compared with contemporaneous spontaneous vaginal deliveries
      (n = 122). A subset of assisted deliveries (n = 87) was prospectively randomized
      to forceps or vacuum-assisted delivery by sealed envelope. Maternal and neonatal
      biometric data were collected, and Apgar scores, umbilical artery blood gas
      analysis, and neonatal ophthalmologic evaluations were performed. RESULTS:
      Moderate to severe retinal hemorrhage was found in 18% of spontaneous, 13% of
      forceps, 28% of vacuum-assisted, and 50% of sequential vacuum and forceps
      assisted deliveries. Fetal distress (P < .008), vacuum-assisted delivery (P <
      .02), decreased birth weight for gestation (P < .004), umbilical artery pH less
      than 7.20 (P < .004), and second stage of labor less than 30 minutes (P < .05)
      were most closely associated with increased degrees of retinal hemorrhage.
      Maternal parity, preeclampsia, length of labor, and head circumference were not
      correlated with retinal hemorrhage. Vacuum-assisted delivery among low birth
      weight infants (P < .0001), short second stage of labor (P < .006), fetal
      acidosis (P < .045), and sequential use of vacuum and forceps for assisted
      delivery (P < .005) formed a logistic model that correctly predicted 81% of
      moderate to severe retinal hemorrhage cases. Logistic analysis of the randomized
      assisted deliveries gave similar results. CONCLUSIONS: Maternal and fetal factors
      other than vacuum-assisted delivery are significant correlates of moderate to
      severe retinal hemorrhage. Vacuum-assisted delivery among small for gestational
      age infants is closely correlated with moderate to severe retinal hemorrhage.

PMID- 8469456
TI  - Intrapartum prediction of birth weight: clinical versus sonographic estimation
      based on femur length alone.
AB  - OBJECTIVE: To determine the relative accuracy of predicting birth weight by
      clinical estimate versus sonographic mensuration of femur length (FL) alone.
      METHODS: Two hundred pregnant women at term and in early labor had the weight of
      their fetuses estimated by clinical and sonographic methods. RESULTS: Clinical
      assessment of birth weight had a significantly lower mean standardized absolute
      error (90.6 g/kg) than sonographic estimate based on FL alone (106.7 g/kg) (P <
      .05). Clinical estimates were significantly more often within 5% (35%) of actual
      birth weight than were those derived sonographically (29%) (P = .005).
      CONCLUSION: Using FL alone to predict birth weight has no advantage over a
      clinical estimate among term patients in labor.

PMID- 8469457
TI  - Amniotic fluid volume estimation in the postdate pregnancy: a comparison of
      techniques.
AB  - OBJECTIVE: To determine the amniotic fluid (AF) volume estimation technique with
      the greatest diagnostic value with respect to perinatal outcome in the postdate
      pregnancy. METHODS: One hundred ninety-eight women who were at least 40 weeks'
      gestation based on ultrasound confirmation or establishment of dates were
      evaluated twice weekly with nonstress tests (NSTs) and AF volume estimation.
      Various indices of AF volume were measured and correlated with perinatal outcome.
      Receiver operating characteristic curves were used to determine optimal cutoff
      values. RESULTS: There was a significantly larger maximal vertical pocket in
      those pregnancies with a normal perinatal outcome than in those with abnormal
      outcome (4.2 +/- 1.4 versus 3.2 +/- 2.0 cm; P = .02). A statistically significant
      difference was also seen with the AF index (10.0 +/- 4.5 versus 7.5 +/- 5.0 cm; P
      = .01). Analysis revealed that the optimal cutoff for identifying clinically
      significant oligohydramnios was a largest vertical pocket less than 2.7 cm, with
      an adjusted odds ratio for abnormal perinatal outcome of 7.11 (95% confidence
      interval [CI] 2.79-18.16). Its sensitivity of 50.0% and specificity of 87.9% were
      superior to the diagnostic value of the AF index of 5 cm, which had a sensitivity
      of 29.2% and specificity of 89.1%. CONCLUSION: A largest vertical pocket
      threshold of 2.7 cm had the greatest diagnostic value for identifying the
      postdate pregnancy at risk for abnormal perinatal outcome, surpassing the AF
      index and the 2-cm largest vertical pocket rule.

PMID- 8469458
TI  - Reproductive outcome after 143 laparoscopic procedures for ectopic pregnancy.
AB  - OBJECTIVE: To analyze reproductive outcome after laparoscopic procedures for
      ectopic pregnancy, with particular attention to laparoscopic salpingectomy.
      METHODS: In a 260-physician multispecialty clinic in the rural upper midwestern
      United States, 143 patients were followed prospectively after undergoing
      laparoscopic procedures for ectopic pregnancy. Ninety-five who sought further
      pregnancies during the study period were analyzed for reproductive outcome.
      Intrauterine pregnancy rates were compared by age, parity, size of ectopic
      gestation, and evidence of prior tubal damage. Life table analysis was also
      performed. RESULTS: The overall intrauterine pregnancy rates for laparoscopic
      salpingostomy (60%) and laparoscopic salpingectomy (54%) were not significantly
      different from each other. However, intrauterine pregnancy rates differed
      significantly by history of prior tubal damage. The pregnancy rate was 79% among
      women without tubal damage and 42% among women with damage. CONCLUSIONS: Our
      intrauterine pregnancy rates after both laparoscopic salpingectomy and
      laparoscopic salpingostomy are similar to those reported in the literature for
      similar procedures performed at laparotomy. In predicting pregnancy outcome after
      laparoscopic procedures for ectopic pregnancy, the major variable seemed to be
      evidence of prior tubal damage. With no evidence of previous damage, we found
      similarly high pregnancy rates for laparoscopic salpingostomy and salpingectomy.

PMID- 8469459
TI  - Hysteroscopic treatment of menorrhagia associated with uterine leiomyomas.
AB  - OBJECTIVE: To determine the effectiveness of hysteroscopic treatment of
      menorrhagia associated with uterine leiomyomas. METHODS: Fifty-one women with
      uterine myomas were treated for menorrhagia by hysteroscopic resection with or
      without endometrial ablation. Patients were followed for 1-5 years after
      treatment. RESULTS: The mean number of pads used during the heaviest day of
      menses decreased from 17.8 before treatment to 6.8 after treatment (P < .005) in
      women undergoing resection only, and from 21.4 to 1.7 pads per day in women whose
      treatment included endometrial ablation (P < .001). Two-thirds of the women who
      underwent ablation were completely amenorrheic after the procedure. Both groups
      experienced significant decreases in dysmenorrhea. Three patients subsequently
      underwent hysterectomy after hysteroscopic treatment, and one required a repeat
      hysteroscopic procedure. CONCLUSION: Hysteroscopic treatment of menorrhagia
      associated with uterine myomas can be effective in carefully selected patients.

PMID- 8469460
TI  - Epidemiologic characteristics of women with idiopathic recurrent vulvovaginal
      candidiasis.
AB  - OBJECTIVE: To evaluate risk factors related to anamnestic variables, sexual
      behavior, feminine hygiene habits, and microbiologic findings in women with
      idiopathic recurrent vulvovaginal candidiasis. METHODS: We conducted a
      multivariate observational study comparing sociodemographic, anamnestic,
      clinical, and microbiologic variables between 86 patients with recurrent vaginal
      candidiasis and 180 controls with nonrecurrent infection. RESULTS: In logistic
      regression analysis, women with recurrent candidal vaginitis were more likely
      than controls to use contraceptive pills (adjusted odds ratio 2.0, 95% confidence
      interval [CI] 1.02-3.91; P = .04) and commercially available solutions for either
      vulvoperineal cleansing (adjusted odds ratio 2.2, 95% CI 1.25-3.88; P = .007) or
      vaginal douching (adjusted odds ratio 1.8, 95% CI 1.0-3.26; P = .05). The rate of
      isolation of non-albicans candida species was significantly higher among cases
      than controls (adjusted odds ratio 3.0, 95% CI 1.50-6.04; P = .005). Finally,
      increasing frequency of monthly sexual intercourse was significantly correlated
      (chi 2 for trend = 4.87; P = .027) with recurrent infection. CONCLUSION: Several
      behavioral factors seem to influence the occurrence of relapses in recurrent
      vulvovaginal candidiasis. Appropriate counseling about contraception, sexual
      activity, and personal hygiene habits could be an important preventive measure in
      these cases.

PMID- 8469461
TI  - Chlamydia trachomatis in patients who used oral contraceptives and had
      intermenstrual spotting.
AB  - OBJECTIVE: To identify the incidence of positive assays for direct antigen
      detection of Chlamydia trachomatis in oral contraceptive (OC) users with and
      without intermenstrual spotting and in women seeking contraception. METHODS: We
      studied 65 women who had used OCs for more than 3 months and who presented with
      intermenstrual spotting for which no readily demonstrable cause could be
      identified. They were compared with 65 matched controls who were taking OCs
      without intermenstrual spotting and who had chlamydia testing because of one or
      more risk factors, and 65 matched controls seeking contraception. The incidence
      of positive tests for each group was compared by chi 2 test for independence
      using the Yates formula. The strength of the relationship was analyzed by
      determining the Craemer phi coefficient. RESULTS: Nineteen of the 65 women
      (29.2%) taking OCs for more than 3 months and experiencing bleeding had positive
      tests, in contrast to seven of 65 matched controls (10.7%) who were also on OCs
      and who had had chlamydia testing because of vaginitis or new or multiple sexual
      consorts, and four of 65 women (6.1%) who were screened for C trachomatis before
      initiation of contraception. The significance level for the chi 2 statistic was P
      < .01. CONCLUSION: Intermenstrual bleeding in women previously well regulated on
      OCs appears to be an added marker for chlamydial infection.

PMID- 8469462
TI  - Diagnosing proximal tubal obstruction: evaluation of peak intrauterine pressures
      using four common cannula techniques in extirpated uteri.
AB  - OBJECTIVE: To compare the ability of four chromotubation techniques to generate
      and maintain intrauterine pressures in the diagnosis of proximal tubal
      obstruction. METHODS: Sixteen extirpated uteri were used for this study. A
      pressure catheter was placed through the fundus into the endometrial cavity.
      Three cannulas were evaluated: 1) the Cohen cannula with hold and no-hold
      techniques, 2) the BARD cervical cannula (dual intrauterine and intracervical
      balloons), and 3) the Harris-Kronner uterine manipulator-injector catheter with
      an intrauterine balloon. Intrauterine pressures were monitored while warm saline
      was infused. The studies were performed with the tubes obstructed, and
      measurements of peak attainable intrauterine pressures were recorded. Data were
      analyzed by t test, with significance set at P < .05. RESULTS: Peak intrauterine
      pressures for the four groups were as follows: 1) Cohen cannula, not holding,
      40.7 +/- 5.1 mmHg; 2) Cohen cannula, holding in place, 63.6 +/- 5.3 mmHg; 3) BARD
      cannula, 112.4 +/- 3.5 mmHg; and 4) Harris-Kronner cannula, 106.3 +/- 4.3 mmHg.
      The BARD and Harris-Kronner cannulas achieved significantly higher intrauterine
      pressures than either method of using the Cohen cannula (P < .001). There was no
      statistically significant difference between the BARD and Harris-Kronner
      cannulas. CONCLUSION: Significant differences in achievable intrauterine
      pressures were demonstrated among catheters in our in vitro model. Based on these
      findings, we believe that the BARD, Harris-Kronner, or other intrauterine balloon
      type cannula should be used before diagnosing proximal tubal obstruction.

PMID- 8469463
TI  - The utility of a home urinary LH immunoassay in timing the postcoital test.
AB  - OBJECTIVE: To evaluate whether a urinary LH immunoassay improves timing of the
      postcoital test compared to traditional timing methods in normally ovulating
      women. METHODS: Subjects included 37 infertile couples evaluated in a tertiary
      care setting. A randomized, prospective trial was performed of two methods of
      postcoital test timing: urinary LH assay or the traditional timing by cycle
      averaging and/or review of basal body temperature graphs. RESULTS: Similar serum
      estradiol, progesterone, LH, number of motile sperm per high-power field,
      cervical mucus scores, and postcoital test scores were identified in both groups.
      CONCLUSION: Urinary LH immunoassays do not appear to improve timing of the
      postcoital test as compared with traditional timing methods.

PMID- 8469464
TI  - Terbutaline tocolysis and glucose intolerance.
AB  - OBJECTIVE: To determine whether there is an increased incidence of glucose
      intolerance in association with chronic terbutaline therapy, administered either
      orally or as a continuous subcutaneous infusion. METHODS: Sixty-nine women
      received terbutaline, orally (38 subjects) or as a continuous subcutaneous
      infusion (31 subjects). Their gestational diabetes screening results were
      compared to the results in 82 women not receiving beta-mimetic therapy. RESULTS:
      Subjects receiving terbutaline had significantly higher mean glucose
      concentrations after the 1-hour 50-g glucose tolerance test (GTT) than did
      controls (P < .05, one-way analysis of variance with multiple comparisons). Among
      subjects receiving a continuous subcutaneous infusion of terbutaline, the
      incidence of abnormal 3-hour 100-g GTT results was higher than among controls (20
      versus 4%; P = .023 by chi 2). CONCLUSIONS: The incidence of GTT abnormalities is
      increased among women receiving terbutaline. We recommend surveillance of glucose
      tolerance among patients receiving terbutaline chronically, regardless of the
      route of administration.

PMID- 8469465
TI  - Confirming the safety of transvaginal sonography in patients suspected of
      placenta previa.
AB  - OBJECTIVE: To evaluate the safety of transvaginal ultrasonography in the
      diagnosis of placenta previa by determining whether the angle between the cervix
      and the vaginal probe is sufficient for alignment of the probe with the cervix.
      METHODS: The angle between the axis of the cervix and that of the vaginal probe
      (the axis of the vagina) was measured from copies of the transvaginal ultrasound
      examinations of 18 patients with documented placenta previa past 20 weeks'
      gestation. The measurements were compared with those of gestationally matched
      controls without placenta previa. RESULTS: The mean angles were 63.8 degrees and
      67.5 degrees, with minimum angles of 44 degrees and 48 degrees for the placenta
      previa and control groups, respectively. The values were not statistically
      different. CONCLUSION: These findings strengthen the previously undocumented
      presumption that the angle between the cervix and vaginal probe is sufficient to
      prevent the probe from inadvertently slipping into the cervix. Therefore, this
      study supports the safety of transvaginal sonography in diagnosing and monitoring
      patients with known placenta previa.

PMID- 8469466
TI  - Double-blind randomized study comparing amoxicillin and erythromycin for the
      treatment of Chlamydia trachomatis in pregnancy.
AB  - OBJECTIVE: To compare the efficacy and patient tolerance of amoxicillin to that
      of erythromycin in the treatment of lower genital tract chlamydia infections
      during pregnancy. METHODS: A double-blind, randomized study was conducted
      comparing oral amoxicillin 500 mg three times daily versus oral erythromycin 500
      mg four times daily for 7 days. One hundred forty-three women with positive
      cervical cultures for chlamydia at less than 36 weeks' gestation were enrolled. A
      test-of-cure culture was obtained 4 weeks after entry into the study and side
      effects were assessed. Success of the regimen was defined as completing the
      course of medication and having a negative test-of-cure culture. RESULTS: Thirty
      of the 65 women in the erythromycin group (46.1%) developed symptoms while taking
      the medication and 15 of them were unable to continue treatment (23.1%). In
      contrast, five of the 65 women (7.7%) in the amoxicillin group became
      symptomatic, with only one of these patients intolerant of the side effects
      (1.5%) (P < .001). Of the 50 patients in the erythromycin group who were able to
      complete their course of medication, only three had a positive test of cure
      (6.0%). In comparison, nine of the 64 patients (14.1%) taking amoxicillin who
      completed their course had positive cultures at test of cure. This difference was
      not statistically significant (P = .14). Forty-seven of the 65 patients (72.3%)
      in the erythromycin group successfully completed their regimen, compared to 55 of
      the 65 women (84.6%) in the amoxicillin group. This difference was not
      statistically significant. CONCLUSIONS: These findings suggest that amoxicillin
      is a reasonable alternative for the treatment of chlamydia in pregnant patients
      intolerant to erythromycin. The incidence of side effects and intolerance to
      therapy for amoxicillin are less than those for erythromycin.

PMID- 8469467
TI  - Clinical and environmental predictors of preterm labor.
AB  - OBJECTIVE: To determine the magnitude of risk for preterm labor associated with
      specific clinical and environmental factors. METHODS: Using a case-control
      design, 266 women with preterm labor and 512 controls were interviewed and their
      medical records reviewed. Crude and adjusted odds ratios were calculated for each
      risk factor. Population-attributable risks were estimated. RESULTS: Third
      trimester bleeding, twin gestation, and chorioamnionitis at presentation were
      strongly associated with preterm labor (odds ratios 11.2-48.3). A history of a
      prior preterm delivery, vaginal bleeding in the first or second trimester,
      maternal diethylstilbestrol exposure, uterine anomalies, and urinary tract
      infection during pregnancy were associated to a lesser extent (odds ratios 1.6
      5.4), as were cigarette smoking and drug use (odds ratios 2.0 and 3.0). Cases who
      had preterm labor preceded by premature rupture of the membranes had a
      substantially higher risk of preterm labor if chorioamnionitis, vaginal bleeding
      early in pregnancy, or urinary tract infection was present. By contrast, women
      who had intact membranes at the onset of preterm labor carried higher risk when
      twin gestation, placental abruption, or uterine anomaly was present. The highest
      population-attributable risks for preterm labor were found in patients with a
      twin gestation or third-trimester bleeding. CONCLUSIONS: Programs to reduce the
      preterm delivery rate should consider the attributable risks for the factors they
      are intended to modify. The attributable risks we obtained suggest that medical
      strategies to reduce the impact of the clinical variables, especially multiple
      gestation, and educational programs to decrease smoking and drug use should
      reduce the preterm delivery rate.

PMID- 8469468
TI  - Active-phase arrest in labor: predictors of cesarean delivery in a nulliparous
      population.
AB  - OBJECTIVE: To identify clinical variables associated with cesarean delivery for
      active-phase arrest with hypotonic labor. METHODS: We reviewed all deliveries at
      our institution from September 1975 through March 1989. Data were collected from
      medical records and a computerized data base. Nulliparas with active-phase arrest
      were identified and those with hypotonic labor (defined as less than 180
      Montevideo units) were selected. The clinical characteristics of each parturient
      were examined. A linear logistic regression analysis was used to examine the
      incidence of cesarean delivery as a function of clinical variables. RESULTS: The
      incidence of active-phase arrest was 4.9%, and hypotonic forces were diagnosed in
      81% of the cases managed with an intrauterine pressure catheter. Despite the
      consistent use of oxytocin in hypotonic labor, the cesarean rate was 60%. Four
      factors correlated with cesarean delivery in this setting: estimated fetal
      weight, station at the time of arrest, duration of ruptured membranes, and year
      of delivery. CONCLUSIONS: After an active-phase arrest, cesarean delivery
      increased when there was suspected cephalopelvic disproportion. In addition, we
      observed a strong correlation between cesarean delivery and the year of delivery,
      which suggests a change in physician behavior over time, independent of all other
      risk factors for cesarean.

PMID- 8469469
TI  - Cognitive deficits in women after childbirth.
AB  - OBJECTIVE: To test the cognitive function of parturients in the days immediately
      after delivery. METHODS: One hundred postpartum mothers who delivered normal full
      term infants were tested on standardized neuropsychological tests--the Wechsler
      Logical Memory Test and the Wechsler Visual Reproduction Test. Their test results
      were compared with those of nonpregnant childless women, third-trimester high
      risk pregnant women, and fathers of newborns. RESULTS: Postpartum women scored
      significantly lower than nonpregnant women on both tests on the first postpartum
      day. The use of intrapartum analgesia mitigated the cognitive deficit. High-risk
      pregnant women and fathers scored lower than nonpregnant women only on the
      Logical Memory Test. CONCLUSION: Objective documentation that postpartum women
      have transient deficits in cognitive function, particularly in memory function,
      can guide caretakers in the design of care plans for the postpartum lying-in
      period.

PMID- 8469470
TI  - Differences in postpartum weight retention between black and white mothers.
AB  - OBJECTIVE: To determine whether the overall retention of weight gained during
      pregnancy and the factors affecting postpartum weight retention differ by race.
      METHODS: Data from the 1988 National Maternal and Infant Health Survey were
      analyzed to examine postpartum weight retention of 20 lb or more among 990 black
      and 1129 white women who began pregnancy with normal weight for height. The
      impact of various maternal characteristics on both weight retention and the
      association between weight retention and race was tested by multivariate methods.
      RESULTS: Black mothers were twice as likely to retain at least 20 lb than white
      mothers (adjusted odds ratio 2.20, 95% confidence interval 1.50-3.22). This black
      white difference did not differ substantially by socioeconomic status. However,
      many factors affecting postpartum weight retention differed by maternal race. For
      example, whereas unmarried status was associated with weight retention among
      white mothers, high parity was associated with weight retention among black
      mothers. Low socioeconomic status and high prenatal weight gain were associated
      with an increased risk of weight retention for both black and white mothers.
      CONCLUSION: These data suggest that population-specific strategies may be needed
      to help mothers return to their pre-pregnancy weight.

PMID- 8469471
TI  - Fetal macrosomia and gestational diabetes: what's the problem?
AB  - OBJECTIVE: To review the definition of, morbidity attendant upon, and
      interventions designed to prevent fetal macrosomia in gestational diabetes. DATA
      SOURCES: Both MEDLINE and manual searches of the Index Medicus from 1980-1992 for
      articles pertaining to fetal macrosomia were employed. Macrosomia was also cross
      referenced with pregnancy in diabetes. METHODS OF STUDY SELECTION: Seventy-nine
      articles that provided definitions, data, and opinions relevant to this topic
      were selected. DATA EXTRACTION AND SYNTHESIS: There is no universally accepted
      definition of fetal macrosomia. Potential associated morbidities include birth
      trauma, neonatal hypoglycemia, and childhood and adolescent obesity. Maternal
      glucose intolerance, age, parity, race and ethnicity, weight, weight gain,
      smoking status, and fetal gender may influence birth weight. Not all of these
      factors have been considered in analyses of the impact of interventions designed
      to prevent macrosomia. CONCLUSIONS: A consensus definition of fetal macrosomia is
      a necessary and attainable goal. Randomized trials are necessary in which all
      factors that influence fetal growth and development are uniformly analyzed to
      develop appropriate clinical interventions.

PMID- 8469472
TI  - Cost of non-insulin-dependent diabetes in women with a history of gestational
      diabetes: implications for prevention.
AB  - Women with gestational diabetes have a 50% risk of developing non-insulin
      dependent diabetes mellitus within 10 years of delivery and thus constitute a
      well-defined target population for primary prevention. Current obstetric
      standards advocate universal screening of all pregnant women for gestational
      diabetes. Therefore, approximately half the reproductive-age United States
      population is screened for carbohydrate intolerance before the onset of overt
      disease. Continuation of dietary and behavioral changes initiated during
      pregnancy theoretically could delay or prevent progression to overt diabetes. We
      present an economic model of the health care dollars that could be saved by
      promoting postpartum life-style changes in women diagnosed with gestational
      diabetes. Assuming the incidence of diabetes could be reduced by 10, 25, or 50%
      in a national cohort of women with gestational diabetes, then 32, 140, or 331
      million health care dollars could be saved over 10 years.

PMID- 8469473
TI  - Detection of fetal cocaine exposure by analysis of amniotic fluid.
AB  - OBJECTIVE: To determine whether analysis of amniotic fluid (AF) using solid-phase
      extraction and high-performance liquid chromatography is useful in detecting
      fetal exposure to cocaine and its metabolites. METHODS: Amniotic fluid and urine
      samples were obtained from 23 subjects with documented cocaine abuse during
      pregnancy and five subjects without a history of cocaine abuse. Urine samples
      were also collected from all newborns. Urine samples were screened using
      conventional immunoassay techniques and confirmed with thin-layer chromatography.
      Using a modified solid-phase extraction procedure, we removed cocaine and its
      metabolites from all AF samples and from the newborn urine samples in which the
      initial screening was positive. Subsequently, we analyzed the extracts with high
      performance liquid chromatography. RESULTS: Cocaine or benzoylecgonine was
      detected in 74% of AF samples taken from the 23 known cocaine abusers. In these
      subjects, conventional maternal and neonatal urine toxicology screens were
      positive in 61 and 35%, respectively. Concentrations in AF ranged from 400 to
      greater than 5000 ng/mL for benzoylecgonine and from trace to 250 ng/mL for
      cocaine. Mean benzoylecgonine recovery from AF was significantly greater than
      from newborn urine (1800 versus 280 ng/mL, respectively; P < .0001). CONCLUSION:
      Analysis of AF appears to be useful in detecting gestational cocaine exposure.

PMID- 8469474
TI  - A new technique of uterine suspension to pectineal ligaments in the management of
      uterovaginal prolapse.
AB  - The incidence of uterovaginal prolapse in young women is high in developing
      countries. Preservation of the uterus is of prime importance in the surgical
      management of these patients. A new technique of uterine suspension to the
      pectineal ligaments is presented as an alternative to traditional procedures.
      Through a Cherney incision, the uterus is suspended to the pectineal ligaments on
      both sides with mersilene tape. A simultaneous Burch colposuspension can be
      useful in selected cases. The operation has been done in 20 women, who averaged
      27.5 years of age. There was no early or late morbidity during the follow-up
      period of 6-30 months. Of nine women desiring further childbearing, seven
      conceived within 6 months of surgery and thus far five have had an uneventful
      vaginal delivery at term; the other two have continuing normal gestations. There
      was no recurrence of prolapse at 6 weeks postpartum in any of the women.

PMID- 8469475
TI  - Diagnosis of pelvic inflammatory disease with 99mtechnetium
      hexamethylpropylenamine-oxime-labeled autologous leukocytes and pelvic
      radionuclide scintigraphy.
AB  - In a prospective study, we assessed the performance of pelvic radionuclide
      scintigraphy after the injection of 99mtechnetium-hexamethylpropylenamine-oxime
      labeled autologous leukocytes as a noninvasive tool for the differential
      diagnosis of pelvic inflammatory disease (PID). The results of radionuclide
      scintigraphy in 20 women with PID confirmed laparoscopically were compared with
      the findings in 20 others hospitalized for suspected PID but with PID ruled out
      later by laparoscopy. The proportion of radionuclide scintigraphic findings
      demonstrating increased uptake in the genital region, compatible with an
      inflammatory process, was significantly larger (P < .001) in patients with PID
      (95%) than in those without PID (15%). The sensitivity of the technique was 95%
      and specificity was 85%; in all, 90% of the patients were correctly classified.
      We conclude that radionuclide scintigraphy preceded by the injection of
      99mtechnetium-hexamethylpropylenamine-oxime-labeled autologous leukocytes can
      detect PID in a high proportion of patients.

PMID- 8469476
TI  - Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard
      vaginal hysterectomy in an outpatient setting.

PMID- 8469477
TI  - Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard
      vaginal hysterectomy in an outpatient setting.

PMID- 8469478
TI  - Myocardial infarction in the third trimester of pregnancy secondary to an aortic
      valve thrombus.
AB  - BACKGROUND: Myocardial infarction during pregnancy is rare, at an estimated one
      case per 10,000 women delivered. The overall mortality rate is 28% and is even
      higher in the second and third trimesters. We report a myocardial infarction
      secondary to a thrombus that developed on an artificial aortic valve in a 25-year
      old woman at 26 weeks' gestation. CASE: The patient, gravida 6, para 3-0-2-3,
      presented with an acute myocardial infarction despite antepartum anticoagulant
      therapy with heparin. During her hospitalization, she experienced a second
      ischemic event, preterm labor, and a small upper gastrointestinal hemorrhage.
      Nitroglycerin, sublingual nifedipine, and heparin were used to stabilize her
      cardiac problems, and her uterine contractions were inhibited with tocolytic
      agents. At 35 weeks' gestation, she underwent an uncomplicated vaginal delivery
      of a 2608-g viable male infant. CONCLUSION: Pregnancy complicated by myocardial
      infarction due to a valve thrombosis in the third trimester can be managed with
      careful attention to controlling the cardiac symptoms and preventing premature
      delivery.

PMID- 8469479
TI  - Fixed mini-dose warfarin for prophylaxis of thromboembolic disease in pregnancy:
      a safe alternative for the fetus?
AB  - BACKGROUND: Fixed mini-dose warfarin has been used for thromboprophylaxis in high
      risk nonpregnant patients with encouraging results. The usefulness of this
      strategy in pregnant women requires documentation of fetal safety. CASE: A woman
      with antithrombin III deficiency suffered a venous thrombosis during early
      pregnancy and could not be successfully managed long term with heparin. One
      milligram of warfarin daily was used for prophylaxis, and serial fetal blood
      samples were used to monitor the fetal coagulation status. No apparent
      coagulation abnormalities were demonstrated in the fetus at 33, 36, and 38 weeks'
      gestation. The woman suffered no further thromboses throughout the remainder of
      her pregnancy and puerperium. CONCLUSIONS: The efficacy of fixed mini-dose
      warfarin for prophylaxis in pregnancies at risk for thromboembolic disease will
      require further investigation. This fetus did not appear vulnerable to
      coagulation abnormalities as a consequence of the warfarin regimen.

PMID- 8469480
TI  - Pregnancy complicated by Gorham disease.
AB  - BACKGROUND: A pregnancy with Gorham disease (massive osteolysis syndrome) is
      described. To our knowledge, this is the first reported case of a pregnancy
      associated with this disease. CASE: A 25-year-old woman was seen for pre
      conception counseling with the diagnosis of Gorham disease. Before pregnancy,
      magnetic resonance imaging confirmed a stable disease process. The woman and
      fetus were followed during pregnancy with ultrasound and consultations. Severe
      preeclampsia developed at delivery, with a significant thrombocytopenia. We
      delivered the infant by low forceps, with a good outcome. Subsequently, the
      mother and child were doing well at 18 months postpartum. CONCLUSION: We briefly
      review this rare bone disease as it relates to pregnancy and provide information
      for preconception counseling.

PMID- 8469481
TI  - Acanthosis nigricans and hyperandrogenism in a pregnancy complicated by diabetes.
AB  - BACKGROUND: Acanthosis nigricans and hyperandrogenism have been associated with
      diabetes mellitus accompanied by insulin resistance. However, these
      manifestations have rarely been reported to occur as a result of the insulin
      resistance of pregnancy. CASE: A 31-year-old woman with diabetes mellitus
      exhibited severe insulin resistance during pregnancy. At 32 weeks, daily
      administration of 500 U insulin was required to maintain glycemic control. Skin
      lesions typical of acanthosis nigricans appeared, and free testosterone levels
      were elevated (10.3 pg/mL). These manifestations resolved after delivery.
      CONCLUSION: This case may demonstrate a correlation between reversible
      gestational insulin resistance and acanthosis nigricans.

PMID- 8469482
TI  - Symptomatic liver hemangioma with intra-tumor hemorrhage treated by angiography
      and embolization during pregnancy.
AB  - BACKGROUND: Cavernous hemangiomas are the most common benign tumors of the liver
      and are found in about 2% of autopsy patients. The vast majority are small (less
      than 4 cm) and asymptomatic, but there have been a few reported cases of these
      lesions leading to severe pain and even spontaneous fatal hemorrhage. Estrogen
      may cause the growth of liver hemangiomas, but there is a paucity of information
      concerning the effect of pregnancy upon these lesions. CASE: A patient presented
      at 18 weeks' gestation with the acute onset of vomiting and epigastric pain. A
      right upper-quadrant ultrasound scan found a 9-cm hypodense lesion within the
      liver, and magnetic resonance imaging (MRI) suggested a hemangioma. The lesion
      was believed to be inoperable, and selective catheterization of the common
      hepatic artery was performed. An angiogram demonstrated a round vascular mass 12
      cm in diameter occupying much of the left side of the liver, with the vascular
      supply from the middle hepatic artery and to a lesser extent from the left
      hepatic artery. Embolization was performed, and a post-embolization image
      demonstrated satisfactory occlusion of the vessels treated. The patient's
      epigastric pain resolved after the procedure. The lesion was observed with
      monthly ultrasound and regressed to about 50% of its original size. The patient
      was scheduled for an elective primary cesarean delivery at 39 weeks to avoid
      possible rupture of the hepatic hemangioma during the second stage of labor. Her
      cesarean and postpartum course were uncomplicated. CONCLUSION: A symptomatic
      liver hemangioma with intratumor hemorrhage can be successfully treated with
      embolization during pregnancy. Because of the paucity of reported cases, it is
      uncertain whether vaginal birth is contraindicated in these patients.

PMID- 8469483
TI  - Intestinal malrotation during pregnancy.
AB  - BACKGROUND: Malrotation of the intestine is an uncommon anomaly most often seen
      in infants, but occasionally in adults. Rarely, symptoms from malrotation may
      occur during pregnancy. CASE: A 30-year-old woman, with a long history of
      abdominal pain and constipation, developed more frequent and severe symptoms in
      the second trimester of pregnancy. She was monitored closely and treated
      conservatively and went on to deliver a full-term, healthy infant. In the
      postpartum period, barium radiographs demonstrated a midgut malrotation. During
      exploratory laparotomy, obstructive peritoneal bands were noted and were
      transected. The mobile cecum and ascending colon were fixated to the abdominal
      wall. CONCLUSION: Symptoms from a malrotation may develop during pregnancy and
      may be nonspecific and vague. Although complications from malrotation can be life
      threatening, a conservative approach with surgical intervention in the postpartum
      period may be appropriate in the proper clinical setting.

PMID- 8469484
TI  - Acute fatty liver of pregnancy in a patient with chronic active hepatitis and
      associated hepatocyte alpha 1-antitrypsin inclusions.
AB  - BACKGROUND: Acute fatty liver of pregnancy is a rare, potentially fatal condition
      that shares many of the signs and symptoms of severe preeclampsia. Early reports
      of this condition noted alarmingly high fetal and maternal mortality rates.
      However, recent reports have described more favorable outcomes due to prompt
      recognition and aggressive treatment. We here describe a patient with acute fatty
      liver of pregnancy superimposed on chronic active hepatitis. CASE: A 27-year-old
      woman, para 0-1-2-1, presented at 36 weeks' gestation with a 2-week history of
      malaise, nausea, emesis, diarrhea, and an 18-lb weight loss. The serum
      concentrations of transaminase enzymes, bilirubin, and alkaline phosphatase were
      increased, and a mild coagulopathy was present. The patient underwent repeat
      cesarean delivery and intraoperative needle biopsy of the liver. Histologic
      examination of the biopsy demonstrated the characteristic changes of acute fatty
      liver of pregnancy and chronic active hepatitis with associated alpha 1
      antitrypsin hepatocyte inclusions. The serum alpha 1-antitrypsin level was mildly
      elevated and the phenotype was normal (PiMM), excluding alpha 1-antitrypsin
      deficiency. Viral and autoimmune etiologies for chronic hepatitis were excluded
      by laboratory studies. The woman experienced rapid resolution of symptoms and
      laboratory abnormalities in the immediate postoperative period. CONCLUSION: Acute
      fatty liver of pregnancy may occur in patients with underlying chronic liver
      disease. Prompt delivery is necessary to reduce the risk of fetal and maternal
      mortality.

PMID- 8469485
TI  - Reversible hypertension in pregnancy caused by obstructive uropathy.
AB  - BACKGROUND: Hypertension with deterioration of renal function after mid-pregnancy
      often signifies preeclampsia and the need for delivery. CASES: We have
      encountered three women with reversible hypertension related to obstructive
      uropathy. The women presented between 21-30 weeks' gestation with hypertension
      accompanied by significantly increased serum creatinine. Although pregnancy
      induced hypertension was considered initially in all, there was no other evidence
      of preeclampsia. In all three, ureteral obstruction was confirmed
      radiographically and found to be associated with uterine overdistention or
      congenital urinary anomalies. Relief of obstruction by ureteral stent placement
      or percutaneous nephrostomy was followed by diuresis and resolution of
      hypertension. In all three women, pregnancy was extended by more than 6 weeks.
      CONCLUSION: Urinary obstruction is a rare but potentially reversible cause of
      hypertension in pregnancy. Relief of obstruction may lead to normalization of
      blood pressure and negate the need for immediate delivery.

PMID- 8469486
TI  - Cavernous hemangioma of the uterus in a pregnant woman.
AB  - BACKGROUND: Cavernous hemangioma of the uterus is a rare but serious condition,
      especially during pregnancy. Most reported cases ended with hysterectomy in an
      attempt to control profuse bleeding, and only one of four resulted in a live
      birth. We describe the sonographic differential diagnosis of this condition and
      propose management of these patients. CASE: Cavernous hemangioma of the uterus
      was diagnosed sonographically at 33 weeks' gestation. Conservative management
      resulted in a favorable outcome for both mother and child. CONCLUSION: Ultrasound
      is helpful in the prenatal diagnosis of cavernous hemangioma of the uterus;
      however, other uterine or placental abnormalities with similar sonographic
      appearances should be considered in the differential diagnosis.

PMID- 8469487
TI  - Third-trimester uterine rupture following hysteroscopic uterine perforation.
AB  - BACKGROUND: As operative hysteroscopy becomes more common, long-term
      complications become apparent. CASE: A 29-year-old woman had a hysteroscopic
      uterine septum resection. This was complicated by a small fundal puncture. In the
      ensuing pregnancy, uterine rupture occurred at 33 weeks and resulted in neonatal
      mortality and maternal morbidity. CONCLUSION: Uterine rupture may follow uterine
      perforation at operative hysteroscopy; patients contemplating pregnancy after
      such perforation warrant appropriate counseling.

PMID- 8469488
TI  - Conservative surgical management of placental implantation site hemorrhage.
AB  - BACKGROUND: Our purpose is to show that a simple, conservative, fertility
      preserving surgical technique can be used to control postpartum hemorrhage from a
      hypotonic placental implantation site. CASE: Postpartum hemorrhage from a
      hypotonic placental implantation site at cesarean delivery was treated with
      surgical excision of the hypotonic segment, resulting in immediate cessation of
      the bleeding when other measures had failed. The patient's postoperative course
      was uneventful. The uterus and adjacent vascular structures were evaluated with
      magnetic resonance imaging studies at 4 weeks postpartum and were free of
      abnormality. CONCLUSION: Simple excision of a hypotonic bleeding site may be
      desirable and practical when fertility preservation is desired.

PMID- 8469489
TI  - Use of the peripherally inserted central catheter for parenteral nutrition during
      pregnancy.
AB  - BACKGROUND: Parenteral nutrition is required during pregnancy to treat
      hyperemesis gravidarum and other conditions in which enteral intake is
      inadequate. We describe the peripherally inserted central catheter. The catheter
      is inserted into the antecubital vein using local analgesia, thus eliminating
      some of the risks associated with obtaining central venous access. CASE: Three
      pregnant patients required parenteral nutrition for refractory hyperemesis
      gravidarum. The peripherally inserted central catheter was successfully placed,
      and central venous administration of hyperosmolar solutions was accomplished
      without complication for periods of 28-137 days. Maternal weight gain and fetal
      growth were adequate. CONCLUSIONS: The peripherally inserted central catheter
      avoids some of the risks related to obtaining central venous access and permits
      long-term administration of parenteral nutrition into the central venous
      circulation.

PMID- 8469490
TI  - Successful delivery after age 50: a report of two cases as a result of oocyte
      donation.
AB  - BACKGROUND: Because of donor oocyte programs, women who previously were
      considered too old to successfully achieve conception and delivery can now bear
      children. To our knowledge, there have been no previous reports of pregnancy
      outcome in women over age 50 who conceived using donor oocytes. This study
      presents the pregnancy and delivery data on two women who delivered at age 52.
      CASES: Case 1 was a 51-year-old woman, gravida 3, para 3, whose three children
      had been conceived with her first husband more than 20 years previously. She had
      remarried 18 years before presentation and had been actively trying to conceive
      for the last 7 years. She was diagnosed as being in menopause based on elevated
      gonadotropins, amenorrhea, and failure to have progesterone-withdrawal menses.
      She conceived on her first embryo transfer cycle with embryos derived from donor
      oocytes and fertilized by her husband's sperm (oocytes were donated by a woman
      who was undergoing retrieval for in vitro fertilization). During pregnancy she
      remained healthy, but had uterine prolapse at 20 weeks. She delivered a normal
      healthy male at 40.5 weeks; cesarean was performed because of a presumptive
      diagnosis of fetal distress after 3 hours of labor, when monitoring revealed
      fetal heart decelerations. Case 2 was also a 51-year-old woman, gravida 6, para
      4, who wished to conceive with her second husband's sperm through the donor
      oocyte program. She had amenorrhea of 2 years' duration and elevated
      gonadotropins. Conception occurred after fertilization of a donor oocyte by her
      husband's sperm. She had an uneventful pregnancy, but labor was induced at 38
      weeks' gestation given the supposed high-risk status of this age group. Apgar
      scores were 8 and 9 at 1 and 5 minutes, respectively. CONCLUSION: Theoretically,
      the risks of pregnancy complications in older patients are magnified given the
      aging maternal cardiovascular system, which may predispose these women to
      placental insufficiency. These first two cases of donor oocyte pregnancies in
      women over age 50 found no maternal or fetal age-related complications. We hope
      these reports will encourage all researchers to share their findings so that
      prospective patients can make better, more informed decisions as to whether they
      want to participate in donor oocyte programs.

PMID- 8469491
TI  - Diagnosis and successful treatment of fetal goitrous hyperthyroidism caused by
      maternal Graves disease.
AB  - BACKGROUND: Intrauterine diagnosis and treatment of fetal goitrous
      hyperthyroidism due to maternal Graves disease has not been reported. CASE: A
      case of fetal goitrous hyperthyroidism caused by maternal Graves disease was
      diagnosed and treated in the second trimester. High concentrations of both
      thyroid-stimulatory immunoglobulins (Igs) and thyrotropin-binding inhibitory Igs
      were detected in both maternal and fetal umbilical venous blood. Maternal
      propylthiouracil (PTU) treatment resulted in normalization of fetal thyroid
      function and a decrease in the size of the fetal thyroid goiter. Although
      euthyroid immediately after birth, the infant later became hyperthyroid and
      required treatment with PTU. CONCLUSION: The relatively high frequency of fetal
      thyroid disorders in maternal Graves disease warrants complete maternal and fetal
      evaluation. Fetal diagnosis and treatment of either hyperthyroidism or
      hypothyroidism are feasible and necessary to prevent fetal morbidity and
      mortality.

PMID- 8469492
TI  - Prenatal diagnosis of congenital lipoid adrenal hyperplasia.
AB  - BACKGROUND: There are no published reports of prenatal diagnosis of congenital
      lipoid adrenal hyperplasia, which is the rarest form of congenital adrenal
      hyperplasia. CASE: Congenital lipoid adrenal hyperplasia was diagnosed prenatally
      based on the existence of one affected sibling in the family, the presence of an
      amniotic fluid cell karyotype of 46,XY, the appearance of normal female genitalia
      on ultrasonography, relatively low amniotic fluid concentration of 17 alpha
      hydroxyprogesterone, low maternal plasma and urinary concentrations of estriol,
      and a positive response to the dehydroepiandrosterone sulfate loading test.
      CONCLUSION: Congenital lipoid adrenal hyperplasia can be diagnosed prenatally.
      Treatment in early infancy can lead to normal mental and physical development.

PMID- 8469493
TI  - Congenital ichthyosis with restrictive dermopathy and Gaucher disease: a new
      syndrome with associated prenatal diagnostic and pathology findings.
AB  - BACKGROUND: Since 1988, three nonrelated fatal cases of congenital ichthyosis
      associated with Gaucher disease have been described in Australia. CASE: We
      present a case of Gaucher disease with congenital ichthyosis and restrictive
      dermopathy and describe the associated prenatal sonographic findings and
      pathology of this new syndrome. CONCLUSION: The unusual association of congenital
      ichthyosis with lipid storage disease may be suspected prenatally. A high index
      of suspicion may prove this condition to be more common than previously thought.

PMID- 8469494
TI  - Prenatal diagnosis and obstetric management of Larsen syndrome.
AB  - BACKGROUND: Larsen syndrome is a disease of generalized defect in collagen
      formation including multiple disorders of the joints and cardiac anomalies. A
      review of the literature revealed no previous reported cases in pregnancy. CASE:
      A 29-year-old woman with known Larsen syndrome thought to be of the autosomal
      recessive type presented in pregnancy; second-trimester ultrasound suggested
      fetal involvement with Larsen syndrome. The patient was followed with serial
      ultrasounds, and she had pediatric and anesthesiologic consultations. She was
      delivered by cesarean of a female infant whose neck was immediately stabilized.
      The infant was then taken to the neonatal intensive care unit, where a diagnosis
      of Larsen syndrome was confirmed. CONCLUSIONS: Larsen syndrome, which may be
      diagnosed prenatally, is a rare and unique condition that requires
      multidisciplinary care. Obstetric management must take into account the increased
      anesthetic and surgical risks to the mother and the risk of fetal injury
      including cervical spine instability. The genetics of Larsen syndrome are also
      discussed.

PMID- 8469495
TI  - Antenatal sonographic findings associated with unilateral pulmonary agenesis.
AB  - BACKGROUND: Unilateral pulmonary agenesis is a rare anomaly that has a relatively
      frequent association with other congenital malformations. Prognosis depends in
      part upon associated anomalies and whether the right or left lung is involved.
      The prenatal sonographic findings of this defect share some similarities with
      those of other intrathoracic lesions or congenital diaphragmatic hernia. CASE:
      Our patient had a twin gestation complicated by early discordant growth and
      hydramnios. The smaller fetus had cardiac dextroposition, abnormally echogenic
      left lung tissue, and a flattened but clearly visible left hemidiaphragm. No
      abdominal viscera were seen in the thoracic cavity. Postnatally, this infant was
      found to have agenesis of the right lung, a tracheoesophageal fistula, and
      pyloric stenosis. CONCLUSION: The diagnosis of unilateral pulmonary agenesis
      should be considered in a fetus with the sonographic findings of a shift of the
      mediastinal structures, echogenic lungs, and an intact diaphragm.

PMID- 8469496
TI  - Color flow mapping and Doppler velocimetry in the diagnosis and management of a
      placental chorioangioma associated with nonimmune fetal hydrops.
AB  - BACKGROUND: Placental chorioangiomas are the most common tumors of the placenta,
      occurring in 1% of all pregnancies. With the increasing use of ultrasound,
      prenatal recognition of these tumors is becoming more common. CASE: A 36-year-old
      woman presented at 28 weeks' gestation with an intrauterine mass suggested by
      color flow and Doppler studies to be a vascular tumor. Because of the association
      of these findings to nonimmune fetal hydrops, management included umbilical blood
      sampling and intravascular transfusion for fetal anemia. This intervention
      temporarily corrected the hydrops and significantly prolonged the pregnancy.
      CONCLUSION: Color flow mapping and Doppler flow studies of intrauterine tumors
      associated with fetal nonimmune hydrops can be helpful in both diagnosis and
      management.

PMID- 8469497
TI  - Metastatic placental lymphoma associated with maternal human immunodeficiency
      virus infection.
AB  - BACKGROUND: Pregnancy complicated by maternal human immunodeficiency virus (HIV)
      infection is increasing in frequency. This report describes a maternal malignancy
      associated with HIV infection that may complicate pregnancy. CASE: A 33-year-old
      primigravida was delivered by cesarean. Histologic examination of the placenta
      revealed the presence of metastatic non-Hodgkin lymphoma of B-cell origin. The
      patient was then found to be infected with HIV. Nine months postpartum, she was
      diagnosed with immunoblastic lymphoma. She is currently undergoing chemotherapy.
      CONCLUSION: Non-Hodgkin lymphoma of B-cell origin is an indication of AIDS.
      Pregnancies associated with maternal HIV infection may be complicated by this
      malignancy, which may metastasize to the products of conception. Careful
      examination of the placenta can detect metastases in women with non-Hodgkin B
      cell lymphoma.

PMID- 8469498
TI  - Pregnancy complicated by medulloblastoma with metastases to the placenta.
AB  - BACKGROUND: Maternal malignancy may complicate as many as one in 1000
      pregnancies. Rarely, the tumor may metastasize to the products of conception. We
      here describe a case of medulloblastoma metastatic to the placenta. CASE: A 21
      year-old woman who had previously undergone resection of a posterior fossa
      medulloblastoma was admitted at 20 weeks' gestation complaining of low back pain.
      Investigation revealed medulloblastoma metastatic to the bone marrow. The
      pregnancy was prolonged to 29 weeks' gestation, at which time she was delivered
      by cesarean. The postoperative course was complicated by coagulopathy, massive
      bleeding, and pneumonia leading to death. Autopsy showed medulloblastoma
      metastatic to the bone marrow and placenta. CONCLUSION: Primary intracranial
      neoplasms may metastasize to the products of conception. The dramatic course of
      the disease in this patient may suggest that medulloblastoma is responsive to
      hormonal therapy.

PMID- 8469499
TI  - Vulvar vestibulitis and interstitial cystitis: a disorder of urogenital sinus
      derived epithelium?
AB  - BACKGROUND: Vulvar vestibulitis and interstitial cystitis are enigmatic and
      controversial conditions. They are increasingly recognized as important causes of
      genitourinary pain in young women. This report proposes an etiologic association
      between the two conditions. CASES: We report three patients with both vulvar
      vestibulitis and interstitial cystitis. Although an association between these
      conditions has previously been proposed, these are the first case reports of the
      coexistence of these conditions in the same patient. CONCLUSION: Because both the
      vestibule of the vulva and the bladder are derived from the urogenital sinus, we
      propose that the coexistence of vulvar vestibulitis and interstitial cystitis in
      some patients represents a generalized disorder of urogenital sinus-derived
      epithelium.

PMID- 8469500
TI  - Nonfluorescent erythrasma of the vulva.
AB  - BACKGROUND: Erythrasma is an uncommon vulvar infection, best diagnosed by its
      fluorescence under the Wood lamp. This report shows that despite a negative Wood
      lamp examination, the diagnosis can be made histologically. CASE: A 42-year-old
      woman was referred to our clinic with a persistent candidal infection. Evaluation
      included a Wood lamp examination, wet mount, and potassium hydroxide test of the
      affected skin, all of which were negative. A biopsy of the area demonstrated rods
      and filamentous organisms in the keratotic layer consistent with a
      Corynebacterium minutissimum infection. The patient was diagnosed as having
      erythrasma, and she responded to oral erythromycin. CONCLUSION: Persistent vulvar
      diseases may be caused by erythrasma despite a negative Wood lamp examination.
      The diagnosis can be made by biopsy of the lesion.

PMID- 8469501
TI  - Vaginal telangiectasias: unusual presentation of the Osler-Weber-Rendu syndrome.
AB  - BACKGROUND: The Osler-Weber-Rendu syndrome (hereditary hemorrhagic
      telangiectasia) is an autosomal dominant disorder of blood vessels associated
      with mucocutaneous telangiectasis and arteriovenous malformations of internal
      organs. CASE: A 23-year-old woman was found on routine gynecologic examination to
      have asymptomatic vaginal telangiectasias, a previously unreported initial site
      of involvement in this syndrome. CONCLUSION: The finding of asymptomatic vaginal
      telangiectasias on routine pelvic examination should alert the clinician to the
      possibility of the Osler-Weber-Rendu syndrome.

PMID- 8469502
TI  - Cryptococcal infection of the vagina.
AB  - BACKGROUND: Cryptococcal infection is opportunistic and occurs most commonly in
      immunocompromised patients. Meningitis is the most frequent manifestation and
      causes marked morbidity and mortality. Other sites are less common. We report a
      case of vaginal cryptococcal infection. CASE: A 72-year-old patient who had
      undergone resection of the colon for cancer 9 years earlier was noted to have a
      suspicious lesion on the right vaginal wall after an abnormal Papanicolaou test.
      Biopsy of the lesion showed findings compatible with cryptococcal infection.
      Serial examinations revealed no evidence of systemic infection or
      immunocompromised condition. Empirical treatment was tried with fluconazole.
      Follow-up colposcopy showed almost complete disappearance of the vaginal lesion,
      and histologic section and culture of the tissue failed to reveal cryptococcus.
      CONCLUSION: Cryptococcal infection is rare, especially in a patient with no
      evidence of an immunocompromised condition. The preliminary result of fluconazole
      treatment was satisfactory. However, further follow-up and evaluation are needed
      to confirm the effectiveness of fluconazole in our patient.

PMID- 8469503
TI  - Topical sucralfate in the treatment of vaginal ulceration.
AB  - BACKGROUND: Non-neoplastic vaginal ulceration is at times recalcitrant to
      traditional methods of treatment. Sucralfate, a basic aluminum salt of sucrose
      octasulfate, binds preferentially to ulcerated areas and promotes healing, an
      effect that does not appear to be acid-dependent. CASE: Three cases of vaginal
      ulceration were treated with vaginal douches of sucralfate 10% suspension twice
      daily. One of the cases was due to laser ablation for intraepithelial neoplasia,
      one was of uncertain etiology, and one was caused by pessary use. CONCLUSION:
      After failure of the initial therapeutic regimens, sucralfate treatment was
      successful in all three cases and was well tolerated without side effects.
      Sucralfate vaginal douches should be considered for the treatment of non
      neoplastic vaginal ulcerations, particularly when other therapy has failed.

PMID- 8469504
TI  - Neovaginal reconstruction with a rectus abdominis myocutaneous flap.
AB  - BACKGROUND: Neovaginal reconstruction after pelvic exenteration has several
      advantages. Besides the obvious psychosocial benefit to the patient and her
      partner, the incorporation of viable tissue into the pelvic cavity decreases the
      incidence of infection and small-bowel complications. Several surgical techniques
      are available to the gynecologic oncologist for construction of a functional
      vagina. Recently, myocutaneous flaps incorporating the rectus abdominis and
      gracilis muscles have been used. Disadvantages of the gracilis myocutaneous flap
      are the 10-20% incidence of flap loss due to vascular compromise and the
      potential for prolapse. The rectus abdominis myocutaneous flap is a large flap
      with a reliable blood supply that allows mobilization without tension on the
      vascular pedicle, resulting in a much lower incidence of vascular compromise.
      CASE: We present two case reports, a review of the gynecologic and surgical
      literature, and the techniques for vaginal reconstruction using the rectus muscle
      as a myocutaneous flap. CONCLUSIONS: The outcome for both patients was a
      satisfactory functional vagina that was technically easy to construct. The rectus
      abdominis myocutaneous flap can provide an adequate neovagina with minimal
      morbidity.

PMID- 8469505
TI  - Salpingitis or oophoritis: what causes fever following oocyte aspiration and
      embryo transfer?
AB  - BACKGROUND: Febrile morbidity following in vitro fertilization and embryo
      transfer (IVF-ET) is a rare but possibly serious complication. This report
      describes a case of salpingitis after IVF-ET and discusses the possible reasons
      for febrile morbidity following this common procedure. CASE: A 37-year-old woman
      undergoing IVF-ET for tubal factor infertility developed sudden, severe pelvic
      pain, fever, and leukocytosis 24 hours after ET. Laparoscopy revealed bilateral
      suppurative pyosalpinges with cystic, hemorrhagic ovaries. Pain, fever, and
      leukocytosis resolved with conservative surgery and intravenous antibiotic
      therapy. CONCLUSIONS: This case presents laparoscopic documentation of a rare
      complication of oocyte aspiration and/or ET, namely, salpingitis. Possibilities
      for the development of salpingitis following IVF-ET include activation of
      quiescent bacteria within the fallopian tubes from a previous pelvic infection,
      puncture of the bowel during oocyte aspiration, inoculation of the pelvis with
      cervicovaginal flora during oocyte aspiration, and introduction of bacteria-laden
      secretions or air into the fallopian tubes during ET. Although rare, the
      possibility of severe pelvic infection following IVF-ET warrants consideration of
      prophylactic antibiotic coverage.

PMID- 8469506
TI  - Tubal pregnancy associated with ampullary tubal leiomyoma.
AB  - BACKGROUND: Fewer than 100 cases of leiomyoma of the fallopian tube have been
      described in the literature; most of them are asymptomatic. CASE: A woman
      presented with a tubal pregnancy which, at laparotomy, proved to be distal to a
      leiomyoma of the tube. CONCLUSION: Tubal myomas may predispose to tubal
      implantation of a conceptus. To our knowledge, this is the first time a tubal
      leiomyoma and a tubal pregnancy have been reported in the English literature.

PMID- 8469507
TI  - Laparoscopic segmental bladder resection for endometriosis: a report of two
      cases.
AB  - BACKGROUND: The proper treatment of bladder endometriosis is unknown. CASE: Two
      women with endometriosis involving the full thickness of the bladder wall
      experienced persistent hematuria during menstruation. They had not responded to
      previous conservative medical or surgical therapy, so we performed laparoscopic
      segmental resection, with satisfactory results. CONCLUSION: Hematuria during
      menstruation due to endometriosis of the bladder is uncommon. In the two cases
      presented, good results followed laparoscopic segmental resection.

PMID- 8469508
TI  - Spontaneous vaginal expulsion of Hulka clips.
AB  - BACKGROUND: Laparoscopic Hulka clip application is a common method of outpatient
      sterilization in women. We present a patient who experienced spontaneous
      expulsion of two Hulka clips. CASE: A 21-year-old woman was seen 17 months after
      sterilization because of spontaneous, asymptomatic passage of two Hulka clips
      into the vagina. The passage of one clip went unnoticed by the patient.
      Radiographic studies confirmed the migration and absence of two Hulka clips
      previously placed on the left fallopian tube. CONCLUSION: In rare circumstances,
      Hulka clips can migrate from the abdominal cavity and be expelled spontaneously,
      possibly by transuterine passage. This migration may occur without the patient's
      knowledge.

PMID- 8469509
TI  - Familial peripartum cardiomyopathy after molar pregnancy.
AB  - BACKGROUND: The potential complications of molar pregnancy are numerous and well
      defined, but associated peripartum cardiomyopathy has not been reported. CASE: A
      16-year-old primigravida with a family history of peripartum cardiomyopathy
      requiring cardiac transplantation underwent suction curettage of a complete mole
      at 12 weeks' gestation. Three months after evacuation, she developed congestive
      heart failure. Radionuclide ventriculography demonstrated an ejection fraction of
      30%, echocardiography revealed enlargement and ventricular hypokinesis, and a
      myocardial biopsy specimen contained hypertrophy and fibrosis without necrosis or
      active inflammation. The patient improved with medical therapy. CONCLUSION:
      Peripartum cardiomyopathy is a potential complication of molar pregnancy. In
      spite of the poor prognosis sometimes reported for this disease, good functional
      outcome may follow.

PMID- 8469510
TI  - Recurrent pancreatitis associated with in vitro fertilization.
AB  - BACKGROUND: We report the possible association between in vitro fertilization
      (IVF) and recurrent acute pancreatitis. CASE: A patient developed acute
      pancreatitis during each of two cycles of IVF. On a spontaneous cycle, serum
      triglycerides were as follows: early follicular phase 2.34 mmol/L, mid-follicular
      phase 4.17 mmol/L, and late follicular phase 6.6 mmol/L. During an episode of
      acute pancreatitis, the serum triglyceride level was 38.45 mmol/L. CONCLUSION:
      Acute pancreatitis may occur in patients with a family or personal history of
      hypertriglyceridemia who are candidates for IVF.

PMID- 8469511
TI  - Endodermal sinus tumor of the vagina: radiation therapy and progeny.
AB  - BACKGROUND: Extraovarian endodermal sinus tumor generally originates in the
      vagina or cervix of young girls. Some 50 cases are known, all younger than 3
      years of age. Many were treated with outdated regimens, and there are 5-year
      survival data on only nine of them. We describe a curative outcome of primary
      radiation only. CASE: A 40-year-old woman had a history of localized endodermal
      sinus tumor of the vagina, stage I, treated by brachytherapy at the age of 6
      months. Radiation had a severe impact upon the later functioning of her pelvic
      organs, with marked deformity of the pelvic floor, vagina, urethra, and bones of
      the pelvic outlet. She conceived by homologous insemination at the age of 34.
      Delivery was by cesarean at 31.5 weeks' gestation. CONCLUSION: Current forms of
      management give preference to limited excisional surgery and multi-agent
      chemotherapy, analogous to that used for the treatment of endodermal sinus tumor
      of the ovary. This is the first report of a patient treated by radium needles and
      the only known patient who had a subsequent pregnancy.

PMID- 8469512
TI  - Development of vaginal adenosis following combined 5-fluorouracil and carbon
      dioxide laser treatments for diffuse vaginal condylomatosis.
AB  - BACKGROUND: The management of vaginal human papillomavirus (HPV) lesions may be
      difficult. We report an unusual long-term consequence of treatment. CASE: A 40
      year-old woman presented with vaginal adenosis following treatment of multiple
      vaginal condylomata by endovaginal applications of 5% 5-fluorouracil cream and
      vaporization of the remaining subclinical condylomata by CO2 laser. CONCLUSION:
      The approach to the management of vaginal condylomatosis should take into
      consideration the possible later occurrence of adenosis.

PMID- 8469513
TI  - Agency for health care policy and research: clinical practice guidelines endorsed
      by ANA.

PMID- 8469514
TI  - AHCPR guideline: pain management.

PMID- 8469515
TI  - HIV client education--what is your role?

PMID- 8469516
TI  - Karen's delivery--graceful and natural.

PMID- 8469517
TI  - Lipid droplet accumulation in the exocrine glands of the newborn rat.
AB  - Exocrine glands including the submandibular gland, sublingual gland, exocrine
      pancreas and exorbital lacrimal gland of newborn rats aged 0 to 14 days were
      examined morphologically, and the following results on the accumulation of lipid
      droplets were obtained. Lipid droplets tended to localize in secretory cells,
      especially in their basal cytoplasm. The degree of lipid droplet accumulation
      varied with the type of exocrine gland. There were large accumulations in the
      sublingual gland, submandibular gland, and exocrine pancreas, but accumulations
      were small in the exorbital lacrimal gland. No difference in lipid droplet
      accumulation was recognized between the 2 types of secretory cells in the
      sublingual gland. The accumulation of lipid droplets peaked 24-48 hours after
      birth in the sublingual gland, submandibular gland and exocrine pancreas, but
      this peak was not clearly observed in the exorbital lacrimal gland. In the group
      of newborn rats separated from their mothers and therefore not suckled, no lipid
      droplets were observed in any gland, suggesting a close relationship between
      lipid droplet accumulation and suckling.

PMID- 8469518
TI  - Arterial supply of the maxillary teeth in the crab-eating monkey (Macaca
      fascicularis).
AB  - Superior dental rami diverging from arterial multi-resources of the crab-eating
      monkey were investigated by means of plastic corrosion castings. Correlations
      between the dental ramus/rami entering the apical foramen/foramina of each
      maxillary tooth were elucidated. Superior dental rami supplying the maxillary
      teeth diverged from the posterior superior alveolar, infraorbital, descending
      palatine, major palatine and sphenopalatine arteries as follows: The posterior
      superior alveolar gave rise to molar branches which supplied three molars and
      rarely an additional two premolars, to premolar branches and to a canine branch
      as its terminus. The infraorbital gave off canine branches. The descending
      palatine gave rise to a molar branch which supplied the lingual root of each
      molar. The major palatine gave rise to a premolar branch which supplied the
      lingual roots of two premolars and the 1st molar, and an incisive branch which
      supplied two incisors. The sphenopalatine supplied the lingual root of each molar
      and rarely the 1st premolar in addition. Two incisors were supplied by the major
      palatine (100%), the canine by the posterior superior alveolar (50%), this artery
      and the infraorbital (43.3%) or the infraorbital only (6.7%). Three roots of each
      premolar were supplied by the posterior superior alveolar, occasionally the
      lingual root (16.7%) and mesiobuccal root (3.3%) of the 1st premolar by the major
      palatine, the lingual root of the 2nd premolar by the major palatine (6.7%) and
      the sphenopalatine (3.3%). Two buccal roots of each molar were also supplied by
      the posterior superior alveolar (100%), occasionally the lingual root of the 1st
      molar by the descending palatine (6.7%), the major palatine (6.7%) or the
      sphenopalatine (3.3%), the lingual root of the 2nd molar by the descending
      palatine (30%), the sphenopalatine (10.0%) or the infraorbital (3.3%), the
      lingual root of the 3rd molar by the descending palatine (23.3%), the
      sphenopalatine (20.0%) or the infraorbital (3.3%). Superior dental rami diverging
      from the posterior superior alveolar artery were distributed to the molars,
      premolars and canine as principal arterial vessels of the crab-eating monkey. The
      descending palatine, sphenopalatine and the infraorbital arteries were
      supplementary to the above main arteries. Two incisors were only supplied by the
      major palatine but the anterior and middle superior alveolar were not observed.

PMID- 8469519
TI  - Correlative light and electron microscopy of the same sections embedded in HPMA,
      Quetol 523 and MMA.
AB  - Semithin sections, cut from tissues stained with acid and basic dyes after
      embedding in 2-hydroxypropyl methacrylate, Quetol 523 and methyl methacrylate,
      showed cytoplasmic components at a high resolution by light microscopy. These
      same sections could then be viewed, after osmium tetroxide, uranyl and lead
      staining, by the electron microscope. These sections had a number of inherent
      advantages: they could be observed with a light microscope; they facilitated
      analysis of cellular structures in the identical sites, and they were frequently
      the optimum thickness to provide three-dimensional information. We clearly
      established the structural detail of this same-section correlative light-electron
      microscopy approach by showing that the coloured materials observed in such
      sections of cells followed the distribution of fine structures within the same
      sections as determined by electron microscopy. In some instances the fidelity of
      the correlation between the distribution of the coloured area and cytoplasmic
      components in identical cells of the same section revealed significant details
      which could not visualized in thin sections. This technique, therefore, provided
      a simple and useful solution to many problems that require the localization of
      cellular components in identical cells selected previously by light microscopy.

PMID- 8469520
TI  - On the arterial supply in the human biceps brachii muscle.
AB  - The distribution of the arterial supply and innervation of skeletal muscle in the
      whole human body has been being researched in our laboratory. The results
      obtained on the biceps brachii from 25 bodies (50 sides) are reported here.
      Generally, in this muscle, A. coracobrachialis (Cb, SATO, 1980), a branch of A.
      axillaris (Ax), is distributed at the upper muscle bundles of the short head
      after running parallel to N. musculocutaneus (Nmc) and supplying M.
      coracobrachialis. The main artery (Ma), which is a branch of A. brachialis (Br),
      is distributed at the upper and middle parts of both heads, and the point where
      Ma enters the muscle bundles almost coincides with the point where R. brachialis
      (Rb) branches from Nmc. R. biceps brachii (Rbi), which is distributed only at
      this muscle and Om, the common trunk to other muscles, is distributed at the
      lower part of the muscle bundles. The arterial supply of this muscle was
      classified as follows according to the conditions of origin and its distribution.
      Type I: Ax(Cb) was distributed to the upper part of the muscle bundle. Type II:
      The absence of Ax(Cb) in the upper part of the muscle bundle. Type A, a and 1:
      Ma.Br(Om) supplying the long, short and both heads of the biceps brachii. Type B,
      b and 2: Ma.Br(Rbi) supplying the long, short and both heads of the biceps
      brachii. In the long head, Type II-A accounted for 62.0%, Type II-B for 30.0%. In
      the short head, Type I-a was 62.0%, Type I-b 28.0%. In both heads, Type I-1 was
      62.0%, Type I-2 28.0%. There were significant differences in the distribution of
      the nutrient arteries between the long and short heads. A. brachialis
      superficialis (Bs) was recognized in 3 of these cases (2 cases of Type III and 1
      case of Type VII by Adachi's classifications), which were rare cases. In these
      cases, arterial branches other than Cb branching from A. brachialis profunda are
      branches of Bs. This means, judging from ontogeny, that Bs, the blood vessels in
      the superficial layer, supplies this muscle, which belongs to the superficial
      layer of the brachium.

PMID- 8469521
TI  - Persistent sciatic artery. Case report.
AB  - A case of a persistent sciatic artery in a 60-year-old Japanese man is reported.
      The right persistent sciatic artery (5 mm in diameter) was joined to the internal
      iliac artery proximally and to the popliteal artery distally. The terminal vessel
      of the femoral artery (3 mm in diameter) was connected to the sciatic artery at
      the popliteal fossa.

PMID- 8469522
TI  - Arterial supply in the human pectoralis minor muscle.
AB  - In the following, we report our findings obtained as a result of injecting an
      acrylic pigment in the arteries supplying the pectoralis minor muscle in 50
      lateral chests of 26 Japanese adults (15 males and 11 females). In the pectoralis
      minor muscle, the muscular bundle near the terminal is supplied by A. processus
      coracoideris (Pc, Sato-Takafuji, '85) or A. coracobrachialis (Cb, Sato, '80) of
      A. axillaris (Ax), while its middle upper and lower peripherals are supplied by
      A. thoracoacromialis (Ta) and A. partis abdominalis (Pab, Sato, '76),
      respectively. Further, the upper and lower peripherals at its origin are supplied
      by A. thoracica suprema (Ts) and A. thoracica lateralis (Tl), respectively. Pc,
      Cb, Pab and Ts may occasionally be absent. Arteries supplying this muscle are
      classified according to their origins and routes of distribution, as follows.
      Type I-a: Pc or Cb, Ta, Pab, Ts and Tl are present, 32%; Type II-a: Ts is absent
      from Type I-a, 14%; Type III-a: Pb and Pc are absent from Type I-a, 20%; Type IV
      a: Cb, Pc and Ts are absent from Type I-a, 10%. Type b is Type a without Pab. The
      rates of appearance of Type I-b, II-b, III-b and IV-b were all 6%. The ratios of
      distribution in area a were as follows, in order of decreasing ratio: 37.6% for
      Pab (37 cases), 32.4% for Tl (49 cases), 30.2% for Ta (49 cases), 10.8% for Ts
      (32 cases), 7% for Cb (9 cases), and 6.37% for Pc. In the pectoralis minor
      muscle, the major supplying arteries are Pab, Tl and Ta, and where Pab was
      absent, this was compensated for by a branch of Ta. The total number of supplying
      arteries in this muscle was two to five, with the majority, or 36%, having four
      arteries. As for sex differences in the incidence of each type, Type I-a appeared
      more often in males (40%) than in females (20%). The rates according to the ribs
      of origin were 46%, 36%, 16%, and 2% for types 2.3.4.5, 3.4.5, 2.3.4, and
      2.3.4.5.6, respectively. It was interesting that all Type II and Type IV cases
      without Ts corresponded to Type 3.4.5 without the muscular bundle arising from
      the second rib, as it suggests the process of degeneration of the pectoralis
      minor muscle in Homo.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8469523
TI  - Immunoelectron microscopic localization of basic FGF in neuroglias and neurons of
      the trigeminal mesencephalic and motor nuclei.
AB  - Discrepancies between previous light microscopic studies on the localization of
      basic fibroblast growth factor (bFGF) in neuroglias and neurons of the normal rat
      brain prompted us to investigate, by electron microscopy, the subcellular
      localization of bFGF-like immunoreactivity in neuroglias and neurons of the
      trigeminal motor and mesencephalic nuclei. Immunostaining intensity differed from
      astrocyte to astrocyte; in astrocytes labeled heavily with bFGF antiserum, the
      precise subcellular location of immunoreaction deposits was difficult to
      determine, whereas mildly labeled astrocytes contained reaction products in
      subcellular regions apart from gliofilaments, mitochondria and Golgi apparatus. A
      comparison of immunostained sections with negative control ones at the light and
      electron microscopic levels revealed that astrocyte nuclei occasionally showed
      bFGF immunoreactivity. Immunoreactive astrocyte processes were also found in
      close apposition to blood vessels. bFGF was detected mainly in intracellular
      structures close to free ribosomes and the endoplasmic reticulum of
      immunoreactive oligodendrocytes and neurons; microglias rarely showed
      immunostaining. The nuclei of the cells with bFGF contained immunoreaction
      deposits of varying intensity, mainly in the euchromatin and rarely in the
      heterochromatin. Occasionally, bFGF of neuroglial origin accumulated in the
      vicinity of the interface between neurons and neuroglias. The extracellular
      matrix was not immunoreactive in any of the areas examined. These findings
      suggest that certain populations of astrocytes and oligodendrocytes as well as
      neurons in the normal brain contain bFGF-like substances.

PMID- 8469524
TI  - Fine structure and elemental analysis of the enamel in the cryptobranchid
      salamander Megalobatrachus japonicus.
AB  - Teeth from Megalobatrachus japonicus were prepared for scanning electron
      microscopy (SEM) and electron microprobe analyzer (EMPA) to assay the elements of
      the enamel layer. The enamel layer of each of tooth is thin and the arrangement
      of the enamel crystals is regular in the Megalobatrachus japonicus. Based on
      calcium, phosphate and magnesium levels of distribution, the calcification level
      of the enamel layer differs between the labial and lingual surfaces.
      Concentrations of iron and fluoride are located in both portions of the enamel
      layer as well. The presence of trace elements and distribution of calcified
      levels are related to the mineral formation in the enamel layer and function of
      the teeth during feeding.

PMID- 8469525
TI  - The regional variation of crypt architecture in the mouse colorectal mucosa with
      special reference to the process of proliferation.
AB  - The NaOH cell-maceration method was applied to the mouse colorectal mucosa to
      demonstrate the three-dimensional architecture of the lamina propria, especially
      that of the glandular crypts. In the surface of the lamina propria, there existed
      the longitudinal ridges and furrows. In the ridges, the crypts opened to the
      lumen individually, and had no internal partitions separating a crypt. The
      lateral walls of the crypts in the ridges had numerous hemispherical concavities
      into which the epithelial cells were tightly fitted. In the furrows, on the other
      hand, the crypts were subdivided into several smaller crypts by the internal
      partitions, and were termed as the "protocrypts". Considered from these findings,
      the crypts in the ridges appear to be matured, while the protocrypts in the
      furrows to the crypts undergoing process of proliferation. Further, it is
      suggested that the crypts proliferate in the furrows and, then, populate in the
      ridges as the mature crypts.

PMID- 8469526
TI  - A case of the human sternocleidomastoid muscle additionally innervated by the
      hypoglossal nerve.
AB  - An anomalous nerve supply from the hypoglossal nerve (XII) to the
      sternocleidomastoid muscle (SM) was observed in the right neck of an 82-year-old
      Japanese female. This nerve branch arose from the hypoglossal nerve at the origin
      of the superior root of the ansa cervicalis. The nerve fiber analysis revealed
      that this branch consisted of fibers from the hypoglossal nerve, the first and
      the second cervical nerves and had the same component as the superior root of the
      ansa cervicalis. SM appeared quite normal and the most part was innervated by the
      accessory nerve and a branch from the cervical plexus. The anomalous branch from
      XII supplied the small deep area near the anterior margin of the middle of the
      sternomastoid portion of SM. It is reasonable to think that the small deep area
      of SM, which was innervated by the anomalous branch from XII, occurs as the
      result of fusion of the muscular component from infrahyoid muscles. If the
      muscular component does not fuse with SM, it is thought to appear as an aberrant
      muscle such as the superior sternoclavicular muscle (Hyrtl) which is also
      supplied from a branch of the superior root of the ansa cervicalis.

PMID- 8469527
TI  - Fine structural aspects of the anterior necrotic zone in the leg bud of the chick
      embryo.
AB  - A fine structural study was undertaken on the area called the anterior necrotic
      zone of leg buds of the chick embryo at stages 22-29. Physiologically dying
      cells, which were distributed in the mesenchymal area, were characterized by
      increased electron density of the cytoplasm, appearance of electron lucent
      vacuoles and condensed chromatin pattern. Many of the dying cells seemed to be
      fragmented into several pieces of cell debris during the necrotic process. Two
      kinds of cells were observed to take up the necrotic cells; one type, large cells
      15 microns or more in size and irregular in shape, which had lysosomes, extended
      microvillus-like cytoplasmic projections and pseudopods, took up pieces of
      necrotic cells by phagocytosis and stored them in acid phosphate-negative and 
      positive vacuoles. The other type was several microns in diameter with numerous
      free ribosomes and stored a small number of vacuoles containing cell debris. At
      stage 29, profiles of necrotic cells lying free in the mesenchymal area, and
      cells containing one or two vacuoles filled with cell debris decreased in number
      as well as large cells containing numerous vacuoles, whose contents seemed to be
      degraded. When pieces of the anterior portion of chick leg buds at stage 24 were
      organ-cultured for 3 days after glutaraldehyde-fixed mouse red blood cells were
      injected, the red blood cells were taken up into cells in the mesenchymal area.
      Formation of large cells containing numerous vacuoles stuffed with red blood
      cells was rare. These findings may imply that most necrotic cells in the anterior
      necrotic zone are disposed of by macrophages and that some are endocytosed by
      mesenchymal cells.

PMID- 8469529
TI  - Notes about nursing from Botswana, Africa, Part II.

PMID- 8469528
TI  - Developmental anatomy of the mouse stapediovestibular and temporomandibular
      joints.
AB  - The genesis, development and growth of the mouse stapediovestibular joint (SVJ),
      which contains the annular ligament, and the temporomandibular joint (TMJ) were
      examined in an attempt to study the stress-bearing articular tissue that is
      thought to be derived from embryonic mesenchyme; the findings were also compared
      with those in the ossicular joints. The following conclusions were obtained: 1)
      The articular cartilage of the mandibular condylar process, stapedial foot plate
      and otic capsule is derived from fetal fibrous articular tissue. 2) The fetal TMJ
      developed into a typical double diarthroses containing an articular disc. 3) The
      fetal syndesmodial SVJ differentiated into the annular ligament containing
      characteristic palisade-like fibroblasts and hammock-like fibers; no interzone
      formation or synovial cavities were observed in the completed and mature
      syndesmodial SVJ. 4) Like the TMJ, the major elastic system fibers in the annular
      ligament were also mechanical-resistant elaunin. 5) Elastogenesis was closely
      related to functional and mechanical factors in the auditory ossicular chain, TMJ
      and annular ligament; the mature incudomalleal and incudostapedial joints
      contained mainly mature elastic fibers, but the mature SVJ and immature TMJ
      contained mainly pre-elastic elaunin fibers. 6) Stress elastosis, turnover of the
      fibrillar component and age changes in cellular and fibrous components were not
      evident in either the mature SVJ or the young functional TMJ.

PMID- 8469530
TI  - New advance directive law.

PMID- 8469531
TI  - Magnetic resonance imaging or arthrographic diagnosis of internal derangement of
      the temporomandibular joint. Correlation comparison study with arthroscopic
      surgical confirmation.
AB  - Although arthrography has long been considered a gold standard for the diagnosis
      of internal derangements of the temporomandibular joint, magnetic resonance
      imaging has rapidly proved to be a valuable tool for other insights into soft
      tissue structures. The goals of this study were twofold: (1) to compare the
      diagnostic efficacy of arthrography with magnetic resonance imaging and (2) to
      compare these results with the actual arthroscopic findings. The correlation
      between arthroscopic examination and independent fluoroscopic arthrogram and
      magnetic resonance imaging was high for the diagnosis of anterior disk
      displacement, as were the correlations between arthroscopic examinations and
      fluoroscopic arthrograms on diagnosing disk perforations. These findings,
      together with the apparent specialized abilities of the arthroscopic examination
      to yield information on the quality of the surface tissues (e.g., cartilage
      degeneration, synovitis, proliferations) led us to conclude that diagnostic
      arthroscopy may prove to be as valuable to the maxillofacial surgeon for the
      diagnosis of intracapsular temporomandibular joint disorders as it is for the
      orthopedic surgeon in diagnosing other joint disorders.

PMID- 8469532
TI  - Osteoarthrosis, the temporomandibular joint, and Eagle's syndrome.
AB  - Temporomandibular joint osteoarthrosis is common but typically asymptomatic. This
      article describes a patient with symptomatic left temporomandibular joint
      osteoarthrosis in whom pain in the right side of the tongue and ear, and
      dysphagia, subsequently developed simulating Eagle's syndrome. The concept of
      Eagle's syndrome is reviewed.

PMID- 8469533
TI  - Microscrew and microplate systems for select osteotomies in orthognathic surgery.
AB  - The use of the semirigid screw and plate systems is common place in orthognathic
      surgery by many oral and maxillofacial surgeons. The size of the screw and plate
      systems used is commonly designated as mini or osteotomy size. Screw diameter is
      generally 2.0 mm and plate thickness range is 0.8 mm to 1.2 mm. The systems
      available perform very well for the majority of osteotomies. There are
      circumstances when these mini systems are not appropriate. Recently developed
      microsystems have been applied by us in selected cases of orthognathic surgery.
      The smallest of the microsystem screws are 0.8 mm diameter and all are available
      in 2, 3, 4, 5, 6, 8 mm lengths. Some microplates are 0.3 mm thick and available
      in various shapes including a straight chain. The resultant profile thickness of
      screw plus plate system becomes 0.8 mm.

PMID- 8469534
TI  - Dental extractions in patients with bleeding disorders. The use of fibrin glue.
AB  - Eighty patients with various bleeding disorders underwent 135 extractions without
      preventive replacement hematologic therapy. The local hemostatic control involved
      the use of fibrin glue Beriplast. Secondary bleeding occurred in 9 of 12 patients
      with severe hemophilia when the concentration of the aprotinin in the fibrin glue
      was 1,000 KIU/ml. When it was increased to 10,000 KIU/ml and swish and swallow
      rinses of tranexamic acid before and after the dental extractions were added,
      only 3 of 25 hemophilia patients suffered from secondary bleeding. Local use of
      fibrin glue is a safe and cost-effective tool to treat patients with severe
      bleeding disorders. None of the 43 patients with coagulopathies other than severe
      hemophilia suffered bleeding after extractions.

PMID- 8469535
TI  - Analysis of the analgesic efficacy and cost-effective use of long-acting local
      anesthetics in outpatient third molar surgery.
AB  - Bupivacaine hydrochloride, an amide-type of long-acting local anesthetic was
      compared with lidocaine hydrochloride to determine its analgesic efficacy and its
      cost-effective use in an oral and maxillofacial surgery private practice. The
      results show that 0.5% bupivacaine hydrochloride provides greater analgesia than
      2% lidocaine, with an insignificant cost increase to the operating surgeon.

PMID- 8469536
TI  - Central giant cell granuloma. Report of a case.
AB  - The central giant cell granuloma is a tumor that has great potential for the
      displacement of teeth and the development of a facial deformity. Although its
      cause and behavior are still matters for discussion, its early diagnosis and
      treatment are a priority. We describe a patient with a large benign central giant
      cell granuloma of the anterior mandible. The clinical, radiographic, and
      histologic appearance, as well as the appropriate treatment, are discussed in
      light of the current literature.

PMID- 8469537
TI  - Quincke's disease: nonhereditary angioneurotic edema of the uvula.
AB  - We report two cases of Quincke's disease, an isolated form of angioneurotic edema
      involving the uvula that is induced by several factors, including foods, drugs,
      and inhalants. Although Quincke's disease has prominent oral manifestations, it
      has only rarely been described in the dental literature. The rapid onset and
      progression of the disorder, combined with the risk of respiratory compromise,
      may result in a serious medial emergency. Clinical manifestations include a
      nonerythematous swollen uvula, fullness in the throat, and signs of airway
      obstruction. A hereditary form of angioneurotic edema is associated with a
      biochemical defect; this must be differentiated from nonhereditary, localized
      forms such as Quincke's disease to determine appropriate treatment and predict
      prognosis. Clinical features and laboratory tests can distinguish hereditary
      angioneurotic edema from the nonhereditary form.

PMID- 8469538
TI  - Direct immunofluorescence of detached gingival epithelium for diagnosis of
      cicatricial pemphigoid. Report of five cases.
AB  - The diagnosis of mucosal cicatricial pemphigoid is often problematic because of
      frequent false negative or equivocal biopsy results. We describe an
      immunofluorescent technique that uses detached gingival epithelium for diagnostic
      purposes when oral manifestations of cicatricial pemphigoid are suspected.
      Erythematous mucosa that is gently rubbed produces detached epithelium that is
      then submitted for direct immunofluorescence studies along with tissue acquired
      via conventional techniques. In the five cases reported, the detached gingival
      epithelium stained intensely for immunoglobulins and complement on the basilar
      pole of the basal epithelial cells. The donor sites healed without a resultant
      periodontal defect. This adjunctive biopsy technique offers the advantage of
      easily procuring gingival tissue with deposition of immunoreactants that are
      quite specific for the diagnosis of cicatricial pemphigoid.

PMID- 8469539
TI  - Burning mouth syndrome. Evaluation of multiple variables among 85 patients.
AB  - The relationship between burning mouth syndrome and 48 variables was investigated
      in 241 patients, 45 years old and older, who had attended the Oral Medicine
      Clinic of the Faculty of Dentistry, University of Stellenbosch during a period of
      4 years. A total of 85 cases of burning mouth syndrome were diagnosed in 65 women
      and 20 men. Statistically significant relationships (p < 0.05) were found with
      self-medication, xerostomia, and other salivary disturbances in both men and
      women with burning mouth syndrome when compared with their respective controls.
      Among the women with BMS, significant relationships were also found with anemia,
      inadequate diet, chronic infection, hormone therapy, ulcerative/erosive lesions,
      and atrophy. In contrast men with BMS showed statistically significant
      relationships between taking prescribed medication, central nervous system
      disturbances, gingivitis, and denture-related problems. In addition, significant
      associations were related to variables such as psychogenic factors,
      regurgitation, flatulence, and periodontitis.

PMID- 8469540
TI  - Psychiatric morbidity in burning mouth syndrome. Psychiatric interview versus
      depression and anxiety scales.
AB  - Seventy-four patients with burning mouth syndrome underwent a psychiatric
      interview; Hamilton's Depression and Anxiety Scales were applied independently. A
      psychiatric diagnosis was established in 38 cases (51.35%). Depression was the
      predominant disorder. The evaluation scales showed that when present, anxiety
      greatly influences the psychiatric condition of these patients. The differences
      in the results obtained with the two methods are discussed.

PMID- 8469541
TI  - Effect of radioactive iodine therapy on salivary flow rates and oral
      Streptococcus mutans prevalence in patients with thyroid cancer.
AB  - Unstimulated and stimulated salivary flow rates, Streptococcus mutans samples,
      and dental caries data were obtained from 50 patients with thyroid cancer who had
      received radioactive iodine, I131, from 0.3 to 20 years earlier. The salivary
      flow rates were compared with a healthy control group, and the S. mutans counts
      were compared to a group of patients with head and neck cancer who were sampled
      before radiotherapy. Flow rates were found to be significantly lower in the
      patients with thyroid cancer, and S. mutans levels were slightly but not
      significantly higher than the controls. Longitudinal flow rate data taken on four
      patients, who served as their own controls before and after I131 therapy,
      indicated a trend in saliva reduction.

PMID- 8469542
TI  - Salivary and lacrimal gland involvement in a patient who had undergone a
      thyroidectomy and was treated with radioiodine for thyroid cancer.
AB  - A patient with bilateral, insidiously developing enlargement of the parotid
      glands that started 1 year after a total thyroidectomy and ablative radioiodine
      therapy (200 mCi I131) for papillary carcinoma is presented. The patient
      displayed prolonged periods of hypothyroidism accompanied by
      hypercholesterolinemia, notwithstanding hormone replacement therapy. Three years
      after surgery, parotid and lacrimal gland functions were reduced and fatty
      degeneration of the parotid parenchyma was demonstrated histologically. The
      submandibular and sublingual glands were preserved. It is suggested that the
      hormonal and metabolic derangements are responsible for the glandular
      dysfunction, rather than a direct effect of iodine on the glands.

PMID- 8469543
TI  - Morphologic and growth effects of tobacco-associated chemical carcinogens and
      smokeless tobacco extracts on human oral epithelial cells in culture.
AB  - Epidemiologic studies show an increase in the use of smokeless tobacco but few in
      vitro studies have directly assessed the potential for smokeless tobacco-induced
      oral carcinogenesis. Oral keratinocytes were grown to 90% confluence from
      explants of human labial and gingival mucosa at 34 degrees C, 5% CO2 in defined
      media. Epithelial monolayers were subsequently subcultured and then treated for 1
      hour with aqueous extracts of moist or leaf smokeless tobacco, or with 0.25 to
      1.0 ng/ml of three common smokeless tobacco carcinogens: 4-(N-methyl-N
      nitrosamino)-1-(3-pyridinyl)-1-butanone; N-nitrosonornicotine; and
      benzo(a)pyrene. Even though the controls and most treatment groups terminally
      differentiated, cells exposed to 4-(N-methyl-N-nitrosamino)-1-(3-pyridinyl)-1
      butanone, N-nitrosonornicotine, and moist and dry extract continued to divide,
      maintained a differentiated phenotype for 8 1/2 to 10 weeks in culture, and
      displayed focal growth and morphologic changes suggestive of early stages in cell
      transformation.

PMID- 8469544
TI  - Multiple idiopathic mandibular bone cysts in a patient with osteogenesis
      imperfecta.
AB  - Although the most common oral manifestation of osteogenesis imperfecta is
      dentinogenesis imperfecta, several authors have described jaw fractures and
      radiolucent bone lesions associated with this disease. We report a case of a 23
      year-old white woman with osteogenesis imperfecta and dentinogenesis imperfecta
      who developed multiple unilocular, bilateral, radiolucent lesions of the mandible
      5 years after presenting with a condylar fracture. This is the first
      documentation by surgical and histopathologic examination that the radiolucent
      lesions in this particular case represent multiple idiopathic bone cysts.

PMID- 8469545
TI  - A case of neurocristopathy that manifests facial clefting and maxillary
      duplication.
AB  - A case of a 6-year-old child with three facial clefts and maxillary duplication
      is presented. Computerized three-dimensional reconstruction from computerized
      tomography imaging was used in the diagnosis of this patient, and an explanation
      of the possible embryologic causes of this malformation is discussed.

PMID- 8469546
TI  - Intraoral sebaceous hyperplasia. Diagnostic criteria.
AB  - Surprisingly little is understood about the physiologic and pathologic processes
      that involve intraoral sebaceous glands. Neoplasms are rare. Hyperplasia of these
      glands is undoubtedly more common, but criteria for the diagnosis of intraoral
      sebaceous hyperplasia have not been established. These lesions are too often
      misdiagnosed as large "Fordyce granules" or, when very large, as sebaceous
      adenomas. On the basis of a series of 31 nonneoplastic sebaceous lesions and on
      published data, the following definition is proposed: intraoral sebaceous
      hyperplasia occurs when a lesion, judged clinically to be a distinct abnormality
      that requires biopsy for diagnosis or confirmation of clinical impression, has
      histologic features of one or more well-differentiated sebaceous glands that
      exhibit no fewer than 15 lobules per gland. Sebaceous glands with fewer than 15
      lobules that form an apparently distinct clinical lesion on the buccal mucosa are
      considered normal, whereas similar lesions of other intraoral sites are
      considered ectopic sebaceous glands. Sebaceous adenomas are less differentiated
      than sebaceous hyperplasia.

PMID- 8469547
TI  - Dentigerous cysts in animals.
AB  - This article is a review of the literature on dentigerous cysts in animals. Three
      different lesions have been referred to in the veterinary literature as
      dentigerous cysts. The first of these cysts, similar to those that occur in human
      beings, is extremely rare. The second lesion, an odontogenic cyst located in the
      anterior mandibles of mature sheep, is quite common in New Zealand and parts of
      Britain. The third is actually a teratoma that contains teeth and is found in the
      temporal region of young horses; it is also rare.

PMID- 8469548
TI  - Indirect cytotoxic evaluation of dental materials.
AB  - The standard for cellular biocompatibility in vitro testing is American National
      Standards Institute/American Dental Association Document No. 41a (1982). The
      standard allows for the contact testing of solid dental materials for
      cytotoxicity with HeLa or mouse fibroblasts (L929). The purpose of this study was
      to evaluate a new method of cytotoxicity testing of biomaterials that allows for
      an economic standardized indirect cytotoxic screening of the originally dispensed
      material over a period of time at intervals decided by the investigator. The
      results show a significant difference of cytotoxicity on the basis of the
      material between the direct contact method and the indirect or diffusion method
      described.

PMID- 8469549
TI  - Cytotoxicity of some modified root canal sealers and their leachable components.
AB  - The toxic effects of modified endodontic sealers, Fillcanal, N-Rickert, FS, and
      Sealer 26, were assessed. The material toxicity was measured through
      radiochromium release method that uses direct and indirect contact methods. The
      sealers were evaluated freshly mixed and after various setting times. L929 mouse
      and periodontal ligament fibroblast cells were used as target cells. Fillcanal, N
      Rickert, and FS showed high toxicity. Fillcanal leaches toxic material when fresh
      and after setting time. Sealer 26 was the least toxic.

PMID- 8469550
TI  - Evaluation of the sealing ability of amalgam, Cavit, and glass ionomer cement in
      the repair of furcation perforations.
AB  - Perforations created in the pulpal floors of 30 extracted molars were repaired
      with amalgam, Cavit, and light cured glass ionomer cement. After the pulp
      chambers and access openings were filled with composite resin, the teeth were
      then immersed in 2% Erythrocin B solution for 1 week. After longitudinal
      sectioning of the teeth, dye penetration was measured. The results indicated
      significant differences between the three materials. Light cured glass ionomer
      exhibited the least dye penetration followed by Cavit and amalgam.

PMID- 8469551
TI  - Extraction site healing in rats. A radiologic densitometric study.
AB  - The present study uses a simple, objective method to radiographically evaluate
      the changes that occur during socket healing in rats. Mandibular left first
      molars were extracted in 35 Wistar rats, which were then sacrificed at 0, 7, 14,
      21, 28, 45, and 60 days after surgery. Mandibles were removed, placed on an ANSI
      size 2 film, and exposed with an aluminum step-wedge, 0.5 to 3.0 mm. Socket
      density was measured with a digital densitometer and related to the equivalent
      density of aluminum. Increased density of the image of the apical and crestal
      areas of the socket was observed on day 7. Maximum density was reached by day 28
      in the apical area; in the crestal area, density increased at a slower rate. The
      density changes found in the present study agree with the known histologic
      reports of socket healing in rats. Densitometric evaluation of extraction socket
      healing, using a step-wedge with 0.5 mm increments, is a useful and reliable tool
      to objectively assess bone formation and mineralization.

PMID- 8469552
TI  - Locating the periapical region in dental radiographs using digital image
      analysis.
AB  - An algorithm was designed to automatically obtain information on the orientation
      of roots in dental radiographs aimed at localizing the periapical region. A curve
      was approximated mathematically by a cubic polynomial to intersect the boundary
      of the root at its apex. The performance was judged by comparing the location of
      this intersection with the actual location of the apex as determined by five
      expert observers. In an experiment with 262 roots of the eight tooth groups, the
      distance between these two points was less than 1 mm in 67.9% of all cases and
      less than 2 mm in 88.2%. The performance of the procedure appeared to depend on
      the tooth group (p < 0.01). The location of the intersection was reproducible
      within 1 mm in 86.4% of all cases. The reproducibility was, however, not equal
      for all tooth groups (p < 0.01). The experts were more consistent in localizing
      the apex than the system was (p < 0.01), although this difference was not
      confirmed for four of the tooth groups (p > 0.57), and was marginal for two
      others (0.01 < p < 0.02). It is concluded that the algorithm is promising in its
      capacity to track a majority of roots down to their apex. It could therefore add
      important knowledge to imaging procedures aimed at the digital analysis of the
      periapical region.

PMID- 8469553
TI  - Validation of a specific selection criterion for dental periapical radiography.
AB  - It has been recommended that the prescription of dental radiographic examinations
      be based on a series of selection criteria. This study evaluated the usefulness
      of the presence of a large or deep restoration as an indicator for the need for a
      radiographic examination. Patients in need of routine examinations were
      questioned regarding pain in restored teeth. The radiographs of 2269 restored
      teeth in 209 patients were evaluated for depth of restoration and presence or
      absence of periapical pathosis. Another 1306 nonrestored teeth in 100 patients
      were evaluated similarly. There was an association between pain and periapical
      pathosis and between depth of restoration and periapical pathosis (p < 0.001 in
      each case). Radiographic yield for positive apical findings was low in restored
      teeth, especially when the restoration was shallow. The radiographic yield may be
      increased if other factors such as pain or integrity of the restoration are used
      to help make the decision regarding the need for radiographs.

PMID- 8469554
TI  - Utilization of radiographs for a state dental board examination.
AB  - A survey of 97 dentists who had recently taken a state dental board examination
      was completed to document the use of radiographs for the screening and treatment
      of their patients. The response rate was 53%. Candidates spent on average 14.25
      hours screening a mean of 18 patients to identify the dental pathoses necessary
      to take the examination. Candidates took a mean of 28.9 (+/- 25.8) radiographs
      for screening purposes and during the examination with a range of 3 radiographs
      to a maximum of 141 radiographs. Time in practice and specialty status did not
      affect the total number of radiographic exposures made. The majority of
      radiographs taken (53%) were unlikely to be used in the direct care of the
      patient's dental needs. The results of this survey indicated that efforts to
      minimize administrative radiographs should be increased.

PMID- 8469555
TI  - Postextraction osteomyelitis in a bone marrow transplant recipient.
AB  - This report describes a case of mandibular osteomyelitis after a dental
      extraction in a patient who subsequently underwent bone marrow transplantation
      (BMT) for lymphoblastic lymphoma. Surgical guidelines consistent with National
      Cancer Institute recommendations were followed for the extraction, which was
      performed before initiation of the myelosuppressive conditioning regimen.
      However, moderate tenderness developed at the extraction site beginning 10 days
      after marrow infusion. On day 26 the patient became febrile and blood culture
      positive for Staphylococcus epidermidis. Radiographs exposed on day 28
      demonstrated changes consistent with low-grade osteomyelitis, including diffuse
      loss of lamina dura and an irregular osseous rarefaction extending 1 cm posterior
      to the extraction site. Although the indwelling Hickman catheter was the presumed
      source for bacteremia, clinical and radiographic data led to consideration of
      mandibular osteomyelitis as an alternative cause. Characteristics of this
      infection in BMT recipients are reviewed. Recommendations for dental extractions
      and prophylactic antibiotic regimens for catheterized BMT recipients are also
      discussed. Although mandibular osteomyelitic lesions are not common in profoundly
      immunosuppressed BMT recipients, prompt recognition and treatment are essential
      when the disease occurs.

PMID- 8469556
TI  - Triamcinolone acetonide versus chlorhexidine for treatment of recurrent
      stomatitis.
AB  - This study compared the efficacy of pain control of two medications, used to
      treat recurrent aphthous stomatitis, placed under a physical barrier of
      cyanoacrylate. Thirty patients with recurrent aphthous stomatitis were selected
      from the records of the Diagnostic Referral Clinic at Indiana University School
      of Dentistry and randomly divided into three groups; one group was a control.
      Experimental groups received a topical application of either triamcinolone
      acetonide (0.025%) or chlorhexidine digluconate (0.12%). Medications were covered
      by isobutyl cyanoacrylate (Iso-Dent). Controls received the Iso-Dent only.
      Patients kept a diary to record their pain level on a 10 cm visual analog scale
      until the lesion healed. Ulcer episodes were treated for 12 weeks. Because some
      patients had multiple episodes, a total of 35 ulcer episodes were available for
      analysis. The mean number of ulcer days for each group was not significantly
      different. ANOVA with repeated measures for 10 days on each patient was first
      performed. A highly significant difference in pain intensity and perception was
      found at different days (p < 0.0001). No significant difference was found between
      the triamcinolone acetonide and chlorhexidine gluconate (p < 0.49).

PMID- 8469557
TI  - Hypodontia and nail dysplasia syndrome. Report of a case.
AB  - The ectodermal dysplasias are a clinically and genetically heterogeneous group of
      more than 120 syndromes involving ectodermally derived structures. The syndrome
      that is autosomal dominantly inherited and characterized by hypodontia,
      dysplastic nails, and normal hair is known as hypodontia-nail dysplasia syndrome,
      or tooth-and-nail syndrome. Because of the minimal manifestations, this syndrome
      may be difficult to diagnose. Patients with hypodontia should be examined for
      dysplastic nails of the hands and feet and referred to medical and dental genetic
      specialists for verification of the diagnosis and counseling. We report a case of
      tooth-and-nail syndrome in a young woman.

PMID- 8469558
TI  - [Ultrasonic study of the thyroid volume in Budapest children].
AB  - The aim of this study was to present the normal thyroid volumes of Budapest
      school-children (from central- and confine-districts). Real-time ultrasound
      instrument was used in study of 1328 children. Authors applied the method of
      Brunn et al. to calculate the size of every single thyroid lobes. Percentile
      curves of thyroid volumes were prepared on the basis of the results in both sexes
      and age between 6 and 14 years. Authors refer to the correlation between size of
      thyroid and (changing) body measurements according to the age and sexes. The
      frequency of symptomless abnormalities is mentioned in this population supporting
      the usefulness of thyroid sonography as a screening method.

PMID- 8469559
TI  - [Diagnosis and treatment of fetal and neonatal tachycardia].
AB  - Severe intrauterine cardiac failure due to supraventricular tachycardia in a 29
      week fetus was diagnosed using 2 dimensional and Doppler echocardiography. The
      prenatal tachycardia was successfully treated, the postnatal finding suggested
      Wolff-Parkinson-White syndrome. The fetal echocardiography by providing
      information on cardiac structure and haemodynamics may provide diagnostic and
      therapeutic useful informations. For the optimal pre- and perinatal management of
      this life-threatening condition absolutely essential a brief collaboration
      between the pediatric cardiologist and obstetricians.

PMID- 8469560
TI  - [Curative activity of the physician and alternative methods].

PMID- 8469561
TI  - [Centenary of the death of Markusovszky].

PMID- 8469562
TI  - [The role of vitamin A analogues and derivatives in the regulation of cell
      function].
AB  - The vitamin A and the retinoids, the vitamin A derivatives play an important role
      in the embryogenesis, in the modulation of the growth, in the differentiation of
      normal, premalignant and malignant epithelial and mesenchymal cells and in the
      maintenance of immune response. The effects of vitamin A are executed by two
      different mechanisms. While the carotenoids of provitamin A activity and the
      vitamin A--the retinol--itself are mainly antioxidant molecules and so some of
      their effects are partly similar to the effects of tocopherol, the retinoids, the
      derivatives of vitamin A, exert their diverse effects by regulating the
      expression of specific genes by the aid of specific nuclear receptors belonging
      to the family of steroid, thyroid hormone, and vitamin D3 receptors. The
      retinoids play a role in the modulation of the effect of these hormones as well.

PMID- 8469563
TI  - [Importance of carotid artery studies prior to coronary surgery].
AB  - The incidence of cerebral complications following extracorporal cardiac
      operations is reported to be approximately 2%. One of the possible reasons behind
      these complications is the presence of significant carotid stenosis as coexistent
      disease to the cardiac illness requiring surgery. Because of the common etiology
      carotid stenosis coexists mainly with a coronary artery disease. The authors make
      known their own screening methods based on the correct exploration of medical
      history and on the proper physical examinations. Coexistent significant carotid
      stenosis was revealed in 3.6% of 1056 patients who underwent coronary surgery
      within the period of 41 months. In all of these cases prophylactic carotid
      endarterectomy was performed. In twenty cases within this group the carotid
      reconstructions were performed simultaneously with myocardium revascularization.
      Staged endprocedures were performed in the other 18 cases. There was no surgical
      mortality and only one patient suffered major stroke. The authors emphasize the
      importance of carotid screening among patients awaiting coronary surgery
      especially in patients who previously sustained cerebral ischemic attacks, the
      presence of carotid bruits or any other known localization of obliterate arterial
      disease and finally in all patients over 60 years of age.

PMID- 8469564
TI  - [Autonomic neuropathy in chronic liver diseases].
AB  - Autonomic neuropathy has been evaluated by various cardiovascular bedside tests
      in 172 patients with chronic alcoholism (36 alcoholics without liver disease, 50
      patients with fatty liver and 86 with cirrhosis), in 21 patients with HBsAg
      positive chronic liver disease, in 14 patients with primary biliary cirrhosis, in
      14 patients with cirrhosis of other origin and in 86 healthy controls.
      Parasympathetic integrity was evaluated by beat-to-beat variation during deep
      breathing, Valsalva manoeuvre and standing up, sympathetic function by blood
      pressure response to standing and to sustained handgrip test. Autonomic reflex
      damage was found in all groups examined. Patients with alcoholic cirrhosis
      exhibited the most severe alterations. Our results suggest, that chronic
      hepatopathy itself presents a pathogenetic factor of autonomic neuropathy.
      Autonomic failure has to be considered as a possible cause of symptoms in liver
      diseases with all its prognostic consequences.

PMID- 8469565
TI  - [Dysfunction of penile erection].
AB  - Nearly 250 men with erectile dysfunction examined during the past 3 years period.
      Beside the examination technique development the author emphasizes on the
      importance of the medical history and the psychological exploration. The
      examinations are indicated after the analysis of the history and after the
      positive result of the noninvasive examination the invasive one is only
      indicated. Intracavernous injection of the vasoactive drugs remains important
      part of the diagnosis, but the combination with the Doppler examination gives
      more information about the origin of the dysfunction.

PMID- 8469567
TI  - [Pathography on Csontvary medals].

PMID- 8469566
TI  - [Etretinate therapy of papillomatosis cutis carcinoides].
AB  - The authors review the case-history of a 67-year old female patient suffering
      from papillomatosis cutis carcinoids. They present other pathographies found in
      the pseudocancerosis group, and their transformation into praecancerosis. They
      give an account of the successful treatment of cases classified under the
      pseudocancerosis group with etretinate. They further call attention to the wide
      spread applicability of retinoids.

PMID- 8469568
TI  - [A journal by medical students from the beginning of the century].

PMID- 8469569
TI  - ONS members observe health care in former Soviet Union.

PMID- 8469570
TI  - So who needs a bronchoscope, anyway?

PMID- 8469571
TI  - Developmental control of collagen gene expression in the rat lung: confirmation
      of early observations of lung growth.
AB  - The short gestation period of the rat allows one to see rapid morphologic and
      biochemical changes in the lung. It has been shown that the rat lung undergoes a
      period of distension over the first several days of life followed by a rapid
      alveolar growth. Total lung collagen also increases during this time period. We
      have examined the changes in types I and III procollagen transcripts during the
      perinatal period and have compared them to the above observations. Total RNA was
      extracted from the lungs of offspring of time-pregnant Sprague-Dawley rats after
      large airways were removed. Northern hybridization was performed to determine the
      quality of steady-state RNA and rule out cross-hybridization while densitometric
      tracings of slot-blot hybridizations allowed comparative estimates of the target
      sequence of RNA. Immediately following birth, the steady-state mRNA procollagen
      levels increased and a shift to a predominant type I production occurred. These
      changes preceded the rapid increase of collagen content and alveolarization known
      to occur at three days of age. These data provide further evidence that collagen
      production is controlled at the level of transcription and in temporal and tissue
      specific manners.

PMID- 8469572
TI  - Poor agreement between reported and recorded nocturnal cough in asthma.
AB  - Reported presence or absence of night cough was compared with tape recorded cough
      in 15 children with perennial asthma (median age, 9 years; range, 7-14) who
      reported troublesome nocturnal symptoms. Measurements were made and diaries kept
      for 7 consecutive nights. Cough was reported on 66 of 105 (66%) and recorded on
      93 (90%) available nights with poor overall agreement (Cohen's coefficient of
      assessment, kappa +0.30, range -0.17 to +1). The poor agreement between
      subjective and objective assessment of an important symptom of nocturnal asthma
      raises questions on the validity of symptom reporting and may in part explain the
      not infrequent disagreement between medical and patient assessment of disease
      severity.

PMID- 8469573
TI  - Postnatal expression of myosin isoforms in the genioglossus and diaphragm
      muscles.
AB  - We studied the expression of myosin heavy chain (MHC) and native myosin isoforms
      in the genioglossus (GG) and costal diaphragm (DIA) muscles of the rat during
      postnatal development using both denaturing and nondenaturing gel
      electrophoresis. Primary myotubes in both fast and slow muscles homogeneously
      express slow as well as embryonic myosin. Since the adult GG is comprised
      primarily of fast MHC isoforms, whereas the adult DIA is characterized by a
      mixture of MHC slow and fast isoforms, we hypothesized that the GG and DIA would
      be subject to different temporal patterns of MHC isoform expression during
      postnatal development. Native myosin and MHC gels demonstrated a persistence of
      neonatal MHC (MHC neo) on day 25 in the GG, whereas this isoform was not detected
      beyond day 21 in the DIA. The MHC phenotype in GG of the adult demonstrated a
      predominance of MHC 2X (35% +/- 8) and MHC 2B (45% +/- 10) with a smaller
      proportion of MHC 2A (19% +/- 5). In contrast, the MHC phenotype in adult DIA was
      characterized by approximately equal proportions of MHC slow (25% +/- 3), MHC 2A
      (34% +/- 10), and MHC 2X (31% +/- 12) with a small percentage of MHC 2B (9% +/-
      7). These data suggest that postnatal regulation of MHC expression in the GG and
      DIA is muscle specific.

PMID- 8469574
TI  - Assessment of forced expiratory volume-time parameters in detecting histamine
      induced bronchoconstriction in wheezy infants.
AB  - A new technique recently introduced allows the measurement of infant lung
      function from lung volumes raised by a pump prior to generation of forced
      expiratory flow-volume (FEFV) curves. Forced expiratory volume-time (FEV1)
      parameters rather than traditional flow parameters are used. The aim of this
      study was to assess the usefulness of FEV1 parameters in detecting airway
      responsiveness to histamine in recurrently wheezy infants. Ten infants (age 7-18
      months) sedated with 80 mg/kg chloral hydrate underwent a histamine inhalation
      challenge. Throughout the challenge FEFV curves were generated from end-tidal
      inspiration. Raised FEFV curves, from a lung volume preset by 15 cmH2O inflation
      pressure, were gathered at baseline and after the final concentration of
      histamine. The mean fall from baseline was 47% in maximal flow at functional
      residual capacity (VmaxFRC) (P < 0.0005), 15.5% in FEV0.5 (P < 0.0001), 13.5% in
      FEV0.75 (P < 0.005), and 11.0% in FEV1.0 (P = 0.057), after the final
      concentration of histamine delivered. Tidal volume and inspiratory volume reached
      above FRC between pre- and posthistamine did not change. Mean oxygen saturation
      fell significantly from 97 to 93%. We conclude that FEV1 parameters adequately
      detect reduced lung function during histamine-induced bronchoconstriction and
      appear suitable for histamine challenge testing in infants.

PMID- 8469575
TI  - Compliance of the respiratory system in newborn infants pre- and postsurfactant
      replacement therapy.
AB  - Surfactant administration causes a rapid and dramatic improvement in gas
      exchange, but paradoxically, studies have failed to show an improvement in the
      mechanical properties of the lung. We have measured dynamic and static (passive
      flow-volume technique) compliance before and after a single dose of bovine lipid
      extract surfactant in 22 premature infants with RDS. This had no effect on the
      measured dynamic compliance. In contrast, surfactant significantly increased
      static compliance from 0.41 +/- 0.02 to 0.55 +/- 0.04 mL/cm H2O/kg. This
      improvement was the result of a substantial recruitment of lung volume after
      surfactant administration. This led us to reduce ventilator pressures, which
      produced an increase in both dynamic and static compliance, but did not recruit
      additional volume. We conclude that surfactant causes a substantial increase in
      static compliance due to volume recruitment, which is consistent with reports of
      increase in the measured FRC. However, despite this improvement, the compliance
      is still below our normal range.

PMID- 8469576
TI  - Radiographic evidence of bronchopulmonary dysplasia in high-risk congenital
      diaphragmatic hernia survivors.
AB  - Congenital diaphragmatic hernia is a congenital malformation associated with
      pulmonary hypoplasia. It often leads to respiratory failure, requiring artificial
      ventilation with high inflation pressures and high percentages of oxygen. We
      evaluated radiographic evidence of bronchopulmonary dysplasia (BPD) in survivors,
      who presented with respiratory distress within 6 hours after birth, by a
      radiographic scoring system measuring the severity of BPD by the Toce score and
      the degree of pulmonary hypoplasia by the Touloukian score. Fifteen of 45
      survivors (33 percent) had clinical and radiological lung disease resembling BPD.
      As a group they had significantly higher Touloukian and Toce scores than
      survivors without BPD. Morbidity expressed as the duration of artificial
      ventilation, supplemental oxygen, and hospital stay was much higher in the BPD
      group. The hypoplastic lung in infants with congenital diaphragmatic hernia
      appears to be as susceptible to barotrauma and pulmonary oxygen toxicity as the
      lungs of prematurely born infants. To what extent BPD occurring in congenital
      diaphragmatic hernia survivors might influence the future development of lung
      function is not yet known.

PMID- 8469577
TI  - Fluid dynamics during initial aeration of mature fetal lung and effect of
      temperature.
AB  - Air volume-pressure (VP) curves were recorded simultaneously on pairs of mature
      rabbit fetuses from the same litter with one member of the pair at 37 degrees C
      and the other at 22 degrees C. Intrasaccular bubbles, formed primarily during
      inflation, were assessed for stability and surface tension (gamma). Average air
      flow rates (dV/dt) were calculated from the VP data. In separate experiments,
      liquid VP curves were recorded at 37 degrees and 22 degrees C: maximal liquid V
      was matched to maximal air V at 37 degrees and 22 degrees C, respectively. Fetal
      pulmonary liquid (FPL) viscosity (eta) and density (rho) were determined by
      standard methods. Both the effect of temperature on lung mechanics as reported
      previously, and the reliability of the rabbit model were confirmed in the paired
      fetuses. Analysis of fluid dynamics revealed that of the six parameters relevant
      to initial inflation-deflation of FPL-filled lungs, liquid rho, distensibility
      (recoil), and gamma were not altered significantly by temperature increase from
      22 degrees to 37 degrees C. Enhanced lung mechanics at 37 degrees C (including
      enhanced inflation at lower P, higher maximal V, increased production of
      intrasaccular bubbles, and higher V at end-deflation) was primarily due to
      lowering of FPL eta at the higher temperature which appears to have an effect by
      augmenting bulk liquid flow and liquid drainage. Lower eta increases bulk flow
      through airways directly. Consequent recruitment and distention of these
      conducting units effectively increases radius (r) and further enhances flow. (The
      ultimate "brake" to airways flow at both temperatures is counter P from gamma at
      air/liquid menisci.).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469578
TI  - Comparison of the squeeze technique and transcutaneous oxygen tension for
      measuring the response to bronchial challenge in normal and wheezy infants.
AB  - The aim of this study was to compare the fall in transcutaneous oxygen tension
      (PtcO2) as an outcome measure during bronchial provocation with histamine, with
      changes in airway function measured by the squeeze technique in healthy infants
      and those with wheezing disorders. PtcO2 was measured during histamine challenge
      in 20 infants, aged 6-16 months, of whom 14 had recurrent cough or wheeze (lower
      respiratory illness, LRI), and 6 were healthy. All were symptom free at the time
      of testing. The minimum value of PtcO2 after each nebulization was compared with
      the minimum baseline value. The response to increasing concentrations of
      histamine was also assessed by measuring maximal flow at functional residual
      capacity (VmaxFRC) by the squeeze technique. The inhaled concentration of
      histamine causing a 30% fall in VmaxFRC was calculated to give the provoking
      concentration (PC30). Baseline VmaxFRC was lower in symptomatic infants (117
      mL/s) than the normal infants (322 mL/s; P < 0.005), but the PC30 was not
      significantly different (7.7 and 5.7 g/L, respectively). There was no difference
      in baseline PtcO2 between the two groups. The infants with LRI had significant
      reductions in PtcO2 at both the final and preceding concentrations of histamine,
      whereas the normal infants had a significant and smaller reduction in PtcO2 only
      at the provoking concentration. Reduction in PtcO2 during bronchial challenge was
      a less sensitive index of bronchial response in healthy infants than in infants
      with a history of recurrent LRI.

PMID- 8469579
TI  - Nonbronchoscopic bronchoalveolar lavage in mechanically ventilated infants:
      technique, efficacy, and applications.
AB  - Bronchoalveolar lavage with the fiberoptic bronchoscope is commonly used for the
      diagnosis of pulmonary infections in mechanically ventilated adults and children.
      However, its use for intubated infants is precluded because the small artificial
      airway does not permit the passage of the bronchoscope. We have developed a
      technique for nonbronchoscopic bronchoalveolar lavage, performed via a sterile,
      disposable feeding tube. We have used this technique in 15 infants with diffuse
      interstitial disease and/or atelectasis, while they were intubated and
      mechanically ventilated. The volume of the lavage effluent averaged 70.3% of the
      volume instilled. Specific diagnosis on the basis of the cytologic evaluation
      and/or culture of the lavage fluid was possible in 9 (60%) patients. Two patients
      with atelectasis showed radiographic evidence of improvement following the
      procedure. There were no complications. We conclude that nonbronchoscopic
      bronchoalveolar lavage is well tolerated, and clinically useful in small,
      mechanically ventilated infants with respiratory failure due to diffuse pulmonary
      disease. This technique provides a lower risk alternative to more invasive, and
      costly procedures.

PMID- 8469580
TI  - Subclinical infantile Chlamydia trachomatis pulmonary infection.

PMID- 8469581
TI  - Report of a weekly New England pediatric pulmonary conference case report: lung
      cavity in a child.

PMID- 8469582
TI  - CT of blunt chest trauma in children.
AB  - While trauma is still the leading cause of death in the pediatric age range, it
      is surprising how little the CT appearances of pediatric chest injury have been
      investigated in the literature. We have reviewed the CT findings of blunt chest
      trauma in 44 children for whom chest CT examinations were requested to
      investigate the extent of intrathoracic injury. We noted a propensity for
      pulmonary contusions to be located posteriorly or posteromedially, and for them
      to be anatomically nonsegmental and crescentic in shape. This is possibly
      attributable to the relatively compliant anterior chest wall in children. The CT
      appearances of other major thoracic injuries are described, including pulmonary
      lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas,
      aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with
      paraspinal fluid collections. Children demonstrating findings incidental to the
      actual injury yet important to the subsequent therapy are also presented. We
      conclude that, in the event of clinically significant blunt chest trauma, the
      single supine chest examination in the trauma room is insufficient to adequately
      identify the extent of intrathoracic injury. With the exception of concern for
      aortic injury for which aortography is indicated, a dynamically enhanced CT scan
      of the thorax should be performed as clinically significant findings may result
      in altered therapy.

PMID- 8469583
TI  - Progressive noninfectious anterior vertebral fusion: MRI findings and association
      with a lipoma of the filum terminale in a 5-year-old girl.
AB  - Progressive noninfectious anterior vertebral fusion (PNAF) is a rare but well
      defined entity of unknown cause. We report the MRI findings in a 5-year-old in
      whom PNAF was associated with a lipoma of the filum terminale.

PMID- 8469584
TI  - Findings on magnetic resonance imaging of the spine and femur in a case of McCune
      Albright syndrome.
AB  - Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright
      syndrome, is seen in the cranium, facial bones, bones of the extremities, and
      ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8
      year-old girl with this syndrome, but 99mTc-methylene diphosphonate bone
      scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae.
      Multiple well-circumscribed areas of low signal intensity were seen on T1
      weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans
      in this disease have never been reported, our findings in this case proved
      interesting for evaluating osseous lesions. MRI made it possible to differentiate
      between fibrous lesions (low signal intensity on T1- and T2-weighted MRI) and
      cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal
      intensity on T2-weighted MRI).

PMID- 8469585
TI  - Development of late congenital hip dysplasia: significance of ultrasound
      screening.
AB  - Ultrasound for detecting congenital hip dysplasia was performed in 5970 infants,
      2121 of whom were reinvestigated. Of those reinvestigated 726 belonged to the
      screened group not at risk examined as newborns, 70 were infants at risk first
      investigated as newborns and 363 were infants at risk first examined after the
      newborn period; the remainder were infants not at risk first investigated after
      the newborn period. Pathological findings were obtained in 7.7% of the entire
      group, in 3.9% of children at no risk, and in 5% of patients at risk.
      Deterioration of Graf's classification of types was seen in 3.2%. 13 children, 3
      of the screened group and 10 of the nonscreened group developed hip dysplasia.
      None of them would have been missed since they were borderline type IIA on at
      least one side, which warranted mandatory follow-up.

PMID- 8469586
TI  - Retrograde percutaneous gastrostomy: a prospective study in 57 children.
AB  - We prospectively studied Retrograde Percutaneous Gastrostomy (RPG) in 57 children
      (age 3 weeks-17 years, 1.7-48 kg) as the feasibility and complications of this
      technique have not been reported in a large series of children. We used IV
      sedation (42), oral sedation (4 neonates), general anaesthesia or local
      anaesthesia only. The retrograde approach for gastrostomy or gastrojejunostomy
      catheter placement is described. Catheter placement was unsuccessful in only one
      child, due to the presence of marked hepatosplenomegaly. Catheters were
      successfully placed in all the other 56 children. In one of these, catheter
      misplacement occurred due to retraction of the stomach from the anterior
      abdominal wall during its insertion. This was recognized during the procedure.
      The catheter was removed and reinserted on the same occasion. One catheter was
      accidentally pulled out after six days and was subsequently replaced. Two
      children had mild, local abdominal tenderness and fever for up to 48 hours but
      post procedure septicemia or significant infection were not encountered. All
      children benefitted from gastrostomy feeding and gained weight.

PMID- 8469587
TI  - Correlation of gastric emptying at one and two hours following formula feeding.
AB  - The acquisition of gastric emptying (GE) data by scintigraphy has become an
      important component of the evaluation of the pediatric patient for
      gastroesophageal reflux (GER). Delay of GE can contribute to ongoing gastric
      distension and hence increase propensity to reflux. Generally, only 1 h GE is
      determined during scintigraphy. Infants with GER have variable patterns of
      symptoms: some have spitting, vomiting, choking, and/or apparent life-threatening
      events in the immediate post-prandial period only, whereas in others symptoms
      persist until the time of next feeding. It is not clear whether differential
      rates of GE contribute towards such disparity of symptoms. We performed this
      prospective study to determine the correlation between GE at 1 h or 2 h,
      respectively, and for 2 h following a feeding in 27 infants under one year of
      age, who were referred for evaluation of GER. Continuous scintigraphy was
      performed for 2 h following a formula feeding. Gastric emptying at 1 h was
      calculated as percent of original dose emptied by 60 min; GE at 2 h was
      calculated as percent of isotope remaining in the stomach at 60 min which was
      emptied by 120 min. The median GE between 0 to 60 min was 36% (95% CI 26.0-42.0)
      and median GE of the residual formula between 60 to 120 min was 45% (95% CI 34.3
      51.3). The correlation coefficient of GE, at 1 h with total GE over 2 h was 0.75
      and of GE during the 2nd h with total GE over 2 h was 0.76. We conclude that
      routine determination of GE for 2 h continuously does not appear to offer
      clinically significant additional information.

PMID- 8469588
TI  - Calcification of scleral-wrapped orbital implant in patients with retinoblastoma.
AB  - Calcification detected by CT is a valuable technique to confirm a clinical
      impression of retinoblastoma. However, when calcification is detected following
      enucleation with placement of a scleral-wrapped orbital implant, the presence of
      calcium may be dystrophic, instead of indicating recurrent tumor growth. Cautious
      follow-up is warranted, and this report suggests that such calcification,
      probably associated with the scleral wrapping, can remain stable over many years.

PMID- 8469589
TI  - Smith-Lemli-Opitz syndrome type II: report of a case with additional radiographic
      findings.
AB  - A phenotypically female infant with 46-XY chromosomes was found to have Smith
      Lemli-Opitz syndrome, type II a rare congenital malformation syndrome with many
      features of the more common classic Smith-Lemli-Opitz syndrome. The patient's
      skeletal survey revealed characteristic and previously undescribed skeletal
      anomalies which are reported. In addition a lipoma of the pituitary gland was
      found on magnetic resonance imaging. This lesion is particularly interesting
      given the hypothesized steroid abnormality in Smith-Lemli-Opitz, type II
      syndrome, the sexual ambiguity of males with this syndrome and the similarity of
      this syndrome to the Pallister-Hall syndrome which characteristically has a
      hamartoblastoma of the hypothalamus.

PMID- 8469590
TI  - Unusual manifestations of Langerhans cell histiocytosis of the head and neck.
      Case report with pseudoaneurysm of external carotid artery, tracheal, mandibular,
      and sphenoid involvement.
AB  - Langerhans cell histiocytosis of the head and neck is an uncommon histiocytic
      proliferative disorder that often clinically resembles an inflammatory process. A
      pseudoaneurysm of the external carotid artery was found by contrast-enhanced CT
      and confirmed by Doppler ultrasonography and angiography in a 9 year old girl
      with a lytic lesion of the mandible, a prior severe tracheal inflammatory
      process, and sclerotic lesions of the sphenoid wings. Biopsies of the mandibular
      lesion, pseudoaneurysm, and trachea demonstrated Langerhans cell histiocytosis.
      In cases of LCH with head and neck involvement, contrast-enhanced CT allows
      adequately detailed initial evaluation of the protean manifestations of this
      disorder.

PMID- 8469591
TI  - Horseshoe lung--a case report with unusual bronchial and pleural anomalies and a
      proposed new classification.
AB  - One case of horseshoe lung with associated scimitar syndrome is presented.
      Unusual bronchial and pleural anomalies as delineated by CT and plain chest
      radiographic imaging are described. The presence of bilateral fissures led to a
      newly proposed classification of horseshoe lung based on pleural anatomy.

PMID- 8469592
TI  - Congenital double pylorus with accessory pyloric channel communicating with an
      intraluminal duplication cyst of the duodenum.
AB  - Congenital double pylorus is a rare anomaly in which two pyloric openings connect
      the antrum of the stomach to the duodenal bulb. We report an unusual case of
      congenital double pylorus in which one of the channels led to an intraluminal
      cystic duplication of the duodenal bulb. An embryologic relation between
      congenital double pylorus and antroduodenal duplications is suggested.

PMID- 8469593
TI  - Ilio-psoas abscess in neonates.
AB  - We report two cases of primary ilio-psoas abscess in neonates diagnosed by CT and
      sonography. Ilio-psoas abscess is extremely uncommon in this age group.

PMID- 8469594
TI  - White matter change on CT associated with superior vena cava syndrome: a case
      report.
AB  - An 11-year-old Japanese girl with nephrotic syndrome developed superior vena cava
      syndrome associated with hypercoagulability and an indwelling catheter. Cranial
      CT revealed diffuse low-density lesions in paraventricular white matter.
      Thrombectomy brought prompt relief of symptoms and correction of CT
      abnormalities.

PMID- 8469595
TI  - Endodermal sinus (yolk sac) tumor of vagina and cervix in an infant.
AB  - A case of vaginal and cervical endodermal sinus (yolk sac) tumor in a 6-month-old
      female infant is reported. The patient presented with an intermittent bloody
      discharge on her diapers. Pelvic CT showed an irregular soft tissue density mass
      with heterogeneous enhancement within the vagina and extending to the cervix. The
      histopathologic features were identical to those of endodermal sinus tumors.

PMID- 8469596
TI  - Endodermal sinus tumour associated with benign teratoma of the common bile duct.
AB  - We report a 5-year-old boy with endodermal sinus tumour associated with benign
      cystic teratoma of the common bile duct (CBD). To our knowledge, there has been
      one case of teratoma of the CBD in the English literature with no morphological
      or radiological description. Our case presented a lobulated polypoid mass
      obstructing the distal CBD on sonography and computed tomography, which resembled
      the botryoid masses of rhabdomyosarcoma.

PMID- 8469597
TI  - Radiological evaluation of pulmonary vein obstruction including two examinations
      by magnetic resonance imaging.
AB  - Congenital obstruction of the pulmonary vein without anomalous drainage can cause
      long-standing pulmonary congestion and pulmonary arterial hypertension, and it
      may include stenosis of individual pulmonary veins and pulmonary vein atresia. We
      reviewed seven cases of pulmonary vein obstruction, five of which were
      accompanied by other cardiac anomalies. Right pulmonary veins were involved in
      all seven cases; one case was bilateral. Pulmonary veins were occluded totally in
      five and partially in three lungs. Diagnostic pulmonary catheterization and
      angiography were performed. Chest radiographs of total occlusion cases showed
      decreased lung volume, features of pulmonary edema, interstitial lesions, and
      pleural changes, which were quite specific, whereas pulmonary venous dilatation
      was the dominant finding in partial obstruction cases. Pulmonary perfusion scan
      (n = 3) showed total perfusion defects in the cases with total occlusion of
      pulmonary veins. Magnetic resonance (MR) imaging (n = 2) demonstrated totally
      occluded pulmonary veins at the venoatrial junction in two lungs and membranous
      focal obstruction in one lung. Two children underwent pneumonectomy and had the
      diagnosis histologically confirmed. Although catheterization and angiography are
      essential for the diagnosis of pulmonary vein obstruction, MR imaging is a useful
      adjunct.

PMID- 8469598
TI  - CT, MRI, and color Doppler ultrasound correlation of pancreatoblastoma: a case
      report.
AB  - Pancreatic neoplasms in childhood are rare but should be considered in the
      differential diagnosis of masses in the region of the lesser sac. A case of
      pancreatoblastoma in a 3 1/2-year-old boy is presented. The patient was studied
      with US, CT, and MR imaging.

PMID- 8469599
TI  - Prenatal diagnosis of colon atresia.
AB  - We report a case of colon atresia diagnosed pre-natally at 32 weeks' gestation.
      The fetal transverse colon was dilated. Complete atresia of the middle transverse
      colon was confirmed after birth. Small bowel dilatation (and clinical
      obstruction) did not develop until after 24 h of age.

PMID- 8469600
TI  - Darrow-Gamble disease: ultrasonographic and radiographic findings.
AB  - A case of Darrow-Gamble disease is presented with review of the radiographic and
      ultrasonographic appearance of this rare cause of profound chronic diarrhea
      beginning at birth. The disease is caused by a defect of active intestinal
      chloride transport which results in a large loss of the electrolytes and water.
      To prevent growth retardation and renal involvement an adequate replacement
      therapy is necessary. This uncommon anomaly was detected by ultrasound 3 weeks
      before delivery. Both sonography and radiography were useful diagnostic tools in
      the postnatal period. The clinical features of the lesion are also discussed.

PMID- 8469601
TI  - Prenatal diagnosis of diastematomyelia.
AB  - Fetal diastematomyelia, a malformation due to a longitudinal split of the cord,
      was diagnosed during the third trimester. Diagnosis was based on the
      visualization of a sagittal bony spur in the thoracolumbar spinal canal,
      associated with enlargement of the canal, hemivertebrae and spina bifida without
      a meningocele.

PMID- 8469602
TI  - Prenatal diagnosis of unilateral hydrocephalus.
AB  - We report a case of unilateral hydrocephalus diagnosed at 20 weeks' gestation, at
      which time marked facial and cranial asymmetry was present already. Brain mantle
      reconstitution was incomplete following ventriculo-peritoneal shunting, and the
      child has significant neurodevelopmental disability.

PMID- 8469603
TI  - Epiglottic enlargement secondary to laryngeal sarcoidosis.
AB  - A case of laryngeal sarcoidosis manifesting as epiglottic enlargement in a 15
      year-old boy is presented. Sarcoidosis of the larynx is unusual in children but
      should be included in the differential diagnosis of epiglottic enlargement.

PMID- 8469604
TI  - Ultrasonography of acute epitrochlear lymphadenitis.
AB  - While the clinical symptomatology and radiographic findings of acute suppurative
      infection of the epitrochlear lymph nodes of the arm have been previously
      described, ultrasonographic findings have not been reported. This case report
      demonstrates that sonographic identification of enlarged epitrochlear lymph nodes
      immediately confirms the diagnosis. We summarize the clinical, radiological, and
      sonographic findings of acute suppurative infection of the epitrochlear lymph
      nodes.

PMID- 8469605
TI  - Osteosarcoma with calcified regional lymph nodes.
AB  - A case of osteosarcoma of osteoblastic type with inguinal calcified
      lymphadenopathy is described. The primary lesion of the distal left femur was
      treated with limb-sparing surgery. Chemotherapy was given before and after the
      surgical procedure. Metachronous calcified lymph node metastases were seen on
      plain radiography, computed tomography and bone radionuclide scan. The patient is
      alive and free of disease more than 40 months after lymphadenectomy and
      radiotherapy of regional node metastases.

PMID- 8469606
TI  - Burkitt's lymphoma with mandible, intra-abdominal and renal involvement--initial
      presentation of HIV infection in a 4-year-old child.
AB  - Burkitt's lymphoma of the jaw was first described as a jaw tumor occurring
      endemically in African children. We report a case of Burkitt's lymphoma in a
      child presenting with a painful jaw mass which proved to be Burkitt's lymphoma;
      renal involvement was also noted. The child was found to be HIV positive.
      Burkitt's may be the initial manifestation of HIV infection in the pediatric
      population.

PMID- 8469607
TI  - Current radiological management of intussusception.

PMID- 8469608
TI  - Thapsigargin discharges intracellular calcium stores and induces transmembrane
      currents in human endothelial cells.
AB  - We have measured the effects of thapsigargin, a specific inhibitor of endoplasmic
      Ca(2+)-adenosine 5'-triphosphatase (Ca(2+)-ATPase), on membrane currents and on
      the intracellular Ca2+ concentration ([Ca2+]i) in single endothelial cells from
      the human umbilical cord vein. Currents were recorded by means of the patch-clamp
      technique in the whole-cell mode and [Ca2+]i was measured using Fura II.
      Application of thapsigargin at concentrations between 0.2 and 2 mumol/l induced a
      slow increase in [Ca2+]i to a peak value of 400 +/- 110 nmol/l above a resting
      level of 120 +/- 35 nmol/l, and then slowly declined to a new steady-state level
      of 315 +/- 90 nmol/l (n = 33). The thapsigargin-induced increase in [Ca2+]i
      depended on the extracellular Ca2+ concentration ([Ca2+]o: it declined after
      removal of extracellular Ca2+, but increased again when [Ca2+]o was augmented,
      indicating that the response depends on a transmembrane influx of Ca2+ ions. The
      peak amplitude of the histamine-induced Ca2+ transient was reduced in the
      presence of thapsigargin. This reduction was more pronounced when histamine was
      applied at the peak of the increase in [Ca2+]i induced by thapsigargin than
      during the rising phase of the changes in [Ca2+]i. The decline of the Ca2+
      transient induced by histamine after washing out the agonist was also affected by
      thapsigargin. Before application of thapsigargin, this decline could be described
      by a single exponential with a time constant tau equal to 24.5 +/- 5 s (n =
      7).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469609
TI  - Genetic regulation of enterocyte function: a quantitative in situ hybridisation
      study of lactase-phlorizin hydrolase and Na(+)-glucose cotransporter mRNAs in
      rabbit small intestine.
AB  - The enterocyte undergoes sequential changes in its structure and function as it
      migrates rapidly from the small intestinal crypts to the villus tip. The
      mechanisms by which these changes are regulated "in tune" with ontogenic and
      dietary changes in the luminal environment are currently under investigation.
      This study has employed oligonucleotide probes to follow the expression of the
      lactase-phlorizin hydrolase (LPH) and Na(+)-glucose cotransporter (SGLT1) genes
      in rabbit small intestine using quantitative in situ hybridisation
      histochemistry. The profiles of LPH mRNA and SGLT1 mRNA accumulation along the
      crypt-villus axis were found to be very similar. Although mRNA was undetectable
      in the crypt. LPH and SGLT1 mRNA levels rose rapidly at the crypt-villus
      junction, reaching a maximum between 210 microns and 330 microns above this
      point. Further up the villus the level of mRNAs declined. SGLT1 mRNA was present
      in all small intestinal segments (duodenum, jejunum and ileum), whereas LPH mRNA
      was absent from the ileum. LPH activity rose and fell in conjunction with mRNA,
      but SGLT1 activity was greatest at the villus tip where mRNA levels were
      considerably reduced. These data have been used to discuss the genetic regulation
      of enterocyte differentiation and function.

PMID- 8469610
TI  - Activation of the nicotinic acetylcholine receptor mobilizes calcium from
      caffeine-insensitive stores in C2C12 mouse myotubes.
AB  - In cultured mouse C2C12 myotubes, digital Ca2+ imaging fluorescence microscopy
      using the acetoxymethyl ester of Fura-2, Fura-2-AM, showed that, in the absence
      of extracellular Ca2+, acetylcholine (ACh) and nicotine, but not muscarine,
      raised the intracellular concentration of Ca2+ ([Ca2+]i) by about tenfold. ACh
      induced Ca2+ mobilization was prevented by thapsigargin, a drug known to deplete
      inositol 1,4,5-trisphosphate (InsP3)-sensitive stores, and was concomitant with
      InsP3 accumulation. Caffeine, which releases Ca2+ from the ryanodine-sensitive
      stores of the sarcoplasmic reticulum, did not interfere with the ACh-induced
      [Ca2+]i increase. Ca2+ mobilization was also inhibited when myotubes were
      depolarized by high K+, or when extracellular Na+ was omitted. Nicotinic ACh
      receptor (nAChR) stimulation lowered intracellular pH with a time course slower
      than the [Ca2+]i increase. Possible mechanisms linking the current flowing
      through the nAChR pore to [Ca2+]i increase are discussed.

PMID- 8469611
TI  - Sarcoplasmic reticulum calcium mobilization in right ventricular pressure
      overload hypertrophy in the ferret: relationships to diastolic dysfunction and a
      negative treppe.
AB  - In a model of right-ventricular pressure-overload hypertrophy (POH) in the
      ferret, action potential duration (to 90% repolarization) was found to be
      significantly longer (228 +/- 11 vs 314 +/- 12 ms) with no change in amplitude
      (85 +/- 3 vs 85 +/- 2 mV) or resting membrane potential (-79 +/- 1.5 vs -79 +/- 1
      mV) for control and POH, respectively. Peak sarcoplasmic reticulum Ca2+ release
      (expressed as the logarithm of the fractional luminescence, -4.2 +/- 0.1 vs -4.4
      +/- 0.3) and resting calcium concentrations (-5.5 +/- 0.1 vs -5.7 +/- 0.1) were
      not different between the two groups (control vs POH respectively). Muscles from
      control and POH animals demonstrated a positive force/interval relationship in
      the presence of physiological extracellular [Ca2+]. However, unlike muscles from
      control animals, muscles from animals with POH subjected to increasing
      frequencies of contraction in the presence of increased extracellular [Ca2+]
      demonstrated further impairment of diastolic relaxation and a negative treppe.
      Exposure of muscles from POH animals to isoproterenol returned the slowed Ca2+
      uptake by the sarcoplasmic reticulum as detected with aequorin to control values,
      although the relaxation phase of the isometric twitch remained prolonged compared
      to non-hypertrophied muscles. Exposure to milrinone also abbreviated the time
      course of the intracellular Ca2+ transient, but did not return it to that seen in
      normal myocardium. The exposure of non-hypertrophied isolated muscles to caffeine
      resulted in similar prolongation of the isometric twitch duration to that seen in
      hypertrophied myocardium. Results of these experiments suggest that impaired
      muscle relaxation in POH reflects changes at the level of the myofilaments. Thus,
      although slowed intracellular calcium mobilization contributes to diastolic
      relaxation abnormalities, it can not be the sole factor responsible for the
      slowed relaxation as has been suggested.

PMID- 8469612
TI  - A method for rapid exchange of solutions at membrane patches using a 10
      microliters microcapsule.
AB  - A rapid exchange (less than 2 ms) of the bath solution facing a membrane patch is
      accomplished by driving the tip of a pipette from the bath through a 100-microns
      oil layer into a small capsule filled with 10 microliters test solution. The
      microcapsule method can be applied to both excised patch configurations, inside
      out and outside-out patches. On and off reactions of Ca(2+)-activated K+ channel
      activity have been recorded after changing the intracellular Ca2+ concentration
      using an inside-out patch. A blockade of these K+ channels by external
      tetraethylammonium ions is demonstrated with an outside-out patch. The blocking
      kinetics of delayed-rectifier K+ channels by a purified peptide toxin from snake
      venom, dendrotoxin, could be measured with our microcapsule method. Using tiny
      volumes of test solutions this method can be helpful in experiments involving
      scarce or expensive solutions.

PMID- 8469613
TI  - Trypsin and alpha-chymotrypsin treatment abolishes glibenclamide sensitivity of
      KATP channels in rat ventricular myocytes.
AB  - Cytoplasmic trypsin-treatment of voltage-sensitive potassium channels has been
      shown to cleave domains of the channel responsible for inactivation of the
      channel. Trypsin has also been reported to remove slow, irreversible
      inactivation, or run-down in ATP-sensitive potassium (KATP) channels. Cytoplasmic
      treatment of rat ventricular KATP channels with either crude, or pure trypsin (1
      2 mg/ml) failed to prevent a slow run-down of channel activity. However, trypsin
      (porcine pancreatic type IX, or type II (Sigma Chem. Co.), or alpha-chymotrypsin
      (Sigma Chem. Co.) rapidly and irreversibly removed, or substantiallly decreased
      glibenclamide and tolbutamide-sensitivity of the channels without removing
      sensitivity to ATP. We conclude that glibenclamide must bind to either a separate
      protein, or to a separate domain on the channel in order to effect channel
      inhibition, and this domain is functionally disconnected from the channel by
      trypsin-, or alpha-chymotrypsin treatment.

PMID- 8469614
TI  - Community health nursing: shelter from the storm.

PMID- 8469615
TI  - New Jersey State Nurses' Association history: what is past is prologue. The sixth
      decade ... 1953-1962.

PMID- 8469616
TI  - Peer assistance. Prevention techniques that can be implemented without formal
      instruction.

PMID- 8469617
TI  - Games nurses play.

PMID- 8469618
TI  - Candidal urinary tract infections: a comprehensive review of their diagnosis and
      management.
AB  - Despite its prevalence, the significance of candiduria remains uncertain. The
      pathogenesis of candidal urinary tract infections has been relatively well
      characterized and many risk factors have been identified. The disorders lack
      consistent diagnostic criteria, however, such as the presence of pyuria or a
      colony count above which is predicative of presence, location, or severity of
      infection. Treatment is unclear due to lack of data defining the natural
      progression of the disease. Although often recommended, it may not always be
      possible to remove risk factors. Amphotericin B, fluconazole, 5-flucytosine, and
      other antifungal agents are important agents for managing candidal urinary tract
      infections.

PMID- 8469619
TI  - Monoclonal antibody therapy for gram-negative sepsis: principles, applications,
      and controversies.
AB  - Gram-negative sepsis is a common event in hospitalized patients and is a leading
      cause of death in the United States. Endotoxin (lipopolysaccharide, LPS), a
      component of the cell wall of gram-negative microorganisms, is responsible for
      the cascade of events leading to the sepsis syndrome consisting of fever,
      tachycardia, tachypnea, and evidence of organ hypoperfusion. The lipid A region
      of endotoxin produces most of these biologic and toxic effects. Monoclonal IgM
      antibodies directed against the lipid A portion of endotoxin (anti-LPS MoAb) have
      been developed for the treatment of gram-negative sepsis. Results of two large
      scale clinical trials suggest that these antibodies offer clinically and
      statistically significant reductions in mortality by a factor of about one-third.
      However, in both trials, this apparent beneficial effect was limited to
      particular subsets of patients, and no overall benefit was seen. These
      considerations, in addition to the likely high cost of the agents, pose questions
      about their ultimate use in the treatment of patients with gram-negative sepsis.
      Nevertheless, the logic of the approach, the demonstration of efficacy in disease
      models, and the advances in modern techniques of molecular biology all suggest
      that these or other closely related products will play a significant role in the
      treatment of this disorder.

PMID- 8469620
TI  - Accuracy of 2- and 8-hour urine collections for measuring creatinine clearance in
      the hospitalized elderly.
AB  - The accuracy of 2- and 8- hour urine collections for estimating creatinine
      clearance was compared with that of the standard 24-hour procedure in 45
      hospitalized elderly patients (age > or = 65 yrs) with indwelling urethral
      catheters. Urine was collected at blocked intervals from 0-2, 2-8, and 8-24 hours
      and then added together to determine the 8- and 24-hour clearances. The mean 8
      hour creatinine clearance was not significantly different from the 24-hour value,
      whereas the mean 2-hour creatinine clearance was significantly different. The 8
      hour value was less biased (2.2 and 10.7 ml/min, respectively) and more precise
      (11.7 and 25.3 ml/min, respectively) than the 2-hour value. Regardless of age,
      renal function, serum creatinine level, or diuretic use, the 8-hour value was
      less biased, usually more precise, and clinically more accurate. Thus it can be
      used in stable, hospitalized, elderly patients with indwelling catheters to
      determine degrees of renal impairment and provide optimum drug dosing.

PMID- 8469621
TI  - Renovascular effects of nonprescription ibuprofen in elderly hypertensive
      patients with mild renal impairment.
AB  - To determine the renovascular effects of nonprescription ibuprofen in the maximum
      labeled over-the-counter (OTC) dosage for 7 days, and to compare these effects
      with those of two other available OTC analgesics, aspirin and acetaminophen, we
      evaluated 25 elderly patients with mild thiazide-treated hypertension and mild
      renal insufficiency. Under double-blind conditions, patients were randomly
      allocated to one of three treatment groups: ibuprofen 400 mg 3 times/day, aspirin
      650 mg 3 times/day, or acetaminophen 650 mg 3 times/day. Blood pressure and
      indexes of renal function (blood urea nitrogen, creatinine clearance, serum
      electrolytes) were measured over 7 days in a clinical research center. None of
      the treatments had a clinically significant effect on blood pressure. Renal
      function indexes also remained unchanged during all three treatments. We conclude
      that elderly patients with mild thiazide-treated hypertension and mild renal
      insufficiency seem not to be at risk of developing additional renal compromise or
      of having their hypertension control diminished by treatment with these OTC
      analgesics for 7 days.

PMID- 8469622
TI  - The effect of isradipine on theophylline pharmacokinetics in healthy volunteers.
AB  - The effects of isradipine 2.5 mg and 5 mg on the disposition of theophylline were
      investigated in a placebo-controlled, randomized, three-way, crossover trial.
      Eleven healthy, nonsmoking men each received a treatment of placebo, and
      isradipine 2.5 mg and 5 mg every 12 hours for 6 consecutive days. On the morning
      of day 6, 2 hours after the isradipine dose, theophylline (solution) 5.0 mg/kg
      was administered orally, and blood samples were collected over 24 hours. A 2-week
      washout period separated treatment sequences. Plasma samples were analyzed for
      theophylline using high-performance liquid chromatography. Using a two-way
      analysis of variance, no significant changes in apparent theophylline clearance
      were observed between placebo, and isradipine 2.5 and 5 mg (0.815 +/- 0.164,
      0.870 +/- 0.212, and 0.827 +/- 0.164 ml/min/kg, respectively; p = 0.136).
      Similarly, no significant change in volume of distribution was noted. These
      findings suggest that isradipine at recommended dosages does not impair
      theophylline metabolism.

PMID- 8469623
TI  - Ode to beer cans, canoes, house trailers, and Jimmy Buffet: a commentary.

PMID- 8469624
TI  - Pseudomonas aeruginosa-acquired resistance to imipenem-cilastatin: commentary on
      clinical implications of antibiotic resistance.

PMID- 8469625
TI  - Human gene therapy.

PMID- 8469626
TI  - Congestive heart failure in neonates due to intracranial arteriovenous
      malformation: endovascular treatment.
AB  - Newborns with intracranial arteriovenous malformations and congestive heart
      failure have an extremely poor prognosis. This report describes two infants with
      intracranial arteriovenous malformations and severe congestive heart failure
      successfully treated in the newborn period with endovascular embolization. Both
      infants had immediate improvement in symptoms and both had second embolization
      procedures performed. Ventriculoperitoneal shunting was necessary in both
      children because of progressive hydrocephalus. At follow-up of more than 4 years,
      neither patient has any sign of congestive heart failure, and one is
      developmentally normal.

PMID- 8469627
TI  - Familial interruption of the aortic arch.
AB  - Interruption of the aortic arch (IAA) is an important congenital cardiac
      malformation occurring in 1.4% of cases with a congenital cardiac malformation.
      Only two reports have described IAA in siblings, each with type B and an
      anomalous right subclavian artery. We report the occurrence of IAA type B with an
      anomalous right subclavian artery in two siblings and their half-sibling, each of
      whom had additional conotruncal cardiac malformations. Recent evidence suggests
      that conotruncal cardiac malformations, including IAA type B, are related to
      abnormalities of neural crest cell migration. Thus, the family reported herein
      may manifest a syndrome related to alterations in mesenchymal tissue/neural crest
      cell migration.

PMID- 8469628
TI  - Seizures due to lidocaine toxicity in a child during cardiac catheterization.
AB  - A 17-month-old boy developed grand mal seizures secondary to lidocaine toxicity
      during balloon dilatation of a congenital pulmonary valve stenosis. Lidocaine at
      38 mg/kg (nine times the recommended maximum dose of 4.5 mg/kg) was administered
      during a 90-min period in order to optimize local anesthesia. This resulted in
      toxic serum lidocaine levels (8.7 mg/L; therapeutic range, 1.5-5 mg/L) at the
      time of seizures. Caution should be exercised with local anesthetics during
      invasive cardiac catheterizations. Hypercarbia (which lowers the seizure
      threshold to local anesthetics) should be avoided and the temptation to exceed
      the maximum recommended dose resisted.

PMID- 8469629
TI  - Failure of adenosine to terminate focal atrial tachycardia.
AB  - Adenosine has proven effectiveness in the diagnosis and treatment of a variety of
      tachycardias with both normal and widened QRS complexes in children and adults.
      Its effectiveness is due to its depressant effects on atrioventricular node
      conduction. Adenosine might also be effective against automatic tachycardia due
      to spontaneous activation in partially depolarized cells. This report describes a
      patient presenting with tachycardia with normal QRS complexes. While the
      adenosine did not restore sinus rhythm, it did disclose the mechanism of the
      arrhythmia. Since other investigators have reported successful interruption of
      automatic atrial tachycardia, this case suggests that automatic atrial
      tachyarrhythmia may be due to more than one mechanism.

PMID- 8469630
TI  - Pseudohypertension in a child with Williams syndrome.
AB  - Pseudohypertension has often been reported in elderly subjects, but is an unusual
      phenomenon in children. We report the case of a 5-year-old child who presented
      with features of Williams syndrome (characterized by elfin facies, supravalvar
      aortic stenosis, and peripheral pulmonary artery stenosis). Repeated blood
      pressure recordings made with appropriately sized blood pressure cuffs were very
      high, while simultaneous intraarterial blood pressure was normal, confirming the
      presence of pseudohypertension. This was shown to be caused by excessively
      thickened arterial vessels.

PMID- 8469631
TI  - Polysplenia with pulmonary arteriovenous malformations.
AB  - A patient with polysplenia syndrome, dextrocardia, left atrial isomerism, normal
      great vessel relationships, and no intracardiac shunts developed progressive
      cyanosis and clubbing. Pulmonary arteriovenous malformations (PAVMs) were
      diagnosed by angiography and confirmed by lung biopsy. Superior mesenteric
      arteriogram revealed hypoplasia of the intrahepatic portal vein branches and a
      portosystemic shunt. The possible etiologies of PAVMs are discussed.

PMID- 8469632
TI  - Severe mitral insufficiency in mucopolysaccharidosis type III-B (Sanfilippo
      syndrome).
AB  - A 6-year-old girl with mucopolysaccharidosis (MPS) III-B (Sanfilippo syndrome)
      who developed severe mitral regurgitation and congestive heart failure requiring
      surgery (valvuloplasty) is reported. One year after surgery the patient remains
      well, with marked improvement in her physical activity, and without signs of
      heart failure. This is only the second report of severe mitral regurgitation in
      MPS III, and is the first report of a successful repair (valvuloplasty) of a
      dysplastic mitral valve in the MPS. Mitral valvuloplasty should be considered
      instead of valve replacement in any MPS patient with mitral valve regurgitation
      requiring surgery.

PMID- 8469633
TI  - Aortic atresia and tricuspid atresia occurring in complete transposition of the
      great vessels.
AB  - A unique case of aortic atresia and tricuspid atresia associated with
      transposition of the great vessels is described in a newborn infant. The
      clinical, echocardiographic, and heart catheterization data are presented. The
      embryological and surgical implications are discussed.

PMID- 8469634
TI  - Discordance between thallium-201 scintigraphy and coronary angiography in
      patients with Kawasaki disease: myocardial ischemia with normal coronary
      angiogram.
AB  - To assess the usefulness of radionuclide tests in detecting coronary occlusive
      lesions in children with Kawasaki disease, we compared the results of stress
      thallium-201 myocardial single photon emission computed tomography with
      dipyridamole infusion and coronary angiography in 34 patients (19 males and 15
      females). Perfusion defects on the stress image only were categorized as
      transient and were attributed to coronary vascular disease in the presence of
      redistribution on the delayed image. Others were classified as persistent, due to
      myocardial damage. Five of the seven children (71%) with severe stenosis on
      coronary angiography showed persistent and/or transient perfusion defects.
      However, six of the 11 children (55%) with aneurysms but no obvious stenosis, and
      four of the 16 children (25%) with normal angiography, showed persistent and/or
      transient defects. After analyzing 20 individual segments of perfusion defects in
      the 15 children, six segments (30%) were attributed to the stenosis of supplying
      coronary arteries, six segments (30%) were related to the coronary aneurysms, and
      eight segments (40%) were unrelated to any abnormalities on angiography. Thus,
      significant discordance between the radionuclide and angiographic studies was
      demonstrated. These results suggest that coronary lesions, as conventionally
      defined by angiography and supplemented by echocardiography, may not completely
      identify all Kawasaki patients who may develop myocardial ischemia in the future
      or who had ischemia in the past.

PMID- 8469635
TI  - Congenital heart disease in CHARGE association.
AB  - This study reviews the spectrum of congenital heart disease and associated
      anomalies in 59 patients with the CHARGE association. We have analyzed our
      clinical experience in managing the cardiovascular anomalies and have reviewed
      outcome and risk factors for mortality. This study also highlights problems of
      cardiac management in children born with multiple system involvement. Twenty
      patients have died; actuarial survival was 78% at 1 year and 60% at 10 years. In
      only four of the nonsurvivors could their demise be ascribed to their underlying
      congenital heart disease. We found the outlook for survival was poor if more than
      one of the following three features were present; cyanotic cardiac lesions,
      bilateral posterior choanal atresia, or tracheoesophageal fistula. However,
      mortality was largely due not to the structural heart or choanal abnormalities,
      but instead reflected the underlying pharyngeal and laryngeal incoordination
      which resulted in aspiration of secretions. Furthermore, outcome is likely to be
      improved if collaboration between specialist surgical teams allows necessary
      procedures to be performed using the minimum of anesthetics. Examination of both
      the short- and long-term management of these children has stressed the importance
      of a multidisciplinary approach to their care. The pattern of cardiac defects was
      not random; lesions within the Fallot spectrum accounted for 33% of their
      congenital heart disease. Atrioventricular septal defects were also
      overrepresented. Not all cardiovascular defects could be explained by
      hypothesizing a neural crest etiology.

PMID- 8469636
TI  - Parachute-like sinus venosus remnant: echocardiographic and pathological
      appearance.
AB  - A female infant with multiple congenital abnormalities and a right atrial "mass"
      on echocardiography is reported. Her general condition at birth was poor, and the
      chest x-ray showed cardiomegaly. Echocardiography demonstrated the usual atrial
      arrangement and concordant atrioventricular and ventriculoarterial connections
      with a mobile right atrial mass. Death occurred at 3 days of age and subsequent
      postmortem examination revealed a hollow, tube-like sinus venosus remnant mobile
      between right atrium and ventricle with numerous other abnormalities of the
      heart, including left heart hypoplasia and tubular hypoplasia of the aortic arch.
      Filling of the sinus venosus remnant with blood had resulted in an
      echocardiographic appearance suggestive of a right atrial tumor.

PMID- 8469637
TI  - Transient mitral regurgitation in acute glomerulonephritis.
AB  - During an epidemic of acute glomerulonephritis (AGN) 15 patients were studied by
      M-mode, cross-sectional, and Doppler echocardiography. All 15 patients had the
      classical signs of the disease including hematuria, proteinuria, edema, and
      consistent laboratory findings. There were 10 boys and five girls with a mean age
      of 8 years. Ten of the 15 patients had an enlarged left atrium and five of these
      10 also had transient mild to moderate mitral regurgitation. In the five patients
      with mitral regurgitation the ratio of left atrium/aorta was 1.48; in the five
      patients with an enlarged left atria without evidence of mitral regurgitation the
      left atrium/aorta ratio was 1.34. All the patients had normal left ventricular
      dimensions, as well as ejection and shortening fractions. The findings of left
      atrial enlargement and mitral regurgitation disappeared gradually in all patients
      within 3 months. There was no correlation between the level of systemic blood
      pressure and the development of mitral regurgitation. A possible cause for these
      changes is fluid overload in the oliguric phase of the acute glomerulonephritis.
      The changes are transient and probably functional. There was no significant
      mitral valve or left atrial anomaly 3 and 6 months after hospital discharge.

PMID- 8469638
TI  - Acute rheumatic fever in Saudi Arabia: mild pattern of initial attack.
AB  - Fifty-one children with the initial attack of acute rheumatic fever (ARF) were
      studied prospectively to verify the sociodemographic and clinical profile and to
      compare results with those from other countries. Most children belonged to large
      families who lived in an urban setting with ready access to medical care. Unlike
      reports from many developing countries, the clinical manifestations in this study
      paralleled data from the West and included arthritis in 76% of the cases,
      carditis in 43%, and chorea in 8%. Among the 22 cases with carditis, 18 had
      mitral regurgitation, three developed combined mitral and aortic regurgitation,
      and one had aortic regurgitation. This study demonstrates the mild nature of ARF
      in Saudi Arabia and supports the concept that climate and geography appear to
      bear little relationship to the incidence and severity of ARF.

PMID- 8469640
TI  - [Genital actinomycosis in the women with in situ intrauterine device].

PMID- 8469639
TI  - Rare types of aortic arch anomalies.
AB  - Rare types of aortic arch malformations include isolation of the right or left
      subclavian arteries in conjunction with a left or right aortic arch respectively.
      Isolation of the innominate or carotid arteries and an aberrant left innominate
      artery may exist in association with a right aortic arch. Other anomalies are
      persistent fifth aortic arch, subclavian artery as the first branch of the aortic
      arch, pulmonary artery, and ductus arteriosus sling. The angiocardiographic
      features and embryology of each of these malformations are discussed.

PMID- 8469641
TI  - [Synchronous occurrence of papillary thyroid cancers in a cyst of the
      thyroglossal duct in in the thyroid gland].

PMID- 8469642
TI  - [Scurvy--500 years after Columbus].

PMID- 8469643
TI  - [Osteogenesis imperfecta with hyperplastic callus formation].

PMID- 8469644
TI  - [Morris Simmonds and his importance in hypophysis research from the current
      viewpoint].

PMID- 8469645
TI  - [Kaspar Hauser--individual pathologic observations based on autopsy findings].

PMID- 8469646
TI  - [Current pathology of the prostate and efferent urinary tract. On the 77th
      Congress of the German Society of Pathology in Wurzburg 1-5 June 1993].

PMID- 8469647
TI  - [Autopsy refusal and reversal of the proof responsibility in the malpractice
      process].

PMID- 8469648
TI  - [Changes in cancer incidence after cholecystectomy, tonsillectomy or
      appendectomy? Studies in an autopsy sample].

PMID- 8469649
TI  - [Morphologic characteristics and differential diagnosis of central mesenchymal
      chondrosarcoma--an analysis of 15 cases].

PMID- 8469650
TI  - [Regenerative nodular hyperplasia of the liver--case reports and comments on
      diagnosis and differential diagnosis].

PMID- 8469651
TI  - [Genetic morphological fatal syndrome. Smith-Lemli-Opitz syndrome].

PMID- 8469652
TI  - [Genetic morphological fatal syndromes. The Fryns syndrome].

PMID- 8469653
TI  - [Genetic morphological fatal syndromes. The cryptophthalmos syndrome (Fraser
      syndrome)].

PMID- 8469654
TI  - ["Iatrogenic" fatal gas gangrene infection].
AB  - The problems associated with lethal gas gangrene infections that arise in
      connection with medical treatment are described and discussed, based on our own
      observations and on cases reported in the literature. Special emphasis is placed
      on questions relating to causality and responsibility. The difficulties
      encountered in the evaluation of such "iatrogenic" gas gangrene infections are
      due to the fact that clostridia occur ubiquitously, i.e. that they also reside in
      the human organism, for instance on the skin. For this reason a positive
      bacteriological diagnosis of gas gangrene does not necessarily mean that a
      clinically relevant infection and/or disease state is present at the same time.
      The implications for morphological practice arising from this situation are
      discussed, especially with regard to the significance of the intravital, agonal
      or postmortem bacteriological diagnosis of gas gangrene. Questions concerning the
      obligation to report such cases when encountered during forensic autopsies are
      also addressed.

PMID- 8469655
TI  - [Extrarenal clearance in HIV-infected patients with chronic kidney failure.
      Experience in a hospital center].
AB  - In HIV-infected patients with end-stage renal failure maintenance dialysis raises
      multiple problems, the most important of these being the quality and duration of
      life in these patients and the risk of contaminating other HIV negative patients
      under dialysis and/or members of the medical-nursing staff. In this study the
      results obtained in 14 patients treated in one single centre over a 5-year period
      are analyzed. Nine patients (group I) had end-stage renal failure consecutive to
      HIV-associated nephropathy: 5 died after 2 to 30 months (mean 9.2 +/- 5.2) of
      dialysis, while 4 patients were alive at the end of the study with a mean follow
      up of 23.8 +/- 8.8 months (5 to 50). Five patients (group II) had end-stage renal
      failure consecutive to a nephropathy unrelated to HIV: only 1 female patient died
      29 months after she was found to be seropositive; the remaining 4 patients were
      alive at the end of the study with a mean 47.5 +/- 5.5 months (33 to 58) of
      follow-up. Ten patients were found to have a less than 8 g/dl Hb anaemia which
      was corrected in the 4 patients who received recombinant human erythropoietin.
      Out of the 9 patients treated with zidovudine (300 mg/day) 6 had haematological
      side-effects. Throughout this study, there was no contamination of HIV negative
      patients or members of the medical-nursing staff. In these 2 groups, the survival
      of HIV positive patients dialysed for chronic renal failure seems to have been
      conditioned by the stage of HIV infection at the time when maintenance dialysis
      was instituted.

PMID- 8469656
TI  - [Hyperandrogenism in hirsute and obese women. Effects of a low calorie diet].
AB  - To investigate the relationship between overweight and hyperandrogenism, a 1500
      kcal/day diet was prescribed for 4 months to 23 hirsute and obese patients. This
      diet decreased body mass index from 29.9 +/- 4.9 to 27.2 +/- 4.4 kg/m2 (P <
      0.008), but had no significant effect on fasting insulin levels (18.9 +/- 14.2
      vs. 21.1 +/- 9.6 mlU/l). Weight lost increased significantly (P < 0.008) the
      plasma concentration of sex-hormone binding-globulin (SHBG) from 21.2 +/- 10.6 to
      26.2 +/- 13.5 nmol/l and decreased significantly (P < 0.04) the SHBG-unbound
      testosterone concentration from 9.3 +/- 6.2 to 7.2 +/- 4.8 ng/dl, without
      changing the concentrations of the main androgens measured in this study.
      Moreover, during diet 5 patients in amenorrhea and 8 among 13 patients with
      irregular menstrual cycle recovered regular menses. We concluded that the control
      of excess body weight in hirsute women is effective but not sufficient to improve
      hyperandrogenism.

PMID- 8469657
TI  - [Azygo-portal disconnection by the abdominal route].
AB  - Azygo-portal disconnection by the abdominal route consists of devascularization
      of the lower oesophagus, cardiac orifice and greater gastric tuberosity by
      ligation of the varices and section of the oesophagus, combined in every case
      with truncular vagotomy and gastric bypass. In emergencies the abdominal approach
      enables the bleeding points to be accurately localized. In the treatment of
      haemorrhages due to portal hypertension, this technique offers an alternative to
      porto-caval bypasses when these cannot be performed (thrombosis or portal
      cavernoma) or when the risk of encephalitis is too high. However, contrary to
      liver transplantation, it is a palliative technique for cirrhotic patients.

PMID- 8469658
TI  - [Febrile cervicalgia caused by Streptococcus milleri external pachymeningitis].

PMID- 8469659
TI  - [Acute necrotic thyroiditis caused by Candida albicans immediately after acute
      hemorrhagic rectocolitis].

PMID- 8469660
TI  - [Outbreak of trichinosis in Auvergne, revealed by acute respiratory distress].

PMID- 8469661
TI  - [Hyperhomocysteinemia, a risk factor of cerebral infarction].

PMID- 8469662
TI  - [Paraneoplastic retinopathy (CAR syndrome) revealing prostatic cancer].

PMID- 8469663
TI  - [Hodgkin's disease with vertebral localizations. Indication for orthopedic
      treatment].

PMID- 8469664
TI  - [Periprosthetic popliteal abscess caused by Listeria monocytogenes].

PMID- 8469665
TI  - [Sclerodermatous cutaneous reaction of graft vs host disease treated with
      thalidomide].

PMID- 8469666
TI  - Sporogony of Theileria sergenti in the salivary glands of the tick vector
      Haemaphysalis longicornis.
AB  - Sporogony of Theileria sergenti in the salivary glands of the tick vector
      Haemaphysalis longicornis was observed by light and transmission electron
      microscopy. Fission bodies that developed from kinetes were observed as masses
      (approximately 32 x 15 microns) that occupied half of the acinous cell at 2 days
      after the infestation of ticks. Parasites possessed an irregular nucleus of low
      electron density, highly electron-dense granules, and mitochondrion-like bodies
      in the cytoplasm. Parasites developed into a multinucleate syncytium, increasing
      in size and complexity. Subsequently, the nuclei of parasites became round and
      highly electron-dense, and tubelike structures and rhoptries as precursors of the
      highly electron-dense granules appeared in the cytoplasm. Approximately 40,000
      sporozoites arose via radial budding from the syncytium that had developed from
      kinetes. As in T. parva, no evidence of discrete secondary or tertiary
      sporoblasts was found in T. sergenti. The sporogony of T. sergenti was extremely
      similar to that of T. parva.

PMID- 8469667
TI  - Ultrastructural observations of host-cell invasion by sporozoites of Eimeria
      papillata in vivo.
AB  - Scanning and transmission electron microscopy were used to study the invasion of
      mouse small-intestinal epithelium by sporozoites of Eimeria papillata. Some mice
      received oocysts by gavage and others received either sporocysts or sporozoites
      by direct injection into the small intestine. The highest concentration of
      invaded cells were found in ligated intestinal tissues studied at 5-45 min after
      the inoculation of sporozoites. Sporozoites actively invaded anterior end first,
      which resulted in extensive damage to the host cell. Such cells showed disrupted
      microvilli; protuberances of cytoplasm into the lumen, apparently the result of a
      disrupted plasma membrane; vacuolization of the cytoplasm; and damage to the
      mitochondria. These damaged cells were rapidly vacated as the sporozoite moved
      laterally into one or more adjacent intact host cells without entering the lumen.
      It is suggested that the host cell initially entered from the lumen becomes so
      severely traumatized that the parasite of necessity enters an adjacent cell as a
      prelude to further development. Various aspects of host-cell invasion by coccidia
      and malarial parasites are reviewed.

PMID- 8469668
TI  - Hatching of Echinostoma caproni miracidia from eggs derived from adults grown in
      hamsters and mice.
AB  - Echinostoma caproni eggs developed fully formed miracidia from hamster-source
      eggs in 9 days and from mouse-source eggs in 10 days under either light or dark
      conditions at 27 degrees C. Incubation of egg cultures under constant light
      resulted in miracidial hatching from hamster-source eggs in 11 days and from
      mouse-source eggs in 13 days. Exposure to light was essential to trigger
      hatching, with incandescent light providing more consistent stimulation than
      fluorescent light. A majority of the miracidia hatched at between 1100 and 1600
      hours, indicating a diurnal circadian pattern. Eggs stored in a dark environment
      for 11 days required 6 days to reach maximal hatching after exposure to light.
      Eggs stored for 46 and 56 days hatched on the same day of their exposure to
      light. Miracidia that hatched after 56 days of dark storage exhibited aberrant
      swimming behavior; those stored in a dark environment for 70 days or longer did
      not hatch when exposed to light.

PMID- 8469669
TI  - A new method for isolation of the intraerythrocytic stages of Plasmodium and
      Babesia from their host cells.
AB  - A new method for the isolation of intraerythrocytic stages of Plasmodium berghei
      and Babesia divergens from red blood cells is described. The technique is based
      on hydrodynamic forces occurring in a flow channel containing a turbulent liquid
      current, which are capable of rupturing infected erythrocytes and removing their
      plasma membrane from the parasites' surface. The temperature and the
      concentration of cells were revealed as factors influencing the hydrodynamic
      forces. About 90% of the intact and apparently infectious parasites of both
      species were isolated from the lysed erythrocytes.

PMID- 8469670
TI  - Further evidence for the occurrence of a distinct strain of Echinococcus
      granulosus in European pigs.
AB  - The morphology, adult development and genetic characteristics of Echinococcus
      granulosus isolated from pigs in Poland were examined and compared with those of
      other recognised strains of E. granulosus. The isolates were characterised by
      their distinct morphology, rapid maturation and unique DNA hybridisation
      profiles. The form of E. granulosus that occurs in European pigs may therefore be
      a distinct strain that can be separated morphologically and genetically from
      other strains and that exhibits features of epidemiological significance,
      including a rapid rate of development in dogs and an apparent low infectivity to
      humans and domestic ungulates.

PMID- 8469671
TI  - Requirements for the induction of cross-reactive anti-Trichinella IgE antibodies
      in mice.
AB  - Mice primed with Trichinella spiralis or T. pseudospiralis and reinfected with
      either the homologous or the heterologous species produced high levels of IgE
      antibodies that cross-reacted with the non-inducing strain in passive cutaneous
      anaphylaxis assays. Cross-reactive antibodies were not induced by primary
      infection. Cross-reactivity persisted for more than 6 months following secondary
      infection or destruction of encysted larvae with mebendazole. Both the prevention
      of larvi-position by thiabendazole and the interruption of infection using
      naphthalophos indicated that the presence of the pre-adult stage alone provided
      sufficient priming for the induction of detectable levels of cross-reactive IgE
      by subsequent reinfection. These results suggest the existence of two sets of
      Trichinella allergens, one comprising species-specific major allergens (MAs) and
      the other comprising minor allergens (mAs) evoking a cross-reactive IgE response
      that occurs to a detectable extent only when the response to MAs has reached its
      ceiling. These findings are relevant to the design of experiments investigating
      the role played by IgE antibodies in protection against reinfection in rodents.

PMID- 8469672
TI  - Hysterothylacium aduncum (Rudolphi, 1862) infection in cod from the Oslofjord:
      seasonal occurrence of third- and fourth-stage larvae as well as adult worms.
AB  - Hysterothylacium aduncum infections in cod from the Oslofjord were followed for 1
      year. The recovered worms were grouped according to developmental stage [third
      stage larvae (L3), fourth-stage larvae (L4) and adult worms] and according to
      location (in the gut or encapsulated on the viscera). The cod were found to be
      infected with H. aduncum (all stages lumped) throughout the whole year, with the
      prevalence approaching 100%. The abundance of the parasites (mean number per fish
      studied), however, was clearly lowest during the summer months. L3 and L4
      recovered from the intestine dominated most of the time but showed a very clear
      peak during late winter and early spring. L3 recovered from the body cavity was
      the only stage that showed a clear peak during the summer months. Adult worms,
      although adult worms were present in very small numbers throughout the year, they
      tended to peak in May and then again in December and January. Since there did not
      seem to be a correlation between the accumulation of L3 in the body cavity and
      the length or age of the fish, the possibility of self-infection whereby the
      larvae reenter the gut and continue to develop into L4 and then into adults, is
      discussed.

PMID- 8469673
TI  - Failure of treatment with alpha-difluoromethylornithine against secondary
      multilocular echinococcosis in mice.
AB  - In AKR/J mice inoculated intraperitoneally with protoscoleces of Echinococcus
      multilocularis, the oral administration of alpha-difluoromethylornithine (DFMO)
      in drinking water had no obvious effect on the development of hydatid cysts. The
      DFMO treatment also caused no apparent depletion of three major polyamines
      (putrescine, spermidine, and spermine) in the cysts, although a slight reduction
      in the putrescine level was detected. The failure of DFMO treatment to reduce the
      growth of cysts in mice may result from the absence of ornithine decarboxylase in
      the parasite.

PMID- 8469674
TI  - Secretion of an Eimeria tenella sporozoite antigen during host-cell invasion:
      visualization of the parasitophorous vacuole membrane and parasitophorous duct
      like structures.

PMID- 8469675
TI  - A cDNA putatively encoding the Pc90 erythrocyte membrane antigen of Plasmodium
      chabaudi.

PMID- 8469677
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 8469676
TI  - Trichinella spiralis--characterization of circulating and immune-complex
      associated antigens.

PMID- 8469678
TI  - Prostaglandin and portal hypertension.

PMID- 8469679
TI  - Exaggerated splanchnic PGI2 release following acute hemorrhage is due to new
      protein synthesis.
AB  - The effect of cycloheximide on increased splanchnic prostacyclin release
      following acute hemorrhage was studied in the rat. Male Sprague-Dawley rats were
      anesthetized and subjected to acute hemorrhage to 30 mm Hg for 30 min (shock) or
      sham shock. The superior mesenteric artery was cannulated and removed with its
      end organ intestine (SV + SI preparation) and perfused in vitro with oxygenated
      Krebs-Henseleit buffer. Cycloheximide was infused in half of the sham and acute
      hemorrhage SV + SI preparations at 50 micrograms/ml. Venous effluent from all
      groups were analyzed for prostanoid release by radioimmunoassay. The SV + SI
      released 10-fold more 6-keto-prostaglandin (PG) F1 alpha than PGE2 and
      thromboxane. Acute hemorrhage increased SV + SI release of 6-keto-PGF1 alpha 3
      fold compared to sham. Cycloheximide abolished the increased 6-keto-PGF1 alpha
      following acute hemorrhage but not the basal release in the sham group.
      Indomethacin decreased PG synthesis in all groups by 90%. Sham PG release was
      dependent on a stable pool of cyclooxygenase with a long half-life and was not
      affected by cycloheximide treatment. Acute hemorrhage stimulated a rapid
      induction of enzymes (cyclooxygenase, prostacyclin synthase) responsible for
      prostacyclin synthesis and release which were dependent on de novo protein
      synthesis.

PMID- 8469680
TI  - Thromboxane receptor antagonism and synthase inhibition in cerebral ischemia.
AB  - Thromboxane A2 (TXA2) is a proaggregatory vasoconstrictor that may suppress
      regional cerebral blood flow (rCBF) during postischemic hypoperfusion. This study
      was undertaken to determine if rCBF could be elevated by postischemic treatment
      with a TXA2 receptor antagonist, SQ29,548, given alone or in combination with 1
      benzylimidazole (1-BI), a thromboxane synthase inhibitor. Wistar rats were
      subjected to 30 min of reversible forebrain ischemia and treated with SQ29,548 or
      an SQ29,548/1-BI combination during 60 min of reperfusion. Cerebral TXB2, the
      stable metabolite of TXA2, was 1.33 +/- 0.91 ng mg brain protein-1 in animals
      treated with SQ29,548 and exposed to ischemia, compared to 1.15 +/- 0.32 in
      ischemic controls (p = NS). Administration of SQ29,548/20 mg kg-1 1-BI reduced
      cerebral TXB2 to 0.20 +/- 0.25 (p < or = 0.01). Regional CBF was depressed
      significantly in ischemic controls compared to sham-ischemic animals (p < or =
      0.01 in all regions except for p < or = 0.05 in diencephalon) and was not altered
      by treatment with SQ29,548. Rats given the SQ29,548/1-BI combination showed an
      overall increase in rCBF that did not reach statistical significance when
      compared to ischemic controls. However, rCBF in hippocampus and diencephalon of
      animals given the drug combination was significantly greater than in rats treated
      with SQ29,548 alone (p < or = 0.05).

PMID- 8469681
TI  - Effects of guinea-pig endometrial proteins on phospholipase A2 activity and
      prostaglandin synthesis.
AB  - The major protein secreted by Day-15 guinea-pig endometrium cultured for 24 h had
      a molecular weight of 68.3 kDa on SDS-PAGE. This protein had no effects on
      phospholipase (PL) A2 activity in vitro and prostaglandin (PG) production by Day
      7 guinea-pig endometrium in culture. Following purification, proteins present in
      fractions F1, F2, F7, F7:2 and F7:3 (which comprised < 15% of the total amount
      protein secreted) increased PLA2 activity in vitro. The major proteins in F7:2
      had molecular weights of 13.9 and 15.6 kDa on SDS-PAGE, but they had no effect on
      endometrial PG synthesis in the concentration used (20 mg/ml). Unpurified
      endometrial secreted proteins had no effect on PLA2 activity, but stimulated
      endometrial PG synthesis. This stimulation was lost following purification of the
      proteins, and may have been due to a large amount of contaminating serum albumin.
      The mechanism by which oestradiol acting on a progesterone-primed guinea-pig
      uterus stimulates endometrial PGF2 alpha synthesis by a process which is
      dependent upon increased endometrial protein synthesis still remains obscure.

PMID- 8469682
TI  - Indomethacin-induced gastrointestinal ulcers in rats: effects of dietary fatty
      acids and endotoxin.
AB  - The purpose of this study was to determine how dietary n-3 and n-6
      polyunsaturated fatty acids (PUFA) affected the gastrointestinal response to
      lipopolysaccharide (LPS) and indomethacin (INDO) in the rat. Rats were fed diets
      containing 12.5% linseed oil (LO-enriched in short-chain n-3 PUFA) or corn oil
      (CO-enriched in n-6 PUFA). After 30 days on the diets, rats were given one of
      three treatments 1:10 mg/kg O55:B5 Escherichia coli LPS intraperitoneally (i.p.),
      2:25 mg/kg INDO subcutaneously (s.c.), 3: a combination of 10 mg/kg i.p. LPS and
      25 mg/kg (s.c.) INDO given 30 min before LPS. 20 h after challenge, rats were
      given an intravenous injection of Monastral Blue B to stain ulcer areas in the
      gastrointestinal tract. Lipopolysaccharide did not result in any Monastral Blue B
      vascular leakage in the gastrointestinal tract. Rats on the LO diet had
      significantly increased stomach and intestinal ulcers compared to CO fed rats.
      When rats were challenged with LPS and INDO, the LPS almost completely eliminated
      small intestinal ulcers, but enhanced ulcer development in the stomach.

PMID- 8469683
TI  - The effects of a cysteinyl leukotriene antagonist (ONO-1078) on antigen-induced
      responses in allergic sheep.
AB  - The cysteinyl leukotrienes (LTC4/D4/E4) are putative mediators of asthma. In this
      study we used sheep allergic to Ascaris suum antigen to examine the effects of a
      novel orally active cysteinyl LT antagonist, ONO-1078, on antigen-induced early
      and late responses, airway inflammation, post challenge (24 h) airway
      hyperresponsiveness (AHR) and mucociliary clearance. Airway responses to antigen
      were determined by measuring specific lung resistance (SRL) before and for 8 h
      after challenge, bronchoalveolar lavage (BAL) was used to estimate airway
      inflammation, and airway responsiveness was measured by determining the carbachol
      dose that increased SRL by 400% (PC400). We also used a radiographic technique to
      measure the antigen-induced change in tracheal mucus velocity (TMV), a marker of
      mucociliary clearance. In two trials separated by at least 21 days, sheep were
      treated once with ONO-1078 (30 mg/kg, p.o.) and once with placebo (0.5%
      methylcellulose), 2 h before and 4 h after antigen challenge. Treatment with ONO
      1078 (n = 7) provided 40% protection (p < 0.10) against the peak early increase
      in SRL, resulted in a more rapid reversal of the early response, and provided 96%
      protection against the peak late (6-8 h) increase in SRL. ONO-1078 also inhibited
      the AHR 24 h after challenge. In the drug trial, PC400 was unchanged as compared
      to pre-challenge, whereas in the placebo trial, PC400 was decreased 1.4-fold (p <
      0.05). Treatment however, did not affect BAL cell numbers or
      differential.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469684
TI  - Arachidonic acid supplementation dose-dependently reverses the effects of a
      butter-enriched diet in rats.
AB  - Male Sprague Dawley rats were fed a butter-enriched diet (50% fat) for 2 weeks
      which was supplemented orally with 9, 18, 36, or 72 mg/day of ethyl arachidonate
      for a further 2 weeks. The control group of animals were fed a 5% fat diet for 4
      weeks. Aortic prostacyclin (PGI2) production, platelet aggregation and
      thromboxane A2 (TXA2) production and plasma and aortic phospholipid (PL) fatty
      acids were measured. 50% butter-feeding resulted in a significant reduction in
      aortic PGI2 production and collagen-induced platelet aggregation and TXA2
      production. These changes were accompanied by a reduction in plasma and aortic PL
      arachidonic acid levels and an increase in eicosapentaenoic acid (EPA),
      docosahexaenoic acid (DHA), 5,8,11-eicosatrienoic acid (ETA) and dihomo-gamma
      linolenic acid (DGLA). These changes in prostanoid production, platelet
      aggregation and PL fatty acid composition were dose-dependently reversed by the
      daily oral administration of ethyl arachidonate (9, 18, 36, or 72 mg). The
      threshold dose being as little as 9 mg of ethyl arachidonate/rat/day for reversal
      of PL fatty acid composition, collagen-induced platelet aggregation and TXA2
      production, and 18 mg of ethyl arachidonate/rat/day for reversal of aortic PGI2
      production. Full reversal was seen generally with 36 or 72 mg of ethyl
      arachidonate/rat/day. The data highlight the responsiveness of tissue eicosanoid
      production to small quantities (ppm) of dietary eicosanoid precursors.

PMID- 8469685
TI  - Importance of secondary TXA2 release in mediating of endothelin-1 induced
      bronchoconstriction and vasopressin in the guinea-pig.
AB  - The i.v. bolus application of 1 nmol/kg endothelin-1 (ET-1) in anaesthetized and
      ventilated guinea-pigs caused an increase in mean arterial blood pressure (BP)
      and a bronchoconstriction. Both have been reduced or abolished by COX inhibition
      (ASA) or substances specifically reducing the thromboxane A2 (TXA2) generation
      (HOE 944) or receptor binding (BM 13177). The significant increase in TXB2
      concentrations in plasma and bronchoalveolar lavage (BAL) after ET-1 challenge
      (15-fold and 4-fold, respectively) have been reduced or abolished by ASA as well
      as HOE 944 and not altered by BM 13177.

PMID- 8469686
TI  - Effects of striatal or accumbens lesions on the amphetamine-induced abolition of
      latent inhibition.
AB  - In this study, we tested the effects of nucleus accumbens or corpus striatum
      lesions on the abolition of latent inhibition induced by d-amphetamine. In the
      latent inhibition paradigm, animals learn to ignore a repeatedly presented
      nonreinforced stimulus. In this paradigm, the repeated nonreinforced preexposure
      to a stimulus retards subsequent conditioning to that stimulus. Pharmacological
      manipulations that enhance the dopaminergic function (e.g., d-amphetamine)
      abolish this ability to ignore an irrelevant stimulus. Previous studies have
      revealed a major role of the nucleus accumbens in the d-amphetamine-induced
      abolition of latent inhibition because intraacumbens injections of the drug mimic
      its systemic effects. The results of this study, however, revealed a significant
      increase in the disruption of latent inhibition by d-amphetamine between corpus
      striatum-lesioned and sham-operated rats, but a marginal difference between
      nucleus accumbens lesioned and sham-operated rats, which had been preexposed to
      the stimulus. These findings indicate that the corpus striatum plays also a major
      role in the disruption of latent inhibition by d-amphetamine. It seems,
      therefore, that the nucleus accumbens and corpus striatum may represent a
      functionally common system regarding the expression of latent inhibition,
      although different experimental manipulation can favor the one structure over the
      other, reflecting probably their complex function.

PMID- 8469687
TI  - Opioid regulation of parental behavior in juvenile rats.
AB  - When exposed to young rats for a period of days, juvenile rats will respond with
      full parental behavior (FPB: retrieval and grouping of, and crouching over,
      pups). Because the parental behavior of juveniles is so robust, and because
      opiates have been shown to be involved in the regulation of parental behavior in
      adult animals, we examined morphine's ability to disrupt the display of parental
      behavior in the juvenile animal. In Experiment 1, 25-day-old males and females
      were administered one of three injection regimens of morphine (MOR), saline
      (SAL), or naloxone (NAL)--[MOR (5.0 mg/kg) + SAL; MOR + NAL (0.5 mg/kg); or SAL +
      SAL]--and 1 h later were exposed to three 1- to 6-day-old neonates. Behavior was
      scored over a 60-min period and animals were considered parental if they
      responded with FPB for 2 consecutive testing days. Whereas the SAL + SAL and MOR
      + NAL were not different, MOR + SAL virtually failed to respond to young over a
      10-day period. Experiment 2 exposed juveniles to young for a period of days until
      they displayed 2 consecutive days of FPB. Next, separate groups of juveniles were
      treated with the same regimen as above. Again, SAL + SAL and MOR + NAL responded
      rapidly to young, whereas MOR + SAL did not. These data suggest that the display
      of parental behavior, both its onset (Experiment 1) and maintenance (Experiment
      2), appears to be regulated by opiates.

PMID- 8469688
TI  - Discriminative stimulus properties of NIK-247 and tetrahydroaminoacridine,
      centrally active cholinesterase inhibitors, in rats.
AB  - The discriminative stimulus effect of the novel centrally active cholinesterase
      inhibitor, NIK-247, was investigated in rats and compared with that of
      tetrahydroaminoacridine (THA). Rats were trained to discriminate either 10 mg/kg
      NIK-247 or 1.8 mg/kg THA from saline in a two-lever food-reinforced procedure.
      The stimulus effect of NIK-247 was substituted for by the cholinesterase
      inhibitors, THA and physostigmine. The THA stimulus was substituted for by NIK
      247 and physostigmine. The muscarinic receptor agonist arecoline substituted for
      the NIK-247 and THA stimuli. Both stimulus effects of NIK-247 and THA were
      blocked by the muscarinic antagonist scopolamine. The dopaminergic-activating
      drugs amantadine and lisuride substituted for the stimulus effects of NIK-247 and
      THA. However, neither the NIK-247 nor the THA stimulus was antagonized by the
      dopamine antagonists haloperidol, SCH 23390, and sulpiride. These results suggest
      that the discriminative stimulus effects of NIK-247 and THA are mediated by
      muscarinic receptors, and that the dopaminergic activity resulting from
      cholinergic activation may account for some part of both stimuli.

PMID- 8469689
TI  - Lack of synergistic feeding enhancement by systemic clonidine and 8-OH-DPAT.
AB  - To expand on recent suggestions that brain alpha 2-adrenergic and serotonergic
      systems may interact in their controls over feeding, three experiments were
      conducted to determine if combining clonidine and 8-hydroxy-2-(di-n
      propylamino)tetralin (8-OH-DPAT) injections subcutaneously might produce
      exponential feeding enhancements greater than responses elicited by either agent
      alone. Ad lib fed adult male rats were tested in 2 x 2 drug designs in all
      studies. In Experiment 1, 30 micrograms/kg clonidine reliably enhanced feeding
      over a 6-hr test period. However, 250 micrograms/kg 8-OH-DPAT showed no signs of
      enhancing this response, but instead seemed to impede it as determined by
      analyses of cumulative intake curves. In Experiment 2, either 10 micrograms/kg
      clonidine or 250 micrograms/kg 8-OH-DPAT reliably enhanced 6-h interval intakes,
      but their combination again failed to synergize other than to interact with time
      in suppressing intake. To determine if feeding synergy might occur if
      subthreshold doses of each agent were combined, Experiment 3 tested 1
      microgram/kg clonidine and 15 micrograms/kg 8-OH-DPAT in 4-h feeding tests.
      Neither agent alone elicited reliable feeding as planned, but their combination
      also failed to stimulate feeding. These findings, combined with other recent
      work, do not support the possibility that previously demonstrated interactions
      between brain alpha 2-adrenergic and serotonergic systems extend to circumstances
      wherein enhancements of the former combined with suppressions of the latter might
      underly robust overeating responses.

PMID- 8469690
TI  - Postnatal handling, perinatal flumazenil, and adult behavior of the Roman rat
      lines.
AB  - The effect of infantile handling stimulation and/or perinatal flumazenil (Ro 15
      1788; a benzodiazepine receptor antagonist; 3.7 mg/kg/day) administration on
      exploratory and emotional-related behavior was investigated using adult females
      from the Roman high- and low-avoidance (RHA/Verh and RLA/Verh) lines. When rats
      (6 months old) were exposed to a hexagonal tunnel maze including an illuminated
      central arena, it was found that RHA/Verh rats were more active, explored more
      maze area, showed more outward preference, and more frequently entered the
      illuminated center than RLA/Verh rats. In addition, postnatal stimulation
      decreased emotional-related behavior in both lines of rats, as expressed by
      increased entry into, and time spent in, the central arena. Perinatal flumazenil
      treatment decreased entry into the maze central arena in both rat lines but this
      effect was counteracted by postnatal (handling) stimulation. Thus, the present
      study extends to adult RHA/Verh and RLA/Verh rats the positive long-lasting
      effects of postnatal handling and shows postnatal handling x flumazenil
      interactions in some behavioral parameters related to the pattern of exploration
      and exploratory efficiency.

PMID- 8469691
TI  - Effects of chronic treatment with two selective 5-HT2 antagonists on sleep in the
      rat.
AB  - The effect of chronic administration of 2(2-dimethylaminoethylthio)-3
      phenylquinoline (ICI-169,369) and 2(2-dimethylamino-2-methylpropylthio)-3
      phenylquinoline (ICI-170,809), two selective 5-HT2 antagonists, on sleep was
      studied in rats. As previously shown, the acute effect of ICI-170,809 was to
      increase latency to rapid eye movement sleep (REMS), decrease the number of REM
      periods (REMPs), suppress the cumulative amount of REMS over 12 h, and increase
      the duration of REMPs in the first 6 h, while having no effect on non-REM sleep
      (NREMS). Administration of ICI-169,369 had similar effects except no change was
      seen in the duration of REMPs and cumulative REMS was suppressed for 24 h. When
      given 2 x daily for 5 days, tolerance to the REMS suppressant effects developed
      in both drugs. After discontinuation of treatment, a REMS rebound occurred after
      ICI-170,809, but not ICI-169,369. No significant effect on NREMS was seen after
      administration of ICI-170,809, whereas ICI-169,369 lowered 24-h cumulative NREMS
      on the fifth day of administration.

PMID- 8469692
TI  - Effect of age and strain on working memory in mice as measured by win-shift
      paradigm.
AB  - Working memory is disrupted in Alzheimer's disease and stroke; therefore, any
      therapeutic drug should restore deficits in working memory. The win-shift
      foraging paradigm has been demonstrated to be a model of working memory in rats.
      In the present study, this paradigm was adapted to mice because of the greater
      ease and economy of testing potential drugs in mice and the wider availability of
      strains of aged mice with naturally occurring working memory deficits. This study
      has demonstrated strain differences in the working memory trace and that age
      induces a deficit that can be detected at 11 months of age in mice. Tacrine and
      physostigmine enhance the memory trace in normal mice and physostigmine can
      reverse age-induced working memory deficits in subjects with mild and moderate
      deficits but not in subjects with severe deficits.

PMID- 8469693
TI  - Effects of sublethal doses of ionizing radiation on repeated acquisition in rats.
AB  - To extend previous research on the effects of ionizing radiation on learning,
      dose-effect data with 60Co gamma-rays were collected for individual rats
      responding under a repeated-acquisition procedure. Under this procedure, subjects
      acquired a different three-response chain each session by responding (nose push)
      on one of three transilluminated response keys in the presence of each of three
      sequentially ordered colors. The response chain was maintained under a second
      order fixed ratio (FR) 2 schedule of food presentation. An error produced a 5-s
      timeout but did not reset the three-response chain. Acquisition of each response
      chain was defined by a decrease in errors as the session progressed (i.e., within
      session error reduction). Each session ended after 200 reinforcements or 90 min,
      whichever occurred first. When day-to-day acquisition for all four subjects
      reached a steady state, the effects of three or four doses of gamma-rays were
      assessed. In general, radiation doses of 1, 3, 4.5, and 8 Gy of gamma radiation
      delivered at a dose rate of 2.5 Gy/min produced a dose-dependent decrease in the
      overall response rate for 24-72 h after exposure in all four subjects. Radiation
      exposure also produced an increase in percent errors but only at doses that
      substantially decreased overall rate of responding. Unlike the effects on
      response rate, which were relatively consistent over a 72-h period, the effects
      on accuracy were greater at 72 h than at 24 h in three of four subjects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8469694
TI  - Comparison of the effects of scopolamine and methylscopolamine on the performance
      of a fixed-ratio discrimination in squirrel monkeys.
AB  - In the presence of a stimulus behind the center key, squirrel monkeys were
      required to complete one of two fixed ratios (FRs) on the center key (FR 30 or FR
      25). Completion of the ratio turned off the center-key stimulus and produced a
      stimulus behind each of the two side keys. If the completed ratio was high (e.g.,
      FR 30), a response on the left key produced a food pellet. If the ratio was low
      (e.g., FR 25) a response on the right key produced food. Errors produced a brief
      timeout. Dose-effect curves for scopolamine (0.001-0.18 mg/kg) and
      methscopolamine (0.0032-5.6 mg/kg) were determined under a FR 30 vs. FR 25
      discrimination, which controlled both moderate levels of accuracy and high rates
      of responding. Scopolamine produced a dose-related decrease in overall response
      rates and increase in percent errors. Methscopolamine decreased response rates
      and increased percent errors in a dose-related manner much like scopolamine.
      However, scopolamine was found to be about 10 times more potent on a mg/kg basis
      than methscopolamine. Scopolamine is in general considered to be centrally acting
      due in part to its lipid solubility. The results from these studies suggest that
      methscopolamine, in general considered to be peripherally acting, may also cross
      the squirrel monkey blood-brain barrier at high doses and produce behavioral
      effects comparable to those of scopolamine.

PMID- 8469695
TI  - Enhanced acquisition of reversal training in a spatial learning task in rats
      treated with chronic nimodipine.
AB  - Nimodipine levels were measured in blood and brain of rats implanted SC with
      sustained-release pellets of nimodipine (0, 10, 20, or 40 mg). Dose-dependent
      levels of nimodipine were detected in both plasma and brain. These results
      indicated the possible usefulness of these pellets in behavioral studies where
      long-term treatment is required. Therefore, the effects of chronic nimodipine,
      using 40-mg pellets, were examined on the performance of young, middle-aged, and
      aged rats in the Morris water maze. Following implantation of either nimodipine
      or placebo pellets, rats were trained for 6 days (three sessions/day) followed by
      6 days of reversal training. During both initial and reversal training, every
      sixth trial was a probe trial. During initial training, there were clear age
      related acquisition deficits in place training, with no effects of chronic
      nimodipine. Nimodipine did, however, enhance performance of rats during the first
      and second probe trials of reversal training. Time spent in the training quadrant
      by nimodipine-treated rats was approximately 30% longer on the first reversal
      probe and 35% longer on the second reversal probe than time spent in this
      quadrant by placebo-treated animals. These results indicate that chronic
      nimodipine enhances the performance of normal animals in reversal training on a
      spatial learning task.

PMID- 8469696
TI  - Pharmacokinetics of nordiazepam in physical dependence and precipitated
      abstinence in dogs.
AB  - Previous studies suggested that the extensive accumulation of benzodiazepines is
      an important factor in the induction of physical dependence. The mechanistic
      basis for accumulation of nordiazepam (ND) and its metabolite, oxazepam (OX),
      have been examined in crossover studies in drug-naive and in ND-dependent dogs
      that exhibited a flumazenil-precipitated abstinence syndrome. ND and parent OX
      have similar pharmacokinetic profiles. Steady-state plasma levels of ND and OX
      cannot be predicted from single-dose pharmacokinetics. Reduced plasma clearance
      of ND and altered plasma protein binding were observed in dogs physically
      dependent upon ND. The benzodiazepine antagonist, flumazenil, significantly
      reduces steady-state plasma levels of total and free ND.

PMID- 8469697
TI  - Effects of NBM lesions with two neurotoxins on spatial memory and autoshaping.
AB  - Four groups of Wistar rats received either vehicle, quisqualate, or one of two
      different ibotenic acid infusions into the basal forebrain. Following recovery
      from surgery, all rats were tested in three distinct behavioral paradigms: the
      Battig radial arm maze, the Barnes circular platform, and autoshaping in an
      operant chamber. The results showed that the size and site of the ibotenic acid
      lesion had a profound effect on acquisition performance in some, but not all,
      procedures. Performance in the Battig maze and acquisition of a food-rewarded
      lever press were in particular disrupted by ibotenic acid lesions. The severity
      of the reduction in cortical choline acetyltransferase (ChAT) did not correlate
      with performance in the tests. Quisqualate produced the largest reduction in ChAT
      levels but had no significant effect on performance in any of the three
      procedures used. Anatomic analysis revealed severe nonspecific damage to the
      striatum following ibotenic acid that was more pronounced in the group receiving
      a highly concentrated solution of ibotenic acid as compared to rats infused with
      a greater volume but less concentrated solution of the neurotoxin. Striatal
      damage was much less severe following quisqualic acid infusions. However, both
      types of neurotoxins produced equivalent nonspecific degeneration of the
      reticular thalamic nucleus. These data confirm reports that nonspecific damage
      appears to define the severity of ibotenic acid lesions on subsequent behavioral
      performance.

PMID- 8469698
TI  - Role of nicotine dose and sensory cues in the regulation of smoke intake.
AB  - We investigated the role of nicotine dose and sensory cues in the regulation of
      ad lib smoke intake. The smoking behavior of 12 adult male smokers was assessed
      in three conditions, presenting either high-nicotine cigarette smoke (high
      nicotine, high sensory), diluted cigarette smoke (low nicotine, low sensory), or
      an aerosol containing cigarette smoke constituents suspended in solution, which
      was low in nicotine, yet high in sensory impact. Subjects showed marked
      compensatory increases in smoking with the dilute smoke conditions, whereas they
      puffed and inhaled the aerosol to a similar extent as the high-nicotine
      cigarette. Thus, subjects regulated their smoking behavior to equate sensory
      intensity rather than nicotine intake. Moreover, the aerosol and high-nicotine
      cigarette conditions lowered craving to a greater degree than the dilute smoke
      condition. Other mood indices, such as arousal and negative affect, were more
      effectively relieved by the high-nicotine dose condition. These results highlight
      the importance of sensory cues in the regulation of smoke intake and modulation
      of craving and suggest the clinical application of techniques for providing
      relief of cigarette craving during smoking cessation.

PMID- 8469699
TI  - Muscarinic and nicotinic influences on masculine sexual behavior in rats: effects
      of oxotremorine, scopolamine, and nicotine.
AB  - In this study, the role of cholinergic systems in the regulation of male sexual
      behavior was analyzed by different approaches. Both muscarinic agonists and
      antagonists, as well as a nicotine agonist, were administered to sexually
      experienced male rats. In Experiment 1, oxotremorine (OXO), a muscarinic agonist,
      decreased the intromission frequency and ejaculatory latency in a dose-dependent
      way. Moreover, an increase in ejaculatory frequency was observed. In Experiment
      2, the muscarinic antagonist scopolamine (SCO) produced a dose-related impairment
      of sexual behavior, decreasing the percentage of sexually active males. The
      smaller doses of SCO delayed the initiation of sexual behavior and decreased
      ejaculatory frequency. In an attempt to analyze the effect of muscarinic
      supersensitivity on sexual behavior, in Experiment 3 a long-term blockade of
      muscarinic receptors (SCO for 17 days) was followed by OXO administration.
      Animals displayed a significant increase of mount frequency, which results in the
      decrease of both the hit rate and ejaculatory frequency. In Experiment 4, six
      doses of nicotine were acutely administered. Only the higher doses (0.4, 0.8, and
      1.6 mg/kg) induced a decrease in intromission frequency, although no significant
      differences were found in any other parameter. These results strongly suggest
      that cholinergic participation in masculine sexual behavior regulation is
      mediated mainly through muscarinic system.

PMID- 8469700
TI  - Morphine-induced feeding: a comparison of the Lewis and Fischer 344 inbred rat
      strains.
AB  - Rats of the Lewis inbred strain have been shown to self-administer more morphine
      than rats of the inbred Fischer 344 (F344) strain. Because morphine reward and
      opioid-induced feeding may involve a common mechanism, we measured whether these
      strains also differ in their feeding response to morphine. In Experiment 1, rats
      were maintained on powdered rat chow and given SC injections of morphine sulfate
      (1, 3, and 10 mg/kg) and saline; all rats were tested with all doses. Food intake
      was measured 2, 4, and 6 h after injection. In Experiment 2, rats were given a
      choice of two diets: a fat/protein diet and a carbohydrate/protein diet. Feeding
      responses to morphine were measured in a manner identical to that in Experiment
      1. In both experiments, the feeding response to morphine was greater in Lewis
      rats than in F344 rats. To determine whether these responses might be explained
      by differences in the levels of morphine achieved in the blood or brain, rats of
      each strain were given SC injections of morphine sulfate (3 mg/kg) and sacrificed
      either 30 min or 3 h after injection. Serum and brain morphine levels were
      determined by radioimmunoassay. Lewis rats had significantly less brain morphine
      than F344 rats at 30 min; they did not differ in morphine content at 3 h. Serum
      levels were similar at 30 min; at 3 h, F344 rats had slightly lower levels than
      Lewis rats. Thus, differences in tissue levels cannot readily explain the
      differences in feeding responses to morphine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469701
TI  - Further characterization of the behavioral effects of peripherally administered
      corticotropin-releasing factor in guinea pigs.
AB  - Guinea pig pups were either not injected (NI) or given SC injection of either
      saline vehicle (SAL) or 14 micrograms of corticotropin-releasing factor (CRF). In
      an isolation test, mean number of vocalizations and several measures of locomotor
      activity were markedly lower for CRF pups than for NI or SAL controls. CRF pups
      defecated less than did SAL pups. No differences were found among conditions for
      self-grooming. Behavioral freezing was shown by only two pups in the entire
      study. Significantly more CRF pups displayed piloerection, eye-closing, and a
      characteristic crouched stance than did controls. In a defensive withdrawal test,
      no differences among conditions were found for the proportion of pups entering a
      darkened chamber or for the latency to enter the chamber; however, CRF pups
      entered the chamber significantly fewer times during the 60-min test than did
      controls. There were no differences among conditions in the distance swum or
      number of turns made in a forced-swim test. These results replicate our earlier
      findings that peripheral injection of CRF suppresses vocalizing and a measure of
      locomotor activity in isolated guinea pig pups and identifies a number of
      additional behavioral effects. Of central interest here, the results indicate
      that the suppression of vocalizing and locomotion during isolation is not due to
      an increase in competing stress-related behavior or to diminished motor capacity.

PMID- 8469702
TI  - Ethanol consumption following acute fenfluramine, fluoxetine, and dietary
      tryptophan.
AB  - Male Sprague-Dawley rats fed a commercial diet with or without tryptophan
      supplementation (0.5% L-TRP) were treated with single IP injections of
      fenfluramine or fluoxetine. Rats had been water deprived prior to injection and
      food was removed during the period of fluid availability. They were offered,
      following drug or saline injection, water, a 5% ethanol solution, or an
      isocaloric sucrose solution (8.75%) for 1 h. Fenfluramine injection significantly
      reduced intake of all fluids, but its effect on ethanol was significantly greater
      than for water or sucrose solutions. Fluoxetine suppressed water and ethanol
      intake but not that of sucrose; the reduction in ethanol intake was significantly
      greater than for water. Ingestion of the tryptophan-supplemented diet in the
      absence of any drug treatment had no effect on fluid intake. However, the
      tryptophan supplementation significantly enhanced the reduction in ethanol intake
      induced by fenfluramine and fluoxetine. It appears that both fenfluramine and
      fluoxetine decrease ethanol intake more so than that of water or sucrose and that
      this effect is exacerbated by tryptophan supplementation.

PMID- 8469703
TI  - Prenatal exposure to morphine or naloxone intensifies morphine dependence at
      maturity.
AB  - Pregnant rats were SC injected with physiological saline (control) or 10 mg/kg
      morphine (morphine group) or 2 mg/kg naloxone (naloxone group) three times daily
      during the last 5 days of gestation. Three weeks after birth, male young rats of
      each group were taken and placed in separate cages. When their body weight
      reached 130-150 g, 10 rats from control, morphine, and naloxone groups were SC
      implanted with two pellets containing 75 mg morphine base (total 150 mg). Three
      days following implantation, rats were IP given 2 mg/kg naloxone for precipitated
      abstinence syndrome. Immediately after naloxone injection, rats were strictly
      observed for 15 min and jumping, wet-dog shakes, teeth-chattering, diarrhoea,
      defecation, and ptosis counted or rated. All abstinence syndrome signs were
      significantly higher in the morphine or naloxone group than in control. On the
      basis of the previous experimental findings supporting the idea that opiate
      physical dependence is related to the binding of opiate, possibly other than
      their own, to NMDA receptors and the upregulation and/or supersensitivity
      associated with the binding, the intensification of morphine dependence has been
      attributed to the long-lasting NMDA receptor upregulation and/or
      supersensitivity.

PMID- 8469704
TI  - Effects of harmane (1-methyl-beta-carboline) on neurons in the nucleus accumbens
      of the rat.
AB  - Harmane, a beta-carboline alkaloid reported to exert locomotor and psychoactive
      effects, is found in certain plants and also has been shown to exist in the
      mammalian brain as an endogenous substance. In this study, the effects of locally
      perfused harmane were examined on spontaneous neuronal activity in the nucleus
      accumbens of urethane-anesthetized rats. Extracellular single-unit recording,
      coupled with push-pull perfusion, enabled the discrimination of specific, dose
      related effects of harmane across a wide concentration range. At lower
      concentrations (10(-9)-10(-11) M), excitation prevailed, while at higher
      concentrations (10(-8)-10(-6) M) depression was most pronounced. These findings
      suggest a neuromodulatory role for harmane in the forebrain reward system.

PMID- 8469705
TI  - Behavioral effects of long-term administration of an anabolic steroid in intact
      and castrated male Wistar rats.
AB  - Once a week, intact and castrated male Wistar rats were intramuscularly injected
      with a 0.2 ml suspension of either 0, 10, or 50 mg nandrolone decanoate in
      cottonseed oil, for 8 consecutive weeks. After the sixth injection, locomotor
      activity was measured in an open-field and the acquisition of lever press
      behavior was assessed in an autoshaping procedure. Subsequently, all subjects
      were exposed to four sessions of continuous reinforcement prior to one session in
      which the effects of steroid administration on extinction were assessed.
      Locomotor activity decreased for all groups of rats with continued exposure to
      the open-field, differences between groups were not observed. Rats treated with
      the highest dose of nandrolone decanoate spent more time in the margin of the
      open-field. There were no significant differences between groups on any of the
      learning measures. Long-term, high-dose steroid administration in conjunction
      with mild food deprivation inhibited growth in intact and castrated rats, while
      low dose administration affected body weight in intact rats only. Steroid
      administration resulted in heavier and enlarged kidneys and lighter testes as
      well. These results suggest that the administration of anabolic steroids not only
      produces observable physiological changes, but that it may also affect
      spontaneous behavior. The failure to find differences in learning indices may
      have been a function of the particular paradigms used in the present experiment.

PMID- 8469706
TI  - Enhanced learning following a single, acute dose of MDA.
AB  - The behavioral effects of a single, acute dose of methylenedioxyamphetamine (MDA)
      were assessed using the rabbit nictitating membrane (NM) preparation. Acquisition
      of the classically conditioned NM response was carried out in a single session
      under MDA at doses of 10 and 20 mumol/kg (1.79 and 3.58 mg/kg, respectively) and
      retention was assessed during a drug-free state 48 h later. In agreement with
      previous reports, MDA at a dose of 10 mumol/kg enhanced acquisition of the
      conditioned NM response and learning was retained in the nondrug state. However,
      MDA at a dose of 20 mumol/kg failed to affect either acquisition or retention. In
      further agreement with previous reports, MDA at 10 mumol/kg facilitated the
      amplitude of the unconditioned response during unpaired stimulus presentations.
      It is suggested that this enhanced motor response may be due to enhanced neural
      transmission in the afferent limb of the unconditioned reflex arc.

PMID- 8469707
TI  - Technique for the continuous infusion of high doses of cocaine by osmotic
      minipump.
AB  - The present article describes a procedure for modifying osmotic minipumps to
      avoid the local, toxic, necrotic effects of high concentrations of drug at the
      exit portal during the chronic, continuous infusion of cocaine. The present
      procedure eliminates the occurrence of necrotic skin lesions otherwise produced
      by SC administration of cocaine and/or other vasoconstrictive agents. The method
      of administration will therefore be useful for administration of other chronic
      drug regimens.

PMID- 8469708
TI  - Ethosuximide suppresses seizures and lethality induced by picrotoxin in
      developing rats.
AB  - The action of ethosuximide (125 or 250 mg/kg, IP) against picrotoxin-induced
      seizures (3-6 mg/kg, IP) was assessed in rats 12, 18, 25, and 90 days old. In 18
      day-old and older controls, picrotoxin regularly elicited clonic seizures; tonic
      clonic seizures were induced in all age categories with high consequent
      mortality. Only the higher dose of ethosuximide (250 mg/kg) increased the latency
      of clonic seizures in 18- and 25-day-old pups. Tonic-clonic seizures were delayed
      by ethosuximide in 12-, 18-, and 90-day-old rats. Picrotoxin-induced lethality
      was suppressed only in 18- and 90-day-old rats by the 250-mg/kg dose of
      ethosuximide. In contrast, ethosuximide pretreatment increased the incidence of
      clonic seizures in 12-day-old rats. The results suggest that only high doses of
      ethosuximide can suppress clonic seizures, and this action is not consistent.
      Tonic-clonic seizures probably have model-specific sensitivity to ethosuximide
      because in previous studies ethosuximide completely suppressed pentylenetetrazol
      induced tonic-clonic seizures but had no effect on kainic acid-induced tonic
      clonic seizures. The suppression of mortality rates is probably due to
      nonspecific effects of high doses of ethosuximide.

PMID- 8469709
TI  - Development of rapid tolerance to pentobarbital and cross-tolerance to ethanol on
      a motor performance test with intoxicated practice.
AB  - Male Wistar rats given a single moderate dose (1.7 mg/kg, IP) of pentobarbital
      (PB), followed by six trials on the moving belt apparatus during the next hour,
      showed tolerance to the motor-impairing effects of a second dose of 17 mg/kg
      given 24 h later. A control group that received saline before the first test
      showed the usual initial sensitivity when tested with PB 24 h later. Three weeks
      later, the first group showed cross-tolerance to the effects of ethanol (1.7
      g/kg, IP) on the same test, while the second group did not. These findings
      support the suggestion that rapid tolerance is closely similar to chronic
      tolerance and that the contribution of intoxicated practice results in a long
      lasting component that applies to cross-tolerance to ethanol on the same test.

PMID- 8469710
TI  - Angiotensin II mediates a conditioned taste aversion in water-replete rats.
AB  - Many compounds that exert an influence on behavioral processes will, under the
      unique conditions of the conditioned taste aversion (CTA) procedure, cause
      animals to avoid consuming an otherwise preferred fluid. While angiotensin II
      (ANG II) is a peptide with a number of behavioral and physiological actions,
      previous research did not support its role as an agent capable of inducing a CTA.
      Those studies used fluid deprivation to induce fluid intake and only a single
      conditioning trial. Fluid deprivation can elevate endogenous ANG II levels that
      may have interfered with or masked the ability of ANG II injections to exert an
      effect as a CTA-inducing agent. The present study reassessed the ability of ANG
      II to induce a CTA using fully hydrated animals and a number of conditioning
      trials. ANG II was able to induce a significant taste aversion at a dose five
      times lower than that used in previous studies.

PMID- 8469711
TI  - Effects of tianeptine on 5-HTP- and dextrofenfluramine-induced hypophagia in the
      rat.
AB  - The aim of this work was to analyze whether tianeptine, a 5-hydroxytryptamine (5
      HT) reuptake enhancer, opposes the loss in food intake elicited by 5-HT release.
      Rats were food deprived for 20 h, pretreated either with saline or 7-[3-chloro-6
      methyl-5, 5-dioxo-6,11-dihydro- (c,f)-dibenzo-(1,2-thiazepine)-11-yl-amino]
      heptanoic acid (tianeptine, 10 mg/kg, IP), and injected 1 h afterwards either
      with saline, with the 5-HT precursor L-5-hydroxytryptophan (5-HTP, 20 or 40
      mg/kg, IP), or with the 5-HT reuptake inhibitor/5-HT releaser dextrofenfluramine
      (d-FEN, 1.5 or 3 mg/kg, IP). Diets were then presented 30 min later, and
      individual food intakes were measured 1, 2, 3, and 4 h after food presentation.
      Saline- and tianeptine-pretreated saline-injected rats ate the most, and to a
      similar extent, during the first hour of food presentation; however, in these
      animals tianeptine pretreatment tended to diminish rates of eating throughout the
      last 3 h of analysis. Administration of 5-HTP or d-FEN triggered immediate dose
      dependent decreases in food intake that were not affected by tianeptine
      pretreatment. In addition, tianeptine pretreatment did not alter either brain d
      FEN or d-norfenfluramine levels, thereby suggesting that the lack of effect of
      tianeptine against d-FEN-elicited hypophagia could not be accounted for by
      changes in d-FEN metabolism. This study opens the possibility that tianeptine
      counteracts the effects of 5-HT release in some paradigms but not in others.

PMID- 8469712
TI  - Electromyographic analysis of exercises proposed for differential activation of
      medial and lateral quadriceps femoris muscle components.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to determine whether active
      exercises combining hip adduction with knee extension activate medial components
      of the quadriceps femoris muscle (QF) more than does knee extension alone.
      SUBJECTS: Twelve healthy adults (6 men, 6 women), aged 20 to 36 years (mean =
      24.8, SD = 5.8), participated in the study. METHODS: The subjects performed
      quadriceps femoris setting (QS), straight leg raising (SLR), straight leg raising
      with the hip laterally rotated (SLR/LR), and straight leg raising combined with
      isometric hip adduction (SLR/ADD). Electromyographic (EMG) activity was recorded
      from the oblique (VMO) and longitudinal (VML) portions of the vastus medialis,
      vastus lateralis (VL), and rectus femoris muscles. RESULTS: Comparison of
      normalized mean EMG magnitudes revealed that the single-joint QF components (VMO,
      VML, and VL) demonstrated significantly greater activity during QS than during
      any of the three SLR variations and that SLR/LR and SLR/ADD did not elicit
      greater relative activity of medial QF components than did QS or SLR. CONCLUSION
      AND DISCUSSION: These findings do not support the notion that concurrent use of
      the hip adductors during knee extensor exercises results in preferential
      strengthening of the VMO.

PMID- 8469713
TI  - Age differences in movement patterns used to rise from a bed in subjects in the
      third through fifth decades of age.
AB  - BACKGROUND AND PURPOSE: The purposes of this study were to describe the movement
      patterns of middle-aged adults when rising from a bed and to determine whether
      there are age-related differences in movement patterns across the third through
      fifth decades of age. SUBJECTS: Ninety-three adults (30 men, 63 women), ranging
      in age from 30 to 59 years, participated in the study. METHODS: The subjects were
      videotaped during 10 trials of rising from a bed. Subjects comprised three age
      groups, as defined by the decades of the thirties, forties, and fifties. Movement
      patterns for four body regions were used to classify the videotaped performances.
      The incidence of each movement pattern was determined for each decade and
      graphed. RESULTS: Subjects in their thirties differed from older subjects in
      movement patterns used to rise from a bed. Movement pattern incidence varied
      across age groups for each body region. The movement patterns of one body region
      predominated in reverse order of a previously proposed developmental sequence.
      CONCLUSION AND DISCUSSION: Results indicate physical therapists should consider
      the patient's age when selecting movement patterns to teach.

PMID- 8469714
TI  - Effect of total contact cast immobilization on subtalar and talocrural joint
      motion in patients with diabetes mellitus.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to determine the effect of
      total contact casting (TCC) on dorsiflexion at the talocrural joint (TCJ) and
      motion (inversion/eversion) at the subtalar joint (STJ). SUBJECTS: Thirty-seven
      patients (29 men, 8 women), ranging in age from 32 to 79 years (mean = 54, SD =
      11), with diabetes mellitus and a unilateral plantar ulceration participated in
      the study. METHODS: The subjects were measured with a goniometer for dorsiflexion
      and STJ range of motion (ROM). The ROMs for each subject's casted and noncasted
      legs were compared before and after treatment with TCC for neuropathic plantar
      ulcers by use of a 2 x 2 repeated-measures analysis of variance design. RESULTS:
      Mean time of immobilization in TCC (healing time) was 42 days (SD = 43, range = 8
      119). The results indicated (1) ROM was unchanged at the STJ, but dorsiflexion
      decreased slightly (1 degree) on both the casted and noncasted sides following
      the last cast removal, and (2) ROM was less on the ulcerated side prior to
      casting compared with the nonulcerated side. CONCLUSION AND DISCUSSION: We
      believe the beneficial effects (healing of wounds) outweigh the minimal
      detrimental effects (decreased dorsiflexion) of treatment with TCC.

PMID- 8469715
TI  - Converting Chattecx Balance System vertical reaction force measurements to center
      of pressure excursion measurements.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to determine the precision
      with which the postural stability data generated by the Chattecx Balance System
      could be converted to center of pressure displacement measurements. SUBJECTS: Two
      men and one woman were selected to represent a broad range of body sizes (age =
      23-33 years, height = 154-175 cm, weight = 45-80 kg). METHODS: The Balance System
      load cells were placed on a force plate, and data were collected simultaneously
      from the Balance System and the force plate while the subjects performed
      standardized postural tasks. Linear regression analysis was used to characterize
      the relationship between the estimated center of pressure from the Balance System
      and the calculated center of pressure from the force plate. RESULTS: Significant
      linear relationships between the center of pressure estimated from the Balance
      System and the center of pressure calculated from the force plate were determined
      (all R2 values = > .90). CONCLUSION AND DISCUSSION: System data can be converted,
      and the methods recommended for use with the Balance System are described.

PMID- 8469717
TI  - DPT controversy.

PMID- 8469716
TI  - Cross-validation of bioelectrical impedance analysis of body composition in
      children and adolescents.
AB  - BACKGROUND AND PURPOSE: The reliability and validity of measurements obtained
      with two bioelectrical impedance analyzers (BIAs), an RJL Systems model BIA-103
      and a Berkeley Medical Research BMR-2000, were investigated using the
      manufacturers' prediction equations for the assessment of fat-free mass (FFM) (in
      kilograms) in children and adolescents. SUBJECTS: Forty-seven healthy children
      and adolescents (23 male, 24 female), ranging in age from 8 to 20 years (mean =
      12.1, SD = 2.3), participated. METHODS: In the context of a repeated-measures
      design, the data were analyzed according to gender and maturation (Tanner
      staging). Hydrostatic weighing (HYDRO) and Lohman's Siri age-adjusted body
      density prediction equation served as the criteria for validating the BIA
      obtained measurements. RESULTS: High intraclass correlation coefficients (ICC >
      or = .987) demonstrated good test-retest (between-week) measurement reliability
      for HYDRO and both BIA methods. Between-method (HYDRO versus BIA) correlation
      coefficients were high for both boys and girls (r > or = .97). The standard
      errors of estimate (SEEs) for FFM were slightly larger for boys than for girls
      and were consistently smaller for the RJL system than for the BMR system (RJL SEE
      = 1.8 kg for boys, 1.3 kg for girls; BMR SEE = 2.4 kg for boys, 1.9 kg for
      girls). The coefficients of determination were high for both BIA methods (r2 > or
      = .929). Total prediction errors (TEs) for FFM showed similar between-method
      trends (RJL TE = 2.1 kg for boys, 1.5 kg for girls; BMR TE = 4.4 kg for boys, 1.9
      kg for girls). DISCUSSION AND CONCLUSION: This study demonstrated that the RJL
      BIA with the manufacturer's prediction equations can be used to reliably and
      accurately assess FFM in 8- to 20-year-old children and adolescents. The
      prediction of FFM by the BMR system was acceptable for girls, but significant
      overprediction of FFM for boys was noted.

PMID- 8469718
TI  - Partition of plasmid R1: a computer simulation.
AB  - A computer-simulated population of individual Escherichia coli cells harboring
      plasmid R1 parA+/parB- has been used to analyze three possible modes of plasmid
      segregation: equi-partition, in which plasmids are partitioned equally to
      daughter cells at cell division; single-site inheritance, in which the products
      of the most recent replication event are partitioned equally and the remaining
      plasmids are distributed randomly; and pair-site partition, in which a single,
      randomly chosen plasmid is actively partitioned to each daughter cell at division
      and the rest are distributed randomly. Comparison between predicted and
      experimental plasmid loss-frequency enabled us to rule out the first of these
      models as a likely mode of action in R1 but was inconclusive regarding the other
      two. The parA region would therefore seem to partition actively only one pair of
      plasmids to each daughter cell, the precise selection rule involved remaining
      unresolved. This question is not easily decided with current technology, as we
      show, but our simulation results also predict that the isolation of rep(Ts)
      mutants will provide an experimental system in which a clear distinction is
      possible between two plasmids that are the products of the most recent
      replication event and two that are chosen strictly at random.

PMID- 8469719
TI  - Characterization, sequence, and replication of a small cryptic plasmid from
      Selenomonas ruminantium subspecies lactilytica.
AB  - A 2.5-kb cryptic plasmid, pJDB21, from the gram-negative ruminal anaerobe,
      Selenomonas ruminantium subspecies lactilytica, was mapped and sequenced. Five
      open reading frames (ORFs) were predicted and expression of two ORFs was
      demonstrated. Analysis of the predicted amino acid sequence of the ORF 1 protein
      indicated approximately 30% homology with the replication protein (rep) common to
      many gram-positive plasmids, and a highly conserved sequence representing the
      origin of replication in these plasmids was located upstream of ORF 1. This
      finding was consistent with a rolling circle form of replication for pJDB21.
      Transformation of Escherichia coli K-12 UB1636pol Ats with pJDB21 showed that the
      plasmid replicated independently of DNA polymerase I and produced a single
      stranded DNA intermediate. Deletion analyses localized the E. coli replication
      function to a 1.4-kb sequence that was mapped to the predicted rep gene.

PMID- 8469720
TI  - Conjugative transfer and in vitro/in vivo stability of the broad-host-range IncP
      R751 plasmid in Brucella spp.
AB  - Escherichia coli strain K12 BM14, carrying plasmid R751 (51.4 kb; Tpr, Tra+,
      IncP), was used as donor in matings with reference strains of the six Brucella
      nomenspecies, not known so far to harbor naturally occurring plasmids. R751 was
      easily transferred to and between Brucella spp., at frequencies ranging between
      10(-1) and 10(-4). All Brucella transconjugants stably maintained plasmid R751
      both in vitro and in vivo in our experimental conditions. No genetic modification
      of the plasmid during and after the conjugal transfer process could be deduced
      from the comparative restriction analysis (BamHI, HindIII, and EcoRI) in each
      Brucella transconjugant and in the E. coli donor.

PMID- 8469721
TI  - The Ti plasmid from the wide host range Agrobacterium vitis strain Tm4: map and
      homology with other Ti plasmids.
AB  - The octopine/cucumopine (o/c) strains of Agrobacterium vitis are divided into
      limited (LHR) and wide host range (WHR) strains. We present here the first map of
      a Ti plasmid from a WHR o/c strain, Tm4. pTiTm4 (252 kb) has homology with the
      octopine Ti plasmid pTiAch5, the nopaline plasmid pTiC58, and the Ri plasmid
      pRiHRI. Approximately 155 kb of pTiTm4 is homologous with the LHR o/c Ti plasmids
      pTiAB3 and pTiAg57, the remaining part is pTiTm4-specific. Our data suggest that
      the evolution of the o/c Ti plasmids was accompanied by large-scale changes in
      plasmid structure. The origin of replication of pTiTm4 was localized by a
      functional assay.

PMID- 8469722
TI  - New suicide vector for gene replacement in yersiniae and other gram-negative
      bacteria.
AB  - A suicide vector named pUK4134 was constructed to enlarge the repertoire of
      vectors available for allelic exchange of mutated sequences in gram-negative
      bacteria. This plasmid combines the properties of two previously described
      plasmid vectors, pJM703.1 and pRTP1. pUK4134 is a suicide vector, carrying the
      origin of replication of the plasmid R6K and thus requiring the product of the
      pir gene for its stable maintenance. The rpsL gene encoding Escherichia coli
      ribosomal protein S12 confers streptomycin sensitivity on streptomycin-resistant
      strains and provides a positive selection for bacteria that have lost the plasmid
      following allelic exchange. The bla gene provides for selection by Apr. Other
      features are a unique EcoRV cloning site, oriT of plasmid RK2, and the
      bacteriophage lambda cos sequence. This vector was successfully used several
      times to carry out allelic exchange in Yersinia pestis.

PMID- 8469723
TI  - Occurrence of extrachromosomal deoxyribonucleic acids in spiroplasmas associated
      with plants, insects, and ticks.
AB  - Several spiroplasmas (helical, motile mollicutes) were previously shown to
      contain extrachromosomal DNA (E-DNA) elements in the form of viruses (double
      stranded viruses or the replicative form of single-stranded viruses) or plasmids.
      These elements are now being investigated as potential vectors for use in
      spiroplasma transformation systems. Described herein is the first extensive
      survey of spiroplasma E-DNA in 23 spiroplasma groups (30 strains), a study
      facilitated by improvements in protocols for E-DNA extraction. E-DNA elements
      were found in spiroplasmas associated with leafhoppers/plants (spiroplasma
      subgroups I-1, I-3, and I-8), other insects (subgroups I-2, I-5, I-6, and I-7 and
      groups IV and XXII), and ticks (subgroup I-4 and groups V and VI). Elements,
      maintained by passage with their host spiroplasmas, were often lost after
      extended passage. Whether the current distribution of E-DNA elements is
      indicative of historical or proximate factors is not known. Many elements (about
      75%) from group I spiroplasmas hybridized with Spiroplasma citri viruses SpV1 or
      SpV3. Of the elements associated with other spiroplasma groups, none hybridized
      with either virus. These include Spiroplasma apis strains B31 (18 kb) and L89 (18
      and 20 kb), S. mirum strains SMCA (20 kb) and Anderson (16 and 20 kb), group VI
      strain Y32 (7, 9, 10, and 16 kb), and group XXII strain CT-1 (8 kb). Several of
      these elements will be characterized and examined for their suitability as
      spiroplasma cloning vectors.

PMID- 8469724
TI  - Control of mini-R1 plasmid replication: a computer simulation.
AB  - A molecular model for the control of plasmid R1 replication has been proposed by
      Nordstrom, Molin and Light (Plasmid 12, 71-90, 1984), involving three genes:
      repA, copA, copB. RepA codes for a polypeptide whose synthesis is required for
      initiation; replication is controlled by regulating this synthesis. CopA encodes
      a small, unstable, untranslated RNA molecule that inhibits translation of the
      repA message whereas copB produces a protein that inhibits transcription from the
      repA promoter. We have recast this model into precise mathematical terms and
      tested it by computer simulation of a synchronous culture in steady-state
      balanced growth, composed of individual Escherichia coli cells harboring the
      small, unstable derivative, mini-R1. All single-cell steady-state distributions
      obtained are independent of initial conditions, and the average values of various
      plasmid-related variables are similar to those measured experimentally. The
      relationship between the number of replication events per cell and the copy
      number at birth, as predicted by the model, mitigates against a sensitive
      correction mechanism for cells born with other than average copy number and is
      much closer quantitatively to a nonresponse system, although there is a weak
      dependence on copy number. The effect of the convergent transcription initiated
      at the repA and copB promoters on the expression of the copA gene is found to
      contribute little to the stability of mini-R1 replicons under steady-state growth
      conditions or to their potential for survival following infection. In fact, the
      role of the entire CopB control loop is shown to be quite minor, both in steady
      state and after infection. It is pointed out that genetic manipulations are far
      more easily performed in silico than in vivo but that results of the kind
      presented here are very often possible only when simulating individual cells.

PMID- 8469725
TI  - Harvard Community Health Plan's Mental Health Redesign Project: a managerial and
      clinical partnership.
AB  - Harvard Community Health Plan, founded in 1969 as a staff model HMO, is currently
      a staff and group model HMO with 521,000 members, 19 health centers and 12
      independently owned group practices with 26 locations. In 1987, the Plan
      initiated a review of its mental health benefit and program because its costs
      were rising, member and clinician dissatisfaction was increasing and many
      believed the problem was the nature and scope of the benefit. After two years of
      study, surveys, interviews, cost and utilization analysis, the Plan identified
      its professional staff as its key asset but recognized many problem areas,
      including problems with access, variation from site to site, inconsistent service
      delivery, lack of consistent utilization management and the need for greater
      diversity along the spectrum of care available to members. From 1989 to 1990,
      more than 200 clinicians and support staff were engaged in the process of
      developing a variety of components to the "mental health redesign program." Three
      simultaneous efforts included developing a method of categorizing patients,
      restructuring the delivery system and redesigning the benefit. A Mental Health
      Patient Assessment Tool was created which assists clinicians in performing
      comprehensive evaluations, administers the benefit, measures progress and
      supports outcomes research. Delivery system changes included the implementation
      of self-referral, access standards, intake triage functions by non-clinical
      staff, program development and an outpatient utilization management function.

PMID- 8469726
TI  - Staff model HMO's and managed mental health care: one plan's experience.
AB  - HMO staff model mental health programs have particular expertise in providing
      these services in an integrated fashion within the context of a total medical
      care system. "Carve-out" approaches to managed mental health care risk losing the
      added value found in primary care based integrated mental health services.
      Employers as purchasers of care are seeking demonstrated value in services, and
      the rise of specialty mental health managed care firms is bringing the
      efficiencies of managed mental health care familiar to HMO's to a broader
      audience. Faced with employer concerns, and this new competitive environment,
      many HMO's are examining their mental health services to determine how these
      services may respond to the needs being expressed by employers today for new
      program options. The Community Health Plan's (CHP) experience is presented to
      illustrates one approach HMO's are taking in today's competitive health care
      environment.

PMID- 8469727
TI  - View from the bridge: reflections of a recovering staff model HMO psychiatrist.
AB  - The phenomenon of managed care is misperceived by its critics as a movement.
      Atheoretical in nature, and driven by spiralling health care costs, it represents
      the introduction of an executive function into the free-for-all (a supremely
      ironic term) of American medicine. Part one of this article traces the origin and
      development of the mental health carve-out, relating it to its antecedents, and
      describing its 3 overlapping phases: utilization review, discounted fees, and
      network development and management. Part two describes the key concept of the
      continuum of care and the role of the case manager in monitoring a care episode.
      The article concludes by anticipating seven future trends and calling for mental
      health leadership to recognize and ally with the need to manage resources in a
      more rational and efficient manner.

PMID- 8469728
TI  - Overview of the HMO movement.
AB  - This article provides a short historical review of the HMO movement to set the
      stage for current HMO developments. It notes the underlying causes of the
      proliferation of HMO managed care models. It defines what should be the rudiments
      of a quality HMO program and how the changing societal environment will bring new
      pressures to bear on HMO programs of the future. As related to the future, the
      author outlines a direction for national health care reforms. The article
      concludes that the health care emphasis of the 90s should be in returning some of
      the responsibility of health care to individual Americans through self-care
      programs that focus on behavioral change, in turn, leading to healthier
      Americans, the keys to containing out of control health care costs.

PMID- 8469729
TI  - [The possibility of using the population characteristics of myelokaryocytes for
      the early diagnosis of radiation lesions].
AB  - The method of flow cytofluorimetry was used to study some population
      characteristics of bone marrow cells of control and irradiated rats. The
      simultaneous recording of cellularity and distribution of myelokaryocytes among
      the cell cycle phases was shown to give reliable results for determining the
      extent to which the organism was exposed at early times following irradiation.

PMID- 8469731
TI  - [The occurrence of cataract in rats as one of the factors worsening the quality
      of their lives in the late periods after whole-body and partial irradiation].
AB  - A study was made of the formation of cataract in rats at remote times after whole
      body and partial X irradiation. The whole-body radiation loses were 5 and 10 Gy
      (two fractions of 5 Gy at a 30-day interval). Partial exposure of the head and
      neck, as well as irradiation of chest were performed with doses of 5, 10 (two
      fractions at a 30-day interval) and 15 Gy (three 5 Gy fractions at a 30-day
      interval). It has been shown that cataract develops not only due to the direct
      effect of radiation on the eye, but also to indirect effect on the experimental
      animal body (with irradiation of the abdomen and diabetes development).

PMID- 8469730
TI  - [The effect of low doses of ionizing radiation on intracellular pH, ATP content
      and synthetic activity in cultured Chinese hamster fibroblasts].
AB  - X irradiation of Chinese fibroblasts with doses of 0.05-0.15 Gy was shown to
      cause intracellular pH (pHi) changes: its diminishing during the first 40-60 min
      by 0.16-0.18 pH units, then the return to the control level 120 min after
      irradiation and, finally, the increase by 0.18-0.20 pH units. Simultaneously, the
      synthesizing activity of the cells changed in the same way. The ATP level changed
      in the opposite way: increased when pH fell and decreased when pH grew. It was
      shown that pHi changes were connected with the changes in Na+/H(+)-exchange
      system, and they seemed to be primary in the chain of the alterations observed.

PMID- 8469732
TI  - [The connection between the content of metallothioneins in the bone marrow and
      liver and the survivability of irradiated mice after cadmium chloride
      administration].
AB  - The survival rate of mice gamma-irradiated at different times after
      administration of Cd2+ (0.75 mg/kg) was shown to be tightly connected with the
      amount of metallothioneins induced by this heavy metal in the bone marrow (r =
      0.96). The connection between the amount of metallothioneins in the liver and the
      survival rate was less pronounced.

PMID- 8469733
TI  - [Synergism and interference in the combined biological action of ionizing and SHF
      radiation].
AB  - In experiments with 933 (CBA x C57Bl)F1 mice it has been found that with any
      variant of alternation and sequence of single ionizing and SHF irradiation with
      lethal doses, the radiation affection caused by gamma quanta is aggravated.
      Preirradiation with gamma or SHF radiation ameliorates the severity of the
      affection caused by the subsequent SHF radiation. Parenteral injection of
      colloidal sulfur 60 min before SHF radiation causes a 2-5-fold increase in the
      survival rate of exposed and protected mice as compared to unprotected animals.

PMID- 8469734
TI  - [The radioprotective effect of GABA-tropic substances, gamma-hydroxybutyrate and
      piracetam].
AB  - From experiments in mice, it is shown that with a radiation dose of 8 Gy (LD96)
      the radioprotective effect was exerted by gamma-aminobutyric acid (GABA),
      substances that increase its concentration in tissues (progabide and valproate),
      and synthetic agonists of both receptor types, particularly baclofen, a GABA
      receptor agonist. The radioprotective effect is also exerted by gamma
      hydroxybutyrate, not piracetam.

PMID- 8469735
TI  - [An increase in the radioprotective effect of O-methyltyramine and mezaton by
      monoamine oxidase inhibitors].
AB  - Specific 2-propynylamine inhibitors of monoamine oxidase (MAO) pargyline and
      especially chlorgyline, a selective inhibitor of MAO A (but not deprenyl, a
      selective inhibitor of MAO B) increase the radioprotective effect of small doses
      of O-methyltyramine and phenylephrine and do not change the efficacy of large
      doses. This is consistent with the receptor theory of the mechanism of protective
      action of amines.

PMID- 8469737
TI  - [The modification of the radiation damage to the chromosomes in the somatic cells
      of radiosensitive Drosophila mutants. The effect of fractionating the gamma-ray
      dose].
AB  - A study was made of the effect of gamma-ray dose fractionation registered by
      chromosome aberration induction in somatic cells of the mutant rad(2)201G1, the
      mutant mus(2)201G1, and the wild type strain of drosophila. The dose
      fractionation upon irradiation of the mutant mus(2)201G1 and control strain
      larvae was shown to decrease the frequency of cytogenetic damages to cells. In
      contrast, when the radiosensitive mutant rad(2)201G1 was exposed, the effect of
      dose fractionation was insignificant.

PMID- 8469736
TI  - [The radioprotective action of an extract of regenerating spleen].
AB  - An extract from regenerating calf spleen increases the survival rate of mice when
      injected after irradiation. The studies of the blood and immune systems
      characteristics at the subcellular, cellular and tissue levels have been shown
      that the preparation containing a complex of hemoregulating compounds modifies
      the processes responsible for radiation damage and repair.

PMID- 8469738
TI  - [The radioecological problems of Eurasia and the sources of radioactive
      environmental contamination in the former USSR].
AB  - There is three major sites of radioactive environmental contamination in the
      former USSR: the Chelyabinsk region in the Urals, Chernobyl NPP in Ukraine and
      Novaya Zemlya in the Arctic Ocean. The first mentioned is the most important with
      regard to local (potential) contamination, the last one dominates the global
      contamination. A number of sites and sources are less well known with regard to
      environmental contamination. This is thus the case for the plutonium production
      factories at Tomsk and Dodonovo. More information on nuclear reactors in lost or
      dumped submarines is also needed. From a global point of view reliable assessment
      of the radioactive run-off from land and deposits of nuclear waste in the Arctic
      Ocean are in particular pertinent.

PMID- 8469739
TI  - [The modification of the radiation damage to the chromosomes in the somatic cells
      of radiosensitive Drosophila mutants. The radioprotective action of cysteamine].
AB  - The radioprotective effect of cysteamine has been studied in larva nerve ganglia
      of the radiosensitive mutant rad(20)201G1, mutagen-sensitive mutant mus(2)201G1
      and the control strain of drosophila. Cysteamine was shown to produce a
      radioprotective effect in somatic cells of mus(2)201G1 and the control strain of
      drosophila which was manifested by the decreased incidence of cells with
      chromosome aberrations and diminished yield of deletions and exchanges. No
      significant radioprotective effect of cysteamine was observed in somatic cells of
      rad(2)201G1 mutant.

PMID- 8469741
TI  - [The ultrastructural organization of pine needles after radiation exposure].
AB  - Pine assimilative tissue was studied in the region of Chernobyl Power Plant
      accident the 1986-1988. With radiation doses of 8-11 Gy pine needle was viable
      inspite of the significant structural changes in cell organelles. With doses of
      20-25 Gy the inner structure of mesophyll cells was impaired. High
      radiosensitivity was displayed by mitochondria and chloroplasts where
      irreversible destruction of membrane systems occurred.

PMID- 8469740
TI  - [The modification of the effect of microwave radiation on the biochemical
      processes in anaphylactic shock by using exposure to a weak and perturbed
      geomagnetic field].
AB  - Repeated exposure of guinea pigs to microwave radiation (1 mW/cm2) caused in some
      animals inhibition of anaphylactic response accompanied by increasing the content
      of histamine, epinephrine and norepinephrine in the blood. This increase was more
      pronounced in irradiated guinea pigs died from anaphylactic shock than in
      nonirradiated animals. The long-term stay in the perturbed and weak geometric
      field reduced the effect induced by microwave radiation.

PMID- 8469742
TI  - [The radioecological lessons of Chernobyl].
AB  - This paper presents the results of radioecological studies undertaken within the
      area exposed to ionizing radiation after Chernobyl disaster. Conclusions are made
      concerning the major regularities in radionuclide migration within various
      natural media and action of ionizing radiation on natural and artificial
      ecosystems. The efficiency of basic protective ecological measures in eliminating
      the accident consequences has been determined. The contribution of
      radioecological studies to the elimination of Chernobyl disaster sequences
      assessed.

PMID- 8469743
TI  - [The effect of ionizing radiation and calcium on plasma membrane structure].
AB  - Plasma membrane thymocytes were irradiated with doses of 10-10(4) Gy in the
      presence of 125 and 1125 mu mol of Ca2+ per 1 mg of membrane proteins.
      Fluorescence of 1-anilinonaphthalene-8-sulphonate and the degree of pyren
      eximerization were determined. The data obtained indicate that calcium can exert
      a stabilizing effect on the plasma membrane structure affected by radiation.

PMID- 8469744
TI  - [Structural changes in the plasma membranes during thymocyte irradiation].
AB  - Thymocytes were irradiated with doses of 4 to 10(3) Gy. The binding of 1-anilino
      naphthalene-8-sulphonate and Ca2+ to plasma membranes; viscosity and lipid
      peroxidation; Stern-Folmer constant; and the number of SH-groups of membrane
      proteins were determined. The structural changes in plasma membranes after
      irradiation of thymocytes were found to be cooperative.

PMID- 8469745
TI  - [Postradiation changes in Ca2+ binding with thymocyte plasma membranes].
AB  - Was determined quantity places and constant binding of calcium with plasma
      membranes thymocytes at rats, that was irradiation at doses 7 Gr. Was establish
      that to 22 days after irradiation the binding Ca2+ with membranes was return to
      control.

PMID- 8469746
TI  - [Changes in the lipid component of thymocyte plasma membranes in exposure to
      ionizing radiation].
AB  - A thymocyte plasma membrane suspension was irradiated with a dose of 5 +/- 10(4)
      Gy. An increase in the rate of lipid peroxidation and a change in the
      phospholipid composition of membranes were revealed. The alteration of the plasma
      membrane structure was characterized by a change in the membrane charge and a
      decrease in the lipid viscosity.

PMID- 8469747
TI  - [The effect of alimentary vitamin E on the seasonal fluctuations in the level of
      fluorescent lipopigments in the tissues of irradiated rats].
AB  - In seasonal experiments (spring and autumn) with Wistar female rats, a study was
      made of the level of lipopigments (LP) and alpha-tocopherol (TPh) fluorescence in
      the liver and brain. Seasonal peculiarities of the parameters under study and
      their dependence on Vitamin E ingestion have been revealed. After irradiation of
      animals, an intimate morphofunctional relationship between LP and TP and its
      sensitivity to alimentary factors have been found. One hour following
      irradiation, part of LP is disintegrated thus releasing the TPh reserve. This may
      be the part of the complex of adaptation changes on the postirradiation metabolic
      effects.

PMID- 8469748
TI  - [The physicochemical status of the plasma membranes of rat fatty tissue and liver
      in the late periods after gamma irradiation at a dose of 1 Gy. Changes in the
      lipid composition].
AB  - A study was made of lipid composition of plasma membranes of adipose tissue and
      liver of rats at remote times (from 15 to 380 days) after single 1-Gy gamma
      irradiation. The changes in membrane lipids were most pronounced during the first
      50 days after irradiation: the cholesterol level increased (the phospholipid
      content in the adipose tissue decreased) and the relative content of linoleic
      (18:2), arachidonic (20:4) and other unsaturated fatty acids decreased. At later
      times following irradiation, the molar cholesterol/phospholipid ratio in
      membranes of experimental animals did not vary from the control and relative
      content of unsaturated fatty acids somewhat increased as compared to that of
      intact animals of the same age.

PMID- 8469749
TI  - [The physicochemical status of the plasma membranes of rat fatty tissue and liver
      in the late periods after gamma irradiation at a dose of 1 Gy. Structural changes
      in the membranes].
AB  - The structural status of plasma membranes of adipose tissue and liver of rats was
      investigated at remote times (from 15 to 380 days) after single 1-Gy gamma
      irradiation. The structural status was estimated by pyrene excimerisation
      parameters and also by both induction resonance energy transfer method and
      membrane tryptophan fluorescence spectral characteristics. On days 50-100
      following irradiation the microviscosity of a lipid phase of membranes increased
      and the mode of lipid/protein interactions changed, whereas at later times the
      indices under study did not vary from the controls. Comparison of the data
      obtained with the former results on lipid content changes indicates that the
      physicochemical status of plasma membranes in rat adipose tissue and liver is
      modified at remote times following 1-Gy gamma irradiation.

PMID- 8469750
TI  - [Can postradiation cell fusion be a factor in the protection of a cell
      population?].
AB  - From the analysis of the literature it is inferred that there is one more type of
      nonspecific protection which is based on the polyploidy process and functions at
      the cell population and tissue levels. With high radiation loads, this process
      maintains the functioning rate of the given tissue and the survival rate of the
      given cell type. A hypothesis is proposed that cell fusion and formation of
      somatic hybrids, that provide clone survival, are particularly effective in tumor
      tissues. This mechanism is activated at high radiation doses: fusion of injured
      cells and formation of polykaryons and then hybrids can give rise to cells
      capable of reproduction. The cellularity is restored.

PMID- 8469752
TI  - [The late effects in treated dogs with a history of acute radiation sickness. The
      hemodynamic status at different times after irradiation].
AB  - Dogs were exposed to X radiation at a dose of 15 Gy; part of them received a
      complex treatment. The morphological studies of internal organs of control dogs
      were made before death (on days 4 to 15 after irradiation). The treated dogs were
      killed 0.5-2 years following irradiation. Hemodynamics normalization was noted in
      1.5-2 years in the liver, brain cortex, adrenals, insular tissue of the pancreas,
      and lymph nodes.

PMID- 8469751
TI  - [The effect of x-ray irradiation on the production of interleukin-6 and tumor
      necrosis factor-alpha by mononuclear cells of the peripheral blood].
AB  - The influence of X-radiation on production of interleukin-6 (IL-6) and alpha
      tumor necrosis factor (TNF) has been investigated. Irradiation with doses of 45,
      90 and 900 cGy was shown to increase considerably TNF and IL-6 production both in
      intact mononuclear cultures of human peripheral blood and in cultures stimulated
      by phytohemagglutinin. In addition to an absolute increase in the production, the
      stimulatory effect was manifested by earlier accumulation of IL-6 and TNF
      activities in supernatant fractions of the cultures under study.

PMID- 8469753
TI  - [Transbrachial arterial catheter angiography. Technique, indications,
      complications].
AB  - In a large group of patients, most of whom were attending a department of
      vascular surgery, who underwent arterial digital subtraction angiography (DSA), a
      transfemoral approach was not possible in 9%. Therefore in 142 cases
      transbrachial arterial angiography was electively performed with 4-F or 5-F
      catheters. This method proved to be a safe and reliable alternative, though the
      examination technique was more demanding and the complication rate somewhat
      higher. It offers clear advantages over a transaxillary or translumbar approach.
      Special attention is paid to the role of transbrachial arterial DSA in evaluating
      the descending aorta and the peripheral outflow in the legs and to its usefulness
      in certain angioplasty manoeuvres.

PMID- 8469754
TI  - [Widening of the retrorectal space. Pelvic lipomatosis].

PMID- 8469755
TI  - [Magnetic resonance in Switzerland today].

PMID- 8469756
TI  - [Magnetic resonance imaging. Sequences, options, indications].
AB  - In the last few years several new MR sequences have been developed an even more
      imaging options have become available. In this paper, the properties of all the
      important MR sequences and their possible variations are discussed and their use
      in different clinical settings is addressed.

PMID- 8469757
TI  - [Magnetic resonance imaging in neuroradiology. Indications and applications].
AB  - On the basis of own experience with 250 MR-Angiographies and with reference to
      the literature the authors report on the role MR-Angiography is assuming in
      neuroradiological diagnostic procedures. As a noninvasive method MR-Angiography
      contributes to the evaluation of vessel stenosis and occlusion, venous sinus
      thrombosis and neurovascular compression syndromes. It supports the work-up of
      space-occupying lesions, as well as arteriovenous malformations and aneurysms. In
      addition to the diagnosis, follow-up examinations serve as a noninvasive means of
      therapy control particularly after interventional endovascular procedures.
      Knowledge of the diagnostic capabilities and limitations, the choice of the
      correct examination technique and modification of technical variables contribute
      to establish MR-Angiography as a valuable adjunct to MR imaging.

PMID- 8469758
TI  - [MR angiography of the abdomen].
AB  - The two techniques currently most often used for MR angiography, those based on
      time-of-flight effects and on phase-contrast, are introduced, and our results
      with three-dimensional phase contrast angiography of the abdomen are presented.
      Several basic differences from other imaging procedures render MR angiography
      clinically useful for screening for renal artery stenosis in critical situations,
      such as renal failure or intolerance to contrast agents. In the future, the
      spectrum of applications of MR angiography will broaden and include other
      indications, such as portal venous hypertension and follow-up studies after
      surgical portal systemic shunting.

PMID- 8469759
TI  - [Imaging of the pericardium using magnetic resonance].
AB  - Evaluation of the pericardium has been rediscovered with the advent of sectional
      imaging modalities such as magnetic resonance. Owing to the improved image
      quality, faster imaging and cine display, MRI has proved to have a useful role in
      assessment of the pericardium. This article illustrates the authors' wide
      experience with MRI of normal and abnormal pericardium in numerous patients. The
      anatomy of the normal pericardium is reviewed, as are the different MR imaging
      techniques used Advantages of MRI in specific situations are discussed.
      Congenital anomalies are covered but particular attention is paid to acquired
      diseases, such as pericardial effusions, with emphasis on the characterization of
      the different pericardiac fluid collections. Pericardial thickening and
      constrictive pericarditis, which are easily differentiated from restrictive
      cardiomyopathy, are also discussed. Finally, primary and metastatic tumors are
      described.

PMID- 8469760
TI  - [Evaluation of underexposed conventional x-ray films following digitization].
AB  - Inadequate exposure of analogue radiographs is reported in the literature to
      occur in 5-25% of cases. Therefore, the present study was performed to test
      whether selective image processing after digitization could reveal diagnostic
      details on underexposed radiographs. In addition, the minimal exposure values
      required for diagnostic purposes after adequate image processing were studied.
      Phantom studies, organ preparations and measurements of physical parameters with
      decreasing exposure values were performed. The detection of anatomic and
      pathologic (nondisplaced fracture lines, microcalcification and renal stones)
      structures were evaluated by 12 readers. Radiographs with exposure values 20-40%
      lower than "ideal" values can provide adequate diagnostic images after digital
      processing. The diagnostic information is significantly impaired with values
      under 50% of the correct exposure values. In conclusion, this method is adequate
      to save underexposed radiographs for diagnostic purposes and to avoid repeated
      examinations.

PMID- 8469762
TI  - Victorian nurses warn of coalition's I.R. policy.

PMID- 8469761
TI  - Politics and nursing: "Pick your package".

PMID- 8469763
TI  - Keep Medicare healthy.

PMID- 8469764
TI  - Career structure review.

PMID- 8469765
TI  - Australian Nursing Federation health policy.

PMID- 8469766
TI  - Immunohistochemical demonstration of angiotensin II receptors in rat brain by use
      of an anti-idiotypic antibody.
AB  - In the present study we investigated the ability of an anti-idiotypic antibody
      which recognizes angiotensin II (AII) receptors to demonstrate the presence of
      such receptors under immunohistochemical conditions. The experiments revealed
      punctate immunoreactive granules on neurons of the nucleus supraopticus and of
      the nucleus paraventricularis of the hypothalamus. This localization of AII
      receptors is consistent with the findings obtained using other experimental
      approaches to the brain renin-angiotensin system. The conclusion of this study is
      that the applied anti-idiotypic antibody seems to be a reliable tool for mapping
      AII receptor distribution. The established experimental approaches to AII
      receptors are thus now supplemented with the possibility of immunohistochemical
      investigation. Moreover, the possible microscopic analysis of AII receptors on
      distinct cells will allow studies at an ultrastructural level.

PMID- 8469767
TI  - Distribution of angiotensin II receptor subtypes in the rabbit brain.
AB  - We have determined the distribution of angiotensin II receptor subtypes in rabbit
      brain using in vitro autoradiography. AT1 receptors were found in very high
      concentrations in the forebrain circumventricular organs--the subfornical organ,
      organum vasculosum of the lamina terminalis, and the median eminence as observed
      in other mammals. However, there was very little labeling in the area postrema.
      In the paraventricular nucleus, median preoptic nucleus, supraoptic nucleus there
      were high levels of predominantly AT1 receptors. High densities of AT1 receptors
      were also found in the nucleus of the solitary tract and the rostral and caudal
      ventrolateral medulla. All of these regions have putative roles in the regulation
      of blood pressure and fluid and electrolyte balance. In the rabbit brain there is
      less AT2 receptor binding than the rat, with most AT2 binding found in the
      molecular layer of the cerebellum and in the septohypothalamic nucleus. In the
      subthalamic nucleus, the mediodorsal and ventroposterior nuclei of the thalamus,
      locus coeruleus and inferior olivary nuclei, areas containing mostly AT2
      receptors in the rat, no binding was detected in the rabbit except in the locus
      coeruleus which contains moderate levels of AT1 receptors. Taken in conjunction
      with our previous results in the rat and human brains, these results reveal that
      AT1 receptors predominate in rostral forebrain, hypothalamus and autonomic
      control centers of the medulla oblongata in all three species. However, the
      distribution and density of AT2 bearing sites in regions such as the septum,
      thalamus subthalamic nuclei, locus coeruleus, cerebellum and inferior olivary
      nuclei show marked species differences.

PMID- 8469768
TI  - Binding and signal transduction of the cloned vascular angiotensin II (AT1a)
      receptor cDNA stably expressed in Chinese hamster ovary cells.
AB  - The vascular angiotensin (A) II receptor cDNA (AT1a) was transfected into Chinese
      hamster ovary (CHO) cells to generate the stable cell line CHO-AT1a. This cell
      line was used to investigate the binding and signal transduction properties of
      the cloned vascular AT1 receptor. Specific binding of sarcosine1(
      )[125I]tyrosine4-isoleucine8-AII ([125I]SI-AII) to CHO-AT1a membranes reached
      equilibrium after 1 h at 25 degrees C and was consistently greater than 95% of
      total binding. Saturation binding analyses demonstrated [125I]SI-AII bound to a
      saturable population of sites on membranes with an equilibrium dissociation
      constant (KD) of 0.7 nM and a binding site maximum of 1.2 pmol/mg protein.
      [125I]SI-AII binding to CHO cells was inhibited by the following compounds with a
      rank order of potency of SI-AII > AII > losartan > AI >> PD 123,177. AII (1
      microM) treatment of CHO-AT1a cells caused an increase in inositol phosphates and
      intracellular calcium relative to basal levels. These responses were blocked by
      losartan but not by PD 123,177. AII (1 microM) did not effect adenylate cyclase
      activity in CHO-AT1a cells, whereas the agonist inhibited adenylate cyclase
      activity in rat liver cell membranes. These effects were blocked by 10 microM
      losartan. These results indicate that CHO-AT1a cells express functional AT1a
      receptors which stimulate phospholipase C activity but not adenylate cyclase
      activity. CHO-AT1a cells should provide a useful model for studies of AT1a
      receptor domains which are critical to signaling pathways.

PMID- 8469769
TI  - Characterization of angiotensin AT1A receptor isoform by its ligand binding
      signature.
AB  - The objective of this study was to determine whether the binding signature of the
      cloned rat AT1A receptor transfected into Chinese hamster ovary cells could be
      distinguished from that of the endogenous AT1B receptor expressed in rat adrenal
      cortex. An extensive series of peptide and nonpeptide Ang II analogs was used for
      the characterization. The binding of [125I]Ang II to the recombinant AT1A
      receptors was quite sensitive to inhibition by GTP gamma S. Scatchard analysis of
      the competition of Ang II revealed two populations of binding sites (site 1: KD =
      3.05 +/- 0.27 nM and a maximum binding (Bmax) of 134 +/- 26 fmol/mg protein; site
      2: KD = 253 +/- 77 nM and Bmax = 1.05 +/- 0.19 pmol/mg protein). The ligand
      binding signature of the AT1A receptor is defined by the affinity (Ki = nM) and
      order of potency of the following ligands: saralasin (2.07) > Ang II (3.35) >
      losartan (14) > Ang III (20) > GR 117289C (28) > EXP6803 (160) > Ang I (281) >
      PD123177 (> 10,000). This binding signature of the cloned AT1A receptors appears
      to be similar to that displayed by rat adrenal cortical cells where AT1B is
      predominantly expressed. These findings suggest that AT1A and AT1B receptors may
      not be easily distinguishable by the currently available ligand agonists or
      antagonists. Consequently, AT1A or AT1B may be considered as isoforms rather than
      subtypes of the AT1 receptors.

PMID- 8469770
TI  - Signal transduction mediated by angiotensin II receptor subtypes expressed in rat
      renal mesangial cells.
AB  - Recent evidence suggests that there are two classes of receptors for angiotensin
      II (AngII), AT1 which is sensitive to losartan (DuP753) and is G-protein coupled,
      and AT2 which is sensitive to both PD123319 and CGP42112A, and is non-G-protein
      coupled. In rat mesangial cells two subtypes of AT1 receptor could be
      distinguished, AT1A subtype is more sensitive to losartan whereas AT1B subtype is
      more sensitive to PD123319, but insensitive to CGP42112A. The present studies
      were designed to ascertain which receptor subtype mediates three AngII-induced
      physiologic functions in rat mesangial cells namely intracellular Ca2+
      mobilization, adenylyl cyclase inhibition and protein synthesis as monitored via
      [3H]leucine incorporation. The rank order of potency for inhibition of AngII
      induced [Ca(2+)]i mobilization and adenylyl cyclase regulation was PD123319 > or
      = losartan > CGP42112A. By contrast, losartan was quite effective at inhibiting
      protein synthesis (IC50 = 8 nM) while PD123319 was without effect. These findings
      are consistent with AngII mediated signal transduction through AT1A and AT1B
      sites for phospholipase C mediated [Ca(2+)]i mobilization and inhibition of
      adenylyl cyclase. On the other hand, AT1A receptors appear to exclusively mediate
      AngII-induced protein synthesis. These observations underscore the complexity of
      AngII mediated signal transduction in glomerular mesangium.

PMID- 8469771
TI  - Angiotensin II binding sites in the rat fetus: characterization of receptor
      subtypes and interaction with guanyl nucleotides.
AB  - Angiotensin II (AII) receptor subtypes were studied in the 18-day gestation fetal
      rat, using two non-peptide AII antagonists: (2-n-butyl-4-chloro-5-hydroxymethyl-1
      (2'-(1H-tetrazol-5-yl) biphenyl-4-yl)methyl)imidazol (DuP 753; type 1 (AT1)
      specific), and 1-(4-amino-3-methylphenyl)methyl-5-diphenacetyl -4,5,6,7
      tetrahydro-1-H-imidazo[4,5-c]pyridine-6-carboxylic acid (PD 123177; type 2 (AT2)
      specific). Autoradiography using 125I(-)[Sar1,Ile8]AII showed that 10 microM PD
      123177 decreased binding to near-nonspecific levels in skin, skeletal muscle and
      adrenal medulla, whereas 10 microM DuP 753 blocked binding in the liver and lung.
      Studies in skin and liver membranes confirmed the autoradiographic data: AT1
      receptors were predominant in the liver (95%), and AT2 in the skin (97%). There
      was no cross-reactivity between receptor subtype and the heterologous antagonist
      up to a concentration of 10 microM. In both skin and liver, 2 mM dithiothreitol
      enhanced the binding of AT2 receptors by increasing receptor affinity, but
      inhibited binding of AT1 by decreasing the receptor number. In the absence of
      antagonists, guanyl nucleotides, added at equilibrium, caused marked dissociation
      of 125I-AII binding in liver membranes, but had minimal effect in skin. However,
      dissociation occurred in the skin when AT2 sites were blocked with 10 microM PD
      123177, and in liver, dissociation was not observed when AT1 sites were blocked
      with DuP 753. Hence, in contrast to classical AII target tissues, which contain
      predominantly AT1, most of the sites in fetal skin and skeletal muscle are AT2.
      The demonstration that the effects of guanyl nucleotides are selective for
      receptor subtype suggests that the AT1 receptor, but not the AT2, is coupled to
      cell function via guanyl nucleotide binding proteins. The functional importance
      of the AT2 receptors and their role in fetal physiology is under current
      investigation.

PMID- 8469772
TI  - Expression of AT2 receptors in rat fetal subdermal cells.
AB  - Using an in situ receptor binding assay with emulsion autoradiography,
      angiotensin II receptors have been localized to the subdermal/subcutaneous region
      of the E19 rat skin. Radioligand binding studies on membranes of epidermis,
      dermis, and subdermal tissues confirmed the localization of receptors to these
      regions and displacement of binding by PD123177 showed the receptor was AT2.
      Scatchard analysis of whole skin membrane binding studies showed the receptor had
      a Kd of 0.8 nM, with a Bmax of 2240 fM/mg protein. Fetal mesenchymal cells were
      placed in culture and angiotensin II binding which was minimal at 48 h increased
      by 30-50-fold after 96 h in culture with the majority of the receptors being AT2.
      Increasing concentrations of FBS caused a decrease in angiotensin II binding,
      while maintaining the same percentage of AT2 binding sites. Increasing the
      initial cell density at which the cells were plated dramatically increased the
      angiotensin II radioligand bound, while decreasing the percentage bound to AT2
      receptors. These findings demonstrate the presence of both angiotensin II
      receptor subtypes in cultured skin mesenchymal cells. They also demonstrate that
      the culture conditions used can either modulate the expression of receptor
      subtypes or select for cells expressing a receptor phenotype. The lower number of
      AT2 binding sites in rapidly dividing cell cultures suggests that the AT2
      receptor may not have a function in cell replication or growth.

PMID- 8469773
TI  - [125I]CGP 42112 binding reveals differences between rat brain and adrenal AT2
      receptor binding sites.
AB  - The AT2 angiotensin II receptor selective ligand CGP42112 was radioiodinated and
      used to study AT2 receptor binding sites in the rat brain (combined olfactory
      bulb, septum, thalamus and midbrain) and whole adrenal. The [125I]CGP 42112
      binding was of high affinity, saturable and specific in both tissues. Competition
      studies with nonselective and angiotensin II receptor subtype selective ligands,
      and evaluation of the effects of the sulfhydryl reducing agent beta
      mercaptoethanol, confirmed that [125I]CGP 42112 bound selectively to the AT2
      angiotensin II receptor subtype. [125I]CGP 42112 bound with higher affinity in
      the brain than in the adrenal. beta-Mercaptoethanol enhanced [125I]CGP 42112
      binding in the brain, but did not alter its binding in the adrenal. A similar
      difference in binding affinity for [125I]sarcosine, isoleucine angiotensin II and
      enhancement of binding affinity by beta-mercaptoethanol was observed in the rat
      brain and adrenal. These observations suggest that the AT2 angiotensin II
      receptor subtypes in the brain and adrenal may differ.

PMID- 8469774
TI  - Regulated expression of angiotensin II (AT2) binding sites in R3T3 cells.
AB  - R3T3 cells are a fibroblast cell line found to selectively express the AT2
      subtype of angiotensin II binding sites. We have previously shown that in these
      cells, the AT2 sites do not appear to be coupled to G-proteins, do not modulate
      any of the common second messenger pathways associated with activation of
      angiotensin II receptors, and do not internalize bound ligand. Here we report
      that expression of AT2 sites in these cells are subject to modulation by a
      variety of conditions. In actively growing cells the expression of AT2 sites is
      very low, while in confluent, quiescent cells, the expression of AT2 sites is
      markedly increased. Addition of serum, or growth factors, to quiescent cells
      causes a rapid decrease in the number of cell-surface AT2 sites. Further,
      incubation of cells with ligands that bind to AT2 sites causes a marked increase
      in the number of these sites in a time and dose dependent manner indicating
      homologous up-regulation of expression. These results indicate that expression of
      AT2 sites in R3T3 cells is under sensitive and rapid control and further indicate
      that these cells may be an excellent model for studying the physiological
      regulation of expression of these sites.

PMID- 8469775
TI  - Sar1-p-benzoylphenylalanine-angiotensin, a new photoaffinity probe for selective
      labeling of the type 2 angiotensin receptor.
AB  - Previous photoaffinity labeling of angiotensin II (Ang) receptors with
      azidophenylalanine containing Ang analogs produced high yield labeling of a 60
      kDa protein on bovine adrenocortical membranes. This preparation is mostly
      enriched in the type 1 Ang receptor (AT1) and AT1 selective ligands (L158,809)
      totally prevented labeling, therefore confirming the AT1 nature of the labeled
      protein. Our attempt to photolabel the type 2 Ang receptor (AT2) of human
      myometrium with [Sar1,D-Phe(N3)8]Ang was unsuccessful, revealing a high degree of
      photolabeling selectivity. An Ang analog, [Sar1,Bpa8]Ang (or BpaAng) was prepared
      containing the photosensitive amino acid p-benzoylphenylalanine (Bpa). This
      compound was a specific but non-competitive Ang antagonist on rabbit aorta with a
      pA2 of 8.5. It displayed good binding affinities for bovine adrenocortical
      membranes (Kd = 6.5 nM), a predominantly AT1 preparation, and for human
      myometrium membranes (Kd = 0.39 nM), a predominantly AT2 preparation.
      Photolabeling experiments with iodinated BpaAng showed that AT1 was not
      covalently labeled whereas AT2 was covalently labeled with high yield. Labeling
      specificity was verified with the AT2-selective ligand PD123319 and with the AT1
      selective antagonist L158,809. Our results indicate that 125I-BpaAng is
      exclusively labeling AT2 sites. This compound should be a useful tool for further
      biochemical characterization of the AT2 binding site.

PMID- 8469776
TI  - Identification and characterization of a novel angiotensin binding site in
      cultured vascular smooth muscle cells that is specific for the hexapeptide (3-8)
      fragment of angiotensin II, angiotensin IV.
AB  - This study demonstrates the existence of a previously unrecognized class of
      angiotensin binding sites on vascular smooth muscle that exhibit high affinity
      and specificity for the hexapeptide (3-8) fragment of angiotensin II (AngIV).
      Binding of [125I]AngIV is saturable, reversible and describes a pharmacologic
      profile that is distinct and separate from the classic AT1 or AT2 angiotensin
      receptors. Saturation binding studies utilizing cultured vascular smooth muscle
      cells obtained from bovine aorta (BVSM) revealed that [125I]AngIV bound to a
      single high affinity site with an associated Hill coefficient of 0.99 +/- 0.003,
      exhibiting a KD = 1.85 +/- 0.45 nM and a corresponding Bmax = 960 +/- 100 fmol mg
      1 protein. Competition binding curves in BVSM demonstrated the following rank
      order effectiveness: AngIV > AngII(3-7) >> AngIII > Sar1,Ile8 AngII > AngII >
      AngII(1-7) > AngII(4-8), DuP 753, PD123177. The presence of the non-hydrolyzable
      GTP analog GTP gamma S, had no effect on [125I]AngIV binding affinity in BVSM.
      The presence of this novel angiotensin binding site on smooth muscle in high
      concentration suggests the possibility that this system may play an important,
      yet unrecognized role in vascular control.

PMID- 8469777
TI  - Angiotensin II binding sites on micro-organisms contaminating cell cultures.
AB  - An angiotensin II (Ang II) binding site, distinct from AT1 and AT2, has been
      found in cell cultures of rat aortic smooth muscle and rat glomerular mesangium.
      It is characterized by a high affinity for Ang II (Kd 0.75 +/- 0.13 nM) and Ang I
      (Ki 0.72 +/- 0.12 nM), but a very low affinity for Ang III (Ki 31 +/- 5 microM).
      Ang(1-7) (Ki 1.01 +/- 0.26 nM) and Ang(1-6) (Ki 4.54 +/- 0.24 nM) are very
      selective for this site, with affinities more than 150- and 10,000-fold greater,
      respectively, than for AT1 or AT2. The selective angiotensin receptor subtype
      ligands losartan and L-158,809 (AT1), PD 123319 and CGP 42112A (AT2) were
      inactive. Binding to this site was abolished after the cells had been treated
      with the antibiotic mixture BM-Cyclin, suggesting that the site is located not on
      the cells, but on a cell culture contaminant. This has been identified as
      Acholeplasma laidlawii. Caution should therefore be exercised when interpreting
      Ang II-related data obtained from cells that have not been checked for Mollicute
      contamination.

PMID- 8469778
TI  - Immunohistochemical mapping of angiotensin AT1 receptors in the brain.
AB  - A new approach to study angiotensin receptor distribution in the brain has been
      taken by developing antibodies to partial sequence of the angiotensin II (AII)
      type-1 receptor subtype (AT1) and demonstrating the presence of receptors with
      immunohistochemical staining. The antibody to a portion of the 3rd cytoplasmic
      loop of the AT1 receptor revealed distinctive punctate immunoreactive staining on
      cell bodies. The cell bodies were distributed in the forebrain in paraventricular
      and supraoptic nuclei, the organum vasculosum lamina terminalis, median preoptic
      area and subfornical organ. In the brainstem, the entire locus coeruleus was
      stained, together with the adjacent mesencephalic and motor nuclei of the
      trigeminal nerve. The auditory system including the cochlear nucleus and superior
      olivary nuclei were stained. In the medulla, all the structures involved in blood
      pressure control were stained including the nucleus of the solitary tract, the
      12th nerve nuclei, the rostroventral lateral area and the nucleus ambiguous.
      Sites where AT2 receptors are located were not stained or staining was limited to
      specific area such as the medial accessory nucleus of the inferior olive.
      Immunocytochemical staining of AT1 receptors provides a new and more precise
      approach to the cellular localization of AII receptors.

PMID- 8469779
TI  - Experimental uremia in male rats: effect on the reproductive tract and fertility.
AB  - Chronic renal failure was induced in 3-month-old male rats by 5/6 nephrectomy.
      Potency and fertility studies were performed after 3 months of chronic uremia.
      The mean serum testosterone at the end of the experiments was significantly
      lower: 0.96 +/- 0.14 ng/mL compared to a control group of sham-operated male
      rats, 2.86 +/- 0.59 ng/mL, p < .001. All the uremic male rats had normal
      accessory gland weights at the end of the study. Fertility and, in most animals,
      sexual behavior and mating were not different from the normal control group. It
      is concluded that in 5/6-nephrectomized uremic male rats, in spite of low
      testosterone level, fertility and reproductive system are maintained similar to
      normal control male rats.

PMID- 8469780
TI  - Role of glutathione for cisplatin nephrotoxicity in young and adult rats.
AB  - Investigations were done in 10- and 55-day-old Wistar rats. Glutathione (GSH)
      level in kidney was decreased by 8 mmol buthionine sulfoximine (BSO)/100 g BW.
      There was no effect on the renal function and nephrotoxicity of cisplatin (0.6 mg
      CP/100 g BW) in adult rats. In young rats BSO treatment was followed by
      nephrotoxic effects. Pt concentration remained unaffected by BSO in young and
      adult rats. GSH concentration in kidney was increased by 100 mg acetyl-cysteine
      (accys)/100 g BW. CP nephrotoxicity was lower in young as well as in adult ac-cys
      treated rats. Pt levels in renal tissue were significantly decreased in rats from
      both age groups. From our results we conclude that the beneficial effect of high
      GSH concentration in renal tissue on CP nephrotoxicity is the result of decreased
      Pt concentration in kidney.

PMID- 8469781
TI  - Electrophoretic analysis of serum and urinary proteins in rats with
      aminonucleoside-induced nephrotic syndrome.
AB  - Albumin; and alpha 1-, alpha 2-, beta-, and gamma-globulins were estimated by
      cellulose acetate electrophoresis in the serum and urine from rats with nephrotic
      syndrome (NS), 2, 4, 6, 8, 10, 12, 16, 20, and 30 days after a single injection
      of puromycin aminonucleoside (PAN). It was found that: (a) total serum protein
      level decreased on days 4-16, and total urine protein excretion rose on days 6
      16; (b) serum albumin level fell on days 4-16, and urine albumin excretion
      increased on days 6-16; (c) serum alpha 1-globulin level rose on days 8-30, and
      urine alpha 1-globulin excretion increased on days 8-16; (d) serum alpha 2
      globulin level remained essentially unchanged, and urine alpha 2-globulin
      excretion rose on days 4-10; (e) serum beta-globulin level decreased on days 4
      20, and urine beta-globulin excretion increased on days 6-16, (f) serum gamma
      globulin level diminished on days 6, 8, and 12, and urine gamma-globulin
      excretion rose on days 6-10. All serum protein fractions were excreted in the
      urine of nephrotic rats; these findings suggest that proteinuria is nonselective.
      The differences observed in the serum protein profiles, even when all protein
      fractions were lost in the urine, suggest an independent regulation of each
      protein fraction in PAN-nephrotic rats. In addition, the electrophoretic profile
      of serum proteins in PAN-nephrotic rats is different from previously reported
      patterns in human nephrosis and in rats with an acute-phase response.

PMID- 8469782
TI  - Renal function and renal platinum content in uninephrectomized rats following
      cisplatin administration.
AB  - The changes in renal function and renal platinum content were assessed in
      uninephrectomized and sham-operated female Wistar rats on the third day after
      treatment with 2.5 mg/kg BW or 5 mg/kg BW cisplatin. Treatment of control and
      nephrectomized rats with 2.5 mg/kg BW cisplatin resulted in indices of renal
      function which were not significantly different from those of animals which had
      received no cisplatin, though the renal platinum contents in nephrectomized rats
      were practically the same as in two-kidney animals given 5 mg/kg BW cisplatin.
      Treatment with 5 mg/kg cisplatin resulted in much less severe changes in kidney
      weight and renal function compared to two-kidney animals, in spite of much more
      substantial (by 49-58%) platinum accumulation.

PMID- 8469783
TI  - Induction of immediate early and stress genes in rat proximal tubule epithelium
      following injury: the significance of cytosolic ionized calcium.
AB  - This study was designed to investigate the influence of intracellular ionized
      calcium ([Ca2+]i) on the induction of c-fos, c-jun, c-myc, and hsp70 genes after
      oxidant stress induced by xanthine/xanthine oxidase (X/XOD) treatment or after
      heat shock using primary cultures of rat proximal tubule epithelium (PTE). X/XOD
      (500 microM/25 mU/mL) induced all of these genes; ionomycin also resulted in
      similar kinetics of induction of all genes. The expression of both c-fos
      following X/XOD treatment and hsp70 following heat shock was markedly decreased
      through chelation of [Ca2+]i by Quin 2/AM. The c-fos expression following X/XOD
      treatment was partly reduced by a protein kinase C inhibitor, staurosporine (ST),
      and markedly inhibited by another protein kinase inhibitor, 2-aminopurine (2AP),
      while both ST and 2AP markedly reduced hsp70 expression. The ADP-ribosylation
      transferase inhibitor 3-aminobenzamide had no effect on either c-fos or hsp70
      expression. These results suggest that cell injuries leading to increased [Ca2+]i
      in PTE result in induction of c-fos, c-jun, c-myc, and hsp70; and that the
      activation of c-fos and hsp70 genes may be regulated by [Ca2+]i and [Ca2+]i
      dependent protein kinases.

PMID- 8469784
TI  - Thyroid hormone profiles in experimental acute renal failure.
AB  - Thyroid hormone profiles were determined in two groups of dogs made uremic,
      either by i.v. uranyl nitrate 10 mg/kg BW injection or by bilateral ureteral
      ligation, and in one group of sham-operated animals. Each group consisted of 6
      dogs and served as its own control. From blood samples taken in 12-h intervals up
      to 144 h for uranyl nitrate-injected dogs and 96 h for operated dogs, serum
      levels of T4, T3, fT4, fT3, rT3, and cortisol were measured by radioimmunoassays.
      The results obtained in both groups of uremic dogs showed an initial sharp fall
      of T4, T3, fT4, and fT3 followed by a plateau or retarded decrease. In sham
      operated dogs the fall of these hormones was slight and of short duration.
      Reverse T3 had a tendency to increase in all groups examined, but a significant
      elevation was recorded only after bilateral ureteral ligation. In this group
      cortisol serum levels were found the highest, being also significantly increased
      in the other two groups. The temporal coincidence of the most marked alterations
      in T3, rT3, and cortisol serum concentrations indicates a significant role of
      stress in thyroid dysfunction. Although serum creatinine rise and weight loss
      were not parallel with thyroid hormone alterations, the involvement of uremic
      compounds and malnutrition in this process is also quite clear. Thus, the data
      presented suggest simultaneous influences of uremic toxins, stress, and
      malnutrition on the induction of thyroid dysfunction in dogs made uremic by
      uranyl nitrate injection or bilateral ureteral ligation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8469785
TI  - Influence of pentoxifylline on renal function in HIV-seropositive patients.
AB  - Pentoxifylline (PTX) has potential usefulness in HIV-seropositive patients due to
      its beneficial effects on renal function, its inhibitory effects on tumor
      necrosis factor alpha, and its vascular effects on microcirculatory disturbances.
      The present study prospectively evaluated the effects of multiple oral doses of
      PTX (400 mg three times daily for 12 weeks) on renal function in 11 HIV
      seropositive patients compared with 14 control patients. Four of these patients
      had HIV-associated nephropathy, manifested by high urinary microalbumin outputs
      (72 +/- 56 micrograms/min; mean +/- SD). Ambulatory 24-h urine collections were
      analyzed for creatinine, electrolytes, and immunological markers at weekly
      intervals for 12 weeks. Urine flow rates diminished to one-half baseline values
      by week 12; changes were related to both time and treatment sequences. There were
      significant decreases in creatinine clearances and electrolyte excretion rates
      over the study period that were not associated with treatment regimens. No
      differences were found in fractional electrolyte, uric acid, microalbumin, and
      neopterin excretion rates either between or within groups. One subject with high
      microalbumin excretion rates had a significant drop over the 12 weeks (133 to 4
      micrograms/min); the other 3 subjects had similar or elevated microalbumin
      outputs by the end of the study. Although well tolerated, therapeutic doses of
      PTX did not significantly affect renal function in HIV-seropositive patients.

PMID- 8469786
TI  - Niceritrol reduces plasma lipoprotein(a) levels in patients undergoing
      maintenance hemodialysis.
AB  - Lp(a) is an LDL-like lipoprotein carrying the apoprotein(a) glycoprotein and has
      recently been recognized to be an independent risk factor for coronary heart
      disease. We studied plasma Lp(a) levels in 40 patients undergoing maintenance
      hemodialysis (24 male, 16 female; aged 16-83 years). Fasting plasma Lp(a) levels
      were measured by an enzyme-linked immunosorbent assay. The median value of plasma
      Lp(a) concentrations in hemodialysis patients was significantly higher than that
      of the normal volunteers (26.0 +/- 2.7 vs. 10.8 +/- 3.7 mg/dL, p < .05). Lp(a)
      levels did not correlate with age, duration of hemodialysis, total cholesterol,
      triglyceride, HDL cholesterol, or LDL cholesterol. The 11 patients whose plasma
      Lp(a) concentrations exceeded 20 mg/dL received niceritrol, a prodrug of
      nicotinic acid, at a dosage of 500 mg t.i.d. for 4 weeks. The plasma Lp(a) levels
      were significantly lower after 4 weeks of treatment (38.3 +/- 4.2 vs. 31.5 +/-
      3.2 mg/dL, p < .01).

PMID- 8469787
TI  - Lithium clearance measurements during recombinant interleukin 2 treatment:
      tubular dysfunction in man.
AB  - Renal tubular function was evaluated in nine patients undergoing recombinant
      interleukin 2 (rIL2) treatment for metastatic colorectal carcinoma. A lithium
      clearance technique was used and the activities of the lysosomal enzyme N N
      acetyl-beta-D-glucosaminidase were also measured in the patients' urine, before
      treatment, during treatment, and then 2 days and 23 days after rIL2 therapy had
      finished. Significant reductions in clearances of creatinine, sodium, and lithium
      were observed. The fractional excretions of sodium and lithium were also reduced.
      Twenty-three days following cessation of rIL2 treatment, there was still a
      significant reduction in creatinine clearance compared with pretreatment values
      (p < .01). The clearances of sodium and lithium were also reduced compared with
      pretreatment values although this did not achieve significance. The fractional
      reabsorption of sodium and water by the proximal nephron increased during rIL2
      treatment, from 0.707 +/- 0.030 (pretreatment) to 0.793 +/- 0.043. This increased
      reabsorption of sodium and water persisted, rising to 0.849 +/- 0.029, 2 days
      following cessation of treatment (p < .001, means +/- SEM). Twenty-three days
      later this had returned toward the pretreatment value, being 0.781 +/- 0.036. The
      fractional reabsorption of sodium by the distal nephron was also significantly
      elevated, both during and 2 days after completing rIL2 treatment. Twenty-three
      days after cessation of rIL2, this value had returned to the pretreatment value.
      However, in contrast, the fractional reabsorption of water by the distal nephron
      demonstrated no change during rIL2 treatment, but 2 days posttreatment was
      significantly reduced and remained low for a further 3 weeks.

PMID- 8469788
TI  - Preliminary screening of the relationship of serum lipids to survival of chronic
      dialysis patients.
AB  - To assess the predictive value of serum lipid measurements in dialysis patients
      once the initial decrease on early dialysis had occurred, we obtained random
      serum cholesterol and triglyceride levels in stable, chronic dialysis patients
      who were then followed up to 9 years. Derived LDL (DLDL) was estimated by the
      Friedewald formula, calculated for all HDL levels between 30 and 45 mg/dL, and
      evaluated statistically against a panel of vascular disease markers, including
      clinical assessment for coronary, peripheral, and cerebrovascular disease; ECG,
      both standard and ambulatory; two-dimensional echocardiogram; and medications.
      Survival was calculated from entry (not dialysis onset) for 58 hemodialysis and
      33 peritoneal dialysis patients. The 91 patients (49 males, 74 diabetics) were
      divided by cholesterol level (> or = 175 mg/dL = 53, < 175 = 38), triglyceride (>
      or = 175 mg/dL = 55, < 175 = 36), and DLDL (> or = 75 = 58, < 75 = 24). High
      total cholesterol was present in a larger proportion of females than low
      cholesterol, but groups were not different with respect to all vascular
      determinants, including survival (mean = 33.4 months vs. 43.2, p = NS). High vs.
      low triglyceride groups were not different with respect to vascular indicators,
      except for both incidence of abnormal standard ECG (69% vs. 42%, p < 0.05) and
      survivals (mean = 42.0 vs. 30.7, p < 0.05; 1 year = 80% vs. 56%, p <
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469789
TI  - Cognitive function and quality of life in end-stage renal failure.
AB  - The Sickness Impact Profile (SIP) and the Wechsler Memory Scale--Revised (WMS-R)
      were administered to a small sample of end-stage renal failure patients. The
      memory test successfully discriminated between patients who were rated by their
      nurses to be well adjusted or poorly adjusted to dialysis treatment. It is
      concluded that this instrument may be useful in investigating cognitive function
      in this patient population.

PMID- 8469790
TI  - Glomerular alterations in experimental oliguric and nonoliguric acute renal
      failure.
AB  - Studies were performed in oliguric and nonoliguric forms of uranyl acetate (UA)
      induced and ischemic acute renal failure (ARF) to examine whether a reduction in
      GFR is correlated with glomerular morphologic alterations. UA-induced nonoliguric
      and oliguric ARF were induced in rabbits by i.v. injections of 0.9 and 2 mg/kg,
      respectively. A 60-min renal artery clamping produced nonoliguric ARF in
      previously uninephrectomized rats, but oliguric ARF in the clamped kidneys of
      sham-nephrectomized animals. A decline in the whole-kidney CIn rate was more
      marked in oliguric ARF kidneys of both models than in nonoliguric ARF kidneys.
      Also, tubular damage was more pronounced in oliguric kidneys when compared with
      nonoliguric kidneys. Scanning electron microscopic observations revealed
      glomerular alterations in oliguric and nonoliguric kidneys in both models,
      evidenced by a flattening and spreading of podocyte cell bodies associated with
      loss of epithelial foot processes and a reduction in the density and diameter of
      endothelial fenestrae. There was no significant difference in these glomerular
      changes between oliguric and nonoliguric kidneys. The findings suggest that less
      reduction in the whole-kidney GFR in nonoliguric ARF kidneys is ascribed largely
      to less pronounced tubular damage rather than to less severe glomerular
      morphologic alterations.

PMID- 8469791
TI  - Peritonitis rates in CAPD patients using the UVXD and O-set systems.
AB  - We report experience with O-set and UVXD systems. Sixty-nine O-set patients (34
      male; mean age +/- SD = 45.7 +/- 13.2 years) were compared with 54 UVXD patients
      (27 male; 56.8 +/- 16.8 years). Total (mean +/- SD) experience were 974 (14.1 +/-
      10.8) months on O-set and 1010.9 (18.7 +/- 15.7) months on UVXD. Thirty-two O-set
      patients avoided peritonitis; 37 had 91 episodes. Seventeen UVXD patients avoided
      peritonitis; 37 had 137 episodes. Peritonitis occurred each 10.7 months (O-set)
      versus 7.4 months (UVXD), which was significantly different (p = 0.032, Z test;
      95% confidence interval = -0.142 to +0.226). There were 18 relapses in 9 O-set
      patients, 34 in 12 UVXD. Gram-positive organisms caused 58.2% and 66%; gram
      negative, 13.2% and 8.8%; and culture negative, 24.2% and 23.4% of peritonitis in
      O-set and UVXD, respectively. The time to first peritonitis was not different,
      7.4 +/- 6.6 months O-set and 7.2 +/- 7.9 months (UVXD). There was no difference
      in the peritonitis-free period, 13.0 +/- 10.0 months (O-set) and 16.5 +/- 14.3
      months (UVXD). There were 1.12 (O-set) and 16.1 (UVXD) cases per patient year,
      and 10.7 (O-set) and 7.43 (UVXD) patient months per episode. The peritonitis rate
      odds ratio was 1:1.85 (O-set:UVXD).

PMID- 8469792
TI  - Circadian blood pressure changes in patients with chronic renal insufficiency: a
      prospective study.
AB  - Circadian blood pressure (BP) rhythm was prospectively studied by ambulatory 24-h
      monitoring in normotensive (n = 27) and hypertensive (n = 41) patients with
      stable progression of chronic renal insufficiency, and in matched control groups
      (healthy subjects: n = 28 and patients with essential hypertension: n = 47)
      without renal disease. The follow-up period lasted 24 months. The renal patients
      showed a disturbance in the 24-h profile of BP, with significantly blunted
      nocturnal pressure reduction as compared with the respective control groups (p <
      0.01 and p < 0.001, respectively). In addition to the rearrangement of circadian
      rhythm, the normotensive and hypertensive renal patients displayed a wider
      distribution of systolic and diastolic BP values and a greater nocturnal
      variability. Among the normotensive and hypertensive patients with chronic renal
      insufficiency, a significant correlation was found between the decline in
      creatinine clearance over the 24-month period and the average nighttime diastolic
      BP (r = 0.526; p < 0.01 and r = 0.613; p = 0.001, respectively) and nocturnal
      diastolic fall (r = 0.612; p < 0.001 and r = 0.496; p < 0.01, respectively).
      These data offer support for the view that renal normotensive patients are
      exposed to a relative hypertension at nighttime and that renal hypertensive
      subjects can be underestimated in their hypertensive status if the measurement of
      BP is confined to daytime. In both groups, nocturnal BP overload can accelerate
      the progression rate of renal insufficiency.

PMID- 8469793
TI  - Oxygen saturation during hemodialysis.
AB  - The aim of this study was to examine the saturation patterns of cuprofane and
      polysulfone membranes in hemodialysis patients, and to correlate that with
      permeability of the alveolar membrane, unloading of CO2 over the membranes, and
      production of oxygen free radicals. Polysulfone membranes did not have the same
      desaturation pattern as the cuprofane membranes. Both membranes were equally
      effective in the unloading of CO2, and so alveolar hypoventilation does not
      explain oxygen desaturation during hemodialysis. White blood cells have a central
      role in the parallel development of early leucopenia and hypoxemia. The precise
      mechanism is still unknown because there were no changes in permeability of the
      alveolar membrane or production of oxygen free radicals.

PMID- 8469794
TI  - 4th International Sorrento Meeting on Current Therapy in Nephrology. May 31-June
      3, 1992, Sorrento, Italy. Abstracts.

PMID- 8469795
TI  - A program evaluation of classroom data collection with bar codes.
AB  - A technology incorporating bar code symbols and hand-held optical scanners was
      evaluated for its utility for routine data collection in a special education
      classroom. A different bar code symbol was created for each Individualized
      Educational Plan objective, each type of response occurrence, and each student in
      the first author's classroom. These symbols were organized by activity and
      printed as data sheets. The teacher and paraprofessionals scanned relevant codes
      with scanners when the students emitted targeted behaviors. The codes, dates, and
      approximate times of the scans were retained in the scanner's electronic memory
      until they could be transferred by communication software to a computer file. The
      data from the computer file were organized weekly into a printed report of
      student performance using a program written with commercially available database
      software. Advantages, disadvantages, and costs of using the system are discussed.

PMID- 8469796
TI  - Delayed identity matching to complex samples: teaching students with mental
      retardation spelling and the prerequisites for equivalence classes.
AB  - Students with mental retardation learned delayed matching to sample in which some
      of the trials involved complex sample stimuli, each consisting of a picture and a
      printed word. A touch to the sample complex removed it from the computer display
      and produced either picture comparisons or a choice pool of letters. If the
      comparisons were pictures, selecting the picture identical to the preceding
      sample was reinforced. If the letters appeared, letter-by-letter construction of
      the preceding printed word sample was reinforced. The procedure engendered new
      constructed-response spelling performances to pictures and dictated words as
      samples. The emergence of relations among different sets of printed words (paired
      with the same pictures) suggested the formation of equivalence classes. One
      subject's data suggest that written spelling, oral spelling, and naming also may
      emerge as byproducts of the intervention.

PMID- 8469797
TI  - Establishing the manding function of communicative gestures with individuals with
      severe/profound mental retardation.
AB  - Procedures for teaching communicative gestures to individuals with mental
      retardation are focused mostly on establishing requesting or manding. It is often
      taken for granted that when a student has been taught to make a request, that he
      or she is indeed manding. Five students with severe/profound mental retardation
      accepted referents, regardless of whether the referents matched the gestures they
      made. Apparently, their responding could not be defined as manding. A correction
      procedure, including interruption, physical guidance, verbal instruction, and
      repetition, was then applied and increased the individuals' correct rejecting of
      unmatching referents. Data were collected within a multiple baseline design
      across individuals. It is suggested that assessing student's response when the
      trainer or teacher delivers items that do not match the referent of a prior
      request is a necessary part of each training program.

PMID- 8469798
TI  - Who is treated using restrictive behavioral procedures? A population perspective.
AB  - Considerable controversy surrounds the continued use of restrictive behavioral
      procedures in the treatment of destructive behaviors, such as self-injury,
      aggression, and property damage, displayed by some people with mental
      retardation. This study reports on the extent that pharmacological and behavioral
      consequences occur in response to these behaviors within a population of 31,000
      people in one state's developmental services system. Data on these individuals
      are analyzed to determine the degree to which intellectual level, residential
      setting type, type and extent of problem behaviors, and age are related to the
      prescriptive use of pharmacologic and behavioral consequences. These variables
      appear to bear a significant relationship on the extent to which consequences are
      applied as part of treatment. Furthermore, although pharmacologic and several
      behavior consequences are applied at similar rates, it was found that generally
      timeout, as a specific treatment procedure, was applied at rates considerably
      less than those for psychoactive medication in each population sub-group that was
      examined.

PMID- 8469799
TI  - Evaluating and improving residential treatment during group leisure situations: a
      program replication and refinement.
AB  - The authors attempted to replicate and refine a program for evaluating and
      improving residential treatment services during group leisure periods in living
      units. In Study 1, an active treatment program was implemented using a consultant
      model in two living units serving persons with severe handicaps. Similar to
      previous research, the program was accompanied by decreases in nonadaptive client
      behavior in both units during leisure periods. In addition, a time-efficient
      monitoring system was developed which suggested that two staff-related variables,
      provision of leisure materials, and interactions with clients were related to the
      program's success. Study 2 evaluated more thoroughly the relationship of these
      variables to client nonadaptive behavior in 20 residential units in four states.
      Significant predictive relationships again were found between nonadaptive
      behavior and material availability, and between nonadaptive behavior and staff
      interactions with clients. Results of Study 2 also indicated that three living
      unit supervisors readily learned to use the evaluation system. Results are
      discussed regarding the importance of simple and efficient monitoring systems for
      routinely evaluating and improving residential services.

PMID- 8469800
TI  - Comparison of sight word training procedures with validation of the most
      practical procedure in teaching reading for daily living.
AB  - The effectiveness and efficiency (training trials and training errors through
      criterion) of stimulus fading, stimulus shaping, time delay, and a feedback only
      procedure were compared in teaching three adults with moderate developmental
      delays sight words encountered in activities of daily living. In Experiment 1,
      the four procedures were assessed during training in a controlled environment to
      identify the most effective and efficient procedure for each participant. All
      three adults acquired the target words, and the four procedures were found to be
      of comparable efficiency in total training sessions, whereas individual
      differences were found in training errors to criterion. In Experiment 2, the
      feedback only procedure was used to teach the three participants sight words in
      community settings. Participants learned new words in the community settings and
      used the previously trained words in daily living activities. The benefit of
      conducting a preliminary evaluation of instructional procedures during controlled
      training is discussed.

PMID- 8469801
TI  - Final report of the Bawnmore Personal Development Programme: staff attitudes and
      sexuality programme development in an Irish service organisation for people with
      mental handicap.
AB  - In this paper, issues on sexuality and mental handicap are reviewed, and
      recognition of the growing importance of sex education to integration is noted.
      The development of a sex education programme and staff training provided within a
      service organisation, with some involvement from other services within an Irish
      setting, are described, and their evaluation is reported. Attitudes towards
      involvement prove of particular interest, and factors influencing continuation or
      discontinuation are identified. The need for attitude change among staff and
      administration towards the priority given to sex education is highlighted, and a
      need for structural change in staffing arrangements to facilitate such education
      is indicated. Failure to recognise sexuality as a research issue in evaluating
      the success of integration efforts is noted, and such research is recommended as
      a top priority for the future.

PMID- 8469802
TI  - Out-of-home placement of children and adolescents with severe handicaps:
      behavioral intentions and behavior.
AB  - This study tracked the thoughts and actions regarding out-of-home placement in
      100 families who had a child or early adolescent with severe handicaps. Parents'
      behavioral intentions regarding out-of-home placement were assessed using a
      single item measure of placement tendency (The Placement Tendency Index) four
      times over a total period of approximately 6 years. Statistical models used to
      predict time until placement indicated that the Placement Tendency Index had
      modest predictive capacity in the long run, but increased predictive utility over
      shorter periods. Closer examination of the movement of scores from one wave of
      data collection to the next revealed three patterns, indicating variability in
      the speed and direction with which parents move along the scale.

PMID- 8469803
TI  - Noncompliant behavior of people with mental retardation.
AB  - Literature pertaining to noncompliant behavior of people with mental retardation
      was reviewed. Noncompliant behavior was considered in terms of antecedents
      (characteristics of instructions), behaviors (characteristics of tasks being
      refused), and consequences (environmental results of noncompliance). Literature
      pertaining to nondisabled "oppositional" children was incorporated along with
      literature pertaining to persons with mental retardation. Research involving
      antecedent conditions suggested that noncompliance is more likely when
      instructions are vague and interrupted with other instructions. It also suggested
      that a series of high probability requests could enhance compliance to a
      subsequent low probability request. Research into behavior variables suggested
      that noncompliance is more likely when task demands are too difficult. Research
      into consequent conditions indicates that either positive or negative
      reinforcement may maintain noncompliant behavior. Treatment studies suggested
      that oppositional children respond poorly to verbal reward alone and somewhat
      better to tangible rewards and to programs utilizing timeout. By contrast,
      noncompliance by people with mental retardation appears to respond well to
      programs utilizing combinations of social and tangible rewards, but results also
      suggest that results of timeout programs are mixed. Implications for treatment
      were discussed along with suggestions for future research.

PMID- 8469804
TI  - [Reactive left ventricular hypertrophy: the functional and organic determinants
      of diastolic dysfunction (the therapeutic implications)].

PMID- 8469805
TI  - [An analysis of the responses to the tilt-table test depending on the clinical
      characteristics of the syncopal episodes in patients without apparent
      cardiopathy].
AB  - Seventy-six consecutive patients were evaluated to assess whether the response to
      head-up tilt test was related to the type of clinical presentation in patients
      with syncope of unknown origin and free from heart disease. The syncopal attacks
      were clinically characterized in a prospective fashion before the tilt test. In
      44 patients (group I) syncope had been preceded by autonomic symptoms or was
      associated with recent or static sustained orthostatism. In 32 patients (group
      II), syncope had been sudden, without prodromal or autonomic symptoms. Mean age
      was 49 +/- 17 years in group I patients and 47 +/- 17 years in group II patients
      (NS). The degree of tilt was 75 degrees. During 30 min no drugs were
      administered, and then isoproterenol was infused for an additional 20 min (1-5
      micrograms/min until a maximal heart rate of 140 bpm was achieved). Tilt test was
      considered as positive when the patient developed syncope or presyncope with
      hypotension. Tilt test was positive in 33 patients from group I (75%) and 12 from
      group II (37.5%)(p = 0.001). The positive response developed within the 30
      initial min of the test (without isoproterenol infusion) in 19 of 33 patients
      from group I (57%) and in 3 of 12 patients from group II (25%) (p = 0.053). It is
      concluded that the response to tilt test is related to the clinical features of
      syncopal attacks.

PMID- 8469806
TI  - [The usefulness of continuous Doppler in the diagnosis of aortic coarctation].
AB  - Were studied 32 patients with coarctation of the aorta by continuous wave Doppler
      ultrasound in order to assess the usefulness of this diagnostic method. Nineteen
      (59%) had native coarctation and 13 (41%) recoarctation. Seventeen (53%) were
      male and 15 (47%) female. The mean age when diagnosis was performed was 56 +/- 54
      months. We found associated anomalies in 15 patients (46%). We studied 5
      variables of the continuous Doppler curve at the descending aorta that were
      compared with those of a control group of 20 patients without cardiac anomalies.
      The variables were: peak systolic gradient (50.1 +/- 18 mmHg; VS 7.6 +/- 3 mmHg;
      p = 0.001); peak diastolic gradient 18.5 +/- 10 mmHg; VS 0.49 +/- 0.5 mmHg; p =
      0.001; systolic velocity half time 151.5 +/- 40 msec; VS 102 +/- 17 msec; p =
      0.01; diastolic velocity half time 132.2 +/- 82 msec; VS 7 +/- 14 msec; p = 0.001
      corrected acceleration time (169 +/- 26 mmHg; VS 138 +/- 22 mmHg; p = 0.01).
      Systolic gradient was highly sensitive (100%) and specific (100%). Diastolic
      gradient and time to half peak diastolic velocity were very specific (100%) and
      less sensitive (93% and 62%). There were 6 false positive and 4 false negative
      when we used the time to half peak systolic velocity (sensitivity 81%,
      specificity 72%). We conclude that continuous Doppler is a useful method in the
      diagnosis of coarctation of the aorta. The most important variables of Doppler
      curve are systolic gradient, diastolic gradient and time to half peak diastolic
      velocity. All patients with coarctation of aorta had at least 2 variables
      altered.

PMID- 8469807
TI  - [The diagnosis of ventricular pseudoaneurysms. The complementary role of
      echocardiography, isotopic ventriculography and contrast ventriculography].
AB  - The diagnostic yield of echocardiography, radionuclide ventriculography (first
      pass and multiple gated) and contrast ventriculography was evaluated in 11
      patients in whom a diagnosis of left ventricular pseudoaneurysm had been made
      during the last ten years. The diagnosis was made by two dimensional
      echocardiography (associated with Doppler in the last 5 patients) in 8 of 11
      patients (sensitivity: 73%). The major limitation of the technique, in addition
      to the impossibility of an adequate recording due to a suboptimal acoustic
      window, is the poor definition of the neck of the pseudoaneurysm, particularly in
      the inferior localization. By contrast, echocardiography is the only technique
      which permits the direct visualization of thrombi within the pseudoaneurysm.
      Multiple gated radionuclide ventriculography was diagnostic in 7 of 10 patients
      (sensitivity: 70%). Its major limitations are the poorer spatial resolution to
      visualize the pseudoaneurysm neck and the thrombi within the cavity. First pass
      radionuclide ventriculography was diagnostic in 4 of 6 patients (sensitivity:
      67%). In one of them it improved on the diagnostic yield of the multiple gated
      technique. Contrast ventriculography was diagnostic in 5 of 7 patients
      (sensitivity: 71%). The diagnosis was missed due to technical problems in one
      patient and to significant thrombosis within the pseudoaneurysm in another. Thus,
      none of the imaging studies has optimal sensitivity. Therefore, all play a
      complementary role in the diagnosis of ventricular pseudoaneurysm.

PMID- 8469808
TI  - [Thrombolytic therapy in acute myocardial infarct. New performance protocols.
      Their influence on mortality and the incidence of complications].
AB  - The new protocols of actuation in acute myocardial infarction thrombolysis have
      increased the number of patients treated, and have changed their characteristics.
      To assess the influence that this event has had in the complications incidence
      and mortality rate, we revise 704 infarcts treated with thrombolytic in a
      coronary unit, during 8 years. We separate two groups: 1) Patients treated since
      november 1983 to december 1988 following the established protocol at the
      beginning of this therapeutic (n = 328). 2) Patients treated since this date to
      july 1991, with a new protocol that include older than 70 years patients, moore
      than 6 hours of therapeutics delay and use of another thrombolytics, moreover
      streptokinase (n = 376). These changes have increased the number of thrombolysis
      in the second group (24.6 vs 49.1%; p < 0.001). Nevertheless being a higher group
      of risk we have found neither a significant mortality increase (6.40 vs 7.71%; p
      = NS), nor complications related to the thrombolysis: The incidence of major
      hemorrhages were 2.13 vs 1.06% (p = NS), cerebral hemorrhages 0.91 vs 1.6% (p =
      NS), hypotension related to the thrombolytics 15.55 vs 5.85% (p < 0.001). Neither
      has had significant difference in the incidence of reinfarcts (6.42 vs 5%; p =
      NS). In conclusion, the great number of thrombolysis realized nowadays, due to
      the actuation protocols changes, have increased significantly, neither the
      complications related with this therapeutic, nor the mortality rate, nor the
      reinfarcts number.

PMID- 8469809
TI  - [The identification of the best thrombolytic. Reflections on a problem without
      resolution].

PMID- 8469810
TI  - [Cardiac arrhythmias (IV). Auricular flutter: its mapping and radiofrequency
      ablation].

PMID- 8469811
TI  - [Coronary ostial stenosis after an aortic valve replacement diagnosed by
      transesophageal echocardiography].
AB  - We submit the case of a 75-year-old man that underwent aortic valve replacement
      whose preoperative coronary angiography showed lesion-free coronaries. Two months
      after surgery he began to feel rapidly progressing effort angina pectoris.
      Transesophageal echocardiography showed prosthetic normal function while allowing
      the study of the great coronary trunks. We observed the presence of a 50%
      stenosis at the ostium of the left coronary artery trunk due to the use of
      selective coronary cannulation to supply cardioplegia solution during valve
      replacement. A second coronary angiography confirmed this finding.
      Transesophageal echocardiography may be used as an initial diagnostic method when
      coronary ostial stenosis is suspected after aortic valve replacement.

PMID- 8469812
TI  - [Percutaneous coronary transluminal angioplasty in a heart transplant recipient].
AB  - A 46-year-old female, who underwent an orthotopic heart transplantation 5 years
      ago, presented an occlusive coronary artery disease with severe stenosis of the
      left anterior descending artery and a large septal perforator. An isonitrile
      scintigraphy showed a decreased uptake involving the anterior and inferior
      segments of the left ventricle. Percutaneous transluminal coronary angioplasty
      was successfully performed in both lesions. Three months after dilatation,
      improvement of the uptake in both myocardial segments was detected. The results
      of the percutaneous transluminal coronary angioplasty published in the literature
      are reviewed.

PMID- 8469813
TI  - [Anomalous origin of the right pulmonary artery from the ascending aorta. Its
      echo-Doppler diagnosis].
AB  - The anomalous origin of the right pulmonary artery from the ascending aorta is a
      rare malformation. Its diagnosis and early surgical treatment are necessary to
      avoid its fatal outcome. We present the pulsed and color echo-Doppler findings in
      a patient with this pathology.

PMID- 8469814
TI  - [A right-to-left shunt through a patent foramen ovale without pulmonary
      hypertension].
AB  - We report the case of a man 67-years-old with right-to-left shunt through a
      patent foramen ovale in absence of pulmonary hypertension. The contrast and
      transesophageal echocardiography showed significant right-to-left shunt and
      provided insight about the mechanisms that cause it. The aortic root was enlarged
      compressing the right atrium. Surgical repair was performed, the foramen ovale
      was closed and right atrial enlargement with a patch was carried out.
      Disappearance of the shunt was confirmed by means of transesophageal
      echocardiography in surgical-room.

PMID- 8469815
TI  - Whole-body plethysmography in the clinical assessment of infants with
      bronchopulmonary diseases.
AB  - Infant whole-body plethysmography offers a unique possibility of measuring end
      expiratory resting level (thoracic gas volume; TGV), and hence lung volume in its
      close interrelationship to airway function (airway resistance; R(aw), its
      reciprocal value, airway conductance, Gaw). Therefore, this technique is a
      valuable aid for objective evaluation of lung diseases in infants. This article
      gives an overview of the physiological background of this particular measuring
      technique and its usefulness in the clinical routine. Plethysmographic data
      obtained in infant survivors of the infant respiratory distress syndrome (iRDS),
      in infants with cystic fibrosis (CF) and in the so-called 'wheezy infants' are
      presented. Special emphasis is given to the fact that in such infants the
      interrelationship between changes in end-expiratory resting level and the deficit
      in airway mechanics is of great importance and, consequently, for the
      determination of functional lung derangement in each particular case of lung
      disease, both TGV and the closely related R(aw) and Gaw have to be evaluated.
      This recommendation has to be kept in mind when the different diagnostic tools
      for evaluation of treatment facilities are applied in this particular young age
      group of patients with lung disease. In children as in adult patients, inhalative
      treatment must be considered the mainstay of all therapeutic measures. However,
      in infants, the efficacy of such treatment regimens must first be evaluated by
      adequate functional investigations. Infant whole-body plethysmography offers one
      such possibility.

PMID- 8469816
TI  - Early and late follow-up of pulmonary embolism.
AB  - This study includes 61 patients referred with pulmonary embolism (PE) during 1
      year. At admission, blood gas analysis, chest radiography and pulmonary lung scan
      were obtained in each patient; in a subset of patients pulmonary angiography was
      also performed to make the definitive diagnosis. Patients were treated with
      heparin and, later, with oral anticoagulants. Blood gas analysis, chest
      radiograph and perfusion lung scan were repeated 7, 30, 180 and 365 days after
      the diagnosis to evaluate the usefulness of these techniques in the follow-up of
      PE. Arterial hypoxemia and perfusion impairment recovered in parallel, both in
      the acute phase after embolism (7 days) and later up to 1 year. The great
      majority of recovery occurred within the first month after embolization.
      Radiographic signs compatible with PE tended to decrease early and disappeared
      almost completely after 30 days. Arterial blood gas analysis and perfusion
      scintigraphy detected 8 recurrences of PE that would be missed by chest
      radiograph. Arterial hypoxemia and the enlargement of descending pulmonary artery
      were positively correlated with the number of unperfused lung segments and, thus,
      may help predicting the severity of perfusion impairment in the acute stage. In
      conclusion, blood gas analysis and chest radiograph may be employed with or
      without perfusion lung scan to follow patients with PE up to 1 month after
      embolization; after that, only blood gas analysis and perfusion lung scan may
      give useful information about recovery from or recurrence of PE.

PMID- 8469817
TI  - Ovine tracheal muscle contraction in vitro: inhibition by calcium channel
      blockers gallopamil and verapamil.
AB  - We compared the inhibitory effects of calcium channel blockers, gallopamil and
      verapamil on acetylcholine (Ach)-induced contractions of ovine tracheal muscle in
      vitro. Adult sheep were sacrificed and tracheal strips were obtained by cutting
      the single tracheal rings from the mid-trachea. Tracheal strips were suspended in
      Krebs-Henseleit solution and isometric tension measured upon stimulation with
      cumulative doses of Ach (10(-7) to 10(-4) M) without and after pretreatment with
      gallopamil (10(-7) to 10(-6) M) or verapamil (10(-6) to 10(-5) M). In untreated
      tissues, the mean concentration of Ach required to produce 50% of maximal
      response (EC50) was 4.3 x 10(-6) M Ach. Both gallopamil and verapamil inhibited
      the Ach-induced contractions of ovine tracheal smooth muscle, by shifting the
      dose-response curves to Ach to the right. EC50 Ach for gallopamil (10(-6) M) and
      verapamil (10(-6) M) was 2.6 x 10(-5) and 5.2 x 10(-6) M, respectively. Dose
      ratio defined as postantagonist EC50 Ach/control EC50 Ach, was 7.7 for gallopamil
      and 2.0 for verapamil. Thus, the inhibitory effect of gallopamil was
      approximately 4-fold more potent than that of verapamil. Gallopamil was 17-fold
      more potent than verapamil in relaxing precontracted tracheal strips. The dose of
      calcium antagonists required to produce 25% relaxation (EC25) of tracheal strips
      precontracted with 10(-4) Ach was 3.7 x 10(-5) M for verapamil and 2.2 x 10(-6) M
      for gallopamil. These results indicate that gallopamil is effective against Ach
      induced contractions of ovine trachealis muscles, and is more potent than
      verapamil.

PMID- 8469818
TI  - Clinical and radiologic features, lung function and therapeutic results in
      pulmonary histiocytosis X.
AB  - Clinical appearance, radiologic findings, lung function and results of
      corticosteroid therapy were analyzed in 42 adult cases of biopsy-proven pulmonary
      histiocytosis X. Symptoms were present in only 64%. Using the ILO classification
      1980, the evaluation of chest radiographs revealed all categories of profusion,
      size and shape of nodules. The characteristic 'ring figures', i.e. thin-walled
      cysts, in the parenchyma were detected in 78% of conventional tomographies (n =
      27) and in all patients examined by CT (n = 5). In patients with early disease,
      lung function tests (n = 26) including body plethysmography, pulmonary diffusing
      capacity and ergospirometry revealed that parameters of gas exchange are most
      sensitive (TL,CO 84%, KCO 72%). Bronchial reactivity to carbachol was
      significantly higher than in controls (n = 12). Lung perfusion scintigram showed
      an abnormal, but uncharacteristic pattern in 81% (n = 26). During corticosteroid
      therapy, no progression was observed (n = 36). 85% of patients with radiographic
      evidence of progressive disease improved after administration of corticosteroids
      (n = 14).

PMID- 8469819
TI  - Multivariate analysis of factors affecting pulmonary function in bronchiectasis.
AB  - Impaired pulmonary function is of prognostic importance in bronchiectasis. To
      assess the factors affecting pulmonary function in bronchiectasis, we studied the
      clinical features, atopic status, bronchial responsiveness, systemic inflammatory
      indices, and sputum characteristics including volume, purulence, leucocyte count,
      neutrophil chemotactic activity, elastolytic activity (EA) and bacteriology in 82
      Chinese patients. The majority of patients had impaired spirometry with airflow
      obstruction but normal carbon monoxide diffusing capacity. Multivariate analysis
      showed that factors significantly associated with worse lung function were:
      bronchial hyperresponsiveness, concomitant asthma, higher serum globulin, higher
      peripheral leucocyte count, lower serum albumin, greater sputum volume, diffuse
      disease and older age. When subjects with clinical asthma were excluded, similar
      factors were identified, and in addition, longer duration of disease, presence of
      eosinophils in sputum and higher sputum EA were significantly related to worse
      spirometry. Most of the identified factors reflect a state of inflammation. Thus
      the findings suggest that persistent inflammation plays an important role in the
      deterioration of lung function in bronchiectasis.

PMID- 8469820
TI  - Dobutamine, but not dopamine, augments the normal chronotropic response to acute
      hypoxemia.
AB  - Infusion of exogenous dopamine has been shown to alter both the hypoxic and the
      hypercapnic ventilatory response, but its effects on the hypoxic and the
      hypercapnic cardiac response have not been reported. The purpose of this study
      was to determine if cardiac responses to hypoxemia and hypercapnia are altered by
      infusion of either dopamine (DOP) or its analog dobutamine (DBT). Baseline mean
      arterial blood pressure (MAP) and heart rate (HR) were measured in 7 normal male
      subjects while normal saline was infused intravenously (NS1) for 30 min. Each
      subject then underwent both a eucapnic hypoxemic challenge (EHC), and a hyperoxic
      hypercapnic challenge (HHC). In a double-blinded randomized fashion either DOP1
      or DBT1 was selected and infused at 5 micrograms/kg/min for 30 min. EHC and HHC
      were again performed. This sequence was then repeated following a second NS
      infusion (NS2) and the alternate vasopressor. On a second study day, the dose of
      dopamine (DOP2) selected was that sufficient to induce a similar rise in MAP as
      seen with DBT1. Following NS and DOP1 there was a reproducible significant linear
      increase in HR with progressive hypoxemia seen in all subjects. This response was
      significantly augmented following infusion of DBT1 (p < 0.03), but no such
      augmentation was noted with DOP2. No significant change in HR was noted during
      HHC. The mechanisms responsible for this augmentation of hypoxemic response
      during dobutamine infusion are unclear, and do not appear to be related to a rise
      in MAP. We speculate that it is due to an effect of dobutamine on beta 1-receptor
      activity.

PMID- 8469822
TI  - Computed tomography findings in idiopathic pulmonary hemosiderosis.
AB  - Computed tomography (CT) findings in a case of idiopathic pulmonary hemosiderosis
      (IPH) are presented. The contribution of this imaging modality to diagnosis is
      discussed.

PMID- 8469821
TI  - Diagnosis of pleural tuberculosis by detection of specific IgG anti-antigen 60 in
      serum and pleural fluid.
AB  - The objective of this study was the prospective evaluation of the IgG antibody
      levels to mycobacterial antigen 60 (A60) in serum and pleural fluid and their
      role in the diagnosis of tuberculous pleuritis. The level of IgG was measured by
      Elisa in 30 patients with tuberculous pleuritis and 48 control subjects with
      pleural effusion (24 with carcinoma, 10 with transudative pleural effusion, 11
      with empyema or parapneumonic effusion, 1 with pulmonary embolism and 2 due to
      systemic lupus erythematosus). The median titers of IgG against A60 of both serum
      and pleural fluid from tuberculous patients [445.6 +/- 133.56 and 263 +/- 72.58
      Elisa units (EU) respectively] were significantly higher than those of
      corresponding median values (97.3 +/- 8.35 and 41.3 +/- 4.93 EU) of the control
      group (p < 0.01 and p < 0.01, respectively). Considering 240 units as cutoff
      point for a positive test in serum, the sensitivity was 53.3% and the specificity
      100%. In the pleural fluid the cutoff point value was established at 150 units,
      with a sensitivity of 50% and specificity of 100%. We concluded that Elisa using
      A60 is a reliable and rapid test with an acceptable sensitivity and magnificent
      specificity.

PMID- 8469823
TI  - From not detected pulmonary embolism to diagnosis of chronic thromboembolic
      pulmonary hypertension: a retrospective study.
AB  - The past and present clinical history of 13 patients with hemodynamic and
      angiographic diagnosis of chronic thromboembolic pulmonary hypertension (CTPH)
      was reviewed in order to investigate the reasons for failure of resolution of
      acute pulmonary embolism (PE) and findings useful for diagnosis of CTPH. All
      patients had chest radiograph, ECG, arterial blood gas analysis and pulmonary
      perfusion scintigraphy performed. Clinical assessment demonstrated that no
      patient had diagnosis and treatment of the several retrospectively identified
      episodes of PE (from 1 to 8); the lack of diagnosis was due to underestimation of
      symptoms and signs such as dyspnea (85%), pleuritic chest pain (31%) or phlebitis
      (46%) that were present months or years earlier. Alternative diagnoses
      erroneously made were dyspnea of unknown origin (5 cases), left heart failure (4
      instances) and pneumonia (2 cases). Once CTPH has developed, chronic dyspnea
      (92%) and substernal chest pain (100%) are almost always present: chest
      radiograph and ECG show signs of chronic hypertension such as enlargement of hila
      (100%), right heart sections (77%), azygos vein (46%) and P pulmonale (67%), T
      inversion on right precordial leads (75%), S-T segment depression (75%),
      respectively. Perfusion scintigraphy shows severe perfusion impairment (55.7% of
      the total vascular bed) paralleled by severe hypoxia (standard PaO2 = 49 +/- 14.1
      mm Hg). In conclusion, patients with PE who develop CTPH are not diagnosed and
      thus untreated because clinical symptoms and signs of acute PE have not been
      recognized. If CTPH develops, clinical assessment (including simple and
      noninvasive techniques such as chest radiograph, ECG and blood gas analysis) may
      show a quite characteristic pattern useful for diagnosis.

PMID- 8469824
TI  - [Fibrosis and fusion of the heart valve].

PMID- 8469825
TI  - [Myocardial hypertrophy and fibrosis].

PMID- 8469826
TI  - [Fibrosis of myocardium after myocardial infarction].

PMID- 8469827
TI  - [Myocardial fibrosis in post-myocarditis].

PMID- 8469828
TI  - [Analysis of respiratory pattern during exercise by respiratory rate-tidal volume
      relationship in healthy subjects].

PMID- 8469829
TI  - [Signal-averaged electrocardiogram in right bundle branch block patients after
      surgical repair for congenital heart disease].
AB  - Right bundle branch block (RBBB) type was investigated using signal-averaged
      electrocardiogram (SAECG) in 35 RBBB patients after surgical repair of
      ventricular septal defect and tetralogy of Fallot. The type of RBBB was first
      identified by body surface mapping; 12 patients had proximal RBBB, and 23 had
      peripheral RBBB. The control group consisted of 20 healthy volunteers. The
      following three findings were seen in most patients with proximal RBBB, and were
      useful for determining the type of RBBB; a filtered QRS duration equal to or
      longer than 160 msec, a fragmented signal number equal to or greater than 10 and
      the whole type of filtered QRS pattern. The sensitivity and specificity of SAECG
      for proximal RBBB were shown to be high. In conclusion, SAECG was found to be
      useful for non-invasive determination of RBBB types.

PMID- 8469830
TI  - [The efficiency of continuous hemofiltration/hemodialysis for acute respiratory
      failure complicated with acute renal failure].
AB  - Continuous hemofiltration/hemodialysis (CHF/CHD) have emerged as effective
      modalities in the management of acute renal failure. More recently, these
      therapies have received attention for non-renal application such as adult
      respiratory distress syndrome (ARDS) and multiple organ failure. To assess the
      potential benefits of CHF/CHD in the management of severe impairment of pulmonary
      gas exchange, we evaluated a series of clinical variables in a group of patients
      with acute respiratory failure complicated with acute renal failure. In 9 of 15
      patients, pulmonary gas exchange was improved. Intrapulmonary shunt (Qs/Qt) and
      pulmonary vascular resistance were also improved during the therapies. The
      beneficial effects of the modalities seems to be induced by effective removal of
      extravascular lung water. However, the fact that the same effects were also
      observed in a few patients with zero or positive fluid balance may indicate the
      possibility of elimination of circulating middle-molecular pulmonary toxic
      mediators. We concluded CHF/CHD are recommendable methods for the management of
      acutely ill patients with respiratory failure.

PMID- 8469831
TI  - [The microcirculatory dynamics of prostaglandin E1 and/or nicardipine and their
      different reactions in the hyper- and hypodynamic state of septic shock in a rat
      model].
AB  - The reactions of the mesenteric microcirculation dynamics to prostaglandin
      E1(PGE1) and nicardipine were investigated under continuous biomicroscopy with a
      high speed video analyzer in septic shock models using rats. Both of the drugs
      induced similar reactions. In the hyperdynamic state, the vasodilation and
      increasing velocity of red blood cells (RBC) stimulated by both of these
      vasodilators were similar to those in normal control state. However, in the
      hypodynamic state the vasodilators especially PGE1 had little effect on
      increasing the velocity of RBC in spite of their vasodilating action. Therefore
      these vasodilators are useful in order to improve the microcirculatory blood flow
      in states such as early septic-shock state.

PMID- 8469832
TI  - [A case of chronic recurrent pulmonary embolism complicated with effort angina
      pectoris].
AB  - A 50-year-old man was admitted to our hospital because of shortness of breath and
      an oppressive feeling in his chest on exertion. As a result of examinations
      including pulmonary-angiography, pulmonary perfusion scan and phlebogram, we
      diagnosed the case as chronic recurrent pulmonary embolism due to deep vein
      thrombosis. Later on, the patient showed an abnormal reaction on treadmill
      exercise test, and revealed redistribution at the anteroseptal and the inferior
      wall on thallium exercise test. We performed coronary angiography and diagnosed
      the case as angina pectoris (seg. 1 was total occlusion, segs. 2 and 3 were
      filled with bridge collateral, seg. 7 was 75% stenotic lesion). We evaluated the
      acute effect of vasodilators on pulmonary and systemic hemodynamics. The effect
      was beneficial in that it improved the hemodynamics. On account of this we
      thought a reversible condition was presented, and we administered these drugs to
      this patient.

PMID- 8469833
TI  - [Activation of coagulation and fibrinolysis in patients with abdominal true
      aortic aneurysm associated with disseminated intravascular coagulation].
AB  - Two cases of abdominal true aortic aneurysm (AAA) associated with disseminated
      intravascular coagulation (DIC) were reported. Case 1 was an 81-year-old male who
      was admitted because of hematoma on the left leg and in whom was found by MRI an
      aortic aneurysm of 14 cm in diameter. Coagulation studies indicated DIC by
      revealing thrombocytopenia, hypofibrinogenemia and increased level of FDP. DIC
      was well controlled by surgical repair of the aneurysm after the administration
      of a small dose of heparin. Case 2 was a 60-year-old male who was admitted
      because of lumbago and hematoemesis and in whom was found by CT and echography an
      aortic aneurysm of 5.5 cm in diameter. Coagulation studies indicated DIC by
      revealing thrombocytopenia and an increased level of FDP. On the 2nd hospital
      day, he suddenly died due to the rupture of the aortic aneurysm. In most of 9
      cases with AAA without DIC, plasma levels of thrombin-antithrombin III complex,
      plasmin-alpha 2 plasmin inhibitor complex and FDP-D dimer were also elevated.
      These findings indicate that the coagulation and fibrinolysis systems were
      generally activated in patients with AAA, and that DIC tends to occur in patients
      with a giant aortic aneurysm or an impending ruptured aneurysm.

PMID- 8469834
TI  - [The efficacy of external high frequency oscillation: experience in a
      quadriplegic patient with alveolar hypoventilation].
AB  - External high frequency oscillation (EHFO) around a negative pressure using a
      thoracoabdominal chamber without an artificial airway has been shown to be an
      effective form of ventilation in a quadriplegic patient. The patient was an 18
      year old male, suffering from high-level cervical cord tumor (lipoma). His
      respiratory distress was severe, respiration was diaphragmatic only. Because of
      acute respiratory insufficiency, he was intubated and put on IPPV. Attempts at
      weaning were not thought to be feasible. Then the Hayek Oscillator was applied
      with a frequency of 120. After 5 days on the Hayek Oscillator, he was extubated.
      EHFO was associated with a significant increase in PaO2 and VA, and a significant
      decrease in PaCO2. It is remarkable that the patient expelled sputum whenever he
      was connected to the Hayek Oscillator, far beyond that achievable by
      physiotherapy. EHFO avoids the need for endotracheal intubation, thus reducing
      the hazards of mechanical ventilation attributable to intubation. We conclude
      that EHFO produces gas exchange significantly and that this technique may have
      potential clinical application.

PMID- 8469835
TI  - [A case of a patient with sternocostoclavicular hyperostosis complaining of
      severe chest pain, which must be distinguished from cardiovascular disease].
AB  - We report a case of a patient complaining of severe chest pain which required a
      differential diagnosis between cardiovascular disease and sternocostoclavicular
      hyperostosis. The patient was a 61-year old male who began experiencing pain
      across both scapulas at the end of September, 1990. He was admitted to our
      hospital when the pain extended to the back and anterior chest areas. Examination
      on admission revealed inflammation with a white blood cell count at 11,800/mm3,
      an erythrocyte sedimentation rate of 136 mm/hr, and CRP at 14.2 mg/dl. Angina
      pectoris was suspected based on findings from coronary arteriography which showed
      60% stenosis at Seg 6. A Ga-scintigram conducted to determine the cause of the
      chest pain revealed accumulations in the upper mediastinum. CT and MRI both
      showed hyperostosis of the sternum, and bone scintigram confirmed marked
      accumulations in the same area. Palmoplantar pustulosis (PPP) was also clearly
      noted on the palms and soles of the feet. Sternocostoclavicular hyperostosis was
      diagnosed based on these findings. Sternocostoclavicular hyperostosis was
      suspected in this case based on the clinical findings, inflammatory state, and
      accumulations revealed by bone scintigraphy. However, the diagnosis could have
      been more conclusive if non-suppurative hyperosteostic osteomyelitis were
      observed by bone biopsy. A differential diagnosis for unknown sources of chest
      pain should be considered in cases such as this.

PMID- 8469836
TI  - [A study of myocardial disorders in an autopsy case of mitochondrial
      encephalomyopathy].
AB  - We report an autopsy case of a 19 year-old man with MELAS (mitochondrial
      myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) a subgroup
      of mitochondrial encephalomyopathy presenting cardiomyopathy. He had repeatedly
      suffered from transient unconsciousness, hemiplegia, hemianopsia and convulsion
      attacks since the age of 9, and he died of severe congestive heart failure. In
      laboratory findings, blood lactate and pyruvate were markedly increased. Skeletal
      muscle biopsy demonstrated numerously scattered ragged-red fibers with modified
      Gomori's trichrome staining. Enzymatic activities of the mitochondrial
      respiratory chain showed a marked decrease of NADH cytochrome c reductase
      (complex I). In postmortem examination, the heart was 310g in weight and had
      right ventricular dilatation. Microscopically, degenerated and scattered
      myocardial cells (ragged-red fibers), interstitial edema and microvascular
      hyperplasia were demonstrated in the myocardium. Under the electron microscope,
      abnormal mitochondria proliferated and myofibrils were unusually sparse.
      Immunohistochemical studies with specific antibodies against the mitochondrial
      electron transfer enzyme subunits revealed a reduction of immunoreactive
      materials for complex I in the myocardium. These results suggested the
      relationship of myocardial disorders and decreased activity of complex I in
      electron transfer enzymes in this patient.

PMID- 8469837
TI  - [Two cases of idiopathic ventricular fibrillation with interesting
      electrocardiographic findings].
AB  - We encountered two cases of ventricular fibrillation (VF) without overt heart
      disease. The first case we report is that of a 47-year-old man, and the second
      case is a 39-year-old man. VF occurred in the night unrelated to myocardial
      ischemia or myocarditis. Their basic ECGs showed normal sinus rhythm, but neither
      QT prolongation nor abnormal Q wave was seen. But we could see IRBBB and ST
      segment elevation in the V1-2 lead not only in the acute phase, but also in the
      chronic phase. Abnormal findings were not found in noninvasive cardiac
      examinations, nor in cardiac catheterization and histological examinations. In
      the second case, VF was induced by electrical stimulation, and Disopyramide was
      found to be effective for the prevention of VF. The patient in the first case
      died suddenly two years after his first attack. Both cases have interesting ECG
      findings, and it may be that they play on important role in discovering the
      etiology of sudden cardiac death.

PMID- 8469838
TI  - [A case of dextrocardia concomitant with tetralogy of Fallot, patent ductus
      arteriosus and bronchiectasia].
AB  - We report a case of dextrocardia concomitant with tetralogy of Fallot (TOF),
      patent ductus arteriosus (PDA), bronchiectasia, and pulmonary tuberculosis. A 24
      years-old man without surgical operation for TOF, whose diagnosis had been made
      at infancy, was admitted to the Osaka City University Hospital because of massive
      hemoptysis. The diagnosis of pulmonary tuberculosis was made. He received anti
      tuberculotic drugs and bronchial arterial embolization improved his symptoms. A
      case of mirror-image dextrocardia concomitant with TOF, PDA, and bronchiectasia,
      as seen in our case, has a low incidence rate, and, moreover, such a case
      concomitant with pulmonary tuberculosis is rarer still.

PMID- 8469839
TI  - [Partial anomalous pulmonary venous connection to inferior vena cava (incomplete
      type of scimitar syndrome) in an elderly patient].
AB  - A 71-year-old woman presented with recent onset of dyspnea and fatigue on
      moderate exertion. She had been well during her entire life and had had three
      pregnancies and deliveries. Cardiomegaly was noted at the age of 30. On physical
      examination, systolic murmur was detected at the lower left sternal border. The
      chest X-ray showed cardiomegaly, increased pulmonary vascular markings and
      elevated right diaphragm. The electrocardiogram showed left ventricular
      hypertrophy. The echocardiography showed enlargement of right ventricle and
      atrium, massive tricuspid regurgitation and anomalous venous flow connected to
      the inferior vena cava from its right-posterior side. Cardiac catheterization
      demonstrated mild pulmonary hypertension and O2 step-up at the level of the
      anomalous venous connection to the inferior vena cava. On pulmonary
      arteriography, left pulmonary venous flow return to the left atrium and atrial
      septal defect was not found. Veins from the right lung met to form one vessel,
      went downward, and connected to the inferior vena cava at the level of Th12. L-R
      shunt was 45% and Qp/Qs was 1.83. Isolated partial anomalous pulmonary venous
      connection is a rare finding, and it is thought that the natural prognosis is
      good. The existence of our case, diagnosed at the age of 71, supported this
      concept.

PMID- 8469840
TI  - Microemboli reduce phase III slopes of CO2 and invert phase III slopes of infused
      SF6.
AB  - We investigated the effect of increasing doses of intravenously infused glass
      microspheres (mean diameter 125 microns) on gas exchange in anesthetized,
      heparinized, mechanically ventilated goats (VT = 16-18 ml/kg). Breath-by-breath
      CO2 expirograms were collected using a computerized system (Study A) during the
      infusion of a total of 15 g of microspheres. We found a 50% decrease in
      extravascular lung water by indicator dilution with a corresponding doubling of
      alveolar dead space (VDalv). Airways deadspace (VDaw) decreased by 13 ml (10%)
      and mean normalized phase III slope for CO2 decreased from 0.23 to -0.08 L-1
      becoming negative in 3 of 5 animals. In a second study (Study B), simultaneous
      breath-by-breath CO2 and infused SF6 expirograms were collected using an infrared
      CO2 analyzer and a mass spectrometer. Under baseline conditions VDaw for CO2 was
      smaller than for SF6 and the ratio of the phase III slope for SF6 to the phase
      III slope for CO2 was 1.39. Following embolization there were no differences in
      VDaw between the two gases, however, the phase III slope for CO2 became either
      slightly negative or extremely flat, while the phase III slope for SF6 became
      negative in 73% of the breaths (-0.17 L-1, P < 0.05). Negative phase III slopes
      have been predicted by a single path model when blood flow is confined to the
      most mouthward generations of the acinus (Schwardt et al., Ann. Biomed. Engin,
      19: 679-697, 1991). The agreement between the numerical model and the
      experimental data is consistent with a serial distribution of blood flow within
      the acinus.

PMID- 8469841
TI  - Effects of hypobaria on parabronchial gas exchange in normoxic and hypoxic ducks.
AB  - Cardio-respiratory parameters and air sac and blood gases were measured in the
      unrestrained, unanesthetized duck during exposure to normobaric (PB = 746 Torr)
      or hypobaric (PB = 253 Torr) normoxia (PIO2 = 143 Torr) and hypoxia (PIO2 = 41.5
      Torr). Compared with normobaria at the same PIO2, hypobaria caused a
      statistically significant increase in ventilation during both normoxia and
      hypoxia, resulting in elevated PO2 and diminished PCO2 in the caudal thoracic and
      clavicular air sac, and in increased PaO2 and decreased PaCO2. Similarly, lactic
      acid production was elevated in hypobaria, and the resulting decrease in arterial
      pH may be responsible for the increase in ventilation. Despite these changes,
      there was no evidence for altered gas exchange efficiency during hypobaria. This
      suggests that no significant diffusion limitation is present in the air capillary
      gas phase in normobaria, that could have been diminished with hypobaria. It also
      suggests that the aerodynamic valving efficiency, present during inspiration at
      the level of the medioventral bronchi, is not affected by hypobaria. Although the
      mechanisms underlying the increased lactic acid production and ventilation are
      not understood, they may exert an advantageous effect on high altitude tolerance
      of the bird.

PMID- 8469842
TI  - Regional lung impedance from forced oscillations through alveolar capsules.
AB  - We developed a technique for applying forced oscillations in flow between 5 and
      200 Hz to the lung through an alveolar capsule. This provided measures of the
      complex alveolar input impedance of the lung, which we modelled in terms of an
      elastic alveolar unit connected to the rest of the lung by a peripheral airway.
      The estimated elastance of the alveolar compartment in 6 normal dogs was about 5
      orders of magnitude greater than the elastance of the entire lung. The resistance
      of the airway leading into the compartment from the rest of the lung was about 5
      orders of magnitude greater than the resistance of the entire airway tree. The
      capsule oscillation technique thus gives mechanical information about an
      extremely small region of the lung (in the order of 10 mm3 in volume) just under
      the capsule. A bolus i.v. injection of methacholine caused a variable response in
      the alveolar regions studied, with some regional elastances and resistances
      increasing while others decreased, despite the fact that overall lung resistance
      and elastance always increased. We conclude that our capsule oscillator technique
      yields precise mechanical information about very small distal regions of the
      lung, and that these regions respond heterogeneously to injected methacholine.

PMID- 8469843
TI  - Differential function of the costal and crural diaphragm during emesis in
      canines.
AB  - In six mongrel dogs under thiopental anesthesia, piezoelectric transducers and
      bipolar electromyographic (EMG) wires were installed onto left costal, medial
      crural and lateral crural segments of the diaphragm. During CO2 rebreathing,
      shortening and EMG activity increased significantly in all three regions of the
      diaphragm compared to resting breathing. During emesis, (1) both shortening and
      EMG activity significantly increased compared to resting in costal segment;
      however, (2) lateral crural shortening was not increased in spite of significant
      increase in EMG activity; furthermore, (3) the medial crural segment lengthened
      without any increased EMG activity. These results demonstrate a differential
      recruitment of costal and crural diaphragm segments, and an additional
      differential activity within the crural segment between medial and lateral crural
      regions, during emesis. This activity of the canine diaphragm is consistent with
      a central influence of emesis upon individual regions of the diaphragm.

PMID- 8469844
TI  - Thin-fiber phrenic afferents mediate the ventilatory response to diaphragmatic
      ischemia.
AB  - We assessed the role of groups III and IV phrenic afferents in the ventilatory
      response to diaphragmatic ischemia in mechanically ventilated, chloralose
      anaesthetized dogs using the in-situ isolated and innervated left hemidiaphragm
      preparation. The inspiratory motor drive to the right (Rt Edi) and left (Lt Edi)
      diaphragms, parasternal (Eps), and alae nasi (Ean) muscles was measured from the
      peak integrated EMG activities. When left diaphragmatic ischemia was produced in
      the control group (n = 6) by occluding the left phrenic artery for 20 min, LtEdi
      increased to 158%, RtEdi to 160%, Eps to 150% and Ean to 135% of baseline values.
      Left diaphragmatic tension, however, remained unchanged during the ischemia
      period. In the capsaicin-treated group (n = 6), we injected repeated doses of
      capsaicin, a selective stimulant of groups III and IV afferents, into the left
      phrenic artery to eliminate inputs from these afferents. Repeated injections of
      capsaicin are known to induce prolonged periods of afferent dysfunction. The
      first two injections of capsaicin (1 mg each) produced transient activation of
      the inspiratory muscles and higher breathing frequencies. Subsequent injections,
      however, failed to elicit any ventilatory changes. When diaphragmatic ischemia
      was induced after the last injection of capsaicin, no changes in the Right Edi,
      Eps and Ean were observed, whereas Left Edi and left diaphragmatic tension
      declined significantly. We conclude that increased inspiratory motor drive during
      selective diaphragmatic ischemia is mediated through the activation of groups III
      and IV phrenic afferents.

PMID- 8469845
TI  - Role of muscle perfusion and baroreception in the hyperpnea following muscle
      contraction in dog.
AB  - The influence of impeding muscle perfusion on the time course of ventilatory
      decline during recovery from electrically induced hindlimb contractions has been
      studied in 14 anesthetized dogs. When intravascular balloons, placed in abdominal
      aorta and inferior vena cava just rostral to the iliac bifurcation, were inflated
      at the cessation of contraction bout, minute ventilation (VE) was significantly
      reduced during recovery compared with control. The subsequent restoration of
      iliac circulation rapidly augmented VE, which peaked at the fifth breath after
      release, by an average of +4.97 L.min-1; VE then returned exponentially to
      resting (pre-contraction) level. Breathing 100% O2 did not affect the VE recovery
      pattern neither during iliac occlusion nor immediately after its release (the
      peak average delta VE = +4.42 L.min-1). When a local anesthetic (5% Lidocaine)
      was applied bilaterally to the regions of carotid bifurcation, systemic blood
      pressure was significantly increased and the VE response to both iliac occlusion
      and release were nearly abolished. The VE response to inhalation of 5% CO2 in air
      was not affected by this procedure, whereas the stimulation of VE with 2 mg i.v.
      bolus of NaCN was attenuated. When the local anesthetic was thoroughly washed out
      (and systemic blood pressure had returned to control level) the previously
      observed VE responses to iliac occlusion and release were restored. These results
      and analysis of the VE response timing (transits and latencies) suggest that the
      vascular rather than humoral effects or tissue 'metaboreception' modulate
      ventilatory recovery from muscular contractions; baroreception appears to be
      important in this process.

PMID- 8469846
TI  - Influence of prolonged adenosine receptor blockade on fetal sleep and breathing
      patterns.
AB  - Chronically prepared fetal sheep were subjected to 48 h infusions of
      theophylline, an adenosine antagonist, enprofylline, a xanthine without adenosine
      antagonism, or saline. Theophylline increased mean (+/- SD) incidence of REM
      sleep from 49.3 +/- 8.3% to 57.3 +/- 6.7% (p < 0.02) and wakefulness from 1.3 +/-
      1.4% to 8.1 +/- 7.1% (p < 0.01). On the first day of theophylline infusion
      incidence of fetal breathing (FB) increased from 37.9 +/- 8.1% to 53.7 +/- 11.6%
      of total time (p < 0.002) and from 76.4 +/- 10.2% to 87.6 +/- 10.3% of REM sleep
      (p < 0.02). Diaphragmatic EMG/min increased from 6.9 +/- 4.0 to 17.3 +/- 13
      arbitrary units (p < 0.02). By the second day of infusion, FB had returned to
      baseline value. Enprofylline and saline had no effect. 125 micrograms phenyl
      isopropyl adenosine (PIA) i.v. caused fetal apnea that was reduced from 143 +/-
      45.5 min on the control day to 39.8 +/- 34.7 min (p < 0.001) during theophylline
      infusion. Enprofylline and saline had no effect, suggesting that the observed
      theophylline effect was due to its adenosine antagonism rather than to non
      specific xanthine action. We conclude that endogenous adenosine suppresses FB,
      but since theophylline did not alter the basic relationship between FB and REM
      sleep it is not primarily responsible for apnea during NREM sleep.

PMID- 8469847
TI  - Effects of halothane and isoflurane in the upper airway of dogs during
      development.
AB  - It has been previously found that volatile anesthetics significantly affect the
      activity of laryngeal receptors. In this study we have investigated the
      respiratory effects of these volatile anesthetics delivered into the upper airway
      of newborn and adult dogs. Experiments were performed on 17 5-14-day-old, 3 26-28
      day-old and 3 adult dogs, anesthetized and breathing spontaneously through a
      tracheostomy. In the youngest age group, halothane decreased ventilation (VE) to
      37.6 +/- 6.8% of control (mean +/- SE; P < 0.01) due to a decrease in both
      frequency and tidal volume. Peak inspiratory and expiratory flows, and esophageal
      pressure (Pes) were depressed also (60.8 +/- 6.5%, 51.6 +/- 7.1% and 66.5 +/-
      8.1% of control, respectively; P < 0.01). Superior laryngeal nerve (SLN) section
      abolished the changes in VE, but residual significant decreases in peak flows and
      Pes were still present and disappeared only after topical anesthetization of the
      nasal cavities. Isoflurane had similar but weaker effects on VE (74.2 +/- 2.8% of
      control; P < 0.01), accompanied by a decrease in peak inspiratory and expiratory
      flows and Pes. SLN section abolished these changes. In the 26-28 day age group
      there was only a decrease in peak inspiratory airflow with the halothane
      challenge; isoflurane did not have any effect. In the adult dogs halothane caused
      only a marginal decrease in inspiratory time. The depressive effects of halothane
      and isoflurane should be considered when they are used for induction of
      anesthesia in newborns.

PMID- 8469849
TI  - Hematologic responses and the early development of hypoxic pulmonary hypertension
      in rats.
AB  - We have previously described the development of greater right ventricular
      hypertrophy after 7 days of hypoxia in the altitude-susceptible H strain compared
      to the resistant M strain of Sprague-Dawley rat. Greater polycythemia also occurs
      in the H strain after 2-3 weeks of hypoxia and is characterized by increased mean
      red cell volume (MCV), reticulocyte count (Retic), and blood viscosity after 4
      weeks of hypoxia. In the present study, we determined the time course of
      development of these hematologic responses, whether differences in MCV are
      associated with differences in red cell deformability, and whether the
      hematologic differences might contribute to the early cardiopulmonary differences
      between the strains. We found that although hematocrit (Hct) did not differ
      between the strains until 21 days of hypoxia, MCV and Retic were greater in the H
      strain after only 3 days and whole blood viscosity was greater after 7 days.
      However, no differences in the viscosity or deformability of reconstituted red
      cells (Hcts 10% and 25%) were apparent at any time during hypoxic exposure.
      Furthermore, pressure-flow curves obtained using blood and lungs isolated from 7
      day hypoxic rats suggested that the largest component of pressure elevation in
      the H rats was related to pulmonary vascular rather than hematologic factors. We
      conclude that although H rats have exaggerated hematologic responses to hypoxia,
      differences in pulmonary vascular structure and tone are more likely to be
      responsible for the strain differences in cardiopulmonary responses occurring
      after 7 days of hypoxia.

PMID- 8469848
TI  - Effects of halothane, enflurane, and isoflurane on laryngeal receptors in dogs.
AB  - The effects of halothane, enflurane, and isoflurane on laryngeal receptors were
      investigated in 6 anesthetized dogs breathing spontaneously through a
      tracheostomy. Single unit action potentials were recorded from the peripheral cut
      end of the superior laryngeal nerve (SLN) while different concentrations of
      volatile anesthetics (1.25, 2.5, 5.0%) were administered in the expiratory
      direction at a constant air-flow (6 l/min) for 1 min through the functionally
      isolated upper airway. A total of 21 respiratory-modulated mechanoreceptors, 18
      "irritant" receptors, and 7 cold receptors were studied. The overall results
      obtained from the 16 respiratory-modulated mechanoreceptors challenged with the 3
      anesthetic gases disclosed a prevalent inhibitory effect and halothane proved to
      be the most effective of the 3 gases. The activity during both the inspiratory
      and expiratory phase was significantly reduced only by halothane (inspiratory
      phase, P < 0.01; expiratory phase, P < 0.05), while neither isoflurane nor
      enflurane caused significant changes in receptor activity. Of the 18 irritant
      receptors, 14 receptors increased their activity in a dose-related manner in
      response to one or more of the anesthetics although the effect of halothane was
      more pronounced than those of enflurane and isoflurane. All of the 7 cold
      receptors consistently increased their activity in a dose-related manner in
      response to halothane whereas 3 of 7 receptors were insensitive to enflurane and
      4 of 7 receptors were insensitive to isoflurane. Our results indicate that, while
      all three commonly used anesthetics can have an effect on different types of
      laryngeal receptors, the effects of halothane are more pronounced than those of
      the other two gases in terms of changes in receptor activity.

PMID- 8469850
TI  - Exogenous erythropoietin fails to augment hypoxic pulmonary hypertension in rats.
AB  - In two rat strains (H and M) with differing susceptibilities to chronic hypoxia
      we examined the role of polycythemia in the differing hypoxic pulmonary
      hemodynamic responses. We hypothesized that augmentation of hematocrit (Hct)
      during hypoxia in the resistant M strain would render cardiopulmonary responses
      similar to those obtained in the susceptible H strain. Administration of human
      recombinant erythropoietin (EPO) in doses of 100, 250 and 500 U.kg-1 s.c. thrice
      weekly for three weeks raised Hct similarly in both strains indicating that
      normoxic rats had similar sensitivities to EPO. In rats exposed to hypobaric
      hypoxia (0.5 atm) for 21 days, EPO (500 U.kg-1 thrice weekly) significantly
      increased Hct and whole blood viscosity as expected. Surprisingly, right
      ventricular (RV) to body weight (BW) ratio as an index of right ventricular
      hypertrophy (RVH) and RV peak systolic pressure did not increase in EPO-injected
      rats of either strain compared to hypoxic controls. Among hypoxic animals, Hct
      correlated highly with viscosity but not with RV/BW. We conclude, contrary to our
      hypothesis, that polycythemia does not appear to be responsible for the strain
      difference in RVH and pulmonary hypertension.

PMID- 8469851
TI  - Haemoglobin function in intact Lampetra fluviatilis erythrocytes.
AB  - The red cell pH as a function of oxygen saturation of haemoglobin and the oxygen
      affinity of haemoglobin as a function of red cell pH in Lampetra fluviatilis were
      studied at intracellular pH values ranging from 6.7 to 8.0. The maximal increase
      in red cell pH upon deoxygenation, 0.326 units, was seen when the pH of oxygen
      saturated erythrocytes was 7.7, a value corresponding to the red cell pH of
      resting lampreys. The effect of oxygen saturation on red cell pH was reduced both
      when the red cell pH was decreased and when it was increased. The haemoglobin
      oxygen affinity was strongly pH-dependent, with a Bohr-factor of -1.03. At a high
      pH (7.67) maintained by lamprey red cells at physiological conditions, the P50
      value was 28.2 Torr. At a pH value (7.33) similar to that of rainbow trout, the
      P50 value was 73 Torr. Thus, the high red cell pH in lamprey is required for
      effective oxygen loading in gills. It also maximizes the apparent cooperativity
      of oxygen binding.

PMID- 8469852
TI  - Signal transduction in smooth muscle cells from human airways.
AB  - The aim of this study deals with the post-receptor events involved in the
      response of cultured smooth muscle (SMC) from human bronchi to various agonists
      of the contraction. [3H]inositol phosphates (IPs) were isolated by high
      performance liquid chromatography (HPLC) and intracellular Ca2+ concentration
      ([Ca2+]i) was determined with the Fura-2 fluorescence technique. Following 5 sec
      stimulation with histamine, an elevation of several [3H]IPs, in particular
      [3H]1,4-IP2, [3H]1,4,5-IP3 and [3H]1,3,4,5-IP4, above the control values was
      observed. Following an incubation of 10 or 15 sec with histamine, the content of
      [3H]1,4,5-IP3 declined towards its basal value, while the amount of metabolites
      ([3H]4-IP, [3H]1,4-IP2, [3H]1,3,4-IP3) increased with time; [3H]1,3,4,5-IP4
      varied little between 5 and 10 sec and decreased at 15 sec. SMC responded also to
      carbachol and to prostaglandin F2 alpha (PGF2 alpha) by an enhanced production of
      [3H]IPs, whereas neurokinin A (NKA) had no effect on the turnover of [3H]IPs.
      Histamine, carbachol and PGF2 alpha evoked a transient elevation in [Ca2+]i,
      followed by a sustained increase. The duration of the transient elevation
      appeared similar to that of the increase in [3H]1,4,5-IP3. These results suggest
      that the 'phospholipase C-1,4,5-IP3-Ca2+ release' signalling pathway is involved
      in the physiological response of human airway SMC to histamine, carbachol and
      PGF2 alpha.

PMID- 8469853
TI  - Effect of acute hypoxia on metabolism and ventilation in awake piglets.
AB  - We studied the effect of acute sustained hypoxia on ventilation (VE) and oxygen
      consumption (VO2) over one hour during quiet wakefulness in young (6 days) and
      older (6 weeks) piglets in thermoneutral conditions during baseline, moderate
      hypoxia (PaO2 approximately 45 mmHg), and severe hypoxia (PaO2 approximately 30
      mmHg). During severe hypoxia, ventilation and pH increased while PaCO2 decreased
      in both age groups. Blood gas changes (decreases PACO2, increases pH), but not
      ventilatory changes, were greater in the older piglets (P < 0.05). VO2 decreased
      similarly (-30%) while VE/VO2 rose over 160% in both age groups. During moderate
      hypoxia, changes in blood gas, VE, and VO2 were in a similar direction, but
      smaller in magnitude. We conclude that: (1) changes in blood gases and VO2 are
      amplified by maturation and severity of hypoxia and (2) blood gas changes are
      greater in older vs young piglets despite similar ventilatory responses
      suggesting maturational differences in CO2 production or dead space ventilation.

PMID- 8469854
TI  - Measurement of solute fluxes in isolated rat lungs.
AB  - Most previous studies in isolated perfused lungs have utilized measurements of
      solute flow from alveolar to vascular space to characterize the barrier and
      transport properties of the alveolar epithelium. In this study, we measured flux
      of a series of nonionic hydrophilic solutes and sodium across the alveolar
      epithelium of the isolated rat lung from perfusate to airspace (P-->A), as well
      as from airspace to perfusate (A-->P). Apparent permeability-surface area
      products (PS) were calculated from the rates of isotope appearance downstream in
      either the airspace or the perfusate. Equivalent pore analysis of data for P-->A
      solute flow demonstrated a small pore population with radius 0.6 nm occupying 85%
      of the total pore area and a large pore population with radius 3.8 nm occupying
      15% of the total area. Similar analysis of A-->P solute flux demonstrated a small
      pore population of 0.6 nm occupying 86% of the total pore area and a large pore
      population with radius 2.9 nm occupying 14% of total pore area. The ratio (R) of
      PSP-->A divided by PSA-->P was 0.8 for the nonionic hydrophilic solutes, while R
      for sodium was 0.5. In the presence of amiloride and ouabain, R for sucrose was
      unchanged while R for sodium increased to 0.8 due to a fall in PSA-->P. The
      difference between R for sodium and R for the passively transported solutes, and
      the reduction in this difference in the presence of sodium transport inhibitors,
      are consistent with active sodium reabsorption by the intact alveolar epithelium.
      Differences in measured unidirectional passive solute fluxes probably result from
      unequal effective surface areas for diffusion from vascular space to airspace and
      vice versa in the anatomically complex mammalian lung.

PMID- 8469855
TI  - Angiotensin II stimulates respiration in awake dogs and antagonizes baroreceptor
      inhibition.
AB  - The effects of intravenous infusions of physiologic doses of angiotensin II (AII)
      on expired ventilation (VE) and acid-base balance were determined in awake dogs.
      A control infusion of saline was followed by AII infusion, initially with mean
      arterial pressure (MAP) raised 15%, and then with MAP at control levels by
      concurrent infusion of sodium nitroprusside (SNP). To control for SNP, the
      protocol was repeated using arginine vasopressin (AVP). Ventilatory responses to
      CO2 (VRC) were measured at the end of these protocols and separately with MAP
      elevated during infusion of AII. With AVP, increased MAP inhibited VE, heart rate
      (HR) and metabolism. However, with MAP elevated during AII infusion, stimulation
      by AII opposed baroreceptor reflexes and these variables, as well as plasma AVP,
      did not change. When MAP was lowered to control during AII infusion all variables
      increased. With AII, PaCO2 followed VE changes, decreasing 3 Torr with MAP at
      control levels; however, [H+] remained constant due to a decrease in arterial
      strong ion difference. The stimulatory effects of AII were not due to SNP; SNP
      did not stimulate VE during AVP infusion. The slope of the VRC was unaltered by
      AII infusion or MAP; however, AVP reduced the VRC slope. Physiological increases
      in AII stimulate VE and other systems at normal MAP and maintain several
      regulatory systems at control levels during baroreceptor inhibition.

PMID- 8469856
TI  - [Human cytogenetics is born in Liege 80 years ago (de Winiwarter, 1912)].

PMID- 8469857
TI  - [Pseudo-asthma. Everything which wheezes is not asthma].

PMID- 8469858
TI  - [Tuberculosis treatment in 1992].

PMID- 8469859
TI  - [Current therapeutic methods in orthodontics].

PMID- 8469860
TI  - [Blood preservation in surgery].

PMID- 8469861
TI  - [Current aspects of locomotor pathology: benign tumors manifested in sports
      practice].

PMID- 8469862
TI  - [Palmoplantar punctate keratosis].

PMID- 8469863
TI  - [Malignant non-Hodgkins lymphoma with primary ovarian location. Observations
      apropos of a case].
AB  - The authors report a case of primary ovarian non Hodgkin malignant lymphoma in a
      41-year-old multiparous woman. An ovarian tumor was diagnosed in a context of
      hypogastric distention and discomfort. A total hysterectomy was performed with
      bilateral uterine appendectomy. The intra-abdominal organs were not affected and
      there were no internal adenopathies. The pathology examination concluded that
      this was a highly malignant, non-Hodgkin lymphoma. The findings of the extension
      assessment were negative. Five cycles of drastic chemotherapy combining
      bleomycin, adriamycin, cyclophosphamide, vincristine, methotrexate, iphosphamide,
      cisplatyl, VP-16 and ara-C have been administered and will be followed by
      abdominal radiotherapy. The patient is considered to be in a state of complete
      remission with a follow-up period of four years.

PMID- 8469864
TI  - [How can compliance be improved in hormone replacement therapy during
      menopause?].
AB  - The main vital risks of the menopause and ageing are related to osteoporosis,
      cardiovascular accidents and cancer. Hormone therapy is effective against the
      first of these, but its efficacy against the second is difficult to measure in
      view of the number of factors involved and is even less clear against the third.
      Without any doubt it does improve all aspects of quality of life, so that it is
      rather surprising that only a minority of women receive treatment and that
      compliance with treatment is irregular, which is attributable to a variety of
      causes. Treatment protocols for the general situation and for specific cases are
      proposed.

PMID- 8469865
TI  - [Does a preventive treatment of pregnancy toxemia exist: the role of aspirin].
AB  - After studying the risk factors of eclamptic toxemia, the author describes the
      various methods of prevention proposed. A salt-free diet has no effect. Increased
      intake of zinc or magnesium has no impact. Calcium (600 to 2,000 mg/d) may reduce
      the incidence of toxemia among teenagers from 27.9% to 4%. Low dose aspirin
      appears to be equally effective. Cod liver oil is currently being tested.

PMID- 8469866
TI  - [Ultrasound and twin pregnancy. The effect of placentation on fetal biometric
      growth and quantitative abnormalities of the amniotic fluid].
AB  - Neonatal retarded growth and hypotrophy are more frequent in monochorial,
      biamniotic twin pregnancies than in bichorial ones. The authors consider the
      various pathogeneses which have been suggested to account for this phenomenon.

PMID- 8469867
TI  - [The fundamental basis and obstetrical applications of mifepristone or RU-486
      (voluntary interrupted pregnancies excluded)].
AB  - RU 486 is an anti-progesterone steroid used in obstetrics to achieve maturation
      of the cervix before an endouterine procedure in late abortions during the first
      3 months, in therapeutic pregnancy termination during months 3-6 or 6-9 and in
      expelling fetuses which have died in utero. RU 486 has also been proposed for use
      in inducing or facilitating labor at term.

PMID- 8469868
TI  - [Management provided for a pelvic unilocular fluid image discovered in in a post
      menopausal female].
AB  - After defining the procedures and limitations of ultrasound-guided puncture in
      woman of a sexually active age, the author considers the situation of menopausal
      women who, despite the commonly held opinion, can develop functional cysts. It is
      true, on the other hand, that they are exposed to a greater risk of cancer.
      However, in these women, cancer usually takes the form of peritoneal carcinosis
      and not that of a "cancerous cyst". In the post-menopausal woman, there is no
      need to envisage a modification of the response in a situation involving an
      ovarian cyst, particularly since the discriminating power of paraclinical tests
      is the same, if not greater (ultrasound, serum 125Ca assay), but particular
      vigilance is necessary in interpreting the symptoms and in managing follow-up if
      ultrasound guided puncture is the only procedure performed. If it is decided to
      operate, bilateral appendicectomy must be performed (together with verification
      of the uterine cavity).

PMID- 8469869
TI  - [The benefits and risks of laparoscopic surgery].
AB  - The advantages of laparoscopic surgery in comparison to those of conventional
      surgery are mainly due to the very low rates of postoperative infections and
      adhesions and due to the aesthetic nature of this type of surgery. Endoscopy
      enables a thorough search of lesions which can then be treated in a more
      conservative manner. The short hospital stay and rapid postoperative recovery are
      two key advantages of endoscopic surgery. Complications at endoscopic surgery
      mainly occur if the safety measures are not strictly followed, due to improper
      choice and use of instruments (eg. old instruments), an antecedent laparotomy and
      also depend upon the type of surgery performed. It should be noted that the
      introduction of the trocar is not a simple affair, that non-recognition of
      complications is not infrequent and that the incidence of complications is
      directly proportional to the experience of the operator.

PMID- 8469870
TI  - [The value of zona drilling and sub-pellucida microinjections in severe
      asthenospermia in fertilization in vitro].

PMID- 8469871
TI  - [Early determination of the fetal sex using ultrasonic measurements of the crown
      rump length].

PMID- 8469872
TI  - [Detection of HBs antigens in pregnancy: a prospective study in Brittany in
      1991].

PMID- 8469873
TI  - [The value of fetal cerebro-placental velocimetry in the monitoring of twin
      pregnancies. Apropos of 72 consecutive cases].

PMID- 8469874
TI  - [The exigency of rigorous control of publications and the validity of diplomas
      involving a specialty with high-risk medico-legal liability].

PMID- 8469875
TI  - [Evaluation and performance of the follow-up in treated cancer of the breast].
AB  - Follow-up of breast cancer is not always the same. On the basis of a
      retrospective study on 92 patients who presented with a progressive disease, the
      authors assess the effectiveness of complementary examinations and propose a
      follow-up protocol: clinical, laboratory tests, consisting of ESR, gamma GT,
      alkaline phosphatases, CA 15.3 every six months (or even every 4 months for CA
      15.3) and radiological follow-up consisting of mammography and chest X-ray every
      year. Other examinations may also be prescribed if any change is detected by any
      of the tests listed above. The authors consider that this approach constitutes a
      balance between the minimalist and maximalist attitudes, and one which
      corresponds to the physician's duty to his patient.

PMID- 8469876
TI  - [The primary care midwife. An experience of integration].

PMID- 8469877
TI  - [The laser in tracheobronchial pathology].

PMID- 8469878
TI  - [Immobility in the elderly patient].

PMID- 8469879
TI  - [The child and play].

PMID- 8469881
TI  - [Energy and reflexology as holistic treatment].

PMID- 8469880
TI  - [The fiber bronchoscope].

PMID- 8469882
TI  - [The European Year of the Elderly and of Solidarity between Generations].

PMID- 8469883
TI  - Lack of nurse practitioner program hurts Idaho nurses.

PMID- 8469884
TI  - A computerized state board exam for 1994.

PMID- 8469885
TI  - Stopping the Medicare tango.

PMID- 8469886
TI  - Nursing's agenda--in Bovill. Interview by Heidi Crouch.

PMID- 8469887
TI  - Idaho Falls Recovery Center--the dream becomes reality.

PMID- 8469888
TI  - [Injury of the spine. Diagnosis, development, prognosis].

PMID- 8469889
TI  - [Recent injuries of the ankle. Diagnostic orientation].

PMID- 8469890
TI  - [Urticaria and Quincke's edema. Etiology, diagnosis, treatment].

PMID- 8469891
TI  - [Iatrogenic agranulocytosis. Etiology, diagnosis, treatment].

PMID- 8469892
TI  - [Interleukins and TNF in septic shock].
AB  - Tumor necrosis factor alpha (TNF alpha) and interleukins (IL) are the principal
      cytokines involved in the clinical and biological manifestations of septic shock.
      Their secretion are triggered mainly by endotoxin, but products of Gram positive
      cocci as well as of virus or of parasites are equally effective. Cytokines
      represent a normal protective defense against infection, but an excessive
      production have toxic effects. In experimental models of endotoxinemia, TNF alpha
      is the first cytokine produced, then IL-1 and IL-6. Other inflammatory mediators
      are secreted later. Thus it seems logical to try to modulate cytokine production
      or actions. However, several questions remains since experimental data are
      sometimes not applicable too human diseases, cytokines are organised in a network
      with several interaction. It is too early to propose routine anti-cytokines drugs
      in septic shock.

PMID- 8469893
TI  - [Other mediators of inflammation and sepsis].
AB  - During sepsis, the systemic inflammatory response is characterized by the release
      of numerous mediators supporting and dispersing inflammation. In Gram negative
      sepsis, the endotoxins play a starting role, while in other sepsis, the
      triggering mediators or mechanisms are unknown but lead to a similar inflammatory
      reaction. Coagulation and complement cascades are activated, with the release of
      chemoattractive substances, mediators and proteases and the activation of
      phagocytic cells. Macrophages/monocytes and polymorphonuclear leucocytes produce
      then active oxygen species and cytokines; they degranulate (releasing active
      enzymes such as myeloperoxidase), they express an increasing number of membrane
      receptors able to interact with endothelial cells and release a supplementary lot
      of inflammatory mediators (prostanoids, platelet activating factor, leukotrienes
      ... ). Platelets, also activated, produce the same mediators (TXA2, PAF ...) or
      specific ones such as serotonine, platelet factor 4, growth factors. Last, but
      not least, the endothelial cells are stimulated, directly (by endotoxins) or
      undirectly (by cytokines, C5a, PAF ...). These cells play then a main role by
      their own phagocytic activity, by alteration of their antithrombotic and
      fibrinolytic potential, by their secretion of inflammatory mediators and by an
      increased expression of receptors of adhesivity for the activated phagocytes or
      platelets, what leads to endothelium injury with membrane permeability
      alterations. These cascades of activation, these extensions of the inflammatory
      reaction by the mediators and by the phagocytes and platelets can explain the
      frequency of multiple organ failure during sepsis as well as the difficulty of an
      adequate pharmacological therapy.

PMID- 8469894
TI  - [Septic shock and regional circulations].
AB  - Owing to the scarcity of clinical studies on this subject, one must turn to
      experimental data, with reservations concerning their extrapolation to human
      beings. Septic shock, a distributive shock, results from a homogeneous decline of
      vascular tone and therefore regional blood flows. Direct vasodilators, such as
      nitric oxide and prostaglandins, and indirect vasodilators, such as cytokines,
      produce vasodilation with hypocontractility. During hyperkinetic shock in
      animals, dilatation of the mesenteric and coronary arteries is observed, with
      reduction of pancreatic and skin muscle flows. Two clinical studies have
      confirmed this coronary vasodilatation without increase in myocardial oxygen
      consumption. In the liver the hepatic artery buffer response is altered, the
      portal flow rate is reduced without changes in portal vein pressure, and the
      hepatic vein saturation is less than that of the pulmonary artery, thus
      testifying to an increase of oxygen extraction, mainly in the liver. The hepatic
      flow rate is also influenced by the liver glucose content. The mesenteric and
      pancreatic circulations are particularly threatened, their flow rate being
      reduced by 50% due to vasoconstriction. In the kidney the flow rate is biphasic:
      high first, then low. Treating hypovolaemia does not prevent the renal function
      from being altered, even when the flow rate is maintained. Blood flow is reduced
      in the respiratory muscles, despite an increase in work and oxygen consumption.
      Finally, treatment with vasopressors does not seem to correct the disorders
      observed in cardiac output distribution and has little increasing effect on
      arterial blood pressure.

PMID- 8469895
TI  - [Myocardial dysfunctions in septic shock].
AB  - Acute myocardial dysfunction is part of the initial presentation of septic shock.
      This sudden and more or less intense dysfunction is potentially reversible. It
      consists of a disturbance of the systolic function in both ventricles, manifested
      by an ejection fraction degression which persists after correction of a possible
      hypovolaemia, associated with a disturbance of the diastolic function which
      restricts ventricular filling. These cardiac disorders interfere with adaptation
      to the sepsis and are clinically expressed by tachycardia.

PMID- 8469896
TI  - [Clinical and etiological diagnosis of septic states].
AB  - The sepsis concept implies a clinical suspicion of infection and a diagnosis of
      host's response to this infection. In increasing order of severity are simple
      sepsis, severe sepsis and septic shock. The semeiology of sepsis consists of
      systemic signs and elements of information on various visceral dysfunctions. The
      aetiological investigation is based on the patient's diathesis, on whether the
      infection is hospital- or community-acquired, on the severity of the sepsis and
      on simple clinical and paraclinical data. Gram-positive infections are usually
      caused by pneumococci and staphylococci, and Gram-negative infections by
      meningococci and enterobacteriaceae. Hospital-acquired infections are remarkable
      for their frequency, their severity and the diagnostic problems they raise due to
      patients' colonization and multiple portals of entry. With the exception of some
      microbiological situations (parasites, fungi, viruses), the main problems raised
      by non-bacterial sepsis relate to occult sepsis and systemic inflammatory
      responses to some acute pathologies, such as burns, pancreatitis or multiple
      injuries. To conclude, redefining the nosology of severe infections to include
      the fundamental concept of host's response should result in a better evaluation
      of the infection, its consequences and the treatment of both.

PMID- 8469897
TI  - [Developmental modalities of septic states. Multiple organ failure syndrome].
AB  - Sepsis syndrome occurs when an acute infection results in an host generalized
      inflammatory response including cytokines production. Death is a frequent and
      unpredictable sequel of this pathological condition. It may be due either to
      uncontrolled circulatory failure, or to multiple organ failure. With the advent
      of nitric oxide in the arena of the most potent vasodilatator agents, we now
      better understand the mechanisms of low vascular resistance during hyperkinetic
      septic shock. However a closer understanding of the mechanisms of multiple organ
      failure is actually required to improve survival rates during severe human
      sepsis.

PMID- 8469898
TI  - [Symptomatic treatment of septic shock].
AB  - Septic shock is characterized by an important vasoplegia associated with an
      oxygen extraction abnormality probably linked to the presence of a biochemical
      alteration at the microcirculatory level. Hemodynamic intervention requires
      aggressive fluid resuscitation complemented if necessary by the use of
      sympathomimetic amines (dopamine and often epinephrine, norepinephrine).
      Dobutamine is indicated when left ventricular dysfunction was obviously
      demonstrated. Swan Ganz catheter is required when hemodynamic intervention -ie
      fluid resuscitation and dopamine-remains unefficacious. However the earlier
      indication of Swan Ganz catheter use might be justified by the necessity of a
      precise preload evaluation and the possibility of the determination of the best
      oxygen transport.

PMID- 8469899
TI  - [Antibiotic treatment of septic states].
AB  - The antibiotic therapy in septic syndrome is most often empiric. Decisions and
      antibiotic choices should result from a careful analysis of past history and
      setting (hospital-acquired infections vs community acquired infections), risk
      factors specific to the host, and characteristics of the suspected infections
      focus: direct examination of body fluid specimens should be obtained rapidly to
      guide the empiric choice. The choice of antibiotics should conform to usual
      guidelines, with the aim of a rapid bactericidal effect in blood, while
      attempting to avoid risks of toxicity. Changes in pharmacokinetics of drugs are
      usual in this context, and frequent dosing is necessary. While effective
      antibiotic therapy is a recognized prognostic parameter, antibiotics are only one
      part of therapy, besides supportive therapy of failing organs, and effective
      drainage or surgery of the infected focus, when feasible.

PMID- 8469900
TI  - [Therapeutic perspectives of severe infectious states].
AB  - Mortality from sepsis is still unacceptably high which justifies a new
      therapeutic approach complementary of antibiotics and symptomatic treatment.
      Recent advances in the understanding of sepsis and septic shock opened new fields
      of therapeutic intervention. Nevertheless, there are so many potential targets
      that is hard to make a choice for evaluation of these new agents: anti-endotoxin
      (monoclonal antibodies, lipid A analogs, BPI), anticytokines (monoclonal
      antibodies, soluble receptors, IL-1 receptor antagonist), anti-inflammatory
      agents (non-steroidal anti-inflammatory agents, anti-PAF, reactive oxygen
      radicals scavengers...), extracorporeal removal of toxic molecules, inhibition of
      the adhesion of polymorphonuclear leucocytes on endothelial surface, optimisation
      of general and regional circulation. The use of these new and often costly drugs
      must rely on multicenter randomized clinical trials since extrapolation to the
      human of experimental data gathered in animal studies are hazardous.

PMID- 8469901
TI  - [Mammographic screening. A key examination for the early diagnosis of breast
      cancer].

PMID- 8469902
TI  - [Surgical treatment of spinal metastasis. Controlled therapeutic management of
      pain and neurologic compression].

PMID- 8469903
TI  - [Branhamella catarrhalis. Rediscovery of a pathogenic bacterium].

PMID- 8469904
TI  - [A few facts acquired apropos of the treatment of myocardial infarction].

PMID- 8469905
TI  - [Suicidal ideas or behaviors. Diagnostic orientation].

PMID- 8469906
TI  - [Convulsive seizure. Diagnostic orientation and emergency treatment with
      posology].

PMID- 8469907
TI  - [Vomiting in infants. Diagnostic orientation].

PMID- 8469908
TI  - [Non-traumatic coma. Diagnostic orientation].

PMID- 8469909
TI  - Contributions to the treatment of primary liver cancer. 4'-epidoxorubicin and
      cisplatin studied in hepatocarcinoma cell cultures and in partially
      hepatectomized rats.

PMID- 8469910
TI  - Inhibitors of the arachidonic acid metabolism attenuate the thyroliberin (TRH)
      stimulated prolactin production without modifying the production of
      inositolphosphates in GH4C1 pituitary cells.
AB  - Some arachidonic acid metabolites might be among the intracellular signalling
      substances that regulate hormone release. We report that the phospholipase A2 and
      diacylglycerol lipase inhibitor quinacrine (1-10 mumol l-1) inhibited the
      thyroliberin stimulated prolactin (rPRL) production in a dose-dependent way in a
      rat pituitary tumour cell line (GH4Cl cells). The lipoxygenase inhibitor
      nafazatrom (5-50 mumol-1) also dose-dependently inhibited the thyroliberin
      stimulated rPRL production, while the cyclo-oxygenase inhibitor indomethacin had
      no such effect on rPRL production. The inhibitors of the arachidonic acid
      metabolism (quinacrine, ETYA and nafazatrom) had no effect on the accumulation of
      inositolpolyphosphates indicating that the arachidonic acid metabolites are not
      involved in the regulation of the phospholipase C activity.

PMID- 8469911
TI  - Glycation and oxidation of human low density lipoproteins reduces heparin binding
      and modifies charge.
AB  - The effects of glycation and oxidation of human low density lipoproteins (LDL) on
      heparin binding were studied and compared with modifications in the charge of the
      particles. Glycation of LDL at a molar ratio of 4 mol glucose mol-1 apoB,
      decreases affinity for heparin, as shown by heparin-agarose affinity
      chromatography since salt molarity needed for elution decreases from 550 mmol l-1
      for control LDL (c-LDL) to 350 mmol l-1 for glycated LDL (glc-LDL). Oxidized LDL
      (oxi-LDL) shows marked heterogeneity, most of the fractions having decreased
      affinity. Heparin-agarose affinity chromatography of LDL preparations shows the
      presence of a small (5-7%), low-affinity fraction in euglycaemic human plasma LDL
      (c-LDL). Its elution volume coincides with both glc-LDL and a fraction of oxi
      LDL, suggesting it may contain glycated and oxidized molecules present in plasma.
      DEAE-Trisacryl anion exchange chromatography elution profiles of c-LDL
      preparations shows the presence of a more electronegative fraction accounting for
      about 10% of total protein. This fraction elutes with 260 mmol l-1 NaCl instead
      of 130 mmol l-1 for the main fraction, it roughly coincides with elution volumes
      of main peaks of glc-LDL and oxi-LDL. Results indicate that glycated particles
      may be present in this fraction. Our data demonstrate then that glycation, and to
      a lesser degree, oxidation of LDL reduce affinity to heparin. From an analytical
      approach, modified LDL can be separated from the bulk of native LDL both by DEAE
      and heparin-agarose chromatographies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469912
TI  - An enzyme-linked immunosorbent assay for plasma-lactoferrin. Concentrations in
      362 healthy, adult blood donors.
AB  - Very different concentrations of plasma-lactoferrin in healthy adults have been
      reported in the literature. We compared three commercially available lactoferrins
      and lactoferrin purified in our laboratory as calibrators in an ELISA. No
      statistical differences among these preparations of lactoferrin were detected.
      The concentration of purified lactoferrin was measured by dry weight, and efforts
      were made in order to minimize loss of purified lactoferrin by adhesion to tubes
      etc. and thus, secure accuracy of the method. Dilutions were made in PBS 0.01 mol
      l-1 with NaCl 0.436 mol l-1, (NH4)2SO4 0.5 mol l-1, BSA 5 gl-1 and normal rabbit
      IgG 10 mg l-1, which was shown to give parallel dilution curves of primary
      calibrator, secondary calibrator and plasma samples. No significant difference in
      the content of lactoferrin in neutrophils (median; range) among men (1.78; 0.83
      4.48 micrograms 10(-6) neutrophils; n = 20) and women (2.12; 1.16-9.30 micrograms
      10(-6) neutrophils; n = 14) was found. Lactoferrin was analysed in EDTA-plasma
      obtained from 135 female and 227 male blood donors. Median concentrations were
      84.7 and 97.8 micrograms l-1 respectively, while 2.5% and 97.5% reference limits
      (with 90% confidence intervals) were estimated to 42.9 (38.7-47.4) micrograms l-1
      and 166.9 (151.0-186.3) micrograms l-1 for women and 52.3 (49.1-55.6) micrograms
      l-1 and 189.9 (175.9-206.4) micrograms l-1 for men, respectively.

PMID- 8469913
TI  - An ELISA for elastase alpha 1-protease inhibitor complexes in human plasma and
      serum.
AB  - An ELISA for neutrophil elastase (ELA) in complex with alpha 1-protease inhibitor
      (PI) (alpha 1-antitrypsin) was developed in microtitre plates and compared to the
      ELISA kit from MERCK (2-h version). Recovery of ELA-PI was good in both assays.
      The detection limits were 4.4 micrograms l-1 and 7.7 micrograms l-1 of the in
      house and MERCK assay, respectively, while limits of quantitation were estimated
      to 7.7 micrograms l-1 (5.5-9.9 micrograms l-1) and 28.9 micrograms l-1 (14.6-44.3
      micrograms l-1) for the two assays. Furthermore, as dilution curves of normal
      plasma were parallel with the calibration curve in the in-house assay over a wide
      range of dilutions, it is feasible to assay plasma in dilutions of only 1:6,
      resulting in a limit of quantitation of only 1.1 micrograms l-1. The total
      analytical coefficient of variation for samples measured in double determinations
      was 10.5%-12.5% in the in-house assay and 13.9%-14.6% in the MERCK assay. One
      hundred-and-eight plasma samples covering a wide range of ELA-PI concentrations
      were analysed in both assays. A proportional difference between the two methods
      was detected, the mean ratio (in-house/MERCK) with 95% confidence limits was
      1.115 (1.070-1.160). The cause of the difference was probably due to difference
      calibration of the assays. Until this problem is solved, method specific
      reference intervals are needed. A reference interval for the in-house method
      based on plasma samples from 123 healthy adults; median age 36 years (range: 19
      65 years) was estimated to 16.5-48.5 micrograms l-1.

PMID- 8469914
TI  - Left ventricular end-diastolic dimensions measured at the P wave and Q wave
      during a randomized, double-blind one-year follow-up study comparing the effect
      of atenolol vs. hydrochlorothiazide + amiloride on blood pressure in men with
      mild to moderate hypertension.
AB  - Echocardiographic measurement of left ventricular (LV) end-diastolic dimensions
      and mass (M) were made at baseline, at 3 and 12 months of a randomized trial
      comparing atenolol 50/100 mg od. and hydrochlorothiazide 25/50 mg+amiloride 5 mg
      od. (co-amiloride) in 100 men with mild to moderate hypertension. Data from 48
      subjects controlled adequately on drug monotherapy and completing 12 months
      treatment are reported (31 randomized to atenolol and 17 to co-amiloride). Left
      ventricular mass was measured with the Penn convention at the R and P wave
      respectively. A significant reduction of LVM was noted after one year in both
      groups (p < 0.05) when measured at the R, but not at the P wave. Measurements
      according to American Society of Echocardiography (ASE method) at the Q wave
      revealed a significant reduction of LV wall thickness (p < 0.01) and an increase
      of LV internal diameter (p < 0.01) with atenolol. In the co-amiloride group non
      significant reductions of LV dimensions were observed. Principally similar
      changes were observed with measurements at the P wave (National Institute of
      Heart method) in both groups, but LV wall thickness was greater and LV internal
      diameter smaller than at the Q wave. With similar effect on LVM, the mechanisms
      in reducing LVM were different between the two drugs. Left ventricular dimensions
      differed when assessed with the two methods applied, stressing the need for
      careful standardization in relation to the cardiac cycle in serial
      echocardiographic measurements.

PMID- 8469915
TI  - Assessment of glycaemic control in non-insulin-dependent diabetes mellitus.
AB  - Blood glucose profiles, fasting blood glucose and glycated haemoglobin were
      followed prospectively for 6 weeks in 14 patients with non-insulin-dependent
      diabetes (NIDDM). Capillary blood glucose was sampled weekly on filter paper and
      analysed in the laboratory. Glycated haemoglobin was determined every other week
      with both cation-exchange chromatography (HbA1-IEC) and aminophenylboronic acid
      affinity chromatography (GHb-PBA). The mean for the blood glucose profiles was
      11.2 +/- 3.5 mmol l-1 (+/- SD) and the mean for fasting blood glucose was 9.5 +/-
      2.8 mmol l-1. For individual patients the differences between mean fasting blood
      glucose and mean blood glucose varied from -1.3 to 4.2 mmol l-1. There was a
      linear relationship between blood glucose and glycated haemoglobin which was
      steeper for GHb-PBA than for HbA1-IEC. The correlations with fasting blood
      glucose and mean blood glucose for HbA1-IEC were r = 0.85 and r = 0.92 and for
      GHb-PBA r = 0.87 and r = 0.96 respectively. Mean blood glucose was better
      correlated to glycated haemoglobin than fasting blood glucose (p < 0.05 for GHb
      PBA).

PMID- 8469916
TI  - Luminol enhanced Fc-receptor dependent chemiluminescence from peripheral PMN
      cells. A methodological study.
AB  - Maximal luminol enhanced chemiluminescence (CL) of PMN cells after Fc-gamma
      receptor stimulation is a way to study the cell activity in connection with
      phagocytic function. Optimal conditions for such a method were elaborated for
      practical clinical use. After blood sampling and gentle mixing the blood sample
      was allowed to stand at +20 degrees C for not more than 1 h. The PMN cells
      prepared at +20 degrees C were washed at +4 degrees C with a phosphate buffer
      containing human serum albumin. A gentle lysis of the red blood cells with NH4Cl
      solution reduced the number of red cells sufficiently not to interfere with the
      CL. Important factors for the precision of the method were reproducible amounts
      of bacteria and a reproducible mixing of the particles during the CL analysis.
      The method had a variation (CV) of 10-15% in healthy individuals.

PMID- 8469917
TI  - Coagulation factors and lipid composition of the blood in treated and untreated
      hypertensive patients.
AB  - The cardiovascular risk factors blood pressure, overweight, hyperlipidaemia and
      several coagulation parameters were studied in a group of 54 otherwise healthy
      patients with essential hypertension of moderate severity. Of the 54 hypertensive
      patients, 43 were treated with anti-hypertensive drugs and 11 were not. The
      patients included in this study who were treated with anti-hypertensive drugs
      were still hypertensive in spite of their treatment. Lipoprotein levels and
      coagulation parameters did not differ between the untreated and treated
      hypertensive patients. Substantial percentages of patients were found to have
      hypertriglyceridaemia (46%), elevated LDL-cholesterol (28%) and elevated
      lipoprotein(a) concentrations (43%). Coagulation factors F VIIIc, fibrin monomer
      and factor VII in males were significantly elevated in comparison with a healthy
      reference group. These data are compatible with a moderate activation of the
      coagulation system. Correlations were established between systolic blood pressure
      and serum cholesterol (r = 0.43, p = 0.003), LDL-cholesterol (r = 0.34, p = 0.02)
      and triglycerides (r = 0.35, p = 0.01); Quetelet-index with fibrinogen (r = 0.37,
      p = 0.02) and thrombin-antithrombin III (r = 0.30, p = 0.04); and triglycerides
      with F VIIc (r = 0.34, p = 0.03) and fibrin monomer (r = 0.29, p = 0.04)
      respectively. These data link hypertension and hyperlipidaemia with increased
      coagulation activity and may contribute to our understanding of why these two
      cardiovascular risk factors accelerate atherogenesis.

PMID- 8469918
TI  - Increased urinary loss of high density lipoproteins in albuminuric insulin
      dependent diabetic patients.
AB  - The pathophysiological mechanisms resulting in hyperlipidaemia in albuminuric
      insulin-dependent diabetic patients are largely unknown. Increased non-specific
      hepatic protein synthesis as a response to urinary protein loss, has been
      proposed. However in that case it is unexplained why the plasma concentration of
      the high density lipoprotein (HDL) subfraction, in contrast to all other
      lipoprotein subfractions, is normal or even reduced in albuminuric patients. We
      studied the urinary excretion of HDL-cholesterol in 26 insulin-dependent diabetic
      patients matched according to sex and age into three groups. I: normal urinary
      albumin excretion (< 30 mg 24 h-1; n = 8); II: incipient nephropathy (urinary
      albumin excretion in the range of 30-300 mg 24 h-1; n = 7); and III: clinical
      nephropathy (urinary albumin excretion > 300 mg 24 h-1; n = 11). Eight normal
      subjects served as controls. Lipoproteins in urine were separated by
      ultracentrifugation, and the daily urinary loss of HDL-cholesterol was 1.30 mumol
      (0.83-2.21) (median and range) in controls, 1.27 mumol (0.56-2.59) in group I,
      1.39 mumol (0.55-1.97) in group II and 4.02 mumol (1.33-42.12) in group III (p <
      0.01). More than 95% of cholesterol in urine was found in the HDL-fraction. The
      plasma concentrations of total cholesterol, very low density lipoprotein
      cholesterol, low density lipoprotein cholesterol and triglyceride were 21-94%
      higher in patients with clinical nephropathy compared with normal controls and
      group I.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8469919
TI  - Continuous blood gas monitoring in haemodialysis using an electrode inserted in
      the extracorporeal dialysis circulation.
AB  - The aim of this study was to evaluate the usefulness of continuous gas monitoring
      during haemodialysis using an oxygen- and carbon dioxide-sensitive electrode
      inserted in the 'arterial' line from the arteriovenous fistula. We investigated
      15 patients with chronic renal failure, treated with regular bicarbonate
      haemodialysis. The PO2 and PCO2 were measured by the new method and compared to
      conventional blood gas analysis of the 'arterial' blood from the dialysis
      circulation. We found the in situ gas sensors were stable and there was no
      systematic difference between gas tensions measured by in situ and conventional
      blood gas measurements. The standard deviations of the difference between paired
      measurements for PO2 and PCO2 were 1.3 and 0.4 kPa, respectively. Therefore, the
      method can be used to detect major changes in blood gas tensions during
      haemodialysis.

PMID- 8469920
TI  - Release of atrial natriuretic factor.
AB  - The cardiac atria synthesize and store a hormone termed atrial natriuretic factor
      (ANF). ANF is released into the systemic circulation, and the circulating 28
      amino acid peptide can be measured by radioimmunoassay. The hormone participates
      in body fluid homeostasis through its effect on renal sodium excretion and by
      inducing a shift of circulating fluid to the interstitial space. Release of ANF
      is mainly regulated by mechanical changes in the left and right atrial wall. It
      has been demonstrated that ANF release is related to changes in atrial wall
      tension occurring during each atrial cycle, and therefore, release of ANF will
      increase with increasing heart rate. Not only the increase in wall tension during
      passive atrial distension (v wave), but also the increase in tension during
      atrial systole (a wave) are determinants of ANF release. The mechanochemical
      transducer is most likely located in the atrial myocytes, but its nature is
      unknown. There is no evidence to suggest that efferent cardiac nerves are
      essential in the regulation of ANF release. Humoral factors have been suggested
      as regulators of ANF release, particularly catecholamines and angiotensin II. A
      receptor-mediated direct stimulatory effect of alpha-adrenergic stimulation and
      an inhibitory effect of beta-adrenergic stimulation have been demonstrated, but
      these direct effects are small compared to the effect of changes in atrial wall
      tension. Circulating catecholamines and angiotensin II stimulate ANF release
      mainly through their haemodynamic effects.

PMID- 8469921
TI  - The Nobel Lectures in Immunology. Lecture for the Nobel Prize for Physiology or
      Medicine, 1984. From the structure of antibodies to the diversification of the
      immune response.

PMID- 8469922
TI  - On the interaction between protein L and immunoglobulins of various mammalian
      species.
AB  - Protein L, a cell wall molecule of certain strains of the anaerobic bacterial
      species Peptostreptococcus magnus, shows high affinity for human immunoglobulin
      (Ig) light chains. In the present study protein L was tested against a panel of
      human myeloma proteins of the IgG, IgM, IgA and IgE classes, and strong binding
      was seen with antibodies carrying kappa light chains. A high degree of
      specificity for Ig was demonstrated in binding experiments with human plasma
      proteins. Apart from human Ig, strong protein L-binding activity was also
      detected in the serum of 12 out of 23 tested additional mammalian species,
      including other primates and rodents. Subsequent analysis with purified Ig
      samples demonstrated the binding of protein L to Ig of important laboratory
      animal species such as the mouse, the rat and the rabbit. The affinity constants
      for the interactions between protein L and polyclonal IgG of these species were
      2.6 x 10(9), 3.9 x 10(8) and 7.4 x 10(7), respectively. In non-human species, the
      binding of protein L was also found to be mediated through Ig light chains, and
      the results demonstrate the potential value of protein L as an immunochemical
      tool.

PMID- 8469923
TI  - Anti-interleukin-2 receptor monoclonal antibody therapy supports a role for Th1
      like cells in HgCl2-induced autoimmunity in rats.
AB  - Brown-Norway (BN) rats injected with HgCl2 develop an autoimmune disease
      characterized by a T-dependent polyclonal B-cell activation. Increase in major
      histocompatibility complex class II molecule expression on B cells concomitant
      with enhancement of serum IgE concentration supports the involvement of the T
      helper 2 (Th2)-like subset in the induction of the disease. The mercury disease
      is autoregulated and does not develop in Lewis (LEW) rats. Considering the
      reciprocal regulation, well defined in mice, between the Th1 and Th2 subsets, we
      addressed the role of the Th1-like subset in this disease. Brown-Norway and LEW
      rats injected with HgCl2 were treated with NDS61, a mouse anti-rat-IL-2R MoAb
      that blocks mainly Th1 cells. Data reported herein show that: (1) HgCl2 treatment
      does not modify either the percentage of IL-2R+ cells or IL-2R expression in both
      BN and LEW rats; (2) treatment of BN rats with NDS61 MoAb does not modify the
      induction phase of the mercury disease but delays in part the regulation phase;
      (3) such a treatment leads to some immune abnormalities in LEW rats; (4) HgCl2
      markedly potentiates the anti-mouse Ig antibody response in BN rats which
      probably limits the effect of this treatment. This study supports a role for the
      Th1-like subset in HgCl2-induced autoimmunity in the rat.

PMID- 8469924
TI  - Cytotoxic T-cell clones isolated from ovarian tumour infiltrating lymphocytes
      recognize common determinants on non-ovarian tumour clones.
AB  - CTL-TIL lines have been developed from tumour infiltrating lymphocytes (TIL) from
      the ascites of patients with ovarian carcinoma, and used to investigate whether
      common tumour antigens are expressed on allogeneic ovarian tumours epithelial
      tumour lines derived from colon and pancreatic carcinoma. Three CTL lines
      expressed preferential cytolytic activity against autologous tumour cells and
      against certain allogeneic ovarian tumour cells that shared HLA-A2 molecules.
      Analysis of the target specificity of these CTL lines indicated that they also
      lysed human colon and pancreatic tumour lines sharing HLA-A2. CTL-TIL clones
      isolated from these lines were found to lyse HLA-A2+ ovarian, colon and
      pancreatic tumours, and to recognize clonally distributed common epitopes on
      pancreas and colon tumour clones. These results indicate that shared tumour
      antigens can be found among tumours of common epithelial cell origin. These
      results indicate a novel class of T-cell-definable tumour antigens recognized by
      tumour-reactive CTL on human tumours and may be significant for understanding of
      cellular immunity in ovarian cancer, identification of CTL-defined tumour
      antigens and future adoptive specific immunotherapeutic approaches in ovarian
      cancer.

PMID- 8469925
TI  - Partial biochemical characterization and purification of IgG2b inducing factor as
      a new cytokine from synovial fluid of patients with rheumatoid arthritis.
AB  - Rheumatoid arthritis synovial fluid (RA-SF) contains a novel biological activity,
      which selectively induces IgG2b antibody production in lipopolysaccharide (LPS)
      activated mouse spleen cells in vitro and in vivo. Our previous studies have
      shown that this activity is not functionally identical to other well-known
      cytokines and interleukins. In this study we demonstrate the partial purification
      and biochemical characterization of the IgG2b inducing activity in RA-SF.
      Biochemical characterization revealed that the IgG2b inducing activity in RA-SF
      has the following properties: it is a protein, sensitive to pH > 11 and < 4,
      which is precipitated by 50% of saturated ammonium sulphate and has a molecular
      weight of 50-70 kDa; it binds to Cibacron-blue and heparin and its activity is
      not mediated by immunoglobulins or immune complexes, which are present in RA-SF.
      Biochemical characteristics of the IgG2b inducing activity also differ from other
      cytokines and interleukins. The term IgG2b inducing factor is proposed for this
      novel activity.

PMID- 8469926
TI  - Differences in the rate of intracellular killing of catalase-negative and
      catalase-positive Listeria monocytogenes by normal and interferon-gamma-activated
      macrophages.
AB  - Intracellular killing of catalase-positive bacteria by murine resident
      macrophages requires the presence of extracellular serum, whereas killing of
      catalase-negative bacteria can occur in the absence of serum. To find out whether
      the intracellular killing of bacteria by rIFN-gamma-activated macrophages also
      requires serum stimulation, we investigated the handling of ingested catalase
      negative and -positive Listeria monocytogenes by peritoneal macrophages of normal
      Swiss mice and mice injected i.p. with 1 x 10(4) U rIFN-gamma 18 h earlier. In
      the absence of extracellular serum, rIFN-gamma-activated macrophages killed
      ingested catalase-negative Listeria more efficiently (P < 0.01) than normal
      resident macrophages. Maximal killing of catalase-negative bacteria by rIFN-gamma
      activated macrophages required an extracellular serum concentration of only 1.0
      to 2.5% compared with the 10% needed by normal macrophages. No differences were
      observed in the rates of intracellular killing of catalase-positive Listeria by
      rIFN-gamma-activated and normal resident macrophages: both populations of
      macrophages required 10% extracellular serum for maximal killing of these
      bacteria, and killing was minimal in the absence of serum. The rIFN-gamma
      activated macrophages displayed enhanced O2-consumption after stimulation with
      phorbol myristate acetate and heat-killed Listeria compared with macrophages from
      normal mice. These findings indicate that, under suboptimal stimulation by
      extracellular serum, rIFN-gamma enhances the intracellular killing of catalase
      negative Listeria which lack endogenous catalase acting as a scavenger of
      reactive oxygen intermediates. The mechanism underlying the enhancement is
      probably the amplification of the respiratory burst by IFN-gamma.

PMID- 8469927
TI  - The primary structure of rabbit serum amyloid A protein isolated from acute phase
      serum.
AB  - Serum amyloid A (SAA) protein, a sensitive acute phase protein and the precursor
      of protein AA in secondary amyloid, was purified from pooled acute phase rabbit
      serum using two different methods: isolation of protein SAA directly by octyl
      Sepharose chromatography of total serum, and dissociation and isolation of apoSAA
      from acute phase high density lipoprotein (HDL). The protein SAA fraction
      obtained was further purified using gel filtration and ion exchange
      chromatography. Rabbit protein SAA has 104 amino acid residues, like human SAA,
      and has a partially blocked N terminus. The highly conserved region from position
      33 to position 63 found in SAA from all species studied was confirmed also in
      rabbit SAA. No microheterogeneities were observed. The amino acid sequence showed
      extensive N-terminal homology with the rabbit amyloid A protein, except for the
      microheterogeneity in position 12 in protein AA. It also showed identical amino
      acid sequence with that deduced from the rabbit cDNA clone pSAA 55. Complete
      homologies were found with clone SAA 2, except for positions 22 and 78, clone SA8
      1, except for positions 22 and 79 and clone SA7-3, except for position 22. This
      pSAA 55/SA7-3/SA8-1/SAA2-like protein was the only SAA isotype found both in
      total serum and in the HDL fraction. Isotypes corresponding to other SAA-like
      genes could not be found in this pool of acute phase rabbit sera.

PMID- 8469928
TI  - Cholera toxin enhances alloantigen presentation by cultured intestinal epithelial
      cells.
AB  - In the present study we show that cholera toxin (CT) strongly potentiates antigen
      presentation by intestinal epithelial cells, probably by enhancing co
      stimulation. This was demonstrated in an allogeneic system using cells from the
      IEC-17 rat epithelial cell line as antigen presenting cells (APC). These cells
      were induced by optimal concentrations of IFN-gamma to express good amounts of Ia
      antigen and cultured for 24-48 h in the presence or absence of CT. Thereafter the
      cells were thoroughly washed and added to cultures containing MHC-incompatible
      spleen cells as responder cells. Epithelial cells exposed to CT demonstrated
      greatly enhanced ability to trigger allogen-specific T-cell proliferation as
      compared with IEC-17 cells treated with IFN-gamma alone. The mechanism for the
      enhanced APC function was investigated by analysing CT-treated IEC-17 cells for
      increased class II MHC antigen expression or enhanced production of cytokines
      with known co-stimulatory function. We found no significant increase in class II
      MHC antigen expression. By contrast, CT strongly promoted, in a dose-dependent
      fashion, the production of both IL-1 and IL-6 cytokines by IEC-17 cells as
      compared with untreated epithelial cells. This effect of CT was specific and not
      due to contaminating endotoxin because excess amounts of soluble toxin receptor,
      ganglioside GM1, added to the IEC-17 cultures completely abrogated the cytokine
      response to CT. These results together with our previous findings of enhanced
      antigen presentation by macrophages stimulated by CT suggest that the potent
      adjuvant function of CT for induction of mucosal immune responses might be
      attributed to an enhanced co-stimulating ability of several putative APC in the
      mucosal immune system: macrophages, B cells and epithelial cells.

PMID- 8469929
TI  - Modification of lymphocyte and monocyte functional activity by polymorphonuclear
      neutrophils in HIV infection.
AB  - The aim of this study was to determine whether polymorphonuclear neutrophils
      (PMN) can modify the immune response in HIV cases. Supernatants of PMN (PMNS)
      from 33 HIV-infected patients (16 with lymphoadenopathy syndrome, 17 with AIDS
      related complex) were tested for their influence on the functional activity of
      lymphocytes and monocytes from 6 healthy donors. PMNS from another 6 healthy
      donors comprised a control group. It was found that PMNS from HIV-infected
      patients, but not from healthy donors, induced suppression of lymphocyte
      proliferative response and down-regulation of CD8 receptor expression on
      lymphocytes. Decrease of NK-cell cytotoxicity in the presence of PMNS from HIV
      infected patients was the same as that from healthy donors. PMNS did not
      influence the production of anti-HIV antibody by lymphocytes from HIV-infected
      patients, as well as non-specific IgG by lymphocytes from healthy donors. PMNS
      effect on functional activity of lymphocytes was blocked completely after
      treatment of PMN by catalase and superoxide dismutase. At the same time PMNS from
      HIV-infected patients but not from healthy donors induced increased production of
      TNF-alpha by monocytes and up-regulation of monocyte phagocytosis. These effects
      were independent of catalase and superoxide dismutase and were not abrogated by
      antibody against IL-1, IL-8, TNF-alpha, IFN-gamma or IFN-alpha.

PMID- 8469930
TI  - A low serum concentration of mannan-binding protein is not associated with
      serogroup B or C meningococcal disease.
AB  - The mammalian C-type serum lectin, mannan-binding protein (MBP), may induce C1q-
      and antibody-independent activation of the classical pathway of complement.
      Accordingly, MBP is considered as a member of the complement system. Complement
      deficiencies have been found with increased frequency in patients with
      meningococcal disease. Therefore, we investigated the MBP levels in patients with
      meningococcal disease. Ninety-nine Norwegian individuals (age 12-21 years) who
      survived severe systemic disease caused by serogroup B or C meningococci were
      investigated. No significant differences were observed in the MBP concentration
      between patients with serogroup B (n = 76) or C (n = 25) disease and healthy
      blood donor controls (n = 40) (P > 0.05). The frequency of patients with low
      levels of MBP (< 100 micrograms/l) was 10.1%. This was not different from
      controls (12.5%). Thus, low MBP concentrations do not appear to predispose to
      serogroup B or C meningococcal disease.

PMID- 8469931
TI  - Identification of a novel 27-kDa protein from Mycobacterium tuberculosis culture
      fluid by a monoclonal antibody specific for the Mycobacterium tuberculosis
      complex.
AB  - Mycobacterium tuberculosis antigens inducing species-specific immune responses
      are likely to be particularly important for serodiagnosis or for skin testing of
      tuberculosis. In the present study, we describe the characterization of two novel
      monoclonal antibodies (MoAbs) A3h4 (IgG2a) and B5g1 (IgM) that are directed to M.
      tuberculosis 27-kDa and 25-kDa proteins respectively. Specificity analysis by
      immunoblotting using 20 different species of mycobacterial sonicates revealed
      that MoAb A3h4 was specific for M. tuberculosis complex alone while MoAb B5g1
      showed a limited cross-reactivity. Direct comparison with previously
      characterized MoAbs revealed that these MoAbs A3h4 and B5g1 defined new antigenic
      determinants of M. tuberculosis. By using M. tuberculosis complex-specific MoAb
      A3h4 we have identified a distinct 27-kDa protein in the M. tuberculosis H37Rv
      culture fluid. Since this MoAb did not bind to the previously characterized
      MPT44, MPT59, MPT45, MPT51 and MPT64 proteins as well as the 23-kDa superoxide
      dismutase (SOD) protein of M. tuberculosis, we conclude that MoAb A3h4 recognizes
      a novel protein in the M. tuberculosis H37Rv culture fluid. Studies of the
      subcellular distribution of these MoAb-reactive proteins indicate that the MoAb
      A3h4-reactive 27-kDa protein is present not only in the culture fluid but also in
      the cytosol and the cell wall of M. tuberculosis. By contrast, B5g1-reactive
      protein is mainly a cytosolic protein. When these MoAbs were tested in a
      previously established ELISA with intact mycobacteria derived from early
      cultures, only MoAb A3h4 showed the positive reactivity to mycobacteria belonging
      to the M. tuberculosis complex. In addition, during the present comparative
      studies of MoAbs we have also found that the previously described MoAb F116-5,
      which is known to recognize the mycobacterial 23-kDa SOD protein [17], cross
      reacted with the MPT44, MPT59, MPT45 and MPT51 secreted proteins but not with
      MPT64 and MPB70. These findings indicate that the family of four secreted
      proteins of M. tuberculosis share a common epitope with M. tuberculosis SOD
      protein.

PMID- 8469932
TI  - Low prevalence of complement deficiencies among patients with meningococcal
      disease in Norway.
AB  - Sera from 98 individuals who had survived meningococcal disease were analysed for
      classical and alternative pathway haemolytic activity and the complement
      components C3, C4 and properdin. No complete deficiency was found. However,
      median properdin concentration was only 86% in the disease group compared with
      the controls (P < 0.001). Properdin was also significantly lower in serogroup C
      disease (median 76%) compared with serogroup B disease (median 90%, P = 0.005).
      Severe properdin deficiency is an established risk factor for meningococcal
      disease. The present data may indicate that even moderately reduced properdin
      level can increase the risk of developing meningococcal disease.

PMID- 8469933
TI  - Linkage disequilibrium within the HLA complex does not extend into HLA-DP.
AB  - It is well known that certain alleles from different loci within the Human
      Leucocyte Antigen (HLA) complex are in linkage disequilibrium. This linkage
      phenomenon is relatively well characterized for haplotypes that include specific
      class I and class II alleles such as HLA-B8 and HLA-DR3. However, the HLA-DP
      genes are located at the centromeric end of the HLA complex and are less well
      characterized with regard to linkage disequilibrium. The availability of a large
      population of healthy subjects and sequence-specific oligonucleotide (SSO) typing
      enabled us to assess the degree of linkage between HLA-DPB1 and HLA-DQB1 genes.
      Using the polymerase chain reaction and a series of oligonucleotide probes which
      define seven DQ beta alleles and twenty DP beta alleles, we studied 180
      unrelated, normal Caucasian individuals and found only weak or negative
      associations between HLA-DPB1 and HLA-DQB1. These data demonstrate that the
      association between HLA-DQ and DP is weak and also imply that DP extended
      haplotypes related to particular diseases may not reflect normal associations.
      Implications of these results might impact on the concept of linkage
      disequilibrium in general as well as the evolution of the HLA complex. In
      addition, extensions of this work may have clinical ramifications with regard to
      bone marrow transplantation and founder effects in certain diseases.

PMID- 8469934
TI  - Characterization of two highly homologous autoantibody-related VH1 genes in
      humans.
AB  - Previously, we showed that the Humha 1lr rearranged gene was almost identical to
      the consensus amino acid sequence of several G6 idiotype-positive rheumatoid
      factor (RF) heavy chains, and to the VH gene-encoded region of the fetally
      expressed 51P1 cDNA. The finding led us to suggest that the ha 1lr-corresponding
      germline gene encodes the heavy chains of many human IgM RFs. We now report the
      isolation of the proposed germline gene, designated Humhv1051; it is identical to
      the consensus sequence of the G6 heavy chain V regions. During this experiment,
      we also isolated unexpectedly an additional VH1 gene, termed Humhv1051K; it
      differs from hv1051 by one amino acid residue. Importantly, hv1051K is identical
      to Humha113, the rearranged VH1 gene of a natural anti-cardiolipin antibody.

PMID- 8469935
TI  - Transfer of CD8+ T cells into SCID mice and activation of memory virus-specific
      cytotoxic T cells.
AB  - The requirements for the activation of naive and memory CD8+ cytotoxic T (Tc)
      cells into effector virus-specific Tc cells after transferring them into SCID
      mice were investigated. SCID mice reconstituted with splenocytes or purified CD8+
      T cells from naive or influenza-immune syngeneic mice and immunized with
      influenza virus generated effector Tc cells specific for influenza virus-infected
      target cells in vitro. The kinetics of the response varied between those two
      populations. The generation of effector Tc cells after transfer of memory CD8+ T
      cells indicates that there exists no absolute requirement for 'help' in the
      activation of memory virus-immune T cells. However, under the conditions
      described here the in vitro immunogenic peptide NPP derived from influenza
      nucleoprotein is not sufficient to elicit a response in vivo.

PMID- 8469936
TI  - Activated natural killer cells suppress myelopoiesis in mice with severe combined
      immunodeficiency.
AB  - The in vivo effect of natural killer (NK) cell activation on autologous
      myelopoiesis was studied in an environment deficient of functional T and B cells.
      Administration of 3,6-bis[2-(Dimethylamino)-ethoxy]-9H-xanthen-9-one
      dihydrochloride) Tilorone) or recombinant interleukin-2 (rIL-2) to mice with
      severe combined immunodeficiency (C.B.-17 scid/scid) resulted in an increase in
      YAC-1 lysis by their splenocytes as well as bone marrow cells. Recombinant IL-2
      furthermore led to a fivefold increase in the cellularity of the spleen. When
      assayed against human NK/lymphokine-activated killer (LAK) target, K562 cell
      line, the IL-2-activated mouse cells exhibited no cytotoxicity across the species
      barrier. Both agents induced a profound suppression of myelopoietic progenitor
      cells as measured in a 7-day granulocyte-macrophage colony forming cell (GM-CFC)
      assay. We conclude that the presence of neither functional T nor B cells is
      necessary for NK cells to mediate inhibition of myelopoiesis in the autologous
      host.

PMID- 8469937
TI  - Incidence density is no density.

PMID- 8469938
TI  - Secular trends in the effect of socio-economic factors on birth weight and infant
      survival in Sweden.
AB  - Time trends in the effect of socio-economic factors on low birth weight,
      stillbirth, perinatal deaths and deaths up to the age of one were studied using a
      medical birth registry linked to census information from 1975, 1980, and 1985.
      For each census year, delivery outcome the following year was studied. Two socio
      economically different groups of women were studied, defined by
      occupation/education, cohabitation, and citizenship--one privileged and one under
      privileged group. A difference in birth weight distribution was found between the
      two groups which is only partly explainable by different smoking habits in early
      pregnancy and did not substantially change during the ten year observation
      period. In 1976, there was virtually no difference in infant mortality between
      the two groups. In 1981 and 1986, infant mortality had decreased in both groups
      but more strongly so in the privileged group, and a difference between the groups
      therefore appeared.

PMID- 8469939
TI  - Temporal and regional trends in fatal childhood injuries in Norway 1971-1989.
AB  - The paper focuses on how mortality due to injuries among Norwegian children has
      varied over time and throughout the country over the last two decades. The
      temporal trends are compared to those of the other Nordic countries. Individual
      data on date of birth and death, county of residence at death, sex and cause of
      death were obtained from the Norwegian Death Registry on all children aged 0-14
      who died during the time-span 1971-1989. Denominators were the number of persons
      alive in the corresponding age, year, sex and county groups. There has been a
      decline in fatal injuries from 25 to 9 deaths per 100,000 person-years in,
      respectively, 1971 and 1989. The decline is less distinct in the late 1980's. The
      rate of fatal injuries have throughout the period been lowest in the county of
      Oslo and highest in Northern Norway with fatal injury rates in Finnmark 3 times
      that of Oslo. The declining time trend was present for all types of injuries
      except bicyclists and passengers, but with the sharpest decline for pedestrians
      and drowning injuries. The regional variation was strongest for drowning and
      showed a different profile from the overall pattern for bicyclists, passengers
      and falling injuries. The incidence of fatal injuries in Norway is comparable to
      those of Denmark, Finland and Iceland, but considerably higher than in Sweden. In
      all Nordic countries the rates have declined to about one third from 1971 to
      1988.

PMID- 8469940
TI  - The relation between teenage smoking and drinking, with special reference to non
      standard family background.
AB  - Associations between simultaneous teenage drinking and smoking are considered in
      a birth cohort born in Northern Finland in 1966 (n = 12,058), especially in non
      standard, mainly single parent families. Data were collected from pregnancy until
      the age of 14. ROC (receiver operating characteristic curve) analysis was used to
      assess how well smoking predicts use of alcohol. Smoking and drinking were more
      interconnected in the non-standard families among both boys (p = 0.007) and girls
      (p = 0.018), but only among boys (p = 0.064) when the data were standardized for
      social class and place of residence and not among girls (p = 0.191). A similar
      relation between smoking and having been drunk was found among boys in non
      standard families (p = 0.016), even when adjusted as above (p = 0.029), but not
      among girls (unadjusted p = 0.235, adjusted p = 0.469). The findings suggest that
      the adolescent boy's self-protective behaviour with respect to the commencement
      of combined experimentation with smoking and drinking is more restricted in non
      standard families than in standard families.

PMID- 8469941
TI  - Validity of register data on acute myocardial infarction and acute stroke: the
      Skaraborg Hypertension Project.
AB  - In the evaluation of a hypertension treatment program, the end-point surveillance
      included incidence of acute myocardial infarction and acute stroke identified
      from hospital in-patient registers and the national mortality register. To
      ascertain the validity, in-patient records containing the ICD-codes 410-411 and
      430-438 were validated. First event of acute myocardial infarction and acute
      stroke suggested in the in-patient register could be confirmed in 96% and 94%,
      respectively. In-patient diagnoses of suspected acute myocardial infarction or
      other acute or subacute ischemic heart diseases, transient ischemic attack and
      unspecified heart diseases, transient ischemic attack and unspecified
      cerebrovascular disease revealed high proportions of what in fact turned out to
      be definite events (11%, 24% and 53% respectively). It is concluded that disease
      ascertainment for this cohort study claims validation of register data with
      hospital records.

PMID- 8469942
TI  - Initiation into drug abuse: the pathway from being offered drugs to trying
      cannabis and progression to intravenous drug abuse.
AB  - The aim of the study was to analyse the initiation process into illicit drug use
      focusing on three endpoints which can be seen as stages in the drug career: being
      offered drugs, using cannabis and using intravenous drugs. Questionnaire data
      were available on 23,482 men, aged 18-20 years, conscripted for military service
      in 1969-70. The association between family background, social conditions, other
      illicit drug use, emotional control and the three endpoints were analysed.
      Although many conscripts tried cannabis, a smaller number continued with
      intravenous drug abuse. These were in general characterised by poor emotional
      control and a history of social maladjustment, and early onset of use. Our
      findings give further evidence for social maladjustment as a causative factor for
      illicit drug use and for the role of cannabis as a stepping stone to heavy drug
      abuse.

PMID- 8469943
TI  - Determinants of health care utilization--visits and referrals.
AB  - This study explores determinants of I) general practitioner (GP) visits and II)
      referrals (outpatient and hospitalization). The analyses were performed with
      regression models on a set of data from a comprehensive population study of 3533
      men and 3578 women aged 40-42 in a county in Northern Norway. Among the various
      health status dimensions included, self-rated health was found to be the most
      important determinant, regardless of type of service. Factors, other than health
      status aspects affecting GP visits, were preoccupation with health and help
      seeking attitude. Volume of resources (GP per population), socio-demographic
      characteristics and social networks did not appear as important. Several
      inequitable effects were revealed on referrals: First, higher rate of referral of
      patients with higher educational achievement indicates a bias towards higher
      social status groups. Second, high GP/population ratio and residence in
      municipalities with referral care facilities were both found to be associated
      with higher probability of referral.

PMID- 8469944
TI  - Differences in the diagnose panorama in primary health care in Dalby, Sweden and
      Spili, Crete.
AB  - We have compared the use of primary health care and the diagnoses at visits to
      doctors in the Spili Health Centre (SHC) in Crete and the Dalby Health Centre
      (DHC) in Sweden. In DHC more patients per 1000 population visited the doctors
      than in SHC. This was so regardless of age-group and sex, in fact more or less
      regardless of diagnosis. Other differences between the populations were: The
      diagnosis acute otitis media was more frequent in the Dalby children than in the
      Spili ones. The opposite was true of "head injuries" which were more frequent in
      the Spili boys. Visits to doctors for bronchitis was more frequent in the Spili
      men, maybe because of the extensive smoking habits of Cretan men. Visits for
      diseases of the musculoskeletal system were more frequent in DHC than in SHC. A
      hypothesis worth testing is that this was influenced by differences in the health
      insurance and sick benefit systems. Angina pectoris was fairly frequent in both
      areas but cardiosclerosis (including healed myocardial infarction) was more
      common in DHC than in SHC. Use of primary health care may be influenced by the
      need for health care in the population, the accessibility of the health care
      facilities, the costs for the patients, the quality of care as perceived by the
      patients and by other sociocultural factors. Comparative studies, even though
      fairly uncommon today, may be of use in generating hypotheses about the impact of
      different factors on the use of health care.

PMID- 8469945
TI  - [Interference versus low frequency. A comparison of 2 methods of electric muscle
      stimulation].
AB  - The purpose of this study was to determine whether inferential or low-frequency
      stimulation can produce a stronger and less painful contraction of the quadriceps
      femoris muscle in 20 healthy subjects. Both currents used a pulse rate of 50 Hz.
      The perceived discomfort experienced with each type of electrical stimulation was
      quantified by the use of a visual analogue scale. An isokinetic dynamometer
      (Cybex) was used to assess peak torque. Paired t-test demonstrated that
      inferential stimulation was perceived to be significantly less uncomfortable than
      low-frequency stimulation and that inferential stimulation produced a
      significantly greater peak torque of muscle contraction than low-frequency
      stimulation. This study indicates that inferential stimulation can produce an
      electrically induced muscle contraction which is stronger and less unpleasant
      than low-frequency stimulation.

PMID- 8469946
TI  - [Selenium metabolism and glutathione peroxidase activity of endurance athletes in
      rest and under exertion].
AB  - Selenium which has been recognised as an essential trace element for mammals and
      humans is part of the enzyme glutathione peroxidase (GSHPx) and of other selenium
      dependent enzymes. GSHPx protects the organism from oxidative damage. Supposing
      that the formation of peroxides is enhanced in athletes during a marathon run the
      question arose whether the selenium concentrations in the blood plasma and the
      GSHPx activities in the erythrocytes are changed. Our experiments were performed
      with 13 athletes completing a marathon. Blood probes were taken before,
      immediately after and two hours after the endurance event. No significant changes
      in the selenium concentrations of the blood plasma probes nor of the enzyme
      glutathione peroxidase activities of the erythrocytes were observed during the
      experiments. The selenium concentrations in the plasma: 77.7 +/- 20.8
      micrograms/l and the GSHPx activities of the erythrocytes 18.2 +/- 7.4 U/g Hb
      were within normal clinical range. Symptoms of selenium deficiency could not be
      detected. In order to answer the question of whether the selenium concentrations
      in the blood of the athletes represent an optimal level for preventing enhanced
      formation of peroxides, intervention studies are needed, including measurement of
      more parameters of lipid peroxidation.

PMID- 8469947
TI  - [Fasting and physical endurance capacity].
AB  - Fasting, or zero calorie diets are used not only by overweight people as a means
      of losing weight, but by athletes too. Their use is then explained on
      philosophical grounds, with the aim of even enhancing sports performance. The
      purpose of this investigation consisted of quantifying the effects of a 10-day
      fast on maximum performance capacity and endurance (as measured on a bicycle
      ergometer) of 12 female students of physical education of normal weight. The
      measurements included resting and exercise metabolism determinants, as well as
      weight and lean body mass. The main results show that after the diet period the
      maximum ergometric performance was lower in absolute terms as well as in relation
      to weight or lean body mass. Performance capacity for submaximal exercise was
      also reduced. Fat combustion was enhanced both at rest and during exercise. The
      reduction of maximum performance and endurance capacity may be explained by an
      enhanced muscle breakdown, an efficiency drop of muscular work, and an inadequate
      glycogen content of the acting muscles. Shorter fasting periods of 24-36 hours
      also lead to a lower performance level for exercise bouts extending from several
      minutes to 1-3 hours. An enhancement of fat combustion was always conspicuous.
      One may conclude that optimal physical performance is dependent on full hepatic
      and muscle glycogen stores. Glycogen concentration in the liver decreases sharply
      as a matter of fact after merely one day of carbohydrate shortage. Zero calorie
      or low carbohydrate diets are thus at variance with an optimal physical work
      capacity.

PMID- 8469948
TI  - [Does drinking protect against mountain sickness?].
AB  - This paper summarizes the main findings of 3 publications of our group [2-4]
      examining fluid balance at high altitude. Of 57 mountaineers ascending from 1170
      m to 4559 m within 22 to 77 hours, 24 developed acute mountain sickness (AMS) and
      16 developed high altitude pulmonary edema (HAPE). In 14 cases HAPE was preceded
      by symptoms of AMS. Independently of the amount of fluid intake, which varied
      from 2 to 4 l/24 h in these studies, subjects developing AMS showed decreased
      diuresis and natriuresis compared to healthy controls with similar fluid intake.
      Higher fluid intake resulted in greater urine output but did not prevent AMS.
      Higher plasma levels of aldosterone at rest and greater exercise-induced rises of
      plasma aldosterone and vasopressine may explain the increased water and salt
      retention in subjects with AMS. Whether these hormonal changes are secondary to a
      more severe hypoxemic stress or present a primary cause of AMS remains to be
      determined.

PMID- 8469949
TI  - Environmental radiochemical analysis. A collection of papers from the 6th
      International Symposium on Environmental Radiochemical Analysis, September 1990,
      Manchester, UK.

PMID- 8469950
TI  - Implementation of a radiochemical procedure for the analysis of isotopes of Pu,
      Am and Cm in food and environmental samples.
AB  - A radiochemical procedure for the analysis of isotopes of Pu, Am and Cm was
      implemented during an expert mission to Thailand sponsored by the International
      Atomic Energy Agency. This method was to be used for the analysis of food and
      environmental samples, particularly those of marine origin. The project was
      initiated by evaluating a procedure which had recently been published by the
      IAEA. This procedure could not handle the wide range of matrix materials used in
      the testing and a program was undertaken to develop a modified procedure.
      Plutonium was radiochemically separated using an anion exchange procedure which
      gives clean separations from the matrix. Americium and curium came off the column
      unseparated from most of the other elements in the matrix and they were separated
      by using a number of steps, which were selected to handle the specific chemical
      and radiochemical interferences in a particular matrix material. Sources were
      prepared for alpha spectrometry by coprecipitation with CeF3. The procedure was
      tested with a wide variety of sample types and good chemical yields and
      separations were obtained in most cases.

PMID- 8469951
TI  - A rapid method for monitoring of uranium and radium in drinking water.
AB  - A time-saving and fairly accurate method for monitoring U and 226Ra in drinking
      water has been devised, using low-background liquid scintillation spectrometry
      and pulse-shape analysis. The samples are prepared for counting by evaporating
      water in a liquid scintillation vial. The residue is dissolved in 1 ml of 0.5 N
      HCl, and a scintillation cocktail is added. Counting is carried out twice: a few
      days and a month after the sample preparation using the Quantulus, a liquid
      scintillation spectrometer equipped with a guard counter and pulse-shape
      analyser. The counter produces separate alpha and beta spectra which enable
      calculation of the approximate U and 226Ra contents. These correlate well with
      the results obtained by radiochemical methods. The measured spectra give valuable
      information on the nuclide content, e.g. increased U, 226Ra, 210Pb and 210Po
      activities, and on the 234U: 238U activity ratio in the water. This kind of
      information is very valuable in deciding on the necessity for time-consuming
      radiochemical analyses for radiation protection purposes or exploration for U ore
      deposits. In many cases the results from the Quantulus are sufficient to
      determine the U and 226Ra levels in drinking water. The lower limits of detection
      for U and 226Ra are 0.02 and 0.01 Bq/l, respectively, when the counting time is
      180 min and the sample volume 38 ml.

PMID- 8469952
TI  - The analysis of naturally-occurring radionuclides from uranium and thorium decay
      series in table mineral waters.
AB  - This project required the highly sensitive analysis of low-level alpha- and beta
      emitters naturally occurring in table mineral water sold on the Swiss market.
      These radionuclides occur in the three major decay series-uranium-238, uranium
      235, and thorium-232. The radionuclides analysed were 238U, 235U, 234U, 232Th,
      230Th, 228Th, 210Po, 210Pb, and 226Ra. Many other radionuclides were determinable
      as a result of their equilibrium with an analysed nuclide. Efficient, element
      specific separation techniques were developed, allowing for the spectral analysis
      of each element without interference from other radioactive elements. Radioactive
      tracers, 232U, 230Th, and 209Po, were necessary to determine the percentage
      yield. These yields often varied greatly between different mineral waters,
      especially for thorium, ranging from 30 to 100%. Uranium, thorium and polonium
      isotopes could be directly analysed for by alpha-spectrometry. 226Ra was
      determined through the ingrowth of its daughter 222Rn by liquid scintillation
      counting. From the samples remaining after 210Po removal, the isotope's re
      ingrowth from 210Pb determined the original 210Pb content. Limits of detection
      ranged from 0.1 to 2.0 mBq/l. The following contents were determined 234U + 238U
      30-720 mBq/l; 232Th + 230Th < 1-5 mBq/l; 228Th 2-40 mBq/l; 226Ra 5-370 mBq/l;
      210Po 1-90 mBq/l; 2,0Pb 1-90 mBq/l.

PMID- 8469953
TI  - Environmental and personnel monitoring for uranium by delayed neutron counting.
AB  - At the Imperial College Reactor Centre we have developed a fully automated, large
      sample, high sensitivity delayed neutron counting system for routine analysis of
      environmental samples and personnel monitoring. Two-hundred fifty samples with a
      maximum volume of 30 ml can be analysed each working day. The detection limits (3
      sigma) for uranium of natural isotopic abundance in our routine samples are
      typically 1 microgram/kg (0.05 Bq/kg) for dry samples and 1 microgram/l (0.05
      Bq/l) for aqueous samples. Daily analysis of BNFL uranium standards, 'in house'
      uranium standards and weekly analysis of IAEA Soil-7 reference material are used
      to ensure constant system sensitivity and accuracy.

PMID- 8469954
TI  - The determination of tritium, 14C and 35S in milk and crop samples using a
      combustion technique.
AB  - The use of a combustion technique for the determination of low energy beta
      emitting radionuclides in solid and liquid samples has been in widespread use for
      a number of years. However, the sensitivity of measurements by existing
      commercially available combustion apparatus has been limited by the amount of
      sample that can be combusted before incorporating the combustion products into a
      liquid scintillator for subsequent counting. Consequently the determination of
      tritium, 14C and 35S at environmental levels has not been possible using
      commercially available equipment. This paper describes the apparatus and method
      that was developed at the Central Veterinary Laboratory for the determination of
      these low energy beta-emitters in milk and crop samples. A typical sample size of
      20-50 g is routinely measured, although the apparatus is designed to be able to
      make several sequential combustions before measurement of the oxidation products
      by liquid scintillation counting.

PMID- 8469955
TI  - Production of a spiked milk reference material.
AB  - A spiked milk reference material containing 134Cs and 137Cs has been successfully
      produced. The material has been characterised in a manner directly traceable to
      national standards of radioactivity. This work is part of a EUROMET project to
      produce spiked reference materials at a range of densities from 0.1 to 2.0 g/cm3.

PMID- 8469956
TI  - Measurements of the gastrointestinal absorption and tissue distribution of
      plutonium, americium and polonium in experimental animals.
AB  - In order to set limits on environmental and occupational intakes of
      radionuclides, information is needed on their uptake and metabolism in man. Human
      data are very limited, particularly for long-lived alpha-emitting isotopes such
      as those of the actinides. Animal experiments are therefore an important source
      of data on the distribution of radionuclides in tissues, and the effects of
      factors such as subject age and the chemical form of elements on gastrointestinal
      absorption. The NRPB performs experimental programs using mainly rats and guinea
      pigs. In order to study the gastrointestinal absorption and tissue distribution
      of plutonium, americium and polonium, a variety of analytical techniques are
      employed. These include ion exchange and solvent extraction leading to alpha
      spectrometry and liquid scintillation counting. The investigation of low specific
      activity environmental or industrial materials, and the very low bioavailability
      of elements such as the actinides, means that very low levels of activity have to
      be measured. Contamination at the dissection and tissue separation stage, as well
      as during the radiochemistry, has to be rigorously avoided. Where very detailed
      information is needed on the location of radionuclides within tissues, such as in
      the study of alpha-emitter distribution in the intestine, autoradiography is
      used. The application and relevance of different measurement techniques to animal
      studies will be discussed and examples of the results presented.

PMID- 8469957
TI  - Radon concentration levels in ground water from Toluca, Mexico.
AB  - Concentration levels of 222Rn have been analysed in water samples from deep wells
      of the aquifers around the City of Toluca, Mexico. The 222Rn source is the decay
      of 226Ra within the solid matrix of the aquifer. With a half life of 1600 years
      the 226Ra continuously releases 222Rn to the pores, from which it diffuses into
      the main body of water. This paper describes the methods used for sampling and
      measuring solubilized and 226Ra-supported 222Rn in the water samples, in order to
      evaluate possible health hazards due to the presence of radon in the drinking
      water supplies. The relationship of 222Rn with the hydrogeologic characteristics
      of the zone is also described. The analytical method involves laboratory
      extraction of 222Rn into toluene. Alpha disintegrations of 222Rn and
      contributions from short-lived daughters are counted by the liquid scintillation
      technique. The system was calibrated using a 226Ra standard solution. Results up
      to 11.3 Bq/l of 222Rn were obtained in the water samples.

PMID- 8469958
TI  - Use of liquid scintillation counting for fast determination of 89Sr and 90Sr in
      milk.
AB  - This paper describes a method of reproducibly recovering strontium (Sr) in 90.4%
      yield from 2-litre samples of raw milk in an analysis time of 5-8 h. All species
      which may interfere with the measurement of 89Sr and 90Sr are effectively
      removed; decontamination factors for Ca, Y, Ba and Cs were found to be adequate,
      and the role of other possible interferences is discussed. The Sr isolate was
      dissolved in scintillation cocktail prior to counting of 89Sr and 90Sr in a
      single measurement with a low-level liquid scintillation spectrometer.
      Scintillation spectra and counting efficiencies for 89Sr, 90Sr and 90Y have been
      established. A simple spectral stripping technique may thus be applied to
      calculate activities from the spectra of real samples. Results of analyses of
      five 2-1 milk samples containing known activities of 89Sr and 90Sr were
      respectively 87.7 +/- 3.5% and 90.4 +/- 3.0% (+/- 1 S.D.) of the activities
      added. A correction factor for the Sr yield was not applied. The detection limit
      of 0.014 Bq for 90Sr samples free of 89Sr implies that the method is also useful
      for routine monitoring of 90Sr.

PMID- 8469959
TI  - Recent results (1986-1989) on the ENEA quality assurance programme for the
      radioactivity surveillance network in Italy.
AB  - A programme for the Quality Assurance of the Italian network for surveillance of
      radioactivity in foodstuff and environmental samples was started by the ENEA in
      1983. The main purpose of this programme is to establish uniform levels of
      accuracy and reproducibility in measurement procedures routinely used by the
      laboratories belonging to the network. This paper describes the technical aspects
      relevant to the calibration and intercomparison campaigns carried out, in Italy,
      in the period 1986-1989. The relevant measurements include gamma spectrometry and
      beta-ray counting in liquid aqueous samples.

PMID- 8469960
TI  - Radiotoxicological intercomparisons organised by the Commissariat a l'Energie
      Atomique group in France.
AB  - People working in French nuclear plants are monitored either by whole body
      counting or by the measurement of biological samples. The radiochemical and
      radiometric procedures used have to be periodically reviewed. A working group,
      including practising biologists from CEA, EDF and the Armed Forces Health
      Service, instituted comparisons of radiotoxicological test assessments. Since
      1978, about 60 intercomparisons have been made. Currently 30 European
      laboratories are involved in these intercomparisons. This paper provides a brief
      history of the intercomparison exercises, describes the logistics of sample
      collection and preparation, and presents the results, showing the position of
      each laboratory in relation to the reference and median values. Diagrams produced
      by radiochemical analysis, relating to plutonium in urine and in faecal samples,
      and to tritium, strontium and enriched uranium in urine, are analysed.

PMID- 8469961
TI  - The distribution of 210Po in human bone.
AB  - Recent measurements of natural radioactivity in human bone using alpha particle
      autoradiography have indicated that the alpha activity concentration in the bone
      marrow is similar to that found in the calcified bone. This paper describes
      radiochemical measurements made on the calcified bone and the associated bone
      marrow from three human femurs. A technique was developed to separate and analyse
      these tissues for the principal naturally-occurring alpha emitter, 210Po. In all
      cases the activity concentration of the calcified bone was greater than that of
      the associated bone marrow. As predicted by the metabolic models used by
      International Commission on Radiological Protection, the majority of the 210Po in
      whole bone was found to be in the calcified region.

PMID- 8469962
TI  - Caesium radioactivity in several selected species of honey.
AB  - In the years following the accident to the nuclear power plant at Chernobyl,
      investigations on several selected species of honey were done to determine their
      134,137Cs contamination. Very low caesium activities were found in flower honeys,
      especially rape honeys. The transfer factor of caesium from the soil to the rape
      plant (Brassica napus var. oleifera) was found to be fCs = 0.116 +/- 0.080 in
      1987, but only fCs = 0.017 +/- 0.017 in 1988, due to the lower availability of
      the caesium by gradual formation of water-insoluble chemical species. Honeydew
      honeys show a slightly higher 134,137Cs contamination. Honeydew is often produced
      by lice setting on spruces. Therefore, needles and twigs of spruces (Picea abies)
      were investigated and relatively high caesium contamination was found in fresh
      needles. A transfer factor for caesium from spruce needles to honeydew honey of
      about 0.1 was estimated. Finally, the caesium contamination in heather honeys and
      heather plants (Calluna vulgaris) was determined. Surprisingly higher factors
      between 2 and 40 were obtained for the caesium transfer from soil to Calluna
      vulgaris. These factors give a good explanation for the relatively high caesium
      contamination of heather honeys.

PMID- 8469963
TI  - No lack of NO activity.

PMID- 8469964
TI  - No lack of NO activity.

PMID- 8469965
TI  - Genome project plans described.

PMID- 8469966
TI  - Early AZT takes a pounding in French-British 'Concorde' trial.

PMID- 8469967
TI  - New AIDS research center to open.

PMID- 8469968
TI  - Ulcers as an infectious disease.

PMID- 8469969
TI  - Evolution. Why some fishes are hotheads.

PMID- 8469970
TI  - Biologists visit New Orleans (under an assumed name)

PMID- 8469971
TI  - Measuring single protein motors at work.

PMID- 8469972
TI  - Electrostatic screening of charge and dipole interactions with the helix
      backbone.
AB  - Electrostatic interactions in proteins are potentially quite strong, but these
      interactions are mitigated by the screening effects of water, ions, and nearby
      protein atoms. The early work of Kirkwood and Westheimer on small organic
      molecules showed that the extent of the screening may depend on whether charged
      or dipolar groups are involved. The dielectric and ionic screening of the
      interactions between the dipolar backbone amide groups of monomeric alpha helices
      and either (i) solvent-exposed charges or (ii) solvent-exposed dipoles at the
      amino terminus was measured. The dielectric screening effects are an order of
      magnitude greater for the backbone-charge interactions than for the backbone
      dipole interactions, and the ionic strength dependence is substantially different
      in the two cases. These results suggest that interactions that involve the
      dipolar groups of proteins may be relatively more important for stability and
      function than is generally thought.

PMID- 8469973
TI  - Impairment of V(D)J recombination in double-strand break repair mutants.
AB  - Cells maintain the integrity of their genome through an intricate network of
      repair systems that recognize and remove lesions from DNA. The only known site
      directed recombination process in vertebrates is the V(D)J recombination of
      lymphocyte antigen receptor genes. A large panel of cell lines deficient in DNA
      repair were tested for the ability to perform V(D)J recombination after
      introduction of the RAG-1 and RAG-2 genes. Two mutants failed to generate normal
      V(D)J recombination, and further analysis provided evidence for two distinct
      nonlymphoid-specific genes that encode factors involved in both DNA repair and
      V(D)J recombination.

PMID- 8469974
TI  - Evolution of endothermy in fish: mapping physiological traits on a molecular
      phylogeny.
AB  - Mackerels, tunas, and billfishes (suborder Scombroidei and Teleostei) provide an
      ideal taxonomic context in which to examine the evolution of endothermy. Multiple
      origins and diverse strategies for endothermy exist among these fish. Here a
      molecular phylogeny of the Scombroidei has been determined by direct sequencing
      of a portion of the mitochondrial cytochrome b gene. The distribution of
      endothermic species within this proposed genealogy indicates that the ability to
      warm the brain and retina arose independently in three lineages, each time in
      association with a movement into colder water. This suggests that the evolution
      of cranial endothermy in fish was selected in order to permit thermal niche
      expansion and not selected for increased aerobic capacity.

PMID- 8469975
TI  - Force of single kinesin molecules measured with optical tweezers.
AB  - Isometric forces generated by single molecules of the mechanochemical enzyme
      kinesin were measured with a laser-induced, single-beam optical gradient trap,
      also known as optical tweezers. For the microspheres used in this study, the
      optical tweezers was spring-like for a radius of 100 nanometers and had a maximum
      force region at a radius of approximately 150 nanometers. With the use of
      biotinylated microtubules and special streptavidin-coated latex microspheres as
      handles, microtubule translocation by single squid kinesin molecules was
      reversibly stalled. The stalled microtubules escaped optical trapping forces of
      1.9 +/- 0.4 piconewtons. The ability to measure force parameters of single
      macromolecules now allows direct testing of molecular models for contractility.

PMID- 8469976
TI  - Decreased expression of myotonin-protein kinase messenger RNA and protein in
      adult form of myotonic dystrophy.
AB  - The myotonic dystrophy mutation has recently been identified; however, the
      molecular mechanism of the disease is still unknown. The sequence of the myotonin
      protein kinase gene was determined, and messenger RNA spliced forms were
      identified in various tissues. Antisera were developed for analytical studies.
      Quantitative reverse transcription-polymerase chain reaction and radioimmunoassay
      were used to demonstrate that decreased levels of the messenger RNA and protein
      expression are associated with the adult form of myotonic dystrophy.

PMID- 8469977
TI  - Women in science.

PMID- 8469978
TI  - Nuclear structure research.

PMID- 8469979
TI  - Clinton's mixed broth for R&D.

PMID- 8469980
TI  - MicroGeneSys: NIH faces down DOD.

PMID- 8469981
TI  - NIH fraudbusters get busted.

PMID- 8469982
TI  - Volcanologists ponder a spate of deaths in the line of duty.

PMID- 8469983
TI  - AIDS research. Keystone's blunt message: 'it's the virus, stupid'.

PMID- 8469984
TI  - Methylation and imprinting: from host defense to gene regulation?

PMID- 8469985
TI  - Monophyletic origins of the metazoa: an evolutionary link with fungi.
AB  - A phylogenetic framework inferred from comparisons of small subunit ribosomal RNA
      sequences describes the evolutionary origin and early branching patterns of the
      kingdom Animalia. Maximum likelihood analyses show the animal lineage is
      monophyletic and includes choanoflagellates. Within the metazoan assemblage, the
      divergence of sponges is followed by the Ctenophora, the Cnidaria plus the
      placozoan Trichoplax adhaerens, and finally by an unresolved polychotomy of
      bilateral animal phyla. From these data, it was inferred that animals and fungi
      share a unique evolutionary history and that their last common ancestor was a
      flagellated protist similar to extant choanoflagellates.

PMID- 8469986
TI  - Transient transfection and expression in the obligate intracellular parasite
      Toxoplasma gondii.
AB  - Toxoplasma gondii is a protozoan pathogen that produces severe disease in humans
      and animals. This obligate intracellular parasite provides an excellent model for
      the study of how such pathogens are able to invade, survive, and replicate
      intracellularly. DNA encoding chloramphenicol acetyltransferase was introduced
      into T. gondii and transiently expressed with the use of three vectors based on
      different Toxoplasma genes. The ability to introduce genes and have them
      efficiently and faithfully expressed is an essential tool for understanding the
      structure-function relation of genes and their products.

PMID- 8469987
TI  - Structure of DNA polymerase I Klenow fragment bound to duplex DNA.
AB  - Klenow fragment of Escherichia coli DNA polymerase I, which was cocrystallized
      with duplex DNA, positioned 11 base pairs of DNA in a groove that lies at right
      angles to the cleft that contains the polymerase active site and is adjacent to
      the 3' to 5' exonuclease domain. When the fragment bound DNA, a region previously
      referred to as the "disordered domain" became more ordered and moved along with
      two helices toward the 3' to 5' exonuclease domain to form the binding groove. A
      single-stranded, 3' extension of three nucleotides bound to the 3' to 5'
      exonuclease active site. Although this cocrystal structure appears to be an
      editing complex, it suggests that the primer strand approaches the catalytic site
      of the polymerase from the direction of the 3' to 5' exonuclease domain and that
      the duplex DNA product may bend to enter the cleft that contains the polymerase
      catalytic site.

PMID- 8469988
TI  - Requirement for tyrosine kinase p56lck for thymic development of transgenic gamma
      delta T cells.
AB  - The Src-related protein tyrosine kinase p56lck is essential for antigen-specific
      signal transduction and thymic maturation of T cells that have an alpha beta T
      cell receptor (TCR), presumably by physical association with CD4 or CD8
      molecules. To evaluate the requirement for p56lck in the development of T cells
      that have gamma delta TCRs, which generally do not express CD4 or CD8, p56lck
      mutant mice were bred with TCR gamma delta transgenic mice. Few peripheral cells
      that carried the transgenes could be detected in p56lck-/- mice, although 70
      percent of thymocytes were transgenic. Development of transgenic gamma delta+
      thymocytes was blocked at an early stage, defined by interleukin-2 receptor alpha
      expression. However, extrathymic development of CD8 alpha alpha+ TCR gamma delta+
      intestinal intraepithelial lymphocytes appeared to be normal. Thus, p56lck is
      crucial for the thymic, but not intestinal, maturation of gamma delta T cells and
      may function in thymic development independently of CD4 or CD8.

PMID- 8469989
TI  - Tumor cell growth arrest caused by subchromosomal transferable DNA fragments from
      chromosome 11.
AB  - A fundamental problem in the identification and isolation of tumor suppressor and
      other growth-inhibiting genes is the loss of power of genetic complementation at
      the subchromosomal level. A direct genetic strategy was developed to isolate
      subchromosomal transferable fragments (STFs) from any chromosome, each containing
      a selectable marker within the human DNA, that could be transferred to any
      mammalian cell. As a test of the method, several overlapping STFs from 11p15 were
      shown to cause in vitro growth arrest of rhabdomyosarcoma cells. This activity
      mapped between the beta-globin and insulin genes.

PMID- 8469990
TI  - Neuronal differentiation rescued by implantation of Weaver granule cell
      precursors into wild-type cerebellar cortex.
AB  - The migration of postmitotic neurons away from compact, germinal zones is a
      critical step in neuronal differentiation in the developing brain. To study the
      molecular signals necessary for cerebellar granule cell migration in situ,
      precursor cells from the neurological mutant mouse weaver, an animal with
      phenotypic defects in migration, were implanted into the external germinal layer
      (EGL) of wild-type cerebellar cortex. In this region, labeled weaver precursor
      cells of the EGL progressed through all stages of granule neuron differentiation,
      including the extension of parallel fibers, migration through the molecular and
      Purkinje cell layers, positioning in the internal granule cell layer, and
      extension of dendrites. Thus, the weaver gene acts nonautonomously in vivo, and
      local cell interactions may induce early steps in neuronal differentiation that
      are required for granule cell migration.

PMID- 8469991
TI  - Socioeconomic forces affecting medicine: times of increased retrenchment and
      accountability.
AB  - Costs of health care are increasing at a rapid rate, but both access to care and
      costs of care have become focal points for current national and local debates.
      Access issues relate not only to those who have no insurance but also to those
      who are underinsured. Cost issues relate most directly to radiology and nuclear
      medicine through their impact on coverage and payment. Increasing scrutiny is
      paid to criteria used for these purposes, and major changes at the federal and
      private level can be expected in the next decade. Finally, the ubiquitous
      development of practice guidelines and their expected use in physician profiles
      will influence the practice of medicine significantly in the future.

PMID- 8469992
TI  - Work force problems in nuclear medicine and possible solutions.
AB  - Nuclear medicine practice and work force demographics reflect the historically
      diverse evolution of this specialty. The most pressing problem for nuclear
      medicine is a projected shortage of fully trained physicians due to practitioner
      retirement that is unmatched by residency program output. During the past decade
      the number of 2-year nuclear medicine residency programs (average of 90) and the
      total number of residents (average of 191 in both years) have remained remarkably
      stable. In contrast, the number of 1-year nuclear radiology residency programs,
      available positions, and residents have declined significantly. A similar decline
      is seen in radiologists obtaining full nuclear medicine training and American
      Board of Nuclear Medicine (ABNM) board certification. This void has been filled
      by nonradiologist trainees who only seek certification by ABNM. Perhaps such
      shifts in resident profile are an early indicator that the United States is
      evolving toward practice models in which nuclear medicine is provided by fully
      trained, full-time physicians, similar to the European work force model. The
      recent Society of Nuclear Medicine survey of 10,446 physicians who practice
      nuclear medicine shows a current practice pattern in the United States that is
      distinctly different from that in Europe. The vast majority of those surveyed
      practice part time. Only 7% of all physicians who practice nuclear medicine do so
      full time, (ie more than 90% of the time), but they account for as much full-time
      employee (FTE) work load as 70% of all part-time physicians. Although the number
      of radiologists entering nuclear medicine is declining, 51% of total FTE work
      load is still done by radiologists with only American Board of Radiology
      certification. Physicians certified by ABNM represent 42% of all FTE work load.
      Cardiologists certified by American Board of Internal Medicine-Cardiovascular
      Specialization account for approximately 4% of nuclear medicine (15% of total
      cardiovascular nuclear medicine) FTE work load. Work force shortage of nuclear
      medicine technologists remains a chronic problem in spite of extensive study:
      however, recent predictions suggest some improvement in the future. Solutions to
      work force problems facing nuclear medicine will require ongoing data surveys,
      aggressive recruitment of trainees, expansion of training positions, and
      socioeconomic initiatives that promote desirable future practice models.

PMID- 8469993
TI  - Nuclear medicine in private practice.
AB  - The private practice of nuclear medicine has evolved over the past decade.
      Federal and state regulatory agencies, reduction in reimbursement, and a shortage
      of qualified physicians and technologists will affect the practice of nuclear
      medicine in the 1990s and beyond. Only by being proactive and able to provide
      credible clinical information to our referring physicians can nuclear medicine
      position itself for the next decade. We must continue to educate referring
      physicians about the cost-effectiveness and functional and physiological nature
      of nuclear medicine. We need to encourage medical students and physicians in
      training to consider nuclear medicine as a career path, and we need to provide
      meaningful clinical information to our referral base. In addition to these
      challenges, we should also remember that nuclear medicine cannot survive in a
      vacuum. We must support our professional societies and have ongoing
      representation at all levels of government. Membership in the American Medical
      Association, the Society of Nuclear Medicine, the American College of Nuclear
      Physicians, the American College of Radiology, and the Radiological Society of
      North America all help strengthen our voice at the state and national levels. We
      must continue to effectively present our specialty's positions to the various
      state and federal agencies that regulate our practice. We must demand high
      quality studies from our peers and continue to be advocates for our patients.

PMID- 8469994
TI  - The potential impact of the resource-based relative value scale on the practice
      of nuclear medicine.
AB  - The Resource-Based Relative Value Scale (RBRVS) is finally here. A system
      designed to equate physician work across the specialties, it has its own peculiar
      and unique problems. Modeling of the system was based on the single physician
      patient interaction; it may not work properly for laboratory specialties. There
      are other unique considerations concerning how the model was constructed.
      Although data were collected specifically for nuclear medicine, they were not
      used in the final computations. There is disagreement over whether those data
      would benefit or hurt nuclear medicine reimbursement. As presently implemented,
      the RBRVS poses grave dangers for the future of nuclear medicine. These dangers
      come not only in the professional reimbursement section of the rules but in the
      technical component areas as well. Estimates for reduction of income by 1996
      range as high as 55% for nuclear medicine. When one factors the implementation of
      the RBRVS by independent insurance carriers into the equation, the entire
      economic future becomes muddy. A brief historical review of the RBRVS, as well as
      discussion of potential future implications of this type of reimbursement system,
      is presented. Prognostication is at least as inexact a science as reimbursement.
      Hopefully, the author's outlook on the future of nuclear medicine is more
      pessimistic than it need be.

PMID- 8469995
TI  - Current procedural terminology coding of nuclear medicine procedures.
AB  - The future of nuclear medicine is dependent on payment for new procedures. Today,
      the basis of payment by the federal government is a relative value unit (RVU)
      system; the RVUS employed in this system are for medical services and procedures
      listed and described in Physicians' Current Procedural Terminology, fourth
      edition. Current procedural terminology (CPT) is maintained by the AMA; annual
      revisions include adding new codes or revised or deleted old codes. This process
      involves all national medical specialty societies. Starting in 1992 a new
      process, the Relative Updating Committee, which was initiated by the AMA,
      organized medicine to formalize a method for recommending relative values for
      physician procedures and services. In this rapidly changing scenario, all nuclear
      medicine procedure codes are under review by the coding and nomenclature
      committees of the medical societies interested in imaging. Significant CPT
      changes and additions were made in the cardiovascular nuclear medicine codes in
      1992, reflecting the current imaging protocols and pharmacological agents for
      performing cardiac stress testing and new codes that recognize combinations of
      ventricular function measurements in patients undergoing myocardial perfusion
      imaging with technetium-99m agents.

PMID- 8469996
TI  - The practice of nuclear medicine in common market countries.
AB  - There is no politically structured European policy on nuclear medicine, and there
      are significant discrepancies between the various member states. It is hard to
      guess whether competing imaging modalities will slow down the process of
      development that took place in underequipped countries. But it appears likely
      that with the free circulation of professionals between European Community
      countries, free competition will stimulate these countries toward major
      development in nuclear medicine.

PMID- 8469997
TI  - Renal clearance determination with one blood sample: improved accuracy and
      universal applicability by a new calculation principle.
AB  - A sufficiently accurate quantification of renal function requiring only one
      plasma sample without an additional gamma camera study has until now only been
      possible in adults. A new principle has been developed that allows the universal
      application of known algorithms, irrespective of the clearance substance used, by
      normalizing the plasma concentrations with respect to individual body dimensions
      of adult as well as infant patients. In this respect, algorithms are established
      for clearance determinations using technetium-99m mercaptoacetyltriglycine which
      are based on steady-state studies as the reference. They allow the calculation of
      quantitative clearance values in infants and require the drawing of only one
      blood sample at any time between 25 and 40 minutes postinjection. The comparison
      with a combined-camera/two-plasma-sample technique performed in 46 children
      ranging in age from 9 days to 14 years (mean, 6.05 years) resulted in a standard
      deviation of 8.5% from the line of identity (r = 0.94). Moreover, this procedure
      also increases accuracy in adult patients, especially those with impaired renal
      function.

PMID- 8469998
TI  - Cost-effectiveness in nuclear medicine.
AB  - There are many pressures on nuclear medicine physicians to keep costs down and to
      produce the most efficacious results for the money spent. A procedure is cost
      effective if its benefits (correct diagnosis, effective treatment, etc.) are
      worth the additional costs (money, radiation dose, etc.). The benefits of
      diagnostic procedures are measured by test performance (diagnostic efficacy
      [efficacy-D]), which in turn depends on a specific task: detection,
      classification, localization, or quantitation. For the detection task, measures
      of test performance include sensitivity, specificity, predictive value, accuracy,
      diagnostic utility, posttest versus pretest disease probability, area under a
      receiver operating characteristic (ROC) curve, and others. Standard measures of
      test performance in the classification, localization, and quantitation tasks have
      not yet been developed. Efficacy-M (management efficacy) is a measure of the
      extent to which a procedure influences patient management appropriately. Efficacy
      O (outcome efficacy) is a measure of the success of therapeutic procedures. Some
      publications illustrating these points are presented. Costs associated with
      nuclear medicine procedures include money, time, discomfort, possible drug
      reactions, radiation dose, and the hypothetical risk of radiation-associated
      cancer. The public's perception of these latter risks, or costs, is much higher
      than our knowledge would justify. Decision trees are useful for laying out all
      possible strategies, outcomes, costs, and benefits, and estimating the cost
      effectiveness of each strategy. Some articles estimating cost-effectiveness in
      nuclear medicine are reviewed, although few articles in the literature make any
      detailed use of decision analysis. Much work remains to be done in forming a
      coherent, consistent procedure for assessing cost-effectiveness in nuclear
      medicine.

PMID- 8469999
TI  - Anterior correction of idiopathic scoliosis using TSRH instrumentation.
AB  - The first 14 consecutive patients with idiopathic lumbar scoliosis treated by
      anterior Texas Scottish Rite Hospital (TSRH) instrumentation are reported.
      Frontal curve correction averaged 76%, with a 5 degrees (9%) loss of correction
      in the follow-up period, which averaged 17.6 months (range, 12-29). Spinal
      balance was improved an average of 1.8 cm toward the center sacral line, and
      apical vertebral rotation was corrected an average of 49%. Instrumentational
      kyphosis was minimal, with total L1-S1 lordosis decreasing an average of 1
      degree, and no measured compensatory hyperlordosis caudal to the instrumented
      segment. One hundred percent of disc spaces were radiographically fused by 8
      months. There were no neurologic, septic, or implant complications. The contoured
      solid rod used in this construct provides the same frontal and rotatory
      correction as previous systems, and minimizes instrumentational kyphosis. Fusion
      occurs rapidly and reliably because of the stiffness of the construct, which also
      may eliminate the need for postoperative immobilization.

PMID- 8470000
TI  - Anterior spinal fusion with Zielke instrumentation for idiopathic scoliosis. A
      frontal and sagittal curve analysis in 36 patients.
AB  - The authors have reviewed the records of 36 patients with idiopathic scoliosis
      who underwent a single-stage anterior spinal fusion with Zielke instrumentation
      to determine if any adverse frontal or secondary sagittal deformities or changes
      in balance resulted from the surgery. Spontaneous correction of uninstrumented
      thoracic curves was noted in five patients with double-major curves, and frontal
      balance was maintained or improved after operation in all but four patients.
      Kyphosis was increased in the instrumented segments in all patients. In the
      uninstrumented segments, however, thoracic kyphosis and lumbar lordosis were
      decreased in all but five patients after operation, whereas overall sagittal
      balance was not adversely affected by the surgery in any patient.

PMID- 8470001
TI  - Cotrel-Dubousset instrumentation. Results in 52 patients.
AB  - Fifty-two posterior spinal fusions were performed for pediatric idiopathic,
      congenital, and neuromuscular scoliotic curves. Cotrel-Dubousset instrumentation
      was used in all patients. Nine had prior anterior spinal releases and fusions.
      The patterns were mixed, with a predominance of right thoracic curvatures. The
      average preoperative curve measured 60.6 degrees, with correction to 29. Seven
      patients required revision surgery, and 17 wore orthoses after operation. There
      were 17 complications in this group, including hook pullout, prominent hardware,
      infection, pseudarthrosis, and two cases of broken Cotrel-Dubousset
      instrumentation rods. Fatigue failure of this instrumentation, secondary to
      pseudarthrosis, has not been reported previously, and these two cases are
      presented in detail. The operative morbidity and difficulty were increased in the
      larger idiopathic curves and in neuromuscular and congenital scoliosis. Cotrel
      Dubousset instrumentation is an overall excellent tool for the multiplanar
      correction of scoliosis and is amenable to revision surgery.

PMID- 8470002
TI  - Long-term results of Boston brace treatment on vertebral rotation in idiopathic
      scoliosis.
AB  - The long-term effect of Boston brace treatment was investigated by computed
      tomography measurements before treatment, after bracing, and at mean follow-up at
      8.5 years in 25 patients with idiopathic scoliosis. At follow-up, the
      pretreatment Cobb angle, the vertebral rotation, the rib hump, and the
      translation of the apical vertebra were not significantly changed. The sagittal
      diameter of the thoracic cage was significantly decreased at follow-up. The
      current study demonstrates that the Boston brace does not improve, but prevents
      progression of vertebral rotation, translation, rib hump, and Cobb angle in
      idiopathic scoliosis. The reduced sagittal diameter is noteworthy and may be of
      importance for cosmesis and pulmonary function.

PMID- 8470003
TI  - External electrical stimulation and bracing for treatment of spondylolysis. A
      case report.
AB  - Evidence indicates that osseous healing of acute spondylolysis can occur without
      surgery, although no existing data supports a particular regimen that optimizes
      healing. This article presents a case study of a 17-year-old athletic male
      student who presented with acute spondylolysis and who was treated with
      intermittent bracing and daily external electric stimulation. The patient was
      treated with a thoracic lumbar sacral orthosis to which an external bone growth
      stimulator was added. Computer tomography scans performed throughout the
      treatment process and described in this report illustrate the progressive healing
      of the right and left pars fractures.

PMID- 8470004
TI  - Modified repair of a defect in spondylolysis or minimal spondylolisthesis by
      pedicle screw, segmental wire fixation, and bone grafting.
AB  - A surgical technique for treatment of spondylolysis or minimal isthmic
      spondylolisthesis is described. The authors based their treatment on the Scott
      technique, which involves placing an 18-gauge stainless steel wire around the
      transverse process bilaterally and then tightening the wires to each other
      inferiorly to the posterior spinal process. The modified technique consists of a
      tension band wire around the posterior spinous process and a 4.5 mm AO cortical
      screw in the pedicle. A case study of a 20-year old female athletic student is
      presented to illustrate the effectiveness of the modified technique. The authors
      believe that this technique offers the advantages of maintaining all motion
      segments and avoiding the risks of damaging the exciting nerve root just beneath
      the transverse process.

PMID- 8470005
TI  - Translaminar facet screw fixation in lumbar spine fusion.
AB  - This study evaluates the clinical result and fusion rate in 61 patients who
      underwent posterolateral spine fusions augmented with translaminar facet screw
      fixation at an average of 24 months after surgery. Sixty patients (98.4%) were
      judged to have a solid fusion by radiographic examination at an average of 5
      months. Fifty-seven patients (93.4%) rated the result of their surgery as good to
      excellent; four patients (6.6%) rated their result as unsatisfactory. There were
      no patients with nerve root injury or other neurologic deficit. The 98.4% fusion
      rate compares favorably with other methods. The results of this study support the
      continued use of translaminar facet screw fixation to augment posterolateral
      fusion in the lumbar spine.

PMID- 8470006
TI  - Posterior instrumentation and fusion for unstable fractures and fracture
      dislocations of the thoracic and lumbar spine. A comparative study of three
      fixation devices in 70 patients.
AB  - Acute unstable thoracic and lumbar spine fractures were treated with either
      Harrington rods and hooks, Luque rods with sublaminar wires, or A-O dynamic
      compression plates with pedicle screws. The results demonstrated failure of all
      three techniques to maintain the sagittal plane correction at 12 months' follow
      up. Furthermore, in lumbar fractures, Harrington rods did not restore or maintain
      sagittal plane alignment as well as Luque rods or pedicle screws and plates.
      Lastly, the pedicle screw fixation system required a shorter segment fusion.

PMID- 8470007
TI  - Anterior transpedicular fixation of the lower thoracic and lumbar spine.
      Experimental verification using a new direction finder.
AB  - Currently, no anterior spinal implant provides a strong bone-screw interface
      because of the cancellous characteristics of the vertebral body. A more secure
      anchorage could be obtained by anterior transpedicular screw fixation. Four
      hundred transpedicular screws located between T7 and L5 were placed using the
      newly developed direction finder. Measurements were obtained directly from
      radiographs of the cadaveric specimens. In 10 cases (2.5%), the screws crossed
      the medial pedicle border, but never by more than 1.4 mm. A lateral protrusion
      was noted in another 41 screws (10%), with no protrusion greater than 2.2 mm.
      Encroachments beyond the superior or inferior border were not observed. The mean
      angle of the screws at each level measured between 7 and 19 in the transverse
      plane and between 2 and 4.5 in the sagittal plane. This technique should be
      reserved for vertebrae without significant arthritic changes. The rare screw with
      minimal infraction through the medial or lateral pedicle wall should not cause
      any vascular or neural compromise. The anterior transpedicular screw technique
      appeared relatively safe (88%) and encouraged the development of the new plate
      system for anterior spinal stabilization.

PMID- 8470008
TI  - Cotrel-Dubousset rods in surgical stabilization of spinal fractures.
AB  - Cotrel-Dubousset instrumentation (CDI) was used to stabilize thoracolumbar
      fractures in 48 consecutive patients at the Lucerne Spinal Center. The results of
      these patients were reviewed with respect to completion of healing, change in
      neurologic status, medical or hardware complications, and follow-up radiographic
      parameters. Twenty patients were braced and 28 were not braced after operation,
      depending on certain criteria. Two elderly patients died at 1 and 6 months after
      their injury, of medical complications. One other patient was lost to follow-up
      after 6 months. Of the remaining 45 patients, all were evaluated at follow-up
      ranging from 12 to 47 months (mean, 21 months). Forty-two of the 45 patients
      (93%) developed a solid stable fusion with the initial procedure. Ten patients of
      45 required additional surgical procedures for a complication rate of 22%, as
      follows: there were two early hardware failures requiring revision and one late
      failure that did not require revision. Five patients required late rod removal
      because of pain. One patient required late syrinx drainage without removal of
      hardware, and another adolescent patient required extension of her fusion because
      of late scoliosis development below the injury site. There were no infections or
      neurologic complications. Cotrel-Dubousset instrumentation rods have been found
      to be an excellent device for thoracolumbar fracture stabilization.

PMID- 8470009
TI  - Residual intersegmental spinal mobility following limited pedicle fixation of
      thoracolumbar spine fractures with the fixateur interne.
AB  - The Fixateur Interne has been proposed for limited pedicle fixation of
      thoracolumbar spine fractures with the assumption that motion in the
      nontraumatized spinal segments could be maintained. To date, no data exist that
      both localize and quantitate spinal mobility about the fractured vertebra.
      Voluntary maximum lateral flexion and extension radiographs were obtained on
      patients with unstable thoracolumbar spine fractures at a minimum of 2 years
      after Fixateur Interne instrumentation (implant was removed after 1 year).
      Residual intersegmental motion was measured at levels adjacent to both the
      vertebra fracture and the fixation. Fifty-nine patients were reviewed, and the
      posterior vertebral body angle demonstrated a mean total sagittal motion of 2.98
      degrees. Cephalad and caudal to the fractured vertebra, a mean of 1.34 degrees
      and 3.08 degrees, respectively, of residual motion was noted; cephalad and caudal
      to the previously instrumented segment a mean of 3.22 degrees and 6.88 degrees,
      respectively, was measured. The authors conclude that residual mobility is most
      evident at the caudal end of the instrumented segment, removed from the fractured
      vertebra. The level with end plate disruption becomes essentially ankylosed, with
      or without a fusion.

PMID- 8470010
TI  - Review of Harrington rod treatment of spinal trauma.
AB  - Harrington rod treatment for spinal trauma has become the gold standard against
      which other treatment modalities are judged. A review of the results of
      Harrington rod treatment is essential to establish a baseline level of efficiency
      in terms of rehabilitation time, correction of deformity, canal decompression,
      motion segment loss, and device-related complications. With economic concerns
      becoming more important in medical treatment, the value of newer techniques must
      be clearly superior to established methods. Harrington rod-augmented spine fusion
      is reliable and cost-effective in the thoracic and thoracolumbar spine. The risks
      of rod failure and late complications related to lost motion segments in the
      lumbar spine make pedicle screw systems a better option in this region.

PMID- 8470011
TI  - Late infection of spinal instrumentation by hematogenous seeding.
AB  - Six cases of late spinal infection following instrumentation are described. In
      all cases, there was a delay of at least 10 months between surgery and the
      clinical development of sepsis. In 5 of the 6 cases, a distant focus of infection
      could be identified. Two patients had active intravenous drug usage, two patients
      were paraplegic with neurogenic bladders, and one patient had an episode of
      pyelonephritis secondary to renal calculi two months prior to presentation. In no
      instance was there any preceding breakdown of overlying skin. This previously
      unreported phenomenon is an extremely rare but major complication of spinal
      surgery.

PMID- 8470012
TI  - The selection of wires for sublaminar fixation.
AB  - The authors report a comparative biomechanical study of the suitability of four
      types of stainless steel wire for sublaminar fixation. Tensile and fatigue tests
      were performed on wires in the configuration used at surgery. They conclude that
      annealed 18-gauge (1.2 mm) wire should be used at each end of a scoliosis fusion,
      at the upper end of a lumbar fusion, and throughout for thoracolumbar fractures.
      Cold-worked 20-gauge (0.87 mm) wire may be used in all other situations, but the
      use of annealed 20-gauge wire should be restricted to the cervical spine. The
      authors emphasize the importance of achieving the correct balance between wire
      stiffness and flexibility, of care in the handling of wires, and of proper
      technique in achieving secure fixation.

PMID- 8470013
TI  - Kinematics of the lumbar spine following pedicle screw plate fixation.
AB  - This investigation was conducted to determine the kinematic response of the
      lumbar spine instrumented with transpedicular screws and plates. Seven unembalmed
      human cadaveric lumbar spines were used. Retroreflective targets were inserted
      into the bony landmarks of each vertebral body, facet column, and spinous
      process. The specimen was quasistatically loaded until failure (initial cycle)
      using an electrohydraulic testing device at a rate of 2.5 mm/sec. After
      radiography, the specimen was again loaded (injury cycle) to the failure
      compression determined in the previous cycle. Transpedicular screws then were
      inserted bilaterally at one level proximal and distal to injury. The stabilized
      cycle of loading was conducted using the procedure adopted in the injury cycle.
      Comparative analysis of the localized kinematic data between the stabilized and
      injured columns indicated a reduction in motion between fixated levels,
      increasing the rigidity of the column. At levels proximal and distal to fixation,
      however, motion increased, indicating added flexibility. These alterations in the
      motion, observed during single-cycle loading, may be further accentuated in vivo,
      leading to hypermobility and degeneration of the spine.

PMID- 8470014
TI  - Anterior spinal fixators. A biomechanical in vitro study.
AB  - In vitro calf spine testing was performed in flexion, rotation, and axial load,
      using a vertebral body corpectomy and anterior iliac crest bone grafting model.
      Anterior spinal fixation devices then were sequentially tested, and axial
      stiffness, torsional stiffness, and flexural strain determined. The constructs
      tested were the Contoured Anterior Spinal Plate (CASP), the Kaneda device, the
      Kostuik-Harrington device (KH), and the Texas Scottish Rite Hospital (TSRH)
      vertebral body screw construct. In torsion, the Kaneda device returned spinal
      stability to that of the intact spine. The Kostuik-Harrington device was unstable
      in torsion. In axial loading and flexion, the Kaneda device and the TSRH
      construct proved the most stiff, with the KH and CASP systems significantly lower
      in stiffness. The authors believe that the Kaneda device and the TSRH vertebral
      body screw construct are effective in restoring acute stability to the lumbar
      spine after corpectomy.

PMID- 8470015
TI  - Somatosensory evoked potential monitoring during Cotrel-Dubousset
      instrumentation. Report of a case.
AB  - Somatosensory evoked potentials produced by electrical stimulation of the
      posterior tibial nerve were recorded from surface electrodes at the scalp and
      cervical spine of a patient with scoliosis undergoing posterior spinal fusion
      with Cotrel-Dubousset instrumentation. During spinal derotation when hypotension
      and anemia were also present, the cortical and subcortical somatosensory evoked
      potentials disappeared. During a wake-up test, the patient demonstrated weakness
      of the left lower extremity, and derotation was stopped. The patient was given
      pharmacologic hypertensive agents and blood transfusions to increase blood
      pressure. Forty minutes later, somatosensory evoked potentials returned and a
      second wake-up test demonstrated normal function in both lower extremities. This
      report demonstrates the accuracy and usefulness of somatosensory evoked potential
      monitoring during spinal fusion with Cotrel-Dubousset instrumentation. To the
      authors knowledge, this is the first report demonstrating a correlation between
      abnormal SEP responses and intraoperative neurologic deficit during the
      derotation maneuver with Cotrel-Dubousset instrumentation and corrected by
      transfusion and restoration of normotension.

PMID- 8470016
TI  - Esophageal penetration by an anterior cervical fixation device. A case report.
AB  - Esophageal complications following anterior cervical fusion procedures have been
      reported in the literature as rare complications of such surgery. The
      complications associated with esophageal penetration have ranged from minor
      complications to mediastinitis and death. The following case report is of a rare
      complication of penetration of the esophagus by an anterior cervical fixation
      device that resulted in a benign post-operative course.

PMID- 8470017
TI  - [Project for establishing medico-pharmaceutical uniformity throughout the
      Republic. 1879].

PMID- 8470018
TI  - [Effectiveness of a carbamate insecticide as a household low-volume spray for
      malaria control].
AB  - A comparative regional-scale evaluation of the epidemiological impact of low
      volume (LV) spray of bendiocarb and the conventional spray of DDT against malaria
      in an endemic area of northern Chiapas was carried out. Three Anopheline species
      were found: Anopheles pseudopunctipennis, An. albinanus and An. argyritarsis. The
      most prevalent was An. pseudopunctipennis, a species we suspect may be involved
      in the transmission of most malaria cases. This species showed high levels of
      resistance to DDT. However, this insecticide had a long residual effect in wall
      bioassays, with mortalities > or = 95 per cent for up to 21 weeks in wood, sticks
      and plaster. Susceptibility to bendiocarb was total, and mortality to LV
      bendiocarb was > or = 75 per cent for up to 16 weeks in wood, sticks and straw.
      Very low numbers of mosquitoes were found throughout the evaluation, although
      malaria transmission continued in control villages (sprayed with DDT), as well as
      treated villages (sprayed with LV bendiocarb). No plasmodium infected mosquitoes
      were found, perhaps due to a very small sample size. The LV spray methodology was
      found to be 1.7 times more effective than conventional spraying in reducing
      malaria incidence. A net reduction of 1.6 times in insecticide application time
      was also found, which would allow spraying at the right time, especially when
      urgent control measures have to be applied, such as in malaria outbreaks.
      Finally, the new methodology costs 2.2 times more than the conventional ddt
      spraying, but if the potential of using spray workers in other activities is
      considered, costs would be comparable to those of DDT spraying.

PMID- 8470019
TI  - [Perspectives on cholera vaccines].
AB  - Perspectives of cholera vaccines with emphasis in their possible usage in Latin
      American countries are discussed. Microbiology, antigenicity, relevant aspects of
      traditional serology, protective immune responses and epidemiological data up to
      December, 1991, are presented. Indications of parenteral vaccines are discussed.
      Finally, perspectives of usage of cholera vaccines in Latin America are analyzed.

PMID- 8470020
TI  - [Hemorrhagic fever and the dengue shock syndrome].
AB  - Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) are the severe
      and/or fatal clinical manifestations of dengue fever. Epidemics of DHF/DSS occur
      mainly in the southeast Asian countries where children are seriously affected and
      high case-fatality ratio is annually reported. Recently significant epidemics of
      DHF/DSS have been reported in Cuba, Venezuela and Brazil, which means that
      reinforcements of the epidemiological surveillance in the countries of the
      American region that show high virus transmission, are urgently needed. The main
      purpose of the present article is to review relevant information regarding the
      clinical manifestations, pathology, diagnostic procedures, treatment of cases,
      pathophysiologic mechanisms and some data related with specific DHF/DSS
      epidemics.

PMID- 8470021
TI  - [Detection of antibodies against Trypanosoma cruzi in blood donors].
AB  - American trypanosomiasis is an endemic disease in Mexico. Blood transfusion has
      been recognized as the second main mechanism of transmission in South American
      countries. There is no definitive information available for Mexico. We obtained
      the prevalence of IgG antibodies against Trypanosoma cruzi among 1076 blood
      donors at the Instituto Nacional de Cardiologia "Ignacio Chavez" in Mexico City.
      We used an antigen freshly prepared from local isolates, and the complete and
      soluble antigen preparations were analyzed with the Western blot technique using
      sera previously characterized as reactive. Blood donors' antibodies were studied
      with DOT-ELISA and Western blot. All donors were asked in regard to place of
      birth, and blood samples were serologically tested as usual in transfusion
      practice. The presence of IgG antibodies to T. cruzi, confirmed with a high
      specificity test, showed a prevalence of 0.28 per cent. Screening for antibodies
      to T. cruzi; should be included in the evaluation of blood donors in Mexico.

PMID- 8470022
TI  - [Reproductive risk factors and uterine cervix cancer in Mexico City].
AB  - An epidemiological case control study nested in the Early Cancer Detection
      program of the Health Ministry in Mexico City was carried out to evaluate the
      principal reproductive risk factors associated with uterine cervix cancer.
      Information from 12,741 gynecological cytologies reported to the National Cancer
      Registry, during the period between January 2 to March 31, 1987 was studied. In
      this population group the most important reproductive risk factors associated
      with uterine cervix cancer were: multiple births (seven or more births, OR =
      3.24, IC 95% = 2.20-4.76), initiation of active sex life before 14 years (OR =
      1.53, 95% IC = 1.13-2.08) and late menarche (in the group with menarche after 17
      year of ages OR = 3.22, 95% IC = 1.06-9.77). In relation to the Early Cancer
      Detection program, an important number of women made use of the program when they
      showed symptoms. The prevalence among women who had at least one symptom was
      43.09 per cent. Women with a tumor at the cervical level at the time of the
      cytology were 7.76 times more likely to have of uterine cervix cancer (95% IC =
      4.84-13.15). Symptoms such as dysfunctional bleeding (OR 2.79, IC 95% = 1.90
      4.12), metrorrhagia (OR 2.66, 95% IC 1.83-3.86) and bloody leukorrhea (OR 2.64,
      95% IC 2.05-3.38) can be relevant findings in women at high risk. The
      attributable fraction of higher exposure in the presence of gynecological signs
      and symptoms is the cervical tumor, with 87.46 per cent.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8470023
TI  - [Midwives' perception of reproductive risk factors].
AB  - Midwives in rural areas of the State of Morelos are one of the most important
      resources used by rural women for health care of pregnancy, delivery and the
      puerperium. This work was aimed at identifying midwives perceptions of pregnant
      women's risk factors, in order to include this knowledge in reproductive health
      programs which articulate institutional and traditional health systems. We
      applied a questionnaire to all midwives in the Municipalities of Ocuituco,
      yecapixtla and Zacualpan, Morelos (n = 35). Four key informants were selected and
      interviewed. These instruments enabled us to measure variability in perception of
      risk factors. Knowledge of risk factors is defective among midwives. Previous
      training made a big difference. Sixty three per cent of midwives who attended
      training courses are better qualified from an academic medicine point of view.
      Only 28.7 per cent of non-trained midwives (43% for both groups), indicating that
      sociocultural aspects prevail over technical training in midwives perceptions of
      reproductive risk factors.

PMID- 8470024
TI  - [Training of epidemiology personnel in Cuba].
AB  - We describe the academic characteristics of the Master of Epidemiology Program
      taught at the Instituto de Medicina Tropical "Pedro Kouri", in La Habana, Cuba.
      We provide a description of the structure of the course along with its didactical
      principles, the main objectives of the different academic modules and the number
      and background of graduates from seven Classes. We also discuss potential work
      areas for graduates and short-term perspectives for their continuing education.

PMID- 8470025
TI  - [Priorities of progress in evaluating and monitoring quality of care].
AB  - This paper discusses the following priorities: redefining and widening the scope
      of assessment, redefining assessment methods, redesigning and evaluating quality
      assurance systems, promoting consumer participation, professionalizing quality
      assurance, and creating a supportive culture. The article proposes empirical
      assessment of quality assurance methods as the highest priority. It concludes
      with the idea that seeking quality is the ethical dimension of professional life.
      Therefore, all reasonable efforts towards monitoring quality will be successful.
      Without this, the cleverest monitoring systems will fact.

PMID- 8470026
TI  - [3D reconstruction of CT data sets. A methodologic comparison].

PMID- 8470027
TI  - [The clinical application of MR angiography in aortic diseases].

PMID- 8470028
TI  - [The place of MR venography in the diagnosis of deep leg and lower limb venous
      thrombosis].

PMID- 8470029
TI  - [Color Doppler sonography of superficially situated malignant tumors].

PMID- 8470030
TI  - [Epidemiological data on chronic myeloid leukemia in Asturias, 1972-1986].
AB  - PURPOSE: To evaluate the incidence of CML in Asturias during the period 1972
      1986, studying the variations in relation to age, sex and geographical zone.
      MATERIAL AND METHODS: Information relating to the date of diagnosis, name, age,
      sex and home address of the 108 cases (65 men and 43 women) diagnosed CML during
      the period 1972-1986 according to conventional criteria was collected from the
      hospital records of the region. For the calculations, SADEI demographic data were
      taken as a reference, comparing the incidence between sexes and geographical
      zones by means of the CHI2. RESULTS: A rate of incidence of 0.64/100,000
      inhabitants/year was obtained, this being 0.8 in men and 0.5 in women (p < 0.05).
      The rate of incidence increased progressively with age until the 45-59 age group
      when it was maximum. There were no differences between the three main centres of
      population Gijon (0.53), Oviedo (0.55) and Aviles (0.69) nor the latter with the
      rest of the zones in Asturias; nor was three either any difference between
      coastal towns (0.56) and those of the interior (0.71) (p = NS). CONCLUSIONS:
      Limited incidence of CML in Asturias without significant differences in its
      geographical distribution within the region. The incidence, which was higher
      among males, increased progressively with age until reaching maximum importance
      in the 45-59 age group.

PMID- 8470031
TI  - [Allogeneic bone marrow transplantation in children with acute lymphoblastic
      leukemia].
AB  - PURPOSE: Long disease-free survival can be achieved with chemotherapy in over 50%
      of children with acute lymphoblastic leukaemia (ALL). However, those children
      suffering relapse or presenting with poor-risk features at diagnosis have scarce
      possibility of doing well with conventional chemotherapy. Bone marrow
      transplantation (BMT) is a good choice in such cases. MATERIAL AND METHODS:
      Between July 1985 and January 1992, twenty-four children with ALL underwent BMT
      in the Service of Pediatrics of the Hospital Ramon y Cajal. In seven patient with
      poor-risk criteria at diagnosis BMT was performed in the first complete remission
      (CR) and in seventeen cases it was performed after the second CR. The
      conditioning for transplantation consisted of cyclophosphamide plus total body
      irradiation in 21 patients and cyclophosphamide plus busulphan in 3 others.
      RESULTS: Fifteen patients persist in CR with post-transplant follow-up of 3 to 73
      months (median, 31 months). Five patients died due to complications of the
      transplantation techniques, and four others died upon leukaemic relapse. The
      probability of disease-free survival for all cases is 61%, a plateau being
      reached at 13 months (83% and 52% for BMT in first or second CR, respectively).
      CONCLUSIONS: These findings confirm the efficacy of BMT in the treatment of
      children with ALL in second CR, or in first CR when there are very poor risk
      criteria at diagnosis.

PMID- 8470032
TI  - [Comparative study of 1st generation versus 2d generation (CAVPE) combinations in
      intermediate and high-grade lymphomas].
AB  - PURPOSE: To compare four first generation chemotherapy regimes (FGR) used by
      GATLA in low and intermediate grade lymphomas. Versus a second generation regimen
      called CAVPE. PATIENTS AND METHODS: A group of 205 patients treated with FGR (79
      with BACOP, 89 with COPP, 19 with CHOP, and 18 with CNOP), and 244 others treated
      with the combination of cyclophosphamide, doxorubicin, vincristine, prednisone
      and etoposide (CAVPE) were included. Two randomized phase III multicentric
      studies, COPP vs BACOPP and CHOP vs CNOP, as a whole group, were compared with
      the second generation scheme, CAVPE. All the patients with FGR received 6 monthly
      treatment courses, and the CAVPE patients were given 8 monthly courses. RESULTS:
      The median age was 55 years (18-85) for the FGR group and 51 years (15-79) for
      the CAVPE group. The stage distribution for both FGR and CAVPE groups was,
      respectively, as follows: II: 38 and 55 cases; III 80 and 84 cases; IV: 87 and
      105 cases. No significant differences were found between both groups when
      comparing other characteristics of the patients, namely, sex, symptoms,
      mediastinal, abdominal or extranodal involvement, liver, spleen or bone-marrow
      infiltration, and bulky tumoural mass. The percentage of complete remission (CR)
      was 52% (107/205) in the patients treated with FGR, and 67% (163/244) in the
      CAVPE group (p < 0.001). The estimated probability of sustained first CR at 72
      months was 38% for the FGR group and 54% for the CAVPE group (p = 0.0167),
      whereas 17% and 36%, respectively, of the evaluable patients were alive and well,
      with no signs of disease progression (p = 0.000). The 72-month survival was
      estimated in 32% and 51%, respectively, for each group (p = 0.0004). CONCLUSIONS:
      1. CAVPE seems to offer better responses and disease-free survival in this non
      selected group of low and intermediate lymphoma patients. 2. The better results
      in terms of CR and lower incidence of relapses attained with CAVPE with regard to
      FGR are probably related with a number of facts, such as the use of more
      aggressive drugs, higher doses, a better drug combination rationale, the
      inclusion of new drugs, such as etoposide, or a selection of the patients.

PMID- 8470033
TI  - [Treatment of acute lymphoid leukemia (ALL) in the child].
AB  - PURPOSE: To analyse the results of the therapy administered to children with ALL
      in Cuba. PATIENTS AND METHODS: Four-hundred and twenty-five children (aged below
      15 years), diagnosed of ALL in 8 different Cuban hospitals between 1973 and 1991,
      were evaluated. Five different therapeutic regimes were used: three "classic"
      GLATHEM protocols in the first period (1973-1981) and two intensive BFM-like
      protocols in the second period (1982-1991). The Kaplan-Meier method was applied
      for survival analysis, and the differences were evaluated by the log-rank and
      Mantel-Cox methods. RESULTS: Two-hundred and sixty-five patients were included in
      the first period, 81 with low-risk disease, 133 with standard risk and 51 with
      poor-risk leukaemia. The second period comprised 160 cases, 50 of low-risk, 83
      with standard risk and 27 with poor-risk leukaemia. The disease-free survival
      probability at 60 months was 35% for the first group and 55% for the second (p <
      0.0001). The 60-month survival (SV) as a whole was 45% for the "classic"
      treatments and 60% for the BFM-like protocols (p < 0.01). The disease-free
      survival (DFS) probability for each prognostic group was as follows: 50% for low
      risk, 43% for standard risk, and 25% for poor-risk (p < 0.001) and the
      probability of survival as a whole was, respectively, 65%, 49% and 28% (p <
      0.001). as for this compilation, 172 patients were out of any treatment for
      periods ranging between 14 and 168 months. CONCLUSIONS: 1) The percentage of
      remissions was similar for both groups of treatments. 2) The results attained
      with BFM-like protocols were better than those of the "classic" therapy with
      regard to the SV and DFS differences. 3) Significant differences can be
      appreciated between good- and poor-prognosis groups for both types of treatment.

PMID- 8470034
TI  - [Salvage treatments in non-Hodgkin's lymphoma. I].

PMID- 8470035
TI  - [Evolution of CD4 and CD8 lymphocyte subsets in HIV seronegative and seropositive
      hemophiliacs].
AB  - PURPOSE: To asses the evolution over time of the CD4, CD8 and total lymphocyte
      counts in both HIV seronegative and HIV seropositive haemophiliacs. PATIENTS AND
      METHODS: A total of 124 haemophilic patients (77 HIV seropositive and 47 HIV
      seronegative) regularly controlled at our Hospital were studied. All patients
      have had several (range 2-15) CD4 and CD8 lymphocyte counts, with a minimum
      interval of 2 or more years between the first count and the last one (median 7.7
      years). A linear regression analysis of the serial cell counts against the time
      was made and the corresponding slopes were estimated for each patient and
      expressed as a percentage of the initial values (standardized slopes). RESULTS:
      In HIV seronegative patients the number of CD4, CD8 and total lymphocytes
      decreased (p < 0.05), but the decrease of the CD4/CD8 ratio was not statistically
      significant. The decline of the CD4 cells showed a trend to remain above 500
      cells/microL. HIV seropositive hemophiliacs had also a substantial decline of
      lymphocyte counts (p < 0.0001), but essentially due to changes of the CD4 cells,
      which declined with a nearly constant rate during the follow-up (median values
      decreased from 793/microL to 324/microL). CD8 cell counts diminished in lower
      grade than the CD4 cells counts, and consequently the percentage of the total
      lymphocyte number increased from 42% to 55%. The CD4/CD8 ratio decreased with a
      standardized slope of -5.7% per year. At the initial evaluation the seropositive
      patients had CD4 cell counts and CD4/CD8 ratios lower than seronegative ones, but
      CD8 cell counts were higher in the first group. Total lymphocyte counts were not
      statistically different at this first evaluation between infected and non
      infected patients. At the final evaluation, differences on CD4 cell counts and
      CD4/CD8 ratio increased, and lymphocyte counts were significantly lower in the
      HIV-seropositive haemophiliacs. However, the final absolute counts of CD8 cells
      were not dissimilar in the two groups of patients. The median standardized slopes
      of the total lymphocyte counts, CD4 cell counts, and CD4/CD8 ratios were
      significantly more negative for the HIV-infected patients (-5.7%, -9.4 and -5.7%,
      respectively) than were these for the non-infected ones (-2.0%, -3.2% and -2.5%,
      respectively). CONCLUSIONS: Lymphocyte counts, mainly the CD4 cell counts,
      decline in treated haemophiliacs independently of their HIV status. In the HIV
      seronegative patients the CD4 cell counts generally stabilize above 500
      cells/microL. However, in the seropositive haemophiliacs these counts show a
      continuous fall, with a median rate of 9% of the initial value per year.

PMID- 8470036
TI  - [Hemophagocytic syndrome associated with histoplasmosis in the acquired
      immunodeficiency syndrome: description of 3 cases and review of the literature].
AB  - Three cases of haemophagocytic syndrome (HPS) due to histoplasmosis in patients
      with the acquired immunodeficiency syndrome (AIDS) are described. At admission
      all had pancytopenia and the bone marrow aspirate showed typical
      haemophagocytosis and the presence of intracellular inclusions compatible with
      Histoplasma capsulatum. One patient had also cerebral toxoplasmosis. One patient
      died shortly after admission from multiple organ failure. Two patients survived,
      one treated with fluconazole and another with amphotericin-B with good response
      and progressive increase in their blood cell counts. We suggest that
      haemophagocytic syndrome due to disseminated histoplasmosis should be included in
      the causes of pancytopenia in patients with AIDS. Bone marrow aspirate is the
      best method for diagnosis.

PMID- 8470037
TI  - [3 families with a congenital factor X deficiency, one of them with an associated
      factor XII deficiency].
AB  - Factor X deficiency constitutes one of the most uncommon congenital bleeding
      disorders. Here we report three families with Factor X deficiency, one of them
      with an associated deficit of Factor XII. Family I presented Red variant
      deficiency (low functional and antigenic activity, the latter in higher levels
      than the former). In Family II functional activity was low but antigenic one was
      normal (Prower defect). Besides, an heterozygous deficiency of factor XII was
      diagnosed. Although genetic analysis supports the hypothesis of combined
      deficiency, the study was possible in only two generations of the propositus, so
      a multiple familial deficiency could not be discarded. Finally, Family III
      suffered from a "classic" or Mr. Stuart deficiency (low levels in functional and
      immunological assays). Besides, crossed immunoelectrophoresis showed a grossly
      pathological pattern.

PMID- 8470038
TI  - [Reference values in hematology].

PMID- 8470039
TI  - [Richter syndrome with exclusively cutaneous involvement].

PMID- 8470040
TI  - A little help from my friends.

PMID- 8470041
TI  - Proposed resolutions for the 1993 TNA HOD. On uniform data reporting about needle
      sticks among health care workers in Texas.

PMID- 8470042
TI  - AIDS Q & A. Antiretroviral drugs. Part 2.

PMID- 8470043
TI  - Paris I dysfibrinogenemia: a point mutation in intron 8 results in insertion of a
      15 amino acid sequence in the fibrinogen gamma-chain.
AB  - Paris I dysfibrinogenemia results in the production of a fibrinogen molecule
      containing a functionally abnormal gamma-chain. We determined the basis of the
      molecular defect using polymerase chain reaction (PCR) to amplify the gamma-chain
      region of the Paris I subject's genomic DNA. Comparative sequence analysis of
      cloned PCR segments of normal and Paris I genomic DNA revealed only an A-->G
      point mutation occurring at nucleotide position 6588 within intron 8 of the Paris
      I gamma-chain gene. We examined six normal individuals and found only normal
      sequence in this region, indicating that this change is not likely to represent a
      normal polymorphism. This nucleotide change leads to a 45 bp fragment being
      inserted between exons 8 and 9 in the mature gamma Paris I chain mRNA, and
      encodes a 15 amino acid insert after gamma 350 [M-C-G-E-A-L-P-M-L-K-D-P-C-Y].
      Alternative splicing of this region from intron 8 into the mature Paris I gamma
      chain mRNA also results after translation into a substitution of S for G at
      position gamma 351. Biochemical studies of 14C-iodoacetamide incorporation into
      disulfide-reduced Paris I and normal fibrinogen corroborated the molecular
      biologic predictions that two additional cysteine residues exist within the gamma
      Paris I chain. We conclude that the insertion of this amino acid sequence leads
      to a conformationally-altered, and dysfunctional gamma-chain in Paris I
      fibrinogen.

PMID- 8470044
TI  - Heparin-releasable and platelet pools of tissue factor pathway inhibitor in
      rabbits.
AB  - Earlier studies from this laboratory have established that tissue factor pathway
      inhibitor (TFPI) functions as a natural anticoagulant protecting rabbits from
      intravascular coagulation triggered by the exposure of blood to small amounts of
      tissue factor. In addition to the TFPI circulating in plasma, humans have been
      shown to have heparin-releasable and platelet pools of TFPI. In order better to
      extrapolate from studies carried out in rabbits to an understanding of human
      hemostasis, we have examined the presence and extent of heparin-releasable and
      platelet pools of TFPI in rabbits. We find that in the rabbit the heparin
      releasable pool of TFPI activity, as measured in a capacity assay, may be smaller
      relative to the plasma pool than in humans; that the platelet pool of TFPI
      activity is comparable to that of humans; and that rabbit TFPI, unlike human
      TFPI, has the same apparent molecular mass in all vascular pools. These studies
      extend our understanding of the properties of TFPI in rabbits and the
      appropriateness of using the rabbit for studies of TFPI relevant to human
      hemostasis.

PMID- 8470045
TI  - The effects of heparin and annexin V on fibrin accretion after injury in the
      jugular veins of rabbits.
AB  - We compared the relative abilities of unfractionated heparin and annexin V to
      prevent fibrin accretion onto injured jugular veins in vivo. Heparin was used to
      accelerate the inhibition of thrombin by antithrombin III, and annexin V was used
      to inhibit the assembly of the prothrombinase complex on phospholipid surfaces,
      thereby blocking thrombin generation. Rabbit jugular veins were isolated in situ,
      a 2 cm segment was injured by perfusing it with air, and then blood flow was re
      established. Five minutes later, each rabbit was injected with heparin (20 U/kg)
      or annexin V (0.3 mg/kg) and then with 125I-fibrinogen. The amount of 125I-fibrin
      accumulation onto each injured vessel wall segment was measured 4 h later. Each
      injured vessel was completely de-endothelialized as a result of the air perfusion
      as demonstrated by electron microscopy. 125I-fibrin accretion onto the injured
      jugular veins was enhanced 2.4-fold as compared to the uninjured veins in sham
      operated animals. Heparin treatment did not reduce fibrin accretion, whereas,
      annexin V treatment decreased fibrin accretion by 60%, p < 0.05. This latter
      effect was achieved without sustained circulating anticoagulation. Additional
      experiments confirmed that the inhibitory effect of annexin V on fibrin accretion
      was associated with a surface specific effect, since more annexin V bound to the
      injured jugular vein segments as compared to the non-injured jugular
      veins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470046
TI  - An antithrombin III assay based on factor Xa inhibition provides a more reliable
      test to identify congenital antithrombin III deficiency than an assay based on
      thrombin inhibition.
AB  - OBJECTIVES: To determine whether functional antithrombin III (AT-III) levels
      measured by a factor Xa inhibition (AT-III-Xa) assay identifies AT-III deficient
      individuals more reliably than functional AT-III levels measured by a thrombin
      inhibition (AT-III-IIa) assay. STUDY DESIGN: Cross-sectional study. PATIENT
      POPULATION: Sixty-seven members of a large family with type 2 AT-III deficiency.
      INTERVENTION: DNA analysis was used as the reference diagnostic standard for AT
      III status and subjects were classified as AT-III deficient or non deficient
      according to these results. Functional AT-III levels were measured in all
      subjects using: 1) a chromogenic substrate for thrombin and added human thrombin
      (AT-III-IIa), and 2) a chromogenic substrate for factor Xa and added bovine
      factor Xa (AT-III-Xa). Functional heparin cofactor II (HC-II) levels were
      measured using a commercially available kit. The proportions of 125I-alpha
      thrombin complexed to AT-III and HC-II were measured by polyacrylamide gel
      electrophoresis and autoradiography. RESULTS: Thirty-one (46%) individuals were
      classified as AT-III deficient and 36 (54%) as AT-III non deficient. AT-III-Xa
      assay measured a significantly lower mean AT-III value and a narrower range for
      individuals classified as AT-III deficient than the AT-III-IIa assay. Using the
      AT-III-IIa assay, six subjects had borderline AT-III levels compared to none with
      the AT-III-Xa assay.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470047
TI  - A method to determine the optimal intensity of oral anticoagulant therapy.
AB  - Oral anticoagulant therapy has been shown to be effective for several
      indications. The optimal intensity of anticoagulation for each indication,
      however, is largely unknown. To determine this optimal intensity, randomised
      clinical trials are conducted in which two target levels of anticoagulation are
      compared. This approach is inefficient, since the choice of the target levels
      will be arbitrary. Moreover, the achieved intensity is not taken into account. We
      propose a method to determine the optimal achieved intensity of anticoagulation.
      This method can be applied within a clinical trial as an "efficacy-analysis", but
      also on data gathered in day-to-day patient care. In this method, INR-specific
      incidence rates of events, either thromboembolic or hemorrhagic, are calculated.
      The numerator of the incidence rate is based on data on the INR at the time of
      the event. The denominator consists of the person-time at each INR value, summed
      over all patients, and is calculated from all INR measurements of all patients
      during the follow-up interval. This INR-specific person-time is calculated with
      the assumption of a linear increase or decrease between two consecutive INR
      determinations. Since the incidence rates may be substratified on covariates,
      efficient assessment of the effects of other factors (e.g. age, sex,
      comedication) by multivariate regression analysis becomes possible. This method
      allows the determination of the optimal pharmacological effects of
      anticoagulation, which can form a rational starting point for choosing the target
      levels in subsequent clinical trials.

PMID- 8470048
TI  - Genetic basis and carrier detection of hemophilia B of Chinese origin.
AB  - We have characterized the genetic defects of 17 hemophilia B patients of Chinese
      origin by means of the polymerase chain reaction (PCR) and direct sequencing. The
      single-strand conformation polymorphism (SSCP) was used as an initial screening
      method to analyze the entire coding region and the flanking introns of each
      individual's factor IX gene. The abnormal exons were subsequently amplified and
      the nucleotide sequence determined. Of the 17 patients studied, 16 had single
      point mutations and one had a gross gene deletion of exons VII and VIII of factor
      IX. Among these 16 factor IX variants with point mutations 13 were missense and
      two were nonsense mutations. The remaining one had a nucleotide deleted,
      resulting in frame shifting at amino acid residue 97. A total of ten novel
      mutations, including the one with gross gene deletion, are reported in this study
      which have not been described previously. Five of the remaining seven variants
      were missense mutations with novel amino acids substituted for residues 127, 132,
      180, 207, and 215, respectively. Mutations containing different amino acid
      residues at those positions have been reported. The last two are variants that
      have already been described to contain mutations at amino acid residues 333 and
      365, respectively. To evaluate the efficiency of SSCP analysis in assessing the
      mutated exons and to further confirm our results we sequenced the entire exons of
      all 17 factor IX genes. The mutations detected by SSCP method were indeed the
      only mutation identified in each factor IX variant.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8470049
TI  - Antithrombotic activity of SR 46349, a novel, potent and selective 5-HT2 receptor
      antagonist.
AB  - SR 46349 (trans-4-[(3Z)3-(2-dimethylaminoethyl)oxyimino-3(2-fluorophe nyl) propen
      1-yl] phenol, hemifumarate) is the first member of a newly-developed 5-HT2
      antagonist series. SR 46349 potently inhibited serotonin-induced aggregation of
      rabbit and human platelets (IC50 = 1 and 3.9 nM respectively) but had no effect
      on the action of other platelet aggregating agents. SR 46349 was 118 and 25 times
      more potent than ketanserin against 5-HT+epinephrine-induced aggregation of
      rabbit and human platelets respectively. A single per os administration of SR
      46349 (1 mg/kg) resulted in a strong inhibition of 5-HT+epinephrine-induced
      platelet aggregation in the rabbit as measured ex vivo (67% inhibition, 6 h after
      the administration). Intravenous or oral administration of SR 46346 inhibited in
      a dose-dependent manner venous thrombosis induced by ligature of the jugular vein
      of rabbits whose blood was made hypercoagulable by i.v. administration of tissue
      thromboplastin. The doses of SR 46349 which inhibited 50% of thrombus formation
      were 1.5 +/- 0.8 mg/kg and 17 +/- 0.5 mg/kg after i.v. or oral administration
      respectively. When given i.v. to rabbits, SR 46349 exhibited a dose-dependent
      antithrombotic effect in an arterio-venous shunt model. Significant increase of
      the bleeding time was observed after the i.v. administration of 5 mg/kg of SR
      46349 (3-fold increase). In dogs, SR 46349 inhibited cyclic coronary artery blood
      flow variations, complete abolition of CFVs being achieved after the i.v.
      administration of 0.5 mg/kg. In conclusion, SR 46349 is a highly potent,
      selective antagonist of serotonin in vitro and is to be considered as a potent,
      orally active antithrombotic agent.

PMID- 8470051
TI  - Human platelets possess tyrosylprotein sulfotransferase (TPST) activity.
AB  - Tyrosine sulfation is a widespread modification of secreted proteins including
      several coagulation proteins synthesized in the liver. Since factor V, a tyrosine
      sulfated protein, is also synthesized in megakaryocytes, we determined whether
      platelets posses tyrosylprotein sulfotransferase (TPST) activity. Using the
      synthetic substrate EAY, substantial TPST activity (0.405 +/- 0.049 pmol EAY-SO4
      formed min-1 mg-1) was detected in platelet homogenates. This activity could not
      be accounted for by contaminating leukocytes, erythrocytes or plasma. The Km of
      platelet TPST for EAY was 3.7 microM and Vmax 0.09 pmol/min. For the cofactor 3'
      phosphoadenosine 5' phosphosulfate (PAPS) the Km was 1.7 microM and Vmax 0.11
      pmol/min. The PAPS analogue 3',5'-adenosine diphosphate inhibited platelet TPST
      with an IC50 of 15.4 microM. These findings suggest that tyrosine sulfation of
      factor V will occur in megakaryocytes. Platelets may be a useful source for
      further study of TPST.

PMID- 8470050
TI  - Potentiating effect of clopidogrel and SR 46349, a novel 5-HT2 antagonist, on
      streptokinase-induced thrombolysis in the rabbit.
AB  - Current thrombolytic strategies have a number of important shortcomings including
      resistance to recanalization and development of acute reocclusion. The purpose of
      this study was to investigate whether the lysis of venous thrombi by
      streptokinase could be enhanced by SR 46349, a novel 5-HT2 receptor antagonist,
      or clopidogrel, an analogue of ticlopidine. The activity of these compounds was
      evaluated by following the lysis of radiolabelled fibrin under a continuous
      infusion of streptokinase (4,000 IU kg-1 h-1 over 4 h). Streptokinase alone
      induced 42% thrombolysis when compared to saline. The i.v. co-administration of
      SR 46349 or clopidogrel (10 mg/kg) enhanced significantly streptokinase-induced
      thrombolysis. Thrombolysis measured by [125I]-fibrinogen lysis increased to 65
      and 59% respectively. This efficacy was achieved without additional prolongation
      of the template bleeding time observed with streptokinase alone. Thus, the
      concomitant use of a 5-HT2 receptor antagonist or an anti-ADP agent during
      streptokinase therapy may facilitate clot lysis.

PMID- 8470052
TI  - Effect of the infusion of OKY-046, a thromboxane A2 synthase inhibitor, on
      urinary metabolites of prostacyclin and thromboxane A2 in healthy human subjects.
AB  - The influence of OKY-046, a selective thromboxane synthase inhibitor, on
      prostanoid formation in healthy human subjects was studied. Vehicle (5% glucose
      solution) or OKY-046 in 5% glucose solution at 15 micrograms kg-1 min-1 was
      intravenously administered to five male healthy volunteers for 6 h. Platelet
      aggregation and thromboxane B2 (TXB2) formation induced by collagen and
      arachidonic acid were suppressed by the infusion of OKY-046, while both were not
      affected by the infusion of vehicle. Urinary excretion of 11-dehydro-thromboxane
      B2, one of major urinary metabolites of thromboxane A2 (TXA2) was decreased by
      the infusion of OKY-046, while that of 2,3-dinor-6-keto-prostaglandin F1 alpha,
      one of major urinary metabolites of prostacyclin (PGI2) was increased. The
      present study demonstrated that the infusion of OKY-046 improved the balance of
      TXA2/PGI2 into antithrombotic state in healthy subjects. It was also suggested
      that endogenously produced (probably platelet-derived) endoperoxides could be
      redirected into prostacyclin in vivo.

PMID- 8470053
TI  - Trimucytin: a collagen-like aggregating inducer isolated from Trimeresurus
      mucrosquamatus snake venom.
AB  - Trimucytin is a potent platelet aggregation inducer isolated from Trimeresurus
      mucrosquamatus snake venom. Similar to collagen, trimucytin has a run of (Gly-Pro
      X) repeats at the N-terminal amino acids sequence. It induced platelet
      aggregation, ATP release and thromboxane formation in rabbit platelets in a
      concentration-dependent manner. The aggregation was not due to released ADP since
      it was not suppressed by creatine phosphate/creatine phosphokinase. It was not
      either due to thromboxane A2 formation because indomethacin and BW755C did not
      have any effect on the aggregation even thromboxane B2 formation was completely
      abolished by indomethacin. Platelet-activating factor (PAF) was not involved in
      the aggregation since a PAF antagonist, kadsurenone, did not affect. However, RGD
      containing peptide triflavin inhibited the aggregation, but not the release of
      ATP, of platelets induced by trimucytin. Indomethacin, mepacrine, prostaglandin
      E1 and tetracaine inhibited the thromboxane B2 formation of platelets caused by
      collagen and trimucytin. Forskolin and sodium nitroprusside inhibited both
      platelet aggregation and ATP release, but not the shape change induced by
      trimucytin. In quin-2 loaded platelets, the rise of intracellular calcium
      concentration caused by trimucytin was decreased by 12-O-tetradecanoyl phorbol-13
      acetate, imipramine, TMB-8 and indomethacin. In the absence of extracellular
      calcium, both collagen and trimucytin caused no thromboxane B2 formation, but
      still induced ATP release which was completely blocked by R 59022. Inositol
      phosphate formation in platelets was markedly enhanced by trimucytin and
      collagen. MAB1988, an antibody against platelet membrane glycoprotein Ia,
      inhibited trimucytin- and collagen-induced platelet aggregation and ATP
      release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470054
TI  - Neonatal vitamin K prophylaxis. Report of Scientific and Standardization
      Subcommittee on Perinatal Haemostasis.

PMID- 8470055
TI  - Intracellular transport-deficient mutants causing hereditary deficiencies of
      factors involved in coagulation and fibrinolysis.

PMID- 8470056
TI  - Immunonephelometric determination of the C4b-binding protein.
AB  - A fully mechanised immunonephelometric method for the rapid and specific
      determination of C4b-binding protein (C4b-BP) in citrated plasma is described.
      The method utilizes commercially available rabbit antiserum against human C4b-BP
      and a nephelometer analyser. A single determination can be performed within 6
      min, requiring 80 microliters sample volume. The measuring range is about 10 to
      200% of normal C4b-BP. Precision is characterized by intraassay coefficients of
      variation between 1.5% and 2.8%, and interassay coefficients of variation between
      4.0% and 4.6% for the same C4b-BP concentrations. The nephelometry of C4b-BP was
      correlated with electroimmunodiffusion (Laurell technique; r = 0.863, y =
      0.909x+7.091, n = 79). C4b-BP concentrations (143%, 96-223%; median and 2.5th
      97.5th percentile) from 83 subjects with increased inflammation markers C
      reactive protein (> 10 mg/l), and fibrinogen (> 4.5 g/l) showing significantly
      higher C4b-BP concentrations compared to 151 obviously healthy subjects (97%, 68
      141%; p < 0.001). In contrast to 81 patients with therapeutic heparinisation
      (90%, 60-131%) significant decreased concentrations were found in 90 subjects
      under oral anticoagulant therapy (OAT) in the stable state (78%, 44-125%; p <
      0.001). Depending on different INR levels (< 2.5, n = 40: 71%, 63-85%; > 2.5, n =
      50: 81%, 68-92%; median and 25th-75th percentile) no significant differences of
      C4b-BP concentrations could be measured.

PMID- 8470057
TI  - Enantioselective antiplatelet actions of nipecotamides.
AB  - Two synthetic racemic nipecotamides, 1-decyl-3-(N,N- diethylcarbamoyl)piperidine
      hydrobromide (1) and alpha, alpha'-bis[3-(N-benzyl-N-methylcarbamoyl)piperidino]
      p-xylene dihydrobromide (2) were resolved on a chiral alpha 1-acid glycoprotein
      semipreparative HPLC column. Thus, rac.1 was resolved into two enantiomers 1A-(+)
      and 1B-(-); rac.2 was separated into the optical antipodes 2A-(-) and 2C-(+), and
      the meso diastereomer 2B-(0). Also on a preparative scale, 97% pure 2C was
      obtained via diastereomeric salt formation using dibenzoyl-L-(-)-tartaric acid.
      The individual isomers were evaluated for their platelet aggregation inhibitory
      potency. In inhibiting ADP-induced aggregation of human platelets in vitro, 1B-(
      ) was 4 times more potent than its optical antipode 1A-(+), and 2C-(+) was 6
      times as active as 2A-(-); the meso diastereomer 2B-(0) had intermediate
      activity. With collagen as the 1B-(-) was twice as active as 1A-(+), and 2C-(+),
      the most active compound in this series (IC50 = 0.96 microM), was 10 times more
      potent than its antipode 2A-(-). Again, the meso diastereomer 2B-(0) had
      intermediate activity. These results demonstrate the enantioselective
      antiplatelet actions of mono- and bis- nipecotamide derivatives.

PMID- 8470058
TI  - Molecular weight and biochemical profile of a chemically modified heparin
      derivative, Suleparoide.
AB  - Recently, a new chemically modified derivative of heparin (Suleparoide, Syntex
      Laboratories Buenos Aires, Argentina) was introduced for the prophylaxis of
      thrombosis and treatment of vascular disorders. This agent is claimed to contain
      a depolymerized, chemically modified, heparin derivative with similar biologic
      actions as heparan sulfate. To study the pharmacologic profile of this agent, we
      have defined its molecular weight distribution profile, utilizing a computerized
      gel permeation chromatographic system equipped with ultraviolet and refractive
      index detectors. Suleparoide exhibited a normal molecular distribution profile
      with no contaminants. It exhibited a weight average of 9.3 K DA and an apparent
      peak MW of 8.0 K DA. Approximately 50% of the molecular components were < 5.0 K
      DA and 40% > 5.0 K DA. The results from these studies on the mechanisms show that
      Suleparoide has anticoagulant activity primarily mediated through Heparin
      Cofactor-II (HC-II) and because of its novel mechanism of action, further
      investigations on the biochemical profile of Suleparoide are carried out. Global
      clotting tests such as Activated Partial Thromboplastin Time (APTT), Heptest and
      Thrombin Time (TT) revealed a concentration dependent effect in all assays.
      Plasma samples supplemented with Suleparoide exhibited no significant anti-Xa and
      anti-IIa activities. However, in the HC-II mediated inhibitory assay for IIa,
      Suleparoide exhibited significant activity. In contrast, the Antithrombin-III (AT
      III) mediated inhibition of IIa was much weaker.

PMID- 8470059
TI  - Supranormal antithrombin III levels induced by concentrate administration are
      ineffective in quenching thrombin generation in acute promyelocytic leukemia.
AB  - Coagulation abnormalities occurring in patients with acute promyelocytic leukemia
      (APL) are partially corrected by heparin administration. This study was
      undertaken to verify if "supra-normal" levels of antithrombin III (AT-III) are
      similarly able to quench intravascular thrombin generation triggered by APL
      cells. Eight patients with APL were randomly assigned to receive either 50 U/kg
      (Group A) or 100 U/kg (Group B) of an AT-III concentrate, starting on the first
      day of chemotherapy and continuing for 7 days thereafter. Fibrinopeptide A (FPA),
      prothrombin fragment F1+2 and thrombin-AT III complexes, measured before and 15
      minutes after each AT-III infusion, decreased significantly after each infusion,
      but the effect was minimal and short-lived, despite the achievement of post
      infusion levels of AT-III activity well above 150% (Group A) or 200% (Group B).
      Small amounts of heparin were consistently detected in AT-III concentrates and
      post-infusion plasma samples. The short-lived quenching of thrombin generation
      after AT-III concentrate could be partially explained by the infusion of heparin,
      rather than by supranormal AT-III levels.

PMID- 8470060
TI  - Construction and its expression of a new retroviral vector containing a human
      blood coagulation factor IX cDNA.
AB  - We constructed a new factor IX expression vector containing a full length factor
      IX cDNA. The Moloney Murine Leukemia Virus (MoMLV)-based retroviral vector pLRNL
      was cloned with the entire coding region of human factor IX down stream of the
      promoter of Rous sarcoma virus, giving rise to the construct pL9RNL. The GP+E 86
      packaging cell was transfected with pL9RNL and two mouse fibroblast cell lines
      (PA317 and NIH3T3) were infected with the virus generated from PA317 cell. During
      the 24 hr culture period, the maximum 1.2 micrograms of factor IX was secreted
      into the medium from 10(6) of GP+E 86 cells. Factor IX in the culture media had
      the relatively normal procoagulant activity and was barium-citrate precipitated.
      Western blotting analysis of the barium-citrate precipitates revealed that a
      single chain 50Kd protein indistinguishable from the plasma-derived factor IX was
      produced in these three cells. The retroviral expression system that we utilized
      herein may contribute to the study of recombinant wild type or various mutant
      factor IX, and to the basic study for the future gene therapy.

PMID- 8470062
TI  - Decreased plasma protein C levels after high dosage of acetylsalicylic acid.

PMID- 8470061
TI  - The development of a simple and quick enzyme-linked immunosorbent assay for anti
      HPA1a (PLA1) antibodies.

PMID- 8470063
TI  - Consistency of responses to separate desmopressin infusions in patients with
      storage pool disease and isolated prolonged bleeding time.

PMID- 8470064
TI  - [Physician--cure yourself?].

PMID- 8470065
TI  - [B-preparations--a strong challenge to the medical profession].

PMID- 8470066
TI  - [Who will lose her uterus?].

PMID- 8470067
TI  - [Is involuntary sterility a disease?].

PMID- 8470068
TI  - [Fertilization in vitro--how large a proportion of couples will have a child?].
AB  - In Norway, the efficacy and the efficiency of IVF treatment for infertile couples
      have been questioned. Information about this topic is important for the general
      public, the infertile population, the gynaecologists and the health authorities.
      We have followed a cohort of 485 infertile couples accepted for in vitro
      fertilization treatment. During a 14 month period starting 1 January 1989 a total
      of 214 women have either delivered or are pregnant in the second or third
      trimester. This number represents 44% of the 485 women accepted for IVF
      treatment, irrespective of whether they were treated or not, and 50% of the
      couples who completed at least one IVF cycle. There was no difference in cycle
      efficiency (pregnancy rate) between the first to third cycle, but this was
      significantly lower in cycle 4-6. There was no difference in delivery rate
      between groups of patients with different diagnoses of female infertility, but an
      additional male factor reduced the delivery rate significantly. Replacement of
      cryopreserved/thawed embryos gave a 5% increase in the delivery rate per couple
      included in the study, and an increase of 13% in the number of deliveries.

PMID- 8470069
TI  - [Fertilization in vitro--success rates and registration].
AB  - There is great uncertainty and concern about the reliability of success rates in
      IVF. This is because of lack of agreement about what defines success and how this
      should be measured. Success should be reported on the basis of real birth rates
      measured against all stimulation cycles and all women accepted for treatment.
      This is because the purpose of IVF is to alleviate infertility, and couples (or
      women) who seek treatment will only consider live birth as a successful result.
      All clinics should be required to submit these results to a national registry in
      order to retain accreditation by the Ministry of Health. The purpose of the
      registry is to make information available to couples (or women) about their real
      chances of giving birth to a child. This will also make it possible to evaluate
      whether the economic resources are used efficiently, a requirement which may help
      to standardize the definition of success used in medical journals.

PMID- 8470070
TI  - [Assisted fertilization--where are we now and where are we going?].
AB  - The authors review the development of assisted reproduction, and describe the
      present status. The efficacy of in vitro fertilization is compared with the
      results of tubal surgery. A comparison is also made of the efficacy of different
      assisted reproductive techniques. Future aspects of assisted reproduction are
      discussed, with particular emphasis on the need for better understanding of the
      implantation process. This may reduce the need for transfer of multiple embryos,
      thereby decreasing risk of multiple pregnancies.

PMID- 8470071
TI  - [Analysis of estrogen receptors in mammary carcinomas. Is immunocytochemical
      determination after formalin fixation sufficient?].
AB  - By application of a monoclonal antibody (Abbott ER-ICA) oestrogen receptors can
      now be demonstrated and semiquantitated on paraffin sections after fixation in
      formalin. In a prospective series of 22 breast carcinomas we found that 82%
      (18/22) were oestrogen receptor positive. The frequency was significantly lower
      in archival tissue comprising 27 invasive carcinomas (56%) and in 63 intraductal
      carcinomas (54%). Even lower frequencies were found in recurrences and metastases
      and none (0/10) of the metastases from tumours of unknown origin were oestrogen
      receptor positive. It is likely that prolonged fixation in formalin destroys the
      receptor protein. Immunocytochemical assessment of oestrogen receptor may be the
      only alternative when dealing with small breast tumours (< 1 cm), in cases of
      suspected recurrences and in cases of unknown receptor status.

PMID- 8470072
TI  - [Dyspepsia and life style].
AB  - Information on eating habits, life situation and perceived stress was collected
      from 100 patients who consulted general practitioner because of dyspeptic
      complaints. This information was compared with information from a control group
      with no dyspeptic symptoms. The patients reported a higher degree of stress in
      connection with occupation and family, and more economic worries, than the
      control group. Patients with ulcus also tended to have a higher consumption of
      tobacco. There were no significant differences in eating habits or alcohol
      consumption between the groups.

PMID- 8470073
TI  - [Aspiration of ganglia in the wrist].
AB  - Because of recently published good results we wished to evaluate the therapeutic
      effect among our own patients of simple aspiration of ganglia near the wrist. We
      entered 24 consecutive patients referred for operation of wrist ganglia into the
      study and administered a regimen of up to three aspirations at intervals of four
      to six weeks. There were five deviants from the protocol. Among the remaining 19
      patients the ganglion had disappeared in 13 by the end of the aspiration regimen.
      However, one year after the first aspiration there had been seven recurrences.
      Only eight of the original 24 patients underwent surgery. The remainder felt that
      this was no longer necessary. In our material simple aspiration had little
      therapeutic effect, but markedly reduced the number of patients operated on for
      ganglia of the wrist.

PMID- 8470074
TI  - [Current principles in the treatment of knee ligament injuries].
AB  - Knee ligament injuries are the leading cause of disability from injuries
      occurring during sports. The incidence of these injuries is increasing in Norway,
      owing to greater participation in recreational and competitive sports. In Norway,
      the main contributor to anterior cruciate ligament injuries is European team
      handball where women who compete at a high level sustain a large number of
      injuries. This paper describes modern principles of diagnosis and treatment of
      these injuries, based on personal research and a review of the literature.

PMID- 8470075
TI  - [Head injuries in sports--evaluation during admission, follow-up and routine
      check-ups].
AB  - The authors review head injuries during sport. Among 3,206 such injuries treated
      at the Regional Hospital, Trondheim, in the course of one year, 12% were injuries
      to head and face. Minor injuries are classified as. Mild (no amnesia or loss of
      consciousness), no symptoms, the activity can continue, but one week of rest is
      recommended. Moderate (amnesia or loss of consciousness < 1 min), medical
      examination, and two weeks of rest are recommended. Major (loss of consciousness
      < 5 min), CT scan and one month of rest are recommended. With repeated moderate
      or triple mild traumas, CT and the possible termination of the sporting season
      should be considered. Serious head injuries with intracranial pathology will
      generally disqualify the person from further elite competition. The possible
      consequences of repeated head injuries during football and other contact sports
      are stressed, and more regular use of neurophysiologic methods (EEG) and magnetic
      resonance (MR) in selected cases is recommended. The authors also point out the
      advantages of using helmets and protective gear, and the doctors' role in
      advocating such equipment.

PMID- 8470076
TI  - [Sports in cold climate].
AB  - In winter sports, and in some summer sports as well, training and competitions
      take place under climatic conditions where it is necessary to be aware of the
      danger of hypothermia. Most of the lesions caused by hypothermia during sports
      activities are minor ones, but severe hypothermia may also occur. Lesions are
      encountered most frequently on the face, including the eyes, and on hands, feet
      and other frontal parts of the body. Special attention must be paid to risk of
      hypothermia in children. The organizers of sports competitions have a duty to
      provide proper rooms where athletes suffering from hypothermia can region their
      proper body temperature, and it should be possible for doctors or paramedics to
      take care of these and other injured athletes at the stadium, and if necessary
      accompany them to the nearest hospital.

PMID- 8470077
TI  - [Health services for physicians. Experiences from a pilot project].
AB  - The topic of article is a two-year trial of health service for doctors in the
      districts of Asker and Eidsvoll, under the auspices of the Akershus branch of the
      Norwegian Medical Association. The object of the trial was to develop a model for
      a health service for doctors. All doctors in the selected districts, except those
      covered by occupational health services, were invited to take part in the trial.
      Doctors recruited as doctors for colleagues, were given systematic tutoring and
      teaching throughout the trial period. The authors describe how the trial was
      organized and carried out, and summarize the practical experience gained so far.
      They also give a brief account of the continued efforts of the Akershus branch of
      the Norwegian Medical Association to develop a better health service for doctors.

PMID- 8470078
TI  - [Physician and patient at the same time. Experiences from participants of a
      health service trial for physicians].
AB  - A health service for doctors was made available in two municipalities. 28 doctors
      participated in a trial lasting two years. The overall evaluation included an
      interview by telephone, and the participants were asked to give their opinion of
      the trial. The response was unanimously positive. Most participants felt a clear
      need for contact, something which was not always apparent to the doctors' doctor.
      The participants appreciated the psychosocial aspect of the trial most of all.
      Lowest marks were awarded to the part dealing with the working environment. Few
      doctors found it difficult to fit into the patient's role. The selection of
      doctors' doctors, and their tutoring and preparation for this role, are probably
      the main factors behind the success of the trial. The evaluation clearly supports
      the creation of a health service for doctors.

PMID- 8470079
TI  - [Invasive or transcutaneous measurements of oxygen saturation and blood gases? An
      evaluation of pulse oximetry and transcutaneous measurement of PO2 and PCO2
      during rest and exercise].
AB  - Arterial and transcutaneous measurements of the oxygen saturation (SO2), the
      partial pressure of oxygen (PO2) and the partial pressure of carbon dioxide (PCO2
      were compared during rest before and after cycling, and during submaximal and
      maximal exercise, in 12 adult patients with cystic fibrosis. SO2 was measured non
      invasively using two different pulse oximeters (Radiometer and Ohmeda,
      respectively) and PO2 and PCO2 were registered with a transcutaneous electrode
      (Radiometer). The coefficients of correlation between arterial and transcutaneous
      values were respectively 0.95 (Radiometer) and 0.85 (Ohmeda) for SO2, 0.77 for
      PO2, and 0.75 for PCO2. On average the differences between arterial and
      transcutaneous values were small, but varied by 3-4% (2SD) for SO2, 2.0 kPa for
      PO2 and 1.0 kPa for PCO2. Our results indicate that pulse oximetry is a
      reasonably good way of detecting severe arterial hypoxemia during work, whereas
      the transcutaneous measurements of PO2 and PCO2 show such large variations that
      this method cannot be recommended for clinical use.

PMID- 8470080
TI  - [Hysterectomy in Norway. Quality of data and clinical practice].
AB  - A nation-wide register of discharges from hospitals was used to analyze the
      practice of hysterectomy in Norwegian hospitals during the three-year period 1988
      to 1990. A total of 10.167 hysterectomies were recorded, 20% of them were
      subtotal hysterectomies. Incidental appendectomy was performed in 4%.
      Approximately 60 hospitals performed hysterectomy. At 17 hospitals the number was
      ten or less per year, while at two hospitals more than 200 hysterectomies were
      performed per year. The national hysterectomy rate was 164 per 100,000 women or
      198 per 100,000 women > or = 15 years. The rate is almost 50% higher than a
      previously reported rate from the period 1977 to 1978, but is still remarkably
      low compared with the rates reported in the international literature.

PMID- 8470081
TI  - [Preoperative fasting].

PMID- 8470082
TI  - [Professional secrecy and research].

PMID- 8470083
TI  - [Empathy].

PMID- 8470084
TI  - [Who is responsible for computerized medical records?].

PMID- 8470085
TI  - [Meeting the hospital devil. The only one with complete access to information and
      unrestricted responsibility in hospitals].

PMID- 8470086
TI  - [Local competence--a condition for local development].

PMID- 8470087
TI  - [Development of the psychiatric outpatient clinics in Oslo. Thoughts on history
      and future].

PMID- 8470088
TI  - [Physician--a changing role].

PMID- 8470089
TI  - [Follow-up and treatment of HIV-positive patients].

PMID- 8470090
TI  - Redistribution of epidermal growth factor receptor as a function of cell density,
      cell-cell adhesion and calcium in human (A-431) cells.
AB  - Cell surface expression of the epidermal growth factor (EGF) receptor in several
      cell lines declines as a function of increased cell density and is associated
      with diminished responsiveness to EGF. However, the mechanism whereby this
      density-induced down regulation of receptors occurs has not been discerned. In
      the present study the distribution of the EGF receptor in A-431 cells as a
      function of cell density using (1) two polyclonal antibodies raised against
      peptide specific sequences of the EGF receptor that recognize either the
      cytoplasmic or extracellular domains of the receptor, respectively, and (2)
      biotinylated EGF, a specific probe for the cell surface receptor is now
      investigated. Immunolocalization of the receptor using the polyclonal antibodies
      or the biotin-EGF revealed that the receptor was homogeneously distributed on the
      cell surface of individual cells, or in cells plated at low density. In contrast,
      as cell density increased, prominent EGF immunoreactivity and biotin-EGF staining
      became limited to the periphery of the cells, at sites of cell-cell apposition,
      and was characterized by a honeycomb pattern, typical of a basolateral
      distribution. The effects of low Ca++ treatment, known to cause cells to round up
      and detach from one another, on EGF receptor distribution in cells at high cell
      density were then examined. Confocal microscopy of immunostained preparations
      revealed that incubation of high density cultures in Ca(++)-free media for as
      little as 10 min restored the homogeneous distribution of the EGF receptor and
      resulted in strong intracellular staining. Three-dimensional reconstruction of
      serial optical sections revealed that redistribution of the EGF receptor
      following low Ca++ treatment involved a heretofore undetected 'ruffling', an
      immunostaining pattern characterized by stripes of intense fluorescence signal
      interspersed with complete absence of fluorescence. Next, cell-cell adhesion was
      disrupted with antisera to the cell adhesion molecule E-cadherin. Although the
      antisera caused cells to detach from one another, eventually leading to cell
      rounding and redistribution of the EGF receptor, the receptor 'ruffling'
      immunostaining pattern rendered by the low Ca++ treatment was not detected. These
      results suggest that an association may exist between the plasma membrane EGF
      receptor distribution, density-induced EGF receptor down regulation, and the
      growth effects of low Ca++ observed in previous studies.

PMID- 8470091
TI  - The Harderian gland of the rodent Octodon degus: a structural and ultrastructural
      study.
AB  - Harderian glands from male and female Octodon degus were examined by light and
      transmission electron microscopy. Two types of secretory units, designated as
      type I and type II, were observed. Type I secretory units comprise three types of
      epithelial cells: Cells packed with numerous lipid droplets (Type a), cells with
      few lipid droplets (Type b), and cells with numerous mitochondria and a very well
      developed Golgi complex (Type c). Type II secretory units were found exclusively
      in female Octodon degus and comprised a type of secretory cells which contained
      numerous basophilic granules in their apical cytoplasm. In addition, in female
      Octodon degus, clusters of lymphocyte-like cells and plasmatic cells were also
      observed. The vascularization of the gland appeared very well developed. The most
      unique feature of the blood supply was the existence of large sinusoidal vessels
      extremely variable in shape. In the medullar region, the sinsoidal wall adapts
      its contour to that of the tubuloalveolar surface. Unmyelinated and myelinated
      nerve fibers were found in the connective stroma of the gland.

PMID- 8470092
TI  - Histological evaluation of the zonation of colloidal gold uptake by the rat
      liver.
AB  - The distribution and endocytotic function of Kupffer cells in the rat liver were
      studied after administration of fibrinogen stabilized colloidal gold suspensions
      either by injection directly into the circulatory system of anaesthetized rats or
      by application to the isolated perfused liver. After exposure to gold particles
      the livers were perfused with fixative and studied using several microscopic
      techniques. Gold was predominantly endocytosed by a highly active population of
      Kupffer cells surrounding the portal spaces resulting in distinct dark patterns
      around the terminal portal veins. In cross-sections of lobules the pattern
      appeared as incomplete networks composed of dark triangular areas with distinct
      borderlines towards light areas concentric with the terminal hepatic veins
      (central veins). The light areas contained few and relatively inactive small
      Kupffer cells. A wide variation of conditions gave essentially the same uptake
      pattern compatible with the concept of microcirculatory zones concentric with the
      terminal hepatic veins (Lamers et al., 1989; Quistorff and Romert, 1989), but
      contradicting the traditional view of microcirculatory zones advanced by
      Rappaport et al. (1954). Since the same pattern developed during conditions of
      anoxia, it seems that oxygen is not the stimulus for the developmental
      distribution of Kupffer cells with high endocytotic activity. In vivo and
      perfusion experiments gave identical patterns, but a higher endocytotic activity
      of endothelial cells was found in perfused isolated livers.

PMID- 8470093
TI  - Filamentous actin detected in rat spermatozoa.
AB  - In this paper we report the positive staining of epididymal spermatozoa and
      testicular cells (late spermatids and spermatozoa) with fluorescent phallotoxins.
      Staining is most obvious with rhodamine phalloidin, but is also detectible with
      NBD-phallacidin. Specific fluorescence is emitted as a linear tract along the
      dorsal curvature of the head and as an inverted V-shaped structure in what
      appears to be the anterior aspect of the post-acrosomal region. We conclude that
      filamentous actin occurs in the heads of rat spermatozoa. Moreover, we speculate
      that this filamentous actin is concentrated in two regions of the perinuclear
      theca; in the subacrosomal space along the dorsal curvature of the nucleus, and
      in the post-acrosomal region in an area termed the ventral spur.

PMID- 8470094
TI  - The participation of growth factors in simulating the quiescent, proliferative,
      and differentiative stages of rat granulosa cells grown in a serum-free medium.
AB  - Ovarian granulosa cells from small antral follicles from immature rats were
      cultured in a serum-free medium on an extracellular matrix for 10 days with
      growth factors in an effort to simulate the metabolic states they experience
      during their differentiation. During in vivo differentiation granulosa cells are
      initially quiescent, later proliferate and subsequently commence differentiation.
      With the production of androstenedione by the vascularized theca interna they
      produce estrogen and when the follicle reaches the preovulatory stage, granulosa
      cells produce both estrogen and progesterone. Culturing granulosa cells in serum
      free medium plus FSH, PDGF, or FSH plus PDGF, the cells remain quiescent. The
      cells proliferate most consistently (as assessed by DNA quantitation) when
      cultured in FSH, PDGF, TGF alpha, TGF beta and GH, and undergo the first level of
      differentiation by producing estrogen (assessed by RIA) when cultured in FSH,
      PDGF, TGF beta, IGF-I and delta 4-A. Further differentiation is achieved in the
      presence of FSH, PDGF, TGF alpha, bFGF and delta 4-A when the cells produce both
      estrogen and progesterone similar to their production in preovulatory follicles.
      Phase contrast photomicrographs were made to monitor cellular shape changes.
      Electron microscopic analysis of the quiescent and proliferative cells reveal
      them to contain the normally occurring organelles. After 8 days in culture, cells
      producing estrogen, and estrogen and progesterone, contain endoplasmic reticulum
      of the smooth variety, an organelle which, in cooperation with mitochondria, is
      known to be involved in the production of steroids such as estrogen and
      progesterone. Therefore, with the addition of one or more growth factors and
      androstenedione to FSH-containing serum free medium, the simulated conditions are
      partially reminiscent of the follicular microenvironment, in which granulosa
      cells cultured on extracellular matrix can exhibit characteristics of growth and
      differentiation similar to folliculogenesis.

PMID- 8470095
TI  - Synchrotron X-ray diffraction and histochemical studies of normal and myopic
      chick eyes.
AB  - Synchrotron X-ray diffraction patterns were obtained from the cornea and
      posterior sclera of control and myopic chicks. No significant differences was
      found in the interfibrillar or in the intermolecular spacing of the collagen
      fibrils from the corneas of control and myopic chicks. The intermolecular spacing
      of myopic sclera was shown to be significantly (p < 0.01) higher than in
      controls. Sclera and cornea from normal and myopic chicks were stained for
      proteoglycans using the 'critical electrolyte' method of Scott and Orford (1981).
      In the sclera, two morphologically distinct types of proteoglycans could be
      distinguished; one small and usually elongated (approximately 20 nm), the other
      larger and irregularly shaped. The small proteoglycans were seen binding
      preferentially to the 'd' and 'e' bands of the collagen fibrils. Small
      proteoglycans were also present within the fibrils, these were usually
      approximately 10 nm in diameter although sizes up to 30 nm were observed.
      Longitudinal sections of fibrils revealed that these intrafibrillar proteoglycans
      were chiefly orientated parallel to the axis of the collagen fibrils, and
      preferentially located along the gap region of the fibrils. No difference was
      observed in the binding sites of the proteoglycans between normal and myopic
      sclera. The larger proteoglycans were also seen aggregated into clumps, which
      were usually associated with spaces between collagen bundles. The differences
      between control and myopic sclera appear to be quantitative rather than
      qualitative suggesting that the scleral expansion in myopia is an enhanced form
      of normal scleral growth.

PMID- 8470096
TI  - Localization of fibronectin in the frog skin.
AB  - In this review, we present structural and ultrastructural localizations of
      fibronectin (FN) in the larval and adult skin of the frog (Rana esculenta) either
      in in vivo or in in vitro conditions. The ventral skin of the tadpole contains
      membrane-associated FN-plaques disposed around the epidermal and dermal cells
      during their climactic rearrangement. Moreover, lines of fibrillar FN are
      detected inside the breaks opened in the derived collagen. The ventral skin of
      the adult frog reveals FN distributed in the three superimposed tissues forming
      the skin, i.e. the epidermis, the dermis and the subcutaneous tissue. In vivo,
      the epidermis is devoid of FN except for the mitochondria-rich cells (MRCs) which
      contain FN cytoplasmic granules. The dermis reveals two distinct collagenous
      networks showing FN localizations. A vertically-oriented network formed by thick
      tracts contains axis of fibrillar FN connecting the upper dermis devoid of FN to
      the FN-rich subcutaneous tissue. In contiguity with an horizontally-oriented
      network comprises thin tracts formed by clear spaces separating the superimposed
      collagen bundles of the dermal stratum compactum. These tracts contain aligned FN
      granules. Inside the thick and thin tracts, the dermal and pigment cells present
      membrane-associated In vitro (in organ culture conditions) MRCs of the epidermis
      maintain their FN localization and, in addition, the stratum germinativum cells
      show cytoplasmic FN granules. Epidermal cells, in the vicinity of the cut edges
      of the cultivated skin fragment, modify their shape and acquire membrane
      associated FN-plaques located between desmosomes. The FN localizations in these
      two collagenous networks of the dermis remain unchanged. In the same way, the FN
      rich subcutaneous tissue is unmodified. In summary, the FN distribution in the
      larval skin is related to the cell rearrangement during the metamorphic climax,
      and, in the adult skin to the cell migration during the wound healing process and
      the pigment cell patterning. The cell migration is demonstrated, in organ culture
      conditions, by antiFN serum used as an experimental tool. FN is an important
      substrate used in the dermal breaks of the larval skin, and in the dermal tracts
      of the adult skin, both allowing the dermal and pigment cell migration.

PMID- 8470097
TI  - [The paraspecific immune defense: possibilities and limits].
AB  - The paraspecific defense system is the phylogenetically older part of the complex
      immune system. It enables the organism to immediately attack various foreign
      substances, infectious germs and toxins when confronted by them. In order to
      activate the paraspecific immune system with the help of drugs, so-called
      "paramunity inducers" are employed. The use of paramunization is a new way of
      prophylaxis and therapy, not only with regard to infections, but also with regard
      to different other indications. The limitations of paramunization are to be found
      in genetic defects of the paraspecific immune system, therefore the success of
      paramunization is dependent on the functioning of the paraspecific defense
      system. The possibility of developing paramunity inducers that are pyrogen-free,
      non-toxic and pleotypically effective in pre-clinical and clinical experiments is
      illustrated through the use of pox and parapox viruses. Inducers based on
      different pox virus species were effective and safe when used in humans as well
      as in animals in the field.

PMID- 8470098
TI  - [The clinical case. Acute skin necrosis in a cat].

PMID- 8470099
TI  - [Trace elements in the liver and myocardium of stillborn dairy calves].
AB  - Trace element analyses were performed on the livers of 52 and the heart muscle of
      19 stillborn dairy calves. All calves originated from one herd and ranged in age
      from 260 days of gestation up to one day old. In the liver the trace element
      concentrations (mg/kg fresh weight) were as follows: Fe: 181.3 +/- 173.5; Zn:
      74.6 +/- 37.7; Cu: 98.1 +/- 42.6; Mn: 1.4 +/- 0.36 and in the heart: Fe: 54.1 +/-
      10.6; Zn: 16.3 +/- 3.8; Cu: 2.5 +/- 0.99; Mn: 0.42 +/- 0.07. Calves from heifers
      had lower Cu values. The relationship between trace element concentration and
      content and liver and heart weight is discussed, as are aspects of
      bioavailability and storage mechanisms as well as clinical signs of trace metal
      deficiencies.

PMID- 8470100
TI  - [The suitability of 1-alpha-hydroxycholecalciferol for the prevention of
      recurrent parturient paresis in dairy cows].
AB  - Sixty-four cows with parturient paresis were given a standard treatment of 500 ml
      calcium gluconate (10.7 g Ca++) infusion solution. Twelve of these cows
      (experimental group = EG 1) additionally received 420 micrograms 1-alpha
      hydroxycholecalciferol (1-alpha-OHD3) with 4 mg 25-hydroxycholecalciferol (25
      OHD3) by the intramuscular route. A further 9 and 10 cows were given 210
      micrograms 1-alpha-OHD3 and 2 mg 25-OHD3 (EG 3) with the calcium infusion, while
      10 cows received either 420 micrograms 1-alpha-OHD3 (EG 4) or 210 micrograms 1
      alpha-OHD3 (EG 5). Twenty-three cows (EG 2 and 4) which were given a calcium
      infusion alone acted as controls. The incidence of recurrence could not be
      reduced by the administration of Vitamin D3 metabolites concurrently with a
      calcium infusion, although calcium and phosphorus levels were higher between 24
      and 48 hours after calcium infusion alone. The combination of 1-alpha-OHD3/25
      OHD3 at the higher dosage resulted in the highest calcium levels.

PMID- 8470101
TI  - [Systematic control of claw health in cows raised in loose housing systems for
      the total year].
AB  - Claw health was systematically checked and recorded in the dairy herd of the
      experimental and teaching unit at Oberschleissheim. The project started in March
      1988 and ended in July 1989. In total 158 dairy cows and 50 heifers of the breeds
      German Black and White as well as German Simmental were examined for claw health
      at intervals of six weeks. Heel erosion was diagnosed most frequently, followed
      by interdigital dermatitis and contusion of the sole. Contusions and ulcerations
      of the sole were located especially in the claws of the hindleg. More than 90
      percent of lameness occurred in the hindleg. Frequency and severity of claw
      disorders were reduced significantly over the 1.5 year period of systematic
      veterinary supervision of claw health. Thirty percent of dairy cows were
      diagnosed as having not any claw disorder at the end of the investigation period.
      The percentage of dairy cows without any claw disorder was increased by 5-10
      percent. Cows of the breed German Simmental in their first lactation were a high
      risk group for contusions of the sole. The repeatability of the claw measurements
      of angle of the dorsal wall, length of the dorsal wall and of the heel, height of
      the heel, diagonal length of the claw and ground surface was usually 0.5 and
      higher. For the claw disorders heel erosion, interdigital hyperplasia and in part
      contusions of the sole, fairly high correlations were estimated between heifers
      and cows as well as between consecutive lactations.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8470102
TI  - [Brush biopsy as a new examination method of the upper respiratory tract in
      cattle and swine].
AB  - Several techniques of cytobrush sampling were developed for morphological
      examination of upper respiratory tract epithelium in cattle and swine. These
      techniques were evaluated in 30 cattle and swine each, with an age of two weeks
      to nine years and three weeks to four years respectively. Optimal anatomical
      locations for sampling were determined. Three cytobrushes of different shapes
      were constructed to optimize sampling in animals of different ages. Two out of
      four cytobrush sampling techniques developed provided sufficient cellular
      material and worked well under field conditions. Rinsing with 0.9% saline largely
      eliminated mucus and other interfering substances.

PMID- 8470103
TI  - [Diagnostic endoscopy and sexoscopy in birds].
AB  - The main indication for clinical endoscopy in birds is--beside diagnostic reasons
      -sex determination in monomorphic avian species. Some typical findings, the
      technical procedure, important differences to endoscopy in mammals and possible
      complications are described.

PMID- 8470104
TI  - [Effect of a paramunity inducer on the incidence of diseases and the plasma
      cortisol content in Thoroughbred foals before and after weaning].
AB  - The effect of the prophylactic application of the paramunity inducer Baypamun on
      the incidence of diseases among foals (n = 63) in four Thoroughbred studs was
      evaluated. In a blind study, 38 of the foals received 2 ml of Baypamun
      intramuscularly while 25 of the foals received a placebo at six and four days
      before weaning and on the fifth day post-weaning. During the observation period
      of three weeks, beginning with the first and ending ten days after the last
      application, 7.9% of the foals treated with Baypamun (3 out of 38) suffered from
      respiratory infections compared to 24% of the foals treated with placebo (6 out
      of 25). The blood plasma cortisol concentrations were also measured in 53 of the
      foals of three studs before and 24 hours after weaning. The cortisol
      concentration increased in all the foals. However, the increase was significant
      only for the Baypamun treated foals of one stud while it was significant for the
      placebo treated foals of all studs (p < 0.01).

PMID- 8470105
TI  - [Simple diaphragmatic eventration (false diaphragmatic hernia) as the cause of a
      fatally progressing colic in a horse].
AB  - The pathology of a horse is described, in which thoracic trauma with costal
      fracture and a small diaphragmatic defect later led to entrapment of small
      intestine in the thorax.

PMID- 8470106
TI  - [Feed allergy in dogs and cats--not only a gastrointestinal problem].
AB  - Immunologically mediated reactions to foods are responsible for up to 10% of all
      allergic syndromes in dogs and cats. Skin lesions (pruritus, erythema and
      papules) represent the main manifestation (70 to 80%) compared to only 10 to 15%
      incidence of gastrointestinal signs in combination with skin problems or alone.
      Diarrhea, vomiting, low appetite, chronic weight loss, abdominal pain and
      lethargy are the most common signs involved in gastrointestinal food allergy.
      There exists no breed or sex predilection in dogs or cats; signs may occur at any
      time during life time. The immunological nature of the disease can only be
      guessed at from anamnestic and clinical features and must be verified by presence
      of lymphocytes, plasma cells, mast cells and eosinophilic granulocytes in
      histological specimens. At this time, the responsible allergen can only be
      identified in a restriction diet trial based on food which the animal has not
      been fed before, given exclusively for at least four weeks to the pet. Changing
      from one brand of commercial diet to another is not recommended. The diagnosis is
      conclusively proven by reproducing the symptoms by feeding the original diet
      after the elimination of signs on the new diet. The pet can then be fed on a
      commercial diet (or home-made food) without the offending allergen(s).

PMID- 8470107
TI  - [Ulna growth retardation syndrome in the dog].
AB  - Premature closure of the distal ulnar physis leads to medial bowing of the
      radius, later to lateral deviation of the carpus, and ventral subluxation of the
      elbow. Diagnosis of this growth disturbance depends on accurate radiographical
      examination. There are different surgical treatments to allow the radius to grow
      without impediment. The prognosis depends on early treatment.

PMID- 8470108
TI  - [Endothelin-1 and endothelin-3 in the plasma of dogs].
AB  - The endothelins represent a family of peptides with potent vasoconstrictory
      effects indicating a role in the regulation of vascular tone. An involvement of
      endothelins in the pathogenesis as well as pathophysiology of vascular diseases
      has been proposed. Therefore, the aim of the presented study was to develop the
      methodology to measure and characterize endothelin-1 (ET-1) and endothelin-3 (ET
      3) in the plasma of dogs. Extraction of acidified plasma samples was performed by
      use of Sep-Pak C18 cartridges and plasma levels of ET-1- and ET-3
      immunoreactivity (ET-1-IR; ET-3-IR) were determined by specific
      radioimmunoassays. The measured ET-immunoreactivities were verified by separation
      of plasma using high-pressure liquid chromatography (HPLC).

PMID- 8470109
TI  - [Lysozyme activity in cat feces].
AB  - Activity of fecal lysozyme was determined in healthy cats and cats with chronic
      diarrhea. The established reference value ranged from 0 up to 2.6 micrograms/g
      feces. Mean activity of the control group was 1.3 +/- 0.9 micrograms/g feces,
      mean activity of the patient group was 3.4 +/- 3.3 micrograms/g. There was a
      statistically significant difference between these two values. Nevertheless it
      was not possible to classify various diseases by evaluating lysozyme activity. In
      addition to endoscopy and histological examination, determination of lysozyme can
      be used as screening test and means of assessment for treatment and progress in
      cats with chronic diarrhea.

PMID- 8470110
TI  - [Propofol--a short-term narcotic--tested in gastroduodenoscopy in the cat].
AB  - The injection anaesthetic propofol (Disoprivan) was used in 85 cats for
      performing gastroduodenoscopy. Anaesthesia and feasibility for executing
      endoscopy were evaluated. Two cats suffered from a transient (30 sec) respiratory
      arrest. In any other cases stable cardiovascular and acceptable respiratory
      conditions were observed. The endoscopy was easy to perform and no emesis was
      induced. Anaesthesia of the cat with propofol can be very well controlled. It is
      characterised by gentle induction and a recovery free from excitation.

PMID- 8470111
TI  - [Sugar diffusion test, an adjuvant method for the diagnostic differentiation of
      streptococci of different serological groups].
AB  - A sugar differentiation test which allows the differentiation of streptococcal
      serological groups by means of visual comparison of degree of haemolysis is
      introduced. The test uses the reagents glucose, lactose and aesculin and is both
      time- and cost-effective.

PMID- 8470112
TI  - Differential expression of the metallothionein gene in liver and brain of mice
      and rats.
AB  - Expression of the metallothionein I (MT-I) gene was studied in liver and brain of
      control mice and rats, as well as following administration of Cd and
      lipopolysaccharide (LPS). Time-course studies revealed that MT mRNA reached a
      maximum in liver of both mice and rats 6 hr following treatment with Cd or LPS.
      MT mRNA from control and Cd- and LPS-treated rat brains could not be detected by
      Northern-blot analysis of total RNA, but Northern analysis with poly(A)-enriched
      RNA revealed that induction of MT mRNA in rat brain does occur with both Cd and
      LPS treatment. In contrast, mouse brain MT mRNA was easily detected by Northern
      blot analysis of total RNA. It was also clear from Northern-blot analyses of both
      mouse and rat brain that LPS induced more MT mRNA than did Cd. Quantitation of MT
      mRNA by solution hybridization revealed that Cd and LPS induced similar amounts
      of MT mRNA in livers of mice (about 0.64 fmol/micrograms total RNA by Cd and 0.68
      by LPS) and rats (about 0.23 fmol/micrograms total RNA by Cd and 0.21 by LPS).
      Therefore, both inducers increased MT mRNA about threefold more in mouse liver
      than in rat liver. In mouse and rat brain, LPS induced about twice as much MT
      mRNA as did Cd (about 0.08 fmol/micrograms total RNA by Cd and 0.16 by LPS in
      mice and about 0.006 fmol/micrograms total RNA by Cd and 0.008 by LPS in rats).
      However, the actual amount of MT mRNA induced in rat brain by either inducer was
      minimal compared to that in mouse brain. In fact, Cd induced 13 times more MT
      mRNA in mouse brain than in rat brain, and LPS induced about 20 times more MT
      mRNA in mouse brain than in rat brain. Cd distribution to liver was similar in
      both mice and rats, but the Cd concentration in mouse brain was about 60% more
      than that in rat brain. Distribution of LPS was also similar in mouse and rat
      livers, as well as in mouse and rat brains. Therefore, there exists a difference
      in the expression of MT gene in both liver and brain of mice and rats, the
      expression in mice being higher than that in rats. These findings suggest that
      such differential expression of the MT gene cannot be entirely accounted for by
      the difference in the tissue distribution of inducers. Other tissue-specific and
      species-specific factors controlling MT gene expression appear to be involved.

PMID- 8470113
TI  - Temporal relationship of changes in hepatobiliary function and morphology in rats
      following alpha-naphthylisothiocyanate (ANIT) administration.
AB  - These studies were designed to evaluate ANIT-induced changes in both
      hepatobiliary function and morphology during the onset, progression, and recovery
      of ANIT-induced cholestasis. A single oral dose of 150 mg/kg of ANIT or vehicle
      was administered by gavage to male Sprague-Dawley rats and hepatobiliary
      structure and function were evaluated 16, 24, 48, 72, and 168 hr later. Increased
      hepatocellular tight junction permeability, increased serum bile acids, and
      decreased bile acid excretion were observed 16 hr after ANIT administration. At
      24 hr, bile flow was decreased in ANIT-treated rats, an effect accompanied by
      increased tight junction permeability, decreased bile acid excretion, and
      decreased erythritol clearance (estimate of canalicular flow). In addition,
      scattered small loci of hepatocellular necrosis accompanied by an inflammatory
      cell response were observed in ANIT-treated rats at this time, with no
      microscopic evidence of bile duct obstruction (BDO). These data suggest that the
      onset of ANIT-induced cholestasis was associated with hepatocanalicular changes
      and not BDO. In contrast, at 48 and 72 hr after ANIT treatment, cholestasis was
      more profound and was accompanied by mild hepatocellular necrosis and widespread
      BDO. Hepatocyte tight junction permeability in ANIT-treated rats was not
      different from controls at 72 hr. These data suggest that the pathogenesis of
      ANIT-induced cholestasis is biphasic; the onset of cholestasis appears to be
      associated with changes in hepatocanalicular function and increased tight
      junction permeability whereas the later and more profound phase of cholestasis
      appears to be related to a combination of BDO and hepatocellular dysfunction. The
      time course of biochemical and morphologic changes following ANIT treatment
      further suggests that the pathophysiologic changes during the onset or initiation
      phase of cholestasis differ from those involved in the later and more profound
      phase of ANIT-induced cholestasis.

PMID- 8470114
TI  - Nephrotoxicity of repeated injections of cadmium-metallothionein in rats.
AB  - Cadmium-metallothionein (Cd-MT) may have a role in the pathogenesis and
      irreversibility of Cd nephrotoxicity. In the present study, rats were injected
      with 0.3 mg Cd/kg body wt per week as Cd-MT for 5 consecutive weeks and a group
      of rats (n = 3) was killed 24 hr after each injection. A group of three rats was
      kept for an additional week after the 5 weeks of Cd-MT injection for recovery.
      After the first injection, urinary Cd and protein levels and kidney/body wt ratio
      were increased. The electrophoretic pattern of urinary protein showed increased
      excretion of low-molecular-weight proteins, especially after the first injection
      of Cd-MT. Tubular cell necrosis occurred after the first week with renal Cd
      levels of only 10 micrograms/g and gradually progressed to severe necrosis with
      inflammation in 3 weeks and then to interstitial fibrosis in 5 weeks. The levels
      of Cd and MT in kidney increased with repeated injection of Cd-MT, but renal Cd
      was about 40 micrograms/g after 5 weeks of injection. Urinary Cd and MT levels
      progressively increased during the Cd exposure period, but returned to
      pretreatment levels during the sixth week (recovery period). Renal cell necrosis
      and inflammation were absent at the sixth week, but interstitial fibrosis
      persisted. This study indicates that nephrotoxicity of Cd in this model is
      related to urinary excretion of Cd-MT and that renal cell injury may be
      independent of Cd in the renal cortex. Nephrotoxicity occurs at levels much lower
      than the proposed critical concentration for Cd (200 micrograms Cd/g) following
      long-term exposure to CdCl2. However, in the absence of continued Cd exposure
      from liver or circulation, the Cd-MT-induced renal damage is reversible.

PMID- 8470115
TI  - Single dose blood toxicokinetics of methacrylonitrile in the F344 rat.
AB  - Methacrylonitrile (MAN) is a widely used industrial chemical. Minimal information
      is available on its effects or toxicokinetics; therefore, current investigations
      were undertaken as part of an overall effort to characterize MAN toxicity in
      laboratory animals. Groups of male F344 rats were administered MAN intravenously
      (29, 58, or 116 mg/kg) or perorally (58 mg/kg). Blood samples were collected at
      various time points after dosing and serum MAN concentrations were measured.
      Concentration versus time profiles were characterized by two phases and a two
      compartment model was selected to fit the data. Toxicokinetic parameters were
      determined using Simusolv. The 39-min terminal half-life shows that 99% of an
      i.v. dose is eliminated in less than 5 hr, suggesting that the potential for MAN
      bioaccumulation is minimal. The volume of distribution at steady-state (747
      ml/kg) indicates little distribution of MAN into tissues. Clearance is higher at
      29 mg/kg than at the two other doses, suggesting that MAN elimination is
      saturable at doses above 29 mg/kg. MAN disposition is route-dependent.
      Approximately 36% of the i.v. dose was exhaled as unchanged MAN, while only 18%
      was eliminated via this route following po administration. MAN disposition data
      also suggest that a significant first-pass metabolism may occur because a higher
      percentage of metabolites was produced following oral vs i.v. administration.
      Perorally, 39% of the dose was exhaled as CO2 and 22% was excreted into the urine
      as metabolites over the 24-hr dosing interval. In comparison, following i.v.
      delivery, 26% of the dose was exhaled as CO2 and 16% was excreted into the urine
      as metabolites. About equal amounts of acetone were excreted following
      administration by either route. This information may prove useful in designing
      long-term toxicity studies for MAN by the National Toxicology Program and in
      interpreting the results of such studies.

PMID- 8470116
TI  - Apoptosis as a mechanism of tributyltin cytotoxicity to thymocytes: relationship
      of apoptotic markers to biochemical and cellular effects.
AB  - Recent in vitro studies have suggested that activation of apoptosis could account
      for the profound depletion of cortical thymocytes, which characterizes
      tributyltin (TBT) immunotoxicity. However, it has also been shown that TBT
      disrupts macromolecular synthesis and cellular energetics to an extent that might
      be expected to interfere with the initiation of apoptosis. The purpose of these
      studies was to further evaluate the morphological and biochemical characteristics
      of thymocyte killing by TBT and to relate this to key cellular processes. Ex vivo
      thymocyte cultures from immature rats were treated with bis(tri-n-butyltin) oxide
      (TBTO) at concentrations ranging from those which rapidly produced necrosis (5-10
      microM), down to cytotoxic but subnecrotic concentrations (0.1-2 microM). In
      cells exposed to TBTO concentrations that caused a rapid and near maximal
      inhibition of protein synthesis, it remained possible to demonstrate the
      stereotypic internucleosomal DNA cleavage and morphological changes indicative of
      apoptosis. Further confirmation that apoptosis was occurring independently from
      protein synthesis was provided by the absence of a protective effect following
      cycloheximide pretreatment. Apoptosis still occurred in TBTO-treated thymocytes
      although intracellular ATP levels were depressed to 20% or less of control
      values. Cytoprotective effects were noted with the intracellular Ca2+ chelators
      BAPTA-AM and Quin-2 AM, and also with zinc. Cell killing by TBTO occurred without
      overt disturbance of thymocyte cell cycle parameters. These results indicate that
      thymocyte apoptosis stimulated by TBT exposure occurs independently of a
      requirement for protein synthesis and does not require fully conserved cellular
      energetics.

PMID- 8470117
TI  - Modeling blood/plasma concentrations in dosed feed and dosed drinking water
      toxicology studies.
AB  - A computer model for predicting blood/plasma concentrations of test chemicals in
      dosed feed and dosed drinking water toxicology studies was developed. The model
      was constructed based on linear theory. The animal's feeding and drinking habits
      and the linear disposition kinetics of the test chemical obtained after a bolus
      gavage dose were built into the model. Blood/plasma concentrations of oxazepam
      and pentachlorophenol in dosed feed and dosed drinking water studies were
      predicted and compared with the experimentally determined data. The model proved
      highly reliable in predicting the blood/plasma concentrations of test chemical in
      dosed feed and dosed drinking water studies. The results suggest that if the
      kinetics of test chemicals fit a one-compartment model then bioaccumulation of
      the test chemical will occur in dosed feed or in dosed drinking water studies
      when absorption half-lives are less than 1.38 hr and elimination half-lives are
      longer than 5 hr. The extent of accumulation is mainly dependent on the
      elimination half-lives. For chemicals with absorption half-lives less than 1.38
      hr and elimination half-lives less than 2 hr, the extent of bioaccumulation will
      be minimal. Blood/plasma concentrations of test chemicals in rats and mice will
      fluctuate daily and a quasi-steady state will be achieved after ad libitum
      exposure to dosed feed or dosed drinking water for approximately 4 days. If a
      daily 12-hr light cycle is used with the light cycle starting at 7:00 AM, the
      expected peak and trough blood concentrations in dosed feed studies will occur
      approximately in the early morning (5:00 AM) and in the late afternoon (4:00 PM),
      respectively. Similar results were obtained for dosed drinking water studies. The
      model should be applicable to dosed feed and dosed drinking water studies using
      other species.

PMID- 8470118
TI  - Alterations in alveolar type II cell metabolism induced by tetrandrine and other
      alkaloids.
AB  - Tetrandrine (TT) and other bisbenzylisoquinoline alkaloids have been used in
      China as a treatment for fibrotic lung diseases. Because of their potential use
      as pulmonary therapeutic agents, we studied the effects of some of these
      compounds on energy metabolism in isolated rat alveolar type II cells, i.e.,
      cells which play a critical role in maintaining normal lung function. Incubation
      of type II cells with most of the alkaloids produces a reduction in cellular ATP
      content. However, there is no effect of the alkaloids on cellular oxygen
      consumption. All of the alkaloids which produce reductions in cell ATP levels
      cause increases in internal calcium levels of type II cells. Incubation of the
      cells with the calcium ionophore, 4-bromo A-23187, leads to increased amounts of
      intracellular calcium and reductions in ATP levels, but has no effect on oxygen
      consumption. Exposure of isolated lung mitochondria to calcium produces a
      concentration-dependent reduction in ATP synthesis with no effect on
      mitochondrial oxygen consumption. Direct exposure of mitochondria to TT has no
      effect on ATP synthesis. These results are consistent with the notion that the
      alkaloids produce an increase in type II cell internal calcium levels which, in
      turn, leads to reduced rates of mitochondrial ATP synthesis.

PMID- 8470119
TI  - Radiometric assay of red cell and plasma cholinesterase in pesticide appliers
      from Minnesota.
AB  - In this study we demonstrate the uses of radiometric assay to detect
      anticholinesterases in a human population (N = 80) exposed to a broad spectrum of
      pesticides. The assay is nondilutional. Therefore, anticholinesterase (AChE)
      agents with low binding affinity can be detected. Our initial results show
      statistically significant exposure-related decreases in either red cell (AChE) or
      plasma cholinesterase activity ((butyrl)cholinesterase; BuChE) occurred not only
      among pesticide appliers who use organophosphates, but also among appliers of the
      fumigant phosphine. These data extend earlier observations made in laboratory
      animals exposed to this fumigant. Significant exposure-related decreases in AChE
      activity were seen in herbicide appliers and appear to be associated with
      exposure to the herbicide 2-methoxy-3,6-dichlorobenzoic acid. There was no
      evidence of exposure-related decreases in BuChE activity in herbicide appliers.
      Our in vivo data, coupled with preliminary in vitro studies of phosphine (50%
      AChE inhibition, 10 ppm) and 2-methoxy-3,6-chlorobenzoic acid (50% AChE and BuChE
      inhibition, 70 ppm), suggest that the radiometric assay may be used to detect a
      broader spectrum of biologically active anticholinesterase agents.

PMID- 8470120
TI  - Contrasting effects of 1,1,1-trichloroethane on [14C]vinyl chloride metabolism
      and activation in hepatic microsomes from phenobarbital- and isoniazid-treated
      rats.
AB  - The interaction of 1,1,1-trichloroethane (TCE), a widely used chlorocarbon
      solvent, on the metabolism and activation of [14C]-vinyl chloride in rat hepatic
      microsomes was investigated to determine the effects of combined exposures to
      these compounds. In microsomes from phenobarbital (PB)-treated rats, TCE
      increased vinyl chloride-protein binding and vinyl chloride aqueous metabolite
      formation over twofold when vinyl chloride 0.32% (v/v) and TCE (0.65%) are
      incubated together. In contrast, under similar incubation conditions, TCE
      inhibited vinyl chloride metabolism and protein binding up to 45% in microsomes
      from isoniazid-treated animals. TCE also inhibited vinyl chloride metabolism and
      binding in microsomes from untreated rats, but to a lesser degree. Like the
      effect of TCE on vinyl chloride-protein binding, TCE increased vinyl chloride
      binding to DNA approximately 130% in microsomes from PB-treated rats, yet
      inhibited vinyl chloride-DNA binding in microsomes from isoniazid-treated and
      untreated animals. Consistent with TCE effects on vinyl chloride binding and
      aqueous metabolite production, TCE further increased cytochrome P450 loss due to
      vinyl chloride metabolism in microsomes from PB-treated rats, but was inhibitory
      to cytochrome P450 loss due to vinyl chloride metabolism in microsomes from
      isoniazid-treated and untreated rats. These data demonstrate that the relatively
      metabolically inert solvent, 1,1,1-trichloroethane, can directly increase vinyl
      chloride metabolism and activation catalyzed by the phenobarbital-inducible
      isozymes, but is inhibitory toward vinyl chloride metabolism catalyzed by the
      isoniazid-inducible CYP2E1.

PMID- 8470121
TI  - Effect of dose on the metabolism of 1,1,2,2-tetrabromoethane in F344/N rats after
      gavage administration.
AB  - 1,1,2,2-Tetrabromo[U-14C]ethane ([14C]TBE) was used to study the metabolism of
      TBE in rats. Three graded doses of TBE (1.17, 13.6, and 123 mg/kg; 1 microCi
      14C/rat at each dose) were administered by gavage to three groups of four rats
      each. Excreta samples were collected at various time intervals up to 96 hr.
      Following euthanization, 14C activity was measured in the excreta, tissues, and
      carcass. The fraction of the dose exhaled as volatile metabolites of TBE,
      excluding 14CO2, was approximately 9-10% higher in rats given the high dose of
      TBE compared to that in rats given either the low or the medium dose. The
      fraction excreted in the urine decreased with increasing TBE dosage. 1,2
      Dibromoethylene and tribromoethylene were identified as exhaled metabolites at
      the high dose. Three major urinary metabolites were identified: dibromoacetic
      acid, glyoxylic acid, and oxalic acid. The results of this study indicate that
      the metabolism of TBE was linear up to a dose of 13.6 mg/kg, but the contribution
      of various TBE metabolic pathways was different at a dose of 123 mg/kg.

PMID- 8470122
TI  - Effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the epidermal growth
      factor receptor in hepatic plasma membranes of rainbow trout (Oncorhynchus
      mykiss).
AB  - Time- and dose-dependent alterations in epidermal growth factor receptor (EGF-R)
      ligand binding and protein kinase activity were observed in hepatic plasma
      membranes of TCDD-treated rainbow trout. Trout were dosed by a single ip
      injection of TCDD in a corn oil vehicle. A single ip injection of TCDD (10
      micrograms TCDD/kg body wt) caused a maximal reduction of EGF binding to hepatic
      plasma membranes by 10 days post-treatment and remained reduced until Day 40.
      EROD activity in the liver microsomes of TCDD-treated trout increased relative to
      that in untreated fish over the course of the study. Protein kinase C and
      tyrosine kinase activity as well as EGF-receptor phosphorylation was greater in
      livers of treated fish than in those of control fish within 5 days but returned
      to control levels by 40 days postinjection. In a dose-response study, EGF binding
      was reduced in a dose-dependent manner with an ED50 of 0.17 micrograms TCDD/kg
      wet wt while EROD activity was induced with an ED50 of 0.79 micrograms TCDD/kg.
      The reduction in EGF binding was correlated to an increase in EROD activity,
      protein kinase C activity, and tyrosine kinase activity but was negatively
      correlated to EGF-receptor phosphorylation. Of the parameters examined in both
      the time-course and dose studies, protein kinase C was the best predictor of the
      reduction of EGF binding to hepatic plasma membranes of rainbow trout. The
      results from this study are consistent with the hypothesis that the mode of
      action of TCDD on the EGF receptor is in part mediated through the protein kinase
      C activity. It also suggests that the toxic mode of action of TCDD is similar in
      rainbow trout and mammals.

PMID- 8470123
TI  - The nongenotoxic hepatocarcinogen Wy-14,643 is an uncoupler of oxidative
      phosphorylation in vivo.
AB  - Wy-14,643 is a potent nongenotoxic hepatic carcinogen and peroxisome proliferator
      in rodents; however, the mechanism by which it causes tumors remains unknown. In
      previous work it was demonstrated that Wy-14,643 caused a dose-dependent
      uncoupling of oxidative phosphorylation (half-maximal effect = 100 microM) in
      isolated mitochondria (Keller et al., 1992, Biochim. Biophys. Acta, 1162, 237
      244); therefore, the purpose of this study was to determine if uncoupling
      occurred in vivo under conditions which lead ultimately to tumors. Rats were fed
      Wy-14,643 (0.1%) in ground laboratory chow for 1, 21, 75, and 105 days. As
      expected, activity of the peroxisomal marker enzyme, acyl-CoA oxidase, was
      increased about eightfold in liver homogenates during the first 3 weeks of
      treatment, confirming the induction of peroxisomes. Basal rates of oxygen uptake
      by the perfused liver were increased significantly by Wy-14,643 treatment at all
      time points studied, consistent with the hypothesis that oxidative
      phosphorylation was uncoupled. Basal rates of oxygen uptake of about 130
      mumol/g/hr were increased by over 20 mumol/g/hr in rats fed Wy-14,643 in their
      diet for 10 weeks. Concomitantly, rates of urea synthesis from ammonia, a process
      highly dependent on ATP supply, were reduced significantly in the perfused liver
      from 104 mumol/g/hr in control livers to 13 mumol/g/hr in livers from rats
      treated with Wy-14,643 for 75 days. Taken together, these data indicate that
      energy supply is disrupted in vivo due to uncoupling of oxidative phosphorylation
      by Wy-14,643.

PMID- 8470124
TI  - Effect of cumulative exposure on nasal response to ozone.
AB  - To assess the potential health risks associated with exposure to low levels of
      ozone, it is essential to know if the ozone-induced responses are dependent on
      cumulative exposures or on the peak concentrations. To answer this question
      female F344/N rats, 11-13 weeks of age, were exposed to a matrix of equal
      concentration x time values that included exposures to 0, 0.12, 0.24, and 0.48
      ppm ozone for 3, 6, 12, or 24 hr. the response of the nasal epithelium was
      measured as induced DNA synthesis determined by the uptake of bromodeoxyuridine
      (a thymidine analog) into epithelial cells lining the nasal anterior
      maxilloturbinates. No increased DNA synthesis was observed in rats exposed to
      0.12 ppm ozone for any of the time periods. For exposures higher than 0.12 ppm
      ozone, the response of the nasal epithelium was similar for equal cumulative
      exposures. The responses, however, were not linearly related to the cumulative
      (concentration x time) exposures. It appeared that some mitigating factor was
      present which decreased the responses at the higher cumulative exposures. No
      frank toxicity or cellular necrosis was observed, indicating that sublethal cell
      damage was sufficient to induce DNA synthesis. A simple mathematical model was
      developed to describe the relationship between ozone exposure and the induction
      of DNA synthesis in the nasal epithelium. The model predicted that the threshold
      concentration of ozone for inducing DNA synthesis in the nasal epithelium was 0.1
      +/- 0.1 ppm. For one measure of ozone toxicity (induced DNA synthesis) at a
      sensitive site in the respiratory tract (maxilloturbinates), the effects of ozone
      were dependent on cumulative exposures at concentrations > 0.12 ppm and within
      the time and concentration ranges used in this study.

PMID- 8470125
TI  - Induction of cytochrome P450-dependent monooxygenases in hamster tissues by
      fasting.
AB  - The effects of fasting on liver, kidney, and lung monooxygenases were studied
      using hamsters starved for 4 days. Fasting treatment increased microsomal
      cytochrome P450 content and NADPH-cytochrome P450 reductase activity in kidney
      and lung. The treatment caused significant increases of aniline hydroxylation, N
      nitrosodimethylamine demethylation, and 7-ethoxycoumarin O-deethylation
      activities in the liver, kidney, and lung. Fasting caused a threefold increase of
      benzphetamine N-demethylation activity in lung and a 25% increase in liver and
      had no effect in kidney. Benzo[a]pyrene hydroxylation activities in the fasted
      hamster liver, kidney, and lung were higher, lower, and similar to the controls,
      respectively. Gel electrophoresis of tissue microsomes from control and fasted
      hamsters revealed that fasting enhanced the intensity of protein band(s) in the
      P450 molecular weight region. Immunoblotting of the microsomal proteins showed
      that fasting induced a protein crossreactive with rabbit antibody raised against
      human P450 2E1 in hamster liver, kidney, and lung. Immunoblotting analysis using
      mouse monoclonal antibody 2-66-3 raised against rat P450 2B1 revealed that
      fasting induced an immunorelated protein preferentially in hamster lung, with
      minimal effects on liver and kidney. Protein blots probed with mouse monoclonal
      antibody 1-12-3 indicated that fasting induced a protein related to P450 1A1 in
      hamster liver, kidney, and lung. These results demonstrate that fasting causes a
      variety of inductive effects on the enzyme components and catalytic activities of
      monooxygenase systems as well as on the P450s 2E, 2B, and 1A in the hamster
      tissues.

PMID- 8470126
TI  - Physiological model for the pharmacokinetics of methyl mercury in the growing
      rat.
AB  - We describe a physiological pharmacokinetic model for methyl mercury and its
      metabolite mercuric mercury in the growing rat. Demethylation appears to occur in
      both host tissues and gastrointestinal flora with elimination dominated by
      biliary secretion of inorganic mercury and by transport of methyl mercury into
      the gut lumen followed by substantial bacterial metabolism. Biliary transport of
      both organic and inorganic mercury is modeled in terms of the known secretion of
      glutathione from the hepatic pool. At 98 days following an oral tracer dose of
      203Hg-labeled methyl mercury chloride, 65% of the administered dose had been
      recovered in the feces as inorganic mercury and 15% as organic mercury. Urinary
      excretion is a minor elimination route, accounting for less than 4% of the dose
      as methyl mercury and 1% of the dose as inorganic mercury. Irreversible
      incorporation of the mercurials into hair is a significant route of elimination.
      Ten percent of the administered dose was contained in the hair shed during the 98
      days and over 12% of the dose (almost 90% of the body burden) remained in the
      hair at the end of that time period. Apparent ingestion of hair by the rats
      during grooming represents a novel form of toxin recirculation. Transport of both
      chemical species between blood and tissues is bidirectional and symmetric with
      relatively slow movement into and out of the brain. Transport mechanisms for both
      mercurial species are discussed in the context of capillary transport physiology
      and the blood-brain barrier to small molecules and proteins.

PMID- 8470128
TI  - Spider venoms are not suitable insecticides.

PMID- 8470127
TI  - The effect of 1-chloro-2,4-dinitrobenzene exposure on antigen receptor (CD3)
      stimulated transmembrane signal transduction in purified subsets of human
      peripheral blood lymphocytes.
AB  - The intracellular low-molecular-weight thiol glutathione (GSH) is an important
      scavenger of free radicals and plays a role in the maintenance of the redox
      status of protein sulfhydryl groups. We have previously shown that human
      peripheral blood lymphocytes sorted on their basal GSH content proliferate
      proportionately to their GSH levels, and that an early event in lymphocyte
      activation appeared to be dependent on GSH. We have now analyzed transmembrane
      signal transduction in cells treated with 1-chloro-2,4-dinitrobenzene (CDNB), a
      GSH-depleting agent. Transmembrane signal transduction was measured as changes in
      intracellular free calcium and in protein tyrosine phosphorylation after
      stimulation with anti-CD3 monoclonal antibody. The results show a CDNB dose
      dependent reduction in GSH content, the magnitude of intracellular free calcium
      mobilization, and the extent of tyrosine phosphorylation of several proteins,
      including phospholipase C-gamma 1. This suggests a role for GSH and/or protein
      thiol redox status in one of the earliest events controlling the ability of
      lymphocytes to respond to important proliferative signals in their environment
      and implies that agents which deplete lymphocyte GSH may be immunosuppressive
      through effects on CD3/T cell receptor-dependent transmembrane signal
      transduction.

PMID- 8470129
TI  - Influence of initial toxicity and extraction procedure on paralytic toxin changes
      in the mussel.
AB  - Farmed mussels were artificially contaminated with a pure culture of an
      Alexandrium tamarense toxic strain (MOG 835), to assess the effect of initial
      toxicity on paralytic toxin change during the depuration process. As previously
      observed in mussel, gonyautoxin GTX2 is eliminated more slowly than other
      gonyautoxins. A toxic level (1300 micrograms PSP per 100 g meat) is required to
      produce a drastic change in the depuration course, i.e. a 'fast' depuration rate
      followed by a 'slow' one. Below this threshold, decontamination becomes slower as
      the proportion of GTX2 increases over the time course. Although GTX2 is slowly
      eliminated during the depuration process, it is also formed in increasing
      quantities during the contamination phase. It remains to be determined whether
      changes in GTX2/GTX3 ratios are due to chemical or biological transformation.

PMID- 8470130
TI  - Isolation of a myotoxin from the venom of Agkistrodon contortrix laticinctus
      (broad-banded copperhead) and pathogenesis of myonecrosis induced by it in mice.
AB  - A myotoxin was isolated from the venom of the broad-banded copperhead
      (Agkistrodon contortrix laticinctus) by HPLC using anion and cation exchange
      chromatography. The toxin has a mol. wt of approximately 14,000 and has a pI
      greater than 9. It does not have phospholipase A activity, but does induce
      myonecrosis of skeletal muscle cells characterized by a hypercontraction of
      myofilaments. Electron microscopic analysis showed that the myotoxin appears to
      disrupt the sarcolemma of skeletal muscle cells. ACL myotoxin is very similar in
      mol. wt, amino acid composition, and myotoxic activity to myotoxins isolated from
      the venoms of Bothrops asper and Bothrops nummifer from Central America,
      suggesting that homologs of this toxin may be found in other crotaline snake
      venoms.

PMID- 8470131
TI  - Effect of bilineobin, a thrombin-like proteinase from the venom of common cantil
      (Agkistrodon bilineatus).
AB  - A thrombin-like proteinase, named bilineobin, was isolated from Agkistrodon
      bilineatus venom by Sephadex G-75, DEAE-Sephacel and Heparin-Sepharose CL-6B
      column chromatography. The purified enzyme has a mol. wt of 57,000 and catalysed
      the hydrolysis of arginine esters and thrombin substrates Boc-Val-Pro-Arg-MCA and
      Boc-Asp(OBz)-Pro-Arg-MCA. Although bilineobin converted fibrinogen into fibrin
      resulting in the production of fibrinopeptides, the activity was relatively low
      (0.65 NIH units/mg). Fibrinopeptides released upon hydrolysis by this proteinase
      were identified as fibrinopeptide A (FpA) and fibrinopeptide B (FpB) by measuring
      fast atom bombardment (FAB) mass spectra and amino acid sequence. This indicates
      that bilineobin hydrolyses the Arg(19)-Gly(20) bond in the A alpha chain and the
      Arg(21)-Gly(22) bond in the B beta chain of the bovine fibrinogen molecule.
      Kinetic study of FpA and FpB release reveals that bilineobin has a preference for
      cleaving the B beta chain. In addition, bilineobin is resistant to thrombin
      inhibitors such as hirudin. These suggest that the mechanism of action of
      bilineobin is similar but not identical to that of thrombin. It was demonstrated
      that the NH2-terminal region of bilineobin has significant similarities in
      sequence with thrombin-like proteinases from other snake venoms; however, only
      three residues were common with thrombin up to residue number 24.

PMID- 8470132
TI  - Binding of myotoxin a to cultured muscle cells.
AB  - The binding of radiolabeled myotoxin a to various cultured cell lines was
      evaluated. One rat skeletal muscle-derived cell line, L8, bound substantially
      more myotoxin a than did all all other cell lines examined. Several biophysical
      parameters of myotoxin a-L8 binding were determined. Binding was saturable with a
      moderate binding affinity. Scatchard analysis and Hill plots indicated a single
      class of binding sites. The binding was reversible, as demonstrated by chase
      experiments. Radiolabeled myotoxin a bound to the cell surface at a site
      inaccessible to the general protease, pronase. Specificity and biological
      relevance of the binding was suggested by competition with unlabeled toxin and
      various peptides derived from the toxin. Biologically active peptides,
      corresponding to the N- and C-terminal sequence of myotoxin a, competed with
      radiolabeled toxin for L8 binding. It was concluded that the L8 system is a
      suitable cell model to study myotoxin a mechanism of action.

PMID- 8470133
TI  - Antagonism of the myotoxic effects of Bothrops jararacussu venom and
      bothropstoxin by polyanions.
AB  - The effects of heparin and other polyanions on the myotoxicity of Bothrops
      jararacussu venom and purified bothropstoxin (BthTX) were investigated. The
      release rate of creatine kinase (CK) from isolated extensor digitorum longus
      muscle and the plasma CK activity of mice were used to quantify the results. The
      myotoxic effects of B. jararacussu venom or BthTX were inhibited by preincubation
      of these agents with one of the following: a heterogeneous heparin preparation
      (designated 'heparin'), low mol. wt heparin (H-4500) or dextran sulfates (DS-8000
      and DS-500,000). Non-sulfated dextran (D-40,000) and two chondroitin sulfates
      were ineffective. The antimyotoxic effects of the polyanions are ascribed to
      their forming inactive acid-base complexes with the basic myotoxins of Bothrops
      venoms. Gel-filtration experiments in Sephadex provided direct evidence for
      complex formation between heparin and BthTX. Intravenous (i.v.) administration of
      H-4500 or DS-8000 opposed the increase in plasma CK activity induced by a
      subsequent i.m. injection of venom or BthTX. In contrast, pretreatment with i.v.
      heparin or DS-500,000 enhanced the venom-induced increase in plasma CK activity.
      This effect was not observed (1) when the animals were treated with a polyvalent
      antivenom, which inhibits the coagulation and local stasis induced by Bothrops
      venoms, and (2) when BthTX, which has no thrombotic or hemorrhagic properties,
      was the myotoxic agent. The potentiation of the venom-induced increase in plasma
      CK activity by heparin and DS-500,000 is ascribed to improved washout of the CK
      released from damaged fibers, because of the anticoagulant properties of the
      drugs.

PMID- 8470134
TI  - Effects of stonefish (Synanceia trachynis) venom on murine and frog neuromuscular
      junctions.
AB  - The neuromuscular toxicity of stonefish (Synanceia trachynis) venom was
      characterized by electrophysiological and electron microscopic examination of
      isolated murine and frog nerve-skeletal muscle preparations exposed to various
      concentrations of venom. Low concentrations of venom (2.5-10 micrograms/ml) acted
      presynaptically by causing release and depletion of neurotransmitter from the
      nerve terminal. The response was Na+ channel-independent (resistant to
      tetrodotoxin), required the presence of either Ca2+ or Mg2+, and was observed
      with botulinum neurotoxin-paralyzed nerve-muscle preparations. Higher
      concentrations of venom (100-300 micrograms/ml) acted postsynaptically and
      presynaptically. They caused irreversible depolarization of muscle cells and
      microscopically observable muscle and nerve damage. We conclude that the
      previously observed neuromuscular toxicity of stonefish venom is a consequence of
      the venom's dose-dependent, presynaptic and postsynaptic actions at the myoneural
      junction.

PMID- 8470135
TI  - Identification and characterization of tox21A: a mite cDNA encoding a paralytic
      neurotoxin related to TxP-I.
AB  - A cDNA library established from polyadenylated RNA isolated from the predatory
      mite Pyemotes tritici was screened for cDNAs homologous to tox34, a cDNA encoding
      an insect-selective paralytic neurotoxin known as TxP-I. Most of the cDNA inserts
      of homologous clones were shorter or of equal length to tox34 but a few were
      longer. Further investigation into the nature of these longer clones led to the
      identification, sequencing and expression of a distinct cDNA referred to as
      tox21A. This cDNA is predicted to encode a polypeptide which shares approximately
      83% amino acid identity with TxP-I. Larvae infected with a recombinant
      baculovirus expressing tox21A are paralyzed during infection in a manner similar
      to larvae infected with tox34-expressing recombinants. The tox21A cDNA may
      represent a duplicated and diverged copy of the TxP-I gene.

PMID- 8470136
TI  - Neutralizing capacity of murine sera induced by different antigens of scorpion
      venom.
AB  - Approximately 700 people die in Mexico each year from scorpion stings. The only
      useful therapy available is antiserum obtained from horses immunized with
      macerates of venomous gland from scorpions of the genus Centruroides. We report
      the results of experiments conducted with mice and rats in order to evaluate the
      relevant components of the venom from Centruroides noxius in the induction of a
      protective response against scorpion envenomation, either in vivo or in vitro.
      Gland macerates of whole telsons (stinger), soluble venom extracted by electrical
      stimulation, toxic fractions from gel filtration on Sephadex G-50 and highly
      purified toxin 2 from this scorpion venom were all used to produce hyperimmune
      mice and rats, which were challenged in vivo with the equivalent of the lethal
      dose 50% (LD50) of soluble venom, or their sera were prepared for in vitro
      neutralization experiments using non-immunized animals. The maximum neutralizing
      capacity (100%) was obtained when soluble venom was used as antigen, while
      purified toxin 2 produces 80% survival in vivo. The neutralizing capacity of
      murine antisera evaluated in vitro was: sera antifraction II > antitoxin 2 >
      antitotal venom > anti-gland macerates of whole telsons. Two additional aspects
      were further investigated in the present work. One is the demonstration by
      immunoblotting that proteins corresponding to the electrophoretic mobility of
      toxins known to block sodium channels are highly immunodominant in this venom.
      Second, there is a strong cross-reactivity of antisera produced with Centruroides
      noxius when assayed against venoms from other dangerous species of Centruroides
      scorpions from Mexico, but not against the Israeli scorpion Leiurus
      quinquestriatus. Finally, the immunodominance of toxic fractions in the immune
      response was observed either with immunization using Freund's adjuvant or by
      means of adsorption to nitrocellulose membranes. This latter vehicle was shown to
      be an excellent detoxifying agent, without changing the immunogenicity of the
      toxins, as might occur with chemical treatment of these neurotoxic peptides.

PMID- 8470137
TI  - Pharmacokinetics of cytotoxin from Chinese cobra (Naja naja atra) venom.
AB  - The pharmacokinetics of cytotoxin from Chinese cobra (Naja naja atra) venom was
      studied in rabbits after i.v. and i.m. injection of 0.2 and 0.5 mg.kg-1,
      respectively. The plasma levels of the cytotoxin were analysed by a biotin-avidin
      enzyme-linked immunosorbent assay. The plasma concentration-time course after
      i.v. administration fitted a two-compartment open model. The half-life (mean +/-
      S.D.) of the alpha-phase was 5.8 +/- 0.6 min and that of the beta-phase 3.5 +/-
      0.2 hr. Apparent volume of distribution was 1.7 +/- 0.3 litres.kg-1, and
      clearance was 5.6 +/- 1.4 ml.min-1. A rapid absorption was observed after i.m.
      injection with peak plasma level of 260 +/- 90 ng.ml-1 reached within 13.6 +/-
      2.4 min. The absorption rate constant was 0.16 +/- 0.03 ml-1. The area under the
      plasma concentration-time curve was 33 +/- 15 micrograms.min.ml-1.

PMID- 8470138
TI  - Biological activities of fumonisins, mycotoxins from Fusarium moniliforme, in
      jimsonweed (Datura stramonium L.) and mammalian cell cultures.
AB  - Fumonisins A1, A2, B1, B2 and B3 are a series of mycotoxins produced by strains
      of Fusarium moniliforme. Fumonisins are hydroxylated long-chain alkylamines
      esterified with propanetricarboxylic acid moieties that represent approximately
      half the mol. wt of the toxins. The A-series fumonisins are N-acetylated, whereas
      the B series contains free amino groups. Hydrolytic removal of the
      propanetricarboxylic acid moieties from fumonisins B1 and B2 yields the
      corresponding aminopentols, AP1 and AP2, respectively. These compounds were
      tested for toxicity on widely differing bioassay systems, representing plant and
      animal systems. The plant bioassay system employed jimsonweed (Datura stramonium
      L.) leaves and leaf discs in which toxicity was detected as electrolyte leakage,
      photobleaching and quantitation of chlorophyll reduction. The animal bioassay
      system employed cultured mammalian cell lines in which toxicity was detected as
      inhibition of cell proliferation. Fumonisins B1, B2 and B3 at 50 micrograms/ml or
      less were effective toxins after exposure periods greater than 24 hr in all plant
      and animal bioassay systems examined, except 3T3 mouse fibroblasts, whereas
      fumonisins A1 and A2 exhibited little or no activity. However, the hydrolytic
      degradation products AP1 and AP2 exhibited toxicity similar to or greater than B
      series fumonisins in all test systems, including substantial toxicity to 3T3
      mouse fibroblasts.

PMID- 8470139
TI  - Isolation and purification of AAL-toxin from Alternaria alternata grown on rice.
AB  - An isolation and purification procedure is described for AAL-toxin, a secondary
      metabolite produced by Alternaria alternata. The method involves growth of the
      fungus on rice media, extraction with chloroform followed by methanol: water from
      fungus-infested rice, and purification of the aqueous layer that contains AAL
      toxin by using chromatography methods. The AAL-toxin was of type A, and white in
      color, and its purity was > or = 95% with mol. wt 522 (M + 1).

PMID- 8470140
TI  - A comparative study of the biological properties of venoms from juvenile and
      adult inland taipan (Oxyuranus microlepidotus) snake venoms.
AB  - The biological properties of adult and juvenile inland taipan (Oxyuranus
      microlepidotus) snake venoms were examined. The enzymatic activities, intravenous
      median lethal dose and procoagulant activity of the juvenile venom samples were
      not significantly different from those of the adult venom samples. Also, the
      juvenile and adult venoms exhibited similar electrophoretic patterns, indicating
      that they possessed similar protein composition.

PMID- 8470141
TI  - Endocytic components: identification and characterization.

PMID- 8470142
TI  - Toward a biochemical definition of the endosomal compartment. Studies using free
      flow electrophoresis.

PMID- 8470143
TI  - Analytical subcellular fractionation of endosomal compartments in rat
      hepatocytes.

PMID- 8470144
TI  - Intravascular volume regulation in cirrhotic patients with functional renal
      failure.
AB  - Central volume expansion is an important component of treating renal dysfunction
      associated with advanced chronic liver disease. Experiments using HWI in these
      patients emphasize the importance of increasing central vascular filling as a way
      to normalize renal function through multiple physiologic mechanisms. However, the
      desired improvement in renal function is not always obtained with HWI, especially
      in patients with greater degrees of hepatic dysfunction, central volume
      depletion, and activation of neurohumoral support systems. This may, in part, be
      related to reflexive decreases in systemic vascular resistance during immersion.
      The development of techniques to expand central arterial volume while maintaining
      systemic vascular resistance and mean arterial pressure may add to the beneficial
      effects on renal function in cirrhotics. Pneumatic compression of the lower
      extremities may be one way of achieving the desired circulatory effects.
      Adjunctive therapy with splanchnic vasoconstrictors may be necessary in patients
      with marked vasodilation but they often have undesirable intrarenal actions.

PMID- 8470145
TI  - Pathogenesis of hepatorenal syndrome.

PMID- 8470146
TI  - Renal failure in cirrhosis and liver transplantation.

PMID- 8470147
TI  - Dialysis in liver failure and liver transplantation.

PMID- 8470148
TI  - Circulation in liver disease.

PMID- 8470149
TI  - Hepatopulmonary syndrome.

PMID- 8470150
TI  - Kidney function following orthotopic liver transplantation and its relationship
      to arterial hypertension.

PMID- 8470151
TI  - Neurological disorders and intraoperative factors in liver transplantation.

PMID- 8470152
TI  - Prophylactic recombinant hepatitis B vaccine in patients undergoing orthotopic
      liver transplantation.

PMID- 8470153
TI  - Nonspecific cholestatic syndrome in liver transplantation: successful symptomatic
      treatment by plasma exchange.

PMID- 8470154
TI  - Hepatitis B virus replication patterns after orthotopic liver transplantation: de
      novo versus recurrent infection.

PMID- 8470155
TI  - Maintenance immunosuppression with prednisone and RS-61443 alone following liver
      transplantation.

PMID- 8470156
TI  - Outcome of patients requiring hemodialysis after liver transplantation.

PMID- 8470157
TI  - Transjugular intrahepatic portacaval stent shunts in patients with renal
      insufficiency.

PMID- 8470158
TI  - Renin-angiotensin-aldosterone system and arterial hypertension following
      orthotopic liver transplantation.

PMID- 8470159
TI  - Child-Pugh score and liver transplantation.

PMID- 8470160
TI  - Neuropsychiatric complications after liver transplantation: a single center
      experience.

PMID- 8470161
TI  - Relationship between cerebral perfusion pressure and systemic hemodynamics in
      fulminant hepatic failure.

PMID- 8470162
TI  - Serum amino acids following human orthotopic liver transplantation.
AB  - Our findings indicate that serum amino acid changes after OLT are complex and
      influenced by multiple factors including sepsis and use of parenteral
      hyperalimentation with exogenous amino acids. Additional factors which may
      influence the rate of normalization of amino acids after OLT include the presence
      of malnutrition (frequently observed before OLT) and the extent of pretransplant
      portal-systemic shunting. Our results demonstrate that the presence of septic
      complications and the use of CPN are important determinants of the postoperative
      levels of several amino acids, including the BCAA/AAA ratio. Our logistic
      regression model using the BCAA/AAA ratio predicted the occurrence of sepsis
      after OLT 77% of the time. Prospective assessment and validation of this model is
      under way.

PMID- 8470163
TI  - Soluble interleukin-2 receptor levels in pediatric liver transplant recipients.

PMID- 8470164
TI  - Somatic muscle catabolism is accelerated after liver transplantation.

PMID- 8470165
TI  - Reversibility of the hepatopulmonary syndrome by orthotopic liver
      transplantation.

PMID- 8470166
TI  - Reversibility of pulmonary hypertension after liver transplantation: a case
      report.

PMID- 8470167
TI  - Dynamic aspects of albumin and other plasma proteins after liver transplantation
      from analbuminemic to normal rats.

PMID- 8470168
TI  - Effect of cyclosporine on the distribution of macrophage phenotypes in the rat
      hepatic allograft.

PMID- 8470169
TI  - Transcranial Doppler: monitoring of cerebral blood flow velocity during liver
      transplantation.

PMID- 8470170
TI  - Comparison of shunt fractions pre- and post-liver transplantation.

PMID- 8470171
TI  - Prognostic value of the APACHE II, SAPS, and TISS indexes in short-term survival
      of liver transplant patients.

PMID- 8470172
TI  - Circulating heparin during liver transplantation.

PMID- 8470173
TI  - Gastric mucosal pH predicts major morbidity following orthotopic liver
      transplantation.

PMID- 8470174
TI  - Hepatic oxygen supply and uptake during anesthesia for orthotopic liver
      transplantation.

PMID- 8470175
TI  - Platelet activating factor mediates systemic circulatory collapse after temporary
      hepatic inflow occlusion.

PMID- 8470176
TI  - Reperfusion during orthotopic liver transplantation: analysis of right
      ventricular dynamics.

PMID- 8470177
TI  - Intra-allograft production and systemic release of tumor necrosis factor-alpha:
      detection upon reperfusion.

PMID- 8470178
TI  - How helpful is intracranial pressure monitoring in patients with acute hepatic
      failure?

PMID- 8470179
TI  - Analysis of two thrombokinetic measurements (thrombelastograph and Sonoclot)
      during liver transplantation.

PMID- 8470180
TI  - In vitro effects of DDAVP during liver transplantation.

PMID- 8470181
TI  - Blood usage in a newly organized liver transplant program.

PMID- 8470182
TI  - Is the ratio of venovenous bypass flow to cardiac output important during
      orthotopic liver transplantation?

PMID- 8470183
TI  - Is it important to measure magnesium concentrations during and immediately after
      liver transplantation?

PMID- 8470184
TI  - Endotoxin and tumor necrosis factor levels and hemodynamics during human liver
      transplantation.

PMID- 8470185
TI  - Vasoactive intestinal peptide and calcitonin gene-related peptide levels and
      hemodynamics during human liver transplantation.

PMID- 8470186
TI  - Transesophageal echocardiographic evaluation of left ventricular function during
      orthotopic liver transplantation.

PMID- 8470187
TI  - Effectiveness of rapid infusion and Bair Hugger systems in maintaining
      normothermia during orthotopic liver transplantation.

PMID- 8470188
TI  - Glucose/insulin to adjust potassium levels during orthotopic liver
      transplantation.

PMID- 8470189
TI  - Incidence and risk factors of early acute renal failure in liver transplant
      patients.

PMID- 8470190
TI  - Blood product transfusion therapy after liver transplantation: comparison of the
      thromboelastogram and conventional coagulation studies.

PMID- 8470191
TI  - Hyperdynamic circulatory state after liver transplantation.
AB  - HCS is common pre-LT (69% of our patients) and frequently develops in NHCS
      patients during LT. There is a trend toward normalization of HCS after LT.
      Despite the increased requirement for postoperative blood transfusion in those
      patients with HCS, it may be prudent to avoid treatment of HCS with
      cardiodepressants and await its spontaneous reversal.

PMID- 8470192
TI  - Successful liver transplantation in patients with mild to moderate pulmonary
      hypertension.

PMID- 8470193
TI  - Intracranial pressure monitoring during liver transplant without venovenous
      bypass for fulminant hepatic failure.

PMID- 8470194
TI  - Right ejection fraction and maximum elasticity are sensitive measurements of
      right ventricular function during liver transplantation.

PMID- 8470195
TI  - Pre- and intraoperative differences between patients with chronic liver disease
      and fulminant hepatic failure undergoing liver transplant.

PMID- 8470196
TI  - Cyclosporine, isoflurane, and oxygenation effects on energy balance in isolated
      hepatocytes.

PMID- 8470197
TI  - Hemodynamic changes during adult liver transplantation with partial vena cava
      clamping.

PMID- 8470198
TI  - Altered hepatic function by atracurium or its breakdown products.

PMID- 8470199
TI  - Use of Swan-Ganz catheter for monitoring right ventricular ejection fraction
      during liver transplantation.

PMID- 8470200
TI  - High-dose laudanosine enhances liver cell activity and bile flow during
      reperfusion of the liver.

PMID- 8470201
TI  - Titrating the preload by using the rapid infusion system: use of echocardiography
      during orthotopic liver transplantation.

PMID- 8470202
TI  - Prostaglandin metabolism and hemodynamic alterations during human liver
      transplantation.

PMID- 8470203
TI  - Hemodynamic monitoring during orthotopic liver transplantation.

PMID- 8470204
TI  - Venovenous bypass vs no bypass in orthotopic liver transplantation: metabolic
      values during reperfusion.

PMID- 8470205
TI  - Liver transplantation for fulminant liver failure: a dilemma in therapeutic
      approach.

PMID- 8470206
TI  - Quantification of liver damage and prediction of 1-year survival after liver
      transplantation by a multifactorial "recovery score".

PMID- 8470207
TI  - Incidence and outcome of OKT3 treatment for early steroid-resistant rejection
      following hepatic transplantation.

PMID- 8470208
TI  - Fulminant hepatic failure, hepatorenal syndrome, and necrotizing pancreatitis
      after minocycline hepatotoxicity.

PMID- 8470209
TI  - Successful liver/kidney transplantation across ABO incompatibility.

PMID- 8470210
TI  - Use of water-soluble liquid vitamin E to enhance cyclosporine absorption in
      children after liver transplant.

PMID- 8470211
TI  - Activated cytokine pattern in hepatorenal syndrome: fall in levels after
      successful orthotopic liver transplantation.

PMID- 8470212
TI  - Use of an absorbable suture material in vascular anastomoses in pediatric liver
      transplantation.

PMID- 8470213
TI  - Protective effect of polyethylene glycol-conjugated superoxide dismutase for cold
      ischemia-reperfusion damage in isolated pig livers.

PMID- 8470214
TI  - Experiences with histidine-tryptophan-ketoglutarate-perfused organs in clinical
      liver transplantation.

PMID- 8470215
TI  - Bilirubin secretion as an early indicator of patient survival following
      orthotopic liver transplantation.

PMID- 8470216
TI  - Orthotopic liver transplantation and renal function; outcome of hepatorenal
      syndrome and trial of verapamil for renal protection in nonhepatorenal syndrome.

PMID- 8470217
TI  - Suppression of hepatic allograft rejection in the rat by mitomycin C-treated
      donor splenocytes: the distribution of donor class I-positive cells in the
      recipient.

PMID- 8470218
TI  - Cannulation of the inferior mesenteric vein for veno-venous bypass in human liver
      transplantation: a reliable procedure?

PMID- 8470219
TI  - Living donor hepatectomy in partial liver transplantation: surgical technique and
      results.

PMID- 8470220
TI  - Influence of warm ischemia on cold-stored, University of Wisconsin solution
      protected rat liver: investigation by 1H-nuclear magnetic resonance relaxometry.

PMID- 8470221
TI  - Liver transplantation for chronic hepatitis B in Asian males.

PMID- 8470222
TI  - Association between preservation injury and early rejection in clinical liver
      transplantation: fact or myth?

PMID- 8470223
TI  - Influence of cyclosporine on liver regeneration after orthotopic reduced-size
      hepatic transplantation in the rat.

PMID- 8470224
TI  - Orthotopic liver transplantation for alpha-1-antitrypsin deficiency in identical
      twins.

PMID- 8470225
TI  - Liver transplantation in alcoholics: assessment of psychological health and work
      activity.

PMID- 8470227
TI  - Hepatic retransplantation in children.

PMID- 8470226
TI  - Indocyanine green clearance in the evaluation of donor livers.

PMID- 8470228
TI  - Comparison of perioperative morbidity following primary liver transplantation and
      liver retransplantation.

PMID- 8470229
TI  - Roux-en-Y anastomotic bleeding following orthotopic liver transplantation:
      experience in our first 300 patients.

PMID- 8470230
TI  - Heterogeneous effect of liver transplantation on the granuloma-enhancing factor
      of primary biliary cirrhosis.

PMID- 8470231
TI  - Hemodynamics in acute porcine heterotopic liver transplantation: effects of graft
      reduction.

PMID- 8470232
TI  - Auxiliary partial liver transplantation in pigs with acute ischemic liver
      failure.

PMID- 8470233
TI  - Parasympathetic tone alterations during rat hepatectomy: a cause of
      preservation/harvest injury?

PMID- 8470234
TI  - Quadruple induction immunosuppression after liver transplantation with
      interleukin-2 receptor antibody (BT 563) is equally effective and better
      tolerated than antithymocyte globulin induction therapy.

PMID- 8470236
TI  - Demonstration of biochemical function by extracorporeal xenohepatocytes in an
      anhepatic animal model.

PMID- 8470235
TI  - Experience of en bloc technique for abdominal organ harvesting for experimental
      transplantation.

PMID- 8470237
TI  - Effect of surgical and spontaneous portasystemic shunts on liver transplantation.

PMID- 8470238
TI  - Cyclosporine vs OKT3 prophylaxis after orthotopic liver transplantation.

PMID- 8470239
TI  - Successful prolonged correction of an inborn metabolic defect by heterotopic
      auxiliary liver transplantation in a dog model.

PMID- 8470240
TI  - Influence of additional warm ischemia on rat hepatic energy metabolism: a
      comparison of University of Wisconsin and HTK protection.

PMID- 8470241
TI  - ABO incompatible liver transplantation in children: a prospective approach.

PMID- 8470242
TI  - Possible role of hepatic nonparenchymal cells in liver allograft rejection.

PMID- 8470243
TI  - Ex vivo perfusion of livers with anti-class II antibody and acute rejection in
      canine liver transplantation.

PMID- 8470244
TI  - Identification of donor and recipient risk factors associated with nonanastomotic
      biliary strictures in human hepatic allografts.

PMID- 8470245
TI  - Quadruple-drug therapy with antithymocyte globulin in the early postoperative
      period after liver transplantation.

PMID- 8470246
TI  - Routine monitoring of liver grafts by transplant aspiration cytology: clinical
      experience with 3000 TACs.

PMID- 8470247
TI  - Acute portal vein thrombosis: a cause of rapid deterioration of liver function,
      treatable by thrombectomy and transplantation.

PMID- 8470248
TI  - Predictors of primary nonfunction: is donor liver fat content important?

PMID- 8470249
TI  - Hepatocyte regeneration during liver allograft rejection in the rat.

PMID- 8470250
TI  - Imprint cytology in liver transplantation: diagnosis of rejection.

PMID- 8470251
TI  - New preparation method for bile cytology in liver transplantation: diagnosis of
      rejection.

PMID- 8470252
TI  - Role of cytochrome P-450 in modulating cyclosporine levels in transplant
      patients.

PMID- 8470253
TI  - N-acetylcysteine attenuates cold ischemia/reperfusion injury in the isolated
      perfused rat liver.

PMID- 8470254
TI  - Impact of liver transplantation on the reversal of hypersplenism.

PMID- 8470255
TI  - Role of T-cell subsets in rat liver allograft rejection.

PMID- 8470256
TI  - Must I be my brother's keeper? Ethical issues in the use of living donors as
      sources of liver and other solid organs.

PMID- 8470257
TI  - Coagulation and liver transplantation.
AB  - In summary, both a thorough understanding of the pathogenesis of coagulopathies
      and an understanding of the proper replacement and pharmacologic therapies based
      on TEG monitoring of coagulability are essential in the management of
      coagulation. As stated by Starzl, "Now cautious correction of coagulation defects
      is an integral part of liver transplantation, greatly diminishing the hemorrhages
      of nightmare proportions that were common."

PMID- 8470258
TI  - Hepatitis C and B in liver transplantation.
AB  - Hepatitis B recurrence remains a major problem facing liver transplantation
      programs. The risk of infection varies depending upon the HBV load. High doses of
      HBIg may reduce the risk of occurrence but it remains expensive. Finally,
      apparently new infections may occur posttransplantation, which may have been
      transmitted by organs or blood from HBsAg (-), HBcAb (+) donors, or may reflect
      reactivation of latent infections in patients who were HBsAg (-). HCV infections
      are common in patients undergoing liver transplantation, and HCV infection recurs
      in > 90% of patients; however, recurrent hepatitis C occurs in less than half of
      these patients. HCV is not an important cause of fulminant non-A, non-B
      hepatitis, but appears to be the most common cause of posttransplant hepatitis.
      So what is in the future? For hepatitis B, we still believe the efficacy of HBIg,
      and in which patients with hepatitis B HBIg should be used, remains to be
      defined. The effects of antivirals on posttransplant hepatitis B, as well as in
      prevention of HBV recurrence, also remain to be determined. In the United States,
      insurance companies are likely to play an important role in determining the
      future of transplantation for hepatitis B. Medicare recently excluded patients
      who were HBsAg (+) from coverage for liver transplantation, and a number of
      private insurers have subsequently followed suit. For HCV, newer screening tests
      for the virus are likely to decrease the rate of HCV acquisition following liver
      transplantation, from the current 35% incidence of HCV acquisition. The impact of
      antiviral treatment on posttransplant hepatitis remains to be determined and
      deserves study. Finally, the development of regimens that might allow prevention
      of recurrent HCV infections in patients undergoing liver transplantation also
      should be a matter of future study.

PMID- 8470259
TI  - Update on preservation of liver grafts.

PMID- 8470260
TI  - Liver disease and pulmonary hypertension.

PMID- 8470261
TI  - Diagnostic criteria for chronic rejection/accelerated graft atherosclerosis in
      heart and kidney transplants: joint proposal from the Fourth Alexis Carrel
      Conference on Chronic Rejection and Accelerated Arteriosclerosis in Transplanted
      Organs.

PMID- 8470262
TI  - Chronic rejection of organ allografts: magnitude of the problem.

PMID- 8470263
TI  - Diagnostic criteria of chronic rejection in transplanted hearts.

PMID- 8470264
TI  - Morphological criteria of chronic rejection: differential diagnosis, including
      cyclosporine nephropathy.

PMID- 8470265
TI  - Transforming growth factor-beta and organ transplantation.

PMID- 8470266
TI  - Atherosclerosis: current understanding of mechanisms and future strategies in
      therapy.
AB  - The lesions of atherosclerosis represent a protective, inflammatory
      fibroproliferative response against the different agents that can cause the
      disease. If the injury continues chronically over a sufficiently long period of
      time, and if opportunity is not given for restitution of normal architecture in
      the artery wall, lesions may progress to a point at which clinical sequelae
      develop. On the other hand, as demonstrated by Brown et al, Kane et al, and
      Blankenhorn et al, the advanced lesions of atherosclerosis can be shown to
      regress. A quantitative, statistical analysis of angiograms in patients who are
      aggressively treated with lipid-lowering agents, such as HMGCoA reductase
      inhibitors has clearly shown this to be the case. Thus, it is entirely
      conceivable that this chronic, excessive, inflammatory, and fibroproliferative
      response can be reversed, given sufficient opportunity for the factors that have
      led to the endothelial and arterial wall injury causing these events to be taken
      into hand and modified.

PMID- 8470267
TI  - Role of hyaluronan in chronic and acutely rejecting kidneys.

PMID- 8470269
TI  - Endothelial integrity and injury in atherogenesis.

PMID- 8470268
TI  - Lymphocyte adhesion and cellular immune reactions in chronic rejection and graft
      arteriosclerosis.

PMID- 8470270
TI  - Endothelium-derived relaxing factor and the vascular role of guanidino compounds.

PMID- 8470271
TI  - Lipid oxidation, vascular inflammation, and coronary atherosclerosis.

PMID- 8470272
TI  - Hyperlipoproteinemia in renal transplant recipients: is there a linkage with
      chronic vascular rejection?

PMID- 8470273
TI  - Leukocyte-endothelium interaction as a target for antiatherogenic strategies in
      allograft transplantation.

PMID- 8470274
TI  - Pathophysiology of allograft arteriosclerosis.

PMID- 8470275
TI  - Cardiac graft arteriosclerosis in the rat.

PMID- 8470276
TI  - Possible in vivo effect and clinical utility of platelet-derived growth factor
      and PDGF antagonists.

PMID- 8470277
TI  - Animal models of chronic heart and kidney allograft rejection.

PMID- 8470278
TI  - Chronic rejection and suboptimal immunosuppression.

PMID- 8470279
TI  - Controlled prospective study of treatment for chronic rejection after kidney
      transplantation by thromboxane synthetase inhibitor.

PMID- 8470280
TI  - Use of NSAIDs in kidney transplantation.

PMID- 8470281
TI  - Use of dietary fish oils in renal allograft recipients with chronic vascular
      rejection.

PMID- 8470282
TI  - Inhibition of graft arteriosclerosis by modulation of the inflammatory response.

PMID- 8470284
TI  - Effect of acute damage from acute rejection and ischemia on long-term renal
      allograft histology.

PMID- 8470283
TI  - Prolonged renal allograft survival in chronic rejection by conversion to triple
      therapy.

PMID- 8470285
TI  - Evaluation of animal models of chronic vascular rejection.

PMID- 8470286
TI  - Chronic rejection of organ allografts may arise from injuries sustained in
      recurring foci of acute rejection that resolve spontaneously.

PMID- 8470287
TI  - Mesangial immunoglobulin A deposition and focal glomerulosclerosis in a renal
      transplant patient with nephrotic syndrome--Berger's disease alone or
      superimposition of focal glomerulosclerosis?

PMID- 8470288
TI  - Estimated number of diabetic recipients of pancreas transplant in Japan.

PMID- 8470289
TI  - Successful 24-hour preservation of canine lungs for allotransplantation using
      verapamil.

PMID- 8470290
TI  - Murine skin allograft histocompatibility combinations susceptible to induction of
      tolerance by intraportal inoculation of allogeneic spleen cells.

PMID- 8470291
TI  - Kidney transplantation in Cyprus.

PMID- 8470292
TI  - Donor-transmitted non-Hodgkin's lymphoma after renal transplantation--a case
      report.

PMID- 8470293
TI  - Appearance of a de novo renal tubulopapillary adenoma in an allograft recipient.

PMID- 8470294
TI  - Interaction between glipizide and cyclosporine: report of two cases.

PMID- 8470295
TI  - Tumor necrosis factor and interleukin-6 in cerebrospinal fluid of a patient with
      recurrent adverse central nervous system events following OKT3.

PMID- 8470296
TI  - Soluble CD23 and interleukin-2 receptor levels in renal allograft recipients.

PMID- 8470297
TI  - Effect of liver and kidney preservation solutions on vascular viability: studies
      on contraction and relaxation of rat aorta in vitro.

PMID- 8470299
TI  - Survey of sickle disease in Kenya.
AB  - In Kenya and most of Eastern Africa, sickle haemoglobin (HbS) is the pre-dominant
      beta-globin chain abnormality; homozygous sickle cell disease, (SCA), is the
      predominant form of sickle cell disease. Although the prevalence of sickle cell
      trait (SCT) in Kenya was known, the magnitude of SCA was yet to be established.
      We performed a national survey in all hospitals from November 1987 to May 1990
      and found 3605 cases with SCA. Age was recorded for 2821 patients. Seventy-seven
      per cent of these patients were below the age of fifteen. The oldest patient was
      a 50-year-old female. The paediatric to adult ratio was 3:1. More than 80% of the
      patients were of Luo or Luhya ethnic origin (Luo 58.4%, Luhya 23.9%). There was a
      discrepancy between SCT rate (SCTr) and the percentage distribution of SCA
      patients per province. The Kambes of the Mijikenda group in the Coast Province
      with the highest SCTr (35%) constituted only 8.5%, but the Luos with a SCTr of
      28%, 58% of the total SCA patient population in Kenya. We found reports of SCA in
      the Somali and Turkana, in whom no SCT had been found previously.

PMID- 8470298
TI  - Prospective in-vivo study of chloroquine resistance of Plasmodium falciparum in
      Zambian under-fives.
AB  - Zambian under-fives with malaria were selected on a positive thick blood smear
      for Plasmodium falciparum of at least 1000 parasites/microliter on the day of
      admission. During a chloroquine course, daily follow-up of parasitaemia was
      performed. Bloodsamples were taken on day 0 and day 3 to measure chloroquine
      levels before admission and after treatment. Eighty four patients were evaluated
      in this study. Forty eight patients did not meet all criteria. Thirty six
      patients met all criteria, of which 16 (44.5%) patients were infected with
      sensitive strains (S) and 20 (55.5%) with resistant strains (R) of P.falciparum.

PMID- 8470300
TI  - The approach to the leprosy problem in the past in Indonesia. A historical review
      of leprosy control activities in Indonesia during the last centuries.
AB  - Due to the severe disabilities leprosy has always been a disease which appealed
      to the imagination. In bygone centuries cause and treatment were unknown and the
      fear to be infected was enormous. In Indonesia medical officers struggled with
      the problem. As early as the 17th century the disease was described in detail by
      Ten Rhijne. In the 19th century leprosy was considered hereditary. After the
      discovery of the leprosy bacillus by Hansen in 1873, confusion continued as the
      bacillus could not be cultivated. Many therapies were tried, but with no result.
      At first patients were isolated in leprosaria, later on a more humane system of
      house-isolation was introduced. Since 1932 Indonesian medical officers have
      played a prominent part in research and the determination of the future approach
      to the problem. Seen against the background of our present knowledge about the
      disease, it is interesting to follow the struggle against leprosy in the past.

PMID- 8470301
TI  - Oesophageal diseases in Sudan, diagnosed by fibreoptic endoscopy.
AB  - Fibreoptic endoscopy was performed on 5,086 consecutive patients with upper
      gastrointestinal tract disease (UGITD) symptoms, at two endoscopy centres in
      Khartoum over five years. Oesophageal disease was diagnosed in 559 patients (11%)
      comprising (20.5%) of all the positive findings. In 46% of all the endoscopies no
      abnormality was detected. The commonest oesophageal disease was varices occurring
      in 186 patients (3.7%) of the 5,086 endoscopies with a mean age of 33.5 +/- 12
      and a male/female ratio of 3.4:1. Hiatus hernia occurred in 124 patients (2.4%)
      with a male/female ratio of 1.6:1, oesophagitis in 115 patients (2.3%) with a
      male/female ratio of 2:1. Carcinoma of the oesophagus was diagnosed in 108
      patients (2.1%), with a mean age of 56 +/- 14 years and a male/female ratio of
      1.4:1. Achalasia of the oesophagus occurred in 20 patients (0.4%), Mallory Weiss
      syndrome in 4 patients (0.08%) and benign strictures in 2 patients (0.04%).

PMID- 8470302
TI  - Esophageal cancer in Qatar.
AB  - There were 41 cases of esophageal cancer over a 7 years period in the State of
      Qatar. Qataris accounted for 30 (73.17%) of these cases while representing about
      38% of the entire population. Also there is a slight preponderance of female
      cases especially among Qataris. Nutritional factors, dietary preferences,
      environmental factors, social status and habits as well as genetic factors may
      constitute important etiologic factors in the genesis of esophageal cancer in
      Qatar.

PMID- 8470303
TI  - Differences in presentation of Hodgkin's disease in Sudan and Western countries.
AB  - A retrospective study was performed dealing with clinical and histopathological
      aspects of Hodgkin's disease in patients presenting to the Radiation and Isotopes
      Centre of Khartoum (RICK) during the period from January 1984 to January 1989. A
      total of 105 patients were studied; this number accounted for 30.6% of all
      lymphoma patients and 2.0% of all cancers seen at RICK during the same period.
      The median age was 30 yrs, and the majority of patients were within two age
      groups, above 25 yrs and above 50 yrs, demonstrating a bimodal pattern. Males
      were commonly affected and this was more marked in children (M:F = 4.7:1.0). Two
      striking differences are observed between this study and those from the western
      world. The first was the high incidence of late clinical stages (III,IV) (70%) in
      this series despite the moderate duration of symptoms. The second was
      predominance of mixed cellularity and lymphocytic predominant sub-groups (65%)
      compared to reports from the western world. A possibility of a chronic
      stimulatory process of the lymphatic system is raised. The high incidence of late
      clinical stages on presentation with favourable histological types needs more
      work.

PMID- 8470304
TI  - Assault, a burden for a rural hospital in Lesotho.
AB  - A retrospective study among adult inpatients revealed the prevalence and
      characteristics of assault trauma in a district hospital in Southern Lesotho. A
      comparison with non-assault trauma and non-trauma inpatients highlights the
      burden of this problem on the available resources. In one year 20.6% of all
      admissions of adult men were victims of purposely inflicted injuries while 11.4%
      were due to other (accidental) trauma. For women these figures were 5.8% and
      10.3% respectively. Post mortem examination at the hospital allowed an estimation
      of the homicide rate of 40.9 per 100,000 in the catchment area of the hospital.
      The age group of 20 to 29 years constitute 40% of the assault patients. Knives
      and sticks cause most damage and the head receives the more serious blows in 67%
      of the cases. The group of assault victims needed considerably more care than
      other patients.

PMID- 8470305
TI  - Haemangioma of the vallecula causing acute upper airway obstruction in a 6 1/2
      week old Nigerian infant with strawberry naevus.
AB  - Expectant management remains the treatment of choice in isolated capillary
      haemangiomata, but active intervention is indicated when they constitute a threat
      to vital functions. We report a 6 1/2 week old Nigerian infant with acute stridor
      and unilateral haemangiomata involving the parieto-temporal scalp, forehead and
      periorbital skin. Direct laryngoscopy showed an ipsilateral haemangioma of the
      vallecula and adjoining structures. Extensive periorbital lesions suggested a
      risk of subsequent occlusive amblyopia. Systemic corticosteroids were initiated
      with good response. The possible diagnostic considerations and therapeutic
      options are discussed. When active management is indicated for infantile
      capillary haemangiomata in resource-poor countries, we emphasise the wisdom of a
      supervised short course of systemic steroids.

PMID- 8470306
TI  - Parathyroid adenoma in northern Nigeria.
AB  - A middle-aged farmer and a female student presented with osteitis fibrosa cystica
      with nephrocalcinosis in the former and nephrolithiasis in the latter due to
      primary hyperparathyroidism. Hypercalcaemia was present in both cases and neck
      exploration revealed a large solitary parathyroid adenoma which was excised.
      Because primary hyperparathyroidism is less common in tropical countries doctors
      may be less familiar with the early manifestations of the disease. The number of
      patients thus undiagnosed and untreated is unknown.

PMID- 8470307
TI  - Stress fracture of the patella in a palmwine tapper.
AB  - Stress fracture of the patella in a twenty-nine-year-old palmwine tapper is
      reported. The fracture occurred during a busy tapping day which was his first
      working day after a ten-day sick off for a febrile illness and presentation was
      delayed for six weeks. Initial diagnosis was pathological fracture, but X-ray
      examination and histology of the biopsy from the fracture site did not suggest
      any associated disease. The pathomechanics of palmwine tapping is very similar to
      jumping (parachute) which is the usual cause of this fracture in developed
      countries.

PMID- 8470308
TI  - Chronic plantar ulcer of a leprosy patient treated by fasciocutaneous instep flap
      transfer. Preliminary result.
AB  - A case of chronic ulceration of the foot (chronicity about 15 years) was treated
      with fasciocutaneous instep flap transfer. The ulcer was on the heel. Healing was
      fast (about 40 days post-operatively. Duration for conventional method is about 6
      months) and after 12 months of ambulation no recurrence was noticed. The female
      patient with only one lower limb (the other already amputated) now goes about
      smilingly selling her wares. However, the footwear for the patient had to be
      further modified.

PMID- 8470309
TI  - Multiple high dose vitamin A supplementation. A report on five cases.
AB  - Vitamin A toxicity is a concern among health care providers, especially when
      present recommendations for vitamin A may result in multiple dosing during a
      short period of time. We observed no vitamin A toxicity in 5 children who
      received multiple high doses of vitamin A. These 8-month to 5-year-old children
      were part of a community trial of vitamin A during acute measles, and were being
      treated at a local hospital for severe acute respiratory infection, malaria,
      and/or diarrhoea. One 12-month-old who received 1,612,500 I.U. within a period of
      three weeks showed elevated serum retinol (3.42 mumol/l), but none of the five
      showed signs of toxicity. These cases illustrate the confusion surrounding the
      correct use of vitamin A for infants and children with multiple morbid
      conditions. A plea is made to report similar situations since clinical trials are
      unethical.

PMID- 8470310
TI  - Cholelithiasis in children with homozygous sickle cell anaemia in northern
      Nigeria.
AB  - The prevalence of gall stones was studied prospectively by abdominal ultrasound
      examination in 65 consecutive children with sickle cell anaemia (SCA) aged 5-13
      years, 35 males and 30 females, in Jos, northern Nigeria. The prevalence of
      cholelithiasis was 4.6%. This rate was similar to previous studies from southern
      Nigeria and higher than that reported in American children with SCA. The
      different dietary habits of children in southern and northern Nigeria appear not
      to play any role in the prevalence rate. None of the children followed up for
      more than 12 months had upper quadrant abdominal pain that warranted surgery.

PMID- 8470311
TI  - Malaria chemosuppression in pregnancy. I. The effect of chemosuppressive drugs on
      maternal parasitaemia.
AB  - A randomized prophylactic drug trial was conducted in a malaria holoendemic area,
      in the Muheza District of Tanzania. Of 327 pregnant women, 124 received proguanil
      (PROG), 113 chloroquine (CQ), 90 the proguanil and chloroquine combination
      (CQ+PROG). Prophylaxis was supervised. Chemosuppressive efficacy was measured
      through the incidence of malaria breakthrough parasitaemias and clinical
      episodes. Groups were comparable by age, parity, residential area, and enrollment
      gestational age. Compliance and drug bio-availability was good. The median
      breakthrough time of the first parasitaemia episode for primigravidae (PG) and
      multigravidae (MG) was significantly shorter for the CQ group (PG = 56, MG = 78
      days) than in the PROG (PG = 97, MG = 112 days) and the CQ+PROG (PG = 138, MG =
      140 days) groups. 56% of the CQ group experienced 2 or more clinical episodes
      compared to 19% (PROG) and 10% (CQ+PROG). PROG and CQ+PROG did not differ
      significantly. Parasite densities and in vitro tests suggested that CQ selected
      for more and highly resistant strain(s). Proguanil is suitable for prophylaxis.
      However, proguanil resistance should be monitored as well as controlled drug
      distribution and usage. Malaria control strategies other than chemoprophylaxis
      should be investigated.

PMID- 8470312
TI  - Diagnosis and treatment of 409 patients with prostatitis syndromes.
AB  - We reviewed 409 patients who had prostatitis syndromes during the period 1985
      1991. Urine analysis, x-ray film of abdomen, and sonograms of the kidneys did not
      contribute to the diagnosis of prostatitis. In 22 percent of the urine samples,
      slight-to-moderate atypia was seen in urine cytology but no malignancy was found.
      Uroflowmetry data were abnormal for 30 percent of the patients, and thus
      uroflowmetry may contribute to treatment selection of patients who may gain from
      specific drugs such as the newly developed alpha-1 receptor blocking agents.
      Positive bacteria cultures were found in 10.4 percent of the prostatic fluid
      cultures and in 14.3 percent of cultures of the urethra. Ureaplasma urealyticum
      was seen in 19.6 percent of the prostatic fluid cultures and in 32 percent of
      cultures of the urethra. Prostatic fluid cultures did not give additional
      information, and the outcome of semen cultures showed a poor correlation with
      urethra or prostatic fluid cultures. In this series, the most advocated treatment
      remains the antibiotic treatment (75% of patients) bringing relief of complaints
      in 35.6 percent of the patients and cure in 23.8 percent. However, similar
      results were found if no antibiotics were administered (relief of complaints in
      31.6% and cure in 30.5%) and more than one course of antibiotics did not improve
      these results. Consequently, we advocate the use of specific antibiotics only
      when the causative bacterial agent has been identified.

PMID- 8470313
TI  - Unilateral nerve-sparing radical prostatectomy and hemicystectomy in management
      of prostate sarcoma.
AB  - A patient with sarcoma of the prostate was treated with radical prostatectomy
      including wide excision of the ipsilateral neurovascular bundle and
      hemicystectomy. Six years postoperatively he is free of disease, continent with a
      bladder capacity of 350 cc, voids to completion, and is potent.

PMID- 8470314
TI  - Reevaluation of prostate biopsy after definitive radiation therapy.
AB  - We have previously reported (1987) that a positive biopsy from a clinically
      normal prostate eighteen months or more after interstitial Iodine 125 or external
      beam irradiation predicted disease progression. In the present study, all
      biopsies were reexamined by the same pathologist (LEL) and correlated with long
      term patient status. Of twenty-six positive biopsy specimens, twenty-two were
      reconfirmed as positive and four were reassigned to a negative diagnosis (false
      positive = 15%). Seventy-two of seventy-seven negative specimens were available
      for reexamination and seventy were reconfirmed as negative while two were
      reassigned to a positive diagnosis (false negative = 2%). A statistically higher
      incidence of local and/or distant failure for patients with positive biopsy
      specimens compared with patients with negative biopsy specimens was again
      confirmed (p = < 0.001). However, there is a group of patients with a positive
      biopsy (17%) who remain clinically free of disease at greater than ten years of
      follow-up. Therefore, a positive biopsy is not an absolute indication of imminent
      failure. Our results demonstrate the technical difficulty and potential error in
      interpreting prostate biopsies after radiation therapy. Therapeutic decisions
      should be based not only on biopsy histology but must also weigh the patient's
      initial tumor stage and grade, current clinical examination, PSA level, age, and
      health.

PMID- 8470315
TI  - Mayo Clinic experience with the AS800 artificial urinary sphincter for urinary
      incontinence after transurethral resection of prostate or open prostatectomy.
AB  - The model AS800 artificial urinary sphincter was implanted in 56 patients with
      urinary incontinence after transurethral resection of the prostate and in 8
      patients after open prostatectomy. Their ages ranged from fifty-three to eighty
      seven years (mean, 70 years). At presentation, 92 percent had total incontinence
      and 8 percent had distressing stress incontinence. Fifteen patients (23%) had had
      previous radiation therapy. Bulbous urethral cuffs were used in 60 (94%) patients
      and vesical neck cuffs in 4 (6%). Follow-up questionnaires were mailed to assess
      satisfaction rate and degree of continence. Continence was significantly improved
      in 90 percent, and 87 percent of the patients were satisfied with their
      sphincters. Surgical revisions were required in 14 patients (22%). Cuff
      compression was inadequate in 9 patients, and erosion led to revision in 3
      patients. At follow-up, 3 patients had had at least one component of the AS800
      removed (complete device in 2 and cuff in 1).

PMID- 8470316
TI  - Clinical fluorescence diagnosis of human bladder carcinoma following low-dose
      Photofrin injection.
AB  - A point-monitoring fluorescence diagnostic system based on a low-energy pulsed
      laser, fiber transmission optics, and an optical multichannel analyzer was used
      for diagnosis of patients with bladder malignancies. Twenty-four patients with
      bladder carcinoma, carcinoma in situ, and/or dysplasia were injected with
      hematoporphyrin derivative, Photofrin, 0.35 or 0.5 mg/kg body weight, forty-eight
      hours prior to the investigation. The ratio between the red sensitizer emission
      and the bluish tissue autofluorescence provided excellent demarcation between
      papillary tumors and normal bladder wall. Certain cases of dysplasia also could
      be differentiated from normal mucosa. Benign exophytic lesions such as
      malakoplakia appeared different from malignant tumors in fluorescence. Flat
      suspicious bladder mucosa such as seen in infectious diseases or after radiation
      therapy appeared normal on fluorescence.

PMID- 8470317
TI  - Role of extracorporeal shock-wave lithotripsy in treatment of urolithiasis in
      patients with medullary sponge kidney.
AB  - In an effort to identify the role of extracorporeal shock-wave lithotripsy (ESWL)
      in the treatment of patients with medullary sponge kidney, a retrospective review
      of our experience with the Dornier HM-3 lithotriptor is presented. From 1986-1991
      17 patients with medullary sponge kidney ranging in age from twenty-eight to
      fifty-eight years received 31 treatments to a total of 24 renal units. Follow-up
      ranged from four to fifty-six months with an average follow-up of twenty-five
      months. ESWL appears to have a role in the treatment of symptomatic urolithiasis
      in patients with medullary sponge kidney. There may also be some benefit in
      treating parenchymal calcifications. No significant side effects from the
      treatment were noted.

PMID- 8470318
TI  - Volume-interval relationship of incontinence episodes in elderly inpatient men.
AB  - Urinary incontinence is an immense source of personal distress for older people.
      The characteristics of urinary incontinence in older people that contribute to
      understanding the pathophysiology of incontinence have not been studied
      extensively. In this study, 66 elderly inpatients were monitored for incontinence
      characteristics of incontinence volume and time interval between episodes. There
      was no correlation between incontinence volume and time between episodes of
      incontinence. This supports a previous observation that the occurrence of urinary
      incontinence in elderly inpatient men is not determined by the accumulated volume
      of urine in the bladder.

PMID- 8470319
TI  - Adherence to urethral catheters by bacteria causing nosocomial infections.
AB  - Previous clinical studies of catheters with hydrophilic coating have, in some
      instances, shown a delay in the onset of significant bacteriuria, while others
      reported no such effect. To attempt to determine reasons for these differences we
      decided to study bacterial adherence of bacteria obtained from nosocomial urinary
      tract infections associated with catheters. Almost all strains adhered to the
      silicone catheter and none of them adhered to the catheter with the hydrophilic
      surface whether incubated in urine or serum. When incubated in urine, all strains
      adhered to the red rubber catheters. Adherence was variable to the Teflon and
      elastomer surfaces.

PMID- 8470320
TI  - Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus
      like syndrome.
AB  - Yohimbine is an indole alkaloid obtained from the yohimbe tree, a common tree in
      West Africa. We describe a forty-two-year black man in whom a generalized
      erythrodermic skin eruption, progressive renal failure, and lupus-like syndrome
      developed following treatment with the drug, yohimbine. A literature review
      failed to reveal any reported association of these side effects. We review
      current information on yohimbine's use in male impotence, reported side effects,
      and its role as a drug allergen.

PMID- 8470321
TI  - Congenital adrenal hyperplasia with testicular tumors, aggression, and gonadal
      failure.
AB  - Bilateral testicular tumors (adrenal rests) may occur in untreated or poorly
      controlled congenital adrenal hyperplasia. This case report describes two unique
      associated phenomena: (1) psychologic disturbances similar to those seen with
      exogenous androgen abuse, which resolved with appropriate glucocorticoid
      suppression of androgen over-production by this abnormal adrenal/adrenal rest
      tissue; and (2) testicular failure which showed a partial, delayed recovery with
      corticosteroid therapy. The need for a careful history and biochemical screening
      for all patients with bilateral testicular tumors is reinforced.

PMID- 8470322
TI  - Intrascrotal neurofibromas.
AB  - A solitary intrascrotal neurofibroma in a seventy-seven-year-old man is reported.
      This benign tumor of the nerve sheath arises from the Schwann cell and is rare in
      the external genitalia, especially in the absence of clinical and histopathologic
      stigmas of von Recklinghausen neurofibromatosis. The literature on intrascrotal
      neurofibromas is reviewed.

PMID- 8470323
TI  - Bladder contracture following intravesical BCG immunotherapy.
AB  - Intravesical BCG immunotherapy is commonly associated with irritative bladder
      symptoms. Bladder contracture as a result of this treatment is rare. Two cases of
      persistent small-capacity bladders occurring more than one year after
      intravesical BCG therapy are reported.

PMID- 8470324
TI  - Nonobstructive right circumcaval ureter associated with double inferior vena
      cava.
AB  - Computerized tomography (CT), intravenous pyelography (IVP), and ultrasound
      characteristics of nonobstructive right circumcaval ureter associated with double
      inferior vena cava in an adult is presented. The CT appearance of the retrocaval
      segment of the circumcaval ureter which was detected as a "thin, long line"
      suggests it might be a useful sign in the incidental diagnosis of the anomaly
      even on noncontrast-enhanced abdominal CT examination. Because of the unique IVP
      appearance of circumcaval ureter in this case, a new classification is presented.

PMID- 8470325
TI  - Neonatal regional anesthesia: alternative to general anesthesia for urologic
      surgery.
AB  - The physiologic immaturity of respiratory musculature and central respiratory
      control centers leads to an increased risk of apnea and respiratory complications
      following general anesthesia in the neonate. Regional anesthetic techniques such
      as spinal and caudal epidural anesthesia may obviate the need for general
      anesthesia and lessen the risks of perioperative morbidity. Although these
      techniques have been previously described in infants, the majority of reports
      focus on regional anesthesia during herniorrhaphy in the former, preterm infant.
      There is relatively little or no information concerning regional anesthesia
      during urologic surgery in infants, especially during the actual neonatal period
      (0 to 28 days). We report on three neonates (2.17 to 3.8 kg) who required
      anesthetic care during the neonatal period for various urologic procedures
      including cystoscopy, incision of a ureterocele, and vesicostomy placement.
      Either caudal or spinal anesthesia was successfully used in the awake infant
      without the need for supplemental anesthetic agents (intravenous or
      inhalational). The advantages, risks, and applications of regional anesthesia
      during urologic surgery in the neonate are reviewed.

PMID- 8470326
TI  - Acute scrotal swelling in Henoch-Schonlein syndrome: evaluation with testicular
      scanning.
AB  - Acute scrotal swelling may accompany Henoch-Schonlein syndrome and may be the
      presenting manifestation mimicking testicular torsion. Two patients with scrotal
      involvement were recently evaluated with nuclear imaging to assess testicular
      perfusion. One patient had normal perfusion, and the other had increased
      perfusion. Scan results allowed expectant management and avoided the need for
      exploratory surgery to rule out testicular torsion.

PMID- 8470327
TI  - Results of undiverted simple closure of 51 urethrocutaneous fistulas in boys.
AB  - Urethral fistulas are an inherent risk of hypospadias repair. Present-day repairs
      of hypospadias in which redundant skin is held to a minimum limit the
      applicability of skin flap advancement technique for closure. To avoid altering
      the cosmesis of the prior hypospadias repair, 51 urethrocutaneous fistulas were
      closed using a three-layer simple closure technique without urinary diversion. An
      80 percent success rate was achieved following the initial closure. A second
      simple closure of those which failed also succeeded in 80 percent of the cases.

PMID- 8470328
TI  - Vesicoureteral reflux in infants under one year old. Follow-up study and
      consideration on development of renal scarring.
AB  - In an attempt to clarify reflux nephropathy (RN), 67 infants aged under one year
      with vesicoureteral reflux (VUR) were retrospectively classified into two groups,
      non-surgical and surgical. They were evaluated on VUR grading, VUR spontaneous
      cessation rate, and incidence of scarring. As a whole, spontaneous cessation rate
      was 61 percent. The cessation rate was higher for infants with lower VUR grading.
      The average age at cessation was 2.5 years. Some patients showed no scarring at
      presentation despite severe VUR. However, most cases of renal scarrings at the
      time of presentation belonged to grade IV or V. Scarring advanced in 3 kidneys of
      the non-surgical group and in 13 kidneys of the surgical group. Of these 16
      kidneys, 7 were rated as grade IV and 9 as grade V. An association between
      development of scarring and recurrent urinary tract infections was suggested.

PMID- 8470329
TI  - Recurrent urinary tract infections and intermittent left flank pain in young
      woman.

PMID- 8470330
TI  - Ureteral fibroepithelial polyp with positive urinary cytology.
AB  - We report on a patient with two fibroepithelial polyps of the upper ureter in
      whom the correct diagnosis was confused by finding voided urine as well as
      ureteral wash, and brush biopsy cytologies positive for malignancy.
      Fibroepithelial polyps and causes of falsely positive urinary cytology are
      reviewed.

PMID- 8470331
TI  - Canine bladder response to red and green light whole bladder photodynamic
      therapy.
AB  - A normal canine bladder model was used to compare the effects of red and green
      light whole bladder photodynamic therapy (PDT). Eighteen dogs were treated with
      Photofrin 1 mg/kg and whole bladder irradiation with red or green light at doses
      ranging from 20 to 60 J/cm2. Toxicity was assessed using cystometry, cystoscopy,
      and histopathology. Green light produced more significant vesical toxicity than
      red light, and this toxicity tended to vary with the light dose administered.
      Whole bladder PDT with green light at doses greater than 20 J/cm2 resulted in
      permanent reductions in bladder capacity. Conversely, a green light dose of 20
      J/cm2 and red light doses ranging from 20 to 60 J/cm2 did not produce any
      significant permanent reductions in bladder capacity. Thus, while green light may
      be more toxic to the bladder than red light, there are distinct combinations of
      red or green light and Photofrin which can be used in the canine bladder to
      achieve mucosal degradation without causing permanent vesical dysfunction.

PMID- 8470332
TI  - Calcitonin gene-related peptide: possibly neurotransmitter contributes to penile
      erection in monkeys.
AB  - The distribution of calcitonin gene-related peptide (CGRP) immunoreactivity in
      the cavernous tissue and the erectile response to intracavernous injection of
      CGRP was investigated in 7 monkeys. Intracavernous CGRP increased cavernous
      arterial flow and induced cavernous smooth muscle relaxation and venous outflow
      occlusion. Intracavernous injection of CGRP antibody did not significantly change
      the erectile response to cavernous nerve stimulation. Histologic staining for
      CGRP immunoreactivity showed nerve fiber-like staining within the cavernous
      arterial wall and the cavernous smooth muscles. These data suggest that CGRP may
      contribute to penile erection in monkeys.

PMID- 8470333
TI  - Involvement of CD8+ T cells in delayed-type hypersensitivity responses against
      bovine leukemia virus (BLV) induced in sheep vaccinated with recombinant vaccinia
      virus expressing BLV envelope glycoprotein.
AB  - Delayed-type hypersensitivity responses against bovine leukemia virus (BLV)
      envelope glycoprotein (gp60) were induced in the skin of sheep vaccinated with
      recombinant vaccinia virus (RVV) expressing BLV glycoprotein. The lesions were
      characterized by marked infiltration of lymphocytes, slight migration of
      neutrophils, eosinophils, and macrophages in the dermis to hypodermis, and
      partial intercellular edema in the reticular layer. Immunohistochemical analysis
      with monoclonal antibodies demonstrated that the lymphocytic infiltrates
      consisted mainly of CD8+ T cells (53.7-55.8% at 48 hours post-challenge of BLV),
      CD4+ T cells (24.7-26.7%), and B cells (11.5-16.9%). The role of CD4+ and CD8+ T
      cells in suppressing BLV growth in RVV-vaccinated animals is discussed.

PMID- 8470334
TI  - Placental pathology of the pregnant mouse inoculated with Brucella abortus strain
      2308.
AB  - Fifty-five pregnant BALB/c mice received various doses of Brucella abortus
      virulent strain 2308 intraperitoneally on day 9 of gestation, and uteri and
      spleens were examined at 3, 5, 7, and 9 days post-inoculation to study the
      pathogenesis of infection. A dose of 10(5.7) B. abortus organisms produced a
      severe, necrosuppurative placentitis. Bacteria multiplied preferentially within
      the placenta and were identified within the rough endoplasmic reticulum of
      trophoblast giant cells and within the visceral yolk sac endoderm. Abortions did
      not occur, but infarction of the labyrinth region of severely affected placentas
      occasionally resulted in fetal death. The severity of infection in the spleens of
      nonpregnant mice receiving the same challenge dose was not significantly
      different from that in the spleens of challenged pregnant mice. These results
      suggest that the sensitivity of the pregnant mouse to placental brucellosis is
      not due to a generalized immunosuppression but rather may involve a combination
      of local suppression of the immune response and a susceptible cell population
      suitable for Brucella colonization and replication. Experimental murine
      brucellosis resembles ruminant brucellosis and provides a model to study the
      intracellular replication of B. abortus in trophoblasts.

PMID- 8470336
TI  - Immunohistochemical evaluation of canine carcinomas with monoclonal antibody
      B72.3.
AB  - Monoclonal antibody (MAb) B72.3 reacts with a tumor-associated glycoprotein,
      designated TAG-72. TAG-72 has been identified in many human carcinomas but
      generally is not found in normal human tissues. Because of its proven utility in
      the diagnosis of human carcinomas, MAb B72.3 was applied to several different
      types of canine carcinomas. Five types of formalin-fixed, paraffin-embedded
      canine carcinomas were evaluated for immunoreactivity with MAb B72.3 by use of an
      avidin biotin immunoperoxidase complex method. Samples were considered positive
      when > or = 5% of all malignant cells contained a distinct intracellular stain.
      Immunoreactivity for MAb B72.3 was observed in 6/9 (67%) pulmonary
      adenocarcinomas, 7/13 (54%) transitional cell carcinomas, 7/11 (64%) mammary
      adenocarcinomas, 7/11 (64%) nasal adenocarcinomas, and 1/2 (50%) prostatic
      adenocarcinomas. The average cellular staining for positive carcinomas was 25%.
      Normal canine tissues from similar anatomic sites had little or no individual
      cell immunoreactivity. These preliminary results indicate that some canine
      carcinomas may express a tumor-associated antigen that is similar to TAG-72 and
      that MAb B72.3 immunoreactivity may be of diagnostic significance in classifying
      animal tumors.

PMID- 8470335
TI  - Bovine beta-mannosidosis: pathologic and genetic findings in Salers calves.
AB  - beta-mannosidosis is a recently recognized lysosomal storage disease in newborn
      Salers calves. Fourteen calves with beta-mannosidase deficiency were examined.
      Twelve calves were from routine laboratory submissions, and two calves were the
      result of a breeding trial. Salers calves with beta-mannosidase deficiency were
      of normal gestational weight, 36 +/- 6 kg, but were affected at birth. The head
      was moderately domed, and there was mild superior brachygnathism. The calves were
      recumbent and had a head tremor. There was bilateral renal enlargement, severe
      hypomyelination in the brain and variable thyroid gland enlargement. Severe
      cytoplasmic vacuolation was present within neurons, tubule epithelial cells,
      follicular cells and macrophages of the nervous, renal, thyroid and lymphoid
      tissues, respectively. Pedigree analysis and breeding trial results were
      consistent with an autosomal recessive disease. An initial biochemical survey of
      1,494 Salers cattle indicated a carrier frequency of 23%.

PMID- 8470337
TI  - Adenomatous hyperplasia of equine allantoic epithelium.
AB  - Adenomatous hyperplasia with or without cystic formation of allantoic epithelium
      was observed in 63/954 equine placentas examined from 1 February 1988 to 31
      January 1990. In 61/63 placentas, the adenomatous hyperplasia was associated with
      other placental lesions: 49 with chronic or chronic-active placentitis, six with
      placental edema, three with fetal diarrhea, one with placentitis and fetal
      diarrhea, one with fetal diarrhea and placental edema, and one with hyperplasia
      of chorionic epithelium. When lesions were less severe, the hyperplastic lesions
      were not grossly visible, but when lesions were severe, nodular, tumorous, cystic
      masses were observed at or near the insertion site of umbilical blood vessels.
      Histologically, lesions classified as stage 1 were characterized by hypertrophy
      and hyperplasia of epithelial cells and formation of intraepithelial glands
      (lumina). Lesions classified as stage 2 were characterized by the presence of
      fibro-adenomatous changes in the allantoic stroma. Lesions classified as stage 3
      were characterized by the formation of the nodular masses, which were composed of
      glandular or cystic structures of various sizes lined by cuboidal or low to
      medium columnar epithelium. These glands or cysts were empty or contained
      amphophilic secretion, a mixture of neutrophils and secretion material, or
      neutrophils. The cause of adenomatous hyperplasia of the equine allantois is not
      certain; however, there is a close connection between chronic placental disorders
      and this hyperplastic lesion.

PMID- 8470338
TI  - Histologic and immunohistochemical studies of granular cell tumors in seven dogs,
      three cats, one horse, and one bird.
AB  - In a retrospective study, granular cell tumors in six dogs (Nos. 1-6), three cats
      (Nos. 1-3), one horse (No. 1), and one cockatiel (Nymphicus hollandicus) (No. 1)
      and a meningioma with a granular cell component in one dog (No. 7) were examined
      histologically and immunohistochemically. These tumors were identified by
      histologic examination of surgical biopsy specimens, except in the horse, in
      which the tumor was an incidental finding at necropsy. These diagnoses were
      initially made by more than one pathologist. Five of the six granular cell tumors
      in the dogs were in the oral cavity; one of these was in the maxillary gingiva of
      a 6-month-old puppy. The tumors in the cats were located in the tongue, vulva,
      and digit. The tumor in the horse was in the lung, and the tumor in the cockatiel
      was in the periocular tissue. Histologically, all granular cell tumors were
      characterized by oval to polygonal cells of various sizes. The cells had
      abundant, pale, eosinophilic cytoplasm with distinct intracytoplasmic granules,
      distinct cell margins, and mostly central nuclei. In the dogs, the gingival tumor
      had a large amount of collagen tissue, the tumor in the tongue had dilated blood
      vessels, and the maxillary tumor in the puppy was more cellular than the other
      tumors. The tumors in the cats were more anaplastic than the other tumors; one,
      located in the digit, was considered malignant. The granules in all of the tumors
      stained with periodic acid-Schiff and were diastase resistant. On staining with
      Luxol fast blue, the granules of all tumors stained different shades of pink,
      with the exception of the tumor in the tongue of a cat, which stained bluish
      green. Immunocytochemically, all tumors except the tumor in the cockatiel reacted
      against antibodies to vimentin. The granular cell tumor in the lung of the horse
      and the intracranial meningioma in a dog reacted to the antibody S-100 protein;
      the tumor in the horse reacted to neuron-specific enolase; tumors in two dogs
      (gingiva and skin) reacted to L-antitrypsin, and the maxillary tumor also reacted
      to lysozyme; the malignant tumor in the digit of a cat and the periocular tumor
      in the cockatiel reacted to muscle common actin and actin; the tumor in the
      cockatiel also reacted to desmin. Results of these immunocytochemical studies
      suggest that granular cell tumors, like tumors composed of rhabdoid cells, clear
      cells, and oncocytes, can have similar morphologic features but be of different
      cellular origins.

PMID- 8470339
TI  - Acute megakaryoblastic leukemia in one cat and two dogs.
AB  - The clinical, hematologic, and histologic features of acute megakaryoblastic
      leukemia are described for an 8-year-old female Domestic Shorthair cat, a 3-year
      old female mixed-breed dog, and a 3-year-old male German Shepherd Dog. The
      neoplastic cells were characterized as belonging to the megakaryocytic lineage.
      The following techniques were used: electron microscopy; detection of antibodies
      against human von Willebrand factor (vWF) and human platelet glycoprotein GP IIIa
      using a modified avidin biotin peroxidase complex technique on formalin-fixed
      paraffin sections; and enzyme histochemical methods on plastic sections for
      alkaline phosphatase, acid phosphatase, myeloperoxidase, alpha-naphthyl acetate
      esterase, alpha-naphthyl butyrate esterase, naphthol AS acetate esterase, and
      naphthol AS-D chloroacetate esterase. In addition, benign megakaryocytic cells,
      platelets, and neoplastic cells were labeled with lectins that have partially
      been shown to bind to platelet glycoproteins of other species. In healthy cats
      and dogs, the megakaryocytes and platelets reacted with lectins PSA, LCA, PHA-L,
      and WGA. Megakaryocytes and platelets from healthy cats were also labeled by
      lectin PNA. The lectins PHA-L and WGA reacted with neoplastic cells from the cat
      and both dogs. Lectin PNA bound to neoplastic cells from the cat, and lectins
      PSA, LCA, and SBA bound to neoplastic cells from both dogs. For the retrospective
      examination of paraffin-embedded material, the detection of vWF and GP IIIa
      appears to be the most reliable method for the identification of megakaryocytic
      cells.

PMID- 8470340
TI  - Granulated round cell tumor of cats.
AB  - Morphologic and biologic features of five feline granulated round cell tumours
      were compared with those previously reported to be of globule leukocyte and large
      granular lymphocyte origin. The five cats ranged from 6 to 9 years of age and
      presented with nonspecific gastrointestinal signs. Four of the five cats were
      tested for feline leukemia virus and were negative by enzyme-linked immunosorbent
      assay. The neoplastic process involved the abdominal cavity in all cases, with a
      predilection for the distal small intestine and mesentery. The liver and
      peripheral and thoracic lymphoid tissues were also sporadically affected.
      Neoplastic round cells contained 0.5-1.5-microns eosinophilic cytoplasmic
      granules that were difficult to discern on causal observation with hematoxylin
      and eosin stain but were deep blue and easily visualized when stained with
      phosphotungstic acid-hematoxylin. In two cases, epithelium in the affected ileum
      and liver contained unusually large numbers of apparently normal globule
      leukocytes. Ultrastructurally, the tumor granules tended to cluster at one
      nuclear pole and were spindle to round in shape with variably dense contents.
      Some granules contained a dense "cap" at one end or internal crystalloid bars
      that distorted the granule membrane. The tumors reported herein are similar to
      all three of the previously reported feline granulated round cell tumors and
      probably have a common cellular origin.

PMID- 8470341
TI  - Nodular granulomatous posthitis caused by Halicephalobus (syn. Micronema) sp. in
      a horse.

PMID- 8470342
TI  - A pseudolipoma on the diaphragmatic surface of the liver in a female B6C3F1
      mouse.

PMID- 8470343
TI  - Bronchoalveolar eosinophilic cells in a canine model of asthma: two distinctive
      populations.
AB  - In a canine model of asthma, the identity and relationships of two types of cells
      with eosinophilic granules found in bronchoalveolar lavage (BAL) were
      investigated. Five female and three male newborn mongrel dogs were sensitized by
      intraperitoneal injection of 500 micrograms ragweed in 30 mg aluminum hydroxide
      repeated weekly for 8 weeks and then biweekly until 16 weeks of age. Three female
      and two male littermate controls received 30 mg aluminum hydroxide. From 4 months
      of age, dogs received six breaths of wet-nebulized ragweed solution through an
      endotracheal tube bimonthly. Bronchoalveolar lavage was performed 2 months or
      more after the last exposure to ragweed and was repeated 5 hours after ragweed
      inhalation. Dogs studied were 15 to 38 months of age. Eosinophilic cell
      populations were determined in BAL and peripheral blood; cells were examined by
      light and electron microscopy. Two eosinophilic cell types were in BAL: an
      eosinophil and an atypical cell with globule leukocyte characteristics. Specific
      microgranules, a constant feature of eosinophils, were prominent in the atypical
      cell and suggest a relationship to the eosinophil granulocyte series for the
      atypical cell and cells identified by others as globule leukocytes. In ragweed
      sensitized animals, there were more eosinophilic cells in BAL fluid and more
      eosinophils in peripheral blood. There was a proportional increase in BAL
      eosinophils 5 hours after ragweed inhalation and a corresponding decline in
      peripheral blood eosinophils. There was no increase in numbers of eosinophils in
      the sensitized animals; eosinophil and atypical cell numbers in littermate
      controls were unchanged.

PMID- 8470344
TI  - Efficacy of an Australian Babesia bovis vaccine strain in Malawi.
AB  - Three calves vaccinated with the Australian Ka strain of Babesia bovis were fully
      protected against experimental infection with an isolate from a farm on which
      four of 210 vaccinated cattle had died from B bovis infection. A degree of cross
      protection against the isolate was demonstrated in one calf which had been
      infected previously with Babesia bigemina.

PMID- 8470345
TI  - Duodenal perforations and gastric ulcers in foals.
AB  - The history, clinical signs, post mortem and histopathological findings from two
      foals with perforating gastroduodenal ulcers and one foal with a non-perforating
      gastric ulcer are compared with those of other species with similar lesions. Two
      of the foals had several erosions in the oesophageal mucosa and the condition had
      been associated with strictures in the duodenum. The cause of the disease remains
      obscure but a possible connection with stress has been suggested.

PMID- 8470346
TI  - Bovine spongiform encephalopathy: observations on the incidence during 1992.

PMID- 8470347
TI  - Improved detection of the beta-agonist clenbuterol by analysis of retina
      extracts.

PMID- 8470348
TI  - Nocardia asteroides mastitis in a small Argentinian herd.

PMID- 8470349
TI  - Absence of circulating TNF alpha in experimental bovine pneumonic pasteurellosis.

PMID- 8470350
TI  - The natural occurrence of aflatoxin B1 in Moroccan poultry feeds.
AB  - The occurrence of AFB1 in Moroccan poultry feeds and their ingredients was
      evaluated. Thirty poultry farms and 4 feedmills were surveyed from September 1989
      to June 1991, and 300-500 g each of feeds (corn, sorghum, wheat bran, soybean
      meal, cottonseed meal, sunflower meal, finished feeds) were sampled.
      Additionally, on farms with suspected mycotoxin problems, necropsies of affected
      chickens were performed for gross and microscopic examinations. A total of 315
      samples were analysed for AFB1 using a semi-quantitative enzyme linked immuno
      sorbent assay (ELISA kits) and thin-layer chromatography. In feedmills, 4% of
      samples contained AFB1; 17% among sunflower meal samples (20-80 ppb) and 4% among
      corn (110 ppb) and mixed feed samples (20-110 ppb). On poultry farms, 17% of
      samples were found contaminated with AFB1; 20% were positive among pellets and
      16% among crumbles and 15% mash feeds. The level of contamination ranged from 20
      ppb to 200 ppb, except for 4 samples that contained high levels of AFB1 (2000
      5625 ppb). These highly-contaminated samples were associated with clinical
      aflatoxicosis in broiler chickens. The most frequent incidence of AFB1
      contamination and the highest AFB1 contamination occurred in feeding troughs
      (23%). Aflatoxins should be considered potential contaminants of poultry feeds
      under Moroccan conditions.

PMID- 8470351
TI  - Effects of vitamin E on cadmium-induced locomotor dysfunctions in rats.
AB  - The effect of co-administration of vitamin E (VE) on cadmium (Cd)-induced
      locomotor deficits in growing rats was investigated. Intraperitoneal
      administration of 0.4 mg Cd/kg/d for 4 w resulted in significant decreases in
      time of ambulation and stereotype and numbers of stereotypic and vertical
      movements, but the resting time was enhanced. Administration of VE (5 mg alpha -
      tocopherol acetate/kg im on alternate days) to these rats effectively antagonised
      these locomotor deficits. The data support the hypothesis that Cd may induce
      oxidative stress in the CNS and that treatment with an antioxidant may be
      beneficial against such damage.

PMID- 8470352
TI  - Effects of hepatic P-450 enzyme inhibitors and inducers on the duration of
      xylazine + ketamine anesthesia in broiler chickens and mice.
AB  - We previously showed that pretreatment with inhibitors of hepatic P-450
      microsomal enzymes prolonged xylazine-ketamine anesthesia, which sometimes led to
      mortality in rats. In this study we determined if similar effects were produced
      in broiler chickens and mice. A combination of 5 mg xylazine/kg and 15 mg
      ketamine/kg im was given to broiler chickens 5-6 w of age, and a combination of
      10 mg xylazine/kg and 200 mg ketamine/kg ip was given to mice. The loss of
      righting reflex was used to measure duration of anesthesia. Pretreatment with 100
      mg chloramphenicol/kg im, 150 mg cimetidine/kg im, 25 mg SKF-525A/kg im or 40 mg
      ketoconazole/kg po significantly increased the duration of xylazine + ketamine
      anesthesia in the chickens. Pretreatment with 40 mg phenobarbital/kg im bid for 3
      d, 25 mg 3-methylcholanthrene/kg im sid for 3 d, or 50 mg rifampin/kg im bid for
      2 d failed to alter the duration of xylazine + ketamine anesthesia in the
      broilers. None of the inhibitors tested altered the duration of anesthesia in
      mice. Some chickens pretreated with inhibitors (cimetidine, ketoconazole, SKF
      525A) or inducers (phenobarbital, 3-MC, rifampin) died. This study suggests that
      hepatic metabolism of xylazine may be similar in the rat and broiler chicken and
      that the pulmonary metabolism of xylazine and ketamine may be different in
      chickens and rats.

PMID- 8470353
TI  - Flatpea intoxication in sheep and indications of ruminal adaptation.
AB  - This paper describes the signs of toxicity when seed-bearing flatpea (Lathyrus
      sylvestris L) hay is fed to sheep. Signs of intoxication (including seizure,
      muscular trembling and spasmotic torticollis) are similar to those observed for
      ammonia toxicity in ruminants. Accumulation of ammonia may be a direct
      consequence of flatpea ingestion, given that 2,4-diaminobutyric acid (DABA, a
      toxic constituent of flatpea) is known to inhibit hepatic urea synthesis.
      However, other modes of toxicity for DABA as well as other flatpea toxins may
      also contribute to this process of intoxication. Our evidence suggests that
      ruminal microbes are responsible for flatpea detoxification and host animal
      protection. The adaptation of sheep to flatpea may be a consequence of enhanced
      ruminal detoxification activity. Ruminal protective functions can be disrupted,
      however, through abrupt monensin feeding or the replacement of nonadapted for
      adapted rumen contents. This disruption temporarily suppresses mechanisms of
      ruminal detoxification. As a consequence sheep can again be made vulnerable to
      flatpea intoxication.

PMID- 8470355
TI  - Red cell and plasma concentrations of fluoxetine and norfluoxetine.
AB  - To study the distribution of fluoxetine and norfluoxetine in blood compartments
      we determined their concentrations in red cells and plasma after the addition of
      500 ng/ml of each compound to human blood in vitro. Red cell and plasma
      fluoxetine concentrations were 493 +/- 79 ng/ml and 454 +/- 53 ng/ml,
      respectively (P > 0.1). To assess the potential implications of this distribution
      on routine monitoring of these compounds in plasma, we determined fluoxetine and
      norfluoxetine concentrations in red cells and plasma in 6 patients receiving
      various doses of fluoxetine. While in 4 patients the concentrations of fluoxetine
      and norfluoxetine in red cells and plasma were comparable, 2 patients had higher
      concentrations of both compounds in red cells. Variations in the distribution of
      fluoxetine and norfluoxetine in blood compartments are relatively small. Plasma
      levels may reflect the drug concentration in whole blood more reliably for
      fluoxetine and norfluoxetine than for tricyclic antidepressants.

PMID- 8470354
TI  - The toxic effects of mature flatpea (Lathyrus sylvestris L cv Lathco) on sheep.
AB  - The toxic effects of mature, seed-bearing flatpea (Lathyrus sylvestris L cv
      Lathco) hay on sheep was studied in a feeding trial with 25 adult ewes. Five ewes
      were barren; 20 were in the last 10 w of pregnancy. The ewes were blocked by
      weight and reproductive status for assignment to treatment groups. Four groups of
      5 ewes each were allotted to 1 of the following diets: 0% (controls), 35.0%,
      52.5% or 70.0% flatpea (FP); and 1 group of 5 ewes was allotted to a diet of
      increasing levels of 17.5, 35.0, 52.5 and 70.0% FP. Flatpea hay was harvested in
      the mature, seed-bearing stage, pelleted, reground and incorporated into a basal
      (control) diet of 30% corn + 70% alfalfa by substitution of an appropriate amount
      of FP for alfalfa. The resulting diets were fed for up to 42 days. The toxic
      nature of FP was expressed by the following dose-related responses: Fluctuating
      reductions in feed intake upon initiation of diets containing 35% FP and above;
      occurrence of a potentially fatal, acute central nervous system syndrome at FP
      levels as low as 35%; and reduced weight gain at FP levels of 52.5% and above. A
      wasting condition was observed in 1 ewe fed 52.5% FP. Four of 5 ewes and 1 lamb
      fed increasing levels of FP developed acute poisoning. One of these ewes
      developed acute neurotoxicosis when consuming 52.5% FP; 3 other ewes and 1 40-d
      old orphaned lamb developed neurotoxicosis upon raising the FP level to
      70.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470356
TI  - Experimental citrinin nephrotoxicosis in dogs: renal function evaluation.
AB  - To assess renal function changes in acute nephrotoxicosis in dogs, the
      development and evolution of renal damage during induced citrinin intoxication
      were studied. Six dogs (experimental group) were given 10 mg citrinin/kg/BW every
      24 h during 2 d, and 5 dogs (control group) received exclusively the diluent (1
      ml 1% sodium carbonate/kg/BW/d for 2 d). The dogs were daily submitted to
      physical examination, urinalysis and blood biochemistry analyses (blood urea,
      serum creatinine, potassium, sodium and glucose) during 2 w. The citrinin-induced
      renal lesions were mainly in the proximal convoluted tubule and characterized by
      proteinuria, glucosuria and the presence of numerous granular casts in the urine
      sediment; these could be detected before elevations in blood urea and creatinine.
      Glucosuria was the earliest abnormality found and lasted 5 d, while proteinuria
      and cylindruria were observed from days 1 to 5 and from days 1 to 15,
      respectively. The glomerular filtration rate was slightly affected as observed by
      blood urea and creatinine elevations from days 2 to 5. Urine analysis is a useful
      tool for the evaluation of nephrotoxicity since most nephrotoxins act primarily
      on the proximal convoluted tubule.

PMID- 8470357
TI  - Sump additives as a source of bioaerosols in a school building.
AB  - An investigation was launched following complaints of poor air quality and
      building-related illness in a public elementary school. Occlusion of air intakes
      put the building under negative pressure and caused vents from a below-ground
      sump to become air intakes. Outside air drawn through the sump pit traveled into
      the adjacent main air handling unit and was disseminated throughout the building.
      Sump additives introduced in an attempt to counteract foul odors contained spores
      of Bacillus species, which appeared as bioaerosols throughout the school. Viable
      microbial sampling identified B subtilis, B cereus, and B licheniformis in the
      sump room and classrooms at levels as high as 760 colony forming units/m3
      (CFU/m3). Concentrations of CO2 in classrooms were 1250 ppm, indicating
      inadequate makeup air. Remediation was accomplished by opening the air intakes,
      isolating the sump room from the air handling system, venting the sump to the
      outside, and flushing the sump with fresh water on a regular basis.

PMID- 8470358
TI  - Ryegrass staggers in heifers: a new mycotoxicosis in Argentina.
AB  - Aberdeen Angus (AA) and crossbred AA x Hereford 8-9 mo old heifers (560 animals)
      showed a typical perennial ryegrass (PRG) staggers syndrome after grazing 26 d in
      a 25-hectare paddock of pure Lolium perenne. Effects were observed in about 50%
      of the herd. When forced to move, the animals showed incoordination, weakening of
      the forelimbs, falling on the chest and neck, and moving in this position during
      the first steps before recovering a normal gait. In severely affected animals all
      of the 4 limbs had extreme rigidity. All the affected animals had generalized
      tremors. Twelve days after removal from this pasture the animals had no symptoms.
      The symptoms described, the pasture conditions (mostly PRG stubble and short PRG
      green plants in slow growth), a positive mouse bioassay of extracts obtained from
      the basal part of the PRG plants, and the microscopic finding of Acremonium lolii
      hyphae in the leaf sheaths of the same plant material produced diagnostic
      evidence to confirm this as a PRG staggers case, the first reported in Argentina.

PMID- 8470359
TI  - Acute overdosage with thioridazine: a review of the available clinical exposure.
AB  - Two hundred and twenty-three cases of acute overdosage associated with
      thioridazine were reviewed. The most frequent feature was impairment of
      consciousness which was linearly dose-related and occasionally resulted in life
      threatening complications. Arrhythmia was the most frequently reported serious
      toxic effect. Patients presenting with anoxia were at risk for arrhythmia, as
      were patients ingesting a high dose. Arrhythmia may, by decreasing cardiac
      output, predispose to the occurrence of all other observed complications (ie,
      pulmonary edema, severe hypotension and renal failure). Therefore, treatment of
      arrhythmias should be the keystone of management of thioridazine overdosage.
      Torsade de pointes was reported only once with overdosage. Isolated ventricular
      arrhythmias (VA) occurred at high doses (median 12 g). At lower doses (median 5
      g), VA were frequently associated with conduction disturbances, which were not,
      as such, statistically predictive of arrhythmias. Since thioridazine in high
      doses exhibits a beta-adrenoceptor and a verapamil-like calcium channel blocking
      effect, drugs with these types of properties are contraindicated. VA may be
      refractory to lidocaine or recur after such therapy. Transient cardiac pacing
      appears to be the most appropriate management of VA. Although its efficacy is
      established for the treatment of phenothiazine-induced arrhythmias, its use
      remains rare (only 3/50 cases).

PMID- 8470361
TI  - A review of Heinz-body anemia in the dog induced by toxins.
AB  - Heinz-body anemia is uncommon in the dog. We review the available literature and
      discuss onions, methylene blue, acetaminophen, zinc, benzocaine, vitamin K and
      phenylhydrazine as toxic materials capable of inducing Heinz-body formation in
      the dog.

PMID- 8470360
TI  - A review of the toxicology of the antibiotic MICOTIL 300.
AB  - MICOTIL 300 is a new macrolide antibiotic for the treatment of Bovine Respiratory
      Disease complex. As with other macrolides used in human and veterinary medicine,
      overdoses of MICOTIL do not produce pathognomonic lesions. The toxicity dose
      response varies among laboratory animal and domestic livestock species. However,
      clinical evidence of MICOTIL toxicity due to large doses is generally a
      manifestation of the positive chronotropic and negative inotropic cardiovascular
      effects. No adverse environmental effects are expected from the use of MICOTIL in
      cattle.

PMID- 8470362
TI  - The effectiveness of a remote access hotline service for the handling of night
      shift calls.
AB  - In order to justify dedicated staff for night calls, improve the quality of our
      handling of these calls, and qualify for certification by the AAPCC, we sought an
      alternative to hiring dedicated night staff. We offered our certified staff
      members the opportunity to fulfill part of their regular duties answering night
      calls from home. We set them up with a computer system, dedicated telephone line,
      texts and consultant information. They were able to access the Poison Center
      hotline computer via a remote access program. A significant increase took place
      in the number of documented calls to the Poison Center during the midnight to
      8:00 am shift. Quality of documentation also improved significantly and level of
      service has been complemented by callers. The remote access method is a viable
      way for a small Poison Center to cover the night shift with certified, reliable,
      capable staff. This method of call answering has solved our major problem of
      hiring night staff who would satisfy requirements and provide excellent service.

PMID- 8470363
TI  - Washington's ER physicians' perceptions of poison centers.

PMID- 8470364
TI  - Ineffectiveness of a mass mailing campaign to improve poison center awareness in
      a rural population.
AB  - The distribution of poison prevention and education literature represents a
      significant part of poison center outreach programs. Yet the effectiveness, in
      terms of cost and impact, of mailing this material in an unsolicited fashion has
      not been investigated. We questioned the effectiveness of poison education
      literature through mass mailing to increase poison center awareness and improve
      one's ability to comprehend and retain appropriate first aid response in the
      event of a poisoning emergency. Two poison education brochures, in English and
      Spanish translation, and 2 telephone stickers were mailed third class to all
      8,948 households in 1 rural county at a total cost of $3,420. A total of 397
      (4.4%) households were randomly selected and successfully completed a 23-question
      telephone survey 6 mo after the mailing. The primary language spoken by the
      respondents were English, 311 (78%) and Spanish, 86 (22%). Children under the age
      of 6 y were present in 101 (25%) households. Only 50 (13%) respondents remembered
      having received any poison education brochures. Although 147 (37%) responded that
      they had heard of the regional poison center, only 63 (16%) said they would call
      the poison center first in the event of a poisoning. Forty-four percent indicated
      they would call 911 first. Only a small increase in penetrance rate was found
      when comparing 6 mo periods before and after the mailing. We conclude that mass
      mailing of poison education brochures made little impact in improving poison
      center awareness and first aid response and was not a cost effective method of
      poison education.

PMID- 8470365
TI  - Content audit of POISINDEX.

PMID- 8470366
TI  - William the Conqueror and the murder of Conan II.

PMID- 8470367
TI  - The neurotoxin-like sequence of human immunodeficiency virus gp120: a comparison
      of sequence data from patients with and without neurological symptoms.
AB  - A region of the human immunodeficiency virus type 1 (HIV-1) envelope glycoprotein
      gp 120 has been claimed previously to be homologous to parts of snake venom
      neurotoxins and rabies virus glycoprotein ("the neurotoxic loop"). We have
      determined DNA sequences directly from a polymerase chain reaction amplified
      fragment corresponding to this region of HIV-1 gp 120 and have translated these
      to protein sequences. This was performed with the prototype HIVSF2 isolate and
      several Swedish HIV-1 strains, which were precultivated from blood cells or
      cerebrospinal fluid (CSF) or were directly obtained from CSF cells of patients
      with and without neurological symptoms. The results show that there are sequence
      similarities between a short segment of gp120 of clinical HIV-1 strains and the
      neurotoxic loop. The strains of patients with neurological symptoms did not,
      however, show a genetic shift of their sequences towards a greater similarity to
      the sequences of snake venom neurotoxins and rabies virus glycoprotein as
      compared to the strains of asymptomatic individuals.

PMID- 8470368
TI  - Molecular cloning and complete nucleotide sequence of genomic RNA of the AIK-C
      strain of attenuated measles virus.
AB  - Twelve cDNA clones covering the entire genome of the AIK-C strain of a seed for
      live measles vaccine were obtained, and the nucleotide sequences were determined.
      The full viral genomic RNA consists of 15,894 nucleotides. Comparisons of the
      nucleotide sequence and the deduced amino acid sequence between the AIK-C and
      other Edmonston strains revealed the following changes: 56 nucleotide differences
      and one C residue insertion, 31 amino acid changes, and 19 silent mutations.

PMID- 8470369
TI  - Comparative sequence analysis of the M gene among rabies virus strains and its
      expression by recombinant vaccinia virus.
AB  - Nucleotide sequences and the deduced amino acid sequences of the gene encoding
      the matrix (M) protein of the Nishigahara and the CVS strains of rabies virus
      have been determined. The M gene is 609 nucleotides long and is capable of coding
      for a peptide composed of 202 amino acids. Sequence comparison of these M genes
      with those of other stains [Pasteur (PV), ERA, Avol] revealed that there is 89.7
      91.5% homology at the nucleotide level, and 90.1-92.1% homology at amino acid
      level, between almost all combinations of these strains. However, in the
      combinations of the PV and ERA strains, and the virulent CVS and the avirulent
      CVS-derived Avol strains, much higher homology was observed both at the
      nucleotide and amino acid levels. The predicted secondary structure and
      hydropathy profiles also exhibited similar features. Recombinant vaccinia virus
      containing the M gene was constructed. Sodium dodecyl sulfate (NaDodSO4)
      polyacrylamide gel electrophoresis of the precipitates obtained by immune
      reaction of the recombinant virus-infected cell lysate with a monoclonal antibody
      against the M protein revealed that electrophoretic mobility of the expressed
      protein is indistinguishable from that of the authentic M protein from rabies
      virions.

PMID- 8470370
TI  - Gene A32 product of vaccinia virus may be an ATPase involved in viral DNA
      packaging as indicated by sequence comparisons with other putative viral ATPases.
AB  - Statistically significant sequence similarity was revealed between the gene A32
      product of vaccinia virus (VV), gene I products (gpI) of filamentous single
      stranded DNA bacteriophages, and IVa2 gene products of adenoviruses. Four
      conserved sequence motifs were delineated, the two N-proximal of which correspond
      to the A and B motifs of the purine NTP-binding pattern. Based on the role of gpI
      and IVa2 proteins in virion morphogenesis, and on the conservation of the NTP
      binding pattern in these proteins, we hypothesize that the A32 gene product might
      be involved in an ATP-consuming function in VV virion formation, e.g., packaging
      of the DNA in the virus particle.

PMID- 8470371
TI  - Sequence and gene structure of the hepatitis E virus isolated from Myanmar.
AB  - Hepatitis E virus (HEV) is a causative agent of enterically transmitted non-A,
      non-B hepatitis. Hepatitis E occurs not only in sporadic forms but also in
      epidemic outbreaks in the developing world. We have revealed the nucleotide and
      predicted amino acid sequences of full cDNA of HEV isolated from sporadic
      hepatitis E of Myanmar. The genome is 7194 nucleotides long, followed by a
      poly(A) tail, and has three open reading frames. The nonstructural gene is
      located in the 5' terminus, while the structural gene is situated in the 3'
      terminus. Our HEV strain has 98.5% nucleic acid identity with the HEV strain
      cloned by workers at Genelabs Incorporated from Myanmar. The difference is point
      nucleotide substitutions. There is a high degree of nucleotide relatedness among
      HEVs isolated from the same geographical location.

PMID- 8470372
TI  - Nurses' perceptions about physical restraints.

PMID- 8470373
TI  - Psychiatric recidivism prediction factors.

PMID- 8470374
TI  - Predicting breast-feeding duration during the postpartum hospitalization.

PMID- 8470375
TI  - Development of the Prenatal Attachment Inventory.

PMID- 8470376
TI  - Circular victimization in the caregiving relationship.

PMID- 8470377
TI  - Israeli RNs' projected work plans.

PMID- 8470378
TI  - Establishing guidelines to determine whether a potential study is a quality
      assessment study or scientific research.

PMID- 8470379
TI  - Qualitative research: the evaluation of its credibility, fittingness, and
      auditability.
AB  - The three criteria of credibility, fittingness, and auditability have been
      focused on in the hope of facilitating the critique of qualitative research. Once
      criteria that are appropriate to qualitative methodologies are developed, the
      scientific merit of these research studies can truly be appreciated. If
      traditional scientific criteria relevant to quantitative studies are used to
      critique qualitative methods, the development and acceptance of this paradigm
      transcending research will be hindered.

PMID- 8470380
TI  - Botulinum toxin. From poison to medicine.
AB  - Although thousands of people in the world each year continue to be poisoned with
      botulinum toxin-food-borne, infantile, or wound botulism-the neurotoxin is now
      sufficiently understood to allow it to be used as a medicinal agent to paralyze
      specific muscles, giving temporary symptomatic relief from a variety of dystonic
      neurologic disorders. I review some of the epidemiologic, clinical, and
      pathophysiologic aspects of botulinum toxin and how the neurotoxin may act as a
      poison or a medicine.

PMID- 8470381
TI  - Homeless families and their children's health problems. A Utah urban experience.
AB  - Descriptive information was obtained about homeless families in the Intermountain
      West and their children's health care needs were defined to help professionals
      develop programs tailored to meet the unique needs of this population. We
      collected data during the well-child visits of 306 children in 161 families
      living at the Travelers Aid Society family shelter. The results reveal 2 types of
      homeless families, episodic and long term. Each requires different levels of
      assistance. This study's profile of mobile, predominantly white, 2-parent
      families with few children (mean of 1.2) differs considerably from that of
      studies conducted on the East and West coasts. The families' nomadic life-style
      (73.1% came from 32 states other than Utah) present important public health
      issues, especially because of the recent resurgence of tuberculosis and declining
      levels of childhood immunizations. The children's health problems were similar to
      those reported nationally: delayed immunizations, dental decay, anemia, and
      impaired vision.

PMID- 8470382
TI  - Controversies in measles immunization recommendations.
AB  - Controversy in medicine is inevitable, but it becomes problematic when the issue
      is a serious public health problem requiring a clear plan of action. In recent
      years measles has made a major resurgence in this country, with provisional
      figures showing 89 measles-related deaths in 1990. The Immunization Practices
      Advisory Committee of the US Public Health Service, the Committee on Infectious
      Diseases of the American Academy of Pediatrics, and the US Preventive Services
      Task Force have all issued recommendations for measles immunization. Most of
      these recommendations are in agreement, but they conflict on the age at which
      vaccination should be given and the number of doses. To assist physicians in
      disentangling this complex web, I review the history of measles immunization in
      the United States and give the rationale for particular positions wherein the
      groups disagree. I describe protocols for routine vaccinations, endemic areas,
      outbreak control, colleges and universities, and international travel.

PMID- 8470383
TI  - HIV-1 seroprevalence among women attending sexually transmitted disease clinics
      in California. California Family of Surveys and Sentinel Surveillance Consortia.
AB  - To evaluate the distribution of the human immunodeficiency virus type 1 (HIV-1)
      epidemic among California women, we analyzed HIV-1 seroprevalence and risk
      factors among women attending sexually transmitted disease (STD) clinics in 21
      local health jurisdictions. Using standardized protocols developed by the Centers
      for Disease Control, we tested unlinked serum specimens from women attending
      participating STD clinics in 1989. We analyzed demographic characteristics, HIV
      risk exposure groups, and results of HIV-1 antibody testing on 17,210 specimens
      with an overall HIV-1 seroprevalence of 0.57%. Seroprevalence rates were highest
      for African-American women, women 25 to 29 years of age, injection drug users,
      and women attending STD clinics in San Francisco. After multiple logistic
      regression analysis, HIV-1 seropositivity remained highest for these four groups.
      The rate of HIV-1 infection among women attending STD clinics in California
      underscores the continued need to make HIV counseling and testing an integral
      component of routine services for women being evaluated for, or presenting with,
      sexually transmitted diseases.

PMID- 8470384
TI  - Does excluding patients without telephones affect the results of telephone
      reminder studies?
AB  - Studies of the effectiveness of telephone reminders to improve the rate of
      appointments kept have shown conflicting results. Few have accounted for patients
      without telephones. We conducted a controlled clinical trial to study the effect
      of excluding patients without telephones in a study of telephone reminders in an
      urban pediatric clinic. Telephone reminders were attempted the evening before
      scheduled visits for 238 subjects; 259 controls received no reminders. The
      overall rate of kept appointments was the same (54%) for both the intervention
      group and the control group. In neither group was there a substantial difference
      in the "show" rate between patients with and without telephones (intervention
      group 52% versus 57%, control group 55% versus 54%). In the intervention group,
      the show rate was higher for those with telephones who were contacted (66%) than
      for those who were not (37%) (P < .001). Telephone reminders did not improve the
      overall rate of kept appointments but appeared to result in a significant
      improvement in the show rate of those who could be reached. Excluding patients
      who could not be reached by telephone may affect the usefulness of previous
      studies.

PMID- 8470385
TI  - Prevention and treatment of foot problems in diabetes mellitus. A comprehensive
      program.
AB  - This discussion was selected from the weekly staff conferences in the Department
      of Medicine, University of California, San Francisco. Taken from a transcription,
      it has been edited by Nathan M. Bass, MD, PhD, Associate Professor of Medicine,
      under the direction of Lloyd H. Smith, Jr, MD, Professor of Medicine and
      Associate Dean in the School of Medicine.

PMID- 8470387
TI  - Carotid endarterectomy.
AB  - The Council on Scientific Affairs of the California Medical Association presents
      the following inventory of items of progress in neurosurgery. Each item, in the
      judgement 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 neurosurgery 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 Neurosurgery of the California Medical
      Association, and the summaries were prepared under its direction.

PMID- 8470388
TI  - The limits of treatment of malignant gliomas.

PMID- 8470386
TI  - Epidemiology of health and safety risks in agriculture and related industries.
      Practical applications for rural physicians.
AB  - Epidemiologic studies document that work in the agricultural sector is associated
      with many occupational health hazards. Exposure to organic dusts and airborne
      microorganisms and their toxins may lead to respiratory disorders. The burden of
      exposure-related chronic bronchitis, asthma, hypersensitivity pneumonitis,
      organic-dust toxic syndrome, and chronic airflow limitation can be diminished by
      appropriate preventive measures. The contribution of exposures to agricultural
      chemicals to cancers and neurodegenerative disorders is being investigated. Some
      studies document that farmers and those in related industries are at higher risk
      for the development of cancer of the stomach, soft tissue sarcoma, non-Hodgkin's
      lymphoma, and multiple myeloma. Chronic encephalopathy and Parkinson's and
      Alzheimer's diseases are being studied in relation to agricultural chemicals. The
      possible carcinogenicity and neurotoxicity of pesticides emphasize the need to
      promote the safe use of chemicals. Another area for health promotion programs is
      disabling injuries and traumatic deaths. Farm accidents are important because of
      their frequent occurrence among young people and disturbing fatality rates. Other
      health issues of concern in these industries include skin diseases, hearing loss,
      and stress.

PMID- 8470389
TI  - Indications and limitations of stereotactic radiosurgery.

PMID- 8470390
TI  - Corpus callosotomy for intractable epilepsy in children.

PMID- 8470391
TI  - Spinal cord injuries in children without radiographic abnormalities.

PMID- 8470392
TI  - Management of growth hormone-secreting pituitary adenomas--early diagnosis leads
      to successful treatment.

PMID- 8470393
TI  - Interventional neuroradiology--a new approach to difficult vascular lesions of
      the brain.

PMID- 8470394
TI  - Preventive aspects of helmet safety.

PMID- 8470395
TI  - Care of patients with aneurysms.

PMID- 8470396
TI  - Epilepsy surgery for hippocampal sclerosis.

PMID- 8470397
TI  - Metastatic spinal tumors.

PMID- 8470398
TI  - Pulmonary dirofilariasis in California.

PMID- 8470399
TI  - Sentinel surveillance and prevention of HIV in women.

PMID- 8470400
TI  - An optimistic message for foot problems in diabetes.

PMID- 8470402
TI  - Global health.

PMID- 8470401
TI  - The Los Angeles riots and the medical profession.

PMID- 8470403
TI  - Evaluation of recent changes in the financing of health services. Report of a WHO
      Study Group.

PMID- 8470404
TI  - [Typical errors in therapy of hypertension--an overview].

PMID- 8470405
TI  - [Therapeutic drug monitoring in general practice--indications and
      interpretation].

PMID- 8470406
TI  - [Rational diagnosis in kidney diseases].

PMID- 8470407
TI  - [The phenomenon of persorption--history and facts].

PMID- 8470408
TI  - [The importance of fasting and vegetarian diet in rheumatic diseases].

PMID- 8470409
TI  - [Modern wound dressings. 2: Occlusive dressings].

PMID- 8470410
TI  - [Diagnostic errors in cardiac arrhythmias].

PMID- 8470411
TI  - [Diagnosis of cerebellopontile angle tumors--only a problem for specialists?].

PMID- 8470412
TI  - [From general practice of an expert assessment service: the physician must
      monitor duration and dose of phototherapy].

PMID- 8470413
TI  - [A case from general practice (7): A physician with heart symptoms].

PMID- 8470414
TI  - [The diagnostic value of standard ECG methods, the cold-pressure test and
      Valsalva maneuver in idiopathic QT syndrome].
AB  - The idiopathic Long QT Syndrome is an infrequently occurring disorder. Affected
      patients usually show ECG alterations and are prone to syncope and sudden
      arrhythmic cardiac death. Adequate therapy with beta-blocking drugs may
      significantly improve the prognosis of affected patients. The early and precise
      diagnosis of the disorder therefore has major prognostic impact. This paper
      reports the diagnostic significance of standard ECG, exercise stress testing,
      ambulatory ECG monitoring, cold pressor test and Valsalva maneuver in 14 patients
      with Long QT Syndrome. The results were compared with those obtained in 14
      healthy age matched volunteers. QTc duration was significantly longer in patients
      with Long QT Syndrome during standard 12-lead ECG at rest (489 +/- 55 ms versus <
      vs. > 412 +/- 25 ms, p < 0.005), exercise stress test (490 +/- 39 ms vs. 409 +/-
      18 ms, p < 0.001), cold pressor test (512 +/- 45 ms vs. 407 +/- 19 ms, p <
      0.001), Valsalva maneuver (497 +/- 49 vs. 407 +/- 18 ms, p < 0.001), minimal
      heart rate during 24-h of ambulatory ECG monitoring (482 +/- 69 ms vs. 402 +/- 22
      ms, p < 0.01) and maximal heart rate during Holter monitoring (460 +/- 47 ms vs.
      411 +/- 27 ms, p < 0.005). Four of 14 patients with Long QT Syndrome had
      pathological findings during ambulatory ECG monitoring (two patients showed short
      episodes of asymptomatic torsade de pointes tachycardia, one patient had an
      intermittent SA-Block, and one patient showed T-wave alternans). All healthy
      volunteers had normal ambulatory ECG recordings (p < 0.05).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8470415
TI  - [Comparison of the cardiodepressive effects of nifedipine, isradipine,
      nisoldipine and felodipine in patients with coronary heart disease].
AB  - To compare the negative inotropic effects of the four dihydropyridine-calcium
      channel-blockers nifedipine (NIF), isradipine (ISR), nisoldipine (NIS) and
      felodipine (FEL) in man, the drugs were infused within 30 min intravenously in an
      equihypotensive dosage (NIF 2 mg, ISR 0.5 mg, NIS 0.5 mg, FEL 0.6 mg; 10 patients
      in each group) in patients with coronary heart disease. As a control, an
      additional 10 patients received isotonic saline solution following an identical
      protocol. The afterload reduction was submaximal (reduction of peripheral
      resistance: NIF -23 +/- 9%, ISR -24 +/- 10%, NIS -28 +/- 6%, FEL -27 +/- 6%; no
      significant difference for group comparison) with a similar kinetic and a steady
      state of the afterload reduction after one-half of the infusion period to achieve
      a comparable sympathetic reflex activation. Preload parameters (PAP, LVEDP) were
      unchanged in all groups. A reflex tachycardia occurred in all treatment groups
      after 15 min of drug infusion. Due to its negative chronotropic properties, the
      reflex tachycardia was significantly attenuated after isradipine as compared to
      the other drugs (heart-rate changes: NIF +13 +/- 7%, p < 0.01; ISR +4 +/- 7%, not
      significant; NIS +20 +/- 10%, p < 0.01; FEL +17 +/- 12%, p < 0.01). Because of
      the baroreflex and sympathetic reflex activation the left-ventricular dp/dtmax
      increased after isradipine (+14 +/- 10%, p < 0.01) and nisoldipine (+16 +/- 13%,
      p < 0.01). The lack of a significant dp/dtmax increase in spite of a comparable
      afterload reduction after felodipine (+5 +/- 8%, not significant) or nifedipine (
      3 +/- 6%, not significant) must be a consequence of the cardiodepressive
      properties of these drugs. Therefore, in an equihypotensive dosage, the strongest
      negative inotropic effects were observed after nifedipine, lesser effects after
      felodipine (p < 0.03), and the weakest cardiodepressive effects after isradipine
      (p < 0.01) and nisoldipine (p < 0.01). For clinical applications the lesser
      cardiodepressive properties of the new dihydropyridine-derivatives should be
      advantageous in patients with already reduced left-ventricular performance or for
      use in combination with other negative inotropic drugs, e.g., betablockers.

PMID- 8470416
TI  - [Does ST-elevation in stress ECG depend on the extent of collateral
      circulation?].
AB  - As a possible cause of exercise-induced ST-elevation in patients without
      myocardial infarction, a poor or absent coronary circulation to the poststenotic
      coronary segment was postulated. To check this thesis, we examined 10 patients
      (pts.) with ST-elevation, respectively, ST-depression and comparable coronary
      status (coronary score 12 vs. 12; mean stenosis diameter 86 vs. 85%) and exercise
      parameters (work load 150 vs. 137.5 Watts; exercise duration 2.8 vs 3.5 min) with
      regard to their collateral circulation. In the group with ST-elevation there were
      nine pts. with severe proximal stenosis of the left anterior descending artery
      (LAD) and one pt. with a stenosis in the middle third of the right coronary
      artery. The 10 patients with ST-depression had a proximal stenosis in the LAD.
      The extent of the angiographically seen collaterals was equal in both groups. As
      a result, this study demonstrates that the size of the collateral circulation has
      no influence on the exercise-induced ST-elevation. The most plausible cause of
      exercise-induced ST-elevation is a functional decrease of the lumen of a severe
      stenosis.

PMID- 8470417
TI  - [Nitroglycerin in comparison with nifedipine in patients with hypertensive
      crisis].
AB  - To determine whether nitroglycerin is just as effective as nifedipine in lowering
      the blood pressure in excessive hypertension and hypertensive crisis, two groups
      of 20 patients received in random sequence either 1.2 mg of nitroglycerin
      sublingually or a 10 mg nifedipine capsule, which was chewed and swallowed. The
      blood pressure fell after 5 min in the nitroglycerin group from 211/122 mm Hg to
      171/95 mm Hg and after nifedipine from 210/118 to 185/102 mm Hg. The greater
      effect of nitroglycerin results from faster absorption through the oral mucosa
      than through the small intestinal mucosa where nifedipine is primarily absorbed.
      After 15 to 20 min a satisfactory reduction in blood pressure was reached in both
      groups: 157/91 and 158/92 mm Hg, respectively. After 30 min the heart rate in the
      nitroglycerin group had decreased from 83 to 80/min, but in the nifedipine group
      it had increased from 84 to 90/min. The reduction in blood pressure persisted up
      to 6 h. No significant difference in side-effects was determined. Since a
      hypertensive crisis is usually accompanied by left-ventricular failure, pulmonary
      edema or angina pectoris and infarction, and nitroglycerin has been definitively
      shown to positively influence these conditions, preference should be given to
      nitroglycerin in the treatment of hypertensive crisis.

PMID- 8470419
TI  - [Stable stimulation impedance of steroid electrodes in various impulse
      amplitudes: indications for low polarization of the electrode-myocardium
      interface].
AB  - The reduction of electrode surface area leads to an increase of pacing impedance
      which may be caused either by higher tissue resistance or by greater polarization
      occurring at the electrode-myocardium interface. The impedance of steroid-eluting
      leads with both 8 mm2 surface area (CapSure 4003, Medtronic n = 12) and with 4
      mm2 (030-368, Telectronics, n = 8) were compared to the impedance of a high
      polarizing Elgiloy lead (PE 60/4 DN, Biotronik; n = 7). All leads were connected
      to the same unipolar VVI pacemaker (Pasys 8329, Medtronic). Pacing impedance was
      measured at 0.8, 1.6, 2.5, 5.0, and 8.0 volts pulse amplitude and at 0.05, 0.25,
      0.5, 1.0, 2.0 msec pulse duration. Impedance of the Elgiloy lead was constant at
      0.05 and 0.25 msec, but increased at longer pulse durations for pulse amplitudes
      below 5.0 volts. Both steroid-eluting leads had constant impedance at each pulse
      duration. The impedance of the 4 mm2 lead was significantly higher than of the 8
      mm2 lead. In contrast to the Elgiloy lead, impedance of the steroid-eluting leads
      is not influenced by pulse-dependent factors such as polarization, indicating
      that the higher impedance of the 4 mm2 steroid-eluting lead is caused by a higher
      tissue resistance and not by greater polarization.

PMID- 8470418
TI  - [Emergency management of type A aortic dissection in the acute rupture phase with
      pericardial tamponade].
AB  - A case of successful operative repair of a previously unknown aortic dissection
      type A after intrapericardial rupture is presented. Under resuscitative measures
      an inferior pericardiotomy was done, followed by sternotomy to control bleeding
      under then stabilized circulation. Without detailed diagnostic evaluation,
      immediate operation with resection of the aneurysm and supracoronary prosthesis
      interposition was carried out. The diagnostic methods and problems, the
      differential diagnosis, and comparable cases from the literature are discussed.

PMID- 8470420
TI  - [8th report of structure and performance figures of heart catheterization
      laboratories in Germany. Results of a survey of the Commission for Clinical
      Cardiology of the German Society of Cardiovascular Research in 1991 with the
      cooperation of the German Society of Pediatric Cardiology].

PMID- 8470421
TI  - [Long-term follow-up of patients with angina pectoris-like chest pain and normal
      coronary angiogram].
AB  - To determine the long-term prognosis of patients (pts) with angina-like chest
      pain and normal coronary arteriograms, 178 pts (61 women, 117 men; mean age 48.1
      years) were followed for an average of 9.8 years (5.5-13.1 years). Eight pts
      (4.5%) died during follow-up: One pt from acute myocardial infarction, one pt
      suddenly, one pt from chronic cor pulmonale and 5 pts from non-cardiac diseases.
      Chest pain remained constant in 137/170 surviving pts (80.6%), but disappeared in
      33 pts (19.4%). Nine of the 178 pts (5.1%) developed manifest coronary artery
      disease (CAD): four of them (2.2%) acute myocardial infarctions including one
      death, after an average of 7.2 years; in five pts (2.8%) with continued chest
      pain a second coronary angiogram showed typical CAD. These pts with manifest CAD
      averaged 2.1 risk factors: six pts were smokers, two pts had elevated cholesterol
      levels (> 7.5 mmol/l), three pts had elevated triglyceride levels (> 2.4 mmol/l),
      two pts had a diabetes mellitus type IIa and six pts were hypertensives. Patients
      without manifestation of CAD averaged only 1.4 risk factors (p < 0.05). Our data
      show that pts with angina-like chest pain and normal coronary angiograms have an
      excellent long-term prognosis (only 0.51% of patients with new manifestations of
      CAD per year). However, angina-like chest pain can persist over many years.

PMID- 8470422
TI  - Indications for smallpox vaccination: policies still differ.
AB  - The need for vaccination of those handling vaccinia and other related
      orthopoxviruses is still uncertain, with UK and US authorities adopting different
      policies. The former revised an earlier decision and now no longer recommend
      vaccination; the latter confirmed earlier decisions to recommend vaccination.
      These policies are reviewed in the light of evidence on the safety and efficacy
      of smallpox vaccine.

PMID- 8470423
TI  - Immunogenicity of a recombinant DNA hepatitis B vaccine in renal transplant
      patients.
AB  - In renal transplant patients hepatitis B infection is associated with a higher
      morbidity and mortality. Therefore, we investigated the immunogenicity of an
      enhanced vaccination scheme with a recombinant DNA hepatitis B vaccine in renal
      allograft recipients. Injections of 40 micrograms were given at months 0, 1, 2
      and 6. Conversion rate (anti-HBS antibody titre > 10 mIU ml-1) was only 36%. On
      the other hand, in patients vaccinated before transplantation, a booster
      injection of 40 micrograms was highly successful, resulting in a rise of antibody
      titre > 10 mIU ml-1 in 86%. In view of the poor vaccination results after
      transplantation, we strongly recommend hepatitis B vaccination prior to
      transplantation.

PMID- 8470424
TI  - Immune response of human volunteers and animals to vaccination with egg-grown
      influenza A (H1N1) virus is influenced by three amino acid substitutions in the
      haemagglutinin molecule.
AB  - Inactivated subunit vaccines were prepared from high-growth reassortants derived
      from two separate egg isolates from a single clinical specimen of influenza A
      (H1N1) virus. One of these reassortants, NIB-14, was antigenically
      indistinguishable from isolates made in tissue culture, while the other, NIB-17,
      was antigenically different and typical of egg isolates. The viruses differed by
      three amino acid residues in the haemagglutinin (HA) molecule and the anti-HA
      serological response induced was studied in animal models and human volunteers.
      In the volunteer groups both vaccines induced very high levels of circulating
      haemagglutination inhibition antibodies but with different serological
      specificities. Both NIB-14 and NIB-17 vaccines induced high levels of cross
      reactive antibodies capable of reacting with both strains, but only NIB-14
      vaccine induced significant levels of strain-specific antibodies capable of
      reacting exclusively with the homologous strain. Antisera containing only cross
      reactive antibodies proved as capable of virus neutralization as antisera
      containing high levels of strain-specific antibodies. We extended the argument
      that epidemic strains are antigenically more closely related to tissue culture
      isolates and established that viruses which differ by only single amino acids at
      critical points in the HA structure can induce a significantly different immune
      response when used as inactivated vaccines.

PMID- 8470425
TI  - Antibody levels determined by an appropriate technology (HI) in local cattle
      following anti-rinderpest campaign in Nigeria.
AB  - The levels of antibodies against rinderpest measured by the haemagglutination
      inhibition (HI) test were titrated in 640 randomly collected sera. Out of 640
      samples, 586 (91%) exhibited high titres of > 4 while 54 (9%) had low titres of <
      or = 4. Of the 400 samples collected in Zaria, 354 (88.5%) had high titres while
      46 (11.5%) had low titres. In Funtua, 140 samples were collected with 132 (94.3%)
      recording high titres while 8 (5.7%) had low titres. All samples (100) collected
      from Shika had high titres (100%). Statistical evaluation with analysis of
      variance and Tukey's HSD tests showed no significant difference at the alpha =
      0.05 level of significance between mean antibody titres in the areas under
      investigation; this showed the vaccines used during the anti-rinderpest campaign
      to be of good immunogenic quality.

PMID- 8470426
TI  - Comparison of conventional adjuvants and 'adjuvant-free' monoclonal antibody
      targeting for stimulating antibody responses against a conjugate of luteinizing
      hormone releasing hormone and avidin.
AB  - A conjugate of luteinizing hormone releasing hormone (LHRH) and avidin was used
      for immunizing mice and sheep. In mice, a range of adjuvants co-administered with
      the conjugate was shown to affect antibody titre and isotype. The commercially
      available Montanide and Ribi adjuvant emulsions, polyadenylic-polyuridylic acid,
      Quil A and Freund's complete adjuvant all produced high antibody titres to LHRH
      (reciprocal titre range 8000-20,000) and avidin (range 9000-35,000). Alhydrogel,
      Pluronic gel, Immunostim, DEAE-Dextran and muramyl dipeptide were weak to
      moderately effective (reciprocal titre ranges of 1300-5000 for LHRH and 3000-6000
      for avidin, respectively). With Quil A, the response to avidin in mice was found
      to consist of roughly equal proportions of the IgG1, IgG2a and IgG2b isotypes. In
      contrast, the response to avidin using the other adjuvants and to LHRH consisted
      predominantly of the IgG1 isotype. An 'adjuvant-free' immunization strategy was
      attempted by targeting the LHRH-avidin conjugate to class II major
      histocompatibility complex (MHC) determinants on cells of the immune system.
      Using an immunoconjugate formed by linking LHRH-avidin to an antibody specific
      for mouse and sheep class II molecules, a twofold augmentation of titres relative
      to controls was obtained in mice. These antibodies were almost exclusively of the
      IgG1 isotype. In contrast, monoclonal antibody targeting in sheep resulted in a
      significantly enhanced immune response (reciprocal titres of 15,000 and 20,000
      for LHRH and avidin, respectively) which was comparable to that achieved by
      immunizing with Quil A as adjuvant. Both the monoclonal antibody targeting and
      Quil A treatments tended to favour the production of antibody isotype IgG1 over
      IgG2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470427
TI  - Distinct patterns of T- and B-cell immunity to respiratory syncytial virus
      induced by individual viral proteins.
AB  - Mice were infected with respiratory syncytial (RS) virus or with recombinant
      vaccinia viruses (rVV) expressing individual RS virus proteins. rVV-G, rVV-F and,
      to a lesser extent, rVV-P induced ELISA-binding anti-RS virus antibodies; those
      induced by rVV-P were non-neutralizing. Different antigens induced helper T cells
      with distinct cytokine secretion profiles: some released IL-2, and others
      predominantly IL-4 and 5. Virus-specific cytotoxicity was induced by infection
      with RS virus, rVV-F or rVV-22K. Different RS virus proteins (given in the same
      route and form) therefore prime for functionally distinct T-cell activities.
      These patterns of virus-specific immunity may help explain the pathogenicity of
      RS virus vaccines, and help in the design of protective, non-pathogenic vaccines
      in the future.

PMID- 8470428
TI  - Vaccination of mice against canine distemper virus-induced encephalitis with
      vaccinia virus recombinants encoding measles or canine distemper virus antigens.
AB  - Measles and canine distemper are caused by serologically related viruses.
      Although dogs immunized with measles virus (MV) do not elicit canine distemper
      virus (CDV) neutralizing antibodies, they are protected against the fatal
      disease. To investigate the potential role of the MV antigens in protection
      against CDV, we have immunized mice with vaccinia virus (VV) recombinants
      expressing the MV haemagglutinin (HA), fusion (F), nucleoprotein (NP) and matrix
      (M) antigens and challenged them with CDV. A partial protection was observed with
      the VV recombinants expressing the F, NP and M antigens, but not the HA. In
      contrast, immunization with a VV recombinant expressing the CDV F protein
      completely protected mice from CDV.

PMID- 8470429
TI  - Serological correlates in whooping cough.
AB  - Antibody concentrations to three Bordetella pertussis antigens in 94 predisease
      samples from women who, within a median of 220 days, developed culture-confirmed
      whooping cough were compared to antibodies in samples from matched controls. The
      median IgG antibody levels were significantly lower to all three antigens,
      pertussis toxin, filamentous haemagglutinin and lipopolysaccharide, in the
      predisease samples of cases as compared to non-cases (p values ranging from
      0.0001 to 0.01). A significant difference in antibody distribution was, however,
      found only to pertussis toxin, measured either by ELISA or by a neutralization
      test (p values of 0.0004 and 0.007, respectively). The results could be
      interpreted as meaning that antibodies to the different antigens all participate
      in protection against disease but that antibodies to pertussis toxin play a major
      role.

PMID- 8470430
TI  - An experimental vaccine cocktail for Plasmodium falciparum malaria.
AB  - Surface proteins from several different life-cycle stages of the malaria parasite
      Plasmodium falciparum were expressed at high levels in the yeast Saccharomyces
      cerevisiae. Purified proteins, both individually and in cocktails, were used to
      immunize mice and goats in conjunction with either Freund's adjuvant or a muramyl
      tripeptide-based adjuvant. Immune responses were measured by enzyme-linked
      immunosorbent assays and by the ability of antisera to inhibit (1) the invasion
      of hepatocytes by live sporozoites, (2) in vitro invasion of human erythrocytes
      by live merozoites, and (3) the development of oocytes in the mosquito vector.
      These results suggest that cocktails of different stage-specific antigens can
      provide the components necessary to block the development of the malaria parasite
      at multiple stages of its life cycle.

PMID- 8470431
TI  - Construction of an aroA mutant of Salmonella serotype Gallinarum: its
      effectiveness in immunization against experimental fowl typhoid.
AB  - An aroA mutant was produced from a virulent strain of Salmonella Gallinarum, the
      causative agent of fowl typhoid in poultry, by Tn10 insertional inactivation and
      deletion. The mutant was highly attenuated for chickens. A single intramuscular
      immunization of 2-week-old chickens with 10(7) mutant organisms reduced mortality
      following oral challenge with 10(8) organisms of the parent strain from 63 to
      30%. In a second experiment multiple immunizations with 10(8) mutant organisms
      reduced mortality after challenge with 10(7) organisms of the virulent strain
      from 77 to 0%. By oral inoculation the mutant was not able to immunize chickens
      against oral challenge.

PMID- 8470432
TI  - Proliferative responses to purified and fractionated Bordetella pertussis
      antigens in mice immunized with whole-cell pertussis vaccine.
AB  - The specificity of the cell-mediated immune response to Bordetella pertussis
      following immunization of C57B1 mice with a whole-cell pertussis vaccine was
      assessed in a proliferation assay. A proliferative response of lymph node
      lymphocytes to the filamentous haemagglutinin, the 69 kDa outer membrane protein
      and the agglutinogens 2 and 3 was demonstrated. The proliferative cells were T
      cells of the CD4+ phenotype. In addition, several as yet uncharacterized antigens
      expressed by B. pertussis were shown to induce a proliferative response, also
      mediated by T cells of the CD4+ phenotype. Although a range of different
      immunization schedules and preparations of pertussis toxin were used, no specific
      proliferative responses to pertussis toxin, which is regarded as a protective
      antigen of major importance from B. pertussis, were found.

PMID- 8470433
TI  - Immunogenicity and pathogenicity of a triple temperature-sensitive modified
      respiratory syncytial virus in adult volunteers.
AB  - The immunogenicity and pathogenicity of a strain of respiratory syncytial (RS)
      virus modified by sequential induction of three temperature-sensitive (ts)
      mutations have been evaluated by intranasal administration to 22 adult
      volunteers. This modified virus, a triple ts mutant designated ts1C, was derived
      from a double mutant ts1B evaluated in a previous trial. The original isolate
      (strain RSS-2) and all its derivatives were propagated throughout in human
      diploid cells in a specially assigned laboratory. The triple mutant ts1C is
      unable to multiply in MRC-5 cells at 37 degrees C and above. Following nasal
      administration of ts1C, immune responses were observed in volunteers with low pre
      existing neutralizing antibody titres. The ability of mutant ts1C to induce upper
      respiratory tract disease in adults was greatly diminished in comparison with the
      non-ts wild-type virus, but not markedly more so than a previously tested double
      ts mutant (ts1B) which replicates at 37 degrees C. Mutant ts1C, however, may have
      greater potential as a live vaccine in view of its inherently greater genetic
      stability.

PMID- 8470434
TI  - Discordance in the determination of non- or low-responders to HBV vaccine using
      IMx-AUSAB or AUSAB-RIA.

PMID- 8470435
TI  - Loss of anti-HBc antibodies after HBV infection in immunized Senegalese children.

PMID- 8470436
TI  - Anterior sacral meningocele and Marfan syndrome: a review.
AB  - Anterior sacral meningocele is a not rare entity. Treatment is usually surgical
      and consists in a transacral posterior approach with patching of the
      communication between the malformation and the dural sac. But surgery can be
      difficult and require multiple procedures. We report the first case of a giant
      anterior sacral meeningocele rapidly cured by a simple endoscopic procedure. We
      believe that more attention should be used in the diagnosis of such cases as they
      can be so easily cured. We have reviewed the literature about anterior sacral
      meningocele and particularly its treatment and its association either with Marfan
      syndrome or a familial occurrence.

PMID- 8470437
TI  - Nonparasitic abdominal serous cysts. A multiple case report.
AB  - A group of 35 patients with nonparasitic abdominal serous cysts is reviewed in
      order to investigate the diagnostic and therapeutic features of these rare
      conditions. In most cases the cysts were localised in the liver. Other
      localisations were the kidney (9 cases), the mesenteric area (2 cases), the
      adrenals (2 cases), the spleen and the pancreas (one case each). The clinical
      symptoms were essentially determinated by the size of the cysts, regardless their
      visceral localisation. Ultrasonography was the most efficient procedure for their
      detection, although this method's precision for the visceral localisation of the
      cysts was not entirely reliable (6 errors). The low incidence of such
      abnormalities as well as the absence of any relevant diagnostic elements for
      establishing the nonparasitic character of the cysts, favoured the confusions
      with nonproliferous hydatid cysts, especially in cases of solitary cysts (7
      patients). The most frequently used surgical procedures were partial cystectomy
      (18 cases) and total cystectomy (8 cases). A personal technique based on
      obliteration of the cavity with the bulging wall of the cysts, was used in two
      patients. When choosing the surgical procedure, the size, site and number of
      cysts were considered. Immediate and late postoperative results were very good.

PMID- 8470438
TI  - Chronic anemia secondary to side-to-side distal small bowel anastomosis.
AB  - Occult intestinal bleeding was diagnosed in a patient who underwent a distal
      small bowel resection. The resection was required for small bowel obstruction.
      She developed iron deficiency anemia four years later. Clinically she presented
      with melena. Colonoscopy, gastroscopy were unsuccessful in making the diagnosis.
      But a 99 mass Technetium (99m Tc) Labeled Red Blood Cell (RBC) scintigraphy,
      established the bleeding site in the gastrointestinal tract. Laparotomy
      identified an ulcerative lesion at the surgical side-to-side anastomosis.
      Histology demonstrated focal ulceration with chronic inflammation but did not
      show crypt abscesses, or granulomata. Medical therapy, including iron and
      Histamine-antagonists were ineffective. She was treated with resection of the
      anastomosis. Gastrointestinal bleeding due to anastomotic ulceration appears to
      be a late complication of small bowel resection with side-to-side anastomosis.

PMID- 8470439
TI  - Association of aortic stenosis and gastrointestinal bleeding (Heyde's syndrome).
      Report of two cases.
AB  - The association between aortic stenosis and digestive angiodysplasia has been
      described for the first time by Heyde in 1958. This entity is thus known as
      Heyde's syndrome. In many instances, the recurrent small intestinal bleeding
      originating from angiodysplasia stopped after aortic valve replacement. We report
      two cases of patients presenting with a recurrent small intestinal bleeding
      originating from digestive angiodysplasia and suffering from aortic stenosis.
      Diagnosis of both pathologies is well documented in both cases. The replacement
      of the aortic valve by a biologic prosthesis stopped the bleeding. Prior to
      aortic valve replacement, the two patients suffered severe recurrent blood loss
      from intestinal angiodysplasia. The treatment of aortic stenosis greatly favored
      both cardiac and general status. We recommend aortic valve replacement with a
      biologic prosthesis prior to intestinal resection in patients presenting with
      Heyde's syndrome. We stress on the fact that anticoagulants must be stopped in
      order to minimize the risk of further bleeding.

PMID- 8470440
TI  - Variant form of popliteal artery entrapment syndrome.
AB  - A forty-six-year-old, non smoker, patient presented with an intermittent
      claudication of the right calf, clinically compatible with a low popliteal artery
      obliteration. Arteriography showed an irregular intercondylar popliteal artery
      and oblitered low popliteal and anterior tibial arteries. Surgical posterior
      access showed a faulty insertion of the mediate gastrocnemius caput responsible
      for popliteal artery entrapment syndrome and for aneurysmal dilatation of the
      popliteal artery above compression. As far as we know, this form of popliteal
      artery entrapment syndrome has not been published yet.

PMID- 8470441
TI  - Use of tissue expansion in head and neck. Review of 33 cases.
AB  - Thirty-three patients have had skin expansion for reconstruction in the head and
      neck area. Expansion was used alone in 21 patients, and combined with other
      techniques in 12 patients. Indications, operative technique, complications and
      failures of the method are discussed.

PMID- 8470442
TI  - Benign tumours of the upper gastro-intestinal tract (stomach, duodenum, small
      bowel): a review of 178 surgical cases. Belgian multicentric study.
AB  - The results of retrospective series counting 178 cases of surgically resected
      stomach, duodenum and small bowel benign tumours are analysed. It is a Belgian
      retrospective multicentric study that extend over a mean duration of 7 years 9
      months. The main symptoms are haemorrhage, dyspepsia, obstruction and
      invagination. The most frequent tumours are leiomyoma, adenomatous polyps, lipoma
      and schwannoma. Preoperative investigations are endoscopy and radiology. To
      finish off the gastro-duodenal tumours examinations, endoscopy is necessary and
      arteriography can be helpful in small bowel tumours. Operative mortality of this
      series is 2.2%; local and general postoperative complications are 34.2%. Observed
      local recurrence in 118 patients with mean follow-up of 27 months is 1.7%. The
      authors emphasize the surgical resection necessity of these tumours as their
      malignant potentiality is not inconsiderable. Considering local recurrence,
      malign change and afar dissemination, a long-term follow-up is recommended.

PMID- 8470443
TI  - Intermittent gallstone ileus following endoscopic biliary sphincterotomy. A case
      report.
AB  - A 72-year-old woman presented with periods of colicky abdominal pain following
      endoscopic sphincterotomy and lithotripsy for choledocholithiasis. A diagnosis of
      intermittent gallstone ileus was made, while it appeared that a large gallstone,
      that was not removed from the common bile duct, obstructed the small bowel. The
      intermittent course was elicited by pendulation of a gallstone between two
      stenoses, which originated from chronic radiation enteritis.

PMID- 8470444
TI  - Selective rupture of the Wirsung duct: a rare form of pancreatic trauma.
AB  - A patient with a traumatic pancreatic lesion, confined to the Wirsung duct, is
      presented. At first laparotomy, the diagnosis was missed. Posttraumatic acute
      pancreatitis led to endoscopic pancreatography, disclosing the exact localization
      of the lesion. Left pancreatectomy led to rapid recovery. A late postoperative
      pancreatic fistula healed without problems.

PMID- 8470445
TI  - Atraumatic splenic rupture in the course of a pneumonia with Streptococcus
      pneumoniae. Case report and literature review.
AB  - Atraumatic splenic ruptures in the course of infectious diseases are rare but
      have been reported. Various germs of viruses can be at the origin of such
      rupture. The more often quoted viral disease is infectious mononucleosis. The
      more frequently involved bacteria are Streptococcus non pneumoniae, Pseudomonas,
      staphylococci and Clostridium. Rupture mechanism is not clearly elucidated; it
      can be connected with sepsis diffusion at spleen level via haematogenic way and
      consequently splenomegaly. Splenic rupture following septicaemia does not always
      entail major splenomegaly nor abscess formation but the attack of the splenic
      tissue itself is sometimes sufficient to bring about the rupture. The present
      case of atraumatic splenic rupture on spleen sepsis, no abscess, starting from a
      pulmonar infection with Streptococcus pneumoniae is, to our knowledge, the first
      case reported in literature.

PMID- 8470446
TI  - Splenic aneurysm rupture. Case report and review of the literature.
AB  - The authors report a case of splenic aneurysm rupture in a 61-year-old woman. The
      diagnosis was made by computed tomography in the second phase of a "double
      rupture phenomenon" in circulatory collapse. This was successfully treated by
      aneurysmectomy and splenectomy. The case is reported together with the literature
      review.

PMID- 8470447
TI  - Intestinal obstruction and portal vein gas embolism.
AB  - The presence of hepatic portal vein gas is the consequence of invasion by
      anaerobic bacteria originating from an intestinal tract lesion. Although this
      phenomenon is rare, it may result from several common intestinal pathologies. The
      prognosis, despite intensive treatment, is often very poor. The authors report a
      case associated with bowel necrosis resulting from intestinal band.

PMID- 8470448
TI  - Treatment of colon endoscopic perforations.
AB  - We describe the treatment of 9 patients who underwent endoscopic perforation of
      the large bowel. All perforations occurred in patients with colonic
      diverticulosis or during polypectomy. The choice between conservative or surgical
      management essentially depends on clinical criteria. Conservative treatment,
      clinical observation, broad spectrum antibiotics and parenteral diet, is
      recommended for patient in good general condition and without any sign of
      peritoneal irritation. Free intraperitoneal gas on X-ray is not an indication for
      laparotomy. On the other hand, the development of peritonism or clinical
      deterioration under medical treatment requires a surgical management. Primary
      suture of the perforation can be performed if the colon was well cleansed for
      colonoscopy, if the perforation is small and if there is no suspicion of
      underlying carcinoma. In the other cases, resection including the perforation
      must be recommended.

PMID- 8470449
TI  - Pulmonary actinomycosis. Case report.
AB  - Pulmonary actinomycosis. Case report. Pulmonary actinomycosis is a rare
      infectious disease. The major difficulty is mainly the diagnosis. A high dose of
      suspicion is required in each intrathoracic process showing malignant behaviour,
      despite benign histology. Especially if the process extends through normal tissue
      planes, actinomycosis should be suspected. The therapy of choice should consist
      in high dose of antibiotics for several months, occasionally followed by surgery.
      Often though, surgery is the first treatment because of the unability to
      differentiate the lesion from malignant tumor. Surgery should always be followed
      by long term antibiotic therapy.

PMID- 8470450
TI  - The global design of the hindlimb in quadrupeds.
AB  - In the hindlimb of quadrupeds three major segments can be distinguished which can
      rotate with respect to each other in the hip, knee and ankle joints. Movements in
      a sagittal plane appear to be controlled by three sets of antagonistic mono
      articular muscle groups (one set per joint) and two sets of antagonistic bi
      articular muscles. This design allows co-activations of mono-articular agonists
      and their bi-articular antagonists. These co-contractions occur for example in
      ballistic tasks such as jumping where the transfer of angular acceleration in the
      joints into the translational acceleration of the hip decreases as a function of
      joint extension. Well-trained humans appear to solve this problem by a distinct
      proximodistal sequence in the timing of the joint extensions and a transport of
      energy via bi-articular muscles. This can also be observed in a number of
      animals. A second example has to do with the necessity for a certain distribution
      of net moments in the joints which is required to control the direction and
      magnitude of the external force on the ground. The control of these moments can
      to a large extent be judged as a requirement which is independent of the joint
      displacements required in the same task. Many walking, running or pulling tasks,
      for example, require knee extension combined with a net knee flexing moment. Co
      activation of mono-articular agonists and their bi-articular antagonists appear
      to solve these problems in an effective and efficient way.

PMID- 8470451
TI  - Comparison of the damping effect of different shoeing by the measurement of hoof
      acceleration.
AB  - The purpose of this study was to compare the damping effect of 16 types of
      shoeing by measuring hoof acceleration parameters on two trotting horses. At
      impact, maximal deceleration had extreme values such as 188 m/s2 (+/- 55) for the
      most damping combination (p < 0.01) and 746 m/s2 (+/- 14) for the steel shoe
      (mean = 551 m/s2 +/- 125). After the shock, the hoof was exposed to a mean
      vibrating acceleration at 418 Hz (+/- 84) which was progressively damped in 37.3
      ms (+/- 10.5). According to these results, the damping ability of different
      farriery products significantly reduces (p < 0.05) shocks and vibrations at hoof
      impact in the athletic horse caused by runs on asphalt or similar surfaces. In
      practice, the use of the most efficient shoeing should help to reduce the
      incidence of the over-used joint diseases in the athletic horse caused by runs on
      hard surfaces.

PMID- 8470452
TI  - Concept of a force-measuring horseshoe.
AB  - To further develop objective methods in the field of gait analysis a force
      measuring horseshoe (FM shoe) has been developed. The ground reaction forces were
      determined by measuring the degree of displacement between the two solid parts of
      the shoe. This was done by three removable measuring units (MUs) that were
      equipped with strain gauges and placed in the toe and in each of the quarter
      parts. Before performing force recordings the sensors were calibrated with the
      actual MUs mounted on the shoe. This can be done in the field with a specially
      developed equipment. The shape of the signal generated by the MUs corresponds
      very well to signals generated by other instrumented shoes and force plate traces
      reported by other authors. In a comparative study between the FM shoe and a force
      plate a good resemblance between force traces from the two systems was seen.
      There is still some work to be done to refine the method of calibrating the FM
      shoe. However, the good linear relationship between forces applied and the sensor
      signals implies that the concept of the FM shoe will fulfill the requirements of
      measuring absolute forces.

PMID- 8470453
TI  - A method to estimate the initial length of equine tendons.
AB  - A procedure is described by which the length of a tendon at the onset of loading
      is determined objectively. The procedure includes the fitting of third-order
      polynomial functions on the load-elongation data. The onset of loading is
      detected by an increasing fit of the polynomial by selective data reduction of
      the initial part of the load-elongation curve. The procedure results in an
      objective and reproducible definition of the zero strain level of a tendon.

PMID- 8470454
TI  - Measurement techniques in animal locomotion analysis.
AB  - Animal performance can be determined by subjective observations or objective
      measurements. Numerical data are only then superior to results of subjective
      observations when they are the result of measurements carried out to test a well
      defined hypothesis or to give the answer to a clear, precisely formulated
      question. In the analysis of kinematics a careful evaluation of the set-up of the
      measurement equipment and the resulting accuracy in the data is required.
      Measurements in three dimensions (3D) are theoretically better than those in 2D.
      Practically, however, collection, analysis, interpretation and presentation of 3D
      data are so much more complicated that frequently 2D analysis appears to be more
      useful. The minimal size of markers necessary to obtain a certain accuracy in
      kinematic data is usually too big for practical use. Smaller markers impair
      accuracy. Reduction of measurement noise is obligatory when time derivatives are
      to be calculated. Skin movement artefacts cannot be removed by data smoothing.
      Forces occurring between the digits and the ground can be determined using a
      force plate or an instrumented shoe. A force plate is accurate, but repeated
      trials are necessary. Using a force shoe each ground contact results in useful
      data. However, the shoe itself may affect locomotion. Surface strains on long
      bones can be recorded relatively easily. Determination of loading forces from
      surface strains is complicated but can be carried out using multiple strain
      gauges and a post-mortem calibration test. Strain in tendons is difficult to
      measure due to problems in defining a'zero' or reference length.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8470455
TI  - Recommended terminology for researchers in locomotion and biomechanics of
      quadrupedal animals.
AB  - This paper summarizes recommendations for terminology to be used in the
      description of quadrupedal locomotion and selected aspects of biomechanics.
      Directional terms and planes of the body (anatomical position, spatial reference
      systems), joint angulation, conformation, general locomotion terminology, phases
      of the stride and limb cycle (e.g. step, cadence) and terminology for the
      description of jumping are described.

PMID- 8470456
TI  - Application of TrackEye in equine locomotion research.
AB  - TrackEye is an analysis system, which is applicable for equine biokinematic
      studies. It covers the whole process from digitizing of images, automatic target
      tracking and analysis. Key components in the system are an image work station for
      processing of video images and a high-resolution film-to-video scanner for 16-mm
      film. A recording module controls the input device and handles the capture of
      image sequences into a videodisc system, and a tracking module is able to follow
      reference markers automatically. The system offers a flexible analysis including
      calculations of markers displacements, distances and joint angles, velocities and
      accelerations. TrackEye was used to study effects of phenylbutazone on the
      fetlock and carpal joint angle movements in a horse with a mild lameness caused
      by osteo-arthritis in the fetlock joint of a forelimb. Significant differences,
      most evident before treatment, were observed in the minimum fetlock and carpal
      joint angles when contralateral limbs were compared (p < 0.001). The minimum
      fetlock angle and the minimum carpal joint angle were significantly greater in
      the lame limb before treatment compared to those 6, 37 and 49 h after the last
      treatment (p < 0.001).

PMID- 8470457
TI  - Quantification of the locomotion of Dutch Warmblood foals.
AB  - To get an in-depth insight into the ontogeny of the equine locomotor apparatus,
      the locomotion of 28 Dutch Warmblood foals was recorded at the walk, trot and
      canter on a treadmill using a CODA-3 apparatus. A great similarity in joint angle
      time diagrams was found, although considerable differences in kinematic gait
      parameters of individual foals could be detected. These results contribute to an
      objective comparison of the locomotor performance of foals.

PMID- 8470458
TI  - Surface strain on the dorsal metacarpus of thoroughbreds at different speeds and
      gaits.
AB  - Stacked rectangular rosette strain gages were used to measure surface bone strain
      on the dorsomedial cortex of the third metacarpal bones in 6 adult Thoroughbred
      horses during treadmill exercise. The peak principal compressive and tensile
      strains, angle of the peak strains and strain rate during loading were calculated
      and compared with speed and gait. At speeds from 4 to 14 m/s loading on the
      metacarpus resulted in compression of the dorsomedial cortex. Tension only
      occurred consistently in 1 forelimb of 1 horse at the walk (2 m/s). The angle of
      peak compression was within 10 degrees of the longitudinal axis of the bone, and
      the magnitude of compression was proportional to the speed of exercise. Mean
      maximum compressive strains in the 6 horses at 2 m/s were -668 mu strain, -1,204
      mu strain at 4 m/s; -1,617 mu strain at 6 m/s; -2,127 mu strain at 8 m/s, and 
      2,533 mu strain at 10 m/s. Recordings from 3 horses gave a mean -3,206 mu strain
      at 12 m/s, and strains at 14 m/s approached -4,000 mu strain. Peak strains were
      similar in both forelimbs at the canter while strain rate tended to be higher in
      the leading forelimb.

PMID- 8470459
TI  - Kinematics of the standardbred trotter measured at 6, 7, 8 and 9 m/s on a
      treadmill, before and after 5 months of prerace training.
AB  - A kinematic study was performed on a group of 8 Standardbred stallions.
      Recordings were done using a modified CODA-3 optoelectronic kinematic analysis
      system with the horses running on a treadmill at speeds of 6, 7, 8, or 9 m/s.
      Linear and temporal gait characteristics, joint angle diagrams and the
      trajectories of the hoof in a plane perpendicular to the direction of movement
      were studied. Two consecutive recording sessions were held at an age of 21-23
      months, and a third was held 5 months later after an intensive training period.
      Joint angle diagrams appeared to show a similar pattern for all horses though
      certain individual characteristics could be identified. Only a few kinematic
      parameters appeared to have significantly changed after the 5-month training
      period (p < 0.05). The hoof trajectories showed marked and consistent differences
      between front and hind hooves, but the most striking feature was the very
      individual character of the patterns exhibited, leading to the assumption that
      these patterns could possibly be used as the 'fingerprint' of the horse.

PMID- 8470460
TI  - In vivo tendon forces in the forelimb of ponies at the walk, validated by ground
      reaction force measurements.
AB  - The load distribution over tendinous structures in the equine forelimb was
      studied by computing forces from in vivo signals of implanted liquid-metal strain
      gauges in 5 ponies. For validation, these tendon forces were converted to joint
      moments, which were summed and compared to the calculated joint moments caused by
      the ground reaction force. Mean peak forces per kilogram body weight (n = 5)
      amounted to 5.2 N/kg for the superficial digital flexor tendon, 3.8 N/kg for the
      deep digital flexor tendon, 7.3 N/kg for the distal accessory (check) ligament
      and 8.4 N/kg for the third interosseous muscle (suspensory ligament). The maximal
      moment exerted by the tendons about the fetlock joint differed 11 +/- 7% (average
      +/- SD, n = 5) from the maximal ground reaction force moment, which difference
      amounted to 17 +/- 15% for the coffin joint moments. These differences appeared
      to result to a substantial extent from errors in the moment arms. Therefore, the
      computed tendon forces were considered to be sufficiently reliable.

PMID- 8470461
TI  - Gallop kinematics of Olympic three-day event horses.
AB  - Limb contact variables of the gallop of 3-day event horses were determined for
      competitors in the 1988 Seoul Summer Olympic Games. Horses were filmed during the
      steeplechase, phase B of the speed and endurance test on day 2 of competition.
      Two 16-mm high-speed cameras were aimed perpendicularly to the direction of
      subject motion along a straightaway on the steeplechase track, filmed at 200
      frames/s. Thirty-four of 48 competitors were filmed and 108 gallop strides
      analyzed. Velocity (VEL) averaged 12.09 +/- 0.10 m/s (mean +/- SE), stride length
      (SL) 6.04 +/- 0.05 m and stride frequency (SF) 2.00 +/- 0.01/s. Superior overall
      3-day event performances were associated with faster VEL and longer SL in the
      steeplechase phase. A linear and quadratic regression of SL and SF against total
      3-day penalty points yielded a response surface revealing that the score was
      optimized with gallop SF between 1.85 and 2.05/s and VEL between 13 and 14.3 m/s.
      Up to 7 m, there appeared to be no upper limit for optimal SL. This study
      provided objective documentation of gallop stride kinematic patterns associated
      with successful performance in world-class 3-day event competition.

PMID- 8470462
TI  - Determination of the center of pressure of the hoofs of the forelimbs of horses
      standing on a flat level surface.
AB  - The pressure exerted on a flat level surface by recently trimmed, unshod hoofs of
      the front limbs of 23 sound, adult horses was measured using pressure-sensitive
      film and a specially built cassette. The horses were tranquilized and stood with
      one foot on the 2.9-cm-thick cassette and the other on a block of equal height.
      The hoofs were observed for motion during the measurement, and the developed film
      was examined for improper alignment of the film or slipping of the hoof. The
      center of pressure was located using the method of weighted proportions of
      Barrey. This static measurement system with a long measurement time and the
      number of measurements reduced the influence of variables inherent in the horses'
      behavior and the measuring system. The calculated point was recorded as falling
      medial to, lateral to or on a line bisecting the central sulcus of the frog. In
      the dorsal to palmar orientation the point was classified with reference to a
      line drawn halfway between the most dorsal and the most palmar mark on the film.
      Forty-six percent of the calculated centers of pressure were located in the
      medial heel area. Binomial analysis for large samples indicates that this was a
      significant variation from a random distribution. Seventy-six percent of the
      centers were located in or on the borders of the medial heel.

PMID- 8470463
TI  - A preliminary study of transitions between the walk and trot in dressage horses.
AB  - The object of this study was to determine the limb support sequence during the
      transitions from walk to trot and from trot to walk in dressage horses under
      saddle and to test the null hypothesis that the limb support sequence during the
      transitions is not related to the level of training. Sixteen dressage horses
      training at novice to FEI Grand Prix level were videotaped performing an average
      of 9 transitions each from walk to trot and from trot to walk. The 30-Hz
      videotapes were viewed in slow motion, and based on the limb support sequence the
      transitions were categorized into two types. In type 1 transitions there were no
      intermediate steps between the walk and trot sequences. Type 2 transitions were
      characterized by intermediate steps, including a single support phase. The
      Kendall rank-order correlation coefficient showed that a higher level of training
      was positively associated with an increased percentage of type 1 transitions for
      both walk-to-trot transitions (p < or = 0.05) and trot-to-walk transitions (p <
      or = 0.01). No significant preference for initiating or completing the trot on
      the left or right diagonal was found using the binomial test for individual
      horses and the Wilcoxon signed-ranks test for the group.

PMID- 8470464
TI  - The extended canter: a comparison of some kinematic variables in horses trained
      for dressage and for racing.
AB  - This study was designed to test the hypothesis that there is no significant
      difference in selected temporal and linear stride variables of the extended
      canter in horses bred and trained for dressage or racing. Nine advanced-level
      dressage horses and 7 Thoroughbred racehorses were filmed at a frame rate of 200
      Hz at an extended canter on a sand track. Two strides were recorded per trial,
      and each horse performed 6 or 7 trials. Temporal and linear data were determined
      from the films, and descriptive statistics (mean, SD) were calculated. Strides
      were selected for analysis on the basis of having a velocity in the range of 6.0
      7.0 m/s, and multivariate analysis of variance was used to detect significant
      differences in the stride kinematics of horses trained for the two sports (p < or
      = 0.01). The average velocity of the dressage horses was 6.37 m/s, compared with
      6.40 m/s for the racehorses. There were no significant differences between the
      two groups in velocity, stride duration, stride length or the distances between
      limb placements. The stance durations of all four limbs and the overlaps between
      them were longer, whereas the duration of the suspension phase was shorter in the
      dressage horses than in the racehorses (p < or = 0.01). The time between impacts
      of the diagonal limb pair was close to zero in both groups, with individual
      horses showing some variability in the order of placement of the diagonal limb
      pair. However, the sequence of footfalls was not significantly different between
      the two groups (p < or = 0.01).

PMID- 8470465
TI  - In vivo measurements of the loading conditions on the tibia of the goat.
AB  - In vivo strain measurements at 8 locations on the tibia of the goat were
      performed. Successive in vitro calibrations were used to determine the assumed
      linear relationship between the measured strain signals and the external loads (3
      forces and 3 moments) at the tibia. For the reconstruction of the in vivo
      external loads from the strain data, a transformation matrix was created from the
      calibration experiments, using 'singular-value decomposition'. The method is a
      reliable technique for measuring in vivo loads during functional gait and gives
      reproducible results.

PMID- 8470466
TI  - Shortening of the forelimb in the horse during the stance phase.
AB  - Compressions in the forelimb of a horse trotting at 3.7 m/s were studied using
      high-speed cinematography. From a diagram of shortenings it has been concluded
      that successive loadings in the longitudinal direction from below signify longer
      impact time and smaller impact forces compared to a theoretically stiff limb. It
      is proposed that the limb takes up the impact force passively until the onset of
      loading at the elbow joint, i.e. 30 ms following first contact.

PMID- 8470467
TI  - Quantification of hind limb lameness in the horse.
AB  - The three-dimensional optoelectronic locomotion analysis system SELSPOT II was
      used for kinematic studies of hind limb locomotion patterns. Two groups, 11 sound
      horses and 15 horses suffering from hind limb lameness, were examined at the
      trot. Both graphical and quantitative analyses were compared in sound and lame
      horses. The parameter hip acceleration quotient (HAQ), using the different peaks
      of vertical acceleration of one hip during one stride, proved to be a suitable
      value for quantitative analysis of hind limb lameness. In sound horses the HAQ
      ranged from 1.03 to 1.54, lame horses showed values between 1.32 and 2.96.
      Checking and documentation of diagnostic anesthesias or therapies are possible
      applications.

PMID- 8470469
TI  - First (ESB) workshop on animal locomotion. Utrecht, The Netherlands, June 20-22,
      1991. Proceedings.

PMID- 8470468
TI  - Relationship between locomotor forces, hoof position and joint motion during the
      support phase of the stride of galloping horses.
AB  - Three methods were used simultaneously to determine the relationships between the
      vertical forces exerted on the hooves and the positions of the limbs and hooves
      at the times of peak vertical forces from 2 horses galloping on a track
      straightaway. Vertical forces were recorded from an instrumented shoe, fetlock
      joint motion was measured with an electrogoniometer and the angles of the carpus,
      fetlock and hoof were determined from slow-motion films. At hoof contact, the
      mean angles of the carpus and fetlock were 181-182 degrees and 199-206 degrees,
      respectively. Peak vertical forces on the heel occurred at or near maximum
      extension of the carpal and fetlock joints. Peak forces on the toe occurred
      during flexion of the fetlock joint and at mean hoof angles of 28-31 degrees from
      the horizontal. The mean angles of the hoof from the horizontal at the time of
      heel contact were 6-7 degrees. Hoof lift occurred at mean carpal angles of 173
      174 degrees and mean fetlock angles of 199-200 degrees.

PMID- 8470470
TI  - Kinematic gait analysis in equine carpal lameness.
AB  - Gait analysis plays a major role in the clinical evaluation of equine lameness.
      It is generally accepted that the clinician expresses the grade of lameness as a
      subjective score. In this study lameness was objectively assessed using a
      standardized transient lameness model, in which lameness was induced by intra
      articular injection of bacterial endotoxin into the radiocarpal joint of ponies.
      Lameness was scored by an experienced clinician, and locomotion was recorded
      simultaneously using a CODA-3 apparatus. The obtained kinematic gait parameters
      correlated well with the clinical lameness score and also provided possibilities
      to objectively study the locomotor disturbances of the lame limb in more detail
      at the walk and trot.

PMID- 8470471
TI  - Stride characteristics of overground versus treadmill locomotion in the saddle
      horse.
AB  - The purpose of this study was to compare the velocity-dependent changes in stride
      length and stride frequency of horses performing the same incremental exercise
      test first on a track with a rider and then on a treadmill with a 0 and 3.5%
      slope successively. Seven French saddle horses undertook the exercise test which
      consisted of 5 stages of increasing speed for 3 min each with 1 min rest between
      each stage (1.6, 4.2, 8.3, 9.2 and 10 m/s). The horses were recorded by use of a
      video camera, and the tapes were analysed with regard to gait parameters. At 1.6,
      8.3, 9.2 and 10 m/s, stride frequencies were significantly (p < 0.01) greater on
      the track than on the treadmill. At the walk, stride length was significantly (p
      < 0.01) shorter on the track than on the treadmill. There were strong linear
      relationships between stride length and speed in all experimental conditions (R2
      > 0.96). The comparison of the regression coefficients revealed significant
      differences (p < 0.01) between track and treadmill locomotion; stride length was
      longer on both the horizontal and inclined treadmill than on the track. The
      incline of the treadmill did not significantly (p > 0.01) influence stride
      parameters.

PMID- 8470473
TI  - Vestibular neuronitis. Proceedings of an international symposium on vestibular
      ganglia and vestibular neuronitis. Yamaguchi, Japan, 14-16 September, 1991.

PMID- 8470472
TI  - Multi-body modelling and simulation of animal locomotion.
AB  - Multi-body models of musculoskeletal systems can be used to determine internal
      forces from measured external forces and movements ('inverse dynamics') and to
      perform simulations of movements using muscle forces or activations as input
      ('direct dynamics'). Examples of 'direct' simulations of movements in the horse
      are presented. With a model of the equine hindlimb, the function of the 'passive
      stay apparatus' could be explained. A model of the forelimb was used to determine
      force distributions in the digital flexor tendons, and to experiment with various
      methods to change the force distribution. Simulations of this type are valuable
      tools in basic research on functional anatomy and aetiology of injuries. An
      application with much future potential is the optimization of sports performances
      using simulation methods.

PMID- 8470474
TI  - Contribution of the vestibular primary neuron and the sensory cell to posture
      recovery.
AB  - The right vestibular nerve of the frog was cut peripherally to the vestibular
      ganglion. The frog sustained a tilting posture toward the right side. This
      tilting disappeared and the frog returned to normal posture. Based on this
      finding, the following experiments were done: In experiment I, the right
      vestibular nerve was again cut after posture recovery. The tilting angle was
      smaller and the recovery period shorter than after the 1st neurectomy. In
      experiment II, the left nerve was cut after posture recovery. The tilting angle
      toward the left was greater than that of the 1st neurectomy. In experiment III,
      the frog underwent bilateral neurectomy. A piece of the bone was inserted into
      the cut ends of the right nerve to inhibit nerve regeneration. The frog slowly
      developed tilting toward the right side. The above results indicate that both
      reactivation of the endorgan and the central compensatory mechanism play
      essential roles, for postural recovery after vestibular neurectomy.

PMID- 8470475
TI  - Vestibular pathology of totally deaf ears.
AB  - The temporal bone vestibular pathologies of 23 totally deaf ears (16 patients)
      were studied. Abnormal findings in the saccule were seen more often than in the
      other vestibular sensory organs. Abnormal findings in the vestibular ganglion
      cells were found in 7 ears. There were fewer ears with main damage in the hair
      cells than with main damage in the nerves.

PMID- 8470476
TI  - Glial fibrillary acidic protein (GFAP)-like immunoreactivity in the vestibular
      endorgan of the rat.
AB  - The distribution of glial fibrillary acidic protein (GFAP)-like immunoreactivity
      in the peripheral vestibular nervous system of normal adult rats was studied
      using immunohistochemical methods. The immunoreactivity was demonstrated at the
      light-microscopic level. GFAP-like immunoreactivity could be seen at the
      vestibular fibers terminating in the hair cells.

PMID- 8470477
TI  - Characterization of the vestibular and spiral ganglion cell somata of the rat by
      distribution of neurofilament proteins.
AB  - Neurons of the spiral and vestibular ganglia of the adult rat were labelled with
      a panel of monoclonal and polyclonal antibodies which were raised against
      different subunits of neurofilament proteins (NFPs). Thirteen antibodies labelled
      intensely the perikarya of a distinct group of somata in both the spiral and
      vestibular ganglia while the majority of somata were unreactive or showed a
      weaker reaction. The distinction between intensely immunostained and other cell
      somata was more conspicuous in the spiral than in the vestibular ganglia.
      Intensely stained somata formed a subpopulation comprising about 9% (range from
      7.2 to 11.1%) in the spiral and about 32% (range from 21.2 to 36.4%) in the
      vestibular ganglia of the total ganglion cell population. Antibodies against
      different subunits of NFPs seemed always to stain the same somata. In
      morphometric analysis the mean diameters of intensely labelled spiral ganglion
      cells were clearly smaller (9.9 microns) than those of the slightly reactive
      cells (11.9 microns). In Scarpa's ganglia the intensely reactive cells were
      larger in size (mean diameter 21.4 microns) than the slightly reactive cells
      (mean diameter 14.7 microns). In the spiral ganglia, the intensely labelled group
      of neurons seems to correspond to the morphologically distinct type II cells
      which may also functionally differ from type I cells. In Scarpa's ganglia, the
      intensely stained subgroup of somata may correspond to the large neurons
      innervating central regions of cristae and maculae. Their functional significance
      remains to be elucidated.

PMID- 8470478
TI  - Clinical observation of 32 cases of vestibular neuronitis.
AB  - Clinical observations were made on 32 patients with vestibular neuronitis in the
      last 5 years: 14 male and 18 female, ranging from 15-76 years, the average being
      46.3. Within the age distribution of the cases, two peaks were observed: a
      younger and an older group. Five patients (15%) had recently contracted infection
      of the upper respiratory tract before the onset of the disease, and two developed
      benign paroxysmal positional vertigo during the recovery period. Spontaneous
      nystagmus was observed in 19 cases (59%) in the first medical examination. There
      were several patients in whom there was the possibility of central lesions based
      upon the findings of equilibrium examinations. No relation was found between the
      degree of canal paresis and the time required for recuperation; however, the
      older patients took much longer to recover from the disease. Our results showed
      that there were considerable individual variations regarding the clinical
      findings, which may suggest that the pathological entity that creates this
      disease is not simple.

PMID- 8470479
TI  - Light and electron microscopic features of the rat vestibular ganglion cells.
AB  - The vestibular ganglion cells of the rat were characterized with regard to the
      cytoplasmic structure by light and electron microscopic observation. Light
      microscopy revealed four types of cells, depending upon the characteristics and
      distribution of Nissl granules. Electron microscopy gave a definite
      classification of these types by the arrangement and distribution of the roughly
      surfaced endoplasmic reticulum and neurofilament. The characteristics of the
      ganglion cells are discussed in relation to their size and function.

PMID- 8470480
TI  - 3-D anatomy of Scarpa's ganglion and surrounding structures.
AB  - We reconstructed in three dimensions, and measured by a computer-aided method
      developed by us, Scarpa's ganglion and surrounding important anatomical
      structures in 7 normal human temporal bones obtained from 7 individuals aged 7
      days to 72 years. We found that this ganglion is shaped like an hourglass and
      lies with its superior part directed anterosuperolaterally, and its inferior part
      posteroinferomedially; these two parts are connected by the isthmus ganglionaris.
      Although the dimensions of the parts of the ganglion varied, such a structure was
      distinguishable in all the specimens we studied. The volume of the ganglion was
      found to be relatively consistent in these postnatal specimens; although the
      width and height of the ganglion varied, they were inversely correlated with each
      other (linear regression analysis, p < 0.05). We did note, however, some
      postnatal increase in the distance from the ganglion to its neighboring
      structures. We also identified a significant correlation between the width of the
      ganglion and the length of the internal auditory canal and the distance from the
      ganglion to the vestibular endorgans in any given specimen (linear regression
      analysis, p < 0.05). These results suggest that although the volume of Scarpa's
      ganglion does not change after birth, its shape does change with the growth of
      the individual temporal bone.

PMID- 8470481
TI  - Three-dimensional observation of the Golgi apparatus in the vestibular (Scarpa's)
      ganglion cell.
AB  - Ultrastructure of the Golgi apparatus and GERL was observed three-dimensionally
      from the functional view point of lysosome formation. GERL directly continues
      with rough endoplasmic reficulum. There are at least two systems for lysosome
      formation, i.e. dependent and not dependent systems on the Golgi stack
      respectively. GERL also continues with a trans Golgi saccule, indicating that
      GERL is a part of the Golgi apparatus.

PMID- 8470482
TI  - Audiovestibular findings in patients with vestibular neuritis: a long-term follow
      up study.
AB  - During the years 1980-1981, 19 patients with a mean age of 39 years, given the
      diagnosis vestibular neuritis were subjected to a caloric bithermal test, a pure
      tone audiogram and stapedius reflex measurements within 1 week, 3 weeks, 9 weeks
      and 1 year after the onset of symptoms, respectively. In a majority of the
      patients the feeling of dysequilibrium and vertigo diminished within the first 3
      weeks and the difference in caloric reaction between the two sides also
      diminished during this period. In 9 of the patients, a uni- or bilaterally
      elevated stapedius reflex threshold was found. The return of the caloric response
      was somewhat slower in this group of patients.

PMID- 8470483
TI  - Three-dimensional reconstruction of the Golgi apparatus and the endoplasmic
      reticulum of the vestibular ganglion cell.

PMID- 8470484
TI  - Ultrastructure of the chick vestibular ganglion and vestibular nucleus. A
      scanning electron microscopic study.
AB  - The fine structure of the chick vestibular ganglion and vestibular nucleus was
      studied in three dimensions using a scanning electron microscope (SEM). NaOH and
      OSO4 maceration methods were applied to observe the configuration in the
      mechanically torn specimens. Also, Tanaka's aldehyde prefix OSO4-DMSO-OSO4 method
      (A-O-D-O method) was applied to observe the intracellular structure in the
      fractured specimens. The surface of the ganglion cell and the nerve processes
      were seen to be covered with abundant thin fibrous tissues in the specimen
      treated with OSO4 maceration. This surface fibrous tissue was completely removed
      with the NaOH maceration method. As a result, the ganglion cell and nerve
      processes could be seen to be enveloped in the myelin sheath. In the fractured
      vestibular ganglion treated by the A-O-D-O method, there were three patterns of
      perikaryal myelination in the vestibular ganglion cells: heavily myelinated,
      lightly myelinated, and unmyelinated, respectively. In the perinuclear region of
      the vestibular ganglion cell, well developed and aggregated cytoplasmic
      organelles such as endoplasmic reticulum, mitochondria, and Golgi apparati were
      observed. In the perinuclear region of the Schwann cell relatively large
      mitochondria were characteristically observed. In the fractured view of the
      vestibular nerves, most of vestibular fibers were compactly myelinated. In the
      vestibular nucleus, the gathering of the neuronal cells were observed with the
      NaOH maceration method.

PMID- 8470485
TI  - Development of the chick vestibular ganglion and its nerve terminating in the
      endorgan.
AB  - We investigated the morphological maturation of the vestibular ganglion and its
      dendrites terminating in the sacculus of the chick embryo. The cytoplasm of the
      ganglion cells had acquired a granular feature due to the abundance of ribosomal
      clusters and rER by the 13th day of incubation. The myelination of the dendrites
      occurred before that of the perikarya. Compact myelin of the dendrites was
      observed on the 13th day of incubation, while that of the perikarya was observed
      in the 20th day of incubation. Nerve endings of afferent and efferent character
      were observed first in the sacculus on the 13th day of incubation. Positive
      immunoreactvity of substance P was observed on the 13th day of incubation. It is
      suggested that the morphological basis of functional activity is present on or
      around the 13th day of incubation.

PMID- 8470486
TI  - Some neurosurgical and clinical neurophysiological notes on selected
      neurootological problems. With special reference to acoustic neurinoma, brain
      death, and NVC.

PMID- 8470487
TI  - Progress of caloric response of vestibular neuronitis.
AB  - Progress of caloric response and subjective symptoms of 60 patients with
      vestibular neuronitis was evaluated by a long term follow-up study. Normalization
      of caloric responses was confirmed in 25 (41.7%) out of 60 patients, 20 of whom
      had recovered within 2 years of the onset of vertigo. The rate of the patients
      with canal paresis was about 90% after 1 month of the onset, and 80% after 6
      months, while 50% of them still showed canal paresis after 5 or 10 years had
      passed. Complete relief from subjective symptoms was recognized in 34 (56.7%)
      cases during the follow-up period. We conclude that the prognosis of vestibular
      neuronitis is not always good, because vestibular function did not recover within
      normal levels in about half of the patients in spite of complete relief from
      subjective symptoms in many of them.

PMID- 8470488
TI  - Importance of cervical muscles in galvanic body sway test.
AB  - Retro-auricular galvanic stimulation in Romberg's posture elicits body sway which
      consists of an initial response (IR) and a deviation response (DR). Generally,
      anodal stimulation of the right side elicits IR to the left and DR to the right.
      We measured the deviation response (VDR) in various conditions in normal
      subjects. There was no significant difference between mean VDR in the standing
      posture weighted on the left foot (0.49 +/- 0.17 cm) and on the right foot (0.39
      +/- 0.20 cm). Stimulation in the squatting posture also elicited IR to the left
      and DR to the right. Stimulation of the right side produced DR backward and to
      the right in the condition of the head facing to the right, and forward and to
      the right in the condition of the head facing to the left. The same body sway
      response as the after galvanic stimulation was also induced by non-galvanic
      maneuvers like inclining the head or moving the finger. Anodal stimulation in the
      sitting posture elicited slight but apparent head inclination to the stimulated
      side. These results suggest that cervical muscles play an important role in the
      galvanic body sway test (GBST), viz. IR and DR seemed to be secondarily produced
      by changes in the muscular tension of the neck.

PMID- 8470489
TI  - Vestibular neuronitis evaluated by the combined galvanic test.
AB  - Forty-two patients with unilateral vestibular neuronitis were examined by the
      combined galvanic test (CGT), consisting of the galvanic eye movement test (GEMT)
      and the galvanic body sway test (GBST). Results of the CGT were evaluated with
      respect to the time period from the onset of vestibular neuronitis. A favorable
      recovery was observed earlier with the GBST than the GEMT. We believe that this
      discrepancy may be due to the difference in compensation between the vestibulo
      ocular reflex and the vestibulo-spinal reflex.

PMID- 8470490
TI  - Interpretation of the combined galvanic test. Findings from cases with vestibular
      neuronitis.
AB  - The combined galvanic test (CGT) was developed in our department for simultaneous
      recording of galvanic eye movement test (GEMT) and galvanic body sway test
      (GBST). Twelve cases of vestibular neuronitis were studied first with the caloric
      test, and then with the CGT. The findings of the caloric test corresponded to
      those of the GEMT, but did not always correspond to those of the GBST. Thus we
      suggest that the GBST reflects an abnormality in a system different from that
      reflected by the caloric test and GEMT. It is likely that the caloric response
      mainly originates from the semicircular canal system. Thus the GEMT may reflect
      an abnormality in the semicircular canal system, while the GBST reflects an
      abnormality in the otolithic system. The CGT may thus be a feasible method of
      differentiating the disorders of the semicircular canal system from those of the
      otolithic system in the vestibular nervous system.

PMID- 8470491
TI  - Relationship between GBST and equilibrium examination in vestibular neuronitis.
AB  - Eleven patients with vestibular neuronitis were followed up from 1988 to 1990.
      The relationship between the GBST and other vestibular examinations was
      investigated. Vertiginous symptoms showed relative improvement, but in the last
      medical examination 4 out of 11 cases (36.4%) complained of unsteadiness when
      their head was rotated and fatigued. Seven patients (63.6%) presented spontaneous
      and positional nystagmus at the first consultation, but only one patient (9.1%)
      at the last one. Seven patients (63.6%) showed canal paresis to caloric
      stimulation, while 3 (27.3%) showed normal responses. In the galvanic body sway
      test (GBST), 9 patients (81.8%) showed abnormal thresholds. There was no
      significant relationship between vertiginous symptoms in the last medical
      examination and prodromes, vertigo type, nystagmus, righting reflex, caloric
      stimulation or the results of the GBST.

PMID- 8470492
TI  - Retro-labyrinthine disorder in cases with peripheral facial palsy.
AB  - In some previously reported cases, facial palsy, even in Bell's palsy, involved
      vestibular dysfunction. Vestibular dysfunction in facial palsy is considered to
      be due to a retro-labyrinthine disorder such as vestibular neuronitis or acoustic
      neuromas. For the past 9 years we have been using the galvanic body sway test
      (GBST) routinely for differential diagnosis of the vestibular system. This paper
      reports GBST detected, retro-labyrinthine disorders in facial palsy. From 1981 to
      1989, equilibrium examinations were performed in 33 cases with Bell's palsy and
      in 12 cases with Hunt's syndrome within 2 weeks after the onset. GBST was tested
      in 10 out of the 17 cases showing canal paresis (CP) in the caloric test.
      Abnormal GBST responses were detected in 9 cases (90%), 4 (80%) with Bell's palsy
      and 5 (100%) with Hunt's syndrome. The incidence of abnormal GBST was very high
      not only in Hunt's syndrome but also in Bell's palsy. The results indicate that
      vestibular dysfunction combined with facial palsy is mainly due to a retro
      labyrinthine disorder and suggest that what is called vestibular neuronitis might
      be caused by a pathogenesis similar to that of facial palsy.

PMID- 8470493
TI  - Clinical significance of the galvanic body sway test in cerebellopontine angle
      tumors.
AB  - Since 1984, we have been modifying a new method of recording fine body sway
      elicited by low current stimuli of less than 0.4 mA, and of quantitatively
      evaluating the responses by Fourier transform. In order to easily and early
      detect acoustic tumors, we have applied a test battery consisting ABR, caloric
      test and galvanic body sway test (GBST) to 31 cases with acoustic neurinoma, to 5
      cases with other CPA-tumors, and to 24 cases suspected of having CPA tumors. Of
      27 cases with acoustic neurinoma on whom the GBST was performed, 25 cases (92.6%)
      shows abnormal responses. On the other hand, the ABR was abnormal in all cases,
      except for one case in the early stage of an ear tumor. However, the ABR was
      positive in 12 cases out of 24 with suspected findings without tumor, but the
      GBST was positive in only 3 cases out of 17 tested. Moreover, 26 cases (83.9%)
      with acoustic tumors showed abnormal CP in their first caloric tests. Comparing
      these observations with the results of image diagnosis, we conclude that the GBST
      is as useful for detecting small acoustic neurinomas as the ABR and the carloric
      test. Therefore, we have routinely used a test battery consisting ABR, caloric
      test and GBST for evaluation of acoustic neurinomas. However, we could not
      differentiate between acoustic neurinoma and CPA-tumor by using the three-test
      battery.

PMID- 8470494
TI  - Vestibular compensation in vestibular neuronitis: evaluation of positional
      nystagmus and caloric nystagmus.
AB  - We evaluated the vestibular functions, especially for positional nystagmus and
      caloric nystagmus, in 43 cases of vestibular neuronitis for long periods after
      its onset. It is shown that in the cases of vestibular neuronitis that were
      studied more than 10 years after the onset of the disease, the completed
      vestibular compensation changed or the vestibular compensation was still
      incomplete.

PMID- 8470495
TI  - Vestibular neuritis: an overview using a classical case.
AB  - Although acute unilateral and/or bilateral vestibular paralysis, known as
      vestibular neuronitis, is the second most common cause of vertigo (the most
      common is benign paroxysmal positional vertigo (BPPV), it is fraught with
      controversies. The clinical symptoms and methods of treatment of vestibular
      neuronitis are well defined; however, the etiology and pathophysiology of this
      disorder are still sketchy. Furthermore, there are no specific diagnostic tests
      available, and unfortunately, there are no animal models for this disorder. The
      purpose of this paper is to present an overview of those controversies using a
      classical case of vestibular neuronitis.

PMID- 8470496
TI  - Recovery of the vestibular function after vestibular neuronitis.
AB  - We performed steroid therapy on 34 cases with vestibular neuronitis and compared
      them with 77 patients not subjected to this therapy to examine the role of
      recovery of their vestibular function. Since no relation was noted between use of
      steroid and changes in subjective symptom of dizziness, the use of steroid is
      likely to facilitate the disappearance of spontaneous nystagmus in the early
      recovery stage. Canal paralysis recovered significantly by steroid and in cases
      of slight and moderate paralysis at the onset, recovery was more significant.
      Steroid therapy is argued to be effective for the recovery of vestibular function
      in cases of vestibular neuronitis.

PMID- 8470497
TI  - Follow-up of square drawing test in vestibular neuronitis.
AB  - The square drawing test (SDT) devised by Sekitani (1975), which is a modification
      of Fukuda's vertical writing test, was performed to evaluate vestibular
      dysfunction in 15 patients with vestibular neuronitis followed up for a long
      period. In particular, two parameters (distance and total length) were analyzed
      in the present study. Distance was analyzed by dividing the 15 cases into 3
      groups. The largest group showed a tendency to shorten at an early stage. Total
      length was examined by dividing the 15 cases into 3 groups. The largest group
      showed a tendency towards macrographism at an early stage. It was found that as
      the degree of caloric responses recovered, the range of distance and total length
      decreased. Considering the correlation between parameters of the SDT (distance
      and total length) and caloric responses we concluded that the SDT is a feasible
      method to evaluate and follow up patients with vestibular dysfunction.

PMID- 8470498
TI  - Prolonged dysequilibrium in three cases with vestibular neuronitis: efficacy of
      vestibular rehabilitation.
AB  - The clinical course of acute unilateral vestibular disturbance in 3 cases with
      vestibular neuronitis and a case with labyrinthine destruction was surveyed for a
      long-term period. Vestibular training with a modified Cawthorne-Cooksey's
      exercise was done in 2 of 3 cases with vestibular neuronitis and a case of
      labyrinthine destruction. All had no severe troubles in activities of their daily
      lives over one year after the onset of the disease, but the central compensation
      was not completed, even in a young patient, in a case of labyrinthine destruction
      and in a well trained case. Spontaneous nystagmus to the affected side and
      increase of body sway with eyes closed were revealed by examinations in all
      cases. Physical exercise was found to be effective for relief from vestibular
      ataxia, but it was difficult to keep the effect even after training.

PMID- 8470499
TI  - Dynamic properties of feed back control of human posture in subjects with
      vestibular neuritis.
AB  - Postural control was studied in 22 subjects with vestibular neruitis within 14
      days after the onset of symptoms. Dynamic feed back control of posture were
      evaluated by analyzing the postural responses to vibration toward calf muscles
      applied according to a PRBS schedule. Properties of the dynamic control was
      normalized as swiftness, stiffness and damping of the responses. There was no
      prominent group differences between the 22 subjects with vestibular neuritis and
      17 normal subjects. However, when studying the change in parameters evoked by
      presence or absence of visual information it was found that the abundant changes
      of control parameters, especially in stiffness, met in normal subjects had
      declined in subjects with vestibular neuritis. The present finding suggests that
      although subjects after an acute vestibular lesion may achieve a sufficient
      postural control by utilizing information from other somatosensory receptors,
      this is concomitant with changes of the feed back control.

PMID- 8470500
TI  - Vestibular neuronitis in children.
AB  - Seventeen cases of vestibular neuronitis in children, including 11 cases from the
      questionnaires of an epidemiological survey in Japan and 6 patients in our
      clinic, were examined. Sex and age distribution was 11 males and 6 females,
      ranging in age from 3 to 15 years. Bilateral and recurrent cases were not
      encountered. Fifty-three percent of children had had a preceding episode of an
      upper respiratory tract infection and this ratio was higher than that in adults.
      The etiology of vestibular neuronitis is probably many-faceted, but it is thought
      that upper respiratory tract infections play an important role especially in
      children. Vertiginous symptoms had almost subsided among children at the last
      visit. However, among adults, 24% of patients felt persisting unsteadiness. The
      disappearance of positional and positioning nystagmus was observed in 71% of
      children at the last visit. Caloric CP failed to recover in only 14% of all cases
      who were re-examined. As shown in this study, the prognosis in children is better
      than in adults for nystagmus and caloric response. The results of this study thus
      indicate that not only central compensation but also recovery of the peripheral
      vestibular function is more effective for bringing recovery from the vestibular
      disorder in children than in adults.

PMID- 8470501
TI  - Vestibular neuronitis in aged patients: results from an epidemiological survey by
      questionnaire in Japan.
AB  - An epidemiological survey of vestibular neuronitis in Japan was done using a
      questionnaire. Answer sheets were obtained from 619 patients with vestibular
      neuronitis. In order to evaluate data from aged patients, 74 cases were singled
      out. The following results were obtained: i) There was no sexual difference and
      no laterality of affected side; ii) There was no case of bilateral vestibular
      neuronitis; iii) Ten cases were reported as recurrent. Aged patients had a
      relatively high rate of recurrence; iv) About 10% of 74 cases had had an upper
      respiratory tract infection, and this rate was lower than that for patients under
      65 years of age; v) Thirty-five cases had complications. Hypertension was the
      most common complication; vi) The caloric test was re-used in 28 cases. The
      continued existence of caloric CP was observed in 23 cases upon re-examination.

PMID- 8470502
TI  - Bilateral vestibular neuronitis.
AB  - Bilateral vestibular neuronitis with a different onset time for each affected
      side was reported in two cases among 74 cases observed. The first case appeared 3
      weeks and the other 5 years before involvement of the second ear. In the case
      with a short period before the second attack, the direction of nystagmus was
      unchanged throughout the clinical course. It is suggested that the direction of
      nystagmus depends upon the severity of each vestibular dysfunction. In the case
      with a long period when the vestibular compensation has been completed, paralytic
      nystagmus was observed and its direction corresponded with the side affected by
      canal.

PMID- 8470503
TI  - A clinical observation of benign paroxysmal positional vertigo (BPPV) after
      vestibular neuronitis (VN).
AB  - We observed 9 cases of BPPV developed after vestibular neuronitis. The interval
      between the onset of BPPV and vestibular neuronitis ranged from 2 weeks to 20
      years. All cases were examined for critical head position which provoked vertigo,
      non-gaze nystagmus, positional and positioning nystagmus and caloric nystagmus.
      No characteristic signs and symptoms could be observed. The function of the
      posterior canal is thought to be necessary to provoke positional vertigo. Thus in
      BPPV after vestibular neuronitis the function of the posterior canal would
      presumably have been preserved to some degree. The first possibility is that the
      function of the posterior canal was not impaired in spite of the damage of the
      lateral canal. The fact that each canal differs in involvement in vestibular
      neuronitis may be explained by the difference in the blood supply or the
      innervation between lateral and posterior canals. If only the artery or nerve
      which is related to the lateral canal is damaged and the artery or nerve to the
      posterior canal is not involved, then the function of the posterior canal is
      preserved. So BPPV may occur soon after the disappearance of severe vertigo. The
      second possibility is that if the posterior canal had been damaged together with
      the lateral canal and the functions are recovering, BPPV may occur some time
      after the onset of vestibular neuronitis. The locus of vestibular neuronitis is
      in the peripheral vestibular system and the extent and degree of the lesion vary,
      which may explain why there can be time difference of the recovery between the
      two canals.

PMID- 8470504
TI  - Cerebellar infarctions and 'vestibular neuritis'.
AB  - Consecutive subjects 50 to 75 years of age with sudden onset of vertigo but
      without cochlear or neurological symptoms were investigated with neuro-imaging
      techniques. Doppler sonography of the vertebral and carotid arteries and
      recording of voluntary saccades and pursuit eye movements, caloric, spontaneous,
      gaze and optokinetic nystagmus. Among those studied, 6 out of 24 subjects could
      be demonstrated to have cerebellar infarctions, another 2 subjects had occlusion
      of one vertebral artery. Caloric tests could not identify subjects with a
      cerebellar infarction whereas prominently reduced pursuit eye movements could.
      Subjects with cerebellar infarction either had a vertebral artery occlusion or
      prominent cardio-embolic risk factors. It is suggested that subjects with
      symptoms as vestibular neuritis should be investigated with pursuit eye movements
      and with at least standard ECG recordings.

PMID- 8470505
TI  - Neuroborreliosis in the etiology of vestibular neuronitis.
AB  - Symptoms and incidence of neuroborreliosis (NB) were studied in ambulatory
      patients visiting the ENT clinic in Helsinki. Especially we tried to search for
      possible markers indicating the connection between vestibular neuronitis and NB.
      A total of 350 patients were screened with the enzyme-linked immunosorbent assay
      (ELISA) technique for possible antibodies against Borrelia burgdorferi (BB).
      Twelve patients had positive serological reactions for BB with sera titer levels
      ranging from 640-14700 (normal < 500). In 2 additional cases, NB was clinically
      confirmed. In 7 cases a history of tick bite and in 4 cases erythema chronicum
      migrans was confirmed. In 9 cases, vertigo was the predominant symptom, and in 3
      cases the symptoms were linked to facial nerve paresis. Six patients suffered
      from hearing loss. In 7 cases, the diagnosis was initially settled as vestibular
      neuronitis. NB seems to be present in about 4% of cases with apparent otologic
      diseases in Finland. In the majority of the cases, the disease resembles
      vestibular neuronitis in the acute stage. Since NB is tractable, all patients
      visiting the ENT clinic, especially those with vertigo, should be screened.

PMID- 8470506
TI  - Viruses and vestibular neuritis: review of human and animal studies.
AB  - There is increasing evidence in man and animals that several human viruses can
      damage the vestibular labyrinth. Clinical and serologic studies of patients with
      vestibular neuritis suggest that the viruses may play a role in the pathogenesis
      of this disease. Temporal bone studies of patients dying after vestibular
      neuritis have found maximal damage in the distal branches of the vestibular
      nerve. These changes are felt to be consistent with a viral etiology. No
      satisfactory animal viral model of vestibular neuritis currently exists. However,
      animal studies have demonstrated that several human viruses including rubeola,
      herpes simplex, reovirus, mouse and guinea pig cytomegalovirus, and neurotropic
      strains of influenza A and mumps virus, can infect the vestibular nerve and the
      vestibular membranous labyrinth.

PMID- 8470507
TI  - Vestibular neuronitis: epidemiological survey by questionnaire in Japan.
AB  - An epidemiological survey on vestibular neuronitis in Japan was conducted by
      means of a questionnaire filled in by major neuro-otology clinics
      (otolaryngologists) during 1988-1990 (3 years). The diagnostic criteria of
      vestibular neuronitis settled on in 1986 by the Standardization Committee of the
      Japan Society of Equilibrium Research were applied. Gross analysis of
      questionnaire answers showed that i) there was no sexual difference, ii) the peak
      of age distribution was between 40-50 years, iii) about 30% of all cases had had
      common colds prior to the disease, the rate being highest among children below 10
      years, iv) disappearance of positional and positioning nystagmus appeared in
      about 60% of all cases within 3 months, and that v) caloric CP was observed in
      about half of the cases at the follow-up test. Progress was not as favorable when
      compared to previous studies.

PMID- 8470508
TI  - Lyme disease with neurological complications in Japan.

PMID- 8470509
TI  - Histological changes of vestibular nerves and ganglion cells in the acoustic
      tumor in relation to clinical functions.

PMID- 8470510
TI  - Auditory and vestibular pathology in brainstem death revealed by auditory
      brainstem response.
AB  - Auditory brainstem response (ABR) before and after the cessation of brainstem
      activity and postmortem histological findings in the temporal bone and auditory
      and vestibular pathways of two cases of brainstem death are reported. A brainstem
      death state of at least 48 h in Case 1 and of at least 24 h for the left side and
      several hours for the right side in Case 2 was demonstrated by neurological
      examination, flat EEG, and persistent absence of ABR. Postmortem examination was
      performed 3 h after death in Case 1, and 1 h after death in Case 2. Pathological
      studies of the entire length of the auditory and vestibular pathway revealed
      total autolysis of the organ of Corti and vestibular endorgans and swollen
      cochlear and vestibular ganglia in Case 1, and, in Case 2, on the right side,
      preservation of the organ of Corti and vestibular endorgans and mildly swollen
      cochlear and vestibular ganglia, but on the left side, destruction of the organ
      of Corti and vestibular endorgan and markedly swollen cochlear and vestibular
      ganglia. We believe that distinct pathological changes in auditory and vestibular
      endorgans, and other changes of the cochlear and vestibular ganglia as observed
      in these two cases, may develop if the duration of absent ABR is prolonged.

PMID- 8470511
TI  - Recent advances in neurotology and otolaryngology. Papers dedicated to Professor
      Kanemasa Mizukoshi upon his retirement as Director of the Department of
      Otolaryngology, Toyama Medical and Pharmaceutical University, Faculty of
      Medicine.

PMID- 8470512
TI  - Body sway response to experimental unbalance in normal subjects and patients with
      unilateral vestibular disorders.
AB  - The function of maintaining posture during temporary unbalance caused by
      experimental vestibular asymmetry was studied. Galvanic stimulation to the
      vestibular nerve causing body deviation to the stimulated ear was given to 31
      normal subjects and 16 patients with peripheral vestibular disorders. The
      velocity of spontaneous body sway and that during body deviation caused by the
      galvanic stimulation were compared. The spontaneous body sway velocity was
      significantly higher than that of normal subjects. In normal subjects, the body
      sway velocity during body deviation remarkably increased, while that in patients
      did not. It is considered that large body sway in patients might conceal the fine
      compensatory body sway during the body deviation and that patients with
      unilateral vestibular dysfunction who have large body sway are always in a
      dysfunction state similar to that which normal subjects experience during body
      deviation caused by galvanic stimulation.

PMID- 8470513
TI  - Vestibular nerve disorder in patients suffering from sudden deafness with vertigo
      and/or vestibular dysfunction.
AB  - Vestibular nerve disorder (VND) in cases suffering from sudden deafness with
      vertigo was studied. Between 1987 and 1991, we observed 46 patients suffering
      from sudden deafness with or without vertigo, who had undergone the caloric test
      and galvanic body sway test (GBST). Twenty-seven patients had vertigo and canal
      paresis (CP) upon the caloric test, 6 vertigo without CP and 13 CP without
      vertigo. VND was detected in 12 of the 46 patients. All those with VND had
      vertigo and CP upon the caloric test, 12/27 (44%). The degree of hearing loss in
      those with VND was significantly (p < 0.05) more severe and their recovery of
      hearing loss was poorer than in patients without VND. These results indicate that
      VND is a common finding in cases of sudden deafness with vertigo especially in
      those with severe hearing loss.

PMID- 8470514
TI  - The contribution of proprioception to posture control in normal subjects.
AB  - In order to investigate the contribution of proprioceptive input to maintaining
      an upright position, stabilometry via 100-Hz vibratory stimulation applied to the
      Achilles tendon was studied and analyzed with respect to area, length and power
      spectra according to the method of fast Fourier transform (FFT). Twenty-one young
      medical students were analyzed in this study. When vibration was applied, the
      body sway was significantly greater than that of control in area and length with
      both eyes open and closed. There was a significant increase of total power in
      both the lateral (X) and antero-posterior (Y) directions with the eyes closed.
      With the eyes open, an increase was found only in the antero-posterior direction.
      The frequency band indicating the maximum spectrum did not shift. Significant
      increases in power spectra were found in the frequency range of more than 2 Hz in
      both two directions with the eyes closed. It was concluded that a vibration given
      to the Achilles tendon provoked a pronounced high frequency body sway especially
      in the antero-posterior direction when visual information was nullified, and that
      proprioceptive information may have a minor role compared with visual
      information.

PMID- 8470515
TI  - Contribution of vision to the stabilization of body sway in patients with
      spinocerebellar degeneration.
AB  - Body sway was recorded with closed eyes, open eyes and visual feedback for 30 s
      each. Thirteen patients with spinocerebellar degeneration and 17 age-matched
      normal controls underwent the examination. Four parameters (area, length, sums of
      frequency spectrum in the anterior-posterior and lateral directions) were
      computed. Furthermore, Romberg ratios between closed and open eye conditions
      [Romberg c/o] and Romberg ratios between closed eyes and visual feedback
      conditions [Romberg c/f] were computed. Four parameters were significantly
      greater in the patients with spinocerebellar degeneration than in the normal
      controls. However, three of eight Romberg ratios were significantly greater in
      the patients with spinocerebellar degeneration than in the normal controls. The
      results implied that the proprioceptive-posture loop was mainly disordered while
      the visuo-postural loop was intact in patients with spinocerebellar degeneration.

PMID- 8470516
TI  - Evaluation of vestibular function by dynamic posturography and other equilibrium
      examinations.
AB  - We evaluated the significance of dynamic posturography (EquiTest) in vestibular
      function assessment by comparing it with our routine equilibrium examinations
      comprised of nystagmographic data and other postural tests. Fifty-two patients
      with unilateral peripheral vestibular disorders were examined. Differences in
      test results between pendular rotation test and dynamic posturography were found
      in 23 out of 52 (44%) patients with unilateral peripheral vestibular disorders.
      In 5 patients, no abnormality of vestibular function could be detected by means
      of a three-test battery (spontaneous and positional nystagmus and pendular
      rotation test) used for evaluating vestibular compensation. In spite of these
      results, the patients complained of vertigo of dizziness and showed abnormal
      results in dynamic posturography. Dynamic posturography was superior to other
      postural tests in the detection of pathology corresponding with the patients'
      complaints. From these results, dynamic posturography (EquiTest) appeared to
      provide new information about such conditions of vestibular patients which other
      equilibrium examinations have not heretofore been able to detect.

PMID- 8470517
TI  - A case of Bickerstaff's encephalitis. With special reference to neurotological
      findings.
AB  - The case of a 60-year old male with prodromal common cold symptoms and
      progression of brain stem involvement with no cardiac or respiratory
      complications is described. This conformed to the criteria of Bickerstaff's
      encephalitis. Neurotological examinations, including the OKN test, the caloric
      test, and the GBST were performed from onset to recovery of the disease. The
      results of these tests closely reflected the central nervous system disorders
      each time, but there was a discrepancy in the results of the two test batteries
      of equilibrium function, the caloric test and the GBST. The caloric test showed
      bilateral canal paresis while the GBST showed normal responses. These results
      suggested that the involved area of the vestibular nucleus was localized to the
      superior portions. Form our clinical observations, we can conclude that
      neurotological examinations provide more vital information for localized
      diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.

PMID- 8470518
TI  - Complex spike responses of cerebellar Purkinje cells to constant velocity
      optokinetic stimuli in the cat flocculus.
AB  - In the cat cerebellar flocculus without cerebrum but with intact accessory optic
      tract, complex spike (CS) responses to horizontal optokinetic stimuli (velocity
      step at 2 degrees/s) were investigated. The directionally selective CS responses
      were present only during the short-duration stimuli but not during the continuous
      unidirectional stimuli. Following the end of the stimuli during the stationary
      surround phase, the CS activity was modulated in a manner opposite to the
      preceding CS response during the stimulation. These CS responses cannot simply be
      interpreted as sensory responses to the retinal slip input; they may in fact be
      deeply associated with the motor control command of the eye movement which would
      be elicited by the retinal slip.

PMID- 8470519
TI  - Autonomic nervous system disturbance as etiological background of vertigo and
      dizziness.
AB  - In order to investigate whether dysautonomia lies behind vertigo and/or dizziness
      in the neurotological clinic, an electrocardiogram (ECG) R-peak to R-peak test (R
      R test) along with the Schellong test were simultaneously performed in 136
      subjects. ECG data were analyzed by a microcomputer, and R-R intervals were
      calculated. In a dynamic test performed during postural changes from the supine
      to the standing position, there were 23 of 55 (41.8%) positive test results in
      patients with peripheral vestibular disorders, 28 of 51 (54.9%) with central
      vestibular disorders, and 15 of 18 (83.3%) with spinocerebellar degeneration. In
      a static test with the patient in the standing position, there were 13 of 55
      (29.1%) positive test results in patients with peripheral vestibular disorders,
      16 of 51 with central vestibular disorders, and 8 of 18 (44.4%) with
      spinocerebellar degeneration. A significant difference in the positive rate
      between spinocerebellar degeneration and both other central and peripheral
      vestibular disorders in the dynamic test was observed. These results also
      demonstrated that dysautonomia upon postural changes might play an important role
      in the development of vertigo and dizziness and that it is provoked by disorders
      of the autoregulatory mechanisms of the cerebral blood flow. This test is
      presumed to be excellent for detecting dysautonomia by virtue of being non
      invasive, having good reproducibility and being readily available to quantitative
      evaluation by using a microcomputer.

PMID- 8470520
TI  - Result of decompression surgery in late-stage severe facial paralysis.
AB  - We investigated the usefulness of decompression surgery in the treatment of the
      facial nerve in 23 patients with severe complete facial paralysis regardless of
      etiology. All patients were followed up for at least one year after onset. Nine
      patients underwent decompression surgery within a month of onset (Group A), 10
      underwent surgery at a later time (Group B), and 4 did not receive surgery (Group
      C). In Group A, 2 patients showed satisfactory recovery and 2 fair recovery. In
      Group B, 4 patients showed satisfactory outcome, and one patient who underwent
      surgery 131 days after onset showed fair outcome. No patient in Group C showed
      satisfactory or fair recovery. There were no significant differences among the
      three groups in the percentage showing sequelae after treatment. We conclude that
      decompression surgery is indicated even for patients with severe facial paralysis
      who have a history of palsy of 2 months' or more duration.

PMID- 8470521
TI  - The fine structure of the guinea pig tympanic membrane with special reference to
      the fiber arrangement.
AB  - The tympanic membrane of the guinea pig was studied by electron microscopy. The
      pars tensa was composed of three layers, i.e., the outer epidermis, the middle
      lamina propria and the inner mucosal membrane. The pars flaccida was negligible
      in size. The fibers in the lamina propria of the tympanic membrane were not
      clearly observable by conventional electron microscopy. With the silver
      methenamine method the fibers were more intensely stained than the epithelial
      cells and could thus be distinctly demonstrated by this method. In the inferior
      larger portion of the pars tensa, the lamina propria contained the outer radial
      and the inner circular fiber bundles. The radial fiber bundles were thicker and
      more densely packed than the circular ones. This fact indicates that the radial
      fibers form the major skeleton of this portion. The superior smaller portion of
      the pars tensa contained several layers of irregularly arranged fiber bundles in
      the lamina propria and was considerably thicker than the inferior larger portion.

PMID- 8470522
TI  - Middle ear barotrauma associated with hyperbaric oxygenation treatment.
AB  - We investigated the signs and symptoms of middle ear barotrauma in 67 patients
      with hyperbaric oxygenation treatment as well as the influence of predisposing
      factors. Ear damage was classified into 5 grades on the basis of objective
      findings at otoscopic examination. The incidence of middle ear barotrauma
      assessed by objective criteria was 68.7%, and showed little variation with age or
      primary disease. On the other hand, the incidence assessed by subjective symptoms
      was lower than the objectively-based incidence in aged patients, those with
      severe neurological diseases, and those who had difficulties speaking. Patients
      with a trauma grade of 2 or more complained of severe symptoms and were
      appropriate candidates for treatment. It is considered that otoscopic examination
      should be performed in patients who undergo hyperbaric oxygenation treatment and
      that prior management of nasal and paranasal diseases is beneficial in the
      prevention and treatment of middle ear barotrauma.

PMID- 8470523
TI  - Immunologic study of the hyaline-vascular type of Castleman's disease. A case
      study.
AB  - We report a case of Castleman's disease in a 48-year-old male who complained of a
      rapidly enlarging mass on the neck. Thrombocytopenia and the facio-scapulo
      humeral type of progressive muscular dystrophy were also present. The mass was
      extirpated, and histopathological examinations showed the hyaline-vascular type
      of Castleman's disease. Following resection, thrombocytopenia was ameliorated.
      Immunological study with flow cytometric analysis was made to clarify the nature
      of his mass. With reference to recent literature we suggest that the hyaline
      vascular type of Castleman's disease may be an atypical hyperplasia of the
      lymphoid tissue.

PMID- 8470524
TI  - Nasal septal neurinoma.
AB  - A case of nasal septal neurinoma is presented. The patient was a 71-year-old male
      who complained of nasal obstruction and epistaxis. Results of the physical
      examination showed a giant mass filling the nasal cavity and the nasopharynx. A
      biopsy taken from its tissue surface showed histological features of
      neurofibroma. The lesion was completely resected with the patient under general
      anesthesia. The tumor completely occupied the right nasal cavity and the
      nasopharynx, partially penetrated the nasal septum and extended to the left nasal
      cavity. After the operation, the final pathological diagnosis was not
      neurofibroma but neurinoma in which Antoni type A and type B cells were mixed.
      The postoperative course was uneventful, and no recurrence has been observed to
      date.

PMID- 8470525
TI  - Botulinum toxin treatment for spasmodic dysphonia.
AB  - Effective treatment of adductor type spasmodic dysphonia with botulinum toxin
      injection is presented. Patients showed objective and/or subjective improvement
      in phonation. The beneficial effect lasted for approximately 3 months. An
      immediate complication is temporary hoarseness or aphonia, mainly due to
      diffusion of BT into the adjacent muscles. This is avoided by limiting the
      injection to one vocal fold only and by keeping the dose at less than 5 units.
      Insertion technique of the needles, such as percutaneous and laryngoscopically
      controlled techniques, are discussed.

PMID- 8470526
TI  - Direction selective climbing fiber responses to horizontal and vertical
      optokinetic stimuli in the cat cerebellar flocculus.
AB  - In ketamine anesthetized cats, complex spike (CS) responses to movement of a
      large-field visual surround (optokinetic stimulus) were recorded in the
      cerebellar flocculus. Two types of Purkinje cells were found. One type showed
      increased CS activity to optokinetic stimuli directed contralaterally to the
      recording site and decreased activity to stimuli directed ipsilaterally. The
      modulation occurred in both monocular (responses to the stimuli for only the
      ipsilateral eye) and binocular forms (dominant eye, ipsilateral). The other type
      of cell showed increased CS activity during upward optokinetic stimuli and
      decreased activity during downward stimuli. The responses occurred only in the
      binocular form. The dominant eye was either ipsilateral or contralateral with
      respect to the recording site. Thus, there are two types of Purkinje cells in the
      cat flocculus: horizontal type cell showing CS modulation during horizontal
      optokinetic stimuli, and vertical type cell showing CS modulation during vertical
      optokinetic stimuli.

PMID- 8470527
TI  - Quantitative evaluation of the function of looking at visual target in
      optokinetic nystagmus.
AB  - A new method is presented to qualitatively evaluate the function of OKN which
      certainly looks at a visual target. Optokinetic stimulation was given to a test
      subject by projecting stripes with a 5 degrees visual angle width at 30 degrees
      intervals, which was accelerated by 1 degree/s2 up to 100 degrees/s. The
      correlation between slow phase and fast phase was computed with our program. Two
      correlations were mixed in a normal response, one indicated low correlation and
      the other high correlation. As normal subjects look at wide interval visual
      targets one by one regardless of the target velocity, low correlation type OKN
      beats are considered to be those which certainly look at the visual target. In
      order to quantitatively analyze this type of OKN, approximate regression lines of
      the low correlation type, [y = ax + b (x: slow phase velocity, y: fast phase
      amplitude or velocity)], were computed by the minimum square method. In normal
      subjects, value a indicates low and value b high velocity and their normal limits
      are determined. The results of cases with central disequilibrium indicate that
      this analysis provides information of pathological OKN different from that of
      such conventional parameters as slow phase velocity and number of nystagmus
      beats.

PMID- 8470528
TI  - Otoconia in young and elderly persons: a temporal bone study.
AB  - Using serially sectioned human temporal bones, the volumes of otoconia masses
      were compared between young children and elderly people. The latter group had
      significantly less otoconia volume than the former group, both in the macula
      utriculi and macula sacculi. The ratio between macula utriculi and macula sacculi
      was 100:70 in the young group, whereas it was 100:35 in the elderly group. Thus,
      the macula sacculi in the elderly group showed the severest otoconia reduction.

PMID- 8470529
TI  - The fine structure of the developing otolithic organs of the rat.
AB  - The fine structure of the otolithic organs in fetal and neonatal rats were
      studied by light and transmission electron microscopy. The otoconia were found at
      the 16.5 gestational day while the otolithic membrane appeared much later. Types
      II and I hair cells were first observed at the 16.5 and 18.5 gestational days,
      respectively. Secretory granules in the supporting cells seemed to release an
      organic material which was destined to be incorporated into the organic matrix of
      the otoconia and/or the otolithic membrane. Protrusions of apical cytoplasm,
      cytoplasmic globules and dilated rough endoplasmic reticulum (rER) were observed
      in epithelial cells of both sensory and non-sensory regions, in particular, in
      the transitional cells. By contrast, otoconia were mainly located above the
      neuroepithelial area. The functional roles of protrusions and cytoplasmic
      globules in the genesis of otoconia remain to be clarified. In addition, the
      pathway for transport of calcium remains obscure.

PMID- 8470530
TI  - Salivary total protein and experimental Coriolis sickness.
AB  - Symptomatic reporting has been used in quantifying the severity of motion
      sickness including Coriolis sickness. This study was designed to objectively
      examine if the dynamic changes of salivary protein concentration relate to the
      severity of Coriolis sickness. Healthy adults with normal vestibular function
      underwent a modified Coriolis Sickness Susceptibility Index (CSSI) test,
      utilizing a staircase profile. Salivary samples were obtained prior to
      stimulation, 15, 30, and 45 min following stimulus onset, and/or upon reaching
      "nausea-II" endpoint. Total protein concentration tended to rise over the initial
      30 min of stimulation, and then level off or decline. A statistically significant
      difference was found between the pre-stimulation and 30 min samples. Although
      some variability existed among the subjects, the general pattern of changes along
      the time course was similar. An inverse correlation approaching statistical
      significance was found between control (non-stimulus) total protein levels, and
      minutes of Coriolis stimulation required to reach the "nausea-II" endpoint. Thus,
      baseline salivary total protein levels can be of use in predicting susceptibility
      of Coriolis sickness and other forms of motion sickness.

PMID- 8470531
TI  - Effect of transdermally administered scopolamine on the vestibular system in
      humans.
AB  - In order to elucidate the effect of scopolamine on the vestibular system in
      humans, various experimentally-induced forms of nystagmus, i.e. caloric
      nystagmus, rotational nystagmus, optokinetic nystagmus, visual-vestibular
      interaction and optokinetic after nystagmus, were evaluated before and after the
      administration of two pieces of Scopoderm-TTS or placebo patches retro
      auricularly. Scopolamine reduced the responses of both the caloric and
      optokinetic after nystagmus compared with the placebo. The possible action site
      of this drug is discussed.

PMID- 8470532
TI  - Development of the vestibular aqueduct in Meniere's disease.
AB  - The external aperture width of the vestibular aqueduct was measured in living
      subjects of various ages, with normal and diseased ears. Measurements were made
      from 3-dimensional reconstruction of CT images, and the developmental process was
      studied. The following results were obtained. i) In Meniere's disease the
      external aperture was hypoplastic and its width significantly smaller than that
      in normal individuals and those with chronic otitis media, including children.
      ii) There were no significant differences between normal ears and ears with
      chronic otitis media in either adults or children. The development of external
      aperture was completed in childhood. iii) In Meniere's disease, hypoplasia
      evidently begins before childhood, which suggests that congenital factors are
      involved in the pathology of this disease.

PMID- 8470533
TI  - The intravenously administered glycerol test.
AB  - Three different methods of performing the glycerol dehydration test were
      evaluated. Method one involved the oral administration of 50 g of 50% glycerol
      solution; method two was the intravenous administration of 500 ml of 10% glycerol
      in saline with 5% fructose; and method three involved the administration of 200
      ml of the same solution. It was found that intravenous administration was safe
      and did not give any unpleasant side effects. Both intravenously administered
      methods appeared to give similar rates of positive diagnosis for Meniere's
      disease.

PMID- 8470534
TI  - Furosemide VOR test for the detection of endolymphatic hydrops.
AB  - In order to detect endolymphatic hydrops, we applied three neuro-otologic
      examination methods, including the furosemide VOR test, the glycerol dehydration
      test, and electrocochleography in 61 patients with unilateral Meniere's disease,
      21 patients with delayed endolymphatic hydrops, and 10 patients with syphilitic
      labyrinthitis. The positive rate of the furosemide VOR test in patients with
      endolymphatic hydrops was more than 50%. Inconsistencies were observed between
      the results of the furosemide VOR test, the glycerol test and/or
      electrocochleography. Therefore, combined test battery of these tests is useful
      clinically for detecting endolymphatic hydrops in the vestibular and cochlear
      systems.

PMID- 8470535
TI  - Intraoperative electrocochleography of endolymphatic hydrops surgery using clicks
      and tone bursts.
AB  - Seventy-seven ears of patients with Meniere's disease (n = 69) and other ears
      with secondary endolymphatic hydrops (n = 8) underwent valved shunt surgery, and
      were monitored with intraoperative electrocochleography (ECoG) using clicks
      stimuli (n = 77), and both clicks and tone bursts (n = 37). Of the 41 ears in
      which the "baseline" measurement was > 35% summating potential to action
      potential (SP/AP) amplitude click ratio, 23 ears (56%) showed a significant ratio
      decrease (improvement). Twenty-six ears out of the 37 that were monitored by both
      clicks and tone bursts had abnormal absolute SP tone bursts amplitudes at
      "baseline" and 8 ears (31%) changed to normal at "closing". When tone burst ECoG
      information is combined with click stimuli, our basic understanding of click ECoG
      is enhanced and our ability to assess electrophysiologic changes intraoperatively
      is improved.

PMID- 8470536
TI  - Electrocochleography in syphilitic hearing loss.
AB  - Syphilitic labyrinthitis presents such symptoms as hearing loss, tinnitus,
      vertigo and/or dizziness, and is well known as one of the endolymphatic hydropic
      diseases. In order to elucidate the relationship between syphilitic hydrops and
      ECochG findings, we performed ECochG in patients with syphilis following our
      previously reported study of patients with Meniere's disease. Twenty-two patients
      who have been serologically and clinically diagnosed as having syphilitic
      labyrinthitis were examined with ECochG between December, 1982 and November,
      1991. Of the 27 ears tested with ECochG, 2 showed no response due to severe
      hearing loss, and increased SP (SP/AP ratio > 0.37) was observed in 14 (56.0%)
      out of the remaining 25 ears. The SP/AP ratio of patients with syphilitic
      labyrinthitis was not significantly different from that of the patients with
      Meniere's disease or delayed endolymphatic hydrops, while it was significantly
      higher than that of the patients with sudden deafness and other types of
      sensorineural hearing loss. We conclude that the electrocochleographic features
      of endolymphatic syphilitic lesions resemble those in Meniere's disease.

PMID- 8470537
TI  - Role of the dorsolateral pontine nucleus in two components of optokinetic
      nystagmus (OKN).
AB  - The anatomical features of the dorsolateral pontine nucleus (DLPN) implicate a
      role of the nucleus in the generation of smooth-pursuit eye movements. The DLPN
      receives convergent inputs from a variety of parieto-occipital cortical visual
      areas and projects its fibers to the flocculus and vermal lobules VI and VII. In
      addition to cortical afferent fibers, the DLPN receives descending fibers from
      the nucleus of the optic tract which is indicated as the first subcortical
      optokinetic nystagmus (OKN) relay. DLPN units respond not only to a discrete
      visual spot but also to large-field OKN stimuli. On the basis of the above
      anatomical and physiological features, OKN was investigated in 2 alert monkeys
      whose DLPN was physiologically identified and into which reversible lidocaine was
      injected. The present findings showed that a rapid rise in OKN velocity was
      reduced in both monkeys, whose lesions included the uppermost rostral part of the
      nucleus in the one monkey and the entire nucleus in the other, whereas
      optokinetic after-nystagmus velocity was affected only in the latter. Taken
      together with physiological data, the DLPN possibly shares the domain of low
      selectivity speed selection in OKN and does not play a main role in the
      generation of OKN.

PMID- 8470538
TI  - Delayed endolymphatic hydrops following acoustic tumor removal with
      intraoperative and postoperative auditory brainstem response improvements.
AB  - A 36-year-old female with delayed endolymphatic hydrops (ELH) after acoustic
      tumor removal of the same ear is reported. She presented at our clinic with
      pressure, fullness, and tinnitus involving her right ear. She had an abnormal
      auditory brainstem response (ABR), and a computed tomography showed a right
      acoustic tumor. She underwent a complete tumor removal from a suboccipital
      incision with significant intraoperative and postoperative ABR improvements.
      Preoperatively, there was no fluctuation in her hearing and her
      electrocochleography (ECoG) was normal. She did well postoperatively, but 18
      months after the tumor surgery she complained of noticeable fluctuating hearing
      loss with increased tinnitus and aural fullness of her right operated ear and
      nausea but no vertigo. Neurotological examinations showed a positive right urea
      dehydration and positive right ECoG for enhanced summating potential to clicks.
      She was diagnosed as cochlear Meniere's disease with delayed ELH, failed medical
      management and then underwent a valved shunt surgery for ELH to stabilize her
      hearing. Eight years after her acoustic tumor surgery and 6 and a half years
      after her ELH surgery she has stabilized hearing with normal ABR and ECoG. Her
      clinical course is presented and a pathogenesis of ELH is discussed.

PMID- 8470539
TI  - Effects of isosorbide in patients with Meniere's disease.
AB  - The effects of isosorbide on vertigo, disability, hearing loss and tinnitus in 32
      patients with Meniere's disease were evaluated after a 24-month observation
      period. Vestibular symptoms in 80% of patients were assessed as improved
      according to the 1985 AAO-HNS post-treatment reporting criteria. In contrast, the
      effect of this osmotic diuretic on cochlear symptoms was limited.

PMID- 8470540
TI  - An application of phase spectral analysis to amplitude-modulation following
      response.
AB  - A phase spectral analysis developed by Fridman (1982) was applied to the
      detection of amplitude-modulated frequency following response (AMFR) and its
      clinical usefulness was evaluated. A 1000 Hz sinusoidally amplitude-modulated
      tone with a modulation frequency of 40 Hz and a modulation depth of 90% was
      delivered to the right ear of 10 normal-hearing subjects. According to Fridman's
      technique, an ensemble of sweeps was divided into 10 groups and group averages
      were obtained. Then phase variances were calculated using fast Fourier transform
      for the group averages. In order to determine the optimal conditions of analysis
      for constructing an automatic detection program using phase spectral analysis,
      frequency spacing, number of sampling points and number of sweeps averaged per
      group were investigated. The sensitivity of phase spectral analysis for automatic
      detection of AMFR was also evaluated. The results suggested that the optimal
      number of sampling points and frequency spacing are 512 points and 4.9 Hz
      (observation window 204.8 ms), respectively. Concerning the average number of
      sweeps, the synchrony measure of the frequency component corresponding to the
      modulation frequency increased as the number of sweeps increased. Furthermore, it
      was demonstrated that threshold determination by phase spectral analysis is more
      sensitive than detection of the threshold by visual analysis of waveform
      configuration.

PMID- 8470541
TI  - Changes in auditory evoked responses during intravenous lidocaine.
AB  - Auditory evoked responses in 21 cases with tinnitus were recorded before and
      after the administration of intravenous lidocaine. A dosage of 1 mg/kg body
      weight was diluted with 20% glucose (20 ml) and administered intravenously over a
      one-min period. The loudness of tinnitus was evaluated during
      electrocochleography (ECochG) or auditory brain-stem response (ABR) recordings
      using a score between 0 and 11. The stimulus sound was a tone burst in a
      frequency that corresponded to the pitch of tinnitus. AP latency on ECochG and
      the inter peak latency (IPL) of wave I-III and wave III-V on ABR were prolonged
      momentarily and tinnitus was reduced. These findings reveal that the sites of
      action for lidocaine are both the inner ear and the brain-stem.

PMID- 8470542
TI  - Neurotological findings in patients with acute mumps deafness.
AB  - We report the neurotological findings in 4 cases of acute stage hearing loss due
      to mumps. In 2 of the cases, the less severe hearing loss which occurred in the
      opposite ear was shown to have improved after therapy. If patients with mumps
      suffer from a mild hearing loss which recovers quickly, the temporary auditory
      problem might go undiagnosed; thus the incidence of mumps deafness might well be
      higher than that reported in the literature. Two of our patients complained of
      dizziness. In the caloric test, a reduced response of the ear with poorer hearing
      was found in 3 cases, and a normal caloric response was revealed in the fourth.
      In the galvanic body sway test (GBST), 3 cases showed a normal response
      bilaterally and one case presented a normal response bilaterally in the first
      test, no response in the right side in the second test, and recovery of response
      in the third test. These findings suggest that an inner ear disorder might occur
      in combination with a retrolabyrinthine disorder in mumps deafness, with the
      former lasting longer and the latter improving earlier.

PMID- 8470543
TI  - Clinical usefulness of the personal computer for equilibrium examinations.
AB  - A personal computer (PC) system and its usefulness for equilibrium examinations
      is reported. The system was introduced into clinical routine practice for the
      following purposes: i) Reduction of test result measurement troubles in clinical
      practice, ii) Clearer observation of eye movements and body sway, iii)
      Quantitative analysis of nystagmus responses or body sway, iv) Easy introduction
      into clinical practice of new parameters or new tests, v) Programmable
      arrangement of stimulating devices, and vi) Effective storage of test data. Our
      PC system has been successful for these purposes and provided many useful options
      in equilibrium examinations. Although computer systems for equilibrium
      examination have not been popular due to high costs, the PC system, which can be
      obtained at a reasonable price, has become as powerful a device as the
      conventional small computer, and is expected to become a popular method for both
      research and routine clinical practice in the near future.

PMID- 8470544
TI  - Effect of intraoperative manipulation and preservation on fascia temporalis used
      in tympanoplasty.
AB  - Fascia temporalis (FT) is generally used as grafting material for primary or
      revision surgery for chronic ear disease. In the latter case, homologous FT,
      stored in various solutions after the intraoperative preparation, that aims to
      dehydrate, is often used. In this study, an ultrastructural analysis of FT has
      been carried out in order to determine whether its structure is affected by the
      different steps that take place before its application as a homograft. As well as
      light, transmission and scanning electron microscopy, immunoperoxidase technique
      for testing monoclonal antibodies against different collagen types was performed.
      The surface appearance of FT proved to be increasingly affected by the
      intraoperative manoeuvres. Moreover, 10% formalin proved to give a better
      preservation of the surface appearance of FT than did 70% alcohol which, also
      after a short period of preservation (15 days), caused severe surface
      alterations. No particular changes in the ultrastructural appearance of FT were
      noticed that could have been attributed to the length of preservation. Type IV
      collagen was detected in the 30-day samples of both alcohol- and formalin
      preserved specimens. From these results, one can speculate that, despite the
      major ultrastructural changes induced in FT by the intraoperative preparation and
      by its preservation, this tissue is still able to maintain a proper connective
      network. This finding could explain the reliability of homologous FT for the
      repair of tympanic membrane perforations.

PMID- 8470545
TI  - [High-frequency hearing thresholds prior to and following middle ear surgery].
AB  - Middle ear surgery may affect the cochlea. On 80 patients, the mean HF thresholds
      before and after middle ear surgery including stapediotomy, combined approach
      tympanoplasty and myringoplasty are compared. A small deterioration of the mean
      HF thresholds up to 10 dB is observed.

PMID- 8470546
TI  - Fluctuating hearing loss in sarcoidosis.
AB  - Sarcoidosis is a systemic granulomatous disease, which can affect the vestibulo
      acoustic system at any level, causing vertigo and/or hearing loss. The main
      mechanism could be vasculitis. One patient with fluctuating hearing loss as the
      first manifestation of a systemic sarcoidosis is presented. Diagnostic
      modalities, especially different sites of biopsy or needle aspiration are
      discussed. The treatment is steroid therapy. Hearing will be restored provided no
      irreversible changes of the VIIIth nerve and/or the inner ear have occurred.

PMID- 8470547
TI  - The effects of ventilation tube placement on hearing, speech, language, cognition
      and behaviour.
AB  - As a part of a larger, multidimensional study on secretory otitis media (SOM) and
      its relation to children's development, the effects of ventilation tube (VT)
      placement on hearing, speech, language, cognition and behaviour were studied over
      a six month period. Children with a clear and persistent picture of SOM were
      examined just before tubes were inserted and again, with the same measures, six
      months later. Their evolution was compared to that of a control group. The
      results indicate, as was expected, that the hearing of the children with SOM
      normalized very quickly after surgery. Speech and expressive language functions
      were comparable for both groups at the two moments of examination. Only verbal
      comprehension of the SOM-group was found to be slightly improved in the course of
      a six month period. No differences in general cognitive functioning and in
      behaviour were found between both groups.

PMID- 8470548
TI  - Intracranial complications of cholesteatoma.
AB  - The incidence of cholesteatoma and its intracranial complications in 1450
      patients treated for chronic middle ear disease at the ENT Department of the
      General Hospital in Osijek over a 15-year period is reported. Nearly 7.5% of
      patients suffering from chronic middle ear disease with cholesteatoma developed
      intracranial complications. The most frequent complication was meningitis. The
      mean age of patients with intracranial complications was 34.6 years. The average
      duration of the disease was 11.9 years. The surgical technique depends on the
      type of complication as well as the general condition of the patient. Brain
      abscess is treated through radical excision of the abscess and in poor risk
      patients, trepanation with aspiration is preferred.

PMID- 8470549
TI  - [Auricular leiomyoma].
AB  - An auricular leiomyoma is reported. This neoplasm is extremely rare in the head
      and neck region. The clinical and histopathological features are discussed.

PMID- 8470550
TI  - Hibernoma of the larynx. Review of the literature and a new case.
AB  - Hibernoma is a rare, benign, soft-tissue tumour composed of cells similar to
      those of brown adipose tissue. Only seven cases in the cervical area have been
      reported and none in the larynx. A case of hibernoma of the pre-epiglottic area
      is presented and the histological, histogenetical and clinical features are
      discussed.

PMID- 8470551
TI  - [A case of 3d pharyngeal pouch sinus].
AB  - The study of the branchial remnants needs a perfect understanding of the
      embryology of the branchial apparatus. Endoscopic excision using the CO2 laser in
      a very rare case of third pouch sinus is reported for the first time.

PMID- 8470552
TI  - [Sleep apnea syndrome. Evaluation following uvulopalatopharyngoplasty].
AB  - 20 cases of uvulopalatopharyngoplasty performed on patients suffering from sleep
      apnea syndrome have been studied with a pre- and post-operative polysomnographic
      recording. Eleven patients (55%) responded to this therapy and showed a
      significative decrease of their post-operative apnea-hypopnea index. An increase
      of the mean oxygen saturation was noticed during sleep. On the contrary, the
      sleep quality did not improve. Age, weight, apnea index are not predictive
      factors influencing the result of UPPP. Even if UPPP has a relatively poor
      success rate it still should be proposed to patients suffering from sleep apnea
      syndrome as it remains the simplest and best tolerated surgical treatment.

PMID- 8470553
TI  - The results of inferior and middle meatal antrostomy under endoscopic control.
AB  - Inferior and middle meatal antrostomy have been used for over a century in the
      treatment of chronic rhinosinusitis. The historical, pathophysiological and
      clinical aspects of the two approaches are discussed to compare the advantages
      and disadvantages of each. Whilst surgery in the inferior meatus is relatively
      safe, it does not address the underlying pathophysiology of the condition in
      contrast to achieving maxillary ostial function which consequently offers better
      surgical results.

PMID- 8470554
TI  - Indications, technique and results of endonasal endoscopic ethmoidectomy.
AB  - Endoscopic ethmoid sinus surgery was introduced in Erlangen in 1976. Posterior-to
      anterior ethmoidectomy under the optical control of a 70 degrees telescope with a
      suction-irrigation handpiece was established for treatment of chronic-diffuse
      hyperplastic paranasal sinusitis. This technique complements partial resections
      of the ethmoid. The different procedures are applied depending upon the extent of
      the disease. The indication for endonasal endoscopic surgery was expanded with
      practical experience. Diseases of the nasolacrimal duct and the frontal sinus,
      the frontal skull base as well as the orbita often proved to be accessible for
      endonasal surgery. A survey of the technical aspects of endoscopic ethmoid
      surgery and an introduction of the extended range of indications are presented
      together with the results of each procedure.

PMID- 8470555
TI  - Assessment of nutrient intake and associated factors in an Indian elderly
      population.
AB  - A group of 420 elderly people (163 women and 257 men with a mean age of 65 years)
      from urban and rural populations in India were selected for the study. The
      caloric intake of 93.3% was less than the recommended allowance, the mean daily
      caloric intake being 1191 kcal in men and 928 kcal in women. Except for calcium,
      all nutrients were deficient in their diet. Illiteracy (53%), lack of knowledge
      regarding daily allowances of nutrients (95%), poor economic background (46.7%),
      and breaking down of joint family system (63%) were possible associated factors
      examined.

PMID- 8470556
TI  - Expressed wish to die and mortality in older people: a community replication.
AB  - Three-year mortality of 1063 community residents aged 65 and over interviewed
      with the Geriatric Mental State Schedule was analysed to examine the influence of
      specific depression symptoms and physical illness in order to test theoretical
      predictions from models proposed by Macdonald and Dunn, and by Jorm and
      colleagues. Expressed wish to die was confirmed as a predictor of mortality,
      controlling for age, sex, and cognitive impairment. The suggestion that the
      effect of depressive symptoms on mortality might be a masked effect of physical
      illness was not confirmed. In general the more specific severe symptoms were
      better predictors of mortality.

PMID- 8470557
TI  - Water balance in elderly people: is there a deficiency of vasopressin?
AB  - Since elderly people are prone to develop both hypo- and hyper-natraemia, we have
      investigated the biochemical and hormonal responses to overnight (9 h) abstinence
      from fluids and subsequent oral water load (20 ml/kg) in a group of healthy
      elderly (E) (mean age 68 years) and young (Y) (mean age 28 years) volunteers. The
      elderly subjects had significantly higher baseline plasma osmolality (E 293.5 +/-
      0.5, Y 290.5 +/- 0.8 mOsm/kg, p < 0.05) but lower urinary osmolality (E 508 +/-
      47, Y 842 +/- 52 mOsm/kg, p < 0.001) and lower plasma vasopressin (E 0.5 +/- 0.1,
      Y 2.3 +/- 0.6 pmol/l, p < 0.001) than the young. There was a significant
      difference in the mode of excretion, particularly maximum free water clearance (E
      6.0 +/- 0.6, Y 10.1 +/- 0.8 ml/min) but no difference in the overall ability to
      excrete the water load (at 4 h E 93 +/- 8%, Y 92 +/- 5%, p > 0.05). The
      biochemical and hormonal results suggest that the elderly subjects were in a
      state similar to partial cranial diabetes insipidus which may predispose them to
      dehydration and hypernatraemia. The reduction in maximum free water clearance may
      predispose them to hyponatraemia if excess fluid is administered.

PMID- 8470558
TI  - Is there a right age for case finding in elderly people?
AB  - If age is a useful basis for determining a screening policy the benefit of the
      resulting interventions should vary with age. The choice of the screening age
      will be such as to maximize the benefit. Data from a study of the screening of
      elderly people by a Health Visitor produced no evidence to support the choice of
      75 as minimum age for screening in primary care. Indeed there was a suggestion
      that age might be more useful as a maximum rather than a minimum criterion.

PMID- 8470559
TI  - Subtypes of overactive bladder in old age.
AB  - The prevalence of urinary incontinence increases dramatically with age and is
      mainly related to urge incontinence and bladder overactivity. It is a reasonable
      hypothesis that bladder overactivity primarily results from a disturbed central
      neuronal control of the lower urinary tract. Different sites and extents of
      neurogenic lesions or dysfunctions should result in different functional and
      urodynamic characteristics. We have recently identified three distinct urodynamic
      subtypes of bladder overactivity, and we report a retrospective study of the
      distribution of these subtypes in elderly patients. Eight hundred and fourteen
      patients aged 65 years or older with symptoms of urgency and/or urge incontinence
      underwent cystometry and the ice-water test. Two hundred and sixty-seven of them
      (33%) presented an overactive bladder. The prevalence of overactive bladder was
      constant up to the age of 65. A marked increase above this age was almost
      entirely ascribed to an increase of the so-called uninhibited overactive bladder
      subtype. This dysfunction occurred in 70% of the older patients. Patients with
      this condition have a coordinated reflex micturition at normal bladder volumes,
      but an abnormal perception of bladder fullness and lack of voluntary inhibitory
      control. This constellation of symptoms and signs indicates a suprapontine
      dysfunction.

PMID- 8470560
TI  - Resting energy expenditure in relation to energy intake in patients with
      Alzheimer's disease, multi-infarct dementia and in control women.
AB  - Energy intake and resting energy expenditure in relation to body composition were
      studied in female patients with Alzheimer's disease, multi-infarct dementia and
      in home-living non-demented elderly women. Patients with Alzheimer's disease
      tended to have lower body weight and higher energy intake (p = NS) than control
      subjects or patients with multi-infarct dementia. Resting energy expenditure did
      not differ significantly between the groups (1089 +/- 129 kcal/day for patients
      with Alzheimer's disease, 1078 +/- 102 kcal/day for patients with multi-infarct
      dementia and 1188 +/- 143 kcal/day for control women; mean +/- SD). Energy
      expenditure did not differ between the groups when calculated in relation to body
      weight or lean body mass. In institutionalized female patients with long-standing
      Alzheimer's disease the resting energy expenditure was not increased, but they
      tended to have low body weight despite a high energy intake.

PMID- 8470561
TI  - Review: Alzheimer's disease and environmental aluminium.

PMID- 8470562
TI  - Age and susceptibility to pneumococcal infection.

PMID- 8470563
TI  - Metabolic switches in ageing.

PMID- 8470564
TI  - The influence of urinary incontinence on the quality of life of elderly women.
AB  - The quality of life assessed by the Nottingham Health Profile Questionnaire was
      compared in a group of women (n = 120) suffering from urinary incontinence (age
      75.4 +/- 1.9, range 65-84 years) and an age-matched representative sample of the
      total population (n = 313). There were no significant differences between the two
      groups of women in occurrence of other illnesses or social characteristics. Women
      suffering from urinary incontinence obtained higher scores in the domains of
      emotional disturbances (p < 0.05) and social isolation (p < 0.001) than women
      from the control group. When subdividing the incontinent women by type of
      incontinence it was found that women suffering from urge and mixed incontinence
      reported emotional disturbances (p < 0.05) more than women from the control
      group. There was, however, no difference within the domain of emotional
      disturbances between stress-incontinent women and the control group. Women
      suffering from urge incontinence reported more disturbance of sleep (p < 0.05)
      than the control group. Women suffering from all types of urinary incontinence (p
      < 0.05) were socially more isolated than those from the age-matched group of
      women from the total population. Urinary incontinence in women has a detrimental
      effect on their daily lives and causes them to avoid social contacts.

PMID- 8470565
TI  - The energetic cost of some daily activities: a comparison in a young and old
      population.
AB  - We compared the energetic costs of some daily activities in two groups, 10 young
      people (24.3 +/- 2.8 years) and 10 old people (74.4 +/- 2.2 years): rising and
      sitting back down on a seat, getting up from and lying down on a bed and getting
      up from the floor. We measured the oxygen consumption and the time necessary for
      the activities. The results showed a noteworthy economical energetic procedure
      when rising and sitting back down on a seat among the older group. The values of
      the energy expenditure were respectively 3.9 +/- 1.3 cal/kg in the older group
      and 5.8 +/- 1.6 in the younger one with a standard seat (45 cm) and 2.7 +/- 1.2
      vs 5.2 +/- 1.5 with a raised seat (60 cm). The activities did not vary
      significantly in time in the two age groups. This procedure could be understood
      as an adaptation of the energy expenditure to the reduced aerobic capacity with
      ageing. Conversely, getting up from and lying down on the floor or a standard
      hospital bed involved the same energy expenditure in the older and younger group,
      but performing these activities took significantly longer for the older people
      (+60% for getting up from the floor, +33% from the bed). As these activities
      revealed no economical energetic procedure in the older group, they appeared
      responsible for a strong factor of dependence. The importance of a learning
      process particularly for the most usual movements in everyday life is discussed.

PMID- 8470566
TI  - Hospital admissions for asthma in Finland during 1972-86 of adults aged 65 years
      and over.
AB  - The aim of this investigation was to examine the use of hospital services, on
      account of asthma, among adults aged 65 and over in 1972-86. According to the
      discharge records maintained by the National Board of Health, asthma caused a
      total of 710,187 hospitalization days and 62,342 periods of hospital treatment
      among elderly people during the 15 years concerned. The annual number of
      hospitalization days per 100,000 persons, standardized for age and sex, was 8438
      and that of treatment periods 731. The figures were higher in the case of
      patients under 75 years than with older age groups, but it was in the oldest age
      groups that the numbers of treatment periods increased most. The mean duration of
      a treatment period decreased from 15.4 days to 9.6 days in the course of the 15
      years, but became longer with increasing age. The 15 years of consistently
      recorded data on asthma patients point to an increase in the use of hospital
      services by elderly people and suggest that the diagnosis and treatment of asthma
      in this sector of the population will pose a challenge for the health service in
      the future.

PMID- 8470567
TI  - Prevention of barium aspiration during videofluoroscopic swallowing studies:
      value of change in posture.
AB  - OBJECTIVE: We investigated the frequency with which changes in the position of a
      patient's head or body eliminated aspiration of liquid barium during
      videofluoroscopic swallowing studies in patients with oropharyngeal dysphagia. We
      also studied factors that influenced the effect of posture on aspiration.
      SUBJECTS AND METHODS: The study group comprised 165 patients consecutively
      referred for videofluoroscopic examination of the oropharyngeal stages of
      swallowing in whom aspiration of barium occurred while swallowing 1, 3, 5, or 10
      ml of thin liquid barium or drinking barium from a cup. When aspiration occurred,
      the patient changed to one of five postures (chin down, chin up, head rotated,
      head tilted, and lying down), selected on the basis of the specific swallowing
      abnormality causing the aspiration. RESULTS: Changes in head or body position
      eliminated aspiration of at least one bolus of barium in 127 (77%) of the 165
      patients, and of all four boluses plus drinking barium from a cup in 41 patients
      (25%). Postural changes were less beneficial in preventing aspiration in patients
      with substantial language or cognitive defects or restricted head movement.
      CONCLUSIONS: Postural techniques can eliminate aspiration of barium of at least
      small volumes in most patients. Expansion of the oropharyngeal swallowing study
      to include the effect of various postures can be done with minimal risk of
      increased aspiration.

PMID- 8470568
TI  - Value of T1 and T2 relaxation times from echoplanar MR imaging in the
      characterization of focal hepatic lesions.
AB  - OBJECTIVE: The purpose of this study was to determine the value of echoplanar
      imaging in characterizing focal hepatic lesions on the basis of image-derived T1
      and T2 relaxation times. SUBJECTS AND METHODS: Forty-six proven hepatic lesions
      were analyzed: 24 solid (21 metastases, three primary liver tumors) and 22
      nonsolid (11 hemangiomas and 11 cysts). Mean lesion size (maximal length) was 4.0
      (+/- 3.2) cm, and 16 of 46 lesions were less than 2.0 cm. A commercially
      available 1.5-T echoplanar-equipped MR scanner was used to obtain fat-suppressed,
      single-excitation (TR essentially infinite) axial images with a slice thickness
      of 10 mm. T1-weighted inversion recovery images (TE = 25 msec; TI = 100, 380,
      600, or 800 msec) were acquired for 28 of 46 lesions, and T2-weighted spin-echo
      images (TE = 25, 50, 100, 75 or 150 msec) were acquired for 45 of 46 lesions. For
      each acquisition (i.e., each different TI or TE), the entire liver was imaged in
      a single breath-hold of 12 sec or less. RESULTS: The mean T1 was 1004 (+/- 234)
      msec for solid lesions, 1337 (+/- 216) msec for hemangiomas, and 3143 (+/- 1392)
      msec for cysts. Although the mean T1 of solid and nonsolid lesions differed (p <
      .004), overlap precluded the use of T1 as a discriminatory index. Mean T2 times
      were 80 (+/- 18) msec for solid lesions, 178 (+/- 40) msec for hemangiomas, and
      517 (+/- 429) msec for cysts. The mean T2 for hemangiomas is the longest reported
      to date. A T2 cutoff of 116 msec was 100% accurate for classifying lesions as
      solid or nonsolid and 93% accurate for characterizing them as benign or
      malignant. CONCLUSION: Our study suggests that echoplanar-derived T2 times (but
      not T1 times) are useful for characterizing focal hepatic lesions. An important
      use may be to characterize small lesions measuring less than 2.0 cm. The main
      advantages of echoplanar imaging are the absence of motion-induced volume
      averaging and phase artifacts, the ability to acquire purely T2-weighted images,
      and the use of multiple data points to calculate relaxation times.

PMID- 8470569
TI  - Traumatic laceration of the liver limited to the bare area: CT findings in 25
      patients.
AB  - OBJECTIVE: The capsular extent of traumatic hepatic lacerations may be limited to
      the bare area of the liver--an area not covered by peritoneal reflection. In
      these cases, intraperitoneal bleeding may not occur, classic peritoneal findings
      may be absent, and results of diagnostic peritoneal lavage may be normal. We
      undertook a study to evaluate the frequency, CT appearance, and significance of
      injury of the bare area of the liver. MATERIALS AND METHODS: We retrospectively
      reviewed radiologic reports of 1469 hemodynamically stable trauma patients
      referred for abdominal CT between January 1986 and September 1992 and selected
      155 patients whose CT reports indicated hepatic injury. Retrospective review of
      the abdominal CT scans of these 155 patients confirmed intrahepatic laceration or
      contusion in all of them. The study involved the 25 (16%) patients in whom the
      capsular extent of injury was limited to the bare area of the liver. RESULTS: In
      all cases, CT scans showed simple or complex lacerations involving predominantly
      or exclusively the posterior segment of the right hepatic lobe, with capsular
      extent limited to the superomedial hepatic surface. Abnormal retroperitoneal
      findings were present in all but two cases. Twenty-two (88%) of 25 patients had
      right-sided retroperitoneal hemorrhage or fluid collections; adrenal hematoma or
      periadrenal fluid was seen in 12 (48%) patients. Abnormal pericaval fluid
      collections were present in nine (36%). Only five (20%) patients had free
      intraperitoneal fluid. Diagnostic peritoneal lavage, performed as a correlative
      procedure in four patients, revealed intraabdominal hemorrhage in one, equivocal
      findings in one, and normal findings in two. Patients who had isolated injuries
      of the bare area of the liver did well clinically and were discharged after an
      uneventful hospital stay of an average of 3 days (range, 2-7 days). CONCLUSION: A
      small percentage of hemodynamically stable patients who have hepatic trauma may
      have lacerations that primarily involve the bare area and that are not suspected
      clinically or detected by diagnostic peritoneal lavage. In these patients, CT may
      be helpful to show the extent of liver injury, identify associated
      retroperitoneal abnormalities, and provide prognostic information.

PMID- 8470570
TI  - Complications after laparoscopic cholecystectomy: imaging findings.
AB  - Laparoscopic cholecystectomy is rapidly becoming an acceptable alternative to
      traditional open cholecystectomy. Laparoscopic procedures are associated with
      shortened recovery periods and hospital stays and the cosmetic benefit of smaller
      scars. Early results from laparoscopic cholecystectomies suggested a high rate of
      complications; however, recent studies have shown that, in experienced hands, the
      complication rates of open and laparoscopic procedures are comparable.
      Complications differ somewhat between the two types of operations. In
      laparoscopic cholecystectomy, complications are associated with virtually every
      aspect of the procedure. The purpose of this essay is to illustrate the imaging
      findings of the complications that occur in patients undergoing laparoscopic
      cholecystectomy.

PMID- 8470571
TI  - Posterior superior pancreaticoduodenal vein: mimic of distal common bile duct at
      sonography.
AB  - OBJECTIVE: Previous investigators have noted that the common bile duct may appear
      to merge with the portal vein on sagittal sonograms, mimicking a venous
      structure. The posterior superior pancreaticoduodenal vein courses adjacent to
      the distal part of the common bile duct within the pancreatic head. A prospective
      study was performed to assess the sonographic appearance of the posterior
      superior pancreaticoduodenal vein. SUBJECTS AND METHODS: The study included 50
      consecutive subjects in whom the pancreatic head was well seen. Anatomic
      characteristics of the posterior superior pancreaticoduodenal vein were noted
      with gray-scale, duplex Doppler, and color Doppler sonography. The site of
      insertion of the posterior superior pancreaticoduodenal vein into the portal vein
      was noted. RESULTS: The posterior superior pancreaticoduodenal vein was
      visualized in all 50 cases. Although it usually (82% of cases) inserted into the
      posterior aspect of the portal vein, the posterior superior pancreaticoduodenal
      vein inserted into the anterior aspect of the portal vein in nine cases (18%),
      resulting in an appearance mimicking the common bile duct on sagittal sonograms.
      Doppler examination showed flow toward the portal vein in all obliquely oriented
      posterior superior pancreaticoduodenal veins, and in 40% overall. The common bile
      duct could always be followed into the porta hepatis and was anterior to the
      posterior superior pancreaticoduodenal vein in 49 cases (98%). CONCLUSION: The
      posterior superior pancreaticoduodenal vein can be seen routinely on sonograms
      when the pancreatic head is unobscured, and it can mimic the common bile duct in
      a significant number of cases. These structures can be distinguished by noting
      continuation of the common bile duct into the porta hepatis, the generally
      anterior position of the common bile duct, and flow in the posterior superior
      pancreaticoduodenal vein on Doppler examination. Awareness of the existence and
      anatomy of the posterior superior pancreaticoduodenal vein minimizes its
      confusion with the common bile duct at sonographic examination.

PMID- 8470572
TI  - Mucin-producing adenoma of the appendix.

PMID- 8470573
TI  - Epidermoid cyst of the testicle: an unusual sonographic finding.

PMID- 8470574
TI  - Detection of multiple myeloma involving the spine: efficacy of fat-suppression
      and contrast-enhanced MR imaging.
AB  - OBJECTIVE: To determine the efficacy of fat-suppressed sequences and contrast
      enhanced MR imaging for the detection of focal spinal lesions caused by multiple
      myeloma, we obtained MR images in 32 patients with newly diagnosed myeloma who
      had back pain. SUBJECTS AND METHODS: All patients had biopsy-proved myeloma and
      had MR imaging at the painful level of the spine. Spin-echo T1-weighted, T2
      weighted, and short TI inversion-recovery (STIR) images; dynamic ultrafast low
      angle shot (turbo-FLASH) images after IV injection of a bolus of paramagnetic
      contrast material; and contrast-enhanced T1-weighted images were obtained. We
      qualitatively compared the signal intensities and contrast enhancement of focal
      lesions with those of the surrounding vertebral bodies. RESULTS: Multiple lesions
      were detected in all but two of the 32 patients. On T2-weighted and STIR images,
      all lesions had homogeneously high signal intensity. On T1-weighted images, the
      lesions were visible as hypointense areas compared with surrounding bone in all
      except four patients, in whom the lesions were isointense or hyperintense. All
      tumor nodules enhanced on turbo-FLASH images obtained in the arterial phase. No
      additional lesions were seen on STIR or contrast-enhanced images. MR findings
      resulted in a change in the staging of the disease in one patient and led to
      prompt treatment in five patients with epidural involvement. CONCLUSION: MR
      imaging appears to be helpful in detecting spinal involvement in patients with
      multiple myeloma. The diagnosis of spinal lesions is best achieved by using
      either fat-suppressed or T2-weighted images. Although myeloma lesions enhanced in
      all patients, contrast material appears to be of no value for the detection of
      additional lesions.

PMID- 8470576
TI  - MR imaging of the sacral plexus: normal findings.
AB  - Imaging of the sacral plexus requires evaluation of both intradural and
      extradural components with cross-sectional techniques. Although CT is useful,
      individual extradural sacral nerves and the sacral plexus usually cannot be
      distinguished from adjacent structures. The higher contrast resolution provided
      by MR imaging allows the region of the sacral plexus to be examined in greater
      detail. With MR imaging, the constant relationship of the neural components to
      one another, and the gluteal vessels in their course from the sacrum to the
      greater sciatic foramen, can be shown consistently. An understanding of the
      anatomy of this area in multiple planes can aid in more accurate localization of
      abnormalities involving the sacral plexus. This pictorial essay reviews the MR
      appearance of the region of the sacral plexus.

PMID- 8470575
TI  - MR appearance of multiple myeloma of the spine before and after treatment.
AB  - OBJECTIVE: The aim of this study was to describe the changes in the MR appearance
      of painful lesions of the spine before and after treatment in 18 patients with
      multiple myeloma and to correlate these changes with the clinical response to
      treatment. SUBJECTS AND METHODS: Eighteen patients with multiple myeloma and
      tumor nodules in the spine had MR imaging of the same site in the spine before
      and after treatment. Unenhanced T1- and T2-weighted spin-echo images, dynamic
      ultrafast low-angle shot (turbo-FLASH) images before and after IV bolus injection
      of paramagnetic contrast material, and contrast-enhanced T1-weighted spin-echo
      images were obtained. Characteristic signal and contrast enhancement before and
      after treatment were compared and were correlated with clinical data and the
      results of immunochemical and pathologic tests. RESULTS: Changes in signal
      intensity and enhancement of the lesions occurred after treatment in 14 of 18
      patients. The characteristics of the lesions after treatment had three patterns:
      (1) rim enhancement or no enhancement of the lesions, (2) early enhancing lesions
      associated with other nonenhancing lesions or lesions with rim enhancement, and
      (3) no change from the enhancement pattern seen before treatment. In 13 of 18
      patients, these patterns correlated well with the response to treatment. A
      discrepancy was observed in five patients. CONCLUSION: The MR appearance of
      spinal myeloma is different before and after treatment. MR images, particularly
      contrast-enhanced images, may be helpful in monitoring the response to treatment
      of focal bone lesions of myeloma.

PMID- 8470577
TI  - MR imaging of the sacral plexus: abnormal findings.
AB  - Patients with symptoms of sacral plexopathy, radiculopathy, or sciatica may have
      disease originating in the neural elements, sacrum, bony pelvis, pelvic soft
      tissues, or gluteal region. As illustrated in our companion article, the sacral
      plexus and surrounding structures can be visualized in detail with MR imaging.
      This pictorial essay illustrates the MR findings in a number of abnormalities
      affecting the sacral plexus. Multiplanar MR examination is particularly helpful
      in defining neural levels of involvement by disease in this region.

PMID- 8470578
TI  - Calcific myonecrosis of the calf manifesting as an enlarging soft-tissue mass:
      imaging features.

PMID- 8470579
TI  - Scaphoid dislocation with radial-axial carpal disruption.

PMID- 8470580
TI  - Embolic cerebral infarction: MR findings in the first 3 hours after onset.
AB  - OBJECTIVE: MR imaging has a high sensitivity for detecting ischemic brain
      parenchyma. The aim of this study was to evaluate the changes in the signal
      intensity of infarcted brain parenchyma on MR images obtained within the first 3
      hr after the onset of signs and symptoms in patients with embolic cerebral
      infarction. MATERIALS AND METHODS: We studied MR images of 16 patients who had a
      diagnosis of embolic cerebral infarction (highly probable according to criteria
      of the National Institute of Neurological and Communicative Disorders and
      Stroke). T1-weighted, T2-weighted, and proton density-weighted MR images were
      obtained within 3 hr after the onset of symptoms. Two neuroradiologists who had
      no knowledge of the diagnoses reviewed the MR images of these 16 patients and 20
      control subjects in random order and evaluated signal-intensity changes in the
      gray and white matter. RESULTS: On proton density-weighted images, the central
      and cortical gray matter showed increased signal intensity in 63-69% and 88-94%
      of the patients, respectively. No abnormalities of the brain parenchyma were
      apparent on T1-weighted and T2-weighted images obtained within 3 hr after the
      onset of symptoms. The adjacent white matter appeared hyperintense on long TR
      images in only a few cases. CONCLUSION: An increased signal intensity in the gray
      matter on proton density-weighted images was the most characteristic parenchymal
      change seen on MR images of the brain obtained within 3 hr after embolic cerebral
      infarction.

PMID- 8470581
TI  - Meningiomas involving the cavernous sinus: value of imaging for predicting
      surgical complications.
AB  - OBJECTIVES: The purpose of this study was to determine if it is possible to
      predict complications of surgery on cavernous sinus meningiomas on the basis of
      preoperative MR and CT findings. MATERIALS AND METHODS: We retrospectively
      reviewed the CT, MR, and postoperative clinical findings in 65 consecutive
      patients with pathologically proved cavernous sinus meningiomas who had surgery
      during the period 1985-1991. Tumors were categorized on the basis of their
      relationship to the cavernous carotid artery. The presence of tumor in three
      anatomic sites (the sella, the sphenoid sinus, and the orbital apex) was also
      correlated with surgical complications. RESULTS: Category 1 tumors, which do not
      completely encircle the cavernous carotid artery, were dissected without injury,
      sacrifice, or grafting of the artery in 91% of cases. Category 2 lesions
      completely encircle the artery but do not narrow its lumen; they could be
      dissected from the cavernous carotid artery without arterial injury in 61% of
      cases, but imaging failed to discriminate differences within this group. Category
      3 lesions, which completely encircle and narrow the cavernous carotid artery, are
      usually difficult to dissect free from the artery. The categories also correlated
      with recovery of extraocular motility; 84% of category 1 lesions compared with
      only 36% of category 2 or 3 lesions will recover to good or excellent extraocular
      motility after cavernous sinus surgery. Tumor involvement of the sella, orbital
      apex, and sphenoid sinus correlated with postoperative endocrine dysfunction,
      decreased visual acuity, and CSF leak, respectively. CONCLUSION: Imaging studies
      can frequently predict the difficulty of resecting cavernous sinus meningiomas
      from the cavernous carotid artery and the likelihood of permanent loss of
      extraocular motility after surgery on these lesions. This information is helpful
      in appropriate preoperative planning and in providing information to patients
      about to undergo such surgery.

PMID- 8470582
TI  - Mesenrhombencephalitis: MR findings in nine patients.
AB  - OBJECTIVE: Mesenrhombencephalitis is a serious form of brainstem inflammation
      predominantly involving the deep and vital portions of the brain, that is, the
      mesencephalon (midbrain) and rhombencephalon (pons, medulla).
      Mesenrhombencephalitis is difficult to diagnose on the basis of clinical and
      laboratory findings alone, and access to this portion of the brain for surgical
      biopsy carries high morbidity. We describe the MR appearance of
      mesenrhombencephalitis and correlate the imaging findings with clinical
      information. MATERIALS AND METHODS: Unenhanced and contrast-enhanced MR images of
      nine patients with mesenrhombencephalitis were reviewed retrospectively and
      correlated with clinical, laboratory, and pathologic data. The patients were
      categorized according to the cause of the disease: three had herpes simplex, one
      had Listeria monocytogenes, and five had mesenrhombencephalitis of undetermined
      cause. The three patients with clinical and MR evidence of herpes simplex
      mesenrhombencephalitis (one confirmed by brain biopsy) were comatose at
      presentation, with cranial nerve abnormalities in two and seizures in one. One
      patient with L. monocytogenes (established by blood culture) had cranial nerve
      palsies, fever, and pain in the ear. Five additional patients had headache
      (three), fever (three), nausea and vomiting (four), cranial nerve palsies
      (three), coma (two), and hyporeflexia (one) or hyperreflexia (four). Brain biopsy
      performed in two patients revealed chronic inflammation of unspecified cause; in
      one, it was compatible with viral encephalitis. RESULTS: MR images in three
      patients with herpes simplex mesenrhombencephalitis showed T2 signal
      hyperintensity in the midbrain (two), pons (one), medulla (one), and temporal
      lobes (three). Parenchymal foci of hemorrhage (methemoglobin, one patient) and
      leptomeningeal enhancement (one patient) were identified in the temporal lobes.
      T2-weighted MR images in one patient with L. monocytogenes showed signal
      hyperintensity in the brainstem, vermis, midbrain, and internal capsules. On T1
      weighted images, low signal was present in these areas, which enhanced with
      paramagnetic contrast agents. In the remaining five patients, T2-weighted MR
      images showed patchy signal hyperintensity in the pons, medulla, and thalamus in
      three each and in the midbrain and temporal lobes in one each. T1-weighted MR
      images showed normal findings (two) or signal hypointensity in the thalamus and
      pons in one patient each. Areas of leptomeningeal and parenchymal enhancement
      were identified in one patient each. Brainstem swelling was seen in three
      patients, one of whom had petechial hemorrhage in the pons and hydrocephalus.
      CONCLUSION: Mesenrhombencephalitis is a serious illness that is diagnosed by a
      combination of imaging, clinical, laboratory, and pathologic studies. MR imaging
      may be crucial to the early diagnosis of this illness, and radiologists must be
      familiar with this uncommon entity and its MR findings in order to make timely
      diagnoses and facilitate treatment.

PMID- 8470583
TI  - Advice for Latin lovers.

PMID- 8470584
TI  - Lesions causing a mass in the medial canthus of the orbit: CT and MR features.
AB  - Few detailed radiologic articles treat the medial canthus as a "compartment" of
      the orbit. Nasal stuffiness and epiphora (excessive tearing) are frequent
      clinical manifestations of diseases involving the medial canthus of the orbit.
      Although some lesions can be adequately evaluated by clinical examination,
      imaging may show unsuspected deep extensions of the abnormality. CT has
      traditionally been the imaging method of choice because of the inherent contrast
      between structures in this region and its superb depiction of bone detail (Fig.
      1). MR imaging can be useful in detecting subtle marrow invasion caused by
      lesions extending beyond the confines of the medial canthus (e.g., frontal bone,
      maxilla). In this pictorial essay, we illustrate the CT and MR appearances of
      diseases that can manifest as a medial canthal mass and provide practical
      differential diagnoses. Lesions can be inflammatory, neoplastic, or developmental
      in origin. Moreover, these lesions can result from abnormalities in the adjacent
      nasolacrimal apparatus, orbit, paranasal sinuses, and nasal cavity, or they can
      reflect an underlying systemic illness.

PMID- 8470585
TI  - Pneumatization of the paranasal sinuses: normal features of importance to the
      accurate interpretation of CT scans and MR images.
AB  - CT and MR imaging of the paranasal sinuses in infants and children reveal a
      spectrum of findings associated with the normal pneumatization process, both
      inside the sinus cavities and in the adjacent marrow spaces. These normal
      findings must be understood and recognized so that CT scans and MR images may be
      accurately interpreted. If such normal developmental radiologic findings are not
      appreciated, misinterpretation may occur and lead to inappropriate treatment. In
      this pictorial essay, the normal process of pneumatization for each paranasal
      sinus group will be described from the first stages of the process to its
      completion. CT scans and MR images will illustrate the range of normal radiologic
      findings associated with the developmental process, with emphasis placed on the
      types of findings that, although normal, create potential interpretive
      difficulties.

PMID- 8470586
TI  - Necrosis of the putamen caused by methanol intoxication: MR findings.

PMID- 8470587
TI  - Volume of the spleen in children as measured on CT scans: normal standards as a
      function of body weight.
AB  - OBJECTIVE: The purpose of this study was to develop standards for the normal
      volume of the spleen in children as measured on CT scans. SUBJECTS AND METHODS:
      CT scans were used to measure the volume of the spleen in 48 children (30 boys
      and 18 girls), 1 day to 18 years old (mean and median ages were 8.2 and 7.8
      years, respectively). Children who had underlying malignant tumors, infection,
      hematologic diseases, or other conditions that could alter splenic size were
      excluded. The area of the spleen on each axial section was determined by tracing
      its outline on the CT monitor and measuring the area of the region of interest.
      The area of the spleen on each section was multiplied by the slice thickness to
      calculate the volume of the spleen for each section. The total volume of the
      spleen was then determined by adding the individual volumes for each of the
      sections through the spleen. This method of calculating splenic volume has been
      validated in previous studies in adult subjects. The volume of the spleen was
      analyzed as a function of both body weight and age. RESULTS: The volume of the
      spleen correlated better with body weight than with age. The best regression
      model (r = .85) was a linear relationship as follows: splenic volume (cm3) = 0.7
      + [4.6 x weight (kg)]. Using these data and a regression model, we generated
      standards for normal volume of the spleen as a function of body weight (with 95%
      tolerance intervals). CONCLUSION: We have developed CT standards for normal
      splenic volume in children. These standards can be used to objectively measure
      the size of the spleen in children who have clinically suspected splenomegaly.

PMID- 8470588
TI  - Malignant meningioma in a child: CT and MR findings.

PMID- 8470590
TI  - Needle-stick injuries and blood contacts during invasive radiologic procedures:
      frequency and risk factors.
AB  - OBJECTIVE: Possible nosocomial transmission of blood-borne pathogens is a serious
      concern for health care workers and patients alike. Needle-stick injuries and
      blood contacts pose a risk of pathogen transmission during procedures. We
      performed a study to determine the frequency of injuries and blood contacts
      during invasive radiologic procedures and to examine procedure-related factors
      that may increase risk of injury or exposure. SUBJECTS AND METHODS: A prospective
      study of needle-stick injuries and blood contacts during invasive radiologic
      procedures was performed. During a 10-week period, information about procedures
      was recorded by technologists or physicians, and needle-stick injuries and
      exposures to patients' blood and body fluids were noted. Data were analyzed with
      the SAS statistical package. RESULTS: Accidental exposure to patients' blood and
      body fluids occurred in 15 of 501 cases (3.0%; 95% confidence interval, 1.7
      4.9%). Of 729 operators at risk, 15 were exposed (2.0%; 95% confidence interval
      1.1-3.3%). Exposure was parenteral in one case and cutaneous in 14. Risk of
      exposure was correlated with procedure duration (p = .003), but not with
      emergency vs elective procedure status (p = .796), procedure type (p = .275), or
      operator experience level (p = .554). Three needle-stick injuries (0.6% of cases)
      occurred, all with sterile instruments; bleeding occurred in two cases. Risk of
      injury was correlated only with procedure type (p = .046). In no case was a
      patient exposed to a physician's blood. CONCLUSION: Whereas cutaneous exposure of
      physicians to patients' blood was not infrequent, parenteral exposure was rare in
      this series. Most of the exposures in this study could have been prevented by the
      use of protective equipment. Patients' contact with physicians' blood did not
      occur in this study.

PMID- 8470589
TI  - Volumetric flow rates in the portal venous system: measurement with cine phase
      contrast MR imaging.
AB  - OBJECTIVE: The purposes of this study were to (1) validate the accuracy of cine
      phase-contrast MR flow measurements within the portal vein, (2) develop a
      suitable protocol for using this method to measure volumetric flow rate in the
      portal venous system, and (3) use this protocol, with Doppler sonography as a
      reference, to measure portal venous flow in healthy volunteers and in patients
      with protal venous hypertension. SUBJECTS AND METHODS: Flow determinations were
      obtained in a model of fluid movement approximating blood-flow conditions in the
      portal venous system. A suitable protocol was based on consideration of the
      theoretical effects of (1) spatial resolution, (2) obliquity of the imaging plane
      to the direction of flow, and (3) signal-to-noise ratio of the signed
      quantitative velocity images (in three volunteers) on the accuracy and precision
      of flow measurements. This protocol was used to obtain cine phase-contrast MR
      images of the portal venous system in five volunteers and six patients. RESULTS:
      Values obtained with a flow phantom showed good accuracy of cine phase-contrast
      measured vs actual volumetric flow rate (r = .995; p = .0001; MR rate = [0.94 x
      actual rate] + 65.6 ml/min; standard error of the y estimate = 67.3 ml/min).
      Velocity encoding and section thickness substantially influenced the signal-to
      noise ratio of the velocity images, whereas flip angle and matrix size had only
      minimal effect. In volunteers and patients, portal volumetric flow rates
      determined by using MR images and Doppler sonography showed good correlation (r =
      .94; p = .0003). CONCLUSION: Our results indicate that cine phase-contrast MR
      imaging is a practical noninvasive method for measuring volumetric flow rates in
      the portal venous system.

PMID- 8470591
TI  - Collapse of a Palmaz stent in the subclavian vein.

PMID- 8470592
TI  - Leiomyosarcoma of the femoral vein: imaging findings.

PMID- 8470593
TI  - Implantation of P.A.S. Port venous access device in the forearm under
      fluoroscopic guidance.

PMID- 8470594
TI  - Cutaneous T-cell lymphoma: value of CT in staging and determining prognosis.
AB  - OBJECTIVE: The usefulness of CT in diagnosing, staging, and establishing the
      prognosis in cutaneous T-cell lymphoma was assessed. CT abnormalities indicative
      of the disease, diffuse peripheral adenopathy and skin lesions, as well as less
      specific signs of generalized lymphoma, were correlated with clinical findings.
      MATERIALS AND METHODS: The study group comprised 33 patients from a total of 87
      with pathologically proved cutaneous T-cell lymphoma who were seen at the
      University of Pittsburgh Medical Center between 1986 and 1991 and who had CT
      scans. All patients had body CT imaging with contiguous axial sections no thicker
      than 10 mm of the chest, abdomen, and pelvis; other CT studies were performed as
      clinically indicated. Because of the cutaneous nature of this lymphoma,
      collimation included the skin surface. RESULTS: In 10 of the 33 patients, all of
      whom had stage II or higher disease, abnormalities indicative of cutaneous T-cell
      lymphoma were seen on CT scans. All 10 had multiple areas of focal skin
      thickening or plaques several centimeters or more in diameter and 5 mm or greater
      in thickness affecting the dermal tissues while leaving the subcutaneous fat
      intact. Extension of individual lesions below the dermis was associated with the
      development of squamous cell cancers in two patients, both of whom had previous
      topical therapy. Seven of the 10 also had an unusual pattern of lymphadenopathy:
      the mediastinum or paraaortic regions were spared while enlarged peripheral nodes
      were seen in both the axillary and inguinal areas. Skin abnormalities were seen
      on CT scans of all patients with lymphadenopathy. CONCLUSION: CT findings in
      cutaneous T-cell lymphoma are related to the pathophysiology of the disease:
      cutaneous plaques and diffuse peripheral adenopathy that spare the mediastinal
      and paraaortic lymph nodes. Although the skin lesions can be easily evaluated
      clinically, secondary malignant neoplasms arising in treated skin lesions can be
      found with CT by their extension into the subcutaneous fat.

PMID- 8470595
TI  - AIDS-related non-Hodgkin's lymphoma: abdominal CT findings in 112 patients.
AB  - OBJECTIVE: Non-Hodgkin's lymphoma is a common complication in patients with HIV
      infection. The purpose of this study was to analyze the abdominal CT findings in
      a large series of patients with this condition. MATERIALS AND METHODS: We
      retrospectively reviewed the abdominal CT examinations of 110 men and two women
      (21-62 years old; average, 39 years) with untreated AIDS-related lymphoma, as
      defined by the Centers for Disease Control. Lymphoma was the initial AIDS
      defining illness in 79% of the patients. RESULTS: Abdominal CT scans showed
      normal findings or only mild enlargement of the liver or spleen in 36% of the 112
      patients, whereas evidence of intraabdominal lymphoma was seen in 64%. Evidence
      of focal lymphomatous involvement was seen on abdominal CT scans in 58 (98%) of
      59 patients in whom the predominant signs and symptoms were related to the
      abdomen and in 14 (26%) of 53 patients with extraabdominal signs or symptoms. In
      the 64% of patients with evidence of intraabdominal lymphoma, lymph node
      enlargement was seen in 56% and extranodal disease was seen in 86%. Extranodal
      sites of involvement in the 72 patients with evidence of intraabdominal lymphoma
      included the gastrointestinal tract (54%), liver (29%), kidney (11%), adrenal
      gland (11%), lower genitourinary tract (10%), spleen (7%), peritoneum and omentum
      (7%), pancreas (5%), epidural space (4%), bone (3%), and muscle (1%). Mild
      enlargement of the liver or spleen was present in a minority of cases. Moderate
      or marked hepatomegaly (cephalocaudal span > 20 cm) and splenomegaly
      (cephalocaudal span > 15 cm) were even less common and occurred only in the
      presence of focal hepatic lesions. CONCLUSION: Our results show that AIDS-related
      lymphoma may affect any abdominal organ, most commonly lymph nodes, the
      gastrointestinal tract, liver, kidney, and adrenal gland. Hepatic or splenic
      enlargement was uncommon and was not often seen as an isolated finding in the
      absence of evidence of abdominal lymphoma.

PMID- 8470596
TI  - Department of Radiology, Massachusetts General Hospital: a brief history.

PMID- 8470597
TI  - Nominal dysphasia redux.

PMID- 8470598
TI  - Removing red arrows efficaciously.

PMID- 8470599
TI  - Calcified pulmonary metastases from a cardiac angiosarcoma.

PMID- 8470600
TI  - Severe nodulocystic acne causing "ring lesions" on mammograms.

PMID- 8470601
TI  - Colonic diaphragms associated with long-term use of nonsteroidal antiinflammatory
      drugs.

PMID- 8470602
TI  - Small-bowel leiomyosarcoma mimicking urachal carcinoma: CT findings.

PMID- 8470603
TI  - Visceral calcifications in patients with AIDS.

PMID- 8470604
TI  - Sonographic demonstration of skeletal muscle invasion by lymphoma.

PMID- 8470605
TI  - Crossed cerebellar diaschisis and atrophy: the role of intractable seizures.

PMID- 8470606
TI  - John Caffey Award. Colonic perforation by air and liquid enemas: comparison study
      in young pigs.
AB  - OBJECTIVE: Hydrostatic enema reduction of intussusception in children has been
      replaced by pneumatic reduction in a number of institutions. Colonic perforation
      occurs in as many as 2.8% of enema reductions, and questions persist about the
      relative safety of enemas performed with air vs fluid. The objectives of this
      study were to investigate and compare the pathologic patterns of in vivo colonic
      perforation and fecal spillage in young pigs given air and hydrostatic enemas,
      with and without the Valsalva maneuver. MATERIALS AND METHODS: Colonic
      perforations were induced in 135 juvenile pigs. The pigs were divided into five
      groups, and enemas with air, barium, and water-soluble contrast material were
      given with and without the Valsalva maneuver to induce the perforations. During
      the enemas, the Valsalva maneuver was observed when the animals strained. In each
      animal, the enema was continued and pressure increased until a perforation was
      detected with fluoroscopy. Radiographic, gross, and histologic examinations of
      each animal were performed after perforations occurred. Differences in fecal
      spillage were noted, and the morphologic variations of the perforations and the
      surrounding tissue were determined. RESULTS: Perforations with hydrostatic
      (barium, water-soluble) enemas occurred at approximately 120 mm Hg of pressure
      (average bag height, 57 in. [143 cm]). No significant variations were found
      between the type of material used for contrast or the use of the Valsalva
      maneuver. With air enemas, perforations occurred at a mean pressure of 108 mm Hg
      without the Valsalva maneuver and at 145 mm Hg with the Valsalva maneuver.
      Perforations during air enemas did not occur during the Valsalva maneuver
      (pressures as high as 270 mm Hg), but rather between Valsalva maneuvers.
      Hydrostatic enemas produced full-thickness tears that were larger than those
      induced by air enemas in all cases. Air enemas with and without the Valsalva
      maneuver produced partial-thickness tears in 45% and 10%, respectively, of the
      pigs. Fecal spillage was diffuse in all hydrostatic perforations. In air enemas,
      spillage was focal in 55% and 90%, respectively, and absent in 45% and 10%,
      respectively, of perforations produced with and without the Valsalva maneuver.
      CONCLUSION: Our results suggest that air enemas are safer than liquid enemas.
      Perforations that occurred during air enemas were smaller and associated with
      less fecal spillage and peritoneal contamination. The Valsalva maneuver appears
      to prevent colonic perforation during air enemas.

PMID- 8470607
TI  - Medicine in American art. The Agnew Clinic.

PMID- 8470608
TI  - The role of MR imaging in carcinoma of the urinary bladder.
AB  - In this article, the role of MR imaging in the management of carcinoma of the
      urinary bladder is reviewed and illustrated. The appearance of the normal urinary
      bladder and of bladder carcinoma on MR images is shown. Important factors for
      optimal MR imaging of urinary bladder carcinoma are reviewed. New developments
      such as three-dimensional and fast spin-echo sequences and the use of contrast
      agents, endorectal imaging, and phased array coils are discussed. Finally, the
      value of MR imaging in the staging of bladder carcinoma is described, and MR
      staging is compared with clinical staging, staging based on findings from
      intravesical sonography, and CT staging.

PMID- 8470609
TI  - MR imaging of the corpus callosum.
AB  - The corpus callosum is the major axonal commissure of the brain, connecting the
      two cerebral hemispheres and providing communication between the cortical and
      subcortical neurons. With MR imaging in the sagittal plane, the corpus callosum
      can be depicted in great detail. We review the normal anatomy, development, and
      process of myelination of the corpus callosum. The MR features of various
      pathologic conditions involving the corpus callosum are described. Finally, we
      discuss the evolving role of MR imaging in neuropsychiatric diseases with respect
      to the corpus callosum.

PMID- 8470610
TI  - Sonography of the upper extremity and jugular veins.
AB  - Color Doppler sonography is a useful technique for rapid, noninvasive evaluation
      of venous disease in the upper extremity. It has been used successfully to
      evaluate thrombosis related to indwelling central catheters. In addition, Doppler
      sonography shows promise for monitoring thrombolytic therapy after "effort
      thrombosis" and detecting intermittent venous compression related to thoracic
      outlet syndrome.

PMID- 8470611
TI  - MR imaging of the myocardium using nonionic contrast medium: signal-intensity
      changes in patients with subacute myocardial infarction.
AB  - OBJECTIVE: Gadodiamide injection (Omniscan, Sanofi Winthrop Pharmaceuticals, New
      York) is a new nonionic MR contrast medium that has been shown in animal studies
      to provide persistent differential enhancement of myocardial infarction. Because
      differential enhancement of normal and infarcted myocardium may be useful for the
      diagnosis and sizing of myocardial infarctions, we assessed the effectiveness of
      gadodiamide injection in enhancing signal-intensity differences between infarcted
      and normal myocardium on spin-echo T1-weighted images. SUBJECTS AND METHODS:
      Signal intensity of normal and infarcted myocardium, contrast ratio, contrast-to
      noise ratio, and signal-to-noise ratio were measured in 12 patients with subacute
      myocardial infarction (mean, 16 days after diagnosis) before and after injection
      of contrast medium. Precontrast T1-weighted and T2-weighted images were obtained
      with a 1.5-T MR imager. T1-weighted images were acquired 5, 15, and 30 min after
      gadodiamide injection (0.2 mmol/kg) and T1-weighted images with fat saturation
      were acquired 10 min after gadodiamide injection. RESULTS: Gadodiamide injection
      significantly increased signal intensity of normal (34 +/- %) and infarcted (90
      +/- %) myocardium compared with their signal intensities on precontrast T1
      weighted images. The contrast ratio was significantly increased, and the
      augmented ratios persisted throughout the 45-min observation period. The contrast
      ratio on T2-weighted images was comparable to that on contrast-enhanced T1
      weighted images (with or without the use of fat saturation). However, the signal
      to-noise and contrast-to-noise ratios of T2-weighted images were significantly
      lower than those of contrast-enhanced T1-weighted images. The maximum contrast-to
      noise ratio for visualizing myocardial infarction was achieved on contrast
      enhanced T1-weighted images with fat saturation. CONCLUSION: Improved and
      persistent contrast between infarcted and normal myocardium can be produced on MR
      images by injecting gadodiamide at a dose of 0.2 mmol/kg, which provides
      prolonged delineation of myocardial infarctions. Maximum contrast-to-noise ratios
      for detecting myocardial infarction can be produced by using fat-saturated T1
      weighted imaging after a high dose of this nonionic contrast medium has been
      administered.

PMID- 8470612
TI  - Aortic valve pressure gradients in patients with aortic valve stenosis:
      quantification with velocity-encoded cine MR imaging.
AB  - OBJECTIVE: Pressure gradients across the aortic valve due to stenosis of the
      valve must be measured accurately to evaluate the functional severity of the
      stenosis. Velocity-encoded cine MR has been used to quantify blood flow and flow
      direction and, more recently, the regurgitant fraction in aortic regurgitation.
      The purpose of this study was to determine the feasibility and accuracy of
      velocity-encoded cine MR for estimating pressure gradients across the aortic
      valve in patients with aortic stenosis. SUBJECTS AND METHODS: We used velocity
      encoded cine MR to measure flow velocity and determine pressure gradients across
      the aortic valve in 19 subjects. The pressure gradient (delta P) was estimated
      from the simplified Bernoulli equation by using the maximum instantaneous aortic
      jet velocity (Vmax): delta P (mm Hg) = 4V2max (m/sec). RESULTS: Maximum and mean
      systolic pressure gradients determined by using velocity-encoded cine MR were 3
      148 mm Hg and 2-87 mm Hg, respectively, for all subjects. The pressure gradients
      correlated closely with gradients determined by using established methods:
      Doppler echocardiography and cardiac catheterization. Correlation coefficients
      (r) were .96 (y = 0.94x - 1.9) and .97 (y = 0.97x + 0.5), respectively.
      CONCLUSION: We conclude that velocity-encoded cine MR imaging provides a
      noninvasive and accurate means for quantifying the severity of valvular aortic
      stenosis. MR is a feasible method for determining pressure gradients across the
      aortic valve.

PMID- 8470613
TI  - Determination of cardiac ejection fraction and left ventricular volume: contrast
      enhanced ultrafast cine MR imaging vs IV digital subtraction ventriculography.
AB  - OBJECTIVE: To assess the accuracy of contrast-enhanced, single breath-hold cine
      MR imaging in the calculation of left ventricular volume and ejection fraction,
      we compared values obtained by using this method with those obtained by using IV
      digital subtraction angiography (IV-DSA). SUBJECTS AND METHODS: All patients (n =
      28) had conventional cine and contrast-enhanced ultrafast cine MR imaging. For
      ultrafast cine MR imaging, a phase-rewind gradient-echo (rewind-SMASH) sequence
      was used: TR, 8 msec (standard excitation and acquisition block of 6 msec with
      phase rewind pulse of 2 msec); TE, 3.2 msec; a 128 x 96 matrix (pile encode
      factor, 6; k-space segment, 16); a 200-mm field of view; and one excitation.
      RESULTS: Values for left ventricular volume and ejection fraction obtained with
      ultrafast cine MR imaging correlated well with those obtained with IV-DSA (end
      diastolic volume, y = 0.986x - 7.79, r = .985; end-systolic volume, y = 0.863x +
      0.71, r = .984; ejection fraction, y = 0.877x + 6.44, r = .887). In the
      calculation of left ventricular volume by the area-length method, manual tracing
      of the left ventricular cavity was more difficult when the conventional cine
      method was used than when the enhanced ultrafast cine method was used.
      CONCLUSION: Our results show that cardiac multiphase study with horizontal long
      axis, first-pass, contrast-enhanced, single breath-hold, cine MR imaging is an
      accurate and highly reproducible method of evaluating left ventricular volume and
      ejection fraction.

PMID- 8470614
TI  - Chest radiographic and CT findings after laser-assisted thoracic surgery.
AB  - OBJECTIVE: Laser-assisted thoracic surgery (performed through a thoracotomy or as
      an endoscopic procedure with thoracoscopy [pleural endoscopy]) is being used
      increasingly for lung-sparing resections of neoplasms, biopsies, and ablation of
      bullae. The technique is useful in treating patients who have limited pulmonary
      reserve and may avoid the problem of distortion of surrounding pulmonary tissue.
      Because laser energy causes injury to lung tissue, postoperative radiographs may
      show findings unique to the laser-assisted technique. The objective of this study
      was to determine postoperative radiographic findings common to laser-assisted
      surgery. MATERIALS AND METHODS: Pre- and postoperative and all follow-up chest
      radiographs were reviewed for 52 consecutive patients who had 60 laser-assisted
      thoracic surgical procedures (35 with an open thoracotomy, 25 with thoracoscopy)
      for resection of peripheral nodules (40), biopsy of focal (five) or diffuse
      (four) lung disease, or ablation of bullae (three). Postoperative chest CT
      studies available for 20 patients also were reviewed. All postoperative
      radiographic studies were evaluated for the presence and duration of
      pneumothoraces, pleural effusions, areas of parenchymal opacification or
      cavitation, and complications requiring surgical or radiologic intervention.
      RESULTS: Pneumothoraces and pleural effusions were seen in 88% and 83% of cases,
      respectively, and were typically small, uncomplicated, and of limited duration.
      Nonspecific parenchymal opacification of various degrees was observed at the
      operative site in all cases and usually regressed within days or weeks to areas
      of parenchymal scarring. Parenchymal cavitation at the operative site occurred in
      15 patients (29%). Eight patients (15%) had complications that required
      intervention, primarily prolonged air leaks and pleural space complications.
      CONCLUSION: Radiographic findings after laser-assisted thoracic surgery are often
      nonspecific and of limited duration. In an asymptomatic patient, cavitation at
      the operative site is a normal finding related to the surgical technique and
      should not be misdiagnosed as infection or tumor. Radiographic findings normally
      resolve to stable cavitary or linear scars.

PMID- 8470615
TI  - Quality improvement techniques: value to improve the timeliness of preoperative
      chest radiographic reports.
AB  - OBJECTIVE: Continuous quality improvement is being advocated as a process that,
      if adopted, could lead to greater efficiency and productivity in medical
      institutions. To determine whether continuous quality improvement techniques
      could be effective in radiology departments, we undertook a model project that
      sought to improve our ability to interpret preoperative chest radiographs before
      surgery. All the preoperative films had been ordered by internists who
      determined, after seeing the patient, that the radiographic examination was
      warranted. MATERIALS AND METHODS: An eight-member team consisting of all persons
      involved in obtaining and interpreting preoperative chest radiographs was
      empowered to evaluate the existing process and make appropriate changes.
      Techniques used included studying and plotting the process, collecting data on
      the causes of delay, and basic statistical analysis of the data using histograms,
      Pareto diagrams, and control charts. On the basis of the data analysis, the team
      instituted changes, which included identifying the preoperative cards with a
      small flag, placing the processed films in yellow-colored jackets, and collating
      these jacketed films after their interpretation. RESULTS: After continuous
      quality improvement intervention, when the process for obtaining and interpreting
      preoperative radiographs was modified, the percentage of chest radiographs
      interpreted before surgery improved from approximately 83% to 98% (p < .001). The
      average waiting period between patient check-in at the outpatient reception area
      and interpretation of the preoperative chest radiograph was reduced from 275 to
      77 min, a 72% reduction (p < .0302). CONCLUSION: Adoption of the quality
      improvement techniques of analyzing customer-supplier relations, understanding
      the causes of variation, and using data to solve problems appears to be a
      desirable management option that should be considered by all medical institutions
      interested in maximizing the quality of care offered while concurrently
      minimizing its cost.

PMID- 8470616
TI  - Screening for colon cancer: programs of the American College of Radiology.

PMID- 8470617
TI  - Consultants listing--January 1993.

PMID- 8470618
TI  - A comparison of controlled negative pressure and aerosol quantitative respirator
      fit test systems by using human subjects.
AB  - A quantitative respirator fit test system based on controlled negative pressure
      was evaluated by comparison testing with a computerized aerosol fit test system.
      Experiments ranged from multiple sequential tests of a single subject wearing a
      respirator equipped with a series of fixed leaks to sequential fit tests of 125
      U.S. Air Force personnel using both systems. Throughout each test phase, measured
      negative pressure fit factors were consistently more conservative and less
      variable than aerosol fit factors. Comparison of subject and fixed leak fit
      factors indicated significant loss of aerosol during subject fit tests. Negative
      pressure system results did not show any effect from subject-related losses.

PMID- 8470619
TI  - Managing workplace exposure information.
AB  - A quality industrial hygiene program must include the collection and management
      of workplace exposure information. For many industrial hygienists, however,
      exposure monitoring data are the only exposure information available. Often,
      there is no attempt to qualitatively estimate and document all known exposures
      because mechanisms for doing so are not widely available. Industrial hygienists
      and other occupational health professionals generally lack information that
      provides sufficient knowledge and understanding about most employee exposures.
      The subject of this paper is a description of one company's approach to
      collecting and managing exposure information through a Job Exposure Profile (JEP)
      system. The JEP system provides a concise and detailed summary of exposure
      information for defined exposure groups that can be tracked over time. The value
      of the system lies in its simplicity and versatility, both as a dynamic tool to
      be incorporated into a comprehensive occupational health program and as a
      historical document. The system serves as an effective method for identifying and
      focusing on significant health hazards for each job at a facility from industrial
      hygiene, medical, epidemiologic, and engineering perspectives.

PMID- 8470620
TI  - Leakage of latex and vinyl exam gloves in high and low risk clinical settings.
AB  - The purpose of this study was to compare leakage rates of used latex and vinyl
      examination gloves from high and low risk clinical units. A total of 4838 latex
      and 1008 vinyl examination gloves were collected and tested by the Food and Drug
      Administration (FDA) watertight leak test: three brands of latex [Brand A: n =
      2920; Brand B: n = 284; Brand C: n = 1634; and one brand of vinyl gloves (Brand
      D: n = 1008]. Seventy percent of latex gloves and 46.7% of vinyl gloves were
      collected from the high risk units. In general, there were no significant
      differences in leakage rates for vinyl gloves between high and low risk units.
      However, latex gloves leaked significantly more often at stress levels 2 and 3
      from the high risk units as compared to the low risk units (X2 = 24.6, p <
      .0001). Regardless of level of stress and duration worn, 85.3% (860/1008) of used
      vinyl gloves and 18.4% (891/4838) of used latex gloves leaked, p < .001). There
      were significant differences in leakage rates between the three brands of latex
      gloves (Brand A, 9.8%; Brand B, 25.1%; Brand C, 30.9%, p < .001). Although latex
      gloves leaked slightly more frequently as stress level increased, glove material
      (latex or vinyl) and brand of glove were the most important predictors of
      leakage.

PMID- 8470621
TI  - Methylene chloride exposure in industrial workers.
AB  - Methods of environmental and biological monitoring were applied in order to
      evaluate exposure to methylene chloride in workers operating in a factory where
      this substance was used as a solvent. For the measurement of methylene chloride
      in environmental concentration, the ambient air was sampled by using personal
      passive dosimeters. The activated charcoal was desorbed with CS2 and injected
      into a gas chromatograph connected with a mass spectrometer. The biological
      monitoring of exposed workers was performed by determining the concentration of
      CO in alveolar air (CA, ppm) and methylene chloride in urine (Cu, mu/L).
      Immediately after the end of the exposure, a urine sample was collected avoiding
      solvent loss and using gas-tight samplers. Excretion level in urine was
      determined by using headspace gas chromatography linked to a mass spectrometer.
      The CO was determined at the end of the shift by using a portable instrument. A
      group of 20 workers (12 smokers and 8 nonsmokers) in the manufacturing plant were
      monitored. No significant correlation was observed among the CO of all subjects
      and the concentration of methylene chloride in ambient air. When those workers
      who smoked were removed from the analysis, a correlation between the methylene
      chloride concentration in air and the CO concentration in alveolar air was found.
      Significant linear correlation was found between the environmental concentration
      of methylene chloride in the breathing zone and methylene chloride concentration
      in urine.

PMID- 8470622
TI  - An analytical approach for reducing workplace health hazards through
      substitution.
AB  - Substitution for a harmful chemical implies that the desired function is
      maintained without using the harmful chemical in question. Improvement can be
      achieved if a less harmful chemical can be used or the same function obtained by
      changing the process and eliminating the harmful chemical agent. In 1982, Denmark
      introduced an authority regulation requiring substitution if functional and
      economical alternatives exist. This paper summarizes the results of 162 examples
      of substitution investigated by the Danish Occupational Health Services. The
      identification and implementation of substitution alternatives is described as an
      iterative process with seven distinct steps. Several tools that are useful in
      evaluating alternatives are described, including Hansen solubility parameters and
      vapor hazard ratios. In addition to the technical issues surrounding
      substitution, this paper describes the social interactions necessary to include
      all affected individuals, along with those having the proper expertise in the
      decision-making process. The use of the described methods may result in a safer
      work-place by eliminating certain hazardous chemicals or practices that have
      historically been used in specific industries.

PMID- 8470623
TI  - pH and Hp--gastric acid secretion and Helicobacter pylori: implications for ulcer
      healing and eradication of the organism.

PMID- 8470624
TI  - The accuracy of endoscopic estimates: what is large? What is small?

PMID- 8470625
TI  - Erythromycin: a motilin agonist and gastrointestinal prokinetic agent.
AB  - Erythromycin, a commonly used antibiotic, has recently emerged as a potential
      gastrointestinal prokinetic agent. This follows a decade of research into the
      mechanism of well-recognized gastrointestinal side effects of erythromycin. Early
      investigations demonstrated that erythromycin increased gastrointestinal
      motility, and more recent studies suggest that it fortuitously binds to and
      stimulates the receptor for the gastrointestinal peptide motilin. From this work
      it appears that a new and powerful class of gastrointestinal prokinetic agents
      will evolve from erythromycin and its derivatives. The role of motilin in the
      genesis of the fasting and fed patterns of gastrointestinal motility is emerging
      through the study of these motilin agonists.

PMID- 8470626
TI  - Omeprazole plus amoxicillin: efficacy of various treatment regimens to eradicate
      Helicobacter pylori.
AB  - In five subsequent open clinical studies, 180 patients with Helicobacter pylori
      (HP)-associated ulcer disease (n = 163) or severe functional dyspepsia (n = 17)
      requiring therapy were treated with either 40 mg omeprazole plus 4 x 500 mg
      amoxicillin suspension for 1 wk (group I, n = 35), 2 x 40 mg omeprazole plus 4 x
      500 mg amoxicillin for 1 wk (group II, n = 50), 2 x 20 mg omeprazole plus 4 x 500
      mg amoxicillin for 2 wk (group III, n = 62), 2 x 20 mg omeprazole (day 1-14) and
      4 x 500 mg amoxicillin (day 8-14) (group IV, n = 22) or with 2 x 20 mg omeprazole
      for 2 wk (group V, n = 11). The HP eradication rates determined with a biopsy
      urease test, microscopy of a mucosal smear, specific culture, and histology after
      modified GIEMSA staining in the 5th wk after discontinuation of study medication
      were 61.3% in group I, 61.7% in group II, 82.8% in group III, 28.6% in group IV,
      and 0% in group V. Apart from clinical insignificant pharyngeal paresthesias (n =
      6), nine patients (5.7%) with combined therapy complained of important side
      effects (stomatitis: n = 3, diarrhea: n = 3, allergic exanthema: n = 3) that led
      to termination of amoxicillin treatment in four cases (2.5%). We conclude that
      omeprazole-enhanced amoxicillin antibiosis is a simple and effective approach to
      the eradication of HP colonization.

PMID- 8470627
TI  - Are endoscopic measurements of colonic polyps reliable?
AB  - Many clinical studies of colorectal adenomatous polyps rely on endoscopic
      estimation of polyp size. To examine the reliability of such measurements, we
      conducted a study using artificial polyps in an endoscopy teaching model. Eight
      experienced endoscopists estimated the size of 13 polyps in two separate sessions
      2 wk apart. Endoscopic estimates of polyp size tended to be significantly lower
      than the true polyp size for all polyps and all endoscopists at both sessions. We
      also found a statistically significant difference in the magnitude of the
      underestimation between the first and second session (p < 0.0001). At the first
      session, polyps tended to be estimated at 64% of their true size, and at the
      second session, the estimates tended to be at 77% of the actual polyp size. We
      estimate the magnitude of the variation in polyp measurements due to individual
      polyps, endoscopist, and examination session, and discuss the impact these
      sources of variation have in planning of clinical trials.

PMID- 8470628
TI  - Placement of a feeding button ("one-step button") as the initial procedure.
AB  - The procedure of choice for enteral feeding access is now percutaneous endoscopic
      gastrostomy (PEG). Standard PEG tubes have the disadvantages of clogging, stomal
      enlargement, and external bulkiness. Button replacement tubes can covert the more
      cumbersome PEG tubes to low external profile devices. A procedure and an early
      experience is described for placement of a button as a single-step procedure.
      This procedure is an over-the-wire, "push" procedure. Sixty-nine buttons were
      placed, 47 (61%) for neurologic reasons and 22 (32%) for cancer and other
      reasons. In 49 of the 69 (71%), there was no difficulty at all with insertion,
      and in only two (3%) could the button not be placed. Complications were assessed
      at 48 h and at 3 wk. No complications were found in 61 (90%). In only two
      patients (3%) were there serious complications (gastro-colon-cutaneous fistula
      and "peritonitis"). The One-Step Button represents a rapid, safe procedure for
      the placement of a low-profile PEG with its attendant advantages.

PMID- 8470629
TI  - Patient factors affecting Helicobacter pylori eradication with triple therapy.
AB  - Duodenal ulcer recurrence and gastritis are reduced with successful Helicobacter
      pylori treatment. To identify the patient factor influencing H. pylori
      eradication, we prospectively evaluated 96 consecutive patients undergoing a
      single 2-wk course of bismuth, tetracycline, and metronidazole therapy. At the
      time of initial esophagogastroduodenoscopy with biopsies, each patient had a
      profile obtained which included demographic information, gastrointestinal
      pathology, and H. pylori status of the spouse. Elimination of H. pylori was
      confirmed by repeat esophagogastroduodenoscopy with biopsies 4 wk after the
      completion of therapy and serial urea breath tests. Eradication at 4 wk was
      successful in 80 of 96 (83%) patients. On multivariate analysis, H. pylori
      elimination was associated with advanced age (p = 0.002) and a greater amount of
      chronic inflammation on baseline antral biopsy (p = 0.024). Eradication was
      inversely associated with the presence of a gastric ulcer (p = 0.008) and lack of
      medication compliance (p = 0.030). Successful eradication reduced the severity of
      both acute and chronic antral mucosal inflammation. Household income, gender,
      ethnic group, smoking, alcohol intake, and H. pylori status of the spouse did not
      differ between the eradicated and noneradicated groups. We conclude that it will
      be important to control for influential patient factors in future studies of H.
      pylori treatment regimens.

PMID- 8470630
TI  - Esophagitis and Helicobacter pylori in children: incidence and therapeutic
      implications.
AB  - The relationship between gastric Helicobacter pylori colonization and esophagitis
      was determined in 457 children undergoing endoscopic evaluation of abdominal pain
      and/or vomiting. In all patients, biopsies of the esophagus were examined
      histologically, and two antral biopsies were analyzed for the presence of H.
      pylori, using standard microbiological and histochemical techniques. The
      incidence of biopsy-proven esophagitis was similar in H. pylori-positive (15/56
      patients) and -negative (94/401; p = NS) groups. Clinical improvement, after 2
      months of antisecretory therapy with H2-receptor antagonists, was independent of
      H. pylori status (11/15 vs. 68/94 responders; p = NS). All 26 H. pylori-negative
      nonresponders became asymptomatic with a second course of H2-blockers. The 4/15
      H. pylori-positive patients (all of whom had associated gastritis/duodenitis) who
      failed antisecretory therapy responded clinically to treatment with amoxicillin
      plus bismuth subsalicylate. These data indicate that primary treatment of biopsy
      confirmed esophagitis in children should include anti-secretory agents,
      regardless of H. pylori status. A small percentage of H. pylori-positive patients
      with esophagitis and concomitant gastroduodenal inflammation may require
      additional antibacterial therapy, suggesting that presence of the organism should
      be assessed in all pediatric patients undergoing upper endoscopic evaluation.

PMID- 8470631
TI  - Survival and prognostic factors of cirrhotic patients with ascites: a study of
      134 outpatients.
AB  - Ascites is a complication of chronic liver disease that is associated with
      decreased survival. The purpose of the present study was to identify some
      prognostic factors easily obtainable by the clinician in a large group of
      cirrhotic patients with ascites, possibly useful for first screening of
      outpatients as candidates for liver transplantation. We studied 134 ambulatory
      patients with cirrhosis who came to our outpatient clinic between July 1983 and
      March 1989 because of an episode of ascites. These patients were then followed up
      for an average period of 31 +/- 23 months and survival was determined. Thirty-one
      variables determined at the time of inclusion were analyzed with a Cox
      proportional hazards model to identify predictors of mortality. Cumulative
      mortality as of June 30, 1991, was 59%. Factors independently correlated with
      death were: refractory ascites (relative risk, 4.78), low albumin levels (3.77),
      high Child-Pugh score (3.31), encephalopathy (2.71), high bilirubin levels
      (2.03), high gamma-glutamyl-transferase levels (1.87), and old age (1.57). The
      results show that 1) the occurrence of refractory ascites has a prognostic value
      superior to those of other variables, and 2) simple clinical and biochemical
      parameters, most of them components of the Child-Pugh score, are useful for a
      first screening of ascitic cirrhotic patients as candidates for liver
      transplantation.

PMID- 8470632
TI  - Ranitidine is effective therapy for erosive esophagitis.
AB  - Two ranitidine dosages were compared for the treatment of erosive esophagitis in
      a multicenter, double-blind, randomized, parallel-group, placebo-controlled
      study. Adults with endoscopically verified erosive esophagitis were treated with
      either ranitidine 150 mg four times daily (n = 106), ranitidine 300 mg four times
      daily (n = 106), or placebo (n = 116) for up to 12 wk. Patients were also
      encouraged to adhere to lifestyle modifications (e.g., to elevate the head of
      bed, etc). Erosive esophagitis healing, determined by endoscopy, was achieved in
      69% and 62% of ranitidine-treated patients by 8 wk and in 79% and 74% by 12 wk
      (150 mg and 300 mg, respectively) compared with 28% of placebo-treated patients
      by 8 wk and 40% by 12 wk (p < 0.001 ranitidine vs. placebo). Onset of heartburn
      relief occurred within 24 h of initiating either ranitidine dosage, and relief
      was maintained throughout the 12-wk study. Both ranitidine dosages displayed
      safety profiles similar to that of placebo. We conclude that ranitidine 150 mg or
      300 mg administered four times daily is effective for healing erosive esophagitis
      and relieving its symptoms.

PMID- 8470633
TI  - Correlation between esophageal motility and 24-hour pH recording in patients with
      gastroesophageal reflux.
AB  - The relationship between manometric and pH-metric data was studied in a group of
      50 patients with symptoms of gastroesophageal reflux. Using a multiple regression
      analysis, we found that the total percentage of reflux was significantly
      correlated to the infradiaphragmatic length and resting pressure of the lower
      esophageal sphincter and also to the mean amplitude of the contractile waves of
      the distal esophagus, thus revealing the important role of these factors in the
      antireflux mechanism. When the patients were divided into groups according to
      their manometric characteristics and the values of the various pH-metric
      parameters between these groups compared using a one-way analysis of variance, we
      found that the amplitude of the contractile waves and the percentage of
      deglutitions without response were related not only to the total percentage of
      reflux but also to the number of reflux episodes of greater than 5 min duration
      and to the duration of the longest episode. This shows that prolonged exposure of
      the esophageal mucosa to the refluxed material may be due, in part, to an
      alteration in the capacity for esophageal clearing.

PMID- 8470634
TI  - Nifedipine for suspected type II sphincter of Oddi dyskinesia.
AB  - Endoscopic sphincterotomy may be the treatment of choice in type I sphincter of
      Oddi dyskinesia, but in type II dyskinesia the results are controversial, the
      complication rate may be high, and technically endoscopic sphincterotomy is not
      always possible. Nifedipine has been observed to relax the sphincter of Oddi and
      to enhance biliary drainage, especially in patients suffering from sphincter of
      Oddi dyskinesia. Therefore, nifedipine (10 mg, three times a day) was compared
      with placebo in treating suspected type II sphincter of Oddi dyskinesia in 13
      cholecystectomized patients in a 16-wk study period in a double-blind "cross
      over" manner. Daily, the patients completed a diary of the pains, need of pain
      medication, and headache. Clinical examinations and blood tests for liver
      chemistry were performed at 4-wk intervals. Nifedipine diminished the number of
      days on which the patients experienced biliary-type pains (10.5 +/- 8.6 vs. 5.8
      +/- 4.1, p = 0.042), and the number of days when pain medication was needed was
      slightly reduced (5.2 +/- 3.9 vs. 3.6 +/- 3.2, p = 0.066). After the study, one
      patient preferred to undergo endoscopic sphincterotomy, eight patients preferred
      to continue with nifedipine, and four patients preferred analgesics only. Liver
      chemistry remained unchanged in this study. Also heart rate, blood pressure, and
      the number of days of headache were not different between the nifedipine and
      placebo periods. We conclude that nifedipine is well tolerated in patients with
      type II sphincter of Oddi dyskinesia, and nifedipine may be tried for reducing
      the number of painful days and need for analgesics in patients with this
      disorder.

PMID- 8470635
TI  - The usefulness of endoscopic retrograde cholangiopancreatography in infants and
      small children.
AB  - We performed endoscopic retrograde cholangiopancreatography (ERCP) on nine
      infants and small children over a period of 7 yr from 1985 to 1991. In three
      infants, diagnosis on admission was congenital biliary atresia or neonatal
      hepatitis. In one, congenital biliary atresia was diagnosed by ERCP. In the other
      six cases, diagnosis on admission was congenital biliary dilation, acute
      cholangitis, or acute pancreatitis. In five, we diagnosed the anomalous
      arrangement of the pancreaticobiliary ductal system by ERCP. ERCP is a relatively
      easy and safe technique when applied to infants and small children. It is also a
      useful procedure when making morphologic diagnosis of organic disorders around
      the biliary and pancreatic ductal system, such as biliary atresia, intrahepatic
      cholestasis, and the anomalous arrangement of the pancreaticobiliary ductal
      system. It enables us to determine the surgical procedure and to investigate the
      residual bile duct after surgical treatment. Therefore, ERCP should be conducted
      on infants and small children who may be suffering from disorders of the
      pancreaticobiliary system.

PMID- 8470636
TI  - A study of the frequency of recovery of unexpected Giardia lamblia and
      Cryptosporidium from duodenal aspirates taken during routine upper endoscopy.
AB  - In this study, our objective was to determine whether the microscopic examination
      of duodenal aspirates recovered during routine upper endoscopy in unselected,
      immunocompetent patients, would disclose unsuspected Giardia lamblia or
      Cryptosporidium. DESIGN: Prospective, cross-sectional study to determine the
      prevalence of duodenal parasitosis. SETTING: Endoscopy unit in a university
      hospital. PATIENTS: One hundred and thirty-one unselected, immunocompetent
      patients undergoing upper endoscopy. MEASUREMENTS: Microscopic examination of
      duodenal aspirates, obtained during upper endoscopy. No pathogenic or commensal
      parasite was identified in any patient. CONCLUSIONS: No case of unsuspected
      parasitosis was found in the present study. On the basis of our findings, we do
      not recommend routine collection of duodenal aspirates during upper endoscopy.

PMID- 8470637
TI  - Endoscopic ultrasonography for assessing the horizontal extent of invasive
      gastric carcinoma.
AB  - Accurately determining the surgical resection line is essential for improving the
      prognosis of patients with gastric carcinoma. Endoscopic ultrasonography (EUS)
      was used to assess the horizontal extent of cancerous invasion below the mucosal
      layer. In 105 patients (110 lesions) with gastric carcinoma, ultrasonographic
      images of resected specimens were compared with histological findings. The
      horizontal extent of the hypoechoic region of in vitro ultrasound was compared
      with the horizontal extent of the cancerous invasion and fibrosis in histological
      sections. In cases showing echo patterns characteristic of peptic ulcerations
      within the tumor focus, the horizontal spread of the echo-poor region correlated
      well with the spread of fibrosis, but not with the cancerous lesion. In other
      cases with no ulceration, the horizontal spread of the echo-poor region
      corresponded well with the cancerous lesions. To evaluate oral invasion of the
      cancerous lesion below the mucosa, 16 patients with gastric carcinoma who had
      clips placed during endoscopy were subsequently examined by EUS. The use of EUS
      combined with the clips allowed for a more accurate diagnosis of the invasion,
      not only in the mucosa, but also into the submucosa and beyond. This combined
      diagnostic method was safe and useful for determining a suitable surgical
      resection line.

PMID- 8470638
TI  - Ultrasonographic prediction of esophageal varices in Schistosomiasis mansoni.
AB  - Bleeding from esophageal varices is a common and serious problem in
      Schistosomiasis mansoni. A simple and accurate method of detection would
      facilitate measurement of individual and community morbidity and allow
      institution of preventive measures. An ultrasonographic scoring system grading
      periportal fibrosis, portal vein diameter, spleen size, and portasystemic
      anastomoses was evaluated as a predictor of esophageal varices and a past history
      of upper gastrointestinal hemorrhage in 43 patients with hepatosplenic
      schistosomiasis. Ultrasonographic variceal score correlated (r = 0.86, p < 0.001)
      with the endoscopic variceal grade. Patients with a sonographic score of 5 or
      greater were highly likely (21 of 23) to have varices of grade II or greater
      (sensitivity, 91.3%; specificity, 94.7%). Only those with sonographic scores of 5
      or greater (15 of 23) had bled from esophageal varices. The ultrasonographic
      score provided a simple, inexpensive, accurate, and noninvasive means of
      screening individuals with hepatosplenic schistosomiasis for esophageal varices,
      and correlated strongly with prior gastrointestinal hemorrhage. It is not known
      whether a similar score would be useful in hepatic cirrhosis.

PMID- 8470639
TI  - Initial experience with the Pentax VSB-P2900 enteroscope.
AB  - Pentax has introduced the VSB-P2900 for endoscopic evaluation of the small bowel.
      This is a standard video upper endoscope lengthened to 250 cm. We report a case
      utilizing this instrument. A 65-yr-old white male was admitted with respiratory
      failure. Gastrointestinal bleeding developed. Upper endoscopy, colonoscopy, push
      enteroscopy, and mesenteric angiography were nondiagnostic. Enteroscopy to the
      proximal to mid ileum was performed. Approximately 90% of the intubated small
      bowel mucosa was visualized. An arteriovenous malformation and an ulcer were
      identified and cauterized. Time elapsed from intubation to extubation was 90 min,
      including two KUBs. No further bleeding was observed. The VSB-P2900 is likely to
      simplify examination of the small intestine. Tip control allows a large
      percentage of the intubated small bowel to be visualized. A working channel
      allows therapeutics. The technique is simple, fast, and within the skills of most
      endoscopists. A safety and efficacy profile need to be determined.

PMID- 8470640
TI  - Pneumocystis carinii pneumonia in patients with ulcerative colitis treated with
      corticosteroids.
AB  - Today, Pneumocystis carinii pneumonia (PCP) is typically associated with AIDS.
      However, in the pre-AIDS era, PCP was known to be associated with various
      immunodeficiency states, malignancies, and immunosuppressive therapy,
      particularly the use of corticosteroids. PCP has been reported to occur during
      immuno-suppressive therapy of some chronic inflammatory states, but it has never
      been reported in patients with inflammatory bowel disease. We report two patients
      with ulcerative colitis who developed PCP during high-dose corticosteroid
      therapy, and review the literature regarding non-AIDS PCP. PCP should thus be
      added to the list of bronchopulmonary complications in inflammatory bowel
      disease. This report should give gastroenterologists further impetus to limit
      immunosuppressive therapy to its minimal effective dose.

PMID- 8470641
TI  - Gastrointestinal manifestations of amyloidosis: a case of diverticular
      perforation.
AB  - Amyloidosis is an intriguing disorder. Its clinical presentation usually rests on
      the organ(s) infiltrated with the amyloid. We report a patient who presented with
      peritonitis secondary to a perforated large jejunal diverticulum and multiple
      small bowel diverticula. We believe the diverticula were a direct result of
      primary amyloid infiltration of the intestine in the antimesenteric location.
      This is the first reported case of small bowel diverticula caused by amyloidosis.

PMID- 8470642
TI  - Crohn's disease and pancreatitis.
AB  - Pancreatitis has rarely been reported as a complication of Crohn's disease. We
      report our experience with two cases of pancreatitis associated with Crohn's
      disease. In one, the pancreatitis occurred secondary to duodenal Crohn's disease
      involving the ampulla of Vater. Endoscopic retrograde pancreatography
      demonstrated involvement of the ampulla, with marked dilation and delayed
      drainage of the pancreatic duct, suggesting mechanical obstruction. In the second
      patient, Crohn's disease was localized to the ileum and colon. We conclude that
      duodenal Crohn's can cause pancreatitis, and this may, in some cases, be on an
      obstructive basis. In addition, non-duodenal Crohn's disease can be associated
      with pancreatitis as well. In a patient with a history of Crohn's disease
      presenting with an atypical exacerbation, pancreatitis should be considered.

PMID- 8470643
TI  - Tracheoesophageal fistula complicating herpes esophagitis in AIDS.
AB  - Immunocompromised individuals are susceptible to a variety of esophageal
      infections. Organisms responsible for esophagitis in patients with the acquired
      immunodeficiency syndrome (AIDS) are briefly reviewed. Usually confined to the
      esophageal mucosa, pathogens known to have the potential for transmural invasion
      are identified. The first report of tracheoesophageal fistulization in an AIDS
      patient with herpes esophagitis is presented.

PMID- 8470644
TI  - Acetaminophen hepatotoxicity: potentiation by isoniazid.
AB  - Potentiation of acetaminophen hepatotoxicity has previously been associated with
      a history of alcohol abuse. Presented here is the case of a 21-yr-old Philippino
      female with rapidly deteriorating hepatic functions. She had been on isoniazid,
      300 mg daily, as prophylaxis against tuberculosis due to a positive tuberculin
      skin test. She took 3.25 g of acetaminophen for abdominal cramping and
      subsequently had rapid deterioration of liver function manifested by prolongation
      of the prothrombin time, elevated ammonia, marked elevation of transaminases, and
      hyperbilirubinemia. Over the course of 1 wk, these values essentially normalized
      and she was discharged. Isoniazid induces the cytochrome P-450 system, resulting
      in increased metabolism of acetaminophen, formation of toxic metabolites,
      depletion of glutathione stores, and subsequent hepatocellular injury. Patients
      on isoniazid should use caution when taking acetaminophen since the potentially
      hepatotoxic effects may be amplified due to induction of the cytochrome P-450
      system.

PMID- 8470645
TI  - Endoscopic ultrasound in the morbidly obese patient: a new indication.

PMID- 8470646
TI  - Primary biliary cystic tumors of the liver.
AB  - Five cases of primary cystic tumors of the intrahepatic bile duct are documented
      over a 5-yr period. Clinically, two cases had recurrent episodes and one had a
      first attack of jaundice, fever, and pain in the upper abdomen; one complained of
      abdominal fullness and one was asymptomatic. The appearance of the tumors were
      single, large, multilocular, and cystic. Important radiological findings included
      irregular thickness of the cystic wall, internal septation, and papillary
      projection. Marked biliary dilation was demonstrated in four of the patients. On
      the cholangiogram, amorphous filling defects were seen in the dilated
      extrahepatic bile ducts, and mucinous material could be removed from the ducts as
      well. Obstruction of the bile ducts by this mucinous bile was assumed to be the
      cause of cholangitis in three patients. Histological examination revealed three
      cases of cystadenoma and two cases of cystadenocarcinoma.

PMID- 8470647
TI  - Intestinal perforation due to Mycobacterium tuberculosis in HIV-infected
      individuals: report of two cases.
AB  - Intestinal perforation is an extremely uncommon complication of Mycobacterium
      tuberculosis (MTB) infection. We describe two cases of multiple intestinal
      perforations secondary to MTB in individuals infected with the human
      immunodeficiency virus (HIV) presenting at the Los Angeles County-University of
      Southern California Medical Center over a 2-month period. For each case, this was
      the first presentation of AIDS. One of the two patients had concurrent pulmonary
      involvement. One patient died, and the other responded to therapy and was
      discharged in stable condition. The most striking finding in both cases was the
      extremely large number of acid-fast bacteria seen transmurally on the
      pathological specimens. This might be related to impaired T-cell function. The
      resurgence of MTB infection in North America, in the presence of the AIDS
      epidemic, may result in an increasing frequency of unusual presentations, such as
      intestinal perforation. Intestinal perforation due to MTB should be considered in
      HIV-infected patients presenting with an acute abdomen.

PMID- 8470648
TI  - Bile acids for PSC: promise for the future or placebo for the present?

PMID- 8470649
TI  - Balloon dilation versus Eder-Puestow: bigger and better?

PMID- 8470650
TI  - Variceal heavyweights: the ring versus the needle.

PMID- 8470651
TI  - Helicobacter pylori does not increase gastrin in chronic gastritis.

PMID- 8470652
TI  - Clofazimine-induced eosinophilic gastroenteritis in AIDS.

PMID- 8470653
TI  - Intramural gastric hematoma originating from an atherosclerotic aneurysm of a
      gastric artery.

PMID- 8470654
TI  - The incidence of bactibilia in gallstone patients without evidence of chronic or
      acute cholecystitis.

PMID- 8470655
TI  - Peritonitis with Mycobacterium avium in a patient with hepatic cirrhosis.

PMID- 8470656
TI  - An open trial of Cedemin, a Gingko biloba extract with PAF-antagonistic effects
      for ulcerative colitis.

PMID- 8470657
TI  - Diffuse cerebral edema following endoscopy.

PMID- 8470658
TI  - Ultrasonic diagnosis of adult intussusception.

PMID- 8470659
TI  - Long accessory hepatic duct associated with congenital dilation of the common
      bile duct.

PMID- 8470660
TI  - Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and
      its determinants: a cohort study in Kigali, Rwanda.
AB  - The authors report the results of the first 2 years of follow-up of a prospective
      cohort study on the mother-to-child transmission of human immunodeficiency virus
      type 1 (HIV-1) and its determinants which started in November 1988 in Kigali,
      Rwanda. The study sample consists of 218 newborns of 215 HIV-1 seropositive women
      matched to 218 newborns of 216 HIV-1 seronegative women of the same age and
      parity. They were followed every 2 weeks during the first 2 years of follow-up.
      HIV-1 antibodies were detected by enzyme-linked immunoadsorbent assay and Western
      blot at 3-month intervals. Two methods of calculating the mother-to-child
      transmission rate were used: method 1 combines the information provided by the
      persistence of HIV-1 antibodies at 15 months of age in children born to HIV
      seropositive mothers and the excess mortality in this group compared with the
      cohort of children born to HIV seronegative mothers; method 2 is a case-by-case
      evaluation of all the children born to HIV seropositive mothers. A logistic
      regression model was used to study the determinants of transmission. The
      probability of survival at 24 months of age was 81% (95% confidence interval (CI)
      75-86) in children born to seropositive mothers, compared with 95% (95% CI 92-98)
      in children born to seronegative mothers (p < 0.001). The mother-to-child
      transmission rate calculated with method 1 was 25.7% (95% CI 18.8-32.5). With
      method 2, the medium estimate was 24.7%. In the multivariate analysis, a CD4/CD8
      ratio < 0.5 was the only maternal factor statistically associated with an
      increased risk of mother-to-child transmission of HIV-1 (odds ratio = 2.9, 95% CI
      1.2-7.2). The authors' findings present evidence for a higher mother-to-child
      transmission rate of HIV-1 in children born in Rwanda than in industrialized
      countries.

PMID- 8470661
TI  - Comparison of voluntary and blinded human immunodeficiency virus type 1 (HIV-1)
      seroprevalence surveys in a high prevalence sexually transmitted disease clinic
      population.
AB  - To compare the seroprevalence of and risk factors for human immunodeficiency
      virus infection (HIV) among patients attending a public sexually transmitted
      disease clinic, the authors conducted both voluntary and blinded seroprevalence
      surveys between June 1989 and August 1990. For the voluntary survey, every twenty
      fifth patient attending the clinic for a new problem was invited to receive
      anonymous testing for HIV antibody. For the blinded survey, sera obtained for
      syphilis serologies from 2,297 (86%) of the 2,682 patients attending the clinic
      for a new problem were tested for HIV antibody after all personal identifiers
      were removed. Of the 946 eligible patients, 631 (66.7%) agreed to participate in
      the voluntary survey. Black men were significantly less likely to participate
      than other men and women (p < 0.0001). The prevalence of HIV antibody was 25%
      greater in the blinded survey than in the voluntary survey (15.2% and 11.4%,
      respectively, p < 0.05). This difference was due primarily to black
      homosexual/bisexual men, who had a 12.7-fold greater risk of HIV infection in the
      blinded survey than in the voluntary survey. These results suggest that blinded
      seroprevalence surveys may provide a better prevalence estimate of HIV infection
      than voluntary surveys. The greater risk for HIV infection observed among
      homosexual and bisexual black men, who were tested only in the blinded
      serosurvey, suggests that efforts to increase voluntary testing for HIV infection
      in this group should be developed.

PMID- 8470662
TI  - Leukemia in telephone linemen.
AB  - This case-control study examines potential associations between telephone
      linework and the occurrence of leukemia except chronic lymphocytic leukemia in a
      primarily retired population of American Telephone and Telegraph Company (AT&T)
      workers. Cases died between 1975 and 1980. Exposure is defined both by job title
      and, for workers with complete job histories, by a lifetime exposure score based
      on industrial hygiene personal monitoring measurements of line and nonline jobs.
      When the time-weighted average mean for each job is accumulated into a lifetime
      exposure score, workers with scores above the median for the population show an
      excess of leukemia 2.5 times higher than workers below the median (95% confidence
      interval (CI) 0.7-8.6). Those individuals with long duration of employment in
      jobs with intermittent peak exposures may be at higher risk of leukemia than
      those with a constant exposure level. Analyses that allow for a latent period
      suggest the risk is associated with exposures that occurred 10 or more years
      before death. Workers with peak exposure scores above the median have odds ratios
      of 2.4 (95% CI 0.7-9.0) and 6.6 (95% CI 0.7-58) for latent periods of 10 and 15
      years, respectively. The data suggest an increasing risk with increasing exposure
      (p for trend = 0.05) when cumulated scores are based on peak exposure scores.
      Peak exposures tended to occur in cable splicing work and in old telephone
      switching offices. The numbers in this study are small and observed differences
      may be due to chance.

PMID- 8470663
TI  - Parental smoking and risk of childhood brain tumors.
AB  - Data from a large, population-based, case-control study were analyzed to assess
      the role of parental smoking in childhood brain tumors. Parents of 361 cases,
      newly diagnosed between January 1, 1977 and December 31, 1981 and ascertained
      from eight Surveillance, Epidemiology, and End Results (SEER) program registries,
      and 1,083 controls had been interviewed. No significant differences in risks were
      found to be associated with maternal or paternal smoking at any time (odds ratio
      (OR) = 0.92 for mothers and 1.06 for fathers), during the year of birth of the
      child (which included both the prenatal and postnatal periods) (ORs = 0.84 for <
      1 pack/day and 1.0 for > or = 1 pack/day for mothers, and 0.68 for < 1 pack/day
      and 1.07 for > or = 1 pack/day for fathers), or 2 years before the child was
      born, i.e., the pre-conception period (ORs = 0.75 for < 1 pack/day and 1.01 for >
      or = 1 pack/day for mothers, and 0.90 for < 1 pack/day and 1.15 for > or = 1
      pack/day for fathers). Mothers were also specifically asked if they smoked during
      the pregnancy, and no association was found compared with never smokers (OR =
      1.08, 95% confidence interval (CI) 0.80-1.45) or for ever-smokers who continued
      to smoke during pregnancy compared with those who stopped smoking during
      pregnancy (OR = 1.15, 95% CI 0.75-1.78). Finally, no significant increase in risk
      of brain tumors was found for the child's passive exposure to parental smoking
      during the period from birth to diagnosis of the brain tumor in the case. The
      lack of an effect of parental smoking was observed for both the major histologic
      types and locations of brain tumors. These findings and those from earlier
      studies provide no support for the hypothesis that parental cigarette smoking
      influences the risk of brain tumors in children.

PMID- 8470664
TI  - Risk of childhood cancer for infants with birth defects. I. A record-linkage
      study, Atlanta, Georgia, 1968-1988.
AB  - To evaluate the risk of childhood cancer among infants with serious birth
      defects, the authors linked records of the population-based registry of the
      Georgia Center for Cancer Statistics for 1975 to 1988 with records of the
      population-based Metropolitan Atlanta Congenital Defects Program for 1968 to
      1987. During the study period, birth defects were diagnosed in 19,373 infants
      younger than 1 year of age, and cancer was diagnosed in 400 children younger than
      15 years of age. The observed number of children with a defect who developed
      cancer was compared with the number expected on the basis of the cancer registry
      rates. Of the 19,373 children with birth defects, 31 developed cancer
      (standardized incidence ratio (SIR) = 2.2, 95% confidence interval (CI) 1.5-3.2).
      Two associations were found: of 532 children with Down's syndrome (trisomy 21),
      three developed acute leukemia (SIR = 50.8, 95% CI 10.5-148.5) while of 746
      children with pyloric stenosis, four developed cancer (SIR = 7.5, 95% CI 2.0
      19.3). These data show that children with selected birth defects are at increased
      risk for specific childhood cancers. Such record-linkage can reveal new
      associations, which can in turn help researchers understand underlying mechanisms
      common to teratogenesis and carcinogenesis.

PMID- 8470665
TI  - Risk of childhood cancer for infants with birth defects. II. A record-linkage
      study, Iowa, 1983-1989.
AB  - To attempt to confirm associations found in a companion study in Atlanta, Georgia
      between Down's syndrome and acute leukemia and between pyloric stenosis and
      childhood cancer, the authors used the State Health Registry of Iowa to link the
      records of infants and children with cancer for 1983 to 1989 with the records of
      infants with birth defects for 1983 to 1988. During the study period, birth
      defects were diagnosed in 10,891 infants younger than 1 year of age, and cancer
      was diagnosed in 396 children younger than 8 years of age. The authors compared
      the observed number of children with a defect who developed cancer with the
      number expected on the basis of the cancer registry rates. Of the 10,891 children
      with birth defects, 16 developed cancer (standardized incidence ratio (SIR) =
      2.0, 95% confidence interval (CI) 1.2-3.3). Of 251 children with Down's syndrome
      (trisomy 21), two developed leukemia (SIR = 32.1, 95% CI 3.9-116.0). None of the
      infants with cancer had pyloric stenosis (SIR = 0.0, 95% CI 0.0-6.7). The results
      of this study supported the association found in the Atlanta study between Down's
      syndrome and leukemia, but did not support the association found there between
      pyloric stenosis and childhood cancer. This study, however, had a shorter follow
      up period and a smaller number of subjects than the Atlanta study.

PMID- 8470666
TI  - Blood pressure and industrial lead exposure.
AB  - The association between environmental lead exposure and raised blood pressure
      remains controversial. This association was examined in a cross-sectional study
      in 1981 on 809 male workers who were occupationally exposed to lead in a factory
      manufacturing car lead accumulator batteries in Birmingham, United Kingdom. Lead
      exposure was assessed by blood lead levels, blood zinc protoporphyrin levels, and
      years of industrial exposure to lead. The geometric mean blood lead level was
      31.6 micrograms/dl with minimum and maximum values of 0 microgram/dl and 98
      micrograms/dl, respectively. Unadjusted systolic blood pressure rose with
      increasing blood lead levels (analysis of variance, F = 3.3, p < 0.05) from 127
      mmHg (95% confidence interval (CI) 123.5-130.5) in men with blood lead levels
      less than 21 micrograms/dl to 133 mmHg (95% CI 128.7-137.3) in men with levels
      exceeding 50 micrograms/dl. Following adjustment for the confounding effects of
      age, body mass index, and alcohol consumption, however, the effect of blood lead
      on systolic pressure was diminished (analysis of variance, F = 1.3, not
      significant) to 129 mmHg and 132 mmHg in the respective categories. There was no
      association between diastolic blood pressure and blood lead. Zinc protoporphyrin
      levels and years of industrial lead exposure did not raise adjusted systolic or
      diastolic pressure. In conclusion, subject to the limitations inherent in a cross
      sectional survey, the findings are consistent with a weak effect of industrial
      lead exposure on systolic blood pressure, within the range of exposures observed
      in this study.

PMID- 8470667
TI  - A comparison of prospective and retrospective responses on sudden infant death
      syndrome by case and control mothers.
AB  - Based on information from two studies of sudden infant death syndrome (SIDS) from
      1988-1991 in Tasmania, Australia, prospective and retrospective maternal
      responses to an identical set of questions were compared for 27 cases and 25
      controls. There was good agreement on demographic factors, maternal obstetric
      history, parental smoking, and infant feeding practices. Reported changes in
      sleep habits were slightly greater for cases, and further work is needed to
      determine if this reflects recall bias or real changes during early infant life.
      Case mother reports regarding family history of disease and infant bedding were
      more discrepant, suggesting recall bias and supporting prospective collection of
      this information.

PMID- 8470668
TI  - Representative and misrepresentative associations of birth defects in livebirths.
      Conditions under which relative risks greater than unity in livebirths
      necessarily imply relative risks greater than unity in all conceptuses.
AB  - One may express the relative risk of defect in all conceptuses, r(def), as a
      function of the relative risk of defect in livebirths, r(def,lb), and in
      embryonic and fetal deaths, r(def,efd), as r(def) = C(lb)r(def,lb) +
      C(efd)r(def,efd), where C(lb) and C(efd) are coefficients defined in terms of
      conceptus and defect viability and lethality. If the relative risk of birth
      defect in livebirths, r(def,lb), is greater than unity, but the relative risk of
      defect in all conceptuses, r(def), is equal to or less than unity (or the reverse
      pattern holds), then the relative risk of defects in livebirths may be said to be
      "distorting" or "misrepresentative" because it does not reflect the nature of the
      association in all conceptuses. The authors define and present an explicit
      expression for a boundary upon the relative risk of defect in livebirths. If the
      relative risk of defect in livebirths is (validly) greater than this boundary
      value, then the relative risk in all conceptuses must be greater than unity and
      the observed relative risk of defect in births is "representative" and not
      distorting. The authors show that the boundary value is equal to 1/C(lb), where
      C(lb) is a simple function of the lethality of all unexposed conceptuses, the
      lethality of unexposed conceptuses with defect, and the relative risk of any
      embryonic and fetal death. Tables of the boundary relative risk for various
      values of these variables are presented. Over a very wide range of reference
      variables, a (valid) relative risk of defect in livebirths of 3.5 or greater
      implies a positive association with defect in all (recognized) conceptuses in the
      population studied.

PMID- 8470670
TI  - FDA clears 26 new drugs for marketing in 1992.

PMID- 8470669
TI  - Sample size and power determination for a binary outcome and an ordinal exposure
      when logistic regression analysis is planned.
AB  - General methods of sample size determination for logistic regression analyses are
      now available, but these will often require substantial information for their
      application. The author presents methods useful in the special case of a binary
      outcome and a three-level quantitative exposure, which includes application to a
      three-level ordinal exposure for a specified scaling. The computationally simple
      methods were developed in planning an investigation of the prognostic value of
      multidrug resistance gene (mdr1) expression in sarcoma. Because logistic
      regression was planned for the analysis, calculations were based on the ability
      to detect a linear trend in the log odds of tumor response to chemotherapy
      associated with increases in the level of mdr1 expression from negative to low
      positive to high positive. Closed form expressions were used to assess
      sensitivity to the ordinal scaling and the distribution of the mdr1 levels, and
      to the assumption of a linear trend in the log odds versus a linear trend in the
      proportions.

PMID- 8470671
TI  - Radiopharmaceutical providers to continue growth.

PMID- 8470672
TI  - Annual Lilly survey shows hospital pharmacy purchases up nearly 20% in 1991.

PMID- 8470673
TI  - Increasing pharmacist involvement in cardiopulmonary resuscitation attempts.

PMID- 8470674
TI  - Showing your worth to the bosses.

PMID- 8470675
TI  - Possible incompatibilities with immune globulin for i.v. use.

PMID- 8470676
TI  - The value of pharmaceutical care.

PMID- 8470677
TI  - Promotion of cost-effective benzodiazepine sedation.

PMID- 8470678
TI  - Alternative way to deal with nonformulary drugs.

PMID- 8470679
TI  - New emphasis on home care.

PMID- 8470680
TI  - Appropriateness of antibiotic selection and use in laminectomy and
      microdiskectomy.
AB  - The selection and timing of antibiotic prophylaxis in spinal surgery patients
      were studied. All laminectomy and microdiskectomy cases in which surgical-wound
      infection had developed within 60 days of surgery during 1990 at a medical center
      were retrospectively reviewed because of the high rate of postoperative wound
      infection for these procedures at the institution. The evaluation covered drug
      selection, the timing of antibiotic administration relative to the surgical
      incision, culture and susceptibility test results, and the length of the surgical
      procedure. Surgical-wound infection was found to have developed in 22 (7%) of the
      315 patients who underwent laminectomy or microdiskectomy. There was no apparent
      difference between the infected group and a matched, uninfected control group in
      either the antibiotic selected or the number of doses given. On the basis of the
      organisms isolated from the wounds and susceptibility test results, the selection
      of cefazolin as the antibiotic was appropriate in 17 of the 22 infected patients.
      However, compared with the control group, the infected group had a significantly
      higher percentage of patients in whom antibiotics had been given more than two
      hours before the time of the surgical incision. The policy on administering
      prophylactic antibiotics was modified; current guidelines include giving the
      first dose of cefazolin upon the induction of anesthesia and follow-up
      administration in three hours if the incision has not been closed by then. The
      selection of a prophylactic antibiotic for spinal surgery patients was
      appropriate, but the timing of drug administration was usually not optimal.

PMID- 8470681
TI  - Ondansetron use in a major university teaching hospital.
AB  - A drug-use evaluation of ondansetron was conducted. Literature-based criteria for
      the use of ondansetron were developed by an oncology specialty resident and a
      clinical pharmacy specialist in oncology. Orders for ondansetron written in the
      hospital or in the outpatient oncology clinic were reviewed over a nine-week
      period. After an interval of education, the use of ondansetron was re-evaluated.
      The data collected included the indication for use, dosage, route of
      administration, and, for inpatient orders during the first evaluation,
      therapeutic outcome. In the first evaluation, 100 orders were reviewed. Some 87%
      of the orders for inpatients and 80% of the outpatient orders met the criteria
      for therapeutic indication. Criteria for dosage and administration were met by
      76% of the inpatient orders and 83% of the outpatient orders. The inpatient
      orders met the criteria for therapeutic outcome in 93% of cases. In the follow-up
      evaluation, 50 orders were reviewed. Some 96% of the inpatient orders and 100% of
      the outpatient orders met the criteria for therapeutic indication. Dosage and
      administration criteria were met by 92% of the inpatient orders but only 24% of
      the outpatient orders. A considerable potential for cost avoidance was
      identified. An evaluation of ondansetron use led to general improvements in
      prescribing patterns, but continued monitoring is necessary to reduce the use of
      inappropriate dosages and routes of administration for outpatients.

PMID- 8470682
TI  - Use of vitamin and mineral supplements by pharmacy students.
AB  - Use of vitamin and mineral supplements by undergraduate pharmacy students and the
      students' perceptions and beliefs about these products were studied.
      Undergraduate pharmacy students from two schools in Philadelphia completed a
      questionnaire in which they were asked whether they had taken vitamin or mineral
      supplements within the preceding two weeks, the reason for taking the
      supplements, and the identity of the type of products taken. General demographic
      information and a self-assessment of health and diet were also obtained. In
      addition, using a five-point Likert scale, students were asked to rate the degree
      to which they agreed with five controversial statements regarding vitamin and
      mineral supplements. Of the 692 students completing the questionnaire, 47% had
      taken supplements in the preceding two weeks. This percentage is higher than that
      determined in surveys of the general population and of professionals in other
      health disciplines. No significant difference was noted in the percentage of men
      and women who took supplements, but the types of products taken by men and women
      differed significantly. The most common reasons for taking supplements were
      inadequate diet, to improve energy, for stress, and for colds. Year in school had
      a modest influence on the beliefs about vitamin and mineral supplement use
      expressed by students. The use of vitamin and mineral supplements among pharmacy
      students was high. Pharmacy schools should devote time in the curriculum to the
      sociological and clinical aspects of vitamin and mineral therapy.

PMID- 8470683
TI  - Automated compounder for adding ingredients to parenteral nutrient base
      solutions.
AB  - The effects of using an automated compounder for adding ingredients to parenteral
      nutrient (PN) base solutions was evaluated. Work-sampling methods were used to
      determine the amount of time spent by pharmacists and technicians in the
      production of PN solutions before and after the implementation of an automated
      device for adding ingredients to PN base solutions. Costs of materials and
      supplies were evaluated before and after the PN compounder was implemented.
      Qualitative (sterility) and quantitative (accuracy) analyses were performed by
      the hospital laboratory. A personnel time savings of 5.4 minutes per PN solution
      (1.0 full-time equivalent [FTE]) was shown. There was also an additional 0.5 FTE
      saved in activities not directly related to PN production. There was a 1.5%
      increase in pharmacist time (mean +/- S.D. preimplementation, 12.66 +/- 2.33
      minutes; postimplementation, 12.85 +/- 1.96 minutes) and a significant 27.9%
      decrease in technician time (mean +/- S.D. preimplementation, 20.29 +/- 2.47
      minutes; postimplementation, 14.62 +/- 2.24 minutes) per PN solution. The break
      even point for personnel and supply costs was 33 PN solutions. Qualitative
      analysis resulted in one positive culture preimplementation and no positive
      cultures postimplementation. Quantitative analysis showed an improvement in
      compounding accuracy. The use of an automated compounder for adding ingredients
      to PN base solutions resulted in personnel time savings and improved accuracy.

PMID- 8470684
TI  - Stability of hydralazine hydrochloride syrup compounded from tablets.
AB  - The stability of hydralazine hydrochloride in an oral syrup and with various
      adjuvants that might be used in a liquid formulation was studied. A syrup
      containing triturated hydralazine hydrochloride 50-mg tablets, a maltitol-based
      syrup vehicle, and other additives was prepared; the theoretical initial
      concentration of hydralazine hydrochloride was 1.25 mg/mL. Three samples were
      each stored at 5, 40, 50, 60, and 70 degrees C. Drug concentration was measured
      with high-performance liquid chromatography at times ranging from 2 to 23 days.
      In a second study, five 50-mL solutions were prepared: (1) hydralazine 1% with no
      pH adjustment, (2) hydralazine 1% with pH adjusted to 6.33, (3) hydralazine 1%
      and edetate disodium 1% with no pH adjustment, (4) hydralazine 1% and edetate
      sodium 1% with no pH adjustment, and (5) hydralazine 1% and sodium bisulfite 1%
      with no pH adjustment. Drug concentration was determined after storage for one
      week at 50 degrees C. There was apparent first-order degradation of hydralazine
      hydrochloride at all temperatures. An Arrhenius plot was used to calculate a
      shelf life of the syrup of 5.13 days at 25 degrees C. There were no changes in pH
      or physical appearance. In the second study, hydralazine hydrochloride solution
      turned yellow immediately after edetate sodium [corrected] was added; at one week
      the loss of drug was 29%. Addition of sodium bisulfite caused a more intense
      yellow coloration, and loss of drug at one week was 80%. Changes in pH were
      minimal. An Arrhenius plot showed that hydralazine hydrochloride was relatively
      unstable in an oral syrup at room temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470685
TI  - Compatibility of cyclosporine with fat emulsion.
AB  - The compatibility of cyclosporine with fat emulsion was studied. Admixtures
      consisted of cyclosporine injection at final drug concentrations of 0.5 and 2.0
      mg/mL in 10% and 20% fat emulsion. Fat emulsion stability was determined by
      visual inspection, pH testing, and particle-size measurements at 0, 24, and 48
      hours. Cyclosporine stability was measured with high-performance liquid
      chromatography at the same intervals. The admixtures were stored in glass
      containers at 23-25 degrees C under fluorescent light. Mean particle diameters
      remained relatively constant in all the admixtures throughout the study period.
      No particles larger than 6 microns were observed. Cyclosporine retained more than
      96% of its initial concentration in all the admixtures. There were no changes in
      color or consistency, and pH did not vary by more than 0.11 pH unit. Cyclosporine
      0.5 or 2 mg/mL was compatible with 10% or 20% fat emulsion at room temperature in
      glass containers for up to 48 hours.

PMID- 8470686
TI  - Stability of famotidine in an extemporaneously prepared oral liquid.
AB  - The stability of famotidine in an extemporaneously prepared oral liquid stored at
      4 and 24 degrees C for 30 days was studied. Famotidine liquid was prepared by
      pulverizing and suspending 12 40-mg tablets in distilled water. This mixture was
      diluted with cherry syrup to a total volume of 60 mL, resulting in a famotidine
      concentration of 8 mg/mL. The liquid was divided into two 30-mL amber glass
      bottles and stored at 4 degrees C and at room temperature (24 degrees C). Samples
      from each of the two bottles were assayed for famotidine content by high
      performance liquid chromatography. Each sample was assayed in duplicate at time 0
      and on days 2, 5, 10, 15, 20, 25 and 30. The concentration of famotidine remained
      above 90% of original concentration for 20 days at 4 degrees C and for 15 days at
      room temperature. After 30 days, famotidine concentration was reduced by 15% and
      24% at 4 degrees C and room temperature respectively. Famotidine liquid 8 mg/mL
      compounded extemporaneously from tablets was stable for 20 days at 4 degrees C
      and for 15 days at 24 degrees C.

PMID- 8470687
TI  - Stability of procainamide hydrochloride syrups compounded from capsules.
AB  - The stability of procainamide hydrochloride in two oral syrups, one prepared with
      sucrose and the other with maltitol, was studied. A syrup containing powder from
      500-mg procainamide hydrochloride capsules, simple sucrose syrup, and other
      additives was prepared; the theoretical initial concentration of procainamide
      hydrochloride was 50 mg/mL. Three samples each were stored at 40, 50, 60, and 70
      degrees C. Drug concentration was measured with high-performance liquid
      chromatography at times ranging from 2 to 107 days. In a second study, a syrup
      containing powder from 500-mg procainamide hydrochloride capsules, a maltitol
      based syrup vehicle, and other additives was prepared; the theoretical initial
      drug concentration was 50 mg/mL. Three samples each were stored at 40, 50, 60,
      and 70 degrees C. Drug concentration was measured at times ranging from 7 to 187
      days. For the sucrose-based syrup, there was apparent first-order degradation of
      procainamide hydrochloride at all temperatures. An Arrhenius plot was used to
      calculate a shelf life of the syrup of 456 days at 25 degrees C. Most samples
      turned brown over time, and pH values were constant. For the maltitol-based
      syrup, drug degradation appeared to be biphasic; an initial period during which
      concentrations remained at nearly 100% was followed by apparent first-order
      degradation. Arrhenius plotting gave a shelf life of 97 days at 25 degrees C.
      Most samples turned brown over time, and pHs remained constant. Arrhenius plots
      indicated that in a maltitol-based oral syrup, procainamide hydrochloride was
      more stable than in a sucrose-based syrup when the storage temperature was above
      37 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470689
TI  - Stability and compatibility of fluconazole and aminophylline in intravenous
      admixtures.
AB  - The stability of aminophylline and fluconazole in intravenous admixtures
      containing both drugs was studied. Admixtures containing aminophylline 2.0 or 1.0
      mg/mL and fluconazole 1.5 or 0.5 mg/mL in 5% dextrose injection or 0.9% sodium
      chloride injection were prepared. Each admixture was prepared in triplicate in
      glass containers and kept at 24 degrees C. Immediately after preparation and at
      one, two, and three hours, samples were visually inspected, tested for pH, and
      assayed in duplicate by high-performance liquid chromatography for theophylline
      concentration and fluconazole concentration. More than 98% of the initial
      aminophylline and fluconazole concentrations remained at each test interval.
      There was no visible evidence of precipitation, gas formation, or color change.
      No appreciable change in pH occurred during the study period. Aminophylline 1.0
      2.0 mg/mL and fluconazole 0.5-1.5 mg/mL admixed in 5% dextrose injection or 0.9%
      sodium chloride injection were stable and compatible for up to three hours at 24
      degrees C.

PMID- 8470688
TI  - Stability and compatibility of minocycline hydrochloride and rifampin in
      intravenous solutions at various temperatures.
AB  - The stability and compatibility of minocycline hydrochloride and rifampin in
      intravenous solutions at several temperatures were studied. Triplicate test
      solutions of (1) minocycline hydrochloride 0.1 mg/mL or rifampin 0.1 mg/mL in 5%
      dextrose injection or 0.9% sodium chloride injection and (2) minocycline
      hydrochloride 0.1 mg/mL admixed with rifampin 0.1 mg/mL in 0.9% sodium chloride
      injection were prepared and stored at various temperatures. Samples were removed
      at intervals for up to seven days and stored at -70 degrees C until analyzed.
      Drug concentration was measured by stability-indicating high-performance liquid
      chromatography. Compatibility was assessed by visual and turbidimetric
      examination. For the solutions containing the drugs separately, minocycline
      hydrochloride was stable in both diluents, with the initial concentration
      declining by 8% at 24 degrees C and 2% at 4 degrees C over seven days. Rifampin
      was less stable, losing 6-8% of the initial concentration in three days at 4
      degrees C and 5-7% in 8 hours and 13-17% in 24 hours at 24 degrees C. There was
      no change in turbidity in the solutions containing either minocycline
      hydrochloride or rifampin. The admixture, however, was turbid after 72 hours at
      37 degrees C. Minocycline hydrochloride in the admixture was stable for seven
      days at 24 and 4 degrees C but not for three days at 37 degrees C. The
      concentration of rifampin decreased 20% in one day at 24 degrees C, 8-10% in
      three days at 4 degrees C, and 14% in 4 hours and 40% and in 24 hours at 37
      degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470690
TI  - Trends in computer hardware and software.
AB  - Previously identified and current trends in the development of computer systems
      and in the use of computers for health care applications are reviewed. Trends
      identified in a 1982 article were increasing miniaturization and archival
      ability, increasing software costs, increasing software independence, user
      empowerment through new software technologies, shorter computer-system life
      cycles, and more rapid development and support of pharmaceutical services. Most
      of these trends continue today. Current trends in hardware and software include
      the increasing use of reduced instruction-set computing, migration to the UNIX
      operating system, the development of large software libraries, microprocessor
      based smart terminals that allow remote validation of data, speech synthesis and
      recognition, application generators, fourth-generation languages, computer-aided
      software engineering, object-oriented technologies, and artificial intelligence.
      Current trends specific to pharmacy and hospitals are the withdrawal of vendors
      of hospital information systems from the pharmacy market, improved linkage of
      information systems within hospitals, and increased regulation by government. The
      computer industry and its products continue to undergo dynamic change. Software
      development continues to lag behind hardware, and its high cost is offsetting the
      savings provided by hardware.

PMID- 8470691
TI  - Adverse drug reaction surveillance in an emergency room.

PMID- 8470692
TI  - Stability of bupivacaine hydrochloride, epinephrine hydrochloride, and fentanyl
      citrate in portable infusion-pump reservoirs.

PMID- 8470693
TI  - Visual compatibility of ciprofloxacin with selected components of total
      parenteral nutrient solutions during simulated Y-site injection.

PMID- 8470694
TI  - Basics of computer hardware and software.
AB  - The basics of computer hardware and software are presented. A computer is a
      general-purpose electronic counting device used in data processing because of its
      accuracy and high speed. The physical components of a computer system are called
      the hardware, which includes the central processing unit and peripheral equipment
      for data input, output, and storage. Computer capacity is measured by the amount
      of data that can be stored in main memory and by the computer word size.
      Performance is indicated by the speed with which instructions are executed. Input
      devices (e.g., keyboard-type terminals) are the components that accept raw data
      and convert it into electronic form, and output devices (e.g., video display
      terminals) present the results of data processing in human-readable form. System
      software is the set of instructions that facilitate hardware use and allow the
      application software, which solves specific user problems, to run efficiently.
      System and application software is written by using various machine and symbolic
      languages. Milestones in software-development techniques include program
      subroutine use, modular programming, functional decomposition, structured
      programming, and structured analysis. Objectives in improving software quality
      are reducing development costs, making maintenance easier, and making development
      results more predictable. Because software development has lagged behind
      revolutionary advances in hardware, the full potential of computers has yet to be
      realized.

PMID- 8470695
TI  - Prescriptive ambivalence.

PMID- 8470696
TI  - Which catheter first?

PMID- 8470698
TI  - Why would an attorney hire a nurse?

PMID- 8470697
TI  - Peds pain protocols.

PMID- 8470699
TI  - Making headway with intracranial hypertension.

PMID- 8470700
TI  - 'End-of-life' care: patients' choices, nurses' challenges.

PMID- 8470701
TI  - Back stress isn't part of the job.

PMID- 8470702
TI  - Superior vena cava syndrome.

PMID- 8470703
TI  - How severe is this frostbite?

PMID- 8470704
TI  - Keeping an eye on magnesium.

PMID- 8470705
TI  - The new food label.

PMID- 8470706
TI  - Let's get our backs up.

PMID- 8470707
TI  - Evaluating needleless i.v. tubing.

PMID- 8470708
TI  - The changing face of rehabilitation nursing.

PMID- 8470709
TI  - Asserting a nurse's "comparative fault," a manufacturer won a 30% reduction in a
      $l50,000 award.

PMID- 8470710
TI  - Small change.

PMID- 8470711
TI  - The history of the National Eye Institute.

PMID- 8470712
TI  - The National Eye Institute. A quarter century of achievement.

PMID- 8470713
TI  - Clinical follow-up of phototherapeutic keratectomy for treatment of corneal
      opacities.
AB  - We performed phototherapeutic keratectomy with a 193-nm excimer laser on 18
      sighted patients (18 eyes) to treat corneal opacities. The corneal opacities were
      caused by corneal dystrophies in five patients; corneal scars secondary to
      corneal ulcers in six patients; corneal scar secondary to trauma in four
      patients; and band keratopathy, atopy, or corneal calcification in three
      patients. Mean follow-up was eight months (range, two to 18 months). Corneal
      clarity improved in 14 of the 18 eyes (77.7%). Four patients, three with band
      keratopathy or calcification and one with postinfectious corneal scar, did not
      improve. Uncorrected visual acuity improved in 11 patients, did not improve in
      five patients (including the four patients in whom treatment failed), and
      decreased in another two patients, apparently because of an increase in irregular
      astigmatism. A hyperopic shift was observed in ten patients. None of the
      successfully treated eyes developed surface problems or recurrence of the disease
      during the follow-up. Phototherapeutic keratectomy thus appears to be a safe and
      effective alternative to penetrating keratoplasty in some patients with selected
      anterior stromal opacities.

PMID- 8470714
TI  - Corneal epithelial changes after excimer laser photorefractive keratectomy.
AB  - We used the specular microscope to investigate corneal epithelial changes after
      excimer laser photorefractive keratectomy. Thirteen patients underwent
      photorefractive keratectomy on one eye to correct myopia. We observed the central
      corneal epithelium of each eye at postoperative periods from one to 15 months
      after photorefractive keratectomy. The fellow eye served as a control. In 11 eyes
      (85%) the central cornea showed normal epithelial patterns. Two eyes had an
      abnormal epithelial pattern that included elongated epithelial cells. There were
      no difference in the mean cell area or coefficient of variation of mean cell area
      between the treated eyes and the control eyes. These results suggest that
      permanent destruction of Bowman's membrane caused by photorefractive keratectomy
      does not affect the morphologic characteristics of the most superficial layer of
      the corneal epithelium in most eyes. However, the presence of abnormal epithelial
      cell patterns in two patients should be considered a risk factor for this
      procedure.

PMID- 8470715
TI  - Corneal light scattering and visual performance in myopic individuals with
      spectacles, contact lenses, or excimer laser photorefractive keratectomy.
AB  - Corneal transparency and visual performance are currently receiving much
      attention after excimer laser surgery. To date, emphasis has been on comparison
      of eyes on which laser surgery has been performed to eyes with emmetropia. A more
      appropriate comparison should be between eyes on which laser surgery has been
      performed and eyes with other forms of correction for myopia. Forward-scattered
      light, back-scattered light, and visual acuity were investigated and data were
      collected from 35 myopic individuals with various types of correction for myopia
      (spectacles, hard and soft contact lenses, and excimer laser surgery). Forward
      scattered light was measured by using a new computerized technique, back
      scattered light was measured with a charge coupled device-camera system, and
      visual acuity was measured with a computerized system at various levels of
      contrast. Spectacles, hard contact lenses, and excimer laser surgery are all
      superior to soft contact lenses in terms of light scatter and low-contrast visual
      acuity and excimer laser photorefractive keratectomy produces comparable results
      to spectacles one year postoperatively. At low-contrast visual acuity, mean
      visual acuity was 2.45 minutes of arc for the spectacle wearers, 3.21 minutes of
      arc for the hard contact-lens wearers, and 5.04 minutes of arc for the soft
      contact-lens wearers. Excimer laser patients had a mean visual acuity of 9.04
      minutes of arc three months postoperatively, and 2.53 minutes of arc after one
      year. A mean value of 2.4% contrast for forward light scatter was obtained for
      spectacle wearers compared with a level of 3.84% contrast for hard contact-lens
      wearers and 16.1% contrast for soft contact-lens wearers. The mean value for
      excimer laser patients was 20% contrast three months postoperatively and 2.1%
      contrast one year postoperatively.

PMID- 8470716
TI  - Comparison of the clinical performance of the Acuvue disposable contact lens and
      CSI lens in patients with giant papillary conjunctivitis.
AB  - Anecdotal reports have suggested that the use of disposable contact lenses is an
      effective treatment for giant papillary conjunctivitis. In a prospective
      randomized double-masked study, we compared the clinical performance of the
      Acuvue (Vistakon, Jacksonville, Florida) disposable contact lens to the
      traditional daily-wear lens of choice, CSI (Pilkington Barnes Hind, Sunnyvale,
      California), in 37 patients with previously diagnosed giant papillary
      conjunctivitis who were examined at one-month intervals for six months. A survey
      questionnaire for grading symptoms disclosed significant improvement in itching,
      discharge, and blurred vision in both groups early in the study. Evaluation of
      patient preference showed that the CSI lens was strongly preferred with regard to
      lens handling (76% vs 8%). In contrast, the Acuvue lens was strongly preferred
      with regard to lens comfort (62% vs 11%). For the variable of overall lens
      preference, there was no significant difference between the two lenses (CSI, 43%
      and Acuvue, 41%). Multiple regression analysis disclosed that both lens comfort
      (P < .002) and lens handling (P = .05) contributed significantly to the choices
      made regarding the dependent variable of overall lens preference. Lens comfort
      (beta = .71) was observed to be approximately 50% more powerful than lens
      handling (beta = .48). There was no significant difference in the rate or cost of
      torn lenses between groups, suggesting that the Acuvue lens can withstand the
      physical manipulation associated with daily-wear use for up to one month. The
      results of this study suggest that the use of disposable contact lenses for the
      treatment of giant papillary conjunctivitis is at least as effective as the
      traditional daily-wear lens of choice.

PMID- 8470717
TI  - Fungal invasion of seven hydrophilic contact lenses.
AB  - In six patients we reviewed the clinical, microbiologic, and histopathologic
      findings of seven hydrophilic contact lenses that had been infiltrated by fungi.
      Three patients had visual blurring or irritation and redness while wearing a
      contaminated lens; of these, two were unaware of any lens deposits. Three of the
      lenses from two patients were spares kept in storage for six months and one year,
      respectively. One contaminated lens had been torn and was kept in a case while a
      loaner lens was worn. Culture of this lens grew Cladosporium species. The contact
      lens case from one patient grew Penicillium species. Gross pathologic inspection
      disclosed multiple brown deposits in five lenses, multiple gray infiltrates in
      one lens, and a white infiltrate in one lens. Light microscopic examination
      disclosed partial-thickness (three lenses) or full-thickness (four lenses)
      invasion of the lens matrix by fungi, which contained granular, brown pigment in
      six lenses.

PMID- 8470718
TI  - Combined treatment of Acanthamoeba keratitis with propamidine, neomycin, and
      polyhexamethylene biguanide.
AB  - We developed an intensive treatment regimen of topical neomycin, propamidine, and
      polyhexamethylene biguanide that was tapered to a maintenance level over a 14- to
      28-day period as toxicity developed. Since July 1991, we used this treatment on
      six eyes of five patients in whom Acanthamoeba keratitis was diagnosed
      clinically. All patients had positive cultures for microorganisms from their
      corneas or contact lens cases or had pathognomonic findings of pseudodendritic
      subepithelial infiltrates and radial keratone-uritis. After therapy, all patients
      improved within two to four weeks, with regression or resolution of neuritis and
      infiltrates, healing of epithelial defects, and lessening of pain. By three to
      four months, visual acuity had returned to 20/20 in all eyes. We believe the
      addition of polyhexamethylene biguanide to our treatment regimen in Acanthamoeba
      keratitis dramatically aided and hastened the clinical improvement in five
      consecutive patients and may, with early diagnosis, increase the number of
      medical cures.

PMID- 8470719
TI  - Comparison of topical ciprofloxacin to conventional antibiotic therapy in the
      treatment of ulcerative keratitis.
AB  - We evaluated the efficacy of ciprofloxacin (3 mg/ml) as the sole topical
      antibiotic used to treat infectious keratitis in 14 patients. We compared the
      ciprofloxacin-treated group to a retrospective control group of 30 consecutive
      culture-positive patients treated with conventional therapy in which cefazolin
      (50 mg/ml) and fortified gentamicin sulfate (9.1 mg/ml) solutions were used. We
      found no remarkable difference between the control group and the ciprofloxacin
      treated group regarding patient age, risk factors, need for hospitalization, and
      virulence of organism isolated. The average time to healing in culture-positive
      ciprofloxacin-treated patients was 34 +/- 33 days vs 45 +/- 71 days in the
      control group and this difference was not statistically significant. The duration
      of antibiotic therapy in the culture-positive ciprofloxacin-treated group was 27
      +/- 15 days vs 33 +/- 50 days in the control group. Four of the 30 control
      patients required modification of their antibiotic regimen, whereas no
      ciprofloxacin-treated patient required a change. Ciprofloxacin appears to be an
      effective single agent in the treatment of ulcerative keratitis.

PMID- 8470720
TI  - Retrocorneal fibrous membranes in failed corneal grafts.
AB  - Histopathologic slides from 170 failed grafts, excised between 1983 and 1990 were
      reviewed. The overall incidence of retrocorneal fibrous membrane was 54% (92
      grafts). The incidence of diffuse (extensive) retrocorneal fibrous membrane was
      17% (29 grafts) and that of focal (peripheral) retrocorneal fibrous membrane was
      37% (63 grafts). A high correlation was found between the clinical presence of
      peripheral anterior synechiae or vitreous adherent to the wound and the finding
      of retrocorneal fibrous membrane in aphakic and pseudophakic failed corneal
      grafts. A high correlation was also found between tube-shunt operation and the
      presence of diffuse retrocorneal fibrous membrane. Sixteen of 63 (25%) regrafted
      failed grafts, that is second grafts, with focal retrocorneal fibrous membranes
      failed within 18 months following surgery. Thirteen of 29 (45%) regrafted failed
      grafts with diffuse retrocorneal fibrous membrane failed within the same period
      and 11 of these (85%) were associated with tube-shunt surgery.

PMID- 8470721
TI  - Diffuse corneal clouding in siblings with fetal alcohol syndrome.
AB  - Three of four siblings born to parents with a history of heavy alcohol abuse had
      bilateral diffusely cloudy corneas at birth. These three siblings, who had mild
      systemic features of fetal alcohol syndrome, underwent corneal transplantations,
      and their specimens were examined by light and electron microscopy.
      Histologically, the alterations in Bowman's layer ranged from thickening to total
      loss. There were varying degrees of corneal stromal edema. The unique pathologic
      feature in the corneas was the anomaly of the anterior banded zone of Descemet's
      membrane, which was either absent, poorly formed, or thinned in the central and
      peripheral cornea. The corneal endothelium was attenuated or multilayered. The
      diffuse clouding and the range of histologic abnormalities in the corneas might
      be related to the maternal alcohol abuse.

PMID- 8470722
TI  - Immunohistopathologic features and therapy of conjunctival lichen planus.
AB  - Lichen planus is an autoimmune disease that typically involves skin and the
      mucosa of the genitalia and mouth. Conjunctival involvement is rare, and the
      microscopic abnormalities of affected conjunctivae are not well characterized. We
      treated two patients with cicatrizing conjunctivitis and extraocular conjunctival
      lichen planus confirmed by biopsy. We found irregular, thickened basement
      membrane with reduplications similar to the findings in oral mucosa affected by
      lichen planus. The absence of basement membrane immunoreactants excluded ocular
      cicatricial pemphigoid. Results of laboratory tests for collagen vascular
      diseases including sarcoidosis and lupus were also negative. Treatment with 2%
      cyclosporine eyedrops controlled inflammation and stopped cicatrization in one
      patient who was followed up for 12 months. The other patient, in whom lichen
      planus was recently diagnosed, responded favorably to topical cyclosporine.
      Lichen planus should be included in the differential diagnosis of cicatrizing
      conjunctivitis and its immunohistopathologic features should be studied in
      conjunctival biopsies. Topical cyclosporine may be used successfully for
      conjunctival lichen planus.

PMID- 8470723
TI  - Parapapillary chorioretinal atrophy in normal-pressure glaucoma.
AB  - Parapapillary chorioretinal atrophy has been shown to be associated with
      glaucomatous optic nerve damage. We sought to determine whether eyes with normal
      pressure glaucoma have an unusually large parapapillary atrophy as compared to
      eyes with primary open-angle glaucoma. Color stereoscopic optic disk photographs
      of 34 patients with normal-pressure glaucoma and 283 patients with primary open
      angle glaucoma were morphometrically analyzed. Both groups were matched for
      neuroretinal rim area and visual field loss. Severely myopic eyes were excluded.
      The parapapillary atrophy was differentiated into a peripheral Zone Alpha with
      irregular pigmentation and a central Zone Beta with visible sclera. Zones Alpha
      and Beta did not differ significantly between the two groups in either frequency
      or size. Eyes with normal-pressure glaucoma do not have an abnormally large
      parapapillary atrophy as compared to eyes with primary open-angle glaucoma, which
      is diagnostically and pathogenetically important.

PMID- 8470724
TI  - Late complications after glaucoma filtering surgery with adjunctive 5
      fluorouracil.
AB  - We studied 105 patients (105 eyes) operated on for glaucoma with adjunctive
      fluorouracil, who were followed up for 12 to 48 months (mean, 34.6 +/- 12.9
      months). Fifty eyes that had previous glaucoma or cataract extraction or had
      inflammatory glaucoma had a high risk for postoperative scarring (high-risk
      group), and 55 eyes had glaucoma surgery as an initial procedure (initial surgery
      group). An intraocular pressure of 20 mm Hg or less, with or without hypotensive
      medications, was found in 42 eyes in the high-risk group (84.0%) and in 53 of the
      eyes in the initial surgery group (96.4%). Of the 105 eyes, an intraocular
      pressure of 12 mm Hg or less without medication was achieved in 17 eyes in the
      high-risk group (34.0%) and in 35 eyes in the initial surgery group (63.6%). Late
      complications in both groups were as follows: endophthalmitis in four eyes (3.8%)
      (two of the infected blebs were located superiorly and two inferiorly), transient
      leaking bleb in two eyes (1.9%), hypotony of an extended period with 180 to 360
      degrees of filtration in three eyes (2.9%), giant bleb extending over the cornea
      in two eyes (1.9%), and a transient, mild iridocyclitis in nine eyes (8.6%).
      Thus, adjunctive fluorouracil after filtering surgery may entail various, mainly
      bleb-related, late side effects and complications.

PMID- 8470725
TI  - Effect of desmopressin on aqueous humor flow in humans.
AB  - The rate of aqueous humor flow was studied in 17 human subjects with neurogenic
      diabetes insipidus. Flow was measured by fluorophotometry on two consecutive
      afternoons. The first day, subjects used desmopressin to control their diuresis;
      on the second day, subjects did not use desmopressin and had uncontrolled
      diuresis. On both days, one eye was treated with the beta-adrenergic antagonist,
      timolol. With desmopressin, the rate of aqueous humor flow in the untreated eye
      was 2.53 +/- 0.79 microliters/min (mean +/- standard deviation) and in the
      timolol-treated eye was 1.69 +/- 0.40 microliters/min. Without desmopressin, the
      rate of aqueous humor flow in the untreated eye was 2.34 +/- 0.69 microliters/min
      and in the timolol-treated eye was 1.53 +/- 0.43 microliters/min. Thus, the use
      of desmopressin was associated with a slightly higher rate of aqueous humor flow
      in both the normal and the beta-adrenergically inhibited eye (P = .05), and the
      suppression of aqueous humor flow associated with beta-adrenergic inhibition
      occurred with and without antidiuretic hormone (P < .001). The observed
      differences in aqueous humor flow on the two days could have been caused by a
      direct effect on the eye or to indirect effects, such as the change in plasma
      osmolality, which changed from 291 +/- 6 mOsm on the desmopressin day to 299 +/-
      8 mOsm on the desmopressin-abstention day (P < .001).

PMID- 8470726
TI  - Therapy for ocular toxoplasmosis.
AB  - We conducted a prospective multicenter study of the efficacy of current
      therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment
      consisted of the following three triple-drug combinations: group 1,
      pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin,
      sulfadiazine, and corticosteroids; and group 3, trimethoprim, sulfamethoxazole
      and corticosteroids. Patients with peripheral retinal lesions were not treated
      systemically. No difference in the duration of inflammatory activity was observed
      between treated and untreated patients (P = .5). The most important factor
      predicting the duration of inflammatory activity was the size of the retinal
      lesion itself, independent of the treatment (P < .001). We found a reduction in
      size of the retinal inflammatory lesion for 49% of the pyrimethamine-treated
      patients (17 of 35) compared to 20% of the untreated patients (eight of 41) (P <
      .01). However, the most frequent occurrence of side effects was also associated
      with pyrimethamine medication (26%, nine of 35). The mean recurrence rate after
      three years of follow-up was 49% for all patients (60 of 122 patients), with no
      differences between treated and untreated patients (P = .6).

PMID- 8470727
TI  - Dystrophic calcification of silicone scleral buckling implant materials.
AB  - In six patients, removal of solid silicone scleral buckling implant materials
      that had been in place between eight and 21 years disclosed gray-white deposits
      firmly adherent to the silicone. Four of the six patients had culture-proven
      infections, whereas two had no evidence of infection and had negative cultures.
      One of these two patients, however, had intermittent pain, which was the
      indication for removal of the implant. Analysis of the deposits disclosed that
      they were calcium phosphate. The exact mechanism responsible for the
      calcification on the silicone material is unknown. Dystrophic calcification can
      occur without infection in injured tissue wherein extracellular deposits of
      devitalized cells, blood cells, and lipids may act as a nidus for calcification.
      In the presence of infection, bacteria may serve as such a nidus. Additionally,
      it is possible that biofilm produced by the bacteria had a role in the deposition
      of calcium phosphate, as well as in its firm adhesion to the silicone materials.
      We considered the possibility of similar deposits developing on intraocular
      silicone lenses.

PMID- 8470728
TI  - Clinical predictors of scleral rupture after blunt ocular trauma.
AB  - We conducted a two-part study to define better the clinical predictors of scleral
      rupture after blunt trauma. In part 1 we ascertained the prevalence of scleral
      rupture among a population of patients examined in an ophthalmic emergency room
      with severe blunt ocular trauma over a six-month period. Scleral rupture was
      diagnosed in ten of 283 patients (3.5%). In part 2 we compared the clinical
      findings in 29 patients with scleral rupture to those of 273 patients with no
      scleral rupture after blunt trauma. We noted that eyes with visual acuity of
      light perception or less, an intraocular pressure of 5 mm Hg or less, an
      abnormally deep or shallow anterior chamber, or a media opacity preventing a view
      of fundus details by indirect ophthalmoscopy, should be considered ruptured when
      severe intra- or periocular hemorrhage is present. This diagnostic algorithm had
      a sensitivity of 100.0% (98.7% to 100.0%), specificity of 98.5% (97.1% to 99.9%),
      and a positive predictive value of 71.4% (66.3% to 76.5%).

PMID- 8470729
TI  - Accurate ultrasonic biometry in pseudophakia.

PMID- 8470730
TI  - Exudative retinal detachment and retinal folds after trabeculectomy.

PMID- 8470731
TI  - Early manifestation of retinal hamartomas in tuberous sclerosis.

PMID- 8470732
TI  - HLA-A29 as a potential risk factor for nonarteritic anterior ischemic optic
      neuropathy.

PMID- 8470733
TI  - Metastatic renal cell carcinoma manifesting as an orbital mass.

PMID- 8470734
TI  - A newborn with posterior lenticonus.

PMID- 8470735
TI  - Development of object vision in infants with permanent cortical visual
      impairment.

PMID- 8470736
TI  - Ciprofloxacin-resistant bacterial keratitis.

PMID- 8470737
TI  - Hypotonous maculopathy after trabeculectomy with subconjunctival 5-fluorouracil.

PMID- 8470738
TI  - Hypotonous maculopathy after trabeculectomy with subconjunctival 5-fluorouracil.

PMID- 8470739
TI  - Improved productivity through purposeful use of additional template for a woman
      with cortical blindness.
AB  - A single-subject study with an ABAB design investigated an adaptation of a work
      activity through the purposeful use of an additional template to improve
      productivity for a woman with cortical blindness resulting from anoxic brain
      damage. The activity required the subject to outline brackets (as parts of a
      handi-rack woodwork project) by tracing a template on a piece of pine board.
      During the baseline phase of the study, the subject used one template to outline
      the brackets. During the intervention phase, the subject used an additional
      template after receiving a brief training in its use. Productivity was measured
      by the number of potentially usable outlined brackets. Data analysis revealed
      that in the intervention phases, productivity improved significantly and accuracy
      increased. The application of tapping the subjects' intact sensory system was
      valuable for determining her vocational potential. The rationale of using an
      additional template to improve productivity was explained by the theory of
      affordance.

PMID- 8470740
TI  - An abbreviated task-oriented assessment (Bay Area Functional Performance
      Evaluation).
AB  - The purpose of this study was to explore development of an abbreviated version of
      the Task-Oriented Assessment component of the Bay Area Functional Performance
      Evaluation (BaFPE). The BaFPE is widely used by occupational therapists
      practicing in mental health, but therapists have requested an instrument that
      could be administered and scored more quickly. Both a subjective and objective
      analysis support the development of an abbreviated version of the Task-Oriented
      Assessment.

PMID- 8470741
TI  - Contingent interaction during work and play tasks for mothers with multiple
      sclerosis and their daughters.
AB  - Occupational therapy has focused on activity as a catalyst for understanding
      human roles and interactions, regardless of whether disability or chronic illness
      is present. Parenting is an important interactional activity accompanied by
      specific role expectations. This investigation examined the interaction patterns
      of mothers with multiple sclerosis and their daughters. Thirty-one mothers with
      multiple sclerosis and their daughters aged 8 to 12 years were compared with 34
      mothers without disabilities and their daughters aged 8 to 12 years. Videotaped
      mother-daughter interactions during a work task and a play task were scored by
      two raters for 11 different behaviors. These behaviors were collapsed into three
      behavioral composites--receptiveness, directiveness, and dissuasiveness--for
      statistical analysis. Statistical analysis revealed no significant differences
      between the two groups on the behavioral composites for either mothers or their
      daughters. The two tasks stimulated a different pattern of mother-daughter
      interactions. For both members of the dyad, interactions during the work task
      were more directive and less dissuasive than those in the play task. The clinical
      implication of this finding indicates the importance of understanding the
      influence of the task selected when observing interaction. Because of recent
      social and legal changes, understanding parenting and chronic illness is
      critical.

PMID- 8470742
TI  - Self-evaluation and self-concept of adolescents with physical disabilities.
AB  - Fifty-three adolescents aged 14 to 18 years with diagnoses of cerebral palsy (n =
      27), cleft lip or palate or both (n = 17), or spina bifida (n = 9) took part in
      this study examining their self-esteem, self-concept, self-acceptance, social
      self-efficacy, and values, as measured by standardized instruments. Comparisons
      were made separately for males and females with norms developed for adolescents
      without disabilities. Significant differences were found only on several aspects
      of self-concept: females with physical disabilities were lower in perceived
      social acceptance, athletic competence, and romantic appeal than the normative
      sample, and males with physical disabilities were lower in perceived scholastic
      competence, athletic competence, and romantic appeal. In addition, social self
      efficacy was found to be a significant predictor of both independence and
      persistence in adolescents with disabilities, who were significantly less
      independent and persistent than were normative samples. The discussion focuses on
      the usefulness of the findings regarding social self-efficacy and the
      implications of the findings for occupational therapists.

PMID- 8470743
TI  - Clinical evaluation of the Hemi Wheelchair Cushion.
AB  - A foam cushion was designed for wheelchair users who propel their wheelchairs
      with the assistance of one lower extremity. It allows users to extend one hip to
      reach the ground without having to slide forward on the seat, thus maintaining a
      more erect posture. The cushion was evaluated to identify contraindications for
      its use. Eleven subjects (10 stroke patients and 1 patient with an above-the-knee
      amputation) were tested on the Hemi Wheelchair Cushion and on a second cushion
      chosen by their primary occupational therapists. Seat interface pressures, both
      before and after dynamic movement, sitting balance, and wheelchair mobility were
      measured for each cushion. An analysis of mean pressure values revealed no
      significant difference between the cushion (p = .80). Average pressures after
      dynamic movement showed a statistically significant difference from pressures
      before activity (p < .05). Subjective evaluation revealed that the Hemi
      Wheelchair Cushion did not adversely affect sitting balance or wheelchair
      mobility, and no contraindications for its use were identified. The results of
      this clinical evaluation indicate that the Hemi Wheelchair Cushion is an
      economical and appropriate option for wheelchair users who propel themselves with
      the assistance of one leg.

PMID- 8470744
TI  - A model to promote activity competence in elders.
AB  - This paper describes an occupational therapy home-based intervention in which
      purposeful activities were used to promote adaptation and competence in older
      adults with chronic disabilities. Seven home care therapists visited 17 randomly
      selected, community-living elders who were chronically disabled and who
      volunteered to participate in the program. The number of visits ranged from 3 to
      10 and occurred over a 3-month period according to clients' needs and wishes.
      Therapists enhanced their ability to enter the client's social and cultural
      system by using participant-observation techniques and collaboratively identified
      activities. Therapists documented each home visit with a structured fieldnote
      form. An analysis of 112 field-notes indicated that therapists were able to
      understand a client's needs; this understanding resulted in small qualitative
      gains in areas identified as important by the client. Reilly's concept of an
      activity continuum was a useful framework from which to work with this
      population. The implications for program development, treatment outcomes, and
      accountability with this approach promote improved future treatment planning with
      the elderly with chronic disability.

PMID- 8470745
TI  - An analysis of a board game as a treatment activity.
AB  - Occupational therapists often use tabletop board games in treatment to help adult
      clients with physical disabilities improve the perceptual, cognitive, sensory,
      and fine motor skill components of occupational behavior. Detailed activity
      analyses of these types of activities, including performance norms, are not
      available in the occupational therapy literature. Such analyses would help
      therapists consider the multiple skill demands of tabletop games and allow more
      systematic grading of these treatment activities. This paper presents a model for
      analyzing therapeutic activities in relation to relevant motor learning and
      cognitive-perceptual literature. Included in this analysis are a description of
      the activity, examination of its component skills and of the qualitative features
      of activity performance, suggestions for grading and for treatment goals, and
      some preliminary performance standards derived from a pilot study of 18 adults
      without physical disabilities. The issue of transfer of skills between games and
      functional activities is also discussed.

PMID- 8470746
TI  - Generalization of occupational therapy effects in psychiatric rehabilitation.
AB  - Psychoeducation procedures dominate the treatment used by occupational therapists
      in psychiatric rehabilitation. The underlying assumption of skills training is
      that the skills taught generalize, that is, they persist beyond the treatment
      session and are used by the client in the community. This paper surveys
      occupational therapy literature to evaluate the generalization of skills taught
      to adult psychiatric clients by occupational therapists. Of the 77 studies
      reviewed, only 13 (17%) mentioned anything related to generalization. Seven of
      these articles statistically evaluated the outcome of skills training, but only
      four specifically assessed generalization of therapy. It is concluded that
      occupational therapists in psychiatry predominantly do not assess generalization
      of therapy. Discussion focuses on how four classes of generalization strategies
      (modifying the community environment, modifying the therapy environment, altering
      the style of therapy, and promoting client involvement) can enhance the
      effectiveness of occupational therapists in psychiatry.

PMID- 8470747
TI  - Linking patient and family stories to caregivers' use of clinical reasoning.
AB  - Due to pressures inherent in the current health care environment, health
      professionals' interactions with patients may be limited to attending to the
      disease process by using the scientific method of clinical reasoning. Health
      professionals may find it difficult to break out of this pattern of
      reductionistic thinking and acting to use other forms of clinical reasoning and
      to elicit patients' perceptions of the illness experience. Older adults and their
      families are particularly susceptible to being treated in a routine, disease
      focused manner. A growing body of literature gives voice to the stories and
      concerns of these persons. The purposes of this paper are to discuss thinking and
      clinical reasoning from several perspectives and to identify selections from
      literature that enhance understanding of the need to pay attention to both the
      disease and the illness experience and to use all forms of clinical reasoning.

PMID- 8470748
TI  - Training for a patient with shoulder disarticulation.
AB  - This patient received 26 outpatient occupational therapy sessions for a total of
      32.5 hr during an 18-week period. All treatment goals were achieved with the
      exception of psychosocial adjustment issues, which are ongoing. He made
      significant gains in right upper quadrant muscle isolation and demonstrated
      control and strength of the upper, middle, and lower trapezius fibers adequate
      for a myoelectric prosthetic. He also made improvement with left manual dexterity
      and unilateral coordination with regard to activities of daily living. He was
      discharged from outpatient occupational therapy services and referred to another
      medical center for prosthetic evaluation. Twenty weeks after discharge from our
      facility, he returned for a follow-up visit. He had been fitted with a shoulder
      cap and his tolerance for wearing it was approximately 10 hr per day. Thirteen
      weeks after the follow-up visit he resumed outpatient occupational therapy. We
      are evaluating his tolerance to the placement of a passive arm to the shoulder
      cap.

PMID- 8470749
TI  - A personalized communication wallet.

PMID- 8470750
TI  - Enhancing the research image of occupational therapy.

PMID- 8470751
TI  - Dangers inherent in the partition of occupational therapy and occupational
      science.

PMID- 8470752
TI  - Variation among early Homo crania from Olduvai Gorge and the Koobi Fora region.
AB  - Fossils recognized as early Homo were discovered first at Olduvai Gorge in 1959
      and 1960. Teeth, skull parts and hand bones representing three individuals were
      found in Bed I, and more material followed from Bed I and lower Bed II. By 1964,
      L.S.B. Leakey, P.V. Tobias, and J.R. Napier were ready to name Homo habilis. But
      almost as soon as they had, there was confusion over the hypodigm of the new
      species. Tobias himself suggested that OH 13 resembles Homo erectus from Java,
      and he noted that OH 16 has teeth as large as those of Australopithecus. By the
      early 1970s, however, Tobias had put these thoughts behind him and returned to
      the opinion that all of the Olduvai remains are Homo habilis. At about this time,
      important discoveries began to flow from the Koobi Fora region in Kenya. To most
      observers, crania such as KNM-ER 1470 confirmed the presence of Homo in East
      Africa at an early date. Some of the other specimens were problematical. A.C.
      Walker and R.E. Leakey raised the possibility that larger skulls including KNM-ER
      1470 differ significantly from smaller-brained, small-toothed individuals such as
      KNM-ER 1813. Other workers emphasized that there are differences of shape as well
      as size among the hominids from Koobi Fora. There is now substantial support for
      the view that in the Turkana and perhaps also in the Olduvai assemblages, there
      is more variation than would be expected among male and female conspecifics. One
      way to approach this question of sorting would be to compare all of the new
      fossils against the original material from Olduvai which was used to characterize
      Homo habilis in 1964. A problem is that the Olduvai remains are fragmentary, and
      none of them provides much information about vault form or facial structure. An
      alternative is to work first with the better crania, even if these are from other
      sites. I have elected to treat KNM-ER 1470 and KNM-ER 1813 as key individuals.
      Comparisons are based on discrete anatomy and measurements. Metric results are
      displayed with ratio diagrams, by which similarity in proportions for several
      skulls can be assessed in respect to a single specimen selected as a standard.
      Crania from Olduvai examined in this way are generally smaller than KNM-ER 1470,
      although OH 7 has a relatively long parietal. In the Koobi Fora assemblage, there
      is variation in brow thickness, frontal flattening and parietal shape relative to
      KNM-ER 1470.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8470753
TI  - Further observations on a method for estimating hominoid dental developmental
      patterns.
AB  - Several recent studies have concluded that early hominines resembled apes in
      patterns of dental ontogeny and have inferred from this conclusion that they were
      ape-like in other aspects of growth and development as well. Prior to their
      employment on fossil juveniles, the comparative methods used in these studies
      were not first tested for their predictive accuracy in distinguishing modern
      humans from apes on the basis of proposed patterns of dental ontogeny. We find
      that 92% of a sample of 48 modern children are classified as ape-like or nonhuman
      by the criteria employed in one of these studies and overlap entirely with fossil
      juvenile dental patterns. The use of these methods to characterize early
      hominines as "ape-like" or distinctly divergent from humans is thus shown to be
      unwarranted.

PMID- 8470754
TI  - Cranial deformation and nonmetric trait variation.
AB  - Cranial deformation is known to influence many traditional craniometric
      variables, but its effects on nonmetric trait variation are not well
      characterized. In this study, we examine the effects of three types of
      deformation (annular, lambdoid flattening, and fronto-occipital) on nonmetric
      traits, using a large sample of protohistoric and prehistoric crania. Our results
      indicate that a few traits are increased or decreased in relative frequency by
      particular types of deformation, but that these effects have little impact on the
      calculation of biological distances between groups.

PMID- 8470755
TI  - Nonmetric cranial variation and the populational affinities of the Pacific
      peoples.
AB  - Nonmetric traits of Hawaiian and Chamorro skulls were examined for evidence
      bearing on their populational affinities. Distance analyses reveal that the
      Hawaiian and Chamorro people, although not very near each other, are both closer
      to the East Asian than to the Jomon-Ainu or to the Arctic peoples. Our study of
      nonmetric cranial variation does not suggest an affinity between the Jomon and
      Pacific peoples.

PMID- 8470756
TI  - Differences in physical growth of Aymara and Quechua children living at high
      altitude in Peru.
AB  - Physical growth of Amerindian children living in two Aymara and three Quechua
      peasant communities in the Andean highlands of southern Peru (altitude 3,810
      3,840 m) was studied, taking into account differences in the microclimate,
      agronomic situation, and sociodemographic variables. Anthropometric measurements
      were taken in 395 children aged under 14 years of age in a sample of 151 families
      in these communities, who were surveyed for sociodemographic variables as well.
      Data on the land system were available for 77 families. In comparison with
      reference populations from the United States (NCHS) and The Netherlands, stature,
      weight, head circumference, and midupper arm circumference (but not weight for
      stature) in the sample children were reduced. Growth retardation increased after
      the age of 1 year. Stature and weight in the present sample were very similar
      compared with previously published data on growth of rural Aymara children living
      near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference,
      and weight for stature were significantly larger in Aymara children compared with
      Quechua children. Land was significantly more fragmented in Aymara compared with
      Quechua families, but amount of land owned was not different. Perinatal and
      infant mortality was elevated in Aymara vs. Quechua communities. Most families in
      Aymara communities used protected drinking water. One Quechua community had a
      severe microclimate, grim economic outlook, and weak social cohesion. Children in
      this community showed significant reductions in weight and midupper arm
      circumference compared with their peers in the other communities. We conclude
      that (presumably nutritionally mediated) intervillage and Aymara-Quechua
      differences in childhood physical growth existed in this rural high-altitude
      population in Peru and were associated with microclimate and the village economy,
      sociodemographic factors, and differences in the land system.

PMID- 8470757
TI  - Partial skeleton of Proconsul nyanzae from Mfangano Island, Kenya.
AB  - A partial skeleton attributed to Proconsul nyanzae (KNM-MW 13142) is described.
      The fossils were found at a site on Mfangano Island, Kenya, which dates to 17.9
      +/- .1 million years ago. KNM-MW 13142 consists of six partial vertebrae (T12
      S1), a nearly complete hipbone, most of the right femur and left femoral shaft, a
      fragmentary tibia and fibula, and a nearly complete talus and calcaneus. This
      skeleton provides the first pelvic fossil known for any East African Miocene
      hominoid. The new Proconsul specimen is compared to a large sample of extant
      anthropoids to determine its functional and phylogenetic affinities. In most
      aspects of its anatomy, KNM-MW 13142 closely resembles nonhominoid anthropoids.
      This individual had a long, flexible spine, narrow torso, and habitually
      pronograde posture, features characteristic of most extant monkeys. Evidence of
      spinal musculature suggests a generalized condition intermediate between that of
      cercopithecoids and hylobatids. The hindlimb of KNM-MW 13142 exhibits relatively
      mobile hip and ankle joints, with structural properties of the femur like those
      of hominoids. This mix of features implies a pattern of posture and locomotion
      that is unlike that of any extant primate. Many aspects of the Proconsul nyanzae
      locomotor skeleton may represent the primitive catarrhine condition.

PMID- 8470758
TI  - Primary lymphoma of the small intestine. A clinicopathological study of 119
      cases.
AB  - Small bowel lymphomas account for 20 to 40% of primary gut lymphomas in Western
      populations and are among the most common malignant tumours of the small bowel.
      We studied 119 cases of primary small bowel lymphoma presenting over 4 decades.
      Two thirds of the patients were men with a peak age incidence in the 7th decade.
      Common presenting features included abdominal pain, weight loss, small bowel
      obstruction, and acute abdomen. Tumours were classified using the Kiel European
      Association for Haematopathology Geneva Workshop scheme and phenotyped on
      paraffin sections; 66% were B cells, and 34% were T cell. In all cases, the
      antibodies L26 and polyclonal CD3 reliably distinguished between B- and T-cell
      tumours. Of the B-cell lymphomas, 62% were diffuse high grade, 20% were low-grade
      lymphomas of mucosa-associated lymphoid tissue, 11% had both low- and high-grade
      components, and 7% were other low-grade types. Of the T-cell lymphomas, 83% were
      high grade, and 49% were enteropathy associated. Most T-cell lymphomas were
      ulcerated plaques or strictures in the proximal small bowel; B-cell lymphomas
      tended to be annular or polypoid masses in the distal and terminal ileum.
      Survival data showed that low-grade B-cell lymphomas had the best outcome and T
      cell lymphomas the worst. Adverse prognostic features included perforation, high
      grade histology, multiple tumours and advanced stage.

PMID- 8470759
TI  - Childhood rhabdomyosarcoma with anaplastic (pleomorphic) features. A report of
      the Intergroup Rhabdomyosarcoma Study.
AB  - The pleomorphic subtype of rhabdomyosarcoma (RMS) is now rarely diagnosed in both
      children and adults. Most cases previously called pleomorphic RMS are probably
      diagnosed as something else, most often embryonal RMS in children and malignant
      fibrous histiocytoma in adults. To analyze the concept of pleomorphic RMS in
      children, we reviewed the tumors of patients entered on the Inter-group
      Rhabdomyosarcoma Study (IRS I, II, and III). The presence of cells with lobated,
      hyperchromatic nuclei at least three times larger than the common tumor cell
      population (anaplastic cells) was selected as the main criterion. Of about 3,000
      cases, 110 showed these types of cells, had sufficient histologic material, and
      had available follow-up data. These tumors were divided into two subgroups:
      Subgroup I tumors contained only scattered anaplastic cells, and tumors with foci
      or large sheets of anaplastic cells were classified as subgroup II. Besides the
      anaplastic-pleomorphic areas, most of these tumors had distinctive features of
      embryonal RMS (105 cases) and rarely had characteristics of alveolar RMS (five
      cases). The age distribution of these patients did not differ significantly from
      those whose tumors did not show the anaplastic features, the average being 6
      years and the median 4 years. Lower extremity, retroperitoneum, and the head and
      neck region were the most common primary tumor sites. The 5-year survival rate
      was 60% for subgroup I tumors and 45% for subgroup II tumors compared with the
      survival rate of 68% for 482 IRS II embryonal RMS cases with no anaplastic
      pleomorphic features. The lower survival rate for patients in subgroup II was
      statistically significant (p = 0.004) and similar to the unfavorable survival of
      patients with alveolar RMS and undifferentiated sarcoma. Because anaplastic cells
      are seen in many soft tissue sarcomas and in both embryonal and alveolar RMS in
      children, this feature is not sufficiently unusual to separate a pleomorphic
      subtype of RMS. The presence of anaplastic cells in aggregates or diffuse sheets
      throughout the tumor, however, portends a poor survival for these patients.

PMID- 8470760
TI  - Crystal-storing histiocytosis associated with lymphoplasmacytic neoplasms. Report
      of three cases mimicking adult rhabdomyoma.
AB  - Massive crystal deposition is rare in lymphoplasmacytic (LPc) or plasma cell
      neoplasms. We report three cases in which the accumulation of crystals in
      histiocytes closely reproduced the histologic features of adult rhabdomyoma. The
      patients, all female, aged 18, 77, and 78 years, presented with tumor of cervical
      lymph nodes (two cases) or the otolaryngic mucosa (two cases). In addition, two
      patients had monoclonal serum or urine immunoglobulin (IgM-kappa-1, unknown-1),
      and one had renal and bone marrow involvement on biopsy. This last patient died
      of acute renal failure at 5 months, another was alive without disease at 8 years,
      and the remaining one was lost to follow-up. Lymph nodes, mucosae, and kidney
      showed a neoplastic LPc infiltrate masked by sheets of large benign histiocytes
      containing sheaves of crystals. Paraffin-section immunohistochemistry
      demonstrated monoclonal staining of the LPc cells in all cases (IgM-kappa-2, IgA
      kappa-1) and of the crystals (IgM-kappa) in one case. In all patients, the
      crystal-containing cells were positive for KP-1 (CD68), but not for desmin,
      muscle-specific actin, or myoglobin. These findings suggest that, in any case of
      adult rhabdomyoma in which the histologic findings are not typical, a crystal
      storing histiocytosis should be ruled out: recognition of the atypical LPc
      component and the histiocytic immunophenotype of the crystal-storing cells will
      help prevent a serious misdiagnosis.

PMID- 8470761
TI  - Complete histologic serial sectioning of a prostate gland with adenocarcinoma.
AB  - Variations in the proportion of surface occupied by tumor (percentage carcinoma),
      carcinoma volume, histologic grade, capsular penetration, and margin positivity
      were assessed in a completely sampled cancerous prostate gland. All prostatic
      tissue was embedded and each block serially sectioned, for a total of 2,678
      histologic sections examined. Although variations in percentage carcinoma and
      carcinoma volume were noted in some blocks, the differences were small when
      compared with the initial set of 19 slides. Histologic Gleason's grade also
      showed little variation in the serial sections. Focal capsular penetration in one
      block and an increase in the number of blocks with a positive anterior margin
      from two to four were identified in serial sections, but this did not alter the
      pathologic stage because of seminal vesicle involvement by tumor. In this
      example, the morphologic prognosticators of tumor volume, histologic grade,
      margin positivity, and pathologic stage were not altered by complete serial
      sectioning.

PMID- 8470762
TI  - Idiopathic retroperitoneal fibrosis is a macrophage-rich process. Implications
      for its pathogenesis and treatment.
AB  - Idiopathic retroperitoneal fibrosis (IRF) is an uncommon disease of obscure
      etiology and pathobiology. Using sections of frozen and paraffin-embedded tissue,
      an immunohistochemical technique, and antibodies to a variety of macrophage- and
      lymphocyte-associated antigens, we studied six examples of IRF. The results
      showed a large population of spindle-shaped cells that expressed the
      immunophenotype of a tissue macrophage, that is, Leu 3a,b (CD4)+, MY7 (CD13)+,
      Leu M5 (CD11c)+, KP-1 and EBM-11 (CD68)+, human leukocyte antigen (HLA-DR)+,
      leukocyte common antigen (CD45)+, HAM-56+, and MAC387+. A subpopulation of these
      cells also reacted with an antibody to the "activation" antigen, interleukin 2R
      (CD25). A control group of "fibroblastic" lesions including keloids, desmoid
      tumors, and an aggressive fibromatosis displayed minimal reactivity with this
      panel of antibodies. The abundance of macrophages suggests that they may play an
      important role in the pathogenesis of IRF. If, as has been suggested by some
      studies, IRF is an immune-mediated phenomenon, the macrophages may be triggered
      to produce cytokines that stimulate fibroblast proliferation and subsequent
      fibrosis that characterize this disease.

PMID- 8470763
TI  - Lymphocytic bronchitis/bronchiolitis in lung allograft recipients.
AB  - Twenty-six cases of lymphocytic bronchitis/bronchiolitis (LBB) identified by
      transbronchial biopsy in 25 lung allograft recipients were studied to determine
      its relationships to acute rejection and bronchiolitis obliterans (OB). LBB
      occurred 355 days after transplantation on average (range, 15-2,118 days) and was
      manifested by a patchy or diffuse submucosal infiltrate of lymphocytes and plasma
      cells, which percolated deep to the smooth muscle layer of the bronchi in 15
      cases. Submucosal granulation tissue and bronchiolitis were observed more
      frequently in patients who developed OB than in those who did not (44% and 88% vs
      23% and 41%). Although 39% of patients progressed to OB overall, the majority of
      patients with LBB who received augmented immunosuppressive therapy (steroids,
      antithymocyte globulin, or both) improved or stabilized their pulmonary function
      abnormalities. Interestingly, LBB was preceded by acute rejection in 20 of 26
      instances, and LBB frequently persisted as a histologic finding after the initial
      diagnostic transbronchial biopsy. LBB appears to be related to previous acute
      rejection episodes and responds to augmented immunosuppressive therapy.

PMID- 8470764
TI  - Eosinophilic and lymphoeosinophilic cholecystitis.
AB  - Eosinophilic cholecystitis (EC) is an infrequent and poorly understood
      inflammatory condition of the gallbladder. First described in 1949, EC may be
      defined as an inflammatory condition of the gallbladder in which the inflammatory
      infiltrate is composed predominately of eosinophils so that their presence
      clearly overshadows the presence of any other inflammatory cell component. In the
      few reports that describe EC, it has been described in association with
      acalculous cholecystitis, with subacute cholecystitis lasting 2 to 3 weeks and
      with several forms of drug therapy. This retrospective clinicopathologic study
      reviewed the histopathologic features of 217 consecutive cholecystectomy
      specimens with special clinical reference to the timing of gallbladder removal
      after symptoms, previous drug therapy, systemic infection, and the presence of
      cholelithiasis. Pathologically, 48 of these cases (22.2%) contained eosinophils
      to some degree. Eosinophilic cholecystitis was diagnosed in 14 (6.4%) of the
      specimens, and another 14 (6.4%) specimens demonstrated substantial numbers of
      eosinophils but also had other types of inflammatory cells in abundance,
      including neutrophils and lymphocytes. Of the eight patients with acalculous
      cholecystitis, six had substantial eosinophils in their gallbladders, whereas the
      other two patients had no eosinophils. In this study, EC was more prevalent than
      in other reported series, and it did not show any association with the timing of
      gallbladder removal after initial symptoms, drug therapy, or other preexisting
      medical conditions. Eosinophilic cholecystitis is more common than previously
      recognized and probably represents a subgroup of patients with a unique or
      hypersensitivity type of inflammatory response to altered bile. Large numbers of
      eosinophils in the inflammatory infiltrate occurred three times more commonly in
      patients with acalculous cholecystitis than in patients with cholelithiasis.

PMID- 8470765
TI  - Calcifying fibrous pseudotumor.
AB  - We report 10 cases of a distinctive benign fibrous lesion characterized by the
      presence of abundant hyalinized collagen with psammomatous or dystrophic
      calcifications and a lymphoplasmacytic infiltrate. The lesions were present from
      2 months to 10 years before resection and ranged in size from 2.5 to 15 cm. They
      involved subcutaneous and deep soft tissues and, although relatively well
      circumscribed, occasionally infiltrative borders or entrapped structures were
      seen on microscopic examination. The lesions were located in the extremities
      (three cases), trunk (two cases), scrotum (two cases), groin (one case), neck
      (one case), and axilla (one case). Both sexes were equally affected. The mean and
      median ages of the patients were 16.2 and 18.5 years, respectively (range, 1 to
      33 years). All cases were initially managed by simple local excision. Follow-up
      ranging from 2 months to more than 10 years (median, 41.5 months) was available
      in six cases and revealed a local recurrence in one instance; this became
      clinically apparent about 7.5 years after the initial resection. Morphologic
      features and follow-up data suggest this may be a unique form of fibrous
      pseudotumor.

PMID- 8470766
TI  - Postimmunization (vaccination) injection-site reactions. A report of four cases
      and review of the literature.
AB  - Four patients each had a single subcutaneous nodule at the site of a previous
      vaccine injection; three after injection of diphtheria, tetanus, and pertussis
      vaccination and one after tetanus toxoid vaccination. Presentation was with a
      mass 4-22 months after vaccination at the site of injection. Histologically,
      three patients had a necrotizing granulomatous reaction with a surrounding
      infiltrate of lymphocytes, plasma cells, histiocytes, and associated fibrosis.
      The fourth patient demonstrated a lymphohistiocytic reaction with a predominance
      of histiocytic cells as well as associated plasma cells, fibroblasts, and
      fibrosis. The lymphoid infiltration in these reactions showed a predominance of T
      lymphocytes over B-lymphocytes. Aluminum was demonstrated in necrotic foci,
      inflammatory stroma, and the granular cytoplasm of histiocytes with the aid of
      solochrome azurine and solochrome cyanine stains as well as by energy-dispersive
      x-ray microanalysis. The reactions are thought to be immunologic
      (hypersensitivity) reactions associated with the aluminum contents of the
      preparation.

PMID- 8470767
TI  - Paratesticular (spermatic cord and tunica testis) fibroblastic/myofibroblastic
      proliferations.

PMID- 8470768
TI  - Prostate in ovarian teratoma.

PMID- 8470769
TI  - PNET vs MPNST.

PMID- 8470770
TI  - Charting a course for the future: a society at the interface.

PMID- 8470771
TI  - Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6),
      and interleukin-1 beta (IL-1 beta) in dengue-infected patients.
AB  - Sensitive immunoenzymatic assays were used to study the levels of tumor necrosis
      factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1 beta in sera from dengue
      infected patients obtained during the 1989-1990 outbreak of dengue-3 in Tahiti,
      French Polynesia. The patients, both children (n = 47) and adults (n = 18), were
      clinically classified as having dengue hemorrhagic fever (DHF) and graded
      according to the severity of illness (grade I = fever, grade II = fever with
      spontaneous hemorrhagic manifestations, grade III = circulatory failure, grade IV
      = deep shock). The serum samples were obtained from day 1 to day 10 after the
      onset of the disease. High levels of TNF-alpha were observed in dengue-infected
      children of all severity grades. The highest values of TNF-alpha were found
      before day 6 after the onset of the infection, these values decreased from day 6
      to day 10. The highest values were observed in sera from grade III and IV
      patients. High values of IL-6 were observed in serum samples of grade I and II
      patients on day 1, which decreased on day 4, and by day 5 were similar to those
      obtained from 25 control children. In grade III and IV patients, the highest
      values of IL-6 were observed from day 3 to day 5 after the onset of infection;
      after day 5, these values were very low.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470772
TI  - Amplification of a Trypanosoma cruzi DNA sequence from inflammatory lesions in
      human chagasic cardiomyopathy.
AB  - The major cause of morbidity and mortality in Chagas' disease is a chronic
      inflammatory cardiomyopathy, which presents ten or more years following initial
      infection. Demonstration of Trypanosoma cruzi in cardiac tissue by routine
      microscopy or culture is difficult in these patients, which has suggested that
      persistent organisms are not required for chronic disease. Consequently, studies
      have focused on elucidating an autoimmune pathogenesis of chronic injury. To
      further assess the persistence of T. cruzi in host tissue, DNA extracted from
      formalin-fixed, paraffin-embedded autopsy specimens from seronegative or
      seropositive patients was amplified by the polymerase chain reaction using T.
      cruzi-specific primers. Trypanosoma cruzi DNA sequences were not consistently
      amplified from four seropositive patients who lacked evidence of fatal chronic
      chagasic cardiomyopathy (CCC) (0 positive of 12 heart samples, 0 positive of four
      gonadal samples, and 0 positive of four adrenal samples) or nine seronegative
      patients (0 positive of 27 heart samples, 0 positive of nine gonadal samples and
      0 positive of nine adrenal samples). In seven seropositive patients with severe
      CCC, cardiac tissue adjacent to inflammatory infiltrates yielded amplified T.
      cruzi DNA sequences in 18 of 21 heart samples. Parallel testing of gonadal and
      adrenal tissues from these same patients produced detectable T. cruzi DNA in none
      of the gonadal tissue samples and one of the seven adrenals. Our studies
      demonstrate that T. cruzi, or a portion of its genome, is present in the
      inflammatory lesion of chronic cardiac Chagas' disease.

PMID- 8470773
TI  - Risk factors of malaria infection during pregnancy in Burkina Faso: suggestion of
      a genetic influence.
AB  - A cohort of 570 untreated pregnant women from Burkina Faso was studied to assess
      the influence of epidemiologic factors on malaria infection, which was quantified
      as the mean of serial, season-adjusted parasitemia measurements (mean parasite
      density [MPD]) carried out during the last five months of gestation. A
      significant effect of the area of maternal residence on the MPD was found (P <
      0.003) and was probably due to geographic differences in mosquito transmission
      conditions. The strong relationship observed between parity and malaria infection
      (P < 0.0001), with MPD levels decreasing as the number of gestations increased,
      confirms that primigravidae are a high-risk group whose protection should be a
      priority. After adjustment for two relevant epidemiologic factors (i.e., area of
      residence and parity), the residual MPD values fitted a mixture of two
      distributions. This result supports the view that a major gene is involved in the
      determination of malaria infection intensities and is consistent with the results
      of a recent familial study in Cameroon.

PMID- 8470774
TI  - Plasmodium falciparum-associated anemia in children at a large urban hospital in
      Zaire.
AB  - Chloroquine-resistant Plasmodium falciparum malaria and human virus (HIV)
      infection through blood transfusions used to treat malaria-associated anemia are
      causes of increasing morbidity and mortality among children in Africa. To
      evaluate the role of malaria and other risk factors for pediatric anemia, we
      conducted a study of children brought to the emergency ward of a large urban
      hospital in Kinshasa, Zaire. A total of 748 children ages six through 59 months
      were enrolled; 318 (43%) children were anemic (hematocrit < 33%), including 74
      (10%) who were severely anemic (hematocrit < 20%). Plasmodium falciparum
      parasites were detected in 166 children (22%); hematocrits for these children
      (mean 25.8%) were significantly lower than for aparasitemic children (mean 33.7%;
      P < 10(-6)). Fever with splenomegaly (odds ratio [OR] = 6.5, P = 0.02),
      parasitemia (OR = 3.5, P < 0.001), lower socioeconomic status (OR = 2.0, P =
      0.004), and malnutrition (OR = 1.8, P = 0.06) were independently associated with
      anemia in a multivariate model. Recent antimalarial therapy was also associated
      with a lower hematocrit, suggesting that chloroquine may have aggravated the
      anemia. A reassessment of the effectiveness of strategies to diagnose and treat
      malaria and malnutrition is necessary to decrease the high prevalence of anemia
      and the resultant high rate of blood transfusions in areas endemic for malaria
      and HIV.

PMID- 8470775
TI  - Comparison of beta-artemether and beta-arteether against malaria parasites in
      vitro and in vivo.
AB  - The antimalarial activity of beta-artemether and beta-arteether was compared in
      three test systems: in vitro against chloroquine-resistant and chloroquine
      sensitive Plasmodium falciparum parasites, in mice infected with P. berghei, and
      in Aotus monkeys infected with chloroquine-resistant P. falciparum. In vitro, the
      mean 50% inhibitory concentration (IC50) for beta-artemether was 1.74 nM (range
      1.34-1.81 nM), and this value for beta-arteether was 1.61 nM (range 1.57-1.92
      nM). They were approximately 2.5-fold more potent than artemisinin, which had a
      mean IC50 of 4.11 nM (range 3.36-4.60 nM). In the mouse model, the 50% curative
      doses (CD50) of beta-artemether and beta-arteether had a mean value of 55 mg/kg
      (32-78 mg/kg). The 50% effective curative doses (ED50) in the Aotus monkey were
      7.1 mg/kg (95% confidence interval [CI] = 3.7-13.5) for beta-artemether and 11.8
      mg/kg (95% CI = 6.5-21.3) for beta-arteether. Overall, the activities of the two
      drugs were comparable.

PMID- 8470776
TI  - Derivation of highly mefloquine-resistant lines from Plasmodium falciparum in
      vitro.
AB  - Serial passage of a multidrug-resistant clone of Plasmodium falciparum in
      concentrations of mefloquine hydrochloride ranging from 30 to 2,400 ng/ml
      resulted in the derivation of increasingly resistant parasite lines in vitro.
      Parasite lines isolated in mefloquine concentrations greater than 300 ng/ml
      demonstrated increased vacuolization, enhanced pigment production, and increased
      growth rates as compared with the progenitor clone, W2-mef. Although
      microdilution incorporation assays demonstrated that the 50% inhibitory
      concentration (IC50) of mefloquine were similar for all lines, the IC90, IC95,
      and IC99 levels were significantly increased. Growth rate assays performed in 5%
      hematocrit suspensions demonstrated different levels of mefloquine resistance
      among these lines. Under these conditions the most resistant line, Mef 2.4, grew
      efficiently in approximately 10-fold higher concentrations of mefloquine than the
      progenitor clone W2-mef. Analysis of drug susceptibility profiles to mefloquine
      hydrochloride, chloroquine diphosphate, quinine sulfate, and halofantrine
      hydrochloride indicated that selection for high levels of mefloquine resistance
      had resulted in significant increases in resistance to halofantrine and increased
      sensitivity to chloroquine. The phenotypic changes demonstrated in the most
      resistant line, Mef 2.4, reflect a multidrug resistant-like phenotype, and appear
      to mimic changes recently reported in drug susceptibility profiles of
      recrudescent isolates following mefloquine treatment failures in Thailand.

PMID- 8470777
TI  - Treatment of malaria in Vietnam with oral artemisinin.
AB  - In this study, 638 patients with either Plasmodium falciparum or P. vivax malaria
      were treated with artemisinin (qinghaosu) that was isolated and formulated into
      tablets and capsules in Vietnam. In all cases, artemisinin treatment resulted in
      a rapid clearance of parasitemia and fever. Recrudescence rates were highest in
      those groups receiving treatment for five or less days (50%), but were between
      10% and 23% for those groups receiving the drug for 5-10 days. A low recrudescent
      rate (9.5%) was also found when patients were treated with a combination of
      artemisinin for three days and tetracycline for five days. Thus, artemisinin
      represents a useful and economically feasible component of the malaria control
      program in Vietnam.

PMID- 8470778
TI  - Human immune responses to the Plasmodium falciparum ring-infected erythrocyte
      surface antigen (Pf155/RESA) after a decrease in malaria transmission in
      Madagascar.
AB  - A resurgence of falciparum malaria occurred in the central highlands of
      Madagascar in the 1980s and was responsible for an outbreak in 1986-1987. Since
      1989, transmission has decreased dramatically. In April 1991, we investigated the
      humoral and cellular immune responses of 53 inhabitants of the village of
      Manarintsoa to six synthetic peptides that reproduced the major B and/or T cell
      epitopes of the Pfl 55/ring-infected erythrocyte surface antigen (RESA) of
      Plasmodium falciparum. The presence of RESA peptide-reactive T cells was assessed
      by lymphocyte proliferation assay as well as by detection of in vitro production
      of interferon-gamma and interleukin-2. The mean values of these cellular
      responses were low, and the results obtained in these three tests showed no
      correlation. Twenty-seven subjects presented with anti-RESA antibodies as
      detected by modified immunofluorescent assay, but the mean levels of anti-peptide
      antibodies were low. When compared with data obtained in January 1988 from the
      same subjects with three of the six peptides, the present data demonstrated a
      decrease in the response to these peptides in terms of both proliferative
      response and mean antibody titers. The mean values of anti-RESA antibodies
      remained unchanged. The fact that cellular and humoral responses to the major Pfl
      55/RESA epitopes decreased but did not disappear probably reflects both the
      remainder of the acquired immunity resulting from the 1986-1987 malaria outbreak,
      and its conservation by the very low level of transmission since 1989.

PMID- 8470779
TI  - Detection of West Nile virus by the polymerase chain reaction and analysis of
      nucleotide sequence variation.
AB  - A polymerase chain reaction (PCR) assay was developed to rapidly detect and
      identify West Nile (WN) virus. The RNA from seven isolates of WN virus from six
      countries and four other flaviviruses (Kunjin, Japanese encephalitis, St. Louis
      encephalitis, and yellow fever viruses) was reverse-transcribed (RT) and
      amplified by PCR. The nucleotide sequences of the amplified products were
      determined by a rapid, automated DNA sequencing method. The WN virus RT/PCR assay
      detected the target gene segment of sequencing method. The WN virus RT/PCR assay
      detected the target gene segment of isolates from both the African-Middle Eastern
      group and the Indian group with a sensitivity of approximately 0.05 pg of viral
      RNA. Kunjin virus was the only other flavivirus tested that produced a band of
      the appropriate size. Five of seven WN virus isolates showed 92-98% homology in
      the nucleotide sequence of their PCR products. The sequence of one isolate was
      virtually identical to the published sequence of the Nigerian isolate (99.5%
      homology). No correlation was established between the degree of nucleotide
      homology, geographic location, time of isolation, or source of the isolates.

PMID- 8470781
TI  - [A modification of the Macintosh blade for difficult intubations].

PMID- 8470780
TI  - Differentiation of Toxoplasma gondii from closely related coccidia by riboprint
      analysis and a surface antigen gene polymerase chain reaction.
AB  - The tachyzoite of the human pathogen Toxoplasma gondii is morphologically
      indistinguishable from the proliferative stages of some other zoonotic coccidia,
      including Sarcocystis. To determine the identity of such coccidia obtained from
      human tissues and other sources, we compared riboprints (through restriction
      enzyme analysis of the polymerase chain reaction [PCR]-amplified small subunit
      rRNA gene) of the following protozoa: the RH and ts-4 strains of T. gondii, lines
      OH3 and S11, which are two recently isolated T. gondii-like parasites from
      Brazil, Neospora caninum, Sarcocystis species, and the malarial parasite
      Plasmodium berghei. In addition, the protozoan genomes were examined by PCR for
      homologs of surface antigen genes of T. gondii, and by Southern hybridization to
      the heterologous rRNA gene probe pSM 389. Strains OH3, S11, ts-4, and RH shared
      identical riboprints, and OH3, S11, and ts-4 have p22 and p30 surface antigen
      gene structures similar to RH. In contrast, riboprints for N. caninum and T.
      gondii differ with respect to Dde 1 sites, and moreover, their genomes vary
      significantly from one another at both the p22 and p30 gene loci. The riboprints
      of Sarcocystis and P. berghei differ markedly from T. gondii and N. caninum and
      from each other. Bam HI pSM 389 restriction fragment length polymorphisms
      differentiate ts-4 from RH, OH3, and S11. Our results confirm that OH3 and S11
      are indeed T. gondii, but that N. caninum and T. gondii are likely to be separate
      species, thereby resolving previous uncertainties concerning the identity of
      these parasites. Together, the variation in riboprints and surface antigen gene
      structure reflects the phylogenetic diversity among these coccidia, and in
      addition, confirms the value of riboprinting in the identification of
      apicomplexan parasites such as T. gondii.

PMID- 8470782
TI  - [A modified Macintosh blade for difficult intubation. The mirror blade].
AB  - Difficult intubations can occur in cases of anatomical or physiological
      abnormalities of the face and neck. They are frequently predictable when specific
      signs are evident preoperatively. There are still occasional unexpected
      difficulties during conventional laryngoscopy when common blades like the
      Macintosh and Foregger types are used. During the past 5 decades several authors
      have proposed many types of laryngoscopes and blades differing in length and
      shape, as well as various accessories such as guide-wires, prisms, and mirrors.
      METHOD. We modified a size 3 Macintosh blade by adding a mirror placed tangential
      to the external curve near the apex. This configuration allows both conventional
      direct visualisation of the vocal cords and non-direct viewing through the
      mirror. Insertion of the tube is facilitated using a specially shaped guide-wire.
      RESULTS. This equipment was used for orotracheal intubation in 20 patients with
      different degrees of direct laryngeal visibility prior to otolaryngologic
      endoscopy and surgery under general anaesthesia. Both methods of larynx
      visualisation were performed and compared. In 1 patient the mirror was not useful
      because it became fogged. In all the others we could avoid this problem by
      warming the blade in water. Only in 1 other case was the conventional view better
      and intubation seemed to be easier than when the mirror was used. In 15 patients
      the vocal cords were visualised better with the mirror, and intubation was
      performed by means of the guide-wire with the non-direct technique. In 2 of these
      cases difficult direct laryngoscopy of grades 3 and 4 according to the Cormack
      and Lehane classification was found. Four patients were difficult to intubate and
      neither type of laryngoscopy was ideal. It is notable that a satisfactory view
      was achieved in the mirror with much less effort. In particular, there was no
      need to introduce the blade as deeply or raise its apex as much as is usually
      done. CONCLUSION. The mirror-blade is a suitable device for management of
      unexpected difficult intubations. Because of its dual availability, it offers
      both direct and non-direct visualisation of the larynx. Handling of this mirror
      blade can be practised extensively, which allows integration of this equipment in
      the "failed intubation drill". This should be an integral part of the teaching
      and training of anaesthesia personnel.

PMID- 8470783
TI  - [General anesthesia in two patients with mitochondrial myopathy].
AB  - Two patients with mitochondrial myopathy (Kearns-Sayre syndrome) received general
      anaesthesia. In the first case propofol-alfentanil anaesthesia was carried out;
      the second patient received propofol-fentanyl anaesthesia. Muscle relaxation was
      provided with vecuronium. In both cases we observed a short episode of
      bradycardia (heart rate < 50.min-1), which was successfully treated with
      atropine. After the propofol infusion had been stopped, both patients rapidly
      gained consciousness and were extubated after prompt spontaneous ventilation had
      returned. Reversal of neuromuscular blockade in the second patient was achieved
      within 5 min by neostigmine. Special anaesthetic problems in patients with
      mitochondrial myopathies such as myocardial conduction disturbances,
      postoperative muscle hypotonia, and possible increased susceptibility to
      malignant hyperthermia can be overcome by the described anaesthetic management.

PMID- 8470784
TI  - [Comments on the paper by R. Fretschner et al. Capnometry in pediatric
      anesthesia].

PMID- 8470785
TI  - [Comments on the paper by H.-J Hartung and Th. Luiz. Total spinal anesthesia].

PMID- 8470786
TI  - [The stellate ganglion blockade].
AB  - Stellate ganglion block is a selective sympathetic blockade affecting one side of
      the head and neck, and the upper extremity and upper part of the thorax on the
      same side. It is an important method of treating impaired vascular circulation,
      sympathetic reflex dystrophy, causalgia and herpes zoster in the area other
      indications, e.g. acute hearing loss and retinal arterial spasms, are still
      disputed. The anatomy of the cervical sympathetic chain, the technique used to
      achieve the block (paratracheal access) and tests of the effectiveness of
      stellate ganglion blockade are described. The side-effects and complications of
      the method and other means of sympathetic blockade are discussed. Patients need
      to be informed of the possible complications and the alternatives available
      before being asked to give informed consent.

PMID- 8470787
TI  - [Acute thromboembolism of the lung. Clinical picture--pathophysiology--diagnosis-
      therapy].
AB  - Pulmonary embolism must often be considered as a differential diagnosis,
      especially in the perioperative period. Only prompt therapeutic measures can
      reduce the high early mortality in the acute phase of this condition. Diagnostic
      and therapeutic measures are dependent on the severity of the symptoms. If
      pulmonary embolism is suspected, heparin is administered. In the case of
      cardiovascular deterioration, other measures have to be taken. Following
      confirmation of the diagnosis of pulmonary embolism, several thrombolytic
      regimens are applicable. Low-dose urokinase (bolus 250,000 U followed by 60,000
      80,000 U/h) is associated with a relatively low incidence of bleeding
      complications. A more rapid reduction of the right ventricular afterload will be
      achieved via short-term thrombolysis. Newer findings suggest that bolus
      thrombolysis with 3 million U urokinase is as effective as 100 mg tissue
      plasminogen activator (rt-PA) administered over a 2-h period. When the patient is
      found to be in a state of shock, confirmation of the diagnosis has to be delayed.
      Recommendations include the bolus application of 1.5-3 million U urokinase when
      right ventricular decompensation is prominent or during cardiopulmonary
      resuscitation. In case of existing contraindications or postoperatively, low-dose
      urokinase treatment (bolus 250,000 U followed by 40,000-60,000 U/h, rarely up to
      2,200 U/kg per hour) may be initiated when the situation is urgent and there are
      no treatment alternatives. Bolus application of 1-2 million U urokinase should be
      considered depending on the severity of the symptoms and the underlying disease.
      In some hospitals, alternative treatment modalities include catheter-assisted
      procedures with subsequent local thrombolysis and surgical embolectomy.
      Pathophysiological aspects as well as therapeutic options in the intensive care
      unit are discussed in depth. In addition to adequate oxygenation, right
      ventricular coronary perfusion and contractility may be maintained using various
      catecholamine infusions. The importance of phosphodiesterase inhibitors, mediator
      antagonists such as acetylsalicylic acid or ketanserin, and dilators of the
      pulmonary vascular bed are discussed.

PMID- 8470788
TI  - [Induction of anesthesia using the new intravenous steroid anesthetic eltanolone
      (pregnanolone). Dose determination and pharmacodynamics].
AB  - Since the 1940s several preclinical investigations have demonstrated the
      anaesthetic activity of a series of structurally related pregnanes without
      notable endocrine action. One of the most active of these is pregnanolone (3
      alpha-hydroxy-5-beta-pregnane-20-one), which is a naturally occurring metabolite
      of progesterone. Pregnanolone is not soluble in water, which has prevented its
      use for clinical research. In 1987, however, a stable oil-in-water emulsion of
      eltanolone that could be used for i.v. administration in man was introduced by
      KABI Pharmacia, Stockholm, Sweden. METHODS. In an open study the dose of
      eltanolone that induces anaesthesia in 50% of the patients (AD50) was estimated
      according to the "up and down method" of Dixon and Massey. Respiratory and
      cardiovascular effects were evaluated as well as the reliability of eltanolone
      emulsion. The study was conducted in accordance with the Declaration of Helsinki
      and started after the approval of the local Medical Ethics Review Committee. In
      all, 31 patients of ASA risk categories I and II (male or female with non child
      bearing potential) were included in the study after written informed consent had
      been obtained. All patients were premedicated with 5 mg midazolam i.m. about 30
      min before the injection of eltanolone. Eltanolone emulsion was given i.v.,
      usually on the back of the hand, over 20 s. In connection with the injection of
      eltanolone every patient was asked whether he or she felt any pain or discomfort
      at the injection site. As suggested by results in volunteers in a previous study
      the starting dose was 0.5 mg/kg body weight. Cessation of counting and loss of
      eyelash reflex were used as indicators of efficacy in the induction of
      anaesthesia. If these criteria were achieved within 120 s after the start of
      injection (responder) the dose for the next patient was decreased by 15%, if not
      (non-responder), the next patient received the same dose plus 15% (up to 1.01
      mg/kg body weight). Heart rate and oxygen saturation were recorded continuously
      (Sirecust 404; Nellcor) from 1 min before to 10 min after the start of injection,
      and blood pressure was measured noninvasively 1 min before induction and then at
      1, 2, 3, 5, 8 and 10 min from the start of the eltanolone injection (Sirecust
      888). If oxygen saturation fell to 85% oxygen was applied by way of the face mask
      and the patients were ventilated if necessary. Respiratory disturbances, time to
      and duration of apnoea were recorded, as were involuntary movements or increase
      in muscle tone. Usually intubation was carried out at the end of the 10-min
      observation period using thiopentone, vecuronium and suxamethonium. If a patient
      did not fall asleep or awoke prematurely, intubation was performed in the same
      way and from this point pharmacodynamic parameters were no longer evaluated for
      the study. RESULTS. The AD50 was 0.33 mg/kg body weight, and the 95% confidence
      interval, 0.30-0.36 mg/kg body weight. The eltanolone dose varied from 0.25 to
      0.5 mg/kg body weight. Induction was successful in 17 (of 31) patients according
      to the eyelash reflex as criterion and in 28 according to cessation of counting.
      Above 0.38 mg/kg body weight efficacy variables were achieved in all patients,
      while below 0.29 mg/kg body weight eyelash reflex was not lost in any patient.
      The mean time to loss of consciousness (cessation of counting) in the responder
      group was 48 +/- 12 s after the start of injection and loss of eyelash reflex was
      recorded after 94 +/- 13 s. In the nonresponder group eyelash reflex persisted
      over 120 s in all patients and counting stopped on average after 72 +/- 23 s.
      Three patients in this group also did not stop counting (dose: 0.29 mg/kg body
      weight). Blood pressure remained stable in all patients but 1 throughout the
      observation period. In 1 patient there was an alarming rise in blood pressure
      from 160/90 mmHg before to 200/100 mmHg 3 min after the injection.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8470789
TI  - [Quality of induction and adrenocortical function. A clinical comparison of
      Etomidate-Lipuro and Hypnomidate].
AB  - The purpose of this study was to compare etomidate in a lipid emulsion (Etomidat
      Lipuro; Braun, Melsungen) and in propylene glycol (Hypnomidate, Janssen
      Pharmaceutica) in 90 patients in terms of anaesthetic induction characteristics
      with special reference to injection side effects, haemodynamic changes, and
      quality of induction. Adrenocortical hormones were determined in 30 patients who
      received either Etomidat-Lipuro, Hypnomidate, or propofol (Diprivan, ICI Pharma)
      for induction of anaesthesia. METHODS: One hundred twenty patients gave their
      informed consent to the study. In the first part, 90 patients were assigned at
      random to two groups in which induction of anaesthesia was performed either with
      Etomidat-Lipuro or Hypnomidate. Anaesthesia was started by i.v. injection of 25
      micrograms/kg alfentanil (Rapifen, Janssen Pharmaceutica). One minute later, the
      hypnotic agent was injected into a freely running i.v. line (18 Gcannula) that
      was used only for the hypnotic and was removed 15 min later. During injection,
      the patients were asked to inform the anaesthesiologist spontaneously and on
      request about their sensations at the injection site. The time from the beginning
      of anaesthesia until the disappearance of the eyelash reflex was measured. The
      patients were ventilated and vecuronium was administered to allow good intubation
      conditions 2-3 min later. For the first 10 min, blood pressure and heart rate
      were measured every minute. Postoperatively, the same investigator made rounds
      once a day and examined the injection sites. Signs of pain, redness, swelling,
      induration, thrombophlebitis, or thrombosis were noted. In the second part of the
      study, 30 patients were investigated for endocrinological changes after induction
      of anaesthesia with Etomidat-Lipuro, Hypnomidate, or Diprivan. The patients were
      allocated to the groups at random. A radial artery catheter was inserted in every
      patient. Sampling took place 30 min before and 1 and 2 h after induction.
      Additional samples were drawn 30 min and 1, 2, and 22 h after i.v. administration
      of 0.25 mg ACTH (Synacthen, Ciba-Geigy). The plasma concentrations of cortisol,
      17 alpha-OH-progesterone, and aldosterone and the renin activity were determined
      by high-performance liquid chromatography. RESULTS: The loss of the eyelash
      reflex occurred 42.9 +/- 8.7 and 42.2 +/- 11.0 s after the administration of
      Etomidat-Lipuro and Hypnomidate. The haemodynamic changes were minimal in both
      groups. After administration of alfentanil, local side effects of the hypnotics
      were scarce, with a tendency to be weaker and more seldom after Etomidat-Lipuro
      (3/55 versus 8/55). The postoperative vein reactions were generally mild and
      occurred in 17 out of 55 patients after Etomidat-Lipuro and 15 out of 55 patients
      after Hypnomidate. In most cases these signs were no longer present on the 2nd
      day after the procedure. Cortisol levels were depressed initially by all the
      hypnotic drugs used. While there was spontaneous recovery in the Diprivan group
      after 2 h combined with a positive overshooting response to ACTH stimulation, in
      the etomidate groups cortisol could not be stimulated; it normalized slowly
      during the following 24 h. The 17 alpha-OH-progesterone increase was significant
      in the etomidate groups after the administration of ACTH. The aldosterone levels
      decreased after etomidate injection and had not normalized 24 h later, while
      there was a normal response to ACTH in the propofol group. There was a normal
      decrease in renin activity in all three groups after the administration of ACTH.
      CONCLUSION: Local side effects are minimal after the administration of Etomidat
      Lipuro and Hypnomidate. Alfentanil reduces the injection pain of etomidate
      induction agents. Cortisol and aldosterone are depressed by etomidate, but the
      clinical relevance is minimal after a single bolus injection.

PMID- 8470790
TI  - [Modified hemoglobin as a blood substitute in a rat model].
AB  - The use of modified haemoglobin solutions as blood substitutes has been
      investigated extensively during the past decades. Ultrapurified, polymerised
      bovine haemoglobin (upbHb) is a promising new substance in this respect. It was
      the aim of the present investigation to study the cardiovascular and respiratory
      effects of massive blood replacement with upbHb in a new model of conscious rats
      with continuous haemodynamic monitoring. METHODS. The right femoral artery and
      vein of 13 male Sprague-Dawley rats were catheterised during halothane-N2O-O2
      anaesthesia. A thermistor catheter was placed in the descending aorta via the
      left femoral artery for measuring cardiac output by the thermodilution method.
      After recovery from anaesthesia blood replacement was achieved by arterial blood
      withdrawal and simultaneous venous infusion of upbHb in equal amounts. The
      haematocrit was lowered to < 3% and the animals were then left undisturbed in a
      rat restrainer while breathing room air. RESULTS. The animals showed no signs of
      disturbed behaviour patterns, distress, or adverse reactions. There were no
      significant changes in cardiac index and oxygen delivery during the investigation
      period of 4 h. A marked increase in mean arterial pressure (MABP) and systemic
      vascular resistance (SVR) of 30% was observed while stroke volume remained
      unchanged. Blood gases, acid-base status, and plasma glucose showed no major
      changes. Plasma oncotic pressure increased during the investigation period.
      CONCLUSIONS. The results indicate that there is adequate oxygenation and
      sufficient systemic oxygen delivery in conscious and drug-free rats after
      isovolaemic haemodilution with upbHb to a final haematocrit of < 3%. In contrast
      to previous haemodilution studies, which have tested non-oxygen-carrying
      solutions, no changes in cardiac index were observed. The cause of the increase
      in MAP and SVR remains to be established.

PMID- 8470791
TI  - [Longitudinal distribution of pulmonary vascular resistance in patients with
      acute respiratory insufficiency].
AB  - Effective pulmonary capillary pressure (Pc) is a major factor determining
      transvascular fluid filtration in the lung. It may easily be estimated from the
      pressure decay after rapid pulmonary artery occlusion. If Pc is known, the
      longitudinal distribution of pulmonary vascular resistance (PVR) can be
      evaluated. The present study was performed to address the following questions:
      (a) whether the severity of acute lung injury influences Pc and the longitudinal
      distribution of PVR; and (b) whether pulmonary artery occlusion (PAOP) or wedge
      pressure represents effective Pc during acute respiratory failure. PATIENTS AND
      METHODS. The investigation was performed in 45 mechanically ventilated patients.
      According to Murray's criteria 13 patients showed no lung injury, 19 had mild to
      moderate lung injury, and 13 had severe lung injury (adult respiratory distress
      syndrome, ARDS). As described by Holloway, effective Pc was evaluated from the
      pressure decay after rapid occlusion of the pulmonary artery (Figs. 1 and 2). The
      precapillary pressure gradient was determined as the difference between mean
      pulmonary artery pressure and Pc, the postcapillary pressure gradient as the
      difference between Pc and PAOP. Three measurements were performed and Pc
      determined as their mean value. The Kruskal-Wallis test and Mann-Whitney U test
      were performed to check statistically significant differences between groups. A
      Bonferroni correction was performed for multiple testing; P < 0.05 was accepted.
      RESULTS. Effective Pc was significantly different between patients with severe
      lung injury (20 +/- 3 mm Hg) and patients with mild to moderate lung injury (16
      +/- 3 mm Hg), and between the latter group and patients without lung injury (12
      +/- 3 mm Hg). The postcapillary pressure gradient and the relative amount of
      pulmonary venous vascular resistance, as well, were significantly influenced by
      the severity of the lung injury. In patients with ARDS the postcapillary pressure
      gradient was 4 +/- 1 mm Hg, whereas in patients with mild to moderate and without
      lung injury the postcapillary pressure gradients were 3 +/- 1 mm Hg and 2 +/- 1
      mm Hg, respectively. Two ARDS patients had a postcapillary pressure gradient of 7
      mm Hg (Pc 22 mm Hg and 19 mm Hg, PAOP 15 mm Hg and 12 mm Hg). One patient with
      severe lung injury had a postcapillary pressure gradient of 9 mm Hg (Pc 22 mm Hg,
      PAOP 13 mm Hg). In patients with severe lung injury 28 +/- 7% of the PVR was
      located in the postcapillary vascular system, whereas in patients with mild to
      moderate and without lung injury 22 +/- 7% and 16 +/- 6% of PVR was located in
      the pulmonary venous system. CONCLUSIONS. The longitudinal distribution of PVR is
      influenced by the severity of lung injury. PAOP, therefore, may not represent
      changes in Pc in patients with acute respiratory failure. The routine use of Pc
      measurement, however, can not be recommended until it has proven more useful than
      determination of PAOP when managing critically ill patients.

PMID- 8470792
TI  - Dynamic fluorescence measurements of two-state systems: applications to calcium
      chelating probes.
AB  - A fluorescence technique for characterizing ligand binding is evaluated. This
      technique uses the combination of steady-state and time-resolved methods to
      recover molar concentrations and overcomes errors inherent in the use of either
      method alone. The technique is applicable to time-resolved measurements made
      either with time-domain or frequency-domain instrumentation. A straightforward
      single-frequency phase/modulation approach is presented to determine whether an
      experimental system can be described by a two-state system. The approach is based
      on a nonlinear transformation of the phase/modulation data that results in a
      linear model function. Here, the theory is applied to the fluorescent calcium
      binding probes Quin-2 and Calcium Green, but is relevant to studies involving
      other interacting systems. The technique described is used to assess the fraction
      of bound ligand (Ca2+) and binding constants for these probes.

PMID- 8470793
TI  - Detection and quantitation of heme-containing proteins by chemiluminescence.
AB  - A commercial assay for chemiluminescence (CL) has recently been developed for
      visualizing horseradish peroxidase-conjugated probes for antibodies and nucleic
      acids. To assess the utility of CL for detecting the peroxidase activity of other
      heme-containing proteins, the sensitivity of CL and a standard chromogenic stain
      for visualizing heme-proteins in SDS-polyacrylamide electrophoretic gels were
      compared. The ability of these systems to visualize heme-proteins on electroblots
      and dot blots was also examined. The chromogenic stain, which uses 3,3',5,5'
      tetramethylbenzidine for a dye, and CL had equal sensitivity in electrophoretic
      gels. Both assays were affected by 2-mercaptoethanol in the solubilization
      buffer. In blotting assays, CL was 10- to 10,000-fold more sensitive for
      detecting samples including cytochrome C and blood. Quantities of protein
      requiring 18 h to detect by staining were visualized in minutes by CL.
      Scintillation spectroscopy of CL emitted by blood, urine containing supplemental
      blood, or urine from a patient with hematuria resulted in a linear relationship
      between peroxidase activity and concentration, allowing for quantitation of blood
      over a broad range of concentrations. These results indicate that CL can rapidly
      detect and quantitate heme-proteins and may facilitate both basic studies of heme
      proteins and clinical and forensic analyses of blood.

PMID- 8470794
TI  - High resolution polyacrylamide gel electrophoresis of Physarum polycephalum
      histones: improved resolution of variants and modified forms.
AB  - An electrophoresis system providing a good resolution of all basic proteins and
      their variants or modified forms extracted from Physarum polycephalum nuclei was
      developed. This two-dimensional polyacrylamide gel electrophoresis system
      combines the use of an AUT gel containing a preformed gradient of urea in the
      first dimension and a SDS polyacrylamide gel in the second one.

PMID- 8470795
TI  - On the activities of Escherichia coli exonuclease III.
AB  - Exonuclease III (Exo III) of Escherichia coli is a DNA-modifying enzyme very
      frequently used in molecular biology. The experiments described here were carried
      out with the aims of reliably controlling exonuclease activity and of learning
      more about the enzyme's specificities. The dependence of Exo III activity on
      factors such as temperature (including heat inactivation), the concentrations of
      Exo III and NaCl, and the concentration and shape of 3' termini was investigated.
      Double stranded DNA was found to be a competitive inhibitor of the enzyme
      activity. Some four nucleotide 3' protrusions were shown to be sensitive to Exo
      III digestion. The synchronism of deletion was also examined. Implications for
      the proposed mechanism of activity are discussed.

PMID- 8470796
TI  - Surface-enhanced Raman spectroscopic detection of CO2-(3), SO2-(3), and nucleic
      acid bases using polyvinyl alcohol film doped with Ag fine particles.
AB  - Surface-enhanced Raman scattering (SERS)-active polyvinyl alcohol films doped
      with Ag particles have been prepared by a counterdiffusion method. SERS spectra
      of CO2-(3), SO2-(3), and DNA bases have been observed by using the films. The
      films containing aggregated Ag particles are useful to observe SERS spectra of
      adsorbates. DNA bases (cytosine, uracil, thymine, guanine, and adenine) can be
      detected at a level of 10(-8)-10(-9) M by this method.

PMID- 8470797
TI  - A fast and sensitive method for detection of phospholipid-binding proteins on
      nitrocellulose membranes.
AB  - We describe a sensitive new method for specific detection and quantitation of
      phospholipid-binding proteins using two purified lipocortins as model proteins.
      The method consists of blotting proteins to nitrocellulose membranes followed by
      incubation with radiolabeled phospholipids and autoradiographic detection of
      bound phospholipids. It allows specific detection of phospholipid binding
      proteins to a threshold of about 100 ng/spot and their quantitation up to several
      micrograms as well as rapid analysis of specific phospholipid binding properties
      of individual proteins. If performed as a dot-blotting technique, the method
      permits the simultaneous analysis of a large number of samples and the
      establishment of Ca2+ and phospholipid binding curves. If blotting is preceded by
      electrophoresis, the method also allows specific detection and quantitative
      estimation of phospholipid binding proteins in crude biological preparations and
      may thus be useful for monitoring and analysis of these proteins in various
      biological samples.

PMID- 8470798
TI  - Glucose metabolism in mammalian cells as determined by mass isotopomer analysis.
AB  - A method using 13C isotopes and GCMS/SIM was developed and was used to study
      glucose metabolism in several mammalian cell lines. Using [U-13C6]glucose, the
      13C isotopomer distributions in glucose, lactic acid, glutamic acid, aspartic
      acid, and gamma-aminobutyric acid produced by the cells were determined, and
      glycolysis, gluconeogenesis, and the flux into the amino acid pools were
      calculated. A 1:1 mixture of [U-13C6]glucose and [1-13C]glucose was used to
      examine the loss of 1-13C carbon from [1-13C]glucose via the pentose
      monophosphate pathway in the cells; this new method measures the production of [3
      13C]lactic acid and [U-13C3]lactic acid, and thus avoids most systematic errors
      that result from the endogenous production of 12C-lactic acid during metabolic
      conversion; in addition, glycolysis and the recycling of glucose and lactic acid
      can be examined at the same time. The mass isotopomer analysis method is
      reproducible and sensitive, and can be used to analyze metabolites in 10(-7) M
      concentration with less than 10(5) cultured human cells. This method was used to
      examine metabolic regulation of glucose in fibroblasts, lymphoblasts, and PC12
      cells under various conditions of metabolic disturbance. The method appears to
      have wide applicability for the study of metabolic regulation of glucose and
      metabolic defects in cells.

PMID- 8470799
TI  - Synthesis of 3,4-cis-[3H]leucocyanidin and enzymatic reduction to catechin.
AB  - A novel method is presented for the synthesis and purification of (+)-2,3-trans
      3,4-cis-[4-3H]leucocyanidin. Soluble enzyme extracts from developing barley
      grains and leaves of the forage legume Onobrychis viciifolia (sainfoin) catalyzed
      the NAD(P)H-dependent reduction of (+)-2,3-trans-3,4-cis-[4-3H]leucocyanidin to
      (+)-[4-3H]catechin. NADPH was the preferred substrate. With extracts of barley
      the rate of reaction with 1 mM NADH was 20% of the rate found with NADPH. With
      extracts from both tissues there was a broad pH optimum around pH 6.6.

PMID- 8470800
TI  - A highly sensitive and fast nonradioactive method for detection of polymerase
      chain reaction products.
AB  - A novel system for the detection of polymerase chain reaction (PCR) products has
      been developed. The system is based on a PCR in which one of the primers is
      biotinylated and digoxigenin-11-dUTP is incorporated during elongation.
      Biotinylated PCR products are captured on streptavidin-coated solid supports, and
      alkaline phosphatase conjugated to anti-digoxigenin antibody is subsequently
      bound to the incorporated digoxigenin. The detection may be obtained with
      colorimetric, fluorescent, or luminescent substrates for alkaline phosphatase.
      The detection system can be performed in microtiter plates allowing easy handling
      of multiple samples. The total assay time following the PCR is between 1 and 2 h
      dependent on the type of substrate and the type of solid support applied in the
      system. Within this period of time the system is capable of detecting 1 template
      in 29 cycles of PCR.

PMID- 8470801
TI  - Dimethyl sulfoxide-mediated primer Tm reduction: a method for analyzing the role
      of renaturation temperature in the polymerase chain reaction.
AB  - We report a method for optimizing the specificity of product formation in the
      polymerase chain reaction (PCR). This technique is based on the use of dimethyl
      sulfoxide (DMSO) and takes into account primer Tm. The reduction in Tm by DMSO is
      directly correlated with renaturation temperature such that a DMSO gradient
      reflects a temperature gradient. We use this relationship to show that optimum
      product formation usually occurs at or within several degrees of the midpoint Tm
      of a given primer pair. We illustrate these correlations using three examples
      deriving PCR products from a human cDNA library, representing the casein kinase
      II alpha and beta subunits as well as the 5' untranslated region for the beta
      subunit. By following product formation as a function of renaturation
      temperature, we postulate rules for cycle design based on primer Tm. Implications
      for the use of degenerate primers are discussed.

PMID- 8470802
TI  - Radiolabeled biotinyl peptides as useful reagents for the study of proteolytic
      enzymes.
AB  - A radiometric assay for studying the proteolytic activity of endopeptidases using
      a radiolabeled biotinyl peptide substrate is described. The method relies on the
      use of a peptidyl substrate incorporating susceptible bonds located between a
      biotinyl group at one end and a radioiodinated group at the other end. Two
      tyrosine-containing peptidyl substrates, a fragment of rat plasma kallikrein and
      a derivative of Leu-enkephalin, were coupled to biotin by reacting with N
      hydroxysuccinimidyl-6-(biotinamido) hexanoate. The enzymatic activity is measured
      by the release into solution of the radiolabeled peptide fragment following
      selective retrieval, using immobilized avidin, of the biotinyl undigested
      substrate and the unlabeled biotinyl peptide fragment. This study illustrates
      that retrieval can be done either before incubation with the enzyme by
      immobilizing the labeled substrate onto avidin-agarose or, alternatively, after
      incubation by treating the resulting digest with immobilized avidin. The identity
      of the labeled released peptides and hence the sites of cleavage can be obtained
      following separation by RP-HPLC. This assay, in addition to allowing proteolysis
      to occur with the substrate either in solution or immobilized, is rapid,
      sensitive (less than 1 pg/ml of trypsin), reproducible, and applicable to the
      detection of members of all endopeptidase classes. Furthermore, incubation of the
      radiolabeled biotinyl peptide substrates with enzymes immobilized within
      polyacrylamide gel slices can be used to detect proteolytic activity following
      electrophoretic separations under denaturing or nondenaturing conditions.

PMID- 8470803
TI  - Electrophoresis of neurochordins, a family of high molecular weight neural tissue
      glycoproteins, on horizontal submerged agarose gels in the presence of dodecyl
      sulfate.
AB  - We have developed a procedure for the use of agarose gels to separate
      electrophoretically neurochordins, a family of high molecular weight neural
      tissue glycoproteins. This procedure is a modification of the method of
      horizontal submerged electrophoresis on agarose gels routinely applied for the
      separation of DNA restrictions. For protein analysis we prepared gels of higher
      agarose concentration (3%), and 0.1% of sodium dodecyl sulfate was present in the
      buffer used both for gel formation and as an electrode buffer. After
      electrophoresis agarose gels can be directly stained with Coomassie blue, or
      proteins can be transferred from the gel to nitrocellulose or nylon filters for
      immunostaining. The main advantage of the proposed method compared to the method
      of electrophoresis on large-pore, composite agarose/polyacrylamide gels is its
      simplicity. Other proteins of very high molecular weight can also be successfully
      separated by this technique.

PMID- 8470804
TI  - Evidence for telluroamino acid in biological materials and some rules of
      assimilation of inorganic tellurium by yeast.
AB  - A natural substance, telluroamino acid, was discovered in tellurium yeast by GC
      and GC/MS. This substance was obtained for the first time by means of the
      assimilation of inorganic tellurium by yeast, having 600 ppm of total Te and 150
      ppm of telluroamino acid. Some rules for such an assimilation were found: the
      content of total Te and telluroamino acid in tellurium-yeast is closely related
      to the kind of culture media used and is proportional to the concentration of Te
      in culture media. This discovery is of theoretical and practical significance,
      especially for the production by a simpler microbiological synthesis of rare and
      expensive organic tellurium compounds which hopefully will prove to be
      anticarcinogens like the selenium-yeast, and for explaining the biochemical
      effect of tellurium on the human body.

PMID- 8470805
TI  - A colorimetric assay for penicillin-V amidase.
AB  - The hydrolysis of penicillin-V to phenoxyacetic acid and 6-aminopenicillanic acid
      by the fungal enzyme penicillin-V amidase is of industrial importance since the 6
      aminopenicillanic acid produced is an intermediate for semisynthetic penicillins.
      A rapid colorimetric assay of penicillin-V amidase was developed which uses 2
      nitro-5-(phenoxyacetamido)-benzoic acid as a substrate. The released chromophore,
      2-amino-5-nitrobenzoic acid, was detected at 405 nm. Using penicillin-V amidase
      from the fungus Fusarium oxysporum, the KM and Vmax for this substrate were 0.89
      mM and 2.6 mumol/min/mg enzyme, respectively. Hydrolysis could be competitively
      inhibited by penicillin-V with a Ki of 4 mM. The change in the initial velocity
      of hydrolysis of 2-nitro-5-(phenoxyacetamido)-benzoic acid at 500 microM was
      linear over the range of 0.5 to 10 micrograms/ml enzyme. These results show that
      this new compound is useful in determining the presence and levels of penicillin
      V amidase.

PMID- 8470806
TI  - A refinement of the Akabayashi-Saito-Kato modification of the enzymatic methods
      for 2-deoxyglucose and 2-deoxyglucose 6-phosphate.
AB  - Akabayashi et al. made a valuable modification of the enzymatic methods from our
      laboratory for measuring 2-deoxyglucose and 2-deoxyglucose 6-phosphate. Their
      modified procedure eliminates glucose and glucose 6-phosphate by conversion to
      fructose-1,6-bisphosphate, thereby saving two analytical steps. However, the
      present report describes a limitation of this new elimination procedure which is
      due to its unexpected reversibility, and provides an easy way to circumvent this
      limitation, namely heating to destroy the reagent enzymes before proceeding. The
      final result is a more flexible analytical scheme that is capable of measuring 2
      deoxyglucose and its phosphate down to extremely low levels in the presence of up
      to thousandfold higher glucose concentrations. The completeness of glucose
      elimination eliminates both the problem of contamination of available glucose-6
      phosphate dehydrogenases with 6-phosphogluconate dehydrogenase, and also the
      effect of the presence in this same enzyme of a trace of glucose dehydrogenase
      activity, which is an apparent side reaction.

PMID- 8470807
TI  - High-performance liquid chromatography separation and quantitation of
      methylprednisolone from rat brain.
AB  - A sensitive, reliable method for the extraction, separation, and quantitation of
      methylprednisolone from rat brain is reported. The method can accurately
      quantitate methylprednisolone levels between 9.8 and 2500 ng/injection using a
      two-step HPLC separation and monitoring absorbance at 254 nm. A 90% extraction
      recovery of methylprednisolone (interday variation of 9.0% and an intraday
      variation of 0.0 to 7.7%) from rat cortex was obtained with a double extraction
      method using low toxicity solvents. These solvents are known to quantitatively
      extract the neutral lipids and phospholipids from brain. Combined with the
      ability to separate the neutral lipid and methylprednisolone fractions for
      further separation, and the ability to separate all phospholipid classes in the
      first run, this method offers great utility combined with the reliable, high
      extraction recovery and sensitive quantitation of methylprednisolone.

PMID- 8470808
TI  - Measurement of intracellular calcium using bioluminescent aequorin expressed in
      human cells.
AB  - Changes in intracellular free calcium concentration ([Ca2+]i) are involved in
      many important physiological responses. Detecting changes in [Ca2+]i is crucial
      to understanding the physiologic roles of intracellular free calcium. We have
      characterized changes of [Ca2+]i in human cells transfected with apoaequorin
      cDNA. When reconstituted in vivo by incubating transfected cells with
      coelenterazine, aequorin emits light upon binding free calcium and acts as a
      bioluminescent indicator for calcium. We have used this system to determine the
      concentration response relationship of serotonin for its receptor. Cells
      cotransfected with serotonin receptor cDNA and apoaequorin cDNA emitted light
      upon treatment with serotonin. The light emission responses were saturable and
      serotonin concentration-dependent, and they were inhibited by serotonin
      antagonists. Human 293 cells that stably express apoaequorin have been created.
      This system should facilitate the investigation of [Ca2+]i involvement in
      physiological and pathophysiological responses.

PMID- 8470809
TI  - Protein kinase assay using tritiated peptide substrates and ferric adsorbent
      paper for phosphopeptide binding.
AB  - The recently described synthesis of ferric adsorbent paper has made possible the
      modification of protein kinase assays. The adsorbent contains ferric chelate
      groups, which are responsible for the binding of phosphopeptide via phosphate
      group. The selective adsorption of phosphopeptide contra nonphosphorylated
      peptide allows the use of tritium-labeled peptides and unlabeled ATP as
      substrates. The binding of the reaction product to the adsorbent was complete and
      was not affected by the amino acid sequence of the peptide. The conditions
      required for the separation of the produced phosphopeptide from the initial
      peptide have been worked out as well. The firmly bound phosphopeptide should be
      released from the ferric adsorbent paper prior to liquid scintillation counting.
      Using 0.1 m NH4HCO3 solution (pH 8.0), the elution of phosphopeptides was almost
      complete. The modified protein kinase assay proposed herein is rapid and allows
      handling of multiple samples simultaneously. In addition, the ferric paper method
      avoids the use of 32P-isotope, replacing it with 3H which has lower radiation
      energy and a much longer half-life.

PMID- 8470810
TI  - Kinetic silver staining and quantification of proteins adsorbed to microtiter
      plates.
AB  - A silver stain was used to detect and quantitate proteins adsorbed to microtiter
      plate wells. The kinetics of the development of the silver stain were analyzed
      with an automated microtiter plate reader. The lag time for stain development was
      found to be a consistent indicator of the amount of protein adsorbed to a
      microtiter plate well. Protein which was not preadsorbed to the microtiter plate
      was not effectively stained by silver. Complete adsorption of protein applied to
      the microtiter plate was possible by drying small amounts of protein in very
      dilute buffers. Variations in sensitivity for different proteins were less than
      30% for the panel of proteins examined. Determinations from kinetic silver
      staining agreed with those from copper staining for bovine albumin adsorbed to
      microtiter plates. The precision of kinetic silver staining assay was optimal in
      the range of 40 to 200 ng per microtiter plate well. In this range, the standard
      deviations averaged less than 5%. Even smaller amounts of protein can be detected
      and interpolated down to approximately 10 ng per well. The kinetic silver
      staining method can be used on standard microtiter plate readers without special
      filters and is readily adaptable to automated systems.

PMID- 8470811
TI  - A critical assessment of the RNAse protection assay as a means of determining
      exon sizes.
AB  - The RNAse protection assay is a highly sensitive assay which is commonly used to
      detect specific hybridization between complementary RNAs and to determine exon
      sizes in gene characterization studies. Unfortunately, each of the numerous steps
      involved in the assay could give artifacts depending on the probe used. In this
      study, common causes of artifacts have been identified using riboprobes which
      identify exons of known sizes. The RNAse concentration and duration of digestion
      used were found to be critical factors affecting exon size estimations. Five
      different riboprobes were tested to obtain a consensus optimum RNAse condition-
      10 micrograms/ml RNAse A, 0.5 microgram/ml RNAse T1--enabling the correct
      determination of exon sizes. This condition was further analyzed for its
      specificity when RNAse protection assays were performed between highly homologous
      RNA fragments from two different species. Results show that this concentration of
      RNAse would efficiently cleave a minimum of two nucleotide mismatches. Single
      nucleotide mismatches were frequently not cleaved by the same RNAse concentration
      making it possible to detect the correct exon size regardless of such sequence
      polymorphisms in gene sequences.

PMID- 8470812
TI  - Anion-exchange analysis of ribulose-bisphosphate carboxylase/oxygenase reactions:
      CO2/O2 specificity determination and identification of side products.
AB  - An improved anion-exchange chromatographic method for determining the
      carboxylation/oxygenation specificity (tau) of ribulose 1,5-bisphosphate
      carboxylase/oxygenase is presented. This assay, which entails radiometric
      detection of [1-3H]ribulose-bisphosphate turnover products separated on MonoQ
      anion-exchange resin, is more convenient, less error-prone, and more generally
      applicable than previous methods of tau determination. It is suitable for both
      wild-type and site-directed mutant enzymes of widely varying activity and
      specificity levels and allows simultaneous visualization of various side products
      of ribulose-bisphosphate processing. A facile method for scrubbing dissolved O2
      from carboxylase reaction solutions, which does not require extensive purging and
      exchange of dissolved gases, is also described.

PMID- 8470813
TI  - Versatile avian retrovirus vectors.

PMID- 8470814
TI  - Instantaneous blocking for immunoblots.

PMID- 8470815
TI  - A pH-independent assay for pectin methyl esterase for use in column
      chromatography.

PMID- 8470816
TI  - Protein molecular weight determinations by MALD mass spectrometry: a superior
      alternative to gel filtration.

PMID- 8470817
TI  - Molecular dosimetry.

PMID- 8470818
TI  - Detection of liquid injection using an atmospheric pressure ionization
      radiofrequency plasma source.
AB  - An atmospheric pressure rf plasma source which operates in a variety of different
      buffer gases has been developed as an ionization method for organic samples
      introduced by liquid injection into atmospheric pressure ionization mass
      spectrometry (API/MS). The rf source can operate in He at < 1 W of load power at
      165 kHz. It can also be sustained in Ar, N2, air, and CO2 at a load power of < 15
      W. In most cases studied, the protonated molecule, MH+, is observed with little
      or no fragmentation even under the relatively high current conditions of the
      discharge. However, using increasingly higher acceleration voltages between the
      skimmers in the differentially pumped region between atmospheric pressure and
      high vacuum, one can induce fragmentation via collision-induced dissociation.
      This can be assisted in these experiments via the use of a heavy buffer gas. The
      detection limits achieved for rf/API plasma detection are typically in the low
      femtomole region for small organic molecules including neurotransmitters, PTH
      amino acids, steroids, drugs, pesticides, and explosives. The detection can be
      performed with quantitation over at least 4 orders of magnitude.

PMID- 8470819
TI  - Collisional fragmentation of glycopeptides by electrospray ionization LC/MS and
      LC/MS/MS: methods for selective detection of glycopeptides in protein digests.
AB  - Mass spectrometric methods of glycopeptide-specific detection in liquid
      chromatography/electrospray mass spectrometry (LC/ESMS) of glycoprotein digests
      are explored using a variety of glycopeptide models and then applied to soluble
      complement receptor type I, a 240-kDa glycoprotein containing 25 potential sites
      of N-glycosylation. The most specific method, requiring a triple quadrupole,
      involves monitoring of sugar oxonium fragment ions during precursor-ion scan
      ESMS/MS. Signals derived from nonglycosylated peptides are virtually eliminated,
      resulting in a total-ion current chromatographic trace of only the glycopeptides
      present in the digest. The corresponding mass spectra yield molecular weight and
      glycopeptide microheterogeneity information. An alternative and complementary
      approach that we term collisional-excitation scanning also involves fragmentation
      of glycopeptides to sugar oxonium ion fragments but does not involve any mass
      selection process, permitting the experiment to be performed on a single
      quadrupole instrument. The resulting total ion chromatogram is similar to the UV
      chromatogram (215 nm), but a selected-ion chromatogram for carbohydrate-specific
      ions such as the N-acetylhexosamine oxonium ion (m/z 204) produces a glycopeptide
      specific trace. Although there can sometimes be peptide interferences in the
      spectra of the indicated glycopeptide-containing chromatographic peaks, this
      latter approach permits peptide mapping to be performed on the same data set that
      also indicates the location of glycopeptides in the chromatogram. Both methods
      are suitable for detection of glycopeptides with all common classes of
      oligosaccharides in either N- or O-linkage to the peptide.

PMID- 8470820
TI  - Determination by heteronuclear NMR spectroscopy of the complete structure of the
      cell wall polysaccharide of Streptococcus sanguis strain K103.
AB  - Although complete structures of complex polysaccharides have traditionally been
      determined by chemical degradative methods, a number of recent developments in
      instrumentation have greatly facilitated this task. We illustrate the application
      of several of these methods in a determination of the complete covalent structure
      of the polysaccharide from Streptococcus sanguis K103, which is composed of an
      octasaccharide repeating subunit linked by phosphodiester bonds. Carbohydrate
      analysis by HPAE-PAD and by reverse-phase chromatography of benzoylated
      derivatives of the hydrolysis products of the polysaccharide gave glucose (3
      mol), galactose (1 mol), rhamnose (2 mol), N-acetylglucosamine (1 mol), and
      galactose 6-phosphate (1 mol). Circular dichroism of the O-benzoylated
      monosaccharides showed the absolute configurations to be D for all residues
      except for rhamnose, which is L. The 1H NMR spectrum was completely assigned by
      two-dimensional homonuclear methods (DQF-COSY, NOESY, HOHAHA). The
      stereochemistry of pyranosides was assigned from 3JHH coupling constant values
      determined from these experiments. The 13C spectrum was assigned by 1H-detected
      heteronuclear multiple-quantum correlation (1H[13C] HMQC) and by the hybrid
      method of HMQC-COSY. The glycosidic linkage positions of the polymer were
      determined by 1H-detected multiple-bond correlation (1H[13C] HMBC) and by 2D
      NOESY spectra. The position of the phosphodiester linkage was determined by
      splitting observed in the 13C resonances due to 31P couplings leading to the
      overall structure given in Chart I.

PMID- 8470821
TI  - Expression of neural cell adhesion molecule (NCAM) during the first molar
      development in the mouse.
AB  - NCAM, the neural cell adhesion molecule, was immunolocalized in the mandibular
      first molar tooth germ of the mouse. NCAM was first detected in the tooth germ of
      the late bud stage, where only the cells in the outer part of the condensed
      mesenchyme (primitive dental follicle) exhibited faint immunoreactivity. The
      entire dental follicle was intensely immunostained for NCAM from cap stage to the
      stage when root formation started. During root formation, NCAM disappeared from
      the follicular tissue surrounding the cervical root as well as from the part
      covering the crown top. This loss of NCAM proceeded in the direction of the root
      apex, but even after the tooth had achieved functional occlusion, NCAM was still
      expressed by the mesenchymal cells adjacent to the root apex. On the other hand,
      NCAM was negative in the dental papilla until birth. After birth, NCAM
      immunoreactivity appeared in the basal portion of the dental papilla, but this
      NCAM-positive area gradually diminished in width during the root elongation.
      Instead, another NCAM-positive zone appeared in the core of the pulp during root
      formation. Even in the tooth that had already erupted, the pulp core contained
      cells that were strongly positive for NCAM immunostaining. In addition to its
      expression in the above two mesenchymal cell lineages, NCAM was transiently
      expressed by epithelial components of the tooth germ, some of the cells of the
      dental lamina and the enamel organ. The results suggest that NCAM participates in
      several processes of tooth development.

PMID- 8470822
TI  - Differentiation of functional hepatocytes and biliary epithelial cells from
      immature hepatocytes of the fetal mouse in vitro.
AB  - Differentiation of functional hepatocytes and biliary epithelial cells from
      immature hepatocytes was analysed in vitro. When fetal mouse liver fragments
      containing immature hepatocytes but no bile ducts were cultured organotypically,
      the immature hepatocytes differentiated into large hepatocytes. Some of these
      expressed bile duct markers such as cytokeratin and Dolichos biflorus agglutinin
      binding sites, though only to a small extent, and typical intrahepatic bile duct
      cells failed to differentiate. Dexamethasone stimulated immature hepatocytes to
      differentiate into both mature hepatocyte and biliary epithelial cell lineages.
      Especially in the liver fragments cultured on Matrigel, dexamethasone stimulated
      the expression of bile duct markers (such as cytokeratin and binding sites for
      two types of lectin) in the immature hepatocytes. These results support the idea
      that immature hepatocytes can differentiate into both mature hepatocytes and
      biliary epithelial cells during normal development of the mouse liver, and
      suggest that glucocorticoids stimulate both these differentiation pathways. It
      also seems that basal laminar components may play a role in bile duct
      differentiation.

PMID- 8470823
TI  - Functional associations between collagen fibre orientation and locomotor strain
      direction in cortical bone of the equine radius.
AB  - A novel technique for determining the collagen fibre orientation pattern of cross
      sections of cortical bone was used to study mid-diaphyseal sections from the
      equine radius. Several in vivo strain gauge studies have demonstrated that this
      bone is loaded in bending during locomotion in such a way that the cranial cortex
      is consistently subjected to longitudinal tensile strains and the caudal cortex
      to longitudinal compressive strains. Twenty-three radii from 17 horses were
      studied. All the bones obtained from adult horses exhibited a consistent pattern
      of collagen fibre orientation across the cortex. The cranial cortex, subjected to
      intermittent tension, and the lateral and medial cortices, through which the
      neutral axis passes, contained predominantly longitudinally oriented collagen
      fibres. The caudal cortex, subjected to longitudinal compression during life,
      contained predominantly oblique/transverse collagen. This pattern was less
      evident in bones from foals. Microscopic analysis of the bones studied showed
      that primary lamellar bone was composed of predominantly longitudinal collagen
      fibres, irrespective of cortex. However, there was a strong relationship between
      cortical location and fibre orientation within remodelled bone. Secondary osteons
      which formed in the caudal (compressive) cortex contained predominantly
      oblique/transverse collagen, while those which formed elsewhere contained
      longitudinal collagen. This observation explained the developmental appearance of
      the characteristic macroscopic pattern of collagen fibre orientation across the
      whole cortex in the adult. These findings provide evidence for the existence of a
      relationship between the mechanical function of a bone with its architecture, and
      now demonstrate that it extends to the molecular level.

PMID- 8470824
TI  - Mechanical implications of collagen fibre orientation in cortical bone of the
      equine radius.
AB  - Mechanical test specimens were prepared from the cranial and caudal cortices of
      radii from eight horses. These were subjected to destructive tests in either
      tension or compression. The ultimate stress, elastic modulus and energy absorbed
      to failure were calculated in either mode of loading. Analysis was performed on
      the specimens following mechanical testing to determine their density, mineral
      content, mineral density distribution and histological type. A novel technique
      was applied to sections from each specimen to quantify the predominant collagen
      fibre orientation of the bone near the plane of fracture. The collagen map for
      each bone studied was in agreement with the previously observed pattern of
      longitudinal orientation in the cranial cortex and more oblique to transverse
      collagen in the caudal cortex. Bone from the cranial cortex had a significantly
      higher ultimate tensile stress (UTS) than that from the caudal cortex (160 MPa vs
      104 MPa; P < 0.001) though this trend was reversed in compression, the caudal
      cortex becoming relatively stronger (185 MPa vs 217 MPa; P < 0.01). Bone from the
      cranial cortex was significantly stiffer than that from the caudal cortex both in
      tension (22 GPa vs 15 GPa; P < 0.001) and compression (19 GPa vs 15 GPa; P <
      0.01). Of all the histo-compositional variables studied, collagen fibre
      orientation was most closely correlated with mechanical properties, accounting
      for 71% of variation in ultimate tensile stress and 58% of variation in the
      elastic modulus. Mineral density and porosity were the only other variables to
      show any significant correlation with either UTS or elastic modulus. The
      variations in mechanical properties around the equine radius, which occur in
      close association with the different collagen fibre orientations, provide maximal
      safety factors in terms of ultimate stress, yet contribute to greater bending of
      the bone as it is loaded during locomotion, and thus lower safety factors through
      the higher strains this engenders.

PMID- 8470825
TI  - Proliferative activity of the developing seminiferous epithelium during
      prespermatogenesis in the golden hamster testis measured by bromodeoxyuridine
      labeling.
AB  - Bromodeoxyuridine (BrdU)-labeling was used to study the cell kinetics of the
      developing seminiferous epithelium in the testes of golden hamsters aged 10.5 to
      27.5 days post conception (dpc), i.e., during a period beginning one
      developmental day before testicular differentiation (11.5 dpc) and extending to
      the appearance of the first "mature" spermatogonia. Supporting (Sertoli) cells
      continuously proliferate throughout the period studied. Labeling indices amount
      to about 30% between the 10.5th and 16.5th dpc, and subsequently decrease to
      levels below 10% on the 26.5th and 27.5th dpc. Germ cells (prespermatogonia)
      proliferate between the 10.5th and 15.5th dpc and again, after a period of
      mitotic quiescence, from the 24.5th dpc onwards. This pattern of
      prespermatogonial proliferation substantiates and further specifies the
      successive appearance of M-prespermatogonia (10.5th to 15.5th dpc:
      proliferating), T1-prespermatogonia (16.5th to 23.5th dpc: quiescent), and T2
      prespermatogonia (24.5th to 27.5th dpc: proliferating). Thus, the M
      prespermatogonial phase of germ cell proliferation is shown to commence at least
      24 h before testicular differentiation. Transitions from M- to T1-phase and from
      T1- to T2-phase are rather abrupt. Both the latter observation and the comparison
      with oogonial development in the female at the corresponding time (onset of
      meiosis) indicate the presence of an underlying control mechanism operative
      during prespermatogenic development. Due to different nuclear staining patterns,
      the BrdU-labeling method allows temporal subdivision of the S-phase, thus opening
      up prospects of more detailed cell-kinetic analyses of the seminiferous
      epithelium.

PMID- 8470826
TI  - Differentiation of the mammalian retinal pigment epithelium in vitro: influence
      of presumptive retinal neuroepithelium and head mesenchyme.
AB  - The ancestor cells of the pigment epithelium of the mammalian eye are derived
      from the neuroepithelial cells of the neural plate. They are neurally determined
      in the process of neurulation but finally decide to follow the pigment cell
      lineage, whereas the adjacent tissue develops into the neuroretina and the optic
      stalk. This decision is most probably made in the developmental stage of eye cup
      formation. The pigment epithelium becomes restricted to the outer leaf of the eye
      cup and does not encroach on the adjacent neuroepithelial tissues of the internal
      leaf and the eye stalk. It is therefore supposed to be channelled by a locally
      confined determinant factor that has not yet been identified. In the present
      study, development of the mammalian eye and the neural versus pigment cell
      decision were investigated in mouse embryos. Three approaches were used to
      discover the source of the putative determinant involved in the process of
      neuroepithelial decision. First, eye primordia were cultured from stage 11
      embryos (0 somites, early neural plate stage, embryonic day 7 1/2-8) to stage 16
      embryos (34 somites, neural tube stage, ed 10); this is prior to pigment cell
      induction. The eye primordia were first cultured in head segments and their
      natural position. In these experiments, 50% of the ocular neuroepithelia
      developed along the nerve cell and glial cell lineage. However, the other 50% of
      the cultured specimens partly developed into pigment epithelia. In these
      specimens the determinant factors had obviously remained functionally intact in
      vitro. In the second type of experiment, the eye primordia were also cultured
      within the head segments, but with the prospective neuroretina selectively
      removed. This experiment should show whether the inner layer of the eye cup (the
      prospective neuroretina) is involved in the neuroepithelial lineage decision. In
      these experiments 90% of the cultured eye primordia failed to develop pigmented
      cells. The prospective neuroretina was therefore considered as a candidate for
      the production of an inductive factor. Finally, eye primordia from stage 14-15
      embryos (13-29 somites, ed 9-9 1/2) were either transplanted into heterotopic
      tissues, such as mesenchymal organs, neuroepithelium or heterochronic muscle, or
      grown as controls in their natural position and tissue environment. In these
      conditions both transplanted eye primordia and controls bore pigmented
      epithelium. Hence, the lineage decision, whether to form neural or pigment cell,
      remained undisturbed in all epitopes tested. On the basis of these experiments,
      it seemed unlikely that the development of pigment cells was initiated by a
      mesenchyme-derived factor exclusively produced near the eye vesicle.

PMID- 8470828
TI  - Experimental study on the formation of the epicardium in chick embryos.
AB  - In chick embryos, the formation of the epicardium proceeds from the attachment of
      a secondary sinuventricular mesocardium. This mesocardium is formed by the
      adhesion of pericardial villi with the dorsal surface of the heart. It was the
      aim of this study to clarify the role of the pericardial villi in the formation
      of the epicardium. For this purpose, the contact between the pericardial villi
      and the heart was prevented by placement of a piece of the shell membrane between
      them. After re-incubation, the hearts of the experimental embryos could be
      assigned to one of two different groups: hearts completely lacking a secondary
      mesocardium (Group A), and hearts without the sinu-ventricular but with a
      dystopic secondary mesocardium (Group B). In Group A, the formation of the
      epicardium and subepicardial mesenchyme was found to be severely disturbed. In
      Group B, the formation of the epicardium proceeded from the point of attachment
      of a dystopic secondary mesocardium; defective development of the subepicardial
      mesenchyme was not encountered. These results support the view that the
      epicardium is derived from the pericardial epithelium.

PMID- 8470827
TI  - Fibroblast growth factor induces primitive streak formation in rabbit pre
      implantation embryos in vitro.
AB  - Culturing of rabbit pre-implantation embryos was performed in Ham's F10 medium
      supplemented with polyvinylpyrrolidone. Under these culture conditions, day 6
      post coitum blastocysts increased their diameter within 24 h to 80% of that of
      day 7 blastocysts grown in vivo. Despite this substained growth, the embryonic
      disc remained undifferentiated with clear signs of degeneration after 24 h of
      culture. Basic fibroblast growth factor (bFGF) was able to overcome this
      developmental block. After 12 h of culture, day 6 blastocysts showed pear-shaped
      embryonic discs, and after 24 h, the primitive streak with Hensen's node was
      visible. The bFGF had no comparable effects on day 5 and day 7 blastocysts. The
      embryonic discs of day 5 blastocysts degenerated, even in the presence of bFGF,
      whereas day 7 blastocysts were able to form their primitive streak, also in the
      absence of bFGF. TGF beta 1 did not promote embryonic development in vitro. The
      data indicate that the onset of mesoderm formation in the rabbit is controlled by
      a growth factor of the FGF-family.

PMID- 8470829
TI  - Morphological evidence for secondary formation of the tail gut in the rat embryo.
AB  - The secondary body formation is a developmental mechanism occurring in the caudal
      part of the embryo in which embryonic structures arise from a mass of mesenchymal
      cells without previous formation of germ layers. The formation of the tail gut by
      this mechanism was investigated on transverse serial semithin and ultrathin
      sections of 12-, 13-, 14- and 15-day rat embryo tails. The tail gut, together
      with the tail portion of the notochord, originates from an axial mass of
      condensed mesenchymal cells named tail cord. Formation of the tail gut involves
      the appearance of large intercellular junctions among tail cord cells, and
      rearrangement of these cells around a newly formed lumen. Mesenchymal
      characteristics of these cells are gradually lost, and they simultaneously
      acquire the morphology of epithelial cells. Some cells of the tail cord, located
      ventral to the tail gut, do not participate in the tail gut formation and form a
      separate mass of cells without any definitive morphogenetic fate. This surplus
      group of cells is first evident in 12-day embryos, and it increases in mass
      during the following 3 days. In 15-day embryos, after the tail gut has completely
      disappeared, the surplus cells represent all that remains of the tail cord. The
      mesenchymal-epithelial transformation of the tail cord cells into the cells of
      the tail gut, and the appearance of the surplus cells, could be considered as the
      main morphological arguments for the secondary formation of the tail gut.

PMID- 8470831
TI  - Detection of HIV-1 by polymerase chain reaction and culture in seronegative
      intravenous drug users in an inner-city emergency department.
AB  - STUDY BACKGROUND: After a health care worker's unprotected exposure to a
      patient's blood, the current recommendation is to obtain consent from the source
      for serologic testing for HIV. If the test is negative, no further follow-up of
      the exposed provider is usually indicated. OBJECTIVE: To determine if patients
      testing negative for HIV-1 antibody on routine serology harbor occult HIV-1
      infection. DESIGN: Cross-sectional, identity-unlinked, patient-related data and
      blood sample procurement for HIV-1 infection. SETTING: Inner-city university
      hospital emergency department with high HIV-1 seroprevalence among patients. TYPE
      OF PARTICIPANTS: IV drug users not known to have HIV-1 infection. MEASUREMENTS:
      Serum samples were analyzed for HIV-1 antibodies by enzyme immunoassay and
      Western blot. Peripheral mononuclear cells were analyzed for HIV-1 provirus by
      polymerase chain reaction and viral culture. MAIN RESULTS: Of 131 patients, 36
      (27.5%) were Western blot-confirmed seropositive for HIV-1. Of the 95
      seronegative patients, six (6.3%) were polymerase chain reaction positive, and
      one of these was confirmed with culture. The negative predictive value of
      standard serology was 93.5% with polymerase chain reaction alone and 98.9% with
      concordant polymerase chain reaction and culture results. CONCLUSION: There may
      be a significant number of ED patients in HIV-1 prevalent populations who have
      occult HIV-1 infection not detectable by serology at the time of a health care
      provider exposure. Although these data suggest that further prospective study is
      warranted to better quantify the frequency of this phenomenon, these preliminary
      data suggest that current Centers for Disease Control recommendations regarding
      provider exposures may need to be reappraised for certain situations.

PMID- 8470830
TI  - Alterations of heart development in Xenopus laevis by galactoside-binding lectin
      or its sugar hapten inhibitor.
AB  - The early heart anlagen of Xenopus laevis embryos were exposed to purified
      embryonic galactoside-binding lectin or its potent hapten inhibitor
      thiodigalactoside (TDG). Heart development was then studied using a variety of
      microscopical techniques. Conotruncal morphology and positioning with respect to
      the ventricle are altered in treated animals. In 34% of animals treated with
      lectin and 35% treated with TDG, the conotruncus leaves the ventricle from an
      abnormal location. Lectin or TDG treatments are also correlated with altered
      conotruncal shape, with the conotruncal regions showing greater radii of
      curvature compared to controls. Conotruncal myocyte differentiation is altered by
      the test treatments, with lack of development of organized myofibrillar arrays.
      Conotruncal cushion development is also affected. Changes occur in the shape and
      size of the primary conotruncal cushion, and alterations of outflow tract
      septation develop. Less maturation of ventricular myocytes is also observed in
      test animals. The results suggest that galactose-lectin interactions are
      important in heart development.

PMID- 8470832
TI  - Clinical use of the erythrocyte sedimentation rate in the evaluation of febrile
      intravenous drug users.
AB  - STUDY OBJECTIVE: To investigate the use of the erythrocyte sedimentation rate in
      the evaluation of febrile IV drug users. DESIGN: Prospective observational cohort
      study. SETTING: Municipal hospital emergency department. TYPE OF PARTICIPANTS:
      One hundred six IV drug users aged 18 years or older, with rectal temperatures of
      37.8 C or more. INTERVENTIONS: Clinical and laboratory variables were obtained by
      trained research assistants, using a standardized data collection instrument.
      RESULTS: The erythrocyte sedimentation rate was the only variable consistently
      associated with illness severity in both the univariate and multivariable
      analyses (P < .0001). At an erythrocyte sedimentation rate of 100 mm/hr or more,
      the test had a specificity of 96% (95% confidence interval, 81% to 100%). In
      contrast, the erythrocyte sedimentation rate displayed a relatively poor
      sensitivity at low values (88% [95% confidence interval, 77% to 95%] at an
      erythrocyte sedimentation rate less than 20). CONCLUSION: An erythrocyte
      sedimentation rate of 100 or more should be regarded as a marker for serious
      illness in IV drug users with fever, but a "normal" erythrocyte sedimentation
      rate of less than 20 does not reliably exclude the presence of serious disease in
      this patient population.

PMID- 8470833
TI  - Emergency department screening for syphilis in pregnant women without prenatal
      care.
AB  - STUDY OBJECTIVE: To determine if there is a high seroprevalence of syphilis in
      pregnant women without prenatal care presenting to an urban emergency department.
      DESIGN: Prospective, nonblinded sampling of pregnant women without prenatal care
      with a comparison group of pregnant women with prenatal care from the obstetrics
      clinic. Patients in the ED setting were asked about such associated risk factors
      as previous syphilis and drug use. SETTING: Urban ED. TYPE OF PARTICIPANTS:
      Pregnant women without prenatal care. INTERVENTION: Patients were screened for
      syphilis using the automated reagin test. Reactive automated reagin tests were
      confirmed by the fluorescent treponemal antibody absorption. In addition, 44
      patients with nonreactive automated reagin tests had confirmatory tests done. New
      cases were verified by the state health department. MEASUREMENTS AND MAIN
      RESULTS: Seventy-two patients were included in the study. The average age was 25
      years. Eight patients (11.1%) were diagnosed with previously undetected syphilis.
      Four patients (5.6%) had previously treated syphilis. The laboratory cost of
      screening was $248 per new case of syphilis detected. The study group was
      compared with 118 patients matched for age and race who presented to the
      obstetrics clinic for routine prenatal care. Two new cases of syphilis were
      discovered in the clinic population (1.7%). CONCLUSION: A high rate of syphilis
      infection was detected in this inner-city ED population presenting without
      prenatal care. This was higher than that found in the patients presenting for
      obstetrics care in the clinic. Patients can be screened effectively in the ED.

PMID- 8470834
TI  - Assessing the diagnostic value of an ECG containing leads V4R, V8, and V9: the 15
      lead ECG.
AB  - STUDY OBJECTIVES: To assess sensitivity, specificity, and odds ratios of ECG
      findings on leads V4R, V8, and V9 for acute myocardial infarction. DESIGN:
      Prospective, two-stage cohort study. SETTING: A 660-bed university-affiliated
      community hospital. TYPE OF PARTICIPANTS: One hundred forty-nine admitted
      patients with suspected myocardial infarction or unstable angina. INTERVENTIONS:
      Standard 12-lead ECG followed immediately by V4R, V8, and V9. MEASUREMENTS:
      Initial ECG findings of ST-segment displacement, Q waves, T-wave inversion, and
      eligibility for thrombolytic therapy. RESULTS: Major abnormalities (ST-segment
      deviation, T-wave inversion, Q waves) were found on the extra three leads in
      28.9% (43 of 149) of patients. Sensitivity of ST-segment elevation for acute
      myocardial infarction on 12 versus 15 leads increased from 47.1% to 58.8%,
      respectively, with no decrease in specificity. McNemar's pair-matched analysis
      for ST-segment elevation on myocardial infarction subgroup showed an association
      of ST elevation with the 15-lead ECG (P < .05). An eightfold increase in the odds
      of detecting ST elevation was found (90% confidence interval, 1.42 to 14.58); 22%
      of patients negative for ST elevation on 12 leads were positive on 15 leads.
      Analysis of ECG criteria for thrombolytic therapy presenting uniquely on extra
      leads showed an increased sensitivity from 35.3% to 44.1% on 12 versus 15 leads,
      respectively; there was a sixfold increase in the odds of meeting ECG
      thrombolytic therapy criteria (90% confidence interval, 0.34 to 11.66); 13.5% of
      patients not meeting criteria on 12 leads did so on 15 leads. CONCLUSION: The 15
      lead ECG provides increased sensitivity and odds of detecting ST-segment
      elevation in acute myocardial infarction patients with no loss of specificity;
      its use may expand the selection of thrombolytic therapy candidates and provide a
      fuller ECG description of the extent of myocardial injury and necrosis.

PMID- 8470835
TI  - Emergency cardiac stress testing in the evaluation of emergency department
      patients with atypical chest pain.
AB  - STUDY OBJECTIVES: To determine the feasibility, safety, and reliability of
      emergency cardiac treadmill exercise stress testing (CTEST) in the evaluation of
      emergency department patients with atypical chest pain. DESIGN: Thirty-two
      patients with atypical chest pain, normal ECGs, and risk factor stratification
      having low-probability of coronary artery disease were evaluated prospectively
      using outpatient, emergency CTEST. Study patients were compared with a
      retrospectively selected sample of admitted patients diagnosed with atypical
      chest pain who met the study criteria and were evaluated with CTEST as
      inpatients. All patients had follow-up at three and six months after evaluation.
      SETTING: University-affiliated community teaching hospital with 65,000 annual ED
      visits. RESULTS: All patients had normal CTEST. No patient had evidence of
      coronary artery disease, myocardial infarction, or sudden death during the follow
      up period. The average length of stay was 5.5 hours for emergency CTEST patients
      versus two days for inpatients. The average patient charge was $467 for ED
      evaluation with emergency CTEST versus $2,340 for inpatient evaluation.
      CONCLUSION: Emergency CTEST is a safe, efficient, cost-effective, and practical
      method of evaluating selected ED patients with chest pain. It is a useful aid for
      clinical decision making and may help to prevent unnecessary hospital admissions.

PMID- 8470836
TI  - Loss and grief reactions after spontaneous miscarriage in the emergency
      department.
AB  - STUDY OBJECTIVE: To describe the psychological and functional consequences of
      miscarriage in women after emergency department treatment and to identify
      variables that are associated with feelings of loss and grief. DESIGN: A
      prospective telephone follow-up study. SETTING: The ED of an urban teaching
      hospital. TYPE OF PARTICIPANTS: A consecutive sample of 44 women who were treated
      for miscarriage. MAIN RESULTS: Women were contacted a median of 17.5 days after
      their miscarriage. Although the pregnancy had been planned by only 12 women
      (28%), 30 (70%) stated they wanted the pregnancy once they knew they were
      pregnant. Women commonly felt a sense of loss (82%) and most experienced some
      limitations with daily functioning (77%). Although wanting the pregnancy was
      associated with a sense of loss, 40% of the women who did not want the pregnancy
      experienced loss. CONCLUSION: Grief reactions are pervasive after spontaneous
      miscarriage. There is no subgroup of women who could be expected not to
      experience loss and grief. The ED management of the woman who miscarries should
      address the anticipated loss and grief.

PMID- 8470837
TI  - The use of structured, complaint-specific patient encounter forms in the
      emergency department.
AB  - STUDY OBJECTIVE: To assess the effect of preprinted, structured, complaint
      specific patient encounter forms on documentation, use of testing, and treatment
      compared with free-text record keeping. DESIGN: Nonrandomized case-control trial.
      SETTING: University-affiliated, tertiary referral hospital emergency department.
      METHODS: The records of all patients with lacerations, pharyngitis, asthma, or
      isolated closed-head injury during an eight-month period were reviewed.
      INTERVENTION: Use of structured complaint-specific patient encounter forms versus
      traditional free-text record keeping. MAIN OUTCOME MEASURE: The null hypothesis
      was that there would be no differences in documentation, test use, or practice
      when the structured forms were used compared with free-text record keeping.
      RESULTS: Differences in documentation that favored the use of the structured
      forms for all four problems studied were seen consistently. Not only was
      documentation improved, but test use also was affected in a way that decreased
      use. In addition, in certain areas (eg, treatment of pharyngitis), clinical
      practice also was changed. CONCLUSION: Structured, problem-specific ED records
      improve documentation and affect both resource use and clinical practice. These
      forms may be useful for improving communication and reimbursement as well as for
      medicolegal documentation. They provide a method for standardized quality
      assurance review and clinical data abstraction. Finally, they provide a method
      for active dissemination of clinical standards.

PMID- 8470838
TI  - Sociodemographic determinants in the hospitalization decision: evaluation of an
      emergency department interhospital transfer policy.
AB  - STUDY OBJECTIVES: To evaluate an emergency department's "treat and transfer"
      policy during a two-month period of reduced inpatient capacity by determining the
      number and characteristics of transferred patients not admitted as planned to the
      receiving hospital. DESIGN: Matched case-control analysis. SETTING: Public
      hospital adult ED. TYPE OF PARTICIPANTS: Patients transferred to other hospitals
      for admission. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twelve percent
      of patients (16 of 135) were not admitted after transfer during the first month,
      and 8% during the two-month period. Only IV drug use was found to be
      significantly associated with an increased risk of discharge without admission
      (odds ratio = 9.5; 95% confidence interval, 1.9 to 47.8). CONCLUSION: Patients
      transferred from the public hospital ED resulted in admission to the receiving
      hospital in 92% of transfers. A history of IV drug use was the only
      characteristic found to be associated with discharge without admission to the
      accepting hospital.

PMID- 8470839
TI  - Compliance with emergency department referral: the effect of computerized
      discharge instructions.
AB  - STUDY OBJECTIVE: To examine the effect of computerized discharge instructions on
      emergency department patient referral recommendations. DESIGN: Prospective,
      descriptive analysis and clinical trial. SETTING: Emergency medicine residency
      affiliated urban hospital with 568 beds and 29,000 annual visits. TYPE OF
      PARTICIPANTS: One thousand ED patients discharged to an outpatient referral
      network during a six-week period. INTERVENTION: Mandatory referral was provided
      in written or computerized (Logicare Corp, Eau Claire, Wisconsin) format for each
      500-patient group. Demographic data and compliance, measured as appointment
      completion within 30 days, were analyzed using chi 2 with Yates' correction,
      Fisher's exact, and odds ratio comparisons (P < .05, 95% confidence interval).
      MEASUREMENTS AND MAIN RESULTS: The institution of computerized discharge
      instructions resulted in increased overall patient compliance from 26.2% to 36.2%
      (P < .0008) with odds ratio of 1.59 (1.2 to 2.1). Subset analysis showed
      increased compliance in patients who were more than 40 years old (32.5% to
      61.1%), were female (28.7% to 39.7%) with a private physician (36.4% to 53.9%),
      established hospital relationship (26.1% to 38.9%), had nonurgent complaints
      (26.5% to 36.2%), were specifically diagnosed with strain or contusion (17.0% to
      36.8%), or were referred to obstetrics/gynecology clinic (13.2% to 48.6%) (P <
      .001). CONCLUSION: Computerized discharge instructions were associated with
      improved compliance with ED referral recommendations, based on historic and
      contemporary controls.

PMID- 8470840
TI  - Use of a bilingual medical history questionnaire in the emergency department.
AB  - STUDY OBJECTIVE: To demonstrate that a complete and rapid clinical history can be
      obtained using a self-administered, bilingual questionnaire. DESIGN: A post-test
      experimental design was used to evaluate time spent obtaining the history and
      information completeness for the two groups. SETTING: Urban county emergency
      department. PARTICIPANTS: All patients were non-English-speaking Hispanic women
      who presented with gynecologic complaints. METHODS: Fifty-five patients completed
      a history questionnaire in Spanish on a form that displayed their responses in
      English on the carbon copy. In the control group, a history was obtained using a
      bilingual interpreter. RESULTS: Average completion time was significantly less (t
      = 14.38; P < .0001) for the experimental group (chi 2 = 5.67 minutes; SD, 1.89)
      than for controls (chi 2 = 14.58 minutes; SD, 4.19). There was no statistical
      difference in review criteria for documentation between groups. CONCLUSION: Using
      a bilingual questionnaire to obtain a clinical history results in more rapid
      patient evaluation without affecting the quality of information obtained.

PMID- 8470841
TI  - Proposals for health care reform: how do we evaluate them?
AB  - The Society for Academic Emergency Medicine suggests a systematic approach to
      evaluating proposals for reform of the medical care system. Described are the
      three components of the problem--access, cost, and quality. Then, goals are
      proposed for health care reform. With this background, we describe the major
      questions that reform proposals must address and the potential impact of reform
      on emergency medicine. Emergency physicians must actively support health reform
      legislation that is in the over-all best interest or our patients and our
      specialty, and work with the new federal administration to evaluate proposed
      changes.

PMID- 8470842
TI  - Social work technician program.
AB  - The increasing use of US emergency departments has resulted in increased patient
      delays and resultant dissatisfaction on the part of the patients and their
      families. Furthermore, recent studies have indicated that these delays may
      jeopardize the health of the ED patient. We describe a program designed to
      address these concerns. The Social Work Technician Program employs social work
      students nearing graduation as liaisons between medical personnel and ED patients
      and their families. This program has been found to promote patient satisfaction
      and welfare while providing the students with a valuable educational experience.

PMID- 8470843
TI  - The choice of thrombolytic agents in the emergency department.
AB  - STUDY OBJECTIVE: To assess the choice of thrombolytic agents in emergency
      departments and whether administrators and third-party payers are influencing
      choices because of cost differences. DESIGN: A telephone survey. TYPE OF
      PARTICIPANTS: ED medical directors, stratifying for hospital ownership, size, and
      regions of the United States. MEASUREMENTS AND MAIN RESULTS: One hundred twenty
      three ED medical directors completed the interview. Findings indicate that
      formularies include recombinant tissue-type plasminogen activator (rt-PA) in
      94.3% of surveyed hospitals and streptokinase in 63.4%. Public hospitals were
      significantly less likely to have rt-PA on the formulary (P = .0001). Based on
      payer type, 68.9% to 77.5% of patients requiring thrombolysis receive rt-PA, with
      approximately 15% of EDs using it for 1% to 25% of patients and an additional 15%
      using it for 26% to 50% of patients. Fourteen medical directors (11%) reported
      that they delay treatment with rt-PA until authorization is provided by the
      health maintenance organization, and 40% indicated they would change their choice
      of agents if rt-PA was denied. Cardiologists were the primary decision makers
      regarding thrombolytic agents in all types of hospitals. CONCLUSION: Although rt
      PA is the most frequently selected thrombolytic agent, significant practice
      variations exist among hospitals. To avoid interference from third-party payers
      and administrators, physicians may need to make decisions regarding such
      expensive agents in more objective forums (eg, pharmacy and therapeutics
      committees) and be better prepared to defend the resulting practice guidelines.

PMID- 8470844
TI  - Clinton's health reform and emergency department volumes: a return visit.

PMID- 8470845
TI  - Acute urinary retention: an unusual presentation of appendiceal abscess.
AB  - Emergency physicians frequently encounter patients with acute urinary retention.
      Although most common among the elderly, pediatric and young adult patients
      occasionally may present with this complaint. The differential diagnosis and
      emergency department work-up must be age specific. We discuss the case of a young
      man who presented with acute urinary retention, subsequently found to be caused
      by undiagnosed appendicitis with appendiceal abscess formation. Only nine such
      cases have been reported in the literature thus far, with only one occurring in
      the nonpediatric population. This case represents the second such case to be
      reported. The importance of a thorough history, physical examination, and
      diagnostic work-up of patients who present with acute urinary retention,
      particularly those in the younger age group, is emphasized.

PMID- 8470846
TI  - Delayed splenic rupture in a drug addict.
AB  - We present the case of a drug addict who was admitted with abdominal pain but
      gave no history of trauma. He subsequently left the hospital against medical
      advice, only to be readmitted a few days later with persistent abdominal pain. He
      was found to have splenic rupture. This case emphasizes the importance of ruling
      out intra-abdominal trauma in any drug addict presenting with acute abdomen.

PMID- 8470847
TI  - Underutilization of Rh prophylaxis in the emergency department.

PMID- 8470848
TI  - Unstable occult cervical-spine fracture.

PMID- 8470849
TI  - Clinical policy for the initial approach to patients presenting with a chief
      complaint of seizure, who are not in status epilepticus. American College of
      Emergency Physicians.

PMID- 8470850
TI  - Variations in mortality and length of stay in intensive care units.
AB  - OBJECTIVE: To evaluate the amount of variation in in-hospital mortality and
      length of intensive care unit (ICU) stay that can be accounted for by clinical
      data available at ICU admission. DESIGN: Inception cohort study. SETTING: Forty
      two ICUs in 40 hospitals, including 26 hospitals that were randomly selected and
      14 large tertiary care hospitals that volunteered for the study. PARTICIPANTS: A
      consecutive sample of 16,622 patients and 17,440 ICU admissions. MEASUREMENTS AND
      MAIN OUTCOMES: Data on selected demographic characteristics, comorbidity, and
      specific physiologic variables were recorded during the first ICU day for an
      average of 415 admissions at each ICU; hospital discharge status (dead or alive)
      and length of ICU stay were recorded for individual patients; and the ratio of
      actual to predicted in-hospital mortality, standardized mortality ratios, and the
      ratio of actual to predicted length of ICU stay were recorded for individual
      ICUs. RESULTS: Unadjusted in-hospital mortality rates for the 42 units varied
      from 6.4% to 40%, and 90% (R2 = 0.90) of this variation was attributable to
      patient characteristics at admission. The standard mortality ratio varied from
      0.67 to 1.25. The mean unadjusted length of ICU stay varied from 3.3 to 7.3 days,
      and 78% of the variation (R2 = 0.78) was attributed to patient and selected
      institutional characteristics. The best performing unit had a length of stay
      ratio of 0.88, whereas the poorest performing unit had a ratio of 1.21.
      CONCLUSIONS: Clinicians can use readily available admission data to adjust for
      considerable variations in patient severity and type in different ICUs. Such data
      should permit precise evaluation and comparison of ICU effectiveness and
      efficiency, which varied substantially in this study, and result in improved
      methods of risk prediction and evaluation of new medical practices.

PMID- 8470851
TI  - Slowing the deterioration of asthma and chronic obstructive pulmonary disease
      observed during bronchodilator therapy by adding inhaled corticosteroids. A 4
      year prospective study.
AB  - OBJECTIVE: To determine if deterioration in patients with asthma or chronic
      obstructive pulmonary disease (COPD) during bronchodilator therapy could be
      slowed by additional treatment with an inhaled corticosteroid. DESIGN: A 4-year
      prospective study. SETTING: Twenty-nine general practices in the catchment area
      of the University of Nijmegen, Nijmegen, the Netherlands. PATIENTS: The study
      included 56 patients (28 with asthma and 28 with COPD) who showed an annual
      decrease in the forced expiratory volume in 1 second (FEV1) of at least 80 mL in
      combination with at least two exacerbations per year during bronchodilator
      therapy alone. Forty-eight patients completed the study. INTERVENTION: During the
      first 2 years of treatment, patients received only bronchodilator therapy
      (salbutamol, 400 micrograms, or ipratropium bromide, 40 micrograms). During years
      3 and 4, they received additional treatment with beclomethasone dipropionate, 400
      micrograms two times daily. RESULTS: Prebronchodilator FEV1 increased 458 mL/y
      (95% CI, 233 to 683 mL/y) during the first 6 months of beclomethasone treatment;
      FEV1 then decreased 102 mL/y (CI, 57 to 147 mL/y) during months 7 to 24. The
      annual decline in FEV1 during beclomethasone treatment was less than the decline
      of 160 mL/y seen before beclomethasone therapy (difference, 58 mL/y; 95% CI, 2 to
      87 mL/y). Only in patients with asthma did beclomethasone treatment improve
      bronchial hyperresponsiveness (assessed by determining the concentration of
      histamine that provoked a 20% decrease in FEV1 [PC20]) by 3.0 doubling doses per
      year (95% CI, 0.8 to 5.2 doses per year). Beclomethasone treatment was associated
      with improvement in peak expiratory flow rate, alleviation of symptoms, and a
      decrease in the number of exacerbations in both patient groups. CONCLUSIONS:
      Adding beclomethasone, 800 micrograms daily, slowed the unfavorable course of
      asthma or COPD seen with bronchodilator therapy alone. This effect was most
      evident in asthmatic patients.

PMID- 8470852
TI  - Cancer risk in relatives of patients with common colorectal cancer.
AB  - OBJECTIVE: To quantify any risk for colorectal cancer in first-degree relatives
      of patients with common colorectal cancer and to define possible markers for
      increased risk. DESIGN: Case-control family study. PATIENTS: Relatives of
      colorectal cancer patients and of matched control patients from a one-surgeon
      practice. METHODS: Family medical histories were obtained for 7493 first-degree
      relatives and 1015 spouses of 523 case-control pairs. Reported diagnoses of
      colorectal cancer in relatives were verified in 79% of instances. RESULTS: By
      case-control analysis, the odds ratio was 1.8 (95% CI, 1.2 to 2.7) for one and
      5.7 (CI, 1.7 to 19.3) for two affected relatives. By matched analysis of risk in
      relatives, the increased risk to parents and siblings was 2.1 times greater for
      case patients than for control patients (CI, 1.4 to 3.1); 3.7 times greater (CI,
      1.5 to 9.1) with case patients diagnosed before 45; and 1.8 times greater (CI,
      1.2 to 2.9) with case patients diagnosed at 45 years or older; and was
      independent of gender, type of relative, site of cancer, and type of cancer
      (single or multiple). The cumulative incidence among first-degree relatives was
      greater for case patients than for control patients (P < 0.001), and in case
      patients, greater for those diagnosed before 55 years of age (P < 0.001). The
      cumulative incidence (+/- S.E.) to age 80 was 11.1% +/- 1.3%, 7.3% +/- 0.8%, and
      4.4% +/- 1.0% among relatives of case patients diagnosed before age 45 years,
      between 45 and 54 years, and at 55 years or older, respectively, and was 2.4% +/-
      0.6% in relatives of control patients. CONCLUSIONS: First-degree relatives of
      patients with common colorectal cancer have an increased risk for colorectal
      cancer. This risk is greater if diagnosis was at an early and is greater when
      other first-degree relatives are affected. This increased risk should be
      considered when formulating screening strategies.

PMID- 8470853
TI  - Chronic active hepatitis associated with trazodone therapy.

PMID- 8470854
TI  - Risk factors for prostate cancer.
AB  - PURPOSE: To review the current state of knowledge regarding risk factors for
      prostate cancer. DATA SOURCES: Analysis of the literature through the use of
      MEDLINE as well as identification of papers through review of article
      bibliographies and the authors' personal files. Current data were also extracted
      from the Surveillance, Epidemiology, and End Results Program (SEER) database.
      DATA SELECTION: A review of risk factors for the development of prostate cancer.
      Emphasis was placed on identifying larger, controlled studies. DATA SYNTHESIS:
      The clinical incidence of prostate cancer is increasing. Risk factors for
      prostate cancer appear to include age, race, positive family history, vasectomy,
      and dietary fat intake. CONCLUSIONS: It appears that prostate cancer results from
      an interplay between endogenous hormones and environmental influences that
      include, most prominently, dietary fat.

PMID- 8470855
TI  - AIDS and the common man.

PMID- 8470856
TI  - Systems for comparing actual and predicted mortality rates: characteristics to
      promote cooperation in improving hospital care.

PMID- 8470857
TI  - The hazards of misguided compassion.

PMID- 8470858
TI  - Cost-effective treatment of Candida esophagitis.

PMID- 8470859
TI  - Cost-effective treatment of Candida esophagitis.

PMID- 8470860
TI  - Cost-effective treatment of Candida esophagitis.

PMID- 8470861
TI  - Selective decontamination of the digestive tract.

PMID- 8470862
TI  - Relation of adrenal androgen to insulin levels.

PMID- 8470863
TI  - Danazol for Henoch-Schonlein purpura.

PMID- 8470864
TI  - Intravenous gammaglobulin in a hypothyroid patient with the antiphospholipid
      antibody syndrome.

PMID- 8470865
TI  - Honing clinical skills.

PMID- 8470866
TI  - Honing clinical skills.

PMID- 8470867
TI  - Prolonged intubation injuries of the larynx: endoscopic diagnosis,
      classification, and treatment.
AB  - Laryngeal trauma from prolonged endotracheal intubation occurs in patients of all
      ages. Most changes are superficial and heal quickly. Injuries that are found
      consistently during intubation include nonspecific changes, edema, granulation
      tissue, ulceration, and other miscellaneous injuries. In this paper significant,
      severe, and lasting trauma of the larynx has been classified on the basis of the
      known factors in pathogenesis, observations made at endoscopy, and photographic
      documentation. This classification has required introduction of new descriptive
      terminology: "tongues of granulation tissue," "ulcerated troughs," "healed
      furrows," and "healed fibrous nodule." During intubation the degree of injury can
      be precisely assessed under general anesthesia by using telescopes for image
      magnification, thus assisting a decision whether to continue intubation or
      perform tracheotomy to minimize long-term morbidity. Changes that are found after
      extubation result from granulation tissue, ulceration, or a combination of both
      and have been illustrated on flow charts; a knowledge and understanding of these
      sequelae allows them to be identified by both indirect and direct laryngoscopy so
      that treatment can be planned.

PMID- 8470868
TI  - Hepatic acylcoenzyme A:cholesterol acyltransferase activity is low in hamsters
      fed apples in addition to a standard diet.
AB  - The effect of consumption of apples as a supplement to a standard diet on hepatic
      acylcoenzyme A: cholesterol acyltransferase (ACAT) activity was investigated in
      adult golden hamsters (Mesocricetus auratus). The experimental diet was given for
      2 months. IN response to the high-fruit intake, the level of cholesteryl esters
      was reduced in the liver, and hepatic ACAT activity, determined in vitro under
      various conditions of incubation, was lowered by about 30%. Moreover, plasma
      cholesterol was redistributed among the lipoproteins, with a decrease in the
      cholesterol transported in the ApoB-rich lipoproteins.

PMID- 8470869
TI  - Effect of inpatient versus outpatient measurement protocol on resting metabolic
      rate and respiratory exchange ratio.
AB  - Resting metabolic rate (RMR) and respiratory exchange ratio (RER) were measured,
      using indirect calorimetry, in 9 healthy, male subjects (28.6 +/- 3.3 years)
      under three conditions: (1) an inpatient, meal-controlled protocol (IPM) in which
      subjects were fed an evening meal and slept overnight in the laboratory prior to
      the morning test; (2) an outpatient, meal-controlled protocol (OPM) in which
      subjects were fed the same meal but slept at home prior to being transported to
      the laboratory for testing, and (3) and outpatient protocol (OP) in which meal
      was not controlled, but subjects were instructed to fast for 12 h prior to
      testing. There were no statistically significant differences in RMR between
      protocols (IPM = 7,928 +/- 360, OPM = 8,015 +/- 331 and OP = 7,987 +/- 315
      kJ/day) or in fasting RER (IPM = 0.82 +/- 0.01, OPM = 0.82 +/- 0.02 and OP = 0.81
      +/- 0.02). These data indicate that in young, healthy males RMR and RER are
      similar when measured under inpatient or outpatient conditions.

PMID- 8470870
TI  - Biodistribution and metabolism of orally administered octacosanol in rats.
AB  - The biodistribution and metabolism of [8-14C]-octacosanol in rats were
      investigated to understand the mechanism of increased physical exercise and motor
      endurance by octacosanol. After 14C-octacosanol administered, radioactivity of
      octacosanol was mainly found in adipose tissue, especially in brown adipose
      tissue. Absorption of octacosanol is very low and mainly excreted through feces.
      The radioactivity of octacosanol was also partly expired as 14CO2. About 49% of
      the administered dose were excreted through different pathways. Metabolites of
      octacosanol are present in the urine. Octacosanol may be partly oxidized and
      degraded to fatty acids through beta-oxidation.

PMID- 8470871
TI  - IgG subclasses to food proteins in atopic and normal individuals.
AB  - IgG subclass antibodies to ovalbumin (OVA), gliadin (GLI) and beta-lactoglobulin
      (beta-lac) were determined in 18 atopic subjects and 18 age- and sex-matched
      controls. IgG antibodies to OVA and GLI were found predominantly as IgG4
      subclass, with the IgG antibodies to beta-lac distributed evenly between IgG2,
      IgG3 and IgG4 in both groups. The proportion of anti-OVA IgG antibodies in the
      IgG3 subclass was significantly higher in the atopic group (22%) than in the
      nonatopic group (8%: p < 0.001). The proportion of anti-GLI IgG3 antibodies was
      also higher in the atopic group (43%) than the nonatopic group (24%: p < 0.001).
      OVA subclass antibodies in the atopic and nonatopic subjects were mainly IgG4,
      and GLI subclass antibodies were mainly IgG3 and IgG4. This study provides
      information on the distribution of IgG subclasses to food proteins, and in
      particular those related to protein GLI. The importance of IgG3 subclasses in
      atopic disease is highlighted; this phenomenon, to our knowledge, has not
      previously been reported.

PMID- 8470872
TI  - Multifrequency bioelectrical impedance as a measure of differences in body water
      distribution.
AB  - In 38 females, aged 21.3 +/- 1.8 years (mean +/- SD) and 22 males, aged 21.6 +/-
      2.0 years, total body water (TBW) was assessed by bioelectrical impedance at a
      frequency of 100 kHz (Z100), and extracellular water (ECW) was assessed at a
      frequency of 1 (Z1) or 5 kHz (Z5). Impedance ratios of low frequencies (Z1 or Z5)
      to high frequency (Z100) were calculated as indicators of body water
      distribution. Furthermore, changes in body water distribution during the
      menstrual cycle were assessed in 16 females, aged 22.1 +/- 1.7 years, divided
      into subjects using or not using oral contraceptives. In general, the ratio ECW
      to TBW was lower in males compared to females, which was reflected in the ratios
      Z1/Z100 and Z5/Z100. However, the ratio Z5/Z100 reflected this difference less
      clear, probably because at 5 kHz the current partly passes the cell membranes.
      Weight changes during the menstrual cycle are generally accepted to be due to a
      retention of ECW. The ratio Z5/Z100 and the ratios Z1/Z100 and Z5/Z100 for those
      subjects not using oral contraceptives differed significantly between day with
      minimal and day with maximal weight. A negative correlation was found between
      weight change, still considering day with minimal and day with maximal weight,
      and change in impedance at 5 and 50 kHz for subjects not using oral
      contraceptives. It is concluded that differences in body water distribution are
      reflected by low-to-high impedance ratios.

PMID- 8470873
TI  - Influence of a single parenteral application of a 10% fish oil emulsion on plasma
      fatty acid pattern and the function of thrombocytes in young adult men.
AB  - 50 ml of a 10% fish oil emulsion (41% omega-3 fatty acids of total fatty acids)
      were infused for 1 h into the arm vein of young, healthy, male volunteers. The
      fatty acid composition of the plasma, aggregation of the blood platelets as well
      as the thromboxane synthesis, were measured before the beginning of infusion, 20,
      60, 120, 360 and 1,440 min after the start of the fat infusion. In the first 60
      min, the fatty acid composition of the plasma changed in correspondence with the
      supplied fatty acid pattern. At the end of the investigation it was again within
      the normal range. As a result of fat application thromboxane synthesis was
      reduced and the aggregation of the platelets was inhibited but it was normalized
      by the 1,440-min value. Fish oil emulsions might be beneficial for parenterally
      fed patients with a high risk of thrombosis. Therefore the performance of further
      investigations using a varying dosage and multiple application can be
      recommended.

PMID- 8470874
TI  - [Pelvic lymphatic excision using laparoscopy. Its value in the staging of tumors
      of the bladder].
AB  - Laparoscopic surgical procedures are being evaluated in urologic diseases
      including bladder cancer. Patients with apparently localized tumors may have
      lymph node involvement indicating disseminated disease for which locoregional
      treatments are inadequate. Laparoscopic lymphadenectomy may be useful for
      staging, since neither noninvasive procedures nor intraoperative examination of
      lymph nodes removed during cystectomy are completely reliable. The technique is
      described in detail. Benefits in bladder cancer patients remain to be determined.

PMID- 8470875
TI  - [Natural history and prognostic factors of superficial tumors of the bladder].
AB  - Forty-five patients with superficial bladder cancer managed by transurethral
      resection alone were studied longitudinally to identify factors associated with
      progression. Tumor grade, multiple tumor foci, and time to first recurrence were
      closely correlated with progression. Findings from this study are compared with
      previous reports. These data are useful to identify patients requiring more
      aggressive therapy, including intravesical anticancer drugs and BCG, and
      monitoring with closer-spaced cystoscopies.

PMID- 8470876
TI  - [Preventive treatment of superficial tumors of the bladder using intravesical
      BCG. Review].
AB  - Local immunotherapy with BCG was first described by Zbar in an experimental
      model. The clinical use of BCG in human bladder carcinoma was proposed by Morales
      in 1976. Since then randomised studies have confirmed the value of BCG against
      recurrence and progression in superficial transitional cell carcinoma of the
      bladder (Lamm, Herr). However the optimal protocol has not been defined and the
      mode of action of BCG remains obscure. In this paper, the authors review the
      clinical results of BCG and its complications then focus on recent immunological
      data concerning its mode of action. Finally a practical protocol is proposed.

PMID- 8470877
TI  - [Radical cystectomy for cancer. Technic].
AB  - Radical cystectomy is the treatment of choice for invasive bladder cancer.
      Morbidity and mortality associated with this procedure have been reduced
      substantially as a result of advances in surgical techniques and instruments. The
      cystectomy technique described herein offers satisfactory exposure and
      hemostasis, thus providing optimal conditions for achieving high-quality urinary
      diversion.

PMID- 8470878
TI  - [A procedure for bladder replacement using a low-pressure ileal reservoir].
AB  - Goals pursued when constructing an ileal pouch after cystectomy include good
      capacity and distensibility, voluntary control of micturition with no residual
      urine, a sensation of fullness, and urinary continence. In addition, metabolic
      disorders due to reabsorption of urine components by the ileal mucosa require
      control. A bladder replacement technique using a low-pressure ileal reservoir is
      described and results in eighty patients are reported. Physiologic features of
      ileal urinary pouches are reviewed.

PMID- 8470879
TI  - [Results of the treatment of bladder tumors infiltrating the muscle].
AB  - Recent studies have shown improvements in survival in patients with invasive
      bladder cancer, perhaps as a result of stage selection and reduced perioperative
      morbidity rather than of increased effectiveness of treatments. The main ongoing
      therapeutic trials (combined use of chemotherapy with either surgery or radiation
      therapy) aim at controlling occult metastases which may be present in up to 50%
      of apparently localized bladder cancers. Identification of risk factors for
      metastatic disease is therefore crucial. In this study, factors potentially
      associated with response to treatment were analyzed on the basis of a review of
      outcomes reported with current treatments.

PMID- 8470880
TI  - [The use of monoclonal antibodies in the evaluation of the aggressiveness of
      tumors of the bladder].
AB  - Monoclonal antibodies produced using hybridoma technology have enabled
      identification of new tumor markers. Targets include tumor-associated antigens,
      growth factors and their receptors, blood group antigens, cell proliferation
      antigens, oncogene or tumor suppressor gene products, and markers for drug
      resistance. Immunohistochemical or flow cytometry studies performed with
      monoclonal antibodies can be used to determine the immunophenotype of normal and
      tumoral urothelium; specificity may be primarily for superficial or deep tumors,
      or for different tumor grades. A number of monoclonal antibodies have been found
      of prognostic value independently from conventional prognostic criteria. Others
      have shown diagnostic value. The most promising monoclonal antibodies are
      reviewed herein.

PMID- 8470881
TI  - [Surgical anatomy of the lymphatic drainage of the bladder].
AB  - Descriptive anatomy teaches us that the lymphatic drainage of the bladder
      converges directly on to the middle and internal chains of the external iliac
      nodes, but never on to the external chain, sometimes on a sacral common iliac
      node and widely on internal iliac nodes. Surgical observations confirm this: no
      lymph node metastasis in the external chain of external iliac nodes is noticed,
      nor common iliac adenopathy without upstream invasion. On the basis of these
      descriptions, lymphadenectomy was performed from inguinal ligament to iliac
      bifurcation. Anatomical data largely explain pelvic recurrences due to the
      existence of unremoved common iliac nodes or unrecognized hypogastric nodes
      because of difficult access without sacrificing efferent branches of internal
      iliac artery.

PMID- 8470882
TI  - Effect of an extract from Phyllanthus amarus on hepatitis B surface antigen gene
      expression in human hepatoma cells.
AB  - It has been suggested that Phyllanthus amarus may be helpful in the treatment of
      hepatitis B virus infection. We studied the effect of an aqueous extract of P.
      amarus on the cultured hepatoma cell line HepA2. This cell line had been
      transfected with tandemly arranged HBV DNA and continued to synthesize and
      secrete both HBsAg and HBeAg. Extract of P. amarus reversibly inhibited cellular
      proliferation and suppressed HBsAg production but not HBeAg production in HepA2
      cells. We also found that P. amarus suppressed HBsAg gene expression at mRNA
      level in a time-dependent manner, and selectively abolished the HBsAg gene
      promoter driven CAT activity. Our results demonstrate that P. amarus contains
      some active components which can suppress the HBsAg gene expression in human
      hepatoma cells. Such suppression may contribute the antiviral activity of P.
      amarus in vivo.

PMID- 8470883
TI  - Inhibition of Sindbis virus replication by cyclopentenone prostaglandins: a cell
      mediated event associated with heat-shock protein synthesis.
AB  - Cyclopentenone prostaglandins (PGs) have been shown to inhibit the replication of
      several DNA and RNA viruses. Here we report on the effect of prostaglandin A1
      (PGA1) on the multiplication of a positive strand RNA virus, Sindbis virus, in
      Vero cells under one-step multiplication conditions. PGA1 was found to inhibit
      Sindbis virus production dose-dependently, and virus yield was reduced by more
      than 90% at the concentration of 8 micrograms/ml, which was non-toxic to the
      cells and did not inhibit DNA, RNA or protein synthesis in Vero cells. The
      cyclopentenone prostaglandin delta 12-PGJ2 was also shown to be a potent
      inhibitor of Sindbis virus replication. Virus-induced reduction of [3H]uridine
      uptake by cells was partially prevented by PGA1 treatment, which also caused a 1
      h delay in the peak of virus RNA synthesis. SDS-PAGE analysis of [35S]methionine
      labeled proteins showed that PGA1 moderately inhibited the synthesis of the viral
      structural proteins E1, E2 and C, and induced the synthesis of a 72 kDa M(r)
      protein, identified as a heat-shock protein related to the HSP70 group, in both
      virus-infected and uninfected cells. Actinomycin D treatment completely prevented
      PGA1-antiviral activity, indicating that a cellular product is responsible for
      this action. PGA1-induced HSP70 is a good candidate for this role.

PMID- 8470884
TI  - Inhibition of duck hepatitis B virus replication by hypericin.
AB  - Hypericin was found to be active against a member of the hepatitis B virus
      family, duck hepatitis B virus (DHBV). After a single 1 h incubation with
      hypericin, cells stably-transfected with a clone of DHBV stopped producing
      infectious virus for several days, though virus-like particles continued to be
      released into the culture medium. Characterization of these virions revealed a
      buoyant density characteristic of infectious virus preparations and lower than
      that of virus cores, suggesting that the particles were enveloped. Western blot
      analysis suggested, however, that the viral preS protein in surface antigen
      particles and, by inference, in virions, was present in covalently cross-linked
      aggregates. Evidence of a similar level of aggregation of the core subunit of
      virion nucleocapsids was not found, nor was there evidence of a similar high
      level of aggregation of cell-associated core and preS proteins. Hypericin was
      only slightly virucidal against DHBV and culture medium from treated cultures did
      not block initiation of infection when added to DHBV susceptible cultures prior
      to a challenge with infectious DHBV. Thus, the primary antiviral activity of
      hypericin against DHBV replication appears to be exerted at a late step in viral
      morphogenesis.

PMID- 8470885
TI  - Siderophores.
AB  - Siderophores, defined as low-iron-induced virtually ferric-specific ligands, are
      widely distributed in microbial species where they function in the sequestration
      and transport of iron. In Escherichia coli biosynthesis of siderophores is
      negatively regulated at the transcriptional level by ferrous ion in conjunction
      with a repressor protein, Fur (ferric uptake regulation). Siderophores are a
      component of the virulence armamentarium of clinical isolates of E. coli and of
      certain other microorganisms pathogenic to man, animals, and plants. The
      mechanism whereby cells accumulate sufficient iron for activation of essential
      enzymes while, at the same time, avoiding excess of a potentially toxic element
      remains one of the most challenging problems in biochemistry.

PMID- 8470886
TI  - Vitamin A inhibits doxorubicin-induced membrane lipid peroxidation in rat tissues
      in vivo.
AB  - The antioxidant activity of vitamin A against lipid peroxidation induced by
      doxorubicin in rat tissues in vivo was investigated. A single ip injection of
      doxorubicin (30 mg/kg body wt) markedly raised the level of peroxidated lipids
      measured as TBARS and conjugated dienes in heart and brain membrane preparations.
      Other tissues, such as retina and liver, did not show any increase of lipid
      peroxides over control values. Pretreatment of rats with two daily subcutaneous
      injections of retinol palmitate (0.25 g/kg body wt), for 2 days, before injecting
      doxorubicin, inhibited peroxidation of heart and brain membrane lipids. The
      antioxidant action of vitamin A does not appear to be mediated by enhancement of
      antioxidant enzyme activities committed to detoxify oxygen radicals. Superoxide
      dismutase and catalase, measured in heart and brain cytosol, were not affected by
      the vitamin A treatment. On the contrary, a slight increase of catalase activity
      was observed in heart and brain cytosol from rats that had been treated with
      doxorubicin. Excess vitamin A may be localized in membranes. Appreciable increase
      of retinyl esters and retinol was measured in membrane preparations from rats
      that had been treated with vitamin A, with respect to control animals. Brain and
      heart membrane preparations from rats receiving vitamin A, assayed in vitro in
      the presence of an Fe3+ ascorbate induction system, showed a delay at the
      beginning of the lipid peroxidation and generated lesser amounts of TBARS, with
      respect to membranes from control rats. Thus, the increase of vitamin A within
      cell membranes results in an increased resistance of membrane lipids to
      peroxidation, both endogenously produced and induced in vitro. These results may
      be consistent with the hypothesis that vitamin A may act as a physiological
      antioxidant in cell membranes where it is localized.

PMID- 8470887
TI  - Hydrophobic affinity chromatography of human thrombin.
AB  - Hydrophobic affinity chromatography on p-chlorobenzylamido-agarose (p-CBA
      agarose) was used to characterize various modified forms of human thrombin.
      Native alpha-thrombin bound tightly to the column and was eluted with either
      acetonitrile or 1,4-dioxane, while the catalytically inactive prethrombin 2 did
      not bind to the matrix. Site-specific chemical modification with pyridoxal 5'
      phosphate resulted in the loss of at least 80% of fibrinogen clotting activity
      but did not influence the binding of thrombin to p-CBA agarose. Modification of
      thrombin with pyridoxal 5'-phosphate is thought to occur at the fibrinogen
      binding site and the heparin-binding site. In contrast, binding of thrombin to p
      CBA agarose was eliminated by modification of the active site histidine using
      either H-D-phenylalanyl-L-prolyl-L-arginine chloromethylketone or dansyl-L
      glutamyl-glycyl-L-arginine chloromethylketone but not with tosyl-L-lysine
      chloromethylketone. The presence of either hirudin or heparin blocked the binding
      of thrombin to p-CBA-agarose but dansyl-arginine-N-(3-ethyl-1,5-pentanediyl)amide
      had no effect. These results indicate that p-CBA agarose binds to thrombin
      outside of the enzyme active site and its use should be valuable in
      characterizing site-specific modified thrombins obtained by either protein
      engineering or chemical modification.

PMID- 8470888
TI  - Complete assignment of 1H and 13C nuclear magnetic resonance chemical shifts of
      beta-1,2-linked mannooligosaccharides isolated from the phosphomannan of the
      pathogenic yeast Candida albicans NIH B-792 strain.
AB  - To confirm correctness of the previous assignment study of H-1 protons of beta
      1,2-linked mannooligosaccharides provided by Shibata et al. (Biochemistry 31,
      5680-5686, 1992), another type of nonempirical assignment of the H-1 signals of
      the same oligosaccharides was achieved by adopting a sequential NMR assignment
      method that combines two-dimensional 1H-13C correlated spectroscopy, two
      dimensional 1H-1H correlated spectroscopy, and two-dimensional heteronuclear
      multiple-bond connectivity. Based on the above results, all of the 1H and most of
      the 13C signals in each oligosaccharide could also be assigned. The results of
      the proton assignment study provided sufficient evidence to confirm the
      correctness of that obtained in the previous H-1 proton assignment study.
      Furthermore, the existence of a regularity rule between the order of mannose
      units and its 1H and 13C chemical shifts has been revealed.

PMID- 8470889
TI  - Analysis and modification of thiols in the hemolymph juvenile hormone binding
      protein of Manduca sexta.
AB  - Hemolymph-induced in vitro modifications of the hemolymph juvenile hormone
      binding protein from the tobacco hornworm, Manduca sexta, were analyzed by
      polyacrylamide gel electrophoresis, Western blots, and equilibrium dialysis. Upon
      hemolymph melanization, a complex reaction involving polymerization of phenolic
      compounds, multiple forms of the protein were detected. Under melanizing
      conditions, one slower- and several faster-migrating proteins were observed. When
      the hemolymph was treated with 100 mM catechol, a melanin precursor, two well
      defined forms of the binding protein appeared. When the protein was incubated
      with excess catechol (> 100 mM) a single faster-migrating form appeared. Both
      fast and slow forms bound juvenile hormone I with similar efficiency. These
      results were duplicated using the thiol modifying reagents p
      chloromercurobenzoate and N-ethylmaleimide, suggesting modification of cysteine
      residues. Using differential alkylation, it was determined that hemolymph
      juvenile hormone binding protein contained two cystine and two cysteine residues.
      One of the cysteines is exposed and readily accessible for modification. Since
      modification of the exposed free thiol did not alter binding, it presumably
      resides outside the hormone-binding domain. The analyses support the observation
      that there is a single form of the hemolymph juvenile hormone-binding protein in
      our strain of M. sexta.

PMID- 8470890
TI  - Identification of the hydrophobic ligand-binding region in recombinant
      glutathione S-transferase P and its binding effect on the conformational state of
      the enzyme.
AB  - Recombinant glutathione S-transferase P (GST-P) was purified in a homogeneous
      state. Fatty acid analysis of the enzyme revealed that the final enzyme
      preparation endogenously bound fatty acids, mostly palmitic acid or stearic acid,
      which were difficult to dissociate from the complex. Temperature-dependent
      analysis by 1H NMR indicated that the molecular motion of fatty acids was
      strongly restrained under physiological conditions, which was significantly
      different from that of serum albumin. On the other hand, there existed another
      hydrophobic ligand-binding region in GST-P, to which 1-amino-8
      naphthalenesulfonic acid and bilirubin would bind with relatively lower affinity
      than the endogenously bound fatty acid. The hydrophobic ligand-binding region was
      determined to be around 141-156 residues from the N-terminus by procedures
      including association of the enzyme to fatty acid-linked Sepharose and affinity
      labeling with fluorescent fatty acid. Furthermore, circular dichroism analysis
      showed that the binding of hydrophobic ligand to GST-P produced a remarkable
      conformational change of the enzyme, which led to states devoid of transferase
      activity. In addition, the hydrophobic ligand binding caused a significant
      fluorescence quenching of tryptophan 38, which was assumed to be located at the
      active center of GST-P. It could be the result of a conformational change of the
      active center of the enzyme.

PMID- 8470891
TI  - Studies on fibronectin and its domains. II. Secondary structure and spatial
      configuration of fibronectin and of its domains.
AB  - Fibronectin (FN) from human plasma, as well as recombinant proteins derived from
      two of its major domains, the N-terminal fibrin-binding domain (FBD) and the cell
      binding domain (CBD), were studied by circular dichroism (CD), Fourier transform
      infrared (FTIR), and fluorescence spectroscopies. Secondary structure estimations
      derived from both FTIR spectra and far uv CD indicate significant differences
      between FBD and CBD proteins. Thus, the CBD 33-kDa protein contains 80% beta
      sheet and 20% beta-turns, whereas the three refolded FBD recombinant proteins
      studied, the 12-, 18.5-, and r31-kDa proteins, as well as the plasma-derived p31
      kDa protein, all contain some percentage of aperiodic structure, ranging from 14
      to 23% for both 31-kDa proteins, and between 33 and 46% for the smaller 12- and
      18.5-kDa proteins. The amount of aperiodic structure increases drastically (from
      23 to 67%) in a misfolded recombinant 31 kDa, the scrambled 31 kDa. Both native
      FN and a chimeric 45-kDa protein, consisting of both the FBD 12-kDa and the CBD
      33-kDa proteins, were found to resemble the CBD 33-kDa protein itself, i.e.,
      consisting only of beta-sheet and beta-turns and being free of aperiodic
      structure. These differences between two types of conformation are corroborated
      by the differences in the environment and spatial configuration of the aromatic
      amino acids of these proteins, as evidenced from near uv CD and intrinsic
      fluorescence spectroscopies. Thus, in the near uv CD the typical CBD proteins,
      i.e., the 33- and 45-kDa proteins display a maximum at 294 nm, whereas the FBD
      proteins, except for the scrambled 31-kDa protein, all have a characteristic
      strong negative peak at 300 nm. Similarly, the lambda max of the emission spectra
      of the whole FN and the 33- and 45-kDa proteins are characteristically blue
      shifted (317-326 nm) and with high normalized intensity, when compared with the
      relatively red-shifted lambda max (338-340 nm) and low intensities of the folded
      FBD proteins. The scrambled 31-kDa protein again takes exception, having a
      relatively high normalized intensity due to misfolding. The two major conclusions
      from this work, attained by a combination of four spectroscopic methods, are: (a)
      functionally different FN domains, i.e., the FBD and CBD adopt totally different
      conformations, with the CBD having an almost exclusive beta structure; (b) the
      functional specificity of the various domains of FN may depend on subtle
      differences in the flexibility in their protein backbones, with the FBD being
      more flexible than the CBD.

PMID- 8470892
TI  - Purification and characterization of an alpha-L-fucosidase from Pomacea
      canaliculata.
AB  - An alpha-L-fucosidase (EC 3.2.1.51) was isolated from the hepatopancreas of
      Pomacea canaliculata. The enzyme was purified 285-fold from the crude enzyme
      extract by procedures involving first heat treatment, ammonium sulfate
      fractionation, second heat treatment, and chromatography on DEAE-Sepharose,
      hydroxylapatite, and L-fucosylamine-CH-Sepharose. When assayed by using p
      nitrophenyl glycosides as substrates, the final preparation was free from other
      glycosidase activities and gave a single protein band which corresponded to alpha
      L-fucosidase activity on disc gel electrophoresis. The molecular weight of the
      enzyme was estimated to be 260,000 by Sephacryl S-300 column chromatography. The
      enzyme has two optimum pH values, 2.5 and 5.0, and the apparent Km value and the
      maximum velocity for p-nitrophenyl alpha-L-fucoside at both pH were calculated to
      be 0.45 mM and 1.46 mumol/min/mg of protein, respectively. The enzyme was shown
      to hydrolyze the Fuc alpha 1-->2Gal, the Fuc alpha 1-->4GlcNAc, and the Fuc alpha
      1-->6GlcNAc linkages, but hardly acts on the Fuc alpha 1-->3GlcNAc linkage in
      various oligosaccharides.

PMID- 8470893
TI  - Structure of D-glyceraldehyde-3-phosphate dehydrogenase from Palinurus versicolor
      carrying the fluorescent NAD derivatives at 2.7 A resolution.
AB  - Ultraviolet irradiation of carboxymethylated D-glyceraldehyde-3-phosphate
      dehydrogenase leads to the formation of a fluorescent NAD derivative. The
      structure of the enzyme from Palinurus versicolor carrying this derivative has
      been determined by molecular replacement and refined using the restrained least
      squares method to 2.7 A with a final crystallographic R-factor of 0.205. The
      polypeptide chain folding and subunit arrangement closely resemble the known
      structure of Homarus americanus GAPDH. The structure at the modified active site
      confirms that the photochemical reaction is a half-of-the-sites reaction and
      occurs in the red and yellow subunit pair. The stereochemical relationship
      between the Trp residues at the active site shows that Trp 310 is most probably
      involved in a radiationless energy transfer to the fluorophore. A large solvent
      channel connecting the catalytic and NAD(+)-binding sites was found parallel to
      the crystallographic axis alpha from packing analysis, suggesting that this
      crystal form may be suitable for a kinetic crystallographic study of the
      apoenzyme.

PMID- 8470894
TI  - Combined effects of streptozotocin-induced diabetes plus 4-methylpyrazole
      treatment on rat liver cytochrome P4502E1.
AB  - The content and activity of cytochrome P4502E1 is increased in the diabetic
      state, primarily due to stabilization of the P4502E1 mRNA. Chemical inducers such
      as 4-methylpyrazole (4MP) increase P4502E1 content by stabilization of the
      protein. Experiments were carried out to evaluate the combined effects of 4MP and
      streptozotocin-induced diabetes on P4502E1 protein, catalytic activity and mRNA
      levels. Immunoblots showed an elevated content of P4502E1 after treatment with
      4MP or streptozotocin, which was further increased when the two treatments were
      combined. Similarly, catalytic activity with effective substrates for P4502E1 was
      increased by the two separate treatments, and further increased by combined
      treatment. In all treatment groups, catalytic activity was strongly inhibited by
      antibody against P4502E1. The content of P4502E1 and catalytic activity in the
      4MP plus streptozotocin group appeared to be additive of the values for the
      separate treatments. P4502E1 mRNA levels were elevated by the streptozotocin
      treatment but not by 4MP treatment; combined treatment with both inducers did not
      elevate P4502E1 mRNA levels beyond the increase produced in the diabetic state.
      CCl4 decreased cellular viability in hepatocytes from streptozotocin- or 4MP
      treated rats, and increased toxicity was found after treatment with both
      inducers. These results contrast the mechanisms of induction of P4502E1 by
      streptozotocin and 4MP, and suggest that each individual mechanism is maintained
      when the two inducers are administered such that effects on P4502E1 protein and
      catalytic activity, but not mRNA, are additive of values found for each inducer
      alone. The diabetic state may be associated with increased sensitivity to toxins
      which are activated by P4502E1, especially if chemical inducers similar to 4MP,
      e.g., ethanol, isoniazid are also present.

PMID- 8470895
TI  - Isolation and characterization of a differentiation-dependent gene in the human
      colonic cell line HT29-18.
AB  - The human colonic epithelial cell line HT29, and its clonal derivatives HT29-18
      and HT-29-18-C1, differentiate in vitro. Differential screening of a subtraction
      cDNA library enriched for sequences unique to HT29-18-C1, a highly differentiated
      subclone of HT29-18, resulted in the isolation of a differentiation-dependent
      cDNA clone, A4. A full-length clone encoding A4 was obtained and sequenced to its
      entirety. It is 945 bp in length and contains an open reading frame (ORF) of 456
      bp. The amino acid sequence deduced from the ORF reveals a polypeptide of 152
      amino acids with a predicted molecular mass of 17,000 Da, a size confirmed by
      coupled in vitro transcription and translation directed by the full-length A4
      cDNA. This polypeptide contains four potential membrane-spanning domains and
      consensus sequences for N-linked glycosylation as well as phosphorylation sites
      for protein kinase C and casein kinase II. Comparison of A4 to published DNA and
      protein sequences revealed no significant homology. Genomic Southern blot
      analysis suggests that the gene is present in a single copy within the human
      genome and is conserved in the rat. Northern blot analysis of RNA obtained from
      various rat tissues shows that the expression of the A4 gene is tissue-selective
      and is enriched in colonic mucosa. In situ hybridization using human intestinal
      tissues indicates that the expression of A4 follows a gradient along the crypt-to
      villus axis with the most abundant message occurring in the lower half of the
      crypt. Furthermore, nuclear run-on assays suggest that the induction of the A4
      gene during differentiation of HT29-18 is regulated at a transcriptional level. A
      clone was isolated from a human genomic library and found to contain all five
      exons of A4. S1 nuclease analysis localized the start site of transcription to an
      adenosine residue 91 nucleotides upstream from the ATG translation initiation
      codon. Examination of the immediate sequence 5' to the mRNA start site reveals no
      TATA box and multiple known enhancer sequences. A4 is also noted to share certain
      features with the gene encoding the cystic fibrosis transmembrane conductance
      regulator protein. They include a similar vertical distribution of expression
      along the intestinal epithelium, enhanced transcription upon differentiation of
      HT29-18, and multiple shared putative regulatory sequences in the promoter
      regions. Further characterization of the mechanisms regulating expression of the
      A4 gene could contribute to the understanding of mammalian intestinal
      differentiation.

PMID- 8470896
TI  - Activity of human DNA polymerases alpha and beta with 2-chloro-2'-deoxyadenosine
      5'-triphosphate as a substrate and quantitative effects of incorporation on chain
      extension.
AB  - When 2-chloro-2'-deoxyadenosine 5'-triphosphate (CldATP) is incorporated into DNA
      by human polymerases alpha and beta (Hpol alpha, Hpol beta) the rate of chain
      extension decreases. In the present study primer extension has been quantitated
      by estimating the concentration of each successive oligonucleotide product at a
      series of time points. This has permitted calculation of pseudo-first-order rate
      constants for successive nucleotide additions to primer. By this method it has
      been shown that rate constants for CldATP addition are 79-100% of those for dATP
      in the case of Hpol alpha, and 26-153% with Hpol beta. The concentrations of
      CldATP for half maximum velocity is 0.6 microM for Hpol alpha, and 6 microM for
      Hpol beta, each about twice the value for dATP. Thus, CldATP is a good substrate
      for both enzymes but is more efficiently used by Hpol alpha. Addition of a single
      analogue residue by Hpol beta to any of seven primers decreases the rate constant
      for addition of the next nucleotide to 2-7% of that after dAMP addition and
      further extension is negligible. Consecutive additions of analogue residues by
      Hpol alpha progressively decrease the rate of subsequent extension, and after
      five consecutive additions extension virtually terminates. These effects probably
      make a major contribution to the cytotoxicity of chlorodeoxyadenosine and its
      therapeutic usefulness as an antileukemic agent.

PMID- 8470897
TI  - Nicotinamide mononucleotide adenylyltransferase activity in human erythrocytes.
AB  - Nicotinamide mononucleotide adenylyltransferase (NMN-AT) activity has not
      hitherto been demonstrated in human red blood cells, owing to its low activity.
      Since it is usually located in the nucleus, the possibility of finding it in
      human erythrocytes was excluded. Here we report the first demonstration and
      characterization of NMN-AT in human red blood cells, by an HPLC method. The
      enzyme is Mg2+ dependent, with a Km of 0.303 mM for nicotinamide mononucleotide
      and 0.103 mM for ATP, and a Vmax of 346 nmol g Hb-1 h-1. The crude preparation is
      also active on nicotinic acid mononucleotide, producing nicotinic acid adenine
      dinucleotide. NMN-AT activity is inhibited by nicotinic acid mononucleotide, and
      nicotinic acid adenylyltransferase is inhibited by nicotinamide mononucleotide.
      Fiftyfold purification of NMN-AT was achieved by DEAE-Toyopearl chromatography,
      and the kinetic characteristics were determined. The partially purified
      preparation maintained its nicotinic acid adenylyltransferase activity. These
      findings are discussed in light of the regulation of NAD metabolism in human red
      blood cells.

PMID- 8470898
TI  - Regional differences in sulfated oligosaccharides of rat gastrointestinal mucin
      as detected by two-dimensional chromatography.
AB  - Radiolabeled sulfated mucin was obtained from rat gastrointestinal tract tissue
      (corpus, antrum, duodenum, jejunum, ileum, or colon) incubated with [35S]sulfate
      in vitro by fractionation of extracts on Superose 6 followed by purification with
      CsCl density gradient centrifugation. Significant amounts of 35S-labeled mucin
      were obtained from each tissue and radioactivity differed according to region, in
      the order colon > duodenum > jejunum > corpus > antrum > ileum. Gel-permeation
      chromatography of 35S-labeled oligosaccharides liberated from each mucin by
      alkaline-borohydrate treatment indicated the 35S-labeled oligosaccharides of each
      mucin differ with respect to elution position. Further examination of fractions
      eluted from the gel-permeation column by thin-layer chromatography showed region
      specific chromatograms for the sulfated oligosaccharides. Thus, not only the
      degree of sulfate incorporation but sulfated oligosaccharide structure differs
      according to the region in gastrointestinal mucin.

PMID- 8470899
TI  - Use of trinitrobenzensulfonate for affinity labeling of lysine residues at
      phosphate binding sites of some enzymes.
AB  - Trinitrobenzensulfonate, a reagent for lysine residues, inactivates lamb liver 6
      phosphogluconate dehydrogenase through affinity labeling. Complete inactivation
      is due to the binding of only one residue of reagent per enzyme subunit. Other
      enzymes with a phosphate binding site are also inactivated by affinity labeling.
      It appears that trinitrobenzensulfonate, when used at low concentrations, first
      binds to a phosphate binding site, then reacts with a nearby lysine residue. This
      reagent presents some advantages over pyridoxal phosphate, which has similar
      characteristics.

PMID- 8470900
TI  - Homocysteine-dependent demethylation of trimethylselenonium ion and selenobetaine
      with methionine formation.
AB  - In the presence of rat liver cytosol and homocysteine, trimethylselenonium ion
      (TMSe+) underwent time-dependent demethylation to dimethylselenide with the
      concurrent formation of methionine. Convenient methods were developed for assay
      of this activity using either radioactive methods based on the gamma emitting
      isotope 75Se or nonradioactive HPLC assay of methionine. The rate of
      demethylation was linear with protein concentration and dependent on
      homocysteine, which could not be replaced by cysteine, glutathione, or
      dithiothreitol. The TMSe+ demethylation rate was inhibited by the addition of
      betaine, sulfobetaine (dimethylthetin), or dimethylglycine. The Km for TMSe+ was
      8 mM compared to 0.04 mM for betaine, but the rate of TMSe+ demethylation was
      approximately 50-fold that of betaine when both were assayed at 25 mM. Methionine
      was also produced from selenobetaine, selenobetaine methylester, and
      sulfobetaine. The selenium analogues of betaine inhibited the demethylation of
      TMSe+ with only minor decreases in methionine production, indicating substrate
      competition. In preliminary studies aimed at the partial purification of the
      TMSe+:homocysteine methyltransferase activity, the enzyme was found to have
      chromatographic and heat stability characteristics similar to
      betaine:homocysteine methyltransferase. The data indicate that
      betaine:homocysteine methyltransferase, or a very similar enzyme, is involved in
      the demethylation of TMSe+ and show that TMSe+, an in vivo urinary selenium
      metabolite of many selenium compounds, is not biologically inert.

PMID- 8470901
TI  - Measurement of uric acid as a marker of oxygen tension in the lung.
AB  - Changes in O2 tension such as those associated with hypoxic ischemia or hyperoxia
      may potentially modulate purine nucleotide turnover and production of associated
      catabolites. We used an isolated perfused rat lung preparation to evaluate the
      effect of O2 tension on pulmonary uric acid production. Three O2 concentrations
      (21%, normoxia; 95%, hyperoxia; 0%, hypoxia) were utilized for both pulmonary
      ventilation and equilibration of recirculating perfusate. All gas mixtures
      contained 5% CO2 and were balanced with N2. We used Certified Virus Free Sprague
      Dawley male rats weighting 250-300 g, four to five rats in each exposure regimen.
      After a 10-min equilibration period, we measured uric acid levels at 0 and 60 min
      in lung perfusate and at 60 min in lung tissue. After 60 min of
      ventilation/perfusion, we observed significant uric acid accumulation in both
      lung tissue (25-60%) and perfusate (8- to 10-fold) for all three O2 regimens.
      However, hypoxia produced substantially greater net uric acid concentrations (net
      = the difference between zero and 60 min) than either normoxia or hyperoxia (1.5
      fold in lung tissue, and 2-fold in perfusate, respectively). The data suggest
      that pulmonary hypoxia results in greater purine catabolism leading to increased
      uric acid production. Vascular space uric acid, as measured in the recirculating
      perfusate, was proportional to lung weight changes (r = 0.99) with hypoxia
      exhibiting the greatest values, possibly reflecting a linkage between tissue
      perturbation and uric acid release. Thus, measurement of uric acid may serve as a
      useful marker of adenine nucleotide turnover and lung injury.

PMID- 8470902
TI  - Solid-state NMR analysis of crosslinking in mussel protein glue.
AB  - Solid-state 13C and 15N NMR spectra have been obtained of intact adhesive plaques
      from the mussel Geukensia demissa labeled by L-[6-13C,6-15N]lysine. The plaques
      are rich in a polyphenolic protein glue which has 50 or more repeats of a
      nonapeptide sequence with one lysine per repeat. The average isotopic 15N
      enrichment of lysyl epsilon nitrogens in the plaques was 4%. These lysyl amines
      are not involved in ionic complexes and do not form observable concentrations of
      covalent crosslinks.

PMID- 8470903
TI  - Molecular dimensions and properties of N-[1-(2-hydroxyethyl)-2-nitro-1H-imidazol
      1-yl]acetamide (SR2508).
AB  - Hypoxic cells in tumors are resistant to radiation and chemotherapy treatment. To
      decrease this resistance, 2-nitroimidazoles are used as radiation and chemical
      sensitizers in the treatment of tumors. Their use is marred by their toxicity.
      Therefore, the compound SR2508, a new 2-nitroimidazole derivative, was introduced
      in an attempt to obtain a less toxic nitroimidazole than those used thus far. The
      molecular structure and conformation of SR2508, determined from X-ray diffraction
      studies, is reported. The compound, formula C7H10N4O4, molecular weight 214.18,
      crystallizes in the monoclinic system, space group P2(1)/c, unit cell dimensions
      a = 12.052(3), b = 11.116(4), c = 7.330(2) A, beta = 106.94(2) degrees, V =
      939.4(5) A3, Z = 4. The crystal structure was refined to Robs = 0.041. The
      imidazole and C-NO2 groups are each planar and inclined at 6.6 degrees to each
      other. The side chain, which contains an amide group, is also planar. There are
      hydrogen bonds between different molecules and they involve O(11) and O(15), as
      well as N(12) and O(15). When compared to other 2-nitroimidazoles that have been
      clinically tested, the hydrogen bonds in SR2508 account for the increased
      hydrophilic character of the compound. Based on the crystal structure data,
      models for a possible interaction between SR2508 and DNA have been proposed.

PMID- 8470904
TI  - Purification and characterization of monkey (Macaca nemestrina) tracheobronchial
      mucin.
AB  - A major mucin glycoprotein was purified from monkey (Macaca nemestrina)
      bronchoalveolar lavages by gel filtration, delipidation, and a series of density
      gradient centrifugations in cesium trifluoroacetate/guanidinium chloride. Lipids
      noncovalently associated with the mucin amounted to 24-36% by weight and
      consisted primarily of phospholipids and glycolipids. The mucin preparation was
      free of low-molecular-weight protein/glycoprotein contaminants,
      glycosaminoglycans/proteoglycans, and nucleic acids. The weight-average molecular
      weight and radius of gyration of the mucin in buffer containing 6 M guanidinium
      chloride was estimated to be approximately 1.56 x 10(6) and 100 nm, respectively,
      by laser light scattering technique. When the mucin was dissolved in 0.15 M NaCl,
      a considerably higher molecular weight of approximately 5.05 x 10(6) and a larger
      radius of gyration of approximately 127 nm were observed suggesting aggregation
      of the mucin molecules. Amino acid composition of the glycoprotein was
      characteristic of mucins with threonine, serine, glutamic acid, proline, glycine,
      and alanine comprising 63%. The total carbohydrate content was 71.5% and
      consisted of GalNAc, GlcNAc, Gal, sialic acids, and fucose in the molar ratio of
      1.0:2.2:2.4:1.4:1.2 with no detectable mannose. Alkaline borohydride treatment
      indicated that 65% of the threonine and 27% of the serine are substituted by
      saccharides via GalNAc residues. An antisera produced against the purified mucin
      was found to react well with the native and weakly with the deglycosylated mucins
      and will be useful for immunoassays. A second, minor, mucin glycoprotein obtained
      during the purification was also partially characterized.

PMID- 8470905
TI  - Identification and regulation of rat squalene synthetase mRNA.

PMID- 8470906
TI  - Effects of radon inhalation on biological function--lipid peroxide level,
      superoxide dismutase activity, and membrane fluidity.
AB  - We administered radon (Rn) to rabbits by inhalation and examined changes in the
      lipid peroxide (TBARS) level, superoxide dismutase (SOD) activity, and membrane
      fluidity in various organs to clarify the therapeutic effects of Rn. The lipid
      peroxide level of the brain was significantly decreased immediately after Rn
      inhalation for 90 min in both the low concentration group (about 7-10 kBq/liter)
      and the high concentration group (about 14-18 kBq/liter) as compared with that in
      the control group. It further decreased in the low concentration group but
      slightly recovered in the high concentration group 2 h after inhalation. The
      lipid peroxide level of the lung showed no change immediately after inhalation
      but decreased significantly in both groups 2 h after inhalation. With regard to
      SOD activity in the brain and lung, only that in the brain showed significant
      increase in the high concentration group immediately after inhalation; no other
      change was observed. Membrane fluidity, especially the fluidity of membrane
      protein, was significantly increased in the brains of both groups immediately
      after inhalation, and that 2 h after inhalation in the lung was significantly
      increased in both groups. These findings suggest that the inhalation of Rn at Rn
      springs contributes to the prevention of brain disorders related to peroxidation
      reactions by promoting these physiologic changes.

PMID- 8470907
TI  - Phosphofructokinase from liver of the rainbow trout, Oncorhynchus mykiss.
AB  - Phosphofructokinase (PFK) from liver of the rainbow trout Oncorhynchus mykiss was
      purified to homogeneity with a recovery of 35% of total activity. The purified
      enzyme was a homotetramer with a native molecular weight of 297,000 +/- 16,000
      and a subunit M(r) of 76,000 +/- 3000. Arrhenius plots of enzyme activity were
      linear over 5-27 degrees C with an activation energy of 52.3 +/- 2.1 kJ/mol. The
      binding of fructose 6-phosphate was cooperative. High ATP increased the Hill
      coefficient and produced a marked allotropic inhibition of the enzyme activity.
      The affinity of the enzyme for fructose 6-phosphate was increased by the addition
      of the enzyme activators such as inorganic phosphate, ammonium ions, AMP, and
      fructose 2,6-bisphosphate; the activators also reduced the inhibitory effect of
      ATP. Trout liver PFK was activated by phosphoenolpyruvate at physiological
      concentrations but was not affected by citrate.

PMID- 8470908
TI  - Inhibition of NAD(P)H:quinone acceptor oxidoreductase by flavones: a structure
      activity study.
AB  - A structure-activity study was carried out to determine the important regions of
      baicalein and oroxylin A, two flavones isolated from the Chinese herb
      Scutellariae radix, in inhibiting NAD(P)H:quinone acceptor oxidoreductase (EC
      1.6.99.2; DT-diaphorase). This quinone reductase is a vitamin K reductase. It is
      a target for and has been used as a model enzyme to investigate the mode of
      action of oral anticoagulants. The two flavones were found to inhibit this
      quinone reductase in nanomolar ranges. The 5-hydroxyl, 7-hydroxyl, 8-hydroxyl,
      and 2-phenyl groups of these flavones were found to be important for their
      inhibition of the enzyme. The inhibition profiles of the flavones on the NADH
      menadione reductase activity, the NADH-potassium ferricyanide reductase activity,
      and the NADH-methyl red reductase activity of this enzyme were different.
      Therefore, even though the flavones were found to be competitive inhibitors with
      respect to NADH, they probably did not inhibit the enzyme by binding to the
      nicotinamide nucleotide binding site. Inhibition kinetic studies which indicated
      that these compounds bound to different sites than those for dicoumarol and
      phenindone were performed. These results indicate that these flavones are a new
      type of inhibitor of NAD(P)H:quinone acceptor oxidoreductase and potentially
      useful as anticoagulant drugs.

PMID- 8470909
TI  - The binding of Cd(II) to the hemocyanin of the Mediterranean crab Carcinus
      maenas.
AB  - The interaction of Carcinus hemocyanin with Cd(II) was studied. The incubation of
      the apoprotein with the metal yields a derivative containing 1 g-at. of EDTA
      stable Cd(II) per 75 kDa. Spectroscopic data ruled out Cd(II) coordination to
      tryptophan or cysteine residues. The optical activity and fluorescence properties
      of the protein are affected by Cd(II) binding and indicate a rearrangement of
      tryptophan residues. The poor Cd(II) binding to the oxy-form and the resistance
      of Cd(II)-hemocyanin to EDTA treatment and to the regeneration by Cu(I) strongly
      indicate that Cd(II) binding to apohemocyanin occurs at the copper-free active
      site. During the metal-binding process, a marked increase of light scattering is
      observed. This effect, however, is reversible provided that the incubation medium
      contains SCN- and glycine as exogenous ligands of the metal in the bulk solution.

PMID- 8470910
TI  - Stereoselective interaction of 2-halo-acyl-CoA derivatives with medium chain acyl
      CoA dehydrogenase from pig kidney.
AB  - Several 2-halo-acyl-CoA derivatives have been synthesized to examine the
      interaction of these potential inhibitors of mitochondrial beta-oxidation with
      the purified medium chain acyl-CoA dehydrogenase from pig kidney. Racemic 2-bromo
      , 2-chloro-, and 2-fluoro-octanoyl-CoA thioesters show 6.6, 33, and 3.5% of the
      activity of octanoyl-CoA in the standard assay system, respectively. Only the S
      enantiomer of these 2-substituted analogues is a significant substrate of the
      dehydrogenase, with S-2-bromo-octanoyl-CoA showing a rate of 18% that of octanoyl
      CoA, compared to about 1% for the R-isomer. The observations presented here
      suggest that a detailed understanding of the mode of action of 2-halo-fatty acids
      as inhibitors of mammalian beta-oxidation will require consideration of the
      metabolic fate and inhibitory effects of both enantiomers.

PMID- 8470911
TI  - Developmental aspects of glucocorticoid regulation of polycyclic aromatic
      hydrocarbon-inducible enzymes in rat liver.
AB  - The expression of hepatic cytochrome P4501A1 (P4501A1), glutathione S-transferase
      Ya subunit (GST), and NAD(P)H:quinone oxidoreductase (QOR) proteins was evaluated
      in fetal, neonatal, and adolescent rats treated with 3-methylcholanthrene (MC)
      and the synthetic glucocorticoid dexamethasone (Dex) to elucidate the
      developmental aspects of glucocorticoid regulation of the induction of drug
      metabolizing enzymes by polycyclic aromatic hydrocarbons in vivo. These
      developmental states were chosen to represent either glucocorticoid deplete or
      replete conditions due to their differences in circulating glucocorticoid levels.
      Rats were treated with either MC (10 mg/kg body wt) or Dex (10 mg/kg body wt) or
      a combination of both and sacrificed 24 h later. In neonatal rats, the enzyme
      activities of P4501A1, GST, and QOR were increased by MC treatment approximately
      65-, 1.4-, and 7-fold, respectively. The induction of these enzymes by MC was
      further potentiated an additional 2-, 1.5-, and 1.4-fold by concomitant Dex
      treatment. In adolescent male rats, Dex potentiated MC induction of P4501A1
      activity (1.7-fold), but repressed MC induction of GST and QOR activities. When
      the protein contents for the three enzymes were measured by Western blot
      analyses, a positive correlation was observed with enzyme activities for all
      conditions except for the adolescent rat, where hepatic protein content of
      P4501A1 of rats treated with both MC and Dex was not significantly increased
      above the level seen with 3-methylcholanthrene treatment alone. The levels of
      specific mRNA and transcriptional activity for cytochrome P4501A1, GST Ya
      isozyme, and QOR closely paralleled the changes seen in their protein content in
      the livers of neonatal and adolescent rats. Dexamethasone potentiation of P4501A1
      expression at the protein and RNA level were clearly statistically significant in
      the neonatal rat, but not in the adolescent rat, suggesting that the circulating
      levels of glucocorticoids are sufficiently low during the neonatal period that
      the full expression of induction of P4501A1 was not attained in the absence of
      exogenously administered glucocorticoids. These data also demonstrate that
      glucocorticoids have differential effects on the induction of GST Ya subunit and
      QOR protein and RNA in the neonatal and adolescent state, possibly related to
      circulating levels of glucocorticoids.

PMID- 8470913
TI  - [Present status of hyperthermia in Japan--emphasis on clinical research].
AB  - A nationwide survey was conducted by the Japan Society of Hyperthermic Oncology
      (JSHO) to investigate the present status of hyperthermia in Japan. The results of
      survey and characteristic clinical research conducted in Japan are described
      here. 1) In Japan, 185 heating equipment units are in operation at 156
      institutes. RF capacitive heating equipment accounts for 60%. 2) Records and
      registration are complete for 9,000 cases treated by hyperthermia. It is
      noteworthy that deep-seated tumors account for 60% of the total cases. 3) The
      percentages of different modalities are as follows: hyperthermia alone, 5.3%;
      thermoradiotherapy, 57.5%; thermochemotherapy, 22.6%; thermochemoradiotherapy,
      14.5%. The present status of hyperthermia is well represented by these
      percentages. 4) The treatment schedule, indications, and treatment results are
      almost completely established for a combination of radiotherapy with
      hyperthermia. 5) Thermochemotherapy is performed at 70% of the surveyed
      institutes, who expect good treatment results. The JSHO organized a joint
      research team for thermochemotherapy, and present results are satisfactory. 6)
      Japan contributes much to the progress of the International Congress of
      Hyperthermic Oncology. The JSHO presents an ideal environment for research on
      hyperthermic oncology.

PMID- 8470912
TI  - [Retinoid signalling pathways].
AB  - Retinoids, all-trans-retinoic acid (AT-RA) and its bioisters, exert diverse and
      profound effects on the growth and differentiation of normal and malignant cells,
      vertebrate development, and homeostasis. Since their nuclear receptors (RARs:
      alpha, beta and gamma) were cloned, extensive studies on retinoid signalling at
      molecular level have elucidated its elaborate mechanisms, by which the expression
      of a variety of retinoid responsive genes are regulated. Furthermore, discoveries
      of the second receptor system of retinoid (RXRs: alpha, beta and gamma) and their
      substantial ligand, 9-cis-retinoic acid (9C-RA), were recently reported. The
      heterodimer formation between RXR and RAR or other members of the steroid/thyroid
      hormone receptor superfamily gave us a new aspect of hormonal gene control
      including retinoids, thyroid hormone, vitamin D3 and others. These heterodimers
      were showed to bind specific response elements consisted of the direct repeat of
      consensus sequence (AGATTC) or its related sequences. Differential regulation of
      retinoid responsive gene by RARs or/and RXRs in vivo is an ongoing subject and
      the combinatory outcome of subtypes or isotypes of receptors, natural response
      elements, natural ligands (AT-RA, 9C-RA, or their metabolites) owing to
      pleiotropic effects of retinoids is being revealed. The anti-malignant effect of
      retinoids is another important theme. The report of prominent therapeutic effect
      of AT-RA against APL patients was sensational. In many APL patients,
      translocation between RAR alpha gene and an oncogenic gene, PML, can be detected,
      although the roles of their fusion products (RAR alpha-PML and PML-RAR alpha) in
      APL induction have not been understood. Furthermore, the cross-talk between RAR
      and AP-1 is thought to give an explanation for the suppressive effects of
      retinoids against tumor promoters (TPA and others). In those contexts, synthetic
      retinoids specific for each subtype of RAR or RXR, which will be useful reagents
      for biological studies and/or excellent therapeutic agents, are being developed.
      Some RAR subtype-selective compounds including antagonists have been already
      reported.

PMID- 8470914
TI  - [Technological progress in hyperthermia].
AB  - In the early stage of hyperthermia, a large number of physical and engineering
      efforts have been done in the development or the improvement of the heating
      techniques. As matters stand, they were not always satisfied clinically. Thus
      even in this moment, clinical techniques of hyperthermia should be build up
      rapidly. This paper describes some of the highlights of ongoing physical
      researches to develop the clinical hyperthermia and to identify a trend of
      emerging physical systems available on hyperthermia.

PMID- 8470915
TI  - [Biological basis of thermochemotherapy].
AB  - Interactive effects of combined treatment with hyperthermia and chemotherapeutic
      agents or chemical substances were interpreted in the experimental aspects of
      medical sciences. It was also interpreted how a physiological circumferential
      conditions in vivo influenced on thermosensitivities of cells, tissues or
      individuals. Among the physiological conditions, hypoxia and insufficient
      nutrition apparently enhance thermosensitivity while reduce radiosensitivity.
      Interactive effects in combined treatments with hyperthermia and alkylating
      agents varies among the alkylating agent adopted. DNA strand scission by
      alkylating agent is increased and repair of the DNA damage is suppressed in
      combination with hyperthermia. Almost all the antimetabolites and botanic
      alkaloids are reported to show no appreciable interactive effect in combination
      with hyperthermia. However, a sort of derivatives of mitotic toxins interacts
      with hyperthermia (unpublished data). Effects of anticancer antibiotics vary due
      to the variety of the mechanism of action of the antibiotics. Therefore,
      interactive effects of these antibiotics with hyperthermia also vary among the
      antibiotics. Most marked interaction with hyperthermia was shown in Mitomycin C,
      while the cell killing effect of Actinomycin D itself was reduced reportedly by
      the combined hyperthermia. Further development in thermophysiology may perform an
      extent of elevation in human whole body temperature. It has been considered
      internal heating may be more efficient than external heating for the hyperthermia
      alone. In the other hand, local heating can chemosensitize within the localized
      heated area where the blood concentration of anticancer drug is even, although
      variety of intervention could be devised to localize anticancer drug
      distribution. Variety of heating modalities and the apparatus would be developed
      which contribute for further interdisciplinary oncotherapy in near future.

PMID- 8470916
TI  - [Current status of thermoradiotherapy in cancer therapy].
AB  - The current status of thermoradiotherapy for cancer is reviewed. The usefulness
      of this combined treatment for superficial tumors, in which heating and
      thermometry are relatively easy to apply, has been clearly demonstrated by many
      clinical results. With recent technological advancements, the application of
      thermoradiotherapy to deep-seated tumors is increasing, and encouraging results
      have been reported for various tumors including brain tumors, carcinomas of the
      breast, lung, esophagus, liver, rectum, urinary bladder, and soft tissue tumors.
      Thermoradiotherapy seems a very promising treatment modality for various
      refractory malignancies.

PMID- 8470917
TI  - [A new sequential chemotherapy of methotrexate with 5-fluorouracil against
      advanced colo-rectal cancer].
AB  - A new sequential chemotherapy consisting of intravenous (IV) administration of
      methotrexate (MTX) 50 mg/m2 followed by 3 equal IV doses of 5-fluorouracil (5-FU)
      500 mg/m2 at 1.4 and 21 hrs. and a leucovorin rescue (15 mg/body/8 hr) from 24
      hrs. after MTX for 3 days was applied every two weeks for the patients with
      advanced colo-rectal cancer. The effectiveness of this MTX/3-dose 5-FU regimen
      was compared retrospectively with that of the standard sequential regimen
      consisting of the IV administration of MTX 100 mg/m2 followed by a single IV dose
      of 5-FU 800 mg/m2 one hr. later and a leucovorin rescue (21 mg/body/6 hr) 24 hrs.
      later given every week, namely MTX/1-dose 5-FU regimen. Partial response was
      achieved in 7 (46.7%) of 15 evaluable patients with the MTX/3-dose 5-FU regimen
      and in 3 (13.6%) of 22 evaluable patients with the MTX/1-dose 5-FU regimen (p <
      0.05). The median survival times were 13 and 9 months, respectively. There were
      no significant difference in the patient characteristics between the two groups,
      and the toxic effects were much lower in the MTX/3-dose 5-FU than in the MTX/1
      dose 5-FU regimen. It is therefore, concluded that the MTX/3-dose 5-FU regimen is
      superior to the standard MTX/1-dose 5-FU regimen.

PMID- 8470918
TI  - [Evaluation of the combination of chemotherapy with etoposide, adriamycin and
      cisplatin (EAP) in advanced or recurrent gastric cancer].
AB  - EAP therapy was performed on 30 cases of advanced or recurrent gastric cancer
      between September 1987 and July 1991. The clinical responses of 15 trial patients
      were evaluated. The overall response rate was 40.0% (CR, one case; PR 5 cases).
      The results were thus not as favorable as that reported by Preusser et al. On the
      contrary, with such a poor response rate, this treatment did not lead to a
      prolonged life span (mean survival time; 5.6 months, median survival time; 4
      months). Side effects, such as myelosuppression, appetite loss, nausea, vomiting,
      liver dysfunction, renal dysfunction, and alopecia, were also observed.
      Myelosuppression was a dose-limiting factor. The rhG-CSF proved in 4 cases to be
      a clinically useful tool against the neutropenia induced by this treatment. It
      may be concluded that EAP should be given to the following selected patients: (1)
      those whose condition is not so far advanced: (2) those who have not received
      many other forms of treatment; and (3) those in excellent general physical
      condition.

PMID- 8470919
TI  - [Antitumor activity of a new antiestrogenic drug, toremifene (NK622) against
      human breast cancer xenografts in nude mice].
AB  - NK622, a novel tamoxifen(TAM) analog with nonsteroidal structure is an
      antiestrogenic drug with less toxicity compared with that of TAM. We studied the
      in vivo antitumor activity against human breast cancer xenografts in nude mice.
      NK 622 significantly inhibited the growth of estrogen-dependent Br-10 breast
      cancer but not inhibited the growth of estrogen-independent MC-2-JCK and MC-5-JCK
      when orally administered once daily for 14 days at the maximum tolerated dose
      (200mg/kg/day). The dose of NK622 in animal studies was calculated by measuring
      plasma level in patients receiving 40 mg/body/day oral treatment and clinically
      equivalent dose (CED) was determined. At the calculated CED, NK622 significantly
      inhibited the growth of Br-10. These results indicate that NK622 is a promising
      drug comparable to TAM because of the growth inhibition of estrogen-dependent
      breast cancers.

PMID- 8470920
TI  - [Effect of medroxyprogesterone acetate on the anticellular activity of 5
      fluorouracil against human breast and stomach cancer cells].
AB  - As 5-fluorouracil (5-FU) has been known to show clinically antitumor effects
      against both breast and stomach carcinomas. We compared the combined effects of
      medroxyprogesterone acetate (MPA) with 5-FU on the growth of cultured human
      breast and stomach carcinoma cells. MPA inhibited the growth of estrogen
      dependent human breast carcinoma MCF-7 cells at the low concentrations and
      exhibited an additive effect in combination with 5-FU. MPA also inhibited the
      growth of human stomach carcinoma MKN-45 cells at relatively high concentrations
      and exhibited an additive effect in combination with 5-FU. Human stomach
      carcinoma MKN-28 cells were rather insensitive to MPA, but, an additive
      combination effect of MPA and 5-FU was observed. These three cell lines were
      found to have MPA-binding proteins which may be distinct from the nuclear
      progesterone receptor, suggesting the correlation with growth-inhibitory activity
      of MPA.

PMID- 8470921
TI  - [Pharmacokinetics and antitumor activity of MX2, a new morpholino anthracycline
      in brain tumor intracerebral transplanted in rats].
AB  - Pharmacokinetics and antitumor activity of MX2.HCl (MX2), a new morpholino
      anthracycline, were investigated in rats transplanted 9L gliosarcoma cells in the
      brain. (1) Pharmacokinetics: AUC of MX2 in the brain tumors which received
      intracarotid and intravenous injection of 2mg/kg of MX2 were 117.50 and 55.94
      micrograms.hr/g, respectively. AUC of the brain tissue was 1.38-3.90
      micrograms.hr/g. (2) Antitumor activity: The inhibition of cell growth at the
      concentration of 0.1 micrograms/ml was 73.1% with MTT assay. The mean survival
      time in tumor-bearing rats after intracarotid and intravenous injection of 2mg/kg
      of MX2 prolonged significantly. Therefore, it seems that MX2 will become an
      efficacious drug for the treatment of malignant glioma.

PMID- 8470922
TI  - [Evaluation of long-term administration of oral anti-cancer agent].
AB  - To evaluate the effectiveness of surgical adjuvant chemotherapy, we attempted to
      determine whether cancer patients were taking oral anticancer agents properly.
      Tegafur or UFT was administrated orally to patients with gastric or colorectal
      cancers after surgery for at least a year. There were 19 gastric cancer patients
      and 18 colorectal cancer patients. Serum levels of Tegafur and 5-FU were measured
      every three months. Results of the study showed that all the patients took
      medicine regularly according to the prescription and serum 5-FU levels of most
      patients (75%) exceeded the minimal effective serum level.

PMID- 8470923
TI  - [A case of advanced gastric cancer responding to an FAP (5-FU, ADM, platinum
      compounds) combined chemotherapy].
AB  - An experience with an advanced gastric cancer patient with metastases to
      bilateral breasts, uterus, abdominal lymph nodes, bilateral axillary and
      supraclavicular lymph nodes, and bone marrow, responded extremely well to an FAP
      combined chemotherapy as reported here. The patients received four courses of 5
      FU (370 mg/m2/day, for five days, continuous infusion), ADM (30 mg/m2 on day 1,
      i.v.) and CDDP (55 mg/m2 on day 1, i.v.) every 3 weeks in our hospital. This was
      followed by 7 months of outpatient therapy with 5-FU (550 mg/m2 on day 1, i.v.),
      ADM (30 mg/m2 on day 1, i.v.) and CBDCA (330 mg/m2 on day 1, i.v.) for every 4
      weeks. The complete remission of the primary and metastatic lesions, that was
      confirmed by the histological examinations, was obtained after 10 months since
      the initial treatment started. The toxicity was generally moderate, however, the
      alopecia was severe. The patient has been living for 6 months without any signs
      of the recurrence after the complete remission obtained.

PMID- 8470924
TI  - [A case report of adenosquamous cell carcinoma of the stomach responding well to
      combination chemotherapy].
AB  - A 51-year-old man with unresectable adenosquamous cell carcinoma classified
      Borrmann type 3 of the stomach was treated with combination chemotherapy. The
      treatment consisted of two parts: intraabdominal administration of CBDCA (400
      mg/body) during the operation, and transcatheteral intraabdominal infusion of
      CDDP(100 mg/m2) on day 1 and oral administration of UFT (400 mg/m2) on day 1 to
      28 from a month after the operation. The latter therapy was performed every four
      weeks, and was administered two times. Primary gastric region was improved like a
      type II-C endoscopically, and metastatic lymphnode measuring 5 cm diameter
      disappeared on a computed tomography after the treatment. Thus, total gastrectomy
      was performed. No cancer cells were shown in both the resected stomach and
      dissected lymphnodes upon histological examination. Generally, patients with
      unresectable gastric cancer have a poor prognosis. But we concluded that the
      survival time and the quality of life in this patient were remarkably improved by
      the effective combination chemotherapy.

PMID- 8470925
TI  - [A case of gastric cancer with multiple liver metastases showing marked efficacy
      of preoperative and postoperative chemotherapy with CDDP, MMC and UFT(PMU), or
      CDDP, MMC, UFT and etoposide (PMUE)].
AB  - The patient, a 65-year-old male with far advanced gastric cancer of H3N4 (Stage
      4), was assumed inoperable on admission and chemotherapy using CDDP, MMC and
      UFT(PMU) was carried out. As a result, the levels of AFP and CEA were reduced
      notably, and PR effects were recognized in liver and lymphnode metastatic lesion.
      Thus, 2 months later, reduction surgery was performed, during which primary
      lesion was resected and a reservoir tube for chemotherapy was placed in the
      common hepatic artery. Subsequently, the chemotherapy with Etoposide added to
      PMU(PMUE) was continued by utilization of a reservoir, so that liver metastasis
      decreased more than 90% from the maximum. However, metastasis lesions of left
      lobe of the liver had enlarged with reincrease of AFP and CEA since 6 months
      after the operation. A month later left lobectomy of the liver was performed.
      Residual metastases of the liver were then enlarged. PMUE with Ca antagonist was
      used with little effect then. The patient died of liver failure 15 months after
      initial admission.

PMID- 8470926
TI  - [A infant case of rhabdomyosarcoma arising from the left iliac region with
      complete remission for 2 years after combination therapy].
AB  - A case of rhabdomyosarcoma in a 14-year-female is reported herein. The patient
      developed left inguinal pain and tumor. She was initially seen by her local
      medical doctor, who biopsied her left inguinal tumor with a pathological report
      of malignancy. She was referred to the Ryukyu University Hospital in July, 1990.
      CT and MRI demonstrated a large tumor 10 cm in diameter arising from the left
      iliac region. The tumor was extirpated and the pathological report indicated
      rhabdomyosarcoma (alveolar type). The patient was treated with VAC chemotherapy
      and local irradiation. Her course has been uneventful for the past 2 years
      without any clinical manifestation of recurrence since surgery.

PMID- 8470927
TI  - [A case of advance colon cancer responding to sequential methotrexate and 5
      fluorouracil therapy].
AB  - A 60-year-old female was diagnosed by X-ray examination and endoscopy as
      ascending colon cancer. Ultrasonography and computed tomography revealed two
      metastatic tumors in the liver. Abdominal surgery revealed peritoneal
      disseminations, massive lymph node metastasis and direct invasion of the
      transverse colon and ileum. From pathological examination the diagnosis was
      moderately differentiated adenocarcinoma. After right hemi-colectomy, sequential
      methotrexate and 5-fluorouracil therapy as well as oral administration of UFT,
      liver metastasis disappeared and no sign of ascites was found in this case.
      Complete response time was over 8 months. There have been no severe
      complications.

PMID- 8470928
TI  - [Etoposide, pirarubicin and cisplatin(ETP) combined therapy of inoperable head
      and neck cancer].

PMID- 8470929
TI  - [Molecular mechanism of carcinogenesis].
AB  - Biological characteristics of cancer cells are thought to be immortalization,
      transformation (abnormal cell growth) and capacity for tumor invasion and
      metastasis. Recent studies have revealed that many cellular genes (oncogenes and
      anti-oncogenes) were activated or suppressed at the level of DNA in cancer cells,
      and in normal condition the products of these genes have important roles in
      signal transduction for cell growth as a positive or negative way. Point mutation
      and unphysiological DNA recombination are considered to be major molecular
      mechanisms in the alteration of these cellular genes. Further, several genes were
      found to be involved in invasion and metastasis. However, still a significant
      portion of cancers remains to be elucidated in terms of unknown cellular (or
      viral) genes involved in multi-step carcinogenesis. Therefore, we need to
      continue the basic research on cancer and to initiate the studies on new
      chemicals, hormones or others by which we could control the activities of known
      oncogene and anti-oncogene products.

PMID- 8470930
TI  - Pathogenesis of lupus dermatoses in autoimmune mice. XIX. Attempts to induce
      subepidermal immunoglobulin deposition in MRL/Mp- +/+ mice.
AB  - The deposition of immunoglobulin (Ig) at the dermo-epidermal junction (DEJ) of
      the skin, frequently observed in autoimmune mouse strains, is similar to that
      seen in patients with systemic lupus erythematosus (SLE). MRL/Mp-lpr/lpr
      (MRL/lpr) mice have an autosomal recessive mutant gene, lpr, which produces
      massive T-cell proliferation and accelerates the onset of autoimmune diseases.
      MRL/Mp- +/+ (MRL/n) mice lack the lpr gene, and do not develop autoimmune disease
      during the first year after birth under pathogen-free conditions. To verify the
      mechanisms of subepidermal Ig deposition in the skin of LE, we designed an
      experiment in which we could induce Ig deposition in the control MRL/n mice.
      Intraperitoneal injection of lymphoproliferative cells of aged MRL/lpr mice
      induced splenomegaly and splenic granulomatous angitis in the control MRL/n mice.
      Lipopolysaccharide (LPS), a polyclonal B-cell activator, induced slight
      splenomegaly and relatively high levels of serum Ig. Dermatopathological
      investigation revealed mild lymphocyte infiltration without positive Ig
      deposition at the DEJ of MRL/n mice treated with proliferative T cells. Injection
      of both proliferative T cells and LPS induced 50% positivity of subepidermal Ig
      deposition, and high levels of serum immunoglobulins and anti-double stranded DNA
      (anti-dsDNA) antibodies. These changes were not observed in MRL/n mice injected
      with thymocytes of newborn MRL/lpr mice. Skin lesions and lupus nephritis were
      not demonstrated in any of the mice tested. This study suggest that both the mild
      inflammatory reaction and the presence of anti-dsDNA antibodies are required for
      the induction Ig deposition at the DEJ in the skin of LE patients.

PMID- 8470931
TI  - Potent debriding ability of collagenolytic protease isolated from the
      hepatopancreas of the king crab Paralithodes camtschatica.
AB  - The debriding activity of the protease complex produced from the hepatopancreas
      of the king crab Paralithodes camtschatica was evaluated in vivo. The results
      clearly showed that the crab preparation had a high debriding ability. Individual
      proteases were isolated chromatographically from the crab complex to compare
      their debriding activities. All the purified proteases were active in vivo. The
      most active component of the complex was the isozyme C of crab collagenolytic
      protease, a member of the chymotrypsin-like protease class.

PMID- 8470932
TI  - Pachyonychia congenita (Jadassohn-Lewandowsky syndrome)--evaluation of symptoms
      in 36 patients.

PMID- 8470933
TI  - Immunohistochemical detection of oestrogen receptor-related protein (p29) in
      apocrine glands.

PMID- 8470934
TI  - Boron, molybdenum, and selenium in aquatic food chains from the lower San Joaquin
      River and its tributaries, California.
AB  - Boron (B), molybdenum (Mo), and selenium (Se) were measured in water, sediment,
      particulate organic detritus, and in various biota--filamentous algae, net
      plankton, macro-invertebrates, and fishes--to determine if concentrations were
      elevated from exposure to agricultural subsurface (tile) drainage during the
      spring and fall 1987, in the San Joaquin River, California. Concentrations of B
      and Se, but not Mo, were higher in most samples from reaches receiving tile
      drainage than in samples from reaches receiving no tile drainage. Maximum
      concentrations of Se in water (0.025 microgram/mL), sediment (3.0 micrograms/g),
      invertebrates (14 micrograms/g), and fishes (17 micrograms/g) measured during
      this study exceeded concentrations that are detrimental to sensitive warmwater
      fishes. Toxic threshold concentrations of B and Mo in fishes and their foods have
      not been identified. Boron and Mo were not biomagnified in the aquatic food
      chain, because concentrations of these two elements were usually higher in
      filamentous algae and detritus than in invertebrates and fishes. Concentrations
      of Se were lower in filamentous algae than in invertebrates and fishes; however,
      concentrations of Se in or on detritus were similar to or higher than in
      invertebrates and fishes. These observations suggest that high concentrations of
      Se accumulated in invertebrates and fishes through food-chain transfer from Se
      enriched detritus rather than from filamentous algae.

PMID- 8470935
TI  - Effects of pentachlorophenol-contaminated food organisms on toxicity and
      bioaccumulation in the frog Xenopus laevis.
AB  - Sub-adult African clawed frogs (Xenopus laevis) were fed pentachlorophenol (PCP)
      injected mealworms containing 64.8 to 2604 ug of PCP per gram of worm for 27
      days. There was no mortality and no significant bioaccumulation of PCP in the
      frogs. After three weeks, frogs fed 2,604 micrograms/g of PCP ceased eating. The
      no observed adverse effects level (NOAEL) based on significantly reduced food
      consumption (PCP-injected mealworms) was 638 micrograms/g. This corresponded to a
      NOAEL based on PCP intake of about 8 micrograms PCP/g frog/day. A toxicity
      threshold model estimated that about 800 micrograms/L of waterborne PCP may be a
      threshold for adverse effects in Xenopus or similar amphibians. Further study is
      needed to verify threshold estimates.

PMID- 8470936
TI  - Subchronic toxicity of aniline hydrochloride in rats.
AB  - Hematological, biochemical and histopathological responses of subchronic exposure
      to aniline hydrochloride (AH) have been investigated in rats. Male Sprague-Dawley
      rats were given 600 ppm of AH in drinking water while the control rats received
      tap water only. Five rats from each group were sacrificed at 30, 60, and 90 days
      of treatment. Organ-to-body weight ratio for spleen in the AH-treated rats was
      56, 61, and 53% higher than controls at days 30, 60, and 90, respectively. Liver
      showed a biphasic pattern for this ratio, a decrease at 30 days and then an
      increase at 60 days. Among other organs, testes showed a significant decrease in
      this ratio at 60 days. Hematological analysis showed 65% increase in WBC counts
      at 30 days in the AH-treated rats, whereas, no changes were recorded at later
      time points. Erythrocyte counts in the AH-treated rats showed very significant
      decreases at all the time points, whereas, hemoglobin and hematocrit decreased at
      30 and 90 days of treatment. Mean corpuscular volume and mean corpuscular
      hemoglobin increased in the AH-treated rats at 60 and 90 days of treatment.
      Methemoglobin content showed significant increases of 89, 59 and 45% at days 30,
      60, and 90, respectively. Among serum immunoglobulins, IgA in the AH-treated
      groups showed 24 and 51% increases at days 60 and 90, respectively. Analysis of
      splenic lymphocyte subpopulation showed a decrease in the T-helper (CD4+/CD8-)
      sub-set at 90 days whereas, other subpopulations were not affected. Aniline
      hydroxylase activity in the liver microsomes of the AH-treated rats was
      significantly higher at 60 days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8470937
TI  - Effect of nitrite on ureagenesis and carbohydrate metabolism in isolated rat
      hepatocytes.
AB  - The effect of three NaNO2 concentrations (0.5, 2.0, and 5.0 mM) on 15N-ammonia
      utilization, ureagenesis, glucose, pyruvate and lactate formation and glycogen
      breakdown were studied in isolated rat hepatocytes. Nitrite failed to affect the
      rate of glycogenolysis as well as the lactate and pyruvate formation, but at the
      same time it markedly increased the glucose formation. It is concluded that the
      increase in the glucose formation results from the nitrite stimulation of the
      rate of gluconeogenesis. An increased sodium nitrite concentration caused a
      significant decrease in the ammonia utilization and urea synthesis; there are
      strong linear correlations between the nitrite concentration and the amount of
      utilized ammonia (r = -0.93) and the formed urea (r = -0.96). The observed lower
      rate of ureagenesis in the presence of nitrite resulted from the diminished
      incorporation of the added 15N-ammonia into urea, as well as from the diminished
      urea formation from endogenous nitrogen. It is concluded that the disturbances in
      carbohydrate and nitrogen metabolism observed in the nitrite-poisoned animals are
      attributed to the direct effect of nitrite on metabolism.

PMID- 8470938
TI  - Levels of five mycotoxins in grains harvested in Atlantic Canada as measured by
      high performance liquid chromatography.
AB  - An analytical protocol using high performance liquid chromatography (HPLC) was
      used to analyze samples of spring wheat, winter wheat, 2-row barley, and 6-row
      barley over a period of three years for the presence of five mycotoxins. These
      included deoxynivalenol, zearalenone, T-2 toxin, HT-2 toxin, and
      diacetoxyscirpenol. The protocol employed a single extraction step using
      acetonitrile-water and two cleanup procedures. One utilized a solid-phase
      extraction column and the other a charcoal-alumina column. Detection limits
      ranged from 0.02 to 0.15 micrograms of mycotoxin g-1 grain. Little T-2 toxin, HT
      2 toxin, or diacetoxyscirpenol was found in the samples. Deoxynivalenol was
      detected in 53 to 62% of the samples tested and zearalenone in 25-29% of the
      samples. Several enzyme-linked immunosorbent assays were used for comparison
      purposes with deoxynivalenol, zearalenone, and T-2 toxin. These kits provided
      reliable qualitative, but not quantitative, data.

PMID- 8470939
TI  - Statistical andrology: standard semen analysis and computer-assisted sperm
      motility analysis.
AB  - Results are reported of a statistical evaluation of the variables obtained by
      standard microscopic semen analysis and by computer-assisted sperm motility
      analysis. Descriptive statistical analysis and cluster analysis were carried out
      on both sets of data. A contingency table was created to compare the
      classifications obtained by the two clustering procedures. A canonical
      correlation analysis was performed to evaluate the classification power of the
      variables obtained by the two semen analyses. The results show that the two
      techniques of semen analysis are complementary and not substitutive and that the
      correlated variables "percentage forward motility" and "sperm velocity" are the
      most discriminating.

PMID- 8470940
TI  - Hypoosmotic swelling test with a medium of distilled water.
AB  - The functional competence of the human sperm membrane is assessed by studying the
      swelling reaction of sperm when suspended in a medium of distilled water (water
      test). Eighty-seven patients with idiopathic infertility were investigated by the
      water test and the results were compared with various semen parameters. High
      correlations with the percentage of b-g type swollen sperm in the water test were
      observed for sperm concentration (r = .53, p < .05) and percent motility (r =
      .62, p < .01). The sperm swelling values obtained by the water test correlated
      well with those obtained by the hypoosmotic swelling test (HOST). Correlation
      coefficients in b-g and g swelling pattern were 0.89 and 0.71, respectively. The
      percentage of g-type swelling obtained by the water test was significantly larger
      than that obtained by the HOST (p < .05), although the two hypoosmotic procedures
      gave similar percentages of b-g swelling pattern. The percentage of g swelling
      pattern obtained by the water test correlated well with percent motility (r =
      .70, p < .001). These findings suggest that the water test is more useful for
      assessing the integrity of the sperm  membrane than the HOST. The relationship
      between this test and subsequent fertility, as well as to other sperm function
      tests, needs further investigation.

PMID- 8470942
TI  - Hypoosmotic swelling: evaluation of sperm tails using strict criteria in cases of
      globozoospermia.
AB  - The semen from two men with globozoospermia was evaluated for hypoosmotic
      swelling changes and morphologic evaluation of the tail using strict criteria. No
      abnormalities were noted. Globozoospermia is due to a genetic defect that results
      in the absence of acrosomal structures. The acrosomal vesicle in the Golgi region
      does not develop in close contact to the nucleus, which results in the formation
      of globe-shape heads. Although some semen parameters were abnormal in both cases,
      they were different types, suggesting no association with round-headed sperm.

PMID- 8470941
TI  - Serum and urinary levels of pituitary--gonadal hormones in insulin-dependent and
      non-insulin-dependent diabetic males with and without neuropathy.
AB  - Diabetic neuropathies were studied in 100 insulin-dependent diabetes mellitus
      patients, 314 non-insulin-dependent diabetes mellitus patients with and without
      an objective evidence of neuropathy (age span, 15-80 years; duration of diabetes
      distributed over 1-33 years), and their age-matched nondiabetic controls. Serum
      and urinary levels of pituitary-gonadal hormones were evaluated in the diabetic
      subjects. There were striking results, i.e., a significantly low serum total and
      serum free (urinary) testosterone level (p < .0005) and a significantly high
      serum and urinary FSH and LH and serum prolactin level (p < .0005), specifically
      in the neuropathic diabetic patients, suggesting a series of pathological
      reactions in the smooth musculature of genital organs characterized by an
      increase in the interstitial thickness of seminiferous tubules, peritubular and
      intertubular fibrosis, and tubular sclerosis. Testicular necrosis, probably due
      to neuropathy, provided an additional aid to confirm these findings. A decrease
      in semen volume and sperm motility in the diabetic neuropathic patients further
      suggested the involvement of the entire smooth musculature of the reproductive
      tract, leading to atonia of the bladder and urethra. Such complications are
      purely neurogenic. The low serum and urinary testosterone levels and increased
      serum and urinary FSH and LH and serum prolactin levels in the diabetic men with
      neuropathy suggest gonadal disorder (hypogonadotropic hypogonadism), which may be
      due to testicular necrosis and thickening of seminiferous tubules, causing
      autonomic lesion.

PMID- 8470943
TI  - Effectiveness of calcium and magnesium on testicular sulfatase activity.
AB  - Nucleotides and calcium ions have been implicated in the regulation of
      biosynthesis of steroids, although the exact locus of calcium activity is not yet
      known. The administration of Ca2+ to Leydig cells increases testosterone
      production. Steroid sulfatase activity is reported to be enhanced by adenine
      nucleotides. In the present study the testicular sulfatase was evaluated in
      subcellular fractions by conversion of sulfate to free steroids in the presence
      or absence of Ca2+ and Mg2+ ions. The specific activity of the enzyme, which was
      located predominantly in submitochondrial fraction, showed a positive correlation
      with calcium, increasing 1.5-fold in the presence of 2.54 mM of calcium (62
      nmol/h mg protein-1). In contrast, magnesium inhibited the enzymatic activity
      1.79-fold in presence of 1.18 mM (23 nmoles/h mg protein-1). It would appear that
      testicular sulfatase is predominantly located in the mitochondria, which is
      recognized as one of the major sites of control of intracellular metabolism, and
      that its enzymatic activity could be modulated by calcium regulating the levels
      of potentially active androgens.

PMID- 8470944
TI  - Anatomical characteristics of the left testicular venous system in man.
AB  - Autopsy was performed on 49 male cadavers and the entire course of the left
      testicular vein (LTV) was studied. The testicular venous pathway was divided into
      four levels: scrotal, inguinal, pelvic, and lumbar. At the scrotal level, many
      small testicular veins constituting the pampiniform plexus showed various
      anastomoses with the cremasteric and vasal veins. At the inguinal and pelvic
      level, 4-12 and 2-8 LTVs were recognized, respectively. At the pelvic level,
      absence of valves was seen in 33% of the cases. At the lumbar level, 1-5 LTVs
      were observed and were mainly anastomosed with the retroperitoneal, ureteral, and
      kidney capsular veins. Absence of valves at the lumbar level was seen in 37% of
      the cases. In 11 cases, the valves that were present were incompetent. The
      presence of more than one LTV at the lumbar level indicates the necessity for
      attentive identification of all of the testicular veins during surgical treatment
      of varicocele.

PMID- 8470945
TI  - Effects of an inhibitor of adenylate cyclase on acrosome reaction induced by
      protein kinase C activators.
AB  - To determine whether the adenylate cyclase and the protein kinase C pathways act
      independently to modulate the human sperm acrosome reaction, we studied the
      effects of 2'-O-methyladenosine (adenylate cyclase inhibitor) on acrosome
      reactions induced by protein kinase C activators (phorbol diesters and synthetic
      diacylglycerols) or an adenylate cyclase stimulator (forskolin:FR). Fifty
      aliquots of capacitated spermatozoa were divided into 5 groups (A, B, C, D, and
      E), each containing 10 samples. One control aliquot (CN) and five experimental
      aliquots (EX1, EX2, EX3, EX4, and EX5) were prepared from each sample. Phorbol 12
      myristate, 13-acetate (PMA, 10 mumol/L), 4 beta-phorbol 12,13-didecanoate (PDD,
      0.1 mumol/L), 1-oleoyl-2-acetyl-sn-glycerol (OAG, 50 mumol/L), 1,2-dioctanoyl-sn
      glycerol (DOG, 50 mumol/L), or FR (10 mumol/L) was added to each of the
      experimental aliquots in groups A, B, C, D, and E, respectively. Increasing
      concentrations of 2'-O-methyladenosine were added to aliquots EX2, EX3, EX4, and
      EX5. After an incubation period of 25 min at 37 degrees C, it was found that the
      percentage of acrosome-reacted spermatozoa (%ARS) was significantly and dose
      dependently decreased by 2'-O-methyladenosine concentrations of 1 mM or more.
      Within each group, the %ARS was significantly higher in EX1 aliquots than in CN
      aliquots. The reduction of acrosome reactions induced by protein kinase C
      activators by the adenylate cyclase inhibitor suggests that the protein kinase C
      pathway interacts with the adenylate cyclase pathway to modulate the human sperm
      acrosome reaction.

PMID- 8470946
TI  - Hormone profiles and contralateral testicular histology in Down's syndrome with
      unilateral testicular tumor.
AB  - Hormonal profiles and testicular histology were studied in two patients with
      Down's syndrome with unilateral testicular tumor. Plasma levels of LH and FSH
      were elevated above normal ranges in both cases. In case 1, plasma testosterone
      level was abnormally low, but prolactin level in plasma was within the normal
      range. Case 2 showed elevated concentration of plasma prolactin and normal level
      of plasma testosterone. The administration of LH-RH resulted in low response of
      plasma gonadotropins. The response of plasma testosterone to the administration
      of HCG was abnormally suppressed in both cases. Testicular histology showed
      reduction of Johnsen score count and tubular diameter, and an increase in wall
      thickness. These results indicated that male patients with Down's syndrome have
      an abnormality in hypothalamo-pituitary-gonadal axis.

PMID- 8470947
TI  - Male reproductive system in patients exposed to ionizing irradiation in the
      Chernobyl accident.
AB  - Twelve men with different forms and stages of chronic radiation dermatitis caused
      by accidental exposure to beta and gamma irradiation during and after the
      Chernobyl atomic power plant accident were examined. Two patients had impotentia
      coeundi, and the others reported various impairments of sexual function. One
      patient had aspermia, two patients had azoospermia, one had oligospermia, and
      four had normal sperm counts. In three samples abnormal forms of spermatozoa were
      increased. Sperm motility was decreased in 3 samples and was normal in another.
      Hormonal analyses demonstrated low testosterone plasma levels in two patients, an
      increase of follicle stimulating hormone (FSH) levels in six patients, and a
      decrease of luteinizing hormone (LH) in one patient. In one patient who showed an
      increase of plasma prolactin level, associated with low testosterone and LH, a
      microadenoma of the pituitary gland (prolactinoma) was detected. It would appear
      that there is an association between accidental exposure to ionizing radiation of
      varying severity and the impairment of exocrine and endocrine testicular
      function, sometimes resulting in long-lasting physiological and psychological
      problems.

PMID- 8470948
TI  - Evolution of the Drosophila melanogaster-sigma virus system in natural
      populations from Languedoc (southern France).
AB  - An analysis of natural populations of Drosophila melanogaster in a southern
      French region (Languedoc) was started in 1983, concerning two non Mendelian
      systems: the P-M system of transposable elements and the sigma virus. This virus
      is not contagious, but only transmitted through gametes; it is usually present in
      a minority of individuals in natural populations. The first data collected
      revealed unexpectedly clear and fast-evolving phenomena; they also gave evidence
      of some interesting correlations between the two systems. This paper presents all
      the results gathered from 1983 to 1991 in the Drosophila-sigma system. Striking
      correlations were observed for three interconnected parameters: frequency of
      infected flies, frequency of an allele of the fly giving resistance to the virus,
      and adaptation of the virus to this allele. This adaptation consisted of a
      qualitative step (change of viral type) followed by quantitative variation
      (better adaptation to the allele). This analysis also showed, firstly, that the
      evolution of natural populations differs completely in Languedoc from the rest of
      France; secondly, that three geographical zones where selective forces worked
      differently persisted over time in Languedoc.

PMID- 8470949
TI  - Polypeptide synthesis induced in Nicotiana clevelandii protoplasts by infection
      with raspberry ringspot nepovirus.
AB  - Infection of Nicotiana clevelandii protoplasts by raspberry ringspot nepovirus
      resulted in the accumulation of about 24 polypeptides that differed in M(r) and
      pI from polypeptides accumulating in mock-inoculated protoplasts. Similar
      polypeptides accumulated in protoplasts infected with the S and E strains of RRV
      but different infection-specific polypeptides were detected in protoplasts
      infected with tobacco ringspot nepovirus. The M(r) of RRV-specific polypeptides
      ranged from 210,000 to 18,000 and most are presumed to be derived from others by
      proteolytic cleavage. No evidence was found for marked changes in polypeptide
      abundance with time after inoculation or for any virus-specific polypeptide
      becoming disproportionately abundant in the medium during culture.

PMID- 8470950
TI  - Direct sequencing of genomic cDNA fragments amplified by the polymerase chain
      reaction for molecular epidemiology of dengue-2 viruses.
AB  - A nucleotide fragment encoding amino acids 29 to 94 in the E-protein of 28 dengue
      2 isolates of diverse geographic and host origins was examined by direct
      sequencing of a polymerase chain reaction (PCR)-amplified product, and compared
      to six previously published sequences. Nucleotide divergence ranged from 0 to
      19.8% corresponding to a maximum of 9% divergence in the amino acid sequence.
      Taking a divergence of 6% between the nucleotide sequence as a cut off for
      genotype classification, six groups have been established. Southeast Asian and
      the Jamaican 1983 genotypes show a high rate of similarity (> 95.2%). Our results
      suggest that virus of this group is now circulating as the dominant topotype in
      Brazil (1990) and in French Guyana (1986-1991). African strains fall into two
      groups, one endemic group (1970-1990) and one epidemic group (1986-1987). The
      three other groups correspond to viruses from Sri Lanka (1982) and the Seychelles
      (1977), from Puerto Rico (1973) and from Tahiti (1975). Our approach appears to
      be valuable characterizing dengue isolates, easily and rapidly.

PMID- 8470951
TI  - African swine fever virus specific porcine cytotoxic T cell activity.
AB  - African swine fever virus (ASFV) specific, cytotoxic T lymphocyte (CTL) activity
      has been studied in a protection model in which SLA inbred miniature swine are
      experimentally inoculated with a naturally occurring, non-fatal ASFV isolate
      (NHV). Peripheral blood mononuclear cells (PBMC) from such infected swine show
      significant activity in CTL assays, using cultured ASFV-infected porcine blood
      derived macrophages as target cells. This CTL activity is elicited from PBMC by
      in vitro restimulation of effector cells with low doses (multiplicity of
      infection = 0.1) of the homologous virus isolate for 48 to 72 h. For SLAc/c
      effectors, this CTL activity appears to be SLA class I restricted because (1)
      blocking target cell antigens with monoclonal antibodies (mAb) against SLA class
      I antigens causes a major reduction in CTL activity; (2) there is preferential
      lysis of SLA class I matched, ASFV infected targets; and (3) depletion of
      effector cells with CD8 specific mAb and complement causes a reduction in CTL
      activity. The CTL activity is ASFV specific for all pigs tested in that infected
      macrophages are preferentially lysed as compared to normal (non-infected)
      cultured macrophages or macrophages infected with hog cholera virus (HCV). Lysis
      of macrophages infected with different ASFV isolates revealed that there is
      marked lysis of macrophages infected with the virulent L60 isolate but less lysis
      of macrophages infected with the DR-II and Tengani isolates. In summary, our data
      show that ASFV specific CTL activity is triggered in swine infected with the NHV
      ASFV isolate.

PMID- 8470952
TI  - Dolphin morbillivirus infection in different parts of the Mediterranean Sea.
AB  - Morbillivirus were isolated from Mediterranean striped dolphins (Stenella
      coeruleoalba) dying along the coasts of Italy and Greece in 1991. They were
      antigenically identical to the morbilliviruses isolated from striped dolphins in
      Spain in 1990.

PMID- 8470953
TI  - Exchange of the cellular growth medium supplement from fetal bovine serum to
      Ultroser G increases the affinity of adenovirus for HeLa cells.
AB  - A comparative investigation was performed on the process of attachment of
      adenovirus type 2 to HeLa cells cultivated in the presence of 3.5% fetal bovine
      serum (FBS-cells) or 2% Ultroser G (USG-cells). The initial rates of virus
      attachment were markedly higher at temperatures between 10 and 35 degrees C for
      the virus binding to USG-cells than to FBS-cells. This was not caused by a higher
      amount of available virus-recognizing cellular receptor sites or cellular
      receptor units recognizing the viral fiber, but could be explained by a higher
      affinity of virions for USG-cells as compared to FBS-cells. Studies of virus
      attachment to cells, pretreated with neuraminidase and/or wheat germ agglutinin,
      suggested that the cellular receptor sites of FBS-cells were masked to a higher
      extent by sialic acid than the cellular receptor sites of USG-cells.

PMID- 8470954
TI  - Enhancement of intracellular uncoating of adenovirus in HeLa cells in the
      presence of benzyl alcohol as a membrane fluidizer.
AB  - The early extra- and intra-cellular interaction between adenovirus type 2 and
      HeLa cells was studied in the presence of benzyl alcohol as a fluidizing agent.
      The process of virus attachment and internalization were not affected at 5-15 mM
      of benzyl alcohol at 25 degrees C. Under the same conditions an enhancement by
      45% at the most was demonstrated for the cell-mediated virion uncoating. By
      completely blocking virion internalization with 50 mM azide the uncoating was
      reduced to 20% of the normal level. The remaining surface-located uncoating was
      not affected by benzyl alcohol. It was demonstrated that an enhancement of the
      intracellular virion uncoating was followed by a raised production of the hexon
      antigen, which was interpreted as an increase in the specific infectivity of the
      virus.

PMID- 8470955
TI  - Sequence of the NS 1 gene of the K 23 isolate of tick-borne encephalitis virus
      and identification of conserved motifs.
AB  - The NS 1 gene from the K 23 isolate of tick-borne encephalitis virus has been
      sequenced. The NS 1 gene sequence, and many structural features of the NS 1
      protein are heavily conserved. Six conserved peptides were also identified.

PMID- 8470956
TI  - Possibility of reinfection after immunisation with RA27/3 live attenuated rubella
      virus.
AB  - A serological study was carried out on 527 girls immunized with RA 27/3 rubella
      vaccine. Data from all scheduled serum samples over a 5-year follow-up were
      available for 102 vaccinees, 10 (9.8%) of whom showed evidence of reinfection
      during the 5th year after immunisation, a year in which there was a rubella
      outbreak in the Siena area (Italy). We examined in greater detail the serological
      responses of these vaccinees after reinfection and the consequent implications
      pertinent to the duration of the protective immunity.

PMID- 8470957
TI  - Nucleotide sequence of the coat protein gene of pelargonium leaf curl virus and
      comparison of the deduced coat protein amino acid sequence with those of other
      tombusviruses.
AB  - The sequence of 1,787 nucleotides (nts) in the genomic RNA of pelargonium leaf
      curl virus (PLCV) was determined. It included the entire coat protein (cp) gene
      (nts 585 to 1,754), 558 nts of the 3' end of the putative RNA polymerase gene, 26
      nts of an intercistronic region between the two genes and 33 nts downstream of
      the stop codon of the cp gene. The cp gene was cloned into the expression vector
      pET8c and expressed in E. coli. The deduced cp amino acid sequence of PLCV was
      compared with those of five other tombusviruses. The closer the degree of
      serological relatedness between two viruses, the more similarity was found in
      their cp amino acid sequences not only in the protruding domains, but also in
      their random and shell domains and in the arm regions. Nucleic acid hybridization
      tests, cp amino acid comparisons and serological tests all suggest the same order
      of sequence for the relationships in the tombusvirus group.

PMID- 8470958
TI  - Pathogenesis of HSV-1/2 induced vaginitis/vulvitis of the mouse: dependence of
      lesions on genetic properties of the virus and analysis of pathohistology.
AB  - A scoring system for herpes simplex virus (HSV) induced vaginitis/vulvitis in
      Balb/c mice was delineated from vaginal infections. Four degrees of
      vaginitis/vulvitis could be distinguished after infection with suitable strains
      of HSV despite nearly identical replication rates. The time course of
      replication, inflammation and pathohistology was compared further. Grade 0 was
      defined by lack of symptoms despite presence of strong replication, which was
      detectable at days 3-6. Focal necrotic lesions of the epithelial layer were
      present containing HSV-specific antigens. DNA could be detected by hybridization
      only in the outer zone of these areas. At day 6 these zones began to be re
      epithelialized. In the vaginal lumen abundant detached epithelial cells and
      granulocytes were already present by day 2. Grade 1 was macroscopically
      characterized by a slight inflammation commencing on days 5-6. Replication and
      antigens in the epithelium were found on days 2-6. HSV-antigens were only
      detected above the basal membrane, and some infiltration with granulocytes and
      lymphocytes was observed below the basal membrane at day 4. Grade 2 showed strong
      redness and inflammation as well as hyperemia. Cellular infiltrates were present
      in the large antigen containing epithelial lesions and below the basal membrane.
      From day 4 on, neurons were HSV-antigen and DNA positive and macrophages in the
      stroma contained antigen. The vulva was also shown to be involved. Grade 3
      exhibited prolonged severe hyperemia, and destruction of the epithelium and the
      stroma with necrosis and infiltration, especially of the vulva. This grading
      system was shown to depend on certain unknown genetic properties of HSV-strains.
      Neither thymidine-kinase activity, replication in macrophages, fusion activity of
      strains nor presence or absence of the Hpa I P-fragment were shown to be of
      importance for severity of vaginitis/vulvitis. Vaginitis/vulvitis was shown to be
      an all or none response to HSV independent of the rate of replication. The set of
      virus genes responsible for neuroinvasiveness after vaginal or i.p. inoculation
      was found to be different. The time course of replication (mainly days 3-6) and
      inflammation (days 5-10) indicates that inflammation seems to be a secondary
      immunological phenomenon induced later by the replication phase of HSV. Our
      system could be useful for separately testing drugs with antiviral and anti
      inflammatory properties.

PMID- 8470959
TI  - Isolation and characterization of simian immunodeficiency virus from African
      white-crowned mangabey monkeys (Cercocebus torquatus lunulatus).
AB  - Forty-eight of 236 sera from seven species of African non-human primates in
      Kenya, including those of white-crowned mangabey monkeys (Cercocebus torquatus
      lunulatus) had antibodies to simian immunodeficiency viruses (SIVs). Isolates of
      simian lentivirus were obtained from seropositive white-crowned mangabey monkeys
      which are indigenous in West Africa. This virus, designated as SIVWCM, appeared
      morphologically similar to HIV by electron microscopy, showed Mg(2+)-dependent
      reverse transcriptase activity, and induced cytopathic effects in human CD4
      positive cells. Western blotting analysis revealed that env products of SIVWCM
      cross-reacted with those of SIVAGM more strongly than with those of HIV-1 and
      SIVMAC, and clear hybridization bands were detected with an SIVAGM probe. For
      comparison of the virus sequence with those of other primate lentiviruses, part
      of the pol gene and the long terminal repeats (LTRs) were amplified and cloned.
      Sequencing showed that SIVWCM isolates were closely related to SIVAGM isolates.
      This study suggested that SIVAGM from the Cercopithecus genus and SIVWCM from the
      Cercocebus genus may be members of an SIV group that is genetically distinct from
      the SIV from a sooty mangabey monkey (SIVSMM) of the genus Cercocebus, to which
      the white-crowned mangabey monkey also belongs.

PMID- 8470960
TI  - Nucleotide sequence, serology and symptomatology suggest that vanilla necrosis
      potyvirus is a strain of watermelon mosaic virus II.
AB  - Vanilla necrosis potyvirus (VNV) is the cause of significant losses to the South
      Pacific islands vanilla crop. The gene for the coat protein of VNV has been
      cloned and sequenced. Comparison of this gene with other potyviral coat protein
      sequences revealed 97% nucleotide sequence homology (98% amino acid homology) to
      a US isolate of watermelon mosaic virus II (WMV-II), 93% nucleotide sequence
      homology (96% amino acid homology) to an Australian isolate of WMV-II and 81%
      nucleotide sequence homology (88% amino acid homology) to soybean mosaic virus-N
      (SMV-N). Serological analysis, by Western blot and ELISA, confirmed the close
      relationship between VNV and WMV-II. Furthermore, a limited host range
      determination found VNV and WMV-II able to infect the same series of test plants.
      However, symptoms differed significantly on three test species demonstrating that
      VNV and WMV-II are not identical in biological properties. We suggest that VNV be
      renamed WMV-II (Tonga).

PMID- 8470961
TI  - Bleb leak with hypotony after laser suture lysis and trabeculectomy with
      mitomycin C.

PMID- 8470962
TI  - Reports by the Silicone Study Group.

PMID- 8470963
TI  - Reports by the Silicone Study Group.

PMID- 8470964
TI  - Removing penetrating fishhooks.

PMID- 8470965
TI  - Effect of continuous circular capsulorhexis and intraocular lens fixation on the
      blood-aqueous barrier.

PMID- 8470966
TI  - High-frequency ultrasound digital signal processing for biometry of the cornea in
      planning phototherapeutic keratectomy.

PMID- 8470967
TI  - Argon laser closure of conjunctival bleb leak.

PMID- 8470968
TI  - Management of combined penetrating intraorbital and intracranial trauma.

PMID- 8470969
TI  - Lisch nodules in Cushing's disease.

PMID- 8470970
TI  - Bilateral microbial keratitis after radial keratotomy.

PMID- 8470971
TI  - Clinton's proposal cuts federal payments to physicians.

PMID- 8470972
TI  - Management of cataract in adults. Quick reference guide for clinicians. The
      Cataract Management Guideline Panel of the Agency for Health Care Policy and
      Research.

PMID- 8470973
TI  - In response to the new guidelines for patients with cataracts.

PMID- 8470974
TI  - Watson and Crick's legacy and future publications in ophthalmic genetics.

PMID- 8470975
TI  - Repair and replacement to restore sight. Report from the Panel on
      Photoreceptor/Retinal Pigment Epithelium.

PMID- 8470976
TI  - Repair and replacement to restore sight. Report from the Panel on Ganglion
      Cell/Connectivity.

PMID- 8470977
TI  - How medicine must change.

PMID- 8470978
TI  - Anti-inflammatory effect of diclofenac drops after argon laser trabeculoplasty.
AB  - Using a laser flare-cell meter, the anti-inflammatory effect of diclofenac sodium
      drops was evaluated after argon laser trabeculoplasty in a double-masked placebo
      controlled study. Fifty-three eyes with pseudoexfoliative (43 eyes) or pigmentary
      glaucoma (10 eyes) were randomly assigned to treatment (n = 27) or placebo (n =
      26) groups. Diclofenac (0.1%) or placebo drops were administered once before and
      after trabeculoplasty and then four times daily for a total of 4 days. Visual
      acuity, intraocular pressure, and anterior chamber flare, measured with the laser
      flare-cell meter, were evaluated before trabeculoplasty, 3 and 6 hours after
      trabeculoplasty, and 1, 2, 4, 7, and 14 days after trabeculoplasty. Flare
      increase after argon laser trabeculoplasty was completely blocked by 0.1% topical
      diclofenac and the mean of maximal flare increases was reduced significantly in
      the diclofenac group. Therefore, 0.1% diclofenac drops represent a very efficient
      anti-inflammatory therapy after argon laser trabeculoplasty.

PMID- 8470979
TI  - A comparison of two energy levels for noncontact transscleral neodymium-YAG
      cyclophotocoagulation.
AB  - In a prospective, clinical trial, 89 patients undergoing transscleral neodymium
      YAG cyclophotocoagulation for intractable glaucoma were randomized to
      approximately 4 or 8 J of laser energy per application and followed up for an
      average of 1 year. The only statistically significant difference between the two
      groups was early anterior chamber reaction, which was more severe among those
      receiving 8 J. There was a trend toward better intraocular pressure control in
      the 8-J group, compared with the 4-J group, with 33 (75%) of 44 patients and 27
      (60%) of 45 patients, respectively, requiring no further surgical intervention
      during the follow-up period. Among those patients not requiring further surgery,
      there was no significant difference in final visual acuities between the two
      groups. These findings suggest that within the range of 4 to 8 J, transscleral
      neodymium-YAG cyclophotocoagulation at the higher energy level may have some
      advantage with regard to intraocular pressure reduction without an increased risk
      of visual loss, compared with the same treatment at the lower energy level.

PMID- 8470980
TI  - One-year results of semiconductor transscleral cyclophotocoagulation in patients
      with glaucoma.
AB  - We evaluated 30 consecutive patients with glaucoma treated with semi-conductor
      diode transscleral cyclophotocoagulation to determine the results and
      complications of this procedure. Twelve months after surgery the mean (+/- SD)
      preoperative intraocular pressure of 32.5 +/- 10.9 mm Hg (n = 30) had dropped to
      20.8 +/- 15.6 mm Hg (n = 19) (P = .018, paired Student's t test), while the mean
      number of preoperative medications received decreased from 2.0 to 1.8 (P = .060,
      Wilcoxon's Signed Rank Test). One year after surgery three patients (10%) were
      unavailable for follow-up, eight (27%) had required other surgical procedures to
      control the intraocular pressure, 17 (56%) had controllable intraocular pressure
      of 21 mm Hg or below or received pain relief from the diode laser alone, and two
      (7%) patients with controlled intraocular pressure had suffered visual loss.
      Other complications included mild conjunctival hyperemia and uveitis in all
      patients and mild ocular pain in six patients. This study suggests the usefulness
      of diode transscleral cyclophotocoagulation in reducing the intraocular pressure
      for up to 1 year.

PMID- 8470981
TI  - Ocular penetration of ceftriaxone, ceftazidime, and vancomycin after
      subconjunctival injection in humans.
AB  - Vancomycin (25 mg), ceftriaxone (125 mg), and ceftazidime (100 mg) were given by
      subconjunctival injection before vitrectomy to patients with uninfected eyes.
      Most of the patients had diabetic vitreous hemorrhage with or without traction
      retinal detachments, and some had rhegmatogenous retinal detachments with
      proliferative vitreoretinopathy. Samples of vitreous were obtained by pars plana
      vitrectomy at intervals from 46 minutes to 4 hours 13 minutes after the
      subconjunctival injection. The median vitreous concentrations of all three drugs
      were below the limit of detection. Vitreous concentrations of these drugs after a
      single subconjunctival injection are exceedingly low.

PMID- 8470982
TI  - Leber's hereditary optic neuropathy. Clinical manifestations of the 14484
      mutation.
AB  - OBJECTIVE: To define the clinical features of Leber's hereditary optic neuropathy
      associated with the 14484 mitochondrial DNA mutation and to compare these
      features with those associated with three other pathogenetic mutations. DESIGN
      AND PATIENTS: Clinical and historical data were collected from 19 visually
      symptomatic patients from 17 independent pedigrees with the molecularly confirmed
      14484 mutation. MAIN OUTCOME MEASURES: Demographic features, age of onset of
      visual loss, nadir of visual acuity, occurrence and timing of visual recovery,
      family history of visual loss, and associated medical and environmental
      conditions. RESULTS: Clinical characteristics associated with the 14484 mutation
      are similar overall to those of the three other primary mutations. One notable
      distinguishing feature is the higher incidence of visual recovery among patients
      with the 14484 mutation. Thirty-seven percent of our patients experienced visual
      recovery compared with 5% with the 11778 mutation (P < .001), 22% with the 3460
      mutation, and 29% with the 15257 mutation. The average age of onset of visual
      symptoms for the patients with the 14484 mutation who had visual recovery was
      younger than for those without recovery (19.6 vs 30.6 years). Thirteen of the 19
      patients had a history of metabolic disturbance, trauma, or substance abuse.
      CONCLUSIONS: Leber's hereditary optic neuropathy associated with the 14484
      mitochondrial DNA mutation may have a better prognosis for visual recovery. The
      phenotypic expression of the 14484 mutation may be influenced by concurrent
      medical and environmental factors. Molecular genetic testing in suspected Leber's
      hereditary optic neuropathy is useful to confirm the diagnosis and to assess
      visual prognosis.

PMID- 8470983
TI  - Anterior corneal disease of epidermolysis bullosa simplex.
AB  - We report the histopathological findings of the anterior cornea from a patient
      with skin biopsy-proven epidermolysis bullosa simplex. As seen with light
      microscopy, the cornea had a fibrocellular pannus deep to a thickened epithelial
      basement membrane. Transmission electron microscopy of the anterior cornea
      demonstrated a nonhomogeneous basal epithelial layer with abnormal attachment
      complexes to an irregular, multilaminar basement membrane. The findings of
      transmission electron microscopy of the bulbar conjunctiva were normal.

PMID- 8470984
TI  - A prospective study of aspirin use and cataract extraction in women.
AB  - We examined the association between aspirin use and the rates of cataract
      extraction during 8 years of follow-up in a large prospective study of women, the
      Nurses' Health Study. From 1980 to 1988, we documented 448 senile cataracts
      diagnosed and extracted during 434,680 person-years of follow-up. While we
      observed a modest positive association at the higher doses of aspirin use in the
      age-adjusted analyses, no association was found after accounting for other
      cataract risk factors (relative risk for > or = 20 years of use, 1.08; 95%
      confidence interval, 0.84 to 1.39). Among women who consumed seven or more
      tablets per week for 20 or more years, there was no suggestion of protection; if
      anything, a nonsignificantly elevated risk was observed (relative risk, 1.31; 95%
      confidence interval, 0.94 to 1.80). We observed no consistent difference in the
      relationship between aspirin use and cataract when assessed by age. Overall, we
      found no evidence to support the substantial reduction in risk of cataract among
      aspirin users as reported in several previous studies.

PMID- 8470985
TI  - National outcomes of penetrating keratoplasty. Risks of endophthalmitis and
      retinal detachment.
AB  - We studied rehospitalization for endophthalmitis or retinal detachment (RD) in
      40,351 Medicare beneficiaries who were admitted to US hospitals for penetrating
      keratoplasty (PK) between 1984 and 1987. This cohort represents 56.5% of all PKs
      performed during this period for recipients of age to receive Medicare benefits.
      Penetrating keratoplasty was combined with intracapsular cataract extraction in
      1188 patients (2.9%) and with extracapsular cataract extraction in 7038 patients
      (17.4%). Anterior vitrectomy was performed in 8428 patients (20.9%). The risk of
      rehospitalization for endophthalmitis within 6 months of PK was 0.77%. Concurrent
      anterior vitrectomy increased this risk to 1.03% (P = .004). The risk of
      rehospitalization for RD within 2 years of PK was 1.85%. Concurrent anterior
      vitrectomy increased this risk to 2.49% (P = .0001). Combined PK and
      intracapsular cataract extraction demonstrated a 3.9-fold increased rate of RD
      compared with PK and extracapsular cataract extraction (P = .0001). Anterior
      vitrectomy with PK and extracapsular cataract extraction increased the risk of RD
      4.3-fold compared with PK and extracapsular cataract extraction alone (P = .007).
      Men were at a 68% higher risk of RD than women (P = .0001). The risk of
      rehospitalization for endophthalmitis following PK is five times higher and the
      risk of RD two times higher than that reported following cataract surgery.
      Anterior vitrectomy, however, results in similar risk increases following either
      surgery.

PMID- 8470986
TI  - Sunlight and age-related macular degeneration. The Beaver Dam Eye Study.
AB  - OBJECTIVE: To investigate the relationship of sunlight exposure with age-related
      maculopathy. This was investigated in the population-based Beaver Dam Eye Study.
      DESIGN: In this cross-sectional population-based study, questionnaire data about
      sunlight exposure were obtained. Stereoscopic color fundus photographs were
      graded to determine the presence of age-related maculopathy. PARTICIPANTS: People
      aged 43 through 84 years who resided in Beaver Dam, Wis, between 1987 and 1988
      were examined between 1988 and 1990. RESULTS: Light exposure was not associated
      with early age-related maculopathy in women. In men, after adjusting for age, the
      amount of time spent outdoors in summer was associated with increased retinal
      pigment (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.01 to 2.04).
      Wearing eyeglasses was inversely associated with increased retinal pigment (OR,
      0.75; 95% CI, 0.58 to 0.97), and the use of hats and sunglasses was inversely
      associated with soft indistinct drusen (OR, 0.61; 95% CI, 0.38 to 0.98). The
      amount of leisure time spent outdoors in summer was significantly associated with
      exudative macular degeneration (OR, 2.26; 95% CI, 1.06 to 4.81) and late
      maculopathy (OR, 2.19; 95% CI, 1.12 to 4.25). There were no associations between
      estimated ambient UV-B exposure and age-related maculopathy. CONCLUSIONS: These
      data suggest that exposure to sunlight may be associated with age-related
      maculopathy. However, longitudinal studies of these associations are needed.

PMID- 8470987
TI  - Infectious crystalline keratopathy. The role of bacterial exopolysaccharide.
AB  - OBJECTIVES: Infectious crystalline keratopathy is a unique pauci-inflammatory
      infection of the cornea most commonly due to viridans type streptococci. We
      investigated the hypothesis that production of exopolysaccharide by streptococci,
      a property that can be induced by growth conditions, may contribute to the
      pathogenesis of infectious crystalline keratopathy by suppressing the ocular
      immune response. METHODS: Streptococcus sanguis type II was grown under two
      conditions, conventionally in brain-heart infusion broth and in 5% sucrose
      supplemented brain-heart infusion broth, to promote exopolysaccharide formation.
      Rabbit corneas were inoculated by passage of 9-0 silk sutures soaked in bacterial
      suspensions. RESULTS: Arborizing, sharply demarcated pauci-inflammatory lesions
      were noted in 71% of rabbit corneas inoculated with S sanguis type II grown in
      sucrose-supplemented media and in 25% of control corneas (P = .05). Suppurative
      lesions developed in the remaining corneas. Histologic evaluation of infectious
      crystalline keratopathy lesions revealed characteristic features. CONCLUSION:
      Increased exopolysaccharide formation by S sanguis type II is associated with
      production of infectious corneal lesions that resemble those of infectious
      crystalline keratopathy.

PMID- 8470988
TI  - Reflectance feedback control of photocoagulation in vivo.
AB  - OBJECTIVE: The objective of this research was to build a real-time feedback
      system that controlled lesion size. Two-dimensional reflectance images were
      acquired with a charge-coupled device camera during irradiation, and argon laser
      exposure was ended when parameters of the image reached prespecified values.
      METHODS: The real-time feedback control system was tested by creating lesions at
      different power levels in pigmented rabbits. Laser exposure time was controlled
      by monitoring the central reflectance. RESULTS: Results of feedback-controlled
      lesions formed in vivo in pigmented rabbits are presented. An ability to produce
      uniform lesions despite variation in tissue absorption or changes in laser power
      is demonstrated. CONCLUSIONS: Reflectance control of photocoagulation is
      possible; incorporation of feedback during photocoagulation has numerous
      therapeutic and safety benefits over current ballistic delivery.

PMID- 8470989
TI  - Effect of oxymetazoline on aqueous humor dynamics and ocular blood flow in
      monkeys and rabbits.
AB  - OBJECTIVE: To evaluate the ocular effects of oxymetazoline hydrochloride, an
      alpha 2 agonist, in cynomolgus monkeys and albino rabbits. METHODS: Intraocular
      pressure was measured before and for 6 hours after application to glaucomatous
      monkey eyes. Outflow facility and aqueous flow rates were measured in normal
      monkey eyes. Uveoscleral outflow was measured in rabbit eyes. Ocular peak pulse
      volume was determined with the ocular blood flow system in normal and
      glaucomatous monkey eyes. RESULTS: Single applications of ozymetazoline reduced
      (P < .001) intraocular pressure up to 6.0 +/- 1.0 mm Hg (mean +/- SEM).
      Enhancement of the ocular hypotensive effect was observed with 5-day twice-daily
      administration. Outflow facility was unaltered; aqueous flow rate was decreased
      (P < .001) by 39% in the treated eyes compared with baseline values; and
      uveoscleral outflow was increased (P < .005) by 56% in the treated eye. Peak
      pulse volume was unchanged. CONCLUSION: Oxymetazoline reduces intraocular
      pressure by decreasing aqueous humor flow rates and increasing uveoscleral
      outflow. Oxymetazoline may have clinical potential as an ocular hypotensive drug.

PMID- 8470990
TI  - The history of vitamin A and its ophthalmic implications. A personal viewpoint.

PMID- 8470991
TI  - Response of retinal capillary hemangioma to cryotherapy.

PMID- 8470992
TI  - Peripapillary subretinal neovascularization associated with coloboma of the optic
      nerve.

PMID- 8470993
TI  - Possible health effects of 50/60Hz electric and magnetic fields: review of
      proposed mechanisms.
AB  - There is inconclusive evidence from both epidemiological and laboratory studies
      that fields similar to those produced by electrical power transmission lines may
      contribute to certain diseases including cancer. There are several objections to
      a hypothesis of a direct causative link, based on identifying a mechanism of
      interaction. One is that the energy density of the fields is several orders of
      magnitude smaller than that associated with random thermal motion in biological
      tissue. Secondly, the induced currents are many times smaller than endogenous
      currents associated with normal membrane processes. A comparison of current
      densities and characteristics associated with field-related phenomena such as
      electrosensitivity in species of fish, night-time melatonin depression in
      rodents, limb regeneration in amphibians and magnetophosphenes in humans reveals
      little that can be of use in determining a 'response metric', yet guide-lines for
      the general public are in fact based on this quantity, for immediate effects at
      least. Indeed, currents induced by the electric component of environmental 50 Hz
      fields are of similar magnitude to those induced by the magnetic component, yet
      epidemiological studies have identified surrogates of the latter as the
      significant exposure metric in relation to cancer incidence. Proposed mechanisms,
      many of which are still at the 'working hypothesis' stage, are compared with
      experimental evidence. Some conflict with epidemiological evidence, itself not
      strong, but becoming stronger, is apparent.

PMID- 8470994
TI  - Testing random number generators for Monte Carlo applications.
AB  - Central to any system for modelling radiation transport phenomena using Monte
      Carlo techniques is the method by which pseudo random numbers are generated. This
      method is commonly referred to as the Random Number Generator (RNG). It is
      usually a computer implemented mathematical algorithm which produces a series of
      numbers uniformly distributed on the interval [0,1). If this series satisfies
      certain statistical tests for randomness, then for practical purposes the pseudo
      random numbers in the series can be considered to be random. Tests of this nature
      are important not only for new RNGs but also to test the implementation of known
      RNG algorithms in different computer environments. Six RNGs have been tested
      using six statistical tests and one visual test. The statistical tests are the
      moments, frequency (digit and number), serial, gap, and poker tests. The visual
      test is a simple two dimensional ordered pair display. In addition the RNGs have
      been tested in a specific Monte Carlo application. This type of test is often
      overlooked, however it is important that in addition to satisfactory performance
      in statistical tests, the RNG be able to perform effectively in the applications
      of interest. The RNGs tested here are based on a variety of algorithms, including
      multiplicative and linear congruential, lagged Fibonacci, and combination
      arithmetic and lagged Fibonacci. The effect of the Bays-Durham shuffling
      algorithm on the output of a known "bad" RNG has also been investigated.

PMID- 8470995
TI  - Scatter radiation in mammography.
AB  - Current information pertinent to scatter radiation for mammographic x-ray spectra
      is limited. Data presented by the National Council on Radiation Protection and
      Measurements (NCRP), the current shielding authority, are restricted to 50 kVp
      tungsten target spectra and contain several incompatibilities with the modern
      mammographic situation. The ratio of scattered to incident exposure was measured
      for two molybdenum target spectra (36 kVp, 30 microns molybdenum filtration and
      49 kVp, 50 microns aluminium filtration). The maximum scatter ratio occurred at
      150 degrees to the primary beam direction for both spectra; the values were (1.73
      +/- 0.09) x 10(3) and (2.6 +/- 0.1) x 10(3) respectively for a field area of 400
      cm2, a scattering distance of 1 m and a primary beam exposure distance of 1 m
      from the x-ray source. The results obtained differ significantly from NCRP based
      data presently used for mammographic shielding calculations. The consequences of
      these differences are discussed.

PMID- 8470996
TI  - Development of the national radionuclide dose calibrator standardisation service.
AB  - The Australian Nuclear Science and Technology Organisation, acting as agent for
      the CSIRO Division of Applied Physics, maintains the Australian standard of
      measurement for activity. The standard includes all nuclear medicine gamma
      emitters and a new standard for pure positron emitters. Under Section 10 of the
      National Measurement Act 1960, if a measurement is made for a legal purpose, or
      if the legality of a measurement is in dispute, it can only be confirmed if the
      following two conditions are fulfilled: (a) that the measurement be in terms of
      the prescribed Australian legal units of measurement. (b) that it can be proven
      to be traceable to an Australian primary standard of measurement. To satisfy
      these requirements, radionuclide dose calibrators require a calibration report
      determined by Ansto. For this reason, Ansto has developed the national
      radionuclide dose calibrator standardisation service.

PMID- 8470997
TI  - International Atomic Energy Agency/World Health Organisation TLD radiotherapy
      dosimetry intercomparison.

PMID- 8470998
TI  - Data acquisition for linac based stereotactic radiosurgery.
AB  - In September 1991 a Philips Stereotactic Radiosurgery System (SRS 200) was
      installed in the Radiotherapy Department at Sir Charles Gairdner Hospital for use
      with an existing 6MV linear accelerator. The treatment planning software requires
      tables of Output Factors, Tissue Maximum Ratios (TMRs) and Off-Axis Ratios (OARs)
      for each specific linac/collimator set combination. Conventional techniques of
      acquiring radiation dose data for patient treatment planning were not suitable
      for the very small field sizes (5-30mm diameter) to be measured. Output Factors
      relative to a 100 x 100 mm field were measured using a large water tank and solid
      state diode detectors. The SRS 200 base frame which usually supports the special
      collimators could not be used with the tank in place and so a method for aligning
      the central axis of the beam, the SRS 200 collimators and diode was developed to
      improve the accuracy of measurement. TMRs were measured using two independent
      methods, similarly for the OARs. The first method of measuring TMRs made use of
      the large water tank and diode detectors. The second method employed the use of
      solid water phantom slabs seated on the base frame of the SRS 200. OARs were
      first measured with the solid water phantom slabs and diode; the second method
      made use of the technique of film dosimetry. Finally, a spherical water phantom
      was designed and built to check the total system accuracy. Agreement between sets
      of results measured by the independent methods was within 0.3% on average for
      TMRs and 0.25mm at the 50% dose level in most cases for the OARs.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8470999
TI  - A device for measuring compression force in mammography.
AB  - Compression in mammography is an accepted technique for improving image quality
      and reducing dose, but excessive compression can cause pain and other undesirable
      effects. Therefore, maximum compression force should be measured in a quality
      assurance programme. A compression force meter, based on a load cell design, has
      been constructed and used to make compression force measurements on three GE
      Senographe 600T mammography machines. These measurements show that the conversion
      from pneumatic pressure (as indicated on the machine) to applied compression
      force is given by Compression Force (N) = (79.0 +/- 0.9) x Pneumatic Pressure
      (bars) + (12.2 +/- 4.0). Using this equation and pneumatic pressure settings on
      nine GE Senographe 600T units in our quality assurance programme, the maximum
      compression force in clinical use ranges from 102 to 150 N with a mean of 126 N.
      This is lower than guidelines used in the United States and the United Kingdom.

PMID- 8471000
TI  - Myogenic and flow-dependent control mechanisms in the coronary microcirculation.
AB  - We have recently gained evidence that segmental coronary microvascular diameters,
      and therefore resistances, are controlled by myogenic and endothelial responses
      to pressure and flow. Furthermore, intact heart studies are demonstrating that
      these mechanisms may interact importantly with the metabolic mechanisms primarily
      governing coronary blood flow. Further studies utilizing measurement of segmental
      coronary microvascular diameters in isolated microvessels and in the beating
      heart may elucidate the nature of these interactions. Clinical studies may
      determine whether reversal of endothelial impairment in the diseased coronary
      microcirculation contributes to autoregulatory vasodilation, increases resting
      myocardial perfusion, and increases the threshold for myocardial ischemia during
      exercise.

PMID- 8471002
TI  - In vivo assessment of the inotropic and toxic effects of oxidized ouabain.
AB  - Oxidized ouabain, a product of the oxidative cleavage of the rhamnose ring in
      ouabain has been found to have a higher inotropic toxic ratio in cultured cardiac
      myocytes. The purpose of our study was to evaluate the efficacy and toxicity of
      oxidized ouabain in comparison with ouabain in intact animals. Drugs were infused
      to healthy cats; the positive inotropic effect, and the time-course of
      development of arrhythmia were followed and recorded until death. Oxidized
      ouabain was associated with a higher increase in arterial blood pressure, a mean
      increase of 41 +/- 19% as compared with 21 +/- 8% in the ouabain group (p <
      0.10). There were no significant differences in maximal increases of dP/dt or
      dP/dt/P (65 +/- 29%, 28 +/- 10% for oxidized ouabain and 49 +/- 16%, 27 +/- 11%
      for ouabain, respectively). The mean doses causing persistent arrhythmia (toxic
      dose) were 93 +/- 23 micrograms/kg of oxidized ouabain vs 39 +/- 14 micrograms/kg
      of ouabain. Lethal arrhythmias were produced by 215 +/- 46 micrograms/kg of
      oxidized ouabain and 62 +/- 16 micrograms/kg of ouabain. The ratio of toxic to
      lethal doses was 0.62 +/- 0.11 for ouabain vs 0.45 +/- 0.09 for oxidized ouabain
      (p < 0.05), but the inotropic to toxic dose ratios were not different. We
      conclude that oxidized ouabain acts similarly to the known cardiac glycosides in
      doses which produce inotropic effects in cats, has a lower potency as compared to
      ouabain, and appears to have a more benign course of intoxication.

PMID- 8471001
TI  - Effects of adenosine on electrical activity of isolated guinea pig hearts.
AB  - Negative chronotropic and dromotropic effects of adenosine seem to be responsible
      for its antiarrhythmic action on supraventricular tachyarrhythmias. To further
      characterize the effects of adenosine on supraventricular arrhythmias heart rate,
      conduction, refractoriness, the time to steady-state of AV-nodal conduction
      slowing and of sinus rate reduction were evaluated. Changes of heart rate,
      conduction intervals and effective refractory periods were determined by the use
      of a high-resolution ECG recording technique in isolated guinea pig hearts
      perfused by the method of Langendorff. Adenosine in concentrations of 3 and 10
      microM reduced sinus rate and prolonged AV-nodal conduction significantly, while
      intraventricular and His bundle conduction were not altered. The maximal effect
      of adenosine on the sinus node and AV nodal conduction occurred after 636 +/- 109
      and 111 +/- 35 (mean +/- SE) beats, respectively. During programmed stimulation
      at a cycle length of 250 ms, adenosine reduced atrial ERP in a dose-dependent
      manner. At cycle lengths of 170 and 200 ms, adenosine increased the atrial ERP at
      3 microM, and then progressively shortened the ERP at higher doses. At all
      adenosine concentrations used, the usual rate-dependent adaption in ERP was
      suppressed. These observations explain the efficacy of adenosine against
      supraventricular tachyarrhythmias where the AV-node forms a part of a reentrant
      circuit. Adenosine shortened the atrial ERP, but at high pacing rates also led to
      a relative prolongation of the atrial ERP as the rate-dependent adaption was
      suppressed. These opposite effects of adenosine may explain earlier contradictory
      findings of its action on atrial arrhythmias.

PMID- 8471003
TI  - Catecholamine-induced cardiac necroses: protective effect of leucocytopenia,
      influence of an S2 antagonist, thromboxanesynthetase inhibitor and prostacycline
      analogue.
AB  - The influence of various drugs and leucocytopenia (induced by cyclosphamid) on
      isoproterenol(40 mg/kg, s.c.)-induced cardiac necroses was investigated in female
      SPF Sprague Dawley rats. The influence of fibrinogen reduction was investigated
      in spontaneously hypertensive rats (SHR). 8-15% of the area of 15 cross-sections
      were evaluated with a computer-aided morphometric device allowing classification
      of number and area of necroses. The reduction of number and area of necroses
      amounted to approximately: 50% by prostacyclin analogue, 25% by S2 inhibition
      (ketanserin). Inhibition of thromboxane synthesis and fibrinogen reduction from
      elevated values (200 mg/dl) below the limit of detection by infusion of 35 U/kg
      Ancrod in SHR had no significant effects, where in SHR only 10 mg/kg
      isoproterenol were tolerated with a higher extent of necrosis formation.
      Leucocytopenia caused a reduction of necroses of over 90%. The condition of
      mismatch of oxygen consumption and supply induced by high doses of isoproterenol
      can be considered a model of angina pectoris. The effect of leucocytopenia
      indicates an essential role of leucocytes in necrosis formation in both
      situations.

PMID- 8471004
TI  - The hemodynamic effect of dietary calcium supplementation on rat renovascular
      hypertension.
AB  - Mechanisms which could be responsible for the hypotensive effects of increasing
      calcium intake from 1.2 to 2.5% of diet were examined in two kidney, one clip
      renovascular hypertension (2K, 1C RHV) in male Sprague-Dawley rats. Plasma renin
      activity was elevated similarly in NCA and HCA rats. No evidence for volume or
      phosphate depletion was found in HCA animals. Cardiac output was not different.
      Decreased sensitivity was demonstrated to moderate doses of norepinephrine in HCA
      rats, while vascular reactivity to exogenously administered angiotensin II over
      the range of doses used was not different between diets. The antihypertensive
      effect of supplemental calcium was associated with a 39% reduction in systemic
      vascular resistance. Therefore, dietary calcium supplementation lowers blood
      pressure in 2-K, 1C RVH primarily due to a systemic vasodilatation and reduced
      vascular reactivity to moderate doses of norepinephrine.

PMID- 8471006
TI  - Calculated mean arterial blood pressure in critically ill neonates.
AB  - Mean arterial pressure (MAP) is the area under the pressure wave form averaged
      over the cardiac cycle. A widely used rule of thumb to estimate MAP of peripheral
      arterial pressure waves in adults is adding one-third of the pulse pressure (PP)
      to diastolic arterial pressure (DAP). However, radial artery pressure waves in
      newborns differ from those in adults and resemble proximal aortic pressure waves,
      so that the above-mentioned calculation of MAP may not be correct. The present
      study was set up to obtain an arithmetical approximation to derive MAP from blood
      pressure waves measured in the radial artery of the neonate. We accurately
      recorded about 300 invasively obtained blood pressure curves in the radial artery
      of 10 neonates admitted for intensive care. We found that MAP in the radial
      artery in these neonates can be well approximated by adding 46.6% PP to DAP
      (range 43.0-50.1%). We suggest that the rule of thumb to derive MAP from radial
      artery waves in the neonate to be approximately the average of systolic and
      diastolic pressure, as opposed to adding one-third of the pulse pressure to the
      diastolic value in the adult.

PMID- 8471005
TI  - Myocardial contractility and ventricular myosin isoenzymes as influenced by
      cardiac hypertrophy and its regression.
AB  - Changes in myocardial contractility and ventricular myosin isoenzymes were
      examined during pressure-overloaded cardiac hypertrophy in rats. Effects of
      regression of cardiac hypertrophy were also examined. Cardiac hypertrophy was
      induced by abdominal aortic constriction in 7-week-old male Wistar rats.
      Regression of cardiac hypertrophy was obtained by opening the aortic band.
      Myocardial contractility was estimated by measuring isometrically developed
      tension and maximum rate of tension rise (+dT/dtmax) in isolated left-ventricular
      papillary muscles perfused with Tyrode solution (32 degrees C, pH 7.4, bubbled
      with 95% O2.5% CO2, stimulation frequency: 0.2 Hz). Left-ventricular myosin
      isoenzymes were separated by pyrophosphate gel electrophoresis and the isoenzyme
      pattern was determined by densitometry. Isometrically developed tension (T) in
      hypertrophic myocardium remained unchanged, but +/-dT/dtmax decreased as compared
      with hearts of normal rats. Decreased +/-dT/dtmax recovered near to the level in
      normal rats by regression of cardiac hypertrophy. Left-ventricular myosin
      isoenzyme pattern shifted towards VM-3 in hypertrophied myocardium and shifted
      again toward VM-1 by regression of cardiac hypertrophy. In conclusion, myocardial
      contractility and ventricular myosin isoenzymes were changed in pressure
      overloaded hypertrophy in rats and these changes were reversible to a normal
      level by regression of cardiac hypertrophy.

PMID- 8471007
TI  - Geometric and muscle physiological factors of the Frank-Starling mechanisms.
AB  - The relation between left-ventricular stroke volume (SV) and end-diastolic volume
      (EDV) was determined based on angiocardiographic measurements in 10 open-chest
      minipigs under varying filling conditions (blood letting or infusions). The
      results were compared with a theoretical relation calculated under the assumption
      of varying EDV but constancy of myocardial properties. In contrast to the linear
      increase of SV as a function of EDV as found in the animal experiments, the
      calculated curve reveals a maximum near the normal operating point with a
      decrease in the range of higher EDV. It can be concluded that the well-known
      increase of SV with increasing ventricular filling, beyond the normal EDV, is
      almost completely due to muscle physiological factors (mainly increase in Ca2+
      sensitivity of the contractile apparatus), whereas the decrease of SV in the
      range of low filling pressure is mainly due to the geometrical conditions.

PMID- 8471008
TI  - Relations between social skills and high-risk sexual interactions among
      adolescents. Current issues and future directions.
AB  - Researchers have begun to employ social-skills training in efforts to change the
      sexual behavior of adolescents. However, despite the promise of social-skills
      training, little is known about how social skills are related to the sexual
      practices of adolescents. The present article reviews the current literature and
      proposes a conceptual framework for understanding the relations between social
      skills and sexual behavior of adolescents by (a) examining the relationship
      between sexual activity and social skills, (b) examining the development of
      sexual-interaction skills and deficits, (c) summarizing what is currently known
      about the relations between social skills and sexual behavior, (d) discussing
      current issues in the assessment and treatment of sexual-interaction skills
      deficits, and (e) proposing some directions for needed research that will add
      both to our current knowledge base and to the effectiveness of applied
      intervention efforts.

PMID- 8471009
TI  - "We'll cross that hurdle when we get to it". Teaching athletic performance within
      adaptive physical education.
AB  - Persons with developmental and physical disabilities who are enrolled in
      educational programs often participate in adaptive physical education classes.
      Primarily, these classes are designed to provide individuals with the opportunity
      to develop their physical abilities. However, they can also serve as a training
      ground for the Special Olympics. Teaching the motor skills that are prerequisite
      to participation in many adaptive physical education and Special Olympics
      activities can be a formidable objective. This study demonstrates how a person
      with developmental disabilities was taught, by way of stimulus control shaping,
      the necessary motor skills to enable him to participate in the hurdling event at
      the Special Olympics.

PMID- 8471010
TI  - Behavioral interventions to reduce maladaptive responding in youth with dual
      sensory impairment. An analysis of direct and concurrent effects.
AB  - Many persons who have multiple sensory, physical, and developmental disabilities
      display behaviors that interfere significantly with adaptive functioning and
      social acceptance. In this investigation, the efficacy of multiple component
      behavioral interventions for reducing maladaptive responding exhibited by two
      individuals with dual sensory impairment and profound mental retardation was
      evaluated. Results indicated that differential reinforcement of other behavior
      (DRO) approaches were not effective in either case. However, when deceleration
      procedures (overcorrection or brief physical restraint) were added, target
      behaviors decreased quickly. Also, interventions were faded in such a way that
      gains were maintained for 6 months with only minimal effort by staff. Ongoing
      assessment of concurrent effects of behavior reduction strategies revealed
      increases in time on task or amount of work completed, even though these
      responses were not targeted specifically. Yet negative side effects (e.g.,
      increases in self-stimulation) also were documented, highlighting the importance
      of evaluating multiple behaviors during intervention. Finally, despite the fact
      that objective assessments led to positive conclusions regarding treatment
      efficacy, ratings of baseline and treatment behavior samples by independent
      judges showed overall improvement in only one case. These findings suggest the
      need for multifaceted evaluation to determine the utility of interventions in
      applied settings.

PMID- 8471011
TI  - Using independence training to teach independent living skills to children and
      young men with visual impairments.
AB  - Two groups of students with visual impairments were taught various independent
      living skills. Of the 7 students, 5 also had a diagnosis of mental retardation.
      One group (3 first graders) was taught the tasks of folding a shirt, making an
      emergency telephone call, and spreading soft foods with a knife. The other group
      (4 young men) was taught to increase leisure skills through three different
      leather-work tasks. Independence training was conducted in a group format and
      included social learning components (e.g., self-evaluation, peer evaluation and
      reinforcement) in addition to traditional operant procedures (e.g., modeling,
      prompting). However, because of the presence of visual impairments, a physical
      and verbal modification of modeling was used, whereby the subject was physically
      guided through the steps and simultaneously provided with a narration of the
      steps. A multiple baseline design across behaviors demonstrated the efficacy of
      the comprehensive training package in training various independent living skills
      to the two groups of visually impaired and mentally retarded students. Social
      validity measures demonstrated the clinical significance of the subsequent
      changes in behavioral skills. Follow-up data collected 10 months after the
      completion of training indicated a good degree of maintenance. The current
      positive results show that training procedures used exclusively with persons with
      mental retardation can be modified and be effective with a different and younger
      population, while targeting different independent living skills.

PMID- 8471012
TI  - Behavioral assessment of anxiety in older adults. Some comments.
AB  - The behavioral assessment of anxiety in older adults is reviewed in this article.
      Despite the high rate of anxiety symptoms uncovered during the course of large
      scale epidemiological studies, the comprehensive evaluation of anxiety in this
      age group (55 and over) is not highly sophisticated at this juncture. In this
      review, diagnostic issues, psychometric evaluation, motoric assessment, and
      psychophysiological assessment are considered. Throughout the articles, gaps in
      the extant research are identified, and a research agenda for the future is
      developed.

PMID- 8471013
TI  - [The hematologic parameters, concentrations of minerals and metabolic products
      and activities of enzymes in sheep].
AB  - In the period of March 1988-March 1989, in 20 Lower Austrian sheep breeding farms
      blood samples were taken in two-month intervals from sheep of the following
      breeds: 130 Tyrolean Mountain sheep, 59 German Improved Land breed, 59 East
      Friesian and 57 German Blackheaded Mutton breed sheep. The following standards
      for sheep were evaluated: Erythrocytes 7,2-11,9 T/L, haematocrit 0,25-0,41 1/L,
      haemoglobin 82-147 g/L, lymphocytes 34-80%, segmented neutrophils 10-53%, band
      neutrophils 1-3%, eosinophilic granulocytes 0-24%, basophilic granulocytes 0-1%,
      monocytes 0-1%, calcium 1,8-2,8 mmol/L, phosphorus 1,0-2,6 mmol/L, magnesium 0,6
      1,3 mmol/L, total protein 53-81 g/L, albumin 22-41 g/L, aspartate
      aminotransferase 27-81 U/L, alanine aminotransferase 3-25 U/L, gamma glutamic
      transaminase 24-59 U/L, alkaline phosphatase 44-355 U/L, creatine kinase 3-130
      U/L, glutamic dehydrogenase 2,0-36,5 U/L, total bilirubin 0,7-5,1 mumol/L,
      cholesterol 1,1-3,2 mmol/l, urea nitrogen 1,3-12,7 mmol/l, creatinine 50-112
      mumol/L. Apart from that, additional standards for the mentioned breeds of sheep
      were evaluated, revealing significant differences. Also the age and the time of
      the year proved to have an influence upon the ascertained blood values.

PMID- 8471014
TI  - [Sarcosporidia as the cause of sudden death during anesthesia in sheep].
AB  - The first two out of an experimental group of 17 sheep assigned for orthopaedic
      surgery died during inhalation anaesthesia with halothane-nitrous oxide-oxygen
      before the arthrotomy of the knee joint could start. Further casualties could be
      prevented by the use of epidural anaesthesia. Each of the 17 sheep underwent a
      pathologic-anatomical, histological, bacteriological and parasitological
      examination. It was found that all of them were infected with sarcosporidia
      oocysts with myocarditis of different intensity. Possible infections with
      sarcosporidia-oocysts in animals, which could have had contact to carnivora, and
      which are taken for therapeutic surgery or for an experiment should be taken into
      consideration, because the lesion in the heart due to sarcosporidia-oocysts can
      be the cause of sudden death.

PMID- 8471015
TI  - [The effect of toxins from Pasteurella multocida type D in calves in vivo].
AB  - By intratracheal injection of purified dermonecrotic toxin from a Pasteurella
      multocida type D strain, pneumonitis in calves could be produced. This
      demonstrates the important role of this toxin in the pathogenesis of pneumonitis
      in calves.

PMID- 8471016
TI  - [Yersinia pseudotuberculosis as a possible cause of abortion in sheep (short
      communication)].
AB  - A case report is given on cases of abortion in a flock of sheep herded on
      different pastures. In three fetuses Yersinia pseudotuberculosis could be
      detected additionally to Chlamydia for the first time in the district of the
      veterinary office of Cottbus.

PMID- 8471017
TI  - [Experimental studies on the development of an antigen-capture test (Capture
      ELIFA) for the detection of Coxiella burnetii in cow's milk as a possible
      alternative to animal studies].
AB  - A sensitive and specific Capture-ELIFA (Enzyme-linked-Immunofluorescent Assay)
      for the detection of Coxiella burnetii was developed using a monoclonal antibody
      and a rabbit immune serum, both directed against Coxiella burnetii, strain Nine
      Mile, phase I. A combination of centrifugation, Pronase-K-digestion and heat
      treatment proved to be advantageous for concentrating, exposure and inactivating
      of Coxiella antigens in milk samples. Using this method of sample preparation 4 x
      10(3) coxiella particles/ml could be detected in experimentally contaminated milk
      samples by the optimized Capture-ELIFA. Preliminary results of comparative
      investigations indicate that the Capture-ELIFA is more sensitive than the
      inoculation of guinea pigs and subsequent detection of seroconversion.

PMID- 8471018
TI  - [Measurement of the mucociliary transport velocity in the trachea of calves].
AB  - A measuring method is presented for the determination of the velocity of
      intratracheal mucociliary transport in calves, which is applicable for
      nonanaesthetized animals directly in the calf stable. The transport velocity in
      the trachea of clinically healthy calves was found to be about 15 mm/min, which
      is in agreement with other reports.

PMID- 8471019
TI  - [Legal problems--particularly regarding doping--in animal purchasing].
AB  - The role of the veterinarian in giving health certificates for animals for
      different purposes in the trade of livestock or sports are being discussed from
      the legal point of view. A set for falsification secure transportation of blood
      samples for doping tests is being demonstrated.

PMID- 8471020
TI  - Polymorphism of two closely linked hexokinase loci in the grasshopper Oxya
      japonica japonica (Orthoptera: Acrididae: Oxyinae).

PMID- 8471021
TI  - Caprine blood groups. 2. The C, G, H, I, J, K, L, N, and Q systems.
AB  - Nine blood group systems of goats were identified using 12 caprine reagents
      produced by absorption of alloimmune antisera. The caprine C blood group system,
      possibly homologous to the ovine C blood group system, was characterized by two
      reagents and shown to be controlled by three alleles, C12, C25, and C-. A more
      complex blood group system of goats, designated G, was identified using three
      reagents and shown to be controlled by six codominant alleles (G10.19.20, G10.19,
      G10.20, G10, G19, G20) and a recessive allele (G-). A further seven one-factor
      two-allelic systems were identified by seven reagents. The nine genetic systems
      provided exclusion probabilities of 0.479, 0.492, 0.548, and 0.572 in Australian
      Angora, Dairy, Cashmere, and Texan Angora goat breeds, respectively.

PMID- 8471022
TI  - Chromosomal effects on peptidase activities in Drosophila melanogaster.
AB  - The peptidase system in Drosophila melanogaster (dipeptidase-A, -B, and -C and
      leucine aminopeptidases G and P) was used as a model to study the effects of
      modifier genes on activity of enzymes with similar functions. A screen of X,
      second, and third chromosome substitution isogenic lines revealed the presence of
      activity modifiers for peptidases on all three chromosomes. Correlation analyses
      indicated that covariation between some of the peptidase activities is
      independent of genetic background, while others are associated with variable
      second chromosomes. Chromosome-specific effects on Km, Vmax, and specific
      activity of partially purified peptidases were also detected. Moreover, a
      repeatable technique using anion-exchange column chromatography allowed the
      characterization of possibly two putative peptidic enzymes, glycyl-L-isoleucine
      ase and L-leucyl-L-proline-ase, whose kinetic properties differ from the
      dipeptidases and the leucine aminopeptidases. These findings confirm the
      existence of activity modifiers for peptidases, much like other enzymes in
      Drosophila melanogaster.

PMID- 8471023
TI  - A correction for allele frequency estimates derived from isofemale lines.
AB  - Isofemale lines are commonly used in Drosophila and other genera for the purpose
      of assaying genetic variation. Isofemale lines can be kept in the laboratory for
      many generations before genetic work is carried out, and permit the confirmation
      of newly discovered alleles. A problem not realized by many workers is that the
      commonly used estimate of allele frequency from these lines is biased. This
      estimation bias occurs at all times after the first laboratory generation,
      regardless of whether single individuals or pooled samples are used in each well
      of an electrophoretic gel. This bias can potentially affect the estimation of
      population genetic parameters, and in the case of rare allele analysis it can
      cause gross overestimates of gene flow. This paper provides a correction for
      allele frequency estimates derived from isofemale lines for any time after the
      lines are established in the laboratory. When pooled samples are used, this
      estimator performs better than the standard estimator at all times after the
      first generation. The estimator is also insensitive to multiple inseminations.
      After the lines have drifted one Ne generations, multiple inseminations actually
      make the new estimator perform better than it does in singly inseminated females.
      Simulations show that estimates made using either estimator after the lines have
      drifted to fixation have a much greater error associated with their use than do
      those estimates made earlier in time using the correction. In general it is
      better to use corrected estimates of gene frequency soon after lines are
      established than to use uncorrected estimates made after the first laboratory
      generation.

PMID- 8471024
TI  - Caprine blood groups. 1. The B system.
AB  - Twelve of 24 monospecific caprine reagents produced by absorption of alloimmune
      antisera identified a complex blood group system of goats which was designated B,
      based on the results of a small comparison test with ovine reagents. The
      frequencies of the 12 B factors differed significantly among the Australian
      Angora, Texan Angora, Cashmere, and Dairy goat breeds. Three of the antigens
      detected by the reagents were shown to be related as linear subtypes, designated
      Ba1, Ba2, and Ba3, and inherited as alleles. The segregations of B factors in 80
      sire groups involving 1086 offspring demonstrated that groups of B factors
      (phenogroups) segregated as products of allelic genes.

PMID- 8471025
TI  - Identification of three Wx proteins in wheat (Triticum aestivum L.).
AB  - Nullisomic analysis of waxy (Wx) protein of hexaploid wheat (Triticum aestivum
      L.) cv. "Chinese Spring" using two-dimensional polyacrylamide gel electrophoresis
      revealed that three Wx loci, Wx-A1, Wx-B1, and Wx-D1, located on chromosome arms
      7AS, 4AL, and 7DS, produce three distinct Wx subunit groups, subunit group-A
      (SGA), SGB, and SGD, respectively. SGA has a higher molecular weight and a more
      basic isoelectric point (pI) than the other two. SGB and SGD have the same
      molecular weight but a slightly different pI range. Owing to the detection of
      these three subunit groups, we were able to identify the expression of three waxy
      genes in wheat endosperm and to find two types of mutants among Japanese wheat
      cultivars, one lacking SGA and the others SGB. These results suggest the
      possibility of breeding a waxy wheat.

PMID- 8471026
TI  - Microsatellite variation in a social insect.
AB  - We undertook a study to explore the potential of microsatellite loci as genetic
      markers for investigating kinship patterns in a social wasp Parachartergus
      colobopterus. A plasmid library with small inserts was screened for several
      oligonucleotide repeat motifs. Positive clones were sequenced and several were
      selected for further work. PCR primers were constructed that would amplify the
      tandem repeat region and a number of female wasps were scored for variation in
      the number of tandem repeats at these loci. The five amplified loci were far more
      variable than allozymes, with an average heterozygosity of 0.35.

PMID- 8471027
TI  - Conformational changes at the active site of creatine kinase at low
      concentrations of guanidinium chloride.
AB  - It has been previously reported that, during denaturation of creatine kinase by
      guanidinium chloride (GdmCl) or urea [Tsou (1986), Trends Biochem. Sci. 11, 427
      429], inactivation occurs before noticeable conformational change can be
      detected, and it is suggested that the conformation at the active site is more
      easily perturbed and hence more flexible than the molecule as a whole. In this
      study, the thiol and amino groups at or near the active site of creatine kinase
      are labelled with o-phthalaldehyde to form a fluorescent probe. Both the emission
      intensity and anisotropy decrease during denaturation indicating exposure of this
      probe and increased mobility of the active site. The above conformational changes
      take place together with enzyme inactivation at lower GdmCl concentrations than
      required to bring about intrinsic fluorescence changes of the enzyme. At the same
      GdmCl concentration, the rate of exposure of the probe is comparable with that of
      inactivation and is several orders of magnitude faster than that for the
      unfolding of the molecule as a whole.

PMID- 8471028
TI  - Changes in uncoupling protein and GLUT4 glucose transporter expressions in
      interscapular brown adipose tissue of diabetic rats: relative roles of
      hyperglycaemia and hypoinsulinaemia.
AB  - We have studied the time course and relative effects of hypoinsulinaemia and
      hyperglycaemia on concentrations of uncoupling protein (UCP) and glucose
      transporter (GLUT4) and their mRNAs in brown adipose tissue (BAT) during the
      early phase of diabetes induced by streptozotocin. Two days after intravenous
      injection of streptozotocin, plasma insulin concentration was at its lowest and
      glycaemia was higher than 22 mmol/l. After 3 days, a 60% decrease in BAT UCP mRNA
      concentration and a 36% decrease in UCP was observed. Concomitantly, there was an
      80% decrease in GLUT4 mRNA and a 44% decrease in GLUT4 levels. When
      hyperglycaemia was prevented by infusing phlorizin into diabetic rats, BAT UCP
      mRNA and protein levels were further decreased (respectively 90% and 60% lower
      than in control rats). In contrast, the marked decreases in GLUT4 mRNA and
      protein concentrations in BAT were similar in hyperglycaemic and normoglycaemic
      diabetic rats. Infusion of physiological amounts of insulin restored
      normoglycaemia in diabetic rats, and BAT UCP and GLUT4 mRNA and protein
      concentrations were maintained at the level of control rats. When insulin
      infusion was stopped, a 75% decrease in BAT UCP mRNA level and a 75% decrease in
      GLUT4 mRNA level were observed after 24 h, but UCP and GLUT4 concentrations did
      not decrease. This study shows that insulin plays an important role in the
      regulation of UCP and GLUT4 mRNA and protein concentrations in BAT.
      Hyperglycaemia partially prevents the rapid decrease in concentration of UCP and
      its mRNA observed in insulinopenic diabetes whereas it did not affect the
      decrease in GLUT4 mRNA and protein concentration. It is suggested that UCP is
      produced by a glucose-dependent gene.

PMID- 8471029
TI  - 4-Chloro-3-hydroxyanthranilate, 6-chlorotryptophan and norharmane attenuate
      quinolinic acid formation by interferon-gamma-stimulated monocytes (THP-1 cells).
AB  - Accumulation of quinolinic acid and L-kynurenine occurs in the brain and/or blood
      following immune activation, and may derive from L-tryptophan following induction
      of indoleamine 2,3-dioxygenase and other kynurenine-pathway enzymes. In the
      present study a survey of various cell lines derived from either brain or
      systemic tissues showed that, while all cells examined responded to interferon
      gamma by increased conversion of L-[13C6]tryptophan into L-kynurenine (human: B
      lymphocytes, neuroblastoma, glioblastoma, lung, liver, kidney; rat brain:
      microglia, astrocytes and oligodendrocytes), only macrophage-derived cells
      (peripheral-blood mononuclear cells; THP-1, U-937) and certain liver cells
      (SKHep1) synthesized [13C6]quinolinic acid. Tumour necrosis factor-alpha enhanced
      the effects of interferon-gamma in THP-1 cells. Norharmane, 6-chloro-DL
      tryptophan and 4-chloro-3-hydroxyanthranilate attenuated quinolinic acid
      formation by THP-1 cells with IC50 values of 51 microM, 58 microM and 0.11 microM
      respectively. Norharmane and 6-chloro-DL-tryptophan attenuated L-kynurenine
      formation with IC50 values of 43 microM and 51 microM respectively, whereas 4
      chloro-3-hydroxyanthranilate had no effect on L-kynurenine accumulation. The
      reductions in L-kynurenine and quinolinic acid formation are consistent with the
      reports that norharmane is an inhibitor of indoleamine 2,3-dioxygenase, 6-chloro
      DL-tryptophan is metabolized through the kynurenine pathway, and 4-chloro-3
      hydroxyanthranilate is an inhibitor of 3-hydroxyanthranilate 3,4-dioxygenase.
      These results suggest that many tissues may contribute to the production of L
      kynurenine following indoleamine 2,3-dioxygenase induction and immune activation.
      Quinolinic acid may be directly synthesized from L-tryptophan in both macrophages
      and certain types of liver cells, although uptake of quinolinic acid precursors
      from blood may contribute to quinolinic acid synthesis in cells that cannot
      convert L-kynurenine into quinolinic acid.

PMID- 8471030
TI  - Evidence for acidity of prelysosomal autophagic/endocytic vacuoles (amphisomes).
AB  - [14C]Lactose electroinjected into isolated rat hepatocytes is normally
      autophagocytosed, transferred to lysosomes and degraded by lysosomal beta
      galactosidase, but at high concentrations of asparagine the transfer is inhibited
      and lactose accumulates in prelysosomal autophagic/endocytic vacuoles
      (amphisomes). The accumulation can be prevented by addition of yeast beta
      galactosidase, which is transferred to the lactose-containing vacuoles by
      endocytosis. Propylamine, a weak base capable of neutralizing acidic vacuoles,
      protects autophagocytosed lactose against both endogenous and exogenous beta
      galactosidase, suggesting that amphisomes, like lysosomes, have an acidic
      internal environment.

PMID- 8471031
TI  - Importance of the evolutionarily conserved glycine residue in the N-terminal
      region of human cystatin C (Gly-11) for cysteine endopeptidase inhibition.
AB  - Human cystatin C variants in which the evolutionarily conserved Gly-11 residue
      has been replaced by residues with positively charged (Arg), negatively charged
      (Glu), bulky hydrophobic (Trp), or small (Ser or Ala) side-chains have been
      produced by site-directed mutagenesis and expression in Escherichia coli. The
      five variants were isolated and structurally verified. Their inhibitory
      properties were compared with those of wild-type recombinant cystatin C by
      determination of the equilibrium constants for dissociation (Ki) of their
      complexes with the cysteine endopeptidases papain and human cathepsin B and with
      the cysteine exopeptidase dipeptidyl peptidase I. The Ser-11 and Ala-11 cystatin
      C variants displayed Ki values for the two endopeptidases that were approx. 20
      fold higher than those of wild-type cystatin C, while the corresponding values
      for the Trp-11. Arg-11 and Glu-11 variants were increased by a factor of about
      2000. In contrast, the Ki values for the interactions of all five variants with
      the exopeptidase differed from that of wild-type cystatin C by a factor of less
      than 10. Wild-type cystatin C and the Ser-11, Ala-11 and Glu-11 variants were
      incubated with neutrophil elastase, which in all cases resulted in the rapid
      hydrolysis of a single peptide bond, between amino acid residues 10 and 11. The
      Ki values for the interactions with papain of these three N-terminal-decapeptide
      lacking cystatin C variants were 20-50 nM, just one order of magnitude higher
      than the value for N-terminally truncated wild-type cystatin C, which in turn was
      similar to the corresponding values for the full-length Glu-11, Arg-11 and Trp-11
      variants. These data indicate that the crucial feature of the conserved Gly
      residue in position 11 of wild-type cystatin C is that this residue, devoid of a
      side-chain, will allow the N-terminal segment of cystatin C to adopt a
      conformation suitable for interaction with the substrate-binding pockets of
      cysteine endopeptidases, resulting in high-affinity binding and efficient
      inhibition. The functional properties of the remaining part of the proteinase
      contact area, which is built from more C-terminal inhibitor segments, are not
      significantly affected even when amino acids with bulky or charged side-chains
      replace the Gly-11 residue of the N-terminal segment.

PMID- 8471032
TI  - Investigations of the mechanism by which mammalian cell growth is inhibited by
      N1N12-bis(ethyl)spermine.
AB  - N1N12-Bis(ethyl)spermine (BESM) and related compounds are powerful inhibitors of
      cell growth that may have potential as anti-neoplastic agents [Bergeron, Neims,
      McManis, Hawthorne, Vinson, Bortell and Ingeno (1988) J. Med. Chem. 31, 1183
      1190]. The mechanism by which these compounds bring about their effects was
      investigated by using variant cell lines in which processes thought to be altered
      by these agents are perturbed. Comparisons between the response of these cells
      and of their parental equivalents to BESM, N1N11-bis(ethyl)norspermine, N1N14
      bis(ethyl)homospermine and N1N8-bis(ethyl)spermidine were then made. It was found
      that D-R cells, an L1210-derived line that over-expresses ornithine
      decarboxylase, were not resistant to these compounds. This indicates that the
      decrease in ornithine decarboxylase is not critical for the action of the
      compounds on cell growth. Furthermore, although polyamine levels were decreased
      in the D-R cells, the content was not totally depleted, indicating that such
      depletion is also not essential for the anti-proliferative effect. Two cell lines
      lacking mitochondrial DNA (human 143B206 cells and chicken DU3 cells) did not
      differ in sensitivity to BESM from their parental 143BTK- and DU24 cells.
      Furthermore, the inhibition of respiration in L1210 cells in response to BESM
      developed more slowly than the inhibition of growth. Thus it appears that the
      inhibitions of mitochondrial DNA synthesis and of mitochondrial respiration are
      also not primary factors in the anti-proliferative effects of these polyamine
      analogues. The inhibition of growth did, however, correlate with the
      intracellular accumulation of the analogues. It appears that the
      bis(ethyl)polyamine derivatives act by binding to intracellular target molecules
      and preventing macromolecular synthesis. The decline in normal polyamines may
      facilitate such binding, but is not essential for growth arrest.

PMID- 8471033
TI  - Hepatic one-carbon metabolism in early folate deficiency in rats.
AB  - Glycine N-methyltransferase (GNMT) is inhibited by 5-methyltetrahydrofolate
      polyglutamate in vitro. It is believed to play a regulatory role in the synthesis
      de novo of methyl groups. We have used the amino-acid-defined diet of Walzem and
      Clifford [(1988) J. Nutr. 118, 1089-1096] to determine whether folate deficiency
      in vivo would affect GNMT activity, as predicted by the studies in vitro.
      Weanling male rats were fed on the folate-deficient diet or a folate-supplemented
      diet pair-fed to the deficient group. A third group was fed on the folate
      supplemented diet ad libitum. Development of folate deficiency rapidly resulted
      in decreased levels of S-adenosylmethionine (SAM) and elevation of S
      adenosylhomocysteine (SAH). The ratios of SAM to SAH were 1.8, 2.7 and 1.5 in the
      deficient group for weeks 2, 3 and 4 of the experiment, and the values were 9.7,
      7.1 and 8.9 for the pair-fed control group and 10.3, 8.8 and 8.0 for the control
      group ad libitum fed. The activity of GNMT was significantly higher in the
      deficient group than in either of the two control groups at each time period.
      This was not due to increased amounts of GNMT protein, but reflected an increase
      in specific enzyme activity. Levels of folate in both the cytosol and
      mitochondria were severely lowered after only 2 weeks on the diet. The
      distribution of folate coenzymes was also affected by the deficiency, which
      resulted in a marked increase in the percentage of tetrahydrofolate
      polyglutamates in both cytosol and mitochondria and a very large decrease in
      cytosolic 5-methyltetrahydrofolate. The increased GNMT activity is therefore
      consistent with decreased folate levels and decreased inhibition of enzyme
      activity.

PMID- 8471034
TI  - Large changes of transition-state structure during experimental evolution of an
      enzyme.
AB  - The question of whether, during the evolution of an enzyme, the transition state
      of the catalysed reaction is largely unchanged, or whether transition state and
      protein change together, was examined using the egb beta-galactosidases of
      Escherichia coli. Charge development at the first chemical state was assumed
      [Konstantinidis and Sinnott (1991) Biochem. J. 279, 587-593] to be proportional
      to delta delta G++, the ratio of second-order rate constants for the hydrolysis
      of beta-D-galactopyranosyl fluoride and 1-fluoro-D-galactopyranosyl fluoride,
      expressed as a free-energy difference. delta delta G++ (kJ.mol-1) falls from 10.4
      for wild-type enzyme to 6.8 and 7.2 as a consequence of two different single
      amino-acid changes (which arise from single evolutionary events), to 6.3 as a
      consequence of the two amino-acid changes together, and then increases slightly
      to 7.3 as a consequence of a third single evolutionary change involving three
      further amino-acid changes.

PMID- 8471035
TI  - An overview of the kinetic parameters of class B beta-lactamases.
AB  - The catalytic properties of three class B beta-lactamases (from Pseudomonas
      maltophilia, Aeromonas hydrophila and Bacillus cereus) were studied and compared
      with those of the Bacteroides fragilis enzyme. The A. hydrophila beta-lactamase
      exhibited a unique specificity profile and could be considered as a rather
      specific 'carbapenemase'. No relationships were found between sequence
      similarities and catalytic properties. The problem of the repartition of class B
      beta-lactamases into sub-classes is discussed. Improved purification methods were
      devised for the P. maltophilia and A. hydrophila beta-lactamases including, for
      the latter enzyme, a very efficient affinity chromatography step on a Zn(2+)
      chelate column.

PMID- 8471036
TI  - Partial characterization of mechanism(s) by which sulphobromophthalein reduces
      biliary lipid secretion.
AB  - This study was performed to explore the mechanisms by which sulphobromophthalein
      (BSP) reduces the secretion of biliary lipid using Sprague-Dawley rats (SDR) and
      mutant rats with congenital conjugated hyperbilirubinaemia bred from SDR (EHBR).
      We infused the bile-salt-pool-depleted rats with sodium taurocholate at a
      constant rate of 160 nmol/min per 100 g body wt. with BSP (12.5, 25 and 50
      nmol/min per 100 g body wt.) or BSP-GSH (12.5, 25 and 50 nmol/min per 100 g body
      wt.). The biliary secretion of BSP and BSP-GSH was markedly impaired in EHBR as
      compared with that in SDR. BSP reduced the biliary secretion of cholesterol and
      phospholipids in a dose-dependent manner without affecting the secretion of bile
      salts and composition of fatty acids in phospholipids in SDR, but had no effect
      on lipid secretion in EHBR. In contrast, BSP-GSH had no such effect on biliary
      lipids, either in the SDR or EHBR. In addition, the amount of BSP in the liver of
      EHBR was in the same range as that of SDR. Therefore it is unlikely that an
      intracellular mechanism is involved in the phenomenon of uncoupling by BSP. We
      conclude that the uncoupling of biliary lipids from bile-salt secretion by BSP
      occurs at the level of the bile canaliculus following the secretion of
      unconjugated BSP.

PMID- 8471037
TI  - Expression of rat liver ketohexokinase in yeast results in fructose intolerance.
AB  - Rat liver ketohexokinase (ATP:D-fructose 1-phosphotransferase; EC 2.7.1.3) was
      purified to homogeneity and the molecular mass of the protein was found by mass
      spectrometry to be 32,800 Da. The enzyme was cleaved and the amino acid sequences
      of seven peptides, comprising 24% of the total sequence, were determined. This
      sequence information was used to design oligonucleotide primers for a PCR using
      rat liver single-stranded cDNA as a template. The 224 bp PCR product was used as
      a probe to screen a rat liver cDNA library. A cDNA sequence of 1342 bp was
      obtained from three positive clones. This contained the entire coding region for
      ketohexokinase, and all seven peptides were identified in the predicted amino
      acid sequence. When ketohexokinase was expressed in Saccharomyces cerevisiae
      using the yeast expression vector pMA91, the cells became intolerant of the
      presence of fructose in their growth media. The growth of an exponential-phase
      culture was completely arrested within 90 min by the addition of fructose to a
      final concentration as low as 0.1% (w/v). This response is associated with an
      accumulation of fructose 1-phosphate. The cDNA for ketohexokinase encodes a
      protein composed of 299 amino acids with a combined molecular mass of 32,728 Da.
      This is in close agreement with the value for the isolated protein determined by
      mass spectrometry. The primary structure does not show any significant homology
      with those of other eukaryotic hexokinases, but it contains a highly conserved
      region that is present in three prokaryotic phosphotransferases that have
      furanose substrates.

PMID- 8471038
TI  - Receptor-mediated endocytosis of retinol-binding protein by liver parenchymal
      cells: interference by radioactive iodination.
AB  - Retinol-binding protein (RBP) was iodinated directly by radio-iodine substitution
      on the tyrosyl residues by the sodium hypochlorite (NaOCl) or the Enzymobead (EB)
      methods, or indirectly by linkage of 125I-tyramine-cellobiose (TC) or 125I-N
      succinimidyl-3-(4- hydroxyphenyl)propionic acid ester (SHPP) adduct on to free
      amino residues of RBP. Binding, uptake and degradation of iodinated RBP were
      studied in isolated rat and rabbit liver parenchymal cells. The amount of ligand
      bound to cells at 4 degrees C was dependent on the type of labelling, in that the
      125I-TC ligand was bound to a lesser extent than NaClO-labelled 125I-RBP, EB
      labelled 125I-RBP and 125I-SHPP-RBP. At 37 degrees C, the 125I-SHPP-RBP and the
      EB-labelled 125I-RBP became cell-associated more rapidly than the other two
      ligands. The higher cell association at 37 degrees C than at 4 degrees C suggests
      that internalization of the ligand occurred at the higher temperature. The
      degradation of the ligands was also different. The EB-labelled 125I-RBP, the 125I
      TC-RBP and the 125I-SHPP-RBP showed an apparent lag phase before a steady
      increase in acid-soluble radioactivity was observed. Much less of EB-labelled
      125I-RBP and 125I-TC-RBP were degraded (about 6%) than of the other two ligands
      (about 16%) after 120 min. About 50% of the acid-soluble radioactivity in these
      experiments could be accounted for by degradation in the medium, suggesting that
      about half of the degradation observed was intracellular. The present study
      therefore shows that the different labelling techniques yield varying estimates
      of the cellular handling of RBP. In addition, a rapid release of RBP was observed
      in experiments where cells were pulsed with radioactive RBP at 4 degrees C,
      washed and incubated further at 37 degrees C. Between 50% and 70% was released
      after 5 min of incubation. By increasing the temperature during the pulse to 37
      degrees C, or by lowering the temperature during the chase to 4 degrees C, much
      less RBP was released from the cells. These data suggest that the release process
      represents recycling of internalized ligand from an early endosome.

PMID- 8471039
TI  - Immunological and biochemical characterization of processing products from the
      neurotensin/neuromedin N precursor in the rat medullary thyroid carcinoma 6-23
      cell line.
AB  - Neurotensin (NT) and neuromedin N (NN) are two related biologically active
      peptides that are encoded in the same precursor molecule. In the rat, the
      precursor consists of a 169-residue polypeptide starting with an N-terminal
      signal peptide and containing in its C-terminal region one copy each of NT and
      NN. NN precedes NT and is separated from it by a Lys-Arg sequence. Two other Lys
      Arg sequences flank the N-terminus of NN and the C-terminus of NT. A fourth Lys
      Arg sequence occurs near the middle of the precursor and is followed by an NN
      like sequence. Finally, an Arg-Arg pair is present within the NT moiety. The four
      Lys-Arg doublets represent putative processing sites in the precursor molecule.
      The present study was designed to investigate the post-translational processing
      of the NT/NN precursor in the rat medullary thyroid carcinoma (rMTC) 6-23 cell
      line, which synthesizes large amounts of NT upon dexamethasone treatment. Five
      region-specific antisera recognizing the free N- or C-termini of sequences
      adjacent to the basic doublets were produced, characterized and used for
      immunoblotting and radioimmunoassay studies in combination with gel filtration,
      reverse-phase h.p.l.c. and trypsin digestion of rMTC 6-23 cell extracts. Because
      two of the antigenic sequences, i.e. NN and the NN-like sequence, start with a
      lysine residue that is essential for recognition by their respective antisera, a
      micromethod by which trypsin specifically cleaves at arginine residues was
      developed. The results show that dexamethasone-treated rMTC 6-23 cells produced
      comparable amounts of NT, NN and a peptide corresponding to a large N-terminal
      precursor fragment lacking the NN and NT moieties. This large fragment was
      purified. N-Terminal sequencing revealed that it started at residue Ser23 of the
      prepro-NT/NN sequence, and thus established the Cys22-Ser23 bond as the cleavage
      site of the signal peptide. Two other large N-terminal fragments bearing
      respectively the NN and NT sequences at their C-termini were present in lower
      amounts. The NN-like sequence was internal to all the large fragments. There was
      no evidence for the presence of peptides with the NN-like sequence at their N
      termini. This shows that, in rMTC 6-23 cells, the precursor is readily processed
      at the three Lys-Arg doublets that flank and separate the NT and NN sequences. In
      contrast, the Lys-Arg doublet that precedes the NN-like sequence is not processed
      in this system.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8471040
TI  - A novel post-translational modification of the peptide antibiotic subtilin:
      isolation and characterization of a natural variant from Bacillus subtilis
      A.T.C.C. 6633.
AB  - A variant of the peptide antibiotic subtilin has been isolated from Bacillus
      subtilis A.T.C.C. 6633, and its structure has been shown to be [N alpha-succinyl
      Trp1]subtilin. The chemical structure of a fragment derived by tryptic hydrolysis
      of the variant is shown to be N alpha-succinyl-Trp-Lys by 1H and 13C n.m.r., fast
      atom-bombardment m.s. and total chemical synthesis [N alpha-Succinyl-Trp1]
      subtilin is produced later in the growth of the bacterium than is subtilin;
      reverse-phase h.p.l.c. analysis shows that after 24 h growth the ratio
      subtilin/[N alpha-succinyl-Trp1]subtilin is approx. 1:2. Although [N alpha
      succinyl-Trp1]subtilin retains significant antibacterial activity, it is 10-20
      times less active than subtilin.

PMID- 8471041
TI  - Biosynthesis, surface expression and function of the fibronectin receptor after
      rat liver cell transformation to tumorigenicity.
AB  - Zajdela hepatoma cells are poorly-adherent cells derived from an undifferentiated
      tumour and transplanted into rat. We compared the biosynthesis, structure and
      function of the fibronectin receptor in normal rat hepatocytes with that in
      Zajdela hepatoma cells. The rat hepatocyte fibronectin receptor has been
      isolated. It is composed of two subunits: alpha 5 (molecular mass 155 kDa) and
      beta 1 (molecular mass 115 kDa). However, its biosynthesis has not yet been
      described. Using polyclonal antibodies raised against each of the subunits of the
      receptor, we observed that the alpha 5-subunit was synthesized as a 155-kDa
      polypeptide in normal rat hepatocytes and Zajdela hepatoma cells. In contrast,
      the molecular mass of the beta 1-subunit was 130 kDa in Zajdela hepatoma cells
      versus 115 kDa in normal rat hepatocytes. Pulse-chase experiments showed that the
      apparent transition time from the 100-kDa beta 1-precursor to the 130-kDa mature
      form was abnormally prolonged in Zajdela hepatoma cells since the latter was not
      detected until 24 h, while the transition from the 100-kDa precursor to the 115
      kDa mature form began within 3 h in normal rat hepatocytes. Digestion of both the
      normal rat hepatocytes and Zajdela hepatoma cells 100-kDa beta 1-precursors with
      endo-beta-N-acetylglucosaminidase H and peptide N-glycosidase yielded products
      from 100 kDa to 84 kDa and 82 kDa, respectively, as judged by SDS/PAGE,
      suggesting that the same polypeptide chain is synthesized in normal rat
      hepatocytes and in Zajdela hepatoma cells. Incubation of the mature normal rat
      hepatocyte beta 1-subunit with peptide N-glycosidase reduced its molecular mass
      from 115 kDa to 82 kDa, as judged by SDS/PAGE, while the molecular mass of the
      abnormal mature Zajdela hepatoma cell beta 1-subunit decreased from 130 to 110
      kDa. Thus, in addition to alterations in the Asn-linked oligosaccharide
      processing, 'ascitic growth' induced other post-translational modifications in
      the Zajdela hepatoma cell beta 1-subunit. Furthermore, both the abnormal mature
      130-kDa and precursor 100-kDa beta 1-subunits were detected on the surface of
      Zajdela hepatoma cells, associated with the alpha 5-subunit. The relationship
      between these structural alterations in the fibronectin receptor and the impaired
      Zajdela hepatoma cell binding to soluble fibronectin or to a coated fibronectin
      matrix that was observed in this study is discussed.

PMID- 8471042
TI  - Expression of the glucose transporter GLUT4 in the muscular dystrophic mdx mouse.
AB  - Glucose transporter protein levels have been investigated in mdx and control
      (C57Bl/10) mice. Crude membrane fractions (microsomes plus plasma membranes) were
      prepared from skeletal muscle, heart, diaphragm and brain of 5-6-week-old and 6-7
      month-old control and mdx mice. Using Western blot analysis with C-terminal
      specific anti-peptide antibodies, we investigated the glucose transporters GLUT4
      in the different muscle tissues and GLUT1 in brain. In skeletal tissue from the
      hindlegs, GLUT4 was increased by approximately 55% in mdx mice compared with
      control mice at both ages studied. In the diaphragm, the amount of GLUT4 protein
      was unchanged in young mdx mice, and was decreased by 37.4 +/- 4.7% in older mice
      compared with age-matched control mice. No difference was observed between mdx
      and control mice in the amounts of GLUT4 and GLUT1 in heart and brain
      preparations respectively. To determine whether the change in GLUT4 protein
      observed in the diaphragm and skeletal muscle of mdx mice was regulated through
      changes at the level of glucose transporter mRNA, Northern blot analyses were
      performed. In skeletal muscle, GLUT4 mRNA level per tissue was not different
      between the two groups of mice at both ages studied. In contrast, the decrease in
      the amount of GLUT4 protein observed in the diaphragm of 6-7-month-old mdx mice
      was accompanied by a decrease in the GLUT4 mRNA level. In conclusion, the levels
      of GLUT4 protein were modified in muscle tissues from mdx compared with control
      mice, and these modifications were different depending on the muscle involved and
      the age of the mice. An increase in the amount of GLUT4 protein in the skeletal
      muscle of mdx mice was not due to changes at the mRNA level. The diaphragms of 6
      7-month-old mdx mice exhibited decreases in GLUT4 protein and mRNA levels that
      were not detected in young animals (5-6 weeks old).

PMID- 8471043
TI  - Differential effects of spermine and its analogues on the structures of
      polynucleotides complexed with ethidium bromide.
AB  - The interactions of spermine and polyamine analogues with synthetic
      polynucleotides of various base sequences complexed with ethidium bromide (EB)
      were investigated using measurements of fluorescence intensity and steady-state
      fluorescence polarization. Spermine and polyamine analogues displaced some but
      not all of the EB bound to poly(dA-dT).poly(dA-dT) or poly(dG-dC).poly(dG-dC),
      suggesting that polyamines may stabilize these polynucleotides in a conformation
      with reduced affinity for EB. Modifications of the aliphatic backbone of spermine
      have pronounced effects on its ability to displace EB from poly(dA-dT).poly(dA
      dT) but not from poly-(dG-dC).poly(dG-dC). Spermine and some but not all of the
      polyamine analogues caused fluorescence depolarization when they interacted with
      the complex of EB and poly(dA-dT).poly-(dA-dT). Neither spermine nor any of the
      analogues, however, induced fluorescence depolarization in the complex of EB with
      poly(dG-dC).poly(dG-dC) or poly(dA).poly(dT). This suggests that spermine and
      some spermine analogues induce structural changes specific to alternating A-T
      sequences.

PMID- 8471044
TI  - Purification, sequence and antibacterial activity of two novel sapecin homologues
      from Sarcophaga embryonic cells: similarity of sapecin B to charybdotoxin.
AB  - Two sapecin homologues were purified from the culture medium of NIH-Sape-4, an
      embryonic cell line of Sarcophaga peregrina (flesh fly). These homologues
      contained six cysteine residues with exactly the same disulphide pairings as
      those in sapecin. The amino acid sequence of one of them, sapecin C, was also
      very similar to that of sapecin. The other homologue, sapecin B, was less similar
      to sapecin but showed significant similarity to charybdotoxin, an inhibitor of K+
      channels isolated from a scorpion venom. Like sapecin, these homologues repressed
      the growth of various Gram-positive bacteria.

PMID- 8471045
TI  - Haemin enhancement of glucose transport in human lymphocytes: stimulation of
      protein tyrosine phosphatase and activation of p56lck tyrosine kinase.
AB  - Following our previous observation that haemin is mitogenic for human
      lymphocytes, we investigated the ability of haemin to enhance glucose uptake in
      these cells. We found that preincubation of human peripheral-blood mononuclear
      cells (PBMC) with haemin for 60 min increased up to 5-fold the rate of 2-deoxy-D
      [1-3H]glucose uptake by the cells. Actinomycin D and cycloheximide did not
      inhibit the effect, and cytochalasin B completely blocked it. Among the
      metalloporphyrins tested (Fe-, Ni-, Co-, Zn- and Sn-protoporphyrin), only haemin
      (Fe-protoporphyrin) induced a marked increase in glucose uptake. Thiourea, a
      scavenger of oxygen free radicals, and 3-amino-1,2,4-triazole inhibited haemin
      induced glucose uptake. Oxidants such as H2O2 and phenylarsine oxide were
      previously reported to stimulate protein tyrosine phosphorylation and to enhance
      glucose uptake. We found that incubation of PBMC with haemin resulted in an
      increase in protein tyrosine phosphatase (PTPase) activity, probably that
      identified as CD45. Similarly to haemin, we found that phytohaemagglutinin also
      enhanced PTPase activity. Haemin also activated the tyrosine kinase p56lck, which
      is negatively controlled by phosphorylation of Tyr-505 at the C-terminus, and
      increased protein tyrosine phosphorylation in these cells. Tyrphostins, specific
      inhibitors of tyrosine kinases, at low concentrations markedly enhanced glucose
      uptake and synergized with haemin in enhancing glucose uptake. At high doses,
      tyrphostins inhibited the effect of haemin. Taken together, we postulate that
      haemin enhancement of glucose uptake in human lymphocytes results from its
      stimulation of PTPase, followed by activation of tyrosine kinase p56lck, leading
      to an increase in protein tyrosine phosphorylation.

PMID- 8471046
TI  - Reconstitution in vitro of the pH-dependent aggregation of pancreatic zymogens en
      route to the secretory granule: implication of GP-2.
AB  - Regulated secretory proteins are thought to be sorted in the trans-Golgi network
      (TGN) via selective aggregation. To elucidate the biogenesis of the secretory
      granule in the exocrine pancreas, we reconstituted in vitro the conditions of pH
      and ions believed to exist in the TGN using the end product of this sorting
      process, the zymogen granule contents. Protein aggregation was dependent on pH
      (acidic) and on the presence of cations (10 mM Ca2+, 150 mM K+) to reproduce the
      pattern of proteins found in the granule. The constitutive secretory protein IgG
      was excluded from these aggregates. Zymogen aggregation correlated with the
      relative proportion of the major granule membrane protein GP-2 in the assay.
      These results show that the glycosylphosphatidylinositol-anchored protein GP-2 co
      aggregates with zymogens in the acidic environment believed to exist in the
      pancreatic TGN, and thus suggest that GP-2 would function as a membrane anchor
      for zymogen aggregates, facilitating their entrapment in budding vesicles
      directed towards the regulated secretory pathway.

PMID- 8471047
TI  - Genetic variation of iron-induced uroporphyria in mice.
AB  - Iron overload causes inhibition of hepatic uroporphyrinogen decarboxylase (UROD)
      and uroporphyria in C57BL/10ScSn but not DBA/2 mice [Smith, Cabral, Carthew,
      Francis and Manson (1989) Int. J. Cancer 43, 492-496]. We have investigated the
      induction of uroporphyria in 12 inbred strains of mice 25 weeks after iron
      treatment (600 mg/kg) to determine if there was any correlation with the Ah
      locus. Under these conditions, inhibition of UROD occurred to varying degrees in
      Ahd mice (SWR and AKR) as well as nominally Ahb-1 (C57BL/6J, C57BL/10ScSn and
      C57BL/10-cc) and Ahb-2 strains (BALB/c and C3H/HeJ). Five other Ahb or Ahd
      strains (C57BL/Ks, A/J, CBA/J, LP and DBA/2) were unaffected. Thus there appeared
      to be no correlation with the Ah phenotype and this illustrated that some other
      variable inherited factors are involved. Comparisons between another susceptible
      strain, A2G, and the congenic A2G-hr/+strain (carrying the recessive hr gene)
      showed a modulating influence associated with the hr locus. In contrast with
      individual mice of inbred strains, which showed consistent responses to iron,
      those of the outbred MF1 strain showed a spectrum of sensitivities as might be
      expected for a heterogeneic stock. The rate of porphyria development was
      accelerated by administration of 5-aminolaevulinic acid (5-ALA) in the drinking
      water, but this did not overcome strain differences. Among four strains the order
      of susceptibility was SWR > C57BL/10ScSn > C57B1/6J > DBA/2 (the last strain was
      completely resistant). With degrees of iron loading greater than 600 mg of Fe/kg
      (1200-1800 mg of Fe/kg) C57BL/10ScSn mice (after 20 weeks) and SWR mice (after 5
      weeks which included 4 weeks of 5-ALA treatment) had less inhibition of UROD and
      a lower uroporphyric response, showing that there was an optimum level of liver
      iron concentration. Studies on selected microsomal enzyme activities associated
      with cytochrome P-450 showed no correlation with the propensities of strains to
      develop porphyria. These activities included the NADPH-dependent oxidation of
      uroporphyrinogen I to uroporphyrin I.

PMID- 8471048
TI  - Active transport of L-proline in the protozoan parasite Trypanosoma brucei
      brucei.
AB  - The characteristics of L-proline transport in the procyclic form of Trypanosoma
      brucei were studied by using L-[14C]proline and a quick separation technique by
      centrifugation through an oil mixture. L-Proline uptake displayed typical
      Michaelis-Menten kinetics, with a Km of 19 microM and a maximum transport
      velocity of 17 nmol/min per 10(8) cells at 27 degrees C. The maximum
      concentration gradient factor obtained after 1 min of incubation was 270-fold in
      0.02 mM proline. Cells permeabilized with 80 microM digitonin were still able to
      accumulate 14C label, but to a lower extent. The temperature-dependence of
      proline uptake gave an apparent activation energy of 74.9 kJ.mol-1. In
      competition studies with a 10-fold excess of structural analogues, L-alanine, L
      cysteine and L-azetidine-2-carboxylate were found to inhibit L-proline uptake.
      Variation of pH or addition of the protonophore carbonyl cyanide m
      chlorophenylhydrazone ('CCCP') did not affect proline transport, showing that it
      is not driven by a protonmotive force. The absence of Na+, with or without
      monensin, did not affect proline transport. The absence of K+ and the addition of
      the Na+,K(+)-ATPase inhibitor ouabain had no significant effect on proline uptake
      activity. The thiol-modifying reagent iodoacetate (10 mM) decreased proline
      uptake by half. KCN (1 mM) inhibited proline uptake to a lesser extent, and the
      degree of inhibition was proportional to the intracellular ATP concentration.
      Preliminary experiments on proline transport in plasma-membrane vesicles of the
      cells, using a filtration technique, showed an uptake of proline (0.67 nmol/mg of
      protein) by the vesicles, but only in the presence of intravesicular ATP. The
      results thus obtained suggest that the proline carrier system in T. brucei is ATP
      driven and independent of Na+, K+ or H+ co-transport.

PMID- 8471049
TI  - Specificity constants for two-substrate reactions.

PMID- 8471050
TI  - Enzyme specificity in reactions of more than one co-substrate.

PMID- 8471051
TI  - Is there an alternating site co-operativity between the two subunits of lamb
      liver 6-phosphogluconate dehydrogenase?

PMID- 8471052
TI  - Deduced amino acid sequence, gene structure and chromosomal location of a novel
      human class Mu glutathione S-transferase, GSTM4.
AB  - The Mu-Class glutathione S-transferases (GSTs) are subject to marked inter
      individual variation in man, owing to the fact that 40-50% of the population fail
      to express M1 subunits. Mu-Class GST from two lymphoblastoid cell lines
      (expressing M1 subunits and the other 'nulled' for M1) have been studied. Both
      cell lines were found to express a Mu-Class GST that has not been described
      previously. The cDNA encoding this novel transferase, designated 'GSTM4' has been
      isolated and the enzyme shown to be comprised of 218 amino acids (including the
      initiator methionine residue) with an M(r) of approx. 25.5 kDa. Molecular cloning
      demonstrated that the lymphoblastoid cell line which expressed GSTM1 possessed
      the b allelic variant (i.e. that with an asparagine residue at position 173). The
      genes for GSTM4 and GSTM1b have been cloned and found to contain seven introns
      and eight exons. The coding region of the GSTM4 gene, including the seven
      introns, encompasses 5.0 kb, whereas the same region of GSTM1b is 5.5 kb; the
      difference in the size of the two genes is due to the length of intron 7. DNA
      sequencing allowed a GSTM4-gene-specific oligo-primer to be designed which has
      been utilized in a PCR-based assay to determine that the GSTM4 gene is located on
      chromosome 1.

PMID- 8471053
TI  - A simple purification of procyclic acidic repetitive protein and demonstration of
      a sialylated glycosyl-phosphatidylinositol membrane anchor.
AB  - The procyclic acidic repetitive protein is the major cell-surface glycoprotein of
      the insect-dwelling procyclic forms of the Trypanosoma brucei species of African
      trypanosomes. The glycoprotein contains an acidic Glu-Pro repeat domain, a
      glycosyl-phosphatidylinositol membrane anchor and a putative asparagine
      glycosylation site. In this paper we describe a rapid purification scheme for
      this glycoprotein, using solvent extraction and hydrophobic interaction
      chromatography, and a partial characterization of the
      glycosylphosphatidylinositol membrane anchor. The carbohydrate composition of the
      anchor is extremely unusual; it contains on average nine GlcNAc, nine Gal, and
      five sialic acid residues. This is the first description of such a heavily
      substituted and negatively charged anchor. A comparison between the trypanosome
      procyclic surface and the Leishmania promastigote surface is also presented.

PMID- 8471054
TI  - A specific binding of the cholecystokinin-releasing peptide (monitor peptide) to
      isolated rat small-intestinal cells.
AB  - A specific binding of the cholecystokinin (CCK)-releasing peptide (monitor
      peptide) to isolated rat jejunal mucosal cells was investigated. The 125I
      labelled purified monitor peptide bound to the rat jejunal cells, and a large
      excess amount of the non-labelled monitor peptide inhibited the binding. The
      binding was completed within 60 min at 37 degrees C. The optimum pH for the
      binding was 8-9. A Scatchard plot of the specific binding was linear, and the
      dissociation constant was 50 nM. The density of the monitor-peptide-binding sites
      was high in duodenum but low in ileal and absent in colonic mucosa. A recombinant
      monitor peptide and four kinds of point mutants of it were prepared. The binding
      of the mutant monitor peptides to the cells indicated that only a trypsin
      inhibitor of the mutants could bind to the mucosal cells. Human pancreatic
      secretory trypsin inhibitor inhibited the specific binding, but other trypsin
      inhibitors, i.e. bovine basic pancreatic trypsin inhibitor, soybean trypsin
      inhibitor, egg-white trypsin inhibitor, leupeptin, antipain and FOY-305, did not
      affect the specific binding at all. These findings suggested that the specific
      binding site for the monitor peptide on the jejunal mucosal cells has a trypsin
      like specificity, exhibiting a special specificity for the pancreatic-secretory
      trypsin-inhibitor family. Autoradiography of an affinity-cross-linked complex of
      the 125I-labelled intact monitor peptide and the binding site suggested that its
      molecular mass was 33 kDa or 53 kDa in the presence or absence of 2
      mercaptoethanol respectively.

PMID- 8471055
TI  - Lipoamidase activity in normal and mutagenized pancreatic cholesterol esterase
      (bile salt-stimulated lipase).
AB  - Purified human milk lipoamidase was digested with endoproteinase Lys-C and the
      digested peptides were subjected to gasphase microsequence analysis. The
      sequencing of three isolated peptides of human milk lipoamidase revealed the
      identity of this protein with human milk bile salt-stimulated lipase (pancreatic
      cholesterol esterase). The identity of the cholesterol esterase with lipoamidase
      was confirmed by expressing a recombinant form of rat pancreatic cholesterol
      esterase and testing for lipoamidase activity of the recombinant protein. The
      results showed that the recombinant cholesterol esterase displayed both lipolytic
      and lipoamidase activities and was capable of hydrolysing triacetin and lipoyl-4
      aminobenzoate (LPAB). The mechanisms of the esterase and amidase activities of
      the enzyme were further tested by determining enzyme activity in a mutagenized
      cholesterol esterase with a His435-->Gln435 substitution. This mutation has been
      shown previously to abolish enzyme activity against esterase substrates
      [DiPersio, Fontaine and Hui (1991) J. Biol. Chem. 266, 4033-4036]. We showed that
      the mutagenized protein was effective in hydrolysing the amidase substrate LPAB
      and displayed similar enzyme kinetics to those of the native enzyme. These data
      indicate that the mechanism for the cholesterol esterase hydrolysis of lipoamides
      is different from that of the hydrolysis of substrates with an ester linkage. The
      presence of an enzyme in the gastrointestinal tract capable of both ester and
      amide hydrolysis suggests an important role for this protein in the digestion and
      absorption processes.

PMID- 8471056
TI  - Role of the C-terminal domain of pulmonary surfactant protein A in binding to
      alveolar type II cells and regulation of phospholipid secretion.
AB  - Surfactant protein A (SP-A), with a reduced denatured molecular mass of 26-38
      kDa, is characterized by a collagen-like sequence in the N-terminal half of the
      protein. This protein forms an oligomeric structure which is dependent upon this
      collagenous domain. SP-A has been demonstrated to function as an inhibitor of
      phospholipid secretion by primary cultures of alveolar type II cells via a cell
      surface receptor for the protein. However, the receptor-binding domain of SP-A
      has not been identified. The purpose of the present study was to investigate the
      role of the C-terminal domain of SP-A in binding to type II cells and regulation
      of phospholipid secretion. A monoclonal antibody to human SP-A, whose epitope was
      localized at the C-terminal domain of the protein, abolished the inhibitory
      activity of human SP-A on lipid secretion by type II cells, and attenuated the
      ability of human SP-A to compete with 125I-(rat SP-A) for receptor binding. SP-A
      was then digested with collagenase and the collagenase-resistant fragment (CRF),
      which is the C-terminal domain of SP-A (thus lacking the N-terminal domain), was
      isolated. Gel filtration chromatography revealed that CRF exists as a monomer in
      solution containing Ca2+. CRF had the ability to inhibit phospholipid secretion,
      although at a higher concentration than for SP-A, and was also able to compete
      with 125I-(rat SP-A) for binding to type II cells. A direct binding study showed
      that CRF bound to type II cells in a concentration-dependent manner. The present
      study demonstrates that the non-collagenous, C-terminal, domain of SP-A is
      responsible for the protein's inhibitory effect on lipid secretion and its
      binding to type II cells.

PMID- 8471058
TI  - When cells take fate into their own hands: differential competence to respond to
      inducing signals generates diversity in the embryonic mesoderm.

PMID- 8471057
TI  - Localization and hormonal stimulation of phosphorylation sites in the LNCaP-cell
      androgen receptor.
AB  - Phosphorylation of the androgen receptor in human prostate tumour cells (LNCaP)
      is increased by addition of androgens to intact cells. Double-label studies,
      using [35S]methionine incorporation into receptor protein, and [32P]P(i) to label
      metabolically receptor phosphorylation sites, have enabled us to determine the
      phosphate content, relative to receptor protein, of both nontransformed and
      transformed and androgen receptors generated in intact LNCaP cells. No net change
      in the phosphorylation of the intact 110 kDa steroid-binding component of the
      androgen-receptor complex was found upon transformation to the tight nuclear
      binding form in the intact cell. Partial proteolysis of androgen receptor protein
      metabolically labelled with [32P]P(i) and photolabelled with [3H]R1881
      (methyltrienolone) revealed that phosphorylation occurs mainly in the N-terminal
      trans-activation domain, whereas no phosphorylation was detected in the steroid-
      and DNA-binding domains. The location of most (> 90%) of the hormonally regulated
      phosphorylation sites in the N-terminal trans-activation domain suggests a role
      of phosphorylation of the androgen receptor in transcription regulation.

PMID- 8471059
TI  - Microdissection and microcloning of human chromosome regions in genome and
      genetic disease analysis.

PMID- 8471060
TI  - Translational regulation by mRNA/protein interactions in eukaryotic cells:
      ferritin and beyond.
AB  - The expression of certain eukaryotic genes is--at least in part--controlled at
      the level of mRNA translation. The step of translational initiation represents
      the primary target for regulation. The regulation of the intracellular iron
      storage protein ferritin in response to iron levels provides a good example of
      translational control by a reversible RNA/protein interaction in the 5'
      untranslated region of an mRNA. We consider mechanisms by which mRNA/protein
      interactions may impede translation initiation and discuss recent data suggesting
      that the ferritin example may represent the 'tip of the iceberg' of a more
      general theme for translational control.

PMID- 8471061
TI  - In pursuit of the functions of the Wnt family of developmental regulators:
      insights from Xenopus laevis.
AB  - Wnts are a recently described family of secreted glycoproteins related to the
      Drosophila segment polarity gene, wingless, and to the proto-oncogene, int-1.
      Wnts are thought to function as developmental modulators, with signalling
      distances of only a few cell diameters. In Xenopus, at least six Wnts, including
      Xwnts-1, -3A, and -4, are expressed initially in the developing central nervous
      system, with some regions expressing multiple Xwnts. Xwnt-8 is expressed by mid
      blastula stage, in ventral and lateral mesoderm. Xwnt-5A mRNAs are stored in the
      egg, and later are expressed throughout the embryo in both ectoderm and mesoderm,
      but with a pronounced enrichment in the head and tail. Recent studies in Xenopus
      have pursued the diverse roles of Xwnts in early development, the mechanisms by
      which Xwnts signal information between cells, and the cell physiological
      responses to Xwnt signals.

PMID- 8471062
TI  - Environmental regulation of virulence factors in Bordetella species.
AB  - Many bacteria respond in a coordinate manner to environmental changes. External
      stimuli, sensed by receptors, are transduced to regulatory proteins which
      participate in well defined pathways of gene expression by varying their
      structure and mode of action. The network of environmental signal transduction is
      responsible for a fine and continuous communication between the host and the
      pathogenic bacteria. As a result, the gene expression machinery of the pathogen
      is modified continuously, in order to establish the optimal conditions for
      bacterial survival and multiplication.

PMID- 8471063
TI  - Transplacental transfer of polychlorinated biphenyls induces simultaneously the
      expression of P450 isoenzymes and the protooncogenes c-Ha-ras and c-raf.
AB  - At day 15 of gestation, rats were injected with a single i.p. dose of 100, 250
      and 500 mg/kg body weight of a mixture of polychlorinated biphenyls (PCBs)
      (Aroclor 1254). Seven days later, significant increases in maternal and foetal
      cytochrome P450, cytochrome b5 and cytochrome c (P450) reductase were found.
      Concomitantly, the metabolism of nitroanisole, aniline, ethoxyresorufin and
      benzo[a]pyrene was significantly increased, but foetal metabolism of
      dimethylnitrosamine was not detectable and only marginal increases in the
      metabolism of aminopyrine and aldrin were seen. In contrast, maternal metabolism
      of dimethylnitrosamine, aminopyrine and aldrin was measurable, but significant
      increases were determined only with the latter substrate. Transplacental transfer
      of PCBs resulted in increased metabolism of substrates catalysed by foetal CYP1A1
      and CYP2B1, but there was no evidence for CYP2E1-catalysed reactions. Further
      measurements show significant increases in foetal and maternal epoxide hydrolase,
      glutathione-S-transferase and UDP-glucuronyl transferase activities, thus
      suggesting that treatment with Aroclor 1254 resulted in coordinated increases in
      foetal and maternal oxidative and post-oxidative drug metabolism. Western blot
      analysis of microsomal proteins shows the induction of foetal and maternal
      CYP1A1, CYP1A2, CYP2A1, CYP2B1, CYP3A1 and CYP4A1. In addition, increased
      expression of CYP2C6 was seen with the mother but not the foetus. Unlike the
      mother, foetal rats did not express CYP2E1 and the expression of the above-listed
      P450 isoenzymes was greater in the mother than the foetus. Northern blot analysis
      shows significant increases in maternal and foetal CYP1A1, CYP1A2 and CYP2B1
      mRNA. An increased amount of CYP3A1 mRNA was only seen with the mother, but not
      the foetus. Treatment of mothers with Aroclor 1254 resulted in reduced CYP2A1,
      CYP2C7, CYP2E1 and CYP4A1 mRNA. Insignificant differences in the expression of
      foetal CYP2A1 and CYP4A1 mRNA were found, but in utero exposure to PCBs reduced
      the amounts of CYP2E1 mRNA and there was no foetal CYP2C7 mRNA transcript.
      Treatment with Aroclor 1254 increased the expression of the protooncogenes c-Ha
      ras and c-raf in the mother and the foetus, but at varying intensities. Pregnancy
      itself was linked to an increased expression of these protooncogenes. erbA and
      erbB mRNA was not detected.

PMID- 8471064
TI  - Identification of the fragment photoaffinity-labeled with azidodansyl-rhizoxin as
      Met-363-Lys-379 on beta-tubulin.
AB  - The rhizoxin (RZX)-binding site on porcine brain tubulin was investigated by
      photoaffinity labeling with the 5-azido-1-naphthalene sulfonyl (azidodansyl)
      derivative of RZX, nor-rhizoxin-22-al-5'-azidonaphthalene-1'-sulfonylhydrazo ne
      (azidodansylrhizoxin: Adan-RZX). Upon ultraviolet irradiation, Adan-RZX generates
      a highly reactive nitrene, which irreversibly binds to an amino acid residue(s)
      near the RZX-binding site. The label was found to be on beta-tubulin. Enzymatic
      digestion of the labeled tubulin generated only one major fluorescent peak on C18
      reverse phase HPLC analysis. The labeled site(s) was mapped by using various
      combinations of highly specific peptidases in succession. That is, the labeled
      fragment generated by the first peptidase was purified by HPLC and exposed to a
      second peptidase; if the retention time in HPLC changed after the second
      digestion, the fragment generated in the first digestion must have contained the
      recognition site(s) of the second enzyme. From the results of these successive
      digestions and the known polypeptide sequences, we could identify the labeled
      fragment as Met-363-Lys-379 of beta-tubulin. This peptidase combination technique
      should be widely applicable.

PMID- 8471065
TI  - Tissue- and subunit-specific regulation of G-protein expression by hypo- and
      hyperthyroidism.
AB  - Thyroid hormone status has profound effects on signal transduction in various
      tissues throughout the body. Therefore, we quantified the signal transducing G
      proteins in the rat heart, cerebral cortex, vas deferens and liver by
      immunoblotting and pertussis toxin labeling in response to chemically induced
      hypothyroidism (treatment with propylthiouracil) and hyperthyroidism (treatment
      with triiodothyronine). Levels of the pertussis toxin (PTX) substrates Gi alpha
      and Go alpha in the heart and vas deferens were inversely correlated with thyroid
      hormone levels, i.e. Gi alpha and Go alpha were decreased or unchanged in
      hyperthyroid rats and increased in hypothyroid rats compared to control animals.
      The cerebral cortex and liver expression of PTX substrates Gi alpha and Go alpha
      was not affected by changes in thyroid hormone. Regulation of Gs alpha protein
      was more complex in that Gs alpha was unaffected in the other tissues tested.
      Expression of G-protein beta-subunits was not affected by thyroid status in the
      heart, liver, or cerebral cortex. Our results suggest that tissue- and G-protein
      specific factors are involved in the regulation of G-protein subunits by thyroid
      hormone. Moreover, cardiac expression of Gs alpha is upregulated by increases or
      decreases in the normal level of thyroid hormone.

PMID- 8471066
TI  - Production of an interleukin-8-like chemokine by cytokine-stimulated rat NRK-49F
      fibroblasts and its suppression by anti-inflammatory steroids.
AB  - Normal rat kidney fibroblasts (NRK-49F cells) stimulated with interleukin-1 beta
      (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) produced mainly cytokine
      induced neutrophil chemoattractant (CINC) which is the rat counterpart of human
      gro/melanoma growth stimulatory activity. In addition, the cytokine-stimulated
      cells produced two minor neutrophil chemoattractants which are highly related to
      murine macrophage inflammatory protein-2 in their NH2-terminal amino acid
      sequences. IL-1 beta was a stronger stimulator than TNF-alpha, and addition of
      both the cytokines into the NRK-49F cell culture caused an additive stimulation
      for rat gro/CINC production. The anti-inflammatory steroids (dexamethasone,
      prednisolone and hydrocortisone) at 10(-9)-10(-6) M significantly suppressed the
      production of rat gro/CINC by the IL-1 beta-stimulated NRK-49F cells in a dose
      dependent manner. The relative potencies of the inhibitory activity of the
      steroids on the rat gro/CINC production were dexamethasone > prednisolone >
      hydrocortisone. On the other hand, the non-steroidal anti-inflammatory drugs
      (indomethacin and piroxicam) at 10(-7)-10(-5) M showed no apparent inhibitory
      effect on rat gro/CINC production by NRK-49F cells stimulated with IL-1 beta.

PMID- 8471067
TI  - Malaria pigment and extracellular iron. Possible target for iron chelating
      agents.
AB  - Extracellular iron is necessary for many biochemical reactions involved in
      Plasmodium falciparum growth and multiplication. The incorporation of radioactive
      iron taken up by the parasite was found, electrophoretically and via gamma
      counting, to be mainly associated with the haemozoin only in the presence of the
      active metabolism of the parasite. The potent antimalarial activity of
      desferrioxamine, a ferric iron chelating agent, has shown that iron deprivation
      is inhibitory to the parasite. We propose that the mechanism of action of
      desferrioxamine in addition to the chelation of iron from the parasitic
      compartment, chelates iron from the haemozoin crystal resulting in free radical
      generation and parasite death. The ability of desferrioxamine and not the ferrous
      iron chelating agent, 2,2'-bipyridyl, to chelate the non-haem iron from the
      haemozoin structure indicates that the oxidative state of iron associated with
      the haemozoin structure is ferric in nature.

PMID- 8471068
TI  - Role of thyroid state on induction by ciprofibrate of laurate hydroxylase and
      peroxisomal enzymes in rat liver microsomes.
AB  - The effects of hypothyroidism and hyperthyroidism upon liver microsomal omega
      laurate hydroxylase activity (cytochrome P450 IV A1-dependent), peroxisome
      proliferation marker enzyme activities and acyl CoA oxidase (AOX) expression
      induced by ciprofibrate (2 mg/kg/day during 8 days) were studied in the male
      Wistar rat so as to clarify firstly the possible involvement of thyroid hormones
      in the modification of peroxisomal ciprofibrate-induced enzyme activities in
      relation to hepatic microsomal cytochrome P450 IV A1 induction, and secondly the
      possible direct effect of thyroid hormones on the gene expression of specific
      peroxisomal enzymes. No significant change was found in the ciprofibrate-induced
      omega-laurate hydroxylase activity in hypothyroid rats or in rats that had
      received a large dose of triiodothyronine (LT3), suggesting that the thyroid
      hormone does not interfere with the peroxisome proliferation process through such
      an indirect mechanism. The induction by ciprofibrate [2-(4-(2
      2dichlorocyclopropyl)phenoxyl-2methyl-propion ic acid)] of mitochondrial alpha
      glycerolphosphate dehydrogenase and microsomal bilirubin UDPGT was decreased
      about 3-fold and 1.5-fold, respectively, while the induction of peroxisomal AOX,
      carnitine acetyl transferase and enoyl CoA hydratase enzyme activities was
      decreased by 36%, 34% and 22% in thyroidectomized animals, as compared to
      euthyroid animals. However, no significant changes in the quantity of peroxisomal
      proteins and in the AOX mRNA level were noted. The administration of large doses
      of LT3 to normal rats decreased the peroxisomal ciprofibrate AOX enzyme induction
      with a marked concomitant decrease in the AOX mRNA level. This suggests that high
      doses of LT3 enhance the turnover of some specific mRNAs or down regulate the
      peroxisome proliferator receptor. Our results also do not exclude inhibition of
      catabolic activity towards AOX which depends on thyroid hormone.

PMID- 8471069
TI  - Iron-initiated tissue oxidation: lipid peroxidation, vitamin E destruction and
      protein thiol oxidation. Inhibition by a novel antioxidant, U-78517F.
AB  - Oxidative injury was initiated by addition of ferrous ammonium sulfate (FAS) to a
      suspension of whole rat brain homogenate in Krebs buffer. After FAS addition,
      tissue vitamin E dropped sharply over a 30-sec interval and then recovered
      marginally for 5 min. After 5 min, vitamin E levels dropped to a low and constant
      level. Also after 5 min, TBARS (thiobarbituric acid reactive substances, a color
      test for lipid peroxidation) showed a statistically significant (P < or = 0.05)
      increase that continued through the remainder of the 30-min experiment. Reduced
      protein thiols decreased significantly (P < or = 0.05) at 15 min post FAS
      addition. This suggests that, in this model of iron-initiated lipid peroxidation
      (LP), the endogenous antioxidant vitamin E is first depleted before membrane
      lipids and membrane bound proteins show evidence of oxidative injury. A novel
      antioxidant, U-78517F, inhibited the destruction of vitamin E, LP and protein
      thiol oxidation in this model. The efficacy of the compound after different times
      of addition is described.

PMID- 8471070
TI  - Induction of P4502E1 by acetone in isolated rabbit hepatocytes. Role of increased
      protein and mRNA synthesis.
AB  - The molecular mechanism(s) underlying induction of the hepatic microsomal
      cytochrome P4502E1 (2E1) by xenobiotics (e.g. ethanol and acetone) is
      controversial. Proposed mechanisms include increased rates of enzyme synthesis
      due to elevated 2E1 mRNA levels, enhanced translation of pre-existing mRNA, or
      stabilization of 2E1 protein. To further assess which, if any, of these events
      predominates during the initial stages of 2E1 protein induction, we investigated
      the effects of acetone treatment on 2E1 content in cultured rabbit hepatocytes,
      an in vitro system that allows for precise control of the cellular mileau.
      Hepatocytes harvested from female rabbits and plated on plastic dishes with serum
      supplemented medium were 90-100% viable for at least 48 hr in culture. Analysis
      of immunoreactive 2E1 content and aniline hydroxylase activity in microsomes
      isolated from hepatocytes cultured for up to 24 hr revealed that 2E1 expression
      was equal to that of microsomes from unplated cells and by 48 hr of culture, 2E1
      levels decreased by only 35%. Moreover, microsomes isolated from cells exposed to
      17 mM acetone for 24 hr exhibited a 53 and 62% increase in aniline hydroxylase
      activity and 2E1 content, respectively, compared to untreated cells. To explain
      these increases, the rate of 2E1 protein synthesis was determined in untreated
      cells or in cells treated with 17 mM acetone by first exposing hepatocytes to
      medium supplemented with 35S-labeled methionine and cysteine ([35S]Met/Cys) and
      subsequently assessing radiolabel incorporation into 2E1 protein. While no
      difference was found between untreated and acetone-treated cells in the
      incorporation of [35S]Met/Cys into trichloracetic acid-precipitable microsomal
      proteins, immunoaffinity purification of 2E1 revealed that incorporation of 35S
      labeled amino acids specifically into 2E1 was elevated by acetone to 200% of
      control values. Treatment of hepatocytes with the transcriptional inhibitor,
      alpha-amanitin, markedly inhibited this acetone-mediated increase in [35S]Met/Cys
      incorporation into 2E1. Analysis of hepatocyte RNA revealed that acetone
      increased 2E1 mRNA to 130 and 160% of control levels at 6 and 24 hr,
      respectively, and that these increases were prevented by pretreatment with alpha
      amanitin. Our results indicate that acetone increases 2E1 protein levels in
      cultured rabbit hepatocytes by stimulating its rate of de novo synthesis. Since
      this increase in 2E1 synthesis stems, at least in part, from the acetone-mediated
      enhancement of hepatocyte 2E1 mRNA content and is inhibitable by alpha-amanitin,
      transcriptional activation of the rabbit CYP2E1 gene is apparently involved in
      the induction of 2E1 protein by acetone.

PMID- 8471071
TI  - Mechanism of resistance to cyclopentenyl cytosine (CPE-C) in Molt-4 lymphoblasts.
AB  - Cyclopentenyl cytosine (CPE-C), a carbocyclic analogue of cytidine, has
      preclinical antineoplastic activity against ara-C resistant murine leukemias and
      a broad spectrum of human tumor xenografts. CPE-C is a prodrug and requires
      intracellular phosphorylation to cyclopentenyl cytosine triphosphate (CPE-CTP)
      which depletes endogenous CTP pools. The initial step in this activation process
      is catalyzed by uridine/cytidine kinase. We studied the mechanism of resistance
      to CPE-C in a Molt-4 T-cell leukemia line made resistant to CPE-C (Molt-4R) by
      culturing it in the continuous presence of increasing concentrations of CPE-C.
      Using a tetrazolium based colorimetric assay to assess cytotoxicity, the IC90 for
      the parent Molt-4 cells (Molt-4WT) was 0.5 microM after a 24 hr drug exposure. In
      contrast, cytotoxicity was not observed at concentrations as high as 1 mM in the
      Molt-4R cells. Following a brief exposure to 1 microM CPE-C, parent drug could be
      detected intracellularly in the resistant and sensitive cell lines. However, CPE
      CTP formation was reduced markedly in the resistant cell line. Measurement of the
      activity of anabolic and catabolic enzymes in the Molt-4WT and Molt-4R cells
      revealed equivalent activities of alkaline and acid phosphatases as well as
      cytidine and dCMP deaminase but there was a significant reduction in
      uridine/cytidine kinase activity in Molt-4R cells. Endogenous ribonucleotide
      pools and CPE-CTP pools were measured in the absence and presence of CPE-C. CTP
      pools were reduced markedly in Molt-4WT cells following exposure to CPE-C.
      However, CTP pools in Molt-4R cells exposed to 100 microM CPE-C were two times
      greater than in the untreated Molt-4WT cells. At high concentrations of CPE-C (10
      and 100 microM), Molt-4R cells were able to generate amounts of CPE-CTP
      equivalent to that seen in Molt-4WT cells exposed to 1 microM CPE-C (a cytotoxic
      concentration of drug in Molt-4WT cells), but no cytotoxic effect was seen in
      Molt-4R cells. Therefore, in addition to decreased uridine/cytidine kinase
      activity, a second mechanism of resistance that is the result of alterations in
      CTP synthetase activity also appears to be operative. Elucidation of the
      mechanism of resistance in vitro may provide insight into the mechanism of action
      of the drug and potential mechanisms of resistance in vivo.

PMID- 8471072
TI  - Differential effects of active isomers, segments, and analogs of dolastatin 10 on
      ligand interactions with tubulin. Correlation with cytotoxicity.
AB  - Dolastatin 10 is a potent antimitotic peptide isolated from the marine mollusk
      Dolabella auricularia. Four of its five residues are modified amino acids (in
      sequence, dolavaline, valine, dolaisoleuine, dolaproine, dolaphenine). Besides
      inhibiting tubulin polymerization, dolastatin 10 non-competitively inhibits vinca
      alkaloid binding to tubulin, inhibits nucleotide exchange and formation of the
      beta s cross-link, and stabilizes the colchicine binding activity of tubulin. To
      examine the mechanism of action of dolastatin 10 we prepared six chiral isomers,
      one tri- and one tetrapeptide segment, and one pentapeptide analog of dolastatin
      10, all of which differ little from dolastatin 10 as inhibitors of tubulin
      polymerization. However, only two of the chiral isomers were similar to
      dolastatin 10 in their cytotoxicity for L1210 murine leukemia cells and in their
      effects on vinblastine binding, nucleotide exchange, beta s cross-link formation,
      and colchicine binding. These were isomer 2, with reversal of configuration at
      position C(19a) in the dolaisoleuine moiety, and isomer 19, with reversal of
      configuration at position C(6) in the dolaphenine moiety. The pentapeptides with
      reduced cytotoxicity and reduced effects on tubulin interactions with other
      ligands were all modified in the dolaproine moiety at positions C(9) and/or
      C(10). The tripeptide and tetrapeptide segments which inhibited polymerization
      but not ligand interactions were the amino terminal tripeptide (lacking
      dolaproine and dolaphenine) and the carboxyl terminal tetrapeptide (lacking
      dolavaline). We speculate that strong inhibition of other ligand interactions
      with tubulin requires stable peptide binding to tubulin (i.e. slow dissociation),
      but that inhibition of polymerization requires only rapid binding to tubulin.

PMID- 8471073
TI  - Effect of tocotrienol on the activities of cytosolic glutathione-dependent
      enzymes in rats treated with 2-acetylaminofluorene.
AB  - The effect of tocotrienol on the activities of glutathione S-transferases (GSTs),
      glutathione reductase (GR) and glutathione peroxidase (GPx) in rats given 2
      acetylaminofluorene (AAF) was investigated over a 20 week period. Liver and
      kidney GST and liver GR activities were significantly increased after AAF
      administration. Kidney GPx activities were significantly affected; activity
      assayed with cumene hydroperoxide (cu-OOH) was increased but activity assayed
      with H2O2 was reduced. Supplementation of the diet with tocotrienol in the AAF
      treated rats reduced the increase in enzyme activities. Tocotrienol on its own
      had no effect on the enzyme activities.

PMID- 8471074
TI  - Comparative study of active absorption by the intestine and disposition of
      anomers of sugar-conjugated compounds.
AB  - Active absorption in the intestine and metabolism of the beta- and alpha-anomers
      of the glucoside and galactoside of p-nitrophenol (p-NP) were studied to find a
      more suitable prodrug for poorly absorbed drugs. The everted sac technique was
      used to investigate the intestinal absorption of these glycosides at 250 microM
      from the mucosal to the serosal side in the rat jejunum. The absorption clearance
      of p-nitrophenyl alpha-D-glucopyranoside (p-NP alpha glc) (0.271 +/- 0.089
      microL/min/cm, mean +/- SE, N = 8) was much lower than that of p-nitrophenyl beta
      D-glucopyranoside (p-NP beta glc) (4.45 +/- 0.34 microL/min/cm, mean +/- SE, N =
      4) which is actively absorbed by a glucose transport carrier [Mizuma et al.,
      Biochem Pharmacol 43: 2037-2039, 1992]. However, the major constituent appearing
      on the serosal side was p-NP (aglycone) after absorption of pNP alpha glc,
      whereas it was p-NP beta glc itself after absorption of p-NP beta glc. The total
      amount transported to the serosal side after 20 min of p-NP alpha glc absorption,
      which was similar to that of p-NP beta glc, was significantly decreased in the
      absence of Na+, indicating the active absorption of p-NP alpha glc by a Na(+)
      dependent glucose transport carrier. Perfusion with a mucosal solution of p-NP
      alpha glc showed that the p-NP concentration on the serosal side (15.8 +/- 1.56
      microM, mean +/- SE, N = 3) was significantly (P < 0.05) higher than that on the
      mucosal side (5.84 +/- 1.24 microM, mean +/- SE, N = 3) at 20 min. This indicated
      that the p-NP appearing on the serosal side was derived not from absorption of p
      NP but from hydrolysis of p-NP alpha glc through the intestinal membrane during
      absorption. On the other hand, after absorption of p-nitrophenyl beta-D
      galactopyranoside (p-NP beta gal), which is actively absorbed by glucose
      transport carrier, p-NP beta gal itself appeared mostly on the serosal side.
      However, p-nitrophenyl alpha-D-galactopyranoside (p-NP alpha gal) absorption,
      which resulted in appearance on the serosal side, was not significantly decreased
      in the presence of 1 mM phloridzin or in the absence of Na+, indicating that the
      contribution of the glucose transport carrier to p-NP alpha gal absorption was
      minimal. The order of the Na(+)-dependent intestinal absorption was p-NP beta glc
      > p-NP alpha glc > p-NP beta gal > p-NP alpha gal.

PMID- 8471075
TI  - Degradation of angiotensin I in the endothelium and smooth muscle of the rat
      aorta.
AB  - In homogenates of the endothelium and smooth muscle cum adventitia of the rat
      aorta, exogenous angiotensin (ANG) I was found to be degraded to des-aspartate
      ANG I (des-Asp-ANG I) instead of ANG II. ANG II and ANG III were not detectable
      in either of the homogenates after 5, 10 and 30 min of incubation with the
      decapeptide. However, both the homogenates were able to catalyse hippuryl-L
      histidyl-L-leucine (HHL) to hippuric acid and the catalysis was completely
      inhibited by 3 microM captopril. The data show that the angiotensin converting
      enzyme (ACE) present in the homogenates of rat aorta, prepared by normal
      laboratory procedures, is not able to hydrolyse ANG I to ANG II. This finding has
      important consequences in the study of vascular ACE as the assay of the enzyme is
      often carried out using crude homogenate and HHL or other artificial substrates.
      In addition, the aminopeptidase that degraded ANG I to des-Asp-ANG I was not
      inhibited by either amastatin or bestatin, indicating that it was not
      aminopeptidase A or B. Together with the recent findings of other investigators
      which show that the de novo production of ANG II in vascular tissues is
      stimulated and inhibited by beta- and alpha-agonists, respectively, our present
      data may suggest that production of vascular ANG II occurs only in intact tissues
      and is probably under adrenergic regulation.

PMID- 8471076
TI  - Kinetic analysis of mutual metabolic inhibition of lidocaine and propranolol in
      rat liver microsomes.
AB  - The metabolic interaction between lidocaine (LD) and propranolol (PL) was
      analysed kinetically in rat liver microsomes. Employing a very short incubation
      time of 30 sec, we demonstrated that PL competitively inhibited liver microsomal
      3-hydroxylation of LD, but did not affect either the formation of
      monoethylglycinexylidide or methylhydroxylidocaine from LD in PL concentrations
      up to 1 microM. On the other hand, LD competitively inhibited PL 4-, 5- and 7
      hydroxylations, but the inhibition type of LD for PL N-desisopropylation could
      not be clarified. Comparison of the kinetic data for liver microsomes from Wistar
      and Dark Agouti rats indicated that among the primary metabolic pathways of LD,
      the Vmax value for 3-hydroxylation was markedly less in female Dark Agouti rats.
      The results suggest that LD 3-hydroxylation and PL ring hydroxylations are
      mediated by the same isozyme(s) belonging to the CYP2D subfamily.

PMID- 8471077
TI  - Lack of discrimination between DNA ligases I and III by two classes of
      inhibitors, anthracyclines and distamycins.
AB  - We have measured the effects of eight distamycin and two anthracycline
      derivatives on polynucleotide joining and self-adenylating activities of human
      DNA ligase I and rat DNA ligases I and III. All test drugs show good inhibitory
      activity against the three enzymes in the poly[d(A-T)] joining assay. Several
      distamycins also inhibit the DNA-independent self-adenylation reaction catalysed
      by the human enzyme and, to a lesser extent, by rat DNA ligases. These results
      confirm that anthracyclines and distamycins express their inhibitory action
      against DNA joining activities mainly via specific interactions with the
      substrate, and suggest that the three test DNA ligases utilize similar, if not
      identical, mechanisms of recognition and interaction with DNA-drug complexes. Our
      findings also indicate that distamycins have a greater affinity for human DNA
      ligase I than for rat enzymes, suggesting that, in this respect, rat DNA ligase I
      is more similar to rat DNA ligase III than to human DNA ligase I.

PMID- 8471078
TI  - Clinical pharmacokinetics of antidepressants in the elderly. Therapeutic
      implications.
AB  - The prevalence of depression in the elderly suggests that a substantial number of
      older patients will be treated with an antidepressant medication such as one of
      the tricyclics, trazodone, fluoxetine or lithium. The physiological changes that
      accompany aging raise the possibilities of altered pharmacokinetics, patterns of
      efficacy and adverse effect profiles. The literature addressing the subject of
      antidepressant use in the elderly has not provided a clear, consistent picture of
      how these drugs behave in this population in comparison with younger patients.
      Particularly in the case of the tricyclic antidepressants (TCAs), a large degree
      of interindividual variation in drug clearance (CL) confounds attempts to find
      differences attributable to age per se. Study design, however, is also a problem
      in that very few investigators include a young control group, choosing instead to
      compare their data with previously reported outcomes. Designations of statistical
      significance and positive correlation also differ among investigators, and the
      clinical significance of any finding is not always addressed. The available data
      suggest that imipramine CL is reduced in the elderly and that amitriptyline CL
      may be reduced. Desipramine CL does not appear to be affected by age, although
      decreased renal function in the elderly may lead to accumulation of the
      hydroxylated metabolite, the clinical importance of which is not known.
      Nortriptyline is the most thoroughly studied TCA in the elderly. CL seems
      decisively lower only in elderly patients with concurrent medical illness. The
      hydroxylated metabolite probably accumulates with diminishing renal function. Not
      enough data are available on doxepin to make a conclusion. Trazodone CL is
      diminished somewhat in elderly men. Lithium CL appears to diminish with the
      declining renal function associated with aging. Fluoxetine data are sparse.
      Available data do not show any decrease in CL of the parent drug; more
      information is needed on the metabolite norfluoxetine. Although knowledge of CL
      changes with aging can help the clinician more accurately achieve the desired
      steady-state concentration of a drug during long term therapy, much work is still
      needed to evaluate the relationships among drug concentrations at steady-state,
      efficacy and adverse effects in the elderly.

PMID- 8471079
TI  - Alcohol consumption and alcohol-related problems in Afro-Caribbeans and south
      Asians in the United Kingdom.
AB  - Data from published sources and unpublished surveys in the U.K. show that average
      alcohol consumption is lower in Afro-Caribbean men and women than in native
      British men and women. The proportion of heavy drinkers is also low in Afro
      Caribbeans. Consistent with these consumption data, hospital admission rates for
      alcohol-related problems are lower in Afro-Caribbeans than in the general
      population. Among South Asians (Indians, Pakistanis and Bangladeshis) average
      alcohol consumption is lower than in the native British population but alcohol
      related morbidity rates for some South Asian communities are higher than for the
      general population. The reasons for these high morbidity rates are not clear.
      Consumption is higher in Sikhs than in Hindus or Muslims, and heavy spirit
      drinking appears to be especially common among Sikh men. Alcohol-related
      psychiatric admission rates for South Asians have risen since 1971, and appear to
      be especially high in Sikh men. The high alcohol-related morbidity rates in this
      group are a priority for further research and efforts at prevention.

PMID- 8471080
TI  - Detection of antibodies to acetaldehyde-albumin conjugates in alcoholic liver
      disease.
AB  - The principal metabolite of ethanol, acetaldehyde, conjugates with various
      proteins that form antibody-inducing neo-antigens. We have analysed sera from
      patients with biopsy-proven alcoholic liver disease (hepatitis = 10, cirrhosis =
      11, steatosis = 3) and controls = 19 (normal teetotallers and 6 non-alcoholic
      liver disease). Sera were examined with an enzyme-linked immunoabsorbent assay
      (ELISA) for antibodies binding preferentially to an acetaldehyde-albumin
      conjugate. Reactive sera from alcohol misusers were then purified using an amino
      hexyl Sepharose affinity column. Antibodies binding to the acetaldehyde-albumin
      epitopes were significantly raised (P < 0.005) in all groups of alcohol misusers,
      and were present in greatest titre in those with alcoholic hepatitis. These
      antibodies were successfully purified using the gel affinity column. We conclude
      that alcohol misusers have significant titres of antibodies reacting to the
      acetaldehyde-albumin complex. The role of these antibodies remains nuclear, but
      may be related to the initiation of an inflammatory response and tissue damage
      following ethanol consumption.

PMID- 8471081
TI  - Antioxidant status and alcohol-related diseases.
AB  - Chronic ethanol consumption is associated with increased incidence of a variety
      of illnesses, including cancer. Studies have shown that ethanol consumption may
      result in increased oxidative stress with formation of lipid peroxides and free
      radicals. The susceptibility of a given tissue to peroxidation is, however, a
      function of the overall balance between prooxidants and antioxidant defence
      systems. The latter involve both intracellular and extracellular protective
      factors were nutrients play an important role. Impaired nutritional status of
      different vitamins and trace elements have been reported in alcoholics. Reduced
      levels of vitamin E have been found in serum of alcoholics with and without liver
      disease and in liver biopsies from alcoholics with cirrhosis. These findings may
      be due to the increased oxidative stress as reported in experimental animals, and
      may be of importance since vitamin E is the major, if not the only, lipid-soluble
      free radical scavenger in some tissues. Reduced antioxidant capacity has been
      found in several tissues and may promote the generation of free radicals and
      lipid peroxides which may damage cells directly, induce inflammation and
      accelerate collagen synthesis. These events may progress to tissue damage and
      disease. The importance of radicals in cancer initiation and promotion is
      presently of great interest. The role of lipid peroxides and free radicals in
      alcohol-related disease and cancer remains unresolved. Further research is
      required to establish the role of these reactive species in the pathogenesis of
      alcohol-related disease, and to evaluate the role of nutrition in favour of the
      antioxidant defence mechanisms.

PMID- 8471082
TI  - Modulation of cancer growth by vitamin E and alcohol.
AB  - Seventy-five percent of esophageal cancers are alcohol related, yet alcohol is
      not a carcinogen. Ethanol may promote carcinogenesis via increased free radical
      products during its metabolism, as indicated by data from this and other studies.
      Ethanol is oxidized to acetaldehyde by alcohol dehydrogenase, catalase and the
      microsomal ethanol oxidizing system (MEOS). Free radicals (FR) are released
      during the oxidation of ethanol by the MEOS. An increased formation of FR in
      tissues would increase their oxidative stress and may increase their
      susceptibility for developing chemically induced cancers. FR and some FR products
      can rapidly react with biological materials, i.e. lipids, proteins and nucleic
      acids, forming toxic products. This study focuses on the effects of FR and/or FR
      products on cancer promotion during alcohol metabolism. Eight groups of mice were
      fed nutritionally adequate diets supplemented with vitamin E and/or ethanol. Some
      groups of mice were also orally gavaged with N-nitrosomethylbenzylamine (NMBzA),
      an esophageal carcinogen. Following the feeding of the various diets for 22
      weeks, livers and esophagi were removed and the FR burden in the liver measured
      by the presence of lipid peroxide products and the number of tumors in each
      esophagus determined. These studies indicate that a linear relationship exists
      between the increasing number of esophageal tumors and increasing levels of lipid
      peroxide products that are formed during FR activity. These results show that FR
      and/or FR products are the cancer promoters during ethanol metabolism, since
      diets supplemented with high levels of vitamin E, which inhibits ethanol-induced
      FR activity and the formation of FR products, suppress the promotion of cancer by
      ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471083
TI  - Studies on the chronopharmacology of ethanol.
AB  - Male subjects (n = 10) were given ethanol (0.75 g/kg) at four equally spaced
      times in the 24 hr cycle (9 am, 3 pm, 9 pm 3 am) in random order. Blood ethanol
      concentrations were monitored by breath analysis and measurements were made of
      the blood or plasma levels of ethanol, acetaldehyde, acetate, pyruvate, lactate
      and cortisol. Blood pressure, heart rate and body temperature were measured
      before and at 60 and 120 min after ethanol administration and the effects of
      ethanol on a number of behavioural parameters and mood were studied. After
      ethanol ingestion, there was a significant decrease in body temperature, systolic
      blood pressure, plasma cortisol and pyruvate levels, whilst acetate levels and
      the lactate:pyruvate ratio were significantly increased. Standing steadiness,
      critical flicker fusion threshold and divided attention tracking control were
      significantly impaired under ethanol and self-report data indicated a significant
      decrease in alertness, co-ordination, concentration and attentiveness. Although a
      significantly higher peak blood ethanol concentration was attained at the 9 am
      session, other time-of-day differences did not reach significance and the
      pharmacokinetics of ethanol were essentially unchanged. Since the only
      significant diurnal variations in the response to ethanol identified in this
      study (apart from the subjective results) were for plasma cortisol concentrations
      and body temperature (both of which are well known to exhibit diurnal
      rhythmicity), it appears that major circadian variability in the metabolic and/or
      behavioural effects of ethanol is unlikely to occur.

PMID- 8471084
TI  - Mathematical modelling of ethanol metabolism in normal subjects and chronic
      alcohol misusers.
AB  - The time course of ethanol disappearance from the blood has been examined in
      normal males and females and in alcohol misusers. Blood alcohol estimations were
      made over a period of 3 hr, following an oral dose of ethanol (0.8 g/kg body
      weight) administered in the form of whisky. Attempts were made to fit the data to
      zero order, first order and mixed zero + first order kinetics. In the majority
      (75%) of normal females the blood ethanol concentrations was still increasing at
      30 min. This was only seen in 50% of normal males and in 50% of non-dependent
      alcohol misusers, but not in dependent alcohol misusers. In all of the normal
      females the disappearance of ethanol could be adequately described by zero order
      kinetics. However, in the normal male group only 20% could be described by zero
      order kinetics, 10% fitted first order kinetics and the remainder required a
      mixed model of zero + first order. The rate constant for the zero order component
      of the control male group was identical to zero order rate constant obtained for
      the female control group. In the female alcohol misuser group, 40% of the curves
      could not be described by zero order kinetics and fitted best to a mixed model.
      The zero order component of the entire group was significantly increased (by 35%)
      compared to that obtained for the female control group. In the male dependent and
      non-dependent alcohol misuser groups, all blood alcohol concentration curves
      fitted best to mixed zero and first order kinetics.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8471085
TI  - The Alcohol Use Disorders Identification Test (AUDIT) and the SMAST-13:
      predictive validity in a rural primary care sample.
AB  - This study was conducted to compare the validity of a new screening instrument
      developed by the World Health Organization, the Alcohol Use Disorders
      Identification Test (AUDIT), to the short version of the MAST in 287 primary care
      patients. Subjects were classified as meeting a lifetime or current DSM-III
      diagnosis of alcohol misuse and/or dependence based on the DIS-R interview
      schedule. Using the original WHO guidelines (score of 11 or more), 37 (13%)
      scored positive on the AUDIT and 103 (36%) had a weighted score of 5 or more on
      the SMAST-13. The internal reliability of the AUDIT was 0.86, compared to the
      SMAST-13 at 0.85. Cut-off scores in this sample for current alcohol problems,
      utilizing Receiver Operating Curves, were 7-8 for the AUDIT and 5 for the SMAST.
      This study confirms the utility of the AUDIT for current alcohol problems and the
      SMAST-13 for lifetime or past problems in a rural clinical sample.

PMID- 8471086
TI  - Patterns of alcohol consumption among the general population of Castile and Leon
      (Spain).
AB  - A total of 2500 individuals, aged 14-70, who live in Castile and Leon (Spain),
      were surveyed in the spring of 1989 with regard to their alcohol consumption and
      its patterns. Among those surveyed 26.2% were 'daily' drinkers and 66.0% 'weekly'
      drinkers. Differences of alcohol use (frequency) and intake were reviewed with
      regard to sociodemographic factors such as gender, age, and marital status. Beer
      (52.6%) was the favourite drink, with wine (20.6%) the second most commonly
      consumed alcohol beverage. Most of those surveyed (54.6%) were 'light' drinkers
      (1-39 g/day of pure alcohol), while 3.0% had an intake of over 80 g/day ('heavy'
      drinkers). The average age at which they started drinking was 16.2 years. The
      results allow a better understanding of the pattern of alcohol consumption in
      Spain.

PMID- 8471087
TI  - Alcohol-nutrient interactions: a critical component of physiological change.

PMID- 8471088
TI  - Dietary fatty acids and alcohol: effects on cellular membranes.
AB  - The consumption of ethanol has been shown to exert profound effects on cellular
      membranes which result in damage and/or adaptation. Both membrane lipids and
      proteins are affected, but because of the physicochemical properties of ethanol,
      many of the membrane effects are directly related to the interaction of ethanol
      with the lipid component of the membrane. In addition to the direct lipid-ethanol
      interaction, ethanol has been shown to dramatically alter lipid metabolism.
      Triacylglycerol accumulates dramatically in the liver, and biosynthesis of the
      polyunsaturated fatty acids seems to be altered via effects upon the acyl-CoA
      desaturases. Because precursors of both families of unsaturated fatty acids, i.e.
      omega 3 and omega 6 families, cannot be synthesized de novo, they must be
      supplied from dietary sources. Thus, the unsaturated membrane fatty acid
      composition depends upon these dietary fats and their metabolism via the
      desaturases. Further, the level of dietary fat seems to play a very important
      role in ethanol-induced damage to various cellular membranes. Diets with high
      levels of fat greatly enhance liver steatosis as well as liver membrane damage
      and liver fibrosis. By altering the composition of dietary fat to include either
      more saturated fatty acids, higher levels of a specific omega 6 fatty acid, alpha
      linolenic acid, or higher levels of the omega 3 fatty acids, biochemical,
      physiological and neurobehavioral effects of ethanol have been shown to be
      modulated. Therefore, it appears that dietary fatty acids may play an important
      role in altering some of the deleterious effects of ethanol.

PMID- 8471089
TI  - Ethanol and diet-induced alterations in Kupffer cell function.
AB  - The effects of 6 weeks of alcohol feeding on phagocytic, metabolic and secretory
      functions as well as gene expression of hepatic Kupffer cells were evaluated in
      vitro using cultured Kupffer cells isolated from male Sprague-Dawley rats. The
      rats were fed either Teklad pelleted rat chow or the 1982 Lieber-DeCarli liquid
      diet containing 6% ethanol (36% calories) or the same liquid diet with maltose
      dextrin isocalorically substituted for the alcohol. Weight gain was greatest in
      the chow-fed animals and least in those receiving ethanol. The alcohol-containing
      diet stimulated Kupffer cell phagocytosis, mitochondrial reduction of MTT,
      secretion of tumor necrosis factor (TNF) and expression of TNF mRNA. However,
      each of these cell functions was also enhanced by the control Lieber-DeCarli
      liquid diet alone and the stimulating effect of the control diet often exceeded
      that induced by ethanol. The results suggest that early in chronic alcohol
      consumption, the immune system may be stimulated by ethanol, and that during
      studies of ethanol-induced changes in immune system function, close attention
      must be given to potentially confounding effects of the diet.

PMID- 8471090
TI  - Nutrient intake and nutritional status in alcoholics.
AB  - The modern techniques used in making reliable nutritional surveys and in
      assessing the nutritional status of alcoholic individuals have greatly improved
      our possibilities to determine the nutrient intake and to detect nutritional
      deficiencies in alcoholics from different social groups. In earlier studies, the
      rather high incidence of malnutrition in alcoholics can be related to the
      patients consisting of indigent, skid row alcoholics or patients with severe
      somatic complications. Later studies have revealed that nutritional deficiencies
      are rare among middle-class alcoholics without significant somatic complications.
      However, selective nutritional deficiencies may be found among lower-income and
      homeless alcoholic populations.

PMID- 8471091
TI  - Role of nutrients in alcohol-induced immunomodulation.
AB  - Immunosuppression observed in chronic alcohol users is caused by multiple factors
      including the amount of alcohol consumed and alcohol-induced nutritional
      deficiencies. Investigators of the immunotoxic effects of ethanol (ETOH)
      frequently concentrate on the effects of ETOH and neglect nutrition as a
      confounding variable. This study investigated the immunotoxic effects of ETOH
      under variable dietary nutritional conditions. Mice were fed diets containing
      various levels of nutrients and ethanol for 7 weeks. Spleen cell number, and
      interleukin-2 and tumor necrosis factor (TNF) secretion were independent of the
      diet consumed, but were affected by consumption of ETOH. Body and spleen weights,
      and interferon-gamma secretion were modulated by ETOH as well as by diet. The
      results indicate that the nutritional composition of the diet consumed during
      concurrent administration of ETOH modulates the immunotoxic effects of chronic
      ETOH ingestion. We conclude that the levels of various nutrients in animal diets
      have to be planned and controlled carefully in order to identify directly the
      immunotoxic effects of ETOH.

PMID- 8471092
TI  - Nutrition in the pathogenesis of alcoholic liver disease.
AB  - The data and experimental results reviewed here allow the construction of the
      following hypothesis: alcohol-induced liver disease results from a combination of
      two phenomena. The first is the induction of the maximum activity of CYP 2E1 by
      several dietary factors, i.e. (1) low carbohydrate-high fat diet; and (2) the
      dietary fats composed of PUFA (Yang et al., 1992). The second is the production
      of lipid peroxidation induced by CYP 2E1 oxidation of ethanol maintained at high
      blood alcohol levels (> 200 mg %) with the availability of PUFA as substrate
      (Ekstrom and Ingelman-Sundberg, 1988; Koop, 1992). Thus, lipid peroxidation may
      be the final common pathway which supports the induction of ALD. Further, it may
      provide the common denominator which links ALD pathogenesis to non-alcoholic
      steato-hepatitis (NASH) (French et al., 1989b), where CYP 2E1 is induced by high
      fat diet and/or diabetes (Dong et al., 1988).

PMID- 8471093
TI  - [The therapeutic value of ambulatory extracorporeal shockwave lithotripsy of
      salivary calculi. Results of a prospective study].
AB  - In a prospective study, results of the extracorporeal shock wave lithotripsy of
      salivary stones were evaluated. The study was performed with the currently
      available technical possibilities of electromagnetic systems to get indication
      criteria for this procedure. Using the Modulith SL 20-lithotripter of Storz
      Medical AG, 33 concrements in 25 patients were treated in 89 lithotripsy
      sections. The stone sizes, localized by ultrasound, ranged from 3 to 13 mm
      diameter (phi 6.9 mm). After application of local anaesthesia, per session on an
      average 1300 shock waves with raising energy levels were applied, the succession
      of shocks fixed to 1 MHz. With the help of ultrasound localisation, a therapeutic
      success with complete emission of the concrement or an adequate disintegration of
      these stones could be achieved in 82% of the parotid gland stones (n = 11) and in
      14% of the submandibular gland stones (n = 22). Since the unhampered functioning
      of these salivary glands is an inevitable pre-condition for the spontaneous
      emission of the disintegrated fragments, the status of function of salivary
      glands should be established by a scintigraphy before performing the ESWL. Even
      though complete emission of the stone could be achieved in only 4 patients, all
      patients were clinically free of symptoms after the treatment. In 3 of 25
      patients, discrete bleeding of a passing nature occurred coming from the salivary
      duct. In 2 patients, formation of haematoma of varying dimensions could be
      visualized by ultrasound. 3 patients showed petechial skin bleeding. The tinnitus
      aurium which affected one patient eased after 3 days. In our patients collective
      a facial nerve damage did not occur.2+ longterm prognosis after this procedure.

PMID- 8471094
TI  - [Magnetic resonance angiography--a new procedure for vascular imaging in the area
      of the head-neck].
AB  - Some six or seven years ago, digital subtraction angiography (DSA) was introduced
      as a new diagnostic tool in the evaluation of vascular lesions. In the diagnostic
      management of vascular disorders in the head and neck, DSA could replace
      conventional angiography almost completely. Now, a new angiographic technique has
      been developed--magnetic resonance angiography (MRA). In the present study 60
      patients with vascular lesions of head and neck were examined with both DSA and
      MRA in order to compare the diagnostic value of these techniques. Our results
      indicate that MRA is at least equivalent in the evaluation of vascular disorders
      in head and neck region. In addition, the advantages of MRA compared to DSA are
      the following: (1) MRA is a non-invasive technique, thus reducing the
      angiographic risk. (2) MRA offers the possibility of multiplanar imaging. (3) MRA
      can be performed simultaneously with MRI if necessary. (4) Compared to other
      angiographic techniques the patient will not be exposed to radiation.

PMID- 8471095
TI  - [Acoustic rhinometry: measuring the early and late phase of allergic immediate
      reaction in allergic rhinitis].
AB  - Acoustic rhinometry is a method to analyse nasal airway geometry. Almost every
      antigen-induced allergic reaction in the nasal cavity leads to morphologic
      changes known as nasal obstruction. Therefore a study in 8 patients suffering
      from allergic rhinitis was conducted. Patients were challenged with 1,000
      Biological Units (BU) of grass pollen or D. pteronyssinus extract in one nostril.
      Acoustic rhinometry (AR) was performed before and 10, 20, 30, 45 and 60 minutes
      and then 2 to 8 hours after allergen exposure. 4 of the patients developed a late
      phase reaction. Changes were seen in the minimal cross-sectional area (MCA) and
      even better in a newly induced volume parameter called volume A (V-A). Volume A
      is calculated by integration of the distance/area graph surrounding the anterior
      part of the lower turbinate. Thus we can get information on more than one point
      of a graph in the important region of the anterior nose. Early phase reaction
      leads to a decrease in both MCA and V-A from 30% to 10% of the baseline value
      whereas late phase reaction gives only a third of this effect. The contralateral
      V-A and MCA are only slightly affected in the early phase, but there is an almost
      symmetric reaction of both sides in the late phase reaction. All changes were
      more pronounced in V-A compared to MCA. Therefore we propose to add V-A to MCA in
      describing the results of AR. Acoustic rhinometry is a suitable method for
      measuring local changes following nasal allergen challenge.

PMID- 8471096
TI  - [The viral and allergic origin of nasal polyposis].
AB  - In spite of recent advances in basic science, the etiology and pathogenesis of
      nasal and paranasal polyps have still not been clarified. Well-defined causal
      factors are hereditary diseases such as cystic fibrosis and primary ciliary
      dyskinesia. Allergic and non-allergic processes of the airways, particularly
      intrinsic asthma and intolerance to non-steroidal antiinflammatory drugs, are
      implicated in the development of nasal polyposis. In the 1930s nasal polyps were
      strongly considered to be a manifestation of allergy. The theory was challenged
      in the 1970s. Many patients with nasal polyps have no identifiable allergic
      disease. The cause of nasal polyps is speculative. 221 patients were included in
      this study, 154 suffering from chronic rhinosinusitis and another 46 from nasal
      polyps. The incidences of aspirin intolerance and of allergy were of no statistic
      relevance. The data indicate that preoperative cortisone application does improve
      the disease-free interval.

PMID- 8471097
TI  - [The Nikolowski trichoadenoma: a rare tumor of the ENT area].
AB  - A case of trichoadenoma Nikolowski in a 74-year-old woman is reported. The tumour
      invaded the upper lip, the base of the columella and the left nasal entrance. The
      tumour was cured by surgery and plastic reconstruction of the defect. This benign
      lesion of the hair follicles is rare and therefore often misdiagnosed as basal
      cell carcinoma or seborrheic keratosis. Examination of tumour cells by DNA-flow
      cytophotometry showed a normal diploid DNA-content of the tumour cells.

PMID- 8471098
TI  - [Morphometric evaluation of connective tissue reaction to cartilage implants].
AB  - In this paper, besides already investigated cartilage implants, we studied
      morphologically and histometrically possibilities to use human thyroid cartilage
      in reconstructive surgery, especially in nasal septum and pyramid
      reconstructions. Preserved human thyroid and rib cartilage as well as rabbit
      preserved rib cartilage were implanted under the back skin of 12 New Zealand
      rabbits. Animals were divided into two groups with 6 specimens in each group
      followed 6 and 12 weeks after implantation. Beside morphological investigation we
      measured histometrically the thickness of connective capsule around implants.
      Results obtained by our morphological and histometric studies indicate that
      preserved human thyroid cartilage could be used in reconstructive surgery with
      the same success as other cartilage implants already used.

PMID- 8471099
TI  - [Cartilage transplantation in the area of the head-neck: comparative study of HLA
      class II antigen induction to chondrocytes in various culture systems].
AB  - Autologous and homologous cartilage grafts are often used in reconstructive head
      and neck surgery. Unfortunately, sometimes the outcome of such operations is
      endangered by graft rejection or resorption. Among other reasons, immunological
      reactions with HLA class II antigen expression are thought to be involved at
      least in failures of vitally grafted cartilage. Up to now, only one case of class
      II antigen expression in a cartilage graft "in vivo" has been reported.
      Nevertheless, it has already been demonstrated that stimulated cartilage cells
      are able to express "in vitro" class II antigens if grown in monolayer cultures.
      However, it has also repeatedly been shown that chondrocytes reveal strong
      dedifferentiating features if cultured in monolayers. Therefore, it was the aim
      of this study to examine whether isolated and stimulated chondrocytes also
      express class II antigens if cultured under in vitro conditions closer to the
      relevant in vivo situation. Hence monolayer, suspension, agar, alginate and organ
      cultures were prepared simultaneously and kept for up to 60 days. Chondrocytes
      were stimulated by the addition of IFN-gamma and tested for class II antigens.
      For the detection of the antigens immunocyto- and immunohistochemical APAAP
      stainings as well as flow cytometric measurements were made. In all examined
      culture systems a class II antigen induction could be observed. Any significant
      differences between the various cultures as to the intensity of antigen
      expression could not be detected. Consequently, the expression of class II
      antigens on stimulated human chondrocytes seems not to be a specificity of
      monolayer cultures. Therefore, class II antigen induction may be considered to
      play a role in the rejection/resorption of vitally grafted cartilage in
      reconstructive surgery.

PMID- 8471100
TI  - [Sigmoid sinus thrombosis, a therapeutic problem].
AB  - Thrombosis of the sigmoid sinus is a relatively uncommon illness. It may present
      in a septic or bland form, and the latter is more or less asymptomatic.
      Angiography, computerised tomography and magnetic resonance imaging are all at
      our disposal for diagnosis of both types of thrombosis, and proper diagnosis of
      the specific form of sinus thrombosis will determine the required therapy.
      Between 1985 and 1990 six patients with sigmoid sinus thrombosis were treated at
      the Departments of ENT, Johannes Gutenberg University, Mainz and Albert Ludwig
      University, Freiburg, Germany, on an in-patient basis. By means of these cases we
      present our experience with this uncommon condition.

PMID- 8471101
TI  - [Antibiotic treatment of Pseudomonas aeruginosa-induced ear canal disease].

PMID- 8471102
TI  - Microbial reduction of aromatic carboxylic acids.
AB  - Several benzoic, cinnamic and phenylacetic acid derivatives were screened with 20
      micro-organisms, mainly fungi, for the reduction of their carboxylic function.
      For all organisms several compounds were reduced in fairly good yields up to 80%
      to the corresponding alcohol. No general rule could be established, concerning
      the substitution pattern, as to which compounds were transformed to the alcohol.
      Generally the reactions were accomplished within 48-70 h. Only minor, if any,
      side products were detected. Dicarboxylic acids, such as phthalic or
      phenylglutaric acids and similar compounds could not be reduced by the
      microorganisms tested.

PMID- 8471103
TI  - Glycogen synthesis in rat liver from a pool of free glucose.
AB  - Glycogen synthesis in isolated perfused livers or livers of anesthesized rats (in
      situ), was studied using radioactively labelled fructose, lactate, and inositol
      as substrates. The specific radioactivity of glucose and glycogen was measured at
      various times and compared with that of some intermediates. The results suggest
      that liver glycogen is formed from the pool of free glucose which in turn is fed
      by the so-called "direct and indirect pathway" of glycogen synthesis. This points
      to an important role of glucose-6-phosphatase, an enzyme complex subject to
      regulation by glucocorticoids, well known promoters of hepatic glycogen
      synthesis.

PMID- 8471104
TI  - Classification of melanocytic lesions with color and texture analysis using
      digital image processing.
AB  - The incidence of malignant melanoma, the most dangerous skin cancer, has
      increased rapidly during the last decade, and the figures are still rising. Since
      well-trained and experienced dermatologists are able to reach only a diagnostic
      accuracy of about 75% in visual preoperative classification, the discriminating
      ability of digital image analysis was evaluated in more than 350 malignant
      melanoma and benign melanocytic lesions that had all been confirmed
      histologically. Color slides of melanocytic lesions were scanned and digitized.
      Computer algorithms were programmed in FORTRAN on a DECstation 5000/200. A
      feature set was calculated describing the texture, color and their distributions
      as well as asymmetry, size and border of each lesion. These features, together
      with the histologic diagnosis, were the input in a commercial statistical
      classification program. In contrast to the accuracy of 75% achievable by the
      human eye, a correct classification rate of about 92% was reached with the
      mathematical classifier as compared with the histologic diagnosis.

PMID- 8471105
TI  - Heterogeneity of DNA ploidy, proliferation index and nuclear size in human
      colorectal carcinomas.
AB  - Measurements of DNA ploidy, proliferation index and nuclear area were performed
      on 210 samples taken from 15 human colorectal tissues. The tissues were divided
      into four groups labeled G1, G2, G3 and C. For each of the 15 tissues 9 samples
      were taken from the so-called unaffected--i.e., marginal--mucosa (G1-G3 groups)
      and 5 from the tumor (C group). The 9 samples from the unaffected mucosa of each
      tumor were obtained at a distance of 10 cm (3 samples/tissue, G1 group), 5 cm (3
      samples/tissue, G2 group) and 1 cm (3 samples/tissue, G3 group) from the tumor.
      Computerized cell image analysis was carried out on Feulgen-stained cell
      suspensions obtained from paraffin-embedded, formalin-fixed tissues. The results
      revealed that four to five analyses are necessary to detect minor aneuploid cell
      nuclei populations in human colorectal tumors. A definite homogeneous diploid
      pattern was found in the G1-G3 samples. In contrast, proliferative activity
      varied widely between the normal and tumor samples, with such variations observed
      at both the sample-to-sample and tissue-to-tissue level. The nuclear area also
      varied markedly across the samples from a given tissue--i.e., both marginal and
      tumoral and across the tissues themselves. Finally, we observed that the diploid
      tumors, the nuclear sizes of which varied as widely as those of the aneuploid
      tumors, possessed a higher proportion of highly proliferating samples than did
      the aneuploid.

PMID- 8471106
TI  - Discriminant analysis for classification of murine melanomas and human cervical
      epithelial cells.
AB  - Computer analysis of cell images offers many advantages over routine visual
      examination. It leads to quantitative and accurate detection of subvisual
      information and provides reproducible measures so that objective decisions in
      cancer diagnosis become possible. Such diagnostic decisions usually follow partly
      from a classification process. In this paper two multivariate discriminant
      analysis methods--namely, linear discriminant analysis (LDA) and quadratic
      discriminant analysis (QDA)--are presented. LDA and QDA were used to classify
      cytologic data based on some morphodensitometric measurements. The cytologic data
      constituted two samples, one representing B16 cell lines and the other including
      three types of normal human cervical epithelial cells. LDA and QDA were assessed
      both individually and in comparison to each other, mainly on the basis of the
      rate of correct classification and robustness. The measurements extracted from
      the cytologic data employed were shown to be stable and consistent. The
      statistical results obtained from experiments on cervical cells look particularly
      promising and encouraging for future work. It has also been shown in this study
      that the classification techniques employed are valid and that LDA performed
      almost as well as QDA.

PMID- 8471107
TI  - Morphometric analysis of neoplastic renal aspirates and benign renal tissue.
AB  - This study was designed to develop a practical morphometric procedure for the
      diagnosis of carcinoma in renal aspirates. We studied aspirates from renal cell
      carcinomas (grades 1-2) and normal kidneys. Video images of nuclei were traced on
      a high-resolution, touch-sensitive screen connected to an image analysis system.
      From each tracing the computer calculated nuclear perimeter length, nuclear
      profile area, maximal chord length, and the means and standard deviation for all
      measurements. Size distribution of nuclear profile areas and perimeter length in
      discrete bins ranged, respectively, from 30 to 80 at 10 microns2 intervals for
      areas and from 1 to 12 microns at 1-micron intervals for the maximum chords. The
      size distribution plots for the maximal chord of individual nuclei demonstrated
      an early narrow peak at low values for normal renal aspirates (peak located in
      the class ranging from 7 to 8 microns), while a broader, flatter peak with a
      shift to the right and a malignant tail was seen in renal cell carcinoma
      aspirates (peak located at 9-10 microns). These data were used for multivariate
      analysis to form two categories to establish a data base against which unknown
      cases could be tested. Multivariate analysis using a total of 14 variables
      yielded a value of 169.1 for the euclidean distances between the center of
      clusters of the neoplastic and normal renal aspirates and confirmed the
      classification with posterior probabilities of 1.0. From these data, automated
      classificatory analysis of 10 unknown cases was performed by means of the k
      nearest neighbor procedure, with correct classification established in each case.

PMID- 8471108
TI  - Computer-designed expert systems for breast cytology diagnosis.
AB  - Three expert systems have been developed to diagnose from nine scalar values
      visually assigned to epithelial cells obtained by breast fine needle aspiration.
      These expert systems achieved up to 0.98 sensitivity and 0.97 specificity. When
      applied to 804 breast masses, the clinical sensitivity was 0.98 and specificity
      was 0.93 (exclusive of the 0.04 unsatisfactory aspirates). Cancers can be missed
      physically during the aspiration process; thus, some clinically suspicious masses
      were biopsied despite benign cytology. This contributed to the difference between
      the expert system and clinical specificities.

PMID- 8471109
TI  - Stress-related psychophysiological reactions of truck drivers in relation to
      anxiety, defense, and situational factors.
AB  - A system analytic frame of reference is chosen for analysing interindividual
      differences in driving a technically optimised tank-lorry in comparison to a
      standard tank-lorry. Seven professional tank-lorry drivers were tested with
      psychological tests, and their test results were related to physiological
      measures assessed under different driving conditions in both lorry types. Two
      dimensions were used to explain the pattern of interactions between the
      independent (psychological and situational) and dependent (physiological)
      variables. It is argued that beyond technical improvements, also taking into
      account information on personality variables and situational factors is a
      promising approach to accident prevention research.

PMID- 8471110
TI  - The call for help after an injury road accident.
AB  - How soon will the authorities receive a call for help after an injury road
      accident? In urban Missouri 70% of the calls were received in less than five
      minutes. But in rural Missouri only 34% of the calls came in that quickly. These
      figures are based on a merge of police and emergency medical services accident
      data in which the earlier of the two notifications is selected as the time of
      first call. Police estimates of accident time are used here to calculate the
      interval from accident to the first call. The police estimates lack precision.
      This is shown by the high percentage of rounded numbers. As averages, however,
      these estimates show little evidence of bias. In urban areas, delays are related
      to time of day and type of road system, while in rural areas, remoteness of
      location is an added factor. Difficulty in finding a telephone quickly in certain
      road environments can be a problem. However, installing more stationary
      telephones along roads may be inefficient. Large areas would have to be covered
      to insure even a modest reduction in delays. More thought, therefore, should be
      given to the use of innovative vehicle-to-satellite technologies.

PMID- 8471111
TI  - The duration of speed reductions attributable to radar detectors.
AB  - The duration of speed reductions attributable to radar detector use was observed.
      When the entire traffic stream was exposed to police radar, the proportion of
      vehicles traveling more than 10 mph over the speed limit dropped initially from
      42% to 28%, but by one mile after exposure, this percentage had already increased
      to 38%. When speeding vehicles with radar detectors (about 45% of all speeding
      vehicles) were exposed to police radar, speeds dropped by approximately 15%, but
      by one mile after exposure, nearly half of the reduction was recovered. These
      findings indicate that radar detector users slow only briefly when alerted to
      police radar and that radar detectors are use primarily to avoid speed limit
      enforcement.

PMID- 8471112
TI  - Harmful events in crashes.
AB  - This study examined objects struck in motor vehicle crashes which cause injury or
      property damage--called harmful events on national accident data files. The
      percentage of loss due to fatalities was found to differ greatly by harmful event
      type. Comprehensive costs were used to combine data on fatalities, injuries, and
      property damage only (PDO) vehicles into a single economic measure of crash loss.
      Use of comprehensive costs can reduce distortions that may occur in analyses
      limited to fatal events. Large differences were identified in average injury
      costs by harmful event type, indicating the need to use specific harmful event
      injury costs in analyses whenever possible. Major differences found between first
      and most harmful events in ran-off-road crashes indicate a need for states to
      collect both data elements on their police accident report forms.

PMID- 8471113
TI  - Restrained occupants on the nonstruck side in lateral collisions.
AB  - Of injury-producing collisions with high seat belt use, some 25% to 30% are
      lateral collisions. This paper describes some of the characteristics of those
      collisions as they relate to the front-seat occupant sitting on the side opposite
      to the impact. The data came from a stratified sample of in-depth crash
      investigations conducted in the Birmingham region in the period 1983 to 1989
      involving current model cars. Crash severity was assessed using the Vehicle
      Deformation Index (VDI) of the Collision Deformation Classification (CDC) ratings
      and velocity change. Injury severity was assessed using AIS 85 for each body
      region. 193 cases of restrained occupants in nonstruck side collisions were
      examined. Of those occupants with head injuries of AIS < or = 2, 35% came out of
      the shoulder section of the seat belt. Of abdominal injuries of AIS < or = 2, 72%
      came from the seat belt itself. Interaction between front seat occupants was not
      a frequent cause of injury to the nonstruck side occupant. Some aspects of seat
      belt geometry might be changed so that the trajectory and loading of the
      nonstruck side occupant are improved.

PMID- 8471114
TI  - Needle covers reduce needlestick injury.
AB  - The objective of the study, conducted in the general wards of Flinders Medical
      Center in South Australia, was to determine whether the risk of needlestick
      injuries from hypodermic needles could be reduced by the use of needle covers
      that are applied with a one-handed technique immediately after use of the needle.
      Baseline rates of needlestick injury were collected for a year prior to the use
      of needle covers, and incident cases of needlestick injury were collected after
      needle covers were introduced. The odds ratio, derived from pre- and post
      intervention data, for injuries over which the use of needle covers could have
      had no influence, was used to show that the net effect of other influences on
      needlestick rates was not significant. The use of needle covers was associated
      with a significant reduction in needlestick injuries to nurses. The odds ratio
      for needlestick injury for nurse injuries that needle covers could not have
      prevented was 0.92. (95% CI 0.40-2.03). The odds ratio for needlestick injury for
      nurse injuries that needle covers could have prevented was 0.40 (95% CI 0.18
      0.82). Although the odds of ratio for needlestick injury to cleaners was 0.19,
      the 95% exact confidence interval was 0.00-1.64.

PMID- 8471115
TI  - Single-vehicle crashes and alcohol: a retrospective study of passenger car
      fatalities in northern Sweden.
AB  - This retrospective study of fatal passenger car crash victims in northern Sweden
      compares 396 multiple-vehicle (MV) and 201 single-vehicle (SV) fatalities from
      1980 through 1989. Compared to MV fatalities, SV victims were more frequently
      males, were younger, were more often inebriated, had higher blood alcohol
      concentrations, had a higher frequency of fatty liver, and were less often
      restrained. The SV fatalities occurred most often from May through October, from
      Fridays through Sundays, and from 9 p.m. to 6 a.m. The road surface was usually
      dry, especially for drunken SV drivers. The SV drivers also more often lacked a
      valid driver's license. The study confirms that alcohol is one of the most
      important factors associated with traffic fatalities, particularly in SV crashes.
      More than half (56%) of the SV victims were inebriated by alcohol (MV, 11%), had
      a mean blood alcohol concentration of 1.9 g/l (MV, 1.6 g/l), and one-third had a
      fatty liver (MV, 20%). We also found a relation between fatty liver and increased
      blood alcohol concentrations, suggesting that studies regarding the role of
      alcohol in traffic fatalities should also include an evaluation of liver
      morphology.

PMID- 8471116
TI  - Elderly in the traffic environment: analysis of fatal crashes in northern Sweden.
AB  - Fatal crashes of the elderly (> or = 60 years; N = 379) in northern Sweden in the
      traffic environment, between 1977 and 1986, were investigated using autopsy and
      police reports. Males had double the death rate of females. The car occupants
      made up the largest category (43%) followed by pedestrians, pedalcyclists, and
      two-wheel-motorvehicle (TWMV) riders, but the risk of fatal injury per unit
      distance travelled was highest for pedestrians and pedalcyclists. Most car
      occupants were killed in vehicle-vehicle crashes, mostly in the daylight and at
      intersections or straight roads. Ice and/or snow (31%) was the major precrash
      factor. In two-thirds of single car crashes, roadside hazards such as trees were
      involved. Most elderly fatally injured car drivers were responsible for the
      crash, and they were commonly involved in collisions with oncoming vehicles. Only
      4% of the fatally injured car drivers were driving under the influence of
      alcohol. Head injuries appeared to be more common in side impact than in frontal
      impacts. Serious chest injuries were more common than head injuries in car
      crashes. One-quarter of the pedestrians were injured at pedestrian crossings and
      about half during darkness. One in six pedestrians were under the influence of
      alcohol. All pedalcyclists were injured in collisions with motor vehicles and
      most were injured at intersections. Pedestrians, pedalcyclists, and TWMV riders
      had more serious head injuries than chest injuries.

PMID- 8471117
TI  - The effectiveness of seat belt legislation in reducing various driver-involved
      injury rates in California.
AB  - This study makes use of econometric models to examine the impact of seat belt
      laws on various driver-involved injury rates in California in both single- and
      multiple-vehicle accidents. The study makes use of a large data set from the U.S.
      D.O.T. State Traffic Accident Files and accounts for the general impact of seat
      belt laws as well as their dynamic effects on injury rates. The models adjust for
      a wide range of additional contributing factors to injury rates, including the
      influence of unemployment rates, speed limits, companion effects, and others.
      Robust results are obtained for the efficacy of seat belt legislation on reducing
      (moderate to fatal) injury rates in California.

PMID- 8471118
TI  - Life-threatening and disabling injuries in car-to-car side impacts--implications
      for development of protective systems.
AB  - Improvements to the passive safety of cars in lateral collisions are of great
      importance. This study of injuries in car side collisions in Sweden by the use of
      two evaluation methods has been performed to establish the basis for future
      development of protective systems for this type of accident. The Folksam car
      accident data file has been used. Injuries were found to be twice as common for
      near-side than for far-side* occupants in car to car impacts. Serious to fatal
      (AIS 3-6) injuries to belted front seat occupants in near side impacts (10% of
      all injuries) were compared with the estimated number of injuries to different
      parts of the body with risk of serious consequences (RSC)--either deaths or
      permanent disabilities (4.5% of all injuries). The two injury evaluation methods
      resulted in different ranking orders. AIS 3-6 injuries were received by the chest
      (37%), abdomen/pelvis (25%), and the head (15%). The RSC method gave a ranking
      order of head (25%), neck (21%), leg (15%), chest (14%), and abdomen/pelvis
      (11%). The method of evaluating AIS 3-6 injuries emphasizes only the threat to
      life. The RSC method also takes into account the risk of disabilities. Injuries
      to the neck and the leg were found to be most disabling, whilst the injuries to
      the head, chest, and abdomen/pelvis were the most life threatening. The study
      also shows that elderly people receive significantly more chest injuries
      (relative to the number of head injuries), on average four times more than young
      people.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471119
TI  - The role of exposure in comparisons of crash risk among different drivers and
      driving environments.
AB  - Crash rates based on drivers, driver-kilometers, and driver-days in the
      denominator were compared, using survey estimates of time and distance driven and
      the annual frequency of traffic crashes in Ontario. Rates by age, sex, and region
      were computed for all crashes and for crashes resulting in injury or fatality.
      Young male drivers remained at high risk for all types of denominator; older
      women had high rates when distance was included in the denominator. When time
      spent driving was substituted, men and women drivers over 60 had very similar
      rates. For comparisons of rural residents with urban and northern residents, time
      and distance give equivalent results. These findings suggest that apparent
      differences in crash risk per kilometre, whether for older women or for urban
      drivers, is explained by differences in typical driving speed and environment.
      Exposure time is better than distance to explain crash risk among drivers and
      regions with very different driving patterns and environments.

PMID- 8471120
TI  - Mass ratio and relative driver fatality risk in two-vehicle crashes.
AB  - The relative risk, R, of a driver fatality in the lighter of two cars compared to
      the risk in the heavier is determined as a function of the ratio, mu, of the mass
      of the heavier to that of the lighter, using Fatal Accident Reporting System data
      for 1975-1989. In all of many cases investigated, the data fitted well the
      functional relationship R = A mu u. When the cars differ only in mass, A = 1; if
      they differ in another dichotomous characteristic, such as old compared to new
      model years, A estimates the influence of this other characteristic when the
      masses are equal. The results show that if a driver transfers to a car lighter by
      1%, that driver's fatality risk in a two-car crash compared to the risk to the
      other involved driver increases by between 2.7% and 4.3%, the specific value
      depending on other factors, such as model year. When one car crashes head-on into
      the side of another of equal mass, driver fatality risk in the side-impacted car
      compared to that in the frontally impacted car is 4.5 +/- 0.6 times as great for
      right-side impacts and 10.1 +/- 1.7 times as great for left-side impacts.
      Extending the analysis to vehicles other than cars provides empirical evidence
      that two previously stated "laws" apply systematically over a wide spectrum of
      vehicles, from mopeds, through motorcycles, small cars, large cars, small trucks
      to large trucks. These laws are that, when other factors are equal, (1) the
      lighter the vehicle, the less risk to other road users, and (2) the heavier the
      vehicle, the less risk to its occupants.

PMID- 8471121
TI  - An emergency rescue service in Brazil.

PMID- 8471122
TI  - Studies of catecholamine metabolism in schizophrenia/psychosis--II.
AB  - Acutely psychotic schizophrenic patients were maintained on debrisoquin (DBQ)
      throughout 5 weeks of treatment with haloperidol. Treatment with haloperidol
      caused initial increases in urinary homovanillic acid (HVA) output that returned
      toward baseline by the 5th week. During haloperidol treatment, plasma levels of
      HVA tended to decrease, concurrent with increased renal clearance of HVA. Plasma
      3-methoxy-4-hydroxyphenylglycol (MHPG) levels and urinary MHPG output both
      decreased over the course of treatment. The differences in HVA and MHPG
      metabolism suggest differential effects of treatment on dopamine and
      norepinephrine systems. Neuroleptic treatment also abolished the marked morning
      decreases in plasma HVA concentrations (reported in part I).

PMID- 8471123
TI  - The 5-HT3 receptor in mammalian brain: a new target for the development of
      psychotropic drugs?

PMID- 8471124
TI  - Schizophrenia: dopamine D1 receptor sequence is normal, but has DNA
      polymorphisms.
AB  - Genes that regulate dopamine (DA) receptors may underlie the overactive DA system
      in schizophrenia. Since it is known that there is an abnormally reduced or absent
      regulation of the DA D2 receptor by the DA D1 receptor in the postmortem
      schizophrenia brain, the human DA D1 receptor gene was sequenced from genomic
      deoxyribonucleic acid (DNA) of seven schizophrenic individuals. The tissues from
      two schizophrenics had previously been found to have a reduced link between DA D1
      and D2 receptors. The D1 receptor genes were amplified by the polymerase chain
      reaction, subcloned, and sequenced. Although three DNA polymorphisms were found,
      the deduced amino acid sequence of the DA D1 receptor was normal in these
      tissues.

PMID- 8471125
TI  - Schizophrenia: normal sequence in the dopamine D2 receptor region that couples to
      G-proteins. DNA polymorphisms in D2.
AB  - Because dopamine (DA) D2 receptors are a target in neuroleptic therapy and have
      been found to be elevated in schizophrenia, the human DA D2 receptor gene was
      examined for possible abnormalities in schizophrenia. Moreover, since D2
      receptors in psychosis have a reduced coupling to D1 receptors, the cytoplasmic
      third loop of D2 was chosen for deoxyribonucleic acid (DNA) sequencing, since
      this region is essential for coupling to G-proteins. This region also contains
      exon 5, which is expressed in the long form of D2, but not in the short form of
      D2. In eight schizophrenia cases, this region had normal exon sequences (exons 4,
      5 and 6), and normal sequences at its intron-exon junctions. However, exon 6
      contained three DNA polymorphic base changes, and introns 4 and 5 revealed three
      missing bases and two polymorphic base changes, none of which would be expected
      to alter the D2 receptor protein in schizophrenia.

PMID- 8471126
TI  - Electroencephalographic sleep in recently remitted, elderly depressed patients in
      double-blind placebo-maintenance therapy.
AB  - The aim of this double-blind placebo-controlled study was to assess the effects
      of clinical state on electroencephalographic (EEG) sleep measures in elderly
      patients with recurrent major depression. We hypothesized that rapid-eye movement
      (REM) latency and delta sleep ratio would remain stable between actively
      depressed and remitted states (i.e., show state independence), and measures of
      sleep continuity would improve with remission (i.e., show state dependence).
      Fifteen elderly outpatients (mean age 65.3 years) had sleep evaluations while ill
      and after remission, an average of 38 weeks later. All patients were in a double
      blind placebo-maintenance condition at the time of follow-up studies. The major
      findings were: 1) no significant change in either REM latency or delta sleep
      ratio; 2) reduction in early morning awakening; and 3) improvement in subjective
      sleep quality despite the stability of most polysomnographic measures. We
      conclude that REM latency and delta sleep ratio are state-independent in patients
      with late-life depression, and that early morning awakening and sleep quality
      improve with remission of symptoms. These findings suggest that EEG sleep changes
      may have significance for understanding the longitudinal course of depression in
      late life.

PMID- 8471127
TI  - A multicenter study of the light visor for seasonal affective disorder: no
      difference in efficacy found between two different intensities.
AB  - Fifty-five patients with winter seasonal affective disorder (SAD) were treated
      with a light visor, a newly developed portable light-delivery system, in a
      controlled parallel design. A dim (400 lux) visor was compared with a bright
      (6000 lux) visor for either 30 or 60 minutes in the morning for 1 week. Response
      rates for these two treatments were 36% and 56%, respectively; the duration of
      treatment sessions did not affect outcome. There was no evidence that the
      brighter visor was superior in efficacy to the dimmer one. Significantly greater
      relapse occurred following withdrawal of the dimmer visor. Alternative
      explanations for these findings are that the light visor is acting as a placebo
      or that it is equally effective over a wide range of intensities.

PMID- 8471128
TI  - Effects of acute and chronic alprazolam treatment on cerebral blood flow, memory,
      sedation, and plasma catecholamines.
AB  - The effects of 0.014 mg/kg intravenous alprazolam administration on cerebral
      blood flow (CBF), memory, sedation, and plasma norepinephrine and epinephrine
      were determined in eight healthy males at baseline levels and following 1 week of
      daily oral alprazolam treatment. At baseline, intravenous alprazolam
      administration caused acute reductions in whole-brain CBF (25% to 30% decrease),
      memory, plasma epinephrine, and self-rated alertness. Following 1 week of
      alprazolam treatment, tolerance developed to the acute effects of intravenous
      alprazolam on CBF, memory, and plasma epinephrine. There were no consistent
      regional neuroanatomic differences in the CBF effects of acute alprazolam, or in
      the development of tolerance to these effects, and no correlations between the
      various measures of acute alprazolam effects on either test day.

PMID- 8471129
TI  - Psychological effects of MDE in normal subjects. Are entactogens a new class of
      psychoactive agents?
AB  - The so-called entactogens 3,4-methylenedioxymethamphetamine ([MDMA] also known as
      "Ecstasy," or "Adam") and its analog 3,4-methylenedioxyethamphetamine ([MDE] also
      known as "Eve") exert similar psychotropic effects in humans. Two double-blind
      placebo-controlled psychometric studies with normal control subjects were
      conducted. Placebo or MDE (140 mg) was administered orally to eight male
      volunteers at 1:30 P.M. and to six subjects (3 male, 3 female) at 11 P.M.
      Psychologic tests and clinical ratings were performed 1 hour before the
      administration of the drugs, as well as 2, 5, and 24 hours after drug intake and
      7 days thereafter in the first study. In the second study, measures were taken at
      times -1, +8.5, +24 hours, and +7 days. The majority of the psychotropic effects
      resembled those that have already been described in anecdotal reports. The
      substance produced a partially controllable state of enhanced insight, empathy,
      and peaceful feelings. All subjects displayed a general stimulation with
      increased psychomotor drive, logorrhea, and facilitation of communication. One of
      the fourteen volunteers developed a toxic psychosis. One volunteer displayed a
      dysphoric reaction, one suffered from episodes of anxiety for some days after the
      experiment. The findings support the hypothesis that MDMA and MDE represent a
      novel pharmacologic class.

PMID- 8471130
TI  - Suicidal behavior and psychotropic medication. Accepted as a consensus statement
      by the ACNP Council, March 2, 1992.

PMID- 8471131
TI  - On the value of measuring dopamine, norepinephrine and their metabolites in
      schizophrenia.

PMID- 8471132
TI  - Studies of catecholamine metabolism in schizophrenia/psychosis--I.
AB  - Acutely psychotic schizophrenic patients not taking antipsychotic medications and
      control subjects were studied before and during treatment with debrisoquin (DBQ),
      an inhibitor of monoamine oxidase, which does not penetrate into brain.
      Homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured
      in plasma, urine, and cerebrospinal fluid (CSF). Significant differences between
      patients and control subjects were more easily discerned during treatment with
      DBQ. In patients, HVA was increased in plasma but not in urine or CSF, although
      MHPG was increased in all three fluids. There were many significant correlations
      between plasma MHPG and HVA levels and clinical ratings of psychoticism. Plasma
      MHPG correlated positively with both the severity of positive and negative
      symptoms and plasma HVA correlated only with positive symptom severity. These
      data suggest that both dopamine and norepinephrine (NE) metabolism are disturbed
      in acutely psychotic schizophrenic patients; disturbed NE metabolism may relate
      to negative symptoms as well.

PMID- 8471133
TI  - Critical evaluation of the clinical relevance of the IgG subclasses assays.
AB  - Human IgG subclasses play a major role in the physiological regulation and
      functions of the immune system. There "personality" is obvious. However, the
      determination requires appropriate reagents and technology. For the IgG1, IgG2,
      IgG3 subclasses, the radial immunodiffusion technique may be sufficient. For the
      IgG4 subclass determination and measurement, more elaborate techniques are
      required. These measurements of existing proteins are of major interest in
      congenital as well as acquired immune deficiencies more often, besides the total
      subclass deficiency, these are of utmost interest to evaluate the specific
      response of a given subclass to a specific antigen. The IgG4 allergen specific
      subclass has been considered to be involved both in allergic reactions and
      associated with the appropriate response to allergen-specific immunotherapy. It
      is now accepted that IgG4 does not play an discernable role in the acute
      inflammatory response of type I hypersensitivity; it has also been demonstrated
      that a number of patients who demonstrate elevated levels of allergens specific
      IgG4 are not protected against allergenic exposure, and conversely, a number of
      patients who have been heated by immunotherapy without demonstrating any
      significant increase in their serum levels of allergen specific IgG4 are indeed
      very well protected. In the field of allergy, the IgG4 determinations remain a
      matter of controversy and research.

PMID- 8471134
TI  - Immunological study of vulvar lichen sclerosus: preliminary considerations.
AB  - Sclero-atrophic lichen (LSA) is a dermatosis that is well defined from the
      clinical and histological viewpoints, but the etiology remains unknown. The main
      symptom is a permanent pruritus which results in a gynecological consultation. We
      have studied the immunological status of 48 patients with LSA and 33 controls.
      The LSA patients showed a significant diminution of peripheral CD3 and CD1 and
      tissue CD2, CD3, CD1 and CD8. There was no difference of IgG, IgM or tissue C3c,
      or serum C3c and C4. These patients also had a higher incidence of
      autoantibodies.

PMID- 8471135
TI  - Mycobacterial infection in HIV+ patients detected with a new immunological method
      (TB test).
AB  - Antibody response to antigen A60 (a mycobacterial antigen) was evaluated in ELISA
      in 18 HIV+ subjects with clinical and cultural evidences of mycobacterial
      infections, in 10 HIV+ subjects without Mycobacterial infections and in 22
      healthy donors. We found higher levels of specific IgG in the HIV+ patients with
      Mycobacterial infections (mean 179.2 +/- 83 U) compared to the values of the
      donors (mean 92.5 +/- 35.5 U: p < 0.01). This test may be useful in the diagnosis
      of tuberculosis, but it needs clinical validation.

PMID- 8471136
TI  - [The effect of respiratory rehabilitation on the functional ventilation changes
      in the asthmatic child].
AB  - The aim of this study was to evaluate the improvement of lung function
      abnormalities during asymptomatic periods in children with perennial atopic
      asthma after physical respiratory rehabilitation and swimming (RR). MATERIAL AND
      METHODS: 240 lung function tests were performed regularly by whole-body
      plethysmography during asymptomatic periods on 68 atopic asthmatic children aged
      5-13 (means 8.7 y), in a follow up four years study (1983-87). TLC, VC, FEV1,
      Raw, MEF50, RV and TGV were recorded. We selected TGV for measured
      hyperinflation, Resistance (Raw) for bronchial obstruction and MEF50 for small
      airways obstruction. We divided these children population in two groups: group A
      control (20 subjects, means 9.3 y. age) immunotherapy (IT) alone; group B (48
      subjects, means 8.03 y. age) IT and respiratory rehabilitation and swimming.
      Furthermore, we compared the evolution of the lung function according to the
      severity of asthma on B group alone. RESULTS: the number of hyperinflated or
      bronchial obstructed children who did RRS is significantly smaller than on the
      control group. Nevertheless, breathing exercises and swimming has no effect on
      peripheral airway obstruction. When we compared the effect of asthma on B group
      alone, we noted that the recovery of lung abnormalities were observed on the
      great majority of mild and moderate hyperinflated and bronchial obstructed
      asthma. In severe asthma, the results were not so good, particularly on bronchial
      and peripheral airway obstruction. In these last cases the functional prognosis
      will be uncertain. CONCLUSION: respiratory rehabilitation and swimming have an
      unquestionable effect on improvement of hyperinflated asthmatic children, some
      effect on improvement on permanent bronchial obstruction, and without any benefit
      on permanent peripheral airway obstruction. Lung function tests might be
      monitored the RR in all asthmatic children with lung function impairment.

PMID- 8471138
TI  - [Information on AIDS in companies].

PMID- 8471137
TI  - In vitro effects of an immunoglobulin preparation for intravenous use (IVIG) on T
      cells activation.
AB  - The "in vitro" effect of different concentrations of polyclonal human
      immunoglobulins for intravenous use (IVIG) on cultured T-lymphocyte response to
      phytohemagglutinin (PHA) was evaluated. Four dilutions of IVIG corresponding with
      the "in vitro" doses currently employed in therapy have been tested by the effect
      on PHA stimulated cultures. The dilution of IVIG corresponding with a low
      therapeutical dose gives a higher statistically significant stimulating effect.
      The results obtained in our work agree with previous studies performed on
      activated B-cells. We can suppose the immunoglobulins may control the T
      lymphocyte activation either by a direct link with a specific Fc-receptor
      expressed on the surface of activated T-cell or by affecting the cytokines
      release from monocyte cells.

PMID- 8471139
TI  - Adhesion molecules in immunity and inflammation.
AB  - Adhesion molecules are essential components of immunitary response and
      inflammation. Adhesion molecules could be classified as integrins, selectins,
      immunoglobulins superfamily and carbohydrates. The role of adhesion molecules in
      inflammation, immunity cancer, acute respiratory diseases, transplantation and
      his possible relevance in therapy are reviewed and discussed.

PMID- 8471140
TI  - Burn victims after a major disaster: reactions of patients and their care-givers.
AB  - There have been considerable advances in the physical management of burns, and
      there is a greater awareness of their psychological impact. However, much less
      attention has been given to the staff who have to deal with burn victims.
      Disasters are critical incidents which offer a magnified opportunity to
      appreciate with what care-givers have to cope and how they do so. This paper
      identifies how complex are the psychological and emotional reactions associated
      with burn care, and it advocates that more should be done, by means of
      debriefing, to cater for the needs of staff after critical incidents.

PMID- 8471141
TI  - Catecholamines: important factors in the increase of oxidative phosphorylation
      coupling in rat-liver mitochondria during the early phase of burn injury.
AB  - Thirty minutes after Sprague-Dawley rats had been injected subcutaneously with
      epinephrine or norepinephrine, the respiratory control ratio (RCR), the rate of
      O2 consumption in state 3 and the rate of ATP formation in liver mitochondria
      succinate respiratory chain were increased. The rate of O2 consumption in state 4
      was increased or only slightly increased. When the rats were injected with the
      adrenergic blocking agents, timolol or phenoxybenzamine, 1 h before the burn, the
      activities of the succinate respiratory chain was partly inhibited 30 min
      postburn. Compared with our previous results, it can be suggested that
      catecholamines may play an important role in the increase of oxidative
      phosphorylation coupling in the early phase of burn injury.

PMID- 8471142
TI  - Side effects of laser therapy, modified by ultraviolet irradiation and para
      aminobenzoic acid in mice.
AB  - Scarring is a well-known side-effect of cutaneous laser treatment and exposure to
      solar ultraviolet radiation is suspected to increase scar formation. We
      investigated how wounds and scarring were modified by interfering in the laser
      induced inflammation using ultraviolet radiation and para-aminobenzoic acid. A
      copper vapour laser operating at 578 nm was used at three different intensities
      and doses. The ultraviolet radiation was administered three times weekly prior to
      and four times weekly after the laser treatment. The daily dose was 21.5 kJ/m2
      equivalent to 3.5 Basic-MED. The laser-induced wounds were evaluated daily and
      histological and biochemical analyses were used to estimate scarring. Ultraviolet
      irradiation resulted at some of the used laser intensities in decreased scores of
      maximum wound area, wound healing time, cumulated wound area, and a decreased
      skin content of hydroxyproline, whereas the degree of the chronic fibrosis tended
      to increase. Application of para-aminobenzoic acid before the solar ultraviolet
      irradiation did not change the acute wound scores but reduced, although not
      significantly, the degree of fibrosis.

PMID- 8471143
TI  - A recombined skin composed of human keratinocytes cultured on cell-free pig
      dermis.
AB  - Treatment of full skin thickness burns requires replacement of both the dermal
      and the epidermal components of the skin. We describe a method of preparing
      recombined human/pig skin (RHPS) by cultivating human keratinocytes on dried cell
      free pig dermis (CFPD). CFPD dried on a tissue culture dish forms a thin collagen
      film which behaves like a firm substrate for cell cultures. HK were grown on the
      epidermal side of the CFPD using lethally irradiated 3T3 cells as feeders. After
      reaching confluency of human keratinocytes, human fibroblasts can be cultured on
      the dermal side of the RHPS. It was possible to obtain approximately 500 cm2 of
      the RHPS from 1 cm2 human split-skin graft in 3 weeks. RHPS is easy to handle, is
      similar in structural, mechanical and adhesive properties to the normal skin, and
      can be meshed. This RHPS might be advantageous for permanent covering of wounds
      in major burns.

PMID- 8471144
TI  - Plasma tumour necrosis factor-alpha (TNF-alpha) levels in patients with burns.
AB  - Levels of plasma tumour necrosis factor-alpha (TNF-alpha) were determined
      consecutively in 42 patients with burns > 20 per cent of the total body surface
      area using an enzyme-linked immunosorbent assay. In the early period after injury
      (including the period of burn shock), 24 patients had detectable TNF-alpha levels
      in their plasma. However, the plasma TNF-alpha levels at the time of admission
      were very low and did not correlate with the extent of the burn or the prognosis.
      In contrast, the maximum plasma TNF-alpha level over the whole clinical course
      was significantly correlated with the area of the burn and the prognosis. No
      correlation was found between the plasma TNF-alpha and plasma endotoxin levels.
      TNF-alpha may be produced locally in infected burns and monitoring of plasma TNF
      alpha levels may be a useful prognostic indicator for burns patients.

PMID- 8471145
TI  - Management of partial thickness burns with Granuflex 'E' dressings.
AB  - In a prospective, open, randomized and parallel group trial, 98 patients with
      partial thickness burns suitable for outpatient management were treated with
      either Granuflex 'E' (n = 49) or Bactigras (n = 49). The objective was to compare
      the safety, efficacy and performance characteristics of Granuflex 'E' with
      Bactigras. The overall rating of the dressing by the investigators and the
      patients showed a significant preference for Granuflex 'E'. In addition, the
      quality of healing was rated as 'excellent' in 56 per cent of patients treated
      with Granuflex 'E', compared with only 11 per cent in the group treated with the
      conventional dressing. Granuflex 'E' is safe, effective and flexible and we
      recommend that it should be used as the first-choice dressing in the management
      of partial skin thickness burns.

PMID- 8471146
TI  - Expanding oral plastic splint for burn patients.
AB  - An expanding oral plastic splint for preventing microstomia from deep facial
      burns is described. This splint adjusts to suit the affected oral angles without
      the need for taking any impression before fabrication. It is especially suitable
      for severely injured patients starting from the early period shortly after
      injury, even if the patient has been intubated. Furthermore the expansion forces
      can be controlled easily according to the degree of contracture.

PMID- 8471147
TI  - The estimation of blood loss during burns surgery.
AB  - The estimations of blood loss and transfusion requirements during burns surgery
      are notoriously difficult. This clinical study investigated the effectiveness of
      estimates made by junior and senior burns surgeons and senior anaesthetists by
      comparing them with calculated blood losses. Regression analysis shows good
      correlation between these methods (r-value range 0.75-0.97), although 'eye
      balling' the losses tends to underestimate the transfusion requirements
      (regression slope coefficients ranged between 0.56 and 0.87). In only five out of
      46 procedures was there a need for late transfusion for an unacceptably low
      haemoglobin level (< 10 g/dl). This provides further empirical evidence for the
      clinical value of each member of the team voicing an estimate of the loss at the
      end of the procedure. The mean blood loss for 1 per cent of burn excised or split
      skin donor site harvested was 117 ml in adult cases. Blood loss can also be
      expressed as a mean percentage of the patient's calculated total blood volume for
      each 1 per cent burn excised or autograft harvested, giving figures of 2.6 per
      cent for adults and 3.4 per cent for children. Gravimetric analysis of soiled
      swabs underestimates the blood loss by approximately 50 per cent.

PMID- 8471148
TI  - Chronically exposed calvarium following electrical burns.
AB  - Electrical burns of the scalp and calvarium are uncommon, but due to various
      conditions peculiar to India such injuries are seen frequently. The presentation
      of such patients at hospital is late because of the paucity of specialized care
      facilities and understanding of the disease process. Such injuries usually cause
      necrosis of the scalp and underlying calvarium with sequestered bone being
      retained in situ by the flimsy adhesions of underlying granulation tissue and
      overhanging edges of the scalp all around caused by secondary wound contraction.
      This paper gives our experience of 14 such cases, explaining the reasons for the
      chronic state and their subsequent clinical management.

PMID- 8471149
TI  - Widely expanded postage stamp skin grafts using a modified Meek technique in
      combination with an allograft overlay.
AB  - A method for obtaining widely expanded postage stamp autografts, first described
      in 1963 by C.P. Meek, has been evaluated in our burns unit. The technique, in
      which an expansion ratio of 1:9 is achieved with the aid of special prefolded
      gauzes, was combined with an overlay of glycerol-preserved allografts applied 1
      week after grafting. This delay did not appear to affect graft take. In a series
      of 16 consecutive skin graft procedures performed on 10 patients with extensive
      burns, the mean epithelialization rate was 90 per cent (range 70-100 per cent)
      within 5 weeks. Cosmetic results were comparable to those achieved with widely
      expanded mesh grafts. The Meek technique utilizes small pieces of autograft, and
      has proved to be a practical alternative to mesh grafts when donor sites are
      limited.

PMID- 8471150
TI  - Estimation of the calorie requirements of burned Chinese adults.
AB  - Studies of energy expenditure in 75 adult Chinese patients with burns covering
      between 5 and 98 per cent of the total body surface area (TBSA) gave the
      following formula for an optimal nutritional regimen: the daily calorie input
      should be 1000 x m2 (surface area) + 25 x per cent TBSA. Glucose should provide
      between 55 and 60 per cent of the calories, fat between 20 and 30 per cent, and
      protein between 15 and 20 per cent. The calorie to nitrogen ratio should lie
      between 150 and 170 to 1.

PMID- 8471151
TI  - Burns complicated with gastrointestinal haemorrhage--an analysis of 70 cases.
AB  - Clinical data concerning the age, burn surface area and depth, burn shock, the
      time and location of haemorrhage, amount of blood lost and prognosis are
      described in 70 burn patients who developed gastrointestinal haemorrhage. The
      relevant morbidity, diagnosis and treatment is discussed.

PMID- 8471152
TI  - Prehospital care of burns: an analysis of 3 years use of the emergency physician
      system (EPS) Cologne.
AB  - Little information is available about the vital parameters of burns victims
      shortly after the accident. Therefore cases of burns, electrical and caustic
      injuries presenting to the Cologne Emergency Physician System over 3 years (n =
      262) were prospectively studied and analysed. The average incidence in Cologne,
      Germany (population 1 million), of burns victims attended by the Emergency
      Medical System and emergency physicians at the scene was 74 adults and 14
      children per year. Children are mainly injured by scalds (41.4 per cent); adults
      by fire accidents (43 per cent). A classification of the victims at the site of
      the accident according to their vital signs (Trauma Score (TS) after Champion H.
      R., Sacco W. J. and Carnazzo A. J. et al. (1981) Trauma Score. Crit. Care Med. 9,
      672) showed, that in spite of a major burn injury, the vital signs were usually
      not or only slightly impaired. Subsequent measurements instituted by the
      emergency physician at the scene increased with decreasing initial TS. With TS =
      14, 50 per cent of the patients were intubated; below 14 points nearly 100 per
      cent. The fluid administered also increased with a decreasing TS.

PMID- 8471153
TI  - New advances in automatic disposable rotating cartridge skin staplers.
AB  - This report describes the design, operation, and mechanical performance of Auto
      Suture Multifire Premium disposable skin staplers and staples in a biomechanical
      laboratory investigation and a clinical evaluation. The performance of this
      reloadable stapler has been compared with that of a new disposable skin stapler
      with a rotating cartridge, the Proximate RH stapler. The latter exemplifies a
      disposable skin stapler whose cartridge cannot be reloaded. The Auto Suture
      Multifire Premium disposable skin stapler has been designed so that its cartridge
      can be reloaded during a single surgical procedure. The most obvious advantage of
      this new device is that it substantially reduces the cost of skin stapling during
      surgery. Another unique benefit of this stapler is that it can accommodate either
      regular or wide staples, allowing the surgeon to use both size of staples without
      discarding the stapler. On the basis of this investigation, the Auto Suture
      Multifire Premium disposable skin stapler is recommended for skin incision and
      graft closure, since it provides maximal visualization of the wound as well as
      the staple during its formation. It delivers the staple into the skin or skin
      graft so that the topspan of the staple is above the skin or wound surface. In
      addition, the Auto Suture Multifire Premium disposable skin stapler has a
      prepositioning (precocking mechanism) that is controlled by the surgeon with
      minimal force, a mechanism which allows the stapler to hold its staple securely,
      even when its pointed legs extend beyond the delivery end of the stapler. The
      force required to form its staples is so low that the surgeon can staple
      repetitively without fatigue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471154
TI  - Burns with pregnancy--a review of 25 cases.
AB  - We have treated 25 pregnant patients with burns over a period of 6 years (1986
      91). During this period total admissions to the burn unit were 1260. There were
      187 women of child-bearing age, with burns ranging between 15 and 100 per cent
      TBSA. We would like to emphasize that, with proper care, the prognosis of
      patients with burns who are pregnant is encouraging and is comparable to any
      other routine burn patient. Abortion was common in the first trimester of
      pregnancy. Septicaemia was the commonest cause of abortion. Fetal death is not
      always preceded by maternal death.

PMID- 8471155
TI  - Versatility of the free or pedicled superficial cervical artery skin flaps in
      head and neck burns.
AB  - The usefulness of the free or pedicled superficial cervical artery skin flap in
      reconstructive surgery of head and neck burns is reported. This flap can be made
      with the pivot point near the cervical region. Moreover, it can be elevated as a
      free or long vascular pedicled flap. Therefore, it is widely applicable in
      reconstructing the scar contractures of the head and neck, particularly in
      extensively and deeply burned patients.

PMID- 8471156
TI  - Osteomyelitis of the spine in a burn patient due to Candida albicans.
AB  - A 38-year-old white-skinned male was burned in an ultralight plane crash and
      sustained a 59 per cent body surface area burn, mostly full thickness skin loss.
      A fracture of the first lumbar vertebra was noted at admission which was treated
      without surgery. Candida septicaemia was diagnosed and treated during the acute
      phase of injury. Extensive grafting was required. Following discharge, the
      patient began experiencing low-grade back pain which was aggravated on postburn
      day 277 by a fall down a flight of stairs. Spinal radiographs obtained following
      this fall revealed osteomyelitis at the level of the eighth and ninth vertebrae
      with an intervertebral abscess. Following evacuation of the disc space during
      surgery, the organism was identified as Candida albicans. Treatment with
      amphotericin B and later fluconazole was initiated. Recovery was uneventful. The
      infection, probably of a haematogenous origin, is the first such case reported in
      the literature to our knowledge.

PMID- 8471157
TI  - Improvement of human keratinocyte isolation and culture using thermolysin.
AB  - We propose a modification of the conventional keratinocyte isolation method which
      has shown a significant improvement in the purity, colony forming efficiency
      (c.f.e.) and growth capacity of the isolated epidermal cell population. This
      method utilized thermolysin since it selectively digests the dermo-epidermal
      junction. Following separation from the dermis, the epidermis was digested with
      trypsin to obtain a single cell suspension. Compared with the conventional
      procedure, this isolation method was shorter and resulted in (i) cells displaying
      a higher colony forming efficiency, (ii) cells reaching confluence 1-3 days
      earlier, (iii) cells not contaminated by fibroblasts, (iv) a cell population
      containing all the basal layer keratinocytes. These cells were suitable for the
      establishment of primary cultures and could be subcultured. Such cell populations
      should be advantageous in studies of epithelial-mesenchymal interactions in which
      keratinocyte populations, free of fibroblasts, are desirable. In the treatment of
      extensively burned patients using cultured epidermal sheets, the main problem
      remains the time required for their production. Thus, the absence of fibroblast
      overgrowth of the keratinocyte cultures and the significantly reduced time to
      obtain confluent cultures and epidermal sheets with our method have very
      important implications for the treatment of large burn wounds.

PMID- 8471158
TI  - Bioactivation of halogenated hydrocarbons by cytochrome P4502E1.
AB  - Numerous halogenated hydrocarbons of the alkane, alkene, and alkyne classes are
      metabolized by P450 enzymes to products that elicit cytotoxic and/or carcinogenic
      effects. Such halogenated hydrocarbons include anesthetics (e.g., halothane and
      enflurane) and industrial solvents (e.g., carbon tetrachloride, chloroform, and
      vinylidine chloride). Formation of reaction intermediates from these compounds
      occurs via P450-promoted dehalogenation, reduction, or reductive oxygenation,
      with certain hydrocarbons undergoing all three reaction types. Of the multiple
      forms of P450 present in liver microsomes, P4502E1 has been identified as the
      primary catalyst of hydrocarbon bioactivation in animals and, most likely, in
      humans as well. As hepatic concentrations of this P450 enzyme are highly
      inducible by ethanol and similar agents, prior exposure to 2E1-inducing compounds
      can play a pivotal role in halogenated hydrocarbon toxicity. Considering that
      metabolism governs the cytotoxicity and carcinogenicity of halogenated
      hydrocarbons, an understanding of the mechanism(s) underlying 2E1 induction in
      man becomes all the more important.

PMID- 8471159
TI  - Free radicals as mediators of tissue injury and disease.
AB  - A radical is any molecule that contains one or more unpaired electrons. Radicals
      are normally generated in many metabolic pathways. Some of these radicals can
      exist in a free form and subsequently interact with various tissue components
      resulting in dysfunction. The potential role of oxygen- or xenobiotic-derived
      free radicals in the pathology of several human diseases has stimulated extensive
      research linking the toxicity of numerous xenobiotics and disease processes to a
      free radical mechanism. However, because free radical-mediated changes are
      pervasive and often poorly understood, the question of whether such species are a
      major cause of tissue injury and human disease remains equivocal. This review
      discusses cellular sources of various radical species and their reactions with
      vital cellular constituents. Examples of purported free radical-mediated
      disorders are discussed in detail to provide insights into the controversy over
      whether free radicals are important mediators of tissue injury.

PMID- 8471160
TI  - Stress proteins in aquatic organisms: an environmental perspective.
AB  - The cellular stress response protects organisms from damage resulting from
      exposure to a wide variety of stressors, including elevated temperatures,
      ultraviolet (UV) light, trace metals, and xenobiotics. The stress response
      entails the rapid synthesis of a suite of proteins referred to as stress
      proteins, or heat-shock proteins, upon exposure to adverse environmental
      conditions. These proteins are highly conserved and have been found in organisms
      as diverse as bacteria, molluscs, and humans. In this review, we discuss the
      stress response in aquatic organisms from an environmental perspective. Our
      current understanding of the cellular functions of stress proteins is examined
      within the context of their role in repair and protection from environmentally
      induced damage, acquired tolerance, and environmental adaptation. The tissue
      specificity of the response and its significance relative to target organ
      toxicity also are addressed. In addition, the usefulness of using the stress
      response as a diagnostic in environmental toxicology is evaluated. From the
      studies discussed in this review, it is apparent that stress proteins are
      involved in organismal adaptation to both natural and anthropogenic environmental
      stress, and that further research using this focus will make important
      contributions to both environmental physiology and ecotoxicology.

PMID- 8471161
TI  - Human TRE17 oncogene is generated from a family of homologous polymorphic
      sequences by single-base changes.
AB  - The tre oncogenic locus was identified in transformants receiving human DNA from
      Ewing's sarcoma cells EW1. Genetic elements of tre originate from chromosomes 5,
      18, and 17. The TRE17 oncogene is consistently transcribed in various human
      cancer cells and proves oncogenic (onc) in expression vector-based assays. Here,
      the nucleotide sequence of TRE17 with defined noncoding and two coding exons
      (4,426 nucleotides) was compared with sequences cloned from placental DNA library
      or generated by polymerase chain reaction (PCR) from EW1 and independent healthy
      individuals. Cloned sequences displayed restriction site polymorphism, with
      different patterns for EW1 and normal tissues. Sequence analysis revealed that
      they originate from a family of homologous sequences alpha, beta, and gamma.
      TRE17 alpha and less frequent TRE17 beta (similarity score approximately equal to
      88%) were found in both normal and EW1 cells. oncTRE17, classified as TRE17 beta,
      differed from the wild-type TRE17 beta, besides a few intronic changes, by a
      single-base frameshift insertion in one of the coding exons. TRE17 gamma, so far
      identified in EW1 but not in normal somatic cells, diverged from oncTRE17 by 6%
      nucleotide substitutions and by stop codons in each reading frame. The results
      are consistent with the possibility that TRE17 sequences other than oncTRE17 are
      translated if alternatively spliced. Expression of TRE17 in normal somatic cells
      was, however, not yet reported.

PMID- 8471162
TI  - Immortalization of a fetal rat brain cell line that expresses corticotropin
      releasing factor mRNA.
AB  - By introducing the SV40 T antigen under the control of promoter sequences from
      the gene encoding the rat corticotropin-releasing factor (CRF) into primary
      cultures from fetal rat brain, a stable cell line was established that expresses
      the SV40 T antigen and transcribes its endogenous CRF gene. The cell line
      exhibits neuronal properties, as demonstrated by positive immunostaining with
      antibodies against neuronal markers, and it provides a useful system for the
      detailed analysis of the transcriptional regulation of the neuropeptide gene at
      an early stage of development. Promoter activities of the CRF 5'-flanking region
      were tested in transient expression assays after transfection of the cell line
      with different fusion constructs with CRF promoter regions linked to the
      bacterial chloramphenicol acetyltransferase (CAT) gene. Basal activity of the
      promoter was determined by DNA sequences between positions -269 and -222 upstream
      of the transcriptional start site and showed weak induction upon treatment with
      forskolin.

PMID- 8471163
TI  - Structure of the gene coding for the human retinoic acid-inducible factor, MK.
AB  - The retinoic acid-inducible MK gene shows a distinct developmental pattern of
      expression, which implies that it has potential growth regulation and
      differentiation functions, particularly in the brain. We report here the cloning
      of the human MK gene from a phage library constructed from placental tissue. The
      structure of this gene has been determined using Southern hybridization and DNA
      sequence analysis. An isolated fragment was cloned and found to contain sequences
      identical to those of a previously isolated human MK cDNA clone, MKHC4. The gene
      contains three introns within the MK coding region as well as additional
      sequence, which indicates the presence of an intron prior to the putative protein
      start site. As judged by sequence analysis of cDNA clones, primer extension
      studies, and Northern analysis, the most abundant human MK message corresponds to
      the major mRNA of the previously described mouse gene. Primer extension studies
      and cDNA sequence data suggest that minor messages may be transcribed from the
      human gene, but no evidence of additional messages has been found by Northern
      analysis. This is in contrast to the mouse MK gene, from which three mRNAs are
      transcribed. Nevertheless, the similarity in the overall genomic structure of the
      human and mouse genes is striking.

PMID- 8471164
TI  - Characterization of seven processed pseudogenes of nucleophosmin/B23 in the human
      genome.
AB  - Genomic blot analysis revealed that the nucleophosmin/B23 gene belongs to a
      multigene family that has about 10 copies per haploid human genome. In searching
      for human nucleophosmin/B23 functional genes, seven processed pseudogenes (NG1
      1.6, NG2-6, NG3-3, NG4-5, NG5-4, NG6-4, and NG7-6) were isolated and
      characterized. Four of them, NG2-6, NG3-3, NG4-5, and NG7-6, contain the
      sequences corresponding to the full-length cDNA. NG1-1.6 is 5'-truncated, whereas
      NG5-4 and NG6-5 are 3'-truncated pseudogenes. Of the seven pseudogenes, NG3-3
      clone has the longest 5' untranslated sequence, which contains 104 nucleotides
      upstream of the translation initiation codon (AUG). Two processed pseudogenes
      (NG2-6 and NG3-3) have different polyadenylation sites from the mRNA, indicating
      the usage of alternative polyadenylation signals at the 3' sequence.

PMID- 8471165
TI  - Oligodeoxynucleotides capable of binding to GC-rich regions in DNA are
      inappropriately synthesized during random hexanucleotide-primed labeling
      reactions.
AB  - Random hexanucleotide labeling is a commonly used and powerful technique for
      preparing radiolabeled nucleic acid probes. Because of the dependence of DNA
      polymerase upon single-stranded DNA as a template, the technique should
      theoretically also be useful for detecting small amounts of single-stranded DNA
      in the presence of a larger amount of double-stranded DNA. In the course of such
      an experiment, we identified an unexpected reaction that could contribute to
      background problems often encountered during Southern and Northern blotting. In
      the complete absence of template, random hexanucleotides appear capable of
      functioning both as template as well as primer, giving rise to labeled
      oligonucleotides as large as 20-mers. Some of these bind very tightly to GC-rich
      regions in target DNA immobilized on membranes, resisting high-stringency washing
      conditions. By choosing shorter incubation times and including sufficient single
      stranded template, the problem may be minimized.

PMID- 8471166
TI  - Binding constant determination studies utilizing recombinant delta CREB protein.
AB  - In this study, we report the binding constants (Kd) of the cAMP-responsive
      element binding protein (delta-CREB) for various cAMP-response element (CRE)
      motifs. We utilized purified recombinant delta CREB protein in binding reactions
      with natural CRE motifs found in the promoter of two neuropeptide hormone genes
      and with several variant CRE motifs. The Kd of delta CREB for the perfectly
      palindromic CRE, TGACG-TCA, found within the somatostatin promoter is estimated
      to be 5.0 x 10(-9) M. The Kd of delta CREB for the variant CRE motif TG_CGTCA
      found within the enkephalin promoter is calculated to be in the 3 x 10(-8) M.
      These studies provide an in vitro quantitative assessment of the binding affinity
      of delta CREB for various CRE motifs.

PMID- 8471167
TI  - Immobilization and recovery of fusion proteins and B-lymphocyte cells using
      magnetic separation.
AB  - A new approach to facilitate immobilization and affinity purification of
      recombinant proteins and selected human B lymphocytes has been developed. Using
      magnetic beads with attached DNA containing the Escherichia coli lac operator,
      fusion proteins comprising the DNA-binding lac repressor could be affinity
      purified and recovered by gentle elution conditions, such as with a lactose
      analogue or by enzymatic means using either deoxyribonuclease (DNase) or
      restriction endonucleases. The results show for the first time that a DNA-binding
      protein can be used for affinity purification of fusion proteins as exemplified
      by the specific and gentle recovery of beta-galactosidase and alkaline
      phosphatase from bacterial lysates using immunomagnetic separation. The approach
      was further extended to cell separation by the efficient recovery and elution of
      human CD37 B lymphocytes from peripheral blood.

PMID- 8471168
TI  - [Surgical treatment of cranial dysostosis with internal fixation method].
AB  - We present our experience using plates and screws for the fixation of
      craniofacial mobilizations. We describe the osteotomies "monoblock advancement"
      combined or not with "facial bipartition", used for the treatment of Crouzon's
      disease and Apert's syndrome respectively. We expose our experience gained on 42
      patients with a follow up of six years, pointing out the indications for plates
      and screws. The advantages of this method are discussed, being mainly these:
      stable fixation, early surgery and no intermaxillary fixation needed.

PMID- 8471169
TI  - [Fatty and muscular areas of the arm: indicators for the nutritional evaluation
      of pre-school children].
AB  - The assessment of skinfold thickness has been used to estimate protein reserve
      through arm muscle area (AMA) and through arm fat area (AFA) it can assess
      caloric reserve. The aim of this paper is to compare trends of AMA in pre-school
      children living in Tijuana with american children of the same ages. This study
      has been accomplish in pre-school children attending to the Federal Education
      System. Through a randomly sample it was chosen 30 school, afterwards in
      systematic was done to assess 900 children aged 48 to 78 months old. This studied
      variables were: weight, height, arm circumference and triceps skinfold thickness,
      obtained according to accepted techniques at the international literature. From
      which were created AMA and AFA, according to formulas already described. A
      multiple regression model was obtained from AMB to height, between expected and
      experimental values. Using analysis of variance to determined differences between
      slopes and intercepts. In this paper are shown the statistics and distributions
      for AMA and AFA. Correlations for reference and experimental values were linear
      and no significant differences were observed between the slopes and intercepts of
      the set of data. These results suggest that form the point of view considering
      AMA, growth rate between Tijuana children and American similars are apparently
      the same at this ages.

PMID- 8471170
TI  - [Subependymal/intraventricular hemorrhage in preterm newborn infants.
      Neurodevelopmental course during the first year of life].
AB  - Subependymal/intraventricular hemorrhage (SE/IVH) is the most frequently
      encountered type of hemorrhage in the neonatal period. Premature infants often
      develop SE/IVH which remains is one of most serious neonatal events. We studied a
      group of 96 premature newborn infants: half of which were diagnosed with SE/IVH.
      We evaluated the babies at six and 12 months of age which++ a battery of
      neurobehavioral exams, including neurological, psychological, motor an
      audiological test. In 52 of infants with SE/IVH showed some type of
      neurobehavioral abnormality, compared with 13% of non-SE/IVH infants. In 56% of
      SE/IVH infants had neurological abnormalities at 12 months (P < 0.0001)
      difference with non-SE/IVH), predominantly in areas of muscle tone and reflex.
      Motor abnormalities were encountered in 42% of SE/IVH children, and in 4% of non
      SE/IVH children at 12 months. Psychometric abnormalities at 12 months were noted
      in 53% of the SE/IVH group. Hypocusis were noted in 38% of the SE/IVH group and
      in 15% of the non-SE/IVH group.

PMID- 8471171
TI  - [Risk factors associated with the development of leukemia in children].
AB  - INTRODUCTION: Leukemia is the most frequent neoplasia in children; in our country
      it is the main cause of medical attention in children with cancer. The are
      different risk factors associated with the development of this kind of cancer.
      OBJECTIVE: To identify which of the already known factors described in the
      literature associated with the development of leukemia are most frequent in the
      pediatric population of Mexico City. MATERIAL AND METHODS: A protective case
      control study was carried out using prevalent and incident cases. In two third
      level hospitals of Mexico City, a total of 81 children who had been diagnosed as
      suffering from different kind of leukemia, confirmed by biopsy of bone marrow,
      were select and studied. The control were 154 children from two different
      sources: 77 of them came from the same hospital where the cases received medical
      care, the selection criteria was not to have any kind of neoplasia; and 77 came
      from the same community where those diagnosed children cases lived, the selection
      criteria for this group was that they were healthy children. Both cases and
      community controls were visited at home and interview to complete precoded
      questionnaire with the different variables of the study. The information from the
      hospital controls was obtained during the time they stayed in the hospital. Odds
      ratio (OR's) for the different associations were calculated, as well as its
      confidence intervals at 95% (IC) accord to Cornfield and unconditioned logistic
      regression was carried out to control confounding variables. RESULTS: OR greater
      than 1 was found in those with familiar cancer background 1.93 (1.2-3.63); the
      mother being exposed to X-ray during pregnancy 1.89 (0.84-4.22); previous
      abortions before the child with leukemia was born 2.44 (1-06-5.68); being born
      from full term birth 2.42 (0.47-16.65); being born with weight greater that 3500
      g 2.21 (1.04-4.33); being exposed to fertilizers 4.73 (1.04-24.14) and
      insecticides 1.93 (1.05-3.56). OR smaller than 1 was found in those who have been
      in a hospital because of an infectious disease during the first year of life 0.57
      (0.17-1.74); to have suffered from chicken pox 0.59 (0.32-1.08). No association
      to parent's age or job was found. Multivariated analysis shows that the exposure
      to insecticide is the most important risk factor associated with the development
      of leukemia in children. CONCLUSIONS: We obtained positive associations to
      different risk factors described in the literature, having found that exposure to
      fertilizers is the most important risk factor and finding no association with the
      parent's occupation. This leads to the need of carrying out further studies to
      investigate, in more detail, the occupation of the father to confirm whether or
      not this is a risk factor.

PMID- 8471172
TI  - [Acute appendicitis in the first 3 years of life: presentation of 72 cases and
      review of the literature].
AB  - The appendicitis in infants, including premature and newborn are exceptional. In
      smallers of three years is few frequently and plenty they are driving to fulfill
      the laparotomy. Diagnostic is hard for the atypical clinical picture and the
      rapid evolution toward appendicular boring and generalized peritonitis, modified
      or not for antibiotics use. The main symptoms of appendicitis finding in this
      study were: fever, vomitus, pain and abdominals distention. To research the
      muscular resistance become generalized, the McBurney signs and bonce. There were
      leucocytosis, urine alterations and the "X"-rays films showed occlusion signs and
      paralytic ileo. The ultra-sound scan were of great utility in the diagnostic of
      acute appendicitis and its complications, abscess of walls of intraperitoneal.
      There surgery was be urgent. The insiction for right half supra and
      infraumbilical become more frequently, next with appendicectomy of Oschner. Were
      utilized drain pipe in perforating or abscess cases. The post-operative
      complications more frequent seen were infection on the surgical hurt. The supured
      and gangrened appendicitis and perforated and abscessed walls were treated with
      antibiotics. The mortality rate were zero in this analyzed group.

PMID- 8471173
TI  - [Antiphospholipid syndrome: a new diagnostic option in rheumatology in children.
      Analysis of 3 clinical cases].
AB  - There are some patients with a clinical picture that suggests to be a
      rheumatological problem. However, it does not have all the criteria to be
      accepted such as specific problems like systemic lupus erythematosus, juvenile
      rheumatoid arthritis, etc. Now we know that a relation between high levels of
      antiphospholipid antibodies exist in these special patients and the name of the
      disease is antiphospholipid syndrome. This problem can be primary or secondary.
      This disease has been studied mainly in adults with SLE an there is not a
      description of this syndrome in national pediatric literature. For this reason we
      present three clinical cases that permit us to review both forms of the syndrome.
      In this way we alert want to the pediatric community about this topic, and if the
      number of cases increases, it will improve the knowledge and prognosis of the
      patients at this age.

PMID- 8471174
TI  - [Disseminated histoplasmosis in pediatrics. Report of a case].
AB  - We report a case of a female infant, from Acapulco Guerrero, Mexico. She had been
      sick for 45 days, with diarrhea and general malaise, fever during the last 20
      days; at physical examination she was pale, with abdominal distention and
      hepatosplenomegaly. She had leukopenia, thrombocytopenia and anemia. The
      microscopic findings in the bone marrow sample were intracytoplasmic and
      extracellular bodies. Both bone marrow and blood cultures were positive for
      Histoplasma capsulatum. Seventy three pediatric cases of diseminated
      histoplasmosis have been described in the medical literature since 1934 to 1988.
      It is know that only about 1% of the persons that become infected will develop a
      diseminated disease.

PMID- 8471175
TI  - [Sudden death syndrome in childhood. Current recommendations for its possible
      prevention].
AB  - The sudden infant death syndrome (SIDS) has a prevalence of 0.31 to 3.5 per 1000
      live newborns. It has its peak between two and four months with a greater
      incidence in the winter season. This syndrome should be diagnosed only after a
      careful post-mortem examination and a review of the death scene. The babies with
      SIDS have physiologic differences in their autonomic nervous system when compared
      with control groups. These babies have a history of excessive room heating and
      infant bedding. In addition the position most commonly used to put these infants
      to bed is the prone position. Changes in the way these infants are put to bed,
      changing from prone to supine position, have led to a significative reduction in
      SIDS. In order to decrease accidental death by asphyxia, pillows filled with
      polysterene beads should be avoided.

PMID- 8471176
TI  - [Hyaline membrane disease].

PMID- 8471177
TI  - Microbial metabolism of quinoline and related compounds. XVI. Quinaldine
      oxidoreductase from Arthrobacter spec. Ru 61a: a molybdenum-containing enzyme
      catalysing the hydroxylation at C-4 of the heterocycle.
AB  - Quinaldine oxidoreductase from Arthrobacter spec. Ru 61a converts quinaldine to
      1H-4-oxoquinaldine. The enzyme was purified 70-fold to apparent homogeneity in a
      5-step procedure with a recovery of 4%. The molecular mass of the native enzyme
      was calculated to be 340,000 Da by gel filtration. SDS-polyacrylamide gel
      electrophoresis of the enzyme revealed 3 protein bands corresponding to 82,000
      Da, 35,000 Da and 22,000 Da. The enzyme contained 1.6 atoms of molybdenum, 8
      atoms of iron, 8 atoms of acid labile sulfur, 2 molecules of FAD and as part of
      the molybdenum cofactor, molybdopterin cytosine dinucleotide. Due to the
      composition of the cofactors the quinaldine oxidoreductase belongs to the class
      of molybdo-iron/sulfur-flavoproteins. Cyanide, arsenite and 4
      hydroxymercuribenzoate were effective inhibitors whereas the enzyme was not
      affected by methanol.

PMID- 8471178
TI  - Amino-acid sequence of the alpha D- and beta-polypeptide chains of the Japanese
      quail hemoglobin.
AB  - Two hemoglobin components are recognized in the erythrocytes of the adult
      Japanese quail: a major (Q-II) and a minor (Q-I) component. We have determined
      the amino-acid sequence of the alpha D-globin of the minor component and the beta
      globin which is common to both components by conventional protein sequence
      analysis. The sequences of both the alpha D- and the beta-globins showed close
      homology with those of their counterpart constituents in other avian hemoglobins.
      Proline at position 119 in the alpha D-globin which is known to be critical for
      the altitude respiration by the alpha 1 beta 1 interface is conserved in the
      Japanese quail hemoglobin.

PMID- 8471179
TI  - Actin-sequestering ability of thymosin beta 4, thymosin beta 4 fragments, and
      thymosin beta 4-like peptides as assessed by the DNase I inhibition assay.
AB  - Thymosin beta 4 containing 43 amino-acid residues belongs to a family of highly
      homologous peptides present at high concentrations in various species, cells, and
      tissues. Safer et al. [J. Biol. Chem. 266, 4029-4032 (1991)] have shown that
      thymosin beta 4 is an actin-sequestering peptide. Because DNase I is inhibited by
      G-actin and not by F-actin we employed this enzymatic assay to determine the
      actin sequestering properties of 4 other thymosin beta 4-like peptides and
      fragments of thymosin beta 4 generated by enzymatic digestions. Thymosin beta 4
      sequesters G-actin at a 1 to 1 ratio an thereby inhibits its polymerisation to F
      actin in high salt solution. The oxidation of the single methionine residue at
      position 6 does not abolish its actin-sequestering properties. However neither
      thymosin beta 4 24-43 nor thymosin beta 4 13-43 inhibit the polymerisation of G
      actin. We conclude from this that some structural features in the amino-acid
      sequence of thymosin beta 4 before position 13 are obligatory for its biological
      function. Oxidized thymosin beta 4 (beta 4-sulfoxide) as well as four other
      thymosin beta 4-like peptides were shown to be actin-sequestering peptides like
      thymosin beta 4.

PMID- 8471180
TI  - Subsite affinities of Aspergillus niger glucoamylase II determined with p
      nitrophenylmaltooligosaccharides.
AB  - Kinetic parameters were obtained for glucoamylase catalysed hydrolysis of
      substrates of an alpha-(1,4)-maltooligosaccharide series and of a p-nitro-phenyl
      alpha-maltooligosaccharide series. p-Nitrophenyl substrates of chain length 11
      and 17 were synthesized in 97% and 95% purity, respectively, to test the
      significance of binding at remote subsites. The affinities of the subsites > 4
      are demonstrated to be insignificant. The subsite binding contributions for D
      glucopyranosyl and for p-nitrophenyl residues were calculated.

PMID- 8471181
TI  - Alterations in lipid characteristics of lysosomes are involved in liver necrosis
      induced by thioacetamide.
AB  - To determine whether lysosomal lipid composition is altered in hepatic necrosis,
      we studied this parameter in thioacetamide-induced necrosis and in its
      regenerating stage as well as in the recovery of thioacetamide-induced injury.
      Results showed that in liver necrosis there is an increase in the protein and
      phospholipid lysosomal contents. This effect may be related to an increased
      number of lysosomes. These organelles also suffered a decrease in cholesterol
      content. When liver necrosis was recovered either pharmacologically or
      spontaneously all three parameters recovered their normal values. These results
      suggest that lysosomes and their lipid composition play a role in progression of
      hepatic necrosis.

PMID- 8471182
TI  - Thimet oligopeptidase--a review of a thiol dependent metallo-endopeptidase also
      known as Pz-peptidase endopeptidase 24.15 and endo-oligopeptidase.
AB  - Thimet oligopeptidase (EC 3.4.24.15) is a thiol-dependent metallo-endopeptidase
      also known as Pz-peptidase, collagenase-like peptidase, endooligopeptidase A,
      soluble metallo-endopeptidase and endopeptidase 24.15. The enzyme is closely
      related to the yeast proteinase yscD. Thimet oligopeptidase (M(r) 74000) is
      widely distributed in animals and plants. In rat liver it exists in a cytoplasmic
      and mitochondrial form; a membrane-bound form of the enzyme was discovered in rat
      brain. Thimet oligopeptidase hydrolyses small peptides but does not act on
      proteins. In rat brain thimet oligopeptidase is involved in the generation of
      enkephalins and inactivation of bioactive peptides and experiments with yeast
      provided good evidence that the enzyme is involved in the late stages of
      cytoplasmatic protein degradation.

PMID- 8471183
TI  - Marketing aspects of company-sponsored postmarketing surveillance studies.

PMID- 8471184
TI  - Theophylline. Current thoughts on the risks and benefits of its use in asthma.
AB  - Theophylline and its derivatives have been used in the treatment of asthma for
      over 50 years, but since the advent of more potent bronchodilators their use has
      become cloaked in controversy. Their continued existence results from their
      undoubted usefulness in severe acute asthma, nocturnal asthma, childhood asthma
      and moderate to severe chronic airflow limitation, and because of habitual use by
      physicians in other situations. The precise mechanism of action of theophylline
      remains uncertain. The role of phosphodiesterase inhibition and adenosine
      antagonism has been reviewed and the clinical significance of the anti
      inflammatory action of theophylline discussed. Theophylline has unpredictable
      metabolism when first administered, and continued monitoring of drug
      concentrations is essential. Commonly encountered adverse effects may occur at
      therapeutic serum concentrations, frequently necessitating drug withdrawal. The
      overlapping therapeutic and toxic theophylline serum ranges can lead to life
      threatening adverse effects at the upper end of the therapeutic range, especially
      in the elderly in whom special precaution is required.

PMID- 8471185
TI  - Comparative tolerability profiles of thrombolytic agents. A review.
AB  - The 4 widely available thrombolytic agents, alteplase (recombinant tissue
      plasminogen activator, rt-PA), anisoylated plasminogen streptokinase activator
      complex (APSAC; anistreplase), streptokinase and urokinase have revolutionised
      the treatment of acute myocardial infarction and are also effective in treating
      pulmonary embolism and peripheral arterial thrombosis. Therapeutic efficacy of
      the agents appears to be similar. Choice of a thrombolytic agent depends more on
      patient characteristics, availability and familiarity with the drug, cost and
      differences in tolerability. While overall thrombolytic therapy is relatively
      safe, these 4 agents differ in their tolerability profiles. Streptokinase has the
      lowest cerebral haemorrhage rate, anistreplase an intermediate and alteplase the
      highest rate. The incidence of total stroke is also higher with alteplase and
      anistreplase than with streptokinase, translating to an actual difference in
      patient risk of 4 extra strokes per 1000 patients treated. Risk of major bleeding
      is dependent on predisposing factors and seems to be similar with each agent. The
      incidence of hypotension with alteplase (4.3% in ISIS-3) is less than with
      streptokinase or anistreplase (6.8 and 7.2%, respectively in ISIS-3). The
      incidence of major anaphylactic reactions with streptokinase and anistreplase is
      low (< 1%). Urokinase and alteplase may be preferred for readministration of
      thrombolytic therapy and anistreplase is the agent of choice where rapid
      completion of therapy is desirable. The various agents may have different
      tolerability profiles with different adjunctive therapies and further data are
      therefore required.

PMID- 8471186
TI  - Drug interactions of clinical significance with opioid analgesics.
AB  - Opioid analgesics and other drugs interact through multiple mechanisms, resulting
      in pharmacological effects that depend upon the pharmacodynamic action studied,
      the interacting agents and the route of administration. Many interactions result
      from induction or inhibition of the hepatic cytochrome P450 mono-oxygenase
      system. The elimination of opioids is largely dependent on hepatic metabolism,
      and drug interactions involving this mechanism can therefore be clinically
      significant. Antibiotics are often used concomitantly with opioids in patients
      undergoing medical or surgical procedures; the best documented metabolic
      interactions are with erythromycin and rifampicin (rifampin). Erythromycin
      increases and rifampicin decreases the effects of opioids. Cimetidine may
      increase the effects of opioids by increasing their duration of action; there
      have been no documented cases of interactions with ranitidine. Carbamazepine,
      phenytoin and the barbiturates can enhance the metabolism of opioids that rely on
      hepatic metabolism. Other pharmacokinetic interactions include those with
      benzodiazepines, tricyclic antidepressants, phenothiazines and metoclopramide.
      Interactions involving pharmacodynamic mechanisms are more common than
      pharmacokinetic ones. Such interactions are manifested clinically as as a
      summation (additive or synergistic) of similar or opposing pharmacological
      effects on the same body system. Idiosyncratic interactions also occur, the
      mechanisms of which have not been proven to be solely modulated by either
      pharmacokinetic or pharmacodynamic means. The knowledge of particular opioid-drug
      interactions, and the causative pharmacokinetic, pharmacodynamic, and
      idiosyncratic mechanisms, allows for the safer administration of opioid
      analgesics.

PMID- 8471187
TI  - Risk-benefit assessment of nicotine preparations in smoking cessation.
AB  - Nicotine influences many risk factors for cardiovascular disease, peptic ulcer
      disease, pregnancy complications and wound healing; however, whether nicotine
      itself actually causes or aggravates these diseases has not been well
      demonstrated. The safety of nicotine preparations for smoking cessation depends
      on the population, formulation, route of administration, dose, and frequency and
      duration of use. Major adverse effects of nicotine polacrilex and transdermal
      nicotine are very rare. Nicotine therapy usually doubles long term abstinence
      rates and is especially beneficial to highly dependent smokers. Nicotine
      replacements produce lower nicotine concentrations than cigarettes, and no tar
      and carbon monoxide; thus, it is difficult to justify absolute contraindications
      to these products. Decisions on the use of nicotine preparations in pregnancy,
      coronary disease, etc., must consider not only the medical status of patients but
      also their likelihood of stopping smoking with and without the help of nicotine
      replacement.

PMID- 8471188
TI  - Effects of exogenous lipids on cancer and cancer chemotherapy. Implications for
      treatment.
AB  - The addition of fatty acids to the diets of tumour-bearing animals results in
      specific and defined structural modification of the tumour membrane lipids
      without disrupting the cell. Furthermore, fatty acids at higher concentrations
      may act directly as anticancer agents, and there is evidence of selective
      sensitivity of neoplastic cells. Similarly, experimental enrichment of the diets
      with specific lipids modulates carcinogen-induced tumorigenesis at the initiation
      or promotion steps, and in some animal models, the growth rate of established
      tumours. Therefore, anticancer therapies which utilise lipid-based strategies may
      be useful clinically. Although dietary strategies used alone may have some
      favourable effect, it seems likely that the combination of diet with anticancer
      drugs has the best possibility of providing the extent of cytotoxicity required
      for tumour eradication. Such combinations could take advantage of an additive
      effect of each, or could act synergistically such as by the influence of dietary
      fatty acid modification on drug transport. However, dietary lipids may also
      increase the toxicity of anticancer drugs to normal tissues and decrease the
      therapeutic index. Further research is needed to define the role of lipids in
      future chemotherapy.

PMID- 8471189
TI  - Acute amitriptyline withdrawal and hyponatraemia. A case report.
AB  - The tricyclic antidepressants (TCAs) are commonly used in the treatment of
      depression and, perhaps due to the nature of the condition being treated, figure
      prominently in cases of deliberate overdosage, where the toxicity of
      amitriptyline has been well established. However, the abrupt cessation of TCA
      administration can also be detrimental to the patient, triggering withdrawal
      phenomena often characterised by an exacerbation of the symptoms for which the
      patient was originally treated. We present a biochemically proven case of
      amitriptyline withdrawal where the clinical features at presentation made it
      difficult to distinguish from acute toxicity. The patient's neurological signs
      and distended bladder suggested amitriptyline toxicity, whereas the history and
      signs of cholinergic hyperactivity were consistent with acute withdrawal. The
      diagnosis was confirmed at a later date when further history and a biochemical
      analysis of plasma TCA concentrations became available. Hyponatraemia may have
      exacerbated the condition of the patient, whether or not it was caused by
      amitriptyline.

PMID- 8471190
TI  - Carbamazepine overdose. Features of 33 cases.
AB  - Review of the medical records of 2 major adult teaching hospitals for a 4-year
      period revealed 33 instances of carbamazepine overdose. These patients had a mean
      age of 30 years and 58% were known epileptics. They ingested a mean of 12g
      carbamazepine (range 1.6 to 45g), with 51% of cases involving other drugs,
      particularly alcohol. The clinical manifestations of toxicity formed a
      recognisable clinical picture of diminished conscious state (100% of patients),
      mydriasis (42%), abnormal muscle tone and tendon reflexes (55%) and ataxia,
      nystagmus or ophthalmoplegia (48%). 24% of cases were complicated by seizures.
      The incidence of hyperglycaemia and hypokalaemia were related to higher drug
      concentrations. 12% showed hyponatraemia and 50% had transient evidence of
      hepatic dysfunction. The pharmacokinetic properties of carbamazepine play a role
      in determining management strategies. Management is largely supportive through
      avoidance of drug interactions, large doses of activated charcoal, careful airway
      management and correction of electrolyte disturbances.

PMID- 8471191
TI  - Biology of Toxoplasma gondii.
AB  - In conclusion, a large body of new information on the biology and immunology of
      T. gondii has accumulated in the past several years. Much of this is due to the
      advent of AIDS and the increased funding made available to researchers interested
      in opportunistic infections in this patient population. These scientific advances
      have led to a better understanding of the process by which Toxoplasma infects
      mammalian host cells, molecular biology and biochemistry of the parasite,
      antigenic structure and immune response to the infection and approaches to be
      adopted for drug design and therapeutic strategies. Thus, it is through such
      recognition of the importance of understanding the basic science of an
      opportunistic pathogen that such advances can be realized.

PMID- 8471192
TI  - HIV-1 infection and modulation of cytokine and growth factor expression in
      Kaposi's sarcoma-derived cells in vitro.
AB  - OBJECTIVES: HIV-1 transcripts have been detected in AIDS-related Kaposi's sarcoma
      (KS) tissues within the factor XIIIa + dermal dendrocytes present in the tumor.
      Various cytokines and growth factors have been shown to influence the growth of
      KS-derived cells in vitro. HIV-1 preferentially infects CD4+ cells and has also
      been found to infect some CD4- cells in vitro. The susceptibility of cultured KS
      cells in vitro to infection with HIV-1 and the expression of interleukin (IL)-1
      beta, IL-6 and basic fibroblast growth factor (bFGF) after exposure to HIV-1 was
      examined. METHODS: The susceptibility of two different KS-derived cell cultures
      to HIV-1 infection was examined by the expression of p24 antigen, detection of
      proviral sequence and electron microscopy. The expression of IL-1 beta, IL-6 and
      bFGF was detected by enzyme-linked immunosorbent assay and reverse transcriptase
      polymerase chain reaction. RESULTS: KS-derived cells can be infected by HIV-1 in
      vitro. Both KS-derived cells were found to express CD4 mRNA. The expression of IL
      1 beta and IL-6 was increased, whereas the expression of bFGF was not stimulated
      after exposure of KS cells to HIV-1. CONCLUSION: These experiments describe the
      in vitro infection of KS-derived cells by HIV-1 and the expression of various
      cytokines and growth factor following infection. The increased production of
      cytokines observed following such infection may be involved in the pathogenesis
      of AIDS-related KS.

PMID- 8471193
TI  - Fibroblast-derived factors preserve viability in vitro of mononuclear cells
      isolated from subjects with HIV-1 infection.
AB  - OBJECTIVE: Peripheral blood mononuclear cells (PBMC) from HIV-infected subjects
      have an increased mortality rate (MR) when incubated in vitro for 3 days in a
      culture medium. We have previously shown that fibroblast-conditioned medium (FCM)
      can preserve viability, without significant activation, of human lymphocytes in
      vitro. We therefore tested the ability of two FCM and other factors to reduce
      spontaneous MR in HIV-positive PBMC. METHODS: PBMC were cultured for 3 days in
      control medium and medium supplemented with FCM or recombinant cytokines
      [interleukin (IL)-2, IL-6, IL-7, granulocyte macrophage colony-stimulating
      factor]. Cells viable at day 3 were counted in a cytofluorimeter after staining
      with ethidium bromide. DNA was extracted from the cultures and evaluated for the
      presence of low molecular weight fragmentation. RESULTS: The MR of PBMC from 51
      HIV-positive subjects and from 21 healthy controls were 30.1 and 9.5%,
      respectively (P < 0.0001). The MR was higher in 40 patients with a CD4+
      lymphocyte count < 400 x 10(6)/l than in subjects with a count > 400 x 10(6)/l
      (32.84 versus 20.96%; P = 0.047). IL-2 and FCM significantly reduced MR in HIV
      positive subjects (MR: 17.8 and 20.4%; P: < 0.001 and 0.005, respectively). This
      effect was more evident in subjects with a CD4+ lymphocyte count < 400 x 10(6)/l
      and in subjects with negative p24 antigenaemia. Cellular proliferation accounts
      for increased survival in IL-2-supplemented cultures but not in those with FCM.
      DNA was extracted from fresh PBMC and cells cultured for 3 days for 22 HIV
      positive cases. DNA degradation was documented and bands related to an apoptotic
      mechanism of death observed, especially in subjects with more advanced disease.
      CONCLUSIONS: Our data suggest that FCM inhibits accelerated cell death in vitro
      of PBMC isolated from HIV-positive patients.

PMID- 8471194
TI  - Effects of retroviral infections on immune function in African-American
      intravenous drug users.
AB  - OBJECTIVES: To determine the effect of retrovirus infection and co-infection, and
      intravenous substance use, on immune function in African-Americans. DESIGN: A
      cohort of South Florida street-recruited African-American intravenous drug users
      formed the study population. The cohort consisted of 90 HIV-negative & human T
      lymphotropic virus (HTLV)-negative, one HIV-negative & HTLV-I-positive, 11 HIV
      negative & HTLV-II-positive, 79 HIV-positive & HTLV-negative, one HIV-positive &
      HTLV-I-positive and 21 HIV-positive & HTLV-II-positive individuals. The results
      reported are for the cross-sectional, baseline assessment of immune parameters.
      METHODS: Lymphocyte phenotypic distributions and functional markers, including
      proliferative response to mitogens and natural killer cell cytotoxicity, were
      determined. Serum immunoglobulin (Ig) levels were determined as a measure of B
      cell activity. RESULTS: HTLV-II infection was associated with increases in CD8
      lymphocyte count and serum Ig, but with no other significant immunologic changes.
      The distribution of CD4 and CD8 percentages, CD4:CD8 ratio, phytohemagglutinin
      (PHA) and pokeweed mitogen (PWM) reactivity, IgA and IgG for the four retrovirus
      serostatus groups suggested the possibility of interactive effects in the co
      infected group, as demonstrated by a trend toward lower medians for CD4 and for
      PHA and PWM response and higher medians for IgG, IgA and CD8. Retrovirus
      seronegative intravenous drug users had significantly impaired immune status
      compared with non-drug-using control individuals. CONCLUSIONS: Immunologic
      dysfunction attributable to HTLV-II infection was minor compared with HIV
      infection in this population. Study subjects who were co-infected with HIV and
      HTLV demonstrated more impairment of immune function than individuals with single
      retrovirus infections.

PMID- 8471195
TI  - Highly specific V3 peptide enzyme immunoassay for serotyping HIV-1 specimens from
      Thailand.
AB  - OBJECTIVE: To develop and evaluate a simple V3 peptide-based enzyme immunoassay
      (EIA) for large-scale serotyping of HIV-1 specimens from Thailand. DESIGN:
      Serologic reactivities with synthetic peptides derived from the V3 loop of gp120
      were used for typing HIV-1 specimens. METHODS: Synthetic peptides PND-A and PND
      B, derived from the consensus amino-acid sequences of the V3 loop of gp120 from
      two major genomic variants of HIV-1 in Thailand (A and B), were evaluated in an
      EIA on 61 Thai HIV-1 sera for which genotypes had been determined by polymerase
      chain reaction. The peptide EIA was then applied to sera from 188 HIV-1-infected
      patients, selected in non-random, convenience samples of known risk groups from
      four geographic regions of Thailand. RESULTS: The sensitivities and specificities
      of PND-A and PND-B were 86% (30 out of 35) and 96% (25 out of 26) and 92% (24 out
      of 26) and 94% (33 out of 35), respectively, with 100% predictive values of a
      monoreactive positive test for both peptides. The assay classified 101 specimens
      as serotype A, 39 as serotype B, eight as serotype AB (dually reactive), and 40
      as untypable (non-reactive). Excluding dual reactors and non-reactors, 92% (77
      out of 84) of specimens from patients probably infected by sexual contact were
      serotype A; conversely, 76% (28 out of 37) of injecting drug users were serotype
      B. CONCLUSION: The serologic results corroborated previous findings, in a smaller
      subset of samples, of an apparent segregation of viral subtypes by mode of
      transmission, suggesting two separate HIV-1 epidemics in Thailand. This peptide
      EIA could be a valuable epidemiologic tool in determining the dynamics of the
      rapid spread of HIV-1 in Thailand.

PMID- 8471196
TI  - Evaluation of mechanical transmission of HIV by the African soft tick,
      Ornithodoros moubata.
AB  - OBJECTIVES: To assess the ability of the African Hut Tampan, Ornithodoros
      moubata, to mechanically transmit HIV-1 and to re-appraise HIV-1 infectivity in
      an arthropod cell line at 28 and 35 degrees C. DESIGN: To evaluate HIV-1
      transmission by O. moubata, as determined by HIV-1 survival, 'blood-meal' size
      and interval between feeds, various tick developmental stages were allowed to
      feed on a heavily infected lymphoblast-rich blood-meal containing HIV-1BRU in an
      in vitro feeding chamber. METHODS: Blood-meal regurgitation was evaluated using
      51Cr-labelled human erythrocytes, and human lymphoblast survival in ticks using
      Trypan blue. HIV-1 survival in ticks was evaluated by reverse transcriptase
      activity in tick homogenates cocultured with CEM lymphoblasts. Polymerase chain
      reaction and Southern blot analysis were used to detect proviral HIV-1 in
      arthropod cells in vitro. RESULTS: HIV-1BRU remained viable for up to 10 days
      with O. moubata adults. This is the longest recorded survival of HIV in an
      arthropod. In agreement with other studies. O. moubata regurgitated part of its
      previous blood-meal into the feeding lesion. Human CEM lymphoblasts partially
      survived for up to 7 days at 28 and 35 degrees C inside O. moubata's digestive
      tract. The blood-meal of adult female ticks was as high as 240 microliters
      (approximately 70 times more than a mosquito), while the most likely potential
      mechanical vectors (fourth- and fifth-stage nymphs) ingested an average of 39
      microliters (maximum, 73 microliters), with some ticks re-feeding as early as 14
      days postfeed in the absence of a moult. Shortcomings associated with the
      experimental protocol suggest that HIV survival within O. moubata may reach 14
      days following natural infection, or that ticks might re-feed earlier. Although
      HIV-1BRU and HIV-1NDK were unable to replicate at 28 and 35 degrees C in CD4-
      Aedes albopictus C6/36 mosquito cells, HIV-1NDK was detected in its proviral
      form. CONCLUSIONS: Our investigations showed that mechanical transmission of HIV
      1 by O. moubata is unlikely to occur in the laboratory. This may not be the
      situation under field conditions.

PMID- 8471197
TI  - The natural history of cryptosporidial diarrhoea in HIV-infected patients.
AB  - OBJECTIVE: To determine the natural history of cryptosporidial infection in HIV
      infected individuals. DESIGN: Retrospective study. SETTING: University teaching
      hospital HIV inpatient and outpatient unit. PATIENTS: Thirty-eight HIV-infected
      patients presenting with cryptosporidial diarrhoea between April 1986 and July
      1991 were identified retrospectively from laboratory records. RESULTS: Eleven of
      the 38 patients had a clinical remission of their diarrhoea. Median lymphocyte
      count of the remission group was significantly higher than that of the non
      remission group (1100 and 550 x 10(6)/l, respectively; P = 0.003). Median
      survival times were 66 and 11.5 weeks for the remission and non-remission groups,
      respectively (P = 0.001). Liver function tests performed at the initial diagnosis
      of cryptosporidial diarrhoea were available for 28 patients. Aspartate
      transaminase was raised in 16 and alkaline phosphatase in 10 of these 28
      patients. Ten patients showed evidence of AIDS-associated sclerosing cholangitis,
      one patient had an episode of acute pancreatitis and another presented with acute
      cholecystitis. CONCLUSIONS: This study suggests that HIV-associated
      cryptosporidial diarrhoea does not have a uniformly poor prognosis. Eleven out of
      38 patients had a spontaneous clinical remission, which appears to be predicted
      by the absolute lymphocyte count. Abnormal liver function tests and hepatobiliary
      disease were common.

PMID- 8471198
TI  - Utility of dapsone for prophylaxis of Pneumocystis carinii pneumonia in
      trimethoprim-sulfamethoxazole-intolerant, HIV-infected individuals.
AB  - OBJECTIVE: To determine the safety and efficacy of 100 mg dapsone three times
      weekly for Pneumocystis carinii pneumonia (PCP) prophylaxis in HIV-infected,
      trimethoprim-sulfamethoxazole (TMP-SMX)-intolerant patients. DESIGN:
      Retrospective chart review of patients followed-up to 22 May 1992. SETTING:
      Infectious diseases outpatient clinic of a tertiary care center in suburban New
      York City. PATIENTS: Twenty-three HIV-infected patients requiring PCP prophylaxis
      with documented intolerance to TMP-SMX. MAIN OUTCOME MEASURES: Patients were
      followed clinically and with laboratory testing at approximately monthly
      intervals. RESULTS: Dapsone was discontinued in nine (39%) patients because of
      adverse reactions. All reactions occurred within the first 2 months of treatment.
      Two (14%) of the remaining 14 patients developed histologically proven PCP over
      126 patient-months of follow-up. CONCLUSION: Approximately 40% of TMP-SMX
      intolerant HIV-infected individuals are also intolerant of dapsone. Prophylaxis
      failures may be expected on a dose regimen of 100 mg dapsone three times weekly.
      More experience with other dose regimens and alternative agents is needed.

PMID- 8471199
TI  - Elevated serum levels of neopterin but not beta 2-microglobulin in HIV-1
      seronegative injecting drug users.
AB  - OBJECTIVE: To determine whether injecting drug use is associated with cellular
      immune activation in the absence of HIV-1 infection. DESIGN: Serum levels of
      neopterin and beta 2-microglobulin (beta 2M) were measured cross-sectionally in
      injecting drug users (IDU) enrolled in a prospective study. SUBJECTS AND METHODS:
      Two hundred and nineteen HIV-1-seronegative, healthy heterosexual black male IDU
      aged 21-49 years were selected from the Baltimore-based AIDS Linked to
      Intravenous Experiences (ALIVE) study. The possibility of including subjects in
      the process of seroconverting to HIV-1 was minimized by restricting the study to
      individuals who remained seronegative 6 months after the specimens used for
      analysis were collected. RESULTS: Mean serum beta 2M levels were not
      statistically different among groups of IDU whose usual pattern of injection was
      at least once a day for up to 3 consecutive days (daily users; n = 65), less than
      once per day (less-than-daily users; n = 75), or not at all for at least 2 weeks
      (non-recent users; n = 79). In contrast, the mean neopterin level was
      significantly (P = 0.039) greater in daily users (6.17 nmol/l) than in the other
      two groups (5.07 and 5.19 nmol/l, respectively, which were not statistically
      different). These results were not affected, by the frequency of using borrowed
      non-sterile works or by other demographic and risk factor variables. CONCLUSIONS:
      Frequent injecting drug use may be independently associated with a small
      elevation of serum neopterin levels, but not beta 2M levels. Although the
      occurrence of a type I error in this sample cannot be completely excluded, serum
      neopterin may be more sensitive than serum beta 2M in detecting activation of
      immunocompetent cells associated with frequent injecting drug use in this
      population.

PMID- 8471200
TI  - Hepatomegaly with severe steatosis in HIV-seropositive patients.
AB  - OBJECTIVE: To describe death attributed to severe hepatomegaly and macrovesicular
      steatosis without inflammation or necrosis in HIV-seropositive patients without
      AIDS. PATIENTS: Patients from the AIDS Clinical Trials Group (ACTG) Adverse
      Reactions and the Food and Drug Administration's (FDA) Spontaneous Report
      databases. RESULTS: Six fatal and two non-fatal cases in which no known cause of
      hepatic steatosis could be found were identified. With one possible exception,
      none of the six fatal cases had a diagnosis of AIDS and all were in reasonable
      nutritional status (as indicated by weight and/or serum albumin); the majority
      were mildly to moderately overweight. All had received at least 6 months of
      antiretroviral therapy, and all had gastrointestinal complaints without other non
      hepatic abdominal pathology. At least three out of the six had no history of
      progressively abnormal liver function tests until a few weeks prior to the onset
      of symptoms and subsequent death. Further investigation of the FDA and ACTG
      databases identified two similar but non-fatal cases in which abnormalities
      resolved after cessation of antiretroviral therapy. CONCLUSIONS: The cases
      described represent a degree of hepatic abnormalities that has not been reported
      previously in HIV-seropositive patients, and are probably an underestimate of
      actual incidence, since patients with possible etiologies of liver disease were
      excluded from the clinical history, laboratory, microbiologic, or histologic
      examination. The etiology of hepatic disease may be associated with
      antiretroviral therapy, HIV, or an unidentifiable infection, and requires further
      investigation.

PMID- 8471201
TI  - Blood transfusion practices in Mwanza Region, Tanzania. Bugando Medical Centre.
AB  - OBJECTIVE: To determine what proportion of blood transfusions given in Mwanza
      Region, Tanzania could be avoided. METHODS: A total of 1029 patients who received
      a blood transfusion in one of eight hospitals were analysed. Two sets of criteria
      for avoidable blood transfusions were determined, on the basis of a literature
      review. RESULTS: The following percentages of blood transfusions in five groups
      of patients were found to be avoidable: operated patients, 8-24%; pregnant women,
      8-10%; children aged under 5 years, 31-52%; children aged 5-14 years, 23-25%; and
      adults, 16-25%. Overall, 23-39% of blood transfusions were avoidable. At least
      75% of all avoidable blood transfusions were to children aged under 5 years.
      CONCLUSIONS: The largest reduction of blood transfusions can be achieved in
      children aged under 5 years, especially in infants aged less than 1 year.
      Following this study, blood transfusion prescribers drew up provisional
      guidelines on blood transfusions, which have been introduced in all hospitals in
      Mwanza Region. An evaluation study has been carried out and is being analysed.

PMID- 8471202
TI  - European Community Concerted Action on HIV seroprevalence among sexually
      transmitted disease patients in 18 European sentinel networks. The European Study
      Group.
AB  - OBJECTIVE: Monitoring HIV infection in sentinel populations of sexually
      transmitted disease (STD) patients in several geographical areas. This paper
      describes the main characteristics of the study populations and compares HIV
      seropositivity rates within and between networks in different subgroups: homo
      /bisexuals, intravenous drug users (IVDU) and non-IVDU heterosexuals. DESIGN: HIV
      testing is performed with informed consent in most networks. It is mandatory for
      STD patients in Hungary, while the English and Welsh, Scottish and French
      networks use unlinked anonymous testing. SETTING: Eighteen networks in 17
      European countries are participating in the study. The networks usually consist
      of STD or dermato-venereology clinics. PATIENTS: Patients presenting at any of
      the clinic sites with a new episode of one or more of a selected list of 12 STD
      were eligible for the study. This study recorded a total of 36,827 STD episodes,
      registered between June 1990 and December 1991. HIV test results were known for
      33,004 (89.6%) of the patients. RESULTS: HIV seropositivity rates were usually
      much higher for the homo-/bisexual and IVDU patients than for the non-IVDU
      heterosexuals. However, HIV-seropositive patients were found among non-IVDU
      heterosexuals in all but the Czech network. CONCLUSION: This Concerted Action has
      successfully launched an HIV sentinel surveillance programme among STD patients
      in 17 European countries using a standard methodology.

PMID- 8471203
TI  - HIV infection in European female sex workers: epidemiological link with use of
      petroleum-based lubricants. European Working Group on HIV Infection in Female
      Prostitutes.
AB  - OBJECTIVES: To assess the prevalence of and risk factors associated with HIV
      infection in European female sex workers, particularly sexual risk factors.
      DESIGN: Multicentre cross-sectional study performed in nine European countries.
      METHODS: Female sex workers voluntarily enrolled between September 1990 and
      November 1991. Face-to-face interviews were conducted in various settings (health
      care, prostitute organizations, outreach) to collect information on over 150
      behavioural, health and sociodemographic variables. Enrollment of intravenous
      drug users (IVDU) was limited to a maximum of 25% of the total sample. The HIV-1
      and HIV-2 antibody status of blood or saliva samples was tested using enzyme
      linked immunosorbent assay and confirmed by Western blot. RESULTS: Eight hundred
      and sixty-six (91.6%) of the 945 interviewees provided blood (n = 824) or saliva
      (n = 42) samples. HIV seroprevalence was 5.3% [44 HIV-1-positives and two HIV-2
      positives (from Lisbon)] overall, 31.8% (35 out of 110) in IVDU and 1.5% (11 out
      of 756) in non-IVDU [odds ratio (OR), 31.6; P < 0.001]. Lack of condom use (P =
      0.002, test for trend) and previous ulcerative sexually transmitted disease (OR,
      3.6; P = 0.06) were associated (on logistic regression) with HIV infection in
      both IVDU and non-IVDU. Previous hepatitis B (OR, 13.8; P = 0.02) and needle
      sharing (OR, 4.1; P = 0.04) were associated with HIV infection in IVDU, and low
      education level (P = 0.02, test for trend), previous transfusion (OR, 9.1; P =
      0.003), origin from sub-Saharan Africa (OR, 5.4; P = 0.05) and use of petroleum
      based lubricants (OR, 15.2; P = 0.001) in non-IVDU. CONCLUSIONS: HIV prevalence
      remains relatively low among non-IVDU prostitutes in Europe. While intravenous
      drug use remains the most important risk factor for HIV, petroleum-based
      lubricants (used by 10% of women in this study) may be a risk factor for HIV
      among European female sex workers; over 80% of those interviewed always used
      condoms with clients.

PMID- 8471204
TI  - HIV risk-related sexual behaviors among heterosexuals in New York City:
      associations with race, sex, and intravenous drug use.
AB  - OBJECTIVE: To investigate the relationship between heterosexual behaviors
      associated with HIV infection and ethnicity, sex, and intravenous drug use.
      METHODS: Subjects were recruited from Bellevue Hospital Center, New York City
      between 1986 and 1989, and interviewed about sexual behaviors and intravenous
      drug use. Analyses were based on 1561 black, white, or Hispanic individuals who
      reported having sexual contact with a member of the opposite sex. RESULTS: Twenty
      seven per cent of the study population were black, 43% Hispanic, and 31% white.
      Blacks were more likely than whites or Hispanics to have initiated sexual
      intercourse at an early age, and to have had a sexually transmitted disease. Sex
      with a female drug user was more common among white men, and contact with a
      prostitute more frequent among Hispanic men. Among the women, Hispanics had fewer
      sexual risk factors overall than whites or blacks. Use of barrier contraceptives
      was uniformly low across all ethnic groups. Intravenous drug use was
      significantly associated with sexual risk-taking. Women were more likely than men
      to have an intravenous drug-using (IVDU) sexual partner. CONCLUSIONS: The large
      prevalence of high-risk sexual practices observed in this study emphasizes the
      continuing need to target AIDS prevention programs at those at highest risk of
      heterosexually transmitted HIV: racial minorities, IVDU, and their sexual
      partners.

PMID- 8471205
TI  - Improved survival from diagnosis of AIDS in adult cases in the United Kingdom and
      bias due to reporting delays.
AB  - OBJECTIVE: To measure developments in survival patterns among United Kingdom
      adult AIDS cases. DESIGN: A follow-up survey of cases reported voluntarily to the
      national surveillance schemes was undertaken to obtain up-to-date information on
      vital status. METHODS: All reporting clinicians who had a current AIDS patient
      not known to have died whose AIDS-defining illness was diagnosed before the end
      of September 1990 were contacted. A total of 3984 cases were included in the
      analysis. RESULTS: An extra third of deaths other than those reported through
      routine channels were ascertained by follow-up. Median survival for patients
      diagnosed before and after the end of 1986 increased from 15 to 18 months for men
      who had sex with men presenting with Kaposi's sarcoma, from 10 to 19 months for
      other men who had sex with men and from 7 to 16 months for all others.
      Improvement in survival was greatest in the first 3 months. One-third of patients
      have been surviving 2 years or more. Factors observed with independent effects on
      improved survival are recent diagnosis, younger age and larger cumulative AIDS
      case load of reporting centre. HIV encephalopathy and other central nervous
      system symptoms may be associated with poorer survival. CONCLUSIONS: Survival
      patterns have been changing and generally improving. Average survival for very
      recent cohorts tends to be underestimated because longer survival has been
      observed in patients for whom there is a longer delay between AIDS diagnosis and
      report to the Communicable Disease Surveillance Centre. Information on mortality
      is improved by active follow-up.

PMID- 8471206
TI  - The epidemiology of AIDS in the Vellore region, southern India.
AB  - OBJECTIVE: To describe the epidemiology of patients with AIDS in Vellore region,
      Southern India. DESIGN AND METHODS: Sixty-one patients with AIDS were diagnosed
      and treated between July 1987 and June 1992. Information on their demographic
      characteristics and probable modes of acquiring HIV infection was collected at
      interviews with them and their spouses. RESULTS: There was a progressive increase
      in the number of patients seen over the 5 years. The mean ages of the 51 men and
      the 10 women were 33 and 29 years, respectively. Of the 44 patients from our
      district (population, 5 million), 28 were from Vellore town and 10 from rural
      areas. Forty-seven (92%) men had frequently used prostitutes. Of the women, four
      were prostitutes, one had had multiple sex partners and five had not had
      extramarital sexual contact. One man and one woman had no other risk factor
      except blood transfusion. Thirty-one (51%) patients had died by August 1992.
      CONCLUSION: The AIDS epidemic in this region is in its early ascending phase,
      with a doubling time of approximately 1 year. Most men with AIDS were infected by
      heterosexual contact with prostitutes, while some women were prostitutes
      themselves. Together with the male-to-female ratio of 5:1, these results suggest
      that the male population at risk has sex with a much smaller population of female
      prostitutes, constituting the major chain of transmission. HIV infection is
      occurring in both urban and rural populations.

PMID- 8471207
TI  - Disclosing HIV seropositivity to significant others.
AB  - OBJECTIVES: To examine gay men's patterns of self-disclosure of HIV
      seropositivity to friends, lovers, relatives and colleagues; to assess the
      effects of disclosure; and to identify reasons for not disclosing to particular
      individuals. DESIGN: Longitudinal questionnaire survey of gay men. METHODS: A
      total of 163 HIV-positive men participating in the AIDS Behavioral Research
      Project, a longitudinal study of San Francisco gay men, completed questionnaires
      about their self-disclosure patterns, health status, and psychological well
      being. RESULTS: HIV-positive men were most likely to disclose their status to
      lovers and closest gay friends. Asymptomatic men were less likely to disclose to
      relatives and colleagues than symptomatic men. Friends and lovers were rated as
      responding more helpfully than relatives and colleagues. Men who perceived their
      significant others as responding more helpfully were less depressed and anxious
      currently and 1 year later. A variety of reasons were given for not disclosing,
      including not wanting to worry others, fear of discrimination, fear of disrupting
      relationships, and emotional self-protection. CONCLUSION: While disclosure can
      have advantages for both HIV-positive individuals and their significant others,
      HIV-positive individuals must be assured that the benefits of doing so will
      outweigh the potential costs.

PMID- 8471208
TI  - p24 antigenaemia and clinical response to zidovudine therapy.

PMID- 8471209
TI  - Case study of zidovudine overdose.

PMID- 8471210
TI  - The presence or absence of gp120/gp160 bands on indeterminate western blots:
      predictive value for HIV seroconversion.

PMID- 8471211
TI  - No antibodies to granulocyte macrophage colony-stimulating factor with prolonged
      use in AIDS.

PMID- 8471212
TI  - Letrazuril therapy for cryptosporidiosis: clinical response and pharmacokinetics.

PMID- 8471213
TI  - The relative efficacy of oral dapsone and nebulized pentamidine as prophylaxis
      for Pneumocystis carinii pneumonia.

PMID- 8471214
TI  - Prevalence of injecting drug use provides the context for epidemiology of HIV
      among injecting drug users.

PMID- 8471215
TI  - Temporal trend of HIV infection among pregnant women in a reference hospital in
      Barcelona.

PMID- 8471216
TI  - Inheritance of parental chromosomes 15 in Angelman syndrome--implications for the
      family.
AB  - Molecular and cytogenetic studies in Angelman syndrome have demonstrated that the
      condition is genetically heterogeneous with a recurrence risk in certain families
      which may be as high as 50%. In an attempt to identify such families, cytogenetic
      polymorphisms of chromosome 15 have been studied in both affected and unaffected
      siblings of Angelman syndrome patients. The results suggest that in those cases
      with a cytogenetically visible 15q11q13 deletion where the recurrence risk is
      low, normal siblings inherit either maternal chromosome 15 homologue with
      impunity. By contrast, in cases where the proband does not demonstrate a
      cytogenetic 15q11q13 deletion, unaffected siblings tend to inherit the
      alternative homologue to that found in their affected siblings. These findings
      may have importance for genetic counseling.

PMID- 8471217
TI  - Autosomal recessive congenital stenosis of aqueduct of Sylvius.
AB  - Congenital hydrocephalus is an etiologically heterogeneous central nervous system
      malformation. Mendelian inheritance of stenosis of the aqueduct of Sylvius (SAS)
      accounts for almost 2% of all nonsyndromic forms. Among the monogenetic forms the
      great majority are X-linked. In this report we describe autosomal recessive
      transmission of SAS hydrocephalus in a high consanguinity family.

PMID- 8471219
TI  - Wiedemann-Beckwith syndrome and chromosomal duplication 4q/deficiency 18p.
AB  - In this report we present a female newborn with Wiedemann-Beckwith syndrome and
      duplication 4q/deficiency 18p as the result of an unbalanced paternal 4q/18p
      translocation: karyotype: 46,XY,t(4;18)(q34.2;p11.32). The different mechanisms
      resulting in prenatal overgrowth and Wiedemann-Beckwith syndrome phenotype are
      reviewed. The suggestion is made that contiguous gene duplications/deletions
      other than those located in the 11p15 region may exist.

PMID- 8471218
TI  - Carpo-tarsal osteolysis. Case report and review of the literature.
AB  - A hereditary form of multicentric osteolysis is described in an 11-year-old girl
      whose father is also affected. The results after corrective surgery on the foot
      with the Ilizarov fixator and the findings during arthroscopy of the knee are
      discussed. The literature is reviewed.

PMID- 8471220
TI  - Larsen syndrome presenting as a familial syndrome of dwarfism, distinct oldish
      facial appearance and bilateral clubfeet in mother and daughter.

PMID- 8471221
TI  - Macrocephaly and mental retardation. The unique association with short stature,
      spastic paraplegia and CNS malformations.
AB  - During a systematic clinical genetic survey of the institutionalized moderately
      to severely mentally retarded we had the occasion to examine two nonrelated adult
      patients who presented a similar MCA/MR syndrome: 1) macrocephaly (OFC > 60 cm)
      with high and broad forehead and contrasting relative midfacial hypoplasia; 2)
      short stature with small and broad hands and feet; 3) neurological symptoms of a
      variable degree of spastic paraplegia and severe CNS malformations on CT-scan
      i.e. internal hydrocephalus and Dandy-Walker variant malformation.

PMID- 8471222
TI  - The fragile-X phenotype. Computer assisted analysis of the dysmorphological
      features and discrimination from the Sotos phenotype.
AB  - Fragile-X and Sotos phenotypes may be difficult to distinguish. This is
      illustrated with a case report. Computer assisted phenotype analyses (MDDB),
      using the complete trait list of this patient, suggested the fragile-X diagnosis,
      which later was confirmed by molecular techniques. The results of corresponding
      phenotype analyses are summarized for 17 children with proven fragile-X, and 10
      children with suggested Sotos syndrome.

PMID- 8471223
TI  - An unclassifiable type of spondylo-peripheral epiphyseal dysplasia associated
      with 21 trisomy.
AB  - We present an unusual type of skeletal dysplasia in a 6 1/2 year-old female child
      with Down syndrome due to classical 21 trisomy. Differential diagnosis with the
      pseudoachrondroplastic forms of spondyloepiphyseal dysplasia shows that the
      epiphyseal changes in the present patient are unique and do not allow to classify
      the skeletal changes of the present patient in this group of disorders.

PMID- 8471224
TI  - The association of hemifacial microsomia, homolateral micro/anophthalmos,
      hemihypotrophy, dental anomalies, submucous cleft palate, CNS malformations and
      hypopigmented skin lesions following Blaschko's lines in two unrelated female
      patients. Further evidence for a lethal mutation surviving in mosaic form in
      "hypomelanosis of Ito".

PMID- 8471225
TI  - Ptosis, coloboma, hypertelorism and mental retardation.

PMID- 8471226
TI  - Intelligence, behaviour and psychosocial development in Turner syndrome. A cross
      sectional study of 50 pre-adolescent and adolescent girls (4-20 years).
AB  - In this paper we report the findings and data on a cross-sectional study of 50
      pre-adolescent and adolescent girls with Turner syndrome. We confirm the presence
      of a typical cognitive profile in the different age groups with normal verbal
      intelligence contrasting with lower results on performal IQ subtests, related to
      relative weaknesses on visuospatial subtests i.e. "Block Design" and "Object
      Assembly". 5% of the girls with a "classical" Turner syndrome karyotype (i.e.
      2/40) were mentally retarded versus 30% (i.e. 3/10) in the group with "rare"
      karyotypic anomalies. We noted a positive influence of hormonal therapy on the
      visuospatial functioning. No evidence was found for a high risk for behavioural
      problems. Hyperactive behaviour was seen in the youngest patients contrasting
      with a tendency to hypoactivity around the age of normal puberty. Problems in
      social development were noted from the age of primary school on resulting in
      social immaturity and even isolation. A proposal for guidance of Turner girls
      during the different developmental periods is given.

PMID- 8471227
TI  - Kabuki make-up (Niikawa-Kuroki) syndrome in a girl presenting with vitiligo
      vulgaris, cleft palate, somatic and psychomotor retardation and facial
      dysmorphism.

PMID- 8471228
TI  - Intravenous erythropoietin (rHuEPO) administration increases plasma endothelin
      and blood pressure in hemodialysis patients.
AB  - The correction of anemia in end stage renal disease with recombinant human
      erythropoietin (rHuEPO) is associated with hypertension in about a third of
      hemodialysis patients. In the present study, we investigated the role of
      endothelin (ET-1) on rHuEPO associated hypertension and the effect of the rHuEPO
      administration route on plasma ET-1 levels. We studied 50 stable chronic
      hemodialysis patients who were divided into three groups: 26 patients received
      rHuEPO intravenously (IV) and 21 subcutaneously (SC). The control group was nine
      patients who were treated with nandrolone decanoate (ND). Prehemodialysis ET-1
      plasma levels were correlated with mean arterial pressure (MAP), hematocrit
      (Hct), time on dialysis, and rHuEPO doses. The antihypertensive therapeutic index
      (ATI) was used to determine the changes in blood pressure medication intake. We
      observed that the ET-1 levels were significantly higher in the IV group (19.3 +/-
      2) than the SC (5.0 +/- 0.6) or ND groups (3.6 +/- 0.4 pg/mL) (P < 0.001, IV v SC
      or ND). After IV rHuEPO treatment, there were increases in both MAP (pre- v post
      rHuEPO, P < .001) and in ATI (pre- v post-rHuEPO, P < .001). In the SC group, the
      increases in MAP and ATI were not significant. Only the IV group showed a
      significant correlation between MAP and ET-1 levels (r = .05, P = .02). To
      accomplish the same Hct, the IV group received higher rHuEPO doses than those of
      the SC (180 +/- 15 v 87 +/- 12 U/kg/week) (P < .001). No significant correlations
      were found between the plasma ET-1 levels and Hct, time on dialysis and rHuEPO
      doses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471229
TI  - Long-term effects of a converting enzyme inhibitor and a calcium channel blocker
      on urinary albumin excretion in patients with essential hypertension.
AB  - Microalbuminuria in patients with essential hypertension is associated with
      increased incidence of cardiovascular morbidity and mortality. Reduction of
      urinary albumin excretion (UAE) with therapy could reduce cardiovascular events.
      The long-term effect of commonly used antihypertensive agents on UAE has not been
      properly investigated. In the present study, we have prospectively studied the
      effects of therapy for 24 months with a converting enzyme inhibitor, enalapril,
      or a calcium channel blocker, nicardipine, on UAE in 40 patients with essential
      hypertension and microalbuminuria. Enalapril and nicardipine were equally
      effective in reducing arterial pressure. However, enalapril decreased UAE from
      77.1 +/- 10.4 to 30.4 +/- 7.9 mg/24 h after 1 year, and to 24.7 +/- 4.8 (P < .01)
      after 2 years of therapy. UAE however, did not change in patients treated with
      nicardipine (from 65.2 +/- 12 to 73 +/- 14 after 1 year, and to 52.7 +/- 21 mg/24
      h after 2 years of therapy). The impact of reducing UAE on overall cardiovascular
      morbidity and mortality and on future progression of renal failure in patients
      with essential hypertension remains to be established.

PMID- 8471230
TI  - Ambulatory blood pressure monitoring in offspring of hypertensive patients.
      Relation to left ventricular structure and function.
AB  - The relation between 24-h ambulatory blood pressure monitoring and
      echocardiographic left ventricular (LV) anatomy and function was examined in 30
      young, normotensive offspring (16 men, 14 women) of hypertensive, parents and in
      20 offspring (12 men, 8 women) of normotensive parents, comparable for age,
      clinical blood pressure, and gender. Offspring of hypertensive subjects exhibited
      higher body mass index (P < .01), relative wall thickness, and LV mass/height
      (both P < .001). No significant difference was found in LV chamber dimensions and
      in either systolic or diastolic function. The 24-h systolic and diastolic blood
      pressures were higher in offspring of hypertensive subjects than in controls (P <
      .001 and P < .0001, respectively), as was the coefficient of variation of 24 h
      systolic blood pressure (P < .01). In pooled groups, LV mass was positively
      related to daytime systolic blood pressure (r = 0.48), daytime diastolic blood
      pressure (r = 0.47) (both P < .001), and the coefficient of variation of 24 h
      diastolic blood pressure (r = 0.37, P < .01). In a multiple regression model,
      including as variables, body mass index, daytime systolic and diastolic blood
      pressures, male gender, and family history of hypertension were the major
      independent predictors of LV mass (both P < .0001), with an additional
      contribution of the coefficient of variation of 24 h diastolic blood pressure (P
      < .05). We conclude that male gender and a family history of hypertension are
      stronger determinants of early changes in cardiac structure than hemodynamic load
      in a group of young, normotensive adults.

PMID- 8471231
TI  - Combined effects of dietary fish oil and sodium restriction on blood pressure in
      enalapril-treated hypertensive rats.
AB  - Sodium restriction and fish oil supplementation are effective dietary measures
      for preventing or treating mild hypertension. However, their usefulness as an
      adjunct to drug treatment of hypertension requires further evaluation. In the
      present study, we examined the influence of dietary sodium and fish oil on the
      antihypertensive effect of the angiotensin converting enzyme (ACE) inhibitor
      enalapril in stroke-prone spontaneously hypertensive rats (SHRSP). Rats were fed
      experimental diets containing fish oil or olive oil (5% w/w) and low (0.04% w/w)
      or normal (0.23% w/w) sodium from 1 to 4 months of age. Tail-cuff blood pressure
      (BP) rose by 8.4 and 4.3 mm Hg/week, respectively, in untreated and enalapril
      treated (2.5 mg/kg/day, orally) rats fed the olive oil/normal sodium diet.
      Feeding fish oil further reduced the rise in enalapril-treated rats to 2.8 mm
      Hg/week. When sodium intake was also restricted, the BP rise was almost prevented
      (1.1 mm Hg/week). In older rats with established hypertension, the low
      sodium/fish oil diet also potentiated the blood pressure reduction by enalapril
      (tail-cuff BP fell by 61 mm Hg compared to 25 mm Hg with enalapril alone). These
      observations were confirmed by direct BP recording in conscious rats following
      the implantation of aortic catheters. Factorial analysis revealed a highly
      significant antihypertensive effect of fish oil in both young and adult SHRSP
      receiving enalapril, and a further interactive effect of dietary sodium
      restriction with fish oil feeding in young rats. The antihypertensive effects of
      the dietary interventions were associated with further reductions of cardiac
      hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471232
TI  - Diurnal blood pressure variability and physical activity measured electronically
      and by diary.
AB  - In order for 24 h ambulatory blood pressure monitoring (ABPM) to be useful in
      clinical decision making, it is necessary to quantify ambient physical activity
      and to develop appropriate norms of ambulatory pressure for different levels of
      activity. The present study has compared the predictive value of physical
      activity determined by an electronic activity monitor or a written diary, for
      concomitantly recorded blood pressure during ABPM in healthy normotensive
      subjects. Each subject wore four activity monitors, on the right and left wrists,
      on the left ankle and at the waist, respectively. Linear regression analysis was
      performed for each subject to determine the correlation between ABPM data
      (systolic and diastolic blood pressure and heart rate) and activity data
      (obtained from diaries and the four monitors). Significant differences in the
      degree of correlation were found for both the location of the activity monitor
      and the time (1/2, 2, 5, 10, 15, and 30 min preceding blood pressure measurement)
      over which activity was averaged (P < .05 by two-way analysis of variance). The
      best correlation was obtained with the activity monitor worn on the dominant
      wrist, and when activity was averaged over 2 to 10 min preceding blood pressure
      determination, accounting for 18 to 69% (mean 36 +/- 5%) of systolic blood
      pressure variation. Diaries performed similarly in these well-motivated subjects.
      It is concluded that because of the significant interaction between activity and
      blood pressure, ABPM data should be interpreted only in the light of concomitant
      activity data.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471233
TI  - Identification and purification of parathyroid hypertensive factor from organ
      culture of parathyroid glands from spontaneously hypertensive rats.
AB  - Parathyroid hypertensive factor (PHF) is a newly described hypertensive factor
      isolated from the plasma of spontaneously hypertensive rats (SHR). Recent studies
      have suggested that the primary origin of PHF is the parathyroid gland (PG). In
      the present investigation, PG from spontaneously hypertensive rats (SHR), as well
      as from normotensive rats, were isolated and maintained in culture. The PG from
      SHR, but not normotensive rats, released PHF into the culture medium. Omission of
      calcium from the culture medium stimulated the release of PHF. For purification
      of PHF, parathyroid gland culture medium (PGCM) was first dialyzed at 1000 mwco,
      and then ultrafiltered at 5000 molecular weight cut-off (mwco). PHF activity was
      retained in the fraction that was greater than 1000 daltons and less than 5000
      daltons. Dialyzed and filtered SHR PGCM was fractionated by molecular exclusion
      HPLC. Biologically active PHF was collected in a discrete region. The
      biologically active molecular exclusion fraction was subsequently fractionated by
      reverse-phase HPLC (C-8). PHF was collected in a single discrete peak, which did
      not occur in culture medium prepared from normotensive PG in a similar manner.
      This biologically active peak occurred in the same position on molecular
      exclusion and reverse-phase HPLC as PHF purified from SHR plasma using similar
      procedures. Incubation of PGCM with trypsin inactivates the biological activity
      of PHF. The UV spectrum of PGCM PHF is identical to that obtained from purified
      plasma PHF. These results are consistent with the presence of a peptide moiety in
      PHF, and support the parathyroid origin of plasma PHF.

PMID- 8471234
TI  - Noninvasive ambulatory 24 h blood pressures and basal blood pressures predict
      development of sustained hypertension from a borderline state.
AB  - A sample of 143 male borderline hypertensives aged 35 to 45, screened from a
      population cohort, were subjected to psychological stress, static work, and
      ambulatory 24 h blood pressure (BP) monitoring to assess the predictive power of
      BP reactivity in the development of established hypertension. After 1 year, a
      follow-up showed that 21 subjects (14.7%) had developed established hypertension
      (causal diastolic (D) BP > or = 95 mm Hg), 25 subjects (15.7%) had become
      normotensive (causal DBP < 85 mm Hg), and 97 (67.8%) remained within the
      borderline range (causal DBP 85 to 94 mm Hg). Those who developed established
      hypertension had considerably higher initial basal resting blood pressures than
      those who remained borderline: systolic (S) BP 134.2 +/- 12.5 v 127.6 +/- 10.7 mm
      Hg, P < .05 and DBP 86.8 +/- 7.9 v 80.4 +/- 7.0 mm Hg, P < .01. They had also
      somewhat higher BP values during mental arithmetic exercises and hand-grip work
      (peak DBP 101.1 +/- 8.8 v 96.8 +/- 8.7 mm Hg, P < .05, and 131.4 +/- 14.8 v 123.5
      +/- 12.9 mm Hg, P < .05, respectively). Those subjects who developed established
      hypertension had significantly higher 24 h mean blood pressures than those who
      remained borderline (24 h SBP 133.3 +/- 11.4 v 126.0 +/- 10.1 mm Hg, P < .01, and
      DBP 84.7 +/- 5.7 v 81.6 +/- 6.8 mm Hg, P < .05). This difference was attributed
      mainly to the differences found during daytime (07:00 to 19:00) hours but was
      also found to be nominally dependent upon those found during nighttime (01:00 to
      07:00) hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471235
TI  - Assessment of left ventricular hypertrophy in patients with essential
      hypertension. A rational basis for the electrocardiogram.
AB  - There is a large body of evidence that the electrocardiogram (ECG) is insensitive
      in the recognition of left ventricular hypertrophy (LVH), in comparison with the
      echocardiogram; however, its specificity is high. In this study we further
      analyzed the performance of the ECG in detecting LVH in 200 consecutive patients
      (124 men and 76 women, mean age 50.9 years) with mild to moderate essential
      hypertension, using echocardiographically determined left ventricular mass (LVM)
      as the standard for comparison. To test the hypothesis that, owing to the high
      number of true positive findings, the ECG may still be useful for clinical
      purposes by selecting subsets of hypertensives with higher degrees of LVH, we
      compared the mean values of LVM index corresponding to either positive (true
      positive) or negative (false negative) electrocardiographic signs of LVH. In this
      study 69 patients (34.5%) had echocardiographic LVH, as defined by a LVM index
      exceeding 125 g/m2 for men and 112 g/m2 for women. Almost all criteria
      demonstrated high levels of specificity (> or = 89%). In the whole group the
      Lewis index ((RI - RIII)+(SIII - SI) > or = 17 mm) showed a slight superiority in
      diagnosing LVH (sensitivity = 43%) in comparison to the remaining criteria; the
      confidence intervals estimate of sensitivities confirmed such diagnostic
      superiority only with respect to those criteria with a sensitivity < or = 17%.
      However, the use of McNemar's test to compare sensitivities of all
      electrocardiographic criteria at matched specificities (> or = 95%) did not show
      significant differences (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471236
TI  - Increased left ventricular mass in normotensive diabetic patients with autonomic
      neuropathy.
AB  - The possible relationship between diabetic autonomic neuropathy, circadian blood
      pressure changes, and echocardiographic parameters was investigated in 27
      normotensive diabetic patients (10 with and 17 without autonomic neuropathy) who
      underwent 24 h noninvasive ambulatory blood pressure monitoring and M-mode
      echocardiographic recording. The two groups were comparable for age, sex,
      duration of diabetes, body mass index, and metabolic control. There were no
      significant differences in 24 h average and diurnal values of systolic,
      diastolic, or mean blood pressure. The percent changes from day to night of
      systolic, diastolic, and mean blood pressures were significantly lower in
      diabetics with neuropathy than in those without (P < .04 or less). Increased left
      ventricular mass index (LVMI) (135.4 +/- 10.2 v 102.9 +/- 6.3; P < .005), septal
      wall thickness, and posterior wall width were observed in neuropathic patients.
      Fractional shortening, peak velocity of early left ventricular filling (E), peak
      velocity of late ventricular filling (A), and their ratio (E/A) were similar in
      the two groups. The increased LVMI we observed may represent a possible link
      between diabetic autonomic neuropathy, nocturnal blood pressure levels, and
      higher cardiovascular mortality rate.

PMID- 8471237
TI  - Polyol pathway-related skeletal muscle contractile and morphological
      abnormalities in diabetic rats.
AB  - This study examined the effect of inhibition of aldose reductase, the first
      enzyme in the polyol pathway, on fast and slow twitch skeletal muscle morphology
      and function in streptozotocin-induced diabetes in rats. There was a preventative
      investigation with diabetes duration of 4 months, and a reversal investigation
      where treatment was given for 2 months following an untreated period of 2 months.
      For slow twitch soleus muscle, contractions were prolonged by diabetes, and this
      was partially prevented but not reversed by treatment. Relaxation was profoundly
      slowed, and both prevention and reversal ameliorated the changes. Diabetes had
      minimal effects on tension production for soleus. However, for fast twitch
      extensor digitorum longus, although there was little effect on speed-related
      contractile parameters, tetanic tension production was progressively reduced with
      diabetes duration. This effect was antagonized by treatment. Soleus fatigue
      resistance was markedly reduced by diabetes, but restored to normal by treatment.
      There was a reduction in oxidative enzyme staining (succinic dehydrogenase), and
      capillary-fibre ratio, both of which were ameliorated by aldose reductase
      inhibition. Mean soleus fibre area was reduced after 4 months of diabetes, and
      this was prevented but not reversed by treatment. Fibre area was also reduced in
      extensor digitorum longus, particularly for fast glycolytic fibres. There was a
      small amelioration with treatment. It is concluded that enhanced polyol pathway
      activity makes a contribution to diabetic myopathy, and that aldose reductase
      inhibitors can prevent this by actions on muscle fibres and their vascular
      supply.

PMID- 8471238
TI  - Effects of D-glucose, L-glucose and D-mannitol on renal calcium handling and
      general renal function in the rat.
AB  - Standard renal clearance techniques were used to compare the effects of D
      glucose, L-glucose and D-mannitol on renal calcium handling and general renal
      function in the anaesthetized rat. A significant (P < 0.01) calciuresis was seen
      in animals infused with D-glucose. This resulted from a decreased tubular
      reabsorption of calcium. A similar response was not seen with L-glucose or D
      mannitol. The contrasting actions of the three sugars on tubular calcium
      transport may relate to their different transport characteristics, since only D
      glucose is actively reabsorbed. Responses of the three sugars also differed with
      respect to fractional fluid and sodium reabsorption which were significantly (P <
      0.001) lower in animals infused with L-glucose and D-mannitol, and plasma insulin
      concentrations which were significantly (P < 0.01) elevated only in the D-glucose
      group. An unexpected finding was a highly significant (P < 0.001) and progressive
      fall in glomerular filtration rate (GFR) in animals infused with L-glucose. The
      reasons for this are not known.

PMID- 8471239
TI  - Renal micropuncture study of the effects of D-glucose tubular calcium handling in
      the anaesthetized rat.
AB  - Tracer microinjection studies were used to grossly locate the nephron site of
      altered calcium transport following D-glucose loading. Superficial proximal and
      distal nephrons were injected with a solution containing 45Ca and either D
      glucose or L-glucose (as control). Tubule calcium transport was assessed from the
      recovery of radioactivity in the final urine. 45Ca recoveries from early proximal
      microinjections were comparable in the two groups (2.63 +/- 0.68 vs. 3.70 +/-
      1.19%). However, 45Ca recoveries from late proximal microinjections were
      significantly higher than D-glucose was included in the injectate (7.39 +/- 1.34
      vs. 2.83 +/- 0.67%, P < 0.05). 45Ca recoveries from distal microinjections were
      also significantly higher in the D-glucose group (87.6 +/- 2.43 vs. 71.0 +/-
      2.92%, P < 0.001). These data suggest that the effects of D-glucose on renal
      calcium handling are mediated at the level of the distal tubule, thick ascending
      limb of the loop of Henle and/or pars recta. The precise mechanisms involved are
      not known.

PMID- 8471240
TI  - Acute and chronic effects of pancreatic glucagon on sugar transport across the
      brush-border and basolateral membranes of rat jejunal enterocytes.
AB  - Preparations of isolated rat jejunal enterocyte and brush-border and basolateral
      membrane vesicles have been used to study the effects of a 15 min exposure of
      upper and mid-villus enterocytes to pancreatic glucagon on the initial,
      unidirectional phlorhizin-sensitive (brush border) transport of galactose and
      phlorhizin-insensitive (basolateral) movement of the sugar. These acute effects
      of glucagon have been compared with responses following treatment of animals for
      1 or 3 days with the hormone. Incubation of cells with glucagon significantly
      stimulated phlorhizin-sensitive uptake by 42 and 64% for upper and mid-villus
      cells, respectively. Glucagon, however, was without effect on phlorhizin
      insensitive galactose uptake. This differential action of the hormone at the two
      cellular loci was confirmed by uptake data obtained using purified brush-border
      and basolateral membrane vesicles prepared from isolated cells. In contrast to
      the acute challenge with glucagon, treatment of animals for 3 days with the
      hormone significantly increased both phlorizin-sensitive (upper villus +31%, mid
      villus +74%) and phlorizin-insensitive (upper villus +42%, mid-villus +53%)
      galactose uptake. Glucagon exposure of exposure of isolated cells from 3 days
      treated animals was without further effect on galactose uptake at the two
      membrane loci. These data represent the first evidence for a direct action of
      pancreatic glucagon on enterocyte sugar transport. Thus the hormone is likely to
      be important in the physiological control of sugar absorption in addition to its
      possible role in the modulation of transport during starvation and diabetes
      mellitus, conditions characterized by hyperglucanonaemia and enhanced intestinal
      sugar transport.

PMID- 8471241
TI  - The short-term synthesis and infant-regulated removal of milk in lactating women.
AB  - We studied how short-term milk synthesis responds to milk removal by observing
      breast volume before and after each breastfeed over 24 h periods within the homes
      of seven lactating mothers, using the Computerized Breast Measurement system.
      Short-term rates of milk synthesis varied markedly between the breasts of
      individual mothers, varied markedly between interfeed intervals for individual
      breasts and, for six of the thirteen breasts studied, were positively related to
      the degree to which the breast was emptied (r2 ranging from 0.32 to 0.95). In
      addition, the infants rarely emptied the breasts of available milk (mean +/- S.D.
      of degree of emptying postfeed = 76 +/- 20%, n = 147) and, within women, storage
      capacity of a breast was related to the demand for milk from that breast (r2 =
      0.91, P < 0.0001). It was concluded that the infants were self-regulating their
      milk intake. Furthermore, the storage capacity of the breast, variations in the
      short-term rates of milk synthesis and responsiveness of milk synthesis to the
      degree of breast emptying provided mechanisms whereby maternal milk supply could
      be directly linked to infant demand. Our findings are discussed with reference to
      the autocrine control of milk synthesis.

PMID- 8471242
TI  - The regulation of intracellular Mg2+ in guinea-pig heart, studied with Mg(2+)
      selective microelectrodes and fluorochromes.
AB  - Because of the reported presence of a Na(+)-Mg2+ exchanger in guinea-pig but not
      in ferret myocardium, the Mg2+ extrusion mechanism in guinea-pig myocardium has
      been reinvestigated using Mg(2+)- and Na(+)- selective microelectrodes and the
      fluorochromes mag-fura-2 and -5. The mean [Mg2+]i measured with microelectrodes
      in trabeculae or papillary muscles was 0.72 mmol/l (n = 22, thirteen experiments;
      range 0.42-1.23 mmol/l). Increasing [Mg2+]o from 0.5 mmol/l to either 10.5 or 20
      mmol/l caused small increases in [Mg2+]i. Decreasing [Na+]o by 50% had no effect
      on the [Mg2+]i and there was no change in [Na+]i on increasing [Mg2+]o from 0.5
      to 10.5 mmol/l. Varying pHo or changing pHi with NH4Cl did not influence the
      [Mg2+]i. In vitro calibration of mag-fura-2 and -5 using the ratio method gave
      values for K'd (experimentally determined dissociation constant) of 22.2 +/- 2.7
      (mean +/- S.D., n = 7) and 25.7 +/- 1.3 (n = 4) mmol/l respectively. Mag-fura-2
      reacted to physiological concentrations of Ca2+ and mag-fura-5 to changes in pH.
      In isolated myocytes, Na+ removal gave an apparent increase of [Mg2+]i with mag
      fura-2 but not with mag-fura-5. However, when the pHi was altered with NH4Cl mag
      fura-5 showed an apparent decrease in [Mg2+]i on application and an apparent
      increase on removal, with a time course similar to the pHi changes. It is
      concluded that Mg2+ extrusion in guinea-pig myocardium is not via a Na(+)-Mg2+
      exchanger. The use of mag-fura-2 and -5 are limited in their application because
      of Ca2+ and H+ sensitivity respectively.

PMID- 8471243
TI  - Short-term oscillations of aortic core temperature and thermogenic organ blood
      flow in the rat.
AB  - Core and organ temperatures in the rat have been found to be subject to regular
      periodic oscillations (with a frequency of ca 12 cycles per day, i.e. 143 mu Hz)
      within set limits, by using a chronic thermocouple implant procedure. These
      cycles consisted of consecutive warming (the temperature increased steadily) and
      cooling periods (the temperature decreased regularly). There were sustained
      temperature differences between several tissues and that of the aortic blood
      (core temperature), higher for brown adipose tissue, kidney and liver, and lower
      for muscle, white adipose tissue and skin. Organ blood flows and cardiac output
      were measured by a radioactive microsphere retention method applied to
      unanaesthetized rats. Blood flow measurements were done on unaware rats (see
      Methods), during either the warming or cooling phases. During the warming phases,
      there was a higher blood flow across the brown adipose tissue, kidney and skin,
      with a cardiac output about twice that found in the cooling periods. The
      haemodynamic changes observed, as well as the organ temperature differences
      observed with respect to the blood, suggest that periodic changes in blood flow
      are an essential part of the operation of the thermogenic system.

PMID- 8471245
TI  - Endometrial expression of progesterone receptor and uteroglobin genes during
      early pregnancy in the rabbit.
AB  - The progesterone receptor (PR) plays a pivotal role in the maturation process of
      the secretory endometrium, implantation and maintenance of pregnancy in rabbits.
      To determine the dynamics of PR gene expression and its physiological
      significance, the endometrial expression of PR and PR mRNA were evaluated and
      compared with the expression of the progesterone-regulated uteroglobin (UG) gene
      during 0-5 days post-coitus in rabbits. The results of immunoblot experiments
      indicated the presence of PR in endometrial cell extracts from days 1-4 of
      pregnancy with maximum PR immunostaining on day 2, followed by a marked
      diminution until its complete disappearance on day 5. When endometrial PR mRNA
      content was assessed by Northern blots, the results were similar to those of PR
      immunostaining, with maximal concentrations on the second day after mating.
      However, PR mRNA levels were still high on day 3, despite the concomitant
      decrease in immunostainable PR. Endometrial UG gene expression, on the other
      hand, exhibited a different time sequence. Thus, the UG content in uterine
      flushings progressively increased from day 3 after mating, reaching maximal
      levels on the fifth day. The endometrial UG mRNA content presented a similar
      profile, as its maximum concentration occurred on days 4-5. The overall results
      indicate that endometrial PR is down-regulated at both the mRNA and protein
      levels, possibly by endogenous progesterone during early pregnancy. The striking
      observation that maximal expression of endometrial UG gene products occurred when
      PR and its mRNA are no longer detectable suggests an important role for this
      progesterone-binding uterine protein during the preimplantation period.

PMID- 8471244
TI  - Acrogranin, an acrosomal cysteine-rich glycoprotein, is the precursor of the
      growth-modulating peptides, granulins, and epithelins, and is expressed in
      somatic as well as male germ cells.
AB  - Spermatogenesis is a unique system of differentiation involving cellular
      remodeling and the biogenesis of sperm-specific organelles. To study the
      biogenesis of one such organelle, the acrosome, we have been examining the gene
      expression, biosynthesis, and targeting of specific acrosomal proteins during
      mammalian spermatogenesis. An acrosomal marker that we recently purified and
      began characterizing is acrogranin, a 67,000-molecular-weight glycoprotein
      originally isolated from guinea pig testes. This glycoprotein is detected in
      pachytene spermatocytes and is found later in the acrosomes of developing
      spermatids and sperm. Immunoblotting of several tissues and immunofluorescent
      localization in frozen sections of guinea pig testes suggested that acrogranin
      was a germ cell-specific glycoprotein that was expressed meiotically and post
      meiotically. However, Northern blot analysis demonstrated that the mRNA for
      acrogranin was ubiquitously expressed in all guinea pig and mouse tissues
      examined. Furthermore, the primary structures of guinea pig and mouse
      acrogranins, deduced from the cDNA sequences, reveal that this glycoprotein is a
      cysteine-rich molecule with a motif that is tandemly repeated seven times, very
      similar to that of the human epithelin/granulin precursor. We conclude that
      guinea pig and mouse acrogranins are homologues of the precursor of the human and
      rat epithelin/granulin peptides previously demonstrated to have growth-modulating
      properties.

PMID- 8471246
TI  - Alanine and leucine transport in unfertilized pig oocytes and early blastocysts.
AB  - Amino acid transport is facilitated by specific transporters within the plasma
      membrane of the cell. In mouse oocytes and cleavage-stage conceptus Na(+)
      dependent L-alanine and L-leucine transport are nearly undetectable. Sodium
      dependent transport via system B0,+ in the mouse conceptus increases greatly
      between the 8-cell and blastocyst stages. By contrast, data presented here for
      the pig show that L-alanine and L-leucine transport is mainly Na(+)-dependent in
      the oocyte; this Na(+)-dependent component of transport becomes undetectable by
      the blastocyst stage. The Na(+)-dependent component of transport in oocytes is
      inhibited by BCH (2-aminoendo-bicyclo[2.2.1] hexane-2-carboxylic acid) and L
      lysine and thus could be a form of system B0,+. In both oocytes and blastocysts
      Na(+)-independent L-leucine transport is inhibited by BCH, which is consistent
      with the presence of system L. The dramatic decrease in Na(+)-dependent amino
      acid transport activity could occur in pig conceptuses in association with the
      onset of RNA synthesis during the 4-cell stage. Regardless of the precise time
      during development at which it occurs, however, this dramatic, developmentally
      regulated decrease in Na(+)-dependent alanine and leucine transport activity
      contrasts sharply with the large increase in Na(+)-dependent system B0,+ activity
      that occurs during preimplantation development of murine conceptuses. Elucidation
      of the molecular mechanisms by which these changes occur should contribute to an
      understanding of regulation of gene expression during early development.

PMID- 8471247
TI  - Mucin-like glycoproteins in the equine embryonic capsule.
AB  - The equine embryonic capsule replaces the zona pellucida and envelopes the
      conceptus during the second and third weeks of pregnancy. Although this capsule
      was described more than 100 years ago, its molecular structure has not been
      characterized. Here we present evidence that the glycoprotein(s) of the equine
      capsule resembles those of the mucin glycoprotein family. The resistance of the
      capsule to chemical and enzymatic solubilization was confirmed, and, as in
      mucins, protein constituted only 35-40% of its total dry mass. Determination of
      the sugar composition of the capsule using colorimetric assays and high
      performance anion-exchange chromatography also showed it to have mucin-like
      characteristics. Gal, GalNAc, sulfated sugars, and sialic acid make up a high
      proportion of the capsular carbohydrate, while GlcNAc, Glc, and Man are minor
      components. These findings were verified using lectin histochemical staining of
      frozen sections of conceptuses. The results of amino acid analysis were also
      consistent with the proposal that the capsular glycoproteins belong to the mucin
      family. Removal of the covalently bound carbohydrate by beta-elimination under
      reducing conditions demonstrated that the capsule is O-glycosylated mainly on
      threonine residues. Affinity chromatography on jacalin-agarose confirmed that,
      like mucins, the capsular glycoproteins are heavily O-glycosylated. SDS-PAGE
      analysis revealed a prominent 21-kDa band, specific to the capsule, in
      preparations solubilized by trypsin but not by other proteases. Characterization
      of its constituent glycoprotein(s) should be helpful in elucidating the role of
      the capsule (and analogous blastocyst coverings in other species) during early
      pregnancy.

PMID- 8471248
TI  - Successful vitrification of bovine blastocysts, derived by in vitro maturation
      and fertilization.
AB  - Bovine blastocysts were produced through maturation, fertilization, and
      development in vitro. For vitrification, solutions designated EFS, GFS, and PFS
      were prepared; these were 40% ethylene glycol, 40% glycerol, and 40% propylene
      glycol, respectively, diluted in modified phosphate-buffered saline (PBS)
      containing 30% Ficoll + 0.5 M sucrose. The embryos were exposed to the solutions
      in one step at room temperature, kept in the solutions for various times,
      vitrified in liquid nitrogen, and warmed rapidly. When the embryos were vitrified
      in EFS solution after 1 or 2 min exposure, the postwarming survival rate,
      assessed by the reexpansion of the blastocoel, was 74-77%. However, when the
      exposure time was extended to 3 min or longer, this rate dropped to 7-0%. This
      reduction was attributed to the toxicity of ethylene glycol. Of the embryos
      vitrified in GFS solution, 53% survived when they were cooled after 1 min
      exposure; as the duration of the exposure increased, the survival rate increased,
      reaching a peak (72%) at 4 min. The rate then decreased gradually with exposure
      time. In PFS solution, embryos surviving after vitrification were recovered only
      with 1 min exposure (33%), reflecting the high toxicity of propylene glycol.
      After vitrification in EFS or GFS solution, two embryos were nonsurgically
      transferred into each of 14 recipient animals. Of the 14 recipients, ten (71%)
      became pregnant; two resulted in early stillbirths, four recipients delivered
      twins (four alive and four stillborn), and two delivered single live calves,
      demonstrating the effectiveness of this simple vitrification method for the
      cryopreservation of in-vitro-produced bovine blastocysts.

PMID- 8471249
TI  - The cleavage rate of digynic triploid mouse embryos during the preimplantation
      period.
AB  - Triploidy is a lethal condition in mammals, with most dying at some stage between
      implantation and term. In humans, however, a very small proportion of triploids
      are liveborn but display a wide range of congenital abnormalities. In particular,
      the placentas of human diandric triploid embryos consistently display "partial"
      hydatidiform molar degeneration, while those of digynic triploids generally do
      not show these histopathological features. In mice, the postimplantation
      development of diandric and digynic triploid embryos also differs. While both
      classes are capable of developing to the forelimb bud stage, no specific
      degenerative features of their placentas have been reported. Diandric triploid
      mouse embryos are morphologically normal while digynic triploid mouse embryos
      consistently display neural tube and occasionally cardiac abnormalities.
      Previously it was shown that the preimplantation development of micromanipulated
      diandric triploid mouse embryos was similar to developmentally matched diploid
      control embryos. In this study, the preimplantation development of
      micromanipulated digynic triploid mouse embryos is analysed and compared with
      that of diandric triploid mouse embryos in order to determine whether there is
      any difference in cleavage rate between these two classes of triploids. Standard
      micromanipulatory procedures were used to insert a female or a male pronucleus
      into a recipient diploid 1-cell stage embryo. The karyoplast was fused to the
      cytoplasm of the embryo by electrofusion. These tripronucleate 1-cell stage
      embryos were then transferred to pseudopregnant recipients and, at specific times
      after the HCG injection to induce ovulation, the embryos were recovered and total
      cell counts made. These results were plotted and regression lines drawn.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471250
TI  - Human sperm-egg binding is inhibited by peptides corresponding to core region of
      an acrosomal serine protease inhibitor.
AB  - An antiserum, designated R4 and raised against denatured hamster acrosomes, was
      shown to localize specifically to the acrosomal region of hamster, rat, mouse,
      and human spermatozoa, and to inhibit both hamster and human sperm-oocyte binding
      in vitro. Following screening of a human testis lambda gt11 cDNA expression
      library with the antiserum R4, a series of cDNA clones were isolated. One (cDNA
      134) was selected based on the ability of the beta-galactosidase fusion protein
      to inhibit human and hamster sperm-zona binding in vitro. The fusion protein was
      also shown to inhibit the penetration of zona-free hamster oocytes by human
      spermatozoa. Sequence analysis revealed that cDNA 134 coded for a portion of a
      serine protease inhibitor (serpin) closely related to plasma Protein C inhibitor.
      Sequencing of an additional cDNA clone (261) and Northern blot analysis confirmed
      that a Protein C inhibitor-like mRNA is synthesised in the human testis. Affinity
      purified anti-134 antibody specifically localized to the acrosomal region of both
      hamster and human sperm. Synthetic peptides corresponding to the conserved core
      region responsible for the interaction of the serpin with its cognate protease
      also blocked human sperm-zona binding in vitro. The results suggest that this
      acrosomally located inhibitor plays an important role in the series of binding
      events that results in human fertilization.

PMID- 8471251
TI  - Incomplete development of human spermatozoa is associated with increased creatine
      phosphokinase concentration and abnormal head morphology.
AB  - Our previous creatine phosphokinase (CK) activity studies in human sperm revealed
      differences among men and among sperm populations within the same specimen.
      Samples with low sperm concentrations, high incidence of abnormal sperm
      morphology, and diminished fertility had higher per sperm CK activity. In the
      present work, we demonstrated, with 14C-FDNB covalent CK active site modification
      and with direct CK immunocytochemistry, that the higher CK activity is related to
      an increased content of CK and of other proteins in sperm. Also, sperm heads with
      higher CK content were significantly larger and rounder and showed a higher
      incidence of amorph configuration. We suggest that these biochemical and
      morphological irregularities are related and are due to a failure of
      spermatogenesis, more specifically, to a higher retention of cytoplasm, which in
      normal sperm development is lost to the Sertoli cells as residual bodies. Thus
      higher CK activity and larger or irregular head size in human sperm signify
      cellular immaturity and a failure to complete spermatogenesis.

PMID- 8471252
TI  - The incidence of aneuploidy after single pulse electroactivation of mouse
      oocytes.
AB  - A brief electric pulse often produces a high rate of activation of recently
      ovulated oocytes. Some other efficient parthenogenetic stimuli, such as alcohol,
      however, disrupt the spindle apparatus and increase the incidence of aneuploidy.
      In this paper, we have determined whether electroactivation per se increases the
      incidence of chromosomal segregation errors in haploid parthenogenones as
      evidenced at first cleavage mitosis. Superovulated F1 hybrid female mice were
      killed at 15.5, 18.5, 22.5, and 25 h after the HCG injection. Batches of 10-12
      cumulus-denuded oocytes were transferred to an electroactivation chamber
      containing mannitol which was connected to a high voltage pulse stimulator and
      the pulse was triggered once. A high proportion of oocytes activated following
      this treatment, but only the single-pronuclear haploid parthenogenones were
      incubated overnight in medium containing colcemid, to determine the incidence of
      aneuploidy as evidenced at first cleavage mitosis. "Sham" electroactivation
      groups were also examined for evidence of activation and aneuploidy as described
      above. In these cases, cumulus-denuded oocytes were put through the
      electroactivation chamber but the pulse was not triggered. A further group of
      oocytes was studied to determine the effect of handling and exposure to
      hyaluronidase on activation frequency and parthenogenetic pathways. Finally, the
      spontaneous rate of aneuploidy was examined in fertilised embryos of F1 hybrid
      female mice x Rb(1.3)1Bnr male mice at first cleavage mitosis. The results show
      that single pulse electroactivation does not increase the level of aneuploidy in
      single-pronuclear parthenogenous compared to the "sham" group or the spontaneous
      rate observed in 1-cell fertilised embryos, nor does aneuploidy appear to
      increase with postovulatory age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471253
TI  - Simultaneous detection of X- and Y-bearing human sperm by double fluorescence in
      situ hybridization.
AB  - Double fluorescence in situ hybridization (FISH) was used to detect sex
      chromosomes in decondensed human sperm nuclei. Biotinylated X chromosome specific
      (TRX) and digoxigenin-labeled Y chromosome specific (HRY) probes were
      simultaneously hybridized to sperm preparations from 12 normal healthy donors.
      After the hybridization, the probes were detected immunocytochemically, using two
      different and independent affinity systems. Ninety-six percent of the 12,636
      sperm showed fluorescent labeling, of which 47.4% were haploid X and 46.8% were
      haploid Y. A frequency of 0.46% of XX-bearing sperm (0.28% disomic, 0.18%
      diploid) and 0.38% YY-bearing sperm (0.21% disomic, 0.17% diploid) was found. The
      overall proportions of X- and Y-bearing sperm in the ejaculates were 47.9% and
      47.2%, respectively, which was not significantly different from the expected
      50:50 ratio. In addition 0.21% of cells appeared to be haploid XY-bearing sperm,
      0.62% were diploid XY-bearing cells, and 0.05% of cells were considered to be
      tetraploid cells. The application of double FISH to human sperm using X
      chromosome and Y-chromosome probes has allowed a more accurate assessment of the
      sex chromosal complements in sperm than single FISH method and quinacrine
      staining for Y-bodies.

PMID- 8471254
TI  - Developmental ability of enucleated bovine oocytes matured in vitro after fusion
      with single blastomeres of eight-cell embryos matured and fertilized in vitro.
AB  - Single blastomeres from eight-cell stage bovine embryos matured and fertilized in
      vitro were electrically fused with enucleated oocytes matured in vitro. In
      experiment 1, The percentage of these reconstituted embryos developed to the two-
      to eight-cell stage 48 hr after electrofusion was increased when both the eight
      cell embryos and the enucleated oocytes were derived from oocytes cultured with
      granulosa cells (14% vs. 38%). In experiment 2, the relationship between
      activation of oocytes and developmental ability of reconstituted embryos was
      examined. Although both ethanol and electrical stimulation efficiently induced
      parthenogenetic activation of oocytes matured in vitro for 26-28 hr (ethanol,
      89%; electrical stimulation, 73%), the ratio of the second polar body extrusion
      differed (80% vs. 22%). Ethanol-treated enucleated oocytes, however, were not
      significantly different from the early cleavage of the reconstituted embryos 48
      hr after electrofusion (nontreated, 38%; treated, 43%). In experiment 3,
      reconstituted embryos at the two- to eight-cell stage 48 hr after the
      electrofusion were cocultured with granulosa cells for 6-7 days. Of 69 embryos,
      one developed to a morula and three developed to blastocysts.

PMID- 8471255
TI  - Separation of bovine X and Y sperm based on surface differences.
AB  - Aqueous two-phase partition involving thin-layer counter current distribution
      (TLCCD) has been used to assess surface heterogeneity of ejaculated bovine sperm.
      When partitioned in charge-insensitive aqueous two-phase systems, which detect
      non-charge associated surface properties, the sperm fractionates into two
      distinct populations. Using a Y-chromosome-specific DNA marker, it has been shown
      that one of these populations is enriched in Y chromosome bearing sperm. However,
      this population is not pure--it consists of 80% Y sperm, with the other 20% being
      X sperm. All the sperm in the original population that had begun to undergo the
      acrosome reaction were separated into this same peak; the sex chromosome
      composition of these sperm is unknown. Since the aqueous partition of sperm is
      based on surface properties these results suggest that two populations of Y sperm
      exist that have different surface characteristics.

PMID- 8471256
TI  - In vitro maturation of oocytes from a marsupial, the tammar wallaby (Macropus
      eugenii).
AB  - This study examined the competence of oocytes from the tammar wallaby, Macropus
      eugenii to mature in vitro. Oocytes were collected from follicles > 1 mm diameter
      24 h after pregnant mare serum gonadotrophin (PMSG) treatment and incubated in
      Eagle's minimum essential medium supplemented with 10% fetal calf serum, at 35
      degrees C in 5% CO2 in air for 24, 36, or 48 h. Oocytes were incubated either
      granulosa cell-intact or granulosa cell-free or in the presence of 10 IU ml-1
      PMSG or 10 micrograms ml-1 porcine luteinizing hormone (LH) + 10 micrograms ml-1
      porcine follicle stimulating hormone (FSH). The ability of oocytes recovered from
      small (< 1.5-mm-diameter) and large (> or = 1.5 mm-diameter) follicles to mature
      in vitro was also examined. The nuclear status of oocytes was assessed using the
      DNA-specific dye Hoechst 33342. Initially, all oocytes examined contained a
      germinal vesicle. After 24 h of culture, 60% of oocytes had progressed to
      metaphase I or anaphase I. After 36 h, approximately 20% of oocytes possessed
      metaphase II chromosomes, and 20% of oocytes were at metaphase I or anaphase I.
      At the completion of the 48 h culture period, 40% of oocytes had completed
      maturation to the metaphase II stage. In vitro oocyte maturation after 48 h was
      not affected by the presence of granulosa cells, PMSG, or LH and FSH. More
      oocytes from large follicles (55%) completed maturation by 48 h than from small
      follicles (20%). Approximately 50% of oocytes remained at the GV stage at all
      times under all conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471257
TI  - Transgenic strategies in reproductive endocrinology.
AB  - The present discussion surveys some of the recently published studies utilizing
      transgenic strategies to address questions in reproductive endocrinology.
      Beginning with a brief introduction of the transgenic method itself, the
      following areas are covered: 1. Sexual development and Mullerian-inhibiting
      substance; 2. Hypogonadal mice and hypothalamic GnRH; 3. The GnRH neuron:
      generation of immortalized rare cell types; 4. Glycoprotein hormones:
      immortalized cells, development and evolution; 5. Growth hormone and
      reproduction; and, 6. Gestation and the insulin-like growth factors. In each
      section, the discussion attempts to be integrative with respect to the
      significance of the results to physiological, cellular and molecular biology. We
      believe this approach is appropriate, as transgenic science itself is necessarily
      an integration of all of these levels of investigation and participation from
      those working at all levels is needed.

PMID- 8471258
TI  - Gene introduction into mouse blastocysts via "pricking".
AB  - It is a well-known phenomenon that cultured mammalian cells that have been
      pricked in the presence of foreign DNA can be transformed. This micromanipulation
      'pricking' technique was applied to mouse blastocysts to determine whether uptake
      of exogenous DNA would occur in the embryos. The middle region of the inner cell
      mass (ICM) was pricked three times in each blastocyst in a medium containing a
      linearized plasmid DNA. When the 60 treated blastocysts were transferred to the
      uterine horns of pseudopregnant females, 30 developing fetuses (50%) at the mid
      gestation stage were obtained. Twenty-two of the 30 fetuses (73%) had less than 1
      copy of the foreign DNA per diploid cell, as revealed by polymerase chain
      reaction (PCR)-Southern analysis, a sensitive technique combined with Southern
      blot processing of the PCR products. The 8 other fetuses were negative for the
      foreign DNA. When blastocysts were pricked in the presence of vector DNA coupling
      E. coli beta-galactosidase (beta-gal) gene to a mouse metallothionein-I (MT-I)
      promoter and assessed for beta-gal activity histochemically after 1 and 5 days of
      culture in the presence of 1 microM CdCl2, at least 65% of the embryos exhibited
      beta-gal activity mainly in the ICM region. These results indicate that mouse
      blastocysts can be transfected with a relatively high efficiency after pricking,
      and that the introduced gene expression occurs. This approach provides a means of
      mapping the regulatory elements of genes that are active in the mouse blastocyst
      ICM, and may be useful in investigating the fate of the ICM cells in an intact
      blastocyst by labeling them via pricking technique.

PMID- 8471259
TI  - Progressive expression of trophoblast-specific genes during formation of mouse
      trophoblast giant cells in vitro.
AB  - The expression of a battery of trophoblast-specific mRNAs was studied during
      trophectoderm development in vivo and in vitro to assess the use of these mRNAs
      as markers of trophoblast differentiation and to examine lineage relationships
      between various trophectoderm derivatives. In situ hybridization of sectioned day
      6.5-18.5 mouse embryos localized mRNAs for mouse placental lactogens I and II and
      mouse proliferin (PLF) to trophoblast giant cells and proliferin-related protein
      mRNA to the spongiotrophoblast and giant cell layers. A fifth marker, cDNA 4311,
      was found only in spongiotrophoblast. Day 3.5 blastocyst outgrowths and day 7.5
      diploid extraembryonic ectoderm (EX) and ectoplacental cone (EPC) were then
      cultured to produce polyploid giant cells in vitro. Cultures were processed for
      in situ hybridization after 2, 4, or 6 days. EX and EPC both formed secondary
      giant cells, which expressed all markers in the same sequence as was observed in
      vivo, and primary giant cells in blastocyst outgrowths expressed the early giant
      cell markers PLF and PL-I on days 4 and 6 of culture. EPC progressed through the
      sequence 2 days ahead of EX, indicating commitment of EPC to giant cell
      formation. These results suggest that EX, EPC, and primary and secondary giant
      cells all share in a common pathway of differentiation and that the highly
      ordered sequence of gene expression characteristic of this pathway occurs
      similarly in vivo and in vitro.

PMID- 8471260
TI  - The protective action of betaine on the deleterious effects of NaCl on
      preimplantation mouse embryos in vitro.
AB  - The development of outbred mouse (CF1) zygotes in vitro has been studied using
      medium SOM in which the concentrations of NaCl (85, 105, 125 mM), glutamine (0,
      1, 2 mM), and betaine (0, 1, 2 mM) were varied. The effects of the compounds were
      studied using a 3(3) factorial experimental arrangement. The inhibitory effect of
      relatively high concentrations of NaCl and the protective effect of glutamine
      were confirmed. Betaine, an organic osmolyte, can also protect against the
      deleterious effects of relatively high concentrations of NaCl. The intracellular
      contents of potassium and sodium have also been measured in single zygotes using
      X-ray electron probe spectrometry. When medium SOM contains 85 mM or 125 mM NaCl,
      the intracellular content of Na rises and the content of K decreases. These
      changes are partially reduced in the presence of 125 mM NaCl if betaine is also
      in the medium. Betaine has no effect on the intracellular content of K and Na if
      the concentration of NaCl is 85 mM. These results suggest that organic osmolytes
      may be required in embryo culture media to prevent excessive changes in the
      intracellular ionic concentration.

PMID- 8471261
TI  - Process of nuclear envelope reduction in spermiogenesis of a mosquito, Culex
      tigripes.
AB  - When the Culex tigripes spermatid begins to elongate, the nucleus exhibits on its
      surface invaginations of the nuclear envelope. These invaginations have a uniform
      diameter of 0.3 microns. They separate from the envelope of the nucleus and form
      spherical intranuclear vesicles. In the old spermatids these vesicles are
      imprisoned in the condensed chromatin. The spermatozoon also possesses these
      vesicles which are then ovoid in shape. This process of vesiculation permits the
      diminution of the surface of the nucleus when it decreases in volume during
      spermiogenesis.

PMID- 8471262
TI  - Noninvasive chemical enucleation of mouse oocytes.
AB  - A noninvasive method of enucleating mouse oocytes has been developed and
      evaluated. Strong chromosome to chromosome binding was induced by culturing early
      metaphase I oocytes in etoposide supplemented medium. Subsequent expulsion of the
      entire chromosome complex during polar body extrusion was facilitated by exposing
      the etoposide treated oocytes to a combination of cycloheximide and etoposide
      during anaphase and telophase. This simple two-step chemical enucleation
      procedure yields fully enucleated mouse oocytes in 96% of cases. Chemically
      enucleated oocytes do not contain maturation promoting factor (MPF) at the end of
      etoposide-cycloheximide enucleation. MPF levels are, however, restored during
      subsequent incubation in drug-free medium and, after 15 h of post-enucleation
      culture, the cytoplasts regain their full capacity for parthenogenetic activation
      and nuclear remodelling. We believe that this novel enucleation technique will
      greatly facilitate the research in nuclear transplantation.

PMID- 8471263
TI  - Control of in vitro maturation of bovine cumulus-oocyte complex by preovulatory
      granulosa cells.
AB  - The present study was designed to investigate 1) the influence of the secretions
      of follicular cells on the in vitro maturation of bovine cumulus-oocyte complexes
      (COCs) and 2) the origin of the factors controlling the metabolic function of
      cumulus cells during the preovulatory period. Preovulatory granulosa cells were
      collected from synchronized heifers either before or 7-9 hr after the luteinizing
      hormone (LH) surge, and their secretions were recovered after a 3 hr incubation.
      Follicular fluids (FFs) originating from the same follicles and sera from the
      same animals were also collected. The effects of FFs, sera, and secretions of
      granulosa cells on COC metabolism were compared during 24 hr of culture. FF
      stimulated cumulus expansion, progesterone secretion, and overall protein
      synthesis by COCs but decreased the amount of a major protein of 28 kDa. The time
      at which FF was collected influenced both cumulus expansion and protein synthesis
      by COCs. The effects of FF on COC metabolism were detected at the lowest protein
      concentration studied (0.073 mg/ml) and could be mimicked with serum, but only at
      a protein concentration 100-fold higher. The inhibitory effect of FF and serum on
      the amount of the 28 kDa protein was reproduced with the secretions of granulosa
      cells, acting at protein concentrations five- and 500-fold lower, respectively.
      However, the secretions of granulosa cells enhanced slightly cumulus expansion
      and had no effect on progesterone secretion and overall protein synthesis by
      COCs. These results suggest that COC metabolism is influenced both by endocrine
      and by local factors secreted by granulosa cells in response to gonadotropins.
      The paracrine control of COC metabolism by preovulatory granulosa cells could be
      exerted not only via intercellular contacts but also via substances secreted in
      FF.

PMID- 8471264
TI  - Production of cumulus expansion enabling factor by mouse oocytes grown in vitro:
      preliminary characterization of the factor.
AB  - The objective of this study was to determine whether fully grown oocytes,
      obtained after isolation from preantral follicles and growth in vitro, secrete
      paracrine factors affecting granulosa cell development and function. If so, the
      relative ease in producing oocytes in this way could facilitate the
      identification and characterization of the factors. As a test of this idea, the
      ability of in vitro grown oocytes to produce a paracrine factor that is known to
      enable the isolated cumulus oophorus to undergo expansion in response to follicle
      stimulating hormone (FSH) was determined. Initial experiments compared culture
      systems, which differed in the orientation of the oocyte-granulosa cell complexes
      from preantral follicles to an extracellular matrix, for their ability to support
      oocyte growth and the acquisition of competence to resume meiosis. The systems
      for culture on the surface of the matrix produced larger oocytes and the highest
      percentage of oocytes having competence to resume meiosis. Oocytes grown using
      this system secreted active cumulus expansion enabling factor, albeit at levels
      about half that of oocytes grown in vivo. A preliminary characterization of the
      cumulus expansion enabling factor secreted by the oocytes grown in vitro showed
      that activity was lost upon treatment with either heat (65 degrees C for 15 min)
      or proteinase K. Activity did not pass through a membrane having a nominal
      molecular weight limit (NMWL) of 100 kd but did pass through a membrane having a
      NMWL of 300 kd. It is concluded that cumulus expansion enabling factor is
      secreted by oocytes grown in vitro. This factor is probably a protein or depends
      upon a protein for its activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471265
TI  - Effects of polyamine biosynthesis inhibitors on the progesterone-initiated
      increase in intracellular free Ca2+ and acrosome reactions in human sperm.
AB  - This laboratory has previously reported that progesterone can initiate a rapid
      transient increase in the concentration of intracellular free Ca2+ ([Ca2+]i) and
      an increase in a Ca(2+)-requiring exocytotic event, the acrosome reaction (AR) in
      human sperm. Rapid increases in Ca2+ fluxes of some mammalian cells caused by
      another steroid, testosterone, require polyamine biosynthesis. Herein, we tested
      two polyamine biosynthesis suicide inhibitors for their effects on the
      progesterone-initiated increase in [Ca2+]i and AR in capacitated human sperm in
      vitro: DL-alpha-(difluoromethyl)ornithine hydrochloride (DFMO), an inhibitor of
      putrescine synthesis by ornithine decarboxylase and (5'[[(Z)-4-amino-2
      butenyl]methylamino]-5'-deoxyadenosine (MDL 73811), an inhibitor of S
      adenosylmethionine decarboxylase (required for spermidine and spermine
      synthesis). Sperm were capacitated in vitro and preincubated 10 min with 4.9 mM
      DFMO or 9.8 microM MDL 73811 with or without various polyamines (245 microM).
      Progesterone (3.09 microM final concentration) or progesterone solvent (ethanol,
      0.1% final concentration) was then added, sperm fixed 1 min after additions and
      AR assayed by indirect immunofluorescence or with fluorescein-labeled Con A
      lectin. DFMO strongly inhibited the AR, but putrescine (product of ornithine
      decarboxylase and precursor of spermidine and spermine) reversed that inhibition.
      Preincubation for 25 min with DMFO + spermidine also reversed DFMO inhibition.
      MDL 73811 inhibited the progesterone-initiated AR, and a 10 min preincubation
      with spermidine, but not putrescine or spermine, reversed that inhibition.
      Preincubations with putrescine alone or with spermidine alone followed by
      addition of the progesterone solvent did not initiate the AR, and such
      preincubations followed by progesterone addition did not increase the AR more
      than progesterone alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471266
TI  - Changing physicians' attitudes, knowledge, and self-efficacy regarding
      cholesterol screening and management.
AB  - The National Cholesterol Education Program (NCEP) has identified a need to convey
      practical approaches for the management of high blood cholesterol (BC) to
      physicians. Our study was a joint effort between the Pawtucket Heart Health
      Program and the Brown University Department of Family Medicine to improve family
      medicine residents' attitudes, knowledge, self-efficacy, and practices regarding
      cholesterol screening and management. Thirty-six resident physicians received a
      BC screening and management training program. This program included training in
      BC screening using the fingerstick method and a desktop analyzer, diet assessment
      and counseling, and a management protocol for evaluation and treatment of high BC
      based on NCEP guidelines. The training program also included evaluation of
      residents' BC screening activity, incentives, chart audits, and biweekly articles
      in the departmental newsletter. We administered a survey to residents before and
      one year after the training program began to assess self-reported knowledge,
      attitudes, self-efficacy, and practices for BC management. Survey results
      indicated that the residents significantly improved their reported knowledge and
      attitudes about BC management. In addition, they significantly increased their
      reported self-efficacy and practices in dietary counseling and patient education.
      Residents also indicated that the training program was worthwhile, necessary, and
      practical and that many would use the materials and protocols in their future
      practices.

PMID- 8471267
TI  - Cancer prevention practices and continuing education needs of primary care
      physicians.
AB  - We surveyed 1,500 primary care physicians in Massachusetts regarding their
      current attitudes and practices, as well as their interests and preferences in
      regard to a continuing education course, in cancer prevention and screening.
      Thirty-three percent (n = 488) of physicians returned questionnaires, with equal
      distribution among internists, family practitioners, and gynecologists. Our
      findings are based on physicians' self-report: 80%-92% of physicians routinely
      perform or order breast, cervical, skin, prostate, and colon examinations (with
      the exception of proctoscopy) for asymptomatic patients 50 years of age and
      older. Perceived barriers reported were as follows: for mammography, patient age
      older than 75; for sigmoidoscopy, cost; for counseling, lack of educational
      materials. Ninety-one percent of physicians rated a comprehensive course on
      cancer detection and prevention emphasizing practical matters and offering
      opportunity to upgrade clinical skills in physical exam and in counseling as
      somewhat to very useful. Specific topic preferences varied by specialty, but
      first preference for all three primary care groups was a course in improving
      their office management of cancer prevention and screening activities. Most
      appealing to practitioners was a one-day course leading to accreditation in
      screening and prevention and to reduction in malpractice premiums.

PMID- 8471268
TI  - Development of a knowledge test in the science of prevention of lung diseases.
AB  - We developed a 50-item multiple choice test to assess knowledge of preventive
      pulmonary medicine. We derived the content of test items from a comprehensive
      preventive pulmonary curriculum, which we developed. The test was administered to
      167 medical students, residents, and practicing physicians to establish its
      psychometric properties and to determine if the test scores discriminated between
      different levels of training. Using this sample, the reliability of the test was
      0.86, and the test significantly differentiated between levels of training in
      pulmonary medicine. We are using this multiple choice test to assess changes in
      knowledge of second-year medical students and of fourth-year medical students
      completing a pulmonary medicine elective rotation.

PMID- 8471269
TI  - Educating medical students and residents as health protectors and patient
      advocates.

PMID- 8471270
TI  - Prevention in the medical curriculum: reform and opportunity.

PMID- 8471271
TI  - Improving the practice of prevention.

PMID- 8471272
TI  - Occupational medicine: defining core values and skills.

PMID- 8471273
TI  - Disease prevention policy under Medicare: a historical and political analysis.
AB  - I review the history and politics of Medicare disease prevention policy and
      identify factors associated with the success or failure of legislative
      initiatives to add preventive services benefits to Medicare. Between 1965 and
      1990, 453 bills for Medicare preventive services were introduced in the U.S.
      Congress, but not until 1980, after 350 bills had failed, was the first
      preventive service added to the Medicare program. Medicare currently pays for
      only four of the 44 preventive services recommended for the elderly by the U.S.
      Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap
      smears, and mammography). In addition, Congress has funded demonstration programs
      for the influenza vaccine and comprehensive preventive services. The preventive
      services added to Medicare reflect the bias of the biomedical model toward
      screening and immunizations. Counseling services have received the least
      legislative attention. Factors associated with successful enactment include
      single-benefit bills, incorporation into budget-deficit reduction legislation,
      documented evidence of cost-effectiveness, public hearings, sponsorship by chairs
      of key congressional committees, and persistent congressional leadership. Factors
      associated with failure include lack of support from Medicare beneficiaries, lack
      of professional support, impact on total Medicare expenditures, disagreement over
      or failure to address payment and financing mechanisms, and competing
      congressional priorities.

PMID- 8471274
TI  - Assessment of community-level influences on individuals' attitudes about
      cigarette smoking, alcohol use, and consumption of dietary fat.
AB  - A basic premise of community-based health promotion is that enduring changes in
      health behaviors are facilitated by changing community norms or the standards of
      acceptable behavior in the community. We examine whether community-level
      influences on individuals' normative attitudes can be related to cigarette
      smoking, alcohol consumption, and dietary fat intake. We conducted a random-digit
      dialing survey of 8,849 adults in 15 communities in the western United States as
      part of the evaluation of the Henry J. Kaiser Family Foundation Community Health
      Promotion Grant Program. We found independent associations among attitudes for
      tobacco, alcohol, and diet and both individual-level and community-level
      characteristics. A significant community effect on attitudes remained even when
      we controlled for individual demographics and health behaviors, as well as for
      the overall prevalence of the target health behavior in the community. The
      specific community characteristics that account for this effect were not clear in
      our analyses, suggesting that influential characteristics vary from community to
      community.

PMID- 8471275
TI  - Use of cocaine during the immediate prepartum period by childbearing women in
      Ohio.
AB  - Despite widespread concern about exposure of infants in utero to cocaine,
      population-based data regarding the prevalence of such exposures are limited. An
      official task force in Ohio called for studies to generate such data for that
      state. During three weeks in late 1990, urine was obtained within 48 hours of
      birth from 1,819 infants born in 25 Ohio hospitals randomly selected from a pool
      of hospitals accounting for over 80% of Ohio births. Maternal age,
      race/ethnicity, and residence information were collected so that results could
      not be linked to individual mothers or infants. Urines were screened for
      benzoylecgonine (BZE), a cocaine metabolite, using a commercially available
      immunoassay. The crude prevalence of BZE positivity was 2.0%. When adjusted for
      unequal cluster sizes and race/ethnicity, the prevalence was 1.4%. The adjusted
      prevalence for infants born to black mothers was 7.2%, for infants born to white
      mothers, 0.3%. Ninety-seven percent of the mothers whose infants tested positive
      were residents of a city of 20,000 or more people. The use of hospital maternity
      units as a basis for anonymous sampling, as demonstrated in this study, may be a
      useful model for other jurisdictions seeking population-based data concerning
      perinatal drug exposures. Such methods may be especially useful for trend studies
      and program evaluation. In this study, we found widely distributed prepartal
      cocaine usage in Ohio. Black newborns were significantly more likely than white
      newborns to show evidence of recent cocaine exposure.

PMID- 8471277
TI  - Development and validation of an immunization tracking system in a large health
      maintenance organization.
AB  - Practitioners seeing individual patients and those charged with improving
      immunization practices in that population need accurate information on the
      epidemiology of immunizations within the population. To meet this need, we have
      developed a computer-based record of data required by the National Childhood
      Vaccine Injury Act of 1986 for all immunizations given to 350,000 enrollees in a
      large health maintenance organization. In the first eight months of operation,
      102,271 immunizations representing 11 separate antigens given to 65,676 enrollees
      were entered into the database. Comparison of immunizations given and recorded in
      the medical record with the database shows that the system has high sensitivity,
      specificity, and positive predictive value, but a relatively low negative
      predictive value. The database is being used for analysis of current immunization
      practices for Haemophilus influenzae b vaccine and for research on adverse
      outcomes of childhood immunizations.

PMID- 8471276
TI  - Sexual risk and perception of risk for HIV infection among multiethnic family
      planning clients.
AB  - Little is known about the relationship among having risks for human
      immunodeficiency virus (HIV) infection, perceiving oneself at risk, and
      initiating risk reduction for young sexually active women. We surveyed a
      multiethnic sample of 267 young-adult female family planning clients attending
      Planned Parenthood clinics to determine these relationships. Perceiving oneself
      at risk was significantly associated with having sex outside of a primary
      relationship in the past year, with having five or more sexual partners in the
      last five years, and with having a primary partner who has other partners. We
      found no significant relationship between perceiving oneself at risk and adopting
      risk-reduction strategies, such as inquiring about a partner's risks or using
      condoms. These data suggest that the women in this population may be overly
      optimistic about their invulnerability to HIV. While those women who perceived
      themselves to be at risk for becoming sexually infected with HIV were more likely
      to report high-risk behaviors, perception of risk did not motivate these women to
      adopt low-risk behavior. These data suggest that simple HIV education and
      acknowledgement may have little effect on reducing exposure to HIV among the
      women in this population. Alternative strategies for reducing risk must be
      explored.

PMID- 8471278
TI  - [Prognostic value of the degree of differentiation and the peri-tumor lymphoid
      infiltration in epidermoid carcinoma of the larynx].
AB  - By multiple linear regression the authors show a closed relationship between
      survival and conventional anatomopathologic data as grade of differentiation and
      of lymphoid infiltration of the primary tumor. This retrospective pathological
      study showed that various degrees of squamous cell differentiation may be
      recognized for malignant laryngeal lesions and that such distinction may be of
      prognostic significance.

PMID- 8471279
TI  - [Interaction of arterial blood pressure and industrial noise on human hearing].
AB  - A cross-sectional study of occupational noise exposure and high blood pressure
      was conducted in a group of 1584 workers. Clinical examination, audiograms, and
      body mass index were compared in exposed and not to noise finding a strong
      relationship between severe noise induced hearing loss and high blood pressure in
      all the staff, as it has been marked by different authors. But when we stratify
      the population in groups of age, we can't find any influence between noise
      exposure and hypertension, or between the appearing of high blood pressure and
      noise induced hearing loss.

PMID- 8471280
TI  - [Results of tracheal reconstructive surgery using homografts preserved in
      formaldehyde].
AB  - The present study was designed to investigate the results of homograft of
      cervical trachea preserved in formaldehyde. Surgical approach consists in end-to
      end anastomosis. In all our cases the graft was rejected, and the animals could
      only live 13 days as a maximum. We find tracheal mucosa is responsible for graft
      antigens. The results both clinical and histopathological are compared with a
      control group and with those obtained by other authors using different
      conservation methods.

PMID- 8471281
TI  - [Clinicopathologic prognostic factors in laryngeal and pharyngolaryngeal tumors.
      I. Carcinoma of the pyriform sinus].
AB  - Prognostic factors of pyriform sinus carcinomas were studied in 122 patients. The
      5-year determinate survival was 25.8%. Factors that implied a bad prognosis were
      an advanced local and nodal stage, and the degree of differentiation. At
      variance, alcohol and tobacco abuse, age, previous tracheostomy, involvement of
      surgical margins and local complications had not any prognostic significance.

PMID- 8471282
TI  - [Appropriateness emergency hospital admissions at an ORL service of a third level
      hospital].
AB  - We present a retrospective epidemiological study about an analysis of the
      emergencies hospital admissions in an ENT service of a tertiary hospital with
      high assistencial pressure, during one year. We study the parameters: date, sex,
      age, complementary examinations, diagnosis and appropriateness of the admission
      following the AEP (Appropriateness Evaluation Protocol) criteria. A remarkable
      finding is the high incidence (31.74%) of emergency admissions in the total
      admission in the ENT service. There was a low frequency of inadequate admission
      of patients. The appropriateness of admissions was highest for foreign bodies and
      respiratory distress; the lowest was for cancer patients. The most frequent
      appropriateness criteria was the need of drugs and/or intravenous fluids.

PMID- 8471283
TI  - [Diagnostic value of auditory brainstem evoked potentials (ABP) in high risk
      premature and newborn infants].
AB  - In this work we have studied 37 children, both preterm and term, belonging ti
      high risk group of contracting hearing loss, in order to confirm the
      predictability of ABR in the diagnostic of the congenital hearing losses during
      the prenatal period and so make possible their immediate and proper
      rehabilitation. With this purpose we have studied parameters such as threshold,
      latency of waves and intervals. We have discovered that in preterm children,
      owing to reasons such as answers of little amplitude, movements of the children
      and difficulty to determine the gestational age, the parameters of normality are
      only the existence or not of waves, discarding the value of the threshold and the
      latency of waves. We have had to wait for 40 weeks to obtain ABR similar to the
      ones in adults, in which the threshold, latency of waves and intervals are
      certain to predict hearing. In spite of it all we have to agree that ABR are the
      best hearing test at those ages. We must not forget that normal ABR could include
      lesions in the upper part of hearing pathway.

PMID- 8471284
TI  - [Hypertrophy of lingual ectopic thyroid gland in pregnancy. A clinical case].
AB  - A 28-year-old female, diagnosed two years ago of euthyroid lingual thyroid, has
      been asymptomatic under observation without treatment until her first pregnancy.
      During her first pregnancy the lingual thyroid tissue increases of size and
      produces dysphagia, pain and oral hemorrhages. We realize a thyroid hormone
      treatment (thyroxine) with regular results. Two months after child-birth the
      female was completely asymptomatic and doesn't need actually thyroxine
      suppression. Various aspects are reviewed, such as the predisposing factors
      (puberty, pregnancy, trauma ...), clinical manifestations, diagnosis and medical
      and surgical treatments in this rara congenital anomaly.

PMID- 8471285
TI  - [Necrotizing osteitis of tympanal bone. Report of 2 cases].
AB  - A large variety of process can cause necrosis of the bony external ear canal,
      found by means otoscopic examination. Two cases with a final diagnosis or
      external ear canal cholesteatoma are reported. A revision of the main
      characteristics of this uncommon entity is performed, with a special emphasis to
      avoid that the scarcity of clinic symptoms favour its growing in depth.

PMID- 8471286
TI  - [Eikenella corrodens as a pathogen of lateral cervical abscess].
AB  - We show a case of right neck abscess, in which the Eikenella corrodens, acted as
      pathogen together which other microorganism. We call attention to this germ that
      has a slow growing in culture and generally intervene in infections in which it
      is assumed the presence of anaerobic germs (intrathoracic abscess, neck abscess,
      etc.) and the are habitually treated with clindamycin, antibiotic which Eikenella
      corrodens is systematically resistant (to this antibiotic).

PMID- 8471287
TI  - [Hypopharyngeal fibrolipoma: description of a case and review of the literature].
AB  - A rare case of hypopharyngeal fibrolipoma is reported. The main symptom which
      brought the patient to an ENT examination was a severe inspiratory dyspnea.
      Symptomatology, diagnosis, treatment and follow-up of this benign tumour are
      described and the literature review is discussed.

PMID- 8471288
TI  - [Otitis externa caused by Vibrio alginolyticus: description of 4 cases].
AB  - Vibrio alginolyticus is a microorganism of marine environment which occasionally
      may cause infections on man. We described four patients with external otitis who
      had prolonged contact with sea water presented itch and seropurulent fluid. V.
      alginolyticus was isolated by pure culture from ear fluid of three of them and
      associated to V. fluvialis in another. The administration of ciprofloxacin in
      three cases, and ceftazidime in the other succeeded in the remission of the
      symptoms.

PMID- 8471289
TI  - [Multiple symmetric lipomatosis. Madelung syndrome. Report of a case].
AB  - We present a case of multiple symmetric lipomatosis. We comment aspects
      diagnostics and therapeutic.

PMID- 8471290
TI  - [Evaluation of the diagnostic efficiency of tridimensional reconstruction with
      nuclear magnetic resonance. Report of a case of nasal sinus carcinoma].
AB  - In the past decades the development of magnetic resonance imaging has
      significantly increased the importance of diagnostic imaging of head and neck
      lesions. The standard imaging method is base on two-dimensional slices. Recently
      3D reconstruction has been established as new imaging method in various medical
      fields. In the present study we analyse the diagnostic value of the
      reconstruction method in a case of carcinoma of the maxillary sinus. The results
      indicate that this technique might be of significant clinical importance for
      preoperative planning in the case of certain tumors located close to the skull
      base.

PMID- 8471291
TI  - [Benign esophagobronchial fistula in an adult].
AB  - The case of a senile dementia patient 86 year old, and a supposed clinical
      history of swallowing a foreign body is presented. After a clinical study
      (esophagogram, flexible and rigid esophagoscopy and bronchoscopy) and finally the
      autopsy of the patient, we found and idiopathic esophago-bronchial fistula.

PMID- 8471293
TI  - Public health education for all?

PMID- 8471292
TI  - [Neurofibromatosis with laryngeal involvement].
AB  - The clinical features of a new case of Von Recklinghausen's neurofibromatosis
      affecting the larynx, are described. The patient was a three year old boy
      presenting with hoarseness. The diagnostic and therapeutic features, and the
      clinical course are described. This is another patient with neurofibromatosis,
      including laryngeal involvement, to be added to the 26 such cases already
      described in the world literature. It is the eleventh laryngeal plexiform
      neurofibroma described. The relevant literature is reviewed.

PMID- 8471294
TI  - Selective medicals at school entry.

PMID- 8471295
TI  - International comparisons of health expenditure.

PMID- 8471296
TI  - Cost of neonatal care across a regional health authority.

PMID- 8471297
TI  - Junior doctors' work at night: what is done and how much is appropriate?
AB  - Regional task forces have given some public health physicians a central role in
      attempts to reduce junior doctors' hours. This topic is the subject of many
      diverse opinions and little research. A key issue that has received little
      attention is the appropriateness of the work undertaken by junior doctors at
      night. This paper determines whether this work can either be postponed to the
      following morning or done by someone else. It was undertaken in two phases: a
      descriptive study using diaries, interviews and collection of data from
      registers; and identification of consensus on appropriateness of activities by a
      nominal group technique. The first phase took place in hospitals in the South
      East of England. The nominal groups consisted of six panels comprising medical,
      nursing and laboratory scientific staff. The panels identified activities done at
      night that can either be postponed to the following day or done by someone else
      and activities where there is disagreement, requiring further research. A third
      of general surgical and orthopaedic operations could safely be postponed until
      the following day. Up to a third of the tasks of house officers could be
      performed by nursing or clerical staff. Many laboratory investigations at night
      could be postponed until the following day. In conclusion, the work of junior
      doctors at night could be reduced by producing guidelines on the need to operate
      at night, by transferring tasks to other professionals, and by reducing the
      number of sites at which services are provided.

PMID- 8471298
TI  - Disease staging--a case-mix system for purchasers?
AB  - The National Health Service (NHS) internal market has directed renewed attention
      at hospital activity data. Purchasers require information on the cost of care
      provided for them, the quality of service and the extent to which their
      population's needs are being met. There is a need for a means of condensing the
      large number of diagnostic codes into groups containing patients with similar
      outcome or resource use, i.e. case-mix systems. These systems have been developed
      in the United States to overcome this problem. Unfortunately, they may not be
      valid or acceptable in other countries. We describe the evaluation of one such
      system, Disease Staging, in the United Kingdom. We conclude that it can be used
      with UK data to produce groups that are homogeneous both in terms of length of
      stay and mortality. Its logic is acceptable to UK clinicians. We discuss the
      major issues involved in using routine hospital data and suggest ways in which
      Disease Staging might be used by purchasers in the UK internal market.

PMID- 8471299
TI  - Breast cancer screening services in three areas: uptake and satisfaction.
AB  - The objective of our study was to test whether attendance for breast cancer
      screening and satisfaction with the service could be predicted from a knowledge
      of the woman's social and psychological characteristics. In a prospective design,
      demographic characteristics, self-reported health status and behaviour,
      expectations and attitudes were examined through postal questionnaires sent out
      shortly before the invitation to screening, and the measures were used to predict
      subsequent attendance and satisfaction. The sample was taken from three areas in
      the South-East Thames Regional Health Authority providing a Forrest service--one
      rural, one provincial and one inner city--and consisted of 3160 women aged 50-64
      invited routinely for screening. The main predictors of attendance were the
      woman's attitude to being screened and her belief that 'salient others' wanted
      her to attend. The main predictors of satisfaction with the service were the
      behaviour of the staff and the facilities at the centre. Three implications of
      the findings are discussed: (a) health education should include partners,
      relatives and friends of the target women, as their views had as much effect on
      attendance as did the women's attitudes; (b) staff training and development
      should focus on communication with the patient; (c) further research should
      examine the precursors of reported discomfort and pain.

PMID- 8471300
TI  - Cervical cytology screening: a comparison of uptake among 'Asian' and 'non-Asian'
      women in Oldham.
AB  - This study investigates the response of 'Asian' and 'non-Asian' women to a
      computer-generated invitation to attend for a cervical smear during a one-year
      period. One hundred and fifty-eight 'Asian' women were compared with 158 non
      'Asian' women from four general practices in Oldham; the women were aged between
      50 and 64 years and were from a restricted geographical area to control for
      socioeconomic factors. It was found that there was no difference in the response
      to the test invitation between the two groups (uptake in 'Asians' 61.5 per cent,
      'non-Asians' 60.6 per cent). 'Non-Asian' women were more likely to have had a
      previous smear than 'Asian' women. The Family Health Services Authority register
      contained a higher number of inaccurate addresses for 'Asian' women. It is
      suggested that ethnicity did not seem to play an important part in the uptake of
      cervical smear testing in this population.

PMID- 8471301
TI  - Health and length of residence among south Asians in Glasgow: a study controlling
      for age.
AB  - To relate health to length of residence in the United Kingdom in an age
      controlled sample of British South Asians, a cross-sectional survey was
      undertaken with interviews and physical measures in a two-stage stratified random
      cluster sample in the City of Glasgow. The sample consisted of 159 South Asians
      aged 30-40, with a mean age of 35 years (73.6 per cent of those invited). The
      main measures considered were body structure, lung function, pulse and blood
      pressure, history of physical and mental health, results of standardized
      questionnaires on mental health, angina and respiratory health, recent and past
      symptoms, history of accidents and sickness behaviour. It was found that over a
      quarter of the health measures showed differences by length of residence, and
      long-established residents had almost consistently worse results. More were
      overweight, reported heart trouble and respiratory conditions, had had accidents,
      experienced symptoms, especially respiratory and psychosomatic, needed glasses
      and took time ill in bed. Comparisons with North Indian data make it unlikely
      that these results are explained by positive selection of recent migrants. Also,
      the results do not endorse the assumption that the UK environment has promoted
      higher levels of health in migrants longer exposed to it, nor that the stress of
      the move promotes higher levels of illness in recent migrants. Further
      investigation is required of ways in which the UK environment, or the particular
      situation of South Asians within it, may be damaging to health.

PMID- 8471302
TI  - Alcohol intake and the U-shaped curve: do non-drinkers have a higher prevalence
      of cardiovascular-related disease?
AB  - The data from the Oxford Vegetarian Study consists of the observation of around
      11,000 individuals followed since the early 1980s. There are around 6000 subjects
      who do not eat meat and 5000 roughly matched individuals who do. An assiduous
      questionnaire survey was conducted at recruitment which inquired about health
      status, diet, drinking and other habits. We have tested the hypothesis that the U
      shaped curve relating quantity of alcohol consumed and health is an artefact of
      selection of some individuals with high consumption and high risk migrating to
      the no-consumption group but retaining a high risk. The Oxford Vegetarian Study
      consists of a high proportion of lifelong teetotallers and ex-drinkers, and hence
      is particularly suitable for testing this hypothesis. We have examined the
      standardized rates of cardiovascular risk factors among the different dietary and
      drinking groups separately for men and women, as the bulk of the observed
      relationship of alcohol with health is mediated through cardiovascular
      mechanisms. We were unable to find a difference in the prevalence of risk factors
      between ex-drinkers and teetotallers, but we did find differences associated with
      dietary practices, particularly among females. These data cast some doubt on the
      hypothesis that selection may explain the apparent protective effect of moderate
      drinking when compared with groups currently not drinking (for whatever reason)
      and heavy drinking.

PMID- 8471303
TI  - Alcohol and pregnancy: an international comparison.
AB  - A study was set up to compare the drinking habits of women of childbearing age in
      two cities (Milan and Southampton) in two countries, Italy and the United
      Kingdom, and to look at the effects of alcohol consumption on the weight of the
      babies born to these women. The sample consisted of 1516 women in Milan and 996
      in Southampton, who were interviewed after delivery; data on their drinking
      history, before and during pregnancy, were gathered, together with social,
      demographic and health data. The clinical records of the women and their babies
      were examined. On average, both groups drank less than one unit/day before
      pregnancy, but there were differences in drinking habits between the two
      countries, as well as in the modifications induced by pregnancy. The possible
      effects of alcohol on birthweight were then considered. After controlling for
      confounding factors, there was no general association between birthweight and
      alcohol consumption. The impact on health education policy is discussed.

PMID- 8471304
TI  - How important is health behaviour to the health of mothers of lower socio
      economic status?
AB  - Secondary analysis of the data available from the national sample in the Health
      and Lifestyle Survey allowed two samples of mothers from Social Classes III
      Manual and IV+V to be selected and the relationships investigated between two
      measures of health and a range of potential explanatory variables, including
      voluntary health behaviour. Analysis of variance was used to establish which sets
      of factors were significantly and independently associated with each of the
      measures of health within the two samples. Health behaviour was identified as
      making an independent, albeit small, contribution in three out of the four
      analyses.

PMID- 8471305
TI  - General practitioner referral patterns.
AB  - A survey of general practitioners (GPs) in the Western Health and Social Services
      Board was carried out in November 1990. The main objectives were to determine the
      factors which influence GPs' decisions to refer to particular hospitals and to
      ascertain current out-patient referral patterns. A self-administered
      questionnaire was sent to 157 GPs. The response rate was 94 per cent. It was
      found that waiting lists and personal knowledge of consultants' expertise were
      considered to be of particular importance in making referral decisions for
      elective/non-urgent procedures. Referrals were usually made to the nearest
      hospital with a relevant out-patient clinic. The majority (96 per cent) of
      respondents indicated that they would be willing to change their referral
      patterns for elective/non-urgent procedures in response to shorter waiting times.
      It is concluded that GPs may be more willing to change their referral patterns
      than might have been expected.

PMID- 8471306
TI  - A prospective study of non-fatal childhood road traffic accidents: what can seat
      restraint achieve?
AB  - A prospective study of children attending an Accident and Emergency Department
      was carried out at the Royal Aberdeen Children's Hospital, to determine the
      association between injury risk and seat restraint usage, and to estimate the
      likely impact of seat restraint usage at various target levels on the incidence
      of non-fatal injuries. The subjects were all 91 cases of non-fatal childhood road
      traffic accidents attending the casualty department between December 1989 and
      November 1990. The main outcome measures were relative risks of three grades of
      injury severity and four types of non-fatal injury, population attributable risk
      fractions and estimated likely reduction in incidence of non-fatal injury at
      three set target levels of seat restraint usage. It was found that 42 (46 per
      cent) children presenting to the A&E Department were unrestrained; 78 (85.7 per
      cent) children sustained some injury. The relative risk for children travelling
      unrestrained in a car for all injuries combined is 1.7 (95 per cent confidence
      interval (CI) 1.17-2.45), the relative risk for head injury is 3.13 (1.78-5.51)
      and for face injury 3.03 (1.44-6.37). The risk of sustaining any moderate or
      worse injury was 3.25 (1.05-10.07). It is estimated that 24.4 per cent (minimum
      5.5 per cent; maximum 45 per cent) of all non-fatal injuries sustained by a child
      car passenger can be prevented if all children are restrained in a child safety
      seat or seat restraint; 49.5 per cent of head injuries (minimum 43.4 per cent;
      maximum 71.9 per cent) and 48.4 per cent of face injuries (minimum 21.9 per cent;
      maximum 75.3 per cent) are preventable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471307
TI  - Migration patterns of children with leukaemia and non-Hodgkin's lymphoma in three
      areas of northern England.
AB  - As part of a more comprehensive study, complete residential histories were
      collected from 109 cases of childhood leukaemia and non-Hodgkin's lymphoma who
      were diagnosed while resident in Gateshead, West Cumbria or North Humberside
      (1973-1987), and who were born in the same areas. Corresponding data were
      obtained from the same number of controls matched by date of birth, sex and area
      of residence at diagnosis and birth. Altogether, 1332 years of residential
      history were available for analysis and of these 131 (9.8 per cent) included a
      change of home. Moving house was much more frequent for both cases and controls
      in the first two years of life (69 out of 432 child-years, i.e. 16 per cent). The
      moves were mostly over short distances, with only 23 per cent being 5 km or more
      and only 9 per cent into another administrative district. Twenty-eight per cent
      of the children had moved house at least once by their second birthday and 48 per
      cent by the age of five years. Few case-control differences were apparent and
      none achieved statistical significance. There was a suggestion of more mobility
      for case children in the first few years of life, especially for cases diagnosed
      shortly after the removal. When the residence of mothers in the year preceding
      the childrens' birth was examined, there were relatively few removals in this
      period (26, i.e. 24 per cent, altogether, of which 14 were over 5 km and nine
      from another administrative district). Of these, 18 case mothers had moved (11
      over 5 km) compared with eight control mothers (three over 5 km).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471308
TI  - Population-based trends in treatment rates in psychiatry in Oxfordshire, 1975
      1986.
AB  - Routinely collected abstracts of medical records for patients in Oxfordshire were
      used to identify each individual's first contact with specialist psychiatric in
      patient, out-patient or community care services over a 12-year period (1975
      1986). During this period first-contact rates for people under 65 years of age
      declined by 3.3 per cent. The decline was observed for contacts with specialist
      care outside hospital as well as for in-patient care. It is therefore not
      attributable simply to a shift away from in-patient care. The decline was seen in
      most major diagnostic groups including schizophrenia, affective psychosis and the
      neuroses, and it is therefore not attributable to changing diagnostic practices
      between these groups. Increases in first-contact rates in this age group were
      found for alcohol-related disorders in women and self-harm in men. First-contact
      rates for people aged 65 years and over increased by 3 per cent per year. The
      condition that mainly accounted for the increase over time was dementia, which
      was by far the commonest recorded psychiatric diagnosis in this age group.
      Although the increase was seen in all modes of care, it was the domiciliary
      visiting service that contributed most to the upward trend. The implications of
      these trends for service planning and their limitations as measures of changes in
      morbidity are discussed.

PMID- 8471309
TI  - Glycosylation of the external domain of SIV gp41 is influenced by the cytoplasmic
      tail.

PMID- 8471310
TI  - In vivo administration to rhesus monkeys of a CD4-specific monoclonal antibody
      capable of blocking AIDS virus replication.
AB  - Monoclonal antibodies (mAbs) specific for CD4 are potent inhibitors of HIV
      replication in vitro. These agents may be useful prophylactically or in chronic
      HIV infection if they can be administered without inducing immunosuppression. In
      the present study, we explored the safety of a CD4-specific murine mAb in rhesus
      monkeys. The mAb 5A8, which binds to domain 2 of the CD4 molecule, inhibits AIDS
      virus replication noncompetitively at a postvirus binding step. This antibody,
      which had a similar affinity for rhesus monkey and human CD4 cells, efficiently
      inhibited in vitro replication of both HIV-1 and the simian immunodeficiency
      virus of macaques. A single 3-mg/kg injection of mAb 5A8 into normal rhesus
      monkeys coated all circulating and lymph node CD4 cells for 4-6 days. CD4 cells
      were not cleared from circulation nor was the CD4 molecule modulated from the
      lymphocyte surface. In fact, administration of mAb 5A8 resulted in an
      approximately one-to twofold increase in absolute number of circulating CD4
      cells. Repeated administration in normal rhesus monkeys resulted in CD4
      lymphocyte coating with mAbs for > 9 days without CD4 cell clearance or
      modulation. While coated with mAbs, PBLs of these monkeys retained normal in
      vitro proliferative responses to mitogens and these animals generated normal
      humoral responses in vivo to tetanus toxoid. Loss of cell coating with mAbs in
      normal monkeys corresponded to the appearance of anti-mouse immunoglobulin
      antibodies. Thus, administration of certain anti-CD4 mAbs capable of blocking HIV
      replication can achieve coating of the entire CD4 cell pool in rhesus monkeys
      without inducing significant cell loss or immunosuppression.

PMID- 8471311
TI  - The reactivities of HIV-1+ human sera with solid-phase V3 loop peptides can be
      poor predictors of their reactivities with V3 loops on native gp120 molecules.
AB  - The binding of HIV-1+ human serum antibodies to solid phase-adsorbed V3 loop
      peptides from the IIIB, SF-2, and MN isolates was compared with the abilities of
      the same peptides to inhibit binding of the sera to the homologous or
      heterologous native gp120 molecules. The reactivities of the sera with the solid
      phase peptides were found to be poor predictors of the potencies of the peptides
      as competitors in solution for antibody binding to the V3 loop in situ.
      Furthermore, the extent of cross-reaction of HIV-1+ human serum antibodies with
      the three V3 peptides in solid-phase assays was potently influenced by the
      presence or absence of nonionic detergent. Because the use of solid-phase V3
      peptide assays is widespread, and there is no consensus on the use or omission of
      detergent, there is considerable potential for confusion. These factors should be
      considered when interpreting data derived from V3 peptide serology when this
      method is used to dissect the human immune response to HIV-1 infection. It is
      also shown in quantitative studies of HIV-1+ serum antibody binding to homologous
      and heterologous gp120s that the general anti-gp120 antibody response is
      significantly "type specific" for the homologous gp120.

PMID- 8471312
TI  - Complement activation by gp160 glycoprotein of HIV-1.
AB  - The ability of the gp160 envelope glycoprotein of HIV-1 to activate human
      complement and to bind C3 fragments was investigated by incubating mammalian
      derived recombinant gp160 with seronegative serum and by quantitating the binding
      of C3b/iC3b to the protein using a biotinylated monoclonal antibody directed
      against a neoepitope expressed by cleaved human C3. Recombinant gp160 activated
      complement in a dose- and time-dependent fashion. Complement activation occurred
      through the classical pathway, independently of antibodies, and required C1q.
      Binding of anti-HIV IgG to rgp160 prior to exposure of the envelope glycoprotein
      to serum resulted in enhanced complement activation. Complexes of rgp120 with
      anti-HIV IgG also cleaved C3 in serum, resulting in deposition of C3b on gp120.
      These results provide a basis for C3-mediated facilitation of viral entry into
      target cells expressing receptors for fragments of human C3.

PMID- 8471313
TI  - Induction of human immunodeficiency virus-specific T cell responses in rhesus
      monkeys by synthetic peptides from gp160.
AB  - We have previously identified several synthetic peptides from conserved regions
      of the human immunodeficiency virus (HIV) envelope protein gp160 that have the
      capacity to induce broadly reactive T cell responses against gp160 in mice of
      several major histocompatibility complex (MHC) haplotypes. In the present
      investigation three rhesus monkeys were immunized with a mixture of eight
      synthetic peptides that are capable of inducing T cell activity in mice.
      Peripheral blood mononuclear cells (PBMCs) from these monkeys were monitored
      every 2 weeks for a period of 34 weeks for proliferative responses against
      individual peptides and recombinant gp160. Peripheral blood mononuclear cells
      from all three rhesus monkeys showed good proliferative responses with peptides
      104 (aa 45-55), 111 (aa 118-130), and 63 (aa 519-543), whereas weak responses
      were observed with peptides 113 (aa 204-216) and 116 (aa 240-252). Two of the
      three rhesus monkey-derived PBMC preparations also showed good proliferative
      responses with peptide 61 (aa 586-598). Significant responses were not observed
      with peptides 105 (aa 48-61) and R15K (aa 315-329) in any of the monkeys
      immunized. However, PBMCs from all three monkeys showed significantly high
      proliferative responses with recombinant gp160, the HIV-1 envelope protein
      precursor. These results demonstrate that mixtures of synthetic peptides from HIV
      env gene product can prime gp160-specific T cell responses in rhesus
      monkeys.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471314
TI  - T cell response to staphylococcal superantigens by asymptomatic HIV-infected
      individuals exhibits selective changes in T cell receptor V beta-chain usage.
AB  - Recognition that the murine mammary tumor C-type retrovirus and the replication
      defective murine leukemia virus have "superantigen" properties raises the specter
      that human immunodeficiency virus might also generate T cell impairment and
      destruction as a result of inherent superantigen properties. The observation that
      individuals with AIDS lack the expression of several T cell receptor V beta-chain
      genes lends support to this hypothesis. Staphylococcal exotoxins represent
      another class of superantigen with a similar ability to stimulate large numbers
      of T cells bearing specific T cell receptor V beta-chain types. To examine the
      hypothesis that T cells from HIV-infected individuals may be exposed to a
      superantigen during the infection process, we have compared the ability of T
      cells from asymptomatic HIV-infected donors and healthy donors to respond to
      stimulation with several known staphylococcal exotoxin superantigens. Following
      in vitro stimulation with staphylococcal enterotoxin D and staphylococcal
      enterotoxin E, asymptomatic HIV-infected individuals responded with a
      significantly different T cell receptor V beta-chain usage to that observed for
      healthy individuals. This skewed V beta-chain usage is likely to reflect
      preferential conditioning of T cells bearing specific V beta-chains as a result
      of HIV infection, supporting the hypothesis of superantigen involvement early in
      the course of infection.

PMID- 8471315
TI  - Human immunodeficiency virus type-1 antibody in 6703 institutionalized mentally
      retarded clients: an unlinked serosurvey at seven California developmental
      centers.
AB  - All clients residing in seven California developmental centers were tested for
      human immunodeficiency virus type 1 (HIV) antibody in an unlinked serosurvey. Of
      6703 clients, 11 (0.16%) were found positive for HIV-1 antibody by confirmatory
      Western blot and immunofluorescent antibody tests. Universal blood and body fluid
      precautions should be rigorously enforced to prevent institutional spread of HIV
      even in this low-risk population.

PMID- 8471316
TI  - Humoral aspects of anti-HIV immune responses in Zairians with AIDS: lower
      antigenemia does not correlate with immune complex levels.
AB  - Serological patterns of anti-HIV immune responses of 150 HIV-infected (65
      asymptomatic, 19 ARC, 66 AIDS) and 150 HIV-negative healthy Zairians were studied
      to determine the clinical significance of p24 antigen, and anti-p24 antibody,
      particularly in relation to p24 relative binding capacity (RBC) and circulating
      immune complexes (CICs). Levels of p24 antigen, anti-p24 antibody titers, and p24
      RBC were evaluated by means of enzyme-linked immunosorbent assay (ELISA).
      Circulating immune complexes were measured by C1q-binding assay. Human
      immunodeficiency virus CICs were detected by polyethylene glycol (PEG)
      precipitation followed by 6 M guanidinium lysis, ELISA, Western blot, or
      radioimmunoprecipitation of the lysed precipitates. Immunoglobulin levels for
      IgG, IgM, IgA, and beta 2-microglobulin (beta 2-M) were quantified in all study
      participants by laser nephelometry and ELISA. All immunoglobulin levels were
      significantly elevated among HIV-positive vs. HIV-negative individuals.
      Immunoglobulin levels correlated well with disease progression among infected
      patients. Similarly, beta 2-M levels were significantly higher in HIV-positive
      vs. HIV-negative individuals and correlated well with progression to AIDS. Free
      p24 antigen in serum was detected in 1.33% of all patients. However, p24
      reactivity increased to 6% (9 of 150 cases) after PEG precipitation and CIC
      dissociation. There was a good correlation between p24 reactivity and disease
      development. High titers of anti-p24 antibody (> 44,100) occurred in at least 80%
      of all patients, and did not correlate with disease stage. Similarly, more than
      60% of patients had high levels of p24 RBC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471317
TI  - Detection of HIV-1 distribution in different blood fractions by two nucleic acid
      amplification assays.
AB  - A new amplification procedure, NASBA (nucleic acid sequence-based amplification),
      was used together with the polymerase chain reaction (PCR) to detect HIV-1
      sequences in different blood fractions of both HIV-infected and uninfected
      samples. We tested whole blood, plasma, peripheral blood mononuclear cells
      (PBMCs), and platelets. No HIV-1 sequences were found in blood fractions of 37
      uninfected persons either by PCR, reverse transcriptase-PCR (RT-PCR), or NASBA.
      We found that none of the infected plasma samples contained HIV-1 DNA sequences.
      However, a high percentage of these plasma samples was positive for HIV-1 RNA:
      86% by NASBA and 80% by RT-PCR. The concordance on a sample-to-sample basis of
      NASBA and RT-PCR was 91%. Only 33% of the plasma samples was HIV-1 p24-antigen
      positive, demonstrating the superior sensitivity of amplification procedures. We
      found that almost all PBMC fractions were positive for HIV-1 (pro)viral sequences
      (99% HIV-1 DNA positive, 91% HIV-1 RNA positive). A large proportion of the
      platelet fractions contained HIV-1 RNA, as demonstrated by positive RT-PCR and
      NASBA results. We found an inverse relation between CD4+ T cell count and T cell
      reactivity on the one hand and detection of HIV-1 sequences by PCR, RT-PCR, and
      NASBA on the other hand in all blood fractions. Quantification of the HIV-1 PCR
      signal in PBMCs revealed an inverse relation of proviral titers with CD4+ levels.
      This finding supports earlier observations that clinical disease and low CD4+
      cell counts are related to an increased viral burden.

PMID- 8471318
TI  - Cutaneous disorders and viral gene expression in HIV-1 transgenic mice.
AB  - Patients infected with HIV-1 experience several hyperproliferative skin
      disorders, including seborrheic dermatitis, ichthyosis, and psoriasis. Transgenic
      mice carrying a subgenomic HIV-1 proviral construct lacking the gag and pol genes
      were found to develop proliferative epidermal lesions, manifested as diffuse
      epidermal hyperplasia in homozygous transgenic mice and benign papillomas in
      heterozygous transgenic mice. Nonpapillomatous skin from both homozygotes and
      heterozygotes expressed viral RNA, and the viral envelope protein gp120 was
      localized to the suprabasal keratinocyte. Papillomas contained increased amounts
      of both viral mRNA and envelope glycoprotein. Exposure of transgenic mice to
      doses of ultraviolet B (UV-B) irradiation that induced cutaneous injury increased
      viral gene expression and resulted in the development of papillomas within 14-21
      days. Cutaneous injury induced by phenol and liquid nitrogen had similar effects.
      These data support a role for HIV-1 gene products in the pathogenesis of
      proliferative epidermal disorders associated with HIV-1 infection. Further, they
      suggest that the process of wound repair increases HIV-1 gene expression in this
      transgenic mouse model.

PMID- 8471320
TI  - New concepts in AIDS pathogenesis.
AB  - The concept that HIV causes AIDS only by directly killing CD4 cells has been
      questioned by a number of investigators. There has been experimental support for
      a number of indirect mechanisms such as apoptosis, anergy, superantigen-induced
      cell proliferation and depletion, defective signaling, molecular mimicry, and
      autoimmunity. In this article we review the available evidence in support of
      these theories and suggest that in spite of their apparent differences, signaling
      by HIV through the T cell receptor could initiate the markedly different
      responses of activation, anergy, and apoptosis. However, the unifying mechanism
      as to how this is achieved remains unclear. It is likely that more than one of
      these mechanisms are involved in CD4 cell depletion during different phases of
      the disease. Understanding these mechanisms and their role in HIV pathogenesis
      would be important in new vaccine and therapeutic approaches.

PMID- 8471319
TI  - Early pathogenesis of disease caused by SIVsmmPBj14 molecular clone 1.9 in
      macaques.
AB  - We have studied the early pathogenesis of infection by molecular clone 1.9 of
      SIVsmmPBj14 in pig-tailed and cynomolgus macaques. Like the uncloned PBj14
      parent, SIVsmmPBj14-1.9 consistently induced an acute clinical syndrome
      characterized by behavioral depression, fever, profuse diarrhea, dehydration,
      lymphadenopathy, splenomegaly, and mucocutaneous exanthema that began at 7 days
      postinfection (DPI). The acute clinical disease coincided with a marked cell
      associated and cell-free viremia, during which SIV p27 was demonstrated in 4 to
      68% of circulating mononuclear leukocytes between 4 and 17 DPI. Also
      characteristic were monocytosis and reductions in CD4+ and CD8+ T lymphocytes, as
      well as CD20+ B lymphocytes. The most profound depletion occurred in the CD44hi
      subset of CD4+ T cells. Unlike animals infected previously with uncloned or
      biologically cloned PBj14, however, all SIVsmmPBj14-1.9-infected macaques
      survived the acute-phase disease to progress to a chronic, largely asymptomatic
      phase of infection. Recovery from the acute-phase disease correlated with down
      modulation of virus replication and the appearance of antibodies to SIV Env and
      Gag proteins. Similar to the PBj14 parent, PBj14-1.9 targeted to intestine,
      spleen, bone marrow, lymph node, and cerebellum. Saliva contained substantial
      quantities of infectious virus and no viral antibodies during the early phase of
      infection. By contrast, saliva from chronically infected animals usually
      contained antibodies but no virus. This study extends previous work demonstrating
      that the acute clinical syndrome produced by SIVsmmPBj14 in pig-tailed macaques
      represents a unique model of lentiviral pathogenesis.

PMID- 8471321
TI  - Cancer epidemiology and privacy laws: recent trends in Germany.

PMID- 8471322
TI  - Increased incidence of sarcoma in patients treated for testicular seminoma.
AB  - In a nationwide cancer registry analysis of second primary malignancies in 6187
      men with testicular cancer in the period 1943-1987, 13 sarcomas were found,
      yielding a 4-fold increase of the relative risk (RR). The majority of sarcomas
      occurred in men with seminoma, and the increased incidence was seen
      irrespectively of time since the diagnosis of testicular cancer. The interval
      between the testicular cancer and the sarcoma varied from 5-34 years. After
      investigation of the hospital records and re-examination of the histological
      specimens, 3 patients were excluded. In spite of this, the RR was still
      considerably increased (at least 3-fold). Seven of the 10 sarcomas were found to
      be located within the field of the radiation treatment administered and three at
      the periphery. The absolute number of these secondary sarcomas is low, but the
      risk of developing such neoplasms and other malignancies should, even so, be kept
      in mind in the follow-up of testicular cancer patients.

PMID- 8471323
TI  - Induction chemotherapy and intensification with autologous bone marrow reinfusion
      in patients with locally advanced and disseminated breast cancer.
AB  - In 56 patients with disseminated or locally advanced breast cancer it was
      attempted to reach a state of no evidence of disease by a remission induction
      regime containing prednisone, 5-fluorouracil, methotrexate, doxorubicin and
      vincristine. If successful, patients received an intensification regimen
      consisting of cyclophosphamide (7 g/m2) and etoposide (1.5 g/m2) with autologous
      bone marrow reinfusion. The complete remission rate of the induction regimen was
      52% and the partial remission rate 42%. 32 patients received the intensification
      regimen. Two toxic deaths occurred. The median time to disease progression in the
      group with disseminated disease was 15 months. After a median observation of 4
      years, 11 out of 19 patients with locally advanced breast cancer were free of
      disease. It is concluded that this approach may lead to prolonged disease-free
      survival in patients with locally advanced breast cancer, but does not influence
      the survival in disseminated disease.

PMID- 8471324
TI  - Incidence of second primary cancer following testicular cancer.
AB  - The incidence of second primary cancers was investigated in 6187 Danish men
      diagnosed with testicular cancer in the period 1943-1987. During the course of
      59,000 person years, 459 subsequent primary cancers occurred. The relative risks
      were significantly increased for leukaemia, gastric cancer, pancreatic cancer,
      bladder cancer, non-melanoma skin cancer and kidney cancer. Increased incidence
      was furthermore suggested for cancer of the rectum, prostate and lung. The
      increased incidence of leukaemia appeared in the first 10 years after testicular
      cancer diagnosis. The excess incidence for gastric cancer, pancreatic cancer,
      rectal cancer and lung cancer was strongest 10-19 years after testicular cancer,
      while the relative risk of non-melanoma skin cancer and prostate cancer increased
      throughout the period of follow-up. The increased incidence of cancer in this
      cohort is most likely an effect of radiotherapy used for testicular cancer. It is
      proposed that the different incidence patterns over time after testicular cancer
      diagnosis reflect differences in the growth rate of tumours originating in
      different tissues.

PMID- 8471325
TI  - Application of a sensitive immunoassay to the study of DNA adducts formed in
      peripheral blood mononuclear cells of patients undergoing high-dose melphalan
      therapy.
AB  - The levels of DNA adducts formed in peripheral blood mononuclear cells of 13
      patients undergoing high-dose melphalan therapy were determined 0-24 h after drug
      administration using a modification of a previously described immunoassay. This
      assay was validated for DNA extracted from drug-treated cells. Adduct levels in
      normal mononuclear blood cells 1 h after drug administration correlated well (r =
      0.846) with drug dose (expressed as mg/m2) and with area under the curve for
      plasma levels of melphalan during the first h (r = 0.842). 1 patient sustained a
      high degree of toxic side-effects from the melphalan treatment and showed a high
      level of adducts. Plasma cell leukaemia tumour cells from another patient showed
      a level of adducts approximately six times higher than those in the normal blood
      cells of the other patients. The levels of DNA adducts in normal peripheral blood
      mononuclear cells did not change markedly between 1 and 24 h after drug
      administration.

PMID- 8471326
TI  - Curability of advanced Burkitt's lymphoma in children by intensive short-term
      chemotherapy.
AB  - The treatment programme (regimen I) we designed in 1982 for advanced Burkitt's
      lymphoma was modified in 1986 as regimen IIA and IIB for patients presenting
      without or with bone marrow (BM) and/or nervous system involvement, respectively.
      Following a 5-week course of cytoreductive chemotherapy, including vincristine
      (VCR), cyclophosphamide (CPM), doxorubicin (DXR), high-dose methotrexate (HDMTX)
      and intrathecal methotrexate and cytarabine (ARAC), high-dose ARAC and cisplatin
      were given as a 4-day continuous infusion. Regimen I continued with an additional
      3-week course including VCR, CPM, DXR and HDMTX, which was omitted in regimen
      IIA. In regimen IIB the initial cytoreductive chemotherapy was complemented by
      adding etoposide and increasing HDMTX doses, and by modifying the high-dose ARAC
      administration modality and was followed, once the bone marrow had recovered, by
      ifosfamide that concluded the programme. A total of 44 children (22 in regimen I
      and 22 in regimens IIA and IIB) were treated, with an overall response rate of
      98%. 4 patients died as a result of treatment related complications. Survival,
      progression-free and event-free survival rates were 73, 70 and 63%, respectively,
      for regimen I, and 82, 90 and 82%, respectively, for regimen IIA and IIB. A short
      chemotherapeutic regimen, using alternating phase-specific and non-specific
      agents, is able to cure the majority of patients with advanced Burkitt's
      lymphoma.

PMID- 8471327
TI  - Adjuvant combination chemotherapy (AMF) following radical resection of carcinoma
      of the pancreas and papilla of Vater--results of a controlled, prospective,
      randomised multicentre study.
AB  - Between 1984 and 1987, 61 radically resected patients with carcinoma of the
      pancreas (n = 47) or the papilla of Vater (n = 14) were randomised either into
      postoperative adjuvant combination chemotherapy (AMF); 5-fluorouracil 500 mg/m2,
      doxorubicin 40 mg/m2, mitomycin C 6 mg/m2 (n = 30) once every 3 weeks for six
      cycles, or into a control group (no adjuvant chemotherapy) (n = 31). The median
      survival in the treatment group was 23 months compared with 11 months (P = 0.02,
      median test) in the control group, dependent on a survival benefit in the
      treatment group during the initial 2 years (P = 0.04 generalised Wilcoxon). The
      long-term prognosis was the same with an identical survival after 2 years (P =
      0.10, power = 0.83). The observed 1, 2, 3 and 5-year survivals in the treatment
      group were 70, 43, 27 and 4% compared with 45, 32, 30 and 8 in the control group.
      1 patient succumbed to sepsis probably attributable to chemotherapy.
      Cardiotoxicity and nephrotoxicity were recorded in 2 patients. These results
      suggest that adjuvant chemotherapy does postpone the incidence of recurrence in
      the first 2 years following radical surgery but increased cure rate was not
      observed.

PMID- 8471328
TI  - Phase II study of vindesine and dacarbazine with or without non-specific
      stimulation of the immune system in patients with metastatic melanoma.
AB  - A single dose of dacarbazine (DTIC), followed by a 5-day intravenous infusion of
      vindesine (VDS) was administered every 3 weeks to 103 patients with metastatic
      melanoma. One half of the patients were randomised to receive intravenous
      methanol extraction residue (MER) of bacillus Calmette-Guerin (BCG) in addition
      to chemotherapy, on days 7 and 14 of each course. 98 patients were evaluable. The
      response rates in treatment groups were 16 and 17%, respectively (confidence
      interval 9-24%). Neither the response rate nor the survival improved when MER was
      added to chemotherapy. Toxicity was moderate except for a significant
      granulocytopenia. The combination of DTIC and VDS is not more effective than DTIC
      alone and has added neurotoxicity.

PMID- 8471329
TI  - Activity and unexpected lung toxicity of the sequential administration of two
      alkylating agents--dacarbazine and fotemustine--in patients with melanoma.
AB  - We report the results and discuss the toxicity of clinical trials based on a
      single concept: the decrease in O6alkyl DNA alkyltransferase (O6AT) resistance
      mechanism when a chloroethylating agent is used sequentially after a methylating
      agent. This decrease in O6AT being dose dependent, several increasing doses of
      dacarbazine (DTIC) have been tested (400 mg/m2 to 1000 mg/m2 every 4 weeks, 3-4 h
      before fotemustine (100 mg/m2 intravenously every 4 weeks). These results (mean
      overall response rate 27%) compared with reference regimes, demonstrate that DTIC
      is able to increase the alkylating power of fotemustine: same range of response
      rate with only half of the two drug doses compared to an alternated combination,
      high activity rate especially in lung metastases (10/42 complete responses +
      13/42 partial responses), different pattern for haematotoxicity, and occurrence
      of a new side-effect: acute lung toxicity as adult respiratory distress syndrome
      (ARDS). This lung toxicity was totally unexpected since several hundreds of
      patients had been so far treated with fotemustine as single agent or in other
      combinations with DTIC without any case of acute or delayed lung toxicity.
      Prophylactic administration of corticoids was not effective and monitoring of the
      respiratory function was of no predictive value. Due to the additional depleting
      effects of DTIC on at least two main defence mechanisms--the O6AT system and
      cytosolic and/or nuclear glutathione--we suppose that the sequence is able to
      increase the alkylating power of fotemustine to an excessive extent and/or that
      the detoxication capacity of the cell against DTIC and/or fotemustine metabolites
      is overwhelmed. Other depletors of the O6AT activity which do not generate
      metabolites that compete for the same detoxication pathway as the
      chloroethylnitrosourea (CENU) metabolites should be tested.

PMID- 8471330
TI  - The identification of informative parameters in the flow cytometric analysis of
      breast carcinoma.
AB  - DNA ploidy and the measurement of proliferation or S-phase fraction are both of
      prognostic significance in breast cancer, yet clinical use is minimal in the U.K.
      Immunohistochemistry is, however, used to aid diagnosis, so a panel of antibodies
      were analysed by flow cytometry to assess their predictive value for prognosis,
      tumour stage and grade. Of 10 parameters tested on 202 breast tumour samples,
      tumour cell proliferation and DNA ploidy were the two most informative;
      cytokeratin staining, natural killer and B-cell infiltration also proved to be of
      value but there was no prognostic value in measuring tumour infiltrating
      monocytes, helper/suppressor T-cell ratios, tumour cell reactivity with
      carcinoembryonic antigen or human milk fat globulin antibodies. For each of the
      informative parameters, scores numerically weighted towards a poorer prognosis
      were derived which when combined, correlated with tumour grade, stage and
      prognosis. Such data interpretation is objective, and can be transposed to other
      human tumours.

PMID- 8471331
TI  - Combination of interleukin-2 and gamma interferon in metastatic renal cell
      carcinoma.
AB  - The use of high-dose interleukin-2 (IL2), alone or in association with lymphokine
      activated killer cells in patients with metastatic renal cell carcinoma (MRCC)
      results in a 20-25% response rate. However, the toxicity of IL2 is substantial
      and despite many clinical trials, response rates initially reported have not been
      improved. The aim of this study was to evaluate a combination of IL2 and gamma
      interferon (IFN) in MRCC with respect to both efficacy and tolerance. IL2 was
      given by continuous intravenous infusion at a daily dose of 24 x 10(6) U/m2 for 2
      consecutive days during 5 consecutive weeks. Gamma IFN was given subcutaneously
      at a daily dose of 5 x 10(6) U/m2 on the same days as IL2. 33 patients with MRCC
      entered the study. Clinical responses were comparable with other published
      series: 7 patients (21%) achieved partial response, 13 (39%) were stable and 13
      had progression, despite therapy. Immunological profile observed with this
      regimen showed a major increase in natural killer cells which became the
      predominant lymphocyte population at the end of the therapy. Tolerance was good
      with 92.5% of the planned doses actually received by the patients. This was
      reflected by an early discharge from the hospital in 95% of the cycles,
      increasing acceptability of the regimen by the patients.

PMID- 8471332
TI  - Tumour necrosis factor-alpha plasma levels after flavone acetic acid
      administration in man and mouse.
AB  - Flavone acetic acid (FAA) is a synthetic flavonoid with a remarkable spectrum of
      anticancer activities in mouse tumours, but with no anticancer activity in
      humans. The mechanism of action of this drug is complex and involves a tumour
      vasculature action similar to the effects of tumour necrosis factor (TNF). To
      assess directly the role of TNF in FAA mechanism of action, this cytokine was
      assayed in both mouse and human plasma after intravenous administration of the
      drug. In mouse, a species particularly sensitive to FAA antitumour action, FAA
      plasma concentrations reached 268 micrograms/ml at 0.5 h and remained high (165
      micrograms/ml) at 6 h following the intravenous administration of an anticancer
      efficacious dose (540 mg/m2). After FAA administration in mouse, TNF activity
      (L929 mouse cell bioassay) increased to 300 pg/ml TNF-alpha-equivalent at 2 h,
      reached a maximum concentration of 600 pg/ml at 4 h, and declined thereafter to
      220 pg/ml at 6 h. TNF activity in mouse plasma was completely abrogated in the
      presence of mouse TNF-alpha antibodies. FAA added directly to blank mouse plasma
      did not show TNF activity. In patients receiving the drug as a 6-h intravenous
      infusion at doses ranging from 3.6 to 8.1 g/m2, FAA plasma levels ranged from 58
      to 449 micrograms/ml at the end of infusion. Human TNF-alpha levels assayed with
      an immunoradiometric assay were either not detectable or very low (< 25 pg/ml)
      before FAA administration. At completion of the FAA infusion, TNF-alpha remained
      near background levels in 20 of the 21 courses. A slight increase in plasma TNF
      alpha was observed in 1 patient at the 8.1 g/m2 dose level of FAA, from 13 pg/ml
      before intravenous infusion, to 70 pg/ml at completion of intravenous infusion.
      Taken together, these data demonstrate a marked interspecies difference with
      regard to TNF-alpha secretion after FAA treatment, as this cytokine is produced
      in mice, whereas it is not significantly secreted in pretreated patients.
      Although the low TNF-alpha levels achieved in mice probably do not explain all of
      FAA antitumour activity in that species, the observed interspecies difference in
      TNF-alpha secretion after FAA administration could partly explain the marked
      difference in FAA antitumour activity observed between mice and humans.

PMID- 8471333
TI  - Dihydropyrimidine dehydrogenase activity in cancer patients.
AB  - Dihydropyrimidine dehydrogenase (DPD) is the major catabolic enzyme of
      pyrimidines and fluoropyrimidines. The clinical course of 2 patients with
      suspected DPD deficiency is described. Both patients had significantly delayed
      clearance of fluorouracil (5-FU), elevated plasma uracil concentrations, and
      subsequent lethal toxicity. The prevalence of DPD deficiency in the general
      population is unknown, but given the large number of cancer patients treated with
      5-FU, it may be of great clinical significance. Lymphocytes have been previously
      shown to be a useful marker of systemic DPD activity. Because DPD activity has
      not been previously reported in a large population of cancer patients using 5-FU
      as the substrate, we determined DPD activity in lymphocytes from 66 patients with
      cancer. DPD activity was determined by a sensitive high performance liquid
      chromatography method. The mean DPD activity (S.D.) in 66 patients with head and
      neck cancer was 0.189 (0.071) nomol/min/mg protein with wide interpatient
      variability (range 0.058-0.357). DPD activity was not correlated to age (r = 
      0.164, P = 0.188). The mean DPD activity in men [0.192 (0.074)] was not
      significantly different from that in women [0.172 (0.057); t-test P = 0.418].
      Likewise, there was no statistical difference in DPD activity in patients who had
      not received prior chemotherapy [0.195 (0.066)] to patients receiving one or more
      cycles of chemotherapy [0.186 (0.074); t-test P = 0.638].

PMID- 8471334
TI  - Cervical cancer incidence and mortality trends in Finland and Estonia: a screened
      vs. an unscreened population.
AB  - Long term trends in the incidence of and mortality from invasive cervical cancer
      have been studied in Finland (1953-1987) and Estonia (1968-1987). The analyses
      are based on the data from the Finnish and Estonian Cancer Registries. An
      organised nationwide screening programme for cervical cancer was started in
      Finland in the early 1960s. In Estonia, no cytological screening programme has
      been introduced, and cervical malignancies are diagnosed in routine
      gynaecological practice. During 1968-1987, both the incidence of and mortality
      from cervical cancer were considerably higher in Estonia than in Finland. A
      decrease has taken place in the cervical cancer incidence and mortality in both
      countries since the mid-1960s, but whereas in Finland the decrease has been
      marked, in Estonia it has been less pronounced and levelled off in the 1980s. In
      1987, the age-standardised (world population) incidence rate per 100,000 women
      was 14.0 in Estonia and 3.8 in Finland, and the age-standardised mortality rate
      was 6.0 and 1.6 per 100,000, respectively. The difference in the incidence of the
      disease in the two neighbouring countries can be partially attributed to
      socioeconomic factors. The main reason for the different slopes of the trend
      curves for cervical cancer is probably the difference in public health policies:
      an effective mass screening programme is being conducted in Finland but not in
      Estonia.

PMID- 8471335
TI  - Isolation of pMGT1: a gene that is repressed by oestrogen and increased by
      antioestrogens and antiprogestins.
AB  - In order to isolate additional markers of oestrogen responsiveness in breast
      cancer and to study the mechanisms associated with the development of endocrine
      resistance, we have searched for oestrogen regulated genes. Differential
      hybridisation analysis of a cDNA library prepared from oestrogen-stimulated T-47D
      cells has led to the isolation of a sequence (pMGT1) whose expression is
      repressed (up to 8-fold) by oestrogen (10(-9) mol/l) and represents the first
      down-regulated gene to be identified by this methodology. Further studies of
      pMGT1 expression in MCF-7 cells has revealed that the pure antioestrogens,
      ICI164384 (10(-7) mol/l) and ICI182780 (10(-7) mol/l) and the antiprogestin
      Ru38486 (10(-7) mol/l), increase pMGT1 mRNA levels by approximately 40-50-fold
      relative to the value seen in cells exposed to oestrogens. Under the same
      conditions, pS2(pLIV2), a gene which is positively regulated by oestradiol, was
      almost undetectable. Significantly, both tamoxifen (10(-7) mol/l), and 4
      hydroxytamoxifen (10(-7) mol/l), failed to increase pMGT1 mRNA levels. Since cell
      culture studies have indicated that ICI164384 and ICI182780 are more effective
      than tamoxifen and 4-hydroxytamoxifen at inhibiting the growth of MCF-7 cells by
      mechanisms that lower their viability and sensitivity to growth factors, it is
      feasible that pMGT1 plays a central role in mediating these events and
      instigating pathways associated with cell death.

PMID- 8471336
TI  - Black (air-cured) and blond (flue-cured) tobacco and cancer risk. III:
      Oesophageal cancer.
AB  - Relative risks of oesophageal cancer for smoking were higher in communities
      smoking mainly black tobacco, when compared with results from populations
      comprising mainly users of blond tobacco. Also, hand-rolled cigarette smoking,
      which could be considered as a proxy indicator of black tobacco smoking, was also
      associated with higher risk of oesophageal cancer, in comparison with the use of
      commercial (manufactured) cigarettes. Finally, the use of pipes and cigars showed
      odds ratios of higher magnitude than those associated with cigarettes. This
      indirect evidence of a higher risk of oesophageal cancer due to the use of black
      products was confirmed in three recent hospital-based case-control studies. These
      investigations were able to compare the effect of both types of tobacco; relative
      risks for black tobacco were two to three times higher than risks associated with
      blond tobacco smoking, after controlling for major potential confounders.
      Laboratory evidence suggests that swallowing tobacco condensates could be a major
      risk factor for oesophageal cancer. Also, the higher content of tobacco-specific
      N-nitroso compounds in black tobacco, including organospecific substances, could
      explain its higher carcinogenic effect on the oesophageal mucosa.

PMID- 8471337
TI  - Economic evaluation and quality of life assessments in cancer clinical trials:
      the CHART Trial.
AB  - Arguments are being made more frequently to incorporate economic evaluations and
      quality of life assessments into clinical trials. Using a randomised,
      multicentre, phase 3 cancer clinical trial as an example, this paper outlines the
      importance of including such assessments; the practical considerations associated
      with the design of such trials; the methods for collecting such data; and, how
      such data can be used. Finally, it is emphasised that the anticipated benefits of
      collecting data relating to resource use and quality of life should outweigh the
      associated costs to research funding organisations.

PMID- 8471338
TI  - Adjuvant treatment in the curative management of rectal cancer: a critical review
      of the results of clinical randomised trials.
AB  - A critical analysis of the results of randomised studies on adjuvant rectal
      cancer led to a different interpretation than given by the 1990 National
      Institutes of Health (NIH) conference which concluded that combined postoperative
      chemotherapy and radiotherapy resulted in increased local control and survival in
      stage II and III patients. We think there is not as yet indisputable evidence for
      the use of such combination postoperatively. Furthermore, this approach resulted
      in increased toxicity and was only consistent with moderate compliance.
      Conversely, preoperative radiotherapy, which was not even mentioned in the
      conclusions and recommendations of the NIH consensus conference, definitely
      increases local control and should now be proposed as standard initial treatment
      in T3T4 resectable rectal cancer. Moreover, preoperative concomitant chemotherapy
      is an attractive area for clinical trials.

PMID- 8471339
TI  - Intermittent continuous intravenous infusion of 5-fluorouracil; a useful approach
      in disseminated colorectal cancer?

PMID- 8471340
TI  - Plasma beta-endorphin levels in patients with gynaecological malignancies.

PMID- 8471341
TI  - Effect of cisplatin on erythropoietin and iron changes.

PMID- 8471342
TI  - Phase II study of oral miltefosine in patients with squamous cell head and neck
      cancer.

PMID- 8471343
TI  - Computer tomography (CT) in the diagnosis and staging of cancer of the penis.

PMID- 8471344
TI  - Continuing medical education in the United States: a critique.

PMID- 8471345
TI  - Recent developments in distance learning.

PMID- 8471346
TI  - [Effect of catalase on acute experimental pancreatitis in rats].
AB  - Oxygen free radicals are highly toxic end products of the cellular oxidative
      metabolism that are scavenged by antioxidative systems such as superoxide
      dismutase and catalase. Previous studies have suggested that oxygen free radicals
      may play a role in the pathophysiology of acute pancreatitis. The present study
      was designed to determine the effect of catalase on experimental acute
      pancreatitis in the rat. Rats were given either saline or enterokinase by the
      intraductal pancreatic route. Catalase was given intraperitoneally at doses of
      80, 160 and 320 mg/kg. Administration of saline resulted in mild acute
      pancreatitis. In contrast, administration of enterokinase resulted in oedema,
      haemorrhage and necrosis of the pancreas. Catalase had no effect when given at 80
      mg/kg; at 160 mg/kg, an improvement at the ultrastructural level was noted,
      whereas at 320 mg/kg, a change in serum calcium level was found. Our studies
      suggest that intraperitoneal administration of catalase slightly improves the
      outcome of experimental acute pancreatitis in the rat.

PMID- 8471347
TI  - [Emphysematous cholecystitis: percutaneous treatment].
AB  - We present two patients with emphysematous cholecystitis treated successfully by
      means of percutaneous cholecystostomy. We emphasize the high mortality rate of
      the disease, and the good response achieved with the percutaneous technique, as
      well as the low complication rate of the procedure.

PMID- 8471348
TI  - [Cytomorphologic characteristics of esophageal carcinosarcoma (pseudosarcoma)].
AB  - We report a case of carcinosarcoma or pseudosarcoma of the esophagus, diagnosed
      through biopsy and endoscopic brush. We also describe several histogenetics
      hypothesis about this infrequent neoplasm and the difficulty of its diagnosis by
      means of endoscopy. We emphasize the endoscopic brush positivity and the
      description of its cytologic characteristics.

PMID- 8471349
TI  - [Post-radiation enteritis: double jejuno-colic stenosis].
AB  - Radiation enteritis is a common complication in patients receiving radiotherapy
      as a part of the treatment of abdominal malignancies. We report the case of a 57
      year male patient with a renal carcinoma, who received radiotherapy and developed
      a double stenosis of the jejunum and the colon ten years later. He had to be
      treated surgically with resection of the affected segments. We would like to
      stress the possibility of this complication in patients who are to be treated
      with radiotherapy.

PMID- 8471350
TI  - [Eosinophilic enteritis with mucosal predominance and with a 4 years' course].
AB  - We report a case of eosinophilic enteritis without eosinophilia in a 42-year-old
      woman with symptoms presumably due to the disease since her childhood. We comment
      the clinical evolution after surgery and some anatomo-clinico and management
      features of this rare entity.

PMID- 8471351
TI  - [Massive lower digestive hemorrhage caused by jejunal cavernous hemangioma
      detected with scintigraphy].
AB  - We report the case of a patient who needed urgent surgical assistance because of
      massive lower gastrointestinal hemorrhage secondary to a jejunal angiodysplasia
      (cavernous hemangioma). These lesions are a rare cause of gastrointestinal
      bleeding of obscure origin. The use of preoperative diagnostic techniques such as
      oral fiber-optic endoscopy, barium intestinal studies and scintigraphy have
      little value when the origin of lower gastrointestinal bleeding is in the small
      bowel. The best yield is obtained with celiac or superior mesenteric angiography.
      There are some cases in which only an exploratory surgical laparotomy is useful
      for the diagnostic supported by intraoperative enteroscopy guided by the surgeon.

PMID- 8471352
TI  - [Cecal hernia through the Winslow's hiatus].
AB  - A new case of cecal herniation through the foramen of Winslow is reported in a 67
      year-old woman, preoperatively diagnosed by water-soluble contrast enema.
      Herniation through Winslow's foramen is an uncommon variety of internal hernias.
      Of 144 cases reported up to 1991 in the world literature, the cecum was involved
      in only 25-30%; and less than 10% of these were radiologically diagnosed before
      surgery.

PMID- 8471353
TI  - [Spontaneous hematoma of the transverse mesocolon].
AB  - A case of spontaneous rupture of an aneurysm of a colic artery is presented. A
      large hematoma in the transverse mesocolon was found. The case is interesting
      because of its rarity and its preoperative angiographic diagnosis.

PMID- 8471354
TI  - [Retroperitoneal hematoma secondary to anticoagulation treatment as a cause of
      abdominal pain].
AB  - Retroperitoneal haematoma during anticoagulant therapy is a rare cause of
      abdominal pain. Over the past five years, five cases of retroperitoneal
      haemorrhage, two of them due to heparin and three to oral anticoagulant, were
      diagnosed in our hospital. All patients presented with abdominal pain and a mass.
      The authors conclude that a high degree of suspicion is mandatory when patients
      on anticoagulant therapy present with abdominal pain.

PMID- 8471355
TI  - [Severe colitis caused by multiresistant Salmonella non-typhi].

PMID- 8471356
TI  - [Jejunal perforation caused by vegetal foreign body].

PMID- 8471357
TI  - [Hepatitis caused by droxicam].

PMID- 8471358
TI  - [A sonographic technique for the diagnosis of chronic non-lithiasic
      cholecystopathy].

PMID- 8471359
TI  - [Stercoral perforation of the sigmoid related with barium ingestion].

PMID- 8471360
TI  - [Prevalence of gastroesophageal reflux in patients with primary motor disorder of
      the esophagus treated with endoscopic pneumatic dilatation].
AB  - The prevalence of gastroesophageal reflux after successful pneumatic dilatation
      was investigated in 30 patients with primary esophageal motor disorder. After a
      median follow-up period of 377 days, three patients presented symptoms of acid
      reflux and five patients had endoscopic esophagitis (grade I, 3 patients; grade
      II, one patient; and grade III, one patient). Ambulatory 24 hr. esophageal pH
      monitoring was positive in 20% and 30% of the patients compared to our normal
      values and to those from other series from the literature, respectively. The
      concordance between pH results and symptoms and/or endoscopic esophagitis was
      very low. It is concluded that 24 hr. esophageal pH monitoring is frequently
      abnormal after pneumatic dilatation, but its clinical significance is low,
      because very few patients have symptoms and/or severe esophagitis.

PMID- 8471361
TI  - [Determination of the tumor marker CA 72-4 in gastric carcinoma].
AB  - In this study, the authors determined the sensitivity and specificity of the new
      tumor marker CA 72-4 in detecting adenocarcinoma of the stomach. CA 72-4 serum
      levels were investigated in 279 patients consisting of: 100 control subjects, 88
      patients with benign gastrointestinal disease and 91 patients with
      gastrointestinal cancer (31 with gastric cancer). We used a cut-off of 5 U/ml.
      The specificity of CA 72-4 was 91% and the sensitivity was 68%. Highest levels of
      CA 72-4 were found in patients with more advanced tumor (stages III-IV) and four
      of 5 patients with stage I had elevated levels of this tumor marker. These
      findings suggest that the use of serum CA 72-4 measurements may be more useful
      than other tumor markers in the diagnosis, prognosis and detection of recurrence
      in patients with gastric cancer. Although CA 72-4 can be elevated in other
      gastrointestinal adenocarcinomas, it can be useful in alerting the clinician to
      the possible presence of an intraabdominal neoplasm.

PMID- 8471362
TI  - [Percutaneous endoscopic feeding gastrostomy. Initial experience with 6 cases].
AB  - Over the past two years we have performed percutaneous endoscopic feeding
      gastrostomy (PEFG) in 5 patients, 4 males and 1 female, aged 42 to 89. All of
      them suffered from either incurable or severe illness which prevented their oral
      feeding. PEFG was performed following the method described by Gauderer and Ponsky
      or traction method. Only in one case it was difficult to perform and in another
      case a second PEFG was needed because of unintentional catheter extraction. PEFG
      allowed an adequate feeding in all of the patients until their death due to
      underlying disorder or to other causes during the follow-up period. The
      complications found included ascites infection in a patient with cirrhosis and
      pneumoperitoneum which resolved spontaneously in another case. No mortality was
      observed related to the procedure.

PMID- 8471363
TI  - Why not model physiologically?

PMID- 8471364
TI  - Synergy and isoboles.

PMID- 8471365
TI  - A physiological model for the distribution of injected agents, with special
      reference to pethidine.
AB  - The model is based on Mapleson's Model P for inhaled anaesthetics, but has
      compartments for lungs, peripheral shunt, kidneys, portal bed, liver, other
      viscera, muscle, other lean, fat, brain, i.m. injection site and for various
      blood "pools". Intracellular and extracellular fluids are represented separately
      in each compartment and in blood. In each fluid, four forms of the agent are
      distinguished: unionized dissolved in water ("standard" form), ionized dissolved
      in water, unionized dissolved in lipid, and bound to protein. Equations define
      the equilibrium between these four forms in any one fluid and between blood and
      tissue. After changing two of the more uncertain numbers in the quantification
      for pethidine, good agreement was obtained between computed and published venous
      concentrations after single i.v. and i.m. injections, continuous i.v. infusions
      and repeated i.m. injections. The model can be used to make a wide variety of
      "what if" predictions.

PMID- 8471366
TI  - Effect on lung volumes of oxygen concentration when breathing is restricted.
AB  - We have examined the effect of the fractional concentration of nitrogen (FIN2) on
      the decrease in lung volumes which occurs during restricted breathing with oxygen
      nitrogen mixtures. Conscious human subjects breathed one of five gas mixtures of
      oxygen and nitrogen for 15 min on each of five occasions. For the final 5 min of
      each 15-min period, functional residual capacity (FRC) was reduced by one tidal
      volume, by external pressurization. After return to normal breathing, the
      subjects showed a statistically significant decrease in FRC and residual volume
      (RV), which became larger as FIO2 increased from 30% to 100%. This reduction in
      lung volumes was resistant to early reexpansion. The maximum decrease in both FRC
      and RV was found with 100% oxygen, and was 10% of the control lung volumes. The
      use of a mixture of 75% nitrogen and 25% oxygen prevented this decrease in lung
      volumes. Nitrogen 50% reduced the decrease in FRC, but did not affect the
      decrease in RV. The difference in effect on lung volumes between FIO2 25% and 30%
      was statistically significant, indicating a watershed area for FIN2 between 70%
      and 75%.

PMID- 8471367
TI  - Effects of PEEP on dynamic hyperinflation in patients with airflow limitation.
AB  - We have studied the effects of extrinsically applied PEEP (PEEPe) and intrinsic
      PEEP (PEEPi) on lung volume and peak airway pressure (Paw,peak) in 10 patients
      with airflow limitation during mechanical ventilation. PEEPe was applied in 2-4
      cm H2O increments until values greater than PEEPi were reached. Total lung
      hyperinflation was quantified by measuring the expired volume resulting from
      deflation (starting at end inspiration) until cessation of expiratory flow. The
      previous expired tidal volume was subtracted from this volume to obtain the
      change in functional residual capacity (delta FRC), the hyperinflation resulting
      from PEEPi and PEEPe. PEEPi (0.49-1.66 kPa) was demonstrated in all patients
      before the application of PEEPe and correlated with delta FRC (r = 0.71), with
      delta FRC increasing by 582 ml/kPa PEEPi (P < 0.05). PEEPe at pressures less than
      PEEPi increased delta FRC by (mean) 186 (SEM) 34 ml/kPa PEEPe (P < 0.05) and
      increased Paw,peak by 0.6 (0.12) kPa/kPa PEEPe (P < 0.05). In contrast, PEEPe at
      pressures greater than PEEPi, increased delta FRC by 695 (128) ml/kPa PEEPe (P <
      0.05) and Paw,peak by 1.8 (0.26) kPa/kPa PEEPe. We conclude that PEEPe may be
      applied cautiously at values less than PEEPi when clinically indicated, but the
      application of PEEPe at values greater than PEEPi may substantially aggravate
      lung hyperinflation.

PMID- 8471368
TI  - Minimum alveolar concentration of sevoflurane in elderly patients.
AB  - We have determined the minimum alveolar concentration (MAC) for sevoflurane in
      elderly patients (mean age 71.4 yr). MAC was found to be 1.48 (SEM 0.08)%, which
      is smaller than the values for children and adults. The magnitude of the change
      in MAC with age is similar to that for halothane and isoflurane. The calculated
      anesthetic ED95 for preventing 95% of patients from moving was 1.98%.

PMID- 8471369
TI  - Clinical and radiological comparison of perivascular and transarterial techniques
      of axillary brachial plexus block.
AB  - The perivascular technique of axillary brachial plexus block results in
      incomplete block of radial and musculocutaneous nerves in 10-20% of patients.
      With the transarterial technique and a large dose of mepivacaine, success rates
      of 99% have been reported. We have compared the clinical efficacy of these
      techniques in 50 patients using 1% mepivacaine 45 ml with adrenaline. If
      required, the block was supplemented with additional blocks of single nerves or
      i.v. alfentanil. Additionally, eight patients in each group were studied with
      computed tomography after contrast medium was added to 0.5% bupivacaine 40 ml.
      There were no statistically significant differences in sensory or motor block
      between the groups at 20 min or in the plasma concentrations of mepivacaine
      measured 0-45 min after injection. In the CT scans, both proximal and distal
      spread of the contrast medium were more common after perivascular than after
      transarterial block. The distribution of the contrast medium was not related to
      the efficacy of the block.

PMID- 8471370
TI  - Improvement in i.v. regional anaesthesia by re-exsanguination before surgery.
AB  - A modification of an i.v. regional anaesthesia (IVRA) technique is described in
      which the arm is re-exsanguinated before surgery (re-IVRA). IVRA and re-IVRA were
      compared for quality of operative field, sensory and motor block, quality of
      analgesia and blood concentrations of prilocaine, lignocaine and mepivacaine in a
      double-blind study in 120 patients undergoing hand surgery. Re-IVRA provided a
      significantly better surgical field without affecting sensory or motor block. Re
      exsanguination improved tolerance of the tourniquet. Plasma concentrations in the
      re-IVRA group showed some increases, but these were not in the toxic range.

PMID- 8471371
TI  - Pharmacokinetics of flumazenil and midazolam.
AB  - We have studied simultaneously the pharmacokinetics of flumazenil and midazolam
      in 12 healthy Chinese children, aged 5-9 yr, undergoing circumcision. Two hours
      before operation each patient received midazolam 0.5 mg kg-1 orally for
      premedication and 0.5 mg kg-1 i.v. during induction. Six minutes after cessation
      of anaesthesia, a bolus of flumazenil 10 micrograms kg-1 was given i.v., followed
      by an infusion of flumazenil at 5 micrograms kg-1 min-1 which was maintained
      until the child could identify himself. Midazolam data were consistent with a
      three-compartment model with a mean (SD) elimination half-life of 107 (30) min,
      total body clearance of 15.4 (3.2) ml min-1 kg-1 and apparent volume of
      distribution at steady state of 1.9 (0.6) litre kg-1. Flumazenil data were best
      interpreted by a monoexponential function, with a mean terminal elimination half
      life of 35.3 (13.8) min, a total plasma clearance of 20.6 (6.9) ml min-1 kg-1 and
      apparent volume of distribution at steady state of 1.0 (0.2) litre kg-1. No
      unchanged midazolam was detected in the 24-h urine sample, but 5.8-13.8% of the
      flumazenil dose was recovered unchanged. At the time of self identification, 4.5
      (1.4) min after flumazenil administration, the mean plasma concentrations of
      midazolam and flumazenil were 163.1 (43.7) and 29.9 (16.1) ng ml-1, respectively.

PMID- 8471372
TI  - Diclofenac and ketoprofen for pain treatment after elective caesarean section.
AB  - We have studied the effect of a constant infusion of diclofenac 150 mg/24 h,
      ketoprofen 200 mg/24 h or placebo on postoperative pain after elective Caesarean
      section performed under spinal or extradural block in 90 patients in a
      prospective, randomized and double-blind study. During the first 24 h after
      operation, patients in the treatment groups were more comfortable than the
      placebo group (P < 0.005); the diclofenac group needed a mean of oxycodone 21.6
      mg/24 h and the ketoprofen group 21.2 mg/24 h, compared with 38.3 mg/24 in the
      placebo group (P < 0.001); the mean time to the first injection of oxycodone was
      270.5 min in the diclofenac group, 270.2 min in the ketoprofen group and 161.2
      min in the placebo group (P < 0.001). During the first 24 h after operation, the
      temperature increased in the control group by 0.7 degrees C compared with 0.1
      degrees C in the diclofenac group and 0.3 degrees C in the ketoprofen group. One
      patient in the diclofenac group was eliminated from the study because of uterine
      relaxation during the first 30 min after start of the drug infusion; this
      improved after cessation of diclofenac and infusion of sulprostone. There were no
      other serious side effects.

PMID- 8471373
TI  - Preoperative indomethacin for pain relief after thoracotomy: comparison with
      postoperative indomethacin.
AB  - Indomethacin commenced before operation was compared with postoperative
      indomethacin administration for pain relief in patients after elective thoracic
      surgery. In addition to indomethacin, all patients received i.v. opioids titrated
      to their individual requirements. There was no significant difference between the
      two groups in quality of pain relief, in cumulative opioid requirement or in the
      incidence of adverse effects. The quality of pain relief compared well with
      previous similar studies using this technique.

PMID- 8471374
TI  - Effects of surgical stimulation on autonomic reflex function: assessment by
      changes in heart rate variability.
AB  - Analysis of small oscillations in heart rate (known as heart rate variability or
      HRV) associated with the activity of homeostatic reflexes can provide a
      noninvasive measure of autonomic reflex function. We have investigated the
      effects of surgical stimulation on autonomic reflex function by assessment of
      changes in HRV. Healthy female patients undergoing laparoscopic tubal ligation
      were anaesthetized with either thiopentone-nitrous oxide-isoflurane (group I; n =
      13) or continuous propofol infusion (group P; n = 13). Power spectral
      measurements of HRV (HRVtot = total HRV power; %HRVlo = percent of HRV power in
      the low frequency range) were obtained at the following times; control; before
      incision; after incision (3 min, 10 min and before skin closure). Compared with
      control values, measurements of HRVtot before incision were reduced significantly
      in both groups (group P: 16 (SEM 3)% of control; group I: 2.5 (0.7)% of control).
      With surgical stimulation, mean HRVtot in group P was restored to 55 (13)% of
      control (P < 0.01 compared with measurement before incision), whereas mean HRVtot
      in group I remained at less than 4% of control (ns). %HRVlo increased also in
      group P, from 49 (7)% to 75(3)% (P < 0.05), consistent with a shift in
      sympathetic-parasympathetic balance towards sympathetic dominance. These results
      suggest that surgical stimulation may have significant effects on the autonomic
      reflexes mediating HRV, and that such effects vary with anesthetic technique.

PMID- 8471375
TI  - Haemodynamic and catecholamine responses to induction of anaesthesia and tracheal
      intubation: comparison between propofol and thiopentone.
AB  - We have studied the haemodynamic changes, QT intervals and catecholamine
      responses to induction of anaesthesia and tracheal intubation in 24 ASA I
      patients allocated randomly to receive either propofol 2.5 mg kg-1 or thiopentone
      5 mg kg-1 over 60 s. After disappearance of the eyelash reflex, the lungs were
      ventilated with 100% oxygen for 3 min. The trachea was intubated after
      administration of vecuronium. With thiopentone, heart rate (HR) was greater than
      with propofol before intubation (P < 0.05). During induction, systolic (SAP) and
      diastolic arterial pressure (DAP) decreased more with propofol than with
      thiopentone. The QT interval was prolonged only during induction with
      thiopentone. In both groups, HR, SAP, DAP and the QT were increased in response
      to intubation (P < 0.001). The SAP and QT interval responses to intubation were
      significantly greater with thiopentone than with propofol (P < 0.05). One patient
      in the thiopentone group with a significantly prolonged QT interval had episodes
      of bigeminy and ventricular tachycardia. In both groups, concentrations of
      noradrenaline in mixed venous plasma increased after intubation (P < 0.001).
      Concentrations of adrenaline increased after intubation only in the thiopentone
      group (P < 0.001).

PMID- 8471376
TI  - Plasma catecholamines and neonatal condition after induction of anaesthesia with
      propofol or thiopentone at caesarean section.
AB  - Increased maternal sympathetic nervous system activity may decrease placental
      perfusion and cause adverse neonatal effects. We have studied the catecholamine
      response and neonatal outcome in Chinese patients with uncomplicated, singleton
      pregnancies undergoing Caesarean section. Anaesthesia was induced with
      thiopentone 4 mg kg-1 (n = 32) or propofol 2 mg kg-1 (n = 30) followed by
      suxamethonium. Laryngoscopy was performed after 1 min and tracheal intubation
      completed by 2 min. Anaesthesia was continued with atracurium, nitrous oxide and
      isoflurane. Maternal venous blood samples were taken at 0, 1, 2, 3, 4 min and at
      delivery for assay of catecholamines. The increase from baseline values in mean
      arterial pressure after tracheal intubation was greater in the thiopentone group
      (29 (SD 15) mm Hg) compared with the propofol group (18 (14) mm Hg) (P < 0.01).
      The concentrations of noradrenaline and adrenaline increased in both groups after
      tracheal intubation. Maximum noradrenaline concentrations were greater in the
      thiopentone group (413 (177) pg ml-1) compared with the propofol group (333 (108)
      pg ml-1) (P < 0.05), but there were no differences between groups in adrenaline
      concentrations. Neonatal Apgar scores, neurobehavioural testing and umbilical
      catecholamine, blood-gas tension and oxygen content analysis were similar between
      groups. Propofol attenuated the hypertensive and catecholamine response
      associated with laryngoscopy and tracheal intubation but there was no improvement
      in neonatal outcome.

PMID- 8471377
TI  - Benzodiazepines and their solvents influence neutrophil granulocyte function.
AB  - We have examined the effects of commercially available preparations and drug-free
      solvents of diazepam (Valium, Diazepam-Lipuro) and midazolam (Dormicum) by N
      formylmethionyl-leucylphenylalanine (FMLP)- and zymosan-induced polymorphonuclear
      cell (PMN) chemiluminescence and in a cell-free chemiluminescence system. In the
      case of Valium, drug-free solvent and diazepam suppressed PMN chemiluminescence.
      With Diazepam-Lipuro, the solvent stimulated and diazepam inhibited PMN
      chemiluminescence. With midazolam (Dormicum), only the active drug depressed PMN
      chemiluminescence. FMLP-induced PMN chemiluminescence was depressed 10-100 fold
      more by diazepam and midazolam than zymosan-induced chemiluminescence.

PMID- 8471378
TI  - IV bolus administration of subconvulsive doses of lignocaine to conscious sheep:
      myocardial pharmacokinetics.
AB  - Mass balance principles were used to study the myocardial pharmacokinetics of
      lignocaine in conscious sheep. After i.v. bolus doses of lignocaine 50, 75 or 100
      mg, arterial lignocaine concentrations reached a peak in approximately 16 s and
      these increased linearly with dose. Coronary sinus concentrations reached a peak
      between 83 and 129 s and the values showed poor relationships with dose. Net
      myocardial lignocaine uptake lasted for approximately 60 s--this was much shorter
      than the reported initial distribution half-life of lignocaine. The maximum rate
      of uptake was proportional to both the dose and the peak arterial lignocaine
      concentrations. At 15 min, the myocardial lignocaine concentrations were 46 (SD
      22)% of their peak values. Pseudo-equilibrium between blood and myocardial
      lignocaine concentrations was not observed. It is concluded that, despite the
      myocardium being very well perfused, lignocaine myocardial concentrations were
      not well represented by blood lignocaine concentrations for at least 15 min. A
      greater understanding of the determinants of myocardial drug concentrations is
      required.

PMID- 8471379
TI  - Influence of cardiac output, injection time and injection volume on the initial
      mixing of drugs with venous blood after i.v. bolus administration to sheep.
AB  - The aim of this study was to quantitate factors affecting the initial "peak" of
      the pulmonary artery (PA) drug concentrations after i.v. bolus drug
      administration, which is a determinant of the subsequent drug uptake into both
      the lungs and other well-perfused organs. Indocyanine green (ICG) was used as a
      marker drug in anaesthetized (1.5% halothane) sheep prepared with an inferior
      vena cava injection catheter and a large-gauge pulmonary artery blood sampling
      catheter. For three ranges of cardiac output, 2.5-mg doses of ICG were injected
      in the following combinations: 10 ml injected over 1, 5 or 10 s; 5 or 25 ml
      injected over 1 s. On-line PA ICG concentrations were recorded for approximately
      60 s using a densitometer. The mean maximum PA ICG concentrations (2-8 mg litre
      1), the mean times at which they occurred (7-18 s after injection) and the time
      lags before ICG was detected in the PA (4-9 s), were inversely related to cardiac
      output, but linearly related to the time over which the injection was made. The
      area under the curve of the peak was related inversely to cardiac output only,
      while the aspect ratio of the peak was related inversely to the time over which
      the injection was made only. The injectate volume had no effect on any of the
      measured values. We conclude that, in some circumstances, the rate of injection
      of drugs with narrow margins of safety should be tailored to the cardiac output
      of an individual.

PMID- 8471380
TI  - Hepatotoxicity of volatile anaesthetics.

PMID- 8471381
TI  - Perioperative management of the obese patient.

PMID- 8471382
TI  - Studies of gastric content: comparison of two methods.
AB  - In 20 patients studied under general anaesthesia, we found good agreement between
      gastric fluid volumes aspirated blindly and total volumes determined by
      fibreoptic gastroscopy (mean under-estimation 6 ml (22%); range 0-50 ml). Gastric
      fluid acidity measurements using an electronic pH meter and pH indicator paper
      also provided results with good agreement (mean difference in pH 0.1; range -0.3
      to 0.5). As the use of a standardized blind gastric aspiration technique and pH
      indicator paper is simpler and provided sufficiently accurate measurements for
      clinical study purposes, we think this method is preferable.

PMID- 8471383
TI  - Accumulation of acetone in blood during long-term anaesthesia with closed
      systems.
AB  - During closed system anaesthesia with isoflurane, patients with a preoperative
      increase in blood concentration of acetone (> 10 mg litre-1) had a significantly
      greater concentration of acetone than patients with an initial normal blood
      concentration of acetone (P < 0.01). Flushing the closed system with a high flow
      of fresh gas had no effect on the blood concentration of acetone. Using a large
      fresh gas flow, there was no increase in blood acetone concentration. Acetone
      concentrations of about 50 mg litre-1 cause problems such as nausea and vomiting
      in the postoperative period. These symptoms occurred more frequently after closed
      system anaesthesia.

PMID- 8471384
TI  - Test-tube equilibration of volatile anaesthetic concentrations.
AB  - We have measured concentrations of volatile anaesthetics after injection into
      test-tube assay solutions. In non-agitated tubes, aqueous anaesthetic
      concentrations decreased significantly throughout 40 min of incubation. Agitation
      (20-s vortex) of the tubes decreased the aqueous anaesthetic concentration by
      approximately 80% from concentrations in non-agitated tubes and resulted in more
      stable liquid anaesthetic concentrations over time. A decrease of less than 15%
      occurred between 10 and 50 min of incubation.

PMID- 8471385
TI  - Delayed presentation of an extradural abscess in a patient with alcohol abuse.
AB  - Three cases of extradural abscess with delayed presentation after extradural
      analgesia have been reported previously. The present report describes a patient
      with alcohol abuse who was treated for 5 days with extradural injections of
      bupivacaine for pain from multiple rib fractures. The first symptoms of an
      extradural abscess developed approximately 11 days after removal of the
      extradural catheter, and definite diagnosis was delayed a further 7 days.

PMID- 8471386
TI  - Electrode burns during local hyperthermia.
AB  - A patient presenting with carcinoma of the breast was treated with local
      hyperthermia by short wave diathermy. During the procedure she suffered severe
      burns at the site of the ECG electrodes as a result of concentration of the
      induced current.

PMID- 8471387
TI  - Comparison of portable emergency ventilators using a lung model.
AB  - A lung model was used to test the performance of five emergency ventilators
      (MEDUMAT Elektronik, MEDUMAT Variabel, OSIRIS, OXYLOG and rescuPAC 2DM). The
      model comprised two glass jars filled with water to suitable compliances and
      connecting tubes. A resistance (obstruction) was added to one of the "bronchial"
      tubes in order to simulate a patient with obstructive lung disease. Preset minute
      volume was compared with measured minute volume and the gas distribution produced
      by the different ventilators. Acceptable performance was found with the MEDUMAT
      Elektronik, MEDUMAT Variabel, OSIRIS and OXYLOG ventilators.

PMID- 8471388
TI  - Pre-emptive analgesia.

PMID- 8471389
TI  - Effect of nitrous oxide on auditory evoked potentials.

PMID- 8471390
TI  - Use of lignocaine in ventricular defibrillation?

PMID- 8471391
TI  - Regurgitation and the laryngeal mask airway.

PMID- 8471392
TI  - Regurgitation and the laryngeal mask airway.

PMID- 8471393
TI  - Editorial II--the National Confidential Enquiry into Perioperative Deaths.

PMID- 8471394
TI  - Propofol and alfentanil mixture.

PMID- 8471395
TI  - Frequency of damaged coaxial breathing system.

PMID- 8471396
TI  - Subdural catheterization and cord damage.

PMID- 8471397
TI  - A great thirst for knowledge.

PMID- 8471398
TI  - The gastrointestinal toxicity of aspirin: an overview of randomised controlled
      trials.
AB  - The proven benefit of aspirin in the secondary prevention of cardiovascular
      disease and its possible value in primary prevention must be weighted against its
      potential hazards. This paper is an overview of the gastrointestinal toxicity of
      aspirin, its most serious complication after intracerebral haemorrhage.
      Information on toxicity has been drawn only from randomised trials, thus avoiding
      the potential biases of observational studies. All randomised placebo controlled
      trials listed in the Anti-platelet Trialists Collaboration where a direct aspirin
      placebo comparison was possible were included. Twenty-one trials were included,
      all but one of secondary prevention. There were over 75,000 person years of
      aspirin exposure. The pooled odds ratios for categories of gastrointestinal
      bleeding (e.g. haematemesis, melaena) were between 1.5-2.0; fatal bleeds were
      very rare. The risk of peptic ulcers was 1.3 and of upper gastrointestinal
      symptoms 1.7. These risks were lower than those found in observational studies.
      Attributable disease rates are also presented. For haematemesis for example they
      varied from 0.2-1.0 per 1000 person years. Toxicity was dose related. Aspirin
      does have significant gastrointestinal toxicity, although this is rarely fatal.
      More recent work has demonstrated the efficacy of low doses of aspirin (75 mg
      daily) but there is limited information yet available on its toxicity.

PMID- 8471399
TI  - The differential effect of aspirin on human platelet activation in aspirin
      sensitive asthmatics and normal subjects.
AB  - 1. The in vitro effect of aspirin on platelet aggregation and ATP release induced
      by platelet activating factor (PAF), arachidonic acid (AA) and collagen (COL) was
      assessed in 10 aspirin-sensitive (ASP+) asthmatic patients and 10 normal
      subjects. 2. For PAF, but not AA or COL, both the baseline EC50 and minimum
      concentration required to produce a maximum response for aggregation were
      significantly increased in ASP+ asthmatics compared with normal subjects (P <
      0.05). Maximum ATP released was greater in ASP+ patients for all agonists but the
      difference was most significant for PAF (P < 0.025). 3. In ASP+ asthmatics COL
      induced, but not AA induced, aggregation was less sensitive to inhibition by
      aspirin compared with normals (P < 0.01). Similarly, analysis of the area under
      the percent inhibition concentration-response curve showed aspirin to be less
      effective in inhibiting platelet aggregation induced by PAF in ASP+ asthmatics
      than in normal subjects (normal subjects: 155 +/- 11 mg% ml-1, ASP+ asthmatics:
      115 +/- 19 mg% ml-1; P < 0.05). 4. Regression analysis showed a poor correlation
      (r = 0.25, P < 0.4933) between the degree of aspirin induced inhibition of ATP
      release and platelet aggregation induced by PAF in ASP+ asthmatics. 5. The
      significant differences observed in platelet responses to PAF, COL and to aspirin
      in ASP+ asthma patients further suggests an abnormality in platelet function
      exists in this syndrome.

PMID- 8471400
TI  - The effect of L-leucine on the absorption of levodopa, studied by regional
      jejunal perfusion in man.
AB  - 1. A new method for perfusing a 10 cm segment of jejunum in humans has been used
      in seven subjects to study the effect of the amino acid L-leucine (40 mM) on the
      intestinal absorption of levodopa (2.5 mM). The tube contains six channels and
      has two inflatable balloons, which enable a perfusion of a closed and defined
      segment of the proximal small intestine. 2. L-leucine decreased the intestinal
      absorption of levodopa from 40 +/- 19 to 21 +/- 15% but was without effect on the
      absorption of antipyrine, benserazide and D-glucose. 3. We confirm that levodopa
      is absorbed by the active transport system normally responsible for the
      absorption of large neutral amino acids (LNAA) in humans. Oral absorption by
      passive diffusion, probably by the paracellular route, might also occur for
      levodopa in the proximal part of the small intestine.

PMID- 8471401
TI  - Endogenous digoxin-like immunoreactivity during pregnancy and at birth.
AB  - 1. We have measured endogenous digoxin-like immunoreactivity (EDLI), in mothers
      and infants, during normal/pathological pregnancies and at birth. 2. During
      pregnancy, EDLI was measured in 38 maternal-fetal pairs. At the time of fetal
      sampling, maternal age was 29 (s.d. 6) years and gestational age was 28 (s.d. 6)
      weeks. EDLI was present in 13 (34%) mothers and in 27 (71%) fetuses. There was no
      correlation between maternal and fetal concentrations or between maternal or
      fetal concentrations and gestational age. 3. EDLI was measured at birth in blood
      samples from 45 maternal-cord pairs. Maternal age was 29 (s.d. 5) years and
      gestational age was 39 (s.d. 2) weeks. EDLI was present in 11 (22%) maternal and
      in 44 (98%) cord samples. The concentrations were significantly higher in cord
      than in fetal or maternal samples (P < 0.001 in both cases). 4. High cord EDLI
      concentrations suggest acute synthesis during delivery. Thus, the placental
      transfer of digoxin calculated from maternal and cord digoxin concentrations at
      birth may be overestimated.

PMID- 8471402
TI  - A comparison of the pharmacokinetic and pharmacodynamic properties of quinine and
      quinidine in healthy Thai males.
AB  - 1. Eight healthy Thai males, aged 19-27 years, received quinine or quinidine
      dihydrochloride 10 mg kg-1 body weight by intravenous infusion over 1 h. At least
      1 week later, the alternative alkaloid was administered. 2. The terminal
      elimination half-time of quinidine was shorter than that of quinine (median
      [range]; 5.7 [5.0-10.0] vs 9.9 [8.8-15.1] h, P < 0.01), the volume of
      distribution at steady state (Vss) for quinidine was larger than that for quinine
      (3.5 [2.5-5.6] vs 3.1 [1.8-4.1] 1 kg-1; P = 0.02) and quinidine was less bound to
      plasma proteins (% free drug: 22.8 [15.4-47.2] vs 9.4 [7.3-15.0]%, P < 0.01).
      Total clearance was greater for quinidine (7.7 [3.9-11.4] vs 3.4 [1.8-4.6] ml min
      1 kg-1, P < 0.01) but not for clearance of unbound drug (32.2 [14.6-50.4] vs 29.9
      [20.2-50.9] ml min-1 kg-1 respectively, P > 0.2). 3. Side-effects, including
      transient hypotension after quinidine in two cases, were mild. 4. Both drugs
      produced prolongation of the rate-corrected QT interval (QTc), with similar rates
      of elimination from the cardiac conduction 'effect' compartment (keo; 4.14 [0.03
      15.33] h-1 for quinine, 3.74 [1.63-13.14] h-1 for quinidine, P > 0.19). Using a
      linear concentration-response model, the intercept ('threshold') for quinidine
      effect was lower than that for quinine (P = 0.004) but the slopes (change in QTc
      for a given change in free drug concentration) were similar (P = 0.56).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471403
TI  - A placebo controlled double-blind evaluation of the pharmacodynamics of fengabine
      vs amitriptyline following single and multiple doses in elderly volunteers.
AB  - 1. The effects of fengabine were compared with those of amitriptyline in healthy
      elderly volunteers. Doses were administered double-blind and assessments were
      made before and after ingestion. 2. Psychomotor performance and cognitive ability
      were measured using tests of choice reaction time, tracking, critical flicker
      fusion threshold, memory scanning and word recognition. Subjective feelings were
      assessed using the Leeds sleep evaluation questionnaire (LSEQ) and line analogue
      rating scales (LARS). 3. Pharmacokinetic data suggest that fengabine may induce
      its own metabolism following repeated dosing. 4. The findings of this study show
      that fengabine 200 mg and 400 mg does not produce any noticeable behavioural
      toxicity in elderly volunteers, in contrast to amitriptyline which had a
      disruptive effect throughout.

PMID- 8471404
TI  - The effects of simvastatin and pravastatin on objective and subjective measures
      of nocturnal sleep: a comparison of two structurally different HMG CoA reductase
      inhibitors in patients with primary moderate hypercholesterolaemia.
AB  - 1. It has been suggested that HMG CoA reductase inhibitors which are administered
      as inactive, lipophilic lactones (e.g. simvastatin) have a greater propensity to
      evoke nocturnal sleep disturbances than pravastatin, an inhibitor given in the
      active, hydrophilic, open-acid form. 2. The effects of 4 weeks treatment with
      equipotent doses of simvastatin (20 mg day-1) and pravastatin (40 mg day-1) have
      been compared using polysomnography and subjective sleep assessments in a double
      blind, placebo-controlled, two-period, incomplete block design study involving 24
      male patients with primary moderate hypercholesterolaemia (mean LDL cholesterol
      5.11 mmol l-1). 3. Analysis of sleep EEG measures relevant to insomnia provided
      no evidence of significant differences between pravastatin, simvastatin and
      placebo, except in terms of entries and latency to stage I sleep. The number of
      entries to stage I sleep was significantly greater after simvastatin treatment
      than after either pravastatin or placebo (P < 0.05), but by contrast the latency
      to stage I sleep was significantly prolonged only in the pravastatin group (P <
      0.05 vs placebo). 4. Subjective ratings of sleep initiation, maintenance and
      quality made during and after therapy were not significantly different between
      the three treatment groups. 5. It appears that the inherent hydrophobicity of
      simvastatin does not increase the occurrence of sleep disturbances in this
      patient population at a dose shown to elicit a characteristic hypolipidaemic
      response.

PMID- 8471405
TI  - Pharmacokinetics and biochemical efficacy after single and multiple oral
      administration of losartan, an orally active nonpeptide angiotensin II receptor
      antagonist, in humans.
AB  - 1. The pharmacokinetics and biochemical efficacy of losartan, an orally active
      nonpeptide angiotensin II (AII) receptor antagonist, were evaluated in healthy
      male volunteers after single and multiple oral administration. 2. Plasma and
      urinary concentrations of losartan and its active metabolite, E-3174, were
      determined by a specific high performance liquid chromatographic (h.p.l.c.)
      method. 3. Plasma concentrations of losartan were proportional to dose over the
      range of 25 to 200 mg and the terminal half-lives (t1/2,z) ranged from 1.5 to 2.5
      h. The mean values of Cmax and AUC0-infinity increased in a dose-dependent
      manner. 4. Plasma concentrations of E-3174 were higher than those of losartan at
      all dose levels. The values of Cmax and AUC0-infinity for E-3174 were
      approximately 2 and 5-8 times higher than those for losartan, respectively. Also
      the value of t1/2,z was 2 times longer than that of losartan. 5. After multiple
      dosing for 7 days, the pharmacokinetics of losartan and E-3174 each did not
      change significantly between day 1 and day 7. 6. Plasma renin activity (PRA) and
      plasma concentrations of AII increased markedly at all dose levels. Plasma
      aldosterone levels were slightly reduced, but a similar decrease was also
      observed with placebo. 7. No clinically significant adverse reaction was observed
      in any of the volunteers during either study. Blood counts, routine laboratory
      tests, urine analyses, and electrocardiograms were also not modified by losartan.
      8. Losartan appears to be a potent orally active angiotensin II antagonist with a
      relatively long duration of action.

PMID- 8471406
TI  - Haemodynamic and hormonal responses to oral enalapril in salt depleted
      normotensive man.
AB  - A combination of dietary sodium restriction (40 mmol day-1) and frusemide
      pretreatment has been used to activate the renin angiotensin system (RAS) in
      order to characterise the haemodynamic and hormonal responses to enalapril in
      young normotensives. Enalapril significantly reduced supine blood pressure with a
      mean maximum fall of 19 +/- 7.6, compared with 6.5 +/- 6.8 mm Hg with placebo.
      Similar but greater responses were seen in erect blood pressure. Mean maximal
      plasma ACE inhibition (78 +/- 5.7%) was associated with a significant increase in
      PRA from 5.2 +/- 2.1 ngAI ml-1 h-1 to a peak of 29.1 +/- 6 ngAI ml-1 h-1. This
      simple well tolerated regimen produced consistent RAS activation and gave readily
      measurable falls in blood pressure following enalapril. This model may be used to
      undertake detailed assessments of ACE inhibition, renin inhibition and
      angiotensin receptor blockade.

PMID- 8471407
TI  - The influence of chronic administration of calcium carbonate on the
      bioavailability of oral ciprofloxacin.
AB  - Six healthy male volunteers participated in a two-period, two-treatment study to
      determine the effect of chronic calcium carbonate administration on ciprofloxacin
      bioavailability. There was a mean reduction of 40% in Cmax and 43% in AUC when
      calcium carbonate was administered with ciprofloxacin, compared with
      ciprofloxacin alone (P < 0.05). There were no changes in either half-life or
      tmax. It is therefore recommended that patients being treated with ciprofloxacin
      for serious infections refrain from ingesting calcium supplements. If this is not
      possible, administration of ciprofloxacin 2 h before ingestion of the supplement
      is suggested.

PMID- 8471408
TI  - The reproducibility of quinine bioavailability.
AB  - Plasma concentrations of quinine were measured in six healthy volunteers after a
      duplicate administration of 15 mg kg-1 of quinine hydrochloride orally and the
      administration of 15 mg kg-1 of quinine dihydrochloride as an infusion over 6 h.
      Quinine absorption rate devised by deconvolution was shown to be complete in less
      than 2 h. The mean (+/- s.d.) fraction available (F) was 0.76 (0.11) after both
      oral doses and maximum plasma drug concentrations occurred at 1.90 (0.83) h and
      2.00 (0.30) h, respectively. The reproducibility of absorption was high, with a
      within-subject coefficient of variation of less than 10% for Cmax, AUC and F.
      Thus, quinine absorption is extensive, fast and reproducible in healthy
      volunteers.

PMID- 8471409
TI  - Food intake increases the relative oral bioavailability of vanoxerine.
AB  - Each of 12 healthy male subjects received single oral doses of 100 mg vanoxerine
      (GBR 12909), a dopamine reuptake inhibitor with potential antidepressant
      activity, on three different occasions (fasting, after a low-fat meal and after a
      high-fat meal) according to a randomized, cross-over design. The mean tmax value
      increased from 0.82 h after fasting to 1.44 h after a low-fat meal and to 2.46 h
      after a high-fat meal. Only modest food effects were seen on mean Cmax values (55
      nM, 52 nM and 84 nM, after fasting, after the low-fat meal and after the high-fat
      meal, respectively) but values of AUC up to the last measurable concentration
      (AUC(0,t)) increased by 76% (from 110 to 194 nM h) after the low-fat meal and by
      255% (from 110 to 391 nM h) after the high-fat meal compared with fasting. All of
      these effects were statistically significant except for the differences in tmax
      and Cmax between fasting and the low-fat meal. The mechanism of these changes is
      unclear, but it seems likely that food may lower the first-pass metabolism of
      vanoxerine, as has been shown for other lipophilic basic drugs.

PMID- 8471410
TI  - A simple collection method for saliva in children: potential for home monitoring
      of carbamazepine therapy.
AB  - We have developed a method of monitoring plasma concentrations of antiepileptic
      drugs which uses salivary samples, and is suitable for home monitoring in
      children. To validate the method, paired plasma and saliva samples from 39
      children aged between 2 and 15 years were assayed for carbamazepine and its
      active metabolite, carbamazepine-10,11-epoxide by h.p.l.c. The method uses a
      gauze-wrapped cotton ball with attached string, to absorb saliva which is then
      separated using a syringe and plunger. There was no adsorption of CBZ and CBZ-E
      and they were stable over 1 month in a domestic freezer. Plasma and salivary free
      CBZ and CBZ-E concentrations were highly correlated (r2 = 0.99 and 0.98,
      respectively).

PMID- 8471411
TI  - Morphine glucuronidation in premature neonates.
AB  - The glucuronidation of morphine was investigated in 10 premature neonates
      (postnatal age < 24 h at initiation of treatment) following 24 h of therapy (2 h
      loading infusion, followed by a constant rate infusion). Morphine, morphine-3
      glucuronide (M3G) and morphine-6-glucuronide (M6G) were measured in plasma
      obtained at 24 h in all babies. Plasma concentrations of M3G and M6G correlated
      significantly with morphine concentration (P < 0.01 in both cases), and with each
      other (P < 0.001), suggesting that the capacity for morphine glucuronidation in
      premature neonates is not saturated at the infusion rates used in this study.
      M3G/morphine and M6G/morphine plasma concentration ratios were independent of
      morphine infusion rates (P > 0.05) and morphine plasma concentrations (P > 0.05),
      providing further evidence of linear kinetics. However, M3G/morphine and
      M6G/morphine plasma concentration ratios increased significantly with increasing
      birth weight (P < 0.05 in both cases). This probably reflects increase in liver
      weight with increasing birth weight. Although morphine glucuronidation is
      deficient in premature neonates, significant concentrations of the respiratory
      stimulant M3G are achieved rapidly (20% of morphine plasma concentrations at 2
      h). At this time, the respiratory depressant M6G could not be detected.

PMID- 8471412
TI  - Bronchodilating effects of the novel potassium channel opener HOE 234 in human
      airways in vitro.
AB  - Bronchodilating effects of the novel potassium channel opener HOE 234 were
      examined in human bronchi in vitro and compared with those of BRL 38227. HOE 234
      produced concentration-dependent relaxations of spontaneous tone and of tone
      increased by methacholine (10(-6) M), with mean EC50 values of 11 nM and 47 nM,
      respectively (n = 5). The relaxation produced by HOE 234 was 7 and 3.5 fold more
      potent than that by BRL 38227 on spontaneous and induced tone, respectively, and
      was inhibited by glibenclamide (10(-5) M). These results suggest that HOE 234 is
      a potent bronchodilator which activates ATP-sensitive potassium channels in human
      airways.

PMID- 8471413
TI  - Potentiation of the hypoglycaemic response to glipizide in diabetic patients by
      histamine H2-receptor antagonists.
AB  - In a randomised placebo controlled study, two groups of six maturity onset
      diabetic patients stabilised on glipizide were given cimetidine (400 mg) or
      ranitidine (150 mg) 3 h before a standardised meal. In comparison with placebo,
      both cimetidine and ranitidine significantly reduced the post-prandial rise in
      blood glucose by a mean of 40% and 25% respectively producing glucose levels of
      less than 3 mmol l-1 (lowest 1.5 mmol l-1) in four patients. Both drugs also
      significantly increased plasma glipizide AUC by approximately 20%. Caution should
      be exercised when initiating treatment with H2-receptor antagonists in diabetics
      receiving sulphonylurea hypoglycaemic agents.

PMID- 8471414
TI  - High clearance of (S)-warfarin in a warfarin-resistant subject.
AB  - A 30 year old black male required a 60 mg daily dose of warfarin to elicit a
      therapeutic anticoagulant response (normal warfarin dose 2.5-10 mg day-1; maximum
      15 mg day-1). Hereditary warfarin resistance was suspected after compliance,
      diet, concurrent medication and any gastrointestinal disorder were eliminated as
      contributory causes. The disposition of vitamin K and vitamin K epoxide was
      examined in the propositus, his two sisters and 13 control black male subjects.
      Each subject was given an i.v. bolus dose (5 mg) of vitamin K prior to and after
      2 weeks of warfarin therapy (5 mg day-1). The oral clearances of (S)- and (R)
      warfarin were also measured in each subject during the last day of warfarin
      therapy. The mean (+/- s.d.) systemic clearance of vitamin K was similar in all
      subjects before (114 +/- 35 ml min-1) and after (112 +/- 40 ml min-1) warfarin
      therapy. The mean (+/- s.d.) AUC value for vitamin K epoxide was increased by
      warfarin treatment (6.5 +/- 5.4 micrograms ml-1 min before and 139 +/- 78
      micrograms ml-1 min after) in all subjects. In the propositus, the oral clearance
      of (S)-warfarin (14.5 ml min-1) and the clearance ratio for (S)/(R)warfarin (2.6)
      differed by more than 7 standard deviations from the control group (4.3 +/- 1.1
      ml min-1 and 1.2 +/- 0.2, respectively). In one sister of the propositus, the
      stereoselective disposition of warfarin was comparable with that of her brother
      ((S)-warfarin clearance = 16.2 ml min-1; and (S)/(R)-warfarin clearance ratio =
      2.7).

PMID- 8471415
TI  - The N-demethylation of imipramine correlates with the oxidation of S-mephenytoin
      (S/R-ratio). A population study.
AB  - The metabolism of imipramine was investigated in 106 healthy volunteers, all
      having a sparteine metabolic ratio (MR) of 0.2-0.5 and hence classified as
      extensive metabolisers. Each subject was given a single oral dose of 25 mg
      imipramine hydrochloride and blood for assays of imipramine and metabolites was
      collected 3 h thereafter. The desipramine/imipramine ratio and the 2-OH
      desipramine/2-OH-imipramine ratio in plasma, reflecting the demethylation of
      imipramine and 2-OH-imipramine, respectively, showed significant negative
      correlations with the mephenytoin S/R ratio (Spearman rank correlation) (rs): 
      0.46, P < 0.00002 and -0.41, P < 0.00002). No correlations were found between the
      2-hydroxylation of imipramine or desipramine and the mephenytoin S/R. These
      findings confirm those of an earlier panel study showing that the demethylation
      of imipramine and 2-OH-imipramine cosegregates in part with the mephenytoin
      oxidation polymorphism.

PMID- 8471417
TI  - International classification of impairments, disabilities, and handicaps.

PMID- 8471416
TI  - The pharmacokinetics and pharmacodynamics of dermatan sulphate MF701 during
      haemodialysis for chronic renal failure.
AB  - Single i.v. bolus doses of dermatan sulphate MF701 were administered before the
      onset of haemodialysis to patients with chronic renal failure, to prevent
      clotting in the extracorporeal circuit. Six patients received 2 mg kg-1; six were
      given 2.5 and 3 mg kg-1; 13 received 4.5 and 6 mg kg-1. Plasma MF701
      concentrations (chromogenic assay), activated partial thromboplastin time (APTT)
      and plasma markers of coagulation and platelet activation (TAT and beta-TG) were
      measured over 4 or 8 h from the onset of dialysis. The disposition of MF701 was
      described by a monoexponential function. C(0) and AUC values increased
      proportionally with dose. Volumes of distribution (approximately 4 l) were dose
      independent. Half-lives showed a non significant increase with dose (from 2.2 to
      3.1 h) and were 2.5-3 times longer than those reported for healthy subjects.
      There was a significant correlation between plasma MF701 concentration and its
      effects in prolonging APTT and suppressing TAT and beta-TG generation during
      dialysis.

PMID- 8471418
TI  - Global health situation. VI. Health care coverage and resources.

PMID- 8471419
TI  - Health services research in oncology.

PMID- 8471420
TI  - The influence of high dose hydroxyurea on the incorporation of 5-iodo-2
      deoxyuridine (IUdR) by human bone marrow and tumour cells in vivo.
AB  - Resistance to cytotoxics precludes the successful treatment of many solid
      tumours. Inhibition of DNA synthesis in normal tissues with antimetabolites such
      as hydroxyurea (HU) may be a useful means of improving the selective uptake of
      toxic thymidine analogues by the relatively resistant tumour cells. HU also
      inhibits DNA repair by the critical depletion of intracellular
      deoxyribonucleotides. Twenty-five patients with various malignancies received 5
      iodo-2-deoxyuridine (IUdR) 100 mg m-2 as a 20 min i.v. infusion and the uptake of
      IUdR was determined 1 h later immunocytochemically. Of these patients, 14
      received IUdR 23 h from the start of a continuous i.v. infusion of HU (36 g over
      36 h). Uptake of IUdR was equally suppressed in bone marrow and tumour aspirates,
      0.1% (+/- 0.2%) of marrow precursor cells and 0.5% (+/- 0.4%) of tumour cells
      respectively, in patients who received HU compared to the uptake of IUdR in 11
      patients who were not given HU 6.8% (+/- 1.1%) and 12.2% (+/- 1.8%) respectively.
      Mean HU plasma concentrations at the time of IUdR administration was 1.7 +/- 0.2
      mM. The growth fraction of tumour cells (using Ki67 labelling) was not changed
      after treatment with HU. It is concluded that (1) since DNA synthesis is
      effectively inhibited by HU in tumour cells, differential uptake of radiolabelled
      IUdR by those cells will not be feasible using the current schedule of HU
      administration, (2) HU may be used as an inhibitor of DNA repair in vivo since
      the degree of inhibition correlates with that required to inhibit repair
      experimentally and that (3) Ki67 labelling index is not useful in studying cell
      kinetics in patients treated with HU.

PMID- 8471421
TI  - Tumour necrotisation in nude mice xenografts by the reversible protein synthesis
      inhibitor zilascorb(2H).
AB  - The deuterated benzaldehyde derivative zilascorb(2H), 5,6-O-benzylidene-d-L
      ascorbic acid, was administered once daily by i.v. injection in nude mice with
      grafted tumours of a human malignant melanoma (E.E.) and ovarian carcinoma (OVCAR
      3) origins. Like benzaldehyde, zilascorb(2H) has been shown to induce protein
      synthesis inhibition at otherwise non-toxic doses in cells grown in vitro, and
      acts reversibly in the sense that protein synthesis returns to normal shortly
      after removal of the drug. The present data indicate that daily injections with
      zilascorb(2H) induce a tumour volume growth inhibitory effect in both tumour
      xenografts studied. Furthermore, from histological examinations of each single
      tumour it was found that tumours of drug-treated animals, although smaller than
      those of placebo-treated (i.e. control) animals, had, on average, a higher
      necrotic fraction than control tumours. Thus, it is concluded that zilascorb(2H)
      induces tumour necrotisation and not just inhibition of the rate of tumour cell
      production. Continued measurement of tumour volume after ended treatment with
      zilascorb(2H) indicated that surviving tumour cells resumed their normal growth
      rate immediately. The reversibility of the effect induced by this compound,
      earlier observed in vitro only, is therefore here confirmed to be valid also in
      two different tumour xenografts in vivo. The present data accords well with the
      assumption that protein synthesis inhibition is the primary cellular effect of
      zilascorb(2H) in vivo. We therefore conclude that zilascorb(2H)-induced cancer
      cell lethality in tumour xenografts probably comes as a secondary consequence of
      prolonged protein synthesis inhibition.

PMID- 8471422
TI  - Inhibitory effect of a cholecystokinin antagonist on pancreatic carcinogenesis
      after pancreatobiliary diversion.
AB  - The role of cholecystokinin (CCK) has been explored in pancreatic carcinogenesis
      following pancreatobiliary diversion (PBD), using the specific CCK receptor
      antagonist CR-1409. Male Wistar rats (n = 80) weighing 70-100 g were given weekly
      i.p. injections of azaserine (30 mg kg-1 week-1) for 3 consecutive weeks. One
      week later animals were randomised to receive either PBD or sham PBD and
      thereafter to receive s.c. injections of either saline or CR-1409 (10 mg kg-1 day
      1, 5 days a week). Six months after operation surviving rats were killed as
      follows: sham + saline 20, PBD + saline 19, sham + CR-1409 14, PBD + CR-1409 11.
      Cardiac blood was taken for CCK assay and the pancreas was excised for wet weight
      measurement and quantitative estimation of atypical acinar cell foci (AACF), the
      precursor of carcinoma. PBD reduced median body weight (3-20% less than shams)
      but trebled the absolute and relative pancreatic weights (P < 0.001). CR-1409
      blunted this adaptive response to PBD, reducing absolute pancreatic weight by 35%
      (P < 0.005). PBD quadrupled circulating CCK concentrations, regardless of the
      antagonist treatment. Acidophilic AACF occurred only in rats with PBD. CR-1409
      markedly reduced the number of observed acidophilic AACF by 90% (P < 0.001) and
      the number of foci per pancreas by 93% (P < 0.001). Moreover, CR-1409 reduced the
      mean focal diameter of each lesion by 18% (P < 0.005), the mean focal volume by
      58% (P < 0.05) and the percentage of pancreas occupied by acidophilic foci by 95%
      (P < 0.001). PBD enhances pancreatic carcinogenesis by causing
      hypercholecystokininaemia, and CR-1409 largely inhibits this enhancement.

PMID- 8471423
TI  - Implantation treatment method of slow release anticancer doxorubicin containing
      hydroxyapatite (DOX-HAP) complex. A basic study of a new treatment for hepatic
      cancer.
AB  - We performed an experimental study on slow releasing anticancer drug implantation
      treatment as a new therapy for hepatocellular carcinoma. Hydroxyapatite (HAP) was
      chosen for the carrier material and doxorubicin hydrochloride (DOX) for
      anticancer agent. DOX-HAP was produced by adsorbing DOX to porous HAP particles
      of 1375 +/- 125 microns diameter using the freeze drying method. In vitro
      experiments showed slow release of the drug resulting in the steady release of
      DOX from HAP for 1 month duration. In healthy white rabbits with DOX-HAP
      implantation in the liver, serum DOX was not detectable, and DOX release rate was
      stable at the implanted region after 7, 14, and 21 days. When DOX-HAP (DOX; 100
      mg kg-1) was administered to mice with sarcoma 180, an improved survival rate was
      observed without acute toxicity. We also found that VX2 liver tumour growth on
      white rabbit was inhibited by implantation of DOX-HAP, without acute toxicity. We
      hope that DOX-HAP implantation therapy will open up new avenues for the treatment
      of hepatoma.

PMID- 8471424
TI  - Uncoupling of growth inhibition and differentiation in dexamethasone-treated
      human rhabdomyosarcoma cells.
AB  - The effects of dexamethasone, a synthetic glucocorticoid, and of N,N
      dimethylformamide on in vitro growth and differentiation and on proto-oncogene
      expression of human rhabdomyosarcoma cells were studied. RD/18 clone cells
      (derived from the embryonal rhabdomyosarcoma cell line RD) treated with 100 nM
      dexamethasone showed an almost complete block of differentiation: about 5% myosin
      positive cells were observed after 2 weeks of culture in dexamethasone
      supplemented differentiation medium, compared to 20% of untreated cultures.
      Dexamethasone also induced a 20-30% growth inhibition and a more flattened
      morphology. The treatment with N,N-dimethylformamide induced a significantly
      increased proportion of myosin-positive cells (reaching about 30%) and a 40%
      growth inhibition. Induction of differentiation inversely correlated with the
      levels of c-myc proto-oncogene expression: after a 2 week culture dexamethasone
      treated cells showed the highest c-myc expression and N,N-dimethylformamide
      treated cells the lowest. Culture conditions per se down-modulated c-erbB1 and up
      regulated c-jun expression, with no relationship to the differentiation pattern.
      Other proto-oncogenes were not expressed (c-sis, N-myc, c-mos, c-myb) or were not
      modulated (c-fos, c-raf). Therefore dexamethasone and N,N-dimethylformamide, both
      causing a decreased growth rate, showed opposing actions on myogenic
      differentiation and on c-myc proto-oncogene expression of human rhabdomyosarcoma
      cells.

PMID- 8471425
TI  - Increased protein degradation and decreased protein synthesis in skeletal muscle
      during cancer cachexia.
AB  - The effects of progressive cachexia on protein metabolism in skeletal muscle has
      been investigated in mice bearing the MAC16 adenocarcinoma which produces
      cachexia with tumour burdens of < 1% of the host weight. Weight loss was
      accompanied by loss of whole body nitrogen in proportion to the overall loss of
      body mass. Using L-[4-3H]phenylalanine to label proteins in gastrocnemius muscle,
      a significant depression (60%) in protein synthesis occurred in animals with a
      weight loss between 15 and 30% accompanied by an increase in protein degradation,
      which increased with increasing weight loss between 15 and 30%. Muscle
      degradation in vitro could be achieved by serum from cachectic animals, which
      appeared to contain a proteolysis-inducing factor. These results suggest that the
      increased degradation of skeletal muscle seen in this model of cachexia may be
      due to a circulating proteolysis-inducing factor.

PMID- 8471426
TI  - Characterisation of UGP and its relationship with beta-core fragment.
AB  - Urinary gonadotrophin peptide (UGP) was originally identified by immunoassay in
      the urine of patients with various types of cancer and by immunohistochemistry in
      human cancers of various histological types. Extracts of normal adult male urine
      also contained UGP by immunoassay. Purified UGP from different starting material
      was subjected to high pressure liquid chromatography (HPLC) prior to defining
      amino acid sequences. Chromatographed UGP after HPLC showed three distinct
      fractions. The N-terminal sequence of peptide 2 was completely homologous with
      the beta-core fragment of human chorionic gonadotrophin (hCG) and this was found
      associated with two smaller peptides. The N-terminal sequence of peptide 1 has
      not been described previously whilst the N-terminus of peptide 3 that was
      sequenced showed complete homology with the N-terminal sequence of eosinophil
      derived neurotoxin and non-secretory ribonuclease. The monoclonal antibodies 2C2
      and 6D3 only bind beta core-fragment (peptide 2) whilst the polyclonal (rabbit)
      antibody AK12 could bind all three peptides. The radioimmunoassay system using
      AK12 could be inhibited by all three peptides and the immunoradiometric assay
      although based on a capture antibody (2C2) that only bound peptide 2, had the
      potential to measure all three peptides (when bound together as UGP) at the
      second step when 125I-AK12 was introduced as the detector. A specific
      radioimmunoassay for peptide 3 was generated using 125I-peptide 3 and the AK12
      antibody. Beta core-fragment on iso-electric focusing was found to have a pI >
      9.5, peptide 3 showed two bands at pI = 3.5 and 3.8 whilst insufficient purified
      peptide 1 was available to determine its iso-electric point. Bioassay studies on
      UGP showed that any biological activity could be attributed to trace
      contamination with hCG.

PMID- 8471427
TI  - Gallium-67 radiotoxicity in human U937 lymphoma cells.
AB  - Promising clinical results have been obtained with radiolabeled antibodies in
      lymphoma patients. The higher uptake by lymphomas of 67Gallium (67Ga) compared
      with monoclonal antibodies makes selective radiotherapy by the widely available
      67Ga appealing. However, the gamma radiation of 67Ga used in scintigraphy is
      considered to be almost non-toxic to lymphoma cells. However, in addition to
      photon radiation 67Ga emits low energy Auger electrons and 80-90 keV conversion
      electrons which could be cytotoxic. The objective of the present study was the
      assessment of radiotoxicity of 67Ga on a lymphoid cell line: U937. Proliferation
      (MTT-assay) and clonogenic capacity (CFU-assay) were measured after 3 and 6 days
      incubation with 10, 20 and 40 microCi ml-1 67Ga. Growth inhibition was 36% after
      3 days incubation and 63% after 6 days incubation with 40 microCi 67Ga ml-1.
      Clonogenic capacity was reduced by 51% after 3 days and 72% after 6 days
      incubation with 40 microCi ml-1 67Ga. A survival curve showed an initial shoulder
      and became steeper beyond 200-250 pCi cell-1 (low linear energy transfer type).
      Iso-effect doses of 67Ga and 90Yttrium (90Y) were determined. The iso-effect dose
      of 40 microCi 67Ga ml-1 (cumulative dose of conversion electrons 306 cGy) was 2.5
      microCi 90Y ml-1 (cumulative dose 494 cGy) and the iso-effect dose of 80 microCi
      67Ga ml-1 was 5.0 microCi 90Y/ml. The main cytotoxic effect of 67Ga seems to be
      induced by the 80 keV conversion electrons. We conclude that the conversion
      electrons of 67Ga have a cytotoxic effect on U937 cells and that in our
      experiments a 16-fold higher microCi-dose of 67Ga than of 90Y was needed for the
      same cytotoxic effect. We believe that 67Ga holds promise for therapeutic use.

PMID- 8471428
TI  - Cellular accumulation of 18F-labelled boronophenylalanine depending on DNA
      synthesis and melanin incorporation: a double-tracer microautoradiographic study
      of B16 melanomas in vivo.
AB  - The cellular distribution of 4-borono-2-[18F]fluoro-L-phenylalanine ([18F]FBPA,
      an analog of p-boronophenylaline), a potential agent for boron neutron capture
      therapy (BNCT), and [6-3H]thymidine ([3H]Thd, a DNA precursor) in murine two B16
      melanoma sublines and FM3A mammary carcinoma was studied in vivo using double
      tracer microautoradiography. Tumour volume, tumour age, cell density in the
      tissues and the proportion of S phase cells in the cell cycle were the same in
      the three tumour models. Volume doubling time, which represents tumour growth
      rate, was fastest in B16F10, followed by B16F1 (P < 0.05), the slowest being in
      FM3A (P < 0.001). The rate of DNA synthesis in S phase cells corresponded to the
      volume doubling time. The greatest amount of [18F]FBPA was observed in S phase
      melanocytes and the lowest amount was found in non-S phase non-melanocytes. The
      [18F]FBPA accumulation was primarily related to the activity of DNA synthesis
      and, secondarily, to the degree of pigmentation in melanocytes. The therapeutic
      efficacy of BNCT with p-boronophenylalanine may be greater in melanoma that
      exhibits greater DNA synthesis activity and higher melanin content.

PMID- 8471429
TI  - Production of matrix metalloproteinase 9 (92-kDa gelatinase) by human oesophageal
      squamous cell carcinoma in response to epidermal growth factor.
AB  - We demonstrated that four human oesophageal squamous cell carcinoma cell lines
      (TE8, TE9, TE10 and TE11) produced matrix metalloproteinase-1 (proMMP-1/tissue
      collagenase), 2 (ProMMP-2/'type IV collagenase'), 3 (proMMP-3/stromelysin), and 9
      (proMMP-9/92-kDa gelatinase) as members of a matrix metalloproteinase (MMP)
      family, which degrades extracellular matrix macromolecules. Under normal culture
      conditions, in immunoblot analysis, proMMP-1 of M(r) = 53,00 was detected in one
      cell line (TE8), proMMP-2 of M(r) = 72,000 in three cell lines (TE9, TE10, and
      TE11), and proMMP-3 of M(r) = 57,000 in all four cell lines. In addition to these
      enzymes, in enzymography, a gelatinolytic activity around M(r) = 92-kDa, likely
      to be proMMP-9, was detected in only one cell line (TE10) under normal culture
      conditions. When these cell lines were treated with epidermal growth factor
      (EGF), however, the agent stimulated three cell lines (TE8, TE10 and TE11) to
      produce proMMP-9 in a dose-dose dependent manner. Oesophageal carcinoma
      conditioned medium stimulated oesophageal fibroblasts to produce proMMP-1, -2,
      and -3, suggesting that the interaction between oesophageal carcinoma and stromal
      fibroblasts also plays a role in the production of MMPs by the latter. Our
      present study illustrates that oesophageal squamous cell carcinoma produces a
      variety of MMPs including proMMP-1, -2, -3, and -9 in vitro, suggesting that the
      ability of MMP production of the tumour may play an important role in its
      malignant behaviour and that the production of proMMP-9 may be regulated by EGF
      via overexpression of EGF receptors.

PMID- 8471430
TI  - The effect of flunarizine on erythrocyte suspension viscosity under conditions of
      extreme hypoxia, low pH, and lactate treatment.
AB  - Flunarizine is a class IV calcium channel blocker which increases oxygen delivery
      to hypoxic regions in solid tumours, exerting a radiosensitising effect in vivo
      in animal tumour models. Precisely how the drug improves oxygenation is not well
      understood. We hypothesised that metabolic conditions present within solid
      tumours reduce red blood cell (RBC) deformability and that flunarizine exerts its
      in vivo effect by preventing this loss of RBC deformability. A microrheometer was
      used to compare the viscosity of rat and human RBC suspensions in conditions of
      hypoxia (pO2 < 10 mmHg), acidic environment (pH 6.8), and elevated lactate
      concentration (lactate 5 mMol l-1), without or with flunarizine at concentrations
      of 5, 10, and 50 mg l-1. The effects of flunarizine on RBC density and morphology
      were also recorded. Hypoxia, low pH, and lactate exposure together increased both
      human and rat RBC suspension viscosity. Flunarizine at concentrations of 5 and 10
      mg l-1 prevented the increases in viscosity. The drug caused dose-dependent
      shifts toward lower cell density while inducing a characteristic cupped shape
      (stomatcytic morphology), suggesting a mechanism involving calmodulin inhibition.
      The results support the hypothesis that flunarizine improves tumour blood flow
      and oxygenation by enhancing flow properties of RBC's in solid tumours.

PMID- 8471431
TI  - Cisplatin-DNA damage recognition proteins in human tumour extracts.
AB  - Enhanced repair of DNA adducts may be a cause of cis-diamminedichloroplatinum(II)
      resistance in solid malignancies. Binding of specific damage recognition proteins
      to the sites of DNA damage may be involved in the initial steps of DNA repair, or
      alternatively may block access of repair proteins to damaged DNA. Proteins which
      bind specifically to CDDP-modified DNA were identified in cell extracts from
      human ovarian carcinoma cell lines by two assays, the gel mobility shift assay
      and the southwestern blot. In the first assay, proteins complexed with CDDP
      modified oligonucleotide and produced two retarded bands, B1 and B2. The B2
      complex was partially purified from an ovarian cell extract by anion exchange
      FPLC, and was shown to bind to DNA damaged by CDDP but not by transDDP or UV
      irradiation. Using the southwestern blot, proteins of 97, 48, and 25 kD were
      identified; each of these bound to CDDP-modified but not undamaged
      oligonucleotide. The partially purified B2 protein fraction contained both the 97
      and the 25 kD damage recognition proteins. A human ovarian carcinoma cell line
      selected in vitro for CDDP-resistance (OV1P/DDP), which is 5-fold more resistant
      to CDDP than the parental line (OV1P), showed an increase in binding of the 97
      and 48 kD damage recognition proteins compared with the parental line. Twelve
      ovarian cell lines differed by up to 3-fold in their expression of these
      proteins, but there was no correlation between the amount of damage recognition
      protein in a cell extract and the cellular sensitivity to CDDP. Damage
      recognition proteins were also demonstrated in extracts prepared from biopsies of
      human ovarian, cervical, and testicular malignancies, but there was no apparent
      difference in the binding activity in extracts from tumours of different CDDP
      sensitivity. The functional role of these damage recognition proteins remains to
      be established.

PMID- 8471432
TI  - An assessment of the reliability and reproducibility of measurement of potential
      doubling times (Tpot) in human colorectal cancers.
AB  - An assessment has been made of the reproducibility of measuring tumour
      proliferation using in vivo iododeoxyuridine (IUdR) labelling and flow cytometry.
      The variation that occurs between different institutions (Paterson Institute for
      Cancer Research, Manchester and the Gray Laboratory, Northwood), different
      observers and different runs on the same flow cytometer have been measured on 139
      samples from 53 patients with colorectal cancer. The results demonstrate that the
      IUdR technique for measuring tumour proliferation is reproducible. Correlations
      were seen between measurements of Tpot obtained by different individuals and on
      separate machines. However, direct comparisons of the measured parameters showed
      that there were highly significant differences in the values obtained between
      institutes and observers (P < 0.001). Despite these variations, there were still
      significant detectable differences in Tpot measurements between individual
      tumours (P < 0.001). Analysis of the results obtained by running the same samples
      on two separate occasions on the same machine showed that the technique was
      highly reproducible and that the staining procedure was stable. Eighty per cent
      of the samples were similarly assigned to either above or below the median Tpot
      value, regardless which observer/laboratory combination was utilised. These data
      suggest that large clinical trials using Tpot should employ a single centre and a
      single individual to prepare, run and analyse samples.

PMID- 8471433
TI  - Prognostic significance of cathepsin-D in patients with breast cancer.
AB  - The expression of the protease cathepsin-D has been evaluated using an
      immunohistochemical technique with a polyclonal antibody in paraffin-embedded
      tissue from 359 patients treated between the years 1975-1981 for Stage I and II
      breast cancer. One hundred and twenty seven patients (35%) have strongly
      positive, granular staining, 138 (38%) are intermediately stained in the
      cytoplasm, and in 94 (26%) no staining is observed. There is a strong positive
      association between expression of cathepsin-D and the presence of tumour in
      axillary lymph nodes (P < 0.006). Expression of the protease is associated with
      significantly poorer survival of patients in univariate analysis (P = 0.025);
      however, this is not independent of other tumour variables.

PMID- 8471434
TI  - Performance status assessment in cancer patients. An inter-observer variability
      study.
AB  - The ECOG Scale of Performance Status (PS) is widely used to quantify the
      functional status of cancer patients, and is an important factor determining
      prognosis in a number of malignant conditions. The PS describes the status of
      symptoms and functions with respect to ambulatory status and need for care. PS 0
      means normal activity, PS 1 means some symptoms, but still near fully ambulatory,
      PS 2 means less than 50%, and PS 3 means more than 50% of daytime in bed, while
      PS 4 means completely bedridden. An inter-observer variability study of PS
      assessment has been carried out to evaluate the non-chance agreement among three
      oncologists rating 100 consecutive cancer patients. Total unanimity was observed
      in 40 cases, unanimity between two observers in 53 cases, and total disagreement
      in seven cases. Kappa statistics reveal the ability of the observers compared to
      change alone and were used to evaluate non-chance agreement. Overall Kappa was
      0.44, (95% confidence limits 0.38-0.51). The Kappa for PS 0 was 0.55 (0.44-0.67),
      while those for PS 1, 2, 3 and four were 0.48 (0.37-0.60), 0.31 (0.19-0.42), 0.43
      (0.32-0.55), and 0.33 (0.33-0.45), respectively. If one observer allocated
      patients to PS 0-2, then another randomly selected observed placed the patients
      in the same category with a probability of 0.92. For patients with PS 3-4 the
      probability that the same category would be chosen was 0.82. Overall, the non
      chance agreement between observers was only moderate, when all ECOG Performance
      Status groups were considered. However, agreement with regard to allocation of
      patients to PS 0-2 versus 3-4 was high. This is of interest because this cut-off
      is often used in clinical studies.

PMID- 8471435
TI  - Primary gastrointestinal non-Hodgkin's lymphoma: a review of 175 British National
      Lymphoma Investigation cases.
AB  - A retrospective analysis was performed upon 175 patients with Non-Hodgkin's
      Lymphoma involving the gastrointestinal tract and entered into BNLI trials and
      studies between 1974-1988. Malignant histiocytosis of the intestine (MHI), which
      was present in 16 patients, was associated with a survival of less than 25% at 18
      months, and probably accounted for the poor survival of patients with jejunal
      involvement. Histopathological evidence of tumour origin from mucosa-associated
      lymphoid tissue (MALT) was found in 50% of patients with gastric involvement and
      in 27% of those with intestinal involvement. The overall survival of the series
      as a whole was 44% at 10 years. Multivariate analysis identified evidence of
      tumour origin from MALT as the only factor to attain prognostic significance in
      patients with gastric involvement, and clinical stage and the presence of MHI as
      the only factors to attain prognostic significance in patients with intestinal
      involvement. It is suggested that there is a need for a large multicentre
      prospective study of GIT lymphoma.

PMID- 8471436
TI  - Frequency of adult T-cell leukaemia/lymphoma and HTLV-I in Ibadan, Nigeria.
AB  - Sera from a small sample of adult blood donors, healthy school children and
      patients with lymphoma, leukaemia, non-haematologic cancer, congenital and
      inflammatory disorders from Ibadan, Nigeria were screened for HTLV-I antibody by
      an enzyme-linked immunoabsorbent assay and confirmed by investigational Western
      blot. Seventy-nine of 236 positively screened samples could not be tested for
      confirmation. Seropositive reactivity was observed in nine of 123 blood donors,
      and 3 of 46 healthy school children but banding patterns on Western blot were
      often sparse. Among non-Burkitt's non Hodgkin's lymphoma patients six of 30 were
      HTLV-I positive including four of four with clinical features of adult T-cell
      leukaemia (ATL). Other clinical conditions had a frequency of positivity
      indistinguishable from healthy donors. Western blot patterns ranged from strong
      with multiple bands, which were uncommon, to those with only p24 and p21 envelope
      positive which were frequent. Given the relative paucity of clinical ATL and the
      unusual Western blot patterns the true rate of HTLV-I infection may be lower than
      estimated. It is possible that a cross-reactive HTLV-I-like virus accounts for
      this pattern.

PMID- 8471437
TI  - Carbon-11-methionine and PET in evaluation of treatment response of breast
      cancer.
AB  - Uptake of L-methyl-11C-methionine (11C-methionine) in breast cancer metastases
      was studied with positron emission tomography (PET). Eight patients with soft
      tissue metastases were studied twice: before the onset of chemotherapy (4),
      hormonal therapy (3) or radiotherapy (1) and 3-14 weeks later. The radioactivity
      concentration of the low molecular weight fraction of venous plasma samples
      separated by fast gel filtration was used as input function. The input corrected
      uptake rate of 11C-methionine (Ki) in breast cancer metastases before the
      treatment ranged between 0.035 and 0.186 1 min-1 and the standardised uptake
      value (SUV) between 2.0 and 11.4. The uptake of 11C-methionine into the
      metastases decreased when clinical objective stability or regression of the
      metastases was later obtained and increased in cases where progressive disease
      was seen during treatment. We conclude that metabolic changes in the amino acid
      metabolism detected by PET precede the clinical response, and may be of clinical
      value in predicting the treatment response.

PMID- 8471438
TI  - Beta-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's
      lymphomas.
AB  - beta-2 microglobulin levels were measured in stored serum taken at presentation
      from 262 patients treated with combination chemotherapy for Kiel classification
      high-grade lymphoma at a single centre over a 15 year period. A significant
      association was found between elevated levels and advanced (Ann Arbor stage III
      or IV) disease or hepatic infiltration, but not with other sites of extranodal
      involvement or bulky disease. Patients with normal levels at presentation had a
      70% remission rate with treatment compared to 37% of those with elevated levels
      (P < 0.001). With median follow up of 6 years duration of remission was
      significantly greater in patients with normal beta-2 microglobulin at
      presentation (plateau at 70%, compared to median remission of 19 months in those
      with raised levels, P < 0.001). Survival overall was also better in the group
      with normal levels (actuarial median 9 years compared to 1 year, P < 0.001).
      Multivariate analyses including treatment type, age, sex, B symptoms, stage,
      bulk, albumin, sodium, alkaline phosphatase, aspartate aminotransferase, lactate
      dehydrogenase and beta-2 microglobulin, placed beta-2 microglobulin among the
      three most influential independent variables for prediction of response rate,
      duration of remission and overall survival.

PMID- 8471439
TI  - Chemotherapy and survival in advanced breast cancer: the inclusion of doxorubicin
      in Cooper type regimens.
AB  - The value of the inclusion of doxorubicin hydrochloride (dox) in Cooper type
      regimens in advanced breast cancer was assessed by performing an overview
      employing summary statistics derived from published papers of randomised clinical
      trials comparing Cooper type regimens that contain dox with regimens in which dox
      was replaced by one or more compounds. Trials were selected which published data
      on survival, time to treatment failure and response rate. This study suggests
      that dox confers advantages on all of these endpoints and that the size of such
      benefits needs to be taken into account when deciding whether to use dox.

PMID- 8471440
TI  - The clinical epidemiology of superficial bladder cancer. Dutch South-East
      Cooperative Urological Group.
AB  - Even though the majority of patients with bladder malignancies initially present
      with low stage disease, the clinical epidemiology of these so-called superficial
      bladder tumours is not well known. In this paper, disease characteristics at
      initial presentation and during follow-up are described in 1,745 primary cases
      documented prospectively in the Netherlands. The risk of recurrent disease after
      primary treatment is very high: in 60% of cases, at least one recurrence is
      diagnosed within 5 years (95% CI: 58-62%). In patients with a small solitary pTa
      grade 1 tumour, the 3-year recurrence risk is 37%. In patients with multiple
      large high grade pT1 tumours, this risk is as high as 77%, despite a significant
      beneficial effect of adjuvant intravesical chemotherapy. The actuarial risk of
      disease progression is 10.2% after 3 years (95% CI: 8.6-11.8%). This risk of
      progression depends on the patient's age at diagnosis, tumour stage, grade,
      multiplicity and the presence of dysplasia or CIS in random urothelium biopsies.
      The use of intravesical instillations with chemotherapy or BCG vaccine after TUR
      does not prevent progressive disease, although this finding is difficult to
      interpret from a non-randomised study. The 5-year relative survival in patients
      with superficial TCC of the bladder is 86% (95% CI: 84-88%).

PMID- 8471441
TI  - The reliability of Cancer Registry records.
AB  - Data from the Thames Cancer Registry were compared with data independently
      abstracted from medical records for 466 patients with confirmed cancer of the
      bladder diagnosed in 1982. High levels of agreement were observed for five
      continuous variables and for tumour morphology. Data concerning tumour stage did
      not clearly distinguish superficial from invasive tumours. Cancer registry data
      were found to be reliable except for tumour stage which may not be clearly
      documented in clinical records.

PMID- 8471442
TI  - Does the month of diagnosis affect survival of cancer patients?
AB  - Some earlier studies based on relatively small data sets have suggested that the
      month of diagnosis affects survival of breast cancer patients. This phenomenon
      has been suggested to be attributable to daylight-related hormonal factors.
      Factors related to the holidays of both the medical personnel and the women
      themselves might also provide the explanation. In this study we assessed the
      effect of the month of diagnosis on the survival of 32,807 female breast cancer
      patients diagnosed in Finland in 1956-1985. Our results indicate that the month
      of diagnosis is a significant prognostic factor after adjusting for age at
      diagnosis, period of diagnosis, and stage at diagnosis. The adjusted relative
      excess risk of death was highest among those diagnosed in July and August, and
      lowest in March and November, the difference between the lowest and highest risk
      being 18%. Since colorectal cancer should not have any daylight-related hormone
      dependent risk determinants, a control cohort of 12,950 women with a diagnosis of
      colorectal cancer in the same calendar period was studied in a similar way. The
      survival pattern by month of diagnosis among the colorectal cancer patients was
      similar to that among breast cancer patients, indicating that general factors
      associated with the health behaviour of women and the health services (such as
      holidays) rather than biological factors may cause seasonal variations in
      survival of cancer patients.

PMID- 8471443
TI  - Breast-feeding and breast cancer in the offspring.
AB  - The causation of breast cancer in certain strains of mice by a virus that can be
      transmitted vertically, through the milk produced during lactation, has led to
      the hypothesis that a similar phenomenon could exist in humans. There have been
      laboratory-based studies in humans suggesting that a virus may be involved in the
      etiology of female breast cancer although other investigations did not support
      this hypothesis. Descriptive data and epidemiologic evidence of ecologic nature
      do not indicate a role of lactation in the causation of human breast cancer, but
      the hypothesis has not been adequately assessed in analytic epidemiologic
      studies. A nested case-control study undertaken in Sweden to examine the role of
      prenatal factors on breast cancer risk in the offspring, allowed the evaluation
      of the importance of breast-feeding in the causation of this disease.
      Standardised records concerning women born at the Uppsala University Hospital
      from 1874 to 1954 were linked with invasive breast cancer incident cases,
      identified through their unique national registration number in the Swedish
      Cancer Registry during 1958-1990. For each case with breast cancer, the females
      born to the first three mothers admitted after the case's mother were selected as
      potential matching controls. Only controls living in Sweden and free from breast
      cancer until the time of diagnosis of breast cancer in the corresponding case
      were eventually included in the study. The analysis was based on 458 cases of
      breast cancer born in singleton pregnancies and 1,197 singleton age- and birth
      date-matched controls. Breast-feeding was not a significant or suggestive risk
      factor for breast cancer in the offspring; compared to women who at discharge
      were wholly or partly breastfed, women who as newborn were not breastfed had a
      relative risk of breast cancer of 0.97 with 95% confidence interval 0.44-2.17 (P
      = 0.95).

PMID- 8471444
TI  - Selected physical activities and the risk of endometrial cancer.
AB  - The relationship between various indicators of physical activity and endometrial
      cancer risk was analysed using data of a case-control study conducted in 1988
      1991 in Switzerland and Italy on 274 histologically confirmed cases and 572
      controls admitted to hospital for acute, non neoplastic, non hormone-related
      diseases. Using a self-rated assessment of total physical activity, there was a
      systematic tendency for the cases to report more frequently 'low' or 'very low'
      physical activity. The relative risks were similar for 'very high' or 'moderately
      high' physical activity, but increased in the two lowest levels, with point
      estimates, in various decades of age, between 1.3 and 2.3 for 'moderately low'
      and over 2.5 for 'very low' physical activity. Although the association was
      apparently stronger at older ages, all the trends in risk were significant.
      Allowance for major identified potential distorting factors, including body mass
      index and a measure of total energy intake, could explain only in part the
      association, and the inverse trends in risk remained statistically significant.
      When selected types of physical activity were analysed, no association was
      observed with climbing stairs or walking, but the risk estimates for the lowest
      level of activity was over 4 for housework, and between 1.5 and 1.9 for sport and
      leisure and occupational activity. Thus, the present findings suggest that a
      moderate or high physical activity is an indicator of reduced endometrial cancer
      risk, although this observation still requires epidemiologic confirmation and
      clearer definition from a pathogenic point of view.

PMID- 8471445
TI  - Receiver operating characteristic (ROC) curve analysis of the tumour markers CEA,
      CA 50 and CA 242 in pancreatic cancer; results from a prospective study.
AB  - The serum values of the tumour markers carcinoembryonic antigen (CEA), cancer
      associated carboanhydrate antigens CA 50 and CA 242 were evaluated in 193
      patients with hepatopancreato-biliary diseases by receiver operating
      characteristic (ROC) curve analysis in order to compare their diagnostic accuracy
      in pancreatic cancer (n = 26), and to define optimal cut-off levels for the serum
      values of these tumour markers in the diagnosis of pancreatic cancer. The ROC
      analysis showed that all marker tests are considerably sensitive (77-81%) at the
      specificity level of 80%. The CA 242 test was more sensitive than CEA and CA 50
      at high specificity levels (> 0.90) but slightly less sensitive at low
      specificity levels (< 0.60). The CEA test and CA 50 test performed equally well
      at high and low specificity levels. According to this study, it would seem
      optimal to use the cut-off level of 4.1 ng ml-1 for CEA, and the level of 137 U
      ml-1 for CA 50, since they gave a sensitivity of 77% at the specificity levels of
      83% and 84%, respectively. For CA 242 the optimal cut-off level was 21 U ml-1,
      which gave a sensitivity and specificity of 81%. In conclusion, the results of
      ROC curve analysis suggest that the CA 242 test has an advantage over CEA and CA
      50 because of its higher specificity in pancreatic cancer. In addition, it would
      seem reasonable to use higher cut-off values than what has been recommended for
      CEA and CA 50 in the diagnosis of pancreatic cancer, but for CA 242 the
      recommended cut-off level of 20 U ml-1 seems appropriate.

PMID- 8471446
TI  - Advanced breast cancer: use of resources and cost implications.
AB  - Little information is currently available on the use of hospital resources and
      the resulting costs of treating any advanced cancer. Such data may be useful for
      planning purposes and for calculating the cost effectiveness of measures designed
      to reduce the incidence of advanced disease (such as the National Breast
      Screening Programme). A retrospective analysis of the medical records of 50
      patients with advanced breast cancer who attended the Guy's Hospital Oncology
      Unit and who died between October 1988 and December 1990 has therefore been
      undertaken. For each patient, the duration of in-patient stays and principal
      indications for admissions were recorded, together with the number of out-patient
      attendances. Details of endocrine treatment, chemotherapy and radiotherapy were
      abstracted as were all radiological and laboratory investigations. Costs for each
      of these activities were calculated. The median duration of advanced disease was
      17 months (mean 27 months; range 7 days-12 years). The mean cost of treatment per
      patients was calculated to be 7,620 pounds (range 317 pounds-27,860 pounds). Mean
      duration of in-patient stay was 32 days (0-133) and this accounted for 56% of
      total costs. The large majority (> 80%) of the time spent as an in-patient was
      for the care of serious illness rather than for specific antitumour treatment.
      Cytotoxic drugs accounted for 9% of the total cost, compared with 8% for
      radiotherapy and 13% for laboratory and radiological investigations.

PMID- 8471447
TI  - Supportive care and the use of relaxation therapy in a district cancer service.
AB  - The development of a cancer support organisation, CancerCare, for North
      Lancashire and South Lakeland is described. The use of relaxation therapy is
      described to illustrate the demand for supportive care. Between January 1990 and
      1991, 513 patients, 243 relatives and 143 bereaved were referred to five cancer
      support nurses. One hundred and sixty-two (32%), 29 (12%) and 49 (34%)
      respectively, used relaxation therapy. The high demand for supportive care
      suggests that services should be made available in any district health provider
      unit. Measures of benefit and better definition of services are required before
      clear recommendations can be made.

PMID- 8471448
TI  - Gall and goodwill.

PMID- 8471449
TI  - Nurses work. Catching the first post.

PMID- 8471450
TI  - Nurses work. Finished after finals?

PMID- 8471451
TI  - Laparoscopic cholecystectomy.
AB  - Advances in surgical technology have enabled the concept of 'keyhole surgery' to
      become a reality. The author describes the technique of laparoscopic
      cholecystectomy and the advantages it offers over conventional methods of
      surgically removing the gall bladder.

PMID- 8471452
TI  - Ethics: can nurses be effective advocates?
AB  - Patient advocacy is currently a subject of burning interest in the nursing
      profession, with encouragement for nurses to assume such a role coming from the
      United Kingdom Central Council (1) and the government (2). This article questions
      whether nurses have had sufficient preparation for this role, and looks at
      factors which may facilitate or impede patient advocacy.

PMID- 8471453
TI  - Improving input to case conferences.
AB  - Nursing contributions to case conferences, particularly those concerned with
      child protection issues, have tended to be inconsistent. Part of the problem has
      been that there is little advice or guidelines to direct the nurses. This article
      reports on an initiative in Croydon which attempted to raise the standards of
      nurse contributions through the use of a specially designed report pack.

PMID- 8471454
TI  - Minor injury care in the community.
AB  - This article describes the setting up and running of a nurse-led, community
      based, minor injuries unit. Initially meeting with resistance from the local
      health authority, a six month pilot study showed that the clinic could operate
      effectively to the benefit of the community. The process of setting up the clinic
      and the type of service it provides are described.

PMID- 8471455
TI  - Resuscitation: outcomes, ethics and accountability.
AB  - The third and last part of Nursing Standard's series on resuscitation deals with
      the difficult issues of outcomes, ethics and responsibility. In particular, the
      vexed question of when not to resuscitate is aired: statistics show the
      remarkably poor success rate of cardiopulmonary resuscitation (CPR), which
      suggests that this invasive and sometimes brutal procedure is carried out
      inappropriately on individuals who are consequently denied the right to a
      peaceful death. Doctors and nurses, the author argues, become sensitive to when a
      life is ending naturally, and should be allowed to restrict the use of CPR to
      those for whom it is likely to help.

PMID- 8471456
TI  - Tradimus. Learning isn't shameful.

PMID- 8471457
TI  - Tradimus. Ward placements: a kick up the assessment.

PMID- 8471458
TI  - Tradimus. Placements: skill on wheels.

PMID- 8471459
TI  - Tradimus. International: Spanish practices.

PMID- 8471460
TI  - Tradimus. Education: practically useless?

PMID- 8471461
TI  - Tradimus. Professional unity: vive la similarity.

PMID- 8471462
TI  - Nurses work. Cutbacks: UK snapshot.

PMID- 8471463
TI  - Just my age? (continuing education credit).
AB  - Most elderly people lead independent lives. However, those who come into contact
      with nurses need a continuum of care, from health advice to full nursing care.
      Health care professionals should not make assumptions based on age and dismiss
      aches and pains as 'just your age'. Rather, they should assess the individual and
      provide care accordingly.

PMID- 8471464
TI  - Black & ethnic minority clients: meeting needs (continuing education credit).
AB  - No matter where nurses work they are bound to come across some clients from the
      black and ethnic minority populations whose first language is not English. It is
      therefore necessary for nurses to understand the different needs of these clients
      and to develop the skills to provide sensitive and appropriate health care
      services for them.

PMID- 8471465
TI  - Unsafe sex and HIV-1 transmission.

PMID- 8471466
TI  - Pneumonia link to HIV status in drug use.

PMID- 8471467
TI  - Nurses work. Careers out of control?

PMID- 8471468
TI  - Nurses work. Help yourself to a job.

PMID- 8471469
TI  - Nurses work. A community nurse at heart. Interview by Charlotte Alderman.

PMID- 8471470
TI  - Nurses work. Getting back to work. Interview by Charlotte Alderman.

PMID- 8471471
TI  - A review of pain assessment tools.
AB  - Pain assessment and control should be a priority within nursing but pain is often
      underassessed and unrelieved. Pain is difficult to assess as it is complex and
      subjective, and assessment is influenced by many factors. A pain assessment tool
      can be invaluable as it can aid the patient to communicate his or her pain,
      remove the subjectivity of assessment, and promote a systematic approach. A
      variety of pain assessment tools have been developed and used in clinical
      settings with subsequent improvements in assessment. They each have specific
      attributes, and their place in clinical practice is considered. It is concluded
      that the use of pain assessment tools is advantageous, and the reasons why they
      are not used more widely are considered.

PMID- 8471472
TI  - Monitoring activities in a long-term ward.
AB  - Moving the emphasis in long-term ward settings from just keeping people clean,
      dry and fed to providing improvement in their quality of life is a laudable aim,
      but this article, based on a six-month project, suggests that doing so is not as
      easy as it might first appear. The authors describe the development of an
      intervention programme for elderly women in a long-term ward and discuss some of
      the difficulties encountered in producing positive changes.

PMID- 8471473
TI  - Ethics: the use and abuse of power in nursing.

PMID- 8471474
TI  - The role of nurses in health purchasing.
AB  - This paper considers nurses' responsibilities on giving advice about the
      purchasing of health care. By outlining the steps in the purchasing cycle, a
      coherent framework is presented for identifying the specific issues associated
      with the purchasing of health services by district health authorities (DHAs), and
      family health service authorities (FHSAs) in England and Wales, and health boards
      (HBs) in Scotland. Purchasing health is every nurse's business. All registered
      nurses in the UK have a contribution that they can and should make to ensure that
      their DHA, HB or FHSA makes the best possible provision for their resident
      population.

PMID- 8471475
TI  - Changes to the Care Sector Consortium responsible for National Vocational
      Qualifications (NVQs) in health and care settings.

PMID- 8471476
TI  - Write off sisters.

PMID- 8471477
TI  - The Standard guide to surviving studying.

PMID- 8471478
TI  - Health promotion goes AWOL.

PMID- 8471479
TI  - Reassurance on risk of HIV-positive midwife.

PMID- 8471480
TI  - Ditching the professional face.

PMID- 8471481
TI  - Maternity care: midwifery is dead.

PMID- 8471482
TI  - Community care: meaning on the streets.

PMID- 8471483
TI  - Nurses work. Growing evidence of cuts in services and nursing posts.

PMID- 8471484
TI  - Prejudice threatens effective HIV nursing.

PMID- 8471485
TI  - Call to extend vigilance in tuberculosis.

PMID- 8471486
TI  - Information services: providing a multi-agency approach.

PMID- 8471487
TI  - Community health: when the taps run dry.

PMID- 8471488
TI  - Nurses work. Headed for mass unemployment?

PMID- 8471489
TI  - Nurses work. New roles for nurses.

PMID- 8471490
TI  - Daphne Heald Research Unit: ten years on.
AB  - The Daphne Heald Research Unit was set up just over ten years ago to develop the
      art and science of nursing through research, and to encourage nurses to use
      research. In the intervening years, four major studies have been published
      looking at the work of clinical nurse specialists in diabetes and stoma care,
      nurses' knowledge of sickle cell disorders and management of early discharge
      after surgery. With three major projects on the way, the Unit is continuing to
      support the need for rigorous research.

PMID- 8471491
TI  - Managing headaches in the workplace.
AB  - Headache may not impose a considerable burden upon the resources of the National
      Health Service, but it does have a significant impact on work attendance, with up
      to seven million working days being lost per year because of headache-related
      problems. The author reviews the problem from the perspective of occupational
      health nurses, and offers a protocol, based on the investigations carried out in
      practice-attached migraine clinics, which will assist their assessment of
      affected employees.

PMID- 8471492
TI  - Performance related pay and NHS nursing.

PMID- 8471494
TI  - A&E or the GP? How patients decide.

PMID- 8471493
TI  - Assessing the risk of pressure sores.
AB  - This article provides an overview of the basic requirements of a good assessment
      tool and details the development of three pressure sore risk assessment scales-
      the Norton score (1), the Waterlow score (2) and the Braden scale (3). The tools
      described are critically reviewed in relation to their reliability and validity,
      and conclusions made regarding their usefulness in clinical practice and
      research.

PMID- 8471495
TI  - Women's network. Women in public.

PMID- 8471496
TI  - Health targets off the rails.

PMID- 8471497
TI  - AIDS focus. AIDS and women on the islands of Zanzibar.

PMID- 8471498
TI  - AIDS focus. The rehabilitation of people with AIDS.

PMID- 8471499
TI  - Managing pain in children. Playing monsters and dragons.

PMID- 8471501
TI  - Managing pain in children. Special care for special babies.

PMID- 8471500
TI  - Managing pain in children. Pain scales for toddlers.

PMID- 8471502
TI  - Managing pain in children. Myths in practice.

PMID- 8471503
TI  - Managing pain in children. Taking action.

PMID- 8471504
TI  - Managing pain in children. 'Relief only when desperate'.

PMID- 8471505
TI  - Managing pain in children. APS: a multidisciplinary team.

PMID- 8471506
TI  - p53 protein expression in benign and malignant skin tumours.
AB  - The skin affords an excellent model of human carcinogenesis because a variety of
      lesions from benign tumours to invasive malignancy, with or without metastatic
      potential, are commonly found, and are accessible to biopsy. To date, few genetic
      alterations have been observed in skin neoplasia. In this study we have used a
      recently developed monoclonal antibody (DO7) to examine p53 protein expression in
      a wide variety of benign and malignant skin lesions. Benign skin lesions were
      negative, but a significant number of malignant epithelial lesions showed
      detectable p53; 56% of squamous carcinomas and 42% of basal cell carcinomas were
      positive. A smaller proportion of dysplastic epithelial lesions were positive
      (27%), and only 3.6% of malignant melanomas were positive. Thus, although
      detectable p53 protein is a common occurrence in malignant epithelial lesions, it
      does not correlate with the malignant phenotype or with metastatic potential. The
      finding of a lower proportion of positivity in dysplastic lesions, and absence of
      staining in benign tumours, suggests that p53 mutation may be involved in the
      progression towards invasive malignancy in human squamous skin lesions.

PMID- 8471507
TI  - Capillary underperfusion in chronic venous insufficiency: a cause for leg
      ulceration?
AB  - Dermal capillaries in the goiter area of the lower leg were examined by video
      microscopy before and after the administration of intravenous fluorescein in 13
      patients with chronic venous insufficiency (CVI) who were at risk of developing
      leg ulceration, and in 13 normal controls. The influence of posture on capillary
      perfusion was determined by viewing the same area of skin with the leg in both
      the supine and dependent positions. Capillary density was lower in patients than
      in controls, irrespective of the position of the leg (P < 0.01). Fluorescence
      angiography studies in normal controls showed a reduction in capillary density
      with dependency (P < 0.01), but patients with CVI showed no significant change.
      Fluorescence angiography revealed a greater number of capillaries than seen
      during native capillaroscopy (P < 0.05). The decreased capillary density, and the
      loss of the postural vasoconstrictor reflex in patients with chronic venous
      incompetence may play a role in the pathogenesis of ulceration.

PMID- 8471508
TI  - The effect of compression on venous stasis.
AB  - Skin blood flow in the lower leg is increased by external compression in standing
      subjects. This prevents the hypoxia induced by standing. The maximum increase in
      oxygen tension is seen when the external pressure is 40-50 mmHg. Pressures in the
      range of those produced by lightweight elastic stockings were found to be
      ineffective. Our results uphold the commonly held clinical opinion that only
      compression bandages or strong stockings are effective in the treatment of venous
      ulcers. External compression when the subject is recumbent causes skin oxygen
      tension to fall. Uniform external pressure exceeding 10 mmHg should therefore be
      avoided in the prophylactic treatment of post-operative deep-vein thrombosis.
      This observation suggests that when the patient is confined to bed, only
      lightweight stockings are safe in the prophylaxis of post-operative deep-vein
      thrombosis.

PMID- 8471509
TI  - Semiquantitative assessment of hirsutism in Dutch women.
AB  - Many doctors frequently encounter hirsute patients. Quantification of hair growth
      may be useful for diagnosis and follow-up. To establish the reference range for
      distribution and density of hair in females, and to determine the regions
      yielding the best discrimination between normal and hirsute women, we studied the
      distribution and density of terminal hair on 12 body regions assessed on a scale
      of 0-4. Prospectively, 81 healthy female volunteers and 71 hirsute patients of
      child-bearing age and Dutch ancestry, who were not receiving medication, and who
      had not had a recent pregnancy were studied. The reference hair pattern was
      established for each body region, and the threshold value yielding the highest
      sensitivity and specificity to evaluate hirsutism was calculated. None of the
      women in the reference population displayed a score of more than 1 for chin,
      upper back, upper abdomen and upper arm, or more than 2 for upper lip, side
      burns, chest, lower back, lower abdomen, thighs or forearm. The best
      discrimination between the reference and hirsute populations was obtained with
      the sum of the scores for four regions: upper lip, chin, lower abdomen and
      thighs. Independent assessment of hair growth by two investigators revealed
      excellent agreement. We conclude that a score of more than 1 for chin, upper
      back, upper abdomen and upper arm, or more than 2 for upper lip, side-burns,
      chest, lower back, lower abdomen, thighs or forearm is abnormal for Dutch women,
      and that assessment of hair growth on the upper lip, chin, lower abdomen and
      thighs is the most suitable way to evaluate hirsutism.

PMID- 8471510
TI  - Continuous formation of nail along the bed.
AB  - To resolve the problem of whether nail is formed continuously along the length of
      the nail bed as well as by the germinal matrix, nail thickness was measured at
      six anatomical points along the length of 20 normal big toe-nails removed after
      injury. Nail water content was constant at 9-10% along the nail length, and the
      nails did not shrink with dehydration. Approximately 79% of nail thickness was
      contributed by the nail matrix, and 21% by the nail bed. The rate of nail
      production was constant at 0.13 mm/mm along the lunula and 0.027 mm/mm along the
      whole bed from the distal lunula to the point of separation at the onychodermal
      band; the fractional change in linear growth and thickness showed less variation
      than absolute change. The continuous production of nail by the bed provides a
      simple biological solution to the problem of attachment of a continuously moving
      plate. It provides a source of entry of drugs into the distal nail plate, and a
      rationale for the use of much shorter courses of antifungal drugs than previously
      believed possible.

PMID- 8471511
TI  - Anticardiolipin antibodies in Adamantiades-Behcet's disease.
AB  - Moderately raised levels of circulating anticardiolipin antibodies were found in
      14 of 30 patients with active Adamantiades-Behcet's disease (46.7%) who were not
      receiving treatment. Three patients showed the IgG isotype, nine the IgM isotype,
      and two had both IgG and IgM isotypes. Statistical analysis, to determine
      possible correlations between anticardiolipin antibodies and clinical features,
      and meta-analysis of the data available, were performed. A positive correlation
      between erythema nodosum and histologically confirmed cutaneous vasculitis and
      the presence of circulating anticardiolipin antibodies of the IgM isotype was
      found (P = 0.017 and 0.018, respectively), whereas the IgG isotype did not
      correlate with any clinical feature. Evaluation of data on other clinical
      manifestations showed no correlation, either with the IgG or IgM isotypes. In
      particular, there was no association of circulating anticardiolipin antibodies
      with the incidence of thrombosis, systemic vasculitis, retinal involvement or
      neurological features. These results suggest that anticardiolipin antibodies do
      not play a major pathogenetic role in Adamantiades-Behcet's disease, but they may
      serve as an additional marker for a risk of the development of cutaneous
      vasculitis such as erythema nodosum.

PMID- 8471512
TI  - Clinical and laboratory studies of the photosensitizing potential of norfloxacin,
      a 4-quinolone broad-spectrum antibiotic.
AB  - Cutaneous photosensitivity reactions are a consistent although uncommon feature
      of the fluoroquinolone group of antibiotics, which are related to nalidixic acid.
      Objective laboratory and clinical data are now routinely required by regulatory
      bodies for new drugs suspected of being photosensitizers, but no clear
      recommendations exist. A series of in vitro tests ranging in complexity revealed
      a UVA-dependent phototoxic potential for the fluoroquinolone norfloxacin similar
      to that for ciprofloxacin, and less than that of nalidixic acid. Controlled
      monochromator phototesting, designed to reveal the clinical characteristics,
      wavelength dependence and severity of cutaneous reactions in normal subjects
      showed both norfloxacin and ciprofloxacin to have a weak phototoxic potential
      which clears within 4 weeks of stopping the drug. UVA wavelengths (335 +/- 30 nm;
      365 +/- 30 nm) appear most responsible for producing an asymptomatic erythema
      which is maximal at 24 h. The clinical study differs from those used previously
      in being blind, containing positive and negative controls, and phototesting after
      cessation of drug intake. The methodology has the anticipated limitation of
      failing to detect idiosyncratic photosensitivity responses.

PMID- 8471513
TI  - Response of psoriasis to psoralen-UVB photochemotherapy.
AB  - The effect of psoralen in combination with 311 nm (UVB) radiation was studied in
      five subjects with normal skin and 10 patients with psoriasis involving both
      forearms. Treatment with oral 8-methoxypsoralen augmented the UVB erythemal
      response at 6 h after irradiation, but had no effect at 24-72 h. In eight of the
      nine patients who completed the trial, lesions of psoriasis on the arms treated
      with psoralen-UVB cleared before lesions on the arms treated with UVB alone. This
      study has shown that psoralen in combination with UVB has an erythemal effect on
      normal skin, and a therapeutic effect in psoriasis which is greater than the
      response to UVB alone.

PMID- 8471514
TI  - Failure of coconut oil to accelerate psoriasis clearance in narrow-band UVB
      phototherapy or photochemotherapy.
AB  - Despite a widely held belief that the use of emollients prior to broad-band UVB
      irradiation accelerates clearance of psoriasis, only one single-blind controlled
      study exists in support of this. No similar study has been carried out with
      photochemotherapy (PUVA) or narrow-band UVB (311-313 nm) phototherapy. As some
      emollients absorb UV radiation, and thereby inhibit psoriasis clearance, there is
      a need to identify emollients suitable for pre-irradiation use. Coconut oil may
      be useful in this respect. In two randomized groups of patients with chronic
      plaque psoriasis undergoing either routine PUVA (n = 14) or narrow-band UVB
      phototherapy (n = 15), a single-blind controlled (half-body) study was undertaken
      to assess the effect of pre-irradiation application of coconut oil. Patients were
      given PUVA twice weekly, or TL-01 therapy thrice weekly. The initial UV dose was
      70% of previously determined minimal phototoxic (MPD) or minimal erythema doses
      (MED), with 40% incremental steps at each visit (reduced if adverse effects
      occurred). Psoriasis severity was scored on each side after every three
      treatments. No significant acceleration of psoriasis clearance was seen in either
      group. We do not, therefore, recommend the routine use of emollients prior to
      PUVA or TL-01 therapy when using near erythemogenic irradiation regimens.

PMID- 8471515
TI  - Results and tissue healing after copper-vapour laser (at 578 nm) treatment of
      port wine stains and facial telangiectasias.
AB  - Twenty-four patients with port wine stains (PWS), and 33 patients with facial
      telangiectasias were treated with a copper-vapour laser (CVL) operating at 578
      nm. Good to excellent results were obtained in 52% of PWS and 69% of facial
      telangiectasias. Enzyme histochemistry revealed vessel-selective damage with
      energy densities up to 12 J/cm2, but a non-specific coagulation necrosis with
      higher fluences (> or = 15 J/cm2). With vessel-selective fluences only moderate
      blanching was obtained in two PWS. All other evaluated patients were treated
      using non-selective energy densities. Tissue healing was comparable with that
      after argon laser treatment. The theoretically correct wavelength (578 nm) alone
      appeared to be no guarantee of vessel-selective damage. The laser employed lacked
      adequate power (only 1.3 W maximum) to transmit sufficient energy into the
      tissues in a short exposure time. However, the clinical results confirm the value
      of the CVL in the treatment of superficial cutaneous angiodysplasias.

PMID- 8471516
TI  - Light cautery and EMLA in the treatment of chloracne lesions.
AB  - We report six patients with chloracne, unresponsive to conventional therapy,
      whose lesions were cleared by treatment with EMLA (eutectic mixture of lignocaine
      [lidocaine] 25 mg/g and prilocaine 25 mg/g) topical anaesthesia and light
      cautery. To the best of our knowledge, this form of treatment for chloracne has
      not previously been reported.

PMID- 8471517
TI  - Inadequate size of 'negative' clinical trials in dermatology.
AB  - Fifty-eight clinical trials with negative conclusions, published in three British
      dermatological journals over the last 4 years, were reviewed to determine the
      risk of their having missed an effective treatment. All but one of the 44
      evaluable trials had a greater than 1 in 10 risk of missing a 25% relative
      treatment difference (median risk 81%), and 31 of the trials (70%) were so small
      that they had a greater than 1 in 10 risk of missing a 50% relative treatment
      difference (median risk 42%). The 'negative' trial result was compatible (within
      95% confidence limits) with a 25% beneficial relative treatment effect in 36
      studies (82%), and a 50% treatment benefit in 22 studies (50%). Only one study
      used confidence intervals to describe the main findings, and only three studies
      (7%) mentioned the basis for sample size estimation at the outset of the study.
      Of particular concern was that in half (23/44) of the studies there was an
      incorrect interpretation of the findings. It is worrying to observe such a
      profusion of clinical trials in dermatology which are too small to answer the
      questions being posed, especially when this is coupled with misreporting of
      results. Apart from ethical concerns, many treatments compatible with a
      considerable treatment benefit may have been erroneously discarded as a result of
      such studies. We recommend the use of confidence intervals to summarize clinical
      trial findings, so that readers can quickly decide whether clinically important
      treatment effects are plausible.

PMID- 8471518
TI  - Monilethrix: a clinicopathological illustration of a cortical defect.
AB  - We describe two sisters aged 2 and 7 years, with monilethrix. The older sister
      was clinically less severely affected but, microscopically, the features of
      weathering and alternating nodes and internodes were more obvious. The younger
      girl had more severe alopecia, with shorter hair, but the microscopic features
      were less marked. Scanning-electron microscopy demonstrated only slight cuticular
      weathering in both cases, and evidence of breakage in the cuticle at points of no
      obvious cuticular pathology. Transmission-electron microscopy showed normal
      cuticle cells in cross-section, but an abnormal cortex. The abnormalities
      included areas of homogeneous non-fibrillar material, and a deviated axis of some
      microfibrils. We consider that these findings support the possibility that a
      cortical defect contributes significantly to the fragility of hair in
      monilethrix. This might explain why hair with marked beading can be stronger than
      hair from an affected sibling with less apparent abnormality.

PMID- 8471519
TI  - Bullous eruption of systemic lupus erythematosus: a clinicopathological study of
      four cases.
AB  - We describe the clinical, histological and immunopathological features of four
      female patients with the bullous eruption of systemic lupus erythematosus
      (bullous SLE). Three patients had circulating anti-basement membrane zone (BMZ)
      antibodies, and Western blot analysis in two cases revealed binding to type VII
      collagen. Immunoelectron microscopy in one of these patients demonstrated
      deposition of antibody in the lamina densa and sublamina densa regions, thus
      sharing immunopathological features with epidermolysis bullosa acquisita (EBA).
      The vesiculobullous lesions developed 8 months to 6 years after the initial
      symptoms of SLE, and cleared promptly with dapsone treatment.

PMID- 8471520
TI  - Cutaneous lymphadenoma: a case report and review of the literature.
AB  - We report a case of cutaneous lymphadenoma, a tumour first described by Santa
      Cruz and Barr under the name of 'lymphoepithelial tumour'. Twenty-three cases
      have been reported to date. The commonest site is the head and neck, and it is
      most commonly diagnosed in the fourth and fifth decades. The usual clinical
      diagnosis is basal cell carcinoma. To date, no recurrences have been observed
      after local excision. The tumour is composed of dermal lobules with a biphasic
      pattern of epithelial and lymphoid cells. It has been suggested that it arises as
      a result of faulty interaction between lymphocytes and epithelial cells.

PMID- 8471521
TI  - Acral epidermolytic hyperkeratosis.
AB  - We present a family with a distinctive pattern of epidermolytic hyperkeratosis
      which is mild, restricted to the distal parts of the limbs, and non-disabling.
      Features of the other variants of epidermolytic hyperkeratosis are discussed.

PMID- 8471522
TI  - Lamellar ichthyosis with laminated membrane structures.

PMID- 8471523
TI  - Successful treatment of sporotrichosis with oral fluconazole: a report of three
      cases.
AB  - We report three cases of sporotrichosis successfully treated with oral
      fluconazole. A verrucous lesion on the toe was cured after 126 days, and a lesion
      on the left foot resolved after 91 days' treatment. A case of lymphangitic-type
      sporotrichosis required 174 days of treatment to achieve a cure, and a higher
      dose (400 mg daily) was necessary in this case. Any side-effects were
      insignificant. We conclude that this new bis-triazole compound can be
      successfully used as an alternative treatment for sporotrichosis when
      conventional drugs must be avoided.

PMID- 8471524
TI  - Toxic epidermal necrolysis and systemic corticosteroids.

PMID- 8471525
TI  - New head louse repellent.

PMID- 8471526
TI  - Herpes simplex virus infection associated with bullous pemphigoid.

PMID- 8471527
TI  - Vitamin D analogues, marrow fibrosis and psoriasis.

PMID- 8471528
TI  - Cutaneous vasculitis in a patient infected with hepatitis C virus. Detection of
      hepatitis C virus RNA in the skin by polymerase chain reaction.

PMID- 8471529
TI  - The effect of platelet inhibitory therapy on prosthetic graft maturation.
AB  - Thirty-eight dogs were randomized to the thromboxane synthetase inhibitor
      CGS12790 (3 mg/kg), aspirin 150 mg and dipyridamole 50 mg (ASA + DPM) or placebo
      (PLA), all twice daily. Two days later, animals underwent bilateral superficial
      femoral artery replacement with knitted Dacron. Grafts were removed at two months
      and subjected to macroscopic and histological examination. Thirty dogs survived
      to two months. Percentage thrombus free area (TFA) was increased from 15.1 +/-
      2.2 with PLA to 46.6 +/- 5.2 with CGS12970 (P < 0.001) and to 32.9 +/- 5.0 with
      ASA + DPM (P < 0.01). At the anastomoses, only CGS12970 significantly reduced
      neointimal thickness, promoted pannus ingrowth and improved endothelialization.
      Percentage luminal occlusion at the midgraft was reduced from 48.2 +/- 5.9 with
      PLA to 33.9 +/- 2.7 with CGS12970 (P < 0.05). These results provide further
      evidence that platelet inhibitory therapy reduces thrombosis but also that the
      platelet is involved in anastomotic maturation. Therapy directed against
      thromboxane synthesis has potential that may be useful in clinical practice.

PMID- 8471530
TI  - Production of salivary microlithiasis in cats by parasympathectomy: light and
      electron microscopy.
AB  - Salivary glands of cat were examined from 1 to 42 days following
      parasympathectomy and compared with contralateral normal control glands.
      Microliths were detected by light microscopy in none of 11 parotid, 31 out of 41
      submandibular and four out of 22 sublingual glands following parasympathectomy,
      and one out of 19 parotid, five out of 28 submandibular and four out of 15
      sublingual normal control glands. The greatly increased occurrence of microliths
      in the submandibular gland was statistically significant. Microliths in the
      parasympathectomized submandibular glands were detected by light microscopy most
      often in ductal lumina, followed by acinar lumina, ductal parenchyma,
      interstitial stroma, and acinar parenchyma. They were detected by electron
      microscopy also in the basement membrane overlying protruding processes of
      myoepithelial cells and in intraparenchymal macrophages. Intracellular microliths
      were in phagosomes. In the parasympathectomized submandibular glands, parenchymal
      atrophy was seen and particularly involved the striated ducts; secretory material
      and cellular debris were seen in lumina; and macrophages and neutrophils were
      more apparent than normally. The great increase of microlithiasis in the
      submandibular gland appears to be the result of secretory inactivity, and
      microliths appear to form in stagnant secretory material and cellular debris in
      lumina and in phagosomes of parenchymal cells.

PMID- 8471531
TI  - Comparison of surface fibroblastic cells in subcutaneous air pouch and synovial
      lining: differences in uridine diphosphoglucose dehydrogenase activity.
AB  - In contrast to synovial tissue, rat subcutaneous air pouch lining was found to
      lack cells showing high activity of uridine diphosphoglucose dehydrogenase, an
      enzyme involved in hyaluronan synthesis. This indicates that the properties of
      cells on the surface of synovium are not determined simply by tissue cavitation.
      Shearing forces may be more important in inducing the specialized behaviour of
      synovial surface fibroblasts.

PMID- 8471532
TI  - The effect of ischaemia on xanthine oxidase activity in rat intestine and liver.
AB  - Effects of 60 and 120 minutes of in-vitro ischaemia on the localization of
      xanthine oxidase activity were studied in rat intestine and liver. A
      histochemical method was applied on unfixed cryostat sections using a
      semipermeable membrane. The incubation medium contained hypoxanthine as
      substrate, cerium ions which capture the enzyme product, hydrogen peroxide, and
      sodium azide to inhibit catalase and peroxidase activities. In a second step
      reaction diaminobenzidine was polymerized in the presence of cobalt ions and
      hydrogen peroxide by decomposition of cerium perhydroxide. Large amounts of final
      reaction product were found in the cytoplasm of enterocytes and goblet cells of
      control small intestine. When the incubation was performed in the absence of
      substrate or in the presence of substrate and allopurinol, a specific inhibitor
      of xanthine oxidase activity, no reaction product was found. After 60 and 120
      minutes of storage of tissue blocks at 37 degrees C enzyme activity was
      significantly reduced in the apical region of epithelial cells, whereas a high
      activity was present in the basal region of these cells. A very low xanthine
      oxidase activity was found in rat liver. Highest activity was present in
      endothelial cells, whereas in liver parenchymal cells, a more pronounced activity
      was found in pericentral than in periportal hepatocytes. Ischaemia up to 120
      minutes did not affect the enzyme activity in livers. It was concluded that
      increased xanthine oxidase activity during ischaemia may not be responsible for
      cell damage during reperfusion in contrast with assumptions in the literature.

PMID- 8471533
TI  - Uridine diphosphoglucose dehydrogenase activity in normal and rheumatoid
      synovium: the description of a specialized synovial lining cell.
AB  - Although synovial lining cells (SLC) have been implicated in the production of
      hyaluronan (HA), which is found at particularly high concentrations in synovial
      fluid, the degree to which individual cells within the synovium are adapted to
      this particular function remains to be elucidated. Uridine diphosphoglucose
      dehydrogenase (UDPGD) activity is the irreversible, rate-limiting step in the
      production of UDP-glucuronate, an essential monosaccharide in the synthesis of
      HA. We have assessed the UDPGD activity, microdensitometrically, in individual
      lining cells of normal and rheumatoid (RA) synovium, using a modified
      quantitative cytochemical method. In normal synovium, high activity was confined
      to the cells of the lining with negligible activity in the deeper subintima. The
      mean UDPGD activity/cell in lining cells of rheumatoid synovium was significantly
      lower than the activity in normal SLC. In some samples of RA and normal synovium,
      a bimodal distribution of cells was evident in the lining on the basis of UDPGD
      activity, a zone of cells in the basal layers with high UDPGD activity and a
      separate population of cells in more superficial layers with relatively low UDPGD
      activity. The results suggest that a particular population of cells is present,
      consistently in normal and more variably in RA synovial lining, which have high
      UDPGD activity/cell and may be involved in the production of HA. Furthermore, in
      RA synovium both the UDPGD activity/cell and the relative proportion of these
      cells within the lining appear to be decreased.

PMID- 8471534
TI  - Ultrastructural changes in rat adipomusculocutaneous flaps during warm ischaemic
      storage and reperfusion.
AB  - Electron microscopy (EM) was used to evaluate ultrastructural changes in
      adipomusculocutaneous rat flaps which had been stored for 0, 2, 4, 6 and 8 hours
      under normothermic conditions (37 degrees C). The effects of treatment with
      desferrioxamine (DFX) or hypertonic citrate flush (HCA), prior to 4 hours of
      storage, were compared to untreated flaps which had been stored for 4 hours.
      Ultrastructural changes caused by 30 minutes of reperfusion, were also studied.
      Most ultrastructural alterations occurred between 2 and 4 hours of warm storage
      and there were further changes in some cells after short periods of reperfusion.
      DFX decreased smooth muscle damage and HCA protected adipocytes but neither of
      these agents preserved endothelial cells. These studies indicated that free
      radical-dependent and independent mechanisms were both involved in events which
      led to flap necrosis after periods of warm storage and reperfusion.

PMID- 8471535
TI  - The effect of cyclosporin A on rabbit nephrotoxic glomerulonephritis.
AB  - The effect of cyclosporin A on the development of the autologous phase of
      experimental rabbit glomerulonephritis was assessed. The glomerulonephritis was
      induced by a single intravenous injection of duck anti-rabbit glomerular basement
      membrane globulin (molecular weight: 115 kDa) into adult rabbits. After 5-7 days,
      diffuse proliferative glomerulonephritis with proteinuria was observed in all the
      animals not treated with cyclosporin A (control group). The cyclosporin A
      treatment was started simultaneously with the injection of duck globulin. This
      attenuated the glomerular lesion, resulting in a normal urinary protein
      excretion. The serum level of autologous anti-duck IgG was reduced. In the group
      of rabbits which received an injection of duck anti-rabbit glomerular basement
      membrane globulin, cyclosporin A treatment and an additional high dose rabbit
      anti-duck globulin 8 days later again no glomerulonephritis was observed.
      However, cyclosporin A treatment had no effect on the observed duck
      immunoglobulin-induced passive Arthus phenomenon.

PMID- 8471536
TI  - Can changes in microcirculation explain capillary growth in skeletal muscle?
AB  - Capillary growth (increase in capillary/fibre (C/F) ratio by 20%) was elicited in
      skeletal muscles either by long-term increase in blood flow (5 weeks
      administration of prazosin in drinking water, 50 mg/l) or 7 days electrical
      stimulation (8 h/day at 10 Hz). Mechanisms that could explain it ((a) increased
      interaction of blood components with endothelial cells (due to increased
      haematocrit or decreased intermittency of flow); (b) increased velocity of flow
      and thus shear stress; (c) increased capillary diameters and thus wall tension)
      were studied in vivo. Red blood cell velocity (Vrbc), vessel diameters and
      intermittency of capillary flow were measured in superficially located
      capillaries in rat tibialis anterior muscles about 18 hours after the last
      treatment, in prazosin treated and chronically stimulated animals, and also in
      animals where red blood cell interaction with capillary endothelium was increased
      by elevating haematocrit from 43.2 +/- 1.7% to 60.9 +/- 0.72% by 11 weeks
      administration of CoCl2. Animals of comparable size and sex were used as
      controls. Capillaries in chronically stimulated muscles had increased Vrbc at
      rest (0.42 +/- 0.06 mm/s vs 0.27 +/- 0.04 in control muscles) and somewhat wider
      diameters, although the intermittency of flow was not different from control
      muscles. Capillaries in prazosin treated rats had a lower intermittency of flow,
      similar diameters and considerably higher Vrbc (0.53 +/- 0.06 mm/s) than control
      animals. CoCl2 treatment resulted in a similar intermittency of flow, did not
      alter capillary diameters or Vrbc and did not result in an increase in C/F
      ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471537
TI  - Progressive splenomegaly with increasing extramedullary haematopoiesis in
      subcutaneous 9L-glioma bearing rats.
AB  - We have succeeded in inducing progressive splenomegaly by inoculating 9L-glioma
      cells into the back subcutaneous regions of Fischer rats. The progressive
      splenomegaly was histologically characterized by progressively increased
      extramedullary haematopoiesis. Immunohistochemically Leu 7 positive cells were
      present in the enlarged spleen, suggesting that the spleen possessed natural
      killer (NK) cells. However, the splenic NK cell activity obtained in a 4h-51Cr
      release assay at 5 weeks after inoculation was below 5%, suggesting that the
      cytotoxic function of the NK cells was depressed. Bone marrow morphologically
      appeared not to be suppressed. Although the exact cause and mechanism of the
      progressive splenomegaly with prominent extramedullary haematopoiesis and severe
      suppression of the splenic NK cell activity remains speculative at present, it
      could be a unique manifestation of a systemic host-reaction reflected by the 9L
      glioma continuously growing in the subcutaneous regions. This experiment could be
      a useful approach to the study of splenic and other reticuloendothelial roles in
      host-immunity in the tumour bearing state.

PMID- 8471538
TI  - Growth factor expression during rat development: a comparison of TGF-beta 3, TGF
      alpha, bFGF, PDGF and PDGF-R.
AB  - At least part of the mechanism underlying fetal development appears to be the
      production of a number of growth factors considered important in the process of
      tumour formation. Using immunocytochemistry, we have investigated the temporal
      and spatial pattern of expression of some of the important growth factors, by the
      fetus. We describe here the cellular localization of transforming growth factor
      beta 3 (TGF-beta 3), platelet derived growth factor (PDGF) and its receptor (PDGF
      R), TGF-alpha and basic fibroblast growth factor (bFGF) in the fetal rat from day
      13 to 21 of gestation. Using antisera raised against an N-terminal portion of TGF
      beta 3, immunoreactivity peaked around day 16 and was seen predominantly within
      epithelial cells. However, using antisera raised against the C-terminal of this
      molecule immunoreactivity was seen exclusively within the extracellular matrix
      underlying adjacent epithelia, and was maintained up until day 21 of gestation.
      Strong expression of TGF-alpha was seen in cells of most organs throughout the
      gestation period studied. Immunoreactivity for bFGF, PDGF and PDGF-R peaked
      around day 18 in both epithelial and mesenchymal cells of all major organ systems
      and then declined by day 21. These data suggest distinct roles for each factor
      during embryogenesis and tumorigenesis.

PMID- 8471539
TI  - Anti-glomerular basement membrane glomerulonephritis (anti-GBM GN) in the mouse:
      BrdU-labelling indices and histological damage.
AB  - In-vivo BrdU incorporation and visualization by immunohistochemistry, previously
      reported in normal mouse kidney, were applied to a mouse model of anti-GBM GN,
      induced by immunization with rabbit anti-mouse GBM antiserum, to assess the
      contribution of capsular cell proliferation in the development of crescents. A
      significant increase (P = 0.003) in the BrdU-labelling index (LI) for capsular
      cells was observed, as compared to normal mice (5.76 +/- 1.1 vs 0.70% +/- 0.12%).
      Elevated LI were also observed for tuft and tubular cells but these increases
      were not statistically significant. It was concluded that, in this model,
      capsular cell proliferation is a major contributory factor to the formation of
      cellular crescents. In addition, other pathological features, indicative of
      glomerular damage, were assessed semi-quantitatively alongside numbers of
      labelled capsular cells per glomerulus. It was found that podocyte vacuolation is
      strongly associated with, and may precede, proliferation, suggesting some common
      causative factor. Fibrin, when present, was confined within the tuft capillary
      loops and was only weakly associated with either podocyte vacuolation or capsular
      cell proliferation. It was concluded that this protein does not play a major role
      in the initiation of pathological damage. Finally, glomerular lesions were found
      to be randomly distributed. Thus, the idea of intraglomerular signalling,
      resulting in 'clustering' of damaged glomeruli, is not supported.

PMID- 8471540
TI  - Factors influencing the ability of different mycoplasmas to colonize the genital
      tract of hormone-treated female mice.
AB  - Colonization of the genital tract of female mice, mainly BALB/c, by Mycoplasma
      genitalium, M. pneumoniae and M. pulmonis was enhanced by pretreatment of the
      mice with progesterone. M. fermentans, M. hominis and M. salivarium, and three
      serotypes and two untyped strains of Ureaplasma urealyticum colonized under the
      influence of oestradiol but not progesterone. Mycoplasmas dependent on
      progesterone were glucose-metabolizing, with strong haemadsorptive and other
      attachment properties, and possessed a terminal structure. Mycoplasmas dependent
      on oestradiol were arginine or arginine/glucose metabolizing. Ureaplasmas also
      required oestradiol. The oestradiol-requiring group appeared to be less
      cytadsorptive and devoid of a morphological terminal structure. Mycoplasmas that
      had had multiple passes in media were less able to colonize. This may be one, but
      not the only, reason for the failure of seven mycoplasmas to colonize under the
      influence of either hormone. The observations suggest the existence of a receptor
      mechanism for colonization, progesterone-requiring mycoplasmas being exposed to,
      and needing, genital tract cells different from those exposed to oestradiol
      requiring mycoplasmas.

PMID- 8471541
TI  - Determination of dihydrocodeine in hair of opiate addicts by GC/MS.
AB  - After the examination of more than 300 hair samples of suspected heroin abusers,
      a large number of which proved positive, we can say that high concentrations of
      dihydrocodeine can be determined either in addition to, or in the place of,
      morphine and also frequently in combination with codeine. The opiates were
      extracted after dissolving the hair samples in NaOH and hydrolysis with HCl. The
      quantitative determination of dihydrocodeine was achieved by derivatisation with
      HFBA using GC/MS at m/u = 497. Dihydrocodeine is used in antitussive drugs. After
      the examination of individual hair samples, it was obvious that some heroin
      consumers had switched to dihydrocodeine. This may lead to the conclusion that
      dihydrocodeine itself is used either as an intoxicating drug or to reduce
      withdrawal symptoms. The increasing number of positive samples should be noted by
      the legal authorities.

PMID- 8471542
TI  - Population genetics of three VNTR polymorphisms in two different Spanish
      populations.
AB  - Two different Spanish populations, one from Galicia (NW Spain) and the other from
      the rest of Spain, have been analyzed at three different hypervariable loci
      (YNH24, MS43a and MS31) using the EDNAP electrophoretic protocol and HinfI as
      restriction enzyme. Although the "rest of Spain" population is a clearly
      stratified population using classical blood groups, no evidence of stratification
      for these loci has been found and the differences to the Galician population were
      not significant, which suggests that a common Spanish population data-base could
      be possible. A semiparametric model is proposed for estimating frequencies, using
      the smoothed cross-validation of Hall et al. (1992) to calculate the size of the
      window utilized.

PMID- 8471543
TI  - PCR-amplification and detection of the human D1S80 VNTR locus. Amplification
      conditions, population genetics and application in forensic analysis.
AB  - A series of experiments has been performed to evaluate amplification and typing
      of the D1S80 VNTR locus. The validation study that has been carried out showed
      that correct D1S80 typing results can be obtained when a defined amplification
      protocol and a high-resolution polyacrylamide gel electrophoresis method are
      used. The use of the Chelex extraction protocol has substantially reduced the
      processing time. DNA-extraction, amplification and subsequent typing can be
      performed in one day. The discrimination power of this locus is 0.94 in a Dutch
      Caucasian population sample. The system is extremely sensitive: 0.1 ng of genomic
      DNA gave a correct typing result. The test could also detect the correct
      genotypes in mixed samples containing DNA from different individuals. Even if the
      major type was in a 20-fold excess, the minority type could still be amplified
      and typed correctly. We have found no deviation from Hardy-Weinberg equilibrium
      in a Dutch Caucasian population sample. Evidence for the somatic stability of
      this locus was obtained from a set of experiments where we compared DNA-profiles
      from corresponding blood, semen and saliva samples. The results of this study
      suggest that in the near future analysis of the D1S80 locus by DNA-amplification
      can be applied in actual forensic case work.

PMID- 8471544
TI  - Genetic variation of microsatellite markers D1S117, D6S89, D11S35, APOC2, and
      D21S168 in the Spanish population.
AB  - We have used PCR amplification to analyse the allele frequency, distribution and
      heterozygosity of 5 microsatellite markers (D1S117, D6S89, D11S35, APOC2, and
      D21S168), in a sample of 100 unrelated Spanish individuals. The loci tested
      exhibit wide allelic variability having 7-17 alleles, PIC (polymorphic
      information content) between 0.79 and 0.86, and heterozygosity between 0.81 and
      0.86. D1S117 and D21S168 have unimodal distribution, APOC2 has 4 common alleles
      which account for 71% of the total variation, D11S35 has a bimodal distribution
      and D6S89 is trimodal. The allelic distribution observed for each locus is in
      agreement with slippage and mispairing as the main mechanisms involved in the
      evolution of microsatellite alleles. Multiplex amplification of loci D6S89 and
      APOC2 was possible due to their non-overlapping allele sizes. The rapidity with
      which microsatellites can be analysed, and the accurate determination of alleles,
      make these markers very powerful tools for genetic typing. The information
      obtained for loci D1S117, D6S89, D11S35, APOC2, and D21S168, provides a basis for
      their use for DNA typing and paternity analysis in the Spanish population.

PMID- 8471545
TI  - Abuse of codeine separated from over-the-counter drugs containing acetylsalicylic
      acid and codeine.
AB  - In Denmark a new trend concerning the abuse of codeine has been observed. Danish
      drug abusers have discovered that codeine is easily separated from certain drugs
      containing acetylsalicylic acid and codeine. When separated the codeine can be
      used either orally or intravenously. Three different drugs combining
      acetylsalicylic acid and codeine are available in Denmark, but codeine is only
      easily separable from one of these. Applying the same procedure to the two other
      drugs produces unpredictable or unfavourable ratios of codeine to acetylsalicylic
      acid. In several countries, however, similar drugs combining acetylsalicylic acid
      and codeine are available. It is not possible from a list of constituents to
      predict how easily codeine can be separated from a particular drug. Therefore it
      is strongly recommended that relevant drugs are tested at local forensic
      laboratories. In case codeine is found to be very easily separated from a product
      appropriate action should be taken.

PMID- 8471546
TI  - Pharmacological studies on meprobamate incorporation in human beard hair.
AB  - The time course of appearance of meprobamate in beard hair after single oral
      administration (400, 800, or 1200 mg) was monitored in 3 groups of 4 subjects by
      GC/MS. Meprobamate appeared in beard hair approximately 4-5 days after
      administration and peaked during the 7-9th day. Drug levels in beard hair
      appeared to be dose-related.

PMID- 8471547
TI  - Postmortem estimation of age at death based on aspartic acid racemization in
      dentin: its applicability for root dentin.
AB  - The extent of aspartic acid racemization in total dentin and in dentin protein
      fractions from the roots of third molars was determined. In several cases coronal
      dentin was also investigated. The results of other authors, according to which
      the racemization of aspartic acid in root dentin apparently proceeds differently
      than in coronal dentin, could be confirmed. Consequently, the data published so
      far on age determination based on the extent of aspartic acid racemization in
      coronal dentin and the "entire dentin of longitudinal sections" cannot be applied
      to root dentin. In total root dentin and the acid soluble protein of root dentin,
      a close relationship was observed between the extent of aspartic acid
      racemization and age. Accordingly, estimation of age at death based on aspartic
      acid racemization in dentin is also possible for root dentin, apparently with
      good results. This is important particularly in those cases where a large portion
      of the coronal dentin is absent, for instance following dental treatment. In the
      investigation of root dentin, regression equations specific for root dentin must
      be employed in the estimation of age at death. Corresponding equations for third
      molars were calculated.

PMID- 8471548
TI  - Experience with the PCR-based HLA-DQ alpha DNA typing system in routine forensic
      casework.
AB  - The results of HLA-DQ alpha typing from 42 routine forensic cases using the
      polymerase chain reaction (PCR) were analyzed regarding the reliability,
      discrimination efficiency and informative value of this system in a given case.
      The cases included stain typing from a variety of different substates, i.e. blood
      and semen stains, mixed body fluids, single hairs, cigarette butts, material from
      fingernail scratches, as well as identification and paternity cases on postmortem
      and fixed tissue. A total of 125 individual stain and tissue samples were
      included. PCR amplification was achieved in 70% of these samples. In cases with
      mixed body fluids, e.g. sperm and vaginal cells from rape cases, DQ alpha typing
      was always carried out successfully. However, only approx. 42% of all samples
      that could be typed were relevant regarding the inclusion or exclusion of a
      suspect. This was mostly due to the limited number of alleles that can be typed
      at the HLA-DQ alpha locus or to the fact that the stain or hair samples did not
      originate from the perpetrator, but from the victim or from other persons not
      related to the crime.

PMID- 8471549
TI  - Interferon alpha-recombinant in the treatment of follicular lymphoma patients.

PMID- 8471550
TI  - A role for proliferative measurements in clinical oncology?
AB  - I feel a simple but properly determined proliferative measurement is within our
      grasp for clinical use. In addition, multi-parametric flow cytometry offers a
      means of obtaining more detailed cell kinetic information, using DNA staining
      combined with staining with one or more antibodies directed against either BrdUrd
      or proliferation-related proteins.

PMID- 8471551
TI  - The pharmacological management of cancer pain. Part 1: The role of non opioid and
      adjuvant drugs.

PMID- 8471552
TI  - Routine follow-up of patients after primary therapy for early breast cancer:
      changing concepts and challenges for the future.
AB  - In an era of increasing financial constraints, physicians are being forced to
      critically re-evaluate various clinical practices that have not been shown to be
      cost-effective or associated with definitive patient benefit. Routine follow-up
      programs following primary therapy for early-stage breast cancer vary widely from
      centre to centre, and although the subject of numerous retrospective analyses,
      they have not been prospectively evaluated to date. This review paper presents
      arguments for changing the emphasis of follow-up visits and stresses the need for
      prospective clinical and cost-benefit evaluations of current follow-up practices.

PMID- 8471553
TI  - Prognostic significance of proliferative activity and ploidy in node-negative
      breast cancers.
AB  - BACKGROUND: Cell kinetics and DNA ploidy have provided relevant information on
      the natural history of breast cancer. We assessed the prognostic role of
      proliferative activity and ploidy, alone and in association with tumor size,
      estrogen (ER) and progesterone (PgR) receptors. PATIENTS AND METHODS: In a series
      of 340 women with resectable node-negative breast cancers given local-regional
      therapy alone until relapse, proliferative activity was determined as the 3H
      thymidine labeling index (3H-dT LI) and flow-cytometric S-phase cell fraction
      (FCM-S), as quantified by using different modeling systems. DNA ploidy, ER and
      PgR content were determined on frozen samples by FCM and by the dextran-coated
      charcoal absorption technique, respectively. RESULTS: FCM-S estimates obtained by
      the different models were weakly associated with one another and to the
      corresponding 3H-dT LIs. Four-year relapse-free survival was significantly
      predicted by 3H-dT LI, ploidy and tumor size but not by FCM-S. Multiple
      regression analysis showed that 3H-dT LI, ploidy and tumor size retained their
      prognostic significance and that 3H-dT LI was the most significant indicator of
      relapse (p = 0.009). CONCLUSIONS: The finding that 3H-dT LI and ploidy are weakly
      related and provide independent prognostic information could allow a more
      accurate identification of patients at different risk of relapse.

PMID- 8471554
TI  - Dose intensification of cisplatin chemotherapy through biweekly administration.
AB  - PURPOSE: Dose intensity (DI, expressed in mg/m2/wk) may be an important factor in
      the clinical use of cisplatin (DDP). We have explored the shortening of the cycle
      interval as a way to increase the DI of DDP. PATIENTS AND METHODS: DDP 180 mg/m2
      was given intravenously (i.v.) over 4 hours; sodium thiosulfate (STS) was given
      i.v. in the opposite arm at a loading dose of 4 g/m2, followed by 12 g/m2 over 6
      hours. Each cycle was repeated every two weeks. Seventy-five cycles were
      administered to 28 patients in this clinical trial. RESULTS: In 19 patients who
      received 2 or more cycles of chemotherapy, a delay of three or more days was
      required on 17/66 courses (26%); the mean DDP DI actually received by these
      patients was 83 mg/m2/wk (88% of the planned DI). The major side effect was
      ototoxicity; this occurred in 9 patients (33%), but none required a hearing aid.
      Myelosuppression was moderate with thrombocytopenia greater than neutropenia.
      Nephrotoxicity (creatinine > 2 mg/dl) occurred on only 2 cycles (3%). Three
      patients (11%) developed symptoms of peripheral neuropathy. In 23 evaluable
      patients, the overall response rate was 39%. CONCLUSION: It is feasible to give
      180 mg/m2 of DDP and STS every two weeks with tolerable nephrotoxicity but
      without blocking other types of toxicity, such as myelosuppression and
      ototoxicity. The shortening of cycle intervals resulted in a markedly increased
      DI.

PMID- 8471555
TI  - Biochemical modulation of 5-fluorouracil: a randomized comparison of sequential
      methotrexate, 5-fluorouracil and leucovorin versus sequential 5-fluorouracil and
      leucovorin in patients with advanced symptomatic colorectal cancer. The Nordic
      Gastrointestinal Tumor Adjuvant Therapy Group.
AB  - BACKGROUND: The optimal chemotherapy for advanced colorectal carcinoma is not
      known. Two regimens, both based upon biochemical modulation of 5-FU, were
      compared in a randomized multicenter trial. PATIENTS AND METHODS: A total of 202
      symptomatic patients were randomly allocated to receive either sequential
      methotrexate, 250 mg/m2, during the first 2 hours and 5-FU, 500 mg/m2, at hours 3
      and 23 followed by leucovorin rescue initiated at hour 24 (15 mg x 8) (MFL) or
      sequential 5-FU 500 mg/m2 followed by leucovorin 60 mg/m2 30-40 minutes later, on
      days 1 and 2 (FLv). Treatments were repeated every 14 days for eight courses and
      then every 3 to 4 weeks. Four patients were unevaluable. RESULTS: The two
      treatments were equally effective with respect to objective response rates
      (complete (CR)+partial (PR), MFL 17%, FLv 21%), subjective response rates
      (symptom relief in the absence of severe adverse effects, 45% vs. 37%), and
      survival (median 7.5 vs. 9 months). All responses lasted at least 4 months.
      Overall, toxicity was low and comparable between the groups, but serious toxicity
      was more common in the MFL group. CONCLUSIONS: Since FLv is easier to administer
      and carries less risk for serious toxicity, it should be recommended as a first
      line treatment before MFL. On either regimen, about 40% of symptomatic patients
      can expect palliation, i.e., symptomatic relief without severe adverse effects,
      for at least 4 months.

PMID- 8471556
TI  - Carboplatin and 5-fluorouracil in poor performance status patients with advanced
      urothelial cancer.
AB  - BACKGROUND: In view of the difficulties in administering aggressive treatment to
      elderly patients, frequently with concomitant medical problems, a treatment
      program with the combination of carboplatin and 5-FU for advanced urothelial
      tumors was designed. The aim was to maintain an efficacious therapeutic schedule
      while minimizing toxicity. PATIENTS AND METHODS: Twenty-three patients with
      advanced bidimensionally measurable urothelial carcinoma were given carboplatin
      100 mg/m2 and 5-fluorouracil 500 mg/m2 days 1-3 which was escalated to
      carboplatin 125 mg/m2 and 5-fluorouracil 625 mg/m2. 5 patients were > 70 years,
      the ECOG performance status was 2-3 in 10 patients (43%), and the creatinine was
      > 2.0 mg/dl in 3 patients (13%). Five patients (22%) had pre-existing cardiac
      disease, and 1 had hepatopathy. Nine patients (39%) had prior cisplatin. RESULTS:
      Ten patients remained at level 1, and 12 others had the dosage escalated to level
      2. Twenty-one patients are evaluable for response. Response was observed in 5 of
      21 (24%) evaluable patients (95% confidence limits 15%-33%), only at dose level
      2. There was 1 CR (5%) and 4 PR (19%). There were no responses in patients who
      had prior DDP versus 5 of 13 (38%) responses in patients who had not had prior
      DDP. The median time to response was 2 months. The median duration of response
      was 8 months. At level 2 myelotoxicity was significant, and led to a return to
      level 1 in 2 patients. Nine of 12 patients (75%) treated at level 2 had grade 3
      leukopenia, and 1 patient had nadir sepsis. 4 patients (33%) had grade 4
      thrombocytopenia. CONCLUSIONS: Moderate activity was shown with this regimen in
      untreated patients at level 2. This regimen presents a feasible outpatient
      alternative for patients who are unable to undergo more aggressive chemotherapy.

PMID- 8471557
TI  - Malignant lymphoproliferative disorders in liver cirrhosis.
AB  - BACKGROUND: Lymphoproliferative disorders in patients with liver cirrhosis,
      although uncommon, have been reported in at least 49 cases. Some authors have
      suggested that the association between chronic liver disease and lymphoma is not
      coincidental, that immune mechanisms may be pathogenetically involved. PATIENTS
      AND METHODS: In the present study we calculated the incidence rate of
      lymphoproliferative disorders in 334 liver cirrhosis patients (201 males, mean
      age 59 +/- 12; 133 females, mean age 61 +/- 11) treated at the Gastroenterology
      Department of the Mauriziano Hospital in Turin from January 1987 to September
      1990. RESULTS: We diagnosed 12 lymphoproliferative disorders, corresponding to an
      incidence of 9.56/1,000 person-years, a figure much higher than expected on the
      basis of the incidence rate registered in the Turin general population. Six of
      the 12 lymphoproliferative disorders were non-Hodgkin's lymphomas of the stomach,
      a proportion by far exceeding expectation. CONCLUSIONS: Our data support the
      hypothesis that the association between chronic liver disease and
      lymphoproliferative disorders is not just coincidental, and suggest that liver
      cirrhosis might be considered an immunological disturbance which entails an
      increased risk of developing lymphoproliferative disorders. Mechanisms causing
      lymphoproliferative disorders to develop in the course of chronic liver disease
      have been hypothesized.

PMID- 8471558
TI  - Effective salvage chemotherapy in relapsed or refractory non-Hodgkin's lymphoma.
AB  - BACKGROUND: Over the last few years, high-dose chemotherapy has been extensively
      investigated in relapsing/refractory non-Hodgkin's lymphoma (NHL). However, this
      approach is reserved to a limited subset of cases and new conventional-dose
      second-line chemotherapies need to be investigated. PATIENTS AND METHODS: Thirty
      consecutive out-patients with refractory or recurrent NHL were given
      polychemotherapy in a regimen consisting of ifosfamide, mitoxantrone and
      etoposide on day 1 and vindesine, cisplatinum and cytosine arabinoside on day 15:
      courses were repeated every 29 days. Five patients had refractory disease
      following first-line chemotherapy and 25 were relapsing. RESULTS: The median
      number of administered cycles was 4 (range 2-8). We observed 16 complete (53%;
      95% confidence interval, 34%-72%) and 3 partial remissions, for an overall
      remission rate of 63% (95% confidence interval, 44%-80%). Responses were seen
      only among patients who achieved at least a partial response during first-line
      therapy. The median duration of complete remission was 15 months (range 5-47+),
      whereas median survival of the treated patients was 26 months (range 2-50+). Five
      patients were long-term responders after 34+, 35+, 46+, 46+ and 47+ months. No
      life threatening toxicity was observed. The main side effects were
      myelosuppression, nausea/vomiting and alopecia. CONCLUSIONS: The proposed regimen
      is feasible and effective in terms of complete remission rate and disease-free
      survival, suggesting that this treatment may be potentially curative in a
      subgroup of relapsed patients with limited tumor burden and normal LDH values. A
      more aggressive approach is needed in refractory patients.

PMID- 8471559
TI  - A phase II study of weekly edatrexate (10-EDAM) in metastatic melanoma. A
      National Cancer Institute of Canada Clinical Trials Group study.
AB  - BACKGROUND: Phase I and II clinical trials have demonstrated acceptable toxicity
      and promising activity of Edatrexate (10-EDAM). The objective of this multicentre
      phase II study was to determine the efficacy and toxicity of this agent in
      patients with metastatic melanoma. PATIENTS AND METHODS: Sixteen previously
      untreated patients with metastatic melanoma received 10-EDAM, 80 mg/m2/week
      intravenously. Patients were evaluated for response and toxicity. RESULTS: There
      were no objective responses. The median dose intensity of 10-EDAM actually
      delivered was 56.25 mg/m2/week (70% of projected). Mucositis of any degree was
      encountered in 93.8% of patients. Grade 3 or 4 mucositis, skin rash, nausea,
      abdominal pain, neutropenia, thrombocytopenia, anemia and hyperbilirubinemia each
      were encountered in 1-2 patients. There was 1 toxic death due to 10-EDAM.
      CONCLUSION: 10-EDAM is an inactive agent in metastatic melanoma.

PMID- 8471560
TI  - Gastric adenocarcinoma after gastric lymphoma: the role of chemoradiotherapy.

PMID- 8471561
TI  - Should we regard CA125 as the indication to treat relapsing ovarian cancer?

PMID- 8471562
TI  - Present-day performance qualities of cardiotocographs.
AB  - Legislation and standards applying to medical electrical equipment are reviewed.
      Although there are no official standards for cardiotocographs, de facto standards
      can be defined. The paper introduces the present-day performance qualities of
      cardiotocographs and the factors which affect the quality of the data. The
      measures used to evaluate the ability of cardiotocographs to indicate correctly
      the fetal heart rate and maternal uterine activity are discussed. Present-day
      cardiotocographs generally perform well but the physiological variables need to
      be defined in order to produce equipment in keeping with clinical needs.

PMID- 8471563
TI  - The fetal ECG: accuracy of measurements.
AB  - Analysis of fetal heart rate is very dependent upon the accuracy with which fetal
      events can be timed. This depends upon signal quality and the type of processing
      used in signal analysis. Signal quality is affected by mode of recording and
      positioning of sensors. Signal loss can be kept to below 5% in routine clinical
      practice with appropriate attention to technique. Accuracy of beat-to-beat
      measurement needs to be 1 ms if short-term variability (epoch length 1/16 min) is
      to be assessed reliably.

PMID- 8471564
TI  - Doppler ultrasound monitoring technology.
AB  - Developments in the signal processing of Doppler ultrasound used for the
      detection of fetal heart rate (FHR) have improved the operation of
      cardiotocographs. These developments are reviewed and the advantages and
      disadvantages of the various Doppler and signal processing methods are compared.

PMID- 8471565
TI  - Signal processing and display--cardiotocographs.
AB  - The technology used in cardiotocographs limits the basic resolution of the
      recorded data. The limitations and errors generated by the data collection,
      signal processing (autocorrelation) and printing the fetal heart rate (FHR) are
      discussed. Although adequate for displaying baseline variability, present-day
      cardiotocographs are incapable of displaying beat-to-beat changes in FHR.

PMID- 8471566
TI  - Communicating the significance of the fetal heart rate record to the user.
AB  - Fetal heart rate (FHR) records should be presented as measurements derived from
      numerical analysis. Such analysis requires computerized systems. The Oxford
      system is the longest established and most tested of the systems available. It
      could provide the basis for a standardized approach to the numerical analysis of
      antepartum FHR records. Intrapartum FHR monitoring is of uncertain clinical
      value. It is premature to recommend standards for numerical analysis to upgrade
      the present methods of data presentation during labour. Once the patterns of
      abnormality are better defined numerically such standards will be mandatory
      because intrapartum FHR records cannot be interpreted reliably by eye.

PMID- 8471567
TI  - Measurement of uterine activity in labour--clinical aspects.
AB  - Intra-uterine pressure measurement remains the most objective way of measuring
      uterine activity in labour, and in this respect is superior to clinical
      assessment or external tocography. However there is little evidence to show that
      improving the assessment of uterine activity in labour is associated with an
      improvement in the outcome of labour for mother or fetus. It seems logical that
      use of intra-uterine pressure monitoring will provide additional safety in women
      with a scarred uterus, breech presentation, high parity, or apparent failure of
      response to induction or augmentation of labour with the usual dose rates of
      oxytocics, but this has not been established by appropriately sized clinical
      trials. Further research to establish the role of uterine activity measurement in
      labour is urgently needed.

PMID- 8471568
TI  - Standards in fetal monitoring--practical requirements for uterine activity
      measurement and recording.
AB  - External monitoring of uterine contractility in human labour can record
      contraction frequency accurately, but cannot determine true intra-uterine
      pressure reliably. It is therefore suitable for use in spontaneous labour where
      there is a need for a marker of contractions to aid in continuous fetal heart
      rate pattern interpretation. Intra-uterine pressure measurement can provide
      quantitative information more reliably over intervals of 10-60 minutes. Although
      active pressure values for individual contractions can vary by up to 50% when
      measured simultaneously by two or more intra-uterine catheters/transducers, this
      variation is not systematic and cumulative measures vary by less than 5%. The
      measurement of baseline tone is affected by variables not related to uterine
      activity and should therefore be excluded when quantitative measures are made.

PMID- 8471569
TI  - Clinical overview of cardiotocography.
AB  - Twenty years after its widespread introduction, the role of continuous fetal
      heart rate and contraction monitoring in labour (cardiotocography, CTG) remains
      uncertain. Although a normal pattern is very reassuring about fetal condition,
      the predictive value of an abnormal pattern is low. In most studies the use of
      CTG has been associated with an increase in intervention in labour, particularly
      caesarean section, without clear evidence of benefit. Fetal blood sampling is the
      most useful associated technique for minimizing unnecessary intervention. The
      relationship between fetal heart rate, fetal blood pH changes and long-term
      outcome remains obscure and further work to clarify this relationship is urgently
      needed.

PMID- 8471570
TI  - Litigation and the cardiotocogram.
AB  - The extent of the liability in obstetric litigation is discussed. Arguments
      between experts reveal the lack of agreed standards in cardiotocography. This
      paper discusses the problems which need to be addressed when defining what
      constitutes an abnormal cardiotocogram (CTG), how long it needs to abnormal
      before it is significant, the contribution made by inadequate equipment and the
      question of whether it is defensible to decide positively not to monitor. Records
      need to be archived for a minimum of 25 years.

PMID- 8471571
TI  - Recovery from intravenous sedation with midazolam--the value of flumazenil.
AB  - A total of 40 patients receiving intravenous midazolam for surgical removal of
      impacted wisdom teeth were randomly assigned to recover either spontaneously or
      undergo reversal by the benzodiazepine antagonist flumazenil. Whilst initial
      postoperative recovery to a 'fully awake' state occurred more rapidly in the
      reversal group, objective psychomotor testing revealed significantly poorer
      performance postoperatively compared with spontaneously recovering patients; this
      emphasises the need to retain patients for at least 1 h prior to discharge home.

PMID- 8471572
TI  - Hemimandibular reconstruction with bipedicled scapular osteocutaneous free flap.
AB  - A case report is presented on the successful use of a bipedicled scapular
      osteocutaneous free flap in a young woman, whose hemimandible was resected
      because of sarcoma, 1 year prior to presentation. The postoperative course was
      uneventful and donor site morbidity minimal.

PMID- 8471573
TI  - Reconstruction of full-thickness cheek defects with a bipaddled radial forearm
      flap.
AB  - The use of a double folded radial forearm free flap for the reconstruction of
      full thickness cheek defects in six patients is reported. A brief comparison with
      other methods is made and a modification of the flap for the reconstruction of
      the angle of the mouth is presented.

PMID- 8471574
TI  - Parathyroid carcinoma presenting with a brown tumour of the mandible in a young
      man.
AB  - A 27-year-old man presented to his dentist with a swelling in his lower jaw.
      Histology revealed this to be a brown tumour associated with primary
      hyperparathyroidism and severe but asymptomatic hypercalcaemia. A large
      parathyroid adenoma was removed and the serum calcium fell to normal.
      Hypercalcaemia recurred and re-exploration of the neck revealed parathyroid
      metastases in cervical lymph nodes. A modified radical neck dissection was
      performed and he has remained normocalcaemic on Vitamin D analogues for 2 years.
      Bone disease of the mandible is a very rare presentation of primary
      hyperparathyroidism. The diagnosis of parathyroid malignancy is often difficult
      histologically, and the optimum treatment is uncertain.

PMID- 8471575
TI  - Lympho-epithelial cysts: a maxillofacial surgeon's perspective.
AB  - Cervical swellings are referred to Oral and Maxillofacial Surgeons and may
      subsequently be diagnosed as lympho-epithelial cysts. The clinical presentation
      of such swellings appears to differ from that seen in other specialties also
      treating these cysts in that a larger proportion of lympho-epithelial cysts
      presenting to our specialty are infected, which complicates the diagnosis and
      also the subsequent management. We present our recent experience of 5 patients
      who underwent excision of a lympho-epithelial cyst, all of which were infected on
      initial presentation and four of which were associated with concurrent
      ipsilateral dento-alveolar infection. The fifth case presented with rapid
      development of a cervical swelling in the immediate post-natal period. As these
      cysts contain abundant lymphoid tissue as an integral part of the lymph drainage
      system of the head and neck, we propose that the management of an infected lympho
      epithelial cyst should include a full clinical and radiographic examination of
      the oral cavity for a possible focus of infection and indeed any patient awaiting
      surgery for a non-infected cyst would benefit from an examination of the mouth
      and treatment of any sites of chronic infection.

PMID- 8471576
TI  - Bifid mandibular condyle resulting from a sagittal fracture of the condylar head.
AB  - Sagittal or vertical fractures of the mandibular condyle and chip fractures of
      the medial part of the condylar head are very rare entities and their
      identification is difficult with conventional radiographs. We report a case of a
      unilateral bifid mandibular condyle which resulted following a sagittal condylar
      fracture. This was associated with a chip fracture of the medial part of the
      condylar head on the contralateral side. These types of condylar fracture do not
      require any surgical treatment, but early mobilization is indicated.

PMID- 8471577
TI  - A simple technique to improve access to the adult palate.
AB  - A simple method to facilitate good access to the palate of the adult patient
      using the Dingman gag is described.

PMID- 8471578
TI  - Civilian attachments for Defence Services trainees.

PMID- 8471579
TI  - Retrobulbar haematoma.

PMID- 8471580
TI  - Retrobulbar haematoma.

PMID- 8471581
TI  - Retrobulbar haematoma.

PMID- 8471582
TI  - Living with the reforms.

PMID- 8471583
TI  - Primary closure of cleft palate: a functional approach.
AB  - The role of the different zones of palatal mucosa in maxillary growth are
      considered and their relevance in surgery of cleft palate discussed. A method of
      cleft palate repair is described, based on a functional repair of the soft
      palate, followed by later closure of the hard palate taking into account the
      anatomy and physiology of the palatal mucosa.

PMID- 8471584
TI  - A comparison of two classification systems for hemifacial microsomia.
AB  - The classification of hemifacial microsomia (HFM) aids in diagnosis, treatment
      planning, prognostic predictions and data evaluation. The aetiological and
      phenotypic heterogeneities of HFM, however, make its classification problematic.
      This study used data from 50 patients to examine the classification of HFM and to
      compare two systems: OMENS and SAT. The results were concordant with current
      literature and demonstrated the phenotypic heterogeneity of HFM. Essentially,
      both classifications embody the major craniofacial defects, but the OMENS system
      appears to be further refined by its differentiation between soft tissue and
      nerve defects, and between orbital and mandibular defects. Neither system,
      however, records deafness or grades auricular tags, although tags occurred in 34%
      of cases and two patients with otherwise 'normal' ears had tags. Therefore, it is
      suggested that auricular tags be graded as minor ear malformations. Furthermore,
      the OMENS system could be strengthened by the addition of an asterisk to the
      acronym in cases with serious non-craniofacial anomalies, for example OMENS*.
      This adds little complexity to the acronym, but immediately indicates when a
      patient's features lie towards the more generalised oculoauriculovertebral end of
      the phenotypic spectrum.

PMID- 8471585
TI  - TMJ performance and behaviour in patients more than 6 years after Le Fort I
      osteotomy.
AB  - Sixteen non cleft patients treated by one piece Le Fort I osteotomy were
      investigated for TMJ symptoms. Clinical examination and subjective assessment by
      the patients was used over a 6-year period. No increase in symptoms was recorded
      in the osteotomy group as compared to the general population, however, condylar
      atrophy was seen in two patients. Both of these patients were classified as high
      mandibular plane angle, with absolute mandibular retrognathism. This suggests
      that this group may be at greater risk of condylar atrophy.

PMID- 8471586
TI  - Perforating vessel(s) of the orbital floor: a cadaveric study.
AB  - Brisk haemorrhage is occasionally encountered in subperiosteal orbital floor
      exploration. Personal experience of the authors of a vessel perforating the
      orbital floor in a roughly similar position in a number of cases prompted further
      study. Twelve fresh cadavers (24 orbits) were dissected specifically to identify
      any vessel(s) perforating the orbital floor. In this study a vessel was
      identified in 83% of the dissections.

PMID- 8471587
TI  - Central giant cell granulomas of the jaws regress with calcitonin therapy.
AB  - Aggressive central giant cell granulomas may be eliminated by administering human
      calcitonin 0.5 mg (100 iu) deep subcutaneously for 1 year. This avoids the need
      for mutilating surgery or radiotherapy in growing children. Aggressive recurrent
      peripheral lesions (the giant cell epulis) can also be treated by excision after
      calcitonin therapy. These giant cell granulomas should be redefined as osteoclast
      granulomas, and the aneurysmal bone cyst, the cystic osteoclast granuloma.
      However the stimulus for the disturbance in the osteo progenitor spindle cell
      needs to be defined.

PMID- 8471588
TI  - A multiple dose comparison of ibuprofen and dihydrocodeine after third molar
      surgery.
AB  - The objectives were to compare the relative merits of ibuprofen 400 mg and
      dihydrocodeine 30 mg or 60 mg taken up to four times daily for up to 6 days in
      the treatment of pain after third molar removal. A randomised, double-blind,
      multiple dose, crossover study was undertaken in 68 patients undergoing two-stage
      bilateral lower third molar removal. The results showed that ibuprofen produced
      significantly greater analgesia than either of the dihydrocodeine treatments on
      the day of surgery. Ibuprofen and dihydrocodeine 60 mg produced significantly
      greater analgesia than dihydrocodeine 30 mg on the day after surgery, and on days
      4 and 5 ibuprofen was again significantly superior to dihydrocodeine 60 mg.
      Roughly half the patients taking dihydrocodeine stopped the study on the day
      after surgery, because of adverse effects and/or inadequate relief, compared with
      6 out of 44 taking ibuprofen. Dihydrocodeine 60 mg produced four times the number
      of patients affected by adverse effects compared with ibuprofen, and
      dihydrocodeine 30 mg three times as many. The principal adverse effects were
      nausea, vomiting and drowsiness. In conclusion, ibuprofen produced better
      analgesia than dihydrocodeine with significantly fewer adverse effects and is
      therefore a better choice for pain relief after oral surgery.

PMID- 8471589
TI  - A human T cell line engineered to secrete chimeric monoclonal antibody.
AB  - Both monoclonal antibodies (MAbs) and human T cells have been used in human tumor
      immunotherapy protocols. Tumor-infiltrating lymphocytes (TILs) and MAbs that can
      mediate antibody-dependent cell-mediated cytotoxicity (ADCC) via human effector
      cells have shown antitumor effects in both animal models and clinical trials. One
      potential novel approach would be to combine these two modalities in the creation
      of a T cell capable of secreting antitumor immunoglobulins (Ig), in essence,
      creating an antitumor Ig "factory" at the tumor site. In the studies reported
      here, we have cloned the D612 MAb Ig genes and generated a chimeric D612 IgG1
      containing the murine variable region and human constant region. D612 MAb has
      been shown to mediate lysis of human colon carcinomas via effector cell-mediated
      ADCC. We have demonstrated that following transfection, chimeric D612 can be
      expressed and secreted by the human T-cell line MOLT-4 at a rate of 0.25
      micrograms/ml per 10(6) cells in 72 hours. The secreted Ig retained its antigen
      binding properties as assayed by competition radioimmunoassay and also its
      ability to mediate ADCC against human tumor cells. To our knowledge, this is the
      first demonstration of the production of a chimeric IgG by human T cells and
      opens the possibility of a therapeutic approach in which TILs secrete humanized
      antitumor MAb capable of mediating ADCC at the tumor site.

PMID- 8471590
TI  - Generation of T-cells reactive to the poorly immunogenic B16-BL6 melanoma with
      efficacy in the treatment of spontaneous metastases.
AB  - The B16-BL6 (BL6) melanoma is a poorly immunogenic murine tumor that is highly
      invasive and spontaneously metastasizes from the primary site. Utilizing an
      established anti-CD3/interleukin-2 (IL-2) culture procedure, we have previously
      reported that lymph nodes (LNs) draining immunogenic murine sarcomas contained
      preeffector cells that could be activated to differentiate into therapeutic
      effector cells for adoptive immunotherapy. By contrast, LNs draining the poorly
      immunogenic BL6 melanoma were found not to be a reliable source of preeffector
      cells. Instead, sensitization of preeffector cells reactive to BL6 required the
      subcutaneous inoculation of tumor admixed with Corynebacterium parvum. LN cells
      draining these vaccination sites demonstrated therapeutic efficacy only after
      subsequent anti-CD3/IL-2 activation. The sensitization of preeffector cells was
      dependent on the presence of tumor antigen and an optimal dose of C. parvum (< or
      = 50 micrograms). Furthermore, kinetic analysis revealed that the preeffector
      response was transient after tumor vaccination. The therapeutic efficacy of anti
      CD3/IL-2 activated LN cells was further evaluated in the treatment of spontaneous
      macroscopic BL6 visceral metastases. Spontaneous visceral metastases were induced
      in animals by inoculation with BL6 tumor in the footpad followed by amputation of
      the primary tumor 3 weeks later. The systemic transfer of 10(8) anti-CD3/IL-2
      activated T-cells and the concomitant intraperitoneal administration of
      subtherapeutic doses of IL-2 1 week after amputation cured 50% of the animals and
      prolonged median survival time (MST) to > 140 days. All mice except one that
      received no treatment or was treated with IL-2 alone succumbed to visceral
      metastases with an MST of approximately 23 days. This study characterizes a model
      whereby the weak immune response to the BL6 melanoma can be positively or
      negatively modulated for the generation of antitumor reactive T-cells useful in
      adoptive immunotherapy.

PMID- 8471591
TI  - Tumor necrosis factor alpha and gamma-interferon enhancement of anti-epidermal
      growth factor receptor monoclonal antibody binding to human melanoma cells.
AB  - Previous studies have demonstrated that the expression of tumor-associated
      antigens can be regulated by cytokines. The purpose of this study was to
      determine whether tumor necrosis factor alpha (TNF alpha) and gamma-interferon
      (IFN gamma) were capable of modulating epidermal growth factor receptor (EGFr)
      immunorecognition on a human melanoma cell line in vitro. DX-3 melanoma cells
      treated for 24-72 h with various concentrations of each cytokine were incubated
      with an anti-EGFr monoclonal antibody (Mab) (A108) that recognizes an
      extracellular domain of the receptor, and differences in binding were analyzed by
      flow cytometry and radioimmunoassay. A dose- and time-dependent enhancement in
      EGFr immunorecognition was measurable in TNF alpha- and IFN gamma-treated cells.
      Combinations of these cytokines enhanced the recognition of EGFr on DX-3 cells to
      a level greater than that achieved with either TNF alpha or IFN gamma alone.
      Scatchard analysis of receptor binding curves revealed that there was no
      significant change in Mab affinity between control and cytokine-treated DX-3
      melanoma cells, whereas a 1.5- to 1.8-fold enhancement in the number of Mab
      binding sites was measurable in TNF alpha- and IFN gamma-treated cells,
      respectively, when compared with controls. Immune complex kinase assay of EGFr
      showed threefold higher tyrosine kinase activity in TNF alpha-treated cells, but
      no change in kinase activity was observed following IFN gamma treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471592
TI  - Immunomodulatory effects of interferon-gamma in patients with metastatic
      malignant melanoma.
AB  - Interferon-gamma (IFN-gamma) is a potent monocyte/macrophage activating agent
      that in animal models exhibits a bell-shaped dose-response curve of
      immunomodulatory activity and antitumor efficacy. Previous clinical trials of IFN
      gamma conducted at the maximal tolerated dose (MTD) have been associated with low
      response rates that may have been due to failure to treat at an optimal
      immunomodulatory dose (OID). The objective of this study was to test the
      hypothesis that optimal immunomodulatory activity of IFN-gamma in patients with
      metastatic melanoma would be obtained at a dose below the MTD. Groups of five
      patients each were given daily subcutaneous injections of IFN-gamma at doses of
      0.01, 0.1, or 0.25 mg/m2. In vivo immunomodulation was assessed by serial
      measurement of serum neopterin and by flow cytometry. IFN-gamma doses of 0.1 or
      0.25 mg/m2 induced significantly greater immunomodulation of monocyte-associated
      immune parameters than 0.01 mg/m2. Changes in immunologic parameters included
      marked elevation of serum neopterin levels, significant increases in monocyte
      expression of CD64, beta 2-microglobulin, and HLA-ABC, and decreased monocyte
      expression of CD14. The most dramatic decreases in CD14 expression were observed
      on monocytes obtained from patients treated at 0.25 mg/m2. The 0.25-mg/m2 dose
      group had significantly lower white blood cell counts on day 14. No bell-shaped
      curve of immunologic response was observed over the dosage range tested. Based on
      the similarity of the immunologic effects at 0.1 and 0.25 mg/m2, treatment at the
      MTD of IFN-gamma (0.25 mg/m2) represents treatment at the OID for patients with
      metastatic malignant melanoma.

PMID- 8471593
TI  - Pharmacodynamics of biological response in vivo after single and multiple doses
      of interferon-beta.
AB  - Interferons (IFNs) induce gene regulation in vivo that may be used to identify
      effective doses, schedules, and potential correlates of therapeutic response. To
      critically examine minimum effective dose, duration of response, and cumulative
      effects of repetitive doses, a range of subcutaneous doses of IFN beta ser was
      studied in 32 healthy human volunteers. IFN-induced products of gene regulation
      assessed were beta 2-microglobulin, neopterin, and tryptophan in serum and 2',5'
      oligoadenylate (2-5A) synthetase activity in peripheral blood mononuclear cells.
      Eight subjects per group received 0.09, 0.9, 9, or 45 MU of IFN beta. Responses
      were measured at 24, 48, and 72 h after single and multiple doses. The lowest
      biologically effective dose was 0.9 MU; significant (p < 0.02) increases were
      observed at 24 h in beta 2-microglobulin and cellular 2-5A synthetase activity.
      At the two higher doses, 9 and 45 MU, changes were observed at 24 h in all
      products (p < 0.01). A dose response (p < 0.01) over the range of 0.09-45 MU was
      observed for all these serum and intracellular gene products. Changes in
      neopterin, beta 2-microglobulin, and cellular 2-5A synthetase correlated
      significantly with each other. The response to a single dose of IFN beta was as
      great in magnitude as the response to multiple doses, suggesting an alternate-day
      schedule would maintain biological response.

PMID- 8471594
TI  - Phase I/II study of murine monoclonal antibody-ricin A chain (XOMAZYME-Mel)
      immunoconjugate plus cyclosporine A in patients with metastatic melanoma.
AB  - XOMAZYME-Mel (XMMME-001-RTA) is an immunoconjugate comprised of ricin A chain
      conjugated to a murine monoclonal antibody directed against high molecular weight
      melanoma antigens. Although not necessarily related to increased toxicity or
      decreased efficacy, the development of anti-immunoconjugate antibodies may limit
      repetitive dosing with an immunoconjugate. We evaluated the role of cyclosporine
      A in blocking the antibody response in patients with melanoma treated with XMMME
      001-RTA. Patients received cyclosporine in divided daily doses to achieve serum
      levels by HPLC of 150-200 ng/ml on days 1-22. On day 3, XMMME-001-RTA was begun
      at dosages 0.2-0.6 mg/kg daily for 5 days. Treatment was repeated every 35 days.
      Three patients were treated in each dosage tier (0.2, 0.4, 0.6 mg/kg). Nine
      patients were entered and all nine were evaluable. Patients had histologically
      confirmed melanoma. Metastatic sites included skin, soft tissue, and lymph nodes
      (seven), lung (two), liver (one), and spleen (one). There were four men and five
      women aged 46-75 years. Toxicities included myalgia, arthralgia, hypoalbuminemia,
      fatigue, elevations in liver function tests, and increased peripheral edema. Four
      patients received two to five repeated dosages of XMMME-001-RTA. One wheal-and
      flare reaction from an immunotoxin test dose of XMMME-001-RTA was noted after
      five cycles. After a test dose subsequent to one cycle, two patients experienced
      chest tightness without ECG changes and were removed from the study. All
      toxicities resolved without sequelae. One patient experienced partial lymph node
      remission for 9 months. A second patient had stable mediastinal disease for 20
      months. XMMME-001-RTA is safe when given repeatedly with cyclosporine.

PMID- 8471595
TI  - Adverse reactions to intravenous contrast media in patients treated with
      interleukin-2.
AB  - Seventy patients consecutively admitted to a single institution were treated with
      high-dose interleukin-2 (IL-2) and analyzed for determining the incidence and
      risk factors associated with reactions to i.v. contrast media. Patients with
      metastatic renal cancer (n = 44) or melanoma (n = 26) received 74 cycles of IL-2
      administered at 2 to 6 x 10(6) U/m2/d for 10-21 days either alone or with
      lymphokine-activated killer (LAK) cells or tumor-infiltrating lymphocytes (TILs).
      Seventy-four computed tomography (CT) scans were performed before administration
      of IL-2; and 74, 59, and 35 CT scans were performed, respectively, 2, 6, and 10
      weeks after administration of IL-2. Of the 168 scans performed after therapy with
      IL-2, non-ionic media were used in 110 and ionic media were used in 58. There
      were no reactions before administration of IL-2, but there were nine reactions
      after therapy with IL-2. Reactions to contrast media occurred 1-4 hours after
      media infusion and included fever, chills, emesis, diarrhea, rash, wheezing,
      hypotension, edema, and oliguria. Hospitalization was required in seven cases,
      including intensive care unit support in four, but all patients recovered fully.
      Contrast reactions were more frequent 2 weeks after therapy with IL-2 (eight of
      74 scans, 11%) compared with 6 weeks after IL-2 (one of 59 scans, 1.7%), but the
      difference was not statistically significant (McNemar's test). Six patients who
      reacted to contrast 2 weeks after IL-2 treatment received contrast 4 weeks later:
      five had no reaction and only one experienced a reaction.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8471596
TI  - Adoptive chemoimmunotherapy for the treatment of relapsed and refractory solid
      tumors using ex vivo activated memory T cells (autolymphocyte therapy) and
      cyclophosphamide.
AB  - 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 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). To determine activity of ALT in human TBH
      with therapy-resistant solid tumors other than RCC and whether it was feasible to
      combine ALT with chemotherapy, we studied 21 patients with relapsed or primary
      refractory solid tumors following a study protocol of adoptive chemoimmunotherapy
      (ACIT) using ALT and cyclophosphamide. Twenty patients were evaluable. Five
      responses were seen, including two complete responses (CRs) and three partial
      responses (PRs). ACIT activity was noted in relapsed TBH who had responded to
      their previous chemotherapy and/or radiation therapy. The toxic effects of this
      ACIT study were minimal with no treatment-related morbidity or mortality. It
      appears that in some relapsed but not primary refractory solid tumors, ACIT using
      ALT (CD45RO+ T cells and cimetidine) together with cyclophosphamide has definite
      antitumor activity associated with little or no toxic effects. Further studies of
      ACIT in solid tumors other than RCC are justified.

PMID- 8471597
TI  - An acetylcholine receptor regulatory site in BC3H1 cells: characterized by laser
      pulse photolysis in the microsecond-to-millisecond time region.
AB  - When a neurotransmitter binds to its specific receptor, the protein forms
      transmembrane channels through which ions flow, leading to changes in
      transmembrane voltage that trigger signal transmission between neurons. How do
      inhibitors affect this process? Interesting and extensive information comes from
      investigations of the acetylcholine receptor, the best known of these proteins.
      This receptor is inhibited by cationic inhibitors, including local anesthetics,
      and acetylcholine at high concentrations. The accepted mechanism, elegant in its
      simplicity, is that these compounds enter the receptor-channel after it opens and
      block inorganic ion flux. This mechanism requires that the inhibitors affect only
      the apparent rate constant for channel closing (k'cl). An alternative mechanism
      invokes a specific regulatory (inhibitory) site to which inhibitors bind before
      the channel opens and the signal is transmitted. This mechanism requires that the
      inhibitors affect the apparent rate constants for both channel opening (k'op) and
      closing. The effect of inhibitors on k'op has not been determined previously.
      This report describes the use of a newly developed laser-pulse photolysis
      technique with a dead time of approximately 120 microseconds to determine the
      effect of a local anesthetic, procaine, one of the best studied cationic
      inhibitors of the acetylcholine receptor, on both k'op and k'cl. Both k'op and
      k'cl were found to decrease with increasing procaine concentration. This effect
      of the inhibitor of k'op cannot be explained by the open-channel-blocking
      mechanism but is consistent with the existence of a regulatory (inhibitory)
      receptor site.

PMID- 8471598
TI  - The energetics and cooperativity of protein folding: a simple experimental
      analysis based upon the solvation of internal residues.
AB  - The reversible unfolding of two dissimilar proteins, phosphoglycerate kinase from
      Bacillus stearothermophilus (PGK) and Staphylococcus aureus nuclease (SAN), was
      induced with two denaturants, urea and guanidinium chloride (GuHCl). For each
      protein, structural transitions were monitored by intrinsic fluorescence
      intensity changes arising from a unique tryptophan residue. In the case of SAN
      the single, native tryptophan residue was used, whereas for PGK two versions, one
      with a tryptophan at position 315 and one at 379, were constructed genetically.
      The resultant folding curves were analyzed by considering the change in the
      solvation free energy of internal amino acid residues as the denaturant
      concentration was varied. We derive the following simple relationship: -RT ln K =
      delta Gw + n delta Gs,m[D]/Kden. + [D]) where K is the equilibrium constant
      describing the distribution of folded and unfolded forms at a given denaturant
      concentration [D], delta Gw is the free energy change for the transition in the
      absence of denaturant, and n is the number of internal side chains becoming
      exposed. delta Gs,m and Kden. are constants derived empirically from the
      solvation energies of model compounds and represent the behavior of an average
      internal side chain between 0 and 6 M GuHCl and 0 and 8 M urea. For proteins of
      known structure these values can easily be derived, and for others, average
      values in guanidinium chloride (delta Gs,m = 0.775 kcal/mol and Kden. = 5.4 M) or
      urea (delta Gs,m = 1.198 kcal/mol and Kden. = 25.25 M) can be used in the
      analysis. Results show that the parameters n and delta Gw are independent of the
      denaturant used for all 12 transitions studied. This supports the hypothesis that
      the unfolding activity of urea and GuHCl can be accounted for by their effect on
      the solvation energy of amino acid side chains which are buried in the folded but
      exposed in the unfolded protein. This simple analytical treatment allows the
      "cooperativity" of protein folding to be interpreted in terms of the number of
      side chains becoming exposed to the solvent in a given step and allows accurate
      estimation of the free energy irrespective of the denaturant concentration needed
      to induce the transition.

PMID- 8471599
TI  - Subunit interactions provide a significant contribution to the stability of the
      dimeric four-alpha-helical-bundle protein ROP.
AB  - Detailed thermodynamic and spectroscopic studies were carried out on the ColE1
      ROP protein in order to establish a quantitative basis for the contribution of
      noncovalent interactions to the stability of four-helix-bundle proteins. The
      energetics of both heat- and GdnHCl-induced denaturation were measured by
      differential scanning microcalorimetry (DSC) and/or by following the change in
      circular dichroism in the far-UV range. Sedimentation equilibrium analyses were
      performed to characterize the state of aggregation of the protein. No
      intermediate species could be detected during thermal unfolding of the dimer in
      the absence of GdnHCl. Under these conditions ROP unfolding exhibits a strict two
      state behavior. The thermodynamic parameters for the reaction N2<->2D are delta
      HD = 580 +/- 20 kJ.(mol of dimer)-1, delta Cp = 10.3 +/- 1.3 kJ.(mol of dimer)
      1.K-1, and Tm = 71.0 +/- 0.5 degrees C. The corresponding Gibbs energy change of
      unfolding is delta GD degree = 71.7 kJ.(mol of dimer)-1 at 25 degrees C and pH 6.
      In the presence of 2.5 M GdnHCl, however, ROP dissociates into monomers at
      elevated temperatures, as the loss of the concentration dependence of Tm and the
      decreased molecular weight demonstrate. The corresponding transition parameters
      are delta HD (2.5 M GdnHCl) = 130 +/- 10 kJ.(mol of monomer)-1 and Tm = 51.6 +/-
      0.3 degrees C. Isothermal unfolding studies at 19 degrees C using GdnHCl as
      denaturant yielded a Gibbs energy change of unfolding of 22.4 kJ.(mol of monomer)
      1. This extrapolated value is 38% lower than the corresponding delta GD degree
      value of 35.85 kJ.(mol of monomer)-1 calculated from thermal unfolding for the
      monomer in the absence of GdnHCl, where the protein is known to be a dimer. These
      results suggest that subunit interactions are an important source of
      stabilization of the native four-helix-bundle structure of ROP.

PMID- 8471600
TI  - Aggregation and denaturation of apomyoglobin in aqueous urea solutions.
AB  - The effects of urea on apomyoglobin solubility have been investigated.
      Apomyoglobin precipitation was found to be a thermodynamically reversible process
      independent of the pathway of aggregation. A liquid-solid phase diagram was
      constructed for the precipitation of apomyoglobin as a function of urea and
      protein concentration. Apomyoglobin solubility decreases by an order of magnitude
      between 0 and 1.5 M urea, reaching a minimum near 2.4 M urea and increasing at
      higher urea concentrations (the denaturation midpoint is at approximately 2.6 M
      urea). This decrease in protein solubility is opposite to that expected based on
      amino acid solubilities, since both polar and nonpolar molecules become more
      soluble with increasing urea concentration. Solubility minima for proteins have
      been rationalized in terms of folding intermediates. However, our structural
      studies show no evidence for folding intermediates in apomyoglobin under the
      experimental conditions, apart from small predenaturation changes. Our data are
      consistent with an alternative hypothesis, namely, that the primary aggregating
      species are denatured protein molecules, rather than intermediate states.
      Consistent with recent thermodynamic and statistical mechanical models, the
      solubility minimum may be described as the result of two competing effects of
      urea: (1) urea denatures the protein, and (2) urea makes the solvent more
      favorable for the native and any denatured state. At low urea concentration,
      solubility decreases with increasing urea concentration due to the domination of
      the solubility behavior by the increase in the population of aggregation
      competent (denatured) protein molecules. However, at high urea concentration, the
      increasingly favorable nature of the solvent dominates, resulting in increasing
      solubility with urea concentration. The phase diagram provides guidance for the
      best experimental conditions (pathway) to use to avoid aggregation during the
      refolding of denaturant-unfolded protein.

PMID- 8471601
TI  - Crystallographic analysis of substrate binding and catalysis in dihydrolipoyl
      transacetylase (E2p).
AB  - The catalytic domain of dihydrolipoyl transacetylase (E2pCD) forms the core of
      the pyruvate dehydrogenase multienzyme complex and catalyzes the
      acetyltransferase reaction using acetylCoA as acetyl donor and dihydrolipoamide
      (Lip(SH)2) as acceptor. The crystal structures of six complexes and derivatives
      of Azotobacter vinelandii E2pCD were solved. The binary complexes of the enzyme
      with CoA and Lip(SH)2 were determined at 2.6- and 3.0-A resolutions,
      respectively. The two substrates are found in an extended conformation at the two
      opposite entrances of the 30 A long channel which runs at the interface between
      two 3-fold-related subunits and forms the catalytic center. The reactive thiol
      groups of both substrates are within hydrogen-bond distance from the side chain
      of His 610. This fact supports the indication, derived from the similarity with
      chloramphenicol acetyl transferase, that the histidine side chain acts as general
      base catalyst in the deprotonation of the reactive thiol of CoA. The conformation
      of Asn 614 appears to be dependent on the protonation state of the active site
      histidine, whose function as base catalyst is modulated in this way. Studies on
      E2pCD soaked in a high concentration of dithionite lead to the structure of the
      binary complex between E2pCD and hydrogen sulfite solved at 2.3-A resolution. It
      appears that the anion is bound in the middle of the catalytic center and is
      therefore capable of hosting and stabilizing a negative charge, which is of
      special interest since the reaction catalyzed by E2pCD is thought to proceed via
      a negatively charged tetrahedral intermediate. The structure of the binary
      complex between E2pCD and hydrogen sulfite suggests that transition-state
      stabilization can be provided by a direct hydrogen bond between the side chain of
      Ser 558 and the oxy anion of the putative intermediate. In the binary complex
      with CoA, the hydroxyl group of Ser 558 is hydrogen bonded to the nitrogen atom
      of one of the two peptide-like units of the substrate. Thus, CoA itself is
      involved in keeping the Ser hydroxyl group in the proper position for transition
      state stabilization. Quite unexpectedly, the structure at 2.6-A resolution of a
      ternary complex in which CoA and Lip(SH)2 are simultaneously bound to E2pCD
      reveals that CoA has an alternative, nonproductive binding mode. In this abortive
      ternary complex, CoA adopts a helical conformation with two intramolecular
      hydrogen bonds and the reactive sulfur of the pantetheine arm positioned 12 A
      away from the active site residues involved in the transferase reaction.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8471603
TI  - Determinants of protein thermostability observed in the 1.9-A crystal structure
      of malate dehydrogenase from the thermophilic bacterium Thermus flavus.
AB  - A binary complex of malate dehydrogenase from the thermophilic bacterium Thermus
      flavus (tMDH) with NADH has been crystallized from poly(ethylene glycol) 3500, pH
      8.5, yielding diffraction-quality crystals in space group P2(1)2(1)2(1). The
      structure was solved at 1.9-A resolution using molecular replacement and refined
      to an R factor of 15.8% with good geometry. The primary sequence of tMDH is 55%
      identical to that of cytoplasmic malate dehydrogenase (cMDH) [Birktoft, J. J.,
      Rhodes, G., & Banaszak, L. J. (1989) Biochemistry 28, 6065-6081], and overall
      their three-dimensional structures are very similar. Like cMDH, tMDH crystallized
      as a dimer with one coenzyme bound per subunit. The coenzyme binds in the
      extended conformation, and most of the interactions with enzyme are similar to
      those in cMDH. In tMDH, small local conformational changes are caused by the
      replacement of a glutamic acid for the aspartic acid involved in hydrogen bonding
      to the adenine ribose of NADH. Comparison of tMDH with cMDH reveals that both
      tMDH subunits more closely resemble the B subunit of cMDH which therefore is the
      more likely representative of the solution conformation. While cMDH is
      inactivated at temperatures above about 50 degrees C, tMDH is fully active at 90
      degrees C. On the basis of the X-ray crystal structure, a number of factors have
      been identified which are likely to contribute to the relative thermostability of
      tMDH compared to cMDH. The most striking of the differences involves the
      introduction of four ion pairs per monomer. All of these ion pairs are solvent
      accessible. Three of these ion pairs are located in the dimer interface, Glu27
      Lys31, Glu57-Lys168, and Glu57-Arg229, and one ion pair, Glu275-Arg149, is at the
      domain interface within each subunit. Additionally, we observe incorporation of
      additional alanines into alpha-helices of tMDH and, in one instance,
      incorporation of an aspartate that functions as a counterchange to an alpha-helix
      dipole. The possible contributions of these and other factors to protein
      thermostability in tMDH are discussed.

PMID- 8471602
TI  - Structure of the cobalt-dependent methionine aminopeptidase from Escherichia
      coli: a new type of proteolytic enzyme.
AB  - The X-ray structure of Escherichia coli methionine aminopeptidase (MAP) has been
      determined to 2.4-A resolution and refined to a crystallographic R-factor of
      18.2%. The fold is novel and displays internal pseudo-2-fold symmetry which
      structurally relates the first and second halves of the polypeptide chain. The
      topology consists of a central antiparallel beta-sheet covered on one side by two
      pairs of alpha-helices and by a C-terminal loop. The other face of the beta
      sheet, together with some irregular loops, forms the active site, which contains
      two cobalt ions 2.9 A apart. These metal ions are liganded by the side chains of
      Asp 97, Asp 108, Glu 204, Glu 235, and His 171 with approximate octahedral
      coordination. In terms of both the novel backbone fold and the constitution of
      the active site, MAP appears to represent a new class of proteolytic enzyme.

PMID- 8471604
TI  - Structure of chicken annexin V at 2.25-A resolution.
AB  - The crystal structure of chicken annexin V has been solved by molecular
      replacement and refined at 2.25 A. The final R factor is 19.7% with good
      geometry. The chicken annexin V structure is very similar to the human annexin V
      structure, with four similar domains each containing five helices. The structure
      includes three calcium ions in domains I, II, and IV, each bound by the
      characteristic K-G-X-G-T-(38 residues)-D/E motif. In view of the structural
      similarity between human and chicken annexin V, we suggest that they have a
      common vital function which developed early in evolutionary history.

PMID- 8471605
TI  - Dynamic light scattering studies of alpha IIb beta 3 solution conformation.
AB  - The prototypical integrin receptor, alpha IIb beta 3, isolated from the membrane
      fraction of human blood platelets by solubilization in Triton X-100 (reduced) and
      affinity chromatography on lentil lectin-agarose, has been further purified by
      gel filtration chromatography in octyl glucoside to obtain the intact receptor
      complex in a form suitable for hydrodynamic measurements. The molecular weight
      [(6.0 +/- 0.2) x 10(3)] and Stokes radius (2.3 +/- 0.1 nm) of detergent micelles
      formed in 0.03 M octyl glucoside have been determined by classical light
      scattering intensity and dynamic light scattering measurements, respectively. An
      algorithm has been developed which explicitly considers the contribution of
      detergent micelles to the intensity autocorrelation function of particles
      suspended in detergent. This procedure has been validated with polystyrene
      particles of known radius, as well as with the soluble protein fibrinogen.
      Application of these procedures to dynamic light scattering data obtained with
      alpha IIb beta 3 resulted in a translational diffusion coefficient (Dto(20,w)) of
      (2.78 +/- 0.31) x 10(-7) cm2 s-1, corresponding to a Strokes radius (Rs) of 7.67
      +/- 0.85 nm for the integrin/octyl glucoside complex. Light scattering intensity
      measurements gave a molecular weight of (2.26 +/- 0.22) x 10(5) for the
      polypeptide moiety of the complex, in excellent agreement with the 2.28 x 10(5)
      value calculated from primary structure data. As a spherical, hydrated alpha IIb
      beta 3 complex, with bound detergent, would exhibit a Stokes radius of
      approximately 5 nm, these data indicate considerable asymmetry in the solution
      conformation of alpha IIb beta 3.

PMID- 8471606
TI  - Calorimetric and spectroscopic studies of the interaction of Manduca sexta
      apolipophorin III with zwitterionic, anionic, and nonionic lipids.
AB  - The nature of the interaction of apolipophorin III (apoLp-III) from the insect
      Manduca sexta with a variety of zwitterionic and anionic phospholipids and with
      several nonionic glycolipids was investigated by differential scanning
      calorimetry (DSC) and 31P-NMR spectroscopy. Monoglucosyldiacylglycerol,
      phosphatidylethanolamine, and phosphatidic acid (pH 7.2) appear to exhibit the
      weakest interaction with apoLp-III. DSC studies revealed that the gel/liquid
      crystalline phase transition of these lipids is little affected by the binding of
      apoLp-III. Diglucosyldiacylglycerol, phosphatidylcholine (PC),
      phosphatidylserine, and phosphatidic acid (pH congruent to 8.8) seem to exhibit
      somewhat stronger interactions with apoLp-III. The binding of apoLp-III to these
      lipids induces the formation of lipid domains which melt less cooperatively and
      at higher temperatures than do the pure lipid dispersions, while having little
      effect on the melting enthalpy of lipid hydrocarbon chains. Phosphatidylglycerol
      (PG) and phosphatidic acid (pH > 9.3) appear to exhibit the strongest
      interactions with apoLp-III. The binding of apoLp-III to these lipids severely
      disrupts their bilayer structure, resulting in marked reductions in the
      cooperativity and enthalpy of the gel/liquid-crystalline phase transition of the
      lipids. Studies of binary mixtures of PC and PG indicate that such bilayer
      disrupting interactions only occur in the presence of nonphysiologically high
      concentrations of PG. The binding of apoLp-III to binary mixtures of
      diacylglycerol and zwitterionic phospholipid has little effect on the chain
      melting or the bilayer/nonbilayer phase transitions of these lipids, but it
      appears to promote the retention of water at the surface of the lipid aggregate.
      Our results indicate that the binding of apoLp-III to lipid bilayers is mediated
      primarily through polar and/or ionic interactions at the lipid bilayer surface.
      Our results also suggest that the interaction of apoLp-III with lipid bilayers
      promotes the hydration of their surfaces, a property which is consistent with the
      proposed in vivo functions of this protein.

PMID- 8471607
TI  - Cooperativity during multiple phosphorylations catalyzed by rhodopsin kinase:
      supporting evidence using synthetic phosphopeptides.
AB  - Rhodopsin kinase is a key component in the shutdown of visual transduction. The
      phosphorylation of rhodopsin's C-terminus was evaluated using synthetic peptides
      derived from the last 12 amino acids (337-348) as substrates and their
      phosphorylated counterparts as inhibitors. It was found that synthetic peptides
      were phosphorylated at the serine residue corresponding to Ser-343 in the primary
      sequence of bovine rhodopsin. The phosphopeptides were prepared by incorporating
      into the peptide chain a trityl-protected serine derivative at the site destined
      to contain the phosphoryl group. The trityl group was selectively released with
      20% (v/v) dichloroacetic acid; the free hydroxyl group was then phosphitylated
      with di-tert-butyl N,N-diethylphosphoramidite, and the resulting phosphite
      derivative was oxidized with m-chloroperoxybenzoic acid. The phosphopeptides were
      found to have a greater affinity for the kinase compared with their
      nonphosphorylated counterparts; for the peptides corresponding to residues 337
      348 of rhodopsin the affinity increased in the order VSKTETSQVAPA <
      VSKTETS[PO3H2]QVAPA < VS[PO3H2]KTETS[PO3H2]QVAPA. The results are interpreted to
      support the cooperativity hypotheses proposed previously [Wilden, U., & Kuhn, H.
      (1982) Biochemistry 21, 3014-3022; Aton, B. R., Litman, B. J., & Jackson, M. L.
      (1984) Biochemistry 23, 1737-1741].

PMID- 8471608
TI  - 13C NMR studies of the enzyme-product complex of Bacillus subtilis chorismate
      mutase.
AB  - The chorismate mutase reaction is a rare enzyme-catalyzed 3,3-sigmatropic
      rearrangement of chorismate to prephenate. Bacillus subtilis chorismate mutase
      was overproduced and purified from Escherichia coli XL1-Blue (pBSCM2) using a
      modification of the procedure of Gray et al. (Gray, J. V., Grolinelli-Pimpaneau,
      B., & Knowles, J. R. (1990) Biochemistry 29, 376-383); the modification leads to
      minimal contaminating prephenate dehydratase activity (< 0.001%). The native
      molecular mass of B. subtilis chorismate mutase was determined by gel filtration
      to be approximately 44 kDa, indicative of a homotrimer of the 14.5-kDa subunits
      as determined by electrospray mass spectrometry. 13C NMR was used to study the
      structure of [U-13C]prephenate bound at the active site of B. subtilis chorismate
      mutase. All the enzyme-bound 13C NMR resonances of [U-13C]prephenate were
      assigned, and where possible, 1JC,Cs were quantified; [1,3,5,8-13C]prephenate and
      [2,6,9-13C]prephenate, prepared respectively from [1,3,5,8-13C]chorismate and
      [2,6,9-13C]chorismate, aided the 13C NMR resonance assignments. Enzyme-bound
      prephenate exhibits remarkably different chemical shifts relative to free
      prephenate; the chemical shift changes range from -6.6 ppm for the C6 resonance
      to 5.6 ppm for the C5 resonance, suggesting a strong perturbation of the C5-C6
      bond. 13C NMR studies of model compounds at various pH values and in various
      solvents suggest that the observed 13C chemical shift changes of enzyme-bound
      prephenate cannot be rationalized solely on the basis of changes in the pKas of
      the carboxylic acid groups or hydrophobic solvation at the active site.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471609
TI  - Phenylhydrazones as new good substrates for the dioxygenase and peroxidase
      reactions of prostaglandin synthase: formation of iron(III)-sigma-phenyl
      complexes.
AB  - Phenylhydrazones of various aromatic and aliphatic aldehydes or ketones act as
      good substrates of the dioxygenase reaction of prostaglandin synthase (PGHS).
      Corresponding alpha-azo hydroperoxides are formed as intermediates with maximum
      initial rates of O2 consumption between 8 and 230 mol (mol of PGHS)-1 s-1 for
      benzophenone and hexanal phenylhydrazone, respectively. The Km values for these
      reactions vary from 100 to 300 microM. These alpha-azo hydroperoxides are then
      converted to the corresponding alpha-azo alcohols by the peroxidase reaction of
      PGHS. During such oxidations of phenylhydrazones by PGHS, a new complex of this
      hemeprotein characterized by peaks at 438 and 556 nm is formed. This complex was
      obtained both by direct reaction of PGHS Fe(III) with phenyldiazene and by
      reaction of PGHS Fe(III) with phenylhydrazine in the presence of O2. By analogy
      to results previously reported for hemoglobin, myoglobin, catalase, and
      cytochrome P450, this species should be a sigma-phenyl PGHS FeIII-Ph complex. The
      PGHS FeIII-Ph complex should derive from an oxidation of the intermediate alpha
      azo alcohol by PGHS Fe(III), cleavage of the resulting alkoxy radical with
      formation of a ketone (or aldehyde) and Ph*, and combination of PGHS Fe(II) with
      Ph*. Such an oxidation of alpha-azo alcohols by lipoxygenase-FeIII with formation
      of Ph* was reported previously. The formation of Ph* and of PGHS FeIII-Ph is
      likely the cause of the inhibitory effects previously reported for arylhydrazones
      toward PGHS.

PMID- 8471610
TI  - Glycosphingolipid backbone conformation and behavior in cholesterol-containing
      phospholipid bilayers.
AB  - 2H NMR spectroscopy was used to consider correspondence between existing single
      crystal X-ray data for glycosphingolipids and their ceramide backbone
      conformation in fluid phospholipid membranes. A monoglycosylated sphingolipid,
      glucosylceramide (GlcCer), which represents the core structure of many important
      glycosphingolipids, was derived by partial synthesis through replacement of all
      native fatty acids with the 18-carbon species, stearic acid, deuterated at C2. N
      [2,2-2H2]stearoyl-GlcCer was used to probe glycosphingolipid orientation and
      motion at low concentration in "fluid" phospholipid bilayers composed of
      dimyristoylphosphatidylcholine (DMPC), with and without physiological amounts of
      cholesterol. Spectral analysis, aided by stereoselective monodeuteration of the
      GlcCer fatty acid at C2, demonstrated that glycosphingolipid average acyl chain
      backbone conformation in fluid phospholipid membranes, with or without
      cholesterol, is likely closely related to that predicted from single crystal X
      ray studies [Pascher, I. (1976) Biochim. Biophys. Acta 455, 433-451; Pascher, I.,
      & Sundell, S. (1977) Chem. Phys. Lipids 20, 175-191]. To test the generality of
      this observation, specific comparisons were made involving galactosylceramide
      (GalCer) and globoside. GalCer provided a glycolipid differing only in
      monosaccharide stereochemistry (galactose vs glucose). Globoside permitted
      isolation of the effect of headgroup size, since it is derived from GlcCer via
      extension of the carbohydrate portion by the oligosaccharide, GalNAc beta 1-
      >3Gal alpha 1-->4Gal attached in beta 1-->4 linkage to the Glc residue.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471611
TI  - Myosin thick filaments and subunit exchange: a stochastic simulation based on the
      kinetics of assembly.
AB  - Subunit exchange between groups of myosin filaments at equilibrium in a volume
      similar to a sarcomere is simulated using Monte Carlo (probabilistic) methods.
      Five published kinetic parameters (three rate constants and two cooperativity
      parameters) which govern the assembly of thick filaments from purified myosin at
      pH 8.0 are used for the computations. Filament length distributions equivalent to
      those measured experimentally in the electron microscope result. Distinctive
      patterns of exchange emerge because cooperativity in myosin assembly is not
      confined to nucleation but functions throughout growth. Fluctuations in filament
      size, first apparent in the millisecond time domain, mediate exchange which first
      occurs at the tips of the filaments and then gradually progresses inwards toward
      the central bare-zone. Exchange rates decreased by an approximate factor of 10
      per decade of time: full exchange takes years, 50% takes 28 h, and 10% takes a
      brief 100 ms. These data represent the fastest possible rates of exchange because
      synthetic myosin filaments lack the overall stabilizing influence of the
      copolymerizing proteins of native filaments. Exchange at equilibrium is therefore
      too slow to explain, for example, the much faster rates recorded in vivo for the
      complete replacement of one myosin isoform by another. Facilitated exchange where
      partial or complete filament dissociation is followed by the introduction of new
      subunits during reassembly offers a means of accelerating exchange. In this
      context, it is shown that the requisite disassembly and reassembly of myosin
      thick filaments can be completed in a minimum of a few seconds.

PMID- 8471612
TI  - Identification of structural features involved in binding of alpha-amanitin to a
      monoclonal antibody.
AB  - Twenty-four derivatives of the cyclic octapeptide alpha-amanitin were assayed for
      their affinities to the monoclonal antibody beta A1/1. The derivatives were of
      natural, semisynthetic, and synthetic origin and had KD values ranging from 2 nM
      to > 70 microM. In the majority of the derivatives the chemical modifications had
      no detectable influence on the overall shape of the double-ring peptide. Given
      this condition, binding factors could be calculated from KD values of the
      amatoxin derivatives, which were valid for all amatoxins for estimating the
      contribution made by single structures to complex formation. The complex between
      alpha-amanitin and the immunoglobulin involves at least eight sites of contact.
      Four of them are responsible for strong interactions: (1) the OH group of
      hydroxyproline2 (binding factor 413), (2) the lipophilic side chain of
      isoleucine6 (binding factor 131), (3) the -CH2- moiety of the adjacent glycine5
      or the absence of a side chain in this position (binding factor 361), and (4) the
      proton at the indole nitrogen of hydroxytryptophan4 (binding factor 140). The
      residual four interactions are hydrogen bonds of lower strength corresponding to
      binding factors of 1.5-8. The key role of the unique conformation of the
      amatoxins in determining their binding properties was shown by two amatoxin
      derivatives in which changes in the conformation were associated with virtually
      complete loss of affinity. For all amatoxin derivatives with conformations
      similar or identical to that of alpha-amanitin, we found empirical evidence that
      those structures of the peptide involved in binding make their contributions
      virtually independent of each other. It is a consequence of this rule that
      structural features that cooperate in binding could be characterized by the
      numerical product of their binding factors.

PMID- 8471613
TI  - Porcine cerebroside sulfate activator: further structural characterization and
      disulfide identification.
AB  - Cerebroside sulfate activator (CS-Act) is a small compact protein which binds and
      solubilizes certain glycosphingolipids. Following the recent publication of the
      purification and preliminary sequence of pig kidney CS-Act [Fluharty, A.L.,
      Katona, Z., Meek, W.E., Frei, K., & Fowler, A.V. (1992) Biochem. Med. Metab.
      Biol. 47, 66-85], we now report the primary sequence of the C-terminal portion of
      this protein and the assignment of the three disulfide bonds. Cyanogen bromide
      (CNBr) treatment of native CS-Act produced three major and several minor peptide
      fragments. Analysis of one HPLC-purified fragment revealed the C-terminus 14
      amino acid sequence. This established the length of the native protein at 79
      residues. In conjunction with the sequence data for one other major HPLC-purified
      CNBr fragment, it could be concluded that the three intrachain disulfide bonds
      were located at half-cystine residues 4 and 77, 7 and 71, and 36 and 47. Mass
      spectrometry (fast atom bombardment and electrospray ionization) showed the
      molecular weight of the major component of the CS-Act preparation to be 9720.5
      Da, which was in close agreement with the calculated mass of the 79 amino acid
      peptide with five covalently attached sugar residues and three internal disulfide
      bonds. The mass spectrometric molecular weight measurements also showed that the
      CS-Act preparation possessed microheterogeneity in its carbohydrate moiety, as
      less intense signals corresponded to species containing (in decreasing order of
      abundance) two, one, four, and three sugar residues.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8471614
TI  - Treatment with a polyamine analog alters DNA-matrix association in HeLa cell
      nuclei: a nucleoid halo assay.
AB  - The polyamine analog 1,14-bis(ethylamino)-5,10-diazatetradecane (BE-4-4-4)
      depletes polyamines and inhibits the growth of tumor cells in tissue culture. We
      treated HeLa cells in culture with BE-4-4-4 for different time periods to produce
      different degrees of polyamine depletion. The cells were lysed and dehistonized
      to obtain nucleoids containing DNA attached to the nuclear matrix. Titration of
      the nucleoids with propidium iodide caused an uncoiling of negatively supercoiled
      DNA, resulting in the formation of a halo surrounding the nucleoid periphery. The
      halo diameters in both the BE-4-4-4-treated cells and the untreated control cells
      were measured using a fluorescence image analysis system. As compared to the
      control cells, the BE-4-4-4-treated cells showed a 20-25% decrease in halo
      diameter, indicating that there was less relaxation of the negative supercoils in
      the nuclear DNA of the BE-4-4-4-treated cells than in the controls.

PMID- 8471615
TI  - Conditions for the stability of the B, C, and Z structural forms of poly(dG-dC)
      in the presence of lithium, potassium, magnesium, calcium, and zinc cations.
AB  - The occurrence of alternative structures for the lithium, sodium, and potassium
      salts of poly(dG-dC) was determined as a function of hydration using IR spectra
      of nonoriented gels. Poly(dG-dC).K with added KCl (r = 0.56 where r is the moles
      of KCl per mole of nucleotide residue) gave results essentially identical to the
      much studied poly(dG-dC).Na with added NaCl (r = 0.56). Both gave a sharp
      transition from a unique B structure (hereafter designated B*) to the Z structure
      upon dehydration. Poly(dG-dC).Li with added LiCl (r = 0.36) assumed the B*
      structure at high hydration but made a broad transition to the C structures as
      hydration was lowered. We believe this is the first clear evidence of the C
      structure for poly(dG-dC). No other structures (A, D, or Z) were observed at any
      hydration in nonoriented gels. Poly(dG-dC).Na with added ZnCl2 (r = 0.2) existed
      as a mixture of the B* and Z structures in maximally hydrated gels. A broad,
      incomplete transition to a higher mole fraction of Z structure occurred upon
      dehydration. Zn2+ promotes the Z structure for poly(dG-dC) and appears to bind to
      guanine residues. Poly(dG-dC).Na with added MgCl2 or CaCl2 (r = 0.2) assumed the
      normal B* structure at maximum hydration with no hint of Z structure. Slight
      dehydration produced a very sharp transition to the Z structure. Both Mg2+ and
      Ca2+ are strong promoters of the Z structure but do not bind to cytosine or
      guanine residues.

PMID- 8471616
TI  - Formation of DNA-protein cross-links in mammalian cells by levuglandin E2.
AB  - Levuglandin E2 (LGE2), a rearrangement product derived from the prostaglandin
      endoperoxide, PGH2, causes repair-resistant DNA-protein cross-links and cell
      death (LD50 = 230 nM) in V79 Chinese hamster lung fibroblasts. The half-life for
      sequestration of LGE2 by covalent binding to cellular nucleophiles is at least an
      hour for 10 microM LG. This suggests that the in vivo production and distribution
      of free LGs should be measurable on this time scale. Following removal of the
      LGE2 and the return of the cultures to normal growth medium, additional DNA
      protein cross-links continued to form over the ensuing 6-24 h. The results
      suggest that LG adducts to DNA or protein are not repaired, but react further at
      sites on protein or DNA in close proximity to the initial adducts, forming cross
      links in a slow phase of the process.

PMID- 8471617
TI  - Quantitative multiplex sequence analysis of mutational hot spots. Frequency and
      specificity of mutations induced by a site-specific ethenocytosine in M13 viral
      DNA.
AB  - We describe an assay for determining the frequency and specificity of mutations
      occurring at hot spots within a population of DNA molecules. The procedure
      consists of (a) annealing the DNA population with a labeled oligonucleotide
      designed to prime DNA synthesis at the mutational hot spot; (b) DNA elongation in
      the presence of a single dideoxynucleoside triphosphate together with 1-3
      deoxynucleoside triphosphates, and (c) quantitation of all limit elongation
      products by high-resolution gel electrophoresis followed by autoradiography and
      computing densitometry. Derivation of mutational frequency and specificity over a
      wide range of values is demonstrated for M13 viral DNA mixtures containing
      defined proportions of wild-type and mutant DNAs, as well as for M13 viral DNA
      populations obtained by transfection of DNA bearing a defined site-specific
      ethenocytosine lesion. The assay is shown to yield results similar to those
      obtained by laborious clone-by-clone sequencing of viral progeny. The method is
      not affected significantly by several tested variables and appears to be suitable
      for use as a quantitative assay for sequence microheterogeneity at defined
      positions within DNA populations. Application of the methodology demonstrates
      that ethenocytosine, an exocyclic DNA lesion induced by carcinogens such as vinyl
      chloride and urethane, is a highly efficient mutagenic lesion with a mutational
      specificity expected for noninstructive lesions.

PMID- 8471618
TI  - UV irradiation of Escherichia coli modulates mutagenesis at a site-specific
      ethenocytosine residue on M13 DNA. Evidence for an inducible recA-independent
      effect.
AB  - Mutagenic action of chemical and physical mutagens is mediated through DNA damage
      and subsequent misreplication at sites of unrepaired damage. Most DNA damage is
      noninstructive in the sense that the causative chemical modification either
      destroys the template information or renders it inaccessible to the DNA
      polymerase. Noninstructive adducts possess high genotoxicity because they stop
      DNA replication. Replication past noninstructive adducts is thought to depend on
      induced functions in addition to the regular replication machinery. In
      Escherichia coli, noninstructive DNA damage leads to induction of the SOS
      regulon, which in turn is thought to provide the inducible functions required for
      replicative bypass of the lesion. Because of the absence of accessible template
      instruction, base incorporation opposite noninstructive lesions is inherently
      error-prone and results in mutagenesis. Ethenocytosine (epsilon C), an exocyclic
      DNA lesion induced by carcinogens such as vinyl chloride and urethane, is a
      highly mutagenic, noninstructive lesion on the basis of its template
      characteristics in vivo and in vitro. However, mutagenesis at epsilon C does not
      require SOS functions, as evidenced by efficient mutagenesis in recA-deleted E.
      coli. Even though efficient mutagenesis in recA-deleted cells shows a lack of SOS
      dependence, the question remains whether SOS induction can modulate mutagenesis
      opposite epsilon C. To examine the possible contribution of SOS functions to
      mutagenesis at epsilon C, we constructed an M13 duplex circular DNA molecule
      containing an epsilon C residue at a unique site. The construct was transfected
      into nonirradiated or UV-irradiated E. coli.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471619
TI  - CA runs increase DNA flexibility in the complex of lambda Cro protein with the
      OR3 site.
AB  - The alternating pyrimidine-purine elements CA, CAC, and CACA are anisotropically
      flexible, as deduced from gel circularization assays on point mutations and
      single-base mismatches in the OR3 site of lambda phage alone and in the specific
      complex with the Cro protein. These sequences evidently promote DNA bending in
      the specific binding region of the complex and may also facilitate overwinding in
      the central nonbinding region. Effects for CACA are exceptionally large and
      suggest that an alternative DNA structure may occur in this element.

PMID- 8471620
TI  - Kinetics of Escherichia coli helicase II-catalyzed unwinding of fully duplex and
      nicked circular DNA.
AB  - Escherichia coli helicase II (UvrD) protein can initiate unwinding of duplex DNA
      at blunt ends or nicks, although these reactions require excess protein. We have
      undertaken kinetic studies of these reactions in order to probe the mechanism of
      initiation of unwinding. DNA unwinding was monitored directly by using agarose
      gel electrophoresis and indirectly through the rate of ATP hydrolysis by helicase
      II in the presence of an ATP-regenerating system. In the presence of fully duplex
      DNA and excess helicase II, the rate of ATP hydrolysis displays a distinct lag
      phase before the final steady-state rate of hydrolysis is reached. This reflects
      the fact that ATP hydrolysis under these conditions results from helicase II
      binding to the ssDNA products of the unwinding reaction, rather than from an
      intrinsic duplex DNA-dependent ATPase activity. Unwinding of short blunt-ended
      duplex DNA (341 and 849 base pairs) occurs in an "all-or-none" reaction,
      indicating that initiation of unwinding by helicase II is rate-limiting. We
      propose a minimal mechanism for the initiation of DNA unwinding by helicase II
      which includes a binding step followed by the rate-limiting formation of an
      initiation complex, possibly involving protein dimerization, and we have
      determined the phenomenological kinetic parameters describing this mechanism.
      Unwinding of a series of DNA substrates containing different initiation sites
      (e.g., blunt ends, internal nicks, and four-nucleotide 3' vs 5' ssDNA flanking
      regions) indicates that the rate of initiation is slowest at nicks and,
      surprisingly, at ends possessing a four-nucleotide 3' ssDNA flanking region.

PMID- 8471621
TI  - Lipid-amphotericin B complex structure in solution: a possible first step in the
      aggregation process in cell membranes.
AB  - The interactions between the polyene antibiotic amphotericin B with
      dipalmitoylphosphatidylcholine were investigated in vesicles (using circular
      dichroism) and in chloroform solution (using circular dichroism and 1H, 13C, and
      31P nuclear magnetic resonance). The results show that amphotericin B readily
      aggregates in vesicles and that the extent of aggregation depends on the
      lipid:drug concentration ratio. Introduction of sterol molecules into the
      membrane hastens the process of aggregation of amphotericin B. In chloroform
      solutions amphotericin B strongly interacts with phospholipid molecules to form a
      stoichiometric complex. The results suggest that there are interactions between
      the conjugated heptene stretch of amphotericin B and the methylene groups of
      lipid acyl chains, while the sugar moiety interacts with the phosphate head group
      by the formation of a hydrogen bond. A model is proposed for the lipid
      amphotericin B complex, in which amphotericin B interacts equally well with the
      two lipid acyl chains, forming a 1:1 complex.

PMID- 8471622
TI  - Relationship between molecular conversions of acrosin and the progression of
      exocytosis in the calcium ionophore-induced acrosome reaction.
AB  - In this study we used a previously characterized monoclonal antibody to analyze
      the molecular conversions of acrosin during the acrosomal exocytosis induced by
      ionophore A23187. Before sperm exposure to the ionophore, most of the sperm
      acrosin was in the form of proacrosin (55-kDa and 53-kDa forms). Upon exposure to
      the ionophore, the concentration of proacrosin in sperm samples decreased rapidly
      and was negatively correlated with the progression of exocytosis. After 1 h of
      ionophore treatment, proacrosin was quantitatively converted into the two active
      acrosin forms, alpha-acrosin (49 kDa) and beta-acrosin (36 kDa). However,
      products of further acrosin conversions were not found after this treatment. As
      compared with the speed of acrosin activation during sperm contact with the
      ionophore, the ionophore-induced release of acrosin from the sperm cells into the
      soluble fraction was apparently delayed, and only the active acrosin forms (49
      kDa and 36 kDa) were found in sperm incubation media. External Ca2+ influenced
      the speed of proacrosin conversion in a concentration-dependent manner. The
      ionophore-induced activation of proacrosin and acrosome reaction were partially
      inhibited by trypsin inhibitors. The results suggest that proacrosin activation
      is an essential step in the mechanism of the acrosomal exocytosis.

PMID- 8471623
TI  - Thrombin and NaF, but not epinephrine, raise cytosolic free Na+ in human
      platelets.
AB  - We have investigated changes in [Na+]i in SBFI-loaded platelets stimulated at 37
      degrees C with thrombin, epinephrine, and NaF. Basal [Na+]i was 4.9 +/- 1.3 mM (n
      = 70). Stimulation of platelets with thrombin (0.1 U/ml) in the presence of 1 mM
      extracellular Ca2+ rapidly raised [Na+]i by 27.3 +/- 6 mM (n = 16). Part of this
      increase (approx. 20-30%) is caused by Na+/H+ exchange, the rest is predominantly
      due to Na+ influx. Epinephrine (20 microM) failed to change [Na+]i both in the
      absence and presence of fibrinogen. This is in agreement with earlier reports
      showing that epinephrine also fails to activate Na+/H+ exchange in human
      platelets. NaF which activates platelets via a direct effect on GTP-binding
      proteins induced a slow rise in [Na+]i to 9.5 +/- 2.5 mM (n = 4) and 33.0 +/- 3.6
      mM (n = 12) at 10 and 20 mM NaF, respectively. This effect was completely blocked
      by SK&F 96365, a blocker of receptor-mediated Ca2+ entry. Hence, the NaF-induced
      increase in [Na+]i is exclusively due to the opening of non-selective cation
      channels. This latter finding agrees with earlier observations which showed that
      NaF does not induce activation of Na+/H+ exchange in platelets.

PMID- 8471624
TI  - Calcium and GTP-gamma-S as single effectors of secretion from permeabilized rat
      mast cells: requirements for ATP.
AB  - Treatment with metabolic inhibitors and addition of exogenous MgATP exerted
      different effects on secretion from streptolysin-O-permeabilized mast cells,
      responding to calcium and GTP-gamma-S as single effectors (i.e., independently of
      each other). These effects were also strongly dependent on the experimental
      conditions. Thus cells, triggered by Ca2+ at the time of permeabilization, did
      not require MgATP, but after metabolic inhibition rapidly became absolutely
      dependent on its provision, requiring high (> mM) concentrations. AMP-PNP was not
      effective. After longer treatment with metabolic inhibitors, the absolute
      dependence on MgATP was also exhibited by cells responding to dual effectors
      (i.e., Ca2+ and GTP-gamma-S applied together). In contrast, calcium independent
      secretion due to GTP-gamma-S was more resistant to metabolic inhibition,
      exhibiting no absolute requirements for MgATP. Once the responsiveness to GTP
      gamma-S had been lost, it could not be restored by addition of MgATP. MgATP, in
      fact, inhibited the response of permeabilized cells to GTP-gamma-S. This effect
      could be mimicked by AMP-PNP. When permeabilized cells were washed before
      triggering, MgATP (0.1-1 mM concentration range) was no longer inhibitory but
      stimulatory. These differences between Ca(2+)- and GTP-gamma-S-induced responses
      indicate that ATP utilization is essential to the calcium, but not to the guanine
      nucleotide, pathway to secretion. The rate of the response to calcium/MgATP was
      much slower in the absence than in the presence of GTP-gamma-S. The onset of
      secretion occurred after an initial delay. This lag phase was abolished by
      addition of GTP-gamma-S, suggesting that a GTP-binding protein may control a
      reaction which constitutes a rate-limiting step in the secretory process.

PMID- 8471625
TI  - Calcium-induced secretion from permeabilized rat mast cells: requirements for
      guanine nucleotides.
AB  - Cells used in this work were permeabilized by streptolysin-O and then washed to
      remove freely soluble components. The secretory responsiveness of these cells to
      various combinations of calcium, MgATP and guanine nucleotide was characterized
      and in most respects was found to be similar to that of the metabolically
      inhibited (unwashed) cells. The content of adenosine and guanine nucleotides,
      which remain within the permeabilized cells after washing, was estimated as 0.83
      and 0.12 mM (extrapolated to intact cells), which constitutes 18 and 25%,
      respectively, of the total nucleotide content of mast cells. High (> mM)
      concentrations of MgATP, required for the calcium-induced secretion, were reduced
      to microM levels by suboptimal concentrations of GTP, which also markedly
      increased both the rate and extent of the response. Similarly, microM
      concentrations of MgATP reduced the requirements of the calcium-dependent
      secretion for GTP. The synergy of the GTP and ATP effects suggests that,
      together, the two nucleotides can maintain a pool of free GTP, presumably as a
      result of transphosphorylation from ATP to GDP. Thus, MgATP may work by
      transphosphorylating the endogenous GDP. However, neither GTP nor GTP-gamma-S
      were effective as substitutes for MgATP in the calcium-induced secretion,
      particularly that from metabolically inhibited cells. This indicates that MgATP
      does not act simply by providing GTP but is needed to maintain a phosphorylated
      state of the system. The synergistic effects of ATP and GTP were observed only in
      the presence of calcium. To test whether calcium/MgATP-induced secretion requires
      an activated G protein, the effects of G-protein inactivators were studied. GDP,
      deoxy GDP and GDP-beta-S exerted differing degrees of inhibition on secretory
      responses induced by various combinations of effectors. The response to
      calcium/MgATP was less sensitive to these inhibitors than that to GTP-gamma-S
      (with or without calcium). However, all three 'inhibitors' were also capable of
      stimulating calcium/MgATP-dependent secretion, indicating a transphosphorylation,
      producing GTP, dGTP and GTP-beta-S. Thus, in the absence of any specific
      inhibitors for either G proteins or the transphosphorylation reaction, the degree
      of dependence of the calcium-induced secretion on a G protein remains unclear.

PMID- 8471626
TI  - Differentiation of human monoblastic leukemia U937 cells induced by inhibitors of
      myosin light chain kinase and prevention of differentiation by granulocyte
      macrophage colony-stimulating factor.
AB  - Inhibitors of protein kinase activities are useful for the study of intracellular
      signal transduction and some of these inhibitors are reported to induce
      differentiation of human leukemia cells. We examined effects of granulocyte
      macrophage colony-stimulating factor (GM-CSF) in combination with several kinase
      inhibitors on differentiation of human leukemia U937 cells. Nitroblue tetrazolium
      (NBT)-reducing activity, a typical marker of myelomonocytic differentiation, of
      U937 cells was induced by genistein and GM-CSF enhanced this activity. GM-CSF
      also induced the NBT-reducing activity of the cells in combination with 2,5
      dihydroxycinnamic acid methyl ester, psi-tectorigenin and staurosporine, although
      each of them did not induce the activity. Inhibitors of myosin light chain
      kinase, 1-(5-chloronaphthalene-1-sulfonyl)-1H-hexahydro-1,4-diazepine
      hydrochloride (ML-9) and 1-(5-iodonaphthalene-1-sulfonyl)-1H-hexahydro-1,4
      diazepine hydrochloride (ML-7), induced in U937 cells NBT-reduction, and lysozyme
      and alpha-naphthyl acetate esterase activities. GM-CSF inhibited this
      differentiation and counteracted the anti-proliferation effect of the kinase
      inhibitors. These results suggest that some protein kinases are involved in
      differentiation of U937 cells and the kinases inhibited by ML-9 and ML-7 are
      associated with signal transduction of GM-CSF.

PMID- 8471627
TI  - Regulation of eukaryotic translation initiation factor expression during T-cell
      activation.
AB  - Primary T-cells are metabolically quiescent, with little DNA, RNA or protein
      synthesis. Upon mitogenic stimulation the rate of protein synthesis increases 10
      fold. We have studied the role of eIF-2 and eIF-4 alpha (eIF-4E) expression in
      the mechanism of translational activation. During this period, the levels of eIF
      2 alpha and eIF-4 alpha mRNA increase some 50-fold. Similar to the increase in
      ribosomes and mRNA, the number of eIF-2 alpha, eIF-2 beta, and eIF-4 alpha
      molecules per cell also increase 2-3-fold. This suggests that in addition to an
      increase in the pool size of translational components, an additional mechanism
      exists which results in an increased efficiency of factor utilization. We have
      looked at initiation factor phosphorylation. We find that eIF-2 alpha does not
      undergo significant changes in its phosphorylation state nor is there a change in
      the efficiency of eIF-2 utilization. However, there is a rapid increase in the
      phosphorylation state of eIF-4 alpha which correlates with the rapid increase in
      translational activity. It thus appears there are 2 distinct components
      responsible for the translational activation of quiescent T-cells during
      mitogenic stimulation. The first is the phosphorylation of eIF-4 alpha, with a
      concomitant increase in the efficiency of eIF-4 alpha utilization. The second is
      an increase in the pool sizes of eIF-2 and eIF-4 alpha.

PMID- 8471628
TI  - Production and regulation of gelatinase B by human T-cells.
AB  - Here we describe for the first time the production of gelatinase B (MMP 9; 92-kDa
      type IV collagenase) by human peripheral blood T-lymphocytes. Expression of this
      enzyme was found to be dependent on the activation status of these T-cells and to
      be regulated by Interleukin-2.

PMID- 8471629
TI  - Protein kinase C isotypes and signal-transduction in human neutrophils: selective
      substrate specificity of calcium-dependent beta-PKC and novel calcium-independent
      nPKC.
AB  - Neutrophils possess at least two phospholipid-dependent forms of protein kinase
      C, a classical Ca/PS/DG-dependent beta-isotype of protein kinase C and a Ca
      independent but PS/DG-dependent novel protein kinase C (nPKC) which we now
      demonstrate to have different substrate specificities. Activation of human
      neutrophils triggers assembly of an NADPH oxidase in the membrane and generation
      of O2-. A role for the major Ca-dependent isotype beta-PKC in neutrophils is
      proposed in stimulus-induced phosphorylation and association of a cytosolic 47
      kDa protein (p47-phox) with the membrane NADPH oxidase. In this study we
      demonstrate that purified beta-PKC and nPKC have very different substrate
      specificities; beta-PKC but not nPKC phosphorylated both endogenous and
      recombinant p47-phox. In addition, beta-PKC but not nPKC phosphorylated
      [ser25]PKC(19-31), the substrate peptide based on a sequence in the Ca-dependent
      alpha, beta and gamma-isotypes. Pseudosubstrate(19-36), derived from the C
      terminus of Ca-dependent PKC isotypes, inhibited beta-PKC but not nPKC activity
      using either Histone IIIS or peptide(19-31) as substrate. Pseudosubstrate(19-36)
      also inhibited beta-PKC catalyzed phosphorylation of endogenous and recombinant
      p47-phox. Pseudosubstrate(19-36) also inhibited the O2- generation triggered by
      GTP gamma S in electroporated neutrophils by 50%. 32P-Labelled neutrophils
      electroporated in the presence of GTP gamma S showed phosphorylation of multiple
      cytosolic proteins including a 47 kDa band, and phosphorylation of membrane
      associated 34 kDa, 47 kDa and 54 kDa proteins. Pseudosubstrate(19-36) inhibited
      phosphorylation of p47-phox in the membrane but not in the cytosol. These
      findings suggest translocatable, Ca-dependent isotypes of PKC such as beta-PKC
      may play a role in the phosphorylation of membrane associated p47-phox and the
      assembly or maintenance of an active NADPH oxidase.

PMID- 8471630
TI  - Establishment of an enzyme immunoassay system for gliostatin/platelet-derived
      endothelial cell growth factor (PD-ECGF).
AB  - A two-site enzyme immunoassay for gliostatin (GLS)/platelet-derived endothelial
      cell growth factor (PD-ECGF) has been developed. The detection limit of
      gliostatin/PD-ECGF was 30 pg/well, and the optimal assay range was 0.1 to
      ng/well. This assay system enabled us to confirm the immunochemical identity of
      both factors and to detect immunoreactive gliostatin/PD-ECGF (IR-GLS/PD-ECGF) in
      human biological body fluids. The age-related analysis from newborn to 69 years
      revealed that the serum IR-GLS/PD-ECGF level was high in infants younger than 1
      year old (1.8 ng/ml) and in the 20-year-old age group (1.8 ng/ml), and highest in
      the umbilical cord blood (2.1 ng/ml). Curiously high concentrations were detected
      in saliva with a significant sex difference (11.3 ng/ml for males and 48.7 ng/ml
      for females), and in synovial fluids (3.7 ng/ml). A number of human tumor cells,
      gastric cancer cells, MKN-74, neuroblastoma cells, GOTO, as well as epidermoid
      carcinoma cells, A431, were found to produce a significant amount of IR-GLS/PD
      ECGF (0.2 to 21.8 ng/mg protein), and some of them secreted the IR-GLS/PD-ECGF in
      the conditioned medium (approximately 0.5 ng/ml). The enzyme immunoassay system
      is sufficiently sensitive for the basic and clinical study of gliostatin/PD-ECGF
      in human body fluids, tissues and organs.

PMID- 8471631
TI  - The mechanism of inhibition of alkylamines on the mast-cell peptidergic pathway.
AB  - GTP-binding proteins are known to play an important role in controlling mast-cell
      exocytosis and are described as the primary targets of peptidic mast-cell
      histamine releasers. The mechanism of inhibition of the mast-cell peptidergic
      pathway by alkylamines, which are selective inhibitors of this pathway, was
      investigated using intact or permeabilized rat peritoneal mast cells. Histamine
      release induced by GTP gamma S and by mastoparan (a venom peptide activating G
      proteins) was inhibited by pretreating mast cells with 0.1 to 3 micrograms/ml of
      a mixture of benzalkonium chloride containing in majority a twelve-carbon-atom
      aliphatic chain (BAC(C approximately 12)). Pure benzalkonium chloride, with a
      fourteen-carbon-atom aliphatic chain (BAC (C14)), at 5 to 10 microM also
      inhibited histamine release induced by GTP gamma S and mastoparan. The dose
      response curve of mastoparan-induced histamine release from intact mast cells was
      shifted to the right by various concentrations of BAC (C14). Similar results were
      obtained with another alkylamine differing from BAC (C14) by the absence of the
      benzene ring, tetradecyltrimethylammonium bromide, TAB (C14). This illustrates
      that the presence of the phenyl radical is not required for the inhibitory effect
      of benzalkonium chloride. BAC (C approximately 12) and BAC (C14) inhibited the
      generation of inositol polyphosphates induced by GTP gamma S. BAC (C
      approximately 12) and TAB (C14) inhibited the mastoparan-stimulated GTPase
      activity from mast-cell Gi-like proteins. These results suggest that alkylamines
      exert selectively their inhibitory effect via an interaction with mast-cell Gi
      like proteins coupled to phospholipase C, i.e., at an early stage in the stimulus
      secretion coupling process.

PMID- 8471632
TI  - Adenylyl cyclase in lung from hypersensitive guinea pig displays increased
      responsiveness to guanine nucleotides and isoprenaline: the role of the G
      proteins Gs and Gi.
AB  - Basal adenylyl cyclase activity in lung membranes isolated from hypersensitive
      guinea pigs was increased and more sensitive to stimulation by isoprenaline, GTP
      and GppNHp when compared to adenylyl cyclase in lung membranes isolated from
      normal healthy guinea pigs. Maximal forskolin-stimulated adenylyl cyclase
      activity was unaltered. There was no change in the immunological quantitative
      amounts of either alpha subunits of the G proteins GiII and Gs (G(o), GiI and
      GiIII were not present). Maximal pertussis-toxin- and cholera-toxin-catalyzed ADP
      ribosylation of Gi alpha and Gs alpha respectively were not significantly
      altered. The addition of purified protein kinase C to isolated lung membranes
      resulted in the phosphorylation of the alpha subunit of Gs (stoichiometry was
      0.53 mol of 32P incorporated/mol of Gs alpha). Addition of protein kinase C to
      lung membranes isolated from hypersensitive guinea pigs was equally effective at
      catalysing the phosphorylation of the alpha subunit of Gs. GppNHp-stimulated and
      basal adenylyl cyclase activity was also enhanced in isolated tracheal smooth
      muscle membranes from hypersensitive guinea pigs. These results suggest that
      hypersensitive reactions are associated with the improved coupling of the
      stimulatory G protein (Gs) with adenylyl cyclase.

PMID- 8471633
TI  - Primary sites of actions of staurosporine and H-7 in the cascade of insulin
      action to glucose transport in rat adipocytes.
AB  - The insulin-stimulated glucose transporter in rat adipocytes was inhibited by two
      protein kinase inhibitors, staurosporine (SSP) and H-7 (1-(5
      isoquinolinylsulfonyl)-2-methylpiperazine). However, whereas SSP (10 microM)
      blocked the insulin-dependent translocation of glucose transporter, H-7 (3 mM)
      did not. The latter inhibited glucose transporter activity not only in cells, but
      also in reconstituted liposomes. On the other hand, SSP blocked both the action
      of insulin and the insulinomimetic action of GTP gamma S (Guanosine 5'-O-(3
      thiotriphosphate)). GTP gamma S had distinct effects on the glucose transport and
      cAMP phosphodiesterase (PDE) activities. It is suggest that H-7 may inhibit
      glucose transport activity per se; a SSP sensitive protein kinases (protein
      kinase C isoforms?) may be involved in cascade of the insulin action on glucose
      transporter as modulated by GTP gamma S; and glucose transport and PDE activities
      may be regulated by distinct GTP gamma S-sensitive factors.

PMID- 8471634
TI  - Differential effects of activation of protein kinase C and cyclic-AMP-dependent
      protein kinase on sodium-dependent phosphate uptake in NIH 3T3 cells.
AB  - Activation of protein kinase C (PKC) by phorbol ester (PMA), or by diacylglycerol
      analogue (OAG) treatment of NIH 3T3 cells resulted in the rapid (within 2-5 min)
      stimulation (approx. 2-fold) of sodium-dependent phosphate (Pi) transport.
      Conversely, preincubation of these cells with forskolin and cholera toxin, or
      incubation with 8-bromo-cAMP, to activate cAMP-dependent protein kinase (PKA),
      resulted in a decrease in Na+/Pi transport. Activation of either PKC or PKA did
      not change the Vmax of Pi uptake. However, activation of PKC did result in an
      increase, while activation of PKA caused a decrease, in the affinity for Pi.
      These results indicate that there is differential regulation of Na+/Pi uptake in
      NIH 3T3 cells by activators of PKC (stimulated) and PKA (inhibited) as a
      consequence of changes in the affinity of the transporter for Pi.

PMID- 8471635
TI  - [Analysis of the conformational mobility of DNA in transcriptionally-active
      chromatin].
AB  - An attempt is made to estimate the degree of conformational flexibility of DNA in
      different fractions of nucleosomes of transcriptionally active chromatin of
      higher eukaryotes, and in yeast nucleosomes as well. We have used the circular
      dichroism method to estimate conformational changes in DNA induced by temperature
      shift. The DNA conformational potential was shown to be approximately the same in
      all the fractions of nucleosomes under study.

PMID- 8471636
TI  - [From disorder to order using the example of the function of phage T4 baseplate].
AB  - The structure of key elements of T4 baseplate distal part was investigated by
      electron microscopy and image processing. The functional aspects of interaction
      of distal part structures in cell infection process were discussed. According to
      the results obtained earlier the baseplate functioning was suggested to be like a
      synchronization process of the complex protein structure caused by variation of
      external factors.

PMID- 8471637
TI  - [Cleavage time for a hydrogen bond under a load].
AB  - Statistics of the hydrogen bond formation and break in a bundle of actin and
      myosin filaments realizing the attractive force in the sarcomere of a muscle is
      studied. Purely mechanical problem of the attractive-force formation and motion
      of myosin heads and action globules under their action is supplemented by
      accounting for the irreversible processes: 1. Thermal de-excitation of the latter
      in the chain of hydrogen bond during the elementary act of the ATP energy use
      resulting in fixing the extended actin filament. 2. Break of the hydrogen bonds,
      realizing this fixing, due to thermal fluctuations for the time tau. The average
      life-time turns out to be the order of time necessary for the movement of z
      membrane sarcomere for the value of action filament extension delta 1, which is
      necessary for the process of muscle contraction to be continued.

PMID- 8471638
TI  - [Parametric resonance as a possible mechanism of action of superlow
      concentrations of biologically active substances at the cellular and subcellular
      levels].
AB  - At extra-low concentrations of biologically active substances (BAS) the limiting
      stage of processes determining their action at cell and sub-sell levels is BAS
      diffusion to the cell surface. According to proposed parametric resonance model
      the BAS activity extreme values are to be observed when the reciprocal values of
      collision frequency between BAS molecules and cell surface coincide (by order of
      magnitude) with the characteristic times of conformational relaxation of certain
      macromolecular structures responsible of the studied process. The calculation
      results do not contradict the experimental data.

PMID- 8471639
TI  - [Formation of stabile cupola-like lipid bilayer membranes with a mobile plateau
      Gibbs boundary].
AB  - Stable bilayer lipid membrane with mobile Platear-Gibbs border have been formed.
      The predominant condition of the formation is the presence of lipid coverage on
      the teflon surface near the hole. The formation process includes transformation
      of the initial planar lipid bilayer into cupola-shaped one by bowing of the lipid
      bilayer due to hydrostatic pressure, movement of the PGb along the teflon
      surface. The bilayer area estimated by electric capacitance increases from 0.1 x
      10(-8) F to 21 x 10(-8) F. Electric conductance of the lipid bilayer has not
      changed except for the phase transition and membrane collapse. The electric
      capacitance of the BLM formed from hydrogenated egg lecithin was changed by
      cooling between 60 degrees and 40 degrees C with the maximum at about phase
      transition range. The individual membrane sustains several scannings of the
      temperature without disruption which is an evidence of the stability of the
      cupola-shaped membranes.

PMID- 8471640
TI  - [Uterotonic effect of oxytocin and transport of Ca2+ through the myometrial
      sarcolemma].
AB  - Effect of oxytocin on contractile activity, passive and Mg2+, ATP-dependent Ca2+
      transport through myocyte plasmic membrane was studied in the experiments carried
      out on intact samples of the uterus smooth muscle and fraction of myometrium
      sarcolemma vesicules. It was shown that at short-term (30 s) application of
      oxytocin (2.10(-7) M) powerful prolonged contractile reaction of myometrium bands
      was observed. After the chelating of Ca2+ in the washing medium by means of EGTA
      (2mM) or while introducing into it blockers of electrically controlled calcium
      channels the bands responded to oxytocin application with a single physical
      contraction. High concentrations of peptide hormone (10(-6) M) introduced into
      the preincubation medium of the smooth muscle bands before the isolation of the
      membrane fraction or directly into the incubation medium produced no effect on
      passive liberation of Ca2+ vesicules from the sarcolemma vesicules. At the same
      time preincubation of the bands in the solution containing smaller concentration
      of octapeptide (10(-7) M) decreased the initial velocity of Mg2+, ATP-dependent
      Ca2+ transport in the vesicules by 30% on the average. Possible mechanisms of
      oxytocin effects on intracellular homeostasis of Ca2+ in the myometrium, on the
      contractile activity of the uterus are discussed.

PMID- 8471641
TI  - [Postural adjustments to voluntary movements. Electrical activity of muscles and
      biomechanics of the human body in an upright position].
AB  - Involuntary movements of the pelvis and legs which accompany voluntary arm
      flexion and correct the orthograde posture start in most trials in normal
      subjects simultaneously with the voluntary arm movement or later was
      demonstrated. At the same time bursts of legs and trunk muscles activity
      anticipate the burst of m.deltoideus activity. In this situation the
      electromechanical delay (EMD) of m.deltoideus is significantly shorter (13-18 ms)
      than EMD of legs and trunk muscles (70-80 ms). Perhaps more long EMD of legs and
      trunk muscles in orthograde posture "impels" anticipation of its activity for
      economic control of the body position in initial period of a fast voluntary
      movement.

PMID- 8471642
TI  - [Experimental evidence in the use of the new tracking role of imino acids in the
      thermodynamics of collagen type proteins].

PMID- 8471643
TI  - [Ionic pairs in Bacillus intermedius 7P ribonuclease].
AB  - On the basis of X-ray determined coordinates specified with computer graphics and
      new data on amino acids sequence in the structure of Bacillus intermedius 7P
      ribonuclease there were analysed potentially charged residues and found ionic
      pairs binding independently denaturing regions-energetic domains. Five clusters
      of charged amino acids were found in the protein structure and several ionic
      bonds between the energetic domains were discovered: Asp7, Asp11-Arg109 and Lys26
      Asp53,Glu72. Breaking of the latter makes their heat denaturation independent.
      Local surrounding of the ionic bonds is characterized and their role in the
      structure and cooperative properties of the globule is discussed.

PMID- 8471644
TI  - [Molten globule unfolding by strong denaturing agents occurs by the "all or
      nothing" principle].
AB  - The equilibrium Gu-HCl-induced denaturation of bovine carbonic anhydrase B and
      beta-lactamase from Staphylococcus aureus was studied at 4 degrees C by the
      multiparametric approach. With the use of fast protein size-exclusion
      chromatography (FPLC) it has been shown that in the region of the molten globule
      random coil transition the distribution function of the protein molecules on size
      is bimodal, i.e. the protein molecules (which are already denatured) can only in
      one of two conformational states. Consequently the unfolding of the molten
      globule can be of "all-or-none" character. This means that a protein molecule can
      be at least in three discrete states: the native, the molten globule and
      unfolded.

PMID- 8471645
TI  - [The state of unfolded globules of protein molecules is more quickly becoming a
      rule, rather than an exception].
AB  - A review of experimental data concerning physical properties of globular protein
      at mild denatured conditions shows that at the present time about 20th proteins
      were obtained in the "molten globule" state at mild denatured conditions (acid or
      basic pH, high temperature or moderate concentrations of guanidine hydrochloride
      or urea). This state is nearly as compact as the native state and has a well
      pronounced secondary structure but has no rigid tertiary structure. A possible
      role of the molten globule state in the processes of formation and of degradation
      of globular proteins are discussed.

PMID- 8471646
TI  - [Artificial proteins with a given spatial structure and biological activity].
AB  - Biologically active fragment 131-138 of human interferon alpha 2 carrying blast
      transforming activity of the protein was attached to the N-terminus of the de
      novo protein albebetin with predetermined tertiary structure by means of genetic
      engineering. The chimeric protein was expressed in a wheat germ cell-free
      translation system and tested for compactness, stability and biological activity.
      According to the tests used albebetin with interferon fragment has a compact and
      relatively stable structure. It binds murine thymocyte receptor with high
      affinity and activates efficiently thymocyte blast transformation at a
      concentration of 10(-11) M.

PMID- 8471647
TI  - [Mechanisms of death of free radical states in proteins].
AB  - Mechanism of the death of free radicals formed under the effect of different
      destructing factors in proteins without a prosthetic group is considered. The
      death of macroradicals in proteins is suggested to be due to a recombination of
      free radical states of aromatic amino acid residues and atom hydrogen braking
      away as a result of transformation of the middle radicals -NH-C alpha R-CO- from
      the nearest NH-group. Possible way of middle radicals transformation is proposed
      which leads to the breakage of hydrogen. The mechanism of macroradicals death
      considered explains basic experimental results obtained in this field.

PMID- 8471648
TI  - [Self-similarity in the structure of DNA: why are introns needed?].
AB  - Consequences of the hypothesis are analyzed that native spatial structure of DNA
      is the so-called crumpled globule, which is statistically free of knots. Since
      crumpled globule is self-similar fractal object in space, fixation of more or
      less unique chain fold, that is the case for eukaryotes, requires some self
      similarity of the sequence. On this basis we explain quantitatively long-range
      power-law correlations in intron containing genes which have been discovered
      recently, predict some more detailed properties of correlations, which partly
      convinced already in experiment, and formulate a few more general hypotheses on
      the statistical properties of presently unassigned parts of DNA, on the role of
      intron as the instrument of fixation of DNA spatial structure and on the possible
      way of creation of such an apparatus in the evolution.

PMID- 8471649
TI  - [An experimental model of continuous biliary and vascular access in the free rat:
      a study of the changes in biliary function under the influence of the parenteral
      administration of amino acids].
AB  - Total parenteral nutrition is associated with different hepatic alterations such
      as cholestasis, steatosis or cholelithiasis. To study such alterations
      anaesthetised rats, in which the enterohepatic circulation of bile acids is
      interrupted, have been widely used. A model of free moving rat with venous and
      biliary catheterization has been developed in this work. This overcomes the
      interferences induced by anaesthesia as well the alterations in hydrostatic
      pressure or restraint-induced stress present in other models. The use of our
      animal model has confirmed previous data from anesthetised rats indicating that
      parenteral solutions of amino acids induce a cholestasis effect, with decreases
      in bile flow but not significant change in bile acid secretion.

PMID- 8471650
TI  - [A computer program for assessing nutritional status and diet preparation].
AB  - This computer program has been written in a BASIC language and designed to assess
      the nutritional status by means of anthropometrical, immunological and clinical
      data. Additionally, it is useful for the design and elaboration of personalized
      diets. The use of this program will allow to work with a great amount of
      nutritional information, besides, it will outstandingly reduce work time and
      increase accuracy to diagnose specific nutritional problems. The data base of
      this program has been made on the basis of current nutritional information and it
      can be easily updated when necessary.

PMID- 8471651
TI  - [The fructosamine monitoring of the effect on glycemic control of hypocaloric
      parenteral nutritional support with glycerol].
AB  - The objective of this paper is to examine the usefulness of plasmatic
      fructosamine finding as an indicator of glycemic control in patients with
      hypocaloric parenteral nutrition with glycerol. Thirty abdominal surgery patients
      were studied. None displayed malnutrition, diabetes mellitus, hepatopathy,
      nephropathy or hyperlipemia in the preoperative stage or during the five days of
      postoperative recovery they were administered hypocaloric parenteral nutrition
      with glycerol. Their plasma levels of glucose, fructosamine, triglycerides,
      albumin and total proteins were found in the preoperative stage and on the first
      and fourth day of postoperative recovery. Following surgery, findings showed an
      increase in triglycerides and a decrease in the protein compartment, while
      glycemia levels remained steady. Furthermore there was a positive correlation
      between the figures for glycemia and later fructosamine figures. The conclusion
      was that providing hypocaloric nutrition with glycerol does not increase
      fructosamine levels. This confirmed prior observations on the slightness of its
      effect on hydrocarbonic metabolisms.

PMID- 8471653
TI  - [Standard formulas of parenteral nutrition. A study of their use in a general
      hospital].
AB  - The goal of the study was to evaluate the use of parenteral nutrition formulas
      with standardized g. of nitrogen, carbohydrates and lipids, and to analyze
      whether the nutritional requirements of the patients treated in our hospital were
      covered by said formulas or whether it was necessary to change and/or standardize
      a new formula. To do so, a review was made of 5.646 parental nutrition mixtures
      prepared in the Pharmacy Service and patterned by the Nutrition Service from
      April, 1991, to May, 1992, for 308 adult patients. The distribution of the
      mixtures by services, diagnoses and the frequency of the different standard
      formulas were studied, comparing standard formula frequency with that of non
      standard formulas. Findings showed that 41.9% of nutrition mixtures were
      patterned in surgery, and the most common diagnosis, cancer, appeared in 24%. Of
      the mixtures, 67.6% were preestablished formulas, and 32.4% were non-standard
      formulas. The order of frequency among standard formulas was: basic standard
      formulas, stress formulas, initial formulas, peripheral formulas, hemodialysis
      formulas and low-volume formulas. All covered the nutritional needs of a large
      share of the patients for the different pathologies in which they were indicated.
      Nevertheless the question of designing a new formula to cover a greater number of
      situations was raised. Protocolization should take place rationally, to meet the
      hospital's most frequent pathologies, and effectiveness should be evaluated after
      tracking and checking each patient.

PMID- 8471652
TI  - [The effect of the administration of an amino acid solution enriched with
      branched-chain amino acids on the nutritional assessment of patients with stress
      who require total parenteral nutrition].
AB  - The effects of two solutions of amino acids (AA) were compared in the nutritional
      assessment of stressed patients requiring total parenteral nutrition (TPN) by
      finding anthropometric, biochemical and immune parameters on day 0 and day 8. In
      addition, calculations were made to find the nutritional prognosis index, stress
      index nitrogenated balance (NB) and net protein use (NPU). A double-blind
      prospective study was run in which 35 patients with moderate to high stress were
      divided at random into two groups to receive, for seven days, TPN that was both
      isonitrogenated (1.56 g/Kg/day of AA) and isocaloric (115.6 +/- 13.6 non-protein
      Kcal/g. nitrogen), 37% as lipids (LCT), differing only in the AA solution used,
      one being 15.6% and the other, 45% BCAA. Twenty-eight patients finished the
      study, 14 in each group. No significant differences were found between the groups
      in the parameters under study; however, the patients who received the 45% BCAA
      solution obtained superior development of the parameters evaluating nutritional
      status and an increase in their NB (p = 0.0213) and NPU (p = 0.0497). Total
      lymphocytes increased significantly in both groups. Disturbances in hepatic
      enzymes and alkaline phosphatase (AF) were higher than in the standard group.
      Gamma glutamyl transferase (GGT) increased in group I (p = 0.0168), while in
      group II there were increases of GGT (p < or = 0.05), glutamic pyruvic
      transaminase (GPT) (p < or = 0.025) and AF (p = 0.0213). In the standard group,
      plasma urea increased (p = 0.0117), and the creatine/size ratio decreased (p =
      0.0094). Anthropometric measurements were not valid in this study. The results do
      not allow the conclusion to be drawn that the 45% BCAA solution is the most
      effective, but it does make clear that its use is suitable in patients with
      moderate and high levels of stress, changing to standard AA solutions when the
      patients improve.

PMID- 8471654
TI  - [A prospective randomized study of the usefulness of weighted versus unweighted
      feeding tubes. A comparison of the transpyloric passage capacity, duration time
      and the signs of intolerance for enteral nutrition].
AB  - Weighted feeding tubes for parenteral nutrition were designed to facilitate
      duodenal intubation and to reduce the risk of aspiration into the bronchi. The
      goal of the study was to compare the effectiveness of two types of tubes,
      weighted and unweighted, with regard to their ability to pass the pylorus in 24
      hours' time, the time they remained, their involuntary detubation percentages,
      and the appearance of signs of digestive intolerance during enteral nutrition.
      Only patients who preserved some level of consciousness were included. Thirty
      eight were fitted with weighted tubes, and 32 with unweighted tubes. Twenty-four
      feeding tubes reached the duodenum during the first day. The average time the
      tubes remained after insertion was 10.2 +/- 1.1 (range of 1-51) days. In 20
      patients, the tube left the body unnoticed, and 15 displayed signs of intolerance
      to enteral nutrition, though it had to be suspended in the case of only 5.
      Weighted feeding tubes showed greater effectiveness in their duodenal intubation
      rate (47% versus 19%, p = 0.0058), the time they remained in the body (12.2 +/-
      1.7 versus 7.9 +/- 1.1 days; p = 0.037) and their percentage of involuntary
      detubation (6 weighted tubes and 14 unweighted tubes, p = 0.009). There were no
      differences between the two tube types with regard to the appearance of signs of
      digestive intolerance. The weighted tubes that reached the duodenum (n = 18) were
      those which remained for the longest periods; 73% of them remained for over 8
      days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471656
TI  - Hypoplastic myelodysplastic syndrome: incidence, morphology, cytogenetics, and
      prognosis.
AB  - The present study, based upon the retrospective evaluation of 352 patients with
      primary myelodysplastic syndrome (pMDS), revealed hypoplastic MDS in 42 patients
      (11.9%). Median age is similar in hypo- and normo-/hypercellular MDS (72.6 versus
      70.7 versus 72.4 years). Hypoplastic MDS occurred significantly more often in
      women compared with normo- and hypercellular MDS. Sequential biopsies were
      performed in 14 patients, showing a persistence of hypoplasia over a period of up
      to 43 months. The proportion of patients showing mesenchymal reaction, especially
      an increase of mast cells, was significantly higher in hypoplastic MDS, whereas
      dysplastic features of hematopoiesis occurred less frequently and were of lower
      grade in comparison to normo-/hyperplastic MDS. Among the subgroup with
      hypoplastic bone marrow, the classification according to FAB criteria revealed 28
      patients with RA (66.7%), three with RARS (7.1%), and eight with RAEB (19.0%), as
      well as one patient each with RAEB-T and CMMol (2.4% each), and one case which
      had to be reckoned among the category of unclassifiable MDS (2.4%). Median
      survival was 21.8 months for hypoplastic MDS, 26.9 months for normoplastic MDS,
      and 14.2 months for hyperplastic MDS. During follow-up, 14 patients (33%) with
      hypoplastic MDS developed acute nonlymphatic leukemia. Although not a constant
      finding, karyotype abnormalities involving particularly chromosome 7 seem to be
      associated with hypoplastic MDS. The results confirm the existence of a
      hypoplastic variant of MDS which seems to more frequently affect female patients,
      and which requires bone marrow biopsy for its accurate diagnosis.

PMID- 8471655
TI  - Biology and treatment of myelodysplastic syndromes--developments in the past
      decade.

PMID- 8471657
TI  - Analysis of lymphocyte subsets in patients with aplastic anemia before and during
      immunosuppressive therapy.
AB  - To define the contribution of T-lymphocyte subsets in the development of aplastic
      anemia (AA), T-cell subpopulations including alpha beta T cells, gamma delta T
      cells, and delta TCS1-positive gamma delta T cells, were analyzed by
      cytophotometry in the peripheral blood (PB) and bone marrow (BM) of patients with
      AA before and after 6 weeks of therapy with anti-lymphocyte globulin (ALG),
      methylprednisolone, and cyclosporin A (CSA). In nine patients with AA a
      significant decrease of PB- and BM-derived T cells was observed after 6 weeks of
      therapy as compared with normal controls. At diagnosis, the CD4/CD8 ratio in PB
      and BM of the patients did not differ from the ratio in the control population;
      however, a reversed ratio (< 1) was present in PB as well as in BM after weeks of
      therapy. Interestingly, lymphocytes expressing the gamma delta T-cell receptor
      (TCR tau delta) were significantly decreased both before (PB 1.2 +/- 0.1%; BM 0.8
      +/- 0.1%) and after 6 weeks of therapy (PB 0.7 +/- 0.1%; BM 0.7 +/- 0.1%) as
      compared with healthy controls (PB 2.4 +/- 0.2%; BM 2.3 +/- 0.2%). However, the
      proportion of the gamma delta-T-cell subpopulation expressing the delta TCS1
      phenotype was markedly increased before (PB 42 +/- 3.5%; BM 31 +/- 3%) and
      especially after 42 days of therapy (PB 77 +/- 12%; BM 45 +/- 2%) as compared
      with that in normal subjects (PB 19 +/- 2%; BM 9.7 +/- 0.8%). At present, follow
      up is under evaluation to correlate these findings with hematological response.
      The pathophysiological significance of the observed alterations within the T-cell
      subsets and especially the gamma delta T-cell populations will require further
      functional analyses, in particular since delta TCS1-positive gamma delta T cells
      exhibit autoimmunological capacity.

PMID- 8471658
TI  - Phase-II study of treatment of refractory acute leukemia with intermediate-dose
      cytosine arabinoside and amsacrine.
AB  - Twenty-five consecutive leukemia patients (21 AML, 4 ALL) with either primary
      resistance (n = 22) or resistant relapse (n = 3) of all FAB subtypes were treated
      with 1 or 2 cycles of ID-ara C (1 g/m2 i.v. q 12 h, days 1-6) and AMSA (120 mg/m2
      i.v., days 5-7). Patients reaching CR received 1 cycle of intensive consolidation
      using ara C 3 g/m2 i.v. q 12 h, days 1-4 and AMSA 120 mg/m2 i.v., day 5. Two
      patients received an allograft thereafter and are still alive and in CCR. CR was
      achieved in 12/25 patients (48%), ten after 1 cycle of induction and two after 2
      cycles; 10/22 patients with primary resistant disease reached CR, and 2/3 with
      resistant relapse. Nine patients remained refractory (36%) and four died during
      hypoplasia (16%). Median DFS of the 12 responders was 2.9 months, median survival
      from time of CR 8.9 months. Median overall survival of responders and
      nonresponders was 6 months from time of resistance. Survival advantage of
      responding patients (n = 12) as compared with nonresponders (n = 13) was 10.7 vs.
      3.2 months (p = 0.002). Toxicity of chemotherapy was acceptable: one patient
      experienced pulmonary edema due to ara C; two patients developed life-threatening
      systemic fungal infections, one of whom died while in CR.

PMID- 8471659
TI  - IEVM chemotherapy with rhGM-CSF support for aggressive non-Hodgkin's lymphomas: a
      pilot study.
AB  - Modern combination chemotherapy cures about one third of patients with non
      Hodgkin's lymphomas (NHL) [3]. Attempts to increase this proportion by more
      intensive chemotherapeutic regimens have failed so far in randomized trials [4,
      5]. Dose intensity has been reported to be important for cure [8]--a factor which
      can be enhanced by hematopoietic growth factors--but addition of recombinant
      human granulocyte colony-stimulating factor (rhG-CSF) to intensive chemotherapy
      did not improve response on survival in a controlled study published recently
      [10]. Therefore, we tried to design a regimen which might be more appropriate for
      combination with growth factors, using pulse chemotherapy rather than continuous
      treatment and employing drugs of low stem-cell toxicity. Ifosfamide (Ifo)
      appeared to be ideal because it is effective even in some resistant cases [1] and
      might act synergistically with anthracyclines by reducing intracellular
      glutathione levels [9]. Epirubicin (Epi) was favored because of its low hemato-
      and cardiotoxicity [2]. These drugs, together with etoposide (VP-16) had been
      found to be very effective in relapsed cases [7]. Methotrexate (Mtx) was added
      because it penetrates the spinal fluid. Moreover, we chose granulocyte/macrophage
      colony-stimulating factor (rhGM-CSF) as an adjunct cytokine because this not only
      enhances neutrophil regeneration [6] but might also have antitumor effects, as
      suggested by an uncontrolled study in sarcomas [11]. This report summarizes our
      experiences regarding feasibility, toxicity, and responses with this new regimen
      obtained in a pilot study.

PMID- 8471660
TI  - Multiple myeloma: effect of daily dichloromethylene bisphosphonate on skeletal
      complications.
AB  - In 1989, a prospective randomized multicenter study was initiated in order to
      determine the safety and efficacy of oral clodronate in myeloma patients. The
      primary objective of this long-term trial is to evaluate whether supportive
      clodronate is able to prevent or retard the progression of bone disease and
      reduce the occurrence of characteristic complications: pain, pathologic
      fractures, and hypercalcemia. We now report first results as an interim analysis,
      including data obtained from 26 patients (total number of Tubingen patients n =
      36) who entered the study at the Medizinische Universitatsklinik Tubingen.
      Patients were randomized to receive either chemotherapy alone (melphalan 15 mg/m2
      i.v. on day 1 and prednisolone 60 mg/m2 orally on days 1-4 every 4 weeks (control
      group) or in combination with 1600 mg clodronate/day orally as a single dose for
      a period of at least 1 year. Repeated radiologic examinations in addition to
      hematologic and biochemical analysis were performed in order to evaluate the
      skeletal status with respect to lytic bone lesions and osteoporosis and the
      course of serum M protein and light chain excretion into urine. Clodronate
      treatment resulted in a significant decrease of serum calcium concentrations and
      of biochemical indices for bone resorption. No clodronate-related toxicity or
      hypocalcemia was observed. In patients treated with chemotherapy alone, this
      effect was less marked and discontinuous. Clodronate-treated patients developed
      fewer progressive bone lesions (significant for lytic, not for osteoporotic
      lesions). No hypercalcemic episodes occurred in the clodronate-treated patients,
      but there were six episodes in the control group. Whereas the number of vertebral
      fractures was evidently less is clodronate-treated patients, three of those
      patients suffered from multiple fractures of long bones and ribs. All together,
      12 pathologic fractures occurred in five clodronate-treated patients, whereas in
      the control group 23 pathologic fractures occurred in the same number of patients
      during the whole observation period. The final analysis of all multicenter
      included patients should clarify these findings. There was a significant finding
      that clodronate proved to have an analgesic effect.

PMID- 8471661
TI  - Acute agranulocytosis after prolonged high-dose usage of intravenous dipyrone--a
      different mechanism of dipyrone toxicity?
AB  - Two seriously injured trauma patients presenting with intense and progressive
      neutropenia are described. Bone marrow examination in both cases showed virtually
      absent granulopoiesis but normal erythropoiesis and megakaryopoiesis, allowing
      the diagnosis of acute agranulocytosis. Discontinuation of only one drug
      (dipyrone) with no further treatment was required for normalization of blood
      parameters. The association of dipyrone with neutropenia is still debatable. The
      recent medical literature on dipyrone generation of agranulocytosis is reviewed.

PMID- 8471662
TI  - Possible selective effects of interferon alpha-2b on a malignant clone in a case
      of polycythemia vera.
AB  - A patient with polycythemia vera associated with chromosomal translocation (6;8)
      (q27;p11) and IgA monoclonal gammopathy was treated with interferon alpha-2b.
      Interferon alpha-2b induced good hematological control and reduced only IgA
      levels, but not IgG and IgM levels. In addition, cytogenetic improvement was
      obtained, the abnormal cells with chromosomal translocation declining from 100%
      to 50%. Interferon alpha may have selective effects on a malignant clone in
      polycythemia vera.

PMID- 8471663
TI  - Flow-cytometric enumeration of reticulocytes.

PMID- 8471664
TI  - [Diadenosine oligophosphates: metabolic pathways and role in regulating the
      functional activity of cells].
AB  - Recent data on the content and biological role of diadenosine oligophosphates in
      procaryotic and eucaryotic cells, animal tissues and organs are reviewed. The
      specific ways of their synthesis and dissociation are presented. The role of
      diadenosine oligophosphates in regulation of cell proliferation and as protectors
      from cells damage with cytotoxic agents in discussed. The perspectives uses of
      diadenosine oligophosphates in medicine have been examined. The role of a
      universal diadenosine oligophosphates system in regulation of cell biological
      activity is postulated.

PMID- 8471665
TI  - [Study of phage T7 DNA-dependent RNA-polymerase using GTP analogs. Affinity
      modification and study of interaction with matrices using fluorescent markers].
AB  - Interactions of the bacteriophage T7 DNA-dependent RNA polymerase with three GTP
      analogs have been studied. All of the three analogs tested contained substituted
      naphthalenesulphamide groups and were shown to be under appropriate conditions
      irreversible covalent inhibitors of the enzyme, the modified enzyme possessing
      fluorescent properties. One of these analogs contained the reactive 2-bromoethyl
      phosphonate group and was shown to cause the loss of the enzyme affinity for
      polynucleotide templates. The other two modifiers which contained the azide
      reactive group did not alter the enzyme-template affinity, the polynucleotide
      binding leading to a notable increase of the enzyme fluorescence intensity. The
      latter two modifiers are supposed to be convenient for fluorescent labelling of
      the active site of RNA polymerase for enzyme-template binding studies.

PMID- 8471666
TI  - [Status of cell membrane enzymes in hypoxia and the protective effect of
      pyrazidole].
AB  - The influence of hypobaric hypoxia simulating the altitude of 9000 m above the
      sea level during 3 hours on the stability of erythrocyte, lysosomal, and
      mitochondrial membranes, has been studied. The increase in extra erythrocyte
      hemoglobin and free iron concentrations and the total peroxidase activity in
      blood plasma testify to increased permeability of the erythrocyte membrane. An
      increase in the free activity of acid peptide hydrolases in the soluble fraction
      and their activity decrease in the lysosomal membrane. The mitochondrial
      monoamine oxidase activity in the soluble fraction of the brain is suggestive of
      structural damages to the mitochondrial membrane. Preliminary administration of
      pyrasidol prior to hypoxia has a stabilizing effect on all types of membrane
      structures.

PMID- 8471667
TI  - [mRNA with an extended Shine-Dalgarno sequence is translated independently of
      ribosomal protein S1].
AB  - The role of the ribosomal protein S1 in translation of a mRNA containing an
      extended Shine-Dalgarno sequence has been investigated. Using the toe printing
      technique, the formation of a ternary initiation complex with both S1-depleted
      30S subunits and subunits treated with anti-S1 antibodies and mini-mRNA
      containing an lambda-cro-mRNA translational initiation region with a very long (9
      nucleotides) Shine-Dalgarno sequence, has been demonstrated. It is concluded that
      initiation of translation on mRNA with extended SD-sequence is S1-independent. By
      means of an E. coli cell-free system of translation (S-100 extract), the
      translation of mini-cro-mRNA by S1-depleted ribosomes has been shown. In contrast
      with mini-cro-mRNA, the 30S subunits without protein S1 are inactive both in the
      ternary initiation complex formation and in cell-free translation with MS2 or fr
      phage RNAs and RNA protein III of phage fd.

PMID- 8471668
TI  - Multiparameter flow cytometric analysis of the effects of indomethacin on
      adipocyte differentiation in A31T6 cells.
AB  - A31T6 proadipocytes, derived from BALB/c-3T3 clone A31, develop responsiveness to
      differentiation-promoting agents at density-arrest and differentiate into
      adipocytes, as determined by the accumulation of cytoplasmic lipid droplets. A
      flow cytometric assay is being employed to monitor the acquisition of aspects of
      the differentiated phenotype. In this study, the assay is used to monitor both
      the rate of differentiation, as defined by the appearance of cells containing
      lipid droplets and the rate of adipocyte maturation, which involves measurement
      of increases in cytoplasmic lipid in cells already committed to the
      differentiation programme. Specifically, we show that: 1) treatment with a
      combination of indomethacin and dexamethasone causes the maximum percentage
      differentiation in the population, 2) addition of indomethacin in combination
      with either dexamethasone or insulin increases the rate of differentiation, and
      3) indomethacin selectively increases the maturation of adipocytes, measured as
      an increase in the amount of lipid per cell. The cytometric assay used in these
      experiments has allowed determination of the effects of indomethacin on aspects
      of the adipocyte phenotype that cannot be measured by standard techniques.

PMID- 8471669
TI  - In vitro BrdUrd incorporation of colorectal tumour tissue.
AB  - This study describes a novel in vitro method for the incorporation of the
      thymidine analogue, bromodeoxyuridine (BrdUrd), in fresh colorectal tumour
      tissue. Disaggregation by pronase, collagenase and DNAse resulted in high cell
      yields of viable single cell suspensions, representative of the original tumour,
      which could be infiltrated with BrdUrd. A modified ELISA identified optimal
      incubation times and BrdUrd concentrations. This technique has been used in
      preliminary studies to investigate two important areas intrinsic in the analysis
      of BrdUrd colorectal cell proliferation data: 1) to determine the effects of the
      individual constituents of the cell culture media, in particular glutamine, on
      BrdUrd incorporation in suspensions of colorectal cells and 2) to examine the
      denaturation step. This method will have wide applicability in investigations of
      cell proliferation status in both normal and diseased tissue.

PMID- 8471670
TI  - Biochemical and morphological characterizations of DU-145 cell mortality in
      rabbit embryo-fetal fluid.
AB  - Rabbit embryo-fetal fluid (EFF) contains regulatory factors of cell proliferation
      which increase the duration of the cell cycle, induce a quiescent status in some
      cells and lead up to cell death in others. The objective of this study was to
      demonstrate which of the two processes, namely necrosis or apoptosis, was
      responsible for the cell death. Inhibitors of protein synthesis, and nuclease and
      phospholipase A2 activities did not restore the viability of the cells treated
      with EFF. Using a combination of DNA labelling and extraction, it was possible to
      show that a large proportion of DNA was fragmented in the cells released in the
      supernatant while only a very small portion of DNA was fragmented in the
      monolayer cells. EFF did not induce fragmentation of DNA into nucleosome-sized
      subunits as analysed using polyacrylamide gel electrophoresis. Nevertheless,
      using cytofluorometric analysis, it was possible to demonstrate that 50% of the
      cells released in the supernatant contained a lower quantity of DNA per cell than
      in the control cells. This was also observed with EFF-treated monolayer cells but
      not in the control monolayer cells. The reduction of the DNA content per
      monolayer cell became significant at 48 h of treatment with EFF. Electron
      microscopic analysis did not reveal blebbing of the cells. However, depletion of
      glycogen, condensation of mitochondria and increasing number of lysosomes and
      residual bodies were observed upon treatment with EFF. From these experiments we
      conclude that the DU-145 cells treated with EFF do not die by apoptosis, but
      rather seem to die by necrosis.

PMID- 8471671
TI  - The role of the IGF-1 receptor in the stimulation of cells by short pulses of
      growth factors.
AB  - Balb/c 3T3 cells require prolonged stimulation by serum or growth factors to
      enter DNA synthesis. However, in p6 cells, a derivative cell line from 3T3 cells
      which constitutively over-express the insulin-like growth factor-1 (IGF-1)
      receptor, a serum pulse of only 1 h is sufficient for maximal stimulation.
      Furthermore, maximal stimulation of DNA synthesis is also obtained when 3T3
      cells, serum-stimulated for only 1 h, are subsequently incubated with IGF-1. Our
      results indicate that short pulses of growth factors render 3T3 cells capable of
      responding to IGF-1, either by increasing the number of IGF-1 receptors or by
      providing a new substrate for the activated receptor.

PMID- 8471672
TI  - Hydroxyurea exposure alters mouse testicular kinetics and sperm chromatin
      structure.
AB  - The effects of hydroxyurea (HU) on testicular cell kinetics and sperm chromatin
      differentiation were investigated in mice. Whole testis, minced testicular cell
      suspensions and caudal epididymal sperm cells were obtained at 8 and 29 days
      after i.p. injections containing 0, 25, 50, 100, 200, 400 and 500 mg/kg HU x 5
      days. Testis weights were unaffected by 25 mg/kg HU while 500 mg/kg caused up to
      a 50% loss of testicular weight by 29 days. Flow cytometrically measured acridine
      orange (AO) stained testicular cells revealed altered population ratios at the
      highest dosages at 8 days and for all dosages except 25 mg/kg HU at 29 days. At 8
      days, 400-500 mg/kg HU caused a near depletion of tetraploid cells. Flow
      cytometry of AO stained sperm, previously treated with acid to potentially induce
      DNA denaturation, was used to follow the shift from normal chromatin structure to
      an abnormal form with increased sensitivity to DNA denaturation in situ. The
      extent of DNA denaturation was quantitated for each cell by the computer-derived
      value alpha t, alpha t = [red/(red+green) fluorescence]. The flow cytometry
      measures, standard deviation of alpha t (SD alpha t), mean of alpha t (X alpha t)
      and cells outside the main peak of alpha t (COMP alpha t), gave similar dose
      response curves to the sperm head morphology assay. SD alpha t was more sensitive
      than the X alpha t as a measure of HU-induced alteration of chromatin structure.
      The major conclusions reached are that HU inhibits DNA synthesis, probably by
      inhibiting ribonucleotide reductase, causing maturation depletion of pachytene
      spermatocytes and, subsequently, depletion of meiotic daughter cells and
      differentiated cell types leading to mature sperm. This inhibition of DNA
      synthesis is related to an alteration of sperm chromatin structure and abnormal
      sperm head morphology.

PMID- 8471673
TI  - Pre-irradiation of tissue culture flasks leads to diminished stem and progenitor
      cell production in long-term bone marrow cultures.
AB  - Empty plastic tissue culture flasks were exposed to X-irradiation doses of 0.3
      10.0 Gy, prior to the establishment of long-term bone marrow cultures. During the
      course of a 10 week culture period, all irradiated plastic flasks exhibited a
      dramatic decrease in the number of both haemopoietic stem cells and myeloid
      progenitor cells, in the non-adherent layer, when compared with controls. This
      decrease was not due to a decrease in the number of non-adherent cells produced.
      Histological examination of non-adherent cells showed an increase in mature
      granulocytic cells with few blast cells. Morphologically, the adherent layers of
      irradiated flasks demonstrated a delay in appearance or absence of fat cell
      production. X-irradiation of glass tissue culture flasks had no deleterious
      effect.

PMID- 8471674
TI  - Cell proliferation kinetics of the bile duct epithelium of the rat.
AB  - Cell proliferation kinetics of the extrahepatic bile duct were studied by flash
      and cumulative labelling methods and immunohistochemical techniques. We compared
      the cell kinetics of the epithelium of the intra- and extra-pancreatic bile ducts
      and of the bile duct of the ampulla in rats administered intraperitoneally with
      bromodeoxyuridine (BrdUrd). After a single injection of BrdUrd (flash labelling),
      labelled cells appeared in the lower portion of the downgrowths of the epithelium
      in the intra- and extra-pancreatic bile ducts. A gradual accumulation of the
      labelled cells at the surface epithelium was observed during the cumulative
      labelling. After cumulative labelling the labelled cells gradually decreased in
      number and were finally confined to the degenerative cell zone of the surface
      epithelium 30 days later. Similarly, after a single injection of BrdUrd, the
      labelled cells in the bile duct of the ampulla appeared at the lower half of the
      crypt from where they migrated to the upper portion during cumulative labelling.
      These findings indicate that epithelial cells of the bile duct are renewed at the
      lower portion of the downgrowths of the epithelium, or crypt, and shed from the
      surface epithelium or upper portion of the fold. The labelling indices reached
      23.83 +/- 7.47% in the intra-pancreatic bile duct, 14.74 +/- 7.99% in the extra
      pancreatic bile duct and 43.42 +/- 4.40% in the bile duct of the ampulla at the
      end of 70 h cumulative labelling. The fluctuating values of the labelling index
      were higher in the bile duct of the ampulla than in the intra- or extra
      pancreatic bile ducts. These results indicate that the bile-duct epithelium
      undergoes a slower renewal rate than the other parts of the gastrointestinal
      tract, and that the renewal time of the epithelial cells is shorter at the bile
      duct of the ampulla than at the intra- or extra-pancreatic bile ducts.

PMID- 8471675
TI  - Homosexual warriors.

PMID- 8471676
TI  - Hippocampus-amygdala volumes and psychopathology in chronic schizophrenia.
AB  - Volumes of the mesiotemporal structures (hippocampus-amygdala complex) were
      measured in 19 men who were chronic multiepisode schizophrenics and 18 age
      matched healthy controls using T1-weighted contiguous coronal magnetic resonance
      images of 3.1-mm width. Using the level of the mammillary bodies as an anatomical
      landmark, the whole hippocampus-amygdala complex was divided into an anterior
      section (mainly containing amygdaloid tissue) and a posterior section (mainly
      containing the hippocampal formation). Total mesiotemporal tissue volume was
      reduced significantly in the patient group compared to controls (-11%), with
      significant reductions in both left (-20%) and right (-15%) hippocampal sections.
      Reduced limbic tissue volume was associated with increased severity of
      psychopathology. Severity of positive psychotic symptoms (Brief Psychiatric
      Rating Scale [BPRS] psychosis factor) was correlated significantly with right and
      left total mesiotemporal volumes (Spearman rho's = -0.61 p < 0.01). Negative
      symptom scores (BPRS anergia factor, Scale for Assessment of Negative Symptoms
      [SANS] global items) were not significantly correlated with any mesiotemporal
      tissue volumes. The data corroborate and extend previous findings of
      temporolimbic structure volume reduction in schizophrenia, and suggest that the
      positive psychotic symptoms of schizophrenia are associated with anatomic
      anomalies in mesiotemporal structure.

PMID- 8471677
TI  - 5-HT1A agonists disrupt memory of fear conditioning in mice.
AB  - A series of experiments was carried out to analyze the effects of the 5-HT1A
      agonists tandospirone or buspirone on the retention of fear conditioning in mice.
      Fear was produced by pairing tone and shock in a conditioned emotional response
      (CER) paradigm and strength of conditioning was assessed by measuring suppression
      of drinking in presence of tone. Fear conditioning was disrupted if tandospirone
      and buspirone were administered before the conditioning session but not before
      the test trial. Diazepam disrupted conditioning at both times. Tandospirone did
      not disrupt performance if conditioning was tested 1 hr rather than 24 hr after
      training, suggesting that disrupted memory rather than impaired acquisition was
      responsible for the deficit. The effect of tandospirone on fear conditioning
      could be reversed by administration of d-amphetamine prior to the retention test,
      which suggests that information was stored but is inaccessible to normal
      retrieval cues. Tandospirone and buspirone also retarded extinction, a clear
      indication that the disruption caused by these drugs is unrelated to their
      anxiolytic action.

PMID- 8471678
TI  - Severe cognitive impairment in elderly schizophrenic patients: a
      clinicopathological study.
AB  - The severe cognitive impairment that affects many of the elderly schizophrenic
      patients could represent the outcome of schizophrenia in old age for the very
      severe and chronically ill patients or may be the result of lengthy
      institutionalization and somatic treatment. Alternatively, it could be due to the
      presence of concurrent dementing disorders, such as Alzheimer's disease (AD) or
      multi-infarct dementia. Using an identical neuropathological protocol, brain
      specimens from schizophrenic patients who showed evidence of severe cognitive
      impairment were compared with 12 age-matched control cases and the same number of
      age-matched cases of neuropathologically confirmed patients with AD. Despite
      their relatively advanced age (mean age 77.1 years +/- 2.8), none of the
      schizophrenia cases showed sufficient degree of senile plaques and
      neurofibrillary tangle formations to confirm a diagnosis of AD. Other
      neurodegenerative disorders associated with dementia were also not identified.
      These studies suggest that alternative explanations need to be sought for the
      severe cognitive impairment commonly encountered in elderly schizophrenic
      patients.

PMID- 8471679
TI  - A clinical test of noradrenergic involvement in the therapeutic mode of action of
      an experimental antidepressant.
AB  - The noradrenaline (NA) hypothesis of depression is founded primarily on
      preclinical and clinically indirect evidence. In two three-compartment randomized
      parallel clinical trials conducted serially, we examined the significance of NA
      uptake for antidepressant activity. The racemic compound oxaprotiline
      (hydroxymaprotiline) is a highly specific inhibitor of NA uptake, whereas its R-(
      ) enantiomer levoprotiline is totally devoid of this property. Oxaprotiline
      significantly resembled amitriptyline in its antidepressant potential.
      Conversely, levoprotiline significantly resembled placebo in antidepressant
      potential. Therefore, NA uptake was necessary for the observed therapeutic effect
      of this experimental antidepressant.

PMID- 8471681
TI  - Does ECT permanently alter seizure threshold?
AB  - Recent research has raised the possibility that electroconvulsive therapy (ECT)
      results in a persistent elevation of seizure threshold among males. In this
      study, seizure threshold, quantified by the method of limits procedure, was
      assessed at the first and last treatments of 148 consecutive depressed patients.
      Patients with and without a prior history of ECT did not differ in seizure
      threshold at the first treatment, seizure duration at the first treatment or
      averaged across all treatments, or in the magnitude of the seizure threshold
      increase over the ECT course. No evidence was obtained that history of ECT was
      associated with alterations of seizure threshold or seizure duration.

PMID- 8471680
TI  - Thyrotropin response to thyrotropin-releasing hormone in patients with dementia
      of the Alzheimer type.
AB  - Eleven patients with senile dementia of the Alzheimer type and 11 age-matched
      control subjects were given the thyrotropin-releasing hormone (TRH) test. The two
      groups did not differ with respect to peak thyrotropin (TSH) response or TSH
      levels at baseline, 20, 30, and 45 min after TRH injection. There were
      significant differences between the groups on Hamilton Depression Rating Scale
      scores (p < 0.03), although neither group met clinical criteria for depression.
      Items that were significantly different pertained to depressed mood, loss of
      interest, loss of insight, suicidal ideation, and obsessional symptoms.

PMID- 8471682
TI  - Blunted TSH and unaltered PRL responses to TRH following repeated administration
      of TRH in neurologic patients: a replication of neuroendocrine features of major
      depression.
AB  - A blunted thyrotropin (TSH) and an unaltered prolactin (PRL) responses to
      thyrotropin-releasing hormone (TRH) are widely recognized in neuroendocrinology
      of depression. We studied effects of repeated TRH administration of 1 mg/day for
      10 days on the pituitary-thyroid axis function and PRL secretion in 16 euthyroid
      patients with neurological disorders. Although levels of serum thyroid hormones
      and of nonstimulated PRL were not affected by the treatment, baseline TSH levels
      were markedly inhibited. A blunted response of TSH to TRH was found without a
      significant effect on a PRL response to TRH after long-term treatment with TRH in
      four patients in whom a TRH test was performed. These changes are similar to
      those in depressed patients. TRH administration in this manner replicates a
      lowered sensitivity of thyrotrophs of the pituitary with a normal responsibility
      of lactotrophs in depression.

PMID- 8471683
TI  - Spectral and topographic analysis of EEG in schizophrenic patients.
AB  - The authors performed spectral analysis of electroencephalograms (EEG), recorded
      awake, with eyes closed, in 13 patients with schizophrenia and 9 age-matched
      individuals without psychiatric diagnosis. We tested several possible
      parameterizations of the data, and two data-reduction strategies; these yielded
      similar results. Comparison of the two groups revealed a relative increase in
      alpha frequency activity in the frontal regions in the patient group. The authors
      believe that this finding is consistent with data from neuropsychologic tests,
      metabolic imaging studies, and evoked potential studies that suggest impaired
      activation of frontal brain areas in patients with schizophrenia.

PMID- 8471684
TI  - Desipramine reduces plasma but not brain thyroxine levels.

PMID- 8471685
TI  - Panic attacks induced by doxapram.

PMID- 8471686
TI  - A preliminary assessment of sensorimotor gating in patients with obsessive
      compulsive disorder.

PMID- 8471687
TI  - Elevated plasma dopamine in posttraumatic stress disorder: a preliminary report.

PMID- 8471688
TI  - Primate models, supermonkeys, and weaklings.

PMID- 8471689
TI  - Postural sway in children from pedigrees exhibiting a high density of alcoholism.
AB  - A total of 98 children participated in a study of the neurobehavioral
      characteristics of individuals from pedigrees in which there was a high density
      of alcoholism. Two groups of children were evaluated (High and Low Risk) using a
      sensitive movement platform and a variety of methods to challenge the motor
      system. High-Risk children showed a greater decrement in postural steadiness when
      visual input was removed than did Low-Risk children. Additionally, the monopedal
      stances revealed hemispheric differences in postural sway as a function of risk
      status. The amount of sway exhibited was correlated with the latency of P300
      recorded using a visual task. Both appear to be indicators of neuropathological
      changes. The present results suggest that postural sway may be a neurobehavioral
      marker for alcoholism risk.

PMID- 8471690
TI  - Ambulatory polysomnography of never-depressed borderline subjects: a high-risk
      approach to rapid eye movement latency.
AB  - The sleep parameters of never-depressed borderline subjects and age- and sex
      matched normal controls were compared by continuous 48-hr ambulatory
      electroencephalographic (EEG) monitoring. Borderline subjects had a significantly
      shorter rapid eye movement latency, normal architecture of rapid eye movements
      sleep, and had familial risks for mood disorders four times greater than in the
      families of controls. Reduced latency of rapid eye movement can be a trait
      indicator of liability to depression, present before the clinical appearance of
      the disorder, and demonstrable in a putative high-risk population.

PMID- 8471691
TI  - The reliability of P50 suppression as measured by the conditioning/testing ratio
      is vastly improved by dipole modeling.
AB  - Suppression of auditory P50 evoked potential amplitude to the second of a pair of
      clicks is potentially important in psychiatric research because it has been shown
      to be abnormal in both schizophrenics and their relatives. However, its clinical
      utility using the standard single-channel electroencephalographic (EEG) peak
      picking methodology is under question because of low test-retest reliability.
      Dipole Components Modeling of the P50 component was attempted as a method for
      increasing the reliability of the P50 suppression measure. It was hypothesized
      that this procedure might work because of pooling of noise from the two responses
      and because of the use of topographic information. Six replications of a P50
      suppression paradigm in 12 subjects were analyzed. Reliability using peak picking
      was 0.27, and was significantly increased to 0.63 using dipole modeling. Dipole
      modeling was helpful not only for better modeling the P50 when it was present,
      but also for deciding that there was no P50 response in one subject.

PMID- 8471692
TI  - Lack of evidence for Huntington's disease-like cognitive dysfunction in obsessive
      compulsive disorder.
AB  - Cognitive deficits in patients with structural lesions of the basal ganglia
      (e.g., Huntington's disease) commonly include slowed processing, reduced verbal
      fluency, difficulty switching set, impaired egocentric spatial ability, poor
      recall, and impaired acquisition of motor skills. The goal of this study was to
      determine if patients with obsessive-compulsive disorder (OCD) would have a
      similar pattern of cognitive dysfunction. A battery of neuropsychological tests,
      including reaction time-based measures of cognitive processing speed and a test
      of procedural, motor-skill learning, was administered to 17 unmedicated OCD
      patients and 16 age-and education-matched normal controls. Eleven individuals
      with trichotillomania, matched with the OCD patients on age, education, age at
      symptom onset, depression, and anxiety were also tested. Contrary to expectation,
      neither the OCD nor trichotillomania patients were impaired on any of the
      measures in the battery. The essentially normal performance by these patients
      suggests that the brain regions responsible for cognitive dysfunction in patients
      with Huntington's disease may differ from those associated with OCD.

PMID- 8471693
TI  - Cerebellar vermal size in schizophrenia: a male effect.
AB  - Magnetic resonance (MR) was used to examine the cerebellar vermis in 23 patients
      with schizophrenia and 16 matched controls. MR midsagittal images were processed
      with computerized image analysis to control partial volume effects as precisely
      as possible. No between-group differences were found for vermal-to-cerebrum
      ratio. When gender differences were examined, male patients showed a lower vermal
      to-brain ratio than their female counterparts, mainly because of a reduction of
      the lobules I-V.

PMID- 8471694
TI  - Effects of gender and social isolation on electroencephalogram and neuroendocrine
      parameters in rats.
AB  - Social separation/isolation from either maternal or peer influence can induce a
      biobehavioral response in rodents and nonhuman primates seeming to mimic certain
      aspects of human psychopathology. To further explore this paradigm, the effects
      of 6 weeks of social isolation on electroencephalographic (EEG) recordings and
      hypothalamic-pituitary-adrenal (HPA) functioning were studied in male and female
      adult rats. Gender differences were observed in EEG and HPA axis functioning in
      these rats. Female rats, overall, were found to have higher levels of EEG slow
      wave activity over the entire recording period, suggesting more intense levels of
      slow-wave sleep in those animals. Female rats were also observed to have overall
      higher plasma corticosterone concentrations and a lower anterior pituitary
      corticotropin-releasing factor (CRF) receptor density compared with male rats.
      The male rats, however, showed greater changes in response to social isolation
      than female rats. EEG power was increased as a result of social isolation in the
      male animals during the first 30-100 min of the recording. Reductions in the
      number of CRF receptors were also observed in the brains of the socially isolated
      rats in several cortical areas; however, again this effect was more prominent in
      the male animals. These studies suggest that gender is an important variable in
      determining the biobehavioral response to social isolation.

PMID- 8471695
TI  - Platelet serotonin-2 receptors in obsessive-compulsive disorder.
AB  - To examine the role of serotonin-2 (5-HT2) receptors in obsessive-compulsive
      disorder (OCD), we studied 5-HT2 receptors in platelets obtained from patients
      with OCD (n = 20) during a drug free baseline period, as well as in normal
      control subjects (n = 25). The maximum number of binding sites (Bmax) and the
      apparent dissociation constant (Kd) of 5-HT2 receptors were determined by
      receptor binding techniques using 125I-lysergic acid diethylamide (LSD) as
      radioligand. We observed that the mean Bmax of 125I-LSD binding in platelets of
      patients with OCD was not significantly different when compared with normal
      control subjects. There was also no significant difference in Kd values between
      patients with OCD and normal control subjects. To examine whether the baseline 5
      HT2 receptors are related to the severity of illness, we determined the
      relationships of the baseline Bmax and Kd with baseline scores of the Hamilton
      Depression Rating Scale (HDRS), the Yale-Brown Obsessive-Compulsive Scale (Y
      BOCS), and the National Institute of Mental Health (NIMH) Obsessive-Compulsive
      scale (GOCS). We found no significant correlation between baseline Bmax and Kd
      with the baseline HDRS, Y-BOCS, or NIMH-GOCS scores. Our results do not indicate
      abnormal 5-HT2 receptors in platelets of patients with OCD.

PMID- 8471696
TI  - Serotonin uptake inhibition by the monoamine oxidase inhibitor brofaromine.
AB  - The selective, reversible monoamine oxidase (MAO) A inhibitor brofaromine
      inhibits serotonin (5-HT) uptake in animal models in vitro and in vivo. We
      investigated whether such an effect can be demonstrated at clinical doses in
      humans by treating three groups of six volunteers with either placebo, 15 mg
      phenelzine three times a day, or 75 mg brofaromine twice a day in a 2-week
      experiment. As an indirect, although relevant parameter, binding of 3H-paroxetine
      to the 5-HT uptake sites on blood platelets was assessed. Moreover, whole-blood 5
      HT as a measure of platelet 5-HT, and serum homovanillic acid (HVA) to
      tentatively estimate MAO inhibition, were determined. Brofaromine reduced 3H
      paroxetine binding to platelets compared with placebo by 20%-25% throughout the
      treatment period, significance being reached on the last treatment day. In
      contrast, phenelzine tended to increase 3H-paroxetine binding. Both drugs
      increased whole-blood 5-HT to approximately 140%-150%. Brofaromine moderately and
      on some days significantly decreased serum HVA, whereas phenelzine only tended to
      do so. Our results suggest that brofaromine at the clinically used dosage of 150
      mg/day does indeed inhibit 5-HT uptake, as evidenced by measurements of 3H
      paroxetine binding to platelets.

PMID- 8471697
TI  - Platelet cytosolic free-calcium concentration is increased in aging and
      Alzheimer's disease.

PMID- 8471698
TI  - Seizure duration, estimation: definition vs. ECT device model.

PMID- 8471699
TI  - [Nursing consultations in primary health care].

PMID- 8471700
TI  - [The prior appointment program: what was expected and what has been gained?].

PMID- 8471701
TI  - [Maternity in adolescents at high social risk].
AB  - OBJECTIVE: To analyse for the 1987-1990 period the indicators of prenatal care
      and the social-health follow-up of adolescent girls included in the mother-child
      programme of Ciutat Vella (Barcelona). This programme was aimed at pregnant women
      resident in the district and with high social risk profiles. DESIGN: Descriptive
      and retrospective study. MEASUREMENTS AND MAIN RESULTS: 175 adolescent mothers
      were included in the programme during the period under study. This represented
      82.9% coverage of all births in the district to this age group. In 10.9% of cases
      the mother stated she lived alone. 10.2% had had a previous child. There were
      drug addiction antecedents in 5% of the mothers. The first prenatal check took
      place during the first three months only in 56% of the pregnancies, with the
      proportion of low weight births (LWB: weight at birth below 2,500 grams) at
      13.1%. During the period under study the proportion of pregnant women checked in
      the first three months went up from 45.6% to 62.5%, while the proportion of LWB's
      went down from 19.3% to 6.3%. CONCLUSIONS: There has been both a striking
      improvement in the indicators of prenatal care and less low weight births during
      the first four years of this programme. It is worth noting the worrying fact that
      one third of pregnant adolescents do not attend for a prenatal check-up before
      three months of their pregnancy have elapsed.

PMID- 8471702
TI  - [The epidemiology of rheumatic diseases in the Principality of Asturias].
AB  - OBJECTIVE: To determine the prevalence of rheumatic illnesses in the Principality
      of Asturias. DESIGN: Crossover study, consisting of an interview and a medical
      examination, administered to 702 people selected in a random fashion, in line
      with multi-stage and proportional sampling. Validated criteria for the diagnosis
      of rheumatic pathology were applied. SETTING: Urban and rural population
      throughout the Autonomous Community of the Principality of Asturias. RESULTS:
      There was a 75.6% response (702 people). In these a 23.8% prevalence of arthrosis
      was found, with a significantly higher proportion among older people and women.
      The second most common condition was rheumatism in soft parts; and then
      lumbalgia, which predominates in middle age. Inflammatory arthropathies are much
      less common (2.5%) in the general population. 6.1% of the sample presented a
      rheumatic pathology that could not be adequately defined. CONCLUSIONS: Rheumatic
      illnesses are extremely common among the general population. Arthrosis,
      rheumatism of the soft parts and lumbalgia are the most customary conditions.
      Their prevalence is much greater than that of inflammatory rheumatism.

PMID- 8471703
TI  - [The companion at the clinical interview].
AB  - OBJECTIVE: To discover how often patients attend a clinical interview with a
      companion; and to define this companion by the variables of age, gender, reason
      for the interview, the relationship (friend or relation) and his/her typology.
      DESIGN: This was a descriptive, prospective study. SETTING: The study was carried
      out in the Almanjayar and Cartuja Health Centres. PATIENTS AND OTHER
      PARTICIPANTS: The 899 people who attended for a consultation during the last week
      of July, 1991, were included in the study. MEASUREMENTS AND MAIN RESULTS:
      Companions were present in 39.15% of the clinical interviews. Patients under 20
      and those with acute complaints were those who most commonly attended with a
      companion. 94% of the companions were family members: most commonly, the mother
      or the husband/wife. 18.7% of the companions caused conflict. CONCLUSIONS: The
      companion can be seen as an important element of the health network as well as a
      social support. Companions with a collaborative attitude can be used to find out
      clinical data and family background during the interview; whereas difficult or
      sick companions require a particular approach to prevent their interfering with
      the development of the clinical interview.

PMID- 8471704
TI  - [The introduction of a program of preventive activities at a health center].
AB  - OBJECTIVE: To define the effect of preventive activities on the population served
      by a health centre; and to make a comparison between the two different shifts, on
      one of which a preventive programme functioned, whereas on the other it did not.
      DESIGN: A descriptive study, using systematic random sampling and internal
      crossed auditing of the health centre's clinical records. SETTING: An urban
      primary care centre. PATIENTS AND OTHER PARTICIPANTS: Two samples of 175 patients
      from both morning and afternoon shifts were compared. INTERVENTIONS: The
      following were studied: antitetanus and German measles vaccinations; control of
      arterial tension; control of cholesterolaemia; a questionnaire on tobacco and
      alcohol consumption. MEASUREMENTS AND MAIN RESULTS: No differences were observed
      in the homogeneity of the tests carried out (DVS = 413.28, p = NS; chi squared =
      9.67, p = NS). Important differences were observed in the percentages for the
      preventive activities carried out. These differences were in favour of the
      morning shift, where the tests were part of the programme, and were statistically
      significant for all tests. Differences were greater in the younger age-groups.
      CONCLUSIONS: Introducing and integrating a programme of preventive activities
      into the daily activity of the consulting room, significantly improves the
      effectiveness of these activities. We believe therefore that the introduction of
      such activities in the form of a programme should be encouraged.

PMID- 8471705
TI  - [Self-perceived health, the use of services and drug consumption in a
      noninstitutionalized older population].
AB  - OBJECTIVE: To describe the self-perceived health status, the use of services and
      drugs consumption of the elderly population in Toledo province. DESIGN:
      Descriptive crossover study. SETTING: Primary Care, Toledo province. PATIENTS AND
      OTHER PARTICIPANTS: 591 people over 65 and not in an institution. Stratified
      according to age, gender and place of residence. MEASUREMENTS AND MAIN RESULTS: A
      validated questionnaire was administered to the elderly people in their homes.
      86.6% of them suffered from at least one chronic illness: the average was 2.30
      per person. 55.2% referred to chewing problems; 43.2% to difficulty in walking;
      69.2% to sight problems; and 40.3% to hearing trouble. 59.6% had visited the
      general doctor at least once during the previous month. During the previous two
      weeks, 71.6% had taken at least one medicine prescribed by the doctor; and 21.2%
      had taken medicine on their own initiative. CONCLUSIONS: There was coincidence
      between the perception of their own health status, the number of chronic
      complaints from which they suffered, the frequency of use of the health services
      and the number of drugs consumed. Women and those over 75 were those who
      described their own health in the most negative way.

PMID- 8471706
TI  - [Osteitis condensans ilii].
AB  - OBJECTIVE: The description of a case of osteitis condensans ilii. DESIGN:
      Descriptive. SETTING: Base health area. PATIENTS AND OTHER PARTICIPANTS: A 24
      year-old puerperal woman. INTERVENTIONS: Analgesic treatment. MEASUREMENTS AND
      MAIN RESULTS: We were presented with the history of a woman with low lumbar pain
      of a mechanical character, after a dystocial birth two months previously. The
      radiology showed a triangular bony condensation on the edge of the sacroiliac
      joints. CONCLUSIONS: Osteitis condensans ilii is a benign structure, almost only
      ever found in women who have borne children. Its presentation is asymptomatic or
      nonspecific (low lumbalgia). Its very specific radiological image needs to be
      distinguished carefully in order to avoid diagnostical confusion with ankylosing
      spondylitis and other causes of sacroiliitis.

PMID- 8471707
TI  - [The degree of agreement in the radiological interpretation of the growth of left
      cardiac cavities between the radiologist, the family physician and residents in
      family and community medicine].
AB  - OBJECTIVE: To discover the level of agreement about the radiological
      interpretation of the growth of left-side cardiac cavities, between the referring
      radiologist (Rx), a family doctor (FD) and three interns studying the third year
      of family and community medicine (IFCM). DESIGN: Observational crossover study.
      SETTING: Primary Care (PC). The Perpetuo Socorro Health Centre in Huesca.
      PATIENTS AND OTHER PARTICIPANTS: Hypertense patients included in the programme of
      one of the general medicine sections. MEASUREMENTS AND MAIN RESULTS: There were
      69 thorax radiographies (TXR), 10 of which were repeated in order to assess the
      level of agreement between different evaluations by the same observer (intra
      observer). Out of these 69, there was agreement between observers in 39 cases
      (66.10%) with Kappa Index (KI) 0.39 +/- 0.12 for two IFCMs (2 and 3); in 44
      (74.57%), with KI 0.55 +/- 0.12 for the first IFCM; and in 40 (67.10%), with KI
      0.39 +/- 0.12 for the FD. The intra-observer agreement was 80% with KI 0.50 +/-
      0.29, 60% with KI 0.20 +/- 0.23 and 90% with KI 0.80 +/- 0.23 for the three
      IFCM's. It was 70% with KI 0.34 +/- 0.27 for the FD and 80% with KI 0.48 +/- 0.29
      for the Rx. CONCLUSIONS: Both the inter- and intra-observer agreement levels were
      insufficient. We propose that our training during the period of specialisation
      should be strengthened on the most useful questions from the PC point of view.
      Studies of this sort need to be carried out in PC in order to obtain maximum
      benefit from these complementary tests.

PMID- 8471708
TI  - [The early detection of oral cancer].

PMID- 8471709
TI  - [The intradermal reaction or Mantoux test. The status of the question].

PMID- 8471710
TI  - [The organization of a health center starting with citizen participation. The
      example of the Centro de Salud Vicente Soldevilla].

PMID- 8471711
TI  - [Auricular fibrillation in a young patient].

PMID- 8471712
TI  - [The guarantee of the quality of prenatal care at a rural health center].

PMID- 8471713
TI  - [Fanconi's anemia].

PMID- 8471714
TI  - [Participatory research in Cuenca Lechera, Departamento de San Jose].

PMID- 8471715
TI  - [The evaluation of a diabetes program in primary care].

PMID- 8471716
TI  - [Considerations on the relevance of original publications].

PMID- 8471717
TI  - Elementary theory of Brownian motion of trapped domains in lipid monolayers.
AB  - An elementary theoretical model is described for the Brownian motion of circular
      lipid domains electrostatically trapped within larger circular lipid domains in
      monolayers at the air-water interface. Earlier work is briefly reviewed, in which
      it is shown that the r.m.s. amplitude of the trapped Brownian motion follows a
      simple Maxwell-Boltzmann distribution, and can be used to determine the absolute
      value of the difference of dipole densities in the two co-existing phases [mu]. A
      comparison of this dipole density difference with that obtained from surface
      potential measurements provides a critical test of the theoretical model. It is
      also shown that the kinetics of Brownian motion can be analyzed to provide
      information on monolayer fluid mechanics and to provide a further test of the
      model. It is pointed out that the ease with which domain movements can be
      observed in the fluorescence microscope, coupled with the fact that the energies
      involved are only of the order of magnitude of kT, suggests that lipid monolayers
      can be used to detect weak specific intermolecular bonds between ligands
      incorporated in the lipid monolayer, and receptors fixed in the aqueous subphase.

PMID- 8471718
TI  - Glycosphingolipid acyl chain orientational order in unsaturated
      phosphatidylcholine bilayers.
AB  - The glycosphingolipid, galactosyl ceramide (GalCer), was studied by 2H nuclear
      magnetic resonance (NMR) in fluid phospholipid bilayer membranes, with regard to
      arrangement of its acyl chain. For this purpose, species with perdeuterated 18
      carbon fatty acid (18:0[d35]GalCer) or with perdeuterated 24-carbon fatty acid
      (24:0[d47] GalCer) were dispersed in bilayers of the 18-carbon phospholipid, 1
      stearoyl-2-oleoyl-phosphatidylcholine (SOPC). For 18:0[d35] GalCer, smoothed
      profiles of the order parameter, SCD, were found to be very similar to one
      another over the range of glycolipid concentration, 5-40 mol%. In addition, they
      were very similar to orientational order parameter profiles well known from the
      literature on phospholipid and glycolipid acyl chains (which deals in general
      with membranes of homogeneous chain length in the range 14-18 carbons).
      Corresponding order parameter profiles for the long-chain species, 24:0[d47]
      GalCer, were also similar to one another for glycolipid concentrations between 5
      and 40 mol%. Their shapes, however, were distinctly different from those of the
      shorter chain analogues. SCD profiles for the two species were quantitatively
      similar to a membrane depth of C15. SCD values at C16 and C17 were approximately
      20 and 30%, respectively, higher for the long-chain glycosphingolipid than for
      its short-chain analogue in SOPC. Nitroxide spin labels attached rigidly to C16
      of the long-chain glycolipid in SOPC gave electron paramagnetic resonance (EPR)
      order parameters that were twice as high as for a spin label at C16 on the
      shorter chain glycolipid. Comparison was made between spectra of 24:0[d47] GalCer
      in SOPC and fully hydrated bilayers of the pure 24:0[d47] GalCer, a system that
      is considered to be partially interdigitated in fluid and gel phases. The
      resultant 2H NMR order parameter profiles displayed similar features, indicating
      that related organizational properties exist in these fluid systems. Effective
      chain length of 24:0[d47] GalCer within the SOPC membrane was calculated using
      the method of Schindler and Seelig (1975. Biochemistry, 14:2283-2287). The result
      suggested that the long-chain fatty acid should protrude roughly one third of the
      host matrix chain length across the bilayer midplane. However, a treatment of the
      same order parameters making very few assumptions about chain conformation
      indicated a high degree of orientational flexibility for the "extra" length of
      the long chain fatty acid. It seems likely that a realistic treatment of the long
      chain fatty acidin a shorter chain fluid host matrix considers interdigitation as
      a subset of the conformational possibilities, many of which are rapidly
      interconverting on the NMR timescale of 10-4_10-5 s and longer lived on the EPR
      timescale of 10-8_10-9 s.

PMID- 8471719
TI  - Molecular dynamics simulation of Pf1 coat protein.
AB  - The results of molecular dynamics simulations of Pf1 coat protein are described
      and compared to experimental NMR data on both the membrane bound and structural
      forms of this viral coat protein. Molecular dynamics simulations of the 46
      residue coat protein and related model sequences were performed according to a
      simple protocol. The simulations were initiated with the polypeptides in a
      completely uniform alpha helical conformation in a dielectric continuum (epsilon
      = 2) and the motions of individual residues were followed as a function of time
      by monitoring the angular fluctuations of amide NH bond vectors. The simulations
      of Pf1 coat protein were able to identify the same mobile and structured segments
      found in experimental NMR studies of the membrane bound form of the protein
      (Shon, K.-J., Y. Kim, L. A. Colnago, and S. J. Opella. 1991. Science (Wash. DC).
      252:1303-1305). Significantly, in addition to mobile amino and carboxyl terminal
      regions, a mobile internal loop was found that connects the rigid hydrophobic and
      amphipathic helices in the protein. NMR experiments show that this mobile loop is
      present in both the viral and membrane bound forms of the protein and that it
      plays a role in viral assembly (Nambudripad, R., W. Stark, S. J. Opella, and L.
      Makowski. 1991. Science (Wash. DC) 252:1305-1308). The results of simulations of
      several alanine based 46 residue polypeptides with some of the charged residues
      present in the Pf1 coat protein sequence suggest that interactions between the
      Asp 14 and Asp 18 sidechains and the peptide backbone are responsible for the
      formation of the mobile loop. The agreement between the results of the
      calculations presented here and the previously reported NMR experiments suggest
      that molecular dynamics simulations might be useful in the prediction of the
      secondary structure and dynamics of individual residues in membrane and
      structural proteins with predominantly alpha helical secondary structure.

PMID- 8471720
TI  - Fluorescence lifetime imaging microscopy (flimscopy). Methodology development and
      application to studies of endosome fusion in single cells.
AB  - A new method of fluorescence microscopy for cell imaging has been developed that
      takes advantage of the spatial variations of fluorescence lifetimes in single
      cells as a source of image contrast, and thus it is named "fluorescence lifetime
      imaging microscopy (flimscopy)". Since time-resolved fluorescence measurements
      are sensitive to molecular dynamics and interactions, flimscopy allows the
      molecular information to be visualized in single cells. In flimscopy
      measurements, several (nanosecond) time-resolved fluorescence images of a sample
      are obtained at various delay times after pulsed laser excitation of the
      microscope's entire field of view. Lifetimes are calculated pixel-by-pixel from
      these time-resolved images, and the spatial variations of the lifetimes are then
      displayed in a pseudocolor format (flimscopy image). The total data acquisition
      time needed to obtain a flimscopy image with the diffraction-limited spatial
      resolution (approximately 250 nm) is decreased to just approximately 30 s for
      approximately 300 fluorescent molecules/micron2. This was achieved by developing
      a high-frequency (400 kHz) nanosecond-gating (9 ns full width at half height)
      signal accumulation system. This technique allows the extent of resonance energy
      transfer to be visualized in single living cells, and is free from the errors due
      to variations in path length, light scattering, and the number of fluorophores
      that necessitate complex corrections in steady-state microfluorometry and
      fluorescence ratio imaging microscopy. Flimscopy was applied here to observe the
      extent of fusion of individual endosomes in single cells. Results revealed the
      occurrence of extensive fusion between primary endocytic vesicles and/or sorting
      endosomes, thereby raising the possibility that the biogenesis of sorting
      endosomes involves multiple fusions of primary endocytic vesicles.

PMID- 8471721
TI  - Physical characterization of cyclosporine binding sites in lymphocytes.
AB  - The binding of cyclosporine to human peripheral blood lymphocytes (PBLs) was
      studied by measuring the fluorescence emission spectrum and lifetime of the
      fluorescent and immunosuppressive cyclosporine derivative dansyl-cyclosporine
      (DCs). The emission maximum and fluorescence lifetime of DCs were characterized
      in several solvents. The fluorescence emission maximum and lifetime of DCs
      increased at a high dielectric constant. The fluorescence lifetime decay curve of
      DCs was a monoexponential function in all solvents tested. Fluorescence
      micrographs of lipid vesicles and erythrocytes labeled with DCs exhibit uniform
      staining patterns, whereas PBLs show heterogeneous DCs labeling. DCs exhibits a
      relatively low emission maximum (490 nm) in erythrocyte membranes. Such an
      emission maximum is characteristic of a hydrophobic environment. DCs in PBLs also
      has a low emission maximum (484 nm). The lifetime of DCs in PBLs required two
      exponential terms to properly fit the lifetime decay curve and could not be
      attributed to light scattering. One short component (4.7 +/- 1.0 ns) and a second
      long component (18.5 +/- 1.0 ns) were resolved from the DCs fluorescence decay
      curves. Time-resolved anisotropy of DCs in PBLs revealed that the labeled drug
      was present in an anisotropic environment, consistent with at least some DCs
      being bound to a membrane. These fluorescence studies suggest that DCs interacts
      with multiple and/or heterogeneous sites in peripheral blood lymphocytes.

PMID- 8471722
TI  - Cholesterol is required for the fusion of single unilamellar vesicles with
      Mycoplasma capricolum.
AB  - Small unilamellar vesicles (SUV) were prepared from the total lipid extract of
      Mycoplasma capricolum. The SUV were labeled with the fluorescent probe
      octadecylrhodamine B chloride (R18) to a level at which the R18 fluorescence was
      self-quenched. At pH 7.4 and 37 degrees C, and in the presence of 5% polyethylene
      glycol, an increase in the R18 fluorescence with time was observed when the R18
      labeled SUV were introduced to a native M. capricolum cell suspension. The
      fluorescence dequenching resulting from dilution of the R18 into the unlabeled
      membranes of M. capricolum, was interpreted as a result of lipid mixing during
      fusion between the SUV and the mycoplasma cells. The presence of cholesterol in
      the SUV was found to be obligatory to allow SUV-mycoplasma fusion to occur.
      Adaptation of M. capricolum cells to grow in a medium containing low cholesterol
      concentration provided cells in which the unesterified cholesterol content was as
      low as 17 micrograms/mg cell protein. The fusion activity of the adapted cells
      was very low or nonexistent. Nonetheless, when an early exponential phase culture
      of the adapted cells was transferred to a cholesterol-rich medium, the cells
      accumulated cholesterol and regained their fusogenic activity. The cholesterol
      requirement for fusion in the target mycoplasma membrane was met by a variety of
      planar sterols having a free beta-hydroxyl group, but differing in the aliphatic
      side chain, e.g., beta-sitosterol or ergosterol, even though these sterols,
      having a bulky side chain, are preferentially localized in the outer leaflet of
      the lipid bilayer. It is suggested that the role of cholesterol in mycoplasma-SUV
      fusion is not at the level of bulk bilayer viscosity but rather, affecting local
      lipid-lipid or lipid-protein interactions that are relevant to the fusion event.

PMID- 8471723
TI  - Correlation of phospholipid structure with functional effects on the nicotinic
      acetylcholine receptor. A modulatory role for phosphatidic acid.
AB  - Fourier transform infrared spectroscopy is used to characterize specific
      interactions between negatively charged lipids, such as phosphatidic acid, and
      the purified nicotinic acetylcholine receptor from Torpedo californica. The
      specific interaction of phosphatidic acid with acetylcholine receptor is
      demonstrated by the receptor-induced perturbation of the lipid ionization state,
      which is monitored using Fourier transform infrared bands arising from the
      phosphate head group. The acetylcholine receptor shifts the pKa of phosphatidic
      acid molecules adjacent to the receptor to a lower value by almost 2 pH units
      from 8.5 to 6.6. Decreased pH also leads to changes in ion channel function and
      to changes in the secondary structure of the acetylcholine receptor in membranes
      containing ionizable phospholipids. Phospholipase D restores functional activity
      of acetylcholine receptor reconstituted in an unfavorable environment containing
      phosphatidylcholine by generating phosphatidic acid. Lipids such as phosphatidic
      acid may serve as allosteric effectors for membrane protein function and the
      lipid-protein interface could be a site for activity-dependent changes that lead
      to modulation of synaptic efficacy.

PMID- 8471724
TI  - Specificity of amphiphilic anionic peptides for fusion of phospholipid vesicles.
AB  - We have synthesized five amphiphilic anionic peptides derived from E5 peptide
      [Murata, M., Takahashi, S., Kagiwada, S., Suzuki, A., Ohnishi, S. 1992.
      Biochemistry 31:1986-1992. E5NN and E5CC are duplications of the N-terminal and
      the C-terminal halves of E5, respectively, and E5CN is an inversion of the N- and
      the C-terminal halves. E5P contains a Pro residue in the center of E5 and E8 has
      8 Glu residues and 9 Leu residues. We studied fusion of
      dioleoylphosphatidylcholine (DOPC) large unilamellar vesicles assayed by
      fluorescent probes. The peptides formed alpha-helical structure with different
      degrees; E5NN, E5CN, and E8 with high helical content and E5CC and E5P with low
      helical content. These peptides bound to DOPC vesicles at acidic pH in proportion
      to the helical content of peptide. The peptides caused leakage of DOPC vesicles
      which increased with decreasing pH. The leakage was also proportional to the
      helicity of peptide. Highly helical peptides E5NN, E5CN, and E8 caused hemolysis
      at acidic pH but not at neutral pH. The fusion activity was also dependent on the
      helicity of peptides. In fusion induced by an equimolar mixture of E5 analogues
      and K5 at neutral pH, E8, E5NN, and E5CN were most active but E5CC did not cause
      fusion. In fusion induced by E5-analogue peptides alone, E5CN was active at
      acidic pH but not at neutral pH. Other peptides did not cause fusion. Amphiphilic
      peptides also appear to require other factors to cause fusion.

PMID- 8471725
TI  - Small angle neutron scattering studies of C8 and C9 and their interactions in
      solution.
AB  - Small angle neutron scattering (SANS) results revealed that contrary to most
      reports C9 is not a globular protein. Its radius of gyration (Rg) at pH 8 and an
      ionic strength of 0.5 is 32.2 +/- 1.4 A increasing to 35 A at physiologic ionic
      strength. In contrast, C8, which has a 2.2-fold larger mass, has a similar Rg
      value [34.6 +/- 1.6 A]. Calibration plots of Rg vs. M(r) indicate that native C8
      is a spherical protein whereas native C9 is elongated. From previous reports it
      was known that native C8 and C9 associate in solutions of low ionic strength.
      SANS results confirmed this observation but also demonstrated that C8-C9
      heterodimers are already formed at physiologic ionic strength. The dimeric
      complex is globular [Rg = 40 +/- 0.8 A] indicating that the proteins associate
      side-by-side rather than end-to-end. In contrast, in presence of the drug
      Suramin, a potent inhibitor of the assembly of the C5b-9 complex, C9 forms a
      complex with twice the molecular mass that is still elongated (Rg = 48.8 +/- 0.8
      A), suggesting that in this case the protein dimerizes end-to-end via a bridging
      Suramin molecule.

PMID- 8471726
TI  - Metal binding properties of single amino acid deletion mutants of zinc finger
      peptides: studies using cobalt(II) as a spectroscopic probe.
AB  - Peptides corresponding to Cys2His2 zinc finger domains from which one amino acid
      has been deleted have been synthesized and their metal-binding properties
      characterized. In contrast to earlier reports (Parraga, G., S. Horvath, L. Hood,
      E. T. Young, and R. E. Klevit. 1990. Proc. Natl. Acad. Sci. USA. 87:137-141.),
      such peptides do bind metal ions such as cobalt(II). A peptide with the sequence
      ProTyrLysCysProGluCysLysSerPheSerGlnLysSerAspLeuValLysHisGlnArgThrHis ThrGly
      (which corresponds to a previously characterized consensus zinc finger sequence
      from which a Gly residue immediately following the second Cys residue has been
      deleted) was found to form a 1:1 peptide to cobalt(II) complex with an absorption
      spectrum quite similar to those previously observed for zinc finger peptide
      cobalt(II) complexes. The dissociation constant for this complex is 6 x 10(-6)M,
      a factor of 100 times higher than that for the parent peptide. A peptide with the
      sequence LysProTyrProCysGlyLeuCysArgCysPheThrArgArgAspLeuLeulleArgHisAlaGln -
      LyslleHisSerGlyAsnLeu corresponding to a similar mutation of the peptide ADR1 was
      also characterized. Spectroscopic studies with cobalt(II) revealed that this
      peptide forms both 1:1 and 2:1 peptide to cobalt(II) complexes. The absorption
      spectra of the two forms and the dissociation constants were determined via
      deconvolution methods. In contrast, the parent peptide ADR1a was found to form
      only a 1:1 complex under comparable conditions and this 1:1 complex was found to
      be more stable than that for the mutant. These results reveal that deletion
      mutations do adversely affect the stability of zinc finger peptide-metal
      complexes but that the effects are not as drastic as had been previously
      described.

PMID- 8471728
TI  - Viral shell game.

PMID- 8471727
TI  - Nucleation and growth phases in the polymerization of coat and scaffolding
      subunits into icosahedral procapsid shells.
AB  - The polymerization of protein subunits into precursor shells empty of DNA is a
      critical process in the assembly of double-stranded DNA viruses. For the well
      characterized icosahedral procapsid of phage P22, coat and scaffolding protein
      subunits do not assemble separately but, upon mixing, copolymerize into double
      shelled procapsids in vitro. The polymerization reaction displays the
      characteristics of a nucleation limited reaction: a paucity of intermediate
      assembly states, a critical concentration, and kinetics displaying a lag phase.
      Partially formed shell intermediates were directly visualized during the growth
      phase by electron microscopy of the reaction mixture. The morphology of these
      intermediates suggests that assembly is a highly directed process. The initial
      rate of this reaction depends on the fifth power of the coat subunit
      concentration and the second or third power of the scaffolding concentration,
      suggesting that pentamer of coat protein and dimers or trimers of scaffolding
      protein, respectively, participate in the rate-limiting step.

PMID- 8471729
TI  - Theory of photoselection by intense light pulses. Influence of reorientational
      dynamics and chemical kinetics on absorbance measurements.
AB  - The theory of absorbance measurements on a system (e.g., chromophore(s) in a
      protein) that undergoes a sequence of reactions initiated by a linearly polarized
      light pulse is developed for excitation pulses of arbitrary intensity. This
      formalism is based on a set of master equations describing the time evolution of
      the orientational distribution function of the various species resulting from
      excitation, reorientational dynamics, and chemical kinetics. For intense but
      short excitation pulses, the changes in absorbance (for arbitrary polarization
      directions of the excitation and probe pulses) and the absorption anisotropy are
      expressed in terms of reorientational correlation functions. The influence of the
      internal motions of the chromophore as well as the overall motions of the
      molecules is considered. When the duration of the excitation pulse is long
      compared to the time-scale of internal motions but comparable to the overall
      correlation time of the molecule that is reorienting isotropically, the problem
      of calculating the changes in absorbance is reduced to the solution of a set of
      first-order coupled differential equations. Emphasis is placed on obtaining
      explicit results for quantities that are measured in photolysis and fluorescence
      experiments so as to facilitate the analysis of experimental data.

PMID- 8471730
TI  - Photoselection in polarized photolysis experiments on heme proteins.
AB  - Polarized photolysis experiments have been performed on the carbon monoxide
      complex of myoglobin to assess the effects of photoselection on the kinetics of
      ligand rebinding and to investigate the reorientational dynamics of the heme
      plane. The results are analyzed in terms of the optical theory developed in the
      preceding paper by Ansari and Szabo. Changes in optical density arising from
      rotational diffusion of the photoselected population produce large deviations
      from the true geminate ligand rebinding curves if measurements are made with only
      a single polarization. The apparent ligand rebinding curves are significantly
      distorted even at photolysis levels greater than 90%. These deviations are
      eliminated by obtaining isotropically-averaged optical densities from
      measurements using both parallel and perpendicular polarizations of the probe
      pulse. These experiments also yield the optical anisotropy, which gives a novel
      method for accurately determining the degree of photolysis, as well as important
      information on the reorientational dynamics of the heme plane. The correlation
      time for the overall rotational diffusion of the molecule is obtained from the
      decay of the anisotropy. The anisotropy prior to rotational diffusion is lower
      than that predicted for a rigidly attached, perfectly circular absorber,
      corresponding to an apparent order parameter of S = 0.95 +/- 0.02. Polarized
      absorption data on single crystals suggest that the decreased anisotropy results
      more from internal motions of the heme plane which take place on time scales
      shorter than the duration of the laser pulse (10 ns) than from out-of-plane
      polarized transitions.

PMID- 8471731
TI  - Molecular dynamics simulations of heme reorientational motions in myoglobin.
AB  - Molecular dynamics simulations of 2-ns duration were performed on
      carbonmonoxymyoglobin and deoxymyoglobin in vacuo to study the reorientational
      dynamics of the heme group. The heme in both simulations undergoes reorientations
      of approximately 5 degrees amplitude on a subpicosecond time scale, which produce
      a rapid initial decay in the reorientational correlation function to about 0.99.
      The heme also experiences infrequent changes in average orientation of
      approximately 10 degrees amplitude, which lead to a larger slow decay of the
      reorientational correlation function over a period of hundreds of picoseconds.
      The simulations have not converged with respect to these infrequent transitions.
      However, an estimate of the order parameter for rapid internal motions of the
      heme from those orientations which are sampled by the simulations suggests that
      the subnanosecond orientational dynamics of the heme accounts for at least 30% of
      the unresolved initial anisotropy decay observed in the nanosecond time-resolved
      optical absorption experiments on myoglobin reported by Ansari et al. in a
      companion paper (Ansari, A., C.M. Jones, E.R. Henry, J. Hofrichter, and W.A.
      Eaton. 1992. Biophys. J. 64:852-868.). A more complete sampling of the accessible
      heme orientations would most likely increase this fraction further. The
      simulation of the liganded molecule also suggests that the conformational
      dynamics of the CO ligand may contribute significantly to discrepancies between
      the ligand conformation as probed by x-ray diffraction and by infrared-optical
      photoselection experiments. The protein back-bone explores multiple conformations
      during the simulations, with the largest structural changes appearing in the E
      and F helices, which are in contact with the heme. The variations in the heme
      orientation correlate with the conformational dynamics of the protein on a time
      scale of hundreds of picoseconds, suggesting that the heme orientation may
      provide a useful probe of dynamical processes in the protein.

PMID- 8471732
TI  - Analysis of ordered arrays of adsorbed lysozyme by scanning tunneling microscopy.
AB  - Scanning tunneling microscopy (STM) has been used to observe lysozyme at a
      graphite surface directly in order to gain mechanistic information about the
      molecular events involved in protein adsorption. The experiments were performed
      using an insulated tip in an aqueous protein solution, allowing the time course
      of the adsorption process to be followed, including the evolution of ordered
      arrays. Ordered arrays of protein molecules were observed, with lattice spacings
      that varied with bulk protein concentration and salt strength. Fourier analysis
      was used to determine the average cell dimensions of an array. From the observed
      lattice spacings, it was possible to estimate the surface coverage of the
      protein, and thus, by varying the conditions, adsorption isotherms could be
      obtained. These isotherms compare well with adsorption isotherms measured using
      total internal reflectance fluorescence (TIRF) spectroscopy on a hydrophobic
      surface. Since the protein is charged and the electrolyte has an effect on the
      isotherms, electrostatics are a likely controlling factor. Molecular
      electrostatics computations were thus used to investigate the possible origins of
      the lattice structure, and they suggest that favorable intermolecular
      interactions among adsorbed molecules are consistent with hydrophobically
      dominated protein-surface interactions.

PMID- 8471733
TI  - Aggregation of hapten-bearing liposomes mediated by specific antibodies.
AB  - We studied specific membrane-membrane interactions mediated by ligand-receptor
      binding in a model system, which consisted of (a) FG3P, the fluorescein hapten
      attached to a phospholipid by a peptidyl spacer as described previously
      (Petrossian, A., A.B. Kantor, and J.C. Owicki. 1985. J. Lipid Res. 26:767-773),
      (b) antifluorescein monoclonal antibodies (MAbs), and (c) phospholipid vesicles
      (liposomes) into which the FG3P was incorporated. The aggregation of the hapten
      bearing liposomes by four MAbs was studied by differential centrifugation. The
      ability of the MAbs to induce vesicle aggregation varied considerably and
      correlated inversely with affinity. Aggregation by one of the MAbs was studied in
      more detail by turbidimetry and freeze-fracture electron microscopy of samples
      frozen throughout the course of the aggregation. Rapid freezing was achieved with
      a double propane-jet apparatus. The aggregate morphologies and the time evolution
      of the aggregate size distribution were obtained from the two-dimensional
      fracture views with a stereological correction. The aggregation kinetics were
      simulated by considering dynamical aggregation according to a mass-action model
      with two parameters, the rate constants for antibody-mediated vesicle aggregation
      and disaggregation. Both rate constants were orders of magnitude lower than the
      rate constants for the corresponding interactions of antibodies with haptens
      either in solution or on vesicles under nonaggregating conditions.

PMID- 8471734
TI  - A COOH-terminal peptide confers regiospecific orientation and facilitates atomic
      force microscopy of an IgG1.
AB  - An antibody (IgG1) was designed for oriented adherence to a metal-containing
      surface. This was achieved by adding a metal-chelating peptide, (CP = His-Trp-His
      His-His-Pro), to the COOH-terminus of the heavy chain through genetic
      engineering. Electroporation of the engineered heavy chain gene into cells
      expressing the complimentary light chain yielded colonies secreting an intact
      antibody containing the metal-chelating peptide (IgG1-CP) which had high affinity
      for a nickel-loaded iminodiacetate column. Purified IgG1-CP was bound to nickel
      treated mica and imaged by atomic force microscopy (AFM). Antibody lacking the
      COOH-terminal metal binding peptide failed to produce discernible AFM images. The
      AFM images of individual IgG1-CP molecules and their calculated dimensions
      demonstrated that regiospecific binding and uniform orientation of the antibody
      was imparted by the peptide. The ability to stably orient macromolecules in their
      native state to a surface may be used advantageously to visualize them.

PMID- 8471735
TI  - Study of the torque of the bacterial flagellar motor using a rotating electric
      field.
AB  - Bacterial flagella are driven by a rotary motor that is energized by an
      electrochemical ion gradient across the cell membrane. In this study the torque
      generated by the flagellar motor was measured in tethered cells of a smooth
      swimming Escherichia coli strain by using rotating electric fields to determine
      the relationship between the torque and speed over a wide range. By measuring the
      electric current applied to the sample cell and combining the data obtained at
      different viscosities, the torque of the flagellar motor was estimated up to 55
      Hz, and also at negative rotation rates. By this method we have found that the
      torque of the flagellar motor linearly decreases with rotation rate from negative
      through positive rate of rotation. In addition, the dependence of torque upon
      temperature was also investigated. We showed that torque at the high speeds
      encountered in swimming cells had a much steeper dependence on temperature that
      at the low speeds encountered in tethered cells. From these results, the
      activation energy of the proton transfer reaction in the torque-generating unit
      was calculated to be about 7.0 x 10(-20) J.

PMID- 8471736
TI  - Cardiovascular effects of capsaicin-sensitive neurons.
AB  - Calcitonin gene-related peptide, the main transmitter released from capsaicin
      sensitive sensory-motor fibers, has positive inotropic and chronotropic effects
      on the heart and causes vasodilatation in the coronary arteries and elsewhere in
      the peripheral vasculature. We review some aspects of the cardiovascular actions
      induced by exogenous calcitonin gene-related peptide and by release of the
      peptide following activation of capsaicin-sensitive nerves. The efferent function
      of cardiac sensory-motor neurones is modulated by a number of endogenous
      substances of physiopathological interest, including opioid peptides,
      norepinephrine and adenosine. The receptors involved in the prejunctional
      regulation due to these substances have been characterized. Studies on the
      mesenteric bed of the rat have shown that, at least in such a resistance vascular
      bed, the relaxing effect of calcitonin gene-related peptide is mediated by a
      direct mechanism independent of endothelium-derived nitric oxide release. In
      cultured human endothelial cells from the umbilical cord vein, calcitonin gene
      related peptide, at nM concentrations, stimulates cell growth in a dose-dependent
      manner. The possible implications of calcitonin gene-related peptide in the
      physio-pathological regulation of the cardiovascular system and in the trophism
      of vascular tissues are discussed.

PMID- 8471737
TI  - Increased nuclear proto-oncogene expression in hypertrophic cardiomyopathy.
AB  - Hypertrophic cardiomyopathy is characterized by an unexplained hypertrophy of the
      left ventricle, particularly the interventricular septum. Although point
      mutations in the beta-myosin chain gene have been found in several US families in
      familiar hypertrophic cardiomyopathy, the pathogenetic pathways leading to
      myocyte hypertrophy, the most important feature, are still not clear. To examine
      whether activation (expression) of nuclear proto-oncogenes may play a role in
      hypertrophic cardiomyopathy, endomyocardial biopsies from 13 patients with
      hypertrophic cardiomyopathy were examined using monoclonal antibodies against c
      myc, c-fos and c-jun. The nuclear proto-oncogenes c-fos, c-jun and c-myc were
      expressed in 53, 60, and 50%, respectively, of patients with hypertrophic
      cardiomyopathy. In control biopsies, c-myc was detectable in only 10% of the
      patients, while c-fos and c-jun were always undetectable. These results show that
      nuclear proto-oncogenes are induced in patients with hypertrophic cardiomyopathy,
      although the triggering mechanisms remain unknown.

PMID- 8471738
TI  - Prodynorphin mRNA is synthesized in adult cultured rat ventricular
      cardiomyocytes.
AB  - In the myocardial cell, stimulation of the K opioid receptor is involved in the
      modulation of cytosolic calcium and pH homeostasis, as well as in the regulation
      of myofilament responsiveness to calcium. In the present study, we found that
      prodynorphin mRNA, which encodes for the synthesis of a common precursor of
      opioid peptides interacting with K sites, is synthesized both in atrial and
      ventricular tissue of the rat heart. In adult cultured rat ventricular
      cardiomyocytes, the level of prodynorphin mRNA did not differ from that detected
      in the original ventricular tissue. This finding indicates that the myocardial
      cell is a source for prodynorphin gene expression and has the potential for an
      intrinsic synthesis of dynorphin-related peptides.

PMID- 8471739
TI  - Myocardial xanthine oxidoreductase activity in hypertensive and
      hypercholesterolemic rats.
AB  - In several species, xanthine oxidoreductase activity seems to be a major source
      of free radicals in myocardial tissue. Its activity changes during development
      and aging, at least in the rat heart. Hardly any data are available about its
      activity in two important diseases, hypertension and hypercholesterolemia, in
      which the production of free radicals induced by xanthine oxidoreductase activity
      could play a role. Therefore we measured the activity of xanthine oxidase and
      dehydrogenase in myocardial tissue of spontaneously hypertensive. Wistar (control
      hypertensive), Yoshida (hypercholesterolemic) and Brown Norway (control
      hypercholesterolemic) rats of various ages. Cytosolic fractions were incubated at
      30 degrees C, pH 8.3, with 60 microM xanthine, and the formation of urate was
      measured with high performance liquid chromatography. In the Wistar group,
      xanthine oxidoreductase activity was relatively constant during aging (about 1.8
      U/g protein). In the hypertensive group, the activity increased gradually from
      1.7 to 2.3 U/g at 18 months (p < 0.05 compared with Wistar at 18 months).
      Xanthine oxidase was about twice as high in both groups at 18 months (p < 0.001
      compared with 2 and 6 months). The ratio of xanthine dehydrogenase to xanthine
      oxidase had decreased 42% at this age (p < 0.001). In the Yoshida and Brown
      Norway groups, xanthine oxidoreductase activity was similar, with a peak at 6
      months. These data suggest that the hypercholesterolemic state does not influence
      xanthine oxidoreductase activity. In contrast, in hypertrophied myocardium,
      xanthine oxidoreductase activity was higher than in the control, suggesting a
      different potential for free-radical generation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471740
TI  - Low frequency oscillations in pulmonary arterial pressure in chronic heart
      failure.
AB  - Spontaneous, sustained low frequency oscillations of pulmonary arterial pressure
      were observed in 8 patients with moderate to severe chronic heart failure during
      recordings of pulmonary arterial pressure of 8.6 to 48 hours duration. The
      oscillations (frequency range 0.015 to 0.035 Hz) had a distinct peak from and
      lower frequency range than respiration (0.2 to 0.6 Hz) and heart rate (0.8 to 1.9
      Hz). They were present from 42% to 82% of the recording time with an amplitude
      varying from undetectable to a maximum range from 5.3 mm Hg to 19.7 mm Hg. When
      detectable, the mean amplitude of the low frequency oscillations of pulmonary
      arterial pressure ranged from 1.2 +/- 1.2(SD) mm Hg to 4.3 +/- 3.3 mm Hg. These
      oscillations are lower in frequency than the low frequency component usually
      described in recordings of systemic arterial pressure and heart rate in normal
      subjects, and are closer to the very low frequency rhythms described in severe
      chronic heart failure and Cheyne Stokes respiration.

PMID- 8471741
TI  - Influence of atherosclerosis on the vascular reactivity of isolated human
      epicardial coronary arteries to leukotriene C4.
AB  - Leukotrienes, lipid mediators derived from arachidonic acid by the 5-lipoxygenase
      pathway, have been implicated in a variety of myocardial ischemic events
      including myocardial infarction and coronary spasm. We have examined the
      comparative effects of leukotriene C4 in isolated human non-atherosclerotic and
      atherosclerotic coronary arteries to gain an insight into the role of
      leukotrienes in coronary heart disease. Human coronary arteries, obtained from
      recipient hearts at the time of cardiac transplantation, were cut into rings and
      examined in an isolated organ bath. In atherosclerotic arteries leukotriene C4
      (1nM-100nM) produced a maximal contractile response of 54.9 +/- 7.98% KCI (n = 7)
      and the mean EC50 value was 11.1nM (95% confidence interval: 9.4-13.0). The
      leukotriene receptor antagonist ICI-198,615 (3 x 10(-8)M) produced an approximate
      50-fold rightward shift of the leukotriene C4 dose-response curve (n = 5). In
      contrast, non-atherosclerotic arteries were either non-responsive (n = 5) or only
      weakly responsive (n = 2) to leukotriene C4 (1nM-100nM), producing an average
      maximum response of 3.65 +/- 3.05% KCI (n = 7; p < 0.01 atherosclerotic vs non
      atherosclerotic). In the presence of indomethacin and in vessels denuded of
      endothelium, non-atherosclerotic arteries remained unresponsive to leukotriene C4
      (n = 3). In addition, leukotriene C4 did not relax preconstricted vessels (n =
      7). In vitro autoradiography showed specific [3H]-leukotriene C4 binding to
      smooth muscle in both non-atherosclerotic and atherosclerotic arteries, with no
      evidence of endothelium-dependent binding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471742
TI  - Modulation of parasympathetic and baroreceptor control of heart rate.
AB  - The heart rate is modulated from beat to beat by efferent vagal and sympathetic
      fibers, the former being the predominant mediators of the chronotropic influence
      of arterial baroreceptors and respiration and the latter being important in the
      cardiac responses to physical and mental stress. Cardiac vagal influences are
      modulated by a number of factors. These can be grouped as: 1) neural factors,
      such as the wakefulness-sleep cycle, the alerting reaction, and exercise; 2)
      humoral-pharmacological factors, such as angiotensin II, atrial natriuretic
      factor, cardiac glycosides; 3) normal aging; 4) a number of cardiovascular and
      other diseases, such as arterial hypertension, coronary artery disease,
      congestive heart failure and diabetes mellitus. The mechanisms underlying
      modulation of cardiac vagal control are not completely understood, the range of
      the possibilities including structural or functional alterations in baroreceptor
      afferents, in central and efferent vagal pathways and in cardiac responsiveness
      to neural stimuli. Irrespective of the mechanisms involved, the modulation of
      cardiac vagal control may have important implications for normal cardiovascular
      homeostasis, as well as for the pathophysiology, diagnosis and prognosis of
      various diseases.

PMID- 8471743
TI  - Use of amrinone in cardiac surgery patients.

PMID- 8471744
TI  - Pharmacologic and mechanical methods of discontinuing extracorporeal circulation
      in patients with heart failure.
AB  - Separation from EC requires simultaneous optimal manipulation of heart rate and
      rhythm, loading conditions, afterload, and contractility. Patients with
      preexisting ventricular dysfunction will have alterations in beta-adrenergic
      receptors and responsiveness to catecholamines, but patients with previously
      normal ventricular function can also develop ventricular dysfunction.
      Catecholamines, by stimulating beta-adrenergic receptors, decrease systolic
      function to allow separation from EC. The phosphodiesterase inhibitors provide
      both inotropic support and vasodilation, to improve both systolic and diastolic
      function. When administered in combination, catecholamines and cyclic-AMP
      specific phosphodiesterase inhibitors can have additive effects to restore beta 1
      adrenergic responsiveness. Combination therapy provides an important support
      during biventricular dysfunction and facilitates separation from EC. Finally,
      mechanical support provides a therapeutic option when pharmacologic therapy is
      ineffective.

PMID- 8471745
TI  - Diastolic dysfunction in post-cardiac surgical management.
AB  - Although an appropriate definition of primary diastolic failure is still not at
      hand, primary diastolic failure is a distinct pathophysiologic syndrome. It is
      due to an increased resistance to ventricular filling and results in an
      inappropriate upward shift of the diastolic P-V relationship, especially during
      exercise. This leads to exercise intolerance with symptoms of congestion. The
      causes are known, ie, impaired systolic relaxation, decreased diastolic
      compliance, and inappropriate tachycardia. Pathophysiologically impaired
      (incomplete or slowed) systolic relaxation must be distinguished from
      physiologic, compensatory prolonged contraction (delayed or retarded relaxation).
      Treatment of diastolic failure is feasible, but necessitates a clear
      understanding of the etiology, pathogenesis, and pathophysiology of the
      underlying cardiac disease. Optimal therapy will depend on the type of disease,
      on the phase during the pathophysiologic evolution of a given disease, and on the
      coexistence and relative contribution of various compensatory or decompensatory
      mechanisms. This often requires a comprehensive analysis of hemodynamics, for
      example, with echo-doppler, completed, whenever necessary, by catheterization.

PMID- 8471746
TI  - Milrinone and postoperative pulmonary hypertension.

PMID- 8471747
TI  - Post-cardiac surgery pulmonary hypertension.

PMID- 8471748
TI  - The role of luminal factors in prostaglandin protection against ethanol-induced
      gastric mucosal injury.
AB  - Prostaglandins (PG) protect the gastric mucosa against damage by several
      irritants, but the mechanisms remain unclear. A standard rat model of gastric
      injury induced by 50% ethanol was used to test the hypothesis that PG protection
      occurs either by increasing luminal fluid volume and hence diluting the irritant,
      or by production of protective factors within this fluid. Quantitative histology
      was used to assess microscopic mucosal damage. The increase in luminal fluid
      volume in prostaglandin E2 (PGE2)-treated animals was measured, and the ability
      of this increased fluid to protect saline-treated animals via dilution of the
      irritant was assessed. The transfer of protection by exchange of luminal fluid
      from PG to non-PG treated animals was also tested. Results showed that PGE2
      induced a specific increase in luminal fluid volume of 45.6%. When given together
      with ethanol treatment the extra fluid volume was not protective. Removal of
      luminal fluid after PG and before ethanol treatment did not abolish protection
      and no protective factor was transferred with the luminal fluid. In conclusion,
      this study has shown that neither dilution of ethanol by accumulation of luminal
      fluid nor the presence of luminal factors is responsible for PG protection.

PMID- 8471749
TI  - High prevalence of duodenal ulcer in Indochinese immigrants attending an
      Australian university hospital.
AB  - Indochinese migrants to Australia appear to have a high prevalence of duodenal
      ulcer (DU). To examine this hypothesis a 2 year audit of the prevalence of
      symptomatic DU among patients attending a general hospital was conducted. The
      last 6 months of this period included a prospective assessment of ulcer risk
      factors. In Australian-born patients DU prevalence was 8.4 per 1000 admissions.
      By comparison, prevalence in Indochinese was 24.6 per 1000 admissions (P < 0.001)
      with an age standardized prevalence of 30.3 per 1000 (P < 0.001). This
      represented a relative risk in Indochinese of 2.9 using crude data and 3.6 after
      age standardization. The increased risk was demonstrated only in males: very few
      DU were diagnosed in female Indochinese. Ulcer prevalence increased in
      Indochinese for each age decile between 10 and 80 years, with statistical
      significance (P < 0.01) reached in the age brackets 0-19, 20-39 and 60-79 years.
      Ulcer prevalence was also increased in some other ethnic groups. However, when
      referral bias was taken into account (by calculating the ratio of endoscopies to
      total admissions for each group), a significant increase in DU prevalence could
      only be confidently demonstrated in Indochinese. Analysis of risk factors showed
      that among DU patients, Indochinese were significantly less likely to smoke (P <
      0.05) and also had a tendency to ingest less non-steroidal anti-inflammatory
      drugs (NSAID) and to consume less alcohol.

PMID- 8471750
TI  - Diagnosis of gastric adenoma versus early gastric cancer by bromodeoxyuridine
      immunohistochemistry from gastric biopsy specimen.
AB  - Differentiation between gastric adenomas and type IIa early gastric cancer by
      macroscopic and histologic examinations is often difficult. This study has shown
      that there are differences in the distribution of S-phase cells in these two
      types of tumour, and these differences can be exploited to differentiate between
      them. The distribution of S-phase cells was assessed by Bromodeoxyuridine (BrdU)
      immunohistochemistry using an in vitro BrdU-labelling method. Biopsy specimens
      were obtained from 27 lesions (12 adenomas and 15 type IIa early gastric
      cancers), and the distributions of BrdU-labelled cells in the tumour thickness as
      well as in the superficial layer of the tumour were determined. Significant
      difference was seen in the labelling of the two tumour types with regard to both
      these parameters. Using the criteria of BrdU immunohistochemistry, the accuracy
      of differentiation between gastric adenomas and cancers was 88.9%. Therefore, it
      is concluded in this study that in vitro BrdU labelling is a useful method of
      diagnosing gastric adenomas and cancers.

PMID- 8471751
TI  - Biliary bile acids in the gall-bladder and the common bile duct of patients with
      anomalous pancreaticobiliary ductal junction.
AB  - The high incidence of biliary tract carcinoma in patients with anomalous
      pancreaticobiliary ductal junction (APBDJ) with or without choledochal cyst (CC)
      has been well documented. Twenty-two patients with APBDJ were divided into three
      groups: Group A, four patients not associated with CC and biliary tract
      carcinoma; Group B, 13 patients with CC but without biliary tract carcinoma; and
      Group C, five patients with biliary tract carcinoma (four with and one without
      CC). Profiles of bile acids in the gall-bladder and/or common bile duct were
      analysed in these patients and compared with those in the control patients with
      cholecystlithiasis to examine the hypothesis that the levels of deoxycholic acid
      (DCA) and lithocholic acid (LCA) are elevated in patients with APBDJ because
      these secondary bile acids are mutagenic. Bile acids were quantified by gas
      liquid chromatography. Total bile acid concentration in the gall-bladder bile was
      significantly lower in any group with APBDJ than that of controls. In the gall
      bladder, increased proportion of chenodeoxycholic acid (CDCA) in Group A and B,
      decreased proportion of DCA in Group B and increased proportion of cholic acid
      (CA) in Group C were found in bile. In the bile duct, total bile acid
      concentration and proportion of DCA were significantly low in bile from Group C
      and decreased proportion of DCA and increased proportion of CDCA were found in
      bile from Group B. In both the gall-bladder and hepatic bile, proportion of LCA
      was not significantly different between any intergroups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8471752
TI  - Prevalence of primary sclerosing cholangitis and other liver diseases in Japanese
      patients with chronic ulcerative colitis.
AB  - An association between primary sclerosing cholangitis (PSC) and chronic
      ulcerative colitis (CUC) is well known in Western countries, but there have been
      no reports on this association in Japan. We reviewed 163 consecutive CUC patients
      (91 males and 72 females) diagnosed from 1984 to 1990 at Tokyo Women's Medical
      College. Abnormal liver function tests were found in 42 patients with CUC
      (25.8%), but chronic liver disease was only diagnosed in seven patients (4.3%).
      Among these seven patients, there were four with PSC, one with small-duct PSC,
      one with transfusion-associated chronic hepatitis and one with Type B liver
      cirrhosis. No relationship was found between the documented colonic
      manifestations of CUC and the presence of PSC. The four PSC patients did not have
      a longer history of CUC at the time of diagnosis of PSC than CUC patients without
      PSC. At the time of PSC diagnosis, two patients were asymptomatic, one presented
      with right upper quadrant pain, and the other had fatigue. Three patients were
      diagnosed as having CUC before the onset of PSC (range 2-13 years), and the other
      patient had both diseases simultaneously. All four had a good prognosis. Thus PSC
      was the most common chronic liver disease associated with CUC in our series, and
      it was present in all our CUC patients with alkaline phosphatase levels exceeding
      twice the upper limit of normal and mild transaminase elevation.

PMID- 8471753
TI  - Measurement of intravariceal pressure by fine needle direct puncture in hepatitis
      B surface antigen-positive cirrhotic patients: the effect of vasopressin.
AB  - The pressure of oesophageal varices was determined by fine needle direct puncture
      in 19 patients with hepatitis B surface antigen (HBsAg)-positive cirrhosis after
      the first episode of variceal bleeding before endoscopic sclerotherapy. Both the
      stability and reliability of the measurement of intravariceal pressure by fine
      needle puncture were confirmed. Seven patients received intravenous 1 mL normal
      saline. Intravariceal pressure did not change before and after injection of
      normal saline (16.3 +/- 4.0 vs 16.0 +/- 4.0 mmHg, P > 0.05). Twelve patients
      received intravenous 1 units vasopressin and this caused a significant reduction
      in intravariceal pressure (15.6 +/- 2.6 vs 10.3 +/- 2.9 mmHg, P < 0.0001). The
      average basal intravariceal pressure in these patients was 15.8 +/- 3.1 mmHg.
      After intravariceal pressure was recorded, the needle was left in situ and
      endoscopic sclerotherapy commenced immediately. During the investigation, no
      adverse reaction or complication was encountered. It was concluded that the
      measurement of intravariceal pressure by fine needle direct puncture followed by
      immediate sclerotherapy is a safe and simple method to evaluate the short-term
      effect of drug prevention from oesophageal variceal bleeding and that vasopressin
      causes reduction of intravariceal pressure.

PMID- 8471754
TI  - Extrahepatic portal vein obstruction in adults detected by ultrasound with
      frequent lack of portal hypertension signs.
AB  - Extrahepatic portal vein obstruction (EHPO) was seen in 54 adult patients at the
      Chiba University Hospital and affiliated hospitals from 1978 to 1991. They were
      classified according to the background disease (Group A, unknown aetiology; Group
      B, benign disease; Group C, malignant disease). Among the initial symptoms and
      signs, abdominal pain was the most frequent in Group A (37%), and symptoms
      attributable to the primary disease in Groups B (44%) and C (75%). Definite or
      probable diagnosis was made in 45 of the 54 patients (81.8%) by ultrasound (US)
      examination carried out because of these symptoms and signs. Signs of portal
      hypertension were observed in 67% of patients; oesophageal varices were seen in
      60%. Extrahepatic portal vein obstruction without portal hypertension signs was
      characterized by thick extensive hepatopetal collaterals or patency of some
      intrahepatic portal veins. Extrahepatic portal vein obstruction patients without
      portal hypertension remained free of its signs for more than 3 years of follow up
      and, in fact, EHPO without portal hypertension signs was a common occurrence.
      Emphasis is made on the diagnostic value of US examination which was useful in
      identifying the relation of clinical manifestation of EHPO to pathophysiology,
      and on the frequent lack of portal hypertension signs in this disease.

PMID- 8471755
TI  - Pruritus and cholestasis: therapeutic options.
AB  - The pathogenesis of pruritus of cholestasis remains unclear. Bile salts do not
      appear to be the sole prurogens in cholestasis. Histaminergic pathways may be
      involved, and central opiate receptor processes seem much more important than has
      previously been recognized. The therapeutic options for relief of cholestatic
      pruritus are summarized in Table 2. Resins such as cholestyramine are the first
      line of therapy. In cases where cholestyramine has failed, rifampicin and
      antihistamines may be beneficial. Opiate antagonists hold great potential if
      opioid withdrawal-like syndromes can be avoided. Ursodeoxycholic acid and
      methotrexate have an advantage in not only relieving pruritus but also
      potentially retarding disease progression in PBC and PSC, respectively, although
      this remains to be proved. Other agents such as EPO and SAMe remain experimental
      and require further study to clarify their effectiveness before they can be
      recommended.

PMID- 8471756
TI  - Tumour suppressor genes and colorectal neoplasia.
AB  - Two distinct gene classes have been implicated in colorectal carcinogenesis.
      Tumour promoter genes (oncogenes, dominant oncogenes) produce an excessive
      positive stimulus to cell proliferation. The ras family of oncogenes are an
      example. Acquired mutations of the c-k-ras gene are commonly found in colonic
      adenomas and carcinomas. Tumour suppressor genes (anti-oncogenes, recessive
      oncogenes) normally constrain or regulate cell proliferation. Loss of this
      function through gene deletion or mutation is oncogenic. Inherited tumour
      suppressor gene mutations have now been identified in several of the familial
      cancer syndromes. Acquired tumour suppressor gene mutations are found in both
      sporadic and hereditary cancers. Together with the tumour promoter genes they
      provide the genetic basis for the cellular changes occurring during
      carcinogenesis. The retinoblastoma gene was the first human tumour suppressor
      gene to be characterized and exemplifies the class. More recently, linkage
      studies in the hereditary cancer syndromes and the detection of specific
      deletions in sporadic tumours have helped to identify several new tumour
      suppressor genes. At least four of these (MCC, APC, p53 and DCC) apparently
      contribute to sporadic colorectal carcinogenesis. Germ line APC mutations produce
      the inherited colorectal cancer syndrome familial adenomatous polyposis (FAP).
      Detection of these mutations using linked markers has already found clinical
      application in the screening of families with this disease. In the future,
      genetic diagnosis of hereditary non-polyposis colorectal cancer (HNPCC) and the
      recognition of those genetically susceptible to sporadic colorectal cancer may
      become possible. At the same time, as our understanding of the genes involved
      improves, new avenues for treatment and prevention of colorectal cancer may
      emerge.

PMID- 8471757
TI  - Selection of patients for liver transplantation.
AB  - Liver transplantation is now available world-wide. It plays an important role in
      the treatment of irreversible acute and chronic liver disease (CLD). Selection of
      patients for liver transplantation is subject to many factors including economic,
      cultural, availability of donor organs and degree of illness. This article looks
      at seven general considerations for recipients of liver transplantation. As well,
      disease-specific criteria are investigated and include such areas as cirrhosis
      due to chronic hepatitis B virus (HBV), hepatitis C virus (HCV) positive
      cirrhosis, fulminant hepatic failure (FHF), malignancy, alcoholic liver disease
      (ALD), metabolic conditions and Budd-Chiari syndrome. If hepatic transplantation
      survival rates were to approach 95%, the relative risk ratio between
      transplantation and conservative therapy would increase. At present an 80% 1-5
      year survival rate following transplantation should be expected.

PMID- 8471758
TI  - Hepatic-pericardio-phrenic collateral (natural shunt) in a patient with Budd
      Chiari syndrome.
AB  - Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to
      portal hypertension and to the development of collaterals that bypass the
      obstruction. Described here is a BCS patient with an unusually large
      transdiaphragmatic collateral between the left hepatic and left innominate veins,
      which decompressed the oesophageal varices. This has not been reported earlier in
      the literature.

PMID- 8471759
TI  - Detecting genetic changes in human tumor cells: have scientists "gone fishing?".

PMID- 8471760
TI  - Autoimmune neutropenia.
AB  - There have been several new developments in the field of autoimmune neutropenia
      over the past decade. Neutropenia caused by antibodies directed against
      granulocyte precursor cells, the oligoclonal nature of antineutrophil antibodies,
      and the expanding knowledge of neutrophil antigens, particularly in relationship
      to autoantibodies, are exciting new areas of investigation. Knowledge has also
      been advanced in the effector mechanisms of neutrophil autoantibodies and the
      effect of autoantibodies on the neutrophil function. In addition, some clinical
      syndromes of immune neutropenia have been better defined over the past decade,
      such as autoimmune neutropenia of infancy and chronic idiopathic neutropenia in
      adults. The past decade also saw interesting developments in the treatment of
      immune neutropenia, particularly in the use of gammaglobulin preparations and
      more recently in the advent of hematopoietic growth factors. This review focuses
      on these newer aspects of autoimmune neutropenia.

PMID- 8471761
TI  - Antineutrophil cytoplasmic autoantibodies: a review of the antigens involved, the
      assays, and the clinical and possible pathogenetic consequences.

PMID- 8471762
TI  - Curability of relapsed childhood B-cell non-Hodgkin's lymphoma after intensive
      first line therapy: a report from the Societe Francaise d'Oncologie Pediatrique.
AB  - The very high cure rate in advanced B-cell non-Hodgkin's lymphoma in children
      using intensive multiagent therapy has been previously reported by the French
      Societe Francaise d'Oncologie Pediatrique lymphoma Malin B type (LMB) group. To
      address the issue of salvageability in an unselected group of patients who had
      all received the same front-line therapy, the outcome of relapses following the
      LMB 84 (216 patients) protocol have been reviewed. Fourteen percent of patients
      achieving complete remission (CR) relapsed, ie, 27 of 195. Relapse sites
      comprised the central nervous system (CNS) alone (6 cases), lung or mediastinum
      (2 cases), abdomen (8 cases), head and neck (2 cases), or multifocal (9 cases).
      There were three early deaths due to disease. Twenty-four patients received
      rescue chemotherapy regimens and 15 were treated with high-dose chemotherapy and
      bone marrow rescue (1 allogeneic). Of these, 9 were in second CR, 4 in second
      partial remission, and 2 treated during progressive disease. One died in CR from
      treatment-related toxicity. Ten relapsed postbone marrow transplant and 4 are
      alive disease free and probably cured. Two of the long-term survivors had some
      delay during initial chemotherapy due to toxicity and two were isolated CNS
      relapses. Twelve of 27 patients did not proceed to megatherapy (12 of 12 died).

PMID- 8471763
TI  - Initial assessment of the beneficial effect of partial splenectomy in hereditary
      spherocytosis.
AB  - Clinical manifestations of hereditary spherocytosis (HS), the most common red
      blood cell (RBC) membrane disorder, can be abrogated or markedly reduced by
      splenectomy. However, concerns regarding risks from overwhelming infections after
      splenectomy have restricted its use, especially in children. This study was
      designed to determine if partial splenectomy can decrease the hemolytic rate
      while maintaining phagocytic function of the spleen. Partial splenectomy was
      performed in 11 children (age 2 to 13) with HS. The effect on hemolytic rate was
      assessed by comparing the presurgical and postsurgical values for hemoglobin,
      reticulocyte number, and RBC life span. The residual splenic phagocytic function
      was assessed using technetium 99m scans and by enumerating the percentage of
      pitted RBCs in circulation. There were no complications from the surgical
      procedure in any of the 11 individuals. Following partial splenectomy, hemoglobin
      increased on the average by 3 g/dL, reticulocyte count decreased by 300 x
      10(6)/L, and RBC life span was substantially prolonged. Normal technetium uptake
      was noted in the splenic remnant and the percentage of pitted RBCs was in the
      normal range. Partial splenectomy is effective in decreasing the hemolytic rate
      while maintaining residual splenic phagocytic function of the spleen in HS. We
      conclude that the use of this procedure as treatment for RBC membrane disorders
      warrants consideration, especially in infants under 5 years of age who need
      frequent transfusions.

PMID- 8471764
TI  - Immune reconstitution in severe combined immunodeficiency disease after lectin
      treated, T-cell-depleted haplocompatible bone marrow transplantation.
AB  - We describe our 9-year experience with lectin-treated T-cell-depleted
      haplocompatible parental bone marrow transplantation (BMT) for 24 patients with
      severe combined immunodeficiency disease (SCID). Nineteen of 21 evaluable
      patients had T-cell engraftment; 2 of 11 patients tested had B-cell and monocyte
      engraftment. Fourteen of 24 (58%) patients are alive 7 months to 9.8 years post
      BMT. Seventeen of 24 patients received pretransplant conditioning with
      chemotherapy and/or total body irradiation, and 8 of 24 received more than one
      transplant. Patients who received conditioning had a survival rate of 61% versus
      57% for those who received no conditioning. None received graft-versus-host
      disease (GVHD) prophylaxis and no patient had acute or chronic GVHD greater than
      grade I. Kinetics and follow-up of immune recovery were analyzed in 14 patients
      who are greater than 1 year from transplant. Half of the patients showed evidence
      of T-cell function by 3 months and normal T-cell function by 4 to 7 months post
      BMT. On average, T-cell numbers and subsets became normal 10 to 12 months
      posttransplant. Recovery of B-cell function was more delayed, although in most
      patients B-cell numbers and IgM levels were normal by 12 months post-BMT. B-cell
      function, as determined by isohemagglutinin titers or specific antibodies to
      pneumococcal polysaccharide, keyhole limpet hemocyanin, or tetanus toxoid, became
      normal in 10 of 14 patients 2 to 8 years post-BMT. Seven of the 14 are off
      gammaglobulin therapy. Production of isohemagglutinins tended to predict recovery
      of antibody response to pneumococcal polysaccharide (P < .064). Based on these
      results, we believe that haplocompatible BMT is an effective, curative treatment
      for patients with SCID who lack an HLA-matched related donor.

PMID- 8471765
TI  - Glanzmann's thrombasthenia caused by homozygosity for a splice defect that leads
      to deletion of the first coding exon of the glycoprotein IIIa mRNA.
AB  - Glanzmann's thrombasthenia (GT) is the result of the absence or of an altered and
      dysfunctional expression on the platelet membrane of the fibrinogen receptor
      (glycoprotein [GP] IIb/IIIa complex). Various molecular genetic mechanisms have
      been found to be responsible for this inherited disease. In a patient with a
      severe type of GT, we have found a splice variant in the GP IIIa gene that leads
      to premature chain termination. Immunoprecipitation experiments, using monoclonal
      antibodies specific for GP IIb/IIIa, showed that GP IIb/IIIa was not detectable
      on the platelet membrane. Amplification of reversely transcribed platelet GP IIIa
      mRNA by the polymerase chain reaction and subsequent sequence analysis showed a
      86-bp deletion, which corresponds to exon i of the GP IIIa gene. This deletion
      results in a shift of the reading frame leading to eight altered amino acids
      followed by a premature termination codon. Analysis of the corresponding genomic
      DNA fragments showed three mutations in the exon i-intron i boundary region of
      the GP IIIa gene. One of these mutations is a G-->T transition that eliminates
      the GT splice donor site in the wild type. This base pair change creates a
      restriction site for the enzyme Mse I. Allele-specific restriction enzyme
      analysis (ASRA) with Mse I of amplified genomic DNA of the parents and the
      proposita showed that both parents (who are first cousins) are heterozygous,
      whereas the proposita is homozygous for the G-->T substitution.

PMID- 8471767
TI  - Generation and characterization of ex vivo propagated autologous CD8+ cells used
      for adoptive immunotherapy of patients infected with human immunodeficiency
      virus.
AB  - Cytolytic T lymphocytes play an important role in host defense against viral
      infections, including human immunodeficiency virus (HIV). In a phase I clinical
      trial (protocol 080 of the AIDS Clinical Trials Group), generation of CD8+
      effector cells from peripheral blood of patients with acquired immunodeficiency
      syndrome (AIDS)-related complex (ARC) or AIDS and safety of autologous adoptive
      transfer of these cells were evaluated. For therapeutic infusions, CD8+ T cells
      were purified by positive selection on anti-CD8 monoclonal antibody-coated flasks
      from leukapheresed peripheral blood of seven patients. These CD8+ T cells were
      cultured in the presence of interleukin-2 and phytohemagglutinin for up to 3
      weeks to obtain cells sufficient for therapeutic infusions (10(8) to 10(10)). All
      31 cell cultures established from the seven patients and used for therapy were
      highly enriched in CD8+ (mean, 97%), CD8+HLA-DR+ (50%), cytotoxic CD8+CD11b-
      (82%), and memory CD29+ (78%) T lymphocytes. In vitro expanded CD8+ cells had
      excellent cytotoxic function at the time they were used for therapy, including
      HIV-specific activity against autologous targets infected with vaccinia vectors
      expressing HIV-IIIb antigens, gag, pol, and env. Anti-HIV activity of cultured
      CD8+ cells was significantly higher than that of autologous fresh peripheral
      blood lymphocytes. Our results show that CD8+ T lymphocytes obtained from
      peripheral blood of symptomatic HIV-infected patients can be purified, cultured
      to obtain large numbers of cells with enhanced anti-HIV activity, and safely
      infused into patients with AIDS as a form of immunotherapy.

PMID- 8471766
TI  - Active site-blocked factor Xa prevents thrombus formation in the coronary
      vasculature in parallel with inhibition of extravascular coagulation in a canine
      thrombosis model.
AB  - Factor Xa is a central procoagulant enzyme, linking the intrinsic and extrinsic
      activation mechanisms to the final common pathway of coagulation. To assess its
      contribution to pathologic thrombosis, studies were performed in a canine
      coronary thrombosis model. Thrombus formation was initiated by the application of
      electric current via a needle electrode placed in the lumen of the left
      circumflex coronary artery. When 50% occlusion of the vessel developed, the
      current was stopped and animals received an intravenous bolus of either saline,
      bovine glutamyl-glycinyl-arginyl-factor Xa (Xai), a competitive inhibitor of
      factor Xa assembly into the prothrombinase complex, Factor X, or heparin. Animals
      infused with saline or factor X (300 micrograms/kg) developed total occlusion of
      the vessel due to a fibrin/platelet thrombus in 70 +/- 11 minutes (36 of 36
      animals) and 74 +/- 13 minutes (8 of 8 animals), respectively. In contrast,
      infusion of Xai prevented thrombus formation completely at a dose of 300
      micrograms/kg (8 of 8 animals). As the dose of Xai was decreased, its
      antithrombotic effect was diminished, with a patency rate of only 2 of 6 animals
      at a dose of 90 micrograms/kg. Xai at 300 micrograms/kg prevented the
      accumulation of 125I-fibrinogen/fibrin at the site of the coronary thrombus by
      approximately 63% and decreased deposition of 111In-labeled platelets by
      approximately 57%. Hemostatic parameters of animals infused with Xai demonstrated
      prolongation of the PT and dose-dependent increased extravascular bleeding
      tendency. These data indicate that factor Xa has a comparably important role in
      thrombus formation and extravascular hemostasis, and contrast with previous
      results in this same animal model in which IXai selectively prevented clotting in
      the coronary vasculature.

PMID- 8471768
TI  - A phase 1 study of adoptive transfer of autologous CD8+ T lymphocytes in patients
      with acquired immunodeficiency syndrome (AIDS)-related complex or AIDS.
AB  - Based on preclinical studies showing that CD8+ T lymphocytes of human
      immunodeficiency syndrome (HIV)-infected subjects have anti-HIV activities, a
      phase 1 study was undertaken to determine the safety and feasibility of infusing
      in vitro purified, activated, and expanded CD8+ cells as a therapeutic measure in
      seven patients with acquired immunodeficiency syndrome (AIDS)-related complex
      (ARC) or AIDS. Autologous CD8+ cells were first selectively isolated in
      monoclonal antibody-coated flasks from peripheral blood mononuclear cells
      recovered by leukapheresis. They were then cultured and expanded with
      phytohemagglutinin and recombinant interleukin-2 (rIL-2) before infusion. Five
      cycles of isolations and infusions of increasing numbers of CD8+ T cells were
      achieved in five of seven subjects. Five cycles could not be completed in two
      subjects with AIDS whose CD4+ cell counts were < or = 48/microliters. Infusions
      of CD8+ cells alone were well tolerated. Four patients received rIL-2 by
      continuous infusion for 5 days with their final cycle of CD8+ cells. All
      developed reversible adverse effects attributable to rIL-2. After infusion, 111In
      labeled CD8+ cells quickly accumulated in the lungs, with less than 10% of the
      labeled cells remaining in the circulation. After 24 hours, labeled CD8+ cells
      were reduced in the lungs, but increased and persisted in liver, spleen, and bone
      marrow. Four of five patients who were treated with multiple infusions of CD8+
      cells have improved or remained clinically stable, and the fifth developed
      Pneumocystis carinii pneumonia but recovered. This study demonstrated that
      infusion of autologous, in vitro expanded and activated CD8+ cells was feasible
      and clinically well tolerated in five of seven subjects with advanced HIV
      infections.

PMID- 8471769
TI  - Clinical features and outcome of T-cell acute lymphoblastic leukemia in childhood
      with respect to alterations at the TAL1 locus: a Pediatric Oncology Group study.
AB  - Alteration of the TAL1 locus is the most common nonrandom genetic defect in
      childhood T-cell acute lymphoblastic leukemia (T-ALL). To determine if
      rearrangements of the TAL1 proto-oncogene confer a distinct leukemic phenotype,
      we studied leukemic peripheral blood or bone marrow samples from 182 children
      with newly diagnosed T-ALL enrolled on Pediatric Oncology Group treatment
      protocols. Forty-eight (26%) of the samples had a local rearrangement of the TAL1
      locus. Demographic and clinical features were compared for patient subgroups with
      and without TAL1 rearrangements. The only clinical correlates that were
      significantly associated with TAL1 gene rearrangements were higher white blood
      cell count (P = .017) and higher hemoglobin (P = .007) at diagnosis.
      Immunophenotypically, samples with altered TAL1 were more likely to be CD2+ (P =
      .001) and lack CD10 (cALLa) expression (P = .007) than those without the
      rearrangement. There was a trend toward improved event-free survival (EFS) in
      patients with TAL1 rearrangements (4-year EFS was 44% +/- 7% for patients without
      the rearrangements v 59% +/- 11% for those with rearrangements), but the
      difference was not significant (P = .34). The role of TAL1 in leukemogenesis has
      yet to be clearly defined, and the prognostic significance of TAL1 gene
      rearrangements in T-ALL deserves further study.

PMID- 8471770
TI  - High frequency of monoallelic retinoblastoma gene deletion in B-cell chronic
      lymphoid leukemia shown by interphase cytogenetics.
AB  - Inactivation of the retinoblastoma tumor-suppressor gene (RB-1) has been
      associated with tumorigenicity in various human malignancies. In chronic lymphoid
      leukemias of B-cell origin (B-CLL) an involvement of RB-1 has been suggested
      based on cytogenetic data. We examined RB-1 and its chromosomal locus 13q14 in 35
      cases of B-CLL by dual-color in situ hybridization to interphase nuclei and by G
      banding analysis of metaphase chromosomes. In one patient (pt) a monosomy 13, and
      in three other pts deletions involving or encompassing band 13q14 were detected
      by conventional cytogenetic analysis. In contrast, in situ hybridization to
      interphase nuclei showed a monoallelic RB-1 deletion in 11 cases (31%). One pt
      showed a translocation with the breakpoint in 13q1?4 on G-banding, but on in situ
      hybridization analysis the RB-1 signals were not affected. Our data show that RB
      1 deletions can be diagnosed accurately by in situ hybridization on the one-cell
      level. The frequency of RB-1 deletions detected in this study is significantly
      higher than previously assumed in B-CLL, and seems to be in the same range as in
      retinoblastoma.

PMID- 8471771
TI  - Thrombospondin from activated platelets promotes sickle erythrocyte adherence to
      human microvascular endothelium under physiologic flow: a potential role for
      platelet activation in sickle cell vaso-occlusion.
AB  - Adherence of erythrocytes to vascular endothelium likely contributes to the
      pathophysiology of episodic vascular occlusion in patients with sickle cell
      disease (SCD). In addition, coagulation activation has been reported in sickle
      patients during complications such as pain episodes. To test the hypothesis that
      platelet activation contributes to sickle erythrocyte binding, we investigated
      whether factors released from activated sickle platelets promote adherence of
      sickle erythrocytes to human microvascular endothelial cells (MEC) under flow
      conditions. Activated sickle platelet supernatant (ASPS) promoted high levels of
      sickle erythrocyte adherence to MEC (55.4 +/- 3.9 erythrocytes/mm2) but only
      moderate adherence of normal erythrocytes to MEC (14.1 +/- 0.7 erythrocytes/mm2).
      When MEC were incubated with an antibody (OKM5) against CD36 (a thrombospondin
      [TSP] receptor), platelet supernatant mediated sickle erythrocyte adherence was
      inhibited 86%, suggesting that TSP participated in the adherence. To further
      define the role of TSP in adherence, additional studies using purified TSP were
      performed. At a concentration of 0.2 micrograms/mL TSP in serum-free media (SFM),
      sickle erythrocyte adherence to MEC was 33.9 +/- 2.7 erythrocytes/mm2 and sixfold
      greater than either sickle erythrocyte adherence in the absence of TSP or normal
      erythrocyte adherence in the presence of TSP. Doubling the concentration of TSP
      to 0.4 micrograms/mL proportionally increased adherence of sickle erythrocytes.
      Incubation of MEC with OKM5 or anti-alpha v monoclonal antibodies inhibited TSP
      mediated sickle erythrocyte adherence more than 95%. These data suggest that
      activated platelet release factors, including alpha-granule TSP, which promote
      receptor-mediated sickle erythrocyte adherence to microvascular endothelium. Such
      factors released during in vivo platelet activation could contribute to vaso
      occlusive complications by promoting erythrocyte adherence and microvascular
      occlusion.

PMID- 8471772
TI  - Distinct fetal Ank-1 and Ank-2 related proteins and mRNAs in normal and nb/nb
      mice.
AB  - Mice homozygous for the mutation normoblastosis (gene symbol nb on chromosome 8)
      are deficient in erythroid ankyrin (ANK-1) and have a severe hemolytic anemia
      throughout life. Characteristic of the disease is a dramatic decrease in the
      level of expression of the Ank-1 gene (chromosome 8). The other major ankyrin
      transcript, brain ankyrin (Ank-2 on chromosome 3) is expressed at normal levels
      in nb/nb mice. Surprisingly, nb/nb fetuses have normal erythrocyte counts despite
      the decreased levels of Ank-1 transcripts. We previously hypothesized that fetal
      specific ankyrin-related proteins could exist in nb/nb fetuses to account for the
      lack of detrimental effects of ANK-1 deficiency. In the present report, Western
      and Northern blot analyses were performed on hematopoietic cells isolated from
      nb/nb and +/+ fetuses. An ANK-1-related protein (165 Kd) in fetal reticulocytes
      persisted in adult nb/nb but not in +/+ reticulocytes. An Ank-1-related
      transcript of 5.5 kb was found in fetal reticulocytes. This transcript appeared
      to be upregulated in nb/nb but not in +/+ adult reticulocytes. A fetal-specific
      ANK-2-related protein (155 Kd) was present in nb/nb and in +/+ fetal
      reticulocytes. Ank-2-related fetal liver mRNAs were present during the time the
      liver was actively generating erythrocytes. Neither the Ank-2-related transcripts
      nor the 155-Kd ANK-2-related protein were found in +/+ or mutant adult
      reticulocytes. The data indicate that (1) unique ankyrin-related proteins and
      mRNAs present in fetal erythrocytes may stabilize the ankyrin-deficient nb/nb
      erythrocytes and (2) adult nb/nb mice may upregulate fetal gene transcripts to
      compensate for the ANK-1 deficiency.

PMID- 8471773
TI  - Molecular characterization of glucose-6-phosphate dehydrogenase (G6PD) deficiency
      in patients of Chinese descent and identification of new base substitutions in
      the human G6PD gene.
AB  - The underlying DNA changes associated with glucose-6-phosphate dehydrogenase
      (G6PD)-deficient Asians have not been extensively investigated. To fill this gap,
      we sequenced the G6PD gene of 43 G6PD-deficient Chinese whose G6PD was well
      characterized biochemically. DNA samples were obtained from peripheral blood of
      these individuals for sequencing using a direct polymerase chain reaction (PCR)
      sequencing procedure. From these 43 samples, we have identified five different
      types of nucleotide substitutions in the G6PD gene: at cDNA 1388 from G to A (Arg
      to His); at cDNA 1376 from G to T (Arg to Leu); at cDNA 1024 from C to T (Leu to
      Phe); at cDNA 392 from G to T (Gly to Val); at cDNA 95 from A to G (His to Arg).
      These five nucleotide substitutions account for over 83% of our 43 G6PD-deficient
      samples and these substitutions have not been reported in non-Asians. The
      substitutions found at cDNA 392 and cDNA 1024 are new findings. The substitutions
      at cDNA 1376 and 1388 account for over 50% of the 43 samples examined indicating
      a high prevalence of these two alleles among G6PD-deficient Chinese. Our findings
      add support to the notion that diverse point mutations may account largely for
      much of the phenotypic heterogeneity of G6PD deficiency.

PMID- 8471774
TI  - Human erythrocyte protein 4.2 deficiency associated with hemolytic anemia and a
      homozygous 40glutamic acid-->lysine substitution in the cytoplasmic domain of
      band 3 (band 3Montefiore).
AB  - Red blood cell (RBC) protein 4.2 deficiency is often associated with a moderate
      nonimmune hemolytic anemia, splenomegaly, and osmotically fragile RBCs
      resembling, but not identical to, hereditary spherocytosis (HS). In the Japanese
      type of protein 4.2 deficiency (protein 4.2Nippon), the anemia is associated with
      a point mutation in the protein 4.2 cDNA. In this report, we describe a patient
      with moderate and apparently episodic nonimmune hemolytic anemia with
      splenomegaly, spherocytosis, osmotically fragile RBCs, reduced whole cell
      deformability, and abnormally dense cells. Sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis analysis of the proposita's RBC membrane proteins showed an
      88% deficiency of protein 4.2 and a 30% deficiency of glyceraldehyde-3-phosphate
      dehydrogenase (band 6). Structural and molecular analyses of the proposita's
      protein 4.2 were normal. In contrast, limited tryptic digestion of the
      proposita's band 3 showed a homozygous abnormality in the cytoplasmic domain.
      Analysis of the pedigree disclosed six members who were heterozygotes for the
      band 3 structural abnormality and one member who was a normal homozygote. Direct
      sequence analysis of the abnormal band 3 tryptic peptide suggested that the
      structural abnormality resided at or near residue 40. Sequence analysis of the
      proposita's band 3 cDNA showed a 232G-->A mutation resulting in a 40glutamic acid
      ->lysine substitution (band 3Montefiore). Allele-specific oligonucleotide
      hybridization was used to probe for the mutation in the pedigree, showing that
      the proposita was homozygous, and the pedigree members who were heterozygous for
      the band 3 structural abnormality were also heterozygous for the band 3Montefiore
      mutation. The band 3Montefiore mutation was absent in 26 chromosomes from race
      matched controls and in one pedigree member who did not express the band 3
      structural abnormality. In coincidence with splenectomy, the proposita's anemia
      was largely corrected along with the disappearance of most spherocytes and
      considerable improvements of RBC osmotic fragility, whole cell deformability, and
      cell density. We conclude that this hereditary hemolytic anemia is associated
      with the homozygous state for band 3Montefiore (40glutamic acid-->lysine) and a
      decreased RBC membrane content of protein 4.2. We speculate that band 3
      structural abnormalities can result in defective interactions with protein 4.2
      and band 6, and in particular, that the region of band 3 containing 40glutamic
      acid is involved directly or indirectly in interactions with these proteins.

PMID- 8471775
TI  - A comparative study of the iron-clearing properties of desferrithiocin analogues
      with desferrioxamine B in a Cebus monkey model.
AB  - A comparative study of the iron-clearing properties of subcutaneously
      administered desferrioxamine B (DFO) with those of orally administered
      desferrithiocin sodium salt (1), desmethyl desferrithiocin (2), desazadesmethyl
      desferrithiocin sodium salt (3), desazadesmethyl desferrithiocin
      pivaloyloxymethyl ester (4), and desazadesmethyl-5,5-dimethyl desferrithiocin (5)
      in an iron-loaded Cebus monkey model and a non-iron overloaded bile duct
      cannulated rat model is presented. All six drugs, which performed well in rodent
      studies, demonstrated increased efficiency in the Cebus monkey model. When
      administered to rodents at a daily dosage of 384 mumol/kg over a period of 10
      days, drug 1 demonstrated severe renal toxicity. whereas drugs 3, 4, and 5
      exhibited severe gastrointestinal (GI) toxicity. Under the same experimental
      protocol, drug 2 did not show significant toxic side effects. In addition, to
      further evaluate the iron-clearing properties of analogue 2, a dose-response
      study was performed in the primates that showed that iron excretion increased in
      a dose-dependent fashion.

PMID- 8471776
TI  - Antenatal management of severe feto-maternal alloimmune thrombocytopenia: HLA
      incompatibility may affect responses to fetal platelet transfusions.
AB  - In feto-maternal alloimmune thrombocytopenia (FMAIT), severe hemorrhage,
      particularly intracranial haemorrhage (ICH), may occur before delivery.
      Management strategies to prevent ICH in high-risk pregnancies include maternal
      administration of intravenous Ig with or without steroids and fetal platelet
      transfusions. This report describes a patient who lost three fetuses with ICH
      because of FMAIT due to anti-HPA-1a. ICH occurred earlier in successive
      pregnancies (at 28, 19, and 16 weeks of gestation) despite maternal treatment
      with intravenous Ig and steroids from 14 weeks of gestation in the third
      pregnancy. The fourth pregnancy was managed by administering weekly
      intraperitoneal injections of Ig to the fetus from 12 to 18 weeks of gestation.
      At 18 weeks, there was no evidence of ICH, but the fetal platelet count was only
      12 x 10(9)/L. Serial fetal platelet transfusions were started, but there were
      poor responses because of immune destruction of the transfused platelets by
      maternal HLA antibodies. There were improved responses to transfusions prepared
      from the mother and from HLA-compatible HPA-1a-negative donors. At 35 weeks of
      gestation, a normal infant was delivered by Caesarean section after 20 platelet
      transfusions. There was prolonged thrombocytopenia in the baby for 15 weeks after
      birth, probably due to transfer of HPA-1a antibodies in the transfusions of
      unwashed maternal platelets. The optimal management of pregnancies likely to be
      severely affected by FMAIT is still evolving. Intensive management was successful
      in this case, but a successful outcome cannot be guaranteed in severely affected
      cases. This is the first time that HLA incompatibility has been found to
      complicate fetal transfusion therapy.

PMID- 8471777
TI  - A sudden increase in factor VIII inhibitor development in multitransfused
      hemophilia A patients in The Netherlands. Dutch Hemophilia Study Group.
AB  - The development of antibodies to factor VIII (inhibitors) in response to clotting
      factor concentrates administration in hemophilia is common during the first few
      years of treatment but rare in multitransfused patients. We have investigated the
      possible association of a recently introduced factor VIII concentrate (Factor
      VIII CPS-P) in The Netherlands with the occurrence of inhibitors. To this effect,
      we conducted two studies. First, we performed a national multicenter study in
      which clinical information and inhibitor test results were obtained for 447
      hemophilia A patients over the period 1988 through 1991. Secondly, for a baseline
      comparison we estimated the frequency of inhibitor development in a closely
      followed cohort of 144 patients, from 1984 through 1989. Before the introduction
      of Factor VIII CPS-P, the incidence of new inhibitors was 4.4/1,000 patient-years
      in the national study from March 1988 through May 1990, and 3.9/1,000 patient
      years in the cohort followed from 1984 through 1989. These figures are similar to
      the incidence of new inhibitors that was found in a large cohort of patients in
      the United States followed in the 1970s. In the period that the new concentrate
      Factor VIII CPS-P was on the market, from June 1990 through November 1991, 11
      clinically relevant inhibitors were detected, which yielded an incidence over
      this interval of 20.1/1,000 patient-years, a 4.5-fold increase compared with the
      previous interval (C195: 1.4 to 14.3). Nine of these 11 patients had in their
      lifetime received over 250 infusions with factor VIII preparations. whereas all
      of the inhibitors detected in the previous time interval, and all of the 24
      inhibitor patients described in the US study, had received less than 250
      infusions in their lifetime. All patients who developed inhibitors after June
      1990 had been exposed to Factor VIII CPS-P, whereas only 75% of the patients who
      did not develop an inhibitor had been exposed to this product. In a prospective
      extension of the study, with a second inhibitor measurement after 3 months, we
      found that one additional inhibitor had developed during 52.5 patient-years of
      Factor VIII CPS-P use. In conclusion, there has been a sudden increase in the
      frequency of inhibitor patients, for a large part among multitransfused patients.
      It seems more than likely that this increase is associated with the introduction
      of a new factor VIII concentrate in The Netherlands.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8471778
TI  - A prospective randomized comparison of total body irradiation-etoposide versus
      busulfan-cyclophosphamide as preparatory regimens for bone marrow transplantation
      in patients with leukemia who were not in first remission: a Southwest Oncology
      Group study.
AB  - Two novel preparatory regimens for conditioning of patients with leukemia for
      allogeneic bone marrow transplantation (BMT) from histocompatible sibling donors
      have been tested in a phase III trial under the auspices of the Southwest
      Oncology Group (SWOG 8612). These two regimens consisted either of fractionated
      total body irradiation and etoposide (FTBI/VP-16) or high-dose busulfan with
      cyclophosphamide (BU/CY). Only patients who had failed prior conventional
      management at least once were study eligible, ie, no patients with acute leukemia
      in first remission (CR) or in first chronic phase (CP) of chronic myelogenous
      leukemia (CML) participated. Patients were stratified according to the following
      risk criteria: "good-risk" patients were those who were in second CR of their
      acute leukemia or in accelerated phase (AP) of CML; "poor-risk" patients had
      further advanced stages of leukemia. During a 52-month period, 131 patients were
      registered of whom 122 (93%) were study eligible. Sixty-one eligible patients
      were randomized to the FTBI/VP-16 arm and 61 to the BU/CY regimen. Of these 122
      patients, 114 (93%) proceeded to BMT according to protocol. Posttransplant
      immunosuppression to prevent graft-versus-host disease (GVHD) consisted of
      cyclosporine and prednisone (CSA/PSE). Neither overall survival nor disease-free
      survival (DFS) differed significantly between the two treatment groups (P = .89
      and .69, respectively). Estimated DFS for "good-risk" patients who had been
      prepared with the FTBI/VP-16 regimen was 55% +/- 11%, as compared with patients
      treated with BU/CY whose DFS figure was 34% +/- 10% (P = .30). For "poor-risk"
      candidates, the DFS rates at 24 months were 17% +/- 6% (for FTBI/VP-16) and 24%
      +/- 8% (for BU/CY), respectively (P = .81). These figures do not differ
      significantly, especially in view of the fact that the "good-risk" patients
      prepared with the FTBI/VP-16 regimen were younger than those treated with BU/CY.
      Both regimens were well tolerated with no regimen-related deaths encountered
      during the 6-week period after BMT. This study also confirmed the efficacy of the
      CSA/PSE combination in the prevention of GVHD with 23 of 113 (20%) of BMT
      recipients developing moderate to severe acute GVHD. The leading cause for
      treatment failure was leukemic relapse (45 of the 114 BMT recipients suffered a
      recurrence of their leukemia), whereas 38 patients died without evidence of
      relapse. Thirty-one patients are alive and in continued CR after marrow
      transplantation; four are alive in relapse.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8471779
TI  - Busulfan-based regimens and allogeneic bone marrow transplantation in patients
      with myelodysplastic syndromes.
AB  - Preparative regimens containing busulfan (BU) followed by allogeneic bone marrow
      transplantation (BMT) were used in 27 consecutive patients with myelodysplastic
      syndromes (MDS). The median age was 33 years (range, 4 to 54). Ten were female
      and 17 male. Sixteen patients had primary MDS, 11 other patients had antecedent
      hematologic diseases or developed MDS after cytotoxic and/or radiation therapy.
      Six patients had leukemic transformation and received antileukemic therapy before
      BMT. Pre-BMT cytogenetic studies showed complex chromosomal abnormalities in 13
      patients, a simple abnormality in 5 patients, and normal chromosome in 8
      patients. Three BU-based preparative regimens were used: 1 patient received BU 4
      mg/kg orally (PO) daily for 4 days and cyclophosphamide (CY) 50 mg/kg
      intravenously (IV) daily for 4 days (BUCY-4); 24 patients received BU 4 mg/kg PO
      daily for 4 days, cytosine arabinoside (ara-C) 2 g/m2 IV every 12 hours for 4
      doses, and CY 60 mg/kg IV daily for 2 days (BAC); and 2 patients with preceding
      Fanconi anemia received BU 2 mg/kg PO daily for 4 days followed by total lymphoid
      irradiation of 5 Gy. Seventeen of 27 patients are alive with no evidence of
      disease. Ten patients have died: 2 from hepatic veno-occlusive disease, 3 from
      sepsis, 1 from a cerebral bleed, 1 from a massive gastrointestinal (GI) bleed
      associated with acute graft-versus-host disease, 1 from hemolytic uremic syndrome
      with adult respiratory distress syndrome, 1 from bronchiolitis obliterans, and
      the only patient who did not engraft died from acute myeloid leukemia. Regimen
      related toxicities (RRT) include GI tract (diarrhea, 14; stomatitis, 11), liver
      (9), cardiac (1), and skin (5). Patients who received a genotypically matched
      marrow graft had a significantly better disease-free survival (DFS) than patients
      who received a nongenotypic marrow graft (P = .02). The Kaplan-Meier analysis
      projects an overall DFS of 56% +/- 13% and 78% +/- 10% for patients who received
      a genotypically matched marrow graft. With the exception of a child who did not
      engraft, there was no relapse of MDS or leukemia. Excellent DFS, acceptable RRT,
      and the ease of administration are advantages of this regimen.

PMID- 8471780
TI  - Correlation of minor histocompatibility antigen-specific cytotoxic T lymphocytes
      with graft-versus-host disease status and analyses of tissue distribution of
      their target antigens.
AB  - Peripheral blood mononuclear cells (PBMC) from 17 patients receiving HLA
      identical sibling bone marrow grafts were stimulated with host pretransplant
      PBMC. Cytotoxic T-cell lines (TCL) with specificity for host pretransplant PBMC
      were obtained from 9 of these patients, all presenting with severe graft-versus
      host disease (GVHD), but from none of the remaining cases lacking evidence of
      disease. Cytotoxic TCL were specific for host targets and failed to lyse donor
      cells. Monoclonal antibodies (MoAbs) blocking experiments and donor population
      screening analyses demonstrated that minor histocompatibility antigen (MiHA)
      specific lysis of host targets was restricted by class I major histocompatibility
      complex (MHC) determinants. Whereas hematopoietic cells such as
      phytohemagglutinin (PHA) blasts or lymphoblastoid cell lines were susceptible to
      lysis by MiHA-specific TCL, keratinocytes (K) representing the natural targets of
      GVHD were quite resistant. Quantitative radioimmunometric measurements indicated
      very low constitutive expression of class I MHC antigens on K targets, which was
      readily increased by treatment with interferon-gamma (IFN-gamma). IFN-gamma
      treatment at the same time rendered these cells susceptible to lysis by MiHA
      specific TCL. Host leukemic cells of 3 patients were recognized by MiHA-specific
      TCL in a chromium release assay and in one experiment host leukemic cells were
      effectively killed and their growth specifically inhibited in a leukemia colony
      assay by a clone. These data demonstrate that (1) host-specific cytotoxic TCL are
      detected exclusively in the PB of patients with acute GVHD grades II through IV
      after allogeneic matched bone marrow transplantation, and (2) their target
      antigens are simultaneously expressed on several host cell lines, including
      lymphoblastoid cell lines, PHA blasts, leukemic cells, and K. We also extend
      previous findings by showing that, besides the expression of the nominal MiHA,
      the density of the restricting class I MHC elements also crucially determines the
      extent of TCL lysis. Because of its capacity to enhance class I MHC antigen
      expression, IFN-gamma represents a key cytokine for determining the
      susceptibility of MiHA targets for lysis by TCL and clones, and in one patient an
      MiHA-specific clone recognized host leukemic cells and also inhibited host
      leukemic cell growth in a colony inhibition assay.

PMID- 8471781
TI  - Diagnosis and incidence of acute promyelocytic leukemia (FAB M3 and M3 variant)
      in childhood.

PMID- 8471782
TI  - Electroneurography: electrical evaluation of the facial nerve.
AB  - This article provides an introduction, anatomic considerations, and description
      of technique for the performance of electroneurography. Two case studies are
      provided as illustrations.

PMID- 8471783
TI  - Audiologic and otolaryngologic findings in progeria: case report.
AB  - Progeria is a rare syndrome, with an estimated incidence of 1 per 250,000 births.
      Although children with progeria have the appearance of premature aging or
      senility, the term is misleading because reported cases of progeria have not
      manifested most physical or biochemical aspects of old age. Many children with
      progeria appear normal at birth and then progressively, and rather rapidly,
      develop the characteristic features during early childhood. Although first
      described in the 1880s, only approximately 100 cases of progeria are reported in
      the international literature. The single case study of hearing in progeria, which
      appeared in 1965, is limited to pure-tone and speech audiometry findings. We
      report the results of otolaryngologic examination and pure-tone, speech,
      immittance, and auditory brainstem response (ABR) audiometry for a 5-year-old
      female with progeria. The patient had a mild-to-moderate, bilateral, conductive
      hearing loss. Immittance measurements were consistent with fixation of the
      ossicular chain and this was confirmed surgically. Mildly prolonged ABR wave I-V
      latencies suggest possible auditory central nervous system involvement.

PMID- 8471784
TI  - Case studies in binaural interference: converging evidence from behavioral and
      electrophysiologic measures.
AB  - We present four case reports of elderly hearing-impaired persons demonstrating a
      binaural interference effect. Performance measures were poorer when stimulation
      was binaural than when it was monaural. In the first case the effect is shown for
      aided speech recognition scores. In the second case it is shown in topographic
      brain maps of the middle-latency auditory evoked potential. In the third and
      fourth cases it is shown for both aided speech recognition and the middle-latency
      response. The effect may be analogous to the phenomenon of binocular rivalry in
      the visual domain.

PMID- 8471785
TI  - Audiometry in the sound field.

PMID- 8471786
TI  - Status of sound field audiometry among audiologists in the United States.
AB  - Results of a national survey on sound field usage and sound field calibration are
      presented. Respondents to the survey were 418 ASHA certified audiologists, who
      answered questions on demographic variables, sound field testing conditions, and
      sound field calibration procedures. Demographic characteristics of the
      respondents indicate that they were representative of ASHA certified
      audiologists. Eighty-one percent of the respondents use sound field audiometry as
      part of their audiologic practice. Electroacoustic calibration of the sound field
      stimuli is done most often by an equipment technician, and only a small
      percentage of the respondents knew how the calibration was done. Results show a
      lack of standardization among sound field test rooms, great diversity in the
      stimuli used for sound field testing, and inconsistent calibration methods.
      Results indicate the need for standards and improved preservice and in-service
      training in sound field calibration techniques.

PMID- 8471787
TI  - Reexamination of gender differences in the source location of N1m.
AB  - Gender differences in the source location of the auditory evoked field (AEF)
      component N1m have been reported previously in a small group of subjects. The
      present study was conducted to evaluate further the existence of gender
      differences in a larger sample. Neuromagnetic recordings of AEFs were obtained
      from young normal hearing subjects using a 1000-Hz tone burst presented at 60 dB
      hearing level (HL). No significant gender-related differences were observed for
      the N1m peak latencies following left and right ear stimulation. The stimulating
      parameters and larger sample used in the present study size may account for the
      difference in gender effects observed between the two studies.

PMID- 8471788
TI  - Interaural attenuation using insert earphones: electrocochleographic approach.
AB  - We measured the interaural attenuation for click stimuli using insert earphones.
      Electrocochleographic thresholds were determined when clicks were presented both
      ipsilaterally and contralaterally to the recording ear. The interaural
      attenuation was calculated as the difference between ipsilateral and
      contralateral thresholds. Results from normal listeners showed that crossover
      occurred. Results agree with previous investigators who used a different
      approach. Results confirm that one may need to mask the nontest ear in clinical
      evoked potential testing even though insert earphones are used. Several
      approaches to the question of when to mask are proposed.

PMID- 8471789
TI  - Computer simulation technique for assessing pediatric auditory test protocols.
AB  - Adaptive testing procedures are widely used for evaluating the hearing of young
      children. A standard protocol for such testing, however, has not been recommended
      and, as a result, many variations of the procedure are used clinically. This
      study, by utilizing computer simulations, varied several test parameters and
      examined the resulting test outcomes. We evaluated the effects of starting level,
      stimulus step size, and the use of conditioning trials on test outcome, while
      also varying the hearing levels and false positive and and negative rates of our
      simulated subjects. Results indicated that a low starting level, with a 20-dB
      down 10-dB up step size, and no conditioning trials produced the most accurate
      estimates of thresholds under most conditions.

PMID- 8471790
TI  - Evaluating performance with high-frequency emphasis amplification.
AB  - Hearing aid fitting for individuals with high-frequency impairment has been
      difficult because of the limited gain available at those frequencies. Special
      high-frequency emphasis hearing aids have been developed in an attempt to
      alleviate this problem. The insertion-gain responses and changes in speech
      recognition performance (in quiet and in noise, aided and unaided) were measured
      for a commercially available high-frequency emphasis hearing aid, using two types
      of speech materials (nonsense syllables, monosyllabic words). The maximum
      obtainable gain observed for high frequencies approximated that prescribed by the
      NAL-R method, but was considerably lower than that prescribed by other common
      prescriptive methods. Furthermore, modest improvements in speech recognition were
      found. When evaluating individuals with high-frequency impairment, speech
      materials administered in noise appeared to be the most sensitive indication of
      improved speech recognition. Special high-frequency emphasis speech materials
      (CUNY NST) were no more sensitive to improvements in performance than
      conventional clinical word lists (NU6).

PMID- 8471791
TI  - Tactile-auditory speech perception by unimodally and bimodally trained normal
      hearing subjects.
AB  - The following study compared the effectiveness of unimodal and bimodal training
      strategies at improving the perception of speech information under a variety of
      conditions. Normal-hearing subjects were trained in the perception of vowel and
      consonant stimuli. Speech information was provided either via a multiple channel
      electrotactile speech processing aid (the Tickle Talker), and/or by a 200-Hz low
      pass filtered auditory signal. Two subjects were trained only in the combined
      tactile-plus-auditory (TA) condition; the remaining two were trained in both the
      tactile-alone (T) and auditory-alone (A) conditions; however, only one condition
      was used at any single time. All subjects were evaluated in the TA, T, and A
      conditions, both at the beginning of the study, prior to training, and at the
      completion of training, on closed-set vowel and consonant confusion tests, and on
      an open-set word test. Results indicated that whilst statistically significant
      improvements occurred from one evaluation period to the next, in both groups of
      subjects, the improvements per condition were not dependent on the type of
      training received. The results provide a preliminary indication that the
      provision of unimodal training does not impair the perception of speech
      information under bimodal perception conditions.

PMID- 8471792
TI  - Increased expression of the calmodulin gene of the late blight fungus
      Phytophthora infestans during pathogenesis on potato.
AB  - In order to isolate in planta-induced genes encoding putative pathogenicity
      factors of the late blight fungus Phytophthora infestans, a genomic library was
      differentially screened. For the differential hybridization, labeled first-strand
      cDNA synthesized on mRNA isolated from P. infestans-infected potato leaves and on
      mRNA isolated from the fungus grown in vitro were used as probes. This screening
      resulted in the isolation of the P. infestans calmodulin gene. The gene,
      designated calA, contains an open reading frame of 447 base pairs without introns
      and is unique in the P. infestans genome. The predicted amino acid sequence is
      89.9-94.6% identical to calmodulins from higher eukaryotes, whereas the identity
      to calmodulins of higher fungi is significantly less (60.8-85.1%). Expression
      studies revealed that the P. infestans calA gene is constitutively expressed in
      in vitro grown mycelium. However, during pathogenesis on potato the level of P.
      infestans calmodulin mRNA is increased approximately fivefold.

PMID- 8471793
TI  - Severe chlorotic spot symptoms in cucumber mosaic virus strain Y-infected
      tobaccos are induced by a combination of the virus coat protein gene and two host
      recessive genes.
AB  - To investigate the genetic determinants of severe chlorotic spot symptoms in
      cucumber mosaic virus (CMV[Y])-inoculated tobacco (Nicotiana tabacum 'Ky57')
      leaves, symptom expression was compared among tobaccos (N. tabacum 'Ky57', N.
      tabacum 'Xanthi nc', and their hybrids) inoculated with CMV(Y), CMV(O), or
      pseudorecombinants of both strains of CMV. Xanthi nc showed very mild chlorotic
      spot symptoms in CMV(Y)-inoculated leaves. Both CMV(O)-inoculated Ky57 and Xanthi
      nc leaves showed no symptoms. In pseudorecombinant-inoculated Ky57 leaves, severe
      symptoms were determined by chimeric CMV(O) and CMV(Y) RNA3 transcripts, which
      contained most of the coat protein gene of CMV(Y). Genetic analysis of severe
      symptom formation in CMV(Y) or pseudorecombinant-inoculated tobaccos indicated
      that two recessive nuclear-coded host genes determined severe symptom formation
      in CMV(Y)-inoculated Ky57. The two recessive host genetic loci completely
      cosegregated with the two recessive burley loci (yb1 and yb2 genes) of Ky57,
      whose character is an apparent reduction in chlorophyll of the stems. When
      several cultivars of N. tabacum were inoculated with CMV(Y), all burley tobaccos
      clearly showed severe symptoms, but most other cultivars showed very mild
      symptoms. These results suggest that severe chlorotic spot symptom formation in
      CMV(Y)-inoculated Ky57 is induced by a combination of the virus coat protein gene
      and two recessive host genes that are closely linked to or identical to yb genes.

PMID- 8471794
TI  - Characterization of two putative pathogenicity genes of the fungal tomato
      pathogen Cladosporium fulvum.
AB  - The fungus Cladosporium fulvum is a biotrophic pathogen of tomato. On susceptible
      tomato plants, the fungus grows abundantly in the extracellular spaces between
      the mesophyll cells. The mechanism by which C. fulvum is able to establish and
      maintain basic compatibility on its one and only host species, the tomato, is
      unknown. The isolation and characterization of pathogenicity factors and the
      corresponding genes will provide insight into the mechanism by which C. fulvum
      colonizes its host. Two putative pathogenicity genes of C. fulvum encoding
      proteins, which occur abundantly in the extracellular space of infected tomato
      leaves, were isolated and characterized (ecp1 and ecp2). The DNA sequences of
      these ecp genes (encoding extracellular protein) do not share homology to any
      sequence present in the DNA databases. The ecp genes are highly expressed in
      planta but not in vitro, suggesting that they play a significant role in
      pathogenesis.

PMID- 8471795
TI  - Interaction of Xanthomonas campestris with Arabidopsis thaliana: characterization
      of a gene from X. c. pv. raphani that confers avirulence to most A. thaliana
      accessions.
AB  - Infiltration of leaves of Arabidopsis thaliana accession Columbia with
      Xanthomonas campestris pathovar campestris leads to bacterial growth and disease
      symptoms reminiscent of those incited in Brassica plants inoculated under the
      same conditions. A search among A. thaliana accessions for variation in the
      reaction phenotype to strains of X. campestris pathovars campestris, aberrans,
      and raphani showed that there were no clear differential responses between plant
      accessions to the individual bacterial strains tested. X. c. pv. raphani strain
      1067 was avirulent to all A. thaliana accessions tested. A gene was cloned from
      X. c. pv. raphani 1067 which, when transferred into the virulent X. c. pv.
      campestris strain 8004, strongly reduced symptom development and bacterial growth
      in A. thaliana Columbia plants but did not affect virulence to Brassica plants.
      The gene (denoted avrXca) interacted with all A. thaliana accessions tested
      except one, Kas-1, which developed disease symptoms and supported growth of the
      transconjugant to levels similar to those with X. c. pv. campestris 8004 alone.
      Sequence analysis of avrXca revealed a probable open reading frame encoding a
      protein of 66,566 Da that has no homology with other known sequences. A sequence
      motif conserved among hrp genes was identified in the 5' noncoding region of
      avrXca, and features characteristic of a signal peptide were found in the N
      terminal portion of the presumed AvrXca protein. DNA from different
      phytopathogenic bacteria contained sequences hybridizing with avrXca in related
      X. campestris pathovars but not in Erwinia or Pseudomonas strains.

PMID- 8471796
TI  - Azorhizobium caulinodans nitrogen fixation (nif/fix) gene regulation: mutagenesis
      of the nifA -24/-12 promoter element, characterization of a ntrA(rpoN) gene, and
      derivation of a model.
AB  - Using site-directed mutagenesis, mutations were introduced in the -24/-12
      promoter element of the Azorhizobium caulinodans nifA gene, and chimeric nifA
      lacZ reporter gene fusions were constructed. Single base-pair mutations in the
      conserved -25 or -13 G residues were found to reduce or abolish nifA promoter
      activity, respectively, demonstrating that the -24/-12 promoter element is
      important for nifA gene expression and suggesting the involvement of a sigma 54
      (NtrA/RpoN)-type transcription factor in nifA gene regulation. A 2-bp mutation at
      positions -25 and -16 was found to create a relatively nitrogen-control
      independent, highly expressed nifA promoter. Using a heterologous ntrA(rpoN) gene
      probe, an A. caulinodans ntrA(rpoN)-like gene was cloned and the DNA sequence of
      this gene and flanking regions was determined. The presence of three open reading
      frames (ORF1-3) was demonstrated. ORF2 was found to contain regions sharing a
      high degree of homology with all characterized bacterial ntrA(rpoN) genes. ORF1
      was found to share homology with ORFs found upstream of other bacterial
      ntrA(rpoN) genes, which have been postulated to encode members of a superfamily
      of ATP-binding proteins. Transposon Tn5 insertion mutations were introduced into
      the cloned ntrA(rpoN) gene, and chromosomal ntrA(rpoN)::Tn5 A. caulinodans
      mutants were created. The resulting mutants were found to be unable to fix
      nitrogen in the free-living state (Nif- in culture) or in stem or root nodules
      induced on Sesbania rostrata (Fix- in planta), and to be unable to grow
      aerobically in the presence of nitrate as sole nitrogen source (Ntr-). A nifH
      lacZ gene fusion was found to be silent in ntrA(rpoN)::Tn5 mutant strains, but a
      nifA-lacZ gene fusion was found to be expressed at a wild-type level, suggesting
      that the ntrA(rpoN) gene identified here controls the expression of some of the
      A. caulinodans nif genes, but not the central nif regulatory gene nifA. Based on
      these results, a new model for the regulation of nif/fix gene expression in A.
      caulinodans is proposed.

PMID- 8471797
TI  - Repeated injections of interferon-alpha A/D in Balb/c mice: behavioral effects.
AB  - Interferon-alpha decreases food intake and activity in mice and humans. The
      present study further explores parallels between effects of this protein in
      humans and mice, using a hybrid recombinant interferon-alpha A/D (INF-alpha A/D)
      that has antiviral and hepatic activity in mice. Measures of activity (open
      field), muscle strength (forelimb grip strength), and motor ability (swim posture
      and endurance with 0, 3, and 6% added weight) were examined in Balb/c mice
      injected with 1600 U/g of hybrid rhuIFN-alpha A/D daily for 5 days (n = 9) or
      with IFN vehicle (n = 11). Open field activity was significantly depressed in the
      group exposed to IFN. The number of times the nose dipped under the water when
      swimming with 3% added body weight was higher in the IFN-treated mice, while
      float time was decreased with 6% added weight. The IFN-treated mice were slower
      to adopt the new strategies necessary to swim with added weight. Depression of
      motor activity is a robust, general effect of IFN treatment observed in this as
      well as previously published studies. Together, these studies demonstrate
      activity decrements in two different strains of mice, two different activity
      measures, acute and chronic injections, and recombinant and nonrecombinant IFN
      preparations.

PMID- 8471798
TI  - Exposure to conspecific alarm chemosignals alters immune responses in BALB/c
      mice.
AB  - Male BALB/cJ mice were exposed for 24 h to odors from donor mice that were either
      footshocked or undisturbed. Mice exposed to odors from footshocked donors had
      suppressed splenic IL-2 production following in vitro concanavalin A (Con A)
      stimulation compared to home cage or apparatus controls. Stress odor exposure
      also resulted in reduced natural killer (NK) cell cytotoxicity against YAC-1
      tumor target cells compared to controls. Stress odor exposure 24 h after
      intraperitoneal injection of keyhole limpet hemocyanin (KLH) increased IgM and
      IgG antibody titers relative to the response of home cage or apparatus control
      animals. These results demonstrate that exposure to olfactory cues from stressed
      rodents alters both cellular and humoral immune responses. This paradigm may
      provide an ethnologically appropriate model of psychosocial stress in rodents.

PMID- 8471799
TI  - Effect of neuropeptide Y on natural killer activity of normal human lymphocytes.
AB  - The in vitro effect of neuropeptide Y (NPY) on natural killer (NK) cell
      activities of normal lymphocytes was investigated. NPY at 10(-9) to 10(-12) M
      concentrations produced significant suppression of NK activity against K 562
      target cells. NPY at 10(-9) to 10(-12) M concentrations also produced significant
      inhibitory effects on NK activities of NK-enriched large granular lymphocytes
      against LAV-infected 8E5/LAV target cells. The suppression was dose dependent
      against both targets. NPY-induced suppression of NK activity of lymphocytes
      against K 562 target cells was specifically reversed by rabbit anti-NPY antisera
      at 1:800 and 1:1600 dilutions, showing the specificity of reactions. Pretreatment
      of target cells with NPY concentrations capable of inhibiting NK activity did not
      affect the sensitivity of K 562 target cells for lysis by effector cells.
      Inhibition of cytotoxicity was not due to direct toxicity of effector cells,
      because lymphocytes treated with NPY showed normal levels of 51Cr release and
      their viability was comparable to that of untreated control cells. These studies
      demonstrated that NPY, a product of sympathetic nervous system activation, may
      have a significant immunoregulatory effect on NK cell activities of normal
      lymphocytes that may be of clinical significance.

PMID- 8471800
TI  - Trait anxiety and anticipatory immune reactions in women receiving adjuvant
      chemotherapy for breast cancer.
AB  - We compared peripheral blood cell counts as well as mitogen activity and natural
      killer-cell activity in women undergoing adjuvant chemotherapy for breast cancer
      in the hospital prior to chemotherapy with assessment at home 2 days earlier.
      Patients compared to controls had an increased number of white blood cell counts
      in the hospital as compared to those at home, mediated by an increased total
      number of granulocytes. Among patients, those with high compared to low trait
      anxiety evidenced immune system changes. Total number of monocytes were reduced
      in patients with high compared to low trait anxiety and natural killer-cell
      activity tended to be compromised in the high anxiety group. Helper/inducer T
      cells isolated from hospital blood samples were lower in patients with high as
      compared to low trait anxiety, while no difference was observed in samples taken
      at home. Conditioned nausea was associated with trait anxiety and patients with
      as compared to without conditioned nausea displayed immune changes similar to
      changes observed as a function of trait anxiety. State anxiety measured at the
      hospital did not relate to immune measures. The observed increase in granulocytes
      is consistent with an interpretation both in terms of conditioning and
      anticipatory stress. The anticipatory immunosuppression in patients with high
      compared to low trait anxiety is consistent with the hypothesis that chemotherapy
      patients may develop conditioned immunosuppression after repeated pairings of
      treatment-related stimuli with the unconditioned immunosuppressive effect of
      chemotherapy.

PMID- 8471801
TI  - Immune responses in male mice with aggressive and submissive behavior patterns:
      strain differences.
AB  - Immune responses in two strains of male mice with aggressive and submissive
      behavior patterns was studied. In aggressive CBA males immunized on the 10th day
      of agonistic confrontations with submissive partners, greater numbers of plaque
      forming cells (PFC) and rosette-forming cells (RFC) were noted compared to
      control mice. Unlike the CBA strain, both PFC and RFC levels in aggressive C57BL
      males did not increase, but both PFC and RFC numbers decreased in submissive
      animals.

PMID- 8471802
TI  - [Laudatio].

PMID- 8471803
TI  - [Social medicine: why--how--what for? (Social medicine and anthropology)].
AB  - The speech held on the occasion of the Salomon Neumann Medal Award 1992 describes
      with biographical pointers how an internistic clinician (for outpatients)
      developed towards taking up social medicine as his specialty. The starting point
      was the management and care of patients suffering from chronic diseases. This was
      an important step in the direction towards "successful conditional healthiness".
      The conditions included in the concept are both of a personal and of a
      sociological nature, i.e. shared by many. They are dealt with by social medicine
      and also by medical sociology, the separation of which constituted an painful
      disappointment. Arguments against a dichotomy of social medicine and medical
      sociology are also supplied by looking back on the history of ideas with emphasis
      on ancient dietetics and ecology, the early Age of Enlightenment (Leibniz) and
      the 19th century (Virchow, Neumann). It is suggested to create an active link
      between social medicine as the overriding concept and epidemiology, social
      hygiene and medical sociology as subsumptions.

PMID- 8471804
TI  - [Portrayal of the chronic patients in literature of the 19th century].
AB  - Chronic disease appears in the literature and fine arts of the 19th century in
      its manifestations, its causes and its therapy, as well as its symbolism.
      Examples of persuasive characters are portrayed next to negative ones-in the
      respective roles of the patient, the physician, the nurse, as well as of the
      relatives. The limits of medicine are also made apparent as well as possibilities
      presented for ways of giving a human meaning to the suffering, disease and death.

PMID- 8471805
TI  - [Ethics in epidemiology].
AB  - Progress in epidemiology was instrumental for recognising health risk factors and
      emphasising health protection and health risk prevention; it may contribute to a
      Copernican turn in setting new priorities in health care politics and health care
      ethics, in redefining health, disease, and individual health literacy and
      responsibility. This paper reviews recent national and international activities
      to formulate a Code of Ethics for Epidemiologists and evaluates central
      bioethical principals for epidemiologists.

PMID- 8471806
TI  - [Expert evaluation and rehabilitation of nonspecific pain conditions].
AB  - Daily expertising practice shows that in case of exclusively somatically induced
      unspecific pain chronification is greatly enhanced. Faced with such phenomena, it
      is suggested that a dualistic manner of interpretation and treatment taking into
      consideration in equal measure both somatic and psychosocial factors and their
      mutual interaction, may initiate a change in the general trend of the patient's
      complaints towards eventual relief.

PMID- 8471807
TI  - [Food borne outbreak of a Salmonella enteritidis epidemic in a large
      pharmaceutical industry].
AB  - In summer 1991 an outbreak of a Salmonella enteritidis epidemic involving about
      600 cases of gastroenteritis occurred at one of the leading pharmaceutical
      companies in southwestern Germany. The main source was a cold fruit soup, in
      addition Salmonella were isolated from meat strips and a curd cheese which were
      used for a salad dressing. A total of 2300 contaminated food portions were served
      resulting in an attack rate of about 25%. The possible origin could have been an
      asymptomatic Salmonella-positive member of the kitchen personnel who was the only
      one who was involved with the preparation of all the incriminated foods. A
      further spread of the epidemic and especially the possible contamination of
      pharmaceuticals was avoided by the timely and adequate reaction of the company's
      occupational medical service. This case exemplifies how classical crisis
      management, "increased initiative on one's own for prevention of infections in
      all areas of food processing" (Steuer) and finally the cooperation of the company
      with different institutions of the public health authorities contribute to the
      control of such a catastrophic scenario.

PMID- 8471808
TI  - [Malaria travel disease--importation to Germany 1988].
AB  - Malaria continues to be an important travellers' disease in Germany. In 1988 885
      cases of malaria were imported into the Federal Republic of Germany. German
      tourists to far-away countries represented the biggest share (about 80%). Africa
      was the most prominently represented continent with 76%. Differentiation
      according to species of pathogens showed that 68% of the diseases were caused by
      Plasmodium falciparum. 11 patients died of malaria in 1988, in all cases due to
      P. falciparum infection. The mortality of the patients increases with age. Only
      in 5 of 11 persons who died there had been a sufficient prophylaxis against
      malaria, at least as far as the anamnesis revealed. Careful planning of
      sufficient prophylaxis taking into consideration the partly very marked
      resistance to a multitude of drugs, as well as competent medical advice to would
      be travellers, are imperative before the number of malaria imports into Germany
      can be reduced.

PMID- 8471809
TI  - [Health care structure legislation--reform of health insurance].
AB  - On January 1st, 1993, the German Health Care Structure Reform Act has come into
      effect. It will fundamentally change the system of health insurance as well as
      the health care system. By the reform act, new structural and controlling
      elements have been installed in all central branches of health care, and, at the
      same time, a new order for the competition between the sickness funds has been
      established. Far-reaching structural alterations affect the hospital sector, the
      drug market and the system of ambulatory care. In the hospital sector, there will
      be a change-over to a price system consisting of special payments, payment
      according to diagnostic-related groups, and differentiated per-diem rates. On the
      drug market there will be introduced, besides a drug budget for doctors, a
      positive list for pharmaceuticals which will be worked out jointly by
      representatives of the medical profession and the sickness funds. In the
      ambulatory sector, licensing restrictions for doctors intending to set up
      practice will be introduced and the importance of the general practitioner or
      family doctor will be enhanced. The Health Care Structure Reform Act provides for
      self-government of the sickness funds and the medical profession with a wide
      range of controlling and shaping instruments. It also places the Ministry of
      Health in a better position to take influence. After the expire of the budgeting
      phase, competitive elements resp. extended controlling measures in the contracts
      sector will become more and more important features of the health care system. It
      remains to be seen whether the new controlling instruments will suffice to cause
      the intended limitation of expenditure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8471810
TI  - [Report of the 28th Annual Congress of the German Society of Social Medicine and
      Prevention--Lubeck, 29 September-3 October 1992].

PMID- 8471811
TI  - Current therapy of systemic sclerosis (scleroderma).
AB  - Treatment of systemic sclerosis (scleroderma) presents a challenge to both the
      patient and the physician. Established approaches include long-term
      physiotherapy, disease-modifying agents such as D-penicillamine, and treatment of
      organ involvement. These efforts are often unsatisfactory since the results are
      poor. However, recent advances include treatment of Raynaud's phenomenon
      (plasmapheresis, stanozolol, and prostacyclin analogues), scleroderma renal
      crisis (angiotensin-converting enzyme inhibitors), and gastric hypomotility
      (cisapride). This article covers the current approaches to the disease-modifying
      therapy including those related to the function of collagen-producing
      fibroblasts, vascular alterations, and the cellular and humoral immune system, as
      well as treatment of involved organs.

PMID- 8471812
TI  - Lipoatrophic diabetes.

PMID- 8471813
TI  - The effect of the apolipoprotein E polymorphism on lipid levels in patients with
      familial defective apolipoprotein B-100.
AB  - Serum lipid concentrations of patients with familial defective apolipoprotein B
      100 (FDB) show a high interindividual variability although the underlying defect
      is caused by a single point mutation. On the other hand, several genetic factors
      modulating serum cholesterol levels are known, such as DNA polymorphisms of the
      apolipoprotein B or the apolipoprotein E (apo E) gene. To assess the effect of
      the apo E polymorphism on serum cholesterol, lipid levels of FDB patients (n =
      36) were compared with those of a normolipidemic control group (n = 272)
      according to their apo E genotype. For the FDB group mean values of low-density
      lipoprotein (LDL) cholesterol (mg/dl) were 225.7 +/- 53.7 for E3/2 genotype (n =
      3), 234.2 +/- 48.3 for E3/3 genotype (n = 20), and 252.4 +/- 73.8 for E4/3
      genotype (n = 13). Means of triglycerides (mg/dl) were 121.0 +/- 21.2, 114.8 +/-
      60.7, and 110.0 +/- 62.8 for the respective apo E genotypes. The calculated
      average effect of the apo E alleles on LDL cholesterol levels was -6.0% for
      allele e2 and +3.7% for e4 relative to the whole FDB group. The effect on
      triglyceride levels was +7.5% for e2 and -3.6% for e4. The control group showed a
      similar variation in LDL cholesterol depending on the different apo E genotypes.
      About 6% of the total variation in LDL cholesterol can be accounted for by the
      apo E locus in normolipidemic and hypercholesterolemic individuals alike.

PMID- 8471814
TI  - Periodic respiration in patients with heart failure.
AB  - Patients with heart failure are known to demonstrate periodic respiration (PR)
      during sleep. The factors causing PR are not well known. We therefore studied 20
      patients (aged 18-66 years) with idiopathic dilated cardiomyopathy. Full-night
      polysomnography and evaluation of respiration and transcutaneous oxygen
      saturation were performed. Hypercapnic ventilatory response (HCVR) was evaluated
      during daytime. The patients showed PR for 25 +/- 26% (mean +/- standard
      deviation) of total sleep time. During PR, oxygen desaturated 7.1 +/- 4.6%. Sleep
      was impaired. HCVR was normal. Oxygen desaturation during PR was predicted by
      HCVR (r = 0.47, P < 0.05) and left atrial diameter (r = 0.60, P < 0.05). The time
      period of PR expressed as a fraction of total sleep time was correlated with HCVR
      (r = 0.45, P < 0.05) and left atrial diameter (r = 0.51, P < 0.05). In
      conclusion, PR with oxygen desaturation, arousals, and impaired sleep was
      observed in stable heart failure. HCVR and left heart dimensions were related to
      PR. These findings confirm the concept of a feedback loop describing respiratory
      control in PR.

PMID- 8471815
TI  - Influence of fiber, xylitol and fructose in enteral formulas on glucose and lipid
      metabolism in normal subjects.
AB  - To verify the benefit of nonglucose carbohydrates and fiber in enteral formula
      diets we studied the postprandial metabolism of eight healthy subjects after the
      intake of two helpings (25 g carbohydrates each) of five commonly used enteral
      formulas over 4 h. There were no significant differences in postprandial
      concentrations of blood glucose among the formulas. The area under the curve of
      postprandial insulin values, however, was significantly smaller after consumption
      of the fructose-containing formula (1948 +/- 285 microU min ml-1, P < 0.05) than
      after fiber-free (3222 +/- 678 microU min ml-1) or two fiber-containing products
      (2664 +/- 326 microU min ml-1, P < 0.05; and 3040 +/- 708 microU min ml-1, P <
      0.05). The insulin area of the xylitol-containing formula (2307 +/- 364 microU
      min ml-1) was significantly smaller compared to the fiber-free product (P <
      0.05). In addition, we found the postprandial increase in triglycerides to be
      significantly higher after the xylitol-containing formula (from 0.93 +/- 0.14 to
      1.25 +/- 0.22 mmol/l) than after the fiber-free product (from 0.82 +/- 0.13 to
      0.97 +/- 0.16 mmol/l, P < 0.05) or the two fiber-containing products (from 0.88
      +/- 0.16 to 0.96 +/- 0.18 mmol/l, P < 0.05; and from 0.80 +/- 0.08 to 0.95 +/-
      0.10 mmol/l, P < 0.05). We conclude that a patient with type II diabetes may
      benefit from replacing glucose and glucose-equivalent carbohydrates with fructose
      or xylitol.

PMID- 8471816
TI  - Postoperative pulmonary complications in patients with esophageal cancer.
AB  - There are recent reports on postoperative pulmonary complications in patients
      with esophageal cancer who were treated preoperatively with chemotherapy and
      irradiation. The Hamburg Esophageal Study Group is currently undertaking a
      prospective randomized study to evaluate the efficacy of preoperative treatment.
      Postoperative pulmonary complications and mortality in these patients with either
      a combined preoperative treatment (group 1, n = 11) or chemotherapy alone (group
      2, n = 9) are evaluated in the present paper. Complete remission of the tumor was
      found more often in group 1 (54.6%) than in group 2 (22.2%). However,
      postoperatively the patients of group 1 developed adult respiratory distress
      syndrome (ARDS; 54.6%) more frequently than in group 2 (11.1%), and all patients
      with ARDS died. Thus, although the combined preoperative treatment is more
      effective in tumor remission, it is associated with a higher respiratory failure
      and postoperative mortality. Therefore, the preoperative regime has now been
      changed by the study group. Since after the clinical manifestation of ARDS no
      causative clinical therapy is available up to now, attention must be focused on
      the prevention of respiratory failure.

PMID- 8471817
TI  - A novel variety of atypical Pneumocystis carinii infection after long-term
      prophylactic pentamidine inhalation in an AIDS patient: large lower lobe
      pneumocystoma.
AB  - Atypical pulmonary manifestations of Pneumocystis carinii infection and fair
      numbers of extrapulmonary and disseminated infections have lately been documented
      in patients with human immunodeficiency virus infection treated prophylactically
      with inhalative pentamidine. We report the case of a 32-year-old homosexual
      patient who was assessed for complaints of night sweats, weight loss, and
      progressive malaise. The patient denied any respiratory tract symptoms such as
      cough, sputum production, pleuritic chest pain, or shortness of breath. Chest X
      ray revealed two large round noncavitating lesions in the lower lobe of the right
      lung. Pneumocystomas were diagnosed by fine-needle aspiration. A 3-week course of
      intravenous high-dose cotrimoxazole resulted in amelioration of symptoms but no
      change in the radiographic appearance of the pulmonary lesions. Four months later
      the patient is alive and stable and is being treated with pentamidine inhalation
      of 300 mg per 2 weeks and two tablets of pyrimethamine sulfadoxine per week.

PMID- 8471818
TI  - Effects of fish oil concentrate on lipoproteins and apolipoproteins in familial
      combined hyperlipidemia.
AB  - The effects of two moderate doses of long-chain n-3 fatty acids (3.0 and 4.5 g
      EPA+DHA per day for 4 weeks each) on serum lipids and lipoproteins of patients
      with familial combined hyperlipidemia (FCH) were studied in a double-blind,
      placebo-controlled clinical trial. In nine patients with FCH n-3 fatty acids led
      to a statistically significant, dose-dependent fall in very low density
      lipoprotein (VLDL) triglycerides (3 g/day: -42%, 4.5 g/day: -55%) VLDL
      cholesterol (3 g/day: -41%, 4.5 g/day: -47%), and VLDL apolipoprotein (apo) B-100
      (3 g/day: -40%, 4.5 g/day: -56%). No overall change in low-density lipoprotein
      (LDL) cholesterol was found, as confirmed statistically. However, when analyzing
      the data of single patients LDL cholesterol and LDL apo B did not change in five
      patients but increased dose dependently (from pretreatment 4.80 +/- 0.93 mmol/l
      to 5.70 +/- 0.93 mmol/l LDL cholesterol after 4.5 g/day) in four. LDL and VLDL
      composition as indicated by cholesterol/apo B-100 and triglyceride/apo B-100
      ratios did not change significantly. High-density lipoprotein (HDL) cholesterol
      was unchanged; the HDL cholesterol/apo A-I+apo A-II ratio increased by 19% (P <
      0.05) during fish oil treatment. We conclude that in FCH moderate doses of long
      chain n-3 fatty acids are highly effective in lowering pathological VLDL
      triglycerides, VLDL cholesterol, and VLDL apo B. LDL cholesterol must, however,
      be monitored during treatment as it may rise substantially in some although not
      in all patients with this disease.

PMID- 8471819
TI  - Chronic pentamidine aerosol prophylaxis does not induce QT prolongation.
AB  - Intravenous administration of pentamidine is known to cause long-QT syndrome
      (Torsade de pointes tachycardias and large QT prolongation) in rare cases and to
      cause small QT prolongation regularly. A similar pattern is seen with other drugs
      known to cause a long-QT syndrome. Pentamidine aerosol prophylaxis is commonly
      used to prevent Pneumocystis carinii pneumonia in HIV-infected persons. The goal
      of this study was to clarify whether pentamidine aerosol prophylaxis induces QT
      prolongation. We examined 100 patients receiving pentamidine aerosol prophylaxis
      at a rather high dose (300 mg biweekly) for at least 1 month (range 1-24) by
      determining the QT interval corrected for heart rate (QTc), blind for treatment.
      In a cross-sectional study, QTc was not different in 50 HIV-infected patients
      with chronic pentamidine aerosol prophylaxis (413 ms), 50 similar HIV-infected
      patients without pentamidine (407 ms), and 50 similar patients without HIV
      infection and without pentamidine (407 ms). In a longitudinal study in another 50
      HIV-infected patients, QTc was the same before (414 ms) and on long-term (median
      9-month) pentamidine aerosol prophylaxis (414 ms). In contrast to the case with
      intravenous pentamidine, we found no QT prolongation and thereby no risk of long
      QT syndrome with pentamidine aerosol prophylaxis.

PMID- 8471820
TI  - Efficacy and tolerance of recombinant tissue-type plasminogen activator in
      patients with thrombotic or embolic occlusions of leg-arteries.
AB  - The efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA)
      was evaluated in 46 patients with thromboembolic arterial occlusions in leg
      arteries. rt-PA was given over 1-4 h with a maximum dose of 18 mg. The effect of
      rt-PA treatment was determined as patency of the occluded arteries in 44
      different patients 14 days after treatment. In 41 patients at least one artery
      was recanalized (93%) by rt-PA, and in almost half of these patients (48%) no
      residual stenosis were detected after the lytic treatment. A slight residual
      stenosis was detected in 29% of the patients and a severe residual stenosis in
      21%. An additional treatment with percutaneous transluminal angioplasty was
      performed in 23 of the 44 patients and successful in 21 (91%). In 8 patients an
      addition catheter-embolectomy was performed. No difference in patency rate was
      detected between patients with thrombotic and those with embolic occlusions. The
      age of the occlusion influenced the patency rate; occlusions under the age of 5
      weeks showed a patency rate of 96% compared to 82% in older occlusions. The
      length of the occlusion did not have any influence on the outcome of the rt-PA
      treatment. From the results of this open study we conclude that a dose of up to
      18 mg of rt-PA is both safe and effective in the treatment of thromboembolic
      occlusions in leg arteries.

PMID- 8471821
TI  - Selective intra-lysosomal concentration of niobium in kidney and bone marrow
      cells: a microanalytical study.
AB  - Niobium is used as an alloy in the industrial and biomedical fields. The
      concentration of the toxic element in organs of a number of animal species has
      been defined by using radioactive niobium (95Nb). However, tissue lesions induced
      by niobium have only been studied at the light microscopy level. In this study,
      we used an electron probe X-ray analyzer equipped with a transmission electron
      microscope to define the localization of this element in kidney and bone marrow
      cells. Results demonstrated that niobium is located in the lysosome and that this
      element coprecipitates with phosphate. In kidney, lysosomes and precipitates are
      eliminated in the tubular lumen. In contrast, precipitates appear to be
      eliminated more slowly from the lysosomes of bone marrow macrophages. These
      processes therefore correspond to one of the mechanisms by which lysosomes
      eliminate certain toxic mineral elements and thus play a role in the more general
      process of the body's defenses.

PMID- 8471822
TI  - Purification of outer membrane iron transport receptors from Escherichia coli by
      fast protein liquid chromatography: FepA and FecA.
AB  - Fast protein liquid chromatography (FPLC) with DEAE-Sepharose Fast Flow, PBE-94
      and Q-Sepharose Fast Flow columns are applied to the purification of the ferric
      enterobactin protein receptor (FepA). The apparent single band of FepA on SDS
      PAGE is isolated and purified into two proteins with very similar molecular
      weights. The two proteins are identified to be FepA and ferric citrate protein
      receptor (FecA) by N-terminus amino acid determination and a computer search with
      the Gene Bank file. The assay of binding activities of these proteins shows that
      both FepA and FecA bind ferric enterobactin, with the former having about double
      the activity of the latter. Competition studies shows that Fe-MECAM is
      competitively bound to both proteins and that ferric parabactin only slightly
      competes with [55Fe]ferric enterobactin. It is found that ferrichrome A has no
      effect on the binding of the receptor proteins with ferric enterobactin.

PMID- 8471823
TI  - Effect of chronic vanadium administration in drinking water to rats.
AB  - Two-month old Wistar rats of both sexes received, as sole drinking liquid, an
      aqueous solution of ammonium metavanadate (AMV) at a concentration of 0.01 or
      0.05 mg V cm-3 (0.2 or 1.0 mM) for a period of 4 weeks. It was calculated that
      the animals took up doses of 1.5 and 5-6 mg V kg body weight-1 24 h-1,
      respectively. Food and AMV solution consumption in the experimental group was
      similar to food and water consumption in the control group. A statistically
      significant decrease of consumption of AMV solution at a concentration of 0.05 mg
      V cm-3 was noted only in males. Hematological examination demonstrated a decrease
      in the erythrocyte count, hemoglobin level and hematocrit index. This decrease in
      the erythrocyte count was associated with an increased percentage of
      reticulocytes in the peripheral blood of the animals drinking the solution with a
      higher vanadium content. Biochemical analyses demonstrated a decrease of L
      ascorbic acid levels in the plasma and erythrocytes of animals drinking the AMV
      solutions. A distinct tendency for the malonyldialdehyde level to increase in the
      blood was also observed. Among the enzymes examined in the erythrocytes
      (catalase, glucose-6-phosphate dehydrogenase, lactate dehydrogenase and delta
      aminolevulinic acid dehydratase [ALA-D]) only ALA-D activity was depressed.

PMID- 8471824
TI  - A novel purification of ferric citrate receptor (FecA) from Escherichia coli
      UT5600 and further characterization of its binding activity.
AB  - In our earlier paper, it was demonstrated that the FecA receptor protein from
      Escherichia coli UT5600/pBB2 (leu-, proC-, trpE-, entA-, rpsl-, delta (ompT-fepA)
      /Ampr, fepA) binds with ferric enterobactin. In order to explore this further the
      outer membrane receptor protein, FecA, has been isolated from UT5600 (fepA-) and
      purified to homogeneity by DE-52-cellulose anion exchange chromatography followed
      by MonoPFPLC chromatofocusing. Partially purified FecA and homogeneous FecA show
      binding activity to [55Fe]ferric enterobactin and the binding is specific.
      Binding activity of FecA can be enhanced by ferric citrate. Lipopolysaccharide
      free FecA as ascertained by silver staining and the endotoxin test still retains
      the same activity. In vivo uptake studies using different strains of E. coli
      suggest that FecA in E. coli plays an important role in ferrienterobactin
      transport.

PMID- 8471825
TI  - Metal resistance in Acinetobacter and its relation to beta-lactamase production.
AB  - Thirty nine clinical isolates of Acinetobacter belonging to six species were
      tested for resistance to 20 metal ions and their ability to produce beta
      lactamase. Fifty two percent of the strains produced beta-lactamase. beta
      Lactamase producers and non-producers were almost equally distributed in the
      different species. A. baumannii was the predominant biotype and was found to be
      most resistant to metals. Resistance to mercury was prevalent in beta-lactamase
      producing A. baumannii only. Silver resistant strains of A. baumannii produced
      beta-lactamase. Sensitivity and resistance to copper and cadium was equally
      distributed between beta-lactamase producers and non-producers. beta-Lactamase
      producer and -non-producer strains were uniformly sensitive to cadmium except
      Acinetobacter genospecies 1.

PMID- 8471826
TI  - Concentrations of heavy metals in maternal and umbilical cord blood.
AB  - Concentrations of lead, cadmium, methylmercury and total mercury were measured in
      maternal and umbilical cord blood using graphite atomic absorption spectrometry.
      Two essential metals, copper and zinc, were also determined using ion
      chromatography. Lead, copper and zinc were found to be lower in the cord blood
      whereas methylmercury and total mercury were higher in cord blood than in
      maternal blood. Little differences were noted for cadmium in maternal and cord
      blood. Significant positive correlations were observed between the concentrations
      in maternal and cord blood with regard to lead (correlation coefficient, r =
      0.44), copper (r = 0.34), zinc (r = 0.29), methylmercury (r = 0.44) and total
      mercury (r = 0.58). These results suggest that, like essential metals, most heavy
      metals can move rather freely across the human placenta. The potential health
      effects of heavy metal transfer from mothers to young infants cannot be
      discounted.

PMID- 8471828
TI  - A single electroconvulsive treatment affects platelet serotonin uptake in bipolar
      I patients.
AB  - We evaluated serotonin (5HT) uptake parameters in platelets of a group of bipolar
      I patients in both a depressive phase and a mixed state, before (t0) and after
      (t1) the first electroconvulsive treatment (ECT). The results showed the presence
      of significant changes in the number of the carrier proteins for 5HT at t1, which
      in most cases preceded the clinical improvement. Although other mechanisms are
      certainly involved, these data suggest that ECT may influence the 5HT transport
      through platelet membranes.

PMID- 8471827
TI  - Plasma concentrations of fluvoxamine and maprotiline in major depression:
      implications on therapeutic efficacy and side effects.
AB  - We examined the relationship between plasma concentrations of specific acting
      antidepressants (fluvoxamine/maprotiline) and clinical improvement as well as the
      impact of the magnitude of the plasma concentration of these antidepressants on
      side effects. Patients (32 patients with major depression) were treated within a
      double-blind parallel trial for four weeks and plasma concentrations were
      obtained before, on days 8 and 28 of the trial. Although there was a fixed
      flexible dosage design it was apparent that 16 patients (89%) of the fluvoxamine
      group and all patients of the maprotiline group received a dosage between 200 and
      300 mg/day in the last week of the trial. Plasma concentrations (mean +/- SD
      micrograms/l) of fluvoxamine were 125 +/- 91 and 142 +/- 108 on days 8 and 28,
      respectively and the range of fluvoxamine plasma concentrations on day 28 was
      from 20 to 417 micrograms/l. Plasma concentrations (mean +/- SD micrograms/l) of
      maprotiline were 146 +/- 62 and 202 +/- 134 on days 8 and 28, respectively and
      the range of maprotiline plasma concentration on day 28 was from 12 to 428
      micrograms/l. There was no linear relationship between plasma concentrations of
      both antidepressants (fluvoxamine/maprotiline) and oral dosage. Whereas there was
      no correlation between fluvoxamine concentration and clinical response there was
      a tendency that higher maprotiline concentrations were associated with a better
      antidepressive efficacy at the end of the trial. Higher concentrations of
      fluvoxamine as well as of maprotiline were significantly (P < 0.05) associated
      with more side effects.

PMID- 8471829
TI  - Chloroquine-induced seizures in mice: the role of monoaminergic mechanisms.
AB  - The influence of some dopaminergic and noradrenergic agents on seizures induced
      by chloroquine (45-100 mg/kg, i.p.) was investigated in mice. Apomorphine (0.2
      0.8 mg/kg, s.c.). L-dopa (25-50 mg/kg, s.c.) benserazide (5 mg/kg, i.p.) plus L
      dopa (50 mg/kg, s.c.), pargyline (100 mg/kg, i.p.), FLA-63 (10-20 mg/kg, s.c.)
      and FLA-63 (10 mg/kg, s.c.) plus L-dopa (50 mg/kg, s.c.) profoundly shortened the
      latency of seizures induced by chloroquine (65 mg/kg, i.p.). L-Dopa (50 mg/kg,
      s.c.) weakly reduced the latency and weakly increased the incidence of
      chloroquine (50 mg/kg, i.p.)-induced seizures. alpha-Methyl-p-tyrosine (25-100
      mg/kg, i.p.) dose-dependently and significantly reduced the incidence and
      significantly prolonged the latency of chloroquine (65 mg/kg, i.p.)-induced
      seizures. However, L-dopa (50 mg/kg, s.c.) effectively increased the proportion
      of animals convulsing and effectively reduced the latency of seizures induced by
      chloroquine (65 mg/kg, i.p.) in alpha-methyl-p-tyrosine-pretreated mice.
      Haloperidol (0.25-1.0 mg/kg, i.p.) and pimozide (2-4 mg/kg, i.p.) markedly
      reduced the incidence and markedly prolonged the latency of seizures induced by
      chloroquine (65 mg/kg, i.p.) in a dose-related manner. However, apomorphine (0.4
      0.8 mg/kg, s.c.) and L-dopa (25-50 mg/kg, s.c.) profoundly attenuated the
      protective effects of haloperidol (0.5 mg/kg, i.p.) and pimozide (4 mg/kg, i.p.)
      against chloroquine (65 mg/kg, i.p.)-induced seizures.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8471830
TI  - The influence of lorazepam medication upon the transfer properties of the brain
      during sleep in man.
AB  - In order to get better insight into the principles of information processing by
      the brain during sleep and its alterations under the influence of drugs we
      applied some tools from linear system theory to sleep EEG data. We investigated
      late components of auditory and visually evoked potentials (AEPs and VEPs) during
      different sleep stages and calculated from these the so-called amplitude
      frequency characteristics (AFC). The main advantage of this analysis is that it
      enables one to detect functional differences during different sleep stages. This
      information can hardly be obtained by conventional spectral analysis. The result
      of our investigation was that the transfer properties of the brain during sleep
      were extremely different and that lorazepam medication not only resulted in
      quantitative alterations of the sleep profile but mainly in highly significant
      alterations of the functional properties of sleep.

PMID- 8471831
TI  - Anti-exploratory effect of N-methyl-D-aspartate in elevated plus-maze.
      Involvement of NMDA and CCK receptors.
AB  - N-Methyl-D-aspartate (NMDA, 20 mg/kg) produced a clear decrease in mouse
      exploration in open parts of an elevated plus-maze. Paradoxically, 40 mg/kg NMDA
      did not modify the behavior of the mice in the plus-maze. NMDA at a dose of 80
      mg/kg again depressed the exploratory activity of mice, but this effect was
      accompanied with tremor and compulsive tail biting. The 'anti-exploratory' dose
      of NMDA (20 mg/kg) increased, whereas the 'tremorigenic' dose (80 mg/kg)
      significantly decreased the number of cholecystokinin (CCK) binding sites in the
      mouse cerebral cortex. The competitive NMDA antagonist (+/-)-CPP (2.5-5 mg/kg)
      and the non-competitive antagonist MK-801 (0.25 mg/kg) antagonized the anti
      exploratory effect of NMDA (20 mg/kg). The tricyclic antidepressant imipramine (5
      mg/kg, but not 1 or 10 mg/kg) also attenuated the inhibition of exploratory
      activity induced by NMDA. Of three CCK receptor antagonists tested, the
      unselective CCK antagonist proglumide (1 mg/kg, but not 0.1 and 10 mg/kg)
      significantly opposed the anti-exploratory action of NMDA. The selective CCK
      antagonists L-365,260 (1 microgram/kg) and devazepide (1 microgram/kg) were
      evidently weaker antagonists of NMDA. Furthermore, 10 micrograms/kg of L-365,260,
      a CCK-B receptor antagonist, and 1 mg/kg of devazepide, a CCK-A receptor
      antagonist, even tended to augment the effect of NMDA in the plus-maze. The
      results of the present study seem to give some support to the notion that not
      only NMDA receptors, but also CCK-ergic mechanisms are involved in the modulation
      of anti-exploratory action of NMDA in the elevated plus-maze.

PMID- 8471832
TI  - Prolactin and thyrotropin responses to ECT after pindolol administration. A
      placebo controlled study.
AB  - The effect of pindolol, a beta-receptor blocker with potent 5-HT1 receptor
      antagonistic properties, on the prolactin (PRL) and thyrotropin (TSH) responses
      to electroconvulsive therapy (ECT) was systematically studied in 12 female
      depressed patients. In a balanced order, crossover design, the patients were
      given placebo or pindolol 5 mg orally, 1 h prior to bilateral ECT. The last five
      patients were additionally tested with 10 mg pindolol during the third ECT.
      Plasma levels of PRL and TSH increased in all three trials, but no consistent
      effect of pindolol on these hormonal responses could be demonstrated. Pindolol
      tended to attenuate seizure duration, especially at the 10 mg dose. The
      participation of 5-HT1 receptor activity in the secretion of PRL and TSH during
      ECT remains uncertain.

PMID- 8471833
TI  - The inheritance pattern of dysplastic naevi in families of dysplastic naevus
      patients.
AB  - Dysplastic naevi (DN) are the major precursor lesions of malignant melanoma, yet
      the presumed mode of inheritance or genetic aetiology of DN remains
      controversial. The inheritance pattern of DN in families from a randomly selected
      population of 26 dysplastic naevus patients was investigated by estimating the
      segregation ratio in families ascertained through an offspring with DN
      (incomplete ascertainment). For families ascertained through a parent with DN
      (complete ascertainment) the transmission pattern was examined by comparing the
      observed number of affected offspring to the expected number using a chi 2
      goodness-of-fit test. Results from the chi 2 tests and the estimated segregation
      ratio of 0.52 (95% confidence interval: 0.31, 0.73) suggest that the inheritance
      pattern for dysplastic naevi in these families is consistent with autosomal
      dominant transmission, although the present study was limited because of a small
      sample size. The findings, therefore, need to be confirmed by a much larger study
      that is able to test more rigorously specific genetic hypotheses.

PMID- 8471834
TI  - Expression of the c-ski proto-oncogene in human melanoma cell lines.
AB  - The aim of this study was to establish whether the expression of proto-oncogene c
      ski in melanoma might be related to alterations of chromosome 1q involving the
      native location of the gene. Six melanoma cell lines, including two carrying
      marker chromosomes derived from breakage at 1q12-q21, were studied. Expression of
      c-ski was observed in all cell lines, with very high levels in five of them.
      However no alteration in c-ski structure or dosage was found in any of the
      melanoma cell lines, including those with non-random breakpoints near the gene. c
      ski Transcripts were detected in cell cultures from normal melanocytes, but at a
      much lower level than that observed in melanoma cell lines. Transcripts of c-myb
      and the beta-NGF gene were not detectable in any of the melanoma cell lines,
      whereas sis- and epidermal growth factor (EGF) receptor gene-specific transcripts
      were present in two and four melanoma cell lines, respectively. The constant
      expression of c-ski in the melanoma-derived cell lines at a level of expression
      much higher than that of normal melanocytes suggests that this proto-oncogene may
      play a role in melanocyte transformation.

PMID- 8471835
TI  - Direct correlation between MUC18 expression and metastatic potential of human
      melanoma cells.
AB  - The expression of the glycoprotein MUC18 in melanoma biopsies has previously been
      shown to increase with increasing tumour thickness, and thus to correlate with
      the probability of metastasis development. We have examined the expression of
      this molecule by nine human melanoma cell lines with known metastatic ability
      (both spontaneous and experimental) in nude mice. Examination of the expression
      of both the MUC18 mRNA and of the glycoprotein on the cell surface revealed a
      statistically significant correlation (P = 0.040) between its expression and the
      ability to form metastases in vivo. Although MUC18 shows sequence similarity to
      neural cell adhesion molecules, no correlation was observed between the site of
      origin of the metastatic lesions (brain, lymph node) and MUC18 expression.

PMID- 8471836
TI  - Immunological and clinical effects of intramuscular rIFN alpha-2a and low dose
      subcutaneous rIL-2 in patients with advanced malignant melanoma.
AB  - Fifteen patients with tumour recurrence following radical surgical excision of
      malignant melanoma were treated with a combination of interferon alpha-2a (rIFN
      alpha-2a) and interleukin-2 (rIL-2). Immunological monitoring (performed prior to
      therapy and on days 7, 21, and 28, of each course of treatment) showed
      significant changes of several parameters after rIFN alpha-2a and rIL-2
      administration. A significant increase in cells expressing CD16 (cells bearing Fc
      receptor), CD25 (cells bearing IL-2 receptor), and CD56 (NK cells, activated
      lymphocytes), as well in levels of soluble IL-2 receptor, beta 2-microglobulin
      and neopterin was observed. Immunological changes were closely related to the
      injection of the biological agent and were more relevant during the first than
      the second cycle of treatment. rIFN alpha-2a and rIL-2 exerted a clear
      synergistic activity on the same immunological parameters. No major response was
      seen with the present approach: four subjects showed rapid progression of
      decrease during the first month of therapy, while of 11 patients who completed
      two courses of treatment, only five were considered in stable disease. In
      conclusion, our results suggest that a combination of rIFN alpha-2a and rIL-2, at
      dosages and schedules, used in this trial, was well-tolerated and immunologically
      active, but was clinically ineffective in the management of advanced melanoma.

PMID- 8471837
TI  - Increased spontaneous mutation rates and prevalence of karyotype abnormalities in
      highly metastatic human melanoma cell lines.
AB  - Previous studies have suggested that increased malignant potential might be
      related to increased genomic instability, but this issue still remains
      controversial. We tested this hypothesis in a human tumour spontaneous metastasis
      model, using six clones and variants isolated from the parental poorly metastatic
      M4Be melanoma cell line, and expressing various metastatic abilities. The
      spontaneous rates of mutation to ouabain resistance measured in these cells by
      Luria and Delbruck fluctuation analysis correlated with the metastatic ability of
      the cells: moderately and highly metastatic cells showed spontaneous mutation
      rates 10 to 50 times higher than those of poorly metastatic cells. Genomic
      instability at the chromosome level was assessed by searching for accumulated
      structural abnormalities in the moderately and highly metastatic cell lines. All
      the cell lines appeared hypertriploid, and showed comparable modal numbers and
      great chromosome dispersion. Unstable DNA amplification in the form of double
      minute chromosomes was shown in one of the four poorly metastatic cell lines, and
      in a significantly higher proportion of the cells of two of the three metastatic
      cell lines. Abnormal chromosomes were demonstrated in all cell lines, with
      markers involving specific rearrangements of chromosomes 1, 6, 7, 8, 9, 11, 14
      and 15, as frequently observed in human melanoma cells. Clonal markers were
      present in all cell lines, documenting the common origin of all variants and
      clones, and specific marker amplification was noticed in highly metastatic cells
      compared to poorly metastatic lines. These results suggest that human tumour
      progression might be accompanied both by an increase in genomic instability and
      by accumulation of karyotypic abnormalities.

PMID- 8471838
TI  - Characterization of cellular infiltration in choroidal melanoma.
AB  - An immunohistochemical double staining technique was used to examine the
      characteristics of cellular infiltration in choroidal melanoma. Seven of 16
      melanomas examined demonstrated high levels of cellular infiltration, mainly with
      T-cells and macrophages, and little infiltration with B-cells and NK cells. The
      majority of T-cells were of the CD8+ type and were activated, as shown by the
      expression of histocompatibility antigens, HLA-DR and IL2-R. Most of the
      infiltrating macrophages also expressed HLA-DR antigen. We also detected
      malignant melanocytes expressing the HLA-DR antigen. This technique could be used
      to study in detail cellular infiltration in a large number of archival choroidal
      melanomas with known clinical history, which would enable detection of markers
      that correlate with the prognosis of the disease.

PMID- 8471839
TI  - Inhibition of melanoma cell/matrix interaction by tamoxifen.
AB  - Following our recent finding that calmodulin antagonists can reduce cancer cell
      attachment to extracellular matrix proteins, we investigated the calmodulin
      antagonistic and anti-attachment properties of the non-steroidal anti-oestrogens
      tamoxifen and droloxifene. These drugs and four of their active metabolites were
      found to have calmodulin antagonist activity with IC50 values of 2-4 microM and
      to be capable of inhibiting attachment of murine B16 melanoma to extracellular
      matrix proteins in vitro. IC50 values for inhibition of attachment were 11 microM
      for tamoxifen and ranged from 5 to 40 microM for the other five compounds tested.
      (Poor reproducibility in drug potency between attachment experiments was almost
      certainly due to the low aqueous solubility of these drugs.) The effects of
      tamoxifen on cell/matrix adhesion were most evident between 15 min and 3 h of
      cell attachment. No effects of tamoxifen were evident in cells which had been
      allowed to attach for 6 h or more. Tamoxifen at concentrations between 0.1 and 30
      microM was without effect on intracellular free calcium concentration. Tamoxifen
      also inhibited attachment of human ocular melanoma cells and human breast cancer
      (MCF7) cells to type I collagen. The concentration at which tamoxifen and its
      metabolites affect cell attachment in vitro (2-14 microM) is of the same order as
      the tissue concentrations of these drugs achieved clinically. The possibility
      exists that reduction of cell/matrix interactions may contribute to the clinical
      anti-metastatic efficacy of tamoxifen and some of its active metabolites.

PMID- 8471840
TI  - Melanoma as a macrophage/melanocyte hybrid and the symbiotic nature of eukaryotic
      cells.

PMID- 8471841
TI  - Melanoma, vitiligo and topographic antigens.

PMID- 8471842
TI  - European Organization for Research and Treatment of Cancer (EORTC)-Melanoma
      Cooperative Group (MCG) meeting. Lyon, France, 6-7 November 1992.

PMID- 8471843
TI  - Expression and single-step purification of enzymatically active vaccinia virus
      thymidine kinase containing an engineered oligohistidine domain by immobilized
      metal affinity chromatography.
AB  - A method has been developed for the controlled expression in Escherichia coli and
      rapid purification of an enzymatically active vaccinia virus (VV) thymidine
      kinase protein containing an engineered oligohistidine domain. The nucleotide
      sequence that encodes the VV thymidine kinase open reading frame was inserted
      into a plasmid expression vector (pET-16b, Novagen Inc., Madison, WI) under the
      control of a strongly repressed bacteriophage T7 promoter and high efficiency
      translational signals. The construct (pET-16b:TK) directs the synthesis of a
      fusion protein (His-TK) with an N-terminal histidine decapeptide fused to the VV
      thymidine kinase polypeptide. Upon induction of E. coli strain BL21(DE3)pLysS
      with isopropyl beta-D-thiogalactoside, accumulation of large quantities of a 22
      kDa protein was detected by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. This protein reacted with polyclonal antiserum raised against a
      TrpE-VVTK fusion protein. The predominantly soluble fusion protein (approximately
      13% of the total soluble bacterial protein) was purified to homogeneity from
      crude bacterial extracts in a single-step by immobilized metal chelate affinity
      chromatography (Ni(2+)-nitrilotriacetic acid-agarose) under nondenaturing
      conditions and was shown to have thymidine kinase activity. The yield of the
      purification scheme was about 15 mg recombinant protein/liter of bacterial
      culture. The availability of purified VV TK protein should greatly facilitate
      biochemical studies on its enzymatic activity, as well as analyses of its
      structural and functional domains.

PMID- 8471844
TI  - One-step chromatographic method for the purification of avian serotransferrin.
AB  - Existing purification procedures for serum transferrins involve multistep
      chromatographic separations and require several days to complete. In addition,
      they have not been tested for purification of transferrins directly from the
      blood of egg-laying animals, where large amounts of circulatory lipoproteins can
      interfere with standard chromatographic separations. We have developed a
      procedure for purifying transferrin in one step directly from the serum of
      ovulating chickens. The method, which is based on hydrophobic interaction
      chromatography, gives a yield of about 12 mg (80%) of purified serotransferrin
      from 3 ml of serum and can be completed in a few hours.

PMID- 8471845
TI  - Characterization and N-terminal amino acid sequences of beta-(1-4)endoxylanases
      from Streptomyces roseiscleroticus: purification incorporating a bioprocessing
      agent.
AB  - Streptomyces roseiscleroticus produces extracellular xylanases when cultured on a
      liquid xylan medium. Purified xylanases are used to facilitate bleaching of kraft
      pulps in the pulp and paper industry. Downstream processing and purification of
      xylanases from S. roseiscleroticus is difficult unless red pigments produced by
      the bacterium are removed. We report that the bioprocessing agent, Biocryl BPA
      1000, removes these pigments allowing purification of four xylanases by HPLC
      employing cation exchange, hydrophobic interaction, and gel filtration. The
      xylanases have been named Xyl1, Xyl2, Xyl3, and Xyl4 according to their order of
      elution from the cation exchange column. The purified xylanases have been
      characterized according to their molecular weights, pH and temperature
      stabilities, N-terminal amino acid sequences, and hydrolysis action patterns on
      oat spelt xylan. The molecular weights by mass spectroscopy for Xyl1-Xyl4 are
      33,647, 33,655, 21,070, and 46,855, respectively. All four xylanases exhibit pH
      optima between 5.0 and 7.0 and temperature optima between 50 and 60 degrees C.
      The N-terminal amino acid sequences are compared to sequences from Streptomyces
      lividans, Streptomyces 36A, and a Chainia sp. The N-terminal amino acid sequence
      of Xyl1 appears to be unique, but sequences from Xyl2, 3, and 4 bear strong
      homology to xylanases cloned from S. lividans. Xyl3 is also homologous to
      xylanases from Streptomyces 36A, and a Chainia sp. Predominant products of
      arabinoxylan hydrolysis by the purified xylanases included xylotriose, tetraose,
      and pentaose. None of the xylanases purified from S. roseiscleroticus produced
      xylose.

PMID- 8471846
TI  - Recombinant human transforming growth factor-beta 1: expression by Chinese
      hamster ovary cells, isolation, and characterization.
AB  - A partial cDNA clone encoding the gene for human transforming growth factor-beta
      1 (TGF-beta 1) was isolated from a human bladder carcinoma cell line (5637) cDNA
      library. Following restriction enzyme processing and ligation of synthetic
      oligonucleotide linkers, the gene was inserted into a plasmid and transfected
      into Chinese hamster ovary cells. Clonal selection and growth conditions resulted
      in a method for production of recombinant human TGF-beta 1 at 7 mg/liter in
      conditioned cell medium. Through a combination of low pH treatment, cation
      exchange chromatography, and salt precipitation, the recombinant human TGF-beta 1
      was purified in milligram amounts to > 95% purity in a yield of about 36%.
      Purification to homogeneity was accomplished by chromatography on C18 silica gel.
      Amino acid analysis, N-terminal sequencing, and growth inhibition assays indicate
      identity with the molecule from human platelets.

PMID- 8471847
TI  - The expression of hemolytically active human complement protein C9 in mammalian,
      insect, and yeast cells.
AB  - The cDNA sequence encoding mature human C9 protein and its signal peptide was
      cloned into three expression vectors for expression in COS-7 (mammalian),
      Spodoptera frugiperda IPLB-SF-21AE (insect), and Saccharomyces cerevisiae (yeast)
      cells. In addition, C9 cDNA encoding only the mature protein was fused to the
      yeast invertase leader sequence (SUC2) and cloned for expression in yeast. Under
      optimal conditions COS-7 and IPLB-SF-21AE cells secreted recombinant C9 (rC9) at
      concentrations of about 111 and 700 ng C9/ml culture supernatant, respectively.
      By comparison S. cerevisiae, whether transformed with C9 cDNA containing its
      native or yeast invertase leader sequence, secreted only very small amounts of
      rC9 (5-10 ng/ml). However, upon lysis concentrations of up to 500 ng/mg dry wt
      were found in yeast cells transformed with C9 cDNA. SDS-PAGE followed by Western
      blot analysis revealed COS-7 cell and S. cerevisiae expressed rC9 to have a MW
      similar to that of native C9 purified from human serum, while rC9 from IPLB-SF
      21AE cells was about 4 kDa smaller. No hemolytic activity of S. cerevisiae
      secreted rC9 could be detected and the specific hemolytic activity of S.
      cerevisiae intracellular rC9 was also very low. However, the specific hemolytic
      activities of COS-7 and IPLB-SF-21AE secreted rC9 were indistinguishable from
      that of purified native human C9. Thus, for future studies on the structure and
      function of C9 where the production of large quantities of mutant protein would
      be desirable, the baculovirus-insect cell expression system appears to offer
      considerable advantages.

PMID- 8471848
TI  - Overcoming inclusion body formation in a high-level expression system.
AB  - Attempts at overexpressing T4-phage deoxycytidylate deaminase using the
      pET3c/BL21(DE3)/pLysS system resulted in this enzyme being part of an inactive
      inclusion-body complex. However, by employing an enriched growth medium it was
      found that the deaminase could be induced in a soluble active form to at least
      20% of this organism's cellular protein. Insoluble inclusion bodies were obtained
      with less rich media. This procedure was employed successfully with other highly
      expressed proteins that formed inclusion bodies. The use of a rich growth medium
      during the course of protein induction may be a valuable adjunct to limiting
      inclusion body formation with this as well as other expression systems.

PMID- 8471849
TI  - Characterization of a truncated form of recombinant porcine growth hormone
      generated in vitro during solubilization of inclusion bodies.
AB  - During the development of a novel solubilization procedure (1) for bacterial
      inclusion bodies (IB's) using the cationic surfactant cetyltrimethylammonium
      chloride (CTAC; (CH3)3-N(+)-C16H33Cl) significant proportions of an apparently
      truncated, lower molecular weight (MW) variant form of recombinant pig growth
      hormone (rPGH) were observed on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis relative to pig pituitary derived GH. The formation of this rPGH
      like species, designated P-band, was found to occur in vitro during
      solubilization of IB's by CTAC and was dependent on pH and temperature of
      solubilization, but was not due directly to the use of CTAC, as purified soluble
      rPGH of the correct MW could not be converted to P-band by exposure to CTAC
      alone. The bacterial proteolysis suspected as being responsible for the in vitro
      formation of P-band could not be inhibited by the use of a "cocktail" of defined
      antiproteolytic agents but was inhibited by pH and temperature, and by
      solubilization of IB's in 5% SDS, 6 M gnHCl or 7.5 M urea. Detailed
      characterization of the structure of P-band by N-terminal amino acid sequencing,
      electrospray mass spectrometry, radioreceptor binding assay, peptide mapping, and
      C-terminal peptide sequencing confirmed that P-band was approximately 950 mass
      units smaller than normal rPGH and lacked eight C-terminal amino acids. A
      significant finding was that P-band is unable to bind to the pig liver-membrane
      GH receptor in a competitive radioreceptor assay. Analysis of the relative
      secondary and tertiary structure of P-band by circular dichroism spectra,
      intrinsic tryptophan-dependent fluorescence, and average surface hydrophobicity
      (2) suggested small but measurable changes to the overall structure of P-band
      relative to normal rPGH. Consequently, our results also suggest that the C
      terminal portion of rPGH, including in particular the last eight amino acids, is
      of major importance in the binding of rPGH to the pig liver membrane GH receptor.

PMID- 8471850
TI  - Methods of analysis for toxic elements in foods. Part IV. General method of
      ashing for the determination of toxic elements.
AB  - As a result of the request of the Codex Alimentarius Committee on Methods of
      Analysis and Sampling, a general method for ashing of foods for the determination
      of toxic elements was assembled. This method consolidates the results of more
      than a decade of interlaboratory work of numerous USSR food laboratories and
      specifies the details of wet and dry ashing procedures.

PMID- 8471851
TI  - New metrological characteristics of analytical methods of analysis used for
      safety control of food and environmental materials.
AB  - MQS and MQSm are new metrological characteristics of the limit of determination
      of methods used for safety control of foods and environmental objects. MQS is the
      minimum quantity of an analyte that can be determined by any applicable method in
      an analytical sample. MQSm is the minimum quantity of analyte that can be
      measured in the test solution in an interlaboratory, method-performance study of
      a specific method, under the condition that MQSm < or = MQS. Examples are given
      of their calculation and use.

PMID- 8471852
TI  - Determination of acesulfam-K in foods.
AB  - A liquid chromatographic method was evaluated for the determination of the
      intense sweetener acesulfam-K in tabletop sweetener, candy, soft drink, fruit
      juice, fruit nectar, yogurt, cream, custard, chocolate, and biscuit commercial
      preparations. Samples are extracted or simply diluted with water and filtered.
      Complex matrixes need a clarification step with Carrez solutions. An aliquot of
      the extract is analyzed on a reversed-phase mu Bondapak C18 column using 0.0125M
      KH2PO4 (pH 3.5)-acetonitrile (90 + 10) as mobile phase. Detection is performed by
      UV absorbance at 220 nm. Recoveries ranged from 95.2 to 106.8%. With one
      exception, all analyzed values were within +/- 15% of the declared levels. The
      repeatabilities and the repeatability coefficients of variation were,
      respectively, 0.37 mg/100 g and 0.98% for products containing less than 40 mg/100
      g acesulfam-K and 2.43 mg/100 g and 1.29% for other products. The same procedure
      also allowed detection of many food additives or natural constituents, such as
      other intense sweeteners, organic acids, and alkaloids, in a single run without
      interfering with acesulfam-K. The method is simple, rapid, precise, and
      sensitive; therefore, it is suitable for routine analyses.

PMID- 8471853
TI  - Determination of aspartame and its major decomposition products in foods.
AB  - A liquid chromatographic procedure already evaluated in a preceding study for the
      analysis of acesulfam-K is also suitable for the determination of the intense
      sweetener aspartame in tabletop sweetener, candy, fruit beverage, fruit pulp,
      soft drink, yogurt, cream, cheese, and chocolate preparations. The method also
      allows the determination of aspartame's major decomposition products:
      diketopiperazine, aspartyl-phenylalanine, and phenylalanine. Samples are
      extracted or diluted with water and filtered. Complex matrixes are centrifuged or
      clarified with Carrez solutions. An aliquot of the extract is analyzed on a
      reversed-phase muBondapak C18 column using 0.0125M KH2PO4 (pH 3.5)-acetonitrile
      ([85 + 15] or [98 + 2]) as mobile phase. Detection is performed by UV absorbance
      at 214 nm. Recoveries ranged from 96.1 to 105.0%. Decomposition of the sweetener
      was observed in most food samples. However, the total aspartame values (measured
      aspartame + breakdown products) were within -10% and +5% of the declared levels.
      The repeatabilities and the repeatability coefficients of variation were,
      respectively, 1.00 mg/100 g and 1.34% for products containing less than 45 mg/100
      g aspartame and 4.11 mg/100 g and 0.91% for other products. The technique is
      precise and sensitive. It enables the detection of many food additives or natural
      constituents, such as other intense sweeteners, organic acids, and alkaloids, in
      the same run without interfering with aspartame or its decomposition products.
      The method is consequently suitable for quality control or monitoring.

PMID- 8471854
TI  - Organochlorine pesticide residues in dairy milk in and around Delhi.
AB  - A survey of dairy milk and milk products in and around Delhi, India, was
      undertaken to monitor the levels of DDT and HCH. The survey revealed that
      pesticide residue levels in milk often exceeded the limits recommended by the
      Food and Agriculture Organization/World Health Organization Expert Committee.
      Maximum residue levels of total HCH in milk (fat/whole milk basis) has not yet
      been prescribed. The 15 samples of dairy milk and 4 samples of milk products
      analyzed had residue levels ranging from 0.022 to 0.166 micrograms/g for HCH and
      from 0.042 to 0.382 micrograms/g for DDT.

PMID- 8471855
TI  - Liquid chromatographic determination of 2-chloro-4-nitroaniline, 2-naphthol, and
      2,4-dinitroaniline in D&C red no. 36.
AB  - A method is described for the determination of the intermediates and a related
      impurity in D&C Red No. 36 by reversed-phase liquid chromatography. This method
      may be used to ensure that limits set forth in the Code of Federal Regulations on
      the amounts of these 3 impurities in the color are not exceeded. The pigment is
      dissolved in boiling dioxane and then precipitated. The filtrate is
      chromatographed by isocratic elution, and then the column is washed and
      reequilibrated. Impurities were identified as 2-chloro-4-nitroaniline (2-Cl-4
      NA), 2-naphthol, and 2,4-dinitroaniline (2,4-DNA) by comparison of their
      retention times and spectra with those of standards. Peak area calibrations were
      linear to at least 0.375% 2-Cl-4-NA, 1.25% 2-naphthol, and 0.025% 2,4-DNA, all
      with zero intercepts. At the specification levels, 99% confidence limits were
      0.30 +/- 0.006% for 2-Cl-4-NA, 1.0 +/- 0.03% for 2-naphthol, and 0.020 +/-
      0.0004% for 2,4-DNA. The limits of determination calculated from calibration data
      were 0.019% for 2-Cl-4-NA, 0.10% for 2-naphthol, and 0.0014% for 2,4-DNA at the
      99% confidence level. Recoveries were 100-104% for 2-Cl-4-NA added to purified
      D&C Red No. 36, 100% for 2-naphthol, and 100-110% for 2,4-DNA; relative standard
      deviations were 0.8-3.4%. A survey of certified D&C Red No. 36 samples showed
      that the batches contained higher levels of intermediates than were determined
      previously by a cellulose column method in which the pigment was not dissolved.

PMID- 8471856
TI  - Automated technique for sampling milk from farm bulk tanks: collaborative study.
AB  - An automated, in-line, mechanical technique for sampling milk from farm bulk
      tanks was evaluated in a collaborative study. The automated sampling device,
      which is mounted on the milk intake line, contains an electronically controlled
      peristaltic pump. The device takes a representative sample of the entire volume
      pumped through the system. Samples taken can be analyzed for both composition and
      microbiological quality. The study was performed in 3 phases. In the first 2
      phases, samples taken by manual and automated methods were compared in analyses
      for somatic cell count, antibiotics, fat, protein, lactose, and solids-not-fat.
      The third phase, using a modified procedure, was designed to compare sampling
      methods in analyses for total bacteria count (standard plate count),
      psychrotrophic bacteria count, and coliform count. Evaluation of the data by a
      nested ANOVA indicated no difference between results for samples taken by the
      automated and manual methods (P = 0.05) in Phases 1 and 2, irrespective of
      whether the bulk milk was agitated before sampling. By introducing a sanitizing
      step between farms in Phase 3, the automated method also provided samples
      comparable with those taken manually for microbial analyses. The automated method
      has been adopted first action by AOAC International.

PMID- 8471857
TI  - Analysis of testosterone esters by tandem mass spectrometry.
AB  - The electron ionization (EI) and chemical ionization (CI) mass spectra of 12
      representative testosterone esters were examined to explore the various
      analytical options available for identification and confirmation of the esters.
      Using EI, a number of fragment ions indicated the identification of the
      testosterone moiety, but structural confirmation of the individual esters often
      required the observance of the molecular ion at very low relative abundance
      ratios. The acceptable analytical method involved CI/tandem mass spectrometry
      based on the production of the 2 generic product ions derived from the protonated
      molecule ion.

PMID- 8471858
TI  - Simultaneous determination of multiple tetracycline residues in milk using metal
      chelate affinity chromatography.
AB  - A method was developed for the determination of 7 tetracyclines in milk. Raw milk
      samples are defatted, acidified, and centrifuged to remove proteins, and the
      tetracyclines are specifically absorbed from the milk by chelation with metal
      ions bound to small Chelating Sepharose Fast Flow columns. The tetracyclines are
      removed from these columns with EDTA-containing buffer, and the extracts are
      further cleaned up by centrifugal ultrafiltration. Finally, the extracts are
      concentrated and analyzed simultaneously by on-line concentration. This method
      has limits of detection for individual tetracyclines of < 5 ng/mL and was
      validated with fortified milk samples at 15, 30, and 60 ng/mL. Recoveries
      exceeded 60% for all tetracyclines at all levels, with good precision. The method
      was also tested on milk from cows dosed with each of the tetracyclines.
      Advantages of this method over existing methods include its sensitivity, minimal
      use of organic solvents, and speed; with an autosampler, at least 14 samples can
      be processed and analyzed in 1 day.

PMID- 8471859
TI  - Quantitation of sulfamethazine in pork tissue by thin-layer chromatography.
AB  - Our earlier method to detect and quantitate sulfamethazine (SMZ) in milk at the
      10 ppb level was modified to quantitate SMZ in pork tissue. Sulfabromomethazine
      (SBZ) is added to the tissue as an internal standard. SMZ and SBZ are extracted
      from the tissue into water as the supernatant of a centrifuged, aqueous
      homogenate and are cleaned up and concentrated by a series of solid-phase
      extractions. The sulfonamide-containing eluate is then separated on a silica gel
      thin-layer chromatographic plate. SBZ and SMZ are derivatized with fluorescamine,
      and their fluorescence is quantitated with a scanning densitometer. The limit of
      detection was estimated at 0.25 ppb (signal-to-noise ratio, 3:1). The average
      accuracy over the analysis range (0.54-21.8 ppb [micrograms/kg]) was 95.6%
      (standard deviation = 29.4%, n = 54).

PMID- 8471860
TI  - Liquid chromatographic detection of a variety of inexpensive sweeteners added to
      pure orange juice.
AB  - Liquid chromatography with pulsed amperometric detection was used to analyze pure
      orange juice adulterated with a variety of inexpensive sweeteners. This method
      can be used to detect low levels (5-10%) of high fructose corn syrup (42 and 55),
      cane sugar hydrolysates (50 and 80%), and beet sugar hydrolysates (chemically or
      enzymatically prepared).

PMID- 8471861
TI  - Evaluation of microbial loads of Bacillus subtilis spores on penicylinders.
AB  - Three types of penicylinders were compared for their retention of spores of
      Bacillus subtilis testing for sporicidal activity of disinfectants. Glass,
      porcelain, and stainless steel penicylinders are inoculated with a water
      suspension of B. subtilis var. niger (ATCC 9372) spores and dried. One set of
      each type of penicylinder is submerged 1 h in 0.9% saline. One set of porcelain
      penicylinders is submerged 15 h in a neutralized chemical germicide, and one set
      is also inoculated with a culture filtrate of B. subtilis (ATCC 19659), dried
      according to the AOAC method, and submerged 1 h in 0.9% saline. Microbial loads
      simulate those held on carriers used to test sporicidal activity of
      disinfectants. Carriers are immersed in chemical germicide, transferred to a
      neutralizer, and placed in a culture medium. Average percentages of B. subtilis
      var. niger spores retained on 10 carriers after 1 h submersion in saline and in
      water were as follows: glass, 93.6%; porcelain, 99.9%; and stainless steel,
      99.5%. Retention of spores after 15 h submersion in a neutralized chemical
      germicide and in water was 98.9%. Porcelain penicylinders inoculated from a
      culture filtrate of B. subtilis (ATCC 19659) retained 26% of the spores after
      being submerged 1 h in saline and placed in water. Glass penicylinders, which
      retained the lowest and most variable number of spores, were the least suitable
      for sporicidal activity testing. B. subtilis (ATCC 19659) spores tested on
      porcelain penicylinders met only the minimum HCl resistance requirements of > or
      = 2 min. On porcelain penicylinders, the resistance of B. subtilis var. niger
      spores to 2.5N HCl was relative to the number of spores inoculated.

PMID- 8471862
TI  - Development of enzyme immunoassay for captan and its degradation product
      tetrahydrophthalimide in foods.
AB  - A simple, sensitive, and precise enzyme-linked immunosorbent assay (ELISA) is
      described for the quantitation of captan as its degradation product
      tetrahydrophthalimide (THPI) in foods using polyclonal antibodies. Three hapten
      analogues of THPI with different alkyl spacer arm lengths were synthesized.
      Immunogens and coating proteins were prepared by coupling these haptens to human
      serum albumin and ovalbumin, respectively. A 5-carbon spacer arm appeared to be
      optimum for the production of antibodies. Heterologous coating proteins did not
      improve the sensitivity, but reduction of homologous coating protein
      concentration did improve the sensitivity, resulting in a concentration of test
      compound required to inhibit binding by 50% of 15.5 ng/mL. The antiserum is
      specific for captan, captafol, and THPI, but not other structurally related
      compounds. The minimum detection limit was 1 ng/mL; the linearity was 1-200
      ng/mL. The overall recoveries of captan and THPI from 11 commodities spiked at 4
      levels were 92 and 100%, respectively. The intra-assay and interassay
      coefficients of variation were 9.1 and 16.8% for apple blanks and 5.9 and 4.2%
      for apple spiked with 3 ppm THPI, respectively. The ELISA described is suitable
      for measuring captan and THPI at levels comparable to those typically found in
      fruit.

PMID- 8471864
TI  - Niacin. I: Dissolution profiles of sustained-release niacin products by automated
      and manual procedures.
AB  - Automated and manual procedures were developed to obtain dissolution profiles of
      sustained-release niacin formulations. The procedures are based on the United
      States Pharmacopeia XXII apparatus 1 (basket) at 100 rpm with 900 mL 0.1N HCl as
      the dissolution medium. Filtered aliquots are read at 260 nm. No interference was
      found from excipients. The procedures are straightforward and will discriminate
      between sustained-release and regular niacin formulations.

PMID- 8471865
TI  - Analysis of milk-based infant formula. Phase V. Vitamins A and E, folic acid, and
      pantothenic acid: Food and Drug Administration-Infant Formula Council:
      collaborative study.
AB  - In 1982, the U.S. Food and Drug Administration, the Infant Formula Council and
      its member companies, contract laboratories, and other government laboratories
      began a study of analytical methods for the nutrients listed in the Infant
      Formula Act of 1980 (P.L. 96-359). Four phases of the study have been completed
      and are discussed in earlier reports. The present report provides data on Phase
      V, in which 13 laboratories collaboratively studied individual methods for folic
      acid, pantothenic acid, and vitamin E, in addition to 2 methods for vitamin A.
      Vitamins A and E are determined by liquid chromatography. Folic acid and
      pantothenic acid are determined by microbiological methods using acidimetric
      and/or turbidimetric assays as the determinative step. In most cases, relative
      standard deviations for repeatability, RSDr, and reproducibility, RSDR, are as
      good as those that would be predicted from other collaborative studies. RSDr and
      RSDR values obtained for the 5 methods are 9.35 and 25.44% for folic acid, 4.59
      and 10.23% for pantothenic acid, 8.46 and 11.69% for vitamin E, 3.62 and 9.72%
      for vitamin A (retinol isomers), and 4.9 and 10.5% for vitamin A (retinol). The 5
      methods have been adopted first action by AOAC International.

PMID- 8471863
TI  - Liquid chromatographic analysis of niacin in fortified food products.
AB  - An ion exchange liquid chromatographic (LC) method using an anion exchange resin
      column was developed for the determination of niacin in fortified foods. Samples
      were extracted by autoclaving with H2SO4 (1 + 1). Florisil open column
      chromatography was used to remove interferences from the sample extracts. Niacin
      levels were quantitated by an LC system using a 250 x 4.1 mm Hamilton PRP-X100
      column, a mobile phase of 2% glacial acetic acid in water, and UV detection at
      254 nm. The limit of detection was 0.11 micrograms niacin/mL, and the standard
      curve was linear from 0.24 to 0.80 micrograms niacin/mL. The system
      reproducibility was evaluated by completing 10 repetitive analyses on an infant
      formula and a macaroni product, which gave an average CV of 2.7%. Mean recovery
      (+/- standard deviation) was 99.8 +/- 7.7 (n = 15). The results compared
      favorably with those by the AOAC microbiological method.

PMID- 8471866
TI  - Comparison of liquid chromatographic method to AOAC microbiological method for
      determination of L-tryptophan in tablets and capsules.
AB  - A reversed-phase liquid chromatographic (LC) method coupled with precolumn
      derivatization of L-tryptophan with phenylisothiocyanate was compared to the AOAC
      microbiological method for determining L-tryptophan in tablets and capsules. For
      the microbiological method, the concentrations of L-tryptophan were 4-8% lower in
      autoclaved test samples (hot method) than in test samples that were not
      autoclaved (cold method). When L-tryptophan values obtained by the LC method were
      compared to those obtained by the cold microbiological method, no significant
      differences were observed (P > 0.05). The mean relative standard deviations were
      2.9% for the LC method and 1.6% for the cold microbiological method. The mean
      recoveries of standard L-tryptophan added before analysis were 99% for the LC
      method and 101% for the cold microbiological method. These results demonstrate
      that both methods are reliable for determining free L-tryptophan contained in
      tablets and capsules. However, the LC method has the advantages of using a
      smaller test portion and having a shorter analysis time.

PMID- 8471867
TI  - Sample preparation bias in carbon stable isotope ratio analysis of fruit juices
      and sweeteners.
AB  - Two sample preparation methods are commonly used for carbon stable isotope ratio
      analysis (SIRA). One involves combustion of the sample with oxygen at 850 degrees
      C; the other involves combustion of the sample with CuO in an evacuated glass
      tube at 550 degrees C. I observed in our laboratory that these 2 methods yield
      different results for sugar-based products such as fruit juices, sweeteners, and
      vanillin. The CuO method yields results approximately 1%. more positive than the
      oxygen combustion method. This bias is also observed in other laboratories, as
      shown in an analysis of the results of the AOAC collaborative studies of carbon
      SIRA of maple syrup, orange juice, honey, and honey protein. The oxygen
      combustion method is the AOAC method for honey, apple juice, and orange juice;
      both methods are incorporated into the AOAC method for maple syrup. I recommend
      that data generated by the CuO combustion method be appropriately corrected to
      yield results concordant with the official oxygen combustion method.

PMID- 8471868
TI  - Liquid chromatographic determination and liquid chromatographic-thermospray mass
      spectrometric confirmation of nicarbazin in chicken tissues: interlaboratory
      study.
AB  - The U.S. Food and Drug Administration sponsored an interlaboratory study of a
      liquid chromatographic determination with ultraviolet detection of nicarbazin in
      chicken liver and muscle tissues. The method determined the 4,4'
      dinitrocarbanilide (DNC) portion of nicarbazin. The interlaboratory study of the
      determinative method was successful for nicarbazin at the 4 ppm level. Results
      showed good reproducibility for the fortified liver and muscle samples. Mean
      interlaboratory recoveries and percent coefficients of variation at about 4 ppm
      were 87.1 and 10.9%, respectively, for muscle and 87.4 and 7.5%, respectively,
      for liver. The interlaboratory analyses of the dosed liver and muscle tissues
      produced concentration levels similar to those obtained by the sponsor. The
      confirmatory procedure, which identified DNC in purified tissue extracts, used
      liquid chromatography-thermospray/mass spectrometry. The confirmatory procedure
      was successfully evaluated by one FDA laboratory.

PMID- 8471869
TI  - Calculation of juice content in a diluted fruit juice beverage.
AB  - A 1990 amendment to the Food, Drug and Cosmetic Act states that if a food
      purports to be a beverage containing vegetable or fruit juice, it shall be deemed
      to be misbranded unless its label bears a statement of the total percentage of
      such fruit or vegetable juice content. The intent of the present paper is to
      assist beverage manufacturers in calculating the juice content of their products
      for the purpose of a label declaration.

PMID- 8471870
TI  - Incidence of fungi in shared-use cosmetics available to the public.
AB  - A survey was conducted to assess both the potential health risk from shared-use
      cosmetics caused by microorganisms and the microbial efficacy of preservatives in
      cosmetics. Samples of 3027 shared-use cosmetic products were collected from 171
      retail establishments nationwide. Fungi were present in 10.4% of the products,
      and 3.9% contained fungal pathogens or opportunistic pathogens. The 423 fungal
      isolates identified represented 33 genera and at least 69 species. A
      disproportionately large share of the fungal isolates were from eye products;
      fewer were from lip products. Pathogenic or opportunistic pathogens made up 32.2%
      of the fungal isolates. A slightly lower percentage of samples that contained
      preservatives had fungi, a fact suggesting that preservatives reduce the
      incidence of fungi in cosmetics. Results of this survey indicate potential
      microbiological problems concerning the safety of shared-use cosmetics.

PMID- 8471871
TI  - Animal drugs.

PMID- 8471872
TI  - Method. I. Liquid chromatographic determination of tiamulin hydrogen fumarate in
      feed premixes.

PMID- 8471873
TI  - Method. II. Liquid chromatographic determination of tiamulin hydrogen fumarate in
      tiamulin-poly(vinyl chloride) formulations.

PMID- 8471874
TI  - Method. III. Liquid chromatographic determination of tiamulin hydrogen fumarate
      in complete swine meal feeds.

PMID- 8471875
TI  - Method. IV. Gas chromatographic determination of tiamulin residues in swine
      liver.

PMID- 8471876
TI  - Method. V. Gas chromatographic/mass spectrometric confirmation of 8
      hydroxymutilin, a tiamulin metabolite, in swine liver extracts.

PMID- 8471877
TI  - [Results of psychosomatic research and their use in gynecology].
AB  - Several more recent research results in psychosomatic obstetrics and gynecology
      will be presented, and directions for the practice will be given. In conclusion,
      it will be discussed how, for the realization of psychosomatic concepts, 'old
      fashioned thinking' with biased, monocausal, scientific approaches is
      unproductive. This concerns, in particular, university gynecological hospitals
      where psychosomatic thinking is only very hesitantly accepted. The goal is,
      therefore, to promote a new thinking process, which incorporates an increased
      consideration of reference points like sensibility, flexibility and creativity.

PMID- 8471878
TI  - [Management of recurrent genital herpes virus infections in gynecology and
      obstetrics].
AB  - Continuous oral therapy with acyclovir (200 mg four times a day or 400 mg twice
      daily) has been shown to be safe and effective in reducing recurrence of genital
      herpes by 74-93%. Continuing therapy appears to be safe, even when used for up to
      4 years. When an episode of genital herpes is diagnosed in term pregnancy,
      cesarean section should be considered, even if intrauterine infection is possible
      until the rupture of membranes. The efficacy of suppressive therapy in term
      pregnancy to reduce the cesarean section rate is the objective of ongoing
      studies.

PMID- 8471879
TI  - [The reproductive medicine legislation: new legal responsibilities for the
      Austrian gynecologist].
AB  - In spring 1992 the Austrian Parliament has enacted a new law dealing with
      reproductive medicine. The 'Act on medically assisted conception' contains
      provisions which totally prohibit particular methods of assisted fertilization
      (such as embryo or egg donation). The main goal of the act, however, is to
      regulate procreative medicine and to amend the Austrian General Civil Code: the
      parents-to-be are now considered to have the legal rights and responsibilities of
      biological parents in any case.

PMID- 8471880
TI  - [Changes in indications for obstetric peridural anesthesia in our clinic].
AB  - In relation to the Swiss average our hospital has had a constant high rate of
      spontaneous deliveries and a low rate of cesarean sections. On the other hand the
      rate of obstetrical peridural anesthesia has been increasing significantly since
      1986. This is above all related to its more frequent usage in cases of cervical
      dystocia and intolerable birth pain. Exactly in these indications peridural
      anesthesia has been very successful. In almost three quarters of the above
      mentioned cases a cesarean section can be avoided due to peridural anesthesia.

PMID- 8471882
TI  - [Ossification of the endometrium: an unusual finding in secondary sterility].
AB  - The rare fact of endometrial ossification can be found after abortion or chronic
      inflammation. We describe a case from our clinic. Despite repeated curettages new
      ossifications occurred. The resulting secondary infertility is persisting.

PMID- 8471881
TI  - Intraperitoneal carboplatin in advanced ovarian carcinoma.
AB  - 24 patients with advanced epithelial ovarian cancer, who demonstrated a clinical
      complete or partial response to the induction of intravenous chemotherapy,
      underwent implantation of a subcutaneous semipermanent port-and-catheter system
      (Port-A-Cath) for intraperitoneal chemotherapy, which consisted of carboplatin
      300 mg/m2 every 4 weeks. The median survival was 27.4 months for minimal residual
      disease versus 8 months for bulky disease (p = 0.0054). The median progression
      free interval was 15.7 months for minimal residual disease versus 1.8 months for
      bulky disease (p = 0.008). There were 3 complications (12.5%) related to the
      catheter: 1 perforation of the large bowel and 2 catheter inflow obstructions.
      Myelosuppression, especially a grade 3 leucopenia in 5 patients (25%) and a grade
      4 thrombopenia in 3 patients (15%), was the dose-limiting toxicity. Even with
      maximum cytoreductive surgery and second-line intraperitoneal carboplatin-based
      chemotherapy, the 5-year progression-free survival (4.1%) remains very small.

PMID- 8471883
TI  - [Erroneous interpretations of archaeologic findings in ancient gynecology].
AB  - The author reviews some archaeologic findings, interesting for medical history,
      in the field of gynaecology. Due to erroneous opinions, they were described a few
      years ago in an incorrect manner in wide-spread publications.

PMID- 8471884
TI  - [Recommendations for substitution with estrogens and progesterones in climacteric
      and in postmenopause. 8th Professional Meeting of the Zurich Discussion Group,
      November 1992].

PMID- 8471885
TI  - [Good future perspectives and optimistic attitude. AIDS congress in Amsterdam].

PMID- 8471886
TI  - [Anatomic principles of surgical therapy of stress incontinence].

PMID- 8471887
TI  - [Results of incontinence operations: comparative study].

PMID- 8471888
TI  - [Incontinence operations--the procedure at the Vienna 1st University Gynecologic
      Clinic].

PMID- 8471890
TI  - [2d International Graz Symposium of diabetes in pregnancy].

PMID- 8471889
TI  - [Abdominal, vaginal or combined: different approaches to a common goal?].

PMID- 8471891
TI  - [Reports of the Austrian Society of Gynecology and Obstetrics].

PMID- 8471892
TI  - Urinary tract infections. Management mayhem?

PMID- 8471893
TI  - Routine examinations the best approach.

PMID- 8471894
TI  - Guilt and sexually transmitted diseases.

PMID- 8471895
TI  - Tororo project.

PMID- 8471896
TI  - Radiology rounds. Angiomyolipoma.

PMID- 8471897
TI  - Dermacase. Candidiasis.

PMID- 8471898
TI  - Residency without walls. The University of British Columbia's Chilliwack program.

PMID- 8471899
TI  - Treating acute urinary tract infections. An RCT of 3-day versus 7-day
      norfloxacin.
AB  - A randomized, controlled trial was carried out to compare two courses of
      treatment in women with acute urinary tract infection in general practice. The 3
      day course of treatment was found to be as effective as, and cheaper than, the 7
      day therapy.

PMID- 8471900
TI  - Illicit drug use among adolescent students. A peer phenomenon?
AB  - Illicit drug use was studied in 2071 students 11 to 18 years of age. Almost all
      drug users had friends who consumed drugs, compared with only one third of those
      who did not use drugs. This suggests a bond between adolescent drug users, who
      form a distinct group of which most students are unaware.

PMID- 8471901
TI  - Continuity of care in the family medicine residency. Results of a national survey
      of program directors.
AB  - Based on the results of a survey of family medicine residency program directors
      across the country, there is a need for a national consensus on the definition of
      continuity of care, and on structures for teaching it and methods of evaluating
      it.

PMID- 8471902
TI  - Managing chronic pain in family practice.
AB  - Pain is common in family practice. In dealing with chronic pain, both the family
      physician and the patient often have problems in defining and in understanding
      the origin of chronic pain and in providing effective pain relief. This article
      explores a practical, holistic approach to understanding and managing chronic
      pain.

PMID- 8471903
TI  - Successful management of chronic pain syndrome.
AB  - Managing patients with chronic pain syndrome can be frustrating and unrewarding.
      Much of the difficulty experienced when managing these patients stems from an
      incomplete understanding of pain, especially the difference between acute and
      chronic pain. Pain theory and treatment of chronic pain syndrome are reviewed. An
      alternative management strategy for chronic pain syndrome is presented and the
      literature is reviewed.

PMID- 8471904
TI  - Managing pain in children. Changing treatment of headaches.
AB  - With growing understanding of the pain system and the variables that contribute
      to pain-suppressing mechanisms, treatments combining pharmacologic and
      psychologic methods are becoming the norm for managing pediatric pain. For
      headaches, however, the trend is away from medication and toward self-management
      strategies using relaxation, hypnosis, and lifestyle changes.

PMID- 8471905
TI  - Prenatal diagnosis of congenital anomalies. What can and should be done?
AB  - Prenatal diagnosis of congenital anomalies provides an opportunity to prepare and
      counsel parents. It can lead to pregnancy termination; to a change in timing,
      mode, or location of delivery; or, in some cases, to prenatal intervention.
      Families with an affected fetus are best managed by a cohesive medical team. This
      article outlines the principles used to manage these cases.

PMID- 8471906
TI  - Sexual medicine in family practice. Part 1: How to help.
AB  - Family physicians are in a unique position to help patients with sexual problems.
      They know their patients over a long time and often have both partners as
      patients. Most problems require minimal intervention, usually by providing
      information. Family physicians are sometimes the only professionals who are
      trusted enough to be told of abusive or incestuous situations.

PMID- 8471907
TI  - Sexual medicine in family practice. Part 2: Treating sexual dysfunction.
AB  - Sexual problems can be caused by organic or psychological factors, or a
      combination of the two. Deciding which leads to an appropriate management plan.
      This paper describes the current status of treatments for common sexual
      dysfunctions seen in family practice.

PMID- 8471908
TI  - Cycling injuries.
AB  - Bicycle-related injuries have increased as cycling has become more popular. Most
      injuries to recreational riders are associated with overuse or improper fit of
      the bicycle. Injuries to racers often result from high speeds, which predispose
      riders to muscle strains, collisions, and falls. Cyclists contact bicycles at the
      pedals, seat, and handlebars. Each is associated with particular cycling
      injuries.

PMID- 8471909
TI  - The diet game. Weighing the options.
AB  - As a major source of nutrition information for the public, physicians have a
      responsibility to assist their patients to make safe choices about weight loss
      programs. While most diet programs result in weight loss, the "quick fix"
      potentially is harmful. This article describes weight control options and their
      strengths and weaknesses.

PMID- 8471910
TI  - Gastric myiasis. Role of the lesser housefly.

PMID- 8471911
TI  - Family medicine research.

PMID- 8471912
TI  - Interventional genetics and cancer treatment.

PMID- 8471913
TI  - Fluoridation in Britain today.

PMID- 8471914
TI  - Urban slums and primary health care.

PMID- 8471915
TI  - All the homeless people--where do they all come from?

PMID- 8471916
TI  - Mainstream America hears it is safe from AIDS.

PMID- 8471917
TI  - Health inequalities: new concerns about the children of single mothers.
AB  - OBJECTIVES: To show that the exclusion from conventional class based analyses of
      child mortality of children whose parents are classified as "unoccupied" produces
      a misleading picture of health inequalities. DESIGN: Reanalysis of data published
      in the childhood supplement of the registrar general's decennial supplement on
      occupational mortality in England and Wales, which compares numerator data for
      registrations of deaths in children over the age of 1 but below their 16th
      birthday in 1979, 1980, 1982, and 1983 with data about children aged 1-15 who
      were enumerated at the 1981 census. RESULTS: Parents who are classified as
      "unoccupied" largely consist of economically inactive single mothers. Their
      children are estimated to represent 89% of the 614,000 aged 1-15 classified as
      "unoccupied" in the childhood supplement. They have the worst mortality record of
      all social groups--an age specific death rate of 68.8/100,000 a year, 42% worse
      than in social class V (48.4/100,000) and worse than that of social class I
      (22.8) by a factor of 3. At older ages (10-15 years) these children have a
      relative risk of death of 4.14 relative to classes I and II; the risk is 2.58 in
      children 0-4 and 2.56 in those 5-9. Relative risks of child mortality in social
      classes I and II in comparison to classes IV and V suggests a progressive
      shallowing from 2.08 at ages 1-4 to 1.37 at ages 10-15. When unoccupied parents
      were combined with classes IV and V and compared with classes I and II, however,
      inequalities seemed to be pervasive throughout childhood; the relative risks were
      2.21 for those aged 1-4 and 1.98 for those aged 10-15. CONCLUSION: Children
      classified as unoccupied are almost certainly living in poverty as well as
      experiencing relatively high risks of mortality. Class based analyses which
      exclude them therefore produce a misleading picture of inequalities in child
      health. The implications for health policy are profound. Strategies to promote
      the nation's health should acknowledge the importance of material and social
      deprivation more explicitly.

PMID- 8471918
TI  - Epidemiology of Alzheimer's presenile dementia in Scotland, 1974-88.
AB  - OBJECTIVE: To describe the epidemiology of presenile Alzheimer's disease in
      Scotland from 1974 to 1988. DESIGN: Retrospective review of hospital records of
      patients aged less than 73 years admitted to psychiatric hospital with various
      diagnoses of dementia. Diagnoses were classified by National Institute for
      Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders
      Association Criteria and the Hachinski score. Completeness of the study sample
      was evaluated by scrutiny of neurology outpatient and general hospital records.
      SETTING: All general psychiatric hospitals in Scotland. SUBJECTS: All patients
      with onset of dementia aged 40-64. MAIN OUTCOME MEASURES: Probable and broad
      Alzheimer's disease, sex of patient, age at onset. RESULTS: 5874 psychiatric
      hospital records, 129 neurology outpatient records, and 89 records from non
      psychiatric hospitals were examined. 317 patients met criteria for probable
      Alzheimer's disease, 569 met criteria for broad Alzheimer's disease, and 267 met
      those for multi-infarct dementia. Minimal incidences per 100,000 population aged
      40-64 years were 22.6 (95% confidence interval, 20.2 to 25.2) and 40.5 (38.9 to
      42.3) per 100,000 for probable and broad Alzheimer's disease. In the 1981 census
      year the annual incidence of probable Alzheimer's disease was 1.6 (1.0 to 2.6).
      Women were at greater risk with incidence rates for probable Alzheimer's disease
      of 28.2 (24.5 to 32.4) per 100,000 compared with 16.5 (13.8 to 19.8) per 100,000
      for men. The incidence per 100,000 for multi-infarct dementia was greater in men
      (25.1, 23.3 to 27.1) than women (13.4, 12.1 to 14.8). CONCLUSION: Female sex
      seems to be positively associated with development of Alzheimer's disease before
      age 65 years.

PMID- 8471919
TI  - Selective serotonin reuptake inhibitors: meta-analysis of efficacy and
      acceptability.
AB  - OBJECTIVE: To examine the evidence for using selective serotonin reuptake
      inhibitors instead of tricyclic antidepressants in the first line treatment of
      depression. DESIGN: Meta-analysis of 63 randomised controlled trials comparing
      the efficacy and acceptability of selective serotonin reuptake inhibitors with
      those of tricyclic and related antidepressants. MAIN OUTCOME MEASURES:
      Improvement in mean scores on Hamilton depression rating scale for 53 randomised
      controlled trials. Pooled drop out rates from the 58 trials which reported drop
      out by treatment group. RESULTS: Among the 20 studies reporting standard
      deviation for the Hamilton score no difference was found in efficacy between
      serotonin reuptake inhibitors and tricyclic and related antidepressants
      (standardised mean difference 0.004, 95% confidence interval -0.096 to 0.105).
      The difference remained insignificant when the remaining 33 studies that used the
      17 item and 21 item Hamilton score were included by ascribing weighted standard
      deviations. The odds ratio for drop out rate in patients receiving serotonin
      reuptake inhibitors compared with those receiving tricyclic antidepressants was
      0.95 (0.86 to 1.07). Similar proportions in both groups cited lack of efficacy as
      the reason for dropping out but slightly more patients in the tricyclic group
      cited side effects (18.8% v 15.4% in serotonin reuptake group). CONCLUSIONS:
      Routine use of selective serotonin reuptake inhibitors as the first line
      treatment of depressive illness may greatly increase cost with only questionable
      benefit.

PMID- 8471920
TI  - Dental disease and risk of coronary heart disease and mortality.
AB  - OBJECTIVE: To investigate a reported association between dental disease and risk
      of coronary heart disease. SETTING: National sample of American adults who
      participated in a health examination survey in the early 1970s. DESIGN:
      Prospective cohort study in which participants underwent a standard dental
      examination at baseline and were followed up to 1987. Proportional hazards
      analysis was used to estimate relative risks adjusted for several covariates.
      MAIN OUTCOME MEASURES: Incidence of mortality or admission to hospital because of
      coronary heart disease; total mortality. RESULTS: Among all 9760 subjects
      included in the analysis those with periodontitis had a 25% increased risk of
      coronary heart disease relative to those with minimal periodontal disease. Poor
      oral hygiene, determined by the extent of dental debris and calculus, was also
      associated with an increased incidence of coronary heart disease. In men younger
      than 50 years at baseline periodontal disease was a stronger risk factor for
      coronary heart disease; men with periodontitis had a relative risk of 1.72. Both
      periodontal disease and poor oral hygiene showed stronger associations with total
      mortality than with coronary heart disease. CONCLUSION: Dental disease is
      associated with an increased risk of coronary heart disease, particularly in
      young men. Whether this is a causal association is unclear. Dental health may be
      a more general indicator of personal hygiene and possibly health care practices.

PMID- 8471921
TI  - Racial discrimination against doctors from ethnic minorities.

PMID- 8471922
TI  - Communication between general practitioners and child psychiatrists.

PMID- 8471923
TI  - Drug misusers in Lothian: changes in injecting habits 1988-90.

PMID- 8471924
TI  - Heartsink hotel revisited.

PMID- 8471925
TI  - General practitioner fundholding: experience in Grampian.
AB  - Proposals for fundholding were greeted with scepticism by many general
      practitioners, and in Scotland the BMA persuaded the government to allow a scheme
      to test the arrangements as a demonstration project operating "shadow" practice
      funds. This allowed the six selected practices to set up administrative and
      computer systems without the worry of dealing with real money. The shadow
      fundholding scheme has since been extended to small practices and to a trial of
      fundholding for all services except accident and emergency. The six practices in
      the original pilot have all become fundholders and are beginning to effect
      improvements in the service to their patients. However, with more practices
      becoming fundholders negotiating contracts with providers is becoming
      increasingly complicated and more time and money needs to be put into this
      aspect.

PMID- 8471926
TI  - The fundholding debate: should practices reconsider the decision not to fundhold?

PMID- 8471927
TI  - NHS internal market 1991-2: towards a balance sheet.
AB  - The first year of the internal market in the NHS has been claimed to have
      resulted in increased efficiency. These claims, however, are hard to substantiate
      because the systems for operating the market are not fully in place. Examination
      of data on tax relief for private health insurance premiums for over 60s, general
      practice fundholding, and implementation and transaction costs suggest that much
      of the increased efficiency is not due to the reforms but to increased funding.
      Furthermore, some of the changes seem to be decreasing market forces and reducing
      efficiency.

PMID- 8471928
TI  - Letter to Mrs Bottomley.

PMID- 8471929
TI  - Cell to cell and cell to matrix adhesion.

PMID- 8471930
TI  - ABC of sleep disorders. Withdrawal from hypnotic drugs.

PMID- 8471931
TI  - Epilepsy mistaken for panic attacks in an adolescent girl.

PMID- 8471932
TI  - Hunting the gowk?--Psychiatric community care in Scotland.
AB  - The implementation of the community care changes throughout the United Kingdom
      from 1 April will mark the culmination of a series of major health and social
      care reforms. The avowed aims of achieving value for money and improved consumer
      choice through the introduction of competitive internal markets have yet to be
      tested. The political complexion of Scotland means that any proposed change to
      the NHS has tended to be greeted with a mixture of suspicion and resistance. As a
      result very few self governing trusts and fundholding general practices exist
      north of the border. And although Scotland has not had a wide reaching policy of
      moving psychiatric patients out of hospitals, community care for mentally ill
      people has advanced spontaneously.

PMID- 8471933
TI  - Improving London's health service.

PMID- 8471934
TI  - Improving London's health services.

PMID- 8471935
TI  - Priorities in first aid.

PMID- 8471936
TI  - Effect of NHS reforms on GPs' referral patterns.

PMID- 8471937
TI  - Effect of NHS reforms on GPs' referral patterns.

PMID- 8471938
TI  - Authors have rights too.

PMID- 8471939
TI  - Authors have rights too.

PMID- 8471940
TI  - Authors have rights too.

PMID- 8471941
TI  - Authors have rights too.

PMID- 8471942
TI  - Liver failure induced by paracetamol.

PMID- 8471943
TI  - Organ donation after paracetamol overdose.

PMID- 8471944
TI  - Obstetric outcome should be analysed by parity.

PMID- 8471945
TI  - Diagnostic dilatation and curettage.

PMID- 8471946
TI  - Diagnostic dilatation and curettage.

PMID- 8471947
TI  - Hypoglycaemia with human and porcine insulins.

PMID- 8471948
TI  - Hypoglycaemia with human and porcine insulins.

PMID- 8471950
TI  - Prescribing folic acid.

PMID- 8471949
TI  - Prevalence of toxoplasma IgG.

PMID- 8471951
TI  - FHSAs and prescribing.

PMID- 8471952
TI  - General practitioners' views of their FHSA.

PMID- 8471953
TI  - GPs in partnership with management.

PMID- 8471954
TI  - Drugs, secrecy, and society.

PMID- 8471955
TI  - Drugs, secrecy and society.

PMID- 8471956
TI  - Effects of treatment with Pluronic F-68 during continuous venous air embolism in
      swine.
AB  - Treatment with the surface-active agent Pluronic F-68, shown to modulate the
      hemodynamic effects of venous air emboli (VAE) in dogs, may be useful for
      treatment of VAE in divers. We report on the effects of injections of Pluronic F
      68 on responses to continuous air infusion in swine. Pretreatment made no
      significant difference in any hemodynamic or ventilatory variables, but the rise
      of pulmonary vascular resistance caused by air infusion was greater in surfactant
      treated animals; this was also evident after a second treatment during the air
      infusion. The small effect of surfactant treatment in our study on swine
      contrasts the effects reported previously in dogs, and could be due to species
      specific differences in lung physiology-anatomy, or due to difference in
      experimental design. We speculate that the minor changes we observed were caused
      by deeper penetration of the bubbles into the pulmonary arterial tree after
      surfactant treatment.

PMID- 8471957
TI  - Alveolar gas exchange during simulated breath-hold diving to 20 m.
AB  - Alveolar gas exchange, as affected by changes in pulmonary blood flow, was
      studied in five subjects performing breath holds lasting 75 s at the surface and
      during compression to 20 m in a hyperbaric chamber. After reaching the maximal
      depth, VO2 started to increase, compared to control, reaching a maximum of 346 +/
      66 (SE) ml (STPD).min-1.m2 (body surface area) at 50 s, i.e., early in the
      ascent; it exceeded the 50-s surface breath-hold value by 214 +/- 9 ml.min-1.m2.
      During descent, CO2 was absorbed from the alveoli into the blood, initially at
      140 +/- 24 ml.min-1.m2; during ascent CO2 was transferred back into the lungs.
      These changes reflected compression and expansion of lung air. The increase in
      VO2 during the dives, which are not steady states, may be explained by an
      increasing cardiac output at depth. An augmented cardiac output had earlier been
      observed under identical conditions and explained by a drop in transthoracic
      pressure, enhancing venous return. Upon surfacing, the PAO2 was about 20 mmHg
      lower than after surface breath holds, reflecting the effects of changes in
      cardiac output.

PMID- 8471958
TI  - Spinal decompression sickness: hydrophobic protein and lamellar bodies in spinal
      tissue.
AB  - Four basic studies have addressed the question of why the spinal cord is so
      vulnerable to decompression injury, with symptoms exceeding those related to the
      brain by a ratio often quoted as 3:1. Hydrophobic protein (HP) was discovered in
      sheep spinal tissue at roughly 3 times (3.3:1) the level in brain and several
      orders of magnitude greater than in skeletal muscle or plasma. Extravascular
      lamellar bodies (LBs) of largely phospholipid (PL) were also demonstrated in
      spinal tissue by electron microscopy using a special fixative, the population
      being 4.1 times that in brain tissue where some LBs were found adjacent to
      vascular endothelium. Extracts of spinal surfactant (HP+PL) were found to be
      particularly surface active on the Langmuir trough, with the HP greatly
      accelerating monolayer equilibration, especially the recruitment of PL to a
      rapidly expanding air-aqueous interface. The PL/HP surfactant complex was found
      to render surfaces hydrophobic when they were able to initiate "strings" of
      bubbles in supersaturated solutions of gases. These results are discussed as
      favoring the concept of autochthonous bubbles causing spinal decompression injury
      exacerbated by the large quantities of spinal surfactant present.

PMID- 8471959
TI  - Effect of hyperbaric and normobaric oxygen on pulmonary endothelial cell
      function.
AB  - The effect of prior exposure to raised partial pressures of oxygen on pulmonary
      endothelial cell function was assessed in the isolated perfused rat lung
      preparation. Prolonged exposure to both 1 bar (48 h) and 2.5 bar (11 h) of oxygen
      caused pulmonary edema and dyspnea. Exposure to 1 bar oxygen for 48 h
      (approximately 0.66 lethal duration) caused a decrease in pulmonary 5
      hydroxytryptamine (5-HT) clearance, suggesting compromised endothelial cell
      integrity. No change in 5-hydroxy-indole acetic acid (5-HIAA) efflux was noted.
      However, exposure to 2.5 bar of oxygen for up to 11 h (approximately 0.85 lethal
      duration) did not decrease pulmonary 5-HT clearance, implying that endothelial
      cell integrity was not compromised after this oxygen exposure. Exposure to 2.5
      bar oxygen resulted in a reduction in 5-HIAA efflux, possibly indicating a
      decrease in metabolism of cleared 5-HT. The absence of a demonstrable impairment
      of 5-HT clearance during the development of pulmonary toxicity on exposure to 2.5
      bar of oxygen suggests that there may be important differences in pathologic
      mechanisms in response to oxygen exposure at partial pressures 1 and 2.5 bar.

PMID- 8471960
TI  - Relationship between the event-related brain potential P300 and inert gas
      narcosis.
AB  - It is known that inert gas narcosis slows both reaction time (RT) and the event
      related brain potential P300 in a correlated and dose-dependent manner. On the
      assumption that P300 reflects the time to evaluate a stimulus and RT reflects
      this time plus the time to select and execute a response, these results have been
      taken to indicate that the locus of the slowing produced by narcosis is early and
      influences stimulus evaluation processes. If this is the case, RT and P300 should
      be slowed identically when cognitive workload is manipulated. To test this
      prediction, subjects breathed 35% nitrous oxide and responded to differences in
      the intensity of either visual (Exp. 1, n = 8) or auditory (Exp. 2, n = 10) two
      choice oddball stimuli with accuracy controlled at a high level. In both
      experiments narcosis slowed RT and P300 additively by increasing the intercept
      rather than the slope of the workload function, but these two measures diverged
      in one important respect; RT was slowed more than P300, as indicated by an RT
      P300 difference analysis. It is concluded that, contrary to previous assumptions,
      narcosis produces two sources of slowing; one stimulus-related and indexed by
      P300 and the other response-related and indexed by the RT-P300 difference.
      Possible mechanisms underlying these sources are discussed.

PMID- 8471961
TI  - Computer simulation of counterlungs.
AB  - We have developed a computer model of chest-mounted counterlungs, which accounts
      for counterlung shape, effective volume, and pressure centroid. The model has
      been validated and the principles are applicable to other counterlung systems.
      The highly non-linear and discontinuous behavior of a counterlung is predicted by
      use of a sophisticated numerical integration method that computes variables such
      as pressure and volume in the time domain. Three separate stiffness (reciprocal
      of compliance) terms have been used which contribute to the diver's work of
      breathing: material elastic stiffness, "gas" stiffness, and "hydrostatic"
      stiffness. The model provides a significant advance in the understanding of
      counterlung behavior, allowing the performance of practical equipment to be
      predicted.

PMID- 8471962
TI  - Changes in frequency of R-plasmid transport in high pressure.

PMID- 8471963
TI  - [The chromosomal sensitivity of hematopoietic cells in Xenopus laevis larvae to
      the action of the chemical mutagen fotrin].
AB  - Using the method of counting micronuclei it was shown that, in peripheral blood
      of larva of frog exposed to high doses of alkylating agent fotrin, the abundance
      of erythrocytes with signs of chromosomal aberrations significantly exceeds the
      level of spontaneous mutations on the 16th, 24th and 30th days of fixation but
      not on the 7th day following the experiment onset. In addition, with all terms of
      fixation under examination, an increased in comparison with norm number of
      binuclear erythrocytes was observed in the population of erythroid cells. Our
      observations combined with the data obtained by other authors confirm that
      amphibian hemopoietic cells can be used as a reliable test system for the
      detection of cyto- and genotoxic compounds as well as for the genetic monitoring
      of water environment.

PMID- 8471964
TI  - [Microbial saprotrophic pharmacotherapy: the possible indications, the conditions
      for its realization and the overall strategy].
AB  - Potential indications for bacterial strains-producers of biologically active
      substances to be utilized for microbial saprotrophic pharmacotherapy are
      presented. These indications include some infectious diseases and tumors, a
      number of noninfectious diseases, transplantation and contraception. The cardinal
      problem of microbial pharmacotherapy, the capacity of strains-producers of
      getting acclimatized to the patient organism, is discussed. For its solution, a
      "microbiological passportization of a patient" ("saprotrophic mapping"), that is
      drawing up a map of patient microbiological status, is proposed. This
      "saprotrophic secretory passportization (mapping)" of strains-producers is first
      submitted for consideration. A strategy of future microbial pharmacotherapy is
      stated. The necessity of careful approbation of this kind of therapy is
      emphasized.

PMID- 8471965
TI  - [The modelling of survival and mortality curves for human populations based on
      the theory of reliability].
AB  - The reliability theory model of aging (Kol'tover 1981, 1982) was used for
      analysis of life-tables of Swedish males and females for 1951-1955, 1962-1973 and
      1971-1975 calendar years. In terms of the model it has been possible 1) to
      explain the Gompertz "law" of mortality; 2) to describe quantitatively
      statistical life-table data including Gompertz's and geriatric ages; 3) to
      predict the behavior of mortality rate function depending on the extent of
      population heterogeneity, among them the existence, at respective degrees of
      heterogeneity, of a maximum in geriatric age range and 4) to estimate the species
      specific maximum life-span potential of animals.

PMID- 8471966
TI  - [The effect of the drug-induced activation and deprivation of the sympathetic
      nervous system on aldosterone receptor binding by the kidney with disturbed
      neurotrophic support].
AB  - The results of studies are presented on the determination of aldosterone
      accumulation by mineralocorticoid receptors on cytoplasm and nuclei of normal rat
      renal tubules as well as in disturbed neurotrophic supply of the kidney including
      that against the background of activation and deprivation of the sympathetic
      nervous system function. It was shown that a pharmacological stimulation of
      sympathetic nervous system potentiated functional disturbances of the renal
      mineralocorticoid receptor apparatus in reflex dystrophy of the kidney. A
      simultaneous pharmacological blockade both of neural and of humoral transmission
      of pathological stimuli from damaged sciatic nerve to the kidney prevented the
      development of these disturbances. A belief is stated that there is a possibility
      of using adrenoceptor blockers as means to prevent or inhibit the development of
      dystrophic alterations in the organism which appear under the lesion of one or
      other part of the nervous system.

PMID- 8471967
TI  - [The effect of cytostatic and immunomodulator therapy on the morphology of the
      tumor and lymphoid organs and on the count of large granular lymphocytes in the
      blood of mice with Lewis carcinoma].
AB  - Effects of separate and combined therapy with nitrosomethylurea (NMU),
      methotrexate thymalin, and reaferon on tumor, thymus and spleen morphology as
      well as the content of large granular lymphocytes in blood were studied in mice
      with Lewis lung carcinoma. The study revealed different effects of methotrexate
      and NMU on tumor and lymphoid organs. The direct NMU damage to tumor was
      accompanied by a suppression of host immune system which was only slightly
      reversed with immunomodulators. The cytotoxic antitumor effect of methotrexate
      was probably related also with the stimulation of host immune system, its cells
      in turn affecting the size of proliferating tumor fraction.

PMID- 8471968
TI  - [Changes in the structure of the respiratory chain of the mitochondria from
      different tissues in relation to the conditions of mammalian development].
AB  - The content and stoichiometric relations of respiratory chain cytochromes were
      studied in mitochondria from femoral muscles of Wistar rats developing either
      under the conditions of hypokinesia or in near-natural ones. It was shown that,
      during early postnatal ontogenesis (until puberty), the maximum level of
      cytochrome aa3 was achieved already within the playing period (by the 30th day)
      in animals developing under near-natural conditions while in the group with
      locomotory deprivation, it was approached only in the midst of puberty (by the
      45th day). By the age of sexual maturity (the 60th day), the oxidative potential
      was higher in the group with natural development. Stoichiometric changes occurred
      in the relation of muscular cytochromes within the considered period. The
      cytochrome b562/aa3 ratio in 30-day-old rat pups from the group with "normal"
      development was twice as high as in adults. Similar alteration of this ratio was
      observed also in the group of animals developing under the conditions of
      hypokinesia though 5 days later. The interorganic analysis showed that the
      cytochrome ratio similar to that observed in muscles of rat pups within the
      playing period was characteristic of the liver and similar to that of adults-of
      the brain. Functional peculiarities of mitochondrial activity was studied on
      mitochondria isolated from brain and liver of adult animals. It was shown that
      the difference in respiratory chain structure, mainly in the b562/aa3 ratio, was
      connected with different substrate specificity. Brain mitochondria characterized
      with the b562/aa3 ratio below 1 possessed a higher affinity to NADH-dependent
      substrates while hepatic mitochondria with the ratio above 1-to FADH-dependent
      substrates.

PMID- 8471969
TI  - [The rate of development, temperature and genetic control].
AB  - The rate of poikilothermic animal development may be expressed quantitatively
      only with a specification of temperature at which this development occurs and on
      which this value depends. Therefore the species feature is not the rate of
      development itself but the character of its dependence upon the temperature and
      the range of temperature within which this development is possible. Obviously,
      the character of this dependence may be in principle expressed by an equation
      which functional form and parameters are inherited like all other features of the
      species. Therefore there should exist genes determining these parameters. Thus
      there is a one-to-one correspondence between the organism genetic apparatus, the
      rate of development and the temperature. The given article presents some
      theoretical and experimental approaches to the study of mechanisms of this
      correspondence.

PMID- 8471970
TI  - [The characteristics of the expression of temperature-dependent dominant lethal
      mutations in Drosophila melanogaster].
AB  - The results of a series of investigations on obtaining and analysing dominant
      temperature-sensitive lethals (DTS-lethals) are summarized. Using EMS, both cold-
      and heat sensitive mutations of this type were induced in large autosomes. The
      cold-sensitive mutations of chromosome 3 were revealed for the first time. The
      effect of genetic phone on DTS lethal penetrance and expressivity was studied.
      The character of expression of two mutations possessing a pleiotropic action was
      examined. The heat-sensitive 1(2)M90DTS mutation disturbed the structure of
      abdominal tergites in all imago and, besides, caused an abrupt decrease in the
      female reproductive period. The pattern of alterations observed in oogenesis
      along with the result of phenogenetic analysis suggest that this gene takes part
      in the genetic control over the proliferation of stem oogonial cells. The cold
      sensitive 1(2)M66DCS mutation caused a number of disturbances in imago thoracic
      structures: inability to flight, raised up wings, extremity fracture, etc. Mutant
      flies showed serious disorders of indirect flight muscles both at morphological
      and at ultrastructural levels. It was established that this mutation was a cold
      sensitive allele of Mhc gene which controls the synthesis of myosine heavy chains
      in drosophila.

PMID- 8471971
TI  - [The prospects for the development and use in ecological research of a
      cytogenetic method of analysing micronuclei in hepatocytes].
AB  - The article deals with peculiarities of hepatocyte proliferation which determine
      the fields of uses for a micronuclear test in hepatocytes and first of all for
      ecological biomonitoring of genotoxic pollution. Theoretical problems are
      considered that substantiate applied practices for performing the micronuclear
      test. Among them there are methods of stimulating the mitotic activity (partial
      resection of liver, necrogenic hepatotoxins, chemical inductors of adaptive
      growth); effects of cellular kinetics (volume of proliferative pool, blockade of
      premitotic period) on quantitative criteria of the method. The capacity of
      hepatocyte population to preserve and accumulate injuries of genetic material is
      discussed.

PMID- 8471972
TI  - [The cytogenetic monitoring of the southern Aral Sea area. An evaluation of the
      genotoxic activity of the water].
AB  - The work gives the data indicating the ability of water sampled from different
      sources of South Priaralje to induce chromosomal abnormalities in somatic and
      sexual cells of mammals. It has been shown also that the studied water samples
      can exert modifying effects on the clastogenic activity of supermutagen
      nitrosomethylurea. Season-dependent fluctuations of level of spontaneous and
      induced mutations have been revealed in three tissue systems (liver, cerebellum,
      and spermatogenic epithelium).

PMID- 8471973
TI  - [The cytostructure and cytochemistry of the retinal pigment epithelium].

PMID- 8471974
TI  - [The use of preparations of protozoan origin as agents for the prevention and
      early therapy of combined radiation-thermal injuries].
AB  - Radioprotective and therapeutic effects of astazian and astazilide, the drugs of
      protozoan origin, were studied in comparison with known modifiers of biological
      reactions (bacterial polysaccharides, synthetic polypeptides) in combined
      radiation-thermal injuries (CRTI). The efficiency of drugs under examination was
      found to be time- and dose-dependent. Application of the drugs of protozoan
      nature 24 hours prior to or 1 hour following CRTI provided 30 to 50% survival of
      experimental animals for 30 days as compared to 4.5% in the group of untreated
      mice. Administration of the drugs 3-7 days following CRTI exerted no therapeutic
      effect.

PMID- 8471975
TI  - [Krezatsin--a stimulant of the activity of regenerating liver cells].
AB  - In experiments with partial hepatectomy in rats, the application of cresacin was
      shown to potentiate processes of hepatocyte regeneration, to increase high-energy
      compounds therein, and to accelerate some phases of mitotic cycle. These
      processes occur along with an inhibition of lipid peroxidation in hepatocytes, a
      decrease in the rate of transmembrane oxygen transport in mitochondria, and a
      reduction of cytochrome oxidase amount. It was concluded that cresacin directly
      stimulates diverse links of metabolic pathway.

PMID- 8471976
TI  - [Changes in the intensity of free-radical reactions in the organs of rats under
      hypokinetic stress and with protection by the delta sleep-inducing peptide and
      its tyrosine-containing analog].
AB  - Dynamics of the hypokinesia-induced changes of free radical and malonic
      dialdehyde content in brain, the changes of respiratory chain state and
      superoxide dismutase activity in liver of rats has been studied using ESR
      technique and biochemical methods. The effect of the preliminary injection of
      DSIP and its analogue ID-2 on these dynamics has also been studied. Using a model
      system constants of the interaction between DSIP or ID-2 and O2-. have been
      determined. The data point to the antioxidant effect of the administration of the
      peptides before hypokinesia. This suggests that the effect involves in mechanisms
      of the anti-stress action of these peptides.

PMID- 8471977
TI  - Active immunization of children with leukemia and other malignancies.
AB  - Active immunization against measles, Haemophilus influenza B, tetanus,
      diphtheria, hepatitis B, influenza, poliomyelitis, and, when indicated varicella
      and pneumococcus induces long-lasting immunologic protection in most healthy
      pediatric vaccine recipients. Among children receiving immunosuppressive therapy
      for cancer, possible early loss of specific immunity acquired from prior
      vaccination or disease, and likely diminished responsiveness to initial or
      booster vaccination must be considered. In addition, the safety of vaccine
      administration requires separate study in this population. Published evidence
      demonstrates preservation of vaccine-induced antibody titers against tetanus,
      diphtheria, poliomyelitis and (in children treated for lymphoma) pneumococcus. In
      contrast, prior immunity to varicella, influenza, and hepatitis B (when naturally
      acquired), and measles (acquired by vaccination) is compromised during and/or
      after antineoplastic therapy. Studies of immunologic protection acquired by prior
      vaccination against hepatitis B, varicella, and H influenza have not been
      published. The safety of administering toxoids and inactivated vaccines in this
      population is well documented. In contrast, morbidity must be expected if live
      attenuated vaccines (oral polio vaccine, attenuated measles vaccine or attenuated
      varicella vaccine) are administered to children receiving anti-cancer therapy.
      The risks of using live vaccines should be measured against demonstrable benefits
      in any vaccine program. The response to initial or booster immunizations against
      tetanus and diphtheria are similar to those in healthy children. For all other
      immunizations reviewed, responsiveness is diminished during periods of
      chemotherapy, more strikingly in children treated for leukemia than for solid
      tumors. Antibody responses to these vaccines range from slightly blunted (in the
      case of H influenza B) to marginal (influenza) or completely useless
      (pneumococcus and hepatitis B in children treated for leukemia).

PMID- 8471978
TI  - Empiric treatment of localized infections in the febrile neutropenic patient with
      monotherapy.
AB  - Empiric therapy is necessary for febrile, neutropenic patients in order to
      minimise morbidity and mortality. Certain agents are now available for
      monotherapy which offer comparable success to combinations of either an
      aminoglycoside with a beta-lactam or two beta-lactams. However, no regimen offers
      complete treatment under all circumstances in all patients. It is also apparent
      that febrile, neutropenic patients comprise a more heterogeneous group than just
      those with bacteraemia, clinically apparent infection and unexplained fever.
      Localized infections occur in just under a third of cases at the onset of fever
      and a similar number will develop during the course of fever. Mortality is higher
      in infections that are accompanied by bacteraemia and also those that develop
      subsequently, especially when related to the lung. The aetiological agent also
      differs with each type of infection as does the duration of fever and symptoms.
      Consequently modifications are required more often. The length of treatment may
      also differ. Therefore, during the first 3-4 days of empiric therapy, every
      effort should be made to identify incipient localized infections in addition to
      detecting bacteraemia. Changes in therapy can then be based on objective grounds
      rather than continued fever offering more patients individual treatment than is
      possible when relying only on the temperature chart.

PMID- 8471979
TI  - Induction therapy for acute myelogenous leukemia in patients over 60 years with
      intermediate-dose cytosine arabinoside, mitoxantrone and etoposide.
AB  - Twenty-three patients greater than age 60 years with acute myelogenous leukemia
      (AML) received induction therapy with continuous infusion cytosine arabinoside
      (1.5 g/m2/day, day 1-3), mitoxantrone (10 mg/m2/day, day 1-3) and etoposide (800
      mg/m2, day 4). Patients entering complete remission (CR) were eligible to receive
      an identical consolidation cycle. Eighteen of the 23 patients (78%; 95%
      confidence interval 56% to 93%) entered CR. Twelve of these received
      consolidation therapy and 4 of these remain in remission at 3 to 20 months.
      Hematologic toxicity of the regimen was acceptable; only 1 patient died following
      therapy (having attained a CR). Non-hematologic toxicity was mostly mild (grade 2
      or less) with one episode of grade 3 cerebellar toxicity. While this regimen
      induces a high CR rate in patients > age 60 years, relapses remain common and
      overall survival is too early to assess.

PMID- 8471980
TI  - Bisantrene in relapsed and refractory acute myelogenous leukemia.
AB  - Because of the lack of standard treatment in refractory and relapsed acute
      myelogenous leukemia (AML) several new drugs have been employed alone to evaluate
      their efficacy in this peculiar category of patient. Bisantrene, a new anthracene
      bishydrazone derivative, has shown antileukemic effect in phase I and II clinical
      trials with acceptable extrahaematological toxicity. Seven patients (six males
      and one female, median age 41.8 years) received Bisantrene (250 mg/sqm/daily 1-7)
      as a single agent in relapsed or refractory leukemia. 5 out of 7 patients
      achieved complete remission, one attained partial remission and one was
      resistant. However, haematological toxicity was severe with prolonged
      myelosuppression. Hepatic toxicity was the main extrahaematological side effect
      and occurred in 3 of 7 patients, however all of them recovered within 40 days. No
      cardiovascular dysfunction occurred although all the patients had been heavily
      previously treated with anthracyclines. Our data confirm that Bisantrere is
      active in relapsed and refractory AML and suggest the need for larger clinical
      trials to better evaluate its efficacy.

PMID- 8471981
TI  - Immunophenotype of acute lymphoblastic leukemia cells: the experience of the
      Italian Cooperative Group (Gimema).
AB  - The immunophenotype of 304 adult lymphoblastic leukemias (> 18 years) diagnosed
      on the basis of the FAB criteria was determined at the time of diagnosis using a
      panel of monoclonal antibodies. The series comprised cases diagnosed and
      immunophenotyped in 43 Italian centers (GIMEMA Cooperative Group) between April
      1988 and June 1991. The immunophenotypic characterization consisted of two
      consecutive steps. The initial screening was based on the reactivity for TdT, HLA
      Dr, CD7, CD10, CD13, CD19, CD24, CD33 and CD41. According to the results
      obtained, the second level of investigation assessed the positivity for intra
      cytoplasmic (Cy) Ig, CD1a, CD2, CD3, CD4, CD5, CD8 and CD20. Based on the
      hierarchical expression of the different B- and T-cell related antigens, each
      case was assigned to a given differentiation stage. B-lineage ALL were classified
      in five subgroups (B0-B4) and T-lineage ALL in four subgroups (T0-T3). Cases in
      which the blasts were lymphoid according to the FAB criteria, but expressed
      myeloid antigens in association with B- and T-lymphoid markers were defined as
      hybrid leukemias. As expected, CD10+ cases (B2-B3) were the most frequent within
      the B-lineage ALL (83.2% of cases). CyIg+ (B3) accounted for about 20% of CD10+
      ALL. Twenty eight cases (13.4%) were at a pre-cALL stage (B0-B1) and of these, 8
      (3.8% of the total series) were positive only for TdT and HLA-Dr (B0).
      Intermediate and mature thymic phenotypes (T2-T3) were predominant within the T
      ALL (67.2%) groups. Five cases, were positive only for TdT and CD7 (CD5+), and
      classified as T0. 9.2% of cases fulfilled the definition of hybrid leukemia,
      largely in view of the co-expression of B-lymphoid and myeloid markers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8471982
TI  - DNA image analysis in childhood acute lymphoblastic leukemia.
AB  - DNA index (DI) and percentages of cells in S and G2/M phase were determined in
      Feulgen stained nuclei of blasts from 31 cases of childhood ALL at diagnosis. In
      6 cases the results of DNA analysis and cytogenetics were concordant showing
      hyperdiploidy. Two other cases with normal karyotype were revealed as DNA
      aneuploid with image analysis. Cases with cytogenetic abnormalities like
      translocation, deletion or presence of single or double supernumerary chromosomes
      had DI within normal ranges. Nine ALL cases (29%) were found to be DNA aneuploid-
      8 hyperdiploid and 1 hypodiploid. The percentages of cells in S and G2/M phase
      for blasts from bone marrow (mean 17.6%) were significantly higher than those
      estimated in the peripheral blood (mean 1.57%). We conclude that analysis by
      image cytometry can detect aneuploid DNA content even in cases, which showed a
      normal karyotype and provides new information concerning the biological aspects
      of leukemic blasts.

PMID- 8471983
TI  - The surgical choice in neutropenic patients with hematological disorders and
      acute abdominal complications.
AB  - The clinical course of patients with hematological disease, especially after
      treatment, is often complicated by gastrointestinal infections. Between 1986 and
      1990 a total of 18 patients affected with hematologic disease and presenting with
      an acute abdomen were admitted to the surgery department at the University of
      Rome "La Sapienza". Most patients were affected with acute or chronic myeloid
      leukemia (61%) and lymphoma. Five patients with acute appendicitis, three with
      necrotizing enterocolitis, three with spontaneous hemoperitoneum, three with
      cholecystitis, two splenic infarctions and two intestinal occlusions were
      diagnosed. Symptoms were often vague and non specific and blood counts revealed
      neutropenia in all but two patients, while anemia was characteristic in
      spontaneous hemoperitoneum and in neutropenic enterocolitis. Fungemia occurred in
      only two cases while bacteremia was present in seven. The most critical patients
      were those affected by neutropenic enterocolitis and acute cholecystitis.
      Sonography was meaningful in the diagnosis of hemoperitoneum, splenic infarct and
      acute cholecystitis. All patients underwent surgical procedures within 48 hours
      of admission to the department. In all cases peritoneal washing was performed and
      at least one peritoneal drainage was left. In all cases of necrotizing
      enterocolitis, intestinal resections, either ileal or colonic, were followed by
      an immediate anastomosis in two layers. Intensive hematological and antibiotic
      post surgical care was performed in all patients. Seven patients presented minor
      complications (38.8%), and only one died (5.5%). Emergency surgical treatment may
      be safely carried out in patients with hematological diseases presenting with an
      acute abdomen. Intensive postsurgical care is mandatory for the recovery of
      patients and the patient's critical condition should not be a deterrent to
      surgical intervention.

PMID- 8471984
TI  - A randomised trial of cyclophosphamide with and without low dose alpha-interferon
      in the treatment of newly diagnosed myeloma.
AB  - The role of alpha-interferon (IFN) in initial treatment of multiple myeloma is
      controversial. We have conducted a trial of cyclophosphamide with and without low
      dose IFN in newly diagnosed myeloma. Thirty four patients, mean age 63 were all
      given cyclophosphamide 600mg/m2 IV every 21 days while 17 were randomised to also
      receive IFN at a dose equivalent to 6mU per week. In the IFN group 8/15
      assessable patients (53%) had a greater than 50% reduction in paraprotein
      compared with 4/16 (25%) of controls (p < 0.05). However the median duration of
      response was the same in the two groups (IFN 8 months, controls 8.5 months).
      After a median follow up of 28 months there is no significant difference in
      survival. Toxicity including myelosuppression was commoner in the IFN group.
      These findings suggest that the addition of IFN to cyclophosphamide is not likely
      to offer major benefits in treating myeloma.

PMID- 8471985
TI  - Resistance to lipophilic cationic compounds in multidrug resistant leukemia
      cells.
AB  - Previously we have shown that multidrug resistant cells are cross-resistant to
      certain permanently charged cationic lipophilic compounds. In the present study
      we extend these observations to additional cationic lipophilic compounds with
      unrelated chemical structures. Study of the growth inhibitory activity of series
      of triphenylalkyl-phosphonium and alkyl-ammonium compounds revealed that cross
      resistance to these compounds in multidrug resistant P-388 murine leukemia cells,
      was related to the presence of cationic charge but not to the molecular
      size/degree of lipophilicity.

PMID- 8471986
TI  - Primary pleomorphic T-cell lymphoma of the spleen.
AB  - We report a case of primary splenic T-cell lymphoma that posed difficult problems
      in differential diagnosis with erythrophagocytic T-gamma lymphoma and
      inflammatory pseudotumor of the spleen. The need for immunophenotypic and
      molecular studies for establishing the correct diagnosis and the importance of
      early detection and treatment, is emphasized in the light of the relatively good
      prognosis of splenic lymphoma, diagnosed in the early stages of disease.

PMID- 8471987
TI  - Sudden onset deafness as a presenting manifestation of chronic lymphocytic
      leukemia.
AB  - An unusual patient with typical Rai Stage 2 (Binet Stage A) chronic lymphocytic
      leukaemia (CLL), who presented with sudden onset deafness as the initial
      manifestation of disease is reported. This sensorineural hearing loss improved
      dramatically after the administration of chemotherapy. This unique observation
      was also associated with reduction of the circulating B-CLL cells and with the
      achievement of a partial response, lasting for almost three years. Recently there
      was another episode of sudden deafness, associated with a rising leukocyte count,
      and disease activity followed once again by recovery after chemotherapy.
      Audiograms were recorded showing positive findings on presentation and recovery
      after therapy. This very rare manifestation of CLL was presumed to be due to
      infiltration of the cochlear duct or the 8th cranial nerve although all imaging
      techniques were negative, because of the rapid relief and recovery achieved after
      specific chemotherapy. The importance of early diagnosis and therapy is stressed
      in the light of the rapid clinical recovery observed here.

PMID- 8471988
TI  - [Biosynthesis of human recombinant interleukin-8 in Escherichia coli].

PMID- 8471989
TI  - [Monoclonal antibody ICO-92 against the transferrin receptor (antigen CD71)].

PMID- 8471990
TI  - Effects of recovery duration and blood lactate level on power output during
      cycling.
AB  - This study identifies the quickest recovery between consecutive anaerobic tests
      to maintain power output (PO) on the repeated test. Sixteen male cyclists
      finished three sessions of max rpm initial and repeated 45-s cycling tests at
      53.9 N. Tests were separated by 6, 9, or 12 min of recovery cycling (80 rpm, 9.8
      N). Results showed no significant differences in PO between initial tests (M =
      578.5 +/- 50 watts). PO was significantly less on the 6-min repeated test (M =
      551.2 +/- 51) compared to the 9- (M = 575.1 +/- 53) and 12-min tests (M = 581.7
      +/- 49.9) (p > 0.05). Net blood lactate [HLa] (repeated test-recovery) was
      significantly related to net PO (repeated test-initial test) on the 9- (r = 0.60,
      p < 0.05) and 12-min (r = 0.64, p < 0.001) trials, but not on the 6-min trial (r
      = 0.35, p = 0.19). In summary, at least 9 min of recovery cycling maintains PO on
      a repeated 45-s cycling test. Elevated [HLa] at the onset of high-intensity
      sprint exercise is moderately associated with PO on repeated cycle ergometer
      tests.

PMID- 8471991
TI  - Ageing and human muscle: observations from Sweden.
AB  - The purposes of this review are to summarize studies of cross-sections of
      autopsied whole muscles from previously physically healthy males and to focus on
      the cause of the ageing atrophy. The ageing atrophy begins around 25 years of age
      and thereafter accelerates. This is caused mainly by a loss of muscle fibres, and
      to a lesser extent by a reduction in fibre size, mostly of the proportion of the
      fibre area in the muscle cross-section occupied by type 2 (fast-twitch) fibres.
      In muscle from old subjects, there is a significant increase in the number of
      enclosed fibres, indicating an increased incidence of fibre type grouping, a loss
      of motor neurons in the spinal cord, and a reduction in the number of functioning
      motor units. These findings strongly suggest a combination of a progressive
      denervation process and an altered physical activity level as the two major
      mechanisms underlying the effects of normal ageing on human muscle. These changes
      have obvious implications for old individuals and their participation in physical
      activity and in sports, which must be accommodated in rehabilitation regimes or
      in training programmes.

PMID- 8471992
TI  - The effects of active and passive recovery on short-term, high intensity power
      output.
AB  - The advantage of active over passive recovery from long and intermediate duration
      exercise is well documented. Success has been attributed to metabolite washout
      and/or lactate (La) utilization by the active musculature. This study was
      designed to determine whether active recovery was superior to passive rest during
      short duration, high intensity performance. On 4 separate days, six athletes
      performed a set of eight 6-s power tests separated by 30-s recovery intervals
      under two recovery conditions. Recovery conditions involved either sitting
      passively on the bike (P) or actively pedaling (A) at 60 rpm using 1 kg
      resistance. A MANOVA on peak power (PP), fatigue rate (F), and total work (TW)
      showed a significant difference due to recovery condition, F(3, 169); p < .0001.
      Separate ANOVAs revealed that PP (A = 1192.85 watts, P = 1134.57 watts; p <
      .0001) and TW (A = 6.59 kJ, P = 6.23 kJ; p < .0001) differed significantly
      between conditions. No difference was found for F (A = 80.12 watts.sec-1, P =
      79.80 watts.sec-1). Results indicate that active recovery provides superior
      performance to passive rest in repeated short-term, high intensity power
      activities.

PMID- 8471993
TI  - Stability of parameter estimates derived from the power/time relationship.
AB  - The hyperbolic relationship between power output (P) and time to exhaustion (t)
      is described as t = W'/(P-theta PA). The purpose of this study was to determine
      the stability of estimations of estimates of theta PA and W', said to reflect
      maximal sustainable power and anaerobic capacity, respectively. Thirteen women
      and 13 men performed five bouts of cycling exercise to exhaustion. Individual
      theta PA and W' were calculated from the results of these five bouts (Trial 1).
      These procedures were repeated (Trial 2). For both sexes, Trial 2 estimates of
      theta PA were 5 to 6% higher than Trial 1 estimates, but they were highly
      correlated. Mean W' estimates were the same in Trials 1 and 2, with higher trial
      to-trial correlations in the men than in the women.

PMID- 8471994
TI  - The relationship between cognitive characteristics and decision making.
AB  - Team handball players (N = 118) underwent a number of cognitive tests to examine
      how much of their decision making (DM) ability, as measured through responses to
      game slides projected to them for 2 seconds under low and high exertion levels
      (i.e., walking and running), was accounted for by cognitive components. A
      stepwise multiple linear regression indicated that experience was the most
      pronounced predictor of DM capacity in both exertion conditions. In the walking
      condition, concentrational consistency, avoidance of concentrational mistakes,
      and short-term memory, together with experience, produced a multiple R of 0.48
      with decision making. In the running condition, choice reaction time (CRT),
      intelligence, and short-term memory, together with experience, correlated 0.46
      with DM. These differences in cognitive abilities, as predictors of DM under
      walking and running conditions, are discussed in terms of information processing
      models and other cognitive processes.

PMID- 8471995
TI  - [Clinical factors which influence the 1-year post-infarction prognosis].
AB  - Many clinical factors influence the 1-year prognosis in myocardial infarction
      (MI) patients. The most important clinical determinants are the left ventricular
      dysfunction, myocardial ischemia, and complex ventricular arrhythmias. Some
      authors have found an independent prognostic value of complex ventricular
      arrhythmias, while others consider that ventricular arrhythmias predict future
      cardiac events only if associated with low ejection fractions. Other factors that
      have 1-year prognostic value are the following: a previous MI, a history of
      angina at least 3 months preceding the infarct, postmyocardial angina, and the
      criteria that indicate to the practitioner whether MI patients are medically
      ineligible for stress testing. There still remain controversies in regard to the
      predictive value of certain variables such as the site, type, and extension of
      the MI, the presence of complex ventricular arrhythmias, exercise-induced
      hypotension, ST segment elevation, and the electrical provocation of dangerous
      arrhythmias.

PMID- 8471996
TI  - Fitness and lifestyle parameters fail to predict back injuries in nurses.
AB  - Performance on fitness and back related isometric strength tests, as well as the
      response to a lifestyle questionnaire, were related to the subsequent occurrence
      of back injuries in 119 nurses. In all, 22% of subjects sustained injuries during
      the 18-month study. Injured nurses were more likely to be from high-risk wards
      and to have received worker's compensation pay for past back injuries. Fitness
      and lifestyle characteristics did not differ significantly between injured and
      not-injured groups. Using backward stepwise logistic regression, a model was
      developed that accounted for 41% of the variability between groups and predicted
      67% of those injured. Prior compensation pay, smoking status, and job
      satisfaction were the most useful discriminators. It was concluded, however, that
      the fitness and lifestyle parameters measured did not effectively predict back
      injury in nurses.

PMID- 8471997
TI  - Effects of jet lag on factors related to sport performance.
AB  - Three studies were performed to evaluate the effects of jet lag on factors
      associated with sport performance. In Study 1, members of the USA Women's Soccer
      Team traveled to Taiwan; in Study 2, North American students and faculty traveled
      to Western Europe; and in Study 3, European students traveled to North America.
      After travel, there was disruption of mood state and a reduction in dynamic
      strength; peak 5-s power and 30-s work capacity were reduced for 2 days (5-s
      power: 9.8 vs. 9.0 vs. 9.0 W.kg-1; 30-s work capacity: 213 vs. 199 vs. 201 J.kg
      1). In these studies, mood state, anaerobic power and capacity, and dynamic
      strength were affected by rapid transmeridianal travel, and even highly trained
      athletes suffered from jet lag. However, effects of travel on the variables
      tested were essentially eliminated after 3 or 4 days.

PMID- 8471998
TI  - A survey of health sciences libraries in hospitals: implications for the 1990s.
AB  - In response to an expressed need for comprehensive data on health sciences
      libraries in hospitals, the American Hospital Association (AHA) conducted a
      survey of all U.S. registered hospitals in 1990. The response rate was 57%.
      Results showed that 2,167 hospitals (31.6% of all U.S. registered hospitals) had
      on-site libraries that met four definitional criteria. Survey results also
      indicated that hospitals use diverse resources and approaches to provide
      information services to a wide array of health care providers and consumers.
      These baseline data, combined with an assessment of key environmental factors
      affecting hospitals, can provide guidance to hospital libraries as they face the
      challenges of the 1990s. The AHA has added the health sciences library to
      services tracked in its annual survey of hospitals; additional research
      opportunities in this area remain.

PMID- 8471999
TI  - The future role of the health sciences library in the Department of Veterans
      Affairs.
AB  - The Department of Veterans Affairs (VA) conducted a survey to ascertain the
      perceptions of 322 library service chiefs and health care administrators within
      the VA health care system. Participants were asked to rate the desirability and
      probability of twenty-five predetermined statements and to identify the forces
      that would have an impact, either positive or negative, on whatever statements
      became reality. The response rate was 93%. Analysis of the data indicated that
      there was no significant difference between the library managers and health care
      administrators in their perceptions. Results indicate that both groups believe
      libraries serve an integral role in VA medical centers and that library services
      cannot be provided as successfully off site. The data also appear to reveal a
      clear consensus on the part of both groups for increased library involvement in
      educational activities and information delivery.

PMID- 8472000
TI  - Paraprofessional staff: a review and report on current duty assignment in
      academic health sciences libraries in North America.
AB  - This paper reviews paraprofessional employment in libraries and examines the
      trend toward assigning increasingly complex duties to academic library
      paraprofessionals. During the spring of 1989, directors of academic health
      sciences libraries in the United States and Canada were surveyed to determine the
      duties assigned to paraprofessionals. The results show that paraprofessionals are
      assigned a wide range of duties, including supervising functional areas, such as
      circulation and interlibrary loan, and some tasks often considered professional,
      such as original cataloging and in-depth reference work. The findings illustrate
      the importance of the paraprofessional to librarianship.

PMID- 8472001
TI  - Selected list of books and journals for the small medical library.
AB  - The potential for the hospital library as an accepted patient-focused module is
      viewed in terms of both the present and the future--or no future--in the
      introduction to this revised recommended list of 606 books and 143 journals.
      Predecessors of this list have been intended as selection guides for a small or
      medium-size library in a hospital or comparable medical facility. Due to rapidly
      rising prices, the secondary purpose--a basic collection for a consortium of
      hospital libraries or a network sharing library resources--may eventually become
      its primary use. Books and journals are categorized by subject; the book list is
      followed by an author/editor index, and the subject list of journals by an
      alphabetical title listing. For the first time, a "minimal core collection"
      consisting of 85 books has been broken out from the 200 asterisked initial
      purchase books. To purchase the entire collection of books and to pay for the
      1993 subscriptions would require about $87,000; the cost of only the asterisked
      books and journals totals $34,800. The "minimal core list" of books costs
      $11,600.

PMID- 8472002
TI  - The UMLS project: making the conceptual connection between users and the
      information they need.
AB  - Conceptual connections between users and information sources depend on an
      accurate representation of the content of available information sources, an
      accurate representation of specific user information needs, and the ability to
      match the two. Establishing such connections is a principal function of medical
      librarians. The goal of the National Library of Medicine's Unified Medical
      Language System (UMLS) project is to facilitate the development of conceptual
      connections between users and relevant machine-readable information. The UMLS
      model involves a combination of three centrally developed Knowledge Sources (a
      Metathesaurus, a Semantic Network, and an Information Sources Map) and a variety
      of smart interface programs that make use of these Knowledge Sources to help
      users in different environments find machine-readable information relevant to
      their particular practice or research problems. The third experimental edition of
      the UMLS Knowledge Sources was issued in the fall of 1992. Current priorities for
      the UMLS project include developing applications that make use of the Knowledge
      Sources and using feedback from these applications to guide ongoing enhancement
      and expansion of the Knowledge Sources. Medical librarians are involved heavily
      in the direction of the UMLS project, in the development of the Knowledge
      Sources, and in their experimental application. The involvement of librarians in
      reviewing, testing, and providing feedback on UMLS products will increase the
      likelihood that the UMLS project will achieve its goal of improving access to
      machine-readable biomedical information.

PMID- 8472003
TI  - Coach: applying UMLS knowledge sources in an expert searcher environment.
AB  - With the development of the Unified Medical Language System (UMLS) Knowledge
      Sources, the National Library of Medicine (NLM) has produced a resource of great
      potential for improving the searching of MEDLINE. The Coach expert searcher
      system, an inhouse research project at NLM, is designed to help users of the
      GRATEFUL MED front-end software improve MEDLINE search and retrieval
      capabilities. This paper describes the Coach program, the knowledge sources it
      uses, and some of the ways it applies elements of the UMLS Metathesaurus to
      facilitate access to the biomedical literature.

PMID- 8472004
TI  - UMLS knowledge for biomedical language processing.
AB  - This paper describes efforts to provide access to the free text in biomedical
      databases. The focus of the effort is the development of SPECIALIST, an
      experimental natural language processing system for the biomedical domain. The
      system includes a broad coverage parser supported by a large lexicon, modules
      that provide access to the extensive Unified Medical Language System (UMLS)
      Knowledge Sources, and a retrieval module that permits experiments in information
      retrieval. The UMLS Metathesaurus and Semantic Network provide a rich source of
      biomedical concepts and their interrelationships. Investigations have been
      conducted to determine the type of information required to effect a map between
      the language of queries and the language of relevant documents. Mappings are
      never straightforward and often involve multiple inferences.

PMID- 8472005
TI  - Generic queries for meeting clinical information needs.
AB  - This paper describes a model for automated information retrieval in which
      questions posed by clinical users are analyzed to establish common syntactic and
      semantic patterns. The patterns are used to develop a set of general-purpose
      questions called generic queries. These generic queries are used in responding to
      specific clinical information needs. Users select generic queries in one of two
      ways. The user may type in questions, which are then analyzed, using natural
      language processing techniques, to identify the most relevant generic query; or
      the user may indicate patient data of interest and then pick one of several
      potentially relevant questions. Once the query and medical concepts have been
      determined, an information source is selected automatically, a retrieval strategy
      is composed and executed, and the results are sorted and filtered for
      presentation to the user. This work makes extensive use of the National Library
      of Medicine's Unified Medical Language System (UMLS): medical concepts are
      derived from the Metathesaurus, medical queries are based on semantic relations
      drawn from the UMLS Semantic Network, and automated source selection makes use of
      the Information Sources Map. The paper describes research currently under way to
      implement this model and reports on experience and results to date.

PMID- 8472006
TI  - Using a network menu and the UMLS Information Sources Map to facilitate access to
      online reference materials.
AB  - As computer technology advances, clinicians and biomedical researchers are
      becoming more dependent upon information from online databases and information
      systems. By using specially configured computer workstations and high-speed
      computer networks, it is now possible to access this information in a rapid and
      straightforward manner. To empower users by providing these capabilities, the
      authors are assembling a variety of network workstations to be located throughout
      Yale-New Haven Medical Center. At the heart of the workstation is NetMenu, a
      program designed to help users connect to a number of important online
      information systems, including a hospital order entry and results reporting
      system, a drug reference, bibliographic retrieval systems, and educational
      programs. In addition, as part of the National Library of Medicine's Unified
      Medical Language System (UMLS) project, the authors have developed a local
      prototype of the UMLS Information Sources Map (ISM) and a companion query
      assistant program to complement the NetMenu in helping users select and connect
      automatically to information services relevant to a particular question. The ISM
      query assistant draws from a listing of many online information sources
      accessible via local and international networks.

PMID- 8472007
TI  - The UMLS Metathesaurus: representing different views of biomedical concepts.
AB  - The UMLS Metathesaurus is a compilation of names, relationships, and associated
      information from a variety of biomedical naming systems representing different
      views of biomedical practice or research. The Metathesaurus is organized by
      meaning, and the fundamental unit in the Metathesaurus is the concept. Differing
      names for a biomedical meaning are linked in a single Metathesaurus concept.
      Extensive additional information describing semantic characteristics, occurrence
      in machine-readable information sources, and how concepts co-occur in these
      sources is also provided, enabling a greater comprehension of the concept in its
      various contexts. The Metathesaurus is not a standardized vocabulary; it is a
      tool for maximizing the usefulness of existing vocabularies. It serves as a
      knowledge source for developers of biomedical information applications and as a
      powerful resource for biomedical information specialists.

PMID- 8472008
TI  - The community-based database prototype of the southeast Florida AIDS Information
      Network.

PMID- 8472009
TI  - Use of MEDLINE by health sciences faculty at the University of Minnesota.

PMID- 8472010
TI  - A study of MeSH and UMLS for subject searching in an online catalog.

PMID- 8472011
TI  - AIDS literature underestimated.

PMID- 8472012
TI  - Journal supplements, libraries, and the FDA.

PMID- 8472013
TI  - Suppression of endotoxin mitogenicity of spleen cells by lipoxygenase inhibitors
      and its reversal by 13-hydroxyoctadecadienoic acid.
AB  - The effects of several inhibitors of lipoxygenases were investigated in murine
      spleen cell cultures activated with endotoxin (lipopolysaccharide). It was found
      that these inhibitors interfere with the proliferative response of the cultures.
      Indomethacin, a specific cyclooxygenase inhibitor, had no such effect. Endotoxin
      induced the synthesis of tumour necrosis factor alpha in spleen cells which was
      prevented by treatment with a lipoxygenase inhibitor. The inhibition of the
      mitogenic effect of endotoxin could be reversed by addition of 13
      hydroxyoctadecadienoic acid. This was not the case with leukotriene B4 and C4 or
      15-hydroxyeicosatetraenoic acid. In contrast, these substances had inhibitory
      effects on the mitogenicity of spleen cells. It is suggested that 13
      hydroxyoctadecadienoic acid is involved in the development of the mitogenic
      reaction, possibly on the level of tumour necrosis factor alpha production of
      macrophages present in the cultures.

PMID- 8472014
TI  - Identification of Yersinia pestis with varied plasmid composition using
      monoclonal and polyclonal fluorescent immunoglobulins.
AB  - The efficiency of serological identification of Yersinia pestis strains which
      contain different plasmids was assessed with polyclonal and monoclonal
      immunoglobulin preparations in the direct fluorescent antibody method. Plague
      polyclonal luminescent immunoglobulins recognize only those Y. pestis strains
      which contain pPst, pFra plasmids or both. Anticapsular plague monoclonal
      antibodies interact only with capsule-forming plague agent strains (pFra+) grown
      at 37 degrees C. With plague monoclonal lipopolysaccharide antibodies one can
      identify all Y. pestis strains irrespective of their plasmid content and
      cultivation temperature. However, these antibodies cross-react with Yersinia
      pseudotuberculosis bacteria in 60% of cases. The problem of laboratory diagnosis
      of the plague organism, whatever its plasmid profile, can be solved through the
      development of a test kit involving two preparations such as plague
      lipopolysaccharide monoclonal luminescent antibodies and pseudotuberculosis
      specific luminescent adsorbed immunoglobulins.

PMID- 8472015
TI  - Inhibition of interleukin-6 release and T-cell proliferation by synthetic mirror
      pseudo cord factor analogues in human peripheral blood mononuclear cells.
AB  - The effects of synthetic alkyl ((alkyl 6-deoxy-a-D-gluco-heptopyranosyluronate) 6
      deoxy-a-D-gluco-heptopyranoside) uronates, a novel type of mirror pseudo cord
      factor, on the in vitro modulation of interleukin-6 production and T-cell
      proliferation in human peripheral blood mononuclear cells, were investigated.
      Synthetic mirror pseudo cord factors with alkyl chains ranging from C16 to C18
      have very weak interleukin-6-inducing capacities and lack mitogenic activities
      for T-cell proliferation. However, they could inhibit IL-6 release induced by
      sonicated Bacillus Calmette-Guerin (S-BCG), bacterial endotoxin, and
      phytohaemagglutinin in a dose-dependent manner. Inhibition was observed not only
      with mononuclear cells but also with purified monocytes. Furthermore, these
      synthetic compounds could suppress T-lymphocyte proliferation stimulated by
      sonicated Mycobacterium tuberculosis H37Rv (S-H37Rv) antigens, S-BCG antigens, as
      well as by recombinant 65 kDa mycobacterial heat-shock protein. In contrast,
      these compounds failed to inhibit the phytohaemagglutinin-induced T-cell
      proliferation. We conclude that the inhibition of cytokine release and T-cell
      proliferation by synthetic mirror pseudo cord factors was due to direct blocking
      of the function and/or activity of monocytes or antigen-presenting cells.

PMID- 8472016
TI  - Changing patterns of the IL-2/IL-2R pathway of lymphocyte activation following
      exposure to Plasmodium falciparum products: a study with squirrel monkey
      peripheral blood mononuclear cells.
AB  - Squirrel monkeys are experimental hosts useful for studies on human malaria. In
      the present work, in vitro lymphocyte reactivity was measured by proliferation in
      the presence of Plasmodium falciparum-derived products, and found to depend on
      the previous malarial status of the animals and upon the source and/or the nature
      of the P. falciparum-derived material. Special attention was given to the IL-2/IL
      2R pathway of lymphocyte activation. Culture supernatant from P. falciparum
      parasitized erythrocytes exerted an inhibitory effect towards T lymphocytes
      obtained from P. falciparum-non-immune squirrel monkeys, when activated, for
      instance, by PHA. These lymphocytes did not incorporate tritiated thymidine
      (neither they did proliferate) although they expressed IL-2 alpha and beta
      binding chains and secreted IL-2 (or at least TCGF). This inhibitory effect could
      not be rescued by the addition of rhIL-2, although the assayed lymphocytes could
      retain the ability to continue their cell cycle progression and divide after
      removal of the P. falciparum-derived inhibitory product(s). The incidence of anti
      mitogenic molecules which impair the IL-2/IL-2R pathway of lymphocyte activation
      in malaria related processes is discussed.

PMID- 8472017
TI  - ESR dating of tooth enamel: comparison with U-series, FT and TL dating at the
      Peking man site.
AB  - Deer tooth samples from Zhoukoudian, the Peking Man Cave, were studied. Non
      linear fitting is used to determine AD, from which ESR ages were calculated by
      both the disequilibria model (DU) and linear uptake model (LU). Comparison of ESR
      ages with those from U-series, FT and TL methods show that the enamel of deer
      teeth is a suitable material for ESR dating.

PMID- 8472018
TI  - Kinetics of distribution of 5-doxylstearic acid in mouse lymphocytes.
AB  - The rate at which stearic acid nitroxide spin labels distribute through cells
      affects the interpretation of data obtained from these nitroxides. We used
      photoreduction of 5-doxylstearic acid (5DS) to determine the rate at which 5DS
      arrives at the outer half of the plasma membrane of mouse lymphocytes and
      macrophages. Our results show that 5DS is in equilibrium with the outer half of
      the plasma membrane of mouse lymphocytes over a time frame of 2 minutes or less.
      Thus, spectra data obtained from 5DS-labelled cells clearly reflects the
      spectrally averaged environment of all the cell membranes in lymphocytes and
      potentially other cells as well. This clarifies the observation that the spectral
      information obtained from doxylstearic acid nitroxides is relatively insensitive
      to environmental changes which would be expected to involve only the plasma
      membrane of the cell.

PMID- 8472019
TI  - Viral transformation of baby hamster kidney cells affects the oxygen sensitivity
      of nitroxide reduction.
AB  - In order to explore and expand the potential applications of nitroxides, it is
      important to understand how nitroxides are metabolized by living systems. We
      studied the oxygen sensitivity of a BHK (baby hamster kidney) cell line and BHK
      cells that had been transformed by adenovirus to determine if the process of
      adenoviral transformation affects nitroxide metabolism. When the BHK cells are
      transformed by adenovirus, they reduce nitroxides essentially independently of
      oxygen concentration. In addition, the rate of reduction of the nitroxides
      decreases by a factor of 10 compared to the rate of reduction in BHK cells. These
      data suggest to us that the process of viral transformation has affected
      dramatically the metabolism of these cells; one possible interpretation is that
      the viral transformed cells lost the ability to perform oxidative
      phosphorylation. We believe that this is a metabolic event which could be
      exploited by magnetic resonance imaging.

PMID- 8472020
TI  - Use of sugars and hair for ESR emergency dosimetry.
AB  - ESR spectrometry of sugars and biological samples is being evaluated for
      emergency personnel dosimetry. Sugars are near tissue-equivalent, universally
      available in pure form and produce a simple, reproducible, low background signal.
      Of the sugars tested, sucrose and dextrose are the most sensitive and the ESR
      signals are proportional to X- or gamma-ray doses over the range of 0.5-10 Gy.
      There is little dependence on radiation energy or dose-rate, and the ESR signals
      remain stable for long periods post-irradiation. Human hair samples show
      considerable variability and signal complexity creating difficulties in dose
      assessment.

PMID- 8472021
TI  - Synthesis and in vivo distribution in the rat of several fluorine-18 labeled 5
      hydroxy-2-aminotetralin derivatives.
AB  - A method is described for the rapid production and purification of new potential
      dopamine agonists. Via thermal heating (refluxing in an oil bath) and microwave
      exposure 2-[N-n-3-fluoropropyl-N-(4-methylphenyl)ethylamino]-5-hydroxyte tralin
      (12), 2-[N-n-3-fluoropropyl-N-(4-fluorophenyl)ethylamino]-5-hydroxyte tralin
      (13), and their isotopic fluorine-18 derivatives were synthesized, respectively.
      The fluorine-18 label was introduced via N-fluoroalkylation with no-carrier-added
      (n.c.a.) 18FCH2CH2CH2I. In 115 min, radiochemical yields of 11% (corrected for
      decay) were achieved for both compounds. The specific activity ranged from 15-75
      GBq/mumol. After i.v. injection in rats, the fluorine-18 labeled compounds were
      evaluated for their in vivo binding to the D2-receptors. The radioactivity levels
      in the striatum, nucleus accumbens and tuberculum olfactorius were not
      significantly higher than in the cerebellum and frontal cortex at 15, 30 and 60
      min after administration of the tetralin derivatives. Dopamine depletion with
      reserpine did not affect the uptake in the dopamine D2-receptor rich area.
      Remarkable high uptakes were found in the adrenal for both compounds.

PMID- 8472022
TI  - Exposure-to-absorbed-dose conversion for human adult cortical bone.
AB  - The conversion of measured exposure to absorbed dose at a point in bone, under
      conditions of electron equilibrium, involves a factor (the f-factor) which is
      proportional to the ratio of the spectrum-averaged photon energy-absorption
      coefficient for bone to that for air. This paper gives mass energy-absorption
      coefficients and f-factors for three compositions of human adult compact or
      cortical bone recommended in publications by the ICRU and the ICRP, for photon
      energies from 1 keV to 1.5 MeV. Spectrum-averaged f-factors for a number of
      calibration x-ray beams ranging from 10 to 250 kVp have been calculated and
      compared to corresponding results obtained with the use of an equivalent photon
      energy derived from the measured thickness of the half-value layer. At low photon
      energies (approximately less than 200 keV), the new f-factor results reflect: (a)
      the rather large differences due to the differing calcium contents among the
      recommended compositions for bone: and (b) the generally poor predictions
      obtained when replacing a broad energy spectrum by an equivalent photon energy.

PMID- 8472023
TI  - Effective atomic number studies in different biological samples for partial and
      total photon interactions in the energy region 10(-3) to 10(5) MeV.
AB  - Effective atomic numbers (Zeff) of 7 different biological samples containing
      several elements were computed for total and partial cross sections using
      theoretical data over a wide range of energy region from 10(-3) to 10(5) MeV. It
      has been found that Zeff changes with change in composition of the material and
      change in energy. The significant changes in Zeff of different biological samples
      are due to domination of different interaction processes in different energy
      regions as number of elements present is quite large in some biological samples
      (e.g. cell, bone, muscle).

PMID- 8472024
TI  - Differentiation of elemental composition of normal and malignant breast tissue by
      instrumental neutron activation analysis.
AB  - Multi-elemental quantitative analyses of 15 paired samples of normal and
      malignant human breast tissue by instrumental neutron activation analysis are
      reported. The elements, Al, Br, Ca, Cl, Co, Cs, Fe, K, Na, Rb, Zn were detected.
      Significantly elevated concentration levels were found for Al, Br, Ca, Cl, Cs, K,
      Na, Zn in malignant compared to normal tissue. Although the role of elemental
      composition in breast cancer is unclear, this finding may be of importance as
      another parameter for differentiating normal from malignant tissue.

PMID- 8472025
TI  - Synthesis of 6-[18F] and 4-[18F]fluoro-L-m-tyrosines via regioselective
      radiofluorodestannylation.
AB  - The regioselective radiofluorodestannylation of 6-trimethylstannyl-L-m-tyrosine
      derivative 6 with [18F]F2 and [18F]acetyl hypofluorite afforded, after acid
      hydrolysis, 6-[18F]fluoro-L-m-tyrosine (8a) in radiochemical yields of 23 and
      17%, respectively. Similarly, 4-[18F]fluoro-L-m-tyrosine (13a) was synthesized in
      11% radiochemical yield from the corresponding 4-trimethylstannyl-L-m-tyrosine
      derivative 11 using [18F]F2. The structural analyses of precursors (6,11),
      intermediates, and the final products (after 18F decay), were carried out by 1H,
      13C, 19F, 119Sn-NMR and high resolution mass spectroscopy.

PMID- 8472026
TI  - Production of no-carrier-added 199Au for gold cluster-labelled antibodies.
AB  - The production of no-carrier-added (NCA) 199Au by neutron activation of 198Pt was
      developed and the radiochemical separation of 199Au from Pt targets was
      investigated. Three different procedures, based on anion exchange in mixed
      solvent media, solvent extraction and extraction chromatography, are reported.
      The extraction chromatography method was superior in terms of yield (> 95%), Pt
      separation factor (< or = 10(-5)), and separation time (approximately 1 hr). This
      scheme has been used to successfully process large amounts (> 30 GBq) of 199Au,
      with an average specific activity of 7.59 GBq/micrograms (205 mCi/micrograms).

PMID- 8472027
TI  - No-carrier-added synthesis of meta-[131I]iodobenzylguanidine.
AB  - No-carrier-added meta-[131I]iodobenzylguanidine ([131I]MIBG) was prepared
      starting with two different metallated precursors. Attempted preparation of 3
      (tri-n-butylstannyl)benzylguanidine was not successful. An alternate two-step
      strategy using 3-(tri-n-butylstannyl)benzylamine could be used to prepare radio
      iodinated [131I]MIBG in an overall radiochemical yield of 30-33%. Synthesis of
      [131I]MIBG via the radioiododesilylation of 3-trimethylsilylbenzylguanidine was
      also investigated. Yields were dependent on temperature, precursor concentration,
      solvent and nature of the oxidant. Radiochemical yields of 90% were obtained in 5
      min at room temperature using either N-chlorosuccinimide or hydrogen peroxide in
      trifluoroacetic acid as oxidants. The percentage of specific binding in vitro of
      no-carrier-added MIBG to SK-N-SH neuroblastoma cells remained constant over a 2
      log activity range, while the binding of MIBG prepared by isotopic exchange
      dropped by a factor of seven. In normal mice, heart and adrenal uptake of no
      carrier-added [131I]MIBG was found to be higher than that of [131I]MIBG prepared
      by isotopic exchange.

PMID- 8472028
TI  - [15O]H2O, [15O]O2 and [15O]CO gas production, monitoring and quality control
      system.
AB  - The 15O gas production system selects the gas production mode, monitors gas
      delivery conditions and performs quality control needed during the production and
      delivery of continuous flow radioactive gas for equilibrium and bolus PET
      studies. Target gas switches choose the appropriate valve positioning for
      [15O]H2O, [15O]O2 or [15O]CO production while flow rate, pressure and
      radioactivity are constantly monitored. The system also includes an IBM PC
      interfaced gas chromatograph which provides chemical and radiochemical quality
      control by on-line, real time, gas sampling of the delivery line.

PMID- 8472029
TI  - Synthesis of [11C]tetrabenazine, a vesicular monoamine uptake inhibitor, for PET
      imaging studies.
AB  - Tetrabenazine (TBZ), a high affinity and specific inhibitor of the vesicular
      monoamine transporter, has been labeled with carbon-11 as a potential probe for
      in vivo positron emission tomographic imaging of monoaminergic neuronal losses in
      neurodegenerative diseases. [11C]TBZ was synthesized by O-[11C]methylation of the
      9-O-desmethylTBZ using [11C]methyl iodide in the presence of tetrabutylammonium
      hydroxide. The radiochemical yields were 35-55% (decay corrected) and the
      synthesis time 32-37 min from EOB. [11C]TBZ was obtained with specific activities
      of 2000-2500 Ci/mmol (EOS) and radiochemical and chemical purities were > 95%.
      [11C]Tetrabenazine is a promising new radioligand for the in vivo study of
      monoaminergic neurons using PET.

PMID- 8472030
TI  - Rapid radiochemical and chemical quality control of [11C]putrescine.
AB  - A short (4.6 x 50 mm) cation exchange column was used in conjunction with
      conductivity and radioactivity detectors to determine the radiochemical purity (>
      99%) and specific radioactivity (0.5-1.0 Ci/mu mol) of [1-11C]putrescine prepared
      via Michael addition of [11C]cyanide to acrylonitrile. The absence of
      acrylonitrile, a rodent carcinogen, from the final preparation was verified at
      the 50 ng level capillary vapor-phase chromatography (VPC) using a nitrogen
      phosphorus detector. Routine VPC analysis using a Poropak Q column and flame
      ionization detection showed that preparations contained no more than 1 microgram
      of acrylonitrile.

PMID- 8472031
TI  - Spatial dose-rate distribution for an 194Ir point source in water.
AB  - The spatial dose-rate distribution arising from a unit activity point source of
      194Ir embedded in an infinite water medium has been calculated. These results may
      prove to be both useful and timely; 194Ir is a beta-particle-emitting
      radionuclide that is a suitable candidate for radioimmunotherapy, and a means for
      producing it fairly easily has recently been made available. Calculation of the
      beta-ray dose-rate distribution is based on a new set of monoenergetic electron
      dose point kernels which are results from an improved Monte Carlo (ETRAN)
      calculation. The spatial dose-rate distribution for 32P was also calculated and
      compared with results from the EGS4-PRESTA and ACCEPT Monte Carlo codes. The
      ETRAN-based distribution agrees with that from EGS4-PRESTA to within 2% out to
      3.6 mm from the source, a distance over which 90% of the source energy is
      deposited. The ETRAN-based distribution also agrees well with that from ACCEPT
      between 0.6 and 4 mm from the source; at distances < 0.6 mm, values from ACCEPT
      are about 6% larger than ones calculated here.

PMID- 8472032
TI  - Urgent issues in public health.

PMID- 8472033
TI  - Urology at Kings County Hospital, Brooklyn. A 25 year experience, 1958-1983.

PMID- 8472034
TI  - Overview of sclerostomy.

PMID- 8472035
TI  - Surgical management of carcinoma of the esophagus.

PMID- 8472036
TI  - Advances in functional restoration.

PMID- 8472037
TI  - Benzene, artificial leather and aplastic anemia: Newark, 1916-1928.

PMID- 8472038
TI  - On entering medicine.

PMID- 8472039
TI  - Patterns of alcohol use and abuse among aging Civil War veterans, 1865-1920.
AB  - Given the extent of alcoholism among elderly people, it is remarkable how little
      is known about the biomedical and social dimensions of alcohol use and abuse in
      late life. In the absence of compelling longitudinal data drawn from contemporary
      sources, a historical perspective may help to illuminate the incidence and
      consequences of alcohol abuse among the elderly. Based on a study of 370 case
      histories drawn from the National Military Home in Dayton, Ohio, which around the
      turn of the century was the nation's largest old-age home, it appears that
      alcohol's social ramifications were more important than its pathological or
      physiological manifestations in late 19th-century America. Drinking habits among
      aging Civil War veterans varied considerably: moderate consumption was
      acceptable; too much of a good thing caused problems.

PMID- 8472040
TI  - Family-centered perinatal education.
AB  - Family-centered perinatal education is a health education service focused on the
      family unit during the childbirth period and is supportive to all family members
      as the family moves from one stage of development to the next. It is distinct
      from traditional childbirth education and family-centered maternity care by being
      a single educational intervention that addresses the needs of the entire family
      during the prenatal and postpartum periods. The advantages of family-centered
      perinatal education are discussed from the consumer's and educator's
      perspectives. Such education emphasizes extending social support into the
      postpartum period as a buffer against the effects of stress on new parents.
      Teaching and learning occur in a more timely manner. Family members learn what is
      most needed when it is most needed and avoid the feeling of being "cut loose"
      from the health care system right after the birth. Family-centered perinatal
      education is likely to become an increasingly popular consumer option as
      hospitals compete to provide the best obstetric/neonatal care.

PMID- 8472041
TI  - Childbirth education classes in homeless shelters.
AB  - Childbirth education can have an enormous positive effect on the maternal health
      and birth experience of women in shelters. The childbirth educator can empower
      economically disadvantaged pregnant women to take personal responsibility for
      their childbirth outcome. The characteristics of women in shelters pose unique
      challenges to childbirth educators. Transient populations, different stages of
      pregnancy, substance abuse, nutrition deficiencies, and difficulties with the
      skills required for being a good parent present unusual problems and rewarding
      educational opportunities. With understanding, sensitivity, and commitment, the
      childbirth educator can prepare women in shelters to participate more actively in
      a healthy and informed birth experience.

PMID- 8472042
TI  - Prenatal education in the work place.
AB  - Advances in neonatal care have improved survival rates among premature and low
      birth-weight (LBW) infants, but highly technical care for these infants costs
      more than $2 billion a year in the United States. The incidence of premature and
      LBW infants can be reduced by prenatal education programs that focus on
      nutrition, obtaining prenatal care, avoiding dangerous substances, and
      recognizing preterm labor. In an effort to contain health care costs, many
      companies self-insure employee health benefits and offer health promotion
      programs designed to improve life style behaviors. This article examines
      providing a prenatal education program in the work place as a way of reducing the
      incidence and costs of prematurity and low birth weight.

PMID- 8472043
TI  - Sibling preparation classes.
AB  - A review of the recent literature substantiates that sibling preparation classes
      help to ease the transition into being a sibling. Studies have shown that as a
      result of this preparation, children who become siblings exhibit fewer anxieties,
      are better able to express their feelings, and the mother feels better able to
      cope with the older child when the infant arrives. This article presents a
      detailed description of one hospital-based sibling preparation class: the setup,
      arrival of the families, tour of the maternity floor, snack and video
      presentation, and the separation into a children's class with specific objectives
      and a parents' class with objectives are presented. A description of other models
      of sibling preparation classes is included.

PMID- 8472044
TI  - Perinatal education for women with physical disabilities.
AB  - Pregnant women with disabilities have many of the same concerns as able-bodied
      pregnant women. However, pregnant women with disabilities have special perinatal
      education needs. Information on the problems encountered and approaches that can
      be used is presented based on current research and interviews with 36
      childbearing women with disabilities.

PMID- 8472045
TI  - Perinatal education for parents of high-risk infants.
AB  - This article presents research-based information about the teaching needs of
      parents of low-birth-weight, preterm infants. An overview is presented regarding
      who needs to be taught, at what times, and in what manner. The type of
      information that parents have stated they found important is reviewed, as are
      general categories of information that health care providers feel are important
      for families to know. Family teaching is a critical component of the care nurses
      give because it helps to ensure that families are able to care for their infants
      at home.

PMID- 8472046
TI  - Critical dimensions in perinatal education.
AB  - A commitment to family-centered care demands that perinatal education include the
      following critical dimensions: presenting information, enhancing coping
      strategies, fostering support systems, promoting informed decision making, and
      integrating consumer advocacy. Families must have accurate, current information
      about pregnancy, birth, infants, early parenting, and the health care system in
      which these vents occur. This information is the foundation, not the final
      product, of perinatal education. Families need appropriate and effective coping
      skills and a strong support network as they move through this stage of the life
      cycle. The ultimate goal, and perhaps the most critical dimension of perinatal
      education, is to promote informed decision making. Families need options and the
      opportunity to understand the implications and feasibility of alternative
      decisions in their lives. The perinatal educator acts as an advocate by providing
      information and support for the client, and in advocating for the client in the
      health care system.

PMID- 8472047
TI  - Strengthening family systems.
AB  - The childbearing year is a psychosocial transition that involves changes in roles
      and status for each member of the family. This change is perhaps most significant
      in the transition that occurs with the birth of the first child. Thus, childbirth
      education can be looked upon as an opportunity to strengthen family systems
      through anticipatory guidance and skill building that family members may use
      throughout the life cycle.

PMID- 8472048
TI  - Developing a perinatal education program.
AB  - The process of assessing learning needs and designing and implementing
      educational offerings for perinatal families is discussed. Common areas of
      evaluation are examined, and sample questions are presented. Through careful
      application of teaching principles in conjunction with the nursing process,
      nurses can effectively develop comprehensive perinatal education programs.

PMID- 8472049
TI  - A comprehensive perinatal education program.
AB  - Perinatal education has become a common standard of preparation for expectant
      families anticipating childbirth and support for new families during the
      transition into parenthood. Twenty-two series and classes are defined and a
      topical outline is provided for a specific audience of clients, including
      infants, preschoolers, expectant parents, new parents, and grandparents.

PMID- 8472050
TI  - Issues in perinatal education.
AB  - There are three critical issues in perinatal education today: changing clients,
      changing perinatal educators, and the changing obstetrical climate. Each of these
      issues is discussed, and difficult philosophical questions that require answers
      are identified. The answers will require serious deliberation, hard thought,
      values clarification, collective wisdom, and an element of risk taking by
      perinatal educators.

PMID- 8472051
TI  - Preconceptional education.
AB  - Recently, attention has been given to the area of preconceptional health
      education and promotion of improved pregnancy outcomes through risk assessment
      and planning. This article identifies successful teaching strategies for
      preconceptional health education by health care providers and identifies class
      content and methods for preconceptional health education, with an emphasis on the
      interdisciplinary team approach.

PMID- 8472052
TI  - The psychoeducational model of prepared childbirth education.
AB  - Prepared, childbirth education classes are designed to teach the expectant mother
      how to effectively cope with the childbirth experience through active
      participation, informed decision making, and noninvasive pain management skills.
      As knowledge and technology increase, it often becomes difficult for the
      childbirth educator to complete the important task of determining the essential
      content for each class. The childbirth educator can follow established guidelines
      for class content with a review the literature or structure the class to meet the
      needs of the participants. An approach used less often, but a powerful and
      effective one, is using a conceptual model as a framework for selecting the
      essential content for classes.

PMID- 8472053
TI  - School-based adolescent pregnancy classes.
AB  - School-based adolescent pregnancy classes provide the childbirth educator with a
      unique opportunity to be visible to students. Attitudes about sexuality and
      pregnancy can be changed within the mainstream population by the presence of
      prepared childbirth classes at schools. The problems of absenteeism and denial of
      pregnancy that result in late reporting to health care providers can be
      minimized. The expectant teen-ager can be encouraged to attend school and given
      self-confidence in assuming the role of a parent after birth. Support can be
      engendered from faculty, students, and the teen-ager's support person.

PMID- 8472054
TI  - Outreach childbirth education classes for low-income families: a strategy for
      program development.
AB  - Childbirth and parenting education programs are coming to the forefront of public
      health initiatives aimed at the reduction of infant mortality and low birth
      weight in high-risk groups in the United States. Childbirth education programs
      have proven effective in helping parents make positive life style changes and can
      play an important role in the reduction of risks associated with poor pregnancy
      outcomes. Childbirth education gives parents the knowledge, desire, and
      confidence they need to change their health behaviors. The Florida Outreach
      Childbirth Education Project offers an example of a statewide program designed to
      serve a high risk population: low-income, low-literacy families.

PMID- 8472055
TI  - Our new journal. Why?

PMID- 8472056
TI  - Effects of aerosolized pentamidine in AIDS patients.

PMID- 8472057
TI  - Effect of long-term therapy with oral steroids on respiratory muscle function and
      ventilatory drive.
AB  - It has been shown that chronic oral steroid therapy (ST) does not induce
      respiratory muscle dysfunction in normal and asthmatic subjects. As
      corticosteroids are sometimes chronically used in the treatment of the patients
      with chronic obstructive pulmonary disease (COPD), the aim of our study was to
      verify whether ST could cause respiratory muscle impairment and, since ST also
      affects the central nervous system, whether ST could influence the ventilatory
      pattern. We retrospectively studied 12 COPD patients (group A), on long-term
      therapy (for at least 4 consecutive months, range 4-18 months) with an oral
      steroid, deflazacort, 15 mg.d-1. The subjects were strictly matched, with regard
      to age, sex, height, weight, forced expiratory volume in one second (FEV1),
      residual volume (RV), arterial oxygen tension (PaCO2), arterial carbon dioxide
      tension (PaCO2) and pH, with 12 COPD patients (Group B) who had never taken oral
      steroids. To assess respiratory muscle strength, we measured maximal inspiratory
      (MIP) and expiratory (MEP) pressures, while mouth occlusion pressure (P0.1) was
      employed to assess neuromuscular drive; ventilatory pattern and airway impedence
      were also evaluated. Effectiveness of ST was confirmed by the plasmatic levels of
      endogenous cortisol. No significant differences were observed between the two
      groups with regard to MIP (A 72.2 +/- 9.7 vs B: 70 +/- 7.2 cmH2O) and MEP (A 91.6
      +/- 10.5 vs B 94.4 +/- 7.6 cmH2O) whilst P0.1 was significantly higher in group A
      (2.6 +/- 0.3 cmH2O) than in group B (1.8 +/- 0.1 cmH2O). No significant
      differences were found among all the ventilatory parameters, but the impedence
      was significantly higher in group A.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472058
TI  - Peak expiratory flow monitoring and airway response to specific bronchial
      provocation tests in asthmatics.
AB  - To assess the validity of peak expiratory flow (PEF), measured by means of a peak
      flow meter, in comparison to forced expiratory volume in one second (FEV1) for
      measuring the airway response during specific bronchial challenges, we registered
      PEF and FEV1 in a random sequence during 75 positive (decrease in FEV1 of > or =
      15% from baseline) and 75 negative (decrease in FEV1 < 15% from baseline)
      challenges with chemicals or allergens. The correlation between PEF and FEV1 in
      terms of absolute values and of percentage of change from baseline was
      statistically highly significant (p < 0.001) in all challenges and in the
      different pattern of response, immediate, dual and late. Relative operating
      characteristic analysis showed that an absolute decrease in PEF of > or = 70
      l.min-1 in the immediate and of > or = 80 l.min-1 in the late phase of the
      response (cut-off points) gave optimal discrimination between challenges with a
      bronchoconstrictive response (defined as a FEV1 decrease > or = 15% from
      baseline), and challenges without. These cut-off points, however, were highly
      specific (92 and 93.3%, respectively), but not as sensitive (70.6 and 61.1%,
      respectively), and smaller absolute changes in PEF from baseline do not exclude a
      bronchoconstrictive response. Our data suggest that PEF readings are a useful
      diagnostic tool in assessing the airway response during a specific bronchial
      challenge in asthmatics, although with some limitations. PEF readings can be used
      to monitor the late response to a challenge during the evening and the night if
      PEF readings are carefully considered in relation to clinical symptoms.

PMID- 8472059
TI  - Thymomodulin enhances phagocytic and intracellular killing activities of
      polymorphonuclear leucocytes without increasing release of chemotactic factors.
AB  - Thymomodulin, a calf thymus derivative, is able to stimulate T-lymphocytes and
      monocytes, and to activate phagocytes and their precursors. However, it is not
      fully understood whether the effect of thymomodulin on phagocytic cells is a
      direct stimulation, or a phenomenon mediated by cytokines released by mononuclear
      cells. To answer this question, we first evaluated the effects of thymomodulin on
      the phagocytosis and intracellular killing of Staphylococcus aureus by blood
      polymorphonuclear cells (PMNs), cultured with or without autologous mononuclear
      cells. Secondly, during the processes of phagocytosis and intracellular killing,
      we evaluated the release by PMNs of chemotactic factors for PMNs, lymphocytes and
      monocytes. No difference was found in the phagocytosis and killing processes when
      PMNs were incubated alone or with autologous mononuclear cells (p > 0.05, each
      comparison). Thymomodulin was able to increase the phagocytosis process when PMNs
      were incubated with lymphocytes and monocytes (p = 0.05), and to enhance the
      killing by PMNs cultured alone (p = 0.05), or cultured with autologous
      mononuclear cells (p < 0.05). The release of chemotactic factors for PMNs,
      lymphocytes and monocytes in the supernatants of the phagocytosis experiments,
      was higher when PMNs were incubated with mononuclear cells, compared to cultures
      of PMNs alone (p < 0.05, each comparison); and thymomodulin did not increase
      their release without the presence of autologous mononuclear cells in the
      cultures (p > 0.05 each comparison). These data suggest that thymomodulin acts
      upon PMNs, inducing mononuclear cells to release factors able to stimulate the
      phagocytosis and the intracellular killing of exogenous organisms, but does not
      amplify the immune reaction enhancing further leucocytes recruitment.

PMID- 8472060
TI  - A case of Churg-Strauss syndrome.

PMID- 8472062
TI  - Home ventilation.

PMID- 8472061
TI  - Central alveolar hypoventilation in a seven year old boy. Long-term treatment by
      nasal mask ventilation.

PMID- 8472063
TI  - Patient selection and techniques for home mechanical ventilation. European
      Respiratory Society Rehabilitation and Chronic Care Scientific Group.

PMID- 8472064
TI  - The carotid body: a review of its anatomy, physiology and clinical importance.
AB  - The carotid body is a peripheral chemoreceptor that monitors arterial blood gas
      tensions and pH. Its main function is to contribute to the regulation of
      breathing although there is evidence for a reflex influence on the pulmonary
      circulation and the kidney. The carotid body's acute response to hypoxia is a
      rapid increase in breathing. The chronic response to hypoxia such as would occur
      at high altitude or as a consequence of COPD, includes growth of the organ, both
      hyperplasia and hypertrophy, modification of amine content and an attenuation of
      its hypoxic sensitivity. It is the latter aspect that may cause severe problems
      of management of COPD for the clinician. It is postulated that the attenuated
      hypoxic sensitivity may play a role in the deterioration of the COPD patient.

PMID- 8472065
TI  - Role of bronchial and bronchoalveolar lavage in chronic obstructive lung disease.
AB  - The authors review the role of bronchoalveolar and bronchial lavage in chronic
      obstructive lung disease patients. Only a few papers were published in the last
      ten years on this matter. In addition, data are incomplete and often conflicting,
      mainly because of the limited number of patients sampled and of non-standardized
      techniques of analysis. However, both bronchoalveolar and bronchial lavage are
      likely to be useful research tools to understand the pathophysiologic mechanisms
      underlying chronic obstructive lung disease.

PMID- 8472066
TI  - A section on education: why?

PMID- 8472067
TI  - Respiratory function in neuromuscular and chest wall diseases.

PMID- 8472068
TI  - Classification of chest wall diseases.
AB  - Several disorders of the thoracic cage are known to cause respiratory failure, by
      means of relatively simple mechanisms, such as the increased work of breathing,
      which results in alveolar hypoventilation. A variety of pathogenic mechanisms may
      be considered, as functions of the types of thoracic disorders present. As causes
      of these additional potential mechanisms, we considered the following: 1)
      ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation
      or acquired defect of the respiratory centres; and 4) excess blood volume and
      fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of
      these disorders can be grouped into two major categories (which nevertheless have
      some of the pathophysiology in common): the mechanical syndrome and the
      neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases
      falling into the first category; namely, kyphoscoliosis, fibrothorax,
      thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital
      deformities of the thoracic cage, which do not have important effects on
      ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also
      considered.

PMID- 8472069
TI  - Respiratory mechanics in kyphoscoliosis.
AB  - Kyphoscoliosis is a restrictive respiratory disorder in which total respiratory
      and lung elastances and lung resistance are increased. Specific airway
      conductance is increased because of greater lung elastic recoil. Corrective
      surgical procedures usually result in further immediate increases beyond that
      related to anaesthesia alone. Despite thoracic deformities, kyphoscoliotics
      maintain near-normal ventilation through increased central drive, and
      compensatory mechanisms including force-length and force-velocity properties of
      contracting inspiratory muscles, the Hering-Breuer reflex, inspiratory duration
      and airflow. The magnitude of compensation to loading in kyphoscoliotics is
      proportionately the same as in normal subjects. A recent study has shown that
      post-inspiratory muscle activity in anaesthetized kyphoscoliotics is
      proportionate to the magnitude of elastic recoil and intrinsic flow resistance.
      Expiratory decay may also be influenced by viscoelastic behaviour of thoracic
      tissues and the transition between their passive and active state.

PMID- 8472070
TI  - Respiratory mechanics in chest wall disease: implications for expiratory flow
      limitation during resting breathing.
AB  - Expiratory flow limitation during tidal breathing in patients with severe
      obstructive pulmonary disease is a well recognized phenomenon. It may be present,
      however, also in patients with severe chest wall disease due to the fact that
      breathing takes place at reduced lung volume.

PMID- 8472071
TI  - Control of breathing in chest wall diseases.
AB  - Chest wall diseases are characterized by an increased stiffness of the chest
      wall, and require more respiratory work to be done to ventilate the lungs
      adequately. We have reviewed the responses of the respiratory system for
      compensate for these mechanical loads: intrinsic (muscular) adaptation and
      central drive (extrinsic) adaptation. In ankylosing spondylitis, there is an
      efficient intrinsic adaptation, mostly by the diaphragm, with good respiratory
      prognosis. It is likely that eucapnic obese patients have a normal adaptation of
      respiratory drive, whereas the failure of the control of breathing may lead to
      obesity hypoventilation syndrome. In kyphoscoliosis, normal gas exchange is
      assumed by an increased muscular contribution, and so depends on an increased
      neural drive. However in major chest distortion, a failure of this neuromuscular
      compensation may occur and be responsible for life threatening episodes.

PMID- 8472072
TI  - Control of breathing in patients with neuromuscular diseases.
AB  - We reviewed the studies devoted to investigate the control of breathing in
      patients with neuromuscular diseases. Neural respiratory drive has been assessed
      in terms of minute ventilation and mouth occlusion pressure (P0.1) in patients
      with several types of neuromuscular affections (amyotrophic lateral sclerosis,
      poliomyelitis and post-polio syndrome, Guillain Barre syndrome, muscular
      dystrophies, inflammatory muscle diseases). More recently we have used
      electromyographic activity of diaphragm to evaluate neural drive in patients with
      myasthenia gravis and muscular dystrophies. The results of these studies seem to
      indicate that patients with myasthenia gravis are not likely to have a decreased
      respiratory drive, the disorder in neuromuscular transmission being probably the
      reason for the apparent decrease in diaphragmatic neural activation during
      hypercapnic stimulation. Increase in neural afferent information from lung and/or
      rib cage might explain both the increased neural respiratory drive and the faster
      breathing observed in patients with neuromuscular disease.

PMID- 8472073
TI  - Evaluation of human diaphragm function.
AB  - When single supramaximal shocks are delivered during relaxation to both phrenic
      nerves simultaneously, the resulting transdiaphragmatic pressure twitch (PdiT) or
      mouth pressure twitch (PmT) are found to decrease linearly with increasing lung
      volume thereby reflecting changes in diaphragm contractility. Whereas fatigue
      decreases PdiT at any given lung volume, chronic lung hyperinflation tends to
      increase PdiT at any given lung volume. When the phrenic nerve shocks are
      delivered during ongoing voluntary contractions, PdiT decreases with increasing
      level of diaphragm activation. Its amplitude thus detects the reverse left for
      full activation of the diaphragm by the voluntary motor drive. The ability to
      maximally activate the diaphragm decreases with fatigue but is retained in
      patients with chronic lung hyperinflation.

PMID- 8472074
TI  - Mechanisms of muscle fatigue.
AB  - The concept of muscle fatigue as a factor limiting muscle performance has evolved
      into one in which fatigue is avoided in order to protect the muscle from injury
      induced by over stimulation. No one mechanism accounts for all the changes in
      muscle performance occurring during fatigue. Research on pathophysiological
      factors limiting force production or shortening capacity during the fatigue
      process has widened to detailed electrophysiologic, metabolic and molecular
      aspects. All are extensively reviewed in the present paper. The known mechanisms
      are likely to be interdependent, synergistic, and integrated. A careful
      interpretation of individual research is implied, particularly when data from
      experimental animal models are translated to human beings.

PMID- 8472075
TI  - Exercise-induced asthma.

PMID- 8472076
TI  - Physical therapy management of patients undergoing limb lengthening by
      distraction osteogenesis.
AB  - Limb lengthening by distraction osteogenesis and external fixation is used
      increasingly in the United States for a variety of orthopaedic conditions.
      Maintenance of joint motion, critical for successful outcomes, can be difficult
      to achieve. The rate of growth needed for distraction osteogenesis is faster than
      that of normal growing bone. Histogenesis of soft tissues must also occur to
      maintain the motion in joints above and below the limb being lengthened. Physical
      therapists in patients' home communities need to be knowledgeable about the
      aggressive management needed to prevent the loss of joint motion. This article
      introduces physical therapists to a commonly used external fixator, the procedure
      of distraction osteogenesis, and the role of functional loading. To assist in
      treatment planning, a physical therapy management plan is presented. Two case
      examples illustrate how therapists can assess a patient's status relative to the
      goals in the management plan and determine intervention priorities.

PMID- 8472077
TI  - Effect of knee angle and ligament insufficiency on anterior tibial translation
      during quadriceps muscle contraction: a preliminary report.
AB  - Additional information is needed regarding the effects of exercise protocols on
      the injured or reconstructed anterior cruciate ligament (ACL). The purpose of
      this investigation was to assess the effects of knee flexion angle and ACL
      insufficiency on anterior tibial translation (ATT) and patellar ligament
      insertion angle as subjects performed maximal isometric quadriceps muscle
      contractions. The subjects were two females and two males between the ages of 18
      and 24 who had sustained injuries that resulted in unilateral ACL insufficiency.
      Each subject performed maximum isometric quadriceps muscle contractions with each
      leg on a Cybex II dynamometer at each of three positions: 15, 45, and 75 degrees
      knee flexion. A lateral knee roentgenogram was obtained as each subject
      maintained each isometric muscle contraction. A roentgenogram also was taken as
      subjects rested each knee in each of the three target positions. Anterior tibial
      translation for each isometric muscle contraction was assessed by measuring the
      anterior displacement of the tibial plateau on the isometric resisted
      roentgenogram relative to the resting roentgenogram. Patellar ligament insertion
      angle also was measured for each roentgenogram. Maximum ATT occurred at the 15
      degrees knee flexion target angle for two subjects and at the 45 degrees target
      angle for the other two subjects. Patellar ligament insertion angle decreased as
      knee flexion angle increased. Appreciable stress may be imposed on the ACL as
      patients perform maximum quadriceps muscle contractions in positions of terminal
      knee extension and in midrange positions previously reported as being safe for
      maximal effort quadriceps exercise. Magnitude of stress imposed on the ACL is
      discussed as a function of the length-tension relationship of the quadriceps
      muscle-tendon unit and insertion angle of the patellar ligament. Suggestions are
      made for additional research regarding appropriate muscle strengthening protocols
      for patients who have undergone ACL reconstruction.

PMID- 8472078
TI  - Iliotibial band tightness and medial patellar glide in patients with
      patellofemoral dysfunction.
AB  - This paper investigates the relationship between iliotibial band tightness and
      medial glide of the patella in patients with patellofemoral dysfunction.
      Stretching the iliotibial band has been advocated in the literature to treat
      patellofemoral dysfunction, but there is little written about the mechanism of
      its influence on the patella. Anatomy and biomechanics are reviewed, with
      emphasis on the lateral retinaculum of the knee and the attachment of the
      iliotibial band to the patella. A study is presented in which 17 patients with
      patellofemoral dysfunction were evaluated. All patients presented with lateral
      tracking of the patella on knee flexion and extension. Medial glide of the
      patella was tested manually, and Ober's Test was performed to test flexibility of
      the iliotibial band. Twelve of 17 patients exhibited a tight iliotibial band with
      hypomobility of medial glide of the patella. Three patients demonstrated normal
      patella mobility with a normal result on Ober's Test. Two patients had hypomobile
      patellae with a normal Ober's Test. This study demonstrates a strong relationship
      between iliotibial band tightness and decreased medial glide of the patella.

PMID- 8472079
TI  - Effect of the aircast on unilateral postural control: amplitude and frequency
      variables.
AB  - Little objective data exist regarding the effect of the Aircast Air-Stirrup on
      motor performance. Thus, the effect of the Aircast on the amplitude and frequency
      of postural sway during unilateral stance was evaluated for 15 uninjured male
      subjects. Postural sway during static and dynamic tests was measured using the
      Chattecx Balance System. Use of the Aircast improved unilateral postural control
      as evidenced by decreases in some of the components of postural sway. Previously,
      a link was made between a large amplitude of unilateral sway and a high
      probability of ankle injury (14). Thus, since Aircast use was found to decrease
      the amplitude of unilateral sway, it may also be beneficial in reducing the
      probability of injury. Although the scope of this study did not allow for
      differentiation among the complex systems involved in postural control, the
      possibility of the Aircast enhancing afferent feedback was proposed. The
      restricted inversion-eversion range of motion associated with the Aircast, in
      conjunction with the present observation that unilateral stability was enhanced
      with its use, suggests that the Aircast may provide a valuable prophylactic role
      in helping to reduce the incidence of ankle injuries.

PMID- 8472080
TI  - Reliability of measuring forward head posture in a clinical setting.
AB  - We believe there is a need to identify a practical method for determining
      objective measurement of forward head posture. In our study, we determined the
      within-tester and between-tester reliabilities for clinical measurements of
      static, sitting, forward head posture using the cervical range of motion (CROM)
      instrument. Repeated measurements were made using a standardized protocol on 40
      patients seated in a standardized position. The seven testers had from 1 to 8
      years of clinical experience. All measurements were recorded by the same
      investigator. The intraclass correlation coefficient (ICC[1,1]) was used to
      quantitate within-tester and between-tester reliability. Measurements of forward
      head position performed by the same physical therapist had high reliability (ICC
      = 0.93). Good reliability (ICC = 0.83) was demonstrated when different physical
      therapists measured the forward head posture of the same patient. We concluded
      that measurements of forward head posture made by physical therapists trained in
      the correct use of the CROM instrument are reliable. This reliability is
      important for determining the effectiveness of treatment programs. On the basis
      of our data, the CROM instrument will assist clinicians in the objective
      evaluation and reassessment of the patient population demonstrating forward head
      posture.

PMID- 8472081
TI  - Retaining the health regions--strategic direction or deregulation?

PMID- 8472082
TI  - Minimally invasive surgery in gynaecology--trick or treat?

PMID- 8472083
TI  - Operative laparoscopy.
AB  - The past decade has witnessed a transition from classic surgery to minimally
      invasive surgery through multiple small incisions under endoscopic vision.
      Although these operations present many technical difficulties and often take
      longer, they usually reduce the hospital stay and allow earlier return to full
      activity.

PMID- 8472084
TI  - Vasovagal syncope: classification, investigation and treatment.
AB  - Syncope is a common and often difficult clinical problem. Head-up tilt testing
      has made it possible to confirm the diagnosis of vasovagal syncope in many
      patients with unexplained loss of consciousness. This review outlines its
      presentation and mechanism, the methodology of diagnostic tilt testing and
      current treatments.

PMID- 8472085
TI  - Acoustic schwannoma.
AB  - Acoustic schwannomas are the commonest tumours of the cerebellopontine angle and
      usually present with unilateral deafness. Earlier diagnosis while the tumour is
      small, coupled with surgical treatment by a specialized neuro-otology team, has
      contributed to a significant decrease in the mortality and morbidity due to these
      tumours.

PMID- 8472086
TI  - Guidelines for the management of community-acquired pneumonia in adults admitted
      to hospital. The British Thoracic Society.
AB  - Around 50,000 people in the UK are admitted to hospital with pneumonia, making it
      one of the commonest causes of admission. This article presents guidelines drawn
      up by the British Thoracic Society to improve the care delivered to such patients
      in the UK.

PMID- 8472087
TI  - What should a clinical director do?
AB  - Clinical directors play an important role in developing service strategy and in
      the introduction of systems needed to generate efficiency and improve quality in
      health care delivery in their provider units. This article emphasizes the range
      of abilities needed to succeed as a clinical director.

PMID- 8472088
TI  - Clinical directorates: the new order.
AB  - Doctors now accept that they must play a leading role in the management of
      hospitals. Clinical directorates embrace a range of managerial responsibilities
      on behalf of colleagues and for the benefit of the organization.

PMID- 8472090
TI  - Changes in terminology serve no useful purpose.

PMID- 8472089
TI  - Depressive stupor following amphetamine withdrawal.

PMID- 8472091
TI  - The acontractile bladder and retention in women.

PMID- 8472092
TI  - Time to ensure a better deal for RA patients.

PMID- 8472093
TI  - The trouble with technology.

PMID- 8472094
TI  - Doctors learning about epilepsy.

PMID- 8472095
TI  - Thinking clearly about diseases of the airways.

PMID- 8472096
TI  - Medical training and the EC.

PMID- 8472097
TI  - Atherosclerotic renal artery stenosis.
AB  - Atherosclerotic renal artery stenosis is a relatively common cause of
      hypertension and renal impairment in the elderly. We review its clinical features
      and the investigations and management options available.

PMID- 8472098
TI  - Transmissible spongiform encephalopathies and human neurodegenerative disease.
AB  - There has been a tremendous amount of publicity concerning the transmissible
      spongiform encephalopathies, and this has led to speculation regarding the
      possible risk to humans following the emergence of new forms in cattle and cats.
      We review the data relating to these diseases in the light of new developments,
      particularly in the fields of molecular biology and epidemiology.

PMID- 8472099
TI  - The role of cytokines in normal and pathological bone states.
AB  - Cytokines have been increasingly implicated in the pathogenesis of many of the
      common proliferative and degenerative diseases. This review outlines the rapidly
      expanding field of cytokines and discusses their role in bone metabolism and bone
      and joint diseases.

PMID- 8472100
TI  - Medical photography.
AB  - Medical photography and illustration still provides an essential service for the
      clinician and researcher, despite an ever-increasing remit. This article
      describes the role of the medical illustration department and may help the
      hospital practitioner to use this service to the full.

PMID- 8472101
TI  - Boot-shaped heart.

PMID- 8472102
TI  - Systemic fungal infections in neonates.
AB  - The 50,000 or so known species of fungi are present in a large part of our
      environment and are common in soil, decaying vegetable matter, animals and air.
      Despite this diversity the actual spectrum of fungal infections in man is limited
      and in neonates is limited even further.

PMID- 8472103
TI  - Malassezia furfur infection in a neonate.

PMID- 8472104
TI  - Anticoagulant-related intracranial haemorrhage.

PMID- 8472105
TI  - Application of SWOT analysis.
AB  - SWOT analysis is an effective and simple planning technique which addresses one
      aspect of many strategic planning processes. Given the complex nature of modern
      health care systems, the ability to use this type of technique can enable health
      professionals to participate more fully in the analysis and implementation of
      health care improvement.

PMID- 8472106
TI  - Decision making in surgery: operative management of a strangulated femoral
      hernia.
AB  - A strangulated femoral hernia can present significant problems to the surgeon,
      particularly since time may be at a premium. However, correct decision making can
      result in the safe management of this problem. This article describes the
      critical decisions central to a successful operation.

PMID- 8472107
TI  - Validation of rating scales in psychiatry.
AB  - Statistical analysis of psychiatric research requires the translation of
      qualitative data into quantitative form. This can be achieved using rating
      scales. However, the reliability and the validity, i.e. the validation of these
      scales, presents significant problems; these shall be outlined in this article.

PMID- 8472108
TI  - Morse marred by the gas man.

PMID- 8472109
TI  - Anxiety and endocrine responses to surgery.

PMID- 8472110
TI  - The use of carbon dioxide as an insufflation agent in barium enema--does it have
      a role?
AB  - A double blind prospective study was undertaken to evaluate the benefit of using
      carbon dioxide in double contrast barium enema (DCBE). 142 consecutive patients
      referred for DCBE were randomly allocated to receive either air or carbon dioxide
      (CO2) as the insufflation agent. The use of CO2 reduced the incidence of
      immediate and delayed severe pain from 31% to 12.5% and from 12.9% to 4.2%
      respectively. There was a statistically significant higher incidence of delayed
      severe pain in the younger age group as found in previous studies. Post
      evacuation films showed that there was less residual gas after CO2. The quality
      of the DCBE was unchanged. We urge the more widespread use of CO2 as insufflation
      agent in DCBE.

PMID- 8472111
TI  - Asymptomatic deep venous thrombosis in the calf: accuracy and limitations of
      ultrasonography as a screening test after total knee arthroplasty.
AB  - Patients who have recently undergone total knee arthroplasty are at high risk of
      developing deep venous thrombosis (DVT) in the calf. The clinical diagnosis of
      DVT is difficult in these patients owing to recent operation. A combination of
      compression ultrasonography (US) and colour flow imaging was used as a screening
      method of asymptomatic DVT in 51 patients who had undergone total knee
      replacement surgery. Both limbs were examined by US from the common femoral vein
      to the ankle approximately 7 days after operation and the results were compared
      with bilateral venography. 12 patients (24%) developed infrapopliteal DVT on the
      operated side, in two cases the thrombosis extended to the lower part of
      popliteal vein. One patient had bilateral thrombosis. US showed sensitivity of
      77%, specificity of 96% and overall accuracy of 93%. US seems to be a useful
      screening method for DVT after knee replacement operation.

PMID- 8472112
TI  - Improved assessment of supraclavicular and abdominal metastases in oesophageal
      and gastro-oesophageal junction carcinoma with the combination of ultrasound and
      computed tomography.
AB  - The purpose of the study was to evaluate ultrasound and computed tomography in
      the assessment of distant metastases, supraclavicular and abdominal, in 113
      patients with carcinoma of the oesophagus and gastrooesophageal junction.
      Ultrasound and computed tomographic findings were compared with the cytological
      data in 29 patients and with the surgical data in 84 patients. In assessing
      distant metastases, ultrasound and computed tomography had a sensitivity of 61%
      and 70%, and a specificity of 93% and 85%, respectively (p = 1.0). When
      ultrasound and computed tomography were combined the sensitivity increased to 83%
      and the specificity decreased to 81%. There was no significant difference in the
      assessment of supraclavicular metastases (p = 0.8), coeliac metastases (p = 1.0)
      or liver and other non-lymphatic abdominal metastases (p = 1.0) on ultrasound or
      computed tomography. The results show that both ultrasound and computed
      tomography should be used for assessment of distant metastases and abnormalities
      confirmed by image-guided biopsy.

PMID- 8472113
TI  - Quantitative image analysis of vertebral body architecture--improved diagnosis in
      osteoporosis based on high-resolution computed tomography.
AB  - 71 women, 64 post-menopausal, were examined by single-energy quantitative
      computed tomography (SEQCT) and by high-resolution computed tomography (HRCT)
      scans through the middle of lumbar vertebral bodies. Computer-assisted image
      analysis of the high-resolution images assessed trabecular morphometry of the
      vertebral spongiosa texture. Texture parameters differed in women with and
      without age-reduced bone density, and in the former group also in patients with
      and without vertebral fractures. Discriminating parameters were the total number,
      diameter and variance of trabecular and intertrabecular spaces as well as the
      trabecular surface (p < 0.05)). A texture index based on these statistically
      selected morphometric parameters identified a subgroup of patients suffering from
      fractures due to abnormal spongiosal architecture but with a bone mineral content
      not indicative for increased fracture risk. The combination of osteodensitometric
      and trabecular morphometry improves the diagnosis of osteoporosis and may
      contribute to the prediction of individual fracture risk.

PMID- 8472114
TI  - Rapid dynamic contrast-enhanced magnetic resonance imaging of the liver and
      portal vein.
AB  - The purpose of this study was firstly to show the diagnostic value of a rapid
      acquisition multislice sequence (TurboFLASH) during bolus injection of gadolinium
      DTPA by comparing it with the pulse sequences currently used for abdominal
      studies and secondly to develop improved scanning protocols for the liver.
      Patients were referred for upper abdominal studies including portal vein
      assessment. 40 patients were imaged in the coronal plane using a multislice
      TurboFLASH (TF) sequence (TR = 100; TE = 4) acquired during a breath-hold period
      of 19 s. The short echo time allows up to 11 slices of 5 mm thickness to be
      acquired simultaneously. Images were obtained before, during and after bolus
      administration of Gd-DTPA. The slices from each acquisition were combined using a
      maximum intensity projection algorithm to include all the vessels on a single
      image. Initially each patient was scanned using a conventional axial T2 weighted
      spin-echo sequence (T2W-SE) (TR2000; TE = 45/90) and a coronal T1 weighted spin
      echo sequence (TR450; TE = 15). The clarity of the demonstration of vascular
      anatomy was compared and scored for all sequences by two radiologists. Vessel
      patency, the conspicuity of mass lesions and the spread of tumour to adjacent
      structures were also scored. The anatomy of the main portal vein was
      significantly better shown by coronal TF images after bolus injection than on T2W
      SE images or TF before Gd-DTPA. The right and left portal veins were equally well
      shown by coronal TF with Gd-DTPA and T2W-SE images. There was no significant
      difference between contrast enhanced TF and T2W-SE imaging in visualization of
      the hepatic veins. More lesions were demonstrated by post-contrast TF than by T2W
      SE imaging. Portal venous occlusion was better appreciated by post-contrast TF.
      Our results demonstrate that Gd-DTPA TF imaging improves visualization of the
      main portal vein compared with SE sequences and provides a more accurate
      assessment of vessel patency. The segmental anatomy of the liver is better
      appreciated and the demonstration of focal liver lesions compared with T2W-SE
      images is improved during the non-equilibrium phase of enhancement. TF
      acquisitions before and after Gd-DTPA are obtained in approximately 5 min; thus a
      marked reduction in examination time can be achieved.

PMID- 8472116
TI  - Implementation of a programme for reduction of radiographic doses and results
      achieved through increases in tube potential.
AB  - Experiences in implementation of a programme to reduce doses to patients from
      radiographic examinations are described. A preliminary survey of entrance doses
      for selected examinations, calculated from mean exposure factors, identified
      equipment and examinations requiring attention. Subsequently more detailed
      studies were carried out with thermoluminescent dosimeters (TLDs). Results were
      coordinated with the aid of a database, which was used to monitor the agreement
      between dose calculations and TLD measurements. Surveys highlighted that doses
      from lumbar and thoracic spine examinations were high throughout the region.
      Reductions of 26-36% in entrance dose and 20-25% in effective dose were achieved
      by raising tube potentials for these examinations. This gave a reduction in
      annual collective dose of 4 man-Sv with no cost implication. In some departments
      dose charts were used to support the purchase of new screens. Surveys revealed a
      wide range in other factors such as transmission of X-ray table tops and results
      are being used in planning replacement of equipment.

PMID- 8472115
TI  - CT-dacryocystography for nasolacrimal duct obstruction following paranasal sinus
      surgery.
AB  - Nasolacrimal duct obstruction and consequent epiphora is a complication that may
      develop in some patients following paranasal sinus surgery. We describe the
      technique of CT-dacryocystography which entails contrast injection of the
      lacrimal system and simultaneous computed tomography (CT) scanning of the facial
      structures. This technique provides concurrent information regarding obstruction
      of the nasolacrimal duct and the presence of disease recurrence or persistence in
      the adjacent paranasal sinuses. The role of CT-dacryocystography prior to
      endoscopic dacryocystorhinostomy is discussed briefly.

PMID- 8472117
TI  - The dose-fractionation sensitivity of the kidney; assessment of viable tubule
      cross-sections at 19 months after X irradiation.
AB  - The formation of viable tubule cross-sections was assessed in histological
      sections of murine kidneys at 19 months after fractionated bilateral X-ray doses
      with 12 h intervals between fractions. The data were analysed using the linear
      quadratic model which provides values of alpha and beta characterizing the slope
      of the dose-response curve, and the ratio of alpha and beta indicative of the
      sparing effect of dose fractionation. The tubule data were characterized by alpha
      = 0.057 +/- 0.009 Gy-1, beta = 0.011 +/- 0.001 Gy-2, alpha/beta = 5.0 +/- 0.9 Gy.
      Also, the number of cells (per focus region of the nephron) calculated as being
      capable of producing a viable focus was 2.5 +/- 0.5, which was confirmed using a
      separate two-dose approach (2.1 +/- 0.3). Together with other data, of the order
      of 1000 regenerative cells per nephron (10(4) total cells) can be deduced. The
      values of the fractionation sensitivity parameters are similar to values measured
      previously for cells taken from irradiated kidneys up to a year after irradiation
      and forming colonies in primary culture, and also similar to values assessed
      using various functional measures of kidney injury.

PMID- 8472118
TI  - Sensitivity of human squamous cell carcinoma of the larynx to fractionated
      radiotherapy.
AB  - Data obtained for the response of tumours from two multicentre clinical trials of
      the British Institute of Radiology have been combined and studied. Both trials
      involved patients with laryngopharyngeal carcinoma. There were 734 patients in
      the first trial, recruited between 1965 and 1975, and 611 patients in the second
      trial, recruited between 1975 and 1985. Observed survival and tumour-free rates
      for all patients are calculated. T-class and the nodal status of the patient at
      the start of the treatment were important factors in the determination of both
      observed survival and tumour-free rates. Overall treatment time was an important
      factor in determining the recurrence of tumour. The longer the overall treatment
      time the greater was the chance of tumour recurrence. The linear-quadratic (LQ)
      model was used in the analysis of the tumour recurrence data for a large group of
      patients with laryngeal tumours without nodal involvement. A small alpha/beta
      ratio of 0.94 Gy was obtained for T3 tumours while that of T2 tumours was
      negative, -10.5 Gy. The value for T1 tumours was higher at 23 Gy. However, use of
      the LQ model with a time component increased the alpha/beta ratios to 26.0 +/-
      27.20 Gy, 18.0 +/- 12.33 Gy and 13.38 +/- 5.40 Gy for T1, T2 and T3 tumours,
      respectively. The time component, the gamma/alpha ratios, for these tumours were
      0.15 +/- 0.27 Gy/day, 0.81 +/- 0.18 Gy/day and 0.76 +/- 0.15 Gy/day,
      respectively.

PMID- 8472119
TI  - Technical note: a new afterloading applicator for primary brachytherapy of
      endometrial cancer.

PMID- 8472120
TI  - Case report: allergic aspergillosis of the sphenoid sinus: pitfall on MRI.
AB  - Recent reports indicate that fungal sinusitis is more common than previously
      thought. Four different histological subtypes of Aspergillus sinusitis are now
      recognized. Fulminant Aspergillosis is usually seen in immunosuppressed patients,
      and chronic invasive Aspergillus sinusitis, allergic Aspergillus sinusitis and
      Aspergilloma are seen in the non-immunocompromised individual. We present a case
      of progressive unilateral visual loss in a 30-year-old woman. The unusual
      magnetic resonance findings and the value of computed tomography are discussed.

PMID- 8472121
TI  - Case report: fatal pulmonary Kaposi's sarcoma and Castleman's disease in a renal
      transplant recipient.
AB  - Two unusual complications of immunosuppression, Castleman's disease and Kaposi's
      sarcoma, occurring in a renal transplant recipient, are reported. Kaposi's
      sarcoma is a potentially curable condition in immunosuppressed patients if
      recognized and treated appropriately. In this patient, the pulmonary Kaposi's
      sarcoma was not diagnosed and this lead to the patient's death.

PMID- 8472122
TI  - Case report: multiple myeloma presenting as bilateral orbital masses: CT and MR
      appearances.

PMID- 8472123
TI  - Case report: haemothorax in hereditary multiple exostosis.

PMID- 8472124
TI  - Case report: cyclosporin A-induced neurotoxicity.
AB  - Acute encephalopathy is a recognized toxic effect of Cyclosporin A (CsA) in organ
      transplantation recipients. A 16-year-old girl presented with acute
      encephalopathy 2 weeks after CsA and methylprednisolone medication for idiopathic
      uveitis. Magnetic resonance imaging showed cortical and white matter occipital
      changes, which were not visible 2 months later. With expanding indication for CsA
      use, an increasing number of neurotoxic cases are to be expected.

PMID- 8472125
TI  - Case of the month: an unexpected twist.

PMID- 8472126
TI  - Short communication: spinal bone density measured with a 5 s scan.

PMID- 8472127
TI  - Basal cell carcinomas do metastasize.

PMID- 8472128
TI  - The role of hysterosalpingography in modern gynaecological practice.

PMID- 8472129
TI  - The role of hysterosalpingography in modern gynaecological practice.

PMID- 8472130
TI  - Hepatectomy for liver metastases.

PMID- 8472131
TI  - Perspectives in European surgery.

PMID- 8472132
TI  - Emergency laparoscopic surgery.
AB  - The acute abdomen continues to demand a large proportion of the general surgeon's
      workload. Recent studies have demonstrated that management errors can be
      significantly reduced using selective laparoscopy and this should now become
      routine practice. The continuing advances in laparoscopic surgery that permit
      many emergency procedures to be performed by this route provide increased impetus
      for a combined approach using diagnostic and therapeutic laparoscopy for the
      management of the acute abdomen. Results of current studies must be awaited
      before the exact role of emergency laparoscopic surgery can be defined, but early
      reports suggest several advantages in using laparoscopy to manage conditions such
      as acute appendicitis, perforated peptic ulcer and gynaecological emergencies.

PMID- 8472133
TI  - Elective lymph node dissection in the management of malignant melanoma.
AB  - The surgical management of regional nodes in patients with cancer has been
      controversial for many years. This paper reviews the role of elective lymph node
      dissection in the management of malignant melanoma. The evidence for and against
      elective lymphadenectomy is discussed and a policy of therapeutic, rather than
      elective, lymph node excision recommended.

PMID- 8472134
TI  - Cytokines, sepsis and immunomodulation.
AB  - Tissue injury and infection produce significant alterations in host metabolic and
      immune homeostasis. It is increasingly clear that many of these changes result
      from a complex cascade of mononuclear phagocyte-derived endogenous mediators.
      Among the more important is a group of host proteins called cytokines, which play
      an integral role in mediating the host response to tissue injury and infection.
      Of these proteins, tumour necrosis factor (TNF) and interleukin (IL) types 1 and
      6 have received much attention for their pathophysiological roles in infection
      and trauma. Evidence is reviewed for the involvement of these cytokines in the
      characteristic alterations in the metabolic and immune responses to such injury.
      These endogenous mediators initiate an integrated fuel substrate and hormonal
      adjustment to trauma and sepsis, and help to provide optimal metabolic
      homeostasis for systemic host defences. Widespread tissue injury, especially when
      associated with fulminant sepsis, may, however, precipitate massive release of
      TNF, IL-1 and IL-6, triggering a series of reactions involving multiple organs,
      and culminating in the 'sepsis syndrome'. New therapies designed to downregulate
      this aberrant response, either by neutralizing endotoxin directly or by blocking
      the release or actions of these cytokines, are reviewed. Although these
      treatments hold much promise for the future management of severely traumatized
      and infected patients, careful evaluation of both the benefits and complications
      of therapy is needed before widespread clinical use can be recommended.

PMID- 8472135
TI  - Intra-abdominal photodynamic therapy: from theory to feasibility.
AB  - Photodynamic therapy is a new anticancer technique, directed at the selective
      destruction of neoplastic tissue, which has been used in the treatment of
      superficial or intraluminal lesions. The technique has now reached the stage
      where it can be considered in the peroperative management of gastrointestinal
      tumours, for example in an attempt to eradicate micrometastases in the tissue
      around the primary tumour or in residual lymph nodes after curative resection.
      Many practical problems remain to be solved, such as the pharmacokinetics of
      photosensitizers, the dosimetry of illumination and the sensitivity of intra
      abdominal organs. An experimental and clinical evaluation is in progress to
      assess the feasibility of photodynamic therapy in surgical practice.

PMID- 8472136
TI  - High incidence of arteriovenous fistula after biopsy of kidney allografts.
AB  - Arteriovenous fistula (AVF) is a well known but rarely diagnosed complication of
      percutaneous biopsy of kidney allografts. In the past diagnosis was usually made
      when clinical signs of an AVF occurred but Doppler ultrasonography has now
      enabled non-invasive diagnosis. Doppler examination of kidney allografts was
      performed after 100 biopsies. A total of ten AVFs were diagnosed within 2 weeks
      of biopsy. On repeated examination 2 months later, no additional fistula was
      detected. All fistulas were detected by abnormal colour shading of the artery and
      vein of the fistula caused by high blood velocity. Quantification in the artery
      supplying the fistula showed a higher systolic velocity compared with that in a
      normal artery of comparable size and location in the graft (mean (range) 64 (25
      150) versus 36 (20-65) cm/s, P < 0.05). Diastolic velocity was also higher in the
      artery supplying the fistula than in a normal artery (mean (range) 34 (9-72)
      versus 7 (0-13) cm/s, P < 0.05). In the group with an AVF the proportion with a
      prolonged bleeding time (> 3 min) was higher (80 versus 47 per cent, P < 0.05),
      as was the prevalence of a platelet count < 200 x 10(9)/l (60 versus 22 per cent,
      P < 0.05). After detection of the fistula, four of the grafts were lost because
      of rejection and two patients died from sepsis during antirejection treatment.
      During follow-up of the remaining four AVFs, three disappeared spontaneously and
      one persisted. None of the fistulas has had an impact on renal function requiring
      intervention. In conclusion, AVF is a complication observed frequently after
      kidney allograft biopsy that can be detected and monitored by Doppler
      ultrasonography.

PMID- 8472137
TI  - Autologous predonation, haemodilution and intraoperative blood salvage in
      elective abdominal aortic aneurysm repair.
AB  - The feasibility of predonated autologous blood transfusion and intraoperative
      blood salvage in elective abdominal aortic aneurysm repair was studied. Twenty
      consecutive patients were evaluated, of whom five were excluded according to
      protocol criteria. Patients each donated 1 unit blood 14 and 7 days before
      operation. A third unit was withdrawn in the anaesthetic room and replaced with
      Hartmann's solution, producing a haemodiluted state. Intraoperative losses were
      minimized using the Haemonetics Cell Saver III Plus autotransfusion system.
      Predonated blood from two patients passed its expiry date owing to repeated
      operation postponements, leaving 13 patients for study. The mean(s.d.)
      intraoperative blood loss was 700(300) ml with a mean(s.d.) intraoperative
      salvage of 420(300) ml. Two patients were transfused intraoperative salvage of
      420(300) ml. Two patients were transfused according to clinical need. Thus nine
      patients safely avoided homologous transfusion. With autologous predonation,
      haemodilution and intraoperative blood salvage, elective aortic aneurysm repair
      can be performed safely with minimal need for homologous blood.

PMID- 8472138
TI  - Surgical treatment of reflux stricture of the oesophagus.
AB  - The choice of surgery in patients with reflux-induced oesophageal stricture
      remains controversial. From 1976 to 1990, a total of 65 patients underwent
      fundoplication (36 patients), Collis gastroplasty plus fundoplication (ten),
      total duodenal diversion (four) and oesophageal resection (15). The postoperative
      mortality rate was 5 per cent (three patients): necrosis of the colon transplant
      in two patients and acute pancreatitis in one. The median follow-up was 25 (range
      6-120) months. After conservative surgery, the median number of dilatations per
      patient per year significantly decreased (P < 0.001). Nine patients (25 per cent)
      complained of persistent or recurrent symptoms after standard fundoplication and
      six required reoperation. Clinical results were satisfactory in patients who
      underwent Collis fundoplication, total duodenal diversion and oesophageal
      resection. It is concluded that the causes of failed fundoplication are
      irreversible stricture or persistent gastro-oesophageal reflux; the latter may be
      caused by inefficacy or deterioration of the partial fundoplication wrap. A
      subtle degree of oesophageal shortening is probably underestimated in such
      patients and this may explain the better results obtained with the Collis
      fundoplication. Total duodenal diversion is a good therapeutic option in patients
      who have undergone previous oesophagogastric surgery. Oesophageal resection
      should be reserved for patients with tight strictures unresponsive to dilatation
      or those with scleroderma, multiple previous operations or severe dysplasia in
      Barrett's oesophagus.

PMID- 8472139
TI  - Thoracoscopy in oesophagectomy for oesophageal cancer.

PMID- 8472140
TI  - Monofilament versus multifilament absorbable sutures for abdominal closure.
AB  - This study compares monofilament continuous absorbable sutures with multifilament
      interrupted absorbable sutures for abdominal closure. Before closure of an
      abdominal incision, 988 patients were randomized to receive either a monofilament
      polyglyconate (Maxon) or a multifilament polyglactin 910 (Vicryl) suture. At 1
      year after operation, 684 patients (69 per cent) were examined for the presence
      of incisional hernia, sinus and other wound-healing problems; 179 (18 per cent)
      had died and 125 (13 per cent) did not attend for follow-up. Incisional hernia
      occurred in 8 per cent of patients receiving monofilament continuous sutures
      compared with 6 per cent of those having multifilament interrupted closure (P not
      significant). Wound dehiscence occurred in 1 per cent of both groups. The mean
      time for suturing was 7.1 min for monofilament continuous and 8.7 min for
      multifilament interrupted sutures (P < 0.001). It is concluded that closure of an
      abdominal incision can be effected by a monofilament continuous absorbable suture
      more quickly than by multifilament interrupted absorbable sutures without an
      increased risk of wound dehiscence or incisional hernia.

PMID- 8472141
TI  - Early gastric cancer: follow-up after gastrectomy in 159 patients.
AB  - The postoperative course of 159 patients with early gastric cancer operated on
      between 1974 and 1987 was followed for a median of 7.3 years. The cumulative 10
      year survival rate(s.e.) calculated using follow-up data to the end of 1989 was
      90.6(2.7) per cent excluding operative death and that from causes other than
      gastric cancer, or 86.3(3.0) per cent when operative mortality was included. The
      overall 10-year survival rate(s.e.) was 77.3(3.7) per cent. Univariate analysis
      showed a significant difference in survival rates between cancers confined to the
      mucosa and those with submucosal invasion (P = 0.02), between patients with and
      without lymph node metastases (P = 0.05) and between those < or = 50 and > 50
      years of age (P = 0.02). Using Cox multivariate analysis and a stepwise procedure
      for eight variables (sex, age, depth of invasion, lymph node metastases, presence
      of ulceration, location, histological type, type of surgery), age and
      histological type had the most significant effect on survival. Seven operative
      deaths were recorded. Eleven patients died from recurrent cancer and one is still
      alive with a gastric remnant recurrence. Other causes of death were metachronous
      primary cancer (six patients), cardiovascular disease (two), pneumonia (three),
      sepsis (one) and car accident (one). Although the prognosis of early gastric
      cancer is relatively good in western countries, patients should be carefully
      followed over a long period for late recurrence and for metachronous cancer,
      which has a high incidence.

PMID- 8472142
TI  - Gastrointestinal surgery in the aged.

PMID- 8472143
TI  - Splenectomy in human immunodeficiency virus-related thrombocytopenia.
AB  - To evaluate the efficacy and safety of splenectomy in patients with human
      immunodeficiency virus (HIV)-related thrombocytopenia, 30 HIV-infected patients
      with thrombocytopenia (platelet count < 50 x 10(9)/l) who underwent splenectomy
      were followed prospectively for a mean period of 42 months. There were no
      perioperative deaths and morbidity was minimal. Twenty-one patients had a
      persistent complete response, six had a partial response and were asymptomatic
      after splenectomy, and only three showed no response. Three patients developed
      acquired immune deficiency syndrome during follow-up, an incidence that was no
      different from that expected. Splenectomy is a safe and effective treatment in
      HIV-infected patients with severe symptomatic thrombocytopenic purpura resistant
      to medical therapy.

PMID- 8472144
TI  - Splenectomy for splenomegaly exceeding 1000 grams: analysis of 47 patients.
AB  - Forty-seven patients who underwent splenectomy for splenomegaly > or = 1000 g
      were studied retrospectively. There were 29 men and 18 women of mean age 56
      (range 19-87) years. Haematological malignancy was the most common disorder (42
      patients). The main indications for splenectomy were cytopenia (20 patients),
      diagnosis (14), initial treatment of leukaemia (eight), pain (four) and
      spontaneous rupture (one). Thirteen patients underwent an associated surgical
      procedure. One patient died (mortality rate 2 per cent) and 12 (26 per cent) had
      postoperative complications. The advantages of splenectomy included
      histopathological diagnosis in 13 of 14 patients with splenomegaly of unknown
      origin, effective initial treatment in prolymphocytic and hairy cell leukaemia,
      definitive relief of pain in all affected patients, and long-term improvement of
      cytopenia in most.

PMID- 8472145
TI  - Percutaneous ultrasound-guided drainage of intra-abdominal abscesses.
AB  - A retrospective review of 200 patients with intra-abdominal abscesses treated by
      percutaneous ultrasound-guided drainage is reported. Abscesses were simple in 151
      patients (75.5 per cent) and complex in 49 (24.5 per cent). In 12 patients the
      abscess communicated with the gastrointestinal tract. There were 17 critically
      ill patients for whom percutaneous drainage was the only therapeutic option
      possible. The success rate was 94.7 per cent (143 of 151 patients) for simple
      abscess and 69 per cent (34 of 49) for complex abscess. The overall success rate
      was 88.5 per cent. The mortality rate was 1.3 per cent (two patients) for simple
      and 16 per cent (eight patients) for complex abscess. The overall mortality rate
      was 5.0 per cent. Percutaneous ultrasound-guided drainage should be the initial
      drainage procedure in patients with a simple abdominal abscess. The presence of a
      complex abscess should not prevent an attempt at percutaneous catheter drainage,
      particularly in high-risk patients, although the risk of failure is greater in
      such cases.

PMID- 8472146
TI  - Repeat liver resection for recurrent colorectal metastases.
AB  - Sixteen patients underwent 18 repeat liver resections for recurrence of
      colorectal hepatic metastases that had been previously resected. Only minor liver
      resection had been undertaken at the first operation; three were palliative. The
      second operation was major hepatectomy in ten patients, minor resection in five
      and orthotopic liver transplantation in one. In one patient, lung metastases were
      resected before the second operation. One repeat hepatectomy was palliative.
      After partial liver resection, there were no deaths and complications were
      observed in six of 15 patients. One patient died 2 weeks after liver
      transplantation. After the second resection, 2-, 3- and 5-year survival rates
      were 67, 57 and 30 per cent; the mean survival time was 33 (range 8-93) months.
      Tumour recurrence was observed in 11 of 14 patients 4-32 (mean 13) months after a
      second curative liver resection; two patients received a third curative operation
      for recurrent liver metastases. After the second curative hepatectomy, seven
      patients died from disease after a mean of 36 (range 14-61) months and seven are
      currently alive at a mean of 33 (range 8-93) months. Four of these patients are
      free from disease 26-93 months after resection and three are alive with
      recurrence. Repeat hepatectomy for recurrent colorectal metastases can prolong
      survival in selected patients and has low operative risk.

PMID- 8472147
TI  - Ultrasonography in the diagnosis of gallbladder polyps.

PMID- 8472148
TI  - Impact of laparoscopic cholecystectomy in the UK: a survey of consultants.

PMID- 8472149
TI  - Lipomatous polyposis of the colon.

PMID- 8472150
TI  - Photoplethysmography in the diagnosis of superficial venous valvular
      incompetence.
AB  - Photoplethysmography was compared with clinical investigation combined with
      Doppler ultrasonography in the diagnosis of superficial venous valvular
      incompetence of the lower limb. In 268 consecutive patients, 536 limbs were
      investigated. A total of 22.1 per cent of the photoplethysmographic
      investigations were uninterpretable because they did not allow reliable
      determination of the refilling time. Agreement between clinical investigation
      combined with Doppler ultrasonography and photoplethysmography was found to be
      poor (kappa = 0.30). These results suggest that photoplethysmography is not the
      non-invasive method of choice for routine evaluation of superficial venous
      valvular incompetence of the leg.

PMID- 8472151
TI  - Cardiac risk and peripheral vascular surgery: new approach based on a
      multifactorial risk index.
AB  - An inexpensive approach to stratification of patients admitted for arterial
      surgery into groups of high and low cardiac risk has been prospectively evaluated
      in 235 consecutive patients. The Goldman and Detsky indices, assessed by a nurse
      the day before surgery, both identified patient groups with increased risk of
      lethal or potentially lethal (myocardial infarction, pulmonary oedema) cardiac
      events within 30 days after peripheral vascular surgery. The Goldman index was
      the more sensitive predictor of cardiac death (overall frequency 3.1 per cent)
      while the Detsky index was superior for prediction of non-lethal cardiac events
      (overall frequency 5.9 per cent). The simplest and yet most effective
      stratification into high and low cardiac risk was achieved using a Detsky score
      of 10 as the cut-off. It is concluded that multifactorial risk index-based
      preoperative screening can identify low-risk patients (Detsky score < or = 10),
      who may be accepted for vascular surgery (aortic aneurysm surgery excluded)
      without additional cardiac testing.

PMID- 8472152
TI  - Effect of seeding time and density on endothelial cell attachment to damaged
      vascular surfaces.
AB  - An in vitro model to facilitate the study of endothelial cell seeding of damaged
      vascular surfaces has been developed. This may have applications in the study of
      endothelial seeding of angioplasty and endarterectomy sites. Using this model,
      the optimum endothelial seeding time for attachment to damaged vascular surfaces
      should not exceed 30 min and, to achieve confluent cell attachment, a seeding
      density > 5 x 10(5) cells/cm2 should be used.

PMID- 8472153
TI  - Long-term results of treatment of peptic stricture of the oesophagus with the
      Angelchik prosthesis.
AB  - An Angelchik prosthesis was inserted in 43 patients with a peptic stricture above
      a hiatus hernia; 16 showed columnar lining of the oesophagus below the stricture.
      The mean preoperative bore of strictures was 8.7 mm. Within months, and without
      dilatation, 33 strictures shortened, 35 widened and of these 13 disappeared with
      a mean bore of 11.7 mm. In the long term, three more strictures resolved but
      three recurred. Final measurements gave a mean bore of 12.2 mm. The mean follow
      up was 3.5 years. Symptomatic and radiological assessments suggested that the
      prosthesis was less effective when sited in the chest.

PMID- 8472154
TI  - Oesophagectomy by a transhiatal approach or thoracotomy: a prospective randomized
      trial.
AB  - A prospective randomized trial of 67 patients undergoing oesophagectomy by either
      a transhiatal approach or right-sided thoracotomy was conducted over a 40-month
      period. In 32 patients the approach was transhiatal and 35 had a thoracotomy; the
      groups were well matched before operation. There were two hospital deaths in
      patients having the transhiatal oesophagectomy and three in those undergoing
      thoracotomy. Blood transfusion, intensive care stay and overall time of
      hospitalization were not significantly different between the two groups. There
      was no difference in the postoperative morbidity rate and, in particular, the
      incidences of pulmonary complications were similar (19 per cent for transhiatal
      oesophagectomy, 20 per cent for thoracotomy) with anastomotic fistula in 6 and 9
      per cent respectively. The median (range) operating time was significantly longer
      in patients having thoracotomy (6 (3.5-9.5) versus 4 (3-8) h). Long-term survival
      was unaffected by the type of operation performed or addition of preoperative
      chemotherapy or radiotherapy. Nodal status was a significant prognostic factor
      within but not between the two groups. It is concluded that oesophagectomy by a
      transhiatal route or right thoracotomy are equally effective surgical options for
      treatment of squamous cell oesophageal cancer.

PMID- 8472155
TI  - Intragastric bile acid and symptoms in patients with an intrathoracic stomach
      after oesophagectomy.
AB  - Bile acid concentration and symptoms were evaluated in 24 patients after total
      oesophagectomy and gastric pull-up. Patients were randomly allocated to receive
      pyloroplasty or not. After operation all were followed for a minimum of 6 months.
      Bile acid concentration in the gastric juice was estimated. The mean(s.d.) bile
      acid concentration 6 months after surgery was similar in patients with and
      without pyloroplasty (34.9(30.1) and 25.0(24.2) mg/dl respectively). Postprandial
      discomfort and bilious eructations were the two most commonly observed symptoms
      in both groups. Other features noted were vomiting, anaemia and anorexia. These
      did not however seem to be related to intragastric bile acid concentration of
      individual patients in either group and occurred irrespective of whether
      pyloroplasty was performed or not.

PMID- 8472156
TI  - Laparoscopic resection of a bleeding gastric tumour.

PMID- 8472157
TI  - Increasing incidence of carcinoma of the gastric cardia in Sweden from 1970 to
      1985.
AB  - Several American, Japanese and European centres have reported an increase in
      carcinoma of the gastric cardia, contrary to the general trend in the incidence
      of gastric cancer. The aim of this nationwide population-based study was to
      describe trends in the incidence of tumours of the gastric cardia in Sweden over
      the 16-year period from 1970 to 1985. The Swedish cancer register, which is more
      than 95 per cent complete, was used to identify cases. There were 1514 men and
      481 women with cancer of the gastric cardia. The age-standardized rates increased
      in men from 1.9 per 10(5) population in 1970-1973 to 3.0 per 10(5) in 1982-1985,
      corresponding to a mean annual increase of 2.5 per cent (95 per cent confidence
      interval (c.i.) 1.6-3.4 per cent). In women, the age-standardized rates increased
      from 0.5 per 10(5) in 1970-1973 to 0.8 per 10(5) in 1982-1985, the mean annual
      increase being 0.9 per cent (95 per cent c.i. 0.0-1.8 per cent). The highest
      incidences were found in southern Sweden, contrary to the geographical
      distribution of gastric cancer in general, which shows a south-to-north gradient.
      The disparate epidemiological features of cancer of the cardia and gastric cancer
      at other sites suggest that the aetiologies may also be different. Since little
      is known about the aetiology of cancer of the cardia, and the incidence seems to
      be rising rapidly, analytical studies are urgently needed.

PMID- 8472158
TI  - Gastric cancer and Helicobacter pylori infection.
AB  - Gastric adenocarcinoma can be divided into two histopathological types:
      intestinal and diffuse. In addition to the role of environmental factors, an
      association between gastric cancer and Helicobacter pylori has been suggested. A
      retrospective study was therefore carried out among 46 patients who had gastric
      cancer. As a control group, 40 patients with non-malignant disorders were
      selected (11 patients with peptic ulcer, 12 with chronic superficial gastritis,
      17 with chronic atrophic gastritis). Twenty-six cancers were classified as
      intestinal type and 20 as diffuse type. H. pylori was found in 23 (88 per cent)
      of the intestinal type and 11 (55 per cent) of the diffuse type (P < 0.05).
      Patients with the intestinal-type gastric cancer had a higher prevalence of H.
      pylori infection than those with gastric ulcer (55 per cent) and chronic
      superficial gastritis (50 per cent) (P < 0.05). These findings suggest that there
      is a possible association between the intestinal type of gastric cancer and H.
      pylori infection.

PMID- 8472159
TI  - Resection of presumed benign liver tumours.
AB  - The surgical treatment of benign liver tumours (focal nodular hyperplasia (FNH)
      and hepatic adenoma) remains controversial. From 1984 to 1990, all 51 women aged
      below 50 years who presented with presumed benign liver tumours and without
      chronic liver disease underwent tumour resection. Preoperative assessment
      included liver tests, ultrasonography and dynamic computed tomography in all
      patients, plus angiography (n = 20), magnetic resonance imaging (n = 22) and
      technetium-sulphur colloid liver scintigraphy (n = 19). The aims of this study
      were to compare preoperative and final pathological diagnosis and determine
      whether surgical treatment was justified. Preoperative assessment suggested FNH
      in 18 patients and hepatic adenoma in 11. In 22 patients, the distinction between
      FNH and adenoma could not be determined before operation. Operative procedures
      included resection of one segment or less in 22 patients, two segments in 14 and
      three or more segments in 15. There was no postoperative death and no serious
      complication. The final diagnosis after pathological examination of resected
      specimens was FNH in 36 patients (71 per cent), including the 18 presumed before
      operation to have FNH, hepatic adenoma in 12 (24 per cent) and malignant lesions
      in three (6 per cent): hepatocellular carcinoma (HCC) arising in normal liver,
      fibrolamellar carcinoma, and adenoma containing areas of HCC in one patient each.
      IN CONCLUSION: (1) precise preoperative diagnosis of benign liver tumours remains
      difficult despite new imaging methods; (2) malignant liver tumours can go
      unrecognized; and (3) resection of all these lesions can be carried out safely.
      Resection of presumed benign liver tumours should be performed in young women
      when a preoperative diagnosis of FNH is not firmly established.

PMID- 8472160
TI  - Clinical trial of tamoxifen in patients with irresectable pancreatic
      adenocarcinoma. The Yorkshire Gastrointestinal Tumour Group.
AB  - Oestrogen-binding sites are present in tissue samples of adenocarcinoma of the
      pancreas. Uncontrolled studies have suggested that survival of patients with this
      tumour may be extended by using the antioestrogen drug tamoxifen. Forty-four
      patients with biopsy-proven irresectable adenocarcinoma of the pancreas were
      recruited into a randomized placebo-controlled clinical trial of tamoxifen 20 mg
      twice daily. All patients were assessed at the time of diagnosis and at monthly
      intervals using the Karnofsky and the Hospital Anxiety and Depression scores for
      quality of life. Analysis of survival by life-tables and the log rank test
      revealed no significant difference in the duration of survival of patients
      treated with tamoxifen or placebo. Quality-of-life assessment revealed no
      significant difference between the groups. Tamoxifen does not confer significant
      benefit to patients with irresectable pancreatic cancer.

PMID- 8472161
TI  - Suppression of macrophage function by suture materials and anastomotic recurrence
      of Crohn's disease.
AB  - After surgical excision of bowel, Crohn's disease is likely to recur around the
      anastomosis. It is suggested that this may indicate a biological effect of suture
      materials on gastrointestinal immunology. To investigate this, the influence of
      six suture materials on the function of macrophages obtained from the rat
      peritoneal cavity and human intestinal mucosa was assessed. All materials
      significantly impaired macrophage function.

PMID- 8472162
TI  - Sphincter rupture in childbirth.
AB  - Thirty-eight women with rupture of the anal sphincter occurring during childbirth
      were followed for 3-12 months. Nineteen had complete rupture of the external anal
      sphincter, 14 had a lesion involving more than half of the sphincter muscle and
      five had a superficial rupture. Fourteen patients presented with continence
      disturbances: nine to solid or liquid faeces and five to flatus. Incontinence was
      present in nine women 3 months after childbirth. Anal manometry and
      electromyography were performed in patients 3-5 days after delivery and repeated
      at 3, 6 and 12 months. Manometry and electromyography were also performed in 16
      control subjects who were nulliparous or had given birth more than 2 years
      previously and 24 primiparous controls, who were investigated at 3-5 days and at
      3 months. There were significant differences between both incontinent and
      continent patients compared with nulliparous and primiparous controls.
      Primiparous control subjects had decreased anal squeeze pressure as well as
      decreased electromyographic activity on the first days after delivery compared
      with nulliparous controls. After 3 months no differences were found. Continence
      disturbances are frequent after sphincter rupture; these patients should be
      monitored after delivery and those with persisting incontinence offered sphincter
      repair.

PMID- 8472163
TI  - Diaphragm-like strictures of the colon induced by non-steroidal anti-inflammatory
      drugs.

PMID- 8472164
TI  - Subtotal splenectomy in Gaucher's disease: towards a definition of critical
      splenic mass.

PMID- 8472165
TI  - Iliofemoral versus femorofemoral bypass: a 6-year audit.

PMID- 8472166
TI  - Perineal trauma from cassette tape boxes.

PMID- 8472167
TI  - Role of sequential leucocyte counts and C-reactive protein measurements in acute
      appendicitis.

PMID- 8472168
TI  - Reperfusion injury in skeletal muscle: a prospective study in patients with acute
      limb ischaemia and claudicants treated by revascularization.

PMID- 8472169
TI  - Physiological and metabolic responses to open and laparoscopic cholecystectomy.

PMID- 8472170
TI  - Place of routine operative cholangiography at cholecystectomy.

PMID- 8472171
TI  - Prospective randomized trial comparing the Shouldice technique and plication darn
      for inguinal hernia.

PMID- 8472172
TI  - Third European Conference on Child Abuse and Neglect, Prague, Czechoslovakia.
      June 23-26, 1991.

PMID- 8472173
TI  - A profile of violence toward children: a national study.
AB  - This paper presents a profile of violence toward children in the United States,
      based on the results from the Second National Family Violence Survey. A national
      probability sample of 6,002 households was surveyed by telephone in 1985, of
      which 3,232 households had at least one child under 18 years old living at home.
      Minor violence, or physical punishment, was most common among mothers, caretakers
      18 to 37 years old, fathers who were unemployed, caretakers with blue-collar
      occupations, households with two to four children at home, and among caretakers
      who used alcohol and other drugs, male children, and children 3 to 6 years old.
      The highest rates of abusive violence occurred in families located in the East,
      families whose annual income was below the poverty line, families where the
      father was unemployed, families where the caretakers held blue-collar jobs,
      families with four or more children, caretakers who used drugs at least once,
      male children, and children 3 to 6 years old. Logistic regressions were done to
      examine the predictive value of these variables.

PMID- 8472174
TI  - Intensive Family Preservation Services with abused and neglected children: an
      examination of group differences.
AB  - Intensive Family Preservation Services (IFPS) have emerged as one of the most
      widely-employed placement prevention models in the field of Family-Based
      Services. Most IFPS evaluations have reported positive outcomes, but some results
      have been mixed. The use of heterogeneous client samples may explain some of the
      equivocal findings, so a study was designed to assess maltreatment group
      differences in a relatively large sample of families referred by Child Protective
      Service (CPS) agencies. It was found that: (a) Neglectful families, in contrast
      to abusive ones, were poorer, more reliant on public income, more likely to be
      headed by a single parent, had more children at imminent risk of placement, and
      were more likely to have medical, mental health, and substance abuse problems;
      (b) families referred for both abuse and neglect were more similar to the neglect
      only group than the abuse-only one; and (c) although the majority of all children
      avoided placement, children from neglectful families were almost twice as likely
      to be placed than children from abusive ones, with those from multiple
      maltreatment families being at highest risk. The implications for research
      methodology and service delivery are discussed.

PMID- 8472175
TI  - Self-report of Guardians Ad Litem: provision of information to judges in child
      abuse and neglect cases.
AB  - Reporting patterns of Guardians Ad Litem to judges in cases on child abuse and
      neglect were studied. Guardians indicated which information they had included in
      reports to judges in recently adjudicated cases of child abuse and neglect.
      Information reported in child abuse cases was compared with information reported
      in neglect cases, and the pattern of reporting was found to be the same in both
      types of cases. Guardians most frequently included information concerning the
      child's physical safety, the interaction between the parent(s) and the child, and
      personality characteristics of the parent(s). Less frequently reported was
      information regarding conflict in the home and family enmeshment.

PMID- 8472176
TI  - Morbidity and death due to child abuse in New Zealand.
AB  - The purpose of this study was to explore under-diagnosis and racial bias among
      child abuse morbidity and mortality data from New Zealand. Computerized files of
      all intentional injury fatalities among children 16 years of age and under for
      1978-87, and all hospital discharges for intentionally injured children 16 and
      under for 1988, were analyzed for evidence of physical abuse and sexual abuse.
      Among the 92 fatalities, only 21 of 68 deaths due to physical and/or sexual abuse
      were so coded. In both the mortality and the morbidity data, there was an
      association between the diagnosis of child abuse and race. In the case of
      fatalities, Maori and Samoan abuse victims were more likely to be assigned an E
      code of E967 ("child battering and other maltreatment") than were "others" (p =
      0.04), controlling for sex. In the case of hospitalizations, the association
      between E967 and whether or not the victim was European was significant for
      physical abuse only (p = 0.05). Assignment of N-code = 995.5 ("child maltreatment
      syndrome") as the reason for admission was significantly associated with race for
      those cases considered by us to have been abused, controlling for age (p = 0.002)
      or sex (p = 0.004).

PMID- 8472177
TI  - Child provocativeness and gender as factors contributing to the blaming of
      victims of physical child abuse.
AB  - This study was an investigation of factors contributing to blame attributions
      directed toward victims of physical child abuse. The total sample consisted of
      897 college undergraduates. Subjects read eight vignettes describing physically
      abusive parent-child interactions, and indicated their attributions of
      responsibility toward parent and child. We predicted that: (a) aggressively
      provocative children (compared to nonprovocative) would be ascribed greater
      blame; (b) male subjects would be more likely to blame the child; (c) in
      situations in which the abusive parent is male (compared to female), the child
      would be blamed more; and (d) male children (compared to females) would receive
      greater blame. The results supported all hypotheses. The data also suggested
      several interaction effects. Significance tests were supplemented with effect
      size analyses.

PMID- 8472178
TI  - Mother-son sexual abuse: rare or underreported? A critique of the research.
AB  - This paper reviews the literature regarding mother-son sexual abuse and critiques
      the methodologies that may be responsible for the underreporting of such cases.
      The review of the clinical and empirical literature reveals discrepancies
      regarding estimates of incidence and prevalence of mother-son sexual abuse. The
      author suggests improved methodologies for researchers interested in studying
      this topic.

PMID- 8472179
TI  - The psychological evaluation of child sexual abuse using the Louisville Behavior
      Checklist and Human Figure Drawing.
AB  - Accurately detecting victims of child sexual abuse when physical evidence is
      lacking is a problem frequently faced by clinicians. This study investigated
      whether Human Figure Drawings and the Louisville Behavior Checklist could be used
      to accurately identify sexually abused children, mental health clinic-referred
      children, and community children. Discriminant function analysis indicated that
      the groups differed significantly on the measures. There was some
      misclassification of individual children on the basis of their checklist and
      drawing scores. Results suggested limited support for the Louisville Behavior
      Checklist but caution in using Human Figure Drawings in the assessment of sexual
      abuse.

PMID- 8472180
TI  - Children's patterns of disclosures and recantations of sexual and ritualistic
      abuse allegations in psychotherapy.
AB  - Patterns of disclosures and recantations of abuse made in psychotherapy were
      examined in a sample of 63 children who reported sexual and ritualistic abuse in
      a preschool setting. Therapists completed a measure that instructed them to
      identify the time since the child began therapy when any disclosures or
      recantations were made, to specify the type of abuse disclosed or recanted, and
      to identify any events that might be related to the timing of a disclosure or
      recantation. The findings revealed that the majority of subjects (76.2%)
      disclosed abuse within the first month of therapy. Recantation occurred in 17
      cases (27%) and all but two children who recanted redisclosed abuse after the
      initial recantation. There was some evidence that children's experiences within
      the legal system may have been associated with recantations. Subjects tended to
      make vague disclosures before revealing more specific acts, reveal less intrusive
      sexual abuse (e.g., kissing) before more intrusive types (e.g., intercourse), and
      to disclose ritualistic abuse after other types.

PMID- 8472181
TI  - HIV vulnerability and the adult survivor of childhood sexual abuse.
AB  - The purpose of this article is to sensitize clinicians working in the field of
      childhood physical/sexual abuse to the connection between untreated childhood
      traumatization and HIV high-risk behaviors. The characteristic abuse symptoms of
      chronic depression, sexual compulsivity, revictimization, and substance abuse are
      identified as barriers to HIV education and intervention for survivors. An
      overview of the existing HIV/child abuse connection research, an illustrative
      case history and a discussion regarding the clinical implications of these
      connections are offered.

PMID- 8472182
TI  - A brief group treatment for the modification of denial in child sexual abusers:
      outcome and follow-up.
AB  - We investigated whether brief structured group treatment could produce a
      reduction of denial of sexual offenses in males convicted of sexually offending
      against children. Such denial can additionally harm victims and often precludes
      admission into sex offender treatment programs, thus ruling out an opportunity to
      decrease the potential of reoffending. The group treatment contained elements of
      victim empathy, cognitive restructuring, sex education, assertiveness and social
      skills, education about sex offender therapy, and a discussion of the possible
      consequences of continued denial. Seventeen child sexual offenders in denial were
      run in two groups. Despite an average length of denial of nearly two years, by
      post-treatment the majority of offenders had come out of denial. Moreover, follow
      up denial data indicated continued admission, and above-average compliance with
      subsequent sex offender therapy. Although the lack of an experimental design
      precludes causal inference, these results are suggestive of an effective method
      for modifying denial in sex offenders against children.

PMID- 8472183
TI  - The relationship between childhood sexual abuse and subsequent onset of bulimia
      nervosa.
AB  - Seventy-two young adult women identified by the Bulimic Investigatory Test,
      Edinburgh (BITE) as having a high probability of suffering from bulimia nervosa
      were compared with 72 matched controls who did not display bulimic symptoms. Both
      groups were given measures of sexual abuse history, dissociation, and early
      family mealtime experiences. Rates of self-reported sexual abuse after the age of
      12 with an adult relative as the perpetrator were significantly greater in the
      women diagnosed as bulimic. Nonsignificant but high rates of sexual abuse prior
      to age 12 were also found for this group. Dissociative experiences were also
      significantly more common in the bulimic group overall, and higher still for
      bulimic women who reported sexual abuse as children. Bulimic women had more
      negative and unusual mealtime experiences than nonbulimic women. Results suggest
      that sexual abuse may be related to the subsequent onset of bulimia nervosa for
      some women.

PMID- 8472184
TI  - Toward a testable developmental model of pedophilia: the development of erotic
      age preference.
AB  - Retrospective self-reports about childhood curiosity to see persons in the nude
      were used to compare the development of erotic sex and age preferences among four
      groups of males; 46 heterosexual pedophiles, 30 homosexual pedophiles, 462
      gynephiles (who erotically prefer physically mature females), and 51 androphiles
      (who erotically prefer physically mature males). The results suggest (a)
      throughout this erotic developmental process among males, the establishment of
      erotic sex preference precedes that of erotic age preference, and (b) a greater
      proportion of pedophiles than of individuals who prefer physically mature
      partners remembers curiosity in their own childhood to see nude children without
      remembering such curiosity in regard to adults. This suggests that in a
      substantial proportion of pedophiles the occurrence of this paraphilia is
      predetermined at a very early developmental phase. A further set of retrospective
      self-reports, obtained from a group of 78 gynephilic university students suggests
      that at least in gynephiles the erotic appeal of children of the preferred sex
      ceases by about the time of puberty. This may be an indication that there exists
      a process of active devaluation of the nonpreferred age bracket, culminating at
      puberty.

PMID- 8472185
TI  - The relationship between inflammation and hyperreactivity of the airways in
      asthma.

PMID- 8472186
TI  - Modifications of PC20 and maximal degree of airway narrowing to methacholine
      after pollen season in pollen sensitive asthmatic patients.
AB  - We examined the effect of cessation of exposure to pollen on non-specific airway
      responsiveness in 10 grass and/or parietaria pollen sensitive asthmatics. Three
      methacholine inhalation challenges were performed, the first during pollen season
      (seasonal period), the second 2 months after the end of season (short time after
      seasonal period), and the third 5 months after the end of season (long time after
      seasonal period). The dose-response curves to methacholine were characterized by
      the PC20 (provocative concentration of methacholine required to produce a 20%
      fall in FEV1) and maximal response plateau, if possible. A maximal response
      plateau on the dose-response curve was considered to be present if three or more
      data points for FEV1 fell within a 5% response range. The challenge was stopped
      when FEV1 dropped more than 50% or the highest concentration of methacholine (200
      mg/ml) was reached. The geometric mean (range) methacholine PC20 increased from
      1.08 (0.18-37.22) in the seasonal period to 4.67 (0.71-200) mg/ml during the long
      time after seasonal period (P < 0.01). On the other hand, in six subjects in whom
      it was possible to obtain a plateau on at least one challenge, the level of the
      maximal response decreased from (mean +/- s.e.m.) 44.1 +/- 4.9 in the seasonal
      period to 30 +/- 4.4 during the long time after seasonal period (P < 0.05). These
      results suggest that in pollen sensitive asthmatic patients, the cessation of
      exposure to pollen is associated with a reduction of non-specific bronchial
      responsiveness (PC20 and maximal degree of airway narrowing to methacholine).

PMID- 8472187
TI  - IgE-binding components of baker's yeast (Saccharomyces cerevisiae) recognized by
      immunoblotting analysis. Simultaneous IgE binding to mannan and 46-48 kD
      allergens of Saccharomyces cerevisiae and Candida albicans.
AB  - The Saccharomyces cerevisiae allergens were characterized by IgE-immunoblotting
      with serum samples of 83 patients; 63 represented patients with atopic dermatitis
      with previous positive skin prick test or RAST for S. cerevisiae, seven patients
      with AD but negative test results and 13 were non-atopic controls. Disrupted
      whole body extract of S. cerevisiae was used in the assays. From the patients
      tested 41 patients with atopic dermatitis appeared positive in IgE immunoblotting
      revealing 22 IgE stained bands. From these bands 10 represented intermediate
      allergens, and 12 minor allergens. The most frequent staining was obtained with
      the 48 kD band (39%). When the staining pattern of 45 kD and 48 kD bands and
      mannan was compared with Candida albicans allergens or purified baker's yeast
      enolase a simultaneous binding was seen with the 48 kD band of S. cerevisiae and
      the 46 kD band of C. albicans and enolase whereas the 45 kD band was neither
      associated with the 46 kD band of C. albicans nor purified enolase. High
      molecular weight staining was found in five samples. The staining pattern was
      associated with the mannose containing structures in parallel with C. albicans.

PMID- 8472188
TI  - Ciliated cell damage in the bronchial epithelium of asthmatics and non
      asthmatics.
AB  - The importance of bronchial epithelial shedding in the pathogenesis of asthma has
      been highlighted by many investigators as a potential mechanism for bronchial
      hyperresponsiveness. It has been suggested that this disruption is the result of
      cytotoxic injury leading to shedding of damaged cells. To investigate whether
      damaged ciliated epithelial cells can be detected within the bronchial mucosa, we
      used tannic acid which only permeates disrupted cellular membranes, as a marker
      of cell damage. Bronchial biopsies from seven asthmatic and six normal subjects,
      were processed in tannic acid prior to preparation and sectioning for
      electronmicroscopic examination. Ciliated epithelial cells staining darkly with
      tannic acid were seen to comprise a similar proportion of the intact portion of
      bronchial epithelium in both normals and asthmatics (medians 31% vs 40%). We
      suggest that ciliated epithelial cells are not shed from the bronchial mucosa
      immediately after damage and that mechanisms other than granulocyte-mediated
      cytotoxicity may account for epithelial disruption in asthma, possibly involving
      the selective damage or reduced expression of intraepithelial intercellular
      adhesion molecules.

PMID- 8472189
TI  - Occupational allergy to bumble bee venom.
AB  - The clinical profile of anaphylactic reactions to bumble bees is described and
      successful immunotherapy with honey bee venom in seven bumble bee allergic
      patients is reported. The cause of the high frequency of sensitization to pollen
      in these patients is discussed.

PMID- 8472190
TI  - In vitro allergenicity of cows' milk substitutes.
AB  - There are numerous alternatives to cows' milk formula for allergic children. We
      have investigated the allergenicity of several of these using RAST and RAST
      inhibition on serum from 16 patients with a known history of cows' milk protein
      intolerance (CMPI) and 16 atopic controls. A RAST grade of > or = 3 for cows'
      milk was present in all those with CMPI, whilst all the controls gave RAST of <
      or = 1. Modified cows' milk formula, goats' infant formula, sheep and goats' milk
      produced similar results to cows' milk. Only two patients had RAST > or = 3 for
      soya milk and the soy/beef hydrolysate gave positive results in only three
      patients. One had positive RAST to Nutramigen and two to Pregestimil. Of the whey
      hydrolysates investigated, Pepti-junior gave seven positive RASTs whilst we were
      unable to bind Alfare to the sepharose in sufficient quantities to interpret the
      results which were negative in all cases. RAST inhibition data on pooled sera
      from the same patients agreed with the RAST results. The inhibition curves showed
      high inhibition with goats', sheep, modified cows' milk formula and the casein
      formula, AL110 (50%). Soy and soy/beef hydrolysate showed a much lower inhibition
      pattern. Casein hydrolysates showed low inhibition while the whey hydrolysate
      produced higher inhibition. We have shown that despite claims of low
      allergenicity, some of these alternative formulae are antigenically recognized in
      vitro by some cows' milk intolerant patients.

PMID- 8472191
TI  - Rapid Hymenoptera venom immunotherapy: comparative safety of three protocols.
AB  - We compared 284 sting-allergic patients treated with either a 4 day (group 1), 6
      hr (group 2) or 210 min (group 3) rapid venom immunotherapy (RVIT) protocol using
      honey bee (HB) or yellow jacket (YJ) venom at cumulative doses of 527.6
      micrograms, 226.6 micrograms and 101.1 micrograms respectively. The 4 day
      protocol involved four times as many injections as the 210 min protocol and twice
      as many as the 6 hr protocol. Desensitization was conducted in a hospital
      providing full emergency resuscitation facilities. In group 1, 1 x 100 micrograms
      boosters were given on days 7, 10, 15 and 45 and, in groups 2 and 3, 2 x 50
      micrograms boosters were given on day 15 and 1 x 100 micrograms on day 45. The
      patients in the three groups were comparable with regard to clinical
      characteristics and immunological reactivity determined by skin tests. All
      patients had large local reactions. Systemic reactions (SR) occurred in 28.2% of
      patients in group 1, 28.6% in group 2 and 6.9% in group 3. The mean total
      cumulative venom dose (s.e.m.) for occurrence of SR was 123.75 (+/- 24.2) in
      group 1, 183.27 (+/- 28.5) in group 2, and 36.43 (+/- 9.3) in group 3. HB led to
      more systemic reactions than YJ venom. The rate of SR decreased when the
      cumulative venom dose was reduced during RVIT. The median dose was 137.6
      micrograms in group 1, 226.6 micrograms in group 2, and 21.1 micrograms in group
      3. No systemic reactions were observed after the booster injections. The results
      of this study suggest that short RVIT protocols with low cumulative doses carry a
      lesser risk of SR.

PMID- 8472192
TI  - Allergic reaction to snake venom after repeated bites of Vipera aspis.

PMID- 8472193
TI  - Allergic skin reaction after inhalation of budesonide.

PMID- 8472194
TI  - Clinical anatomy of the equine head.
AB  - This topical presentation emphasizes the structures most likely to be encountered
      in the diagnosis and treatment of diseases of the equine head. Most of the
      approaches are from superficial to deep. Anatomic variations associated with
      aging are described. The larynx and guttural pouches are not included in this
      article.

PMID- 8472195
TI  - Diseases of the nasal cavity.
AB  - Conditions of this portion of the respiratory tract are relatively uncommon. This
      article reviews these conditions and discusses the different modes of therapy.
      The conditions covered are redundant alar folds, diseases of the nasal septum,
      fungal infections, neoplasms, nasal polyps, and ethmoid hematomas. The different
      surgical approaches to the nasal cavity are reviewed, and surgery of removal of
      the nasal septum and the alar fold are described.

PMID- 8472196
TI  - Examination of the oral cavity and routine dental care.
AB  - Techniques and equipment used to examine the oral cavity thoroughly are
      explained. Common routine dental procedures described include removal of enamel
      points, wolf teeth, and retained caps. Abnormalities of the incisors are
      discussed.

PMID- 8472197
TI  - Dental surgery.
AB  - Anatomy, physiology, and diseases of the teeth are presented. Signs of dental
      disease and techniques for oral and radiographic examination of the teeth are
      discussed. Surgical procedures described include extraction, repulsion, and
      endodontic therapy.

PMID- 8472198
TI  - Paranasal sinuses.
AB  - Numerous conditions, including trauma, infection, neoplasia, and developmental
      problems, can affect the paranasal sinuses. Successful resolution of these
      problems is predicated upon a thorough diagnostic workup to ensure the most
      accurate presumptive diagnosis. Surgical intervention is enhanced by using
      approaches that allow wide access to sinus compartments. Rigorous postoperative
      management is also important to a successful outcome.

PMID- 8472199
TI  - Head trauma.
AB  - The equine head is especially prone to trauma from kicks, collisions,
      entrapments, and falls. The specialized structures of the equine head are
      important in both function and appearance. When injury causes either loss of
      function or cosmesis, timely treatment is paramount. This article discusses the
      occurrence and therapy of trauma to the equine head, including fractures of the
      mandible and premaxilla, facial bone, hyoid apparatus, and skull base.

PMID- 8472200
TI  - Reconstructive surgery of selected injuries of the head.
AB  - Traumatic injuries to the head region of the horse are a common presenting
      complaint. Because of a copious blood supply, these wounds typically exhibit a
      tremendous capability for healing. By following the basic principles of wound
      management and employing a few techniques unique for specific injuries, the
      healing of these wounds can result in a satisfactory outcome.

PMID- 8472201
TI  - Neurologic evaluation of the equine head and neurogenic dysphagia.
AB  - Neurologic evaluation should be performed in horses with diseases of the head.
      Although neurologic examination should focus on assessing behavior, mental
      status, and cranial nerve evaluation, evaluation of neurologic function of other
      body regions should be performed. Neurologic evaluation of the head can be
      performed expediently by practitioners to provide useful diagnostic and
      prognostic information. The numerous causes of dysphagia can be classified as
      obstructive, painful, or neurogenic. Common causes of neurogenic dysphagia are
      summarized, and methods for initial diagnosis and management are described.
      Maintaining adequate nutrition and preventing aspiration pneumonia are principal
      concerns in managing horses with neurogenic dysphagia.

PMID- 8472202
TI  - Neoplasia.
AB  - Equine tumors are rather uncommon; however, of the body regions, the head is a
      relatively common location for neoplasia, including sarcoids and squamous cell
      carcinomas of the skin, tumors of the sinus/nasal cavity, and bony tumors of the
      head. Tumors discussed in the article include odontogenic and bony tumors;
      sarcoids; tumors of the guttural pouch and pharyngeal and oral mucosa; tumors of
      the larynx; and tumors of the paranasal sinuses and nasal passages. In general,
      tumors involving deeper structures of the head carry a poor prognosis; however,
      some tumors such as sarcoids, ossifying fibromas, and osteomas of the paranasal
      sinus often can be treated effectively by cytoreductive surgery, with or without
      adjunctive treatment modalities. The clinical signs, prognoses, and therapeutic
      options for specific tumor types and locations are reviewed. Ophthalmic tumors
      are not discussed.

PMID- 8472203
TI  - Miscellaneous conditions of the equine head.
AB  - Nutritional secondary hyperparathyroidism is associated with horses that are fed
      diets with an imbalance of calcium and phosphorus or diets containing oxalates.
      Clinical signs include a shifting lameness, with tenderness of the joints,
      reluctance to move, or a stiff, stilted gait. Some horses may have broadening of
      the nasal bones, enlargement of the maxilla and/or the mandible, or a ridge over
      the nasal bones. Diagnosis may include physical examination findings; analysis of
      feed; and clinical pathologic data, which may include normocalcemia, normal to
      increased serum phosphorus, and increased fractional excretion of phosphorus
      (normal FxP < 0.5%). The primary objective of therapy is to correct the
      nutritional calcium to phosphorus imbalance. Sialoliths are calcific concretions
      that develop in the salivary gland or duct. Therapy generally involves surgical
      removal, and associated complications are uncommon. Obstruction of the
      nasolacrimal duct occurs most commonly secondary to intraluminal foreign
      material, although congenital atresia may occur. Clinical signs include epiphora,
      conjunctivitis, and mucopurulent discharge. Foreign material is often removed by
      retrograde saline flush and atresia is resolved by surgery.

PMID- 8472204
TI  - Clinical examination of the equine head.
AB  - Examination of the equine head should be a routine part of any complete physical
      examination. It can be performed rapidly and efficiently while providing
      important information about the health and function of several major body
      systems.

PMID- 8472205
TI  - Radiographic examination of the equine head.
AB  - Radiographic examinations of the equine head can be performed with portable x-ray
      machines. The views comprising the examination depend on the area of the head
      being examined. With a knowledge of radiographic anatomy and radiographic signs
      of disease, valuable diagnostic information can be obtained from the radiographic
      examination. In addition, the radiographic information can also be used to
      develop a prognosis and determine the most appropriate therapy.

PMID- 8472206
TI  - Diagnostic techniques for evaluation of the paranasal sinuses.
AB  - Physical examination of the paranasal sinuses is often insufficient to
      confidently reach a conclusion concerning suspected pathology in these cavities.
      Often, other evaluation techniques are necessary. This article describes physical
      examination, rhinoscopy, sinus centesis, radiology, and sinus endoscopy of the
      equine paranasal sinuses. These techniques can be used to diagnosis and determine
      the cause of most sinus disorders.

PMID- 8472207
TI  - Congenital diseases of the equine head.
AB  - Many questions concerning heritability arise when a veterinarian is asked to
      supervise and treat disease of congenital origin. Genetic counseling, ethics, and
      legality are often confronted in discussions between animal health professionals
      and laymen in animal industry. Guidelines have been offered as in the 1984
      statement of the Judicial Council of the American Veterinary Medical Association:
      "Performance of surgical procedures in all species for the purpose of concealing
      genetic defects in animals to be shown, raced, bred, or sold as breeding animals
      is unethical. However, should the health or welfare of the individual patient
      require correction of such genetic defects, it is recommended that the patient be
      rendered incapable of reproduction." The Australian Veterinary Law, Ethics,
      Etiquette and Convention declares it fraud to alter a defect for sale purposes
      and unethical for a veterinarian to perform such treatments. It is permissible to
      correct defects causing discomfort or inconvenience, but the veterinarian is
      required to advise appropriate breeding counseling. Genetic counseling has
      progressed significantly in human medicine. This has been supported by better
      diagnostic methods for genetic disorders, greater acceptance of preventive
      measures, and extended screening programs to identify carriers of specific
      abnormal genes or chromosomal aberrations. Congenital diseases in veterinary
      medicine are constantly under investigation. The veterinary practitioner must
      continue to operate with an appreciation of the incomplete understanding of most
      of these abnormalities and act in accordance with personal ethical judgment and
      the guidance of the American Veterinary Medical Association when treating the
      affected individual animal patient.

PMID- 8472208
TI  - The need for sterilization.

PMID- 8472209
TI  - Can you read this?

PMID- 8472210
TI  - Fluoride recommendations released. Canadian Conference on the Evaluation of
      Current Recommendations Concerning Fluorides, April 9-11, 1992.

PMID- 8472211
TI  - Handpiece sterilization--the debate continues.

PMID- 8472212
TI  - Bloodborne pathogens in the health care setting: risk for transmission.
      Laboratory Centre for Disease Control, Health and Welfare Canada.

PMID- 8472213
TI  - The effectiveness of the Nd:YAG laser in the treatment of dental
      hypersensitivity.
AB  - Dentin hypersensitivity is one of the most painful and least predictably treated
      chronic conditions in dentistry. The effectiveness of laser therapy in the
      reduction of dentin hypersensitivity and its effects on pulpal vitality were
      studied. Nineteen subjects participated in the randomized, double-blind study,
      and were followed up for three months. Two sites were treated. One received
      helium neon (He:Ne) laser treatment and the other received He:Ne plus Nd:YAG
      (He:Ne+Nd:YAG) laser treatment. Laser treatment consisted of 30 millijoules (mJ)
      to 100 mJ per pulse, at 10 pulses per second (pps) in increments of 10-40 seconds
      each over a total treatment time of less than two minutes, without local
      anesthesia. Hypersensitivity was assessed by mechanical stimulus (using a sharp
      explorer), and thermal stimulus (using a blast of cold air from a dental
      syringe). Pulpal vitality was measured using an electrical stimulus. The results
      indicate that immediately following laser treatment and for three months
      thereafter, the subjects' perceived level of discomfort decreased. He:Ne
      treatment reduced dentin hypersensitivity to air by 63 per cent and to mechanical
      stimulation by 61 per cent over three months. The He:Ne + Nd:YAG treatment
      reduced dentin sensitivity to air by 58 per cent and to mechanical stimulation by
      61 per cent. All teeth remained vital after laser treatment, with no adverse
      reactions or complications. He:Ne and He:Ne + Nd:YAG laser treatment can be used
      to reduce dentin hypersensitivity without detrimental pulpal effects.

PMID- 8472215
TI  - New vistas in communication.

PMID- 8472214
TI  - [The self-aspirating syringe in local anesthesia].
AB  - Dentists routinely inject local anesthetic solutions in their daily practice.
      However, it is important not to inject intravascularly. Consequently,
      manufacturers offer two types of dental syringes: one with a mechanical
      aspirating device (harpoon) and the other with a self-aspirating mechanism. We
      have verified the efficacy of a self-aspirating syringe as presented on the
      market and another self-aspirating syringe which we lightly modified.

PMID- 8472216
TI  - Getting the message heard--who should be the messenger?

PMID- 8472217
TI  - Operation tundra storm.

PMID- 8472218
TI  - Cutaneous malignant melanoma.

PMID- 8472219
TI  - Modified technique for radial artery cannulation.

PMID- 8472221
TI  - The case of Canadian general surgeons: getting the message heard.
AB  - The problem of physician resources is at the top of the health care policy
      agenda, and physicians are faced with the challenge of change. General surgeons,
      like others, must address the changes in health care needs and demands,
      technology, information and funding. This paper begins with a demographic and
      workload profile of general surgery based on data provided by the Canadian
      Medical Association's Physician Resource Questionnaire (PRQ). The findings
      indicate the following: the supply of general surgical procedures has been
      declining; general surgeons are older than other specialists; and the proportion
      of women in general surgery is lower than that of the profession as a whole. The
      practice profile of general surgery is also changing because of advances in
      technology and information and the changing practice of subspecialists. Changes
      affecting general surgery raise important questions regarding future physician
      resource policies. The medical profession's involvement in the area of physician
      resources at the national level is outlined, with a particular focus on the role
      of the Canadian Medical Association. It is important that general surgeons become
      involved in the discussion, since the policy decisions made today will affect the
      future practice of general surgery.

PMID- 8472220
TI  - State of the art of venous investigation and treatment.
AB  - OBJECTIVE: To discuss current investigative and treatment modalities in all
      venous problems, ranging from telangiectasia to chronic venous insufficiency.
      DATA SOURCES: A thorough review of current literature plus the author's personal
      experience and ideas. DATA SYNTHESIS: Clinical interest and research into venous
      disease is increasing. Despite advanced investigative technology, the definitive
      management of chronic venous insufficiency remains controversial. Deep valvular
      reconstruction is now possible; however, indications for this type of procedure
      are rare. CONCLUSION: The renewed interest in venous disease will likely lead to
      specific treatments for all aspects of venous disease, especially for chronic
      venous insufficiency.

PMID- 8472222
TI  - A perspective on tumour progression.
AB  - During their natural history, tumours may acquire new phenotypic traits. This
      process, tumour progression, becomes clinically important when tumours acquire
      the ability to invade and metastasize or when they develop drug resistance. An
      acquired genetic instability modulated by selection likely contributes to this
      progression. More than one genetic mechanism is probably involved, a small number
      of point mutations being complemented by karyotypic events, gene amplification
      and altered gene expression. More complicated traits, such as the ability to
      invade and metastasize, may be acquired through the inappropriate and
      disorganized reexpression of genetic programs suppressed during embryologic
      development.

PMID- 8472223
TI  - Pin-site radioulnar synostosis after external fixation of a distal radial
      fracture: two case reports.
AB  - Complications of distal radial fracture and external fixation are common, but the
      authors report, in two patients, a previously unrecognized complication, that of
      radioulnar synostosis. In both cases the proximally placed pins extended across
      the interosseous region, and the distal ends were adjacent to the ulna. Hematoma
      and osseous debris were introduced into the interosseous region. Several weeks
      after the external fixator was removed, the patients were noted to have a
      restricted range of pronation and supination. A radioulnar synostosis had formed
      across the interosseous region. Resection of the synostosis restored pronation
      and supination. With careful pin placement this complication will be avoided.

PMID- 8472224
TI  - Initial nonfunction in cadaveric renal transplantation.
AB  - Patients who receive a kidney transplant that does not function immediately have
      more complications and decreased graft survival than patients whose allografts
      function immediately. To determine the causes of initial nonfunction (INF), the
      authors reviewed 188 consecutive cadaveric kidney transplants performed between
      1985 and 1988 at the University Hospital, London, Ont. Data were collected on 16
      putative risk factors for INF, which were divided into three categories: donor,
      recipient and technical. INF was defined as the need for dialysis within 7 days
      of transplantation. Forty-eight (26%) of the 188 allografts had INF, 6 of which
      never functioned. Univariate analysis identified five variables associated with
      increased risk of INF: no donor dopamine use, back-table flush, single-organ
      retrieval, exchanged kidney and prolonged cold ischemic time. Multivariate
      analysis, however, identified only three variables associated with INF:
      cerebrovascular accident as the cause of donor death, no donor dopamine use and
      single-organ retrieval. The authors recommend (a) low-dose dopamine therapy for
      all donors and (b) multiorgan retrieval to produce quality kidneys for
      transplantation.

PMID- 8472225
TI  - Verrucous carcinoma of the genital tract: is it a distinct entity?
AB  - Between 1974 and 1985, 16 patients (7 men, 9 women) with a diagnosis of genital
      verrucous carcinoma were identified from the cancer registry of the Tom Baker
      Cancer Centre in Calgary. All the men had lesions on the penis. In the women,
      five lesions were on the vulva, four were on the cervix and two were on the
      vagina (two women each had two involved sites). The histologic slides from the
      surgically excised specimens were reviewed, and, by applying strict criteria, all
      cases could be reclassified as giant condyloma (five cases), intraepithelial
      neoplasia with or without condylomatous features (eight cases) or invasive
      squamous cell carcinoma (five cases). The authors believe that, in genital
      lesions associated with the human papillomavirus, a diagnosis of verrucous
      carcinoma is nonspecific and may lead to inappropriate clinical management.

PMID- 8472226
TI  - "No stent, no diversion" Mathieu hypospadias repair.
AB  - The Mathieu procedure is a surgical technique for anterior hypospadias repair.
      The disadvantage of this technique is the prolonged hospital stay associated with
      postoperative urinary diversion. In an effort to reduce the length of hospital
      stay the authors carried out a prospective study to determine the usefulness of
      urethral stents and urinary diversion after Mathieu repair. Seventeen boys (mean
      age 4.1 years) formed the experimental group, and 19 boys (mean age 4.6 years)
      served as controls. Urinary diversion and urethral stents were used
      postoperatively in the control group but not in the experimental group. After a
      minimum of 6 months of observation the complications noted in both groups were
      found to be similar. The authors conclude that urinary diversion and urethral
      stents have no beneficial effects on surgical outcome but do prolong hospital
      stay.

PMID- 8472227
TI  - The morbidity of abdominal hysterectomy.
AB  - OBJECTIVE: To determine the morbidity of abdominal hysterectomy. DESIGN:
      Descriptive. Physician billings to the Quebec Health Care Plan in the 1-month
      period after abdominal hysterectomy were examined. SETTING: Operations performed
      in 102 hospitals in the Province of Quebec between Jan. 1, 1989, and Mar. 31,
      1989, were selected. PATIENTS: The study group included 3322 patients who had
      abdominal hysterectomy. Patients who had vaginal or abdominal hysterectomy for
      invasive cancer or pregnancy-related complications were excluded. A patient was
      considered to be morbid if the physician's intervention indicated concern for the
      patient's well-being. MAIN OUTCOME MEASURES: Multiple logistic regression
      analysis to determine the adjusted rate ratio for inclusion in a categorical list
      of morbid patients among different subsets of surgeons, hospitals and patients.
      RESULTS: Postoperative morbidity occurred in 646 patients (19.5%), who spent an
      average of 1.7 days longer in the hospital than patients with no postoperative
      morbidity. There were two postoperative deaths (0.1%). Forty-nine patients (1.5%)
      had postoperative surgical intervention. On 119 occasions (3.6%), patients were
      treated in the intensive care unit. A consultation was given by a medical
      specialist in 303 cases (9.1%). The rate ratio for postoperative morbidity was
      not significantly affected by years in practice or specialty of the surgeon but
      was increased for operations performed in mid-sized hospitals. The strongest
      predictor of postoperative morbidity was pre-existing medical disorder (RR).
      CONCLUSION: The major causes of morbidity in patients who undergo abdominal
      hysterectomies are medical rather than surgical.

PMID- 8472228
TI  - An unusual intraoperative complication of stapled colorectal anastomosis: report
      of a case and review of the literature.
AB  - The unusual intraoperative complication of inadvertent formation of a stapled
      colovaginal anastomosis is described in a 61-year-old woman with diverticular
      disease. Intraoperative complications of linear staplers, linear cutters and
      circular end-to-end anastomotic staplers are reviewed, as are methods of
      prevention and management of such complications. The discussion focuses mainly on
      the complications that may arise in low anterior resection. They are more likely
      due to operator error than to instrument failure.

PMID- 8472229
TI  - Foot infections in diabetics: the antibiotic choice.
AB  - The authors studied 59 diabetics with foot infections to determine the organisms
      responsible and the sensitivity to antibiotics. All infections were polymicrobial
      (aerobic and anaerobic). On average 3.2 isolates per culture were obtained from
      the depth of the infection. The commonest organisms in order of frequency were:
      Staphylococcus aureus, beta-hemolytic streptococci, Proteus sp., Bacteroides sp.,
      enterococci, Klebsiella sp. and Pseudomonas aeruginosa. A combination of
      piperacillin and cloxacillin is recommended as initial therapy for foot
      infections in diabetic patients because it was found to be effective for 73% of
      the causative microorganisms.

PMID- 8472230
TI  - Foreign bodies in the rectum.
AB  - Although infrequent, rectal foreign bodies present a challenge in management. The
      authors report on their experience with 29 patients who had rectal foreign
      bodies. Emergency-department procedures included rectal examination, proctoscopy
      and abdominal radiography. Soft or low-lying objects having an edge could be
      grasped and removed safely in the emergency department, but grasping hard objects
      was potentially traumatic and occasionally resulted in upward migration toward
      the sigmoid. Operating-room procedures included anal dilatation under general
      anesthesia, transrectal manipulation, bimanual palpation if necessary and
      withdrawal of the foreign body. In two cases, rectal mucosa was trapped--in an
      open deodorant bottle in one patient and in a curtain rod in the second patient;
      operative release of the mucosa enabled safe removal. Two patients presented with
      peritonitis; both had "broomstick" injuries and required proximal colostomy. Five
      patients had perianal sepsis due to inadvertently ingested pieces of wood (three)
      and chicken bones (two). The mean hospital stay was 3 days (range from 6 hours to
      6 days). There were no deaths. Because of the potential complications, rectal
      foreign bodies should be regarded seriously and treated expeditiously.

PMID- 8472231
TI  - Soft tissue sarcomas: a plea for proper management.
AB  - Although soft tissue sarcomas are relatively uncommon, they often occur in young
      patients and if properly treated are often curable. Unfortunately, inappropriate
      approaches to biopsy before adequate staging may compromise a successful outcome.
      The roles of diagnostic imaging (particularly magnetic resonance imaging) in
      adequate preoperative evaluation and staging and the fundamental principles of
      surgical management are discussed.

PMID- 8472232
TI  - The Advanced Trauma Life Support Program in Manitoba: a 5-year review.
AB  - Twenty Advanced Trauma Life Support (ATLS) courses were conducted at the
      University of Manitoba between 1982 and 1987. There were 302 registrants, 95 of
      whom were from rural communities. Twelve registrants failed the course. The
      impact of the program was assessed by questionnaire (68.8% response overall). The
      response from department heads of surgery in urban hospitals was 87.5% and from
      surgeons in rural areas 50%. Fifty-eight percent of rural surgeons, 62.5% of
      urban surgeons and 75% of urban emergency-department directors claimed they could
      identify those who had attended an ATLS course by the increased confidence
      demonstrated and the use of more timely and appropriate consultation and
      treatment. Thirty percent of rural surgeons, 37% of urban surgeons and 42% of
      emergency-department directors claimed that mortality and morbidity were
      decreased when care was provided by ATLS-trained physicians. The remainder were
      undecided because of lack of information. Ninety-three percent of respondents
      indicated that the course increased their confidence, trauma capability and
      ability to communicate with consultant trauma surgeons. Fifty-two percent thought
      the course should be mandatory for all physicians, and 100% thought it should be
      mandatory for all emergency-department physicians. The data suggest that although
      most physicians treat fewer trauma patients 5 years after their ATLS training,
      the course is still highly recommended, and it has improved trauma care. Although
      the ATLS program was intended primarily for rural physicians, more urban-based
      physicians registered for it.

PMID- 8472234
TI  - Fulfilling a wish.
AB  - As awareness of the need for organ donations grows, so does the frequency of
      requests by terminal patients to become donors. Recently, we experienced just
      such a phenomenon at Plummer Memorial Hospital.

PMID- 8472233
TI  - A comparison between expanded polytetrafluoroethylene and plasma
      tetrafluoroethylene grafts for hemodialysis access.
AB  - Animal studies have indicated that plasma tetrafluoroethylene (TFE) may be a
      better prosthetic material than expanded polytetrafluoroethylene (ePTFE) for
      arteriovenous access in patients who require hemodialysis because it combines the
      advantages of both Dacron and Teflon. A randomized clinical trial to compare the
      two materials was conducted between May 1987 and January 1989. Forty-four
      patients were enrolled, 22 in each group. The status of the grafts was monitored
      for at least 18 months. The patency rate for plasma TFE was 59% and for ePTFE was
      64%. Kaplan-Meier analysis and Wilcoxon testing revealed no statistical
      differences between the two groups. Four grafts became infected, two in each
      group, and one aneurysm developed. Despite its theoretical advantages, plasma TFE
      was found to be similar to ePTFE as a graft material for hemodialysis.

PMID- 8472235
TI  - Medication non-compliance.
AB  - Medication non-compliance is a perplexing, pervasive and poorly understood
      problem. Historically, the medical community viewed it as an act of defiance. But
      in recent years nurses have challenged that position, instead seeing non
      compliance as behavior that can be intentional or unintentional; detrimental or,
      on occasion, beneficial.

PMID- 8472236
TI  - Nursing: the endangered profession?
AB  - The history of nursing illustrates patterns that continue to threaten the
      recruitment and retention of nurses today. Three contemporary examples illustrate
      key dilemmas the nursing profession is facing. They also provide us with clues to
      patterns and themes that have recurred throughout our history.

PMID- 8472237
TI  - Rekindling the nursing diagnosis flame.
AB  - In today's complex and rapidly changing health care environment, it is not enough
      for nurses to possess advanced technological skills. Rather, they need clinical
      judgement, decision-making and diagnostic skills far beyond previous
      expectations.

PMID- 8472238
TI  - Treating nocturnal enuresis.
AB  - Nocturnal enuresis, commonly known as bedwetting, is described in documents
      dating from 1550 BC. Derived from the Greek word enourein, meaning "in urine" or
      "inability to control urination," it occurs in 15 to 20 per cent of five year
      olds and is twice as common in boys as girls. Indeed, no cure has yet been found
      and thousands of children and their families live with the distress the condition
      causes. Among affected children, this often includes behavioral problems and low
      self-esteem.

PMID- 8472239
TI  - Innovation through collaboration.
AB  - In light of the Canadian Nurses Association's position that the baccalaureate
      degree would be the requirement for entry to practice by the year 2000, plus
      evidence of a rapidly changing health care system, changing client
      characteristics, and on-going economic constraints, administrators of nursing
      programs in Edmonton recognized the need for a more process-oriented curriculum
      to prepare nurses to be more capable of facing future challenges. Not
      surprisingly, limited funds and differing human and material resources meant they
      could not complete a major curriculum change individually. Collaboration proved
      to be the key that increased access to baccalaureate nursing education in
      Alberta.

PMID- 8472240
TI  - Toxoplasmosis and pregnancy.
AB  - Toxoplasmosis is an infection caused by the protozoa toxoplasma gondii that is
      prevalent worldwide. The protozoa was given its name when it was first isolated
      in 1909 in Africa in a rodent, Ctenodactylus gondii. It can be contracted by
      eating infected meat or eggs that are raw or undercooked, or through contact with
      the feces of an infected cat. More dangerously, it can be congenitally acquired
      by transfer through the placenta if the mother contracts the disease during
      pregnancy. Although the flu-like symptoms of the disease can be mild in adults
      (fatigue, muscle spasms, lymphadenopathy) or often subclinical, infants who
      acquired the disease congenitally face severe mental and physical problems.

PMID- 8472241
TI  - Unmarried motherhood.
AB  - In the past, the children of unmarried women were stigmatized and treated as
      second-class citizens by both society and the law. As societal attitudes have
      become more tolerant, however, the laws have been changed to ensure equality for
      all children. Despite this, there is little evidence to show that the children of
      unmarried mothers receive the rights guaranteed them by law, or that the birth
      parents and caregivers are even aware of those rights.

PMID- 8472242
TI  - Powering up our professional image.
AB  - Traditionally, women have been society's healers. The practices of healing were
      closely associated with organized churches. Nursing developed to give women an
      opportunity to do God's work. Since caring and nurturing were believed to be
      innate characteristics of women, nursing offered an opportunity to express these
      attributes in an appropriate and productive way.

PMID- 8472243
TI  - [Preoperative structured patient education].
AB  - This article describes the factors that motivated the nursing staff of the
      cardiac surgery unit at the Royal Victoria Hospital in Montreal, to revise their
      preoperative teaching program. The motivating factors described are the length of
      the preoperative waiting period; the level of preoperative anxiety; the decreased
      length of hospital stay; the dissatisfaction of the nursing staff with current
      patient teaching practices; and the lack of available resources. The
      reorganization of the teaching program was based upon the previously described
      factors combined with a review of the literature that demonstrated the impact of
      preoperative anxiety, emotional support and psycho-educational interventions upon
      the client's recovery. The goals of the new teaching program are to provide the
      client and the family with cognitive and sensory information about the client's
      impending hospitalization, chronic illness and necessary lifestyle modifications.
      The program consists of a system of telephone calls during the preoperative
      waiting period; a videotape viewing; a tour of the cardiac surgery unit; informal
      discussion groups; and the availability of nursing consultation to decrease
      preoperative anxiety. The end result of these interventions is more time for
      client support and integration of necessary information by the client and family.
      This kind of program has the potential to provide satisfaction at many levels by
      identifying client's at risk; increasing client knowledge; increasing support;
      decreasing anxiety during the preoperative waiting period; and decreasing the
      length of hospital stay. The nursing staff gained a heightened sense of
      accomplishment because the program was developed according to the nursing
      department's philosophy, which includes primary nursing.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8472244
TI  - [Quality of services in a small hospital].
AB  - The nursing services department of a 64 bed hospital in Caraquet, New Brunswick,
      (serving a widespread population of 25,000 people) decided to check the quality
      of care offered to their patients. A search was conducted among numerous quality
      of care management models to find the one that best suited their needs. They
      chose a structured quality appraisal and management program currently being used
      by the Royal Victoria Hospital in Montreal. The author outlines the way quality
      assurance directors in this Montreal hospital empower their health care
      providers. The author describes the concept of quality and summarizes the
      oriental and occidental ideologies that influence it. The nursing staff's
      perception of the essential elements of quality assurance are explained and the
      stages are identified. The author maintains that decentralization and delegation
      empowers individuals and instills confidence while maintaining the essential
      personal touch. She believes that the organization of the future is one that will
      promote teamwork. She also believes that motivation, participative management and
      workplace satisfaction promote quality care--"care that doesn't cost a dime."
      This program has numerous advantages. It allows employees to fully participate in
      the process. It also averts potential problems, and provides employees with the
      ability to discover and problem solve when necessary. It also allows for the
      strengths and weaknesses of each service to be outlined and identified
      deficiencies corrected.

PMID- 8472245
TI  - Pathogenesis and pathophysiology of bacterial meningitis.
AB  - Bacterial meningitis remains a disease with associated unacceptable morbidity and
      mortality rates despite the availability of effective bactericidal antimicrobial
      therapy. Through the use of experimental animal models of infection, a great deal
      of information has been gleaned concerning the pathogenic and pathophysiologic
      mechanisms operable in bacterial meningitis. Most cases of bacterial meningitis
      begin with host acquisition of a new organism by nasopharyngeal colonization
      followed by systemic invasion and development of a high-grade bacteremia.
      Bacterial encapsulation contributes to this bacteremia by inhibiting neutrophil
      phagocytosis and resisting classic complement-mediated bactericidal activity.
      Central nervous system invasion then occurs, although the exact site of bacterial
      traversal into the central nervous system is unknown. By production and/or
      release of virulence factors into and stimulation of formation of inflammatory
      cytokines within the central nervous system, meningeal pathogens increase
      permeability of the blood-brain barrier, thus allowing protein and neutrophils to
      move into the subarachnoid space. There is then an intense subarachnoid space
      inflammatory response, which leads to many of the pathophysiologic consequences
      of bacterial meningitis, including cerebral edema and increased intracranial
      pressure. Attenuation of this inflammatory response with adjunctive dexamethasone
      therapy is associated with reduced concentrations of tumor necrosis factor in the
      cerebrospinal fluid, with diminished cerebrospinal fluid leukocytosis, and
      perhaps with improvement of morbidity, as demonstrated in recent clinical trials.
      Further information on the pathogenesis and pathophysiology of bacterial
      meningitis should lead to the development of more innovative treatment and/or
      preventive strategies for this disorder.

PMID- 8472246
TI  - Role of iron in regulation of virulence genes.
AB  - The abilities of bacterial pathogens to adapt to the environment within the host
      are essential to their virulence. Microorganisms have adapted to the iron
      limitation present in mammalian hosts by evolving diverse mechanisms for the
      assimilation of iron sufficient for growth. In addition, many bacterial pathogens
      have used the low concentration of iron present in the host as an important
      signal to enhance the expression of a wide variety of bacterial toxins and other
      virulence determinants. The molecular basis of coordinate regulation by iron has
      been most thoroughly studied in Escherichia coli. In this organism, coordinate
      regulation of gene expression by iron depends on the regulatory gene, fur.
      Regulation of gene expression by iron in a number of pathogenic organisms is
      coordinated by proteins homologous to the Fur protein of E. coli. Additional
      regulatory proteins may be superimposed on the Fur repressor to provide the fine
      tuning necessary for the precise regulation of individual virulence genes in
      response to iron and other environmental signals. Studies of the mechanisms of
      regulation of iron acquisition systems and virulence determinants by iron should
      lead to a better understanding of the adaptive response of bacteria to the low
      iron environment of the host and its importance in virulence.

PMID- 8472250
TI  - Synthesis and conformational analysis of muramic acid delta-lactam structures and
      their 4-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl) derivatives, characteristic
      of bacterial spore peptidoglycan.
AB  - 1,6-Anhydro-4-O-benzyl-beta-muramic acid 1',2-lactam (2) was prepared by
      reduction of 1,6-anhydro-2-azido-4-O-benzyl-2-deoxy-3-O-[(R)-1-
      methoxycarbonylethyl]-beta-D-glucopyranose (1) followed by cyclisation.
      Debenzylation of 2 (-->3) and glycosylation of HO-4 with 3,4,6-tri-O-acetyl-2-
      deoxy-2-phthalimido-beta-D-glucopyranosyl chloride afforded 75% of a beta-(1-->4)
      linked disaccharide derivative (7). Removal of the Phth group from 7, then
      acetylation, and O-deacetylation yielded 4-O-(2-acetamido-2-deoxy-beta-D
      glucopyranosyl)-2-amino-1,6-anhydro-3-O- [(R)- 1-carboxyethyl]-2-deoxy-beta-D
      glucopyranose 1',2-lactam (10) Acetolysis of the 1,6-anhydro ring in the 4
      acetate (4) of 3 and the 3',4',6'-triacetate (9) of 10, with saponification of
      the products 5 and 11, afforded 2-amino-3-O- [(R)-1-carboxyethyl]-2-deoxy-D
      glucopyranose 1',2-lactam (6) and 4-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)
      2-amino-3- O-[(R)-1-carboxyethyl]-2-deoxy-beta-D-glucopyranose 1',2-lactam (12),
      respectively. The structure of 12 corresponds to that of the disaccharide unit
      characteristic of the glycan chains of bacterial spore peptidoglycan. 1H NMR
      spectroscopy indicated that the beta-D-glucopyranose ring in the 1,6-anhydro 1',2
      lactam derivatives adopts the BO,3 conformation. On cleavage of the 1,6-anhydro
      ring by acetolysis, the D-glucopyranose ring adopts the 4C1 conformation. X-ray
      analysis of 2, 4, and 5 confirmed the proposed structures. Molecular mechanics
      and molecular dynamics simulations were used to follow the transformation of the
      BO,3 conformation of the D-glucopyranose ring via transition states to the 4C1
      form.

PMID- 8472251
TI  - Iodonium ion-assisted synthesis of a haptenic tetrasaccharide fragment
      corresponding to the inner cell-wall glycopeptidolipid of Mycobacterium avium
      serotype 4.
AB  - Condensation of ethyl 2,4-di-O-benzoyl-1-thio-alpha-L-rhamnopyranoside with ethyl
      3-O-benzyl-4-O-chloroacetyl-2-O-methyl-1-thio-beta-L-fucopyranoside in the
      presence of iodonium di-sym-collidine perchlorate afforded exclusively ethyl 2,4
      di-O-benzoyl-3-O-(3-O-benzyl-4-O- chloroacetyl-2-O-methyl-alpha-L-fucopyranosyl)
      1-thio-alpha-L-rhamnop yra noside. This disaccharide derivative was extended at C
      1 with 3-benzyloxycarbonylaminopropyl 6-deoxy-3,4-O-isopropylidene-alpha-L-
      talopyranoside, using N-iodosuccinimide and triflic acid as the catalyst, to
      furnish 3-benzyloxycarbonylaminopropyl 6-deoxy-2-O-[2,4-di-O-benzoyl-3-O-(3-O
      benzyl-4-O-chloroacetyl-2-O-me thy l- alpha-L-fucopyranosyl)-alpha-L
      rhamnopyranosyl]-3,4-O-isopropylidene-alp ha-L- talopyranoside (20). Selective
      removal of the chloroacetyl group from 20, followed by condensation with ethyl
      2,3-di-O-benzoyl-4-O-methyl-1-thio-alpha-L- rhamnopyranoside in the presence of
      the same thiophilic promoter, yielded a fully protected tetrasaccharide
      derivative. Deprotection of the latter gave the target compound 3-aminopropyl 6
      deoxy-2-O-[3-O-[2-O- methyl-(4-O-methyl-alpha-L-rhamnopyranosyl)-alpha-L
      fucopyranosyl]-alpha -L- rhamnopyranosyl]-alpha-L-talopyranoside (1).

PMID- 8472248
TI  - Pathogenesis of infections related to intravascular catheterization.
AB  - Over the past few decades, there have been major technological improvements in
      the manufacture of intravenous solutions and the manufacture and design of
      catheter materials. However, the risk of infection in patients receiving infusion
      therapy remains substantial, in part because of host factors (for example,
      increased use of immunosuppressive therapy, more aggressive surgery and life
      support, and improved survival at the extremes of life) and in part because of
      the availability of catheters that can be left in place for very long periods.
      Microbial components of normal skin flora, particularly coagulase-negative
      staphylococci, have emerged as the predominant pathogens in catheter-associated
      infections. Therefore, efforts to prevent skin microorganisms from entering the
      catheter wound (such as tunnelling of catheters and use of catheter cuffs and
      local antimicrobial agents) are logical and relatively effective. The specific
      properties of microorganisms that transform normally harmless commensals such as
      coagulase-negative staphylococci into formidable pathogens in the presence of a
      plastic foreign body are being explored. For example, Staphylococcus epidermidis
      elaborates a polysaccharide adhesin that also functions as a capsule and is a
      target for opsonic killing. However, the interactions between microorganism and
      catheter that lead to adherence, persistence, infection, and dissemination appear
      to be multifactorial.

PMID- 8472252
TI  - A convenient synthesis of lacto-N-biose I [beta-D-Gal p-(1-->3)-beta-D- Glc pNAc]
      linked oligosaccharides from phenyl O-(tetra-O-acetyl-beta-D- galactopyranosyl)
      (1-->3)-4,6-di-O-acetyl-2-deoxy-2-phthalimido-1-thio- beta-D- glucopyranoside.

PMID- 8472247
TI  - Physical and chemical methods for enhancing rapid detection of viruses and other
      agents.
AB  - Viral replication events can be enhanced by physical, chemical, or heat treatment
      of cells. The centrifugation of cells can stimulate them to proliferate, reduce
      their generation times, and activate gene expression. Human endothelial cells can
      be activated to release cyclo-oxygenase metabolites after rocking for 5 min, and
      mechanical stress can stimulate endothelial cells to proliferate. Centrifugation
      of virus-infected cultures can increase cytopathic effects (CPE), enhance the
      number of infected cells, increase viral yields, and reduce viral detection times
      and may increase viral isolation rates. The rolling of virus-infected cells also
      has an effect similar to that of centrifugation. The continuous rolling of virus
      infected cultures at < or = 2.0 rpm can enhance enterovirus, rhinovirus,
      reovirus, rotavirus, paramyxovirus, herpesvirus, and vaccinia virus CPE or yields
      or both. For some viruses, the continuous rolling of infected cell cultures at 96
      rpm (1.9 x g) is superior to rolling at 2.0 rpm for viral replication or CPE
      production. In addition to centrifugation and rolling, the treatment of cells
      with chemicals or heat can also enhance viral yields or CPE. For example, the
      treatment of virus-infected cells with dimethyl sulfoxide can enhance viral
      transformation, increase plaque numbers and plaque size, increase the number of
      cells producing antigens, and increase viral yields. The infectivity of fowl
      plague virus is increased by 80-fold when 4% dimethyl sulfoxide is added to
      culture medium immediately after infection. The heat shocking of virus-infected
      cells also has been shown to have a stimulatory effect on the replication events
      of cytomegalovirus, Epstein-Barr virus, and human immunodeficiency virus. The
      effects of motion, chemicals, or heat treatments on viral replication are not
      well understood. These treatments apparently activate cells to make them more
      permissive to viral infection and viral replication. Perhaps heat shock proteins
      or stress proteins are a common factor for this enhancement phenomenon. The
      utility of these treatments alone or in combination with other methods for
      enhancing viral isolation and replication in a diagnostic setting needs further
      investigation.

PMID- 8472253
TI  - A novel regioselective desulfation of polysaccharide sulfates: Specific 6-O
      desulfation with N,O-bis(trimethylsilyl)acetamide.

PMID- 8472249
TI  - Paracoccidioidomycosis: an update.
AB  - This review summarizes knowledge on various aspects of paracoccidioidomycosis.
      Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal
      dimorphism; arthroconidia are infectious in animals and, by electron microscopy,
      appear well provided for survival. The mycelial-to-yeast-phase transformation
      requires a strict control of glucan synthesis probably mediated by membrane
      enzymes. Hormonal influences on the transformation of the fungus (mycelium or
      conidium to yeast phase) have been demonstrated. Estrogen-binding proteins have
      been detected in the fungal cytosol, and during the transformation novel proteins
      are produced as a result of estradiol incorporation. Clinical forms have been
      better defined on the basis of better experimental models. Emphasis has been
      placed on the lungs as the portal of entry and on the existence of silent
      pulmonary infections. A specific Paracoccidioides brasiliensis antigen, the 43
      kDa glycoprotein (Gp43), has been identified, characterized, and cloned. This has
      led to improved reproducibility and specificity of serologic tests. The
      depression of cell-mediated immune responses has been associated with severe
      disease in humans and in the experimental host. T-cell subsets in patients'
      tissues were characterized by means of monoclonal antibodies, and a reduced
      CD4/CD8 ratio was demonstrated. This has been related to alterations in
      lymphokine and tumor necrosis factor production, production of antigen-antibody
      complexes, etc. Amphotericin B has provided effective therapy. Azole derivatives
      have also improved prognosis and facilitated therapy. Itraconazole is presently
      the drug of choice, yet incapacitating sequelae (mainly pulmonary fibrosis) still
      constitute major problems.

PMID- 8472254
TI  - The gum exudate of Encephalartos friderici-guilielmi.
AB  - Studies of the structure of the polysaccharide gum exudate from Encephalartos
      friderici-guilielmi (a Cycad) confirmed its resemblance to those from other
      species of the same genus. Partial acid hydrolysis gave numerous products which
      showed a strong correlation with those from E. longifolius gum. The course of
      sequential Smith degradations was monitored by analysis of the molecular weights
      and composition of the products. The mild acid-hydrolysis step of the Smith
      degradation proceeded in two stages, the second being very slow but yielding a (1
      ->3)-D-galactan with < 20% of other residues (D-mannose, and some L-arabinose and
      L-rhamnose). A tentative formulation of the gum shows L-rhamnose and D-glucuronic
      acid residues exterior to a branched D-galactan framework; these structures are 3
      linked to D-mannose, through D-galactopyranosyl or possibly L-arabinopyranosyl
      residues, within mannoglucuronoglycan chains. Other units occupy O-4 of D
      mannose.

PMID- 8472256
TI  - Synthesis of plasmalopsychosines A and B two novel lysosphingolipids found in
      human brain.

PMID- 8472255
TI  - Structure elucidation of a novel acidic tetrasaccharide and hexasaccharide
      derived from a chemically modified heparin.

PMID- 8472257
TI  - Determination of the position of the O-acetyl group in a beta-(1-->4)-mannan
      (acemannan) from Aloe barbardensis Miller.

PMID- 8472258
TI  - Location of a second O-acetyl group in xanthan gum by the reductive-cleavage
      method.

PMID- 8472259
TI  - Selective deacylation on the glucosyl moiety of octa-O-acetylsucrose by enzymic
      hydrolysis: formation of 2,1',3',4',6'-penta-O-acetylsucrose.

PMID- 8472260
TI  - Inclusion complexes of cyclomaltoheptaose (beta-cyclodextrin) and its methylated
      derivatives with the main components of the pheromone of the olive fruit fly.
AB  - The inclusion complexes of cyclomaltoheptaose (beta CD) and heptakis(2,3,6-tri-O
      methyl)cyclomaltoheptaose (TM-beta CD) with the four major components of the
      pheromone of the olive fruit fly (Dacus oleae), namely 1,7
      dioxaspiro[5.5]undecane, (-)-alpha-pinene, nonanal, and ethyl dodecanoate, and
      the complex of heptakis(2,6-di-O-methyl)cyclomaltoheptaose (DM-beta CD) with 1,7
      dioxaspiro[5.5]undecane were studied. The complexes were characterised in the
      solid state by differential scanning calorimetry and X-ray powder diffraction. In
      aqueous solution, the structure of the complexes was investigated by 1H NMR
      spectroscopy. In solution, 1,7-dioxaspiro[5.5]undecane, (-)-alpha-pinene, and
      nonanal enter the cavity of the cyclo-oligosaccharides. Association constants for
      some of these complexes were also measured. The complexes of ethyl dodecanoate
      did not provide evidence of their structure in solution. This was attributed to
      the existence of negligible amounts of these complexes in water due to the
      combined effects of low solubility and low association constant.

PMID- 8472261
TI  - Crystal structure of 2,5-anhydro-1-O-(p-tolylsulfonyl)-D-mannitol.
AB  - 2,5-Anhydro-1-O-(p-tolylsulfonyl)-D-mannitol, C13H18SO7, Mr = 318.4, monoclinic,
      C2, a = 26.370(6), b = 7.9741(11), c = 6.6801(6) A, beta = 91.401(11) degrees, V
      = 1404.3(6) A3, Z = 4, DX = 1.506 g/cm3, CuK alpha, lambda = 1.54184 A, mu =
      23.03 cm-1, F(000) = 672, T = 296(1) K, R = 0.042 for 2832 observations with I >
      3 sigma (I) (of 2864 unique data). On the esterified side of the molecule, three
      bond lengths and three bond angles show small changes compared to the
      unesterified side, which is similar to the symmetrical parent compound, 2,5
      anhydro-D-mannitol. The conformation of the five-membered ring is E5 with P =
      49.3 degrees and tau m = 38.1 degrees. The hydroxymethyl groups adopt g+ and g-
      dispositions similar to the parent molecule. The three hydroxyl groups are
      involved in a network of intermolecular hydrogen bounds both as donors and
      acceptors.

PMID- 8472262
TI  - The crystal and molecular structure of beta-D-fructofuranosyl alpha-D
      xylopyranoside hemihydrate.
AB  - The crystal and molecular structure of beta-D-fructofuranosyl alpha-D
      xylopyranoside (xylosucrose) hemihydrate, C11H20O10.0.5H2O, is orthorhombic,
      P2(1)2(1)2, with a = 20.919(5), b = 18.727(2), c = 7.071(1) A, V = 2770.1(2) A3,
      Z = 8, and Dx = 1.541 g.cm-3. The structure was solved by direct methods and
      refined to R = 0.040 for 2564 observed reflections. Two independent xylosucrose
      molecules exist in the unit cell, and their conformations about the 1-->2'
      glycosidic bond are similar to sucrose. The orientations of the primary hydroxyl
      groups in the two molecules differ. An O-1'...O-2 intramolecular hydrogen bond
      was observed in the one molecule, while an O-6'...O-5 intramolecular hydrogen
      bond was observed in the other involving disorder of O-6'.

PMID- 8472263
TI  - A new approach to the chemical synthesis of the trisaccharide, and the terminal
      di- and mono-saccharide units of the major, serologically active glycolipid from
      Mycobacterium leprae.
AB  - The key intermediates for the synthesis of p-trifluoroacetamidophenyl O-(3,6-di-O
      methyl-beta-D-glucopyranosyl)-(1-->4)-O-(2,3-di-O-methyl-alp ha-L-
      rhamnopyranosyl)-(1-->2)-3-O-methyl-alpha-L-rhamnopyranoside (15), as well as p
      trifluoroacetamidophenyl O-(3,6-di-O-methyl-beta-D- glucopyranosyl)-(1-->4)-2,3
      di-O-methyl-alpha-L-rhamnopyranoside (29), were the methyl and ethyl O-(2-O
      benzyl-4,6-O-benzylidene-3-O-methyl-beta- D-glucopyranosyl)-(1-->4)-2,3-O
      diphenylmethylene-1-thio-alpha-L- rhamnopyranosides (10 and 24). Dichloroalane
      treatment of 10 and 24 removed the diphenylmethylene group, liberating HO-2 and
      HO-3 of the rhamnopyranoside residue, and opened the benzylidene acetal
      regioselectively to give the 4-O-benzyl-glucopyranosyl disaccharides. Methylation
      of the free OH groups resulted in the tetra-O-methyl 1-thio disaccharides (12 and
      26), useful as glycosyl donors. Introduction of these temporary blocking groups
      allowed a drastic reduction in the number of synthetic steps to the target
      compounds.

PMID- 8472264
TI  - Ischaemic myocardial injury and ventricular remodelling.

PMID- 8472265
TI  - Stress proteins--an endogenous route to myocardial protection: fact or fiction?

PMID- 8472266
TI  - Understanding the jargon: a glossary of terms used (and misused) in the study of
      ischaemia and reperfusion.

PMID- 8472267
TI  - Lack of inotropic effect of cyclosporin A in isolated guinea pig left atria.
AB  - OBJECTIVE: Cyclosporin A is being widely used to prevent graft rejection in organ
      transplantation and to treat autoimmune diseases. Since various toxic side
      effects have been observed, the aim of this study was to look for even a subtle
      deleterious effect of cyclosporin A on cardiac inotropy in electrically
      stimulated guinea pig left atria. METHODS: The left atrial muscles of guinea
      pigs, in Tyrode's solution containing 2.7 or 5.4 mM potassium, were electrically
      stimulated by one of two methods: (1) continuously at 3 Hz, during which
      cyclosporin A was applied cumulatively (from 10(-9) to 10(-5) M); or (2)
      stimulated intermittently at 2.5 Hz in 5 mM cyclosporin A, with rest periods of 4
      s duration interposed every 4 min. The effects of cyclosporin A on contractile
      force were observed for 150 min in the first stimulation method, and the effects
      on the steady state contractile force and amplitude of post-rest contraction were
      observed for 240 min in the second method. RESULTS: The steady state contractile
      force of the atria declined within the 4 h period at 2.7 mM potassium in Tyrode's
      solution both in the cyclosporin A group (n = 10) and in the control group (n =
      5) to 68(SD 11)% and to 63(4)%, respectively. After 4 h the amplitudes of the
      post-rest contraction were 101(16)% and 101(4)% in cyclosporin A and control
      groups, respectively. At 5.4 mM potassium, the following values were obtained
      (cyclosporin A v control): steady state force 70(8)% (n = 11) v 69(8)% (n = 5);
      post-rest force 105(9)% v 102(7)%. CONCLUSIONS: Cyclosporin A does not influence
      the steady state contractile force or the amplitude of the post-rest contraction,
      suggesting the absence of inotropic effects on isolated guinea pig left atria.

PMID- 8472268
TI  - Increased elastin content and decreased elastin concentration may be predisposing
      factors in dissecting aneurysms of human thoracic aorta.
AB  - OBJECTIVE: The aim was to investigate whether changes in elastin distribution in
      the thoracic aorta are associated with occurrence of dissecting aneurysms.
      METHODS: Ten thoracic aortas were obtained at necropsy from dissections (mean
      patient age 74.3 years, SD 7.3) and from 10 age matched controls (mean age 73.1
      years, SD 6.9). Full wall thickness samples (1 cm diameter) were taken at 12
      sites between heart and diaphragm from aortas of dissections and controls.
      Elastin content (total elastin per sample), concentration (mg.mg-1 tissue dry
      weight), degree of cross linking, and amino acid composition were determined.
      RESULTS: Comparison of areas of dissected aortas involved in dissection with
      corresponding areas of controls showed significant increases in content of
      elastin (p < 0.05), content and concentration of proteins other than elastin and
      collagen (p < 0.01), and a decrease in elastin concentration (p < 0.01).
      Comparison of areas remote from dissection with corresponding areas in controls
      showed no significant differences except for decreased elastin concentration (p <
      0.05). There were no differences in elastin cross linking. Elastin from dissected
      aortas had a higher content of aspartate, threonine, serine, glutamate, and
      lysine and a lower content of glycine, alanine, and valine than elastin from
      controls (p < 0.05). CONCLUSIONS: Biochemical changes in dissections are
      localised to the dissected area, with increased deposition of elastin, collagen,
      and other proteins. The altered matrix composition is likely to change the
      mechanical properties, possibly increasing the tendency to rupture.

PMID- 8472269
TI  - Effects of arterial distensibility on left ventricular ejection in the depressed
      contractile state.
AB  - OBJECTIVE: The aim was to evaluate the effects of arterial distensibility on
      ventricular ejection in various ventricular contractile states: (1) control; (2)
      a regionally depressed contractile state due to left circumflex coronary artery
      occlusion (ligation); (3) a globally depressed contractile state induced by
      lignocaine (lignocaine); and (4) a globally augmented contractile state due to
      dobutamine infusion (dobutamine). METHODS: Arterial compliance was decreased from
      2.3 x 10(-4) dyne-1.cm5 (C2.3) to 0.4 x 10(-4) dyne-1.cm5 (C0.4), maintaining
      other afterload components and left ventricular end diastolic pressure constant.
      Nine excised perfused and paced canine hearts, supported from donor dogs, were
      used. RESULTS: In control, ligation, lignocaine, and dobutamine groups, the
      difference in cardiac output between the compliance values of C0.4 and C2.3 was
      124(SEM 32), 204(36), 163(33), and 130(24) ml, respectively. Thus cardiac output
      at C0.4, as a percentage of that at C2.3, was 88(2.8)% (control), 75(2.9)%
      (ligation), 82(2.9)% (lignocaine), and 88(2.4)% (dobutamine), respectively:
      control v ligation, and lignocaine v ligation, p < 0.001; control v lignocaine,
      and dobutamine v ligation, p < 0.01. Stroke work at C0.4 decreased in the
      ligation group (63%, p < 0.001) and in the lignocaine group (70%, p < 0.001).
      CONCLUSIONS: When cardiac dysfunction is already present, decreased arterial
      distensibility has a further deleterious effect on cardiac output. This may be
      due to the fact that the pressure at the end of ejection is higher and as a
      result the change in dimension during ejection is considerably reduced,
      especially in cases with depressed cardiac function caused by afterload
      dependency.

PMID- 8472270
TI  - Cardiac transplantation affects ventricular expression of brain natriuretic
      peptide.
AB  - OBJECTIVE: The aim was to examine the ventricular expression of brain natriuretic
      peptide (BNP) in the transplanted human heart. METHODS: Serial right ventricular
      biopsies (n = 68) and plasma samples (n = 68) were obtained for measurement of
      BNP and atrial natriuretic peptide (ANP) from 14 orthotopic cardiac transplant
      recipients from 1-74 weeks after transplantation. Right ventricular specimens (n
      = 10) were also obtained from normal hearts during necropsy as controls. RESULTS:
      Mean ventricular BNP in cardiac transplant recipients was higher (p < 0.05) than
      in normal hearts, at 13531(SEM 2244) pg.mg-1 soluble protein (range 3232-109448)
      v 56(11) pg.mg-1 (range 16-91). Ventricular BNP and ANP values were correlated (r
      = 0.57, p < 0.05). Plasma BNP concentrations were higher (p < 0.05) than plasma
      ANP concentrations, at 202(16) pg.ml-1 (range 84-655) v 100(12) pg.ml-1 (range 8
      484), and were raised (p < 0.05) in comparison with normal plasma BNP
      concentrations of 20(1.8) pg.ml-1 (range 10-23). Mean ventricular BNP was
      correlated with time after transplant (r = 0.72, p < 0.05, n = 68) and with mean
      plasma BNP (r = 0.80, p < 0.05, n = 14). There was no significant relationship
      between BNP levels and intracardiac or systemic blood pressure, or prednisolone
      dose (0.1-0.3 mg.kg-1.d-1). The increase in ventricular BNP with time after
      transplant was not explained by cardiac rejection assessed from histology, and
      plasma BNP was not significantly increased during rejection episodes.
      CONCLUSIONS: High levels of BNP are synthesised and secreted by the transplanted
      human ventricle, and the transplanted ventricle may be an important source of
      circulating BNP. The significant positive association between ventricular BNP and
      time after transplant suggests a possible self compensatory mechanism or
      functional adaptation of the transplanted heart which may be beneficial to
      ventricular function.

PMID- 8472271
TI  - Relationship of abnormal intracellular calcium mobilisation to myocyte
      hypertrophy in human ventricular myocardium.
AB  - OBJECTIVE: Calcium transients in muscles from patients with end stage heart
      failure consist of two components (L1 and L2) at physiological extracellular
      calcium concentrations ([Ca2+]o); the second component (L2) can appear in normal
      human myocardium at high [Ca2+]o. In muscles from end stage heart failure
      patients L2 is associated with significant hypertrophy. To expand these
      observations a group of muscles from control patients with mild hypertrophy but
      without overt heart disease was studied (n = 8), in which a second calcium
      transient component was present during high [Ca2+]o. METHODS: Using the ratio of
      the two components of the calcium transient (L2/L1) seen in trabeculae from heart
      failure patients as a marker of intracellular calcium mobilisation, the
      hypothesis was tested that the extent of abnormality in transsarcolemmal calcium
      flux, and/or sarcoplasmic reticular calcium release and reuptake, correlates with
      the degree of hypertrophy present. RESULTS: In contrast to non-hypertrophied
      myocardium, hypertrophied myocardium from patients without heart failure often
      showed an increase in the L2/L1 ratio at higher [Ca2+]o. Hypertrophied myocardium
      from patients with failure showed a progressive increase in the L2/L1 ratio,
      reflecting further impairment of calcium mobilisation. There was a positive
      correlation between the degree of hypertrophy and calcium mobilisation
      alterations that was enhanced by raised [Ca2+]o. Altered [Ca2+]i mobilisation may
      develop early in the course of hypertrophy, before the onset of clinical signs of
      cardiac dysfunction.

PMID- 8472272
TI  - Impaired contraction and relaxation in skin resistance arteries from patients
      with congestive heart failure.
AB  - OBJECTIVE: The aim was to determine the pharmacological reactivity of human small
      resistance arteries in patients with cardiac failure. METHODS: Small arteries (<
      300 microns internal diameter) were removed from gluteal skin biopsy specimens
      and mounted in a double myograph for isometric force recording. RESULTS: Arteries
      from six patients with congestive heart failure contracted to only 65% of the
      maximum response recorded in nine arteries from normal volunteers when activated
      by potassium chloride (124 mM), noradrenaline (1 microM), or both. The lesser
      contraction in congestive heart failure vessels with no significant shift in
      sensitivity (EC50) was also observed in concentration-response studies with
      noradrenaline, angiotensin I, and angiotensin II. The concentration-contraction
      curves for serotonin showed only 40% of the maximum contractility to K+ in normal
      arteries, and this ratio was similar in congestive heart failure arteries. Normal
      arteries precontracted with noradrenaline (1 microM) relaxed in response to
      sodium nitroprusside, calcitonin gene related peptide, and the endothelium
      dependent agonist acetylcholine; in congestive heart failure vessels there was a
      marked loss of the relaxation response only to acetylcholine. CONCLUSIONS: These
      results suggest that in chronic congestive heart failure skin resistance arteries
      have impaired contraction responses probably independent of any receptor down
      regulation. The loss of endothelium dependent vasodilatation to acetylcholine
      suggests that EDRF release is impaired. These changes may well play an important
      role in the disturbances of peripheral vascular function associated with heart
      failure.

PMID- 8472273
TI  - The left ventricle affects the duration of right ventricular ejection.
AB  - OBJECTIVE: The aim was to determine if rapid changes in left ventricular pressure
      can acutely alter right ventricular systolic pressure and thus influence the
      length of right ventricular ejection. METHODS: The experiments were performed in
      six open chest anaesthetised dogs, weight 18-25.5 kg. Left and right ventricular
      pressures and pulmonary blood flow were recorded continuously as left ventricular
      pressure was abruptly decreased by opening a shunt in systole. From these data,
      the pressure and flow changes and the duration of right ventricular ejection were
      determined. RESULTS: Opening the left ventricular shunt caused left ventricular
      pressure to fall from 94.1(SD 10.5) to 62.6(11.3) mm Hg (p < 0.01), right
      ventricular pressure to fall from 30.3(4.6) to 27.0(3.6) mm Hg (p < 0.01), and
      pulmonary flow to fall from 69.5(14.2) to 57.5(13.9) ml.s-1. The duration of
      right ventricular ejection, determined from pulmonary flow, also decreased from
      192.7(22.7) to 157.2(18.7) ms (p < 0.05) and was significantly related to the
      length of left ventricular systole. Time between end diastole and peak negative
      dP/dt decreased for both left and right ventricle. Left and right ventricular
      time intervals were related before (r = 0.99) and after (r = 0.75) opening the
      shunt. CONCLUSIONS: The duration of right ventricular ejection was decreased by a
      sudden decrease in left ventricular afterload and was significantly related to
      the length of left ventricular systole. The duration of right ventricular
      ejection may be coupled with left ventricular contraction through ventricular
      interdependence.

PMID- 8472274
TI  - Kinetics of hydrolysis of cardiac S1 heavy chain isoforms and identification of
      light chain and actin binding sites.
AB  - OBJECTIVE: A comparative study of the kinetics of proteolysis of myosin S1 heavy
      chain was performed using dog ventricular and atrial S1 to distinguish between
      protease sensitive sites in S1 isotypes and to determine the binding sites on S1
      heavy chain for LC1, LC2, and actin. METHODS: Digestion of S1 as a function of
      actin was performed at 25 degrees C at a trypsin to S1 ratio (w/w) of 1:1500.
      Myofibrils were digested (trypsin/myofibrils w/w ratio = 1:300) in the presence
      of ATP, ADP, and under rigor conditions. Light chain and actin binding sites were
      identified by the gel overlay method. RESULTS: Ventricular and atrial S1 were
      proteolysed at 0.13 min-1 and 0.04 min-1 respectively. Actin significantly
      reduced the cleavage rate of both S1 heavy chains by blocking hydrolysis at the
      50/20 kD site. Myofibrillar myosin heavy chains from ventricles were also
      hydrolysed faster than those of the atria in the presence of 4 mM MgATP. The
      calculated rates were 0.42-0.50 and 0.17-0.19 min-1 for ventricular and atrial
      myofibrils respectively. MgADP 2 mM or absence of nucleotides reduced the
      cleavage rates to 0.04-0.07 (ventricular myofibrils) and 0.02-0.03 min-1 (atrial
      myofibrils) respectively. Gel overlay experiments showed that 125I labelled LC1
      and LC2 bound to the 20 kD fragment and actin mainly to the 50 and 20 kD
      peptides. CONCLUSIONS: The 50/20 kD site in either ventricular or atrial S1 was
      blocked when actin was present, while proteolysis at the 25/50 site proceeded
      regardless of the presence of actin. However, the 25/50 site was less accessible
      to trypsin in the alpha myosin heavy chain, since the roughly threefold reduction
      in the rates of hydrolysis of atrial S1 heavy chain was also maintained in the
      myofibrils in rigor or in the presence of ADP. Although actin made contact with
      the 70 kD and the 25 kD fragments, the 50 kD and 20 kD fragments appeared to be
      the central "anchor" for binding of both light chains and actin.

PMID- 8472275
TI  - Cardiovascular responses to intrathecal dopamine receptor agonists after spinal
      transection in conscious rats.
AB  - OBJECTIVE: The cardiovascular responses to transient intrathecal administration
      of dopamine agonists were studied daily in chronically prepared rats that had
      been spinally transected or were sham operated. The goals were (1) to determine
      the group differences in evoked heart rate and arterial pressure responses and
      (2) to determine, within the transected group, whether or not the long term
      responses could be dissociated. The hypothesis tested is that cord transection
      releases a tonic inhibition of cardiovascular responsiveness independently of the
      mechanism of receptor hypersensitivity. METHODS: Changes in mean aortic blood
      pressure and heart rate induced by intrathecal administration of the mixed D1/D2
      dopamine receptor agonist apomorphine (150 nmol per rat) were measured in
      conscious rats during a 10 d experimental period following spinal transection.
      RESULTS: Complete spinal transection did not affect aortic pressure but increased
      basal heart rate values by about 33% with respect to normal rats (p < 0.001).
      When apomorphine was injected caudally to the section (at T9-T10) but not
      rostrally (at T2-T4), it induced a 50% greater and an 800% more long lasting
      decrease in mean aortic pressure and a 230% greater and 70% more long lasting
      decrease in heart rate in spinal than in sham operated rats. These increases in
      cardiovascular responses were corroborated by a leftward shift of the apomorphine
      dose-response curves. They were also found after intrathecal administration of
      highly selective D1 and D2 receptor agonists fenoldopam (50 nmol per rat) and
      quinpirole (150 nmol per rat), and were specifically blocked by intrathecal
      haloperidol (27 nmol per rat), a non-selective dopamine antagonist. CONCLUSIONS:
      Complete spinal transection induces different increases in hypotensive and
      bradycardic responses to the stimulation of caudally located spinal dopamine
      receptors which could be due to the destruction of a tonically inhibiting spinal
      system rather than to hypersensitivity of the dopamine receptors.

PMID- 8472276
TI  - Lack of effect of propranolol on canine coronary collateral development during
      progressive coronary stenosis and occlusion.
AB  - OBJECTIVE: The aim was to test the effect of propranolol, a beta adrenergic
      receptor blocking drug which diminishes myocardial ischaemia, on coronary
      collateral development. METHODS: Dogs were chronically instrumented with a left
      circumflex coronary artery Doppler flow probe, ameroid constrictor, pneumatic
      occluder, and left atrial and aortic catheters. Haemodynamic studies and
      measurements of normal myocardial and collateral blood flows were performed at
      least weekly after surgery, or sooner if the left circumflex artery occluded
      spontaneously, in eight control dogs and seven animals treated with propranolol,
      240 mg twice daily (a dose which successfully attenuated the chronotropic effect
      of a graded infusion of isoprenaline). In dogs in which the left circumflex
      artery occluded within the first four weeks after surgery, collateral blood flow
      was measured during exercise on a motorized treadmill. RESULTS: There was no
      difference between the groups in the rate or pattern of coronary collateral
      development, magnitude of collateral flow before or after spontaneous left
      circumflex occlusion, and collateral vascular reserve during exercise. At the
      time of coronary occlusion resting collateral flow was equivalent to normal
      perfusion levels in both groups and averaged 87-96% of normal flows during
      exercise. CONCLUSIONS: Propranolol has no observable effect on coronary
      collateral development despite its acknowledged ability to prevent or attenuate
      myocardial ischaemia.

PMID- 8472277
TI  - A numerical model of early diastolic filling: importance of intraventricular
      pressure wave propagation.
AB  - OBJECTIVE: The aim was to clarify the mechanism of the following observations:
      (1) left ventricular pressure recordings during diastole have shown that the
      minimum pressure at the base is greater than that at the apex; (2)
      echocardiographic measurements of the short axis dimension of the left ventricle
      during early filling have shown that the maximum rate of increase at the base
      occurs before that at mid-cavity. These observations cannot be explained on the
      basis of simple pressure-volume relationships and suggest that diastolic
      haemodynamics are more complex. METHODS: A numerical (computer) model of early
      diastolic filling was developed. The model represents the atrium and ventricle as
      distensible cylinders connected by a valve. Parameters in the model such as
      ventricular stiffness and rate and duration of relaxation can be varied and the
      resulting haemodynamic changes observed. RESULTS: Despite the simplicity of the
      model and the omission of several physiological variables, intracavity pressure
      gradients and the phase relation of radial wall movements are generated that
      appear to be similar to those found in the human heart. CONCLUSIONS: The results
      suggest that these observations can be explained by inflow causing a pressure
      disturbance at the base which propagates to the apex, and which is reflected back
      to the base. The time between peak rate of change of short axis dimension at the
      base and mid-cavity may thus be a practical way of assessing diastolic function
      independently of loading conditions. These values can easily be measured by M
      mode echocardiography.

PMID- 8472279
TI  - Direct myocardial effects of cocaine.
AB  - OBJECTIVE: The aim was to determine whether cocaine has a direct effect on the
      myocardium which is independent of coronary vasospasm. METHODS: Cocaine was
      introduced into the perfusate of the isolated rabbit ventricular septal
      preparation in the concentration range 10(-5) to 10(-3)M while holding coronary
      flow of oxygenated Krebs solution constant at 3.0 ml.min-1 by a perfusion pump.
      The septa were obtained from white male New Zealand rabbits and were paced at 48
      beats.min-1. Mechanical and enzymatic measurements were performed. RESULTS:
      Developed tension (T), maximum contraction velocity (+dT/dt), and maximum
      relaxation velocity (-dT/dt) were all depressed to approximately the same degree
      at each different cocaine concentration and averaged 4, 48, and 95% at 10(-5),
      10(-4), and 10(-3)M cocaine respectively, with an ED50 = 9 x 10(-5)M. Relaxation
      time (tR/T) was prolonged, but the ED50 was greater (by 1.5 times) than for the
      other mechanical parameters. Simultaneously, an increase in excitation threshold
      dysrhythmia developed which resulted in 17, 50, and 90 beats missed per 100
      stimulations at 10(-5), 10(-4), and 10(-3)M cocaine respectively. Resting tension
      (RT) was not altered. Coronary flow rate was not reduced in presence of cocaine
      because of the constant delivery pump. T, +dT/dt, -dT/dt and modulation of the
      excitation threshold completely recovered after washout of cocaine. CONCLUSIONS:
      Cocaine has acute direct, though reversible, depressant effects on the
      myocardium, including depression of function and modulation of excitation
      threshold, which are independent of its effect on coronary flow.

PMID- 8472278
TI  - Negative inotropic and relaxant effects of cocaine on myopathic human ventricular
      myocardium and epicardial coronary arteries in vitro.
AB  - OBJECTIVE: Cocaine produces both vascular and myocardial effects that can lead to
      serious cardiovascular complications in man. Tissue catecholamine stores are
      known to be depleted in the advanced stages of heart failure. The effects of
      cocaine on cardiac and coronary smooth muscle isolated from patients with end
      stage heart failure was tested in order to evaluate the direct actions of this
      drug on human tissue. METHODS: Effects of cocaine HCl were studied on cardiac
      ventricular trabeculae carneae and epicardial coronary artery segments obtained
      at heart transplantation from patients with end stage heart failure. Muscles were
      placed in organ baths under physiological conditions for recording isometric
      tension; a subset of muscles was loaded intracellularly with the bioluminescent
      calcium indicator, aequorin. Cardiac muscles were stimulated with threshold
      pulses delivered via a punctate electrode at 0.33 Hz. Coronary segments were
      studied under basal conditions and after contraction with 60 mM KCl. RESULTS: In
      both cardiac muscle and vascular smooth muscle preparations, cocaine (10(-6)-10(
      3) M) produced dose related negative inotropic and relaxant effects,
      respectively; positive inotropic actions and vasoconstriction were not seen. In
      cardiac muscle, the negative inotropic actions were associated with a
      simultaneous decrease in peak intracellular calcium levels. In contrast, cocaine
      induced relaxation of potassium contracted vascular smooth muscle was not
      associated with a fall in peak intracellular calcium levels, a result consistent
      with decreased myofilament calcium responsiveness. CONCLUSIONS: These results
      indicate that the depressant effects of cocaine on cardiac versus vascular smooth
      muscle occur by different mechanisms and suggest the need for specific
      therapeutic approaches to managing cardiac depression versus vasodilation when
      these occur in cocaine intoxicated patients.

PMID- 8472280
TI  - Effects of coronary blood flow on myocardial grey level amplitude in two
      dimensional echocardiography: an experimental study.
AB  - OBJECTIVE: The aims were: (1) to evaluate whether differences in absolute and
      cyclic echocardiographic image amplitude exist in different layers
      (subendocardium and subepicardium) and regions (septal, anterior, lateral,
      inferior wall) of the canine left ventricle; (2) to assess the dependence of
      these variables upon local variations of coronary blood flow. METHODS: In six
      anaesthetised open chest dogs the circumflex coronary artery was cannulated and
      perfused by a roller pump with blood from their own femoral artery. Maximum
      coronary vasodilatation was obtained by continuous adenosine infusion. The
      absolute values and the transmural distribution of coronary blood flow were
      measured by radionuclide labelled microspheres. Echo images were obtained in
      short axis view by a commercially available electronic sector scanner with a 5.0
      MHz transducer directly placed on the epicardial surface of the right ventricle,
      and digitised off-line into a matrix of 256 x 256 pixels with 25% grey level per
      pixel. The average grey level was calculated for each region of interest.
      RESULTS: In 32 different conditions, circumflex flow ranged from 0.80 to 12.89
      ml.min-1.g-1 and the endocardial/epicardial ratio of flow from 0.53 to 1.73. In
      the circumflex region (subjected to flow changes) segmental amplitude varied from
      76(SD 20) (end diastole) to 56(18) (end systole), p < 0.001. In all regions, a
      consistent cyclic variation was found, ranging from 9(14) to 28(16)%. For all
      levels of flow, subendocardial and subepicardial regions showed similar values of
      both absolute amplitude and cyclic variation. No significant relationship was
      found between transmural distribution of blood flow and either segmental
      amplitude (r = 0.26) or cyclic variation (r = 0.04). CONCLUSIONS: (1) a
      consistent cyclic grey level variation is present in all regions of the canine
      left ventricle, but subendocardial and subepicardial layers show similar values
      of both absolute amplitude and cyclic variation; (2) in the absence of severe
      underperfusion and echocardiographically detectable dyssynergy, absolute
      amplitude and cyclic variation are totally unrelated to changes in coronary blood
      flow.

PMID- 8472281
TI  - Three dimensional visualisation of velocity profiles in the normal porcine
      pulmonary trunk.
AB  - OBJECTIVE: The aim was to obtain detailed data of velocity profile development in
      the porcine pulmonary trunk. METHODS: Hot film anemometry was used for point
      blood velocity measurements in the entire cross sectional area one diameter
      downstream of the normal porcine pulmonary valve. Computerised three dimensional
      visualisations of the spatial and temporal development of blood velocity profiles
      were made. Measurement series were conducted under spontaneous and stressed
      haemodynamic conditions in 16 pigs with a body weight of approximately 90 kg.
      RESULTS: The velocity profiles revealed consistent temporal and spatial
      development characteristics. In the systolic acceleration phase the profile was
      flat, but during peak systole an initially counterclockwise rotation was seen;
      subsequently the profile turned clockwise and ultimately counterclockwise to
      become flat during early and late systolic deceleration phases. CONCLUSIONS:
      These skewed, rotating velocity profiles are in conflict with the generally
      accepted assumption that the velocity profile in the pulmonary trunk is flat. The
      rotating skewness of the velocity profile in the porcine pulmonary trunk has not
      been described before. The reason for the rotating velocity profile is obscure.

PMID- 8472283
TI  - Contractile properties of isolated porcine ventricular myocytes.
AB  - OBJECTIVE: The aim was to examine the structure, function, and inotropic
      responsiveness of isolated porcine myocytes. METHODS: Left ventricular myocytes
      were harvested from six pigs with normal echocardiographic and pressure indices
      of left ventricular function: fractional shortening 30 (SEM 2)%, peak+dP/dt
      1225(110) mm Hg.s-1, end diastolic pressure 7(2) mm Hg, and cardiac output
      2.8(0.5) litres.min-1. Indices of myocyte contractility were examined using a
      computer assisted video edge detection system which included the percent and
      velocity of myocyte shortening. Myocyte contractions were recorded by alternating
      field stimulation at 1 Hz and measurements performed in the presence of 2-10 mM
      extracellular Ca2+. Contractile properties of isolated porcine myocytes were
      examined unattached (n = 20) or following attachment to a basement membrane
      substrate (n = 63). RESULTS: Left ventricular myocytes were successfully obtained
      from all pigs with a 68% average yield of viable myocytes. Isolated myocyte
      length was 128(6) microns with an average profile surface area of 2226(51)
      microns 2 (coefficients of variation of 25% and 35% respectively). Electron
      microscopic examination showed normal cytoarchitecture with 62(4)% myofibrils by
      volume. Baseline extent and velocity of shortening for unattached myocytes was
      6.2% and 77(10) microns.s-1 respectively. Baseline extent and velocity of
      shortening for myocytes adherent to a basement substrate were 4.9(0.4)% and 64(7)
      microns.s-1. These indices of myocyte contractile function increased from
      baseline values for both the unattached and attached cells with increased
      extracellular Ca2+. CONCLUSIONS: Isolated porcine left ventricular myocytes
      retain normal cytoarchitecture and composition, respond to field stimulation, and
      are responsive to extracellular Ca2+. Myocytes adherent to a basement membrane
      substrate were capable of contracting against this resistive load.

PMID- 8472282
TI  - Influence of hyperkalaemia and ischaemia on non-receptor-mediated cardiac
      electrophysiological effects of naloxone.
AB  - OBJECTIVE: The aim was to investigate the cardiac electrophysiological effects of
      the opioid receptor antagonist naloxone and examine whether hyperkalaemia and
      ischaemia influence these effects. METHODS: The cardiac electrophysiological
      effects of racemic naloxone, nalmafene, and morphine were examined in superfused
      rabbit papillary muscles under normal conditions and in the case of naloxone
      under conditions of hyperkalaemia. The electrophysiological effects of racemic
      naloxone and d-naloxone were examined in arterially perfused rabbit
      interventricular septa before and during 30 min global zero flow ischaemia; the
      rate of rise of extracellular K+ concentration was also measured. RESULTS:
      Naloxone, nalmafene and morphine all prolonged action potential duration and
      effective refractory period in superfused papillary muscles (class III effects),
      suggesting that these effects are not receptor mediated. During hyperkalaemia,
      naloxone increased the depressant effect on the maximum upstroke velocity of the
      action potential and enhanced post-repolarisation refractoriness, further
      suggesting a class I effect. Both racemic naloxone (active at opioid receptors)
      and d-naloxone (inactive) prolonged action potential duration and effective
      refractory period in septa, again suggesting non-receptor-mediated effects.
      During myocardial ischaemia the class III effects of both compounds were
      gradually lost in such a way that post-repolarisation refractoriness developed.
      Both compounds reduced the rate of rise of extracellular K+ concentration and
      preserved resting membrane potential, but the fall in maximum upstroke velocity
      was enhanced, again suggesting that naloxone has an additional class I effect in
      partially depolarised ventricular myocardium. CONCLUSIONS: The antiarrhythmic
      activity of naloxone in models of myocardial ischaemia/reperfusion can be
      explained by non-opioid receptor mediated effects on the duration and maximum
      upstroke velocity of the action potential and on extracellular potassium
      accumulation during ischaemia.

PMID- 8472284
TI  - Ischaemia and reperfusion induced transient QRS vector changes: relationship to
      size of the ischaemic territory.
AB  - OBJECTIVE: The aim was to investigate QRS vector changes during the first 30 min
      of coronary occlusion or the early phase of reperfusion with special reference to
      location and size of myocardium at risk. METHODS: 24 h experiments were performed
      in closed chest anaesthetised pigs. QRS vectors were studied by computerised
      vectorcardiography via Frank leads. Occlusion of the left anterior descending
      coronary artery followed by reperfusion was induced in 23 pigs and a sustained
      occlusion in 20 pigs: left anterior descending coronary artery in seven, right
      coronary artery in eight, and left circumflex coronary artery in five. Myocardium
      at risk was measured in postmortem autoradiograms. Eight animals were excluded.
      RESULTS: Four minutes after occlusion, QRS(mean) deviated towards the ischaemic
      region in 34/35 animals and returned thereafter at varying speeds. In half of the
      reperfused animals, deviation of QRS vectors towards the ischaemic territory was
      also observed during the first minutes of reperfusion. A paradoxical increase in
      QRS vector changes, "reperfusion peak", was recorded during the initial minutes
      of reperfusion in 12/19 animals. Maximum spatial QRS vector magnitude increased
      in all right coronary or left circumflex coronary occlusion animals compared to
      6/25 in left anterior descending coronary occlusion animals. QRS vector
      difference, change in spatial QRS vector angle, and maximum change in QRS azimuth
      4 min after occlusion correlated significantly with extent of myocardium at risk.
      CONCLUSIONS: Marked directional and quantitative QRS vector changes, with
      significant relation to size and location of myocardium at risk, were recorded
      during the initial minutes of ischaemia. The transient increase in QRS vector
      changes during the first minutes of reperfusion deserves further exploration as a
      new indicator of reperfusion.

PMID- 8472286
TI  - [Smoking and the development of lung cancer].
AB  - It is generally accepted that cigarette smoking is the most important lung cancer
      risk factor to which 80-90% of lung cancer mortality in advanced countries with a
      high tobacco consumption is ascribed. In the Czech Republic the increase of
      tobacco consumption since the end of the Second World War was arrested at the end
      of the sixties. Since the beginning of the seventies the cigarette consumption
      did not change substantially and varied close to 2500 cigarettes per inhabitant
      above 15 years. No reliable data are so far available in the Czech Republic on
      the development of the prevalence of smoking in different age groups of the
      population. According to several non-representative surveys in different
      districts it may be assumed that in men aged 25-64 years in the course of the
      last 20 years the ratio of male smokers declined probably, while it increased in
      female smokers. Due to the long "latency" between exposure to noxious substances
      and the manifestation of lung cancer which amounts to two, three or more decades,
      we have to evaluate the present mortality rate from lung cancer as a reflection
      of carcinogenic factors (above all cigarette smoking) in the more remote past.
      When evaluating the trend of mortality from lung cancer in the Czech Republic
      during 1953-1989, throughout that period the values were much higher in men that
      in women and the trend in the two sexes was quite different. In men the mortality
      rate from lung cancer increased in 1953-1967 to three times the initial value,
      while in women the levels remained low.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472285
TI  - Role of locally formed angiotensin II and bradykinin in the reduction of
      myocardial infarct size in dogs.
AB  - OBJECTIVE: The aim was to investigate the role of local formation of angiotensin
      II and bradykinin in the reduction of myocardial infarct size. METHODS:
      Bilaterally nephrectomised male mongrel dogs were used. Effects were compared of
      pretreatment with three inhibitors of angiotensin II forming enzyme-captopril (an
      angiotensin converting enzyme inhibitor), nafamostat (a serine protease
      inhibitor), and chymostatin (a cysteine protease inhibitor)--on left anterior
      descending coronary artery occlusion. Haemodynamic variables were monitored and
      blood was collected from the anterior interventricular vein and the aorta.
      Angiotensin I, angiotensin II, and bradykinin were measured by radioimmunoassay.
      After 90 min of occlusion, infarct sizes were determined by a macroscopic enzyme
      technique. RESULTS: Angiotensin II release into the anterior interventricular
      vein increased from 0.03(SEM 1.19) pg.min-1 (before coronary occlusion) to
      4.64(1.37) pg.min-1 (n = 14, p < 0.05), while angiotensin I release and plasma
      renin activity remained unchanged. The increase in angiotensin II release was
      inhibited by nafamostat and chymostatin, but not by captopril. Bradykinin release
      increased from -3.18(2.72) (before coronary occlusion) to 34.7(12.3) pg.min-1 (n
      = 14 p < 0.05) by 30 min after occlusion. This increase was augmented by
      captopril, from 4.10(2.86) before occlusion to 97.8(39.6) pg.min-1 at 5 min after
      occlusion (n = 12, p < 0.05), but not by nafamostat or chymostatin. Infarct size
      was smaller (p < 0.05) in the captopril group than in the control group.
      CONCLUSIONS: Angiotensin II is locally produced in the ischaemic heart by both
      serine protease(s) and chymostatin inhibitable protease(s), but not by
      angiotensin converting enzyme. From the reduction in myocardial infarct size
      produced by angiotensin converting enzyme inhibition, it seems that bradykinin
      accumulation may play a more important role than the suppression of angiotensin
      II formation.

PMID- 8472287
TI  - [Prevalence of bronchial asthma, chronic bronchitis and bronchial hyperreactivity
      in the adult population in the Prague 8 district].
AB  - The prevalence was assessed in a randomized group of 18-year-old and older
      inhabitants of Prague 8. A total of 8458 internationally tested questionnaires
      were sent out to a population of 90,458; information was obtained on 7605
      (89.9%), 1274 were given a detailed examination by standardized methods.
      Cumulative prevalence of bronchial asthma (B): 2.3% +/- 0.3% (same in M and F).
      The highest values at the age of 18-20 years were 3.5%; 3.6% in the age group 21
      30 years, the absolutely highest values--4.6%--were recorded in 18-year-old men.
      Contemporary prevalence of BA: 1.99%. In BA bronchial obstructions were found in
      51%, bronchial hyperreactivity in 75%, positive skin tests in 71%, an increase of
      IgE in 36%. Prevalence of chronic bronchitis (CHB): 14.1%; men 17.6% women-
      11.3%, highest value--18.9%--in the age group 70-80 years; absolutely highest
      values were recorded in men aged 70-80 years--20.9%. In CHB there was a bronchial
      obstruction in 55% and this obstruction was reversible in 40%. In the group CHB
      bronchial asthma was recorded in 20%. Prevalence of bronchial hyperreactivity
      (BHR) was estimated from results of broncho-provocative tests and from the
      calculation according to prevalence of BHR in respiratory diseases. The thus
      calculated figure was 13.7%. The incidence of bronchial asthma in chronic
      bronchitis in 1/6 and of bronchial hyperreactivity in more than 1/10 of the adult
      population are striking facts. It is essential to find the causes of these
      findings and make effective provisions to counteract them.

PMID- 8472288
TI  - [Immunologic laboratory findings in relatives of patients with common variable
      immunodeficiency].
AB  - A statistically significant increase of selective IgA deficiency was found
      evaluating 52 first degree relatives of 15 patients with common variable
      immunodeficiency, 4/5 of these cases were observed in the children of our
      patients. In addition to this decreased mean serum IgM level and increase of
      frequency of antithyroid autoantibodies compared to control subjects were
      observed. An excess of rheumatoid factor or antinuclear antibodies as not
      observed.

PMID- 8472289
TI  - [New advances in dermatology in the USA].

PMID- 8472290
TI  - [Why do we make mistakes in identifying risk patients?].
AB  - Risk stratification studies, which are aimed at early identification of patients
      at high risk of clinical complications, are based on comparatively complex
      techniques for the analysis of retrospectively collected clinical data. Many of
      these studies contain serious misconceptions and errors in their analysis. This
      paper is a methodological review which lists the most frequent errors and
      omissions in retrospective stratification studies. The paper explains the
      principle of receiver operator characteristics and positive and negative
      predictive accuracy, and demonstrates the necessity of using a representative
      patient population for risk stratification. The danger of misleading conclusions
      resulting from a multivariate analysis, and several suggestions on how to
      organise and evaluate these studies are also discussed.

PMID- 8472291
TI  - [Ultraviolet rays and their biological effects].
AB  - In conjunction with contamination of the atmosphere by freons interest in
      geophysical and health aspects of "ozone holes"--seasonal incidence of increased
      intensity of UV radiation--is increasing. Its biological effects depend on the
      intensity, period of exposure and wavelength. There is a wide range of different
      damage, local as well as general. In addition to pigmentation of the skin and
      symptoms produced by an elevated histamine blood level we find also changes which
      may have more serious and permanent consequences. These changes include the
      number and structure of Langerhans islets, changes of the peripheral capillary
      walls, dimerization of pyrimidine and thymine in DNA. These changes contribute to
      the development of malignancies of the skin. After exposure of the eye changes of
      pigmentation are found, and depending on the dose, also development of
      conjunctivitis or retinal damage. Recently interaction of UV radiation with
      arsenic was investigated. Conversely therapeutic effects of UV radiation in
      combination with chemotherapy are used in dermatology, such as inhibition of
      contact sensitization.

PMID- 8472292
TI  - [The clinical picture of biocompatibility of intraocular lenses used in cataract
      surgery].
AB  - Implantation of a synthetic prosthesis of a turbid lens is associated with a
      defined reaction of intraocular tissues. The extent of tissue damage along with a
      disorder of the haemato-ocular barrier and properties of the implant determine
      the extent of the inflammatory reaction leading to accumulation of proteins and
      cells in the anterior chamber of the eye and on the anterior surface of the
      artificial lens. The intensity of this reaction has an impact also on the final
      functional effect of the operation.

PMID- 8472293
TI  - [Diagnosis of primary hyperlipoproteinemia during a preventive examination].
AB  - The study analyses the occurrence and etiology of hyperlipoproteinemia (HLP) in
      healthy middle-aged probands who participated in a preventive examination.
      Frequency of HLP was 35%. After a 2-month low-cholesterol-diet, a control
      biochemical examination was done. The concentration of serum triglycerides
      decreased significantly (3.02 +/- 1.47, 2.02 +/- 1.14, p < 0.05, respectively).
      The occurrence of type IV HLP decreased from 51.6% to 24.4% (p < 0.003). For the
      analysis of etiology of HLP we divided the hyperlipemic probands on the basis of
      presence of normolipemy (I. group), or HLP (II. group) in the control, and
      compared the lipid levels between them. We found out that the cholesterol levels
      in the II. group were significantly higher than in the I. group already before
      the diet-period (7.0 +/- 0.87 mmol/l, 5.85 +/- 0.81 respectively, p < 0.001),
      although the both groups did not differ in the triglyceride levels. Genetic
      examination in families revealed familial combined HLP in 24.4%, primary
      hypercholesterolemia in 12%, familial hypertriglyceridemia in 2% polygenic
      hypertriglyceridemia in 18%. We found out not only very high incidence of HLP in
      a sample of Slovak population but also that the most cases have the genetic
      background. The most frequent type of HLP was type IV. Since the triglyceride
      levels give poor information about the coronary risk, we recommend to examine the
      HDL-cholesterol already in the screening preventive programs.

PMID- 8472294
TI  - [Disorders of the acid-base equilibrium in delirium tremens].
AB  - The objective of the present work was to assess the most frequent disorder of the
      acid-base equilibrium in delirium tremens. The author examined a group of 77
      alcoholics with delirium tremens. In 62 (80.5%) by the Astrup method respiratory
      alkalosis was detected, in 7 (9%) metabolic alkalosis was recorded, in 1 (1.5%)
      metabolic acidosis and in 7 patients (9%) the values of the acid-base equilibrium
      were normal. In predominant alkalotic syndrome the mean serum potassium level was
      lower, 3.4 mmol/l (2.2-4.6), and the level of chlorides 97.8 mmol/l (50-144.5).
      The mean sodium concentration was 138.1 mmol/l (121.5 to 147). The author
      discusses the causes of the impaired acid-base balance in delirium tremens. It is
      assumed that the main cause is the rebound phenomenon of the respiratory centre
      which causes hyperventilation and changes of the ion metabolisms induced by
      alcohol abuse and its discontinuation. A negative effect is exerted by shortage
      of energy substrates and protein catabolism the effect of ethyl alcohol on the
      intermediary metabolism, the psychosis as such, insufficiency of parenchymatous
      organs and neurohumoral dysregulation after discontinued alcohol intake.
      Examination of the acid-base equilibrium in delirium tremens is essential for
      differential diagnosis, correct treatment and prevention of complications. The
      author discusses briefly treatment of delirium tremens and principles of
      correction of associated acid-base and ion disorders.

PMID- 8472295
TI  - [The importance of recombination in resolving paternity disputes].
AB  - For evaluation of the results of HLA examinations in paternity disputes the
      objective finding that the man has HLA antigens which the child inherited from
      the father, is decisive. The controversy as regards heredity ensuing from
      assessment of HLA haplotypes of the man by family studies is caused by
      recombination. The author presents a case of this type.

PMID- 8472296
TI  - [Report on the activities of the Central Commission on Ethics of the Czech
      Ministry of Health 1990-1992].
AB  - The central ethical commission (CEC) of the Czech Ministry of Health was founded
      in 1990. The authors submit a report on the activities of this advisory and
      expert in the sphere of medical ethics. They emphasize that a standpoint was
      elaborated regarding the problem of doping in the Czech Republic, a moral code of
      patients' rights and other important documents. The CEC takes into account also
      views of chairmen of local ethical commissions which were assembled by means of a
      questionnaire. The CEC foresee its future activity in particular in adequate
      presentation of its views to the professional and lay public.

PMID- 8472297
TI  - [Paracelsus (1493-1541) and his legacy to our time].

PMID- 8472298
TI  - Improvements for the anatomical characterization of insect neurons in whole
      mount: the use of cyanine-derived fluorophores and laser scanning confocal
      microscopy.
AB  - The optical sectioning capability of the laser scanning confocal microscope was
      utilized to image dye-filled neurons within whole-mounted insect ganglia.
      Specific pterothoracic interneurons, in the moth Manduca sexta, were retrogradely
      filled with Neurobiotin and subsequently visualized with a monoclonal anti-biotin
      conjugated with one of the following fluorophores: fluorescein, and the newly
      developed cyanines, Cy3.18 (Cy3) and Cy5.18 (Cy5). Overall, the Cy5 fluorophore
      was best suited for imaging insect neurons within ganglia. This new methodology
      allowed us to identify and characterize morphologically a collection of
      descending multisegmental interneurons with large or small diameter somata. A
      variety of larger molecular weight (10,000 daltons) tracers was also used to
      examine the possibility of nonselective filling of neurons with Neurobiotin,
      possibly through gap junctions. We also investigated the usefulness of Cy3 and
      Cy5 as fluorophores for transmitter immunostaining of neurons in whole mount.
      Neurons immunoreactive for serotonin and the neuropeptides, FMRFamide and SCPB,
      were imaged in the brain and the pterothoracic ganglion. The central projections
      of some of these immunoreactive neurons were imaged in their entirety.

PMID- 8472299
TI  - Selective binding and transcytosis of latex microspheres by rabbit intestinal M
      cells.
AB  - The interaction between polystyrene microspheres and the follicle-associated
      epithelium of rabbit Peyer's patches has been examined. Microspheres bind
      selectively to, and are transcytosed by, membranous or microfold (M) cells within
      the follicle-associated epithelium. M cells are able to transport, in 45 min,
      approximately 10(5) microspheres of 0.46 micron diameter across the epithelium
      overlying each lymphoid follicle dome of rabbit Peyer's patches. The high
      capacity of M cells for particulate transcytosis and the subsequent delivery of
      these particulates to the mucosal immune system highlights the potential
      importance of this portal in the delivery of antigens and drugs. In addition, the
      selective binding and uptake of microspheres may be utilised as a functional
      marker in the identification and isolation of M cells.

PMID- 8472300
TI  - Aggregation of macrophages in the tips of intestinal villi in guinea pigs: their
      possible role in the phagocytosis of effete epithelial cells.
AB  - Numerous macrophages were found aggregated in the lamina propria at the tips of
      villi in the small intestine of guinea pigs. These macrophages extended their
      pseudopodia into the epithelial lining and internalized fragments of effete
      enterocytes in their phagosomes. The epithelium of the villus tips was found to
      be infiltrated with numerous lymphocytes. They possessed electron-dense granules
      characteristic of natural killer cells, and actively interdigitated with the
      enterocytes. The latter were either fragmented or extensively lost in their basal
      cytoplasm, often leaving an attenuated apical cytoplasm of the cell.
      Immunohistochemical labeling using bromodeoxyuridine demonstrated that at 96 h
      after its administration, immunolabeled nuclei were encountered in the cytoplasm
      of macrophages in the lamina propria at the villus tips. These findings suggest
      that in the guinea pig, effete enterocytes are not simply exfoliated into the
      lumen, but are damaged by intraepithelial lymphocytes possessing a natural killer
      cytotoxicity, and subsequently phagocytosed by subepithelial macrophages.

PMID- 8472301
TI  - The Leydig cell of the human testis--a new member of the diffuse neuroendocrine
      system.
AB  - A number of marker substances for neuronal and neuroendocrine cells have been
      demonstrated in the cytoplasm of the interstitial Leydig cells of human testes
      using basic immunocytochemical methods and some of their modifications. We were
      able to reveal immunoreactivity for enzymes involved in the synthesis of the
      catecholamines dopamine and noradrenaline (tyrosine hydroxylase, aromatic L-amino
      acid decarboxylase, dopamine-beta-hydroxylase), for the indolamine 5
      hydroxytryptamine (serotonin), as well as for a number of well-known neuronal
      markers such as the neurofilament protein 200, synaptophysin, chromogranin A + B,
      the neural cell-adhesion molecule (N-CAM), the microtubule-associated protein
      (MAP-2), and the calcium-binding proteins: S-100, calbindin and parvalbumin.
      Immunoreactivity for these substances was found in the majority of the
      interstitial cells although differences in the staining intensity among the
      individual Leydig cells and among Leydig cells from different patients were
      observed. At the electron-microscopic level the Leydig cell cytoplasm was seen to
      contain microtubules, intermediate- and microfilaments as well as clear (40-60
      nm) and dense-core (100-300 nm) vesicles, providing a morphological correlate for
      some of the immunocytochemical results. Although individual marker substances are
      not absolutely specific for nerve and neuroendocrine cells, the results obtained,
      together with the already established neuron-specific enolase-, substance P-,
      methionine-enkephalin- and proopiomelanocortin (POMC)-derived peptide-like
      immunoreactivity, provide strong evidence for the neuroendocrine (paraneuronal,
      APUD-like) nature of the Leydig cells of the human testis.

PMID- 8472302
TI  - Immuno-electron microscopic localization of calmodulin and calmodulin-binding
      proteins in the mouse germ cells during spermatogenesis and maturation.
AB  - When extracts of mouse testis were Western-blotted against a monoclonal antibody
      which reacts with calmodulin in the presence of Ca2+, all calmodulin was
      associated with the macromolecules of molecular weight above 50 kDa. Immuno
      electron microscopy of testes using this antibody indicated that calmodulin is
      localized at higher density in the nucleus and cytoplasm of germ cells during the
      developmental phase between pachytene and round spermatid, showing the highest
      level just before meiotic divisions. There was no special association of
      calmodulin to any organelles in these cells. Extremely low levels of calmodulin
      occurred in spermatogonia and other testicular tissue cells. Calmodulin decreased
      dramatically as spermatids underwent metamorphosis, becoming detectable only at
      the perinuclear space of sperm heads. Further relocation to the postacrosomal
      region occurred during sperm transit to the cauda epididymis. Immunodetection
      after the calmodulin overlay on ultrathin sections revealed a sharp increase of
      calmodulin immunogold deposits in the nuclei of spermatids accompanying their
      condensation. The results indicate that some calmodulin-binding proteins, but not
      calmodulin itself, accumulate in the nuclei during the final steps of
      spermiogenesis.

PMID- 8472304
TI  - Morphological observations on the unique paired capillaries of the opossum
      retina.
AB  - Light-microscopic and ultrastructural analysis of the ocular tissues of the North
      American opossum (Didelphis virginiana) revealed that the arterial and venous
      segments of retinal vessels, including capillaries of the smallest calibre, occur
      in pairs. They do not form anastomotic networks, the common pattern in mammals
      with vascularised retinae, but instead the two segments of the pair join to form
      hairpin end loops. The paired vessels, with the arteriolar limb usually on the
      vitread aspect, penetrate the retina and branch to form three distinct layers of
      capillaries. The most superficial lies in the nerve fiber layer, the middle is
      situated in the inner nuclear layer and the deepest extends to the external
      limiting membrane, which is considerably deeper than in normal mammalian
      holangiotic retinae. The paired capillaries display classical morphological
      features of central nervous system capillaries, i.e., they are lined by
      continuous endothelial cells united by tight junctions. The lining endothelium is
      supported by a distinct basal lamina that splits to envelop pericytes. The
      latter, although abundant, are invariably interposed between the two vessels that
      form each vascular unit. Phylogenetic and functional aspects of this unique form
      of retinal vascularisation are discussed.

PMID- 8472303
TI  - Bone-like nodules formed in vitro by rat periodontal ligament cells.
AB  - The periodontal ligament has been shown to possess the ability to regenerate both
      new cementum and alveolar bone as well as a self-regenerative capacity; however,
      the source of cementoblasts and osteoblasts is not still clear. We investigated
      the development of bone-like tissue in vitro by periodontal ligament cells, in
      order to determine whether the periodontal ligament contains osteoprogenitor
      cells. Periodontal ligament cells were obtained from periodontal ligament tissue
      attached to the maxillary incisors of 6-week-old WKA rats by means of the explant
      technique. Cells at passage #3 were cultured for long term in alpha-minimum
      essential medium containing 10% fetal bovine serum, antibiotics, and 50
      micrograms/ml ascorbic acid, and were then examined using phase-contrast
      microscopy, histochemistry, transmission electron microscopy, X-ray
      microanalysis, and electron diffraction. Nodules were formed in the cultures, and
      when 10 mM Na-beta-glycerophosphate was added, these nodules became mineralized.
      The mineralized nodules were identified as bone-like elements in view of the
      presence of osteoblast-like and osteocyte-like cells, collagenous matrix, a
      mineral composed of hydroxyapatite, and intense alkaline phosphatase activity.
      The results show that the periodontal ligament contains osteoprogenitor cells,
      which differentiate into osteoblasts and produce bone-like tissue.

PMID- 8472305
TI  - Computer-assisted morphometry of the intracapillary leukocyte pool in the rabbit
      lung.
AB  - Computer-assisted morphometry was performed to evaluate the number and cell
      characteristics of capillary and alveolar leukocytes in rabbit lungs. An image
      processing system and a programmable spread-sheet program were used, which
      allowed morphometric analysis of a large reference area. Neutrophils represented
      the largest intracapillary leukocyte population (2.2 x 10(7)/ml parenchyma, which
      corresponds to an approximately 104-fold microvascular enrichment of this cell
      type related to cell counts calculated for the capillary blood volume). In
      addition, large numbers of intracapillary lymphocytes (1.7 x 10(7)/ml parenchyma;
      47-fold enrichment) and monocytes (0.3 x 10(7)/ml parenchyma; 86-fold enrichment)
      were detected. The total count of pulmonary leukocytes thus approximated the
      total number of pulmonary endothelial cells; and the total circulating pools of
      the different leukocytes were surpassed by the corresponding lung capillary
      pools, 3.2-fold for neutrophils, 1.2-fold for lymphocytes and 4.8-fold for
      monocytes. In contrast, alveolar cell numbers ranged from 1-2% of the capillary
      counts for all types of leukocytes. We conclude that the rabbit lung
      microvasculature harbours large pools of immunocompetent cells, which may
      contribute to host-defense mechanisms at the gas-exchange area.

PMID- 8472306
TI  - Localization and production of immunoreactive endothelin-1 in the trophoblast of
      human placenta.
AB  - Regarding their endocrine and paracrine activities, endothelins can be considered
      as peptide hormones and growth factors. The presence of endothelin-1 (ET-1)
      binding sites on smooth muscle of placental villous vessels, on villous
      trophoblast and on purified trophoblast in culture raises the question of the
      origin of the peptide. In placenta, endothelin could derive from maternal, fetal
      and/or endogenous sources. Therefore, localization of ET-1 was investigated by
      use of immunohistochemistry in human term placenta and in cultured trophoblast
      using the avidin-biotin-peroxidase complex procedure. Specificity of
      immunostaining was demonstrated by applying ET-1 antibody that has been
      preabsorbed with excess peptide. In sections of placenta, ET-1 immunoreactivity
      (ET-1 IR) was specifically detected in the endothelium of the vessels and in the
      syncytiotrophoblast of the villi. ET-1 IR was also detected in the decidua-like
      cells and in the extravillous cytotrophoblast of the basal plate, a region where
      the maternal and fetal cells intermingle closely. The extravillous
      cytotrophoblast of the chorionic plate and of the placental septa also exhibited
      a strong ET-1 IR. For trophoblast culture cytotrophoblastic cells were obtained
      from placental villi by trypsin-DNase dispersion, further purified on Percoll
      gradient and enriched by employing a monoclonal anti-HLA class-I antibody. The
      trophoblastic origin of the cells was demonstrated by immunohistochemistry and by
      studying the secretion of gestational hormones during culture. After different
      periods of culture of purified cytotrophoblastic cells (1 to 5 days), ET-1 IR was
      observed in 95% of cells: cytotrophoblastic cells, trophoblast aggregates, and
      syncytiotrophoblast.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472307
TI  - Cells isolated from the endosteal bone surface of adult rats express
      differentiated osteoblastic characteristics in vitro.
AB  - Endosteal bone surface cells were previously shown to be involved in the
      regulation of bone formation in humans. In this study, we have characterized the
      cells isolated from the endosteal bone surface in adult rats. Fragments of
      periosteum-free tibia were obtained from 4-, 6- and 9-month-old rats by
      collagenase digestion, and the phenotypic characteristics of the osteoblastic
      cells migrating from the endosteal bone surface were evaluated in culture.
      Endosteal bone surface cells present a strong alkaline phosphatase (ALP) activity
      as shown by cytochemistry and measured biochemically. The cells synthesize high
      levels of osteocalcin as measured by radioimmunoassay. Osteocalcin production was
      increased after stimulation with 10 nM 1,25 dihydroxyvitamin D (1,25(OH)2 D) and
      the response to 1,25(OH)2 D was similar at all ages. Endosteal cells from young
      adult rats (4 months old) but not from older rats (6 and 9 months old) showed
      increased cAMP production in response to 10 nM parathyroid hormone (PTH),
      suggesting an age-related decrease in the PTH-responsiveness of the bone surface
      cells. Immunocytochemistry using specific antibodies showed that preconfluent
      endosteal bone cells from adult rats expressed collagen and noncollagenous bone
      proteins in culture in the absence of inducers. The cells synthesized mostly type
      I collagen which remained localized intracellularly. Type-III collagen was only
      expressed at low levels. The bone surface cells also expressed osteocalcin and
      bone sialoprotein, two markers of differentiated osteoblasts, as well as
      osteonectin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472308
TI  - Effect of mechanical stimulation on the production of soluble bone factors in
      cultured fetal mouse calvariae.
AB  - Mechanical stimulation by intermittent compressive force (ICF) stimulates bone
      formation and inhibits bone resorption in cultured fetal mouse bone. Fetal bone
      tissue can produce autocrine factors that stimulate bone cell replication and
      matrix formation, and paracrine factors that increase the formation of osteoclast
      precursor-like cells from bone marrow. In the present study, we have tested
      whether ICF affects the production of such local factors in fetal mouse
      calvariae. Calvariae were cultured for 4 days in the presence and absence of ICF
      (130 mbar, 0.3 Hz). Conditioned medium was collected daily and pooled. We found
      that conditioned medium from ICF-exposed cultures stimulated [3H]-TdR
      incorporation into DNA, and [3H]-proline incorporation into collagenase
      digestible protein but not into non-collagen protein in fresh calvarial cultures.
      Treatment with conditioned medium from ICF-exposed cultures had earlier effects
      on [3H]-TdR and [3H]-proline incorporation than direct treatment with ICF.
      Conditioned medium from ICF-exposed cultures decreased the number of osteoclast
      precursor-like cells in bone marrow cultures stained for tartrate-resistant acid
      phosphatase. We conclude that ICF stimulates the release (activity) of an
      autocrine growth-factor from bone. In addition, ICF can stimulate the release
      (activity) of a paracrine factor, inhibiting the growth and/or differentiation of
      osteoclast precursor-like cells. These data suggest that mechanical forces may
      modulate skeletal (re)modeling by affecting the production of local growth
      factors.

PMID- 8472310
TI  - Cytotoxic ribonucleases and chimeras in cancer therapy.
AB  - Ribonucleases serve as cytotoxic agents during host defense and physiological
      cell death pathways. In bacteria, higher plants, and mammals, ribonucleases
      appear to bind cells, enter the cytosol where they degrade RNA, and kill the
      target cell. This process functions in interstrain competition in bacteria, in
      the death of incompatible pollen in higher plants, and likely plays a role in the
      antiparasitic and anticancer activity of eosinophils in man. One can alter the
      target cell specificity of RNases by coupling them to new cell-binding domains.
      Chemically coupling RNases to new binding moieties or fusing RNase genes to
      antibody genes results in chimeric molecules with specified cell-type
      cytotoxicity. Thus, one can target one's own host defense cytotoxins to select
      cell populations. This allows the use of human proteins, instead of plant and
      bacterial toxins, in the construction of immunotoxins. RNases also can be
      engineered to kill cells by cytosolic expression or to kill viruses by packaging
      into viruses. Engineering RNases into cell-type-specific cytotoxins may result in
      a new class of therapeutic reagents. We review a number of interesting
      physiological cell cytotoxicity pathways utilizing RNases and then describe the
      recent results on engineering RNases for therapeutic use.

PMID- 8472311
TI  - Therapeutic applications of anti-CD4 antibodies.
AB  - The CD4 molecule represents a major functional T-cell surface molecule, defining
      an important T-cell subset, which also is expressed on monocyte, dendritic, and
      Langerhans cells. Various in vivo studies have demonstrated its implication in
      various steps of physiological T-cell activation: 1. CD4 interacts with its
      physiological ligand, the class II molecules, thus increasing the affinity of the
      conjugation between CD4+CD(3+)-TCR+ and class II+ antigen-presenting cells. 2.
      Through CD4, the signal transduction machinery is stimulated via its association
      with p56lck. In addition, CD4 has proved to be the receptor for gp120, the
      surface glycoprotein of HIV, that allows the virus to penetrate the CD4+ T cells
      and monocytes. Based on in vitro studies in various animal models, CD4 mAbs have
      proved to be efficient in the prevention and/or therapy of a variety of
      immunologically based diseases: 1. When injected early in the prodromic phase of
      autoimmune diseases (AID) such as diabetes, either delay or prevention is
      achieved with or without maintenance after therapy. 2. These mAbs have proved to
      be self-tolerogenic, thus allowing prolonged in vivo therapy and suppression of
      immunogenicity of mAb of a distinct specificity. In humans, CD4 mAbs are, or
      could be, used and evaluated in AID (lupus, diabetes, rheumatoid arthritis,
      etc.), transplantation, leukemias and lymphomas expressing CD4, and, finally, in
      AIDS patients, in whom CD4 mAbs can block HIV-CD4 binding and deliver a negative
      signal to T cell, thus blocking T-cell activation and HIV transcription. CD4 mAbs
      at least provide evidence that the CD4 molecules are suitable for
      immunomodulation and could be the target for a new pharmacological antagonist.

PMID- 8472309
TI  - Irradiation-induced effects on the innervation of rat salivary glands: changes in
      enkephalin- and bombesin-like immunoreactivity in ganglionic cells and
      intraglandular nerve fibers.
AB  - When treating head and neck for cancer with the use of radiotherapy the salivary
      glands are usually within the treatment volume with ensuing dryness and
      discomfort. Since the autonomic nervous system is of pivotal importance for the
      salivary gland function and integrity, the irradiation-induced effects may
      involve an influence on the innervation of salivary glands. Therefore, the rat
      submandibular gland, including the submandibular ganglionic cells, has been
      subjected to immunohistochemical examination with respect to expression of
      neuropeptides following fractionated irradiation with high energy photons. A
      markedly enhanced expression of bombesin- and leu-enkephalin-(ENK)-like
      immunoreactivities (LI) in the ganglionic cells and a pronounced increase in the
      number of nerve fibers showing these immunoreactivities in the submandibular
      gland tissue following irradiation were observed 10 days after treatment. On the
      other hand, no changes in the patterns of VIP (vasoactive intestinal polypeptide)
      and NPY (neuropeptide Y)-immunoreactivities occurred. Thus, the present study
      shows that alterations in the expression of certain neuropeptides take place in
      the submandibular gland and its associated ganglionic cells in response to
      irradiation of the head and neck region. These changes may add further
      explanation to the inherent radiosensitivity of salivary glands.

PMID- 8472312
TI  - Scintigraphic assessment of therapeutic aerosols.
AB  - Drugs are delivered to the upper or lower respiratory tract as aerosols via a
      range of inhalation devices in order to achieve either topical or systemic
      effects. It is important to be aware of the deposition pattern within the target
      organ inasmuch as treatment or prophylaxis will be effective only if sufficient
      drug is delivered directly to the required site. Drugs delivered to the nasal
      passages must be retained in the nose sufficiently long enough to exert a local
      effect or to be absorbed before they are removed by mucociliary clearance. Gamma
      scintigraphy is a noninvasive technique capable of giving information about total
      and regional deposition in the lungs, or deposition in and subsequent clearance
      from the nasal passages, thus providing data that are difficult or impossible to
      obtain by other means. Radiolabeling strategies for scintigraphic studies of the
      respiratory tract usually involve the radionuclide 99mTc, which is added to the
      formulation in order to trace the location of the drug substance in the body. It
      is difficult to find suitable gamma ray-emitting radionuclides for direct
      chemical labeling of drug molecules. Pharmacoscintigraphic studies, combining
      scintigraphy and conventional pharmacokinetics, are able to give valuable
      insights into the in vivo behavior of compounds delivered to the systemic
      circulation via the respiratory tract.

PMID- 8472313
TI  - Reversibility of changes in nucleic acid methylation and gene expression induced
      in rat liver by severe dietary methyl deficiency.
AB  - As we have reported previously, both DNA and tRNA become hypomethylated in livers
      of rats fed a cancer promoting, methyl-deficient diet (MDD) for as short a period
      as one week. Within the same period, activities of tRNA and DNA
      methyltransferases (MTases) increase and levels of mRNAs for several genes
      believed to have roles in growth regulation are altered. These diet-induced
      changes in nucleic acid methylation and gene expression increased in extent when
      MDD was fed continuously for four weeks. We also observed hypomethylation of
      specific CCGG sites within several genes for which mRNA levels were increased.
      These included c-myc, c-fos and c-Ha-ras. To investigate the reversibility of
      such diet-induced alterations in methylation and gene expression, animals were
      fed MDD for four weeks, after which a diet supplemented with adequate sources of
      methyl groups (CSD) was fed for 1-3 weeks. One to two weeks after the restoration
      of an adequate diet, the overall extent of methylation of tRNA and DNA from
      livers of these rats did not differ from that of tRNA and DNA from livers of age
      matched animals continually maintained on CSD. At the same time, activities of
      MTases in the liver dropped to normal values. Levels of mRNAs for all genes
      studied returned to control levels within three weeks after ending MDD feeding,
      although at different rates. In contrast, MDD-induced hypomethylation of some
      HpaII sites in c-myc, c-fos and c-Ha-ras genes persisted after 3 weeks refeeding
      of an adequate diet. These results, which demonstrate that most of the effects of
      MDD on the parameters we have studied occur rapidly and are essentially
      reversible, are consistent with the role of MDDs as promoters of
      hepatocarcinogenesis. However, the finding that unmethylated sites persist in
      genes that play a role in growth regulation suggests a mechanism by which
      intermittent or long term exposure to MDDs could result in heritable phenotypic
      changes in some hepatocytes that lead to hyperplasia and tumorigenesis.

PMID- 8472314
TI  - Increased poly(ADP-ribosyl)ation in intact cells by cisplatin treatment.
AB  - Cisplatin (DDP) is a clinically important antitumor drug that induces the
      formation of DNA-DNA and DNA-protein crosslinks. We have studied whether poly(ADP
      ribosyl)ation, a post-translational modification of nuclear proteins that is
      drastically increased by the presence of DNA strand breaks and plays a role in
      DNA repair, is induced following DDP treatment of cell cultures. By using an
      immunofluorescence technique for the in situ detection of poly(ADP-ribose) in
      intact cells, we found spotty nuclear signals after DDP treatment of O-342 rat
      ovarian tumor cells or CV-1 monkey cells, but not in untreated control cells, nor
      in DDP-treated cells postincubated with the ADP-ribosylation inhibitor 3
      aminobenzamide. Our results thus provide direct evidence for an involvement of
      poly(ADP-ribosyl)ation in the cell's response to DDP treatment and, more
      generally, illustrate the versatility of this rapid in situ method for the
      detection of increased poly(ADP-ribosyl)ation in living cells.

PMID- 8472315
TI  - The glutathione S-transferases: polymerase chain reaction studies on the
      frequency of the GSTM1 0 genotype in patients with pituitary adenomas.
AB  - The frequency of the GSTM1 0 polymorphism at the glutathione S-transferase M1
      locus has been determined in controls and patients with pituitary adenomas by
      using the polymerase chain reaction to amplify genomic DNA in the exon 4-5 region
      of the gene. The frequency of the genotype in patients with prolactinomas, non
      functional adenomas, corticotrophinomas and somatotrophinomas varied between 52
      67% compared with 44% in the controls. In the patients with prolactinomas the
      frequency of the genotype (67%) was significantly greater than in controls with
      odds ratio analysis indicating that GSTM1 0 individuals have a 2.56-fold greater
      risk of developing this adenoma.

PMID- 8472316
TI  - Quantitation of tissue- and sex-specific induction of rat GSH transferase
      subunits by dietary 1,2-dithiole-3-thiones.
AB  - Male and female Sprague--Dawley rats were maintained for 5 days on control diet
      or diet containing 0.075% (w/w) 1,2-dithiole-3-thione (D3T) or 5-(2-pyrazinyl)-4
      methyl-1,2-dithiole-3-thione (oltipraz). The content of GSH transferase (GST)
      subunits 1a, 1b, 2, 3, 4, 6, 7, 8, 10 and 11 in the soluble fraction of liver,
      kidney, small intestine, stomach and lung of control and D3T-fed animals was
      determined. Liver and kidney were similarly analysed for the oltipraz-fed
      animals. Significant induction of GST subunits by D3T was seen in all tissues,
      the most substantial being subunit 7 in male liver (approximately 50-fold) and
      subunits 1b, 3 and 10 in male and female small intestine (5- to 16-fold).
      Generally subunits 7, 10, 1b and 3 were most affected, while subunits 6 and 8
      were hardly inducible. Oltipraz caused qualitatively similar inductions in the
      liver and kidney. The effect of GSH transferase induction on the hepatic capacity
      for GSH conjugation of aflatoxin B1 exo-8,9-oxide is assessed.

PMID- 8472317
TI  - A study on skin tumour formation in mice with 50 Hz magnetic field exposure.
AB  - In order to test the possibility that magnetic fields (MF) act as a tumour
      promoter, a long-term skin carcinogenicity study of 50 Hz sinusoidal MF with flux
      densities of 50 microT and 0.5 mT was performed in female NMRI mice. 7,12
      dimethylbenz[a]anthracene (DMBA) in acetone was applied to the dorsal skin, as an
      initiator, and exposure to MF was performed for 19 (weekdays) or 21 h/day
      (weekends and holidays) for 103 weeks starting one week after the initiator
      treatment. The phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) was used
      as a positive control for skin tumour promoting activity. MF was also evaluated
      for complete carcinogenic action in groups of mice that were treated with acetone
      only. Six animals from each group were taken for skin hyperplasia analysis and
      were killed after 9, 26 and 52 weeks. The appearance of skin lesions were
      carefully followed and histopathological diagnosis was made for all neoplasms
      present at death. The statistical analyses on occurrence of skin tumour bearing
      animals and cumulated skin tumours, with corrections for survival did not reveal
      a difference between the controls and the MF exposed groups. The epithelial
      thickness of DMBA + MF-treated animals was of the same magnitude as for DMBA
      treated animals. Leukaemia was a little more frequent among animals exposed to
      0.5 mT MF compared to the control animals. However this difference was not
      statistically significant.

PMID- 8472318
TI  - Differential growth control of normal, preneoplastic and neoplastic Syrian
      hamster embryo cells in serum-free media.
AB  - The objective of this work was to develop a serum-free medium that supported the
      growth of secondary Syrian hamster embryo (SHE) cells suitable for use in the
      morphological transformation assay (MTA). The current assay employs high levels
      of fetal bovine serum, each lot of which must be selected for its efficacy in the
      assay. To circumvent the problems associated with the use of serum, two serum
      free media (CGM-4 and CGM-9) were developed. The approach used was to replace
      serum with more defined hormones and growth factors. DME/F12 with low NaHCO3 (pH
      6.7) was chosen as a basal nutrient medium since this pH has been reported to
      give enhanced transformation. Both serum-free media supported the clonal high
      density growth of normal secondary SHE cells. These media were also found to
      support the growth of several established SHE cell lines exhibiting successive
      stages of neoplastic progression. However, significant differential responses of
      the individual cell lines to CGM-4 and CGM-9 were observed, whereas, in serum
      supplemented medium all three lines responded similarly. These results raise the
      hope that CGM-4 and CGM-9 will be useful for studies of altered autocrine
      function during transformation and progression as well as for use in the
      transformation assay itself.

PMID- 8472319
TI  - Human hepatic CYP1A1 and CYP1A2 content, determined with specific anti-peptide
      antibodies, correlates with the mutagenic activation of PhIP.
AB  - Mono-specific antibodies targeted to human CYP1A1 and CYP1A2 have been produced
      by immunizing rabbits with protein conjugates of short synthetic peptides
      corresponding to residues 290-297 and 284-296 respectively, of these enzymes. The
      antibody targeted to CYP1A1 bound in immunoblotting to the recombinant protein
      expressed in yeast but did not bind to any human hepatic microsomal protein,
      whereas the antibody targeted to CYP1A2 bound only to this enzyme in
      immunoblotting of human hepatic microsomal fractions and did not recognize
      recombinant human CYP1A1. The intensity of hepatic microsomal CYP1A2
      immunoreactivity (n = 5) correlated significantly with a number of activities
      characteristic of this enzyme: phenacetin O-deethylase (POD), ethoxyresorufin O
      deethylase (EROD) and methoxyresorufin O-demethylase activities and the ability
      to activate the dietary carcinogen 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline
      (MeIQx), to a mutagen. The anti-CYP1A2 anti-peptide antibody consistently
      inhibited both POD and EROD activities, but inhibition was incomplete (28%). In
      view of the known (> 90%) contribution of CYP1A2 to these activities and the
      correlation with antibody binding, this is consonant with an epitope for the anti
      CYP1A2 anti-peptide antibody that forms the edge of a functionally important
      proinhibitory surface region previously identified in rat cytochromes CYP1A.
      CYP1A2 immunoreactivity determined by immunoblotting correlated significantly
      with the ability of human hepatic microsomal fractions to activate 2-amino-1
      methyl-6-phenylimidazo[4,5-b] pyridine (PhIP), another dietary carcinogen, to a
      mutagen. It is concluded that CYP1A1 is absent from human liver and that CYP1A2
      is likely to be a major catalyst in the hepatic activation of PhIP.

PMID- 8472320
TI  - The role of O6-alkylguanine-DNA alkyltransferase in protecting Rat4 cells against
      the mutagenic effects of O6-substituted guanine residues incorporated in codon 12
      of the H-ras gene.
AB  - The role of rat O6-alkylguanine-DNA alkyltransferase (AGT) in modulating
      mutagenesis by O6-substituted guanines in the rat H-ras gene was examined. Rat4
      cells were transfected with vectors carrying O6-methyl-, O6-ethyl- or O6
      benzylguanine residues in place of the normal guanines at either the first,
      second, or both the first and second positions in codon 12 (GGA) of the H-ras
      coding sequence. The percentage of transformed colonies was determined for cells
      grown in normal medium or in medium containing O6-benzylguanine to completely
      deplete AGT. In parallel experiments with O6-methylguanine-containing vectors,
      the percentage of cellular DNA harboring codon 12 mutations was determined for
      normal cells and cells lacking AGT. A reasonable correspondence was observed
      between the percentage of mutated DNA and the percentage of transformed colonies
      produced in both types of cells. The results indicate that the contribution of
      AGT to the repair of O6-substituted guanine damage decreases as the O6
      substituent is changed from methyl > ethyl > benzyl. Additionally, cellular AGT
      appears to repair an O6-methylguanine more readily at the first position of codon
      12 than the second position. However, other repair mechanisms in these mammalian
      cells appear to play a major role in correcting low levels of O6-substituted
      guanine damage including O6-methylguanine damage.

PMID- 8472321
TI  - Sulfotransferase-mediated mutagenicity of 1-hydroxymethylpyrene and 4H
      cyclopenta[def]chrysen-4-ol and its enhancement by chloride anions.
AB  - 1-Hydroxymethylpyrene (HMP), a primary benzylic alcohol, and 4H
      cyclopenta[def]chrysen-4-ol (OH-CPC), a secondary benzylic alcohol, were
      investigated for mutagenicity in Salmonella typhimurium (reversion of the his-
      strain TA98) in the presence of various xenobiotic-metabolizing systems. In the
      direct test, HMP was inactive and OH-CPC was very weakly active. In the presence
      of NADPH-fortified postmitochondrial fraction from rat liver (S9/NADPH), no
      activation of OH-CPC was observed, whereas strong mutagenic effects were elicited
      by HMP. In the presence of cytosol and 3'-phosphoadenosine-5'-phosphosulfate
      (PAPS), both alcohols were activated to potent mutagens. For equal mutagenic
      effects, approximately 650-fold lower concentrations of HMP were required in the
      cytosol/PAPS-mediated assay than in the S9/NADPH-mediated assay. The cytosol/PAPS
      mediated mutagenicity of both alcohols was 3- to 4-fold enhanced, when KCl (125
      mM) was present during the exposure. The authentic chloromethylarenes, 1
      chloromethylpyrene and 4-chloro-4H-cyclopenta[def]chrysene, showed very strong
      direct mutagenicity. These results, taken together with previous findings,
      indicate that both primary and secondary benzylic alcohols derived from
      polycyclic aromatic hydrocarbons may be activated by sulfotransferases to
      electrophilic sulfuric acid esters, and by subsequent substitution reaction to
      further active species such as benzylic chlorides.

PMID- 8472322
TI  - Expression of DNA methyltransferase in LEC rats during hepatocarcinogenesis.
AB  - The Long-Evans with a cinnamon-like color (LEC) rat is a mutant of the Long-Evans
      strain that develops hereditary hepatitis and hepatoma with ageing. Age-related
      changes in the mRNA expression of DNA methyltransferase (DNA MTase) were examined
      in livers of LEC rats using Long Evans with an agouti color (LEA) rats as
      controls. A dramatic increase in the expression of this mRNA was observed in LEC
      rats at 20 weeks when acute hepatitis appeared. Their high mRNA levels were
      maintained until 52 weeks of age. The mRNA expression as well as DNA MTase
      activities were found to be higher in cancer lesions than in adjacent normal
      tissue. These increases may be related to liver regeneration and to early events
      in cellular transformation of LEC rats.

PMID- 8472323
TI  - Temporal dissociation between cell proliferation and eosinophilic foci
      development in the exocrine pancreas of rats initiated with 4
      hydroxyaminoquinoline 1-oxide and administered soybean trypsin inhibitor.
AB  - Male Sprague-Dawley rats received a single i.v. injection of 4
      hydroxyaminoquinoline 1-oxide (HAQO) 7 mg/kg body weight or vehicle alone, and
      starting 7 days thereafter, were then fed basal diet with or without a 5% soybean
      trypsin inhibitor (SBTI) supplement. Subgroups were sequentially killed after 2,
      4, 7, 14, 30, 60 and 100 days on this regimen, in each case 1 h after injection
      of bromodeoxyuridine (BrdU). In the HAQO/SBTI and SBTI alone groups, 2 days after
      the SBTI treatment the labeling indices of acinar cells were increased
      approximately 12- and 11-fold respectively, dropping rapidly thereafter and
      returning to the control value by day 30. The earliest eosinophilic foci were
      noted in the HAQO/SBTI group 60 days after HAQO initiation, with the component
      cells demonstrating markedly increased labeling indices in contrast to the
      completely normalized levels observed in the surrounding exocrine tissue. On the
      other hand, eosinophilic foci were scarcely induced in the HAQO or SBTI alone
      group throughout the experiment. These results thus indicate a clear temporal
      dissociation between initial proliferation in parenchymal pancreatic tissue
      caused by SBTI and subsequent development of eosinophilic foci in rats initiated
      with HAQO.

PMID- 8472324
TI  - Ability of peroxisome proliferators to induce cell transformation, chromosome
      aberrations and peroxisome proliferation in cultured Syrian hamster embryo cells.
AB  - Di(2-ethylhexyl)phthalate (DEHP), a commonly used plasticizer, induces
      proliferation of peroxisomes in liver cells and causes hepatocellular carcinomas
      when chronically administered in the diet to rodents. To examine possible
      mechanisms for DEHP-associated cancer, we have measured induction of
      morphological transformation, chromosome aberrations and peroxisome
      proliferations of cultured Syrian hamster embryo (SHE) cells by DEHP and other
      peroxisome proliferators. Morphological transformation of SHE cells was weakly
      induced by treatment for 48 h with DEHP and its metabolite mono(2
      ethylhexyl)phthalate (MEHP). The transformation frequency by DEHP was enhanced by
      exogenous metabolic activation using rat liver postmitochondrial supernatants.
      Treatment for 24 h with DEHP resulted in chromosome aberrations of the cells only
      in the presence of exogenous metabolic activation. 2-(p-chlorophenoxy)-2
      methylpropionic acid ethyl ester (clofibrate), a widely used hypolipidemic drug,
      failed to induce morphological transformation or chromosome aberrations of SHE
      cells. Treatment with [4-chloro-6-(2,3-xylidino)-2-pyrimidinylthio] acetic acid
      (WY-14,643), which is a more potent carcinogen than DEHP or clofibrate, elicited
      a lower frequency of morphological transformation than DEHP in the presence of
      exogenous metabolic activation but was more active than DEHP at inducing
      chromosome aberrations. Similar levels of peroxisome proliferation, as determined
      by an intensity of diaminobenzidine staining, were observed in cultures treated
      for 2 h with DEHP, MEHP, clofibrate or WY-14,643. These results suggest a
      possible involvement of genetic damage by DEHP metabolites in the induction of
      cell transformation of SHE cells by DEHP; however, no clear relationship among
      induction of peroxisome proliferation, carcinogenicity in vivo and cell
      transformation was observed. Although the ability to induce cell transformation
      and chromosomal mutations is not adequate to explain the carcinogenicity of this
      class of compounds, these biological effects may be contributory to the
      carcinogenic activities of peroxisome proliferators.

PMID- 8472325
TI  - Species differences in the production and clearance of 1,3-butadiene metabolites:
      a mechanistic model indicates predominantly physiological, not biochemical,
      control.
AB  - Inhaled 1,3-butadiene, a monomer used in the production of synthetic rubber and
      other resins, is metabolized to mutagenic and carcinogenic epoxide intermediates.
      A physiologically based pharmacokinetic model of the uptake, tissue distribution,
      and metabolism of butadiene was constructed to determine if the biochemical
      kinetic constants obtained from in vitro studies are consistent with the observed
      in vivo uptake and metabolism. The model includes compartments for lung, blood,
      fat, liver, other rapidly perfused tissues ('viscera') and slowly perfused
      tissues. Metabolism of butadiene was assumed to occur in viscera in addition to
      lung and liver. Enzymatic reaction rate equations for the formation of 1,2-epoxy
      3-butene, for hydrolysis of this epoxide, and for its conjugation with
      glutathione were also included. Physiological and biochemical parameters for the
      mouse, rat and human were obtained from the literature; they were not adjusted to
      produce a fit to experimental data. The model was used to test the hypothesis
      that differences in uptake and clearance of butadiene by the three species are
      due to differences in the activities of the metabolizing enzymes. The model
      reproduces whole-body observations for the mouse and rat. It predicts that
      inhalation uptake of butadiene and formation and retention of epoxybutene are
      controlled to a much greater extent by physiological parameters than by
      biochemical parameters and that storage in the fat represents a significant
      fraction of the retained butadiene. Accumulation of epoxybutene in the blood is
      predicted to be higher in mice than in rats or humans, but accumulation of the
      epoxide intermediate in the liver is predicted to be highest in humans. The
      epoxide tissue concentrations predicted by the model do not, by themselves,
      correlate with tumor incidence in mice and rats, indicating that other factors
      are crucial for carcinogenesis induced by butadiene.

PMID- 8472326
TI  - Carcinogenicity, metabolism and Ki-ras proto-oncogene activation by 7,12
      dimethylbenz[a]anthracene in rainbow trout embryos.
AB  - Field studies suggest that recent epizootics of hepatic neoplasms in some feral
      fish populations are associated with polycyclic aromatic hydrocarbon (PAH)
      exposure, but attempts to induce liver tumors in these species under laboratory
      conditions have been unsuccessful. Several studies have shown hepatic neoplasma
      to be inducible in laboratory fish species following PAH exposure at the free
      swimming life stage. However, neither the susceptibility of the fish embryonic
      life stage to tumor induction by PAHs nor the potential of these carcinogens to
      induce oncogenic point mutations analogous to those reported in feral fish
      hepatic tumors have been clearly established. To address this, rainbow trout
      embryos were exposed by passive water uptake to 7,12-dimethylbenz[a]anthracene
      (DMBA), a potent model PAH in many mammalian tumor protocols. DMBA was rapidly
      absorbed by trout eggs and metabolized. The major non-polar metabolites
      identified were 12-hydroxymethyl-7-methylbenz[a]anthracene and 3,4-dihydroxy-3,4
      dihydro-DMBA, whereas approximately 25% of the water soluble metabolites were
      identified as glucuronides by beta-glucuronidase treatment. Embryonic DNA
      adduction increased with time of DMBA exposure (2.2 +/- 0.3 pmol DMBA
      equivalents/mg DNA at 24 h). Liver tumor incidence nine months after DMBA
      treatment was found to increase with DMBA concentration and exposure period (3.8%
      at 1 p.p.m./2 h; 23% at 5 p.p.m./2 h; 85% at 5 p.p.m./24 h). Stomach adenomas and
      nephroblastomas also were observed at low incidence in the DMBA-treated trout.
      Among 11 hepatic tumors examined, nine carried Ki-ras alleles with activating
      point mutations in codon 12 (4/11 GGA-->AGA; 4/11 GGA-->GTA) or codon 61 (1/11
      CAG-->CTG). This spectrum differs substantially from those reported for DMBA
      initiated mouse skin papillomas or hepatic tumors. These results may have
      important environmental implications because they suggest that even a brief
      exposure to PAHs during a sensitive stage of development may adversely affect
      some fish populations. They also indicate considerable variation in DMBA ras gene
      mutations among species and target organs.

PMID- 8472327
TI  - Genotoxic activity of 1-chloromethylpyrene in stomach epithelium in vivo:
      insensitivity of the stomach scintillation UDS assay.
AB  - An acknowledged weakness of current testing programmes for genotoxic hazard has
      been the potential insensitivity of the established mouse bone marrow
      micronucleus test and rat liver unscheduled DNA synthesis (UDS) assays to direct
      acting or short-lived mutagens, which may be consumed at the site of initial
      contact. In such cases, in vivo test systems sampling tissues such as the skin or
      the stomach would provide valuable data. To test these principles a stomach UDS
      assay was evaluated using the potent locally active mutagen 1-chloromethylpyrene
      (1-CMP). Contrary to expectations, no UDS response was observed 16 h following 1
      CMP dosage by oral gavage. To confirm the integrity of the 1-CMP used for the
      stomach UDS assay, a sample of the stored chemical was re-evaluated in vitro and
      shown to be still strongly positive in the Ames assay and to have alkylating
      activity at least 15 min after incubation at stomach acid pH. No UDS response was
      observed when test dose levels were reduced or when earlier sampling times were
      used. Other genotoxic endpoints were examined in stomach. 32P-Postlabelling
      analysis revealed high levels of adduct formation in gastric DNA. An assay
      utilizing electrophoresis of DNA (the comet assay) showed the occurrence of DNA
      damage following dosing with 1-CMP in vivo. These positive results confirmed that
      1-CMP should be regarded as a potential in vivo genotoxin. The failure to detect
      a UDS response to 1-CMP in stomach was investigated; a strong UDS response was
      observed in an in vitro hepatocyte UDS assay of 1-CMP indicating that the rat was
      capable of repairing 1-CMP-derived DNA adducts. Pretreatment of rats with
      hydroxyurea depressed the level of incorporation of thymidine into DNA both in
      negative and positive [methyl-N-nitrosoguanidine (MNNG)] controls. The results of
      these studies indicated that the protease digestion method employed did not
      selectively or efficiently sample those cells with any UDS response to 1-CMP or
      MNNG, and the activity seen for the latter was most likely due to the presence of
      S phase cells within the digests. As a result of the finding that UDS responses
      were not demonstrated for the potent direct-acting mutagens 1-CMP and MNNG, the
      protease digestion/scintillation method for stomach UDS does not appear to have
      general value in a screening programme for locally active genotoxic agents.

PMID- 8472328
TI  - Mutation in Escherichia coli and mammalian cells induced by closely spaced 1
      methylpyrene-deoxyadenosine adducts in opposite DNA strands.
AB  - Twenty-eight base complementary oligonucleotides were synthesized with
      deoxyadenosine residues modified at the N6 position with 1-methylpyrene (MP)
      specifically positioned 3 bp apart in opposite DNA strands. Doubly modified
      constructs as well as non-modified and singly modified constructs were ligated
      into M13mp19 and an SV40-based shuttle vector pSVL-lac for transfection into
      Escherichia coli and large T-antigen-expressing monkey kidney epithelial cells
      respectively. Repair of MP adducts was analyzed by direct nucleotide sequencing
      after selection of clones containing the 28mer construct. In E. coli, double MP
      adducts induced base substitutions at positions mainly adjacent to modified
      adenines, while single MP adducts were not mutagenic. Single base insertions were
      also induced proximal to modified adenines. The frequency of mutation induced by
      double MP adducts in E. coli was approximately 4% (eight mutations out of 196
      analyzed). In monkey kidney cells, double MP adducts induced one and three base
      deletions and single base insertions. Base substitution was observed in
      constructs containing non-modified and singly modified adenine residues,
      indicative of a significant spontaneous mutation rate. The frequency of mutation
      induced by double MP adducts in monkey kidney cells was approximately 9% (six
      mutations out of 66 clones analyzed). Modification of adenine residues by MP
      caused termination of DNA replication by E. coli DNA polymerase I (Klenow
      fragment) in vitro at the position opposite the MP adduct and at the preceding
      base. The repair of closely spaced polycyclic aromatic hydrocarbon adducts in
      opposite DNA strands is discussed as it relates to mutagenesis and carcinogenesis
      in mammalian cells.

PMID- 8472329
TI  - Promutagenic methylation damage in liver DNA of mice infected with Schistosoma
      mansoni.
AB  - Male and female BK-TO mice were infected with different numbers of Schistosoma
      mansoni cercariae under standard environmental conditions. Promutagenic
      methylation damage (O6-methyldeoxyguanosine; O6-MedG) was detected in liver DNA,
      but not in kidney, spleen or bladder DNA of infected animals. It was shown that
      levels of hepatic O6-MedG increased with increasing intensities of schistosomal
      infection. Possible mechanisms of action are discussed. These include the
      activating effects of schistosomes and their products on murine macrophages and
      subsequent endogenous formation of N-nitroso compounds by the activated
      macrophages.

PMID- 8472330
TI  - Vitamin E is a complete tumor promoter in mouse skin.
AB  - The dorsal skins of 6-8 week old female SENCAR mice were initiated with a single
      application of 10 nmol of 7,12-dimethylbenz[a]anthracene (DMBA) and subsequently
      promoted twice/week with topical applications of vitamin E (dl-alpha-tocopherol,
      80 mumol/treatment). Vitamin E from two separate commercial suppliers was tested.
      For comparison, a group of similar mice, also initiated with DMBA, was promoted
      twice/week with the known tumor promoter 12-O-tetradecanoylphorbol-13- acetate
      (TPA, 2 micrograms/treatment). Papillomas appeared 39 and 50 days respectively
      after promotion began with vitamin E from the two different sources, as compared
      with 32 days in the group receiving TPA promoted. Hundred per cent of TPA
      promoted animals and 92-96% of the vitamin E-promoted mice developed tumors. A
      maximum of 15 papillomas/animal appeared in the TPA-promoted mice. The two
      vitamin E preparations were somewhat less effective than TPA and showed different
      relative potencies, producing about seven and 12 papillomas per animal
      respectively. Unlike TPA, vitamin E showed very little ability to produce an
      inflammatory response in skin. To test whether initiated cells that did not
      appear as papillomas after vitamin E promotion were still viable, and had
      proceeded past stage I of promotion (conversion), the group that developed 12
      papillomas/animal from vitamin E promotion was further promoted with mezerein, a
      stage II promoter. In this group, the papilloma frequency then increased to
      approximately 17/animal. The animals were followed over the course of their
      lifespan and monitored for skin carcinomas. In the TPA-promoted group 64% of the
      mice developed carcinomas, while the two vitamin E-promoted groups showed 48 and
      60% incidence respectively. These results indicate that topically applied vitamin
      E acts as a complete tumor promoter in DMBA-initiated mouse skin, with an
      efficiency approaching that of TPA. Since vitamin E is a powerful antioxidant,
      they also suggest that reduction of cellular oxidant levels may trigger the tumor
      promotional process, and it may therefore be prudent to avoid repetitive or
      prolonged topical exposure of human skin to antioxidants like vitamin E.

PMID- 8472331
TI  - N-acetylation phenotype and genotype and risk of bladder cancer in benzidine
      exposed workers.
AB  - Several studies in subjects occupationally exposed to arylamine carcinogens have
      shown increased risks for bladder cancer associated with the slow acetylator
      phenotype. To follow up these reports, a case-control study of N-acetylation and
      bladder cancer risk was carried out among subjects occupationally exposed to
      benzidine, in benzidine dye production and use facilities in China. Thirty-eight
      bladder cancer cases and 43 controls from these factories were included for study
      of acetylation phenotype, by dapsone administration, and for polymorphisms in the
      NAT2 gene, by a polymerase chain reaction (PCR)-based test. In contrast to
      previous studies, no increase in bladder cancer risk was found for the slow N
      acetylation phenotype (OR = 0.3; 95% CI = 0.1-1.3) or for slow N-acetylation
      associated double mutations in NAT2 (OR = 0.5; 95% CI = 0.1-1.8). Examination of
      specific mutations and adjustment for age, weight, city and tobacco use did not
      alter the results. When examined by level of benzidine exposure in the cases, the
      bladder cancer risks associated with low (OR = 0.3, 95% CI = 0.0-2.2), medium (OR
      = 0.7, 95% CI = 0.1-4.5) and high (OR = 0.6, 95% CI = 0.1-3.5) exposure showed no
      interaction between genotype and benzidine exposure, within the range of
      exposures experienced by subjects in this study. This study, which is the first
      to incorporate phenotypic and genotypic analyses, provides evidence that the NAT2
      related slow N-acetylation polymorphism is not associated with an increased risk
      of bladder cancer in workers exposed to benzidine, and may have a protective
      effect.

PMID- 8472332
TI  - Ionizing radiation induces O6-alkylguanine-DNA-alkyltransferase mRNA and activity
      in mouse tissues.
AB  - The effect of exposure to whole-body gamma-irradiation or fast electrons on O6
      alkylguanine-DNA-alkyltransferase (ATase) activity and mRNA abundance has been
      examined in mice. In response to gamma-radiation, hepatic ATase activity was
      significantly raised in BDF1 mice 24 h post-irradiation, reaching a maximum of 2-
      to 3-fold at 36 h and beginning to decrease by 48-60 h. A small but consistently
      higher level of induction was achieved when mice were exposed using a low dose
      rate (0.015 Gy/min) compared to a high dose rate (0.5 Gy/min). ATase activity was
      also induced approximately 2-fold 48 h post-irradiation in brain, kidney, lung
      and spleen, with a greater induction again observed in response to the lower dose
      rate. In response to fast electrons from a linear accelerator hepatic ATase
      activity was also induced 2- to 3-fold 48 h post-irradiation in BDF1, BALB/c,
      C57Bl and DBA2 strains. Induction of ATase activity in livers of BDF1 mice was
      observed 48 h after a total single dose of 5 Gy gamma-radiation (2-fold),
      increasing to a slightly higher level at 15 Gy, but no induction was observed at
      doses of 2 Gy and below. Although a maximum 2- to 3-fold induction of ATase
      activity was observed, mRNA levels were induced 3- to 4-fold by 48 h after a dose
      of 15 Gy. Furthermore, significant increases in mRNA levels were detected at low
      doses (1-2 Gy) at which there was no apparent increase in ATase activity. This
      suggests that ionizing radiation increases ATase levels by a process involving
      transcriptional upregulation but that strong post-transcriptional and/or
      translational controls operate to limit induction of enzyme activity to 2- to 3
      fold. This is the first report of an in vivo induction of ATase by ionizing
      radiation in a species other than the rat.

PMID- 8472333
TI  - Species differences in the hydrolysis of 2-cyanoethylene oxide, the epoxide
      metabolite of acrylonitrile.
AB  - The carcinogenic effects of acrylonitrile in rats are believed to be mediated by
      its DNA-reactive epoxide metabolite, 2-cyanoethylene oxide (CEO). Previous
      studies have shown that conjugation with glutathione is the major detoxication
      pathway for both acrylonitrile and CEO. This study investigated the role of
      epoxide hydrolase in the hydrolysis of CEO by HPLC analysis of the products from
      [2,3-14C]CEO. CEO is a relatively stable epoxide with a half-life of 99 min at 37
      degrees C in sodium phosphate buffer (0.1 M), pH 7.3. Incubation with hepatic
      microsomes or cytosols from male F-344 rats or B6C3F1 mice did not enhance the
      rate of hydrolysis of CEO (0.69 nmol/min). Human hepatic microsomes significantly
      increased the rate of hydrolysis of CEO, whereas human hepatic cytosols did not.
      Human hepatic microsomal hydrolysis activity was heat-sensitive and potently
      inhibited by 1,1,1-trichloropropene oxide (IC50 of 23 microM), indicating that
      epoxide hydrolase was the catalyst. The hydrolysis of CEO catalyzed by hepatic
      microsomes from six individuals exhibited normal saturation kinetics with KM
      ranging from 0.6 to 3.2 mM and Vmax from 8.3 to 18.8 nmol hydrolysis
      products/min/mg protein. Pretreatment of rodents with phenobarbital or acetone
      induced hepatic microsomal hydrolysis activity toward CEO, whereas treatment with
      beta-naphthoflavone, dexamethasone or acrylonitrile itself was without effect.
      These data show that humans possess an additional detoxication pathway for CEO
      that is not active in rodents (but is inducible). The presence of an active
      epoxide hydrolase hydrolysis activity toward CEO in humans should be considered
      in assessments of cancer risk from acrylonitrile exposure.

PMID- 8472334
TI  - Intermediate biomarkers of colon cancer: modulation of expression of ras oncogene
      by chemopreventive agents during azoxymethane induced colon carcinogenesis.
AB  - In our attempts to evaluate the influence of chemopreventive agents on
      intermediate biomarkers of colon cancer, we have investigated the effect of D,L
      alpha-difluoromethylornithine (DFMO), an irreversible inhibitor of ornithine
      decarboxylase and piroxicam, a non-steroidal anti-inflammatory drug (NSAID) on
      the expression levels of biochemically active p21ras, the protein product of
      cellular ras protooncogenes during the development of azoxymethane (AOM) induced
      colon carcinogenesis in male F344 rats in order to explore the plausibility of
      using p21ras as an intermediate biochemical marker of colon cancer. Groups of
      male F344 rats were fed the modified AIN-76A diets containing 0 or 150 p.p.m.
      piroxicam or 4000 p.p.m. DFMO and administered s.c. AOM dissolved in normal
      saline at a dose of 15 mg/kg body wt/week, once weekly, for 4 weeks. Vehicle
      control groups received s.c. equal vol of normal saline. Groups of animals were
      then killed at 0, 4, 16, 24 and 32 weeks after the last injection of AOM or
      saline and their colonic mucosa and tumors analyzed for biochemically active
      p21ras levels. AOM treatment significantly increased the expression of
      biochemically active p21ras. The AOM-induced expression of biochemically active
      p21ras was significantly suppressed by dietary DFMO and piroxicam. DFMO exerted a
      more pronounced inhibitory effect on AOM-induced colon tumor development as well
      as the expression of biochemically active p21ras. These results indicate that the
      determination of biochemically active p21ras may be effectively used in clinical
      chemoprevention trials as an intermediate end-point to monitor the colon
      carcinogenesis.

PMID- 8472335
TI  - Studies on the relationship between hemoglobin and DNA adducts of malonaldehyde
      and their stability in vivo.
AB  - The stability of the adducts of malonaldehyde (MA) to N-terminal valine in
      hemoglobin (Hb) and to guanine at N1,N2 in liver DNA was determined in vivo. Mice
      were injected with radiolabeled or unlabeled MA and the decay of the levels of Hb
      and DNA adducts was determined using the N-alkyl Edman method and the 32P
      postlabeling assay respectively. The rate of adduct formation was much higher
      towards valine in Hb than towards guanine in DNA. The highest level of adducts to
      valine was observed 4 h after the treatment, whereas the corresponding level for
      guanine was after approximately 120 h. The adduct to guanine in DNA was
      significantly more stable. The estimated half-lives of the adduct to N-terminal
      valine in Hb and for the adduct to guanine in DNA were approximately 6 and
      approximately 12.5 days respectively. The persistence of DNA adducts from MA in
      liver indicates that this type of adduct is poorly recognized by DNA repair
      enzymes and thus may accumulate during chronic exposure.

PMID- 8472336
TI  - Inhibition of 8-hydroxydeoxyguanosine formation by curcumin in mouse fibroblast
      cells.
AB  - Curcumin, a pigment responsible for the yellow color of curry, has been shown to
      be an anti-inflammation agent, an antioxidant and an antipromoter. 8
      Hydroxydeoxyguanosine (8-OH-dG), an oxidized nucleoside, may be responsible for a
      genetic event of tumor promotion in carcinogenesis. 8-OH-dG can be detected
      selectively and sensitively at the fmol level by HPLC-electrochemical detection
      at an applied potential of +0.8 V versus Ag/AgCl. Phorbol-12-myristate-13-acetate
      (PMA), a potent tumor promoter, induces lipid peroxidation and 8-OH-dG formation.
      Curcumin can strongly scavenge the hydroxyl radical (OH.) to prevent 8-OH-dG
      formation from dG (deoxyguanosine) in vitro and reduce the production of PMA
      induced lipid peroxidation and 8-OH-dG in mouse fibroblast cells. These results
      suggest that curcumin inhibits the PMA-induced tumor promotion by functioning as
      an OH. radical scavenger to prevent 8-OH-dG formation within the DNA molecule.

PMID- 8472337
TI  - Differential effects of dietary beta-carotene on papilloma and carcinoma
      formation induced by an initiation-promotion protocol in SENCAR mouse skin.
AB  - SENCAR mice were used to determine the effects of the provitamin A compound beta
      carotene on papilloma formation and the conversion of papillomas to carcinomas in
      a two-stage protocol with one application of the initiator 7,12
      dimethylbenz[a]anthracene (DMBA, 20 micrograms) and 20 weekly applications of the
      promotor 12-O-tetradecanoylphorbol-13-acetate (TPA, 2 micrograms). A purified
      vitamin A-free diet was supplemented with beta-carotene at four levels (0.6, 6,
      60 and 600 micrograms/g of diet) for female mice and two levels (60 and 600
      micrograms/g) for male mice. Dietary supplementations of beta-carotene did not
      result in significant changes in body weight and survival of female and male
      mice. However, papillomas developed more rapidly and papilloma incidence (% mice
      with papillomas) reached its maximum (100%) sooner in male mice fed 600
      micrograms of beta-carotene/g of diet than those fed 60 micrograms/g. There were
      smaller differences in papilloma incidence among the dietary groups in female
      mice, but the papilloma incidence again reached 100% sooner in mice fed 600
      micrograms of beta-carotene/g of diet. Female and male mice fed 600 micrograms of
      beta-carotene/g of diet had significantly higher papilloma yields (average number
      of papillomas/mouse) than other dietary groups and a very low percentage of these
      papillomas converted to carcinomas in these mice. Thus, beta-carotene at 600
      micrograms/g inhibited the conversion of papillomas to carcinomas in both sexes.
      In addition, papilloma yields were higher in female mice and these papillomas
      regressed more quickly than those in the corresponding groups of male mice. In
      conclusion, dietary beta-carotene caused differential effects on papilloma and
      carcinoma yields and sex-dependent differences in papilloma formation in female
      and male SENCAR mice treated with DMBA and TPA in a two-stage carcinogenesis
      protocol.

PMID- 8472338
TI  - Comparison of 12-O-tetradecanoylphorbol-13-acetate and teleocidin for induction
      of epidermal hyperplasia, activation of epidermal PKC isozymes and skin tumor
      promotion in SENCAR and C57BL/6 mice.
AB  - The present study compared the ability of 12-O-tetradecanoylphorbol-13-acetate
      (TPA) and teleocidin to induce sustained epidermal hyperplasia, activate
      partially purified epidermal protein kinase C (PKC) isozymes and promote skin
      tumors in SENCAR and C57BL/6 mice. Teleocidin was less effective than TPA on a
      molar basis for inducing sustained epidermal hyperplasia, promoting skin tumors
      and activating partially purified epidermal PKC isozymes in vitro when examined
      using SENCAR mice. In contrast, teleocidin was more effective than TPA on a molar
      basis for inducing sustained epidermal hyperplasia, approximately equi-effective
      for promoting skin tumors and significantly less effective for activating PKC
      isozymes in vitro when examined using C57BL/6 mice. Despite the differences in
      response of C57BL/6 mice to TPA and teleocidin, this mouse strain was still
      highly resistant to skin tumor promotion by both types of promoters when compared
      with SENCAR mice. The current results, when considered in light of our recent
      studies (Cancer Res., 51, 1398-1405, 1991), indicate that C57BL/6 are generally
      resistant to a variety of classes of skin tumor promoters, including the
      teleocidins. In addition, except for the phorbol esters, the induction of
      sustained epidermal hyperplasia does not appear to be as good a marker for
      overall promotion responsiveness between SENCAR and C57BL/6 mice with other
      classes of tumor promoters; although the induction of a significant sustained
      hyperplasia in the latter mouse strain did yield a weak tumor response. Taken
      together, the current data suggest that factors in addition to the induction of
      sustained epidermal hyperplasia, control responsiveness of C57BL/6 mice to skin
      tumor promotion by diverse promoting stimuli.

PMID- 8472339
TI  - Specificity of mutations induced by N-methyl-N-nitrosourea in a cDNA of the hprt
      gene.
AB  - N-Methyl-N-nitrosourea (MNU) reacts with DNA to produce a variety of lesions, of
      which O6-methylguanine (O6-MeG) has been implicated in the mutagenic and
      carcinogenic effects of this agent. The present study aimed to investigate the
      types and position specificities of mutations induced by MNU. Mutational sequence
      alterations were determined for 53 independent mutations induced by MNU in a cDNA
      of the human hprt gene, which is stably integrated into chromosomes of the mouse
      cell line VH12. The majority of the mutations induced by MNU were base
      substitutions (85%), mostly GC to AT transitions (41/43), and the remainder (15%)
      were frameshift or deletion mutations resulting from loss or addition of a few
      bases. The transition mutations occurred preferentially at the middle G in 5'
      purine-G-N-3' sequences in the non-transcribed strand, and were distributed
      nonrandomly over the coding region of the gene. Analysis of the results suggests
      that, when interpreting mutational specificity and distribution, not only the
      nature of the mutational target sequence, but also the functional domains of the
      protein should be considered.

PMID- 8472340
TI  - Cell type-specific expression of the O6-alkylguanine-DNA alkyltransferase gene in
      normal human liver tissues as revealed by in situ hybridization.
AB  - The O6-alkylguanine-DNA alkyltransferase (ATase) is known to overcome the effects
      of promutagenic, precarcinogenic O6-alkylguanine induced in DNA by exposure to
      environmental, chemotherapeutic and dietary alkylating agents. Within an organ,
      the cell type-specific responses to these agents may be attributed, in part, to
      varying expression of critical DNA repair genes, like ATase. In order to
      determine the cell-specific expression of the human ATase gene, in situ
      hybridization was used to map the cellular distribution of ATase mRNA in tissue
      sections of normal human fetal and adult livers. Tissue sections were hybridized
      with a digoxigenin-labeled 39 base oligomer, antisense to ATase cDNA. Following
      immunodetection, using an alkaline phosphatase-conjugated anti-digoxigenin
      antibody, the ATase-specific mRNA levels were visualized in parallel with liver
      cell type identification. The specificity of the antisense probe and
      hybridization to human ATase mRNA was demonstrated by: (i) staining of Mer+ and
      not Mer- cells by the antisense probe; (ii) faint staining of liver sections when
      the antisense probe was not used during hybridization; (iii) no hybridization of
      liver sections by the sense probe; (iv) no staining of sections preincubated with
      RNase before hybridization; and (v) the retention of cell type-specific staining
      patterns in tissue sections incubated with DNase prior to hybridization with the
      antisense probe. The staining patterns appeared similar in adjacent sections of
      tissues obtained from the same liver and in sections obtained from either adult
      or fetal livers of different individuals. The expression of the ATase mRNA, as
      noted by stain intensity, appeared highest in all of the bile ductal cells. There
      was a heterogenous expression in hepatocytes, which varied from moderate to high
      stain. Staining in Kupffer cells also appeared to be high. Sinusoidal cells,
      endothelial cells of the hepatic artery and cells of the connective tissue showed
      weak hybridization, indicating low levels of ATase mRNA. These data explain, in
      part, the basis for a differential response of various cell types within the
      liver to the mutagenic and carcinogenic effects of alkylating agents.

PMID- 8472341
TI  - Mutagenicity of the bile of dogs with an experimental model of an anomalous
      arrangement of the pancreaticobiliary duct.
AB  - To learn the reasons for the high incidence of biliary carcinoma in patients with
      anomalous arrangement of the pancreaticobiliary duct (APBD) mutagenicity of the
      bile of APBD-modeled dogs that had received a dorsal pancreatico-cholecystostomy
      was assayed by the Ames Salmonella mutation test. The bile from two out of 18
      APBD dogs was mutagenic for Salmonella typhimurium strain TA98 under the
      condition of metabolic activation by rat liver S9 fraction, while the bile from
      17 normal dogs was not mutagenic. Furthermore, the bile from five APBD dogs i.p.
      administered 1-nitropyrene (1-NP), which is a typical environmental mutagen, was
      more mutagenic for strain TA98 than that from 1-NP-treated normal dogs. The bile
      from the APBD dogs had very high amylase activity, indicating that the bile
      contained pancreatic juice as a result of the pancreatico-cholecystostomy. When
      pancreatic juice from a normal dog was added to the bile from 1-NP-treated normal
      dogs, mutagenicity of the bile increased 1.6- to 2.0-fold. Furthermore, sulfatase
      increased the mutagenic activity of the bile in the presence of the pancreatic
      juice. HPLC revealed that the bile from a 1-NP-treated APBD dog contained
      mutagenic 1-nitro-6/8-hydroxypyrene and 1-nitro-3-hydroxypyrene, while bile from
      a 1-NP-treated normal dog did not contain these deconjugated products. The
      pancreatic juice from a normal dog had very high gamma-glutamyltransferase (GGT)
      and aminopeptidase activities and low sulfatase activity, but it had no beta
      glucuronidase activity. In addition, the bacteria that easily infect the biliary
      duct of APBD dogs, Escherichia coli, Klebsiella, Enterobacter and Proteus, had
      high beta-glucuronidase activity. In particular, Klebsiella showed a very high
      sulfatase activity. These results suggest that pancreatic juice enzymes and
      bacteria infecting the biliary duct deconjugate the detoxified mutagens in the
      bile and induce mutagenicity of the bile from APBD dogs or APBD patients.

PMID- 8472342
TI  - Inhibition by phenylethyl and phenylhexyl isothiocyanate of metabolism of and DNA
      methylation by N-nitrosomethylamylamine in rats.
AB  - We investigated the effect of 2-phenylethyl and 6-phenylhexyl isothiocyanate
      (PEITC and PHITC) on the metabolism of the rat esophageal carcinogen, N
      nitrosomethylamylamine (NMAA). PEITC was administered orally to MRC-Wistar rats
      as single doses of 0.1 or 1.0 mmol/kg, or by other regimens. When esophagi and
      liver slices from the treated rats were incubated with 23 microM NMAA, the
      formation of 2- to 5-hydroxy-NMAA was inhibited by 45-90% for esophagus and by 14
      19% for liver slices. In contrast, when esophagi and liver slices from untreated
      MRC-Wistar rats were incubated in vitro with NMAA and 10 microM PEITC, the PEITC
      inhibited hydroxy-NMAA formation similarly (by 79-89%) in the two tissues. Also,
      PEITC inhibited the formation from NMAA of the hydroxy-NMAAs, formaldehyde and
      pentaldehyde by esophageal and liver microsomes to similar extents. In studies on
      DNA methylation by NMAA, 7- and O6-methylguanine (O6-MeG) were determined by HPLC
      with fluorimetric detection. Guanine methylation in esophageal and liver DNA was
      generally close to linear for doses of 5-50 mg NMAA/kg. With 50 mg NMAA/kg,
      guanine methylation in esophageal and liver DNA peaked after 5 h, and 8-11% of
      the peak O6-MeG persisted after 72 h. A single dose of 0.1 or 1.0 mmol PEITC/kg
      reduced the O6-MeG levels by 44-51% in the esophagus but by only 7-22% in the
      liver. Administration of the PEITC homolog, PHITC, inhibited NMAA metabolism by
      liver slices from the treated rats and the methylation of guanine in liver DNA,
      but had little effect in the esophagus, i.e. PHITC tended to have the opposite
      tissue specificity to PEITC. The finding that administration of PEITC
      specifically inhibited NMAA metabolism in the rat esophagus supports the view
      that PEITC may be a useful chemopreventive agent against esophageal
      carcinogenesis in humans.

PMID- 8472343
TI  - Increased expression of the female-predominant cytochrome P4502C12 in liver
      nodules from male Wistar rats.
AB  - Nodules and hepatomas from male and female rats treated according to the
      resistant hepatocyte (RH) model were analyzed with respect to expression of the
      male-predominant cytochrome P4502C11 (P450(16 alpha)) and the female-predominant
      cytochrome P4502C12 (P450(15 beta)) at the transcriptional and at the mRNA and
      protein levels. In male nodules isolated 8 and 11 to 12 months after initiation
      and in hepatomas, the expression of P450(16 alpha) mRNA was 3- to 11-fold lower
      than in surrounding liver, whereas a 2- to 8-fold higher expression of P450(15
      beta) was observed compared with surrounding tissue. These alterations in P450
      mRNA expression were reflected by similar changes at the protein level. Nuclear
      transcription of the cytochrome P450(16 alpha) gene was lower in male nodules
      than in surrounding liver whereas transcription of the P450(15 beta) gene was
      higher in the nodules. In nodules and hepatomas from female rats no significant
      differences in either mRNA expression or protein level of either P450(16 alpha)
      or P450(15 beta) were seen. The present study indicates that liver nodules are,
      to some extent, withdrawn from the normal endocrine regulation of rat liver
      function. Furthermore, the observed increase in a specific cytochrome P450
      species (P450(15 beta)) in male liver nodules contradicts the previous suggestion
      of a general downregulation of this enzyme family as a characteristic of the
      nodular phenotype.

PMID- 8472344
TI  - The proximal promoter region of the human heme oxygenase gene contains elements
      involved in stimulation of transcriptional activity by a variety of agents
      including oxidants.
AB  - The rate of transcription of the heme oxygenase gene is enhanced by a variety of
      agents including oxidants such as hydrogen peroxide and UVA (320-380 nm)
      radiation and the sulfhydryl reagent, sodium arsenite. To further analyze the
      inducible response, we have isolated genomic clones of the human heme oxygenase
      gene. A 1.44 kb fragment corresponding to a region extending from 1416 bp
      upstream of the mRNA cap site to 24 bp into the 5' untranslated region of the
      mRNA has been further subcloned and sequenced and used as the basis for the
      construction of recombinant CAT transient expression vectors. By deleting large
      portions of this fragment, we have established that elements within 121 bp of
      sequence immediately upstream of the mRNA cap site respond to various agents
      (sodium arsenite, hydrogen peroxide, hemin, cadmium chloride and 12-O
      tetradecanoyl-phorbol-13-acetate) to give a 3- to 5-fold enhancement in transient
      expression of the reporter gene. Under the assay conditions employed, induction
      can only be detected when a SV40 enhancer element is present upstream of the
      promoter sequence. However, control experiments show that the SV40 sequences
      serve to amplify the response and are not directly involved in the induction
      itself. Only a small induction occurs when the entire 1.44 kb fragment is
      present. The results are consistent with the possibility that additional
      inducible enhancer elements lie outside of the sequence under study and that a
      silencer or negative regulatory element occurs upstream of the mRNA cap site
      within the 1.44 kb fragment.

PMID- 8472345
TI  - Reaction of cyclopenta[c,d]pyrene-3,4-epoxide with DNA and deoxynucleotides.
AB  - Cyclopenta[c,d]pyrene (CPP) is a widespread polycyclic aromatic hydrocarbon with
      potent mutagenic and carcinogenic activity. The trans isomer of 3,4-dihydro-3,4
      dihydroxy-cyclopenta[c,d]pyrene has been shown to be the major metabolic product
      of CPP in rat, mouse or human microsomal systems, as well as in peroxyl radical
      generating systems, indicating the preferential formation of its obligatory
      precursor, CPP-3,4-epoxide. The direct mutagenicity of CPP-3,4-epoxide, the
      inactivity of 3,4-dihydro-CPP and the DNA adduct forming capacity of CPP in vivo
      has prompted analysis of the DNA adducts produced by CPP-3,4-epoxide to provide
      information pertaining to: (i) the role this postulated major ultimate mutagenic
      metabolite may play in the formation of DNA adducts in vivo; (ii) the base
      selectivity of CPP-3,4-epoxide DNA adducts; and (iii) the role of CPP-3,4-epoxide
      in the mutagenicity/carcinogenicity of CPP. CPP-3,4-epoxide was reacted with calf
      thymus DNA, dGp, dAp, dTp, dCp, poly dG-dC, poly dA-dT and poly dG. Adducts were
      analyzed by the butanol-enhanced version of 32P-postlabeling. Four major and at
      least three minor adducts formed with DNA in vitro, which were further analyzed
      for their base selectivity. A similar spectrum of adducts was exhibited by dGp,
      poly dG-dC and poly dG. dCp, dTp, and dAp formed one, two, and four adducts
      respectively. The relative binding in adducts per 10(7) nucleotides was in the
      following descending order: dGp (6000), poly dG-dC (5800), dTp (5300), dAp
      (4800), calf thymus DNA (3800), poly dA-dT (2300), poly dG (2600) and dCp (20).
      Adducts derived from either dGp, poly dG-dC or poly dG co-migrated with the DNA
      adducts in three solvent systems, indicating that CPP-3,4-epoxide forms DNA
      adducts almost exclusively with deoxyguanosine.

PMID- 8472346
TI  - Initiation and promotion of colonic aberrant crypt foci in rats by 5
      hydroxymethyl-2-furaldehyde in thermolyzed sucrose.
AB  - We have previously shown that thermolyzed sucrose in the diet promotes the growth
      of aberrant crypt foci (ACF) in the rat. HPLC analysis of the light caramel
      colored product showed that it contained 1% 5-hydroxymethyl-2-furaldehyde (HMF),
      confirmed by mass and NMR spectroscopy. To determine whether HMF was responsible
      for the promotion of ACF by thermolyzed sucrose, 45 F344 female rats were
      initiated with the colon carcinogen azoxymethane (AOM), and a week later were
      randomized to four groups receiving AIN-76 diets containing untreated sucrose,
      20% thermolyzed sucrose, 20% butanol extracted thermolyzed sucrose (HMF free) or
      1% HMF. Thermolyzed sucrose in the diet led to larger ACF as previously observed.
      Thermolyzed sucrose extracted to remove HMF, did not affect ACF size, but 1% HMF
      added to the diet led to a larger ACF both with relation to average size and
      number of ACF of larger sizes (P < 0.05). To determine whether HMF had initiating
      effects, 172 female F344 rats were given water, HMF (at doses to 300 mg/kg) or
      AOM (5 mg/kg) by gavage twice and the total number of ACF was scored 30 days
      later. The results demonstrated that HMF induces ACF in a dose-dependent manner
      (P < 0.02), though the effect was much weaker than that of AOM. We conclude that
      sugar heated under household cooking conditions may act as both an initiator and
      a promoter of colon cancer because of the presence of HMF.

PMID- 8472347
TI  - Sucrose enhancement of the early steps of colon carcinogenesis in mice.
AB  - The association of refined sugars and colorectal cancers and polyps in three
      recent case-control studies led us to investigate the effects of sucrose,
      fructose and glucose on colonic epithelial proliferation and sensitivity to
      carcinogenesis. CF1 and C57BL/6J mice were used; proliferation was assessed as
      vincristine-accumulated mitotic figures per crypt section; sensitivity to
      carcinogenesis was assessed as the number of aberrant crypt foci (ACF) per colon
      observed following the colon carcinogen, azoxymethane (AOM, 3 mg/kg and 5 mg/kg).
      Oral gavages of sucrose and fructose in CF1 mice (10 g/kg) increased colonic
      proliferation 16 h later (2.8 +/- 0.6 and 4.1 +/- 0.7 (mean +/- SEM) accumulated
      mitotic figures/crypt section), compared with glucose and water (1.0 +/- 0.2 and
      0.4 +/- 0.1). Sucrose and fructose given 14 h prior to the AOM (5 mg/kg)
      increased the sensitivity of the colon to carcinogenesis (18.4 +/- 1.5 and 13.1
      +/- 1.8 ACF/colon), compared with glucose and water (11.4 +/- 2.0 and 8.6 +/-
      1.1). Similar results were observed with C57BL/6J mice. We conclude that dietary
      sucrose and fructose may represent risk factors for colorectal cancer through a
      direct effect of the sugars on colonic epithelial proliferation.

PMID- 8472348
TI  - Prothrombin activation fragment assay.

PMID- 8472349
TI  - Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in
      clinical medicine.
AB  - The clinical performance of a laboratory test can be described in terms of
      diagnostic accuracy, or the ability to correctly classify subjects into
      clinically relevant subgroups. Diagnostic accuracy refers to the quality of the
      information provided by the classification device and should be distinguished
      from the usefulness, or actual practical value, of the information. Receiver
      operating characteristic (ROC) plots provide a pure index of accuracy by
      demonstrating the limits of a test's ability to discriminate between alternative
      states of health over the complete spectrum of operating conditions. Furthermore,
      ROC plots occupy a central or unifying position in the process of assessing and
      using diagnostic tools. Once the plot is generated, a user can readily go on to
      many other activities such as performing quantitative ROC analysis and
      comparisons of tests, using likelihood ratio to revise the probability of disease
      in individual subjects, selecting decision thresholds, using logistic-regression
      analysis, using discriminant-function analysis, or incorporating the tool into a
      clinical strategy by using decision analysis.

PMID- 8472350
TI  - Enzyme immunoassay for intact human insulin in serum or plasma.
AB  - We describe an enzyme-linked two-site immunoassay for quantitation of intact
      insulin in human serum and plasma. The method uses two murine monoclonal
      antibodies that bind to two different epitopes on the insulin molecule. The
      immunoassay is specific. Human proinsulin is not bound by the antibodies, and the
      binding of partially processed proinsulin intermediates is believed to be of
      minor clinical importance. The relative response of human, bovine, and porcine
      insulin is 1, 1, and 3, respectively. The assay is sensitive (detection limit 5
      pmol/L), accurate (101% recovery with 50 pmol/L insulin added to samples, 95%
      with 100 pmol/L, and 89% with 300 pmol/L), and fast (results within 3 h), and has
      a high analytical capacity (done in microtiter plates). The working assay range
      selected is 5-600 pmol/L, corresponding to a clinically useful range. Because of
      its specificity, this two-site immunoassay gives results that are lower than
      those obtained by using a competitive radioimmunoassay, both in normal
      individuals and in non-insulin-dependent diabetics.

PMID- 8472351
TI  - Carnitine measurements in liver, muscle tissue, and blood in normal subjects.
AB  - We determined carnitine concentrations in blood and in liver and abdominal muscle
      biopsy specimens in 13 men and 16 women undergoing elective surgery (mostly
      gallbladder removal). The data suggest that the carnitine pools of plasma and
      erythrocytes are different. The erythrocytes show a higher acylcarnitine
      concentration than does plasma (P < 0.001). Several reference bases for values in
      tissues have been used--dry weight, noncollagen protein (NCP), and DNA--because
      these may be differently influenced by disease. In liver specimens, the quotient
      NCP (g)/DNA (g) was significantly higher in men, 54.4 +/- 6.3 (mean +/- SD), than
      in women, 47.7 +/- 7.0 (P < 0.01). Liver total carnitine content in relation to
      DNA was significantly higher in men than in women: 0.29 +/- 0.06 vs 0.22 +/- 0.08
      mmol/g DNA (P < 0.01). Free carnitine content was significantly higher in men
      than in women independently of the reference base, e.g., 3.7 +/- 1.0 mumol/g NCP
      for men vs 2.9 +/- 1.0 for women (P < 0.05). No difference was found between the
      sexes in the abdominal muscle carnitine content, 20.6 +/- 6.7 mumol/g NCP for men
      vs 17.9 +/- 5.0 for women. Our study establishes control ranges, thereby
      providing an important basis for studies of patients with abnormal carnitine
      metabolism.

PMID- 8472352
TI  - Urinary neopterin as a predictive marker of coronary artery abnormalities in
      Kawasaki syndrome.
AB  - We investigated whether urinary neopterin concentrations respond to the
      pathological conditions (especially coronary artery dilatation) of Kawasaki
      syndrome. All of 29 children with Kawasaki syndrome had very high urinary
      neopterin concentrations. Increased urinary neopterin concentrations coincided
      with fever and with monocytosis in peripheral blood. The urinary neopterin
      excretion peaking within the first 8 days after onset correlated with the
      development of coronary artery dilatation. Increased urinary neopterin
      concentrations indicate that cell-mediated immunity is activated in patients with
      Kawasaki syndrome. Endogenous interferon-gamma and activation of
      monocytes/macrophages may play a role in the pathogenesis of Kawasaki syndrome.
      Not only do neopterin concentrations correlate with symptoms in the acute phase
      of Kawasaki syndrome, they also act as a predictive marker of coronary artery
      abnormalities in affected patients.

PMID- 8472353
TI  - Characteristics and clinical application of a radiometric Escherichia coli-based
      phospholipase A2 assay modified for serum analysis.
AB  - Determination of activities of phospholipase A2 (PLA2) in human sera was based on
      the hydrolysis of phospholipids from [1-14C]oleic acid-labeled Escherichia coli
      biomembranes. The E. coli membranes served as substrate specifically for the PLA2
      of human serum and were essentially resistant to other lipases in human sera,
      i.e., lipoprotein lipases, hepatic triacylglycerolipase, or pancreatic lipase in
      acute pancreatitis. Exchange of phospholipids between the serum and the
      biomembrane compartment aggravates the determination of PLA2 activity in human
      serum, which is naturally rich in phospholipids. In our modified E. coli assay,
      which overcomes these difficulties, the main substrate components
      phosphatidylethanolamine (70%) and cardiolipin (25%) were > 90% labeled in the sn
      2 position. Fatty acids released by PLA2 activity were eluted from an aminopropyl
      solid-phase column directly into scintillation vials, where the radioactivity was
      counted. The ratio of [1-14C]oleic acid to released total fatty acids was used to
      calculate true enzymatic activity. The linear assay range extended from 0 to 3.6
      U/L (0-60 nkat/L), with a detection limit of < 0.03 U/L (< 0.5 nkat/L). Within
      assay imprecision (CV) was < 6% and between-assay is < 10% over the whole
      activity range. The normal range for men was 0-0.44 U/L (0-7.33 nkat/L) and for
      women 0.044-1.11 U/L (0.73-18.4 nkat/L). Patients with septicemia, pancreatitis,
      acute respiratory distress syndrome, or other severe diseases had PLA2 values up
      to 540 U/L (9000 nkat/L).

PMID- 8472354
TI  - Increased urinary excretion of pyridinium cross-links in cancer patients.
AB  - Pyridinoline (PYD) and deoxypyridinoline (DPD), two collagen-based cross-links
      found in bone, were measured by high-performance liquid chromatography in urine
      samples from 65 control subjects and 97 patients with either untreated or
      progressive cancer. Patients with cancer had significantly (P < 0.001) higher
      urine concentrations of PYD and DPD than did control subjects. Both cross-links
      were increased in cancer patients with and without clinically detectable bone
      metastases, although patients with bone and liver involvement had higher mean
      concentrations. The mean concentrations of both cross-links were also
      significantly higher in the urine samples of inpatients than in an outpatient
      ambulatory population. These findings suggest that the measurement of PYD and DPD
      in urine may be useful in assessing bone metastases and bone resorption in cancer
      patients.

PMID- 8472355
TI  - One-step competitive immunochromatographic assay for semiquantitative
      determination of lipoprotein(a) in plasma.
AB  - Numerous studies have associated high concentrations of lipoprotein(a) [Lp(a)]
      with atherosclerosis. We developed a rapid, one-step competitive
      immunochromatographic assay to measure Lp(a) in plasma. The assay is performed on
      a nitrocellulose membrane strip and the result is determined by a visual readout
      of rust-colored colloidal selenium. The assay is based on the principle that
      Lp(a) in the sample will compete with Lp(a)-coated colloidal selenium for binding
      to the anti-Lp(a) monoclonal antibody immobilized on the assay strip in the
      format of four ladder bars. The number of capture bars that appear as a result of
      the formation of colloidal selenium color is proportional to the concentration of
      the Lp(a) protein in the samples. The strip assay semiquantitatively measures
      Lp(a) concentrations ranging from 0 to 180 mg/L of Lp(a) protein in serum,
      plasma, or fingerstick whole-blood samples. This assay appears very useful for
      quick identification of individuals with above-normal concentrations of plasma
      Lp(a) protein (> 70 mg/L), and has potential for monitoring a patient's response
      to treatment with Lp(a)-lowering drugs.

PMID- 8472356
TI  - Specific glycation of albumin depends on its half-life.
AB  - Some suggest that measurements of plasma fructosamine concentration should be
      corrected for the plasma protein (or albumin) concentration because the extent of
      glycation per volume depends on both protein and glucose concentrations. Several
      reports, however, demonstrate a poor correlation between plasma fructosamine and
      albumin concentrations in diabetic patients. In vitro kinetic and in vivo studies
      have shown that glycation is also dependent on the half-lives of plasma proteins.
      Because a decrease in plasma albumin diminishes its catabolism, we speculated
      that low albumin concentrations are associated with a greater extent of glycation
      on a molar basis (specific glycation) and vice versa. To test this hypothesis, we
      studied plasma albumin, total protein, and fructosamine in 63 nondiabetic
      subjects with normal plasma fasting glucose concentrations and hemoglobin A1c
      between 5.1% and 5.9%. Plasma fructosamine was poorly correlated with albumin
      concentration (r = 0.348) but a logarithmic plot of the specific glycation of
      albumin vs albumin concentration showed a better correlation (r = -0.842),
      suggesting that the kinetic considerations were operating in vivo. Therefore,
      because lower specific glycation of plasma albumin "compensates" for higher
      concentration, correction of fructosamine for albumin content in patients will
      overestimate mean blood glucose when albumin is low and underestimate it when
      albumin is high.

PMID- 8472357
TI  - Measuring L-dopa in plasma and urine to monitor therapy of elderly patients with
      Parkinson disease treated with L-dopa and a dopa decarboxylase inhibitor.
AB  - We have established a method for measuring L-dopa in plasma and urine, including
      the metabolites dopamine and L-dopac, using separation by ion-pair reversed-phase
      HPLC and quantification with an electrochemical detector. The assay was applied
      to the therapeutic monitoring of elderly patients with established Parkinson
      disease being treated with L-dopa plus a dopa decarboxylase inhibitor. Plasma L
      dopa was evaluated in relation to dosage and postdose sampling time in 71
      outpatients with Parkinson disease. L-Dopa concentrations were greatest in the
      patients taking the highest dosages prescribed and decreased significantly with
      increasing time after postdose sampling. Comparison of plasma L-dopa
      concentrations with a published therapeutic range established by intravenous
      administration of L-dopa was helpful in assessing the suitability of each
      patient's drug dosage, assessing patients' compliance, and avoiding overdosage
      but was not useful in the overall clinical assessment of progression of disease
      or of the long-term therapeutic response. Urine measurements confirmed the plasma
      concentrations but showed no further advantage. The recommended time for sample
      collection is between 1.5 and 3 h after the first morning dose. Plasma is the
      preferred matrix but if blood sampling is difficult, particularly from
      elderly/infirm individuals, an untimed urine collection could be used.

PMID- 8472358
TI  - Radioimmunoassay for the pyridinoline cross-linked carboxy-terminal telopeptide
      of type I collagen: a new serum marker of bone collagen degradation.
AB  - We developed a radioimmunoassay (RIA) for the carboxy-terminal telopeptides of
      type I collagen (ICTP), cross-linked with the helical domain of another type I
      collagen molecule, after isolation from human femoral bone. The cross-linked
      peptide was liberated by digesting insoluble, denatured bone collagen either with
      bacterial collagenase or with trypsin, and purified by two successive reversed
      phase separations on HPLC, with monitoring of pyridinoline-specific fluorescence.
      The purity of the peptide was verified by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis, and its origin in the type I collagen fibers was determined
      by amino-terminal amino acid sequencing. Polyclonal antibodies and a separation
      reagent containing second antibody and polyethylene glycol are used in the RIA.
      An immunologically identical, somewhat larger antigen is present in human serum;
      its concentration increases in multiple myeloma and in rheumatoid arthritis. The
      ICTP antigen seems to be cleared from the circulation by the kidneys, because
      glomerular filtration rates that are two-thirds of normal or less are associated
      with increased circulating ICTP concentrations. The CVs of the method are between
      3% and 8% for a wide range of concentrations. The analysis of 40 serum samples
      can be completed in 4 h.

PMID- 8472359
TI  - "Direct" and total bilirubin tests: contemporary problems.
AB  - In eight unique challenges mailed by The College of American Pathologists
      Comprehensive Chemistry Survey to participating laboratories within 3 years,
      results for direct-reacting bilirubin (DBIL) were highly variable among the 12
      largest peer groups, and most of the results differed greatly from the values
      obtained by a referred method. Peer-group mean values for total bilirubin (TBIL)
      were in much better agreement with each other and with those obtained by the
      Reference Method for TBIL. From a review of the information on the assay of DBIL
      provided to us by the manufacturers, we conclude that among the major causes of
      the large variability and bias in DBIL assays are problems with calibration, lack
      of a serum blank measurement, inadequate concentrations of HCl in the reaction
      mixture, inappropriate use of bichromatic correction methods, and possibly the
      use of wetting agents or surfactants in the reagent. Within-group SDs were small
      and generally acceptable. The among-peer-group variability in DBIL values is
      attributable to bias, not imprecision. We recommend several simple changes that
      could improve the accuracy of DBIL determinations in clinical laboratories.

PMID- 8472360
TI  - Multicenter evaluation of Iso-ALP test kit for measurement of bone alkaline
      phosphatase activity in serum and plasma.
AB  - A test kit (Iso-ALP, Boehringer Mannheim) for measuring human bone alkaline
      phosphatase activity in serum or plasma was evaluated in five laboratories in
      three countries. The assay is based on the principle described by Rosalki and Foo
      (Clin Chem 1984;30:1182-6) and uses wheat germ lectin to precipitate bone
      alkaline phosphatase. Residual ALP in the supernate in comparison with total ALP
      is used to quantify the bone fraction. The imprecision of residual ALP
      measurement was low (median between-run CV 4.9%) and comparable with that of
      total ALP. Linearity of precipitation was demonstrable up to a bone ALP activity
      (diethanolamine buffer 37 degrees C) of 2000 U/L, though a matrix effect was
      observed for dilutions of high-activity sera in saline or bovine serum albumin.
      For assaying patients' samples, different batches of lectin demonstrated
      excellent comparability. Taking electrophoresis as a basis for standardization,
      we determined that the lectin precipitated approximately 90% of bone ALP, but <
      5% of nonbone ALP. From this we derived serum/plasma upper reference limits for
      bone ALP activity in adults and children.

PMID- 8472361
TI  - Rapid determination of serum myoglobin with a routine chemistry analyzer.
AB  - A turbidimetric immunoassay system (Turbitime system, Behringwerke AG) allows
      rapid determination of myoglobin in serum. We adapted the reagents for this
      myoglobin assay (Turbiquant myoglobin) for use with a Hitachi 717 analyzer. No
      high-dose hook effect was observed up to 15,000 micrograms/L. Interassay CVs were
      4.6% (mean = 72.0 micrograms/L; n = 9) and 2.5% (mean = 365.6 micrograms/L; n =
      11). The calibration curve was stable for at least 1 month. Hemolysis did not
      interfere, and turbidity from lipemia interfered only when absorbance exceeded
      2.0 A. Results of this method (y) correlated well with those by the Turbitime
      method (y = 1.256x - 44.1 micrograms/L; n = 91; r = 0.991) and by a commercially
      available radioimmunoassay (Byk-Sangtec; y = 0.739x - 42.2 micrograms/L; n = 94;
      r = 0.991). The upper limit (95th percentile) of the reference interval for
      myoglobin was estimated at 57.9 micrograms/L. The positive predictive value for
      results of myoglobin at admission was 89% with this upper reference limit and 99%
      with 100 micrograms/L, whereas the negative predictive value was about 60% for
      both limits.

PMID- 8472362
TI  - Comparison of lipid fatty acids on a concentration basis vs weight percentage
      basis in patients with and without coronary artery disease or diabetes.
AB  - Lipid fatty acid compositions are almost always expressed on a weight percentage
      basis rather than as weight or molar concentrations. With the former method of
      calculation, each fatty acid has an effect on the composition of the other fatty
      acids, an interdependence that can potentially lead to inaccurate and misleading
      results. Here we compare the concentrations per liter and the weight percentage
      compositions of cholesteryl ester and phospholipid fatty acids in individuals
      with and without coronary artery disease as well as free fatty acid compositions
      in individuals with and without diabetes. A new method for quantifying lipid
      fatty acids is also presented. Fatty acid results expressed as concentrations and
      those calculated on a weight percentage basis may lead to different conclusions,
      because significant differences between patient groups can be lost with the
      latter approach. We conclude that serum concentrations of lipid fatty acids are
      more accurate reflections of changes in lipid fatty acids than are weight
      percentage calculations, and are more easily interpreted in metabolic and
      therapeutic terms.

PMID- 8472363
TI  - Enzyme immunoassay--a new technique for estimating hemoglobin A1c.
AB  - We describe a method for estimating hemoglobin A1c (HbA1c) with a commercially
      available enzyme immunoassay system. The method is based on microtiter plate
      technology, utilizing an antibody raised to hemoglobin, the epitope being the
      Amadori product of glucose plus the first eight amino acids on the N-terminal end
      of the beta chain of hemoglobin. The enzyme immunoassay displays good within
      batch (CV 2.3-2.4%) and between-batch (CV 2.6-5.0%) precision, and the results
      were not affected by different types of anticoagulant. The method was linear
      within the expected range of results and showed good correlation (r = 0.88-0.98)
      with established methods for estimating glycohemoglobin. Using this method, we
      obtained a reference interval of 2.8-4.9% (central 95%) for HbA1c in a
      nondiabetic population. The percentages of hemoglobin that were HbA1c in
      diabetics (6.86% +/- 2.51%) were significantly greater (P < 0.001) than in
      nondiabetics (3.46% +/- 0.52%).

PMID- 8472364
TI  - Measurement of heroin and its metabolites by isotope-dilution electron-impact
      mass spectrometry.
AB  - A solid-phase extraction procedure was developed for the isolation of heroin, 6
      acetylmorphine, and morphine from blood, plasma, saliva, and urine with
      subsequent assay by gas chromatography/mass spectrometry. Aprotic solvents, mild
      elution conditions, and an enzyme inhibitor were used to ensure maximum analyte
      stability. Samples were extracted and the extract was divided into two equal
      portions. One portion was assayed directly for heroin; detector response was
      linear over a concentration range of 1.0 to 250 micrograms/L. The second part of
      the extract was reacted with N-methyl-bis-trifluoroacetamide and assayed for the
      trifluoroacetyl derivatives of 6-acetylmorphine and morphine; detector response
      was linear over a concentration range of 1.0 to 500 micrograms/L. The limit of
      sensitivity was 1.0 microgram/L for each analyte. Hydrolysis of heroin to 6
      acetylmorphine during extraction and analysis was < 5%. The method can be used to
      corroborate heroin use and to study the pharmacological effects of heroin and its
      metabolites.

PMID- 8472365
TI  - Clinical and laboratory studies of time-resolved fluorescence immunoassays of
      thyrotropin and free triiodothyronine.
AB  - We evaluated a new time-resolved immunofluorometric assay (TR-IFMA) for
      thyrotropin (TSH) and a time-resolved fluoroimmunoassay (TR-FIA) for free
      triiodothyronine (FT3) in serum. Delfia hTSH Ultra is a solid-phase two-site TR
      IFMA involving three monoclonal antibodies directed against different antigenic
      sites on the human TSH molecule. It offers improved analytical (+3 SD of zero)
      and functional (10% between-assay CV) detection limits of 0.001 and 0.016 mlU/L,
      respectively. Results of the assay agreed closely with those of a second
      generation immunoradiometric assay (TSH-IRMA) for samples with TSH > 0.2 mlU/L (n
      = 114). The nonparametric reference interval for TSH in euthyroid men and women
      was 0.5-4.7 mlU/L (n = 200). The TSH concentrations of hyperthyroid subjects (n =
      29) were < 0.016 mlU/L (median; range < 0.016-0.063 mlU/L). The Delfia FT3 assay,
      a solid-phase TR-FIA, is based on the back-titration principle and second
      antibody separation. The parametric reference interval for FT3 in euthyroid men
      and women was 4.2-7.6 pmol/L (n = 320). The FT3 concentration in hyperthyroidism
      (n = 29) was 23 +/- 22 pmol/L (mean +/- SD; range 7.9-85 pmol/L). These methods
      offered rapid results (2-4 h for the whole procedure) and were simple to run.

PMID- 8472366
TI  - Effects of age, race, sex, and smoking on prothrombin fragment 1.2 in a healthy
      population.
AB  - Prothrombin fragment 1.2 (F1.2) is a biomarker of thrombin generation during
      blood coagulation and has diagnostic potential for assessing thrombotic risk and
      monitoring anticoagulation therapy. We used a monoclonal antibody-based
      immunoassay for plasma F1.2 to establish a well-defined reference interval and to
      evaluate the effects of age, race, sex, and smoking status on F1.2 concentrations
      in a healthy population. Plasma samples and demographic information were obtained
      from 357 healthy individuals. F1.2 concentrations more closely followed a
      lognormal than a gaussian frequency distribution. In a multiple linear-regression
      model in which the logarithms of F1.2 concentrations were regressed on age, race,
      sex, and smoking status, the significant explanatory variables were age and, to a
      lesser extent, sex and smoking. A segmented "hockey stick" regression model
      indicated that F1.2 concentrations and age were unrelated for individuals < 44
      years old but were positively correlated above that age threshold. The estimated
      95% tolerance interval (P = 0.95) for F1.2 in healthy individuals < 44 years old
      (n = 268) was 0.21-2.78 nmol/L. We conclude that age-matched F1.2 reference
      intervals may be important for studies evaluating the diagnostic utility of F1.2
      measurements, and that the clinical relevance of increased thrombin generation
      during aging warrants further investigation.

PMID- 8472367
TI  - Automated spectrophotometric method for determining oxidized and reduced
      glutathione in liver.
AB  - An enzymatic recycling method has been applied to the measurement of total and
      oxidized glutathione with a centrifugal analyzer. When the reduced form of
      glutathione (GSH) was masked with 2-vinylpyridine to measure the oxidized
      glutathione (GSSG), the time to ensure full derivatization was three times longer
      than has been reported. The method is quick, simple, accurate, and precise (1.27%
      for GSH, 3.3% for GSSG intraassay CV; 2.15% for GSH, 5% for GSSG interassay CV),
      and the automation allows large numbers of samples to be conveniently assayed.

PMID- 8472368
TI  - Quantitative analysis of serum proteins separated by capillary electrophoresis.
AB  - The possibility of open tubular capillary electrophoresis for clinical diagnostic
      use is examined. Capillary electrophoresis was performed in an untreated 50
      microns (i.d.) x 100 cm (65 cm to detector) capillary with detection of
      absorbance at 200 nm. Conditions for the separation of serum proteins without
      adsorption to the capillary surface were established. Quantitative analyses of
      serum samples from 38 patients with liver cirrhosis, nephrotic syndrome, or
      polyclonal gammopathy by capillary electrophoresis were done and the results were
      compared with those by conventional agarose gel electrophoresis and sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. All samples were analyzed in
      duplicate. We evaluated linearity of response, within-run CV, and the correlation
      between capillary electrophoresis and agarose gel electrophoresis.

PMID- 8472369
TI  - A color test for methanol.

PMID- 8472370
TI  - Serum neopterin in acute rheumatic fever.

PMID- 8472371
TI  - Presence of endogenous digitalis-like factors in milk.

PMID- 8472373
TI  - Increased concentrations of fecal anti-gliadin IgA antibodies in untreated celiac
      disease.

PMID- 8472372
TI  - Cost-effective method for detection of "hook effect" in tumor marker immunometric
      assays.

PMID- 8472374
TI  - Strength of the signal, analytical variability, and predictive value of test
      results.

PMID- 8472375
TI  - Measurement of creatinine in urine screening for drugs of abuse.

PMID- 8472376
TI  - Trimethobenzamide cross-reacts in immunoassays of amphetamine/methamphetamine.

PMID- 8472377
TI  - Analysis of myeloma patients' specimens by the CEDIA Vitamin B12 & folate assays.

PMID- 8472378
TI  - Circulating proalbumin associated with a second case of antitrypsin Pittsburgh.
AB  - We report here the conclusive identification of circulating proalbumin of normal
      N-terminal sequence (Arg Gly Val Phe Arg Arg Asp Ala) in a second child with the
      alpha 1-antitrypsin Pittsburgh 358 Met-->Arg mutation. As in the first case, the
      proalbumin made up 3-5% of the total serum albumin. The finding of proalbumin
      associated with a second de novo mutation at the inhibitory site bait of
      antitrypsin confirms our earlier hypothesis; that antitrypsin Pittsburgh was
      acting as a specific intracellular inhibitor of the hepatic proalbumin convertase
      and that antitrypsin Pittsburgh could be used as a probe to identify the
      proprotein convertase.

PMID- 8472379
TI  - Gravimetric determination of the water concentration in whole blood, plasma and
      erythrocytes and correlations with hematological and clinicochemical parameters.
AB  - We have assessed gravimetric methods for determination of intravascular water,
      established whole blood-, plasma- and erythrocyte water reference values in a
      healthy volunteer group (n = 97, 48 females) and correlated these variables with
      30 simultaneous hematological, clinicochemical and body parameters. The water
      standard was 55.56 mol/kg = 100 mass %. For erythrocyte water determination three
      methods were evaluated: 2 indirect methods were easy to perform, the third, using
      a hematocrit centrifuge, was the most reliable. Imprecision (within-batch
      coefficient of variation (CV), %) was excellent: whole blood 0.2, plasma 0.1,
      erythrocytes 0.7-2.2 and recoveries (means, %) 99.7-100.1. Serum water was found
      to be slightly higher than plasma water. Volunteer group, mean reference values,
      mass %: whole blood water 79.7, plasma water 91.2, erythrocyte water, three
      methods 66.2, 64.6 and 64.2, respectively. Females had mean 1.6 mass % higher
      whole blood water and 0.9-1.0 mass % higher erythrocyte water than males with no
      difference in plasma water. In the volunteer group whole blood water correlated
      strongly with hematocrit (r = -0.96), hemoglobin (r = -0.94) and erythrocytes (r
      = -0.85) and centrifuge hematocrit (r = -0.91). Plasma water correlated strongly
      with plasma total protein (r = -0.74, all correlations P < 0.001). Hemoglobin and
      hematocrit can serve as surrogate parameters for whole blood water when water
      determination is not available; total protein reflects plasma water.

PMID- 8472380
TI  - Circulating tumour-associated mucin concentrations, determined by the CASA assay,
      in healthy women.
AB  - This investigation was undertaken to establish a reference range for tumour
      associated MUC1 mucins in the serum of healthy women of the ages at risk for
      adenocarcinoma of the ovary and breast. Blood samples and clinical information
      were obtained from 5,000 women attending a breast screening mammography clinic.
      Data from women diagnosed with breast carcinoma and those subsequently diagnosed
      with other cancers were omitted from the reference range. Mucin concentrations
      were measured using the CASA assay which detects the protein core of MUC1 encoded
      mucins. Multiple linear regression analysis showed no effect on CASA
      concentrations by non-malignant changes to the breast, menopausal status,
      presence/absence of the reproductive tract, parity or history of hormone use.
      However, CASA concentrations were significantly increased in smokers (P < 0.001)
      and progressively increased with age (P < 0.001). These data show that these
      factors must be given consideration when setting upper limits of normal using
      MUC1 protein core binding assays.

PMID- 8472381
TI  - Determination of lipoprotein(a): enzyme immunoassay and immunoradiometric assay
      compared.
AB  - Lipoprotein(a) (Lp(a)) concentration in plasma is a strong independent risk
      factor for pre-mature atherosclerosis. Lp(a) closely resembles LDL. Its protein
      moiety contains apolipoprotein (apo) B-100 and apo(a). Two enzyme immunoassays
      (EIAs) for Lp(a) have been developed. In both, polyclonal antibodies for apo(a)
      are used as capturing antibodies. In the first, Lp(a) is detected with anti
      apo(a) (apo(a)-EIA). In the second, detection is carried out with anti-apo B
      (Lp(a):B-EIA). Neither plasminogen nor LDL cross-reacted in the assays. Lp(a) was
      also measured using a commercial sandwich immunoradiometric assay (IRMA). This
      assay uses two monoclonal antibodies for apo(a). One of them, the solid phase
      antibody, cross-reacted with plasminogen. However, at physiological plasminogen
      concentrations there was no competition for solid phase binding sites. A quantity
      of plasma samples (201) were assayed for Lp(a) with the three methods. The best
      correlation was obtained between the IRMA and the Lp(a):B-EIA (r = 0.909).
      Correlations between the apo(a)-EIA and the IRMA or the Lp(a):B-EIA were 0.763
      and 0.695, respectively. As compared to the EIAs, the IRMA overestimated Lp(a) by
      about 30%. It is concluded that both the Lp(a):B-EIA and the IRMA reflect the
      concentration of Lp(a) particles in plasma. In contrast, the apo(a)-EIA measures
      apo(a) antigen and may therefore be susceptible to the size polymorphism of
      apo(a).

PMID- 8472382
TI  - Variability of kidney tubular interstitial distortions in glomerulonephritis as
      measured by 1H-NMR urinalysis.
AB  - 1H-NMR urinalysis is used for reliable non-invasive diagnostics of tubular and
      papillary distortions in glomerulonephritis. The study of urine from 52 patients
      with various clinical forms of the disease shows that these dysfunctions can
      manifest and develop independently of the degree of glomerular lesions at any
      stage of the glomerulonephritis. Tubular and papillary changes can be negligible
      even in terminal uremia and drastic in cases of clinically preserved kidney
      function. In addition, the results indicate that not only tubular interstitial
      changes, but also isolated tubular or papillary distortions can develop at any
      stage of the disease. Thus 1H-NMR urinalysis is suitable for diagnosing latent
      tubular interstitial changes which are not readily detected by traditional
      techniques. This is important since early tubular intervention worsens the
      prognosis of the glomerulonephritis progression. Thus an approach enables
      identification of a group at risk of rapid deterioration of the disease among
      patients whose serum has normal creatinine levels. This additional information is
      valuable for the proper treatment of patients, and makes 1H-NMR urinalysis a
      prospective method for screening urine in glomerulonephritis. Further studies are
      required to decide whether the technique can be recommended for clinical
      practice.

PMID- 8472383
TI  - Enzymatic determinations in acute rejection after liver transplantation:
      preliminary report on necrosis index.
AB  - The catalytic activities of some mitochondrial and cytoplasmic enzymes were
      measured in plasma from 19 patients after orthotopic liver transplantation, in
      order to detect and monitor the evolution of hepatocellular damage and to predict
      liver rejection. The enzymatic activities determined were: mitochondrial
      isoenzyme of aspartate aminotransferase, glutamate dehydrogenase, alanine
      aminotransferase, aspartate aminotransferase, gamma-glutamyltranspeptidase and
      alkaline phosphatase. The results of all enzymatic activities were normalized by
      expressing them as multiples of the upper limit of the relevant reference range
      and then the necrosis index (NI) has been calculated. The proposed NI consists of
      percent ratio of the normalized mitochondrial enzymatic activities over the sum
      of cytoplasmic and mitochondrial normalized activities. We observed that NI
      values higher than 30% correctly identified all but two acute rejection events
      which were documented by liver biopsies showing a diagnostic sensitivity of 90%,
      specificity of 78% and a predictive value of 90%.

PMID- 8472384
TI  - Antioxidant defenses and its modulation by iron in carrageenan-induced
      inflammation in rats.
AB  - The concentration of endogenous antioxidants has been studied in rats with a
      carrageenan-induced granuloma. This animal model of inflammation allowed us to
      study the antioxidant defenses and the oxidative stress in plasma and in the site
      of inflammation (exudate) and their modulation by the levels of iron in the
      organism after iron-dextran or desferrioxamine administration. In inflamed rats
      without supplementary treatment, an interrelation between urate, ascorbate and
      vitamin E levels has been observed and it appears to be an important mechanism to
      prevent the depletion of the antioxidants. Further, the sulphydryl groups,
      caeruloplasmin and retinol also contribute to the defense in this experimental
      model. Iron overload increases the production of malondialdehyde and decreases
      some antioxidants such as ascorbic acid and SH groups but, on the other hand, it
      raises the levels of urate and caeruloplasmin. However, the protective effect of
      desferrioxamine has not been observed, and in our conditions this may be due to
      the induced mobilization of iron. Our results show that antioxidants have an
      important role in the prevention of lipid peroxidation by free radicals produced
      during inflammatory processes. This protective effect depends on the stage of
      inflammation.

PMID- 8472385
TI  - High performance liquid chromatographic determination of free and conjugated bile
      acids in serum, liver biopsies, bile, gastric juice and feces by fluorescence
      labeling.
AB  - Separation and measurement of commonly occurring free and conjugated bile acids
      in serum, liver biopsies, bile, gastric juice and feces have been successfully
      accomplished using high performance liquid chromatography with fluorescence
      labeling. Free and conjugated bile acids were extracted from pretreated samples
      using Sep-Pak C18 cartridges and then fractionated on a piperidinohydroxypropyl
      Sephadex LH-20 column. Free and glycine conjugated bile acids were labelled with
      4-bromomethyl-7-methoxycoumarin. Taurine conjugated bile acids were hydrolysed
      with cholylglycine hydrolase prior to derivatization with 4-bromomethyl-7
      methoxycoumarin. Labelled bile acids were eluted using an
      acetonitrile/methanol/water gradient on an ultrasphere ODS column. The eluate was
      monitored by a fluorophotometer at 360 nm (excitation) and 410 nm (emission).
      Linearity was obtained between 50 and 400 nmol. Recoveries from serum, gastric
      juice and feces were greater than 87%. This is therefore a sensitive method for
      the precise quantification of bile acids in serum, liver biopsies, bile, gastric
      juice and feces.

PMID- 8472386
TI  - Trace element concentrations (Cu, Zn, Fe) in sera from patients with dilated
      cardiomyopathy.
AB  - The trace element concentrations (Cu, Zn, Fe) in sera from patients with dilated
      cardiomyopathy are reported. Patients with dilated cardiomyopathy have high
      copper and low zinc concentrations in serum compared to healthy controls. The
      trace element concentration profile is different from that of other heart
      diseases like myocardial infarction and coronary heart disease. The copper
      concentration in serum shows a highly significant inverse relationship with the
      ejection fraction and the cardiac index. Pathophysiological processes which raise
      the copper concentration in serum may influence the ejection fraction and the
      cardiac index.

PMID- 8472387
TI  - Cholinesterases in cerebrospinal fluid in patients with meningitis and
      hydrocephaly.

PMID- 8472388
TI  - Plasma malondialdehyde in type 1 and type 2 diabetic patients.
AB  - Malondialdehyde, a marker of lipid peroxidation, was measured as thiobarbituric
      acid reactive substances (TBARS) in 117 diabetic patients and 53 controls.
      Patients were divided into groups and subgroups according to the type of diabetes
      (type 1 and type 2) and the existence or not of vascular complication (macro- or
      micro-angiopathy). Results showed that TBARS concentrations were significantly
      higher in type 1 (P < 0.0001) and type 2 (P < 0.001) diabetic patients than in
      the control group. The plasma TBARS concentrations in type 1 and type 2 diabetic
      patients did not differ significantly. Among the patients with vascular disease,
      type 2 diabetic patients with macroangiopathy had significantly higher TBARS
      concentrations than patients with no vascular complication (P < 0.05). Whichever
      the type of diabetes, there was no correlation between TBARS concentrations and
      glycaemic control: glycosylated haemoglobin, fasting blood glucose. This study
      confirmed the existence of lipid peroxidation disorders in diabetic patients.

PMID- 8472390
TI  - Contamination of biological samples in metal determination.

PMID- 8472389
TI  - Correction factors for single radial immunodiffusion and electroimmunodiffusion
      assays of IgA in secretory fluids.

PMID- 8472391
TI  - Biological variability of twenty-five serum analytes during normal pregnancy.

PMID- 8472392
TI  - Antioxidants and heart disease: epidemiology and clinical evidence.
AB  - One in three Americans will eventually die of cardiovascular disease. Antioxidant
      vitamins, which are postulated to reduce risk by about 20-30%, could have
      substantial clinical and public health impact. Basic research, clinical
      observation, and epidemiology have contributed to an emerging body of evidence on
      the atherogenicity of oxidized low-density lipoprotein, which could be an
      important mechanism to explain why antioxidant vitamins may decrease risk of
      coronary disease. The antioxidant-vitamin/cardiovascular-disease hypothesis has
      recently been explored in several large prospective cohort studies, but the
      findings were not all consistent. In several randomized, small-scale trials using
      subjects with existing vascular disease, data indicate benefits associated with
      vitamin E and beta carotene. Over the next several years, data from a number of
      ongoing primary prevention trials and proposed secondary prevention trials should
      determine whether antioxidant vitamins decrease risk of vascular disease.

PMID- 8472393
TI  - Vitamin E: more than an antioxidant.
AB  - The effect of vitamin E on platelet function has been reviewed. Although vitamin
      E inhibits platelet aggregation in vitro, in vivo it has no significant effect
      when administered in doses up to 1200 U/day. Platelet adhesion, on the contrary,
      is strongly inhibited by alpha-tocopherol. Doses of 400 IU/day provide greater
      than 75% inhibition of platelet adhesion to a variety of adhesive proteins when
      tested at low shear rate in a laminar flow chamber. The antiadhesive effect of
      vitamin E appears to be related to a reduction in the number and size of
      pseudopodia upon platelet activation. This effect of vitamin E may be related to
      changes in fatty acylation of structural platelet proteins. Clinical studies of
      vitamin E supplementation in patients with thromboembolic disease are in
      progress.

PMID- 8472394
TI  - Reactive oxygen metabolites, neutrophils, and the pathogenesis of ischemic
      tissue/reperfusion.
AB  - Considerable research effort has been directed at elucidating the mechanisms
      underlying the pathophysiologic alterations associated with reperfusion
      (reoxygenation) of ischemic (hypoxic) tissues. As a consequence of this intensive
      effort, a large body of evidence has accumulated, implicating a role for reactive
      oxygen metabolites and activated granulocytes in the genesis of postischemic
      cellular dysfunction. Figure 1 summarizes a hypothesis that has been proposed to
      explain the interaction of xanthine oxidase-derived oxidants, granulocyte
      infiltration, and the microvascular and parenchymal cell dysfunction that occurs
      in postischemic tissues. According to this scheme, xanthine oxidase-derived
      oxidants, produced at reperfusion, initiate the formation and release of
      proinflammatory agents, which subsequently attract and activate granulocytes. The
      activated neutrophils adhere to the microvascular endothelium, extravasate, and
      release cytotoxic oxidants and proteases, which contribute to tissue dysfunction.
      The aim of this review is to summarize the evidence that we and others have
      accumulated in support of this hypothesis.

PMID- 8472395
TI  - Oxidized LDL and atherogenesis: relation to risk factors for coronary heart
      disease.
AB  - According to a new theory, a critical step in atherogenesis is oxidation of low
      density lipoprotein (LDL) within the arterial wall. Direct data supporting this
      theory are limited, but indirect evidence suggests that oxidized LDL plays a role
      in atherogenesis. An important question is whether the LDL-oxidation hypothesis
      conforms to what is known about other risk factors for coronary heart disease
      (CHD), such as hypertension, smoking, low high-density lipoprotein (HDL) levels,
      and diabetes mellitus. Perhaps a unified theory of atherogenesis could be
      formulated if these risk factors exert their atherogenic actions in part by
      promoting, facilitating, or permitting the oxidation of LDL.

PMID- 8472396
TI  - Oxidized LDL and antioxidants.
AB  - Several studies have shown that the oxidative modification of low-density
      lipoprotein (LDL) may promote fatty-streak formation, the early lesion of
      atherosclerosis. Epidemiologic data suggest that decreased levels of
      micronutrient antioxidants are associated with an increased frequency of
      cardiovascular disease. Micronutrients that can act as antioxidants--ascorbic
      acid, alpha-tocopherol, and beta-carotene--have been shown to prevent LDL
      oxidation in vitro and retard the progression of atherosclerosis in animal
      models. In addition, supplementation of human subjects with these compounds have
      been shown to increase the resistance of their LDL to oxidation without producing
      side effects. Thus, these antioxidant micronutrients have the potential to become
      an additional treatment modality in the therapeutic arsenal against
      atherosclerosis.

PMID- 8472397
TI  - Expression of 67 kDa laminin receptor in human breast cancer cells: regulation by
      progestins.
AB  - The level of 67 kDa laminin receptor (67LR) expression on breast and colon tumor
      cell surfaces was previously shown to be correlated with the capacity of tumor
      cells to metastasize. In the present work we investigate the effects of
      progestins and estrogen on the expression of 67LR in two sublines of the T47D
      human breast cancer cells: weakly tumorigenic, poorly invasive parental T47D
      cells and a highly tumorigenic, more invasive T47Dco subclone. Immunoblotting
      with an affinity purified antibody directed against a synthetic peptide
      recognizes the 67LR in these cells. 67LR expression in the T47Dco subclone is 5.5
      fold higher than in their parental T47D cells. Treatment of T47D cells with 1 nM
      of the synthetic progestin R5020 results in a 4-fold increase in 67LR protein
      expression. Estrogen also induced 67LR expression, but only by 1.5-fold. The
      progestin-stimulated expression of the 67LR correlates with a 4.3-fold increase
      in attachment of T47D cells to laminin. A monoclonal antibody, mAb 13, directed
      against beta 1 integrin, completely blocks the attachment of T47D cells to
      fibronectin, only partially inhibits the attachment of T47D cells to laminin, and
      appears not to affect the progestin-stimulated laminin attachment of T47D cells.
      A new antiprogestin, ZK 112.993, significantly inhibits both progestin-stimulated
      67LR expression and the increased attachment to laminin. These results suggest a
      possible role for progestin in mediating one of the multiple events thought to be
      important in metastasis of steroid receptor positive human breast cancer cells.

PMID- 8472399
TI  - Soft-tissue sarcomas. Future perspectives.
AB  - Although the previous outlook for patients with soft-tissue tumors was poor, in
      recent years advances have been made in earlier recognition and management of
      soft-tissue sarcomas. Advances include improved clinical pathologic correlation
      and clinical staging, as well as improved concept of what constitutes adequate
      surgical management. In addition, recent advances in surgical adjuvant treatment
      programs promise better results. Moreover, a better understanding of the biology
      of cancer and the development of sophisticated techniques of molecular biology
      should lead to more effective treatment.

PMID- 8472398
TI  - Significance of platelets in an antimetastatic activity of bacterial
      lipopolysaccharide.
AB  - Recently we reported an antimetastatic activity of bacterial lipopolysaccharide
      (LPS) on a NK-cell-resistant murine fibrosarcoma (NFSa). Here we investigate and
      report the mechanistic significance of platelets in this activity. The number of
      circulating platelets was reduced to 63% of the control 3 days after an i.v.
      injection of 1.0 micrograms LPS, and then recovered to the level of control at
      day 10. Aggregation efficiency of platelets was impaired by LPS. The number of
      metastatic lung colonies after an i.v. injection of tumor cells was maximally
      reduced to 2.2% of the control at day 3 and increased in proportion to the
      recovery of platelet number. Neuraminidase (Ndase), which caused a non
      immunological thrombocytopenia, also inhibited lung metastasis when injected
      prior to an i.v. tumor cell challenge. LPS and Ndase showed an identical pattern
      against five other syngeneic tumors; these agents inhibited lung metastases of
      the FSa fibrosarcoma and the SCC VII squamous cell carcinoma but failed to
      inhibit those of the NR-S1 squamous cell carcinoma, the MMCa#4 mammary
      adenocarcinoma and the NR-PG parotid gland tumor. All the three cells which were
      not responsive to any agents possessed a high aggregating activity of platelets
      while the other three tumors responsive to both agents did not show a detectable
      level of this activity. Platelet transfusion failed to modify the antimetastatic
      activity of LPS. These results suggest that platelets play an important role in
      the antimetastatic activity of LPS, though whether the role is principal or
      assistant remains to be seen.

PMID- 8472400
TI  - Osteogenesis imperfecta as a differential diagnosis of pathologic burst fractures
      of the spine. A case report.
AB  - A 22-year-old man suffered two noncontiguous burst fractures of the thoracic
      spine after minor motor vehicular trauma. He was diagnosed with pathologic spinal
      burst fracture associated with osteogenesis imperfecta Sillence Type 1A. The
      diagnosis was based on the relatively minor nature of the trauma, clinical
      characteristics, roentgenograms, and detailed family history. Osteogenesis
      imperfecta, although rare, should be considered in the differential diagnosis of
      severe burst fractures of the spine.

PMID- 8472401
TI  - Foraminal and extraforaminal lumbar disk herniations.
AB  - Thirteen patients with foraminal or extraforaminal lumbar disk herniation were
      treated during a 32-month period. Myelography and magnetic resonance imaging
      proved to be ineffective in identifying the lesion in most patients. High
      resolution computed tomography demonstrated the lesions in all patients, and the
      findings were subsequently confirmed at surgery. Surgical treatment consisting of
      disk fragment removal and nerve root decompression was effective in relieving
      radicular pain.

PMID- 8472402
TI  - Lumbar spinal stenosis secondary to calcium pyrophosphate crystal deposition
      (pseudogout).
AB  - A 62-year-old man demonstrated symptoms, signs, and radiographic evidence of
      lumbar spinal stenosis and intraoperative pathologic findings of tophaceous
      deposition in the ligamentum flavum. Although there have been reports of cervical
      calcium pyrophosphate dihydrate crystal deposition (CPPD) with neurologic
      compression, this report appears to be the first case of lumbar spinal stenosis
      secondary to CPPD. Cervical calcium pyrophosphate dihydrate crystal deposition
      should be added to the differential diagnosis of spinal stenosis.

PMID- 8472403
TI  - Biomechanical comparison of bone graft used in anterior spinal reconstruction.
      Freeze-dried demineralized femoral segments versus fresh fibular segments and
      tricortical iliac blocks in autopsy specimens.
AB  - This study compares the compression strength of frozen corticocancellous iliac
      blocks and short fibular segments with freeze-dried, partially ("surface")
      demineralized microperforated (FDPDM) short femoral segments. Three blocks from
      each iliac crest and segments from the fibular and femoral diaphyses were
      retrieved. The femoral segments were microperforated, demineralized for 24 hours,
      and freeze-dried. All were then loaded to failure in a stress testing machine.
      The FDPDM showed a significantly higher failure load and stiffness than the
      fibular segments and the iliac crest segments. The femoral and fibular segments
      were similar in strength but significantly higher than iliac crest grafts.
      Compared with commonly used frozen grafts, freeze-dried partially demineralized
      femoral segments may be used safely as axial load-bearing struts in anterior
      spine reconstruction.

PMID- 8472404
TI  - Osteonecrosis of the humeral head in sickle cell disease.
AB  - The prevalence and incidence of osteonecrosis (ON) of the humeral head in sickle
      cell disease was determined by a study of 2524 patients who were entered into a
      prospective study and followed for an average of 5.6 years. At entry, 5.6% had
      roentgenographic evidence of ON in one or both shoulders. There was little
      difference in age-adjusted prevalence among genotypes, but there were striking
      differences in age-specific rates. Observed at ages ranging from five to 24
      years, 3.25% of sickle cell anemia (S/S) patients, but only 1.1% of sickle cell
      disease (S/C) patients, had ON. No S/beta+ thalassemia patients younger than 25
      years of age had ON on entry. The highest age-adjusted incidence rate was found
      in S/S patients with concomitant alpha-thalassemia (4.85 per hundred patient
      years), followed by S/beta zero-thalassemia (4.84 per hundred patient-years),
      S/beta+ thalassemia (2.61 per hundred patient-years), S/S without alpha
      thalassemia (2.54 per hundred patient-years), and S/C (1.66 per hundred patient
      years). Only 20.9% of patients reported pain or had limited range of movement at
      the time of diagnosis. Sickle cell disease is a frequent cause of ON of the
      humeral head, especially in children and young adults.

PMID- 8472405
TI  - Supporting layers of the glenohumeral joint. An anatomic study.
AB  - Based on anatomic and surgical dissections, the anatomy of the shoulder region is
      described in terms of four layers that overlie and support the glenohumeral
      joint. Each layer envelops the glenohumeral joint on its anterior, lateral, and
      posterior aspects, and between each layer there is a plane for safe and easy
      dissection. Layer 1 is composed of the deltoid and pectoralis major muscle
      bellies with their overlying fascia and enveloping epimysium. Anteriorly, Layer 2
      consists of the clavipectoral fascia, the conjoined tendon of the short head of
      the biceps and coracobrachialis, and the coracoacromial ligament. Posteriorly,
      Layer 2 is the dense posterior scapular fascia that overlies the infraspinatus
      and teres minor muscle bellies. It is continuous with the clavipectoral fascia
      around the lateral aspect of the proximal humerus. Deep to Layer 2, the
      subdeltoid bursa yields a dissection plane that encompasses the anterior,
      lateral, superior, and variably the posterior aspects of the glenohumeral joint.
      Layer 3 consists of the deep layer of the subdeltoid bursa and the underlying
      musculotendinous units of the rotator cuff, including subscapularis,
      supraspinatus, infraspinatus, and teres minor. Layer 4 is the capsule of the
      glenohumeral joint. This includes the glenohumeral ligaments and coracohumeral
      ligament. These four layers were present and consistent in each shoulder
      dissected. Significant variations were present only within the deepest layer
      (shoulder joint capsule). This system can serve as a learning tool and will
      provide a more organized approach to facilitate surgical dissection in the
      region.

PMID- 8472406
TI  - Acute prosthetic replacement for severe fractures of the proximal humerus.
AB  - Nineteen patients with 20 severe proximal humeral fractures were treated early
      with a Neer humeral prosthesis from 1979 to 1986. There were 18 four-part and two
      three-part fractures. The average age of the patients at the time of injury was
      64 years. Follow-up evaluation was performed at an average of 40 months. Pain
      relief was satisfactory in 18 of 20 fractures. Patients were satisfied with the
      result in 16 of the 20 shoulders. Functional evaluation was good or fair in 15 of
      20 patients. Active forward elevation averaged 72 degrees and active external
      rotation 16 degrees. Complications consisted of one axillary nerve palsy, one
      postoperative posterior dislocation, loosening of one uncemented humeral
      prosthesis, and one breakage of fixation wire requiring subsequent removal.
      Patients who could not comply with the postoperative rehabilitation program had
      poor results. Poor function appeared to be directly related to lack of rotator
      cuff integrity. Surgical techniques designed to securing tuberosity union are
      essential.

PMID- 8472407
TI  - Cemented versus cementless total hip arthroplasty. A comparative study of
      equivalent patient populations.
AB  - Seventy-one cemented total hip arthroplasties (THAs) in 66 patients were compared
      with 70 cementless THAs in 61 patients. The cemented and cementless components
      were identical except for the presence of a porous proximal surface on the
      cementless component. The mean follow-up time was 4.3 years in the cemented group
      and 4.1 years in the cementless group, with a minimum follow-up of two years.
      Postoperative Charnley pain scores were identical for both groups, as was the
      incidence of limp. The final Charnley function score, however was significantly
      higher in the cementless group (5.6) than in the cemented group (5.1). One
      revision was performed in the cemented group, none in the cementless group.
      Complete demarcation of the bone-cement interface was presented in two cemented
      components and was associated with subsidence. Three cementless components had
      early subsidence, and two of these had complete radiopaque lines around the
      porous surface. None of these three patients, however, had unsatisfactory pain or
      function scores. The most important finding of this study is the equivalence of
      clinical results noted in both cemented and cementless THA as late as six years
      after operation.

PMID- 8472408
TI  - Occurrence and incidence of the second hip fracture.
AB  - During a 16-year period, 256 second hip fractures were found in 3898 persons 40
      years of age and older who had a previous hip fracture. Ninety-two percent of the
      second fractures were contralateral, and 68% of these were the same type as the
      first. Thus, 62% of the femoral neck and 72% of the trochanteric fractures were
      preceded by a contralateral fracture of the same type. The mean interval between
      fractures was 3.3 years, and there was no significant difference between genders
      or among fracture types. The risk of the first fracture was 1.6 per 1000 men per
      year and 3.6 per 1000 women, and for the second fracture 15 per 1000 men per year
      and 22 per 1000 women. This increase was highly significant for both genders,
      especially for men.

PMID- 8472409
TI  - Long-term evaluation of hip arthroplasty in patients with an ipsilateral knee
      arthrodesis.
AB  - Hip arthroplasty with an ipsilateral knee arthrodesis occurs infrequently but
      does raise concern regarding surgical technical difficulties, dislocation,
      sepsis, and long-term loosening. Sixteen patients were evaluated 7.5 years
      (average period) after surgery. Technical difficulties were not prohibitive. No
      dislocation or revision was necessary in any of the cases. Two patients died as a
      result of unrelated sepsis from an infected knee. Loosening and protrusio of the
      acetabulum occurred in two patients. Hip arthroplasty in patients with a fused
      knee does not incur undue risk of loosening or instability and can provide long
      term good function and pain relief. Patients with multiple joint arthroplasties,
      in whom concurrent sepsis occurs, can have devastating results.

PMID- 8472410
TI  - A comparison of the perioperative morbidity in total joint arthroplasty in the
      obese and nonobese patient.
AB  - The goal of this study was to determine if obesity is a risk factor for total
      joint arthroplasty. This was a retrospective review of 130 patients treated with
      either primary total hip arthroplasty or primary total knee arthroplasty during a
      two-year period (154 consecutive arthroplasties). The patients were placed in the
      nonobese or obese group. Obesity was defined as 20% above ideal weight for
      height, based on life insurance tables. There were 51 in the nonobese groups and
      103 in the obese group. Charts were reviewed for a number of factors associated
      with postoperative complications. Operative time, intravenous fluids
      administered, and total blood loss were found to be slightly higher in the obese
      group. Only the difference in operative time proved statistically significant,
      however. The hospitalization time, number of days with a fever, number of
      transfusions, preoperative and postoperative hemoglobin levels, and days
      requiring intramuscular narcotics were very similar between the two groups. There
      were 0.29 minor complications per nonobese patient, but only 0.22 per obese
      patient. Major complications were encountered 0.22 times per nonobese patient and
      0.10 times per obese patient. The patient is not necessarily at a higher risk for
      peroperative complications in total joint arthroplasty. The longevity of the
      implant in the obese patient was not determined in this perioperative study.

PMID- 8472411
TI  - Three-dimensional modeling of cartilage thickness in hip dysplasia.
AB  - The cartilage thickness in both normal hips and in coxarthrosis secondary to hip
      dysplasia was examined using a computer model. The hip cartilage thickness was
      calculated in three dimensions from computed tomographic images of the hip joint.
      In normal hip joints, the anterior cartilage was thicker than the posterior
      cartilage. In hip joints affected by secondary coxarthrosis, the cartilage
      thinned as the disease progressed. Approximately 80% of patients demonstrated
      thinning of the anterior apical cartilage, resulting in a forward and upward
      displacement of the femoral head.

PMID- 8472412
TI  - Rapidly progressive protrusio acetabuli in patients with rheumatoid arthritis.
AB  - Current literature suggests protrusio acetabuli in patients with rheumatoid
      arthritis progresses at a gradual rate of 2-3 mm per year. This report presents
      five patients with rheumatoid arthritis (RA) who experienced rapidly progressive
      protrusio. The period of rapid clinical progression averaged 40 days. During
      progression, medial protrusio increased an average of 7.5 mm, superior protrusio
      advanced 6.9 mm, femoral head width decreased 2.7 mm and center-edge angle
      increased 20.7 degrees. Axial protrusio occurred along an axis 137 degrees from
      vertical. A key clinical feature was an absence of significant hip symptoms
      before a marked increase in symptoms over a period of days to several weeks,
      resulting in a significant decrease in the patient's ambulatory capacity.
      Osteopenia was a consistent preexisting radiographic feature. The findings
      underscore the existence of rapidly progressive protrusio in the natural history
      of RA and its importance in the differential diagnosis of hip pain in patients
      with RA. Early recognition is important to minimize the potential complications
      of delayed surgical treatment.

PMID- 8472413
TI  - Principles of staging of soft-tissue sarcomas.
AB  - The TNM staging system is a modus for diagnosis and treatment in which T is the
      extent of the tumor involvement, N is lymph node involvement, and M is the
      metastases; this system is supplemented with a histologic malignancy grade.
      Staging systems identify specific prognostic factors with which to predict
      clinical outcome. Staging systems are useful for assigning treatment priorities,
      determining the role of adjuvant therapies, and evaluating clinical
      investigations. Unfortunately, no universally accepted staging system for soft
      tissue sarcomas exists. This is related to the relatively low incidence of
      sarcomas, the unique and unpredictable behavior of sarcomas, significant
      disagreement regarding histogenesis and grading, and lack of consensus regarding
      the value of various prognostic factors. In adults, the two most commonly used
      staging systems are those developed by the American Joint Committee on Cancer and
      by Enneking. In children, the Intergroup Rhabdomyosarcoma Study and the
      International Union Against Cancer have described the systems most commonly used.
      These systems for soft-tissue sarcomas rely on an ability to accurately determine
      both the local and distant extent of disease. Advances in the field of computed
      tomography and magnetic resonance imaging have made this possible. It is likely
      that a staging system based upon a more sophisticated understanding of the basic
      biology of sarcomas will become available.

PMID- 8472414
TI  - Roentgenographic assessment of the hip-knee-ankle axis in medial gonarthrosis. A
      study of reproducibility.
AB  - A preoperative reliable recording of the knee alignment is necessary to calculate
      the correct wedge at high tibial osteotomy for medial gonarthrosis. To determine
      the reproducibility of the hip-knee-ankle angle (HKA), a preoperative, whole
      lower limb roentgenogram was obtained twice in eight patients, and each
      roentgenogram was judged by two radiologists. Assessment of the HKA had a
      variability of at most 2 degrees, which is highly significant for a reliable
      calculation of the wedge at tibial osteotomy.

PMID- 8472415
TI  - Indications and results of nonoperative treatment of patellar fractures.
AB  - It is uncontested that most patellar fractures have to be treated by open
      reduction and internal fixation. Nevertheless, there are well-defined types of
      patellar fractures in which such a procedure is unnecessary because the fracture
      is stable and the retropatellar surface is congruous. In these fractures internal
      fixation would constitute overtreatment; conservative treatment yields good
      results in such cases. In this report, 40 patellar fractures treated
      conservatively were reviewed (average, 30.5 months after injury). Results were
      assessed subjectively and objectively. Of the 40 patients, 80% were pain free and
      90% had a full range of knee motion.

PMID- 8472416
TI  - Surgical treatment of unresolved Osgood-Schlatter lesion.
AB  - The Osgood-Schlatter lesion is considered a traction apophysitis. Treatment is
      generally conservative, and only rarely does a surgical treatment become
      necessary for the persistence of pain and swelling over the tibial tubercle. The
      most widely used procedure consists of the excision of all intratendinous
      ossicles with or without removal of the prominent tibial tubercle. In 15 cases
      treated in this manner compared with 11 cases treated with various procedures
      before 1975, the results were clearly better with the former. There was only one
      fair and no poor results. Removal of all loose intratendinous ossicles associated
      with prominent tibial tubercles is the procedure of choice, both from the
      functional and the cosmetic point of view.

PMID- 8472417
TI  - Primary repair of quadriceps tendon ruptures. Results of treatment.
AB  - Results of primary repair of 19 quadriceps tendon ruptures in 19 patients were
      studied. Average patient age was 47.4 years. Predisposition to the site of tear
      according to age was noted. Seventy-five percent (nine of 12) of patients older
      than 40 years of age had ruptures at the tendon-bone junction, and 71% (five of
      seven) of patients younger than 40 years had ruptures at the midtendinous area.
      Repair for injuries in the midtendon-musculotendinous junction consisted of
      debridement, freshening of the edges, and reapproximation. Ruptures in the tendon
      bone junction required suturing through three to four holes drilled through the
      proximal pole of the patella. Postoperatively, patients were immobilized for six
      weeks. Excellent results were noted in all 17 patients who had early repair and
      good results in two patients who had delayed repair. Patient age, gender,
      mechanism of injury, site of rupture, and type of repair did not affect the
      outcome of treatment.

PMID- 8472418
TI  - Morphologic changes in the human patellar tendon after bone-tendon-bone anterior
      cruciate ligament reconstruction.
AB  - Magnetic resonance imaging (MRI) was performed on 15 patients, an average of 2.5
      years after arthroscopically assisted bone-tendon-bone (BTB) anterior cruciate
      ligament (ACL) reconstruction, to evaluate the patellar tendon donor site. Five
      patients who had arthroscopically assisted ACL reconstruction using the
      semitendinosus tendon as a graft also were scanned bilaterally and evaluated. The
      mean difference between the involved and uninvolved patellar tendon length was 
      0.2 mm for the BTB patients and -2.6 mm for the semitendinosus patients. The mean
      difference between patellar tendon width for the BTB patients was 1.1 mm and 1.9
      mm for the semitendinosus patients. The mean difference between patellar tendon
      thickness was 0.4 mm for the BTB surgery group and 0.02 mm for the semitendinosus
      surgery group. None of the differences were statistically significant. Results
      indicate that harvesting the central one third of the patellar tendon does not
      significantly affect the length, width, or thickness of the tendon at least 22
      months after arthroscopically assisted BTB-ACL.

PMID- 8472419
TI  - A new method using computed tomographic scan to measure the rectus femoris
      patellar tendon Q-angle comparison with conventional method.
AB  - The Q-angle should be the angle generated by a line connecting the anteroinferior
      iliac spine (AIIS), the bottom of the groove of the femoral condyle, and the
      tibial tubercle. The Q-angle was measured by computed tomography (CT) in 43 lower
      limbs with recurrent patellar dislocation and 26 normal controls. The mean Q
      angle was 20 degrees in the dislocated group and 13 degrees in controls, a
      significant difference. No significant difference was found in the Q-angle
      between the dislocated and control groups using the conventional method. Lower
      limb rotation had little effect on accuracy of the method.

PMID- 8472420
TI  - Adhesions of distal tibiofibular syndesmosis. A cause of chronic ankle pain after
      fracture.
AB  - Ankle pain after uncomplicated ankle fractures poses a diagnostic and therapeutic
      challenge, especially in joints that exhibit insignificant radiographic changes.
      Ankle joint arthroscopy has become an important diagnostic and therapeutic tool
      for such cases. Adhesion of the distal tibiofibular syndesmosis, as yet an
      undescribed entity, was found to be the cause of chronic ankle pain in 11 of 19
      patients suffering from chronic ankle pain after an uncomplicated fracture of the
      ankle. Symptoms resolved after arthroscopic resection of the adhesions in all 11
      patients. Arthroscopy has an important role in diagnosis and management of
      unexplained ankle pain after a seemingly uncomplicated fracture.

PMID- 8472421
TI  - Transfibular compression arthrodesis of the ankle joint.
AB  - Eleven ankle arthrodeses were performed on ten patients using a transfibular
      technique. This technique employs a lateral approach in which the distal fibula
      is resected while preserving the peroneal tendon sheath, allowing excellent
      exposure and contouring of the tibiotalar joint. Compression is attained by using
      a T-plate placed across the tibiotalar joint with the aid of an AO compression
      apparatus. At 2.5 years after operation, fusion was achieved in ten ankles.
      Average time in immobilization was 11.8 weeks, and the fused ankle was
      cosmetically pleasing. Fusion occurred in nine of 11 ankles fused using other
      methods during this period. Pin tract infection occurred in three, the time in
      immobilization averaged 16.2 weeks, and the cosmetic result was inferior.

PMID- 8472422
TI  - Elective foot surgery in limbs with arterial disease.
AB  - Surgical correction of foot deformities is generally indicated to relieve the
      disability. The presence or suspicion of arterial disease may lead to the
      reluctance to operate because of the concern that healing might not occur,
      however. Twenty-three patients were referred for vascular assessment before
      elective foot surgery. There was little or no evidence of arterial disease in 15
      limbs. In eight limbs there was unequivocal evidence of complete obstruction in
      the main limb artery. Contrary to what might be expected, healing after surgery
      occurred without difficulties in the limbs with arterial obstruction. The
      arterial disease as assessed by laboratory methods was not severe. The results
      indicate that elective foot surgery can be safely undertaken in some limbs.
      Simple laboratory methods for assessment of arterial circulation include
      measurements of distal blood pressure, skin temperature, transcutaneous oxygen
      tension, and assessment of digital pulsatility. A useful approach for estimating
      the chances of healing after elective surgery in limbs with arterial obstruction
      is formulated on the basis of the clinical and laboratory assessment.

PMID- 8472423
TI  - Osteosarcoma of the patella. A case report.
AB  - A 34-year-old woman complained of pain and swelling in the left patella. Because
      of roentgenogram showed hardly any destruction of the patella, she was not
      initially treated for a bone tumor. The clinical course followed the initial
      symptoms of a respiratory disorder with pulmonary metastatic foci. A bone tumor
      was first suspected after aspiration cytology of a lung tumor mass. A left
      patellectomy was performed to relieve the pain and confirm the diagnosis. The
      pain was relieved by the operation, but respiratory failure set in and progressed
      rapidly. The patient died three days later. Histologic examination showed that
      the tumor tissue consisted of atypical cells, spindle to polygonal in shape. The
      marrow space of the patella was predominantly occupied by neoplastic
      cartilaginous tissue. The pathologic diagnosis was primary chondroblastic
      osteosarcoma of the patella.

PMID- 8472424
TI  - Wound complication in surgery of soft tissue sarcoma. Analysis of 103 consecutive
      patients managed without adjuvant therapy.
AB  - In a consecutive series of 103 patients with soft tissue sarcoma, operated on
      from 1987 through 1990, clinical and perioperative factors were assessed for the
      development of wound complications. Local excision was performed in 98 cases and
      amputation in five. None had preoperative radiation therapy or chemotherapy. The
      overall incidence of wound complication was 40%. There were 16 infections, 13
      necroses, and 12 hematomas. The complication rate was significantly lower in the
      upper extremity (17%) as compared with the trunk and lower extremity (45%).
      Superficially located and deep tumors had equal incidences of wound
      complications. Regarding deep tumors, wound complication was significantly
      related to large tumor size, old age, long operating time, and excessive blood
      loss. No such correlations could be found for superficial tumors. The median
      hospitalization time for patients with deep tumors who developed complications
      was 23 days, as compared with 11 days for those without. Complications in
      patients with superficial tumors did not lead to a lengthened hospital stay. A
      considerable complication rate was associated with limb-sparing surgery for soft
      tissue sarcomas. This incidence could probably be reduced by taking into account
      risk factors associated with wound complications, better preoperative planning,
      and close cooperation with plastic surgeons for adequate wound coverage.

PMID- 8472425
TI  - The effects of therapeutic doses of irradiation on experimental bone graft
      incorporation over a porous-coated segmental defect endoprosthesis.
AB  - The incorporation of autogeneic bone graft into a porous coated segmental
      endoprosthesis after high-dose irradiation was studied in dogs. A mid-diaphyseal
      defect was surgically created and then reconstructed with a porous-coated
      segmental endoprosthesis in 16 dogs. Autogeneic bone grafts were placed over the
      porous-coated regions of the endoprosthesis and at the endoprosthesis-bone
      junctions to achieve extracortical fixation. In eight dogs, the reconstructed
      femora were treated with a time-equivalent dose of 5500 cGy, delivered over a
      five-week period, beginning three weeks after surgery. In eight dogs, which
      served as the control group, the reconstructed femora were not irradiated. Dogs
      were killed 12 weeks after surgery, and the reconstructed femora were evaluated
      clinically, roentgenographically, mechanically, and histologically. Extracortical
      bone formation and bone ingrowth into the porous-coated segmental endoprosthesis
      were significantly inhibited by high-dose irradiation. Nonirradiated
      reconstructed femora had higher maximum torque at the implant-bone junction than
      irradiated femora. Nonirradiated femora had significantly greater bone ingrowth
      within the porous space than irradiated femora. Intracortically, irradiated
      femora had greater unlabeled bone and less porosity as well as more new bone than
      nonirradiated femora at 12 weeks postsurgery. Extracortically, irradiated femora
      had greater original cortical bone and less porosity as well as more new bone
      than nonirradiated femora at 12 weeks postsurgery. Mineral apposition was less in
      the irradiated femora from the initiation of radiotherapy to the time of killing
      five weeks after cessation of irradiation.

PMID- 8472426
TI  - The effect of anterior cruciate ligament resection and immediate or delayed
      implantation of a meniscus prosthesis on knee joint biomechanics and cartilage.
      An experimental study in rabbits.
AB  - In a rabbit experiment with anterior cruciate ligament (ACL) resection, immediate
      substitution of the medial meniscus with a prosthesis was compared with delayed
      prosthetic implantation after a postmeniscectomy period of three weeks. The knees
      with a prosthetic implant were compared with their contralateral joints as well
      as to joints with an intact ACL and menisci. Anterior cruciate ligament resection
      alone led to disturbed biomechanics and cartilage degeneration. Anterior cruciate
      ligament resection in combination with meniscus resection increased cartilage
      degeneration and led to more inferior biomechanics. Ingrowth and stable fixation
      was less frequent when the prosthesis was inserted three weeks after meniscus
      resection than when inserted immediately. Furthermore, in knees with delayed
      prosthetic implantation, only minor improvement in terms of cartilage protection
      was shown when compared with knees with resection only. In contrast, knees with
      immediate meniscus replacement demonstrated similar joint stiffness and stress
      relaxation characteristics and similar cartilage protection effects as knees with
      a nonresected medial meniscus.

PMID- 8472427
TI  - The effects of an artificial meniscus substitute in a knee joint with a resected
      anterior cruciate ligament. An experimental study in rabbits.
AB  - A Dacron meniscus prosthesis was substituted for the medial meniscus in an
      anterior cruciate ligament (ACL) resected rabbit knee. At three months, the
      joints were evaluated biomechanically, with gross and histologic inspection. In a
      paired comparison with the contralateral knee, differences between ACL resection
      with intact, incised, or resected medial menisci were evaluated. Knees with
      intact menisci and ligaments served as controls. Because of cartilage
      destruction, soft-tissue hypertrophy, and increased anterior laxity, joint
      stiffness was less than normal in all ACL-resected knees. Ingrowth and stable
      fixation, especially of the posterior horns of the prostheses and the incised
      menisci, were rare. Almost all normal menisci had ruptured in the same area.
      Anterior cruciate ligament resection led to severe osteoarthrosis in both
      compartments, regardless of initial meniscal treatment. Knees with prostheses had
      the same incidence and severity of osteoarthrosis as knees with meniscus
      resection. Anterior cruciate ligament resection alone induced excessive
      osteoarthrosis and synovitis and diminished the effects of different meniscal
      treatments three months earlier.

PMID- 8472428
TI  - Pharmacologic and clinical aspects of intraarticular injection of hyaluronate.
AB  - Hyaluronate (HA) is linear unbranched polysaccharide consisting of repeating
      disaccharide units of (1-4)-D-glucuronic acid-beta-(1-3)-D-N-acetylglucosamine.
      Extensive research has been conducted on HA, a major component of connective
      tissue. Hyaluronate, molecular weight 80 x 10(4)d, is available for the
      intraarticular injective treatment of osteoarthrosis of the knee and
      periarthritis of the shoulder. Hyaluronate relieves pain and has metabolic
      effects on articular cartilage, synovial tissue, and synovial fluid. Hyaluronate
      is a safe and effective treatment for patients with osteoarthrosis of the knee
      and periarthritis of the shoulder.

PMID- 8472429
TI  - Gene expression during bone repair.
AB  - Detailed understanding of the basic events in fracture healing constitutes a
      foundation for the development of new approaches to stimulate bone healing. Since
      the fracture healing process repeats, in an adult organism, several stages of
      skeletal growth in the same temporal order, it offers an interesting model for
      developmental regulation of cellular phenotypes and tissue-specific genes.
      Molecular biology has introduced new methods to study the regulatory phenomena
      during the process of fracture repair. Gene technology has also produced purified
      growth factors for research, which will help to understand their roles in
      fracture healing. This review summarizes data on the regulation of genes coding
      for extracellular matrix components and growth regulatory molecules during
      fracture healing. The information available focuses on the sequential expression
      of genes coding for collagens, proteoglycans, and some other matrix proteins
      during secondary (callus) healing. The temporal and spatial appearance of the
      different connective tissue components, mesenchyme, cartilage, and bone, are
      closely linked to the expression of genes coding for their characteristic
      constituents. Members of the transforming growth factor-beta superfamily, such as
      the bone morphogenetic proteins (BMP), are currently the most interesting ones
      among the factors that regulate chondrogenesis and osteogenesis. In the coming
      years, the availability of new cloned probes combined with sensitive analytical
      methods, as reviewed here, will add greatly to our understanding of the various
      aspects of gene expression during bone repair. This information should provide
      answers to some of the unresolved questions in fracture callus development.

PMID- 8472430
TI  - Biopsy of soft-tissue tumors.
AB  - Biopsy is an integral part of the overall management of patients with soft-tissue
      sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc
      excision. There are advantages and disadvantages of each. Open biopsy requires
      strict adherence to a number of surgical principles. Proper execution requires
      determination of appropriate biopsy site, meticulous technique, and close
      collaboration with an experienced pathologist. Failure to adhere to these
      principles may result in untoward consequences for patients.

PMID- 8472431
TI  - Rhabdomyosarcoma.
AB  - In children and young adults, rhabdomyosarcoma occurs with a frequency that is
      equal to or greater than that of all the other forms of soft-tissue sarcoma
      combined. Although the responsiveness of rhabdomyosarcoma to chemotherapy varies
      greatly among tumors with different primary sites and with different histologic
      features, the overall results of chemotherapy have been more impressive in
      rhabdomyosarcoma than in any other form of soft-tissue sarcoma. Rhabdomyosarcomas
      occur in almost all sites and age groups. Those that occur in trunk and extremity
      sites have an unusually high instance of alveolar or undifferentiated histologic
      features and are more common in older children and young adults. Although they
      constitute only one third of all patients with rhabdomyosarcoma, tumors that are
      primary in trunk and extremity sites present some of the most difficult
      therapeutic problems in the management of all patients with this tumor. The
      ability to accomplish an initial complete local tumor excision still represents a
      major factor in survival. Early reexcision in the case of incompletely excised
      tumors with small volumes of residual tumor is effective when feasible. Local
      control of rhabdomyosarcoma can be achieved by high-dose irradiation and
      frequently by lower-dose irradiation when given in conjunction with chemotherapy.
      Second-look surgery is an accurate predictor of outcome, and late excision of
      residual tumor after chemotherapy-radiation therapy regimens may influence
      outcome. A regimen of vincristine, actinomycin-D, and cyclophosphamide given as a
      "pulse", with or without Adriamycin (doxorubicin), is the standard chemotherapy
      with cisplatin, etoposide, melphalan, and other agents now under study in trials
      of the Intergroup Rhabdomyosarcoma Study.

PMID- 8472432
TI  - Liposarcoma.
AB  - Liposarcoma is second in frequency only to malignant fibrous histiocytoma among
      the soft-tissue sarcomas. It occurs almost exclusively in adults and is found
      most often in the thigh or retroperitoneum. It rarely arises from a lipoma and
      does not occur in the subcutaneous tissues. Liposarcomas are divided into
      histologic subtypes with different microscopic appearances and slightly different
      behavior characteristics. Surgical resection with a wide surgical margin is the
      treatment of choice. When amputation is required to obtain an adequate surgical
      margin, local irradiation can be used as an adjuvant and a limb-sparing operation
      can be done. Currently, no evidence exists that adjuvant chemotherapy is
      indicated for patients with liposarcoma, although numerous studies are being done
      to investigate its use. As is the case for all sarcomas, the lung is the most
      common site of metastasis; however, liposarcoma has an unusual propensity to
      metastasize to the retroperitoneum, mediastinum, and bone.

PMID- 8472433
TI  - Management of extremity soft-tissue sarcomas.
AB  - Management of extremity soft-tissue sarcomas requires accurate clinical staging,
      pathologic diagnosis, surgical resection with a wide margin, and adjuvant
      radiation therapy for high-grade lesions. Brachytherapy offers a clean benefit in
      local control for large (> 5 cm) high-grade sarcomas. The role of radiation
      therapy for small high-grade and all low-grade soft-tissue sarcomas still is
      being evaluated. Survival is function of histologic grade, age of patient, size
      and location of the tumor, metastases, and adequacy of the surgical resection.
      Efficacy of chemotherapy has yet to be proven.

PMID- 8472434
TI  - Integration of limb-sparing surgery, brachytherapy, and external-beam irradiation
      in the treatment of soft-tissue sarcomas.
AB  - Advances in the integration of limb-sparing surgery and adjuvant radiation
      therapy have nearly eliminated the need for ablative or radical resections in the
      management of soft-tissue sarcomas. The combination of wide or marginal surgical
      resections, brachytherapy, and external-beam irradiation resulted in a local
      recurrence rate of 9% in 68 patients followed for a minimum of two years. All
      recurrences were in nonsubcutaneous high-grade lesions. Treatment-related
      morbidity occurred in 22% of patients. Wound-healing complications developed in
      17% and resolved with nonoperative treatment in half. These results support the
      efficacy of limb-sparing surgery and adjuvant radiation therapy in the management
      of soft-tissue sarcomas. Integration of chemotherapy may be necessary for the
      higher-grade lesions, although effectiveness is uncertain.

PMID- 8472435
TI  - Adjuvant chemotherapy in the treatment of soft-tissue sarcoma.
AB  - Standard therapy for treatment of soft-tissue sarcoma dictates adequate surgical
      resection with or without radiation therapy. However, metastases occur in a
      substantial proportion of cases, and, if improvement in survival is to be
      obtained, elimination of hematogenously borne micrometastasis will be required. A
      number of randomized, controlled clinical trials have been performed evaluating
      the use of cytotoxic chemotherapy in the treatment of localized soft-tissue
      sarcoma. Single-arm studies evaluating the use of intraarterial chemotherapy as
      an adjunct to limb-sparing surgery have been reported. Many of these studies have
      methodologic weaknesses, and have yielded conflicting results. Reviewed in
      detail, these studies are evaluated in the light of opportunities for clinical
      research.

PMID- 8472436
TI  - Chemotherapy for soft-tissue sarcomas.
AB  - Single-agent and combination chemotherapy have greater than 20% single-agent
      activity: doxorubicin and ifosfamide. Certain other anthracycline analogues
      possess similar activity. It remains a question whether combination therapy is
      any better than single-agent doxorubicin. Randomized trials have demonstrated
      enhanced response rates and increased toxicity for the combinations, but
      survival, with limited follow-up data, is not improved. The role of adjuvant
      chemotherapy also is not yet established. Two of 12 trials demonstrate survival
      benefits; however, most show a delay in relapse with about a 10% risk of
      irreversible toxicity. New agents, targets, and methods to circumvent resistance
      mechanisms developed in the laboratory are necessary to advance the field.

PMID- 8472437
TI  - Combined percutaneous and "minimal" internal fixation for displaced articular
      fractures of the calcaneus.
AB  - Forty-one displaced intraarticular fractures of the calcaneus in 38 patients were
      treated with open reduction and screw fixation of the posterior facet, bone
      grafting, and percutaneous pinning of the body. A single extensile posterolateral
      approach was used in all but two cases in which an additional medial incision was
      needed. Using early functional aftercare, all fractures healed without secondary
      displacement in an average of eight weeks. Follow-up periods averaged 4.2 years.
      Results were graded as excellent in 14 patients, good in 16, fair in three, and
      poor in five. There was a strict correlation between the clinical results and the
      severity of the articular comminution. A satisfactory outcome depended on the
      restoration of articular congruency and extraarticular alignment of the os
      calcis.

PMID- 8472438
TI  - Surgical management of calcaneal fractures using bilateral incisions and minimal
      internal fixation.
AB  - Nine patients with displaced calcaneal fractures were approached through
      bilateral incisions and stabilized with minimal internal fixation. All patients
      were men, with an average age of 35 years (range, 19-65). All fracture patterns
      had three-part split depression fractures of the posterior facet, a single intact
      sustentacular tali fragment, middle facet, and anterior body fractures. The
      reduction of tubercle impaction and varus angulation was accomplished by
      stabilization of the sustentacular tali-posterior tubercle fracture line through
      a modified medial vertical incision. Minimal fixation using either a three-prong
      staple or 4-mm lag screws was sufficient to stabilize this fracture pattern.
      Posterolateral facet articular elevation, and final reconstruction of Bohler's
      and Gissane's angles were performed through an extended lateral incision. Five of
      nine calcanei were stabilized with lag screws only and four required minimal
      lateral plate osteosynthesis. Preoperative Bohler's and Gissane's angles averaged
      6 degrees and 138 degrees; postoperative angles averaged 34 degrees and 123
      degrees, respectively. The average difference between postoperative Bohler's and
      Gissane's angles compared with the normal contralateral side was 1 degree each.
      There was no loss of reduction, and healing was uneventful. There was anatomic
      reconstruction of both medial and lateral cortexes in all cases. In this specific
      fracture pattern, medial stabilization of the sustentacular talitubercle fracture
      line can reduce both the amount and extent of lateral fixation, facilitate
      anatomic reduction of the posterior facet, and reduce postoperative implant
      sequelae after internal fixation.

PMID- 8472439
TI  - Open reduction and circular external fixation of intraarticular calcaneal
      fractures.
AB  - Open reduction and internal fixation techniques do not allow early weight
      bearing. In an effort to develop a better method to obtain calcaneal fracture
      reduction and maintain it in the face of early weight bearing, a circular
      external fixator was applied to seven patients in combination with a limited
      lateral approach and open reduction and internal fixation of the depressed
      subtalar joint fragments. The operative technique uses the Ilizarov circular
      external fixator to obtain a ligamentotaxis reduction, following which the
      depressed subtalar joint fragments are elevated open; then, the fixator is used
      to reduce the lateral translation. All displacements of the fracture fragments
      are corrected. This method proved successful in six patients, all of whom
      achieved a satisfactory result with anatomic restoration of the subtalar joint
      and heel. One patient went on to late partial collapse of the posterior facet.
      Subtalar motion was greater than 50% in four of seven patients. None of the
      patients complained of heel pad pain, which was attributed to the desensitization
      of the heel by early weight bearing. This technique has produced encouraging
      preliminary results in two- to four-year follow-up evaluation.

PMID- 8472440
TI  - Two-stage operative treatment of comminuted os calcis fractures. Primary indirect
      reduction with medial external fixation and delayed lateral plate fixation.
AB  - The indication for otherwise established lateral plate fixation in fractures of
      the calcaneus becomes relative when severe comminution (Sander's Type III and IV)
      of the bone involves concomitant massive soft-tissue swelling. The calcaneus is
      shortened, Bohler's angle flattened, and lateral bulging and varus deformity
      persist throughout the six or more days needed for soft-tissue compromise to
      recede. Intraoperatively, problems with anatomic reduction are encountered
      primarily because of soft-tissue shrinkage and muscle contraction, underscoring
      the rationale for conservative treatment modalities. A two-stage approach-
      primary medial external fixation and delayed lateral plate fixation--stabilizes
      the calcaneus in a nearly anatomic position by calculated distraction through
      medial external fixation, leaving joint congruency to be restored in a secondary
      procedure, when soft tissues pose no problem for a lateral approach. The two
      stage procedure was used in 13 of 49 cases, in which soft-tissue compromise was
      severe. Anatomic primary reduction greatly facilitated delayed lateral plate
      fixation. Infection rates were not traced to the external fixation. Massive bone
      grafting was associated with a high occurrence of complications.

PMID- 8472441
TI  - Compartment syndromes of the foot after calcaneal fractures.
AB  - Approximately 10% of calcaneal fractures develop compartment syndromes of the
      foot, and of these, one half develop clawing of the lesser toes and other foot
      deformities, including stiffness and neurovascular dysfunction. Tense swelling
      and severe pain are the hallmarks of an impending compartment syndrome. The
      diagnosis is confirmed by multistick invasive catheterization, particularly of
      the calcaneal compartment in the hindfoot. Immediate fasciotomy is recommended to
      prevent the development of ischemic contracture. It is recommended that open
      reduction and internal fixation of a calcaneal fracture is performed on a delayed
      basis, after the fasciotomy wounds are closed.

PMID- 8472442
TI  - The management of soft-tissue problems associated with calcaneal fractures.
AB  - Soft-tissue problems associated with fractures of the calcaneus are common and
      can present many pitfalls. A classification of soft-tissue problems has been
      devised to facilitate treatment: Type 1, closed fractures treated by open
      reduction and internal fixation with an inability to close the skin. Type 2,
      wound break down after open reduction. Type 3, open fractures of the calcaneus
      with traumatic large soft-tissue loss but with adequate bone stock. Type 4,
      traumatic loss of soft tissue and bone. Type 5, calcaneal osteomyelitis. Type 6,
      chronic unstable soft tissue over the calcaneus. There are various surgical
      options of skin graft, rotational flaps, and free-tissue transfers that best
      reconstruct each of these individual problems.

PMID- 8472443
TI  - Reconstructive osteotomy of the calcaneus with subtalar arthrodesis for malunited
      calcaneal fractures.
AB  - A technique of dealing with the late complications of malunited calcaneal
      fractures is based on the philosophy of reversing the deformity associated with
      late complications. The primary fracture is a shearing fracture that runs
      obliquely down the length of the calcaneus from superolateral to inferomedial and
      anterolateral to posteromedial. This permits the tuberosity of the calcaneus to
      translate laterally and proximally, and often splits the posterior facet. The
      complications of malunion are loss of height of the heel with concomitant
      dorsiflexion of the talus, widening of the heel, lateral impingement of the
      peroneal tendons and the distal fibula, and subtalar posttraumatic arthritis. The
      primary fracture deformity contributes directly to the late complications. The
      reconstructive osteotomy recreates the primary fracture. This permits
      repositioning of the tuberosity that narrows the heel, alleviates impingement,
      and returns height to the heel. The subtalar arthrodesis alleviates the symptoms
      of posttraumatic arthritis. The reconstruction is not dependent on cortical bone
      grafts for stability. The clinical series involved ten feet with an average
      follow-up period of 14 months. Two were revisions of previous triple arthrodeses.
      Results were satisfactory in nine feet.

PMID- 8472444
TI  - Parosteal (juxtacortical) chondrosarcoma of the humerus associated with regional
      lymph node metastasis. A case report.
AB  - Recurring parosteal (juxtacortical) chondrosarcoma of the humerus occurred in a
      79-year-old man. Roentgenograms of the left humerus showed minimal cortical
      irregularity and a large soft tissue mass without calcification or periosteal
      reaction. Magnetic resonance imaging (MRI) showed a multilobular tumor of high
      intensity (T2-weighted imaging) without marrow involvement. During the left
      shoulder disarticulation an enlarged axillary lymph nodes was discovered and
      removed. Macroscopic examination of the disarticulated humerus showed a large
      yellow parosteal mass, which looked like cartilage, completely surrounding the
      humeral shaft. The marrow cavity was almost normal except for a small erosion at
      the site of the olecranon fossa. The histologic diagnosis of the mass was Grade 2
      chondrosarcoma of parosteal (juxtacortical or periosteal) origin associated with
      regional lymph node metastasis. The features that made this case unique were a
      long history of the tumor (for 32 years), minimal cortical destruction of the
      bone by the tumor, and regional lymph node metastasis. This case illustrates the
      differential diagnosis of the parosteal chondrosarcoma from periosteal
      osteosarcoma and extraskeletal myxoid chondrosarcoma.

PMID- 8472445
TI  - Biomechanics of the subtalar joint complex.
AB  - The subtalar joint complex is formed by the posterior talocalcaneal joint and the
      acetabulum pedis lodging the talar head. The basic motion at the joint is that of
      male ovoid surfaces moving over female ovoid surfaces and vice versa. The motion
      generated at the joint is that of flexion-supination-adduction or extension
      pronation-abduction. The subtalar motion is generated by the contour and
      orientation of the articular surfaces and is guided by the intrinsic ligaments:
      the interosseous talocalcaneal ligament of the canalis tarsi and the cervical
      ligament. Further support is provided by the extrinsic ligaments: the
      calcaneofibular ligament and the tibiocalcaneal fascicle of the deltoid ligament.
      Under tibiotalar vertical loading with internal rotation, the subtalar joint
      complex is in a close-pack position with maximum talar head surface contact in
      the acetabulum pedis. The component ligaments of the latter are under maximum
      tension. The posterior talocalcaneal surfaces are interlocked laterally.

PMID- 8472446
TI  - Arthroscopic subacromial decompression versus open acromioplasty. A two-year
      follow-up study.
AB  - In a prospective study, 20 patients were randomly selected for either open
      acromioplasty according to Neer or for arthroscopic subacromial + decompression
      (ASD). All suffered from shoulder impingement for which conservative treatment
      had been unsuccessful. Functional results after two years were assessed. All
      patients were assessed radiographically to visualize recurrence of subacromial
      osteophytes. Functional results in the arthroscopic group are good and similar to
      those after open surgery. Both methods seem to result in adequate subacromial
      decompression, including bone resection. The arthroscopic method also has in its
      favor less operating time, earlier restoration of active range of motion, and
      reduction in time away from work.

PMID- 8472447
TI  - Total elbow arthroplasty. An 18-year experience.
AB  - In 34 primary and 18 revision total elbow arthroplasties (TEAs), rheumatoid
      arthritis (RA) was the most common indication, with traumatic arthritis next most
      common. The indications were primarily pain and decreased range of motion. Follow
      up time averaged 7.6 years for index arthroplasties. Complication rates of
      primary arthroplasties were high, with 40% neural problems, 9.3% aseptic
      loosening, and 13.3% early postoperative infection. Overall function was
      satisfactory in 68% of patients with RA. In agreement, the rates of revision were
      high. Overall satisfaction was good, and function was fair in patients with TEA.

PMID- 8472448
TI  - A comparison of femoral neck fixation with the reconstruction nail versus
      cancellous screws in anatomic specimens.
AB  - Femoral neck fixation techniques were applied to five matched pairs of autopsy
      specimens to evaluate the fixation of the Russell-Taylor femoral nail in
      ipsilateral neck and shaft fractures of the femur. Reconstruction nail fixation
      of the femoral neck was compared with that of three parallel screws. The intact
      and postfixation femora were subjected to an applied bending moment in 0 degrees,
      30 degrees, and 90 degrees of simulated hip flexion. The bending stiffness was
      determined from the load deformation data for each intact femur and then after
      the appropriate fixation. The fatigue response of the fixation, presence of
      osteopenia, degree of fracture reduction, and device alignment showed that the
      stiffness ratio (fixed to normal) of the nail was greater in most specimens.
      There was no statistical difference in retained stiffness after cyclic loading
      between the nail and cancellous screw fixations. The ultimate strength of the
      nail was 2.5 times the strength of the screw fixation of the femoral neck. Thus,
      the nail provided biomechanically sound fixation of the femoral neck.

PMID- 8472449
TI  - Total hip arthroplasty in juvenile rheumatoid arthritis.
AB  - A series of 17 primary total hip arthroplasties in patients with juvenile
      rheumatoid arthritis (JRA) were performed at a mean age of 18 years with an
      average follow-up period of 9.3 years. There were 13 cemented prostheses and four
      noncemented. All patients were satisfied with their hip surgery and reported
      either slight or no hip pain according to the Harris hip rating system.
      Ambulation improved postoperatively and all but one patient was at least a
      limited community ambulator (able to ambulate short distances outside the home
      with crutches, walker, or cane). Roentgenogram evaluation showed five cemented
      hips that were believed to be definitely loose with impending failure. All were
      functioning well. One acetabular component has been revised to date. No femoral
      components have been revised. The four noncemented hips with an average follow-up
      period of five years were functioning well.

PMID- 8472450
TI  - Avascular necrosis of the femoral head in sickle cell disease. An integrated
      classification.
AB  - Avascular necrosis of the femoral head (ANFH) is one of the crippling
      complications of sickle cell disease (SCD), and to date there is no
      classification that could identify patients in the early phase of the necrosis.
      Based on the experience of 66 ANFH in 43 patients with SC hemoglobinopathy, the
      necrosed hips were classified into four grades, Grade I to Grave IV, based on
      patient history, clinical evaluation, and radiologic examination. In Grade I, the
      patient complains of the mildest symptoms with minimal clinical signs and
      radiologic changes. The most severe form, Grade IV, is where the findings are
      unbearable pain with disability and marked roentgenographic evidence of
      osteonecrosis. This classification identifies patients in Grade I and II, which,
      with early diagnosis and proper management, could delay further deterioration of
      the necrosed femoral head.

PMID- 8472451
TI  - Role of mesenchymal collagenase in the loosening of total hip prosthesis.
AB  - Fibroblast-type interstitial collagenase (E.C. 3.4.24.7) was associated with
      loosening of total hip prostheses in eight patients: there were four cemented
      stems and one cementless stem with the common type of loosening and two cemented
      stems and one cementless acetabular component with aggressive granulomatous
      lesions. The authors used a specific, well-characterized, heterologous, affinity
      purified, polyclonal rabbit anti-human fibroblast collagenase antiserum applied
      in avidin-biotin-peroxidase-complex (ABC) staining. In the aggressive
      granulomatous type of loosening, collagenase was found in most of the fibroblast-
      and macrophagelike cells, including multinuclear giant cells and epithelioid
      cells in periprosthetic tissue. Collagenase-positive cells also were found in the
      periprosthetic tissue associated with common loosening. Collagenase was also
      found in capillary and postcapillary venule endothelial cells in the richly
      vascularized aggressive granulomatous tissue. Collagenase was extracted directly
      from the tissue samples and incubated with soluble Type I collagen. Collagen
      degradation products then were analyzed by sodium dodecyl sulfate (SDS)
      polyacrylamide gel electrophoresis, and the three-fourths length degradation
      product quantitated by gel scanning densitometry. In both aggressive
      granulomatosis and the common type of loosening, extractable collagenase was
      found in tissue. No significant differences between the sample groups were
      detected in respect to total measurable collagenase, however. The extractable
      collagenase was present in a latent form that could be activated by the
      organomercurial procollagenase activator, phenylmercuric chloride (PMC). It is
      likely that interstitial collagenase contributes to rapid growth of reactive
      infiltrative tissue, loosening of the prosthesis associated with aggressive
      granulomatosis, and the periprosthetic lytic process associated with the common
      type of hip prosthesis loosening.

PMID- 8472452
TI  - Dialysis arthropathy of the hip.
AB  - Beta 2-microglobulin amyloid deposition is associated with a destructive
      arthropathy in the hip of chronic hemodialysis patients. Twenty-five hips from 18
      patients were assessed for the presence and immunohistochemical type of amyloid.
      The hemodialysis group was compared with an age- and disease-matched control
      group that had no evidence of renal failure. Beta 2-microglobulin amyloid
      deposits were present in all patients who had been on hemodialysis for 18 months
      or more. Beta 2-microglobulin amyloid deposits were not found in patients who had
      been on hemodialysis for less than 18 months. Amyloid deposits were seen first in
      the articular cartilage and later involved the synovial membrane, joint capsule,
      and subchondral bone as well. The presence and amount of amyloid deposition
      correlated to the duration of hemodialysis. Severely affected hip
      roentgenographically had a concentric loss of joint space, periarticular
      erosions, and cystic lesions in the femoral head and acetabulum. These pathologic
      and roentgenographic changes suggest that amyloid deposition leads directly to
      the erosive hip arthropathy occurring in hemodialysis patients.

PMID- 8472453
TI  - Cemented acetabular reconstruction with the Muller support ring. A minimum five
      year clinical and roentgenographic follow-up study.
AB  - In a previous study, the results of cemented acetabular reconstruction with a
      Muller support ring were reported after a mean follow-up period of 40 months. The
      current report concerns a minimum five-year follow-up study of the same 43
      patients. Two early failures at four months and at 17 months were related to poor
      surgical technique. The latest overall functional results, according to the Merle
      d'Aubigne rating scale, were excellent, very good, or good in 81.82% of the hips:
      a drop from 86.67% since the previous report. Sequential roentgenographic
      analysis demonstrated a high incidence of nonprogressive radiolucencies at the
      cement-bone interface. These nonprogressive radiolucencies did not correlate with
      the overall functional results. The progression of a radiolucency at the cement
      bone interface, however, or the appearance of radiolucencies around the screw
      threads, always resulted in clinical failure.

PMID- 8472454
TI  - Contribution of rectus femoris and vasti to knee extension. An electromyographic
      study.
AB  - Electromyographic (EMG) activity was recorded from the five components of the
      quadriceps during maximum knee extension with the limb in six combinations of hip
      and knee flexion: the hip at 0 degrees, 40 degrees, and 80 degrees with the knee
      at 15 degrees and 60 degrees. None of the six positions could isolate the vasti
      from the rectus femoris. The highest EMG activity of all five muscles was
      recorded with the limb in 40 degrees hip flexion and 15 degrees knee flexion. The
      lowest EMG activity was recorded with the hip at 0 degrees and the knee at 60
      degrees flexion. Overall, the knee extension torques were 40% higher with the
      knee at 60 degrees flexion than at 15 degrees flexion. The lowest torques were
      generated with the limb positioned at 80 degrees hip flexion and 15 degrees knee
      flexion. During maximum knee extension, the vasti muscles do not work in
      isolation of the rectus femoris, regardless of the amount of hip flexion. All
      portions of the quadriceps worked in all positions, which suggests these muscles
      may be strengthened effectively in many different positions to accommodate the
      patient's comfort and interest.

PMID- 8472455
TI  - Difficulties with bearing dislocation and breakage using a movable bearing total
      knee replacement system.
AB  - In 1980, the low contact stress, or New Jersey, system was introduced with
      movable high-density polyethylene bearings between the metallic femoral and
      tibial components. This system was developed to deal with two principal concerns
      of conventional knee replacement systems: loosening and wear. A federal Drug
      Administration review was required, and the study was performed in two phases.
      From 1981 until 1984, components were cemented in 40 knees, which then were
      evaluated for an average of seven years after surgery. From 1984 until 1986, 16
      knees were selected for cementless fixation and were followed for an average of
      five years. The cemented group had a failure rate of 10% (four knees), two from
      tibial component loosening, one from bearing dislocation, and one from infection.
      Failure was determined by the necessity for revision. The uncemented group had a
      failure rate of 31% (four knees from bearing fracture and one from knee pain of
      uncertain source). Bearing failure was attributable to the entrapment of the
      subluxed lateral bearing. Sacrifice of the anterior cruciate ligament predisposes
      the system to bearing subluxation and failure.

PMID- 8472456
TI  - Long-term follow-up study on the Maquet procedure with special reference to the
      causes of failure.
AB  - Thirty-nine patients with symptomatic osteoarthrosis (OA) of the patellofemoral
      joint were treated with 42 anterior tibial tubercle elevations, also known as the
      Maquet procedure. The patients all had symptomatic OA of the patellofemoral joint
      that fell into one of three categories: old patellar fracture, chronic patellar
      subluxation, or postpatellectomy pain. In the latter group, the OA was manifested
      by erosions of trochlear articular cartilage from the articulating quadriceps
      tendon-patellar ligament suture line. All 39 patients had a 1.5-2.5-cm tibial
      tubercle elevation with medial displacement, as necessary, to centralize their
      patellofemoral mechanisms. Follow-up period averaged 6.1 years. Seventy-nine
      percent (33 of 42 procedures) had good to excellent results. There was a major
      complication rate of 7%. Six of the nine failures were attributable to
      social/psychiatric reasons. Previously unrecognized tibiofemoral OA was the
      reason for poor results in two of the other failures, and one failure was
      unexplained. Patients with long-standing symptoms caused by patellofemoral OA
      should preoperatively be psychologically evaluated and diagnostically
      arthroscoped before the Maquet procedure is carried out.

PMID- 8472457
TI  - The axes of rotation of the knee.
AB  - Knee motion is believed to occur about a variable flexion-extension (FE) axis
      perpendicular to the sagittal plane and a longitudinal rotation (LR) axis. The
      authors used a mechanical device to locate the FE and the LR axes of six fresh
      anatomic specimen knees. The motion of points on the LR axis produced circular,
      planar paths about the fixed FE axis. Magnetic resonance (MR) images in planes
      perpendicular to the FE axis showed a circular profile for the femoral condyles.
      The FE axis is constant and directed from anterosuperior on the medial side to
      posteroinferior on the lateral side, passing through the origins of the medial
      and lateral collateral ligaments and superior to the crossing point of the
      cruciates. The LR axis is anterior and not perpendicular to the FE axis, the
      anatomic planes. This offset produces the valgus and external rotation observed
      with extension. The implications of two fixed offset axes for knee motion on
      prosthetic design, braces, gait analysis, and reconstructive surgery are
      profound.

PMID- 8472458
TI  - Treatment of complex tibial shaft fractures. Arguments for early secondary
      intramedullary nailing.
AB  - In 135 cases of mainly open tibial shaft fractures treated primarily with
      external fixation, 73 patients (54%) were treated exclusively with external
      fixation; osteomyelitis occurred in 8.2%, nonunion in 8.2%, and malunion in
      32.8%. Later sequential plating was performed in 38 patients (28%), and in 24
      patients (18%) secondary intramedullary nailing. Patients with delayed nailing
      after primary external fixation had the lowest incidence of osseous infection
      (4.1%) and nonunion (4.1%), the lowest malunion rates under strict criteria
      (24%), and a significantly shorter healing time (21.5 weeks versus 33.4 weeks
      after secondary plating and 30.2 weeks after treatment with external fixation
      alone). Patients treated with secondary plating had osseous infection in 10.2%,
      nonunion in 7.8%, and malunion in 29.3%. Changing to an intramedullary nail after
      primary treatment of open tibial shaft fractures with external fixation was a
      more effective way to treat these fractures than definitive treatment with
      external fixation alone or delayed secondary treatment by plating. Sequential
      nailing can be performed as early as one to three weeks after trauma without the
      necessity of a safety interval between the removal of external fixation and
      intramedullary nailing to prevent infection.

PMID- 8472459
TI  - Anatomy of the calcaneus.
AB  - The calcaneus is the largest tarsal bone in the foot and is well designed to
      sustain high tensile, bending, and compressive forces. However, high
      instantaneous loads often result in fracture. Any treatment of calcaneal
      fractures requires a working knowledge of the anatomy. The major neurovascular
      structures are located medially and are well insulated by the medial soft
      tissues. These structures are at risk, however, during medial approaches to the
      calcaneus. Laterally, there are several bony landmarks that are palpable
      primarily because of the relative paucity of the soft-tissue elements. Lateral
      approaches to the calcaneus have been associated with the areas of skin necrosis
      that may be related to the arterial anatomy. The calcaneus has four articular
      surfaces. The congruity of these articular surfaces and their relationship to one
      another can be assessed roentgenographically. With adequate knowledge of the bony
      anatomy of the calcaneus and its soft tissue envelope, a rational approach in
      assessment and treatment of calcaneal fractures can be developed.

PMID- 8472460
TI  - Complicated removal of the distal locking device of Brooker-Wills.
AB  - Fractures of the femur in two women, ages 17 and 27, were treated with Brooker
      Wills nails. While the distal deployment device was inserted into the nail in one
      patient, the tip of the driver/inserter broke into the proximal end of the distal
      deployment device. This complicated the extraction of the nail and the distal
      locking device after healing of the fracture. In the other patient, removal of
      the distal locking device and the nail was complicated by inability to engage the
      tip of the driver inserter into the proximal end of the distal deployment device.
      The method described here facilitates removal of nails and the distal locks.

PMID- 8472461
TI  - The effects of freeze-drying and rehydration on cancellous bone.
AB  - Processing technique significantly affects the strength and stiffness of bone for
      use as a structural alloimplant in reconstructive surgery. The effects of the
      rehydration of freeze-dried human cancellous bone were studied using 14-mm
      diameter cancellous dowels taken from matched cadaveric sites. Three different
      methods of rehydration were evaluated and compared with unrehydrated freeze-dried
      and frozen grafts. All samples were biomechanically tested in anatomically
      matched pair groups to determine compressive strength and stiffness. The strength
      of each tested graft was expressed as a percentage of its matched pair control.
      Freeze-dried grafts rehydrated for 24 hours compared with frozen grafts showed no
      significant difference in mean compressive strength (92.6% +/- 13.3% of control).
      Analysis of in vacuo versus ex vacuo rehydration at one hour showed a 38% greater
      mean compressive strength and a 42% greater mean stiffness for the ex vacuo
      group. Unrehydrated grafts appeared to be both stronger and stiffer than their
      rehydrated counterparts. These results suggest that the rehydration of freeze
      dried grafts may adversely affect graft strength and stiffness. Rehydration under
      a negative pressure may proceed more rapidly than the process at atmospheric
      pressures. These findings limit the acceptability of freeze-dried grafts as
      structural implants.

PMID- 8472462
TI  - A biomechanical analysis of atlantoaxial stabilization methods using a bovine
      model. C1/C2 fixation analysis.
AB  - The reliability and initial postoperative stability of six widely used C1-C2
      surgical constructs were evaluated by nondestructive biomechanical testing of ten
      fresh bovine upper cervical spine segments. The six fixation techniques were the
      simple midline sublaminar C1 wiring (SMW), the modified Gallie wiring (MGW), the
      Brook wedge arthrodesis (BWA), the bilateral lateral mass screw (LMS), and the
      Clark arthrodesis without (CWO) and with (CW) the adjunctive use of
      polymethylmethacrylate (PMMA) cement. Instability was produced by resection of
      the base of the dens. Intact, destabilized, and instrumented constructs were
      tested in unconstrained flexion, extension, torsion, anterior, and posterior
      shear forces. The LMS and CW techniques proved the most effective in achieving C1
      C2 stability. Sublaminar C2 wiring methods tended to have greater torsional and
      shear stiffness. Less rigid fixation techniques frequently loosened. All non-PMMA
      enhanced wired constructs failed to restore the ability to adequately resist the
      posterior translation of C1 on C2. Stabilization of an unstable atlantoaxial
      articulation is best accomplished by a lateral mass screw or sublaminar C1-C2
      PMMA-enhanced technique. Other techniques provided less consistent and reliable
      surgical fixation. Because of the inadequacy of wired constructs to resist
      posterior shear in patients with this instability pattern, the usual treatment
      may need to be modified to include more prolonged or protective external
      immobilization or more rigid fixation techniques. Although less rigid, the SMW
      and the MGW techniques are safer because they require less-frequent passage of
      sublaminar wires, avoid potential problems with PMMA, and obviate the hazards of
      further lateral dissection and insertion of the transarticular screws.

PMID- 8472463
TI  - Osteoinductive activity of composites of bone morphogenetic protein and pure
      titanium.
AB  - Titanium sponges were infused with bone morphogenetic protein (BMP-Ti), and the
      osteoinductivity of the resultant composite was measured. New bone formation
      occurred three weeks after implantation and was identified by soft x-ray
      analysis. Quantitative analysis showed no significant difference between BMP-Ti
      composites and control samples (BMP only). Consequently, pure titanium neither
      inhibited nor promoted BMP activity. Chondrocytes and new bone formation occurred
      in direct contact with the surfaces of the titanium. X-ray microanalysis
      demonstrated new bone formation inside the pores of the titanium sponges. The BMP
      Ti composite has interesting properties as an osteoinductive implant and has
      potential practical clinical applications.

PMID- 8472464
TI  - The mechanism, reduction technique, and results in fractures of the os calcis,
      1951-52.

PMID- 8472465
TI  - International documentation and evaluation system.

PMID- 8472466
TI  - Osteoarthritis/osteoarthrosis.

PMID- 8472467
TI  - A common problem with cementless femoral components.

PMID- 8472468
TI  - Mechanism and pathoanatomy of the intraarticular calcaneal fracture.
AB  - The mechanism and pathoanatomy of the acute intraarticular calcaneal fracture is
      produced by axial loading. A combination of shear and compression forces produce
      two characteristic primary fracture lines. Shearing forces produce a fracture
      dividing the calcaneus into medial and lateral portions. This fracture line
      typically splits the posterior facet and can extend anteriorly to involve the
      anterior and cuboid facets. Compression forces divide the calcaneus into anterior
      and posterior portions. This fracture line can extend medially to involve the
      middle facet. Loss of calcaneal height and length are readily explained by this
      mechanism.

PMID- 8472469
TI  - The radiologic evaluation of calcaneal fractures.
AB  - Although computed tomography (CT) scanning has revolutionized the treatment of
      calcaneal fractures, simple studies such as Bohler's view still have a role in
      the diagnosis and management of these fractures. This article reviews the
      benefits and limitations of these imaging techniques for calcaneal fractures.

PMID- 8472470
TI  - Intraarticular calcaneal fractures. Results of closed treatment.
AB  - Thirty intraarticular calcaneal fractures were studied by computed tomography and
      then treated with a variety of closed methods. A classification of the fractures
      was devised according to the amount of displacement of the posterior facet.
      Follow-up evaluation showed that Type I fractures recovered function and healed
      extremely well. Closed treatment should be the treatment of choice for Type I
      fracture patterns. Type II and III fractures had unacceptable results with closed
      treatment. Alternate forms of treatment should be considered in dealing with more
      severely displaced fractures.

PMID- 8472471
TI  - The operative treatment of intraarticular calcaneal fractures. Indications,
      technique, and results in 257 cases.
AB  - Since 1972, 257 intraarticular fractures of the calcaneus have been treated with
      operative intervention. A lateral incision and a third tubular plate were used in
      all cases. The functional results were considered excellent or good in 85%, and
      there was an infection rate of 2.7%. Although 50% of patients showed a reduced
      mobility of the subtalar joint, pain and limited ambulation were rare. Only six
      patients required a late subtalar arthrodesis.

PMID- 8472472
TI  - Open treatment of acute calcaneal fractures.
AB  - Displaced intraarticular fractures of the calcaneus require operative
      intervention to restore the anatomy of the bone, which in turn is the requirement
      for recovery of subtalar joint mobility. Surgery through a lateral incision,
      without opening the sheath of the peroneal tendons, and the use of lag screws and
      a "Y-plate," must restore not only the respective positions of the "three poles"
      of the calcaneus but also the respective orientations of the articular surfaces.
      Stable internal fixation allows early active and passive mobilization of the
      subtalar and ankle joints. If this is not achieved, the functional outcome will
      be poor.

PMID- 8472473
TI  - Surgical treatment of displaced intraarticular fractures of the calcaneus. A
      combined lateral and medial approach.
AB  - Twenty-two patients with 22 displaced intraarticular fractures of the calcaneus
      were treated by open reduction and internal fixation using a lateral approach
      and, when needed, a medial approach, followed by early motion. These patients
      were evaluated from 16 to 72 months (average, 37 months) after surgery. At follow
      up evaluation, the result was assessed on the basis of restoration of anatomy and
      function. Combining the anatomic and functional findings, the results in this
      series were good in 17 patients, fair in one, and poor in four.

PMID- 8472474
TI  - Osteosynthesis of displaced intraarticular fractures of the calcaneus. Results in
      123 cases.
AB  - The operative treatment of intraarticular calcaneal fractures has three principal
      aims: restoration of height, length, and width of the calcaneus, reconstruction
      of the subtalar and calcaneocuboid joint surfaces, and stable osteosynthesis
      using an H-plate or screws. In 68% of the cases, the sustentacular fragment was
      the key to open reduction, making the medial approach mandatory. In complex
      fractures, a lateral approach is added. In "blow-out" fractures or cases with
      comminution of the sustentacular fragment, an extended lateral approach only is
      used. For precise preoperative planning of roentgenograms in three planes, four
      Broden's views and axial plus coroneal or three-dimensional computed tomography
      scans are required. From July 1983 to July 1990, 157 intraarticular calcaneal
      fractures were treated by open reduction. The results in 123 cases are 61% good
      or excellent, 32.5% satisfactory, and 6.5% poor. The following early
      complications occurred: superficial wound edge necrosis (8.3%), hematoma (2.5%),
      nonunion (1.3%), and infection (1.9%). Four patients (3.3%) in the follow-up
      group have developed degenerative changes severe enough to require subtalar
      fusion. To facilitate the comparison of results, new fracture classification and
      follow-up scoring systems have been devised.

PMID- 8472475
TI  - Operative treatment in 120 displaced intraarticular calcaneal fractures. Results
      using a prognostic computed tomography scan classification.
AB  - From January 1987 to September 1990, 132 displaced intraarticular calcaneal
      fractures were treated operatively using a lateral approach, lag screws, and side
      plate without bone graft. To evaluate the results, a classification for
      intraarticular calcaneal fractures was developed, based on standardized coronal
      and transverse computed tomography (CT) scans of both feet. Type 1 fractures were
      nondisplaced (and received nonoperative treatment); Type II were two-part or
      split fractures; Type III were three-part or split depression fractures; and Type
      IV were four-part or highly comminuted articular fractures. Results were
      evaluated using the Maryland Foot Score and repeat CT scans. One hundred twenty
      cases were available for a minimum of one year follow-up evaluation (range, 12-56
      months; mean, 29.3 months). Roentgenographic evaluation of calcaneal body
      dimensions showed restoration of heel height (98%), width (110%), and length
      (100%) to virtually normal in all cases, regardless of preoperative displacement.
      Roentgenographically, articular reduction was anatomic in 68 of 79 (86%) Type II
      fractures, 18 of 30 (60%) Type III fractures, and 0 of 11 (0%) Type IV fractures.
      Excellent or good clinical results occurred in 58 of 79 (73%) Type II fractures,
      21 of 30 (70%) Type III fractures, and one of 11 (9%) Type IV fractures. When
      excellent and good clinical results were compared by year, a distinct learning
      curve appeared (1987, 27%; 1988, 54%; 1989, 74%; 1990, 84%). Despite an improved
      outcome for Type II and III fractures with increasing surgical experience, the
      results of operative intervention in Type IV fractures were no better, even after
      four years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472476
TI  - The medical approach for calcaneal fractures.
AB  - A practical classification of calcaneus fractures based on standard heel
      roentgenograms and Broden's views is presented. Diagnosis is made from these
      roentgenograms, even though many believe that more sophisticated studies are
      needed. In fact, only the Broden's and lateral views are needed for diagnosis.
      What one needs to know is the type of fracture present, whether it is a tongue or
      joint depression-type fracture, and the width of the fragment. The necessary
      information is easily determined from these roentgenograms. Once these facts are
      known, a plan of approach can be made. The medial approach is an indirect method
      of reduction as one might use for the tibia or femur fracture. Experience has
      shown that the longitudinal threaded pin is an excellent method of stabilization.
      It is quick and effective. It has eliminated the need for exposure of the
      neurovascular bundle. Minimal metal is implanted, and a smaller incision is used.
      Most common calcaneal fractures can be reduced well from the medial side. A few
      may need lateral reduction also, but this is simplified if the nonarticular
      components of the fracture are reduced first by the medial approach technique.
      The results of the medial approach technique have been much better in the last 12
      years. This is attributed to the classification, the knowledgeable interpretation
      of the roentgenograms, and use of the threaded longitudinal pin for fixation.

PMID- 8472477
TI  - Acute pulmonary complications in immunocompromised non-AIDS patients: comparison
      of diagnostic accuracy of CT and chest radiography.
AB  - To compare the abilities of computed tomography (CT) and radiography in detection
      and diagnosis of acute pulmonary complications in immunocompromised non-AIDS
      patients, the CT scans and radiographs of 45 immunocompromised non-AIDS patients
      with proven pulmonary disease and 20 normal controls were independently assessed
      by two observers, without knowledge of clinical or pathologic data. The observers
      listed the three most likely diagnoses and their degree of confidence in the
      first-choice diagnosis on a three-point scale. The sensitivity and specificity in
      detecting pulmonary complications was 100% and 98% for CT, compared to 98% and
      93%, respectively, for chest radiography. In the immunocompromised patients, the
      first-choice diagnosis was correct in 44% of CT and 30% of radiograph readings (P
      < 0.01). The correct diagnosis was among the top three diagnoses in 70% of CT
      scans and 53% of radiograph readings (P < 0.01). Confidence level one (definite)
      was reached in 33% of CT scans and 10% of chest radiographs (P < 0.001). Diseases
      with a dominant nodular pattern had a higher occurrence of correct first-choice
      diagnosis (62% vs 34%, P < 0.02) and level one confidence ratings (53% vs 13%, P
      < 0.001) than diseases with ground-glass opacity, consolidation or irregular
      linear opacities. We conclude that chest radiographs and CT scans have comparable
      sensitivity in detecting acute pulmonary complications in immunocompromised non
      AIDS patients. CT is superior to chest radiography in the differential diagnosis
      of acute pulmonary complications in these patients.

PMID- 8472478
TI  - The prevalence of paranasal sinus disease in HIV infection and AIDS on cranial MR
      imaging.
AB  - Sinusitis poses a difficult clinical challenge in the management of patients with
      AIDS because of high rates of relapse and the association with unusual pathogens.
      To determine the prevalence and severity of sinus disease in this group we
      prospectively analysed the condition of the paranasal sinuses shown on cranial MR
      scans of 156 patients referred for the investigation of suspected intracranial
      pathologies. These included 104 HIV seropositive patients, including 93 with an
      AIDS-defining diagnosis (CDC IV). Forty-two scans were performed on age-matched
      controls. The scans were timed to control for seasonal variations in sinus
      disease and were interpreted by two radiologists who were blinded to the clinical
      and serological status of the patients. Severe mucosal disease (more than one
      sinus showing > 75% obliteration) or moderate mucosal disease (only one sinus
      showing > 75% obliteration) was seen in 15.1% (14/93) patients with AIDS and none
      of the 42 controls (chi 2 = 6.73, P < 0.01). The mean maximum mucosal thickness
      in patients with AIDS was significantly greater than the control group (P <
      0.001) and also significantly greater than in seropositive patients who had not
      had an AIDS-defining diagnosis (CDC II/III) (P = 0.006). Paranasal sinus mucosal
      abnormalities seen on MRI are greater in prevalence and severity in patients with
      AIDS and about one in seven would be expected to have at least one sinus largely
      obliterated.

PMID- 8472479
TI  - Ablation of mediastinal parathyroid adenomas by superselective embolization of
      the internal mammary artery with alcohol.
AB  - Two young patients (20 and 21 years) had recurrent hyperparathyroidism following
      neck exploration. Non-invasive investigations failed to localize a parathyroid
      adenoma. In both cases selective catheterization of the internal mammary arteries
      combined with digital angiography demonstrated hypervascular mediastinal
      adenomas. Using a coaxial catheterization technique (Tracker 18 and 10), both
      branch arteries of the internal mammary supplying the adenoma were selectively
      catheterized. In one case absolute alcohol and the other a mixture of Lipiodol
      and absolute alcohol were used to effect the ablation. The procedures were
      uneventful and serum calcium levels have subsequently returned to within normal
      limits. The follow-up in these two cases extends to 2 1/2 years in one and 10
      months in the other case.

PMID- 8472480
TI  - Duplex Doppler detection of hepatic artery thrombosis following liver
      transplantation.
AB  - Hepatic artery thrombosis is a major cause of morbidity and mortality following
      liver transplantation. We assessed the value of prospective duplex Doppler
      ultrasound in detecting hepatic artery thrombosis. One hundred consecutive
      transplants in 90 patients were studied. Duplex Doppler detected all 10 proven
      cases of hepatic artery thrombosis. No case of hepatic artery thrombosis was
      found with a normal duplex study. All arteriograms performed following an
      abnormal ultrasound demonstrated hepatic arterial occlusion or anastomotic
      stenosis or a segment of irregular arterial narrowing. We conclude that duplex
      Doppler is a practical and sensitive method of selecting patients with a
      presumptive diagnosis of hepatic artery thrombosis for further investigation by
      angiography.

PMID- 8472481
TI  - Phase III trial of oral magnetic particles in MRI of abdomen and pelvis.
AB  - A prospective Phase III trial was performed to evaluate the efficacy in clinical
      practice of a new gastro-intestinal contrast agent, Oral Magnetic Particles
      (OMP), for use in abdominal and pelvic magnetic resonance imaging (MRI). This was
      an open study comprising 35 patients each given 800 ml of OMP at a concentration
      of 0.5 g/l. Distribution of the agent was most reliable in the small bowel.
      General contrast effect was satisfactory, and image quality and diagnostic
      confidence were enhanced. Administration of OMP increased diagnostic information
      in the magnetic resonance (MR) image in 50% of patients. No clinically
      significant adverse effects were observed. The results confirm in a clinical
      setting a potential role for this new contrast agent.

PMID- 8472482
TI  - Balloon-expandable intravascular stents in atherosclerotic iliac artery stenosis:
      preliminary experience.
AB  - Ten patients with symptomatic iliac artery stenosis underwent percutaneous
      insertion of balloon-expandable intravascular stents. A total of 12 stents were
      inserted in the common iliac (7 patients) and external iliac (3 patients)
      arteries. The indications for placement were unsuccessful angioplasty (5 cases),
      to improve inflow prior to a subsequent distal bypass graft (3 cases) and
      localized iliac disease in patients deemed unfit for aorto-femoral by-pass
      surgery (2 cases). Of the 10 patients, five had rest pain and five had severe
      intermittent claudication at distances varying from 25 to 75 yards, prior to the
      procedure. Ankle-Arm Doppler systolic pressure indices increased from a mean of
      0.61 to 0.91 post procedure. Eight of the 10 patients are asymptomatic at follow
      up, average 12 months (range 8-18 months). One patient died from an unrelated
      cause and the other patient remains symptomatic due to distal disease (Table 1).
      Our experience suggests that percutaneous insertion of balloon-expandable
      intravascular stents is a valuable technique for treatment of external and common
      iliac stenosis.

PMID- 8472483
TI  - Transpopliteal angioplasty of combined iliofemoral occlusions.
AB  - We report two cases of iliofemoral occlusive vascular disease which were
      successfully treated by angioplasty via the popliteal artery. The merits of this
      approach, when ipsilateral femoral puncture is precluded, are discussed.

PMID- 8472484
TI  - Computed tomography of vertebral tuberculosis: patterns of bone destruction.
AB  - A retrospective analysis was performed of CT scans of 30 consecutive patients
      with a clinical suspicion or diagnosis of spinal tuberculosis. Four patterns of
      bone destruction were noted, namely, fragmentary, osteolytic, subperiosteal and
      well-defined lytic with sclerotic margins. The fragmentary type was most common
      (47%). Intervertebral disc destruction was always associated with contiguous
      vertebral body destruction. Associated paravertebral soft-tissue masses were seen
      in all patients. Epidural extension of disease was seen in 66% and showed a very
      good correlation with neurological signs on clinical evaluation. Bone fragments
      were detected in the epidural soft-tissue mass in 65% of patients with epidural
      extension of disease. CT appearances of bone destruction are highly suggestive of
      tuberculous osteomyelitis in about half the patients.

PMID- 8472485
TI  - Colonic sonography: preliminary observations.
AB  - Transrectal instillation of water is a recently described technique for improved
      sonological imaging of the lumen and wall of the colon. In order to assess the
      accuracy of this technique, termed colonic sonography (CS), in the detection of
      abnormalities of the large bowel, 100 consecutive patients were subjected to
      colonic sonography and the results were compared with the results of colonoscopy
      and surgery. The technique showed a sensitivity of 91% for the detection of
      colonic tuberculosis, 89% for ulcerative colitis and 83% for colonic cancers.
      Small mucosal ulcers, polyps less than 7 mm in diameter and the changes of non
      specific colitis were not detected. Sonography displayed the entire colon more
      consistently than colonoscopy. The extent and extra-colonic spread of disease
      were better appreciated. The procedure was not adversely influenced by the
      presence of faecal material within the colon and was well tolerated. Colonic
      sonography is a promising new technique for detecting significant colonic
      pathology and merits further comparison with existing modalities.

PMID- 8472486
TI  - Technical report: the Venflon 2 intravenous cannula used for arterial
      catheterization.
AB  - Using conventional guidewire techniques we have found the Venflon 2 (Viggo
      Spectramed) to be a safe and effective arteriographic puncture needle. The
      Venflon 2 offers significant technical advantages and cost savings when compared
      with traditional needles. Its use and limitations are discussed.

PMID- 8472487
TI  - Case report: sonographic detection of renal transplant cortical calcification.
AB  - Cortical calcification in a transplanted kidney was detected by high resolution
      ultrasound, not visible on plain abdominal radiography. Early recognition of
      these sonographic appearances should lead to a more accurate diagnosis and
      institution of appropriate treatment in patients with post-operative transplant
      dysfunction.

PMID- 8472488
TI  - Case report: accumulation of 99mTc-hydroxymethylene diphosphonate by liver
      metastases of prostatic adenocarcinoma.
AB  - We describe the case of a man with known prostatic carcinoma and bone metastases
      who was admitted with jaundice and hepatomegaly. A bone scan showed uptake of
      diphosphonate by the liver and ultrasound suggested the presence of diffuse
      metastatic disease. Liver biopsy revealed foci of carcinoma cells in the portal
      tracts which exhibited positive cytoplasmic staining for prostate-specific
      antigen, thus confirming the presence of metastatic prostatic adenocarcinoma.

PMID- 8472489
TI  - Case report: imaging of widespread plexiform neurofibromatosis.
AB  - Although the cutaneous, bony and retroperitoneal appearances of peripheral von
      Recklinghausen neurofibromatosis are well known, involvement of intra-abdominal
      organs and of the mediastinum is less well recognised. We present the case of a
      woman with peripheral neurofibromatosis who presented with loin pain. In addition
      to cutaneous neurofibromas, plexiform neurofibromas were present in the
      mediastinum, liver, mesentery and psoas muscles.

PMID- 8472490
TI  - Case report: radiological features of epidermal inclusion cyst of the tympanic
      membrane.
AB  - Computed tomography (CT) proved to be invaluable in diagnosing and ascertaining
      the extent of an epidermal inclusion cyst of the tympanic membrane secondary to a
      previous myringoplasty.

PMID- 8472491
TI  - Case report: pericolic abscess secondary to torsion of an appendix epiploica.
AB  - Torsion of the appendices epiploicae is a rare condition which may present with
      acute abdominal pain and mimic appendicitis. Untreated, peritonitis or intestinal
      obstruction may result. We present a case in which torsion of an appendix
      epiploica led to the development of a pericolic abscess communicating between the
      colon and lesser sac. To our knowledge these radiological findings have not been
      described previously.

PMID- 8472492
TI  - A pseudo body packer.

PMID- 8472493
TI  - Risks of diagnostic radiation.

PMID- 8472494
TI  - Bone marrow trephine biopsy: anterior superior iliac spine versus posterior
      superior iliac spine.
AB  - Bone marrow biopsy (BMB) is generally performed either on the anterior superior
      iliac spine (ASIS) or the posterior superior iliac spine (PSIS), the choice
      between these two sites depending largely upon practice at individual centres. No
      previous study has attempted to ascertain which of these two sites is preferable
      for needle BMB. We studied 72 biopsies, of which 36 were of the PSIS and 36 of
      the ASIS, measuring the length of the cylinder and the area of the histologic
      section. We asked those patients who had undergone BMB at both sites which had
      been the less painful. The cylinders obtained from the PSIS were found to have a
      significantly greater length and area than those obtained from the ASIS (P <
      0.00001). Of the 13 patients who underwent BMB at both sites, 11 reported the
      PSIS biopsy to have been distinctly less painful (P = 0.012). We conclude that
      needle BMB of the PSIS provides samples of greater length and area, and is less
      painful, than that of the ASIS.

PMID- 8472495
TI  - A computerized expert system for handling the output of the Technicon H1
      haematology analyser.
AB  - A computer-based expert system is described which handles the output of the
      Technicon H1 in the haematology laboratory of a large teaching hospital. Using
      patient request data, analyser results, error and morphology flags, the expert
      system decides; whether to validate the main indices plus differential; whether a
      blood film is required for manual review; and which abnormal results require
      phoning to the requesting doctor. The results of this computer-assisted analysis
      are sent to a printer adjacent to the analyser. The print-out details any further
      action required of the operator before release of results to the main hospital
      computer, and serves as a log of all samples run on that analyser. Benefits of
      the expert system include greatly simplified interpretation of the large array of
      analyser flags, and consistency in sample handling for all operators over all
      shifts.

PMID- 8472496
TI  - The effect of acidified glucose nutrient solution on preservation of platelet
      concentrate.
AB  - The preservation effect of a new platelet solution--acidified glucose nutrient
      solution (AGN)--was tested by adding AGN to pooled platelet rich plasma (PRP)
      prior to preparation of platelet concentrates (PC). Each PRP unit was prepared
      from a unit of whole blood and four PRP of the same blood group were pooled in
      400 ml volume PVC bags. Equal aliquots of each pooled PRP were made prior to
      preparation of PC. AGN was added to one aliquot and nothing was added to the
      control aliquot. Equal volume and concentration PC were then prepared and the PC
      were further aliquoted for storage at 22 degrees C. After five days, the
      parameters of platelet count, pH, aggregability and hypotonic shock response
      (HSR) for PC preserved in AGN plasma were better than those of the controls
      preserved in normal ACD plasma. The aggregability and HSR of AGN platelet
      concentrates recovered to baseline after two h of incubation with fresh plasma.
      The results of electron microscopy show that platelets preserved in AGN have less
      changes in morphology. The results of our work suggest that the preservation
      effect of AGN on PC is similar to the effect of using second generation
      containers or preparation of platelets from thrombocytapheresis.

PMID- 8472497
TI  - Acute promyelocytic leukaemia following radioiodine therapy.

PMID- 8472498
TI  - Haemolytic transfusion reaction--successful attenuation with methylprednisolone
      and high dose immunoglobulin.

PMID- 8472499
TI  - The combination of hydroxyurea and leucapheresis in the treatment of chronic
      myeloid leukaemia in pregnancy.
AB  - Treatment of malignancy during pregnancy is difficult because of the potential
      teratogenicity of chemotherapeutic agents. Leucapheresis was employed in the
      initial management of a pregnant patient with chronic myeloid leukaemia. It was
      subsequently replaced with oral hydroxyurea during the second trimester.
      Successful delivery of a live male infant was achieved and the child has normal
      growth and development to date.

PMID- 8472500
TI  - Spontaneous remission of chronic pure red cell aplasia after failure of
      immunosuppressive therapy.

PMID- 8472501
TI  - Reference ranges for haematology parameters in pregnancy derived from patient
      populations.
AB  - Reference ranges for several haematology parameters in pregnancy were determined
      by the mathematical detection of Gaussian and Gamma distributions in partitioned
      but unselected patient data. For each trimester, red cell parameters were shown
      to be well described by Gaussian distributions. Platelet and white cell
      parameters were best described by Gamma distributions with the exception of
      eosinophil and basophil counts for which neither distribution was applicable. The
      reference ranges derived for each trimester are compared.

PMID- 8472502
TI  - Clostridium perfringens in the immunocomprised.

PMID- 8472503
TI  - Automated differential count rejections and in vitro platelet aggregation in
      blood from patients taking warfarin.

PMID- 8472504
TI  - Red cell distribution width (RDW) in sickle cell disease.

PMID- 8472505
TI  - Circadian variations in platelet aggregability in non insulin dependent diabetes
      patients (NIDDM).
AB  - Circadian rhythms of platelet activity have been extensively investigated in
      recent years in view of a possible correlation with the increased morning
      frequency of thrombotic events. Since a role of enhanced platelet activity has
      been suggested in diabetic macro- and microvascular disease, the aim of the
      present study was to analyze the circadian variations of in vitro platelet
      aggregability in patients with non insulin-dependent diabetes mellitus. Eighteen
      in-patients, ranging in age from 49 to 73 years, all in good metabolic control,
      were included in the study. Aggregometric patterns were analyzed in blood samples
      collected at 0700, 0900, 1100 and 1700. A significant increase of the threshold
      concentrations for ADP-collagen- and arachidonic acid-induced platelet
      aggregation has been observed in the interval 0700-1100 or 0700-1700, suggesting,
      also in diabetic patients as in normal subjects, a maximum of platelet activity
      in the morning, regardless of postural changes and timing of meals.

PMID- 8472506
TI  - [Heparinization in dialysis: new clinico-therapeutic directions].
AB  - The authors describe side-effects of heparin administration during chronic
      dialytic treatment. For every complication they present a new clinical and
      therapeutic guideline. They then illustrate their method for monitoring heparin
      therapy with partial activated thromboplastin time and low dose heparin combined
      with prostacyclin.

PMID- 8472507
TI  - [The prevalence of arrhythmias in subjects over 80 years old. The prognostic role
      of anamnestic symptomatology and the therapeutic directions].
AB  - 24-hour Holter monitoring was performed in 129 unselected subjects older than 80
      years (69 women and 60 men) in order to evaluate arrhythmia incidence and to
      establish significance of symptoms; 56% patients had lipothymia and/or syncope,
      chest pain and palpitations, 44% were asymptomatic. All patients showed high
      incidence of hyperkinetic and hypokinetic arrhythmias; no significant differences
      between symptomatic and asymptomatic patients in arrhythmia incidence were seen.
      Moreover, no correlation could be seen of the symptoms reported by the patient to
      the incidence of any particular type of arrhythmia. In conclusion, these
      preliminary data suggest a criticism of the opportunity of indiscriminate and
      long term antiarrhythmic therapy. Nevertheless, Holter monitoring is useful in
      detecting hypokinetic arrhythmias of asymptomatic patients in whom pacemaker
      implantation is essential and curative.

PMID- 8472508
TI  - [The role of disease-modifying antirheumatic drugs (DMARDs) in the therapy of
      rheumatoid arthritis].
AB  - The destructive process seen on the cartilage and on the sub-chondral bone of
      patients with rheumatoid arthritis, which is a chronic inflammatory disease of
      unknown aetiology, is in part unavoidable. The aim of the treatment is not only
      to reduce articular inflammation and/or to relieve pain, but also to prevent or
      delay articular damage and to improve quality of life of rheumatoid patients. The
      use of new available drugs, with a modern therapeutic approach, seems to be apt
      to improve considerably the outcome in rheumatoid patients.

PMID- 8472509
TI  - [An increase in the median plasma values of progesterone in luteal deficiencies
      treated with clomifene citrate in the early follicular phase].
AB  - A clinical study performed during 265 cycles in 63 normo-ovulating and normo
      menstruating patients, of whom 27 with a luteal phase defect (LPD), assessed by
      morphological, hormonal, echographic and clinic criteria. These were given
      Clomiphene Citrate, 100 mg per day from the second to sixth day of the cycle, for
      a total of 108 cycles. The other 36 patients, without any luteal abnormality,
      were utilized as a control group during 156 cycles. At the end of the study there
      were no significant differences in hormonal, echographic and morphological
      parameters between the two groups.

PMID- 8472510
TI  - [Ocular involvement in rheumatoid arthritis].
AB  - The authors evaluated ocular involvement in 23 patients affected by rheumatoid
      arthritis (RA) according to ARA criteria. Slit-lamp biomicroscopic examination
      showed signs of keratoconjunctivitis sicca in one patient (4%), while a positive
      bilateral Schirmer test was found in six subjects (26%). Fluorescein angiography,
      carried out in 11 of the 23 RA patients, showed retinal vasculitis in 18% of the
      patients examined, even if no clinical and ophthalmoscopic signs of retinal
      vessel inflammation were present. The authors suggest that fluorescein
      angiography should be performed in patients affected by particularly active RA,
      with recent onset of the disease (< 12 months), high titres of classical IgM
      rheumatoid factor and raised concentrations of circulating immune complexes. The
      study confirmed moreover the uncommon ocular toxicity related to the drugs
      frequently employed in RA treatment (antimalarials, gold salts, glucocorticoids).
      Indeed, only one case (4%) of posterior subcapsular cataract clearly related to
      steroid therapy was found.

PMID- 8472511
TI  - [The use of picotamide in nephropathy with mesangial IgA deposits. The effect on
      thromboxane generation].
AB  - IgA nephropathy (Berger's disease) is one of the commonest forms of glomerular
      disease, not rarely progressing to renal failure. Hemostatic system activation
      may play a role in the development of glomerular injury. In a series of 12 adult
      patients affected with IgA nephropathy we have observed increased plasma levels
      of D-dimer, a stable end-product of cross-linked fibrin degradation that is
      considered a reliable index of blood clotting activation, as well as "in vitro"
      raised generation of thromboxane, the main platelet product of arachidonic acid
      metabolism that seems to play an important role in glomerulosclerosis.
      Picotamide, a novel antiplatelet drug acting as thromboxane synthase inhibitor as
      well as thromboxane receptor antagonist, administered for 8-12 weeks, was
      effective in reducing thromboxane generation. We conclude that picotamide may be
      useful in the management of glomerular nephropathy.

PMID- 8472512
TI  - [The role of infective intestinal complications on the course of Crohn's disease
      and ulcerative rectocolitis].
AB  - The authors studied the incidence of protozoal and bacterial infection in 41
      cases of Crohn disease und ulcerative colitis; the effect of anti infective
      therapy on the clinical course has also been tested. Patients with ulcerative
      colitis are more frequently involved in this type of complication than those with
      Crohn disease. Therapy has a positive influence on the course of the disease;
      therefore systematic study of the faeces for bacteria and parasites is necessary
      for a correct understanding of chronic inflammatory bowel disease and for
      specific treatment.

PMID- 8472513
TI  - [The use of contact lenses: the reality and outlook].

PMID- 8472514
TI  - [Acute hepatitis, chronic hepatitis, cirrhosis: the intermediate and final stages
      in liver damage induced by chronic alcohol abuse].
AB  - Having briefly analyzed the metabolism of ethanol in man, the author describes
      hepatocellular damage induced by alcohol abuse and histological, clinical and
      biohumoral features of acute alcoholic hepatitis, chronic hepatitis and
      cirrhosis. Seventy-five clinical cases of acute alcoholic hepatitis, chronic
      hepatitis and cirrhosis are also illustrated, studied and observed during five
      years.

PMID- 8472515
TI  - [Appropriate consumer behaviors: breakfast].

PMID- 8472516
TI  - [A bioequivalence study of tablet and powder formulations of the nonsteroidal
      anti-inflammatory drug 2-methoxyphenyl 1-methyl-5-(p-methylbenzoylpyrrol)-2
      acetamidoacetate].
AB  - The purpose of the current study was that of evaluating and comparing the
      pharmacokinetic parameters (Tmax, Cmax, Ke, AUC, t1/2 beta) at the compounds TGA,
      tolmetin and MCPA obtained from healthy volunteers following a single oral
      administration of 600 mg of 2-methoxyphenyl 1-methyl 5 p-methylbenzoylpyrrole
      2acetamide acetate (ST-679, previously called MED-15) in the form of tablets and
      envelopes in order to establish the bioequivalence of the above-mentioned
      preparations. The results obtained indicate that the administration of 600 mg of
      2 methoxyphenyl 1-methyl 5 p-methylbenzoylpyrrole-2acetamide acetate (ST-679)
      tablets produces from a pharmacokinetics point of view, in man, pharmacokinetic
      parameters comparable to those obtained following administration of the same dose
      of the drug in envelopes. It is, therefore, possible to affirm that the
      preparation of 2-methoxyphenyl 1-methyl 5-p-methylbenzoylpyrrole-2acetamide
      acetate (ST-679) in envelopes is bioequivalent to that of the tablets.

PMID- 8472517
TI  - [A clinical study to determine the optimal dosage of ST-679 in the treatment of
      rheumatic diseases].
AB  - A study was performed with 60 patients, affected by acute phase rheumatological
      pathology, in order to determine the optimum posology of ST-679 administered
      orally. The 60 patients were divided into 4 groups: 3 treated with ST-679 at
      different dosages (group 1 = 600 mg/die; group 2 = 1200 mg/die; group 3 = 1800
      mg/die) and one with placebo (group 4 = 600 mg/die). The highest dosage employed
      (1800 mg/die) performs an excellent therapeutical activity which is equivalent to
      that at the 1200 mg in reducing pain symptomatology, but on the average less
      tolerated. The 600 mg dosage was less efficacious with respect to the two higher
      doses.

PMID- 8472518
TI  - [An evaluation of the therapeutic activity and tolerance of ST-679 in patients
      with osteoarthritis at different sites. A controlled double-blind study vs
      tolmetin].
AB  - A multicentered study was carried out, under double-blind conditions, on 160
      elderly patients afflicted with differently localized symptomatic osteoarthritis,
      for the purpose of evaluating the therapeutical efficacy and tolerability of ST
      679 (per-os at a dose of 1200 mg pro die in 80 patients) and to compare them with
      those of tolmetin (per os at a dose of 1200 mg pro die in 80 patients). It was
      demonstrated that ST-679 was significantly active on all of the clinical
      parameters of the illness already recorded after a month of treatment. ST-679 was
      always excellently tolerated as shown by the scarce incidence of adverse
      reactions. Results of laboratory tests, of tests for hidden blood in the feces
      and of a gastroduodenoscopy confirmed the excellent biological and gastric
      tolerability of ST-679. ST-679 demonstrated, moreover, a significantly better
      tolerability with respect to tolmetin.

PMID- 8472519
TI  - [A bioequivalence study in man of tablet and capsule formulations of the
      nonsteroidal anti-inflammatory compound 2-methoxyphenyl 1-methyl-5-(p
      methylbenzoylpyrrol)-2-acetamidoacetate].
AB  - ST-679.(2-methoxyphenyl 1-methyl-5p-methylbenzoyl pyrrole-2-acetamide acetate) is
      a novel non-steroid anti-inflammatory agent consisting of tolmetin linked by an
      amide link to guaiacole-esterified glycine. The above reported study was aimed at
      to evaluation and comparison of pharmacokinetic parameters (Tmax, Cmax, AUC, t1/2
      beta) of TGA, tolmetin, and MCPA in healthy volunteers after a single oral 600 mg
      tablet or capsule of ST-679 in order to assess the bioequivalence of the two
      formulations. The findings obtained show that pharmacokinetic parameters after
      administration of a 600 mg tablet are comparable to those after a 600 mg capsule.
      The two formulations may therefore be considered bioequivalent.

PMID- 8472520
TI  - [The drug treatment of postoperative pain].
AB  - The study, conducted on 40 patients with pain resulting from "minor" general
      surgery, for the purpose of evaluating the efficacy and tolerability of ST-679
      (administered in a single oral dose of 1200 mg in 20 patients) and to compare
      them with those of paracetamol (administered in a single oral dose of 1000 mg in
      20 patients), demonstrated that the new drug was active on all recorded
      parameters and superior to the reference drug. The evaluation of the evolution of
      pain, performed using the Scott-Huskisson visual analog scale, evidenced that the
      maximum analgesic efficacy of ST-679 is reached after 1 hour and 15 minutes from
      assumption and remains unaltered until the final observation (6 hours). The
      paracetamol registers maximum analgesic efficacy after 30 minutes, but does not
      remain constant for the entire observation period. All the other parameters
      evaluated (variation in pain intensity, peak of analgesic activity and total
      remission of pain) are significantly favorable to ST-679. The tolerability of ST
      679 was very good and better than the reference drug.

PMID- 8472521
TI  - [The treatment of postoperative pain in obstetrical-gynecologic surgery. A
      comparative study between ST-679 and paracetamol].
AB  - In double-blind conditions, ST-679 (a single oral 1200 mg dose in 20 patients),
      or paracetamol (a single oral dose of 1000 mg in 20 patients) was administered to
      forty patients who presented pain as a result of obstetrical-gynecological
      surgery. The study proposed to evaluate the analgesic efficacy and tolerability
      of ST-679, a new non-steroid antiphlogistic drug, as compared to a reference drug
      amply utilized in clinical practice such as paracetamol. The average estimation
      of tolerability, with regard to paracetamol, was significantly in favor of ST
      679.

PMID- 8472523
TI  - [A comparative evaluation of the remission from acute lumbar-sciatic pain
      following treatment with meclofenamic acid and naproxen].
AB  - This study was performed to assess the analgesic effect and the onset of action
      of meclofenamic acid compared with naproxene in patients affected by acute lumbar
      sciatic pain. Thirty patients of both sexes were randomly allocated to 2 groups
      of 15 patients each; the first group was treated with meclofenamic acid (200 mg
      b.i.d.) and the second with naproxene (500 mg b.i.d.). Both drugs were
      administered as suppositories for a week. The intensity of pain, both at rest and
      after movement, was assessed by means of analogic scales at basal time and 15,
      30, 60, 180, 360 minutes, 4 and 8 days after the first administration. Both types
      of pain were significantly decreased with respect to basal values in meclofenamic
      acid group (P < 0.01), 60 minutes after onset of treatment, while in the
      naproxene group the effect was later. Moreover the analgesic effect was
      significantly greater in the meclofenamic acid group with respect to the
      naproxene group, after 15 minutes for pain at rest (P < 0.05) and after 30
      minutes for pain after movement (P < 0.02). Similarly, after 4 and 8 days, both
      types of pain improved to a larger extent in the meclofenamic acid group with
      respect to the naproxene group (P < 0.05 after four days and P < 0.01 after eight
      days). This study has shown that meclofenamic acid has greater efficacy and
      faster analgesic effect than naproxene. Meclofenamic acid has proved to be a drug
      of choice in the treatment of slight to moderate musculo-skeletal pain syndromes.

PMID- 8472522
TI  - [An evaluation of the analgesic activity and tolerance of ST-679 in patients with
      pain following orthopedic and traumatological interventions].
AB  - The analgesic efficacy and tolerability of ST-679 (administered in a single oral
      dose of 1200 mg) was evaluated in a double-blind parallel-group study, as
      compared with paracetamol (administered in a single oral dose of 1000 mg) on 40
      patients with pain following orthopedic or traumatological surgery. ST-679 was
      shown to possess better analgesic qualities with respect to paracetamol, in that
      the effect establishes itself more quickly and, moreover, both the maximum
      analgesic activity performed as well as the constant level on which such activity
      tends to stabilize is greater. No adverse reaction was recorded for either
      treatment, but ST-679 demonstrated a better tolerability with regard to
      paracetamol.

PMID- 8472524
TI  - [The behavior of the fibrinogen polymerization curve in hypercholesterolemic
      subjects].
AB  - Several epidemiological and clinical studies performed in subjects with risk
      factors for atherosclerotic cardiovascular events, have shown changes in plasma
      levels and/or activities of coagulation factors that could suggest a
      prothrombotic state. We studied the behaviour of the fibrinogen polymerization
      curve (FPC), a spectrophotometric technique evaluating the kinetics of fibrinogen
      transformation into fibrin, in 68 subjects with and without hypercholesterolemia.
      Significant differences were found between FPCs of subjects with serum
      cholesterol > 240 mg/dl and < or = 240 mg/dl respectively. In fact, FPCs of the
      first group showed high reaction velocity rate, short latency time and higher
      optical density rate, final readings; besides, the behaviour of FPCs was not
      correlated to plasma fibrinogen concentrations. Therefore, FPC could be a useful
      test to identify a thrombophilic condition in hypercholesterolemic patients.

PMID- 8472525
TI  - [Nimodipine in ischemic cerebropathy].
AB  - Fifty patients of either sex with acute and chronic cerebrovascular disorders
      were submitted to an observation protocol and treated with oral nimodipine
      (tablets or drops) at a daily dosage of 90 mg for 1 to 3 months. Nimodipine
      proved useful both from the therapeutic point of view and for its easy handling
      in acute pathology (TIA, RIND, minor stroke, complete stroke) as well as chronic
      cerebral ischemia. The drug was well tolerated both locally and systemically; in
      patients with concomitant arterial hypertension, nimodipine reduced blood
      pressure with a tendency towards stabilization at near-normal levels.

PMID- 8472526
TI  - [A new granular effervescent 10-mg formulation of cisapride in the treatment of
      gastroesophageal reflux].
AB  - The efficacy and tolerability of Cisapride effervescent granules for treatment of
      gastroesophageal reflux disease were compared to a metoclopramide-dimeticone
      combination. The double-blind study was performed in two groups of 10 patients
      each who received 3 sachets daily of either drug for 8 weeks. Cisapride
      effervescent granules induced a statistically significant improvement of 75% of
      symptoms (6/8) while this improvement was obtained with the reference drug for
      only 60% (3/5). Statistical evaluation showed Cisapride effervescent granules to
      be more effective than the reference drug for 2 of 5 evaluable symptoms; mean
      global improvement amounted to 83 vs 58%. Final physician opinion was more
      favorable to Cisapride effervescent granules than to the reference drug (p <
      0.005). Treatment did not have to be withdrawn nor were clinically significant
      changes of laboratory values observed. Both drugs were found to be well tolerated
      without differences between the two groups. Three patients treated with Cisapride
      effervescent granules complained of short-lasting mild abdominal discomfort the
      relations of which to the drug was doubtful, and which subsided spontaneously
      without need to withdraw treatment or to apply other types of therapy.

PMID- 8472527
TI  - [The utility of a classification scale of lumbar pain for the diagnosis of the
      fibromyalgia syndrome].
AB  - To help fibromyalgia syndrome's diagnosis, the authors propose the use of Back
      Pain Classification Scale (BPCS), verbal test for pain analysis, able to
      distinguish between organic and functional disease. Two-hundred patients
      suspected for fibromyalgia and forty controls completed the questionnaire and so
      it was possible correctly to distinguish patients with organic disease from those
      affected by fibromyalgia. The authors conclude that BPCS can represent a useful
      tool for fibromyalgia diagnosis.

PMID- 8472528
TI  - [An open study on the clinical efficacy of citicoline in patients with chronic
      cerebral vasculopathy].
AB  - In this study we evaluated the safety/efficacy of citicoline in 30 patients
      affected by atherosclerotic processes with cerebral localization. Aim of this
      study was to confirm, from a clinical point of view, the efficacy of citicoline
      in increasing blood flow in the vascular zone and in exerting a trophic action on
      cerebral cells improving the symptoms related to the chronic cerebrovasculopathy.
      Therapeutic effect was evaluated, by means of subjective parameters, at the
      beginning, during and at the end of the study. The results obtained was
      statistically analyzed confirming the efficacy of citicoline on the subjective
      symptomatology. Safety was excellent in all cases.

PMID- 8472529
TI  - [Gamma-vinyl-GABA: the first trials in Italy].
AB  - Vigabatrin (gamma-vinyl-GABA), a structural analogue of GABA, is a selective
      inhibitor of GABA transaminase. Vigabatrin has been effective in patients with
      refractory epilepsy. We treated patients with complex partial seizures and some
      of them also with secondary generalized seizures. Vigabatrin was administered as
      "add on therapy" (Table 1) and monotherapy (Table 2). As to table 1, concerning a
      variety of treatments and too few patients we could not reach any definitive
      statistical conclusion (paired Student's t test not significant). In table 2 the
      paired Student's t test was significant with p < 0.01. Longer follow-up is needed
      to determine whether the clinical effect is maintained and no severe side effects
      appear.

PMID- 8472530
TI  - [The therapy of Raynaud's phenomenon].
AB  - Management of Raynaud's phenomenon is essentially "symptomatic". Some hygienic
      behavioral rules intended to eliminate all factors (cold, cigarette smoking,
      drugs, traumata) apt to trigger the phenomenon are essential. A number of drugs
      have been suggested for treatment: Nifedipine had been found to be effective in
      reducing frequency and duration of vasospastic attacks thanks to its mainly
      vasodilatory action, to its ability to influence platelet activity as well as to
      its antithrombotic effect. Also the most recent generation of calcium-channel
      blockers (nicardipine felodipine, isradipine, etc.) were found to have
      therapeutic efficacy comparable to that of nifedipine, with the added advantage
      of a once daily dosage. Ketanserin, a serotoninergic antagonist, is a valid
      alternative to calcium-channel blockers for treatment of Raynaud's phenomenon in
      as much as it can reduce frequency, duration and severity of vasospastic attacks,
      although not all authors agree upon this point. The use of prostanoids is usually
      reserved for cases of Raynaud's phenomenon associated with systemic sclerosis
      accompanied by extensive trophic disorders. Surgery is indicated only in selected
      cases.

PMID- 8472531
TI  - [Scrofula in an elderly woman. A clinical case].
AB  - The case is described of an elderly woman with scrofula. The peculiarity of this
      case consisted in the comparative rarity of primary tubercular lymphadenopathy (a
      pathology that in the past used to be common in poor socioeconomic conditions)
      even considering the present renewed diffusion of tuberculosis; especially as
      this elderly patient had no previous history of tubercular infection.

PMID- 8472532
TI  - The chicken histone gene family.
AB  - 1. Most of the chicken 43 core and H1 histone genes belong to two major histone
      gene clusters. 2. Each of six H1 genes encodes a different H1 protein sequence.
      3. The known core histone genes, four H2A, seven H2B, and seven H3 genes,
      respectively, encode two, three and three different protein variants, whereas the
      four known H4 genes encode the same amino acid sequence. 4. The core histone
      genes have particular transcription regulatory elements within the 5'-flanking
      regions and the regulations of their expressions are distinct, even though they
      are members of the same core histone gene family. 5. There are some undefined
      differences in the DNA structures of the particular core histone genes in various
      chicken tissues and these structural variations probably result in differences in
      their transcriptional regulation.

PMID- 8472533
TI  - Expression of the myc proto-oncogene in the rainbow trout Oncorhynchus mykiss.
AB  - 1. The myc proto-oncogene is shown to be expressed in the pituitary gland, brain
      and heart of the rainbow trout. 2. Based on transcript sizes the pituitary gland
      expressed B-myc and L-myc, the brain expresses L-myc and the heart expresses
      either C-myc or L-myc. 3. Pituitary B-myc is expressed at a level 3-fold greater
      than liver C-myc and 8-fold greater than the heart transcript. 4. The amounts of
      the pituitary B-myc and heart transcript nearly double as the fish approach
      sexual maturity.

PMID- 8472534
TI  - Ecdysteroids during development in the ovine parasitic nematode, Haemonchus
      contortus.
AB  - 1. Samples of embryonating eggs, infective larvae, fourth-stage larvae, young
      adults, and male and female mature adults of Haemonchus contortus were collected
      for steroids analysis; lipids were extracted, partially purified, fractionated
      with HPLC, and analyzed for ecdysteroids by radioimmunoassay. 2. Free ecdysone
      and 20-hydroxyecdysone were detected in all samples; maximal concentrations
      occurred in the fourth-stage larvae and young adults. 3. Conjugated ecdysone and
      20-hydroxyecdysone were detected in all samples but the infected larvae; maximal
      concentrations occurred in the fourth-stage larvae and young adults. 4. Patterns
      of ecdysteroid occurrence support regulatory roles in embryogenesis, cuticular
      deposition, and gonadogenesis. 5. Relative concentrations of ecdysteroids are
      comparable to those previously reported in eggs and adults of Ascaris suum.

PMID- 8472535
TI  - Chicken eggshell porphyrins and the glyoxalase pathway: its possible
      physiological role.
AB  - 1. The plasma 4,5-dioxovaleric acid (DOVA) levels of two different breeds of
      chicken were determined and found to be higher in the group with a higher
      porphyrin eggshell content. 2. The erythrocyte and uterus glyoxalase II activity,
      investigated by means of a new spectrophotometric method, was found to be
      significantly higher in the group with a low porphyrin eggshell content. 3. A
      comparative genetic study of two chicken populations, one with white and one with
      dark eggshells, showed different gene frequencies for the glyoxalase I
      polymorphism. 4. An interpretation of these data suggests that the glyoxalase
      pathway may be involved in the metabolism of early porphyrin precursors.

PMID- 8472536
TI  - Comparison of hemocyte components from Schistosoma mansoni (Trematoda)
      susceptible and resistant Biomphalaria glabrata (Gastropoda) that cross-react
      with larval schistosome surface proteins.
AB  - 1. Cross-reactive antigens between larval Schistosoma mansoni and hemocytes from
      schistosome-resistant and susceptible strains of Biomphalaria glabrata were
      identified and compared using sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE), immunoblotting and surface radioiodination. 2. Four
      sporocyst (larval S. mansoni) surface antigens (27, 39, 40 and 70 kDa) reacted
      with antibodies to hemocytes from resistant snails whereas only one surface
      antigen (70 kDa) was recognized by antibodies to hemocytes from susceptible B.
      glabrata. 3. The wider distribution and greater frequency of cross-reactive
      antigens between resistant hemocytes and sporocysts suggests that such cross
      reactivity may be involved in the hemocyte-mediated killing of larval
      schistosomes that occurs in this host-parasite system.

PMID- 8472537
TI  - Quantification, immunoaffinity purification and sequence analysis of a pigment
      dispersing hormone of the shore crab, Carcinus maenas (L.).
AB  - 1. A sensitive sandwich-ELISA for pigment-dispersing hormone (PDH) with a
      detection limit of approximately 5 fmol per well has been developed using primary
      IgG and secondary biotinylated IgG fractions from an antiserum against beta-PDH
      and streptavidin-peroxidase conjugate for detection. 2. ELISA determinations in
      different parts of the central nervous system of the shore crab Carcinus maenas
      revealed maximum levels of 15.1 pmol immunoreactive PDH in the two eyestalk
      ganglia of one crab, 3.6 pmol in the sinus glands, 2.8 pmol in the brain and 0.8
      pmol in the thoracic ganglia. 3. Carcinus PDH was purified from whole eyestalk
      ganglia and sinus glands by use of a simple two-step purification procedure
      consisting of immunoaffinity-prepurification on an anti-PDH IgG-protein A
      Sepharose column and HPLC. 4. Automated gas-phase sequencing of the purified
      peptide and FAB-mass spectroscopy unambiguously revealed the sequence of Carcinus
      PDH as NSELINSILGLPKVMNDAamide (M(r) 1927.2 Da), which is identical to the beta
      PDH of other brachyuran crustaceans.

PMID- 8472538
TI  - In vitro poly-(ADP-ribosyl)ation of chromatin proteins in the rat tapeworm,
      Hymenolepis diminuta.
AB  - 1. (ADP-ribose)-transferase activity in crude chromatin of H. diminuta was
      demonstrated. 2. Chromatin proteins were ADP-ribosylated in vitro and selectively
      extracted. 60, 12 and 18% of the (ADP-ribose)n of chromatin proteins was
      associated with total histones, histone H1 and histone H2B, respectively. 3. The
      extent of oligo-(ADP-ribose) compared to total (ADP-ribose)n in the chromatin
      fraction, in the histone fraction, the histone H1 fraction and the histone H2B
      fraction was 45, 60, 26 and 49%, with an average chain length of 2.8, 2.1, 1.8
      and 2.6, respectively. 4. Analysis of (ADP-ribosyl)n-ated proteins by acetic
      acid/urea polyacrylamide gel electrophoresis demonstrated that histone H1,
      histone H2B and a 35 kDa non-histone protein were major (ADP-ribose)n acceptors.

PMID- 8472539
TI  - Ascorbate-2-sulfate sulfohydrolase in fish and mammal. Comparative
      characterization and possible involvement in ascorbate metabolism.
AB  - 1. The new assay conditions were determined for crude and purified enzyme
      ascorbate-2-sulfate sulfohydrolase from liver tissues of two fish species and
      bovine. 2. The major departure from the existing indirect method, based on
      reduction of 2,6-dichlorophenolindophenol (DCIP) by released ascorbic acid and
      change from pink-blue to a colorless molecule, takes into account the shift of
      maximum absorbance of DCIP from 516 nm at pH 5.14 to 600 nm at pH 6.5. 3. The
      direct method is based on colorimetric assay of liberated ascorbic acid including
      correction for interfering substances. The optimum pH for both fish ascorbate
      sulfatases was 5.5. 4. The Km for bovine ascorbate sulfatase was confirmed to be
      approximately 7 mM at 37 degrees C. 5. Partly purified ascorbate-sulfate
      sulfohydrolase has a Km value in rainbow trout of 0.4 mM and it changes very
      little in the range of water temperatures characteristic for this stenothermic
      fish species. 6. In eurythermic chub, the Km values increased from 1.2 to 4.3 mM
      with rising temperatures.

PMID- 8472540
TI  - Mitogenicity of the earthworm's (Eisenia foetida) insulin-like proteins.
AB  - 1. Biologically active glycolipoprotein complex (G-90), isolated from whole
      earthworm tissue extract (Eisenia foetida), was separated into seven fractions by
      gel-filtration. 2. It has been shown by radioimmunoassay that each of the
      fractions, except the lightest one, is cross-reactive with porcine anti-insulin
      antibodies. Molecules that possess such activity were detected by immunoblotting.
      3. All fractions, except the heaviest and the lightest one, stimulate mammalian
      normal and transformed cell proliferation in serum-free conditions in vitro. The
      intensity of stimulation depends on cell type. Stimulation is completely
      abolished if the medium is supplemented with fetal calf serum.

PMID- 8472541
TI  - Gender dependence of D-aspartate oxidase activity in rat tissues.
AB  - 1. A gender difference in D-aspartate oxidase activity was demonstrated for the
      first time in rat tissues. 2. In adult Wistar rats, the hepatic enzyme activity
      was constantly higher in females than males. The renal activity showed a similar
      tendency. 3. The gender difference in the hepatic activity was not observed in
      newborn animals, but became apparent with growth almost in parallel with sexual
      maturation. 4. The hepatic activity in females was greatly affected by pregnancy
      and parturition.

PMID- 8472542
TI  - A comparative study of DNA amount and nuclear dry weight in four different
      species (Rana catesbeiana, Salmo gairdneri, Gallus domesticus and Homo sapiens).
AB  - 1. Quantitative electron microscopic and cytophotometric determinations of
      average nuclear weight, unit weight of chromatin fiber, chromatin fiber diameter
      and DNA amount were made and compared from lymphocytes in human, chicken, frog
      and trout. 2. From these determinations the "packing ratio" of DNA in chromatin
      fibers was calculated. 3. Nuclear mass and DNA amounts were highest in frog and
      lowest in chicken, while fiber diameter and mass of unit fiber measured highest
      in trout followed by chicken, frog and man. 4. The packing ratios were 21.4 in
      chicken, 35.2 in human, 47.0 in trout, 51.1 in frog and show a trend of being
      lower in amniotes than in anamniotes. 5. As only four species were studied, no
      conclusions regarding evolutionary implications or relationships between them
      could be made from these measurements.

PMID- 8472543
TI  - The isolation and properties of whole casein: some implications for comparative
      studies.
AB  - 1. Problems in the isolation of whole casein from bovine milk are considered. A
      summary is given of our experiences in its isolation. 2. The physical
      characteristics, sedimentation velocity, heterogeneity, absorptivity, nitrogen,
      phosphorus and carbohydrate contents of whole casein prepared from normal and sub
      clinical mastitic milk samples by a variety of methods are compared. The methods
      are acid precipitation, high-speed centrifugation, with and without added calcium
      (II), and ammonium sulphate precipitation. 3. A description is given of the low
      temperature ammonium sulphate procedure preferred for the isolation of whole
      casein, especially when it is to be used for subsequent fractionation for
      conformation and micelle studies. 4. The question of the use of bovine casein as
      a paradigm for the caseins of other mammalian species and the need for further
      studies of the physical, chemical and biological properties of the caseins are
      discussed.

PMID- 8472544
TI  - Prolactin binding sites in the adrenal glands of mink (Mustela vison).
AB  - 1. The purpose of this study was to determine if the mink adrenal gland might be
      a target organ for prolactin by establishing whether or not binding sites for the
      hormone exist in adrenal cell membranes. 2. Adrenal glands were collected from
      adult female mink in November, 1991, homogenized and subjected to differential
      centrifugation into three particulate fractions; 1500, 15,000 and 50,000 g. All
      binding determinations were made using 125I-oPRL and 200-300 micrograms protein
      from the 50,000 g particulate fraction. Optimal binding occurred within 8 hr at
      25 degrees C. 3. Scatchard analysis of saturation data revealed a single set of
      high affinity (Kd = 9.27 x 10(-11) +/- 1.63 M), low capacity (Bmax = 34.22 +/-
      5.37 fmol/mg) binding sites. 4. Binding sites appeared to be hormone specific as
      only oPRL (73% displacement) and oLH (8% displacement) inhibited binding of 125I
      oPRL to adrenal membranes. No inhibition of 125I-oPRL binding to adrenal
      membranes occurred in the presence of a 500-fold excess of bTSH, oGH or oFSH. 5.
      Prolactin binding sites were readily detected in adrenal and kidney tissue, but
      were low in liver and almost non-detectable in spleen or lung tissue. 6. Our data
      suggest that the mink adrenal gland is a target organ for prolactin and that an
      interaction between the pituitary and adrenal glands may exist that is important
      for the regulation of such physiological processes as fur growth cycles.

PMID- 8472545
TI  - Development of an HPLC method to estimate hexosamines and its application to
      determine mucin content in rat and human gastric mucosa.
AB  - 1. An HPLC analysis of hexosamines and related compounds modified from the Waters
      Pico-Tag amino acid analysis procedure is described. 2. This method is applicable
      to determine glucosamine and galactosamine not only in the hydrolyzate of
      purified glycoconjugate such as gastric mucin and ovalbumin but also in crude
      materials such as rat gastric mucosal extract and powdered bovine nasal
      cartilage. 3. Compared with a conventional colorimetric hexosamine determination,
      sensitivity of this method is almost 100 times higher. 4. By applying this
      method, a simple but highly sensitive procedure to determine mucin content in a
      crude stomach specimen of rat and that in a biopsied human gastric mucosa was
      also developed.

PMID- 8472546
TI  - Molecular cloning and expression of yellowfin porgy (Acanthopagrus latus
      houttuyn) growth hormone cDNA.
AB  - 1. The growth hormone cDNA of yellowfin porgy (ypGH cDNA) consisted of 915 base
      pairs. 2. The deduced amino acid (aa) sequence showed that the pre-GH comprised
      204 residues, of which the first 17 residues formed a signal peptide. 3.
      Comparison of aa sequence of ypGH to seabream, tuna, rainbow trout and chum
      salmon showed that ypGH shared 95.1, 94.1, 65.3 and 62.4% homology with these
      species, respectively. 4. By expressing the ypGH cDNA in E. coli, a polypeptide
      around 23 kilodaltons (kDa) was found which was immunoreactive to GH antibody.

PMID- 8472547
TI  - Expression of the albumin gene in the yolk sac and liver during chick
      embryogenesis.
AB  - 1. Albumin mRNA is first detectable in vascular yolk sac on the third day of egg
      incubation, increases to peak level on day 14 and declines to zero by day 19. 2.
      Vascular yolk sac RNA contains a 6-10-fold higher level of albumin transcripts
      compared to non-vascularized yolk sac, suggesting a role for vascularization in
      promoting albumin gene expression. 3. Embryonic liver albumin transcripts are
      first detectable at day 6.5, increase 6-fold by day 8, continue to rise at a
      lower rate until day 14 and remain constant thereafter. 4. Albumin protein
      synthesis in liver cubes also exhibits a large increase over days 7-10. In
      contrast, another liver-specific constitutive protein, apolipoprotein B, shows a
      different biosynthetic pattern. 5. The data suggest development of hepatic
      albumin gene-specific regulatory factors over days 7-10.

PMID- 8472548
TI  - Cerebral specialization for speech perception and movement organization in adults
      with Down's syndrome.
AB  - Adults with Down's syndrome and a group of undifferentiated mentally handicapped
      persons were examined using a free recall dichotic listening procedure to
      determine a laterality index for the perception of speech sounds. Subjects also
      performed both the visual and verbal portions of a standard apraxia battery. As
      in previous research, subjects with Down's syndrome tended to display a left ear
      advantage on the dichotic listening test. As well, they performed better on the
      apraxia battery when movements were cued visually rather than verbally. This
      verbal-motor disadvantage increased as the left ear dichotic listening advantage
      became more pronounced. It is argued that the verbal-motor difficulties
      experienced by persons with Down's syndrome stem from a dissociation of the
      functional systems responsible for speech perception and movement organization
      (Elliott and Weeks, 1990).

PMID- 8472549
TI  - Handedness, sex, and familial sinistrality effects on spatial tasks.
AB  - Left-handed (N = 109) and right-handed (N = 115) undergraduates (99 males, 125
      females) received the SIBT (a "mental rotation" test), the 3DD (3-dimensional
      drawing test), and a family sinistrality (FS) questionnaire. Left-handers were
      further separated into consistent left-handed (CLH) and inconsistent left-handed
      (ILH) subgroups, based on consistency of hand preference. On the spatial tests,
      males outperformed females, with no overall handedness effects. Also, for males,
      CLH's (but not ILH's) performed significantly worse than right-handers on the
      SIBT, but this difference was not found on the 3DD. For females, no handedness
      subgroup differences were found on either spatial tasks. Familial sinistrality
      was twice as common in left-handers as in right-handers. Among males, the
      incidence of FS+ in the CLH subgroup also was over twice that for ILH's. Thus,
      where left-handers report a greater incidence of FS+, and are inferior to right
      handers in mental rotation skill, it is CLH's (particularly males) who contribute
      mostly to these effects. The results suggest that previous discrepant findings
      reported in studies of the cognitive correlates of left-handedness may be due in
      part to the mixing of two distinct left-handed subgroups. An understanding of the
      differences between them may be crucial for better understanding the genetic and
      neurobiological mechanisms underlying handedness.

PMID- 8472550
TI  - Analysis of the syndrome of unilateral neglect.
AB  - Using a variety of clinical measures of unilateral neglect 40 right hemisphere
      lesioned stroke subjects were compared in terms of neuropsychological deficit.
      The results of the study encourage the view that unilateral neglect is a complex
      syndrome and subjects who indicate the disorder may vary in systematic
      dimensions. There are at least two factors contributing to the neglect syndrome-
      a scanning factor of external stimuli and a disrupted internal representation of
      space factor. Both the obtained factors were correlated with functional
      independence at 6 months post-stroke in a further group of 27 right hemisphere
      lesioned stroke patients. It is probable that most commonly these factors co
      exist and form the classical neglect syndrome but theoretically they may occur
      separately and this leads to implications for management.

PMID- 8472551
TI  - Visuospatial judgment: a cross-national comparison.
AB  - Two samples of American and Italian 8 to 12 year-old children were compared for
      their performance on the Judgment of Spatial Orientation Test. No group
      difference emerged and, consequently, the same normative standards for
      performance can be applied in both countries. In both groups males performed
      better than females.

PMID- 8472552
TI  - Laterality in cats: paw preference and performance in a visuomotor activity.
AB  - Laterality in paw use was investigated over a period of 6 years in 44 domestic
      cats trained to perform a reaching movement toward a moving spot of light. Both
      paw preference and paw performance were recorded. At a 50 percent criterion, no
      significant paw preference was found at the level of the group. When a 90 percent
      criterion was considered, 23 subjects had a significant preference for one paw.
      Among these strongly lateralized animals, there were more left- (N = 17) than
      right-pawed (N = 6) cats. The analysis of visuo-motor performances included
      reaction time, movement time, and reaching accuracy. Lateralized cats had a
      faster reaction time than nonlateralized cats. The more-used paw had a shorter
      reaction time, a shorter movement time, and was also more accurate than the less
      used paw. Thus, the findings demonstrate a functional advantage of being
      lateralized. Moreover, the results confirm the existence of an asymmetry of paw
      preference in cats and show a consistent relation between paw preference and
      performance.

PMID- 8472553
TI  - Spontaneous recovery of impaired memory span: does comprehension recover?
AB  - We have previously described a patient, T.B., who had a memory span of two digits
      and a sentence span of three words. He showed no evidence of effects of either
      phonological similarity or word length on span and his deficit was interpreted as
      reflecting the impaired functioning of the phonological loop component of working
      memory. Analysis of his language comprehension indicated normal processing of
      short sentences, together with a marked deficit in understanding long sentences,
      whether these were presented visually or auditorily (Baddeley and Wilson, 1988).
      When re-tested after several years, T.B.'s memory span had increased to nine
      digits, and showed clear effects of phonological similarity and word length. His
      performance on a series of language comprehension tests indicated a complete
      recovery, although he continued to show impairment on two tests of phonological
      awareness. These results are consistent with the proposed link between
      phonological working memory and language comprehension. In addition, they
      indicate a dissociation between short-term phonological memory and phonological
      awareness.

PMID- 8472554
TI  - A differential effect of concurrent verbal activity on right arm movements
      rightwards and leftwards.
AB  - Twenty right-handed male subjects had to follow a target which moved horizontally
      with a velocity of 40 degrees/s either rightwards or leftwards by moving their
      right arm. During the pursuit movement, subjects had to speak a sentence or to
      accomplish this procedure without speaking. It could be shown that while subjects
      spoke, the pursuit movement was performed more inaccurately than during the
      control session. Furthermore, it was shown that during concurrent speaking,
      pursuit movements rightwards were more inaccurate than movements to the left.
      This result is in line with theoretical implications according to which visually
      guided right-arm movements rightwards are controlled by a neural network located
      in the left hemisphere, whereas right-arm movements leftwards are controlled by a
      neural network distributed over both hemispheres.

PMID- 8472555
TI  - Homing in on neglect: a case study of visual search.
AB  - We report three studies of visual search in a patient with left neglect after a
      right parietal infarct. Manipulations whereby the patient's attention is
      explicitly drawn to the spatial extent of the page on which the stimuli for
      cancellation are displayed have little or no effect on the number of targets
      cancelled. The results are consistent with a "zoom lens" model of attentional
      deployment. "Neglect" on search tasks seems to reflect a systematic bias that
      emerges when global attention is constricted to permit analysis of local
      features.

PMID- 8472556
TI  - Unconscious processing in memory recall. A study of three amnesic patients.
AB  - The sudden resurgence of precise information some time after the failure of its
      recall (memory block) suggests the intervention of unconscious processes. In
      normal subjects the experimental demonstration of such processes meets with
      methodological snags. They are avoided in patients with a pure amnesic syndrome
      because retrograde amnesia produces many instances of missing memories, while
      anterograde amnesia prevents the patient from consciously thinking about it.
      Three patients with a pure amnesic syndrome were submitted to 4 interviews over
      12 days on 3 topics concerning places and itineraries that were very familiar
      before the disease, and a shocking event of their life. Retrieved memories were
      compared to those of normal matched subjects. The results showed a dramatic
      increase for memories of places and itineraries over sessions, and the absence of
      improvement of autobiographical memories. These findings underline the role of
      the activation of unconscious processes in recall and the different status of
      semantic and episodic memory.

PMID- 8472557
TI  - Selective increase in the right hemisphere transcranial Doppler velocity during a
      spatial task.
AB  - Transcranial Doppler ultrasonography of the middle cerebral arteries was
      performed during two tasks: sorting of mah-jongg tiles and vibratory stimulation.
      These tasks selectively increase cerebral blood flow by positron emission
      tomography. The purpose of this study was to determine if analogous increases in
      cerebral blood flow velocity could be detected. We measured flow velocity during
      right hand manipulation followed by left hand manipulation, or vice versa, with
      resting studies in between. The average increase in the mean velocity, by paired
      t-test, was significant for the right middle cerebral artery with both left hand
      (p < .0005) and right hand (p < .005) tile sorting. For the left middle cerebral
      artery, there was an increase in the mean velocity with right hand (p < .005) but
      not for left hand sorting (p = .13). These findings support the importance of the
      right hemisphere in the performance of this type of spatial task. No significant
      flow velocity increase occurred during vibratory stimulation.

PMID- 8472558
TI  - Lexical-phonological processing of functors: evidence from fluent aphasia.
AB  - The purpose of this study was to investigate how functors are processed at the
      lexical-phonological level. Four fluent aphasics with impaired ability to fully
      activate entries in the phonological lexicon, as revealed by their noun
      production, were asked to repeat and read aloud individual functors. Similarities
      between their functor and noun production (e.g., level of performance, production
      of phonological errors) indicated that functors are stored along with content
      words in the phonological lexicon, and are stored with a similar abstract
      structure. We also considered whether the sentence-planning system can facilitate
      the phonological encoding of functors presented in isolation.

PMID- 8472559
TI  - Impaired discrimination of familiar from unfamiliar faces.
AB  - We report investigations of the face processing abilities of J.T., a man who had
      suffered a right hemisphere stroke. J.T. showed a marked problem in
      discriminating between familiar and unfamiliar faces, with no corresponding
      problem in discriminating familiar from unfamiliar names. The problem with faces
      was still found 2 years after the stroke, but had resolved at long-term follow-up
      (9 years post stroke). When given unlimited time to respond, J.T. did not show
      any problem in recognising familiar faces, but tended to think that he recognised
      unfamiliar faces. When under time pressure, however, J.T. also failed to
      recognise a number of familiar faces which he could readily identify when the
      time pressure was removed. J.T.'s ability to remember a face and to think of
      other people who might be similar in appearance was affected by whether or not
      the face seemed familiar or unfamiliar to him. Hence, whatever underlay the
      spurious sense of familiarity was sufficient to produce real differences between
      the way in which genuinely unfamiliar and spuriously familiar faces were seen,
      leading us to suggest that his impaired discrimination of unfamiliar from
      familiar faces reflected a malfunction of face recognition units.

PMID- 8472560
TI  - Phasic and tonic alertness in Alzheimer's disease.
AB  - Phasic alertness (the rapid mobilization of resources to process an expected
      stimulus) was examined in Alzheimer patients and normals by a choice RT task in
      which the stimulus was usually preceded by a warning signal. The time subjects
      needed to attain maximal phasic alertness was determined by varying the Stimulus
      Onset Asynchrony (SOA) between the warning and the stimulus. In comparison to
      trials without any warning, presentation of a warning signal reduced the RT of
      Alzheimer patients as much as it did that of normals. Similarly, the SOA
      necessary for maximal alertness was the same in Alzheimer patients and in
      normals. Maintenance of tonic alertness was investigated by examining how RT
      changed across a long period of continuous testing. Alzheimer patients and
      normals showed a similar rise in RT with increasing time on task. These results
      suggest that phasic and tonic alertness are relatively unimpaired by Alzheimer's
      disease.

PMID- 8472561
TI  - Recall and recognition memory in Parkinson's disease.
AB  - This study is concerned with recall and recognition memory in patients with
      Parkinson's disease. The results show that the Parkinson group was significantly
      impaired on tests of free recall compared to a group of age matched controls. By
      contrast, when given tests of recognition memory for the same items their
      performance was practically identical. In recall, significant main effects are
      reported for serial position and list presentation but no qualitative differences
      were observed between the two groups on these measures, both of which showed a
      primacy and recency effect. However, the control subjects recalled significantly
      more words in their original order of presentation than the patient group, a
      difference which appears to have occurred at the level of input. It was concluded
      that although the patient group was able to adopt and use similar strategies to
      the control subjects, they were less efficient in using these, a difficulty which
      was attributed to limited capacity due to mental slowness.

PMID- 8472562
TI  - Blood conservation in critical care--the evidence accumulates.

PMID- 8472563
TI  - Improved communication with the Passy-Muir valve: the aim of technology and the
      result of training.

PMID- 8472564
TI  - Pediatric intensive care unit, "know then thyself".

PMID- 8472565
TI  - Clinical performance of a blood gas monitor: a prospective, multicenter trial.
AB  - OBJECTIVE: To prospectively assess the clinical performance of a fluorescent
      optode-based blood gas monitoring system that is designed to perform arterial pH,
      PCO2, and PO2 measurements as frequently as clinically required without violating
      the integrity of the arterial catheter tubing system or permanently removing
      blood from the patient. DESIGN: A prospective, multicenter study to compare
      modern blood gas analyzer measurements with the coinciding measurements of the
      blood gas monitoring system. SETTING: Four intensive care units (ICUs) in
      academic centers with varying patient populations, blood gas measurement
      routines, and blood gas laboratory facilities. PATIENTS: Adult ICU patients (n =
      117), with appropriately functioning radial arterial catheters in place, who were
      assessed as likely to require multiple arterial blood gas measurements for > or =
      2 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 117
      patients had 1,341 concurrent blood gas analyzer and monitor measurements of
      arterial pH, PCO2, and PO2 over a 1- to 4-day period. The range of values were
      7.14 to 7.64 for arterial pH, 19 to 98 torr (2.5 to 13.0 kPa) for PaCO2, and 38
      to 413 torr (5.1 to 54.9 kPa) for PaO2. Linear regression analysis of the optode
      based monitor compared with the electrode-based blood gas analyzer demonstrated
      r2 values of .85 for pH, .92 for PCO2, and .94 for PO2. Comparative statistical
      analyses for bias (mean difference between analyzer and monitor) and precision
      (standard deviation of the mean difference [+/- SD] between analyzer and monitor)
      were respectively:-0.004 and +/- 0.027 for pH; -0.8 torr (-0.11 kPa) and +/- 2.4
      torr (0.32 kPa) for PCO2; -2.2 torr (-0.31 kPa) and +/- 8.7 torr (1.2 kPa) for
      PO2. CONCLUSIONS: Clinical performance of this fluorescent, optode-based blood
      gas monitoring system demonstrates stability, consistency, and accuracy
      comparable to modern blood gas analyzers. This system withstood the normal abuse
      and rigors of clinical conditions common to the ICU while reliably performing in
      critically ill patients for up to 80 hrs. Use of the device did not significantly
      alter the function or longevity normally expected from a 20-gauge radial artery
      catheter. We submit that this blood gas monitoring system can replace the use of
      blood gas analyzers for ICU patients with indwelling arterial catheters.

PMID- 8472566
TI  - Initial evaluation of a new intra-arterial blood gas system in humans.
AB  - OBJECTIVE: To evaluate the in vivo performance of a continuous intra-arterial
      blood gas monitor as compared with in vitro arterial blood gases for measurements
      of PaO2, PaCO2, and arterial pH. DESIGN: Consecutive patient enrollment. SETTING:
      Medical intensive care unit of a county teaching hospital. PATIENTS: Five
      critically ill patients. INTERVENTIONS: All patients had a fiberoptic sensor
      placed through a 20-gauge cannula inserted into the radial artery. Sensor and
      arterial blood gas measurements were monitored up to 68 hrs. Arterial blood gases
      were analyzed on two blood gas analyzers. MEASUREMENTS AND MAIN RESULTS: A total
      of 104 arterial blood gases were obtained for comparison of sensor measurements
      with blood gas analyzer values. Comparison of the sensor values with the blood
      gas analyzer values showed bias and precision values of -0.021 and 0.037 for
      arterial pH, 1.74 and 6.06 torr (0.23 and 0.81 kPa) for PaCO2, and -5.89 and
      13.19 torr (-0.79 and 1.76 kPa) for PaO2, respectively. Comparison of the two
      blood gas analyzer measurements showed bias and precision values of -0.030 and
      0.010 for arterial pH, 1.96 and 2.55 torr (0.26 and 0.34 kPa) for PaCO2, and 
      5.77 and 17.15 torr (-0.77 and 2.29 kPa) for PaO2, respectively. No complications
      attributable to the sensor were detected. CONCLUSIONS: The performance of this
      fiberoptic continuous intra-arterial blood gas monitor is comparable to that of
      blood gas analyzers and compares favorably with previously reported studies
      utilizing other sensors in reliably and reproducibly approximating PaO2, PaCO2,
      and arterial pH values. This monitoring capability was accomplished with no
      patient morbidity. Further study is indicated to confirm these initial results
      and to establish the role of a continuous intra-arterial blood gas monitor in
      critically ill patients.

PMID- 8472567
TI  - A clinical evaluation of a blood conservation device in medical intensive care
      unit patients.
AB  - OBJECTIVES: This study was designed to a) document the efficacy of a device
      intended to conserve blood in critically ill patients; b) determine the effect of
      this blood conservation on hemoglobin concentration and the need for blood
      transfusions; c) determine if the blood conservation device resulted in
      interference with arterial pressure waveforms; d) determine if use of the blood
      conservation device resulted in a difference in the number of accidental needle
      punctures suffered by healthcare workers. DESIGN: Prospective, randomized,
      controlled trial. A clinical trial using prospective, random allocation of
      consecutive eligible patients. SETTING: The medical intensive care unit (ICU) of
      a university hospital located in a large metropolitan area. PATIENTS: A total of
      100 patients who were admitted to the medical ICU, required arterial line
      monitoring for clinical purposes, and were managed by the ICU medical service.
      Exclusion criteria included active bleeding or chronic renal failure at the time
      of ICU admission. INTERVENTIONS: Patients in the experimental group had a blood
      conservation device incorporated into the arterial pressure monitoring system,
      while patients in the control group received a conventional arterial pressure
      monitoring system. MEASUREMENTS AND MAIN RESULTS: Data gathered included: age;
      gender; ICU discharge status; the duration of ICU stay; time in the study; volume
      of all blood drawn, discarded, or lost due to leakage; hemoglobin concentrations;
      blood transfusions; and accidental needle injuries. Arterial pressure waveforms
      were recorded and inspected for dampening or other deformation. Mean hemoglobin
      concentrations were compared on ICU admission and at 12-hr intervals. Demographic
      and clinical characteristics of the two groups were not significantly different.
      The volume of blood drawn and discarded from arterial catheters was significantly
      lower in the blood conservation group (blood conservation device: 5.7 +/- 7.5 mL;
      control: 96.4 +/- 88.5 mL; p < .0001), as was the total volume of blood discarded
      (blood conservation device: 19.4 +/- 47.4 mL; control: 103.5 +/- 99.9 mL; p <
      .0001). Mean hemoglobin concentration on admission was similar in the two groups
      (blood conservation device group: 11.8 +/- 2.5 g/dL; control group: 12.6 +/- 2.3
      g/dL). In both groups, the mean hemoglobin concentration declined most rapidly in
      the first 24 hrs of ICU care and, thereafter, declined more slowly. Although the
      mean hemoglobin concentration was higher in the blood conservation group after 6
      days, statistical significance was not reached until 9.5 days of ICU care. The
      mean change in hemoglobin concentration (overall: 1.2 +/- 2.2 g/dL) during the
      study represents a statistically significant (p < .0001) decrease of 9.7%.
      Hemoglobin concentration during the study decreased by 1.4 +/- 2.2 g/dL in the
      control group and 1.0 +/- 2.3 g/dL in the blood conservation group (p =
      nonsignificant). Univariate and multiple regression analysis demonstrated
      discarded blood volume to be a significant and independent predictor of the
      decline in hemoglobin concentration. Transfusion requirements were similar in
      both groups. The blood conservation system did not alter or interfere with
      pressure waveforms. There were no accidental needle injuries noted. CONCLUSIONS:
      The conservation of blood in critically ill patients must be a high-priority
      concern of all healthcare workers. Our data indicate that the blood conservation
      system eliminates a significant factor in the decline in hemoglobin
      concentration. With devices as described here, there is no reason to continue the
      practice of wasting the blood of critically ill patients in order to prevent
      preanalytic error.

PMID- 8472568
TI  - Evaluation of a new blood-conserving arterial line system for patients in
      intensive care units.
AB  - OBJECTIVE: To evaluate blood samples obtained from a new blood-conserving
      arterial line system for the presence of hemodilution or heparin contamination.
      DESIGN: Prospective, clinical trial. SETTING: A coronary intensive care unit in a
      tertiary-care teaching hospital. PATIENTS: Cardiovascular patients in whom
      invasive arterial blood pressure monitoring was indicated. INTERVENTIONS: Paired
      blood samples were obtained from a conventional arterial line system and a new
      blood-conserving arterial line system for the measurement of hematocrit and
      partial thromboplastin time, and compared to evaluate for the presence of either
      hemodilution or heparin contamination. MEASUREMENTS AND MAIN RESULTS: A Bland
      Altman bias analysis of the variability between the two blood draw methods was
      performed. The analysis indicated that a) a randomly determined partial
      thromboplastin time obtained from the blood-conserving arterial line would lie
      between 3.32 and -5.11 of the partial thromboplastin time taken from the
      conventional arterial line value with 95% confidence; and b) a randomly
      determined hematocrit obtained from the blood-conserving arterial line would lie
      between 1.97 and -1.85 of the hematocrit taken from the conventional arterial
      line value with 95% confidence. CONCLUSIONS: We concluded that a) blood samples
      obtained with the blood-conserving arterial line demonstrate no evidence of
      hemodilution or heparin contamination; b) the blood-conserving arterial line
      provides blood samples without the need for an initial volume of blood to be
      discarded; c) the blood-conserving arterial line provides a means for blood
      conservation in the intensive care setting.

PMID- 8472569
TI  - Verbal communication of ventilator-dependent patients.
AB  - OBJECTIVE: To assess whether communication capabilities of ventilator-dependent
      patients are improved by the use of the Passy-Muir unidirectional valve. DESIGN:
      Prospective study. SETTING: An 18-bed multidisciplinary intensive care unit (ICU)
      at the University Hospital, Las Palmas, Spain. PATIENTS: Ten chronic ventilator
      dependent patients who had undergone tracheostomy and met the following criteria:
      ability to eliminate tracheobronchial secretions in order to maintain a patent
      and unobstructed airway, adequate gas exchange while ventilated with an FIO2 of <
      or = 0.4 (Pao2 > 60 torr [8 kPa]), Paco2 of < 55 torr (7.3 kPa), normal
      hemodynamics without the need for administration of vasopressors, and normal
      mental state. Eight patients presented with pulmonary disease, and two presented
      with neuromuscular disease. INTERVENTIONS AND METHODS: Before attaching the Passy
      Muir valve, the following procedures were performed: a) suction of tracheal and
      pharyngeal secretions; b) deflation of the tracheostomy tube cuff; c) increase in
      the ventilator's tidal volume setting to maintain the inspiratory pressure before
      cuff's deflation; d) set peak inspiratory pressure alarm and disconnect
      expiratory volume alarm. The valve was then connected between the tracheostomy
      tube and the Y-shaped piece of the ventilator's circuit. Respiratory movements,
      arterial blood gases, peak inspiratory pressure, respiratory rate, quantity of
      secretions, and changes in sense of smell were monitored during the study. The
      valve's efficacy was evaluated according to the patient's ability to talk and be
      understood during the entire respiratory cycle. RESULTS: The Passy-Muir valve was
      effective in improving communication in eight of ten patients who, during its
      use, presented insignificant cardiorespiratory changes, decreased secretions, and
      effected considerable improvement in well-being. Its use was impossible in two
      patients: one with severe pulmonary disease because cuff deflation prevented
      adequate ventilation, and one patient with neuromuscular disease and
      laryngopharyngeal dysfunction. CONCLUSIONS: The Passy-Muir unidirectional valve
      allows ventilator-dependent patients to talk and communicate without assistance.
      Patients felt better and were motivated to participate in their own care.

PMID- 8472570
TI  - Massive airway leaks: an analysis of the role of endotracheal tubes.
AB  - OBJECTIVE: To determine the abnormalities present in endotracheal tubes removed
      from mechanically ventilated patients for "massive airleak." "Massive airleak"
      was defined as a leak that the attending physician felt was indicative of
      endotracheal tube defect such that extubation (and reintubation, if needed) would
      be indicated. DESIGN: Prospective, observational study. SETTING: Mixed medical
      surgical intensive care unit at a community teaching hospital. PATIENTS:
      Seventeen patients among 1,082 patients who were undergoing mechanical
      ventilation during the study period. INTERVENTIONS: Authors were not involved in
      the evaluation of most airleak situations and most participating physicians were
      unaware of the study. All physicians involved were board certified in pulmonary,
      critical care, emergency medicine, or anesthesiology. Removed endotracheal tubes
      were grossly inspected and subjected to pneumatic stress to determine the sites
      of the leakage. MEASUREMENTS AND MAIN RESULTS: Eighteen endotracheal tubes were
      examined over a 2-yr period. Of these tubes, 11 (61%) had no evidence of
      mechanical fault. Five (28%) tubes had defects in the tracheal cuff and two (11%)
      tubes had abnormalities of the pilot valve apparatus. Condensation within the
      pilot valve cuff was present in 14 of 18 tubes and was present in ten of 11
      intact tubes. Although the study population had an equal number of orally and
      nasally placed endotracheal tubes, intact tubes were disproportionately oral
      (8/11) and tubes wtih cuff leaks were predominantly nasal (4/5) (p = .038).
      CONCLUSIONS: A large number of endotracheal tubes removed for presumed defect are
      flawless. The authors speculate that tube malposition is the most likely
      explantation for this phenomenon. Our findings suggest that patient care might
      improve with more meticulous daily attention to the airway, as well as a more
      analytical rather than action-oriented approach to the leaking endotracheal tube.

PMID- 8472571
TI  - Continuous veno-venous hemofiltration with dialysis removes cytokines from the
      circulation of septic patients.
AB  - OBJECTIVE: To determine whether continuous veno-venous hemofiltration with
      dialysis leads to extraction of tumor necrosis factor-alpha (TNF-alpha) and
      interleukin-1 beta (IL-1 beta) from the circulation of critically ill patients
      with sepsis and acute renal failure and to quantitate the clearance and removal
      rates of these cytokines and their effect on serum cytokine concentrations.
      DESIGN: Prospective, controlled study of TNF-alpha IL-1 beta extraction by
      continuous veno-venous hemofiltration with dialysis in patients with septic acute
      renal failure. SETTING: Intensive care unit of a tertiary institution. PATIENTS:
      Eighteen critically ill patients with sepsis and acute renal failure. Control
      group of six patients experiencing an acute illness while undergoing chronic
      hemodialysis. INTERVENTIONS: Collection of blood samples before continuous veno
      venous hemofiltration with hemodialysis. Simultaneous collection of prefilter
      blood and ultradiafiltrate after 4 and 24 hrs of treatment. MEASUREMENTS AND MAIN
      RESULTS: TNF-alpha and IL-1 beta concentrations were measured in blood and
      ultradiafiltrate. Their clearances and daily extraction were calculated and
      compared with a control group. TNF-alpha was detected in 66.6% of serum samples
      of patients with septic acute renal failure; IL-1 beta was detected in 55% of
      patients' sera samples. Both TNF-alpha and IL-1 beta were cleared by the
      hemofilter during continuous veno-venous hemofiltration with dialysis. The mean
      clearance for TNF-alpha was 30.7 L/day (95% confidence interval 22.4 to 39) with
      a daily mean excretion of 14.1 micrograms (95% confidence interval 1.7 to 26.5).
      Mean IL-1 beta clearance was 36.1 L/day (95% confidence interval 25.4 to 46.8)
      equivalent to a mean daily IL-1 beta excretion of 1 microgram (95% confidence
      interval 0.9 to 1.1). No measurable concentrations of TNF-alpha or IL-1 beta were
      found in the serum or ultrafiltrate specimens of control patients. CONCLUSIONS:
      These findings demonstrate that continuous veno-venous hemofiltration with
      dialysis can remove both TNF-alpha and IL-1 beta from the circulation of septic,
      critically ill patients. This cytokine extraction may prove to be of benefit in
      attenuating the progression of multiple organ dysfunction in patients with sepsis
      associated renal failure, who are receiving continuous veno-venous hemofiltration
      with dialysis. This potential benefit of existing hemofiltration therapies
      supports their preferential implementation in patients with renal failure
      associated with severe sepsis. These observations may stimulate the modification
      of filtration membrane design seeking to specifically augment the clearance from
      the circulation of a variety of such cytokines.

PMID- 8472572
TI  - Evaluation of gastric emptying in severe, burn-injured patients.
AB  - OBJECTIVE: The aim of this study was to evaluate the possible effect of a severe
      burn on gastric emptying by determining the absorption kinetics of orally
      administered acetaminophen. DESIGN: A prospective, controlled study. SETTING: A
      ten-bed burn center in a 1,300-bed university hospital. PATIENTS: Ten adult
      patients suffering from second-degree burn involving > 20% of total body surface
      area and 20 normal, healthy volunteers who acted as controls. INTERVENTIONS:
      Patients received routine treatment such as nutritional support and cimetidine.
      However, opiates were stopped for at least 12 hrs before the start of the study,
      and nonsteroidal anti-inflammatory drugs as alternatives were used. After an 8-hr
      fast, the subjects ingested 0.5 g acetaminophen with 200 mL of water. The plasma
      concentrations of acetaminophen were determined by high-performance liquid
      chromatography, and the absorption kinetics was estimated from determination of
      time to reach the maximum plasma concentration, the maximum plasma concentration,
      and the area under the plasma concentration-time curve. MEASUREMENTS AND MAIN
      RESULTS: The mean time for reaching the maximum plasma concentration was 33 +/-
      24 (SD) mins in patients and 39 +/- 24 mins in the healthy volunteers. The mean
      area under the plasma concentration-time curve from time 0 to 120 mins and the
      mean maximum plasma concentration were 556 +/- 190 micrograms/mL/min and 9.5 +/-
      3.5 micrograms/mL in patients, and 539 +/- 131 micrograms/mL/min and 7.8 +/- 2.8
      micrograms/mL in volunteers, respectively. There was no statistical difference
      between groups in the time to reach the maximum plasma concentration, the area
      under the plasma concentration-time curve from time 0 to 120 mins, and the
      maximum plasma concentration. The time for reaching the maximum plasma
      concentration was not correlated with the severity of the burn (% area of burn)
      and the duration of healing (days) after burn. CONCLUSIONS: We conclude that
      severe burn injury does not affect the kinetics of gastric emptying, and that 200
      mL of water ingested 2 hrs before anesthesia is quite safe in severely burned
      patients. Also, the absorption kinetics of acetaminophen was not altered by burn
      injury.

PMID- 8472573
TI  - Usefulness of atrial electrograms recorded via central venous catheters in the
      diagnosis of complex cardiac arrhythmias.
AB  - OBJECTIVE: To assess the role of intravascular atrial electrograms in improving
      the diagnosis of complex cardiac arrhythmias in critically ill patients. DESIGN:
      Prospective, clinical study comparing the accuracy of cardiac rhythm diagnosis
      using standard surface electrocardiogram (EKG) and intravascular atrial
      electrograms. SETTING: Intensive care unit of a university teaching hospital.
      PATIENTS: A total of 57 critically ill patients (44 cardiothoracic surgery, five
      acute myocardial infarction, two septic shock, six miscellaneous) with 85 complex
      cardiac arrhythmias that were unable to be diagnosed with certainty using the
      surface EKG. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The
      intravascular atrial electrogram altered diagnosis based on the surface EKG in 11
      (13%) patients and confirmed rhythm diagnosis in 60 (71%) of 85 patients with
      arrhythmia. Of 61 patients with wide complex tachycardia, 40 (66%) were diagnosed
      as ventricular tachycardia (atrioventricular dissociation demonstrated on the
      atrial electrogram), and 11 (18%) as supraventricular tachycardia with aberrant
      conduction. Ten (16%) wide complex tachycardias could not be diagnosed with
      confidence using both surface EKG and intravascular electrogram. There were no
      adverse effects with this technique. CONCLUSIONS: Intravascular atrial
      electrograms recorded via central venous catheters are useful in the diagnosis of
      complex cardiac arrhythmias, particularly ventricular tachycardia. The technique
      is safe, simple, and quick.

PMID- 8472574
TI  - Endocrine profiles for outcome prediction from the intensive care unit.
AB  - OBJECTIVE: To evaluate the discriminating ability of various specific endocrine
      studies on patient outcome from the intensive care unit (ICU). DESIGN:
      Prospective cohort study of patients requiring intensive care. SETTING: Adult
      medical and coronary care units in a military referral hospital. PATIENTS: A
      total of 61 consecutive patients requiring intensive care over a 5-month period
      and 20 control subjects. INTERVENTIONS: Patients were evaluated within 24 hrs of
      ICU admission (day 1) with determination of the following variables: serum
      triiodothyronine, thyroxine, triiodothyronine resin uptake, thyrotropin,
      luteinizing hormone, follicle-stimulating hormone, testosterone, basal cortisol,
      adrenocorticotropic hormone-stimulated cortisol, cortisol increment, and Acute
      Physiology and Chronic Health Evaluation (APACHE II) score. A total of 24 hrs
      later (day 2), the same battery of tests was repeated with the exception of the
      adrenocorticotropic hormone-stimulated cortisol, cortisol increment, and APACHE
      II score. Individual variables were compared between survivors and nonsurvivors.
      MEASUREMENTS AND MAIN RESULTS: The best discriminators of patient outcome in
      descending order were the basal serum cortisol and triiodothyronine
      concentrations obtained on day 2 and the APACHE II score with predictive
      abilities of 81%, 74%, and 70%, respectively. No combination of variables was
      superior to the day 2 basal cortisol concentration for discrimination of outcome.
      CONCLUSIONS: The basal cortisol and triiodothyronine concentrations obtained from
      blood samples collected within 48 hrs of ICU admission appear to be better
      discriminators of patient outcome than the APACHE II score.

PMID- 8472575
TI  - Alteration of taurine homeostasis in acute heatstroke.
AB  - OBJECTIVE: To investigate the potential role of taurine as a hypothermic
      modulator during heatstroke. DESIGN: Prospective analyses. SETTING: Heatstroke
      Center in makkah, Saudi Arabia. PATIENTS: Twenty-nine adult patients with
      heatstroke. INTERVENTIONS: High-performance liquid chromatography was used to
      measure plasma and urine taurine concentrations in heatstroke patients on
      admission (precooling) and 24 hrs after complete cooling (postcooling).
      MEASUREMENTS AND MAIN RESULTS: There were 18 males and 11 females with a mean
      rectal temperature of 42.2 +/- 0.14 degrees C. At the precooling time period, the
      taurine concentrations were increased (plasma 180 +/- 14 mumol/L; urine 4142 +/-
      720 mumol/L [normal ranges 45.5 to 138.2 and 168 to 1890 mumol/L, respectively]).
      At the postcooling time period, taurine concentrations were significantly (p <
      .0001) decreased (54 +/- 6 and 802 +/- 160 mumol/L for plasma and urine,
      respectively). No correlation was found between taurine and creatine kinase
      activity, or between precooling temperature and taurinemia or taurinuria.
      CONCLUSIONS: The source and clinical significance of the increased taurine
      concentrations are to be determined. The involvement of taurine in the regulation
      of core body temperature suggests that it may have an adaptive role in
      heatstroke.

PMID- 8472576
TI  - Physiologic variables and fluid resuscitation in the postoperative intensive care
      unit patient.
AB  - OBJECTIVE: To examine how critical surgical illness and its management alter some
      of the biochemical, physiologic, and hematologic parameters commonly used to
      monitor postoperative, critically ill patients. DESIGN: Prospective survey of 150
      patients over 3 months. SETTING: University hospital surgical intensive care
      unit. PATIENTS: A total of 150 consecutive adult patients admitted to the surgery
      anesthesiology intensive care unit. MATERIALS AND METHODS: The effects of surgery
      on serum albumin and total protein concentrations, and lymphocyte counts were
      investigated. This investigation was done by comparing the values before surgery
      with those values after surgery and by also comparing what happened after
      different types of surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:
      After surgery, decreases in serum albumin concentrations were significantly
      related to the estimated blood loss and acute gain in body weight from
      intravenous fluid resuscitation. The decreases in serum albumin and total protein
      concentrations were greater after elective abdominal surgery than after elective
      thoracic surgery. Total lymphocyte counts were significantly (< 1000 cells/mm3)
      reduced only in patients undergoing abdominal surgery. CONCLUSIONS: Serum albumin
      and total protein concentrations and total lymphocyte counts were significantly
      reduced by surgical injury, with significantly greater decreases seen after
      abdominal than thoracic surgery. These decreases were caused, in large part, by
      the volume of intravenous fluid used in resuscitation and blood loss. The changes
      in these variables are thus dependent on the type of surgical stress and the
      perioperative fluid therapy.

PMID- 8472577
TI  - Adaptation of pressure support ventilation to increasing ventilatory demand
      during experimental airway obstruction and acute lung injury.
AB  - OBJECTIVE: To estimate the changes in the relative amount of ventilatory
      assistance offered by inspiratory pressure support during changing ventilatory
      demand with external airway obstruction and with oleic acid-induced acute lung
      injury. DESIGN: Prospective, controlled, crossover study. SETTING: Experimental
      laboratory in a university anesthesiology department. SUBJECTS: Eight dogs
      anesthetized with pentobarbital. INTERVENTIONS: An external resistor was placed
      in the breathing circuit to produce increased resistance to breathing. Acute lung
      injury was produced with oleic acid. Ventilatory demand was increased by
      increasing the CO2 concentration in inspired gas to produce an increase of 20
      torr (2.7 kPa) in end-tidal CO2 tension. During airway obstruction, pressure
      support was adjusted to reduce the inspiratory decrease in intrathoracic pressure
      to the level present during unobstructed breathing. During acute lung injury,
      pressure support was applied to reduce the maximum negative deflection of
      intrathoracic pressure by 50%. MEASUREMENTS AND MAIN RESULTS: The ventilator
      effort was estimated by calculating the pressure-time integral of proximal airway
      pressure; the spontaneous ventilatory effort was estimated in a similar manner
      from esophageal pressure. The pressure support averaged 10 +/- 3 cm H2O during
      airway obstruction and 7 +/- 2 cm H2O during lung injury. The CO2 challenge
      effected an average increase in mean minute ventilation of 78% during airway
      obstruction (p < .001) and 120% during acute lung injury (p < .01). The
      augmentation of minute ventilation was accomplished by increasing the ventilatory
      rate and the transpulmonary pressure while inspiratory time remained unchanged.
      The pressure-time integrals measured using both airway (p < .001) and esophageal
      pressure (p < .01) increased significantly during each CO2 challenge, reflecting
      an increase in the contribution of both the ventilator and the animal to the
      required breathing effort. Significant decreases in the relative magnitude of the
      ventilator effort both during airway obstruction (p < .05) and during lung injury
      (p < .01) indicated that the increase in the spontaneous effort was predominant
      over the increase in mechanical ventilatory support. CONCLUSIONS: A ventilatory
      rate-dependent adaptation of pressure support to increased ventilatory demand
      occurs in an experimental setting both during airway obstruction and lung injury.
      The results of this study confirm an advantage of breath-to-breath inspiratory
      pressure support over techniques designed to supply a predetermined mechanical
      minute volume.

PMID- 8472578
TI  - Exogenous surfactant therapy increases static lung compliance, and cannot be
      assessed by measurements of dynamic compliance alone.
AB  - OBJECTIVE: To study the immediate effects of exogenous surfactant therapy on
      blood gases, lung volumes, and lung mechanics in adult rabbits with
      experimentally induced respiratory distress syndrome. DESIGN: Prospective
      randomized, controlled study. SETTING: Laboratory and animal facility of a large
      university. SUBJECTS: Twelve adult New Zealand white rabbits. INTERVENTIONS:
      Respiratory failure was induced by repeated bilateral whole-lung lavage with
      saline (30 mL/kg body weight). After the last lavage, the animals were randomly
      assigned to two groups. Group 1 received surfactant (120 mg/kg body weight) that
      was suspended in a 0.6% sodium chloride solution. Group 2 received comparable
      volumes of the same hypotonic solution and served as controls. MEASUREMENTS AND
      MAIN RESULTS: Before and after endotracheal surfactant instillation, blood gases
      and functional residual capacity were measured, and lung mechanics from tidal
      volumes and pressure-volume curves were calculated. Functional residual capacity
      was measured by a computerized, multiple-breath, washin-washout method using
      sulfur hexafluoride (SF6) as tracer gas. The pressure-volume curves were obtained
      by an occlusion technique originally described for measuring static breath-by
      breath compliance. The technique was modified for present use and fully
      computerized. Within 60 mins after surfactant instillation, there were marked
      improvements in Pao2 (61 +/- 7 torr [8.2 +/- 0.9 kPa] to 470 +/- 47 torr [62.6 +/
      6.2 kPa]) and in functional residual capacity (7.6 +/- 1.4 to 17.7 +/- 1.6 mL/kg
      body weight) at unchanged ventilatory settings. The pressure-volume curves became
      steeper over time and the pressure-volume curves for total lung volume were
      restored to an almost normal state. Maximum compliance calculated from the
      pressure-volume curves increased by 92% but there was no significant change in
      dynamic compliance. In the control group, no improvements in any measured or
      calculated lung parameters were seen. CONCLUSIONS: The findings indicate that
      during mechanical ventilation, the effects of surfactant therapy on lung
      mechanics are best characterized by changes in functional residual capacity and
      maximum compliance obtained from static pressure-volume curves and not by dynamic
      compliance.

PMID- 8472579
TI  - Cocaine significantly impairs myocardial relaxation.
AB  - OBJECTIVES: To determine the immediate effects of intravenous "recreational"
      doses of cocaine on myocardial ventricular relaxation and contraction and on
      coronary blood flow. To determine the cardiac effects of cocaine after the
      administration of propranolol, as propranolol has been used to limit the
      cardiovascular effects of cocaine. DESIGN: Prospective study. SUBJECTS: Twenty
      mongrel dogs. INTERVENTIONS: We continuously recorded central aortic pressure,
      left atrial and ventricular pressures, coronary artery blood flow, and
      electrocardiograms in each dog. We determined from the left ventricular pressure
      waveforms the maximum rate of pressure increase [(dP/dt)max] and the time
      constant of isovolumic ventricular relaxation as our indices of ventricular
      contraction and relaxation. MEASUREMENTS AND MAIN RESULTS: In our initial series
      of experiments, we obtained pressure, coronary artery blood flow, and
      electrocardiographic recordings in ten anesthetized dogs before and for 40 mins
      after the intravenous administration of cocaine, in doses of 2.5 and then 5
      mg/kg. In our second series of experiments in ten additional dogs, we injected
      0.5 mg/kg of propranolol intravenously 30 mins before the injection of cocaine
      (2.5 mg/kg), and obtained hemodynamic and electrocardiographic recordings before
      and for 40 mins after the injection of propranolol and cocaine. Cocaine, 2.5
      mg/kg, abruptly increased the time constant of isovolumic ventricular relaxation
      from 22.9 +/- 1.2 to 29 +/- 2.2 msecs at 1 min (p < .05) and to 35.3 +/- 2 msec
      at 40 mins (p < .01) but did not significantly change the mean arterial pressure,
      left atrial pressure, heart rate, coronary blood flow, or the maximum rate of
      left ventricular pressure increase [(dP/dt)max]. Cocaine also progressively
      displaced the electrocardiographic ST segments by 3.2 +/- 0.6 mm (p < .01) over
      40 mins. Cocaine, 5 mg/kg, rapidly increased the time constant of isovolumic
      ventricular relaxation from 28.5 +/- 2.5 to 41 +/- 3 msecs in 1 min (p < .05) and
      to 48.7 +/- 4 msecs at 40 mins (p < .01) and reduced (dP/dt)max from 2905 +/- 370
      to 1422 +/- 121 mm Hg/sec at 1 min (p < .01); (dP/dt)max returned to 2351 +/- 415
      mm Hg/sec during the next 39 mins. Cocaine did not significantly change either
      the mean arterial or left atrial pressures. However, this dose of cocaine did
      decrease, over 40 mins, the heart rate from 184 +/- 11 to 139 +/- 11 beats/min (p
      < .01) and reduced coronary blood flow by 20% (p < .01). Cocaine also displaced
      the electrocardiographic ST segments by 3.3 mm over 40 mins (p < .05). Cocaine
      and propranolol abruptly increased the time constant of isovolumic ventricular
      relaxation from 26.4 +/- 1.3 to 43.2 +/- 2.1 msecs (p < .01) at 1 min and to 46.8
      +/- 1.5 msecs at 3 mins (p < .01). The time constant of isovolumic ventricular
      relaxation remained abnormally increased at 43.0 +/- 1.4 msecs at 40 mins.
      Cocaine and propranolol reduced (dP/dt)max from 2760 +/- 458 mm Hg/sec to a
      minimum value of 1400 +/- 119 mm Hg/sec at 2 mins (p < .01). However, (dP/dt)max
      then returned to 2201 +/- 359 mm Hg/sec during the next 38 mins. Cocaine and
      propranolol did not significantly change the mean arterial and left atrial
      pressures, or heart rate, but did reduce coronary blood flow, over 40 mins, by
      25% (p < .001). Cocaine also maximally displaced the electrocardiographic ST
      segments by 1 +/- 0.2 mm (p < .01). CONCLUSIONS: Cocaine substantially impairs
      myocardial ventricular relaxation for periods of at least 40 mins. Propranolol
      significantly intensifies cocaine's depressant effect on ventricular relaxation.

PMID- 8472580
TI  - Indicator amount, temperature, and intrinsic cardiac output affect thermodilution
      cardiac output accuracy and reproducibility.
AB  - OBJECTIVE: To determine the accuracy and reproducibility of four thermodilution
      indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL
      iced injectates) at clinically relevant flow rates. DESIGN: Quasi-experimental
      study. SETTING: Animal research laboratory of a health sciences university.
      SUBJECTS: Six virgin western-breed ewes. INTERVENTIONS: Data were collected from
      six ewes that had ascending aorta electromagnetic flow probes and inferior vena
      cava occluders. Cardiac output was manipulated by inferior vena cava occlusion
      and isoproterenol infusion. Four thermodilution indicators were tested at high
      and low levels of cardiac output and compared with the electromagnetic flowmeter
      measurements of cardiac output. MEASUREMENTS AND MAIN RESULTS: The indicator
      amounts were determined from both injectate volume and temperature difference
      between the injectate and blood. Using 5-mL room temperature injectate as a
      reference, 10-mL room contained 2 x, 5-mL iced 2.1 x, and 10-mL iced 4.1 x the
      indicator amount of 5-mL room temperature injectate. Approximately 210
      simultaneous thermodilution and electromagnetic flow measurements were made for
      each injectate over a flow range of 1.5 to 15.7 L/min. For the entire cardiac
      output range, systematic error was not present. However, the r2 value (.92) for
      the 10-mL iced injectate group was greater (p < .05) than that value (.79) for
      the 5-mL iced injectate group, while r2 values were .79 for the 10-mL room
      temperature group and .49 for the 5-mL room temperature group. At flow rates of <
      4.7 L/min, r2 was not different among injectates, but reduced indicator amounts
      progressively overestimated output (p < .05), reaching 21% for the 5-mL room
      temperature group. At flow rates of > 7.7 L/min, the r2 value (.81) for the 10-mL
      iced group was greater (p < .05) than that value (.45) for the 5-mL iced group,
      while r2 values were .24 for the 10-mL room temperature group and .08 for the 5
      mL room temperature group. Systematic error was not present. CONCLUSIONS: At low
      cardiac output levels, reduced indicator impairs accuracy but not
      reproducibility, a phenomenon that is perhaps related to indicator loss. At high
      cardiac output rates, reduced indicator impairs reproducibility. This phenomenon
      is probably related to low signal-to-noise ratio. Thermodilution indicator
      amounts should be tailored to the output range.

PMID- 8472581
TI  - Civilian triage in the intensive care unit: the ritual of the last bed.
AB  - OBJECTIVE: To evaluate the numerous problems that exist when there is an acute
      shortage of trained critical care nurses, no triage officer is available or
      designated, there is no cooperation among intensive care units (ICUs) or
      alternative sites, or there is excessive political or financial pressure applied
      to maintain a referral practice or to fill all the beds, or limited ability to
      divert ambulances to other hospitals. The Joint Commission on Accreditation of
      Health Care organizations now mandates a written policy: "when patient load
      exceeds optimal operational capacity" (1992). DATA SOURCES/STUDY SELECTION:
      Selected clinical, philosophical, and public policy literature on the subject of
      triage. DATA SYNTHESIS/DATA EXTRACTION: 1) An ICU medical director, designee, or
      supervisory nurse should be empowered as the gatekeeper/triage officer. 2) The
      basis for regulating admission, discharge, or triage from the special care unit
      should be medical suitability (from a utilitarian or egalitarian point of view).
      During high-level triage when all ICU patients are receiving active therapy,
      these decisions should override the individual primary physician-patient
      relationship. 3) The guidelines should follow the "congestive heart failure"
      treatment analogy: a) preload reduction: hold high-risk patients in the
      postanesthesia care unit or Emergency Room, postpone surgery, hold transfers in
      outlying ICUs; b) improve cardiac performance: increase efficiency and decrease
      workload per patient by performing fewer invasive procedures and transporting
      fewer patients for abdominal computed tomography scans; c) afterload reduction:
      keep unstable patients in the postanesthesia care unit, send sicker patients to
      intermediate care units, send "stable" ventilator-dependent patients to general
      medical/surgical units, and transfer or resolve issues regarding "hopeless"
      patients. CONCLUSIONS: It is necessary to have public disclosure of the broader
      issues related to high-level triage. The first issue is recognition that there
      are periods of time when ICU capacity is exceeded or skilled critical care nurse
      availability is reduced. The next issue is the decision of who is best suited to
      make complex and dynamic triage decisions and what kind of oversight should be
      provided. Other issues relate to whether there should be patient or family
      consent, and what to do about patients receiving marginal benefit or who are
      considered hopeless or unsalvageable, yet the family or surrogate decision maker
      (or perhaps one of the consultants) wants to continue active care in the ICU. In
      the conflict between individual and community rights and benefits, there should
      be a nonlitigious approach when a patient is harmed during these periods of high
      census or limited capacity. In recognition of these complex issues (including
      potential conflicts among ICUs, hospital administration, individual physicians,
      and the various medical and surgical programs feeding patients into special care
      units), the Society of Critical Care Medicine has organized a Task Force on the
      legal and ethical justification for triage.

PMID- 8472582
TI  - Pediatric intensive care units: results of a national survey.
AB  - OBJECTIVE: To describe the structure and organization of pediatric intensive care
      units (ICUs) in the United States. SURVEY METHODS: We directed a mail survey to
      pediatric ICU medical and nursing directors and hospital quality assurance
      officers. A total of 201 of 301 hospitals with pediatric ICUs initially
      responded. Telephone confirmation of the mail survey (n = 193) and telephone data
      collection for mail survey nonresponders (n = 42) were also undertaken. SURVEY
      RESULTS: The largest proportion (40.0%) of pediatric ICUs had four to six beds
      per unit, while only 6.0% had > 18 beds per unit. The admissions per year
      averaged 528 +/- 24, and the mortality rates averaged 5.5 +/- 0.2%. Only 79.6% of
      the pediatric ICUs had full-time medical directors. A pediatric intensivist was
      available to 73.2% of the units. Physician coverage for 24 hrs/day dedicated only
      to the pediatric ICU was present in 48.5% of hospitals. As ICU size increased,
      the estimated mortality rates increased, as did the percentages with full-time
      directors, pediatric intensivists, and 24 hrs/day dedicated coverage. Medical
      school affiliation existed for 79.6% of pediatric ICU hospitals, and 81.1% of
      these hospitals were the primary teaching program sites for pediatrics. Other
      ICUs caring for children were present in 30.2% of the hospitals. SURVEY
      APPLICATION: The mail survey respondents were stratified using four factors:
      size, teaching status, intensivist status, and coordination of care status. A
      total of 16 respondents were randomly selected for an ongoing outcomes study of
      the importance of these factors. CONCLUSIONS: Substantial diversity exists in
      pediatric ICU structure and organization. Determining factors associated with
      quality of care is important for improving outcomes.

PMID- 8472583
TI  - A model for technology assessment applied to pulse oximetry. The Technology
      Assessment Task Force of the Society of Critical Care Medicine.
AB  - OBJECTIVES: To test a model for the assessment of critical care technology. To
      develop practice guidelines for the use of pulse oximetry. DATA SOURCES: A
      computer-assisted search of the English language literature and interviews with
      recognized experts in the field of pulse oximetry. STUDY SELECTION: Those studies
      that addressed one or more of the seven questions contained in our technology
      assessment template were analyzed. Study design was not a factor in article
      selection. However, the lack of well-designed clinical outcome studies was an
      important factor in determining the method of practice policy development we
      utilized. DATA EXTRACTION: A focus person summarized the data from the selected
      studies that related to each of the seven assessment questions. The preliminary
      data summary developed by the focus person was further analyzed and refined by
      the task force and then sent to 16 expert reviewers for comment. These expert
      comments were considered by the task force, and this final consensus report was
      developed. DATA SYNTHESIS: Pulse oximetry combines the principles of
      spectrophotometry and plethysmography to noninvasively measure oxygen saturation
      with a high degree of accuracy over the range of 80% to 100% saturation, assuming
      the device is being used according to the manufacturer's instructions and without
      any adverse operating conditions. The appropriate clinical uses of pulse oximetry
      fall into one of two broad categories: as a warning system based on continuous
      real-time measurement of arterial desaturation, or as an end-point for titration
      of therapeutic interventions. There are no published studies that allow for
      definitive, outcome-based conclusions concerning either the clinical impact or
      cost-benefit ratio of pulse oximetry. CONCLUSIONS: The model developed for
      technology assessment proved to be appropriate for assessing pulse oximetry. The
      available data have allowed us to develop an evidence-based practice policy for
      the use of pulse oximetry in critical care. Critical care clinicians,
      researchers, and industry have a shared responsibility to provide valid outcome
      and efficacy studies of new technologies.

PMID- 8472584
TI  - Extracorporeal membrane oxygenation support for cardiac dysfunction from
      tricyclic antidepressant overdose.

PMID- 8472585
TI  - Late presentation of misalignment of lung vessels with alveolar capillary
      dysplasia.

PMID- 8472586
TI  - Sensory evoked potentials accurately predict recovery from prolonged coma caused
      by strangulation.

PMID- 8472587
TI  - Relative humidity not absolute humidity is of great importance when using a
      humidifier with a heating wire.

PMID- 8472588
TI  - Electrical power failure in a cardiothoracic intensive care unit.

PMID- 8472589
TI  - Electrical power failure in a cardiothoracic intensive care unit.

PMID- 8472590
TI  - Mammography: breast implants--types, complications, and adjacent breast
      pathology.
AB  - Approximately 1.5 million women in the United States currently have breast
      implants. The majority were placed for cosmetic augmentation, but 20% were placed
      for reconstruction after the loss or deformity of a breast. The augmented breast
      is a challenge to the mammographer. Many of the palpable and mammographically
      detected abnormalities in these patients are related to the implant itself.
      Since, however, there is breast tissue present with cosmetic augmentation, the
      full range of fibrocystic and neoplastic conditions that can affect the breast
      may be seen. The presence of the implant makes imaging the breast more difficult
      because the implant obscures the nearby breast tissue. This paper reviews the
      history and evolution of various breast prostheses. The surgical approaches to
      placement of implants and complications associated with their use will be
      discussed. Examples of concomitant pathologies and a review of imaging strategies
      will be given.

PMID- 8472591
TI  - Cervical lymph node metastasis.

PMID- 8472592
TI  - Predictors of mortality, COPD morbidity, and respiratory cancer--with special
      reference to respiratory symptoms, lung function, and occupational exposure
      cement dust.

PMID- 8472593
TI  - Elastolytic activity of human monocytes. With special reference to rheumatoid
      arthritis and giant cell arteritis.

PMID- 8472594
TI  - Xamoterol--a beta-1-adrenoceptor partial agonist. Pharmacology and clinical use.

PMID- 8472595
TI  - Reliability in perinatal audit. A qualitative study--a preliminary investigation.
AB  - The aim of this study was to elucidate some aspects of reliability in perinatal
      audit, both by describing aspects of the ways in which consensus is reached
      between experts in perinatal audit and by examining the extent of agreement
      between two separate panels assessing peri- and neonatal care in 17 cases of
      neonatal deaths. The consensus process was elucidated by a questionnaire answered
      by 16 perinatal experts who had participated in a perinatal audit and by analyses
      of audiotapes. In 70-95% of the cases, most of the experts had reached the same
      conclusions during their work at home as the panel did after the joint
      discussions. The audiotapes revealed that the experts adjust their individual
      interpretations during discussions with other experts. Agreement in evaluation
      between two panels was elucidated by agreement in evaluation of the quality of
      antenatal care, intrapartum care, and neonatal care in the 17 cases of neonatal
      deaths. The two panels agreed in evaluation of antenatal care in 15 cases, in
      intrapartum care in 14 cases, and in neonatal care in 15 cases. Although the
      material is small, our results seem to indicate that the conclusions drawn in
      perinatal audit are reliable when the experts have detailed knowledge of the
      structure of perinatal and neonatal care, when there are agreed standards of
      satisfactory care, and when they have the possibility of adjusting their
      individual interpretations during discussion with other experts.

PMID- 8472596
TI  - Do specialists give special antibiotic treatment?
AB  - The use of antibiotics is increasing with increasing ecological and economic
      problems as a consequence. In Denmark, antibiotics are prescribed by doctors and
      in order to intervene, it is important to know details about prescription habits.
      Danish patients are referred to specialists by their general practitioner when
      further investigation or treatment is needed. In one week in 1988, 180
      specialists (60%) participated in a study registering all prescriptions made by
      these specialists. Only 3.2 patients per specialist were treated with
      antibiotics. The infections were mainly of the upper respiratory tract, the skin,
      or gynecological. The prescribed daily dosages (PDD) did not differ from those
      given by the general practitioners, but the specialists used significantly less
      penicillin and significantly more erythromycin, tetracycline or local
      antibiotics. Compared with the general practitioners the specialists in Denmark
      only prescribed approximately 10% of the total amount of antibiotics used outside
      the hospitals. Their contribution to the potential ecological and economic
      problems caused by antibiotics in Denmark is limited.

PMID- 8472597
TI  - Regulation and function of host defences in the murine lymphocytic
      choriomeningitis virus infection.

PMID- 8472598
TI  - Idiopathic myelofibrosis. Clinical aspects and studies on extracellular matrix
      metabolism.

PMID- 8472599
TI  - Proteolytic modification of beta 2-microglobulin in human serum.

PMID- 8472600
TI  - Normal age-related changes in bone mass, structure, and strength--consequences of
      the remodelling process.

PMID- 8472601
TI  - Justification for magnesium therapy in acute ischaemic heart disease. Clinical
      and experimental studies.

PMID- 8472602
TI  - Method for counting mitoses by image processing in Feulgen stained breast cancer
      sections.
AB  - This study describes an image processing method for the assessment of the mitotic
      count in Feulgen-stained breast cancer sections. The segmentation procedure was
      optimized to eliminate 95-98% of the nonmitoses, whereas 11% of the mitoses did
      not survive the segmentation procedure. Contour features and optical density
      measurements of the remaining objects were computed to allow for classification.
      Twelve specimens were analyzed, nine used to serve as a training set, and three
      put aside for later use as independent test set. The fully automatic image
      processing method correctly classified 81% of the mitoses at the specimen level
      while inserting 30% false positives. The automatic procedure strongly correlated
      with the interactive counting procedure (r = 0.98). Although the fully automatic
      method provided satisfactory results, it is not yet suited for clinical practice.
      The automated method with an interactive evaluation step gave an accurate
      reflection of the mitotic count showing an almost perfect correlation with the
      results of the interactive morphometry (r = 0.998). Therefore this semiautomated
      method may be useful as prescreening device.

PMID- 8472603
TI  - Flow cytometric measurement of [Ca2+]i and pHi in conjugated natural killer cells
      and K562 target cells during the cytotoxic process.
AB  - We describe a flow cytometric assay that enables one to follow conjugate
      formation between cytotoxic cells and their target cells during the cytotoxic
      process. In addition, the internal calcium concentration ([Ca2+]i) and internal
      pH (pHi) of the conjugated cells can be monitored and directly compared to the
      nonconjugated cells. This is achieved by labeling one cell type with the Ca(2+)
      specific dye Fluo-3, while the other cell type is labeled with the pH-sensitive
      dye SNARF-1. As these fluorochromes have different emission spectra, events
      positive for both fluorochromes are identified as conjugates. The results show
      that the conjugates can be clearly distinguished from single cytotoxic cells
      [natural killer (NK) cells] and target cells [K562 cells, (TC)]. Upon binding,
      [Ca2+]i is increased in the NK cells as well as in the TC. In conjugated NK cells
      this increase of [Ca2+]i is temperature dependent and is followed by a decrease
      to a normal [Ca2+]i value later on. The [Ca2+]i in NK cells increases in 2 steps,
      which may be related to the binding--and lethal hit phase. Upon conjugate
      formation, NK cells show a slight increase in pHi (0.2-0.3 pH units). TC do not
      reveal a significant change in pHi.

PMID- 8472604
TI  - Multiparameter flow cytometric analysis of a novel cytotoxin (factor 2) induced
      tumor cell membrane permeability.
AB  - An improved twin-probe multiparameter flow cytometric technique was applied to
      examine a novel cytotoxin, Factor (F2), induced tumor cell permeability. Ability
      to retain preloaded intracellular bis-carboxyethyl carboxyfluorescein (BCECF,
      green fluorescence) and to exclude extracellular propidium (red fluorescence) was
      measured simultaneously with forward and right-angle scatter. In addition to the
      two expected cell populations which were stained green negative, red positive
      ("membrane-damaged" and "non-viable", Region 2), and green positive, red negative
      ("membrane intact" and "viable", Region 3), a third population was seen which
      fluoresced neither green nor red and displayed intermediate light scatter
      characteristics (Region 1). K562 cells progressed from Region 3 to Region 1, and
      then from Region 1 to Region 2 after treatment with F2. These results suggest
      that sequential changes in membrane structure lead to increased permeability,
      first with respect to intracellular BCECF and then in turn to extracellular
      propidium. Flow cytometric changes caused by F2 were detectable 10 min after
      treatment with 2.5 U/ml of F2, and 5 min after 10 or 40 U/ml of F2. Flow
      cytometric analysis showed that F2-induced tumor cell lysis and growth inhibition
      were accompanied by rapid alternations in tumor cell membrane permeability. Flow
      cytometric analysis also distinguished F2 cytotoxicity from phorbol myristate
      acetate (PMA) associated cytotoxicity to K562 cells and determined that F2
      produced spontaneously or induced by PMA and/or ciprofloxacin had a similar
      ability to induce tumor cell membrane permeability change.

PMID- 8472605
TI  - Characterization of hypoxia-dependent peroxide production in cultures of
      Saccharomyces cerevisiae using flow cytometry: a model for ischemic tissue
      destruction.
AB  - Peroxide production in cultures of Saccharomyces cerevisiae was measured using
      the H2O2-sensitive fluorescent probe 2',7'-dichlorofluorescein diacetate (DCFH
      DA) and flow cytometry. Aeration of cultures of S. cerevisiae exposed to a period
      of hypoxia was found to induce elevated levels of peroxide that were 100-fold
      higher than the levels observed in cultures maintained under exclusively aerated
      or hypoxic conditions. Simultaneous viability analysis, using the fluorescent DNA
      intercalating dye propidium iodide, indicated that the increase in peroxide
      generation preceded cell damage and death. Various agents were found to influence
      the effect of peroxides on cell viability. The addition of ethanol to hypoxic
      stationary cultures dramatically increased the rate of cell death without further
      increasing the amount of peroxide produced, while glucose inhibited peroxide
      production and decreased the rate of cell death. Surprisingly, elevated peroxide
      levels of hypoxic/reaerated cultures were maintained upon addition of KH2PO4,
      although the cells remained viable for extended periods of time when compared to
      control and other test cultures. Similarities between our observations and those
      of other investigators using anoxic/reperfused organs suggest that
      hypoxic/reaerated yeast cultures may be a useful model system to study ischemia
      dependent tissue destruction of mammals.

PMID- 8472606
TI  - Nationwide quality control trial on lymphocyte immunophenotyping and flow
      cytometer performance in Italy.
AB  - The Italian Society for Cytometry (Gruppo Italiano di Citometria, GIC) promoted
      this nationwide large-scale quality control trial on cellular immunophenotyping
      and flow cytometer performance in 1991. The aim of this independent study was to
      evaluate instrument performance with calibrated fluorescence microbeads (minimum
      threshold for FITC, linearity, coefficients of variation and resolution indexes
      for fluorescence), and to correlate it to the measurement of lyophilized
      lymphocyte surface immunofluorescence staining with a wide spectrum of antibodies
      (percentage of positive cells and fluorescence mean intensity). A single send-out
      was made to 306 laboratories with 350 instruments throughout Italy. Each kit
      included anonymous vials containing premixed calibrated microbeads, lyophilized
      human lymphocytes and small aliquots of conjugated monoclonal antibodies, for
      both single FITC and double FITC/PE staining. Participants were also asked to use
      their own anti-CD4 monoclonal. A valid answer was returned by 209 laboratories
      with 221 instruments. Gating was not an assay variable. The minimum sensitivity
      threshold for FITC ranged from 26.6 to 11,293 MESF, with marked instrument
      heterogeneity as far as the relationship between FITC threshold and coefficients
      of variation for fluorescence was concerned. A low FITC threshold also correlated
      with a good resolution index for low intensity stainings. No performance
      comparisons among instrument brands and models were made. The lyophilized
      lymphocyte analysis showed an overall frequency of outliers ranging from 3.2% to
      19.7%, with a maximum for CD2 FITC (19.7%) and CD3 + HLA-DR + (12.1%). A strongly
      negative relationship was evident between the FITC threshold and the number of
      CD2+ cells, whereas the sensitivity threshold had virtually no effects on the
      measured level of higher antigen density markers like CD4 and many others.
      Absolute fluorescence intensity measurements of CD4+ and CD19+ were also made.
      This study design proved valid and suitable for a large-scale evaluation of both
      instrument performance and cytometer operators' skill. A number of practical
      problems were identified among participants, thus stressing the need for more
      effective educational programmes and technical guidelines.

PMID- 8472607
TI  - Evaluation of a dual-color flow cytometry immunophenotyping panel in a
      multicenter quality assurance program.
AB  - A basic immunophenotyping panel that employed dual-color combinations of
      fluorescein isothiocyanate (FITC) and phycoerythrin (PE) conjugated monoclonal
      antibodies (mAb; FITC-CD45/PE-CD14, FITC-IgG1/PE-IgG2, FITC-CD3/PE-CD8, FITC
      CD3/PE-CD4, FITC-CD3/PE-CD16 + PE-CD56, and PE-CD19) was utilized in a quality
      assurance program to determine whether the 4 laboratories participating in a
      multicenter AIDS study obtained similar lymphocyte subset percentage values for T
      cells, B cells, NK cells, and CD4+ and CD8+ T cells. Over a 1 1/2 year period, 78
      shared peripheral blood specimens were prepared and analyzed in each laboratory.
      The CD45bright CD14- percentage for each specimen was used to correct that
      individual's lymphocyte subset values. Interlaboratory coefficients of variation
      (CV) for the human immunodeficiency virus type I (HIV) seronegative (n = 38) and
      HIV-seropositive (n = 40) specimens using this panel were < 3% for total T cells;
      < 5% for CD4+ T cells and CD8+ T cells; < or = 17% for B and NK cells; and < 8%
      for CD4T/CD8T ratios. The 6-tube basic immunophenotyping panel has several
      notable features: a) for clinical studies, it permits comprehensive evaluation of
      an individual's major lymphocyte subsets, i.e., T, B, NK, and CD4+ and CD8+ T
      cells; b) for interlaboratory proficiency testing programs, it allows the
      detection of differences among laboratories in measurements of several
      functionally distinct cell populations; and c) for within-sample quality
      assurance, it provides several quality control checks, including the lymphosum,
      i.e., the sum of an individual's corrected T+B+NK values, a sum that was
      generally 100 +/- 5% on the HIV-seronegative specimens analyzed in this study.

PMID- 8472608
TI  - Proposal for standardization of flow cytometric reticulocyte maturity index (RMI)
      measurements.
AB  - Flow cytometric (FCM) reticulocyte analysis is more accurate, sensitive, and
      reproducible relative to previously employed manual microscopic methods in
      clinical laboratory hematology. FCM reticulocyte analysis using RNA binding
      fluorochromes additionally allows for the quantification of fluorescence
      intensity or population distribution of the reticulocyte RNA content. Viewed from
      the perspective of erythroid maturation, quantification of the fluorescence
      intensity distribution provides a reticulocyte maturation index (RMI). We
      performed a systematic study of 18 different methods to express thiazole orange
      stained reticulocyte fluorescence intensity, compared to standard mean
      fluorescence intensity quantification, using 185 anemic and non-anemic human
      blood samples. The method best correlating with the mean fluorescence intensity
      RMI on 2 different FCM instruments (R2 = 0.93 and 0.86) was a ratio of the highly
      fluorescent reticulocytes, defined using a normal adult population, and the total
      number of reticulocytes (HFR%). In contrast to mean fluorescence intensity
      measurements, a HFR% RMI parameter can provide similar units of expression (0.01
      1.00) with good correlation between different FCM instruments (R2 = 0.76). We
      conclude the HFR% method of RMI expression provides a superior means of
      interlaboratory standardization and clinical comprehension of this useful
      diagnostic parameter in clinical laboratory hematology.

PMID- 8472609
TI  - DNA content parameters of paraffin-embedded soft tissue sarcomas: optimization of
      retrieval technique and comparison to fresh tissue.
AB  - DNA content analysis of formalin fixed paraffin embedded (FFPE) tissue permits
      determination of the influence of DNA content on the prognosis in cohorts of
      patients for whom the clinical outcome is known. Of key importance in such an
      analysis is the accuracy of DNA content determination. Variations in the quality
      of DNA histograms from FFPE tissues of different types prompted a comparative
      evaluation of the preparative methodology of FFPE soft tissue sarcomas for DNA
      flow cytometry. Following deparaffination and rehydration of fixed tissue, and
      prior to fluorochrome staining, tissue blocks of 15 DNA aneuploid soft tissue
      sarcomas were subjected to repeated experimental (time x concentration) enzyme
      exposures. The goal of these studies was to define the optimal tissue specific
      retrieval technique with the coefficient of variation, maintenance of DNA
      aneuploidy, and DNA index as endpoints. After optimizing the technique, the DNA
      content of 50 soft tissue neoplasms derived from FFPE specimens was compared to
      the corresponding fresh surgical tissue. The observed 14 percent error rate in
      the determination of DNA ploidy status suggest limited utility for FFPE tissue in
      prospective therapeutic trials of soft tissue sarcoma.

PMID- 8472610
TI  - Flow cytometric analysis of xenobiotic metabolism activity in isolated rat
      hepatocytes.
AB  - Flow cytometry offers great potential for the study of xenobiotic metabolism in
      intact cells. We explored this application by the use of ethoxyfluorescein ethyl
      ester (EFEE) and isolated rat hepatocytes, a classic system for studying such
      reactions. EFEE is only weakly fluorescent and it diffuses freely into viable
      cells, where it is metabolized to fluorescein by a process dependent upon mixed
      function oxidase activity. In the current study, viable hepatocytes were first
      identified by flow cytometric assessment of fluorescein diacetate staining. The
      viable subpopulation was also identifiable on the basis of forward and right
      angle light scattering properties alone, and it was in this fraction that EFEE
      metabolism was measured. Metabolism of EFEE to fluorescein was quantified by flow
      cytometry. SKF 525A, alpha-naphthoflavone, and metyrapone, classic inhibitors of
      mixed-function oxidation, each inhibited the metabolism of EFEE. These results
      demonstrate the potential of EFEE for use in flow cytometric studies of drug
      metabolism, such as in multiparameter mechanistic assays of cellular xenobiotic
      metabolism and toxicity, and in the isolation by fluorescence-activated cell
      sorting of subpopulations which differ in this activity.

PMID- 8472611
TI  - Flow cytometric estimation of poly(A)+ RNA by fluorescent in situ hybridization.
AB  - A method for the detection of poly(A)+ RNA in cell suspensions by in situ
      hybridization and flow cytometry is described. The hybridizing properties of
      oligothymidylate o(dT) was well preserved after coupling to fluorescein. This
      fluorescent oligonucleotide was used as a probe to determine the poly(A)+ RNA
      content of fixed HL60 leukemic cells by flow cytometry. Labeling was considerably
      reduced by treating the cells with RNAse, and by competitive hybridization with
      either poly(U) or free poly(A). Labeling was also decreased in a time-dependent
      fashion by incubating the cells with actinomycin D prior to fixation. This method
      represents an improvement on the methods measuring total RNA and could be of
      value in investigations on the effect of drugs on RNA metabolism.

PMID- 8472612
TI  - Flow cytometric evaluation of human basophils.
AB  - The expression of CD45 and IgE cell surface antigens on human leucocytes was
      studied by flow cytometry. More than 80% of sorted cells that expressed low CD45
      (CD45dim) and high IgE (IgEbright) antigen site density were identified as
      basophils. Immunomagnetic depletion of the CD45dim-IgEbright cell subset by a
      biotin-coupled anti-IgE antibody and streptavidin-coated magnetic beads was
      greater than 90%, and more than 80% of cells binding significant numbers of beads
      exhibited the morphological characteristics of basophils. Interestingly, when the
      cell staining was performed in the presence of calcium and magnesium, we observed
      a significant increase of CD45 and an equivalent decrease of IgE cell surface
      expression, as well as an IgE concentration dependent diminution of the number of
      CD45dim-IgEbright cells.

PMID- 8472613
TI  - Identification of a marker chromosome in a rat ascitic tumor by flow cytometry
      using a modified method for preparing chromosome suspensions.
AB  - Preparation of good chromosome suspensions is a crucial step in obtaining good
      flow karyotypes from different types of cells. Although several methods are in
      use, not all are suitable for all cell types. Primary cells from murine tissues
      are specially difficult to flow karyotype. We have modified the existing
      protocols for preparing chromosome suspensions from the Zajdela ascitic hepatoma
      (ZAH) cells of rat and have constructed their flow karyograms. Our karyograms
      show a distinct marker chromosome in these cells, which could not be resolved
      using other protocols. We have also used this method for preparing chromosomes
      from the bone marrow cells of the rat and have compared their flow karyograms
      with the ZAH karyotype. We expect that our protocol will be useful for studying
      other types of tumor and normal cells.

PMID- 8472614
TI  - Chronic hepatitis.
AB  - Evaluation, management and treatment of patients with chronic inflammation of the
      liver is an important task for the clinician. Almost every ongoing liver injury
      has an element of inflammation. In those disorders grouped as chronic hepatitis,
      the brunt of the liver injury is borne by the hepatocyte and continues until
      either the stimulus is removed or the inflammatory response is blunted. Chronic
      viral infection is by far the most important cause of chronic hepatitis.
      Hepatitis B and hepatitis C infections are both frequent causes and may result in
      cirrhosis. Interferon therapy has proven useful in the treatment of some patients
      with bone disorders. Idiopathic autoimmune chronic hepatitis is an important
      contributor to the diagnosis of chronic hepatitis and usually responds to
      corticosteroid therapy. Because of the availability of effective therapy,
      Wilson's disease, which is a quite rare but important cause of chronic hepatitis,
      should be considered. Even more rarely, an ongoing reaction to the continued
      administration of a therapeutic drug leads to chronic hepatitis. Advances in
      diagnosis, increased understanding of the courses followed by each of the major
      disorders, and the availability of effective treatment for many patients has
      heightened interest in the syndrome of chronic hepatitis.

PMID- 8472615
TI  - Acute mesenteric ischemia: pathophysiology, diagnosis, and treatment.
AB  - Ischemia has traditionally been viewed as arising only from abnormalities of
      oxygen dynamics, namely the cellular hypoxia resulting from the imbalances
      between oxygen supply, consumption, and demand. Recently, it has become clear
      that such a view is too restrictive. Hypoperfusion may be caused by both anatomic
      and functional impediments to either inflow or to outflow from an organ.
      Furthermore, the pathophysiologic consequences are likely to involve not only
      cellular hypoxia, but also a restricted supply of nutrients and other important
      molecules and an abnormal elimination of physiologic wastes such as carbon
      dioxide. Hence the recommendation that ischemia be defined as a dual defect of
      oxygen deficit and carbon dioxide excess. AMI is, therefore, a severe anatomic or
      functional impediment to the splanchnic circulation, resulting in a dual defect
      of intestinal hypoxia and cellular hypercarbia. Although the functional and
      structural consequences of cellular hypoxia are well known, the pathophysiology
      of cellular hypercarbia has only begun to be explored. AMI syndromes include
      three related processes: occlusive mesenteric ischemia, nonocclusive ischemia,
      and sepsis-induced SI. Leakage of bacteria or bacterial toxins into the
      circulation during mesenteric ischemia forms the basis of the systemic components
      of this syndrome. Striving for an earlier diagnosis, treating the systemic
      (septic) consequences, and taking measures to promptly restore mucosal oxygen
      balance through aggressive pharmacologic and appropriate surgical intervention
      have significantly improved the prognosis. About 80% of patients with acute
      arterial embolism, 60% of those with nonocclusive ischemia, and only 20% of
      patients with arterial thrombosis are expected to live without significant
      residual nutritional deficits. The cause of death is usually sepsis and
      multisystem organ failure, and therefore, further reductions in mortality are
      likely to occur with the improved prevention and treatment of sepsis.

PMID- 8472616
TI  - Association of elastin glycation and calcium deposit in diabetic rat aorta.
AB  - The relationship between glycation of the aortic elastin and calcium deposits in
      the aorta was studied in streptozocin (STZ)-induced diabetic rats. 5
      Hydroxymethylfurfural (5-HMF) which was released from aortic elastin by acid, was
      assayed after STZ treatment as an index of early stage glycation. The amount of
      released 5-HMF increased at 5 weeks and paradoxically decreased at 10 weeks after
      STZ treatment, though it remained higher than that of control rats. This
      paradoxical pattern was reproduced by the in vitro incubation of elastin with
      glucose and it is presumably due to further advancement of glycation reactions in
      diabetic rats. The level of 5-HMF did not change significantly in control rats at
      corresponding time points of 9, 11 and 16 weeks of age. Fluorescence of porcine
      pancreatic elastase I-digested elastin which served as an index of advanced
      glycation, increased by 1.6 times at 3 weeks and reached a maximum of 1.9-fold
      higher than that of control rats at 10 weeks. The calcium content of the aorta at
      10 weeks in diabetic rats was significantly increased by 1.4-fold compared with
      control rats. This study showed that the increased elastin glycation in the aorta
      even at the early stage of diabetes is associated with calcium deposit in the
      aorta. These results are consistent with the interpretation that elastin
      glycation in the aorta is the potential accelerating factor for diabetic
      macroangiopathy.

PMID- 8472617
TI  - Aminoguanidine inhibits protein browning without extensive Amadori carbonyl
      blocking.
AB  - It has been proposed that aminoguanidine reacts extensively with Amadori carbonyl
      groups of glycated proteins thus blocking them and inhibiting the further
      reactions which lead to browning and fluorescence development. We have glycated
      bovine serum albumin in the presence of 1, 5, 10 and 25 mM aminoguanidine and
      measured fluorescence development at 440 nm upon excitation at 370 nm, free
      (unblocked) Amadori groups as fructosamine with a colorimetric assay and furosine
      by HPLC, as an index of total Amadori products. Aminoguandine significantly
      inhibited fluorescence development at all the tested concentrations (31%, 65%,
      69% and 82% inhibitions, respectively) (P < 0.001). Blocking of Amadori groups
      was demonstrated by decreased fructosamine and unchanged furosine yields but only
      at the higher concentrations and to a very limited extent (13% and 27% blocking,
      respectively) (P < 0.01). Incubation of Aminoguanidine with albumin produced the
      appearance of 320 nm absorbing yellow chromophores, quite increased in the
      presence of glucose. These results suggest that Aminoguanidine is able to block
      Amadori groups, as previously hypothesized, but question the importance of this
      mechanism as an explanation of its capacity to inhibit browning. Scavenging of
      glucose seems to have no impact on glycation as seen by unchanged furosine
      yields.

PMID- 8472618
TI  - Assessment of pupillary responses to light with IRIS.
AB  - With a newly developed method, IRIS, the potential usefulness of various
      parameters of pupillary reflexes for the assessment of autonomic nerve function
      was studied. Constriction latency decreased and dilatation latency increased
      significantly with higher intensities of light (P < 0.01 and P < 0.05,
      respectively). Thirteen subjects were tested twice one year apart in order to
      examine long-term intra-individual variability; no significant differences (all P
      > 0.3) were found. Reproducibility and reliability of hippus and pupil cycle time
      were lower than for the determination of constriction and dilatation latency.
      None of the parameters was correlated with age (all P > 0.3). We conclude that
      pupillary constriction and dilatation latency, assessed with IRIS, are the main
      dynamical parameters for the study of parasympathetic and sympathetic parts of
      the autonomic nervous system, that controls the pupillary system. Although a
      statical parameter, useful additional information may be obtained from the dark
      adapted pupil diameter. Hippus cycle time and pupil cycle time do not provide
      additional information and therefore cannot be recommended as standard tests for
      autonomic nerve function.

PMID- 8472619
TI  - The inhibitory action of buformin, a biguanide on gluconeogenesis from alanine
      and its transport system in rat livers.
AB  - The effect of buformin, a biguanide, on gluconeogenesis from 10 mM alanine in the
      presence of 143 nM glucagon were studied using isolated rat liver perfusions. In
      addition, to investigate possible mechanisms of biguanide action, alanine
      utilization in isolated rat liver perfusion and [3H]alanine uptake in isolated
      hepatocytes were observed. Buformin (1.85 mM) strongly inhibited gluconeogenesis
      from alanine in the presence of glucagon in both normal and streptozocin-induced
      diabetic rat livers. This inhibition was followed by a decrease in alanine
      utilization. Both of these inhibitory effects of buformin were dose-dependent.
      [3H]Alanine uptake was significantly inhibited by buformin. The effect of this
      agent was similar to but weaker than that of ouabain. However, tolbutamide failed
      to reduce either alanine utilization or [3H]alanine uptake, although this drug
      significantly inhibited gluconeogenesis from alanine. These data suggest that
      biguanides may reduce hepatic alanine utilization via the inhibition of Na+/L
      alanine transport activity as one possible mechanism, resulting the inhibition of
      gluconeogenesis from alanine in the presence of glucagon.

PMID- 8472620
TI  - Factors influencing the clinical outcome of continuous subcutaneous insulin
      infusion in routine practice.
AB  - Possible factors that might influence the outcome of continuous subcutaneous
      insulin infusion (CSII) treatment were investigated in forty-nine, type 1,
      diabetic patients with median treatment of 3.25 years in routine diabetes care.
      In nine patients pump treatment was discontinued largely within the first 6
      months. Patients characterized as blue-collar workers discontinued pump treatment
      at a significantly higher rate. Of the remaining forty patients those with the
      longest treatment experience were of attracted interest. Among twenty patients
      who had used CSII three years or more improvement of metabolic control was most
      evident in patients with high haemoglobin A1c (HbA1c) values before CSII (R
      square 0.673, P = 0.0001) and in subjects with low insulin requirements on
      injection therapy (R-square 0.334, P = 0.0076). This improvement was not
      explained by more frequent monitoring of blood glucose only. It was found that
      those who had the lowest body mass index (BMI) before pump treatment had the more
      pronounced increase of BMI, while those in the upper normal range had an
      unchanged or reduced body mass (R-square 0.271, P = 0.0115). We conclude that
      high HbA1c values, low insulin requirements and low body mass in conventional
      injection therapy are the most important factors when trying to achieve and
      maintain metabolic improvement in CSII treated type 1 diabetic patients.

PMID- 8472621
TI  - A study of response pattern of non-insulin dependent diabetics to yoga therapy.
AB  - Changes in blood glucose and glucose tolerance by oral glucose tolerance test
      (OGTT) after 40 days of yoga therapy in 149 non-insulin-dependent diabetics
      (NIDDM) were investigated. The response to yoga in these subjects was categorized
      according to a severity scale index (SSI) based on area index total (AIT) under
      OGTT curve. One hundred and four patients showed a fair to good response to the
      yoga therapy. There was a significant reduction in hyperglycemia and AIT with
      decrease in oral hypoglycemia and AIT with decrease in oral hypoglycemic drugs
      required for maintenance of normoglycemia. It is concluded that yoga, a simple
      and economical therapy, may be considered a beneficial adjuvant for NIDDM
      patients.

PMID- 8472622
TI  - Estimation of the prevalence of diabetes mellitus diagnosed, and incidence of
      type 1 (insulin-dependent) diabetes mellitus in the Avila Health Care region of
      Spain.
AB  - We studied the prevalence of diabetes mellitus diagnosed in the Avila Health Care
      region, Spain, based on the prescribed daily dosage (PDD) of insulin (corrected
      in function of insulin loss (PDDc)) and sulphonureas, from a sample
      representative of prescribing physicians (A, n = 48) and pharmacies (B, n = 25)
      in our region. The amounts of the PDDcs of insulin sold during 1989 per 1000
      inhabitants/day were 6.06 and 6.20, respectively for the two samples (A and B).
      The figures for PDDs of sulphonurea/1000 inhabitants/day were 16.25 and 19.16,
      respectively. We determined the proportion that diabetic patients on diet alone
      represented in relation to non-insulin treated diabetic patients who visited the
      only specialized clinic for diabetic patients in our province in 1989. These
      patients accounted for 40.83% of non-insulin treated diabetic patients. The
      patients being treated with biguanides or with a combination of anti-diabetic
      drugs accounted for less than 1% of those treated in the specialized clinic.
      Taking this into account, the prevalence of diabetes mellitus in Avila was 3.35%
      (C.I. 95%: 3.10-3.59), according to the sample A and 3.85% (C.I. 95%: 3.50-4.31)
      according to the sample B. In addition, we studied the hospital admission records
      during three consecutive years in order to find out the incidence of type 1
      insulin-dependent diabetes mellitus (IDDM) below 15 years of age in the Avila
      Health Care region of Spain. All prescribing physicians that did not work in the
      Hospital (197 in the rural area and 18 in the urban area) were used as the
      secondary source for validation of case ascertainment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8472624
TI  - Gangliosides prevent insulitis but not islet B cell destruction in low-dose
      streptozocin-treated mice.
AB  - High doses of gangliosides were given to low-dose streptozocin(LDS)-treated mice,
      in order to observe their ability to prevent diabetes in this animal model and
      also to look for any modification in the early histopathological lesions
      occurring in pancreatic islets. Cronassial, 150 mg/kg body wt., (21% GM1, 40%
      GD1a, 16% GD1b, 19% GT1b and 5% other) was given to 20 C57BL6/J mice in which
      diabetes was induced 1 week after the start of the Cronassial treatment. Data
      obtained from animals killed 1 and 3 weeks from the end of the LDS treatment
      demonstrate that gangliosides stop infiltration of the islets but do not prevent
      destruction of islet B cells. Therefore, inflammation is not obligatory for the
      development of the disease in this model. Streptozocin exerts a direct cytotoxic
      action of considerable importance and is able to act prolongedly on target cells.
      The destruction achieved is similar to that produced by administration of a
      single high dose even though it takes place over a longer period. Our results
      underline the complexity of the LDS-induced diabetic disease.

PMID- 8472623
TI  - Immunological resistance to human biosynthetic insulin--effects of
      immunosuppression and plasmapheresis.
AB  - A 55-year-old gentleman, after being treated for a short time with a diet and
      with Chlorpropamide, was switched to purified porcine insulin due to ketonuria
      and ketoacidosis. After a year the patient developed immunological insulin
      resistance (mean daily insulin dose: 3.72 U/kg body weight; anti-insulin
      antibodies 78%). In order to lower anti-insulin antibodies human recombinant DNA
      insulin was introduced into further therapy. Contrary to expectations, the
      patient did not reduce whatsoever his anti-insulin antibodies and his daily
      insulin dose increased up to 5.63 U/kg body weight. Introduction of combined
      immunosuppressive therapy (prednisone plus azathioprine) together with
      plasmapheresis resulted in rapid lowering of daily insulin requirement and
      reduction in anti-insulin antibodies. Immunosuppressive therapy was continued
      with 10 mg of prednisone and a year later the patients insulin daily requirement
      was 0.66 U/kg BW while his antibodies were 18%. The possible causes of insulin
      resistance to human recombinant DNA insulin are discussed as well as the
      advantage of combined immunosuppressive therapy together with plasmapheresis that
      was used for rapid lowering of insulin daily requirement and anti-insulin
      antibodies titer.

PMID- 8472625
TI  - The effects of subcutaneous human proinsulin on the production of 64/65 split
      proinsulin, glucose turnover and intermediary metabolism in non-insulin-dependent
      diabetic man.
AB  - We have compared the effects of subcutaneously injected human proinsulin, insulin
      zinc suspension and inactive diluent (control) on glucose turnover, intermediary
      carbohydrate and lipid metabolism in non-insulin-dependent diabetic man. Six
      weight-matched (24.8 +/- 1.6 kg M-2) non-insulin-dependent diabetic subjects
      underwent 3 separate, randomized, 10 h isoglycemic clamps. Glucose turnover was
      measured using a primed continuous infusion of [6'6'2H2] glucose. Each subject
      received 0.35 U/kg of hormone or control made up to isovolumetric amounts. The
      mean blood glucose level of 7.3 +/- 0.8 mmol/l was similar at the start of each
      isoglycemic clamp. Incremental area under the curve proinsulin levels (1195 +/-
      146 nmol/l) were about 21-fold higher, on a molar basis, than insulin (62.4 +/-
      10 nmol/l). Des 64/65 split proinsulin increased in a parallel manner to intact
      proinsulin (r = 0.99, P < 0.0001) and comprised approximately 13% of the intact
      proinsulin concentration. Hepatic glucose production was suppressed similarly
      following proinsulin and insulin zinc injection. However, both proinsulin and
      insulin zinc had a significantly greater effect on suppression of hepatic glucose
      production compared to control (P = 0.01, P = 0.009, respectively). Metabolic
      clearance rate of glucose fell significantly during the control studies compared
      to insulin zinc or proinsulin injections (P < 0.05). Blood lactate, pyruvate and
      alanine concentrations were similar following control or hormone injections.
      However blood glycerol, 3-hydroxybutyrate and plasma-non-esterified fatty acids
      were suppressed significantly by proinsulin and insulin zinc compared to control
      injections. The conclusions were: (1) In overnight fasted hyperglycemic non
      insulin-dependent subjects s.c. injections of proinsulin and insulin zinc can
      produce similar effects on glucose turnover, intermediary lipid and carbohydrate
      metabolism. (2) Similar carbohydrate intermediary metabolism profiles can be
      obtained following insulin zinc, proinsulin or control injections. (3) However
      lipolysis and ketogenesis were significantly suppressed by both hormones compared
      to control. (4) Subcutaneous proinsulin injection resulted in approximately 13%
      conversion to des 64/65 split proinsulin.

PMID- 8472626
TI  - Coexistence of diabetes and hypertension results in unique structural alterations
      in the renal artery in rats beyond that found with diabetes alone.
AB  - Numerous investigators have presented evidence of increased mortality in patients
      with diabetes mellitus due to cardiovascular disease. It is still unclear as to
      the reasons why there is a predisposition to vascular pathology that in the
      advanced state leads to atherosclerosis. Our hypotheses were: (1) The condition
      of diabetes mellitus in a streptozocin animal model may show vascular changes
      similar to early pathology in macrovessels and (2) since the model is
      normotensive, inducing hypertension will result in early atherogenic pathology.
      We carried out a quantitative analysis of the renal artery using light and
      electron microscopy to test the hypotheses. Male Wistar rats had diabetes
      mellitus induced using streptozocin and 1 week later half of the diabetic animals
      had hypertension induced with deoxycorticosterone acetate (DOCA). Samples were
      taken following 7 weeks of diabetes, or 7 weeks of diabetes with DOCA
      administration during the final 6 weeks. The renal artery from the diabetic group
      did not have any differences in wall or luminal dimensions from control, but did
      have proportionately more extracellular matrix than smooth muscle in the tunica
      media. This is evidence of structural change, in a large supply artery, as a
      manifestation of diabetes mellitus, similar to that seen in vascular disease.
      Vessels from the control/hypertensive had a significantly thickened tunica media
      as did the diabetic/hypertensive over control values. The latter also had
      proportionately even greater significant elevation of the extracellular matrix
      compared with either the diabetic or control/hypertensive. In addition, only the
      diabetic/hypertensive group showed marked subendothelial invasion of macrophage
      type cells and deposits of various shapes and densities. We have, therefore,
      demonstrated significant vascular alteration due to the diabetic condition in
      this animal models and also shown that with hypertension and diabetes combined,
      the early vascular pathology is exacerbated.

PMID- 8472627
TI  - Mechanism of insulin secretion by midaglizole.
AB  - Midaglizole was introduced as a hypoglycemic agent, but its insulin releasing
      mechanism remains unknown. In the present study, the effect of midaglizole upon
      the B cell function of the pancreas was investigated, using an in situ local
      circulation of the canine pancreas. The graded doses of midaglizole (0.2, 1.0 and
      2.0 mg/kg) revealed a dose-related response of plasma insulin. The administration
      of yohimbine, a classical alpha 2-antagonist (1.11 mg/kg) revealed a similar
      increase in plasma insulin to that with midaglizole of equimolar amount. During
      the clonidine infusion midaglizole did not elicit any significant rise in plasma
      insulin, whereas yohimbine increased plasma insulin significantly. During
      glucagon infusion plasma insulin increased following midaglizole infusion but not
      by yohimbine. The simultaneous administration of diazoxide (K-channel opener)
      suppressed the midaglizole-induced insulin secretion. These results obtained in
      the present experiments revealed a different mechanism of insulin releasing
      action of midaglizole from that of yohimbine. Furthermore, the finding with
      diazoxide administration suggests that midaglizole stimulates insulin release
      through an interaction of K(+)-channel of the pancreatic B-cell.

PMID- 8472628
TI  - Clinical evaluation of biosynthetic glucagon treatment for recovery from
      hypoglycemia developed in diabetic patients. The GL-G Hypoglycemia Study Group.
AB  - Biosynthetic glucagon (GL-G) produced by recombinant DNA technology with
      transformed yeast strains is already available for clinical use. We studied the
      effects of 1 mg GL-G injection on plasma glucose level and hypoglycemic symptoms
      in 38 diabetic patients treated with insulin or oral hypoglycemic agents during
      spontaneous hypoglycemic episodes. In both intramuscularly and intravenously
      administered GL-G groups, plasma glucose significantly increased from 58.1 +/-
      11.4 to 113.2 +/- 6.9 mg/dl (i.m., n = 17, P < 0.01) and from 76.4 +/- 4.4 to
      125.7 +/- 5.9 mg/dl (i.v., n = 15, P < 0.01), respectively 20 min after the
      administration and the symptoms due to hypoglycemia subsided promptly after the
      injection of GL-G in 27 cases. The hyperglycemic effect of intramuscularly
      injected GL-G was more potent and long-standing than when intravenously injected,
      particularly in insulin-dependent diabetic (IDDM) patients. Neither significant
      changes of antibody levels against yeast proteins nor serious adverse effects
      were observed after GL-G administration. Biosynthetic glucagon is safe and useful
      for the treatment of hypoglycemia developing in diabetic patients.

PMID- 8472629
TI  - Self-reported quality of life and the effect of different clinical and
      demographic characteristics in people with type 1 diabetes.
AB  - The aims of the present study were to describe how people with type 1 diabetes
      experienced their quality of life and to examine the effect of the different
      background characteristics of sex, age, social status, education, disease
      duration. HbA1 levels, regimen and the frequency of complications on self
      reported quality of life. A self-administered questionnaire consisting of 28
      items measuring satisfaction within the physical, psychological, social and
      activity/behavioural life-domain and 11 well-being scales was completed by 247
      patients with type 1 diabetes who consecutively attended a Norwegian diabetes
      clinic. Main findings from the study showed that over 80% of patients reported
      their capacity for self-care, general well-being, satisfaction with life and
      social contacts to be quite good or better. Forty five percent of patients
      perceived their life situation to be negatively effected due to diabetes.
      Multivariate analysis showed that living alone had a negative effect on
      satisfaction in the physical, social and psychological life-domain. Higher levels
      of HbA1 were associated with reported lower satisfaction within the physical and
      activity/behavioural life-domain. The effect of the different background
      characteristics on reported well-being showed no consistent pattern. These
      findings indicate that the majority of patients in this study experienced a
      satisfactory quality of life despite living with a chronic illness such as
      diabetes.

PMID- 8472630
TI  - Immunoprotection in spontaneous remission of type 1 diabetes: long-term follow-up
      results.
AB  - This prospective pilot study was undertaken to test the efficacy of oral methyl
      prednisolone (MP) therapy at spontaneous remission phase of type 1 diabetes in
      intervening the course of the disease. Twenty-five type 1 diabetic patients who
      were classified as having a spontaneous remission (honeymoon) were divided into
      treatment and non-treatment groups on voluntary basis. Fifteen patients thus
      making up the treatment group (13 males and 2 females, mean age 23.8 +/- 6.2
      years) received 0.7-1.0 mg/kg/day of MP p.o. for 2 weeks. The dose of the drug
      was then gradually diminished every week until 5 mg/day (approx. 0.1 mg/kg/day)
      and discontinued at 10 +/- 2 weeks. In case of hyperglycemia occurring in 12 of
      15 patients due to the administration of steroid, insulin was used to normalize
      blood glucose levels (average 0.47 +/- 0.21 IU/kg/day). The non-treatment group
      (8 males and 2 females, mean age 21.8 +/- 8.9) did not receive any special
      medication or placebo except for insulin whenever necessary to regulate glycemia.
      Upon completion of protocol, all patients in treatment group displayed clinical
      remission with 10 still in non-insulin requiring remission for follow-up periods
      ranging between 16 and 91 months. The remaining 5 patients relapsed within 3-15
      months of therapy. Other metabolic (including basal and stimulated C-peptide
      levels) and immunological indices that have spontaneously ameliorated with the
      occurrence of honeymoon were also maintained within normal range in the NIR
      patients. Meanwhile, natural remission in the non-MP-treated group terminated at
      3.4 +/- 0.6 months with deterioration of all metabolic and immunological markers
      as well as increasing requirements for insulin. In conclusion, the spontaneous
      remission of the patients could be prolonged significantly by MP therapy as
      opposed to no therapy (P < 0.001). These results suggest that the spontaneous
      remission phase may be a crucial point of intervention in immunotherapy of type 1
      diabetes and that randomized trials with MP at this particular phase would be
      worthwhile.

PMID- 8472631
TI  - The effects of participation in a support group on self-assessed quality of life
      in people with insulin-dependent diabetes mellitus.
AB  - The aim of the present study was to examine the effect of participation in a
      support group on self-assessed quality of life. Based on an initial self-report
      assessment of quality of life 25 people were allocated to 5 groups comprising 4-6
      participants (intervention group) and 36 controls. The support groups met fort
      nightly for 6 months and were facilitated by the investigator and a diabetic
      nurse specialist. Group processes were aimed at alleviating distress and improve
      satisfaction with life and included installation of hope, imparting information
      and group cohesiveness. Both the intervention and control group completed the
      quality of life measure at the end of 6 months. There were no significant
      differences between the intervention and control group on background
      characteristics or quality of life pre-test scores. No significant differences
      were found between the intervention and control group on difference in pre and
      post-test scores, indicating that support group participation did not effect self
      assessed quality of life. This finding may be due to methodological issues i.e.
      selection, sample size and the instrument used, the implementation of the
      intervention and/or the concept of quality of life as an outcome variable.

PMID- 8472632
TI  - Conflicting gastric inhibitory polypeptide data: possible causes.
AB  - The literature with respect to GIP is flooded with conflicting data especially
      with respect to its role in type 2 diabetes mellitus, obesity, type 1 diabetes
      mellitus and chronic pancreatitis. This review describes possible reasons for the
      discrepancies which include species variation of GIP, heterogeneity of molecules
      with different immunoreactivity and bioactivity, deterioration of
      immunoreactivity of standard and sample on prolonged storage and the effect of
      the preceding intake of type and quantity of food. The problems can be resolved
      by raising antibodies to synthetic human GIP and its fragments, the chemical
      characterization of and the raising of antibodies to immunoreactive GIP 8000, the
      correct storage of samples and the standard preparation of subjects prior to
      experimental procedures.

PMID- 8472633
TI  - [Radiofrequency ablation of accessory pathways in pre-excitation syndrome].
AB  - Various parameters relating to the radio-frequency ablation of accessory pathways
      were studied in 53 patients (27 males, 26 females: mean age 38.5 [14-64] years)
      with a history of paroxysmal tachycardia (over 1 month to 50 years), shown to be
      caused by an accessory pathway (Wolff-Parkinson-White syndrome). In all patients
      the following values were obtained: (1) number of procedures necessary to achieve
      permanent blockage of the accessory pathway (1-4); (2) duration of each procedure
      (45-420 min); (3) duration of fluoroscopy (5-102 min); (4) number of necessary
      radio-frequency applications (1-48); and (5) cumulative energy per procedure. To
      ablate left-lateral pathways (n = 10) required fewer procedures, shorter duration
      per procedure, shorter fluoroscopy time, fewer current applications and less
      total energy than coagulation of right-sided pathways (n = 10). Those various
      parameters were greatest for ablation of septal and para-septal pathways (n = 9).
      Pathways which conducted only retrogradely (n = 15) were more difficult to ablate
      than those with anterograde conduction (n = 38). There were two complications. In
      one case a tension pneumothorax occurred after faulty puncture of the subclavian
      vein; in the other, the left ventricle was perforated causing an acute tamponade
      which required pericardiocentesis with subsequent suture closure of the
      perforation. It is concluded that, in principle, all accessory pathways,
      regardless of their conduction potential and site, can be ablated by a radio
      frequency current.

PMID- 8472634
TI  - [Improvement of coronary reserve following regression of hypertrophy resulting
      from blood pressure lowering therapy with a beta-receptor blocker].
AB  - The coronary microcirculation was investigated by the argon gas method in ten
      patients (eight men, two women; mean age 56 [44-63] years) before and after an
      average of 12.9 (9-18) months of treatment with the cardioselective beta-receptor
      blocker bisoprolol. Left ventricular muscle mass was measured
      echocardiographically, before and after the treatment. All these patients were
      known to have hypertension, with exercise-related angina and ischaemic signs in
      the resting ECG, but normal coronary angiograms. After the treatment period both
      maximal coronary perfusion and coronary reserve had increased by 22%. At the same
      time, left ventricular muscle mass had decreased from 161 +/- 18 to 146 +/- 21
      g/m2. These results demonstrate that blood pressure reducing treatment can bring
      about not only a regression of left ventricular hypertrophy, but also an
      improvement in coronary reserve.

PMID- 8472635
TI  - [Abdominal aortitis in polymyalgia rheumatica. Disease course as documented with
      computerized tomography and proton spin tomography].
AB  - In a 59-year-old woman, after four years of ambiguous and unidentified course of
      her disease (feeling of weakness, inappetence, weight loss, pain in the shoulder
      girdle, sub-febrile temperatures, increased BSR), polymyalgia rheumatica was
      eventually diagnosed. The findings at the abdominal aorta were particularly
      marked: sonography revealed a 10 mm wide echo-poor fringe around the aorta which
      in the computed tomogram became slightly more echogenic after injection of
      contrast medium. In the magnetic resonance tomogram (MR) the aortic wall was
      homogeneously thickened and well-defined against the retroperitoneal tissue.
      Subsequent to the diagnosis a therapy with glucocorticoids was initiated and
      strictly continued for by now 18 months. This resulted in long-term clinical
      remission. CT and MR proved highly suitable for long-term monitoring (> 5 years).

PMID- 8472636
TI  - [Diagnostic advantage of biplane trans-esophageal echocardiography].

PMID- 8472637
TI  - [Isolated systolic hypertension in old age].

PMID- 8472638
TI  - [Exceeding of speed limit by physicians responding to emergencies. Decision by
      the Bavarian Supreme Assize Court on 10-1-1990].

PMID- 8472639
TI  - [Colonoscopy using contrast media].

PMID- 8472640
TI  - [Epidemiologic studies of C. bovis and T. saginata infections in eastern and
      western Germany].
AB  - An investigation on the epidemiological situation of cysticercosis/taeniasis
      (Taenia saginata--GOEZE, 1782) showed clear differences in the proportion of
      cattle infected with C. bovis in the eastern and western part of Germany. Reasons
      for the high level of the C. bovis infection in the former GDR are a bad waste
      water situation and an increased intensification of agriculture (high
      concentration of cattle, increased irrigation).

PMID- 8472641
TI  - [Trace element supply of newborn calves. Effect of the mother and of the genetic
      makeup, sex and degree of maturity of the newborn].
AB  - Stillborn calves of a large dairy cattle herd were used for investigations of
      trace element (Fe, Zn, Cu, Mn) content of the liver and heart muscle. Trace
      element content varied markedly in the liver and in the heart muscle too but in
      the heart muscle with a smaller degree. Calves from heifers had a greater trace
      element content in the liver and heart muscle than those from cows. Premature
      calves had small amounts of Mn and Cu in their livers and small but term calves
      had less Fe and Zn in their livers. Single calves from cows had a greater amount
      of trace elements in the liver and heart muscle than twin calves.

PMID- 8472642
TI  - Liquid storage and freezing of semen from New Forest and Welsh Pony stallions.
AB  - Two experiments were conducted to examine the effects of liquid storage extender
      and of a modified freezing protocol on motility and morphology parameters of 3
      year-old pony stallions. In experiment 1 ejaculates were diluted 1 + 1 (v+v) with
      glycine-egg-yolk extender (D11) or skim milk extender (SME), centrifuged,
      resuspended in the corresponding extender and kept at +5 degrees C. Concerning
      motion characteristics, both progressive motility and average path velocity of
      semen stored in SME was significantly superior to semen stored in D11 after 6, 18
      and 42 hrs. However, over time of storage the D11 seemed to have more beneficial
      effect on sperm morphology and acrosome integrity compared to SME. In experiment
      2 ejaculates--after centrifugation in D11--were resuspended in lactose-egg-yolk
      glycerol extender, packaged in 0.5 ml straws and frozen at computer controlled
      cooling rates. There was a significant decrease from fresh to post thaw motility,
      velocity and percentage of morphologically normal spermatozoa, whereas acrosome
      morphology not seemed to be affected by freezing/thawing.

PMID- 8472643
TI  - [Basic reproductive toxicological studies of the effect of furazolidone on the
      hypothalamo-hypophyseo-gonadal axis of male rats].
AB  - The reproductive-toxic effects of furazolidone on testis, epididymis and selected
      nuclei of the hypothalamus of male wistar rats were investigated. After a dosage
      of 50 mg/kg b.w. daily over five days no changes of testis and epididymis were
      detected in relation to controls by means of light microscope. Using morphometric
      methods a significant increase of the nucleus volume of the measured nuclei of
      the hypothalamus (Ncl. ventromedialis, Ncl. praeopticus medialis, Ncl.
      infundibularis) could be shown. After the high dosage of 200 mg/kg b.w. daily for
      five days testis and epididymis showed marked signs of atrophy and the volume of
      the investigated nuclei of the hypothalamus was significantly increased. These
      results suggest that--contrary to the wide spread opinion the testis would react
      most sensitive to chemical agents--more attention should be directed to the
      hypothalamus in reproductive-toxicological studies.

PMID- 8472644
TI  - [Testing of rapeseed with different glucosinolate contents in growing swine--a
      contribution for the evaluation of native harmful substances in food].
AB  - Glucosinolates are present in kale but also in rapeseed meal. Rapeseed meal diets
      with 0.2 to 8 g (0.5-19 mmol) glucosinolates/kg were tested with a total of 197
      growing pigs. The iodine supply was different. In case of lacking iodine pigs
      consumed less of feed with rapeseed meal. The growth was strongly lowered.
      Clinical hypothyroidism had occurred. In the serum T4 was not detectable. The
      strongly enlarged thyroid contained only little iodine. The Zn status was
      impaired. The serum vitamin A concentration was increased and Cu has been
      accumulated in the liver. Giving iodine the glucosinolates were without any
      effect or the effects were weakened. In case of < 2 g glucosinolates/kg diet the
      feed intake was not impaired. 1 g glucosinolates/kg diet had not affected thyroid
      weight (reference range: 80-120 mg/kg body weight). However iodine dosage was
      above requirement. In people an estimated daily intake of 0.1 g glucosinolates
      may be a health risk only under iodine deficiency conditions.

PMID- 8472645
TI  - [Comparison of EBL cells and ELISA in the culture and serological diagnosis of
      rhinitis atrophicans in swine].
AB  - Pasteurella multocida isolates from 271 nasal swabs of pigs were tested in EBL
      cell culture for toxin production. Mixed bacteria cultures of the same swabs were
      examined in the P. multocida toxin ELISA K462 (Dakopatts). In the ELISA 114 swabs
      reacted positive, whereas toxigenic P. multocida were detected by the EBL cell
      test in 86 swabs. In a neutralization test (SNT) combined with EBL cell culture
      and with the ELISA 111 sera were examined for P. multocida antitoxin. The toxin
      had to be more concentrated for the ELISA than for the cell culture; therefore
      the SNT with EBL cells was more sensitive. Whereas 101 sera had titres of 1:4 or
      higher in the cell culture, 68 of these sera were positive in the ELISA.

PMID- 8472646
TI  - Human studies do not support the methylation threshold hypothesis for the
      toxicity of inorganic arsenic.
AB  - Inorganic arsenic (In-As) is an established human carcinogen. Methylation to
      monomethylarsonate (MMA) and dimethylarsinate (DMA) is believed to be the
      detoxification mechanism for In-As. Urinary measurement of In-As, MMA, and DMA is
      considered a good biological marker of internal dose to In-As, since it excludes
      other ingested forms of arsenic which are much less toxic, and because urinary
      excretion is the main form of elimination of In-As. A methylation threshold
      hypothesis for In-As has been proposed, stating that after exposure to In-As
      reaches a certain level or threshold, methylation capacity begins to decline,
      thus increasing the toxic effects of In-As. We investigated the validity of this
      hypothesis by analyzing the data from studies which measured urinary In-As, MMA,
      and DMA in different populations, ranging from background to high occupational
      and environmental exposure groups. We also present data from our study of a
      highly exposed population in California. Our analysis focused on the proportion
      of urinary In-As remaining in the unmethylated form [In-As/(In-As + MMA + DMA)].
      The results indicate that epidemiological and experimental human data do not
      support the methylation threshold hypothesis. On average, 20-25% In-As remains
      unmethylated regardless of the exposure level. The wide range of interindividual
      variability in methylation capacity found in some studies warrants further
      investigation.

PMID- 8472647
TI  - Ozone effect on respiratory syncytial virus infectivity and cytokine production
      by human alveolar macrophages.
AB  - This study was performed to evaluate the effect of ozone (O3) exposure at 1 ppm
      for 2 hr on the susceptibility/resistance of adult human alveolar macrophages
      (AM) to infection with respiratory syncytial virus (RSV) in vitro and on RSV
      induced cytokine production by the AM. AM were first exposed to O3 or to filtered
      air and then infected with RSV at multiplicities of infection (m.o.i.) of 0.1,
      1.0, and 10. The percentage RSV-infected AM and the amount of infectious virus
      released by the cells were determined at Days 2 and 4 after infection.
      Interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF) levels in the
      supernatants were determined on Day 2. No difference in the percentage infected
      AM or in the amount of infectious RSV produced was found between control and O3
      exposed cultures. However, O3-exposed AM infected with RSV at m.o.i. 1 produced
      less IL-1 in response to RSV infection than control AM: 63.6 pg/ml compared with
      98.5 pg/ml. No difference in IL-1 was seen with m.o.i. 10. IL-6 levels were also
      decreased, but only after infection with m.o.i. 0.1. At this level of infection
      830 pg/ml was produced by control AM as compared to 468.2 pg/ml by O3-exposed AM.
      TNF production was unaffected by O3 at all multiplicities of infection.
      Statistical analysis of the O3 effect on AM cytokine production induced by the
      different multiplicities, however, revealed no significant effect of O3. Based on
      these observations it appears unlikely that O3 alters susceptibility of AM to
      infection with RSV, nor does O3 dramatically alter cytokine production in
      response to RSV since effects on IL-1 and IL-6 secretion were only found with the
      lowest levels of infection which induced cytokine release.

PMID- 8472648
TI  - Airborne endotoxin concentrations in various work areas within a cotton mill in
      Central America.
AB  - Gram-negative bacteria and their endotoxins have been shown to cause profound
      changes in the structure and function of mammalian lungs. Airborne exposures in
      humans have resulted in bronchoconstriction and symptoms of chest tightness and
      dyspnea. Cotton dust is often heavily contaminated and endotoxin has been
      postulated to be the agent in cotton dust which is responsible for the byssinosis
      syndrome. Previous studies of cotton dust have revealed variable amounts of
      contamination by bacterial endotoxin, with the variability determined in large
      part by botanical and climatic characteristics. We report here the results of an
      environmental study conducted in a cotton mill located in the tropics of Central
      America using locally grown cotton. Results indicate that airborne endotoxin was
      present in all yarn preparation and weaving areas and ranged from a low of 18
      EU/m3 in weaving to a high of 3138 EU/m3 in opening areas. Airborne levels and
      the amount of endotoxin per nanogram of dust were not higher than values obtained
      in temperate climates.

PMID- 8472649
TI  - Occupational health issues in developing countries.

PMID- 8472650
TI  - Evaluation of brain function in acute carbon monoxide poisoning with
      multimodality evoked potentials.
AB  - The median nerve somatosensory evoked potentials (SEP), pattern reversal visual
      evoked potentials (VEP), and brain stem auditory evoked potentials (BAEP) were
      studied in 109 healthy adults and in 88 patients with acute carbon monoxide (CO)
      poisoning. The upper limits for normal values of peak and interpeak latencies of
      multimodalities of evoked potentials in the reference group were established by a
      stepwise multiple regression analysis. SEP changes selectively affecting N32 and
      N60 were found in 78.8% of patients. There was prolonged P100 latency of VEP in
      58.2% of the cases examined. The prevalence of BAEP abnormalities in comatose
      patients (36%) was significantly higher than that (8.6%) in conscious patients.
      BAEP abnormalities were most frequently seen in comatose patients who had
      diminished brain stem reflexes (77.8%). It has been found that a consistent
      abnormality involving N20 and subsequent peaks in SEP, a remarkable prolongation
      of P100 latency in VEP, or a prolongation of III-V interpeak latency in BAEP as
      well as the reoccurrence of evoked potential abnormalities after initial recovery
      all indicate unfavorable outcomes in patients with acute CO poisoning. The
      multimodality evoked potentials have proved to be sensitive indicators in the
      evaluation of brain dysfunction and in the prediction of prognosis of acute CO
      poisoning and the development of delayed encephalopathy.

PMID- 8472651
TI  - A study on the neurobehavioral effects of occupational exposure to organic
      solvents in Korean workers.
AB  - In order to investigate the neurobehavioral effects in workers occupationally
      exposed to organic solvents in Korea using WHO neurobehavioral core test battery
      (NCTB), a cross-sectional study of 113 male car painters and printers and 81
      controls was conducted. Among the seven tests of the NCTB, only four tests-
      simple reaction time, Santa Ana dexterity, digit symbol, and Benton visual
      retention tests--were administered to the subjects because of time limitations.
      Painters and printers were exposed mainly to toluene, xylenes, and methyl ethyl
      ketone and often to solvent mixtures. The range of the solvent exposure level was
      0.10-2.29 of hygienic effect. Poorer performance of Benton visual retention in
      the exposed group when compared to the control group was found after controlling
      confounders. No exposure-dependent effect was found. Further investigation with a
      matched control group regarding confounding factors is required for conclusive
      results.

PMID- 8472652
TI  - Axonal sprouting of motor nerve in acrylamide-intoxicated rats with progressive
      weakness.
AB  - Quantitative morphologic studies on the motor axons in endplates of extensor
      digitorum longus muscle (EDL M) and soleus muscle, and on the myelinated fibers
      of the nerve to EDL M and other lower limb nerves were made on rats showing
      progressive weakness, intoxicated with acrylamide for 4 weeks (test), using
      silver staining. Terminal sproutings were significantly greater in frequencies in
      test compared with control in both muscles. In addition, morphologic changes in
      test consisted of a significant increase in the number of axon terminal branches
      and in the frequency of swellings of the preterminal, terminal, and ultraterminal
      axons and in an increase of myelinated fibers showing axonal degeneration in the
      nerve to EDL M. Such findings were in contrast with the previous report that
      cumulative doses of acrylamide inhibit sprouting of motor axons in endplates.

PMID- 8472653
TI  - Polyneuropathy due to ethylene oxide, propylene oxide, and butylene oxide.
AB  - Axonal neuropathy occurs due to occupational ethylene oxide (EtO) exposure. The
      experimental model of human EtO neuropathy was established. In addition, the
      neurotoxic effects of propylene oxide (PpO) and butylene oxide (BtO) were
      demonstrated in rats. Although no human neuropathy due to PpO or BtO is reported,
      both chemicals must be considered to be neurotoxic, based on this study.

PMID- 8472654
TI  - Significance of subclinical entrapment of nerves in lead neuropathy.
AB  - We examined a left-handed 25-year-old man engaged for 2 years at a vinyl chloride
      resin factory where he had been exposed to lead stearate, a stabilizer of resin.
      Neurological examination revealed atrophy of small hand muscles, especially in
      the left dorsal interossei. Sensation of all modalities was intact. A nerve
      conduction study showed conduction block at the elbow, indicating possible
      cubital tunnel syndrome. Following CaEDTA therapy, continued recovery of
      conduction velocities, amplitude of compound muscle action potential, and
      diminution of conduction block at elbow were observed within a few months. In
      lead intoxication, nerves may incur mechanical damage. Subclinical entrapment may
      thus be an important factor leading to vulnerability of nerves in lead
      neuropathy.

PMID- 8472655
TI  - Evaluation and control of mercury vapor exposure in the cell house of chlor
      alkali plants.
AB  - A pilot study was carried out in the cell houses of three chlor alkali plants to
      assess level of exposure to mercury vapors among workers by air and biological
      monitoring. Overall airborne mercury concentrations (mg/m3) were found to range
      from 0.05 to 0.42 (mean, 0.21, n = 68), 0.03 to 0.16 (mean, .08, n = 49), and
      0.02 to 0.17 (mean, 0.04, n = 26), whereas urinary mercury levels (mg/liter) of
      the exposed workers of the respective plants ranged from 0.076 to 0.592 (mean,
      0.207, SD, 0.107, n = 19), 0.015 to 0.220 (mean, 0.070, SD, 0.054, n = 16), and
      0.013 to 0.275 (mean, 0.06, SD, 0.054, n = 23). Unattended mercury spillage on
      the floor and improper sealing of the lids of the end boxes of electrolysis cells
      were found to be main factors attributing to prevalence of mercury vapors in
      excess of the permissible exposure limit of 0.05 mg/m3. Based on the deficiencies
      observed, appropriate control measures have been suggested to reduce airborne
      mercury vapor concentrations in the work environment.

PMID- 8472656
TI  - Studies on neurolathyrism.
AB  - Neurolathyrism is a neurological condition seen among people who eat the seeds of
      Lathyrus sativus (LS) as a principal source of food energy for 2 months or more.
      It is characterized by severe muscular rigidity and paralysis of the lower limbs.
      beta-N-Oxalyl-L-alpha,beta-diaminopropionic acid is the principal toxin found in
      the seed. No experimental animal model for neurolathyrism could be produced by
      feeding either the seeds or the toxin, although the condition has been known for
      centuries. We discovered that experimental neurolathyrism could be produced in
      guinea pigs and primates that needed an external supply of ascorbic acid by
      making them subclinically deficient in ascorbic acid and feeding them the seeds
      of LS or extracts thereof. Autoclaving the seeds of LS with lime removes the
      toxin.

PMID- 8472657
TI  - Neurobehavioral effects in occupational chemical exposure.
AB  - Neurobehavioral effects in 30 female workers (aged 18-41, mean 25.6) exposed to
      an average of 341 mg/m3 (SD 100) toluene for an average of 5.7 years (SD 3.3)
      compared with 30 matched controls (aged 18-48, mean 25.1), 24 male workers (aged
      18-32, mean 24.7) exposed to 268 mg/m3 (SD 185) toluene equivalent of mixed
      solvent (82.2% toluene, 12.3% ethyl acetate, and 5.5% methyl ethyl ketone) for
      2.3 years (SD 3.0) compared with 24 matched controls (aged 17-31, mean 24.3), and
      94 dentists (aged 24-49, mean 31.7) exposed to 0.017 mg/m3 (SD 0.009) of
      elemental mercury for 7.4 years (SD 5.3) compared with 54 referents (aged 23-50,
      mean 33.6) were studied. The Z score (made up of Digit Span, Symbols Digit, and
      Grooved Peg Board) for the workers exposed to toluene was 0.79, for workers
      exposed to mixed solvents was 0.38, and for the dentists exposed to mercury was
      0.42. The Z score for each group of exposed subjects was statistically poorer
      than that for its controls. Neurobehavioral performance was statistically related
      to exposure intensity for the toluene-exposed workers and to years of exposure or
      dose (exposure intensity x years of exposure) for mixed solvent- and mercury
      exposed subjects. The type of chemical species and pattern of exposure appear to
      influence whether the adverse effects will be cumulative.

PMID- 8472658
TI  - Dose-dependent increase in subjective symptoms among toluene-exposed workers.
AB  - A factory survey on dose-response relationship in toluene toxicity was conducted
      in 1985-1989 in four cities in China. The examination items consisted of personal
      diffusive sampling for TWA exposure measurement, questionnaires on subjective
      symptoms, hematology and serum biochemistry, and clinical examination including
      simple neurology tests. Hippuric acid was also determined in urine samples
      collected at the end of the shift. With selection criteria that (1) complete
      results were available on all study items and (2) valid toluene exposure data
      (i.e., toluene shared 90% or more of the exposure) were obtained for the exposed,
      452 toluene-exposed workers (206 men and 246 women; toluene exposure at 24.7 ppm
      as GM) and 517 nonexposed controls (246 men and 271 women) were selected. The
      subjective symptoms increased in close association with the intensity of exposure
      to toluene; the threshold concentration appeared to exist at 100 ppm in the case
      of symptoms during work, and it might be at 50-100 ppm when symptoms off work
      were evaluated. During the work with exposure at higher concentrations, various
      symptoms possibly related to CNS or local effects (e.g., eyes, nose, and throat)
      were complained, and dizziness and floating sensations were identified as typical
      symptoms with significant dose-response relationship. Several symptoms persisted
      off work, most of which were apparently related but not necessarily limited to
      CNS effects. Hematology and serum biochemistry were essentially negative.

PMID- 8472659
TI  - Change in hen sciatic nerve calcium after a single oral dose of tri-o-tolyl
      phosphate.
AB  - Six trace elements were monitored in neural tissue homogenates from White Leghorn
      hens orally dosed with tri-o-tolyl phosphate (TOTP) or tri-m-tolyl phosphate
      (TMTP) (200 mg/kg). Treated birds were monitored daily for development of delayed
      neurotoxicity, and concentrations of calcium, copper, iron, magnesium, manganese,
      and zinc were measured with atomic absorption spectroscopy at the time of maximal
      locomotor impairment (27-35 days postdosing). TOTP-treated birds manifested motor
      deficit by 15 days postdosing, while hens administered TMTP exhibited no signs of
      delayed neurotoxicity. Total calcium content in the sciatic nerve homogenates
      from TOTP-dosed hens was significantly less (P < 0.05) at the time of maximal
      locomotor impairment, while no shifts in the other trace elements were found.
      Therefore, the ortho isomer of tritolylphosphate elicited symptoms of delayed
      neurotoxicity in the hen (i.e., organophosphorus ester-induced delayed
      neurotoxicity or OPIDN) and caused a decrease in total calcium content in the
      sciatic nerve homogenates, in contrast to effects of the meta isomer. Analysis of
      neural homogenates at time of maximal locomotor impairment reflected secondary
      events in the degradative processes, since the initial assault of TOTP happens
      early after administration. Therefore, at fully developed OPIDN alteration of
      calcium balance in sciatic nerves is an indicator of axonopathy in a degenerated
      nerve following chemical injury.

PMID- 8472660
TI  - Three-dimensional brain metabolic imaging in patients with toxic encephalopathy.
AB  - Thirty-three workers, ages 24 to 63, developed clinical toxic encephalopathy
      after exposure to neurotoxins and were studied by SPECT brain scans. Five were
      exposed to pesticides, 13 were acutely exposed to mixtures of solvents, 8 were
      chronically exposed to mixtures of hazardous wastes that contained organic
      solvents, 2 were acutely exposed to phosgene and other toxins, and 5 had
      exposures to hydrogen sulfide. Twenty-nine had neuropsychological testing and all
      had a medical history and physical. Of the workers who had a clinical diagnosis
      of toxic encephalopathy, 31 (93.9%) had abnormal SPECT brain scans with the most
      frequent areas of abnormality being temporal lobes (67.7%), frontal lobes
      (61.3%), basal ganglia (45.2%), thalamus (29.0%), parietal lobes (12.9%),
      motorstrip (9.68%), cerebral hemisphere (6.45%), occipital lobes (3.23%), and
      caudate nucleus (3.23%). Twenty-three out of 29 (79.3%) neuropsychological
      evaluations were abnormal. Other modalities when performed included the following
      percentages of abnormals: NCV, 33.3%; CPT sensory nerve testing, 91.3%;
      vestibular function testing, 71.4%; olfactory testing, 89.2%; sleep EEG analysis,
      85.7%; EEG, 8.33%; CT, 7.14%; and MRI brain scans, 28.6%. The complex of symptoms
      seen in toxic encephalopathy implies dysfunction involving several CNS regions.
      This series of patients adds to the previous experience of brain metabolic
      imaging and demonstrates that certain areas of the brain are typically affected
      despite differences in toxin structure, that these lesions can be globally
      defined by SPECT/PET brain scans, that these lesion correlate well with clinical
      and neuropsychological testing, and that such testing is a useful adjunct to
      previous methods. EEG and structural brain imaging such as CT and MRI are
      observed to have poor sensitivity in this type of patient. Additional metabolic
      imaging studies need to be done to explore dose, time, and specific toxin effects
      as well as mechanisms of toxicity and olfactory migration.

PMID- 8472662
TI  - A reproducible trigger for the measurement of trigeminal latencies elicited by a
      glabellar tap.
AB  - In order to develop a screening test of trigeminal latencies which could be used
      in the field, a stimulator which delivered a "tap" consisting of a focused puff
      of air to the glabella was compared with a tap delivered by means of a
      lightweight hammer with a piezoelectric trigger similar to that described by
      Shahani (Shahani and Young, 1972, Neurology 22, 149-154). Results were similar
      for both methods although the mechanical tap failed to elicit a response from the
      left side in one subject. The benefit of the air tap is in the reproducible force
      of the tap and better aim than is possible with the hammer.

PMID- 8472661
TI  - Psychological effects of low exposure to mercury vapor: application of a computer
      administered neurobehavioral evaluation system.
AB  - A computer-administered neurobehavioral evaluation system in a Chinese language
      version (NES-C) and a mood inventory of the profile of mood states (POMS) were
      applied to assess the psychological effects of low-level exposure to mercury
      vapor in a group of 88 workers (19 males and 69 females, with mean age of 34.2
      years) exposed to mercury vapor (average duration of exposure 10.4 years). The
      well-matched group of 97 nonexposed workers was treated as the control. The
      intensity of current mercury vapor was relatively mild as reflected by the
      average level of mercury in the air of the workplace (0.033 mg/m3) and in urine
      (0.025 mg/liter). The results indicated that the profile of mood states posed was
      moving to the negative side in Hg-exposed group and most of the NES-C
      performances, in particular, the mental arithmetic, two-digit search, switching
      attention, visual choice reaction time, and finger tapping, were also
      significantly affected compared with those obtained from controls (P < 0.05
      0.01). The present study and the previous study on the validation of the system
      suggest that the NES-C we developed is valid for the neurotoxicity screening
      among the working population exposed to neurotoxic agents.

PMID- 8472663
TI  - Pulmonary function in asbestosis and asbestos-related pleural disease.
AB  - This review begins with the classic physiologic syndrome of interstitial lung
      disease (ILD) described in established asbestosis in the 1950s: reduced VC and
      pulmonary compliance, maintenance of airflow (measured indirectly), decreased
      diffusing capacity (a laborious undertaking in those years), and
      hyperventilation, increased dead space (VD/VT), and desaturation on exercise.
      Small airways dysfunction (SAD) was recognized in the 1960s and 1970s as the
      physiologic counterpart of the early peripheral bronchiolar inflammatory and
      fibrotic narrowing reported in experimental animals and in asbestos workers. SAD
      is nonspecific and is often overshadowed by more severe obstruction caused by
      smoking or by the countervailing effects of increased lung recoil caused by
      interstitial fibrosis. Airtrapping secondary to SAD may explain some of the
      reduction in VC in asbestos exposed workers whose FEV1/FVC is normal. There may
      be a greater frequency of obstructive airways disease in asbestos workers who
      smoke than in other smokers, suggesting an interaction between these two noxious
      inhalants. An interaction is seen in the greater frequency and severity of
      radiographic asbestosis in smokers at equivalent durations of exposure and in the
      greater reduction in FVC in smokers at equivalent ILO profusion scores. The
      functional importance of PT is well documented by lower values for FVC at
      equivalent profusions of parenchymal disease. This is true of circumscribed PT
      but much more so of diffuse PT, which can occasionally result in ventilatory
      failure and death. Incremental exercise testing often reveals evidence of
      excessive ventilation and abnormal gas exchange (VD/VT) attributable to ILD, when
      standard tests of pulmonary function and chest radiography are normal. These
      abnormalities help explain dyspnea in such patients.

PMID- 8472664
TI  - Acute and chronic neurological symptoms among paint workers exposed to mixtures
      of organic solvents.
AB  - The purpose of this study was to determine the prevalence rates of acute and
      chronic neurologic symptoms among paint workers and the association of such
      symptoms with the severity of exposure to mixtures of solvents. Two paint
      manufacturing factories and 25 various kinds of spray painting factories were
      selected for study. Air concentrations of organic solvents were measured by
      personal samplers and were analyzed by gas chromatography. A total of 196 workers
      were given a screening neurological examination and a questionnaire on acute and
      chronic neurologic symptoms. A detailed personal medical history and a profile on
      alcohol consumption and medication were also included. The results showed that
      xylenes and toluene were the major solvents found in almost all the air samples
      with average contents of 50 and 24% on a weight basis of 73 air samples. We
      classified workers according to different exposure patterns and different air
      concentrations of breathing zones: high (8-hr hygienic effect, 0.25-9.86; median,
      1.66), short-term high (hygienic effect, 0-3.38; median, 0.12), and low (hygienic
      effect, 0-0.38; median, 0.12). All workers showed no overt neurological signs
      such as ataxic gait, poor coordination, or muscle weakness. After excluding those
      workers who consumed more than 280 g of alcohol per week (n = 8), took
      antihypertensive medications (n = 4), or were treated with antipsychotic agents
      (n = 1), we found that the severity of exposure was associated with acute
      symptoms of headache and chest tightness and chronic symptoms of dizziness, easy
      fatigability, depressed mood, and palpitation. There was no association between
      peripheral neurological symptoms and the severity of exposure. Workers in the
      high exposure group were 2.7 times more likely to develop two or more acute
      symptoms and 3.3 times more likely to develop three or more chronic symptoms of
      the central nervous system than the low exposure group. After modeling by
      multiple logistic regression, we concluded that exposure to a medium level of
      mixtures of solvents (hygienic effect exceeding 1.66) may produce acute and
      chronic central neurological symptoms.

PMID- 8472665
TI  - Magnetic resonance imaging (MRI), neurobehavioral testing, and toxic
      encephalopathy: two cases.
AB  - The objective of this investigation was to examine cerebral magnetic resonance
      imaging (MRI) pathology and functional deficits demonstrated by
      neuropsychological testing in cases of toxic encephalopathy. Two subjects,
      occupationally exposed to toxic chemicals, were studied. As part of their
      neurological assessment, MRI was done and each underwent a neuropsychological
      battery for patients with toxic exposures (White et al. Clin. Neuropharmacol.
      13(5), 392-412, 1990). In Case 1, who was exposed to inorganic mercury, MRI
      showed mild central and cortical atrophy. Punctiform foci (T2) were noted in both
      frontal regions underlying the precentral gyri and in the subcortical myelin.
      Neuropsychological testing showed problems in cognitive flexibility, cognitive
      tracking, inhibiting perseveration, fine manual motor coordination, visuospatial
      analysis and organization, memory, and affect and personality. In Case 2, who was
      exposed to 2.6-dimethyl-4-heptanone, MRI showed multiple small foci in the white
      matter and pons. Neuropsychological testing indicated affective changes, deficits
      in manual motor speed, verbal fluency, visuospatial organization, and short-term
      memory. Lack of aphasia in patients with toxic encephalopathy indicates that
      neurotoxins probably affect subcortical and mesial temporal structures more than
      cortical gray matter. These MRI studies show subcortical sites of pathology.

PMID- 8472666
TI  - Covariates of computerized neurobehavioral test performance in epidemiologic
      investigations.
AB  - Computerized neurobehavioral tests are being used increasingly in occupational
      and environmental health to measure potential effects of exposure to
      neurotoxicants. Many factors affect performance on these tests. Data sets from
      application of a computerized neurobehavioral evaluation system in epidemiologic
      investigations of two occupational groups, printing pressmen and construction
      painters, were analyzed. Age and education were the major covariates of
      performance in these groups. The reliability of these computerized tests was also
      reviewed. Computerized neurobehavioral tests are similar to conventional tests in
      terms of reliability and relationships to known covariates.

PMID- 8472667
TI  - Occupational exposure to neurotoxicants: preliminary survey in five industries of
      the Camacari Petrochemical Complex, Brazil.
AB  - The Camacari Petrochemical Complex (CPC) is the biggest and most important
      industrial complex of the northeastern region of Brazil. At present, its 54
      companies employ directly and indirectly about 50,000 people. Used there as
      solvent and raw material, compounds such as benzene and its homologues n-hexane,
      haloalkanes, and some alcohols have as their prime targets the central and
      peripheral nervous systems. Despite widespread use of these chemicals, the
      workers are little aware of their toxicity, and the evaluation of exposure to
      them has only recently become a worrisome issue. This paper discusses the
      contamination of occupational environments in some industries of the CPC, as well
      as the neurobehavioral impairment that could be found among their workers.

PMID- 8472668
TI  - Effect of carbon tetrachloride on allylnitrile-induced head twitching.
AB  - Allylnitrile is known to induce head twitching in rats and mice. Carbon
      tetrachloride (CCl4) impairs the hepatic mixed function oxidase system and lowers
      acute toxicity of nitriles. In the present study we examined the effect of CCl4
      on the allylnitrile-induced head twitching to elucidate the mechanism of the
      abnormal behavior. In rats, CCl4 pretreatment inhibited the head twitching
      induced by allylnitrile (1.49 mmole/kg, po), the maximal and dose-dependent
      inhibition occurring when CCl4 was given just prior to the nitrile
      administration, while CCl4 post-treatment had no effect on the head twitching. A
      dose-dependent inhibition of cyanide formation arising from allylnitrile in the
      liver and a dose-dependent attenuation of acute toxicity of allylnitrile were
      observed when CCl4 was given just prior to the nitrile administration in rats and
      mice. Intracerebroventricular injection of allylnitrile (2.0 to 18 mumole/brain)
      induced no head twitching in rats. The results suggest that active metabolites of
      allylnitrile are responsible for the head twitching, and that CCl4 prevents the
      metabolic process in the liver by forming conjugates with allylnitrile, resulting
      in the inhibition of the head twitching.

PMID- 8472669
TI  - Evaluation of the critical value of driving fatigue based on the fuzzy sets
      theory.
AB  - Applying the newly developed multistage evaluation method based on the fuzzy sets
      theory, we have evaluated the sense of driving fatigue of 8 male drivers who
      covered 400 km in 8 hr in the daytime, empirically revealing the distribution of
      the degree of driving fatigue. The critical values from "no" to "a bit" and "a
      bit" to "fatigued" are 1 and 5.5 hr, respectively. Finally, a tentative study of
      the psychophysical relations between driving time and driving fatigue has been
      made, leading to a curve of driving fatigue under the conditions of this
      experiment.

PMID- 8472670
TI  - Strategies for the prevention of environmental neurotoxic illness.
AB  - Toxic chemicals in the environment can cause a wide range of neurological
      disease. High-dose exposures to environmental neurotoxicants have produced
      encephalopathy in children ingesting chips of lead-based paint, blindness in
      persons who ingested methanol, blindness and ataxia in persons who consumed
      organic mercury, spinal cord degeneration and peripheral neuropathy in persons
      exposed to tri-ortho-cresyl phosphate (TOCP), and Parkinsonism in persons exposed
      to MPTP or to manganese. Environmental neurotoxicants have also been shown to
      produce a wide range of subclinical neurotoxic effects, including reduction in
      intelligence, impairment in reasoning ability, shortening of attention span, and
      alternation of behavior. The first step in the prevention of environmental
      neurotoxicity is to test chemicals for their toxic potential. More than 70,000
      chemicals are currently in commerce. However, except for pharmaceuticals, fewer
      than 10% of these chemicals have been tested for neurotoxicity. A logical
      approach to neurotoxicologic assessment of chemical substances will build on and
      extend currently available test systems. It will have a tiered structure. The
      first or screening tier will consist of tests to measure obvious structural and
      functional changes, often a functional observational battery. Subsequent levels
      of testing will be guided by the results of initial screening. Toxicologic
      testing must be supplemented by epidemiologic surveillance of populations exposed
      to known and suspect neurotoxicants. Screening programs in these populations
      designed to detect excessive absorption of a neurotoxic agent or subclinical
      neurological dysfunction can be useful in identifying affected individuals before
      severe disability occurs.

PMID- 8472671
TI  - Assessing the neurotoxic potential of chemicals--a multidisciplinary approach.
AB  - Since 1981, the development of methodology to assess the neurotoxic potential of
      chemicals has been a high priority within the International Programme on Chemical
      Safety (IPCS). Following the completion of an in-depth review of the scientific
      principles and methods for the assessment of neurotoxicity associated with
      chemical exposures, IPCS started to develop a multidisciplinary and comprehensive
      approach for neurotoxicity testing of chemicals. In view of the complexity of the
      nervous system and the variety of effects caused by chemicals, no single test or
      approach will be appropriate. Initially, IPCS evaluated neurobehavioral tests as
      well as in vitro procedures as screening tests, and an international
      collaborative study of neurobehavioral tests appropriate for screening chemicals
      for neurotoxicity is now in progress. Possible integration of higher level
      neurobehavioral tests with neurophysiological, biochemical, and pathological
      procedures in future testing strategies are discussed.

PMID- 8472672
TI  - Neurobehavioral effects of intrauterine mercury exposure: potential sources of
      bias.
AB  - Sources of bias were examined in a study of neurobehavioral effects of
      intrauterine exposure to methyl mercury in the Faroe Islands. The cohort of 1000
      children was born during a 21-month period and did not differ from Faroese births
      in general as regards major obstetrical parameters. However, high mercury
      concentrations in the cord blood was associated with increased birth weight,
      presumably because other constituents of marine fish may cause a prolongation of
      the gestation period. Thus, children with high mercury exposures were somewhat
      protected against low birth weight and its associated neurobehavioral risks. Less
      than 25% of the women indicated occasional alcohol drinking during pregnancy,
      thus suggesting a limited fetal exposure to this neurobehavioral risk factor.
      However, maternal alcohol drinking caused a decrease in mercury concentrations in
      cord blood, probably because of a toxicokinetic interaction between ethanol and
      mercury. Any alcohol-related effect on neurobehavioral development would then be
      associated with lower levels of mercury exposures. The effects of these
      confounders would tend to bias the results of the study toward the null
      hypothesis.

PMID- 8472673
TI  - Mortality from working in the aluminum reduction industry.
AB  - Next to oxygen and silicon, aluminum is the most common element on this planet's
      surface. Studies of potential carcinogenics in aluminum workers have been
      reported to be equivocal, and consequently can give rise to serious global
      concern. However, studies have not taken into consideration smoking histories.
      Also a review of published articles suggests that the conclusions have been
      unduly conservative, and that criteria for causation have not been met.

PMID- 8472674
TI  - Respiratory findings among millwright and machinery erectors: identification of
      health hazards from asbestos in place at work.
AB  - Asbestos-associated diseases are prevalent in the construction trades primarily
      because of the previously widespread use of asbestos-containing insulation
      materials. Workers in metal-related trades, employed at construction sites and
      power facilities, but who do not routinely handle such materials as part of their
      work, may also be at risk for significant asbestos exposure. In order to evaluate
      such risk, a clinical field survey was conducted of 110 millwright and machinery
      erectors from the New York metropolitan area. A high prevalence of chest
      roentgenologic abnormalities was found. Forty-nine (44.5%) of the examined
      workers had pleural abnormalities consistent with asbestos-induced effects.
      Eighteen workers showed evidence of unilateral pleural thickening. Duration from
      onset of employment was significantly longer for those with pleural abnormalities
      (mean 32.3 years) as compared to those with normal chest radiographs (mean 18.5
      years). Thirteen workers (11.8%) had radiographic signs of interstitial lung
      disease. The workers with pleural abnormalities had lower mean values of
      restrictive and obstructive lung function parameters than those with normal
      pleura. Multivariate and logistic regression analyses demonstrated association
      between duration of employment in the millwright trade and pleural abnormalities
      which was independent of smoking status. These findings suggest that millwright
      and machinery erectors employed in work environments where there is potential for
      primarily indirect exposure to airborne asbestos-containing dust are at risk for
      adverse effects from such exposure.

PMID- 8472675
TI  - Effects of neurotoxins on brain creatine kinase activity.
AB  - The effects of ethylene oxide (EO), acrylamide, N,N'-methylene-bis-acrylamide
      (bis-acrylamide), and methyl mercury chloride (MMC) on brain creatine kinase (CK)
      activity were examined in vivo. EO and acrylamide, both of which cause central
      peripheral distal axonopathy, inhibited CK activity in the brain and spinal cord.
      On the other hand, neither bis-acrylamide, a nonneurotoxic analogue, nor MMC
      which causes neuronopathy affected brain CK activity significantly. The
      inhibition of CK may play a role in the pathogenesis of distal axonal
      degeneration in the central and peripheral nervous systems.

PMID- 8472676
TI  - Effects of methyl mercury in postnatal developing rats.
AB  - Rats on Postnatal Days 1 (PD 1), 14 (PD 14), and 35 (PD 35) were orally
      administered 0, 2.60, 3.64, 5.10, 7.14, and 10 mg/kg/day of methyl mercury
      chloride (MMC) for 10 consecutive days. Mercury (Hg) accumulation in the brain of
      the rats treated with 10 mg/kg/day of MMC for 10 consecutive days was highest in
      PD-14 rats, followed by PD-35 and PD-1 rats. Hg accumulations in the liver and
      kidney were lowest in PD-1 rats and increased markedly with development in
      postnatal phase. The effect of MMC treatment on body weight change was most
      severe in PD-35 rats. The body weight loss began on Day 5 in PD-35 rats and on
      Day 10 in PD-14 rats treated with 10 mg/kg/day of MMC, but not in PD-1 rates
      under the same treatment. The phenomenon of hindlimb-crossing was induced on Day
      11 in PD-14 rats and on Day 14 in PD-35 rats treated with 10 mg/kg/day of MMC,
      but was not observed in PD-1 rats. The deficit of rotarod performance was
      apparent only at the dose of 7.14 mg/kg/day of MMC in PD-35 rats, whereas rotarod
      performance was dose-dependently inhibited by MMC treatment in PD-14 rats, and
      lowered even at the dose of 2.6 mg/kg/day of MMC. However, the performance was
      gradually restored to the control level by 1 month except in rats given 7.14
      mg/kg/day of MMC. These findings indicated that the Hg distribution and the
      effects of MMC treatment on body weight gain and motor coordination were
      different among the rat postnatal developing phases.

PMID- 8472677
TI  - Effects of ozone and nitrogen dioxide on drinking and eating behaviors in mice.
AB  - Male ICR mice were exposed continuously to ozone (O3) and nitrogen dioxide (NO2)
      for 7 days to examine the effects on drinking and eating behaviors. Ozone at 0.1
      ppm did not affect drinking and eating activities, whereas drinking activity
      decreased in a concentration-dependent manner to 47.7, 12.8, and 3.0% of the
      control value with 2-day exposures to 0.2, 0.4, and 0.8 ppm O3, respectively, and
      eating activity decreased to 35.2 and 8.7% of the control value at 0.4 and 0.8
      ppm O3, respectively. Body weight also decreased markedly by 2.0, 4.6, and 7.5 g
      at 0.2, 0.4, and 0.8 ppm O3, respectively. These decrements reached a maximum on
      the second day of exposure. However, alterations in drinking and eating
      activities and body weight were transient, leading to recovery during the
      continuous O3 exposures. The recovery processes were dependent on the
      concentrations of O3. Nitrogen dioxide at 4 ppm did not affect drinking and
      eating activities, whereas drinking activity decreased in a concentration
      dependent manner to 56.8, 8.3, and 18.7% of the control value with 2-day
      exposures to 6, 8, and 12 ppm NO2, respectively, and eating activity decreased
      markedly to 21.8 and 16.4% at 8 and 12 ppm NO2, respectively. Body weight also
      decreased by 2.5, 5.5, and 6.1 g at 6, 8, and 12 ppm NO2, respectively. These
      decrements reached a maximum on the second day of exposure. As in the O3
      exposures, the decrements in drinking and eating activities and body weight were
      transient and recovered during the continuous exposures to NO2 depending on the
      concentrations of NO2. Drinking and eating activities and body weights of mice
      that had been previously exposed to 12 ppm NO2 for 7 days did not show changes
      when the mice were exposed to 0.4 ppm O3 9 days after NO2 exposure. The present
      study demonstrates that photochemical oxidants suppress drinking and eating
      behaviors in mice and that they recover thereafter under the continuous exposure
      conditions.

PMID- 8472678
TI  - Effects of toluene administration on delayed matching-to-sample performance in
      the pigeon.
AB  - Four pigeons were trained using a delayed matching-to-sample task. This task was
      composed of identity matching-to-sample trials and oddity from sample trials. In
      the case of identity trials, pigeons were required to choose the same stimulus as
      a sample to reach a food reward, and in the case of oddity trials, they had to
      choose a different stimulus from a sample to gain a food reward. After the
      performance became stable, toluene was administered intramuscularly at dosages of
      10, 20, 40, and 80 mg/kg and tests were executed. The dosage of 10 mg/kg toluene
      caused increases in the percentage of correct responses in the 5- and 10-sec
      delay intervals, and 20 and 40 mg/kg toluene injections also increased the
      correct responses to some extent. At the dosage of 80 mg/kg toluene, the correct
      responses decreased and the performance was impaired. Toluene administration at
      relatively low dosages, especially 10 mg/kg, seemed to have excitatory effects on
      the CNS in pigeons, and presumably its arousal actions activated memory
      processes.

PMID- 8472679
TI  - International comparison of odor threshold values of several odorants in Japan
      and in The Netherlands.
AB  - The purpose of this paper is to compare the published odor threshold values of
      six odorants. In Japan, all of the odor threshold values used in the Offensive
      Odor Control Law (enacted in 1972) were determined in an odor-free room (4 m3) by
      a trained panel (20 men, ages 30-45 years who were perfumers) who sniffed the
      odors directly and made absolute judgments of odor quality and intensity. In The
      Netherlands, sensorial odor concentration measurements were made with an
      olfactometer in a mobile sniffing car with eight panelists, four men and four
      women, ages 18-40 years. Such presentations are repeated with different dilution
      ratios. Comparison of the threshold data for the six different compounds given as
      the barely perceptible concentration level revealed striking similarities for
      hydrogen sulfide (in Japan 0.0005 ppm/in The Netherlands 0.0003 ppm), phenol
      (0.012/0.010), styrene (0.033/0.016), toluene (0.92/0.99), and
      tetrachloroethylene (1.8/1.2) but not for m-xylene (0.012/0.12). Such a
      similarity was not found with any other literature sources.

PMID- 8472680
TI  - Nervous system effects of occupational exposure to styrene: a clinical and
      neurophysiological study.
AB  - Quantitative EEG of 99 workers occupationally exposed to styrene was analyzed and
      compared to exposure parameters. All of the workers came from reinforced plastics
      industry. The workplaces and factories were previously evaluated, and the
      exposure levels were known rather accurately. The exposure information form
      workplaces and the individual exposure data were combined to form an Exposure
      Index, which reliably reflected long-term exposure to styrene in various
      occupational settings. All of the subjects underwent careful medical,
      neurological, and neurophysiological examinations. Quantitative EEG was recorded
      from 19 channels and analyzed for absolute and relative power, asymmetry,
      coherence, frequency distribution, and statistical normative database comparisons
      (Neurometrics). The EEG data showed a significant increase of abnormal EEG
      classifications in workers with higher exposure. When the workers were divided
      into two groups, based on the exposure data, those with higher exposure had
      higher absolute EEG power in alpha and beta bands in the frontotemporal regions
      of the brain. The findings indicate that abnormalities in cerebral function can
      be demonstrated even with relatively low mean exposure levels. It is concluded
      that the efforts to lower the administrative hygienic levels of styrene have been
      in the right direction.

PMID- 8472681
TI  - Individual-administered human behavioral test batteries to identify neurotoxic
      chemicals.
AB  - Most research demonstrating behavioral effects of occupational chemical exposures
      is produced in established laboratories using a consistent set or battery of
      tests. Exemplifying this tradition are batteries developed at Finland's Institute
      of Occupational Health, Milan's Institute of Occupational Health, Sweden's
      National Institute of Occupational Health, Australia's National Institute of
      Occupational Safety and Health, and at universities in the United States and
      other countries. In 1983, under the World Health Organization (WHO) aegis,
      experienced human occupational researchers recommended the Neurobehavioral Core
      Test Battery (NCTB) as a screening instrument to be administered by an individual
      to subjects exposed to chemicals believed to be neurotoxic. Health professionals
      from 50 cities in 27 countries distributed on every large continent have been
      trained to administer the NCTB according to its Operational Guide. Six issues
      need to be addressed regarding human-administered test batteries: (a) The
      critical role of individual-administered batteries to screen chemically exposed
      populations in a field increasingly dominated by computer-administered batteries;
      (b) selection criteria for tests to assess known and unknown chemicals; (c)
      utility of baseline data for study analysis and interpretation; (d) test battery
      validation; (e) availability and cost of inexpensive test batteries; and (f)
      equivalence of computer- and human-administered variants of the same tests.

PMID- 8472682
TI  - Can visual perception be used to estimate body part angles?
AB  - For two decades, observational methods have been used to measure postural loads
      in industry. These methods depend on the analyst's judgment to characterize
      correctly the working postures. The errors associated with estimating the body
      part's angular deviation from the neutral position are not known. Recently,
      videotaping of a work situation, followed by examination of the tape to assess
      postural position has become more commonly practised. This study was conducted to
      determine the error which accompanies the judging (without tools) of postural
      angles. In the present study, a method was used whereby 20 subjects were asked to
      report the perceived angles which closely matched the actual shoulder flexion
      angle displayed on the TV screen. The results showed no significant differences
      among the three angular ranges ('low', 1-60 degrees; 'medium', 61-120 degrees;
      and 'high', 121-180 degrees) of shoulder flexion, in terms of algebraic and
      absolute errors. Subjects tended to slightly overestimate the true angle in the
      low range and to slightly underestimate the true angle in the medium and high
      angle ranges. This study suggests that visual perception can be used to estimate
      shoulder flexion angles displayed on a VDT.

PMID- 8472683
TI  - Menstrual cycle effects on a VDT-based simulation task: cognitive indices and
      subjective ratings.
AB  - It is unclear whether the menstrual cycle affects the basics of performance,
      mainly task performance and cognitive functions. We examined menstrual cycle
      effects on VDT-based task performance, cognitive indices based on the signal
      detection theory, and subjective ratings in questionnaires. We experimented in
      three phases: premenstrual, menstrual and postmenstrual phases. Previous studies
      reported premenstrual tension syndrome (PMST) in the premenstrual phase. Women
      used physiological and psychological strategies to cope during the menstrual
      phase. However, task performance, cognitive indices and subjective ratings showed
      no menstrual cycle effects. Thus, we can conclude that the information processing
      for the VDT-based task was not affected by menstrual cycle.

PMID- 8472684
TI  - Wrist motions in industry.
AB  - Cumulative trauma disorders (CTDs) are disorders of the body's tendons and nerves
      due to repeated exertions and excessive movements. Workers in industrial tasks
      who have to move their hands and wrists repeatedly and/or forcefully are
      susceptible to CTDs. One of the major research voids in the study of occupational
      wrist CTDs is the lack of quantification of the relationship between the known
      kinematic risk factors, such as wrist angle and repetition, and CTD risk. A
      quantitative surveillance study was performed in industry in which workers' three
      dimensional wrist motions were monitored on the factory floor. A total of 40
      subjects from eight industrial plants participated in this study (20 workers in
      each of two risk groups, low and high). The wrist motion parameters that were
      monitored for each subject were position, angular velocity, and angular
      acceleration measures in each plane of movement (radial/ulnar, flexion/extension,
      and pronation/supination). Descriptive analyses of these measures indicated that
      generally the mean of the high-risk subjects was larger in magnitude than that of
      their low-risk counterparts. However, only the velocity and acceleration
      parameters resulted in significant differences between low- and high-risk groups.
      These results demonstrate the importance of dynamic components in assessing CTD
      risk.

PMID- 8472685
TI  - The effects of biofeedback on carpal tunnel syndrome.
AB  - Behaviour modification based on audible electromyographic (EMG) biofeedback
      signals was used to discourage the awkward hand postures and the exertion of
      excessive force with the fingers, which are suspected of causing carpal tunnel
      syndrome (CTS). The null hypothesis was that participation in such a biofeedback
      programme has no effect on CTS symptoms. Before and during an 8-week study, data
      were collected from two groups of five female assembly line workers each. The
      biofeedback group received training and input, while the control group did not.
      Test results indicated that the null hypothesis could not be rejected.

PMID- 8472686
TI  - An analytical method for characterizing repetitive motion and postural stress
      using spectral analysis.
AB  - The availability of small, inexpensive electrogoniometers has made wrist posture
      measurement during repetitive manual work practical. Efficient analytical
      methods, however, are not currently available for quantifying the degree of
      repetitiveness and the interaction with postural stress. Spectral analysis was
      investigated as a method for characterizing repetitive wrist motion and postural
      stress using a simple peg transfer task. Wrist posture was controlled by
      adjusting the pegboard location and by having subjects reach over an obstruction.
      Work pace was externally controlled using an auditory signal. Angular wrist
      flexion/extension and ulnar/radial deviation was recorded using a 60 Hz sample
      rate. Power spectra were computed by stratifying data segments into individual
      work elements, divided by break points associated with the task. Peak spectral
      magnitudes and frequency components corresponded closely with joint displacement
      amplitudes and repetition rates. Spectrum DC component magnitudes were directly
      related to sustained wrist postures.

PMID- 8472687
TI  - Static force exertion in postures with different degrees of freedom.
AB  - In assessing human force exertion, the use of standardized postures can lead to
      the inaccurate prediction of the forces and postures which occur in everyday
      life. Therefore force data obtained using postures freely chosen by subjects
      themselves may be considered more relevant. A standardized posture, however, is
      considered to yield more reliable data. The question arose whether it would be
      possible to combine the two in some way, calling the result a 'functional
      posture'. Research was necessary to determine a way of operationalizing these
      functional postures, and to test their reproducibility. First, a method is
      proposed to describe functional postures through explorative research. This
      includes the fixation of members that transfer force to the outside world, while
      the rest of the body is allowed to move freely. The results of further research
      show that the exerted force is reproducible in free, functional, and standardized
      postures. The difference in average force, though, is considerable and
      significant. The conclusion is that force exertion in free posture is most
      suitable for design research.

PMID- 8472688
TI  - Spectral analysis of erector spinae EMG during intermittent isometric fatiguing
      exercise.
AB  - The applicability of EMG spectral analysis in the study of muscular fatigue of
      the erector spinae muscle was investigated. At three locations (L1, L2, L5) of
      the erector spinae muscle, representing different functional parts, EMG was
      sampled during fatiguing intermittent isometric extension of the trunk. The
      multifidus muscle (L5) appeared to show the most consistent changes of the EMG
      power spectrum as a consequence of fatigue. Whether the effects of the increase
      in muscle temperature on the power spectrum could be eliminated by low-pass
      filtering the data (60 Hz and 40 Hz) was also investigated. It was expected that
      this would make it possible to detect better the effects of fatigue on the firing
      characteristics of the motorunits by the inherent changes in the power spectrum.
      Low-pass filtering did not cause a more significant trend of the median frequency
      of the power spectrum. Future research will have to explore which parts of the
      power spectrum are affected by an increase of the muscle temperature.

PMID- 8472689
TI  - Spinal compression tolerance limits for the design of manual material handling
      operations in the workplace.
AB  - Spinal compression tolerance limits (SCTL) have been widely used by ergonomists
      in setting work tolerance limits for manual materials handling (MMH) operations.
      Thus, the effect of personal and experimental factors on spinal compression
      tolerance limits (SCTL) is reviewed with the aid of regression and correlation
      analyses performed on data compiled from the published literature. Tables of SCTL
      from various sources utilizing large number of specimens and personal factors are
      presented so that they can be accessed by ergonomists easily. Integrated
      biomechanical guidelines based on SCTL are provided for the design of MMH
      operations in the workplace. It is suggested that, in order to reduce the
      probability of MMH injuries, biomechanical tolerance limits should be set at the
      damage load instead of the load at fracture. The damage load is the weight which
      causes the first gross signs of damage such as tissue fluid and blood. An
      algorithm is described to demonstrate the use of a biomechanics approach to the
      design of MMH operations.

PMID- 8472690
TI  - Effect of prior exercise at different pedalling frequencies on maximal power in
      humans.
AB  - The effect of prior submaximal exercise performed at two different pedalling
      frequencies, 60 and 120 rev.min-1, on maximal short-term power output (STPO) was
      investigated in seven male subjects during cycling exercise on an isokinetic
      cycle ergometer. Exercise of 6-min duration at a power output equivalent to 92
      (SD 5)% maximal oxygen uptake (VO2max), whether performed at a pedalling
      frequency of 60 or 120 rev.min-1, reduced maximal STPO generated at 120 rev.min-1
      to a much greater extent than maximal STPO at 60 rev.min-1. After 6-min
      submaximal exercise at 60 rev.min-1 mean reductions in maximal STPO measured at
      120 and 60 rev.min-1 were 27 (SD 11)% and 15 (SD 9)% respectively, and were not
      significantly different from the reductions after exercise at 120 rev.min-1, 20
      (SD 13)% and 5 (SD 9)%, respectively. In addition, we measured the effect of
      prior exercise performed at the same absolute external mechanical power output
      [236 (SD 30)W] with pedalling frequencies of 60 and 120 rev.min-1. Although the
      external power output was the same, the leg forces required (absolute as well as
      expressed as a proportion of the maximal leg force available at the same
      velocity) were much higher in prior exercise performed at 60 rev.min-1.
      Nevertheless, maximal STPO generated at 120 rev.min-1 was reduced after exercise
      at 120 rev.min-1 [20 (SD 13)%, P < 0.05] whereas no significant reduction in
      maximal STPO was found after prior exercise at 60 rev.min-1.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8472691
TI  - Comparison of muscle sympathetic nerve activity during exercise in dominant and
      nondominant forearm.
AB  - To determine whether or not muscle endurance training alters exercise-induced
      sympathetic nerve response, we recorded muscle sympathetic nerve activity (MSNA)
      microneurographically during forearm exercise and compared MSNA between dominant
      (D) and non-dominant (ND) forearms of players of racket sports. Three kinds of
      forearm exercise were conducted on each side; static (SHG) and dynamic (DHG, at a
      rate of 1 Hz) handgrip exercise at a loading of 25% of maximal voluntary
      contraction until exhaustion, and 10-min submaximal dynamic handgrip (at a rate
      of 1 Hz) at an intensity of 0.9 W. Heart rate, ventilation and blood pressure
      were also monitored at rest and during SHG and DHG exercises. During the last
      minute of SHG exercise, MSNA burst rate had increased on average by 290 (SEM 46)%
      in D and 330 (SEM 46)% in ND, while during DHG it increased by 288 (SEM 38)% in D
      and 344 (SEM 36)% in ND, respectively. There were no significant differences in
      the MSNA responses between D and ND forearms in either exercise modes.
      Significant increases in heart rate, ventilation and blood pressure during the
      last minute of fatiguing SHG and DHG were observed, but there were no significant
      differences between the two forearms. During submaximal DHG, while MSNA increased
      significantly above control values in both D and ND, the MSNA response was less
      in D than that in ND forearm. The results would suggest that exercise-induced
      MSNA responsiveness is influenced little by muscle endurance training but the
      intensity of response may be due to the magnitude of metaboreceptor stimulation
      in the exercising muscle.

PMID- 8472692
TI  - H-reflexes are smaller in dancers from The Royal Danish Ballet than in well
      trained athletes.
AB  - The size of the maximal H-reflex (Hmax) was measured at rest and expressed as a
      percentage of the maximal M-response (Mmax) in 17 untrained subjects, 27
      moderately trained subjects, 19 well-trained subjects and 7 dancers from the
      Royal Danish Ballet. The Hmax/Mmax was significantly larger in the moderately and
      well-trained subjects than in the untrained subjects but smaller in the ballet
      dancers. It is therefore suggested that both the amount and the type of habitual
      activity may influence the excitability of spinal reflexes.

PMID- 8472693
TI  - Effects of physical exercise on the elasticity and elastic components of the rat
      aorta.
AB  - To evaluate the effects of exercise on aortic wall elasticity and elastic
      components, young male rats underwent various exercise regimes for 16 weeks. In
      the exercised rats, the aortic incremental elastic modulus decreased
      significantly when under physiological strain. The aortic content of elastin
      increased significantly and the calcium content of elastin decreased
      significantly in the exercised group. The accumulated data from the exercised and
      sedentary groups revealed that the elastin calcium content was related positively
      to the incremental elastic modulus. We concluded that physical exercise from an
      early age decreases the calcium deposit in aortic wall elastin and that this
      effect probably produced in the exercised rats a distensible aorta.

PMID- 8472694
TI  - Effect of a high-carbohydrate diet intake on muscle glycogen repletion after
      exercise in rats previously fed a high-fat diet.
AB  - The effect of a high-carbohydrate (C) diet intake on muscle glycogen repletion
      during the early period of recovery from exercise was studied in rats previously
      fed a high-fat (F) diet. In experiment 1, 3 week-old male and in experiment 2, 3
      week-old female rats were used. Rats were fed either the F or the C diet for 2-10
      weeks ad libitum and then were meal-fed regularly twice a day for 25 days in
      experiment 1, or for 5 weeks in experiment 2. During the period of regular
      feeding, half of the rats in both dietary groups continued to eat as before (F-F
      and C-C) but the other half of the rats were switched to the counterpart diets (F
      C and C-F) in experiment 1. In experiment 2, half of the F-F group were switched
      to the C diet (F-C) for 3, 7, and 14 days after the period of regular feeding.
      Pre-exercise glycogen content in soleus, red gastrocnemius, and heart muscles and
      liver was higher in rats fed the C diet (C-C and F-C) than in rats fed the F diet
      (F-F and C-F) in experiment 1. Glycogen repletion in red muscle 2 h after the
      ingestion of a glucose and citrate (3.0 and 0.5 g, respectively, per kg body
      mass) drink was also higher in the former than in the latter. There was a
      positive relationship in skeletal muscles between pre-exercise glycogen content
      and the rate of glycogen repletion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472696
TI  - Carbohydrate consumption prior to repeated bouts of high-intensity exercise.
AB  - Rapid depletion of muscle glycogen occurs during activities greater than 100% of
      maximal oxygen uptake. While carbohydrate ingestion prior to an endurance event
      has been shown to be beneficial, the effects of carbohydrate ingestion on
      repeated bouts of high-intensity exercise are not known. Therefore, the purpose
      of this study was to determine if carbohydrate ingestion prior to repeated bouts
      of high-intensity, short-duration exercise would improve performance. Ten well
      trained male cyclists performed two experimental rides, one 15 min after
      consumption of 5.0 ml.kg-1 body weight of a 19.7% carbohydrate drink and one
      following a placebo. The experimental ride consisted of four 1.6 km timed
      performance rides separated by 4.8 km steady-state rides at 80% of maximal oxygen
      uptake (between the last two performance rides the steady-state rides were 1.6 km
      at 80% and 1.6 km at 90%). Blood glucose levels were significantly increased
      following both the ingestion of the carbohydrate beverage and the performance of
      the exercise bout. Total exercise time following ingestion of the experimental
      drink [mean (SD); 25.6 (3.3) min] was not different from that following ingestion
      of the placebo [25.2 (3.3) min]. Similarly, the sum of all four timed performance
      rides following ingestion of the experimental drink [6.8 (0.9) min] was not
      different from that following ingestion of the placebo [6.6 (0.9) min]. In the
      present study, carbohydrate ingestion 15 min prior to exercise increased blood
      glucose levels, although performance time was not affected.

PMID- 8472695
TI  - Rapid increase in the number of androgen receptors following electrical
      stimulation of the rat muscle.
AB  - The changes in the number of androgen receptors in rat gastrocnemius muscle
      following muscle contraction caused by electrical stimulation were investigated.
      The gastrocnemius muscle of one leg, which was selected at random for each rat,
      was stimulated with needle type electrodes, e.g. for 2 s at 10 V and 100 Hz, with
      5-s intervals. The contralateral leg was left unstimulated as a control. One set
      consisted of ten such stimuli, followed by 5-min rest. Three sets every 2 days
      caused a statistically significant increase in muscle mass, the increase being
      about 2.5% after the 3rd day of stimulation, 4.4% after the 5th day, 5.9% after
      the 13th day and 8.3% after the 27th day compared with each control muscle (P <
      0.001 in each case). The protein content also increased but the water content did
      not change. Stimulation over 4 weeks induced an increase in the area of the cross
      section of the muscle fibres to about 30% more than that of the control muscles,
      though the total muscle fibre numbers were slightly, but significantly, reduced.
      Electromechanical properties supported the development of the muscle by
      stimulation, because the maximal isometric tetanic force and peak twitch force
      markedly increased in the stimulated muscle. The androgen receptors in the muscle
      cytosol fraction were determined by means of a binding assay involving
      [3H]methyltrienolone, which is an analogue of testosterone, the number having
      rapidly increased in the stimulated leg, when compared with that in the control
      leg, by about 25% after the 3rd day. The increase then slowed down, reaching a
      plateau after the 5th-day of stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472697
TI  - The effects of acute altitude exposure in Swiss highlanders and lowlanders.
AB  - The functional characteristics at rest in responding to stepwise acute exposure
      to simulated altitude (6000 m) were compared in 10 acclimatized mountaineers
      (highlanders), residents of Zermatt (1616 m) working at an altitude up to about
      4000 m, and in 11 nonacclimatized control subjects (lowlanders) living and
      working in Zurich (450 m). In comparison with the lowlanders, the highlanders
      showed at altitude significantly greater hyperventilation, lower heart rate and
      systolic blood pressure, smaller haemoconcentration, lower urodilatin secretion
      and natriuresis, and a preserved neuropsychological ability (attentiveness) and
      vasomotor tone (diastolic blood pressure); the critical altitude at which hypoxic
      short-term adaptation became insufficient was 6000 m. The lowlanders, however,
      manifested reduced tolerance of hypoxia, i.e. insufficient short-term adjustment
      with subjective and objective distress coinciding with the first signs of hypoxia
      of the central nervous system, already apparent at and above 4000 m. It was
      concluded that the functional differences between highlanders and lowlanders in
      responding to acute gradual hypoxia indicated factors contributing to altitude
      acclimatization.

PMID- 8472698
TI  - Relationship between cardiac output and oxygen uptake at the onset of exercise.
AB  - The purpose of the present study was to assess the relationship between the
      rapidity of increased gas exchange (i.e. oxygen uptake VO2) and increased cardiac
      output (Qc) during the transient phase following the onset of exercise. Five
      healthy male subjects performed multiple rest-exercise or light exercise (25 W)
      exercise transitions on an electrically braked ergometer at exercise intensities
      of 50, 75, or 100 W for 6 min, respectively. Each transition was performed at
      least eight times for each load in random order. The VO2 was obtained by a breath
      by-breath method, and Qc was measured by an impedance method during normal
      breathing, using an ensemble average. On transitions from rest to exercise, VO2
      rapidly increased during phase I with time constants of 6.8-7.3 s. The Qc also
      showed a similar rapid increment with time constants of 6.0-6.8 s with an
      apparent increase in stroke volume (SV). In this phase I, VO2 increased to about
      29.7%-34.1% of the steady-state value and Qc increased to about 58.3%-87.0%.
      Thereafter, some 20 s after the onset of exercise a mono-exponential increase to
      steady-state occurred both in VO2 and Qc with time constants of 26.7-32.3 and
      23.7-34.4 s, respectively. The insignificant difference between Qc and VO2 time
      constants in phase I and the abrupt increase in both Qc and SV at the onset of
      exercise from rest provided further evidence for a "cardiodynamic" contribution
      to VO2 following the onset of exercise from rest.

PMID- 8472699
TI  - Myo-electric fatigue manifestations revisited: power spectrum, conduction
      velocity, and amplitude of human elbow flexor muscles during isolated and
      repetitive endurance contractions at 30% maximal voluntary contraction.
AB  - A brief survey of the literature on manifestations of myo-electric fatigue has
      disclosed a surprisingly sharp conflict between early studies, focusing on
      neuromotor regulatory mechanisms, and more recent studies which stress the
      determinant influence of local metabolism and skewed homeostasis. Favoured
      explanations concerning changes in the electromyographic (EMG) spectrum were
      synchronization/grouping of motor unit (MU) firing and conduction velocity (CV)
      decreases of the action potential propagation. The notion of mutual exclusivity
      interwoven with these theories prompted us to reinvestigate the EMG of moderate
      level, static endurance contraction. Ten men in their twenties performed
      isometric elbow flexion (elbow angle 135 degrees) at 30% maximal voluntary
      contraction (MVC), and the surface EMG of the brachioradialis (BR) and biceps
      brachii (BB) muscles was recorded. Initially the CV--determined by cross
      correlation--was 4.3 m.s-1 (BR) and 4.6 m.s-1 (BB). At exhaustion the CV of the
      BR muscle had declined by 33%, roughly twice the decrease of the BB CV.
      Substantially larger relative median frequency (fm) reductions of 50% (BR) and
      43% (BB) were found. Simultaneously, the root-mean-square amplitudes grew by 150%
      (BR) and 120% (BB). All changes during contraction reached the same level of
      significance (P < 0.001, both muscles). From the largely uniform relative
      increases in fm and CV during the last 4 min of a 5-min recovery period,
      variations in CV were suggested to produce equivalent shifts in fm. The gradually
      increasing discrepancies between relative decreases in fm and CV during
      contraction presumably reflected centrally mediated regulation of MU firing
      patterns (notably synchronization). After the 5-min recovery another 11 endurance
      contractions at 30% MVC were executed, separated by 5-min intervals. The series
      of contractions reduced the endurance time to one-third of the 153 s initially
      sustained, while the terminal CV recordings increased by 1.0 (BR) and 0.6 (BB)
      m.s-1, and the terminal fm increased by 24 (BR) and 14 (BB) Hz. The relative CV
      decreased in direct proportion of the endurance time and the fm decreases varied
      with the CV; the findings did not support a causal link between CV decrease
      (signifying impaired fibre excitability) and the force failure of exhaustion.

PMID- 8472700
TI  - Daily activity and body temperature.
AB  - Body temperature varies between 36 and 39 degrees C in states ranging from sleep
      to high levels of sustained exercise, but it is not known whether this continuum
      of body temperature is related to a continuum of activity. Calorimetric studies
      of sedentary days were undertaken with four levels of food intake, men doing mild
      sustained exercise, and men and women walking and cycling vigorously. Steady
      states of metabolism were followed by slow exponential changes to steady states
      of heat loss (sigma Q), followed in turn by changes in rectal temperature
      (T(re)). Regression analysis showed a continuous, curvilinear relationship
      between sigma Q and T(re) from the low end of the activity spectrum (50 W) to
      progressively higher levels of exercise (600 W). These related continua of
      activity and body temperature appear to be the result of heat regulation.

PMID- 8472701
TI  - Isokinematic muscle mechanics in four groups of women of increasing age.
AB  - The purpose of this study was to evaluate the effects of age on dynamic muscle
      attributes of the knee extensors and flexors in postmenopausal women. Young
      healthy women (3rd decade, n = 15; 4th decade, n = 5) and older healthy women
      (6th decade, n = 9; 7th decade, n = 6) were tested at six angular velocities from
      60 degrees.s-1 to 400 degrees.s-1. The 3rd and 4th decade groups produced greater
      extensor and flexor values for strength related variables at all angular
      velocities (peak torque, angle specific torque, work, power) than both the 6th
      and 7th decade groups (P < 0.05). However, relative changes in these variables,
      with increments in angular velocity, were equivalent among the groups. Analysis
      of the flexor: extensor ratios for these variables demonstrated a differential
      loss in flexor function with increased age, perhaps indicative of type II motor
      unit loss or muscle fibre atrophy. It is suggested that such changes may be
      present even within 4th decade subjects.

PMID- 8472702
TI  - Effect of endurance training on excessive CO2 expiration due to lactate
      production in exercise.

PMID- 8472703
TI  - A new method for the evaluation of anaerobic running power in athletes.
AB  - A new maximal anaerobic running power (MARP) test was developed. It consisted of
      n.20-s runs on a treadmill with a 100-s recovery between the runs. During the
      first run the treadmill speed was 3.97 m.s-1 and the gradient 5 degrees. The
      speed of the treadmill was increased by 0.35 m.s-1 for each consecutive run until
      exhaustion. The height of counter-movement jumps and blood lactate concentration
      ([la-]b) were measured after each run. Submaximal ([la-]b = 3 mmol.l-1 and 10
      mmol.l-1) and maximal speed and power (W3mmol, W10mmol and Wmax, respectively)
      were calculated and W was expressed in oxygen equivalents according to the
      American College of Sports Medicine equation. Thirteen male athletes whose times
      over 400 m ranged from 47.98 s to 54.70 s served as subjects. In the MARP-test
      the speed at exhaustion was 6.89 (SD 0.28) m.s-1 corresponding to a Wmax of 118
      (SD 5) ml.kg-1 x min-1. The peak [la-]b after exhaustion was 17.0 (SD 1.6) mmol.l
      1. A significant correlation (r = 0.89, P < 0.001) was observed between the Wmax
      and the average speed in the 400-m sprint. The maximal 20-m sprinting speed on a
      track and W10mmol correlated with both the Wmax and the 400-m speed. It was
      concluded that the new method allows the evaluation of several determinants of
      maximal anaerobic performance including changes in the force-generating capacity
      of leg muscles and [la-]b relative to the speed of the sprint running. the [la-]b
      at submaximal sprinting speed was suggested as describing the anaerobic sprinting
      economy.

PMID- 8472704
TI  - Decision support by computer analysis of selected case history variables in the
      emergency room among patients with acute chest pain.
AB  - A computer system to be used in the emergency room has been developed for
      estimating the risk of acute coronary heart disease (ACHD). The system uses data
      on 38 case history and clinical variables collected consecutively over a year
      from 918 patients with acute chest pain. A statistical procedure based on Bayes'
      formula is used to estimate disease probabilities. A quadratic scoring rule was
      used for variable selection. The score increased markedly until 15-20 variables
      had been added, reached a maximum after inclusion of about 30 variables and then
      deteriorated slightly. Thus, the number of variables carrying additional
      information on the presence/absence of ACHD seems to be much larger than the
      number normally utilized by doctors and by other decision support systems.
      Reclassification into two groups, those with and without ACHD, gives a diagnostic
      accuracy of 89%. We conclude that analysing detailed case histories by computer
      is a promising decision support system for use in the emergency room as a
      supplement to ECG analysis.

PMID- 8472705
TI  - Prospective evaluation of an EDB-based diagnostic program to be used in patients
      admitted to hospital with acute chest pain.
AB  - A recently designed computer based decision support system (DSP), almost
      exclusively based on case history data, was developed to facilitate immediate
      differentiation between patients with and without urgent need for coronary care
      unit (CCU) transferral from the emergency room, and additionally to distinguish
      between patients with and without acute myocardial infarction (MI). One-year's
      prospective testing in a consecutive series of 1252 patients with acute chest
      pain revealed that the DSP, used in addition to ECG and clinical examination,
      demonstrated a sensitivity of 96% in the detection of patients in need of CCU
      observation (MI-sensitivity of 98%), and a specificity of 56% in excluding
      patients who were not in need of CCU observation. The proportion of referrals to
      the CCU judged to be unnecessary was only 17% of the total number of patients
      seen in the emergency room.

PMID- 8472706
TI  - Diagnosis of prosthetic heart valve thrombosis. The respective values of
      transthoracic and transoesophageal Doppler echocardiography.
AB  - Early diagnosis of acute prosthetic thrombosis remains a challenge. In 20
      patients with 23 thrombosed cardiac valves, we evaluated the respective value of
      transthoracic (TTE) and transoesophageal (TEE) Doppler echocardiography.
      According to the presence or absence of prosthetic obstruction by continuous-wave
      Doppler, prostheses were separated into two groups. Group 1 included nine
      thrombosed prostheses (8 mitral, 1 aortic) with severe obstruction. All patients
      presented with severe symptoms of heart failure. Transthoracic Doppler
      echocardiography allowed immediate diagnosis of prosthetic thrombosis, even in
      critically ill patients, showing (1) eccentric transprosthetic colour flow jets
      in all eight mitral prostheses, (2) severe obstruction on Doppler examination
      (mean gradient = 18 to 36 mmHg in eight mitral prostheses, and 69 mmHg in one
      aortic valve), and (3) direct echocardiographic evidence of thrombosis (i.e.
      thrombus or abnormal disc or leaflet motion) in four patients. All nine patients
      were immediately treated by surgery (n = 8) or fibrinolysis (n = 1) on the basis
      of TTE results only. TEE allowed better visualization of thrombus and restricted
      leaflet or disc motion, but had little influence on patient management. Group 2
      included 14 thrombosed prostheses (10 mitral, 4 aortic) with mild or absent
      obstruction. In three patients with massive mitral prosthetic thrombosis, an
      associated minimal thrombosis of a prosthetic aortic valve was found at surgery,
      but was detected neither by TTE, nor by TEE. The 11 remaining patients with
      isolated partial mitral (n = 10) or aortic (n = 1) thrombosis. Clinical
      presentation was fever, cerebral embolism, or mild dyspnoea, but no heart
      failure. TTE was normal in all.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472707
TI  - Quantitation of global and regional left ventricular function by cine magnetic
      resonance imaging during dobutamine stress in normal human subjects.
AB  - Magnetic resonance imaging (MRI) provides high-resolution images of the heart.
      However, physical exercise during MRI is difficult due to space restriction and
      motion artefacts. To evaluate the feasibility of MRI during stress conditions,
      dobutamine was used as an alternative to exercise. Haemodynamics, ventricular
      volumes and wall thickening were measured at rest and during peak dobutamine
      infusion (15 micrograms.kg-1 x min-1) in 23 normal human subjects. To calculate
      left ventricular volumes, eight short-axis views were obtained encompassing the
      left ventricle from base to apex. At six levels, percent systolic wall thickening
      (%WTh) was measured in 18 segments (20 degrees intervals). Heart rate, systolic
      and diastolic blood pressures, stroke index, cardiac output and left ventricular
      ejection fraction increased significantly during dobutamine infusion (all P
      values < 0.001). In addition, %WTh increased significantly (P < 0.001) during
      dobutamine compared to the control state at all levels except in the apical and
      low-left ventricular levels. Both in control conditions and during dobutamine,
      segmental wall motion analysis showed the highest %WTh at the posterolateral area
      and the lowest %WTh at the septal region (P < 0.05). MRI clearly identifies wall
      motion dynamics and provides calculations of segmental wall thickening and
      haemodynamic parameters. Dobutamine is a useful stress agent by virtue of its
      safety, operator control and its effects which resemble physical exercise.

PMID- 8472708
TI  - Classification of electrocardiographic ST-T segments--human expert vs artificial
      neural network.
AB  - Artificial neural networks, which can be used for pattern recognition, have
      recently become more readily available for application in different research
      fields. In the present study, the use of neural networks was assessed for a
      selected aspect of electrocardiographic (ECG) waveform classification. Two
      experienced electrocardiographers classified 1000 ECG complexes singly on the
      basis of the configuration of the ST-T segments into eight different classes. ECG
      data from 500 of these ST-T segments together with the corresponding
      classifications were used for training a variety of neural networks. After this
      training process, the optimum network correctly classified 399/500 (79.8%) ST-T
      segments in the separate test set. This compared with a repeatability of 428/500
      (85.6%) for one electrocardiographer. Conventional criteria for the
      classification of one type of ST-T abnormality had a much worse performance than
      the neural network. It is concluded that neural networks, if carefully
      incorporated into selected areas of ECG interpretation programs, could be of
      value in the near future.

PMID- 8472709
TI  - Derivation and validation of a new angiographic score of right coronary artery
      perfusion.
AB  - A semi-quantitative right coronary artery score (RCA score) was derived from the
      ratio of the number of the major left ventricular branches of the right coronary
      artery to the total of the right coronary and left circumflex arteries, to
      stratify the extent of perfusion in patients with right coronary artery
      dominance. Thirty-seven patients with one-vessel coronary disease involving a
      dominant right coronary artery proximal to the left ventricular branches were
      selected for study. Thallium scintigraphy was performed after right intracoronary
      injection in 11 patients, and 26 patients underwent conventional stress thallium
      scintigraphy (24 exercise thallium and two dipyridamole thallium scintigraphy).
      Thallium scores of perfusion region size after right intracoronary thallium
      injection and perfusion defect size in stress thallium studies were quantitated
      from planar thallium images. Both the RCA score and the regional thallium scores
      spanned over a wide range. The RCA score (range 0.23-0.85) correlated best with
      the posterior (70 degrees left anterior oblique view) plus lateral segment (40
      degrees left anterior oblique view) thallium score (r = 0.88 and 0.53 for
      intracoronary and stress thallium studies respectively). It also correlated with
      the summed thallium scores in the posterior, lateral, apical and inferior
      segments (r = 0.73 and 0.54 respectively) but not with thallium scores in the
      apex or inferior segment alone. The proposed RCA score quantitates the variable
      posterolateral perfusion territory of the right coronary artery, and could
      stratify the area of myocardium at risk from coronary stenosis in the majority of
      patients with right coronary dominance.

PMID- 8472710
TI  - Effects of adrenaline on ventricular function and coronary haemodynamics in
      relation to catecholamine handling in transplanted human hearts.
AB  - We investigated cardiovascular and coronary responses to intravenous infusions of
      adrenaline, which raised arterial concentrations in a stepwise fashion from basal
      to about 5-6 nmol.l-1, in 11 non-rejecting heart transplanted patients, and in
      eight intact innervated subjects. Cardiac adrenaline extraction and noradrenaline
      release rate were also measured. The transplanted patients showed larger
      increases in heart rate (36 +/- 11% vs 16 +/- 6%, P < 0.0001) and cardiac index
      (80 +/- 30% vs 56 +/- 19%, P < 0.05), while stroke volume increments were similar
      in the two groups (32 +/- 17% vs 35 +/- 13%). The study groups did not differ
      with respect to changes in arterial pressure, cardiac work or peripheral
      resistances. Coronary sinus blood flow increased to a greater extent in the
      transplanted group (75 +/- 35% vs 48 +/- 31%, P < 0.05) and myocardial oxygen
      consumption also tended to increase more in these patients (78 +/- 42% vs 48 +/-
      34%, NS). Myocardial adrenaline extraction was greatly reduced in the transplant
      patients (-6 +/- 25% vs 64 +/- 18%, P < 0.001), while forearm adrenaline
      extraction was similar in the two groups (41 +/- 22% vs 40 +/- 23%, NS). Cardiac
      noradrenaline overflow tended to be lower in the transplanted group (12 +/- 62 vs
      48 +/- 43 pmol.min-1, NS). There was a wide range of noradrenaline overflow
      values (-64 to 147 pmol.min-1) and definite high values in three patients.
      Cardiac noradrenaline overflow was not correlated to heart rate responsiveness to
      adrenaline. We conclude that patients with cardiac transplantation respond to
      adrenaline with exaggerated increases in heart rate and thus in cardiac output.
      High values of cardiac noradrenaline overflow are seen in some transplant
      recipients and may suggest reinnervation. Signs of reinnervation are not
      associated with consistently lower heart rate responses to beta-adrenergic
      stimulation.

PMID- 8472711
TI  - Occurrence of angina pectoris prior to acute myocardial infarction and its
      relation to prognosis.
AB  - In 917 patients with acute myocardial infarction (AMI) we evaluated the impact of
      previous angina pectoris on the prognosis. Thirty-four percent of the patients
      had chronic angina prior to AMI, and 22% had angina pectoris of short duration.
      Patients with chronic angina pectoris differed from the remaining patients having
      a more frequent previous history of AMI, diabetes mellitus, hypertension, and
      congestive heart failure. They less frequently developed a Q-wave AMI, and had
      smaller infarcts according to maximum serum-enzyme activity as compared with the
      remaining patients. They had a higher one-year mortality rate (36%) as compared
      with those having angina pectoris of short duration (22%), and those with no
      angina pectoris (26%). Their reinfarction rate was also higher (26%) as compared
      with that in the other two groups (15% and 9% respectively). In a multivariate
      analysis considering age, sex, clinical history, initial symptoms, initial
      electrocardiogram and estimated infarct size, previous chronic angina pectoris
      was not an independent risk factor for death, but was independently associated
      with the risk of reinfarction (P < 0.001). Among patients with a history of
      angina pectoris the outcome was related to medication prior to onset of AMI and
      at discharge from hospital. Patients in whom beta-blockers were prescribed at
      discharge had a one-year mortality of 13% as compared with 30% in the remaining
      patients (P < 0.001).

PMID- 8472713
TI  - Seven-year prognostic value of the electrocardiogram at rest and an exercise test
      in patients admitted for, but without, confirmed myocardial infarction.
AB  - The seven-year prognosis for cardiac events (non-fatal acute myocardial
      infarction (AMI) or cardiac death) following discharge was related to an
      electrocardiogram (ECG) at rest and a symptom-limited exercise test in 217
      patients admitted with chest pain without confirmed AMI. The follow-up time was
      86-98 months, median 88 months. Although the 7-year prognosis was better than in
      a comparable group of patients with AMI (P < 0.0001), the frequency of cardiac
      events was still very high. Patients with negative T waves, ST depression or
      elevation, intraventricular block or Q waves at rest, ST abnormalities during
      exercise or both constituted a high-risk group. In patients without these ECG
      abnormalities the prognosis was significantly better (P << 0.0001). The
      percentages without cardiac events after 7 years were 53 and 92 respectively.
      Patients with a low rise in the rate-pressure product indicative of decreased
      function of the left ventricle and patients who developed angina pectoris during
      exercise also had a significantly impaired 7-year prognosis. This non-invasive
      approach to risk stratification identified a group of non-AMI patients with a
      high risk for cardiac events, and a group comprising more than 50% of the
      patients with a very low risk.

PMID- 8472712
TI  - In-hospital experience with multiprogrammable implantable
      antitachycardia/antifibrillation devices.
AB  - Multiprogrammable, automatic internal defibrillators with (n = 45) and without (n
      = 15) antitachycardia pacing features were implanted in 60 consecutive patients
      with refractory, malignant ventricular tachycardia (VT) (n = 42) or fibrillation
      (VF) (n = 18). Left ventricular (LV) ejection fraction was reduced to 39% +/- 12%
      as a result of structural heart disease in 56 patients. The complexity of the
      systems caused no additional risks to the surgical procedure or postoperative
      management. VT/VF detection parameters were individually adjusted to the
      arrhythmia type (detection cycle length 323 +/- 40 ms in patients with VF vs 405
      +/- 40 ms for VT patients, P < 0.05) and incidence (longer detection periods if
      frequent nonsustained VT was also present). Shock energy was reduced in patients
      with VT as compared to VF (11J vs 24J, P < 0.05). Antitachycardia pacing was
      activated in 19/28 (68%) patients with well tolerated VT. Signal, telemetry, as
      detected by the device, combined with programmability allowed the device to be
      checked for correct decisions (these were inappropriate in four patients in three
      of whom corrections were non-invasive) prior to discharge. In conclusion, in the
      automatic tachyarrhythmia control devices we studied, programmability and
      flexibility appeared to be clinically safe and useful. Prolonged observation
      periods are required, however, to evaluate the true clinical safety and
      persistent efficacy of device programmability and flexibility.

PMID- 8472714
TI  - The mechanism of directional coronary atherectomy.
AB  - An attempt was made to assess the mechanism of directional coronary atherectomy
      using different methods of analysis. Quantitative coronary angiography was used
      as the gold standard to assess the immediate results of atherectomy, and a
      comparative quantitative analysis of atherectomy and balloon angioplasty was
      made. To determine whether the post-atherectomy cross-sectional area is close to
      a circle, we compared the area measurements obtained by edge detection with those
      obtained by videodensitometry. Finally, the extent of a 'Dotter' effect was
      established by quantitative angiography following crossing the stenosis with the
      atherectomy device. For the purpose of this study, the results of the first 113
      successful atherectomy procedures were reviewed. In matched lesions, directional
      atherectomy induced a greater increase in minimal luminal diameter than balloon
      angioplasty (1.6 mm vs 0.8 mm; P < 0.0001). However, this luminal improvement is
      due to a substantial 'Dotter' effect induced by the bulky atherectomy device.
      Following atherectomy, only a slight difference in cross-sectional area
      measurements between edge detection and videodensitometry (mean difference: 0.28
      mm2) was found. Histologic examination of an atherectomized coronary artery
      showed a near-circular postatherectomy area geometry. In conclusion, directional
      atherectomy is a very effective device with a substantially better initial result
      than balloon angioplasty. However, insertion of this bulky device itself causes
      an important 'Dotter' effect.

PMID- 8472715
TI  - Electrophysiological characteristics of asymptomatic Wolff-Parkinson-White
      syndrome.
AB  - Although most asymptomatic patients with the Wolff-Parkinson-White syndrome have
      a good prognosis, some die suddenly. Electrophysiological testing may identify
      patients at possible risk of sudden death. The mechanism of sudden death in these
      patients is believed to result from ventricular fibrillation due to atrial
      fibrillation with rapid anterograde conduction over the accessory pathway.
      Consequently, we performed electrophysiological studies in 40 asymptomatic
      patients with the Wolff-Parkinson-White syndrome. Certain electrophysiological
      properties clearly identified these patients: (1) in most patients sustained
      reciprocating tachycardia could not be induced and this explains the absence of
      symptoms of regular fast palpitations; (2) the incidence of inducible sustained
      atrial tachyarrhythmias (30%), of short RR intervals between pre-excited beats
      (20%) and of risk of sudden death (12.5%) was similar to the incidence in
      symptomatic patients with the Wolff-Parkinson-White syndrome and reciprocating
      tachycardia. Because of the ease with which transoesophageal study can be
      performed we think that the asymptomatic Wolff-Parkinson-White syndrome should be
      systematically evaluated so as to reassure patients with the benign form that
      they can lead a normal life and take part in sport and secondly to define the
      real prognosis of the patients whose characteristics suggests a risk of sudden
      death.

PMID- 8472716
TI  - Is sympathetic neural hyperactivity in chronic heart failure affected by heart
      transplantation?
AB  - It has been suggested that immunosuppression with cyclosporine induces marked
      sympathetic neural hyperactivity in heart transplant recipients. In the present
      study, the resting level of sympathetic nerve activity was investigated with
      intraneural recording in nine patients with severe chronic heart failure (NYHA
      class III-IV despite ongoing therapy), in nine heart-transplanted patients with
      previous heart failure (NYHA class III-IV) receiving standard low-dose triple
      drug immunosuppression and in six age-matched controls without cardiovascular
      disease. Compared to the control group, resting sympathetic nerve discharge was
      markedly increased in heart failure patients (92 +/- 2 vs 60 +/- 6 B/100 b, P <
      0.01), sympathetic nerve activity was lower in the majority of heart failure
      patients after heart transplantation, and mean burst incidence was significantly
      lower than in the cardiac failure group (70 +/- 7, P < 0.01). The difference
      between transplanted patients and the control group was not statistically
      significant. Thus, heart transplant recipients may reduce the augmented central
      sympathetic drive associated with cardiac failure despite ongoing cyclosporine
      treatment.

PMID- 8472717
TI  - Impaired subsidiary pacemaker function in patients with a right bundle branch
      block created prior to complete catheter ablation of the AV junction.
AB  - The impact of a right bundle branch block (RBBB), inadvertently created prior to
      complete ablation of the atrioventricular (AV) junction, on the intrinsic
      subsidiary pacemaker function was investigated. In 31 patients suffering from
      intractable supraventricular tachyarrhythmia, catheter ablation of the AV
      junction was performed using direct current (n = 13) or radiofrequency (n = 18)
      energy. In 16/31 patients a RBBB was created prior to complete AV ablation.
      Subsidiary pacemaker function was evaluated after a mean period of 5 months.
      Following 5 min of ventricular pacing (70 beats.min-1) escape interval and
      spontaneous heart rate were measured. In patients with a RBBB there was a trend
      towards a longer escape interval (2979 +/- 2559 vs 1867 +/- 1254 ms, P = ns) and
      a significantly lower intrinsic heart rate (38 +/- 14 vs 47 +/- 8 beats.min-1, P
      < 0.05). Pacemaker dependency was only observed among patients with a RBBB (4/16
      vs 0/15, P < 0.05). HV intervals were shorter in those energy discharges
      resulting in a RBBB as compared to those inducing a complete heart block (52 +/-
      8 vs 66 +/- 6 ms, P < 0.05). Creation of a RBBB prior to complete ablation of the
      AV junction results in impaired intrinsic subsidiary pacemaker function; the most
      proximal catheter position should be carefully sought to minimize the risk of
      pacemaker dependency.

PMID- 8472718
TI  - Heart rate and late mortality in cardiac transplant recipients.
AB  - There are currently 104 patients at this centre who have survived at least 3
      months after orthotopic cardiac transplantation. Seven of these long-term
      survivors have subsequently died and in three cases death was sudden and
      unexpected. All three of these patients had been noted to have inappropriately
      high resting heart rates (> 130 b.min-1). The rhythm was sinus tachycardia,
      supraventricular tachycardia or both intermittently. The heart rates of all 104
      long-term survivors were recorded from ECGs taken at routine follow-up visits
      every 3 months for one year and annually thereafter. The overall mean heart rate
      was 100 +/- 13.2 b.min-1. Four patients, including the three identified above,
      had mean heart rates greater than the 95th centile. The mortality rate in this
      group is 75%. Four deaths have occurred in the remaining 100 patients (P <
      0.001). In our series, an inappropriately high resting heart rate due to sinus
      tachycardia or supraventricular tachycardia in long-term survivors of cardiac
      transplantation, is an adverse prognostic sign.

PMID- 8472720
TI  - The effect of verapamil on major events in patients with impaired cardiac
      function recovering from acute myocardial infarction. The Danish Study Group on
      Verapamil in Myocardial Infarction.
AB  - In the Danish Verapamil Infarction Trial II (DAVIT II) intervention with
      verapamil significantly decreased the first major event rate (i.e. reinfarction
      or death) in patients recovering from acute myocardial infarction. As calcium
      channel antagonists might have a detrimental effect in patients with heart
      failure, the effect of verapamil on major events in patients with and without
      impaired left ventricular function was analysed. Eight hundred and seventy-eight
      patients were randomized to verapamil 120 mg t.i.d. and 897 to placebo. Patients
      were followed up to 18 months. The endpoint was the first major event while on
      trial medication. In patients treated for heart failure during the acute phase of
      myocardial infarction, the lowest 18-month event rate was seen in the verapamil
      group (21.2% vs 22.2%) (absolute numbers: events/patients verapamil 47/291;
      placebo 60/323) (ns). Similarly, in patients treated with diuretics at
      randomization, the lowest 18-month event rate was seen in those randomized to
      verapamil (22.4 vs 24.3%) (absolute numbers: events/patients verapamil 57/349;
      placebo 76/375 (ns). When patients were subdivided according to New York Heart
      Association functional classes, verapamil reduced the event rate in all classes,
      but none of these differences was statistically significant. In patients without
      heart failure during the acute phase and in patients without diuretic treatment
      at randomization, treatment with verapamil caused a significant reduction in
      major events (hazard ratio (95% confidence limits): 0.66 (0.47, 0.92); 0.66
      (0.45, 0.96) respectively). Long-term treatment with verapamil after acute
      myocardial infarction caused a significant reduction in major events.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8472719
TI  - A comparison of nisoldipine and nifedipine, in combination with atenolol, in the
      management of myocardial ischaemia.
AB  - The effects of the addition of slow-release nifedipine 20 mg twice daily and
      nisoldipine 10 mg twice daily to atenolol monotherapy were compared in a double
      blind placebo-controlled study of 24 patients with chronic stable angina
      pectoris. Neither nisoldipine nor nifedipine was associated with significant
      subjective benefit at these doses. Two hours post-dosing, exercise capacity
      improved after both nisoldipine (duration + 37 s, P < 0.01; time to angina + 67
      s, P < 0.01; time to significant ST depression + 60 s, P < 0.01) and nifedipine
      (duration + 21 s, ns; time to angina + 56 s, P < 0.05; time to significant ST
      depression + 49 s P < 0.05). However, this improvement was not maintained 12 h
      post-dosing. Ambulatory monitoring did not demonstrate a significant reduction in
      the amount of silent or total ischaemia following the addition of either
      nifedipine or nisoldipine to atenolol monotherapy. There was no significant
      difference between nifedipine and nisoldipine in any parameter tested. In
      conclusion, like slow-release nifedipine 20 mg, the effective duration of anti
      ischaemic action of nisoldipine 10 mg is less than 12 h. Since several patients
      experienced vasodilatory unwanted effects, more frequent administration rather
      than larger individual doses may be desirable to achieve a clinical response.

PMID- 8472721
TI  - The use of propafenone in the treatment of tachyarrhythmias in children.
AB  - Propafenone was given to 60 children (mean age 4.5 years) with paroxysmal re
      entrant supraventricular tachycardia (rSVT: 41 cases), postoperative automatic
      junctional tachycardia (JET: eight cases), automatic atrial tachycardia (AT:four
      cases), ventricular tachycardia (VT:four cases) and atrial flutter (AF: three
      cases). In acute cases (29) propafenone was administered intravenously (mean dose
      1.3 +/- 0.5 mg.kg-1) chronic oral treatment (mean dose of either 11 +/- 3.3
      mg.kg.day-1 or 265 +/- 78 mg.m-2 x day-1) was given to 48 children, in 2-3
      divided doses. Overall efficacy was 76% for acute and 69% for chronic treatment,
      with best results in paroxysmal rSVT. It was effective in 89% acutely of those
      treated acutely and in 69% of those administered chronically. The efficacy of
      propafenone in the prevention of rSVT was strictly related to the incidence of
      attacks before treatment:propafenone was indeed inefficacious in 6/11, 6/14 and
      0/12 of patients with daily, weekly and monthly attacks respectively. Side
      effects were observed in 25% of patients: 6% required suspension of therapy due
      to pro-arrhythmic effects in one patient on intravenous administration,
      peripheral neuropathy in one case and hypotension in two postoperative JET
      patients. In conclusion, its efficacy and limited side effects make propafenone a
      relatively safe and very useful drug in the treatment of various
      tachyarrhythmias. However, risk of unpredictable toxic levels requires careful
      use of the drug especially in the first days of treatment, when a daily
      monitoring of ECG is strongly recommended.

PMID- 8472722
TI  - Calcium sensitization with pimobendan: pharmacology, haemodynamic improvement,
      and sudden death in patients with chronic congestive heart failure.
AB  - Calcium sensitization increases myocardial contractility by improving energy
      utilization of the myocardium, without an increase in intracellular
      concentrations of cyclic adenosine monophosphate. The calcium sensitizer most
      extensively studied up to now is pimobendan (UD-CG 115 BS). Vasodilatation
      results primarily from phosphodiesterase III inhibition. Orally administered
      pimobendan appears rapidly in plasma. A peak concentration is reached 1.5 h after
      drug intake; elimination from the plasma compartment has a half-life of 1.5 h.
      First-pass hepatic O-desmethylation of pimobendan produces the active metabolite
      UD-CG 212; plasma concentration curves of UD-CG 212 are similar to those of
      pimobendan, with a peak concentration 1-2 h later than the peak concentration of
      the parent compound. In patients with chronic congestive heart failure,
      pimobendan produces a dose-dependent and prolonged decrease in pulmonary
      capillary wedge pressure and an increase in cardiac output. Maintenance doses of
      pimobendan are well tolerated and may lead to lasting symptomatic improvement in
      patients with heart failure; open and blinded trials show that exercise tolerance
      increases. No attenuation of these effects is seen during long-term therapy with
      pimobendan. Patients in chronic congestive heart failure frequently die suddenly;
      many inotropic agents increase the incidence of sudden death in these patients.
      Although proarrhythmia has never been observed with pimobendan, arrhythmia
      suppression with amiodarone seems prudent in heart failure patients receiving
      maintenance doses of pimobendan.

PMID- 8472723
TI  - Left ventricular assistance using a catheter-mounted coaxial flow pump (Hemopump)
      in a canine model of regional myocardial ischaemia.
AB  - The global and regional effects of left ventricular circulatory assistance were
      examined in dogs during acute myocardial infarction using a new coaxial flow
      device (Hemopump). In 12 dogs the left anterior descending coronary artery was
      occluded for 4 h and subsequently reperfused for 12 h. In six dogs, left
      ventricular assistance was started 90 min after coronary artery occlusion and
      maintained for several hours; six control animals received no circulatory
      support. Survival rate in the animals receiving mechanical support was 100% vs 0%
      in the control group. The Hemopump reduced left ventricular stroke work up to 80%
      and maintained blood flows to the brain, kidneys, liver and intestine throughout
      the experiment. Infarct size, expressed as a percentage of the left ventricle,
      however, was not modified (12% in supported animals vs 13% in control dogs). Side
      effects of the coaxial flow pump were thrombocytopaenia, occurring in all six
      dogs, and haemolysis, which was demonstrated in one animal. It was concluded that
      the Hemopump provides effective global and regional circulatory support in a
      canine model of severe cardiogenic shock. However, the value of left ventricular
      support to modify infarct size could not be demonstrated in this experimental
      model.

PMID- 8472725
TI  - Open heart surgery in Europe 1990.

PMID- 8472724
TI  - Renovascular hypertension and coronary heart disease complicating essential
      thrombocythemia.
AB  - A 36-year-old male was evaluated for treatment-resistant hypertension. A high
      platelet count 828 x 10(9).l-1, led to the diagnosis of essential thrombocythemia
      (ET). Aorto-renal angiography revealed critical bilateral renal artery stenosis
      and coronary angiography showed three-vessel disease. Percutaneous transluminal
      renal angioplasty was only partially successful. The patient received a 12-week
      course of busulphan and subsequently the thrombocyte count decreased to 200 x
      10(9).l-1. Renal angiography 12 months later showed bilateral regression of the
      renal artery stenosis with lowering of the blood pressure to normal levels.

PMID- 8472727
TI  - Carcinoma of the inguinal region arising from endometriosis of the round
      ligament. Report of a case.
AB  - The case is reported of a patient with a mixed epithelial tumor, composed mainly
      of a clear cell and endometrioid carcinoma, arising from a focus of preexisting
      endometriosis of the round ligament. The tumor was presented as a painful
      inguinal hernia.

PMID- 8472726
TI  - The addition of etoposide and ifosfamide to cisplatin as second line therapy in
      ovarian carcinoma.
AB  - Forty-five patients with progressive or recurrent ovarian carcinoma received
      cisplatin, etoposide, and ifosfamide as salvage chemotherapy. The primary purpose
      of this trial was to evaluate if etoposide and ifosfamide added to cisplatin was
      effective second line therapy in the 20 patients with progressive or recurrent
      ovarian cancer after first line cisplatin-based chemotherapy. The overall
      response in the 20 patients was 20%, all of which were complete responses.
      However, responses were seen only in patients who had previously responded to
      first line cisplatin-based chemotherapy and then developed recurrent cancer,
      whereas none of the patients whose cancer progressed during first line cisplatin
      based chemotherapy responded. The addition of etoposide and ifosfamide to
      cisplatin as second line therapy does not potentiate cisplatin in patients
      demonstrating first line cisplatin resistance and most likely does not contribute
      to the second line responses in those patients who demonstrated first line
      cisplatin sensitivity. This combination is also ineffective as third, forth,
      fifth or sixth line salvage chemotherapy with a response rate of only 8%.

PMID- 8472728
TI  - Topical acetone for control of life-threatening vaginal hemorrhage from recurrent
      gynecologic cancer.
AB  - Two patients with intractable, life-threatening vaginal bleeding from recurrent
      gynecologic cancer were successfully treated with application of topical acetone
      or placement of an acetone-soaked pack, with immediate control of hemorrhage and
      no immediate side effects other than pain. No long-term adverse effects were
      noted. Acetone application may control vaginal bleeding from recurrent pelvic
      malignancy, particularly in previously radiated patients who cannot safely be
      treated with additional radiotherapy or when embolic techniques are not
      immediately available or practical.

PMID- 8472729
TI  - Negative second-look laparotomy does not preclude recurrence in stage I ovarian
      carcinoma of any histological variety.
AB  - Between January 1980 and June 1991, 56 patients with Stage I ovarian carcinoma of
      different histological varieties were submitted to a second-look laparotomy (SLL)
      at the University Clinic (Hospital de Cruces) of Bilbao, Spain. The operation was
      performed upon all patients one year after initial surgery, after completion of
      adjuvant chemotherapy, or after one year of observation in those cases that were
      not treated postoperatively. The SLL was negative in 55 of cases and positive in
      one. The median follow-up after SLL was 59 months. Of the 55 negative cases, four
      (7.3%) have had a recurrence of their tumor during their long-term follow-up.
      Three had epithelial tumors and had received complete postoperative chemotherapy,
      and the fourth was a dysgerminoma. The three patients with epithelial tumors have
      died under second-line chemotherapy, whereas the dysgerminoma patient is
      responding well to rescue polychemotherapy. In view of these results, it is
      useless and probably unethical to perform second-look laparotomy in Stage I
      ovarian carcinoma if the initial staging was properly performed.

PMID- 8472731
TI  - Response of "benign" metastasizing leiomyoma to progestin withdrawal. Case
      report.
AB  - We report a rare case of a benign metastasizing leiomyoma in which progestin
      therapy permitted or promoted pulmonary metastases, but progestin withdrawal
      induced a marked tumor regression. The significance of these observations is
      discussed relative to the estrogen and progesterone receptor positivity of this
      patient's tumor.

PMID- 8472730
TI  - Primary carcinoid tumor of the ovary. A case report.
AB  - The clinicopathologic features of a patient with primary carcinoid tumor of the
      ovary who presented with the signs of cardiac failure are described. The patient
      underwent total abdominal hysterectomy + bilateral salpingo-oophorectomy +
      omentectomy + bilateral pelvic lymphadenectomy + appendectomy; and she is alive
      with no evidence of recurrent disease one year after surgery.

PMID- 8472732
TI  - Serous papillary adenocarcinoma of the endometrium. A unique entity with a grave
      prognosis. Case report and review of the literature.
AB  - A case of Papillary Serous Adenocarcinoma of the endometrium is described. This
      unique variant of endometrial carcinoma was described initially only 10 years
      ago. The tumor has distinct pathological characteristics and a very grave
      prognosis. The importance of identifying this unique tumor type is related to
      appropriate treatment as well as to correct statistical analysis of endometrial
      carcinoma.

PMID- 8472733
TI  - Endometrioid carcinoma of the ovary. Retrospective study.
AB  - From 1985 to 1991, 9 patients with endometrioid carcinoma of the ovary were
      treated and followed at the University of Ancona, Department of Gynecology and
      Obstetrics. Four patients (44.4%) had Stage I disease, 1 (11.1%) Stage II, 1
      (11.1%) Stage III and 3 (33.3%) Stage IV. Six patients (66.6%) had grade 2 of the
      disease and 3 (33.3%) grade 3. Two of the patients (22.2%) had synchronous
      endometrial carcinoma while 3 had histologic evidence of endometriosis at the
      time of presentation. All the patients received treatment of combination of
      surgery, polychemotherapy, hormone and/or immunotherapy. The overall survival
      rate after a median follow up of 26.6 months was 66.6%. A high survival (100%)
      was observed for patients with associated endometriosis.

PMID- 8472734
TI  - Vulvar carcinoma at Srinagarind Hospital, Khon Kaen, Thailand.
AB  - From 1978 to 1991, 69 cases of primary carcinoma of the vulva were diagnosed and
      treated at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University,
      Thailand. The average age was 56 years at the time of diagnosis. Five patients
      (7.2%) were in FIGO Stage I, 25 (36.2%) Stage II, 28 (40.6%) Stage III and 11
      (15.9%) Stage IV. Histologically, 60 cases were squamous cell carcinoma, large
      cell non-keratinizing type, 2 (2.9%) of squamous cell carcinoma, large cell
      keratinizing type, 2 (2.9%) of adenocarcinoma, 1 (1.4%) of basal cell carcinoma
      and 1 (1.4%) of malignant melanoma. Radical vulvectomy with inguino-femoral
      lymphadenectomy were performed in 42 patients. The rest were rejected or
      unsuitable for surgery. The actuarial 5 and 10-year survival rate for 61 patients
      followed up 1 to 14 years was 66.0%. The 5-year survival rate for operable cases
      was 88.5% but for unoperable cases it was only 22.0%. The authors still confirm
      surgery as the primary treatment of choice for this rare malignancy.

PMID- 8472735
TI  - Prevention of postoperative thromboembolism in gynaecological malignancy.
AB  - A prospective randomized clinical trial compared the efficacy of low doses of
      heparin (LDH) and heparin plus dihydroergotamine mesylate (HDHE) in the
      prevention of thromboembolism in gynaecological patients with malignancy
      undergoing major surgery. One hundred and fifty-five patients, with a mean age
      54.5 years were allocated to receive 5,000 IU unfractionated heparin or 5,000 IU
      unfractionated heparin +0.5 mg dihydroergotamine mesylate twice daily. Treatment
      was begun 2 hours preoperatively and continued until discharge (12 +/- 7 days).
      The incidence of thromboembolism determined by radiolabelled fibrinogen and lung
      perfusion scanning was 21.3% in LDH group and 22.7% in HDHE group. There were no
      statistically significant differences between the two groups (p > 0.1). The
      observed haemorrhagic rate was 1.9% in both groups. HDHE prevention was more
      expensive but without significant advantage over LDH. During two months after
      surgery 4 patients (5%) in the LDH group and 1 patient (1.8%) in the HDHE group
      developed deep vein thrombosis.

PMID- 8472736
TI  - Risk factors in vulvar carcinoma recurrences.
AB  - 18 patients with invasive vulvar carcinoma treated by radical vulvectomy and
      bilateral groin lymphadenectomy have been evaluated. An 18% of local and 22% of
      pelvic or distant recurrences occurred. The local recurrences had favorable
      prognosis, whereas the pelvic or distant recurrences a worse prognosis. The
      staging, the tumour size, the nodes involvement, the stromal infiltration and the
      lymphoplasmacytic infiltration, as prognostic factors, have been evaluated. All
      these factors, except the tumour size, influenced the pelvic or distant
      recurrences. The pelvic or distant recurrences were contemporaneously associated
      with mild phlogistic infiltration and depth of invasion > 5 mm.

PMID- 8472737
TI  - Antiarrhythmic effects of bisaramil in canine models of ventricular arrhythmia.
AB  - The antiarrhythmic effects of bisaramil were examined in canine models of
      digitalis-, adrenaline- and two-stage coronary ligation- induced arrhythmia.
      Bisaramil (0.3-1.5 mg/kg i.v.) suppressed all the arrhythmias. The antiarrhythmic
      plasma concentration (IC50) for arrhythmias induced by digitalis, adrenaline, and
      24 h two-stage coronary ligation were 0.11, 0.81, and 0.75 micrograms/ml,
      respectively. Bisaramil is a potent class I agent, judging from its low
      antiarrhythmic plasma concentrations. Oral bisaramil (10 mg/kg) also suppressed
      24-h coronary ligation-induced arrhythmia. These results indicate that bisaramil
      may be a useful drug for the treatment of various clinical ventricular
      arrhythmias.

PMID- 8472738
TI  - Effects of central vasopressin administration to infant rats.
AB  - The neurohypophyseal peptide hormone arginine-vasopressin functions as a
      neuropeptide in several brain areas in addition to its role as a posterior
      pituitary hormone. Several studies indicate that arginine-vasopressin and
      arginine-vasopressin receptors appear early in the infant rat brain. To determine
      if arginine-vasopressin receptors in the infant were responsive to exogenous
      peptides, we compared the behavioral effects of central or peripheral
      administration of arginine-vasopressin, arginine vasotocin, the oxytocin
      precursor oxytocin-Gly-Lys-Arg, and arginine-vasopressin receptor antagonists in
      socially isolated rat pups. Central administration of arginine-vasopressin
      decreased the number of rat pup ultrasonic vocalizations, reduced locomotor
      activity and decreased the latency to express a response to negative geotaxis.
      Temperature was also reduced at all doses tested. Co-administration of arginine
      vasopressin and receptor antagonists suggested that changes in vocal behavior
      were mediated by the V1 receptor subtype. Changes in core temperature appeared to
      be mediated by a V2 receptor subtype. Peripheral arginine-vasopressin
      administration increased calling and decreased core body temperature. Neither
      effect was blocked by central receptor antagonist administration. The results are
      consistent with the hypothesis that arginine-vasopressin receptors in the infant
      rat brain are functional.

PMID- 8472739
TI  - Identification of a specific receptor for interleukin-1 in vascular smooth muscle
      cells: regulation by interleukin-1 and interleukin-6.
AB  - A fluorescently labeled ligand was utilized to establish the existence of an
      interleukin-1 (IL-1) receptor in vascular smooth muscle. The binding of the
      phycoerythrin-labeled IL-1 beta to the murine T cell line, EL-4, was examined as
      a positive control. The phycoerythrin-labeled IL-1 beta identified a specific IL
      1 receptor in the EL-4 cells. Vascular smooth muscle cells were also positively
      stained by the fluorescent ligand. The binding of phycoerythrin-labeled IL-1 beta
      to these cells was saturable and reversed by 100-fold excess unlabeled IL-1 beta.
      Incubation of the vascular smooth muscle cells with IL-1 beta (25 ng/ml) or IL-6
      (250 ng/ml) for 18 h increased and decreased, respectively, the percentage of
      cells positively stained by phycoerythrin-labeled IL-1 beta which suggests these
      cytokines regulate IL-1 receptor expression in these cells. These data indicate a
      specific receptor for IL-1 exists in vascular smooth muscle cells.

PMID- 8472740
TI  - The role of atrial natriuretic peptide in the diuretic effect of Ca2+ entry
      blockers.
AB  - The effect of three calcium entry blockers--verapamil, nifedipine and felodipine-
      on diuresis, natriuresis, the renin-aldosterone axis, and atrial natriuretic
      peptide (ANP) levels was studied in 30 previously untreated patients with mild to
      moderate essential hypertension. All three blockers produced significant
      antihypertensive effects after 2 and after 24 h. Heart rate tended to decrease,
      but did not change significantly after verapamil, but increased significantly 1-2
      h after nifedipine and felodipine. Plasma renin activity (PRA) did not change
      significantly with any treatment, and plasma aldosterone decreased with all three
      agents. ANP levels did not change significantly after verapamil, but increased
      significantly after nifedipine and felodipine. There was a significant positive
      correlation between the maximal change in ANP level and urinary sodium after
      nifedipine and felodipine. The increase in urinary sodium after verapamil was not
      significant. The role of the direct renal effect of calcium entry blockers in
      their persistent natriuretic action is discussed, as well as their short-term
      enhancement of ANP levels, which may account for the initial diuretic and
      natriuretic effects seen with this class of dihydropiridines.

PMID- 8472741
TI  - Effect of ovarian steroids and diethylstilbestrol on the contractile responses of
      the human myometrium and intramyometrial arteries.
AB  - Estriol, estradiol, progesterone and diethylstilbestrol in the concentration
      range of 0.2-40 microM inhibited the spontaneous contractions of the myometrium
      in a dose-dependent manner but the differences in IC50 values obtained with
      different hormones were not statistically significant. All these hormones caused
      a concentration-dependent inhibition of the K(+)-induced contraction. The IC50
      values were lowest for diethylstilbestrol and highest for estriol. Vasopressin at
      concentrations of 1.5 x 10(-6) - 1.8 x 10(-3) U/ml stimulated myometrial
      contractions. These responses were also inhibited by ovarian steroids and
      diethylstilbestrol. The IC50 values for estriol and progesterone were
      significantly higher than for estradiol or diethylstilbestrol. The values for
      estriol and progesterone did not differ significantly. In the uterine arteries,
      which lacked spontaneous activity, ovarian steroids and diethylstilbestrol
      inhibited contractions induced by K+ depolarization. As with myometrium, the
      lowest effect was observed with estriol and the highest with diethylstilbestrol.
      A dose-dependent inhibition by all four hormones (0.2-40 microM) of vasopressin
      induced contractile responses of the uterine arteries was observed. With the
      lowest concentration of progesterone, however, the arterial response to
      vasopressin was enhanced. The increases by progesterone (0.02 and 0.2 microM) of
      responses induced by vasopressin were statistically significant (P < 0.05). The
      present data strongly suggest that, in human myometrium and uterine arteries,
      ovarian steroids and diethylstilbestrol cause a more pronounced inhibition of
      receptor-mediated than of voltage-dependent Ca2+ channels. The increase by a very
      low (physiological) concentration of progesterone of vasopressin-induced
      responses in both myometrium and arteries may be of significance in the
      pathophysiology of dysmenorrhea.

PMID- 8472742
TI  - Haloperidol and clozapine increase intraneuronal dopamine metabolism, but not
      gamma-butyrolactone-resistant dopamine release.
AB  - In a previous study, two coexisting mechanisms of dopamine release were
      identified in dopamine neuron terminals. One can be blocked with gamma
      butyrolactone, suggesting it is impulse flow-dependent, while the other one
      cannot and is apparently impulse flow-independent. The goal of this study was to
      further characterize the gamma-butyrolactone-resistant mechanism and its relation
      to dopamine metabolism. Following acute and chronic haloperidol or clozapine
      treatment, gamma-butyrolactone was given to block dopamine neuronal impulse flow.
      In all groups, 3-methoxytyramine levels after monoamine oxidase inhibition with
      pargyline (an index of dopamine release) were measured in the frontal cortex,
      nucleus accumbens and striatum. Regional steady-state levels of dopamine, 3,4
      dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were also measured
      in the rats treated acutely with neuroleptics. In all three regions, gamma
      butyrolactone reduced the 3-methoxytyramine levels by over 50% after chronic
      neuroleptic treatment. This indicates that dopamine release from the terminals is
      primarily impulse flow-dependent during chronic neuroleptic treatment, both in
      the dopamine neurons which do undergo depolarization block, and in those that do
      not. No neuroleptic effect on the gamma-butyrolactone-resistant dopamine release
      was observed, while DOPAC and HVA were markedly elevated by the acute treatment,
      suggesting a predominant production of these metabolites from unreleased
      dopamine.

PMID- 8472743
TI  - Behavioral effects of chronic cocaine treatment in the week-old rat pup.
AB  - Chronic treatment of adult animals with cocaine results in sensitization to some
      behavioral effects and tolerance to others but there are few reports on the
      effects of chronic stimulants during early development. The present experiments
      assessed the development of cocaine-induced alterations in locomotor activity and
      separation induced ultrasonic vocalization, a fundamental behavior of infant
      rats. The first study demonstrated a dose dependent suppression of ultrasounds in
      naive pups at 7 days of age that lasted at least 60 min and that was accompanied
      by a dose dependent increase in locomotion. To assess chronic effects, pups were
      injected with cocaine (5.0-30.0 mg/kg) twice daily from ages 1 to 7 days and then
      tested at 7, 8 and 10 days of age for vocalization in response to isolation from
      the dam and littermates. There were minimal effects on baseline levels of crying,
      but following chronic treatment with cocaine, pups showed generally higher levels
      of ultrasounds when tested with an acute challenge of cocaine at 7 and 8 days of
      age. In chronically treated pups locomotor activity was increased during baseline
      tests. At 10 days of age, 3 days after the last treatment with cocaine, in the
      highest dose treatment condition, there was an exaggerated reduction of
      ultrasounds when tested with a littermate. The results demonstrate that chronic
      exposure to cocaine during early development disrupts the normal regulation of a
      developmentally important socially mediated behavior.

PMID- 8472744
TI  - Isradipine attenuates the ischemia-induced release of dopamine in the striatum of
      the rat.
AB  - We examined the effect of isradipine, a blocker of L-type voltage-sensitive Ca2+
      channels (VSCCs), on the ischemia-induced release of dopamine in the rat
      striatum. Perfusion of 200 micrograms/ml isradipine in the striatum did not alter
      extracellular dopamine concentrations monitored by microdialysis. However, a
      marked increase (145-fold) in dopamine level during forebrain ischemia, developed
      by bilateral carotid artery occlusion, was attenuated significantly by 37% by
      isradipine whereas the intensity of ischemia, monitored by striatal blood flow,
      was unchanged. These results suggest that isradipine attenuates the ischemia
      induced release of dopamine via blockade of L-type VSCCs on dopaminergic neurons.

PMID- 8472745
TI  - High- and low-affinity states of dopamine D1 receptors in schizophrenia.
AB  - Using SKF-38393/[3H]SCH-23390 dopamine D1 receptor agonist/antagonist competition
      binding technique, we showed that schizophrenics distinguished from the neuro
      psychiatric and normal controls by exhibiting a significant increase in the
      density of the low-affinity state, and a concomitant enhancement in the binding
      affinity of the high-affinity state of D1 dopamine receptors in caudate nucleus.
      The results suggest that perturbation in dynamic equilibrium of high- and low
      affinity states of D1 receptors underlies the pathogenesis of schizophrenia.

PMID- 8472746
TI  - Effects of a novel thyrotropin-releasing hormone analogue, JTP-2942, on
      extracellular acetylcholine and choline levels in the rat frontal cortex and
      hippocampus.
AB  - The effects of a novel thyrotropin-releasing hormone (TRH) analogue, N alpha
      [(1S,2R)-2-methyl-4-oxocyclopentanecarbonyl]-L-histidyl-L-pr olinamide (JTP-2942)
      on acetylcholine (ACh) release and on the extracellular choline level were
      investigated in rat frontal cortex and hippocampus by microdialysis, and were
      compared with effects of TRH. JTP-2942 (0.3 mg/kg i.p.) produced a marked (>
      300%) and persistent increase of ACh release in both the frontal cortex and
      hippocampus, while TRH (3 mg/kg i.p.) caused a significant but transient increase
      of ACh to about 200% in the frontal cortex. Both drugs significantly decreased
      the choline levels in both brain regions. Investigation of the effects of JTP
      2942 (0.001-1 mM) and TRH (1 and 10 mM) on ACh release and choline levels when
      perfused through the dialysis probe revealed that JTP-2942 had a greater effect
      than TRH in both the frontal cortex and the hippocampus. The action of JTP-2942
      was about 1000-fold more potent than that of TRH in both brain regions. Oral
      administration of JTP-2942 at a dose of 10 mg/kg markedly and persistently
      increased the release of ACh and at doses of 1-10 mg/kg decreased the
      extracellular choline level in the frontal cortex and hippocampus. These results
      also suggest that JTP-2942 has some selectivity for the hippocampus compared to
      the frontal cortex after both systemic administration and local injection. The
      increase of ACh release caused by JTP-2942 was completely antagonized by
      perfusion with tetrodotoxin (TTX, 1 microM), suggesting that the action of JTP
      2942 on cholinergic neurons was mediated via neuronal activity.

PMID- 8472747
TI  - Autoradiographic studies of RP 62203, a potent 5-HT2 receptor antagonist.
      Pharmacological characterization of [3H]RP 62203 binding in the rat brain.
AB  - The binding properties and localization of [3H]RP 62203, a novel ligand for 5-HT2
      receptors, were investigated on rat brain sections. The specific binding of this
      5-HT2 receptor antagonist was reversible and could be displaced by ritanserin (1
      microM). Saturation experiments revealed a single class of binding sites with a
      KD of 0.128 +/- 0.018 nM and a Bmax of 1.67 +/- 0.06 pmol/mg protein.
      Pharmacological specificity was demonstrated by the potency order of displacing
      agents: RP 62203 > ritanserin > spiperone > methysergide > mianserin >
      pipamperone > cinanserin > 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI).
      Quantitative autoradiography showed a heterogeneous distribution of [3H]RP 62203
      binding sites, with the highest densities in the frontal, parietal and auditory
      cortices (layer IV), claustrum and olfactory bulb. Binding densities in the
      occipital cortex, caudate putamen and thalamic nuclei were moderate, whereas the
      hippocampus and substantia nigra displayed a very low density of binding sites.
      The cerebellar cortex appeared almost devoid of [3H]RP 62203 binding sites. The
      anatomical distribution of binding sites demonstrated that [3H]RP 62203
      essentially bound only to rat brain regions known to contain 5-HT2 receptors.
      This ligand could thus be a useful tool to visualize 5-HT2 receptors.

PMID- 8472748
TI  - Role of endothelin ETB receptors in bronchoconstrictor and vasoconstrictor
      responses in guinea-pigs.
AB  - In anesthetized and ventilated guinea-pigs, intravenous injections of endothelin
      (ET)-1 (0.5 nmol/kg), ET-3 (0.5 nmol/kg), and [Ala1,3,11,15]ET-1 (20 nmol/kg), an
      ETB-selective receptor agonist, induced bronchoconstrictor and transient
      vasoconstrictor responses. Only the ET-1-induced transient vasoconstriction was
      followed by a secondary sustained pressor response. The ETA-selective receptor
      antagonist, BQ-123 (1 mg/kg i.v.), attenuated only the sustained pressor
      response. These results indicate that the bronchoconstrictor and transient
      vasoconstrictor responses to endothelins in guinea-pigs are mediated by ETB
      receptors, whilst the sustained pressor response is mediated by ETA receptors.
      The thromboxane A2 receptor antagonist, L-670,596 (0.5 mg/kg, i.v.) and a high
      dose of BQ-123 (30 mg/kg i.v.) abolished the bronchoconstriction only without
      affecting the transient pressor response to endothelin isopeptides. These results
      suggest that the ETB-mediated bronchoconstriction depends on thromboxane A2
      formation. The different sensitivity of these ETB-mediated transient responses to
      BQ-123 suggests the possible existence of distinct ETB receptor subtypes.

PMID- 8472749
TI  - Protection of infarcted, chronically reperfused hearts by an alpha-tocopherol
      analogue.
AB  - Free radicals may cause part of the irreversible injury which occurs during
      myocardial infarction and reperfusion. In the present study MDL 73404, a
      hydrophilic, cardioselective, free radical scavenger analogue of alpha
      tocopherol, was evaluated for its effects on infarct size as well as on
      indicators of reperfusion injury. A pentobarbitone-anaesthetised rat model of
      coronary artery ligation (60 min; followed by 8 days of reperfusion) was used.
      Intravenous infusion of MDL 73404 (3 mg/kg per h) began 10 min before occlusion
      until 30 min after the onset of reperfusion. MDL 73404 reduced (P < 0.02) the
      elevated serum levels of thiobarbituric acid reactive substances and plasma
      levels of creatine phosphokinase (P < 0.01). An increase in cardiac output and
      heart rate together with a decrease (P < 0.01) in infarct size was evident in
      rats that had received MDL 73404, 8 days previously. Isolated infarcted hearts
      obtained from rats after 8 days of reperfusion had greater (P < 0.01) + dP/dt
      max, -dP/dt max, left ventricular systolic pressure and coronary flow after MDL
      73404 compared to saline-treated controls. Infusion of [14C]MDL 73404, during the
      time of occlusion resulted in a concentration of 14.5 +/- 2.2 mg eq/g in the non
      ischaemic ventricular tissue and a concentration of 3.0 +/- 0.4 mg eq/g in the
      area at risk. After infusion for the 30 min of reperfusion, 6.4 +/- 0.2 mg eq/g
      was detected in the non-ischaemic ventricular tissue but only 3.1 +/- 0.5 mg eq/g
      in the area at risk.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472750
TI  - Nitric oxide inhalation attenuates pulmonary hypertension and improves gas
      exchange in endotoxin shock.
AB  - Nitric oxide (10 ppm) inhaled by pigs before or during endotoxin shock induced by
      an infusion of E. coli lipopolysaccharide. Nitric oxide inhalation selectively
      attenuated pulmonary hypertension during endotoxin infusion without influencing
      mean arterial blood pressure and cardiac output. Upon cessation of nitric oxide
      inhalation, pulmonary artery pressure rapidly increased to levels seen in
      endotoxin-treated controls. The oxygenation and pH of arterial blood were
      significantly higher in the animals receiving nitric oxide. A marked increase in
      arterial plasma noradrenaline and neuropeptide Y was seen in endotoxin-treated
      control pigs while in the nitric oxide-treated pigs this increase was markedly
      reduced. The increase in arterial plasma endothelin-1 was not influenced by
      nitric oxide inhalation. Infusion of L-arginine (substrate for nitric oxide
      synthesis) also attenuated the pulmonary hypertension but was not selective for
      the pulmonary vasculature. L-Nitro-arginine (a nitric oxide synthesis inhibitor)
      initiated a rapid but brief elevation of arterial blood pressure and of pulmonary
      artery pressure as well as a reduction in cardiac output. Nitric oxide inhalation
      selectively reduces pulmonary hypertension in porcine endotoxin shock and
      improves arterial oxygenation and pH with a marked attenuation of sympathetic
      activation.

PMID- 8472751
TI  - MK-801 is neuroprotective but does not improve survival in severe forebrain
      ischemia.
AB  - The effects of MK-801 on postischemic recovery, survival and neuronal
      preservation in the cortex, hippocampus and striatum were studied in Mongolian
      gerbils. The drug was administered 30 min prior to 20 of min forebrain ischemia
      induced by bilateral ligation of the carotids. Neurological recovery and survival
      were monitored for 7 days. At the end of the monitoring period neuronal damage
      was analyzed in the brains of the survivors in both groups. Treatment with MK-801
      did not improve either neurological recovery or end-point survival. However,
      significant (P < 0.01) neuronal protection was observed in the hippocampi and
      striata of the drug treated animals while cortical neurons were not significantly
      protected. These findings demonstrate that protection against ischemic neuronal
      damage can be observed without concomitant improvement in either postischemic
      neurological recovery or survival. Protection of selectively vulnerable brain
      regions, often used as the predictor of the therapeutic potential of an agent,
      does not appear to correlate well with postischemic survival in this animal model
      of ischemia.

PMID- 8472752
TI  - Characterization of 5-HT receptors in simian isolated gastroepiploic artery.
AB  - The vascular responses of simian gastroepiploic arteries to 5-hydroxytryptamine
      (5-HT), 5-carboxamidotryptamine (5-CT, a selective 5-HT1-like receptor agonist),
      8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT, a selective 5-HT1A receptor
      agonist), m-trifluoromethylphenylpiperazine (TFMPP, a selective 5-HT1B receptor
      agonist), noradrenaline and KCl were examined in isolated, cannulated and
      perfused preparations. 5-HT induced dose-dependent vasoconstrictions more
      potently than noradrenaline did. The rank order of potency was 5-HT >
      noradrenaline > 5-CT >> 8-OH-DPAT = TFMPP. 5-HT- and 5-CT-induced
      vasoconstrictions were not significantly changed by endothelial denudation,
      although acetylcholine-induced vasodilatations were abolished. 5-HT-induced
      vasoconstrictions were depressed by phentolamine (an alpha-adrenoceptor
      antagonist), diltiazem (a calcium ion channel inhibitor), methysergide (a 5HT1-
      and 5HT2-receptor antagonist) and ketanserin (a selective 5-HT2 receptor
      antagonist). Noradrenaline-induced vasoconstrictions were readily inhibited by
      phentolamine and ketanserin. 5-CT-, 8-OH-DPAT- and TFMPP-induced
      vasoconstrictions were inhibited by both methysergide and ketanserin. KCl-induced
      vasoconstrictions were blocked by diltiazem. From these results, we conclude that
      (1) the simian gastroepiploic artery contains 5-HT receptors, (2) 5-HT1-like and
      5-HT2 receptors are involved in the vasoconstriction of the simian gastroepiploic
      artery, and (3) the vasoconstriction is at least partially related to the
      activation of calcium ion channels.

PMID- 8472753
TI  - 5-HT3 receptors augment neuronal, cholinergic contractions in guinea pig trachea.
AB  - Serotonin (5-HT) and the selective 5-HT3 receptor agonist, 2-methyl-5
      hydroxytryptamine enhanced electrical field stimulated contractions of the
      isolated guinea pig trachea. 5-HT (EC50 = 3.5 microM) was twice as potent as 2
      methyl-5-hydroxytryptamine (EC50 = 7.4 microM). The effects of 5-HT and 2-methyl
      5-hydroxytryptamine were antagonized by the selective 5-HT3 receptor antagonist;
      zacopride (apparent pA2 = 7.60 against 2-methyl-5-hydroxytryptamine). 2-Methyl-5
      hydroxytryptamine (10 microM) had no effect on contractile responses to exogenous
      acetylcholine. Furthermore, the increase in electrical field stimulated
      contraction by 2-methyl-5-hydroxytryptamine was unchanged by hexamethonium (100
      microM) but contractions were blocked by atropine (1 microM). These results
      suggest that excitatory 5-HT3 receptors exist on postganglionic cholinergic
      nerves in the isolated guinea pig trachea.

PMID- 8472754
TI  - The hydrophilic spin trap, 5,5-dimethyl-1-pyrroline-1-oxide, does not protect the
      rat heart from reperfusion injury.
AB  - The role and site of free radical generation in myocardial ischemia/reperfusion
      injury were investigated using the hydrophilic spin trapping agent, 5,5-dimethyl
      1-pyrroline-1-oxide (DMPO). DMPO (40 mM) proved ineffective in preserving the
      contractile performance and energy metabolism of Langendorff-perfused rat hearts
      following ischemia and reperfusion. This result, which is in contrast with the
      cardioprotection observed with hydrophobic spin traps, suggests that free
      radicals are generated intracellularly under these conditions.

PMID- 8472755
TI  - Contractile effects caused by thaliporphine in the guinea-pig ileum.
AB  - The intestinal effects of thaliporphine, a potent vasoconstrictor, were studied
      using the isolated guinea-pig ileum. Thaliporphine (0.1-100 microM) caused
      contraction in a concentration-dependent manner. The contraction was not affected
      by pretreatment of the ileum with tetrodotoxin, phentolamine, prazosin,
      propranolol, naloxone, atropine, diphenhydramine, methysergide, indomethacin or
      staurosporine. However, the contraction was inhibited markedly by nifedipine and
      verapamil. These results suggest that thaliporphine causes contraction of
      intestinal smooth muscle by a direct effect on muscle mediated by an increased
      Ca2+ influx through voltage-dependent Ca2+ channels.

PMID- 8472756
TI  - The C-terminal neurotensin-(8-13) fragment potently modulates rat neostriatal
      dopamine D2 receptors.
AB  - The effects of neurotensin fragments and of neurotensin itself on the
      characteristics of neostriatal dopamine D2 agonist binding were studied in
      competition experiments with dopamine using the D2 antagonist, [3H]raclopride.
      The biologically active neurotensin-(8-13) fragment, but not the inactive
      neurotensin-(1-7) fragment, caused a concentration-related increase in the KH and
      KL values of dopamine with a maximal increase by 110 and 97%, respectively, at 1
      nM, while neurotensin-(1-13) only induced such changes at 10 nM. In view of the
      higher potency and the increased ability of neurotensin-(8-13) versus neurotensin
      (1-13) to reduce the affinities of the high- and low-affinity states of the
      neostriatal D2 receptors, the C-terminal neurotensin fragments may be among the
      endogenous ligands of the neostriatal neurotensin receptors.

PMID- 8472757
TI  - Nitric oxide from polymorphonuclear leukocytes modulates red blood cell
      deformability in vitro.
AB  - We confirmed that iloprost is very potent in preserving the deformability of
      rabbit red blood cells (RBC). Incubation of RBC with a small number (up to 1.2 x
      10(6) cells/ml) of polymorphonuclear leukocytes (PMNs) caused a gradual decline
      in RBC deformability. The addition of PMNs up to 2.8 x 10(6) cells/ml increased
      RBC deformability but, at higher concentrations, both in the presence and absence
      of a neutrophil activating cytokine (interleukin-8; IL-8), PMNs reduced the
      deformability of RBCs. In the presence of a small number of PMNs, the
      deformability of RBC was increased by nitric oxide (NO) donors, such as
      sydnonimine (SIN-1) or sodium nitroprusside, and reduced by the NO synthase
      inhibitor, NG-monomethyl-L-arginine. We suggest that the deformability of RBC is
      modulated by PMNs via the release of NO and that the NO concentration is of
      critical importance in this modulatory mechanism. NO seems to preserve or enhance
      RBC deformability within a certain range of concentrations, but these effects are
      reversed or eliminated at both too low and too high concentrations.

PMID- 8472758
TI  - Effects of Ca2+ channel antagonists in guinea-pig normal and skinned gall
      bladder.
AB  - CaCl2 (0.01-50 mM, in K(+)-depolarized tissues), KCl (0.1-100 mM) and
      acetylcholine (1 nM-10 mM) produced concentration-dependent contractions of
      guinea-pig isolated gall bladder. Nifedipine (1-100 microM), verapamil (1-100
      microM), diltiazem (1-100 microM), cinnarizine (1-100 microM), and flunarizine (1
      100 microM) each produced a concentration-related inhibition of the log
      concentration-effect curve for CaCl2. The rank order of potencies of these
      antagonists, measured as the IC50 against Ca2+ (50 mM)-induced contraction of
      depolarized gall bladder, was diltiazem (0.25 microM) > or = verapamil (0.8
      microM) approximately nifedipine (1.2 microM) >> cinnarizine (25 microM)
      approximately flunarizine (80 microM). Verapamil and diltiazem depressed KCl
      induced contraction with an effectiveness and potency similar to those displayed
      against CaCl2 but nifedipine, cinnarizine and flunarizine were less effective
      against contractions in response to KCl compared to CaCl2. Verapamil and
      diltiazem, but not the other Ca2+ channel antagonists tested, had a specific
      inhibitory effect on the contractions due to KCl when compared to acetylcholine
      induced contractions. Cinnarizine (10-100 microM) and flunarizine (10-100
      microM), but not the other antagonists tested, depressed Ca2+ (20 microM)-evoked
      contraction of skinned guinea-pig gall bladder preparations. It is concluded that
      distinct differences exist between the Ca2+ channel antagonists examined. The
      action of nifedipine, verapamil and diltiazem is restricted to the plasmalemma
      whereas cinnarizine and flunarizine also act on the intracellular contractile
      apparatus.

PMID- 8472759
TI  - Working memory deficits induced by intrahippocampal administration of 8-OH-DPAT,
      a 5-HT1A receptor agonist, in the rat.
AB  - In a test of working memory using a three-panel runway task, the 5-HT1A receptor
      agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), at 1.0 mg/kg i.p.
      significantly increased the number of errors (attempts to pass through two
      incorrect panels of the three panel gates at four choice points), but it had no
      effect on errors in a test of reference memory. Intrahippocampal injection of 8
      OH-DPAT at 10 micrograms/side also significantly increased the number of working
      memory errors, without affecting that of reference memory errors. The effect of
      intrahippocampal 8-OH-DPAT (10 micrograms/side) on working memory was blocked by
      the 5-HT1A receptor antagonist, (-)-propranolol, at 5 mg/kg i.p. These results
      suggest that activation of hippocampal 5-HT1A receptors impairs working memory,
      but does not affect retention of reference memory.

PMID- 8472760
TI  - Membrane activity of class III antiarrhythmic compounds; a comparison between
      ibutilide, d-sotalol, E-4031, sematilide and dofetilide.
AB  - This study compares the membrane activity of ibutilide, d-sotalol, sematilide, E
      4031 and dofetilide on single ventricular cells under identical experimental
      conditions. We found that ibutilide and dofetilide produced a 'bell-shaped'
      concentration-dependent effect on action potential duration. Ionic current
      measurement showed that ibutilide, at 10(-8) M, increased a late inward current;
      the other compounds had either no effect or decreased it. Moreover, only
      ibutilide, at a high concentration of 10(-5) M, increased an outward current, as
      oppose to a uniform depression of IK by d-sotalol, sematilide, E-4031 and
      dofetilide, and the depression of IK by the latter compounds could be reversed by
      10(-5) M ibutilide. Finally, low concentration of ibutilide could further prolong
      the action potential duration that had already been prolonged by a K+ channel
      blocker, but a high concentration of ibutilide did just the opposite by reversing
      the prolongation caused by K+ channel blockers. Therefore, action potentials
      agree well with the ionic current results. Possible mechanistic advantage of
      ibutilide over K+ channel blockers was discussed.

PMID- 8472761
TI  - Effect of K+ depolarization, tetrodotoxin, and NMDA receptor inhibition on
      extracellular adenosine levels in rat striatum.
AB  - Extracellular adenosine in the striatum of adult male rats was measured by the
      use of a microdialysis fibre inserted transversely in the striatum. The adenosine
      concentration in samples of perfusate was determined by HPLC coupled to U.V.
      detection. The adenosine concentration (corrected for recovery) decreased after
      implantation of the probe. Two hours later it was 1.83 +/- 0.22 in anaesthetized
      rats, whereas it was 40% higher in rats in which anaesthesia had been
      discontinued. Twenty-four hours later the adenosine concentration was 0.124 +/-
      0.09 microM; the addition of dipyridamole (100 microM), an adenosine uptake
      blocker, to the perfusate resulted in a 76% increase in adenosine concentration
      in the effluent, whereas addition of the adenosine deaminase inhibitor erythro-2
      (hydroxy-3-nonyl) adenine (100 microM) caused a 260% increase. The addition of
      tetrodotoxin (1 microM) was followed by a decrease in basal adenosine
      concentration and a partial inhibition of the increase in adenosine evoked by K+
      depolarization. The increase induced by high K+ was markedly inhibited by the
      NMDA receptor antagonist D(-)-amino-7-phosphoeptanoic acid (1 mM, D-AP7). These
      findings indicate that the extracellular adenosine level is influenced by
      neuronal activity, and that under strong depolarizing conditions the increase in
      adenosine level involves NMDA receptor activation.

PMID- 8472762
TI  - Suppressive effect of cycloheximide on behavioral sensitization to
      methamphetamine in mice.
AB  - The effect of a protein synthesis inhibitor, cycloheximide, on behavioral
      sensitization to methamphetamine was investigated in mice. As indicated by the
      sensitization tests, repeated injection of methamphetamine (2 mg/kg i.p.) at
      intervals of 3 and 4 days resulted in a progressive augmentation of the locomotor
      stimulating effect of methamphetamine. This phenomenon, called locomotor
      sensitization, was attenuated by simultaneous treatment with cycloheximide (120
      mg/kg i.p.) at the time of stimulant injection. In contrast, when mice were
      treated with cycloheximide 4 h after stimulant injection, locomotor activity was
      progressively augmented in the same way as observed in mice receiving repeated
      injections of methamphetamine alone. On challenge, it was noted that locomotor
      activity was significantly higher in mice injected repeatedly with the stimulant
      alone and in those mice treated with the inhibitor 4 h after the stimulant
      injection compared to the saline-treated control mice. However, mice that had
      been simultaneously treated with cycloheximide and methamphetamine showed almost
      the same locomotor activity as the saline-treated control mice. These
      observations indicated that the locomotor sensitization to methamphetamine was
      possibly suppressed by simultaneous treatment with cycloheximide. We then
      examined the dose- and time-dependent nature of the effect of cycloheximide on
      locomotor sensitization. The stimulation of locomotion observed after repeated
      injection of the stimulant at a dose of 1.5 mg/kg was significantly attenuated by
      simultaneous treatment with 120 or 240 mg/kg of cycloheximide, but not by
      treatment with 60 mg/kg of the inhibitor. However, all the treatments failed to
      suppress the development of locomotor sensitization elicited by 3 mg/kg of
      methamphetamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472763
TI  - The role of Escherichia coli O 157 infections in the classical (enteropathic)
      haemolytic uraemic syndrome: results of a Central European, multicentre study.
AB  - To assess the importance of infection by Verotoxin (VT) producing Escherichia
      coli (VTEC) in children with HUS in Central Europe, stool and/or serum samples
      obtained from 147 patients from 28 paediatric centres were prospectively examined
      for the presence of VTEC and the kinetics of faecal VT titres (FVT), and for VT
      neutralization titres and antibodies against E. coli O 157 lipopolysaccharide,
      respectively. Ninety-two percent of the patients had classic (enteropathic) HUS
      (E+ HUS). Evidence of VTEC infection was obtained in 86% of them. VTEC/FVT were
      identified in 55/118 E+ cases (47%). A prominent feature was the frequent
      isolation of sorbitol-fermenting, VT2-producing E. coli O 157.H-.VT1 (C600/H19)
      was neutralized by 9%, and VT2 (C600/933W) by 99% of the initial serum samples
      from E+ patients, compared to 3% (VT1) and 100% (VT2) from age-related controls.
      Fourfold titre rises against VT1 and/or VT2 were observed in 13/70 (19%), and
      significantly elevated O 157 LPS IgM and/or IgA antibodies in 106/128 (83%) of
      the E+ patients. The ubiquitous VT2 neutralizing principle in the serum of HUS
      patients as of healthy controls warrants further investigations.

PMID- 8472764
TI  - A longitudinal study of Vero cytotoxin producing Escherichia coli in cattle
      calves in Sri Lanka.
AB  - Two cohorts of 10 and 16 calves were followed at weekly or fortnightly intervals
      from 4-28 and 1-9 weeks respectively to determine whether natural infection by
      Vero cytotoxin (VT) producing Escherichia coli (VTEC) occurred. Ninety-one of 171
      (53%) faecal specimens were VTEC positive and 20-80% of animals at any given time
      excreted VTEC. Of 104 VTEC strains studied further, 6 different serogroups (O
      22.H16; O 25.H5; O 49.H-; O 86.H26; O 88.H25; O 153.H12) and an untypable strain
      (O? .H21) were identified. All strains belonging to the same serotype had
      identical profiles of reactivity with DNA probes to toxins VT1 or 2, LTI or II
      and a probe (CVD419) derived from a plasmid carried by enterohaemorrhagic
      Escherichia coli O 157.H7. Four of these serotypes were found in the faecal flora
      of the calves, taken as a group, throughout the 4-month study period. Sixty
      percent of the strains hybridized with the probe for VT1, 4% with the probe for
      VT2, and 36% with both probes. Faecal VTEC were significantly associated with
      overt diarrhoeal illness in animals < 10 weeks of age, but no characteristic
      profile of markers (serotype or hybridization pattern) in E. coli isolates was
      associated with diarrhoea. A serological response to VT1 was detected in some
      animals, but faecal VT1 VTEC excretion persisted in spite of seroconversion. VT1
      seroconversion was not associated with diarrhoea. A serological response to VT2
      was not detected even in those animals excreting VT2 VTEC in the faeces.

PMID- 8472765
TI  - Egg-related Salmonella enteritidis, Italy, 1991.
AB  - In recent years, Salmonella enteritidis has become an increasingly important
      public health problem in Italy. In some parts of the country, the fraction of
      total human salmonella isolates accounted for by S. enteritidis has risen from 3
      4% in the mid-1980s to more than 30% in 1990. Between 1990 and 1991, the number
      of reported S. enteritidis outbreaks increased more than sixfold. The 33
      outbreaks reported in 1991 occurred in seven contiguous regions in northern and
      central Italy and were clustered in time between June and October: in the
      majority, products containing raw or undercooked shell eggs were implicated. Five
      of the egg-related outbreaks that occurred within a 30 kilometre radius over a 7
      week period were investigated in detail. A phage type 1 strain containing a 38.9
      MDa plasmid appeared responsible for three of the outbreaks, while in the
      remaining two a phage type 4 strain, also with a 38.9 MDa plasmid was isolated.
      Efforts are being made to enhance epidemiological surveillance and laboratory
      evaluation, and the use of pasteurized eggs has been recommended for high-risk
      populations.

PMID- 8472766
TI  - A large outbreak of human salmonellosis traced to a local pig farm.
AB  - An outbreak of Salmonella typhimurium definitive type (DT) 193 affecting 206
      persons occurred in July and August 1989 in a small town in northern England. A
      descriptive study suggested that cold meats including pork from a butcher's shop
      in the town were vehicles of infection. An analytical study of a cohort attending
      a function in the town showed a significant association between illness and
      consumption of cold roast pork supplied by the butcher's shop (P = 0.00000004).
      S. typhimurium DT 193 with the same antibiotic resistance pattern (to ampicillin,
      streptomycin, sulphonamides and tetracyclines) as the outbreak strain, and
      possessing a single plasmid of 80 MDa was isolated from samples of meat bought
      from the shop and implicated in illness, and from samples of pig faeces taken
      from the farm supplying the shop. It was concluded that inadequate processing of
      infected pork meat at the shop may have contributed to this outbreak but that
      cross contamination also played an important part in transmission. Control
      measures included a temporary closure of the shop and subsequent implementation
      of a detailed protocol for meat processing and monitoring of all procedures at
      the shop.

PMID- 8472767
TI  - Shigellosis due to occupational contact with non-human primates.
AB  - A small cluster of dysenteric illness, due to Shigella flexneri, was identified
      among technical assistants of a primate research unit. All of the affected
      individuals had been in regular contact with a colony of cynomolgus macaque
      monkeys, one of which was known to have suffered from acute haemorrhagic colitis
      in the preceding few weeks. Four monkeys were found to be excreting S. flexneri
      bacilli of identical antigen type (1b) to that isolated from the human cases.
      Investigation of working practices revealed the potential for inadvertent faeco
      oral spread and the need to improve existing control methods. We conclude that
      this small outbreak of shigellosis represents a primate-associated occupational
      zoonosis. The risk may not be fully appreciated by handlers or their doctors.

PMID- 8472768
TI  - Human isolates of apramycin-resistant Escherichia coli which contain the genes
      for the AAC(3)IV enzyme.
AB  - Gentamicin-resistant Escherichia coli isolated at different periods from patients
      in two hospitals were tested for resistance to the aminoglycoside antibiotic
      apramycin. Twenty-four of 93 (26%) gentamicin-resistant isolates collected from
      the Royal Liverpool Hospital between 1981 and 1990 were resistant to apramycin.
      Thirteen isolates were highly resistant to apramycin (minimal inhibitory
      concentration (MIC) > or = 1024 micrograms/ml), were also resistant to
      gentamicin, netilmicin and tobramycin, and hybridized with a DNA probe derived
      from the aminoglycoside acetyltransferase (3)IV (AAC(3)IV) gene. The proportion
      of gentamicin-resistant isolates which had high level resistance to apramycin
      increased from 7% in 1981-5 to 24% in 1986-90. Twelve gentamicin-resistant E.
      coli from Guy's and St Thomas's Hospital isolated between 1977 and 1980 were also
      tested for resistance to apramycin. For five of these isolates the MICs of
      apramycin was 32-256 micrograms/ml. None was shown to have a conjugative plasmid
      carrying resistance to apramycin and only one hybridized with the DNA probe for
      the AAC(3)IV enzyme.

PMID- 8472769
TI  - A point source outbreak of campylobacter infection related to bird-pecked milk.
AB  - A point source outbreak of Campylobacter jejuni affected 11 children in a day
      nursery. Milk consumed by the children was known to have been pecked by magpies
      on occasions. Illness was significantly associated with consumption of milk on a
      single morning. Examination of milk from a bottle pecked after the outbreak
      yielded campylobacters. The level of contamination was approximately six cells of
      C. jejuni per 500 ml of milk.

PMID- 8472770
TI  - The seasonality of canine births and human campylobacteriosis: a hypothesis.
AB  - The seasonality of canine births was investigated using records from the Kennel
      Club and the breeding centre for the Guide Dogs for the Blind Association. In
      these populations a distinct seasonal pattern was found with a greater number of
      puppies being born in the summer months than the winter. The hypothesis that the
      greater number of puppies acquired as pets during the summer months may
      contribute to the seasonal rise in human campylobacter cases, seen at this time,
      is discussed.

PMID- 8472771
TI  - The role of management systems in the epidemiology of thermophilic campylobacters
      among poultry in eastern zone of Tanzania.
AB  - A total of 255 samples of droppings collected from a total of 22 different
      poultry units were examined for the presence of thermophilic campylobacters and
      the isolates biotyped using Skirrow's protocol. The organisms were isolated from
      90 (35.3%) of all samples. Among the 22 units investigated, 13 (59%) were found
      to have unsatisfactory management systems, while 7 (32%) and 2 (9%) were found to
      have unsatisfactory and good systems respectively. Significantly large numbers of
      isolations, 68 of 147 (46.2%), were made from samples collected from poultry
      units with poor management (P < 0.005), compared with 19 out of 84 (22.6%)
      samples which were collected from satisfactory units and 3 out of 24 (12.5%)
      samples collected from units exercising particularly good management. Nineteen of
      72 (26.4%) samples collected from broilers, 32 out of 132 (24.2%) samples
      collected from layers and 39 out of 51 (76.49%) samples collected from indigenous
      free range poultry were positive for campylobacters. Among the 90 strains
      isolated from various units, 64 (70.1%) were Campylobacter jejuni, 25 (27.7%)
      were C. coli, and only 1 (2.2%) was C. laridis.

PMID- 8472772
TI  - Adherence to HEp-2 cells and enteropathogenic potential of Aeromonas spp.
AB  - Aeromonas strains (total = 60) of clinical, water and food origin were tested for
      adherence to HEp-2 cells. Environmental strains were selected (except for A.
      caviae) to include primarily those expressing other virulence-associated
      properties. Adhesion was markedly species-dependent (A. veronii biotype sobria,
      15 of 26 [58%]. A caviae, 4 of 12 [33%] and A. hydrophila, 2 of 8 [11%]). A.
      veronii biotype sobria were adhesive, irrespective of source (62 and 54% for
      clinical and environmental strains, respectively). Adherent strains of this
      species were enterotoxin-positive and most (13 of 15) grew at 43 degrees C. A.
      caviae isolated from clinical specimens contained a higher proportion (75%) of
      adherent strains than environmental strains (13%). Virulent subsets of A. veronii
      biotype sobria and A. caviae are adherent to HEp-2 cells. The HEp-2 assay is a
      useful model for investigating mechanisms of adherence and enteropathogenicity of
      virulent Aeromonas species.

PMID- 8472773
TI  - Antimicrobial susceptibilities and serotyping of Neisseria gonorrhoeae in
      southern Africa: influence of geographical source of infection.
AB  - One hundred and ninety-two strains of Neisseria gonorrhoeae isolated from migrant
      mine-workers were tested for their susceptibility to antibiotics, auxotyped and
      serotyped. Of the total, 93 (48%) were acquired locally and 64 (33%) from
      different geographical locations. Plasmid-mediated resistance to penicillin was
      found in 28 (14.6%) strains and was associated predominantly with the presence of
      5.0 kb penicillinase encoding plasmid (18/28, 64%). Chromosomal resistance to
      penicillin (MIC > or = 1 mg/l) was detected in 14 (7.3%) strains. Resistance to
      tetracycline was chromosomally and not plasmid-mediated. Antibiotic resistance
      was encountered most commonly among strains acquired in Natal. The overall
      gonococcal population was sensitive to ceftriaxone, ciprofloxacin, spectinomycin
      and azithromycin. Nine auxotype/serovar (A/S) classes were encountered among
      penicillinase-producing N. gonorrhoeae (PPNG) compared to 24 A/S classes among
      non-PPNG strains. The most common A/S class was NR/IA-6 which accounted for 38%
      of PPNG and 15% of non-PPNG.

PMID- 8472774
TI  - Different seroprevalences of antibodies against Neisseria meningitidis serogroup
      A and Haemophilus influenzae type b in Sudanese and Swedish children.
AB  - Sampling of sera from 202 Sudanese and 124 Swedish children 1-14 years of age was
      conducted at the end of the 1980s presenting an opportunity to compare the
      seroprevalence of anti-Neisseria meningitidis (MC) serogroup A antibodies in an
      area immediately before outbreak of an epidemic (Sudan 1988) with a low endemic
      area (Sweden). An ELISA antibody assay was developed for detection of antibodies
      against capsular polysaccharide of MC serogroup A and Haemophilus influenzae type
      b (Hib). Serum antibody against MC serogroup A was found significantly more
      frequently in Sudanese than in Swedish children. This indicates that factors
      other than herd immunity, as measured by serum antibodies against MC serogroup A
      polysaccharide, are important for avoidance of an MC serogroup A epidemic. The
      seroprevalence of Hib antibodies was, in contrast, significantly higher in
      Swedish than in Sudanese children, especially for 5-9-year-old children. A
      possible explanation may be the different systems of day-care of children in the
      two countries.

PMID- 8472775
TI  - Bacterial load of cockroaches in relation to urban environment.
AB  - Sanitation is an important problem in relation to the control of pests in urban
      environments. This investigation analysed the potential risk related to the
      presence of cockroaches and their capacity for disseminating bacteria in six
      different types of buildings: hospital nursing area and out-patient area,
      swimming-pool pool-side and toilet area, low-income flats and food-handling
      places. Fifty-six species of bacteria were identified from 157 samples, 14 of
      these have previously been reported as potentially pathogenic for man and
      vertebrates. Similarities were found between samples collected in (a) the
      hospital out-patient area and food-handling establishments and (b) the hospital
      nursing area and flats. Pool-sides possessed a poorer bacterial flora. There was
      a greater bacterial specific diversity in food-handling establishments, flats and
      swimming-bath toilet area. Enterobacter cloacae. Klebsiella pneumoniae and
      Klebsiella oxytoca were dominant species in flats and the hospital nursing area.
      Therefore, cockroaches can play a role in disseminating bacteria, which they can
      carry passively on their cuticle.

PMID- 8472776
TI  - The prevalence of Fusobacterium necrophorum biovar A in animal faeces.
AB  - Only a small proportion of animals tested were found to be excreting
      Fusobacterium necrophorum biovar A, the causative organism of necrobacillosis, in
      the faeces (3 of 69 wallabies, 1 of 66 deer, 2 of 81 cattle). The two positive
      cattle belonged to a single group of calves on a farm with a history of
      necrobacillosis and the litter underfoot also readily yielded biovar A organisms.
      All attempts to demonstrate biovar A in litter on other farms and in soil from an
      area populated by wallabies and deer failed. Ruminal contents from young beef
      cattle proved a fertile source of F. necrophorum biovar A, 15 of 18 animals
      giving a positive result. It is suggested that disturbance of the
      gastrointestinal microflora leads to intestinal multiplication and faecal
      excretion of the organism, which may then give rise to necrobacillosis of the
      body surface.

PMID- 8472777
TI  - Effect of disturbance of the gastrointestinal microflora on the faecal excretion
      of Fusobacterium necrophorum biovar A.
AB  - Oral pretreatment of mice with either a mixture of kanamycin and erythromycin or
      metronidazole to modify the gut microflora greatly enhanced the faecal excretion
      of Fusobacterium necrophorum biovar A given by mouth. This lends support to the
      suggestion that disturbance of the gastrointestinal microflora in animals such as
      cattle, which often carry the organism in the rumen, may lead to intestinal
      multiplication and faecal excretion, thereby providing a source of infection that
      may lead to necrobacillosis of the body surface.

PMID- 8472778
TI  - Effect of respiratory syncytial virus infection on binding of Neisseria
      meningitidis and Haemophilus influenzae type b to a human epithelial cell line
      (HEp-2).
AB  - It has been suggested that individuals might be more readily colonized with
      bacteria that cause meningitis through enhanced binding of the bacteria to virus
      infected epithelial cells. As respiratory syncytial virus (RSV) affects infants
      and children in the age group also susceptible to bacterial meningitis, we tested
      the hypothesis that infection of HEp-2 cells by RSV might enhance binding of
      Neisseria meningitidis or Haemophilus influenzae type b (Hib). Attachment of
      fluorescein-labelled bacteria to HEp-2 cells was measured by flow cytometry, and
      RSV-infected cells bound significantly more meningococci (P < 0.001) and Hib (P <
      0.01) than uninfected cells. Although the isolates expressed different antigenic
      characteristics (3 meningococci and 5 Hib), all showed a similar pattern of
      binding. The results are discussed with reference to the methods used for
      detection of bacterial binding and to interactions that might explain the
      increased binding to RSV-infected cells.

PMID- 8472779
TI  - The epidemic cycle of Chlamydia pneumoniae infection in eastern Finland, 1972
      1987.
AB  - The epidemic cycle of Chlamydia pneumoniae infection was examined in two areas in
      eastern Finland over a period of 15 years, 1972-87. The C. pneumoniae IgG
      antibody prevalence was determined with 5-year intervals in a random sample of
      the population aged 25-59 years. The total number of sera studied using
      immunofluorescence was 2387. In 1972 the antibody prevalence was 57% and it
      increased to 66% in 1977. Over the next 5 years the prevalence decreased to 44%
      in 1982, but by 1987 it had again increased to 59%. The temporal variation in
      prevalence was statistically significant (P < 0.001) and similar for both
      genders. Throughout the observation period the overall prevalence was 7-11%
      higher in men than in women (P < 0.01). The antibody prevalence increased with
      age, being the highest among the oldest study subjects of both genders. The
      periods of high and low prevalence alternated in an epidemic cycle (P < 0.001) of
      about 10 years.

PMID- 8472780
TI  - Seroprevalence of HIV-1 and HIV-2 infection among children diagnosed with protein
      calorie malnutrition in Nigeria.
AB  - Excessive weight loss due to protein calorie malnutrition (PCM) is a significant
      problem in Nigerian children. This syndrome may be difficult to differentiate
      from the wasting disease caused by human immunodeficiency virus type 1 (HIV-1)
      infection. We studied 70 children admitted to the Baptist Medical Center in
      Ogbomosho, Nigeria in 1990 with PCM for prevalence of antibodies to HIV-1 and HIV
      2. The cohort was from low-risk mothers and had a median age of 25 months (range,
      4 months-9 years) with a weight deficit of at least 20% of the theoretical weight
      for age. Two sera were positive for anti-HIV-1 by both ELISA and Western blot
      (WB). A high prevalence of samples negative for HIV-1 antibody by ELISA were
      repeatedly reactive (11%, 8/70) or indeterminate (46%, 32/70) by WB. None of the
      sera was positive for antibody to HIV-2. There was no correlation of ELISA
      positivity or extent of WB banding with successful recovery from malnutrition.
      These results indicate a relatively low but significant prevalence of HIV-1
      infection in Nigerian children with PCM. The high prevalence of indeterminate
      reactions in WB assays for HIV-1 suggests that other procedures may be necessary
      for confirmatory diagnosis of HIV-1 infection in this African population.

PMID- 8472781
TI  - Antenatal survey for the seroprevalence of HTLV-1 infections in the West
      Midlands, England.
AB  - The sera of 3522 women who attended an antenatal clinic in Birmingham, England
      were tested anonymously for antibodies against HTLV-1. Samples from 5 women
      (0.14%) were positive, one serum showed indeterminate reactivity. Two of the
      women (0.06%) were born in the West Indies (of Afro-Caribbean ethnic origin), one
      (0.03%) in Africa (of African ethnic origin), and three (0.09%) were white
      Caucasian women born in the UK. Thus, HTLV-1 infection in pregnant women in the
      UK, though comparatively rare, is not negligible. As transmission of HTLV-1 to
      the newborn via breast milk has been observed and as seropositive mothers can be
      advised to refrain from breastfeeding or to treat their milk, the question of
      routine screening for HTLV-1 infection during antenatal care is discussed.

PMID- 8472782
TI  - Prevalence of viral antibodies and helminths in field populations of house mice
      (Mus domesticus) in southeastern Australia.
AB  - A 13-month study of wild mice (Mus domesticus) in wheatlands in southeastern
      Australia contrasted changes in the seroprevalence of antibody to 13 viruses and
      the occurrence of helminths with changes in their population dynamics. Mice were
      seropositive for mouse hepatitis virus (MHV), rotavirus, minute virus of mice
      (MVM), mouse adenovirus (MAdV), reovirus (reo 3), and murine cytomegalovirus
      (MCMV). The seroprevalences of all but rotavirus varied significantly with time
      and increased with host density. Near the end of the study, host density declined
      rapidly and the seroprevalence of MVM and reo 3 increased significantly. These
      two viruses had low seroprevalence when host survival was high and high
      seroprevalence when host survival was low, indicating they may play a role in
      regulating mouse populations. In the case of MVM, there was evidence of a viral
      epizootic during the decline in mouse abundance. The prevalence of four helminths
      (Taenia taeniaeformis, Syphacia obvelata, and Vampirolepis spp.) differed
      significantly with time but showed no apparent association with host density.
      These findings highlight the need for further study on the effect of viruses on
      the population dynamics of mice.

PMID- 8472783
TI  - Topical norepinephrine, isoproterenol, terbutaline, forskolin and 8-bromo cyclic
      AMP increase lens equatorial current.
AB  - The equatorial current of the frog lens was studied with microelectrodes and a
      vibrating probe. Norepinephrine, isoproterenol and terbutaline applied topically
      at the surface of the cornea as a 1% solution increased the equatorial current of
      the lens about 80%. This increase was blocked by timolol. Topical forskolin
      increased the equatorial current by over 80%. This effect of forskolin was not
      blocked by timolol. These substances did not affect the equatorial current of the
      lens when the lens was suspended in a frog Ringers solution. 8-Bromo cyclic AMP
      increased the equatorial current when it was applied topically but not when it
      was added directly to the medium bathing an isolated lens. The results suggest
      that beta-adrenergic agonists, applied topically to the cornea, increase the
      equatorial current of the lens by a mechanism that is mediated by cyclic AMP. The
      finding that 8-bromo cyclic AMP did not act directly on the lens suggests that a
      currently unknown substance or process is active at the level of the lens.

PMID- 8472784
TI  - Effect of xylose on the synthesis of phosphorylcholine and phosphorylethanolamine
      in rat lenses.
AB  - Choline, an essential phospholipid precursor, enters the lens by a facilitated
      transport system and is phosphorylated to form phosphorylcholine (P-choline).
      Intact lenses incubated with [3H]choline accumulate both [3H]choline and P
      [3H]choline. The rate and extent of this accumulation have been used to study the
      effects of osmotic or oxidative cataractogenic stress, and also to test the
      ability of compounds to protect lenses from stress-related damage. The initial
      effect of oxidative stress on choline metabolism is decreased choline transport,
      but the mechanism by which osmotic stress affects the accumulation of [3H]choline
      is not understood. The effects of osmotic and oxidative stress on choline influx
      and metabolism were compared in rat lenses incubated in TC-199 medium. After
      osmotic stress by incubation with 30 mM xylose for up to 24 hr, lenses
      accumulated the same amount of radiolabel as controls during a 30 min pulse with
      [3H]choline. However, if the lenses were exposed to [3H]choline for 6 hr so that
      accumulation of radiolabel in the lenses was limited by the rate of P-choline
      synthesis, xylose treated lenses accumulated less choline than controls.
      Separation of the lenticular radiolabel into [3H]choline and P-[3H]choline
      confirmed that xylose decreased synthesis of P-choline, although adequate
      unphosphorylated [3H]choline was available in the lenses. A decrease in P
      [3H]ethanolamine synthesis was also seen in xylose-treated lenses incubated with
      [3H]ethanolamine. Ethanolamine can enter lenses by a non-saturable process which
      is not dependent upon a transporter. Although xylose decreased P-choline
      synthesis in intact lenses, neither xylose nor xylitol inhibited choline kinase
      in lens homogenates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472785
TI  - Difference in glutathione S-transferase response to oxidative stress between
      porcine and bovine lens.
AB  - Porcine and bovine lens GSTs were compared in the stability against various
      oxidative stress which is a major factor of cataract formation in order to
      clarify the role of lens glutathione S-transferase (GST) and its relation to
      cataractogenesis. Class pi porcine lens GST was inactivated reversibly by
      biological disulfides, cystine and cystamine, and also inactivated by active
      oxygen species such as O2- generated through xanthine-xanthine oxidase system and
      H2O2. On the other hand, class mu bovine lens GST was insensitive to such applied
      oxidative stress. Furthermore, 1,2-naphthoquinone, which is a metabolite of
      naphthalene and an actual inducer of naphthalene cataract, strongly inactivated
      porcine lens GST though it did not affect bovine enzyme. Thus, porcine and bovine
      lens GSTs had different sensitivity to various oxidative stress which could
      induce cataract formation. The results suggest that the differential expression
      of GST isozymes among animals may explain the variation in the cataract formation
      caused by oxidative stress.

PMID- 8472786
TI  - 13C NMR studies of protein motional dynamics in bovine, human, rat, and chicken
      ocular lenses.
AB  - The motional dynamics of lens proteins were studied by two 13C nuclear magnetic
      resonance (NMR) techniques sensitive to molecular motion to define the effect of
      lens water content on the presence of solid-like protein domains in ocular lenses
      from bovine (juvenile and adult), human, rat, and chicken eyes. The solid state
      13C NMR technique of proton dipolar decoupling was used to study slow (solid
      like) motions (correlation time, tau o > or = 10 microseconds), whereas for
      intermediate (mobile) protein, rotational reorientational motion (tau o range of
      1-500 nsec) the 13C off-resonance rotating frame spin-lattice relaxation
      technique was employed. 13C NMR studies of calf lens cortical and nuclear
      homogenates indicated a reversible loss of lens protein motional freedom with
      decreasing water content. Values of 6% and 63% solid-like protein contents were
      obtained for native cortical and nuclear calf lens homogenates, respectively. At
      equivalent total protein concentrations cortical and nuclear calf lens
      homogenates exhibited essentially the same solid-like (motionally restricted)
      protein content. Lens protein rotational correlation times determined by off
      resonance rotating frame spin-lattice relaxation measurements were consistent
      with lens protein aggregation. The solid-like protein content of the bovine
      nuclear lens region was observed to increase with age, whereas no significant
      change was detected for the cortex. Across lens species an inverse correlation
      between the percentage of solid-like protein content and water content was
      observed. Very broad 13C NMR resonances, even in the presence of proton dipolar
      decoupling, were observed for the lens proteins present in the cataractous human
      lens, indicating the presence of highly aggregated protein species. The
      occurrence of solid-like protein domains in lens tissue has implications for the
      interpretation of proton nuclear magnetic resonance dispersion (NMRD)
      measurements of lens homogenates and for proton magnetization transfer contrast
      enhanced magnetic resonance imaging of lens. Solid-like protein domains may play
      a protective role in the maintenance of lens transparency by minimizing enhanced
      refractive index fluctuations created by protein packing defects resulting from
      post-translational modification.

PMID- 8472787
TI  - UV filters in human lenses: tryptophan catabolism.
AB  - Primate lenses are unique in that they convert tryptophan (trp) into 3
      hydroxykynurenine glucoside (30HKG). This is the major short-wave absorbing
      pigment present in human lenses and it may play a role in protecting the eye from
      UV-induced photodamage. A study has been performed on aspects of this metabolic
      pathway in human lenses. A significant rate of synthesis could be observed in a
      24-hr period using intact lenses to which radiolabelled tryptophan had been
      added. Label was found in kynurenine (Kyn), 3-hydroxykynurenine (30HKyn) and
      30HKG, although always to the greatest extent in the latter metabolite.
      Considerable variation in the proportion of label incorporated into 30HKG was
      observed. Older lenses tended to accumulate a greater percentage into the
      glucoside; the data indicating a generally greater flux through the trp catabolic
      pathway in lenses above 60 years of age. Pulse-chase experiments on lens pairs
      suggested that there may be a significant loss or metabolism of 30HKG.
      Biosynthesis of 30HKG was found to take place in the lens epithelial cells. A
      linear rate of 30HKG efflux from organ cultured lenses was observed indicating
      that one pathway for removal of this compound involves diffusion through the lens
      capsule. That this pathway also occurs in vivo was confirmed by analysing samples
      of human vitreous humour. Based on efflux rates from cultured lenses (1.07 x 10(
      3) +/- 0.293 x 10(-3) mumol hr-1, n = 5), half-life values for 30HKG in the lens
      ranging between 7 and 40 hr were calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472788
TI  - Relationship between lens protein glycation and membrane structure in human
      cataract.
AB  - Glycation, which begins with the spontaneous reaction between sugar and proteins
      by the formation of Schiff bases, is known to especially damage long-lived
      proteins such as lens crystallins, and has been implicated in the ageing process
      and particularly in cataract formation. In this study of human senile cataract, a
      specific method is used to measure the formation of Amadori compounds in control
      postmortem and cataractous lenses, but no difference was found. However, the
      fluorescence of proteins at 430 nm (exc 350 nm), which has been attributed to
      advanced glycation, increased with normal ageing of the lens (cortex versus
      nucleus, and as a function of subject's age for each type of fibres) and was
      further enhanced in cataractous lenses. The precise molecular origin of this
      fluorescence remains to be elucidated. In parallel to the accumulation of non
      tryptophan fluorophores, a decrease in the membrane fluidity was observed with
      lens ageing and more acutely with cataract. Both parameters are positively
      correlated (P < 1%). The modification of the membrane structure with glycation
      could explain the strong permeability changes occurring during cataract, measured
      here in terms of cation concentration and inositol leakage, as shown by the
      negative relationship between the fluorescence signal and the sodium to potassium
      ratio or the inositol level.

PMID- 8472790
TI  - The effect of white light and UV-A on the green autofluorescence of the rabbit
      lens in vivo.
AB  - The part of the light spectrum which is responsible for an increase of lenticular
      green autofluorescence upon white light exposure was determined for the rabbit.
      The increase of autofluorescence as a function of the light energy was measured,
      to assess a possible threshold energy for lens alterations. Thirteen rabbits
      (Chinchilla Greys) were used. An area of 3 or 4.7 mm2 of the lens was exposed to
      light from a standard tungsten halogen lamp (250 W, lambda = 360-720 nm).
      Wavelength selection was performed with the use of light filters. The light dose
      was adjusted by varying the exposure time between 15 min and 180 min. The green
      lenticular autofluorescence (lambda exc = 420-490 nm, lambda fluor = 530-600 nm)
      was measured with a fluorophotometer. A significant increase of lenticular
      autofluorescence after exposure was observed only if the exposure light contained
      high wavelength UV-A (lambda = 360-400 nm; 0.8% of the total white light energy);
      additional white light (without UV-A; up to 13 kJ cm-2) did not have any effect
      on autofluorescence. The autofluorescence returned to pre-exposure values within
      4 days. No lesions could be seen on slitlamp examination. The autofluorescence
      after exposure to UV-A increased linearly with the exposure energy from 13 J cm-2
      (14 mW cm-2 for 15 min) up to 155 J cm-2. The increase was 2.0% of the pre
      exposure value per J cm-2 and the correlation coefficient 0.94, P < 0.001. A
      threshold energy was not found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472789
TI  - Alterations in viscosity and filterability of whole blood and blood cell
      subpopulations in diabetic cats.
AB  - Capillary closure and venous dilatation occur early in diabetic retinopathy, and
      altered blood rheology may play a role. For example previous studies have shown
      leukocytes are less deformable, are more activated, and occlude retinal
      capillaries more often in diabetic subjects. The purpose of this study was to
      determine if rheologic changes developed in diabetic cats, a model in which we
      have documented retinal capillary basement membrane thickening, microaneurysms,
      and intraretinal hemorrhage characteristics of early diabetic retinopathy.
      Viscosity of blood, plasma and purified erythrocyte suspensions was measured by
      rotational viscometry and plasma fibrinogen content was determined by heat
      precipitation. Filterability of blood and purified erythrocyte, mononuclear
      leukocyte, and granulocyte suspensions was determined at constant flow, measuring
      the increase in pressure over 2 min relative to the pressure generated by buffer
      alone. Viscosity of whole blood and plasma, but not erythrocytes, was
      significantly elevated (P < 0.005) in the diabetic cats over normals at all shear
      rates studied (450, 225 and 90 sec-1). Furthermore, fibrinogen levels were
      significantly elevated in diabetic cats compared to normals (P < 0.004), and were
      positively correlated with the viscosity of whole blood and plasma. The
      filterability of mononuclear leukocytes and whole blood in diabetic cats was
      decreased 56% and 74% when compared to normals, P < 0.0006 and P < 0.025,
      respectively. In contrast, the filterability of granulocytes and erythrocytes was
      not significantly different between the two groups. These results suggest that
      the rheologic alterations in diabetes are numerous, and involve both cellular and
      plasma protein changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472791
TI  - A simple three-compartment model of anterior segment kinetics.
AB  - Diffusion of fluorescein between the plasma and anterior chamber has been
      considered a one-step process with transfer coefficient kd. However, after
      systemic administration, fluorescein enters the anterior chamber by a different
      kinetic than this simple model predicts. In this study we added to the model
      another compartment, the 'iris', between the plasma and anterior chamber. When
      fluorescein diffuses into the anterior chamber, it must cross two barriers, one
      between plasma and iris with coefficient ki.ip, and one between iris and anterior
      chamber with coefficient ki.ia. Fluorescein was measured in the anterior chamber
      after intravenous injection and was compared to fluorescein concentration
      calculated by using both kinetic models, the three-compartment model (iris,
      anterior chamber, and cornea) and the two-compartment model (anterior chamber and
      cornea). Transfer coefficients were determined by the method of least squares in
      12 pigmented rabbits and two groups of six human subjects measured in two
      previous fluorophotometry studies. In all subjects except one, the three
      compartment model matched the data better than the two-compartment model. In a
      second experiment, diffusion of fluorescein out of the anterior chamber was
      studied in 15 pigmented rabbits. Diffusional loss was determined from the
      relative clearances of rhodamine-labeled dextran, a large molecule that left only
      by bulk outflow, and fluorescein that was cleared by diffusion and outflow. The
      upper 95% confidence limit of diffusional clearance was less than 11% of total
      clearance in anesthetized rabbits.

PMID- 8472792
TI  - Identification of a gamma S-crystallin fragment in human lenses.

PMID- 8472793
TI  - Does dopamine act at dopamine receptors in the ciliary epithelia?

PMID- 8472794
TI  - On the identity of the cone types of the rat retina.

PMID- 8472795
TI  - A computer program for application in epidemiological analysis.
AB  - The importance of computer science as a working tool for the health sector is an
      unquestionable fact in any modern society. EPIDEMO, developed by the authors, can
      be defined as a set of programs whose main characteristic is its ability to
      process a given series of data in a totally integrated way, with an
      epidemiological and statistical approach. EPIDEMO is a program with a good
      relational database, which allows preliminary statistical analyses of data that
      can easily be expanded with more specific statistical options, and is compatible
      with other programs available on the market. It is a useful, accurate and
      versatile tool that meets the needs of health professionals in the field of
      epidemiological research.

PMID- 8472796
TI  - Planning of a screening programme for cervical cancer in Liguria and evaluation
      of the attitude of the female population towards cancer detection.
AB  - In 1990 an investigation aimed at evaluating the possibility of organizing a
      regional screening programme for the early detection of cervical cancer was
      carried out in Liguria. Information on resources available for early detection of
      cervical cancer was obtained from 12 of 20 Public Health Units; a screening
      programme was feasible in 8 of them. The number of Pap tests examined was
      evaluated for 6 of 20 cytology laboratories. Only one laboratory examined more
      than 20,000 Pap tests in 1989 and, according to the international guidelines, can
      be a referring centre for screening. However, no information was available
      concerning inter- and intralaboratory quality control programmes. In the same
      period a population-based survey was carried out using a self-administered
      questionnaire in order to evaluate the attitudes of women towards cervical cancer
      prevention. A total of 1,454 of 4,197 women (35%) participated in the study.
      Younger, well educated women employed in non non-manual work were more likely to
      participate in the study. About 65% of the respondents had satisfactory practices
      with regards to the Pap test, suggesting a strong self-selection that probably
      resulted in a sample of women more health-conscious than the general population.
      In conclusion, our results suggest that major interventions should be carried out
      in the Public Health Units to direct resources to the needs of the population. In
      addition, new educational methods should be adopted to reach selected population
      groups to encourage them to have a Pap test performed on a regular basis.

PMID- 8472797
TI  - Lifetime menstrual activity--indicator of breast cancer risk.
AB  - A case-control study of 67 cases of breast cancer and 157 controls was conducted
      to investigate the role of different behavioral, reproductive, and hormonal
      factors and to develop a unifying indicator of breast cancer risk. The results
      confirm previous reports of the influence of smoking on the risk of breast
      cancer. Age at menarche was found to be a risk factor among the premenopausal
      women. Late age at menopause was suggestive of an increase in risk. Long use of
      oral contraceptive or estrogen supplementation were risk-enhancing both pre- and
      postmenopausally. Lifetime duration of menstrual activity (LMA) combines age at
      menarche and menopause, parity, and lactation into a biologically plausible
      model. Our findings concerning LMA support its role as a determinant of breast
      cancer.

PMID- 8472798
TI  - Familial risk of colo-rectal cancer in a low incidence area in southern Italy.
AB  - The risk of colo-rectal cancer (CRC) in subjects with a positive family history
      (FH+) for malignancy has been assessed by means of a case-control study carried
      out between 1987-89 in an area of about 215,000 inhabitants in Southern Italy.
      One hundred and nineteen CRC cases were compared with 119 sex- and age-frequency
      matched population controls. Detailed pedigrees were collected at the family
      homes of both cases and controls. The odds ratio (OR) of CRC, adjusted by means
      of logistic regression for age, sex and number of first-degree relatives,
      increased with the number of any kinds of cancers in first-degree relatives with
      a significant linear trend (p = 0.042), while there was no risk with a FH+ for
      digestive cancer excluding CRC or for other cancers excluding large bowel and
      digestive organs. The OR (and 95% confidence interval) for CRC was 5.9 (1.64
      21.23) for at least one first-degree relative with CRC. After a mutual adjustment
      between CRC and the other cancers in the families of cases and controls, the risk
      of CRC with a FH+ for other cancers did not change, revealing a strong
      association (p = 0.002) for CRC alone. From the analysis of the family history of
      cancer in the case group, the relative frequency of families that satisfied the
      criteria for so-called hereditary non-polyposic colo-rectal cancer (HNPCC) was
      2.6%. The increased relative risk of CRC observed only in families with FH+ for
      CRC is a supportive finding for organizing and planning prevention and genetic
      counselling for these families, whose members should be referred for further
      assessment.

PMID- 8472799
TI  - Testing a new health indicator: using avoidable causes of death and life
      expectancy for Spain between 1975-1986.
AB  - The concept of avoidable cause of death serves as the basis for measuring the
      quality and diversity of a health care system. In this study the authors propose
      a new way to use this kind of mortality by combining with the concept of life
      expectancy to obtain what they call "life expectancy free of avoidable mortality"
      (LEFAM). This indicator was 76.9 in 1986 in Spain while life expectancy was
      75.83. If these deaths were avoidable there would be a gain of 1.09 years per
      person born. There is an important difference between the would-be male gain of
      1.76 years and the would-be female gain of 0.6. In the ecological study, LEFAM
      would better explain the year to year changes of the resources in the health
      sector, measured in terms of the human resources (R = 0.96), the hospital beds
      per thousand persons (R = -0.86), and would also increase the relation with other
      health indicators such as infant mortality rate (R = 0.98) and mortality rate (R
      = 0.59) as compared with life expectancy alone.

PMID- 8472800
TI  - Alcohol drinking among adolescents from town and mountainous areas in north
      Italy.
AB  - Alcohol consumption was investigated among 9th and 13th grade high school
      students in the town of Brescia (an urban area) and in the Local Health Unit of
      Breno, a mountainous area in the province of Brescia. A total of 1364 students
      from Brescia and 1373 from Breno completed an anonymous questionnaire during
      school time. In both groups alcohol consumption was greater among 13th graders
      (modal age: 18 years) and males than 9th graders (modal age: 14 years) and
      females. Beer was the favourite alcoholic beverage, but wine was the most widely
      consumed daily beverage: among males, about 8% in grade 9 and 15% in grade 13
      drank at least one glass of wine every day. The majority of both 9th and 13th
      graders had more than one type of alcoholic beverage a week, although many
      females drank beer only. Total alcohol consumption was higher among the
      mountainous area students than urban students, especially 9th graders, and
      greater differences were observed in the consumption of beer with respect to
      wine. The proportion of male students from Brescia and Breno who consumed more
      than 6 alcohol units a week were, respectively, 17% and 25% in grade 9 and 36%
      and 42% in grade 13. A higher prevalence of drunkenness was found among the
      students from the mountainous area with respect to the urban students, especially
      males. Among 13th grade males, 42% of students from Brescia and 60% from Breno
      claimed one or more episodes of drunkenness during the year prior to the
      interview.

PMID- 8472801
TI  - Census in a rural area of Ethiopia: methodology and results.
AB  - A census and an ecologic survey were performed in 39 villages of a rural district
      of Arsi Region, Ethiopia, in difficult field circumstances. Information on age,
      ethnic group, education and family relationship, as well as data on health
      facilities and availability of basic services were collected. Supervised
      students, working in teams, were used as interviewers. Communities were involved
      through plenary meetings and community health agents participated in the data
      collection process. A total of 64,714 people in 12,152 households were
      registered. The repeatability of age assessment was investigated by comparing the
      results from two villages with data obtained in a pilot study carried out 6
      months earlier. The technical error was only 0.80 and 1.67 in the 0-5 and 6-15
      age-groups, respectively. Three percent of the total population was under one
      year, less than previously estimated. This may, in part, be due to the family
      planning programme in the region. Eighteen percent of the households were headed
      by females. School attendance was less common among females and in the Oromo
      ethnic group. The availability of basic services, including safe water and basic
      sanitation supplies, was very poor in the area.

PMID- 8472802
TI  - Antigens of Rickettsia conorii recognized by seropositive healthy people from
      Salamanca (central-west Spain).
AB  - The antigenic reactivity in Western immunoblotting assay of individual Rickettsia
      conorii components with sera of healthy people living in Salamanca Province, an
      endemic zone of Mediterranean spotted fever, is evaluated. Polypeptides of
      molecular weights 100 kDa (92.7%), 135 kDa (75.6%), 160 kDa (70.7%) and 115 kDa
      (48.8%) were recognized by a higher proportion of sera with indirect
      immunofluorescent antibody test titers > or = 1:80. Reaction with apparent
      rickettsial lipopolysaccharide was found in 15 (36.6%) of these samples. The
      involvement of different rickettsial strains, atypical routes of inoculation,
      varying content of the inoculum, and host factors may be determinants of the
      clinical expression of the spotted fever group rickettsial infection in people
      who produce antibodies reactive with Rickettsia conorii antigens.

PMID- 8472803
TI  - Antimicrobial resistance among clinical isolates of Haemophilus influenzae in
      northern Italy. Collaborative Study on Pediatric Infectious Diseases.
AB  - Only scanty data are available on the susceptibility of Haemophilus influenzae in
      Italy. The in vitro activity of ampicillin, ampicillin-sulbactam, cefaclor,
      cefuroxime, cefotaxime, chloramphenicol, erythromycin and trimethoprim
      sulfamethoxazole against 327 strains of Haemophilus influenzae (55 encapsulated,
      272 non-typeable) isolated from adults and children in northern Italy, between
      January 1984 and December 1989, was compared. Patients were affected by
      meningitis or other invasive infections, conjunctivitis, otitis, sinusitis,
      pneumonia or bronchitis. Minimal inhibiting concentrations were determined by a
      microdilution technique in Mueller Hinton broth supplemented with 10
      microliters/ml NAD and 2-5% lysed horse blood. A concentration of 1 x 10(5) to 5
      x 10(5) CFU/ml was used as the inoculum. The antibiotics were tested at
      concentrations ranging from 0.03 to 64 microliters/ml with the exception of
      trimethoprim-sulfamethoxazole, for which the range of concentrations examined
      were 0.01/0.25 to 32/512 microliters/ml. All the strains tested were susceptible
      to ampicillin-sulbactam, cefuroxime and cefotaxime, and more than 95% were
      susceptible to ampicillin, cefaclor and chloramphenicol. Only 4% were susceptible
      to erythromycin but most minimal inhibiting concentrations fell into the
      intermediate category. Strains isolated from adults were more susceptible to
      trimethoprim-sulfamethoxazole than strains isolated from children (85% vs 66%; p
      = 0.011).

PMID- 8472804
TI  - Treatment and serological studies of an Italian case of penicilliosis marneffei
      contracted in Thailand by a drug addict infected with the human immunodeficiency
      virus.
AB  - A case of disseminated penicilliosis marneffei, the first to be diagnosed in
      Italy, is described in a male HIV-positive drug addict. The patient had visited
      Thailand several times in the two years prior to his hospitalization. The
      presenting signs were fever, productive cough, facial skin papules and pustules,
      nodules on both thumbs and oropharyngeal candidiasis. Penicillium marneffei was
      isolated from a series of blood specimens with the lysis centrifugation
      procedure. Septate, yeast-like cells were observed in histological sections of
      the nodules and sputum smears. The patient was treated for 6 weeks with
      amphotericin B (total dosage 1,400 mg) and flucytosine (150 mg/kg/die) for the
      first 3 weeks. Prompt clinical improvement and sterilization of all biological
      specimens were attained. Itraconazole was administered as maintenance therapy
      (400 mg/die for the first month and 200 mg afterward). During the follow-up
      period, no relapse was observed. The patient, however, did succumb to a variety
      of non-mycotic infections and died nine months after start of therapy. At
      autopsy, P. marneffei was not detected in his tissues. Serological studies were
      performed with a micro-immunodiffusion procedure using a mycelial culture
      filtrate antigen of P. marneffei. Sera taken early in the course of the disease
      gave positive antibody reactions. Whereas sera taken 3-5 months following therapy
      were negative. All known cases of penicilliosis marneffei in bamboo rats and in
      humans among the inhabitants and visitors to the endemic areas of P. marneffei in
      South East Asia and Indonesia are summarized.

PMID- 8472805
TI  - Advances in investigations of Lyme borreliosis in the territory of the former
      USSR.
AB  - Whereas late manifestations of Lyme borreliosis were described in Russia more
      than 100 years ago, early manifestations were described as different disease
      entities such as tick-borne erythema, etc. In 1985 Lyme borreliosis was first
      verified serologically and the agent was first identified in 1986. By the
      beginning of 1992 Lyme borreliosis was serologically confirmed in patients from
      the Baltics to the Far East. Their geographical patterns in Russia are closely
      related to areas of the hard ticks Ixodes persulcatus and Ixodes ricinus which
      are also the main vectors of tick-borne encephalitis virus. As in the case of
      this infection, in the west of Russia there are "ricinus" natural foci of Lyme
      borreliosis, and to the east there are similar "persulcatus" foci; through large
      territories in the East Europe there are common foci for both species. Many
      Borrelia burgdorferi strains of tick origin have been isolated from various
      regions of Russia and neighbouring republics. Adult tick infection rates vary
      from several per cent to 30% in I. ricinus and up to 50-60% in I. persulcatus.
      Double infections of Lyme borreliosis spirochetes and tick-borne encephalitis
      virus have been recorded for ticks as well as for humans. Lyme borreliosis
      morbidity and its importance for the Russia territory are discussed.

PMID- 8472806
TI  - Evaluation of a passive microcapsule agglutination test for the screening of
      human leptospirosis.
AB  - Microcapsules, absorbed with two mixed antigens--each composed of 3 sonicated
      leptospira serovars--were developed in the past as a microcapsule agglutination
      test (MCA-LS) for the screening of clinical leptospirosis. For this study, fifty
      serum samples, taken at an earlier and at a later stage of illness from 25
      Italian in-patients with clinical symptoms of leptospirosis, were tested with
      both the MCA-LS one-dilution test and the microscopic agglutination (MA) test,
      the confirmatory test for leptospirosis, with 18 leptospira strains circulating
      in Italy. Compared with MA, MCA-LS showed a sensitivity of 91.7%, and a
      specificity of 92.3%, including leptospirosis not sustained by the diagnostic
      strains used in the MCA-LS kit.

PMID- 8472807
TI  - Diagnosis of Mycoplasma pneumoniae infection by specific IgM antibodies using a
      new capture-enzyme-immunoassay.
AB  - A total of 1226 sera from 1055 patients with respiratory tract infections were
      tested. IgM antibodies were detected by an antibody-capture enzyme-immunoassay
      (Mp TEST, Diatech Diagnostica Ltd, Israel). Acute infection with IgM antibodies
      to Mycoplasma pneumoniae was detected in 211 patients. Presence of IgM was
      closely associated to some or all pneumonia-related symptoms. Eighty-one of IgM
      positive patients treated with tetracycline or erythromycin responded positively.
      Of the 211 patients, 63 (30%) had low levels and 23 (11%) had moderate levels of
      IgM antibodies already in the first serum sample. In these 86 patients (41%) the
      complement fixation (CF) test was negative or very low positive. Thus in these
      cases, the CF test would have missed the early diagnosis in the first serum
      samples.

PMID- 8472808
TI  - Misincorporation of uracil into the DNA of folate- and B12-deficient HL60 cells.
AB  - HL60 cells were cultured for 10 days under various experimental conditions. They
      were then incubated with 1 mumol/l [5-3H] uridine for 2 hours and their DNA
      extracted. The DNA was hydrolysed to deoxyribonucleosides with phosphodiesterase
      and alkaline phosphatase and the hydrolysate subjected to Aminex A6
      chromatography. The elution profiles showed that, when compared with control
      cells, DNA from cells grown in medium deficient in folate, B12 or both folate and
      B12 contained increased amounts of deoxyuridine (dU) and increased radioactivity
      in the dU peak. The data demonstrate that misincorporation of uracil into DNA
      occurs in a myeloid cell line cultured in growth medium deficient in folate, B12
      or both folate and B12.

PMID- 8472809
TI  - Interleukin-4 induces proliferation of adult T-cell leukemia cells.
AB  - To evaluate the effect of IL-4 on the growth of leukemic cells from adult T-cell
      leukemia (ATL) patients (ATL cells) and determine whether the IL-4 autocrine
      mechanism is involved in the growth of ATL cells, we studied the proliferative
      response of ATL cells, from 11 patients, cultured in the presence or absence of
      IL-4 in vitro. Leukemic cells from 10 of the 11 patients examined proliferated in
      response to both IL-2 and IL-4 in a dose-dependent manner. The proliferative
      response to IL-4 was higher than that obtained with IL-2 in 8 patients. The
      expression of the IL-2 receptor (IL-2R) alpha alpha-chain in leukemic cells from
      some patients was also enhanced by IL-4. The IL-4 receptor was demonstrated by
      flow cytometry on the surface of ATL cells. Neither IL-4-induced proliferation of
      ATL cells nor IL-4-induced IL-2R expression on ATL cells was inhibited by anti
      Tac or anti-IL-2 antibody and, therefore, these effects of IL-4 are considered
      independent of endogenous IL-2 activity. However, IL-2 and IL-4 were undetectable
      in the culture supernatants of ATL cells from any patient by enzyme-linked
      immunosorbent assay. Interferon-gamma (IFN-gamma) partially inhibited IL-2 or IL
      4-induced proliferation of ATL cells. These results suggest that leukemic cells
      from ATL patients proliferate by an IL-2 or IL-4 paracrine mechanism in lymphoid
      tissue in vivo and that IFN-gamma inhibits IL-2- or IL-4-induced proliferation of
      ATL cells.

PMID- 8472810
TI  - Plasma and cellular pharmacokinetics of m-AMSA related to in vitro toxicity
      towards normal and leukemic clonogenic bone marrow cells (CFU-GM, CFU-L).
AB  - Plasma and cellular pharmacokinetics of m-AMSA were investigated in 5 patients
      with acute leukemia, using HPLC. The pharmacokinetic data served as a guideline
      for in vitro toxicity tests on clonogenic bone marrow cells. m-AMSA was
      administered as a 3-hour intravenous infusion of 100 mg/m2. Median plasma and
      nucleated blood cell peak concentrations were 1.25 and 6.36 micrograms/ml
      followed by biphasic elimination with a median T1/2 alpha alpha of 1.6 h and 0.3
      h and a median T1/2 beta of 5.0 h and 5.0 h respectively. Median plasma and
      cellular area under the curve (AUC) for a 24-h period amounted 6.2
      micrograms.h/ml and 49.8 micrograms.h/ml respectively. In vitro cellular uptake
      was maximal at least within 30 minutes. No differential toxicity for CFU-GM and
      CFU-L was observed in relation to exposure time. Median IC50 for CFU-GM and CFU-L
      was 2.2, 1.8 and 1.6 micrograms/ml after incubation periods of resp. 0.08, 4 and
      24 h. The corresponding m-AMSA concentration x time products to achieve 50%
      inhibition (IAUC50) were 0.18, 7.2 and 38.4 micrograms.h/ml, respectively. 48-h
      prestimulation of the clonogenic bone marrow cells with Human Placenta
      Conditioned Medium increased sensitivity (median 1.7 x) after 4 h incubation with
      mAMSA. Short exposure provides maximal, concentration-related, cellular uptake,
      resulting in effective inhibition of growth of clonogenic bone marrow cells.

PMID- 8472811
TI  - A retrospective analysis of bleeding complications in 438 patients with acute
      leukaemia during the years 1972-1991.
AB  - The incidence and mortality of bleeding complications have been investigated in
      438 patients with acute leukaemia consolidated either by chemotherapy (n = 241)
      or by bone marrow transplantation (n = 197). Bleeding signs on admission were
      found in 38% of the chemotherapy-treated group. Haemorrhagic deaths during the
      1st month were seen in 10%. The majority of the major bleedings were localized
      intracranial, but gastrointestinal haemorrhages were also common. The platelet
      count was significantly lower (40 x 10(9)/l versus 69 x 10(9)/l, p < 0.001) and
      the leukocyte count significantly higher (31.2 x 10(9)/l versus 11.6 x 10(9)/l, p
      < 0.001) in the group with bleeding complications than in those without. The
      haemorrhagic mortality in patients consolidated with chemotherapy compared with
      transplant patients was similar, 23% and 19%. The majority of the lethal
      haemorrhages in the latter group were observed in patients undergoing allogenic
      bone marrow transplantation after engraftment. Septicaemia, graft-versus-host and
      venous occlusive disease were contributing factors.

PMID- 8472812
TI  - Improved survival and marrow engraftment of mice transplanted with bone marrow of
      GM-CSF-treated donors.
AB  - Recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF)
      administered to bone marrow (BM) transplant recipients is associated with earlier
      recovery. We have investigated the possibility of stimulating normal donor mice
      in vivo with GM-CSF. Donor balb/c mice were injected i.p. with GM-CSF (5000 u) or
      saline. Seventy-two hours later 5 x 10(5)BM cells from either GM-CSF-treated or
      control donors were infused into lethally irradiated (850 R) recipients. In the
      recipients of BM from GM-CSF-treated donors, significantly higher CFU-S and
      significantly higher survival rate (57% [n = 65]; vs. 30% [n = 63]; p < 0.05)
      were noted. Donor mice of the GM-CSF group did not differ in bone-marrow
      cellularity and composition from their controls. However, recipients of BM from
      GM-CSF-treated mice had higher blood counts of haemoglobin, leukocytes and
      platelets compared to controls. These data demonstrate that pretreatment of BM
      donors with GM-CSF may be of benefit in improving survival and marrow engraftment
      in mice.

PMID- 8472813
TI  - Bezafibrate-induced neutropenia.

PMID- 8472814
TI  - Hodgkin's disease and Sjogren's syndrome.

PMID- 8472815
TI  - Autoimmune hypothyroidism and granulocyte-macrophage colony-stimulating factor.

PMID- 8472816
TI  - Influence of human serum on human bone-marrow-derived stromal cell layers.

PMID- 8472817
TI  - Focus on mesothelioma and the mesothelial cell.

PMID- 8472818
TI  - Chemoprevention of cancer.

PMID- 8472819
TI  - Analysis of longitudinal data: choosing and interpreting regression models.

PMID- 8472820
TI  - Muscarinic receptor subtypes in airways.

PMID- 8472821
TI  - How the lung deals with oxidants.

PMID- 8472822
TI  - Reliability of a monitoring system for respiratory emergency room admissions.
AB  - A respiratory emergency room admissions monitoring system (RERAMS) was set up in
      Barcelona between 1985-1989, in order to investigate asthma epidemics in the
      city. Information on emergency room admissions for asthma and chronic obstructive
      pulmonary disease (COPD) was recorded daily from the four main hospitals of the
      city. The present study aims at assessing the reliability and coverage of this
      monitoring system. Identification of asthma and COPD emergencies was repeated by
      a reference observer, following the same protocol to extract data as that used by
      the register. To assess the coverage of the monitoring system, information was
      collected over 28 randomly selected days, from the emergency room clinical
      records for the seven additional hospitals in the city with five or more daily
      emergencies. Identification of asthma emergencies was highly reliable (kappa
      value, kappa = 0.81) as was the discrimination between asthma and COPD diagnoses
      (kappa = 0.91). Reliability for emergencies classified as COPD was lower, but
      still good (kappa = 0.65). The monitoring system covered 76 and 78% of all
      Barcelona asthma and COPD emergency room admissions, respectively. Emergency room
      admissions from our monitoring system did not differ in terms of social and
      demographic characteristics from emergencies recorded at the other hospitals. We
      conclude that the monitoring system for the Barcelona respiratory emergency room
      admissions was highly reliable, which suggests that, when adequately collected,
      information from clinical records of respiratory emergencies could be used for
      environmental epidemiological purposes.

PMID- 8472824
TI  - Vital prognosis in intrathoracic sarcoidosis with special reference to pulmonary
      function and radiological stage.
AB  - A follow-up of 254 patients with intrathoracic sarcoidosis has been carried out
      after a median of 27 yrs from the diagnostic admission. All patients could be
      traced. At the end of follow-up there was no excess mortality (80 deaths observed
      versus 65.5 expected). However, during the first 20 yrs of follow-up a slight
      excess mortality was seen. Thirty three out of the 80 deaths were related to
      sarcoidosis. No excess number of deaths from lung cancer or lymphoma was
      observed. Erythema nodosum was of no prognostic significance concerning survival.
      X-ray stage was related to survival with a significant excess mortality for stage
      3. Early clearing of X-ray changes gave a favourable vital prognosis. Survival
      was related to lung function, and for forced expiratory volume in one second
      (FEV1), FEV1/forced vital capacity (FVC) index and total lung capacity (TLC) this
      relationship reached levels of statistical significance. In multivariate Cox
      regression models, with age and sex entered as covariates, the same parameters
      were found to be significant predictors of mortality. Patients with FEV1 < or =
      50% predicted had an increased mortality risk of 4.2 (95% confidence interval 1.8
      9.6) when compared to patients with FEV1 > 80% predicted. Likewise, patients with
      TLC < or = 80% predicted had a mortality risk of 2.6 (1.5-4.5) when compared to
      patients with TLC > 80% predicted. In conclusion, a modest excess mortality was
      observed during the first 20 yrs of follow-up. Furthermore, both X-ray staging
      and lung function at the time of diagnosis influenced long-term mortality in
      patients with intrathoracic sarcoidosis.

PMID- 8472823
TI  - Longitudinal methods for describing the relationship between pulmonary function,
      respiratory symptoms and smoking in elderly subjects: the Tucson Study.
AB  - In this study recently developed longitudinal techniques are used to examine the
      relationship between respiratory symptoms, smoking and pulmonary function
      measures in elderly subjects. The subjects were participants in the Tucson
      Epidemiological Study of Airways Obstructive Disease, aged > or = 55 yrs at the
      first survey 1972-1973, who had received pulmonary function testing and completed
      questionnaires in at least one of the six selected surveys. There were 633 males
      and 891 females, with up to 14 yrs follow-up included in the analysis. Based on
      their questionnaire responses, subjects were classified according to their
      respiratory symptoms and smoking habits at each survey. The pulmonary function
      testing included forced vital capacity (FVC), forced expiratory volume in one
      second (FEV1), and their ratio (FEV1/FVC). The pulmonary function data were
      analysed gender specific, with and without stratifying on vital status. The
      results indicate that respiratory symptoms are generally associated with lower
      levels of lung function, and that the impairment associated with chronic cough
      was observed predominantly in male subjects. The negative association of smoking
      was apparent in most measures, but was largest and most progressive in the
      FEV1/FVC ratios. Ex-smokers, in all cases, had better lung function values than
      current smokers, but their mean curves were always significantly below the values
      of nonsmokers.

PMID- 8472825
TI  - Is lung retransplantation indicated? Report on four patients.
AB  - As more lung transplantations are performed, many patients will suffer graft
      failure and will be considered for retransplantation. This article reviews the
      case management reports of four patients who received lung or heart/lung
      retransplantation, with overall disappointing results. The pros and cons of lung
      retransplantation are discussed.

PMID- 8472826
TI  - Effects of intrinsic PEEP on pulmonary gas exchange in mechanically-ventilated
      patients.
AB  - The aim of the study was to assess the impact of the intrinsic positive end
      expiratory pressure (PEEPi) on pulmonary gas exchange in mechanically-ventilated
      patients, by comparing the effects of similar levels (0.8-0.9 kPa) of positive
      end-expiratory pressure (PEEP) and PEEPi. Ten patients with acute respiratory
      failure, without chronic airway disease, were studied with three ventilatory
      modes: 1) intermittent positive pressure ventilation with zero end-expiratory
      pressure (ZEEP mode); 2) continuous positive pressure ventilation with PEEP set
      by the ventilator (PEEP mode); and 3) intrinsic PEEP elicited by adequate
      shortening of the expiratory time (PEEPi mode). Cardiorespiratory variables (e.g.
      respiratory compliance and resistance, arterial and mixed venous blood gases,
      cardiac output, pulmonary capillary pressure, oxygen delivery) were measured
      during each ventilatory mode. Compared to ZEEP, both PEEP and PEEPi decreased
      cardiac output while increasing arterial oxygen tension (PaO2). However, the
      improvement of PaO2 was more consistent (8 out of 10 patients), and larger (+2.1
      kPa, on average, p < 0.05) with PEEP than with PEEPi (5 out of 10 patients, and
      +1.4 kPa, on average, NS). Since the effects of PEEP and PEEPi on ventilation,
      lung volume, compliance, cardiac output (QT), mixed venous oxygen tension (PvO2)
      and oxygen consumption (VO2) were similar, we attributed the less favourable
      impact of PEEPi on PaO2 to a less homogeneous distribution of PEEPi between lung
      units with different time constant, and hence to a more uneven distribution of
      the inspired gas.

PMID- 8472827
TI  - Comparison of nasal pressure support ventilation with nasal intermittent positive
      pressure ventilation in patients with nocturnal hypoventilation.
AB  - Nasal intermittent positive pressure ventilation (NIPPV) provides effective
      ventilatory support in patients with nocturnal hypoventilation. Nasal pressure
      support ventilation (NPSV), which only provides ventilation in response to
      patient triggering, may also be effective, simpler, and cheaper, but has not been
      evaluated. NIPPV and NPSV were compared in 12 patients with nocturnal
      hypoventilation, requiring domiciliary ventilatory support. The patients were
      studied on three consecutive nights, in random order: a control night without
      ventilation and a night on each mode of ventilatory support using the bilevel
      positive airway pressure (BiPAP) ventilator. Both NIPPV and NPSV significantly
      increased mean arterial oxygen saturation (SaO2) compared to the control night
      (NIPPV mean increase 4.1%; 95% confidence interval (CI) 2.2 to 6.1, NPSV 4.4%; CI
      2.1 to 6.6) with no significant difference between the two modes. The percentage
      of the study night spent below 90% SaO2 was significantly reduced by both
      ventilator modes compared to the control night (median reduction on NIPPV 37%; CI
      -54 to -10, reduction on NPSV 31%; CI -53 to -9, with no significant difference
      between NPSV and NIPPV. NPSV was as effective as NIPPV in patients with nocturnal
      hypoventilation, which suggests that these patients are able to trigger the
      ventilator adequately. The lower cost of NPSV will make it accessible to more
      patients with chronic lung disease.

PMID- 8472828
TI  - The muscarinic M1-receptor-selective antagonist, telenzepine, had no
      bronchodilatory effects in COPD patients.
AB  - In a double-blind, placebo-controlled, randomized, cross-over trial, we studied
      the effects of the muscarinic M1-receptor-selective antagonist (+/-)-telenzepine
      (3 mg orally at 6 p.m. for 5 days) in 21 patients with chronic obstructive
      pulmonary disease (COPD). At enrollment all patients showed at least a 50%
      decrease in airway resistance (Raw) after inhalation of 400 micrograms fenoterol
      or 200 micrograms oxitropium bromide. Telenzepine did not have a significant
      effect on forced expiratory volume in one second (FEV1) or forced vital capacity
      (FVC). Also, no significant changes could be detected in daily spirometric
      profiles or Raw. The results indicate that short-term treatment with the M1
      selective antagonist, telenzepine, does not improve airway function in COPD
      patients, at least after administration by the oral route.

PMID- 8472829
TI  - Minor acute effect of an inhaled corticosteroid (budesonide) on bronchial
      hyperresponsiveness to methacholine in children with asthma.
AB  - Several studies have shown that long-term administration of inhaled
      corticosteroid reduces airway hyperresponsiveness. This study was performed in
      order to exclude an acute effect of inhaled corticosteroid. In a double-blind,
      randomized, cross-over study, children with asthma, who had never used inhaled or
      oral corticosteroid, received a single dose of 0.8 mg budesonide or placebo on
      two separate days, with an interval of at least 48 h. On each test day, baseline
      forced expiratory volume in one second (FEV1) and methacholine responsiveness
      (expressed as provocative dose producing a 20% fall in FEV1 (PD20) to
      methacholine, in doubling dose) were measured. Both measurements were repeated 2
      and 5 h after administration of the drug. Twenty children were included in the
      study. FEV1 showed a mean increase of 1% at 5 h on the budesonide day, and a
      decrease of 2% on the placebo day (p = 0.01). PD20 increased by 0.1 doubling dose
      on the budesonide day, and decreased by 0.4 doubling dose on the placebo day.
      These changes are within the measurement variation (p = 0.06). We conclude that a
      single dose of 0.8 mg budesonide has a minor effect on methacholine
      responsiveness 5 h after administration in children with asthma. It is unlikely
      that such an effect interferes with the interpretation of data collected in long
      term studies.

PMID- 8472830
TI  - Bronchodilator effect of nebulized sodium cromoglycate in children born
      prematurely.
AB  - We wished to determine whether nebulized sodium cromoglycate (SCG) has
      bronchodilator effects in very young children. In 18 children born prematurely
      and studied at a median of 15 months of age, thoracic gas volume (TGV) and
      airways resistance (Raw), were measured and hence specific airways conductance
      (sGaw) was calculated before (baseline) and after nebulized saline, and then
      after sodium cromoglycate. sGaw improved significantly in 10 infants after SCG,
      compared to only in two following saline. These preliminary results suggest that
      nebulized SCG may have an acute bronchodilator effect in some children born
      prematurely.

PMID- 8472831
TI  - Acute exposure to swine dust causes bronchial hyperresponsiveness in healthy
      subjects.
AB  - Six urban subjects, with little or no previous experience of farm-work, were
      exposed to dust while weighing swine for 2-5 h. Three subjects experienced toxic
      symptoms 4-5 h after the beginning of exposure. Bronchial responsiveness
      increased in all subjects within 6 h (more than three doubling steps difference
      in a methacholine test). One week later, airway responsiveness had partly
      normalized. The mean (interquartile range) cumulative dose of methacholine
      causing a 20% decrease in forced expiratory volume in one second (FEV1) was 3.1
      (1.0-6.6) mg, before exposure, fell to 0.13 (0.01-0.76) mg 6 h after exposure (p
      < 0.02), and was 0.99 (0.42-1.5) mg one week later (n = 5, p < 0.05), Mean (SD)
      FEV1 decreased 5 (2)%. The concentration of total dust varied between 9 and 14
      mg.m-3 and of endotoxin between 0.1 and 0.5 mu g.m-3. Thus inhalation of swine
      farm dust, caused a marked increase in bronchial responsiveness in non-sensitized
      subjects.

PMID- 8472832
TI  - Bronchoalveolar lavage in allergic granulomatosis and angiitis.
AB  - Pulmonary involvement occurs in approximatively half of patients with allergic
      granulomatosis and angiitis (AGA). We studied bronchoalveolar cells from six
      patients with histologically proven AGA and compared our results with those
      obtained from four patients with chronic eosinophilic pneumonia (CEP), nine
      nonsmoking patients with bronchial asthma and blood eosinophilia, and 10 healthy
      nonsmokers. Pulmonary infiltrates were present in 5 out of 6 AGA patients. None
      of these patients was receiving corticosteroids at the time of entry to the
      study. Pulmonary function tests were normal in two cases, and demonstrated on
      obstructive ventilatory disorder with hypoxaemia in four cases. Total cell yield
      did not differ between AGA patients (22.4 +/- 4.9 x 10(4) cells.ml-1), asthmatics
      (9.6 +/- 1.7 x 10(4) cells.ml-1) and controls (11.3 +/- 1.5 x 10(4) cells.ml-1),
      whereas it was dramatically increased in patients with CEP (186.4 +/- 26.3 x
      10(4) cells.ml-1). All six AGA patients demonstrated an increased percentage of
      alveolar eosinophils (mean: 31.1 +/- 9.9%; range 6-66%). In two patients
      evaluation of alveolar eosinophil subpopulations showed a low percentage (27 and
      36%) of hypodense cells, when compared to the high levels (> 80%) found in CEP.
      No significant correlation could be established between bronchoalveolar (BAL)
      results and clinical data, pulmonary function abnormalities, or biological
      results. Sequential evaluation of alveolitis in two AGA patients undergoing
      corticosteroid therapy demonstrated persistent alveolar eosinophilia, despite
      disappearance of clinical, radiological and biological abnormalities. Our data
      demonstrate that eosinophils are present in the alveolar spaces of patients with
      AGA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472833
TI  - Gastrin-releasing peptide-like immunoreactive substance in bronchoalveolar lavage
      of idiopathic pulmonary fibrosis and sarcoidosis.
AB  - The neuropeptide gastrin releasing peptide (GRP) is present in the lung, and
      functions as a modulator of tissue growth and repair in fibrotic processes, or as
      a modulator of cell movement and differentiation in various inflammatory
      processes, including granulomatous ones. In idiopathic pulmonary fibrosis (IPF),
      changes in the bronchoalveolar lavage (BAL) content of GRP can be expected. We
      measured GRP-like immunoreactive substances (GRP-IS) and another neuropeptide,
      vasoactive intestinal peptide (VIP)-IS in BAL by enzyme immunoassay. Our results
      showed a decrease in BAL GRP-IS in patients with IPF (26.5 +/- 5.5 pg.mg-1
      protein) and sarcoidosis (35.9 +/- 9.2 pg.mg-1), compared to healthy nonsmokers
      (63.4 +/- 9.0 pg.mg-1). When data were expressed as pg.ml-1 BAL fluid recovered,
      a decrease was only seen in IPF, not in sarcoidosis. The levels of VIP-IS in BAL
      were not different between the groups studied. Increased protein levels in BAL
      had no correlation with the levels of GRP-IS or VIP-IS in BAL. Furthermore, BAL
      neutrophil percentages had no correlation with the levels of GRP-IS in BAL of
      patients with IPF. Using reversed phase high performance liquid chromatography
      (HPLC), several kinds of GRP-IS were detected in BAL. These findings suggest that
      the decreased level of GRP-IS in BAL may reflect a loss of GRP-producing cells
      due to chronic lung injury and fibrosis in patients with IPF.

PMID- 8472834
TI  - Nonadrenergic, noncholinergic responses stabilize smooth muscle tone, with and
      without parasympathetic activation, in guinea-pig isolated airways.
AB  - In guinea-pig isolated airways, nonadrenergic, noncholinergic (NANC) neural
      responses converge towards a similar level of smooth muscle tone, via a
      contraction when the tone is low prior to stimulation, and via a relaxation when
      the tone is high prior to stimulation. We wanted to assess the effect of
      simultaneous parasympathetic activation on these converging NANC responses, with
      and without the addition of sympathetic activation. In guinea-pig isolated
      airways, the spontaneous airway tone was initially abolished by indomethacin (10
      microM). In one series, adrenergic depletion by guanethidine (10 microM) was then
      established, with and without cholinergic blockade by atropine (1 microM). In
      another series, either cholinergic blockade by atropine (1 microM) or no blockade
      was utilized. Responses to electrical field stimulation (1,200 mA, 0.5 ms, 3 Hz
      for 240 s) were studied with no induced tone, at a moderate (0.3 microM) and at a
      near-maximum (6 microM), histamine-induced tone. The mean level of the tonus
      equilibrium (% of maximum tone) was higher with the simultaneous NANC and
      parasympathetic activation than with NANC activation alone (75% compared with
      44%, in the main bronchus, n = 8). The level of the tonus equilibrium was also
      higher with the simultaneous NANC, sympathetic and parasympathetic activation
      than with NANC and sympathetic activation only (49% compared with 21%, in the
      main bronchus, n = 8). The pattern was similar in the distal trachea. In
      conclusion, NANC neural responses can stabilize smooth muscle tone, and this
      stabilizing effect can be modulated by both parasympathetic and sympathetic
      activation, in guinea-pig isolated airways.

PMID- 8472835
TI  - Protection by N-acetylcysteine against pulmonary endothelial cell damage induced
      by oxidant injury.
AB  - The protective effect of N-acetylcysteine (NAC) against oxidant lung injury was
      investigated in a model of acute immunological alveolitis in the rat.
      Intrapulmonary immune complex deposition into rat lungs, induced by intratracheal
      infusion of immunoglobulin G (IgG) anti-bovine serum albumin (BSA) antibodies and
      intravenous injection of the antigen, caused lung damage associated with a marked
      decrease in [14C]5-hydroxytryptamine ([14C]5HT) uptake capacity, taken as a
      biochemical marker of endothelial cell function. The oral administration of a
      single dose of NAC (2 mmol.kg-1) 60 min before antigen/antibody (Ag/Ab) treatment
      was effective in preventing pulmonary endothelial cell [14C]5HT uptake loss
      induced by immune complex deposition. The mechanisms involved in this lung
      protective action of NAC were investigated by studying the antioxidant activity
      of NAC on hypoxanthine/xanthine oxidase-induced lung damage in vitro, and the
      effectiveness of the drug as lung glutathione (reduced form) (GSH) precursor in
      diethylmaleate-depleted rats. The results obtained provide further evidence on
      the ability of NAC to reduce the susceptibility of lung tissue to free radical
      induced damage, by potentiating the antioxidant defence systems.

PMID- 8472836
TI  - Occupational asthma due to zinc.
AB  - We describe a subject who developed asthma symptoms 2 yrs after being employed at
      a plant where metals were galvanized in heated zinc. The subject was not atopic.
      Baseline spirometry was normal three months after he left work but there was mild
      bronchial hyperresponsiveness to methacholine. Monitoring of forced expiratory
      volume in one second (FEV1) during a day at work showed a maximum fall in FEV1 of
      24% at the end of the day and an increase in bronchial responsiveness on the
      following day. Environmental monitoring revealed that zinc and iron were present
      in the working environment at concentrations that were lower than the "threshold
      limit value-short term exposure level" (TLV-STEL) standards. Positive immediate
      skin tests to zinc sulphate at concentrations of 1 and 10 mg.ml-1 were obtained,
      although no specific immunoglobulin E (IgE) antibodies to zinc could be found.
      Skin tests with copper, chromium and cobalt were negative. Specific inhalation
      challenges were performed, having the subject inhale a solution of zinc sulphate
      at a 10 mg.ml-1 concentration for 6 min. An immediate reaction was elicited
      (maximum fall in FEV1 of 23%). We conclude that zinc can cause occupational
      asthma.

PMID- 8472837
TI  - [Short-term effectiveness of fissure sealants].
AB  - Fluoride therapy is a widely accepted method of reducing smooth surface caries.
      Sealant therapy is intended to provide similar results for the occlusal surfaces
      of the teeth. In this study the retention of sealants was examined and a
      comparison was made between the caries rate in the group with sealed molars and
      controls after 12 months... The caries increment was significantly lower in the
      sealed group.

PMID- 8472838
TI  - [The effect of rare earth metal-containing toothpastes on dental enamel
      solubility in vitro].
AB  - The effect of different REE containing toothpastes has been studied on human
      dental enamel, in an experimental model, using diluted suspensions of
      toothpastes. The grade of remineralization has been characterised by the amount
      of dissolved phosphorus from the enamel samples. All the investigated-, REE
      containing toothpastes decreased the acid-solubility of dental enamel, the best
      results were found in the group of samarium-containing toothpastes.

PMID- 8472839
TI  - [Computerized data base for recording information on patients with
      hypersensitivity to metals].
AB  - The authors describe a computer analysable etiological card used for registration
      of data of Ni hypersensitive patients' with oral symptoms. The collection and
      evaluation of the data related to the pathological changes and predisposing
      factors can be useful in prevention of development of hypersensitivity or
      clinical symptoms of hypersensitivity in cases belonging to this risk group.

PMID- 8472840
TI  - Mechanisms of prolactin receptor regulation in mammary gland.

PMID- 8472841
TI  - Follistatins: more than follicle-stimulating hormone suppressing proteins.

PMID- 8472842
TI  - High level expression of human neuropeptide Y receptors in mammalian cells
      infected with a recombinant vaccinia virus.
AB  - Neuropeptide Y (NPY) is a 36 amino acid peptide present in the central and
      peripheral nervous system. Numerous studies point to a role of NPY in
      cardiovascular regulation. NPY effects are mediated through stimulation of
      specific cell surface G protein-coupled receptors. To allow biochemical studies
      of the receptor and of its interaction with the ligand, we have developed a
      potent expression system for NPY receptors using a recombinant vaccinia virus. A
      human NPY receptor cDNA was fused to a strong vaccinia virus promoter and
      inserted into the viral genome by homologous recombination. Recombinant viruses
      were isolated and tested for their ability to induce NPY binding site expression
      following infection of mammalian cell lines. Using saturation and competition
      binding experiments we measured a Bmax of 5-10 x 10(6) NPY binding sites per
      cell. The Kd for the binding of NPY is about 20 nM. Labelling of infected cells
      with a fluorochrome-labelled NPY indicated that the recombinant protein
      integrates into the cell membrane.

PMID- 8472843
TI  - Regulation of thyroid hormone receptor beta-2 mRNA levels by retinoic acid.
AB  - The thyroid hormone receptor, TR beta-2, whose expression is limited to the
      pituitary and parts of the central nervous system, is strongly negatively
      regulated at the pre-translational level by thyroid hormone (T3). We have
      investigated whether retinoic acid (RA), whose receptors (RARs) share a high
      degree of homology with the thyroid hormone receptors (TRs), can regulate this
      gene in a manner similar to T3, as has been shown for the growth hormone (GH)
      gene. GH3 cells were incubated with 10 nM T3, 1 microM RA or both for 48 h and
      then TR beta-2 mRNA levels determined by RNA blot hybridization analysis. We
      observed a 73% decrease in TR beta-2 mRNA levels after incubation with T3 and a
      two-fold increase in TR beta-2 mRNA levels after incubation with RA alone. In the
      presence of RA, the T3 effect on TR beta-2 mRNA levels was blunted with mRNA
      levels decreasing by only 20%. We investigated the mechanism by which retinoic
      acid increases and opposes the effects of T3 on levels of TR beta-2 mRNA. In
      transient transfection experiments using a reporter plasmid containing the TR
      beta-2 promoter and in nuclear run on assays, we found no effect of RA on TR beta
      2 gene transcription. We then investigated whether the effects of RA were
      mediated at the post-transcriptional level. Determination of the apparent half
      life of TR beta-2 mRNA using the transcriptional inhibitor, actinomycin D, showed
      that RA had no effect on TR beta-2 mRNA stability.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8472844
TI  - Progesterone modulation of gonadotropin secretion by dispersed rat pituitary
      cells in culture. IV. Follicle-stimulating hormone synthesis and release.
AB  - Estradiol-treated, rat pituitary cells were studied to examine the effects of
      progesterone (P) on follicle-stimulating hormone (FSH) synthesis and secretion.
      Progesterone was administered prior to or concurrent with 3 h secretory
      challenges with either gonadotropin-releasing hormone (GnRH), the iontophore
      A23187, the protein kinase C activator phorbol 12,13-myristate (PMA), or no
      secretagogue. Medium FSH levels and cell FSH stores were quantified by
      radioimmunoassay and bioassay. Acute (< 6 h) exposures to P increased medium
      levels of immunoreactive and bioactive FSH following GnRH challenge without
      influencing total (cell + medium) values whereas chronic (9-24 h) treatments
      increased both parameters. Chronic P elevated total FSH levels even when no
      secretagogue was present. Studies with antiprogestins, 5 alpha
      dihydroprogesterone and 5 alpha-reductase inhibitors revealed that this direct
      action of P depended on progestin receptor occupation but not on 5 alpha
      reduction. These studies indicate that P selectively increases bioactive and
      immunoactive FSH levels, presumably by increasing FSH synthesis, and characterize
      the time course and cellular mechanisms of this response. To accommodate for P
      modulation of total FSH levels, FSH secretion was standardized as the percentage
      of cellular stores available for release. Progesterone modulation of GnRH
      stimulated FSH secretion was multiphasic, i.e. increased at 0-6 h, unchanged at 9
      h and suppressed at 24 h. Acute and chronic exposures to P similarly modulated
      A23187-stimulated FSH release, whereas both P treatments increased PMA-stimulated
      FSH secretion. In these experiments P modulated luteinizing hormone secretion in
      parallel fashion, suggesting that common cellular mechanisms underlie peptidergic
      and steroidal regulation of the secretion of both gonadotropins.

PMID- 8472845
TI  - Efficient amidation of C-peptide deleted NPY precursors by non-endocrine cells is
      affected by the presence of Lys-Arg at the C-terminus.
AB  - Post-translational processing of peptide precursors producing amidated,
      biologically active peptides generally occurs in specially differentiated
      endocrine or neural cells. However, we have previously shown that a C-peptide
      deleted precursor of neuropeptide Y (NPY1-39) in which the precursor terminates
      in the sequence Gly-Lys-Arg was partially amidated by the non-endocrine cell
      line, CHO. In the present study we show that two other non-endocrine cell lines,
      NIH 3T3 and BHK, also possess amidating activities and that the NPY1-39 precursor
      was completely converted to NPY1-36 amide by the NIH 3T3 cell line. The role of
      the two basic residues (Lys-Arg) in the C-terminus was studied by transfection of
      a construct encoding a NPY precursor terminating with glycine alone. Both the CHO
      and NIH 3T3 cell lines, transfected with this construct, secreted a significantly
      smaller fraction of NPY reactive material as amidated NPY compared to the
      fraction of amidated NPY secreted by the cells transfected with the NPY1-39
      precursor. It is concluded that the capacity to perform C-terminal amidation
      appears to be a universal feature of eukaryotic cells and that the
      carboxypeptidase E-like enzyme influences the amidation process, beyond its known
      ability to remove the C-terminal basic residues.

PMID- 8472846
TI  - Insulin secretion without the participation of arachidonic acid.
AB  - In order to study the role of arachidonic acid (AA) in depolarization-induced
      insulin secretion rat insulinoma cells (RINm5F) were depleted of AA by
      cultivation in essential fatty acid-free medium. Within 2 weeks AA content of
      these cells was decreased to a non-detectable level as assessed by gas
      chromatography (GC). Different cell lines were obtained by supplementation of the
      defatted medium with oleic acid or the AA precursor linoleic acid (7 and 70
      microM, each). The AA content varied in dependence from the precursor
      availability from 0 to about 14% of long chain fatty acids. Variation in AA
      content or the depletion of AA to a non-detectable level did not modulate insulin
      synthesis, basal and potassium-induced insulin release, cell growth (cell number
      and protein), membrane depolarization and increases in cytosolic Ca2+. In AA
      containing cells no eicosanoids was produced in the course of stimulated hormone
      release. The data suggest that in RINm5F cells release of AA and/or formation of
      oxidized metabolites from AA are not essential for functional integrity.

PMID- 8472847
TI  - Differential expression of human placental growth hormone variant and chorionic
      somatomammotropin genes in choriocarcinoma cells treated with methotrexate.
AB  - Chorionic somatomammotropin (hCS) genes (hCS-A and hCS-B) and the placental
      growth hormone variant (hGH-V) gene are expressed in the syncytiotrophoblast in
      vivo, and at low levels in cytotrophoblast-like choriocarcinoma (BeWo) cells.
      Treatment of choriocarcinoma cells with methotrexate (MTX) will induce a cell
      type intermediate between a cytotrophoblast and syncytiotrophoblast. After
      treatment with MTX, hCS/hGH-V mRNA levels were decreased in BeWo cells, and only
      hGH-V and minor hCS-A related transcripts of 1.6, 2.1 and 4.2 kilobases, termed
      hCS-A2, hCS-A3 and hCS-A4, respectively, were detected. By contrast, chorionic
      gonadotropin RNA levels were increased. This pattern of hCS/hGH-V expression
      resembles that observed when BeWo cells are grown in thyroid hormone (T3)
      depleted serum, where hGH-V/hCS RNA increases in response to T3. This increase is
      blunted by MTX treatment, but is not due to a decrease in number or affinity of
      T3 receptors. These data indicate that the hGH-V and hCS genes can be
      differentially regulated by MTX, and are consistent with MTX interfering with T3
      responsiveness of these genes. Also, if BeWo cells treated with MTX do represent
      a transitional state, these data raise the possibility that hGH-V and hCS possess
      a different temporal pattern of expression in the developing trophoblast.

PMID- 8472848
TI  - An androgenic affinity ligand covalently binds to cytosolic aldehyde
      dehydrogenase from human genital skin fibroblasts.
AB  - A 56 kDa protein expressed in human genital skin fibroblasts was first identified
      by independent laboratories on the basis of its specific expression in androgen
      target cells and its ability to covalently bind androgenic affinity ligands.
      Recently, immunoscreening of a cDNA library with antisera directed against this
      protein resulted in the isolation of a partial cDNA clone identical to human
      cytosolic aldehyde dehydrogenase (ALDH1). We report here the preparation of a
      full-length cDNA encoding ALDH1 from human genital fibroblasts. Translation of
      the encoded protein in a cell-free system yields a 56 kDa product that can be
      covalently radiolabeled with [3H]dihydrotestosterone 17 beta-bromoacetate (DHT
      BA). Expression of the full-length clone in mammalian cells also results in
      expression of a 56 kDa DHT-BA binding protein. The covalent binding of DHT-BA by
      ALDH1 is an intrinsic property of the enzyme and is not dependent on androgen
      receptor expression.

PMID- 8472849
TI  - Platelet derived growth factor-A chain gene expression in cultured mesangial
      cells: regulation by phorbol ester at the level of mRNA abundance, transcription
      and mRNA stability.
AB  - In human renal mesangial cells, platelet derived growth factor (PDGF)-A chain is
      subject to regulation by protein kinase C (PKC) activator, phorbol ester (phorbol
      12-myristate 13-acetate, PMA). Treatment of mesangial cells with PMA increases
      PDGF-A chain mRNA abundance as analyzed by Northern blot hybridization. In
      contrast to the effect of PMA, the inactive analog phorbol had no effect on PDGF
      A chain mRNA levels, while the PKC inhibitor H7 markedly reduced the PMA-induced
      increment in PDGF-A chain mRNA. To determine the mechanism by which PMA increases
      the abundance of this gene, transcription rate was measured by nuclear transcript
      elongation assay. Treatment of mesangial cells with PMA resulted in a 2-fold
      increase in PDGF-A chain gene transcription. In addition, we analyzed the effects
      of PMA on PDGF-A chain mRNA half-life as measured directly by pulse-chase method.
      PDGF-A chain mRNA has a half-life of about 106 min. The PDGF-A chain mRNA half
      life was reduced by 30% (t1/2 = 74 min) when mesangial cells were incubated with
      PMA. Our results demonstrate that in human renal mesangial cells, the regulation
      of PDGF-A chain gene expression by PMA is primarily at the level of
      transcription.

PMID- 8472850
TI  - Transcription rate of the follicle stimulating hormone (FSH) beta subunit gene is
      reduced by inhibin in sheep but this does not fully explain the decrease in mRNA.
AB  - Studies were conducted in vitro and in vivo to determine whether or not inhibin
      affects the transcription rate of the gene for the beta subunit of follicle
      stimulating hormone (FSH beta). Pituitary cells in primary culture were incubated
      with 0-3000 milli-units/ml inhibin; a dose-related decrement in mRNA was obtained
      but a parallel effect was not observed for the transcription rate of the FSH beta
      gene in a nuclear run-on experiment. To determine effects in vivo, ovariectomized
      ewes were treated with saline (group 1), 75 micrograms inhibin 6 h before
      slaughter (group 2), inhibin 6 h and 12 h before slaughter (group 3) or inhibin
      12 h before slaughter (group 4). In samples taken each 2 h, plasma FSH levels
      were seen to be maximally reduced 6 h after a single injection of inhibin; at
      this time mRNA levels were reduced up to 100% whereas FSH beta gene transcription
      rate was reduced by 50%. A second injection at 6 h (group 3) caused a further
      reduction in plasma FSH levels with no additional effect on transcription rate.
      In those sheep killed 12 h after a single inhibin injection, transcription rate
      for the FSH beta gene, cytoplasmic mRNA levels and plasma FSH concentrations had
      recovered. These studies show that the rapid effect of inhibin on FSH beta mRNA
      levels may be due, in part, to an effect on transcription rate of the FSH beta
      gene. An additional mechanism is required, however, to fully explain the inhibin
      effect on FSH beta mRNA levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472852
TI  - High expression of the hormone binding active extracellular domain (1-294) of rat
      lutropin receptor in Escherichia coli.
AB  - Using the polymerase chain reaction (PCR) technique, the cDNA fragment
      corresponding to the receptor coding region for residues 1-294 was prepared from
      rat lutropin receptor (LHR) cDNA and subsequently subcloned into Escherichia coli
      expression vector pT7-7. This truncated receptor was efficiently expressed in E.
      coli as indicated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      (SDS-PAGE) and silver staining. The recombinant protein present in the inclusion
      bodies was solubilized in 6 M guanidine-HCl and purified in two successive steps
      of fast performance liquid chromatography (FPLC) using Superose-12 and Mono Q
      columns. Refolding of the purified recombinant protein was achieved in 1.5 M
      guanidine-HCl in the presence of an equimolar proportion of cysteine and cystine.
      The refolded soluble truncated LHR(1-294) had apparent molecular weights of 33
      kDa and 140 kDa under reducing and nonreducing conditions, respectively. The
      multimeric nature of the extracellular domain of the receptor is believed to be
      due to its self-association by intermolecular disulfide bond formation since the
      1-294 amino acid segment has nine cysteine residues and thus has one or possibly
      more free sulfhydryl groups. The purified truncated receptor had high binding
      affinity for human choriogonadotropin (hCG) as indicated by ligand blotting on
      SDS-PAGE and radioligand receptor assays. The amount of hCG required for 50%
      inhibition of binding of 125I-hCG to the soluble truncated receptor was 2.7 x 10(
      10) M (or 12.25 ng). Similarly, the amount of soluble truncated receptor required
      for 50% inhibition of 125I-hCG binding to the rat ovarian receptor in the
      radioligand receptor assay was 58 ng.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472851
TI  - Effect of benzyl succinate on insulin receptor function and insulin action in
      skeletal muscle: further evidence for a lack of spare high-affinity insulin
      receptors.
AB  - Benzyl succinate inhibited insulin binding and tyrosine receptor kinase in a
      concentration-dependent manner in the partially purified insulin receptor
      preparation from rat skeletal muscle. Benzyl succinate lowered the apparent
      number of high-affinity insulin binding sites. We have made use of the inhibitory
      effect of benzyl succinate to investigate the possible presence of spare high
      affinity insulin receptors in muscle. Benzyl succinate inhibited the effect of a
      supramaximal concentration of insulin on 3-O-methylglucose uptake, 2
      (methylamino)isobutyric acid uptake and lactate production by the incubated
      muscle. Furthermore, the inhibitory effect of benzyl succinate on insulin binding
      in vitro closely correlated with its inhibitory effect on insulin action in vivo.
      These findings suggest the absence of spare high-affinity insulin receptors in
      skeletal muscle. In contrast to data obtained in skeletal muscle, benzyl
      succinate did not affect the maximally insulin-stimulated glucose transport,
      although it caused a marked decrease in insulin sensitivity in isolated rat
      adipocytes, for which the existence of spare insulin receptors is well
      documented.

PMID- 8472853
TI  - Blockade of androstenedione-induced stimulation of androgen-sensitive parameters
      in the rat prostate by combination of Flutamide and 4-MA.
AB  - In order to mimic the human situation in which adrenal steroid precursors are
      converted to the active androgen dihydrotestosterone (DHT) in prostatic tissue,
      we have used castrated rats supplemented with the precursor steroid
      androstenedione (delta 4-dione) released from Silastic implants. While it is well
      known that the action of DHT can be partially neutralized by antiandrogens which
      compete for binding to the androgen receptor, we have used 17 beta-N,N
      diethylcarbamoyl-4-methyl-4-aza-5 alpha-androstan-3-one (4-MA), an inhibitor of 5
      alpha-reductase, the enzyme which converts testosterone into DHT, in order to
      decrease intraprostatic DHT levels and thus facilitate the action of the
      antiandrogen. Animals were treated for 7 days with Flutamide (FLU, 2 mg) or 4-MA
      (4 mg) injected subcutaneously, twice daily, alone or in combination. 4-MA
      administered alone caused a 54% inhibition of delta 4-dione-stimulated ventral
      prostate weight while FLU exerted a 74% inhibitory effect and 4-MA+FLU further
      improved inhibition to 81%. We then measured, by in situ hybridization, the
      levels of prostatic mRNAs encoding the C1 and C3 components of the prostatic
      binding protein (PBP) which are highly specific and sensitive markers of androgen
      action. PBP-C3 mRNA levels fell by 95% following castration while treatment with
      delta 4-dione completely reversed the effect of castration. Administration of FLU
      or 4-MA independently caused 33% and 10% decreases, respectively, of PBP-C3 mRNA
      levels stimulated by delta 4-dione while the combination of both compounds
      further inhibited PBP-C3 mRNA levels to reach a 55% inhibition. Similar effects
      were observed on PBP-C1 mRNA levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472854
TI  - Prostaglandin F2 alpha activates protein kinase C in human ovarian cells.
AB  - Recent studies in several non-primate species have suggested that prostaglandin
      F2 alpha (PGF2 alpha) inhibits luteal cell progesterone production by activating
      the calcium and phospholipid-dependent protein kinase, protein kinase C (PKC).
      This study investigated the presence of PKC in human ovarian cells and assessed
      the ability of PGF2 alpha and its structural analogue, cloprostenol, to generate
      inositol polyphosphates and activate PKC. PKC was detected in cultured human
      granulosa-lutein cells and human luteal cells (from mid-late luteal phase). The
      major proportion of PKC detected was cytosol-associated in both cell types.
      Cloprostenol increased the generation of inositol polyphosphates in cultured
      human granulosa-lutein cells in a dose- and time-dependent manner. In addition
      both cloprostenol and PGF2 alpha activated PKC (as assessed by redistribution of
      enzyme activity from a principally cytosol-associated form to a membrane
      associated form) in both granulosa-lutein and luteal cells. Short-term exposure
      of both cell types to phorbol myristate acetate (4 beta-PMA) activated PKC,
      whilst prolonged exposure of human granulosa-lutein cells to 4 beta-PMA led to a
      > 85% loss of total PKC activity. The inactive phorbol ester, 4 alpha-PMA, had no
      effect on PKC activity when exposed to cells for up to 20 h. These results
      demonstrate the presence of PKC in human ovarian cells and the ability of PGF2
      alpha to induce translocation/activation of this kinase.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8472855
TI  - Serotonin-dependent collagenase induction in rat myometrial smooth muscle cells:
      mediation by the 5-HT2 receptor.
AB  - Recent studies have shown that serotonin (5-hydroxytryptamine; 5-HT) is required
      for the induction of interstitial collagenase in cultured rat and human
      myometrial smooth muscle cells. The present study was performed to determine
      which serotonin receptor subtype mediates the induction of collagenase in these
      cells. [125I]DOI ((+/- )-1-(2,5-dimethoxy-4-[125I]iodophenyl)-2-aminopropane), a
      5-HT2 receptor agonist radioligand, bound specifically to sites in myometrial
      cell membranes, and exhibited binding characteristics essentially identical to
      those observed with brain 5-HT2 receptors. Radioligands selective for other
      serotonin receptor subtypes (5-HT1 and 5-HT3) failed to yield detectable binding.
      Northern blot analysis demonstrated the presence of 5-HT2 mRNA in the uterine
      smooth muscle cell cultures, whereas transcripts for 5-HT1A and 5-HT1C receptors
      were not detectable. Moreover, RT-PCR indicated that 5-HT2 receptor mRNA is
      present in freshly isolated uterine tissue as well. Selective antagonists of the
      5-HT2 receptor, ketanserin and spiperone, displayed concentration-dependent
      inhibition of serotonin-mediated collagenase induction in the myometrial
      cultures. These antagonists yielded IC50 values of 4.7 nM and 2.7 nM
      respectively, characteristic of values expected from a 5-HT2 receptor-mediated
      response. In addition, a number of selective 5-HT2 receptor agonists (quipazine,
      alpha-methyl-serotonin, DOI) mimicked the ability of serotonin to induce
      collagenase production, whereas compounds selective for 5-HT1 and 5-HT3 receptor
      subtypes had little effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472856
TI  - Effect of thyroid hormone on T3-receptor mRNA levels and growth of thyrotropic
      tumors.
AB  - Thyrotropic tumors (TtT97) contain mRNA transcripts for three T3-receptor (TR)
      isoforms, alpha 1, beta 1 and beta 2, and a non-receptor alpha 2-variant. We
      administered T4 (5 mg/l of drinking water) for one month to TtT97-bearing mice,
      to examine its effect on tumor growth and tumor TR isoform steady-state mRNA
      levels. Baseline mice were killed at the start of the experiment, and placebo
      mice were maintained hypothyroid. The treated tumors were 30-35% smaller than the
      baseline tumors (p = NS), while the placebo tumors were 2- to 7-fold larger than
      the baseline tumors (p < 0.05). TR beta 1 mRNA increased 5- to 6-fold, while TR
      beta 2 mRNA decreased by 76%. TR alpha 1 and the alpha 2-variant decreased by 52%
      and 70%, respectively. Therefore, the tumors decreased their growth rate in
      response to T4 administration, and increased the ratio of TR beta 1 to TR beta 2
      mRNA. This raises the intriguing possibility of a correlation between the
      relative abundance of the TR beta isoforms and tumor growth.

PMID- 8472857
TI  - C-myc gene chromatin of estrogen receptor positive and negative breast cancer
      cells.
AB  - Expression of the c-myc protooncogene is estrogen regulated in estrogen receptor
      (ER) positive, hormone-dependent human breast cancer cells, but it is
      constitutively active in ER negative, hormone-independent breast cancer cells. To
      determine whether these differences are reflected in c-myc chromatin, DNase I
      hypersensitive sites (DHS) were mapped. Six DHS were detected in all cell lines
      studied, with DHS 3(2) being more prominent than DHS 3(1). The accessibility of
      DHS 2 was markedly greater in ER negative cells than in ER positive cells, and
      this relative accessibility remained unchanged when cells were grown in estrogen
      free medium. DHS 2, 3(1) and 3(2) map near the P0, P1 and P2 promoters,
      respectively. An analysis of promoter usage demonstrated that P2 was the
      preferred promoter. Thus, the differences in the accessibility of DHS 2 in c-myc
      chromatin of ER positive and negative cells likely reflects alterations in DNA
      protein interactions in this region.

PMID- 8472858
TI  - Vanadate treatment of diabetic rats reverses the impaired expression of genes
      involved in hepatic glucose metabolism: effects on glycolytic and gluconeogenic
      enzymes, and on glucose transporter GLUT2.
AB  - The trace element vanadium is a potent insulinomimetic agent in vitro. Oral
      administration of vanadate to rats made diabetic by streptozotocin (45 mg/kg
      i.v.) caused a 65% fall in plasma glucose levels without modifying low
      insulinemia. We studied whether the hypoglycemic effect of vanadate was
      associated with altered expression of genes involved in key steps of hepatic
      glucose metabolism. Glucokinase (GK) and L-type pyruvate kinase (L-PK) mRNA
      levels were decreased respectively by 90% and 70% in fed diabetic rats, in close
      correlation with changes in enzyme activities. Eighteen days of vanadate
      treatment partially restored GK mRNA and activity (40% of control levels), and
      totally restored L-PK parameters. In contrast to the glycolytic enzymes, mRNA
      levels and activity of the gluconeogenic enzyme, phosphoenolpyruvate
      carboxykinase (PEPCK) were increased (15- and 2-fold, respectively) in fed
      diabetic rats. Vanadate treatment normalized both PEPCK mRNA and activity in
      diabetic rat liver. The 2-fold increase in liver glucose transporter (GLUT2) mRNA
      and protein, produced by diabetes, was also corrected by this treatment. In
      conclusion, oral vanadate given to diabetic rats induces a shift of the
      predominating gluconeogenic flux, with subsequent high hepatic glucose
      production, into a glycolytic flux by pretranslational regulatory mechanisms.

PMID- 8472859
TI  - Pituitary as a target organ for toxic effects of P4501A1 inducing chemicals.
AB  - We report here that cytochrome P4501A1 in the male rainbow trout pituitary is
      highly inducible by beta-naphthoflavone. Pituitary cells containing inducible
      P4501A1 were identified by double immunostaining as gonadotrophs containing
      gonadotropin II. Thus, the pituitary gonadotrophs may be target cells for
      polyaromatic hydrocarbons. Elevated plasma levels of gonadotropin II (GTH II) and
      testosterone in the induced fish indicated that the functioning of the pituitary
      was disturbed. Because GTH II regulate the final stage of sexual maturation the
      results implies that exposure to P4501A1 inducing compounds may disturb this
      development stage.

PMID- 8472860
TI  - What is the function of circulating insulin-like growth factor-2 in postnatal
      life?

PMID- 8472861
TI  - In situ hybridization for creatine kinase-B messenger RNA in rat uterus and
      brain.
AB  - Creatine kinase-B (CKB) is present in both uterus and brain, and in uterus its
      synthesis (protein and mRNA) is regulated by estrogen. In the present study we
      have used in situ hybridization to detect CKB mRNA in uterus and brain, and to
      determine whether there is cell type specific induction of CKB by estrogen in
      these tissues. Tissue was taken from ovariectomized (ovx) rats that had been
      injected with either estrogen (17 beta-estradiol-3-benzoate and/or 17 beta
      estradiol) or vehicle alone, 2, 8, 24 and 72 h previously. The brains and uteri
      were removed, frozen, cryostat-sectioned, and processed for in situ hybridization
      histochemistry. The uterine and brain sections were incubated with a tritiated
      DNA probe complementary to a 3' fragment of CKB mRNA, or a control sense probe to
      the same 3' fragment. In uterine smooth muscle cells, a 2.5- and 3.5-fold
      induction of CKB mRNA was observed 2 and 24 h after estrogen administration,
      respectively, and levels approached ovx controls at 72 h. A smaller induction
      (1.9-fold, 2 h) was observed in uterine epithelium, with little induction of CKB
      mRNA in stroma. In the brain CKB mRNA was detected in neurons, but not in clearly
      identified glia, and only occasionally in ependymal cells. In brain regions
      containing estrogen receptors there was no evidence of a significant estrogen
      effect on CKB mRNA levels. Some brain regions had higher neuronal expression than
      others (e.g. medial septum vs. preoptic area), but expression was widespread and
      not limited to neuroendocrine sites.

PMID- 8472862
TI  - Biphasic effect of basic fibroblast growth factor on 125I-human chorionic
      gonadotropin binding to cultured immature Leydig cells.
AB  - The present studies examined the effects of basic fibroblast growth factor (bFGF
      or FGF-2) on 125I-human chorionic gonadotropin (hCG) binding to cultured immature
      rat Leydig cells. We found that low concentrations of bFGF (0.1-1.0 ng/ml)
      inhibited 125I-hCG binding to cultured immature Leydig cells in a dose- and time
      dependent manner; however, this inhibition was reversed partially at higher bFGF
      concentrations (10-200 ng/ml). The decline in 125I-hCG binding by bFGF was due to
      a reduction in the number of binding sites per cell and not to a change in
      receptor affinity for the ligand. The inclusion of 10 micrograms/ml heparin (a
      concentration that is reported to block bFGF binding to heparan sulfate
      proteoglycans) with increasing bFGF concentrations had no effect on the
      inhibition of 125I-hCG binding by low bFGF concentrations, but completely blocked
      the secondary increase in binding by higher bFGF concentrations. In addition,
      neither varying heparin concentrations (0.1-25 micrograms/ml) nor insulin or
      insulin-like growth factor-I had any effect on the inhibition of 125I-hCG binding
      by 1 ng/ml bFGF. These studies suggest that receptor-mediated actions of bFGF
      (inhibition of hCG binding by low bFGF concentrations) on cultured immature
      Leydig cells are unaffected by heparin; however, the secondary increase in 125I
      hCG binding observed with higher bFGF concentrations (mediated by bFGF binding to
      heparan sulfate proteoglycans) is blocked by heparin.

PMID- 8472863
TI  - Effect of various protein kinase inhibitors on the induction of milk protein gene
      expression by prolactin.
AB  - Prolactin has many known functions and one of them is to induce the expression of
      milk protein gene expression in the mammary gland. Specific membrane receptors
      have been recently characterized but the transduction mechanism involved in the
      transfer of the prolactin signal to milk protein genes remains unknown. In the
      present work, it is shown that several protein kinase inhibitors block prolactin
      action on milk protein genes. Primary rabbit mammary cells were cultured for
      several days on floating collagen gel in a serum-free medium. Prolactin and the
      inhibitors of protein kinase were then added to the culture medium. After 1 day,
      the concentration of alpha s1-casein in the culture medium was measured using a
      specific radioimmunoassay. The concentration of several mRNAs in cell extracts
      was also evaluated using Northern blot analysis. alpha s1-Casein secretion and
      alpha s1-casein mRNA accumulation were induced by prolactin. This induction was
      blocked by staurosporine, sphingosine, quercetin, genistein and to some extent by
      o-hydroxyphenyl acetate, but not by H7, polymyxin B, benzylsuccinate and
      lavendustin A. The concentration of the mRNA coding for transferrin, which is
      abundantly secreted in rabbit milk independently of prolactin action, was only
      moderately altered by the inhibitors. The concentration of two house-keeping
      mRNAs, beta-actin and glyceraldehyde 3-phosphate dehydrogenase, was lowered only
      by genistein after 1 day but not after 4 h of culture. These data show for the
      first time that a Ser/Thre kinase, which is not kinase C, and possibly a tyrosine
      kinase is involved in the transduction of the prolactin message from the receptor
      to the milk protein genes.

PMID- 8472864
TI  - Fuel secretagogue stimulation of arachidonic acid accumulation in fresh and
      cultured pancreatic islets.
AB  - It has been previously demonstrated that glucose stimulation of islets of
      Langerhans causes an accumulation of unesterified arachidonic acid that
      correlates with insulin secretion. In addition, it is well established that
      glucose metabolism is essential for insulin secretion. We show that non
      metabolizable analogs of glucose which do not stimulate insulin secretion fail to
      cause significant accumulation of unesterified arachidonic acid. In addition,
      mannoheptulose, an inhibitor of glucose metabolism, completely blocks the glucose
      induced increase in arachidonic acid accumulation. Among the nutrient
      secretagogues tested, only alpha-ketoisocaproic acid causes a significant
      increase in unesterified arachidonic acid accumulation. Mannose, fructose, and
      glyceraldehyde, in particular, failed to elicit a significant increase in
      unesterified arachidonic acid accumulation. Our data, taken together with
      previous studies, suggests that glucose must be metabolized to induce
      accumulation of unesterified arachidonic acid in pancreatic islets.

PMID- 8472865
TI  - Insulin receptor beta-subunit serine phosphorylation in permeabilized cultured
      fetal rat hepatocytes.
AB  - Regulation of cellular protein phosphorylation by insulin was investigated after
      short exposure at 37 degrees C prior to applying the
      permeabilization/phosphorylation step in the presence of digitonin and [gamma
      32P]ATP for 30 min at 4 degrees C. The results revealed major 32P incorporation
      into a limited number of membrane polypeptides exhibiting a molecular mass of 95,
      58 and 51 kDa. Phosphorylation of 95 kDa protein was selectively inhibited with
      Ca(2+)-free EGTA-containing permeabilization/phosphorylation buffer and became
      predominant in the presence of Ca2+. Considering in particular its
      immunoprecipitation by a monoclonal antibody directed against insulin receptor,
      the 32P-labeled 95 kDa protein represented the beta-subunit of the insulin
      receptor. Its phosphorylation was transiently stimulated after exposure to
      insulin (35% after 2 min), and concerned mostly serine residues under both basal
      and stimulated conditions. Vanadate had a similar effect and both agents favored
      glycogenesis, whereas heparin which inhibited 95 kDa protein phosphoseryl
      phosphorylation had an opposite effect on glycogenesis. These results suggest a
      biological role for the membrane-associated phosphoseryl-protein kinase(s) and
      phosphatase(s) acting on the insulin receptor beta-subunit in cultured fetal
      hepatocytes.

PMID- 8472866
TI  - Effect of epidermal growth factor/transforming growth factor alpha on lactate
      production in porcine Sertoli cells: glucose transport and lactate dehydrogenase
      isozymes as potential sites of action.
AB  - Germ cell development is dependent upon the delivery of essential nutriments such
      as lactate originating from Sertoli cells. Lactate production is under the
      systemic control but probably also under a local control exerted via certain
      growth factors. By using a model of porcine cultured Sertoli cells, we have
      characterized the action of epidermal growth factor (EGF) on lactate production
      and further delineated the potential biochemical mechanisms involved in the EGF
      action. EGF stimulated lactate production in a time and dose dependent manner
      with a half-maximal (ED50) and maximal effects, respectively with 3.8 (0.6 x 10(
      9) M) and 22 ng/ml of EGF. Lactate formation involves several biochemical steps
      among which the glucose substrate uptake and transport system as well as the
      lactate dehydrogenase (LDH) activity appear to play key roles. We report here
      that EGF increased the uptake of glucose evaluated through that of 2-deoxy-D
      glucose (2-DOG), a non-metabolizable glucose analog. Such an increase in glucose
      substrate uptake occurs both after a long term (48 h) and a short term treatment
      (ED50 = 6.4 ng/ml, 1.1 x 10(-9) M EGF). Moreover, EGF was also able to enhance
      the activity of the Sertoli cell LDH. The maximal effect of the growth factor on
      LDH activity was observed after a long term (24 h) treatment with an ED50 of 7
      ng/ml (1.2 x 10(-9) M).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472867
TI  - Transforming growth factor beta stimulation of parathyroid hormone-related
      protein (PTHrP): a paracrine regulator?
AB  - The regulation of PTHrP expression and production by transforming growth factor
      beta (TGF beta) has been investigated in an epidermal squamous cancer cell line
      COLO 16. TGF beta 1 treatment increased steady-state levels of PTHrP mRNA and
      concentrations of PTHrP immunoreactivity in conditioned medium in a time- and
      dose-dependent manner with a half-maximal effect at 40 pM. An effect of TGF beta
      1 on PTHrP mRNA was observed first after 4 h treatment and continued to increase
      up to 48 h with a concomitant increase in PTHrP immunoreactivity in the culture
      medium. TGF beta 1 was found to stabilize PTHrP mRNA as assessed by actinomycin
      C1 experiments. In addition, a direct effect of TGF beta to increase PTHrP
      transcription was indicated by nuclear run-on and transient transfection
      experiments using a CAT promoter/expression construct encompassing the region 
      1100 bp to -20 bp from the initiating AUG of the human PTHrP gene. The
      conditioned medium from COLO 16 cells was also shown to contain both latent and
      active TGF beta at concentrations of 160 pM and 16 pM, respectively, in 72 h
      conditioned medium. A neutralizing antibody to TGF beta 1 (and TGF beta 2)
      decreased the level of immunoassayable PTHrP in the medium.

PMID- 8472868
TI  - Dopamine regulates D2 receptor gene expression in normal but not in tumorous rat
      pituitary cells.
AB  - Abnormalities of dopamine D2 receptors may be implicated in the development of
      some pituitary tumours. Previously we have identified dopamine D2 receptor gene
      expression both in normal rat pituitaries and in dopamine resistant GH3 rat
      pituitary tumour cells. In this study we have examined the effect of dopamine on
      D2 receptor gene expression in these cells using a probe specific for both D2
      receptor isoforms. Normal rat pituitary cells were maximally stimulated by 100 nM
      dopamine at which concentration D2 receptor mRNA concentrations were 400% greater
      than that measured in controls. No increase in D2 receptor gene expression was
      observed in GH3 pituitary tumour cells.

PMID- 8472869
TI  - Influence of hormones on tumor growth, cell kinetics, estrogen receptor and
      insulin-like growth factor-I-related protein of human breast cancer (MCF-7) cells
      transplanted in nude mice.
AB  - The influence of estrogens and tamoxifen on estrogen receptor (ER)-positive human
      breast cancer (MCF-7) cells transplanted into athymic nude mice was investigated.
      The mice were divided into the following three groups: (1) an E2 group with mice
      receiving 17 beta-estradiol dipropionate; (2) a TAM group with mice receiving
      tamoxifen; (3) a control group with mice given no hormone. (1) Tumor growth was
      significantly increased in the E2 group, but significantly decreased in the TAM
      group compared to control; (2) the tumor contents of insulin-like growth factor-I
      (IGF-I) and the rate of IGF-I-positive cells were significantly lower in the E2
      group, but significantly higher in the TAM groups compared to control; (3) the
      IGF-I-positive cell rates were in significant inverse correlation with the
      [3H]thymidine-labeled cell rates in the E2, TAM and control groups. Thus, the
      tumor contents of IGF-I and the rate of IGF-I-positive cells were inversely
      correlated to the tumor growth and the [3H]thymidine-labeled cell rate in this in
      vivo study, although IGF-I is known to be a mitogen for breast cancer cells in
      vitro. Further studies are necessary to answer the questions as to the in vivo
      roles of immunoreactive IGF-I in ER-positive breast cancer.

PMID- 8472870
TI  - Autoimmune T-cell recognition sites of human thyrotropin receptor in Graves'
      disease.
AB  - Five overlapping synthetic peptides representing two regions of thyrotropin (TSH)
      binding sites of human thyrotropin receptor (TSHR) (peptides 12-30, 24-44, 308
      328, 324-344 and 339-364) were investigated for their ability to cause
      proliferation of peripheral blood lymphocytes (PBL) from eight patients with
      Graves' disease. The same experiment was done using PBL from four cases with
      Hashimoto's thyroiditis, two cases with subacute thyroiditis, two cases with
      rheumatoid arthritis (RA) and eight normal volunteers. PBL obtained from each
      patient with Graves' disease responded to one or more of peptides 12-30, 24-44,
      308-328 and 324-344, while peptide 339-364 had no stimulating activity. The level
      of stimulating activity of each of the four aforementioned TSHR peptides varied
      from patient to patient. None of the five TSHR peptides caused the proliferation
      of PBL from patients with Hashimoto's thyroiditis, subacute thyroiditis, or RA
      and from normal volunteers. The results indicate that the proliferation of PBL by
      TSHR peptides is specific in patients with Graves' disease and that the regions
      of TSHR which are involved in the binding to TSH are also the target of
      autoimmune T-cell recognition in Graves' disease. The difference in T-cell
      response from patient to patient could be explained by genetic regulation toward
      each autodeterminant.

PMID- 8472871
TI  - Cytotoxic activity of lutropin-gelonin conjugate in mouse Leydig tumor cells:
      potentiation of the hormonotoxin activity by different drugs.
AB  - A hormonotoxin preparation composed of gelonin, a basic protein of 30,000 Da
      isolated from the plant Gelonium multiflorum and the luteinizing hormone (LH,
      lutropin) isolated from the sheep pituitary has been studied for its cytotoxic
      action on mouse testicular Leydig tumor cells (MA-10 cells). Gelonin modified
      with 2-iminothiolane and conjugated with hormone modified by N-succinimidyl-3-2
      pyridyl dithiopropionate was able to inhibit protein synthesis in Leydig tumor
      cells. An enhancement of the cytotoxicity of the hormonotoxin was obtained in the
      presence of drugs like quinacrine, chloroquine, verapamil and monensin. We report
      that the cytotoxicity of hormonotoxin was enhanced 10-15 times with quinacrine
      (7.6 microM), chloroquine (29 microM), verapamil (40 microM) and monensin (0.29
      microM). While quinacrine, chloroquine and verapamil were not cytotoxic to MA-10
      cells for up to 48 h, monensin alone reduced protein synthesis significantly in
      48 h. All the drugs studied here inhibited steroidogenic action of the native
      hormone even at concentrations which were not detrimental to protein synthesis.
      On the basis of the above studies, we suggest that it may be feasible to develop
      combination strategies to destroy gonadal cells bearing gonadotropin (LH)
      receptors. In cells not bearing LH receptors (COS-7 cell line) there was no
      cytotoxicity either with hormonotoxin alone or in combination with the drugs,
      suggesting specificity of action.

PMID- 8472872
TI  - Osmotic stimuli attenuate vasoactive intestinal peptide gene expression in the
      rat anterior pituitary gland.
AB  - Studies on vasoactive intestinal peptide (VIP) in the anterior pituitary gland
      have shown that it is synthesized locally, physiologically regulated, and may act
      as a paracrine/autocrine factor. We have now investigated the regulation of
      anterior pituitary VIP gene expression in rats during osmotic stimulation. Both
      salt-loading and dehydration resulted in a progressive and marked reduction in
      VIP mRNA levels as determined by Northern analysis, to 10% of control levels at
      14 days of salt-loading. The 1.7 and 1.0 kb VIP RNA transcripts were equally
      affected. Since anterior pituitary VIP is partially localized in lactotrophs we
      also measured prolactin (PRL) mRNA levels. In contrast to VIP, PRL mRNA levels
      were increased during both osmotic paradigms, the mRNA levels being significantly
      raised after 5 days of salt-loading to 130% of controls. Further experiments,
      conducted to examine the mechanism by which VIP gene expression is down-regulated
      during osmotic stimulation, demonstrated that dopamine and angiotensin II do not
      appear to be involved. The results show dissociated regulation of VIP and PRL
      during osmotic stimulation and provide suggestive evidence of a role for anterior
      pituitary VIP in the animal's osmoregulatory responses. VIP may therefore be a
      paracrine factor with diverse functional roles.

PMID- 8472874
TI  - American Diabetes Association. 53rd annual meeting. June 12-15, 1993. Abstracts.

PMID- 8472873
TI  - Structural and functional characterization of the rat follistatin (activin
      binding protein) gene promoter.
AB  - Follistatin was originally identified as a specific inhibitor of follicle
      stimulating hormone secretion and later characterized as a binding protein for
      activin. Since activin regulates hormone secretion and cell differentiation, the
      importance of understanding the mechanisms regulating the synthesis of its
      binding protein, follistatin, is evident. To study the regulation of follistatin
      gene expression, we first determined the transcription start site (cap site) of
      the rat follistatin gene using primer extension and ribonuclease protection
      assay. Our results led to the identification of multiple cap sites located at
      three different positions of the promoter. DNA sequence analysis revealed that
      each cap site was located at approximately 30 nucleotide (nt) downstream of three
      distinct TATA-like sequences. In primary cultures of rat granulosa cells,
      transfection studies using 5'-flanking regions of follistatin gene fused to the
      chloramphenicol acetyltransferase (CAT) reporter gene revealed the presence of
      two DNA segments that act to suppress basal transcriptional activity. The
      promoter activity of the CAT construct containing 2.6 kilo base pairs (kb) of 5'
      flanking region was induced 2.5-fold above basal activity by forskolin (10
      microM), and 1.6-fold by 12-O-tetradecanoylphorbol 13-acetate (TPA, 100 nM). Co
      treatment with forskolin and TPA resulted in a 6.4-fold induction in its promoter
      activity, suggesting that two distinct signal transduction pathways, the cAMP
      dependent protein kinase-A pathway and diacylglycerol-dependent protein kinase-C
      pathway, act coordinately to modulate follistatin gene transcription. Experiments
      using a series of 5'-flanking region deletion constructs located the regulatory
      regions responsive to these two pharmacological agents at nt -312 to -32 and -35
      to +139.

PMID- 8472875
TI  - Speech spectra for six recorded monosyllabic word tests.
AB  - Speech spectra (long-term RMS levels and 1% speech peaks) in third-octave bands
      were determined for six monosyllabic word test materials: digital recordings of
      the Central Institute for the Deaf W-22 word test and the Northwestern University
      NU-6 word test obtained from Qualitone; audiotape recordings of the Central
      Institute for the Deaf W-22 word test, the Northwestern University NU-6 word
      test, and the Harvard Psycho-Acoustic Laboratory PB-50 word test obtained from
      Auditec of St. Louis; and an audio-tape recording of the Maryland CNC word test
      obtained from Olsen Distributors. The spectra were generally within 2 SD of
      previous results for continuous speech spoken by an average male talker (Cox,
      Matesich, & Moore, 1988; Cox & Moore, 1988), but differed sufficiently from those
      data and from one another to affect the accuracy of Articulation Index
      calculations. The relationship between the level of the calibration tone and the
      speech in the third-octave band centered at 1000 Hz was different for each
      recording.

PMID- 8472876
TI  - The effect of listeners' experience on the evaluation of intonation contours
      produced by hearing-impaired children.
AB  - This study investigated the effect of the listener's experience on the evaluation
      of intonation contours produced by hearing-impaired children. Stimuli included
      imitations of intonation (based on synthetic speech stimuli) produced by hearing
      impaired children. Twenty listeners (10 experienced and 10 naive) evaluated the
      intonation production by means of two evaluation tools: a rating scale and a
      forced-choice test. No significant differences were found between the two
      listener groups using the forced-choice test, either for the falling or for the
      rising contours. However, a significant difference was found between the two
      listener groups using the rating scale, with regard to both the rising and the
      falling contours. Thus, the effect of experience decreased when using the forced
      choice procedure. This finding supports the use of the forced-choice method for
      providing a perceptual measure of speech production performance that is
      independent of the listener's experience.

PMID- 8472877
TI  - Factors in the development of a training program for use with tactile devices.
AB  - A review of the literature suggests that, in order to maximize the benefits
      available through a tactile device, it must be accompanied by an effective and
      adaptive training program. There are a number of factors to consider in the
      design of such a training program, including the type of tasks and response
      formats to include, the amount of training, subject motivation and device use,
      the characteristics of the potential user population, the specific device to be
      used and the type of information it provides, and the evaluation procedures to be
      followed. The type and saliency of the information provided by a particular
      tactile device are highlighted as the most important yet neglected consideration
      in designing a training program. The training program used with the University of
      Melbourne's multiple-channel electrotactile device is presented to show how these
      important factors may be addressed, to indicate the flexibility required in a
      training program, and to provide a general framework on which researchers may
      base the development of programs for other tactile devices.

PMID- 8472878
TI  - Development of a hearing test protocol for profoundly involved multi-handicapped
      children.
AB  - The purpose of the present study was to develop a protocol for use in testing the
      hearing of profoundly involved multi-handicapped children. Behavioral observation
      audiometry, visual reinforcement audiometry, auditory brain stem response (ABR),
      and noise-tone-difference tests were administered to 156 children with multiple
      handicaps. Eighty-three percent of the children with normal middle ear function
      were estimated to have normal hearing or, at worst, a mild hearing loss, by one
      or more of the tests. ABR was the single best test, followed by behavioral
      observation audiometry and noise-tone-difference. However, only 65% of the
      children would have passed had they only been tested with ABR. If agreement among
      two of the tests had been required, hearing loss would have been ruled out in
      only 34% of the children. A factor analysis revealed that the various hearing
      tests were associated with different medical and physical conditions which might
      influence threshold estimation for multi-handicapped children. These results
      support use of a series-positive test battery protocol in which individual tests
      are used sequentially with the purpose of ruling out moderate-profound
      sensorineural hearing loss.

PMID- 8472879
TI  - Click-evoked otoacoustic emissions and hearing threshold in sensorineural hearing
      loss.
AB  - The influence of hearing loss on the click-evoked otoacoustic emissions (EOAE)
      were studied in 931 ears. The EOAEs were never found when hearing loss on the
      best hearing frequency was above 40 dB HL. The presence of EOAEs reflects the
      hearing threshold at the best hearing frequency, not only at the middle
      frequencies.

PMID- 8472880
TI  - Experimental design for hearing aid research.

PMID- 8472881
TI  - Improving the reliability of the auditory middle latency response by monitoring
      EEG delta activity.
AB  - The auditory middle latency response (MLR), a useful tool in the assessment of
      low-frequency auditory sensitivity, can be consistently recorded in young
      children during wakefulness, stages 1 and 2, and REM sleep. Responses are often
      absent or questionable during stage 4. An on-line measure indicating favorable
      periods for recording MLR during sleep is important for interpretation of absent
      potentials. Here, for children 5 to 7 years old, the reliability and
      detectability of MLR was compared to sleep state and the dominance of delta
      activity (0-3 Hz) in the EEG frequency spectrum. Dominance of delta activity, a
      characteristic of stage 4, was expressed in a "delta ratio," a measure of
      relative EEG energy in the 0 to 3 Hz frequency spectrum. A fixed delta ratio (DR
      = 9) allowed the differentiation of periods favorable for MLR. MLR wave Pa
      amplitude and latency also varied with delta ratio. Results indicate that on-line
      monitoring of the delta ratio will allow reliable testing of MLR in clinical
      situations.

PMID- 8472882
TI  - A comparison of auditory brain stem response thresholds and latencies elicited by
      air- and bone-conducted stimuli.
AB  - Auditory brain stem responses (ABRs) were measured for stimuli presented both by
      air conduction and by bone conduction. Stimuli included clicks and tone bursts at
      octave frequencies from 250 to 4000 Hz. ABR thresholds were comparable for air-
      and bone-conducted stimuli. Wave V latencies were longer for bone-conducted
      stimuli compared to similar responses for air conduction. This effect was evident
      for both clicks and tone bursts. The fact that these latency differences were
      largely independent of stimulus spectrum suggests that they are not due to
      differences between the frequency responses of air and bone conduction
      transducers. This finding is expected when one considers the interaction between
      output, threshold, and frequency for both transducer types. These data also
      suggest that there are inherent differences in transmission by air and bone
      conduction that affect response latency but are unrelated to the amplitude
      spectrum in the signal.

PMID- 8472883
TI  - The effect of forward masker duration, rise/fall time, and integrated pressure on
      auditory brain stem evoked responses in human newborns and adults.
AB  - The effects of duration, rise/fall time, integrated pressure, and intensity of a
      forward masker on the auditory brain stem evoked response (ABR) were examined in
      three studies. Keeping peak masker intensity constant, integrated masker pressure
      was a better predictor of ABR latency prolongation than masker duration or
      rise/fall time in human newborns. Masker effects varied as a function of masker
      intensity. Greater ABR latency prolongation was observed for more intense
      maskers. Furthermore, latency prolongation was observed with increasing masker
      duration for high-intensity, but not low-intensity maskers. Forward masking had a
      greater effect on newborn wave V latencies than adult wave V latencies; however,
      increasing masker duration had similar effects on newborn and adult wave V
      latencies.

PMID- 8472884
TI  - 1,25-Dihydroxy vitamin D3 stimulation of TGF-beta expression in chick embryonic
      calvarial bone.
AB  - Bone is a highly active producer of the cytokine, transforming growth factor-beta
      (TGF-beta), which is likely to be functionally involved in the regulation and
      maintenance of bone development and growth. In addition, bone functions are also
      regulated by the major calciotropic hormone, 1,25-dihydroxy vitamin D3
      (1,25(OH)2D3). This investigation aims to examine the possible relationship
      between TGF-beta and 1,25(OH)2D3 using an unique calcium-deficient chick
      embryonic model. By means of long-term culture without the eggshell (shell-less
      or SL culture), chick embryos may be rendered severely calcium-deficient with
      gross undermineralization of the skeleton. We have previously observed that the
      calvaria of these SL embryos develop abnormal chondrogenic phenotype, with
      production of collagen type II, and elevated TGF-beta expression. Administration
      of 1,25(OH)2D3 to the SL embryos in vivo on incubation days 10 and 12 (SL + D
      embryos) resulted in near-normal serum calcium on day 14 and improved calvarial
      calcification. However, TGF-beta expression in the SL + D calvaria was further
      increased compared to untreated SL calvaria, when analyzed at both the mRNA and
      protein levels. Histolocalization of gene expression by immunohistochemistry and
      in situ hybridization revealed that cells in the less mineralized orbital and
      temporal zones of the calvarium are particularly affected by the 1,25(OH)2D3
      treatment. Interestingly, the increased TGF-beta expression resulting from
      1,25(OH)2D3 treatment did not correct the aberrant collagen phenotype in the SL
      calvaria. These observations suggest that TGF-beta expression by bone cells in
      situ is stimulated by 1,25(OH)2D3, and that normal cellular differentiation and
      morphogenesis of the embryonic calvaria are dependent on proper and balanced TGF
      beta expression as well as the state of tissue mineralization.

PMID- 8472885
TI  - Pathology of 46,XY pure gonadal dysgenesis: absence of testis differentiation
      associated with mutations in the testis-determining factor.
AB  - Individuals with 46, XY pure gonadal dysgenesis present with a completely female
      phenotype. These individuals develop bilateral streak gonads and have normal
      Mullerian structures. The apparent absence of testicular tissue in these
      individuals suggests a mutation in the initial steps of the male sex-determining
      pathway. A candidate gene for the primary signal in this pathway was recently
      cloned (SRY) which encodes a protein with a DNA-binding capacity. In a study of
      14 XY females with pure gonadal dysgenesis harbouring SRY, we analysed the
      histology of the gonads and compared it to the presence or absence of mutations
      in the SRY open reading frame (SRY-orf). The histological analysis revealed two
      distinct groups of streak gonads. In the first group, the gonad was composed of
      exclusively ovarian-like stroma, with sclero-hyaline nodules in some areas. No
      tubules were observed. The gonads in the second group were composed of
      undifferentiated stroma harbouring either tubules or a rete structure. This
      suggests that in the latter group some differentiation (towards testis formation)
      has occurred, whereas in the first group ovarian differentiation has been
      interrupted. Individuals with mutations in the SRY-orf were found to have streak
      gonads of the first group, whereas most of the remaining XY females without
      detectable mutation in the SRY-orf had streak gonads belonging to the second
      group. On the basis of histology, it may be possible to distinguish between
      mutations in the sex-determining or sex-differentiation pathways. We suggest that
      SRY may play a role in rete testis formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472886
TI  - Endogenous activation of c-myc expression and DNA synthesis in serum-starved
      neonatal rat smooth muscle cells.
AB  - Earlier studies have shown that smooth muscle cells (SMC) from arteries of
      neonatal and adult rats differ markedly in their in vitro growth characteristics.
      Since some of these differences may be relevant to the proliferation of SMC in
      atherosclerotic plaques we examined the expression of three proto-oncogenes (c
      fos, c-jun, and c-myc) and an SMC-specific differentiation marker (alpha-actin)
      in cultured SMC. In presence of serum cultured adult SMC contained lower levels
      of alpha-actin mRNA than neonatal cells. In neonatal cells serum-starvation
      resulted in a distinct increase in both c-myc and alpha-actin mRNA levels,
      whereas the expression of these genes appeared to be unaffected in adult cells.
      Transfer of adult SMC proliferating in the presence of fetal calf serum to serum
      free medium for 48 h almost completely inhibited DNA synthesis, whereas transfer
      of neonatal SMC to serum-free medium reduced DNA synthesis only to about 50%.
      Serum-starved adult and neonatal SMC did not contain c-fos or c-jun transcripts,
      but in both cell types serum-stimulation resulted in a comparable increase in the
      expression of both genes. The present results demonstrate clear differences in
      the mechanisms regulating gene expression in adult and neonatal SMC.

PMID- 8472888
TI  - Nutrients and the human genome: new frontiers for the next century.

PMID- 8472887
TI  - Murine erythroleukemia cells contain two distinct GATA-binding proteins that have
      different patterns of expression during cellular differentiation.
AB  - GATA-1 is a major transcription factor of the erythroid lineage that has been
      implicated in the induced expression of a variety of red cell-specific genes
      during terminal differentiation of murine erythroleukemia cells. Although the
      GATA-1 protein is present at nearly equal levels before and after differentiation
      of murine erythroleukemia cells, in this study it was found that in the early
      commitment stages of the differentiation program there is a transient decrease in
      the GATA-1 mRNA and DNA binding activity levels due to a temporary block in
      transcription of the gene. Moreover, using a whole cell extraction procedure it
      was discovered that murine erythroleukemia cells contain a second GATA binding
      activity (denoted GATA-rel) which appears to be distinct from the GATA-1 factor
      based on its non-reactivity to two GATA-1 antisera. This protein has a limited
      tissue specificity, as it could not be detected in extracts from CHO, NIH 3T3, or
      COS cells. Similarly to the GATA-1 DNA-binding activity, the GATA-rel activity
      decreased during the early stages of differentiation. However, unlike GATA-1,
      GATA-rel activity did not return to pre-induced levels at later times. These
      results suggest that changes in gene expression during erythroid terminal
      differentiation may involve an interplay on levels of different GATA-binding
      factors.

PMID- 8472889
TI  - Dr. Kinyoun's legacy: the international dimensions of the National Institutes of
      Health.

PMID- 8472890
TI  - Thromboregulation: multicellular modulation of platelet reactivity in hemostasis
      and thrombosis.
AB  - Blood platelets represent the first line of host defense when normal vessels are
      injured. Platelet adhesion to subendothelium, aggregation, and further platelet
      recruitment culminate in hemostatic plug formation, which is accompanied by the
      consolidating effect of fibrin deposition on and between platelets. The process
      is multicellular in that erythrocytes promote and neutrophils inhibit platelet
      plug formation. Endothelial cells in proximity possess three protective
      mechanisms (thrombo-regulators) for limiting the size of the hemostatic plug
      ADPase, eicosanoids, endothelium-dependent relaxing factor/NO. We propose that in
      advanced atherosclerotic blood vessels such as coronary arteries, an ulcer or
      fissure in the fibrous cap of the atheroma serves as an agonist that transforms
      the platelet into a major prothrombotic offender. Induction of excessive platelet
      activation overcomes the normal thromboregulatory mechanisms. Erythrocytes
      further activate platelets, even in the presence of aspirin, and neutrophil
      blockage of platelet reactivity is insufficient to prevent impending vascular
      occlusion. Appreciating that multiple cell types and metabolic pathways are
      involved in modulation of platelet reactivity in vascular occlusion is a
      relatively recent concept. Strategies designed to restore processes such as
      thromboregulation may serve to improve therapeusis in thrombosis, which at
      present is far from optimal.

PMID- 8472891
TI  - Endothelial cell gene expression in response to injury.
AB  - Endothelial cells respond to injury with acute alterations in mediator generation
      and surface molecule expression. Endothelial cells may respond, depending on the
      stimulus, by altering the expression of various genes whose products are central
      to endothelial cell matrix remodeling, coagulation, and fibrinolysis, as well as
      interactions with polymorphonuclear leukocytes, platelets, and lymphocytes and in
      angiogenesis. These responses comprise endothelial activation or differentiation.
      The molecular events involved in endothelial perception of injury and in
      regulation of gene expression by cytokines, reactive oxygen intermediates, and
      mechanical forces are discussed. In addition, because endothelial cells from
      different sites exhibit heterogeneity regarding their injury responses, where
      possible this heterogeneity in endothelial gene expression is highlighted.

PMID- 8472892
TI  - Glycoprotein biosynthesis in yeast.
AB  - Many proteins in the yeast Saccharomyces cerevisiae are modified by the
      attachment of N-linked saccharides to asparagine, of O-linked mannose glycans to
      serine or threonine, and of glycosylphosphoinositol membrane anchors. The
      biosynthetic events leading to these modifications are coupled to the secretory
      pathway. Early stages of N-linked glycosylation and the formation of
      glycosylphosphoinositol anchors have been conserved through evolution of
      eukaryotes. Studies of yeast offer a variety of genetic and molecular biological
      approaches, which have led to the isolation of different glycosylation mutants
      and of genes for enzymes involved in glycosylation. Yeast mutants are useful to
      identify biosynthetic intermediates, to establish whether a given enzyme is
      essential for viability, and to determine how cellular functions are affected
      when glycosylation is perturbed. Yeast glycosylation mutants and genes can be
      used to identify their counterparts in other eukaryotes.

PMID- 8472893
TI  - Choline phospholipids: signal transduction and carcinogenesis.
AB  - Phospholipids act as vital elements in transmembrane signaling. Agonist-induced
      hydrolysis of phosphatidylinositides has been established as a major mechanism
      for transmitting messages into the interior of cells via protein phosphorylation
      cascades, ultimately regulating gene transcription. There is a growing body of
      evidence that choline phospholipids (phosphatidylcholine, sphingomyelin, and
      their metabolites) also are important mediators and modulators of transmembrane
      signaling. These functions may explain how choline phospholipids influence normal
      physiological processes as well as a diverse group of pathological processes.

PMID- 8472894
TI  - Aspects of life development at deep sea hydrothermal vents.
AB  - Hydrothermal vent organisms are living in an unexpected deep-sea environment,
      several thousand meters below the surface, where the earth's crustal plates are
      spreading apart. The vent fluids are usually hot (350 degrees C), anoxic, and
      contain high concentrations of hydrogen sulfide. This environment may be
      considered as extreme given the pressure, the high temperature, the chemical
      toxicity of the fluids, and the total lack of photosynthetic production for
      animal nutrition. The recent discovery of the unique fauna of the hydrothermal
      vent communities has brought an unexpected mode of animal nutrition in which
      chemoautotrophic bacterial symbionts are maintained within specialized cells of
      the host animal. The bacterial symbionts obtain energy by oxidizing reduced
      sulfur compounds from the environment. A portion of this fixed carbon is used by
      the eukaryotic host. The present review will focus on four of the main topics
      studied on the paradigmatic vent organism Riftia pachyptila, a giant gutless tube
      worm: 1) the chemoautotrophic symbiosis, 2) the toxicity of hydrogen sulfide, 3)
      the characteristics of the extracellular matrices of the worms, especially data
      obtained on collagens, and 4) the influence of temperature and pressure on worm
      biology.

PMID- 8472895
TI  - Proline-mediated enhancement of hepatocyte function in a collagen gel sandwich
      culture configuration.
AB  - Isolated rat primary hepatocytes were cultured between two layers of gelled
      collagen in a sandwich configuration that reinstates the cellular polarity
      necessary for long-term function in vitro. Maintenance of hepatocyte function, as
      measured by the secretion of albumin, was shown to be dependent on both the
      sandwich gel configuration and the continued presence of L-proline in the culture
      media. Cis-hydroxyproline, an analog of proline known to prevent the proper
      folding of triple helical collagen molecules, inhibited the response of
      sandwiched hepatocytes to proline in a dose-dependent and reversible manner. The
      addition of cis-hydroxyproline to cultures established for 7 days also resulted
      in the inhibition of hepatocyte function. These data support the hypothesis that
      continued collagen synthesis by hepatocytes is critical for hepatocyte function
      in the sandwich gel configuration.

PMID- 8472897
TI  - Brain metabolism, "ferrin," and non-carbohydrate oxidation.

PMID- 8472896
TI  - Astrocyte expression of mRNA encoding cytokines IP-10 and JE/MCP-1 in
      experimental autoimmune encephalomyelitis.
AB  - Mononuclear leukocytes preferentially accumulate in the central nervous system
      (CNS) during the course of experimental autoimmune encephalomyelitis (EAE). To
      address factors that govern leukocyte trafficking in EAE, we monitored expression
      of mRNAs encoding IP-10 and JE/MCP-1, which are members of a family of
      chemoattractant cytokines. A transient burst of IP-10 and JE/MCP-1 mRNA
      accumulation in the CNS occurred, in close relation to the onset of histologic
      and clinical disease. In situ hybridizations showed, unexpectedly, that
      astrocytes were the major source of mRNAs encoding IP-10 and JE/MCP-1. These
      observations implicate astrocyte-derived cytokines as potential chemoattractants
      for inflammatory cells during EAE.

PMID- 8472899
TI  - Decolorization of industrial effluents containing reactive dyes by actinomycetes.
AB  - Actinomycete strains have been identified which decolorize effluents containing
      different types of reactive dyes. Adsorption of anthraquinone, phthalocyanine and
      azo dyes to the cells of some of the strains resulted in the decolorization of
      the effluents, but no degradation of the dyes was observed. In contrast,
      effluents containing an azo-copper complex and a formazan-copper complex dye were
      almost completely decolorized by several of the strains without adsorption to the
      cells. The observed changes in the visible spectra indicated a degradation during
      incubation with the strains.

PMID- 8472898
TI  - A natural isolate of Pseudomonas maltophila which degrades aromatic sulfonic
      acids.
AB  - A natural isolate, designated BSA56, which was originally selected for growth
      with benzene sulfonic acid as sole carbon and energy source, was identified as a
      strain of Pseudomonas maltophila. Strain BSA56 grew on a wide range of aromatic
      sulfonic acids and was shown to release sulfite from benzene sulfonic acid and 2
      naphthalene sulfonic acid. Although it also grew on toluene sulfonic acid and
      pyridine sulfonic acid, no significant sulfite release was observed with these
      substrates. Release of sulfite from benzene sulfonic acid was greatly promoted by
      the presence of glycerol. The ability to release sulfite was induced by growth in
      the presence of benzene sulfonic acid and was repressed almost entirely by
      substrates allowing rapid growth such as acetate. Strain BSA56 grew better at 30
      degrees C than 37 degrees C on most aromatic substrates, but the reverse was true
      for most aromatic sulfonates. Several mutants of BSA56 were isolated with defects
      in benzoate, salicylate, or gentisate metabolism. However, all these mutants
      retained the ability to degrade the aromatic sulfonates.

PMID- 8472900
TI  - EnvC, a new lipoprotein of the cytoplasmic membrane of Escherichia coli.
AB  - A gene product with an apparent molecular mass of approximately 39,000 Da can be
      identified in the cytoplasmic membrane of Escherichia coli upon expression of
      cloned envC. In this communication we report that the product was labelled with
      [3H]glycerol and [3H]palmitic acid, and a precursor molecule of increased
      molecular mass was accumulated when cells were treated with globomycin, a
      specific inhibitor for the prolipoprotein signal peptidase. The same precursor
      molecule was encoded by an envC mutant gene, in which the cysteine residue in a
      pentapeptide sequence, Leu-Ile-Ala-Gly-Cys24 within the amino terminal region of
      EnvC, was replaced by tryptophane (Trp24). This protein was not labelled with
      [3H]glycerol. The results demonstrate that the envC gene product represents a new
      lipoprotein of the cytoplasmic membrane of E. coli.

PMID- 8472901
TI  - Analysis of common antigen of flagella in Bacillus cereus and Bacillus
      thuringiensis.
AB  - Flagellar antigen of Bacillus cereus H.1 was purified and tested for
      serodiagnostic antigen by ELISA. The antibody against the flagellar antigen of B.
      cereus H.1 reacted not only with the homologous specific antigen but also reacted
      with the flagellar antigens of 23 strains of B. cereus. This common flagellar
      antigen of B. cereus was found to be due to 61-kDa protein by SDS-PAGE and
      immunoblot assay. Monoclonal antibody H15A5 against common antigenic epitope of
      B. cereus also reacted with flagellar antigens of 21 strains of Bacillus
      thuringiensis by ELISA. This monoclonal antibody reacted with the 61-kDa protein
      of the flagella of B. cereus H.1 and H.2 and B. thuringiensis Kurstaki HD1,
      Alesti and Aizawai juroi by immunoblot analysis. These results indicated that the
      common antigenic epitope of the 61-kDa protein existed in the flagella both of B.
      cereus and B. thuringiensis.

PMID- 8472902
TI  - A NheI macrorestriction map of the Neisseria meningitidis B1940 genome.
AB  - A macrorestriction map of the Neisseria meningitidis strain B1940 genome was
      constructed by two-dimensional pulsed-field gel electrophoresis (2D-PFGE)
      techniques. Digestion of the genomic DNA with the restriction endonuclease NheI
      revealed 15 fragments between 10 kb and 450 kb. The sum of the fragments and
      resolution of the linearized chromosome yielded a total genome size of about 2.3
      Mbp. By overlapping methylation with the AluI-methylase six NheI recognition
      sites could be blocked. Fragments were ordered by partial/complete 2D-PFGE of
      genomic DNA with and without prior AluI methylation, respectively. All nine AluI
      methylase/NheI and 14 NheI restriction sites could be mapped on a single circular
      chromosome. This map will serve as a useful tool for further genetic analysis of
      meningococci and exemplifies the power of non-radioactive 2D-PFGE techniques to
      construct large physical genome maps with a single restriction enzyme.

PMID- 8472903
TI  - Mice are protected against Bordetella pertussis infection by intra-nasal
      immunization with filamentous haemagglutinin.
AB  - Intra-nasal immunization of mice with purified Bordetella pertussis filamentous
      haemagglutinin (FHA) or a crude cell sonicate was shown to protect against
      subsequent B. pertussis aerosol challenge. Immunization with FHA was found to be
      the most effective and resulted in complete clearance of the bacterial infection
      from the lungs within 14 days. Serum IgG and lung IgA anti-FHA antibodies were
      detectable within 4 weeks of the first immunization and anamnestic responses were
      seen following secondary immunization and subsequent challenge with B. pertussis.
      Nasal administration of pertussis antigens is a route which induces good systemic
      serum, as well as local secretory, antibody responses.

PMID- 8472904
TI  - Comparison of outer membrane protein profiles of Vibrio vulnificus biotypes 1 and
      2.
AB  - The outer membrane proteins of 17 Vibrio vulnificus biotype 2 strains from
      Japanese and European eels, and 12 biotype 1 strains from clinical and
      environmental sources have been compared. The overall profile in both biotypes
      was similar, and a major protein band of molecular mass 36 kDa was detected in
      the majority of the strains. Differences in the minor bands allowed
      differentiation of strains from different origins, suggesting that outer membrane
      protein profiles could be useful as epidemiological markers in the species V.
      vulnificus. Immunoblotting with antisera to whole cells of selected strains of
      biotypes 1 and 2 showed a strong antigenic response to outer membrane proteins
      66, 60, 48, 46 and 44 kDa; these were common to all strains examined, independent
      of their biotypes and origins. These results demonstrate the presence of
      antigenically related outer membrane proteins in both biotypes of V. vulnificus.

PMID- 8472905
TI  - Surface films of Escherichia coli colonies.
AB  - Escherichia coli colony surfaces were examined using SEM and TEM. The results
      indicated that bacterial colonies in the course of their development produce
      surface films which become thicker with increased growth duration. Membrane
      vesicles contribute to the formation of the surface film. The complex
      organization of the film suggests that it may perform specific functions.

PMID- 8472906
TI  - The fdp1 and cif1 mutations are caused by different single nucleotide changes in
      the yeast CIF1 gene.
AB  - The allelism between the mutations cif1 and fdp1 from Saccharomyces cerevisiae
      has been demonstrated using PCR techniques and complementation of function. The
      cif1 mutation results in a shortened version of the protein while the fdp1
      mutation introduces a charged residue in a highly hydrophobic stretch.

PMID- 8472907
TI  - Accumulation and intracellular compartmentation of lithium ions in Saccharomyces
      cerevisiae.
AB  - Accumulation of Li+ in Saccharomyces cerevisiae X2180-1B occurred via an apparent
      stoichiometric relationship of 1:1 (K+/Li+) when S. cerevisiae was incubated in
      the presence of 5 and 10 mM LiCl for 3 h. Other cellular cations (Mg2+, Ca2+ and
      Na+) did not vary on Li+ accumulation, although lithium chemistry dictates a
      degree of similarity to Group I and II metal cations. Compartmentation of Li+ was
      mainly in the vacuole which accounted for 85% of the Li+ accumulated after a 6-h
      incubation period. The remainder was located in the cytosol with negligible
      amounts being bound to cell fragments including the cell wall. Transmission
      electron microscopy of Li(+)-loaded cells revealed enlarged vacuoles compared
      with control cells. This asymmetric cellular distribution may therefore enhance
      tolerance of S. cerevisiae to Li+ and ensure that essential metabolic processes
      in the cytosol are not disrupted.

PMID- 8472908
TI  - Differential effects of anticytoskeletal compounds on the localization and
      chemical patterns of actin in germinating conidia of Neurospora crassa.
AB  - Anti-actin drugs, cytochalasins A and B, inhibited both normal single, and
      benomyl-induced multiple, germ tube outgrowth from conidia of Neurospora crassa.
      Actin was cytochemically found to be concentrated in each of the benomyl-induced
      germ tube tips. No significant quantitative changes either in total actin or its
      isoforms were measured in the inhibitor-treated germlings. While intact
      microtubules are required for normal, monopolar axiation of the germ tube, they
      appear not to be necessary for benomyl-induced multipolar outgrowth which, in
      contrast, still requires intact actin microfilaments. Microfilaments and
      microtubules thus play complementary roles in the normal germination of conidia.

PMID- 8472909
TI  - A truncated glucoamylase gene fusion for heterologous protein secretion from
      Aspergillus niger.
AB  - The secreted yield of hen egg-white lysozyme (HEWL) from the filamentous fungus
      Aspergillus niger was increased 10-20-fold by constructing a novel gene fusion.
      The cDNA sequence encoding mature HEWL was fused in frame to part of the native
      A. niger gene encoding glucoamylase (glaA), separated by a proteolytic cleavage
      site for in vivo processing. Using this construct, peak secreted HEWL yields of 1
      g/l were obtained in A. niger shake flask cultures compared to about 50 mg/l when
      using an expression cassette lacking any glaA coding sequence. The portion of
      glaA used in the gene fusion encoded the first 498 amino acids of glucoamylase
      (G498) and comprised its secretion signal, the catalytic domain and most of the O
      glycosylated linker region which, in the entire glucoamylase molecule, spatially
      separates and links the catalytic and starch-binding domains.

PMID- 8472910
TI  - Cloning and expression of the D-ribulose-1,5-bisphosphate carboxylase/oxygenase
      form II gene from Thiobacillus intermedius in Escherichia coli.
AB  - Both form I and II ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO)
      genes were detected in Thiobacillus intermedius by heterologous hybridization
      using specific probes from Anacystis nidulans and Rhodobacter sphaeroides,
      respectively. However, only the previously reported form I enzyme could be
      demonstrated in cells grown under a number of different conditions. The reason(s)
      why the form II gene is not expressed in T. intermedius is/are not clear at this
      time. The form II gene was isolated from a lambda library by screening with the
      Rb. sphaeroides probe. A SalI fragment from this clone was ligated into pUC8 and
      transformed into Escherichia coli DH5 alpha. Subclones pTi20IIA and pTi20IIB
      representing both orientations relative to the lac promoter were isolated. Low
      levels of RuBisCO activity were detected in both induced and non-induced pTi20IIA
      indicating the probable expression from a T. intermedius promoter. Induced
      pTi20IIB produced much higher levels of enzyme activity. Analysis of cell-free
      extracts using sucrose density gradients confirmed the expression of a form II
      RuBisCO similar in size to that found in Rhodobacter capsulatus. Other Calvin
      cycle genes were not clustered with either the form I or form II genes.

PMID- 8472911
TI  - Glucose-fructose oxidoreductase, a periplasmic enzyme of Zymomonas mobilis, is
      active in its precursor form.
AB  - Glucose-fructose oxidoreductase (GFOR) is a periplasmic enzyme of the
      ethanologenic, Gram-negative bacterium Zymomonas mobilis. It contains tightly
      bound NADP+ as cofactor. In Z. mobilis GFOR-recombinant strains, a precursor form
      of GFOR was accumulated. To assay the preGFOR for its NADP(H) content and
      enzymatic activity, it was purified from an overproducing strain. Using SDS-PAGE,
      the precursor subunit size was determined to approximately 45 kDa (compared with
      a 40 kDa subunit size for the mature GFOR subunit). The N-terminal amino acid
      sequence of the precursor was determined. The N-terminal residues of the GFOR
      matched with the signal sequence from the DNA sequence of the gene gfo. The
      precursor form of GFOR was enzymatically active and contained the cofactor
      NADP(H).

PMID- 8472912
TI  - Using fusions with luxAB from Vibrio harveyi MAV to quantify induction and
      catabolite repression of the xyl operon in Staphylococcus carnosus TM300.
AB  - The luxA,B genes from the Gram-negative marine bacterium Vibrio harveyi MAV were
      used in Staphylococcus carnosus TM300 as a reporter system for regulated
      expression of xylose utilization. The luciferase genes were fused to the xyl
      operon from Staphylococcus xylosus C2a. Expression of bioluminescence was induced
      through addition of xylose and repressed in the presence of glucose. A method to
      quantitate bioluminescence directly from the culture is described.

PMID- 8472913
TI  - Artificial neural network analysis of pyrolysis mass spectrometric data in the
      identification of Streptomyces strains.
AB  - Sixteen representatives of three morphologically distinct groups of
      streptomycetes were recovered from soil using selective isolation procedures.
      Duplicated batches of the test strains were examined by Curie-point pyrolysis
      mass spectrometry and the first data set used for conventional multivariate
      statistical analyses and as a training set for an artificial neural network. The
      second set of data was used for 'operational fingerprinting' and for testing the
      artificial neural network. All of the test strains were correctly identified
      using the artificial neural network whereas only fifteen of the sixteen strains
      were assigned to the correct group using the conventional operational
      fingerprinting procedure. Artificial neural network analysis of pyrolysis mass
      spectrometric data provides a rapid, cost-effective and reproducible way of
      identifying and typing large numbers of microorganisms.

PMID- 8472914
TI  - A stereospecific alignment between the promoter and the cis-acting sequence is
      required for Lrp-dependent activation of ilvIH transcription in Escherichia coli.
AB  - The leucine-responsive regulatory protein (Lrp) is a DNA binding protein that
      affects, either positively or negatively, the expression of several E. coli
      genes. The ilvIH operon is positively regulated by Lrp and leucine counteracts
      this effect reducing 5- to 10-fold the efficiency of ilvIH transcription. An
      investigation of the mechanism of transcription activation of the ilvIH operon by
      Lrp indicated that: (i) a stereospecific alignment between the ilvIH promoter and
      the cis-acting sequence upstream of it is required for activation; (ii) a correct
      distance between the promoter and the adjacent cis-acting sequence is needed for
      leucine to counteract the positive role of Lrp; (iii) Lrp fails to activate
      transcription when the cis-acting region is placed several hundred base pairs
      upstream of the ilvIH promoter.

PMID- 8472915
TI  - Oligomers of 4-chloroaniline are intermediates formed during its biodegradation
      by Phanerochaete chrysosporium.
AB  - Lignin peroxidase H2 (LP-H2) from Phanerochaete chrysosporium oxidized 4
      chloroaniline to form several oligomers. Included among the compounds identified
      were: 4,4'-dichloroazobenzene, 2-(4-chloroanilino)-5-hydroxybenzoquinone-di-4
      chloroanil and 2-amino-5-(4-chloroanilino) benzoquinone-di-4-chloroanil. In
      contrast to results by others, we showed that oligomers of 4-chloroaniline were
      also formed by the fungus in vivo. It was also demonstrated that, although these
      potentially toxic intermediates are made, they are also degraded.

PMID- 8472916
TI  - A monoclonal antibody to Shigella dysenteriae serotype 13 cross-reacting with
      Shiga toxin.
AB  - A monoclonal antibody (mAb ICT6) was produced against the newly described
      Shigella dysenteriae serotype type 13. The mAb was of IgM isotype and recognized
      purified Shiga toxin in ELISA and immunoblot. It also recognized periplasmic
      extract S. dysenteriae type 13 in immunoblot as did an affinity-purified
      polyclonal rabbit antiserum and a previously described monoclonal antibody to the
      B subunit of Shiga toxin. The mAb ICT6 did not neutralize the cytotoxic effects
      or S. dysenteriae type 13, Shiga toxin or periplasmic extracts of S. dysenteriae
      type 1 for HeLa cells.

PMID- 8472917
TI  - Phenylacetate-coenzyme A ligase is induced during growth on phenylacetic acid in
      different bacteria of several genera.
AB  - Nine different bacterial strains that utilise phenylacetic acid as the only
      carbon and energy source were isolated from samples of different geographical
      origin. The isolates were characterised taxonomically and physiologically.
      Evidence is presented that in all the isolates as well as in four previously
      isolated control strains with the ability to utilize phenylacetic acid, the
      enzyme phenylacetate-CoA ligase is specifically induced during growth on
      phenylacetic acid. The Michaelis constant (Km) in one Pseudomonas strain was
      sufficiently low (-1 mM) to suggest that the enzyme may have a role in
      phenylacetic acid metabolism.

PMID- 8472918
TI  - Escherichia coli K-12 ferrous iron uptake mutants are impaired in their ability
      to colonize the mouse intestine.
AB  - The streptomycin-treated mouse colonization model was used to investigate the
      role of the Fe2+ uptake system (Feo) of Escherichia coli K12 in the colonization
      of the mouse intestine. Mutants impaired in the uptake of Fe2+ ions were shown to
      be deficient also in their colonization ability. Both enterochelin-producing and
      enterochelin-nonproducing Escherichia coli feo mutants were unable to colonize
      the mouse intestine. These results demonstrated that Fe(II) is an essential
      source of iron for E. coli grown in the intestine.

PMID- 8472919
TI  - A PCR primer-specific to Cylindrocarpon heteronema for detection of the pathogen
      in apple wood.
AB  - An oligonucleotide primer (ChInt) was synthesised from the variable internally
      transcribed spacer (ITS) 1 region of ribosomal DNA (rDNA) of Cylindrocarpon
      heteronema. PCR with primers ChInt and ITS4 (from a conserved sequence of the
      rDNA) amplified a 470-bp fragment from several isolates of C. heteronema but not
      from various apple wood saprophytes. Amplification of this fragment was achieved
      from 1-2 pg of fungal DNA. These primers amplified a fragment of the same size
      from DNA extracted from cankered wood but only after impurities were removed from
      the DNA on a Qiagen tip-5 column. Southern hybridization analysis confirmed the
      470-bp fragment from C. heteronema DNA and cankered wood to be identical.

PMID- 8472920
TI  - Androgen binding proteins in Cochliobolus lunatus.
AB  - Testosterone and 4-androstene-3,17-dione (androstenedione) binding proteins were
      found in the cytosol of Cochliobolus lunatus, a filamentous fungus. The maximal
      androgen binding occurred by 120 min at 0 degrees C. Androgen binding proteins
      were degraded by protease treatment and at high temperature. The mean Kd
      determined for testosterone binding protein (TBP) by Scatchard analysis was 4.5
      nM and the maximum capacity Bmax was 120 fmol/mg protein; for androstenedione
      binding protein (ABP) the Kd was 8 nM and Bmax was 390 fmol/mg protein. Steroid
      binding specificity for TBP, in order of decreasing affinity, was the following:
      androstenedione, progesterone, dihydrotestosterone, 17 beta-estradiol and
      estrone. The same order was found for ABP.

PMID- 8472921
TI  - Acetoin production in Saccharomyces cerevisiae wine yeasts.
AB  - One hundred strains of Saccharomyces cerevisiae were examined for the capacity to
      produce acetoin in synthetic medium and in grape must. The low production of
      acetoin was found to be the more common pattern in this species. Most strains
      exhibited a similar distribution in both media, production ranging from non
      detectable amounts to 12 mg l-1. Only four strains produced high quantities of
      acetoin, up to 29.5 mg l-1 in synthetic medium and up to 194.6 mg l-1 in grape
      must. This biometric study showed the existence of two phenotypes, "low and high
      acetoin production", that could be selected for conferring a desirable flavour of
      the final product.

PMID- 8472922
TI  - Identification of sialic acids on the cell surface of hyphae and yeast forms of
      the human pathogen Paracoccidioides brasiliensis.
AB  - Paracoccidioides brasiliensis, the agent of paracoccidioidomycosis, when grown in
      a synthetic medium, expresses at the cell surface of both yeast and mycelial
      forms acidic glycoconjugates containing N-acetylneuraminic acid units. Sialic
      acids were extracted using mild hydrolytic conditions, and were identified by
      thin-layer and gas chromatography, standard colorimetry, reaction with periodate
      resorcinol and mass spectrometry. Their surface location was inferred from
      fluorescent-lectin (Limulus polyphemus agglutinin) binding to whole cells
      abrogated by previous treatment with neuraminidase. Expression of sialic acids on
      virulent yeast forms of P. brasiliensis (3.7 x 10(6) residues per cell) may
      inhibit fungal phagocytosis during early infection, when the immunological
      response is still being built up.

PMID- 8472923
TI  - Phosphate-starvation induced changes in Thiobacillus ferrooxidans.
AB  - We have analysed the response of the acidophilic chemolithotroph Thiobacillus
      ferrooxidans to phosphate starvation. Cultivation of the bacteria in the absence
      of added phosphate induced a remarkable filamentation of the cells.
      Polyacrylamide gel electrophoresis revealed several proteins whose levels
      increased upon phosphate limitation, as well as some polypeptides that were
      exclusively synthesized under this growth limitation. One of the proteins whose
      level increased by the lack of phosphate was apparently an acid phosphatase with
      a pH optimum of about 3.8, and a molecular mass of 26 kDa, which was located in
      the periplasm. The N-terminal sequence of a 26 kDa protein derepressed by
      starvation, which may correspond to the T. ferrooxidans starvation, which may
      correspond to the T. ferrooxidans phosphatase, showed 30% and 35% identity with
      the known sequence of Lysobacter enzymogenes and Escherichia coli alkaline
      phosphatases, respectively.

PMID- 8472924
TI  - Arginine utilization by Mycoplasma fermentans is not regulated by glucose
      metabolism: a 13C-NMR study.
AB  - 13C-NMR studies on the effect of glucose metabolism on arginine hydrolysis in
      Mycoplasma fermentans cells have been performed using a continuous perfusion
      technique. With this procedure we were able to show, in the presence of glucose,
      the rapid accumulation of lactic acid and, in the presence of arginine, the
      formation of citrulline that is apparently further metabolized. As the
      accumulation of lactate and the breakdown of arginine were observed in the
      simultaneous presence of both substrates, it is suggested that the glucose
      utilization has little or no effect on the deimination of arginine to citrulline.

PMID- 8472925
TI  - Hydrostatic pressure is like high temperature and oxidative stress in the damage
      it causes to yeast.
AB  - A comparison of barotolerance, thermotolerance and oxygen tolerance was made
      under different physiological conditions, such as heat shocked and recovered
      state, different growth phases and changes of physiological conditions by
      mutations. The three kinds of tolerance showed similar features under different
      physiological conditions. We suggest that the damage caused by hydrostatic
      pressure may be essentially the same as that due to high temperature and
      oxidative stress in yeast.

PMID- 8472926
TI  - Glucose and zinc concentration influence fusarin C synthesis, ethanol synthesis
      and lipid composition in Fusarium moniliforme submerged cultures.
AB  - A fusarin C-producing Fusarium moniliforme strain was grown in submerged culture
      with defined media containing differing amounts of glucose (30 g/l or 90 g/l) and
      zinc (5 ppb or 3200 ppb). The influence of zinc on fusarin C synthesis and lipid
      composition was dependent on the initial glucose concentration. In cultures
      supplied with 30 g/l glucose, zinc inhibited fusarin C and lipid synthesis by
      diverting common substrates to ethanol synthesis. Zinc-supplemented cultures with
      90 g/l glucose had ample carbon substrate to produce both ethanol and fusarin C.
      More total lipid with a higher unsaturated fatty acid content (more oleic acid
      and less stearic acid) was found in F. moniliforme biomass produced in zinc
      deficient media.

PMID- 8472927
TI  - Carnitine acetyltransferase is absent from acuJ mutants of Aspergillus nidulans.
AB  - The acuJ mutant of Aspergillus nidulans has been shown to lack carnitine
      acetyltransferase (CAT) activity when grown under conditions where this activity
      is readily detectable in wild-type strains. Revertants selected for growth on
      acetate recover CAT activity and the ability to grow on long-chain fatty acids.
      When growing on carbon sources such as sucrose, cytosolic acetyl coenzyme A was
      generated by adenosine triphosphate (ATP):citrate lyase.

PMID- 8472928
TI  - Purification and characterization of three carboxylesterases from
      Enterobacteriaceae.
AB  - The carboxylesterases from Proteus vulgaris, Salmonella enterica and Citrobacter
      amalonaticus were purified 104-, 95- and 120-fold, respectively by
      chromatography. The enzymes had similar catalytic activities but differed
      considerably in their inactivation by heat, di-isopropyl fluorophosphate and
      Cd2+, Zn2+, Hg2+ and Cu2+. Quantitative neutralization of hydrolytic activity
      with specific immunoglobulins indicated that the three enzymes were antigenically
      distinct.

PMID- 8472929
TI  - Lytic action of cloned pneumococcal phage lysis genes in Streptococcus
      pneumoniae.
AB  - The genes hbl3, cpl1 and cpl7 coding for the pneumococcal phage lytic enzymes
      HBL3, CPL1 and CPL7, respectively, have been cloned into shuttle plasmids that
      can replicate in Streptococcus pneumoniae and Escherichia coli. All these genes
      were expressed in E. coli under the control of either the lytP promoter of the
      lytA gene, which codes for the major pneumococcal autolysin, or the promoter of
      the tetracycline-resistance gene (tetP). In contrast, cpl1 and cpl7 genes that
      code for lysozymes were expressed in pneumococcus only under the control of tetP,
      whereas the hbl3 gene that codes for an amidase can be expressed using either
      promoter. The phage lysozymes or amidase expressed in S. pneumoniae M31, a mutant
      deleted in the lytA gene coding for short chains, were placed under physiological
      control since these transformed bacteria grew as normal 'diplo' cells during the
      exponential phase and underwent autolysis only after long incubation at 37
      degrees C. The lysis genes appear to be expressed constitutively in the
      transformed pneumococci, since sharply defined lysis of these cultures could be
      induced prematurely during the exponential phase of growth by addition of sodium
      deoxycholate.

PMID- 8472930
TI  - Genetic epidemiology of autosomal recessive spastic ataxia of Charlevoix-Saguenay
      in northeastern Quebec.
AB  - Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a disorder
      that has an elevated frequency in Saguenay-Lac-St-Jean (SLSJ) and Charlevoix, two
      geographically isolated regions in the past of northeastern Quebec. The incidence
      at birth and the carrier rate in SLSJ were estimated at 1/1,932 liveborn infants
      and 1/22 inhabitants, respectively, for the period 1941-1985. The mean inbreeding
      coefficient was twice higher and the mean kinship coefficient 3 times higher
      among the ARSACS families than among control families. In the SLSJ region, the
      birth places of the ARSACS individuals and their parents did not show a clustered
      distribution. The genealogical reconstruction suggests that the high incidence of
      ARSACS in SLSJ and Charlevoix is likely to be the result of a founder effect.
      Because the disease is apparently unknown elsewhere in the world and a high
      proportion of French Canadians presently living in eastern Quebec have ancestors
      coming from Perche, a small region in France, it also suggests that a unique
      mutation accounts for most, if not all, of the ARSACS cases known in these
      regions.

PMID- 8472931
TI  - Apo E allele frequencies in younger (age 42-50) vs older (age 65-90) women.
AB  - Allelic variation at the apolipoprotein E (Apo E) structural locus has been shown
      to influence concentrations of total cholesterol and low density lipoprotein
      cholesterol (LDL-C). Apo E has six phenotypes resulting from three common alleles
      at this locus. The epsilon 2 allele is associated with lower LDL-C and the
      epsilon 4 allele with higher LDL-C. In the current study, we compared the epsilon
      allele distribution in two cohorts of white women recruited from population based
      listing of southwestern Pennsylvania. The "younger" cohort consisted of 473
      women, age 42-50; the "older" cohort, 870 women, age 65-90. A comparison of the
      overall distribution of allele frequencies in the two cohorts was significantly
      different. The allele frequency of epsilon 4 was lower in the older cohort (0.098
      vs. 0.122, P = 0.08) and the epsilon 2 allele frequency was higher (0.084 vs.
      0.059, P = 0.05) in the older cohort. These observations are consistent with the
      hypothesis that there may be a selection against individuals with the epsilon 4
      allele. However, future research is needed to confirm this observation and to
      compare survival in individuals by their epsilon allele.

PMID- 8472932
TI  - A form of sensorineural deafness is determined by a mitochondrial and an
      autosomal locus: evidence from pedigree segregation analysis.
AB  - We have previously reported a large Israeli-Arab pedigree with sensorineural
      deafness possibly determined simultaneously by two loci--one mitochondrial, and
      one autosomal recessive. This was analyzed by extending classic segregation
      analysis methods to the many nuclear families derived from the maternal line
      pedigree. Here we expand this pedigree and extend our analysis by using the
      regressive models for segregation analysis on the entire pedigree. The
      corresponding REGD computer program was utilized and the marrying-in males' and
      paternal line members' affection statuses were assigned as unknown to accommodate
      the exclusive maternal transmission pattern. For the autosomal locus, a simple
      autosomal recessive (q = 0.52) model with a nearly complete penetrance (0.93) was
      found to be the best-fitting model. Equally importantly, we were also able to use
      the power of the regressive models to test the hypothesis of mitochondrial
      heteroplasmy as an alternative for the proposed autosomal locus. We found no
      evidence for the heteroplasmy hypothesis as an explanation for the incomplete
      maternal transmission of deafness in this pedigree. Thus, even if the
      mitochondrial mutation occurred in a heteroplasmic distribution in the family
      members, this could not explain the familial aggregation in this pedigree, and an
      autosomal recessive locus is still required. These results provide further
      support for the concept that the sensorineural deafness occurring in this large
      Israeli-Arab pedigree results from simultaneous involvement of two genes at two
      different loci, one mitochondrial and likely homoplasmic, and the other autosomal
      and recessive.

PMID- 8472933
TI  - Cigarette smoking and trisomy 21 at amniocentesis.
AB  - Several studies raise the possibility that smoking during pregnancy is associated
      with a slightly decreased odds of trisomy 21 at birth. If it is, associations may
      reflect decreased incidence at conception, increased intrauterine loss (at one or
      several times in gestation), or both. Women (n = 13,729) undergoing prenatal
      diagnosis completed a questionnaire before learning karyotype results. For each
      women with a trisomy, up to 4 controls with chromosomally normal pregnancies,
      matched for age and hospital, were selected. Analyses drew on the 89 trisomy 21
      control matched m-tuples in which diagnosis was by amniocentesis at 14-26 weeks.
      We compared the odds of smoking at last menstrual period and in the past in cases
      and controls. The odds of current smoking versus never smoking were decreased
      [adjusted odds ratio = 0.8, 95% confidence interval (CI) 0.4-1.6] and the odds of
      exsmoking increased (adjusted odds ratio = 1.4, 95% CI 0.9-2.4) in trisomy 21
      cases. The association with current smoking was essentially unchanged when the
      unexposed reference group was defined as exsmokers and women who never smoked
      (adjusted odds ratio = 0.7, 95% CI 0.4-1.4). These results for current smoking
      agree well with a summary estimate based on combined studies of births. One
      interpretation is that at amniocentesis, as has been reported for births, current
      smoking is associated with a slightly decreased odds of trisomy 21. If
      associations at amniocentesis and birth are of equal magnitude, the explanation
      that observations at birth reflect increased loss in the second half of pregnancy
      with current smoking is unlikely to be correct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8472934
TI  - Estimating age at onset distributions: the bias from prevalent cases and its
      impact on risk estimation.
AB  - Since many disorders have a variable age at onset, knowing the age at onset
      distribution of a disease facilitates epidemiologic analyses in several ways. The
      age at onset distribution is commonly used to estimate morbidity risks or the
      recurrence risks in genetic counseling. Unfortunately, estimation of a disease's
      age at onset distribution is not straightforward. The observed age at onset
      distribution obtained from prevalent cases is usually used in these epidemiologic
      analyses. Through simulation studies, we show that, in certain situations, the
      observed age at onset distribution has a non-negligible downward bias. This bias
      can lead to a substantial underestimation of the morbidity risk or the recurrence
      risk. The simulations also demonstrate that a non-parametric approach for
      correcting the age at onset distribution works well even when mortality increases
      after onset. The results have implications for diseases that have adult onset
      and/or increased mortality after onset. We suggest that researchers should use
      corrected age at onset distributions, rather than relying on observed
      distributions, in the calculation of either morbidity risks or recurrence risks.

PMID- 8472935
TI  - A generalized estimating equations approach to fitting major gene models in
      segregation analysis of continuous phenotypes.
AB  - This paper discusses the application of estimating equations methods based on a
      quadratic exponential model [Prentice and Zhao, 1991] as a potential competitor
      with full likelihood approaches to estimating the effect of major genes in a
      segregation analysis [Elston, 1981] of continuous phenotypes, in the single
      allele problem. We show that while the estimating equations methods based on the
      quadratic exponential family cannot be used by themselves to estimate all
      parameters of interest, an iterative two-stage approach can be used, in which the
      population allele frequency is first considered to be a known parameter, which
      permits the estimating equations method to estimate the remaining parameters. At
      the second stage a "pseudo-profile" loglikelihood based only on the founders is
      used to estimate the allele frequency. After each maximization of the pseudo
      profile loglikelihood at the second stage, the parameters in the first stage are
      reestimated using a new value of the allele frequency, and a new value of the
      second stage pseudo-profile loglikelihood is obtained. We used simulated pedigree
      data for illustrations.

PMID- 8472936
TI  - Distribution of the admixture test for the detection of linkage under
      heterogeneity.
AB  - The admixture test for the detection of linkage under heterogeneity is
      considered. We show that the null distribution of this test statistic has half
      its weight concentrated on zero and the other half on a complicated distribution
      that can be approximated by max (X1,X2) where X1 and X2 are independent X1(2)
      variables. We also investigate the stability of the size of the test for small
      samples. The power of this test to detect linkage, when heterogeneity is present,
      can be substantially greater than the standard test that assumes homogeneity.
      Even when heterogeneity is not present, the test is only slightly less powerful
      than the homogeneous test. This would suggest the use of the admixture test in
      preference to the homogeneous test if the presence of heterogeneity is at all
      suspected.

PMID- 8472937
TI  - Neuro-ophthalmology and psychiatry.
AB  - Neuro-ophthalmology and psychiatry interact over several issues. The neuro
      ophthalmologist can confirm the suspicion of nonorganic visual dysfunction by
      demonstrating the functional integrity of the visual system and the
      nonphysiologic nature of the visual complaints. He or she may recognize evidence
      of organic dysfunction in the patient with a presumed psychiatric diagnosis. In
      some cases, the pathology may be related to the use of certain psychiatric
      medications. Specialized examination techniques within the realm of neuro
      ophthalmology may provide subtle information about the functional integrity of
      the central nervous system in patients with psychiatric disease. Clinical and
      investigational collaboration between the neuro-ophthalmologist and the
      psychiatrist will provide the most appropriate patient management and may further
      our understanding of the biological basis of psychiatry.

PMID- 8472938
TI  - Etomidate anesthesia increases seizure duration during ECT. A retrospective
      study.
AB  - We reviewed charts of 28 consecutive depressed psychiatric inpatients who had
      received electroconvulsive therapy (ECT). As a preliminary investigation, we
      compared the effects of thiopental and etomidate anesthesia on seizure duration.
      Etomidate, a nonbarbiturate, has been shown to enhance seizure activity in other
      contexts. The mean age of our sample was 64 years. Because each patient received
      both etomidate and thiopental at various sessions during their course of ECT,
      each patient served as his or her own control. The mean proportion of etomidate
      sessions per patient was 54%. Mean seizure durations were significantly longer (p
      < 0.001) for the etomidate sessions as compared with the thiopental sessions. In
      contrast to some prior reports we found that the use of etomidate anesthesia in
      our sample of 28 consecutive inpatients enhanced seizure duration in ECT.
      Although controversial, some have advocated that longer seizure times will
      enhance effectiveness of ECT. We could not compare the anesthetic agents'
      clinical efficacy in relieving depression due to the retrospective nature of our
      study.

PMID- 8472939
TI  - Consultation-liaison psychiatry in Australia.
AB  - Consultation-liaison (C-L) psychiatry as a service entity has developed slowly
      and to a variable extent in Australia despite the presence of factors conducive
      to its development. These include a compulsory national health insurance system
      and a favorable disposition to the biopsychosocial model and to psychoanalytic
      ideas. C-L psychiatry, however, does enjoy a high profile in many undergraduate
      medical and postgraduate psychiatry teaching programs. Research on C-L psychiatry
      is emerging, complementing a strong history of research in psychosomatic
      medicine. An Australian and New Zealand C-L psychiatry interest group is being
      formed. Collaboration with the MICRO-CARES Consortium and the European
      Consultation-Liaison Workgroup is proving to be a great stimulus.

PMID- 8472940
TI  - Psychiatric morbidity in a pregnant population in Nigeria.
AB  - Psychiatric morbidity among 240 pregnant women attending an antenatal unit was
      assessed by a two-stage screening procedure, using the General Health
      Questionnaire (GHQ-30) and Present State Examination Schedule (PSE). The
      prevalence of psychiatric morbidity was found to be significantly associated with
      younger age (< 24 years), being primigravid, married for less than 1 year, having
      an unsupportive husband, and a previous history of induced abortion. It is
      suggested that more attention needs to be paid to the mental health of pregnant
      women in developing countries (where pregnancy rates and the risks associated
      with pregnancy/delivery are much higher than in the developed countries) at the
      primary, secondary, and tertiary levels of health care.

PMID- 8472941
TI  - Rapidly cycling bipolar II disorder following liver transplantation.
AB  - During the last decade the psychiatric aspects of liver transplantation have been
      widely described. Although affective complications are some of the most
      prevalent, a complete and persistent bipolar II syndrome following
      transplantation has never been reported before. In this paper we describe a
      patient who developed a rapidly cycling bipolar II disorder after liver
      transplantation. He presented a major depressive episode within the first 48
      hours following transplantation, and subsequently started cycling from depression
      to hypomania with only brief periods of euthymia. One year after transplantation,
      only lithium carbonate has proved to be useful to ameliorate his persistent
      disorder. There was no premorbid or family history of affective illness. Although
      the course of the disorder seemed to be independent from any pharmacologic or
      psychosocial factor, it is suggested that transplantation, corticosteroids, and
      cyclosporine may have played some role in the pathogenesis of the syndrome.

PMID- 8472942
TI  - Screening for depression and anxiety in cancer patients using the Hospital
      Anxiety and Depression Scale.
AB  - Nine hundred and thirty inpatients and outpatients with cancer were approached to
      complete the Hospital Anxiety and Depression Scale (HADS). Eight hundred and nine
      (86.9%) of those approached participated in this screening. Using the suggested
      cutoff score of 8 for the anxiety and depression subscales, we found that 47.6%
      of this population would warrant further psychiatric evaluation. Twenty-three
      percent (23.1%) had scores 11 or greater and would be the most likely to have had
      anxiety (17.7%) or depressive (9.9%) disorders based on DSM-III-R criteria.
      Patients with active malignant disease and inpatient status were more likely to
      have higher depression scores. The HADS was an easily administered tool that
      identified a large proportion of cancer patients as having high levels of anxiety
      or depression. However, clinical psychiatric interviews were not performed, so it
      is not possible to determine what proportion of patients would benefit from
      treatment.

PMID- 8472943
TI  - Suicide evaluation in medical patients. A pilot study.
AB  - General hospital psychiatrists were given a pilot questionnaire aimed at
      characterizing patients evaluated for suicidality. Twenty-seven patients
      evaluated for suicidality in a 4-month period were studied for demographic,
      medical, psychiatric, and suicidal variables. Comparison with medical patients
      who had attempted/completed suicide in prior studies and recommendations to
      reduce suicidal impulses and improve the database were discussed.

PMID- 8472944
TI  - Recent life events, gender, and the control of diabetes mellitus.
AB  - Sixty-six outpatients with insulin-dependent diabetes mellitus (IDDM) filled in a
      life event questionnaire reflecting positive and negative life events perceived
      to have occurred over the past year. The difference in glycosylated hemoglobin
      (HbA1C) measures obtained before and after the 1-year period in question (Delta
      HbA1C) served as a proxy measure of change in metabolic control. Among males,
      those reporting predominantly negative life events showed poorer metabolic
      control than those reporting few negative life events or none. Among females, the
      greater the number of events reported, especially positive ones, the greater the
      change for the better in HbA1C over the event year studied. These results suggest
      that life events may be significant to metabolic control in insulin-dependent
      diabetes. This only becomes apparent, however, when the two genders are analyzed
      separately, as various relationships found in one sex may be lacking or even
      opposite to the other sex. The findings also suggest the importance to the
      diabetic of learning of life events both the relative lack and preponderance of
      positive as well as negative events.

PMID- 8472945
TI  - White coat: to wear or not to wear?

PMID- 8472946
TI  - Wearing a white coat.

PMID- 8472947
TI  - Toga alba.

PMID- 8472948
TI  - An optical scan/statistical package for clinical data management in C-L
      psychiatry.
AB  - This paper explores aspects of the need for clinical database management systems
      that permit ongoing service management, measurement of the quality and
      appropriateness of care, databased administration of consultation liaison (C-L)
      services, teaching/educational observations, and research. It describes an
      OPTICAL SCAN databased management system that permits flexible form generation,
      desktop publishing, and linking of observations in multiple files. This enhanced
      MICRO-CARES software system--Medical Application Platform (MAP)--permits direct
      transfer of the data to ASCII and SAS format for mainframe manipulation of the
      clinical information. The director of a C-L service may now develop his or her
      own forms, incorporate structured instruments, or develop "branch chains" of
      essential data to add to the core data set without the effort and expense to
      reprint forms or consult with commercial vendors.

PMID- 8472949
TI  - Sequence analysis of the phage 21 genes for prohead assembly and head completion.
AB  - Phage 21 is a temperate lambdoid coliphage, and its head-encoding genes, as well
      as those of phage lambda, are descended from a common ancestral phage. The head
      protein-encoding genes of phage 21 have been sequenced, confirming earlier
      genetic studies indicating that the head-encoding genes of 21 and lambda are
      analogous in location, size, and function. The phage 21 head-encoding genes
      identified (and their lambda analogues) include: 3(W), 4(B), 5(C), 6(Nu3), shp
      (D), 7(E), and 8(FII), respectively. An open reading frame, orf1, is analogous in
      position and shares some sequence identity with FI, a phage lambda gene involved
      in DNA packaging. The phage 21 major head protein, gp7, is predicted to have
      strong sequence identity (65%) with the lambda major capsid protein, gpE,
      including amino acids known to be important for capsid form determination. The
      nested genes 5/6 of phage 21 and C/Nu3 of lambda differ by several rearrangements
      including deletions and a triplication. The possibility that lambda genes C/Nu3
      evolved from ancestal nested genes containing a triplication is discussed.

PMID- 8472950
TI  - Overproduction and single-step purification of GAL4 fusion proteins from
      Escherichia coli.
AB  - A DNA fragment encoding the yeast GAL4 transcriptional activator DNA-binding
      domain (amino acids 1-93) was cloned into an Escherichia coli expression vector
      such that the overproduced protein is tagged with six histidine residues and a
      factor Xa protease cleavage site. The vector also contains unique restriction
      sites at the 3' end of the gene to allow the construction of fusion proteins.
      These fusion proteins can easily be purified to homogeneity and their activity
      tested in vitro.

PMID- 8472951
TI  - Deletion mutations in the speED operon: spermidine is not essential for the
      growth of Escherichia coli.
AB  - Null mutants of Escherichia coli were constructed that cannot synthesize
      spermidine, because of deletions in the gene encoding S-adenosylmethionine
      decarboxylase. These mutants are still able to grow at near normal rates in
      purified media deficient in polyamines. These results in E. coli differ from
      recent findings that null mutants of Saccharomyces cerevisiae and of Neurospora
      crassa have an absolute growth requirement for spermidine.

PMID- 8472952
TI  - Cloning and sequencing of two new fli genes, the products of which are essential
      for Salmonella flagellar biosynthesis.
AB  - We have identified two new open reading frames downstream from fliC, which appear
      to encode 19- and 20-kDa proteins that are essential for flagellar formation. The
      nucleotide and the predicted amino acid sequences of the genes are presented.
      Both genes, termed fliU and fliV, are preceded by the flagellar-specific -10
      consensus promoter DNA sequence, suggesting their expression in the earlier
      stages of flagellar-component biosynthesis.

PMID- 8472953
TI  - Organization of the genes encoding p-aminobenzoic acid synthetase from
      Streptomyces lividans 1326.
AB  - Genes involved in the biosynthesis of p-aminobenzoic acid (PABA) in Streptomyces
      lividans 1326 were cloned in pBR322 by complementing a pabB mutant of Escherichia
      coli. A 2.7-kb BamHI-SstI fragment of the cloned DNA complemented pabA and pabB
      mutations in both E. coli and S. lividans; complementation in S. lividans was
      accompanied by integration of the recombinant plasmid into the host chromosome.
      The nucleotide (nt) sequence of the 2.7-kb fragment contained two open reading
      frames, the deduced amino acid sequences of which were similar to those of pabA
      and pabB products from other bacteria. The nt sequences indicated that pabA and
      pabB are closely linked in S. lividans and supported cloning evidence that the
      genes are expressed from a promoter with features resembling those of most E.
      coli promoters.

PMID- 8472954
TI  - The pab gene of Streptomyces griseus, encoding p-aminobenzoic acid synthase, is
      located between genes possibly involved in candicidin biosynthesis.
AB  - The nucleotide (nt) sequence of the gene (pab) encoding p-aminobenzoic acid
      (PABA) synthase, a key enzyme in the biosynthesis of candicidin by Streptomyces
      griseus IMRU3570, was determined and an open reading frame (ORF) of 2171 nt was
      found. The predicted amino acid sequence demonstrated extensive sequence identity
      with PABA synthases (Pab) from Gram-negative Enterobacteria. The protein encoded
      by ORF pab shows a clear relationship at the N terminus with PabA and at the C
      terminus with PabB from Escherichia coli, Serratia and Klebsiella. We also
      determined the extent of a spontaneous deletion that removed the ORF located
      upstream from pab near the 5' end of the cloned fragment. The deletion occurred
      when the gene was cloned in the BamHI site of pBR322 and allowed pab expression
      in E. coli.

PMID- 8472955
TI  - A cloned replicon of Saccharopolyspora phages JHJ-1 and JHJ-3 is stably
      maintained as a plasmid in various actinomycetes.
AB  - A replicon of phage JHJ-1 (and JHJ-3) was cloned. The autonomously replicating
      phage element was maintained as a medium-copy-number shuttle plasmid in many
      actinomycetes, and was efficiently transmitted to spores without antibiotic
      selection. One gene was shown to be expressed in a vector containing the JHJ-3
      replicon.

PMID- 8472956
TI  - The lumazine protein-encoding gene in Photobacterium leiognathi is linked to the
      lux operon.
AB  - The nucleotide (nt) sequence of the lumP (EMBL accession No. X65612) gene of
      Photobacterium leiognathi PL741 was determined and the amino acid (aa) sequence
      deduced. The encoded aa sequence of lumP was identified as that of the lumazine
      protein (LumP) by homology with that of Photobacterium phosphoreum (56%). This
      small protein has a calculated M(r) of 19,997 and comprises 186 aa residues.
      Biochemical studies suggested that LumP is the protein which, when combined with
      luciferase, is responsible for the bioluminescent spectrum shift from blue-green
      light (490-505 nm) to blue (470 nm) in P. leiognathi. The nt sequence of the
      flanking region showed that lumP is linked to the lux operon but runs in the
      opposite direction. The gene order of the lumP and lux operon is as follows: <-
      lumP-R&R-luxC-luxD-luxA-luxB-luxN-lu xE-->; the R&R regulatory region sequence
      included two promoter systems, PR for the lux operon and PL for the lumP or the
      lum operon.

PMID- 8472957
TI  - Sequence of the luxD gene encoding acyltransferase of the lux operon from
      Photobacterium leiognathi.
AB  - The nucleotide sequence of luxD (EMBL accession No. X65611), encoding
      acyltransferase (ACT), of the lux operon from Photobacterium leiognathi PL741 was
      determined, and the amino acid (aa) sequence was deduced. ACT is a component of
      the fatty acid reductase complex, which is responsible for converting fatty acid
      to aldehyde that serves as the substrate in the luciferase-catalyzed
      bioluminescent reactions. The protein has a calculated M(r) of 34,384 and
      comprises 305 aa residues. Alignment and comparison of the ACT of P. leiognathi
      with that of Vibrio fischeri ATCC7744, V. harveyi B392 and Xenorhabdus
      luminescens Hm shows that there is 66%, 59% and 61% aa identity, respectively.

PMID- 8472958
TI  - Sequence of a newly identified Mycobacterium tuberculosis gene encoding a protein
      with sequence homology to virulence-regulating proteins.
AB  - Analysis of the nucleotide sequence of a gene cloned from a Mycobacterium
      tuberculosis H37Rv genomic library predicted a 339-amino-acid protein with an
      M(r) of 37,656. The protein exhibited significant homology with the Cfad, FapR
      and Rns proteins from different enterotoxigenic strains of Escherichia coli, VirF
      protein of Shigella and VirFy protein of Yersinia, all of which regulate
      virulence-associated genes.

PMID- 8472959
TI  - A chromosomal expression vector for Escherichia coli based on the bacteriophage
      Mu.
AB  - A new Escherichia coli expression vector with increased stability was developed
      based on bacteriophage Mu. Unlike traditional expression vectors, the vector
      described herein is chromosome based rather than existing as an autonomously
      replicating plasmid. The chromosomal location resulted in extreme stability of
      the vector even in the absence of selective pressure. Both replication and
      heterologous protein synthesis could be induced by temperature shift. Expression
      of the heterologous gene was controlled by the Mu middle promoter and was
      dependent on the presence of the transactivator, Mor, of the Mu middle promoter.
      Four proteins, beta-galactosidase, chloramphenicol acetyltransferase, porcine
      somatotropin and human growth hormone, were made from this vector at levels
      ranging from 5 to 20% of total cell protein. Expression from the middle promoter
      was highest when inductions were done in rich media. The expression of some genes
      varied in different strains.

PMID- 8472960
TI  - A method for the site-directed mono- and multi-mutagenesis of double-stranded
      DNA.
AB  - A general solid-phase method for the site-directed mutagenesis of double-stranded
      DNA (dsDNA) is described. Plasmid DNA is linearized using either a restriction
      endonuclease (ENase) or the RecA-assisted ENase or RecA-AC cleavage method.
      Alternatively, PCR may be used to generate linear dsDNA. One or both strands of
      the DNA is biotinylated and attached to a solid support, and the DNA strands are
      separated using 0.2 M NaOH. An extension oligodeoxyribonucleotide (oligo) and a
      single or multiple oligo(s) containing the desired mutation(s) are annealed to
      one of the bound DNA strands and used to initiate the synthesis of a
      complementary strand by a nonstrand-displacing DNA polymerase. The in vitro
      synthesized strand incorporating the desired alteration(s) is melted off of the
      support and recircularized using one of several types of bridging oligos, DNA
      ligase, and a DNA polymerase and transformed into the host. Greater than 90%
      mutagenic efficiency has been obtained using this method.

PMID- 8472961
TI  - Genetic organization and sequence of the region encoding integrative functions
      from Lactobacillus gasseri temperate bacteriophage phi adh.
AB  - A 2.0-kb fragment from the Lactobacillus gasseri temperate bacteriophage phi adh
      contained the essential genetic determinants for site-specific integration. The
      nucleotide sequence of this fragment was determined. An open reading frame
      (intG), which adjoined the phage attachment site (attP), encoded a deduced
      protein related to the integrase family. The organization of this region was
      comparable to other phage site-specific recombination systems.

PMID- 8472962
TI  - Overproduction of Anabaena 7120 ribulose-bisphosphate carboxylase/oxygenase in
      Escherichia coli.
AB  - As a prerequisite to protein engineering, we have overexpressed the rbcLS operon
      of the cyanobacterium Anabaena 7120, in Escherichia coli. The operon encodes the
      large and small subunits of ribulose-bisphosphate carboxylase/oxygenase
      (Rubisco). Levels of active enzyme exceed 6% of soluble protein. We noted an
      apparent third gene, an unidentified open reading frame (URF) referred to here as
      rbcX, in the 558-bp intergenic space between the large and small subunit encoding
      genes. The URF, rbcX, has no known function. High-level production of Rubisco
      activity from the rbc operon in E. coli required simultaneous overproduction of
      the GroESL chaperonins under a regimen of limited growth, in contrast to more
      modest conditions which suffice for efficient production of the Anacystis
      nidulans cyanobacterial Rubisco. Deletion of rbcX or inversion of the rbcL-rbcS
      order did not enhance expression levels. The recombinant Rubisco, purified to
      near homogeneity, exhibited functional properties [Km(ribulose-P2), kcat,
      transition-state-analogue binding stoichiometry/exchange, and specificity factor]
      essentially identical to those of the enzyme obtained from Anabaena.

PMID- 8472963
TI  - Propagation of phage Mu in IHF-deficient Escherichia coli in the absence of the H
      NS histone-like protein.
AB  - Integration host factor (IHF) is known to be required for the expression of early
      genes and formation of the transpososome of mutator phage Mu. Prophage Mucts62
      was stably maintained at 30 degrees C and proliferated effectively after thermal
      induction at 42 degrees C in an Escherichia coli mutant defective in the histone
      like H-NS and IHF proteins. No IHF activity was detected in cells lacking H-NS
      and IHF; cells could not be transformed with plasmid pCL1920, which is based on
      the pSC101 replicon whose replication requires IHF. No difference in the
      superhelical densities of the reporter plasmid was detected in the H-NS, IHF null
      mutant and parental cells. From these results it is concluded that IHF is not
      essential for Mu development. These results also suggest that H-NS may function
      as a silencer for Pe operon expression and that IHF overcomes the inhibitory
      effect of H-NS.

PMID- 8472964
TI  - Overproduction, purification, and characterization of DNA-binding protein P19 of
      bacteriophage PRD1.
AB  - The early protein, P19, of bacteriophage PRD1 was purified after overexpression
      of the cloned gene, XIX, in Escherichia coli DH5 alpha cells. The purified
      protein binds as multimers to single-stranded DNA (ssDNA), and with a lower
      affinity to double-stranded DNA (dsDNA), without sequence-specificity. Two
      distinct P19-ssDNA complexes were discovered in gel- mobility-shift assays at
      different protein:DNA ratios. P19 was capable of fully protecting ssDNA against
      nuclease P1. Electron microscopy of protein P19-ssDNA complexes showed DNA
      molecules which were extensively coated with protein and whose contour length was
      clearly reduced by P19 binding. The results suggest that P19 binds to ssDNA with
      moderate cooperativity and are consistent with the DNA being wrapped around the
      P19 multimers.

PMID- 8472965
TI  - Synthetic biomaterials in facial plastic and reconstructive surgery.

PMID- 8472966
TI  - Recent advances and trends in the management of maxillofacial and frontal trauma.

PMID- 8472967
TI  - Bone inductive biomaterials in facial plastic and reconstructive surgery.

PMID- 8472968
TI  - Advances in surgical hair restoration.

PMID- 8472969
TI  - Surgical tissue adhesives in facial plastic and reconstructive surgery.

PMID- 8472970
TI  - Current concepts in cutaneous laser surgery.

PMID- 8472971
TI  - Facial nerve regeneration, growth factors, and return of the mimetic, symmetrical
      smile.

PMID- 8472972
TI  - Presurgical orthopedic treatment for cleft lip and palate.

PMID- 8472973
TI  - Molecular biology of colorectal neoplasia.

PMID- 8472974
TI  - Helicobacter pylori: 10th anniversary of its culture in April 1982.

PMID- 8472975
TI  - Mechanisms underlying the antireflux action of fundoplication.
AB  - The effect of fundoplication on patterns of gastro-oesophageal reflux and the
      underlying motor mechanisms were investigated in 18 patients with symptomatic
      reflux. Oesophageal motility and pH were recorded concurrently after a standard
      meal. Studies were performed preoperatively and from 5 to 27 months after
      surgery. Fundoplication virtually eliminated reflux in all but three patients.
      Control of reflux was associated with a 50% fall in the number of transient lower
      oesophageal sphincter relaxations, a fall in the proportion of transient lower
      oesophageal sphincter relaxations accompanied by reflux from 47% to 17%, and an
      increase in the mean residual pressure at the gastro-oesophageal junction during
      swallow induced lower oesophageal sphincter relaxation from 0.7 mm Hg to 6.0 mm
      Hg. Basal pressure at the gastro-oesophageal junction rose from 10.9 mm Hg to
      14.5 mm Hg, however, there was no correlation between postoperative reflux and
      basal gastro-oesophageal junction pressure. These findings suggest that the anti
      reflux effects of fundoplication result from changes in the mechanical behaviour
      of the gastro-oesophageal junction that result in incomplete abolition of the
      high pressure zone during lower oesophageal sphincter relaxation, and reduced
      triggering of transient lower oesophageal sphincter relaxations.

PMID- 8472976
TI  - Determinants of oesophageal 'alkaline' pH environment in controls and patients
      with gastro-oesophageal reflux disease.
AB  - The determinants of the oesophageal alkaline pH environment are poorly
      understood. Saliva (pH 6.4-7.8) may be a major contributor, although some argue
      the importance of refluxed alkaline duodenal contents. Acid and alkaline reflux
      parameters were studied over 2 days in 30 subjects (control, oesophagitis and
      Barrett's patients; 10 each) using glass pH electrodes. In phase 1, one pH
      electrode was placed 1 cm below the upper oesophageal sphincter to assess the
      influence of saliva and the other 5 cm above the lower oesophageal sphincter.
      Phase 2 was identical except that one pH probe was 5 cm below the lower
      oesophageal sphincter to record duodenogastric reflux. Patient groups spent, on
      average, 50 fold more time during the upright and supine periods at acidic pH
      than controls. Saliva was responsible for the percentage of time the pH > 7 and
      contributed significantly to the percentage of time the pH > 6 in both the
      proximal and distal oesophagus of control subjects, as shown by an absence of pH
      > 7 and a significant (p < 0.001) fourfold decrease in pH > 6 during sleep. A
      similar pattern was seen in the proximal oesophagus of both reflux groups. The
      reflux and Barrett's patients, however did not show a significant decrease in the
      percentage of time the pH > 6 at night in the distal oesophagus suggesting a
      relative increase in 'alkaline' exposure from another source. This was not
      because of duodenogastric reflux as the corresponding pH rises in the fundus of
      the stomach were non-existent. Although this was not studied specifically, it is
      believed to be a protective meachanism, the result of alkaline secretion produced
      by submucosal oesophageal glands.

PMID- 8472977
TI  - Oesophageal motor response to reflux is not impaired in reflux oesophagitis.
AB  - Whether the oesophageal motor response to reflux, as recorded over 24 hours, is
      impaired in patients with reflux oesophagitis was investigated. Twenty three
      patients with oesophagitis (Savary-Miller grades I-IV) and 23 control subjects
      matched for age and sex underwent 24 hour ambulatory pH and pressure monitoring.
      All contractions occurring in the 2 minute period after the onset of each reflux
      episode were analysed automatically using dedicated computer algorithms. A total
      of 2085 reflux episodes occurred--1513 in patients and 572 in controls.
      Oesophageal acid exposure was greater (p < 0.01) in patients than in controls
      (mean (SEM) % time pH < 4 13.3 (1.7) and 5.3 (0.9)%, respectively). The mean
      duration of the supine reflux episodes was longer (p < 0.01) in patients (11.2
      (2.8) minutes) than in controls (5.1 (1.8) minutes). In the upright period, no
      significant differences in the motor response to reflux were found. In the supine
      period, the patients showed a higher number of reflux induced contractions (4.40
      (0.61) v 1.62 (0.31), p < 0.01), a higher contraction amplitude (4.55 (0.42) v
      2.99 (0.71) kPa, p < 0.02) and longer contractions (1.86 (0.19) v 1.32 (0.29)
      seconds, p < 0.05). The percentages of peristaltic and simultaneous contractions
      that occurred in response to supine reflux did not differ between the two groups.
      In patients with reflux oesophagitis the motor response of the oesophagus to
      reflux is not impaired. During the supine period the response is even stronger
      than in healthy controls.

PMID- 8472978
TI  - Cholecystokinin in the control of gastric acid secretion in man.
AB  - This study was designed to determine the role of cholecystokinin in the control
      gastric acid secretion in men using loxiglumide, a specific cholecystokinin
      receptor blocker. Three groups of healthy subjects (A, B, and C) were used; group
      A--for studies with postprandial gastric secretion, group B--for studies with
      exogenous gastric secretagogues and group C--for 12 hour intragastric pH-metry.
      Cephalic phase stimulated by modified sham feeding in group A subjects increased
      gastric acid secretion to about 50% of pentagastrin maximum and the treatment
      with loxiglumide in a standard dose (20 mumol/kg iv loading dose plus infusion of
      20 mumol/kg/h afterwards) failed to affect this secretion. Gastric acid response
      to a 5% peptone meal instilled intragastrically greatly enhanced gastric acid
      secretion and plasma gastrin concentration but the addition of loxiglumide in the
      standard dose resulted in further increase in both gastric acid and plasma
      gastrin responses to peptone meal. Infusion of caerulein in gradually increasing
      doses (15-120 pmol/kg/h) and gastrin releasing peptide (25-200 pmol/kg/h)
      resulted in a dose dependent stimulation of gastric acid secretion reaching about
      35% and 25% of maximum attained with pentagastrin. When loxiglumide was added in
      a standard dose, the acid responses to caerulein and gastrin releasing peptide
      were further increased two to three fold attaining the peak reaching,
      respectively, about 100% and 50% of pentagastrin maximum. In group C subjects, 12
      hour pH-metry revealed the usual increase in gastric pH after each meal in tests
      with placebo. Loxiglumide (1200 mg tablets tid, po) resulted in significantly
      lower pH after each meal and this was accompanied by significantly higher gastrin
      responses than in placebo tests. We conclude that cholecystokinin released by
      peptone meal, ordinary meals or gastrin releasing peptide exerts a potent
      inhibitory influence on gastric acid secretion and gastrin release in men and
      this inhibition involves subtype A cholecystokinin receptors.

PMID- 8472979
TI  - Role of eicosanoids, nitric oxide, and afferent neurons in antacid induced
      protection in the rat stomach.
AB  - The mechanism underlying the mucosal protective effect of antacids is still
      unclear. This study shows that in rats the aluminum containing antacid,
      hydrotalcit, induces dose dependent protection against gastric mucosal damage
      caused by ethanol or indomethacin which is considerably enhanced by
      acidification. Hydrotalcit did not increase gastric mucosal formation or the
      intraluminal release of prostaglandins, and did not prevent the increase in
      mucosal leukotriene C4 formation in response to ethanol. Pretreatment with
      indomethacin did not attenuate the protective effect of unmodified or acidified
      hydrotalcit. Furthermore, hydrotalcit significantly reduced the gastric damage
      caused by indomethacin even when it was administered up to 2 hours after the
      ulcerogen. In indomethacin treated rats, simultaneous administration of
      hydrotalcit did not affect the concentrations of indomethacin in serum or
      inflammatory exudates nor did it attenuate the inhibition of prostaglandin
      release into the exudates. In hydrotalcit treated rats there was no attenuation
      of the increase in sulphidopeptide leukotriene release or decrease in leukocyte
      influx into inflammatory exudates elicited by indomethacin administration.
      Functional ablation of afferent neurons and inhibition of endogenous nitric oxide
      partially antagonised the protective effect of unmodified, but not of acidified,
      hydrotalcit. It is concluded that (i) the protective effect of unmodified and
      acidified hydrotalcit is independent of the eicosanoid system; (ii) protection
      against indomethacin induced gastric lesions does not require treatment before
      dosing of the ulcerogen and does not interfere with absorption and anti
      inflammatory actions of indomethacin; (iii) endogenous nitric oxide and afferent
      neurons contribute partly to the effect of unmodified, but not of acidified,
      hydrotalcit suggesting that different mechanisms mediate their mucosal protective
      activity.

PMID- 8472980
TI  - Effect of ranitidine bismuth citrate on postprandial plasma gastrin and
      pepsinogens.
AB  - Ranitidine bismuth citrate was compared with an equipotent dose of ranitidine, to
      determine whether the former, by an anti-Helicobacter pylori activity, would
      counteract the rise of gastrin resulting from ranitidine's gastric acid
      antisecretory activity. Twenty four men with duodenal ulcers were studied before
      and on the 8th day of dosing with either ranitidine bismuth citrate 800 mg twice
      daily or ranitidine 300 mg twice daily (double blind, randomised, parallel
      groups). Fasting and postprandial plasma gastrin and plasma pepsinogen I and II
      concentrations were measured, and a 13C-urea breath test was performed before and
      on the 8th day of dosing. The 13C-urea breath tests were positive in 21 patients
      before dosing and remained positive in nine of nine of the ranitidine dosed
      patients, whereas only two of 12 patients treated with ranitidine bismuth citrate
      remained positive. The expected rise in meal stimulated plasma gastrin with
      ranitidine was seen in the 12 patients who received ranitidine but, despite
      suppression of H pylori urease activity in 10 of 12 patients taking ranitidine
      bismuth citrate, there was no attenuation of the meal stimulated gastrin rise.
      There was no significant difference in the mean derived (4 hour) plasma
      pepsinogen I and II concentrations after dosing with ranitidine or ranitidine
      bismuth citrate.

PMID- 8472981
TI  - Endoscopic injection therapy to prevent rebleeding from peptic ulcers with a
      protruding vessel: a controlled comparative trial.
AB  - Seventy five patients with severely bleeding peptic ulcer were included in a
      controlled comparative trial to assess the efficacy and safety of endoscopic
      injection therapy in preventing rebleeding from peptic ulcers that presented at
      endoscopy with a protruding vessel. Twenty five patients were treated with
      injection of epinephrine followed by polidocanol, 25 were treated with injection
      of absolute alcohol, and 25 with sham injection. Rebleeding occurred in 44% of
      patients in the sham group, 40% of those treated with epinephrine and
      polidocanol, and in 20% of those treated with absolute ethanol. The difference in
      the haemostasis rate between the control and ethanol treated subjects nearly
      reached significance (p = 0.07). A second therapy session resulted in haemostasis
      rates of 68% in the epinephrine-polidocanol group and of 88% in the absolute
      ethanol group. These rates after two treatments as well as the emergency surgery
      rates (32% in the epinephrine-polidocanol group and 8% in the absolute ethanol
      group; p = 0.07) were not significantly different. In eight of the 11 patients
      with rebleeding in the sham treatment group, definitive haemostasis was achieved
      by elective injection therapy. Overall transfusion requirements were mean (SD)
      6.0 (0.7) units in the sham group, 6.0 (0.9) in the epinephrine-polidocanol
      group, and 3.9 (0.5) in the absolute ethanol group. Only the difference between
      ethanol and sham was significant (p = 0.02). This study shows that injection with
      absolute ethanol reduces rebleeding in these patients and significantly lowers
      transfusion requirements. Absolute ethanol was superior to epinephrine
      polidocanol, which was not significantly better than sham therapy.

PMID- 8472982
TI  - Secretor status and Helicobacter pylori infection are independent risk factors
      for gastroduodenal disease.
AB  - The hypothesis that non-secretors of ABO blood group antigens, a group shown to
      be more susceptible to certain bacterial infections, may be at greater risk of
      gastroduodenal disease because of increased susceptibility to Helicobacter pylori
      infection was investigated. Of 101 patients with symptoms of dyspepsia who were
      undergoing endoscopy, 32% were non-secretors (determined from Lewis blood group
      phenotype), 36% had endoscopically visible gastroduodenal disease (antral
      gastritis, gastric ulcer, erosive duodenitis, duodenal ulcer or some
      combination), and 58% had H pylori detected in antral biopsy specimens. Non
      secretors and patients with H pylori infection were significantly more likely to
      have gastroduodenal disease (p = 0.02 and p = 0.002 respectively). There was,
      however, no significant association between secretor status and H pylori
      infection, logistic regression analysis confirming that these were independently
      associated with gastroduodenal disease. Overall, the relative risk of
      gastroduodenal disease for non-secretors compared with secretors was 1.9 (95%
      confidence intervals 1.2, 3.2). Non-secretion of ABO blood group antigens is not
      related to H pylori infection but is independently and significantly associated
      with endoscopic gastroduodenal disease. The mechanism of this remains to be
      explained.

PMID- 8472983
TI  - Intestinal permeability in patients with coeliac disease and relatives of
      patients with coeliac disease.
AB  - The functional integrity of the small bowel is impaired in coeliac disease.
      Intestinal permeability, as measured by the sugar absorption test probably
      reflects this phenomenon. In the sugar absorption test a solution of lactulose
      and mannitol was given to the fasting patient and the lactulose/mannitol ratio
      measured in urine collected over a period of five hours. The sugar absorption
      test was performed in nine patients with coeliac disease with an abnormal jejunum
      on histological examination, 10 relatives of patients with coeliac disease with
      aspecific symptoms but no villous atrophy, six patients with aspecific
      gastrointestinal symptoms but no villous atrophy, and 22 healthy controls to
      determine whether functional integrity is different in these groups. The
      lactulose/mannitol ratio (mean (SEM) is significantly higher in both coeliac
      disease (0.243 (0.034), p < 0.0001)) and relatives of patients with coeliac
      disease (0.158 (0.040), p < 0.005)) v both healthy controls (0.043 (0.006)) and
      patients with aspecific gastrointestinal symptoms (0.040 (0.011)). The
      lactulose/mannitol ratio in relatives of coeliac disease patients was
      significantly lower than in the coeliac disease patient group (p = 0.04). The
      lactulose/mannitol ratio was the same in healthy controls and patients with
      aspecific gastrointestinal symptoms. It is concluded that the sugar absorption
      test is a sensitive test that distinguishes between patients with coeliac disease
      and healthy controls. The explanation for the increased permeability in relatives
      of patients with coeliac disease is uncertain. Increased intestinal permeability
      may be related to constitutional factors in people susceptible to coeliac disease
      and may detect latent coeliac disease. The sugar absorption test may therefore be
      helpful in family studies of coeliac disease.

PMID- 8472984
TI  - Does the fatty acid profile of dietary fat influence its trophic effect on the
      small intestinal mucosa?
AB  - To compare the enterotrophic effects of different triglycerides, five groups of
      eight rats were fed mixed diets giving 50% of calories as oils rich in either
      essential fatty acids (EFA), alpha-linolenic acid, fully saturated fatty acids,
      oleic acid, or medium chain fatty acids. After 21-24 days there were no
      significant differences between the groups in overall small intestinal whole gut
      weight, mucosal weight, or mucosal DNA; overall mucosal protein showed slight
      variation (p < 0.05) that was compatible with differences in food intake between
      the groups. However, long chain triglycerides (LCT) and medium chain
      triglycerides (MCT) differed in their regional effects on cell proliferation; all
      four LCT rich diets increased mucosal mass and cell proliferation maximally in
      the mid small intestine, while MCT had their greatest effect proximally.
      Subsequently, two groups of eight rats were fed diets in which EFA or MCT were
      given as twice daily boluses (29% of dietary calories) for 20 to 23 days and
      compared with a third group of eight rats receiving a glucose rich, low fat diet.
      EFA and MCT boluses increased the overall parameters of small intestinal mucosal
      mass and for both oils the effects were now maximal in the mid small intestine.
      Thus different triglycerides have similar effects on overall small intestinal
      mucosal mass, but MCT differ from LCT in their regional effects on mucosal cell
      proliferation when they are given in mixed diets, although not when given as
      boluses.

PMID- 8472985
TI  - Effects of dietary calcium and phosphate on the intestinal interactions between
      calcium, phosphate, fatty acids, and bile acids.
AB  - Luminal free fatty acids and bile acids may damage the colonic epithelium and
      stimulate proliferation, which may increase the risk of colon cancer. It has been
      suggested that only soluble calcium ions (Ca2+) precipitate fatty acids and bile
      acids, thus reducing their lytic activity. Consequently, precipitation of luminal
      Ca2+ by dietary phosphate should inhibit these effects. To evaluate the proposed
      antagonistic effects of dietary calcium and phosphate, we studied the intestinal
      interactions between calcium, phosphate, fatty acids, and bile acids in rats fed
      purified diets that differed only in the concentrations of calcium and phosphate.
      Increased dietary calcium drastically decreased the solubility of fatty acids in
      the ileum, colon, and faeces, as well as the solubility of bile acids in the
      colon and faeces. Although dietary calcium strongly increased the total faecal
      fatty acid concentration and hardly affected the total faecal bile acid
      concentration, the fatty acid and bile acid concentrations in faecal water were
      drastically decreased by dietary calcium. Consequently, the lytic activity of
      faecal water was decreased. Dietary phosphate did not interfere with these
      intestinal effects of calcium. These results indicate that dietary phosphate does
      not inhibit the protective effects of dietary calcium on luminal solubility and
      the lytic activity of fatty and bile acids.

PMID- 8472986
TI  - Antibodies to Mycobacterium paratuberculosis and nine species of environmental
      mycobacteria in Crohn's disease and control subjects.
AB  - Cultural and serological studies have provided limited, often conflicting,
      evidence of a role for mycobacteria in the pathogenesis of Crohn's disease.
      Interest has focussed on Mycobacterium paratuberculosis, previously considered to
      be common in the environment with no major role as a human pathogen. Whether a
      specific serum antibody response to mycobacteria occurs in Crohn's disease or
      ulcerative colitis was investigated. Sera from patients with Crohn's disease (n =
      38), ulcerative colitis (n = 15), and a healthy control population (n = 30) were
      assayed in an enzyme linked immunosorbent assay (ELISA) using eight filtered
      sonicate mycobacterial preparations and a purified protein derivative made from
      the bovine tubercle bacillus. In addition, IgG, IgM, and IgA levels to M
      paratuberculosis were determined in sera from patients with active (n = 24) or
      inactive (n = 29) Crohn's disease and the control populations. There was strong
      evidence of contact with environmental mycobacteria in all patients and control
      populations, with the greatest responses to preparations of M avium, M
      tuberculosis, and M kansasii. A large proportion of patients with Crohn's disease
      had antibodies that bound most antigens tested but there were no statistical
      differences between these values and those of the control population. Similarly,
      there were no differences in antibody levels to M paratuberculosis in patient and
      control groups. Although a subset of patients with active Crohn's disease (25%)
      had IgG concentrations that exceeded the control mean by more than 2 SD, this
      phenomenon may not be specific to Crohn's disease: 20% of a small group of
      patients with coeliac disease had similarly raised IgG levels to M
      paratuberculosis. These findings do not provide serological evidence of a role
      for this organism in the pathogenesis of Crohn's disease.

PMID- 8472987
TI  - Early mucosal changes in Crohn's disease.
AB  - Aphthoid ulceration has been regarded as an early macroscopic feature of Crohn's
      disease, yet the cause of this mucosal lesion is unknown. Examination of areas of
      apparently normal and non-inflamed bowel in Crohn's disease has allowed the
      identification of mucosal changes which occur before macroscopic and microscopic
      ulceration. Thirty five resection specimens from patients with Crohn's disease
      were compared with 12 specimens from patients with ulcerative colitis and 13
      controls. Specimens were fixed either by immersion in formalin in the routine way
      or by perfusion fixation with formalin at mean arterial pressure. Immunostaining
      for macrophages, vessel wall, and blood constituents allowed identification of
      small mucosal capillaries which were not apparent otherwise. In Crohn's disease
      damage and rupture of these small capillaries occurred before infiltration of the
      lamina propria by inflammatory cells. Loss of the overlying epithelium seemed to
      follow this vascular damage.

PMID- 8472988
TI  - Diversion colitis and involution of the defunctioned anorectum.
AB  - To measure the effects of defunction in the anorectum, 12 patients (seven men and
      five women aged 59 (44-81) years) were studied after the Hartmann operation. The
      operation was for septic complications of diverticular disease in nine and
      sigmoid carcinoma in three patients. Physiology studies were undertaken 1 and 3
      months after surgery, and diversion colitis was assessed endoscopically and by
      mucosal biopsy at 3 months. There was no change in anal sphincter function by
      three months. Proctometrogram studies, however, showed an appreciable decrease in
      rectal volume in all cases, by a mean of 35% of the 1 month volume. The maximum
      tolerable volume at 1 month was 157 (111-210) ml and at 3 months 87 (71-145) ml;
      p < 0.01. There was no change in rectal sensation or compliance. Erythema and
      granularity without gross erosions or ulceration were found at endoscopy.
      Histology showed abnormalities in all cases by 3 months. The characteristic
      features were of a chronic inflammatory cell infiltrate with surface exudate,
      microscopic erosions, and lymphoid follicular hyperplasia. Crypt abscesses were
      not a feature at this stage and there was no distortion of crypt architecture.
      After defunction the previously normal rectum is affected by diversion colitis
      which, at 3 months, is mild but has characteristics that distinguish the changes
      from those of inflammatory bowel disease. It is associated with progressive
      rectal stump involution.

PMID- 8472989
TI  - High frequency of K-ras mutations in sporadic colorectal adenomas.
AB  - The frequency of activating mutations at codons 12 and 13 of the K-ras gene was
      investigated in 57 sporadic adenomas from 47 patients using the polymerase chain
      reaction and oligonucleotide hybridisation assay. Sixty eight per cent of the
      adenomas tested were positive for K-ras mutations. This high frequency, combined
      with the lack of a correlation between mutations and adenoma size, suggest that K
      ras mutations occur earlier in the adenoma-carcinoma sequence than has previously
      been suggested. The high frequency observed in sporadic adenomas contrasts with
      the reported low frequency (18%) in adenomas from patients with familial
      adenomatous polyposis (FAP), suggesting a possible difference in the molecular
      genesis of FAP and non-FAP adenomas. Finally, it was found that adenomas from
      patients with a personal history of colorectal cancer were more likely to contain
      a K-ras mutation than those from patients with no such history. This is a new
      finding and worthy of further study.

PMID- 8472990
TI  - Autonomic dysfunction in gastrointestinal motility disorders.
AB  - The records of 113 consecutive patients with a suspected gastrointestinal
      motility disorder referred between January 1988 and July 1991 were
      retrospectively reviewed. The aims were to identify the prevalence of autonomic
      dysfunction in those with or without associated neurological disease and to
      determine the diagnostic value of testing for autonomic dysfunction. All patients
      had gastrointestinal manometry (3 hours fasting, 2 hours fed), 94 of 113
      underwent testing of sympathetic adrenergic and cholinergic function and
      cardiovagal cholinergic function. All tests were scored in a standard manner.
      There was a significant (p < 0.05) but modest (r = 0.28) rank correlation between
      autonomic and motility scores. This correlation was stronger (r = 0.67, p = 0.01)
      in diabetic patients. The number of patients in each group with autonomic
      dysfunction was as follows: irritable bowel syndrome nine of 33, idiopathic upper
      gastrointestinal dysmotility six of 21, diabetes mellitus nine of 13, identified
      non-diabetic neurological syndromes six of nine, postvagotomy or abdominal
      surgery three of 11, and myopathic pseudo-obstruction two of seven. Autonomic
      testing is useful in the assessment of autonomic involvement outside the
      gastrointestinal tract. Logistic discriminant analysis showed that autonomic
      function testing did not add to the diagnostic value of motility tests in
      distinguishing between patients with and without irritable bowel syndrome,
      although a slight improvement was indicated for identifying neuropathic
      dysmotilities. Thus, the aetiological role of general autonomic dysfunction in
      irritable bowel syndrome and idiopathic and postvagotomy dysmotilities deserves
      further study. The addition of autonomic function tests does not add
      substantially to the diagnostic accuracy of clinical, radiological, endoscopic,
      and manometric techniques in most patients referred for evaluation of a suspected
      motility disorder.

PMID- 8472991
TI  - Radioisotope determination of regional colonic transit in severe constipation:
      comparison with radio opaque markers.
AB  - Radio-opaque markers have a well established role in distinguishing between
      patients with normal and those with slow intestinal transit, but in the latter
      group their accuracy in defining the region of delay has not been established. To
      study regional colonic transit accurately the transit of a radioisotope labelled
      meal was determined and findings were compared with those of simultaneously
      ingested radio-opaque markers. Twelve healthy controls (mean age 33 years) and 12
      severely constipated women (mean age 36 years, bowel frequency < once per week)
      were studied On day 1, a meal containing 10 MBq 111In bound to 0.7 mm resin
      microspheres was ingested. Subjects also ingested a set of radiologically
      distinguishable markers on three successive days. Abdominal scans were obtained
      three times daily for 7 days. Abdominal radiographs were obtained after 72 or 96
      hours and again at 144 or 168 hours. Eight 'regions of interest' were created-
      one for the small bowel, six for the colon, and one for excreted stool. The
      constipated patients all showed colonic transit outside the normal range, with a
      variable site of delay demonstrated by time activity curves for each region. To
      provide a different measure of the effectiveness of colonic transport, the
      movement of the 'centre of mass' for the radioisotope and for the markers was
      then determined. The radioisotope and radiopaque marker methods gave similar
      results. At all times between 24 and 144 hours there was no significant
      difference for the position of the centre of mass between the radio-opaque and
      marker methods. At all times, however, the mean difference between the markers
      and the radioisotopes was positive, indicating that the center of mass of the
      markers was always head of that of the radioisotope. The mean difference between
      the methods was never greater than one region of interest, and ranged from 12 to
      72% of one region of interest in the colon. The difference between these two
      methods could reach up to two colonic segments in certain patients at one time.
      Radioisotope ingestion provides accurate information about the transit through
      individual colonic regions because of the possibility of frequent observations
      and the clear delineation of the entire colon. Although these features were not
      obtained with radio-opaque markers, they are suitable as a screening test for the
      presence and pattern of colonic delay.

PMID- 8472992
TI  - Increased ethane exhalation, an in vivo index of lipid peroxidation, in alcohol
      abusers.
AB  - Ethane exhalation was measured in 42 control subjects, 52 patients with various
      non-alcoholic liver diseases, and 89 alcohol abusers who had been admitted to
      hospital for alcohol withdrawal and assessment of liver disease (six with normal
      liver tests, 10 with steatosis with or without fibrosis, six with alcoholic
      hepatitis, 29 with cirrhosis, 34 with both cirrhosis and alcoholic hepatitis, and
      four with both cirrhosis and a hepatocellular carcinoma). Ethane exhalation was
      similar in control subjects and in patients with non-alcoholic liver diseases,
      but was five times higher in alcohol abusers. Ethane exhalation in alcohol
      abusers was significantly, but very weakly, correlated with the daily ethanol
      intake before hospital admission, and the histological score for steatosis, but
      not with the inflammation or alcoholic hepatitis scores. Ethane exhalation was
      inversely correlated with the duration of abstinence before the test. In nine
      alcoholic patients, the exhalation of ethane was measured repeatedly, and showed
      slow improvement during abstinence. Ethane exhalation was significantly but
      weakly correlated with the Pugh's score in patients with alcoholic cirrhosis. It
      is concluded that the mean ethane exhalation is increased in alcohol abusers. One
      of the possible mechanisms may be the presence of oxidizable fat in the liver.
      The weak correlation with the Pugh's score is consistent with the contribution of
      many other factors in the progression to severe liver disease.

PMID- 8472993
TI  - Laser lithotripsy of difficult bile duct stones under direct visual control.
AB  - Biliary laser lithotripsy was performed under direct visual control in 35
      consecutive patients not amenable to routine endoscopy. The patients had 1-50
      (median 1) bile duct stones with the greatest diameter of the largest stone being
      9-42 mm (median 20 mm). Conventional endoscopic treatment had failed because of
      an inaccessible papilla (16 patients), biliary strictures (seven patients), and
      impaction or large size of calculi (12 patients). Twelve patients, depending on
      their anatomical condition, underwent peroral cholangioscopy by means of a mother
      babyscope system. Percutaneous cholangioscopy was initially carried out in 23
      patients, 7-20 days (median 10 days) after creation of a transhepatic fistula.
      Pulsed dye laser (32 patients) or alexandrite laser (three patients) lithotripsy
      was applied under an appropriate direct visual control in all cases. Complete
      stone disintegration succeeded in 33 of 35 patients. All resultant fragments
      passed the papilla within a mean number of 1.3 treatment sessions. Peroral
      cholangioscopic lithotripsy failed in two cases. One patient successfully
      underwent percutaneous laser treatment and the other patient was referred to
      surgery. Fever, temporary haemobilia, or a subcapsular liver haematoma were seen
      in a total of eight patients during establishment of the cutaneobiliary fistula.
      A 95 year old patient who had been admitted with septic cholangitis died because
      of cardiorespiratory failure 5 days after bile duct clearance. It is concluded
      that laser lithotripsy performed under a direct visual control is an effective
      and safe procedure for the non-surgical treatment of difficult bile duct stones.
      Ductal clearance can usually be achieved in a single treatment session when the
      papilla and the stones are accessible by the peroral route. Percutaneous
      cholangioscopic lithotripsy is more time consuming but highly effective even in
      patients with a difficult anatomy, bile duct strictures, or intrahepatic calculi.
      This approach should be limited, however, to cases not amenable to retrograde
      procedures because the creation of the cutaneobiliary fistula is not without
      risks.

PMID- 8472994
TI  - Organising unrestricted open access gastroscopy in South Tees.
AB  - Increasing demand for upper gastrointestinal endoscopy has forced many clinicians
      to reconsider the policy of seeing all patients in a specialist clinic before
      gastroscopy. The following are considered essential in setting up an open access
      gastroscopy service. (1) Assessment of the need by examination of waiting times
      for the outpatient clinic and the proportion of patients requiring upper
      gastrointestinal endoscopy, and consultation with colleagues in general practice.
      During the first 2 years of the service the average waiting time for a medical
      gastrointestinal outpatient appointment has fallen from over 120 days to 37 days
      in this area. (2) An adequately staffed and equipped gastrointestinal unit with
      well motivated nurses (the workload will increase) and sufficient clinical
      support to allocate patients to the next available gastroscopy list is vital. A
      safe mechanism for relaying information back to the GP (including histology
      reports) is essential otherwise medicolegal problems could arise. Open access
      gastroscopy now accounts for 29% of the total endoscopy workload in South Tees.
      (3) Close cooperation between medical and surgical gastroenterologists must be
      achieved to ensure a uniform approach to the provision of this service and equal
      distribution of the endoscopy workload. This will require close examination of
      the potential numbers and may necessitate appointment of a clinical assistant or
      additional consultant. Clinical assistants perform just over 50% of the open
      access gastroscopies in South Tees and the waiting time has been kept short
      (average 17 days). (4) A comprehensive request form with guidelines for GPs and a
      specific box identifying whether the GP requires a report and brief advice only
      or follow up at the discretion of the endoscopist (often a clinical assistant) is
      required. (5) Management must be involved in identifying adequate resources. (6)
      Methods of monitoring requests and outcome measures to ensure effective audit
      must be established.

PMID- 8472995
TI  - Surgery for uncomplicated gastro-oesophageal reflux.

PMID- 8472996
TI  - Hysterectomy and the irritable bowel.

PMID- 8472997
TI  - Colonic tuberculosis.

PMID- 8472998
TI  - New theories based on inappropriate application of high technology.

PMID- 8472999
TI  - Acetorphan and diarrhoea.

PMID- 8473000
TI  - Factors affecting the distribution of ingested propionic acid in the rat
      forestomach.
AB  - Propionic acid (PA) when incorporated into food pellets and fed to male Wistar
      rats for 20 wk had no effect on the forestomach mucosa; however, in powdered diet
      PA led to pronounced hyperplasia and severe inflammatory lesions in the
      forestomach mucosa near the limiting ridge. Since this discrepancy in the effect
      of PA may have been caused by the type of diet in which PA was administered, the
      distribution of total PA (including the corresponding acid-soluble CoA ester) in
      different parts of the stomach and certain variables affecting this distribution
      were investigated. In the forestomachs of rats fed 4% PA in powdered diet, the
      amount of PA in hyperplasias (1553 +/- 508 micrograms PA/g tissue) was three
      times higher than that in the remainder of the tissue (479 +/- 247 micrograms
      PA/g tissue). The PA content decreased progressively towards the glandular parts.
      There was a slight, but not significant, decrease in the PA content of the
      forestomach and a slight increase in the PA content of the glandular stomach in
      rats fed pelleted food compared with those fed powdered diet. Supplementation of
      1% L-carnitine to PA powdered diet for 12 wk led to a significant decrease (P <
      0.02) in PA accumulation in hyperplastic tissues compared with hyperplasias
      induced by PA alone, although L-carnitine had no influence on the severity of
      hyperplastic changes in the forestomachs of rats. The present study shows that
      the type of diet in which PA was administered to male Wistar rats is of great
      importance for the development of hyperplasia, PA or the corresponding CoA ester
      can accumulate in the forestomach and is preferably accumulated in hyperplasias,
      and PA accumulation does not appear to be directly related to the severity of
      hyperplastic changes.

PMID- 8473001
TI  - Metabolism and excretion of dimethoate following ingestion of overtolerance peas
      and a bolus dose.
AB  - Data to guide an exposure assessment were obtained by giving sugar peas
      containing overtolerance dimethoate residues (17 ppm; 8% oxon) and a bolus dose
      of dimethoate to a healthy adult male. The dimethoate tolerance on peas was and
      remains 2 ppm. Serial total urine samples were collected and analysed for
      dimethoate and its oxon, dimethylphosphate, dimethylphosphorothioate (DMTP) and
      dimethylphosphorodithioate. The dose of dimethoate administered was approx. 0.1
      mg/kg body weight and produced no symptoms of toxicity. Dimethylphosphates
      appeared in the urine within 2 hr. The major metabolite (about 60%) was DMTP.
      Only traces (< 0.5%) of dimethoate and oxon were recovered from urine.
      Acetylcholinesterase inhibition was not observed although urinary metabolites
      were prominent, indicating that they are better indicators of acute exposure than
      cholinesterase inhibition. The results obtained using a bolus dose were virtually
      identical to those from the trial with overtolerance peas, and indicated that
      dimethoate is readily absorbed and its urinary metabolites are readily eliminated
      following exposures to low doses (0.1 mg/kg body weight).

PMID- 8473002
TI  - Delayed effects of neonatal exposure to Tween 80 on female reproductive organs in
      rats.
AB  - Neonatal female rats were injected ip (0.1 ml/rat) with Tween 80 in 1, 5 or 10%
      aqueous solution on days 4-7 after birth. Treatment with Tween 80 accelerated
      maturation, prolonged the oestrus cycle, and induced persistent vaginal oestrus.
      The relative weight of the uterus and ovaries was decreased relative to the
      untreated controls. Squamous cell metaplasia of the epithelial lining of the
      uterus and cytological changes in the uterus were indicative of chronic
      oestrogenic stimulation. Ovaries were without corpora lutea, and had degenerative
      follicles.

PMID- 8473003
TI  - Effect of dietary T-2 toxin on biogenic monoamines in discrete areas of the rat
      brain.
AB  - Acute T-2 toxin treatments alter biogenic monoamine concentrations in the brain;
      however, these perturbations have not been well documented or demonstrated in
      feeding trials. In this study, the effect of dietary T-2 toxin on regional brain
      concentrations of biogenic monoamines and their metabolites was investigated in
      male rats fed a semi-synthetic diet containing 0, 2.5 or 10 ppm T-2 toxin for
      either 7 or 14 days. Reduction in feed consumption, feed efficiency and weight
      gain was observed in rats fed either 2.5 or 10 ppm T-2 toxin. This effect was
      transient in animals fed the 10 ppm T-2 toxin diet, with feed consumption, feed
      efficiency and weight gain improving significantly during wk 2. T-2 toxin
      affected brain biogenic monoamine concentrations. In the nucleus raphe magnus,
      serotonin, 5-hydroxy-3-indoleacetic acid and norepinephrine increased in a dose
      dependent manner, and dopamine increased transiently. In the substantia nigra of
      rats fed 10 ppm T-2, epinephrine increased after 7 days and norepinephrine
      decreased after 14 days, when compared with controls. Dihydroxyphenylacetic acid
      concentrations in the paraventricular nucleus and medial forebrain bundle were
      lower in T-2 toxin-treated rats than in control animals. The observed effects of
      T-2 toxin on brain monoamines and the resulting neurochemical imbalance may
      account for the physiological manifestation of trichothecene intoxication.

PMID- 8473004
TI  - Developmental toxicity of orally administered thiabendazole in Sprague-Dawley
      rats and New Zealand white rabbits.
AB  - The developmental toxicity of thiabendazole (TBZ) was assessed in studies in New
      Zealand white rabbits and Sprague-Dawley rats. The doses of TBZ for these studies
      were based on decreases in maternal weight gain in dose range-finding studies in
      pregnant females of each species. In rabbits, TBZ was administered orally at
      doses ranging from 24 to 600 mg/kg body weight/day in two separate studies. In
      rats, TBZ was administered at doses of 10, 40 or 80 mg/kg body weight/day. In all
      studies, TBZ was administered daily by gavage in aqueous suspension on gestation
      days 6 to 17. In the initial rabbit study, weight loss occurred in the 600
      mg/kg/day group and weight gain decreased in the 120 mg/kg/day group. In
      addition, there were four complete litter resorptions and four abortions in the
      120 and 600 mg/kg/day groups, respectively. To determine whether these changes
      (known to occur spontaneously in rabbits) were reproducible, the study was
      repeated. In this study, decreased maternal weight gain and decreased foetal
      weights were found at 600 mg TBZ/kg/day, but there was no evidence of selective
      developmental toxicity. Similarly, in rats TBZ produced decreased maternal weight
      gain (12 to 26%) associated with slight (5 to 7%) decreases in foetal weights at
      doses of 30 and 80 mg/kg/day. No changes were found at 10 mg TBZ/kg/day and no
      evidence of selective developmental toxicity or teratogenicity was found at any
      dose. On the basis of these results, it is concluded that TBZ is not teratogenic
      or selectivity foetotoxic in rats or rabbits.

PMID- 8473005
TI  - Effect of captopril on the cytological and biochemical changes induced by
      adriamycin.
AB  - Captopril, an angiotensin-converting enzyme inhibitor, was evaluated for its
      antimutagenic potential. Male Swiss albino mice (6-8 wk old) were treated orally
      with different doses of captopril dissolved in water for 7 days. Some of the mice
      in each group were injected ip with adriamycin (ADM; 15 mg/kg body weight) and
      killed after 30 hr. Femoral cells of mice were collected and studied for
      reduction of micronuclei. Proteins, RNA and DNA were determined in hepatic cells.
      Captopril pretreatment was found to reduce ADM-induced micronuclei in
      polychromatic cells and increase the quantity of protein, RNA and DNA in hepatic
      cells. The inhibition of clastogenicity observed may be due to free-radical
      scavenging action of captopril.

PMID- 8473006
TI  - Effects of Curcuma xanthorrhiza Roxb. and curcuminoids on the level of serum and
      liver lipids, serum apolipoprotein A-I and lipogenic enzymes in rats.
AB  - Curcuma xanthorrhiza Roxb., a medicinal plant used in Indonesia, has been shown
      to exert diverse physiological functions. However, little attention has been paid
      to its effect on lipid metabolism. We have investigated the effects of C.
      xanthorrhiza on serum and liver lipids, serum high density lipoprotein (HDL)
      cholesterol and apolipoprotein (apo) A-I, and liver lipogenic enzymes in rats. In
      rats given a cholesterol-free diet, C. xanthorrhiza decreased the concentrations
      of serum triglycerides and phospholipids, and liver cholesterol, and increased
      serum HDL-cholesterol and apo A-I. The activity of liver fatty acid synthase, but
      not glycerophosphate dehydrogenase, was decreased by the medicinal plant. In rats
      on a high-cholesterol diet, C. xanthorrhiza did not suppress the elevation of
      serum cholesterol, although it did decrease liver cholesterol. Curcuminoids
      prepared from C. xanthorrhiza had no significant effects on the serum and liver
      lipids. These studies, therefore, indicate that C. xanthorrhiza contains an
      active principle(s) other than curcuminoids which can modify the metabolism of
      lipids and lipoproteins.

PMID- 8473007
TI  - Development of an ocular irritation test in the mouse: image analysis of corneal
      lesions.
AB  - An ocular irritation test in the mouse has been developed, in which corneal
      lesions consecutive to instillation of ophthalmic preparations are assessed by
      digital image processing. The high sensitivity of this method makes it possible
      to test very low (i.e. therapeutic) concentrations, which do not produce
      macroscopic damage to the eye. The relatively low variability of the results
      allows the determination of irritation potential with a small number of animals.
      The test permits the establishment of the relationship between instilled
      concentrations and corneal lesions. The rapidity and simplicity of this approach
      make the proposed test suitable for the screening of ophthalmic preparations.

PMID- 8473008
TI  - What does carcinogenicity mean and how should we test for it?

PMID- 8473009
TI  - Interferon-gamma-activated monocytes impair infectivity of HIV particles by an
      oxygen metabolite-dependent reaction.
AB  - Mononuclear phagocytes generate microbicidal oxygen metabolites spontaneously and
      after phagocytic stimulation by a NADPH-dependent enzymatic reaction called the
      oxidative burst. The spontaneous release of reactive oxygen radicals and
      intermediates (ROI) increases five- to eightfold after treatment of monocytes
      with the lymphokine interferon-gamma (IFN-gamma). The effect of the IFN-gamma
      activated release of ROI by human monocytes on the infectivity of free human
      immunodeficiency virus (HIV) in the supernatant was investigated with the
      following results. First, IFN-gamma-activated, but neither control monocytes nor
      lipopolysaccharide-stimulated monocytes effectively decreased the infectivity of
      cell-free HIV-1 in culture medium supernatant. Second, the mechanism of
      inactivation was dependent on the enhanced spontaneous release of ROI by IFN
      gamma-activated mononuclear phagocytes, since either the enzyme catalase or the
      free radical scavenger butylated hydroxyanisole (BHA) could block this activity.
      Third, soluble and solid-phase HIV-1 outer envelope glycoprotein (gp120) failed
      to trigger the oxidative burst activity after specific gp120-monocytic CD4
      receptor interaction. These results indicate an anti-viral effect of IFN-gamma
      activated monocytes/macrophages on HIV-1 which may have important implications
      for our understanding of spread of the virus in the body and the development of
      full-blown AIDS after a long period of latency.

PMID- 8473010
TI  - Interferon-gamma inhibits interleukin-8 production by human polymorphonuclear
      leucocytes.
AB  - Stimulation of human polymorphonuclear leucocytes (PMN) with phagocytosable
      particles [yeast-IgG (Y-IgG)], lipopolysaccharide (LPS), tumour necrosis factor
      (TNF) or formyl-methionyl-leucyl-phenyl-alanine (FMLP) results in an increase of
      the interleukin-8 (IL-8) mRNA accumulation and a subsequent release of the
      protein. Here, we report that interferon-gamma (IFN-gamma) down-regulates the
      constitutive IL-8 mRNA levels expressed by resting PMN. As shown by Northern
      analysis, this down-modulation occurred rapidly, was not dependent on new protein
      synthesis, and was not caused by an increased rate of degradation of IL-8 mRNA.
      Preincubation of PMN with IFN-gamma significantly inhibited their ability to
      release IL-8 upon stimulation with TNF, LPS, FMLP and Y-IgG, but enhanced the
      respiratory burst capability in response to FMLP and TNF. TNF-, LPS- and FMLP
      induced expression of IL-8 mRNA was also selectively inhibited by IFN-gamma.
      Taken together these findings suggest that IFN-gamma has important regulatory
      effects on acute inflammatory response because of its capacity to modulate
      negatively IL-8 gene expression and secretion by human PMN. Further observations
      revealed that, in human PMN, degradation of IL-8 mRNA is finely regulated, and
      that cycloheximide (CHX), an inhibitor of protein synthesis, super-induces the
      mRNA accumulation for IL-8 in a dose- and time-dependent manner.

PMID- 8473011
TI  - Contact sensitization to oxazolone: involvement of both interferon-gamma and
      interleukin-4 in oxazolone-specific Ig and T-cell responses.
AB  - The synthesis and role of several lymphokines were examined during contact
      sensitization to oxazolone (OX). Application of OX to the skin of mice increased
      the delayed-type hypersensitivity (DTH) response to challenge, serum titres of OX
      specific IgG1 and IgG2a, and draining lymph node cell (LNC) numbers. At day 3, LN
      contained detectable interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and
      granulocyte-macrophage colony-stimulating factor (GM-CSF) but not IL-2 or IL-3
      mRNAs; IL-3 and higher levels of IL-4, IFN-gamma and GM-CSF mRNAs were measured
      after 24 hr culture with anti-CD3 antibody in OX-primed but not unprimed LNC. As
      a result of sensitization, LNC secreted IL-3 constitutively and produced elevated
      levels of IL-2, IL-3, IL-4 and IFN-gamma in response to anti-CD3 antibody; a
      similar but weaker lymphokine response was recalled by OX-protein conjugate. CD4+
      cells were the major source of the anti-CD3-induced lymphokines except IFN-gamma,
      which was derived mainly from CD8+ cells. Since both IL-4 and IFN-gamma were
      synthesized by OX-primed LNC in vivo and in vitro, their role was investigated by
      administering anti-lymphokine antibodies at the time of sensitization. Anti-IL-4
      treatment reduced OX-specific serum IgG1 titres without affecting IgG2a titres,
      whereas anti-IFN-gamma treatment reduced IgG2a but not IgG1 titres. Although
      neither antibody altered DTH responsiveness, anti-IFN-gamma treatment markedly
      increased IL-4 production by CD4+ LNC and reduced IFN-gamma production in vitro,
      particularly by CD4+ cells. We conclude that endogenous IL-4 and IFN-gamma
      reciprocally influence the isotype of the Ig response to OX and that IFN-gamma
      also affects the relative levels of IL-4 and IFN-gamma synthesis by CD4+ LNC.

PMID- 8473012
TI  - Interleukin-6 biosynthesis is increased by histamine in human B-cell and
      glioblastoma cell lines.
AB  - An enhancing effect of histamine on the biosynthesis and gene expression of
      interleukin-6 (IL-6) by human cell lines, Epstein-Barr virus (EBV)-infected human
      B lymphoma line BMNH and the glioblastoma line SK-MG4 has been found. No similar
      effect of histamine has been detected on the IL-6 production by any other B-cell
      line, CESS or human peripheral monocytes. Histamine stimulates the IgM production
      of BMNH cells by autocrine action of IL-6 induced by histamine, since either
      neutralization of IL-6 by polyclonal antibody or blocking the IL-6 receptor by
      specific monoclonal antibody abolished the effect of histamine.

PMID- 8473013
TI  - Transforming growth factor-beta 1 enhances polymorphonuclear leucocyte
      accumulation in dermal inflammation and transendothelial migration by a priming
      action.
AB  - Acute inflammatory reactions are usually characterized by polymorphonuclear
      leucocyte (PMNL) migration into inflamed tissues. Transforming growth factors
      beta 1 (TGF-beta 1) may be involved in inflammatory reactions but its actions are
      controversial and require further in vivo studies. We employed a rabbit dermal
      inflammation model to investigate the effect of TGF-beta 1 on PMNL migration
      induced by cytokines and chemotactic factors, using 51Cr-labelled leucocytes to
      quantify PMNL accumulation in dermal lesions. Injection of TGF-beta 1, over a
      wide dose range, alone did not elicit PMNL accumulation (0.14 x 10(6) PMNL/site).
      This contrasted with responses to interleukin-1 alpha (IL-1 alpha) (11.8 x 10(6)
      PMNL/site), tumour necrosis factor-alpha (TNF-alpha) (4.5), lipopolysaccharide
      (LPS) (14.9), FNLP (10.1), or IL-8 (6.6). However, when sites were pretreated for
      3 hr with TGF-beta 1 (1-10 ng) and subsequently re-injected with the inflammatory
      stimuli, TGF-beta 1 primed the tissue for an enhanced recruitment of PMNL in
      response to the endothelium-activating inflammatory agents, IL-1 alpha, TNF-alpha
      and LPS, but not to IL-8 or FNLP, which are directly PMNL chemotactic. For
      example, with IL-1 alpha, PMNL accumulation was 205% greater than the additive
      sum of each response alone (P < 0.05). This was confirmed histologically. TGF
      beta 1 pretreatment enhanced PMNL accumulation over a wide dose range of IL-1
      alpha and LPS. TGF-beta 1 did not alter the kinetics of IL-1 alpha or LPS-induced
      PMNL accumulation, but increased the peak rate of accumulation in lesions. Using
      an in vitro PMNL transendothelial migration system, TGF-beta 1 (10 ng/ml) was
      found to prime the endothelium for responsiveness to a submaximal dose of IL-1
      alpha (0.005 ng/ml) or a threshold dose of LPS (0.01 ng/ml), resulting in
      enhanced PMNL transendothelial migration. Thus, TGF-beta 1 may have a role in
      priming the microvasculature for enhanced PMNL emigration, especially in response
      to endothelium-activating agents.

PMID- 8473014
TI  - Regulatory effect of interleukin-4 (IL-4) on the expression and function of
      lymphocyte adhesion receptors involved in IL-2-induced cell aggregation.
AB  - Human recombinant interleukin-4 (rIL-4) was studied for its capacity to inhibit
      rIL-2-induced lymphoid cell aggregation. In contrast to rIL-2, rIL-4 was unable
      to induce cluster formation by itself. However, when added simultaneously with
      rIL-2 to cultures of freshly isolated peripheral blood lymphocytes (PBL), rIL-4
      inhibited cell aggregation in a dose-dependent way. In contrast, PBL,
      preactivated by a 4-day culture in the presence of 500 U/ml rIL-2, were not
      inhibited in their adhesive capacity by rIL-4. Inhibition of cell aggregation was
      most prominent at 24 hr and virtually lost after 72 hr of culture. Phenotypical
      analysis revealed that rIL-4, with similar kinetics, decreased the rIL-2-mediated
      up-regulation of the CD2, CD54 and CD49e adhesion molecules. In addition, it was
      observed that up-regulation of the activation epitope on CD11a recognized by the
      mAb NKI-L16, was prevented. During 24hr of culture rIL-4 itself did not alter the
      expression of these antigens. Blocking experiments with mAb directed against
      adhesion structures did not reveal a direct role for CD49e, but obviously
      demonstrated involvement of CD11a/CD18-CD54 and CD2-CD58 interactions in the rIL
      2-induced adhesion. Therefore, rIL-4 appears to inhibit the early phase of rIL-2
      induced aggregation by preventing the up-regulation of CD54 and CD2 antigens and
      by inhibiting the generation of the activated state of the CD11a/CD18 receptor.

PMID- 8473015
TI  - Diversity of functional T-cell receptor delta-chain transcripts from bone marrow
      cells of athymic nude mice.
AB  - CD3+ cells are detectable in bone marrow of athymic mice homozygous for the nude
      mutation. As previously shown, cells expressing the gamma delta T-cell receptor
      (TcR) represent 30-40% of this T-cell population. Using V delta-specific, V alpha
      4-specific, and C delta-specific primers, TcR delta-chain transcripts were
      reverse transcribed and polymerase chain reaction (PCR)-amplified from total RNA
      prepared from bone marrow cells (BMC) of 6-month-old NMRI nu/nu mice. Amplified
      TcR delta-chain cDNA was cloned, and 49 randomly selected clones derived from
      seven amplification reactions were sequenced. Sequence analyses showed: (1) more
      than 80% of the sequenced clones represented in-frame transcripts of the TcR
      delta-chain; (2) in-frame transcripts containing V delta 1-, V delta 2-, V delta
      3-, V delta 4-, V delta 5-, V delta 6- and V alpha 4-gene segments were
      detectable in nude BMC; (3) V delta 2-, V delta 4- and V delta 5-containing
      transcripts were more abundant and more diverse than V delta 1- and V delta 3
      containing transcripts; (4) extensive N-region diversity was present in the V
      delta-D delta 2 (N1), D delta 2-D delta 1 (N2) and D delta 1-J delta 1 (N3)
      junctional regions; (5) P nucleotide additions were present in many transcripts;
      and (6) unusual truncated, in-frame transcripts with deleted D- and J-region
      genes were detected. A large potential TcR delta-chain repertoire is thus present
      in nude BMC.

PMID- 8473016
TI  - Platelet-activating factor-induced human eosinophil activation. Generation and
      release of cyclo-oxygenase metabolites in human blood eosinophils from
      asthmatics.
AB  - The spontaneous and stimulated generation of fatty acid cyclo-oxygenase pathway
      derived products of arachidonic acid from highly purified (91.6 +/- 1.3%, n = 23)
      human blood eosinophils obtained from asthmatics were examined using combined gas
      chromatography/mass spectrometry. Under resting conditions, eosinophils
      spontaneously generated 0.24 +/- 0.10 pg prostaglandin E2 (PGE2), 0.51 +/- 0.20
      prostaglandin D2 (PGD2), 0.35 +/- 0.10 pg prostaglandin F2 alpha (PGF2 alpha) and
      8.5 +/- 2.2 pg thromboxane B2 (TXB2), the stable metabolite of TXA2 per 10(6)
      cells. In contrast, 6-keto-prostaglandin F1 alpha and 9 alpha,11 beta
      prostaglandin F2 were not detectable. Stimulation of eosinophils with platelet
      activating factor (PAF) for 5 min induced a two- to sixfold increase in the
      biosynthesis of prostanoids. More than 95% of the generated prostanoids were
      released into the surrounding medium. The response to PAF was inhibited by the
      PAF receptor antagonist WEB 2086 (1 microM). The fatty acid cyclo-oxygenase
      inhibitor, ibuprofen, abolished both the spontaneous and PAF-stimulated
      generation of prostanoids by eosinophils. LTB4, PMA and calcimycin also produced
      an increase in prostanoid production, whereas lyso-PAF, the PAF precursor and
      metabolite, failed to induce prostanoid generation over basal production. In
      conclusion, the results demonstrate that PAF potently activates human eosinophils
      to generate and release several fatty acid cyclo-oxygenase metabolites of the
      arachidonic acid pathway, with TXB2 being the most abundant. These data are in
      agreement with previous observations suggesting that PAF may be an important
      stimulus for prostanoid release by the eosinophil in allergic diseases such as
      asthma.

PMID- 8473017
TI  - Malaria antigen and cytokine-induced production of reactive nitrogen
      intermediates by murine macrophages: no relevance to the development of
      experimental cerebral malaria.
AB  - The in vitro production of reactive nitrogen intermediates (RNI) by murine
      macrophages was evaluated in response to heat-stable malaria antigen and
      cytokines. Malaria antigen, interferon-gamma (IFN-gamma) and tumour necrosis
      factor (TNF) induced RNI production in macrophages in a dose-dependent way. RNI
      production steadily increased over a 2-day period and was enhanced when the
      malaria antigen was co-incubated with IFN-gamma and/or TNF. RNI production
      induced by either IFN-gamma or malaria antigen or a combination of the two was
      suppressed by pentoxifylline in a dose-dependent manner. Pentoxifylline did not
      significantly influence TNF-induced RNI production. L-N-monomethyl arginine
      reduced malaria antigen, IFN-gamma and TNF-induced RNI production when these
      reagents were used in combination or alone. An anti-TNF monoclonal antibody (mAb)
      reduced IFN-gamma-induced RNI production, but did not significantly alter the
      malaria antigen-induced RNI synthesis by macrophages. The influence of inhibitors
      of nitric oxide synthase, L-N-monomethyl arginine and N omega-nitro-L-arginine,
      was studied in experimental cerebral malaria. They did not exert any significant
      effect on the development of cerebral malaria in Plasmodium berghei ANKA-infected
      CBA/J mice.

PMID- 8473018
TI  - IgE and IgG2a antibody responses are induced by different antigen groups of the
      nematode Nippostrongylus brasiliensis in rats.
AB  - The differences were examined between IgE, IgG1 and IgG2a antibody responses
      against two kinds of nematode antigens in rats infected with Nippostrongylus
      brasiliensis. With ELISA studies, remarkable IgE and IgG1 antibody responses were
      observed against antigens in excretory/secretory products (ES) of N.
      brasiliensis, whereas the IgG2a antibody response against ES was negligible. On
      the other hand, antibody response to antigens in an extract of homogenized adult
      worm (AW) was observed mainly in IgG2a, with little response in IgE or IgG1.
      Immunohistochemical studies showed that IgE- and IgG1-binding antigens were
      localized almost exclusively in the subventral glands, a secretory apparatus in
      N. brasiliensis, while IgG2a-binding antigens were found mainly in the nematode
      wall along the body cavity. Immunoblot analysis revealed that the major IgE- and
      IgG1-binding molecules in ES were identical. On the other hand, some, but not
      all, of the major IgG2a-binding molecules in AW were different from the IgE/IgG1
      binding molecules in ES. The findings suggest that the IgE/IgG1 and IgG2a
      antibody responses in N. brasiliensis-infected rats are induced by different
      groups of nematode antigens. Thus, it is presumed that the production of each
      class of antibody might be dependent, at least in part, on the nature of the
      antigen or antigen-linked molecules.

PMID- 8473019
TI  - Immune-mediated alteration of the terminal sugars of goblet cell mucins in the
      small intestine of Nippostrongylus brasiliensis-infected rats.
AB  - Alteration of terminal sugars of goblet cell mucins in the small intestinal
      mucosa was examined by lectin histochemistry in rats infected with
      Nippostrongylus brasiliensis. To see whether alteration of the nature of mucins
      was regulated by the local immune system, adult worms were implanted
      intraduodenally into recipient rats of various immune status. When 7-day-old
      ('normal') adult worms were implanted into naive euthymic rats, about 60%
      remained until day 7 and then were expelled. The number of goblet cells
      transiently decreased on day 5 and then progressively increased from day 9
      onwards. In parallel with the hyperplasia, mucins in and released from goblet
      cells strongly expressed terminal N-acetyl-D-galactosamine which was specifically
      recognized by Helix pomatia agglutinin (HPA). When 13-day-old ('damaged') adult
      worms were implanted into naive euthymic rats, they were rapidly expelled by day
      9 in association with hastened goblet cell hyperplasia and the alteration of
      terminal sugars of the mucins. Hastened worm expulsion, goblet cell hyperplasia
      and alteration of terminal sugars of the mucins were also observed when 'normal'
      worms were implanted into immune recipients. On the other hand, after
      implantation of 'normal' worms into hypothymic (rnu/rnu) rats, goblet cell
      hyperplasia or the alteration of terminal sugars of the mucins was almost
      completely absent. These results suggest that alteration of sugar residues of
      goblet cell mucins, especially the strong expression of terminal N-acetyl-D
      galactosamine, is regulated by the host's immune system and seems to be important
      in the expulsion of N. brasiliensis.

PMID- 8473020
TI  - Influence of severe protein malnutrition on rat lacrimal, salivary and
      gastrointestinal immune expression during development, adulthood and ageing.
AB  - The objective of the present study was to examine and to compare the impact of
      severe protein malnutrition during development, adulthood and ageing on secretory
      immune expression in the eye, mouth and small intestine. In addition, we sought
      to determine whether potential abrogation of mucosal immunity by protein
      deprivation might be reversed by the administration of a balanced diet. Weanling,
      adult and aged rats were provided isocaloric diets containing 24% (control), 19%,
      14%, 10%, 6% and/or 3.2% protein levels for defined periods and various
      immunological parameters were evaluated before, during and after the dietary
      regimen. Our results demonstrated the following. (1) Severe protein malnutrition
      (3.2%) dramatically suppressed the secretory immune system in eyes of weanling
      rats. After 8 weeks of protein insufficiency, tear IgA concentrations in young
      rats had undergone a precipitous decrease, such that IgA could not be detected in
      tears. This response was paralleled by a significant decline in the tear volume,
      tear secretory component (SC), IgG and total protein content, number of IgA
      containing cells in lacrimal tissue, as well as the amounts of SC and/or IgA in
      saliva, intestinal secretions and serum. In contrast, the immunological effects
      of protein malnutrition in adult or aged animals varied considerably depending
      upon the specific mucosal site. (2) The influence of protein deprivation was dose
      dependent and reversible: maintenance of weanling rats on 10%, 6% or 3.2% protein
      diets interfered with the establishment of ocular and intestinal mucosal
      immunity, but later administration of optimal diets to these malnourished animals
      permitted a rapid immune recovery. (3) The impact of protein malnutrition on tear
      IgA levels in weanling animals, as shown by pair-feeding experiments, appeared to
      reflect primarily protein deficiency and not caloric restriction. Overall, these
      findings show that dietary protein plays a significant, site-specific role in the
      developmental expression of the secretory immune system.

PMID- 8473021
TI  - Interaction of the terminal complement components C5b-9 with synovial
      fibroblasts: binding to the membrane surface leads to increased levels in
      collagenase-specific mRNA.
AB  - The late complement components, apart from their lytic function, are known to
      trigger the release of various proinflammatory substances from different types of
      nucleated cells. In the present study, the interaction of C5b-9 with synovial
      fibroblast cells (SFC) was examined. It was found that incubation of SFC with
      activated complement components resulted in binding of C5b-9 to the cell
      membrane; subsequently an increase in abundance of collagenase-specific mRNA was
      seen, as assessed by Northern blotting. When C8-deficient serum was used as
      source of complement neither binding of C5b-9 nor an increase in collagenase
      specific mRNA could be detected. These findings suggest that C5b-9, which might
      be generated during rheumatoid inflammation, may contribute to chronic joint
      destruction by triggering collagenolytic activity.

PMID- 8473022
TI  - Natural killer cells and tumour necrosis factor-alpha-mediated enteropathy in
      mice.
AB  - We have shown previously that normal mice given interferon-alpha/beta (IFN
      alpha/beta) or tumour necrosis factor-alpha (TNF-alpha) develop marked intestinal
      pathology which is similar to that found in enteropathies associated with cell
      mediated immunity in vivo, such as graft-versus-host reaction (GVHR). The
      enteropathy induced by IFN-alpha/beta and GVHR are both dependent on the presence
      of natural killer (NK) cells and here we have examined whether NK cells are also
      required for enteropathy caused by TNF-alpha. Mice injected with recombinant TNF
      alpha displayed enhanced splenic NK cell activity and developed significant
      villus atrophy and crypt hypertrophy in the small intestine. Administration of
      anti-asialo GM1 antibody abolished the NK cell activity in both normal and TNF
      alpha-injected mice, but had no effect on the enteropathy caused by TNF-alpha. We
      conclude that NK cells are not required for TNF-alpha to damage the small
      intestine.

PMID- 8473023
TI  - Measuring rates of fluid flow through dentine in vivo.

PMID- 8473024
TI  - New developments in confocal optical microscopy for monitoring fluid flow in
      dentine.

PMID- 8473025
TI  - Determining the internal morphology of root canals.

PMID- 8473026
TI  - The use of electronic apex locators in endodontic therapy.

PMID- 8473027
TI  - Leakage around root canal fillings.

PMID- 8473028
TI  - Micropuncture measurements of interstitial fluid and vascular pressures in dental
      pulp.

PMID- 8473029
TI  - Methods for assessing pulpal innervation and monitoring reinnervation.

PMID- 8473030
TI  - A comparison of the dentine-removing characteristics of two endosonic units.
AB  - The purpose of this study was to compare the dentine-removing characteristics of
      size 25 K-files activated by the Cavi-Endo and Piezon-Endo units. The influence
      of power-setting, direction of file oscillation, interfacial force and operator
      assisted movement were studied. Filing was performed on flat surfaces of dentine
      and impressions of the instrumented surfaces revealed characteristic patterns of
      dentine removal corresponding to the area of contact with the file which was
      quantified using a Reflex microscope. Differences in dentine removal as affected
      by the power output of the two systems were only apparent when the maximum power
      setting on the Cavi-Endo was compared with the maximum recommended for root canal
      preparation on the Piezon-Endo. The Cavi-Endo removed significantly more dentine
      than the Piezon-Endo. When operator-assisted movement of the file was
      superimposed, both systems removed significantly more dentine than without
      assisted filing, However, the Piezon-Endo now removed significantly more dentine
      than the Cavi-Endo. This difference was more apparent when the file oscillated
      perpendicular to the dentine surface, compared with oscillation parallel to the
      substrate. An increase in the interfacial force from 30 g to 60 g resulted in a
      greater reduction in dentine removal by the Cavi-Endo compared with the Piezon
      Endo. Thus, at a 30 g interfacial force there were insignificant differences
      between the endosonic units but at 60 g, the Piezon-Endo removed significantly
      more dentine than the Cavi-Endo. The dentine-removing characteristics of the two
      endosonic units tested are very different under certain conditions. These
      findings may have important clinical implications.

PMID- 8473031
TI  - Replication of sensitive dentine.

PMID- 8473032
TI  - Endodontic leakage studies reconsidered. Part I. Methodology, application and
      relevance.
AB  - An increasing number of endodontic leakage studies have been published. In the
      1990 volumes of Journal of Endodontics and International Endodontic Journal,
      there was one leakage study to every 4.3 scientific articles. The most popular
      method was linear measurement of tracer (dye or radioisotope) penetration along a
      root filling. Comparing some data on linear measurement of dye penetration
      following the cold lateral condensation of gutta-percha that were published
      between 1980 and 1990, a high level of variation has been found, although the
      experimental methods used in these studies were quite similar. In almost all
      studies evaluating various techniques, the cold lateral condensation technique
      has been used as a standard control for comparison. The reliability of these
      results is questionable. The problems with such studies are discussed. It seems
      that more research should be done on leakage study methodology, instead of
      continuing to evaluate the sealing ability of different materials and techniques
      by methods that may give little relevant information.

PMID- 8473033
TI  - Testing sensitive dentine in man.

PMID- 8473034
TI  - Endodontic leakage studies reconsidered. Part II. Statistical aspects.
AB  - The aim of many endodontic studies is to compare two or more treatment methods,
      techniques or materials, for example, to detect differences in mean leakage
      scores. As it is not feasible to study large populations, samples are taken. The
      important question then arises as to how large the sample sizes have to be in
      order to establish the 'true' (= populations') mean scores. First, it must be
      determined which magnitude of the difference (= v) between the mean scores is of
      endodontic interest. Based upon v and a few related statistical parameters, one
      may calculate how large the samples must be in order that a statistical test
      yields a significant result for a difference that is of endodontic importance. In
      other words, the 'power' of a test, depending on the sample size among other
      factors, must be large enough to detect the 'true' a priori determined difference
      between the populations. The use of small sample sizes may imply that a rather
      large difference between two mean leakage scores is not found to be significant,
      thereby leading to incorrect conclusions. This article describes the power and
      the statistical related factors that determine the adequate size of samples.
      Examples of power calculation are presented. Next, the power of publicized
      endodontic leakage studies was evaluated. Almost two-thirds of the sample sizes
      were 10 or less, and about 90% were 20 or less. Less than one-half of the tests
      had an adequate power (conventionally > or = 0.80). It is necessary to be
      cautious when extrapolating the results of such studies, because of the limited
      power of the statistical tests. The power may be increased by using larger sample
      sizes or, alternatively, by enlarging the 'effect size', by either taking an
      interest in a larger difference between the mean scores, or by minimizing the
      variability of the data.

PMID- 8473035
TI  - Clinical measurement of hypersensitive dentine.

PMID- 8473037
TI  - Pulpal blood flow: use of radio-labelled microspheres.

PMID- 8473036
TI  - The relationship between the root canal filling and post space preparation.
AB  - The restoration of root treated teeth often requires the use of posts. Their use
      may affect the quality of the seal of the root canal filling. The various aspects
      of the relationship between root canal filling and post space preparation are
      discussed in this review. It is recommended that the use of posts should be
      avoided whenever possible. Where the preparation of post space is required,
      immediate removal of gutta-percha using heated instruments and small Gates
      Glidden drills is the method of choice.

PMID- 8473038
TI  - Monitoring blood flow changes by radioisotope clearance from a depot in a cavity
      in dentine.

PMID- 8473039
TI  - Laser Doppler technique--a future diagnostic tool for tooth pulp vitality.

PMID- 8473040
TI  - Advantages and limitations of laser Doppler flow meters.

PMID- 8473041
TI  - Relevance of DT-diaphorase activity to mitomycin C (MMC) efficacy on human cancer
      cells: differences in in vitro and in vivo systems.
AB  - Using 4 human cancer cell lines, 4 tumors xenografted into nude mice, and 11
      fresh tumor specimens removed at surgery, we investigated the relevance of
      NAD(P)H:quinone oxidoreductase (DT-diaphorase, DTD) activity (nmoles/min/mg
      protein) to mitomycin C (MMC)-induced cytotoxicity. In culture cell lines, KB
      cells had significantly higher levels of DTD activity (8260) than PH101 (1934),
      SH101 (1805) or K562 (1796), and the highest sensitivity to MMC. In contrast, the
      higher the DTD activity of xenografts, the greater their resistance to MMC, while
      the inhibition rate of relative tumor growth for MMC, as evaluated by the NCI
      protocol, was highest in SH-6, high in CH-5, lower in CH-4 and lowest in EH-6.
      The investigation using 11 fresh tumor specimens also showed an inverse
      relationship between IC50 values after a 30-min MMC treatment, as evaluated by
      ATP assay and DTD activities. Moreover, a non-toxic DTD inhibitor, dicoumarol
      (DIC), or flavin adenine dinucleotide (FAD), suppressed the efficacy of MMC in
      culture cells, but enhanced it in xenografts. Thus, we suggest that DTD may play
      an important role in MMC-induced cytotoxicity but MMC metabolism by DTD in solid
      tumors may differ from that in culture cells.

PMID- 8473042
TI  - Altered dexamethasone responsiveness and loss of growth control in tumorigenic
      mouse lung cell lines.
AB  - Glucocorticoid hormones induce differentiation, inhibit proliferation, and, in
      mice, reduce carcinogen-induced tumorigenesis of lung epithelial cells. Therefore
      we examined dexamethasone effects on tumorigenic and non-tumorigenic mouse lung
      epithelial-derived cell lines. Non-tumorigenic cells were growth inhibited and
      exhibited CAT activity in pMMTV-CAT transfectants in response to dexamethasone.
      Tumorigenic cell lines exhibited a range of responses to dexamethasone. While one
      tumorigenic line was growth-inhibited and responsive in CAT assays, 2 other
      tumorigenic cell lines were unresponsive both in CAT and in growth assays. A
      fourth tumorigenic cell line exhibited intermediate sensitivity in CAT assays and
      was actually growth-enhanced by dexamethasone. Although no difference between
      cell lines was observed in the abundance of glucocorticoid receptor protein on
      Western blots, the least dexamethasone-responsive tumorigenic lines exhibited
      very little binding of 3H-dexamethasone. Clones of tumorigenic lines stably
      transfected with the rat glucocorticoid receptor gene were more dexamethasone
      sensitive in CAT assays and were growth-inhibited by dexamethasone. These data
      suggest that the neoplastic progression of cell lines derived from mouse lung
      frequently involves the acquisition of diminished glucocorticoid responsiveness.

PMID- 8473043
TI  - Conditional expression and oncogenicity of c-myc linked to a CD2 gene dominant
      control region.
AB  - Over-expression of the c-myc gene is widely implicated in the genesis of lymphoid
      neoplasia, including tumours of the T-cell lineage. To study the effects of
      deregulated c-myc expression on T-cell development and oncogenesis, we sought to
      generate a transgenic mouse model in which c-myc expression was targeted
      specifically to the T-cell lineage. A plasmid construct containing a dominant
      control region (DCR) from the human CD2 locus linked 5' to the human c-myc gene
      was used to generate 2 lines of transgenic mice. Both strains developed thymic
      lymphoma at low frequency, but thymic development and peripheral T-cell numbers
      were otherwise apparently normal. Low tumour penetrance was consistent with the
      observed lack of stable CD2-myc transgene mRNA in tissues of healthy transgenic
      mice. In contrast, transgene RNA was detected in all malignant tumours as well as
      in early lymphomatous lesions. RNase protection analyses confirmed these findings
      and showed that the PI human c-myc promoter was active in all neoplastic tissues
      but not in the thymus or other tissues of healthy transgenic mice. Despite the
      low spontaneous tumour incidence, the presence of the transgene markedly and
      uniformly accelerated the onset of tumours after neonatal infection with Moloney
      murine leukaemia virus. All tumours were rearranged for T-cell receptor beta
      chain genes and were of T-cell origin from their surface phenotype (Thy-1+, CD3+,
      CD4+/-, CD8+, sIg-). Virus-accelerated tumours contained clonal integrations of
      Moloney murine leukaemia virus, suggesting that proviral insertional mutagenesis
      may have played a role in tumour development. Analysis of several candidate myc
      cooperating genes failed to reveal any rearrangements apart from a low frequency
      involving proviral insertion at the pim-1 locus. The CD2-myc mouse should
      therefore be a valuable system in screening for novel myc-collaborating genes
      involved in T-cell lymphoma.

PMID- 8473044
TI  - The permissive role of oxygen-derived free radicals in the development of colonic
      cancer in the rat. A new theory for carcinogenesis.
AB  - The colonic carcinogen 1,2-dimethylhydrazine (DMH) was given to male rats at 10
      weeks of age in the form of weekly s.c. injections for 28 weeks. The results
      obtained show that the incidence of colonic cancer is directly dependent on
      dietary fat intake and that carcinogens which produce colonic cancer in the
      presence of a high-fat diet are rendered harmless when a low-fat diet is
      consumed. These results suggest that dietary fat is permissive for colonic
      carcinogenesis. Administration of the radical scavengers allopurinol and dimethyl
      sulfoxide afforded dose-dependent protection against this permissive role.

PMID- 8473045
TI  - Descriptive epidemiology of malignant carcinoids in the Swiss Canton of Vaud.

PMID- 8473046
TI  - UICC Study Group on Basic and Clinical Cancer Research: genotypes and phenotypes
      of tumor suppressors. Meeting held at Woods Hole, MA, October 1-4, 1992.

PMID- 8473047
TI  - Non-melanoma skin cancer: ten years of cancer-registry-based surveillance.
AB  - The Tasmanian Cancer Registry carried out population-based surveillance of non
      melanoma skin cancer (NMSC) from 1978 to 1987. A total of 8,651 NMSC were
      recorded in 7,160 individuals, representing an age-standardized rate of
      161/100,000 per year. Ninety-four percent of cases were based on histological
      diagnosis. Incidence of basal-cell carcinoma (BCC) was higher than the incidence
      of squamous-cell carcinoma (SCC). The incidence of NMSC was twice as high in men
      as in women. Incidence increased substantially with age, more markedly for SCC
      than BCC. For most body sites, BCC was more frequent, but on highly exposed sites
      such as the backs of hands, lower limbs in women and ears in men, the incidence
      of SCC was higher. There was an overall increase of 7% per year in the age
      standardized incidence rate of NMSC. The increase was more marked for BCC than
      for SCC, and was consistent across age groups and both sexes. A first NMSC during
      the study period was associated with a 12-fold increase among men and a 15-fold
      increase among women in the risk of development of a new NMSC within 5 years,
      when compared with the NMSC incidence recorded for the population as a whole.

PMID- 8473048
TI  - Corn and wheat-flour consumption and mortality from esophageal cancer in Shanxi,
      China.
AB  - In order to identify factors that may explain the great variation in mortality
      from esophageal cancer in Shanxi Province, China, an ecological study was carried
      out in 21 communes in that province. Mortality data were obtained from the
      registration records of the population of 148,928 during 1983 to 1988, which
      provided 744,640 person-years of observation. The data regarding average
      consumption of each kind of grain, potatoes and sweet potatoes were from food
      allocation records. The data regarding consumption of meat, eggs, fruit,
      vegetables and the data regarding alcohol drinking were from interviews. The
      concentrations of nitrite and of nitrate in pickled vegetables and in drinking
      water were measured. A significant positive relation was found between mortality
      rate and the consumption of dietary corn and wheat flour. Also, a significant
      inverse relation was found between the mortality rate and the dietary sorghum and
      millet level. The age- and sex-adjusted mortality-rate ratio of esophageal cancer
      for residents in the third and highest quartiles of corn- and wheat-flour
      consumption are 1.4 (95% CI: 1.1-2.0) and 3.2 (2.5-4.2), respectively, compared
      with those in the lowest quartile. Other factors studied did not contribute to
      the great variation in esophageal cancer mortality in the areas studied.

PMID- 8473049
TI  - Age-period-cohort modelling of large-bowel-cancer incidence by anatomic sub-site
      and sex in Connecticut.
AB  - In order to investigate etiologic distinctions among the anatomic sub-sites of
      the large bowel by sex, the relationship between large-bowel-cancer incidence and
      age at diagnosis, time period at diagnosis, and birth cohort was analyzed by
      anatomic sub-site and by sex, using data from the Connecticut Tumor Registry.
      Included in the study were all incident large-bowel-cancer cases occurring
      between 1950 and 1984 among Connecticut residents aged 40 to 79. Cancers of the
      large bowel were classified into 5 anatomic sub-sites: ascending colon (including
      cecum), transverse colon (including flexures), descending colon, sigmoid colon,
      and rectum (including rectosigmoid junction, anal canal, and anus). The data were
      fitted to log-linear age-period-cohort models. For each of the sub-sites, the age
      period-cohort patterns for males and females differed. Within each sex, sub-site
      groupings with common patterns were indicated. Among males, the age-period-cohort
      patterns for the colon sub-sites were fairly similar; but the pattern for the
      rectum differed markedly from that for the colon sub-sites. There were secondary
      differences among the colon sub-sites that pointed to a secondary distinction
      between the right and the left colons. Among females, the age-period-cohort
      patterns for the left colon sub-sites and the rectum were fairly similar. The
      pattern for the transverse colon differed moderately from that of the left colon,
      and differed substantially from that of the rectum and the ascending colon. The
      ascending colon differed markedly from each of the other sub-sites. It is
      possible that these differences in age-period-cohort patterns reflect etiologic
      distinctions among sub-site groupings and between the sexes.

PMID- 8473050
TI  - Time trends in cancer mortality in Estonia, 1965-1989.
AB  - Mortality rates for cancer of all sites combined and for 12 selected sites or
      site groups in Estonia from 1965 to 1989 were studied to assess overall progress
      in controlling cancer. Between 1965-1969 and 1985-1989, age-standardized
      mortality (world population) increased by 12.0% among males and decreased by 5.1%
      among females. The changes in mortality for the age-groups 20-44, 45-64, and 65
      and over were -0.3%, 23.5% and 5.8% among males and 0.9%, -7.0% and -4.4% among
      females, respectively. In males, the most marked rise in mortality occurred for
      cancers of the oral cavity and pharynx, intestine and larynx. In females, the
      most rapid increase was observed for cancers of the lung, oral cavity and pharynx
      and breast. The decline in stomach cancer and cervical cancer mortality reflects
      worldwide trends. However, the noticeable increase in mortality rates for most of
      the sites indicates a need for strong preventive measures, particularly anti
      smoking campaigns. In general, the time trends in mortality from all cancers
      combined demonstrate that in Estonia, over the last 25 years, no progress against
      cancer has been achieved.

PMID- 8473051
TI  - Interleukin 7 enhances the proliferation and effector function of tumor
      infiltrating lymphocytes from renal-cell carcinoma.
AB  - Previous studies have documented the effects of IL2 on the growth and effector
      function of tumor-infiltrating lymphocytes (TIL) in cancer patients. Since IL7 is
      known to induce T- and NK-cell responses in the peripheral blood, we examined the
      immuno-enhancing effects of IL7 on TIL derived from human renal-cell carcinoma
      (RCC). Whereas IL2 induced the growth of freshly isolated TIL in vitro, IL7 was
      ineffective alone and failed to increase the total number of cells proliferating
      to IL2. However, IL7 did provide a proliferative signal to TIL that were
      initially expanded in culture with either IL2 or IL2/IL7 for 2 weeks. IL7 also
      induced the proliferation of CD4+ and CD8+ TIL lines that have specificity for
      RCC. The proliferative response induced by IL7 was independent of IL2, since anti
      IL2 antibodies did not block IL7-induced proliferation of TIL. IL7 did cooperate
      with anti-CD3 stimulation for the induction of proliferation; however, the
      magnitude of this interaction was variable and the response usually additive. In
      addition, IL7 synergized with anti-CD3 to induce the secretion of IFN gamma from
      short-term-cultured TIL and from a TIL line. Although IL7 did not promote the
      development of a tumor-specific T-cell response from IL2-expanded TIL, IL7
      enhanced lymphokine-activated killer (LAK) activity from some short-term-cultured
      TIL. These results illustrate that IL7 can potentiate the growth and production
      of IFN gamma from RCC-reactive TIL and, to a lesser extent, enhance IL2-induced
      LAK activity of TIL.

PMID- 8473052
TI  - Shedding of GD2 ganglioside in patients with retinoblastoma.
AB  - Retinoblastoma is a rare tumor of the young child with an intraocular
      localization that leads to certain problems of diagnosis. With the aim of
      defining a biochemical marker--which is still lacking for this disease--the
      gangliosides of a pool of fresh retinoblastoma tumors were analyzed. The
      ganglioside pattern was shown to have GM3, GM2, GM1, GD3, GD2, GD1b and GT1b as
      the major components. The occurrence of a high concentration of GD2 in the tumors
      led us to investigate the possibility of changes in the level of GD2 in the sera
      of retinoblastoma patients, using quantitative immunostaining with GD2-specific
      mouse monoclonal antibodies (MAbs). In 9 out of 10 tumor-bearing patients, the
      serum level of GD2 ganglioside was significantly higher than the average value
      found in normal individuals. A 2-year follow-up of patients showed that
      successful treatment resulted in a rapid decrease in the serum level of GD2 down
      to the normal range, from which a subsequent elevation was seen only in relapsing
      patients. Although the clinical study needs further development, the results
      obtained to date suggest that GD2 is shed in the serum of tumor-bearing patients
      and that the level of GD2 could be a potential serum marker of human
      retinoblastoma.

PMID- 8473053
TI  - Involvement of p53 gene mutations in human endometrial carcinomas.
AB  - Mutations in the p53 gene are associated with a wide variety of human
      malignancies. Point mutation in one allele and loss of the remaining one
      generally lead to inactivation of p53 protein. A high frequency of allelic losses
      corresponding to the 17p13.3 region that contained the p53 gene sequence was also
      noted in human endometrial carcinoma. Thus, in order to confirm involvement of
      the p53 gene in endometrial carcinogenesis, we searched for nucleotide sequence
      change in this gene in 42 endometrial carcinomas that had been subjected to
      previous LOH analyses. Using the polymerase-chain-reaction-single-strand
      conformation polymorphism (PCR-SSCP) method, we detected p53 gene mutations in 4
      specimens. Two adenocarcinomas with allelic loss on 17p contained a mutant p53
      gene in the allele that was retained. One specimen with a p53 gene mutation
      contained a 17q deletion but was uninformative for LOH on 17p. p53 gene mutation
      was also noted in the remaining stage-I carcinoma, though the 17p deletion was
      not detected in the previous LOH examination. However, 5 specimens with the LOH
      on 17p retained the wild-type p53 gene. In the remaining 33 specimens, both
      alleles of p53 gene seemed to be normal. The mutations observed in 2 specimens
      (cases 10 and 24), involving C-to-T and T-to-G substitutions, were located in a
      highly conserved region. However, the mutations identified in the remaining 2
      cases (29 and 35) were at regions positioned outside conserved stretches.

PMID- 8473054
TI  - Granulocyte-macrophage colony-stimulating factor induces human melanoma-cell
      migration.
AB  - Tumor metastasis is the primary cause of death for cancer patients. The
      metastatic cascade requires successful tumor cell invasion into and through
      vascular and parenchymal barriers. We have shown that autocrine motility factor
      (AMF, autotaxin) and the insulin-like growth factors (IGFs) induce tumor-cell
      migration. Since granulocyte-macrophage colony-stimulating factor (GM-CSF) has
      been shown to prime neutrophils for chemotaxis, we have therefore studied the
      influence of GM-CSF upon tumor cells and report that GM-CSF stimulates migration
      of these cells in a dose-dependent fashion. The ED50 for A2058 human melanoma
      cell line chemotaxis to GM-CSF is approx. 60 pM. The motile response to GM-CSF
      was additive to that of IGF-I and AMF, both of which are potent attractants for
      tumor cells. Pre-treatment of cells for 2 hr with non-toxic concentrations of
      pertussis toxin (PT) or amiloride resulted in a 50% inhibition of chemotaxis to
      GM-CSF. Therefore, GM-CSF, through PT- and amiloride-sensitive signal pathways,
      is a potent attractant for melanoma cells, the response to which is additive to
      that of other attractants. The presence of the GM-CSF receptor in A2058 melanoma
      cells was indicated by Northern-blot analysis which identified message
      transcripts of 2.1 and 3.0 kb. These data emphasize the versatility of the
      melanoma cell migration response to an array of cytokines, including GM-CSF.

PMID- 8473055
TI  - Role of protein kinase C and cytokines on the function and production of
      cytolytic granules in alpha CD3-activated killer-cell-mediated killing of tumor
      cells.
AB  - The effects of PMA and staurosporine (PKC depletor/antagonist) and IL-2/IL4 were
      used to determine the role of PKC and cytokine on alpha CD3-induced activated
      killer cells (CD3-AK). The present study examines their effects on the production
      of BLT-esterase and on the effector function of CD3-AK cells as well as the
      cytolytic granules. The production of BLT-esterase generally correlated with the
      cytolytic activity of CD3-AK cells and was reduced by PKC depletor/inhibitor but
      increased by IL-4. In studying the effector function of CD3-AK cells, we found
      that adding PMA or SSP at the effector phase inhibited the PKC-dependent slow
      lysis. PMA, but not SSP, also reduced fast lysis, which was shown to be a PKC
      independent event. Additional experiments were performed to determine the effect
      of PKC on the lytic granules and to ascertain whether PMA has other effects on
      the effector-to-target relationship unrelated to PKC. It was found that neither
      PMA nor SSP affects the function of cytolytic granules, as measured by hemolytic
      assay against anucleated target (SRBC). These findings indicate that PKC has no
      direct effect on the granules. During testing against the nucleated tumor target
      through a novel approach using non-cytolytic surrogate killers, the lytic
      activity of the granules was inhibited by PMA, suggesting that exocytosis or
      delivery of granules to nucleated target cells may require mobilization of
      intracellular Ca2+ in the killer cells, and this process is inhibited by PMA. Our
      findings indicate that PKC and cytokines regulate the production but not the
      lytic activity of cytolytic granules. Nonetheless, delivery of cytolytic granules
      from killer cells to the nucleated tumor target appears to be a Ca(2+)-dependent
      event unrelated to PKC.

PMID- 8473056
TI  - Thrombin stimulates melanoma tumor-cell binding to endothelial cells and
      subendothelial matrix.
AB  - Thrombin has been shown to activate tumor-cell adhesion to platelets, fibronectin
      and von Willebrand factor 2- to 3-fold in vitro, and enhance metastasis 10- to
      156-fold in vivo. We therefore elected to determine whether thrombin binds to
      tumor cells and whether thrombin-treated tumor cells enhance their adhesion to
      endothelial cells, the first barrier to tumor invasion and metastasis. Thrombin
      treated human and hamster melanoma cells (SK-Mel-28 and HM-29) enhanced their
      adhesion to bovine aortic endothelial cells 2.1- to 2.3-fold, respectively.
      Similar results were obtained with bovine capillary endothelial cells. Thrombin
      activation of tumor cells was rapid, reaching its peak 15 min after thrombin
      activation; and transient, declining to baseline levels by 60 min. 125I-thrombin
      bound to both SK-Mel-28 and HM-29 cells in a saturation-dependent manner, was
      inhibitable by unlabelled thrombin, and could be 90% washed away with buffer
      following 30 min of incubation. Electron microscopy of tumor cells bound to
      fibronectin-coated millipore filters revealed adhesion of naive as well as
      thrombin-treated tumor cells to endothelial cells and subendothelial matrix
      between endothelial cells. Neither mode of adhesion was preferentially enhanced
      by thrombin-treated tumor cells. Both naive and thrombin-treated SK-Mel-28 cells
      had the adhesive ligand integrin receptors: alpha 3 beta l (fibronectin, laminin,
      collagen); alpha 5 beta l (fibronectin); alpha v beta x (vitronectin). Receptors
      for the beta 2 integrin family (LFA-I and Mac-I) were not found, nor were
      receptors of the beta 3 integrin family, GPIIIa. The receptor ligands fibronectin
      and vitronectin were present. None of the above receptors or ligands increased
      their density or appeared de novo after thrombin stimulation. Thus, 2 melanoma
      cell lines have thrombin receptors which, when occupied, lead to enhanced
      adhesion of tumor cells to endothelium and subendothelial matrix.

PMID- 8473057
TI  - Ultrastructural evidence of the mechanisms responsible for interleukin-4
      activated rejection of a spontaneous murine adenocarcinoma.
AB  - The ultrastructural pattern of the anti-tumor response elicited by interleukin-4
      (IL-4) was investigated by using a spontaneous mammary adenocarcinoma (TS/A)
      unable to elicit protective immunity in syngeneic BALB/c mice as suggested by a
      variety of preimmunization-challenge experiments. A subcutaneous lethal challenge
      of TS/A tumor cells was inhibited in a significant number of BALB/c mice
      receiving recombinant murine IL-4 injected daily for 10 days around the tumor
      draining lymph node. Tumor rejection was mainly the result of direct membrane and
      cytoplasmic damage to tumor cells by eosinophils, neutrophils and macrophages
      that deeply penetrated the proliferating tumor mass. Lymphocytes and fibroblasts
      participated in the reaction by interacting with tumor cells, granulocytes and
      each other. The most frequent cell interactions in the peri- and intra-tumoral
      areas and in the tumor-draining lymph nodes are illustrated. The efficiency with
      which the IL-4-activated reaction leads to tumor inhibition and induction of a T
      lymphocyte-dependent tumor-specific immune memory appears to depend on
      interactions between distinct leukocytes.

PMID- 8473058
TI  - The treatment of addiction in group psychotherapy.
AB  - This article gives specific reasons and evidence why group psychotherapy is the
      treatment of choice for addictions. Utilizing object relations theory and the
      self-psychology of Kohut, the authors present a model of group psychotherapy that
      combines these perspectives with those of Yalom's interactional group
      psychotherapy. Agreeing with Kohut and other object relation theorists, the
      authors view addiction as a condition that is the result of a person's misguided
      attempts at self-repair because of deficits in psychic structure. Vulnerability
      of self is the consequence of developmental failures and deprivation. Substance
      abuse only exacerbates this condition leading to exaggerated difficulty in
      regulation of affect, self-care, and characterological pathology. Abstinence is
      usually required as the first step in arresting this process and establishing a
      treatment regimen that will allow the vulnerabilities of the self to be altered
      and restored. This article suggests that this recovery and treatment process is
      best accomplished in a group therapy setting that is conducted within the
      guidelines of the principles of object relations theory and a modified version of
      Yalom's interactional group therapy format.

PMID- 8473059
TI  - Groups for the chronic mental patient and the legacy of failure.
AB  - Group treatment of the chronically mentally ill has often been a fruitless and
      exasperating experience. The intense emotional responses of group leaders in
      working with this chronic population reinforces a spiral of repetitive failures.
      An attempt to intervene in this chronic spiral will be presented by the author's
      experience in leading a training group of mental health workers who, in turn,
      lead groups of chronic patients. In particular, the effects of projective
      identification on various holding environments will be examined by using the
      methodology of object relations. Understanding and utilizing countertransference
      responses of the training leader illuminate the unconscious aims of chronic
      patients to perpetuate their internal and interpersonal lives by their effect on
      the group leaders who work with them and on each other. This understanding can
      lead to interventions that have more constructive outcomes.

PMID- 8473060
TI  - "Telling one's story" in an incest survivors group.
AB  - This article discusses the technical considerations that contribute to making
      "telling one's story" in an incest survivors group a ritual of active mastery
      leading to psychological growth. Survivors approach the task of sharing memories
      with a variety of wishes and fears that can emerge as powerful group transference
      paradigms. These paradigms, while they vividly illuminate the survivor's past and
      present interpersonal expectations, can threaten to derail the telling
      experience. Actively interpreted, however, the group transference aspects of the
      telling experience can yield valuable insights that become the focus for the
      remainder of the survivor's group treatment. This article details the process of
      preparing the individual survivor and the group for the process of telling (and
      listening) and the subsequent task of working through the insights derived from
      the telling experience. Two case examples demonstrate these techniques.

PMID- 8473061
TI  - A group psychotherapy approach to postpartum depression.
AB  - In this article, the current knowledge of postpartum depression is reviewed,
      leading to an understanding of this form of depression as an expression of
      psychosocial factors compounded by the biological changes of the puerperium. A
      rationale for treating women in the context of the postpartum period is
      described. A novel approach to treatment is presented. The treatment uses the
      medium of group psychotherapy to administer interventions. The interventions are
      introduced in three phases across six months in weekly group sessions. The
      systematic intervention program focuses on decreasing four symptoms common to
      postpartum depression: depressed feelings, anxiety, distress, and low self
      esteem. Spouses are involved in the treatment plan from the onset, participating
      in assessment sessions and in a couples group.

PMID- 8473062
TI  - How to deal with moral issues in group therapy without being judgmental.
AB  - The author discusses the pervasive difficulty psychotherapists seem to have in
      discussing patient morality, relating it to the fear of imposing (and feeling)
      shame and guilt. A way of nonjudgmentally discussing moral values with patients
      is presented, which places emphasis not on moral abrogations, but rather on the
      "virtues" of altruism, responsibility, justice, egalitarianism, and honesty.
      Drawing on empirical studies of prosocial behavior, the author gives a rationale
      for how these virtues may, whether the therapist is conscious of it or not, be
      inherently promoted through the group therapy process. Ways are suggested by
      which the therapist can help the group deal with thorny moral issues and confront
      the morally confused patient without causing shame.

PMID- 8473063
TI  - Developing object constancy in group psychotherapy.
AB  - This article describes a therapeutic approach that fosters the development of
      object constancy in group psychotherapy. By managing group boundaries, instilling
      an analytic attitude of self-reflective curiosity, and fostering shared group
      experiences, the therapist helps to create an environment in which individuals
      can develop a constant sense of themselves and relate to others as separate and
      distinct persons.

PMID- 8473064
TI  - The use of a group meal in the brief group therapy of bulimia nervosa.
AB  - The group meal is a technique that can be easily incorporated into traditional
      forms of short-term group therapy for bulimia nervosa. It is a modification of
      the exposure and response-prevention model that has been used in the treatment of
      this population. Patients plan and eat a meal together with the group therapist
      during one of the group therapy sessions. Over the course of the meal, patients
      discuss thoughts and feelings as they experience them, allowing for greater depth
      of therapeutic work than when simply recalling events that occurred between
      sessions. A case example is described to illustrate several of the important
      themes that emerge, including reactions to feeling full, family meals, and the
      relationship between overeating and feelings about the self.

PMID- 8473065
TI  - Writing for publication: overcoming common obstacles.
AB  - This article presents the results of a survey of recent authors in the
      International Journal of Group Psychotherapy who were asked to identify (a) the
      three most difficult obstacles they encountered when publishing their first
      article, (b) three types of resources that were most helpful when preparing their
      manuscript for publication, and (c) advice they would offer to authors who are
      planning their first paper for submission to a mental health journal. Common
      problems in manuscripts submitted for editorial review are also highlighted,
      based on an analysis of 150 letters mailed to authors whose papers were rejected
      or accepted pending revision. The goal of the present article is to provide
      guidelines for how to publish successfully.

PMID- 8473066
TI  - Microlymphatics of human skin.
AB  - Microlymphatics of human skin form two superposed networks. The superficial one
      located at the level of dermal papillae may be visualized by fluorescence
      microlymphography. Microlymphatics fill from a subepidermal depot of minute
      amounts of FITC-dextran 150,000. In primary lymphedema with late onset the
      depicted network with vessels of normal size is significantly larger than in
      healthy controls, whereas in congenital lymphedema (Milroy's disease)
      microlymphatics are aplastic or ectatic (diameter > 90 microns). Lymphatic
      microangiopathy with obliterations of microvessels develops in chronic venous
      insufficiency, in lipedema (preliminary results) and after recurrent erysipelata.
      In healthy controls microlymphatics are permeable to FITC-dextran 40,000 and
      impermeable to the larger molecule 150,000. Preserved fragments of the network in
      chronic venous insufficiency exhibit increased permeability to FITC-dextran
      150,000. After visualization of the vessels by the fluorescent dye microlymphatic
      pressure may be measured by the servo-nulling technique. First results indicate
      that microlymphatic hypertension contributes to edema formation in patients with
      primary lymphedema.

PMID- 8473067
TI  - Erythrocyte-leukocyte interactions in the vascular bed of isolated perfused rat
      lungs.
AB  - An earlier study of perfused rat lungs showed that leukocytes, given as bolus
      injections, seemed to become more or less permanently trapped in the pulmonary
      microvascular bed under erythrocyte-free perfusion. The aim of the present study
      was, therefore, to investigate the rheologic effects of erythrocytes on the
      leukocyte microcirculation of perfused rat lungs. Leukocyte and erythrocyte
      suspensions were given as bolus injections during cell-free, constant pressure
      perfusion of ventilated rat lungs. Leukocyte numbers were counted in samples of
      the venous effluent and flow resistance changes were computed from registrations
      of flow rate, arterial and venous pressures. The preparations showed a continuous
      efflux of leukocytes which had been trapped in the pulmonary microcirculation
      before the perfusion was started. A bolus infusion of erythrocytes (3 ml,
      hematocrit: 30%) caused a transient flow resistance increase during the passage
      of the erythrocyte bolus through the vascular bed. This initial peak was
      accompanied by an increased venous efflux of leukocytes and followed by a lower
      second peak, attributed to a redistribution of trapped leukocytes in the
      capillary bed. Infusions of mixed cell suspensions (20-30 x 10(6) leukocytes in
      30% hematocrit) caused a transient resistance increase similar to that caused by
      erythrocytes and a sustained resistance increase, less persistent than that
      caused by leukocytes. The present data suggest that the infusion of erythrocytes
      caused a re-distribution and an increased efflux of leukocytes, pooled in the
      pulmonary microcirculation. The rheological effects of erythrocytes could,
      hypothetically, result from mechanical interactions with the leukocytes in the
      pulmonary microvessels.

PMID- 8473068
TI  - Fine structure of capillaries in ischaemic and non ischaemic rat striated muscle.
      Effect of torbafylline.
AB  - Capillary ultrastructure was studied in ischaemic and contralateral extensor
      digitorum longus (EDL) muscle, in the diaphragm and left ventricular papillary
      muscle of rats with unilateral ligation of the common iliac artery (L), in
      ischaemic stimulated muscles (SL), and in ischaemic stimulated muscles of animals
      treated with a new xanthine derivative, torbafylline (SL&T). Muscles were
      stimulated at 10Hz via implanted electrodes 7 times/day for 2 weeks. Torbafylline
      or water was given by gavage morning and evening. Nominal evaluation of capillary
      ultrastructure revealed endothelial swelling in 52.7 +/- 8.7% (mean +/- SEM)
      capillaries in ischaemic muscles, 35.2 +/- 5.6% in contralateral muscles and
      about 30% in the diaphragm and papillary muscle. Stimulation of ischaemic muscles
      increased this proportion to 62.6 +/- 6.2% (not significant vs. L), 57.8 +/- 9.5%
      (p < 0.05 vs. L), 62.6 +/- 6.3 (p < 0.05 vs. L) and 43.7 +/- 4.2% (p < 0.05 vs.
      L) in ischaemic and contralateral EDL, diaphragm and papillary muscle,
      respectively. Administration of torbafylline reduced the proportion of swollen
      capillaries to 37.8 +/- 6.1.45% (p < 0.02 vs. SL) in ischaemic muscles, and to
      26.2 +/- 2.1% (p < 0.001) in papillary muscle, with a smaller effect in the
      contralateral EDL and the diaphragm. Stereological analysis showed that
      stimulation led to a marked increase in capillary size vs. contralateral muscles.
      A similar lumen volume density across all groups (Vv = 0.36-0.39), vs. control Vv
      = 0.47, reflected structural heterogeneity within the capillary population of
      EDL. For most components this intra- animal variation obscured drug treatment
      effects, the exception being Vv(nucleus) which was least in SL&T. Activity in
      ischaemic muscles can thus result in widespread capillary endothelial damage in
      muscles, and attenuation of this swelling by torbafylline may explain the
      beneficial effect of this drug on capillary perfusion and performance.

PMID- 8473069
TI  - Spatial relationship between leukocyte accumulation and microvascular injury
      during reperfusion following hepatic ischemia.
AB  - In order to further elucidate the possible contribution of leukocytes to
      microvascular injury during reperfusion following total hepatic ischemia, we
      studied the spatial relationship between areas of white cell accumulation and
      areas of microvascular damage in the rat liver in vivo. No-flow hepatic ischemia
      was produced for 90 min in vivo and during the ensuing reperfusion phase (I/R)
      leukocyte accumulation, absolute number of perfused sinusoids per unit area, and
      red blood cell velocity were quantitated using in vivo epi-fluorescence video
      microscopy. The total number of stationary leukocytes in the liver during
      reperfusion was found to be significantly elevated following ischemia compared to
      time-matched sham-operated controls. In addition, by 2 hr of reperfusion,
      approximately 80% of the leukocytes in the I/R group were extravascular compared
      to only about 50% in the controls. When leukocyte accumulation and
      microhemodynamics were expressed on the basis of whole liver, the increased
      accumulation of leukocytes was associated with decreased microvascular perfusion
      as indicated by decreased number of sinusoids perfused and decreased red blood
      cell velocity. However, when the data were analyzed on the basis of .05mm2
      microscopic fields on the surface of the liver, there was no difference in
      leukocyte accumulation in areas with sinusoidal blood flow compared to areas that
      were devoid of perfused sinusoids. Moreover, in a correlation analysis of number
      of adherent leukocytes/microscopic field vs red blood cell velocity in perfused
      sinusoids in that field, only a very small negative correlation between
      leukocytes/field and red blood cell velocity was found (r = -.23, p < .05). These
      results demonstrate that at the whole organ level leukocyte accumulation appears
      to correlate well with microvascular damage; however, this increase in whole
      liver accumulation of leukocytes does not necessarily reflect accumulation at
      sites of overt microvascular damage. Thus, leukocyte-independent factors are
      likely to be of considerable quantitative importance in microvascular injury
      during reperfusion following hepatic ischemia.

PMID- 8473070
TI  - Involvement of 5-lipoxygenase products in cigarette smoke-induced
      leukocyte/endothelium interaction in hamsters.
AB  - Although cigarette smoke (CS) has been identified as an independent risk factor
      for atherogenesis and sudden cardiac death, the underlying pathomechanism has not
      been clarified. A common factor of both atherogenesis and ischemia/reperfusion
      damage associated with myocardial infarction is the adhesion of circulating
      leukocytes to the vascular endothelium. Searching for the mechanism by which CS
      exerts its deleterious effects on the cardiovascular system, we used a dorsal
      skinfold chamber model in hamsters for intravital microscopy to examine the
      effect of CS on the interaction of fluorescently stained leukocytes with the
      microvascular endothelium in striated muscle. Exposure of awake animals (n = 7)
      for 5 minutes to the mainstream smoke of one cigarette (2R1 research cigarette)
      elicited rolling and subsequent adhesion of circulating leukocytes to the
      endothelium of both arterioles and postcapillary venules with a maximum 30
      minutes after CS-exposure. In order to test a putative mediator role of the
      chemotactic and adhesion-promoting leukotrienes in this event, we pretreated
      another group of 7 animals with MK-886, a potent and specific inhibitor of
      leukotriene biosynthesis (20 mumol/kg body weight, iv, 30 minutes prior to CS
      exposure). While no inhibitory effect was seen on CS-induced leukocyte rolling
      along the microvascular endothelium. MK-886 pretreatment significantly attenuated
      leukocyte adhesion to arterioles (5.2 +/- 13.7 cells/mm2 vs. 54.1 +/- 54.8 in
      control animals. P < 0.01) and venules (37.0 +/- 33.6 cells/mm2 vs. 161.6 +/-
      91.1 in control animals, P < 0.01), 30 minutes after CS exposure, suggesting a
      key mediator role of leukotrienes in this event. We propose that the stimulation
      of leukocyte/endothelium interaction by CS may provide the pathophysiologic basis
      for--or at least contribute to--its deleterious effects on cardiovascular
      mortality and morbidity. The identification of the mediator role of leukotrienes
      in this event may open the way to novel pharmacologic and dietary approaches for
      the prophylaxis of CS-induced cardiovascular pathology.

PMID- 8473071
TI  - Evidence of flowmotion induced changes in local tissue oxygenation.
AB  - The effect of cyclic blood flow velocity on local tissue oxygenation was studied
      by means of a mathematical simulation in the situation where red blood cells
      (RBC) act as discrete oxygen sources. Cyclic time varying fluctuations of
      capillary blood (flowmotion) are due to arteriolar vasomotion. This effect was
      introduced into the model as an oscillating RBC velocity with equal periods of
      high and low velocity regulated by a square wave function. Changes in RBC
      velocity coupled with a constant time-average capillary hematocrit lead to
      periods of high and low flux. Input parameters were flowmotion frequency and
      amplitude, capillary hematocrit, and mean RBC velocity. All results were related
      to baseline states where the velocity and hematocrit are steady. Our principle
      finding is that flowmotion alters the tissue oxygenation, whereby: 1) high
      amplitudes of flowmotion cause a modest increase in axial delivery of oxygen but
      with a decreased average tissue pO2; 2) decreasing flowmotion frequencies lead to
      increased radial penetration of oxygen; 3) the lower frequencies of flowmotion
      cause an increase in the volume of tissue that achieves at least a pO2 level of 5
      mmHg. Isovolemic hemodilution was simulated and found to substantially increase
      the volume of oxygenated tissue as a function of flowmotion. These findings
      indicate that pO2 transients caused by flowmotion oxygenate tissue domains which
      under steady-state conditions would remain anoxic.

PMID- 8473072
TI  - Biological zero in laser Doppler measurements in normal, ischaemic and inflamed
      human skin.
AB  - The Biological Zero (BZ) signal in laser Doppler flowmetry was recorded during
      temporary occlusion of the arterial circulation to the limb by a blood pressure
      cuff inflated suprasystolically for 2 min. The non-thermoregulatory skin at the
      ankle was compared with the thermoregulatory skin over the toe pad in patients
      with lower limb arterial obstructive disease, elderly controls without arterial
      disease and young healthy adults under cool (15-17 degrees C) and warm (25-27
      degrees C) ambient conditions. The absolute BZ values did not differ
      significantly within the three groups at the two room temperatures. However the
      resting laser Doppler flowmetry signal (LDflux) was consistently higher under
      warm than cold room temperatures: these differences were much greater at the toe
      than at the ankle. Accordingly, the relative size of BZ, expressed as a
      percentage of the resting LDflux, was least over the toe in a warm room (5-10%)
      and greatest over the malleolus (59-83%) in the cold room. The changes during the
      evolution of a positive tuberculin skin reaction were followed as a model of
      chronic inflammation in man. The resting LDflux rose 10 fold (from 0.3 to 3.4V)
      while the change in the BZ was minor (0.16-0.2V). Thus the rise in LDflux in a
      fully developed tuberculin reaction was approximately 30X greater than that for
      the corresponding BZ. Concurrent measurements of the alternative output from the
      laser Doppler flowmeter (CMBC) showed in a similar pattern. Since the BZ signal
      can be a substantial proportion of the resting LDflux measurement, we support the
      recommendation that the BZ should be measured wherever possible and practicable,
      for subtraction from the observed LDflux to assess the true flow: 'raw' LDflux
      measurements should be interpreted with extreme caution, particularly at
      relatively low resting LDflux levels.

PMID- 8473073
TI  - Evidence for skin microvascular compartmentalization by laser-Doppler and
      photoplethysmographic techniques.
AB  - Indices of perfusion were obtained using commercial laser-Doppler instruments
      with differing wavelengths on metatarsal skin of sheep (which is abundant with
      AVAs) and compared with quantitative measurements of AVA and capillary blood flow
      using microspheres; an infra-red photoplethysmograph was also compared. The data
      provide physiological evidence that laser-Doppler instruments of longer
      wavelength sense to a greater depth, and our photoplethysmograph behaves
      similarly to a "near-infra-red" laser. Thus, we suggest that near-infra-red
      light, either laser-Doppler or photoplethysmograph, should be used to measure a
      parameter most representative of total local blood flow, and light of a very much
      shorter wavelength, probably green light, would allow more confidence in
      estimates of true capillary perfusion. Because the commonly used visible red
      light can, but does not necessarily detect deep AVA perfusion, the influence
      depending upon the magnitude of the AVA perfusion, measurements by an instrument
      based on such red light is difficult to define.

PMID- 8473074
TI  - The "learning curve" in the performance of laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy was successfully performed on 23 of the first 28
      patients in whom this was attempted (82.1%). After the first ten cases, the
      success rate increased to 94.4%. There was only one major complication which
      prolonged hospital stay but did not require re-operation. Operative time
      decreased markedly from a mean of 160 minutes for the first ten cases to 61
      minutes for the remainder. This increase in operative speed was not accompanied
      by an increase in complications, in spite of a liberalization of patient
      selection criteria. It is clear that a steep "learning curve" exists for this
      procedure and must be recognized and appreciated if laparoscopic cholecystectomy
      is to become a safe and efficient procedure.

PMID- 8473075
TI  - Multivariate study of prognostic factors for differentiated thyroid carcinoma:
      the significance of histologic subtype.
AB  - We re-examined 239 patients with differentiated thyroid carcinoma (222 with
      papillary carcinoma and 17 with follicular carcinoma) especially for the clinico
      pathologic entity of poorly differentiated carcinoma, and made univariate and
      multivariate analyses of the results to evaluate whether it would be of value in
      estimating the prognosis in thyroid cancer patients. In the univariate study, no
      significant difference was found in either survival and disease-free survival
      between papillary and follicular carcinomas, but between well differentiated and
      poorly differentiated carcinomas. In the multivariate study, however, the
      presence of poorly differentiated carcinoma did not appear to be an unfavorable
      prognostic factor. The sex, tumor size, and presence of distant metastases or
      grossly malignant residue in the neck after operation were, on the other hand,
      confirmed by the analyses to be important prognostic factors. We concluded that
      histologic subclassification may be less useful in estimating the prognosis in
      patients with differentiated thyroid carcinoma than other factors such as sex and
      the extent of the tumor.

PMID- 8473076
TI  - Analysis of hepatic recurrence of colorectal cancer after resection of hepatic
      metastases.
AB  - Forty patients with history of resected hepatic metastases of colorectal cancer
      were examined for pattern of recurrence. The 5-year survival rate was 41.3% for
      40 patients. Recurrences of the malignancy were seen in 25 of the patients, with
      hepatic recurrence in 42.5% of them. The hepatic recurrence rate did not
      correlate with the lobar distribution of metastases or surgical methods. The
      pathological margins of less than 1 cm, 3 or more liver metastatic lesions, and
      the metastatic lesions of greater than 5 cm were at increased risk of hepatic
      recurrence. The recurrence rate was high, or 56% for aneuploid tumors, while it
      was 18.5% for diploid tumors.

PMID- 8473077
TI  - Increased leukocyte adhesiveness/aggregation and tissue leukostasis following
      surgical trauma.
AB  - The purpose of the present study was to document the increased leukocyte
      adhesiveness/aggregation (LAA) and tissue leukostasis that follow surgical
      trauma. We found that following major abdominal surgery, the percentage of
      aggregated leukocytes in the peripheral blood increased from 8.6 +/- 7 to 21.7 +/
      11.5 (p < 0.001), while the respective values for patients undergoing minor
      surgery were 3.7 +/- 2.4 and 19.7 +/- 7.6% (p < 0.001). The state of LAA was also
      determined in eight dogs after partial collectomy and four controls. A clear
      increment in the degree of tissue leukostasis (especially in the spleen, liver
      and lungs) was noted in the operated as compared to the control animals. In
      addition, a significant correlation was found between the state of LAA,
      determined in the venous (p = 0.0004) and arterial (p = 0.002) blood of these
      animals and the degree of tissue leukostasis. We conclude that a state of
      increased LAA in the peripheral blood is induced by surgical trauma and that this
      increased LAA correlates with tissue leukostasis.

PMID- 8473078
TI  - Traffic accident induced thoracic outlet syndrome: decompression without rib
      resection, correction of associated recurrent thoracic aneurysm.
AB  - Traffic accident injuries accounted for the sum of 72 billion in the United
      States last year. These injuries included Thoracic Outlet Syndrome and its
      associated Thoracic Aortic Aneurysms. Typically, the injured person has stopped
      for a red traffic light when another vehicle of higher speed and weight hits the
      stopped vehicle from behind. The force exerted hyperextends the neck and
      stretches the scalenus muscles. The muscles stretch, bleed, hypertrophy, and
      shorten. This process further narrows the already crowded triangular tunnel
      through which the neurovascular bundle passes. Sixty-five severely symptomatic
      Thoracic Outlet patients were operated on no sooner than two months after the
      accident to allow the non-surgical measures to take effect. The median age for
      these patients was 33.8 years. The female to male preponderance was 40/25. All
      patients had MRI of the cervical spine to rule out radiculopathy. MRI of the
      thorax was also requested when a Thoracic Aneurysm was suspected. Nerve
      conduction tests of the upper extremities were also taken to support the
      diagnosis. The most valuable clinical test was Elevated Arm Stress Exercising
      which was positive in all cases. At operation, the Brachial Plexus was compressed
      mostly by the hypertrophied, adherent, and fibrous scalenus medius from behind.
      The approach was anterior and supraclavicular in all cases including the
      recurrent one. Both scalenus medius and anticus were largely resected to enlarge
      the Thoracic Outlet triangular tunnel. The first rib was not resected in any of
      these patients, but all costo-cervical ligaments and bands and/or cervical ribs
      were resected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473079
TI  - Iatrogenic perforations of the esophagus.
AB  - The authors herein report their personal experience in the management of 21
      patients with iatrogenic perforation of the esophagus, collected in a fifteen
      year period. The etiology was more commonly a hiatal surgical procedure (28.6%),
      following diagnostic endoscopy (19%), endoscopic dilatation for achalasia (19%)
      and foreign body (19%). Consequently, 47.6% of the lesions were located in the
      abdominal, 28.6% in the thoracic and 23.8% in the cervical esophagus. Treatment
      was set up at surgery in 28.6%, within 6 hours in 47.6% and within 48 hours in
      9.6%. Conservative medical management was successfully carried out in three cases
      (14.2%). As a result of their policy of "tailored" treatment on single lesion
      characteristics (size and location, underlying esophageal diseases, early or
      delayed diagnosis) they report an overall mortality rate of 28.6%, the prognosis
      being worse in thoracic (50%) than in abdominal perforations (30%). Based on this
      series and on a literature review the authors suggest that the best management
      should be "tailored" to single patients characteristics. Early diagnosis and
      treatment are the most important prognostic factors.

PMID- 8473080
TI  - Diagnosis and management of heterotopic pancreas.
AB  - Fifteen patients with 16 histologically verified heterotopic pancreas lesions
      were encountered at our department during a period of 22 years. The incidence was
      0.25% of the findings of all abdominal operations during the same period.
      Heterotopic pancreas caused symptoms in 5 patients. All the remaining 10 patients
      were asymptomatic, whose lesions were found coincidentally at the time of surgery
      for other abdominal diseases. Heterotopic pancreas developed most frequently in
      the jejunum (46.7%). Preoperatively, only 2 lesions of the stomach in 2 patients
      were suspected to be heterotopic pancreas. At the time of operation, 10 of 16
      lesions were diagnosed correctly on the basis of the macroscopic features.
      Malignant degeneration was seen in the duodenal and jejunal heterotopic pancreas.
      The former lesion was successfully resected by pancreatoduodenectomy. There were
      no deaths related to heterotopic pancreas or to the operations performed.
      Resection of the tissue-bearing area is advisable when the condition is
      encountered coincidentally at operation, and surgical exploration should be done
      for all symptomatic patients, particularly in the absence of histological
      diagnosis.

PMID- 8473082
TI  - Videoendoscopic thoracic surgery.
AB  - Personal experience of 42 videothoracoscopic operations is reported. From
      September 91 to May 92 we performed 10 major lung resections (1 pneumonectomy, 8
      lobectomies, 1 segmentectomy) 9 wedge lung resections, 4 excisions of pulmonary
      bullae, 12 pleurectomies with or without apicectomy, 6 excisions of mediastinal
      masses (3 thymomas, 2 mediastinal cysts, 1 thoracic disembryoma), 1 removal of
      esophageal leiomyoma. No major complications occurred. Except for one patient
      submitted to bullectomy with pleurectomy who required a second thoracoscopy due
      to postoperative bleeding, all patients had excellent p.o. course. We describe
      technical details employed in different videothoracoscopic operations and discuss
      personal results and principles of videothoracoscopic approach. Different fields
      of videoendoscopic chest surgery are examined. Present data seem to advocate
      videothoracoscopic treatment for many thoracic diseases and also for major lung
      resections, due to its minimal trauma and little functional impairment.
      Nevertheless this still remains avant-garde surgery. Further improvement in
      endoscopic instrumentation is necessary and may lead to future extensions of
      videothoracoscopic surgical possibilities.

PMID- 8473081
TI  - The value of histological study by surface analysis of preserved and injected
      pancreatic grafts: a prospective controlled study in dogs.
AB  - To evaluate the effects of pancreas preservation and pancreatic duct obliteration
      on the endocrine pancreas, three groups of dogs were used: a control group (six)
      in which histologic analysis of normal pancreas was performed and two randomized
      groups (seven) from which the caudal pancreas was auto-transplanted, injected
      with fibrin glue and removed on the 28th day. In Group A, each graft was flushed
      out with Euro-Collins' solution and immediately transplanted. In Group B, each
      graft was preserved 24 hours in a preservation solution and transplanted. Islet
      surface ratios on the sections and mean islet surfaces were greater in the
      control group than in Group A (p = 0.011 and 0.023) and no different between
      control group and Group B (p = 0.334 and 0.099). This surface analysis study
      suggests that the mode of management of grafts in itself explains the alteration
      of endocrine pancreas and that obliteration of the pancreatic ducts has little
      influence on this alteration.

PMID- 8473083
TI  - Diagnostic and therapeutic strategies of pyogenic liver abscess.
AB  - The infectious routes and etiologies of 26 cases with pyogenic liver abscess were
      portal spread in one, hematogenous in three, biliary in 12, transarterial
      embolization (TAE) in three, posthepatectomy in one and cryptogenic in five
      cases. Portal and hematogenous cases tend to show solitary and cystic pattern on
      echogram, and the majority of the bacteria detected was Klebsiella. While most
      biliary cases show multiple and cystic with tumor pattern on echogram, and an
      unhomogeneous low density in CT feature, anaerobic bacteria and candida were
      isolated only from the biliary or TAE cases. Most cases could be cured completely
      by the various kinds of abscess drainage, but two TAE cases with PTAD
      (percutaneous transhepatic abscess drainage) and two biliary cases with PTBD (PT
      biliary drainage) and PTAD died due to a delay in establishing a diagnosis and to
      the severity of the condition. An early diagnosis followed by PTAD or PTBD were
      thought to be of prime importance.

PMID- 8473084
TI  - Caroli's disease: study of six cases, including one with epithelial dysplasia.
AB  - Six cases of Caroli's Disease are reviewed. Three of the patients had an
      associated form of the disease, one of which had a congenital hepatic fibrosis,
      another a cystic dilatation of extrahepatic bile duct and the last one suffered
      both the above mentioned associated anomalies. Three patients presented with the
      simple form which was initially described by Caroli. The distribution of the
      biliary lesions was a bilobar one in four cases and monolobar in two. One patient
      presented areas of biliary ectasia partially lined by dysplastic epithelium.
      Surgical treatment was used in four cases, a left hepatectomy being carried out
      in two of them and an internal biliary drainage by Roux-Y hepaticojejunostomy in
      the other two. This is a rare disease, frequently associated with congenital
      hepatic fibrosis, possibly pre-malignant and whose treatment of choice is hepatic
      resection.

PMID- 8473085
TI  - Thrombolytic therapy before reconstructive vascular procedures for acute or
      subacute graft occlusions.
AB  - The purpose of this study was to evaluate the efficacy of direct intra-arterial
      Urokinase infusions prior to anticipated adjunctive reconstructive vascular
      procedures in 16 patients with 24 acutely or subacutely occluded lower extremity
      grafts (22 femoropopliteal, 2 femorotibial). Complete thrombolysis was achieved
      angiographically in 18 (75%) of 24 graft occlusions. Neither age, gender, current
      smoking, diabetes mellitus, hypertension, nor coronary arterial disease were
      significantly associated with complete thrombolysis. The only significant factor
      related to complete thrombolysis was the duration of the occlusion prior to lytic
      treatment (p < 0.05). Adjunctive reconstructive procedures were performed for
      eleven of 18 cases in which complete thrombolysis was achieved. These included
      nine percutaneous transluminal balloon angioplasties (at eight distal and one
      proximal anastomotic stenoses) and two bypass operations (femoropopliteal). The
      remaining seven cases had no adjunctive procedure. These 18 cases were examined
      for patency rates during nine months of follow-up. Six (54%) of 11 cases with
      adjunctive reconstructive vascular procedures remained patent, while one (14%) of
      seven cases with no adjunctive procedure remained patent (p = 0.1). Six (25%) of
      24 cases resulted in incomplete thrombolysis. Vascular procedures following these
      cases included two bypass operations, three amputations and one sympathectomy.
      This study suggests that complete thrombolysis of acutely occluded grafts might
      have minimized subsequent reconstructive procedures. Identification of
      correctable lesions and adjunctive reconstructive procedures performed following
      complete thrombolysis may be the important factors related to long-term patency.

PMID- 8473086
TI  - Intra-arterial streptokinase as adjuvant therapy for complicated Buerger's
      disease: early trials.
AB  - Selective low-dose intra-arterial streptokinase was used in 11 long standing,
      complicated cases of Buerger's disease of the lower limbs suffering from acute
      exacerbations or thrombotic episodes with resulting variable degrees of gangrene
      or pre-gangrene of toes or feet, often despite previous lumbar sympathectomy.
      They had no other possible therapeutic options but wait for major amputation. The
      overall success rate (with amputation avoided or altered) was 58.3% and bleeding
      complications occurred in 16.6% of the total limbs at risk included. Favorable
      factors influencing the therapeutic outcome of thrombolytic therapy were a
      shorter presentation time, previous sympathectomy and nicotine abstinence. Even
      with necessary precautions, the technique does not seem to be totally safe.
      However it can be rewarded in some properly selected cases.

PMID- 8473087
TI  - Myxoid chondrosarcoma of the abdominal aorta.
AB  - In this case report we present a 64 year old man who underwent resection of his
      infrarenal abdominal aortic aneurysm. Thrombus of unusual color, texture and
      consistency was noted within this aneurysm which upon histopathologic analysis
      had the characteristics of a myxoid chondrosarcoma. Primary myxoid chondrosarcoma
      of the abdominal aorta is very rare and to our knowledge this report represents
      the first recorded case. The clinical presentation of our patient was dominated
      by hypertension and severe lower extremity claudication associated with
      microembolization to the left fourth toe.

PMID- 8473088
TI  - Immunoprophylaxis in "septic risk" patients undergoing surgery for
      gastrointestinal cancer. Results of a randomized, multicenter clinical trial.
AB  - The results of a randomized, multicenter clinical trial of immunoprophylaxis of
      post-operative infections with intravenous Immunoglobulins (IVIG) (Sandoglobulin)
      in "septic-risk" patients undergoing surgery for gastrointestinal cancer are
      presented. "Septic-risk" patients were selected by an original multiparametric
      test based on delayed hypersensitivity skin testing and serum protein
      electrophoretic sub-fractions. This screening test had shown 76% positive
      predictivity in a previous validation assessment. In the present study, 159
      "septic-risk" patients were selected prospectively from 369 patients undergoing
      colo-rectal (colon) and other kinds of gastrointestinal (non-colon) oncologic
      surgery: 80 "septic-risk" patients were included in the colon and 79 in the non
      colon group. Immunoprophylaxis with IVIG (15 g on the day prior to operation, on
      the 1st and 5th postoperative days) was randomly associated with antibiotic
      prophylaxis (cefoxitin: 2 g one hour prior to, followed by 2 g at the end of
      operation plus 2 g every six hours for 24 hours) in colon surgery while the
      prophylactic schedule in non-colon surgery was only based on random
      administration of IVIG, at the same dosage as in the colon group. There was a
      clear-cut reduction of post-operative infections both in colon and non-colon
      "septic-risk" patients who had IVIG prophylaxis; in the colon group, 37 and 21
      infections (P < 0.004) in antibiotic (A) versus IVIG plus antibiotic (IVIG + A)
      subset, respectively; in the non-colon group, 33 and 19 infections (P < 0.01) in
      control (C) versus (IVIG) subset, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473089
TI  - Iatrogenic ocular complications in patients after jejunoileal bypass surgery.
AB  - We conducted complete eye examinations and retinal function tests on nine
      patients who had undergone jejunoileal bypass (JIB) surgery and subsequently had
      low serum vitamin A levels. All patients had manifested clinically demonstrable
      keratoconjunctival xerosis; in addition, two had abnormally high dark-adaptation
      final thresholds, and two had concomitant implicit prolongation in the
      electroretinogram. The age-matched control groups that consisted of 14 patients
      with various gastrointestinal disorders and four asymptomatic volunteers showed
      fewer or no ocular abnormalities. Our findings suggest that, even though patients
      who underwent JIB surgery may manifest keratoconjunctival xerosis and have low
      serum vitamin A levels for several months to years, retinal function will remain
      normal until the tissue stores of vitamin A are depleted. A long-term
      ophthalmologic follow-up of JIB patients, therefore, is recommended.

PMID- 8473090
TI  - Bilateral orchiectomy in the management of stage D-2 prostate cancer.
AB  - The records of 115 patients with stage D-2 prostate cancer treated with bilateral
      orchiectomy were reviewed to determine the effect of this procedure in previously
      untreated patients and in patients who had prior hormone therapy. Previously
      untreated patients survived 22.8 months while those who had prior hormone therapy
      survived 39.3 months (p < 0.001). Bilateral orchiectomy may be of additional
      clinical benefit in patients with advanced prostate cancer who have had prior
      hormone therapy.

PMID- 8473091
TI  - Experience in 4500 cases of laparoscopic sterilization.
AB  - Laparoscopic sterilization under local anaesthesia was found to be a safe and
      effective procedure and the most popular method of voluntary sterilization in
      rural India. The difficulties encountered included omental emphysema and
      prolapse, bleeding from the mesosalpynx, cervix and abdominal wound, oedematous
      fallopian tubes and their bisection. In 3 cases, Verres needle penetrated the
      colon but it was diagnosed before inserting the trocar and cannula. Cardiac and
      respiratory arrest occurred in one case each but the patients could be revived
      and there was no mortality. In 3 cases, laparoscopy had to be abandoned because
      the laparoscope could not be passed into the peritoneal cavity. The failure rate
      was 0.5 percent.

PMID- 8473092
TI  - An improved method for transpyloric placement of nasoenteric feeding tubes.
AB  - Post pyloric placement of small bore feeding tubes can be an elusive goal.
      Failure to achieve the post pyloric position can result in fatal complications.
      The following study presents a cost-effective, rapid technique for achieving post
      pyloric placement of feeding tubes utilizing gastric insufflation and right
      lateral decubitus positioning. Four study groups were identified. Group I
      utilized the new technique as first attempt (n = 21). Group 2 utilized the
      traditional, standard technique of insertion as first attempt (n = 20). Group 3
      consisted of Group I failures after which the new technique was utilized (n = 19)
      Group 4 consisted of Group 3 failures after which the new technique was
      reattempted. Overall success rate of the new technique was 93%. This was highly
      significant with p < 0.0001. No significant difference was noted between
      inserters or type of tube used. The new technique described required no expensive
      equipment, minimal training and consistently allowed for transpyloric passage of
      the feeding tube.

PMID- 8473093
TI  - Esophago-rectal reflex. Description and clinical significance.
AB  - The present communication describes the "esophago-rectal reflex" and its clinical
      significance. The study was performed in 19 healthy volunteers and 14 constipated
      subjects. The technique comprised the introduction into the esophagus of a
      balloon-tipped tube so that the balloon lay within the lower esophageal sphincter
      (LES). The rectal and rectal neck pressures were measured by means of perfused
      open-ended tubes. The esophageal balloon was inflated with 2, 4 and 6 ml water
      and the responses of the rectal and rectal neck pressures were recorded.
      Distension of the LES was accompanied by significant rectal pressure increase (P
      < 0.001); the pressure increased with increasing LES distension. Anesthetized LES
      mucosa did not evoke the rectal pressure response. The rectal neck pressure did
      not show significant change with LES distension (P > 0.05). Both the rectal and
      rectal neck pressures showed insignificant response to LES distension in
      constipated subjects (P > 0.05). The esophago-rectal reflex seems to be conducted
      through the myenteric plexus from the esophagus down along the gut wall to the
      rectum, initiating rectal contractions. It is likely that these signals alarm the
      rectum for the entrance of new contents in the gut so that the rectum may
      evacuate its contents.

PMID- 8473094
TI  - Suturing techniques for a restricted operating space.
AB  - The movements of the needle holder and the needle do not correspond when the
      needle grip is modified for suturing in awkward sites. In this study the range of
      movement of the needle holder was determined for three modified grips and the
      optimum suturing methods were determined for horizontal and vertical suturing
      fields and for restricted and open operating spaces. Gripping a needle obliquely
      resulted in a 90 degree counterclockwise rotation of the range of movement of the
      needle holder. Gripping it after rotation deviated the needle holder without
      altering the range of movement. A combined grip achieved by rotating after
      shifting had an intermediate effect. The optimum suturing for a restricted
      horizontal operating space was to use a half-circle needle in the first half of
      its range of movement with the rotated grip. With the oblique grip the last half
      of the range should be used and in the middle the combined grip is used although
      gripping the needle is most stable with the oblique grip. For a restricted
      vertical operating space, the third quarter of the movement range was allotted to
      the rotated grip and the last quarter to the combined grip.

PMID- 8473095
TI  - [Renaissance of laparoscopic techniques in diagnosis of abdominal diseases].

PMID- 8473096
TI  - [Therapeutic laparoscopy for the internist].

PMID- 8473097
TI  - [The importance of conventional radiology in the current gastroenterology
      diagnostic concept].

PMID- 8473098
TI  - [Computerized tomography in diseases of parenchymatous organs of the epigastrium-
      liver, pancreas, spleen].

PMID- 8473099
TI  - [MR spectroscopy. Possibilities for the functional assessment metabolically
      active abdominal organs].

PMID- 8473100
TI  - [Methods in nuclear medicine and their significance for diagnosis of
      gastrointestinal diseases].

PMID- 8473101
TI  - [Electronic documentation of images and findings in gastroenterology].

PMID- 8473102
TI  - [Right-sided epigastric pain and ascites in a 24-year-old female patient].

PMID- 8473103
TI  - [Jaundice].

PMID- 8473104
TI  - Introduction of Eliot L. Berson, 1992 Friedenwald Award winner.

PMID- 8473105
TI  - Retinitis pigmentosa. The Friedenwald Lecture.

PMID- 8473106
TI  - Determination of cellular types in the retina.

PMID- 8473107
TI  - Incremental light detection thresholds across the central visual field of human
      albinos.
AB  - PURPOSE: The authors investigated central retinal function in albinism by
      measuring incremental light detection thresholds in a group of oculocutaneous
      human albinos. METHODS: Eleven oculocutaneous human albinos (six tyrosinase
      negative and five oculocutaneous positive), six patients with idiopathic
      congenital nystagmus, and six normal control subjects participated in the study.
      Using a Goldmann bowl perimeter, incremental light detection thresholds were
      measured in the vertical meridian across the central +/- 30 degrees of the
      retina. Target presentation times were 1 sec for all subjects, and in the case of
      four albinos and one patient with idiopathic nystagmus, they were limited to the
      low-velocity period of each nystagmus cycle. RESULTS: For the normal control
      subjects, the maximum sensitivity was found to be -0.60 +/- 0.10 log units. By
      comparison, at 0 degrees, a range of sensitivities was obtained from the albino
      subjects (-0.9 to -2.1 log units) and from those with idiopathic nystagmus (-0.7
      to -1.9 log units). The albinos had diverse retinal sensitivity profiles ranging
      from a near-normal peaked curve to a flat homogeneous profile. A variety of
      sensitivity profiles was also detected in those with idiopathic nystagmus,
      although, compared with the albino curves, a greater proportion were peaked. No
      sensitivity differences were found between the short and the longer target
      presentations. CONCLUSIONS: The variety of retinal sensitivity profiles obtained
      in this study suggests that, in albinism, considerable intersubject variability
      in the degree of foveal hypoplasia exists and that albino "foveal" function can
      reach near-normal levels, for at least some visual tasks.

PMID- 8473108
TI  - Magnification perimetry.
AB  - PURPOSE: The authors used a method of spatial scaling to quantify the
      eccentricity-related decline in differential light sensitivity as a function of
      visual field meridian and age. METHODS: Differential light threshold at the fovea
      was measured in two groups of subjects of differing age (young mean age, 23.6 yr;
      standard deviation, 2.4 yr; elderly mean age, 69.6 yr; standard deviation, 6.2
      yr) using a Goldmann size I stimulus moving across fixation at 1 degree/sec. With
      luminance kept constant, eccentricity thresholds for kinetic stimuli of
      increasing magnification were then measured. The results were analyzed in terms
      of the E2 value, which specifies the eccentricity at which the stimulus size must
      double to maintain performance equivalent to that at the fovea. RESULTS: For the
      young subjects, eccentricity thresholds increased linearly with an increase in
      stimulus diameter for most meridians. E2 varied between 5-12 degrees, depending
      on the meridian, and showed the same meridional trend as that of retinal ganglion
      cell distribution, although the magnitudes of E2 were different. For the elderly
      subjects, the eccentricity thresholds increased in a nonlinear manner with the
      stimulus diameter. CONCLUSIONS: Further factors, such as spatial summation, must
      also determine the eccentricity dependence of the differential light threshold
      because ganglion cell density decreases at a much faster rate than the
      differential light threshold. The most marked effects of age on differential
      light sensitivity occur at the fovea and beyond 20 degrees in the peripheral
      field, with a relative sparing in the pericentral area.

PMID- 8473109
TI  - Quantitative evaluation of saccadic and smooth pursuit eye movements. Is it
      reliable?
AB  - PURPOSE: The authors evaluated the reliability of the coefficients of the (1)
      amplitude/duration and (2) amplitude/peak velocity relationships of the mean
      precision values and the mean latency values (saccadic eye movements) and the
      coefficients of the target velocity/gain relationship (smooth pursuit eye
      movements). They computed test-retest maximum variability limits for these
      parameters. METHODS: After a 1-week interval, saccadic and smooth pursuit eye
      movements were recorded twice from 20 healthy subjects; 12 of these subjects
      underwent a third recording session. The estimate of the intraclass coefficient
      of reliability, R, was adopted to evaluate the reliability of eye movement
      quantitative analysis. RESULTS: The data demonstrated that the reliability was
      fairly good for the amplitude/peak velocity relationship, was good for the
      precision, and was excellent for the amplitude/duration, the target velocity/gain
      relationships, and the latency. CONCLUSIONS: Quantitative analysis of both
      saccadic and smooth pursuit eye movements is reliable. One statistic used to
      estimate reliability, ie, the within-subjects mean square value, also enables the
      determination of test-retest normal variability values for both the variances and
      the differences of measurements.

PMID- 8473110
TI  - Predictive value of the pattern electroretinogram in high-risk ocular
      hypertension.
AB  - PURPOSE: The pattern electroretinogram (PERG) is reduced in early glaucoma and in
      some eyes with ocular hypertension (OHT). This study was designed to test the
      ability of the PERG to predict the development of visual field loss in OHT eyes.
      METHODS: In 29 eyes of 18 patients with high-risk OHT, the visual fields were
      tested, and the PERG was recorded using counterphasing checkerboard patterns at
      check sizes of 0.8 degrees and 15 degrees at 16 reversals/sec. The visual fields
      were retested 11-31 mo later. Initially, 12 eyes had pathologic PERG recordings.
      RESULTS: During the observation period, visual field loss developed in five eyes.
      All these eyes had a pathologic PERG recorded during the first visit. Of the eyes
      that had a normal PERG, none had field changes. CONCLUSIONS: Within the
      reservations of the limited sample size and follow-up interval, these findings
      suggest that the PERG can be used to discriminate between patients with OHT who
      will develop visual field loss and those who will not.

PMID- 8473111
TI  - Retinal blood flow by hydrogen clearance polarography in the streptozotocin
      induced diabetic rat.
AB  - PURPOSE: The authors compared retinal blood flow in rats after 5 weeks of
      streptozotocin (STZ)-induced diabetes with that in age-matched control animals.
      METHODS: The flow measurements were based on the hydrogen clearance technique and
      the intraocular placement microelectrodes at the surface of the retina. The
      hydrogen was delivered by bolus injection (100 microliters) of hydrogen-saturated
      saline into the ipsilateral carotid artery using a cannula through the lingual
      artery. The rats were anesthetized and artificially ventilated. Care was taken to
      match the systemic blood pressure and blood gases in the two groups. RESULTS: The
      mean retinal blood flow in the STZ group after 5-6 weeks duration of
      hyperglycemia was 487 +/- 59 ml/min/100g (standard error) compared with 330 +/-
      16 ml/min/100 g in the age-matched controls. The variation in retinal blood flow
      was far more pronounced in the STZ group, even in different locations in the same
      eye. Changes in fundus appearance were also noted, with second-order arterioles
      being more apparent and the retina more "pinkish" in appearance in the STZ
      animals. CONCLUSIONS: The mean retinal blood flow in the region of retina studied
      in the two groups was significantly higher in the STZ animals than in age-matched
      controls. The increased heterogeneity of retinal blood flow may reflect a
      disruption to the normal blood flow control mechanisms in the retina after only 5
      weeks of STZ-induced diabetes.

PMID- 8473112
TI  - Heterogeneity of endothelium-dependent regulation in ophthalmic and ciliary
      arteries.
AB  - PURPOSE: Endothelial cells modulate vascular tone by releasing the vasodilator
      nitric oxide (NO) or the vasoconstrictor endothelin-1. From one vascular bed to
      another and between vessels of different diameter, heterogeneities of endothelium
      dependent regulatory mechanisms exist. Hence, the current study compared the
      effects of NO and endothelin-1 in the porcine ophthalmic artery and one of its
      branches, the ciliary artery. METHODS: Porcine eyes were obtained at the
      slaughterhouse. The ophthalmic and ciliary arteries were dissected free under a
      microscope and suspended in myograph systems (95% O2 and 5% CO2, 37 degrees C)
      for isometric tension recording. RESULTS: In both vessels, bradykinin stimulated
      the release of NO, but the sensitivity to bradykinin increased with decreasing
      vascular diameter. By contrast, the basal release of NO became less efficient in
      inhibiting contractions to serotonin and endothelin-1 in ciliary versus
      ophthalmic artery. Endothelin-1 induced potent contractions that were more
      pronounced in ciliary than in ophthalmic artery. Serotonin-induced contractions
      also were more efficient in ciliary artery but less than to those to endothelin
      1. Contractions to serotonin were inhibited in both blood vessels by the 5-HT2
      serotonergic antagonist ketanserin. CONCLUSIONS: Thus endothelium-derived
      vasoactive substances are potent regulators of porcine extraocular ophthalmic
      circulation. Their effects increase with decreasing vascular diameter, suggesting
      an important role of NO and endothelin-1 in the regulation of ophthalmic
      circulation. A dysfunction of these regulatory mechanisms could have implications
      about the pathogenesis of ophthalmic complications seen in diabetes,
      hypertension, and in certain forms of glaucoma associated with ocular vasospasms.

PMID- 8473113
TI  - Electroretinographic results and ocular vascular perfusion in type 1 diabetes.
AB  - PURPOSE: Although functional changes in vision are known to occur before overt
      diabetic retinopathy, the relationship between (1) the degree and timing of any
      visual dysfunction and (2) the duration and control of diabetes remains poorly
      defined. The authors compared the ability of patients with insulin-dependent
      diabetes mellitus and nondiabetic subjects to sustain normal retinal function
      during transient physiologic stress. Such provocative testing may be clinically
      useful to show subclinical dysfunction. METHODS: Retinal function during altered
      ocular perfusion pressure (OPP) produced by body inversion and scleral suction
      was quantified by scotopic white-flash electroretinography (ERG) in 11 young
      volunteers with insulin-dependent diabetes mellitus but without significant
      retinopathy and a group of normal subjects. RESULTS: Baseline ERG a- and b-waves
      did not differ across test groups, but the a-wave implicit time was prolonged for
      diabetic patients. Furthermore, four of five oscillatory potentials (OP) in the
      diabetic patients were smaller than those in the nondiabetic subjects. Although
      the amplitude and implicit time of some OP in the diabetic patients were changed
      to a larger degree, the overall OP response profile did not differ widely from
      that for the nondiabetic subjects. Also, the a- and b-waves and the OP index for
      the test eye in diabetic and normal subjects did not differ, but the control eyes
      showed some differences in these parameters. CONCLUSIONS: Retinal function and
      vascular autoregulation in young diabetic patients without visible retinopathy
      did not differ from those in nondiabetic subjects; they were reduced in both
      groups by a short-term attenuation of the OPP.

PMID- 8473114
TI  - Microinjection of L-lactate in the preretinal vitreous induces segmental
      vasodilation in the inner retina of miniature pigs.
AB  - PURPOSE: The authors investigated the hypothesis that the retinal vasomotor
      effect of acute hypoxia is mediated by lactate. METHODS: Retinal vasomotor
      arteriolar response was measured in the intact eyes of miniature pigs after
      systemic administration and after local preretinal juxta-arteriolar
      microinjection of lactate. RESULTS: Injection of L-lactate (physiologically
      produced lactate) into the systemic circulation decreased the arterial blood pH
      but did not dilate the retinal arterioles. By contrast, microinjections of L
      lactate (0.5 mol/l, pH 2) into the juxta-arteriolar vitreous induced a reversible
      segmental vasodilation of 32 +/- 4% (standard deviation). This vasodilation did
      not depend on periarteriolar pH lowering because microinjections of a 0.5 mol/l L
      lactate at neutral pH also dilated segmentally the retinal arterioles (37 +/-
      5.5%). The effect of lactate was stereospecific because microinjections of the
      isomer D-lactate (0.5 mol/l, pH 2) did not affect the arteriolar caliber (P =
      0.63). Perfusion of the eye with the cyclo-oxygenase inhibitor indomethacin,
      through cannulization of the sublingual artery, caused a generalized reversible
      arteriolar vasoconstriction of 51 +/- 9.8% but did not inhibit the segmental
      vasodilator effect of locally microinjected L-lactate. CONCLUSIONS: It is known
      that acute hypoxia in the isolated retina causes an increase in lactate
      production. In the intact eye, there is a retinal vasodilation, which is not
      inhibited by indomethacin. Hence, it was concluded that retinal, but not blood,
      lactate is a possible mediator of the acute hypoxia-induced vasodilation.

PMID- 8473115
TI  - Aclacinomycin A in the treatment of experimental proliferative vitreoretinopathy.
      Efficacy and toxicity in the rabbit eye.
AB  - PURPOSE: Aclacinomycin A is an oligosaccharide anthracycline that, by contrast
      with daunomycin, lacks carcinogenicity. The authors evaluated the efficacy of
      aclacinomycin A in prevention of experimental proliferative vitreoretinopathy
      (PVR) and its toxicity on the rabbit retina. METHODS: Dutch-belted rabbit were
      used to create a model for traction retinal detachment. Seven to 10 days after
      vitreous gas compression, 25,000 homologous fibroblasts were injected into the
      vitreous cavity. Subsequently, the eyes received either sham injections or doses
      of 6, 30, or 60 nmol of aclacinomycin A, respectively. The fundus findings were
      documented on days 7, 14, and 28 after the fibroblast injection. The toxicity
      studies were conducted according to the same protocol as was used for the
      efficacy evaluation but without the fibroblast injection. Simultaneous
      electroretinograms were recorded on days 0, 3, 7, and 14 from the right eyes that
      were injected with 30 or 60 nmol of aclacinomycin A and the left eyes that were
      sham injected. Morphologic studies were conducted on the eyes enucleated on days
      3, 7, and 14 after drug exposure. RESULTS: Intraocular administration of 30 nmol
      of aclacinomycin A on day 2 after fibroblast injection resulted in a detachment
      rate of 37.5% (controls, 100%; P < 0.01, by Fisher's exact test). Administration
      of 60 nmol of aclacinomycin A 3 days after fibroblast injection resulted in a
      detachment rate of 26.7% (controls, 100%; P < 0.0001). Six nanomoles of
      aclacinomycin A 3 days after fibroblast injection had no effect. No
      electroretinogram changes were present in eyes treated with 30 nmol of
      aclacinomycin A. Such recordings from eyes exposed to 60 nmol of aclacinomycin A
      demonstrated decreased a- and b-waves on day 3; these completely recovered by day
      7. Morphologic studies of these eyes revealed no damage to the retina.
      CONCLUSIONS: These results suggest that aclacinomycin A should be considered an
      alternative to daunomycin for treatment of human PVR because, in addition to its
      lack of carcinogenicity, it shows good efficacy and causes less retinal toxicity.

PMID- 8473116
TI  - Stereopsis after congenital cataract.
AB  - PURPOSE: The authors determined whether stereopsis can be demonstrated in
      children treated for congenital cataract after compensating for their amblyopia
      and strabismus. METHODS: A custom-made set of large stereograms was used to
      compensate for amblyopia and presented in a synoptophore to facilitate motor
      fusion. Each pair of stereograms contained five wide vertical bars of high
      contrast, of which two or three were in crossed disparity. The authors aligned
      the stimuli in the synoptophore, then decreased the disparity until the child
      could no longer identify which bars appeared to be "in front." RESULTS: In normal
      children (n = 25), stereo acuity on this test (Tytla-Lewis-Maurer-Brent [TLMB]
      test) correlated well with the Titmus and Randot results within the ranges
      measured by those tests. Seven children in whom a traumatic cataract had
      developed after 6 yr of age (four with no clinical stereopsis) had TLMB test
      stereo acuities ranging from 225 to 28 arc-sec. Of 30 children treated for
      congenital cataract with no clinical stereopsis, 5 regularly achieved a TLMB
      stereo acuity of up to 225 arc-sec, and 2 with Titmus stereo acuities up to 200
      arc-sec, each had a TLMB stereo acuity of 112 arc-sec. These seven congenital
      cases (two unilateral and five bilateral) with measurable TLMB acuities are among
      those with the shortest deprivation, the highest minimum resolvable acuity, and
      the highest contrast sensitivity. CONCLUSIONS: By compensating for amblyopia and
      strabismus, stereopsis can be demonstrated in some form-deprived amblyopic
      patients.

PMID- 8473117
TI  - The inhibitory effects of integrin antibodies and the RGD tripeptide on early eye
      development.
AB  - PURPOSE: The authors investigated the effects of probes that disrupt integrin
      extracellular matrix interactions on early eye development. METHODS: Antibodies
      and peptides that have been shown in other studies to block the interaction of
      cell surface integrins with various ligands were microinjected into the preoptic
      regions of chick embryos. Eye morphogenesis and biochemical differentiation of
      ocular tissue layers were assessed by histologic and immunohistochemical
      analyses. RESULTS: Antibodies that bind to the beta 1 subunit of integrin and
      block its function prevented normal eye morphogenesis but did not block
      expression of certain cell differentiation markers. The RGD tripeptide showed the
      same inhibitory capacity as did the anti-integrin antibodies. CONCLUSIONS:
      Integrin-based cell-cell and/or cell-extracellular matrix interactions are
      important in early eye morphogenesis. By contrast, certain aspects of tissue and
      cell differentiation, such as the expression of carbonic anhydrase II, are
      controlled independent of morphogenesis.

PMID- 8473118
TI  - Latent nystagmus. Release and suppression at will.
AB  - PURPOSE: The authors report the cases two unusual patients with infantile
      convergent strabismus and latent nystagmus. METHODS: Electronystagmography was
      used. RESULTS: The two patients were able to release and suppress their nystagmus
      at will. With voluntary effort, the nystagmus became as strong as it was when
      brought out by occlusion of the squinting eye and, in one of the patients, even
      stronger. The nystagmus beat toward the fixing eye, and the slow phases had
      slightly decreasing velocity or were linear. Both patients were able to evoke and
      to stop the nystagmus in front of visual contours and, one of them, also in the
      dark. CONCLUSIONS: This phenomenon could be the result of voluntary control of
      the visual input contributed by the amblyopic eye and/or a direct influence of
      will on the slow eye movement and fixation systems. A mechanism related to
      vergence eye movements is less likely. The ability to release and suppress a
      latent nystagmus at will is unusual and, to the authors' knowledge, has not been
      described before.

PMID- 8473119
TI  - Quantitation of total protein deposits on contact lenses by means of amino acid
      analysis.
AB  - PURPOSE: This study was done to characterize and quantify the protein deposits on
      worn contact lenses and to measure the residual deposits after extraction in 2%
      sodium dodecyl sulfate and the total protein deposits on worn vifilcon,
      atlafilcon, and tefilcon lenses (Food and Drug Administration Types IV, II, and
      I, respectively). METHODS: Contact lens extracts were separated with gel
      electrophoresis, and the amount of protein was estimated after silver staining
      and densitometry. To determine the residual deposits, the contact lenses were
      hydrolyzed, and amino acid analysis was carried out by reverse-phase high
      performance liquid chromatography after precolumn derivatization with
      phenylisothiocyanate. Refinement of the hydrolysis conditions was undertaken to
      minimize interference by the lens polymers. RESULTS: The extraction removed only
      approximately 25% of the protein deposits. Mild hydrolytic conditions, 20 hr in 6
      N HCl at 105 degrees C, were found to cause minimal polymer interference. Of the
      350, 10, and 20 micrograms of protein typically determined on whole vifilcon,
      atlafilcon, and tefilcon lenses, the polymers were estimated to account for 4,
      0.5, and less than 0.4 micrograms, respectively. CONCLUSIONS: Hydrolysis of worn
      contact lenses with subsequent amino acid separation can be applied to determine
      the total protein deposits without the uncertainty inherent in extraction of the
      deposits.

PMID- 8473120
TI  - In vitro growth and differentiation of rabbit bulbar, fornix, and palpebral
      conjunctival epithelia. Implications on conjunctival epithelial
      transdifferentiation and stem cells.
AB  - PURPOSE: The anterior surface of the eye is covered by several physically
      contiguous but histologically distinguishable epithelial overlying the cornea,
      limbus, bulbar conjunctiva, fornix conjunctiva, and palpebral conjunctiva. It is
      important to determine whether the different phenotypes of these epithelia are
      the result of intrinsic divergence, extrinsic modulation, or a combination of
      both. Based on keratin expression and cell kinetic criteria, the authors
      previously suggested that corneal epithelial stem cells may actually reside in
      the limbal basal layer. METHODS: In this article, the relationship between the
      corneal-limbal epithelial cells and conjunctival epithelial cells was analyzed by
      comparing their growth and differentiation properties in an identical cell
      culture environment. RESULTS: Using Dispase instead of trypsin to dissociate the
      cells, the authors were able to grow all five rabbit ocular surface epithelia in
      the presence of 3T3 feeder cells. They found that corneal and limbal cells
      synthesize identical keratins, including large amounts of the K3 and K12 markers
      of corneal-type differentiation. By contrast, all three conjunctival epithelia
      shared another keratin pattern, with large amounts of simple epithelial keratins
      but only minute amounts of K3/K12 keratins. CONCLUSIONS: This observation,
      coupled with previous findings that the "transdifferentiation" of conjunctival
      epithelial cells to corneal epithelium appears to be both incomplete and
      reversible, provides strong evidence that (1) the limbal-corneal epithelial cells
      form a lineage distinct from the conjunctival lineage and (2) conjunctival
      transdifferentiation actually represents a process of environmental modulation.
      In addition, of the three types of conjunctival epithelial cells, fornix cells
      were found to have a much greater proliferative potential than bulbar and
      palpebral cells. This observation, coupled with recent finding that fornix is
      enriched in slow-cycling (label-retaining) cells, raises the possibility that
      conjunctival epithelial stem cells may preferentially reside in the fornix.

PMID- 8473121
TI  - Integrins in the wounded and unwounded stratified squamous epithelium of the
      cornea.
AB  - PURPOSE: The authors determined the synthesis, cell surface expression, and
      localization of integrins in the rat corneal epithelium to detect whether any
      changes in integrins occur during epithelial migration in response to simple
      debridement wounding. METHODS: Immunoprecipitation analysis of extracts from
      either metabolically or surface-labeled rat epithelia was done to assess the
      synthesis and cell surface expression of integrins in the normal cornea. The
      localization of integrins was determined by indirect immunofluorescence of frozen
      sections obtained from control corneas and from those after debridement wounding.
      Immunoblotting of extracts from time course experiments was done on organ
      cultures of rat corneas after debridement to determine if any changes in the
      amounts of integrins occurred. The cell adhesion function of integrins on control
      and migrating epithelial cells was evaluated by cell adhesion assays. RESULTS:
      The data indicated that the corneal epithelium has a variety of distinct integrin
      subunits including beta 1, beta 4, beta 5, alpha 2, alpha 3, alpha 5, alpha 6,
      and alpha v. Although beta 1, beta 5, alpha 2, alpha 3, and alpha v were
      localized to sites of apparent cell-cell contact, alpha 5, alpha 6, and beta 4
      were localized specifically to the basal membrane of the basal cells. Little
      change occurred in the localization of integrins in the migrating epithelial
      sheets. At 3, 6, 9, 12, 18, and 24 hr after wounding, the amount of the beta 1,
      beta 4, alpha 3, alpha 5, and alpha 6 integrin subunits (as measured by
      immunoblots) was not altered relative to that of the control corneas. Adhesion
      assays also showed no differences in adhesion of stationary versus migrating
      corneal epithelial cells to fibronectin and laminin. CONCLUSIONS: Integrin
      localization, production, and cell adhesion function in the stratified squamous
      epithelium of the cornea are not dramatically altered during epithelial cell
      migration over simple debridement wounds. Integrins in the cell membrane at sites
      of cell-cell interaction and as components of the hemidesmosomes in stationary
      epithelia may be available for rapid recruitment as epithelial cell migration
      proceeds.

PMID- 8473122
TI  - Expression of basic fibroblast growth factor and its receptor in the retina of
      Royal College of Surgeons rats. A comparative study.
AB  - PURPOSE: The aim of this study was to identify whether abnormalities in the
      synthesis of basic fibroblast growth factor (bFGF) or its receptor (bFGF-R) were
      responsible for the photoreceptor dystrophy in Royal College of Surgeons (RCS)
      rats. METHODS: The polymerase chain reaction was used to detect the expression of
      bFGF and bFGF-R messenger RNA in the retinal pigment epithelial (RPE) cells and
      the neural retina of RCS dystrophic rats and in PVG/C and RCS-rdy+ control
      animals. RESULTS: In the RPE, it was found that there was no significant
      difference in the expression of bFGF and bFGF-R between RCS rats and the controls
      at the ages of 21 days and 3 mo. In the neural retina, the level of bFGF
      expression was lower in the 21-day-old RCS rats compared with the control group,
      but bFGF-R expression was as strong as in the PVG/C and RCS-rdy+ animals.
      However, in 3-mo-old RCS rat neural retina, the bFGF and bFGF-R expression was
      found to be significantly lower than in the control animals. CONCLUSIONS:
      Although the mutant gene in RCS rats is expressed in the RPE cells, these results
      suggest that there is no significant defect in bFGF or bFGF-R expression in the
      RPE cells of RCS rats, which would be an initiating factor in the development of
      photoreceptor degeneration in these animals. The lowered bFGF levels in the
      neural retina at early stages (postnatal day 21) may explain the prolongation of
      photoreceptor survival when exogenous bFGF is injected.

PMID- 8473123
TI  - Correlation between the physiologic and morphologic changes in experimental
      autoimmune uveitis induced by peptide G of S-antigen.
AB  - PURPOSE: The authors followed and correlated the physiologic and morphologic
      changes occurring in experimental autoimmune uveitis (EAU) induced by the peptide
      G of S-antigen. METHODS: EAU was induced in Lewis rats by footpad inoculation of
      a 13-amino acid synthetic peptide (peptide G) in complete Freund's adjuvant.
      Electroretinography (ERG) was used to follow the physiologic changes, and light
      and electron microscopy were used to examine the morphologic changes. RESULTS:
      Serial ERG recordings showed a progressive decrease in the b-wave amplitude and a
      depression of retinal sensitivity beginning on day 18-21 postinoculation (PI). By
      day 35 PI, the b-wave was decreased by 91%, and the sensitivity was depressed by
      4.68 log units. Negative ERG were recorded during the intermediate and late
      stage. Light and electron microscopy of the retina showed better correlation of
      the pathologic changes with b-wave depression than with PI day. CONCLUSIONS: ERG
      recordings were a good method to detect, follow, and quantify the severity of
      EAU. Their good correlation with the morphologic changes showed that this method
      can be used to assess the condition of the retina noninvasively.

PMID- 8473124
TI  - Simulation of corneal neovascularization by inverted diffusion limited
      aggregation.
AB  - PURPOSE: The authors modeled the normally avascular mammalian cornea response to
      injury by neovascularization. The nature of this process remains obscure,
      although diffusion mechanisms are thought to be involved. METHODS: Corneal
      neovascularization was simulated using fractal stochastic computer models for
      nonequilibrium diffusion (inverted diffusion limited aggregation) and a
      stochastic ballistic aggregation. RESULTS: The inverted diffusion limited
      aggregation model was found to generate patterns strikingly similar to those
      observed in pathologic neovascularization of the cornea in vivo. CONCLUSIONS:
      This result supports the role of random diffusion mechanisms modified by
      environmental factors, such as the release of angiogenic factors in corneal
      angiogenesis.

PMID- 8473125
TI  - Single-cell contraction assay for human ciliary muscle cells. Effect of
      carbachol.
AB  - PURPOSE: The authors developed an assay to observe the contraction of a single
      human ciliary muscle cell. METHODS: Cultured human ciliary muscle cells were
      partially detached from the culture dish by incubation with a nonenzymatic
      dissociation buffer and treated with carbachol or pilocarpine. Contraction was
      quantified by measuring the cross-sectional surface areas of the cells. RESULTS:
      Carbachol decreased the cell surface area in a time-dependent manner. Contraction
      was observed within 1 min after the addition of carbachol and completed in less
      than 15 min. The effect of carbachol was dose dependent. For example, at 10 min
      after treatment with 10 mumol/l carbachol, the relative surface areas of cells
      decreased to 47% +/- 4% (mean +/- standard error of the mean, n = 7, with surface
      area at 0 min defined as 100%). The relative surface areas were 74% +/- 4% (n =
      7) after 1 mumol/l and 100% +/- 9% (n = 7) after 0.1 mumol/l carbachol treatment.
      This contractile effect was antagonized by pretreatment with atropine, a specific
      muscarinic antagonist. CONCLUSIONS: A simple method was established to study the
      functional changes of human ciliary muscle cells.

PMID- 8473126
TI  - Whatever happened to abstracts from different sections of the association for
      research in vision and ophthalmology?
AB  - PURPOSE: The authors investigated the fate of abstracts from each ARVO section
      (May 1985 meeting), the overall publication percentage, and the journals in which
      the abstract-derived articles were published. METHODS: They performed a MEDLINE
      search by first author for 25 or 26 randomly selected abstracts from each section
      to identify those that led to full-length articles in peer-reviewed journals.
      RESULTS: Overall, 63% of abstracts led to full-length articles in peer-reviewed
      journals within our search period of 87 months. The publication rate of oral
      presentation abstracts (68%) was significantly higher than that of poster
      presentation abstracts (56%). A greater proportion of basic science-oriented
      abstracts (67%) led to publication than the clinically oriented abstracts (56%).
      The rate of publication was lowest for the Cornea section (40%) and highest for
      Physiology and Pharmacology (80%) and Biochemistry (76%). The abstract-derived
      articles were published in 67 different peer-reviewed journals, with 43% of the
      articles appearing in only five journals. CONCLUSIONS: The fact that the majority
      of abstracts led to full-length articles supports ARVO's goal of a large
      interdisciplinary appeal with the exchange of ideas among different
      investigators.

PMID- 8473127
TI  - A comparison of SPECT and planar ventilation perfusion lung scanning.
AB  - In order to define the role of Single Photon Emission Computed Tomography (SPECT)
      in the diagnosis of pulmonary embolus; SPECT and Planar ventilation and perfusion
      lung studies were performed consecutively on eleven patients referred with
      suspected embolus. Three patients were shown to have 'high probability'
      ventilation perfusion mismatches. SPECT imaging allowed segmental localisation of
      the perfusion defect and revealed additional defects not seen on planar scans.
      SPECT lung study was performed with minimal technical difficulty and was well
      tolerated by all patients studied. SPECT is likely to become the method of choice
      for investigating patients referred with suspected pulmonary embolus.

PMID- 8473128
TI  - A case report of an Irish family displaying nail-patella syndrome.
AB  - This is a case report of an Irish family displaying classical features of Nail
      Patella Syndrome--also known as Osteo-onycho Dystrophy--involving four members
      over three generations. This rare autosomal dominant disorder is well defined
      with four classical characteristics: dysplasia of finger nails, hypoplastic or
      absent patellae, hypoplasia of the head of the radius and often the capitulum of
      the humerus leading to subluxation or dislocation of the radial head and iliac
      prominences, known as iliac horns which are usually bilateral and symmetrical.
      Renal dysfunction is also commonly reported. This is the first report of the Nail
      Patella Syndrome in an Irish family.

PMID- 8473129
TI  - Thoraco-abdominal aortic aneurysm replacement using hypothermic circulatory
      arrest.

PMID- 8473131
TI  - The management of hyperlipidaemia.

PMID- 8473130
TI  - Prevalence of metronidazole-resistant Helicobacter pylori in dyspeptic patients.
AB  - Susceptibility to metronidazole of 213 clinical strains of H. pylori from
      dyspeptic patients was determined by a plate dilution method. Seventy two (33.8%)
      of the strains were resistant to metronidazole (MIC > 8 mg/L), 20 of these were
      from 24 patients who had received previously metronidazole (83.3%), giving a
      primary (pretreatment) resistance rate of 27.5% (52/189). The resistance rate was
      higher in women than in men, especially aged 50 to 59 years old (43.6% vs 23.3%,
      p < 0.001). The resistance rate was lower in patients at 60 or over (9.8%), but
      similar between the younger patients groups (38.8% - 49.0%). There was no
      difference in the resistance rate between peptic ulcer disease (32.6%) and
      nonulcer dyspepsia (34.7%). These data indicated that metronidazole resistance in
      H. pylori is absolutely associated with previous use of the drug, and the higher
      resistance rate in women may be due to the more frequent prescription of the drug
      for their gynaecological infection or operation. Therefore, testing of
      susceptibility of H. pylori to metronidazole is important. A new susceptibility
      testing technique, the E-test was evaluated in this study and found to give
      comparable results to the plate dilution method and also had the advantage of
      being simple to perform.

PMID- 8473132
TI  - Management of congestive cardiac failure.

PMID- 8473133
TI  - Management of mild to moderate hypertension.

PMID- 8473134
TI  - Angiotensin converting enzymes inhibitors in heart failure.

PMID- 8473135
TI  - The management of chronic epilepsy.

PMID- 8473136
TI  - The use of primary care services by drug users attending a HIV prevention unit.
AB  - Intravenous drug using clients of a Dublin HIV Prevention Unit were interviewed
      about their use of general practitioner services. Sixty eight percent of clients
      had visited a GP within the previous year and 48% were registered with a GP under
      the General Medical Services (GMS) Scheme. Of 161 interviewees 60 were being
      treated with a fixed dose regimen of methadone at the Prevention Unit; this group
      was far less likely to visit a GP with a drug related problem and far less likely
      to have received methadone from a GP. Members of the GMS were much more likely
      than non members to have visited a GP and also more likely to have attended a
      specific GP for all problems besides methadone treatment. Methadone treatment and
      medical cover within the GMS Scheme emerged as important influences on the
      behaviour of clients with respect to general practitioners.

PMID- 8473137
TI  - A review of triplet pregnancy.
AB  - Nineteen sets of triplets were delivered in the National Maternity Hospital
      between January 1st 1980 and December 31st 1990 inclusive. Thirteen triplet
      pregnancies resulted from spontaneous ovulation and six from ovulation induction
      therapy for infertility. Management was conservative. Bed rest and home
      monitoring were not advised routinely and cervical cerclage and tocolytic agents
      were not used. Ten of the patients were delivered by caesarean section. The
      prematurity rate was 79% and five sets of triplets were delivered before 32 weeks
      gestation. The perinatal mortality rate was 35/1000. This reflects a general
      improvement in the obstetric and neonatal care of triplet pregnancy over the past
      decade.

PMID- 8473138
TI  - A case control study of malignant melanoma.
AB  - A case-control study of 100 cases of malignant melanoma (MM) and 100 matched
      controls has been completed. The male:female ratio of patients with MM was 1:2.4,
      which is similar to that found in other European studies and the mean age was
      49.1 years (range 19-82 years). Significant differences were seen between cases
      and controls for area of residence and social class, more cases than controls
      came from rural areas (P = 0.007) and cases were of higher social class than
      controls (P = 0.003) and had attained a higher level of education (P = 0.005).
      Phenotypic differences between cases and controls were also observed, namely
      cases were more likely to have light coloured (blue/grey/green) eyes (P = 0.003)
      and to have had fair/red hair at age 20 (P = 0.004). Cases were also more likely
      than controls to dislike exposure to hot sun (P = 0.008) to report sunburning
      easily (P = 0.001) and to have experienced episodes of sunburn with blistering
      more frequently than controls (P = 0.01). History of longterm exposure to
      ultraviolet radiation (UV) through working outdoors, leisure activities, living
      abroad in sunny climates, or sun holidays was similar between cases and controls.
      This study supports evidence from elsewhere that episodes of acute sunburn in
      susceptible individuals increase risk of MM and that longterm regular exposure to
      UV which is important in non-melanoma skin cancer does not play a major role in
      the development of MM.

PMID- 8473139
TI  - Socioeconomic factors and mortality in small areas.
AB  - The aim of this study was to determine the extent to which variation in
      socioeconomic factors derived from the 1986 census could "explain" variation in
      standardised mortality ratio (SMR) between the 322 electoral wards and district
      electoral divisions (DEDs) in Dublin. Factors examined included percentage of
      population in the various Irish social class groupings, percentage of male
      unemployment, number of cars per private household and number of persons per car.
      Regression analysis between SMR and each of these factors individually showed a
      significant relationship in every case. The explanatory variables studied were
      all highly correlated and stepwise forward multiple regression was used to
      identify factors which had an independent effect. Two factors emerged as
      significant--percentage of persons in social classes 5 & 6 (semiskilled and
      unskilled) and number of cars per private household. This model explained 27.4%
      of the variance in SMR. We conclude that the variation of SMRs between DEDs in
      Dublin can partly be explained by variation in socioeconomic factors.

PMID- 8473140
TI  - Long term home oxygen; current practices in Ireland.
AB  - We set out to determine the number of patients being provided with LTOT by the
      community health services and to review the criteria which are required to be
      fulfilled before LTOT will be provided by these services. We also wished to
      determine whether concentrators or cylinders were in use; how LTOT was managed
      and monitored and assess any possible savings to the health service if all
      patients were supplied with oxygen concentrators rather than cylinder supply.

PMID- 8473141
TI  - Self poisoning: admission to intensive care over a one year period.
AB  - The charts of all cases of self-poisoning admitted to an intensive care unit over
      one year are reviewed Two distinct groups are seen, according to the substances
      ingested The group who took prescription medications tended to be younger, and
      had a better outcome Those poisoned with household or industrial products were
      older, had a longer stay in intensive care, needed more intensive therapy and
      organ support and had a higher mortality.

PMID- 8473142
TI  - HLA typing in Irish psoriatics.
AB  - Histocompatibility antigens were determined in 93 unrelated Irish psoriatic
      patients. The results were compared with the HLA profiles of 253 healthy
      unrelated Irish controls. There was a statistically significant increase in HLA
      B17 (P < 0.0001), B13 (P = 0.02), and B27 (P = 0.015) among the psoriatic
      patients. The frequency of HLAB8 (P = 0.002) and HLA B12 (P = 0.001) was lower
      than expected. When the subgroup of patients with psoriatic arthritis was
      evaluated separately, it was noted that the increase in HLAB27 was highly
      statistically significant (P < 0.0001). The relative risks of an Irish patient
      carrying the major psoriasis associated alleles of developing psoriasis are
      documented;-possession of the HLA B17 and B13 antigens conferring a risk of
      developing psoriasis vulgaris of 6.08 and 2.9 respectively. Further values for
      psoriatic subsets are presented. This is the first report of HLA typing in an
      Irish psoriatic population. The findings are discussed and compared with other
      population groups.

PMID- 8473143
TI  - Clinical applications of echocardiography in patients with acute myocardial
      infarction.
AB  - The ability of echocardiography to visualize ventricular wall motion
      abnormalities induced by ischaemia and infarction makes it an ideal tool in the
      assessment of patients with acute myocardial infarction. Echocardiographic
      derived measurements of infarction severity, such as the wall motion score index,
      correlate well with both early and late complications. Echocardiography is of
      considerable value in the detection of mechanical complications of myocardial
      infarction such as aneurysm and thrombus formation, infarction expansion,
      ventricular septal rupture and mitral regurgitation; Doppler echocardiography is
      of particular worth in the detection of the latter two complications. Serial
      echocardiographic imaging before and after various coronary reperfusion
      strategies allows useful assessment of the success of these strategies. Following
      a myocardial infarction, a predischarge resting or exercise 2-dimensional
      echocardiographic study provides valuable information regarding the likelihood of
      adverse cardiac events during long term follow-up.

PMID- 8473144
TI  - Do not resuscitate orders in an Irish teaching hospital.
AB  - A chart review was performed to determine the resuscitation status of all in
      patients in this hospital on a single day. A decision not to resuscitate had been
      made for 11 (3.7%) of 293 patients. Seven of these patients had a severe stroke,
      two had dementia and one had a malignancy. We identified a further 22 patients
      who would be unlikely to benefit from resuscitative efforts but who had not been
      excluded from resuscitation: four patients with major impairment following a
      stroke, five patients with severe dementia and 13 patients with incurable
      malignancy. A policy of routinely discussing and documenting the resuscitation
      status of patients might reduce the unnecessary performance of cardiopulmonary
      resuscitation.

PMID- 8473145
TI  - Do elderly patients mind how doctors address them?
AB  - A survey was carried out in the Geriatric Unit at Cork Regional Hospital to
      determine how elderly patients would like to be addressed by their doctor. Two
      hundred patients over the age of 65 were given a Questionnaire asking them to
      state their preference. Only a minority (4.5%) expressed a definite preference
      for the formal mode of address. The remainder either did not mind (38%) or
      preferred to be addressed by their first name (57.5%). We concluded that most
      elderly patients do have a preference and this should be established on
      admission.

PMID- 8473146
TI  - Very long term retention of bronchial foreign bodies two new cases and a review
      of the literature.
AB  - We report two cases in which foreign bodies were retrieved from the bronchus
      after intervals of 25 years or more. Both occurred in women in their 30s, in
      neither case was there a history of aspiration, and both patients were
      asymptomatic for many years. The literature on protracted retention of bronchial
      foreign bodies is reviewed using a Medline search and relevant bibliography.

PMID- 8473147
TI  - Breast screening.

PMID- 8473148
TI  - Infection and the role of the clinical microbiologist.

PMID- 8473150
TI  - Copying procedures in focal brain-damaged patients.
AB  - We aimed to ascertain whether non-apraxic, focal brain-damaged patients used
      abnormal constructional procedures. We tested a series of consecutive patients,
      classified according to lesion locus and side against a matched sample of normal
      volunteers. Subjects had to copy the Rey-Osterreith Figure, a complex and
      structured item that explores copying strategies. We used special testing and
      scoring methods to analyze different steps of the copy. Unlike the controls, the
      patients did not choose the central elements of the figure as guiding structures.
      All patient groups followed an equivalent "pathological", "piecemeal" procedure.

PMID- 8473149
TI  - Clinical study of large kindreds with autosomal dominant HLA-linked
      spinocerebellar ataxia (SCA1) of late onset.
AB  - Six families with SCA1 were studied. The clinical data on 35 patients are
      reported. Cerebellar and pyramidal system involvement was invariably found in
      association with brainstem, spinal cord and/or peripheral nervous system
      disorders. In our patients the clinical features appeared concordant when the
      patients with the same disease duration were compared. Previous reports of SCA1
      families had shown great variability in clinical phenotype both interfamilial and
      intrafamilial. We suggest that the phenotype might appear more homogeneous if
      disease duration is taken into account.

PMID- 8473151
TI  - Meningiomas in elderly patients. Clinico-therapeutic considerations.
AB  - This study examines the immediate and long-term results of surgical treatment for
      intracranial meningioma in patients aged 65 and over. Average patient age was 69
      years. The most frequent localizations were the convexity (29.8%) and the
      sphenoid wing (20.1%). Preoperative risk factors included hypertension (16.1%),
      cardiopathies (16.1%), diabetes (12.9%) pneumopathies (12.9%) and peripheral
      vascular diseases (9.6%). All patients were assessed according to the Karnofsky
      Performance Status (KPS). Operative mortality was 18.5% (23 cases). At long term
      follow up (minimum 4 months, maximum 12 years, average 5 years) 31.5% of patients
      were cured, 32.3% had improved and 4% had worsened. The risk factors that mainly
      influenced results included poor preoperative clinical condition as expressed by
      low KPS, while the most frequent medical postoperative complications that
      increased the rate of operative mortality were brain edema, infections and lung
      embolism.

PMID- 8473152
TI  - Amyotrophic choreo-acanthocytosis: a neuropathological and immunocytochemical
      study.
AB  - A 47 year old man, one of a sibship affected by amyotrophic choreo-acanthocytosis
      was studied neuropathologically after some years of clinical observation. Besides
      the classic optical findings (neuronal loss, astrocytic gliosis and "status
      spongiosus" in the basal ganglia, namely in the caudate nucleus) a few MEnk+ and
      NPY+ neurons were observed immunocytochemically in the striatum. In the spinal
      cord also, while no neuronal loss was perceivable, both mild demyelination and
      interfibrillary astrocytic hyperplasia of the long tracts were present. On the
      other hand, microscopic findings of muscle and peripheral nerve showed no
      differences from what was previously intra-vitam appreciated in the same patient.
      The neuropathological and immunocytochemical findings of this case are discussed
      in relation to the differential diagnosis between amyotrophic choreo
      acanthocytosis and Huntington's disease.

PMID- 8473153
TI  - Before M.A.S.T.-I: analysis of the population of a participating center.
AB  - Between 1 January 1989 and 31 December 1990 568 consecutive patients were
      admitted to our unit for ischemic stroke (defined on clinical criteria and with
      CT or MR evidence of ischemic areas or exclusion of hemorrhage or tumor). The
      interval between onset of symptoms and arrival in hospital was under 6 h in 270
      cases (47.5%). We classified our population according to the clinical criteria
      proposed by Bamford et al. by subgroup as follows: LACI (27.5%); PACI (24.5%);
      TACI (30.6%); POCI (17.4%). The mortality in our population was 10.9%. The
      distribution of the risk factors considered was: hypertension in 387 cases (67%),
      diabetes in 158 cases (27.8%), NVAF in 95 cases (16.7%). Our data show that about
      a half of all patients with ischemic stroke can expect to receive treatment at
      the acute stage.

PMID- 8473154
TI  - Neuro-Behcet: clinical features and MRI correlates.
AB  - This paper highlights the fundamental role of MRI in the diagnosis of Neuro
      Behcet disease. We present 4 cases examined between 1990 and 1991. Treatment in
      all the cases seems to have improved the patients' prognoses.

PMID- 8473155
TI  - Multifactorial study of inflammatory myopathies. Report of 29 cases.
AB  - We made a comparative clinical, immunopathological and therapeutic evaluation in
      17 patients with polymyositis (PM) and 12 patients with dermatomyositis (DM),
      followed up at our Neuromuscular Center. DM can be distinguished by its clinical
      appearance and pathological changes. Current evidence suggests that it results
      from vasculopathy. For studying these inflammatory myopathies we used
      multifactorial diagnostic criteria, evaluating the therapeutic response by means
      of a composite clinical and functional score in a longitudinal study. In muscle
      biopsy specimens we characterized with monoclonal antibodies T lymphocyte
      subpopulations (CD4, CD8), macrophages, IgG, IgM, C1q, C3, C4 complement
      fractions, MHC-I, MHC-II. In PM the cell-mediated immunity was more pronounced
      and in some cases both MHC-I and MHC-II molecules were found on the surface or
      within muscle fibers. Our patients were treated with steroids; in resistant cases
      azathioprine, cyclophosphamide, plasmapheresis, high-dose intravenous
      immunoglobulins (ivIgG) and total body irradiation were added to the therapeutic
      schedule.

PMID- 8473156
TI  - Cryptococcal meningoencephalitis in a non immunocompromised patient: case report
      with necropsy.

PMID- 8473158
TI  - Ethical considerations regarding overinvestigation in neurology.

PMID- 8473157
TI  - Category-specific deficits for grammatical classes of words: evidence for
      possible anatomical correlates.
AB  - Several neuropsychological studies have shown that brain-damaged patients may
      demonstrate category-specific deficits for grammatical classes of words, such as
      nouns and verbs. We describe 3 patients with selective impairments of these
      latter categories. The first patient, with marked atrophy of the left temporal
      lobe, was disproportionately impaired in naming and comprehension of nouns. The
      second patient, with a predominantly left frontal lobe atrophy, was selectively
      impaired in naming and comprehension of verbs. The third patient, with a left
      frontal lobe perfusion abnormality, had a selective impairment in naming and
      comprehension of verbs. Evidence from the present study support the hypothesis
      that anatomically distinct neural systems in the temporal and frontal lobes of
      the dominant hemisphere might play a critical role in lexical processing of nouns
      and verbs respectively.

PMID- 8473159
TI  - Strongyloides infection in Hawaii: an imported case.
AB  - Tropical diseases may present anywhere in the world. A case of strongyloidiasis
      in Hawaii, identified by a characteristic manifestation, larva currens, is
      described. Strongyloides infection may persist long after leaving an endemic area
      through the mechanism of autoinfection and, especially under circumstances of
      immunosuppression, may become overwhelming (the hyperinfection syndrome), with a
      likelihood of being fatal. Each case of Strongyloides infection should be treated
      aggressively in order to prevent this dangerous outcome; in addition, the
      parasite should be eliminated before immunosuppressive therapy is begun.

PMID- 8473160
TI  - A rare case of cholera in Hawaii.
AB  - Cholera is the most fatal of the infectious diarrheas but only rarely encountered
      in Hawaii. Two cases previously have been documented in the Islands. We describe
      an elderly patient, without obvious risk factors, who contracted cholera. Early
      consideration of cholera as a diagnostic possibility is recommended in patients
      with unexplained, profuse diarrhea. The unique features of this case are
      discussed in this report.

PMID- 8473161
TI  - Do we need second generation lithotripters in Hawaii?
AB  - The Kidney Stone Center of the Pacific (KSCoP) currently provides statewide
      services for kidney lithotripsy. The non-invasive technique uses shock waves to
      disintegrate kidney stones. Extracorporeal shock wave lithotripsy (ESWL) can be
      used successfully in 85% to 90% of kidney stone patients when surgery is
      indicated.

PMID- 8473162
TI  - [The dynamic hip screw support plate for management of unstable proximal femoral
      fractures].
AB  - The DHS-Implant system is a technically simple and widely used operative
      treatment modality for pertrochanteric fractures of the femur. In unstable 4 part
      fractures rotation of the head and neck fragment around the lag screw and a
      significant impaction might lead to a lateralisation of the greater trochanter
      and therefore to an important shortening. To prevent these effects we treated 17
      patients with 4 part-fractures with a prototype of a modular trochanteric DHS
      buttress plate. With this additional implant the lateralisation of the greater
      trochanter could be prevented in all cases. This also leads to a limitation of
      the telescoping, with less shortening even with immediate full weight bearing.

PMID- 8473163
TI  - [The gamma nail--an ideal implant for treatment of unstable fractures in elderly
      patients].
AB  - Altogether we used the Gamma-Nail in 150 cases. We show here a series of 50
      instable pertrochanteric femur fractures in very old patients which we treated
      with a Gamma-Nail. All cases started with full weight bearing at the 4th day
      after operation. A clinical and radiological control 12 weeks later shows good
      mobilisation of the hip in 70% of the cases. Shortening of the operated leg is
      rare in comparison of cases treated with a DHS. Two thirds of the patients
      returned after dismission of the hospital to the old social situation. The
      advantages in treating instable pertrochanteric femur fractures with the Gamma
      Nail are immediate full weight bearing without risks of shortening of the
      operated leg and the closed reduction of the fracture.

PMID- 8473165
TI  - [Osteosynthesis in dislocated femoral neck fracture (Garden 3 and 4). Long-term
      results and treatment concept].
AB  - The dislocated fracture of the femoral neck (Garden type 3 and 4) in the young
      patient is preferably treated by open reduction and internal fixation. In the
      period 1980-1989 we fixed 49 fractures with a dynamic hip screw, a 130 degrees
      angled plate, screws alone, or by a valgisation osteotomy fixed with a 120
      degrees-plate (Pauwels osteotomy). 30 fractures were reviewed after 66 months in
      average. We observed radiological signs of femoral neck necrosis in 9 patients,
      thereof 7 with symptoms, and radiological signs of osteoarthritis in 3 patients,
      two with symptoms. The possible factors causing these late complications are
      discussed. We advocate the immediate open reduction to evacuate the intracapsular
      hematoma into a slight valgus over-correction for stability. For the fixation we
      use 3 screws in good bone quality, the dynamic hip screw and the angled plate in
      osteoporotic bone often combined with an accessory screw for rotational
      stability. The functional long-term result was good or excellent in 70%. By
      avoiding technical errors this rate can be improved.

PMID- 8473164
TI  - [Management of femoral neck fractures at the Liestal canton hospital].
AB  - The mode of treatment for femoral neck fractures at the Kantonsspital Liestal
      depends on age primarily. Patients over 70 years of age are treated with a
      unipolar endoprosthesis. Screws are being used in cases of medial femoral neck
      fractures, DHS in cases of lateral fractures. Total hip arthroplasty is only
      indicated in patients with evident osteoarthritis. 78 femoral neck fractures were
      seen in a 3-year-period. 50 endoprostheses were used in 49 patients. The mean age
      at time of surgery was 80 years. 70% of the patients have died at a mean survival
      time of 2 1/4 years. 13 out of a total of 14 surviving patients were
      investigated. The follow-up of 10 surviving patients reveals radiographically a
      mild protrusion in one case only. Clinically all 13 surviving patients are not
      compromised by the endoprosthesis after 5 years. We consider the implantation of
      a unipolar endoprosthesis in patients with femoral neck fractures at age over 70
      years the treatment of choice. There is an acceptably low risk for protrusion as
      a late complication in regard to a reduced life expectancy.

PMID- 8473166
TI  - [The dynamic hip screw (DHS) in femoral neck fractures].
AB  - Out of 224 patients with femoral neck fractures, 40 patients have been treated by
      ORIF with the dynamic hip screw, whereas 27 have been fixed by large cancellous
      bone screws and 148 femoral heads were replaced by a prosthesis. The ORIF with
      dynamic hip screw has been performed as an emergency intervention within 6.2
      hours after accident. Good general condition without contraindication against an
      emergency operation as well as a biological age below 65 years and no pre
      existing coxarthrosis are mandatory for the indication for open rigid internal
      fixation. Personal follow-up of 37 patients with x-ray documentation after at
      least 18 months (mean 35.4 months) showed complete rehabilitation in 31 patients
      and 4 femoral head necrosis (10.8%). We conclude that these good results are due
      to the short interval between accident and operation as well as to the evacuation
      of the intraarticular hematoma together with stable internal fixation and
      functional rehabilitation. Due to our good results we prefer long cancellous bone
      screws for the operative fixation of femoral neck fractures in younger patients,
      whereas in the older group the dynamic hip screw is preferred.

PMID- 8473167
TI  - [Fractures near the femur head in children and adolescents].
AB  - 13 patients (1981-1991) between 1.5-15.5 years (average 10.2 years) with Delbet I
      III fractures were analysed of the incidence of avascular necrosis. Only one
      (type II fracture) of our 13 patients was associated with a severe complication
      (Ratliff type I) of an avascular necrosis of the femoral head. This satisfactory
      result may be explained by our concept of immediate open reduction and minimal
      internal fixation of the displaced fractures.

PMID- 8473168
TI  - [Primary management and problems with osteosynthesis of subtrochanteric fractures
      of the femur].
AB  - From 1986 to 1991 we treated 63 patients with subtrochanteric fracture of the
      femur. The etiology in 53 patients with 40 fractures mostly pedestrians, hit by a
      car; or motor vehicle accidents, in other words high velocity injuries that
      resulted in a significant number of multiply injured patients of whom 38 were
      polytraumatized, by our definition a multiply injured person with a life
      threatening injury of at least one of the following body parts: head, neck,
      thorax, abdomen, spine, extremities with neurovascular compromise and pelvic
      girdle.

PMID- 8473169
TI  - [Laparoscopic cholecystectomy in a medical training center. Apropos of 208
      interventions].
AB  - Laparoscopic cholecystectomy is a relatively recent acquisition and still remains
      limited to few surgeons. We started an education program for surgeons used to
      open biliary surgery. Between september 1990 and december 1991, 208 patients have
      been operated on by 14 operators flanked by 2 teachers. Technique was
      standardized and all patients were looked preoperatively for absence of stones in
      bile ducts using i.v. cholangiography and tomography. Only 6 patients (< 3%)
      needed to be converted to laparotomy. Morbidity was less than 6% and due to minor
      complications. Only one patient needed a reoperation because of incisional
      hernia. Mortality was null. Mean postoperative hospitalization time was less than
      3 days. We conclude that laparoscopic activity in a teaching center allows
      acquisition of a new technique modality while remaining safe for patients.

PMID- 8473170
TI  - [Biliary pancreatitis--a good indication for laparoscopic cholecystectomy].
AB  - Recently the indication for laparoscopic cholecystectomy has been enlarged to
      include biliary pancreatitis. While a majority of reports recommend early open
      cholecystectomy for biliary pancreatitis the use of laparoscopic cholecystectomy
      in this disease has not yet been discussed. We retrospectively reviewed 52
      patients with biliary pancreatitis being admitted to our ward in the last five
      years. Cholecystectomy was performed in 48 patients. Ten had undergone
      laparoscopic cholecystectomy. Postoperative complications occurred in 8 of the 48
      patients (16.6%). Four patients (8.3%) died due to necrotizing pancreatitis or
      rupture of pseudocysts. We found a correlation between morbidity and mortality
      and the prognostic score as well as the presence of pseudocysts. We conclude that
      biliary pancreatitis is a good indication for laparoscopic cholecystectomy in
      patients with a low prognostic score. The presence of pseudocysts in our view is
      no contraindication for laparoscopy. Although it may increase postoperative
      morbidity. Choledocholithiasis has to be ruled out either by preoperative ERCP or
      during laparoscopy with intraoperative cholangiography.

PMID- 8473171
TI  - [Laparoscopic versus conventional appendectomy: a comparison].
AB  - We compared two groups of patients with acute appendicitis, from whom the first
      one had been operated conventionally, the second group by laparoscopy. There was
      no difference between the two groups regarding length of hospital stay, local and
      general complications. Only the operating time was quite longer in the
      laparoscopic group. In our experience laparoscopic appendectomy is an easy and
      safe procedure which can allow young surgeons to be properly trained in
      laparoscopic techniques.

PMID- 8473172
TI  - [Bile duct injuries in laparoscopic cholecystectomy].
AB  - We report on three patients with iatrogenic lesions of the common bile duct after
      laparoscopic cholecystectomy. In one patient, an additional occlusion of the
      hepatic artery was found. The leading postoperative signs were jaundice and
      cholangitis. Endoscopic and radiologic intervention failed to correct the common
      bile duct stenosis in all three patients. Surgical correction by
      hepaticojejunostomy was successful, although the postoperative follow-up is still
      short.

PMID- 8473173
TI  - [Mirizzi syndrome--a contraindication for laparoscopic surgery].
AB  - The Mirizzi syndrome refers to a benign obstruction of the common hepatic duct by
      a stone impacted within the cystic duct or the neck of the gallbladder causing an
      obstructive jaundice. According to McSherry's subclassification based on
      endoscopic retrograde cholangio-pancreatography we distinguish a type I,
      involving an external compression of the common hepatic duct by a large stone
      impacted in the cystic duct or Hartmann's pouch without lesion of the gallbladder
      or the common hepatic duct wall. In type II a cholecysto-choledochal fistula is
      present, caused by a calculous which has already eroded partly or completely into
      the common bile duct. The type I is better treated with a partial
      cholecystectomy, the type II with a partial cholecystectomy and a bilio-digestive
      anastomosis. Due to a severe inflammatory process with dense adhesions and
      odematous changes of the hepato-duodenal ligament, it is dangerous to prepare the
      Calot's triangle, in case of conventional cholecystectomy and/or in case of
      laparoscopic cholecystectomy. From 1986-1991 we have successfully treated 10
      patients according to this concept (7 patients with type II, 3 patients with type
      I). We have no mortality and no lesion of the biliary system. One patient has
      been reoperated because of a postoperative hemorrhage and biliary fistula. One
      patient developed a benign stricture which could be dilated two months after the
      procedure. Two patients were found with an incidental carcinoma of the
      gallbladder.

PMID- 8473174
TI  - [Laparoscopic cholecystectomy in acute cholecystitis. Experiences with 20 cases].
AB  - With the experience of 80 cases of laparoscopic cholecystectomy, we started to
      operate all gallbladders by the laparoscopic way, even if there was the diagnosis
      of an acute cholecystitis. Between May 1991 and January 1992, 20 patients with
      acute cholecystitis have been operated by laparoscopic surgery. The patients'
      ages varied from 21 to 75 years (mean 53 years). The preoperative evaluation of
      the biliferous ducts, especially in case of cholestasis, should give a precise
      diagnosis of anatomic variations or stones. Therefore the ERCP as an additional
      preoperative examination was necessary in 10 (50%) cases. 14 (70%) could be
      operated by the laparoscopic way without surgical complications. In 6 patients
      closed procedures had to be changed to open cholecystectomy because of the
      following reasons: Scars and uncertainty about the anatomy in Calot's triangle
      (4x), severe adhesions to the colon (1x), and perforation of a gallbladder with
      necrotic wall, respectively. The good results, the possibility of a direct view
      of the situs, and the fact that anytime during the operation a change to the open
      procedure is possible, are reasons to start all cholecystectomies by the
      laparoscopic manner.

PMID- 8473175
TI  - [Do pulmonary changes appear after elective laparoscopic cholecystectomy?].
AB  - 30 patients without history of pulmonary disease who underwent elective
      laparoscopic cholecystectomy were examined on the day before and on the 2nd day
      after operation. Investigations included physical examination, chest X-ray and a
      spirometry. In case of postoperative pathological findings the same examinations
      were repeated 14 days after operation. On the chest X-ray 5 patients had
      postoperative alterations which disappeared within 14 days. The spirometry showed
      a slight decrease of VC, FRC and FEV1 which after 2 weeks had almost regained
      normal values. Therefore we do not consider it necessary to perform routine
      respiratory prophylaxis in patients undergoing elective laparoscopic
      cholecystectomy.

PMID- 8473176
TI  - [Stomach cancer: 10 years experiences with surgical treatment and possibilities
      for improving the prognosis].
AB  - We retrospectively evaluated data on 111 consecutive patients operated between
      1976 and 1985 for gastric carcinoma. Patients were staged according to the TNM
      classification (stage I - 17%, II - 15%, III - 30%, IV - 37%). 66 patients
      (59.5%) underwent radical resection. Most of curative resections were subtotal
      distal gastrectomies. Extended lymphadenectomy was not performed. The operative
      mortality rate was 7.4% in case of curative resections, and 9.6% overall. 20 out
      of 66 radically operated patients (30%) were treated with adjuvant cytotoxic
      chemotherapy, while 9 out of 45 non radically operated patients were treated with
      palliative cytotoxic chemotherapy. The median follow-up time was 36 months
      (range: 1-166 months) for patients operated for cure and 25 months for the whole
      population. The estimated adjusted 5-year survival rate was 41.3% after operation
      in a curative intent, 82.9% for stage I, 62.8% for stage II, 17.8% for stage III,
      3.3% for stage IV. The duration of symptoms before diagnosis was longer than 6
      months in 18 patients (16.2%) and longer than 10 months in 9 patients (8.1%).
      Patients who were symptomatic since more than 10 months were on the average about
      10 years younger than the rest of the population. The median duration of symptoms
      was 3.2 months overall, but reached 7.1 months in patients less than 40 years
      old. Patients with an early gastric cancer (11/111: 9.9%) or stage I disease
      (19/111: 17.1%) had always symptoms since less than 5 months. The proportion of
      early gastric cancer increased from 6.3% (3/48) to 12.7% (8/63) from 1976-1980 to
      1981-1985, simultaneously to the diffusion of the upper gastrointestinal
      endoscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473177
TI  - [Value of antral mucosectomy, selective proximal vagotomy and a combination of
      the 2 procedures in serum gastrin production and inhibition of stomach acid. An
      experimental study].
AB  - This experimental study was aimed at determining the volume and acidity produced
      by the normal stomach, following antral mucosectomy (MA), proximal selective
      vagotomy (VSP) and combination of both procedures. In 10 mongrel dogs, a double
      lumen tube was placed in the stomach under general anesthesia. One of the lumen
      was rinsed with a constant flow and the other retrieved the gastric secretion.
      Gastric secretion and acidity were calculated every 10 minutes for 120 minutes.
      At 60 minutes, pentagastrin was injected. After these controls, a MA was carried
      out in half the animals and a VSP in the other half. 6 and 12 weeks
      postoperatively, the same controls were repeated. The dogs were then submitted to
      the operation of the other group. Following MA and pentagastrin stimulation, the
      gastric secretion (volume) is not modified with regard to the preoperative
      levels. On the other hand, after VSP, pentagastrin stimulation induces only a
      small volume response. The vagus thus seems to be involved in liquid secretion of
      the stomach. Following MA, pentagastrin stimulation lowers gastric pH at 6 weeks
      but not at 12 weeks postoperatively. Gastrin is known to have a trophic effect on
      the oxyntic mucosa. This effect disappears in a few weeks and explains these
      different figures. Following VSP, gastric acidity decreases and plasmatic gastrin
      increases. In this situation, pentagastrin directly acts on a trophic mucosa and
      produces the important lowering of the gastric pH. Finally, after MA,
      pentagastrin induces an increase in plasmatic gastrin. This effect seems to be
      mediated by central stimulation of the nuclei of the vagus nerve.

PMID- 8473178
TI  - [Late results after individualized lateral internal sphincterotomy].
AB  - A total of 75 patients underwent individualized lateral internal sphincterotomy
      for acute and chronic anal fissure (n = 30) or high pressure hemorrhoids (n = 45)
      and were followed-up 3 months and 3 years (13-66 months) postoperatively. All but
      one patient with anal fissure (97%) and 38 out of 45 patients with hemorrhoids
      (84%) remained symptom free; only one patient (1.3%) occasionally had symptoms of
      minor incontinence. Following the operation both the maximum resting pressure and
      the medium anal pressure fell significantly and were completely or nearly
      normalized in 54 (72%) and 17 (23%) patients respectively. At medium follow-up of
      3 months and 3 years postoperatively there was no significant difference in the
      two sets of postoperative manometric results.

PMID- 8473179
TI  - [Colonic malrotation observed in the adult].
AB  - Malrotation is a rare aetiological factor of intestinal occlusion in adult. We
      report our experience of 16 cases collected from 1976 to 1991. The incidence is
      about 0.2-0.5% with two peaks, at 25 and 55 years respectively. Mean age is of 41
      years. The symptoms were occlusion in more than 90%. A contrast enema was
      performed in acute as well as in chronic situations. The surgical treatment
      whatever it is, is the treatment of choice but has to be put in balance with age.

PMID- 8473180
TI  - [Multiple tumors of the colon and rectum].
AB  - The possible occurrence of multiple synchronous or metachronous malignant lesions
      in patients with a carcinoma of the colon and rectum is a well known event. In
      this population-based study in the Geneva area from 1970 to 1986, the frequency
      of synchronous colorectal carcinomas was of 1.1% and that of metachronous
      carcinomas of 1%. The relative risk of metachronous colorectal carcinoma is
      higher than in the general population (colon after rectum 1.2, colon after colon
      1.7 and rectum after rectum 1.4). A high association of adenomatous polyps with
      multiple colorectal carcinomas was observed. The 5-year actuarial survival in
      case of curative resection was of 87% for metachronous carcinomas, 35% for single
      carcinomas and 33% for synchronous carcinomas. We conclude that complete
      preoperative colonoscopy, whenever possible, should be performed to screen
      patients with synchronous carcinomas. Finally, a lifelong follow-up of the
      residual colon or rectum should be planned to detect metachronous lesions.

PMID- 8473182
TI  - [Multi-organ procurement from the perspective of a hospital not involved in
      transplantation. Requirements, implementation, problems].
AB  - Our algorithm is an example in which way the multiple organ donation can be
      organised in a hospital, which doesn't perform transplantations. We are showing
      problems which occur during the evaluation of the donor and till the explantation
      can be performed. In the conclusion we are demanding for better coordination and
      better support from the transplantation centers.

PMID- 8473181
TI  - [Thrombopenia after liver transplantation].
AB  - Thrombocytopenia (TP) is a common finding after liver transplantation and is
      often multifactorially induced. In 31 of 33 liver transplant recipients (operated
      between 1986 and 1991 at our institution) TP was observed but only in 4 the nadir
      of the platelet count was less than 20,000/mm3. Highly significant influence in
      the severity of postoperative TP as well as on the recovery time (defined as the
      first day with a platelet count higher than 100,000/mm3) was found for a
      preexisting TP and for the intraoperative need for blood transfusions. 8/33
      patients had a concomitant splenectomy but no effect on platelet nadir nor on the
      recovery time could be detected. In our series we could not find any platelet
      related factor with a significant impact on patient survival. In one patient
      severe TP was induced by a CMV-related hematophagic histiocytosis fully
      regredient with antiviral therapy. Another patient with AB0 incompatible graft
      had a severe TP induced by graft versus host disease.

PMID- 8473183
TI  - [Extracorporeal cholelithotripsy, is it still justified as treatment of
      cholecystolithiasis?].
AB  - This prospective study evaluates the results of extracorporal shock-wave
      piezoelectric lithotripsy in 52 patients, 41 with radiolucent and 11 with
      calcified shell gallstones. The fragmentation rate was above 90% and the
      complication rate 31% particularly with pains or intolerance to the adjuvant
      dissolution therapy. At the end of the treatment, seven cholecystectomies were
      carried out among the 31 patients for who lithotripsy failed. After 18 months,
      the success rate was 23% and 12 patients only remained stone free. Nowadays,
      thanks to the new laparoscopic therapy, extracorporal shock-wave lithotripsy is
      no longer judged appropriate, especially because of its poor cost-effectiveness
      and high recurrence ratio.

PMID- 8473184
TI  - [Preoperative ERCP and laparoscopic cholecystectomy for treatment of
      choledocholithiasis].
AB  - Out of 110 patients suffering from gallstone-related symptoms, 21 underwent ERCP
      prior to laparoscopic cholecystectomy. Indications for this combined treatment
      were laboratory signs of cholestasis (36%), pancreatitis (29%), pathological IVC
      (18%), sonographic evidence for bile duct dilatation (10%) and cholangitis (7%).
      Local and general complications were not increased neither intraoperatively nor
      postoperatively. Median duration of postoperative hospital stay was four days for
      ERCP-treated patients as compared to three days for patients subjected to
      laparoscopic cholecystectomy only. In summary treatment of choledocholithiasis by
      a combination of preoperative ERCP and laparoscopic cholecystectomy offers the
      following advantages: high patient comfort, low incidence of complications and
      short hospitalization compares favourably with conventional common bile duct
      exploration.

PMID- 8473185
TI  - [Polytrauma: comparison of the hospital course after air- (with emergency
      physician) versus ground transport (without emergency physician)].
AB  - We analyzed the influence of initial intensive care at the accident site
      performed by an emergency physician and followed by helicopter transport on the
      course during hospital stay in patients with multiple trauma. We therefore
      compared the dates of 107 patients transported by the swiss air rescue (REGA) and
      an emergency physician with 131 patients transported by an ambulance and
      paramedic staff. By similar case material the REGA-patients showed a higher
      injury severity grade. Mortality of the REGA-patients was significantly higher
      (21%) than of the ambulance-patients (10%), but length of stay was significantly
      shorter and morbidity identical. We suspect, that the higher mortality of the
      REGA-patients is explained by the large number of surgically nontreatable severe
      traumas. None of the REGA-patients arrived at hospital with circulatory
      insufficiency whereas 4 of the ambulance-patients were in state of shock. We
      assume that first of all primary treatment of the scene of injury by an emergency
      physician and eventually also transport by helicopter have a positive effect on
      the course of patients with multiple trauma during hospital stay.

PMID- 8473186
TI  - [Unstable spinal injuries in craniocerebral trauma].
AB  - Estimates of the incidence of injury to the cervical spine among patients
      suffering blunt trauma to the head vary widely. In an attempt to quantify the
      risk, the records of 593 consecutive patients with blunt craniocerebral injuries
      admitted to our trauma center in 1991 were reviewed. The overall incidence of
      cervical spine injuries was 5.8% and for the unstable cervical spine injuries
      2.9%. In the management of head trauma with associated cervical spine injuries
      realignment and immobilisation of the spine and surgery of the head were carried
      out as first step, followed by decompression and stabilisation of the affected
      segment in the same session. In patients with altered consciousness a loss of
      cooperation is always present and an early spinal stabilisation for the optimal
      treatment in the intensive care unit and in the wake-up-phase is important.

PMID- 8473188
TI  - [Initial experiences with the unreamed AO tibial nail].
AB  - It is generally accepted that intramedullary nailing in combination with reaming
      should be avoided in treating open fractures. However the use of an unreamed,
      solid nail combined with interlocking allows stabilization also of open and
      complex fractures. 20 tibia fractures (65% open, 45% complex fractures) have been
      treated by the AO unreamed tibial nail (UTN), 12 (5 of them open fractures) by
      direct nailing and 8 after initial stabilization by an external fixator. In our
      series no intraoperative complications, no soft-tissue healing problems and no
      infections occurred. Thus, treatment of both, open and comminuted fractures by
      UTN appears to be rather safe and generally needs no secondary stabilization.

PMID- 8473187
TI  - [Initial experiences with the unreamed tibial nail].
AB  - During a one-year period starting January 1991, 17 tibial shaft fractures have
      been treated with the new AO unreamed tibial nail in a prospective study.
      Fractures were classified according to the AO classification: 10 type A, 6 type
      B, one type C. 7 fractures were closed. Out of those 3 showed marked soft tissue
      contusions and 2 required a fasciotomy because of a concomitant compartment
      syndrome. The open fractures were classified according to the Gustilo
      classification: 3 grade I, 5 grade II, 1 grade III B and 1 grade III C injury.
      There were 5 polytraumatised patients (ISS 27-34). The nailing procedure was
      preformed on the day of admission in 11 cases and in a delayed fashion (2-14 days
      after the accident) in 6 cases. There were no specific technical problems
      encountered intraoperatively. The only perioperative complication consisted of 1
      case of fat embolism syndrome. 1 fracture required secondary plate osteosynthesis
      because of a unacceptable valgus deformity 6 weeks postoperatively. There was 1
      too long nail implanted at the initial surgery, which then had to be changed
      during the rehabilitation period because of pain in the region of the knee. In 3
      cases the interlocking bolts broke and 3 other cases required secondary
      dynamisation. There was a complete follow-up in all cases of at least 6 months.
      There were no infections. All fractures are healed. Full weight bearing was
      allowed at a mean of 10 weeks for closed fractures and 14 weeks for open
      fractures, respectively. All but one fracture (valgus 8 degrees) healed in a
      correct axial alignment without shortening.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473189
TI  - [Stable interlocking intramedullary nailing of humeral fractures with the Seidel
      nail].
AB  - 22 fractures of the humerus (15 traumatological, 7 pathological) were treated
      with the Seidel-Nail. The results after a follow-up between 4 and 20 months
      showed good mobility of the shoulder. As major complications two paresis of the
      radial nerve occurred. One disappeared spontaneously. The Seidel-Nail is a good
      implant for all kind of shaft fractures with an intact distal fragment of 5 cm
      and also for fractures of an intact humerus head.

PMID- 8473190
TI  - [Osteosynthesis of subcapital humerus fracture with unconventionally applied
      implants].
AB  - The osteosynthesis of proximal humerus fractures with the commonly used plates is
      often critical because of the small space subacromial, the irritation of the
      blood supply by the broad plates and the poor proximal anchorage without angle
      stability. The osteosynthesis with a children hip plate or a angle plate like
      modified DC-plate is thought to be a reliable alternative.

PMID- 8473191
TI  - [Results of intramedullary nailing in humerus shaft fractures].
AB  - We present an analysis of a retrospective study of 61 humeral shaft fractures,
      stabilized with a thin AO tibial nail. All fractures were analysed according to
      the AO-classification. Follow-up included 48/61 patients and averaged 82 months.
      Local complications were postoperative radial nerve palsy in 1/61, infection in
      0/61 and non-union in 4/56. A good result in shoulder function was obtained in
      41/48 cases.

PMID- 8473192
TI  - [Preoperative arthroscopy in fresh complex internal knee injuries].
AB  - With reference to a prospective study 197 preoperative arthroscopies were carried
      out on 194 patients with fresh severe internal lesions of the knee. The injuries
      are analysed, in particular diagnostic and treatment of additional meniscus
      lesions. Advantages and disadvantages of the procedure are discussed.

PMID- 8473193
TI  - [Arthroscopy in diagnosis of carpal instability].
AB  - In a series of 45 patients with carpal instability, arthroscopy detected 2.9
      ligament tears per wrist. The lesions were found in 50% in the radio-carpal
      compartment and in 50% in the midcarpal compartment on the ulnar aspect. In 70%
      the tears were found to be combined in both compartments. These findings may be
      in contrast to the today's classification of carpal instability. Arthroscopy is
      of great value in evaluating the most appropriate method of surgical repair on
      patients with carpal instability.

PMID- 8473194
TI  - [Results of surgical therapy of ulnar sulcus syndrome. Submuscular anterior
      transposition versus simple decompression of the ulnar nerve].
AB  - The operative treatment of the ulnar neuropathy at the elbow is controversial. We
      studied the course of 79 patients who had been operated for the first time,
      either by simple decompression (31 cases) or by submuscular anterior
      transposition (48 cases) of the ulnar nerve. Our results show that the simple
      decompression can be recommended in all patients without cubital (sub)luxation of
      the ulnar nerve. The submuscular anterior transposition should be preferred if a
      tendency of cubital (sub)luxation of the ulnar nerve has been found.

PMID- 8473195
TI  - [Characteristics of tumor diseases in patients with colorectal cancer].
AB  - Medical histories for the years 1978 to 1988 were reviewed to ascertain
      associations between colorectal cancers and extraintestinal malignancies. 61 out
      of 838 patients (7.3%) had an extraintestinal malignancy before the colorectal
      cancer. In males the rate was 5.4% and in females 10.4%. In males a high
      association was shown between cancers of the large bowel and urogenital cancers.
      In females colorectal cancer was associated with breast and gynecologic cancers.
      We conclude that patients with gynecologic and urologic tumors have an increased
      risk to develop cancers of the large bowel and that these high risk patients
      should undergo long-term follow-ups.

PMID- 8473196
TI  - [Complications of T-drainage after choledochotomy].

PMID- 8473198
TI  - Estimating the initial reaction velocity of a soluble dehydrogenase in situ.
AB  - The initial reaction velocities (vi) of lactate dehydrogenase in single
      hepatocytes were determined, by microdensitometry or computer-assisted image
      analysis, in sections of unfixed mouse liver incubated at 37 degrees C on
      substrate-containing agarose gel films. They were found to fit the equations vi =
      2.82 degrees A and vi = vi + 2 degrees A, where vi and degrees A are,
      respectively, the gradients (or steady-state linear velocities) and the
      intercepts on the absorbance axis of the linear regression lines of the
      absorbance (A) on incubation time plots for incubation times between 1 and 3 min.
      Both equations were independent of section thickness between 4 and 14 microns.
      The observed and calculated values of vi agreed within 11.5% (n = 71). The
      validity of the equations for vi was confirmed by showing that the calculated vi
      was proportional to the thickness of the section and hence the amount of enzyme
      present. Thus, vi can be determined from measurements of either degrees A alone
      or vi and degrees A.

PMID- 8473197
TI  - Spatial analysis of intranuclear human repetitive DNA regions by in situ
      hybridization and digital fluorescence microscopy.
AB  - Non-isotopic (fluorescent) in situ hybridization has established itself as a
      useful technique for the localization of DNA sequences in both metaphase and
      interphase cells. The rapid development of digital fluorescence microscopy,
      especially confocal microscopy, has become a powerful aid for the evaluation of
      the hybridization results in cytogenetic and cell biological applications. In
      this review we will demonstrate the utility of these methodologies for the three
      dimensional visualization and analysis of chromosome-specific (peri)centromeric
      repetitive DNA sequences within the intranuclear structure of human cells and
      cell lines.

PMID- 8473199
TI  - Kinetic analysis of lactate dehydrogenase in situ in mouse liver determined with
      a quantitative histochemical technique.
AB  - The kinetics of lactate dehydrogenase in situ were studied in sections of unfixed
      liver of the male mouse using a quantitative histochemical technique. The
      sections were incubated on substrate-containing gel films. The absorbance of the
      final reaction products deposited in a single hepatocyte was measured
      continuously during the incubation as a function of incubation time using a
      scanning microdensitometer. The absorbance increased non-linearly during the
      first minute of incubation, but linearly for at least the next 3 min afterwards.
      The initial velocity (vi) of the dehydrogenase was calculated from two equations
      proposed previously by us, vi = 2.82 degrees A and vi = vi + 2 degrees A, where
      vi and degrees A are, respectively, the gradient and intercept of the linear
      regression line of absorbance on time for incubation times between 1 and 3 min.
      The dependence of vi on lactate concentration gave the following mean kinetic
      constants. For periportal hepatocytes, the apparent Km = 14 mM and Vmax = 80
      mumoles hydrogen equivalents formed cm-3 hepatocyte cytoplasm min-1. For
      pericentral hepatocytes, Km = 12 mM and Vmax = 87 mumoles hydrogen equivalents cm
      3 min-1. The Km values are very similar to those determined previously from
      biochemical assays. The concentrations of the enzyme in single hepatocytes
      calculated from the Vmax values are in good agreement with those obtained by
      another method. These data substantiate the validity of our equations.

PMID- 8473200
TI  - Noradrenergic and acetylcholinesterase-positive nerve fibres of the uterus in
      sexually immature and cycling rats.
AB  - The distribution and density of the noradrenergic and acetylcholinesterase
      positive nerve fibres were histochemically studied in different uterine regions
      of prepubertal and cycling rats in dioestrus and oestrus. Besides the rich and
      double innervation of blood vessels, both types of nerve fibre were found in the
      myometrium and cervical musculature. The non-vascular noradrenergic network
      looked denser at the tubal end of the horns and at the cervix, whereas the
      acetylcholinesterase-positive innervation was poor at the tubal end, increasing
      toward the cervix. Contrasting with the middle third of the uterine horn, at the
      tubal end, the myometrial longitudinal layer was much more innervated than the
      circular one, especially by the noradrenergic nerve fibres. The prepubertal rats
      presented an adult pattern of uterine autonomic innervation. In the cycling
      animals, this innervation was nearly the same during oestrus and dioestrus
      regarding both the density of nerve fibres and intensity of the histochemical
      reactions.

PMID- 8473201
TI  - Tissue distribution of amyloid P component as defined by a monoclonal antibody
      produced by immunization with human glomerular basement membranes.
AB  - A monoclonal antibody reactive against amyloid P component (NCL-AMP) has been
      developed following immunization of mice with partially-purified human glomerular
      basement membranes (GBM) and standard hybridization and cloning techniques. The
      antibody reactivity was evaluated by enzyme-linked immunosorbent assay (ELISA)
      and by the indirect immunoperoxidase technique on sections of frozen and fixed
      human kidney and other tissues. The distribution of amyloid P component in
      various normal tissues is described and the possible co-localization with the
      Goodpasture antigen is discussed. In addition, the suitability of the antibody
      for detection of amyloid deposits in renal amyloidosis is demonstrated and its
      potential for use in other pathological conditions is considered.

PMID- 8473202
TI  - Semiquantitative immunohistochemical studies of blood group antigen A, B, H,
      Le(a), Le(b) structures and Ii backbone chains in the normal human cervix and in
      cervical adenocarcinoma.
AB  - Epithelia frequently express blood group antigens and these are often perturbed
      in neoplasia. This study has characterized the range of expression of ABH and
      Lewis terminal structures and the Ii backbone chains in the normal human cervix
      by semiquantitative immunohistochemistry. Effects of the secretor gene were
      defined by determination of salivary secretor status. Modifications of blood
      group antigen expression in cervical adenocarcinoma were also addressed. Normal
      cervical squamous and glandular epithelia showed a range of expression of the
      antigens studied. Lewis-gene-negative cases showed no expression of Lewis
      antigens. Secretor status had no effect on ABH expression in squamous epithelium,
      but it did have a marked effect on ABH expression in glands and on Le(b)
      expression in both squamous and glandular epithelia. Patterns of expression of i
      chains in squamous epithelium suggest that these may be the carriers of ABH and
      Lewis antigens in a proportion of cases. Distinct patterns of expression were
      seen in glandular tubal metaplasia and in endothelium. Adenocarcinomas showed
      topographical rather than quantitative changes in blood group antigen expression
      with more extensive luminal expression of ABH, Lewis and Ii structures than that
      seen in normal glands. This change is distinct from those usually associated with
      malignancy.

PMID- 8473203
TI  - [Regenerating hair cells. A therapy concept for the future?].

PMID- 8473204
TI  - [Acceptance and hearing aid use by patients of retirement age (in the Magdeburg
      clinical area)].
AB  - Providing patients with hearing aids in the former German Democratic Republic was
      carried out in audiological centers by otolaryngologists and authorized
      audiologic-phonatric assistants. The available selection of hearing aids was
      limited. A randomized group of 119 patients rehabilitated with hearing aids was
      examined. The current study includes persons older than 65 years. In 78.4% of the
      patients treated, the quality of life was improved with the hearing aids. In
      contrast, the other patients reported the aids to be useless. Nearly 90% of all
      patients had no problems in managing their hearing aids. About 75% of the
      patients used the hearing aid the whole day. In addition to the hearing aid
      prescribed, 33 patients also have had to read lips and only a combination of both
      allows these patients to have adequate communication. Patients reported that 80%
      of the hearing aids worked well or were rarely out of order. Further, 68% of the
      people questioned reported a positive attitude of their fellow citizens. Only 6%
      mentioned that the use of hearing aids to treat presbycusis disturbed social
      communications. Since hearing loss can be progressive and to avoid interference
      in early rehabilitation, frequent follow-ups by otorhinolaryngologists are
      required. The evaluation of patients with hearing disorders requires the
      collaboration of physicians and hearing aid acousticians in order to give
      patients the most information and understanding of their deafness.

PMID- 8473205
TI  - [3D endoscopy].
AB  - With the aid of a 6 mm 0 degree stereo-endoscope supplied with a 100 Hz monitor
      and high-speed liquid crystal shutter, three-dimensional endoscopy of the upper
      airway was realized for the first time. The equipment used is based on
      alternating sequential projections of left and right eye images on a single tv
      screen. Two high-speed liquid crystal stereo switches (LCSS) are integrated in
      glasses and a rapid switching time of 100 microseconds is used. In a comparative
      study this innovative endoscopic technique was tested for its practicability in
      sinus surgery and endoscopy of the upper airway. With this equipment an excellent
      view was obtained of the pharynx, larynx and trachea. For sinus surgery, however,
      a stereoendoscope with smaller dimensions has to be developed.

PMID- 8473206
TI  - [Prevention of vascular complications in endonasal paranasal sinus surgery. I:
      Anatomic principles and surgical significance].
AB  - Anatomic and histologic investigations were performed in 59 cadaver half-heads in
      order to demonstrate areas of hazard at the posterior skull base during
      endoscopic surgery and determine morphologic features of surgical relevance. In
      78% of the heads the internal carotid artery bulged into the sphenoid sinus from
      laterally directly behind and beyond the tuberculum for the optic nerve
      ("anterior bulging"). In 25% of all cases the carotid artery also bulged into the
      sphenoid sinus from behind ("posterior bulging"). This bulging could amount to as
      much as 7 mm. Additionally, the thickness of the bony wall at the point of the
      largest prominence could be very thin (0.1 mm), with 12% of all cases showing
      bony dehiscences. The width of the posterior ethmoid cells and pneumatization of
      the paranasal sinuses at this point differed widely, ranging from 8-24 mm.
      Classification of the carotid loop into five different types demonstrated that
      the bulgings of the internal carotid artery were larger in more curved types of
      the artery ("omega" and "U" types) and were smaller in less curved types ("Arkus"
      and "V" types).

PMID- 8473207
TI  - [The physician and accidents. Legal and medical problems].
AB  - German law requires that any physician at a place of accident is obliged to help
      according to his training and ability. As an emergency doctor on duty he works in
      a warrantee position. In cases with multiple accident victims triage may be
      necessary, corresponding to the priority of medical care. In criminal procedures
      against a physician due to omitted help, there is no probative charge against the
      accused. On the other hand, civil law sets up an objective standard: attention as
      required in communication. In giving initial medical assistance for unconscious
      patients or injured children, rules of "authorized management without commission"
      become valid. Basic first aid measures involve: securing, saving and rescue. Life
      threatening situations such as severe bleeding, airway obstruction and cardiac
      arrest must be dealt with immediately. Following this, such measures as proper
      positioning, clearing of the respiratory tract, removal of dental prostheses,
      evaluation of multiple injuries, avoidance of hypothermia and initiating
      infusions are mandatory. The orientating examination of the accident victim is
      described, as is the "ABCD Rule" for treating respiratory insufficiency or
      circulatory arrest and shock, using heart massage and artificial respiration.
      Finally, medical first aid is described for special injuries, such as cerebral or
      thoracic trauma, fractures and burns. The psychological situation affecting the
      physician at the place of an accident is characterized.

PMID- 8473208
TI  - Opposes early-age neutering.

PMID- 8473209
TI  - Fluid therapy for smoke and fire injury.

PMID- 8473210
TI  - Nasopharyngeal foreign body.

PMID- 8473211
TI  - Escherichia coli O157:H7 infection forces awareness of food production and
      handling.

PMID- 8473212
TI  - AAFCO serves up new regulations to pet food industry.

PMID- 8473213
TI  - AVMA legislation: partial solution to drug availability problem.

PMID- 8473214
TI  - Trinidad veterinarian.

PMID- 8473215
TI  - Negligence in diagnosis.

PMID- 8473216
TI  - Frequency of procedure and proficiency expected of new veterinary school
      graduates with regard to small animal surgical procedures in private practice.

PMID- 8473217
TI  - Conservation and wildlife preservation challenges for veterinarians.

PMID- 8473218
TI  - Wildlife health and the urban-wildlife interface.

PMID- 8473219
TI  - Relationships of agricultural and economic policy to the health of farm families,
      livestock, and the environment.

PMID- 8473220
TI  - Environmental disasters and veterinarians' response.

PMID- 8473221
TI  - The environment and regulatory impacts.

PMID- 8473222
TI  - Effect of subclinical infection with Actinobacillus pleuropneumoniae in
      commingled feeder swine.
AB  - Sequential serologic analysis for Actinobacillus pleuropneumoniae was done on 240
      commingled feeder swine at 1 and 21 days after purchase and at slaughter. At the
      beginning of the experiment, mean weight of the pigs was 18.6 kg, and the pigs
      were maintained to a mean slaughter weight of 109.95 kg. A fourfold increase in
      antibody titer against Actinobacillus pleuropneumoniae was demonstrated in 28
      (12%) pigs. Mean adjusted rate of gain for infected pigs was 0.74 +/- 0.10 kg/d
      and 0.77 +/- 0.09 kg/d for uninfected pigs. Differences in feed efficiency were
      not detected between infected and uninfected pigs. Our findings suggested that
      5.64 additional days are required for pigs with subclinical infection to reach
      market weight of 113.6 kg, compared with that for uninfected herdmates. A
      vaccination program to prevent subclinical infection may not be cost effective.

PMID- 8473223
TI  - Pathologic correlations with magnetic resonance images of osteochondrosis lesions
      in canine shoulders.
AB  - Twelve shoulders in 6 dogs with clinical and radiographic evidence of
      osteochondrosis were examined by magnetic resonance imaging performed on a 0.5-T
      superconductive system. Scans were obtained with 5-mm-thick slices and 0.75-mm
      pixel size. Unenhanced T1-weighted spin-echo and unenhanced T2*-weighted gradient
      echo images were obtained, using a high-resolution surface coil. The T1-weighted
      sequences were repeated after IV injection of 0.1 mmol of gadopentetate
      dimeglumine/kg of body weight (0.2 ml/kg). In 6 joints, histologic examination of
      synovia and articular cartilage was carried out. The magnetic resonance images
      were correlated with arthrographic, arthroscopic, and histologic findings.
      Magnetic resonance imaging was useful in evaluating the extent of subchondral
      lesions and the severity of inflammatory changes within the subchondral bone.
      Areas of low signal (visible subchondrally on T1-weighted images that were
      enhanced by administration of contrast medium) indicated active inflammatory
      changes within the subchondral bone. Although articular cartilage discontinuity
      could be detected, loose cartilage flaps could not always be reliably
      demonstrated. Signal inhomogeneity within the articular cartilage was presumed to
      correspond with zones of cartilage degeneration.

PMID- 8473224
TI  - Comparison of computed tomography with radiography as a noninvasive diagnostic
      technique for chronic nasal disease in dogs.
AB  - Computed tomography was evaluated as a noninvasive technique for the diagnosis of
      chronic nasal disease in dogs. Computed tomographic images, radiographs, and
      histopathologic findings were compared in 11 dogs with chronic nasal disease.
      Definitive diagnosis was made following traumatic nasal flush, exploratory
      surgery, or necropsy. The study included 8 dogs with intranasal tumors, 2 dogs
      with bacterial rhinitis (Pasteurella sp), and 1 dog with mycotic rhinitis
      (Aspergillus sp). Computed tomography was superior to radiography in defining the
      extent of the disease process and in differentiating infectious rhinitis from
      nasal neoplasms. It defined lesions in the palate, nasopharyngeal meatus,
      maxillary sinus, caudal ethmoturbinates, and periorbital tissues that were
      difficult to demonstrate by use of conventional radiography. Tumors appeared as
      space-occupying lesions that obliterated the turbinates, caused deviation of the
      nasal septum, and eroded bone. Rhinitis appeared as a cavitating lesion that
      spared the paranasal sinuses, thickened and distorted the turbinates, and widened
      the meatus. Although morphologically distinct on computed tomographic images,
      infectious rhinitis and nasal neoplasms could not be differentiated by
      attenuation measurements or degree of contrast enhancement. Computed tomography
      appeared to be a reliable, noninvasive technique for the diagnosis of chronic
      nasal disease in dogs, and a promising alternative to diagnostic techniques
      currently in use.

PMID- 8473225
TI  - Adverse effects of administration of propofol with various preanesthetic regimens
      in dogs.
AB  - The effects of propofol on anesthetic induction were evaluated in 40 dogs
      anesthetized with isoflurane. Propofol is a rapidly acting, nonbarbiturate drug
      that induces anesthesia of ultrashort duration with IV administration. Four
      preanesthetic regimens were used: anesthesia without preanesthetic drugs; or with
      preanesthetic administration of acepromazine (0.1 mg/kg of body weight, IM),
      diazepam (0.2 mg/kg, IV), or acepromazine (0.02 mg/kg) and butorphanol (0.4
      mg/kg) IM. Heart rate, systolic arterial blood pressure (SAP), respiration,
      quality of induction and recovery, and adverse effects were induction and
      recovery, and adverse effects were recorded. Intravenous propofol administration
      induced a variable period of apnea in 34 of 40 dogs. Cyanosis (in 2 dogs) and
      signs of pain on injection (in 3 dogs) were infrequently observed during
      induction. One dog developed ventricular premature depolarizations after propofol
      administration. Venous CO2 tension increased and pH decreased immediately after
      propofol administration, regardless of preanesthetic regimen. The SAP
      significantly (P < 0.05) decreased after propofol administration in dogs treated
      with acepromazine (SAP, 178 mm of Hg before vs 128 mm of Hg after propofol) and
      with acepromazine/butorphanol (SAP, 184 mm of Hg before vs 98 mm of Hg after
      propofol). When used for induction, propofol induces anesthetic-related adverse
      effects, some of which can be minimized by preanesthetic medication. Recovery
      characteristics varied with preanesthetic medication, independent of propofol
      administration.

PMID- 8473226
TI  - Pulmonary edema associated with transient airway obstruction in three horses.
AB  - Pulmonary edema associated with transient airway obstruction was detected in 3
      horses. The cause of obstruction was different in each horse, but after relief of
      the obstruction, clinical signs and radiographic abnormalities were indicative of
      pulmonary edema. In 2 of the 3 horses, pink frothy fluid was evident in the
      airways. The horses were treated with furosemide, nasal insufflation of O2, anti
      inflammatory agents, and anti-biotics. Of the 3 horses examined, 1 horse died
      acutely, 1 horse recovered fully, and 1 developed pleuritis and was subsequently
      euthanatized.

PMID- 8473227
TI  - Use of a modified Roux-en-Y procedure for treatment of pyloroduodenal obstruction
      in a horse.
AB  - A modification of the Roux-en-Y anastomosis procedure was used to bypass a
      pyloroduodenal mass in a 12-year-old Arabian stallion. Clinical signs had
      consisted of a 4-week progression of ventral and hind limb edema,
      hypoproteinemia, fecal occult blood, intermittent abdominal pain, weight loss,
      and gastric reflux. On exploratory celiotomy, an obstructive mass was found in
      the pylorus and proximal portion of the duodenum. Gastrojejunostomy and
      duodenojejunostomy were performed by use of stapled side-to-side anastomosis
      techniques. Inaccessibility of the obstructed pyloric region prevented resection
      of the affected area.

PMID- 8473228
TI  - Repair of sacral fracture in two dairy cattle.
AB  - Sacral fractures in 2 dairy cattle were repaired surgically for cosmetic reasons.
      A heifer had a Salter-Harris type-I fracture of the fifth sacral vertebra, which
      was repaired with a 4.5-mm narrow dynamic compression plate. A cow had complete
      fracture of the fourth sacral body, which was repaired with 2 extra-large plastic
      spinous process plates. Both fixations were successful in restoring the dorsal
      contour of the sacrococcygeal region.

PMID- 8473229
TI  - Hemorrhage into the guttural pouch (auditory tube diverticulum) associated with
      rupture of the longus capitis muscle in three horses.
AB  - Three horses were determined to have hemorrhage into a guttural pouch
      unassociated with mycosis, empyema, neoplasia, or foreign body. The source of the
      hemorrhage appeared to be the rupture of the longus capitis muscle and its
      associated vascular supply.

PMID- 8473230
TI  - Primary parathyroid gland hyperplasia in dogs: six cases (1982-1991).
AB  - Persistent hypercalcemia attributable to parathyroid gland hyperplasia was
      identified in 6 dogs with primary hyperparathyroidism. Clinical signs included
      polydipsia (n = 4), polyuria (n = 4), and signs caused by cystic calculi (n = 3).
      Abnormal clinical pathologic findings included hypercalcemia (mean, 13.6 mg/dl;
      range, 12.6 to 14.7 mg/dl; n = 6), hypophosphatemia (mean, 2.2 mg/dl; range, 1.4
      to 2.9 mg/dl; n = 6), high serum alkaline phosphatase activity (mean, 222 IU/L;
      range, 161 to 286 IU/L; n = 3), and isosthenuria (mean, 1.012; range, 1.006 to
      1.017; n = 6). Serum parathyroid hormone concentration was within the reference
      range or high (mean, 23 pmol/L; range, 7 to 119 pmol/L; reference range, 1.5 to
      13 pmol/L) in all dogs. At surgery, the number of large parathyroid glands was
      variable, being limited to 1 gland in 3 dogs, 2 glands in 2 dogs, and 4 glands in
      1 dog. All visibly large parathyroid glands were surgically removed from each
      dog. Serum calcium concentration decreased into or below the reference range
      within 72 hours of surgery in all dogs, confirming the diagnosis of primary
      parathyroid disease. Multiple nodules of adenomatous hyperplasia were identified
      in each dog. All 6 dogs were treated with vitamin D and calcium carbonate
      following surgery. The dog from which all 4 parathyroid glands were removed has
      remained eucalcemic for more than 1 year with vitamin D supplementation. Vitamin
      D and calcium administration was discontinued within 4 to 12 weeks of surgery in
      the remaining 5 dogs. These dogs remained eucalcemic without vitamin D
      supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473231
TI  - Cholelithiasis in dogs: 29 cases (1980-1990).
AB  - Medical records of 29 dogs with cholelithiasis were reviewed. Aged female small
      breed dogs were overrepresented. Mean age was 9.5 years, and mean weight was 12
      kg. Vomiting, anorexia, weakness, polyuria/polydipsia, weight loss, icterus,
      fever, and signs of abdominal pain were the most common clinical signs.
      Leukocytosis, neutrophilia with left shift, monocytosis, high activity of serum
      hepatic enzymes, hypoalbuminemia, and high concentrations of serum total
      bilirubin were common. Radiopaque choleliths were evident on abdominal
      radiography of 13 of 27 dogs. Microbial culturing of bile isolated organisms in
      15 of 20 dogs. Gram-negative bacteria were most common. Surgery was performed in
      22 dogs. Four dogs were treated medically, and 3 dogs were euthanatized without
      treatment. Surgical treatment consisted of cholecystectomy in 11 dogs,
      choledochotomy in 5 dogs, cholecystotomy in 4 dogs, and cholecystojejunostomy in
      1 dog. Sphincter of Oddiotomy was performed in 1 dog. Five dogs had concurrent
      generalized peritonitis attributable to bile. Multiple choleliths were detected
      in most of the dogs. Choleliths were located in the gallbladder in 20 dogs and in
      the bile ducts in 14 dogs. The most common abnormalities of the gallbladder,
      identified histologically, were chronic cholecystitis, mucosal hyperplasia, and
      pericholecystic inflammation. The most common abnormalities of the liver were
      cholestasis, hepatocellular degeneration, and periportal fibrosis. Survival rate
      of dogs that underwent cholecystectomy tended to be higher (86%) than that of
      dogs treated via cholecystotomy (50%) or cholecystectomy in combination with
      choledochotomy (33%). Dogs that underwent medical treatment, abdominal
      exploratory, cholecystojenunostomy, choledochotomy, and sphincter of Oddiotomy
      died or were euthanatized because of redevelopment of clinical signs associated
      with cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473232
TI  - What is your diagnosis? Avulsion of the urethra from the urinary bladder.

PMID- 8473233
TI  - Decreased responsiveness to progesterone of spermatozoa in oligozoospermic
      patients.
AB  - Spermatozoa from oligozoospermic subjects are characterized by a reduced in vitro
      ability to penetrate hamster oocytes and by a decreased responsiveness to
      physiological stimuli that trigger the acrosome reaction. One of the first steps
      in the induction of the acrosome reaction is an increase of intracellular free
      calcium concentrations ([Ca2+]i). It has been recently shown that progesterone
      (P) is able to increase [Ca2+]i in capacitated human sperm at concentrations
      similar to those found in follicular fluid. We evaluated sperm [Ca2+]i increase
      in response to P (0.1 micrograms/ml) in 19 normo- and 17 oligozoospermic
      subjects. The average percentage of [Ca2+]i increase over the basal level was
      significantly lower in spermatozoa from oligozoospermic subjects when compared to
      normozoospermic subjects (138.7 +/- 8.22% increase in oligo- versus 263.3 +/-
      39.7% increase in normozoospermic subjects; P < 0.001). Progesterone-stimulated
      [Ca2+]i increase was significantly correlated with sperm motility (r = 0.54),
      sperm concentration (r = 0.96), and sperm morphology (% of normal forms) (r =
      0.49). In addition P induced a significant increase of acrosome-reacted
      spermatozoa in normospermic patients (n = 10), whereas no significant effect was
      observed in spermatozoa from oligozoospermic men (n = 7). Taken together, these
      results indicate that spermatozoa from oligozoospermic men have a reduced ability
      to initiate the cascade of events that lead to the acrosome reaction in response
      to a physiological stimulus, such as P, and might contribute to explaining the
      reduced fertilizing capacity of these patients.

PMID- 8473234
TI  - Androgen UDP-glucuronyl transferase activity is found primarily in liver in the
      rat.
AB  - UDP-glucuronyl transferase (UDPGT) activity was determined for androgens in
      tissue minces and microsomal fractions from the liver and extrahepatic tissues
      (kidney, skin, prostate, and preputial glands) of the male rat. Liver microsomes
      showed the highest UDPGT activity with each of the androgens tested (Vmax = 7, 3,
      and 10 nmol/minute/mg protein for testosterone, androsterone, and androstanediol,
      respectively). UDPGT activity (Vmax) for androstanediol in the liver was 10(2)
      fold higher than in the kidney and 10(3)-fold higher than in the skin and
      prostate. UDPGT activity for androgens was not detected in microsomes from
      preputial glands. Furthermore, no body site distribution was found for androgen
      UDPGT activity in skin microsomes. The Michaelis-Menten constant (Km) for UDPGT
      in liver microsomes was 20.4, 12.2, and 2.2 microM, respectively, for
      testosterone, androstanediol, and androsterone. Kidney microsomes showed a Km of
      19.4 and 26.9 microM, respectively, for androstanediol and androsterone. The Km
      for testosterone was very high in the kidney (138 microM), suggesting that it was
      a poor substrate. In microsomes from the skin and prostate, the Km was very high
      (range 43-162 microM) for all three androgen substrates, suggesting that these
      androgens were not the preferred substrates for UDPGT in these tissues. These
      results indicate that the liver was the main site of androgen UDPGT activity and
      the skin and prostate formed little, if any, androgen glucuronides. These results
      suggest that androstanediol glucuronide was formed primarily in the liver and may
      not be a reliable marker of peripheral androgen metabolism.

PMID- 8473235
TI  - Immunocytochemical localization of the Yf subunit of glutathione S-transferase P
      shows regional variation in the staining of epithelial cells of the testis,
      efferent ducts, and epididymis of the male rat.
AB  - Glutathione S-transferases (GSTs) are a family of isozymes that catalyze the
      conjugation of glutathione (GSH), a tripeptide found in all mammalian cells; this
      function plays a protective role, as the addition of GSH to an electrophile
      generally forms a less toxic product. The pi class of GSTs contains homodimers of
      the Yf subunit, also known as Yp or rat subunit 7; this subunit is found in high
      concentrations in the testis and epididymis. The objective of the present study
      was to localize immunocytochemically the Yf subunit in the testis and in the
      various regions of the epididymis using light, electron, and confocal microscopy.
      In the testis, immunoperoxidase staining was localized exclusively to Sertoli and
      Leydig cells. The low cuboidal epithelial cells of the rete testis and the sparse
      ciliated cells of the ductuli efferents were also immunoreactive. A distinct
      pattern of immunostaining for the Yf subunit was observed in the different
      regions of the epididymis. The proximal area of the initial segment showed
      intense reactivity localized to epithelial basal cells. Basal cells in the middle
      area of the initial segment were also reactive, as were a second unidentified
      population of cells located in the apical region of the epithelium. The
      epithelium, including both principal and basal cells, in the distal initial
      segment, intermediate zone, and proximal caput epididymidis showed a weak,
      moderate, or strong degree of reactivity, respectively. In the distal caput
      epididymidis, however, principal cells showed a checkerboard-like pattern of
      immunoreactivity, with some cells being intensely stained or faintly stained,
      whereas others were unreactive. Strikingly, in the corpus and proximal cauda
      epididymidis, intense immunostaining was localized exclusively over the
      epithelial basal cells. As viewed in the light and confocal microscope, the
      intensely stained basal cells showed extensive processes that covered most of the
      base of the epididymal tubule. Upon quantitation of the immunogold labeling
      density (the number of gold particles/microns2) in principal and basal cells of
      the different regions of the epididymis, we observed a sharp decline in
      immunogold labeling of principal cells coupled with a dramatic increase in
      labeling of basal cells as we progressed along the tissue, particularly in the
      transition from the caput to the corpus epididymidis. This study constitutes the
      first demonstration of a protein that is selectively expressed in epithelial
      basal cells of the corpus and proximal cauda epididymidis.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8473236
TI  - Pharmacokinetics and pharmacodynamics of a parenteral testosterone microsphere
      formulation in the male rat. Demonstration of dose dependence and controlled
      release.
AB  - This study examined the pharmacokinetics (the time course and pattern of
      testosterone release) and pharmacodynamics (effects on accessory sex organ
      weights, and serum LH and FSH levels) of a biodegradable testosterone microsphere
      formulation in the male rat. Two hundred seventy-five 55-day-old, sexually mature
      male rats underwent surgical orchiectomy or sham surgery and were divided into
      five groups as follows, to receive placebo or testosterone microsphere systems
      designed to release 25, 75, or 225 micrograms/day testosterone: group I: intact
      age-matched controls, sham operated, placebo microspheres; group II: surgically
      orchiectomized, placebo microspheres; group III: surgically orchiectomized, 25
      micrograms/day testosterone microspheres; group IV: surgically orchiectomized, 75
      micrograms/day testosterone microspheres; and group V: surgically orchiectomized,
      225 micrograms/day testosterone microspheres. Serum testosterone levels were
      fairly uniform from day 2 to 85 without any significant trend. After day 100,
      serum testosterone levels gradually fell into the castrate range by day 196.
      There was a dose-dependent increase in serum testosterone levels in groups III,
      IV, and V over those seen in group II (castrated rats, placebo treated). Prostate
      and seminal vesicle weights were significantly lower in castrated animals treated
      with placebo or the 25-micrograms/day testosterone microsphere system (group
      III). Mean prostate and seminal vesicle weights in groups IV and V were not
      significantly different from those in intact controls (group I) in the first 85
      days. After day 85-100, seminal vesicle and prostate weights declined gradually
      in groups III, IV, and V, approaching castrate range by day 196.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8473237
TI  - Importance of total motile oval count in interpreting the hamster ovum sperm
      penetration assay.
AB  - A prospective study relating computer-assisted semen analysis (CASA) and
      technician-determined morphology to sperm penetration assay (SPA) outcome in
      patients with unexplained infertility or male factor was undertaken on 190 males
      aged 28-45 to determine the value of total motile oval count (TMO), compared to
      concentration, motility, and morphology considered independently, in predicting
      the outcome of the SPA. Prewash sperm count ranged 20-1,328 x 10(6), motility 0
      93%, morphology 25-78% oval (%OVAL), and SPA scores 0-100%. Multiple regression
      analysis yielded two statistical models that identified significant predictors
      for % penetration (%P). Only TMO in one model and %OVAL in an independent effects
      model showed statistically significant correlation (P < 0.0001) to %P for all
      subjects. Discriminant function analysis showed the TMO model 85.4% accurate in
      classifying %P both in the abnormal range (< 20%P) and in the normal range (> or
      = 20%P). The independent effects model correctly classified 93% in the abnormal
      group, but projected 72 false negatives in the 101 subjects with %P > or = 20%,
      correctly classifying only 28.7%. Relative risk analysis showed TMO as a stronger
      risk factor affecting SPA outcome than %OVAL. It is concluded from this study
      that below 20%P, both TMO and %OVAL appeared to be comparable as predictive
      factors. Additionally, the TMO model was equally predictive for SPA > or = 20%P,
      where the independent effects model showed only 28.7% accuracy. SPA outcome
      appeared to be more profoundly affected by a decrease in TMO than by a decrease
      in %OVAL alone.

PMID- 8473238
TI  - Computer-assisted semen analysis (CASA) of epididymal sperm from the domestic
      cat.
AB  - Motion characteristics of epididymal sperm from domestic cats exhibiting a high
      (> 60%; normozoospermic; n = 21) or low (< 40%; teratozoospermic; n = 6)
      occurrence of structurally normal spermatozoa were correlated with morphology
      (MOR) using computer-assisted semen analysis (CASA). Mean values and standard
      errors for percent motility (MOT), curvilinear velocity (VCL), linearity (LIN),
      straight line velocity (VSL), and amplitude of lateral head displacement (ALH)
      were recorded for 3 hours. Average values for percent normal spermatozoa, MOT,
      VCL, VSL, and ALH were higher (P < 0.01) in samples from normozoospermic cats
      than from teratozoospermic cats at 0 hours, and there was no difference in motion
      parameters over the 3-hour incubation period in either group. Strong correlations
      (P < 0.01) existed between MOR and VCL, VSL, ALH, or MOT, but not LIN, upon
      regression analysis. We conclude that (1) motion parameters of domestic cat sperm
      are significantly correlated with morphology and (2) abnormal motion parameters
      associated with low fertility potential in other species are prevalent in samples
      from teratozoospermic cats. The correlation between morphology and altered sperm
      movement found in this study suggests that motion analysis of spermatozoa by CASA
      may be useful in evaluating fertilization potential in felids.

PMID- 8473239
TI  - Effect of catheter composition on sperm quality.
AB  - Bladder catheterization for collection of retrograde ejaculates is commonly
      practiced, although previous studies have shown that materials used in the
      manufacture of the catheters may be toxic to sperm. Potential toxicity is
      particularly relevant to electroejaculation, as sperm from anejaculatory
      individuals undergoing this procedure characteristically exhibit poor motility
      and viability. To determine the effect of short-term exposure to various catheter
      materials on sperm quality, donor semen was diluted with BWW medium and aliquots
      incubated for 1 and 5 minutes with segments of four different catheters. The
      catheters were composed of latex, silicone rubber, polytetrafluoroethylene
      (Teflon), and radio-opaque Teflon, respectively. Following incubation, eosin
      nigrosin staining for viability was performed and sperm motility assessed using
      computer-assisted sperm analysis (Cellsoft, Cryo Resources, Ltd). In the second
      phase of the study, donor semen was incubated with catheter segments coated with
      0.3 ml of a water-soluble, nontoxic lubricant (Cellulosagel, Lederle) to evaluate
      whether the combination adversely affects sperm. Percent motility and viability
      for the semen specimens incubated with the four catheters alone did not differ
      significantly from control values either at 1 or at 5 minutes (P = 0.3, motility;
      P = 0.6, viability). The addition of lubricant did not change the catheter data
      significantly, indicating the absence of independent or synergistic toxicity (P =
      0.5, motility; P = 0.4, viability). This study provides substantial evidence that
      brief exposure to conventional catheters, with or without a nontoxic lubricant,
      does not adversely affect sperm motility or viability.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8473240
TI  - Hormonal modulation of the interactions of cultured rat testicular Sertoli and
      peritubular myoid cells. Effects on glycosaminoglycan synthesis.
AB  - Previous investigators have suggested metabolic cooperation between Sertoli and
      peritubular cells. This study concerns Sertoli cell and peritubular myoid cell
      interactions in terms of synthesis of one of the main testicular extracellular
      matrix (ECM) constituents, glycosaminoglycans (GAG). We have tested the effect of
      hormones and other regulatory agents such as a combination of FSH, insulin,
      retinol, and testosterone (FIRT) on monocultures of Sertoli and peritubular myoid
      cells, and have examined whether or not coculture of Sertoli and peritubular
      myoid cells substitutes for the stimulation by FIRT. Cocultures of Sertoli and
      testicular peritubular myoid cells showed significant increases in the levels of
      secreted protein and sulfoprotein, as well as in cell-associated GAG synthesis in
      untreated cultures. This indicates cell-cell cooperation between Sertoli and
      peritubular myoid cells in the testis in terms of sulfated protein and GAG
      synthesis. Addition of the hormone mixture and retinol (FIRT) stimulated cell
      associated and ECM-associated GAG in peritubular myoid cells, suggesting a role
      of circulating hormones in ECM production by peritubular myoid cells in vivo.
      Cocultures of Sertoli and myoid cells substituted for the stimulatory response of
      FIRT on peritubular myoid cells, predominantly in terms of cell-associated GAG
      synthesis, which again emphasizes that the paracrine regulation of testicular ECM
      synthesis is dependent on Sertoli-myoid cell cooperation.

PMID- 8473241
TI  - Sleep and active cochlear micromechanical properties in human subjects.
AB  - In this paper the effect of sleep on the cochlea is studied by transiently evoked
      otoacoustic emissions (TEOAEs). Amplitude increases considerably (e.g., 4 dB) and
      the effect of a contralateral noise on the TEOAEs decreases during the night.
      These modifications can be related to sleep, although there is no link to
      electroencephalographic sleep stage. During sleep onset, the effect of
      contralateral noise disappears: this could correspond to a functional rest of the
      auditory pathway during that period.

PMID- 8473242
TI  - Electrical stimulation of the auditory nerve: the effect of electrode position on
      neural excitation.
AB  - Histological studies have shown that the Melbourne/Cochlear electrode array lies
      along the outer wall of the scala tympani and is therefore some distance from the
      residual VIIIth nerve elements. In order to investigate the influence of
      electrode position on neural excitation we systematically varied the position of
      the electrode array within the cat scala tympani while recording electrically
      evoked auditory brainstem responses (EABRs). Using both normal hearing and long
      term deafened animals, we observed significant reductions in EABR thresholds as
      the electrode array was moved from the outer wall towards the modiolus. Further
      threshold reductions were observed when the array was placed underneath the
      osseous spiral lamina (OSL) close to the peripheral dendrites. These changes were
      independent of the bipolar inter-electrode separation, and were observed over a
      wide range of cochlear pathologies varying from normal to a moderate spiral
      ganglion cell loss. Interestingly, the one animal exhibiting extensive neural
      loss showed no correlation between EABR threshold and electrode position. There
      was also a general decrease in the gradient of the EABR input-output function as
      the electrode array was moved closer to the neural elements. This was, however,
      only statistically significant when the electrode was positioned adjacent to the
      peripheral dendrites. Significant reductions in EABR threshold were also observed
      as the inter-electrode spacing of the bipolar electrodes was increased. The
      gradient of the EABR input-output function also increased with increasing inter
      electrode spacing, although again, this was only significant when the electrode
      array was positioned close to the neural elements. The present results indicate
      that the optimum placement of a Melbourne/Cochlear electrode array is adjacent to
      the peripheral dendrites. However, such a site would be difficult to achieve in
      practice while minimizing insertion trauma. An array lying adjacent to the
      modiolus would be a safe alternative while ensuring a significant reduction in
      threshold compared with the existing site (outer wall). This placement should
      result in more localized neural excitation patterns, an increase in the number of
      bipolar electrodes available, together with an increase in their dynamic range.
      These changes may lead to further improvements in speech perception among
      cochlear implant patients.

PMID- 8473243
TI  - Incorporation of D3H glucosamine to the adult and developing cochlear tectorial
      membrane of normal and hypothyroid rats.
AB  - The uptake of D-3H-glucosamine by the developing cochlea of normal and
      hypothyroid rats was examined using light microscopic radioautography. During
      postnatal development, normal and hypothyroid rat cochleas exhibited a layer of
      radiolabelling in the tectorial membrane (TM). This layer first appeared in the
      TM region which covers the spiral limbus and the Kolliker's organ (KO), then
      progressively reached the apical part of the TM covering the organ of Corti.
      Radiolabelling was significantly greater in hypothyroid than in normal cochleas.
      These findings suggests that the enormous size reached by the TM in the
      congenital hypothyroidism could be related to an increase of epithelial
      secretion, at least for carbohydrates. It also suggests that TM, in normal and
      hypothyroid cochleas, could be formed during development by the addition of
      successive layers. Older layers could be displaced upwards by the new ones.
      Cochleas of normal young adult rats, treated with D-3H-glucosamine, showed a very
      scarce and diffuse radiolabelling. Cochleas of hypothyroid young adult rats
      exhibited a thickened and distorted TM, which incorporated a significant amount
      of carbohydrates. These results suggest that TM secretion is highly reduced in
      young adult normal animals, while in young adult hypothyroid ones it is still
      active. During cochlear maturation, thyroxine seems to be necessary, not only for
      the synthesis of normal glycoproteins (as suggested by previous reports), but
      also for the control of glycoprotein secretion.

PMID- 8473244
TI  - Two-tone suppression and distortion production on the basilar membrane in the
      hook region of cat and guinea pig cochleae.
AB  - Two-tone suppression and two-tone distortion were investigated at the level of
      the basilar membrane in the hook region of cat and guinea pig cochleae using a
      displacement-sensitive laser interferometric measurement system. The system
      allowed measurements to be performed at physiological stimulus levels in the
      cochlear region tuned to 30-35 kHz in cat and 29 kHz in guinea pig. The amplitude
      of vibration of the basilar membrane due to a probe tone at the characteristic
      frequency (CF) was attenuated during the presentation of a simultaneous
      suppressor tone either above or below CF. The amount of suppression depended on
      the intensities of both probe and suppressor, and the relationship of the
      suppressor frequency to the CF. Suppressors at frequencies more than an octave
      below the CF attenuated the responses to the CF probe at a rate of up to 1 dB/dB,
      with little variation based on suppressor frequency. As the suppressor frequency
      was increased above CF the rate of suppression decreased rapidly. The lowest
      suppressor intensity at which attenuation of the probe response was observed did
      not vary in direct proportion to the probe intensity. This suppression threshold
      often varied only a few dB SPL when the probe was varied over a 20 dB SPL range.
      In a few instances the rate of attenuation was as much as a factor of two greater
      at the lowest probe intensities than at higher intensities. It is noteworthy that
      suppression was found when the frequency of the suppressor was either above or
      below CF in the same preparation. Low frequency suppressor tones suppress basilar
      membrane motion at the CF when the basilar membrane undergoes displacement toward
      either scala. The maximum suppression occurs around 100 microseconds after the
      peak excursions caused by the low frequency biasing tone. Two-tone distortion
      products were often observed even at stimulus levels below those causing two-tone
      suppression at the site studied. The cubic difference tone (CDT) was the most
      prominent of the distortion products. The level of the CDT component varied
      nonmonotonically with the level of either of the primary tones. Responses at the
      difference frequency between the two primaries were usually below the noise floor
      of the recording system. The existence of both two-tone distortion and two-tone
      suppression was dependent on the presence of a cochlear nonlinearity.

PMID- 8473245
TI  - Frequency-related differences in the speed of human auditory processing.
AB  - Three experiments were performed, two comparing the peak latencies of auditory
      evoked potentials (AEPs) elicited by 250 Hz and 4000 Hz tone pips and a third
      comparing simple reaction times (RTs) to the same stimuli. In the AEP
      experiments, the latencies of brainstem, middle and long-latency components were
      delayed following 250 Hz tone pips in comparison with the latencies of the same
      components evoked by loudness-matched 4000 Hz tones. Frequency-related latency
      differences increased with component latency, ranging from less than 1.0 ms for
      wave V of the brainstem AEP, to more than 20.0 ms for the cortical N1 component.
      Interpeak latency differences were also significantly lengthened following the
      250 Hz tone pips. In the behavioral study, RTs were 14.6 ms slower following 250
      than 4000 Hz tone pips. The results suggest that the time required for the
      sensory analysis of auditory signals varies inversely with their frequency.

PMID- 8473246
TI  - The influence of temporal pattern of stimulation on delay tuning of neurons in
      the auditory cortex of the FM bat, Myotis lucifugus.
AB  - In echolocating bats, delay-sensitive neurons show facilitative responses to
      simulated pulse-echo pairs at particular echo delays. Three experiments examined
      how the temporal pattern of stimulation affected the delay tuning of neurons in
      the auditory cortex of the awake FM bat, Myotis lucifugus. First, delay tuning
      was compared using a series of pulse-echo pairs fixed in echo delay ('standard'
      stimuli), and a series of pulse-echo pairs in which successive sound pairs
      decreased by a fixed echo-delay step ('approach' stimuli). Similar best delays
      were measured with both stimulation patterns presented at repetition rates in
      which the neuron was delay-sensitive. At the higher delay-sensitive pulse
      repetition rates, approach stimuli evoked larger delay-dependent responses.
      Second, approach stimuli were fixed at different intertrial intervals. The best
      delay was unaffected by intertrial interval, although some neurons showed larger
      responses for longer intertrial intervals (0.5, 1.0 s), especially at the higher
      delay-sensitive pulse repetition rates. Third, approach stimuli were fixed at
      different echo-delay steps to simulate target velocity. The majority of neurons
      showed some sensitivity to echo-delay step, with clear preference for target
      velocity mainly between 1.8-7.0 m/s. This suggests that delay-sensitive neurons
      compute target velocity by rate of change of echo delay over successive echoes.
      Thus, response properties of cortical neurons are influenced by dynamic acoustic
      conditions found in target-directed flight.

PMID- 8473247
TI  - Increment detection of bandlimited noises in the chinchilla.
AB  - A positive reinforcement, adaptive tracking procedure was used to study the
      intensity discrimination abilities of six chinchillas to noise signals. Increment
      detection thresholds were obtained using a two-down, one-up tracking rule. The
      effect of overall noise masker level and the effect of noise bandwidth on
      increment detection thresholds were studied. The continuous noise masker and the
      signal increment had equal bandwidths. Increment detection thresholds are
      independent of overall level for wideband noise; the asymptotic DL for wideband
      noise is 1.334 dB. In addition, increment detection thresholds decrease as the
      bandwidth of the noise increases. The observed slope of the bandwidth function
      for the chinchilla is independent of overall level and is around -2.8 dB/decade.
      The slope of the bandwidth function obtained for the chinchilla is similar to
      values reported for human subjects under similar conditions, but is less than the
      slope predicted by the ideal energy detector model.

PMID- 8473248
TI  - The innervation of the organ of Corti in the rat.
AB  - To date our knowledge of the baso-apical distribution of the afferent and
      efferent nerve fibers innervating the organ of Corti is only fragmentary. This
      study makes an effort to lay the basis for a comprehensive analysis of cochlear
      innervation. Using a quantitative electronmicroscopic method, the fiber density
      of all cochlear fibers along the entire length of the cochlear duct was
      investigated in adult rats, Rattus norvegicus. Myelinated and unmyelinated nerve
      fibers in the primary osseous spiral lamina and afferent and efferent nerve
      fibers to the outer hair cells (OHCs) in the tunnel of Corti were counted. The
      rat cochlea is innervated by 19000 nerve fibers which consist of 79% afferent and
      21% efferent fibers. The inner hair cells (IHCs) are innervated by 14000 afferent
      and 2000 efferent fibers. The OHCs are innervated by 1000 afferent and 2000
      efferent fibers. The maximum fiber density of IHC afferents, OHC afferents and
      IHC efferents was found in the middle of the cochlea. This corresponds to the
      region at the basilar membrane where the frequency range of maximum sensitivity
      is located [8 kHz-31 kHz; Kelly and Masterton, J. Comp. Physiol. Psychol. 91, 930
      936 (1977)]. The efferent nerve fibers to the OHCs consists of two different
      morphological sub-types: large fibers containing mitochondria and neurotubules
      (type I) and small fibers containing neurofilaments (type II). The fiber density
      of type I OHC efferents decreases from base to apex corresponding to the
      frequency dispersion along the basilar membrane. The fiber density of type II OHC
      efferents has maxima at the base and at the apex and a minimum in the middle of
      the cochlea. This minimum corresponds to the region at the basilar membrane where
      the frequency range of maximum sensitivity is located.

PMID- 8473249
TI  - Binaural interaction in auditory evoked potentials: brainstem, middle- and long
      latency components.
AB  - Binaural interaction occurs in the auditory evoked potentials when the sum of the
      monaural auditory evoked potentials are not equivalent to the binaural evoked
      auditory potentials. Binaural interaction of the early- (0-10 ms), middle- (10-50
      ms) and long-latency (50-200 ms) auditory evoked potentials was studied in 17
      normal young adults. For the early components, binaural interaction was maximal
      at 7.35 ms accounting for a reduction of 21% of the amplitude of the binaural
      evoked potentials. For the middle latency auditory evoked potentials, binaural
      interaction was maximal at 39.6 ms accounting for a reduction of 48% of the
      binaural evoked potential. For the long-latency auditory evoked potentials,
      binaural interaction was maximal at 145 ms accounting for a reduction of 38% of
      the binaural evoked potential. In all of the auditory evoked potentials binaural
      interaction was long lasting around the maxima. The binaural interaction
      component extends for several milliseconds in the brainstem to tens of
      milliseconds in the middle- and long-latency components. Binaural interaction
      takes the form of a reduction of amplitude of the binaural evoked potential
      relative to the sum of the monaural responses, suggests that inhibitory processes
      are represented in binaural interaction using evoked potentials. Binaural
      processing in the auditory pathway is maximal in the time domain of the middle
      latency components reflecting activity in the thalamo-cortical portions of the
      auditory pathways.

PMID- 8473250
TI  - Effects of active student response during error correction on the acquisition,
      maintenance, and generalization of sight words by students with developmental
      disabilities.
AB  - We used an alternating treatments design to compare the effects of active student
      response error correction and no-response error correction during sight word
      instruction. Six students with developmental disabilities were provided one-to
      one daily sight word instruction on eight sets of 20 unknown words. Each set of
      20 words was divided randomly into two equal groups. Student errors during
      instruction on one group of words were immediately followed by the teacher
      modeling the word and the student repeating it (active student response
      instruction). Errors on the other group of words were immediately followed by the
      teacher modeling the word while the student attended to the word card (no
      response instruction). For all 6 students, the active student response error
      correction procedure resulted in more words read correctly during instruction,
      same-day tests, next-day tests, 2-week maintenance tests, and generality tests
      (words read in sentences).

PMID- 8473251
TI  - Teaching children with autism to initiate to peers: effects of a script-fading
      procedure.
AB  - A script that was systematically faded from end to beginning was used to teach
      peer initiations about recently completed, current, and future activities. The
      effectiveness of the script-fading procedure was assessed via a multiple baseline
      design across 4 children with autism. During baseline, the children seldom
      initiated to peers, although all had previously acquired some functional
      expressive language and sometimes spontaneously addressed adults. When the script
      was introduced, peer initiations increased, and as the script was faded,
      unscripted initiations increased. With the minimal written prompts available in
      the final fading steps, initiations generalized to a different setting, time,
      teacher, and activity; and for 3 of the 4 children, peer initiations were
      maintained at a 2-month follow-up. After the script was faded, the participants'
      levels of peer initiations were within the same range as a normative sample of 3
      nondisabled youngsters. The script-fading procedure enabled children with severe
      social and verbal deficits to practice context-specific, peer-directed generative
      language that was not prompted by adults or peer confederates.

PMID- 8473252
TI  - Effects of signaling invasive procedures on a hospitalized infant's affective
      behaviors.
AB  - We report the effects of using a visual and auditory stimulus signaling impending
      painful medical procedures versus "safe" periods on the affective behavior of a
      hospitalized infant. The results of a reversal design suggested that the
      signaling procedures increased positive behaviors and decreased negative
      behaviors during both noninvasive and invasive caregiver events.

PMID- 8473253
TI  - Momentum versus extinction effects in the treatment of self-injurious escape
      behavior.
AB  - An individual's self-injurious escape behavior was treated using a high
      probability instructional sequence with and without extinction. When presented
      alone, the high-probability sequence did not reduce self-injurious behavior. When
      escape extinction was implemented either alone or in combination with the high
      probability sequence, self-injury decreased and compliance increased, suggesting
      that extinction may be a necessary component of the treatment for behavior
      problems maintained by escape.

PMID- 8473254
TI  - Programming participation in family activities for children with autism: parents'
      use of photographic activity schedules.
AB  - The parents of 3 boys with autism were taught to help their children follow
      photographic activity schedules depicting a variety of home-living tasks. A
      multiple baseline across participants showed that the home-based intervention
      produced increases in children's engagement and social initiations and decreases
      in disruptive behavior, which were maintained for as long as 10 months.

PMID- 8473255
TI  - Reduction of self-injurious hand mouthing using response blocking.
AB  - We evaluated a response-blocking procedure for reducing the self-injurious hand
      mouthing of 2 adults with profound disabilities. The procedure reduced mouthing
      in both cases. The results suggest research is warranted to delineate the
      behavioral process responsible for the effect of response blocking and to
      determine the procedure's long-term utility.

PMID- 8473256
TI  - Functional communication training with and without extinction and punishment.
AB  - Functional communication training has been reported to be a promising treatment
      for severe behavior problems. In this study, functional communication training
      alone and combined with extinction and/or punishment was evaluated for 4 clients
      with severe retardation, behavior problems, and communication deficits. The
      participants were inpatients on a hospital unit for treatment of severe behavior
      disorders. They received individualized interventions based on functional
      assessment that included reinforcement of a communication response with the same
      function as their destructive behavior. Results showed that for some patients,
      functional communication training was not sufficient to produce clinically
      significant reductions in destructive behavior, and the combination of training
      plus punishment produced the largest and most consistent reductions.

PMID- 8473257
TI  - Impulsivity in students with serious emotional disturbance: the interactive
      effects of reinforcer rate, delay, and quality.
AB  - We conducted two studies extending basic matching research on self-control and
      impulsivity to the investigation of choices of students diagnosed as seriously
      emotionally disturbed. In Study 1 we examined the interaction between unequal
      rates of reinforcement and equal versus unequal delays to reinforcer access on
      performance of concurrently available sets of math problems. The results of a
      reversal design showed that when delays to reinforcer access were the same for
      both response alternatives, the time allocated to each was approximately
      proportional to obtained reinforcement. When the delays to reinforcer access
      differed between the response alternatives, there was a bias toward the response
      alternative and schedule with the lower delays, suggesting impulsivity (i.e.,
      immediate reinforcer access overrode the effects of rate of reinforcement). In
      Study 2 we examined the interactive effects of reinforcer rate, quality, and
      delay. Conditions involving delayed access to the high-quality reinforcers on the
      rich schedule (with immediate access to low-quality reinforcers earned on the
      lean schedule) were alternated with immediate access to low-quality reinforcers
      on the rich schedule (with delayed access to high-quality reinforcers on the lean
      schedule) using a reversal design. With 1 student, reinforcer quality overrode
      the effects of both reinforcer rate and delay to reinforcer access. The other
      student tended to respond exclusively to the alternative associated with
      immediate access to reinforcers. The studies demonstrate a methodology based on
      matching theory for determining influential dimensions of reinforcers governing
      individuals' choices.

PMID- 8473258
TI  - Analysis of a simplified treatment for stuttering in children.
AB  - We investigated the effectiveness of a simplified program for the treatment of
      stuttering in children. The simplified treatment included awareness training, in
      which the subjects learned to detect every occurrence of stuttering; training a
      response incompatible with stuttering, which involved relaxation and regulation
      of air flow over the larynx when speaking; and social support, which involved
      parent-delivered prompts and praise of children's use of the techniques in
      everyday environments. Eight children were treated in their homes with the
      simplified treatment, in a multiple baseline across subjects design, and all
      reached the criterion level of less than 3% words stuttered. In addition, the
      reduction in stuttering generalized to the school setting and was maintained at
      posttreatment (10 to 13 months). The subjects' rates of speech remained stable
      throughout baseline and treatment. Pretreatment and posttreatment ratings by the
      parents showed that they found treatment to be both acceptable and credible.
      Finally, social validity measures revealed a noticeable improvement in the
      subjects' speech to parents and speech pathologists.

PMID- 8473259
TI  - Teaching choice making during social interactions to students with profound
      multiple disabilities.
AB  - We taught 4 students with profound multiple disabilities to use a microswitch
      communication system to request a change in recreational stimuli during social
      interactions with nondisabled peers. In Study 1, we conducted a preference
      assessment across a range of stimuli for each student. The most and least
      preferred stimuli were incorporated into microswitch communication system
      training in Study 2. During the second study, 3 of the 4 students (a) learned to
      use the microswitch communication system to control stimulus presentation, (b)
      more clearly differentiated their time among stimuli, and (c) increased their
      level of general alertness. Study 3 extended the use of the microswitch
      communication system to social interactions with nondisabled peers. Two students
      were more engaged in interactions when they chose when to change stimuli; 1
      student was more alert when a peer chose when to change activities; a 4th student
      showed an undifferentiated pattern. The outcomes of the investigation are
      discussed in terms of the effects of controlling stimulus presentation on the
      behavior of students with profound multiple disabilities and the stability of
      preference hierarchies over time.

PMID- 8473260
TI  - Effects of memory aids on the dyadic conversations of individuals with dementia.
AB  - The effects of a prosthetic memory aid on the conversational content and social
      skills of dyads with dementia were evaluated. Six individuals with moderate to
      severe dementia served as either subject or partner in dyads during 5-min
      conversational probes conducted three times per week in day-care and nursing-home
      settings. During phases when a memory aid, consisting of personally relevant
      picture and sentence stimuli, was available, most subjects used their own aid to
      improve the quality of conversations by increasing the frequency of on-topic
      statements, diminishing nonproductive utterances, lengthening their
      conversational turn, and/or increasing the frequency of turns taken. Most
      partners demonstrated awareness of social discourse conventions by appropriately
      relinquishing conversational dominance, decreasing both content and nonproductive
      utterances, and increasing acknowledging or affirmative comments when subjects
      used memory aids. Naive judges' ratings of aided and unaided conversational
      samples on seven conversational dimensions reflected differences in perceptions
      of significant improvement as a function of the conversational discourse style of
      each dyad.

PMID- 8473261
TI  - Teaching children with autism to use photographic activity schedules: maintenance
      and generalization of complex response chains.
AB  - We used a graduated guidance procedure to teach 4 boys with autism to follow
      photographic activity schedules to increase on-task and on-schedule behavior. The
      multiple baseline across participants design included baseline, teaching,
      maintenance, resequencing of photographs, and generalization to novel photographs
      phases. The results indicated that photographic activity schedules (albums
      depicting after-school activities) produced sustained engagement, and skills
      generalized to a new sequence of photographs and to new photographs. The
      acquisition of schedule-following skills enabled these children with severe
      developmental disabilities to display lengthy response chains, independently
      change activities, and change activities in different group home settings in the
      absence of immediate supervision and prompts from others.

PMID- 8473262
TI  - The role of attention in the treatment of attention-maintained self-injurious
      behavior: noncontingent reinforcement and differential reinforcement of other
      behavior.
AB  - Because there are potentially serious limitations to differential reinforcement
      of other behavior (DRO) (which is probably the most widely used treatment
      procedure for behavior problems), we examined an alternative procedure-
      noncontingent reinforcement (NCR). Three females with developmental disabilities,
      all of whom engaged in severe self-injurious behavior, participated. During a
      pretreatment functional analysis, each subject's self-injury was shown to be
      differentially sensitive to social attention as a maintaining consequence. Next,
      each subject was exposed to a DRO treatment and an NCR treatment. During DRO,
      attention was delivered contingent on the absence of self-injury for prespecified
      intervals. During NCR, attention was delivered on a fixed-time schedule that was
      not influenced by the subject's behavior. Results showed that both procedures
      were highly effective in reducing self-injury, probably because the functional
      reinforcer for self-injury was used during treatment. Furthermore, there was
      evidence that NCR attenuated several of the limitations of DRO. These results are
      particularly interesting in light of the long experimental history of NCR as a
      control rather than as a therapeutic procedure.

PMID- 8473263
TI  - Relative effects of whole-word and phonetic-prompt error correction on the
      acquisition and maintenance of sight words by students with developmental
      disabilities.
AB  - We used an alternating treatments design to compare the effects of two procedures
      for correcting student errors during sight word drills. Each of the 5
      participating students with developmental disabilities was provided daily one-to
      one instruction on individualized sets of 14 unknown words. Each week's new set
      of unknown words was divided randomly into two groups of equal size. Student
      errors during instruction were immediately followed by whole-word error
      correction (the teacher stated the complete word and the student repeated it) for
      one group of words and by phonetic-prompt error correction (the teacher provided
      phonetic prompts) for the other group of words. During instruction, all 5
      students read correctly a higher percentage of whole-word corrected words than
      phonetic-prompt corrected words. Data from same-day tests (immediately following
      instruction) and next-day tests showed the students learned more words taught
      with whole-word error correction than they learned with phonetic-prompt error
      correction.

PMID- 8473264
TI  - "Normal" breast cells adjacent to a tumor grown in long-term three-dimensional
      culture.

PMID- 8473265
TI  - TGF-beta gene expression depends on tissue architecture.

PMID- 8473266
TI  - New model of vascular cell repair in vitro.

PMID- 8473267
TI  - A novel human glioma cell line from pituitaries.

PMID- 8473268
TI  - Insulin-like growth factor-II receptor expression in normal and N-methyl-N'-nitro
      nitrosoguanidine exposed cell lines: assessment by flow cytometry.

PMID- 8473269
TI  - Factors regulating the emergence of spontaneous and X-ray-induced variants in
      primary rat tracheal epithelial cell cultures.
AB  - A series of experiments have been carried out to identify those factors that
      affect the number of altered populations detected in control, nonexposed, and
      radiation-exposed primary cultures of rat tracheal epithelial cells. The number
      of colony forming cells per milliliter of culture medium and the frequency with
      which the culture medium is changed seemed to be the most critical factors
      regulating the emergence of induced and spontaneous variants. Increasing the
      number of cells plated so that of colony forming cells increase from 25 to 200
      per ml, regardless of the dish size used, was associated with a 200-fold decline
      in the frequency of spontaneous variants and a 40-fold decline in X-ray-induced
      variants. Increasing the interval between medium changes from 3 to 7 days after
      the first week of culture was associated with a 10-fold decrease in the frequency
      of spontaneous variants. The frequency of spontaneous and induced variants is
      markedly less dependent on culture density at densities between 150 and 600
      colony forming cells per ml. The type of medium used to establish primary
      cultures had little effect on the frequency of variants detected. Similarly, when
      assays were performed at densities in excess of 150 colony forming cells per ml
      the frequency of spontaneous and x-ray-induced variants was not affected by the
      absence of epidermal growth factor, increased levels of calcium (final
      concentration, 0.8 mM), or by removal of pyruvate from the selection medium.

PMID- 8473270
TI  - Isolation and culture of rat superior mesenteric artery smooth muscle cells.
AB  - The structure and function of vascular smooth muscle cells have been extensively
      investigated with the aid of in vitro culture techniques. The majority of studies
      have utilized aortic tissue as the source of cells. We present here a method for
      isolating and culturing smooth muscle cells of the rat superior mesenteric
      artery, an elasto-muscular vessel that is structurally and functionally different
      from the aorta. Cells were isolated from partially digested explants and
      characterized by immunochemical and biochemical techniques. Unlike cultured
      fibroblasts, the cultured cells stained positive for smooth muscle specific
      actin. The cells also produced laminin and type IV collagen in culture. This
      method provides a means for the isolation of large numbers of viable smooth
      muscle cells from the superior mesenteric artery which can be propagated in
      culture for in vitro study.

PMID- 8473271
TI  - Retinoic acid modulation of alpha(1-->2) fucosyltransferase activity and
      sensitivity of tumor cells to LAK-mediated cytotoxicity.
AB  - We examined the effects of all-trans retinoic acid (RA) on alpha(1-->2)
      fucosyltransferase activity and sensitivity to LAK-mediated cytotoxicity in two
      rat colon carcinoma cell lines differing by their glycosylation state and their
      tumorigenic potential. RA induced a decrease in alpha(1-->2) fucosyltransferase
      activity in the more tumorigenic variant PROb. Fucosyltransferase mRNA levels
      were not affected by RA treatment in PROb cells, suggesting a posttranscriptional
      control. This inhibition was accompanied by a decreased expression of fucosylated
      membrane glycoconjugates and by a significant increase in the sensitivity to LAK
      mediated cytotoxicity. REGb cells, which exhibited a very low enzymatic activity
      and very few fucosylated glycoconjugates, were more sensitive to LAK-lysis than
      PROb cells and were not affected by RA treatment.

PMID- 8473272
TI  - Differences in growth of neurons from normal and regenerated teleost spinal cord
      in vitro.
AB  - Explants and dissociated cells from normal adult spinal cord and regenerating
      cord of the teleost Apteronotus albifrons were grown in vitro for periods of 8 to
      12 wk. During this time the neurons showed extensive neurite outgrowth. Neurite
      outgrowth from tissue explants and dissociated cells of regenerated spinal cord
      starts sooner and is more profuse than that from normal (unregenerated) cord.
      Neurite outgrowth is maximized by using adhesive substrata and a high density of
      explants or dissociated cells. Inasmuch as Apteronotus does regenerate its spinal
      cord naturally after injury, whereas mammals do not, this culture system will be
      useful to study factors that control (permit) regeneration of spinal neurons in
      this adult vertebrate.

PMID- 8473273
TI  - Polarized secretion of tissue-plasminogen activator in cultured thyroid cells.
AB  - We studied the polarized secretion of tissue-type plasminogen activator in
      porcine thyroid cells cultured as a monolayer on porous bottom chambers. The
      presence of tissue-type plasminogen activator was detected by zymographic
      analysis on two independent media that were in contact either with the apical
      surface or with the basolateral membrane. The amount of tissue-type plasminogen
      activator was determined in both media by ELISA and enzyme assay. Measurable
      tissue-type plasminogen activator activity was found in the basal but not in the
      apical medium. However, on zymogram, a lytic zone corresponding to tissue-type
      plasminogen activator was visible in both media. In addition, a lytic band at 130
      kDa suggested presence of a complex formed by tissue-type plasminogen activator
      and an inhibitor. Preferential basolateral tissue-type plasminogen activator
      antigen secretion (70%) has been observed, showing the possible relation between
      tissue-type plasminogen activator and extracellular matrix components. Neither
      tissue-type plasminogen activator level nor polarized secretion seemed to be
      regulated by thyrotropin (0.1 mU/ml).

PMID- 8473274
TI  - Serum-free medium for long-term growth, freezing, cloning and fusion of myelomas
      and hybridomas.

PMID- 8473275
TI  - Endothelial proliferation and adhesivity.

PMID- 8473276
TI  - The role of family education.
AB  - A mentally ill relative not only represents a tragedy for a family but also poses
      a challenge to the practitioner trying to understand the family's perspective as
      they attempt to cope with this profoundly difficult situation. Such an
      understanding calls for a new professional paradigm that includes the family in
      the treatment process, taking into account the subjective experiences and
      objective burdens of mental illness. When families are well-informed about mental
      illness, they can become allies in treatment, control stress, and participate in
      problem-solving.

PMID- 8473277
TI  - Mental health care policy in the 1990s: discrimination in health care coverage of
      the seriously mentally ill.
AB  - The severely mentally ill face many roadblocks, not the least of which is
      discrimination by the government and by insurance companies. The inadequate
      coverage allowed the severely mentally ill by the insurance industry, Medicare,
      and Medicaid is often as little as one fifth or less the coverage allowed other
      serious illnesses. This inequity not only contributes to the terrible stigma of
      mental illness, but also greatly increases patient suffering and results in
      needless fatalities--suicides that could have been prevented by properly
      reimbursed treatment. As the federal government prepares for essential health
      care cost reform, it is imperative that policy leaders, physicians, and mental
      health care advocates demand equal treatment under the law for the severely
      mentally ill. The Equitable Health Care for Severe Mental Illnesses Act of 1992
      can provide a model for such action.

PMID- 8473278
TI  - A system approach to reducing relapse in schizophrenia.
AB  - Successful treatment of schizophrenia depends on understanding the nature of the
      disorder and providing a system of care with the primary locus in the community.
      Care must be continuous and must fulfill a wide variety of needs required for
      patients to make a stable adjustment to the community. The Dane County,
      Wisconsin, integrated system of community-based care is a proven model. It is
      based on the above principles and has resulted in more patients living
      independently and working productively, with fewer hospitalizations. The majority
      of funding for the Dane County Mental Health System is allocated to community
      services making it possible to offer a comprehensive set of programs. These
      programs work cooperatively to do whatever is needed to help patients achieve a
      stable life, of decent quality, in the community. The conceptual framework for
      the treatment of persons with schizophrenia, the principles of treatment, and a
      system of care based on those principles is discussed.

PMID- 8473279
TI  - The anaerobic ribonucleotide reductase from Escherichia coli.

PMID- 8473280
TI  - Phosphorylation and dephosphorylation catalyzed in vitro by purified components
      of the nitrate sensing system, NarX and NarL.
AB  - The regulation of specific gene expression by nitrate in Escherichia coli is
      mediated by the NarX/NarQ-NarL system. Based on sequence homologies with a family
      of two-component regulatory systems in bacteria, NarL has been identified as a
      putative response regulator while NarX and NarQ were proposed to be alternative
      membrane-associated sensors that activate NarL in the presence of nitrate. To
      investigate the interaction of NarX and NarL in vitro, both proteins were
      purified from overproducing strains. Purified NarX was rapidly labeled when
      incubated with [gamma-32P] ATP but not with [alpha-32P]ATP in a reaction that
      required Mg2+ but was unaffected by nitrate. Incubation of the labeled NarX with
      purified NarL resulted in the transient phosphorylation of NarL. Both the
      phosphorylation and dephosphorylation of NarL required Mg2+, and neither reaction
      was affected by the presence of nitrate. NarL-phosphate, stabilized by the
      addition of EDTA, ran as a monomer on gel filtration. Dephosphorylation of the
      isolated NarL-phosphate required the addition of both Mg2+ and the NarX protein.
      The relative stabilities of the phosphorylated forms of the two proteins at
      different pH values were consistent with the proposal that, in analogy to other
      related two-component regulatory systems, NarX and NarL were phosphorylated on
      specific histidine and aspartate residues, respectively.

PMID- 8473281
TI  - Specificity of Goodpasture autoantibodies for the recombinant noncollagenous
      domains of human type IV collagen.
AB  - Type IV collagen has recently emerged as a family composed of five known chains
      (alpha 1-alpha 5), each of which contains a carboxyl-terminal noncollagenous
      domain (NC1) of approximately 230 amino acids. The NC1 domain of the alpha 3(IV)
      chain is the probable target for autoantibodies in patients with Goodpasture
      syndrome (GP), as evidenced from studies employing bovine type IV collagen. In
      the present experiments, the specificity of GP antibodies for the five NC1
      domains of human type IV collagen was determined by using recombinant NC1 domains
      as the antigen. cDNAs encoding each NC1 domain were expressed in E. coli as
      fusion proteins with a 6-histidine amino-terminal leader. The recombinant NC1
      monomers r alpha 1(IV), r alpha 2(IV), r alpha 3(IV), r alpha 4(IV), and r alpha
      5(IV) were purified by affinity chromatography to the fusion protein using a
      nickel resin column, and then characterized by electrophoresis and immunoblot
      analysis using chain-specific peptide antibodies. The specificity of GP
      antibodies from four patients to these recombinant proteins was then further
      evaluated by immunoblot analysis and enzyme-linked immunosorbent assay
      measurements. The GP antibodies reacted strongly with the r alpha 3(IV) NC1
      domain but were not reactive when tested against the other four recombinant
      monomers. In contrast, neither antisera from patients with two other forms of
      autoimmune disease (anti-tubular basement membrane disease and Wegener's
      syndrome) nor normal control sera bound to any of the recombinant NC1 moieties.
      These results unambiguously establish that GP antibodies are specifically
      targeted to the NC1 domain of the alpha 3(IV) chain of human type IV collagen.
      The findings also establish a methodology for large scale preparation of r alpha
      3(IV) NC1 domain for use in diagnostic tests and development of therapeutic
      procedures and offer a strategy for the elucidation of a more complete GP epitope
      by site-directed mutagenesis.

PMID- 8473282
TI  - Calcium-dependent cyclosporin A-sensitive activation of the interleukin-2
      promoter by p56lck.
AB  - T-cell antigen receptor engagement results in suboptimal activation of protein
      kinase C and a prolonged increase in intracellular free calcium concentration.
      These signals, in combination with stimulation via accessory molecules usually
      supplied by the antigen presenting cell, activate expression of interleukin-2 (IL
      2) and initiate autocrine growth. The lymphocyte-specific tyrosine kinase p56lck
      is physically associated with CD4 and is brought into close proximity of the
      intracellular domain of the antigen receptor by CD4 recognition of the major
      histocompatibility complex during antigen presentation. p56lck activation
      enhances and may be essential for antigen receptor signaling. We report that a
      constitutively active form of p56lck delivers a signal which contributes to IL-2
      promoter activation. The signal substituted for a calcium-mobilizing signal in a
      Jurkat cell model of T-cell activation. The activation was sensitive to EGTA and
      cyclosporin A, indicating that p56lck functions at an early stage of the calcium
      mediated pathway. The transcription factor NF-AT mediated, at least in part, the
      p56lck activation of IL-2 expression. In addition, activated p56lck synergized
      with constitutively active p21Ha-ras, which can replace protein kinase C
      activation, resulting in activation of NF-AT in the absence of external signals.

PMID- 8473283
TI  - A Na(+)-dependent creatine transporter in rabbit brain, muscle, heart, and
      kidney. cDNA cloning and functional expression.
AB  - A cDNA has been cloned from rabbit brain that is a new member of the emerging
      family of Na(+)-dependent plasma membrane transporters for several
      neurotransmitters and structurally related compounds. Functional expression of
      this cDNA in COS-7 cells identifies its product as a Na(+)- and Cl(-)-dependent
      creatine transporter with a Km of approximately 35 microM. Its creatine
      transporter activity is efficiently antagonized by 3-guanidinopropionate, a well
      characterized alternative substrate of creatine transport in several tissues, and
      by 4-guanidinobutyrate. More distant structural analogues of creatine are much
      less efficient or inactive as antagonists, indicating a high substrate
      specificity of the transporter. Northern blot hybridization detects the
      expression of its mRNA in most tissues tested, most prominently in kidney, heart,
      and muscle, but not in liver and intestine. A full-length cDNA clone was also
      isolated from a muscle cDNA library and found to contain the same coding
      sequence. Substrate affinity and specificity of the cloned transporter are very
      similar to the endogenous creatine transporter of the COS-7 cells and to the
      creatine transport activities of several cell types described in the literature.
      Moreover, its mRNA is most abundant in the tissues known to possess high creatine
      uptake capacity.

PMID- 8473284
TI  - Evolution of the type II hexokinase gene by duplication and fusion of the
      glucokinase gene with conservation of its organization.
AB  - The type I, II, and III isozymes of mammalian hexokinase (100 kDa) all consist of
      a duplicated, highly homologous peptide sequence, each half of which is very
      similar to that of glucokinase (type IV hexokinase, 50 kDa) and yeast hexokinase
      (50 kDa). We isolated a genomic clone of type II hexokinase that contained five
      exons encoding the C-terminal region of type II hexokinase. The positions of
      intron insertions of the isolated clone were found to be identical with those of
      the glucokinase gene, indicating that the type II hexokinase gene arose from the
      glucokinase gene. Furthermore, we prepared two DNA fragments of the type II
      hexokinase gene amplified from total genomic DNA. The exons in these fragments
      were found to be constructed by linkage of the coding region of the last exon and
      second exon of the glucokinase gene, indicating that the hexokinase gene arose by
      fusion of two glucokinase genes. These results clearly show that the mammalian
      hexokinase gene evolved from the glucokinase gene by gene duplication and fusion
      with conservation of the gene organization.

PMID- 8473285
TI  - Sinusoidal oscillations in intracellular calcium requiring negative feedback by
      protein kinase C.
AB  - Stimulation of mouse lacrimal acinar cells with submaximal concentrations of the
      muscarinic agonist, methacholine, resulted in an increase in intracellular
      calcium ([Ca2+]i), which took the form of sinusoidal oscillations. These
      oscillations were relatively constant (approximately 4-5/min) regardless of the
      methacholine concentration, suggesting that the oscillations arise from an
      oscillating negative feedback in the signal transduction pathway. This negative
      feedback appears to involve oscillations in protein kinase C activity because the
      oscillations were prevented by activation, inhibition, or down-regulation of
      protein C. Activation of protein kinase C with phorbol esters inhibited the
      methacholine-induced [Ca2+]i signal and formation of the Ca2+ mobilizing
      messenger, inositol 1,4,5-trisphosphate. [Ca2+]i signals elicited by
      intracellular introduction of inositol phosphates did not oscillate and were not
      affected by activators or inhibitors of protein kinase C. Thus, the constant
      frequency [Ca2+]i oscillations appear to result from a negative feedback loop
      involving inhibition of inositol trisphosphate production by protein kinase C.

PMID- 8473286
TI  - His865 is the catalytically important histidyl residue of Syrian hamster 3
      hydroxy-3-methylglutaryl-coenzyme A reductase.
AB  - Involvement in catalysis of a histidyl residue of Syrian hamster 3-hydroxy-3
      methylglutaryl-coenzyme A (HMG-CoA) reductase was suggested by the ability of
      diethyl pyrocarbonate to abolish catalytic activity, accompanying spectral
      changes, and reactivation by hydroxylamine. The 7 histidines present in the
      catalytic domain of the hamster enzyme were changed to glutamine (His474, His487,
      His634, His751, His860, and His865), lysine (His865), or tyrosine (His868).
      Overexpression in Escherichia coli yielded six soluble mutant proteins, one
      insoluble protein (H634Q), and one which was degraded in vivo (H487Q). Following
      purification to homogeneity, mutant enzymes H474Q, H751Q, H860Q, and H868Y had
      essentially wild-type catalytic activity, while mutant enzymes H865K and H865Q
      had less than 0.6% wild-type activity. The low activity of mutant enzymes H865K
      and H865Q is unlikely to reflect altered structural integrity since both
      chromatographed on affinity supports like wild-type enzyme and had Km values for
      (S)-HMG-CoA (31 and 16 microM) and for NADPH (60 and 24 microM) close to those
      for wild-type enzyme (31 and 52 microM for (S)-HMG-CoA and NADPH, respectively).
      His865 of hamster HMG-CoA reductase, the histidine of the consensus Leu-Val-Xaa
      Ser-His-Met-Xaa-Xaa-Asn-Arg-Ser motif and the only histidine conserved among the
      catalytic domains of all HMG-CoA reductases, thus appears to be a general
      acid/base functional in catalysis.

PMID- 8473287
TI  - Domain structure and domain-domain interactions in human coagulation factor IX.
AB  - Coagulation factor IX has the modular composition Gla-(EGF)2-SP, where Gla, EGF,
      and SP represent the gamma-carboxy-Glu-rich, epidermal growth factor-like, and
      serine protease modules, respectively. The protein melts in two distinct
      temperature regions. The SP module melts at lower temperature between 42 and 55
      degrees C, depending on the pH, with irreversible loss of esterolytic activity.
      The endotherm corresponding to this transition is readily described by a two
      state transition indicating the melting of a single cooperative unit. A thrombin
      generated 12-kDa fragment representing the COOH-terminal half of the SP module
      and a 45-kDa fragment containing the NH2-terminal half of the SP module and the
      rest of the molecule can be separated by exclusion chromatography in 3 M urea and
      recombined in its absence. Both fragments retain a compact structure as evidenced
      by melting transitions near 60 degrees C at neutral pH. This indicates that the
      SP module contains two independently folded domains that strongly interact with
      each other and seem to merge into one cooperative unit in the intact protein. At
      low pH at high temperature a second peak appears which is also observed in a 19
      kDa fragment containing the EGF modules. Thermodynamic analysis of this second
      peak showed that the two EGF modules are independently folded and provided
      evidence for a weak interaction between them. Fluorescence and CD measurements
      indicated that the secondary structure of the isolated 6-kDa Gla fragment is
      substantially increased in the presence of Ca2+. The Ca2+-loaded Gla fragment
      undergoes a sigmoidal unfolding transition as revealed by fluorescence and CD
      measurements. This same transition in a 25-kDa Gla-(EGF)2 fragment was stabilized
      by more than 10 degrees C, indicating a strong interaction between the Ca(2+)
      loaded Gla and EGF domains. Thus, factor IX consists of five independently folded
      interacting domains.

PMID- 8473288
TI  - Binding of lipoprotein lipase to heparin. Identification of five critical
      residues in two distinct segments of the amino-terminal domain.
AB  - Binding to heparan sulfate governs many aspects of the physiological action and
      regulation of the lipolytic enzyme, lipoprotein lipase (LPL). In an attempt to
      identify the structural determinants which mediate this interaction, basic
      residues in three segments of the primary sequence of human LPL (residues 147
      151, 279-282, and 292-304) were replaced with alanine, either singly or in
      various combinations, and variant proteins were subjected to affinity
      chromatography on heparin-Superose. Five basic residues in two distinct segments
      of the primary sequence were critical determinants of the high affinity for
      heparin manifested by the active enzyme (R279, K280, R282, K296, R297). By
      contrast, no such evidence could be detected for basic residues in the first
      cluster (K147, K148) or for other basic residues in the third cluster (K292,
      R294, K304), while the evidence for K300 was unresolved. The conformation of this
      heparin-binding domain can be inferred by reference to the three-dimensional
      structure of the homologous enzyme, pancreatic lipase (Winkler, F. K., D'Arcy,
      A., and Hunziker, W. (1990) Nature 343, 771-774). Affinity of the active enzyme
      for heparin could not be reduced below a threshold, suggesting that other heparin
      binding determinants exist elsewhere in the molecule, as supported by recently
      published evidence (Davis, R. C., Wong, H., Nikazy, J., Wang, K., Han, Q., and
      Schotz, M. C. (1992) J. Biol. Chem. 267, 21499-21504).

PMID- 8473289
TI  - PACE/furin can process the vitamin K-dependent pro-factor IX precursor within the
      secretory pathway.
AB  - Factor IX is synthesized as a precursor polypeptide which requires proteolytic
      cleavage of the propeptide for functional activity. Expression of factor IX at
      high levels in Chinese hamster ovary (CHO) cells results in the secretion of a
      mixture of profactor IX and mature factor IX. We have studied whether the
      processing of profactor IX may be mediated by the recently discovered subtilisin
      like serine proteases PACE/furin and/or PACE4. Co-transfection of a PACE
      expression vector with a profactor IX expression vector resulted in the secretion
      of fully processed factor IX. In contrast, co-transfection of a PACE4 expression
      vector with a profactor IX expression vector did not increase processing of
      profactor IX to the mature form. A factor IX Arg-to-Thr mutation at the P1
      position (residue 39) destroyed the ability for PACE to process profactor IX.
      Amino-terminal sequence analysis demonstrated that processing mediated by PACE
      occurred at the authentic site within profactor IX. The specificity of profactor
      IX processing by PACE was also evaluated by transfection of a vector encoding the
      serine protease inhibitor alpha 1-antitrypsin. Expression of wild-type alpha 1
      antitrypsin, which does not inhibit PACE, did not influence processing of
      profactor IX mediated by co-expression of PACE. In contrast, the alpha 1
      antitrypsin Pittsburgh mutant, which inhibits PACE, inhibited profactor IX
      processing activity mediated by transfected PACE as well as the endogenous CHO
      cell propeptide processing enzyme. Pulse-chase labeling indicated that PACE
      processed profactor IX late within the secretory pathway, although a secreted
      soluble mutant PACE was also capable of processing profactor IX in the
      conditioned medium. The results implicate PACE as a candidate for the enzyme that
      processes profactor IX in vivo.

PMID- 8473290
TI  - Ionizing radiation induces expression of interleukin 6 by human fibroblasts
      involving activation of nuclear factor-kappa B.
AB  - We here report that human lung fibroblasts respond to x-ray treatment (XRT) with
      release of interleukin (IL)-6. Synthesis of IL-6 upon ionizing radiation is
      preceded by an increase of IL-6 transcript levels resulting from transcriptional
      activation of the IL-6 gene. Analysis of deleted fragments of the IL-6 promoter
      indicated that transcriptional activation of the IL-6 promoter was due to
      enhanced binding activity of the transcription factor nuclear factor (NF)-kappa
      B. Although AP-1 did not participate in the rapid induction of the IL-6 promoter,
      its binding activity was also enhanced by XRT. In contrast to binding kinetics
      observed with NF-kappa B, AP-1 binding following XRT was biphasic with the second
      peak being dependent on de novo protein synthesis. In contrast, however, NF-IL-6
      activity was not enhanced by XRT in fibroblasts. The introduction of both the NF
      kappa B- and the AP-1 recognition sequence conferred inducibility by XRT to a
      heterologous promoter, with reporter gene activity being maximal 24 or 48 h
      following XRT, respectively. Sequential activation of two distinct transcription
      factors might thus contribute to synchronize transcriptional activation of
      different genes participating in the x-ray response.

PMID- 8473291
TI  - Pituitary-specific repression of placental members of the human growth hormone
      gene family. A possible mechanism for locus regulation.
AB  - Five members of the human growth hormone (GH) gene family are located at a single
      locus on chromosome 17. Growth hormone is expressed in the pituitary under the
      control of the tissue-specific factor Pit 1/GHF-1, and chorionic
      somatomammotropin (CS) -A, -B, and -L, as well as placental GH variant, are
      expressed specifically in the placental syncytiotrophoblast. Despite this
      specificity in vivo, the CS-A promoter can bind Pit 1/GHF-1 and allow CS-A
      promoter activity in pituitary tumor cells after gene transfer. We have
      identified and characterized PSF sequences associated with only the placental
      members in the GH/CS locus which repress placental promoter activity > 90% in
      transfected pituitary cells. These sequences do not significantly affect promoter
      function in placental cells after gene transfer. Repressor activity correlates
      with binding of protein at two sites (PSF-A and PSF-B) with pituitary, but not
      placental, nuclear extracts. Competition studies suggest an interaction between
      PSF and Pit 1/GHF-1 proteins. These results indicate that PSF protein can repress
      CS-A promoter activity in a tissue-specific manner in vitro and provide a
      possible mechanism by which expression of placental members of the GH family are
      inhibited in the pituitary in vivo.

PMID- 8473292
TI  - Phosphatidic acid, lysophosphatidic acid, and lipid A are inhibitors of
      glycosylphosphatidylinositol-specific phospholipase D. Specific inhibition of a
      phospholipase by product analogues?
AB  - Previous work has suggested that the glycosylphosphatidylinositol-specific
      phospholipase D (GPI-PLD) purified from bovine serum is inhibited by phosphatidic
      acid (PA). In this study we report on the specificity and mechanism of this
      phenomenon using [3H]myristate-labeled variant surface glycoprotein dispersed in
      Nonidet P-40 as substrate. Inhibition of GPI-PLD by PAs (IC50 approximately 1
      microM) was relatively independent of the length or degree of unsaturation of the
      fatty acyl chains. It was also observed that lysophosphatidic acid and several
      natural and synthetic lipid A preparations were inhibitory in the same
      concentration range. The inhibitory potency of PA, lysophosphatidic acid, and
      lipid A was dependent on the detergent concentration in the assay but in all
      cases this was in a large (i.e. > 100-fold) molar excess over the inhibitor. The
      inhibitory lipids did not affect substrate availability nor did they reduce
      hydrolysis of variant surface glycoprotein by a bacterial phosphatidylinositol
      specific phospholipase C. Studies with a wide range of other lipids, detergents,
      and phosphate esters indicated that inhibition was specific for lipids containing
      a phosphomonoester group. The data suggest that inhibition is due to a direct
      interaction between PA (or lipid A) and the GPI-PLD rather than an indirect
      effect on the substrate particle.

PMID- 8473293
TI  - Inhibition of apolipoprotein E degradation in a post-Golgi compartment by a
      cysteine protease inhibitor.
AB  - In our prior studies on lipoprotein stimulation of apolipoprotein E (apoE)
      secretion in HepG2 cells, it became clear that a proportion of the newly
      synthesized apoE was degraded intracellularly (Ye, S. Q., Olson, L. M., Reardon,
      C. A., and Getz, G. S. (1992) J. Biol. Chem. 267, 21961-21966). The present study
      was designed to determine the nature of the proteases and the intracellular sites
      involved in newly synthesized apoE degradation. The effect of seven protease
      inhibitors on total apoE levels was examined. Only N-acetyl-leucyl-leucyl
      norleucinal (ALLN), a cysteine protease inhibitor, significantly blocked apoE
      degradation in HepG2 cells. The amount of total apoE from cells chased with ALLN
      for 4 h was increased by 1.58 +/- 0.05-fold relative to the controls (n = 11, p <
      0.01). ALLN extended the half-life of apoE from 2.61 h to 4.38 h (p < 0.01). This
      effect occurs in a post-Golgi compartment since in the presence of brefeldin A,
      ALLN had no effect on intracellular apoE levels. Chloroquine and NH4Cl
      significantly reduced apoE degradation; however, ALLN plus either of these
      reagents appear to have an additive effect. The amount of apoE in cells chased in
      Ca(2+)-free medium was significantly higher than that in cells chased in Ca(2+)
      containing medium (1.70 +/- 0.07-fold, n = 6, p < 0.01). ALLN plus Ca(2+)-free
      medium had no additive effect. ALLN had no significant influence on the
      degradation of albumin but had a similar effect on transfected apoE in Chinese
      hamster ovary cells. Overall, these data suggest that apoE may be degraded in a
      post-Golgi compartment of HepG2 and Chinese hamster ovary cells by lysosomal
      enzymes and cytosolic Ca(2+)-dependent cysteine proteases. ALLN inhibits the
      latter.

PMID- 8473294
TI  - Nucleotide binding properties of bovine brain uncoating ATPase.
AB  - Many functions of the 70-kDa heat-shock proteins (hsp70s) appear to be regulated
      by bound nucleotide. In this study we examined the nucleotide binding properties
      of purified bovine brain uncoating ATPase, one of the constitutively expressed
      members of the hsp70 family. We found that uncoating ATPase purified by ATP
      agarose column chromatography retained one ADP molecule bound per enzyme molecule
      which could not be removed by extensive dialysis. Since this bound ADP exchanged
      rapidly with free ADP or ATP, the inability to remove the bound nucleotide was
      not due to slow dissociation but rather to strong binding of the nucleotide to
      the uncoating ATPase. In confirmation of this view, equilibrium dialysis
      experiments suggested that the dissociation constants for both ADP and ATP were
      less than 0.1 microM. Schmid et al. (Schmid, S. L., Braell, W. A., and Rothman,
      J. E. (1985) J. Biol. Chem 260, 10057-10062) suggested that the uncoating ATPase
      had two sites for bound nucleotide, one specific for ATP and one binding both ATP
      and ATP analogues but not ADP. In contrast, we found that enzyme with bound ADP
      did not bind further adenosine 5'-(beta,gamma-imino)triphosphate or dATP, nor did
      more than one ATP molecule bind per enzyme even in 200 microM free ATP. These
      results strongly suggest that the enzyme has only one binding site for
      nucleotide. During steady-state ATP hydrolysis, 85% of the bound nucleotide at
      this site was determined to be ATP and 15% ADP; this is consistent with the rate
      of ADP release determined in the exchange experiments noted above, where ADP
      release was found to be six times faster than the overall rate of ATP hydrolysis.

PMID- 8473295
TI  - Kinetics of GLUT1 and GLUT4 glucose transporters expressed in Xenopus oocytes.
AB  - The predominant mechanism by which insulin activates glucose transport in muscle
      and adipose tissue is by affecting the redistribution of the facilitated hexose
      carriers, GLUT1 and GLUT4, from an intracellular site to the plasma membrane. A
      quantitative analysis of this process has been hampered by the lack of reliable
      determinations for kinetic constants catalyzed by each of these isoforms. In
      order to obtain such information, each transporter was expressed in Xenopus
      oocytes by the injection of mRNA encoding rat GLUT1 or GLUT4. Equilibrium
      exchange 3-O-methylglucose uptake was measured and the data fitted to a two
      compartment model, yielding Km = 26.2 mM and Vmax = 3.5 nmol/min/cell for GLUT1
      and Km = 4.3 mM and Vmax = 0.7 nmol/min/cell for GLUT4. Measurement of the
      abundance of cell surface transporters was accomplished by two independent
      protocols: photolabeling with the impermeant hexose analog 2-N-4-(1-azi-2,2,2
      trifluoroethyl)benzoyl-1,3-bis(D-mannos-4 -yloxy)-2-propylamine and subcellular
      fractionation of oocytes. Data obtained by either technique revealed that the
      ratio of plasma membrane GLUT1 to GLUT4 was about 4; this paralleled the relative
      maximal velocities for hexose transport, indicating that the turn-over numbers
      for the two isoforms were the same. Moreover, measurement of the concentration of
      exofacially disposed transporters with 2-N-4-(1-azi-2,2,2-trifluoroethyl)benzoyl
      1,3-bis(D-mannos-4 -yloxy)-2-propylamine allowed calculation of the turnover
      number to be about 20,000 min-1. These data indicate that, at low substrate
      concentrations, the catalytic efficiency of GLUT4 is significantly greater than
      GLUT1. Extrapolation to mammalian systems suggests that GLUT4 is responsible for
      virtually all of the hexose uptake in insulin-responsive targets, particularly in
      the presence of hormone.

PMID- 8473296
TI  - Characterization of transferrin-independent iron transport in K562 cells. Unique
      properties provide evidence for multiple pathways of iron uptake.
AB  - The present study characterizes the transport of nontransferrin (non-Tf) iron by
      K562 cells. Accumulation of radiolabel by cells incubated with 55Fe
      nitrilotriacetate (NTA) is a saturable process that is time and temperature
      dependent (Ea approximately 20 kcal/mol). Initial rate analysis of iron influx
      yields values of Vmax = 855 fmol/min/10(6) cells and apparent Km = 0.54 microM.
      NHCL4 and chloroquine, agents that block cellular acquisition of iron from Tf, do
      not interfere with assimilation from FeNTA, demonstrating that uptake is truly
      independent of the Tf-mediated pathway. Furthermore, the inactivation of this
      transport mechanism by limited proteolytic digestion on ice indicates that
      specific cell surface proteins are involved. The extent of radiolabel
      incorporation into heme and ferritin is the same regardless of whether K562 cells
      acquire iron from 55FeNTA via the cell surface mechanism or from 55Fe-Tf via
      receptor-mediated endocytosis. Unlike other Tf-independent iron transport
      pathways that have been described, the K562 cell transport mechanism is not
      inhibited by divalent cations such as Ni2+, Co2+, or Mn2+. Uptake from 55FeNTA
      can be blocked by Cu2+ but at concentrations > 1500-fold molar excess. However,
      Cd2+ is a fairly specific inhibitor of 55Fe uptake by K562 cells (IC50
      approximately 50 microM). Additionally, the K562 cell transport mechanism is not
      Ca2+ dependent and does not appear to be regulated by extracellular iron salts,
      in contrast to features noted for non-Tf iron uptake by fibroblasts (Sturrock,
      A., Alexander, J., Lamb, J., Craven, C. M., and Kaplan, J. (1991) J. Biol. Chem.
      265, 3139-3145; Kaplan, J., Jordan, I., and Sturrock, A. (1991) J. Biol. Chem.
      266, 2997-3004). These unique characteristics of the K562 cell uptake mechanism
      suggest that multiple transport systems function in Tf-independent iron
      assimilation.

PMID- 8473297
TI  - Identification of potential active-site residues in the human poly(ADP-ribose)
      polymerase.
AB  - The carboxyl-terminal catalytic domain of the human poly(ADP-ribose) polymerase
      (PARP) exhibits sequence homology with the NAD(P)(+)-dependent leucine and
      glutamate dehydrogenases. To clarify the role played by some conserved residues
      between PARP and NAD(P)(+)-dependent dehydrogenases, point mutations were
      introduced into the whole enzyme context. Non-conservative mutations of Lys-893
      (K893I) and Asp-993 (D993A) completely inactivate human PARP, whereas
      conservative and nonconservative mutations of Asp-914 (D914E and D914A,
      respectively) and Lys-953 (K953R and K953I, respectively) partially alter PARP
      activity. The consequences of conservative substitution of Lys-893 and Asp-993 on
      the kinetic properties of human poly(ADP-ribose) polymerase enzyme and the
      polymer it synthesizes suggest that these 2 amino acids are directly involved in
      the covalent attachment of the first ADP-ribosyl residue from NAD+ onto the
      acceptor amino acid. In addition, the recent resolution of the three-dimensional
      structure of the NAD(+)-linked glutamate dehydrogenase from Clostridium symbiosum
      (Baker, P.J., Britton, K.L., Engel, P.C., Farrants, G.W., Lilley, K.S., Rice,
      D.W., and Stillman, T.J. (1992) Proteins 12, 75-86) strongly supports our
      alignment with leucine and glutamate dehydrogenases and provides an interesting
      structural framework for the analysis of our results of site-directed
      mutagenesis.

PMID- 8473298
TI  - Inhibition by tentoxin of cooperativity among nucleotide binding sites on
      chloroplast coupling factor 1.
AB  - Tentoxin, a cyclic tetrapeptide produced by the fungus Alternaria tenuis, is a
      potent inhibitor of the chloroplast coupling factor 1 from certain sensitive
      species of plants. We have shown that the beta subunit is at least partly
      responsible for conferring sensitivity to the toxin. This was confirmed by Avni
      et al. (Avni, A., Anderson, J.D., Holland, N., Rochaix, J-D., Gromet-Elhanan, Z.,
      and Edelman, M. (1992) Science 257, 1245-1247) who demonstrated the importance
      for tentoxin sensitivity of an acidic amino acid residue at position 83 in the
      beta subunit sequence. In this paper we show that the Ca(2+)-ATPase and Mg(2+)
      ATPase activities of CF1 lacking the delta and epsilon subunits, CF1(-delta
      epsilon), were fully sensitive to tentoxin, even after the gamma subunit is
      cleaved by trypsin into several smaller fragments. We also show that the isolated
      reconstitutively active beta subunit of CF1 does not effectively compete with
      CF1(-delta epsilon) for tentoxin binding. The results suggest that tight tentoxin
      binding requires the presence of at least the alpha and beta subunits but is
      independent of the delta and epsilon subunits. Tentoxin inhibited the release of
      a tightly bound molecule of ADP from CF1, which was induced by the binding of the
      ATP analogue adenylyl-beta,gamma-imidodiphosphate (AMP-PNP). AMP-PNP was shown
      previously (Shapiro, A.B., and McCarty, R.E. (1990) J. Biol. Chem. 265, 4340
      4347) to cause two adenine nucleotide binding sites on CF1, sites 1 and 3, to
      switch their properties, possibly as part of an alternating site catalytic
      cooperativity mechanism (Boyer, P.D. (1989) FASEB J. 3, 2164-2178). It is
      proposed that the effect of tentoxin on catalytic cooperativity in CF1 results
      from tentoxin binding at an interface between alpha and beta subunits, preventing
      transfer of information between different nucleotide binding sites on the enzyme.

PMID- 8473299
TI  - Structure-function studies of yeast ferrochelatase. Identification and functional
      analysis of amino acid substitutions that increase Vmax and the KM for both
      substrates.
AB  - The molecular basis of the ferrochelatase defects was investigated in two
      "protoporphyric" and partially heme-deficient yeast mutants. Ferrochelatase, a
      mitochondrial inner membrane-bound enzyme, catalyzes the incorporation of ferrous
      iron into protoporphyrin, the last step in protoheme biosynthesis. The mutant
      cells made normal amounts of normal-sized ferrochelatase, as detected by
      immunoblotting. The mutations were identified by sequencing the mutant hem15
      alleles amplified in vitro from mutant strains genomic DNA. A single nucleotide
      change, causing an amino acid substitution, was found in each mutant.
      Substitution of the conserved Ser-169 by Phe caused a 10-fold increase in Vmax
      and a 45- and 35-fold increase in the KM for protoporphyrin and metal,
      respectively. Replacement of Ser-174 by Pro produced the same effects, but to a
      lesser degree. There was a good correlation between the ferrochelatase defects
      measured in vitro and the heme synthesis deficiencies estimated in vivo. The
      decreased in vivo heme synthesis is probably due to the lower affinity of the
      mutant enzymes for iron. We propose that the region identified by the two close
      mutations contributes to the binding domains of metal and protoporphyrin.

PMID- 8473300
TI  - Distinct subdomains of human endothelin receptors determine their selectivity to
      endothelinA-selective antagonist and endothelinB-selective agonists.
AB  - The endothelin (ET) family of peptides acts via two subtypes of G-protein-coupled
      heptahelical receptors termed ETA and ETB, which have distinct rank orders of
      affinity to endothelin receptor agonists and antagonists. To delineate which
      portions of the receptor molecules determine ligand selectivity, we have
      constructed a series of chimeras between human ETA and ETB receptors and
      characterized the chimeric receptors expressed in heterologous cell lines by
      competitive radioligand binding analysis and by measuring agonist-induced
      transients of intracellular Ca2+. We demonstrate that the binding determinant for
      the ETB-selective agonists ET-3, BQ3020, and IRL1620 residues within the region
      spanning the putative transmembrane helices IV-VI and the adjacent loop regions.
      In contrast, the transmembrane helices I, II, III, and VII plus the intervening
      loop regions specify the selectivity for BQ123, an ETA-selective antagonist.
      BQ123 exhibited no detectable agonistic activity in all wild-type and chimeric
      receptors tested. A chimeric receptor that has the transmembrane helices IV-VI
      (and adjacent loops) from the ETB receptor inserted into the remaining regions
      from the ETA receptor binds both the ETA- and ETB-selective ligands with high
      affinities. Moreover, BQ123 competitively inhibits the binding of the amino
      terminally truncated ETB agonists, 125I-BQ3020 and 125I-IRL1620, to this chimeric
      receptor, suggesting that BQ123 is a mimic of the carboxyl-terminal linear
      portion of endothelins. These findings indicate that there are at least two
      separable ligand interaction subdomains within the endothelin receptors.

PMID- 8473301
TI  - Thapsigargin causes Ca2+ release and collapse of the membrane potential of
      Trypanosoma brucei mitochondria in situ and of isolated rat liver mitochondria.
AB  - Thapsigargin, previously reported to release Ca2+ from non-mitochondrial stores
      of different cell types, as well as nigericin, were found, when used at high
      concentrations, to release Ca2+ and collapse the membrane potential of
      Trypanosoma brucei bloodstream and procyclic trypomastigotes mitochondria in
      situ. At similarly high concentrations (> 10 microM), thapsigargin was also found
      to release Ca2+ and collapse the membrane potential of isolated rat liver
      mitochondria. These results indicate that care should be taken when attributing
      the effects of thapsigargin in intact cells to the specific inhibition of the
      sarcoplasmic and endoplasmic reticulum Ca(2+)-ATPase family of calcium pumps. In
      addition, we have found no evidence for an increase in intracellular Ca2+ by
      release of the ion from intracellular stores by nigericin, measuring changes in
      cytosolic Ca2+ by dual wavelength spectrofluorometry in fura-2-loaded T. brucei
      bloodstream trypomastigotes or measuring Ca2+ transport in digitonin
      permeabilized cells.

PMID- 8473302
TI  - Cholesterol loading of macrophages leads to marked enhancement of native
      lipoprotein(a) and apoprotein(a) internalization and degradation.
AB  - Lipoprotein(a) levels in the plasma are strongly correlated with atherosclerotic
      coronary artery disease. Although the mechanism of this effect is not known, the
      interaction of lipoprotein(a) with macrophages may be important. Previous work
      has shown that macrophages in culture internalize and degrade native
      lipoprotein(a) poorly. In the present study, the interaction of Lp(a) with mouse
      peritoneal and human monocyte-derived macrophages that were cholesterol-loaded,
      such as occur in atheromata, was investigated. 125I-Lp(a) degradation was
      increased 4-5-fold in macrophages that had been loaded with cholesterol by
      incubation with acetyl-LDL for 2-4 days. The enhanced degradation of Lp(a) by
      foam cells was chloroquine-sensitive and dependent upon the presence of calcium
      in the extracellular medium. Incubation of the macrophages with acetyl-LDL plus
      an inhibitor of acyl CoA:cholesterol acyltransferase, which increased the free
      cholesterol content and decreased the cholesteryl ester content of the cells,
      resulted in an even greater up-regulation of 125I-Lp(a) degradation (8-23-fold
      over control macrophages). The interaction of Lp(a) with cholesterol-loaded
      macrophages involved the apoprotein(a) moiety of Lp(a) since 125I-apoprotein(a),
      but not 125I-Lp(a-), was degraded to a much greater extent by foam cells compared
      to control macrophages. The uptake and degradation of Lp(a) in foam cells was not
      mediated by LDL, scavenger, LDL receptor-related protein (LRP), or plasminogen
      receptors. Thus, cholesterol loading of macrophages markedly enhances the
      internalization and lysosomal degradation of Lp(a) and apo(a) by a calcium
      dependent receptor activity different from known lipoprotein receptors.

PMID- 8473303
TI  - Fibrin affinity of urokinase-type plasminogen activator. Evidence that Zn2+
      mediates strong and specific interaction of single-chain urokinase with fibrin.
AB  - Interactions of components of the fibrinolytic system with fibrin play a key role
      in localization and regulation of plasminogen activation at the clot surface.
      Although interaction of tissue plasminogen activator (tPA) with fibrin is well
      established, the prevailing view is that urokinase-type plasminogen activator
      (uPA) does not bind to fibrin. In this report, I show that although there is
      little or no interaction of single-chain urokinase (Sc-uPA), two-chain urokinase
      (Tc-uPA), or low molecular weight urokinase (LMW-uPA) with fibrin in the absence
      of divalent metal cations, Sc-uPA is effectively bound to fibrin in the presence
      of Zn2+. By comparison, Tc-uPA is poorly bound and LMW-uPA is not bound to fibrin
      in the presence of the metal ion. The Zn(2+)-mediated fibrin binding of Sc-uPA is
      reversible, specific, and saturable. The interaction involves a single class of
      binding site with dissociation constant of 0.3 microM and stoichiometry of 2.7.
      Lacking apparent affinity for fibrin, uPA has not been considered to play a role
      in physiological fibrinolysis. The present study conclusively shows that Sc-uPA
      possesses a latent affinity for fibrin that is expressed in the presence of Zn2+.
      These findings raise the possibility that Zn2+ plays a regulatory role in uPA
      mediated fibrinolysis by promoting effective localization of Sc-uPA at the clot
      surface.

PMID- 8473304
TI  - 1H NMR-based determination of the three-dimensional structure of the human plasma
      fibronectin fragment containing inter-chain disulfide bonds.
AB  - Human plasma fibronectin is a plasma glycoprotein that plays an important role in
      many biological processes. It consists of two identical 230-250-kDa subunits that
      are joined by two disulfide bonds near their carboxyl termini. Each subunit
      contains various binding domains composed of three types of homologous repeats.
      Recent work has determined the three-dimensional structures of various repeat
      fragments, but little is known about the three-dimensional structure of the
      carboxyl-terminal region. A recent NMR study of a plasmin-digested carboxyl
      terminal inter-chain disulfide-linked heptapeptide dimer has proposed that the
      two subunits are arranged in an antiparallel fashion (An et al. (1992)
      Biochemistry 31, 9927-9933). We have now determined the three-dimensional
      structure for a substantial portion of a trypsin-digested interchain disulfide
      linked 52-residue (6 kDa) fragment of the carboxyl-terminal of human plasma
      fibronectin (which includes the above-mentioned heptapeptide dimer) using two
      dimensional NMR methods and a new strategy for NMR-based protein structure
      determination. The NMR data requires that the two chains in the dimer be linked
      in a symmetric, antiparallel arrangement. The resulting monomer conformation
      consists of two twisted or coiled segments, Thr3-Asn6 and Ile9-Phe12, connected
      by the Cys7-Pro8 residues in extended conformations, with the two monomer chains
      cross-linked at residues Cys7 and Cys11. The conformation of the heptapeptide
      dimer region differs substantially from the conformation proposed by An et al.

PMID- 8473305
TI  - Isolation, sequence analysis, and cloning of haemadin. An anticoagulant peptide
      from the Indian leech.
AB  - A slow, tight-binding inhibitor of thrombin with an apparent molecular mass of
      about 5 kDa has been isolated from Haemadipsa sylvestris, an Indian leech of the
      family of Haemadipsidae. The inhibitory activity, called haemadin, is thrombin
      specific since it does not inhibit other proteases like trypsin, chymotrypsin,
      factor Xa, or plasmin. NH2-terminal amino acid sequence analysis (residues 1-45)
      does not reveal any homology to known serine protease inhibitors, including the
      thrombin-specific inhibitor hirudin. The haemadin cDNA cloned by polymerase chain
      reaction techniques codes for a polypeptide of 57 amino acid residues preceded by
      20 residues of a signal peptide sequence. A synthetic gene coding for the mature
      haemadin was expressed in Escherichia coli. Recombinant haemadin displays a
      similar inhibition constant and specific activity as its natural counterpart.
      Although there is no obvious sequence identity between haemadin and hirudin, both
      proteins seem to share common mechanisms for thrombin inhibition.

PMID- 8473306
TI  - The effect of activated protein C on fibrinolysis in cell-free plasma can be
      attributed specifically to attenuation of prothrombin activation.
AB  - The effect of human activated protein C (APC) on tissue plasminogen activator
      (tPA)-induced fibrinolysis was studied in cell free plasma and in a system of
      purified components. Clots were produced by adding plasma or a solution of
      fibrinogen and plasminogen to the wells of a microtiter plate containing small
      separated aliquots of Ca2+, thrombin, and tPA, plus and minus APC. Initial
      clotting and subsequent fibrinolysis were monitored continuously by turbidity.
      The lysis time of dialyzed normal human plasma (NHP) was longer than that of
      dialyzed barium citrate-adsorbed plasma (BAP). APC had no effect on the lysis
      time of BAP but shortened the lysis time of NHP to that of BAP. Two fractions
      were produced from material eluted from the barium citrate pellet by
      precipitation of selective components with polyethylene glycol 8000 (PEG). One
      fraction comprised materials which precipitated at 5% PEG (5% PF) and the other
      materials which precipitated between 5 and 40% PEG (5-40% PF). Both fractions
      together, but neither alone, prolonged the lysis time of BAP, an effect which
      could be reversed by APC. Fractionation of the 5% PF showed that the component
      with the required activity has properties of the procoagulant surface and can be
      replaced with vesicles of phosphatidylcholine/phosphatidylserine (PCPS). In
      addition, the 5-40% PF can be replaced with either the combination of purified
      coagulation Factors II, IX, and X or Factor II plus the prothrombin activator
      Factor Xa. When Factor Xa was used as the activator in BAP plus PSPC vesicles, a
      dose-dependent saturable increase in lysis time was observed with a half-maximal
      increase occurring at 32 pM Factor Xa. This effect was eliminated by APC. In a
      system of purified components comprising PCPS vesicles, Factors V and II, protein
      S, plasminogen and fibrinogen; the prothrombin activators Factor Xa and ecarin
      both induced a prolongation of the lysis time. APC prevented prolongation by
      Factor Xa but not by ecarin. The time courses of the generation of thrombin and
      plasmin during fibrinolysis of clots produced from systems of purified components
      in the presence and absence of APC, and with Factor Xa as the prothrombin
      activator, were determined by standardized activity assays using chromogenic
      substrates. In the absence of APC the lysis time was 145 min, and prothrombin was
      quantitatively converted to thrombin. In the presence of APC, however, the lysis
      time was reduced to 100 min with no evidence for the activation of
      prothrombin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8473307
TI  - Determination of the DNA bend angle induced by the restriction endonuclease EcoRV
      in the presence of Mg2+.
AB  - We have used the method of Zinkel and Crothers (Zinkel, S.S., and Crothers, D.M.
      (1990) Biopolymers 29, 29-38) to determine the degree of bending induced by the
      binding of the restriction endonuclease EcoRV to its recognition sequence (
      GATATC-). A set of four calibration DNA fragments was constructed that contained
      zero, two, four, or six phased A-tracts in their centers and an EcoRV site at the
      5'-end to account for the electrophoretic influence of the bound protein. The
      mobilities of these calibration molecules complexed with EcoRV were compared to
      that of a test DNA containing a central EcoRV site also complexed with EcoRV. The
      EcoRV-induced bend angle was found to be 44 degrees +/- 4 degrees. These
      experiments were performed with a catalytically inactive EcoRV mutant that still
      binds DNA specifically in the presence of Mg2+. In the absence of Mg2+, which is
      necessary for specific binding, there is no difference in the mobilities of the
      fragments with a peripheral or a central EcoRV site complexed with EcoRV,
      indicating that nonspecific binding on average does not lead to measurable DNA
      bending.

PMID- 8473308
TI  - The function and distinctive regulation of the integrin VLA-3 in cell adhesion,
      spreading, and homotypic cell aggregation.
AB  - To assess directly the functional role of the integrin VLA-3 (alpha 3 beta 1), we
      transfected human alpha 3 cDNA into erythroleukemia (K562) cells and
      rhabdomyosarcoma (RD) cells. The resulting transfectants (KA3 and RA3) expressed
      alpha 3 beta 1 on the cell surface as confirmed using a panel of nine anti-alpha
      3 monoclonal antibodies. Neither of the transfected cells exhibited increased
      adhesion to the extracellular matrix proteins fibronectin, laminin, and collagen.
      However, the KA3 transfectants did bind strongly to the extracellular matrix
      deposited by epidermal and carcinoma cell lines, allowing the cells to attach and
      spread. Binding to this cell-deposited ligand, probably containing
      epiligrin/kalinin, was specific to VLA-3 and could be inhibited by anti-alpha 3
      antibodies and by EDTA, but not by RGD peptides. In marked contrast to other
      integrins (VLA-2 and VLA-4), VLA-3 showed high constitutive activity in K562
      cells, but was minimally active in RD cells. Also contrasting with other beta 1
      integrins, VLA-3 was minimally stimulated by the anti-beta 1 monoclonal antibody
      TS/216 under normal conditions. VLA-3-mediated adhesive function was well
      supported by either Mg2+ or Mn2+, but was almost completely abolished by the
      presence of 1 mM Ca2+. Surprisingly, this negative Ca2+ effect was completely
      overcome by the addition of the stimulatory anti-beta 1 monoclonal antibody
      TS2/16. Together, these results point to markedly distinct regulation for VLA-3
      function compared to other beta 1 integrins. Also, all anti-VLA-3 antibodies were
      able to induce temperature-dependent homotypic cell aggregation of KA3 cells, but
      not K562 cells. However, this aggregation did not appear to be directly mediated
      by VLA-3 since it was not inhibited by EDTA. In addition, no enhancement of
      heterotypic cell-cell adhesion was observed in alpha 3-transfected cells.

PMID- 8473309
TI  - Saccharomyces cerevisiae elongation factor 2. Mutagenesis of the histidine
      precursor of diphthamide yields a functional protein that is resistant to
      diphtheria toxin.
AB  - Protein synthesis elongation factor 2 (EF-2) is the target of the ADP
      ribosylating activity of diphtheria toxin which is responsible for cell killing.
      Diphthamide, an unique post-translationally modified histidine residue, is both
      required for and the site of this ADP-ribosylation. Although present in the EF-2
      of all eukaryotes and archaebacteria, the function of diphthamide is unknown.
      Here we describe the site-specific mutagenesis of the histidine precursor of
      diphthamide, histidine 699, in yeast EF-2. Plasmid-borne EFT was randomly
      mutagenized at the histidine 699 codon, and the technique of plasmid shuffling
      was utilized to select strains that were maintained by the mutant EFT. These
      mutants were screened for diphtheria toxin resistance. Sequence analysis of the
      EFT in 49 toxin-resistant isolates showed that histidine 699 had been replaced by
      1 of 4 amino acids: asparagine, glutamine, leucine, or methionine. All 11 of the
      possible codons corresponding to these 4 amino acids were found. The growth rates
      of cells sustained by the mutant forms of EF-2 were slightly slower than those of
      isogenic wild-type cells. We conclude that despite its strict conservation and
      universal post-translational modification, the histidine precursor of diphthamide
      is not essential to the function of yeast EF-2 in protein synthesis.

PMID- 8473310
TI  - Reversible palmitoylation of the protein-tyrosine kinase p56lck.
AB  - The myristoylated protein-tyrosine kinase, p56lck, is expressed predominantly in
      T cells where it is believed to play a role in T cell activation. We observed a
      56-kDa protein that became metabolically labeled in intact T lymphoid cells that
      were incubated with either [3H]myristate or [3H]palmitate. This protein was
      identified as p56lck based on its specific immunoprecipitation with polyclonal
      antisera to p56lck, by induction of a shift in its electrophoretic mobility
      following treatment of cells with 12-O-tetradecanoylphorbol-13-acetate and by co
      chromatography with p56lck on protamine-agarose. Characterization of the two
      acylation events revealed that, in contrast to the p56lck-associated
      radioactivity from [3H]myristate-labeled cells, the p56lck-associated
      radioactivity from [3H]palmitate-labeled cells was susceptible to cleavage by
      neutral hydroxylamine and was not blocked by inhibitors of protein synthesis.
      Pulse-chase analyses revealed that the labeling of p56lck with [3H]palmitate, but
      not [3H]myristate, was reversible. The presence of covalently attached palmitate
      on p56lck from [3H]palmitate-labeled cells was verified by thin-layer
      chromatography following acid hydrolysis of the acylated protein. 2
      Hydroxymyristate, which is metabolically activated to form a potent inhibitor of
      protein myristoylation, specifically inhibited the acylation of p56lck with
      [3H]myristate without affecting its labeling with [3H]palmitate. These studies
      indicate that p56lck is both a cotranslationally myristoylated and post
      translationally palmitoylated protein.

PMID- 8473311
TI  - In organello footprinting. Analysis of protein binding at regulatory regions in
      bovine mitochondrial DNA.
AB  - Detailed study of mammalian mitochondrial transcriptional and replicative
      mechanisms is currently limited to in vitro analyses, requiring isolation and
      reassembly of functional components to mimic the in vivo process. To complement
      these studies and begin understanding the intracellular function of mitochondrial
      DNA (mtDNA) regulatory regions, we developed in organello footprinting to
      investigate protein-DNA interactions within the mitochondrion. Using a
      methylation protection technique and mitochondria isolated from bovine brain
      tissue, we analyzed five domains believed critical for regulating mtDNA function.
      Near equivalent protein-DNA interactions were seen upstream of both light and
      heavy strand RNA start sites at positions consistent with those observed for
      human mitochondrial transcription factor 1 DNA binding in vitro. Downstream of
      the 16 S rRNA gene, a high level of protein occupancy was detected within the
      bovine homologue of the human tridecamer sequence required for attenuation of
      transcription in vitro. Immediately upstream of the origin of heavy strand
      replication, a novel site of protein-mtDNA interaction was observed within
      conserved sequence block 1, suggesting its potential as a regulatory element
      involved in initiation of heavy strand DNA synthesis. Unlike regions associated
      with the origin of heavy strand replication, protein-mtDNA interaction was not
      detected at the origin of light strand replication or within flanking tRNA genes.

PMID- 8473312
TI  - Nucleotide binding to actin. Cation dependence of nucleotide dissociation and
      exchange rates.
AB  - We have reinvestigated nucleotide binding to actin in order to resolve conflicts
      regarding the mechanism of nucleotide dissociation and exchange. We present
      evidence that supports a mechanism for nucleotide binding to actin in which the
      tightly bound divalent cation (Ca2+ or Mg2+) directly interacts with the bound
      nucleotide. The dissociation rates of ATP or ADP from actin are limited by the
      dissociation of the high affinity divalent cation from actin and vary inversely
      with free Ca2+ or free Mg2+ concentration. The divalent cation concentration
      range over which attenuation of the ATP dissociation takes place is about 100
      fold greater for Mg2+ than that for Ca2+ due to the much slower association rate
      constant for Mg2+ compared with Ca2+. The relative affinity for ATP versus ADP is
      200:1 for Ca-actin in 100 microM free [Ca2+], and 4:1 for Mg-actin in 100 microM
      free [Mg2+]. Actin without a tightly bound divalent cation has about a 3-fold
      greater affinity for ATP than ADP. At constant free divalent cation
      concentration, the rate of nucleotide exchange on actin is described by
      competitive binding kinetics.

PMID- 8473313
TI  - G protein-mediated inhibition of phospholipase C activity in a solubilized
      membrane preparation.
AB  - In solubilized bovine brain membrane preparations AlF4- (20 microM AlCl3 plus 10
      mM NaF) and 50 nM guanosine 5-O-(2-thiotriphosphate) (GTP gamma S) promoted a
      rapid but transient inhibition of phospholipase C (PLC) activity. Maximal
      inhibition was evident within 7 min of incubation, followed by reversal of
      inhibition. In contrast, 10 microM GTP gamma S did not induce inhibition of PLC
      activity but rather produced a time-dependent stimulation of PLC activity. GTP
      gamma S-dependent inhibition of PLC activity was concentration-dependent with
      half-maximal inhibition at 1 nM. Inhibition was antagonized by guanosine 5-O-(2
      thiodiphosphate (GDP beta S). Pertussis toxin delayed the onset of inhibition by
      GTP gamma S but did not prevent the inhibitory effect. alpha o-GTP gamma S or
      alpha o-GDP had little effect on PLC activity. alpha i-GTP gamma S and alpha i
      GDP produced a 15% inhibition of PLC activity. Beta gamma subunits did not
      inhibit basal PLC activity but did attenuate the net degree of inhibition due to
      GTP gamma S. Inhibition was associated with a decrease in the Ca2+ sensitivity of
      PLC. Preincubation of membranes with anti-PLC-beta 1 antibody, but not anti-PLC
      gamma 1 or anti-PLC-delta 1, prevented the GTP gamma S-mediated inhibition of
      PLC. These studies implicate PLC-beta 1 as an effector system that is under
      negative modulation by a G protein-dependent mechanism.

PMID- 8473314
TI  - Phosphorylation of HIV-1 gag proteins by protein kinase C.
AB  - We have demonstrated that the 17-kDa N-terminal matrix protein (p17gag) of HIV-1
      Pr55gag is a substrate for protein kinase C (PKC). Phosphorylation of p17gag and
      Pr55gag was studied in vivo by infecting COS-7 cells with a recombinant vaccinia
      virus containing the HIV-1 gag-pol gene. Basal gag protein phosphorylation was
      inhibited up to 75% with the PKC inhibitor, H-7, and stimulated 3-4-fold with
      phorbol 12-myristate 13-acetate. In experiments using MCF-7 cell lines, p17gag
      and Pr55gag were dramatically phosphorylated only in clones with high PKC
      activity. Bacterially expressed and purified non-myristoylated and N
      myristoylated p17gag were efficiently phosphorylated in a Ca2+ and
      phosphatidylserine-dependent manner by purified PKC. The N-myristoylated p17gag
      exhibited an apparent Km = 4 microM for PKC phosphorylation. Both in vitro and in
      vivo phosphorylated p17gag yielded identical V8 protease digestion phosphopeptide
      maps, indicating identical PKC phosphorylation sites. Phosphoamino acid analysis
      of the in vitro phosphorylated p17gag revealed only phosphoserine. These data are
      consistent with the identification of a highly conserved consensus PKC
      phosphorylation site motif in the HIV-1 gag protein at Ser111 and suggests that
      PKC phosphorylation plays an important role in gag protein function.

PMID- 8473315
TI  - Inhibitory properties of full-length and truncated recombinant tissue factor
      pathway inhibitor (TFPI). Evidence that the third Kunitz-type domain of TFPI is
      not essential for the inhibition of factor VIIa-tissue factor complexes on cell
      surfaces.
AB  - Human tissue factor pathway inhibitor (TFPI) is a plasma protease inhibitor that
      consists of three tandem Kunitz-type inhibitor domains flanked by a negatively
      charged NH2 terminus and a positively charged COOH-terminal tail. Previous
      studies have shown that the first and second Kunitz-type domains in TFPI are
      involved in the inhibition of factor VIIa and factor Xa activity, respectively.
      In the present study, we have compared the inhibitory properties of full-length
      recombinant TFPI and a truncated form of TFPI lacking the third Kunitz-type
      domain and COOH-terminal tail (TFPI1-161) with respect to inhibition of factor
      VIIa-tissue factor complexes on the surface of a human bladder carcinoma cell
      line J82. Full-length TFPI and TFPI1-161 were kinetically indistinguishable with
      respect to neutralization of the proteolytic activity of preformed complexes of
      factor VIIa-tissue factor on the J82 cell surface in the absence of factor Xa.
      Equimolar amounts of factor Xa augmented the anticoagulant activity of both
      preparations of TFPI to the same extent, and both preparations of TFPI were
      equally effective in inhibiting factor VIIa-tissue factor amidolytic activity in
      solution phase. In addition, plasma concentrations of both forms of TFPI, in
      stoichiometric complex with factor Xa, inhibited cell surface factor VIIa-tissue
      factor proteolytic activity markedly faster than plasma levels of antithrombin
      III, even in the presence of 1 unit/ml heparin. The results of displacement
      studies suggested slight differences in the affinity of the two TFPI molecules
      for the cell surface in that approximately 5% of a VIIa.TF.Xa.TFPI1-161
      quaternary complex on J82 cells was displaceable from the cell surface by high
      concentrations of factor VIIa (10-100 nM), whereas only 1-2% of a VIIa.TF.Xa.TFPI
      complex was displaceable under comparable conditions. Pretreatment of the cells
      with TFPI/Xa alone or together with R152E factor VII, followed by factor VIIa
      treatment, revealed significant differences in the two TFPI forms with respect to
      the degree with which offered factor VIIa could restore factor X activation on
      the cell surface. These differences notwithstanding, our collective findings
      indicate that the third Kunitz-type domain and/or COOH-terminal tail of TFPI is
      not essential for the inhibition of cell surface factor VIIa-tissue factor
      complexes and suggests that TFPI1-161 may be a useful therapeutic agent in the
      treatment of thromboembolic episodes.

PMID- 8473316
TI  - Mutagenic analysis of AMP nucleosidase from Escherichia coli. Deletion of a
      region similar to AMP deaminase and peptide characterization by mass
      spectrometry.
AB  - AMP nucleosidase (EC 3.2.2.4) from Escherichia coli and AMP deaminase (EC
      3.5.4.6) from bakers' yeast are proposed to regulate cellular AMP levels under
      allosteric control of the activator ATP and the inhibitor, PO4. Both enzymes
      contain catalytic sites which bind AMP and regulatory sites which bind ATP. The
      deduced amino acid sequences of the proteins revealed only one region of homology
      in which six of eight amino acids are identical. A similar sequence is found in
      glyceraldehyde-3-phosphate dehydrogenase, phoE, ras proteins, RNA polymerase,
      K(+)-ATPase, nucleolin, and other proteins expected to have nucleotide or
      phosphate binding properties. In the crystal structure of glyceraldehyde-3
      phosphate dehydrogenase, this sequence is part of the NAD(+)-binding site. The
      function of these amino acids was explored with a deletion mutant of AMP
      nucleosidase. The protein was over-produced in a pTZ construct using the AMP
      nucleosidase promoter which resulted in approximately 30% of the total protein as
      the desired enzyme. The mutation was characterized by DNA sequence analysis and
      by direct analysis of the peptides using high performance liquid chromatography
      mass spectrometry. Deletion of amino acids 128-135, corresponding to DGSELTLD,
      produced an enzyme with a 20-fold decrease in Vmax but with smaller changes in
      substrate saturation kinetics, activation by MgATP, inhibition by inorganic
      phosphate, and inhibition by the tight-binding inhibitor, formycin 5-phosphate.
      The deletion mutant of AMP nucleosidase exhibits hysteresis in establishing a
      steady-state rate of product formation which is most pronounced in the absence of
      MgATP. These results establish that the sequence DGSELTLD in E. coli AMP
      nucleosidase is not required for binding of AMP, MgATP, or inorganic phosphate.
      However, the mutant enzyme has a structural defect related to the polymerization
      state which delays the onset of catalysis and decreases the catalytic efficiency.

PMID- 8473317
TI  - Lysine 87 in the beta subunit of tryptophan synthase that forms an internal
      aldimine with pyridoxal phosphate serves critical roles in transimination,
      catalysis, and product release.
AB  - This study provides valuable insights into the functions of the lysine residue
      that forms an internal aldimine with pyridoxal phosphate in the beta subunit of
      tryptophan synthase from Salmonella typhimurium. Our spectroscopic and kinetic
      studies demonstrate that a mutant alpha 2 beta 2 complex having beta subunit
      lysine 87 replaced by threonine forms external aldimines with several amino acids
      including L-serine, beta-chloro-1-alanine, L-tryptophan, and D-tryptophan.
      Because the rates of aldimine formation are very slow, we conclude that one role
      of lysine 87 in the wild type enzyme is to facilitate formation of external
      aldimines by transimination. Lysine 87 is an essential catalytic residue because
      the mutant alpha 2 beta 2 complex has no measurable activity in reactions
      catalyzed by the beta subunit and does not convert external aldimines to
      products. The mutant enzyme carries out two slow partial beta-elimination
      reactions: the conversion of beta-chloro-L-alanine and L-serine to enzyme-bound
      aminoacrylate. The reaction with L-serine is catalyzed by ammonia, which
      partially replaces the deleted epsilon-amino group. Lysine 87 is important for
      substrate and product release because L-serine, L-tryptophan, and aminoacrylate
      dissociate very slowly from the mutant alpha 2 beta 2 complex. Our ability to
      prepare very stable derivatives of the mutant alpha 2 beta 2 complex containing
      tightly bound aldimines with a substrate, a product, or a reaction intermediate
      provides valuable materials for ongoing x-ray crystallographic investigations and
      future kinetic analyses of the allosteric activation of the alpha subunit by beta
      subunit ligands.

PMID- 8473318
TI  - Characterization of the purified vitamin K-dependent gamma-glutamyl carboxylase.
AB  - Vitamin K-dependent carboxylase, purified from bovine liver, has properties
      similar to those reported for the carboxylase activity present in crude,
      solubilized microsomes. The purified carboxylase was found to possess the vitamin
      K epoxidase activity, believed to be essential for vitamin K-dependent
      carboxylation, but did not contain vitamin K epoxide reductase activity. Kinetic
      studies of the carboxylase done under defined conditions were complicated by the
      non-Michaelis-Menten kinetic behavior observed for reactions with two of the
      enzymes substrates, FLEEL and vitamin K1 hydroquinone. Initial rate experiments
      with the substrate FLEEL demonstrated behavior consistent with substrate
      inhibition and gave half-maximal activity at 1 mM FLEEL. Experiments with the
      substrate vitamin K1 hydroquinone also displayed non-Michaelis-Menten kinetics,
      as maximal activity was reached prematurely in relation to behavior at lower
      concentrations. Half-maximal activity was observed at 35 microM vitamin K1
      hydroquinone. Initial rate experiments with varying NaH14CO3 concentration
      displayed Michaelis-Menten kinetics and gave a Km(app) of 0.29 mM. At cosubstrate
      concentrations chosen to obtain near-maximal activity, initial rate studies with
      varying NaH14CO3 concentration indicated a kcat near 1.0 s-1. Removal of the
      fourth substrate, oxygen, resulted in the loss of more than 99% of carboxylase
      activity. The sulfhydryl reagent N-ethylmaleimide inhibited carboxylase
      irreversibly, as did the anticoagulant warfarin.

PMID- 8473319
TI  - Dityrosine and tyrosine oxidation products are endogenous markers for the
      selective proteolysis of oxidatively modified red blood cell hemoglobin by (the
      19 S) proteasome.
AB  - Cells exposed to oxidative stress have been shown previously to exhibit both
      protein oxidation and increased proteolysis. Experiments conducted with purified
      proteins in vitro have indicated that oxidatively modified proteins may be
      selectively degraded by intracellular proteases, but a definitive cause-and
      effect relationship has not been demonstrated previously in intact cells. Several
      investigators have proposed that oxidatively modified proteins are selectively
      degraded within cells, but the possibility that oxidants may activate
      intracellular proteases (directly or indirectly) to catalyze the indiscriminate
      degradation of undamaged proteins has not been discounted. Armed with the
      knowledge that dityrosine is a specific product of protein oxidation, we
      undertook a series of experiments to test the hypothesis that oxidized proteins
      undergo selective intracellular degradation. Our results demonstrate that
      dityrosine is produced in the hemoglobin molecule when red blood cells are
      exposed to a continuous flux of hydrogen peroxide (H2O2). The dityrosine so
      produced is only released from the hemoglobin by proteolysis and is stable to
      prolonged incubation with cell extracts. Inhibitors of proteolysis have no effect
      on dityrosine production but do effectively prevent dityrosine release.
      Proteasome (the 670-kDa multicatalytic proteinase complex, that we have
      previously called macroxyproteinase or MOP (Pacifici, R. E., Salo, D. C., and
      Davies, K. J. A. (1989) Free Radical Biol. & Med. 7, 521-526; Salo, D. C.,
      Pacifici, R. E., Lin, S. W., Giulivi, C., and Davies, K. J. A. (1990) J. Biol.
      Chem. 265, 11919-11927; Pacifici, R. E., and Davies, K. J. A. (1991) Gerontology
      37, 166-180) appears responsible for dityrosine release during the selective
      degradation of oxidatively modified proteins in red blood cells and red cell
      extracts. We conclude that the elevated rates of proteolysis observed in response
      to oxidative stress do, indeed, reflect selective degradation of oxidatively
      modified (damaged) proteins. Despite a relatively low production rate, dityrosine
      has a high fluorometric quantum yield and is, of course, a specific product of
      protein oxidation. As an apparently stable metabolic end product, dityrosine may
      prove to be an extremely valuable (cellular or urinary) marker or index of
      organismal oxidative stress.

PMID- 8473321
TI  - Triacylglycerol synthesis by an sn-1,2(2,3)-diacylglycerol transacylase from rat
      intestinal microsomes.
AB  - A membrane-associated sn-1,2(2,3)-diacylglycerol transacylase activity was
      purified 550-fold from the microsomes of rat intestinal villus cells. The enzyme
      was solubilized with the zwitterionic detergent 3-[(3
      cholamidopropyl)dimethylammonio]-1-propanesulfonate and was isolated and purified
      by sequential chromatography on hydroxylapatite, an anion exchanger, Affi-Gel
      heparin and Cibacron blue A-agarose. SDS-polyacrylamide gel electrophoresis
      revealed two major closely migrating polypeptides of apparent molecular mass of
      50 and 52 kDa. Incubation of the isolated enzyme with sn-1,2(2,3)dioleoyl-[2
      3H]glycerol yielded trioleoyl[2-3H]glycerol and 2-oleoyl[2-3H]glycerol. The
      synthesis of triacylglycerols was independent of acyl-CoA, as indicated by the
      absence of incorporation of radioactivity from [1-14C]oleoyl-CoA into mono-, di-,
      or triacylglycerols under these conditions. The transacylase did not hydrolyze
      triacylglycerols readily and was not affected by the acyltransferase inhibitors,
      N-ethylmaleimide and 4,4'-diisothiocyanostilbene-2,2'-disulfonate, while the
      lipase/hydrolase inhibitors NaF, phenylmethylsulfonyl fluoride, and diethyl p
      nitrophenyl phosphate caused partial inactivation. The enzyme was specific toward
      1(3)-positions of rac 1,2-diacylglycerols but did not utilize the -1,3
      diacylglycerols or other neutral lipid esters effectively and was not capable of
      removing fatty acids from phosphatidylcholine or of transfer of fatty acids from
      X (unspecified enantiomer)-1,2-diacylglycerol to lysophosphatidylcholine. Since
      the diacylglycerol transacylation did not lead to accumulation of either sn-1,2-
      or sn-2,3-diacylglycerols during incubation with the racemates, it is concluded
      that both sn-1,2- and sn-2,3-s are utilized at similar rates.

PMID- 8473320
TI  - Properties and regulation of the cell cycle-specific NIMA protein kinase of
      Aspergillus nidulans.
AB  - NIMA is the protein product of the nimA gene of the filamentous fungus
      Aspergillus nidulans, required for progression of cells from G2 into mitosis. The
      protein kinase activity of NIMA, assayed by phosphorylation of beta-casein,
      varies during the nuclear division cycle, reaching a maximum in late G2 and M. To
      investigate the biochemical properties of this cell cycle-regulated protein
      kinase, we have expressed nimA cDNA that encodes full-length NIMA in Escherichia
      coli as a fusion product with glutathione S-transferase. Purified NIMA
      phosphorylated beta-casein, with a Km of 38 microM and Vmax of 156 nmol/min/mg.
      NIMA also demonstrated a Km of 69 microM for ATP. Both recombinant and cellular
      NIMA kinases behaved as oligomers on gel filtration chromatography, and their
      kinase activities were strongly inhibited by various salts. By using both protein
      and peptide substrates, NIMA demonstrated a serine/threonine-specific protein
      kinase activity. Cellular NIMA exists as a phosphoprotein, and bacterially
      expressed NIMA was also phosphorylated on multiple serine/threonine residues.
      Some of these phosphorylations appeared essential for NIMA activity as the enzyme
      could be dephosphorylated and inactivated in vitro by protein serine/threonine
      phosphatases. Use of a kinase-negative mutant of NIMA revealed that the NIMA
      enzyme undergoes autophosphorylation when expressed at high concentrations in
      bacteria. Taken together, these data suggest that cellular mechanisms may exist
      to regulate the phosphorylation state and activity of the NIMA protein kinase
      during the nuclear division cycle in A. nidulans.

PMID- 8473322
TI  - ADP induces inositol phosphate-independent intracellular Ca2+ mobilization in
      brain capillary endothelial cells.
AB  - The action of adenine and uracyl nucleotides on rat brain capillary endothelial
      cells was investigated. ATP, UTP, and adenosine 5'-O-(3-thiotrisphosphate)
      activated phospholipase C and induced large increases in [Ca2+]i. ADP had a
      different action. At low concentrations (< 10 microM), ADP induced the
      mobilization of a thapsigargin-sensitive intracellular Ca2+ store in the absence
      of measurable production of inositol phosphates. At larger concentrations (> 30
      microM), ADP activated phospholipase C. The actions of ATP and ADP and of UTP and
      ADP were additive. Those of ATP and UTP were not. In the presence of ATP or UTP,
      the dose-response curve for ADP action on [Ca2+]i was monophasic and corresponded
      to the high affinity responses. Finally, we observed that ADP did not desensitize
      cells to the actions of ATP and UTP. In contrast, cross-desensitization of the
      actions of ATP and UTP were observed. It is concluded that two types of receptors
      account for the actions of nucleotides: (i) a nucleotide that recognizes ATP and
      UTP and that is positively coupled to phospholipase C; and (ii) an ADP-specific
      receptor that induces the mobilization of a thapsigargin-sensitive intracellular
      Ca2+ pool in a manner independent of the formation of inositol phosphates.

PMID- 8473323
TI  - Characterization of the human ADP-ribosylation factor 3 promoter. Transcriptional
      regulation of a TATA-less promoter.
AB  - The 5'-flanking region of the human ADP-ribosylation factor 3 gene contains the
      features of a housekeeping gene. It lacks a TATA or CAAT box, has several GC
      boxes within a highly GC-rich region, and utilizes multiple transcription
      initiation sites. The cis-acting elements involved in regulating expression of
      the gene were identified by transient transfections of IMR-32 neuroblastoma
      cells. Reporter plasmids were modified to facilitate construction of defined
      promoter deletions linked to chloramphenicol acetyltransferase or luciferase
      using ligation-independent cloning. Transfection analyses indicated that
      sequences within 58 base pairs of the transcription initiation site were
      necessary for full expression, in particular a sequence containing the 10-base
      pair palindrome TCTCGCGAGA. Electrophoretic mobility shift assays performed with
      IMR-32 nuclear extracts demonstrated that a DNA-binding protein, termed TLTF,
      bound to an oligonucleotide containing this palindrome. Competition experiments
      showed that mutations within the core of the palindrome abolished in vitro
      binding and that the same protein bound to a 5'-proximal sequence. Expression of
      the promoter containing a mutated palindrome was reduced dramatically, consistent
      with the conclusion that this region functions in vivo to control expression of
      the ARF3 gene.

PMID- 8473324
TI  - ARD 1, a 64-kDa guanine nucleotide-binding protein with a carboxyl-terminal ADP
      ribosylation factor domain.
AB  - Clones referred to as ARD 1 were isolated from human and rat cDNA libraries. ARD
      1 genes encode a putative 64-kDa protein that contains an 18-kDa ADP-ribosylation
      factor (ARF) domain at the carboxyl terminus and is much larger than the other
      monomeric approximately 20-kDa guanine nucleotide-binding ARF proteins thus far
      identified. ARD 1 mRNAs of 3.7 and 4.1 kilobases were detected in all rat tissues
      as well as in mouse and rabbit brain, human fibroblasts, and human neuroblastoma
      cells but not in HL-60 cells. Based on sequence identities, ARD 1 is highly
      conserved between rat and human. The ARF domain of ARD 1 contains the consensus
      sequences believed to be involved in guanine nucleotide binding, which are
      conserved in the ARFs and other GTP-binding proteins. Recombinant ARD 1 or the
      ARF domain of ARD 1, which lacks the 15 amino acids corresponding to the amino
      terminal regions of ARFs stimulated, in a GTP-dependent manner, cholera toxin ADP
      ribosyltransferase activity in the presence of 0.3% Tween 20. It had no effect in
      the presence of SDS, dimyristoylphosphatidylcholine/cholate, or cardiolipin.
      These observations are consistent with the conclusion that the amino-terminal
      region of ARF proteins is not required for activation of cholera toxin. In
      addition, the characteristic features of ARF proteins may be found as domains of
      larger mammalian proteins.

PMID- 8473325
TI  - Identification of a new cell adhesion motif in two homologous peptides from the
      COOH-terminal cell binding domain of human thrombospondin.
AB  - Thrombospondin-1 (TS1) contains at least four domains that support cell
      attachment. The COOH-terminal cell binding domain (CBD) was first identified with
      a monoclonal antibody against TS1 that blocked secretion-dependent platelet
      aggregation. Subsequently, this domain of TS1 has been found to bind a number of
      normal and transformed cells. We have localized attachment sites for human
      melanoma cells (G361) within the CBD to two noncontiguous 30-residue peptides
      designated C4 and C7 (Kosfeld, M. D., and Frazier, W. A. (1991) J. Biol. Chem.
      267, 16230-16236). Here we report studies to define the active sequences within
      C4 and C7. An octapeptide, RFYVVMWK (4N1-1), from C4 and a pentapeptide, IRVVM
      (7N3-1), from C7 were found to support attachment of G361 melanomas, K562
      erythroleukemia cells, HT1080 fibrosarcomas, C32 amelanotic melanomas, and
      endothelial cells. These peptides also inhibit the adhesion of cells to the
      recombinant CBD of TS1. The hexapeptide RFYVVM (4N1-2) also inhibits cell
      attachment. The inhibitory effect of combinations of C4- and C7-derived peptides
      is synergistic. The sequences 4N1-1 and 7N3-1 of TS1 share homology with two cell
      adhesive peptides from laminin (LM), LMF9 and LMPA22-2, respectively. These TS1
      and LM peptides are interchangeable in inhibiting the adhesion of G361 cells to
      LM or TS1, suggesting a possible sharing of receptors by LM and TS1. K562 cells,
      however, bound only to TS1, and this binding was inhibited preferentially by the
      TS1 CBD peptides, indicating a receptor specific for TS1 which does not recognize
      LM. The active TS1 peptides are highly conserved among five species and four
      isoforms of TS1. Homologs of the TS1 peptides are found in tenascin, a matrix
      protein that shares several properties with TS1 and in factor VIII, alpha 2
      macroglobulin, and von Willebrand factor.

PMID- 8473326
TI  - Membrane binding kinetics of factor VIII indicate a complex binding process.
AB  - Factor VIII functions as a component of the tenase enzyme complex upon
      phospholipid membranes. Factor VIII binds to phosphatidylserine-containing
      membranes and apparently provides high affinity binding sites for factor IXa upon
      these membranes. We have characterized the binding kinetics of human factor VIII
      with phosphatidylserine-containing membranes and directly compared the measured
      properties with those of factor V. The initial phase of association was evaluated
      in a stopped-flow apparatus by fluorescence energy transfer from aromatic
      residues in the protein to dansyl-labeled phosphatidylethanolamine in the
      vesicles. Association proceeded at an apparent second-order rate of 0.12 microM-1
      s-1 for extruded phospholipid vesicles and 0.42 microM-1 s-1 for sonicated
      vesicles under pseudo-first-order conditions in which the phospholipid
      concentration determined the rate. Increased temperature resulted in more rapid
      association, and the effect decreased in the order extruded vesicles > sonicated
      vesicles > extruded vesicles of dioleoylphospholipids, indicating that the
      structure of the phospholipid membrane contributes to the activation energy of
      binding. The binding of fluorescein-labeled factor VIII to membranes supported on
      glass microspheres (lipospheres) was monitored by flow cytometry. Under
      conditions in which the factor VIII concentration determined the rate there was
      rapid initial association at 6.9 microM-1 s-1, accounting for half of the bound
      factor VIII, and a slower component of 0.87 microM-1 s-1, accounting for the
      other half. Likewise, the dissociation of factor VIII from liposphere membranes
      was biphasic with a faster component of 0.010 s-1 and a slower component of
      0.0012 s-1. Rates of association and dissociation for factor V were similar to
      those for factor VIII and were biphasic. These results allow estimation of the
      size of the phospholipid sites that interact with factors VIII and V and suggest
      that both proteins bind to membranes via a multistep process in which rapid
      association is followed by a slower step yielding higher affinity binding.

PMID- 8473327
TI  - Cloning of type XVII collagen. Complementary and genomic DNA sequences of mouse
      180-kilodalton bullous pemphigoid antigen (BPAG2) predict an interrupted
      collagenous domain, a transmembrane segment, and unusual features in the 5'-end
      of the gene and the 3'-untranslated region of the mRNA.
AB  - Thus far, 16 distinct vertebrate collagens (types I-XVI) have been delineated. In
      this study, we have cloned a mouse collagenous protein, the 180-kDa bullous
      pemphigoid antigen (BPAG2). Isolation of over-lapping clones, together with 5'
      and 3' rapid amplification of cDNA ends, allowed delineation of the entire coding
      sequence. The 5' and 3' ends of the mRNA transcripts were confirmed by primer
      extension and anchored reverse transcription polymerase chain reaction analyses.
      The deduced polypeptide contained 1,433 amino acids, including a collagenous
      domain that consisted of 13 separate segments. Computer analysis of the deduced
      amino acid sequence demonstrated the presence of a membrane-associated segment.
      Examination of the 5' end of the BPAG2 gene revealed that the 295-base pair (bp)
      exon 1 contained two segments of (T)13AA and TT(A)11, whereas exon 2 was shown to
      contain the translation initiation codon. The 3' end of the mRNA transcript
      identified two 6-bp inverted repeat sequences that could form a stem for a 30-bp
      hairpin loop followed by a series of U residues. Comparison of mouse and human
      BPAG2 sequences demonstrated 86% homology and the unit of evolutionary period of
      4.2 million years. In summary, we have cloned full-length mouse BPAG2 cDNA
      sequences that encode a collagenous polypeptide. We propose that this polypeptide
      be designated as the alpha 1-chain of type XVII collagen.

PMID- 8473328
TI  - Molecular cloning and genomic organization of a gene for luciferin-binding
      protein from the dinoflagellate Gonyaulax polyedra.
AB  - The circadian expressed luciferin-binding protein (LBP) gene from the marine
      bioluminescent alga Gonyaulax polyedra represents the first dinoflagellate gene
      that has been cloned and sequenced at both cDNA and genomic levels. Starting with
      a fragment from the 3'-end of the LBP cDNA that was found by immunoscreening of a
      cDNA library, genomic clones were obtained by the inverse polymerase chain
      reaction technique. Full-length cDNA clones were selected by screening a cDNA
      library by plaque hybridizations and by polymerase chain reaction amplifications.
      The LBP sequence has a 2004-nucleotide open reading frame coding for a protein of
      668 amino acids (approximately 75 kDa). The reading frame and identity of the
      clone were confirmed by the sequence of an octapeptide obtained from a purified
      fragment of CNBr-treated LBP. A variant LBP cDNA was found to differ in sequence
      by approximately 11% at the DNA level. The untranslated regions of the mRNA are
      111 nucleotides (5'-untranslated region) and 158 nucleotides (3'-untranslated
      region) long, respectively. The LBP gene contains no introns and exhibits certain
      features not typical for a eukaryotic gene. Its promoter does not include the
      typical TATA box within approximately 50 nucleotides upstream of the
      transcription start site, and the usual poly(A+) signal (AAUAAA) is not present
      on the end of the LBP mRNA. The copy number of the gene is very high
      (approximately 1000 copies/cell). However, the universal genetic code and
      conserved positions relevant for the translational apparatus are maintained.

PMID- 8473329
TI  - RNR-1, a nuclear receptor in the NGFI-B/Nur77 family that is rapidly induced in
      regenerating liver.
AB  - Liver regeneration following partial hepatectomy provides one of the few systems
      for analysis of mitogenesis in the fully developed, intact animal. Immediate
      early growth response genes, induced in the absence of prior protein synthesis,
      play an important regulatory role in the regenerative process. During screening
      of a subtracted cDNA library of immediate-early genes induced during liver
      regeneration, a novel member of the thyroid/steroid receptor superfamily, RNR-1
      (regenerating liver nuclear receptor), was identified. This gene is not expressed
      in quiescent liver but is rapidly induced following partial hepatectomy and is
      specific to hepatic growth as it is not induced in other mitogen-treated cells.
      RNR-1 is also expressed in brain. A full-length cDNA clone of RNR-1 encodes a 66
      kDa, 597-amino acid protein as verified by in vitro translation in reticulocyte
      lysate. RNR-1 is highly homologous to r-NGFI-B/m-Nur77 particularly in the DNA
      binding (94%) and putative ligand binding (59%) domains. Using a mobility shift
      assay, we have shown that RNR-1 specifically binds to the NGFI-B DNA half-site
      and forms a complex very similar in size to the Nur77 complex, suggesting that
      RNR-1 also may bind as a monomer. Consistent with this finding, the A box region
      important in mediating half-site binding is 100% conserved between r-NGFI-B/m
      Nur77. Both RNR-1 and Nur77 strongly transactivate a reporter driven by a
      consensus r-NGFI-B/Nur77 binding site, and their effect together is additive. As
      both the RNR-1 and r-NGFI/m-nur77 genes are induced during liver regeneration, it
      is very possible that RNR-1 acts concomitantly with r-NGFI/m-Nur77 in regulating
      the expression of delayed-early genes during liver regeneration.

PMID- 8473330
TI  - An enhancer for transcription of collagen IV genes is activated by F9 cell
      differentiation.
AB  - Expression of collagen IV genes is developmentally regulated and cell type
      specific. To identify transcriptional control elements for the mouse alpha 2(IV)
      collagen gene, several promoter constructs were transiently transfected into
      mouse PYS-2 (parietal yolk sac) cells. Within the 5.5-kb (kilobase) upstream and
      8.5-kb downstream sequences from the transcription start site, we have identified
      several regulatory active regions. Here, we report characterization of the most
      proximal 0.3-kb enhancer found at 4.5-kb upstream of the alpha 2(IV) collagen
      gene. This enhancer is transcriptionally active in cells that make collagen IV
      such as PYS-2 cells and differentiated F9 cells, but has little if any activity
      in cells that do not make collagen IV including NIH 3T3 cells and
      undifferentiated F9 embryonal carcinoma stem cells. This enhancer, linked to the
      herpes simplex virus TK gene promoter, confers a cell type-specific and
      differentiation-induced expression on the TK gene as well. Mutational and 5' and
      3' deletion analysis demonstrate that this enhancer activity requires two
      identical response elements (GAACAAT) present in the 0.3-kb enhancer sequence. In
      gel shift assay, the GAACAAT element forms a complex that is specific for cells
      that make collagen IV.

PMID- 8473331
TI  - Association of heterogeneous nuclear ribonucleoprotein A1 and C proteins with
      reiterated AUUUA sequences.
AB  - Post-transcriptional regulatory mechanisms have been shown to play a major role
      in gene expression in eukaryotic cells. The presence of a reiterated pentamer
      (AUUUA) in the 3'-untranslated region (UTR) of mRNAs encoding lymphokines,
      cytokines, transcription factors, and proto-oncogenes has been shown to be
      associated with rapid turnover and translation attenuation. Cytoplasmic proteins
      (70, 50, 43, 36, and 25 kDa) capable of specifically binding to RNAs containing
      these AU-rich sequences were identified in human peripheral blood T lymphocytes.
      Levels of the 36-kDa protein were markedly increased following transcriptional,
      but not translational inhibition, a feature recently reported for hnRNP A1, a
      protein of comparable mass. Antibodies directed against heterogeneous nuclear
      ribonucleoproteins (hnRNPs) A1 and C immunoprecipitated 36- and 43-kDa proteins
      that had bound the AUUUA-rich region contained in the 3'-UTR of granulocyte
      macrophage colony-stimulating factor mRNA. Recombinant hnRNP A1 was shown to
      preferentially bind to RNAs containing AUUUA sequences in a specific manner, and
      displayed comparable patterns to the 36-kDa AU-specific binding proteins
      following partial proteolysis. These data identify for the first time hnRNP A1
      and C as cytoplasmic proteins in human lymphocytes that are capable of
      specifically associating with reiterated AUUUA sequences present in the 3'-UTR of
      labile mRNAs. As such, they may play a role as trans-acting factors in the
      modulation of cytoplasmic mRNA turnover and translation, in addition to their
      previously characterized roles as pre-mRNA binding proteins involved in nuclear
      mRNA processing.

PMID- 8473332
TI  - Cloning, expression, and characterization of Cryptococcus neoformans
      dihydrofolate reductase.
AB  - The Cryptococcus neoformans dihydrofolate reductase (DHFR) gene has been isolated
      from cDNA and genomic DNA libraries. The 690-base pair coding sequence codes for
      a 25,152-Da protein, which is the largest monofunctional DHFR yet reported. The
      gene contains two introns, and several putative regulatory sequences have been
      identified. The coding sequence was placed in a pUC-based expression vector,
      which expresses C. neoformans DHFR in Escherichia coli at a level of about 5% of
      the total soluble extract. The expressed DHFR was purified to homogeneity by
      methotrexate-Sepharose affinity chromatography, followed by anion exchange
      chromatography on Q-Sepharose. On SDS-polyacrylamide gel electrophoresis, the
      purified enzyme migrates as a single protein with apparent mass of 28 kDa. The
      molecular weight, as determined by electrospray mass spectral analysis, and the
      amino-terminal sequence are in accord with what was predicted from the DNA
      sequence. Steady state kinetic parameters, effects of pH, salts, and inhibition
      constants of several anti-folates have been determined.

PMID- 8473333
TI  - A basis for differentiating among the multiple human Mu-glutathione S
      transferases and molecular cloning of brain GSTM5.
AB  - Specific cDNA probes and antisera were employed to interpret genetic
      polymorphisms of human Mu-class glutathione S-transferases and to provide a basis
      for identifying individual forms in human tissues. A cDNA probe that cross
      hybridized with various human and rodent Mu-glutathione S-transferase
      transcripts, hybridized with at least three discrete components by Northern
      analysis of RNA from human tissue. The smallest (1.3 kb) transcript was
      identified as the one that encodes GSTM3-3 subunits. A form designated GSTM5, was
      cloned from a human brain cDNA library and its sequence determined. The open
      reading frame of GSTM5 shared a high degree of homology with the sequences of
      other Mu-class glutathione S-transferases, but its 846-nucleotide 3'-noncoding
      region was unique and considerably larger than that of any of the other Mu forms.
      Specific synthetic peptide antigens were utilized to distinguish among Mu-class
      glutathione S-transferases in different tissues of representative individuals.
      The primary hepatic transcript was that encoding GSTM1-1 with much lesser amounts
      of GSTM3-3, but livers were devoid of GSTM2-2, and GSTM5-5. Immunoblots confirmed
      that null-phenotype individuals lacked the GSTM1 gene rather than its GSTM2
      homologue that is nearly identical in its exon sequences. The null phenotype
      therefore was conspicuous in liver, where GSTM1-1 ordinarily was the predominant
      Mu transcript, but brain and testis contained all four forms. A general strategy
      was devised to distinguish among and assign primary structures to individual
      glutathione S-transferases from human tissue.

PMID- 8473334
TI  - Biosynthesis of human fibrinogen. Subunit interactions and potential
      intermediates in the assembly.
AB  - Stable transfected baby hamster kidney (BHK) cells expressing human alpha, beta,
      and gamma fibrinogen chains together, in various combinations of any two, or
      individually, were established. Several types of subunit interactions were
      observed in the intracellular extracts of the transfected BHK cell lines as well
      as in Hep G2 cells. These included: 1) formation of alpha gamma dimers linked by
      a disulfide bond(s), 2) formation of beta gamma dimers linked by a disulfide
      bond(s), 3) formation of alpha beta gamma half-molecules linked by disulfide
      bonds, and 4) formation of mature fibrinogen, which was also secreted into the
      cell culture medium. Analysis of the chain composition confirmed the
      stoichiometry of the alpha gamma, beta gamma, and alpha beta gamma complexes.
      These data are consistent with the proposal that the alpha gamma and beta gamma
      dimers as well as the alpha beta gamma half-molecules are intermediates in the
      assembly and biosynthesis of fibrinogen. In contrast, disulfide-linked alpha beta
      complexes were not found in transfected BHK cells or in Hep G2 cells, suggesting
      that the formation of disulfide bonds between these two chains most likely occurs
      when alpha beta gamma half-molecules are formed from alpha gamma and/or beta
      gamma complexes and when alpha beta gamma half-molecules dimerize to generate the
      mature molecule. Dimers, trimers, and larger oligomers of each individual chain
      linked by disulfide bonds were also identified when each chain was expressed in
      the absence of the other two chains. Preferential formation of alpha gamma and
      beta gamma complexes, rather than oligomers of individual chains, suggested that
      the oligomers were less likely to be intermediates in the assembly of fibrinogen.
      A model for fibrinogen assembly is presented based on these results.

PMID- 8473335
TI  - Platelet-derived growth factor stimulates a biphasic mobilization of arachidonic
      acid in Swiss 3T3 cells. The role of phospholipase A2.
AB  - Stimulation of quiescent Swiss 3T3 cells with platelet-derived growth factor
      (PDGF) increased the initial rate of cytosolic phospholipase A2 activity by 95 +/
      6% over extracts from control cells. Cytosolic phospholipase A2 activity
      increased rapidly following PDGF treatment (near maximum stimulation by 2.5 min)
      and was dose-dependent (EC50 = 2 ng/ml). Epidermal growth factor, vasopressin,
      and phorbol 12,13-dibutyrate also increased cytosolic phospholipase A2 activity
      but did not produce a sustained mobilization of arachidonic acid in these cells.
      Detailed kinetic analysis of PDGF-induced arachidonic acid mobilization revealed
      a biphasic release of 3H radioactivity into the extracellular medium. A first,
      rapid phase, occurred within 15 min which, like the activation of cytosolic
      phospholipase A2 activity, was independent of de novo RNA and protein synthesis.
      After 20 min of stimulation, a second phase became evident which accounts for the
      majority of arachidonic acid mobilized by PDGF. This second phase was abolished
      in the presence of either cycloheximide or actinomycin D. Both inhibitors blocked
      the release of arachidonic acid rather than inhibiting cyclooxygenase activity
      and consequently prostaglandin E2 production. These findings demonstrate a
      biphasic mobilization of arachidonic acid in Swiss 3T3 cells by PDGF. Cytosolic
      phospholipase A2 activity could contribute to the rapid first phase but not the
      second major phase, which is dependent upon de novo protein synthesis.

PMID- 8473336
TI  - Structural analysis of the myoglobin reconstituted with iron porphine.
AB  - Sperm whale apomyoglobin was complexed with iron porphine to examine the
      influence of completely removed heme side chains on the entire molecular
      structure. Paramagnetic NMR peak from the proximal histidine of the deoxy protein
      ensured formation of the iron-histidine bond. Porphine pyrrole-proton NMR signals
      of the cyanmet and deoxy derivatives are unusually sharp single lines manifesting
      rapid heme rotation about the iron-histidine bond. X-ray crystallographic
      structure of the cyanmet derivative, determined with a final R factor of 0.21 for
      11,808 independent reflections ranging from 7 to 1.8 A, was resolved at 1.8 A
      resolution. The result confirmed 1:1 coupling between apomyoglobin and iron
      porphine. The cyano ligand adopts a bent configuration with an Fe-C-N angle of
      127 degrees and a Fe-CN distance of 1.89 A. The overall globin structure and side
      chain conformations are remarkably similar to those of native myoglobin despite
      intensive disruption of the original heme-globin interactions. The native
      apoprotein structure unexpectedly conserved even after iron porphine insertion
      demonstrates that the complex polypeptide fold of holomyoglobin is more inherent
      in the amino acid sequence than is generally believed.

PMID- 8473337
TI  - Interference by PR-bound RNA polymerase with PRM function in vitro. Modulation by
      the bacteriophage lambda cI protein.
AB  - Activation of the weak PRM promoter by cI protein is an essential process in the
      establishment of lysogeny. Much evidence has accumulated that cI protein binds
      cooperatively to the operators OR1 and OR2 and that protein at the OR2 site
      contacts RNA polymerase to facilitate open complex formation at the PRM promoter.
      We had shown previously in vitro that RNA polymerase situated at the nearby PR
      promoter could interfere with open complex formation at PRM and that an
      additional mechanism of PRM activation in vitro involved cI-mediated RNA
      polymerase exclusion from PR. Here we further characterize this second indirect
      mode of activation. We demonstrate the addition of cI and inactivation of the PR
      promoter activate open complex formation at PRM similarly over the temperature
      range from 37 to 20 degrees C in which the extent of activation decreases from 8-
      to 2-fold. We also show that the binding of cI protein to OR1 is sufficient to
      effect an increase in the rate of synthesis of abortive RNA products at PRM. This
      result is difficult to explain based on direct cI-RNA polymerase contacts alone
      but is readily interpreted in terms of our previously proposed model involving
      the exclusion of an interfering RNA polymerase from binding at PR.

PMID- 8473338
TI  - Senescent WI-38 cells fail to express EPC-1, a gene induced in young cells upon
      entry into the G0 state.
AB  - Recently we reported the isolation of cDNAs for a number of genes that are
      differentially expressed between nonproliferating early (young) and late
      (senescent) population doubling level (PDL) WI-38 human, fetal lung-derived,
      fibroblast-like cells. We now demonstrate that one of these isolates, EPC-1
      (early PDL cDNA-1), derives from an approximately 1.4-kilobase mRNA species that
      is expressed at a > or = 100-fold higher level in serum-starved, confluent, young
      versus similarly treated senescent WI-38 cells. Complete nucleotide sequence
      analysis of this cDNA confirms its identity with that of a cDNA encoding a
      secreted, retinal pigmented epithelium differentiation factor as well as
      similarity of the encoded protein with a number of mammalian serine protease
      inhibitors. We show that EPC-1 expression is associated with G0 growth arrest in
      WI-38 cells. The mRNA readily accumulates in density-arrested and/or serum
      starved young cells but not in log phase, low density young cells. In contrast,
      EPC-1 transcript abundance and expression of the encoded, secreted protein are
      both negligible in senescent WI-38 cells under all culture conditions tested.
      These findings support the hypothesis that senescent WI-38 cells exhibit a state
      of growth arrest fundamentally distinct from that of quiescent (G0) young cells.

PMID- 8473339
TI  - CD45-associated kinase activity requires lck but not T cell receptor expression
      in the Jurkat T cell line.
AB  - The earliest biochemical event known to be associated with T cell receptor (TCR)
      engagement is the activation of a protein tyrosine kinase thought to be a member
      of the src family. Expression of CD45, the major receptor tyrosine phosphatase
      present on T cells, is required for efficient coupling between the TCR and its
      signaling machinery. One model to explain the role of CD45 in regulating TCR
      signaling is that the phosphatase dephosphorylates the regulatory C-terminal
      tyrosine of lck. In the present report we confirm the finding of a trimolecular
      complex containing CD45, lck, and a 34-kDa protein (p34) in the Jurkat T cell
      line. Additionally, we extend this work with the observation that specific in
      vitro kinase activity associated with CD45 requires the expression of lck in
      Jurkat-derived clones as does the in vivo phosphorylation of p34. The association
      between CD45 and lck is shown not to require the expression of or activation of
      the TCR. Finally, we demonstrate that even in the absence of lck p34 associates
      with CD45, implying a direct association between this molecule and the
      phosphatase. These data suggest strongly that lck is the relevant protein
      tyrosine kinase found in CD45 immunoprecipitates in the Jurkat T cell line and
      that there is an additional association between CD45 and p34 which does not
      require the presence of the protein tyrosine kinase.

PMID- 8473340
TI  - Inhibition of the copper incorporation into ceruloplasmin leads to the deficiency
      in serum ceruloplasmin activity in Long-Evans cinnamon mutant rat.
AB  - Although ceruloplasmin is known to be a copper-transporting protein, little is
      known about the biochemical mechanisms of copper incorporation into ceruloplasmin
      during the biosynthesis. We have examined various levels of ceruloplasmin
      biosynthesis in the Long-Evans Cinnamon (LEC) rat, which possesses a mutation
      causing the deficiency in serum ceruloplasmin activity associated with excess
      hepatic copper accumulation. Southern and Northern blot analyses revealed that
      the gene and mRNA encoding ceruloplasmin resided normally in LEC rat liver.
      Western blot analysis showed a normal level of ceruloplasmin in LEC rat serum.
      Following metabolic labeling of hepatocytes with 64Cu, no radioactive copper was
      detected in the ceruloplasmin fraction in LEC rat hepatocytes using Sephadex G-75
      column chromatography, indicating that copper incorporation into ceruloplasmin is
      deficient in the LEC rat. Furthermore, LEC rat hepatocytes incubated with 64Cu
      also showed a reduction in the efficiency of copper transport from cytosolic to
      noncytosolic fractions and a reduced copper efflux from the hepatocytes,
      indicating that LEC rat hepatocytes possess an abnormality in copper metabolism.
      These results suggest that an abnormality of the copper delivery mechanism causes
      an inhibition of copper incorporation into the ceruloplasmin molecule in the
      liver, leading to the deficiency in serum ceruloplasmin activity in the LEC rat.
      In addition, this abnormality also seems to cause an inhibition of biliary copper
      excretion. The blocking of these two copper exclusion pathways is thought to lead
      to excess hepatic copper accumulation in the LEC rat. Thus, the LEC rat should be
      a good model for studying the biochemical process responsible for copper
      delivery.

PMID- 8473341
TI  - Conformational change and membrane association of the PutA protein are coincident
      with reduction of its FAD cofactor by proline.
AB  - The PutA protein is both the put repressor and a membrane-bound enzyme with
      proline and delta 1-pyrroline-5-carboxylate dehydrogenase activities. The
      conditions required for association of purified PutA protein with membrane
      vesicles suggested that a redox switching mechanism might determine the
      proportion of PutA protein functioning as a dehydrogenase (Wood, J. M. (1987)
      Proc. Natl. Acad. Sci. USA 84, 373-377). The FAD cofactor was released from the
      PutA protein with 1 M KBr at neutral pH. The apoprotein retained delta 1
      pyrroline-5-carboxylate dehydrogenase and DNA binding but not proline
      dehydrogenase activity. Reconstitution with FAD fully restored proline
      dehydrogenase activity. Proline at a concentration of 0.11 mM caused half-maximal
      bleaching of the FAD in PutA. Chymotryptic digestion of the PutA protein in the
      presence and absence of proline demonstrated that the persistence of a 119-kDa
      protein fragment was characteristic of the reduced protein. Identical digestion
      patterns were obtained from the apoprotein in the presence and absence of
      proline. The quantity of the 119-kDa fragment produced varied with proline
      concentration, yielding a midpoint of 0.056 mM proline. The fraction of PutA
      protein associated with membrane vesicles was also a function of proline
      concentration, yielding a titration midpoint of 0.10 mM proline. Membrane binding
      was thus coincident with both flavin reduction and a change in protein
      conformation.

PMID- 8473342
TI  - Phenotypic analysis of proteinase A mutants. Implications for autoactivation and
      the maturation pathway of the vacuolar hydrolases of Saccharomyces cerevisiae.
AB  - We have isolated a number of mutants deficient in activity of the vacuolar
      hydrolase proteinase A (PrA). The mutations were sequenced and although they all
      map in the PEP4 gene, which encodes the precursor to PrA, three distinguishable
      phenotypes have surfaced. The properties of the pep4-7 missense mutant suggested
      that the activation of the precursor to proteinase A is due to an autocatalytic
      cleavage. PrA active site mutations were constructed and resulted in accumulation
      of PrA antigen in the inactive precursor form. Although protease B (PrB), another
      vacuolar hydrolase, is not required for the production of active PrA, the active
      form of PrA that accumulates in a strain lacking PrB is larger than that found in
      a strain containing active PrB. We have purified this larger form of PrA and
      determined that it bears 7 additional amino acids at its NH2 terminus. It has
      become apparent from all the studies performed on the maturation pathway of the
      vacuolar hydrolases that there is a great deal of redundancy built into the
      system.

PMID- 8473343
TI  - Structural and functional domains of the Drosophila ncd microtubule motor
      protein.
AB  - Nonclaret disjunctional (ncd) is a kinesin-related microtubule motor protein that
      is required for proper chromosome distribution in Drosophila. Despite its
      sequence similarity to kinesin heavy chain, ncd translocates with the opposite
      polarity as kinesin, toward microtubule minus ends. We have expressed different
      regions of the protein in bacteria and analyzed the proteins for function.
      Results indicate that ncd consists of three domains: a basic, proline-rich N
      terminal "tail," a central alpha-helical coiled-coil stalk, and a C-terminal
      motor domain. The ncd N terminus proteins bundle microtubules in motility assays
      and show ATP-independent binding to microtubules in solution. Truncated proteins,
      lacking the tail but containing the predicted motor domain and differing lengths
      of the stalk, did not support microtubule gliding in in vitro assays but showed
      microtubule-stimulated MgATPase activity in solution. Addition of a nonspecific N
      terminus to two of the truncated proteins restored directional gliding and
      rotation of microtubules in motility assays, demonstrating that these properties
      map to the predicted mechanochemical domain of ncd. Physical properties of the C
      terminus proteins indicate that the stalk region is important for dimerization
      and that the ncd protein probably exists and functions as a dimer.

PMID- 8473344
TI  - Dissociation of heparin-dependent thrombin and factor Xa inhibitory activities of
      antithrombin-III by mutations in the reactive site.
AB  - Antithrombin-III (AT-III) is a heparin-dependent inhibitor of thrombin and Factor
      Xa, two serine proteases that are crucial for blood coagulation. In order to
      assess whether it would be possible to target AT-III only towards Factor Xa, we
      replaced parts of the reactive site, or P region, of AT-III by sequences present
      in prothrombin, a substrate of Factor Xa in the coagulation cascade. We show that
      replacement of the P3 to P3' region generates the hypothesized phenotype. In
      fact, point mutation of the P1' site from Ser (present in AT-III) to Ile (present
      in prothrombin) is sufficient to dissociate heparin-dependent thrombin and Factor
      Xa inhibitory activities. Interestingly, a combined mutation at P3 and P3' brings
      about the same dissociation. We show that besides Ile, other amino acids at P1'
      can lead to the dissociation in inhibitory activity. Amino acids with small side
      chains (Gly, Ser, Ala, and Thr) have only a marginal effect on the inhibitory
      activity against either protease. However, larger residues at the P1' position
      abolish the heparin-dependent anti-thrombin activity, whereas the heparin
      dependent anti-Factor Xa activity is not at all or only moderately affected.
      These results can be rationalized by a comparison of the x-ray structure and a
      three-dimensional model of the S1' binding pockets of thrombin and Factor Xa,
      respectively. It appears that the S1' pocket of Factor Xa leaves much more space
      for the P1' residue of AT-III than the S1' pocket of thrombin.

PMID- 8473345
TI  - Polarized secretion of thrombospondin is opposite to thyroglobulin in thyroid
      epithelial cells.
AB  - In addition to thyroglobulin, primary thyrocytes secrete into the culture medium
      significant quantities of p500, a protein so named because of its M(r) > or =
      500,000. Epithelial monolayers cultured on porous filters serve as a useful model
      system in which to study protein secretion. From these monolayers, thyroglobulin,
      the precursor in thyroid hormonogenesis, was released with apical predominance,
      while p500 was found mostly in the basolateral medium. Thyrocyte exposure to
      thyrotropin augmented selectively thyroglobulin but not p500 production. By
      contrast, exposure to cycloheximide actually augmented p500 production, a
      response observed for immediate-early proto-oncogenes. Using thyrocyte
      conditioned medium, the p500 protein was purified to homogeneity. Peptide
      sequencing of tryptic fragments of purified p500 showed identity to
      thrombospondin. Immunoprecipitation of thrombospondin from media bathing primary
      thyrocytes and the FRTL5 cell line quantitatively recovered p500, confirming its
      identity and indicating an epithelial origin. Gel filtration of secreted
      thrombospondin eluted at a high molecular weight, suggesting complexation with
      components of the extracellular matrix. Further, immunofluorescence showed
      cellular codistribution of thrombospondin and thyroglobulin, although
      thrombospondin exhibited predominantly an extracellular, basolateral deposition.
      It seems likely that thrombospondin production by thyrocytes plays a role in the
      growth or development of the thyroid epithelium.

PMID- 8473346
TI  - Molecular cloning of human prostaglandin endoperoxide synthase type II and
      demonstration of expression in response to cytokines.
AB  - Prostaglandin endoperoxide synthase (PHS) catalyzes the committed step in the
      biosynthesis of prostaglandins and thromboxane. We recently observed dissociation
      of PHS activity and enzyme mass measured in an immunoassay of endothelial cells
      exposed to tumor necrosis factor. These data and observations by others suggested
      that endothelial cells express an alternate PHS. We now report the molecular
      cloning of human PHS type II from an endothelial cell cDNA library. The protein
      encoded by this cDNA shares 61% identity with the human PHS I. Southern analysis
      demonstrated a single copy of PHS II and we found a polymorphism in approximately
      5% of the population. PHS II mapped to chromosome 1, in contrast to PHS I, which
      is on chromosome 9. The PHS II cDNA hybridized strongly to a 4.3-kilobase (kb)
      message from endothelial cells. Stimulation of the cells with tumor necrosis
      factor, phorbol 12-myristate 13-acetate, lipopolysaccharide, or interleukin-1
      increased mRNA levels for PHS II, and this change correlated well with increased
      prostacyclin biosynthesis. Cycloheximide induced PHS II mRNA without a
      corresponding activity increase demonstrating that translation of the 4.3-kb
      message is required for increased prostacyclin biosynthesis. We conclude that
      expression of PHS II may have important pathophysiological effects in the
      vasculature.

PMID- 8473347
TI  - Fpg protein of Escherichia coli is a zinc finger protein whose cysteine residues
      have a structural and/or functional role.
AB  - The Fpg protein of Escherichia coli is a DNA repair enzyme with DNA glycosylase,
      abasic site nicking, and deoxyribose excising activities. Analysis of the amino
      acid sequence of this protein suggests that the Fpg protein is a zinc finger
      protein with a Cys-X2-Cys-X16-Cys-X2-Cys motif. Competition experiments show that
      the Fpg protein substitutes Cu(II), Cd(II), and Hg(II), metal ions classically
      associated with substitutions in zinc finger proteins. The Fpg protein activities
      are inhibited following the reaction with a Cys-specific reagent at low
      protein:reagent ratios, suggesting that these residues are important for the
      enzymatic activities. Site-directed mutagenesis was used to produce 6 mutant Fpg
      proteins with Cys-->Gly mutations. Substitution of the zinc in these proteins by
      65Zn(II) indicates that all the proteins bind zinc, but the Zn(II) is not
      retained as strongly in the zinc finger mutants. The mutations in the Fpg protein
      outside the zinc finger consensus sequence do not eliminate the Fapy-DNA
      glycosylase and abasic site nicking. One of the Fpg mutant proteins outside the
      zinc finger has a reduced capacity to release deoxyribose from abasic sites. Cys-
      >Gly mutations in the zinc finger consensus sequence reduce all three
      aforementioned activities substantially. The purified Fpg proteins with Cys-->Gly
      mutations in the zinc finger consensus sequence do not incise DNA at abasic sites
      with the same efficiency nor mechanism as the native Fpg protein. The wild type
      Fpg protein and the Fpg proteins mutated outside the zinc finger sequence bind an
      oligonucleotide with a unique chemically reduced abasic site in a defined
      sequence as assayed by retention on nitrocellulose filters, whereas the mutant
      Fpg proteins within the zinc finger sequence do not bind to the same
      oligonucleotide. Therefore, the disruption of zinc coordination in the zinc
      finger of the Fpg protein is associated with decreased binding capacity to DNA as
      well as decreased enzymatic activities.

PMID- 8473348
TI  - Purification and characterization of a novel zinc-proteinase from cultures of
      Aeromonas hydrophila.
AB  - While searching for an enzyme capable of breaking epsilon-(gamma-Glu)-Lys
      isopeptide bonds cross-linking protein chains, we purified a metallo-proteinase
      which mimics the action of an isopeptidase on the gamma-chain dimers of cross
      linked fibrin. The enzyme is present in the growth medium of the bacterium
      Aeromonas hydrophila, isolated from the intestinal tract of the leech Hirudo
      medicinalis. It is a 19-kDa protein which specifically hydrolyzes the Gly-Ala
      peptide bond within the Gly-Gly-Ala sequence, located near the cross-link site in
      the gamma-chain dimer of fibrin. Substrate specificity studies with a number of
      synthetic peptides suggest that the enzyme prefers Gly-Gly or acetyl-Gly in the
      P2 and P1 positions, respectively (Schecter, I., and Berger, A. (1967) Biochem.
      Biophys. Res. Commun. 27, 157-162). Nonpolar amino acid residues seem to be
      favored in the P1' and P2' positions. The enzyme contains one atom of zinc and is
      inhibited by 1,10-phenanthroline, but not by EDTA. Iodoacetate, leupeptin,
      diisopropyl fluorophosphate, phenylmethylsulfonyl fluoride, pepstatin, and alpha
      2-macroglobulin have no effect on enzyme activity. Disulfide reducing reagents,
      such as dithiothreitol or 2-mercaptoethanol, inactivate the enzyme completely.
      The partial amino-terminal sequence shows 46% identity with a zinc metallo
      proteinase from a strain of Lysobacter enzymogenes and 69% identity with the LasA
      protein from Pseudomonas aeruginosa.

PMID- 8473349
TI  - Interleukin-6 activates and regulates transcription factors of the interferon
      regulatory factor family in M1 cells.
AB  - Activation of (2'-5') A synthetase gene expression in interleukin-6 (IL-6)
      treated myeloleukemic M1 cells correlates with protein binding to the interferon
      response sequence enhancer (IRS). A new interferon response sequence complex, F6,
      is induced by IL-6 independently of interferon and is identified here as
      comprising the interferon regulatory factor-1 (IRF-1) and IRF-2, by use of
      specific antibodies in DNA mobility shift assays with probes containing IRF
      binding sites. IRF-1 and IRF-2 have, respectively, positive and negative
      transcriptional effects on interferon-beta and interferon-inducible genes. In the
      IL-6-treated M1or cells, IRF-1 binding is activated early and maximally at 1 h,
      whereas the onset of IRF-2 binding is delayed. In a cell variant M1res, where (2'
      5') A synthetase is no more induced, IRF-2 binding is constitutive, and IRF-1
      binding is not seen before or after IL-6 treatment. In sensitive M1or cells, IL-6
      rapidly induces IRF-1 mRNA, but in M1res cells, IRF-1 mRNA is constitutively high
      and not changed by IL-6. IRF-2 mRNA levels are also constitutive and not
      inducible by IL-6 even in M1or cells. The dissociation between induction of mRNAs
      and of protein binding observed suggests that the activity of the IRF proteins is
      regulated by IL-6. Transcripts of a third member of the IRF gene family, ICSBP,
      encoding a protein known to act as repressor, were found to be strongly down
      regulated by IL-6. The rapid activation of IRF-1 and the modulation of the other
      transcription factors of this family may play a role in the early phase of IL-6
      action on the M1 cells.

PMID- 8473350
TI  - Dahl's salt-resistant normotensive rat has mutations in cytochrome P450(11 beta),
      but the salt-sensitive hypertensive rat does not.
AB  - Molecular cloning of cytochrome P450(11 beta) cDNAs from the adrenal glands of
      Dahl's salt-sensitive hypertensive (DS) and salt-resistant normotensive (DR) rats
      was performed using a combined technique of the first strand cDNA synthesis by
      reverse transcriptase followed by polymerase chain reaction. The cDNA sequence of
      P450(11 beta)-DS was identical to that of wild type P450(11 beta). In contrast,
      the clone obtained from the DR rat contained six nucleotide substitutions causing
      five amino acid alterations (Arg-127-->Cys, Val-351-->Ala, Val-381-->Leu, Ile-384
      ->Leu, and Val-443-->Met). When the two cDNAs were expressed in COS-7 cells and
      steroid conversion rates of the transformed cells were determined, a ratio of 18
      hydroxylation to 11 beta-hydroxylation of 11-deoxycorticosterone by P450(11 beta)
      DS-expressed cells was 0.58, whereas that by P450(11 beta)-DR-expressed cells was
      0.23. Plasma levels of 18-hydroxy-11-deoxycorticosterone and corticosterone (the
      11 beta-hydroxylation product of 11-deoxycorticosterone) in DS and DR rats well
      reflected the steroidogenic activities of the two P450s. These results suggest
      that the characteristic plasma steroid level of the DR rat is caused by the
      mutations in P450(11 beta) gene and may act to maintain the normotensive blood
      pressure in this rat strain during sodium loading.

PMID- 8473351
TI  - Functional divergence of protein kinase C (PKC) family members. PKC gamma differs
      from PKC alpha and -beta II and nPKC epsilon in its competence to mediate-12-O
      tetradecanoyl phorbol 13-acetate (TPA)-responsive transcriptional activation
      through a TPA-response element.
AB  - We have established an assay system where overexpression of a specific protein
      kinase C (PKC) type caused by introduction of the respective cDNA results in the
      enhancement of a cell response: the transcriptional activation of a set of genes
      in response to PKC activators such as 12-O-tetradecanoylphorbol 13-acetate (TPA).
      When monitored by the expression of a reporter gene containing the
      chloramphenicol acetyltransferase gene fused downstream of a synthetic TPA
      response element (TRE) or a serum response element (SRE), the overexpression of
      cPKC alpha and -beta II or nPKC epsilon all resulted in the enhancement of
      transcriptional activation through both TRE and SRE. On the other hand, PKC gamma
      activates TRE only very weakly, although it activates SRE in a similar manner to
      the other PKC members examined. The overexpression of cPKC alpha and -beta II or
      nPKC epsilon, but not cPKC gamma, resulted in the enhanced expression of the
      endogenous c-jun gene, which contains TRE in the 5'-upstream, promoter region.
      The gel mobility shift assay showed that the activation of PKC gamma, as well as
      PKC alpha and -beta II and nPKC epsilon, causes the increase in TRE-binding
      proteins, suggesting that transcriptional activation through TRE requires an
      additional step, which is not activated by PKC gamma, such as a qualitative
      change in TRE-binding or in TRE-associating proteins. This finding provides not
      only a rationale to explain the presence of multiple PKC family members, but also
      permits the dissection of the complex cellular signaling cascade involving PKC
      family members.

PMID- 8473352
TI  - Isolation and characterization of rat CYP11B genes involved in late steps of
      mineralo- and glucocorticoid syntheses.
AB  - We isolated and characterized four forms of rat CYP11B genes, which were
      tentatively named CYP11B1, -B2, -B3, and -B4. Genomic Southern analyses indicated
      that the members of the rat CYP11B gene subfamily were confined to these four
      genes; among them, CYP11B1 and -B2 encoded steroid 11 beta-hydroxylase and
      aldosterone synthase, respectively, while CYP11B3 was a gene highly homologous to
      CYP11B1 without a known expression product. By being devoid of a region spanning
      two exons conserved in the other three, CYP11B4 was presumably a pseudogene. In
      the nucleotide sequences, CYP11B1, -B3, and -B4 showed 95-96 and 93-100%
      identities in the coding and 0.5-kilobase 5'-flanking regions, respectively.
      However, the homology between the nucleotide sequences of one of the three and
      CYP11B2 was rather low, about 90 and 50% in the coding and 0.5-kilobase 5'
      flanking regions, respectively. As a whole, CYP11B2 rather than CYP11B1, -B3, or 
      B4 was more homologous to CYP11B genes of other animals such as cow and human. In
      transient transfection experiments using mouse adrenocortical Y1 cells and
      chloramphenicol acetyltransferase gene constructs, the 0.5-kilobase 5'-flanking
      region of CYP11B1 had a 4- and 10-fold higher promoter activity than the
      corresponding regions of CYP11B2 and -B3, respectively. The possible presence of
      a suppressive element(s) was noted in the upstream of the 0.5-kilobase region of
      CYP11B1. Although a variant of cAMP-responsive element, which was present in rat
      CYP11B2 and all known CYP11B genes of other animals, was modified in rat CYP11B1
      and -B3 genes, dibutyryl cAMP stimulated all the promoter activities of the 5'
      flanking regions of the rat genes by 3-fold.

PMID- 8473353
TI  - Human eosinophil cytotoxicity-enhancing factor. Eosinophil-stimulating and
      dithiol reductase activities of biosynthetic (recombinant) species with COOH
      terminal deletions.
AB  - U937 cells produce eosinophil cytotoxicity-enhancing factor (ECEF) polypeptides
      of 14 and 10 kDa that have identical NH2-terminal amino acid sequences. The 10
      kDa form has greater eosinophil-stimulating activity (half-maximal at > 20-fold
      lower concentration). We considered the hypothesis that there is a precursor
      product relationship between the 14- and 10-kDa species. Recombinant 14-kDa 104
      amino acid ECEF (rECEF-104) had a slight stimulatory effect on eosinophil
      cytotoxic function at concentrations of 160 nM and above. In contrast, two
      species, rECEF-80 and rECEF-84, representing cleavage products of approximately
      10 kDa had substantial statistically significant cytotoxicity-enhancing activity
      at concentrations as low as 10 pM. This evidence demonstrates the potential to
      generate the high-activity ECEF species by proteolytic cleavage of the 104-amino
      acid species. Another feature of this cytokine is the sequence from amino acids
      31 to 34, which constitutes the conserved and active site of the enzyme
      thioredoxin. When tested for dithiol reductase enzymatic activity, rECEF-104 was
      active in a dose- and time-dependent manner, whereas the truncated forms of the
      molecule had no dithiol reductase activity. Thus the eosinophil-stimulating
      functions of the molecule do not correlate with its enzymatic activity. The
      evidence shows that the enzymatic activity is not essential for the initial
      interaction of ECEF with the eosinophil, and it suggests that the ECEF molecule
      functions by means of two discrete mechanisms.

PMID- 8473354
TI  - Transcriptional activation of the inducible nuclear receptor gene nur77 by nerve
      growth factor and membrane depolarization in PC12 cells.
AB  - nur77 is an immediate-early gene inducible by nerve growth factor or membrane
      depolarization in the rat pheochromocytoma cell line PC12 and by serum growth
      factors in fibroblasts. The nur77-encoded protein is a member of the
      steroid/thyroid hormone receptor superfamily and can act as a potent
      transcription activator. The induction of nur77 in PC12 cells is rapid and
      transient, with kinetics similar to those of the c-fos protooncogene. Induction
      does not require de novo protein synthesis. Whereas transcriptional activation of
      c-fos by nerve growth factor in PC12 cells requires a 20-base pair serum response
      element in its promoter, there is no such sequence in the nur77 promoter. To
      understand the mechanism for the activation of nur77, we have analyzed the
      inducibility of a series of transfected nur77 minigenes using an S1 nuclease
      protection assay. We identified the sequence 22-86 nucleotides upstream of the
      transcription start site as necessary and sufficient for nur77 induction by nerve
      growth factor and membrane depolarization in PC12 cells. Sequences farther
      upstream enhance the induction. Analysis of base substitution mutations allowed
      us to identify three sequence elements within this region that are essential for
      induction. These sequence elements include two copies of an AP1-like element and
      a GC-rich sequence. Unlike transcriptional activation of c-fos, the sequence
      requirements for the activation of nur77 by nerve growth factor and membrane
      depolarization cannot be readily separated. Taken together, our data suggest that
      activation of nur77 and c-fos by nerve growth factor occurs through different
      mechanisms in PC12 cells.

PMID- 8473355
TI  - Memories of a childhood pharmacy.

PMID- 8473356
TI  - Dry and photo-aged skin: manifestations and management.
AB  - A review is presented on the causes and management of dry and photo-aged skin.
      The causative factors discussed range from adverse weather conditions to serious
      dermatological disease. The potential use of moisturizers in certain clinical
      cutaneous disorders. The main types of skin moisturizers and anti-ageing
      substances currently available are reviewed with particular emphasis on the
      rationale behind their development.

PMID- 8473357
TI  - Vitamin therapy in cystic fibrosis--a review and rationale.
AB  - Vitamin supplements are routinely prescribed in cystic fibrosis, but published
      recommendations vary widely and there is little consistency in clinical practice.
      A review of the literature confirms that, while supplementation of the water
      soluble vitamins (including B12 and folate) is unnecessary in uncomplicated
      cystic fibrosis, deficiency of the fat-soluble vitamins can lead to clinical
      problems. Supplements of these vitamins should be ensured for all patients with
      cystic fibrosis, while sparing them the unnecessary inconvenience of taking other
      vitamin supplements except where these are specifically indicated.

PMID- 8473358
TI  - Effect of oral activated charcoal on propranolol pharmacokinetics following
      intravenous administration to rabbits.
AB  - The pharmacokinetics of propranolol following intravenous administration (1
      mg/kg), with and without treatment with oral activated charcoal, was investigated
      in rabbits. In charcoal-treated rabbits a significant reduction in propranolol
      serum concentrations was observed compared to control animals. Charcoal treatment
      significantly reduced the half-life of elimination (16.6%) and the mean residence
      time (19%) of propranolol. A 17% increase in the systemic clearance and a 14%
      decrease in AUC were also noted. Charcoal administration did not significantly
      alter the volume of distribution (Vc' V(area) and Vss) or the apparent
      distribution half-life. A two-compartment model adequately described propranolol
      in control and treated rabbits. The results indicate that administration of oral
      activated charcoal enhances the systemic elimination of propranolol. This is
      presumably mediated by interruption of the enterohepatic circulation of
      propranolol by activated charcoal.

PMID- 8473359
TI  - Drug-induced thrombocytosis.
AB  - Thrombocytosis is generally defined as platelet counts greater than 400,000/mm3.
      Thrombocytosis can be either primary or secondary. Adrenalin was one of the first
      drugs noticed to cause platelet elevations, probably due to demargination of
      platelets in the pulmonary vasculature. Vinca alkaloids have the most convincing
      data to show that they can induce thrombocytosis through their thrombocyte
      stimulating properties. Miconazole has been implicated in causing thrombocytosis
      and has a documented case validated by drug rechallenge. Iron, predictably, can
      cause a transient thrombocytosis. The beta-lactam antibiotic data are very
      difficult to interpret due to the possibility of an acute-phase reaction in an
      infected patient being the cause of the thrombocytosis.

PMID- 8473360
TI  - Paracetamol poisoning and the kidney.
AB  - Nephrotoxicity is less common than hepatotoxicity in paracetamol overdose but
      renal tubular damage and acute renal failure occur even in the absence of
      hepatotoxicity. It is possible that antidotal therapy with agents such as N
      acetylcysteine may not prevent renal toxicity and, indeed, on the basis of animal
      work, may actually potentiate tubular damage. Careful clinical attention should
      be paid to renal function in patients poisoned with paracetamol.

PMID- 8473361
TI  - Estimation of population pharmacokinetics for carbamazepine in Malaysian patients
      using the OPT computer program.
AB  - We used OPT to estimate individual and population pharmacokinetics for
      carbamazepine (CBZ) in Malaysian epileptic patients attending our Neurology
      Clinic. We noted that plasma CBZ concentrations and clearances correlated poorly
      with daily doses and body weights respectively but we found the values for
      clearance, volumes of distribution, elimination rate constants and half lives to
      be in good agreement with earlier reports. We conclude that OPT is a simple yet
      useful program to derive individual and population pharmacokinetic parameters for
      CBZ for use in dosage adjustments. We also conclude that although the Malaysian
      population do not differ substantially in handling CBZ, available data for the
      pharmacokinetic parameters must be used cautiously in applying it to the
      therapeutic drug monitoring for CBZ in our patients.

PMID- 8473362
TI  - Treatment of nephrotic syndrome associated with idiopathic rapidly progressive
      glomerulonephritis and cyclosporin A.
AB  - Recent reports suggest that cyclosporin A is beneficial in inducing remission of
      idiopathic nephrotic syndrome. Nephrotic syndrome is seen in 10-30% of patients
      with rapidly progressive glomerulonephritis. We report a case of a 69-year-old
      man with nephrotic syndrome, associated with idiopathic rapidly progressive
      glomerulonephritis, who was treated initially with corticosteroid and
      cyclophosphamide. Three months later he developed thrombophlebitis and leucopenia
      and cyclophosphamide was suspended. Relapse of nephrotic syndrome associated with
      rapidly progressive glomerulonephritis developed and therapy with cyclosporin A
      was used with a good response.

PMID- 8473363
TI  - Digoxin pharmacokinetics in patients with high serum digoxin concentrations.
AB  - Digitalis intoxication is a frequent iatrogenic effect in patients on treatment
      with digoxin. In the present study we evaluated the pharmacokinetic behaviour of
      digoxin and the factors responsible for intoxication by this drug in monitored
      patients exhibiting clinical signs of overdosing with serum levels > 2 ng/ml. A
      control group of patients was used as a reference whose population
      pharmacokinetic parameters obtained by a maximum likelihood method were: Vd =
      542.92 +/- 274.53 (litre); Cl = 8.73 +/- 1.55 (litre/h) (mean +/- SD).
      Statistically significant differences (P < 0.001) were found between the mean Cl
      values in both groups of patients. The difference between the dose-level ratios
      established in both populations studied also proved to be significant (P <
      0.001). Calculation of the optimum dose for each patient showed that the doses
      recommended in intoxicated patients should be three times lower than those used
      in the control population. A good correlation was found between the
      concentrations observed 24 h after administration and the mean concentrations
      observed at steady state predicted for both population groups. Multiple
      regression analysis showed that the variables with the greatest predictive value
      for clearance in intoxicated patients were age and renal function. The
      modifications observed in the pharmacokinetic behaviour and in the response to
      digoxin in this type of patient suggest systematic monitoring using
      pharmacokinetic and clinical criteria jointly.

PMID- 8473364
TI  - Stability of lorazepam diluted in bacteriostatic water for injection at two
      temperatures.
AB  - Lorazepam is commonly used to produce sedation in infants. As errors may occur
      with the measurement of small volumes of concentrated drugs, we studied the
      stability of lorazepam diluted from 4 mg/ml to 1 mg/ml in bacteriostatic water
      for injection at two temperatures. The diluted lorazepam was stored in 10 glass
      vials (five at 22 degrees C and five at 4 degrees C). Samples were collected at
      0, 7, 14, 28, 42, 56, 70 and 91 days after storage at each temperature. Lorazepam
      was measured in duplicate from each of five vials (n = 10) at each temperature by
      a specific and stability-indicating high-performance liquid chromatographic
      (HPLC) method. After 7 days' storage, the mean lorazepam concentration was 88% of
      the original concentration at 22 degrees C, and 90% of the original concentration
      at 4 degrees C. After 2 weeks of storage, the mean lorazepam concentration was
      42% of the original concentration at 22 degrees C, and 1.5% of the original
      concentration at 4 degrees C. Crystals appeared after 4 weeks of storage at 22
      degrees C and after 2 weeks of storage at 4 degrees C. At 3 months the mean
      lorazepam concentration was 6.1% and 7.5% of the original concentration at 22
      degrees C and 4 degrees C, respectively. Thus, lorazepam diluted in
      bacteriostatic water for injection and stored in glass vials is stable for less
      than 7 days at 22 degrees C and for 7 days at 4 degrees C.

PMID- 8473365
TI  - Strategies for non-insulin-dependent diabetes mellitus.

PMID- 8473366
TI  - Managing prostate cancer. Part II: Disseminated disease.
AB  - Each year in the United States, approximately 100,000 men are found to have
      prostate cancer. Of these, about half show evidence of bony metastases at the
      time of presentation. Each year, too, some 30,000 American men die of prostate
      cancer. Conceptually, the treatment of metastatic prostate cancer has changed
      little in the 50 years since Charles B. Huggins and Clarence V. Hodges discovered
      the hormone-dependent nature of prostate cancer cells. Still, as the years have
      passed, several therapeutic options have become available. For the most advanced
      cases, treatment centers on relief of urinary obstruction and amelioration of the
      pain of bony metastases, along with vigilance for the potentially disastrous
      sequelae of acute neurologic change due to spinal fractures. In Part I of this
      article, which appeared in the April 15 issue of Hospital Practice, we discussed
      the assessment and management of localized carcinoma of the prostate. In this
      part, the focus shifts to disseminated disease (Figure 1). We again present two
      cases representing distinctly different points on the spectrum of disease and
      discuss how management would proceed in each case. This strategy affords an
      opportunity to review the various available treatment options, with their
      advantages and drawbacks.

PMID- 8473367
TI  - Diagnosis and treatment of celiac sprue.
AB  - Celiac sprue, also termed celiac disease or gluten-sensitive enteropathy, is a
      chronic disease in which malabsorption of nutrients is caused by a
      characteristic, but nonspecific, lesion of the small-intestinal mucosa. The
      lesion is produced, through unclear mechanisms, by protein constituents of some
      cereal grains. Exclusion of wheat gluten and rye, barley, and oat prolamins from
      the diet results in a prompt improvement in absorption, along with reversion,
      toward normal, of the associated small-intestinal lesion. The spectrum of
      manifestations of celiac sprue is remarkably broad, but the severity of disease
      generally correlates with the length of small intestine that is damaged. When
      most or all of the small-intestinal mucosa is involved, symptoms are severe and
      malabsorption is generalized. In such patients, a diagnosis of celiac sprue is
      usually considered. When, on the other hand, the mucosal lesion is limited to the
      duodenum and proximal jejunum, overt gastrointestinal symptoms and steatorrhea
      may be absent. In those patients, clinical manifestations, if present at all, may
      reflect malabsorption of only one or two substances, notably iron and folate,
      that normally are absorbed somewhat selectively by the proximal intestine.
      Arriving at the correct diagnosis in such cases may be quite challenging.

PMID- 8473368
TI  - Electroconvulsive therapy in the elderly.

PMID- 8473369
TI  - The need for office-based precepting.

PMID- 8473370
TI  - Five cases in search of a diagnostician.

PMID- 8473371
TI  - Magnesium: deficiencies and therapeutic uses.
AB  - Hypomagnesemia, which may be difficult to diagnose, can complicate diabetes
      mellitus or a variety of cardiovascular diseases. In some patients, an infused
      multielectrolyte preparation is often the best solution.

PMID- 8473372
TI  - Colorimetric detection for PCR amplified HIV-1 DNA using magnetic beads.
AB  - A rapid and nonradioactive detection method for polymerase chain reaction (PCR)
      amplified HIV-1 DNA was developed using a colorimetric detection system.
      Hybridization between biotin-labeled amplified targets and digoxigenin-capture
      probes occurs in solution followed by efficient and rapid capture onto
      streptavidin-magnetic beads. The presence of the digoxigenin-capture probe
      hybridized with biotin-labeled targets is then detected by antidigoxigenin
      alkaline phosphatase conjugates using a colorimetric substrate. This approach is
      highly sensitive and can detect less than 10 HIV targets prior to PCR in
      approximately 50 min.

PMID- 8473373
TI  - Remission of subclinical adrenocortical failure in subjects with adrenal
      autoantibodies.
AB  - Idiopathic Addison's disease is a chronic organ-specific autoimmune disorder with
      a long subclinical period characterized only by the presence of adrenal
      autoantibodies (AA) with or without adrenal function failure. The aim of this
      longitudinal study was to evaluate the behavior of AA using, an indirect
      fluorescence method, and adrenal function in 20 AA-positive and 50 AA-negative
      patients screened by an investigation of a large population of organ-specific
      autoimmune disease patients without clinical Addison's disease. As controls, 100
      normal age-matched subjects were tested only once. In the 20 AA-positive and 50
      negative patients, AA and adrenal functional tests were evaluated every 4 months
      for 5 yr. The AA-positive patients were grouped into 5 adrenal functional stages,
      specifically: stage 0, normal adrenal function; stage 1, high PRA and low (or
      normal) aldosterone levels alone; stage 2, along with impaired cortisol response
      to ACTH, stage 3, along with increased ACTH levels; and stage 4, clinically overt
      Addison's disease. On the basis of the behavior of AA, the 20 positive patients
      were grouped as follows: group A, 11 patients with AA titer of 1:8 or higher at
      the first observation and persistently AA positive in subsequent observations,
      with titers ranging from 1:8 to 1:64; group B, 6 patients with initial AA titers
      of 1:8 or lower and AA disappearance in subsequent observations; and group C, 3
      patients with AA titer of 1:32 or higher, undergoing corticosteroid therapy after
      the start of the study and showing AA disappearance in subsequent observations.
      With respect to adrenal function in group A, 2 patients initially in stage 1 and
      1 patient initially in stage 2 did not progress to the upper stages, whereas 5
      patients initially in stage 0 and 3 initially in stage 1 progressed subsequently
      to the upper stages, in 2 cases reaching overt clinical Addison's disease (stage
      4). On the other hand, all of the patients of group B showed both a spontaneous
      disappearance of AA and recovery of adrenal function during the study span. Also,
      the 3 patients of group C showed disappearance of AA after corticosteroid therapy
      with recovery of adrenal function. None of the 50 patients who were initially AA
      negative became AA positive subsequently or showed impairment of adrenal
      function. We reached the following conclusions. 1) AA, even if present initially
      in some subjects without clinical Addison's disease, can subsequently disappear.
      2) Restoration of adrenal function after disappearance of AA indicates that a
      spontaneous remission of subclinical adrenocortical failure can occur.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8473374
TI  - Concanavalin A affinity chromatography of human serum gonadotropins: evidence for
      changes of carbohydrate structure in different clinical conditions.
AB  - We have studied the carbohydrate of circulating human gonadotropins (FSH and LH)
      in different clinical conditions using Concanavalin A (Con A) affinity
      chromatography. This technique permits separation of molecules differing in the
      extent of carbohydrate branching. The proportion of molecules that does not bind
      to Con A was greater in circulating FSH than in LH, reflecting a higher content
      of multiantennary and/or bisected biantennary complex carbohydrate structures in
      serum FSH. No significant difference in gonadotropin binding pattern to Con A was
      found between normal controls and patients with chronic uremia or gonadotropin
      secreting pituitary adenomas. On the contrary, sera from postmenopausal women and
      fetuses contained a greater proportion of FSH and LH that bound to Con A,
      indicating a shift from multiantennary and/or bisecting structures to hybrid
      and/or high mannose forms, i.e. to the secretion of less mature forms.
      International Reference Preparations, derived from pituitary extracts, were more
      retained on Con A than circulating hormones, suggesting that carbohydrate chains
      of the intrapituitary hormone stock are less mature than those present in the
      circulation. Less mature forms were also found in FSH, but not in LH, from normal
      controls after GnRH injection. Finally, a higher proportion of unbound forms,
      i.e. complex carbohydrate chains, was found in healthy subjects presenting with
      an immunologically anomalous variant of LH. In conclusion, the current data show
      that the hormonal status of the individual may differently affect carbohydrate
      branching of gonadotropins. Alteration in glycosylation is likely to be involved
      in masking at least one epitope specific for intact LH dimer, thus indicating
      that it may modulate the tertiary structure of glycoprotein hormones.

PMID- 8473375
TI  - Atrial natriuretic hormone: a paracrine or endocrine role within the human
      placenta?
AB  - There is evidence to suggest that the human placenta may synthesize atrial
      natriuretic hormone (ANH). To test this hypothesis we examined specimens of
      normal term placenta obtained at elective caesarean section for evidence of
      either storage or synthesis of this peptide. No immunocytochemical or
      ultrastructural evidence of ANH storage was found. RNA extracted from cultured
      cytotrophoblast cells, the chorionic or decidual plates, or from placental villi
      contained no ANH-encoding messenger RNA by Northern blot analysis. Polymerase
      chain reaction amplification of these RNA extracts using primers directed to the
      midportion of the ANH gene failed to demonstrate any evidence of ANH-encoding
      RNA. We conclude that ANH is neither stored nor synthesized within the normal
      term placenta, and thus a purely endocrine role for this peptide within the
      fetoplacental compartment is proposed.

PMID- 8473376
TI  - Oral gossypol in the treatment of metastatic adrenal cancer.
AB  - Medical treatment of metastatic adrenal cancer is largely unsuccessful and has
      considerable toxicity. We previously demonstrated the activity of the plant toxin
      gossypol against human adrenal cancers in nude mice. We therefore examined the
      efficacy and toxicity of oral gossypol as a treatment for adrenal cancer in
      humans. Twenty-one patients with metastatic adrenal cancer received oral gossypol
      at doses of 30-70 mg/day. Patients were monitored for side effects of gossypol,
      changes in hormone secretion, and tumor response. Eighteen patients completed at
      least 6 weeks of gossypol treatment. Three of these patients, whose tumors were
      refractory to other chemotherapeutic agents, had partial tumor responses (> or =
      50% decrease in tumor volume) that lasted from several months to over 1 yr. One
      patient had a minor response followed by resection of her remaining disease, 1
      patient had stable disease, and 13 patients had disease progression. Three
      patients died of their disease without receiving sufficient gossypol to achieve
      detectable drug levels, and were eliminated from the final analysis. The side
      effects of gossypol were generally well tolerated; the only serious side effect
      was abdominal ileus that resolved when the drug was temporarily withheld and
      restarted at a lower dose. We conclude that oral gossypol can be used relatively
      safely on an outpatient basis for the treatment of metastatic adrenal cancer. The
      response rate is similar to the other agents currently available for adrenal
      cancer, and responses were seen in patients who had failed other chemotherapeutic
      regimens. This study provides the first indication that gossypol may have
      activity against cancer in humans, suggesting the need for further investigation
      of gossypol as an antitumor agent.

PMID- 8473377
TI  - Thyrotropin-producing microadenoma associated with pituitary resistance to
      thyroid hormone.
AB  - A 21-yr-old female with hyperthyroidism is described. Though her serum-free T3
      was 17.8 pmol/L and free T4 was 60.2 pmol/L, TSH was as high as 10.7 mU/L. TRH
      stimulated an increase in TSH from 10.7-91.7 mU/L. T3 administration in gradually
      increasing doses of 100, 200, and 400 mg/day resulted in gradual reduction in
      serum TSH. Cranial computed tomography and magnetic resonance imaging revealed a
      microadenoma of the pituitary gland. Histology of the surgical specimen showed a
      TSH-producing adenoma with TSH cell cluster islets and decreased numbers of TSH
      cells in the nonneoplastic pituitary. Cultured cells from the adenoma secreted
      TSH spontaneously and in response to TRH. This TRH-stimulated TSH secretion was
      suppressed by T3 in a dose-dependent manner. One year postoperatively, neither
      residual tumor nor recurrence were seen by computed tomography and magnetic
      resonance imaging. However TSH, as well as free T3 or T4, was still high and
      overresponsive to TRH.

PMID- 8473378
TI  - The effect of light on core body temperature is mediated by melatonin in women.
AB  - Acute exposure to bright light at night reduces the nocturnal decline of core
      body temperature (cBT) and inhibits melatonin secretion in men. Since inhibition
      of melatonin secretion by beta-adrenergic blockade reduces the nocturnal decline
      of cBT by 40% in women, experiments were performed to investigate whether the
      thermoregulatory effect of light is mediated by modifications of melatonin
      secretion in cycling women. Results show that the elevation of cBT induced by
      nocturnal exposure to bright light (3000 lux) can be reversed completely by
      circumventing the decline of serum melatonin levels with concurrent oral
      administration of melatonin. Our finding establishes melatonin as the mediator of
      the effect of light on cBT in women and provides a rationale for the use of
      orally administered melatonin as an aid in the reentrainment of the cBT rhythm in
      desynchronized conditions.

PMID- 8473379
TI  - Growth hormone induces insulin resistance in Laron dwarf cells via lactogenic
      receptors.
AB  - GH is the hormone primarily responsible for regulating body size within the
      genetic program. While GH has pleiotropic actions on cellular growth and
      metabolism, most of its effects are believed to be mediated by a single GH
      receptor. This receptor is not functional in tissues from patients with Laron
      dwarfism. We used human T-cell leukemia virus-immortalized T-lymphoblast cell
      lines from Laron dwarfs and normal individuals to examine the mechanism of GH
      induced insulin resistance at the cellular level. GH (5-500 micrograms/L) caused
      a profound decrease in the sensitivity of normal T-lymphoblasts in response to
      all insulin concentrations (P < 0.0001 vs. insulin alone); pretreatment with GH
      and GH receptor antibody significantly improved sensitivity to all concentrations
      of insulin (P = NS vs. insulin alone). Preincubation with GH and PRL receptor
      antibody was associated with partial improvement in insulin sensitivity (P =
      0.004 vs. insulin alone). Thus, in normal T-cell lines, the major pathway of GH
      induced insulin resistance appears to be directed by the GH receptor, with a
      smaller effect mediated through the PRL receptor. While T-cell lines from Laron
      dwarfs do not respond to GH in clonal proliferation assays, GH (50 and 100
      micrograms/L) caused profound insulin resistance in these cells (P = 0.008 and P
      < 0.0001, respectively, vs. insulin alone). GH receptor antibody did not abrogate
      this effect at any insulin concentration (P = NS vs. insulin alone), but there
      was partial restoration of insulin sensitivity when GH and PRL receptor antibody
      were coincubated (P = 0.0069 vs. insulin alone). Thus, in Laron T-cell lines, PRL
      and perhaps other lactogenic receptors appear to mediate GH-induced insulin
      resistance. The kinetics of GH-induced insulin resistance in Laron T-cells were
      also distinct from the pattern seen in normal T-cells, and unlike in normal
      cells, GH had no effect on insulin-like growth factor-I-induced clonal expansion
      of Laron T-cell lines (P = NS vs. insulin-like growth factor-I alone). These
      results provide evidence for an alternative pathway of GH action revealed in
      cells lacking classical growth responses to GH.

PMID- 8473380
TI  - Alterations in luteinizing hormone secretory activity in women with insulin
      dependent diabetes mellitus and secondary amenorrhea.
AB  - To investigate hypothalamic and/or pituitary abnormalities in women with poorly
      controlled insulin-dependent diabetes mellitus (IDDM) and secondary amenorrhea,
      we measured serum LH every 10 min for 24 h and for 2 additional h after the
      administration of exogenous GnRH in 8 women with IDDM and amenorrhea and compared
      these to data from 15 eumenorrheic nondiabetic women. LH pulses were
      characterized by the pulse detection algorithm Cluster, and secretory episodes
      were evaluated using the multiple parameter deconvolution procedure Deconv.
      Cluster analysis revealed fewer LH pulses per 24 h (14.3 +/- 1.2 vs. 19.9 +/-
      0.6; P < 0.001; mean +/- SEM), a greater peak width (63 +/- 4.9 vs. 44 +/- 2.2
      min; P < 0.01), and greater peak area (136 +/- 17 vs. 89 +/- 13 IU/L.min; P <
      0.01) in the diabetic women. Analysis with Deconv revealed fewer LH secretory
      episodes per 24 h in the diabetic women (14.4 +/- 0.9 vs. 20.4 +/- 0.5; P <
      0.001) and no statistical difference in LH half-lives. The IDDM women responded
      to a 10-micrograms GnRH bolus with LH pulses of larger total (51 +/- 15.9 vs. 15
      +/- 1.4 IU/L; P < 0.01) and incremental (29 +/- 7.6 vs. 9 +/- 1.2; P < 0.001)
      amplitude. In summary, we observed that amenorrheic diabetic women have fewer LH
      pulses/secretory episodes than normal women. However, they respond well to
      exogenous GnRH, suggesting that compromise of the GnRH pulse generator, rather
      than pituitary dysfunction, is responsible for their menstrual dysfunction.

PMID- 8473381
TI  - Spontaneous growth hormone release in term infants: changes during the first four
      days of life.
AB  - Healthy term infants have higher umbilical cord GH levels compared to older
      infants and children. In the sheep, GH concentrations rapidly fall within an hour
      of birth; the physiology of GH release after parturition in the human term infant
      is less well known. The purpose of this study was to investigate spontaneous 12-h
      GH release in male and female term infants of varying postnatal ages. We studied
      14 infants (7 males and 7 females). Subjects were divided into those studied
      earlier following delivery (28.2 +/- 3.4 h of age, mean +/- SE) and into those
      studied at a later time (74.8 +/- 3.5 h, P < 0.0005). The age at study was
      defined as the age (hours) when blood sampling began. There were eight infants
      studied at an early age (four males and four females) and six studied at a later
      age (three males and three females). Subjects were comparable with respect to
      gestational age, birth weight, and length; all were biochemically euthyroid. One
      infant was large for gestational age although his head circumference was in the
      normal range. Blood (0.1 mL) was taken every 30 min over a 12-h period from an
      indwelling umbilical catheter; no stress occurred during the blood withdrawal. GH
      was determined by a double-antibody RIA using 0.01 mL plasma. GH pulse detection
      was undertaken using Cluster, a computerized pulse detection algorithm. Total
      insulin-like growth factor I (IGF-I) was measured following separation of the
      IGFs from the serum binding proteins. Spontaneous pulsatile GH release was
      observed in all infants studied. No differences in GH characteristics were found
      between male and female subgroups in the early or late study groups. In
      subsequent analysis, the data for the males and females are combined. The GH
      pulse frequency per 12 h was greater in the earlier studied group, 5.1 +/- 0.9
      (mean +/- SE) vs. 2.5 +/- 0.7 in the later group (P < 0.05). The maximal pulse
      amplitude was 47.1 +/- 7.9 micrograms/L in the early and 27.1 +/- 4.1 in the
      later studied group (P < 0.06). The incremental pulse amplitude was 26.4 +/- 3.4
      micrograms/L in the early and 12.8 +/- 2.7 in the later group (P = 0.01). The
      pulse width was greater in the later studied group (202.8 +/- 71.1 min vs. 84.1
      +/- 21.6, P < 0.06).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8473382
TI  - Corticotropin-releasing hormone in baboon pregnancy.
AB  - During human pregnancy, plasma CRH immunoreactivity (CRH-IR) rises progressively,
      peaking during labor and falling after delivery. Among animal species, only
      higher primates have elevated CRH-IR during pregnancy. This study examines
      whether changes in plasma CRH-IR in the baboon (Papio hamadryas) are similar to
      those in the human. CRH-IR was determined by RIA in 16 baboons at different
      stages of gestation (44 samples) and in 3 males. Assays were performed on Vycor
      extracts of plasma and CRH-IR diluted in parallel to synthetic human (h) CRH-41
      standard. Reverse phase high pressure liquid chromatography and size-exclusion
      chromatography with Sephadex G-50 showed that baboon CRH-IR eluted in a position
      similar to that of hCRH-41. Regression analysis revealed a cubic association
      between plasma CRH-IR and gestational age, with peak concentrations occurring at
      60 days gestation (term = 182 days). Although greatly elevated concentrations
      persisted throughout pregnancy, concentrations in the first half (1-91 days) were
      significantly higher (mean +/- SEM, 1.9 +/- 0.3 nM/L; n = 27) than in the second
      half (92-182 days; 1.0 +/- 0.2 nM/L; n = 11; P < 0.003 by t test). CRH-IR fell to
      low levels by day 1 postpartum. The concentration of total cortisol in
      nonpregnant animals was 1370.9 +/- 134.9 nM/L (n = 5), which was similar to
      pregnancy levels (1346.3 +/- 356.1 nM/L; n = 28); there was no gestational age
      related pattern evident. Plasma corticosteroid-binding globulin was estimated by
      RIA, and plasma free cortisol was calculated to be 73 +/- 14 nM/L in pregnant
      animals and showed no gestational age-related changes. The mean progesterone
      concentration in the pregnant baboon was 12.5 +/- 2.2 nM/L (7-169 days; n = 27).
      There was no significant change in progesterone levels during the period of
      gestation studied; however, they were higher than nonpregnant levels. Baboon and
      human plasma (0.1 mL each) were incubated with [125I]Tyr-hCRH in Tris-HCl buffer
      (pH 7.5) and chromatographed with Sephadex G-75, using the same buffer. The
      radioactivity of fractions was determined, and no CRH-binding protein was
      identified in baboon plasma. This study indicates that gestational changes in CRH
      IR in the baboon are different from those observed in humans. There is a
      dissociation between maternal plasma CRH and cortisol. The apparent lack of
      bioactivity of baboon plasma CRH is not due to a circulating binding protein,
      which is absent in this species.

PMID- 8473383
TI  - Ingestion of androgenic-anabolic steroids induces mild thyroidal impairment in
      male body builders.
AB  - Self-administration of very high doses of androgenic anabolic steroids is common
      use in power athletes because of their favorable effect on performance. Since
      androgenic steroids decrease serum T4-binding globulin (TBG) concentrations
      dramatically, we were interested in the effects of this procedure on thyroid
      function: we performed TRH tests (200 micrograms Relefact, i.v.), with blood
      withdrawal before and for 180 min after injection, for determination, using RIA
      kits, of serum concentrations of total and free T4, total T3, TSH, and TBG in 13
      young (20-29 yr old) male body builders with clinically normal thyroid glands,
      who were all in the same state of training. Five of these athletes admitted
      taking androgenic anabolic steroids at an average total dose of 1.2 g/week for at
      least 6 weeks before the tests. TBG, total T4, and total T3 were significantly (P
      < 0.001) decreased, whereas basal TSH and free T4 were not significantly
      different from the values of the other 8 without androgenic steroids. The maximum
      TSH increase after TRH administration (mean +/- SE, 16 -/+ 6 vs. 9 -/+ 4 mU/L; P
      < 0.05) was relatively increased, whereas the T3 response to TRH (0.61 -/+ 0.10
      vs. 1.13 -/+ 0.13 nmol/L; P < 0.05) was relatively decreased in the group
      receiving androgens. The 5 patients taking androgens had significantly greater
      weight (114 vs. 90 kg; P < 0.01) and higher total cholesterol levels (6.3 -/+ 1.3
      vs. 3.8 -/+ 0.3 mmol/L; P < 0.05) together with very low high density lipoprotein
      cholesterol levels (0.20 -/+ 0.03 vs. 1.03 -/+ 0.10; P < 0.001) than the
      controls. PRL levels were normal and similar in both groups. We conclude from our
      results that high dose androgenic anabolic steroid administration leads to a
      relative impairment (within the normal range) of thyroid function. Whether this
      is due to a direct thyroid hormone release (or synthesis?)-blocking effect of
      these steroids needs further investigation.

PMID- 8473384
TI  - Islet amyloid polypeptide-like immunoreactivity in human tissue and endocrine
      tumors.
AB  - We have detected islet amyloid polypeptide (IAPP)-like immunoreactivity (-LI) in
      human pancreas and in a range of endocrine tumors, including oat cell carcinoma
      of the lung and pancreatic tumours producing insulin, gastrin, glucagon, and
      vasoactive intestinal peptide. Gel permeation chromatography of the IAPP-LI
      revealed that, except in the carcinoid, more than 80% coeluted with synthetic
      human IAPP. The remaining immunoreactivity consisted of variable amounts of
      larger and smaller molecular forms. The concentration of IAPP-LI in the
      circulation of patients with diagnosed pancreatic endocrine tumors was not
      significantly elevated above normal fasting levels. IAPP is, therefore, produced
      by a range of endocrine tumors and may relate to the deposition of endocrine
      amyloid.

PMID- 8473385
TI  - Human plasma free activin and inhibin levels during the menstrual cycle.
AB  - The role of inhibin in gonadal function and reproduction has been confirmed by
      the measurement of plasma inhibin levels, but there has been no clinical data
      available on activin because of the lack of a good assay method. We measured
      plasma free activin levels during the normal menstrual cycle using a newly
      developed competitive protein binding assay with follistatin as the binding
      protein. Plasma inhibin levels were measured simultaneously using an alpha
      subunit N-terminal fragment RIA with recombinant inhibin as the reference
      standard. Four normal women, aged 23-29 years, were investigated by obtaining
      plasma at 3-day intervals. Plasma inhibin levels showed some variation during the
      follicular phase, but a parallel rise in inhibin and progesterone was observed
      during the luteal phase. These findings confirmed those of previous studies. In
      contrast, plasma free activin levels did not show any substantial changes during
      the menstrual cycle. This study suggests that activin has no endocrine role in
      modulating the pituitary-gonadal axis during the normal menstrual cycle, while
      changes of inhibin reflect cyclic gonadal function and indicate an endocrine role
      for this protein in modulating gonadal activity.

PMID- 8473386
TI  - Clinical review 44: Medullary thyroid carcinoma: recent progress.

PMID- 8473387
TI  - Peking Union Medical College Hospital, a palace of endocrine treasures.

PMID- 8473388
TI  - A new dimension on the induced release of growth hormone in obese subjects.

PMID- 8473389
TI  - Massive growth hormone (GH) discharge in obese subjects after the combined
      administration of GH-releasing hormone and GHRP-6: evidence for a marked
      somatotroph secretory capability in obesity.
AB  - GH secretion in response to all provocative stimuli is decreased in patients with
      obesity. However, the precise mechanism causing this impairment in GH release is
      unknown. His-DTrp-Ala-Trp-DPhe-Lys-NH2 (GHRP-6) is a synthetic compound that
      releases GH in a dose-related and specific manner in several species, including
      man. To gain further insight into disrupted GH secretion in obesity, GHRP-6 and
      GH-releasing hormone (GHRH) at a dose of 100 micrograms, i.v., were administered
      either alone or in combination in a group of 19 obese subjects. In a group of
      obese patients, GHRP-6 induced GH secretion, with a GH peak (mean +/- SEM) of
      15.7 +/- 4.4 micrograms/L and an area under the curve (AUC) of 674 +/- 187, which
      were larger than those after GHRH stimulation (6.8 +/- 1.1 and 412 +/- 71,
      respectively). Enhancement of the endogenous cholinergic tone was obtained in
      another group of obese subjects by means of pyridostigmine (120 mg, orally).
      Pyridostigmine administered 60 min before GHRP-6, increased both the mean GH peak
      (32.2 +/- 6.9) and the AUC (1413 +/- 537) after GHRP-6 administration. In a
      separate group of subjects, the combined administration of GHRP-6 and GHRH
      induced a massive discharge of GH, with individual responses ranging from 14-86
      micrograms/L. GHRP-6 plus GHRH induced a mean GH peak of 42.2 +/- 10.9 and an AUC
      of 1894 +/- 784 (P < 0.05), clearly indicating a potentiating (synergic) action
      when the two compounds were administered together. These data show that GH
      responses to GHRP-6 were almost twice those to GHRH in obese patients. The
      stimulatory effect exerted by pyridostigmine on GHRP-6-induced GH secretion
      supported the view of increased somatostatinergic tone in obesity. Finally, the
      massive GH discharge that followed the administration of GHRH plus GHRP-6 was not
      observed after any stimulus in obesity, clearly indicating that the impaired GH
      secretion is a functional and potentially reversible state.

PMID- 8473390
TI  - X-chromosome-linked Kallmann's syndrome: pathology at the molecular level.

PMID- 8473391
TI  - Xp22.3 deletions in isolated familial Kallmann's syndrome.
AB  - Several familial cases of Kallmann's syndrome (KS) have been reported, among
      which the X-chromosome-linked mode of inheritance is the most frequent. The gene
      responsible for the X-linked KS has been localized to the terminal part of the X
      chromosome short arm (Xp22.3 region), immediately proximal to the steroid
      sulfatase gene responsible for X-linked ichthyosis. Large deletions of this
      region have been previously shown in patients affected with both X-linked
      ichthyosis and KS. We report here the search for Xp22.3 deletions in 20 unrelated
      males affected with isolated X-linked KS. Only 2 deletions were found using
      Southern blot analysis, indicating that large deletions are uncommon in patients
      affected with KS alone. Both deletions were shown to include the entire KAL gene
      responsible for X-linked KS. The patients carrying these deletions exhibit
      additional clinical anomalies, which are discussed: unilateral renal aplasia,
      unilateral absence of vas deferens, mirror movements, and sensory neural hearing
      loss.

PMID- 8473392
TI  - Assay of brain natriuretic peptide (BNP) in human plasma: evidence for high
      molecular weight BNP as a major plasma component in heart failure.
AB  - A RIA for human brain natriuretic peptide (BNP) was developed. Both BNP and
      atrial natriuretic peptide (ANP) were extracted from human plasma with Vycor
      glass powder (71% recovery for BNP). The assay had a minimum detection limit of
      0.45 fmol/tube and an IC50 of 9 fmol/tube. The within-assay coefficients of
      variation were 11.4% at 4 pmol/L and 3.2% at 22 pmol/L, and the between-assay
      coefficient of variation was 11% at 24 pmol/L. There was no significant loss of
      immunoreactive (IR)-BNP in plasma samples stored at -80 C for 4 weeks. Low rates
      of labeled BNP and IR-BNP degradation occurred in EDTA plasma incubated at 37 C.
      The mean venous plasma IR-BNP (6.3 +/- 0.3 pmol/L) in normal subjects (n = 48)
      was significantly lower than plasma ANP (8.4 +/- 0.6 pmol/L). In contrast to ANP,
      IR-BNP did not increase when normotensive or hypertensive subjects changed from
      erect to supine posture. Markedly elevated levels were found in patients with
      congestive heart failure (mean IR-BNP, 87 +/- 11 pmol/L; ANP, 87 +/- 12 pmol/L; n
      = 35), recent myocardial infarction (mean IR-BNP, 60 +/- 9 pmol/L; ANP, 33 +/- 6
      pmol/L; n = 7), and chronic renal failure. High pressure liquid chromatography of
      plasma extracts from heart failure subjects revealed both high (mol wt, 10,000)
      and low (mol wt, 4,000) mol wt IR-BNP. High mol wt BNP was the major component
      (mean ratio, 1.9:1) and was linearly correlated with low mol wt BNP (r = 0.99).
      HPLC of plasma extracts from three normal subjects receiving constant infusions
      of human BNP (2 pmol/kg.min) showed a single major peak eluting in the position
      of hBNP-32, with no evidence of high mol wt material. These results show that
      whereas marked elevations in BNP occur in circulatory disorders, a major (> 50%)
      and consistent contribution to immunoreactivity is due to precursor forms.
      Further, compared to ANP, there is no IR-BNP response to supine posture in normal
      and hypertensive subjects.

PMID- 8473393
TI  - Effects of calcitriol and phosphorus therapy on the growth of patients with X
      linked hypophosphatemia.
AB  - Patients with X-linked hypophosphatemic rickets exhibit clinically evident
      derangements that include bowed legs and short stature. Although contemporary
      treatment may result in healing of the rachitic/osteomalacic disorder and
      straightening of the lower extremities, therapy often does not stimulate growth.
      Whether such persistent short stature is related to the variable physical
      manifestations of the disease, the baseline biochemistries, and/or the
      biochemical response to treatment remains unknown. Therefore, we studied 12
      children with X-linked hypophosphatemia to determine if their growth response to
      calcitriol/phosphorus therapy was dependent upon anthropomorphic characteristics
      and/or the pre- and posttreatment biochemistries. We observed that growth
      responsive and resistant youths exhibited similar serum calcium, phosphorus, and
      creatinine levels at presentation and during therapy. In addition, sexual
      development was indistinguishable in both groups and growth kinetics appeared
      independent of physical deformity. In contrast, growth resistant youths presented
      at less than the 5th percentile whereas growth responsive children were at the
      15th percentile or greater. Thus, our data indicate that growth response to
      calcitriol/phosphate therapy is not a consequence of the biochemical response to
      therapy or physical deformities. Rather, the criterion that best predicts the
      growth response is the height percentile at the inception of therapy.

PMID- 8473394
TI  - Effects of different plasma glucose concentrations on lipolytic and ketogenic
      responsiveness to epinephrine in type I (insulin-dependent) diabetic subjects.
AB  - The effects of two different plasma glucose concentrations (5 and 10 mmol/L) on
      lipolysis and ketogenesis during baseline and in response to epinephrine infusion
      were evaluated in insulin-dependent diabetic patients. Each insulin-dependent
      diabetic subject was studied during euglycemia, hyperglycemia with
      hypoinsulinemia, and hyperglycemia with hyperinsulinemia. Total ketone body (TKB)
      concentrations were significantly higher in hyperglycemic-hypoinsulinemic
      diabetics than in hyperglycemic-hyperinsulinemic and normoglycemic diabetics.
      Hyperglycemic-hyperinsulinemics had higher TKB concentrations than euglycemic
      diabetics. During epinephrine infusion, the ketone body rate of appearance and
      concentration significantly increased in all groups. Plasma FFA concentrations
      were significantly higher in hyperglycemic-hypoinsulinemic diabetics than in the
      other groups. During epinephrine infusion, the plasma FFA rate of appearance and
      concentration significantly increased in all groups. The apparent fraction of FFA
      converted to ketones was increased by epinephrine in all groups, except in
      hyperglycemic-hyperinsulinemic diabetics. In conclusion, this study demonstrates
      that although insulin alone decreases FFA and TKB concentrations, it does not
      affect the fraction of FFA converted to ketones. If hyperinsulinemia is
      superimposed on hyperglycemia, there is both a reduction of ketogenesis capacity,
      compared to hyperglycemia alone, and a decrease in the apparent fraction of FFA
      converted to ketone bodies.

PMID- 8473395
TI  - The relationship between luteinizing hormone and estradiol secretion in female
      precocious puberty: evaluation by sensitive gonadotropin assays and the
      leuprolide stimulation test.
AB  - We used the GnRH agonist (GnRHa) stimulation test (20 micrograms/kg leuprolide
      sc, followed by 24-h serial sampling) to investigate the relationship between
      gonadotropin and estradiol (E2) secretion in the early phase of female central
      precocious puberty (CPP). Girls with CPP and moderately increased (early
      pubertal) peak E2 concentrations after GnRHa stimulation (136 +/- 11 pmol/L;
      range, 92-176; group B; n = 7) were compared to girls with CPP and higher
      (midpubertal) peak E2 responses to GnRHa (mean +/- SE, 590 +/- 63 pmol/L; range,
      235-1189; group C; n = 19) and to a group of subjects with no breast development
      and a prepubertal hypothalamic-pituitary-gonadal axis (peak E2 response to GnRHa,
      39 +/- 7 pM/L; range, 18-62; group A; n = 6). Compared to group A subjects,
      patients in group B had similar (P > 0.2) peak GnRHa-stimulated LH concentrations
      (B, 4.8 +/- 1 IU/L; A, 2.3 +/- 0.5 IU/L) and peak nocturnal LH (B, 0.81 +/- 0.2;
      A, 0.25 +/- 0 IU/L), but higher peak GnRHa-stimulated FSH concentrations (B, 26
      +/- 7; A, 11 +/- 2 IU/L; P < 0.05) and mean nocturnal FSH (B, 4.2 +/- 1; A, 1.1
      +/- 0.3 IU/L; P < 0.05) concentrations. Compared to group B, group C patients had
      higher (P < 0.001) GnRHa-stimulated peak LH (67 +/- 19 IU/L) and higher (P <
      0.05) peak nocturnal LH (9.7 +/- 2.9 IU/L) concentrations, but similar GnRHa
      stimulated peak FSH (27 +/- 3 IU/L) and mean nocturnal FSH (3.8 +/- 0.5 IU/L)
      levels. Group C patients with a ratio of peak GnRHa-stimulated LH to FSH
      concentrations below or above 1, respectively, had similar peak E2 responses to
      GnRHa (516 +/- 80 vs. 644 +/- 92 pM/L; P > 0.1). Stepwise regression analysis
      indicated that the peak LH response to GnRHa (r = 0.76; P < 0.001), but none of
      the FSH secretory parameters (P > 0.10), affected the E2 response to GnRHa. These
      data suggest that girls with CPP in the early phase of activation of the
      hypothalamic-pituitary-gonadal axis are capable of clinically relevant E2
      production, which may occur in the face of low LH secretion and low LH/FSH ratios
      and cannot be explained solely on the basis of increased FSH secretion. Thus,
      endocrine or paracrine factors other than gonadotropins may be important in
      amplifying E2 secretion in the early phase of CPP.

PMID- 8473396
TI  - Familial short stature with very high levels of growth hormone binding protein.
AB  - We report a familial syndrome of short stature associated with partial GH
      resistance and very high levels of GH binding protein (GHBP). In three
      individuals of the same family, presenting with growth failure, high circulating
      GH levels, both basal and stimulated, were found. Insulin-like growth factor-1
      plasma levels were either normal or in the low normal range. GH binding activity
      was extremely elevated in the plasma of the three subjects, with very high
      maximum binding capacity (30- to 110-fold higher than that of normal adult
      plasma) and normal binding affinity (5-7.4 x 10(8) M-1). The cause and the exact
      consequences of the very high level of plasma GHBP, resulting in a low proportion
      of free circulating GH, remain to be clarified. The short stature and the partial
      GH resistance are probably related to high GHBP levels.

PMID- 8473397
TI  - Turner syndrome adolescents receiving growth hormone are not osteopenic.
AB  - Deficits in bone mineral have been widely reported in Turner syndrome. The bone
      mineral status of 19 adolescents with Turner syndrome (16 receiving GH therapy)
      was evaluated by dual photon absorptiometry of the lumbar spine and whole body
      and compared with a normal female control group (n = 45) with the same mean age
      (14.3 yr). The conventional measurements of bone mass, bone mineral content (BMC
      = g), and bone mineral density (BMD = g/cm2), as well as bone mineral apparent
      density (BMAD = g/cm3), an expression of bone mineral adjusted for bone volume,
      were determined for both sites. Although mean BMC was decreased in Turner
      females, mean BMD and BMAD in the two groups were not significantly different.
      Analyzed in relation to chronologic age, bone age, height, and pubertal status,
      mean BMD and BMAD values in Turner subjects were equal to or greater than that of
      controls. BMD and BMAD were elevated in the Turner group vs. controls matched for
      height. In subjects with bone age less than or equal to 12.5 yr, mean spinal BMAD
      was unexpectedly greater in Turner patients compared with controls (0.148 +/-
      0.011 vs. 0.134 +/- 0.013, P = 0.009). When data were analyzed by pubertal
      status, mean spinal BMD and BMAD in subjects with Tanner breast stages 1-2 were
      higher in the Turner group than in the controls (BMAD 0.146 +/- 0.011 vs. 0.132
      +/- 0.015, P = 0.015). No differences were seen in mid- to late pubertal females.
      Bone mineral properties were additionally reassessed after a mean interval of 1.3
      yr in 10 of the subjects with Turner syndrome. Percentage increases in mean
      follow-up spinal BMD and BMAD were greater in 5 subjects begun on estrogen
      replacement than in 5 untreated patients. We conclude that: 1) bone mineral
      values in adolescents with Turner syndrome on GH therapy are not abnormal, 2)
      lumbar bone mineral is greater in younger Turner adolescents matched with
      controls for bone age or pubertal status, a difference which could relate to GH
      therapy, and 3) estrogen therapy may augment bone mineral accretion in Turner
      syndrome, but early estrogen replacement cannot be justified on the basis of bone
      mineral status.

PMID- 8473398
TI  - The calciotropic hormone response to changes in serum calcium during exercise in
      female long distance runners.
AB  - The purpose of this study was to evaluate the effects of 45 min of submaximal
      running on calciotropic hormone levels in female long distance runners. Fourteen
      long distance runners and six sedentary controls (less than three exercise
      sessions per week) had bone mineral density (BMD) of the lumbar spine (L2-L4),
      femoral neck, and tibia measured by dual photon absorptiometry. All of the
      sedentary controls and eight runners (NormR) had BMD values within the normal
      range for women of their age. The remaining six runners had BMD L2-L4 measures
      greater than 1 SD below normal values and were classified as the low bone density
      group (LowR). Subjects were tested for their calciotropic hormone response to
      submaximal running using both an oral calcium load (dairy product), to induce a
      significant elevation in serum calcium, and no calcium load. In both exercise
      tests, serum calcium rose in NormR and LowR, with a greater increase induced by
      the oral calcium load. In NormR, the increase in serum calcium resulted in
      decreased PTH levels, with small increases in calcitonin levels. In contrast,
      LowR showed significant (P < 0.05) increases in PTH levels, with concurrent
      decreases in calcitonin levels. The changes in calciotropic hormone levels were
      shown to be significantly associated with BMD. Our results suggest that in well
      trained female runners with low spinal bone density, long distance running may
      aggravate this condition through the effect of exercise-related elevations of PTH
      on bone turnover. Alterations in the homeostatic control mechanisms for calcium
      during exercise should also be considered in the clinical assessment of female
      runners with spinal osteopenia.

PMID- 8473399
TI  - The unique steroidogenesis of the aldosteronoma in the differential diagnosis of
      primary aldosteronism.
AB  - 18-Hydroxycortisol and 18-oxocortisol have been isolated from the urine of
      patients with aldosterone producing adrenocortical adenomas, but not from those
      with idiopathic hyperaldosteronism associated with bilateral adrenal hyperplasia.
      These C-18 oxygenated cortisols are biosynthesized by the substitution of
      cortisol for the normal substrate, corticosterone, in the terminal oxidase system
      required for the biosynthesis of 18-hydroxycorticosterone and aldosterone. To
      make use of this biochemical difference between the two groups in the
      preoperative diagnosis of primary aldosteronism, we have developed and utilized a
      specific primary standard analytical method, stable isotope dilution mass
      fragmentography, for quantifying 18-hydroxycortisol and the tetrahydro metabolite
      of 18-oxocortisol in 24-h urine samples. The normal range by this technique of
      4.6 +/- 1.8 micrograms/day tetrahydro 18-oxocortisol and 43 +/- 23 micrograms/day
      18-hydroxycortisol in urine was lower and narrower than previous estimates using
      other methods. Excretion of the 18-oxocortisol metabolite ranged from 2-12
      micrograms/day in bilateral hyperplasia and 17-1203 micrograms/day in typical
      adenomas. 18-Hydroxycortisol excretion similarly separated bilateral hyperplasia
      (23-59 micrograms/day) from typical adenomas (60-2750 micrograms/day). The
      cortisol C-18 oxidation pathway describes a unique steroidogenic mechanism in the
      aldosteronoma not present in idiopathic aldosteronism due to bilateral adrenal
      hyperplasia and as such provides a basis for the biochemical classification of
      primary aldosteronism and the differentiation of these two groups. This unique
      biochemistry was also observed in unilateral hyperplasia but not in the renin
      dependent aldosteronoma.

PMID- 8473400
TI  - More basic forms of both human follicle-stimulating hormone and luteinizing
      hormone in serum at midcycle compared with the follicular or luteal phase.
AB  - The purpose of this study was to compare the heterogeneity and median charge of
      FSH and LH in serum at different phases of the normal human menstrual cycle.
      Serum specimens were obtained during the follicular phase [9.0 +/- 1.9 (+/- SD)
      days before the midcycle], at the midcycle LH peak, and during the luteal phase
      (9.75 +/- 1.6 days after the midcycle) in 16 women with normal menstrual cycles.
      The 48 serum specimens were subjected to electrophoresis in 0.17% agarose
      suspension in 0.075 M veronal buffer at pH 8.6, using a column suitable for
      measuring the median charge of the isoforms of FSH and LH, expressed as median
      electrophoretic mobility. Four sera were also analyzed by use of a larger column,
      giving a high resolution. The FSH and LH activities were measured with a time
      resolved sandwich fluoroimmunoassay. The number of isoforms of both FSH and LH in
      each serum specimen analyzed by electrophoresis with high resolution was between
      20-30. The median charge of the isoforms of FSH was less negative (P < 0.001) at
      the midcycle than in the follicular or luteal phase in all 16 women. The same was
      found for LH in 14 of 15 women. The median charge of FSH or LH in the follicular
      phase was not significantly different from that in the luteal phase of the cycle.
      We conclude that at least 20-30 isoforms of both FSH and LH circulate in blood
      during the menstrual cycle. More basic isoforms of both hormones appear in serum
      at midcycle than in the follicular or luteal phase. The difference is most likely
      due to a selective secretion from the pituitary of more basic forms of FSH and LH
      at midcycle.

PMID- 8473401
TI  - Diltiazem stimulates parathyroid hormone secretion in vivo whereas felodipine
      does not.
AB  - The impact of two calcium channel blockers of different structure, diltiazem and
      felodipine, on PTH secretion was studied under hyper- and hypocalcemic
      conditions. Six healthy volunteers were investigated before and after treatment
      with felodipine, then after treatment with diltiazem. Under each of these three
      conditions, they received first a calcium infusion (0.109 mmol/kg over 130 min).
      Blood was drawn every 5-10 min for measurements of Ca2+ and intact PTH
      concentrations, and urine was collected over the infusion periods for
      measurements of calcium and creatinine. Basal levels of Ca2+ and intact PTH
      concentrations were similar under the three conditions. During calcium infusion,
      Ca2+ increased linearly from 1.27 to 1.51 mmol/L during the control period. Based
      on the whole response curve, Ca2+/time, this rise was less marked (P < 0.002)
      during each of the calcium channel blocker periods than under control conditions,
      although the three values of urinary calcium excretion were similar. In addition,
      PTH secretion was less suppressed on diltiazem than on felodipine therapy or
      during the control period (P < 0.04). During EDTA infusion, Ca2+ decreased in a
      linear way from 1.27 to 1.07 mmol/L during the control period. Based on the whole
      response curve, Ca2+/time, this decrease was more marked during felodipine than
      during diltiazem treatment or in the control period (P < 0.001). Although Ca2+
      concentrations did not differ between the control and diltiazem periods, PTH
      levels were 1.3-fold higher (P < 0.0001) during diltiazem, but similar in the
      control and felodipine periods. These data demonstrate that diltiazem, but not
      felodipine, stimulates PTH secretion in vivo in man, with a maximal effect
      observed under hypocalcemic conditions.

PMID- 8473402
TI  - Differential effects of glucose stimulation upon rapid pulses and ultradian
      oscillations of insulin secretion.
AB  - To determine the effect of glucose stimulation on the rapid 8- to 15-min pulses
      and the ultradian 80- to 170-min oscillations of insulin secretion, peripheral
      concentrations of glucose, insulin, and C-peptide were measured at 2-min
      intervals over 2 h (i.e. rapid experiments), at 15-min intervals over 8-20 h
      (i.e. ultradian experiments) in 17 normal subjects during saline infusion, or
      during constant glucose infusion at a rate of 3 mg/(kg.min) (i.e. low dose) or 6
      mg/(kg.min) (i.e. high dose). In the ultradian experiments, insulin secretory
      rates (ISR) were calculated by deconvolution of the plasma C-peptide
      concentrations. Significant oscillations with 125- to 166-min periods were
      detected in all glucose and ISR profiles. The numbers of ISR oscillations per 24
      h were similar during saline infusion and low and high dose glucose infusion. In
      contrast, the amplitude of the ISR peaks increased progressively from 14 +/- 1
      pmol/min during saline infusion to 50 +/- 7 pmol/min and further to 97 +/- 9
      pmol/min during low and high dose glucose infusions, respectively. When expressed
      as percent increment, the amplitude of the ISR oscillations increased
      significantly from 31 +/- 5% during saline infusion to 41 +/- 4% during low dose
      glucose infusion and 44 +/- 3% during high dose glucose infusion (P < 0.05). In
      all profiles obtained from the 2-min sampling experiments, rapid pulses of
      glucose, insulin, and C-peptide were apparent. The number of insulin pulses
      during saline and glucose infusions corresponded to a mean periodicity of 10 min.
      The amplitude of these rapid insulin pulses increased from 17.3 +/- 2.9 to 39.8
      +/- 11.8 pmol/L (P < 0.01) in response to glucose. In contrast to the ultradian
      oscillations, the relative amplitude of the rapid insulin pulses decreased
      significantly from 28.8 +/- 3.4% during saline infusion to 13.6 +/- 1.6% during
      high dose glucose infusion (P < 0.01). Our findings demonstrate that the
      pancreatic response to glucose stimulation is different for the rapid pulses and
      the ultradian oscillations. When the rate of glucose stimulation is increased,
      the absolute amplitude of both the rapid pulses and the ultradian oscillations
      increases. However, when expressed as percent increment, the amplitude of the
      rapid pulses decreases during glucose stimulation, whereas the amplitude of the
      ultradian oscillations increases. These findings suggest that the two oscillatory
      modes have a different origin and physiological significance.

PMID- 8473403
TI  - Effect of premature birth and survival on hepatic thyroxine 5'-monodeiodinase
      activity in baboons.
AB  - Plasma thyroid hormones and hepatic 5'-monodeiodinase type I (5'-MDI) activity
      were measured in a primate model of premature birth and survival. When
      prematurely delivered at 140 days (term gestation is 184 days), infant baboons
      developed hyaline membrane disease, had no surge in T3 and T4, temporarily
      developed hypothyroxinemia, and had extremely low T3 concentrations during the
      first 40 h of life. After 4 days, both plasma T4 and T3 levels progressively
      increased, but were still considerably lower at 16 days compared to those in
      normal term infants. Hepatic 5'-MDI activity was measured in the presence of
      dithiothreitol in fetal, premature, and infant baboons. Fetal baboons at 140 and
      161 days gestation had 80% less 5'-MDI activity than term infants, but at 178-180
      days gestation, near term, fetal hepatic 5'-MDI activity increased to levels
      similar to those in young adults. Interruption of in utero development by
      premature birth resulted in no change in hepatic 5'-MDI activity after 24 h, but
      within 6 days after delivery, hepatic 5'-MDI had significantly increased to
      levels observed in fetal baboons near term. Kinetic analysis revealed that fetal
      and premature 5'-MDI had different maximum velocities and similar apparent Km
      values. There was no significant difference in hepatic total, protein, or
      nonprotein sulfhydryl groups between 1- and 10-day-old premature (140 days
      gestation) baboons. These results suggest that premature birth does not limit the
      postnatal maturation of hepatic 5'-MDI activity.

PMID- 8473404
TI  - Brain natriuretic peptide is present in the human amniotic fluid and is secreted
      from amnion cells.
AB  - The presence and biochemical characteristics of human brain natriuretic peptide
      (hBNP) in the amniotic fluid at various gestational ages were investigated. The
      hBNP-like immunoreactivity (hBNP-LI) levels in amniotic fluid, determined by RIA,
      were 118.7 +/- 57.6 pmol/L (mean +/- SEM; n = 5) and 107.7 +/- 8.7 pmol/L (n = 9)
      in the first and second trimesters of pregnancy, respectively; it was
      significantly decreased to 28.4 +/- 5.1 pmol/L (n = 9) in the third trimester.
      However, human atrial natriuretic peptide-like immunoreactivity (hANP-LI) was not
      detected (< 0.3 pmol/L) in any of these samples. Northern blot analysis
      demonstrated hBNP mRNA in human amnion tissue. Moreover, cultured amnion cells
      secreted a significant amount of hBNP-LI (100-200 fmol/10(6) cells/day), but not
      hANP-LI, into the culture medium. The synthesis of hBNP in cultured amnion cells
      was further confirmed using the polymerase chain reaction. High performance gel
      permeation chromatography of hBNP-LI extracted from human amniotic fluid and the
      culture medium of amnion cells revealed that the predominant molecular form of
      hBNP-LI in both samples was the hBNP precursor, with an approximate mol wt of 12
      kilodaltons. These findings indicate that hBNP is present in the human amniotic
      fluid, and that amnion cells synthesize hBNP and secrete it into the amniotic
      cavity.

PMID- 8473405
TI  - Additive insulinotropic effects of exogenous synthetic human gastric inhibitory
      polypeptide and glucagon-like peptide-1-(7-36) amide infused at near
      physiological insulinotropic hormone and glucose concentrations.
AB  - Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1-(7-36) amide
      (GLP-1) are glucose-dependent insulinotropic gut hormones that may explain the
      greater insulin secretory response with oral compared to i.v. glucose (incretin
      effect). To study their individual and combined contributions, in eight healthy
      volunteers, on separate occasions, synthetic human GIP (1 pmol/kg.min) and/or GLP
      1 (0.3 pmol/kg.min) or placebo were infused i.v. (-30 to 120 min), while at 0
      min, a glucose infusion "isoglycemic" to the profile after an oral glucose load
      of 50 g/400 mL was started. After the administration of 50 g oral glucose,
      immunoreactive GIP rose several-fold to 337 +/- 43 pmol/L, while there was only a
      transient (10-30 min) and moderate increment in immunoreactive GLP-1 (from basal,
      25-30, to 41 +/- 4 pmol/L). Isoglycemic i.v. glucose infusions led to smaller B
      cell responses (estimated incretin effect, 41 +/- 5%). With single infusions of
      GIP or GLP-1 (circulating concentrations, 464 +/- 73 and 54 +/- 3 pmol/L,
      respectively), B-cell responses were significantly augmented compared to i.v.
      glucose alone and were no longer significantly different from those after oral
      glucose. The combination of GIP and GLP-1 led to B-cell responses that were
      significantly higher than those with either hormone alone (additive mode of
      cooperation). Plasma GIP concentrations were similar after endogenous secretion
      (oral glucose) and i.v. infusion, while exogenously administered GLP-1 led to
      plasma levels that were maintained at an elevated level for a longer period
      during exogenous infusion than after stimulation by oral glucose. When, in seven
      volunteers, a lower dose (0.15 pmol/kg.min) of GLP-1 was infused during
      isoglycemic glucose infusion experiments only for the duration of elevated plasma
      levels in the oral glucose challenges (0-30 min), a significant, but transient,
      increment in insulin and C-peptide concentrations was observed, which was
      equivalent to 26 +/- 10% of the estimated incretin effect. Therefore, in
      conclusion, circulating GIP seems to make a major contribution to the incretin
      effect after oral glucose, and GLP-1 appears to mediate a smaller proportion. GIP
      and GLP-1 can interact in an additive manner in normal man.

PMID- 8473406
TI  - Origin and significance of plasma androsterone glucuronide levels: a parameter of
      adrenal androgen secretion and hepatic 5 alpha-reductase activity.
AB  - To evaluate the reliability of plasma androsterone glucuronide (ADTG) as a
      parameter of androgenicity at the target tissue level, we studied the origin of
      ADTG in women, by measuring the plasma conversion rate of different possible
      precursors as well as by measuring ADTG levels in ovariectomized women and women
      with Addison's disease. In women, ADTG levels reflect essentially adrenal
      androgen secretion, dehydroepiandrosterone sulfate (DHEAS) being the major
      precursor, accounting for 70%-80% of ADTG levels. As estimated from the
      ADTG/DHEAS ratio in hirsute women (increased peripheral 5 alpha-reductase) and
      hyperthyroid women (increased hepatic 5 alpha-reductase), it appears that hepatic
      5 alpha-reductase is a major determinant of the conversion of precursors to
      plasma ADTG. In men, plasma testosterone and DHEAS appear to contribute to a
      comparable extent to plasma ADTG levels, as suggested by data obtained in
      orchidectomized men and men with Addison's disease. In accordance with the role
      of DHEAS as a precursor, plasma levels of ADTG decrease significantly with age in
      both men and women. Our data do not support the concept that plasma ADTG levels
      reflect primarily peripheral androgen formation.

PMID- 8473407
TI  - Serum concentrations of type I and III procollagen propeptides in healthy
      children and girls with central precocious puberty during treatment with
      gonadotropin-releasing hormone analog and cyproterone acetate.
AB  - Serum levels of type I and III procollagen propeptides (s-PICP and s-PIIINP) were
      measured in 466 healthy school children and in 23 girls with central precocious
      puberty (CPP) during GnRH analog and cyproterone acetate therapy, using two
      commercially available RIAs. In normal children, s-PICP and s-PIIINP changed
      significantly with age and pubertal development stages. For s-PIIINP, a peak was
      seen at 12 yr for girls and 13 yr for boys; no peak could be discerned for s
      PICP. The prepubertal (Tanner stage 1) s-PICP value (mean +/- SD) for girls was
      374 +/- 132 micrograms/L, the midpubertal value (stage 3) was 442 +/- 135
      micrograms/L, and the postpubertal value (stage 5) was 203 +/- 103 micrograms/L.
      The mean s-PIIINP levels for girls were 9.1 +/- 2.4, 15.0 +/- 4.3, and 6.8 +/-
      3.1 micrograms/L, respectively. For boys, levels were 362 +/- 119, 544 +/- 138,
      and 359 +/- 256 micrograms/L for s-PICP and 8.5 +/- 2.2, 14.5 +/- 5.0, and 8.6 +/
      3.8 micrograms/L for s-PIIINP (P < 0.001 for both propeptides in both boys and
      girls). There was, however, a large variation in normal values for both
      propeptides within the age groups and pubertal stages. There was a significant
      correlation of s-PICP and s-PIIINP levels to height velocity in girls (r = 0.35;
      P < 0.001 and r = 0.33; P < 0.001, respectively), while in boys, only s-PIIINP
      showed significant correlation to height velocity (r = 0.40; P < 0.001). In
      untreated girls with CPP, serum levels of s-PIIINP were elevated [PIIINP SD score
      (SDS), 2.13]. Levels of s-PICP were normal (PICP SDS, 0.39). Levels of both
      propeptides decreased within 2 months after initiation of therapy and remained
      below initial values (P < 0.01). The decrease in s-PIIINP after 2 months of
      therapy showed a significant correlation with the fall in height velocity SDS for
      chronological age after 6 months of therapy (r = 0.64; P < 0.01). We conclude
      that s-PIIINP and, to a lesser degree, s-PICP reflect growth in normal children,
      but due to the large variation, both propeptides seem unsuitable as markers for
      screening of growth disorders in children.

PMID- 8473408
TI  - Subnormal androgen and elevated progesterone levels in women treated for
      congenital virilizing 21-hydroxylase deficiency.
AB  - Clinical, anthropometric, and endocrine data were examined in 22 corticosteroid
      treated, prenatally virilized women with congenital adrenal hyperplasia (CAH) due
      to 21-hydroxylase deficiency and in 22 matched healthy controls. In view of the
      androgen excess, limited growth, and subfertility associated with CAH, the
      investigation focused on androgenic/anabolic status and circulating progesterone
      levels. CAH patients were shorter and had a significantly higher body mass index
      than the controls. One pregnancy was reported in the CAH group compared to 15 in
      the controls. Five of the CAH patients were judged as undersubstituted based on
      greatly elevated circulating levels of 17 alpha-hydroxyprogesterone. These five
      patients had elevated serum levels of progesterone (P) and testosterone (T) and
      elevated ratios between T and sex hormone-binding globulin, but subnormal levels
      of dehydroepiandrosterone (DHA) and its sulfate. The remaining 17 well
      substituted patients had elevated follicular phase levels of P, but subnormal
      levels of all androgens (4-androstene-3,17-dione, T, DHA, and DHA sulfate) and
      subnormal T/sex hormone-binding globulin ratios. Contrary to the apprehension
      that normally guides the treatment of CAH, well substituted patients may be
      considered hypoandrogenic rather than hyperandrogenic. The elevated levels of P
      may have a minipill-like effect, which may be one of the causes of the
      differences in fertility between salt-wasting and simple virilizing CAH.

PMID- 8473409
TI  - Growth hormone (GH) secretion from human lymphocytes is up-regulated by GH, but
      not affected by insulin-like growth factor-I.
AB  - Regulation of GH secretion from phytohemagglutinin (PHA)-stimulated lymphocytes
      was investigated in six normal subjects. Peripheral blood mononuclear cells were
      incubated with PHA (10 micrograms/mL) in the presence of various amounts of
      recombinant human GH (0-100 ng/L) and/or recombinant human insulin-like growth
      factor-I (0-1000 micrograms/L), and the secreted GH was measured by a highly
      sensitive enzyme immunoassay. PHA-stimulated lymphocytes secreted immunoreactive
      GH in all subjects (13.6 +/- 2.4 ng/L). Exogenous GH up-regulated the GH
      secretion in a dose-dependent manner, while IGF-I did not affect either basal GH
      secretion or the up-regulation by exogenous GH. These findings suggest a
      difference in the regulation of GH secretion between endocrine and immune
      systems.

PMID- 8473410
TI  - Gonadotropin-releasing hormone pulse generator activity during pubertal
      transition in girls: pulsatile and diurnal patterns of circulating gonadotropins.
AB  - To delineate the activity of the GnRH pulse generator during pubertal transition,
      40 healthy girls 7-18 yr of age were studied. Ten were prepubertal (PP), 7 were
      in early puberty (EP), and 23 were in late puberty (LP, all postmenarcheal).
      Serum concentrations of LH and FSH were measured with immunofluorometric assays,
      which have a sensitivity about 100-fold that of RIA, in samples taken at 10-min
      intervals for 24 h during basal conditions, during Nal-Glu antagonist
      suppression, and in response to GnRH stimulation (10 micrograms). Serum levels of
      androstenedione, testosterone, and estradiol were measured with RIA. A pulsatile
      pattern of LH and FSH secretion was found in girls of all ages. PP girls had
      irregular LH pulses with low amplitudes during the daytime, but increased
      amplitude LH and FSH pulses were evident within 1 h after sleep-onset. Older PP
      girls had more regular and higher amplitude pulses throughout sleep than younger
      PP girls. The sleep-related LH and FSH pulses in PP girls were abolished with Nal
      Glu GnRH antagonist treatment, reflecting endogenous GnRH pulse activities. The
      PP group had the most pronounced amplification of LH secretion with sleep
      yielding a sleep-wake ratio of 4, which decreased to 2 in the EP group and to 1
      in the LP group. The emergence of regular daytime LH pulses along with a further
      amplification of pulsatile activity during sleep was closely related to the onset
      of breast development. By the age of 16 yr, an LH secretory pattern
      characteristic of adult women in the early follicular phase, i.e. a decrease in
      LH concentration during sleep, was established. Mean 24-h LH concentrations
      increased 40-fold from PP to LP consequent to a 9-fold increase in pulse
      amplitude and a 4-fold increase in pulse number (both P < 0.0001). Mean FSH
      concentrations (24 h), which were 20-fold higher than corresponding LH
      concentrations in the PP group, increased only 3-fold from the PP to the LP
      group. FSH pulse secretion appears to be predominantly GnRH dependent in PP girls
      in contrast to girls after ovarian activation, as indicated by the increased FSH
      responses to both GnRH antagonist suppression and GnRH stimulation in the PP as
      compared to the EP and LP groups. We conclude that the GnRH pulse generator is
      functionally active in prepubertal girls with selective expression of LH and FSH
      pulses after the onset of sleep. The onset of puberty is associated with a
      greater increase in LH pulse amplitude than frequency.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8473411
TI  - Intranasal administration of human growth hormone (hGH) in combination with a
      membrane permeation enhancer in patients with GH deficiency: a pharmacokinetic
      study.
AB  - Recombinant human GH (hGH) combined with a permeation enhancer for the nasal
      mucosa, sodium tauro-24,25-dihydrofusidate (STDHF), was administered intranasally
      (in) in six patients with classical GH deficiency. Three different doses were
      tested (0.2, 0.4, and 0.8 IU/kg BW). The concentration of STDHF was 1% in all
      doses. As a comparison, all patients received a sc injection of hGH (0.1 IU/kg
      BW). Blood samples were obtained at frequent intervals for up to 8 h (in doses)
      or 24 h (sc dose) and analyzed for the plasma concentration of hGH. All three
      i.n. doses gave a rapid increase in hGH with peak maxima (Cmax) at 20-30 min, and
      a decline to baseline within 2-3 h. In contrast, the sc dose resulted in a Cmax 2
      3 h after the injection, followed by a plateau phase for 2-3 h. The baseline was
      reached 12-14 h after administration. The uptake [area under the curve (AUC)] was
      considerably lower for all three in doses, i.e. 1.6-3% of the AUC obtained with
      the sc dose. However, the Cmax varied between 5.7 +/- 1.4% (0.8 IU/kg BW) and
      15.8 +/- 2.1% (0.4 IU/kg BW) of the maximal peak with the sc dose. Of the in
      doses, 0.4 IU/kg BW resulted in the highest AUC and Cmax. A self-rating protocol
      was also used to estimate nasal sensations for up to 2 h after dosing. All
      sensations (itching, burning, sneezing, and running of the nose) were transient
      and tolerable. This study demonstrates that hGH can be administered intranasally
      in combination with STDHF. The in dosing results in a plasma peak of hGH very
      similar to the physiological endogenous peak. No side-effects were noted, other
      than a transient nasal irritation. Therefore, the nasal route for hGH
      administration offers a more physiological and more convenient alternative to
      injections for the treatment of GH deficiency.

PMID- 8473412
TI  - Mitogenic action, regulation, and localization of insulin-like growth factors in
      the human fetal adrenal gland.
AB  - Polypeptide growth factors may play an important role in the regulation of human
      fetal adrenal cortical growth by mediating the tropic actions of ACTH. The
      abundance of mRNA encoding insulin-like growth factor-II (IGF-II) is high in the
      human fetal adrenal gland and is stimulated by ACTH in cultured fetal adrenal
      cortical cells. Therefore, we studied the mitogenic action, regulation, and
      localization of IGF-II and a closely related peptide, IGF-I, in primary cultures
      of human fetal adrenal cortical cells and whole human fetal adrenal glands.
      Recombinant human IGF-I and IGF-II stimulated proliferation of fetal adrenal
      cortical cells in a dose-dependent fashion (1-1000 ng/mL; 0.133-133 nM). At 1000
      ng/mL (133 nM), both peptides increased cell number 1.8- to 2-fold. Combinations
      of IGF-I or -II (100 ng/mL; 13.3 nM) with basic fibroblast growth factor (bFGF;
      0.1 ng/mL; 6 pM) or epidermal growth factor (EGF; 1.0 ng/mL; 0.17 nM) had a
      greater effect on proliferation than bFGF, EGF, or either of the IGFs alone,
      suggesting an additive interaction. IGF-II mRNA was detected in cultured adrenal
      cortical cells by in situ hybridization analysis, and its abundance was
      stimulated by ACTH. In contrast, IGF-I mRNA was not detected in cultured fetal
      zone cells and was not regulated by ACTH. In whole human fetal adrenal glands,
      IGF-II mRNA was detected in the definitive and fetal zones and in the capsule,
      whereas IGF-I mRNA was detected only in the capsule and not in the two cortical
      zones. Using Northern blot analysis, we found that mRNA encoding IGF-II was
      present in high abundance in fetal adrenal glands (16-22 weeks) and barely
      detectable in adult adrenals, whereas mRNA encoding IGF-I was present in very low
      abundance in the fetal adrenal, but was high in adult human adrenals. As IGF-II
      expression is high in the human fetal adrenal cortex and is regulated by ACTH, we
      propose that it is the dominant of the two IGFs regulating human fetal adrenal
      growth. The cooperative mitogenic effect of IGF-II with bFGF and EGF and the
      regulation of its expression by ACTH support the hypothesis that IGF-II may act
      as a mediator, in concert with bFGF and possibly EGF, of the tropic action of
      ACTH in regulating the rapid growth of the human fetal adrenal cortex during
      midgestation.

PMID- 8473413
TI  - Androstanediol glucuronide production in human liver, prostate, and skin.
      Evidence for the importance of the liver in 5 alpha-reduced androgen metabolism.
AB  - Androstanediol glucuronide (Adiol G) has been reported to be a marker of
      peripheral androgen metabolism and action. It consists of two isomers, Adiol 3-G
      and Adiol 17-G. Adiol G is formed from unconjugated precursors by the enzyme
      glucuronyl transferase. To determine the likely source of Adiol G formation in
      man, we developed a glucuronyl transferase assay and measured the activity of
      this enzyme in human liver, abdominal and scalp skin, and prostate. In human
      liver, glucuronyl transferase activity was linear with respect to time (up to 120
      min) and tissue concentration (up to 1 mg/ml). Apparent Michaelis-Menten constant
      Km (micromolar) and maximum velocity (Vmax) (picomoles per mg/30 min) were 5.6
      and 140 for dihydrotestosterone, 8.9 and 1300 for androstanediol, and 3.1 and 46
      for androsterone, respectively. Conversion of androstanediol to Adiol G (/0.5 mg
      tissue.30 min) was 5.8-13.2%. Over 80% of the Adiol G formed in human liver was
      Adiol 17-G, similar to what has been previously found in human serum. Glucuronyl
      transferase activity was present at low levels in human prostate (conversion of
      androstanediol to Adiol G was 0.04-4.6%/50 mg tissue.120 min). Analogous
      conversion rates (/50 mg tissue.120 min) for human scalp skin were 0.2-0.4% and
      for human abdominal skin were 0.07-0.14%. Although dihydrotestosterone may be
      converted to androstanediol in peripheral tissues such as skin and prostate, our
      results suggest that the principal site of androgen conjugation to glucuronic
      acid is the liver. The present results cast doubt upon the role of androstanediol
      glucuronide as a specific marker of cutaneous androgen metabolism.

PMID- 8473414
TI  - Relationship between nocturnal serum thyrotropin peak and metabolic control in
      diabetic patients.
AB  - Circadian variations in serum TSH, especially its nocturnal rise, are often
      blunted in nonthyroidal illness. We analyzed TSH secretion in 15 diabetic
      patients (7 with type I and 8 with type II diabetes mellitus). Patients were
      evaluated when diabetes was poorly controlled (fasting blood glucose ranging from
      13.7-19.2 mmol/L with absence of ketoacidosis) and after achieving glycemic
      control. Before correction of hyperglycemia, the nocturnal serum TSH peak (2230
      0200 h) was abolished in 11 of 15 patients (73%); the mean (+/- SE) night
      TSH/morning TSH x 100 was 109.0 +/- 9.5 (range, 66.7-166.7) vs. a mean of 216.5
      +/- 27.0 (range, 139.8-462.5) in normal controls. The mean morning TSH value in
      diabetics (1.9 +/- 0.4 mU/L) did not differ from that in normal age- and sex
      matched controls. The mean TSH increase after iv administration of TRH was only
      slightly reduced (8.4 +/- 1.2 mU/L pretreatment vs. 10.8 +/- 1.6 mU/L
      posttreatment), with the TRH test blunted in 3 cases. No differences were found
      between type I and type II patients. Correction of hyperglycemia was associated
      with the reappearance of a nocturnal TSH peak in all but 1 patient (mean TSH
      peak, 198.2 +/- 13.0; P = NS vs. controls). This change paralleled the
      normalization of serum total T3 and rT3, which were reduced and increased,
      respectively, when diabetes was poorly controlled. An inverse relationship was
      found between serum fructosamine levels and the nocturnal TSH peak, suggesting
      that metabolic decompensation accounts for the abolishment of the latter.

PMID- 8473415
TI  - Administration of an aromatase inhibitor during the late follicular phase of
      gonadotropin-treated cycles in rhesus monkeys: effects on follicle development,
      oocyte maturation, and subsequent luteal function.
AB  - Local modulation of follicular and gametogenic functions by ovarian androgens and
      estrogens in mammalian species has been proposed. This study examined the effects
      of elevated androgen/estrogen ratios during follicular maturation in vivo by
      inhibiting aromatase activity in rhesus monkeys. To obviate steroid feedback
      effects, gonadotropin-treated animals were used. Beginning at menses (day 1),
      animals received human (h) FSH (60 IU/day, im) on days 1-6, followed by hFSH plus
      hLH (60 IU/day, im) on days 7-9 to promote the growth of multiple follicles.
      Ovulatory maturation was induced by hCG (1000 IU, im) on day 10. On days 8-10,
      four animals received an aromatase inhibitor, 1,4,6-androstatrien-3,17-dione
      (ATD; 1-1.25 g, orally, twice/day), while five served as controls and received no
      further treatment. Within 8 h of ATD treatment, a 63% reduction in serum
      estradiol levels relative to control values was evident, which reached maximal
      suppression (84%) by day 10. A marked elevation (17-fold) in serum
      androstenedione and a lesser increase (2.6-fold) in serum testosterone occurred
      with aromatase inhibition, yielding androstenedione/estradiol (18.0) and
      testosterone/estradiol (1.9) ratios greater than those in controls (0.6 and 0.3,
      respectively). ATD treatment did not alter follicular diameters or the total
      number of follicles per animal (20 +/- 3) relative to control values (16 +/- 3).
      Of the total cohort classified, the proportion of oocytes collected at prophase I
      was greater (P < 0.05) after ATD treatment (31%) than in controls (11%).
      Completion of oocyte meiosis to metaphase II was retarded (P < 0.05) in ATD
      treated (4%) compared to control (26%) animals. Furthermore, the in vitro
      fertilization rate of metaphase II oocytes from ATD-treated animals (9%) was
      reduced (P < 0.05) relative to that in controls (25%). While basal progesterone
      production by luteinizing granulosa cells in vitro was similar between groups,
      the addition of hCG in vitro enhanced progesterone secretion by cells from ATD
      treated animals (3.1 +/- 0.3-fold over basal) to a greater extent (P = 0.05) than
      in controls (1.5 +/- 0.3-fold). Progesterone receptor was detected by
      immunocytochemistry in nuclei of luteinizing granulosa cells from ATD-treated
      animals as well as controls. Serum progesterone profiles and the length of the
      luteal phase were similar between groups. Thus, acute elevation of serum
      androgen/estrogen ratios in vivo during follicular maturation was detrimental to
      the gametogenic functions of the primate follicle, but did not alter follicular
      growth, events of early luteinization, or subsequent luteal function.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8473416
TI  - Androgen-stimulated pubertal growth: the effects of testosterone and
      dihydrotestosterone on growth hormone and insulin-like growth factor-I in the
      treatment of short stature and delayed puberty.
AB  - The purpose of this study was to investigate the roles of androgenic and
      estrogenic mechanisms in the stimulation of structural growth and plasma GH in
      male puberty. To resolve these two possible mechanisms, we compared the effect of
      two androgens in the treatment of constitutional delay in growth and adolescence:
      an aromatizable androgen, testosterone (T), and a nonaromatizable androgen,
      dihydrotestosterone (DHT). Nine adolescent males, Tanner stage 1 or 2, were
      studied before and during treatment with T enanthate (group A) or DHT heptanoate
      (group B). After 2.5 months of treatment, the height velocity (HV) was 12.6 +/-
      2.8 cm/yr (n = 3) in group A and 8.9 +/- 1.7 cm/yr (n = 6) in group B, both
      within the range of peak HV for pubertal males. In group A, the integrated
      concentration of GH (ICGH) increased from 3.12 +/- 0.90 to 13.67 +/- 6.0
      micrograms/L (P < 0.05), and plasma insulin-like growth factor-I (IGFI) increased
      from 126.7 +/- 2.5 to 350.3 +/- 20.3 micrograms/L (P < 0.01); plasma T increased
      from 0.8 +/- 0.5 to 33.8 +/- 11.0 nmol/L (P < 0.001), and the LH response to LHRH
      decreased from 27.6 +/- 10.7 to 5.9 +/- 2.5 IU/L (P = NS). In group B, ICGH
      decreased from 4.32 +/- 0.61 to 2.39 +/- 0.42 (P < 0.025), and IGF-I decreased
      from 218.3 +/- 39.2 to 184.0 +/- 15.8 (P = NS). Plasma T increased from 2.0 +/-
      0.5 to 2.7 +/- 0.8 (P = NS), and the LH response to LHRH decreased from 45.7 +/-
      14.5 to 10.7 +/- 5.8 (P < 0.05). To further evaluate the mechanism of the effect
      of DHT on plasma GH, seven male subjects with adolescent gynecomastia were
      treated with DHT heptanoate, and their responses were studied at 1 week and 3.5
      months. ICGH decreased in conjunction with a decrease in the integrated T
      concentration (r = -0.77; P < 0.001) and to a slight degree with decreasing
      plasma estradiol (r = -0.39; P < 0.2). Plasma IGF-I did not show a significant
      change in the subjects with gynecomastia. Thus, the increase in GH at puberty in
      males appears to be due to an estrogen-dependent mechanism. The suppressive
      effect of DHT on GH secretion may be due to either suppression of estradiol
      production or a direct effect. Acceleration of HV into the peak pubertal range by
      DHT without an increase in plasma GH suggests that an increase in GH is not
      necessary for the pubertal growth spurt.

PMID- 8473417
TI  - Induction of a polarized micro-environment by human T cells and interferon-gamma
      in three-dimensional spheroid cultures of human endometrial epithelial cells.
AB  - Expression of human leukocyte antigen (HLA)-DR molecules and proliferation of
      epithelium in human endometrium are polarized. We have suggested that the
      induction of such a polarized micro-environment is T cell and interferon (IFN)
      gamma dependent. The present study was designed to demonstrate the induction of
      such a micro-environment around T cells and around the source of IFN-gamma.
      Spheroids reminiscent of endometrial glands were formed by allowing three
      dimensional aggregation of endometrial epithelial cells of a cloned HLA-DR
      negative endometrial carcinoma cell line (ECC1) over agarose. Both HLA-DR
      expression and inhibition of proliferation were found to be directly dependent on
      the dose of IFN-gamma that was allowed to diffuse in the agarose beneath the
      spheroids. To show that the interaction of the epithelial cells with activated T
      cells also induces HLA-DR molecules in a paracrine fashion in the epithelial
      cells, ECC1 spheroids were co-cultured with increasing numbers of allogeneic
      peripheral blood T cells for various time-intervals. T cells bound to the ECC1
      cells, and became activated as indicated by the expression of interleukin (IL)-2
      receptor and HLA-DR molecules. A focal HLA-DR expression became apparent in the
      ECC1 cells adjacent to the T cells. As the number of T cells added to spheroid
      cultures was increased, a concomitant increase in the number of HLA-DR positive
      ECC1 cells occurred and HLA-DR immunoreactivity was enhanced in each cell. There
      was a corresponding decrease in the proliferation of the ECC1 cells in T cell
      ECC1 spheroid co-cultures. Based on these data, we suggest that activation of T
      cells is associated with the induction of HLA-DR expression and inhibition of
      proliferation in a paracrine fashion in the epithelial cells and may be
      responsible for the creation of a polarized micro-environment in vivo.

PMID- 8473418
TI  - Effect of tamoxifen alone and in combination with RU 486 on the endometrium in
      the mid-luteal phase.
AB  - The effects of RU 486 combined with tamoxifen and tamoxifen alone on hormonal
      parameters and endometrial development at the time of implantation were studied.
      Measurements of cytosolic oestrogen and progesterone receptors in endometrium and
      placental protein 14 (PP14) in plasma were also included. Three dosage schedules
      were used: single oral dose of 40 mg tamoxifen alone and in combination with 200
      mg RU 486, and 40 mg tamoxifen for three consecutive days starting on the first
      day after the luteinizing hormone (LH) surge. The combined treatment prolonged
      the luteal phase (P < 0.05) and increased the plasma levels of progesterone. A
      single dose of tamoxifen did not affect the bleeding pattern and plasma hormone
      levels, but raised plasma oestradiol and LH with the 3-day treatment. The
      endometrium was retarded after the combined and the 3-day treatment with
      tamoxifen. Concentrations of cytosolic progesterone receptors were higher after
      the combined therapy, but were unaffected after tamoxifen only. PP14 levels were
      higher (P < 0.05) after repeated tamoxifen doses than in controls, but were lower
      with combined treatment. Progesterone and oestrogen are evidently necessary for
      endometrial maturation during the secretory phase of the menstrual cycle. PP14
      levels in plasma cannot be used for clinical assessments of endometrial function
      because high levels coincide with disturbed endometrial development.

PMID- 8473419
TI  - Effects of continuous treatment with low dose mifepristone throughout one
      menstrual cycle.
AB  - The effects of continuous low dose mifepristone (RU 486) 10, 5 or 1 mg/day on the
      menstrual cycle were assessed in groups of five volunteers, who were treated for
      30 days from the beginning of the cycle. Hormonal determinations in blood and
      urine samples, ovarian ultrasonography and an endometrial biopsy taken on day 22
      29 of treatment were used to monitor the cycle. Pre- and post-treatment cycles
      presented a normal profile. During treatment, concentrations of RU 486 in plasma
      ranged from 65 nmol/l with 1 mg/day to 1000 nmol/l with 10 mg/day. With 10 or 5
      mg/day, all treated cycles were prolonged as a result of arrested or slower
      follicular growth during treatment. Gonadotrophins, sex steroids and their
      urinary metabolites remained at early follicular phase levels throughout
      treatment, whereas androstenedione, prolactin and cortisol were unaffected.
      Follicular maturation resumed after discontinuation of treatment and several days
      later a luteinizing hormone surge followed by a luteal phase was observed in all
      cases. Ovulation was suppressed during treatment only in one of the five cycles
      treated with 1 mg/day. Endometrial maturation was disturbed by all doses. These
      data demonstrate a differential threshold of the follicle and the endometrium to
      mifepristone. This finding has potential application in the contraceptive field.

PMID- 8473420
TI  - Validation of the dual analyte assay of the oestrone:pregnanediol ratio in
      monitoring ovarian function.
AB  - The purpose of this study was to validate the dual analyte system (Boots Celltech
      Ltd, Slough, UK) as a marker of ovarian function. For this purpose the urinary
      profile of the ratio of oestrone-3-glucuronide to pregnanediol-3-glucuronide in
      urine (E13G/PD3G) was compared with plasma concentrations of oestradiol,
      progesterone, luteinizing hormone (LH) and follicle stimulating hormone from day
      8-24 of the menstrual cycle in 23 women. Daily transvaginal ultrasound was also
      performed from day 8 of the cycle until sonographic evidence of follicular
      rupture. The ratio of urinary metabolites exhibited a maximum value close to
      ovulation. In the majority of cases this coincided with the day of LH peak, and
      was followed by follicular rupture within the next 24 h in 74% of cases. The
      assay gives a good marker of ovulation, however, it is unlikely to help in
      detecting the initiation of the fertile period or the quality of the menstrual
      cycle.

PMID- 8473421
TI  - A prospective study to evaluate the efficacy of modified swim-up preparation for
      male sex selection.
AB  - A previously published study reporting the use of a modified swim-up technique
      for sperm preparation prior to insemination which resulted in a high percentage
      of male births has been criticized for its lack of controls. The present
      prospective study was initiated to investigate further the efficacy of modified
      swim-up preparation for male sex-selection when applied in a properly defined
      control group. Our results showed that the proportion of males born in singleton
      pregnancies was approximately 50% in the group inseminated following sperm
      preparation with Percoll and in the control group with no sperm preparation
      compared with 88.5% in the group treated with the modified method of swim-up
      sperm preparation prior to insemination. This high rate of males in the group
      treated with modified swim-up was also observed in singleton pregnancies of women
      taking ovulation inducing drugs (primarily clomiphene citrate). This contrasts
      with previous publications in which a higher rate of females was found in
      clomiphene citrate patients using the albumin separation technique. How the
      mechanism of the swim-up procedure may result in a high male birth rate remains
      unclear. A high percentage of y enriched semen was found using fluorochrome
      quinacrine mustard staining but this procedure may falsely stain autosomal
      chromosomes. If analysis using sensitive DNA probes fails to confirm the y
      enrichment of the spermatozoa, one must hypothesize that the modified swim-up
      procedure damages the x-spermatozoa.

PMID- 8473422
TI  - Aetiology of congenital absence of vas deferens: genetic study of three
      generations.
AB  - Bilateral congenital absence of the vas deferens (CAVD) is a form of male
      sterility (found in otherwise normal men) of unknown aetiology. Because males
      with cystic fibrosis (CF) almost invariably have CAVD as well, we investigated
      the hypothesis that men with isolated CAVD might share a common genetic
      background with males with CF. Genetic testing for CF was carried out in three
      generations of subjects: 44 patients with CAVD and their wives, 24 of their
      parents, and 13 of their offspring generated by microsurgical epididymal sperm
      aspiration (MESA) and in-vitro fertilization (IVF). DNA extracted from peripheral
      lymphocytes was amplified by the polymerase chain reaction (PCR) and then
      analysed for 12 mutations in the cystic fibrosis transmembrane conductance
      regulatory (CFTR) gene. Among 44 patients tested with CAVD, 26 (59%) were
      positive for at least one CF mutation, while the carrier frequency for CF
      mutations in the general population is only 4%. Four patients were found to be
      compound heterozygotes, three with genotypes Delta F-508/R117H, one with
      R553X/R117H. Among 24 parents tested, 15 (seven fathers, eight mothers) had sons
      with CAVD who were positive for CF mutations. Of these, nine (four fathers and
      five mothers) were found to be carriers for CF mutations. These four fathers,
      although carriers of CF mutations, were obviously fertile. Of the 13 offspring
      tested, six (three boys and three girls) had CF positive fathers. Of these, three
      (two girls and one boy) were found to be carriers for CF mutations. These
      MESA/IVF children are the first offspring to whom men with CAVD have been able to
      transmit CF mutations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473423
TI  - Cytogenetic and morphological observations of single pronucleated human oocytes
      after in-vitro fertilization.
AB  - At 16-18 h after insemination, 5.5% of the inseminated oocytes displayed only one
      pronucleus. The incidence of single-pronucleated oocytes was not correlated with
      the age of the patient. Cytogenetic analysis of 41 embryos derived from single
      pronucleated oocytes revealed a haploid chromosome complement in 12.2%, a diploid
      chromosome complement in 80.5% and a triploid set in 7.3% of the embryos. In one
      diploid metaphase, a Y chromosome could be clearly demonstrated. A total of 312
      single-pronucleated oocytes were evaluated twice (at 16-18 h and at 20-24 h after
      insemination). In 25% of the single-pronucleated oocytes a second pronucleus was
      observed 4-6 h later, suggesting asynchronous or delayed pronuclear formation.
      The cleavage of these embryos was similar to the cleavage of embryos with two
      pronuclei at the first evaluation. Parthenogenetic activation and asynchronous
      pronuclei may both be mechanisms leading to the morphological observation of a
      single pronucleus. In clinical practice, the second repeat observation of single
      pronucleated oocytes became part of the standard procedure.

PMID- 8473424
TI  - Lack of mutational alteration in the conserved regions of ZFY and SRY genes of
      46,XY females with gonadal dysgenesis.
AB  - To further our understanding of the mechanism of action of regulatory and
      structural genes involved in human sex determination, we have examined three sex
      reversed 46,XY females and two of their normal fathers for any mutational
      alteration in ZFY and SRY genes, using polymerase chain reaction and single
      strand conformation polymorphism and by subsequent DNA sequencing. We could not
      find any mutation in the ZFY and SRY genes of these patients and their fathers.
      The results seem to suggest that although ZFY and SRY may be required for
      initiation of testis differentiation and male sex determination, sex-reversed
      females may predominantly result from alterations in genes either downstream or
      secondary to ZFY or SRY.

PMID- 8473425
TI  - Immaturity and chromosomal abnormalities in oocytes that fail to develop
      pronuclei following insemination in vitro.
AB  - A total of 293 oocytes that failed to develop pronuclei after insemination in
      vitro with apparently normal, fertile spermatozoa were obtained from 87 women
      undergoing therapeutic in-vitro fertilization. The oocytes were investigated
      cytogenetically to determine the incidence of immaturity and chromosomal
      abnormalities. Cytogenetic examination was possible in 81% of the preparations,
      in which immaturity and chromosomal abnormalities were present in 29.5 and 58.7%
      respectively.

PMID- 8473426
TI  - A controlled study comparing patients with and without polycystic ovaries
      undergoing in-vitro fertilization.
AB  - The outcome of in-vitro fertilization and embryo transfer (IVF-ET) was compared
      in 76 patients with polycystic ovaries (PCO) diagnosed on pre-treatment
      ultrasound scan, and 76 control patients who had normal ovaries and were matched
      for age, cause of infertility and stimulation regimen. Despite receiving
      significantly less human menopausal gonadotrophin (HMG), patients with PCO, as
      compared with controls, had significantly higher serum oestradiol levels on the
      day of human chorionic gonadotrophin administration (5940 +/- 255 versus 4370 +/-
      240 pmol/l, P < 0.001), developed more follicles (14.9 +/- 0.7 versus 9.8 +/-
      0.6, P < 0.001) and produced more oocytes (9.3 +/- 0.6 versus 6.8 +/- 0.5, P =
      0.003). However, fertilization rates were reduced in the PCO patients (52.8 +/-
      3.4% versus 66.1 +/- 3.4%, P = 0.007). There was no significant difference in
      cleavage rates. The pregnancy rate/embryo transfer was 25.4% in the PCO group and
      23.0% in the group with normal ovaries. There were three high order multiple
      pregnancies in the PCO group compared with none in the group with normal ovaries.
      Of the PCO patients, 10.5% developed moderate/severe ovarian hyperstimulation
      syndrome (OHSS) compared with none of the controls (P = 0.006). Patients with and
      without PCO undergoing IVF have comparable pregnancy and livebirth rates.
      However, it is important to diagnose PCO before ovarian stimulation is initiated
      as these patients are more likely to develop moderate or severe OHSS following
      IVF-ET.

PMID- 8473427
TI  - Comparative trial between an ultra-short and long protocol of luteinizing hormone
      releasing hormone agonist for ovarian stimulation in in-vitro fertilization.
AB  - A total of 312 patients with tubal infertility participated in a prospective
      randomized study comparing two regimens of ovarian stimulation with a luteinizing
      hormone-releasing hormone agonist (buserelin) and human menopausal gonadotrophin
      (HMG). Half of the patients were given an ultra-short treatment protocol when the
      agonist was administered on days 2, 3 and 4 of the stimulated cycles; the other
      half were given a long protocol when the agonist was administered from the mid
      luteal phase of the cycle preceding the treatment cycle. The mean number of HMG
      ampoules used per patient was significantly higher in the long protocol. No
      significant differences were found between the two groups in the incidence of
      cancelled cycles, failed oocyte recovery, mean number of oocytes recovered per
      patient, complete failure of fertilization and the fertilization and embryo
      cleavage rate. More patients undergoing the long protocol had supernumerary
      embryos cryopreserved and successful deliveries.

PMID- 8473428
TI  - Cervical leukocytosis and abnormal post-coital test: a diagnostic and therapeutic
      approach.
AB  - Inflammatory processes and cell-mediated immunological reactions in the cervix
      and vagina have been implicated as causal factors in some cases of infertility.
      This investigation examined whether cervical Papanicolaou (PAP) smears in
      combination with post-coital tests could reveal infertile patients with
      asymptomatic cervical leukocytosis. Women (n = 56) attending a hospital-based
      community infertility clinic were subjected to post-coital tests and simultaneous
      preparation of cervical PAP smears. Those women (n = 18) with both abnormal post
      coital tests and asymptomatic cervical leukocytosis, based on abnormally high
      numbers of leukocytes in the PAP smear, were randomly divided into two groups.
      One group (n = 10) received antibiotic therapy and the other (n = 8) received no
      therapy. In the treated group six women became pregnant within 3 months after
      treatment; none of the eight untreated patients became pregnant within the same
      period. These results suggest that cervical PAP smears, in cases with abnormal
      post-coital tests, are useful in detecting couples whose infertility may be due
      to simple, undetected, asymptomatic bacterial infections.

PMID- 8473429
TI  - The efficacy and efficiency of an in-vitro fertilization programme including
      embryo cryopreservation: a cohort study.
AB  - A cohort of 485 couples starting their first in-vitro fertilization (IVF) attempt
      between January, 1989 and February, 1991 inclusive, were followed until June 1,
      1992. A total of 1086 treatment cycles were initiated (mean 2.2, range 1-6). Of
      these, 235 (21.8%) cycles were cancelled, giving a total of 851 embryo
      replacements (mean 1.7, range 1-5). After IVF treatment, 189 women have either
      delivered or have an ongoing pregnancy in the second or third trimester. This
      gives a baby take-home rate of 17.4% per started cycle and 22.2% per embryo
      replacement. For 91 (18.6%) of the couples, the treatment was abandoned prior to
      completion of the three scheduled IVF attempts and 57 (11.7%) of these had no
      completed IVF cycles. In the group of couples with reduced sperm quality, the
      delivery rate was significantly lower than that of the other groups. A total of
      193 women had embryos cryopreserved in at least one IVF cycle; 124 of these women
      started a frozen embryo replacement cycle and 88 had at least one cycle with
      replacement of frozen/thawed embryos, resulting in 25 deliveries/ongoing
      pregnancies. Due to the Norwegian law on assisted procreation 65 (33.7%) of the
      women have had their frozen embryos thawed and discarded after 12 months of
      storage. The cryopreservation programme, with the limitations of the Norwegian
      law, gives a 5.2% increase in the baby take-home rate for women entering the IVF
      programme, an increase of 13.2% in the number of ongoing pregnancies/deliveries
      and an 11.6% increase in number of children/viable fetuses.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8473430
TI  - Acrosin activity in human spermatozoa in relation to semen quality and in-vitro
      fertilization.
AB  - Acrosin, a sperm proteinase released during acrosomal exocytosis, facilitates
      penetration through the oocyte vestments. The purpose of this investigation was
      to determine if a correlation exists between the acrosin activity of ejaculated
      human spermatozoa, before motility enrichment techniques, and in-vitro
      fertilization (IVF) success using selected (glass wool or swim-up) spermatozoa.
      Since all the oocytes were retrieved from women receiving exogenous hormonal
      stimulation and a mixed population of mature and immature oocytes were
      encountered, only cases with > or = 50% mature oocytes were analysed. Under these
      conditions, the acrosin activity was significantly greater (P < 0.01) in the
      ejaculates in which spermatozoa ultimately fertilized > or = 70% of the mature
      oocytes, than in the ejaculates in which spermatozoa ultimately fertilized < 70%
      of the mature oocytes. Furthermore, a strong correlation (r = 0.962, P = 0.0001)
      was detected between pre-IVF acrosin activity and subsequent high (> or = 70%)
      IVF success. Acrosin activity from normozoospermic and oligo-asthenozoospermic
      men was also compared and was significantly (P < 0.01) higher for the
      normozoospermic group. These data suggest that measurement of acrosin activity
      may be a valuable clinical laboratory assay for assessing the sperm fertilizing
      potential and that low acrosin activity is associated with abnormal semen
      characteristics.

PMID- 8473431
TI  - Lectin binding as a biological test in vitro for the prediction of functional
      activity of human spermatozoa.
AB  - Adequate acrosome reaction is one of the essential events that has to occur in
      successful mammalian fertilization. The purpose of the present study was to
      assess the acrosome reaction in human spermatozoa by means of iodine-labelled
      lectins concanavalin A and peanut agglutinin ([125I]Con A and [125I]PNA). Six
      sperm samples in the control (fertile) group were compared with 24 samples
      obtained from infertile patients. The acrosome reaction in both groups was
      induced in vitro by adding follicular fluid. Iodine-labelled lectins were bound
      to the sperm surface, and alteration in the binding capacity for [125I]PNA and
      [125I]Con A after induced acrosomal reaction was the main parameter for the
      prediction of acrosome reaction and fertilizing ability. It is hoped that with
      the availability of this test, in-vivo data may be accumulated.

PMID- 8473432
TI  - Development of embryos from natural cycle in-vitro fertilization: impact of
      medium type and female infertility factors.
AB  - Single embryos derived from natural cycle in-vitro fertilization (IVF) were
      graded during the pre-transfer culture period using morphological criteria. Most
      embryos developed well in culture with 96% showing continuing division and 68%
      showing good morphological appearance, although embryo quality tended to decline
      with an increased incidence of fragmentation and uneven cleavage as division
      proceeded. Both the pregnancy rate and the distribution of embryo grades were
      similar among four different culture media used, suggesting that choice of medium
      had little impact on outcome. In contrast, there were marked differences in
      pregnancy rate according to the type of infertility, which was not reflected in a
      decrease in embryo quality. However, although embryos from patients with tubal
      infertility implanted and formed viable pregnancies irrespective of morphological
      appearance, only 'good' quality embryos from patients with non-tubal (or
      'unexplained') infertility were able to implant. Thus the appearance of the
      embryo derived from natural cycle IVF in women with unexplained infertility may
      be of clinical relevance.

PMID- 8473433
TI  - Requirement of preimplantation human embryos for extracellular calmodulin for
      development.
AB  - The objective of this study was to investigate the requirement for calmodulin in
      the cell division of the early human preimplantation embryo. Experiments using
      three agents capable of inhibiting calmodulin activity, N-(6-aminohexyl)-5-chloro
      1-naphthalenesulphonamide (W7), W7 linked to agarose beads (W7-agarose) and
      calmodulin antibody, showed that W7 and calmodulin antibody arrested division of
      embryos in a dose-dependent manner. As W7 is able to penetrate the zona pellucida
      and enter the cells, calmodulin antibody can traverse the zona but not enter the
      cells and W7-agarose cannot traverse the zona, we have deduced that the
      calmodulin which appears relevant to embryo division may be both intracellular
      and intrazonal but not extrazonal. We conclude that calmodulin is specifically
      required for cell division in the early human preimplantation embryo and that the
      concentration of calmodulin surrounding the embryo within the zona is
      particularly important to embryo development.

PMID- 8473434
TI  - Steroid secretion by human early embryos in culture.
AB  - The ability of in-vitro fertilized human embryos to secrete oestradiol in culture
      in the presence of precursor androgen was demonstrated in four independent
      cultures. Varying amounts of oestradiol were detected and secretion was observed
      as early as days 5-8 post-fertilization. The pattern of human chorionic
      gonadotrophin secretion was similar to oestradiol secretion for individual
      embryos. In one additional culture, secretion of oestradiol and progesterone was
      observed.

PMID- 8473435
TI  - In-vitro development of in-vivo produced rhesus monkey morulae and blastocysts to
      hatched, attached, and post-attached blastocyst stages: morphology and early
      secretion of chorionic gonadotrophin.
AB  - The earliest time of secretion of chorionic gonadotrophin (CG) by primate embryos
      and its role during preimplantation development and implantation are not clearly
      determined. We cultured in-vivo fertilized/developed zona-intact, morphologically
      normal morulae (n = 11) and early blastocysts (n = 11), freshly recovered (by non
      surgical uterine flushing) on days 5 and 6 of pregnancy, respectively (day 0 =
      the day following LH surge), from non-superovulated naturally bred rhesus monkeys
      (Macaca mulatta). Embryos were cultured for a minimum of 24 days in dishes
      containing 1 ml of CMRL-1066 supplemented with 20% bovine fetal serum in a
      humidified atmosphere of 5% CO2 in air at 37 degrees C. The culture medium was
      changed every 48 h. The percentage of hatched blastocysts, developed from morulae
      and early blastocysts, was 90.9; elapsed times (mean +/- SEM) were 67.8 +/- 4.4 h
      (morula) and 37.8 +/- 3.6 h (blastocyst). The minimum number of Hoechst-stained
      cells/hatched blastocyst was 531. The mean diameter (+/- SEM) of cultured embryos
      increased from 180 microns at the beginning of culture to 374 +/- 28 and 450 +/-
      19 microns at the fully expanded and hatched blastocyst stages, respectively.
      Hatched blastocysts continued to expand (maximum diameter: 1125 +/- 25 microns);
      after an additional 94-96 h they attached firmly to the serum-coated dishes and
      produced highly proliferating multinucleate trophectodermal cells, extending to a
      maximum diameter of 2-6 mm by 11-21 days of culture. Biologically active CG in
      embryo-grown, serial spent media samples was measured in a mouse Leydig cell
      bioassay.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473436
TI  - Mouse embryo cleavage, metabolism and viability: role of medium composition.
AB  - The cleavage, metabolism and viability of mouse zygotes were assessed after
      culture in media of different ionic and metabolite composition. Medium with a
      high potassium concentration, characteristic of mammalian oviduct fluid,
      inhibited cleavage and blastocyst formation (P < 0.01). This inhibition was
      partially alleviated by the removal of phosphate, and subsequently abolished by
      supplementation with amino acids, vitamins, insulin, epidermal growth factor and
      transferrin (AVIET). Glucose uptake by cultured blastocysts, measured
      fluorimetrically, was not affected by the ionic or metabolite composition of the
      medium, but was significantly reduced by the inclusion of AVIET (P < 0.01).
      Lactate production was also significantly reduced in the presence of AVIET (P <
      0.01). Calculations of metabolic activity revealed that embryos cultured in the
      presence of AVIET had a glycolytic activity similar to embryos developed in vivo.
      In contrast, embryos cultured in conventional embryo culture media exhibited an
      elevated glycolytic activity. Culturing embryos for 4 days in a reduced lactate
      concentration (4.79 mM), significantly increased fetal development after
      transfer, compared with embryos cultured in the concentration of lactate present
      in conventional embryo culture media (23.3 mM; P < 0.01). In contrast, when
      embryos were transferred on day 3 of culture, significantly more fetuses were
      obtained from embryos cultured in high levels of lactate (P < 0.01).
      Supplementation of medium with AVIET significantly increased resultant fetal
      weights after transfer (P < 0.05). This study demonstrates that different media
      are required to maintain embryo viability on successive days of culture, and
      highlights the potential limitations of employing simple salt solutions for the
      culture of preimplantation mammalian embryos.

PMID- 8473437
TI  - Preimplantation diagnosis of aneuploidy using fluorescent in-situ hybridization:
      evaluation using a chromosome 18-specific probe.
AB  - Fluorescent detection of in-situ hybridization (FISH) with a chromosome 18
      specific probe (P5041 B.5 D18Z1) has been used to assess the use of this method
      for preimplantation diagnosis of aneuploidy. Interphase nuclei (n = 802) have
      been analysed from 59 normally fertilized embryos developing in vitro at the
      normal rate between days 2 and 7 postinsemination. The efficiency of
      hybridization in control cells, as assessed by the proportion with two signals in
      normal female lymphocytes was 88.9% (n = 353) and with three signals in a
      trisomic (48,XXX+18) fibroblast cell line 74.0% (n = 290). Fifty-four of the
      human embryos were considered to be diploid on the basis that the majority of
      nuclei had two signals. Some nuclei in these embryos had one or no signal,
      especially on day 2, and tetraploid nuclei were also widespread. Among the
      remaining five embryos, one 5-cell embryo on day 2 had three hybridization
      signals in 4/5 nuclei and was trisomic for chromosome 18, one 4-cell embryo on
      day 2 had only one signal in 4/4 nuclei and was monosomic, and the three other
      embryos were aneuploid mosaics and/or had multi-nucleated blastomeres. Analysis
      of the incidence of interphase nuclei with more or less than the diploid number
      of hybridization signals indicates that more than a single nucleus will be
      necessary for accurate preimplantation diagnosis of aneuploidy.

PMID- 8473438
TI  - Diagnosing sphingolipidoses in murine and human embryos.
AB  - The aim of this study was to diagnose lipid storage diseases in embryos at the
      preimplantation stage. Two parallel approaches were employed. Firstly, activities
      of several sphingolipid hydrolases were determined in extracts of murine embryos
      and also human oocytes and polyspermic embryos. Sensitive fluorescent or
      fluorogenic procedures provided indications that Tay-Sachs, Gaucher and Krabbe
      diseases might be diagnosed in one human blastomere, while for Niemann-Pick
      disease two might be required. Secondly, pyrene lipids were administered into
      murine embryos and their fluorescence was quantified by computerized imaging
      microscopy. As a model of Gaucher disease, the fluorescent substrate pyrene
      glucosylceramide was administered into murine embryos in the presence or absence
      of an inhibitor of the enzyme beta-glucosidase. Because of decreased degradation
      of the substrate in enzyme-inhibited cells, the fluorescence per blastomere was
      considerably greater relative to those which received no inhibitor. The results
      indicated that lipid storage diseases might be diagnosed in single human
      blastomeres at the preimplantation stage, obviating the need for pre-natal
      diagnosis and abortion of affected foetuses.

PMID- 8473439
TI  - Anti-endometrial and anti-endothelial auto-antibodies in women with
      endometriosis.
AB  - The present study investigates the specificity of anti-endometrial antibodies
      present in serum of women with endometriosis. A two colour indirect immuno
      histochemical method was used, so that the antigenic reactivity of endogenous
      immunoglobulins was blocked and specific anti-endometrial antibodies were readily
      distinguishable. Serum was collected from women with endometriosis, before and
      after 6 months of treatment, and from women without the disease. The reactivity
      of serum with uterine and ectopic endometrium from women with and without the
      disease was studied. The frequency of anti-endometrial antibodies in the serum of
      women with endometriosis was higher (P < 0.001) than in control sera. Most
      antibodies specifically reacted with glands in ectopic and uterine endometrium.
      Antibody reactivity was strongest with endometrium from control women, compared
      with uterine and ectopic endometrium from women with endometriosis (P < 0.01). A
      proportion of sera containing anti-endometrial antibodies also reacted with
      vascular endothelium. Binding was strongest to vessels in uterine and ectopic
      endometrium from women with endometriosis compared to endometrium from women
      without the disease (P < 0.01). The presence of anti-endometrial antibodies was
      associated with infertility.

PMID- 8473440
TI  - Endocrinology of in-vitro fertilization pregnancies during the first trimester.
AB  - The endocrine function of the corpus luteum and placenta and the inter
      relationships between ovarian steroids and the placental proteins in pregnancies
      achieved following ovarian stimulation, in-vitro fertilization and embryo
      transfer (IVF-ET) have been investigated. The serum concentrations of human
      chorionic gonadotrophin (HCG), Schwangerschaft protein-1 (SP-1), pregnancy
      associated plasma protein A (PAPP-A), progesterone and oestradiol were measured
      at weekly intervals between the 4th (ET plus 2 weeks) and 14th week of gestation
      in 86 pregnancies. The mean concentrations of the placental proteins and
      oestradiol were significantly higher in twin than in singleton pregnancies from
      as early as 5 weeks gestation, but the mean concentrations of progesterone were
      significantly higher only at the end of the first trimester. Ranking, as
      demonstrated by the presence of statistically significant correlations between
      serum levels of each substance analysed in week 13 with those of preceding weeks,
      was established for progesterone and SP-1 from the 5th week, for oestradiol and
      PAPP-A from the 7th week and for HCG from the 8th week of gestation. The presence
      of statistically significant correlations between each substance analysed
      suggests that the placenta becomes the dominant source of oestradiol from 8 weeks
      gestation and of progesterone not until 12 weeks gestation, and that the
      placental synthesis of HCG, SP-1, PAPP-A, oestradiol and progesterone appear to
      be linked. There were no statistically significant correlations between the serum
      concentrations of HCG and either progesterone or oestradiol until the production
      of each had become predominantly placental.

PMID- 8473441
TI  - Circulating placental protein 14: in the first trimester of spontaneous and IVF
      pregnancies.
AB  - Circulating placental protein 14 (PP14) levels were measured during the first
      trimester in three groups of pregnant women: (i) natural conception (n = 15);
      (ii) pituitary desensitization with buserelin and ovarian stimulation with human
      menopausal gonadotrophin (HMG) followed by in-vitro fertilization and embryo
      transfer (IVF-ET) (n = 15); and (iii) ovarian stimulation with clomiphene citrate
      and HMG, followed by IVF-ET (n = 16). A 7- to 8-fold increase in serum PP14
      levels was observed in normal pregnancies between weeks 4 and 10. This increase
      was earlier and less marked in group (ii) and absent in group (iii). These
      findings support the concept that endometrial function is altered in pregnancies
      achieved following ovarian stimulation. Alternatively, if the ovary is an
      important source of PP14, then these data suggest that in contrast to ovarian
      synthesis of steroids and the peptide relaxin, ovarian stimulation results in an
      impairment of PP14 synthesis, and that this is most marked when clomiphene
      citrate has been used.

PMID- 8473442
TI  - Relationship of biochemical pregnancy to pre-ovulatory endometrial thickness and
      pattern in patients undergoing ovulation induction.
AB  - In order to assess the relationship between pre-ovulatory endometrial thickness
      and pattern and biochemical pregnancy, the pregnancy outcome was retrospectively
      analysed in 81 patients undergoing ovulation induction evaluated by vaginal
      ultrasound on the day of human chorionic gonadotrophin (HCG) administration or
      luteinizing hormone (LH) surge. Biochemical pregnancies occurred in 7/32 (21.9%)
      pregnancies when endometrial thickness was < 9 mm, compared to 0/49 when
      endometrial thickness was > or = 9 mm on the day of HCG administration or LH
      surge (P < 0.0025). Clinical abortions occurred in 5/32 (15.6%) pregnancies when
      endometrial thickness was 6-8 mm, compared to 6/49 (12.2%) when endometrial
      thickness was 6-8 mm (NS). Endometrial thickness was related to the cycle day of
      HCG or LH surge (r = 0.37, P < 0.001) but was unrelated to oestradiol level on
      the day of HCG administration or LH surge (r = 0.12). Biochemical pregnancies
      were related to endometrial pattern (r = -0.22, P = 0.02) but were unrelated to
      maternal age or previous abortions. Clinical abortions were related to age (r =
      0.26, P = 0.01) and to previous abortion (r = 0.25, P = 0.013) but were unrelated
      to endometrial pattern. Neither biochemical pregnancy nor clinical abortion was
      related to oestradiol or LH levels on the day of HCG administration or LH surge.
      These findings suggest that the majority of biochemical pregnancies do not result
      from karyotypically abnormal embryos, as do clinical abortions.

PMID- 8473443
TI  - Ultrasound evidence for variability in the size and development of normal human
      embryos before the tenth post-insemination week after assisted reproductive
      technologies.
AB  - Differences in human chorionic gonadotrophin (HCG), average chorionic sac
      diameter, embryo/fetus crown-rump length and biparietal diameter were determined
      in 107 singleton pregnancies delivered after 34 weeks, whose post-insemination
      age was precisely known as a result of in-vitro fertilization (n = 28) or gamete
      intra-Fallopian transfer (n = 79). Crown-rump lengths were interpreted in
      relation to the developmental stage of the embryo. A 7-fold to 10-fold difference
      in HCG levels was observed on post-insemination days 13-16. A 2-fold to 3-fold
      difference occurred in average chorionic sac diameter on days 25-36. A 2-fold
      difference occurred in crown-rump length on seven of 10 days prior to day 44.
      Biparietal diameter differed by no more than 42% from day 57-68 and 20% after day
      68. Chorionic sac diameter, crown-rump length, and biparietal diameter were also
      related to newborn weight. The results suggest firstly that marked differences
      occur in the rate of early human development, secondly, that the differences
      occur prior to day 27 when observable cardiac activity begins, and thirdly, that
      the differences are minimized after day 68 when the embryonic period of
      development is completed.

PMID- 8473444
TI  - Successful triplet pregnancy in a patient with a unicornuate uterus with a
      cavitary communicating rudimentary horn.
AB  - In a patient with primary infertility, ovulation was induced by monitored
      stimulation with human menopausal gonadotrophins (HMG) because of polycystic
      ovarian disease. Infertility work-up had shown a unicornuate uterus with a
      cavitary communicating rudimentary horn. The husband showed a varicocele-related
      moderate oligo-asthenoteratozoospermia. A triplet pregnancy occurred in a third
      HMG ovulation induction cycle combined with intra-uterine insemination of the
      husband's washed semen. The pregnancy was carefully monitored, and measures to
      prevent premature delivery were taken. Because of the patient's obvious
      discomfort in the presence of premature labour, Caesarean section was performed
      at 33 weeks gestation and three healthy infants were delivered. This is the first
      report of a successful triplet pregnancy in a women with a unicornuate uterus.
      The reproductive and obstetric outcome of this condition in general, and in the
      case of multiple pregnancy, is discussed.

PMID- 8473445
TI  - The techniques and complications of out-patient uterine washing in the assessment
      of endometrial function.
AB  - The complications of a consecutive series of 90 uterine washings performed among
      52 women were studied. The amount of discomfort was significantly less than that
      of endometrial biopsy but greater than that of cervical smear or blood sampling.
      Incomplete recovery of fluid (< 8 ml from 10 ml flushing fluid) was reported in
      only 3% of cases. Vaginal bleeding, pelvic infection and delayed abdominal pain
      were not encountered. The techniques of uterine washing are simple and may have
      important implications in the study of endometrial function.

PMID- 8473446
TI  - Management of suboptimal sonographic endometrial patterns in patients undergoing
      in-vitro fertilization and embryo transfer.
AB  - A total of 816 women who underwent 1332 cycles of ovarian stimulation for in
      vitro fertilization and embryo transfer (IVF/ET) had sonographic assessments of
      the endometrium within 2 days of oocyte retrieval. Endometrial linings were
      classified on the basis of thickness and echogenicity, using a grading system
      described previously. Grades I and IIB ('poor') were associated with a 6% viable
      pregnancy rate (advanced beyond 12 weeks' gestation) compared with a 29% rate for
      Grade IIA ('optimal'). In a subset of 112 women with poor endometrial linings
      during natural cycles, eight out of 21 women (38%) under 40 years of age
      developed optimal linings following ovarian stimulation with menotrophins, while
      19 out of 91 women (21%) aged 41-45 years converted to optimal linings. Twenty
      two out of 47 women (44%) who failed to develop optimal endometrial linings
      following ovarian stimulation converted to Grade IIA during subsequent cycles of
      exogenous oestrogen replacement. The financial, emotional, and physical burden
      associated with IVF/ET demands that patients with poor endometrial linings
      following ovarian stimulation with menotrophins be counselled with regard to
      either cancelling their cycles of treatment, or having their embryos
      cryopreserved for transfer to the uterus during a subsequent hormonal replacement
      cycle.

PMID- 8473447
TI  - Treatment with naltrexone in hypothalamic ovarian failure: induction of ovulation
      and pregnancy.
AB  - Sixty-six women suffering from various grades of hypothalamic ovarian failure
      were treated with the opiate antagonist naltrexone at doses ranging from 25 to
      150 mg per day. This treatment resulted in complete normalization of the
      menstrual cycle in 49 of 66 patients, as indicated by the pattern of circulating
      levels of gonadotrophins and ovarian steroids. Five patients failed to respond,
      three of whom were suffering from primary hypothalamic amenorrhoea. In patients
      who responded to the administration of naltrexone, there was a dramatic increase
      in the amplitude and frequency of gonadotrophin pulses, reflecting disinhibition
      of the hypothalamic gonadotrophin-releasing hormone (GnRH) pulse generator.
      Eighteen pregnancies were achieved in 16 women who were also treated for
      infertility, resulting in a cumulative pregnancy rate closely resembling that of
      a normal population. There were only minor side-effects that could be attributed
      to the drug. These data demonstrate that chronic administration of an opiate
      antagonist will normalize ovarian function in women suffering from different
      grades of hypothalamic ovarian failure. The data therefore support the view that
      suppression of the activity of the hypothalamic pulse generator, that directs
      GnRH release, is mediated by endogenous opioids. Also, that hypothalamic ovarian
      failure is the consequence of an inappropriate increase in opioid tone impinging
      on neurons that release GnRH in a pulsatile manner into the pituitary portal
      circulation.

PMID- 8473448
TI  - Endocrine changes and clinical outcome after laparoscopic ovarian resection in
      women with polycystic ovaries.
AB  - Ovarian laparoscopic resection was applied to 23 sterile patients affected with
      polycystic ovarian disease (PCOD) resistant to different pharmacological
      treatments, in order to induce ovulation. After resection, 56% of the patients
      had spontaneous ovulatory cycles and 13 pregnancies arose. Ten of the pregnancies
      were spontaneous and three followed treatment with clomiphene. Hormone changes
      were assessed in 15 patients, including five with spontaneous menstruation but
      without ovulation and five with persistent amenorrhoea for 3 months after
      resection. A significant decrease in both androstenedione and testosterone levels
      occurred in all patients. These decreases were not related to the clinical
      results of resection. Luteinizing hormone (LH) did not vary greatly in any group
      after resection. Mean values and mean pulsatility of follicle stimulating hormone
      (FSH) increased significantly only in pregnant patients or those with spontaneous
      ovulatory cycles. The results of gonadotrophin-releasing hormone (GnRH) assays
      did not change after resection. The mechanisms involved in the resumption of
      cyclic function of the hypophyseal-ovarian axis after resection are discussed
      briefly.

PMID- 8473449
TI  - Sandostatin has no direct effect on ovarian steroidogenesis in vitro.
AB  - Rat granulosa and theca-interstitial cells from immature, oestradiol-treated rats
      were isolated and incubated for 144 h with follicle stimulating hormone (FSH),
      luteinizing hormone (LH), insulin alone or in combinations, and with two doses of
      sandostatin (10(-7) M and 10(-6) M per culture). Oestradiol and testosterone
      production by granulosa and theca-interstitial cells, respectively, was measured
      in culture media. The stimulatory effects of FSH alone and FSH with insulin but
      not insulin alone on oestradiol production by granulosa cells were observed.
      Similarly, increased testosterone concentrations after treatment with LH alone
      and LH with insulin but not insulin alone were found in media from theca
      interstitial cells. The addition of high or low doses of sandostatin to the
      cultures did not affect the production of oestradiol or testosterone. It was
      concluded that sandostatin does not exert any direct effect on ovarian
      steroidogenesis in vitro.

PMID- 8473450
TI  - Doubling the human menopausal gonadotrophin dose in the course of an in-vitro
      fertilization treatment cycle in low responders: a randomized study.
AB  - The effect of doubling the human menopausal gonadotrophin (HMG) dose in the same
      treatment cycle in which the ovarian response after 5 days of ovarian stimulation
      with 225 IU/day is 'low', has been evaluated in a prospective randomized study.
      Forty-six patients met the ultrasound and oestradiol criteria for enrollment in
      the study, one patient participated twice. In 22 patients treatment was continued
      with 225 IU HMG/day and in 25 patients the HMG dose was increased to 450 IU/day.
      No effect of doubling the HMG dose was found on the length of the ovarian
      stimulation, peak oestradiol values, number of follicles > or = 11 and > or = 14
      mm in diameter respectively on ultrasound on the day of HCG administration,
      number of cancelled cycles, number of oocytes at follicular puncture and the
      number of patients with < or = 3 oocytes at retrieval. It is concluded that
      doubling the HMG dose in the course of an IVF treatment cycle is not effective in
      enhancing ovarian response in low responders. This is in accordance with current
      theories on follicular growth, which state that follicular recruitment occurs
      only in the late luteal and early follicular phase of the menstrual cycle.

PMID- 8473451
TI  - Is the measurement of oestradiol/progesterone ratios in the peri-implantation
      period of any value in predicting endometrial development?
AB  - To examine the value of the measurement of oestradiol/progesterone ratios in the
      peri-implantation period, three different types of cycle were studied; natural
      cycles (n = 13), cycles treated with anti-oestrogens (n = 19), and artificial
      cycles (n = 41) produced by six different hormone replacement regimens. Normal
      endometrial development was found to occur across a wide range of
      oestradiol/progesterone ratios. There was no significant correlation between the
      oestradiol/progesterone ratios and results of endometrial dating. The results
      suggest that oestradiol/progesterone ratios are of limited value in predicting
      endometrial development at the time of implantation.

PMID- 8473452
TI  - Impact of gonadotrophin dose on pre-embryo recovery and development in
      superovulated mice.
AB  - A dose-response analysis was performed by stimulating mice with Humegon, which
      contains approximately equal amounts of follicle stimulating hormone (FSH) and
      luteinizing hormone (LH). The effect of increasing stimulation was assessed by
      monitoring the number and developmental stages of pre-embryos flushed from the
      tubes, and the developmental potency of these pre-embryos after culturing for 72
      h. Increasing the stimulation doses resulted in an increased recovery of 2-cell
      pre-embryos. A maximal plateau of 40-50 2-cell pre-embryos was reached after
      stimulation with 15-30 IU FSH/LH. Higher stimulation doses up to 50 IU FSH/LH
      showed no further increase in pre-embryo recovery. Increased stimulation doses
      did not affect the number of 1-cell pre-embryos or the number of pre-embryos
      which developed further than the 2-cell stage. An average of 88 +/- 1.7% of the
      flushed pre-embryos were 2-cell pre-embryos. The fraction of flushed pre-embryos
      which developed into blastocysts after 72 h of culturing was constant at all
      stimulation doses, with an average of 81 +/- 1.9%. A maximal plateau of 35-40
      blastocysts was reached after stimulating with 15-30 IU FSH/LH. The group of pre
      embryos at less advanced developmental stages and the group of degenerated pre
      embryos showed a small but dose dependent increase in number. In conclusion, we
      found that increasing doses of Humegon resulted in an increased recovery of pre
      embryos capable of preimplantation development. This increased recovery occurred
      despite the high level of LH contained in this FSH/LH stimulation.

PMID- 8473453
TI  - A prospective randomized comparison of levonorgestrel with the Yuzpe regimen in
      post-coital contraception.
AB  - A prospective randomized study was conducted at the Family Planning Association
      of Hong Kong to compare the efficacy of the Yuzpe regimen and levonorgestrel
      (0.75 mg for two doses 12 h apart) in post-coital contraception. A total of 424
      subjects were recruited into the Yuzpe group and 410 subjects into the
      levonorgestrel group; 77 subjects in the Yuzpe group and 79 subjects in the
      levonorgestrel group had further acts of intercourse during the treatment cycle.
      Fifteen pregnancies (3.5%) occurred in the Yuzpe group and 12 pregnancies (2.9%)
      in the levonorgestrel group. After excluding the patients who had further acts of
      intercourse, the failure rates in the Yuzpe group and the levonorgestrel group
      were 2.6 and 2.4% respectively. The incidence of nausea, vomiting and fatigue in
      the Yuzpe group was significantly higher than those in the levonorgestrel group.
      We conclude that levonorgestrel is an effective drug for post-coital
      contraception with a lower incidence of side-effects than the Yuzpe regimen.

PMID- 8473454
TI  - Improvement of clinical pregnancy rate and implantation rate of in-vitro
      fertilization-embryo transfer patients by using methylprednisone.
AB  - A prospective non-randomized study was undertaken to test whether
      immunosuppression improves implantation and pregnancy rates in an in-vitro
      fertilization-embryo transfer (IVF-ET) programme in patients with tubal factor
      infertility. Treatment involved ovarian stimulation, transvaginal oocyte
      retrieval, IVF-ET, and assessment of short-term administration of large doses of
      corticosteroids (60 mg of methyl-prednisone x 4 days). When compared to the group
      that did not receive immunosuppressive doses of methylprednisone (group A; mean
      age 31.85 +/- 4.09 years), those subjects who were treated (group A2) showed a
      statistically significant increase in pregnancy (P < 0.01) and take home baby
      rate (P < 0.01). Similar results were observed in subjects who received
      corticosteroids in their first IVF-ET attempt (group B; mean age 34.32 +/- 4.98
      years). Our results suggest that immunosuppressive doses of corticosteroids
      administered for a short period of time to patients undergoing IVF-ET could
      significantly improve the implantation and pregnancy rates. Possible mechanisms
      of action of corticosteroids are proposed.

PMID- 8473455
TI  - Psychosocial impacts of infertility on Greek couples.
AB  - Psychosocial impacts of infertility were investigated in couples undergoing
      different treatment procedures in our clinic. Couples were interviewed in a semi
      structured way by a psychologist or a psychiatrist and responded to three
      specially structured questionnaires: the Life Events Scale, the Marlowe
      Crowne/Taylor Scale and the Side Effect Checklist. The data were analysed in
      terms of demographic characteristics as well as treatment procedure. The
      psychosocial, psychosexual and emotional outcomes of their infertility problem
      and Greek traditional culture laws are discussed. Stress has been identified in
      both sexes, depression mostly in women, while men showed a tendency towards
      repressed anxiety and thus a greater risk of psychosomatic illness, a finding
      supported by their response to the Side Effect Checklist. Women showed a high
      defensive anxiety and also reported numerous psychosomatic symptoms. These
      couples seem to have special needs and fears, both general and treatment
      specific. Very few of our couples would be considered as severely emotionally
      disturbed. Women seem to have more difficulties in social adjustment. Sexual
      dysfunction was reported by almost half of our subjects, although this was
      associated with a degree of deterioration in their marriage. Guilt feelings,
      particularly connected with previous abortions, seem to be torturing most women.
      Finally, both partners seem to have psychological problems irrespective of the
      one in whom the aetiological problem was found. Moreover, traditional rules seem
      to impose a special burden on people coming from rural areas. Our results
      strongly support the belief that infertile couples undergoing different
      treatments need psychological counselling and supportive psychotherapy.

PMID- 8473456
TI  - Characterization of abnormal one pronuclear human oocytes by morphology,
      cytogenetics and in-situ hybridization.
AB  - The morphology, chromosomal constitution and developmental capability of abnormal
      human oocytes (94/3500 oocytes; 2.7%) which after insemination exhibited only one
      pronucleus were examined. The majority of one pronuclear oocytes exhibited two or
      more distinct polar bodies. Dividing oocytes showed irregular chromosome
      distribution from haploid to diploid. Embryos resulting from abnormal oocytes
      displayed limited developmental potential. Many of them underwent fragmentation
      or were arrested at the 2- or 8-cell stage of development, and only some reached
      the morula or blastocyst state (11/35 oocytes). In approximately 45% (15/33) of
      examined oocytes, decondensed sperm heads or tiny nucleus-like structures were
      found in addition to a single nucleus. Chromosome Y was also detected in
      chromosomal preparations in approximately 10% of the oocytes by in-situ
      hybridization utilizing the human Y chromosome-specific DNA probe (DYZ3). These
      observations provided strong evidence that many of these oocytes originated from
      fertilized oocytes. The origin of the other one pronuclear oocytes could not be
      determined. Parthenogenetic activation of some oocytes cannot be excluded and
      other explanations concerning the origin of abnormal oocytes are discussed.

PMID- 8473457
TI  - Tumour necrosis factor alpha and interleukin 2 in normal and infected human
      seminal fluid.
AB  - The presence of cytokines such as the tumour necrosis factor alpha (TNF alpha)
      and interleukin 2 (IL2) in human spermatozoa is still to be defined. The aim of
      this study was to measure the concentration of both soluble factors in seminal
      fluid. Data from normal semen samples (n = 24) confirmed the presence of IL2 (258
      +/- 84 fmol/ml corresponding to 953 +/- 369 fmol/total volume of ejaculate) and
      TNF alpha (62.2 +/- 16.4 fmol/ml corresponding to 231.3 +/- 86 fmol/total volume
      of ejaculate). A significant positive correlation (r = 0.59; P < 0.01) was
      observed between the TNF alpha and the IL2 concentrations. The concentrations of
      these cytokines were not related to sperm parameters. In contrast, IL2
      concentrations (196.9 +/- 60.4 fmol/ml; 686.2 +/- 236.7 fmol/total volume of
      ejaculate) evaluated in 16 seminal fluids with identified bacterial agents were
      lower than in the control group, whereas TNF alpha concentrations (68.6 +/- 12.3
      fmol/ml; 241.3 +/- 78.9 fmol/total volume of ejaculate) were not significantly
      different from the controls. Further studies are needed to determine the
      potential role of these cytokines in the physiology of semen and their usefulness
      as indicators of reproductive pathology.

PMID- 8473458
TI  - Acrosome reactivity in spermatozoa of different morphology in response to
      stimulation with follicular fluid.
AB  - The ability of the morphologically abnormal spermatozoon to undergo the processes
      necessary for fertilization is unknown; one of the essential processes is the
      acrosome reaction. In order to assess this, spermatozoa from 10 known fertile
      donors were incubated with either follicular fluid or Earle's medium containing 3
      mg/ml bovine serum albumin at 37 degrees C for 6 h. The spermatozoa were then
      stained with 2% Trypan Blue prior to being fixed in glutaraldehyde and stained
      for the presence of the acrosomal cap using the triple stain. Fifty live
      spermatozoa in each of four morphological categories (normal head, large head,
      small head, abnormal neck or tail) were examined and the number of acrosome
      reacted spermatozoa determined. There was a significant difference between the
      morphological groups in the baseline number of acrosome-reacted spermatozoa,
      determined by examining sperm samples incubated in Earle's medium; however, the
      number of spermatozoa undergoing the acrosome reaction in response to stimulation
      with follicular fluid (i.e. the number of spermatozoa acrosome-reacted in
      follicular fluid minus the number acrosome-reacted in Earle's medium) was similar
      for all morphological groups. This suggests that abnormal sperm morphology did
      not affect the response of spermatozoa to activation of the acrosome reaction by
      exogenous stimuli.

PMID- 8473459
TI  - Ultrastructural observations on the entry of Chlamydia trachomatis into human
      spermatozoa.
AB  - Chlamydia trachomatis infections are an important problem in human reproduction
      and family planning. In this study, the significance of chlamydial infection in
      male infertility and artificial insemination has been investigated. Electron
      microscope observations on male ejaculates have revealed the presence of the
      elementary and reticulate body forms of C.trachomatis in spermatozoa.
      Furthermore, the entry of the elementary body into the human spermatozoon head
      has been demonstrated. After the passage of the infectious elementary body into
      the nucleus, all stages of reticulate body formation in the head of the
      spermatozoon were detected. According to ultrastructural findings, C.trachomatis
      not only adhered to but also penetrated into the tail structure. Thus two
      different functional and morphological forms of C.trachomatis can infect and be
      transmitted by spermatozoa and may cause infertility.

PMID- 8473460
TI  - Two pregnancies after in-vitro fertilization with spermatozoa from alloplastic
      spermatocoeles.
AB  - Two case reports describe successful in-vitro fertilization (IVF) of oocytes of
      two 28-year-old women with epididymal spermatozoa aspirated from alloplastic
      spermatocoeles of the husbands. Both men suffered from complete ejaculatory
      failure, which was caused by paraplegia in the first and by radical surgery of an
      embryonic carcinoma of the testis in the second. Motile spermatozoa were
      aspirated in the first case 4 months after implantation of the spermatocoele, and
      in the second at 1 month. For the first couple, IVF treatment led to a singleton
      pregnancy; the child has since been born. In the second couple, IVF treatment
      resulted in a twin pregnancy, with intra-uterine abortion of one gestational sac.
      The resulting singleton pregnancy is still ongoing.

PMID- 8473461
TI  - Synergistic effect of TEST--yolk buffer treatment and glass wool filtration of
      spermatozoa on the outcome of the hamster oocyte penetration assay.
AB  - Enhanced penetration of zona-free hamster oocytes occurs after spermatozoa have
      either been treated with TEST--yolk buffer or processed by glass wool filtration.
      The present study was conducted to determine if a synergistic effect on
      fertilizing ability could be achieved by combining these two treatments.
      Ejaculates (n = 16) were treated with TEST--yolk buffer (TYB) and divided into
      two aliquots. One aliquot was kept as control and the other aliquot was filtered
      through glass wool prior to the sperm penetration assay. The TYB--glass wool
      filtered spermatozoa penetrated a significantly higher percentage of oocytes than
      the TYB treated spermatozoa.

PMID- 8473462
TI  - Purification of a factor from human peritoneal fluid that is able to immobilize
      spermatozoa.
AB  - Human peritoneal fluid has been claimed to influence sperm motility. This report
      gives evidence for the presence in midcycle peritoneal fluid of a protein-bound,
      lipidic (hydrophobic) component able to immobilize spermatozoa as a function of
      time. This component was extracted from molecular weight-sieving and ion
      exchange/high pressure liquid chromatography (HPLC)-purified peritoneal fluid
      fractions by either chloroform/methanol or charcoal treatments; resuspension of
      the chloroform/methanol extract with BWW-buffer and subsequent testing on
      spermatozoa resulted in sperm immobilization. Sequential or step-down
      chromatographic procedures (molecular weight-sieving-->cation-exchange-->anion
      exchange HPLC separations of native peritoneal fluid) and extensive dialysis
      against double distilled water allowed the purification of the sperm immobilizing
      factor, as evidenced by the shorter incubation times necessary for sperm
      immobilization. Furthermore, the active fraction was found to immobilize
      spermatozoa without affecting its viability. Separation of the
      chloroform/methanol extracted immobilizing fraction on thin layer chromatography
      under conditions for phospholipid detection allowed the identification of a
      characteristic band which, after re-extraction, was found to be the sperm
      immobilizing substance. This factor does not contain choline, ethanolamine or
      serine. These results suggest that some lipidic peritoneal fluid components may
      influence sperm motility.

PMID- 8473463
TI  - The effect of three anti-oestrogen drugs on cervical mucus quality and in-vitro
      sperm-cervical mucus interaction in ovulatory women.
AB  - The anti-oestrogens, clomiphene citrate, tamoxifen and cyclofenil are commonly
      used in the treatment of female infertility. Their role in the management of
      anovulation is well established but there is continuing controversy about their
      relevance to other areas of management. We have studied the effects of each of
      these drugs on cervical mucus and sperm-cervical mucus interaction among 23
      patients with unexplained infertility. Each patient received all three drugs in
      an alternative month treatment regime and in addition acted as her own control.
      The starting point in each patient was randomized. Luteinizing hormone (LH) and
      oestradiol were measured daily from day 10, and follicle scanning was also
      undertaken. Cervical mucus quality and sperm-cervical mucus interaction were
      studied on the day of onset of the LH surge. The use of clomiphene and tamoxifen
      resulted in a significant reduction in cervical mucus score and sperm-cervical
      mucus interaction as judged by the distance travelled by the vanguard
      spermatozoa. Cyclofenil had no effect on these parameters.

PMID- 8473464
TI  - Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy--a
      prospective study.
AB  - A prospective study was conducted on the incidence of intra-uterine pathology
      diagnosed by hysteroscopy in 147 women who underwent dilatation and sharp
      curettage due to spontaneous first trimester abortion. The diagnostic
      hysteroscopies were performed 4-6 weeks after the miscarriage, using CO2 as
      medium for uterine distention. In 38 patients (25.9%), uterine pathology was
      found, of whom 28 patients (19%) had intra-uterine adhesions (IUA). The incidence
      of IUA following only one abortion was 16.3% (16 out of 98 cases), all were of
      mild extent and filmy consistency, occupying less than one-quarter of the uterine
      cavity. The incidence of IUA after two abortions was 14% (3/21) but the incidence
      after three or more spontaneous abortions was significantly elevated (32%, 9/28),
      (P < 0.05, chi-square test). In addition, 58% of IUA diagnosed in the latter two
      groups were of a more severe extent. After a first miscarriage, occurrence of
      post-abortion IUA was not related to the serum oestrogen concentration on the day
      of curettage, nor was it related to any of the oestrogen treatment modalities
      used in this study. Although in most of these cases normal recovery of the
      endometrium was the rule, the high incidence of IUA diagnosed in this prospective
      study stresses the need for preventive treatment and close follow-up of patients
      after sharp curettage due to spontaneous abortion. Obviously oestrogen treatment
      alone did not prove to be effective and other treatment methods should be
      evaluated. The high incidence and severity of IUA in habitual aborters clearly
      justifies the performance of a diagnostic hysteroscopy as a standard evaluation.

PMID- 8473465
TI  - Transcervical falloposcopy: preliminary experience.
AB  - The new technique of endoluminal tubal exploration was evaluated by performing
      transcervical falloposcopy instead of chromoperturbation under control of
      concurrent laparoscopy. In this feasibility study, catheterization was performed
      with the use of either a transhysteroscopic or a free-hand tubal cannulation
      technique. A total of 66 patients were investigated for primary or secondary
      infertility with proximal and/or distal suspected tubal defects on the basis of
      prior hysterosalpingography; three patients were investigated for unruptured
      tubal pregnancy; two patients were investigated to localize the tip of the tubal
      embryo transfer catheter. Transcervical catheterization was successful in 110 of
      the 130 tubes (84.6%). Successful and informative falloposcopy was achieved in
      30% of the 110 cannulated tubes. The transcervical free-hand cannulation
      technique was as effective as the transhysteroscopic approach. Recanalization of
      at least one tube was achieved in 83% of women with proximal obstruction. Tubal
      cannulation by the tubal embryo transfer catheter was confirmed by falloposcopy
      in the two cases where free-hand catheterization was used. This study confirms
      that it is possible to visualize the tubal lumen and demonstrates that the free
      hand cannulation technique is a simple and effective alternative to the
      transhysteroscopic approach. However, further progress in catheter technology has
      to be achieved in order to perform regularly successful transcervical
      falloposcopy in damaged tubes.

PMID- 8473466
TI  - Pre-operative gonadotrophin-releasing hormone agonist treatment in surgery for
      uterine leiomyomata.
AB  - To determine whether pre-operative treatment with gonadotrophin-releasing hormone
      (GnRH) analogue may have a beneficial effect on surgery outcome, 53 patients with
      symptomatic fibroid uteri awaiting myomectomy or transabdominal hysterectomy
      (TAH), were randomly divided into a study group (n = 29) and a control group (n =
      24). The study group of patients were treated by an i.m. injection of D-Trp6 LHRH
      microcapsules at 2 months and 1 month prior to surgery. The control group had no
      pre-operative treatment. Haemoglobin concentration and oestradiol, follicle
      stimulating hormone and luteinizing hormone concentrations were measured at 2
      months and 1 month prior to surgery, and at surgery. The duration of surgery was
      shorter in the study group (49 versus 70 min in the hysterectomy group) and intra
      operative blood loss was less (208 versus 309 ml in the hysterectomies and 320
      versus 476 ml in the myomectomies). Pre-operative treatment with GnRH-agonists
      which induces shrinkage of the uterus and fibroids is therefore efficient in
      shortening the duration of surgery, and diminishing the intra-operative blood
      loss in surgery for fibroid uteri. Such pre-operative treatment is therefore a
      useful addition to surgery in cases with symptomatic fibroid uteri.

PMID- 8473467
TI  - Sperm/egg binding patterns and oocyte cytology in retrospective analysis of
      fertilization failure in vitro.
AB  - Failures of fertilization in in-vitro fertilization have been often linked to
      visually recognizable defects in spermatozoa, and occasionally to anti-sperm
      antibodies. However, some total failures and the frequent lack of fertilization
      in some eggs of normal appearance (partial failure) often remain unexplained.
      Simple evaluation of the configuration of sperm binding to the zona pellucida and
      of the oocyte features revealed by acetic alcohol fixation and lacmoid staining,
      may provide diagnostic clues in this respect. Among 25 cases of unanticipated
      total failure, this approach identified some men with normal semen analyses whose
      spermatozoa displayed either a total inability to bind to the zona or, after
      binding, an inability to intrude into the zona matrix. However, in 10 of these
      cases significant numbers of spermatozoa were bound to and intruded deep into the
      zona, a pattern consistent with the possibility of an egg defect, specifically a
      resistance to the passage of spermatozoa past the inner portion of the zona
      pellucida. Such a block also appeared to be the main cause of fertilization
      failure among 442 unfertilized eggs from 154 partial failure patients. As in the
      total failures, the inability of apparently competent spermatozoa to penetrate
      the zona was often associated with ooplasmic anomalies (refractile bodies, extra
      groups of chromosomes, chromatin rings or masses, one or more pronuclei with one
      or no polar bodies, and other occasional anomalies). These anomalies occurred in
      79.4% of this unfertilized oocyte subset, in contrast to a 27.4% incidence in 238
      oocytes not fertilized because of sperm defects. Simple retrospective assessment
      of sperm binding patterns and oocyte cytology can be a valuable complement to
      semen analysis in diagnosis of fertilization failure in vitro.

PMID- 8473468
TI  - Zona opening with 308 nm XeCl excimer laser improves fertilization by spermatozoa
      from long-term vasectomized mice.
AB  - Spermatozoa from long-term vasectomized mice have greatly reduced fertilizing
      ability in vivo and in vitro, which makes this a useful animal model for male
      factor infertility. The purpose of this study was to evaluate the 308 nm XeCl
      excimer laser for opening the zona pellucida to enhance the fertilization rate
      with spermatozoa from vasectomized males. Inseminating zona-intact (control)
      oocytes with 5 x 10(6) spermatozoa/ml resulted in only 6% fertilization and 33.3%
      development to the blastocyst stage; zona-opened oocytes showed significant
      improvement with 31.5% fertilization, 90% cleavage to the 2-cell stage, and 72.2%
      blastocyst formation. Out of the 130 oocytes in the experimental group, zona
      ablation was performed successfully on 127 and only three were damaged. These
      results suggest that laser micromanipulation for assisted fertilization
      potentially offers a simplified and precise method for mechanical zona cutting.

PMID- 8473469
TI  - Repeated sperm injection under the zona following initial fertilization failure.
AB  - When fertilization fails following micromanipulative under-zona insemination, it
      is possible to repeat the procedure adding more spermatozoa to achieve
      fertilization, embryonic development and pregnancy. We report on 18 human in
      vitro fertilization cycles where this approach was used. In nine cycles only late
      fertilized embryos were available for transfer, and these gave rise to two viable
      pregnancies (22.2% per transfer). In six cycles, where a mixture of late- and
      timely fertilized embryos were available for transfer, two viable pregnancies
      arose (33.3% per transfer). In three cycles no fertilization was achieved even
      after reinsemination by repeated under-zona insemination.

PMID- 8473470
TI  - Cytogenetic sexing of mouse embryos.
AB  - Cytogenetic sexing by means of chromosome C-banding was carried out in 1/2 and
      2/4 biopsied mouse embryos. Chromosome spreads were obtained in 85.0% of 1/2
      embryos and in 77.5% of 2/4-embryos. Sexing was accomplished in 30.0% of 1/2
      embryos and 52.5% of 2/4-embryos, with a loss due to poor technique of 12.5 and
      15.0% respectively. Transfer of sexed embryos resulted in a low implantation
      rate. The two live fetuses obtained were of the predicted sex.

PMID- 8473471
TI  - Expression of integrins by human trophoblast and differential adhesion to laminin
      or fibronectin.
AB  - The process of placental implantation involves a series of transformations of
      trophoblast from a single polarized epithelial layer resting on a basement
      membrane (villous trophoblast), to cellular aggregates (trophoblast columns)
      which ultimately disperse to invade uterine decidua as individual cells
      (interstitial trophoblast). Such tissue re-modelling is associated with changes
      in the constituents of the extracellular matrix and in the expression of matrix
      receptors by the cells, the most relevant being the family of integrins which
      bind to laminin and fibronectin. In this study we show, by immunohistology and
      flow cytometry, a gradual loss of laminin receptors with the concomitant
      acquisition of fibronectin receptors as trophoblast is transformed from the
      villous phenotype, through the cell columns, into the extravillous population.
      The pattern of staining for the alpha 5, alpha 6, beta 1 and beta 4 subunits
      indicates that the integrins expressed by trophoblast are predominantly the alpha
      5 beta 1 and the alpha 6 beta 4 heterodimers. We have also shown that isolated
      trophoblast cells assume a flattened, sessile phenotype when cultured on laminin
      but exhibit a more spreading, motile morphology when plated on fibronectin. In
      addition, numerous multinucleated giant cells are observed on a fibronectin
      substrate. Our data suggest that the relative expression of laminin and
      fibronectin receptors may determine the morphology and behaviour of trophoblast
      during the process of implantation.

PMID- 8473472
TI  - Serum placental protein 14 concentrations in the first trimester of ovum donation
      pregnancies.
AB  - The concentration of the endometrial glycoprotein placental protein 14 (PP14) has
      been measured at weekly intervals during the first trimester in serum obtained
      from women who had become pregnant naturally (n = 15, all singleton) or following
      ovum donation (n = 16, 15 singleton and one twin) after ovarian failure (n = 13),
      Turner's syndrome (n = 2) or post-chemotherapy (n = 1). The concentration of PP14
      failed to rise in ovum donation pregnancies, and was significantly reduced
      compared to the concentration in natural conceptions from 5 to 13 weeks gestation
      (P < 0.05-0.01). These findings demonstrate that the corpus luteum is essential
      for the normal increase in serum PP14 in the first trimester. Furthermore, they
      suggest that progesterone is not the major stimulus to PP14 synthesis in early
      pregnancy.

PMID- 8473473
TI  - Oocyte donation in menopausal women aged over 40 years.
AB  - In order to investigate the pregnancy potential of menopausal women over 40 years
      of age by use of donor eggs, we retrospectively analysed the results of our ovum
      donation programme. Forty-one clinical pregnancies were established in 134
      recipient cycles. The recipients were divided into three age groups (40-43, 44-47
      and > or = 48 years) in order to investigate the implantation rate with respect
      to age. The 30.6% pregnancy rate per embryo transfer cycle and 9.7% implantation
      rate per embryo appeared to be constant in all age groups studied. Fourteen
      pregnancies ended in miscarriage, there was one ectopic pregnancy and 25 healthy
      babies have been delivered. The oldest woman to deliver was 54 years of age. This
      report highlights the question of age limit for application of the new
      reproductive technologies, and especially of oocyte donation.

PMID- 8473474
TI  - Mifepristone (RU 486) induces embryo expulsion in first trimester non-developing
      pregnancies: a prospective randomized trial.
AB  - This study was designed to investigate the use of oral mifepristone (RU 486) for
      the induction of natural expulsion of concepti in women with spontaneously
      interrupted pregnancy in the first trimester. It consisted of a double-blind
      placebo-controlled study of mifepristone (600 mg) against placebo. A total of 46
      women consulting for interrupted pregnancy were diagnosed at ultrasound with no
      clinical sign of miscarriage. Measurements were made of the occurrence of natural
      expulsion, the frequency of complete expulsion, the need for subsequent surgical
      evacuation, analgesia and the need for transfusion. Natural expulsion occurred
      within 5 days in 82% of patients receiving mifepristone treatment versus 8% of
      placebo-treated patients (P < 0.001). All patients experienced bleeding after RU
      486 and two needed emergency aspiration for haemorrhagic expulsion. The treatment
      failed in four patients, who underwent evacuation under local anaesthesia. In the
      control group, 19 patients underwent evacuation under local (n = 10) or general
      (n = 9) anaesthesia. It was concluded that a standard oral pilot dose of 600 mg
      of mifepristone induces natural expulsion in 82% of women with non-developing
      first trimester intrauterine pregnancies.

PMID- 8473475
TI  - The high fertility of agonadal and amenorrhoeic women after oocyte donation.

PMID- 8473476
TI  - The high fertility of agonadal and amenorrhoeic women after oocyte donation.

PMID- 8473477
TI  - The fraud conviction of Cecil B. Jacobson.

PMID- 8473478
TI  - Treatment of severe male infertility with pure follicle-stimulating hormone
      (FSH): the need for a properly controlled multicentre trial.

PMID- 8473479
TI  - The power of negative thinking.

PMID- 8473480
TI  - Preventing antiphospholipid antibody-induced fetal loss: a new idea.

PMID- 8473481
TI  - Vitamin K nutrition and postmenopausal osteoporosis.

PMID- 8473482
TI  - Antioxidant treatment inhibits the development of intimal thickening after
      balloon injury of the aorta in hypercholesterolemic rabbits.
AB  - The effect of the antioxidant butylated hydroxytoluene (BHT) on the accumulation
      of intimal smooth muscle cells (SMC) and development of intimal thickening after
      balloon catheter injury of the aorta were studied in rabbits with dietary-induced
      hyperlipidemia. Two sets of New Zealand White rabbits (eight rabbits in each
      group) were fed either 0.25% cholesterol or 0.25% cholesterol/1% BHT for a total
      of 6 wk. Serum lipid levels did not differ between the two groups. 3 wk after the
      start of the study, a balloon injury of the aorta was performed, after which the
      rabbits were kept on their respective diets for another 3 wk. After this period
      of time, the rabbits were killed and their aortas were investigated. The BHT
      treated rabbits had only one fourth of the intimal thickness (P < 0.0001) and
      half the number of SMC/mm intima (P < 0.001), as compared to the rabbits fed only
      cholesterol. There was also a lower number of macrophages in the BHT-treated
      group. T lymphocytes were present in the intima of cholesterol-fed rabbits,
      whereas no such cells could be identified in the BHT-fed animals. There were
      significantly lower levels of autooxidation products of cholesterol (7
      oxocholesterol, cholesterol-5,6-epoxide, and 7 beta-hydroxycholesterol) in the
      aortas of BHT-treated rabbits, P < 0.001. In conclusion, the antioxidant BHT
      effectively inhibited the accumulation of intimal SMC and the development of
      intimal thickening of the aorta in hypercholesterolemic rabbits after a balloon
      catheter-induced injury. These results indicate that antioxidants may modify
      intimal response to injury.

PMID- 8473483
TI  - Replication of Marburg virus in human endothelial cells. A possible mechanism for
      the development of viral hemorrhagic disease.
AB  - Marburg and Ebola virus, members of the family Filoviridae, cause a severe
      hemorrhagic disease in humans and primates. The disease is characterized as a
      pantropic virus infection often resulting in a fulminating shock associated with
      hemorrhage, and death. All known histological and pathophysiological parameters
      of the disease are not sufficient to explain the devastating symptoms. Previous
      studies suggested a nonspecific destruction of the endothelium as a possible
      mechanism. Concerning the important regulatory functions of the endothelium
      (blood pressure, anti-thrombogenicity, homeostasis), we examined Marburg virus
      replication in primary cultures of human endothelial cells and organ cultures of
      human umbilical cord veins. We show here that Marburg virus replicates in
      endothelial cells almost as well as in monkey kidney cells commonly used for
      virus propagation. Our data support the concept that the destruction of
      endothelial cells resulting from Marburg virus replication is a possible
      mechanism responsible for the hemorrhagic disease and the shock syndrome typical
      of this infection.

PMID- 8473484
TI  - Human eosinophil major basic protein is an endogenous allosteric antagonist at
      the inhibitory muscarinic M2 receptor.
AB  - The effect of human eosinophil major basic protein (MBP) as well as other
      eosinophil proteins, on binding of [3H]N-methyl-scopolamine ([3H]NMS: 1 x 10(-10)
      M) to muscarinic M2 receptors in heart membranes and M3 receptors in
      submandibular gland membranes was studied. MBP inhibited specific binding of
      [3H]NMS to M2 receptors but not to M3 receptors. MBP also inhibited atropine
      induced dissociation of [3H]NMS-receptor complexes in a dose-dependent fashion,
      demonstrating that the interaction of MBP with the M2 muscarinic receptor is
      allosteric. This effect of MBP suggests that it may function as an endogenous
      allosteric inhibitor of agonist binding to the M2 muscarinic receptor. Inhibition
      of [3H]NMS binding by MBP was reversible by treatment with heparin, which binds
      and neutralizes MBP. Eosinophil peroxidase (EPO) also inhibited specific binding
      of [3H]NMS to M2 receptors but not to M3 receptors and inhibited atropine-induced
      dissociation of [3H]NMS-receptor complexes. On a molar basis, EPO is less potent
      than MBP. Neither eosinophil cationic protein nor eosinophil-derived neurotoxin
      affected binding of [3H]NMS to M2 receptors. Thus both MBP and EPO are selective
      allosteric antagonists at M2 receptors. The effects of these proteins may be
      important causes of M2 receptor dysfunction and enhanced vagally mediated
      bronchoconstriction in asthma.

PMID- 8473485
TI  - Induction patterns of 70 genes during nine days after hepatectomy define the
      temporal course of liver regeneration.
AB  - Liver regeneration is an important process that allows for recovery from hepatic
      injuries caused by viruses, toxins, ischemia, surgery, and transplantation.
      Previously, we identified > 70 immediate-early genes induced in regenerating
      liver after hepatectomy, 41 of which were novel. While it is expected that the
      proteins encoded by these genes may have important roles in regulating
      progression through the G1 phase of the cell cycle during regeneration, we were
      surprised to note that many of these "early" genes are expressed for extended
      periods during the hepatic growth response. Here we define several patterns of
      expression of immediate-early, delayed-early, and liver-specific genes during the
      9-d period after hepatectomy. One pattern of induction parallels the major growth
      period of the liver that ends at 60-72 h after hepatectomy. A second pattern has
      two peaks coincident with the first and second G1 phases of the two hepatic cell
      cycles. A third group, which includes liver-specific genes such as C/EBP alpha,
      shows maximal expression after the growth period. Although the peak in DNA
      synthesis in nonparenchymal cells occur 24 h later than in hepatocytes, most of
      the genes studied demonstrate similar induction in both cell types. This finding
      suggests that the G0/G1 transition occurs simultaneously in all cells in the
      liver, but that the G1 phase of nonparenchymal cells may be relatively prolonged.
      Finally, we examined the expression of > 70 genes in clinical settings that could
      induce liver regeneration, including after perfusion in a donor liver, hepatic
      ischemia, and fulminant hepatic failure. We found that a small number of early
      and liver-specific genes were selectively activated in human livers under these
      conditions, and we thereby provide a potential means of measuring the caliber of
      the regenerative response in clinical situations.

PMID- 8473486
TI  - Roles of endothelin-1 and nitric oxide in the mechanism for ethanol-induced
      vasoconstriction in rat liver.
AB  - This study was designed to investigate the mechanism for ethanol-induced hepatic
      vasoconstriction in isolated perfused rat liver. Upon initiation of ethanol
      infusion into the portal vein at concentrations ranging from 25 to 100 mM, portal
      pressure began to increase in a concentration-dependent manner and reached
      maximal levels in 2-5 min (initial phase), followed by a gradual decrease over
      the period of ethanol infusion (escape phenomenon). Endothelin-1 antiserum
      significantly inhibited this ethanol-induced hepatic vasoconstriction by 45-80%.
      Cessation of infusion of endothelin-1 antiserum was followed by a subsequent
      increase in portal pressure. On the other hand, when a nitric oxide synthesis
      inhibitor, NG-monomethyl-L-arginine (L-NMMA), was infused into the portal vein
      simultaneously with ethanol, the initial phase of the response of portal pressure
      to ethanol was not altered and the peak values of portal pressure remained
      unchanged. However, after the peak increase in portal pressure, the rate of
      decrease was less than in the absence of L-NMMA. Thus, L-NMMA diminished the
      escape phenomenon and sustained the vasoconstriction. This study supports the
      hypothesis that two endothelium-derived vasoactive factors, endothelin-1 and
      nitric oxide, regulate hepatic vascular tone in the presence of ethanol.

PMID- 8473487
TI  - Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in
      health and disease.
AB  - Plasma and whole-body turnover studies of human C-reactive protein (CRP),
      isolated from a single normal healthy donor and labeled with 125I, were
      undertaken in 8 healthy control subjects and 35 hospitalized patients including
      cases of rheumatoid arthritis, systemic lupus erythematosus, infections, and
      neoplasia. Plasma clearance of 125I-CRP closely approximated to a monoexponential
      function and was similar in the control and all patient groups. There was no
      evidence for accelerated clearance or catabolism of CRP in any of the diseases
      studied. The 19-h half-life was more rapid than that of most human plasma
      proteins studied previously, and the fractional catabolic rate was independent of
      the plasma CRP concentration. The synthesis rate of CRP is thus the only
      significant determinant of its plasma level, confirming the validity of serum CRP
      measurement as an objective index of disease activity in disorders associated
      with an acute-phase response. Approximately 90% of injected radioactivity was
      recovered in the urine after 7 d, and scintigraphic imaging studies with 123I
      labeled CRP in 10 patients with different focal pathology showed no significant
      localization of tracer. The functions of CRP are thus likely to be effected
      predominantly in the fluid phase rather than by major deposition at sites of
      tissue damage or inflammation.

PMID- 8473488
TI  - Vasodilator and constrictor actions of platelet-activating factor in the isolated
      microperfused afferent arteriole of the rabbit kidney. Role of endothelium
      derived relaxing factor/nitric oxide and cyclooxygenase products.
AB  - It has been suggested that platelet-activating factor (PAF) plays a prominent
      role in the control of glomerular hemodynamics in various physiological and
      pathological conditions. We examined the direct effect of PAF on rabbit
      glomerular afferent arterioles (Af-Arts) microperfused in vitro and tested
      whether endothelium-derived relaxing factor/nitric oxide (EDNO) and
      cyclooxygenase products are involved in its actions. In nanomolar concentrations
      PAF caused dose-dependent constriction of Af-Arts, with the maximum constriction
      being 34 +/- 10% at 4 x 10(-8) M (n = 9, P < 0.001). The constriction was blunted
      by cyclooxygenase inhibition (11 +/- 6%, n = 7, P < 0.05) but augmented by EDNO
      inhibition (76 +/- 14%, n = 8, P < 0.005). To study a possible vasodilator effect
      of PAF, Af-Arts were preconstricted with norepinephrine and increasing
      concentrations of PAF added to the lumen. At picomolar concentrations (lower than
      those that caused constriction), PAF produced dose-dependent vasodilation that
      was unaffected by cyclooxygenase inhibition but was abolished by EDNO synthesis
      inhibition. Both PAF-induced constriction and dilation of Af-Arts were blocked by
      a PAF receptor antagonist. This study demonstrates that PAF has a receptor
      mediated biphasic effect on rabbit Af-Arts, dilating them at low concentrations
      while constricting them at higher concentrations. Our results suggest that PAF's
      vasodilator action may be due to production of EDNO, while its constrictor action
      is mediated at least in part through cyclooxygenase products.

PMID- 8473489
TI  - N-3 fatty acids stimulate intracellular degradation of apoprotein B in rat
      hepatocytes.
AB  - When rat hepatocytes were incubated with albumin complexed to the n-3 fatty
      acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), rather than to
      oleic acid (OA), the secretion of newly synthesized apoprotein B100 (apoB100) or
      B48 (apoB48) was reduced, despite stimulation of cellular triglyceride synthesis
      by all three fatty acids. When pulse-chase studies of apoB synthesis and
      secretion were performed in the presence of OA, EPA, or DHA, there were no
      significant changes in the initial synthetic rates of either apoB species.
      However, during the chase period, the total recovery of labeled apoB100 and
      apoB48 from the cell and medium was less in the n-3 fatty acid groups, so that by
      150 min, approximately half as much labeled apoB was recovered as in the OA
      group. Overall, the decreased accumulation in medium of labeled apoB in the
      presence of EPA and DHA could be quantitatively accounted for by increased
      degradation of intracellular apoB. Thus, in the primary hepatocyte, apoB
      degradation is not constitutive, but can be regulated by n-3 fatty acids.

PMID- 8473490
TI  - Cytokine patterns in the pathogenesis of human leishmaniasis.
AB  - The host response to infection appears to be regulated by specific patterns of
      local cytokine production. In the mouse, resistance to many pathogens including
      Leishmania is associated with a TH1 cytokine profile, IL-2 and IFN-gamma; whereas
      susceptibility to infection is associated with production of TH2 cytokines, IL-4,
      IL-5, and IL-10. To determine the cytokine patterns of the local immune response
      to Leishmania infection in humans, we used the polymerase chain reaction to
      compare cytokine mRNAs in biopsy specimens of American cutaneous leishmaniasis.
      In localized cutaneous leishmaniasis and the Montenegro delayed-type
      hypersensitivity reaction, type 1 cytokine mRNAs such as IL-2, IFN-gamma, and
      lymphotoxin were relatively predominant. In the chronic and destructive
      mucocutaneous form of leishmaniasis, there was a mixture of type 1 and type 2
      cytokines, with a striking abundance of IL-4 mRNA in lesions. These results
      suggest that clinical course of infection with Leishmania braziliensis in man is
      associated with specific local patterns of cytokine production.

PMID- 8473491
TI  - Autoantibody reactive with three classes of RNA polymerases in sera from patients
      with systemic sclerosis.
AB  - We have identified a novel autoantibody reactive with all three classes of RNA
      polymerases, well-characterized nuclear enzymes, in sera from patients with
      systemic sclerosis (SSc). After incubation with [35S]methionine-labeled HeLa cell
      extracts, 14 of 275 SSc sera immunoprecipitated 12 or 14 proteins with similar
      molecular weights as those of several subunit proteins of eukaryotic RNA
      polymerases I, II, and III. Purified IgG from these two types of sera inhibited
      RNA transcription catalyzed by RNA polymerases I, II, and III in vitro.
      Immunoblot analysis using RNA polymerase-enriched fraction showed that the
      majority of these sera reacted with 42- or 25-kD protein. Anti-RNA polymerase
      antibody was highly specific to SSc, especially to diffuse cutaneous SSc.
      Clinical features associated with this antibody included a high frequency of
      heart and kidney involvement and a poor survival rate at 5 yr after first visit.
      These findings indicate that the autoantibody to three classes of RNA polymerases
      is a new marker for a unique subset of diffuse cutaneous SSc.

PMID- 8473492
TI  - Homologous upregulation of human arterial alpha-adrenergic responses by
      guanadrel.
AB  - The purpose of this study was to test the hypothesis that there is homologous
      upregulation of arterial alpha-adrenergic responsiveness during suppression of
      sympathetic nervous system (SNS) activity in humans. 10 subjects (19-28 yr) were
      studied during placebo and when SNS activity was suppressed by guanadrel. Changes
      in forearm blood flow (FABF) mediated by the intraarterial infusion of
      norepinephrine (NE), angiotensin II (AII), and phentolamine were measured by
      plethysmography. During guanadrel compared with placebo, plasma NE levels (1.28
      +/- 0.09-0.85 +/- 0.06 nM; P = 0.0001) and the extra vascular NE release rate
      derived from [3H]NE kinetics were lower (7.1 +/- 0.7-4.0 +/- 0.2 nmol/min per m2;
      P = 0.0004), suggesting suppression of SNS activity. During guanadrel, there was
      increased sensitivity in the FABF response to NE (analysis of variance P = 0.03).
      In contrast, there was no difference in the FABF response to AII (analysis of
      variance P = 0.81), suggesting that the upregulation observed to NE was
      homologous. The increase in FABF during phentolamine was similar during guanadrel
      compared with placebo (guanadrel: 141 +/- 37 vs. placebo; 187 +/- 27% increase; P
      = 0.33), suggesting that there was at least partial compensation to maintain
      constant endogenous arterial alpha-adrenergic tone. We conclude that there is
      homologous upregulation of arterial alpha-adrenergic responsiveness in humans
      when SNS activity is suppressed by guanadrel.

PMID- 8473493
TI  - In vivo metabolism of a mutant form of apolipoprotein A-I, apo A-IMilano,
      associated with familial hypoalphalipoproteinemia.
AB  - Apo A-IMilano is a mutant form of apo A-I in which cysteine is substituted for
      arginine at amino acid 173. Subjects with apo A-IMilano are characterized by
      having low levels of plasma HDL cholesterol and apo A-I. To determine the kinetic
      etiology of the decreased plasma levels of the apo A-I in these individuals,
      normal and mutant apo A-I were isolated, radiolabeled with either 125I or 131I,
      and both types of apo A-I were simultaneously injected into two normal control
      subjects and two subjects heterozygous for apo A-IMilano. In the normal subjects,
      apo A-IMilano was catabolized more rapidly than the normal apo A-I (mean
      residence times of 5.11 d for normal apo A-I vs. 3.91 d for apo A-IMilano),
      clearly establishing that apo A-IMilano is kinetically abnormal and that it has a
      shortened residence time in plasma. In the two apo A-IMilano subjects, both types
      of apo A-I were catabolized more rapidly than normal (residence times ranging
      from 2.63 to 3.70 d) with normal total apo A-I production rates (mean of 10.3 vs.
      10.4 mg/kg per d in the normal subjects). Therefore, in the subjects with apo A
      IMilano, the decreased apo A-I levels are caused by rapid catabolism of apo A-I
      and not to a decreased production rate, and the abnormal apo A-IMilano leads to
      the rapid catabolism of both the normal and mutant forms of apo A-I in the
      affected subjects.

PMID- 8473494
TI  - Differential effects of renin-angiotensin system blockade on atherogenesis in
      cholesterol-fed rabbits.
AB  - To investigate the mechanism by which angiotensin-converting enzyme (ACE)
      inhibition attenuates atherogenesis, we have studied the effects of a non
      sulfhydryl ACE inhibitor, enalapril, and an angiotensin receptor antagonist, SC
      51316, in cholesterol-fed rabbits. After 3 mo of enalapril treatment (10 mg/kg
      per d, p.o.) the percent plaque areas in the thoracic aortas of treated animals
      were significantly reduced (controls: 86.8 +/- 3.5%; treated: 31.1 +/- 8%, P <
      0.001). Aortic cholesterol content was also reduced (controls: 31.4 +/- 3.2 mg/g
      tissue; treated: 7.4 +/- 1.8 mg/g, P < 0.001). Enalapril had no significant
      effect on plasma lipid levels or conscious blood pressure. In a second study, the
      angiotensin II receptor antagonist SC-51316 was administered at a dose equivalent
      to enalapril at blocking angiotensin pressor effects in vivo (30 mg/kg per d,
      p.o.). Evaluation after 3 mo indicated no significant attenuation of aortic
      atherosclerosis. These results demonstrate that: (a) enalapril attenuates
      atherogenesis without affecting either blood pressure or plasma lipid levels; (b)
      antioxidant activity, found with sulfhydryl-containing ACE inhibitors, is not
      necessary for reducing plaque formation; and (c) the attenuation of atherogenesis
      by ACE inhibition may not be due to blockade of the renin-angiotensin system.
      Alternatively, one must consider the multiple effects of ACE inhibition on other
      hormone systems, such as bradykinin, or the possibility that alternate
      angiotensin II receptors may be involved in atherosclerosis.

PMID- 8473495
TI  - Negative transcriptional regulation of human interleukin 2 (IL-2) gene by
      glucocorticoids through interference with nuclear transcription factors AP-1 and
      NF-AT.
AB  - IL-2 gene transcription is affected by several nuclear proteins. We asked whether
      dexamethasone (Dex) and cyclosporin A (CsA) inhibit IL-2 gene transcription by
      interfering with the activity of nuclear proteins that bind to the IL-2 promoter.
      Nuclear extracts from primary human T lymphocytes were analyzed by
      electrophoretic DNA mobility shift assays. Both Dex and CsA inhibited the binding
      of transcription factors AP-1 and NF-AT, but not of NF-kB and OCT-1/OAF, to their
      corresponding sites on the IL-2 gene promoter. To correlate changes in nuclear
      factor binding in vitro with transcriptional activity in vivo and define the
      structural requirements for IL-2 promoter repression, we used transient DNA
      transfections. Jurkat cells were transfected with plasmids containing either the
      intact IL-2 promoter or its AP-1, NF-AT, and NF-kB motifs. Dex inhibited the IL-2
      promoter and the AP-1, but not the NF-AT and NF-kB plasmids. In contrast, CsA
      inhibited the IL-2 promoter and the NF-AT, but not the AP-1 and NF-kB plasmids.
      These results suggest that in human T lymphocytes both Dex and CsA inhibited IL-2
      gene transcription through interference with transcription factors AP-1 and NF
      AT. We propose that, while maximum inhibition may involve interaction with both
      transcription factors, AP-1 is the primary target of Dex.

PMID- 8473496
TI  - Dual Ca2+ requirement for optimal lipid peroxidation of low density lipoprotein
      by activated human monocytes.
AB  - The oxidative modification of LDL seems a key event in atherogenesis and may
      participate in inflammatory tissue injury. Our previous studies suggested that
      the process of LDL oxidation by activated human monocytes/macrophages required O2
      and activity of intracellular lipoxygenase. Herein, we studied the mechanisms
      involved in this oxidative modification of LDL. In this study, we used the human
      monocytoid cell line U937 to examine the role of Ca2+ in U937 cell-mediated lipid
      peroxidation of LDL. U937 cells were activated by opsonized zymosan. Removal of
      Ca2+ from cell culture medium by EGTA inhibited U937 cell-mediated peroxidation
      of LDL lipids. Therefore, Ca2+ influx and mobilization were examined for their
      influence on U937 cell-mediated LDL lipid peroxidation. Ca2+ channel blockers
      nifedipine and verapamil blocked both Ca2+ influx and LDL lipid peroxidation by
      activated U937 cells. The inhibitory effects of nifedipine and verapamil were
      dose dependent. TMB-8 and ryanodine, agents known to prevent Ca2+ release from
      intracellular stores, also caused a dose-dependent inhibition of LDL lipid
      peroxidation by activated U937 cells while exhibiting no effect on Ca2+ influx.
      Thus, both Ca2+ influx through functional calcium channels and Ca2+ mobilization
      from intracellular stores participate in the oxidative modification of LDL by
      activated U937 cells. 45Ca2+ uptake experiments revealed profound Ca2+ influx
      during the early stages of U937 cell activation, however, the Ca2+ ionophore 4
      bromo A23187 was unable to induce activation of U937 cells and peroxidation of
      LDL lipids. Release of intracellular Ca2+ by thapsigargin only caused a
      suboptimal peroxidation of LDL lipids. Our results indicate that although
      increases in intracellular Ca2+ levels provided by both influx and intracellular
      Ca2+ mobilization are required, other intracellular signals may be involved for
      optimal peroxidation of LDL lipids by activated human monocytes.

PMID- 8473497
TI  - Role of AT1 receptors in the resetting of the baroreflex control of heart rate by
      angiotensin II in the rabbit.
AB  - Angiotensin II (Ang II) resets the baroreflex control of heart rate to a higher
      blood pressure. This action is apparently mediated via Ang II receptors in the
      area postrema, but it is not known if these are of the AT1 or AT2 subtype. In the
      present study the effects of losartan, a selective AT1 receptor antagonist, and
      PD 123319, a selective AT2 antagonist, on the cardiac baroreflex response to Ang
      II were investigated in conscious rabbits with chronically implanted arterial and
      venous catheters. Baroreflex curves were generated with intravenous infusions of
      phenylephrine and nitroprusside (2.6-25 micrograms/kg per min) and analyzed using
      a four-parameter logistic model to yield their upper and lower plateaus, arterial
      pressure at the midpoint of the heart rate range (BP50), and slope coefficient.
      From these four parameters, the gain and range of the baroreflex were calculated.
      Background intravenous infusion of Ang II at 10 ng/kg per min increased mean
      arterial pressure by 17 mmHg but did not change heart rate. Ang II shifted the
      baroreflex curve to the right as indicated by an increase in BP50 from 70.9 +/-
      2.0 to 89.3 +/- 2.7 mmHg (P < 0.05), but did not change baroreflex gain
      significantly. Ang II did not alter the upper plateau of the baroreflex, but
      decreased the lower plateau from 119.4 +/- 10.3 to 73.6 +/- 11.5 beats per minute
      (bpm) (P < 0.05), extending the heart rate range by 52.5 bpm. Pretreatment with
      losartan completely abolished the pressor and cardiac baroreflex responses to Ang
      II. In contrast, PD 123319 had no effect on these responses. Administration of
      losartan alone to block endogenous Ang II shifted the baroreflex curve to the
      left as indicated by a decrease in BP50 from 71.2 +/- 2.7 to 64.7 +/- 2.5 mmHg (P
      < 0.05). These results demonstrate that the resetting of the baroreflex control
      of heart rate by Ang II is mediated by AT1 receptors, and that basal levels of
      endogenous Ang II exert a tonic action on the cardiac baroreflex to increase the
      setpoint around which the baroreflex regulates heart rate.

PMID- 8473498
TI  - Cloning of a virulence factor of Entamoeba histolytica. Pathogenic strains
      possess a unique cysteine proteinase gene.
AB  - Cysteine proteinases are hypothesized to be important virulence factors of
      Entamoeba histolytica, the causative agent of amebic dysentery and liver
      abscesses. The release of a histolytic cysteine proteinase from E. histolytica
      correlates with the pathogenicity of both axenic strains and recent clinical
      isolates as determined by clinical history of invasive disease, zymodeme
      analysis, and cytopathic effect. We now show that pathogenic isolates have a
      unique cysteine proteinase gene (ACP1). Two other cysteine proteinase genes
      (ACP2, ACP3) are 85% identical to each other and are present in both pathogenic
      and nonpathogenic isolates. ACP1 is only 35 and 45% identical in sequence to the
      two genes found in all isolates and is present on a distinct chromosome-size DNA
      fragment. Presence of the ACP1 gene correlates with increased proteinase
      expression and activity in pathogenic isolates as well as cytopathic effect on a
      fibroblast monolayer, an in vitro assay of virulence. Analysis of the predicted
      amino acid sequence of the ACP1 proteinase gene reveals homology with cysteine
      proteinases released by activated macrophages and invasive cancer cells,
      suggesting an evolutionarily conserved mechanism of tissue invasion. The
      observation that a histolytic cysteine proteinase gene is present only in
      pathogenic isolates of E. histolytica suggests that this aspect of virulence in
      amebiasis is genetically predetermined.

PMID- 8473499
TI  - Direct interactions of human lymphocytes with the yeast-like organism,
      Cryptococcus neoformans.
AB  - Lymphocytes, especially CD4+ T cells, are essential for clearance of the yeast
      like organism Cryptococcus neoformans from the infected host. The mechanism(s) by
      which the lymphocytes facilitate elimination of cryptococci has not been
      elucidated. It is generally thought, however, that lymphocytes reactive with C.
      neoformans indirectly function by production of lymphokines to enhance clearance
      of the organism by natural effector cells such as macrophages. In the present
      study, we assessed the ability of freshly isolated human lymphocytes to interact
      directly with C. neoformans and to limit the growth of the organism in vitro. We
      found that large granular lymphocytes (LGL) as well as T cells bound to
      cryptococcal cells when the lymphocytes were mixed with the cryptococcal cells at
      a 2:1 ratio. The physical binding interactions of the two lymphocyte populations
      were different. LGL attached to the cryptococcal cells by many microvilli; T
      lymphocytes associated with the yeast through broad areas of membrane attached to
      the cryptococcal cell surface. The two types of lymphocyte interactions did not
      result in phagocytosis but resulted in direct inhibition of cryptococcal growth,
      making these lymphocyte interactions with cryptococci distinctly different from
      interactions of monocytes with cryptococci. With the human natural killer (NK)
      cell line, NK 3.3, we confirmed that NK cells that were present in the LGL
      population were capable of limiting the growth of C. neoformans. Through
      immunoelectron microscopy, human CD3+ lymphocytes were seen attached to
      cryptococcal cells and by mass cytolysis, human CD3+ lymphocytes were shown to be
      responsible for inhibition of C. neoformans growth. The direct inhibitory
      interactions of NK cells and T lymphocytes with cryptococcal cells may be
      important means of host defense against this ubiquitous organism that frequently
      causes life-threatening disease in AIDS patients.

PMID- 8473500
TI  - Induction of cytokine expression by leukemia inhibitory factor.
AB  - Biological effects of cytokines are in part determined by their interactions in
      the regulation of cytokine production. This study analyzes the effects of
      leukemia inhibitory factor (LIF) on cytokine expression in different cell
      lineages. Recombinant human LIF increases levels of IL-1 beta, IL-6, and IL-8
      mRNA in human articular chondrocytes as demonstrated by Northern blotting. These
      cytokine mRNAs are detectable as early as 1.3 h after stimulation and reach their
      maximum after 5 h. The LIF effects are dose dependent and of similar magnitude to
      those of IL-1. By metabolic labeling and immunoprecipitation it is shown that LIF
      induces synthesis and secretion of IL-6. IL-6 bioactivity in conditioned media,
      as measured by the B9 hybridoma proliferation assay, is increased by LIF. Effects
      of LIF on cytokine expression are not confined to connective tissue cells. By PCR
      it is shown that human blood monocytes express IL-6 mRNA after stimulation with
      LIF. An increase in IL-6 mRNA levels is detectable 2 h after stimulation, and
      this starts to decline by 5 h. The response is of shorter duration as compared
      with IL-1 beta. In addition to increased mRNA expression, LIF also stimulates
      release of biologically active IL-6 from blood monocytes. In synoviocytes and
      neuronal as well as epithelial cell lines, LIF increases IL-1 beta and IL-6 gene
      expression. In summary, LIF induces cytokine expression in a wide variety of
      tissues. These results suggest that through the induction of cytokines, LIF can
      modulate inflammation, immune responses, and connective tissue metabolism, and
      act as a pathogenetic mediator in different disease states.

PMID- 8473501
TI  - NO forms an adduct with serum albumin that has endothelium-derived relaxing
      factor-like properties.
AB  - Recent evidence suggests that sulfhydryl species can react with oxides of
      nitrogen under physiologic conditions and thereby stabilize endothelium-derived
      relaxing factor (EDRF) activity, but the presence of a specific in vivo thiol
      carrier for nitric oxide (NO) remains controversial. The single free sulfhydryl
      of serum albumin is the most abundant thiol species in plasma (approximately 0.5
      mM) and is particularly reactive towards NO. To examine the potential role of
      serum albumin in endogenous nitric oxide metabolism, we synthesized S-nitroso-BSA
      (S-NO-BSA), a model S-nitroso-protein, and examined its effects on platelet
      function and coronary and systemic vascular tone in 16 mongrel dogs. Intravenous
      bolus S-NO-BSA markedly reduced mean arterial pressure in a dose-dependent manner
      and proved seven and a half-fold less potent than intravenous nitroglycerin and
      10-fold less potent than intravenous S-nitroso-cysteine (half-maximal response of
      75 nmol/kg compared to 10 and 7.5 nmol/kg, respectively; P < 0.05); when given by
      intravenous infusion (half-maximal response = 10 nmol/kg per min), however, S-NO
      BSA and nitroglycerin were equipotent. Intravenous bolus S-NO-BSA had a greater
      duration of action than either nitroglycerin or S-nitroso-cysteine and produced
      marked prolongation of the template bleeding time associated with dose-dependent
      inhibition of ex vivo platelet aggregation (half-maximal response approximately
      70 nmol/kg). Intracoronary S-NO-BSA increased coronary blood flow (mean +/- SEM)
      less effectively than nitroprusside, acetylcholine, or S-nitroso-cysteine (165%
      +/- 24% vs. 315% +/- 82%, 483% +/- 55%, or 475% +/- 66%, respectively; P < 0.05)
      although with much longer duration of action. On a molar basis, S-nitroso
      cysteine proved more effective than S-nitroso-BSA, nitroprusside, or
      acetylcholine as an epicardial coronary vasodilator. Thus, serum albumin reacts
      with oxides of nitrogen to form a stable S-nitroso-thiol with properties
      reminiscent of authentic EDRF supporting the view that protein associated thiol
      may participate in the action and metabolism of EDRF.

PMID- 8473502
TI  - Fluid and electrolyte transport by cultured human airway epithelia.
AB  - An understanding of the fluid and electrolyte transport properties of any
      epithelium requires knowledge of the direction, rate, and regulation of fluid
      transport and the composition of the fluid. Although human airway epithelial
      likely play a key role in controlling the quantity and composition of the
      respiratory tract fluid, evidence for such a role is not available. To obtain
      such knowledge, we measured fluid and electrolyte transport by cultured human
      nasal epithelia. Under basal conditions we found that epithelia absorbed Na+ and
      fluid; both processes were inhibited by addition of amiloride to the mucosal
      surface. These data suggest that active Na+ absorption is responsible for fluid
      absorption. Interestingly, Na+ absorption was not accompanied by the net
      absorption of Cl-; some other anion accompanied Na+. The combination of cAMP
      agonists and mucosal amiloride stimulated the secretion of NaCl-rich fluid. But
      surprisingly, the response to cAMP agonists in the absence of amiloride showed
      substantial intersubject variability: cAMP stimulated fluid secretion across some
      epithelia, for others, cAMP stimulated fluid absorption. The explanation for the
      differences in response is uncertain, but we speculate that the magnitude of
      apical membrane Na+ conductance may modulate the direction of fluid transport in
      response to cAMP. We also found that airway epithelial secrete H+ and absorb K+
      under basal conditions; both processes were inhibited by cAMP agonists. Because
      the H+/K(+)-ATPase inhibitor, SCH 28080, inhibited K+ absorption, an apical
      membrane H+/K(+)-ATPase may be at least partly responsible for K+ and H+
      transport. However, H+/K+ exchange could not entirely account for the luminal
      acidification. The finding that cAMP agonists inhibited luminal acidification may
      be explained by the recent finding that cAMP increases apical HCO3- conductance.
      These results provide new insights into how the intact airway epithelium may
      modify the composition of the respiratory tract fluid.

PMID- 8473503
TI  - Diaphragm mechanics in dogs with unilateral emphysema.
AB  - We studied dogs with unilateral papain-induced emphysema to answer two questions:
      (1) Do emphysema lung-apposed hemidiaphragm (DiE) and normal lung-apposed
      hemidiaphragm (DiN) have equal capacities for lowering lung surface pressure? and
      (2) Are side-to-side differences in intrathoracic pressure the result of unequal
      force outputs by DiE and DiN or are they caused by differences in their
      mechanical efficiency as pressure generators? After the airways of the
      emphysematous and normal lungs were intubated with a dual lumen endotracheal
      tube, both phrenic nerves were maximally stimulated at rates between 1 and 50 Hz
      and the changes in airway occlusion pressure (delta PaoE,N) and diaphragm length
      (sonomicrometry) were recorded. In all animals, delta PaoN exceeded delta PaoE.
      Differences in pressure ranged from 1.2 +/- 0.6 cm H2O during a twitch to 6.0 +/-
      2.9 cm H2O during a 50-Hz tetanus. Midcostal bundles of DiE shortened less than
      corresponding bundles of DiN, but both reached the same active length relative to
      their optimal lengths, which were measured in vitro. There was no significant
      difference in fiber type distribution, fiber cross-sectional area, or maximal
      isometric tetanic tensions among midcostal regions of DiE and DiN. We conclude
      that unilateral hyperinflation impairs the mechanical efficiency of the apposing
      hemidiaphragm as a pressure generator.

PMID- 8473504
TI  - Medium tonicity regulates expression of the Na(+)- and Cl(-)-dependent betaine
      transporter in Madin-Darby canine kidney cells by increasing transcription of the
      transporter gene.
AB  - Betaine is one of the major compatible osmolytes accumulated by kidney derived
      Madin-Darby canine kidney cells cultured in hypertonic medium. Betaine is
      accumulated by Na(+)- and Cl(-)-dependent uptake from the medium. To gain insight
      into the mechanism by which hypertonicity evokes an increase in the Vmax of the
      betaine transporter in Madin-Darby canine kidney cells, we measured the relative
      abundance of mRNA for the transporter in cells shifted to a hypertonic medium and
      found parallel increases in mRNA abundance and cotransporter activity. The
      increase in mRNA levels preceded the increase in transporter activity slightly.
      Transcription of the gene for the transporter rose rapidly and to the same
      relative extent as mRNA abundance in cells shifted to hypertonic medium,
      indicating that transcription of the gene for the cotransporter plays a major
      role in regulating the accumulation of betaine in response to hypertonicity.

PMID- 8473506
TI  - Sequence polymorphisms in the apolipoprotein (a) gene. Evidence for dissociation
      between apolipoprotein(a) size and plasma lipoprotein(a) levels.
AB  - Apolipoprotein(a) [apo(a)], an apolipoprotein unique to lipoprotein(a) [Lp(a)],
      is highly polymorphic in size. Previous studies have indicated that the size of
      the apo(a) gene tends to be inversely correlated with the plasma level of Lp(a).
      However, several exceptions to this general trend have been identified.
      Individuals with apo(a) alleles of identical size do not always have similar
      plasma concentrations of Lp(a). To determine if these differences in plasma Lp(a)
      concentrations were due to sequence variations in the apo(a) gene, we examined
      the sequences of apo(a) alleles in 23 individuals homozygous for same-sized
      apo(a) alleles. We identified four single-strand DNA conformation polymorphisms
      (SSCPs) in the apo(a) gene. Of the 23 homozygotes, 21 (91%) were heterozygous for
      at least one of the SSCPs. Analysis of a family in which a parent was homozygous
      for the same-sized apo(a) allele revealed that each allele, though identical
      size, segregated with different plasma concentrations of Lp(a). These studies
      indicate that the apo(a) gene is even more polymorphic in sequence than was
      previously appreciated, and that sequence variations at the apo(a) locus, other
      than the number of kringle 4 repeats, contribute to the plasma concentration of
      Lp(a).

PMID- 8473505
TI  - Bone marrow cells in X-linked agammaglobulinemia express pre-B-specific genes
      (lambda-like and V pre-B) and present immunoglobulin V-D-J gene usage strongly
      biased to a fetal-like repertoire.
AB  - Expression of Ig and Ig-related genes has been studied in bone marrow cells from
      two patients with severe form of X-linked agammaglobulinemia (XLA). Phenotypic
      analysis revealed the presence of pre-B cells, in the absence of mature B cell
      markers. The pre-B-specific genes, lambda-like and V pre-B, were normally
      transcribed. Sequence analysis of 48 distinct V-D-J cDNA clones directly derived
      from XLA bone marrow cells indicated that they had characteristics of an early
      fetal pre-B repertoire. All VH families were identified, with a strong bias in
      the gene usage: a few VH genes were largely overexpressed, either germline or
      slightly mutated; most genes had been located 3' of the VH locus and were also
      used in fetal liver (8-13 wk of gestation). Short D regions, (resulting from D-D
      fusion, making usage of all D genes in both orientations with utilization of the
      three reading frames), restricted N diversity, and a fetal JH usage pattern were
      also observed. Taken together, our data suggest that the XLA defect does not
      alter V-D-J rearrangements nor the expression of mu, lambda-like, and V pre-B
      transcripts and most likely results in a poor efficiency of some critical steps
      of the B cell maturation.

PMID- 8473507
TI  - Molecular basis for fibrinogen Dusart (A alpha 554 Arg-->Cys) and its association
      with abnormal fibrin polymerization and thrombophilia.
AB  - The molecular defect in the abnormal fibrinogen Dusart (Paris V) that is
      associated with thrombophilia was determined by sequence analysis of genomic DNA
      that had been amplified using the polymerase chain reaction. The propositus was
      heterozygous for a single base change (C-->T) in the A alpha-chain gene,
      resulting in the amino acid substitution A alpha 554 Arg-->Cys. Restriction
      analysis of the amplified DNA derived from the family members showed that his
      father and his two sons were also heterozygous. Electron microscopic studies on
      fibrin formed from purified fibrinogen Dusart demonstrated fibers that were much
      thinner than in normal fibrin. In contrast to the previously observed defective
      binding of plasminogen, the binding of thrombospondin to immobilized fibrinogen
      Dusart was similar to that of normal fibrinogen. Immunoblot analysis of plasma
      fibrinogen demonstrated that a substantial part of the fibrinogen Dusart
      molecules were disulfide-linked to albumin. The plasma of the affected family
      members also contained fibrinogen-albumin complexes. Furthermore, small amounts
      of high molecular weight complexes containing fibrinogen were detected in all the
      heterozygous individuals. These data indicate that the molecular abnormality in
      fibrinogen Dusart (A alpha 554 Arg-->Cys) results in defective lateral
      association of the fibrin fibers and disulfide-linked complex formation with
      albumin, and is associated with a family history of recurrent thrombosis in the
      affected individuals.

PMID- 8473508
TI  - Processing of epidermal glucosylceramides is required for optimal mammalian
      cutaneous permeability barrier function.
AB  - The interstices of the mammalian stratum corneum contain lipids in a system of
      continuous membrane bilayers critical for the epidermal permeability barrier.
      During the transition from inner to outer stratum corneum, the content of polar
      lipids including glucosylceramides, decreases while ceramide content increases.
      We investigated whether inhibition of glucosylceramide hydrolysis would alter
      epidermal permeability barrier function. Daily topical applications of
      bromoconduritol B epoxide (BrCBE) to intact murine skin selectively inhibited
      beta-glucocerebrosidase, increased glucosylceramide content of stratum corneum
      with ceramide content remaining largely unchanged, and caused a progressive,
      reversible decrease in barrier function. Histochemistry of inhibitor-treated
      epidermis revealed persistence of periodic acid-Schiff-positive staining in
      stratum corneum cell membranes, consistent with retention of hexose moieties.
      Electron microscopy of inhibitor-treated samples revealed no evidence of toxicity
      or changes in the epidermal lipid delivery system. However, immature membrane
      structures persisted in the intercellular spaces throughout the stratum corneum,
      with reappearance of mature membrane structures progressing outward from the
      lower stratum corneum upon termination of BrCBE. Finally, the induced barrier
      abnormality was not reversed by coapplications of ceramide. These data
      demonstrate that glucosylceramide hydrolysis is important in the formation of the
      epidermal permeability barrier, and suggest that accumulation of
      glucosylceramides in stratum corneum intercellular membrane domains leads to
      abnormal barrier function.

PMID- 8473509
TI  - Dietary fat increases high density lipoprotein (HDL) levels both by increasing
      the transport rates and decreasing the fractional catabolic rates of HDL
      cholesterol ester and apolipoprotein (Apo) A-I. Presentation of a new animal
      model and mechanistic studies in human Apo A-I transgenic and control mice.
AB  - In humans, diets high in saturated fat and cholesterol raise HDL-cholesterol (HDL
      C) levels. To explore the mechanism, we have devised a mouse model that mimics
      the human situation. In this model, HuAITg and control mice were studied on low
      fat (9% cal)-low cholesterol (57 mg/1,000 kcal) (chow) and high fat (41% cal)
      high cholesterol (437 mg/1,000 kcal) (milk-fat based) diets. The mice responded
      to increased dietary fat by increasing both HDL-C and apo A-I levels, with a
      greater increase in HDL-C levels. This was compatible with an increase in HDL
      size observed by nondenaturing gradient gel electrophoresis. Turnover studies
      with doubly labeled HDL showed that dietary fat both increase the transport rate
      (TR) and decreased the fractional catabolic rate of HDL cholesterol ester (CE)
      and apo A-I, with the largest effect on HDL CE TR. The latter suggested that
      dietary fat increases reverse cholesterol transport through the HDL pathway,
      perhaps as an adaptation to the metabolic load of a high fat diet. The increase
      in apo A-I TR by dietary fat was confirmed by experiments showing increased apo A
      I secretion from primary hepatocytes isolated from animals on the high fat diet.
      The increased apo A-I production was not associated with any increase in hepatic
      or intestinal apo A-I mRNA, suggesting that the mechanism of the dietary fat
      effect was posttranscriptional, involving either increased translatability of the
      apo A-I mRNA or less intracellular apo A-I degradation. The dietary fat-induced
      decrease in HDL CE and apo A-I fractional catabolic rate may have been caused by
      the increase in HDL particle size, as was suggested by our previous studies in
      humans. In summary, a mouse model has been developed and experiments performed to
      better understand the paradoxical HDL-raising effect of a high fat diet.

PMID- 8473510
TI  - Erythrocyte membrane proteins reactive with human (warm-reacting) anti-red cell
      autoantibodies.
AB  - Immunoglobulin G (IgG) autoantibodies of 20 patients with autoimmune hemolytic
      anemia (AHA) were used in immunoaffinity assays with surface-radioiodinated human
      red blood cells (RBCs), and detergent-solubilized products were analyzed by SDS
      PAGE/autoradiography. Four membrane proteins were identified as candidate
      autoantigens: a nonglycosylated polypeptide with an apparent molecular mass of 34
      kD (p34) that was expressed in all available RBC phenotypes except Rhnull but
      differed consistently in apparent molecular mass from the 32-kD Rh(D) polypeptide
      co-isolated by IgG allo-anti-D; a heterogenous 37-55-kD glycoprotein, also
      deficient in Rhnull RBCs, which disappeared after deglycosylation by N-glycanase,
      with the appearance of a sharp, new approximately 31-kD band distinct from p34
      and from Rh(D) polypeptide; a approximately 100-kD major membrane glycoprotein
      identified by immunoblotting as the band 3 anion transporter; and glycophorin A
      (GPA), also confirmed by immunoblotting. GP37-55 was not seen in the absence of
      p34, and both proteins are likely to be members of the Rh family. Indeed, a 34-kD
      polypeptide band and 37-55-kD poly-disperse "smear," isolated concurrently from
      the same labeled RBCs by IgG allo-anti-e, were indistinguishable from their
      autoantibody-isolated counterparts and may well be the same protein identified at
      different epitopes by the auto- and allo-antibodies. Individual AHA patients'
      autoantibodies isolated p34 and gp37-55, alone or in combination with band 3
      (nine cases); strong band 3 alone (five cases); and combinations of band 3 with
      GPA (six cases). The autoantibodies of three additional patients whose AHA had
      been induced by alpha-methyldopa also isolated p34 and gp37-55.

PMID- 8473511
TI  - Genetic basis of human complement C4A deficiency. Detection of a point mutation
      leading to nonexpression.
AB  - The fourth component of the human complement system (C4) is coded for by two
      genes, C4A and C4B, located within the MHC. Null alleles of C4 (C4Q0) are defined
      by the absence of C4 protein in plasma. These null alleles are due either to
      large gene deletions or to nonexpression of the respective genes. In a previous
      study, evidence was obtained for nonexpressed defective genes at the C4A locus,
      and for gene conversion at the C4B locus. To further characterize the molecular
      basis of these non-expressed C4A genes, we selected nine pairs of PCR primers
      from flanking genomic intron sequences to amplify all 41 exons from individuals
      with a defective C4A gene. The amplified products were subjected to single
      stranded conformation polymorphism (SSCP) analysis to detect possible mutations.
      PCR products exhibiting a variation in the SSCP pattern were sequenced directly.
      In 10 of 12 individuals studied, we detected a 2-bp insertion in exon 29 leading
      to nonexpression due to the creation of a termination codon, which was observed
      in linkage to the haplotype HLA-B60-DR6 in seven cases. In one of the other two
      individuals without this mutation, evidence was obtained for gene conversion to
      the C4B isotype. The genetic basis of C4A nonexpression in the second individual
      is not yet known and will be subject to further analysis.

PMID- 8473512
TI  - Genesis and evolution of antichromatin autoantibodies in murine lupus implicates
      T-dependent immunization with self antigen.
AB  - Autoantibodies reacting with chromatin and its components, histones and DNA, are
      characteristic of the human autoimmune disease SLE and drug-induced lupus, but
      the mechanisms of their induction remain unknown. Serial serum samples collected
      over short intervals from lupus-prone MRL/MP-lpr/lpr and BXSB mice were tested by
      ELISA on chromatin and its substructures to characterize the initial autoimmune
      response to these antigens. Direct binding studies demonstrated that the early
      autoantibodies recognized discontinuous epitopes on native chromatin and the (H2A
      H2B)-DNA subnucleosome. As the immune response progressed, native DNA and other
      chromatin constituents generally became antigenic. Based on adsorption studies
      and IgG subclass restriction, antibodies to native DNA were more related to
      chromatin than to denatured DNA. The kinetics of autoantibody appearance and the
      Ig class distribution were similar to the kinetics and distribution seen in
      antibodies induced by immunization with an exogenous T-dependent antigen. These
      results are most consistent with the view that autoantibodies reacting with
      chromatin are generated by autoimmunization with chromatin, and antibodies to
      native DNA are a subset of the wide spectrum of antichromatin autoantibodies.

PMID- 8473513
TI  - IL-1-induced murine osteoblast IL-6 production is mediated by the type 1 IL-1
      receptor and is increased by 1,25 dihydroxyvitamin D3.
AB  - IL-1-induced osteoblast IL-6 production represents one possible mechanism by
      which IL-1 augments bone resorption. In this report, we show that the murine
      osteoblastic cell line (MC3T3-E1) expresses type 1 IL-1 receptors based on 125I
      HrIL1 alpha binding, blocked by type 1 IL-1R antibodies (35F5), and analysis of
      MC3T3 RNA by reverse transcription (RT)-DNA amplification and Northern analysis.
      MC3T3 cells do not express detectable type 2 IL-1R mRNA by RT-DNA amplification.
      IL-1 induces (IL-1 ED50, 0.1 pM) IL-6 production through the type 1 IL-1R as 35F5
      antibodies block IL-1-stimulated IL-6 production. Vitamin D3 increases IL-1R
      expression dose- and metabolite-dependently, with 1,25-(OH)2D3 having the
      greatest potency, and also enhances IL-1's capacity to stimulate IL-6 production
      at low IL-1 levels. Both IL-1 and 1,25-(OH)2D3 induce type 1 IL-1R and not type 2
      IL-1R upregulation based on ligand binding and RT-DNA amplification. Increased IL
      1R expression requires a 5-7-h treatment and is protein/RNA synthesis dependent.
      These observations imply that IL-1-induced IL-6 production in osteoblasts is
      mediated by type 1 IL-1Rs and that increased IL-1R expression could play a role
      in mediating IL-1-induced skeletal responses.

PMID- 8473514
TI  - Increased plasma and renal clearance of an exchangeable pool of apolipoprotein A
      I in subjects with low levels of high density lipoprotein cholesterol.
AB  - Plasma levels of HDL apo A-I are reduced in individuals with low HDL cholesterol
      (HDL-C) concentrations as a result of increased fractional catabolic rates
      (FCRs). To determine the basis for the high apo A-I FCRs, seven subjects with low
      HDL-C levels (31.0 +/- 4.3 mg/dl) were compared with three subjects with high HDL
      C levels (72.0 +/- 4.5 mg/dl). Each subject received autologous HDL that was
      labeled directly by the iodine-monochloride method (whole-labeled) and autologous
      HDL that was labeled by exchange with homologous radiolabeled apo A-I (exchange
      labeled). Blood was obtained for 2 wk, specific activities determined, and FCRs
      (d-1 +/- SD) estimated. In every subject, whether in the low or high HDL-C group,
      the exchange-labeled FCR was greater than the whole-labeled FCR. The exchange
      labeled FCR was higher in the low HDL-C group (0.339 +/- 0.043) versus the high
      HDL-C group (0.234 +/- 0.047; P < 0.009). The whole-labeled FCR was also greater
      in the low HDL-C group (0.239 +/- 0.023) versus the high HDL-C group (0.161 +/-
      0.064; P < 0.02). In addition, in both low and high HDL groups
      ultracentrifugation resulted in more radioactivity in d > 1.210 (as percentage of
      total plasma counts per minute) with the exchange-labeled tracer than with the
      whole-labeled tracer (12.55 +/- 4.95% vs. 1.02 +/- 0.38%; P < 0.003). With both
      HDL tracers, more radioactivity was found in d > 1.210 in the low versus the high
      HDL-C groups. When apo A-I catabolism was studied by perfusing isolated rabbit
      kidneys with whole-labeled HDL, there was twice as much accumulation (cpm/g
      cortex) of HDL apo A-I isolated from subjects with low HDL-C than from subjects
      with high HDL-C (P < 0.0025). Finally, HDL that had been isolated from subjects
      with high levels of HDL-C was triglyceride enriched and exposed to partially
      purified lipases before perfusion through kidneys. Threefold more apo A-I from
      modified HDL accumulated in the cortex compared with the unmodified preparation
      (P < 0.007). The results of these in vivo and ex vivo studies indicate that
      individuals with low HDL-C levels have more loosely bound, easily exchanged apo A
      I and that this exchangeable apo A-I is more readily cleared by the kidney.

PMID- 8473515
TI  - Gene p53 mutations are restricted to poorly differentiated and undifferentiated
      carcinomas of the thyroid gland.
AB  - The p53 gene was analyzed in tumor specimens obtained from 52 patients with
      various types of carcinoma of the thyroid gland by a combined molecular and
      immunocytochemical approach. The histologic types included 37 well-differentiated
      papillary and follicular carcinomas, 8 poorly differentiated, and 7
      undifferentiated carcinomas. The p53 gene was shown to be unaffected in all
      differentiated tumors by single-strand conformation polymorphism analysis.
      However, in two out of eight (25%) of poorly differentiated carcinomas and five
      out of seven (71%) undifferentiated carcinomas, p53 mutations were identified and
      subsequently characterized by DNA sequencing. One undifferentiated carcinoma
      displayed two areas with varying degrees of differentiation. The comparative
      analysis of the p53 gene, in both the more and the less differentiated area of
      this tumor, clearly showed that the p53 mutation was confined to the latter
      component of the tumor specimen. These results indicate that mutations of the p53
      gene are associated with the most aggressive histologic types of thyroid tumors,
      such as the undifferentiated carcinoma and, to a certain extent, the poorly
      differentiated carcinoma, and that the alterations of this gene represent a late
      genetic event in human thyroid carcinogenesis.

PMID- 8473516
TI  - Dietary induced subclinical vitamin K deficiency in normal human subjects.
AB  - A subclinical vitamin K deficiency was induced in 32 healthy subjects (four
      groups of eight males and females) aged 20-40 and 60-80 yr residing in the
      Metabolic Research Unit of the Human Nutrition Research Center on Aging at Tufts
      University. Volunteers were initially fed (4 d) a baseline-period diet containing
      the recommended daily allowance for vitamin K which is equivalent to 80
      micrograms/d of phylloquinone (vitamin K1). During the baseline period various
      parameters of vitamin K nutritional status were monitored. The baseline period
      was followed by a 13-d depletion period during which the subjects were fed a very
      low vitamin K1 diet (approximately 10 micrograms/d). After depletion, the
      subjects entered a 16-d repletion period (four stages lasting 4 d each) during
      which time they were repleted with 5, 15, 25, and 45 micrograms of vitamin K1 per
      day. Vitamin K1 depletion dramatically and significantly decreased plasma vitamin
      K1 levels (P < 0.0001) in both elderly and young groups to values 13-18% of day 1
      (elderly 0.22 nM, young 0.14 nM). Repleting the subjects with up to 45 micrograms
      of vitamin K1 per day failed, in the case of the young subjects, to bring plasma
      vitamin K1 levels back into the normal range. Dietary vitamin K1 restriction
      induced different responses in the urinary excretion of gamma-carboxyglutamic
      acid between the young and the elderly subjects with values decreasing
      significantly (P < 0.03) in the young while remaining unchanged in the elderly.
      The vitamin K1 depletion period had no significant effect on either prothrombin
      and activated partial thromboplastin times, or Factor VII and protein C (as
      determined by antigenic and functional assays). By using a monoclonal antibody,
      decarboxy prothrombin was found to increase slightly but significantly in both
      groups (P < 0.05) as a consequence of the low vitamin K1 diet. This study clearly
      shows that a diet low in vitamin K1 can result in a functional subclinical
      deficiency of vitamin K (decreased urinary gamma-carboxyglutamic acid excretion)
      without affecting blood coagulation.

PMID- 8473517
TI  - Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture in
      elderly women.
AB  - It has been previously shown that the level of circulating undercarboxylated
      osteocalcin (ucOC) is elevated in elderly women in comparison with young,
      healthy, premenopausal ones. To understand the mechanism of the increase in the
      ucOC in the elderly and to assess its potential consequences on bone fragility,
      we have measured ucOC in the sera of 195 elderly institutionalized women 70-101
      yr of age. In 45 women (23%) serum ucOC was above the upper limit of the normal
      range for young women. The level of ucOC was negatively correlated with 25OHD (r
      = -0.32, P < 0.001) even after excluding the effect of age, parathyroid hormone
      (PTH), and creatinine by partial correlation (r = -0.24, P < 0.002). During an 18
      mo follow-up, 15 women sustained a hip fracture and their baseline ucOC level was
      higher (P < 0.01) in women who subsequently sustained hip fracture than in the
      nonfracture group contrasting with no significant differences for serum calcium,
      phosphate, alkaline phosphatase, creatinine, PTH, 250HD, and total and
      carboxylated OC. The risk of hip fracture was increased in women with elevated
      ucOC (relative ratio 5.9, 99.9% Cl 1.5-22.7, P < 0.001). During 1 yr of
      calcium/vitamin D2 treatment, ucOC decreased (P < 0.05), especially in those with
      the initially increased values (from 2.22 +/- 0.35 to 1.41 +/- 0.29 ng/ml, P
      <0.005) contrasting with an increase in the placebo group (P < 0.05). In
      conclusion, the increase in ucOC in the elderly reflects not only some degree of
      vitamin K deficiency but also their poor vitamin D status, suggesting that
      vitamin D may be important, either directly or indirectly through its effect on
      bone turnover, for achieving a normal gamma-carboxylation of OC. The ucOC, but
      not conventional calcium metabolism parameters, predicts the subsequent risk of
      hip fracture, suggesting that serum ucOC reflects some changes in bone matrix
      associated with increased fragility.

PMID- 8473518
TI  - Bone morphogenetic protein expression in human atherosclerotic lesions.
AB  - Artery wall calcification associated with atherosclerosis frequently contains
      fully formed bone tissue including marrow. The cellular origin is not known. In
      this study, bone morphogenetic protein-2a, a potent factor for osteoblastic
      differentiation, was found to be expressed in calcified human atherosclerotic
      plaque. In addition, cells cultured from the aortic wall formed calcified nodules
      similar to those found in bone cell cultures and expressed bone morphogenetic
      protein-2a with prolonged culture. The predominant cells in these nodules had
      immunocytochemical features characteristic of microvascular pericytes that are
      capable of osteoblastic differentiation. Pericyte-like cells were also found by
      immunohistochemistry in the intima of bovine and human aorta. These findings
      suggest that arterial calcification is a regulated process similar to bone
      formation, possibly mediated by pericyte-like cells.

PMID- 8473519
TI  - Anatomical and developmental patterns of facilitative glucose transporter gene
      expression in the rat kidney.
AB  - In situ hybridization was used to map cellular patterns of gene expression for
      facilitative glucose transporters (GTs) 1-5 in the developing and adult rat
      kidney. GT3 was not detected. GT1 mRNA was present in the proximal straight
      tubule (PST), distal nephron and collecting duct. GT2 mRNA was localized in both
      proximal convoluted and PST, while GT5 mRNA was detected only in the PST. GT4
      mRNA and immunoreactivity were focally localized in the thick ascending limb of
      Henle's loop and were coexpressed with IGF-I. Thus, each of the four different
      isoforms demonstrated a distinct renal distribution, with GTs 1, 2, and 5
      coexpressed in the PST. Renal GT1 and GT5 gene expression were unchanged
      throughout development, while GT2 was most abundant before weaning and GT4 was
      first detected after weaning. Only GT4 appeared to be hormonally regulated: It
      was decreased after hypophysectomy and increased after vasopressin treatment, but
      was not affected by 1 or 4 d of insulinopenic diabetes mellitus. The coexpression
      of GT4 and IGF-I in the thick ascending limb segment of the nephron suggests a
      novel autocrine/paracrine mechanism by which cells may control local fuel economy
      independently from that of the larger structure to which they belong and from the
      systemic hormonal milieu.

PMID- 8473520
TI  - Hereditary tyrosinemia type I. Self-induced correction of the fumarylacetoacetase
      defect.
AB  - Two Norwegian patients with chronic tyrosinemia type I showed > 50% residual
      fumarylacetoacetase activity in liver samples obtained during liver
      transplantation. The enzyme characteristics of both patients were comparable with
      those of a normal control. Immunohistochemistry on liver sections from these
      patients and from three other Norwegian tyrosinemia patients revealed a mosaicism
      of fumarylacetoacetase immunoreactivity corresponding completely or partly to
      some of the regenerating nodules. This appearance of enzyme protein is presumably
      induced by the disease process. The mechanism involved remains unclear and could
      be caused by a genetic alteration, regained translation of messenger RNA, or to
      enhanced stability of an abnormal enzyme.

PMID- 8473521
TI  - Recombinant platelet-derived growth factor B gene expression in porcine arteries
      induce intimal hyperplasia in vivo.
AB  - Platelet-derived growth factor (PDGF) B chain induces cell proliferation in vitro
      and is associated with arterial lesions that cause cardiovascular disease.
      However, it has been difficult to document the biological response to PDGF B gene
      expression in arteries in vivo. To determine the biologic effects of this growth
      factor in vivo, we have introduced an eukaryotic expression vector plasmid
      encoding recombinant PDGF B by direct gene transfer into porcine iliofemoral
      arteries using DNA liposome complexes. The presence of PDGF B plasmid DNA and
      expression of recombinant mRNA were confirmed by polymerase chain reaction
      analysis, and recombinant PDGF protein was demonstrated by immunohistochemistry.
      Intimal thickening was observed in porcine arteries 21 days following
      transfection with the recombinant PDGF B gene compared with arteries transduced
      with a control gene, E. coli beta-galactosidase. An eightfold increase in intimal
      to medial ratio was present in PDGF B gene transfected arteries compared with
      control transfected arteries (P = 0.001). This study suggests that expression of
      a recombinant PDGF B gene in vivo can play a role in the induction of intimal
      hyperplasia, which can lead to cardiovascular diseases.

PMID- 8473522
TI  - Suppression of food intake by apolipoprotein A-IV is mediated through the central
      nervous system in rats.
AB  - The aim of this experiment was to investigate whether the anorectic effect of
      apolipoprotein A-IV (apo A-IV) after lipid feeding is mediated via the central
      nervous system. Infusion of 0.5 micrograms of apo A-IV into the third ventricle
      failed to suppress food intake. Higher doses (1 micrograms or higher) of apo A-IV
      infused into the third ventricle inhibited food intake in a dose-dependent
      manner. In contrast, when apo A-I was infused into the third ventricle it had no
      effect on food intake. To further test the hypothesis that apo A-IV is an
      important factor controlling food intake, we administered goat anti-rat apo A-IV
      serum into the third ventricle of rats that were allowed food and water and lib.
      In all rats tested, this treatment resulted in enhanced food intake. In contrast,
      infusion of goat anti-rat apo A-IV serum failed to elicit such a response.
      Lastly, we determined the apo A-IV concentration in plasma and cerebrospinal
      fluid before and during active lipid absorption. Apo A-IV concentration in
      cerebrospinal fluid was about 1/20 that of plasma. Both serum and cerebrospinal
      fluid apo A-IV increased markedly as a result of feeding of lipid. In conclusion,
      we propose that apo A-IV may act centrally to control food intake.

PMID- 8473523
TI  - Prevention of fetal loss in experimental antiphospholipid syndrome by in vivo
      administration of recombinant interleukin-3.
AB  - Antiphospholipid antibodies are strongly associated with arterial and venous
      thrombosis and with fetal loss. Recently an experimental model for
      antiphospholipid syndrome (APLS) was established in our laboratory. In this
      model, mice are immunized passively or actively with anticardiolipin antibodies
      and acquire the syndrome, which is characterized by prolonged activated partial
      thromboplastin time (APTT), thrombocytopenia, low fecundity rate, and fetal loss.
      In a normal process of pregnancy, lymphokines affect fetal implantation and
      development. Cytokines from the colony stimulating factor family, like GM-CSF and
      IL-3, were shown to be positive signals for implantation and to promote placental
      development and fetal growth. Given our preliminary findings of low IL-3 in mice
      with APLS and the efficacy of IL-3 in preventing fetal loss in a strain of mice
      prone to fetal resorption, our aim in the present study was to examine the effect
      of murine recombinant IL-3 (mrIL-3) on pregnant mice induced with experimental
      APLS. Mice were passively transfused to the tail vein, 24 h following mating,
      with anticardiolipin antibodies. The mice were divided into two groups: one group
      was injected intraperitoneally with mrIL-3 on days 6.5, 8.5, and 10.5 after
      mating, while the control group was injected with PBS. When the mice were killed
      on day 15 of pregnancy a 32% +/- 4.2 resorption rate was observed in the anti
      cardiolipin-immunized group, which was reduced to 4% +/- 0.3 following treatment
      with mrIL-3. The thrombocytopenia associated with the experimental APLS was also
      corrected following lymphokine administration. IL-3 may be effective in
      prevention of recurrent fetal loss in APLS.

PMID- 8473524
TI  - Enhanced prostacyclin synthesis in endothelial cells by retrovirus-mediated
      transfer of prostaglandin H synthase cDNA.
AB  - A retroviral vector (BAG) was used to transfer human prostaglandin H synthase
      (PGHS-1) gene into a human endothelial cell line for enhancement of PGI2
      synthesis. Cells infected with BAG containing PGHS-1 cDNA in the sense
      orientation relative to the retroviral promoter (PGHS(S)) expressed a 30-fold
      increase in mRNA but, due to a reading frame shift, did not show an increase in
      PGHS protein or in PGI2 synthesis, while those with PGHS-1 in reverse orientation
      relative to the viral promoter (PGHS(R)), produced a > 10-fold increase in PGHS
      mRNA over the control (169 +/- 22 vs 14.8 +/- 1.2 amol/micrograms RNA) with a
      concordant increase in PGHS protein (5.82 +/- 1.07 vs 0.23 +/- 0.04 ng/mg
      protein) and enzyme activity. Primer extension analysis of PGHS(R) revealed two
      transcription start sites located in the SV40 late promoter region adjacent to
      PGHS-1 cDNA. PGHS(R) cells produced a high basal PGI2 level which was increased
      by several-fold in response to stimulation by ionophore, arachidonic acid, and
      thrombin. Kinetic analysis revealed the PGI2 synthetic rate to be 14 ng/min-1 per
      million cells and t1/2 of PGI2 synthesis, 13.3 min. These findings indicate that
      transfer of PGHS-1 gene into vascular cells enhances PGI2 synthesis and may be a
      useful strategy for restoring thromboprotective property of damaged blood
      vessels.

PMID- 8473525
TI  - Prediction of the development of low birth weight preterm infants by a new
      neonatal medical index.
AB  - A new neonatal medical index (NMI) was used to predict the mental and motor
      development of low birth weight, preterm infants up to 3-years-old. The NMI is a
      summary score of only a few clinically salient items that are readily available
      on brief chart review. The sample consisted of 512 of 608 infants randomly
      assigned to the control group of the eight-site Infant Health and Development
      Program and on whom the complete set of developmental outcome measures was
      available. The developmental tests administered were the Bayley Scales at 12 and
      24 months and the Stanford-Binet at 3 years. The findings indicated the NMI was
      predictive of later cognitive and motor development, and in infants born weighing
      less than 1500 g, the effects of neonatal medical complications continued to
      adversely influence these children's development to at least 3 years of age. In
      the heavier babies the developmental effects of sociodemographic factors
      predominated by 24 months and beyond.

PMID- 8473526
TI  - Cranial sonography and neurological examination at term and motor performance
      through 19 months of age.
AB  - This study examined the role of cranial sonography and neurological examination
      in the prediction of developmental progress during the first 19 months of life in
      extremely preterm infants. Forty-seven infants with mean birth weight 993 +/- 197
      g and gestational age 27.9 +/- 1.9 weeks were studied. Each infant was classified
      as normal, suspect, or abnormal using cranial sonography and a structured
      neurological examination. Developmental outcome was assessed using the Infant
      Neurological International Battery (INFANIB) at 4, 8, and 14 months and the
      Rockford Infant Developmental Evaluation Skills (RIDES) at 19 months. Sonographic
      classification was the best predictor of outcome through 14 months, F(2.72) =
      12.4, p < .001. The neurological examination predicted performance only at 4
      months. No infant classified as normal on both examinations was abnormal on
      follow-up. Infants with suspect or abnormal neurological examinations had normal
      outcomes if their sonographic findings were normal.

PMID- 8473527
TI  - Correlates of psychological adjustment to pediatric physical disorders: a meta
      analytic review and comparison with existing models.
AB  - Thirty-eight studies of correlates of children's adjustment to physical disorders
      were reviewed in a meta-analysis and compared with existing models. Results
      indicate (1) considered collectively, disease/disability risk factors,
      parent/family risk factors, and child characteristics are significantly
      correlated with child adjustment although stressors (including socioeconomic
      status) are not; (2) disease/disability risk factors show significantly lower
      correlations than do parent/family or child characteristics; (3) child
      characteristics show the strongest correlation to adjustment, but these measures
      may be contaminated because items on some of these scales (e.g., self-concept,
      temperament) sometimes overlap with those on measures of total adjustment. With
      the exception of studies of disease severity, the number of studies meeting
      criteria for inclusion, with quantifiable correlates and measures of adjustment,
      was quite small. Inclusion of child, family/parent, social and medical
      risk/protective factors in future models is most appropriate, but greater
      emphasis needs to be placed on the child and family/parent characteristics.
      Greater attention also must be devoted to examining the interaction of
      risk/protective factors, including those that may be general and those that may
      be specific to a particular disability.

PMID- 8473528
TI  - Repeated social stress during pregnancy impairs neuromotor development of the
      primate infant.
AB  - Neuromotor responses were assessed in 90 infant squirrel monkeys born from normal
      and stressed pregnancies. Repeated psychological disturbance during pregnancy,
      evoked by disruption of the pregnant female's social relationships, significantly
      altered the performance of the young infant on a standardized battery of
      neuromotor tests. As compared with infants from undisturbed pregnancies, infants
      from chronically stressed pregnancies had poorer motor abilities, impaired
      balance reactions, and reduced postrotary nystagmus. They also had shorter
      attention spans and looking episodes during the administration of orientation
      items. In contrast, when only a single stressful period was imposed during
      midgestation, infants were not significantly different from control subjects.
      These findings indicate that sustained stress across pregnancy can have
      deleterious effects on fetal development, but a short period of stress, at least
      when restricted to midgestation, does not appear to adversely affect neuromotor
      responses of the young primate infant.

PMID- 8473529
TI  - Development in children's causal theories of their seizure disorders.
AB  - Despite the prevalence of seizure disorders in children, little is known about
      how youngsters with epilepsy understand the cause of their disorder. Fifty
      children and adolescents with idiopathic seizure disorders, between 5- and 16
      years-old, were questioned about the etiology of seizure episodes and of seizure
      disorders, as well as their understanding of physical causality, general illness
      causality, and brain functioning. Responses were scored for their conceptual
      complexity according to scales paralleling Piaget's stages of cognitive
      development. Older children had more cognitively sophisticated concepts of
      epilepsy than did younger children. Overall, however, children scored
      significantly lower on questions about their seizure disorders than on questions
      assessing their understanding of physical causality, general illness causality,
      and brain functioning. Many children had misconceptions about seizure disorders
      and lacked disease-related information; only 41% of the children identified
      epilepsy as a disease involving the brain. These findings underline the need for
      including educational intervention in the comprehensive care of pediatric seizure
      disorders.

PMID- 8473530
TI  - In the eyes of the beholder: family and maternal influences on perceptions of
      adjustment of children with a chronic illness.
AB  - Investigation of the adjustment of children with a chronic illness has been
      complicated by an imprecise definition of adjustment, immense diversity in the
      kinds of chronic illnesses studied, and multiple instruments and sources of
      measurement of the child's behavior. In this study we have used a composite
      construct of adjustment, looked separately at reports from three separate
      observers of children's behavior, and limited our investigation to a few discrete
      types of illnesses. The investigation explores the contribution of selected
      characteristics of mothers and of families to children's adjustment as reported
      by children, their mothers, and their teachers. Family interactions were
      important to the psychological adjustment of all children (healthy or with a
      chronic illness and independent of age and socioeconomic status) as reported by
      all three observers. The mother's self-esteem and reported size of her social
      network were not associated with children's adjustment, but the mother's health
      locus of control beliefs interacted with the child's intelligence to predict
      children's adjustment. The pattern of these associations was different for
      different illness groups and for each of the three observers.

PMID- 8473531
TI  - Improved maintenance of plaque control by electrical toothbrushing in
      periodontitis patients with low compliance.
AB  - Patients showing low compliance with oral hygiene were selected from a population
      of patients referred for specialist treatment of periodontitis. The patients
      selected did not show an acceptable plaque control in spite of a prolonged
      training period. Plaque around 40% of the tooth surfaces, documented over a
      period of 4 to 40 months of frequent information and instructions, was found in
      10 patients around the age of 40 years with a marked overrepresentation of men.
      Substitution of the ordinary toothbrush with an electrical toothbrush using the
      same working principles, resulted in a decreased plaque score of approximately
      10% maintained over a considerable time period (12-36 months). A common complaint
      among the patients was that the oral hygiene procedures were time-consuming and
      cumbersome. They considered the electrical toothbrush as simple and time saving.
      Even if these possibilities were not investigated, merely the patients' positive
      attitude may have made the efforts of tooth cleaning including the proximal
      cleaning more tolerable, thus improving the compliance. Contributing to the
      improved compliance might also have been the electrical toothbrush per se. The
      cleaning technique allows the patient to concentrate on aiming the bristles at
      the gingival sulcus, while the brush makes the movements. In conclusion, it
      should be worthwhile recommending an electrical toothbrush with simple working
      technique to low compliant periodontitis patients restricting the recalls to
      twice a year.

PMID- 8473532
TI  - The effects of Acacia arabica gum on the in vitro growth and protease activities
      of periodontopathic bacteria.
AB  - The antibacterial activity of acacia gum was assessed using fresh isolates and
      reference strains of Actinobacillus actinomycetemcomitans, Capnocytophaga spp.,
      Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola. A fine
      aqueous suspension of gum was produced by sonication and then a soluble fraction
      isolated by centrifugation and membrane filtration. These preparations were
      incorporated into columbia agar at doubling concentrations. Growth of P.
      gingivalis and P. intermedia cultures on the agar was inhibited by whole gum
      sonicate at concentrations of 0.5-1.0% w/v. Both species showed reduced
      susceptibility when horse blood was present in the agar. The gum soluble fraction
      did not inhibit growth of any bacterial culture. The effect of acacia on
      bacterial proteases was examined with cell sonicates from log phase broth
      cultures. Enzyme activities were determined by fluorimetric assay with various
      synthetic peptide substrates. Most protease activities reduced in the presence of
      0.5% w/v gum sonicate, with the trypsin-like activities of P. gingivalis and P.
      intermedia proving most sensitive. The gum soluble fraction was nearly always
      less inhibitory than the sonicate. The action of acacia gum against suspected
      periodontal pathogens and their enzymes suggests that it may be of clinical
      value.

PMID- 8473533
TI  - Comparability and discriminating power of 4 plaque quantifications.
AB  - This study was designed for analysis of the discriminating power of 4 different
      quantifications of supragingival plaque: (1) plaque wet weight (PWW); (2) the
      plaque index (PlI); (3) the PLQ index measuring the coronal extension of plaque;
      (4) the area % of stained plaque. Different quantities of plaque were produced by
      adding chlorhexidine acetate (CHX), hydrogen peroxide (H2O2), or sucrose to
      experimental chewing gums. Total mean scores of 12 subjects in each of 3 test
      groups revealed that chewing of CHX gum resulted in the lowest plaque scores with
      all 4 quantifications and that the highest scores were recorded for the PWW or
      PlI of the sucrose gum users. Chewing of the H2O2 gum produced as much plaque as
      the sucrose gum when evaluated according to the PLQ index and exceeded the
      sucrose gum scores when evaluated according to the area % index. The PWW
      discriminated best between low, medium and high plaque scores after chewing of
      both CHX, H2O2 and sucrose gums. PlI scores 1 and 3 remained stable whereas the
      frequency of PlI score 0 strongly decreased and that of score 2 strongly
      increased when going from gums producing low (CHX) and medium (H2O2) to large
      (sucrose) amounts of plaque. The PLQ index discriminated well between low and
      medium but poorly between medium and large amounts of plaque. The area % index
      functioned well when subjects with low (CHX) and medium (H2O2) plaque scores were
      subgrouped into those with < 30%, 30-70% or > 70% of their tooth surfaces covered
      with stained plaque.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473534
TI  - A comparison of methods to assess marginal bone height around endosseous
      implants.
AB  - 3 methods of measurements of marginal bone level on intra-oral radiographs of
      endosseous implants are described: measurements with a computerized image
      analysis system, with a magnifying-glass and with a digital sliding gauge. The
      accuracy of each of these methods was investigated and compared. The intra- and
      inter-observer error analysis showed that determining the precise bone height on
      the image is responsible for a large standard deviation for each method. It is
      concluded that measurements with a digital sliding gauge are preferable because
      it is easy to put into practice, and in addition, accuracy matches the accuracy
      of the other methods.

PMID- 8473535
TI  - Periodontal healing in teeth with periapical lesions. A clinical retrospective
      study.
AB  - The purpose of the present investigation was to compare clinical periodontal
      healing in periodontally involved teeth with and without pulpal pathosis. The
      investigation was conducted as a retrospective study on a consecutive referral
      population. The periapical conditions in endodontically involved single-rooted
      teeth from a selected patient sample were evaluated and correlated with their
      periodontal healing pattern. Multiple regression analysis of the registered
      variables showed that initial mean pocket depth and time elapsed after treatment
      significantly influenced change in pocket-depth. Non-surgical treatment of
      periodontal pockets exceeding 2.5 mm in teeth with horizontal marginal defects,
      over the observation period, showed significantly reduced mean pocket depth
      reduction in teeth with periapical pathology compared to teeth without periapical
      pathology. It was, furthermore, evident that proximal restorations, abutments for
      fixed bridges and root fillings with and without dowels did not significantly
      influence pocket depth reduction in the present material. It was concluded, based
      on the present results, that a root-canal infection, evident as a periapical
      radiolucency, if left untreated may in the long term perspective result in
      retarded or impaired periodontal healing following periodontal therapy and,
      consequently, should be given appropriate consideration when coordinating
      endodontic therapy and periodontal treatment.

PMID- 8473536
TI  - Meta-analysis of surgical versus non-surgical methods of treatment for
      periodontal disease.
AB  - A meta-analysis was performed on 5 randomized controlled trials comparing
      surgical with non-surgical treatment for periodontal disease. The specific
      procedures considered were the modified Widman flap compared with scaling and
      root planning or curettage with anesthesia. We chose the most consistently
      reported outcomes, pocket depth and attachment level, for analysis. At 1 year of
      follow-up, surgical treatment reduced pocket depth more than non-surgical for all
      initial levels of disease, but by 5 years, only the deepest initial pockets (> 7
      mm) showed significant improvement over non-surgically treated teeth (0.51 mm
      reduction, p < 0.01). Attachment level showed significantly better early results
      for non-surgical treatment for less diseased teeth, but by 5 years, all
      significant differences had disappeared. We computed quality scores following a
      method described by Chalmers. The mean quality score for study data analysis and
      presentation was 0.37 +/- 0.009 and for the study protocol, the mean quality
      score was 0.19 +/- 0.002. We find that this meta-analysis supports findings
      relating response to therapy with initial level of disease severity. We also find
      that the choice of outcome measure influences the choice of therapy, with
      surgical therapy providing greater benefit for probing depth and non-surgical
      therapy providing greater benefit for attachment level. These results must be
      viewed, however, in light of the low quality scores of the evaluated studies and
      the potential for bias due to lack of binding, the small mean treatment
      differences, and the observer measurement variability.

PMID- 8473537
TI  - Periodontal disease in an Amish population.
AB  - Epidemiological studies of periodontal disease have attempted to focus on defined
      groups in which the variables thought to be responsible for disease could be
      controlled or more easily identified. This study documents periodontal disease
      parameters in a unique population of Amish farmers. A total of 371 Amish were
      contacted and 282 were examined in their homes giving a participation rate of
      76%. Ages ranged from 18 to 79 years. Overall means for periodontal conditions
      were 1.54 mm for attachment loss, 2.63 mm for pocket depth, 0.17 for calculus,
      0.63 for plaque and 0.61 for gingivitis. One dental examiner conducted all
      examinations. Prevalence of periodontal disease tended to be higher among males
      and increased with age. The majority of Amish examined had little evidence of
      destructive periodontal disease; about 3.4% of teeth examined had attachment loss
      of 6 mm or more. These findings indicate a modest level of periodontal disease
      among the Amish. It is of interest that this population does not generally seek
      routine dental care. Preliminary analyses of health behavior data collected
      indicate a lack of regular oral hygiene practices. It appears that the Amish may
      have protective factors which affect their level of disease.

PMID- 8473538
TI  - The plaque-removing efficacy of an oscillating/rotating toothbrush. A short-term
      study.
AB  - The purpose of the present study was to test the effectiveness of a new type of
      BRAUN electric toothbrush (D5) in comparison with the traditional BRAUN electric
      toothbrush (D3) and to a manual toothbrush (M). For this study, 60 dental
      students were selected who had no previous experience with the use of an electric
      toothbrush. The study consisted of 3 experiments. Prior to each experiment, all
      students were asked to abstain from all oral hygiene procedures for at least 24
      h. In Exp I, the efficacy of toothbrushing was studied when one of the
      investigators brushed the teeth of the students. No toothpaste was used in this
      first part of the study. In Exp II, the efficacy of brushing was evaluated when
      the brushing was carried out by the students themselves. In Exp III, the efficacy
      of the brushing was studied after the students had received a professional
      instruction and oral prophylaxis. The available time for the brushing amounted to
      a total of 2 min per mouth. The amount of dental plaque was evaluated by means of
      the Silness and Loe plaque index at 6 sites around the tooth. Results showed in
      Exp I that both electric toothbrushes proved to remove significantly more plaque
      than the manual toothbrush (M 78%; D3 85%; D5 86%). In Exp II, no significant
      differences in plaque-removing efficacy were found between the 3 brushes (M 73%;
      D3 72%; D5 73%). In Exp III, the D5 proved to remove significantly more plaque
      than the other two brushes (M 77%; D3 77%; D5 83%).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8473539
TI  - Effect of rinsing time on antiplaque-antigingivitis efficacy of listerine.
AB  - This double-blind, controlled clinical study compared the effectiveness of 30-
      and 60-s listerine rinses in both inhibiting the development of, and reducing
      existing, supragingival plaque and gingivitis, using an experimental gingivitis
      model. 94 subjects completed this study. For each subject, a modified gingival
      index, modified Quigley-Hein plaque index and Eastman interdental bleeding index
      were recorded at baseline and at 2 weeks. Following the baseline examinations,
      subjects received half-mouth prophylaxes, and began 2 x daily supervised rinsing
      either with listerine for 30 or 60 s or with a control mouthrinse for 30 s as
      their sole oral hygiene measure. Statistical analysis (ANCOVA) showed that both
      the 30- and 60-s listerine rinses were significantly (p < 0.01) more effective
      than the control in inhibiting and reducing plaque, gingivitis and gingival
      bleeding. Although 60-s rinses with listerine were significantly more effective
      (p < 0.01) than 30-s rinses in controlling plaque, the 2 rinse durations were
      similarly effective in controlling interdental bleeding and gingivitis. This
      study confirms the recommendation of 2x daily rinsing with listerine for 30 s as
      an effective regimen for gingivitis control.

PMID- 8473540
TI  - Gingival hyperplasia in renal allograft recipients receiving cyclosporin-A and
      calcium antagonists.
AB  - Although it is established that the immunosuppressant cyclosporin-A (CsA) and
      calcium antagonists [Nifedipine (Nif) and Diltiazem (Dz)] can independently
      induce gingival enlargement, little has been documented on the significance of
      the salivary CsA levels and the combined effect of CsA and a calcium antagonist
      upon gingival tissues. In the present cross-sectional investigation, clinical
      periodontal parameters and the pharmacologic profiles of CsA, Nif, and Dz were
      determined for 66 renal transplant recipients. Subjects were divided into the
      following groups: Group (Gp) 1: CsA [n = 18]; Gp 2: CsA + Nif [n = 15]; Gp 3: CsA
      + Dz [n = 12] and a negative Control Gp 4: azathioprine [n = 21]. A gingival
      enlargement score was assessed for each patient from study models using a
      hyperplastic index (HI). Pharmacologic profiles included CsA whole blood and
      whole saliva levels as measured by fluorescence polarization immunoassay. The HI
      scores between Gp 1, 2 and 3 were not significantly different. However, when
      compared with controls (Gp 4), there was a significant difference in HI and all
      individual groups (Gp 1, 2, 3) (p < 0.05). Gingival hyperplasia was only weakly
      related to plaque and calculus but was unrelated to CsA dose (mg/kg/day),
      duration of CsA therapy (months), CsA blood or saliva levels (ng/ml), or the
      concurrent administration of a Nif or Dz. Gingival enlargement was found to occur
      in 49% of subjects who were either on CsA or CsA and a calcium antagonist. It is
      concluded that CsA alone or in combination with a calcium antagonist caused a
      significant increase in gingival enlargement compared with controls.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8473541
TI  - Prevention of transmission of resistant bacteria between periodontal sites during
      subgingival application of antibiotics.
AB  - This study was designed to investigate whether antibiotic resistant micro
      organisms are able to contaminate and survive on syringe tips used for
      subgingival deposition of antibiotics, and to test simple and effective means of
      disinfecting the syringe tip between applications. In the first part of the
      study, syringe tips used for application of Minocycline subgingival formula in 20
      adult periodontitis patients were cultured for bacteria resistant to this drug
      before and after disinfecting them with ethanol. The results showed that 80% of
      the unwashed syringes were culture positive for minocycline resistant bacteria,
      whereas only 1 ethanol washed syringe tip was contaminated. In part II of the
      study, after dispensing minocycline periodontal formula in 20 patients, 10 of the
      syringe tips were washed with ethanol while 10 were left untreated. All syringes
      were stored in a refrigerator for 8 days, whereafter the tips were sampled for
      resistant bacteria. 20% of the unwashed tips were contaminated after 8 days
      incubation at 4 degrees C. None of the ethanol washed syringe tips were culture
      positive. We conclude that syringe tips may be contaminated with antibiotic
      resistant bacteria after dispensing the antibiotic in periodontal pockets. The
      transmission of these bacteria to other periodontal sites may be avoided by
      disinfecting the syringe tip with ethanol between applications. We have also
      shown that antibiotic resistant bacteria may survive on the syringe tip following
      8 days storage in a refrigerator, suggesting that syringes used for subgingival
      deposition of an antibiotic should not be stored for reuse.

PMID- 8473542
TI  - Industry under siege.

PMID- 8473543
TI  - Cocaine abuse in North America: a milestone in history.
AB  - The euphoric effects of coca leaves have been known to mankind for thousands of
      years. Yet the first epidemic of cocaine use in America occurred during the late
      19th century. Initially, there were no laws restricting the consumption or sale
      of cocaine. In fact, cocaine was freely available in drug stores, saloons, from
      mail-order vendors, and even in grocery stores. It is reported that one drug
      manufacturer, in 1885, was selling cocaine in 15 different forms, including
      cigarettes, cheroots, inhalants, cordials, crystals, and solutions. Many famous
      imported wines, such as "Vin Mariani," contained a mixture of wine and coca. For
      consumers on budgets, the wonder drug was available as Coca-Cola and dozens of
      other soda pops and pick-me-up drinks. One of them even had a simple and direct
      name, Dope. Soon enough, the ill effects of cocaine became apparent, and by the
      1920s cocaine was the most feared of all illicit drugs. Most states began
      enacting laws against cocaine use. President William Taft proclaimed cocaine as
      Public Enemy No. 1, and in 1914 the Congress passed the Harrison act, which
      tightly regulated the distribution and sale of cocaine. By the late 1950s,
      cocaine use in the United States was simply considered a problem in the past.
      Unfortunately, the people who were aware of the nation's first cocaine epidemic
      gradually passed away, and America once again was ready for its fling with
      cocaine in the 1960s. Today, it is estimated that upwards of 50 million
      Americans, that is one in four, have used cocaine. In addition, another fifty
      thousand people use this substance for the first time each day. More than 6
      million Americans use cocaine on a regular basis. Little wonder, then, that
      America as well as the other countries have declared a "War on Drugs." In this
      review, pharmacology of cocaine, major complications arising from its use, and
      efforts to curb its abuse are discussed.

PMID- 8473544
TI  - Teaching clinical pharmacology: a process of 'lifelong learning'.

PMID- 8473545
TI  - Immunopharmacology and adverse drug reactions.
AB  - Adverse drug reactions are common and troublesome complications of contemporary
      pharmacotherapy. Adverse drug reactions are frequently, and often incorrectly,
      referred to as "allergy". Although there are multiple mechanisms for adverse drug
      reactions, adverse drug reactions mediated by the immune system account for a
      disproportionate number of fatal and serious adverse reactions, and constitute a
      major clinical problem for patients and physicians. The immune system has evolved
      in multicellular organisms as a defence against infection. Interactions between
      drugs and the immune system occur as inadvertent consequences of the protective
      function of the immune system, with drug molecules or drug-carrier haptens being
      recognized as "non-self" by the immune system. The classical mechanisms for drug
      hypersensitivity described by Gell and Coombs (Types 1 to 4) include IgE
      mediated, cytotoxic, immune complex-mediated and delayed mechanism. These
      mechanisms provide elegant models for drug-immune interactions that can provide
      mechanistic explanations for events such as urticaria associated with
      penicillins. However, these mechanisms do not account for many of the
      immunologically mediated adverse reactions commonly encountered in clinical
      practice. Over the last two decades, there has been an increasing awareness of
      the importance of reactive drug metabolites and drug-protein interactions in the
      initiation of immunologic events mediating adverse drug reactions. Reactive drug
      metabolites may produce direct and profound effects on various functions of the
      immune system. Although some adverse reactions mediated by the immune system
      occur with equal frequency among adults and children, some of these reactions
      appear to be markedly more common among children than adults.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8473546
TI  - Hemofiltrability of histamine H2-receptor antagonist, nizatidine, and its
      metabolites in patients with renal failure.
AB  - To study if an H2-receptor antagonist, nizatidine, and its metabolites [N-2
      monodesmethylnizatidine (N-2-MDMN) and nizatidine sulfoxide (nizatidine S-Ox)]
      would be removed by an arteriovenous hemofiltration, the authors measured their
      plasma concentrations and amounts recovered in ultrafiltrate during 11 sessions
      of an intermittent hemofiltration performed in seven patients with renal failure
      who were given an oral administration of nizatidine (150 mg). The concentrations
      of the parent drug and its metabolites in plasma and ultrafiltrate were
      determined with a high-performance liquid chromatography with ultraviolet
      absorbance detection. The mean (+/- standard deviation [SD]) amounts of
      nizatidine removed by the procedure performed at the mean ultrafiltration rate of
      18 (range, 11-25) mL/min over the mean duration of 179 (60 to 300) minutes
      accounted for 1.9 +/- 1.4% of the dose administered. The corresponding values for
      N-2-MDMN and nizatidine S-Ox were 0.3 +/- 0.2% and 0.2 +/- 0.2% of the molar dose
      of nizatidine, respectively. There was a significant correlation between the
      filtration rate and the hemofiltration clearance of nizatidine (r = .94, P <
      .001) or its active metabolite, N-2-MDMN (r = 0.83, P < .01), indicating that the
      sieving coefficient (Sc), an index of filtration efficiency, for these compounds
      is largely constant (0.59 and 0.67 for nizatidine and N-2-MDMN, respectively)
      under the current hemofiltration conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473547
TI  - Effect of concomitantly administered cimetidine or ranitidine on the
      pharmacokinetics of the 5-HT2-receptor antagonist ritanserin.
AB  - The effects of concurrent administration of either cimetidine 800 mg once daily
      or ranitidine 300 mg once daily on the single-dose pharmacokinetics of ritanserin
      10 mg were investigated in an open, randomized three-way cross-over, controlled
      investigation in 9 healthy volunteers. Concurrent administration of cimetidine
      had no significant effect on the area under the plasma concentration-time curve
      of ritanserin compared with control experiments. The maximum plasma concentration
      of ritanserin was decreased significantly (105.0 +/- 9.2 versus 125.0 +/- 13.8
      ng/mL; P = .0039), whereas time to reach maximal concentration (tmax) of
      ritanserin was only slightly but not significantly increased, if the subjects
      were pretreated with cimetidine. After concurrent ingestion of ranitidine, only a
      trend to a decrease in the maximum plasma concentration of ritanserin was
      observed. Time to achieve the maximum plasma concentration, terminal half-life of
      elimination, and the total area under the plasma concentration-time curve of
      ritanserin were not altered in comparison with control experiments. The results
      of the study show that concurrent treatment with cimetidine 800 mg once daily or
      ranitidine 300 mg once daily has no apparent effect on the systemically available
      amount of ritanserin after a single oral dose of 10 mg. Both H2-antagonists cause
      a significant (cimetidine) or borderline significant (ranitidine) decrease of the
      maximum plasma concentration of ritanserin and a slight but not significant
      increase in tmax (cimetidine). These effects are of minor clinical importance and
      seem most likely be due to a decrease of the rate of absorption of ritanserin
      during concurrent administration of cimetidine/ranitidine.

PMID- 8473548
TI  - High-calcium diet in spontaneously hypertensive rats: intervention with calcium
      antagonist verapamil.
AB  - A number of studies have shown an antihypertensive effect for high-calcium diets,
      but others have found no effect or, even a prohypertensive effect. Because of
      these disparate results, studies were conducted in spontaneously hypertensive
      rats (SHR) fed either a normal calcium diet (1.0% calcium) or a high-calcium diet
      (4.0% calcium) with or without verapamil HCl (50 mg/kg body weight) from ages 5
      to 12 weeks. Systolic blood pressure (SBP) and heart rate (HR) were measured by
      indirect tail cuff method. During the analysis of the electrolytes and vasoactive
      hormones monitored in this study, it was found that rats fed high-calcium diet
      had significantly elevated serum ionized and total calcium and calcium excretion.
      Systolic blood pressure for the verapamil-normal calcium diet (week 5, 148 +/- 4
      mm Hg; week 7, 162 +/- 4 mm Hg) did not differ significantly from that of normal
      calcium diet (week 5, 152 +/- 2 mm Hg; week 7, 160 +/- 1 mm Hg). The high-calcium
      diet potentiated the development of hypertension, i.e., SBP was (157 +/- 2 mm Hg)
      on the 5th week and (174 +/- 4 mm Hg) on the 7th week. Conversely, verapamil high
      calcium diet prevented the development of hypertension (week 5, SBP was 139 +/- 4
      mm Hg; week 7, SBP was 146 +/- 3 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473549
TI  - Antihypertensive action of heparin: role of the renin-angiotensin aldosterone
      system and prostaglandins.
AB  - Chronic subcutaneous administration of heparin consistently lowers blood pressure
      in hypertensive rats. This antihypertensive effect is related at least in part to
      a concomitant decrease in hematocrit. Groups of spontaneously hypertensive (SHR)
      and normotensive Wistar (NWR) rats were treated with subcutaneous heparin (700
      U/d) for 6 weeks. Weekly determinations of systolic blood pressure (tail-cuff)
      and hematocrit were done. Peripheral plasma renin activity, plasma aldosterone,
      plasma prostaglandins (PGs) (PGF2 alpha, PGI2), thromboxane A2, and urinary
      kallikrein were measured. Blood pressure responses of acute and chronic heparin
      treatment to vasoconstrictor substances, including angiotensin I, angiotensin II,
      and norepinephrine, were determined. As before, heparin produced a significant (P
      < .01) decrease in hematocrit in both SHRs and NWRs, but a parallel decrease in
      blood pressure was noted only in SHRs. A significant (P < .001) increase in
      plasma renin activity was found in heparin-treated SHRs and NWRs; however, a
      corresponding elevation of plasma aldosterone level was noted only in heparin
      treated NWR. Plasma aldosterone level significantly (P < .01) decreased in
      heparin-treated SHRs. Plasma PGs and urinary kallikrein levels were not different
      among the groups. The blood pressure responses to vasoconstrictor substances were
      essentially similar among the heparin-treated and control groups. These findings
      suggest that PGs or kallikrein have a slight or no role in determining the
      antihypertensive effect of heparin. Conversely, the results suggest that a
      reduced aldosterone level contributes to the antihypertensive mechanism of
      heparin.

PMID- 8473550
TI  - Short- and long-term effects of spirapril on renal hemodynamics in patients with
      essential hypertension.
AB  - Sixteen essential hypertensive patients were entered into a protocol assessing
      the effect of Spirapril, an angiotensin-converting enzyme (ACE) inhibitor, on
      blood pressure, the renin-aldosterone system, and renal function. Specifically
      monitored before, during 6 weeks, and 6 months of Spirapril therapy were plasma
      renin activity, plasma aldosterone, serum ACE, the renal clearances of
      creatinine, inulin, and para-aminohippurate, and urinary albumin excretion. Blood
      pressure was well controlled. Spirapril stimulated plasma renin activity and
      suppressed ACE throughout the entire protocol. Renal clearances were unchanged.
      Renal vascular resistance was decreased. Urinary albumin excretion was decreased.
      The authors conclude that the ACE inhibitor, Spirapril, when used as an effective
      antihypertensive agent, preserves renal function, lowers renal vascular
      resistance, and decreases urinary albumin excretion.

PMID- 8473551
TI  - Pharmacokinetics of clentiazem after intravenous and oral administration in
      healthy subjects.
AB  - This study characterized the pharmacokinetics of clentiazem (CLZ) after a single
      intravenous bolus (IV) and oral (PO) dose in humans. Twenty-four healthy male
      subjects (28.5 +/- 5.2 years; 77 +/- 8.2 kg) received IV (20 mg) and PO (80 mg)
      doses of CLZ as part of a four-way, randomized, complete crossover study. Serial
      blood samples were drawn up to 48 hours after administration of the drug. Plasma
      samples were analyzed for CLZ and three metabolites by a high-pressure liquid
      chromatography method. The values (mean [CV, %]) for systemic clearance, volume
      of distribution at steady-state, and half-life of CLZ were 63.6 L/hour (23.5),
      756.1 L (19.1), and 10.6 hours (33.1), respectively, after IV administration. The
      peak plasma CLZ concentration (Cmax) and time to Cmax were 37.0 ng/mL (38.7) and
      3.7 hours (22.9), respectively, with a lag time after PO administration. The
      absolute bioavailability of PO CLZ was 45% (30.7). The ratio of area under the
      curve of N-desmethyl CLZ to that of CLZ increased from 0.15 (57.0) after IV to
      0.60 (21.4) after PO administration, suggesting a significant first-pass effect.
      The mean residence time and mean absorption time of CLZ were 12.3 hours (24.3)
      and 3.1 hours (88.1), respectively. The plasma concentration-time data of CLZ can
      be described by either a one- or two-compartment pharmacokinetic model.

PMID- 8473552
TI  - Hypoglycemic and insulin response to a continuous intravenous infusion of CGP
      35126 recombinant human insulin-like growth factor-I (rhIGF-I) in healthy males.
AB  - Recombinant human insulin-like growth factor-I (rhIGF-I) produced by expression
      in a yeast vector was evaluated in seven normal men to determine effects on
      plasma glucose and insulin levels. Each subject received an initial intravenous
      infusion of normal saline and on the following day, rhIGF-I at a rate of 21.4
      micrograms/kg/hour. Each infusion lasted for 7 hours. The subjects' fasting
      baseline glucose and insulin levels were not statistically different (P > .05)
      from their pre-dose levels. Compared with the saline (control) infusion, serum
      glucose levels were statistically lower (P < .05) 2 hours into the rhIGF-I
      infusion. These lower glucose levels were maintained until the subjects consumed
      a standard lunch (4 hours into the infusion). Insulin levels demonstrated a
      similar response to rhIGF-I, but decreases in insulin levels occurred after the
      rhIGF-I hypoglycemic effect. This observation suggests that suppression of
      insulin levels may be due to secondary hypoglycemia rather than to a direct rhIGF
      I effect. This study demonstrated the desired rhIGF-I effect of lowering
      subjects' glucose levels without clinically significant hypoglycemia. This
      finding suggests that rhIGF-I may have potential clinical utility in
      hyperglycemic states.

PMID- 8473553
TI  - A phase I dose-ranging safety and pharmacokinetics study of a novel oral
      thromboxane synthase inhibitor, FCE 22, 178.
AB  - A 100- to 3200-mg dose range of FCE 22,178 was studied in this phase I single
      dose escalation safety/kinetics study. After oral administration, a rapid drug
      absorptive phase and a biexponential disposition profile were observed. Mean
      estimates of the terminal elimination half-life of FCE 22,178, over the doses
      studied, ranged from 7.6 to 14.4 hours. A disproportionate increase in both
      maximum peak plasma concentration (Cmax) and area under the curve (AUC0-infinity)
      was noticed for doses higher than 400 mg. Mean estimates of systemic clearance
      (CLs/F) over the 100- to 400-mg doses were 0.053 to 0.064 L/hour/kg, and were
      significantly higher for the three higher dose levels. This nonlinearity appears
      to be related to the changes in oral bioavailability. Estimates of distribution
      volume (Vd, lambda z/F) for FCE 22,178 increased from 0.75 L/kg at the 100-mg
      dose to 3.00 L/kg at the 3200-mg dose, and renal clearance (CLr) also increased
      with dose. Both observations may be related to an increase in free fraction of
      FCE 22,178 at higher doses. Urinary excretion of unchanged drug averaged < 10%
      for all dose levels. The urinary excretion of the glucuronide metabolite (M1)
      averaged 41 to 70% for doses up to 400 mg, but diminished to 13% at the 3200-mg
      dose. The disposition of M1 appeared to be formation-rate limited. In addition,
      the ratio of the formation to the disposition clearance for M1 was relatively
      stable and apparently dose independent. No drug-related adverse experiences were
      observed over the studied dose range after single doses at FCE 22,178.

PMID- 8473554
TI  - Effect of food and a monoglyceride emulsion formulation on danazol
      bioavailability.
AB  - The bioavailability of a single 100-mg dose of danazol delivered from the
      commercial formulation (hard gelatin capsule) and from an experimental lipid
      emulsion formulation of danazol was studied in 11 healthy female volunteers in
      both fed and fasted states. The emulsion formulation (fasted) increased
      bioavailability fourfold compared with the capsule (P = .0001); the difference,
      however, was not significant in the fed state. Food increased the bioavailability
      of the capsule formulation more than threefold over fasted administration (P =
      .0001). In a separate study of 12 female volunteers, single doses of the emulsion
      formulation of danazol administered with food demonstrated essentially dose
      proportional pharmacokinetics over the dose range studied (50-200 mg). The
      authors conclude that factors that increase the extent of solubilization lead to
      significant enhancement in the bioavailability of danazol.

PMID- 8473555
TI  - Rabies: a review.

PMID- 8473557
TI  - The enigma of the proliferative enteropathies: a review.

PMID- 8473556
TI  - Neurones in autonomic ganglia of normal horses contain phosphorylated
      neurofilaments.
AB  - Neurofilaments (NF) are composed of three polypeptides of differing molecular
      size, termed NF-L, NF-M and NF-H. The NF-H and, to a lesser degree, NF-M
      components are phosphorylated. In the majority of normal neurones, the location
      of phosphorylated NF is confined to neuronal processes, particularly the axon,
      and excluded from the perikaryon. Cell bodies of autonomic neurones of the rat do
      not contain phosphorylated NF. In many disease states, phosphorylated NF
      accumulate in the neuronal cell body and therefore in most circumstances their
      presence indicates abnormality. This paper reports that in at least two autonomic
      ganglia of normal horses (stellate and coeliomesenteric) the vast majority of
      neuronal perikarya immunostain strongly for phosphorylated NF. Pretreatment with
      alkaline phosphatase abolishes staining.

PMID- 8473558
TI  - The relationship of the canine acanthomatous epulis to ameloblastoma.
AB  - This paper compares the microscopic features and clinical behaviour of the
      acanthomatous epulis in dogs with those of ameloblastoma in human beings. The
      acanthomatous epulis has similar microscopic features to one histological variant
      of human ameloblastoma, the acanthomatous ameloblastoma. Moreover, its clinical
      behaviour is equivalent to that of intraosseous ameloblastoma in human beings,
      not of the human peripheral (extraosseous) ameloblastoma, as has been suggested.
      The stroma of acanthomatous epulides varies and does not always resemble
      periodontal ligament, a feature that in dogs has been used to distinguish them
      from ameloblastomas. It is concluded that the acanthomatous epulis (1) is an
      ameloblastoma, (2) arises from the gingival epithelium in some cases, but (3) may
      also arise intraosseously and then break out of bone. We recommend the term
      canine acanthomatous ameloblastoma as being appropriate for this lesion.

PMID- 8473559
TI  - Metastasis of a myxoid leiomyosarcoma via the renal and hepatic portal
      circulation in a sarus crane (Grus antigone).
AB  - A 12-year-old female sarus crane (Grus antigone) developed a recurrent
      proliferative lesion in the subcutaneous tissue of the tarsometatarsus, which
      failed to respond to medical and surgical therapy. The crane was killed and
      microscopic examination of the tissues taken at necropsy revealed a myxomatous,
      poorly-differentiated sarcoma with metastasis to the liver and kidney.
      Immunohistochemical staining for muscle actin, smooth muscle myosin and vimentin
      were positive, indicating that the primary and metastatic tumours were
      leiomyosarcomas. Location of the metastatic lesions in only the portal venous
      system of the liver and veins of the kidney indicated that the route of
      metastasis was the portal circulation via the ischiatic vein, caudal mesenteric
      vein and both the renal-portal shunt and hepatic portal vein. This is the first
      report of metastatic subcutaneous leiomyosarcoma in an avian species.

PMID- 8473560
TI  - Morphological and functional disturbances in pulmonary vascular endothelium
      following exposure of sheep to an "avirulent" strain of Pasteurella haemolytica.
AB  - Sheep were vaccinated with a live attenuated strain of Pasteurella haemolytica
      and killed 3 days later. Segments of main intrapulmonic artery and vein were
      removed for biophysical and scanning electron microscopic studies. In the
      pulmonary artery, vaccination with Pasteurella haemolytica caused an increase in
      the number of endothelial cell surface blebs and, in some cases, those blebs
      appeared to be splitting open, suggesting cell damage or irritation. There was a
      surprising lack of platelet adherence to the lesions, suggesting that an
      antiplatelet factor is released by the damaged endothelium. The endothelial
      dependent relaxant response to bradykinin was enhanced following vaccination. In
      the pulmonary vein, ultrastructural lesions similar to those in the artery were
      present in vaccinated animals. Bradykinin caused a contraction, an effect that
      was reduced following vaccination with Pasteurella haemolytica. These experiments
      demonstrate that a live, vaccine-derived strain of Pasteurella haemolytica causes
      both morphological and functional changes in the pulmonary vascular endothelium.

PMID- 8473561
TI  - Effects of Pasteurella multocida toxin on the osteoclast population of the rat.
AB  - Pasteurella multocida type D toxin is a peptide shown to induce severe atrophic
      rhinitis in the pig as the result of an increased osteoclastic resorption of the
      ventral nasal turbinates. In the present study, the effects of the toxin on the
      histological, cytochemical and ultrastructural features of the osteoclast
      population of the rat were examined. Pasteurella multocida toxin induced atrophy
      of the ventral and dorsal nasal turbinates and thinning of the nasal bones. The
      number and size of the long bone metaphyseal osteoclasts were significantly
      increased, but not the number of nuclei per cell. Osteoclasts of toxin-treated
      rats had more developed clear zones and ruffled borders than those of the
      controls and their cytoplasmic vacuoles were more abundant and larger. We
      concluded that P. multocida toxin stimulates bone resorption by osteoclasts in
      the rat by increasing resorption activity and by increasing their number. Its
      action is not limited to the nasal turbinates but occurs also in the other bones,
      such as the long bones.

PMID- 8473562
TI  - Pathology of experimental traumatic craniocerebral missile injury.
AB  - The neuropathological alterations in sheep associated with head wounds inflicted
      by a .22 calibre rifle are reported. Brain damage was manifest as a permanent
      haemorrhagic wound cavity produced by crushing and laceration of tissue during
      missile penetration, secondary tracks due to bone and bullet fragments, widely
      distributed stretch injuries to blood vessels, nerve fibres and neurons as a
      consequence of the radial forces of the temporary cavity which develops as a
      bullet penetrates tissue, marked subarachnoid and intraventricular haemorrhage,
      and distortion and displacement of the brain.

PMID- 8473563
TI  - Preliminary findings of alterations in serum alkaline phosphatase activity in
      chickens during coccidial infections.
AB  - Two-week-old broiler chickens were inoculated orally with various doses of avian
      Eimeria that infect different sections of the intestine. The coccidia used were
      E. acervulina (duodenum), E. maxima (jejunum), E. brunetti (ileum) and E. tenella
      (caecum). The measurements evaluated were weight gains, intestinal lesion scores
      and changes in serum alkaline phosphatase (SAP) activity 6 days after infection.
      SAP activity was inversely proportional to both oocyst dose and gross intestinal
      lesion score, and directly proportional to weight gains with infections of E.
      acervulina, E. maxima and E. tenella. However, no significant changes in the SAP
      activity were found in those birds infected with E. brunetti. Taken together, the
      data suggest that SAP activity may be a sensitive marker of the pathogenesis of
      certain coccidial infections, especially in the duodenum, jejunum and caecum,
      that may be used as an additional factor in evaluating coccidial control
      measures.

PMID- 8473564
TI  - Comparison of pathological signs of disease in specific-pathogen-free calves
      after inoculation of the respiratory tract with Ureaplasma diversum or Mycoplasma
      canis.
AB  - To confirm the pathogenic role of Ureaplasma diversum in respiratory disease of
      calves, we inoculated caesarean-delivered, colostrum-deprived calves intranasally
      with a dose of 10(7) colour-changing units (CCU) or endobronchially with a dose
      of 10(10) CCU. Clinical signs of respiratory disease were not observed, but in
      the endobronchially inoculated calves, thick cuffs of round cells surrounded the
      bronchi, bronchioli and blood vessels, and a lobular catarrhal pneumonia
      developed. It was concluded that the pathogenicity of U. diversum can be
      demonstrated after endobronchial but not after intranasal inoculation. Similar
      calves were inoculated endobronchially with a dose of 2 x 10(10) colony-forming
      units of Mycoplasma canis. Clinical signs of respiratory disease were not
      observed. At day 2 after inoculation, only slight pathological signs of
      respiratory disease were detected, and these disappeared at day 9. M. canis was
      not recovered from the lungs. Hence, M. canis could not be clearly identified as
      a pathogen in respiratory disease of calves. By comparing the results of the
      various experiments, we concluded that thin cuffs of round cells in the lungs can
      indicate mycoplasma infections, but that these are not necessarily pathognomonic.

PMID- 8473565
TI  - Spontaneous neoplasia in the ferret (Mustela putorius furo).
AB  - Thirteen spontaneous tumours in ferrets from two laboratory breeding colonies are
      described, including two types not previously reported in this species, namely,
      uterine teratoma and neurilemmoma. The literature on tumours in laboratory and
      domestic ferrets is comprehensively reviewed from the first reported case in
      1950. Only 20 cases were reported from 1950 to 1979, nearly all from laboratory
      or zoological collections. In the following 10 years more than 170 further cases
      were reported, about half of them in domestic pet ferrets. A review of the
      limited literature on tumours in related species reveals substantial incidences
      in black-footed ferrets and ranch mink allowed to live out their lifespan, and
      isolated cases in polecats and at least eight other species of Mustelidae.

PMID- 8473566
TI  - Synthesis and distribution of atrial natriuretic peptide (ANP) in hearts from
      normal dogs and those with cardiac abnormalities.
AB  - The cardiac distribution of immunoreactive atrial natriuretic peptide (IR-ANP)
      and ANP-specific mRNA was studied in 35 normal dogs and 44 dogs with primary and
      secondary heart abnormalities. According to clinical and pathological findings
      the dogs were assigned to seven groups: Group 1, normal young dogs (< 12 months);
      Group 2, normal adult dogs (> 12 months); Group 3, low to moderate hypertrophy;
      Group 4, severe hypertrophy; Group 5, dilated cardiomyopathy; Group 6, renal
      failure with secondary left ventricular hypertrophy; and Group 7, other heart
      abnormalities. In comparison with hearts of normal dogs, the amount of IR-ANP and
      ANP-specific mRNA was reduced in the atria and increased in the ventricles of
      dogs with hypertrophy and cardiomyopathy. The immunoreactivity in normal canine
      atria was far lower than in control rats and hamsters. The pattern of ventricular
      immunoreactivity was faint and patchy. Only in a few ventricular localizations of
      three dogs of Group 5 and one dog of Group 6 was there a granular pattern
      suggesting the presence of secretory granules. A state of intense secretory
      stimulation in cardiomyopathy was indicated by electron microscopy. Due to its
      low concentration and localized pattern, however, IR-ANP does not seem to be a
      reliable marker for the presence of hypertrophic or cardiomyopathic changes in
      dogs.

PMID- 8473567
TI  - Spread and distribution of Coxiella burnetii in C57BL/6J (H-2b) and Balb/cJ (H
      2d) mice after intraperitoneal infection.
AB  - Spread and distribution of Coxiella burnetii were investigated
      immunocytochemically and antigen dissemination was correlated with light
      microscopic alterations in Balb/cJ (H-2d) and C57BL/6J (H-2b) mice.
      Intraperitoneal inoculation of C. burnetii resulted in a self-limiting systemic
      infection. Gross findings consisted of hepatosplenomegaly and histological
      lesions were characterized by microabscesses and granulomas in numerous organs
      including spleen, liver, mesentery, bone marrow, lymph nodes, pancreas, heart and
      uterus. In addition, splenic lymphoid depletion, venous microthrombi and
      reduction of bone marrow cells were observed. Coxiella burnetii antigen was
      demonstrated immunocytochemically in the aforementioned organs, especially in
      spleen, liver and most of all in the bone marrow. Coxiella antigen was detected
      in macrophages, macrophage precursor cells, and occasionally endothelial cells.
      Numerous C. burnetii antigen-positive cells were observed between 5 and 12 days
      post-infection; thereafter, the amount of C. burnetii antigen decreased rapidly.
      Immunopositivity was detectable until 30 and 44 days post-infection in the bone
      marrow of Balb/cJ and C57BL/6J mice, respectively. Severity of histological
      lesions was associated with presence and clearance of C. burnetii antigen.
      Specific IgM antibodies were detected 4 days after infection and IgG
      seroconversion was noticed 7 to 10 days post-infection. Coxiella burnetii
      specific IgM and IgG antibodies were still present 150 days after infection.
      Significant strain-specific differences in the antibody response were not found.
      The findings demonstrate systemic spread of C. burnetii, especially to bone
      marrow, spleen and liver, and antigen distribution was closely correlated with
      the appearance and degree of histological lesions.

PMID- 8473568
TI  - Cycloheximide or nordihydroguaiaretic acid protects mice against the lethal and
      hepatocytolytic effects of a combined challenge with D-galactosamine and
      bacterial endotoxin.
AB  - Both cycloheximide and nordihydroguaiaretic acid protect mice against the
      fatalities and associated panlobular hepatocyte necrosis that follow a challenge
      with D-galactosamine and bacterial endotoxin. It is proposed that cycloheximide
      acts as an inhibitor of the endotoxin-induced activation of phospholipase A2,
      thereby inhibiting the synthesis of leukotrienes which is now known to be a
      prerequisite for tumour necrosis factor-alpha (TNF) biosynthesis, the latter
      cytokine being regarded as the terminal mediator of the fatal D-galactosamine and
      endotoxin-induced syndrome. Nordihydroguaiaretic acid protection is explained by
      its inhibition of lipoxygenase enzymes, and thus ultimately of TNF production in
      response to endotoxin.

PMID- 8473569
TI  - Cell shape changes induced by sulphate in the Cloudman mouse melanoma cell line.
AB  - The mechanism of cell shape changes and haematogenous translocations (metastases)
      in mouse malignant melanoma cells induced by phorbol esters and protein kinase C
      (PKC) is reported as adhesion "downregulation", exocytosis and motility. However,
      PKC activation also produces intracellular alkalinization, a causal factor in
      plasma membrane internalization, cell rounding and detachment that does not
      necessarily implicate specific cell adhesion downregulation. We show here that
      Cloudman mouse malignant melanoma cells can be induced to round up and detach
      with concomitant intracellular alkalinization by simple inorganic sulphate
      treatment, thereby suggesting an alternative explanation to the reported
      phenomena.

PMID- 8473570
TI  - Introduction to special section: theoretical developments in the cognitive
      psychotherapies.
AB  - The cognitive psychotherapies have developed and substantially differentiated
      since their inception in the 1950s. Six major themes in their theoretical
      development are discussed: (a) the differentiation of rationalist and
      constructivist therapies and metatheories of knowing; (b) the acknowledgement of
      social, biological, and embodiment processes in therapy; (c) the recognition of
      unconscious processes; (d) an increasing focus on self-organizing and self
      protective processes in life span personality development, with such processes
      being embedded in interpersonal and social system dynamics; (e) a shift toward
      different views of emotionality and the incorporation of experiential techniques;
      and (f) a synergistic involvement in the psychotherapy integration movement. The
      cognitive psychotherapies reflect remarkable activity, a point illustrated and
      elaborated in the articles that constitute this special section.

PMID- 8473571
TI  - Cognitive therapy: past, present, and future.
AB  - Proponents of cognitive therapy have striven to establish this approach as a
      mature system of psychotherapy for over 3 decades. The theoretical formulations
      have been enriched by clinical extrapolations from the neopsychoanalysts and
      experimental findings from cognitive psychology. The therapeutic strategies and
      techniques have been refined as a result of interaction with behavior therapy,
      which also influenced the emphasis on empirical testing of the theoretical
      formulations and the therapeutic applications. Outcome trials have demonstrated
      efficacy in a number of common disorders. New emphasis on the crucial importance
      of specific formulations (especially dysfunctional beliefs) has provided
      important clues to the treatment of a large number of other disorders. I conclude
      that cognitive therapy has fulfilled the criteria of a system of psychotherapy by
      providing a coherent, testable theory of personality, psychopathology, and
      therapeutic change; a teachable, testable set of therapeutic principles,
      strategies, and techniques that articulate with the theory; and a body of
      clinical and empirical data that support the theory and the efficacy of the
      theory.

PMID- 8473572
TI  - Reflections on rational-emotive therapy.

PMID- 8473573
TI  - Changing conceptions of cognitive behavior modification: retrospect and prospect.
AB  - A retrospective analysis of cognitive behavior modification reveals that 3 major
      metaphors have been offered to explain the role that cognitions play in behavior
      change. These metaphors include cognition as a form of conditioning, information
      processing, and, currently, narrative construction. The implications of using
      each of these metaphors are discussed.

PMID- 8473574
TI  - An appraisal of cognitive therapy.
AB  - This review describes the development of cognitive therapy (CT) for depression in
      the 1960s and 1970s and its application to diverse clinical populations. The
      question of how CT works, in terms of both active therapeutic ingredients and
      mechanisms of change within the individual, is addressed. The limitations of CT
      are discussed, as well as recent developments and modifications of the therapy
      that have evolved in response to these perceived limitations and that bring it
      closer to other therapy approaches. The review concludes with some directions for
      future research.

PMID- 8473575
TI  - An appraisal of rational-emotive therapy.
AB  - Albert Ellis's rational-emotive therapy (RET) is scrutinized on several
      conceptual and empirical grounds, including its reliance on constructive
      assessment and its ethical stance. Its professional impact thus far exceeds its
      scientific status. Opinion varies on how even to define irrational beliefs; 1
      consequence is problems in assessing them. Meta-analytic reviews provide support
      for the general utility of RET, but more qualitative reviews question both the
      internal and external validity of much of the published research. Lacking are
      process studies that can shed light on the mechanisms of therapeutic change, a
      situation likely due to the complexity of RET and to a lack of consensus as well
      about its very definition. Perhaps more progress can be achieved by forsaking
      studies of RET as a package and shifting instead to examination of specific
      therapeutic tactics in particular circumstances.

PMID- 8473576
TI  - An appraisal of constructivist psychotherapies.
AB  - Predicated on a postmodern epistemology, constructivist theories emphasize the
      proactive, self-organizing features of human knowing and their implications for
      psychotherapy. This article outlines the potential contributions of 4 clinical
      lineages sharing a constructivist philosophy--personal construct theory,
      structural--developmental cognitive therapy, narrative reconstruction, and
      constructivist family therapy--and briefly reviews emerging trends in
      psychotherapy research compatible with this perspective. Although current
      constructivist approaches confront problems as well as prospects, they represent
      a growing force within psychotherapy, contributing to the sophistication of
      psychological theory, the diversification of clinical research, and the extension
      of therapeutic technique.

PMID- 8473577
TI  - Cognitive-behavioral therapies with youth: guiding theory, current status, and
      emerging developments.
AB  - This article begins with a brief description of the guiding theory behind
      cognitive-behavioral interventions with youth, such as a therapeutic posture, an
      important cognitive distinction, and a specific treatment goal. Next, on the
      basis of a review of the literature, the nature of cognitive functioning, the
      treatments, and the outcome of treatment studies are described and examined for
      (a) aggression, (b) anxiety, (c) depression, and (d) attention-deficit
      hyperactivity. Conclusions and emerging developments are provided.

PMID- 8473578
TI  - Cognitive therapy of anxiety disorders.
AB  - A review of studies of cognitive-behavioral therapy (CBT) for generalized anxiety
      disorder, panic disorder with and without agoraphobia, and social phobia
      indicates that CBT is consistently more effective than waiting-list and placebo
      control groups. In general, CBT has proved more beneficial than supportive
      therapy as well. Comparisons with active behavioral treatments provide more
      variable results. Converging evidence suggests that cognitive change may be a
      strong predictor of treatment outcome, but that such change may be produced by a
      number of therapeutic approaches. Pretest-posttest change with CBT is depicted in
      meta-analytic summary form for each disorder.

PMID- 8473579
TI  - Cognitive treatments for eating disorders.
AB  - Cognitive-behavioral therapy (CBT) is applicable to all eating disorders but has
      been most intensively studied in the treatment of bulimia nervosa (BN). CBT is
      designed to alter abnormal attitudes about body shape and weight, replace
      dysfunctional dieting with normal eating habits, and develop coping skills for
      resisting binge eating and purging. CBT is effective in reducing all core
      features of BN and shows good maintenance of therapeutic improvement. Although
      superior to therapy with antidepressant drugs, CBT has not been shown to be
      consistently superior to alternative psychological treatments. Different
      hypotheses about CBT's mechanisms of action are discussed.

PMID- 8473580
TI  - Cognitive therapy for depression: conceptual issues and clinical efficacy.
AB  - Cognitive therapy has emerged as 1 of the most promising psychosocial
      interventions for the treatment of depression. It appears to be at least the
      equal of alternative interventions (including pharmacotherapy) with respect to
      acute treatment. In addition, there are indications that it may reduce risk of
      symptom return after treatment termination. Nonetheless, design limitations
      reduce the certainty with which such conclusions can be drawn. Furthermore, tests
      of its efficacy have largely been limited to nonbipolar outpatient (or
      subclinical) samples. At this time, cognitive therapy is best considered a
      promising, but as yet not adequately tested, intervention for the treatment of
      depression.

PMID- 8473581
TI  - Long-term sequelae of childhood sexual abuse: perceived family environment,
      psychopathology, and dissociation.
AB  - In this study, 105 abused and nonabused women were examined for patterns of adult
      psychopathology associated with childhood sexual abuse and to test the extent to
      which these patterns are independent of other pathogenic properties of the family
      environment. Clinical and nonclinical Ss completed the Family Environment Scale,
      the Minnesota Multiphasic Personality Inventory (MMPI), the Rorschach, and the
      Stanford Hypnotic Susceptibility Scale. Greater nonspecific impairment among
      abused women may be a consequence, at least in part, of pathogenic family
      structure rather than sexual abuse per se. However, MMPI and Rorschach responses
      suggest sexual abuse may render victims especially vulnerable to specific
      disturbances i involving soma and self. Abuse was associated with greater use of
      dissociation, but covariance analysis revealed this effect to be accounted for by
      family pathology. There was no evidence that sexual trauma is associated with
      hypnotizability.

PMID- 8473582
TI  - Sexual abuse, family environment, and psychological symptoms: on the validity of
      statistical control.
AB  - M. R. Nash, T. L. Hulsey, M. C. Sexton, T. L. Harralson, and W. Lambert (1993)
      reported on the effects of controlling for family environment when studying
      sexual abuse sequelae. Sexual abuse history was associated with elevated
      Minnesota Multiphasic Personality Inventory and Rorschach scores in a sample of
      105 women, but many of the reported differences disappeared when a Family
      Functioning Scale score was used as a covariate. The present article considers
      the findings of Nash et al. in terms of the theoretical and statistical
      constraints placed on analysis of covariance and other partializing procedures.
      Because family dysfunction is not always causally antecedent to sexual abuse, and
      given the quasi-experimental quality of most abuse research, the use of covariate
      techniques to test hypotheses about the causal role of family environment in the
      impacts of sexual abuse may be ill advised. Analyses of a 2,964-subject data set
      illustrate these concerns.

PMID- 8473583
TI  - Culturally tailored HIV-AIDS risk-reduction messages targeted to African-American
      urban women: impact on risk sensitization and risk reduction.
AB  - African-American women recruited from low-income housing projects in Chicago (N =
      106) were randomly assigned to view 1 of 3 20-min videotapes: a standard public
      health service tape on prevention of acquired immunodeficiency syndrome (AIDS),
      the same public health service tape but matching presenter and participant
      ethnicity and sex, or a tape that included the same content but was framed in a
      context specifically intended to increase cultural relevance. Participants who
      viewed the tapes presented by African-American women were significantly more
      sensitized to AIDS and were more likely to have discussed AIDS with friends, to
      be tested for human immunodeficiency virus (HIV) antibodies during the follow-up
      interval, and to request condoms at follow-up. These results support the use of
      culturally sensitive AIDS prevention messages targeted to specific populations,
      particularly to promote HIV-antibody testing.

PMID- 8473584
TI  - Group cognitive-behavioral therapy and group interpersonal psychotherapy for the
      nonpurging bulimic individual: a controlled comparison.
AB  - This study evaluated the effectiveness of group cognitive-behavioral treatment
      (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six
      women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT,
      or a wait-list control (WL). Treatment was administered in small groups that met
      for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment
      conditions showed significant improvement in reducing binge eating, whereas the
      WL condition did not. Binge eating remained significantly below baseline levels
      for both treatment conditions at 6-month and 1-year follow-ups. These data
      support the central role of both eating behavior and interpersonal factors in the
      understanding and treatment of bulimia.

PMID- 8473585
TI  - Comparing the process in psychodynamic and cognitive-behavioral therapies.
AB  - Archival records were used to compare the therapy process in 30 brief
      psychodynamic and 32 cognitive-behavioral therapies. Verbatim transcripts of 186
      treatment sessions were rated with the Psychotherapy Process Q-set, designed to
      provide a standard language for the description of process. Results demonstrated
      that although some features were common to both treatments, there were important
      differences. Cognitive-behavioral therapy promoted control of negative affect
      through the use of intellect and rationality combined with vigorous
      encouragement, support, and reassurance from therapists. In psychodynamic
      psychotherapies, there was an emphasis on the evocation of affect, on bringing
      troublesome feelings into awareness, and on integrating current difficulties with
      previous life experience, using the therapist-patient relationship as a change
      agent. The clinical theoretical precepts underlying psychodynamic treatments
      received considerable support. In cognitive-behavioral therapies, there was
      evidence for the importance of developmental, as opposed to rationalist,
      intervention strategies for treatment outcome.

PMID- 8473586
TI  - Peer drug associations and emotional restraint: causes or consequences of
      adolescents' drug use?
AB  - A 3-wave longitudinal design was used to examine the relationships among
      emotional restraint, peer drug associations, and gateway drug use in a sample of
      1,256 middle school students. Structural equation modeling was used to compare 3
      models: (a) One model viewed drug use as a consequence of emotional restraint and
      peer variables; (b) 1 viewed drug use as a cause of restraint and peer variables,
      and (c) 1 included reciprocal effects. All 3 models fit the data fairly well.
      However, the reciprocal model fit the data significantly better than either of
      the others. Within this model, low emotional restraint was significantly related
      to subsequent increases in gateway drug use among boys. In contrast, peer drug
      models and peer pressure were not related to subsequent changes in gateway drug
      use. Changes in peer drug models were, however, predicted by previous levels of
      gateway drug use.

PMID- 8473587
TI  - Children in homeless families: risks to mental health and development.
AB  - This study examined the psychological adjustment of 159 homeless children in
      comparison with a sample of 62 low-income children living at home. In each group,
      ages ranged from 8 to 17 years. As expected, homeless children were found to have
      greater recent stress exposure than housed poor children, as well as more
      disrupted schooling and friendships. Child behavior problems were above normative
      levels for homeless children, particularly for antisocial behavior. Across the 2
      samples, however, behavior problems were more related to parental distress,
      cumulative risk status, and recent adversity than to housing status or income.
      Results suggest that homeless children share many of the risks and problems of
      other American children being reared in poverty.

PMID- 8473588
TI  - Expectancy challenge and drinking reduction: experimental evidence for a
      mediational process.
AB  - Substantial correlational evidence supports a causal (mediational) interpretation
      of alcohol expectancy operation, but definitive support requires a true
      experimental test. Thus, moderately to heavily drinking male college students
      were randomly assigned to 1 of 3 conditions in a pre-post design: Expectancy
      challenge (designed to manipulate expectancy levels), "traditional" information,
      and assessment-only control. Expectancy challenge produced significant drinking
      decreases, compared with the other 2 groups. Decreases in measured expectancies
      paralleled drinking decreases in the challenge condition. Significant increases
      in alcohol knowledge in the traditional program were not associated with
      decreased drinking. These experimental findings support a causal (mediational)
      interpretation of expectancy operation. The implications for a cognitive (memory)
      model of expectancies and for prevention and intervention programs for problem
      drinking and alcoholism are discussed.

PMID- 8473589
TI  - Stress exposure and stress generation in children of depressed mothers.
AB  - Two hypotheses were tested: (a) One mechanism contributing to the high rate of
      disorder in children of women with affective disorders is elevated exposure to
      stressful events and conditions and (b) the children of depressed women,
      particularly women with unipolar depression, contribute to event occurrence
      because of increased interpersonal conflict. Life stress interview assessments
      were made at 6-month intervals for 3 years on 53 children of unipolar, bipolar,
      medically ill, and normal women. Both hypotheses were confirmed. Transactional
      models of risk and further studies of the interpersonal functioning of children
      at risk for depression are needed.

PMID- 8473590
TI  - Final year dental students' views on cross-infection precautions.
AB  - This study was undertaken to determine the influence that undergraduate training
      currently has on the formation of clinical management strategies for minimizing
      cross-infection, among final year dental students. A 10-page questionnaire was
      sent to final year dental students attending 15 of the UK's 16 dental schools. A
      response rate of 60.5% was obtained. A large proportion of the students said they
      would be prepared to treat a known HBV carrier (90.4%) or HIV carrier (84.3%); a
      much higher proportion than has previously been found among qualified dental
      personnel. However, only 55.6% of the students agreed with current
      recommendations that they ought to adopt a universal cross-infection policy.
      Nevertheless, most students agreed with recommendations that they ought to wear
      gloves (96.6%), eye protection (84.3%) and a surgical mask (62.6%). Disparity
      between some responses suggested that some final year dental students might not
      have a fully thought out cross-infection strategy.

PMID- 8473592
TI  - Fracture strength of all-porcelain, resin-bonded bridges after testing in an
      artificial oral environment.
AB  - Twenty all-porcelain In-Ceram bridges were resin bonded to natural teeth on a
      study model. Ten of the test specimens were fixed on abutments placed directly in
      resin, and 10 were supported by an artificial periodontal membrane. Incisal
      forces of physiological magnitude and direction were applied in three bridges of
      both groups (test samples) in an artificial oral environment (1250,000 cycles).
      The fracture strength of the six test and 14 control specimens was tested in a
      universal testing instrument and the rupture strength measured. There was no
      significant difference between the fracture strength of the test and control
      samples. The artificial periodontal membrane around the abutment teeth did not
      reduce the fracture strength of the In-Ceram bridges.

PMID- 8473591
TI  - A comparison of the shear bond strengths to a resin composite of two conventional
      and two resin-modified glass polyalkenoate (ionomer) cements.
AB  - The inability of resin composite to bond directly to dentine has compromised the
      clinical success of this restorative material. This problem may be overcome by
      the so-called laminate technique in which glass polyalkenoate cement is placed
      upon dentine and then covered with a resin composite. The cement both adheres to
      dentine and affords micromechanical attachment to the composite. The introduction
      of the resin-modified glass polyalkenoate cements (RMCs) offers the potential for
      chemical union between cement and composite. This investigation examined the
      shear bond strengths of P-50 resin composite to four glass polyalkenoate lining
      materials, with and without the application of an intermediate bonding agent
      (Scotchbond 2). Two of the cements were RMCs (Vitrebond, XR-Ionomer) and the
      others were conventional base materials (Baseline, Ketac-Bond). The bond between
      P-50 and Vitrebond with or without Scotchbond 2 was significantly (P < 0.01)
      stronger and more consistent (P < 0.05) than that observed for all other
      materials. The treatment of the conventional materials and XR-Ionomer with
      Scotchbond 2 significantly (P < 0.01) improved the bond strengths to P-50. It is
      concluded that Vitrebond formed the most favourable cement-resin composite bond
      and that the other materials studied should be used in conjunction with an
      effective intermediate bonding agent, such as Scotchbond 2.

PMID- 8473593
TI  - Change in pH during setting of polyelectrolyte dental cements.
AB  - The change in pH during setting has been studied for five different glass
      polyalkenoate (ionomer) cements and for two different zinc polycarboxylate
      cements using a flat-headed combination electrode on both the fresh cement and on
      a slurry of the set cement. The results show that the pH of the glass ionomers
      was slightly lower in the early stages of setting than was the pH of the zinc
      polycarboxylates and also that the pH of glass ionomers rises more slowly. For
      anhydrous cements (i.e. those formulated from dried polymer) pH was found to rise
      quicker than for hydrous cements (i.e. those prepared from aqueous solutions of
      polymer). Previous workers have assumed that anhydrous cements undergo slower
      rises in pH than hydrous ones. Our results clearly refute this assumption, and
      also suggest that the reported pulpal irritation associated with the use of
      anhydrous glass ionomers may be due to something other than low pH.

PMID- 8473594
TI  - Durability of restorations in primary molars.
AB  - Techniques used to restore carious primary molars have changed over the past
      decade as new adhesive materials have been developed. The most meaningful way of
      assessing the efficacy of a technique is by clinical trials. This article reviews
      the information concerning amalgam, composite and glass polyalkenoate (ionomer)
      cement as well as extracoronal restorations. Stainless steel/nickel chrome crowns
      provide the most durable restoration, often surviving until the tooth exfoliates.
      Class II amalgam restorations, whilst being prone to fracture, have been shown to
      survive about 3 years, a figure that improves with increasing age of the child
      and the use of local anaesthesia. Over the shorter term resin-based composites
      appear to be at least as durable as amalgam, particularly with respect to the
      maintenance of a good anatomical form. In contrast, when assessed at 6 years the
      failure rate of composite restorations is high, 62%, whereas the failure rate of
      amalgam restorations at 5 years is as low as 20%. Glass ionomer cements and
      cermets are alternative materials for use in the primary dentition. The reported
      success rate of 33% over 5 years for conventional glass ionomer cements is
      encouraging, however cermets appear to be less successful but have not been
      evaluated over the longer term. Glass ionomer cements provide a means of
      restoring primary molars with minimal amount of destruction of sound tooth tissue
      and reduced treatment time for the young patient, whilst the local fluoride
      release is also a potential advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473595
TI  - Three-year follow-up of five posterior composites: in vivo wear.
AB  - The wear of five posterior composites at occlusal contact areas (OCA) and contact
      free occlusal areas (CFOA) was evaluated in Class II cavities over a 3-year
      period with an accurate 3D-measuring technique. A clinical evaluation was also
      performed. The ultrafine compact-filled composites (Willems et al., 1992) showed
      acceptable OCA-wear rates ranging from 110 to 149 microns after 3 years. This is
      very similar to the OCA-wear rate of human enamel on molars, which is about 122
      microns after 3 years. The fine compact-filled composite had an unacceptable OCA
      wear value of 242 microns after 3 years. The ultrafine midway-filled composite
      showed an exceptionally high CFOA-wear value of 151 microns after 3 years, which
      gave the impression of it being gradually washed out of the cavity. Clinically,
      70% of the restorations made with the ultrafine midway-filled composite showed
      excellent colour match after 3 years. For most of the compact-filled composites
      slightly opaque fillings were noted and 63% of the restorations made with one of
      these materials were clearly opaque. It can be concluded that the investigated
      ultrafine compact-filled composites can be considered as amalgam alternatives as
      far as their wear resistance is concerned.

PMID- 8473596
TI  - Three-year follow-up of five posterior composites: SEM study of differential
      wear.
AB  - Assessing the wear of both enamel and composite at a shared occlusal contact area
      offers the opportunity to determine the differential wear between enamel and
      composite on the same tooth. Differential wear measurements were carried out on
      five posterior composite materials with an accurate 3D-measuring technique. The
      distinct wear step between enamel and composite was visualized by means of
      scanning electron photomicrographs. Both investigated ultrafine midway-filled and
      fine compact-filled composites (Willems et al., 1992a) have a considerably higher
      differential wear value and are, therefore, less suitable for rehabilitation of
      posterior teeth than are the ultrafine compact-filled composites, which have, in
      this study, a very satisfactory differential wear rate and appear to be highly
      wear resistant materials suitable for use in stress-bearing areas.

PMID- 8473597
TI  - A SEM study of denture plaque and oral mucosa of denture-related stomatitis.
AB  - The aim of this study was to compare the morphology of denture plaque and
      adjacent palatal mucosa in five subjects with denture-related stomatitis and a
      control group of five healthy subjects. Scanning electron microscope examination
      of copper plate replicas, which preliminary studies established were superior to
      epoxy resin replicas, showed that there were no consistent differences between
      the morphology of denture plaque and adjacent mucosa in the denture-related
      stomatitis group and control group. In each, the surface of the denture plaque
      was composed predominantly of coccoid- and rod-shaped bacteria with only some
      yeast cells. The mucosa was largely devoid of microorganisms and individual
      epithelial cells were shedding from its surface.

PMID- 8473598
TI  - Copper plate replica SEM of developing dental plaque in monkeys (Macaca
      fascicularis).
AB  - The aim of the study was to examine the development of dental plaque in macaque
      monkeys (Macaca fascicularis). Copper plate replicas were constructed from
      impressions of the labial surface of one of the upper central incisor teeth after
      tooth cleaning and when plaque had accumulated for 12, 24 and 48 h in each of
      five animals. Scanning electron microscope examination of the replicas showed
      that bacteria were present on the tooth surface as scattered individual cells,
      which after 24 h had formed a continuous layer. Both coccoid and filamentous
      bacteria were visible in 48-hour-old plaque. Such a rapid accumulation of
      potentially periodontopathic dental plaque emphasizes the importance of regular
      and meticulous oral hygiene.

PMID- 8473599
TI  - Assessing dental patients for their risk of being carriers of a blood-borne
      virus: the views of final year dental students.
AB  - A questionnaire was sent to final year dental students in all but one of the
      dental schools in the UK in 1991. The response was 447 out of 739 (60.5%). The
      students were asked about how they intended to approach various aspects of
      patient care once they were qualified and in practice. Almost half (44%) said
      they would use a cross-infection policy in which precautions would be stepped up
      for 'risky' patients. This study was undertaken to determine what they think are
      factors which might identify a patient who is infected, or at risk of being
      infected, by either hepatitis B virus or the human immunodeficiency virus. Those
      who said they would take personal histories to determine a patient's risk (30%)
      seemed prepared to ask about experiences which have relatively low predictive
      value for infection (e.g. blood transfusions), yet are reluctant to ask more
      pertinent questions, i.e. those concerning sexual activity. Those who would
      attempt to assess patients' risk status without asking 'intrusive questions'
      (14%) seem to have differing views about what sort of observable factors would be
      useful in framing such an assessment.

PMID- 8473600
TI  - Control of insecticide resistance in laboratory populations of house fly
      (Diptera: Muscidae) by introduction of susceptibility genes.
AB  - We investigated the effects of immigration of individuals carrying susceptibility
      alleles on the level of resistance in populations of the house fly, Musca
      domestica L., selected for malathion resistance. Two types of males, WHO/IN males
      (homozygous for susceptibility genes) and A14-WHO males (heterozygous for the
      second chromosome) were released into the resistant populations in 1:9, 1:1, and
      9:1 ratios of immigrant/resident males. In both experiments, we observed that
      increasing the ratio of immigrant to resident males from 1:9 to 9:1 caused an
      associated increase in mortality caused by malathion applications. Release of A14
      WHO males was more effective in stopping the evolution of resistance in resistant
      populations than was release of WHO/IN males. Fitness parameters of resistant and
      susceptible strains were also compared. The WHO/IN strain had low viability and
      fecundity. R and A14-WHO males were longer-lived compared with WHO/IN males,
      although they did not differ in mating success.

PMID- 8473601
TI  - Biochemistry and genetics of thiodicarb resistance in the house fly (Diptera:
      Muscidae).
AB  - The biochemistry and genetics of thiodicarb resistance were studied in the house
      fly, Musca domestica L. Bioassays with several strains revealed that a thiodicarb
      resistant strain was also resistant to carbaryl and to several organophosphates.
      Bioassays with a thiodicarb-synergist combination showed that resistance was only
      partially blocked by use of a synergist, suggesting the presence of target site
      resistance. The inheritance of resistance to thiodicarb was studied through
      crosses of the resistant parent to a multimutant, susceptible strain. Bioassays
      of backcrosses and the F2 generation showed that the major gene(s) conferring
      resistance to thiodicarb were on chromosome II. Cholinesterase assays showed that
      the enzyme of the resistant strain was several times more resistant to inhibition
      by carbamates than the enzyme of a susceptible strain or a strain with only
      metabolic resistance to insecticides. The data indicate that resistance to
      thiodicarb in the house fly was mainly because of target site changes. In
      addition, metabolism may contribute to resistance.

PMID- 8473602
TI  - An insert earphone system for delivery of spectrally shaped signals for
      physiological studies.
AB  - Acoustic signals arriving at the eardrum in free-space carry directionally
      dependent temporal and spectral information resulting from the acoustical effects
      of the body, head, and external ear as well as from differences in the length of
      the sound path to each ear. Through analysis of the responses of single auditory
      neurons, the acoustical and neural mechanisms by which sounds in free-space are
      localized are being studied. The approach involves simulation of free-field
      signals at the two eardrums of a cat via earphones and a study of the neuronal
      responses to such a virtual acoustic space. This approach makes it possible to
      manipulate different stimulus parameters independently in order to examine their
      role in determining the spatial characteristics of neuronal response. This report
      describes an insert earphone system designed for the delivery of such simulated
      signals which are broadband transients having complex spectra that mimic the
      acoustic transfer function of the external ear for frequency components up to 30
      kHz or more.

PMID- 8473603
TI  - Analyses of Mossbauer mechanical measurements indicate that the cochlea is
      mechanically active.
AB  - Using the results of Mossbauer measurements, mechanical activity in the cochlea
      was tested for by comparing the measured basilar membrane (BM) transverse
      velocity amplitude with that calculated for a lossless mechanically passive
      system, derived from the measured BM velocity phase. If the cochlea is considered
      to be a lossless mechanically passive system, then the transverse velocity
      amplitude can be calculated from the group velocity and the relative variation of
      stiffness along the BM. The group velocity can be derived from the Mossbauer
      phase measurements, and the relative variation of stiffness along the BM can be
      derived from the frequency map of the cochlea. Making some general assumptions,
      the actual transverse velocity amplitudes are then compared from the Mossbauer
      amplitude data with those derived from the Mossbauer phase data, to determine if
      there is a significant transverse velocity gain. This operation was performed on
      several sets of Mossbauer data. From Mossbauer data showing sharp tuning,
      differences were found of up to 40 dB between the actual transverse velocity
      amplitude and the calculated lossless passive transverse velocity amplitude
      derived from the phase data. Examination of the assumptions made during the
      calculation of the lossless passive transverse velocity amplitude showed that
      none could account for a 40-dB transverse velocity gain. Thus, it is concluded
      that this transverse velocity gain can only be accounted for by the contribution
      to the amplitude of the transverse BM velocity by mechanically active elements
      along the cochlear duct. From Mossbauer data showing much less sharp tuning, it
      was found that the actual transverse velocity amplitude was approximately equal
      to the calculated lossless passive transverse velocity amplitude, basal to the
      characteristic place. This result is attributed to the disabling of the
      mechanically active elements along the cochlear duct. Apical to the
      characteristic place, the actual transverse velocity amplitude is shown to behave
      in a manner that suggests that the effective damping increases markedly in this
      region. This increase in effective damping is not necessarily due to an increase
      in viscous damping but could be due to any mechanism removing energy from the BM
      traveling wave. As an example, this paper discusses how this effective damping
      could be accounted for the transfer of energy to another mode of vibration at the
      characteristic place.

PMID- 8473604
TI  - A life-sized physical model of the human cochlea with optical holographic
      readout.
AB  - A life-sized physical model of the human cochlea is demonstrated. The model
      consists of two fluid-filled chambers separated by a polymer membrane and
      connected through a small hole that serves the same functional purpose as the
      helicotrema. The dimensions of the two chambers were made identical to those of
      scala vestibuli and scala tympani in the real cochlea. The membrane's width and
      length are the same as the values measured for the biological basilar membranes,
      and its thickness is chosen to give it appropriate rigidity. A piezoelectric
      transducer drives the system via an elastic window (acting as the oval window) on
      one side of the scala vestibuli. The resulting vibration pattern on the basilar
      membrane is investigated with an optical novelty filter, with detection
      sensitivity of 0.3 A at 2 kHz with a 1-Hz bandwidth. The overall response of this
      model is found to be a good extrapolation of Bekesy's low-frequency data.
      However, the tuning curves of this model are not as sharp as those found by
      Rhode, Johnstone, and others from the in vivo measurements. Possible implications
      of these results are discussed.

PMID- 8473605
TI  - Temporary threshold and loudness shifts: frequency patterns and correlations.
AB  - Two experiments studied the frequency pattern of TLS (temporary loudness shift)
      as a function of the level and frequency of the fatiguing sound. In experiment 1,
      the fatiguing tones were intermittent 375-, 1500-, or 3000-Hz tones (10 s on/10 s
      off) at 75, 80, 85, 90, or 95 dB SPL. The TLS patterns were established for a
      continuous, 60-phon test tone at different frequencies presented simultaneously
      with the intermittent fatiguing tone. In experiment 2, a 1000-Hz exposure tone
      with an intermittency of 10 s on/20 s off was used with a continuous 60-dB test
      tone at different frequencies. In both experiments, the total exposure duration
      was 60 s; TLS was measured 5 s after the exposure ended. For the lowest two
      exposure levels, the TLS pattern had one peak centered on the exposure frequency.
      As the exposure level increased, a two-peak pattern became evident, with the
      second peak at higher test frequencies. This finding could be interpreted as
      psychoacoustical evidence for the double (passive and active) mode of
      displacement of the basilar membrane. In experiment 2, a TTS (temporary threshold
      shift) measurement after exposure to a 45-min, 1000-Hz tone at 90 dB was added to
      the TLS sessions. The correlations between maximum TTS after a 45-min exposure
      and the TLS obtained after a 60-s exposure were calculated for each of the
      exposure levels and test frequencies used in TLS measurements. The correlation
      reached as high as 0.9 for TLSs measured at 1120 Hz after a 90-dB exposure; it
      was smaller but significant for TLSs at the exposure frequency. Despite these
      correlations, differences in the overall patterns of TTS and TLS suggest that
      they stem from two different mechanisms.

PMID- 8473606
TI  - Effects of varying signal and noise levels on pure-tone frequency discrimination
      in humans and monkeys.
AB  - This study examined the effects of presenting various signal and noise levels on
      pure-tone frequency difference limens (FDLs) in humans and monkey. Signal levels
      for two frequencies of 500 Hz and 4 kHz were varied both in quiet and in noise.
      For the lower frequency of 500 Hz, the two species exhibited qualitatively
      divergent FDLs as level increased in quiet: FDLs decreased at high levels for
      humans, but increased for monkeys. In noise, differences between human and monkey
      FDLs were less pronounced. At 500 Hz, monkeys exhibited slightly lower FDLs in
      noise than in quiet. At the higher frequency of 4 kHz, under all conditions, FDLs
      for both species were qualitatively similar. Results are discussed in relation to
      (1) different use of "temporal" coding mechanisms by humans and monkeys at 500
      Hz, and (2) similar use of "rate-place" coding mechanisms at 4 kHz.

PMID- 8473607
TI  - Effects of varying signal duration on pure-tone frequency discrimination in
      humans and monkeys.
AB  - This study examined the effects of varying signal duration and pulse repetition
      rate on pure tone frequency difference limens (FDLs) at 500 Hz and 4 kHz in
      humans and monkeys. Two experiments examined FDLs as a function of tone duration
      from 12-400 ms, using stimuli presented either with a constant pulse rate, or
      with a constant interstimulus interval. In both cases, at 500 Hz, human FDLs
      increased more than monkey FDLs as duration decreased from 400 to 12 ms. This
      effect resulted in monkey FDLs that were about 14 times larger than human FDLs at
      400 ms, but only about 4 times larger at 12 ms. At 4 kHz, human and monkey FDLs
      showed more similar rates of increase as duration decreased. A third experiment
      examined FDLs at 500 Hz for a 100-ms tone as a function of pulse rate (1 per 250
      2000 ms). Here, FDLs for humans and monkeys varied in a similar fashion,
      indicating that both species' sensitivity was similarly affected by manipulating
      temporal variables relating to memory load, rather than sensory coding. These
      data provide evidence that, at 500 Hz, humans have a qualitatively different pure
      tone frequency analyzing mechanism from monkeys, possibly based on better access
      to phase-locking mechanisms.

PMID- 8473608
TI  - Effect of spectral envelope smearing on speech reception. II.
AB  - This paper describes two experiments on the effect of reduced spectral contrast
      on the speech-reception threshold (SRT) for sentences in a background of
      interfering sound. Signal processing is performed by smoothing the envelope of
      the squared short-time fast Fourier transform by a convolution with a Gaussian
      shaped filter, and overlapping additions to reconstruct a continuous signal. In
      the first experiment the effect of reduced spectral contrast on the SRT for male
      speech is investigated and compared with previously obtained results for female
      speech [ter Keurs et al., J. Acoust. Soc. Am. 91, 2872-2880 (1992)]. Spectral
      energy is smeared over bandwidths of 1/8, 1/4, 1/3, 1/2, 1, 2, and 4 oct. The
      results show that, despite the differences in spectral pattern between male and
      female voices, the SRT in noise increases similarly for both voices for smearing
      bandwidths over 1/3 oct. In terms of the ripple density of the spectral envelope
      the results indicate that the range of lower spectral modulations, up to a limit
      of about 1.5 periods/oct, is sufficient for the intelligibility of speech in
      interfering sounds. In the second experiment the extent of the threshold
      difference between a speech masker and a noise masker is investigated for
      spectral smearing bandwidths of 1/2, 1, and 2 oct. The release from masking found
      for the speech masker relative to the (steady-state) noise masker decreases with
      spectral envelope smearing.

PMID- 8473609
TI  - Acoustic image representation of a point target in the bat Eptesicus fuscus:
      evidence for sensitivity to echo phase in bat sonar.
AB  - Echolocating bats, Eptesicus fuscus, were trained in two distinct behavioral
      tasks to investigate the images they perceive of a sonar point target. In the
      first task, bats were trained in a two-alternative forced-choice procedure to
      detect electronically simulated target echoes at a range of approximately 57 cm.
      Half of the trials in the detection task contained echoes from a stationary
      target (simulated by a fixed echo delay) and half contained echoes from a
      jittering target (simulated by an echo delay alternating between two time values
      over successive sonar emissions). In the second task, bats were trained in a two
      alternative forced-choice procedure to discriminate between electronically
      simulated stationary and jittering targets, centered about a range of 57 cm. Both
      target detection and target jitter discrimination performance were assessed as a
      function of jitter magnitude, with jitter values ranging from 0-60 microseconds
      (corresponding to a change in distance of 0 to 10.3 mm). In both detection and
      discrimination tasks, the bat's performance changed cyclically with the magnitude
      of echo jitter. Specifically, when the phase of the playback echoes was
      unchanged, performance levels were poorest at 0 and 30 microseconds, and when the
      phase of the echoes alternated by 180 deg from one to the next, performance
      levels were poorest at 15 and 40-50 microseconds. The results suggest that
      Eptesicus is sensitive to the phase reversal of echoes and thus have implications
      for assessing receiver models of echolocation.

PMID- 8473610
TI  - Detection of temporal gaps in sinusoids: effects of frequency and level.
AB  - Thresholds for the detection of gaps in sinusoidal signals were measured as a
      function of frequency (100-2000 Hz) and level (25-85 dB SPL) in 11 normally
      hearing subjects. The sinusoids were presented in a background noise intended to
      mask spectral splatter associated with the gap. In a separate experiment,
      auditory filter shapes and detection efficiency were estimated for the same 11
      subjects using the notched-noise method, at center frequencies of 100, 200, 400,
      and 800 Hz. Gap thresholds varied only slightly with frequency over the range 400
      2000 Hz, but increased markedly at 200 and 100 Hz. At all center frequencies, gap
      thresholds were almost invariant with level for levels above 55 dB SPL. Gap
      thresholds increased at low levels, reaching values about 50% greater than their
      asymptotic values at a sensation level of about 20 dB. The decrease in auditory
      filter bandwidth with decreasing center frequency does not seem sufficient to
      account for the increase in gap thresholds. Also, individual gap thresholds at a
      given center frequency were not significantly correlated with the bandwidth of
      the auditory filter at that center frequency, as would be expected if the
      auditory filter played a role in limiting gap detection. Detection efficiency
      decreased with decreasing center frequency. Individual differences in detection
      efficiency were significantly correlated with gap thresholds. However, changes in
      detection efficiency with frequency do not seem to be of the right form to
      account for the increase in gap thresholds at low frequencies. It seems likely
      that there is a central sliding temporal integrator which integrates over longer
      times at lower center frequencies.

PMID- 8473611
TI  - Detecting temporal asynchrony with asynchronous standards.
AB  - The ability of listeners to detect asynchrony in either the temporal onset or
      offset of individual components in a multicomponent complex was investigated. A
      standard stimulus was created having a simple kind of asynchrony by linearly
      delaying successive components of a complex stimulus. Additional asynchrony (the
      signal) was created by altering the temporal position of a single component of
      the complex relative to its temporal position in the standard. Asynchrony
      discrimination was measured for harmonic signals (experiment I) and for complexes
      in which the components were logarithmically spaced in frequency (experiment II).
      For the onset condition, asynchrony in either the harmonic or logarithmic complex
      greatly increased the difficulty in detecting the temporal asynchrony of a single
      component. For the offset condition, asynchrony discrimination was not greatly
      affected by asynchrony in the standard.

PMID- 8473612
TI  - Extracting dynamic parameters from speech movement data.
AB  - A quantitative characterization of articulatory movements, using the parameter
      values of a linear second-order dynamical system, was developed in order to
      compare classes of movements, in particular, classes defined by linguistic
      factors such as syllable position, stress, and vowel quality. Movements of the
      lower lip in utterances such as ['bibebib] and [babe'bab] were partitioned into
      sections ("windows") in two ways: at successive displacement peaks and valleys,
      and at the right edge of plateau regions around such extreme values. The
      linguistic factors affected natural frequency in similar ways regardless of
      whether damping ratio was permitted to vary or held fixed at one of several
      different values. Damping ratio was generally unaffected by the linguistic
      factors. For the most part, the type of partition or window did not affect the
      patterns of the results, with the exception of the closing gesture out of the
      reduced syllable.

PMID- 8473613
TI  - Production and perception of a novel, second-language phonetic contrast.
AB  - Four experiments, all of which focused on vowel duration, assessed Chinese
      subjects' production and perception of the contrast between /t/ and /d/ in the
      final position of English words. Vowel duration was measured in minimal pairs in
      the first experiment. The stimuli in natural-edited beat-bead and bat-bad
      continua in which vowel duration varied in 20-ms steps were then presented to
      native English and Chinese subjects in a forced-choice test, in an experiment
      using the method of adjustment, and in an imitation task. The non-natives who
      learned English in childhood closely resembled native speakers in all four
      experiments. Three groups of non-natives who had learned English as a second
      language in adulthood, on the other hand, differed from the native speakers. The
      late learners produced significantly longer vowels in words ending in /d/ than
      /t/. However, the late learners' vowel duration differences were much smaller
      than the native speakers', and were correlated significantly with degree of
      foreign accent in English. The late learners differed from the native speakers in
      several ways in the two perception experiments, and also in the imitation task.
      The pattern of significant and nonsignificant between-group differences, but not
      data for individual subjects, was consistent with the hypothesis that L2 (second
      language) production accuracy is limited by the adequacy of perceptual
      representations for sounds in the L2.

PMID- 8473614
TI  - Comment on "Temporal modulation transfer functions in patients with cochlear
      implants" [J. Acoust. Soc. Am. 91,2156-2164 (1992)].

PMID- 8473615
TI  - Ratio of variance to mean of action potential counts for an auditory nerve fiber
      model with second-order refractory behavior.
AB  - Sequences of interval times were generated with the first- and second-order
      interval probability dependence proposed by Gaumond et al. [J. Neurophysiol. 48,
      856-873 (1982)] to characterize cochlear nerve fiber spontaneous action potential
      (AP) sequences. The ratio F(T) of the variance to the mean of the count of APs in
      bins of T s was computed for the simulated sequences, and compared to the
      corresponding measure for cochlear nerve fiber data presented by Lowen and Teich
      [J. Acoust. Soc. Am. 92, 803-806 (1992)]. The simulations were generally
      consistent with the data in the range 15 < T < 100 ms.

PMID- 8473616
TI  - Alteration of central auditory processing of brief stimuli: a review and a neural
      model.
AB  - There is evidence that the manner in which the central auditory system processes
      transient signals can be altered by either of two seemingly unrelated
      experimental factors, namely, hearing loss, or the presence of a continuous tone
      of moderate intensity. In particular, altered processing of brief signals in the
      central auditory system is indicated by either: (i) lower (better) behaviorally
      measured thresholds for pulsate electrical stimulation of brain-stem auditory
      nuclei, or (ii) an increased amplitude of some components of the brain stem or
      cortical potentials evoked by brief acoustic stimuli. A simple two-neuron model
      which evolved from the above findings and related visual system phenomena was
      used to evaluate the effects produced by hearing loss or continuous tone. In the
      model, a "hearing loss" condition, which was represented by less spontaneous
      neural activity (and, hence, reduced inhibition) relative to a "normal hearing"
      condition, yielded both increased gain for steady-state stimuli and increased
      responsiveness for transient stimuli. Thus the model provides two possible, and
      simultaneously operable, explanations of reduced electrical stimulation
      thresholds and increased evoked potential amplitude: one based on increased
      steady-state gain and the other based on increased responsiveness to transient
      stimuli. A third condition, "normal hearing with a longer excitatory time
      constant," yielded effects that were similar to those produced by reduced
      inhibition, thereby suggesting a physiological basis for alteration of
      psychophysically measured time constants.

PMID- 8473617
TI  - Otoacoustic emissions from normal-hearing and hearing-impaired subjects:
      distortion product responses.
AB  - Distortion product otoacoustic emissions (DPOAE) were measured in normal-hearing
      and hearing-impaired human subjects. Analyses based on decision theory were used
      to evaluate DPOAE test performance. Specifically, relative operating
      characteristic (ROC) curves were constructed and the areas under these curves
      were used to estimate the extent to which normal and impaired ears could be
      correctly identified by these measures. DPOAE amplitude and DPOAE/noise
      measurements were able to distinguish between normal and impaired subjects at
      4000, 8000, and, to a lesser extent, at 2000 Hz. The ability of these measures to
      distinguish between groups decreased, however, as frequency and audiometric
      criterion used to separate normal and hearing-impaired ears decreased. At 500 Hz,
      performance was no better than chance, regardless of the audiometric criterion
      for normal hearing. Cumulative distributions of misses (hearing-impaired ears
      incorrectly identified as normal hearing) and false alarms (normal-hearing ears
      identified as hearing impaired) were constructed and used to evaluate test
      performance for a range of hit rates (i.e., the percentage of correctly
      identified hearing-impaired ears). Depending on the desired hit rate, criterion
      values of -5 to -12 dB SPL for DPOAE amplitudes and 8 to 15 dB for DPOAE/noise
      accurately distinguished normal-hearing ears from those with thresholds greater
      than 20 dB HL for the two frequencies at which performance was best (4000 and
      8000 Hz). It would appear that DPOAE measurements can be used to accurately
      identify the presence of high-frequency hearing loss, but are not accurate
      predictors of hearing status at lower frequencies, at least for the conditions of
      the present measurements.

PMID- 8473618
TI  - Intermodulation distortion (F2-F1) in inner hair cell and basilar membrane
      responses.
AB  - Round window (RW) recordings in guinea pigs show a large response at the
      frequency of the quadratic difference tone (QDT) at F2-F1 for high-frequency (> 8
      kHz) tone pairs. The magnitude of the RW response is dependent on frequency and
      level of the primaries. The QDT cochlear microphonic produced is largest for
      primaries with a frequency separation of approximately 900 Hz. Its source is
      probably the local activity of hair cells in basal cochlear locations where the
      high-frequency tones interact. QDT measurements from locations inside the organ
      of Corti show that the magnitude of the QDT is largest in the inner hair cell
      (IHC) region and monotonically increases as the difference in the frequency of
      the primaries decreases. Measured as IHC intracellular ac receptor potential, the
      QDT appears to be the result of a mechanical stimulus to the cell rather than as
      an inherent property of the nonlinear transduction in the IHC. However, QDT of
      the same form is not evident in the velocity responses of the basilar membrane.
      These results suggest that the outer hair cells (OHC) produce a strong quadratic
      distortion product mechanical force to stimulate inner hair cells. This
      mechanical drive may not be present, or is a weak component, in basilar membrane
      motion.

PMID- 8473619
TI  - A comparison of N1 of the whole nerve action potential and wave i of the brain
      stem auditory evoked response in Mongolian gerbil.
AB  - The present study seeks to provide empirical support for the assumption that wave
      i of the gerbil brain-stem auditory evoked response (BAER) corresponds to N1 of
      the whole nerve action potential (WNAP) by comparing the latency and amplitude of
      BAER wave i and WNAP N1. Fourteen 3-month old gerbils were anesthetized with
      Nembutal and Urethane-Dial. Normothermia was maintained by a homeothermic blanket
      system. BAERs were recorded with Grass needle electrodes placed subdermally. The
      WNAP was recorded with a silver wire placed in the round window niche. WNAP and
      BAER were simultaneously recorded with a passband of 100-10,000 Hz. Responses
      consisted of 500 sweeps, and two responses were obtained for each condition.
      Clicks were 25-microseconds electrical pulses. Tonebursts were shaped with a
      Hanning window, with 1-ms rise and fall times. Toneburst frequencies included 1,
      2, 4, 8, and 16 kHz. For each stimulus, responses were obtained at levels of 30,
      50, 70, and 90 dB pSPL. SPL was measured near the entrance to the ear canal with
      an Etymotic ER-7C probe microphone. Dependent variables were the latency and
      amplitude of N1 of the WNAP and wave i of the BAER. The latencies of wave i and
      N1 were very similar. Mean (across animal) latencies of N1 and wave i were within
      70 microseconds for all six stimuli (clicks, tonebursts) and all four levels.
      Latency/intensity function slopes for N1 and wave i were also very similar, with
      both dependent variables showing an increasing latency/intensity function slope
      with decreasing toneburst frequency. The N1/wave i amplitude ratio was
      computed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473620
TI  - Binaural maximum length sequence auditory-evoked brain-stem responses in human
      adults.
AB  - This study compared monaural and binaural maximum length sequence auditory-evoked
      brain-stem responses (MLS ABRs) in normal hearing adults. The first experiment
      demonstrated that reliable binaural MLS ABRs could be recorded which were
      essentially the same as those recorded monaurally. The second experiment
      generalized this finding by assessing a range of intensities including threshold
      stimuli. ABR thresholds, wave V latency x intensity and amplitude x intensity
      functions, wave V latency and amplitude reproducibility, and waveform
      reproducibility were comparable for the monaural and binaural MLS ABRs with some
      minor qualifications. In the third experiment, comparability of monaural and
      binaural MLS ABRs was generalized to a range of rates from those used
      conventionally to rates far faster than possible with signal averaging. Again,
      there was little difference between the binaural and monaural MLS ABRs over the
      range of rates assessed.

PMID- 8473621
TI  - Audiometric and histological differences between the effects of continuous and
      impulsive noise exposures.
AB  - An experiment was designed to determine if, for equal SPL and power spectrum, the
      effects on hearing of high-kurtosis noise exposures and a Gaussian noise exposure
      are different and the extent to which any differences measured in terms of
      audiometric and histological variables are frequency specific. Three groups of
      chinchillas with 10 animals/group were exposed for 5 days at 90 dB SPL to one of
      three types of noise, each with the same power spectrum. The impulsiveness,
      defined by the kurtosis, and the region of the spectrum from which the impulsive
      components of the noise were created differed for two of the noises, while the
      third was a continuous Gaussian noise. The results show that the most impulsive
      noise produced up to 20 dB greater permanent threshold shift at the high
      frequencies than did the Gaussian noise exposure. However, these audiometric
      results were difficult to reconcile with the pattern of sensory cell losses that
      showed statistically significant larger losses of outer hair cells for the
      impulsive exposure in the 0.25-kHz region. When the impacts in a high-kurtosis
      noise were created from the energy in the 1- through 6-kHz region of the
      spectrum, the audiometric profile of hearing loss was similar to that produced by
      the Gaussian noise; however, inner hair cell losses were significantly greater in
      the 4-kHz octave band region of the cochlea.

PMID- 8473622
TI  - A maximum-likelihood method for estimating thresholds in a yes-no task.
AB  - A maximum-likelihood procedure for estimating threshold values in a yes-no task
      is presented. In computer simulations of this procedure, it is demonstrated that
      the variability of the threshold estimates is little affected by the density of
      the hypotheses tested for a fixed range, or by serious misestimates of the slope
      of the psychometric functions. The threshold value is also largely independent of
      the starting value of the signal. The standard deviation of the threshold
      estimates appears to decrease with the square root of the number of trials, with
      a 2- to 3-dB standard deviation possible if only 12 trials are used in the
      threshold estimates. Data are presented using human listeners tested on 5 days.
      Two threshold estimates, based on 12 trials, were made at each of the six
      audiometric frequencies on each day. The mean data appear sensible, and the
      standard deviation of the measured thresholds is about 3 dB. Using this
      procedure, it takes less than 3 min to measure the audiogram for a single ear.

PMID- 8473623
TI  - Comodulation masking release as a function of type of signal, gated or continuous
      masking, monaural or dichotic presentation of flanking bands, and center
      frequency.
AB  - Thresholds were measured for detecting a signal centered in a narrow-band noise
      (NBN) masker (on-frequency band, OFB), for the OFB alone, and with two flanking
      bands (FBs) added to the OFB, one centered above and one below the OFB. The FBs
      were either correlated with the OFB or were independent and were presented either
      to the same ear as the signal plus OFB (monaural condition) or to the opposite
      ear (dichotic condition). The OFB and FBs were either gated with the signal, or
      were presented continuously. Three signal types were used: a pure tone; an NBN
      uncorrelated with the OFB; and an NBN correlated with the OFB. The signal was
      centered at 0.5, 2, or 6 kHz. Comodulation masking release was estimated either
      as the difference between threshold with the OFB alone and with the OFB plus
      correlated FBs [CMR(R-C)], or as the difference between thresholds using
      correlated and uncorrelated FBs [CMR(U-C)]. Although there were marked individual
      differences, positive CMR(R-C) values were found in all conditions for all three
      signal types. CMR(U-C) values were often larger than those for CMR(R-C),
      reflecting the fact that the uncorrelated FBs tended to produce interference
      effects, especially for the gated maskers, and at 6 kHz. Values of CMR were
      larger and more consistent across subjects for continuous than for gated maskers.
      For continuous maskers, the values of CMR tended to be smallest for the
      correlated-NBN signal. Results are discussed in terms of available cues and in
      terms of perceptual grouping mechanisms.

PMID- 8473624
TI  - Source level discrimination by the lateral line system of the mottled sculpin,
      Cottus bairdi.
AB  - A conditioned feeding response of the mottled sculpin was used to measure level
      discrimination by the lateral line system as a function of source level,
      frequency, and distance. Level discrimination limens (LDLs) were determined with
      a 6-mm-diam, sinusoidally vibrating sphere placed in front of the trunk lateral
      line system at varying distances from the trunk of the fish. LDLs were relatively
      independent of frequency over most of the detection bandwidth, with mean values
      ranging from 5-6 dB from 10 to 50 Hz at a fish-to-source distance of 15 mm. The
      mean LDL at 100 Hz, near the upper end of the frequency range of the lateral line
      system was 8-9 dB at the same source distance. Mean LDLs at 10 and 20 dB above
      detection threshold were not significantly different, nor were mean LDLs at
      distances ranging from 7.5 to 30 mm for a 50-Hz, 10-dB SL source. The level
      encoding features of posterior lateral line fibers innervating the trunk were
      also determined from data previously collected under stimulus conditions nearly
      identical to those used for behavioral studies. Afferent fibers responded to
      level increments with increases in both spike rate and phase-locking over most of
      the conditions used in behavioral experiments. Although it was impossible to
      eliminate spike rate as a level-encoding mechanism at any stimulus condition,
      phase-locking appeared to be a strong candidate at low source levels and
      vibration frequencies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473625
TI  - Comparison of spectral and nonspectral frequency difference limens for human and
      nonhuman primates.
AB  - Difference limens for frequency were measured in normal-hearing human and
      nonhuman-primate (macaque) subjects. Stimuli were 1-kHz pure tones, containing
      both spectral and temporal cues, and 100-Hz sinusoidally amplitude modulated
      broadband noise (SAM noise), containing only temporal (nonspectral) cues.
      Subjects were tested for a minimum of 20 sessions and until difference limens
      were stable over time for each stimulus at each of several sensation levels.
      Difference limens for pure-tone stimuli showed almost no overlap between human
      and nonhuman-primate subjects. Difference limens for SAM-noise stimuli for human
      and nonhuman-primate subjects overlapped considerably. The correlations between
      performance for the pure-tone stimuli and performance for the SAM noise stimuli
      averaged 0.60. These data suggest that at least two factors influence pure-tone
      frequency discrimination. One factor is dependent on the presence of place
      mechanisms while the other factor, or group of factors, seems to influence both
      spectral and nonspectral frequency discrimination.

PMID- 8473626
TI  - Dichotic interference effects in gap detection.
AB  - Thresholds for detecting a temporal gap in a 20-Hz-wide band of noise (the
      target) were measured for the target alone, and in the presence of multiple 20-Hz
      wide flanking bands presented to the opposite ear. The flanking bands caused gap
      thresholds to increase, and this effect was greater at higher levels of the
      flanking bands. The impairment to gap detection was greater when the flanking
      bands were comodulated with the target (i.e., had the same envelope) than when
      they were not comodulated, except at very low and high levels of the flanking
      bands. A series of supplementary experiments was conducted to investigate why the
      difference between comodulated and noncomodulated bands was reduced at high
      levels. The results suggest that this was not due to inter-aural crosstalk. It
      may have been partly caused by: (1) a central masking effect that reduced the
      effective sensation level of the target band at high levels of the contralateral
      flanking bands; (2) reduced independence of the flanking bands owing to
      broadening of the auditory filters at high levels. The results are discussed in
      terms of perceptual grouping processes.

PMID- 8473627
TI  - Auditory and visual localization performance in a sequential discrimination task.
AB  - Four subjects were tested in a two-alternative, forced-choice, three down-one up
      adaptive paradigm in which two 200-ms signals were presented sequentially with a
      200-ms interstimulus interval. The subject's task was to indicate whether the
      second stimulus was to the right or left of the first. Tests were conducted with
      57 dB (A-weighted), 1.0-kHz high-pass noise, the minimum audible angle (MAA)
      task, and with lights emitting 620 nm at a luminance level of 200 mL, the minimum
      visible angle (MVA) task. Localization performance in the MAA task was equal to
      or better than that obtained in the MVA task for all regions of the frontal field
      with only one exception, presentations at 0 degrees azimuth. The implications of
      these results are discussed.

PMID- 8473628
TI  - Prewhitening for intelligibility gain in hearing aid arrays.
AB  - In this article, prewhitening multimicrophone data prior to use in an optimum
      spatial-filter preprocessor for a monaural hearing aid is considered. Considering
      preprocessor capabilities, interference signal spectral content and
      intelligibility, it is argued that prewhitening is advantageous. This advantage
      is illustrated via simulation of a head worn array. Also, an effective procedure
      for the design of (prewhitening) digital filters is presented. The effectiveness
      of this filter design technique is shown by presenting several prewhitening
      filter design examples.

PMID- 8473629
TI  - Speaking fundamental frequency, intensity, and rate of adventitiously profoundly
      hearing-impaired adult women.
AB  - No objective group data on speaking fundamental frequency (F0), intensity, or
      rate have been reported on the speech of adventitiously profoundly hearing
      impaired adult women. Results of the present study showed that F0 was
      significantly higher, intensity significantly greater, and speaking rate
      significantly slower for 12 adventitiously profoundly hearing-impaired adult
      women than for 20 normal-hearing control subjects of the same sex and approximate
      age. Based on these objective data, aural rehabilitation is recommended for the
      improvement and monitoring of speaking F0, intensity, and rate abnormalities in
      the adventitiously profoundly hearing impaired.

PMID- 8473630
TI  - FO gives voicing information even with unambiguous voice onset times.
AB  - The voiced/voiceless distinction for English utterance-initial stop consonants is
      primarily realized as differences in the voice onset time (VOT), which is largely
      signaled by the time between the stop burst and the onset of voicing. The voicing
      of stops has also been shown to affect the vowel's FO after release, with
      voiceless stops being associated with higher FO. When the VOT is ambiguous, these
      FO "perturbations" have been shown to affect voicing judgments. This is to be
      expected of what can be considered a redundant feature, that is, that it should
      carry a distinction in cases where the primary feature is neutralized. However,
      when the voicing judgments were made as quickly as possible, an inappropriate FO
      was found to slow response time even for unambiguous VOTs. This was true both of
      FO contours and level FO differences. These results reinforce the plausibility of
      tonogenesis, and they add further weight to the claim that listeners make full
      use of the signal given to them, even when overt labeling would seem to indicate
      otherwise.

PMID- 8473631
TI  - Adequacy of auditory models to predict human internal representation of speech
      sounds.
AB  - A long-standing question that arises when studying a particular auditory model is
      how to evaluate its performance. More precisely, it is of interest to evaluate to
      what extent the model representation can describe the actual human internal
      representation. Here, this question is addressed in the context of speech
      perception. That is, given a speech representation based on the auditory system,
      to what extent can it preserve phonetic information that is perceptually
      relevant? To answer this question, a diagnostic system has been developed that
      simulates the psychophysical procedure used in the standard Diagnostic-Rhyme Test
      (DRT). In the psychophysical procedure, the subject has all the cognitive
      information needed for the discrimination task, a priori. Hence, errors in
      discrimination are due mainly to inaccuracies in the auditory representation of
      the stimulus. In the simulation, the human observer is replaced by an array of
      recognizers, one for each pair of words in the DRT database. The recognizer used
      [Ghitza and Sondhi, J. Acoust. Soc. Am. Suppl. 1 87, S107 (1990)] was designed to
      keep errors due to the recognition procedure to a minimum, so that the overall
      detected errors are due mainly to inaccuracies in the front-end representation.
      The system provides detailed diagnostics that show the error distributions among
      six phonetically distinctive features. Results are given for the behavior of two
      speech analysis methods, a representation based on the auditory system and one
      based on the Fourier power spectrum, in quiet and in a noisy environment. These
      results are compared with psychophysical results for the same database.

PMID- 8473632
TI  - Passive acoustic localization of the Atlantic bottlenose dolphin using whistles
      and echolocation clicks.
AB  - A method for localization and tracking of calling marine mammals was tested under
      realistic field conditions that include noise, multipath, and arbitrarily located
      sensors. Experiments were performed in two locations using four and six
      hydrophones with captive Atlantic bottlenose dolphins (Tursiops truncatus).
      Acoustic signals from the animals were collected in the field using a digital
      acoustic data acquisition system. The data were then processed off-line to
      determine relative hydrophone positions and the animal locations. Accurate
      hydrophone position estimates are achieved by pinging sequentially from each
      hydrophone to all the others. A two-step least-squares algorithm is then used to
      determine sensor locations from the calibration data. Animal locations are
      determined by estimating the time differences of arrival of the dolphin signals
      at the different sensors. The peak of a matched filter output or the first cycle
      of the observed waveform is used to determine arrival time of an echolocation
      click. Cross correlation between hydrophones is used to determine inter-sensor
      time delays of whistles. Calculation of source location using the time difference
      of arrival measurements is done using a least-squares solution to minimize error.
      These preliminary experimental results based on a small set of data show that
      realistic trajectories for moving animals may be generated from consecutive
      location estimates.

PMID- 8473633
TI  - Multi-frequency transducer assembly for nonlinear ultrasonic measurements.

PMID- 8473634
TI  - Identification of extensive coronary artery disease in women by exercise single
      photon emission computed tomographic (SPECT) thallium imaging.
AB  - OBJECTIVES: The aim of this study was to examine the ability of exercise single
      photon emission computed tomographic (SPECT) thallium imaging to identify high
      risk women with left main or three-vessel coronary artery disease using a
      stepwise discriminant analysis. BACKGROUND: Previous studies have used
      statistical methods to identify high risk men with coronary artery disease. Only
      limited data are available in women. METHODS: Exercise SPECT thallium imaging and
      coronary arteriography were performed for evaluation of chest pain in 243 women.
      Group 1 comprised 58 women with left main or three-vessel coronary disease and
      group 2 comprised 185 women with no or one- or two-vessel disease. Stepwise
      discriminant analysis was used to determine predictors of left main or three
      vessel disease. RESULTS: On univariate analysis, women in group 1 were older (p <
      0.03) and had a lower exercise work load (p < 0.02), lower exercise heart rate (p
      < 0.004), higher prevalence rate of diabetes mellitus (p < 0.0003) and more
      multivessel thallium abnormality (p < 0.0001) compared with women in group 2. On
      multivariate analysis, only multivessel thallium abnormality (F = 43) and
      exercise heart rate (F = 6) were independent predictors of left main or three
      vessel coronary disease. A model based on these two variables separated the women
      into three risk groups: 99 patients with 9%, 70 patients with 23% and 74 patients
      with 45% prevalence of left main or three-vessel disease (p < 0.0001).
      CONCLUSIONS: High risk women with left main or three-vessel coronary disease can
      be identified by exercise SPECT thallium imaging.

PMID- 8473635
TI  - Comparison in women versus men of composition of atherosclerotic plaques in
      native coronary arteries and in saphenous veins used as aortocoronary conduits.
AB  - OBJECTIVES: This study quantifies and compares the components of atherosclerotic
      plaques in native coronary arteries and in saphenous vein grafts used for
      aortocoronary bypass surgery in women versus those in men. BACKGROUND: Plaque
      composition has been described in various manifestations of fatal coronary artery
      disease and after the bypass operation, but no reports have investigated this
      composition according to gender. METHODS: A total of 979 5-mm segments of native
      coronary arteries and 842 5-mm segments of saphenous vein grafts were examined by
      computerized planimetric technique in 11 women and 11 men who were matched for
      survival time after the bypass operation. RESULTS: Comparison of the plaque
      components revealed that atherosclerotic plaques in women, compared with those in
      men, contained significantly more cellular fibrous tissue, both in native
      coronary arteries (mean 38% vs. 4%, p < 0.001) and in saphenous vein grafts (mean
      70% vs. 36%, p < 0.05). In contrast, the proportion of dense fibrous tissue was
      significantly less in the atherosclerotic plaques of women than in those of men,
      both in native coronary arteries (mean 50% vs. 85%, p < 0.001) and in saphenous
      vein grafts (mean 25% vs. 57%, p < 0.05). CONCLUSIONS: Cellular fibrous tissue is
      often found at an early stage of plaque development, whereas dense fibrous tissue
      is a major component in later stages. Thus, the plaque composition of the native
      coronary arteries and saphenous venous conduits differed in men and women, with
      the plaques of the women appearing younger than those of the men.

PMID- 8473636
TI  - Sequential teboroxime imaging during and after balloon occlusion of a coronary
      artery.
AB  - OBJECTIVES: We sought to assess whether sequential teboroxime imaging can rapidly
      evaluate vessel patency and identify the coronary artery occluded in patients
      undergoing balloon occlusion of a coronary artery. BACKGROUND: Intravenous
      thrombolytic therapy results in successful reperfusion of the infarct-related
      artery in only 50% to 80% of cases. A noninvasive technique to serially evaluate
      coronary perfusion would identify patients who might benefit from other
      interventions such as emergency percutaneous transluminal coronary angioplasty,
      coronary artery bypass grafting or increased intensity of thrombolytic therapy.
      METHODS: Teboroxime scans were performed during balloon occlusion in 15
      nonconsecutive patients undergoing angioplasty of a major coronary artery.
      Equivalent views were repeated after successful angioplasty. RESULTS: The mean
      time between balloon occlusion and reperfusion imaging was 1.6 +/- 0.6 h. The
      mean number of defects decreased significantly from 4.13 +/- 1.01 during balloon
      occlusion to 0.27 +/- 0.44 after reperfusion (p = 0.0006). There was a 30%
      decrease in the defect/normal zone count/pixel ratios during balloon occlusion
      and normalization of these ratios after reperfusion (p = 0.0006). The scans
      correctly identified all nine left anterior descending coronary artery occlusions
      and both right coronary artery occlusions. One of the four left circumflex
      coronary artery occlusions was incorrectly identified as a right coronary artery
      occlusion by scan criteria. Overall, the scans correctly identified the occluded
      artery 93% of the time (kappa = 0.88). The scan was 100% accurate for
      distinguishing occlusion of the left anterior descending coronary artery (n = 9)
      from occlusions of the left circumflex or right coronary artery (n = 6).
      CONCLUSIONS: We believe that this is the first clinical study to demonstrate that
      sequential planar imaging with teboroxime can 1) rapidly detect acute coronary
      artery occlusion and reperfusion, and 2) identify the occluded coronary artery. A
      trial comparing rapid sequential teboroxime imaging with coronary angiography in
      patients receiving thrombolytic therapy for acute myocardial infarction is
      warranted.

PMID- 8473637
TI  - The proper tool for the job.

PMID- 8473638
TI  - Adenosine thallium-201 is superior to exercise thallium-201 for detecting
      coronary artery disease in patients with left bundle branch block.
AB  - OBJECTIVES: We sought to assess the comparative diagnostic accuracy of adenosine
      versus exercise in conjunction with thallium-201 scintigraphy for the detection
      and localization of coronary artery disease in patients with left bundle branch
      block on the rest electrocardiogram (ECG). BACKGROUND: Patients with left bundle
      branch block on the rest ECG frequently have artifactual reversible septal
      perfusion defects on exercise thallium-201 scintigraphy. Adenosine thallium
      scintigraphy is a theoretically attractive alternative in these patients.
      METHODS: One hundred seventy-three consecutive patients with left bundle branch
      block were evaluated with either exercise thallium (n = 56) or adenosine thallium
      (n = 117) scintigraphy. The tomographic thallium images were interpreted visually
      with adjunctive quantitative analysis. Follow-up cardiac catheterization was
      performed in 31 of the 56 patients in the exercise thallium group and 42 of the
      117 patients in the adenosine thallium group. RESULTS: Minor subjective side
      effects were noted in most patients in the adenosine thallium group (86%);
      atrioventricular block occurred in seven patients (6%). The overall predictive
      accuracy was 93% in the adenosine thallium group and 68% in the exercise thallium
      group (p = 0.01). The combined specificity for the detection of disease in the
      coronary arteries subtending the septum (the left anterior descending and right
      coronary arteries) was only 42% with exercise thallium scintigraphy versus 82%
      with adenosine thallium scintigraphy (p < 0.0002). CONCLUSIONS: Adenosine
      thallium imaging 1) was superior to exercise thallium imaging in the detection of
      coronary artery disease in patients with left bundle branch block; 2) obviated
      septal artifacts, thereby markedly improving the specificity in the left anterior
      descending and right coronary arteries; and 3) was safe in patients with left
      bundle branch block.

PMID- 8473639
TI  - Progression of coronary artery disease is dependent on anatomic location and
      diameter. The INTACT investigators.
AB  - OBJECTIVES: This study represents the first prospective, quantitative analysis of
      the association of progression of coronary atherosclerosis with anatomic site and
      diameter. BACKGROUND: The progressive course of coronary artery disease has been
      documented in many angiographic follow-up trials. METHODS: The data of 348
      patients with coronary artery disease from the International Nifedipine Trial on
      Antiatherosclerotic Therapy (INTACT) were reviewed. Standardized coronary
      angiograms were taken 3 years apart and were analyzed quantitatively. The
      coronary tree was subdivided into 25 segments. The progression of 1,063
      preexisting coronary stenoses and the appearance of 247 newly formed stenoses was
      assessed in relation to the mean diameter of segments (< 2 mm, 2 to 3 mm, > 3 mm)
      and to their position in the coronary tree (proximal, mid, distal) and in the
      three major coronary arteries. RESULTS: Decreases in the minimal diameter of
      preexisting stenoses were largest in segments that were > 3 mm in diameter (mean
      +/- SD 0.23 +/- 0.5 mm vs. 0.10 +/- 0.4 mm and 0.02 +/- 0.3 mm, p < 0.001), in a
      proximal position (0.14 +/- 0.5 mm vs. 0.09 +/- 0.4 mm and 0.06 +/- 0.3 mm, p =
      0.081) and in the right coronary artery (0.14 +/- 0.4 mm vs. 0.07 +/- 0.4 mm and
      0.07 +/- 0.3 mm, p < 0.01). Changes in percent diameter stenosis of preexisting
      stenoses were lowest in segments that were < 2 mm in diameter and in a distal
      position (p = NS). The number of new stenoses/segment was lowest in segments that
      were < 2 mm in diameter (44 of 1,756 vs. 139 of 1,967 and 64 of 1,125, p < 0.001)
      and in a distal position (77 of 2,370 vs. 84 of 1,193 and 86 of 1,285, p < 0.001)
      and was highest in segments of the right coronary artery (100 of 1,546 vs. 66 of
      1,496 and 72 of 1,492, p = 0.044). CONCLUSIONS: Progression of coronary artery
      disease occurs most frequently in coronary segments that are > 2 mm in diameter,
      in a proximal or midartery position and in the right coronary artery.

PMID- 8473640
TI  - Angina and persistent exercise thallium defects: independent risk factors in
      elective vascular surgery.
AB  - OBJECTIVES: In this study, we assessed the utility of exercise thallium-201
      scintigraphy and other clinical factors in predicting perioperative cardiac
      complications in patients undergoing elective vascular surgery. BACKGROUND: The
      risk of cardiac complications among such patients is very high. METHODS: The
      study group comprised 116 men (mean age 67 years). Fifty patients (43%) had a
      history of coronary artery disease, including angina pectoris in 26 (22%),
      myocardial infarction in 32 (28%) and coronary artery bypass surgery in 19 (16%).
      RESULTS: There were a total of 22 perioperative myocardial infarctions (18.9%),
      including 2 cardiac deaths (1.7%). A significantly greater proportion (p < 0.05)
      of patients with than without perioperative complications had a history of
      coronary artery disease (77% vs. 35%), angina (59% vs. 14%), prior myocardial
      infarction (50% vs. 22%), abnormal electrocardiogram (68% vs. 40%) and abnormal
      exercise thallium test (75% vs. 47%). The patient group with complications also
      had a significantly lower mean rest ejection fraction (45 +/- 3% vs. 55 +/- 2%, p
      < 0.005). Independent predictors of complication, as determined by straight
      logistic regression, were angina and fixed thallium defects after exercise.
      CONCLUSIONS: Our data indicate that angina and the presence of fixed thallium
      defects after exercise are independent predictors of cardiac risk in patients
      undergoing elective vascular surgery. These findings are compatible with other
      studies showing that nonredistribution on standard 3- to 4-h delayed studies
      cannot exclude viable myocardium at risk.

PMID- 8473641
TI  - Assessment of perioperative risk: have we put the cart before the horse.

PMID- 8473642
TI  - Isovolumetric relaxation flow in patients with ischemic heart disease.
AB  - OBJECTIVES: The purpose of this study was to clarify the characteristics of flow
      during the isovolumetric relaxation period and to analyze the relation between
      these flow patterns and standard hemodynamic indexes. BACKGROUND: Outward motion
      of the left ventricle during the isovolumetric relaxation period has been
      observed by cineangiography. However, there is little information about blood
      flow during this period. METHODS: Seventy-nine patients with ischemic heart
      disease were examined by pulsed Doppler echocardiography and cardiac
      catheterization. All patients were classified into three groups according to the
      observed patterns of isovolumetric relaxation flow: group I (n = 41), flow
      directed toward the apex; group II (n = 21), flow directed toward the base, and
      group III (n = 17), low velocity flow (< 12 cm/s) without a dominant direction.
      Patients in group I were further classified into group Ia (n = 19) with normal
      ventriculograms and group Ib (n = 22) with asynergy. RESULTS: Left ventricular
      ejection fraction and negative first derivative of left ventricular pressure were
      significantly lower in group II (49 +/- 9% and 1,274 +/- 212 mm Hg/s,
      respectively) and group III (38 +/- 8% and 1,147 +/- 280 mm Hg/s, respectively)
      than in group Ia (68 +/- 7% and 1,727 +/- 358 mm Hg/s), each p < 0.01. Time
      constant was significantly prolonged in group II (49 +/- 6 ms) and group III (48
      +/- 6 ms) compared with that in group Ia (41 +/- 6 ms), p < 0.05. On left
      ventriculography, patterns of outward wall motion during the isovolumetric
      relaxation period were associated with the patterns of isovolumetric relaxation
      flow. CONCLUSIONS: Changes in left ventricular relaxation are accompanied by
      alterations in isovolumetric relaxation flow. It is therefore useful to evaluate
      isovolumetric relaxation flow when investigating early diastolic ventricular
      function.

PMID- 8473643
TI  - Percutaneous transluminal coronary angioplasty in chronic coronary artery
      occlusion.
AB  - OBJECTIVES: This study was conducted to determine the procedural success rate,
      complication rate and long-term outcome of percutaneous transluminal coronary
      angioplasty in chronically occluded coronary arteries. BACKGROUND: Coronary
      angioplasty of chronically occluded vessels has a lower success rate than has
      angioplasty of nonoccluded vessels, but it is frequently considered safe because
      the target vessel is already occluded. The purpose of this study was to determine
      the reliability of these assumptions at our institution, with the objectives
      stated above. METHODS: We identified from the angioplasty data base at our
      institution 100 consecutive coronary angioplasty procedures performed between
      1987 and 1991 for chronic total occlusion, defined as complete occlusion
      (Thrombolysis in Myocardial Infarction [TIMI] grades 0 and 1 flow) for > or = 3
      months. The records of the 95 patients who underwent these procedures were
      reviewed to determine procedural outcome and medium-term results. RESULTS:
      Procedural success was obtained in 47 occluded vessels (47%). Significantly fewer
      successes were obtained in the right coronary artery (26.8%) than in either the
      left anterior descending (57.1%) or the left circumflex (45%) coronary artery (p
      < 0.05). A procedural failure without serious adverse consequences occurred in 45
      procedures (45%), but in eight patients (right coronary artery in five, left
      anterior descending artery in three) attempted recanalization was complicated by
      extensive coronary dissection with acute myocardial ischemia, and one of these
      patients died. There were no emergency operations, but elective coronary artery
      bypass surgery was undertaken in 26 patients (in 3 after extensive dissection, in
      7 after an apparently good result and in 16 in whom the procedure failed). At 12
      months after the procedure, 64.1% of those with a procedural success were event
      free compared with 32.6% of those whose procedure was both unsuccessful and
      uncomplicated (p < 0.025) and 25% of those in whom it was unsuccessful and
      complicated by coronary dissection (p < 0.025). CONCLUSIONS: In this series of
      recanalization of chronically occluded coronary arteries, there was a low
      procedural success rate, particularly for the right coronary artery. However,
      when procedural success was obtained, the long-term outlook was good. The overall
      risk of coronary dissection was comparable to the risk in nonoccluded vessels but
      was particularly high in the right coronary artery (13%).

PMID- 8473644
TI  - Aspirin, but not heparin, suppresses the transient increase in thromboxane
      biosynthesis associated with cardiac catheterization or coronary angioplasty.
AB  - OBJECTIVES: We sought to study the dose dependence of in vivo suppression by
      aspirin of enhanced thromboxane biosynthesis in the setting of coronary
      angioplasty and to evaluate the effects of heparin and aspirin during cardiac
      catheterization. BACKGROUND: Percutaneous transluminal coronary angioplasty
      induces a controlled injury of the intima of the diseased arterial segment, with
      rapid deposition of platelets at the site of dilation. Thus, it provides a
      clinical model of intracoronary platelet activation. METHODS: The urinary
      excretion of a major enzymatic metabolite of thromboxane A2, 11-dehydro
      thromboxane B2, was measured in 57 patients with stable coronary artery disease
      undergoing cardiac catheterization (n = 28) or elective single-vessel
      percutaneous transluminal coronary angioplasty (n = 29). Three consecutive urine
      collections were obtained from all patients before during and after either
      procedure. Patients undergoing catheterization were treated with the following
      regimens: a) no aspirin for > or = 10 days and no heparin (n = 12); b) no aspirin
      for > or = 10 days but heparin, 10,000 IU, at the time of catheterization (n =
      5); c) aspirin, 300 mg/day, for at least 5 days (n = 11). Patients undergoing
      coronary angioplasty were randomly assigned to short-term treatment with aspirin
      given as a) 75 mg/day for > or = 5 days before angioplasty (n = 11); b) 300
      mg/day for > or = 3 days before angioplasty (n = 9); or c) 300 mg/day for > or =
      3 days before angioplasty followed by 1,000 mg during angioplasty (n = 9).
      RESULTS: In patients undergoing catheterization, urinary 11-dehydro-thromboxane
      B2 excretion (pg/mg creatinine) increased from 563 +/- 481 (mean +/- SD) to 1,684
      +/- 1,332 in the absence and from 620 +/- 191 to 1,588 +/- 597 in the presence of
      heparin. No increase was observed in the group receiving aspirin (from 240 +/-
      141 to 215 +/- 115). In patients undergoing coronary angioplasty treated with
      aspirin, 75 mg/day, urinary 11-dehydro-thromboxane B2 averaged 180 +/- 112, 223
      +/- 178 and 294 +/- 260, respectively, before, during and after the procedure. At
      300 mg/day, the corresponding values were 185 +/- 48, 217 +/- 70 and 197 +/- 93.
      In patients also receiving aspirin, 1,000 mg, during angioplasty, 11-dehydro
      thromboxane B2 averaged 151 +/- 66, 138 +/- 43 and 133 +/- 77, respectively.
      CONCLUSIONS: Enhanced thromboxane biosynthesis associated with cardiac
      catheterization or coronary angioplasty can be largely suppressed by low dose
      aspirin. This finding is consistent with the view that this alteration reflects
      platelet activation.

PMID- 8473645
TI  - Restenosis after directional coronary atherectomy and balloon angioplasty:
      comparative analysis based on matched lesions.
AB  - OBJECTIVES: Late lumen narrowing after directional coronary atherectomy was
      assessed by quantitative coronary angiography and compared with that after
      balloon angioplasty. BACKGROUND: Directional coronary atherectomy has been
      introduced as an alternative technique for balloon angioplasty and may reduce the
      incidence of restenosis. METHODS: A prospectively collected consecutive series of
      87 native coronary artery lesions successfully treated with atherectomy were
      matched with 87 coronary artery lesions selected from a consecutive series of
      lesions that had been successfully dilated by balloon angioplasty. Late
      angiographic analysis was performed in 158 lesions. The net gain index represents
      the ultimate gain in minimal lumen diameter at follow-up study, normalized for
      the vessel size. This index is the result of the relative gain attained during
      the procedure (the ratio of the change in minimal lumen diameter and reference
      diameter) and the relative loss observed during the follow-up period (the ratio
      of the change in minimal lumen diameter during the follow-up period and the
      reference diameter). RESULTS: Matching for clinical and angiographic variables
      resulted in two comparable groups with similar baseline stenosis characteristics.
      Atherectomy resulted in a more pronounced increase in minimal lumen diameter than
      did balloon angioplasty (mean +/- SD 1.17 +/- 0.29 to 2.44 +/- 0.42 mm vs. 1.21
      +/- 0.38 to 2.00 +/- 0.36 mm, p < 0.001). However, this favorable immediate
      result was subsequently lost during late angiographic follow-up, so that the
      minimal lumen diameter at follow-up and the net gain index did not differ
      significantly between the two groups (1.76 +/- 0.62 vs. 1.77 +/- 0.59 mm, p =
      0.93, and 0.18 +/- 0.19 vs. 0.17 +/- 0.17, p = 0.70). Consequently, the relative
      gain and relative loss were higher in the atherectomy group. For both techniques,
      the relative gain was linearly related to the relative loss but the slope of the
      regression line was steeper for atherectomy, suggesting that the relative loss in
      the atherectomy group is proportionally even larger for a given relative gain
      compared with that in the angioplasty group. CONCLUSIONS: In matched groups of
      patients, atherectomy induces a greater initial gain in minimal lumen diameter
      than does balloon angioplasty. However, the vascular wall injury induced by the
      device is of a different nature (debulking vs. dilating) that leads to more
      relative loss over the follow-up period in the atherectomy group.

PMID- 8473646
TI  - Impact of early perfusion status of the infarct-related artery on short-term
      mortality after thrombolysis for acute myocardial infarction: retrospective
      analysis of four German multicenter studies.
AB  - OBJECTIVE: This study evaluated the impact of early patency of the infarct
      related vessel on short-term mortality after thrombolysis for acute myocardial
      infarction. BACKGROUND: Different thrombolytic regimens for acute myocardial
      infarction proved to be equally effective in large scale mortality trials despite
      significant differences in their efficacy with respect to early infarct-related
      vessel patency as shown in smaller angiographic trials. METHODS: Patients from
      four German multicenter studies of thrombolysis in acute myocardial infarction
      were retrospectively evaluated. Of 939 patients with acute myocardial infarction
      (duration of symptoms < 6 h) treated with thrombolysis, 907 (96.6%) had an
      angiogram of the infarct-related artery 90 min after the initiation of
      thrombolytic therapy. The perfusion status was graded according to the
      Thrombolysis in Myocardial Infarction (TIMI) study criteria. RESULTS: Complete
      reperfusion (TIMI grade 3) was found in 561 of 907 patients and partial
      reperfusion (TIMI grade 2) in 122 of 907. Overall, the in-hospital mortality rate
      was 4.6% (43 patients). In patients with complete reperfusion of the infarct
      related vessel, the mortality rate was only 2.7% versus 7.1% in patients with an
      occluded vessel at the 90-min angiogram. This difference was highly significant
      in univariate as well as in multivariate analysis. In patients with partial
      perfusion of the infarct vessel, the mortality rate was 6.6%. CONCLUSIONS: The
      early perfusion status of the infarct-related artery is an independent predictor
      of short-term survival. However, only complete early reperfusion is associated
      with a reduced in-hospital mortality rate whereas patients with partial perfusion
      (TIMI grade 2) have a short-term prognosis similar to that of patients with
      persistently occluded infarct vessels. Therefore, when used as a surrogate end
      point for mortality, only TIMI grade 3 perfusion of the infarct vessel should be
      interpreted as a treatment success of thrombolysis in acute myocardial
      infarction.

PMID- 8473647
TI  - Trickle down thrombolysis.

PMID- 8473648
TI  - Genesis of the Austin Flint murmur: relation to mitral inflow and aortic
      regurgitant flow dynamics.
AB  - OBJECTIVES: This study was designed to elucidate the genesis of the Austin Flint
      murmur. BACKGROUND: The Austin Flint murmur is an apical diastolic rumble
      associated with significant aortic regurgitation. The precise mechanism of the
      murmur remains unclear. METHODS: The relation between the Austin Flint murmur and
      mitral inflow and aortic regurgitant flow dynamics was evaluated nonivasively in
      13 patients with moderate to severe aortic regurgitation and 15 control subjects
      using phonocardiographic and pulsed and color-coded Doppler echocardiographic
      techniques. The severity of aortic regurgitation was determined by color-coded
      Doppler echocardiography on the basis of the maximal distance of the regurgitant
      signal. RESULTS: The direction of aortic regurgitant flow was unrelated to the
      presence of the Austin Flint murmur. The severity of aortic regurgitation was
      greater in patients with than in those without this murmur. The peak mitral
      inflow velocity during early diastole (E) was significantly increased, and both
      peak mitral inflow velocity at atrial contraction (A) and the A/E ratio were
      significantly decreased in patients with the Austin Flint murmur compared with
      values in those without this murmur or in control subjects. However, the maximal
      amplitude of the Austin Flint murmur did not coincide temporally with the peak
      mitral inflow velocity. The murmur continued both after rapid mitral inflow had
      ended and during diastolic mitral regurgitation. CONCLUSIONS: The increased
      velocity of early diastolic mitral inflow in patients with the Austin Flint
      murmur is due to aortic regurgitation, but rapid mitral inflow is not an
      essential requirement for production of the murmur. In some cases, the Austin
      Flint murmur may be generated by aortic regurgitant flow alone.

PMID- 8473649
TI  - Ventricular fibrillation in patients without significant structural heart
      disease: a multicenter experience with implantable cardioverter-defibrillator
      therapy.
AB  - OBJECTIVES: This study was undertaken to characterize the outcome of survivors of
      ventricular fibrillation with no or minimal structural heart disease who received
      an implantable cardioverter-defibrillator. BACKGROUND: The prognosis among
      survivors of ventricular fibrillation with minimal or no structural cardiac
      abnormalities remains unclear. Since the advent of implantable cardioverter
      defibrillators, this question takes on added importance. METHODS: This 10-center
      retrospective study provided information on 28 survivors of ventricular
      fibrillation (mean age 42 years) with minimal or no structural abnormalities who
      were treated with an implantable cardioverter-defibrillator. RESULTS: Ventricular
      tachyarrhythmias (polymorphic in all but one patient) were induced during
      baseline programmed stimulation in 39% of patients. During a median 30.6-month
      follow-up period after implantable cardioverter-defibrillator implantation, there
      were no cardiac deaths and two noncardiac deaths. Sixteen patients experienced 36
      shock episodes (total 88 shocks). The majority of shocks were classified as
      "indeterminate"; one patient received 47 "spurious" shocks during one shock
      episode and each of four patients received one "appropriate" shock. Ventricular
      arrhythmias were not inducible in any of these latter four patients. CONCLUSIONS:
      Survivors of ventricular fibrillation with minimal or no structural cardiac
      abnormalities receiving an implantable cardioverter-defibrillator have an
      excellent 3-year survival rate. The occurrence, albeit infrequent, of appropriate
      implantable cardioverter-defibrillator shocks in this group suggests that these
      patients have a potential risk of recurrent cardiac arrest whose fatal outcome
      may be avoided by implantable cardioverter-defibrillator therapy.

PMID- 8473650
TI  - Randomized controlled comparison of antitachycardia pacing algorithms for
      termination of ventricular tachycardia.
AB  - OBJECTIVES: This study compared the efficacy and safety of two antitachycardia
      pacing algorithms in the treatment of ventricular tachycardia. BACKGROUND: There
      is agreement that antitachycardia pacing should be adapted to tachycardia rate
      and be delivered in a burst, but the ideal pacing pattern is not well understood.
      Effective antitachycardia pacing burst patterns include those with a between
      burst decrement (SCAN) with or without an additional within-burst decrement
      (RAMP). METHODS: Prospective randomized crossover comparison of two
      antitachycardia pacing algorithms (RAMP vs. SCAN) on identical induced sustained
      ventricular tachycardias was performed. RESULTS: Sixty-five ventricular
      tachycardias (mean cycle length 364 +/- 74 ms) from 37 invasive studies performed
      in 29 patients were studied; 86% of patients had coronary artery disease and 72%
      were receiving antiarrhythmic therapy at the time of study. Of the 65
      tachycardias, 40 were identical pairs and 25 were unpaired (including 8 with a >
      30-ms difference in cycle length of induced ventricular tachycardia pairs). In
      the paired pacing trials, conversion to sinus rhythm occurred, respectively, in
      85% of SCAN versus 90% of RAMP protocols (p = 0.63, power = 93%) and within 1.4
      +/- 0.7 versus 1.7 +/- 1.1 attempts (p = 0.41). Discordance for pacing success
      was seen in three pairs. In unpaired trials, conversion to sinus rhythm occurred
      in 73% and 57%, respectively (p = 0.68, power = 88%). Tachycardia acceleration
      during pacing occurred in 7 (11%) of 65 attempts (5 SCAN, 2 RAMP). Acceleration
      in unpaired ventricular tachycardia trials was correlated with tachycardia cycle
      length. Failure to convert ventricular tachycardia was associated with a shorter
      tachycardia cycle length (p < 0.05). CONCLUSIONS: In the patients studied,
      adaptive antitachycardia pacing was safe and effective and, when successful,
      occurred within three attempts of an 8-beat adaptive burst algorithm. Changes in
      burst pattern did not affect pacing safety or efficacy. Antitachycardia pacing
      success was dependent on induced ventricular tachycardia cycle length.

PMID- 8473651
TI  - Value of signal-averaged electrocardiography, radionuclide ventriculography,
      Holter monitoring and clinical variables for prediction of arrhythmic events in
      survivors of acute myocardial infarction in the thrombolytic era.
AB  - OBJECTIVES: This study assessed the ability of signal-averaged
      electrocardiography, radionuclide ventriculography and Holter
      electrocardiographic (ECG) monitoring and clinical variables to identify patients
      at risk of serious arrhythmic events after myocardial infarction in the
      thrombolytic era. BACKGROUND: Most studies of signal-averaged
      electrocardiography, radionuclide ventriculography and Holter ECG monitoring in
      risk stratification after myocardial infarction preceded the introduction of
      thrombolytic therapy. METHODS: A consecutive series of 301 survivors of
      myocardial infarction, 205 (68%) of whom received thrombolytic agents, underwent
      signal-averaged electrocardiography (1st 48 h, day 6 and discharge), Holter ECG
      monitoring (days 6 to 7) and radionuclide left ventriculography (days 7 to 14).
      Median follow-up time was 1.03 years. RESULTS: Thirteen patients (4.3%) had an
      arrhythmic event (sudden death in 11, sustained ventricular tachyarrhythmia in
      2). The 25-Hz high pass filtered signal-averaged ECG at discharge was 64%
      sensitive (95% confidence intervals [CI] 36% to 92%) and 81% specific (95% CI 76%
      to 86%). High grade ventricular ectopic activity on the Holter ECG was only 38%
      sensitive (95% CI 12% to 64%) and 74% specific (95% CI 71% to 77%). Left
      ventricular ejection fraction < 0.4 was the best test for prediction of
      arrhythmic events (sensitivity 75% [95% CI 50% to 100%] and specificity 81% [95%
      CI 76% to 85%]). In multivariate analysis, in rank order, digoxin therapy at
      discharge, an abnormal 25-Hz signal-averaged ECG before discharge, absence of
      angina before index infarction and previous infarction were predictive of
      arrhythmic events. With digoxin therapy excluded, ejection fraction was an
      independent predictor. Discriminant analysis identified a high risk group (12% of
      the study patients) with an event rate of 26%. CONCLUSIONS: The signal-averaged
      ECG and left ventricular ejection fraction are each independently predictive of
      arrhythmic events after myocardial infarction, but the Holter ECG is not. A
      combination of clinical and investigative variables, including the signal
      averaged ECG, best identifies patients at highest risk.

PMID- 8473652
TI  - Effects of procainamide on the signal-averaged electrocardiogram in relation to
      the results of programmed ventricular stimulation in patients with sustained
      monomorphic ventricular tachycardia.
AB  - OBJECTIVES: The aim of this study was to assess the ability of the signal
      averaged electrocardiogram (ECG) to predict the efficacy of procainamide.
      BACKGROUND: The main role of the signal-averaged ECG has been the identification
      of postinfarction patients at risk of sudden death. Prediction of the efficacy of
      antiarrhythmic drugs represents another potential clinical application of this
      technique. METHODS: The study examined the effects of procainamide on the time
      domain and spectral temporal analysis of the signal-averaged ECG in relation to
      the results of programmed ventricular stimulation studies in 31 patients with
      inducible sustained monomorphic ventricular tachycardia. RESULTS: Procainamide
      significantly prolonged the total and the initial QRS complex and low amplitude
      signal durations (mean +/- SD 135 +/- 30 vs. 161 +/- 46 ms, p < 0.0001; 87 +/- 16
      vs. 98 +/- 20 ms, p < 0.0001, and 48 +/- 23 vs. 63 +/- 36 ms, p < 0.001,
      respectively) whereas the root-mean-square voltage of the total QRS complex and
      of the last 40 ms of the QRS complex was significantly reduced (mean +/- SD 112
      +/- 36 vs. 87 +/- 36 microV, p < 0.0001; 21 +/- 19 vs. 13 +/- 12 microV, p <
      0.002, respectively). The results of spectral temporal mapping of the signal
      averaged ECG were similar before and after procainamide administration.
      Procainamide prevented the inducibility of sustained ventricular tachycardia or
      prolonged the cycle length of ventricular tachycardia by > or = 100 ms in 16
      patients (52%) (responders). The fractional prolongation of the total QRS
      duration was significantly greater in responders (26 +/- 15%) than in
      nonresponders (10 +/- 10%) (p < 0.002) and, when this prolongation was > or =
      15%, identified responders with a sensitivity of 94%, a specificity of 87% and an
      overall predictive accuracy of 90%. CONCLUSIONS: The effects of procainamide on
      inducibility of ventricular tachycardia during programmed ventricular stimulation
      can be predicted by the degree of drug-induced prolongation of the signal
      averaged QRS complex.

PMID- 8473653
TI  - Effect on coronary artery anatomy of radiofrequency catheter ablation of atrial
      insertion sites of accessory pathways.
AB  - OBJECTIVES: The purpose of this study was to analyze the effects of
      radiofrequency catheter ablation of the atrial insertion site of accessory
      pathways on the angiographic appearance of coronary arteries. BACKGROUND:
      Radiofrequency catheter ablation of accessory pathways requires the application
      of energy to the endocardial surface of the atrioventricular groove adjacent to
      the major epicardial coronary arteries. A systematic analysis of the effect of
      radiofrequency ablation on coronary arteries has not previously been
      demonstrated. METHODS: Seventy consecutive patients with 76 accessory pathways (7
      right free wall, 44 left free wall, 12 posteroseptal, 8 anteroseptal and 5
      midseptal) were studied. Quantitative coronary angiography was performed before,
      immediately after and a mean of 69 +/- 42 days after radiofrequency catheter
      ablation. RESULTS: Coronary artery diameter adjacent to the ablating electrode
      was 2.6 +/- 0.9 mm before ablation, 2.7 +/- 0.9 mm immediately after ablation and
      2.7 +/- 1.0 mm at the time of follow-up study. Angiographic findings were
      unchanged from baseline in 69 of 70 patients immediately after ablation and in
      all 70 patients at the time of follow-up study. CONCLUSIONS: Radiofrequency
      catheter ablation of the atrial insertion site of accessory pathways does not
      result in short-term angiographic changes in coronary artery anatomy.

PMID- 8473654
TI  - Effect of therapy with an angiotensin-converting enzyme inhibitor on hemodynamic
      and counterregulatory responses during continuous therapy with nitroglycerin.
AB  - OBJECTIVES: We sought to characterize the reflex counterregulatory responses
      throughout a 6-day period of continuous nitroglycerin therapy and to examine the
      effect of concurrent administration of a non-thiol angiotensin-converting enzyme
      inhibitor (benazepril) on the nature of those responses. BACKGROUND: Therapy with
      nitroglycerin has been shown to be associated with reflex counterregulatory
      responses. METHODS: Standing systolic blood pressure, hormonal responses, urinary
      sodium and hematocrit levels were monitored during 6 days of continuous
      transdermal nitroglycerin therapy in normal volunteers. Using a double-blind
      randomized parallel design, 11 subjects received placebo and 9 received
      benazepril. Hemodynamic responses to sublingual nitroglycerin administration were
      evaluated before and after sustained therapy with transdermal nitroglycerin.
      RESULTS: Attenuation of the hypotensive response to transdermal nitroglycerin was
      rapid in the group receiving placebo and the group receiving benazepril. There
      were no significant hormonal responses to transdermal nitroglycerin in either
      group, and sodium retention was modest and transient. Hematocrit levels decreased
      after transdermal nitroglycerin therapy and remained depressed for the duration
      of nitroglycerin therapy, a finding that suggests plasma volume expansion. Blood
      pressure responses to sublingual nitroglycerin in both groups were similar before
      and after continuous transdermal nitroglycerin therapy. CONCLUSIONS: These data
      suggest that plasma volume expansion plays a more important role than
      neurohormonal responses in the loss of nitrate effects during sustained therapy.
      That therapy with an angiotensin-converting enzyme inhibitor did not modify the
      hemodynamic responses to continuous nitroglycerin therapy supports this
      conclusion. Further investigation will be necessary to confirm whether therapy
      with an angiotensin-converting enzyme inhibitor has any role in the prevention of
      nitrate tolerance.

PMID- 8473655
TI  - Left ventricular diastolic dysfunction late after coarctation repair in
      childhood: influence of left ventricular hypertrophy.
AB  - OBJECTIVES: Left ventricular systolic and diastolic function were evaluated late
      after successful operation for aortic coarctation in childhood. BACKGROUND:
      Persistent arterial hypertension and left ventricular hypertrophy after
      coarctation repair might impair left ventricular function. METHODS: Biplane
      angiography and simultaneous high fidelity pressure measurements were performed
      in 12 patients 3 to 12 years postoperatively (residual pressure gradient 4 mm
      Hg). Eight patients were normotensive and four had borderline hypertension. Data
      at rest and after nitroprusside infusion (1.7 micrograms/kg per min) were
      evaluated and compared with data from 12 control subjects. RESULTS: Systolic left
      ventricular function (ejection fraction-end-systolic wall stress relation) was
      normal in all patients. However, left ventricular muscle mass (113 vs. 86 g/m2),
      right atrial pressure (5.2 vs. 1.9 mm Hg) and left ventricular end-diastolic
      pressure (16 vs. 11 mm Hg) were significantly higher in patients than in control
      subjects. There was a linear relation between muscle mass and left ventricular
      end-diastolic (r = 0.66, p < 0.001) or right atrial (r = 0.60, p < 0.01)
      pressure. Left ventricular relaxation and myocardial stiffness were normal.
      However, there was an upward shift of the diastolic pressure-volume curve when
      compared with control values, but this shift was reversed by the administration
      of nitroprusside. CONCLUSIONS: Systolic function is normal late after coarctation
      repair. However, diastolic function can be abnormal with an upward shift of the
      diastolic pressure-volume curve that is reversed by nitroprusside administration
      and is probably due to residual left ventricular hypertrophy.

PMID- 8473656
TI  - Selective pulmonary and systemic vasodilator effects of amrinone in children: new
      therapeutic implications.
AB  - OBJECTIVES: The present study was performed to determine the systemic and
      pulmonary hemodynamic effects of amrinone in infants and children with a cardiac
      left to right shunt to determine if there is a beneficial effect on the
      pathophysiology of this condition. BACKGROUND: Amrinone is a bipyridine
      derivative with inotropic and vasodilator effects that have not been
      systematically evaluated in the pediatric patient with increased pulmonary blood
      flow. METHODS: Nineteen patients (aged 2 months to 8.3 years) with one or more
      left to right shunts were evaluated during cardiac catheterization with direct
      hemodynamic measurements made before and 10 min (peak effect) after
      administration of a bolus injection of amrinone, 3 mg/kg body weight. The Fick
      method was used to calculate pulmonary and systemic blood flow, and resistances
      were then calculated. RESULTS: In group A, five patients with normal pulmonary
      artery pressure and resistance, amrinone significantly reduced mean pulmonary
      artery pressure by 19%, mean left atrial pressure by 39% and systemic vascular
      resistance by 17%. In group B, seven patients with pulmonary artery hypertension
      (mean pulmonary artery pressure > 20 mm Hg) and normal pulmonary vascular
      resistance (total pulmonary resistance < or = 3 Wood U.m2), amrinone
      significantly reduced the pulmonary artery pressure by 27%, systolic aortic
      pressure by 5%, mean aortic pressure by 12%, pulmonary arteriolar resistance by
      36% and total pulmonary vascular resistance by 26%. In group C, seven patients
      with pulmonary artery hypertension (mean pulmonary artery pressure > 20 mm Hg)
      and elevated pulmonary vascular resistance (total pulmonary resistance > 3 Wood
      U.m2), amrinone significantly reduced the pulmonary arteriolar resistance by 49%,
      total pulmonary resistance by 47% and pulmonary arteriolar/systemic vascular
      resistance ratio by 45% and increased the heart rate by 15%. CONCLUSIONS: In
      children with a cardiac left to right shunt, amrinone 1) appears to have
      selective vasodilator effects depending on the pulmonary artery pressure and
      resistance, 2) has a beneficial hemodynamic effect in children with normal
      pulmonary artery pressure and resistance, and 3) may have a role in the treatment
      of patients with pulmonary artery hypertension without causing systemic
      hypotension.

PMID- 8473657
TI  - Cardiac teratogenesis of halogenated hydrocarbon-contaminated drinking water.
AB  - OBJECTIVES: The purpose of this study was to test the hypothesis that
      administration of trichloroethylene and dichloroethylene to pregnant rats during
      organogenesis would produce a significant fetal cardiac teratogenic effect. It
      was also hypothesized that administration of these compounds only before
      pregnancy would not be associated with fetal cardiac teratogenesis. BACKGROUND:
      Epidemiologic observations demonstrated an increased number of congenital cardiac
      defects in children whose mother resided in an area with drinking water
      contaminated by trichloroethylene and dichloroethylene. A prior provocative
      intrauterine exposure study in rats established a positive link between these
      contaminants and an increased number of fetal hearts with congenital cardiac
      defects. METHODS: Sprague-Dawley rats were given pure tap drinking water (control
      subjects) or water contaminated with high or low dose of trichloroethylene or
      dichloroethylene (experimental groups) during prepregnancy only, prepregnancy and
      pregnancy or during pregnancy alone. RESULTS: A total of 2,045 fetuses were
      examined. Trichloroethylene or dichloroethylene delivered exclusively in the
      period before pregnancy caused no increase in congenital cardiac malformations
      over the control level. Compared with the control group, rats exposed to these
      agents both before and during pregnancy, had a significantly greater number of
      fetuses with cogenital cardiac malformations. Trichloroethylene (high dose only)
      administered only during pregnancy produced a significant increase in cardiac
      defects. Other fetal variables, including noncardiac congenital abnormalities,
      showed no significant difference between control and treated groups. CONCLUSIONS:
      Trichloroethylene and dichloroethylene administered during organogenesis are
      cardiac, but not general, teratogens. The data indicate that these agents
      administered in drinking water to pregnant rats caused an increased number of
      congenital cardiac defects in rat fetuses.

PMID- 8473658
TI  - Heart disease and the environment.

PMID- 8473659
TI  - Estimation of right ventricular mass in normal subjects and in patients with
      primary pulmonary hypertension by nuclear magnetic resonance imaging.
AB  - OBJECTIVES: This study was designed to test the accuracy of nuclear magnetic
      resonance (NMR) imaging as a noninvasive technique for estimating right
      ventricular mass in normal subjects and in patients with primary pulmonary
      hypertension. BACKGROUND: An accurate means of noninvasively estimating right
      ventricular mass may allow better characterization of the degree of right-sided
      pressure or volume overload caused by underlying cardiac or pulmonary diseases.
      METHODS: End-diastolic short-axis electrocardiogram (ECG)-gated spin echo NMR
      images of the heart were obtained in vivo in 13 patients with primary pulmonary
      hypertension and 10 normal adult volunteers. Both right and left ventricular mass
      were computed by summing the myocardial slice volumes over all slices spanning
      the myocardium and multiplying by myocardial density. This technique of
      myocardial mass determination was verified by imaging 10 calf hearts and
      comparing the NMR-determined right and left myocardial mass with the actual mass
      determined by weighing the right and left ventricles. RESULTS: In the calf heart
      study, an excellent correlation was obtained between the directly measured
      ventricular mass and the NMR-calculated mass, for both the right and the left
      ventricle. Patients with primary pulmonary hypertension had an elevated right
      ventricular mass index compared with that of normal subjects (62.69 +/- 8.72 g/m2
      vs. 23.32 +/- 1.36 g/m2, p < 0.0005). There was no significant difference in left
      ventricular mass index between the two groups. Both mean intraobserver and inter
      observer variability in myocardial mass determination were low. Linear regression
      analysis between right ventricular mass index and mean pulmonary artery pressure
      was significant (r = 0.75, p < 0.003). CONCLUSIONS: Electrocardiogram-gated spin
      echo NMR imaging of the heart may be used for quantitating right ventricular mass
      in normal subjects and in patients with primary pulmonary hypertension, in whom
      it may also provide an alternative noninvasive technique for estimating mean
      pulmonary artery pressure.

PMID- 8473660
TI  - Measurement accuracy of cardiac output in humans: indicator-dilution technique
      versus geometric analysis by ultrafast computed tomography.
AB  - OBJECTIVES: The aim of this study was to evaluate measurement accuracy of cardiac
      output in humans by comparing the indicator-dilution technique with geometric
      analysis by ultrafast computed tomography. BACKGROUND: Ultrafast computed
      tomography can be used to measure cardiac output by two methods. First, by
      scanning to obtain end-systolic and end-diastolic short-axis images of the
      ventricular cavities at sequential tomographic levels, the stroke volume and
      therefore the cardiac output can be calculated. Second, indicator-dilution theory
      (the Stewart-Hamilton equation) can be applied to measurements of the
      concentration of radiographic contrast in the blood pool after a bolus injection.
      The latter method has not been validated in humans. METHODS: The accuracy of the
      geometric method itself was first established by comparing left and right
      ventricular stroke volumes in 29 patients without valvular regurgitation or an
      intracardiac shunt, whose left and right ventricular stroke volumes should have
      been identical (group A). In a subset of 17 patients, the geometric method was
      compared with the indicator-dilution method (group B). RESULTS: Geometric
      analysis showed that the mean difference between left and right ventricular
      stroke volume was 1.8 +/- 7.3 ml, with a percentage SD of the differences of 9.3%
      (r = 0.9). Comparison wih indicator dilution-calculated cardiac output showed a
      mean difference of 0.079 +/- 1.22 liters/min, with a percent SD of the
      differences of 23.7% (r = 0.6). There was no improvement in this comparison with
      individual calibration of the scanner for each patient. CONCLUSIONS: The
      disparity found between data obtained with the geometric and indicator-dilution
      methods may be a result of the hemodynamic effects of contrast medium or it may
      suggest the possibility that some assumptions of indicator-dilution theory are
      not valid.

PMID- 8473661
TI  - Is the Watanabe heritable hyperlipidemic rabbit a suitable experimental model for
      percutaneous transluminal coronary angioplasty in humans? A light microscopic,
      immunohistochemical and ultrastructural study.
AB  - OBJECTIVES: This study was designed to assess an experimental model for the study
      of mechanisms that underlie restenosis after percutaneous transluminal coronary
      angioplasty. BACKGROUND: The Watanabe heritable hyperlipidemic (WHHL) rabbit
      lacks the receptor for low density lipoproteins, produces atherosclerotic lesions
      very similar to those in humans and, therefore, could serve as a suitable model.
      METHODS: Percutaneous transluminal angioplasty was performed on the left
      subclavian artery of 10 homozygous rabbits. The animals were killed at a few
      hours or 3, 7, 14 or 28 days after the procedure. The artery was fixed by
      perfusion, and the site of angioplasty was examined by both light and electron
      microscopy with the use of conventional and immunohistochemical staining
      techniques. RESULTS: Angioplasty had caused a flap-like or dissecting tear into
      the media. At day 3, cells within the preexisting media adjacent to the injury
      had the ultrastructural characteristics of synthetic smooth muscle cells. At day
      7, spindle cells at the site of injury stained either negative or very weakly
      positive with a marker for actin; ultrastructurally, these cells had the
      synthetic phenotype. At day 14, the spindle cells showed a mix of contractile and
      synthetic phenotypes. The surface was partially covered by endothelial cells. At
      day 28, the dominant cell type was the contractile smooth muscle cell and the
      surface was completely covered by endothelial cells. CONCLUSIONS: Both the injury
      and the response to injury after percutaneous transluminal angioplasty were
      almost identical to that seen in humans after coronary angioplasty. Thus, the
      WHHL rabbit appears to be an appropriate experimental model for use in further
      studies.

PMID- 8473662
TI  - Coronary circulation in dogs with an experimental decrease in aortic compliance.
AB  - OBJECTIVES: This study was designed to investigate the effects of decreased
      aortic compliance on the coronary circulation. BACKGROUND: A decrease in aortic
      compliance due to arteriosclerosis is observed in patients with coronary artery
      disease. However, the effects of decreased aortic compliance on the coronary
      circulation have not yet been investigated sufficiently. METHODS: Hemodynamics,
      subendocardial electrocardiogram (ECG), myocardial segmental length and
      myocardial blood flow were investigated in six dogs with aortic bandaging
      (bandaged group) and five dogs with a sham operation (control group) at rest and
      during pacing 4 weeks after surgery. RESULTS: Aortic compliance in the bandaged
      group was less than that in the control group (0.24 +/- 0.20 vs. 0.50 +/- 0.22
      ml/mm Hg, p < 0.05). Pulse pressure and the tension-time index were significantly
      greater in the bandaged group than in the control group, but systemic vascular
      resistance was not altered significantly. The subendocardial/subepicardial flow
      ratio was lower in the bandaged group than in the control group (0.95 +/- 0.31
      vs. 1.57 +/- 0.26, p < 0.05). In the region supplied by the left circumflex
      artery with a stenosis that was adjusted to eliminate reactive hyperemia, rapid
      atrial pacing (heart rate 200 beats/min) further decreased endocardial flow and
      the endocardial/epicardial flow ratio in the bandaged group. Moreover, both the
      reduction of segmental shortening and the ST elevation on the subendocardial ECG
      in the left circumflex-supplied region during pacing were greater in the bandaged
      group. CONCLUSIONS: These results indicate that decreased aortic compliance
      greatly increases the risk of subendocardial ischemia in the presence of coronary
      stenosis.

PMID- 8473663
TI  - Ultrasound enhancement of thrombolysis and reperfusion in vitro.
AB  - OBJECTIVES: The aims of this study were 1) to develop an in vitro flow system in
      which reperfusion mediated by ultrasound-accelerated thrombolysis could be
      studied, and 2) to test whether ultrasound-accelerated thrombolysis could hasten
      reperfusion in this system. BACKGROUND: Ultrasound has been shown to increase
      tissue plasminogen activator (t-PA)-induced thrombolysis in vitro as assessed by
      radioactive fibrinogen release from labeled clots and in an animal in vivo model.
      METHODS: To test whether reperfusion is accelerated, we created obstructive whole
      blood clots in an in vitro flow system. Four control clots were exposed to
      ultrasound only without any thrombolytic agent (group 1). Sixteen clots were
      exposed to continuous infusion of recombinant tissue-type plasminogen activator
      rt-PA and randomized to either continuous wave ultrasound exposure at a frequency
      of 0.5 MHz and an intensity of 8 W/cm2 (group 2) or to no ultrasound (group 3).
      Flow distal to the clot and the rate of release of radiolabeled fibrin products
      were used as an index of reperfusion and thrombolysis, respectively. Samples were
      obtained for measurements of lytic variables such as plasminogen, fibrinogen and
      rt-PA concentrations. RESULTS: Flow was significantly higher in the rt-PA-treated
      clots within 10 min of exposure to ultrasound than in those without such exposure
      (9.4 +/- 9.9% of maximal flow in group 2 vs. 0.5 +/- 1.5% in group 3, p < 0.05).
      The maximal difference in flow between groups 2 and 3 was achieved at 25 min
      (61.0 +/- 30.4% vs. 14.2 +/- 14.7%, p = 0.03). Thrombolysis was significantly
      higher after 15 min of ultrasound exposure (12.8 +/- 9.1% in the ultrasound
      treated group 2 vs. 4.0 +/- 3.9% in group 3, p < 0.05). The maximal difference
      between groups 2 and 3 occurred at 25 min (26.7 +/- 13.1% vs. 7.24 +/- 5.7%, p <
      0.004). Neither flow nor clot lysis occurred in group 1. Plasminogen and
      fibrinogen concentrations and rt-PA antigen concentrations were consistent with
      those observed during fibrinolytic therapy in vivo. CONCLUSIONS: Continuous wave
      ultrasound at 0.5 MHz and an intensity of 8 W/cm2 accelerates rt-PA-induced
      thrombolysis and reperfusion in vitro.

PMID- 8473664
TI  - Low pressure radiofrequency balloon angioplasty: evaluation in porcine peripheral
      arteries.
AB  - OBJECTIVES: The purpose of this study was to evaluate the efficacy of
      radiofrequency-powered thermal balloon angioplasty in an in vivo porcine model.
      BACKGROUND: Various modes of thermal energy used adjunctively during balloon
      angioplasty have demonstrated the potential to enhance the results of acute lumen
      dilation. METHODS: In normal pigs, 75 peripheral arteries were dilated with a
      newly designed, radiofrequency-powered, thermal angioplasty balloon. All
      inflations were performed at 2-atm pressure for 85 s. Dilations were performed
      either with (hot) or without (cold) the application of heat. Lumen dimensions and
      vessel morphology were assessed with intravascular ultrasonography. At the end of
      each study, dilated arterial segments were harvested for histologic examination.
      RESULTS: Single cold balloon inflations resulted in a 12.7% increase in arterial
      cross-sectional area whereas single hot inflations resulted in a 22.9% increase
      (p < 0.03). Similarly, when multiple cold inflations were compared with multiple
      hot inflations, two, three and four sequential hot inflations resulted in a
      significantly greater increase in cross-sectional area than an equivalent number
      of cold inflations (p < 0.03). Histologic examination demonstrated a temperature
      dependent effect on the depth of medial necrosis and extent of arterial wall
      thinning (p < 0.001) as well as evidence for uniform alteration of elastic tissue
      fibers at temperatures of > or = 60 degrees C (p < 0.03). CONCLUSIONS: Low
      pressure radiofrequency thermal balloon angioplasty results in a greater increase
      in cross-sectional area in porcine peripheral arteries than does nonheated
      conventional balloon angioplasty. The pathologic basis for this enhanced dilation
      may be a temperature-dependent effect on medial necrosis, thinning of the
      arterial wall or alteration of vascular elastic fibers, alone or in combination.

PMID- 8473665
TI  - Coupling between regional myocardial oxygen consumption and contraction under
      altered preload and afterload.
AB  - OBJECTIVES: This study was designed to assess the relation between left
      ventricular regional myocardial oxygen consumption (VO2) and variables of
      regional myocardial contractile function under various loading conditions.
      BACKGROUND: Although the relation between global VO2 and global ventricular
      function has been extensively studied, the relation between regional VO2 and
      regional myocardial contraction is not fully understood. METHODS: Myocardial
      shortening (regional area shrinkage), regional work, regional total mechanical
      energy index and regional VO2 were measured under variously altered loading
      conditions in the isolated, blood-perfused dog left ventricle. Regional total
      mechanical energy per beat was quantified by wall tension-regional area area
      (TAA) by the analogy of left ventricular pressure-volume area. Left ventricular
      loading conditions were altered by changing end-diastolic volume and stroke
      volume with a servo pump as follows: 1) increased preload (increased end
      diastolic volume and stroke volume at a constant ejection fraction), 2) decreased
      afterload (increased stroke volume at a constant end-diastolic volume), 3)
      increased preload and afterload (increased end-diastolic volume at a constant
      stroke volume), and 4) altered mode of contraction (ejecting vs. isovolumetric
      contractions). RESULTS: During increased preload, all three variables correlated
      positively with regional VO2 (r = 0.78 to 1.00). During decreased afterload, the
      correlation was negative for area shrinkage (r = -0.65 to -0.91) and variable for
      regional work (r = -0.55 to 0.98) but positive and highly linear for TAA (r =
      0.80 to 0.99). During increased preload and afterload, the correlation was again
      negative for area shrinkage (r = -0.77 to -0.97) but positive for regional work
      (r = 0.83 to 0.93) and TAA (r = 0.95 to 0.99). During altered mode of
      contraction, the correlation was insignificant for area shrinkage (r = 0.24 to
      0.57) and moderate for regional work (r = 0.50 to 0.79), whereas again highly
      linear for TAA (r = 0.95 to 0.98). Thus, only TAA correlated closely with
      regional VO2 under any loading conditions. Furthermore, the slope and regional
      VO2 intercept of the regional VO2-TAA relation was remarkably consistent among
      the different hearts and loading conditions. CONCLUSIONS: We conclude that there
      is a tight coupling between regional VO2 and regional total mechanical energy
      represented by TAA regardless of left ventricular afterload and preload
      conditions.

PMID- 8473666
TI  - What does FACC mean to you?

PMID- 8473667
TI  - President's page: the prevention paradox.

PMID- 8473668
TI  - PR interval and heart size in the humpback whale.

PMID- 8473669
TI  - A major antigen of Alternaria alternata with potential for safe and effective
      immunotherapy.

PMID- 8473670
TI  - The effect of vacuum cleaners on the concentration and particle size distribution
      of airborne cat allergen.
AB  - BACKGROUND: Vacuum cleaners are essential for the removal of dust from the
      surface of carpets; however, they may also contribute to airborne dust both by
      leakage through the cleaner and disturbance of floor dust. METHODS: The present
      studies used established techniques for measuring airborne Fel d I to study the
      effects of vacuum cleaners on airborne cat allergen under laboratory conditions
      and in houses with cats. Nine different models were loaded with dust containing
      50 mg Fel d I and run for 15 minutes in a laboratory room (volume approximately
      18 m3). Leakage was expressed as the airborne concentration of allergen in
      nanograms per cubic meter. RESULTS: Cleaners incorporating a double-thickness
      dust bag either did not leak, that is, less than 0.4 ng Fel d I/m3 or had minor
      leakage approximately 5 ng/m3. Vacuum cleaners with single-thickness paper bags
      leaked more, that is, 15 to > 90 ng/m3 with the exception of the cleaner with an
      efficient outer bag. Detailed studies on a vacuum cleaner that leaked showed that
      placing dust in the bag, replacing the dust bag with a double-thickness bag, and
      placing an electrostatic filter over the exhaust reduced levels from greater than
      90 ng/m3 to less than 2 ng/m3. Two water-filter vacuum cleaners each emitted cat
      allergen (up to > 100 ng/m3) with a mean of approximately 90% on particles less
      than 2.5 microns diameter. This emission could be almost completely controlled by
      taping electrostatic filter paper over the air outlet. CONCLUSIONS: In houses
      with cats, different models of vacuum cleaners could either reduce or increase
      total airborne allergen, and could also selectively increase certain particle
      sizes. These results suggest that cat allergen is a good model for studying the
      effectiveness of vacuum cleaners recommended to allergic patients.

PMID- 8473671
TI  - Trends in the prevalence of asthma hospitalization in the 5- to 14-year-old
      Michigan Medicaid population, 1980 to 1986.
AB  - BACKGROUND: Despite advances in therapy, morbidity and mortality rates as a
      result of pediatric asthma appear to have increased during the past decade.
      Epidemiologic evidence suggests that these increases disproportionately affected
      black children and the urban poor. METHODS: With use of data from the Medicaid
      Management Information System, we estimated the prevalence of asthma
      hospitalization in the 5- to 14-year-old Michigan Medicaid population for the
      period 1980 to 1986. RESULTS: Large increases were seen between 1980 and 1984,
      with leveling off or a slight decline thereafter. In 5- to 9-year-old children,
      the prevalence of asthma hospitalization increased from 2.3 per 1000 persons in
      1980 to 4.5 per 1000 in 1984. Ten- to 14-year-old children demonstrated an
      increase of 2.2 per 1000 in 1980 to 3.2 per 1000 in 1984. Comparable trends
      occurred in all strata defined by age, race, residency, and gender. However, the
      largest increases were noted in urban black children, in which the rate more than
      doubled from 3.2 per 1000 in 1980 to 7.1 per 1000 in 1984. The adjusted relative
      risk for asthma hospitalization associated with being male was 1.6 (95% CI: 1.5,
      1.7), with being black was 2.2 (95% CI: 2.1, 2.4), and with living in an urban
      county was 1.1 (95% CI: 1.04, 1.4). CONCLUSIONS: Within this relatively
      homogeneous low socioeconomic population, black race remained a strong predictor
      for asthma hospitalization, whereas urban residence was only minimally associated
      with this outcome.

PMID- 8473672
TI  - Mite asthma in childhood: a study of the relationship between exposure to house
      dust mites and disease activity.
AB  - BACKGROUND: Children with asthma are commonly sensitized to the house dust mite.
      METHODS: We took monthly measurements from July to December of the amount of
      mites in the mattresses of asthmatic children and correlated them with symptom
      score, pulmonary function, and airway hyperreactivity to methacholine. RESULTS:
      In spite of the high number of Dermatophagoides pteronyssinus throughout this
      period, symptom and treatment scores, as well as PC20 to methacholine, worsened
      during the months of September and October. CONCLUSIONS: It is concluded that
      when asthmatic children allergic to mites are exposed to high levels of mite
      allergen, the number of mites in the mattress dust no longer correlate with
      increased symptoms, and that other factors are more likely to be associated with
      exacerbation.

PMID- 8473673
TI  - Prepolymers of hexamethylene diisocyanate as a cause of occupational asthma.
AB  - BACKGROUND: Occupational asthma (OA) caused by products that contain
      hexamethylene diisocyanate (HDI) has been ascribed to the highly volatile monomer
      of HDI. Most two-component paints are now made up primarily of nonvolatile
      prepolymers of HDI (30% to 60%) with only trace amounts (< 0.1%) of the monomer.
      The respective role of the two chemical forms of HDI in causing OA has never been
      investigated. METHODS: Twenty workers who were consecutively referred for
      possible OA that resulted from exposure to spray paints underwent inhalation
      challenges on separate days with pure HDI monomer and the commercial formulation
      of HDI prepolymers to which they had been exposed at work. RESULTS: Specific
      inhalation challenges elicited a positive asthmatic reaction in 10 of the 20
      subjects. Among these subjects, four had positive bronchial reactions (two early,
      one late, and one dual) to both the monomer and the prepolymers. Four other
      subjects had asthmatic reactions (two early, one late, and one dual) after
      exposure to the prepolymers but not after exposure to the monomer. The
      discordance in bronchial response elicited by the monomer and the prepolymers
      could not be due to differences in the level of baseline nonspecific bronchial
      reactivity or in HDI concentrations during the tests. One subject showed an
      atypical progressive reaction after exposure to the monomer but not after
      exposure to the prepolymer. In this case, the discordant response could be
      explained by differences in HDI concentration. CONCLUSION: These observations
      show that, although they are nonvolatile, the prepolymers of HDI can induce OA
      and that asthmatic reactions as a result of exposure to prepolymers but not the
      monomer is not a rare occurrence.

PMID- 8473674
TI  - The effects of season, climate, and air-conditioning on the prevalence of
      Dermatophagoides mite allergens in household dust.
AB  - BACKGROUND: Clinical evidence reveals a strong relationship between dust mite
      allergen levels and asthma. This study suggests the relative importance and
      interactions among factors that influence mite allergen levels in human
      dwellings. METHODS: Dermatophagoides pteronyssinus allergen (Der p I) and D.
      farinae allergen (Der f I) were measured in 536 dust samples collected from 424
      homes across the United States. RESULTS: There were distinct seasonal
      fluctuations of Der p I and Der f I. Der p I rapidly increased to peak in July
      then gradually decreased through October. Der f I slowly rose to peak later,
      around September, before declining. Different climates in regions of the United
      States had no significant affect on the quantity of Der p I or Der f I. However,
      regional climate differences seemed to influence the prevalence of either D.
      pteronyssinus or D. farinae. Air-conditioning significantly reduced (p < 0.001)
      Der I mite allergens detected in the dust samples, and a tendency existed for Der
      f I to be higher than Der p I in air-conditioned homes. There was a significant
      (p < 0.01) interaction between air-conditioning and seasons. The most dramatic
      affect was observed during the summer months, the cooling season, from
      approximately May to September. CONCLUSIONS: These findings show that distinct
      seasonal fluctuations exist of D. pteronyssinus and D. farinae mite populations,
      and suggest that differences in the microclimate within homes may have a dramatic
      affect on Dermatophagoides mite populations.

PMID- 8473675
TI  - Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gelatin.
AB  - BACKGROUND: Allergic reactions to measles, mumps, and rubella (MMR) vaccine are
      rare; some have been attributed to allergy to trace quantities of egg proteins.
      We report a 17-year-old female who had an anaphylactic reaction to MMR vaccine. A
      primary vaccination with MMR at age 15 months had been uneventful. She is not
      allergic to eggs; however, ear and throat pruritus and tongue swelling develop
      after she eats gelatin. MMR vaccine contains gelatin as a stabilizer. METHODS AND
      RESULTS: Prick skin tests were positive to 1:10 wt/vol dilutions of MMR vaccine
      and gelatin but negative to egg. By immunoassay, her serum IgE antibodies were
      elevated to both MMR vaccine and gelatin, but not to isolated MMR antigens. IgE
      binding to the gelatin carrier could be inhibited in a dose-dependent fashion by
      addition of not only MMR vaccine but also gelatin from a variety of animal
      sources. Immunoblotting confirmed the presence of IgE antibodies to multiple
      gelatin components as well as to MMR vaccine components. CONCLUSIONS: We conclude
      that the patient has an anaphylactic sensitivity to gelatin, and that her
      anaphylaxis to MMR vaccine was caused by the gelatin component. This sensitivity
      may explain other cases of MMR anaphylaxis.

PMID- 8473676
TI  - Efficacy and safety of low-dose troleandomycin therapy in children with severe,
      steroid-requiring asthma.
AB  - BACKGROUND: Troleandomycin (TAO), a macrolide antibiotic, was studied as an
      alternative treatment in 18 children with severe, steroid-requiring asthma.
      METHODS: In this investigation three treatment arms were used in randomized,
      double-blind, parallel fashion: combination TAO and methylprednisolone (MPn),
      combination TAO and prednisone, and MPn alone. RESULTS: All groups tolerated a
      considerable reduction in glucocorticoid dose over the 12 weeks of the study: 80%
      +/- 6% for TAO-MPn, 55% +/- 8% for TAO-prednisone, and 44% +/- 14% for MPn alone.
      These reductions are all statistically significant (p < 0.05) within groups, and
      the differences between groups were statistically significant between the TAO-MPn
      and MPn alone groups. The concentration of methacholine required to induce a 20%
      decrease in forced expiratory volume in 1 second and pulmonary function were not
      significantly improved in any treatment group. Safety parameters including blood
      chemistry and hematology, adrenal function assessment; bone densitometry, and
      muscle strength testing, were not altered significantly. Two patients who
      received TAO had elevated liver enzyme levels; one required discontinuation of
      TAO and one experienced spontaneous resolution without intervention. Lack of
      statistically significant changes in the efficacy parameters were likely a result
      of small sample size and effects of the glucocorticoid dose taper. CONCLUSIONS:
      TAO is safe and may be a reasonable treatment alternative in a limited trial for
      patients who are unable to tolerate tapering of their glucocorticoid dosage.
      Therapy should be guided by the goal of treatment, that is, glucocorticoid dose
      reduction or improvement of pulmonary function with appropriate monitoring of
      pulmonary function and adverse effects.

PMID- 8473677
TI  - Influence of natural antigenic exposure on expiratory flows, methacholine
      responsiveness, and airway inflammation in mild allergic asthma.
AB  - BACKGROUND: This study looked at respiratory symptoms, peak expiratory flow rates
      (PEFRs), airway responsiveness to methacholine and inflammatory changes on
      bronchial biopsies, bronchial lavage (BL), and bronchoalveolar lavage (BAL)
      during natural antigenic exposure in nine subjects with pollen-sensitized
      seasonal asthma. METHODS: The subjects recorded daily symptoms of asthma, cough
      and rhinitis, and morning and evening PEFRs between January and September, during
      and out of the pollen exposure. Baseline forced expiratory volume in 1 second,
      forced vital capacity, and methacholine responsiveness were measured every 3 to 4
      weeks. BAL, BL, and bronchial biopsies were performed in the pollen season at the
      initial increase of asthma symptoms and out of pollen exposure. RESULTS: At the
      time of bronchoscopy during the pollen season compared with out of season,
      asthmatic subjects had an increase in asthma symptom score (1.18 +/- 0.24/0.44 +/
      0.18, p < 0.05), a reduction of PEFR (407 +/- 23/442 +/- 20 L/min, p = 0.02),
      and a decrease in PC20 (1.15/1.48 mg/ml, p = 0.05). In asthmatic subjects, median
      BAL and BL cell counts and cell differentials during or out of antigenic exposure
      were similar, but BAL and BL eosinophils and metachromatic cells counts were
      always higher than in healthy subjects. In comparison with controls, biopsies
      obtained in asthmatic subjects showed airway lesions such as epithelial
      desquamation, squamous cell metaplasia, thickening of basal membrane,
      inflammatory cells (p < 0.05 for neutrophils), edema, and ciliary abnormalities.
      During pollen exposure, inflammatory signs increased, but this change was only
      significant for the extent of epithelial desquamation and neutrophil counts. No
      significant correlation was found between the intensity of airway inflammation
      and changes in airway responsiveness. CONCLUSIONS: In subjects with mild allergic
      asthma and pollen-induced asthma, seasonal antigenic exposure was associated with
      an increase in epithelial shedding and in the number of neutrophils on bronchial
      biopsies, suggesting a mild increase in baseline airway inflammation. However,
      these changes were not correlated with increases in airway responsiveness.

PMID- 8473678
TI  - Altered platelet function associated with the bronchial hyperresponsiveness
      accompanying nocturnal asthma.
AB  - BACKGROUND: Nocturnal awakening is a common feature of bronchial asthma, and yet
      the mechanisms underlying this phenomenon are poorly understood. We investigated
      whether nocturnal awakening is associated with changes in platelet function with
      the use of a variety of markers of platelet activation. METHODS: Ten patients
      with a history of nocturnal asthma and 10 age- and sex-matched healthy control
      subjects were studied at 10:00 PM, 4:00 AM, and 10:00 AM on 2 consecutive days.
      The following parameters were tested: forced expiratory volume in 1 second
      (FEV1), log dose of methacholine inducing a 20% fall in FEV1, platelet count and
      volume, platelet aggregation induced by collagen or activating factor, and plasma
      and intraplatelet levels of beta-thromboglobulin and platelet factor 4. RESULTS:
      We have demonstrated that altered platelet function and platelet activation
      occurs at 4:00 AM in patients with nocturnal asthma and is associated with the
      maximum increases in bronchial reactivity. Such changes were not observed in 10
      control subjects. Platelet dysfunction has been detected as a reduced aggregatory
      response of platelets to collagen and platelet activating factor such that up to
      5 times more platelet activating factor and 1.5 times more collagen were required
      to elicit a threshold aggregatory response in asthmatic subjects when compared
      with control subjects; this difference was evident at all time points tested.
      Furthermore, at 4:00 AM there were significantly lower levels of intraplatelet
      beta-thromboglobulin corresponding to the maximum reduction in peak expiratory
      flow and to the maximal increase in bronchial responses to inhaled methacholine.
      CONCLUSIONS: These results suggest that platelet activation accompanies nocturnal
      asthma and further suggest that platelets may play a role in this common clinical
      condition.

PMID- 8473679
TI  - The effect of BAY u 3405, a thromboxane receptor antagonist, on prostaglandin D2
      induced nasal blockage.
AB  - BACKGROUND: Nasal lavage and challenge studies in allergic rhinitis implicate
      prostaglandin (PG) D2 in the genesis of nasal blockage. PG D2 is known to act via
      at least two receptors, the thromboxane prostanoid receptor and the PG D2
      prostanoid (DP) receptor; the lower airway effects are mediated chiefly by the TP
      receptor. The receptor involved in the genesis of PG D2-induced nasal blockage is
      unknown. BAY u 3405 is a potent selective competitive TP receptor antagonist,
      which inhibits the lower airway response to PG D2, and shifts the dose-response
      curve to the right by up to 16-fold. METHODS: The efficacy of a single oral dose
      of 20 mg of BAY u 3405 was examined in comparison with PG D2 nasal insufflation
      in a randomized, double-blind, placebo-controlled crossover study, with objective
      measurement of nasal resistance by active posterior rhinomanometry. RESULTS: BAY
      u 3405 afforded no protection against PG D2-induced nasal blockage. CONCLUSIONS:
      This suggests that PG D2-induced nasal blockage may be mediated by the DP
      receptor rather than the TP receptor and that TP receptor antagonists are
      unlikely to be of benefit in the treatment of allergic rhinitis. In vivo
      investigation with specific potent DP receptor antagonists is awaited.

PMID- 8473680
TI  - Ketotifen inhibits exacerbation of allergic airway hyperreactivity by racemic
      salbutamol in the guinea pig.
AB  - In passively sensitized anesthetized guinea pigs, intravenous infusion of low
      doses of antigen ovalbumin induced a marked increased responsivity of the airways
      to intravenous injection of leukotriene C4. Sustained infusion of racemic
      salbutamol intensified responses to leukotriene C4 both before and after infusion
      of ovalbumin. Hyperreactivity as a result of infusion of ovalbumin was inhibited
      by intraduodenal injection of either hydrocortisone or ketotifen at doses that
      did not diminish responses to leukotriene C4 in animals not exposed to antigen.
      Ketotifen, but not hydrocortisone, inhibited the enhanced hyperreactivity
      associated with infusion of racemic salbutamol.

PMID- 8473681
TI  - The role of 5-lipoxygenase products in preclinical models of asthma.
AB  - BACKGROUND: The action of 5-lipoxygenase on arachidonic acid generates potent
      inflammatory mediators that may contribute to the pathophysiology of asthma.
      METHODS: Using the potent and selective 5-lipoxygenase inhibitor BI-L-239, we
      have examined the role of 5-lipoxygenase products in three animal models of
      asthma. RESULTS: In vitro BI-L-239 inhibited 5-lipoxygenase product generation
      from human lung mast cells, alveolar macrophages, and peripheral blood leukocytes
      with a concentration that would provide 50% inhibition values of 28 to 340
      nmol/L. A 36-fold selectivity for immunoreactive leukotriene C4 versus
      immunoreactive prostaglandin D2 inhibition was demonstrated in mast cells. In
      anesthetized cynomolgus monkeys, inhaled BI-L-239 provided dose-dependent
      inhibition of the inhaled Ascaris-induced immunoreactive leukotriene C4 release
      (maximum, 73%; bronchoalveolar lavage [BAL], 20 minutes), late-phase
      bronchoconstriction (maximum, 41%; +6 to 8 hours), and neutrophil infiltration
      (maximum, 63%; BAL, +8 hours). In conscious sheep, inhaled BI-L-239 provided dose
      dependent inhibition of the inhaled Ascaris-induced late-phase
      bronchoconstriction (maximum, 66%; +6 to 8 hours) and increase in airway
      responsiveness (maximum, 82%; carbachol, +24 hours). The acute
      bronchoconstriction was shortened, and neutrophil infiltration diminished
      (maximum, 61%; BAL, +8 hours) in this model. Finally in conscious actively
      sensitized guinea pigs pretreated with pyrilamine and indomethacin, inhaled BI-L
      239 attenuated acute bronchoconstriction (maximum, 80%; +5 to 15 minutes),
      leukocyte infiltration (58%; BAL, +3 days) and increase in airway responsiveness
      (100%; methacholine, +3 days) induced by three alternate-day ovalbumin
      inhalations. CONCLUSIONS: In conclusion, results in these three animal models
      indicate that 5-lipoxygenase products may be major contributors to the
      bronchoconstriction (especially late phase), leukocyte infiltration, and airway
      hyperresponsiveness that characterize asthma.

PMID- 8473682
TI  - The effect of time and extraction buffers on residual protein and allergen
      content of extracts derived from four strains of Alternaria.
AB  - BACKGROUND: A series of studies was performed to identify optimal elution
      conditions for production of desired Alternaria allergens with simultaneous
      reduction of undesired ones. METHODS: Proteins and allergens from four strains of
      Alternaria extracted for differing time intervals and in different buffers were
      analyzed by one- and two-dimensional electrophoresis, as well as by
      immunoglobulin E enzyme-linked immunosorbent assay inhibition and immunoblotting.
      RESULTS: The amount of protein and carbohydrate released varied with each time
      interval but was consistent between buffers. Extracts from longer time intervals
      tended to contain more carbohydrate. Electrophoresis of the four strains
      demonstrated many similar proteins; however, the concentrations of these proteins
      showed considerable interstrain difference. Comparison of extraction times for
      single strains by immunoblotting showed that certain allergens are preferentially
      released during specific time intervals. Some allergens were seen to be most
      prevalent in a 24-hour extract, whereas others were most prevalent in a 1-hour
      extract. Two-dimensional electrophoresis resolved bands into discrete spots. The
      major shared elements of the four strains could be easily identified. The
      appearance and disappearance of individual protein elements with time was seen.
      CONCLUSIONS: Elution conditions have a significant impact on quantities of
      specific glycoproteins contained in extracts of Alternaria and must be controlled
      and optimized when such extracts are produced for allergen purification.

PMID- 8473683
TI  - Increased secretion of tumor necrosis factor-alpha, interleukin-1-beta, and
      interleukin-6 by alveolar macrophages from patients with sarcoidosis.
AB  - BACKGROUND: Alveolar macrophages from patients with sarcoidosis were analyzed for
      their ability to secrete tumor necrosis factor-alpha (TNF-alpha), interleukin-1
      beta (IL-1-beta), and interleukin-6 (IL-6). RESULTS: Constitutive release of all
      three monokines in these patients was concomitantly increased in the active state
      of disease in comparison with inactive sarcoidosis or healthy control subjects.
      Alveolar macrophages from patients with inactive sarcoidosis compared with cells
      from healthy subjects showed increased spontaneous secretion of TNF-alpha and IL
      6 only, whereas the constitutive release of IL-1-beta was similar as in healthy
      volunteers. In vitro stimulation of alveolar macrophages from healthy control
      subjects with lipopolysaccharide or pokeweed mitogen led to a time- and dose
      dependent enhanced secretion of TNF-alpha, IL-1-beta, and IL-6. In a similar
      manner, with corresponding cells from patients with sarcoidosis the secretion of
      all three cytokines could be further increased by stimulation with
      lipopolysaccharide or pokeweed mitogen. CONCLUSIONS: The data presented indicate
      that an increased release of TNF-alpha, IL-1-beta, and IL-6 correlates to disease
      activity and may play a critical part in the pathogenesis of sarcoidosis.

PMID- 8473685
TI  - Rhinopharyngolaryngoscopy. Upper Airway Allergy Committee.

PMID- 8473684
TI  - Lol p I-induced IL-4 and IFN-gamma production by peripheral blood mononuclear
      cells of atopic and nonatopic subjects during and out of the pollen season.
AB  - The reciprocal effects of IL-4 and IFN-gamma on IgE synthesis have been well
      established. It has also been shown that these two lymphokines are secreted by
      different subsets of CD4+ T cells (TH1 and TH2), and that TH2 helper T
      lymphocytes could be involved in the pathophysiology of allergic diseases. But
      little is known about the effects of an allergen on the profile of lymphokine
      synthesis by human peripheral blood mononuclear cells (PBMCs) of allergic and
      nonallergic subjects. We studied the production of IL-4 and IFN-gamma by PBMCs of
      atopic and nonatopic donors after in vitro stimulation by the group 1 allergen
      from Lolium perenne pollen (Lol p I), during and out of the grass pollen season.
      On natural exposure to pollen, Lol p I-induced IL-4 production was observed only
      with atopic donors (6 of 8), whereas the synthesis of IFN-gamma was observed for
      all nonatopic donors (7 of 7) and most allergic patients (5 of 7). At the time of
      the study, higher amounts of IFN-gamma were produced by PBMCs of nonatopic donors
      than by PBMCs of atopic patients. Out of the pollen season the production of IL-4
      was not observed either by atopic (n = 11) or by nonatopic subjects (n = 5). On
      the other hand, IFN-gamma was produced by PBMCs of most subjects (atopic, 10 of
      11; nonatopic, 5 of 5), but at the time of the study no difference was observed
      between the two groups. These results show that Lol p I induces different
      profiles of IL-4 and IFN-gamma production by PBMCs of atopic and nonatopic
      subjects. In atopic subjects this profile of lymphokine synthesis is influenced
      by the natural exposure to pollen, which is in keeping with the seasonal rise of
      IgE antibodies.

PMID- 8473686
TI  - Comparisons of inflammatory responses in IgE-mediated and codeine-induced skin
      reactions.

PMID- 8473687
TI  - Gastrointestinal proliferation and aging.
AB  - The gastrointestinal tract represents an organ system that is characterized by
      rapid proliferation and by cells that demonstrate differentiation from immature
      stem cells to terminal differentiated mature cells. Aging gastrointestinal
      tissues illustrate markedly different phenomena from aged post-mitotic cells.
      Contrary to generally held prejudices, a state of hyperproliferation, not
      hypoproliferation, occurs in the epithelial cells of the stomach, the small
      intestine, and the large intestine of stable-fed, aged rodents when compared to
      young mature rodents. Furthermore, abnormalities of proliferative and
      differentiation responses become evident when gastrointestinal tissues are
      stimulated by injury, or by starvation and refeeding. We speculate that such
      changes in proliferation and differentiation expose aging gastrointestinal
      epithelial cells to genotoxic effects that may increase the susceptibility to
      gastrointestinal cancers.

PMID- 8473688
TI  - The effect of age on the synthesis of two heat shock proteins in the hsp70
      family.
AB  - Hepatocytes isolated from male F344 rats were exposed to elevated temperatures
      (40 degrees C to 45 degrees C), and the incorporation of [35S]-L-methionine into
      proteins was measured from fluorograms of two-dimensional polyacrylamide gels.
      The synthesis of two proteins was induced by temperatures of 40 degrees C to 42.5
      degrees C; however, 45 degrees C inhibited the synthesis of all proteins. Based
      on their apparent molecular weights and pI values and their recognition by a
      monoclonal antibody to the HSP70 gene family, the two proteins induced by
      hyperthermia were found to be the highly heat-inducible hsp70 and the
      constitutive hsc70. Because a heat shock of 42.5 degrees C for 30 minutes had
      very little effect on cell viability and induced the synthesis of hsp70 and
      hsc70, this heat shock was used to study the effect of age on the ability of
      hepatocytes to respond to the stress of hyperthermia. Neither hepatocytes
      isolated from young adult (5-7 months) nor old (25-27 months) rats synthesized
      detectable amounts of hsp70 when incubated at 37 degrees C. However, heat shock
      induced the synthesis of both hsp70 and hsc70 in hepatocytes isolated from young
      adult and old rats. The induction of hsp70 synthesis was significantly lower
      (37%) for hepatocytes isolated from old rats compared to hepatocytes isolated
      from young adult rats. However, neither the basal level nor the induced level of
      hsc70 synthesis changed significantly with age. Thus, aging resulted in a
      decrease in the ability of hepatocytes to synthesize hsp70 in response to
      hyperthermia; this effect, however, was specific for hsp70.

PMID- 8473689
TI  - Oxygen-dependent perturbation of life span and aging rate in the nematode.
AB  - The effects of atmospheric oxygen on the life span and aging rate of the nematode
      Caenorhabditis elegans were examined. The mean and maximum life spans of both the
      wild type and mev-1(kn1) mutant, whose cytoplasmic superoxide dismutase activity
      level is about half of the wild type, were increased and decreased under low and
      high concentrations of oxygen, respectively. The Gompertz component, a parameter
      of aging rate, of the wild type was smaller under 1% oxygen than under 2% or more
      oxygen. Further, the Gompertz component of the mutant increased with an increase
      in oxygen concentration. These effects of oxygen on the perturbation of life span
      and aging rate were more pronounced in the mev-1(kn1) mutant than in the wild
      type. The oxygen-dependent perturbation of life span and aging rate seems to be
      enhanced by a genetic defect of the mutant in antioxidant defense. A 1% oxygen
      exposure at the early phase of life span was ineffective for life span extension
      in the mutant, suggesting that the effect of oxygen concentrations on life span
      is not secondary to the effects of development and maturation. These results show
      that changes in oxygen concentration perturb aging rate, and hence oxygen is
      involved in the specification of life span of the nematode.

PMID- 8473690
TI  - Dietary restriction retards onset but not progression of leukemia in male F344
      rats.
AB  - The objective of this study was to determine the effect of dietary restriction on
      the spontaneous occurrence and the progression of leukemia in male F344 rats. The
      analysis involved both sacrificed rats and those that died spontaneously. These
      rats had been either ad libitum fed (AL) or restricted to approximately 60% of
      the ad libitum intake (DR) from 6 weeks of age. Dietary restriction delayed
      spontaneous death due to this disease by delaying the occurrence of leukemia.
      However, dietary restriction did not retard its progression, i.e., the time
      between occurrence and death.

PMID- 8473691
TI  - Aging as a modulator of respiratory sinus arrhythmia.
AB  - Aging is associated with an accentuated shift toward sympathetic outflow.
      Evidence suggests that sympathetic and vagal-cardiac activity change
      reciprocally. If this hypothesis is correct, then aging would result in an
      attenuation of vagal-cardiac activity. The current cross-sectional investigation
      assessed the relationship between aging, vagal-cardiac activity, and arteriolar
      compliance (AC). Respiratory sinus arrhythmia (RSA) and finger plethysmography,
      noninvasive measures of vagal-cardiac activity and arteriolar compliance,
      respectively, were made on 70 normotensive male subjects (age range 15-81 years).
      Both RSA and AC decreased with age (r = .71 and .89, respectively, p < .001).
      Analysis of variance revealed significant differences between the six decade
      groups for RSA and AC (p < .05). These findings support the notion that there is
      an age-related loss of vagal-cardiac activity that could be partly explained by
      the loss of arteriolar compliance. These findings are consistent with the
      hypothesis that there is autonomic nervous system compensation of cardiovascular
      function in response to an age-related decrease in arteriolar compliance in a
      normotensive population.

PMID- 8473692
TI  - Development and validation of a physical performance instrument for the
      functionally impaired elderly: the Physical Disability Index (PDI).
AB  - Article describes development of the Physical Disability Index (PDI), an observer
      administered, performance-based instrument measuring physical disability in frail
      elderly persons without severe cognitive impairment. Sixty-five items in four
      subscales encompassing Range of Motion (ROM), Strength (STR), Balance (BAL), and
      Mobility (MOB) were measured. Subjects were randomly selected frail nursing home
      residents (N = 103) with a Folstein Mini-Mental State Exam (MMSE) score of > or =
      11. Using correlation matrices, cluster analysis, and regression techniques, the
      scale was reduced to 54 items. All individual item values were standardized and
      aggregated into subscale and summary PDI scores, each with a range of 0-100. Test
      retest and interrater reliability were evaluated. Discriminant and convergent
      validity were established using MMSE, Physical Self-Maintenance Scale (PSMS), and
      Sickness Impact Profile-Physical Dimension (SIP-PD). PDI is a performance-based
      instrument that appears to discriminate among frail individuals with differing
      levels of physical function. Further testing is warranted in other populations of
      frail-elderly persons to ascertain its applicability and generalizability.

PMID- 8473693
TI  - Oral health status of the elderly in New England.
AB  - The New England Elders Dental Study (NEEDS) reports the prevalence, extent and
      severity of oral diseases and conditions among a representative sample of
      community-dwelling elders age 70 and older residing throughout the six New
      England states. In-home, full-mouth examinations were conducted by four
      calibrated dentists who used National Institute of Dental Research (NIDR)
      standardized disease measures plus additional diagnostic codes on all tooth
      surfaces. Only 37.6% of elders age 70 and older were edentulous, while dentate
      elders had a mean number of teeth per person ranging from 21.5 to 17.9 across age
      and gender cohorts. The prevalence of untreated coronal decay in elders with
      teeth was 28% in female elders and 34% in male elders. More than 90% of all
      elders with teeth had coronal fillings and 22% exhibited untreated root caries.
      Periodontal destruction was substantial, with 66% of dentate elders exhibiting
      moderate periodontal pockets (4-6 mm) while 21% exhibited severe periodontal
      pocketing (> 6 mm). Comparisons with national surveys suggest that periodontal
      disease prevalence and severity appear to have been underestimated in previous
      national studies of the elderly. Because of aging and tooth retention trends, the
      periodontal disease problem of the elderly may be increasing in the face of
      dentists' tendency to underdiagnose the periodontal diseases, legal constraints
      on dental hygienists to independently treat them, and inadequate funding for
      conservative nonsurgical therapies.

PMID- 8473694
TI  - Thermally-induced cutaneous vasodilatation in aging.
AB  - A decrease in heat-induced cutaneous vasodilatation has been implicated as the
      cause of increased heat stress in the elderly. We used laser Doppler techniques
      to study the skin blood flow response to local heat in 82 healthy volunteers.
      There were 39 young volunteers, mean age 29 +/- 1, and 43 elderly volunteers,
      mean age 76 +/- 1. There was minimal difference in skin blood flow at 35 degrees
      C between the two groups. In contrast, skin blood flow at 44 degrees C was
      significantly lower in the older subjects at nutritively perfused sites, such as
      the knee and elbow. However, there was no difference between the young and old
      groups in skin blood flow at the finger or toe pulp, sites with primarily
      arteriovenous anastomotic (AVA) flow. In the older subjects, the two components
      of skin blood flow, microvascular volume (VOL) and red blood cell velocity (VEL),
      were both decreased at 44 degrees C at nutritive sites, but not at AVA sites.
      Regression analysis demonstrated a linear fall in blood flow, VOL, and VEL with
      advancing age at nutritive sites at 44 degrees C. We conclude that thermally
      induced cutaneous blood flow is reduced in older persons at nutritive capillary
      sites, but not at AVA sites.

PMID- 8473695
TI  - The difference in stiffness of the active plantarflexors between young and
      elderly human females.
AB  - The purpose of this investigation was to determine the difference in the
      intrinsic stiffness of the active plantarflexor muscles between young and elderly
      human females, and to determine changes in this stiffness associated with a 6
      week strengthening exercise program. Intrinsic muscle stiffness was determined by
      measuring the resistance in the first 62 milliseconds offered by the muscle to
      multiple single stretch trials at 20% to 60% of maximal isometric contraction.
      Stiffnesses were related to pre-stretch torque (K/PST) by a linear fit. The K/PST
      relationship of the elderly subjects exhibited a steeper slope, indicating a
      greater increase in stiffness with an increase in pre-stretch torque. The effect
      of testing subjects at identical relative, but different absolute pre-stretch
      torque levels precluded definitive conclusions on possible stiffness differences
      between the age groups. After the strengthening exercise program, the
      plantarflexors showed an increase in maximum produced torque, and a decrease in
      stiffness as well as a decrease in the slope of the K/PST relationship.

PMID- 8473696
TI  - Anticipatory postural adjustments in older adults: are changes in response
      characteristics due to changes in strategy?
AB  - The purpose of this study was to determine if (a) the aging process directly
      affects the ability to prepare postural adjustments in advance of voluntary
      movements, or (b) if aging leads to longer movement times which, in turn, lead to
      less need for advance preparation of the postural muscles. That is, is velocity a
      mediating variable between age and lack of postural preparation? Postural and
      prime mover muscle response characteristics of young (n = 16, age 27 +/- 5 years)
      and older (n = 16, age 71 +/- 8 years) adults were evaluated in an arm-raising
      paradigm across many arm movement velocity conditions. Older and young adults did
      not differ in arm movement velocities. Therefore, observed differences between
      age groups were directly related to the aging process. Muscle timing and
      sequencing were affected differentially between age groups depending upon which
      velocity condition was specified. Age-related differences were found in the
      timing of two postural muscles: in older subjects the contralateral erector
      spinae muscles were activated later, relative to the deltoid, than in younger
      subjects, with fewer older subjects showing preparatory activity. Also, older
      subjects showed more frequent activation of the quadriceps than young subjects.

PMID- 8473697
TI  - Life span changes in the verbal categorization of odors.
AB  - An odor description task was used to explore age-related change in odor
      perception based on 1.19 million U.S. and Canadian respondents (ages 10-90 years)
      to the National Geographic Smell Survey. Respondents sampled six
      microencapsulated odorants and selected 1 of 11 descriptors to characterize each
      smell. Four odors were characterized by strong consensus endorsement of a single
      descriptor. This consensus weakened with advancing age, and nonmodal descriptors
      were endorsed more frequently. Nonmodal responses were neither randomly selected,
      nor systematically biased across odors. Rather, they showed odor-specific
      patterns of change. Together, these results suggest a marked change in odor
      categorization across the life span. Odor descriptor profiles were used to
      generate age-specific multidimensional scaling maps. Stimulus configurations were
      stable from the third through fifth decades. Those from the sixth through ninth
      decades showed major displacements for two odors, and suggest that the sweet
      dimension of odor quality may be particularly variable with maturation.

PMID- 8473698
TI  - Prior knowledge and face recognition in a community-based sample of healthy, very
      old adults.
AB  - This experiment addressed the effects of prior knowledge on episodic face
      recognition in a community-based sample of healthy older adults from 75 to 96
      years of age (N = 228). Subjects were presented with photographs of public
      Swedish individuals who attained their fame during the 1930s and 1940s, or during
      the 1980s. Results indicated an overall deterioration of face recognition
      performance across age. However, performance was higher with the dated than with
      the contemporary faces across the entire age range, suggesting that the ability
      to utilize prior knowledge in the context of face recognition is well preserved
      in very old age. Finally, a multiple regression analysis indicated that, among a
      variety of demographic, psychometric, and biological variables, age was the best
      predictor of face recognition performance.

PMID- 8473699
TI  - Item and relational processing in young and older adults.
AB  - The item and relational information framework of memory provided a methodology
      for an analytical approach to age differences in encoding and retrieval
      processes. Subjects were given related or unrelated words to sort or rate for
      pleasantness. Young adults performed better than older adults in free recall, but
      older adults were able to use both item and relational information as well as
      young adults. In a second experiment, subjects also sorted or rated a list
      composed of different numbers of category items. The pattern of free recall and
      cued recall scores indicated that item and relational information affected the
      memory performance of both age groups in a similar fashion. By examining memory
      in terms of item and relational information, it appears that older adults do not
      have difficulty combining two types of target information during encoding and
      that the information assists in recall of target items.

PMID- 8473700
TI  - Age differences in letter and color matching: selective attention or internal
      noise?
AB  - We tested healthy young and older adults on a letter-matching task that varied
      letter identity and letter color (Experiment 1) and on a color matching task that
      varied letter color and letter identity (Experiment 2). The goal of this
      investigation was to empirically disentangle the theoretical concepts of internal
      noise and selective attention. The results from Experiment 1 indicated that both
      young and older adults exhibited "fast-same" effects for reaction time and "false
      different" effects for errors, and older adults exhibited a relatively larger
      "false-different" effect. However, letter color did not affect performance. The
      data from Experiment 2 indicated that older adults, compared with young adults,
      evidenced greater interference from "different-similar" letter pairs than
      "different-dissimilar" letter pairs even though the task was color matching.
      These data suggest that older adults evidenced greater levels of internal noise,
      and that this factor may modulate age differences in selective attention.

PMID- 8473701
TI  - Conservation of energy, uncertainty reduction, and swift utilization of medical
      care among the elderly.
AB  - This study examined age differences in the timing of the decision to seek medical
      care. Two cohorts, one of middle-aged (40 to 55 years, n = 88) and one of older
      patients (65 and over, n = 80), who sought medical care when symptomatic were
      interviewed at the time of their visit. Age differences were examined with
      respect to total delay (the time from first noticing symptoms until calling for
      care), as well as its two constituent phases: appraisal delay (symptom onset
      until deciding one was ill) and illness delay (decision one was ill until calling
      for care). Older persons were expected to be more conserving of physical and
      psychic resources, and thus quicker in seeking care. The cohort effect was
      expected to be most visible for symptoms judged to be of uncertain seriousness.
      The delay results and ancillary findings on reasons given for delay are generally
      supportive of the hypotheses, with the caveat that the cohort difference also
      reflects higher levels of avoidance behavior by the middle-aged than by the older
      subjects.

PMID- 8473702
TI  - Automatic and effortful memory processes in depressed persons.
AB  - Clinical lore has held that depression results in memory dysfunction,
      particularly in older adults. Some believe that memory loss due to depression is
      indistinguishable from an organic dementia and label such dysfunction
      pseudodementia. Previous literature has inconclusively supported the relation
      between depression and memory deficits. This research assessed three groups of
      subjects: (a) 30 depressed patients, (b) 20 psychiatric controls, and (c) 30
      normal controls. Dependent memory tasks were designed to vary along the automatic
      and effortful memory encoding continuum defined by Hasher and Zacks (1979). Two
      tasks were designed to be effortful (free recall and paired associates) and two
      tasks were designed to be automatic (memory for frequency and location). Contrary
      to predictions, depression was not related to memory deficits. However, post-hoc
      analyses indicated that psychiatric hospitalization and psychotropic medication
      had a greater negative impact on memory than did depression. As predicted, age
      resulted in effortful encoding deficits whereas age resulted in minimal deficits
      on the automatic tasks. There was no evidence of an interaction between
      depression and age that would be consistent with the descriptive label of
      pseudodementia.

PMID- 8473703
TI  - Pain and depression in the nursing home: corroborating results.
AB  - The relationship between depressed affect and pain was examined in secondary
      analysis of data on 408 nursing home residents. Also assessed were cognitive
      impairment, activities of daily living impairment, quality of social networks,
      and number of medical diagnoses. Analysis revealed that depressed residents were
      more likely to have pain, regardless of the presence of cognitive impairment.
      Multiple regression revealed that depressed affect was predicted by more pain, a
      greater number of medical diagnoses, and poor quality of the social network.
      These findings corroborate and extend those from a recent study of nursing home
      and congregate apartment residents (Parmelee et al., 1991). This corroboration
      and extension of findings occurred despite differences between the two studies
      with regard to characteristics of participants (this research included residents
      with all levels of cognitive impairment, and research by Parmelee et al. excluded
      those who were too disoriented to respond to questions), type of data collection
      employed (this research used ratings by professional caregivers whereas research
      by Parmelee et al. used self-report), and assessment instruments used to tap
      constructs.

PMID- 8473704
TI  - Evidence for a preretirement process among older male workers.
AB  - As part of a preretirement role-exit process, older workers could be expected to
      reinterpret their situations and report less favorable job attitudes as they
      approach retirement. Using 4-wave, 9-year (1978-1987) panel data on 1,365
      nonretired male workers aged 50-69, attitudes about job tension and fatigue were
      examined along the dimension of self-reported proximity (time-left) to
      retirement. Results from pooled time-series analysis showed that men evaluated
      their jobs as more burdensome when drawing closer to a fixed age for retirement,
      regardless of age and other factors. This is evidence for a preretirement
      dynamic, and it encourages the notion that time-left at work organizes the
      experience of older workers.

PMID- 8473705
TI  - Poverty among older Americans: the plight of nonmetropolitan elders.
AB  - Elderly persons in nonmetropolitan areas are more likely to be poor than their
      metropolitan counterparts, and the gap between them increases with age. This
      study provides a comprehensive empirical comparison of the nature of income
      poverty among metropolitan (metro) and nonmetropolitan (nonmetro) elders. Drawing
      on the 1990 Current Population Survey, we document differences in poverty by age
      and for various demographic subgroups of the elderly population. These analyses
      show that poverty rates are higher among nonmetro elders for virtually all
      demographic subgroups. We estimate logistic regression models to predict the
      likelihood that elders are poor to separate the effects of population composition
      from those of nonmetro residence. We find that even after controlling for age,
      sex, race, marital status, and living arrangements, nonmetro elders are more
      likely to be poor than those in metro areas.

PMID- 8473706
TI  - Nativity, acculturation, and economic status: explanations of Asian American
      living arrangements in later life.
AB  - Using 1980 Census data, we examined the household and nonhousehold living
      arrangements for older, unmarried women of Japanese, Chinese, Filipino, and
      Korean descent, finding substantial variation across ethnic groups. We tested
      three hypotheses regarding the effects of acculturation, economic status, and
      nativity/immigration status. The results from our multivariate analyses show that
      Chinese-origin and Filipino-origin women who are less acculturated are more
      likely to live with others than those who are more acculturated. Members from
      each Asian American group who can afford independent living are more likely to
      purchase their privacy. The most consistent finding shows that older, unmarried
      Asian American women who have migrated to the United States since 1965 are more
      likely than similar native-born women to live in a complex household as compared
      to living alone.

PMID- 8473707
TI  - Who helps whom in older parent-child families.
AB  - While previous research has assumed that older persons who live with adult
      children do so because of their poverty or disability, some recent evidence
      suggests that many of these extended households primarily benefit the child. This
      article attempts to provide a better understanding of the relative contributions
      of parents and adult children who live together through detailed analysis of data
      from the Survey of Income and Program Participation (SIPP). We find unmarried
      children tend to benefit more from and contribute less to extended households
      than married children. Similarly, unmarried parents benefit more from living with
      children than married parents. Results of logistic regression show that financial
      need and need for assistance with activities of daily living wre important
      determinants of coresidence for both unmarried children and unmarried parents.
      Controlling need, racial and ethnic minorities were more likely to live in
      extended families than non-Hispanic Whites.

PMID- 8473708
TI  - Determining the pattern of community care: is coresidence more important than
      caregiver relationship?
AB  - Researchers have previously emphasized the importance of kinship tie to
      explaining the pattern of care received by a disabled elder. For example, it has
      been argued that spouses are a distinct group of caregivers, i.e., they provide
      more care with less help from others and experience more stress. However, based
      on the theory of primary group structures and functions, this study hypothesized
      that coresidence rather than the kinship tie is more important in determining the
      pattern of caregiving. When spouses are compared to other coresiding caregivers,
      patterns of informal care and use of formal services are similar. Variance in
      amounts of informal care is explained by elder gender and frailty level rather
      than by caregiver relationship. Similarly, level of frailty was the only
      important predictor of use of formal services.

PMID- 8473709
TI  - Joint impairment and self-reported disability in elderly persons.
AB  - Recent findings indicating that arthritis is a major contributor to disability in
      elderly persons are based on self-reported diagnostic information. We conducted
      physical examinations of the joints at baseline on 541 older persons. We then
      tested a multivariate model of total/generic disability which included respondent
      group, demographic and chronic disease variables (joint impairment and comorbid
      conditions), arthritis pain, and psychological status. Hierarchical multiple
      regression found that the model explained 55 percent (adjusted R2 = .55) of the
      variance in baseline disability with joint impairment accounting for 15 percent
      (change in R2 = .15) of the variance. When joint impairment was removed from the
      model, arthritis pain worked well as a surrogate. Together, these findings
      strongly support the importance of musculoskeletal disease in explaining
      disability in the elderly population.

PMID- 8473710
TI  - Expressions of individuality in cognitively impaired elders. Need for individual
      assessment and care.
AB  - 1. Cognitively impaired elders uniquely express their individuality (expressed
      selfness) despite the effects of the dementing process. 2. Recognizing and
      attending to expressed selfness has implications for planning nursing care both
      to meet specific needs and to support existing characteristics and behaviors. 3.
      With the multiple losses encountered in dementia, supporting expressed selfness
      accessible to the individual can enhance the quality of the individual's living
      experience.

PMID- 8473711
TI  - Cerumen impaction. Prevalence and detection in nursing homes.
AB  - 1. Many people, including health care professionals, believe that hearing loss is
      a normal part of aging and that little can be done to improve older adults'
      hearing. If the staff and physicians believe that hearing loss among nursing home
      residents is expected due to advanced age, then the likelihood of further
      evaluation of hearing impairments is minimal. 2. Hearing loss is a serious health
      problem among the elderly. Social isolation, depression, acting out
      inappropriately, and paranoia have been related to impaired hearing. Cerumen
      impaction is a reversible, frequently overlooked cause of a conductive hearing
      loss. 3. Twenty-five percent of nursing home residents were found to have
      impacted cerumen. One of the nursing homes in the study differed from the others
      because no residents had cerumen impaction. This was the only home that employed
      two nurses who had specialty preparation in gerontological nursing. If that home
      had been excluded, the impaction rate would have been 34%.

PMID- 8473712
TI  - Institutional policy: use of restraints in extended care and nursing homes.
AB  - 1. The percentage of patients restrained on these nursing home and extended care
      units was 32%, similar to that for other nursing home studies. 2. The
      archetypical restrained patient was older, new on the unit, had altered thought
      processes and a high potential for injury, and required extensive nursing care.
      Typically, the type of restraint a patient wore was a vest posey, on the day
      shift while in his room. 3. The most frequent rationale given by nurses for
      applying restraints was to prevent patient falls; however, half the time, this
      rationale was not charted. 4. Upon examining institutional restraint policy,
      nurses should be prepared to implement changes in documentation format, provide
      staff education regarding restraint use and alternatives available, institute a
      rehabilitative and restorative nursing care and fall prevention program, redesign
      the physical environment, and designate adequate resources for an effective
      diversion activity program.

PMID- 8473713
TI  - Understanding and applying research to your practice.

PMID- 8473714
TI  - Legal risks of nontraditional nursing care.

PMID- 8473715
TI  - Cognitively impaired elders. Using research findings to improve nursing care.
AB  - 1. Cognitive changes may be similar in people with Alzheimer's disease, but each
      person loses abilities differently, and each individual responds differently to
      interventions. 2. Assessment of cognitive function is needed in order to design
      appropriate interventions that will be specific in facilitating independence in
      cognitively impaired elders. 3. Research findings suggest that functional ability
      in cognitively impaired elders can be maximized by assessing cognitive abilities
      and using this information to tailor specific interventions that will facilitate
      independence.

PMID- 8473716
TI  - The effects of nefazodone, imipramine and placebo, alone and combined with
      alcohol, in normal subjects.
AB  - Nefazodone (200 mg, 400 mg/day) imipramine (150 mg/day) and placebo were
      administered to 12 normal, healthy volunteer subjects for a period of 8 days
      each. A measured dose of alcohol was consumed with the drug on day 8. A battery
      of physiological, psychomotor, cognitive and subjective tests was carried out
      before drug administration and 2 h after drug administration on days 1, 7, and 8.
      Nefazodone had little effect on heart rate and blood pressure whereas imipramine
      increased both heart rate and diastolic blood pressure. Nefazodone 400 mg
      impaired the critical flicker fusion threshold. Dose-dependent improvements in
      psychomotor performance (Gibson Spiral Maze) and complex memory performance
      (learning, pursuit rotor, and visual working memory) were produced by nefazodone
      while imipramine administration impaired performance on these tasks. Subjective
      changes in alertness and bodily symptoms were produced by all active compounds.
      While nefazodone failed to potentiate the sedative-hypnotic (depressant) effects
      of alcohol, imipramine tended to enhance them for psychomotor performance, memory
      assessments, and some subjective ratings. Thus, nefazodone, particularly at lower
      dose levels, causes less disruption of human performance than imipramine. This
      effect probably reflects the lack of anticholinergic activity of nefazodone.
      Also, nefazodone failed to potentiate the depressant effects of alcohol, perhaps
      because of its minimal alpha-blockade.

PMID- 8473717
TI  - Relationship between antidepressant response and plasma concentrations of
      fluoxetine and norfluoxetine.
AB  - The relationship between plasma concentration, clinical outcome and side-effects
      was examined in 23 patients with major depressive disorder (DSM-III-R) treated
      with fluoxetine. All patients received a fixed dose of 20 mg for 6 weeks. Good
      response was observed in 57% of patients, while 30% of patients had moderate
      responses after 6 weeks of treatment. Fluoxetine and norfluoxetine plasma
      concentrations were not significantly influenced by age and sex. At 6 weeks,
      plasma fluoxetine concentrations were not significantly different between
      responders and non-responders to treatment (82.2 +/- 59.6 micrograms/l vs. 84.7
      +/- 6.7 micrograms/l) or those with or without side-effects (74.6 +/- 28.7
      micrograms/l vs. 87.0 +/- 66.6 micrograms/l). Similarly, norfluoxetine
      concentrations were not significantly different for responders and non-responders
      (65.5 +/- 28.9 micrograms/l vs. 66.5 +/- 26.2 micrograms/l) or those with or
      without side-effects (66.6 +/- 14.4 micrograms/l vs. 61.5 +/- 33.6 micrograms/l).
      Plasma concentrations and clinical outcome were not related in a simple manner.
      Further studies are needed to evaluate the role of monitoring plasma
      fluoxetine/norfluoxetine concentrations as a routine procedure.

PMID- 8473718
TI  - A pharmacological comparison of citalopram, a bicyclic serotonin selective uptake
      inhibitor, with traditional tricyclic antidepressants.
AB  - Major depressive disorder is a very common and a very serious illness that not
      only disrupts the lives of the people with the condition but also the lives of
      their families. Effective identification and treatment of those with this disease
      would greatly improve the lives of a very sizeable proportion of the people of
      the world. Numerous drugs have been introduced since the 1950s that have proven
      to be useful in the therapy of major depressive disorder patients but these
      compounds typically have unwanted side effects due to their actions on many
      different aspects of brain function. Citalopram, one of the more recently
      developed antidepressant drugs, is a selective inhibitor of the transport of the
      neurotransmitter serotonin into nerve terminals and other cells that accumulate
      serotonin. Citalopram does not affect the uptake of other neurotransmitters nor
      does it have affinity for the receptors of any neurotransmitter. It is as
      effective therapeutically as the older antidepressants but it produces
      considerably fewer side effects than the traditional antidepressants such as
      amitriptyline. Citalopram appears to have minimal effects on the cardiovascular
      system and to be one of the few antidepressants to be eliminated to any extent by
      the kidneys. These characteristics may be an advantage in treating elderly
      patients with major depressive disorder, or those patients unable to tolerate the
      anti-cholinergic side effects of the traditional antidepressants.

PMID- 8473719
TI  - Differential effects of lorazepam and oxazepam on priming.
AB  - The effects of lorazepam (2 mg), oxazepam (30 mg) and placebo on performance in
      implicit and explicit memory tasks were compared in a double-blind, independent
      group study with 36 healthy volunteers. Both benzodiazepines (BZs) impaired
      performance on the explicit task (free recall). However, only lorazepam impaired
      performance of the implicit task (word-stem completion). A similar pattern of
      drug effects was observed on a secondary task which used different instructions
      at stimulus presentation. BZ effects on the explicit task were more associated
      with levels of sedation (indexed by finger tapping speed) than their effects on
      the implicit task. It is concluded that both BZs impair episodic memory but only
      lorazepam impairs priming.

PMID- 8473720
TI  - The effects of moclobemide on psychomotor performance and cognitive function.
AB  - Sixteen young male volunteers received single doses of moclobemide 200 mg,
      moclobemide 400 mg, amitriptyline 50 mg and placebo in a double-blind crossover
      study. Subjects then completed a test battery which is sensitive to the effects
      of psychoactive drugs at 1, 2, and 4 h post-dose. The test battery included tasks
      of choice reaction time, tracking, critical flicker fusion threshold and memory
      scanning. Subjective feelings were assessed using the Leeds sleep evaluation
      questionnaire (LSEQ) and line analogue rating scales (LARS). The results show
      that the positive internal control (amitriptyline) has a sedative effect in that
      it increased critical flicker fusion threshold, reaction time and tracking error.
      Moclobemide 400 mg increased reaction time in the tracking task but neither dose
      of moclobemide impaired psychomotor performance or cognitive ability in any of
      the other tests.

PMID- 8473721
TI  - The prolactin response to d- and l-fenfluramine and to d-amphetamine in human
      subjects.
AB  - Twelve normal male volunteers took part in a double-blind placebo-controlled
      study to measure the effects of d- and l-fenfluramine singly and in combination
      with d-amphetamine on plasma prolactin levels. Both isomers of fenfluramine were
      found to differ significantly in their effects from d-amphetamine, and from
      placebo, causing prolactin levels to rise. d-Fenfluramine produced the greatest
      change. There were minor differences between the level of activity of the two
      drugs when given in conjunction with d-amphetamine. d-Amphetamine produced a non
      significant reduction in prolactin secretion. The neurochemical basis for the
      experimental findings reported is considered, with special reference to the use
      of d-fenfluramine as a specific serotonergic probe.

PMID- 8473722
TI  - The loss of appetite during depression with melancholia: a qualitative and
      quantitative analysis.
AB  - The loss of appetite occurring severe depression was investigated with an
      experimental method comparing the eating behaviour of 12 melancholic inpatients
      to 12 matched normal controls. Food intake and appetite, divided into more basic
      components such as desire to eat, hunger, satiety, prospective food consumption
      and pleasure from eating, were monitored during a test meal. Patients ate less
      than controls, but the difference was not significant. The pattern resulting from
      the temporal tracking of the appetite ratings indicated that patients were
      disturbed at the beginning of the meal and showed a decreased desire to eat,
      hunger and prospective food consumption and an increased satiety and that their
      pleasure from eating was diminished. These findings suggest that the loss of
      appetite induced by melancholia follows a specific pattern.

PMID- 8473723
TI  - Seizures induced by combined levomepromazine-fluvoxamine treatment.
AB  - We report a case of combined levomepromazine-fluvoxamine treatment-induced
      seizures. It seems that combined treatment of fluvoxamine with phenothiazines may
      possess proconvulsive activity.

PMID- 8473724
TI  - Clozapine-lithium combined treatment and agranulocytosis.
AB  - A case report of clozapine-induced agranulocytosis in a patient treated
      concomitantly with lithium is reported. The possible role of lithium in the
      mechanism of clozapine myelosuppression is discussed.

PMID- 8473725
TI  - Psychosis following readministration of diethyl proprion: a possible role for
      kindling?
AB  - The case of an organic psychosis following the readministration of an amphetamine
      like anorexiant is described. Previous therapeutic use of the same drug 2 years
      earlier was without adverse effect. Similar phenomena have been reported with
      other drugs, and both behavioural sensitization and kindling are possible
      explanations. The latter, however, provides a parsimonious explanation, a
      therapeutic rationale, and brings together seemingly disparate laboratory and
      clinical phenomena.

PMID- 8473726
TI  - Class II-restricted presentation of a hen egg lysozyme determinant derived from
      endogenous antigen sequestered in the cytoplasm or endoplasmic reticulum of the
      antigen presenting cells.
AB  - A cDNA encoding a form of hen egg lysozyme (HEL) lacking a leader sequence and
      predicted to be localized in the cytoplasm, was transfected into MHC class II
      positive B lymphoma cells. Cytoplasmically expressed HEL (cytHEL) had a half-life
      of less than 5 min and did not react with HEL specific mAb suggesting non-native
      conformation. Cells expressing cytoplasmic HEL, as well as cells previously
      reported to express a low level of HEL retained in the endoplasmic reticulum
      (ERHEL), constitutively presented the HEL determinant encoded by residues 46-61
      to a sensitive class II-restricted T hybridoma (3A9). Constitutive presentation
      of HEL determinants was not detectable in cytHEL or ERHEL transfectants using T
      hybridomas with lower sensitivity to exogenous Ag. Constitutive presentation of
      HEL46-61 derived from cytoplasmic HEL was demonstrable in multiple transfected
      clones and was most obvious when a CMV rather than SV40 promoter was used to
      express the cytHEL gene. The presentation of HEL46-61 by cytHEL transfectants was
      not due to HEL reuptake by bystander cells because there was no biochemical
      evidence of cytHEL shedding and cytHEL supernatants added to indicator APC did
      not result in HEL46-61 presentation. Constitutive presentation of endogenous
      HEL46-61 by the cytHEL and ERHEL transfectants was inhibited by chloroquine, and
      recovery of presentation of endogenous HEL was slower in cytHEL compared with
      ERHEL transfectants. The findings indicate that class II-restricted presentation
      of Ag retained in the cytoplasm or endoplasmic reticulum does take place but
      probably requires abundant levels of intracellular Ag and is easily disrupted by
      lysosomotropic agents. These pathways of presentation may be important when high
      levels of foreign endoplasmic reticulum-retained or cytoplasmic Ag are present
      (e.g., viral infection), and during the acquisition of self-tolerance by highly
      sensitive developing T cells.

PMID- 8473727
TI  - An essential role for Langerhans cell-derived IL-1 beta in the initiation of
      primary immune responses in skin.
AB  - Langerhans cells (LC) are Ag-presenting cells required for induction of primary
      immune responses in skin. After activation by Ag, LC express increased levels of
      MHC class II Ag, exhibit increased accessory cell activity, and migrate to
      regional lymph nodes where they stimulate T cells. One of the earliest
      manifestations of LC activation is the accumulation of increased amounts of IL-1
      beta mRNA in LC within 15 min after exposure to contact allergens in vivo. To
      determine if enhanced IL-1 beta production by LC could be causally linked to
      epicutaneous sensitization, we injected IL-1 beta intradermally into the ears of
      BALB/c mice and extracted total epidermal RNA 4 h later. A quantitative reverse
      transcriptase-polymerase chain reaction technique was used to compare changes in
      IL-1 alpha, IL-1 beta, macrophage inflammatory protein 2, IL-10, TNF-alpha, and 1
      A alpha chain mRNA signals caused by intradermally-injected IL-1 beta to those
      caused by intradermal IL-1 alpha or TNF alpha, or by topical application of the
      contact allergen trinitrochlorobenzene (3% TNCB). Intradermal injection of 25 ng
      IL-1 beta resulted in 5-to 100-fold enhancement of mRNA signals for IL-1 alpha,
      IL-1 beta, MIP-2, IL-10, TNF alpha, and class II I-A alpha, mimicking the changes
      caused by allergen. In contrast, injection of equivalent amounts of IL-1 alpha or
      TNF alpha did not significantly alter the epidermal cytokine pattern. Simulating
      the effects of topically applied TNCB, intradermally-injected IL-1 beta (but not
      IL-1 alpha or TNF alpha) also caused enhancement of LC MHC class II expression.
      In addition, LC derived from IL-1 beta-injected skin were 2 to 3 times more
      potent accessory cells in an anti-CD3 proliferation assay than LC from IL-1 alpha
      or sham-injected skin. Finally, injection of hamster anti-mIL-1 beta mAb into the
      skin prior to TNCB treatment completely prevented sensitization to this allergen,
      although injections of similar amounts of hamster anti-mIL-1 alpha mAb or PBS
      were without effect. Taken together, our data indicate that dendritic cell
      derived IL-1 beta may be a critical molecule required for initiation of primary
      immune responses in skin.

PMID- 8473728
TI  - Aberrant induction of T cell tolerance in B cell suppressed mice.
AB  - Self-tolerance is the process by which the T cell repertoire develops without
      expressing self-reactive specificities. The mechanisms which functionally
      eliminate self-reactive T cells are clonal deletion and clonal inactivation, and
      both of these phenomena have been studied in T cell populations reactive to
      endogenous superantigens that are encoded by endogenous mouse mammary tumor
      proviruses (Mtv). The studies described here demonstrate that the kinetics of Etc
      1 (encoded by the Mtv-9 open reading frame gene)-mediated deletion are much
      slower than that seen for Mls 1a (encoded by the Mtv-7 open reading frame), and
      that Etc-1-reactive T cells are present in the periphery up to 2 wk after birth.
      The deletion of peripheral Etc-1-reactive T cells late in ontogeny indicates an
      efficient mechanism of peripheral clonal deletion in these animals. The clonal
      deletion of Etc-1-reactive cells is abrogated in B cell-suppressed animals;
      however, clonal elimination of peripheral V beta 5+ or V beta 11+ (Etc-1
      reactive) T cells can be induced when these mice are allowed to recover their B
      cell population after cessation of anti-mu treatment. Finally, we establish that
      peripheral Etc-1-reactive V beta 11+/CD4+ T cells remaining in B cell-suppressed
      and recovering animals are markedly less responsive to stimulation through the
      TCR than are control T cells. These data support the idea that peripheral self
      reactive T cells can be rendered tolerant by two mechanisms which may be
      temporally related. This model suggests that clonal hyporesponsiveness may be
      followed by clonal deletion.

PMID- 8473729
TI  - Modulation of in vivo immune response by selective depletion of neutrophils using
      a monoclonal antibody, RP-3. I. Inhibition by RP-3 treatment of the priming and
      effector phases of delayed type hypersensitivity to sheep red blood cells in
      rats.
AB  - Recent studies on neutrophils have revealed that these cells produce various
      cytokines, and may be involved in regulation of the immune response. We examined
      whether neutrophils are involved in delayed type hypersensitivity (DTH) to SRBC
      in rats by selective depletion of in vivo neutrophils using a mAb designated RP
      3. When the rats had been treated with RP-3 at the time of priming with SRBC, DTH
      to these cells was inhibited. Furthermore, RP-3 treatment was effective in
      inhibiting the effector phase of the DTH response to SRBC. When spleen cells from
      rats that had been treated with RP-3 at the time of immunization were used for
      local transfer of DTH, footpad swelling was significantly less than that induced
      by spleen cells from the RP-3-untreated immune rats.

PMID- 8473730
TI  - Modulation of in vivo immune response by selective depletion of neutrophils using
      a monoclonal antibody, RP-3. II. Inhibition by RP-3 treatment of mononuclear
      leukocyte recruitment in delayed-type hypersensitivity to sheep red blood cells
      in rats.
AB  - We demonstrated in our previous paper that treatment of rats with RP-3, a mAb
      that depletes in vivo neutrophils selectively, resulted in inhibition of both the
      priming and effector phases of delayed type hypersensitivity (DTH) to SRBC. In
      order to clarify the mechanisms of this phenomenon, we examined the effect of RP
      3 treatment on mononuclear leukocyte (MNL) recruitment in DTH. When rats had been
      treated with RP-3 at the time of Ag priming, MNL migration, which accompanies
      DTH, was inhibited. The prior infiltration of neutrophils was also partially
      required for MNL recruitment because migration was inhibited when the immune rats
      were treated with RP-3 at the time of DTH elicitation.

PMID- 8473731
TI  - Cross-linking of B cell receptor-related MB-1 molecule induces protein tyrosine
      phosphorylation in early B lineage cells.
AB  - Cross-linking of surface B cell Ag receptor (BCR) induces tyrosine
      phosphorylation of BCR-associated components through a receptor-mediated signal
      transmission pathway. B cell-specific mb-1 and B29 genes encode the alpha/beta
      components of the BCR-associated complex in mature sIgM+ B cells. Here, we
      studied the involvement of the mb-1 gene product, MB-1, in the BCR-related
      structure of immature B cells. Affinity-purified anti-MB-1 antibody
      coprecipitated mu chain/20-kDa/15-kDa proteins together with monomer MB-1 and Ig
      alpha/Ig-beta heterodimer components from digitonin lysates of the pre-B cell
      line 18.81. The monomer MB-1 and Ig-alpha in the pre-B cell line were shown to
      migrate with identical patterns in nonequilibrium pH gradient gel
      electrophoresis/SDS-PAGE. Western blot analysis showed that MB-1 protein is
      coprecipitated with mu chain from the pre-B cell line. We studied the tyrosine
      phosphorylation response of bone marrow B lineage cells as well as spleen B cells
      after cross-linking of BCR-related components with anti-mu, anti-kappa, and anti
      MB-1 antibodies. We identified the activation of tyrosine kinase by direct cross
      linking of MB-1 expressed on the surface of early B lineage cells. Anti-mu
      antibody stimulation induced the activation of tyrosine kinase in early (5- to 10
      min) and late (30- to 120-min) responses in bone marrow early B lineage cells.
      Anti-MB-1 mAb (11-18-5) induced the late response exclusively but anti-kappa
      antibody induced only the early response. These results clearly indicate that MB
      1 acts in the BCR-mediated signal transmission in early B lineage cells. To
      explore the molecular mechanism of protein tyrosine phosphorylation in bone
      marrow B lineage cells, we studied associated components of the BCR complex by
      using an in vitro kinase reaction and observed the phosphorylation of a 60-kDa
      protein in pre-B cell lines. The 60-kDa phosphoprotein coprecipitated with MB-1
      and the BCR-related complex is very similar to the Src-type Fyn tyrosine kinase
      or a Fyn-related protein.

PMID- 8473732
TI  - Acquired resistance to superantigen-induced T cell shock. V beta selective T cell
      unresponsiveness unfolds directly from a transient state of hyperreactivity.
AB  - TCR V beta selective T cell activation and systemic release of T cell-derived
      lymphokines causing lethal shock in D-galactosamine (D-Gal)-sensitized mice
      depicts only one facet of in vivo challenge with the superantigen staphylococcal
      enterotoxin B (SEB). An immediate second major aspect represents the induction of
      peripheral unresponsiveness in SEB-reactive V beta 8+ T cells. SEB causes in vivo
      within 4 h resistance to an otherwise lethal challenge with SEB plus D-Gal, as
      well as to a challenge with the heterologous ligand toxic shock syndrome toxin 1
      plus D-Gal. Contrary to the first challenge, no serum-borne IL-2 and TNF are
      discernible during the second challenge. On the other hand, kinetic analyses in
      vitro of LN cells draining the site of the first in vivo challenge indicate that
      SEB-reactive T cells develop via a transient state of hyperreactivity into a
      profound state of ligand-specific unresponsiveness. Yet unresponsive V beta 8+ T
      cells express IL-2R and are responsive to the growth-promoting effect of IL-2.
      Cyclosporin A does not impair sequential induction of hyperreactivity and
      unresponsiveness with concomitant IL-2R expression, but effectively blocks
      systemic IL-2 and TNF release during the initial hyperreactive phase. Taken
      together, the in vitro data imply that ligand-specific hyperreactivity followed
      immediately by ligand-specific unresponsiveness represents a hallmark of in vivo
      challenge with the superantigen SEB. The in vivo data suggest the existence of
      additional suppressive elements masking the ligand specificity of the state of
      unresponsiveness induced by SEB.

PMID- 8473733
TI  - Profound deletion of mature T cells in vivo by chronic exposure to exogenous
      superantigen.
AB  - It has been noted previously that superantigens can under different circumstances
      stimulate activation, expansion, anergy, and/or deletion of reactive T cells in
      vivo and in vitro. Here, we present a detailed examination of the expansion and
      deletion of T cells in vivo in response to the superantigens staphylococcal
      enterotoxin A (SEA) in the B10.BR mouse. Mice were either acutely or chronically
      exposed to varying doses of SEA, and the relative level of T cells bearing SEA
      reactive V beta elements was followed over time in lymphocytes purified from
      peripheral blood, lymph nodes, mesenteric lymph nodes, and spleen. In most cases,
      an initial sharp rise in the proportion of reactive T cells was followed by a
      dramatic decline. Cells of the CD4+ and CD8+ lineages displayed subtle
      differences in their kinetics of activation and deletion, as well as their
      sensitivity to different doses of SEA. Furthermore, cells bearing either of two V
      beta elements previously characterized as SEA-reactive showed some differences in
      their responses to SEA treatment. Acute exposure usually caused the disappearance
      of only 50% to 70% of reactive T cells; however, chronic exposure to SEA caused
      almost complete deletion of target T cells. Deletion was evident even in animals
      treated with very low doses of SEA, doses that were too small to cause any
      apparent T cell proliferation. Thus, proliferation does not appear to be a
      prerequisite for peripheral deletion of T cells.

PMID- 8473734
TI  - Strain-dependent leakiness of mice with severe combined immune deficiency.
AB  - Mice with immunodeficiency provide an excellent in vivo model for cell transfer
      experiments. In this study, we compare the extent of immune deficiency of the
      original CB17 severe combined immune-deficient (SCID) mice with that of two other
      strains of immune-deficient mice, the recently developed C3H SCID mice and the
      beige/nude/X-linked immune-deficient (BNX) mice. Detectable levels of serum lg
      (higher than 0.4 microgram/ml) were found in 79% of CB17 SCID mice studied (n =
      24) and in all BNX mice (n = 12); some leaky CB17 SCID mice had normal levels of
      Ig. In contrast, only 15% of C3H SCID mice (n = 61) had detectable serum lg; the
      highest Ig level in this strain was 9.6 micrograms/ml. Age had no effect on serum
      Ig concentrations of C3H SCID mice; in contrast, all old (> 1-year-old) CB17 SCID
      mice studied had detectable levels of serum Ig. Transfer of syngeneic, normal,
      neonatal thymocytes increased serum Ig of SCID mouse origin to near-normal levels
      in all CB17 SCID mice but had no effect on serum lg concentrations in C3H SCID
      mice. Treatment with anti-asialo-GM-1 antiserum to abrogate NK cell activity
      increased serum Ig levels in 37% of CB17 SCID mice but had no effect on Ig
      production in C3H SCID mice. Flow cytometric analysis failed to identify mature T
      or B cells in C3H SCID mice; in contrast, some leaky CB17 SCID mice had
      detectable numbers of T and B cells in the peritoneal cavity. After immunization
      with bacteriophage phi X 174, neither C3H nor CB17 SCID mice, including leaky
      mice, produced specific antibody to phage. In contrast, BNX mice produced small
      but significant amounts of anti-phage antibody. These results indicate that, of
      the three strains of immune-deficient mice, C3H SCID mice have the most severe
      immune defect. We predict that C3H SCID mice will be best suited for cell
      transfer experiments.

PMID- 8473735
TI  - Photoaffinity labeling of the T cell receptor on living cytotoxic T lymphocytes.
AB  - Using a direct binding assay based on photoaffinity labeling, we have studied the
      interaction of an antigenic peptide with MHC class I molecules and the TCR on
      living cells. Two photoreactive derivatives of the H-2Kd (Kd) restricted
      Plasmodium berghei circumsporozoite (PbCS) peptide 253-260 (YIPSAEKI) were used.
      The first derivative contained an N-terminal photoreactive iodo, 4-azido
      salicyloyl (IASA) group and biotin on the TCR contact residue Lys259 [IASA
      YIPSAEK(biotin)I]. As previously described, this derivative selectively bound to
      and labeled the Kd molecule. The second photoreactive compound, the isomeric
      biotin-YIPSAEK(IASA)I, also efficiently bound to the Kd molecule, but failed to
      label this protein. A CTL clone derived from a mouse immunized with this
      derivative recognized this conjugate but not the parental P. berghei
      circumsporozoite peptide or the [IASA-YIPSAEK-(biotin)I] derivative in an Kd
      restricted manner. Incubation of the cloned CTL cells with biotin-YIPSAEK(IASA)I,
      but not its isomer, followed by UV irradiation resulted in photoaffinity labeling
      of the TCR-alpha chain that was dependent on the conjugate binding to the Kd
      molecule. The TCR labeling was partially inhibited by anti-LFA 1 and anti-ICAM1
      mAb, but was increased by addition of beta 2m or soluble KdQ10. The exquisite
      labeling selectivity of the two photoprobes opens a new, direct approach to the
      molecular analysis of antigen presentation and recognition by living CTL.

PMID- 8473736
TI  - p21ras function is important for T cell antigen receptor and protein kinase C
      regulation of nuclear factor of activated T cells.
AB  - In T cells, signals initiated at the TCR, and in particular activation of protein
      kinase C (PKC), can activate the p21ras proteins. Triggering of the TCR and PKC
      is required for the efficient production of the T cell growth factor, IL-2. IL-2
      gene transcription is controlled by a 275-bp enhancer that is known to contain
      binding sites for many transcription factors including the octamer family of
      proteins, NF kappa B, AP-1, and a T cell-specific factor, NFAT (nuclear factor of
      activated T cells). NFAT binds to a region of the IL-2 enhancer that has been
      defined as a TCR response element (ARRE-2), and is induced in response to
      increases in intracellular calcium, stimulation of PKC, or triggering of the TCR.
      To determine whether p21ras is involved in the signals that regulate NFAT, we
      examined the effect of expression of a constitutively active p21ras mutant, v-Ha
      ras, and a dominant inhibitory mutant of p21ras, c-Ha-ras(asn)17, on the
      induction of a NFAT-driven reporter gene (NFAT CAT) during T cell activation. The
      constitutively active Ras mutant could synergize with the calcium ionophore
      ionomycin to induce NFAT. In addition, expression of p21v-Ha-ras could enhance
      NFAT CAT induction in response to TCR and PKC agonists. The dominant inhibitory
      mutant of p21ras could prevent NFAT CAT expression in response to PKC or TCR
      triggering. These data show that Ras regulates NFAT, and that p21ras function is
      important for the TCR- and PKC-regulated pathways that regulate NFAT.

PMID- 8473737
TI  - Differential nuclear expression of enhancer A DNA-binding proteins in human first
      trimester trophoblast cells.
AB  - In order to investigate the possible molecular regulatory mechanisms that repress
      classical HLA class I and stimulate nonclassical HLA-G and E-class I gene
      transcription in human trophoblast cells, we searched for the nuclear expression
      of the enhancer A DNA-binding proteins of the KBF1/NF-KB/rel family. Using both
      purified extravillous cytotrophoblast and villous syncytiotrophoblast from first
      trimester human placenta, it appeared that members of this family were present in
      the cytotrophoblast and absent in the syncytiotrophoblast. First, using the
      double stranded enhancer A DNA nucleotidic sequence that contains the palindromic
      KB site, known to be the binding site of the p50 subunits of KBF1-NF-KB and c-rel
      factors, we demonstrated, by band-shift assay, that binding activity, inhibited
      by addition of anti-p50 polyclonal serum, was present in cytotrophoblast as well
      as control maternal decidual cells, embryonic fibroblasts, and the trophoblast
      derived JAR cell line. In contrast, this DNA-protein complex was undetectable in
      syncytiotrophoblast nuclear extracts. The specificity of this protein-DNA complex
      was further demonstrated by its disappearance upon competition with an excess of
      cold homologous nucleotidic competitor. Other nucleoprotein complexes were also
      detected in all nuclear extracts, including syncytiotrophoblast, that were
      competed out by an excess of cold enhancer A competitor DNA but were not affected
      by the addition of anti-p50 or anti-NF-KB sera, suggesting the presence of
      additional enhancer A-binding factors different from the KBF1/NF-KB/rel family.
      Second, using a Western immunoblot analysis, a doublet around 85 kDa was
      specifically stained by the same anti-p50 serum in cytotrophoblast, maternal
      decidual cells, embryonic fibroblasts, and the JAR nuclear extracts whereas no
      signal was obtained in syncytiotrophoblast. Finally, immunofluorescence cell
      staining using the same anti-p50 serum showed a positive staining in both
      cytoplasm and nucleus of cytotrophoblast and its absence in syncytiotrophoblast.
      We hypothesize that this enhancer A DNA-binding factor might represent the c-rel
      trans-acting factor, related to p50/KBF1/NF-KB proteins, and we discuss its
      possible relevance to the HLA class I transcription in human tissues.

PMID- 8473738
TI  - Isolation and characterization of a novel B cell activation gene.
AB  - Using subtractive cDNA cloning, we have isolated a series of cDNA clones that are
      differentially expressed between B and T lymphocytes. Whereas some of the
      isolated cDNA are from known B cell-specific genes, many of them represent
      previously uncharacterized genes. One of these unknown genes was denoted as BL34.
      Northern blot analysis performed with the BL34 cDNA revealed a 1.6-kb mRNA
      transcript that was present at low levels in RNA extracted from resting B
      lymphocytes, but whose expression was markedly increased in RNA prepared from
      mitogen-activated B cells. Similarly, RNA prepared from several B cell lines
      treated with phorbol myristate acetate (PMA) contained high levels of BL34 mRNA.
      In contrast, RNA from purified T cells treated with phytohemagglutinin and PMA
      had undetectable amounts of BL34 mRNA. In addition, high levels of BL34 mRNA were
      detected in RNA purified from PBMC of a patient with B cell acute lymphocytic
      leukemia. Southern blot analysis of human DNA from various tissues and cells
      lines demonstrated that BL34 is a single-copy gene without evidence of
      rearrangement. Two full length BL34 cDNA were sequenced, and an open reading
      frame of 588 bp was identified that was predicted to encode for a 196 amino acid
      protein. Searches of several protein data bases failed to find any homologous
      proteins. To directly analyze the expression of BL34 mRNA in lymphoid tissues in
      situ, hybridization studies with human tonsil tissue sections were performed.
      BL34 mRNA was detected in a portion of the cells in the germinal center region
      and adjacent to the mantle region. Further characterization of the BL34 gene and
      its protein should lead to insights to its role in B cell function and the
      consequences of its over-expression in acute lymphocytic leukemia.

PMID- 8473739
TI  - The role of viral enhancer "core" motif-related sequences in regulating T cell
      receptor-gamma and -delta gene expression.
AB  - T cells express clonally distributed alpha beta or gamma delta Ag receptor
      heterodimers. Transcriptional enhancers for the genes of all four subunits are
      active in both gamma delta and alpha beta T cells, but are less active or
      inactive in other cells. Conserved sequence motifs are present in all four
      enhancers, suggesting that common transcription factors regulate TCR gene
      expression. One of these motifs in the gamma 3 site of the TCR-gamma enhancer is
      similar to motifs found in several other lymphoid-specific and viral enhancers.
      This conserved "core" sequence is present in the enhancers of Moloney and SL3-3
      murine leukemia viruses, important for transcription in T cells and in
      determining disease specificity. Here we characterize the gamma 3 site of the
      gamma enhancer and a corresponding homologous site, delta E3, of the TCR-delta
      enhancer. Our results suggest that the core site is critical for activity of the
      200-bp gamma enhancer fragment and of the gamma 3 and delta E3 sites.
      Furthermore, we identify a nuclear factor in human T cell lines that specifically
      binds the core region in these and several other core-containing enhancers. This
      factor may be identical to or related to a purified bovine nuclear core binding
      factor that binds the core region of the Moloney murine leukemia virus enhancer,
      gamma 3 and delta E3 sites, suggesting that similar proteins regulate the TCR
      gamma, delta and Moloney murine leukemia virus enhancers. Other sequences in the
      gamma 3 site upstream of the core sequence are also critical for activity in T
      cells, suggesting that at least two different factors are required for functional
      activity of the gamma 3 site.

PMID- 8473740
TI  - Autoantibodies in Chagas' disease. An antibody cross-reactive with human and
      Trypanosoma cruzi ribosomal proteins.
AB  - Sera from 102 patients with chronic Chagas' disease were studied for the presence
      of autoantibodies to intracellular proteins and nucleic acids by three different
      methods. Only four sera had autoantibodies detected by indirect
      immunofluorescence on HEp-2 cells. All of the sera were negative for anti-dsDNA,
      anti-Ro/SSA, anti-La/SSB, anti-Sm and anti-RNP autoantibodies but 12 (12%) of the
      sera had low to moderate levels of anti-histone antibodies. When Chagas sera were
      tested for autoantibodies to a total HeLa cell extract by Western blotting, weak
      reactivity was observed in 31 sera. Despite significant heterogeneity in the
      protein Ag targeted by these sera, seven recognized a 23-kDa protein. Strong
      binding to this 23 kDa protein was observed in one-third of the sera when
      isolated ribosomes were used as source of Ag. In contrast, no autoreactivity was
      detected with ribosomal proteins P0, P1, and P2. These findings confirm the
      presence of autoantibodies in chronic Chagas' disease and indicate a remarkable
      restricted humoral immune response to human ribosomal proteins. Furthermore,
      affinity-isolated anti-23-kDa antibody cross-reacted with a Trypanosoma cruzi
      ribosomal protein of similar molecular weight. This molecular mimicry may be
      responsible for the apparent breakdown of self-tolerance resulting in tissue
      damage. Indeed, experiments demonstrating that immunization of mice and rabbit
      with T. cruzi ribosomes have been reported to induce myocarditis.

PMID- 8473741
TI  - IL-2 is necessary for the progression of leishmaniasis in susceptible murine
      hosts.
AB  - BALB/c mice are highly susceptible to disseminated infection with the
      intracellular protozoa Leishmania major. Progression of disease requires in vivo
      expansion of Th2 CD4+ lymphocytes and is reversed by treatment with anti-IL-4
      monoclonal antibody. Inasmuch as IL-2 may be necessary for both the production of
      IL-4 and differentiation of Th2 cells, the possible contribution of IL-2 to
      progressive infection was examined. Four weekly injections of anti-IL-2 mAb
      (S4B6) cured more than 80% of BALB/c mice infected with L. major, as determined
      by diminished footpad swelling and decreased numbers of parasites in infected
      tissues. Multiple doses of S4B6 were necessary for benefit; a single dose given
      at the time of infection was ineffective. The anti-IL-2R mAb PC61 demonstrated a
      similar protective effect when administered twice weekly for 4 wk. Anti-IL-2
      mediated cure of cutaneous leishmaniasis was associated with increased IFN-gamma
      and decreased IL-4 production by regional lymph node cells compared to untreated
      BALB/c mice with progressive illness. Both CD4+ and CD8+ T lymphocytes
      contributed to the increased expression of IFN-gamma mRNA in cured mice. These
      data suggest that levels of IL-2 suboptimal for Th2 expansion in vivo do not
      inhibit Th1 CD4+ and CD8+ T cell activation and IFN-gamma synthesis. Other
      cytokines or activation pathways that are either IL-2-independent or synergistic
      with low levels of IL-2 may account for the appearance of curative T cell
      responses during treatment with anti-IL-2 antibodies.

PMID- 8473742
TI  - Differential expression of IgE and IgG4 specific antibody responses in
      asymptomatic and chronic human filariasis.
AB  - A population of 164 adult individuals resident in an area endemic for Brugia
      malayi lymphatic filariasis has been studied for humoral immune responses to
      filarial parasites. Antibody levels to Ag extracted from adult worms were
      determined for each of the IgG subclasses, for IgM and for IgE. The dominant
      isotype of antifilarial antibody was IgG4, which represented 88% of total IgG in
      asymptomatic microfilaremics, most of whom possessed 100 to 1000 micrograms/ml of
      specific antibody of this subclass (geometric mean 762 micrograms/ml). Patients
      with chronic disease (elephantiasis), who were generally amicrofilaremic, had
      substantially higher levels of IgG1, IgG2, and IgG3, but a 3.4-fold lower
      geometric mean level of specific IgG4 (222 micrograms/ml) than asymptomatics with
      or without microfilaremia. In contrast, specific IgE antibody levels in cases of
      elephantiasis were on average 4.5 times higher than those found in the
      asymptomatic carrier state. The majority of microfilaremics were therefore
      typified by extremely high specific IgG4 concentrations and relatively low IgE
      reactivities, whereas clinical cases tended to show the reverse relationship. The
      possible roles of these isotypes and the implications of changing IgG4/IgE
      balances in disease are discussed.

PMID- 8473743
TI  - Ity influences the production of IFN-gamma by murine splenocytes stimulated in
      vitro with Salmonella typhimurium.
AB  - The Ity-Lsh-Bcg genetic locus in the mouse has been documented to confer innate
      resistance to at least three intracellular pathogens: Salmonella typhimurium,
      Leishmania donovani, and Mycobacterium. Expression of the resistance gene(s)
      results in a slower net growth of these pathogens in the reticuloendothelial
      system early postinfection. Although it is clear that the resident macrophages in
      resistant mice are functionally superior with regard to antimicrobial activity,
      the exact mechanism(s) underlying the control exerted by this gene is not
      understood. Using S. typhimurium infection as a model, we have examined the
      influence of this resistance gene(s) on the production of IFN-gamma, a cytokine
      known to play an important role in host-defense against several intracellular
      pathogens. We compared IFN-gamma production by splenocytes from resistant
      (Ity(r)) and sensitive (Ity(s)) inbred mouse strains after stimulation in vitro
      with S. typhimurium. Spleen cells from Ity(r) mouse strains produced
      significantly higher levels of IFN-gamma when compared to spleen cells obtained
      from Ity(s) mouse strains. Enhanced IFN-gamma production was not a generalized
      response to bacteria. Listeria monocytogenes induced comparable levels of IFN
      gamma production from both Ity(r) (CBA/J) and Ity(s) (C57BL/6) mice. Splenocytes
      from Ity congenic mouse strains displayed similar differences in the level of IFN
      gamma produced after S. typhimurium stimulation, with spleen cells from the
      Ity(r) strain producing significantly higher levels of IFN-gamma when compared to
      spleen cells from the Ity(s) strain. A requirement for adherent cells and/or
      adherent cell-derived factors has been documented for IFN-gamma production by S.
      typhimurium-stimulated splenocytes. Interestingly, supernatant from adherent
      cells obtained from Ity(r) mouse strains was found to induce the production of
      significantly higher levels of IFN-gamma when compared to adherent cell
      supernatant from Ity(s) strains. Nylon wool nonadherent cells from Ity(s) mouse
      strains produced high levels of IFN-gamma when exposed to supernatants obtained
      from adherent cells of Ity(r) mouse strains. In contrast, nylon wool nonadherent
      cells from Ity(r) mouse strains produced reduced levels of IFN-gamma when exposed
      to supernatant obtained from adherent cells of Ity(s) mouse strains. Thus,
      modulation of IFN-gamma production appears to be a function of the Ity(r)
      gene(s). This study documents for the first time that the Ity locus may play a
      role in controlling resistance to Salmonella infection by regulating IFN-gamma
      production by NK cells.

PMID- 8473744
TI  - Salmonella typhimurium induces IFN-gamma production in murine splenocytes. Role
      of natural killer cells and macrophages.
AB  - IFN-gamma is a cytokine known to play an important role in host defense against
      Salmonella typhimurium. The lymphoid cells required for in vitro production of
      IFN-gamma after S. typhimurium stimulation of mouse spleen cells was
      investigated. Spleen cells depleted of cells bearing NK1.1, asialo GM1, Thy 1.2,
      or CD5 resulted in a significant reduction in IFN-gamma production after
      stimulation with S. typhimurium. In contrast, Con A-induced IFN-gamma production
      was only slightly reduced after depletion of NK1.1- or asialo GM1-bearing cells.
      Spleen cells from SCID mice produced elevated levels of IFN-gamma after
      stimulation with S. typhimurium. IFN-gamma production by SCID spleen cells was
      dependent upon asialo GM1+ T cells, suggesting that NK cells were the cells
      producing IFN-gamma in response to S. typhimurium. Splenic adherent cells were
      required for optimal IFN-gamma production. However, direct contact between the
      adherent and nylon wool nonadherent (NWNA) cell populations was not essential.
      IFN-gamma production was observed when the adherent and NWNA cell populations
      were physically separated or when supernatant from S. typhimurium-stimulated
      adherent cells was added to NWNA cells. Optimal IFN-gamma production was
      dependent on the presence of TNF-alpha, inasmuch as addition of antibody to TNF
      alpha to spleen cell or NWNA cell cultures significantly reduced IFN-gamma
      production. However, addition of rTNF-alpha did not induce IFN-gamma production
      by NWNA cells. These findings document the existence of a T-independent mechanism
      for early IFN-gamma production in response to S. typhimurium, and show that TNF
      alpha is necessary but not sufficient for the production of IFN-gamma.

PMID- 8473745
TI  - Toxoplasma gondii induces a T-independent IFN-gamma response in natural killer
      cells that requires both adherent accessory cells and tumor necrosis factor
      alpha.
AB  - Spleen cells from scid mice produce high levels of IFN-gamma when exposed to
      either live tachyzoites of Toxoplasma gondii or a soluble parasite extract. Small
      numbers of parasites are sufficient to stimulate this response, which is also
      induced by cell-free supernatants of cultured tachyzoites. The parasite molecules
      responsible for triggering IFN-gamma production are heat-labile but resistant to
      freezing and thawing. Depletion of NK cells or adherent cells from the splenocyte
      population abolishes the response. Moreover, cultured bone marrow-derived NK
      cells are stimulated by Toxoplasma to produce IFN-gamma, but only when
      supplemented with adherent peritoneal washout or thioglycollate-induced exudate
      cells. Supernatants of macrophages preincubated with T. gondii extract also
      induce IFN-gamma synthesis by cultured NK cells. Addition of neutralizing mAb
      against TNF-alpha abolishes the IFN-gamma response of scid spleen cells exposed
      to the parasite or of NK cells incubated with supernatants of adherent cells
      stimulated with T. gondii extract. Moreover, splenic adherent cells produce low
      levels of TNF-alpha in response to the parasite. Nevertheless, TNF-alpha alone is
      not sufficient to trigger IFN-gamma production from purified NK cell populations.
      These findings provide the first example of the stimulation of T-independent IFN
      gamma production by a protozoan. The ability of T. gondii to trigger this pathway
      may underlie its induction of strong IFN-gamma-dependent nonspecific and specific
      cell-mediated immunity.

PMID- 8473746
TI  - Regulation of expression of IL-1 receptor antagonist protein in human synovial
      and dermal fibroblasts.
AB  - The IL-1R antagonist protein (IRAP) is a competitive inhibitor of IL-1, which is
      predominantly synthesized by monocytes. We show that this molecule is also
      expressed in human synovial fibroblasts and dermal fibroblasts (CRL 1445). IRAP
      mRNA was regulated in a time- and dose-dependent manner by IL-1 alpha, TNF-alpha,
      LPS, and PMA. Maximal induction of IRAP mRNA was observed between 8 and 16 h
      after stimulation with IL-1 alpha (1 U/ml), TNF-alpha (10 U/ml), LPS (50 ng/ml),
      and PMA (10 ng/ml). Their relative efficacy was as follows: PMA > LPS > IL-1
      alpha > TNF-alpha. Potentiation was observed when fibroblasts were treated with
      IL-1 alpha plus basic fibroblast growth factor and IL-1 alpha plus platelet
      derived growth factor-BB homodimer. Although LPS and PMA were the best inducers
      of IRAP mRNA, quantitation of the IRAP protein revealed that its synthesis and
      release were differentially regulated. Immunoprecipitation and SDS-PAGE of
      culture supernatant from LPS-treated cells and cell lysates of fibroblasts
      treated with LPS or PMA showed a single IRAP band with a molecular mass of
      approximately 22 kDa. Very little IRAP was detected in culture supernatants of
      cells treated with PMA. Quantitation of IRAP revealed that LPS induced the
      synthesis of secreted IRAP that was released, whereas the majority of the protein
      induced by PMA remained cell-associated. Reverse transcriptase-polymerase chain
      reaction amplification demonstrated that although LPS and PMA induced both
      transcripts, LPS preferentially induced secreted IRAP, whereas PMA differentially
      induced intracellular IRAP mRNA. Fibroblasts synthesize at least two different
      forms of IRAP depending on the inducing signal, and may regulate the inflammatory
      response by dampening the proinflammatory effects of IL-1 via a negative feedback
      mechanism with IRAP. The relative importance of fibroblast sIRAP vs intracellular
      IRAP in regulating the inflammatory response by the connective tissue remains to
      be determined.

PMID- 8473747
TI  - Anti-KCA-3, a monoclonal antibody reactive with a rat complement C3 receptor,
      distinguishes Kupffer cells from other macrophages.
AB  - A new mAb, designated anti-KCA-3, was developed against rat Kupffer cells. The
      reactivity of anti-KCA-3 was restricted to macrophages with preferential binding
      to Kupffer cells; only a few macrophages in the spleen, lymph nodes, lungs, and
      intestine stained with the antibody. A very small number of peritoneal resident
      and exudate macrophages reacted with the antibody and no reactivity was seen
      within the thymus, skin, heart, kidneys, brain, peripheral blood, and bone
      marrow. KCA-3 was expressed predominantly by the Kupffer cells in the periportal
      region rather than in the centrilobular region of the hepatic lobules. The cells
      in the portal tract did not stain with the antibody. The staining of the
      cytosmears and FACS analysis of the Kupffer cell fraction isolated from hepatic
      sinusoidal cells by centrifugal elutriation revealed that as many as 62% and 49%
      of the cells were stained with anti-KCA-3, respectively. Immunoelectron
      microscopic study of the liver indicated that expression of KCA-3 on Kupffer
      cells was limited to the plasma membrane facing the sinusoid rather than the
      space of Disse. Immunoprecipitation and SDS-PAGE analysis demonstrated KCA-3 to
      have a m.w. of approximately 50 kDa under both reducing and nonreducing
      conditions. After treatment of KCA-3 with N-glycanase, there was no significant
      change in the m.w., indicating KCA-3 was not highly glycosylated. C3b- and iC3b
      mediated rosette formation between Kupffer cells and sensitized SRBC was
      inhibited by the antibody, implying that KCA-3 functioned as a complement C3
      receptor or complement receptor-associated molecule. Furthermore, KCA-3 was
      eluted from C3b-Sepharose but not HSA-Sepharose after incubation with Kupffer
      cell lysate, indicating that KCA-3 directly binds C3b. The cell distribution,
      ligand-binding specificity, and biochemical properties of the protein were found
      to be different from the complement C3 receptors previously described. Because
      OX42 (antibody reactive with the rat CR3 receptor) inhibited complement C3
      mediated rosette formation with peritoneal resident macrophages but not with
      Kupffer cells, the findings suggest that C3-mediated binding to Kupffer cells and
      to peritoneal macrophages is mediated by two different receptors. We conclude
      that anti-KCA-3 recognizes a novel type of complement C3 receptor preferentially
      expressed on Kupffer cells.

PMID- 8473748
TI  - Picolinic acid, a catabolite of L-tryptophan, is a costimulus for the induction
      of reactive nitrogen intermediate production in murine macrophages.
AB  - In this study we investigated the effects of picolinic acid, a catabolite of L
      tryptophan, on the production of L-arginine-derived reactive nitrogen
      intermediates in the murine macrophage cell line ANA-1. ANA-1 macrophages did not
      produce nitrite (NO2-) constitutively, but accumulated detectable levels of NO2-
      on exposure to IFN-gamma. Picolinic acid, although ineffective by itself,
      augmented IFN-gamma-induced NO2- production. The activity of picolinic acid was
      evident at 1 mM and reached its maximum at 4 mM. Picolinic acid also augmented
      the IFN-gamma-dependent expression of TNF-alpha mRNA, but did not appreciably
      affect the secretion of the TNF-alpha protein. Neutralizing concentrations of
      anti-TNF mAb completely abrogated IFN-gamma- and IFN-gamma plus rTNF-alpha
      induced NO2- production in ANA-1 macrophages, but only decreased by approximately
      50% the synergistic interaction between IFN-gamma and picolinic acid. Although IL
      4 inhibited the expression of IFN-gamma plus picolinic acid-induced TNF-alpha
      mRNA and protein, it only partially suppressed picolinic acid-dependent NO2-
      production. Therefore, picolinic acid may affect NO2- production via both TNF
      alpha-dependent and TNF-alpha-independent pathways. Overall, this study suggests
      that amino acid catabolites may be important for the activation and the
      expression of effector functions by murine macrophages, and provides the first
      evidence of a possible connection between tryptophan and arginine metabolism.

PMID- 8473749
TI  - Complement factors H and I synthesized by B cell lines function to generate a
      growth factor activity from C3.
AB  - B lymphocytes and transformed B lymphoblastoid cell lines express CR2 (CD21,
      C3d/EBV-receptor) that is specific for C3 fragments generated by cleavage of C3b
      or spontaneously hydrolyzed native C3 (C3i) by the serum enzyme factor I and its
      cofactor, factor H. It had been shown previously that the Raji B cell line could
      be cultivated in serum-free medium supplemented with only transferrin and either
      OKB7 anti-CR2 mAb, C3d, or C3d-derived peptides containing the CR2 binding site.
      Because these agents appeared to function through ligation of CR2, it was unclear
      how native C3 could also serve as a growth factor, because C3 does not bind to
      CR2. It appeared possible that Raji cells might be able to use endogenous factors
      H and I to generate a CR2 ligand from C3, because previous studies had shown that
      Raji cells synthesized factor H and probably also synthesized factor I. PCR
      analysis was used to demonstrate factor I mRNA in Raji cells. Secretion of Raji
      cell factor I protein was confirmed by a sensitive mAb ELISA. Several B cell
      lines were examined for C3-dependent growth. Raji cells required both C3 (or
      OKB7) and transferrin for growth, whereas Wil-2 cells grew with transferrin alone
      and C3 enhanced the growth-promoting activity of transferrin. Two other B cell
      lines (Daudi and U698M), the T cell line 8402, and the U937 monocytoid cell line
      could not be sustained with transferrin plus C3. The C3-dependent growth of Raji
      cells was inhibited almost completely by either OX-23 anti-factor H or 052.11.3
      anti-factor I mAb that also blocked the activity of serum-derived factor H or I,
      respectively. By contrast, there was no inhibition of growth by either OX-24 anti
      factor H or OX-21 anti-factor I mAb that did not block factors H and I activity.
      After the spontaneous hydrolysis of native C3 to C3i, it is hypothesized that
      Raji cells convert C3i to iC3i with endogenous factors H and I, and then this
      iC3i serves as a growth factor by binding to membrane CR2.

PMID- 8473750
TI  - Heterologous desensitization of the high affinity receptor for IgE (Fc epsilon
      R1) on RBL cells.
AB  - To study the properties of Fc epsilon RI desensitization induced by aggregation
      of that receptor, RBL cells were sensitized with a mixture of two different IgE
      mAb to create two different populations of IgE-receptor complexes. Cross-linking
      of one receptor population containing anti-dinitrophenyl (DNP) IgE with a
      bivalent Ag, 1-DNP-amino-12-biotinamidododecane)2-avidin ((DNP)2-avidin), results
      in desensitization of a subsequent response, both of the same receptor population
      (homologous desensitization) and of the second receptor population containing
      anti-5-dimethylaminonaphthalene-1-sulfonyl (dansyl) IgE (heterologous
      desensitization). The extent of heterologous desensitization is dependent on
      several parameters, including the concentration of both the first and the second
      Ag and the densities of the respective IgE populations. Heterologous
      desensitization of the Ca2+ response is more sensitive to the concentration of
      the second stimulus (dansyl-BSA) than heterologous desensitization of the
      degranulation response. AlF4-, which activates GTP-binding proteins, can
      effectively replace (DNP)2-avidin as the initial stimulant and desensitizing
      agent. Other agents that mobilize intracellular Ca2+ including thrombin and a
      Ca2+ ionophore are less effective at replacing (DNP)2-avidin. Because
      prestimulation with Ag does not desensitize subsequent responses to AlF4- or Ca2+
      ionophore, it appears that signal transduction via Fc epsilon RI is impaired at
      an early step. Addition of monovalent DNP hapten within approximately 10 min
      after cross-linking by (DNP)2-avidin completely prevents the desensitization of
      the subsequent Ca2+ or degranulation response to dansyl-BSA. After longer times
      of incubation with DNP Ag, the DNP hapten becomes increasingly less effective at
      preventing the desensitization of the dansyl-BSA response, even though ongoing
      signal transduction by the DNP Ag is halted. These results suggest a form of
      cellular memory for the desensitized state.

PMID- 8473751
TI  - Diverse T cell receptor V beta gene usage in the central nervous system in
      experimental allergic encephalomyelitis.
AB  - The repertoire of TCR V beta genes transcribed and expressed within the central
      nervous system was determined in mice with experimental allergic
      encephalomyelitis. Disease was induced in (PL/J x SJL/)F1 mice by immunizing with
      myelin basic protein-acetylated peptide 1-11, and mice were sacrificed at
      intervals from day 3 postimmunization to 3 wk after recovery from disease.
      Transcription of V beta genes was determined by reverse transcriptase polymerase
      chain reaction on RNA extracted from spinal cord, and expression of the V beta
      gene products was detected by immunohistochemistry with mAb specific for various
      V beta proteins. Multiple V beta genes were found to be transcribed and expressed
      in the central nervous system starting 7 days after immunization, and continuing
      up to 3 wk after clinical recovery. Preferential utilization of a single TCR V
      beta gene was not detected in the central nervous system at any time in the
      course of disease.

PMID- 8473752
TI  - Functional and molecular characterization of tumor-infiltrating lymphocytes
      transduced with tumor necrosis factor-alpha cDNA for the gene therapy of cancer
      in humans.
AB  - TNF is effective in causing the regression of selected murine tumors when
      administered at high concentrations. Therapeutic levels in humans cannot be
      obtained systemically, however, because of dose-limiting toxicity. The
      development of immunotherapy with IL-2 and tumor-infiltrating lymphocytes (TIL),
      which can accumulate at tumor sites in some patients, and of efficient retroviral
      techniques for gene transfer into eukaryotic cells has allowed new therapeutic
      approaches using TNF. We have retrovirally transduced human TIL with the gene for
      TNF in an attempt to deliver high concentrations of TNF to the tumor site without
      dose-limiting systemic toxicity. Successful gene insertion was confirmed by
      Southern hybridization in 16 of 16 transduced and selected TIL cultures from 15
      different patients, with an estimated 28 to 93% transduced cells within each
      culture. Transduced selected TIL cultures produced greater amounts of TNF,
      compared with nontransduced controls, in 11 of 16 cultures evaluated. However,
      overall production of TNF was > 30-fold lower, compared with a transduced and
      highly selected tumor cell line control (MEL-TNF). In addition, steady state
      levels of vector-derived transcript in nine of 10 transduced selected TIL
      cultures were < 14% of the amount seen in the MEL-TNF control line. In an attempt
      to increase TNF production, TIL were transduced with a mutated form of TNF
      containing the IFN-gamma signal peptide in place of the transmembranous region,
      to enhance secretion into the endoplasmic reticulum. By using this vector, TNF
      production increased by an average of fivefold. These studies demonstrate that
      TIL can be genetically modified to express and secrete a protein for use in
      targeted cancer therapy but that partial expression blockades exist that prevent
      maximal cytokine production by introduced genes in TIL.

PMID- 8473753
TI  - Superantigen can reactivate bacterial cell wall-induced arthritis.
AB  - Intravenous injection of toxic shock syndrome toxin-1 (TSST-1) produced by
      Staphylococcus aureus, can reactivate arthritis in a rat ankle joint that has
      been previously inflamed by injection of peptidoglycanpolysaccharide polymers
      isolated from the cell walls of group A streptococci. The severity and chronicity
      of this renewed arthritis is dose dependent and at higher doses (125
      micrograms/kg) a prolonged joint inflammation with pannus formation and marginal
      erosion of cartilage and bone is induced after a single injection of TSST-1. Only
      modest synovial hyperplasia is induced in control ankle joints by systemic
      injection of TSST-1. Another superantigen, streptococcal pyrogenic exotoxin
      induces a much weaker, acute reactivation of arthritis that resolves by 2 days.
      Repeated injections of TSST-1 at 7-day intervals give the same undiminished
      pattern of joint response, but the joint swelling persists at a higher level with
      each succeeding injection. Cyclosporin A suppresses all phases of the recurrent
      arthritis, indicating that TSST-1 could be functioning through its property of a
      superantigen activating T lymphocytes. II-1 receptor antagonist and anti-TNF
      alpha neutralizing antibody, which reduce reactivation of arthritis by
      peptidoglycan-polysaccharide polymers, have no effect on reactivation by TSST-1.
      This experimental model provides a means to examine in vivo the possible role of
      superantigens in rheumatoid arthritis and related diseases, and to analyze the
      cellular and molecular pathways induced by this family of microbial products.

PMID- 8473754
TI  - lpr T cells are necessary for autoantibody production in lpr mice.
AB  - Mice homozygous for the gene Ipr develop a spectrum of autoantibodies closely
      resembling that of human SLE. Previous work has shown that the lpr defect must be
      expressed in the T cells that hyperproliferate and in the B cells that produce
      autoantibodies. Although autoantibody production in lpr mice requires T cells, it
      is not known whether these need to be lpr T cells. To ask whether normal (+/+) T
      cells can help lpr B cells produce autoantibodies, we have constructed chimeras
      containing mixtures of lpr-derived and normal-derived lymphoid cells, and have
      selectively eliminated the lpr-derived T cells by in vivo treatment with
      monoclonal anti-Thy-1 of the appropriate allotype. A mixture of T cell-depleted
      bone marrow from congenic strains of normal and lpr mice differentially marked by
      Ig H chain allotype and Thy-1 alleles was transferred into lethally irradiated
      lpr mice. The mice received weekly injections of either anti-Thy-1.2 to deplete
      specifically lpr T cells or an isotype-matched irrelevant control mAb. Absence of
      lpr-derived T cells in the experimental group was documented by
      immunofluorescence. In mice treated with control antibody, autoantibodies of Ipr
      origin were present in high titers, as determined by allotype-specific ELISA. In
      contrast, mice depleted of lpr-derived T cells had greatly reduced titers of
      antichromatin and rheumatoid factor. These mice also had increased levels of
      serum total IgM and IgG2a of +/+ origin. Parallel experiments were performed
      using a combination of two lpr marrow sources, also differentially marked by Ig H
      chain allotype and Thy-1 expression. Mice depleted of Thy-1.2-bearing T cells
      produced autoantibodies of both allotypes due to the presence of Thy-1.1-bearing
      T cells of Ipr origin. These data indicate that autoantibody production in lpr
      mice requires expression of the lpr gene in those T cells that provide help.

PMID- 8473755
TI  - Susceptibility to inflammatory disease in HLA-B27 transgenic rat lines correlates
      with the level of B27 expression.
AB  - To investigate the role of the class I MHC molecule HLA-B27 in the
      spondyloarthropathies, we produced rats transgenic for HLA-B27 and human beta 2
      microglobulin. Of five lines bearing > 1 copy of each transgene and showing
      hemizygous expression of both transgenes, two (lines 21-4H and 33-3) developed
      spontaneous inflammatory disease that closely resembled B27-associated human
      disease. Two lines, 21-4L and 25-6, remained healthy even when homozygous for the
      transgene locus, whereas the 21-3 line, bearing the third highest transgene copy
      number, developed disease similar to that of the 21-4H and 33-3 lines only when
      homozygous for the transgene locus. The disease-prone lines showed higher
      expression of B27--thymic mRNA in utero, splenic mRNA by 5 days of age, and
      splenic cell surface protein by the time of disease onset--than the disease
      resistant lines. Disease susceptibility thus appeared to correlate with gene copy
      number and the quantity of B27 in lymphoid cells. The increase in the amount of
      B27 protein did not appear to be simply a consequence of the inflammatory disease
      because 1) there was no similar change in endogenous RT1 class I expression; 2)
      no alteration of B27 expression occurred in 21-4H rats with adjuvant-induced
      arthritis; 3) in rats with inflammatory disease transgenic for HLA-A2 and the 21
      4H transgene locus, A2 expression was the same as in healthy rats transgenic for
      A2 but not B27; and 4) the transgenes in disease-prone and disease-resistant
      lines were equally susceptible to induction by IFN-gamma. Immunocytochemistry of
      the distal colon, an early site of inflammation, showed that the B27 Ag is
      expressed at high levels in cells of the lamina propria, but not at all in
      colonic epithelial cells. Taken together, the data suggest that the B27 transgene
      is expressed in a copy number dependent, position-independent manner in lymphoid
      tissue and that disease results from the expression of B27 above a critical
      threshold level.

PMID- 8473756
TI  - Increased IL-6 production and IL-6-mediated Ig secretion in murine host-vs-graft
      disease.
AB  - BALB/c mice neonatally injected with semiallogenic (A/J x BALB/c)F1 splenocytes
      develop a host-vs-graft (HVG) reaction between host T cells and donor B cells,
      resulting in hypergammaglobulinemia, splenomegaly, and increased serum levels of
      various autoantibodies. This syndrome is associated with a polyclonal activation
      of the donor-derived B cells. High serum levels of IL-6 were found in 4-wk-old
      mice undergoing HVG disease (mean +/- SEM, 132 +/- 93 as compared with 12 +/- 2
      in control mice, p < 0.05). Also supernatants of spleen cell cultures from HVG
      mice contained increased levels of IL-6. In situ hybridization and cell depletion
      experiments demonstrated that host macrophages were responsible for this
      pathologic IL-6 secretion. The spontaneous in vitro production of autoreactive
      antibodies by donor B cells from HVG mice was further enhanced by adding human
      rIL-6, whereas addition of human rIL-1 beta, human rIL-2, murine rIL-4, murine
      rIL-5, or combinations of these cytokines had no effect. Finally, addition of
      blocking anti-IL-6 and anti-IL-6 receptor mAb markedly reduced hyper IgG1
      production in cultures of spleen cells from HVG mice. These data suggest that an
      increased production of IL-6 by persistently stimulated host macrophages is
      involved in the activation of donor B cells leading to HVG disease.

PMID- 8473757
TI  - Enhanced IL-1 beta and tumor necrosis factor-alpha release and messenger RNA
      expression in macrophages from idiopathic pulmonary fibrosis or after asbestos
      exposure.
AB  - Idiopathic pulmonary fibrosis (IPF) and asbestosis are fibrotic interstitial lung
      diseases characterized by alveolar wall fibrosis with accumulation of
      extracellular matrix, interstitial remodeling, and increased numbers of activated
      alveolar macrophages. Animal models and in vitro studies have shown that
      macrophage cytokines, namely IL-1 beta and TNF-alpha, play significant roles in
      the development of fibrosis. We found significant increases for TNF-alpha release
      in both diseases (p < 0.01) and a significant increase for IL-1 beta release in
      asbestosis compared to normal controls (p < 0.01). Also, the mRNA expression of
      these cytokines was increased in alveolar macrophages from patients with IPF or
      asbestosis compared with normals. The level of TNF-alpha release in macrophage
      supernatants correlated with the number of neutrophils per milliliter
      bronchoalveolar lavage fluid returned. Chrysotile, crocidolite, amosite asbestos,
      and silica stimulated IL-1 beta and TNF-alpha release and up-regulated their
      respective mRNA in macrophages or monocytes. To evaluate the role of IL-1 beta
      and TNF-alpha in the accumulation of extracellular matrix, we studied collagen
      types I and III and fibronectin gene expression in human diploid lung fibroblasts
      after short term (2 h) serum-free exposure to recombinant cytokines. Both
      cytokines up-regulated these genes 1.5- to 3.6-fold. These cytokines have the
      potential to influence the remodeling and fibrosis observed in the lower
      respiratory tract in IPF and asbestosis.

PMID- 8473758
TI  - Fluconazole resistance in Candida in patients with AIDS--a therapeutic approach.

PMID- 8473759
TI  - Candidaemia: risk factors in patients with cystic fibrosis who have totally
      implantable venous access systems.
AB  - Patients with cystic fibrosis who have totally implantable venous access devices
      often have other consequences of their multi-system disease which predispose them
      to catheter-associated systemic infection. We describe four episodes of fungaemia
      in three patients. Each case presented with persistent fever during an acute
      respiratory exacerbation. The four episodes were successfully treated, but
      removal of the venous access device was necessary in each case. Identified risk
      factors for systemic fungal injection were: combinations of a severe background
      respiratory deficiency; an acute respiratory exacerbation; malnutrition; repeated
      and frequent broad spectrum antibiotic therapy; parenteral nutrition; and
      diabetes mellitus. Unexplained fever in high risk patients with cystic fibrosis
      who have indwelling venous access systems should be treated empirically with
      antifungal agents while awaiting blood culture results. If fungaemia is confirmed
      the venous access device must be removed. Daily prophylactic fluconazole may
      prevent recurrences.

PMID- 8473760
TI  - Treatment of Candida albicans fungaemia with fluconazole.
AB  - Sixty-five patients with Candida albicans fungaemia, admitted to intensive care
      units, were treated intravenously with fluconazole. All patients had at least one
      blood culture which was positive for C. albicans. The first group of 34
      consecutive patients received fluconazole at a dose of 5 mg/kg bodyweight/day and
      the subsequent 31 patients received 10 mg/kg/day. Thirty patients in each group
      were evaluated. The clinical response rate was 60% in the 5 mg/kg once daily
      group and 83% in the group which received 10 mg/kg/day. Eradication of C.
      albicans from the blood was achieved in all but two patients in the 5 mg/kg group
      and in all patients in the 10 mg/kg group. As regards other sites of infection,
      eradication was achieved in only nine of 25 cases from the 5 mg/kg group and in
      11 of 23 cases from the 10 mg/kg group. Death related to fungal infection
      occurred in eight patients receiving 5 mg/kg/day and in one patient receiving 10
      mg/kg/day. Fluconazole was reasonably well tolerated. Raised concentrations of
      liver enzymes were observed in 14 patients. Other adverse effects were fatigue,
      nausea, gastric pain, sleepiness and epileptic seizure. In conclusion,
      fluconazole at a dose of 10 mg/kg/day would seem to be an effective and safe drug
      for the management of C. albicans fungaemia.

PMID- 8473761
TI  - Application of the polymerase chain reaction to the diagnosis of human
      toxoplasmosis.
AB  - Toxoplasmosis may cause significant damage to the developing fetus and is a life
      threatening opportunistic infection in immunocompromised persons. Serological
      investigation is unreliable, while isolation of the parasite is time consuming
      and may lack sensitivity. We have developed a system for detecting Toxoplasma
      gondii based on the amplification of the P30 gene using sequential rounds of PCR
      and nested primers. The clinical value of this technique was assessed by the
      investigation of a range of tissues taken from pregnant women, fetuses, neonates,
      AIDS patients and organ graft recipients. The PCR assay produced more positive
      reactions than isolation of the parasite by means of cell culture or animal
      inoculation. Extended autoradiography was found to be more sensitive than stained
      agarose gels for detecting the PCR product. Systematic contamination of PCR
      reactions was avoided but it was not possible to exclude sporadic contamination
      in certain cases. Detection of specific DNA is of clinical value in the
      investigation of the pregnant woman in order to assess the risk of transplacental
      passage of infection and in the fetus and neonate to identify congenital
      toxoplasmosis. Even so, PCR findings must be interpreted with caution because of
      the risk of a sample being contaminated. PCR may be the investigation of choice
      when brain biopsy is performed on a patient with AIDS and when toxoplasmosis
      associated with bone marrow transplantation is suspected.

PMID- 8473762
TI  - Septic shock in critically ill patients: aetiology, management and outcome.
AB  - Over a period of 28 months, 45 episodes of septic shock from 83 episodes of
      bacteraemia were studied prospectively to evaluate their clinical profile,
      management and outcome. Thirty-six patients were studied, the overall incidence
      of septic shock being 54.2%. Gram-negative organisms accounted for 23 (51.1%) of
      such episodes, Gram-positive 17 (37.8%), and three episodes were polymicrobial
      (6.7%). The organisms isolated most frequently were Staphylococcus epidermidis
      (17.8%), Pseudomonas aeruginosa (13.3%), Escherichia coli and Klebsiella sp.
      (each 11.1%). Coagulation abnormalities were detected in 32 episodes (78%) and
      disseminated intravascular coagulation (DIC) occurred in 11 of these with high
      mortality. The most common underlying conditions were respiratory, hepatic and
      renal failures. The majority of these patients received crystalloids, colloids,
      vasopressor drugs and blood. Swan-Ganz catheters (SGC) were inserted on eight
      occasions, the majority of times indicating a hyperdynamic circulatory response.
      The overall mortality was 40%, despite aggressive management and intensive care.
      The most important factor in reducing mortality is early detection of bacteraemia
      and prompt management of these patients.

PMID- 8473763
TI  - Schistosomiasis in Leicester.
AB  - Twenty-two cases of schistosomiasis were diagnosed in the Infectious Diseases
      Unit in Leicester during a 5-year period. There were 11 cases of Schistosoma
      haematobium infection and three of S. mansoni infection. The schistosoma type in
      the remaining eight cases was uncertain. Fourteen asymptomatic family members of
      patients with proven schistosomiasis were screened and 6 (43%) had evidence of
      schistosomal infection. Seventeen (77%) of the patients were thought to have been
      infected in Malawi and all but one of these had swum in Lake Malawi. The study
      highlights the large proportion of cases who acquired infection in Malawi and
      emphasises the importance of family screening.

PMID- 8473764
TI  - Fatal disseminated adenovirus type 2 infection following bone marrow
      transplantation for Hurler's syndrome: a primary infection.
AB  - A 5-month-old girl given an allogeneic bone marrow transplant for Hurler's
      syndrome succumbed to fatal pneumonia 5 weeks after the transplant. Adenovirus
      type 2 was isolated from her urine before she died. Immunoperoxidase and electron
      microscopical studies of liver and lungs post mortem confirmed a disseminated
      adenovirus infection. The serological findings and the patient's young age
      suggested that the infection was a primary one. The importance of considering
      exogenous sources of adenovirus infection in bone marrow transplant recipients is
      discussed.

PMID- 8473765
TI  - Cardiac dysfunction in paediatric HIV infection.
AB  - A child under long term surveillance for vertically acquired HIV-I infection
      developed respiratory symptoms. Dilated cardiomyopathy was diagnosed. Clinical
      and echocardiographic assessment of six other children with symptomatic HIV
      disease showed no evidence of cardiac dysfunction. The exact prevalence of this
      complication in paediatric HIV infection is unknown, but the potential diagnostic
      difficulties are highlighted.

PMID- 8473766
TI  - Highly virulent Streptococcus pyogenes rheumatic pancarditis and fatal
      septicaemia with septic shock.

PMID- 8473767
TI  - Retained Hickman catheter cuff as a source of infection.
AB  - Two cases of Pseudomonas aeruginosa infection complicating retained subcutaneous
      Hickman catheter cuffs are described. Foreign body-associated Pseudomonas
      infection is unlikely to respond to treatment with antibiotics alone. We
      therefore recommend that the cuff is removed at the same time as the Hickman
      catheter is pulled out so as to prevent future infection.

PMID- 8473768
TI  - Disseminated blastomycosis masquerading as tuberculosis.
AB  - Two patients were mistakenly treated for several months for tuberculosis. Both
      had lung and vertebral involvement and one patient had superficial skin lesions
      as well. Blastomycosis was eventually confirmed by fungal culture, but only after
      both patients had deteriorated markedly; one died soon after treatment with
      amphotericin B was started. In Africa, blastomycosis is a relatively rare
      condition which can mimic tuberculosis; it is one of several infections which
      should be borne in mind when dealing with apparently non-responsive tuberculosis.

PMID- 8473769
TI  - Citrobacter diversus ventriculitis and brain abscesses in an adult.
AB  - A case of Citrobacter diversus brain abscesses following urinary infection in an
      adult is described. The patient was treated with surgical drainage, netilmicin
      and cefotaxime. Citrobacter species CNS infection is discussed.

PMID- 8473770
TI  - Primary amoebic meningo-encephalitis in southern Africa.
AB  - A fatal childhood case of confirmed primary amoebic meningo-encephalitis due to
      Naegleria fowleri is reported. This appears to be the first such case identified
      in southern Africa. The diagnosis and management of this unusual and lethal
      infection is discussed and attention is drawn to the possible danger of swimming
      in contaminated warm water.

PMID- 8473771
TI  - Haemophilus influenzae type b disease in north-west England.
AB  - A study was made in the north-west of England during 1989 in order to ascertain
      the incidence of serious Haemophilus influenzae infection, its short-term
      morbidity and certain characteristics of treatment. The incidence of culture
      proven infection was 28 per 100,000 children under 5 years of age. Case fatality
      was 3%, one of the deaths being in a 6-year-old child. Some of the information
      obtained will help to assess the cost-effectiveness of the new vaccine to be
      administered to children in the U.K. The mean length of stay in hospital for all
      cases was 10 days. Of a total of 87 patients, 20 (23%) were admitted to an
      intensive therapy unit while five were transferred from a district general
      hospital to a regional paediatric unit. The estimated average cost per episode of
      acute care was 2700 pounds. Antibiotic regimens varied considerably.

PMID- 8473772
TI  - Clenched fist actinomycosis in a penicillin-allergic female.

PMID- 8473773
TI  - Mycobacterium malmoense infection in an immunocompromised patient.

PMID- 8473774
TI  - Recurrent Mycobacterium bovis infection following a ferret bite.

PMID- 8473775
TI  - Rapid diagnosis of tuberculous meningitis.

PMID- 8473776
TI  - Enterovirulent Escherichia coli can cause bacteraemia in immunocompromised
      patients.

PMID- 8473777
TI  - Detection of verotoxin-producing strains of Escherichia coli.

PMID- 8473778
TI  - Serum albumin and other parameters in HIV infected intravenous drug users.

PMID- 8473779
TI  - [Evaluation of results following thymectomy in myasthenia gravis].
AB  - Sixty-nine patients with generalized myasthenia gravis underwent thymectomy
      consecutively between 1980 and 1991 and were evaluated 1 month to 120 months
      after operation. Extended thymectomy was performed in 43 patients and other
      procedures in 26. The effect of thymectomy were as follows: 14.5% of the patients
      achieved complete remission (no symptoms, no medication), 73.9% showed
      improvement; in total 88.4% had palliation. The long-term changes of the
      remission rate at one and five years after operation were 11.5% and 19.2%, and
      showed a delayed remission. The long-term changes of the improvement and
      palliation rate were 55.7% and 67.2% at one year, 69.2% and 88.5% at five years
      after operation. There was significant difference in remission rate according to
      age at the time of operation and age of onset, but the response did not depend on
      sex, presence or absence of thymoma, preoperative duration of illness, Osserman's
      type and operative procedure.

PMID- 8473780
TI  - [Mechanisms of organ failure following cardiopulmonary bypass--preventive effects
      of Ca2+ blocker (nicardipine)].
AB  - The causes of organ failure following cardiopulmonary bypass (CPB) were multi
      factorial. Damage was initiated by elastase which was released from activated
      granulocytes under conditions of significant reduction in the protease inhibitor
      level (p < 0.01). The increase in endothelin excretion observed during and after
      the CPB induced a further vasoconstrictive response in the microvasculature and
      accelerated ischemic cellular damage. Upon completion of the CPB, the elevation
      of the lysosomal enzyme beta-glucuronidase was influenced by the elastase and
      endothelin concentrations (r = 0.8 and r = 0.67 respectively). Renal damage,
      which was detected by an increase in renal tubular enzymes (N-acetyl-beta-D
      glucosaminidase and gamma-glutamyltranspeptidase), was affected by endothelin (r
      = 0.61, 0.75) and elastase concentrations (r = 0.74, 0.75) respectively. In the
      group treated with nicardipine during the CPB, an increase in beta-glucuronidase
      was significantly low (p < 0.01) and renal tubular damage was significantly
      reduced. Moreover, lesser elevation of the elastase level on arrival in the ICU
      was evidenced (p < 0.05). Thus we concluded that nicardipine inhibited the
      release of elastase from the activated neutrophils and prevented the
      vasoconstriction caused by the endothelin secretion.

PMID- 8473781
TI  - [Effectiveness of erythropoietin for cardiovascular surgery to prevent homologous
      blood transfusions].
AB  - Erythropoietin (EPO) was used preoperatively in 109 cardiovascular surgery cases
      to prevent homologous blood transfusions. Operative procedures in all these cases
      were coronary artery bypass grafting in 80 cases, valve replacement in 14, and a
      few cases of aortic vascular replacement or others, aging about average 62 years
      and weighing about average 54 kg. EPO was administered concomitantly with oral
      iron sulfate in the following three different manners; 100 units per body weight
      daily intravenously, 300 U./B.W. twice in a week intravenously, and 600 U./B.W.
      once in a week subcutaneously. Autologous blood donations were also performed as
      long as the blood hemoglobin levels were over 12 (g/dl) and repeated until the
      date of operation, and these blood deposits were returned to each patient at the
      time of operation. The blood hemoglobin level had increased on average from 12.6
      (+/- 1.5 SD) to 13.6 (+/- 1.2 SD) after 23 days (+/- 13 SD) administration of
      EPO, while autologous blood deposit of 536 ml (+/- 353 SD) was obtained.
      Homologous blood transfusions were unnecessary in 89% of all cases, especially
      good in 96.7% of the group with over 12 of hemoglobin level before EPO
      administration. However, it remained within 79.6% of those with lesser to 12, so
      there was still room for improvement in this anemic group. No adverse effects
      were recognized in all cases. It was concluded that preoperative use of EPO is
      efficient to promote autologous blood donation, and its application will be
      expanded to anemic cases. EPO could offer an excellent means of preventing
      homologous blood transfusion. Further study concerning the appropriate
      application of erythropoietin seems to be required.

PMID- 8473782
TI  - [Biventricular repair with a modified Glenn shunt for the hypoplastic right
      ventricle].
AB  - Between 1982 and 1990, 14 patients with small right ventricle underwent
      biventricular repair with a modified Glenn shunt. The patients consisted of 8
      cases of pulmonary atresia and intact ventricular septum, 2 with pulmonary
      stenosis and intact ventricular septum, 3 with tetralogy of Fallot, 1 with
      pulmonary atresia and straddling tricuspid valve. Nine patients had one or more
      prior preliminary palliative procedures. Repairs consisted of a modified Glenn
      shunt and closure of the intracardiac and extracardiac shunt, with right
      ventricular outflow reconstruction in 13, and pulmonary valvotomy in 1. In nine
      patients superior vena cava was not ligated. There was one operative death (7%).
      Preoperative RVEDV ranged from 19 to 70% of normal with a mean of 36.1% of
      normal. Preoperative pulmonary resistance ranged from 1.6 to 5.3 unit with a mean
      of 2.8 unit. Preoperative PA index ranged from 102 to 444 mm2/m2 with a mean of
      234.3 mm2/m2. No patients died later. Follow-up 2 to 9 year after operation
      showed that 9 patients were in the New York Heart Association class I and 4 were
      in class II. Our experience shows that this procedure can be safely done for
      patients, who have hypoplastic right ventricle smaller than 40% of normal and are
      not candidate for Fontan procedure because of high pulmonary vascular resistance
      and inadequate size of pulmonary artery. In this procedure a modified Glenn shunt
      without ligation of SVC may effectively reduce the volume overload on the right
      ventricle.

PMID- 8473783
TI  - [Surgical repair of total anomalous pulmonary venous drainage--four adult cases
      of successful operation].
AB  - We have experienced four adult cases of total anomalous pulmonary venous drainage
      (TAPVD). They were three females and one male, age between 18-51 with a mean of
      33.8. In Darling's classification, they constituted of three cases of type Ia and
      one type IV. Cardiac catheterization revealed 1.71-5.93 with a mean of 3.92 in
      Qp/Qs and 0.34-0.49 with a mean of 0.38 in Pp/Ps. The pulmonary to systemic
      resistance ratio (Rp/Rs) was then calculated as 0.02-0.15 with a mean of 0.09.
      All cases showed short route type of drainage vein in pulmonary arteriography.
      None of them had stenosis or obstruction in the drainage veins. The operation was
      composed of anastomosis between the left atrium and the common pulmonary vein,
      closure of the atrial septal defect (ASD), and ligation of the drainage vein.
      Gersony-Malm's method was adopted in two cases and the posterior approach in two
      cases in anastomoses between the left atrium and the common pulmonary vein.
      Intraatrial approach combined with posterior approach was tried in a case with
      small left atrium. The mean size of ASD was 43 mm (35-55 mm) in diameter. Patch
      closure was performed in three cases. Important factors in survival for adult
      TAPVD are large ASD and short route type drainage vein without stenosis. All of
      four cases had good results. The operation method is variable and an easier
      approach must be adopted.

PMID- 8473784
TI  - [Cerebral renal and hepatic tissue blood flow during retrograde inferior vena
      caval perfusion--an experimental study in dogs].
AB  - Cerebral tissue blood flow (CBF), renal tissue blood flow (RBF), hepatic tissue
      blood flow (HBF), and oxygen metabolism have been measured in 8 mongrel dogs
      which underwent hypothermic (20 degrees C) retrograde perfusion via the inferior
      vena cava (IVC). IVC perfusion was performed with aortic drainage and cross
      clamping of superior vena cava (SVC) at IVC pressures of 20 or 30 mmHg. CBF, RBF,
      and HBF at 30 mmHg of IVC pressure were 10.4 +/- 6.8, 11.4 +/- 5.5, and 19.2 +/-
      11.3 mL/min/100 g. These values were 33%, 47%, and 64% of those observed with a
      cardiopulmonary bypass and flow rate of 1000 mL/min, and 77%, 112%, and 168% of
      those observed with retrograde cerebral perfusion via the both internal maxillary
      veins at 25 mmHg of SVC pressure. Oxygen consumption at this time was 3.78 +/-
      1.77 mL/min. CBF, RBF, HBF, and oxygen consumption at 20 mmHg of IVC pressure
      were 7.7 +/- 4.8, 7.5 +/- 4.7, and 9.9 +/- 4.7 mL/min/100 g and 2.02 +/- 0.72
      mL/min, respectively. As IVC pressure increased, CBF, RBF, HBF, and oxygen
      consumption increased. However, high IVC pressure by the retrograde perfusion was
      associated with high portal venous pressure, which would cause ascites. IVC
      perfusion can supply some amount of blood flow to the liver and kidney. It may
      therefore be advantageous to maintain proper IVC pressure to protect the
      abdominal organs during systemic arterial circulatory arrest under deep
      hypothermia.

PMID- 8473785
TI  - [Effect of intravenous recombinant human superoxide dismutase on reducing
      reperfusion injury].
AB  - This study was performed to evaluate effects of recombinant human superoxide
      dismutase (r-hSOD) administered intravenously just prior to reperfusion on
      reduction of reperfusion injury by using regional left ventricular function
      recovery in quantitatively controlled reperfusion model. Mongrel dogs underwent 2
      hours of left anterior coronary artery clamping followed by 30 minutes of partial
      reperfusion (25% of control flow) and 30 minutes of full reperfusion (full
      opening of occluder). Regional left ventricular functions: % segmental shortening
      (%SS), % active shortening (%AS) = systolic shortening/total shortening, were
      evaluated during reperfusion. Dogs were divided into 2 groups, Control group and
      SOD group: r-hSOD was administered 100,000 Unit/kg in bolus intravenously before
      reperfusion. Measured left ventricular segments were classified by temperature
      drop in thermography into the central (> or = 2 degrees C) and the marginal (< 2
      degrees C) ischemic zones. In the central ischemic zone, the values of %SS before
      left anterior descending coronary artery clamping were 11% and 12% in Control and
      SOD groups, respectively. Just after occlusion of coronary artery, %SS dropped
      down to the range of -5% to -7% and kept the same level during ischemia. After
      partial reperfusion, there was no significant difference of %SS between Control
      and SOD groups, however, after full reperfusion, %SS of SOD group showed better
      improvement than that of Control group (p < 0.05). As for %AS in the central
      ischemic zones, the same tendency was present. In the marginal ischemic zone, the
      values of %SS went down when left anterior descending coronary artery was
      occluded.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473786
TI  - [Surgical treatment of double orifice mitral valve in atrioventricular septal
      defect].
AB  - Ten patients with double orifice mitral valve and atrioventricular septal defect
      (AVSD) were examined. There were four cases with incomplete type, three with
      intermediate type and three with complete type AVSD. All patients with incomplete
      type AVSD were doing well after the mitral cleft repair, Leaving the accessory
      orifice untouched. Various valve repair procedures and prosthetic valve
      replacement were performed in the patients with intermediate and complete types
      of AVSD with left-sided atrioventricular valve regurgitation. There were three
      operative deaths, which included one patient with the intermediate type and two
      with the complete type. All of them were one-month old babies and were operated
      on emergency. Their general operative findings were hypoplasia of the common
      atrioventricular valve leaflets, abnormal attachment of the chorda tendineae and
      papillary muscle dysplasia. These findings increased the difficulty of the valve
      plasty to control mitral regurgitation.

PMID- 8473787
TI  - [Composite valve graft replacement for aortic root aneurysm or dissection].
AB  - Fifty four patients who had aneurysms (n = 35) or dissections (n = 19) associated
      with aortic regurgitation underwent the replacement of the ascending aorta and
      aortic valve by composite valve graft during 15-year period between September
      1976 and December 1991. Of these, 49 (90.7%) patients had an annuloaortic ectasia
      and 26 (48.1%) had the Marfan syndrome. The methods of coronary artery
      reattachment to the graft were as follows: direct reattachment (original
      Bentall's technique) in 45 patients, aortic button technique (Carrel's patch
      technique) in 6, Cabrol's technique in 2 and Piehler's technique in 1 patients.
      Seven patients with a DeBakey type I dissection had concomitant replacement of
      the aortic arch with an aid of selective cerebral perfusion. The overall hospital
      mortality rate was 12.9%, and it has significantly decreased to 6.7% since we
      adopted a cold cardioplegia, preclotting the graft with albumin autoclave
      technique and coronary artery reattachment using conventional over-and-over and
      interrupted mattress sutures with pledgets during the last 10-years. The mean
      duration of follow-up period was 58.6 months. The actuarial survival rate at 10
      years for all patients was 76.4%; for those with dissection, 78.4%; and for
      patients with Marfan syndrome, 70.4%. Reoperation for the prosthesis-related
      complications was necessary in only one patient, although operations on the
      remainder of aorta were required in 5 patients. Actuarial freedom from these
      operations at 10 years was 74.1%, but it was 69.3% for the subgroup with Marfan
      syndrome. The present data indicates that composite valve graft technique is an
      useful method for patients with aortic root aneurysms or dissections.

PMID- 8473788
TI  - [The significance of body weight measurement of esophageal cancer patients in
      intra- and postoperative fluid administration].
AB  - We tried to clarify the intra- and postoperative pathological state in resected
      thoracic esophageal cancer patients and analyze the particularity of fluid
      administration by measuring body weight at certain time serially. We studied 26
      resected thoracic esophageal cancer patients between September, 1989 and January,
      1991 who underwent an operation through right thoracotomy prior to laparotomy at
      the same time, and all cases were under general anesthesia combined with epidural
      anesthesia. We measured body weight preoperatively, just after operation, on the
      first, second and third postoperative days by means of LIFTER (Ted Hoyer & Co.
      Inc), and also calculated water balance and measured pressures and cardiac output
      by Swan-Ganz catheter in 19 cases. As a result, change in body weight was
      remarkable in resected thoracic esophageal cancer patients intra- and
      postoperatively. The peak of weight gain was noticed and they gained about 3
      kilograms in weight on the 1st postoperative day, while in circulation
      hypovolemia was found on the data by means of Swan-Ganz catheter. There was a
      high correlation between rate of change in weight (kg/hr) and water balance
      (ml/kg/hr) (r = 0.91). We calculated insensible loss by the difference between
      water balance and body weight. It was about 1.73 intraoperatively, 0
      postoperatively, 0.35-0.5 ml/kg/hr on from the 1st through the 3rd postoperative
      day. It is concluded that body weight measurement is a very easy, precise and
      useful bedside technique in the intra- and postoperative fluid administration of
      esophageal cancer patients, because it is very important not only to understand
      the circulation volume but also to know the interstitial fluid change.

PMID- 8473789
TI  - [Participation of platelet activating factor in the pulmonary injury during
      cardiopulmonary bypass].
AB  - Activations of leukocytes and platelets have been considered to be one of the
      major harmful factors related to Adult Respiratory Distress Syndrome (ARDS). As a
      hypothesis of the present study, similar events may exaggerate the post perfusion
      lung syndrome following the cardiopulmonary bypass (BPB). Since platelet
      activating factor (PAF) is a strong activator of leukocytes and platelets, we
      measured the kinetics of PAF level, number of leukocytes and platelets in 20
      anesthetized dogs. beta-TG and PF4 were also measured in patients with organic
      heart disease before and after CPB. We also studied the preventive effects of PAF
      antagonist (CV-3988) on the postperfusion lung injury in dogs. The PAF activities
      increased twice 5 minutes after the beginning of CPB, then it was progressively
      increased to a level 4.5 times at the end of CPB. Circulating numbers of
      leukocytes and platelets depleted sharply after the CPB, and then decreased
      gradually. Such depletion was not modified by PAF antagonist, CV-3988.
      Accumulation of leukocytes at the pulmonary circulation, and the microscopic
      evidence of leukocyte sequestration in pulmonary capillary beds were noted in
      cases without PAF antagonist. Rapid increases of beta-TG and PF45 minutes after
      the beginning of CPB also showed that activation of platelets occurs immediately.
      Adhesion of activated leukocytes or platelets to the pulmonary capillary bed in
      dog cases may suggest the ensuring damage to the vascular beds by releasing free
      radicals, lysosomal enzymes, or other chemical mediators. Restriction of inflow
      rate of activated leukocytes to the lung or the heart before aortic clamping may
      attenuate harmful effects of leukocytes on the respiratory function related to
      the CPB.

PMID- 8473790
TI  - [A clinical trial of recombinant human superoxide dismutase for myocardial
      protection].
AB  - This study explored the effect of recombinant human superoxide dismutase (rh-SOD)
      for the prevention of reperfusion injury and the myocardial protection in open
      heart surgery. Fifty one patients undergoing cardiac valve replacements were
      divided into the following four groups; group I (n = 14), 50 ml of saline was
      administered through the aortic root into the coronary artery a few minutes prior
      to reperfusion; group II (n = 14), rh-SOD (10000 U/kg) was administered as the
      same manner as the group I; group III (n = 13), rh-SOD (10000 U/kg) was
      administered into the cardiopulmonary circuit a few minutes prior to reperfusion;
      group IV (n = 10), rh-SOD (3000 U/kg) was administered as the same manner as the
      group III. They received continuous perfusion of cold blood and GIK solution
      every 30 minutes. Arterial blood samplings for Creatine phosphokinase MBisozyme
      (CPK-MB), alpha-hydroxy lactic acid dehydrogenase (HBDH), thiobarbituric acid
      reactive substance (TBA) were measured up to 24 hours after the reperfusion. CPK
      MB values at 12 and 24 hours after reperfusion, and HBDH value at 12 hours after
      the reperfusion in group II were significantly lower than those in group I. CPK
      MB and HBDH levels in group III were lower than group I without statistically
      significant differences. TBA levels in group II at 9 and 12 hours after the
      reperfusion were lower than these in group I. TBA levels were not statistically
      different in group I, III and IV. These results suggest that administration of rh
      SOD at the time of reperfusion may be required to prevent reperfusion injury in
      open heart surgery.

PMID- 8473791
TI  - [Surgical treatment of aortic valve regurgitation associated with Behcet's
      disease].
AB  - We experienced a patient of aortic valve regurgitation associated with Behcet's
      disease. The patient underwent aortic valve replacement. There are 15 cases of
      valvular heart disease associated with Behcet's disease including this reported
      case. Patients often have perivalvular leakage after valve replacement because
      not only the aortic but also the surrounding aortic walls become inflamed from
      the effects of Behcet's disease. We treated our patient to prevent complication.
      The aortic valve was fixed from the outside of a 2/3 round aortic wall using a
      teflon strip. The operation was performed when the inflammatory signs and
      findings subsided, and an adrenal steroid was used after the operation.
      Satisfactory results were obtained, but since Behcet's disease is systemic
      progressive and chronic disease, strict observation of the patients and systemic
      controls of inflammation should be recommended continuously.

PMID- 8473792
TI  - [A case of T-cell type malignant lymphoma of the lung].
AB  - A case of T-cell type malignant lymphoma of the lung was reported. A 69-year-old
      woman was referred to our institute because of an abnormal shadow on the chest
      roentgenogram. She was symptom-free, and physical examination showed no
      abnormalities. Her laboratory tests were within normal limits. The chest
      roentgenogram showed a well-defined, nodular density in the left lower lung field
      without air bronchogram. She underwent a left lower lobectomy and a mediastinal
      lymphnodes dissection. This disclosed an elastic hard nodule, 2 cm in diameter,
      without pleural invasion. Pathologically the tumor was diagnosed as malignant
      lymphoma of T-cell type without regional lymphnode involvement. She is doing well
      without any sings of recurrence for one year after the operation.

PMID- 8473793
TI  - [A case report of a chronic traumatic thoracic aneurysm].
AB  - A successful experience of a case with chronic traumatic thoracic aneurysm is
      reported. A 51-year-old male patient had a history of a blunt chest trauma in a
      traffic accident one and a half year ago. He developed gradual hoarseness because
      of the recurrence nerve paralysis. Computed tomography and angiography revealed a
      saccular aneurysm at thoracic descending aorta. It was treated with direct
      closure of the tear under partial clamp of the aorta. His postoperative course
      was excellent. He is doing well two years after operation.

PMID- 8473794
TI  - [A case of mitral regurgitation caused by total rupture of the posterior
      papillary muscle after acute myocardial infarction].
AB  - We observed a case of severe mitral regurgitation caused by total rupture of the
      posterior papillary muscle 13 days after acute myocardial infarction. The patient
      was a 76-year-old man who suddenly felt anterior chest pain. He was admitted to
      another hospital with the diagnosis of acute myocardial infarction.
      Electrocardiogram suggested a posterior infarction. He did well during the first
      12 days of hospitalization, but at noon on the 13th day he developed anterior
      chest pain and dyspnea. Echocardiography demonstrated rupture of the posterior
      papillary muscle. He was subsequently transferred to our hospital with acute
      heart failure. He was initially treated with an intra-aortic balloon pump.
      Cardiac catheterization demonstrated 99% stenosis of segment 2 of the right
      coronary artery and mitral regurgitation, Sellers' stage IV. Intraoperative
      findings included total rupture of the posterior papillary muscle. Mitral valve
      replacement was performed using a Carbomedics prosthetic valve. The patient was
      discharged 53 days after surgery without heart failure or angina pectoris. This
      case represents the 6th successful operation of total papillary muscle rupture in
      Japan.

PMID- 8473795
TI  - [A case of the successful treatment of pulmonary artery pseudoaneurysm after PA
      banding].
AB  - Pulmonary artery pseudoaneurysm after PA banding is a rare complication and its
      mortality is very high. The authors successfully operated on this sort of lesion.
      To our knowledge, this is the first successful case in Japanese literature. The
      second of twins was found to be suffering asplenia, dextro cardia, TAPVC,
      atrioventricular septal defect, corrected TGA and PDA. On the 19th day of life,
      increasingly pulmonary congestion forced us to operate. We performed PDA
      ligation, correction of TAPVC, together with extrathoracically adjustable PA
      banding. 5 months following this operation, spike fever and swelling of anterior
      thorax were noted. PA angiography was performed, and it showed that the pulmonary
      artery had been cut through by the band and a pseudoaneurysm had developed. The
      PA banding was removed and an end-to-end anastomosis of the PA was performed
      using cardiopulmonary bypass and deep hypothermia with surface cooling. The
      diameter of the PA anastomosis was designed to be one half that of her aorta.
      Staphylococcus aureus was cultured from the specimen of the PA band. It was
      thought to have contributed to the development of this aneurysm. The post
      operative course was uneventful.

PMID- 8473796
TI  - [Primary chondrosarcoma of the pulmonary artery].
AB  - A 69-year-old woman who had progressive dyspnea, edema and oliguria was diagnosed
      as primary sarcoma arising in the pulmonary trunk by preoperative examination.
      She received thoracotomy and total resection of the tumor in the pulmonary trunk
      utilizing cardiopulmonary bypass. A microscopical examination revealed that the
      tumor had the features of the chondrosarcoma originating in the pulmonary artery.
      There have been very few reports on chondrosarcoma in the pulmonary artery. It is
      reported that the prognosis of the sarcoma in the pulmonary artery is less
      favorable, however, this case had uneventfully postoperative course and no signs
      of recurrence one year after operation.

PMID- 8473797
TI  - [Prosthetic valve endocarditis after double valve replacement].
AB  - This is a report of a patient who underwent re-AVR due to prosthetic valve
      endocarditis after double valve replacement (MVR, AVR). A 54-year-old female was
      admitted to other hospital on April 14, 1990, because of high fever, progressive
      anemia, and cardiomegaly. The patient was hospitalized to our department urgently
      with the diagnosis of prosthetic valve endocarditis. Arterial blood culture grew
      methicillin-resistant Staphylococcus epidermidis. Echocardiography showed a
      vegetation at the disc of the mechanical valve in the mitral position, but we
      could not find any vegetation or thrombus there at the reoperation, and the
      aortic mechanical valve seemed to be intact. Signs of inflammation continued to
      be positive after reoperation. On the 33rd hospital day, a diastolic murmur was
      heard, and emergency cardiac catheterization was done. Detachment of the
      prosthetic aortic valve and rupture of the sinus of Valsalva due to mycotic
      aneurysm, and the dissection of the aorta had occurred. We performed re-AVR and
      replacement of the ascending aorta. The patient died of multiple organ failure
      following drug-induced hepatic failure. It is suggestive that we missed the
      prosthetic aortic valve endocarditis during the reoperation. Our thoughts and
      introspections on the echocardiographic diagnosis of the prosthetic valve
      endocarditis after double valve replacement were discussed.

PMID- 8473798
TI  - [Myxoma originating from right ventricle found incidentally with cardiac murmur-
      a case report of surgical treatment].
AB  - We report a rare case of a 21-year-old male who had myxoma originating from
      septal band of the right ventricle. He was otherwise healthy young man without
      any associated symptom. His cardiac murmur was found incidentally upon routine
      health control mass examination. Subsequently, echocardiography and
      angiocardiography demonstrated a tumor occupying the right ventricular outflow
      tract and protruding into the main pulmonary artery in systolic phase. He was
      operated upon using extracorporeal circulation. By right ventriculotomy the tumor
      was resected together with septal tissue 5 mm around the stalk, which branched
      into the myocardium. Resected mass was 4 x 3.7 cm in size and 5 grams in weight.
      Because of the frozen section of the surgical stump was positive for tumor cells,
      additional resection of septal myocardium was carried out. The defect was closed
      using mattress sutures with dacron felt strips. His postoperative course was
      uneventful. Thirty-two months after the surgery, patient has no sign of
      recurrence. Right ventricular myxoma is uncommon with only 27 cases appearing in
      Japanese literature. In review of literature, we discussed the characteristics
      and management of the right ventricular myxoma.

PMID- 8473799
TI  - [Successful surgical management for chronic sternal osteomyelitis and anterior
      mediastinal abscess after double valve replacement by total sternectomy and
      pectoralis major muscle flaps].
AB  - A 63-year-old woman underwent double (aortic and mitral) valve replacement in
      February, 1987. Thirty days later, purulent drainage developed at the sternotomy
      incision with high fever. Wound cultures revealed staphylococcus aureus. She was
      treated by local wound care with antibiotics. About one month later, she had a
      satisfactory wound healing. But three cutaneous fistulas with discharge emerged
      at the sternotomy incision in November (9 months later) and the cultures grew the
      same species. The fistulogram showed the communication between these tracts and
      the mediastinum. The diagnosis of chronic sternal osteomyelitis and anterior
      mediastinal abscess was made. At first the resection of the xiphoid process and
      the mediastinal drainage were carried out in March, 1988. Inspite of this
      procedure, she still had persistent purulent discharge. Then, en bloc excision of
      the infected sternum and the adjacent costal cartilage were performed in April.
      The defect was obliterated with the bilateral pectoralis major muscle flaps.
      After the radical operation, her wound was completely healed, even though the
      ventilatory support was needed for 24 days because of flail chest due to the
      anterior chest wall instability. Now she has been free from recurrence for four
      years. Total sternectomy and pectoralis major muscle plombage seem to be a very
      effective management in chronic sternal osteomyelitis.

PMID- 8473800
TI  - [A case of Behcet's disease associated with ascending aortitis and aortic
      regurgitations--surgical repair with Cabrol's method].
AB  - This is the case report of a 52 years old female patient operated with Cabrol's
      method for the inflammatory lesion of the aortic root in Behcet's disease. The
      diagnosis of incomplete type of Behcet's disease had already been established 4
      years ago and the patient had been taking regular check-up since then. About one
      year ago, newly developed cardiac murmur compatible with aortic regurgitation was
      detected and the patient was subsequently referred to us for the surgical repair.
      Although aortic valve replacement (AVR) was attempted first, Cabrol's method was
      lastly chosen, since inflammatory features on the surface of the ascending aorta
      associated with slight aortic annular dilatation were observed during the
      procedure and it was easily anticipated that these might induce postoperative
      paravalvular leakage and pseudoaneurysm, if AVR were performed. Two weeks after
      the surgery, the patient developed aphthous stomatitis associated with several
      other evidences of inflammatory recurrence, the steroid therapy was instituted
      with prednisolone. Post operative progress was uneventful and the patient has
      been completely well at the 6th month after the surgery. In conclusion, it is
      strongly recommended the Cabrol's method should be chosen to prevent post
      operative unfavourable complications, whenever any evidence of inflammation is
      observed around the aortic root area.

PMID- 8473801
TI  - [Two cases of Morgagni's hernia].
AB  - Two cases of Morgagni's hernia comprising protrusion of the omentum alone are
      reported. The treated patients were 65- and 63-year-old obese women. They were
      referred to our hospital because of chest pain or vomiting accompanied by
      abnormal shadow in right cardiophrenic angle on chest roentgenogram. Computed
      tomogram (CT) demonstrated a mass of fat density behind the sternum for the both
      patients. The first patient was diagnosed as Morgagni's hernia by
      pneumoperitoneum, and surgical repair was done by the transabdominal approach.
      Magnetic resonance imaging (MRI) was carried out for the second patient, and
      showed intrathoracic mass lesion which was continuous with the subphrenic tissue.
      Although the second patient was diagnosed as mediastinal lipoma, median
      sternotomy revealed that the mass lesion was Morgagni's hernia. Postoperatively,
      both patients recovered uneventfully. The Morgagni's hernia has been reported to
      be about 3% of all diaphragmatic hernia. This disease may be discovered either
      because it causes respiratory or gastrointestinal complaints, or because an
      abnormal shadow in right cardiophrenic angle on a chest roentgenogram. If air
      filled structures are present in the hernia, a barium study will confirm the
      diagnosis. In a case with a hernia containing only omentum, the diagnosis is
      difficult. CT has been regarded as the procedure of choice by several authors.
      The coronal and sagittal views of MRI can demonstrate the relationship between
      the herniated structures and the diaphragm, heart, pericardium. We emphasize the
      role of MRI for the diagnosis of Morgagni's hernia.

PMID- 8473802
TI  - [Total arch replacement for dissecting aneurysm using permanent bypass to the
      supra-aortic branches and left-heart bypass].
AB  - The patient was a 36-year-old women with Marfan syndrome who had received graft
      replacement of ascending aorta for Stanford-type A dissecting aneurysm two years
      ago. She was re-operated on for residual arch and descending aortic dissection.
      We have found that it was Simple and effective to perform total arch replacement
      by using permanent bypass to the three principal supra-aortic branches and left
      heart bypass.

PMID- 8473803
TI  - [A case report of surgical treatment for aortic valve papillary fibroelastoma].
AB  - A 71-year-old woman was referred to our hospital for aortic valve replacement
      because of the vegetation of aortic valve. She had transient right arm weakness
      and aphasia in November 1991. On two-dimensional echocardiogram, she was found to
      have a mobile, pedunculated mass attached to the non-coronary cusp of the aortic
      valve. At operation, multiple frond-like tumor measuring 7*7 mm was found
      attached to the free-edge of the non-coronary cusp of the aortic valve. The
      aortic valve with this tumor was excised and replaced with a 21-mm Carpentier
      Edwards prosthesis. Microscopic sections revealed the typical findings of a
      papillary fibroelastoma. The patient's postoperative course was unremarkable.

PMID- 8473804
TI  - [Simultaneous cesarean section and mitral valve replacement for infective
      endocarditis during pregnancy--a case report].
AB  - Infective endocarditis (IE) during pregnancy is uncommon. A 31-week-pregnant, 21
      year-old woman suffered from severe mitral regurgitation caused by IE. She fell
      into heart failure and threatened abortion. Following to cesarean section, an
      emergent mitral valve replacement with a bioprosthetic valve was successfully
      performed. Her postoperative recovery was uneventful and she was discharged home
      30 days after the operation. Her baby, however, died of intracranial hemorrhage
      caused by hypoxia 171 days after delivery. A strategy of simultaneous open heart
      surgery and cesarean section is recommended when emergent open heart surgery is
      inevitable for the treatment of cardiac diseases in cases with 24 and/or more
      weeks' gestation.

PMID- 8473805
TI  - [Pseudo-false aneurysm of the left ventricle perforated into the right ventricle-
      a case report].
AB  - A case of pseudo-false aneurysm of the left ventricle perforated into the right
      ventricle was reported. The patient was 60-year-old male with acute inferior
      myocardial infarction. Echocardiography showed a thin wall cavity on the apex of
      the right ventricle. Communication between the left ventricle and the right
      ventricle was detected on pulsed Doppler echocardiography. Surgery revealed a
      pseudo-false aneurysm in the free wall of the right ventricle communicating to
      both ventricles. We emphasize the importance of preoperative morphological and
      hemodynamic evaluation with Doppler echocardiography in the case of post
      myocardial infarction ventricular septal perforation.

PMID- 8473806
TI  - [Injury of pulmonary artery and intrathoracic artery--a surgical case report].
AB  - The patient was a 52-year-old man. Tube drainage was performed to the right
      traumatic hemothorax. Then, 2,000 ml of blood flowed out and bleeding stopped for
      a time. Four hours later after injury, massive bleeding occurred again. So
      emergency thoracotomy was performed and we found a laceration in the main
      pulmonary artery and injury of intrathoracic artery. Pulmonary artery disruption
      from blunt chest trauma is rare. Further discussion was made by reviewing the
      related literature.

PMID- 8473807
TI  - [Isolated iliac aneurysms. Sixty-seven cases in forty-eight patients].
AB  - 77 pure iliac aneurysms where detected in a group of 48 patients along a period
      of 21 years, and represented 12.3% of all patients having aortic, iliac, or aorto
      iliac aneurysms. The study group comprised 42 men and 6 women, 48-86 years old
      (mean 67.8 years). The aneurysm was located on the right side in 51.9%, on left
      side in 48.1%. The affection of the common iliac arteries (70.1%) was more
      frequent than it was on the internal iliac arteries (18.2%), or in the external
      iliac arteries (11.7%). The diameter was from 2 to 10 cms. 44 patients out of 48
      (91.6%) where symptomatic, and 15 presented a rupture syndrome (31.3%). 10
      patients (20.8%) had a pulsating mass. The etiology was unknown in 8 cases
      (16.7%); 2 patients had a mycotic aneurysm (4.2%). The remaining 38 patients
      (79.1%) had an aneurysm of atheromatous origin. 5 arteritic patients (10.4%) did
      not have any cure for their aneurysm, because it was considered threatening for 4
      of them. The fifth patient was not treated because the artery was so calcified
      that it could not be clamped. A lumbar sympathectomy on the same side of the
      lesion was realised, in addition to the peripheral surgical act for arteritis.
      One patient had an endoaneurysmorrhaphy, another had an exclusion by ligature
      section of the aneurysm. For the remaining 41 patients (83.1%) the aneurysms
      where flattened, and vascular continuity was re-established by a prosthesis. 7
      patients (12%) decreased post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473808
TI  - [Buerger's disease and juvenile arteriopathy. Analysis and classification based
      on a series of 127 cases].
AB  - The prevalence and even the existence of Buerger's disease or thromboangiitis
      obliterans (TAO) are still ill-defined. The analysis of a continuous series of
      127 young patients with obstructive arterial disease of the lower limbs (mean
      follow-up 67.7 months, lost to follow-up 13.8%) allows the evaluation of the
      clinical, radiological and evolutive characteristics of the patients. The
      positive diagnosis of TAO relies upon the four usual criteria: onset of the
      disease before 40, no other vascular risk factor than smoking, popliteal or infra
      popliteal arterial lesions, migrant superficial thrombosis. The patients are
      classified in 4 groups: Group I: undisputed TAO, presence of all the criteria, 13
      cases (10.2%). Group II: probable TAO, presence of three criteria (no history of
      superficial thrombophlebitis), 19 cases (14.9%). Group III: tobacco-related
      atheroma, presence of two criteria (age under 40, no other risk factor than
      smoking), supra-popliteal lesions, 17 cases (13.4%). Group IV: precocious
      atheroma, presence of one criterium (age under 40), other risk factors,
      indifferent level of the arterial lesions, 78 cases (61.4%). The statistical
      analysis relies upon the comparison of the mean values for measurable parameters
      (Student-Fisher), for frequencies and percentages (Chi 2 Yates-Fisher) and upon a
      step by step discriminant analysis between groups I and IV, groups I and II and
      groups III and IV. The level of significance is 5%. The analysis points to two
      fundamental results: There is no significant difference either between groups I
      and II or between groups III and IV. Groups I and IV are significantly different
      for a lot of clinical, radiological and evolutive criteria.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8473809
TI  - [General principles of medical care of the diabetic foot].
AB  - In diabetic patients the foot is the focal point of neurologic, arterial and
      infectious complications. Affections of the foot are generally synonymous with a
      diabetic trophic disorder: the risk of gangrene is 17 times greater in diabetics
      than in non diabetics. Trophic disorders can affect the functional prognosis when
      they lead to amputation with subsequent altered weight bearing. They can provoke
      worsening of a subjacent arteriopathy, until then partially or totally
      asymptomatic, when the excision wound lacks the hemodynamic capacity for healing
      because of the associated arteriopathy. They can also induce local, regional
      (cellulitis) or even general (septicemia) infectious complications. They have a
      major socio-economic effect, by the loss of quality of life, the inability to
      work, and the cost of hospital and general care they engender. Finally, they have
      to be experienced by the patient and the treating team as a failure since, in the
      majority of cases, they imply an insufficient a priori knowledge of the
      predisposing factors: arteriopathy of legs and neuropathy with loss of
      sensitivity depriving the patient of the pain alarm signal if cutaneous lesions
      develop, and a delay in the recognition of triggering factors represented by
      microtrauma caused by shoes, particularly burns, frostbite or
      infections.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473810
TI  - [Medical treatment of diabetic arteriopathy].
AB  - Medical care of arteriopathy of leg in a diabetic patient involves control of
      diabetes combined with a series of non specific measures applicable to all
      atheromatous arteriopathies. Allowance must be made for the often silent nature
      of the arterial lesion, explicable by the associated peripheral neuropathy and
      the site of the lesions, generally more distal or staged than in non diabetics. A
      stable blood sugar level must be obtained to provoke improvement in
      hemorrheologic parameters and to slow the atheromatous process. A dietary regimen
      is associated with oral hypoglycemic agents or insulin therapy, the latter
      systematically for trophic disorders, administered as multiple injections or by
      insulin pump until complete healing is obtained. Insulin therapy normalizes
      abnormal blood lipid levels secondary to an uncontrolled diabetes. Other vascular
      risk factors (primary hyperlipoproteinemia, hypertension, smoking) must be
      allowed for. Of major importance in these patients at risk are foot hygiene,
      prevention of local trauma and correction of plantar anomalies. Aggravating
      factors in patients with arteritis are diabetic neuropathy and foot deformities.
      Regular walking is encouraged. Drug therapy (oral or injectable vasoactive
      agents, platelet antiaggregants, prostacyclin, normal blood volume restoration)
      depends on the severity of the arteriopathy and any complications. Analgesics are
      often required in advanced stages. Local therapy and sometimes antibiotics are
      necessary for trophic disorders. The frequent asymptomatic character up to the
      stage of gangrene should not, because of the diabetic diathesis, induce a wait
      and see attitude, and revascularization by angioplasty or shunt operation should
      be envisaged. A frequent complication of sugar diabetes, arteriopathy of the leg
      should be diagnosed early before it is revealed by a gangrenous lesion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8473811
TI  - [Treatment of diabetic arteriopathy. Importance of transluminal angioplasty].
AB  - Results are reported of a retrospective analysis of transluminal angioplasty
      (TLA) interventions in 20 diabetic patients, 16 men and 4 women, mean age 56
      years (range 32 to 82 years), with 24 dilated lesions, 16 patients having insulin
      dependent diabetes. In 12 cases the lesions were at the intermittent claudication
      stage, trophic lesions being present in 8 cases. Stenotic lesions were iliac (12
      cases), superficial femoral (2 cases), popliteal (6 cases) and tibial (4 cases).
      One patient developed an acute occlusion following popliteal-anterior tibial
      recanalization, the only direct complication of the angioplasty. Angiography
      showed immediate satisfactory results in 22 of the 24 dilated lesions. Functional
      and hemodynamic improvement was a constant finding in patients with intermittent
      claudication, trophic lesions being healed in 4 cases (50%) the other patient
      showing either no change or requiring an unavoidable amputation (2 cases). These
      overall findings suggest that at the intermittent claudication stage no
      differences exist in the results of TLA when compared with a non diabetic
      population; inversely, in the presence of trophic disorders, the local conditions
      (distal bed, infection, gangrene) interfere considerably in the course of the
      dilatation. Transluminal angioplasty should therefore be carried out as early as
      possible in diabetics; arteriography should be performed as soon as even minimal
      claudication appears and, a fortiori, even at the onset of a trophic lesion.

PMID- 8473812
TI  - [Foot equipment of diabetic arteriopathy].
AB  - Surgical appliances have a place of choice in the care of the foot with trophic
      lesions in diabetics, after partial amputation and as a preventive measure when
      it is free from trophic disorders. The type of appliance will depend on the
      footwear and the possibility of wearing orthopedic soles, whatever the stage of
      the affection. For the foot free from trophic disorders the shoes should be wide
      fitting, in soft leather and of the seamless type. Made to measure shoes should
      be reserved for badly deformed feet. The soles should be molded in silicone or
      polyurethane to distribute weight bearing and to avoid it over zones at risk.
      Appliances for the foot with trophic lesions should allow the resumption of
      walking. If the lesions are too extensive an orthosis is performed or a specific
      type of slipper with molded soles is worn to avoid pressure on the wounds. After
      amputation of toes a silicone orthoplasty is used to fill the interdigital space
      to avoid deformity of the other toes. If a front of foot has been amputated a
      corrected silicone molded sole with false extremity is applied. For a back of
      foot amputation an orthoprosthesis is made, preferentially in silicone
      introductible in a regular high sided shoe. In order to fulfil its preventive or
      temporary role, the appliance should evolve with time and be followed up
      regularly with close collaboration between the diabetic specialist the podologist
      and the orthotist.

PMID- 8473813
TI  - [Angioscopy of lower limb arteries. History and technique, cost and practical
      information].
AB  - The historical background to angioscopy shows that the principal successes
      recorded by its use result from the miniaturization of fibroscopes and the
      progress in video imaging. The first tentative use of angioscopy was by surgeons
      during operations carried out at about 1970, that of percutaneous angioscopy
      dating from 1984. The material used for diagnostic (fibroscope, cinecamera, video
      system, flushing pump) and interventional (fibroscope, clamps, Dormia cage,
      endoprostheses ... ) angioscopy is such that the basic equipment requires an
      outlay of about 150 to 200,000 francs. Percutaneous angioscopy implies the
      insertion of a catheter allowing flushing of the arterial lumen by means of a
      pressurized perfusion pump which, when reversed, is transformed into an
      aspirating pump for removal of the clot and/or atheromatous debris. The procedure
      is simple and does not expose to more complications than conventional
      arteriography.

PMID- 8473814
TI  - [Percutaneous diagnostic angioscopy. Primary lesions].
AB  - Efficacy of percutaneous treatments of arterial affections requires the correct
      choice of indications, necessitating precise knowledge of elementary arterial
      lesions. Arterial endoscopy appears to be more specific than angiography for this
      use, since it allows direct vision in vivo of the lesion, a histopathologic
      approach compared with the non univocal images produced by angiography (for
      example, an arterial obstruction can result from varied causes). Different
      accidents to the endothelial surface can be observed: golden yellow atheromatous
      elevations on a straw yellow background, intimal flaps, mobile intra-luminal
      vegetations. Established atheromatous stenosis are smooth and regular, or on the
      contrary ulcerated and edged with irregular flaps capable of provoking an
      eccentric residual lumen. The vegetating atheromatous lesions may project into
      the lumen, often as calcified and thus pearly white scales adhering to the wall,
      or as larger occlusive lesions. When capable of being isolated, a thrombus often
      completes the stenosis: its recognition is therefore fundamental since its
      removal exposes the subjacent lesions to be treated. The fresh clot is coral
      shaped, bright red and mobile in the blood flow. Established clots are compact
      and greenish brown. At an advanced stage of atheroma the surface of the occluding
      clot is covered with a regular straw yellow endothelium. In the presence of a
      dissecting vessel the fibroscope may be introduced into the false channel, no
      longer showing typical endothelium but a coagulated mass interspersed with
      fibrous bands. Prosthetic stenosis result from either intimal hyperplasia or a
      suturing fault with plication.

PMID- 8473815
TI  - [Interventional angioscopy].
AB  - Since 1987, routine angioscopic examination has been performed in 191 patients
      undergoing angioplasty, with interventions (196) after a 2 year surveillance
      period (55). Angioscopy allowed follow up "de visu" of the performance of
      angioplasty, details of its mechanism to be precise and under dilatation to be
      carried out. For femoral artery occlusions it allowed treatment "a la carte":
      conventional dilatation of vegetating atheroma, specific treatment of established
      thrombi (5) and abstention from therapy of atheroma covered by endothelium (3).
      It also enabled fresh thrombi complicating a stenosis or at the origin of a
      thrombus to be detected. The extraction technique employed (15) is described. It
      facilitated catheterization by directing the probe, enabled avoidance of
      bypassing of stenosis and flaps and of dissection or false introduction into
      collaterals (10). Directed biopsy could be carried out in inflammatory arteritis
      (7). Vegetating atheromatous lesions could be opened and extracted, facilitating
      subsequent dilatation and allowing an approach to removal of iliac artery
      obstructions without major risks of complications (13). Finally, after an
      ineffective dilatation or the presence of a dissection, it assisted making the
      decision to introduce a stent (9), the tolerance and outcome of these stents are
      described. Or the 196 patients considered suitable for angioplasty, our
      therapeutic conduct was modified by angioscopy in 58 cases (29%). Not simply a
      new diagnostic tool, it plays a role in interventional vascular techniques.

PMID- 8473816
TI  - [Arterial hypertension, vascular remodelling and atherosclerosis].
AB  - Therapy of essential hypertension (HT) should not imply the simple lowering of
      blood pressure alone but also reduction of the trophic effects provoked on the
      vascular system. Regression of left ventricular hypertrophy must be combined with
      "remodelling" of the overall arterial network to adapt to the abnormal physical
      forces acting on the vascular wall. This adaptive process has both qualitative
      and functional effects with structural modifications of the large arterial trunks
      as well as the smaller arteries, provoking adverse effects once they increase
      vascular resistance and diminish large artery compliance. Additionally, they tend
      to induce chronicity of HT, particularly since at the crossroad of these
      pathologic processes exist anomalies of endothelial secretory function. Treatment
      of HT should therefore comprise care of the vascular system, inasmuch as common
      mechanisms of cellular hypertrophy and proliferation are found in uncomplicated
      hypertension and atherosclerosis.

PMID- 8473817
TI  - [Importance of venous angioplasty in the treatment of subclavian venous
      thrombosis due to thoraco-brachial outlet syndrome].
AB  - A patient with subclavian vein thrombosis was treated successfully by
      transluminal angioplasty after initial inefficacy of thrombolytic agents.
      Although employed previously in the treatment of intrinsic and extrinsic
      subclavian vein stenosis with variable results, this technique has not been used
      up to the present for the acute phase of thrombosis. Because of the presence of a
      thoraco-brachial outlet syndrome, the procedure was completed by a first rib
      resection. A control phlebography in forced abduction at two month follow up
      showed excellent permeability of the subclavian vein.

PMID- 8473818
TI  - [Cutaneous hemangioma associated with eosinophilia].
AB  - A patient with a cutaneous angioma developed an intravascular coagulation
      syndrome with a eosinophilic leukocytosis and multiple arterial and venous
      thromboses affecting the vital prognosis. The possible role of the eosinophilia
      in the mechanism of complications is discussed. Local modifications in the
      angioma are suggestive signs preceding the onset of general thrombotic
      complications, their severity contrasting with the simplicity of the secondary
      surgical excision of the angioma.

PMID- 8473819
TI  - [A rare cause of claudication in a young person: cystic adventitial degeneration
      of the popliteal artery. Case study].
AB  - The authors report a new case of cystic adventitial disease of the popliteal
      artery in a 43 year old woman. It is a rare disease in young people which concern
      essentially the adventitium of the arterial wall. When echographic aspect mimics
      thrombosed aneurysm aspect, the diagnostic is done by arteriography. Two surgical
      technics are convenient: the adventitiotomy and the venous bypass.

PMID- 8473820
TI  - [Treatment of superficial varicose phlebitis].
AB  - The usual physical activity of the patient must be preserved when treating
      phlebitis of superficial varicosities, maintenance of the ability to walk about
      being an essential factor for a favorable outcome. Local and general anti
      inflammatory treatment of the initial acute phase of inflammation for less than
      one week improves the comfort of the patient and facilitates the application of
      the indispensable compression. Ambulatory thrombectomy can rapidly relieve pain,
      decompress the varicosities, accelerate revascularization and reduce the risk of
      residual pigmentation. To be simple and useful this procedure must be carried out
      before the fibrous organization of the clot. Stasis is controlled by an elastic
      stocking or bandage, the latter being often more effective and better tolerated
      initially. Compression must be maintained until elimination of the responsible
      varicose vein. Surgery and anticoagulants of all types are not indicated for
      treatment of uncomplicated superficial thrombosis, being indicated only in case
      of an authentic extension to the deep venous network. Surgery should then be
      limited to a safety crossectomy, heparins being reserved strictly for often
      prolonged preventive therapy or for treatment of a deep phlebitis.

PMID- 8473821
TI  - [Is it necessary to operate on small abdominal aortic aneurysms?].
AB  - The indication for surgical treatment of aneurysms of 5 cm diameter or larger is
      no longer the subject of much debate but the problem still arises for aneurysms
      equal to or less than 4 cm in diameter. This problem is a real one since
      epidemiologic studies have shown the frequency of aortic aneurysms to be about
      45/100,000 in men and 20/100,000 in women. The incidence of rupture in these
      small aneurysms is null for some authors, such as Nevitt, for those of less than
      5 cm, but Crawford reported an incidence of 9%. Exceptionally, rupture may occur
      in ectatic aortitis with weakened walls. Small aneurysms are generally kept under
      observation and not operated upon immediately. The increase in size varies
      between 21 and 40 mm according to the patient. Apart from the size of the
      aneurysm a further factor to be allowed for is the presence or absence of an
      intramural clot. In addition to the possible role it can play in the course of
      the aneurysm itself it may be the source of an emboli, which, after rupture, are
      the cause of the second symptomatology of aortic aneurysms. Indications for
      surgery of small aneurysms should be restricted to those with large intramural
      aneurysms, those with irregular morphology of a segment possibly the site of
      weakening of the wall which can be detected by a scan or NMR imaging, without
      forgetting certain sacciform aneurysms suggestive of a mycotic etiology and
      requiring surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473822
TI  - Application of corrosion cast method for scanning electron microscopic
      observation of mouse embryo vasculature.
AB  - We described a method for making vascular corrosion casts of mouse embryos and
      applied it to study the vasculature of the whole body mouse embryo at 13.5 days
      (body length 9-11 mm) to 18.5 days (body length 18-23 mm), as well as that of its
      respective organs. The Mercox resin was perfused via the umbilical vessels using
      a special needle made by pulling the hematocrit tube (caliber 100-200 microns).
      The specimens were treated with 10% NaOH, rinsed, dried, coated with gold and
      observed under a scanning electron microscope. Visceral organs of a 13.5 day
      embryo were rather immature, but the liver vasculature was relatively well
      developed. In a 15.5 day embryo, the whole body vasculature was relatively well
      developed and the features of respective organs could be identified. In a 18.5
      day embryo, almost all organs and extremities were well developed, but sensory
      organs in some parts showed immature development.

PMID- 8473823
TI  - An improved technique for observing both membranous organelles and cytoskeleton
      in saponin-extracted cells.
AB  - Detergent-extraction of soluble cytoplasmic proteins under low osmotic pressure
      induces severe morphological damage, particularly on membranous organelles,
      although this processing is often required to observe cytoskeletal elements in
      the cells. In the present study, the osmotic adjustment of the rinsing solution
      and fixative, which were used after the detergent-extraction using saponin, has
      greatly improved the ultrastructure of membranous organelles. This improved
      method allowed us to observe both cytoskeletal elements and the fine structure of
      membranous organelles by electron microscopy.

PMID- 8473824
TI  - Monoclonal antibody enhancement of FSH-induced uterine growth in snell dwarf
      mice.
AB  - The enhancing effect of bovine FSH monoclonal antibody (bFSH-MAb) on the
      gonadotrophic activity of FSH was investigated in dwarf mice using a uterine
      weight bioassay. Increasing doses of bovine FSH (NIH-FSH-B1; 3.3, 10 or 30
      micrograms/day) were administered for 5 days to dwarf mice (groups of five) with
      or without administration of a bFSH-MAb preparation (USDA-bFSH-MC28; 100
      micrograms protein/day) which at a dilution of 1:15,000 bound 50% of 125I
      labelled bFSH (USDA-bFSH-BP3). The bFSH, at the doses given, gave no increases in
      uterine weight; when, however, these doses were given with bFSH-MAb, significant
      (three- to four fold) increases in uterine weight resulted.

PMID- 8473825
TI  - Declining sperm counts in men--is there an endocrine cause?

PMID- 8473826
TI  - The role of thyroidal type-I iodothyronine deiodinase in tri-iodothyronine
      production by human and sheep thyrocytes in primary culture.
AB  - We have studied the origin of tri-iodothyronine (T3) secreted by human and sheep
      thyrocytes in primary culture and also the expression of type-I thyroidal
      iodothyronine deiodinase (ID-I) in the thyroid and liver of man and various other
      animals. Inhibitors of ID-I reduced T3 secretion from human but not sheep
      thyrocytes. In contrast, inhibitors of de-novo thyroid hormone synthesis reduced
      both thyroxine (T4) and T3 production in sheep thyrocytes, but had no effect on
      the T3 secreted by human thyrocytes. Human thyrocytes did not produce T4 under
      the culture conditions used, although some endogenous T4 was present in the cells
      following their isolation. Although thyrotrophin (TSH) stimulated T3 production
      in both human and sheep thyrocytes, iodine in the form of potassium iodide was
      only essential for T3 and T4 production by the sheep cells. Although 125I from
      Na125I was incorporated into T3 and T4 in TSH-stimulated sheep thyrocytes, no
      125I incorporation into T3 or T4 was detected in TSH-stimulated human thyrocytes.
      Using activity measurements and affinity labelling, ID-I was present in the
      livers of all species studied, but ID-I could not be detected in thyroid tissue
      from cattle, pigs, sheep, goats, rabbits, deer or llamas. In contrast, thyroid
      tissue from man, mice, guinea-pigs and rats had significant ID-I activity and
      expressed an affinity-labelled protein with a molecular mass of approximately
      28.1 kDa on SDS-PAGE. These data show that under the culture conditions used,
      sheep thyrocytes produced T3 by de-novo synthesis, whilst human thyrocytes
      produced T3 by deiodination of endogenous T4. We conclude that thyroidal ID-I
      shows marked species difference in its expression and that, in those species
      which express the enzyme (man, mice, guinea-pigs and rats, in this study), it
      appears that it may make an important contribution to thyroidal T3 production.

PMID- 8473827
TI  - Specificity studies of particulate binding sites for steroid hormones in
      subcellular fractions of the porcine corpus luteum.
AB  - We have studied the binding of a number of radiolabelled steroids and lipophilic
      substances to porcine corpus luteum (CL) particulate fractions. Following
      preincubation of CL homogenates with radiolabelled progesterone or pregnenolone
      prior to fractionation on continuous sucrose density gradients, a broad peak of
      binding was observed associated with a particulate fraction of buoyant density
      1.05-1.10 g/cm3. Progesterone content also peaked at a similar buoyant density
      (1.06-1.12 g/cm3). Pretreatment of luteal homogenates with digitonin perturbed
      the buoyant density of the progesterone-binding particulate fraction to 1.10-1.14
      g/cm3 and sharpened the binding peak. Progesterone content was also perturbed to
      a similar extent by digitonin pretreatment, without release of the steroid.
      Oestrogens were also sequestered by this fraction, but steroid precursors
      (cholesterol, cholesterol ester), corticosteroids (cortisol, corticosterone),
      sterol conjugates (oestrone sulphate, pregnanediol glucuronide) and other
      lipophilic substances (arachidonic acid, phospholipid, prostaglandins E1, E2 and
      F2 alpha) were not bound. Androgens were bound weakly by fractions from control
      gradients but, in the presence of digitonin, significant binding could be
      demonstrated. Radiolabelled steroids were shown to interact directly with luteal
      membrane fractions, rather than interacting first with cytosolic steroid
      receptors which then bound to membranes. Furthermore, [3H]progesterone was not
      bound by porcine granulosa cell particulate fractions. These observations suggest
      that this fraction may be involved in sequestration or packaging of progesterone
      for secretion by the luteal cell.

PMID- 8473828
TI  - Sex steroids affect glucocorticoid response to chronic inflammation and to
      interleukin-1.
AB  - The influence of gender and sex hormones upon both the hypothalamic-pituitary
      adrenal (HPA) axis and the immune and inflammatory responses is well recognized,
      but it is not clear to what extent the two effects are interdependent. We have
      investigated this interaction using a chronic inflammation model. Corticosterone
      levels were measured in mature BALB/c male and female mice, which were intact,
      sham-operated or gonadectomized. No significant differences were found between
      groups in baseline corticosterone, but systemic inflammation (cotton-induced
      granulomas) resulted in stimulation of the HPA axis in a reproducible pattern.
      Corticosterone levels were higher in sham-operated females than in males, but
      gonadectomy had opposing effects in the two genders, resulting in reduced levels
      in females but significantly increased levels in males. A similar pattern emerged
      after stimulation by ether exposure or injection of interleukin-1 beta. In the
      chronic inflammatory model, replacement of ovariectomized females with
      physiological levels of progesterone restored a response similar to that of
      intact females. Physiological levels of 5 alpha-dihydrotestosterone prevented the
      increase in corticosterone levels caused by castration in males and also resulted
      in reduced corticosterone levels in sham-operated females. Oestradiol treatment
      did not affect corticosterone levels. Release of interleukin-1 by peritoneal
      macrophages from intact and gonadectomized mice with chronic inflammation
      followed a similar pattern, females releasing more than males. These data suggest
      a complex inter-relationship between sex steroids, inflammatory stimuli and the
      HPA axis, such that females have a greater tendency than males to generate
      activating signals and in addition have a greater sensitivity to such factors.

PMID- 8473829
TI  - Effects of growth hormone and thyroxine on kidney insulin-like growth factor-I
      and renal growth in hypophysectomized rats.
AB  - The effects of treatment for 11 days with human growth hormone (hGH; 140
      micrograms/day), thyroxine (T4; micrograms/day) and hGH+T4 on renal growth and
      content of insulin-like growth factor-I (IGF-I) in hypophysectomized rats have
      been compared with saline-treated hypophysectomized animals and intact control
      animals. Right kidney weight and kidney weight/body weight ratio remained low in
      the saline-treated group (313 +/- 9 mg vs 694 +/- 28 mg in controls on day 11, P
      < 0.001 and 3.4 +/- 0.12 x 10(-3) vs 4.2 +/- 0.10 x 10(-3), P < 0.005
      respectively). In T4- and hGH-treated animals, kidney weight gain was similar (to
      420 +/- 14 and 450 +/- 22 mg on day 11 respectively, P > 0.05), whilst the
      increase was greater in the group given hGH+T4 (to 572 +/- 34 mg, P < 0.001
      compared with hGH- and T4-treated groups). The kidney weight/body weight ratio
      became normal in the T4- and hGH+T4-treated animals but remained low in the hGH
      treated group. The renal content of IGF-I was low in the saline-treated animals
      throughout the study (92 +/- 10 ng/g on day 11 vs 219 +/- 8 ng/g in control
      animals, P < 0.001), but increased to a maximum of 88% above baseline on day 1 in
      the group given T4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473830
TI  - Liposome-mediated macrophage depletion: an experimental approach to study the
      role of testicular macrophages in the rat.
AB  - Liposome-entrapped dichloromethylene diphosphonate was injected locally into the
      right testes of adult rats. This treatment, which has been found to deplete
      resident macrophages in some other organs, reduced the number of testicular
      macrophages by at least 90%. Testicular weight and seminiferous tubule morphology
      were unaffected by liposome treatment. Leydig cell testosterone secretion
      gradually declined in the macrophage-depleted testes, and there was a
      compensatory increase in Leydig cell size and testosterone secretion in the
      contralateral saline-injected testes. These observations suggest that macrophages
      influence Leydig cell function locally. It is concluded that liposome-mediated
      depletion of testicular macrophages may serve as an experimental model with which
      to study the physiological role of these cells.

PMID- 8473831
TI  - The human chorionic gonadotrophin-induced inflammation-like response is enhanced
      in macrophage-depleted rat testes.
AB  - Liposome-entrapped dichloromethylene diphosphonate (Cl2MDP) was injected locally
      into the right testes of adult rats in order to deplete testicular macrophages.
      The number of testicular macrophages in the treated testes was reduced by at
      least 90% at 7 and 14 days after treatment. Unilaterally testicular macrophage
      depleted animals were treated with 100 IU human chorionic gonadotrophin (hCG)
      subcutaneously and the inflammatory response was compared in the macrophage
      depleted and intact contralateral testis. Four hours after hCG treatment,
      intratesticular testosterone was similarly increased in intact and macrophage
      depleted testes. In macrophage-depleted testes there was a large increase in the
      number of leukocytes in testicular blood vessels and numerous leukocytes had
      migrated into the interstitial tissue. This response was greater than in the
      intact contralateral testis. It was concluded that testicular macrophages are
      probably not the origin of the inflammatory mediator secreted in the rat testis
      after hCG treatment. On the contrary, it appears that testicular macrophages may
      secrete factors inhibiting hCG-induced testicular inflammation.

PMID- 8473832
TI  - Paracrine effects via the epidermal growth factor receptor in the rodent testis
      may be mediated by non-Leydig interstitial cells.
AB  - The epidermal growth factor (EGF) receptor is expressed in a wide variety of cell
      types and is known to be present in the testis of many species including man. In
      the present study, specific 125I-labelled EGF binding was observed in isolated
      interstitial cell preparations from both the intact and Leydig cell-depleted rat
      testis. It was demonstrated that the population of cells to which 125I-labelled
      EGF binds has a different buoyant density from either of the two adult Leydig
      cell populations, and remains unchanged in the absence of Leydig cells following
      in-vivo treatment with ethane dimethane sulphonate (EDS). Cells of this density
      (1.064 g/ml) identified by electron microscopy were fusiform mesenchymal cells,
      identical to those suggested by others to be able to differentiate into Leydig
      cells in vitro, i.e. Leydig cell precursors. In a culture system using two
      interstitial cell preparations of different buoyant densities from immature rats,
      both EGF and transforming growth factor-alpha (TGF-alpha) caused increased
      [3H]thymidine incorporation in the less dense cell preparation. TGF-alpha was
      more potent than EGF. EGF increased testosterone production in both fractions in
      amounts which could be related to the amount of 3 beta-hydroxysteroid
      dehydrogenase (3 beta-HSD)-positive cells. This study demonstrated that rat
      Leydig cells (defined as those cells which bind 125I-labelled human chorionic
      gonadotrophin, have distinct buoyant densities, are 3 beta-HSD positive and are
      sensitive to EDS), do not bind 125I-labelled EGF. Rather, EGF binds to a
      mesenchymal cell without LH receptors which is resistant to EDS.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8473833
TI  - Serum and urinary concentrations of sex hormones and genital swelling during the
      menstrual cycle of the gibbon.
AB  - The relationship between sex hormone concentrations and female genital swelling
      during the menstrual cycle in the monogamous gibbon was comparable with that of
      polygamous female primates, such as the chimpanzee, which live in multimale
      groups and have larger swellings. The data, therefore, support the hypothesis
      proposed by C. R. Carpenter more than 50 years ago, that the gibbon's genital
      swelling, like that of other female primates, reflects basic physiological
      processes associated with progress of the menstrual cycle. Genital swelling
      increased during the follicular phase with increasing concentrations of
      oestradiol and oestrone glucuronide, reached maximal swelling in association with
      the mid-cycle peaks in the oestrogens and LH and began detumescence with the
      initial increases in progesterone during the luteal phase. The data also suggest
      that the menstrual cycle of the gibbon is shorter than previously reported, since
      cycles of 19-22 days exhibited hormone patterns that are consistent with
      ovulation. The genital swelling of the female gibbon is a useful marker for
      monitoring progress of the menstrual cycle and the presumptive time of ovulation.

PMID- 8473834
TI  - The 11 beta-hydroxysteroid dehydrogenase inhibitor glycyrrhetinic acid affects
      corticosteroid feedback regulation of hypothalamic corticotrophin-releasing
      peptides in rats.
AB  - Steroid-metabolizing enzymes modulate the effects of androgens on brain
      differentiation and function, but no similar enzymatic system has been
      demonstrated for adrenocorticosteroids which exert feedback control on the
      hypothalamus. 11 beta-Hydroxysteroid dehydrogenase (11 beta-OHSD) rapidly
      metabolizes physiological glucocorticoids (corticosterone, cortisol) to inactive
      products, thereby regulating glucocorticoid access to peripheral
      mineralocorticoid and glucocorticoid receptors in a site-specific manner. Using
      in-situ hybridization, we found expression of 11 beta-OHSD mRNA in neurones of
      the hypothalamic paraventricular nucleus (PVN) where corticotrophin-releasing
      factor-41 (CRF-41) is synthesized and from where it is released into hypophysial
      portal blood. Administration of glycyrrhetinic acid (GE), a potent 11 beta-OHSD
      inhibitor, decreased CRF-41 release into hypophysial portal blood in the presence
      of unchanged circulating glucocorticoid levels, suggesting that 11 beta-OHSD
      regulates the effective corticosterone feedback signal to CRF-41 neurones. These
      effects of GE were not observed in adrenalectomized animals, demonstrating
      dependence on adrenal products. In contrast, GE led to two- to threefold
      increases in arginine vasopressin and oxytocin release into portal blood, effects
      also dependent upon intact adrenal glands. These results suggest that 11 beta
      OHSD in the PVN, and possibly other sites, may represent a novel and important
      control point of corticosteroid feedback on CRF-41 release in vivo.

PMID- 8473835
TI  - The action of LH-releasing hormone and five analogues on oestradiol, oxytocin and
      vasopressin secretion by bovine granulosa cells in culture.
AB  - The release of oxytocin, arginine-8-vasopressin and oestradiol-17 beta by bovine
      granulosa cells in culture was analysed either with or without LH-releasing
      hormone (LHRH), its agonists (cyclo [Pro1DPhe6] LHRH and des 1-3, 10[DAla6] LHRH)
      or antagonists ([DPhe2DPhe6] LHRH, [DPhe2DPhe(NH2)6] LHRH or cyclo
      [Pro1DPhe2DPhe6] LHRH). All preparations used stimulated granulosa oxytocin and
      oestradiol secretion. Vasopressin release was significantly increased after all
      treatments with LHRH antagonists, but not after LHRH or its agonists. Our
      observations demonstrated a direct influence of LHRH and its analogues on the
      secretion of oestrogen and nonapeptide hormones by bovine granulosa cells. A
      comparison of the effects of LHRH, its agonists and antagonists suggests that the
      action of these peptides at the hypophysial and ovarian level is relatively
      independent.

PMID- 8473836
TI  - Serum levels of adrenal androgens up to adrenarche in Peruvian children living at
      sea level and at high altitude.
AB  - Serum levels of adrenal androgens were measured in children of both sexes living
      at sea level and at high altitude using a cross-sectional design. The levels were
      compared in relation to age at each altitude (150 m and 3400 m above sea level),
      and the first significant increase in mean levels compared with values at
      preceding ages was assessed and defined as adrenarche. A total of 118 boys and 95
      girls aged 6-12 years living at low altitude and 95 boys and 104 girls aged 7-15
      years living at high altitude, all of them attending public schools, were
      studied. Serum dehydroepiandrosterone, dehydroepiandrosterone sulphate and
      androstenedione were measured by radioimmunoassay and height and weight by
      standard anthropometric techniques. There were two significant increases in serum
      levels of adrenal androgens, the first observed in children between 6 and 8 years
      at sea level, and between 7 and 9 years at high altitude, and the second in
      children between 10 and 12 years at sea level and between 12 and 15 years at high
      altitude. Serum adrenal androgen levels increased earlier in children at sea
      level than at high altitude. It is concluded that adrenarche occurs later at high
      altitude than at sea level.

PMID- 8473837
TI  - Contextual processing of multidimensional and unidimensional auditory stimuli.
AB  - Stimulus context (the distribution of stimulus values) can strongly affect both
      perception and judgment. In 14 experiments, the method of magnitude estimation
      revealed 2 fundamentally different kinds of context effect in loudness. An
      assimilative effect dominated when stimuli varied unidimensionally (in intensity
      only). But a contrasting, or adaptation-like, effect dominated when stimuli
      varied multidimensionally (in frequency and intensity). In Experiment 15, direct
      loudness comparison revealed a potent, adaptational process specific to the
      signal frequency. Taken together, these and other results are compatible with the
      view that loudness perception and judgment reflect the net outcome of 2 different
      contextual processes: a relatively early (though probably not peripheral) process
      of perceptual adaptation and a later process of response-dependent assimilation.

PMID- 8473838
TI  - Common factors in the identification of an assortment of brief everyday sounds.
AB  - Acoustic, ecological, perceptual and cognitive factors that are common in the
      identification of 41 brief, varied sounds were evaluated. In Experiment 1,
      identification time and accuracy, causal uncertainty values, and spectral and
      temporal properties of the sounds were obtained. Experiment 2 was a survey to
      obtain ecological frequency counts. Experiment 3 solicited perceptual-cognitive
      ratings. Factor analyses of spectral parameters and perceptual-cognitive ratings
      were performed. Identification time and causal uncertainty are highly
      interrelated, and both are related to ecological frequency and the presence of
      harmonics and similar spectral bursts. Experiments 4 and 5 used a priming
      paradigm to verify correlational relationships between identification time and
      causal uncertainty and to assess the effect of sound typicality. Results support
      a hybrid approach for theories of everyday sound identification.

PMID- 8473839
TI  - Phonetic coherence in duplex perception: effects of acoustic differences and
      lexical status.
AB  - A modified version of duplex perception was used to investigate the nature of
      perceptual organization of speech. Ss were asked to identify stimuli in which a
      third-formant transition was presented to 1 ear and a full syllable (base) was
      presented to the other ear. Phonetic integration occurred even when the spectral
      composition or onset frequency of the isolated transition was varied relative to
      the base. However, when onset asynchronies were added to spectral differences,
      the isolated transition ceased to contribute to the syllable percept. Lexical
      status of the eventual phonetic percepts also influenced the phonetic integration
      of acoustic components into syllable percepts. These results suggest that
      combinations of low-level acoustic and phonetic differences between components
      and higher level lexical information interact to influence the grouping of
      acoustic components into phonetic percepts.

PMID- 8473840
TI  - Olfactory perception and olfactory imagery: a multidimensional analysis.
AB  - Whether a system of imagery for olfaction exists is currently an unsettled issue.
      Moreover, the dimensions underlying odor perception have eluded researchers for
      many years. Two experiments bearing on these issues are presented. In one
      experiment, a group of 32 undergraduates rated the similarity of pairs of 16
      commonplace odorants (e.g., chocolate and leather) they perceived using scratch
      and sniff stimuli; in another, a different group of 44 undergraduates was asked
      to imagine and then rate the similarity of the same pairs of odors.
      Multidimensional scaling of the data suggests that three-dimensional solutions
      with similar stimulus dimensions, such as fruitiness, strength, and familiarity,
      underlied the ratings of both perceived and imagined odors. By finding that
      similar dimensions define the psychological space of both the imagery and the
      perception tasks, this study suggests that imagery does indeed exist for
      olfaction.

PMID- 8473841
TI  - Odor-intensity interaction in binary mixtures.
AB  - Four principles underlying odor summation in mixtures were examined on the bases
      of 10 Ss' magnitude estimates of 41 mixtures and their components (pyridine and
      DMDS). Thus, the overall intensity summation for mixtures are compared to self
      addition reflected by the power function for single substances: Hypoaddition is a
      characteristic of both. Compromise is found for 25% of the mixtures, but it is
      not inherent in the power function. No level dependency is found for mixtures,
      although it is in accordance with the power function. Asymmetrical summation
      exists for mixtures and is inconsistent with the power function. Therefore, the
      idea of a congruence in odor-intensity summation processes is rejected. The
      results also constitute a successful cross-validation of the angle alpha (99
      degrees vs. 102 degrees) of the perceptual vector model reported by B. Berglund
      et al. (1973).

PMID- 8473842
TI  - Dual-task interference and the cerebral hemispheres.
AB  - It has been argued that dual-task interference is reduced when the two cerebral
      hemispheres can carry out the two tasks independently. Evidence for this idea has
      arisen from studies involving manipulations such as lateralized stimulation or
      response, or requiring mental operations believed to depend primarily on a
      particular hemisphere. However, these studies have typically involved a very
      limited degree of response uncertainty, which appears critical in producing the
      most extreme dual-task interference (the psychological refractory effect). Pairs
      of tasks with independent response uncertainty were examined, and various
      manipulations were used to promote hemispheric task separation. Dual-task
      interference was not modulated by these manipulations. It seems likely that
      response selection represents a central bottleneck, in the sense that this
      process cannot operate simultaneously and independently in the two hemispheres.

PMID- 8473843
TI  - What enumeration studies can show us about spatial attention: evidence for
      limited capacity preattentive processing.
AB  - Subitizing, the enumeration of 1-4 items, is rapid (40-120 ms/item) and accurate.
      Counting, the enumeration of 5 items or more, is slow (250-350 ms/item) and error
      prone. Why are small numbers of items enumerated differently from large numbers
      of items? It is suggested that subitizing relies on a preattentive mechanism. Ss
      could subitize heterogeneously sized multicontour items but not concentric
      multicontour items, which require attentional processing because preattentive
      gestalt processes misgroup contours from different items to form units.
      Similarly, Ss could subitize target items among distractors but only if the
      targets and distractors differed by a feature, a property derived through
      preattentive analysis. Thus, subitizing must rely on a mechanism that can handle
      a few items at once, which operates before attention but after preattentive
      operations of feature detection and grouping.

PMID- 8473844
TI  - The locus of inhibition in the priming of static objects: object token versus
      location.
AB  - The inhibition witnessed in the negative priming effect has been accounted for by
      positing an object file containing both identity and location information. In the
      present study, four experiments with 31 human subjects replicate the negative
      priming effect and, using new dual-target conditions where subjects respond to
      the target first perceived on a two-target forced-choice probe trial, suggest
      that location alone could account for the observed inhibition. Experiment 1
      establishes an RT baseline for the new dual-target condition, whereas Experiments
      2 and 3 replicate previously found single-target effects under dual-target
      conditions. Experiment 4 allows a concurrent determination of the inhibition
      accruing to both the target and distractor. The results are discussed relative to
      the likely existence of different kinds of inhibition which reveal themselves as
      a function of task demands.

PMID- 8473845
TI  - Skewed symmetry: a nonaccidental property used to perceive visual forms.
AB  - Mathematically, skewed symmetry is a nonaccidental property because it can be
      interpreted as bilateral symmetry in depth viewed from a nonorthogonal angle. To
      find out whether this is a useful property in the perception of visual forms, 4
      experiments were designed in which the Ss had to determine whether 2 symmetric or
      random patterns were the same regardless of possible affine transformations
      between them. The results provided mixed evidence: Although there was always a
      large symmetry advantage, skewed symmetry was only perceived as bilateral
      symmetry in depth for dot patterns with higher order types of symmetry
      (Experiment 1), when the dots were connected to form closed polygons (Experiments
      2 and 4), or when they were surrounded by a frame to enhance their planarity
      (Experiment 3). In other cases, Ss relied on local groupings on the basis of
      proximity or curvilinearity, which are qualitatively affine invariant.

PMID- 8473846
TI  - Dynamical constraints on pictorial action lines.
AB  - Pictorial action lines are an effective way of portraying movement in a static
      drawing. When such lines emanate from the backs of characters, they can give a
      sense of the path or style of movement. Seven experiments assessed whether
      photographic streak lines-lines that depict actual movement paths-can, in and of
      themselves, be informative about the act that produced them. Lines were produced
      as a darkly clad actor with point-lights attached to his major joints performed a
      number of actions in front of an open-lens camera. Completely naive Ss had little
      success identifying events in these photographs. Once Ss were told of the
      photographic technique, however, striking proficiency was achieved. Subtle
      distinctions (e.g., whether the movement was forward or backward or performed
      while wearing weights) were made for some of the events. Results are discussed in
      terms of various treatments of pictorial information.

PMID- 8473847
TI  - Coupling dynamics in interlimb coordination.
AB  - In 1:1 frequency locking, the interlimb phase difference phi is an order
      parameter quantifying the spatial-temporal organization of 2 rhythmic subsystems.
      Dynamical modeling and experimental analyses indicate that an intentional
      parameter phi psi (intended coordination mode, phi = 0 degrees or phi = 180
      degrees) and 2 control parameters omega c (coupled frequency) and delta omega
      (difference between uncoupled eigen-frequencies) affect phi. An experiment was
      conducted on 1:1 frequency locking in which phi psi, omega c, and delta omega
      were manipulated using a paradigm in which a person swings hand-held pendulums.
      As delta omega deviated from 0, the observed phi deviated from the phi psi,
      indicating a displacement in the phi attractor point. The displacements were
      exaggerated by increasing omega c. The displacements were coordinated with a
      decrease in the stability of phi and with higher harmonics in power spectrum of
      phi. Implications of the results for modeling interlimb coordination are
      discussed.

PMID- 8473848
TI  - Production of polyrhythms.
AB  - Previous research has shown that there are strong constraints on the concurrent
      performance of nonharmonically related motor sequences such as polyrhythms. A
      model of polyrhythm production is proposed that involves a hierarchical timing
      system. The model assumes a single mechanism (a counter) for the timing and
      serial ordering of responses. Predictions derived from the model were tested in
      an experiment in which skilled (musically trained) and unskilled Ss attempted to
      reproduce polyrhythms of varying complexity. The results agreed with the model's
      predictions and showed that Ss adopted a hierarchical form of integrated motor
      organization in which movements of the slow hand were subordinate to movements of
      the fast hand. This strategy was consistent across S groups, polyrhythms, and
      hand arrangements.

PMID- 8473849
TI  - Intentionality in human gait control: modifying the frequency-to-amplitude
      relationship.
AB  - Tight frequency-to-amplitude relationships are observed in spontaneous human
      steady gait. If required, however, they can be modified. The following
      experiments were aimed at the processes underlying this flexibility, which forms
      the fundamental basis of the intentional adaptive capabilities of locomotion. In
      Experiment 1, Ss had to intentionally modify the frequency-to-amplitude
      relationship (leading to preferred or nonpreferred steady states). In Experiment
      2, they had to temporarily perturbate the stride-frequency-to-amplitude
      relationship to intentionally shorten or lengthen 1 stride. Within the important
      constraints exerted by the head-arm-trunk system on leg movement, the results
      pointed out 2 main strategies that allow the S to intentionally adapt stride
      organization on-line: adjustment of the tonic properties of the oscillating leg
      to achieve nonpreferred steady states and phasic action to ensure temporary
      movement away from a steady state.

PMID- 8473850
TI  - Effects of sulfhydryl inhibitors on depolarizations-contraction coupling in frog
      skeletal muscle fibers.
AB  - We have studied the effects of the sulfhydryl reagents on contractile responses,
      using either electrically stimulated single muscle fibers or short muscle fibers
      that were voltage-clamped with a two-microelectrode voltage-clamp technique that
      allows the fiber tension in response to membrane depolarization to be recorded.
      The sulfhydryl inhibitors para-chloromercuribenzoic acid (PCMB) and
      parahydroximercuriphenyl sulfonic acid (PHMPS), at concentrations from 0.5 to 2
      mM, cause loss of the contractile ability; however, before this effect is
      completed, they change the fiber contractile behavior in a complex way. After
      relatively short exposure to the compounds, < 20 min, before the fibers lose
      their contractile capacity, secondary tension responses may appear after
      electrically elicited twitches or tetani. After losing their ability to contract
      in response to electrical stimulation, the fibers maintain their capacity to
      develop caffeine contractures, even after prolonged periods (120 min) of exposure
      to PHMPS. In fibers under voltage-clamp conditions, contractility is also lost;
      however, before this happens, long-lasting (i.e., minutes) episodes of
      spontaneous contractile activity may occur with the membrane polarized at -100
      mV. After more prolonged exposure (> 30 min), the responses to membrane
      depolarization are reduced and eventually disappear. The agent DTT at a
      concentration of 2 mM appears to protect the fibers from the effects of PCMB and
      PHMPS. Furthermore, after loss of the contractile responses by the action of PCMB
      or PHMPS, addition of 2 mM DTT causes recovery of tension development capacity.

PMID- 8473851
TI  - Anion modulation of taste responses in sodium-sensitive neurons of the hamster
      chorda tympani nerve.
AB  - Beidler's work in the 1950s showed that anions can strongly influence gustatory
      responses to sodium salts. We have demonstrated "anion inhibition" in the hamster
      by showing that the chorda tympani nerve responds more strongly to NaCl than to
      Na acetate over a wide range of concentrations. Iontophoretic presentation of Cl-
      and acetate to the anterior tongue elicited no response in the chorda tympani,
      suggesting that these anions are not directly stimulatory. Drugs (0.01, 1.0, and
      100 microM anthracene-9-carboxylate, diphenylamine-2-carboxylate, 4-acetamido-4'
      isothiocyanatostilbene-2,2'-disulfonate, and furosemide) that interfere with
      movements of Cl- across epithelial cells were ineffective in altering chorda
      tympani responses to 0.03 M of either NaCl or Na acetate. Anion inhibition
      related to movements of anions across epithelial membranes therefore seems
      unlikely. The chorda tympani contains a population of nerve fibers highly
      selective for Na+ (N fibers) and another population sensitive to Na+ as well as
      other salts and acids (H fibers). We found that N fibers respond similarly to
      NaCl and Na acetate, with spiking activity increasing with increasing stimulus
      concentration (0.01-1.0 M). H fibers, however, respond more strongly to NaCl than
      to Na acetate. Furthermore, H fibers increase spiking with increases in NaCl
      concentration, but generally decrease their responses to increasing
      concentrations of Na acetate. It appears that anion inhibition applies to taste
      cells innervated by H fibers but not by N fibers. Taste cells innervated by N
      fibers use an apical Na+ channel, whereas those innervated by H fibers may use a
      paracellularly mediated, basolateral site of excitation.

PMID- 8473852
TI  - Primary structure, partial purification and regulation of key enzymes of the
      acetyl cycle of arginine biosynthesis in Bacillus stearothermophilus: dual
      function of ornithine acetyltransferase.
AB  - A 3.4 kb EcoRI fragment, cloned in E. coli, that carries part of a cluster of
      genes encoding arginine biosynthetic functions of the thermophilic bacterium
      Bacillus stearothermophilus, was sequenced on both strands. The sequence consists
      of a truncated argC gene, an argJ region encoding a polypeptide with both N
      acetylglutamate synthase and ornithine acetyltransferase activities, the argB
      gene and the N-terminal part of argD. The argB gene encodes a 258-amino-acid
      polypeptide with a deduced M(r) of 26918. A very high and thermostable N
      acetylglutamate 5-phosphotransferase activity was detected in extracts of E. coli
      arg B mutants transformed with the 3.4 kb fragment on a plasmid. A polypeptide
      band of M(r) 27,000 was detected by SDS-PAGE of heat-treated extract from such a
      strain. Both N-acetylglutamate synthase and ornithine acetyltransferase are
      encoded by the same 1290 bp open reading frame. The deduced sequence of 410 amino
      acids corresponds to a peptide of M(r) 43,349. The subcloned B.
      stearothermophilus argJ can complement a double argA argE E. coli mutant to
      prototrophy. Gel-filtration of a heat-treated extract of the complemented double
      mutant E. coli host showed that N-acetylglutamate synthase and ornithine
      acetyltransferase activities co-elute in a single peak corresponding to M(r)
      110,000. Both activities were also heat-inactivated at the same temperature and
      strongly inhibited by ornithine. These results suggest that both activities can
      be ascribed to a single protein.

PMID- 8473853
TI  - Molecular and enzymological evidence for two classes of fumarase in Bacillus
      stearothermophilus (var. non-diastaticus).
AB  - The gene (fumABst) encoding an oxygen-labile fumarase of Bacillus
      stearothermophilus has been cloned and sequenced. The structural gene (1542 bp)
      encodes a product (FumABst) of M(r) 56,788 containing 514 amino acid residues.
      The amino acid sequence is 23% identical (37% similar) to FumA and FumB, the
      labile [4Fe-4S]-containing fumarases (Class I enzymes) of Escherichia coli. It
      exhibits no significant similarity to FumC and CitG, the stable fumarases (Class
      II enzymes) of E. coli and Bacillus subtilis (respectively). Enzymological
      studies indicated that FumABst resembles the iron-sulphur-containing fumarases in
      being dimeric (M(r) 2 x 58,500), oxygen labile and partially reactivated by Fe2+
      plus DTT. The fumABst gene is the first gene encoding a Class I fumarase to be
      characterized in any organism other than E. coli. Enzymological and DNA
      hybridization studies further indicated that B. stearothermophilus resembles E.
      coli in containing an oxygen-stable fumarase (Class II enzyme). Sequence
      comparisons revealed significant similarities between the Class I fumarases and
      the products of adjacent open-reading frames (orfZ1 and orfZ2) located upstream
      of the macromolecular synthesis operon (rpsU-dnaG-rpoD) at 67 min in the E.coli
      linkage map. Located downstream of fumABst, there is an unidentified gene (orf2),
      which is homologous to the rhizobial nodB genes involved in the initiation of
      root nodule formation.

PMID- 8473854
TI  - Putrescine oxidase of Micrococcus rubens: primary structure and Escherichia coli.
AB  - The flavin adenine dinucleotide (FAD)-containing putrescine oxidase of
      Micrococcus rubens catalyses the oxidative deamination of putrescine. The amino
      acid sequences of the NH2-termini of the mature enzyme and lysyl-endopeptidase
      generated fragments were determined for preparation of synthetic oligonucleotides
      as hybridization probes for cloning. A 4.4 kb BamHI fragment which contained DNA
      sequences hybridizing to the probes was cloned in pUC19 in Escherichia coli. The
      nucleotide sequence together with the determined amino acid sequences revealed
      that this enzyme consists of 480 amino acids (M(r) 52,000) and contains an FAD
      binding consensus sequence at its NH2-terminal portion. In front of the
      transcriptional start point, which is 28 bases upstream of the initiation codon
      as determined by primer extension, -35 and -10 sequences similar to typical
      prokaryotic promoter consensus sequences are present. E. coli JM109 containing
      the putrescine oxidase gene just downstream of the lac promoter in pUC18 produced
      a large amount of this protein when grown at 37 degrees C but in the enzymically
      inactive form of inclusion bodies. However, cultivation of the recombinant E.
      coli cells at temperatures below 30 degrees C led to production of active enzyme
      (20 times as much as produced by the original M. rubens strain).

PMID- 8473855
TI  - Characterization of a calcium porter of Streptococcus pneumoniae involved in
      calcium regulation of growth and competence.
AB  - It is shown that Streptococcus pneumoniae possesses a Ca2+ transporter, sensitive
      to the amiloride derivative 2',4'-dimethylbenzamil (DMB), which is essential for
      grown at high Ca(2+)-concentrations, and which mediates the triggering by Ca2+ of
      competence for genetic transformation in the exponential phase and autolysis in
      the late exponential phase. DMB inhibited both Ca2+ transport and the Ca2+
      response. Kinetic analysis of 45Ca2+ transport in ATP-depleted S. pneumoniae
      revealed an electrogenic influx sensitive to DMB. This transport was cooperative
      with respect to Ca2+ concentration, and exhibited a Hill coefficient (nH) of 2.
      In bacteria pre-loaded with 45Ca2+, a DMB-sensitive efflux could be triggered by
      an imposed Na+ gradient. The efflux kinetics showed the same cooperativity
      profile as Ca2+ concentration and a similar nH value to that of influx,
      suggesting a possible Na+/Ca2+ antiport. Cooperativity of transport was lowered
      (nH = 1) by a mutation that confers resistance to DMB and abolishes the Ca2+
      response. These results demonstrate that DMB-sensitive Ca2+ transport is
      essential for growth and competence regulation. The role of the DMB-sensitive
      porter involved in Ca2+ circulation and in Ca2+ homeostasis and its possible
      regulation by competence factor are discussed.

PMID- 8473856
TI  - Further characterization of the assimilatory nitrate reductase from the yeast
      Candida nitratophila.
AB  - Nitrate reductase from the yeast Candida nitratophila was found to contain one
      molecule of cytochrome b557 and one atom of molybdenum per subunit. FAD/haem
      dependent diaphorase activity (haem domain) was associated with a 40 kDa tryptic
      fragment of the subunit. The 50 amino-terminal residues of this fragment were
      determined, and the sequence did not show significant similarity to deduced
      sequences of other nitrate reductases previously published. Increasing ionic
      strength in vitro had a stimulatory effect on enzymic activity via stimulation of
      the molybdenum-dependent terminal nitrate-reducing activity. Stimulation of
      activity by exogenous protein (bovine serum albumin or casein) also appeared to
      be an ionic effect. Stimulation of catalytic activity by phosphate was a separate
      effect.

PMID- 8473857
TI  - Purification and partial characterization of acid phosphatase from Candida
      lipolytica.
AB  - Non-specific acid phosphatase from Candida lipolytica cells was purified 111-fold
      by chromatography on DEAE-cellulose and gel filtration on Sephadex G-100 and
      Sepharose 4B. The enzyme is a glycoprotein containing 67% neutral sugars. The
      molecular mass of the highly purified acid phosphatase was found to be
      approximately 95 kDa by both SDS-PAGE and gel filtration. The pH and temperature
      optima were 5.8 and 55 degrees C, respectively. The enzyme was stable at pH
      values between 3.5 and 5.5 and at temperatures up to 60 degrees C. The purified
      phosphatase had a Km value of 3.64 mM for p-nitrophenyl phosphate and showed
      broad substrate specificity.

PMID- 8473858
TI  - Investigation of a killer strain of Zygosaccharomyces bailii.
AB  - The yeast Zygosaccharomyces bailii strain 412 was found to liberate a killer
      toxin (KT412) lethal to sensitive strains of Saccharomyces cerevisiae and Candida
      glabrata. Culture supernatants of the killer strain were concentrated by
      ultrafiltration and the extracellular protein was purified by gel filtration and
      ion-exchange chromatography. Gel filtration and SDS-PAGE of the
      electrophoretically homogeneous killer protein indicated an apparent molecular
      mass of 10 kDa. The killer toxin KT412 is probably not glycosylated since it did
      not show any detectable carbohydrate structures. KT412 was bound to sensitive but
      not to resistant yeast cells. The mannan, and not the glucan, fraction of the
      cell wall of the sensitive yeast was the primary target for the killer toxin
      binding. The killer strain Z. bailii 412 contained three double-stranded RNA
      plasmids of 1.9, 2.9 and 4.0 kb. Curing by cycloheximide resulted in the
      concomitant loss of killer activity and the 1.9 kb dsRNA species that is
      therefore regarded as equivalent to the killer-toxin-coding M-plasmids of S.
      cerevisiae.

PMID- 8473859
TI  - Saccharomyces cerevisiae has an inducible response to menadione which differs
      from that to hydrogen peroxide.
AB  - Exponential phase cells of Saccharomyces cerevisiae treated with the superoxide
      free-radical generating agent menadione (MD; 0.2 mM) for 60 min adapted to become
      resistant to the lethal effects of a higher concentration of MD (4 mM).
      Inhibition of protein synthesis by treatment with cycloheximide totally prevented
      the adaptation to MD, indicating that this is an inducible response completely
      dependent on protein synthesis; this differs from the situation with peroxide in
      which only some of the adaptive response is cycloheximide-sensitive. Cells
      subjected to heat shock (23 to 37 degrees C) or treatment with hydrogen peroxide
      (H2O2; 0.2 mM, 60 min) became more resistant to 4 mM-MD; however, MD pretreatment
      did not induce any thermotolerance or resistance to peroxide. These differences
      between the response to MD and H2O2 were reflected in the results of L
      [35S]methionine labelling studies. Using one-dimensional electrophoresis, only
      one polypeptide (60 kDa) was seen to be induced by 0.2 mM-MD and this was also
      induced by heat shock but not peroxide stress. With heat shock or peroxide
      treatment the induction of at least 10 polypeptides was detected using this
      approach. Using an isogenic petite strain, it was found that functional
      mitochondria were needed for conferring full resistance to MD, but that induction
      of the adaptive response was not dependent on mitochondrial function.

PMID- 8473860
TI  - Properties of genes involved in the control of isocitrate lyase production in
      Aspergillus nidulans.
AB  - The interaction between genes of Aspergillus nidulans conferring constitutive
      synthesis of isocitrate lyase (iclc A and iclcB) and fluoroacetate resistance
      (facB) has been investigated. Although facB mutants are unable to induce the
      glyoxylate cycle enzyme isocitrate lyase in response to acetate as sole carbon
      source, this phenotype was suppressed in recombinants of the type iclc;facB. The
      iclcA and iclcB mutations do not alter significantly the activities of eight
      enzymes of intermediary metabolism assayed. We conclude that the iclc genes are
      probably bona fide isocitrate lyase regulatory genes.

PMID- 8473861
TI  - Evaluation of a strategy for identifying nodulation competitiveness genes in
      Rhizobium leguminosarum biovar phaseoli.
AB  - Rhizobium leguminosarum biovar phaseoli strain KIM5s is consistently much more
      competitive than strain CE3 in nodulation of beans (Phaseolus vulgaris L.) in the
      laboratory and in the field. To identify genes that contribute to the
      competitiveness of KIM5s, we transferred a cosmid library containing KIM5s DNA
      into CE3 and applied the transconjugants to bean plants to allow the plants to
      enrich for those with enhanced nodulation competitiveness. The nodule isolates
      were then applied to plants for further enrichment. Of 75 isolates from nodules
      sampled after the two enrichments, 9 were more competitive than CE3. For example,
      when outnumbered in the inocula 40-fold by a reference strain, these nine strains
      typically occupied 15-40% of the nodules compared with 0-3% for CE3. However,
      when these strains were cured of the cosmids, they remained highly competitive,
      demonstrating that the enhanced competitiveness of the strains was not associated
      with the cosmids. We found no evidence for cosmid insertion into the chromosome
      or for cosmid-induced genetic changes in these cured strains. We found some
      evidence suggesting that their altered competitiveness was due to spontaneous
      genetic changes that did not involve the cosmids. Although these highly
      competitive variants remain genetically uncharacterized, they may provide insight
      into bacterial traits that contribute to, or detract from, successful nodulation
      competitiveness.

PMID- 8473862
TI  - A comparison of the multiple alleles of xylS carried by TOL plasmids pWW53 and
      pDK1 and its implications for their evolutionary relationship.
AB  - Both of the independently isolated TOL plasmids pWW53 and pDK1 contain multiple
      regions homologous to the xylS regulatory gene of the archetypal TOL plasmid
      pWW0. The three homologues on pWW53 vary in the extent of their homology to
      xylSpWW0, xylS1pWW53 is 99% identical to xylSpWW0 and is located relative to the
      single copy of xylRpWW53 in exactly the same way as xylS and xylR on pWW0. The
      DNA sequence of xylS3pWW53 is 87% identical to the xylSpWW0 sequence within the
      coding region but the non-coding DNA upstream is not homologous. There is a frame
      shift change at the end of the coding region which causes the C terminus of
      XylS3pWW53 to be extended by an additional 10 amino acids relative to XylSpWW0.
      xylS2pWW53 is anomalous and appears to encode a truncated pseudogene lacking the
      first 525 bases found in the other xylS genes. Evidence is presented to show that
      both xylS1pWW53 and xylS3pWW53 act as regulators of meta pathway operons. Plasmid
      pDK1 carries two homologues of xylS. xylS1pDK1 is functional and is a hybrid
      gene: its 5' end and the upstream sequences are highly homologous to both
      xylS1pWW53 and xylSpWW0, whereas its 3' end is identical to xylS3pWW53. The
      sequence of xylS2pDK1 is identical to that of the anomalous truncated xylS2pWW53.
      Comparison of the organization and the restriction maps of the xyl catabolic
      operons on pDK1 and pWW53, together with the nucleotide sequences presented here,
      indicates that the catabolic DNA on pDK1 has derived from a replicon on which the
      xyl genes are organized similarly to pWW53 and that a genetic rearrangement has
      taken place involving a reciprocal recombination internal to two of its xylS
      homologues.

PMID- 8473863
TI  - Cloning and sequencing of the gene which encodes the highly inducible acetamidase
      of Mycobacterium smegmatis.
AB  - The acetamidase of Mycobacterium smegmatis NCTC 8159 was purified, and the
      sequences of its amino-terminus and of two peptides obtained by proteolysis of
      the protein were obtained. A DNA fragment including the amidase structural gene
      was cloned in Escherichia coli, using oligonucleotide probes designed on the
      basis of the peptide sequences and a codon usage table calculated from published
      sequences of nine protein-antigen-encoding genes of the Mycobacterium
      tuberculosis complex. Sequence analysis of the cloned DNA revealed that the
      amidase gene encoded 406 amino acid residues. The nucleotide sequence close to
      and upstream of the amidase gene contained a probable ribosome-binding site but
      no identifiable promoter sequences. Three additional potential open-reading
      frames were found upstream of and very close to the amidase gene, with consensus
      '-35' and '-10' promoter sites between the first and second of these. It is hoped
      that the highly inducible expression of the acetamidase gene can be exploited to
      allow regulated expression of other genes cloned in mycobacteria.

PMID- 8473864
TI  - Characterization of two different types of resistance genes among producers of
      fortimicin-group antibiotics.
AB  - Fortimicin-A (FTM-A; astromicin)-resistance genes (fmr genes) isolated from six
      producers of the FTM-group of antibiotics were analysed. These genes could be
      classified into two types by the resistance profiles to aminoglycoside
      antibiotics and by their DNA homologies. Three genes, fmrT from the istamycin
      producer Streptomyces tenjimariensis ATCC 31603, fmrS from the sannamycin
      producer Streptomyces sannanensis IFO 14239 and fmrH from the sporaricin producer
      Saccharopolyspora hirsuta ATCC 20501, conferred resistance to FTM-A, kanamycin
      (Km) and neomycin B (Nm-B), but not to gentamicin (Gm). The other three genes,
      fmrO from the FTM-A producer Micromonospora olivasterospora ATCC 21819, fmrM from
      the antibiotic SF-2052 producer Micromonospora sp. SF-2098 (ATCC 31580) and fmrD
      from the dactimicin producer Dactylosporangium matsuzakiense ATCC 31570,
      conferred resistance to FTM-A, Km and Gm, but not to Nm-B. No DNA homology was
      detected between the two types of the resistance genes in Southern-blot analysis.
      The present results revealed that, in spite of the similarity of their
      biosynthesis genes, there are at least two different types of resistance genes
      among the FTM-group antibiotic producers.

PMID- 8473865
TI  - A macrolide-lincosamide-streptogramin B resistance determinant from Bacillus
      anthracis 590: cloning and expression of ermJ.
AB  - The inducible macrolide-lincosamide-streptogramin B resistance determinant, ermJ,
      from Bacillus anthracis 590 was cloned in Escherichia coli CSH26. The DNA
      sequence of ermJ was similar to that of ermK or ermD from B. licheniformis,
      suggesting that ermK-like genes have been distributed in Bacillus strains by
      transposition. Expression of ermJ was achieved in a B. subtilis minicell system,
      and the rRNA methyltransferase product of ermJ was purified. The molecular mass
      of the enzyme was 58 kDa, and it was concluded to be a homodimer. Its biochemical
      characteristics were different from those of ermC methyltransferase.

PMID- 8473866
TI  - Cell-surface location of Listeria-specific protein p60--detection of Listeria
      cells by indirect immunofluorescence.
AB  - A specific polyclonal antiserum was prepared against a gel-purified 60 kDa
      extracellular protein of Listeria monocytogenes ATCC 19111 corresponding to
      protein p60 previously detected in culture broths of L. monocytogenes strains
      Mackaness and EGD [Kuhn, M. & Goebel, W. (1989), Infection and Immunity 57, 55
      61]. Indirect immunogold labelling combined with transmission electron microscopy
      and high-resolution scanning electron microscopy were used to investigate the
      location and distribution of p60 on the bacterial cell surface. In bacteria grown
      to the early stationary phase about 25% of the extracellular protein was
      estimated to be associated with the cell surface. The anti-p60 antiserum proved
      to be Listeria-specific. In an indirect immunofluorescence test the antiserum
      reacted with Listeria strains representing all species and different serotypes,
      except L. seeligeri, L. welshimeri, L. grayi and L. murrayi. No immunological
      cross-reactions were observed with 27 strains of bacteria from 16 other genera.
      The value of the anti-p60 antiserum in developing a diagnostic assay for Listeria
      cells in environmental samples and foods is discussed.

PMID- 8473867
TI  - Similarity in the EDTA-soluble antigens of Clostridium chauvoei and C. septicum.
AB  - The EDTA-soluble antigens were prepared from whole cells of six strains of
      Clostridium chauvoei and five strains of C. septicum and were compared by sodium
      dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot
      analysis. SDS-PAGE profiles of the 11 strains were nearly identical, although
      there were slight variations in molecular mass in adjacent bands. In immunoblot
      analysis with two antisera against C. chauvoei and three against C. septicum, the
      antigens of all strains tested reacted with all five antisera and there were no
      differences in reactivities to the same antiserum between homologous and
      heterologous antigens. In an immunoblot reacted with a single antiserum, band
      patterns of 10 of the 11 strains were quite similar. After cross-absorption,
      antisera to both species lost most of their reactivities not only to heterologous
      antigens but also to homologous antigens. These results indicate that the two
      species share many common antigens and that there is a marked similarity in the
      antigenic properties of EDTA-soluble material.

PMID- 8473868
TI  - Calcium- and mucin-binding proteins of staphylococci.
AB  - The association of staphylococci with the mucus gel that overlays the mucosa of
      the respiratory tract may lead to clearance of cocci or, in certain conditions
      such as cystic fibrosis (CF), to colonization. In the present study, a
      quantitative radioassay was used to study the effect of Ca2+, which is elevated
      in CF sputa, on the adhesion of 3H-labelled Staphylococcus aureus to submaxillary
      gland mucin immobilized in MaxiSorp 96-well, break-apart modules. Ca2+
      significantly enhanced the adhesion of S. aureus (five strains) and
      Staphylococcus epidermidis (four strains). The reaction was specific because
      adhesion was not enhanced in the presence of Mg2+, Ca(2+) + EGTA (a Ca2+
      chelator) or protamine and was not attributable to hydrophobicity of the test
      strains. Staphylococcal adhesion was significantly (P < or = 0.005) blocked in
      the presence of highly sialated and sulphated reagents, which suggests that Ca2+
      binds to the sialic acid and sulphate residues of immobilized mucin. The Ca(2+)
      binding sites on the surface of S. aureus were trypsin-sensitive; in addition,
      125I-labelled solubilized S. aureus surface proteins reacted with immobilized
      mucin in a direct binding assay, and the reaction was significantly enhanced by
      Ca2+. Autoradiography demonstrated that 45Ca bound directly to two polypeptides
      (M(r) 170,000 and 150,000) of solubilized staphylococcal surface proteins
      separated by SDS-PAGE, and that 125I-labelled mucin bound directly to three
      staphylococcal polypeptides (M(r) 40,000, 35,000, and 29,000). These results
      suggest that S. aureus adhesion to mucin is mediated by at least two mechanisms:
      via Ca(2+)-binding surface proteins in the presence of Ca2+ and via mucin-binding
      surface proteins unrelated to Ca2+.

PMID- 8473869
TI  - Fusion of the genes encoding Escherichia coli heat-stable enterotoxin b (STb) and
      the maltose-binding protein to obtain mature STb enterotoxin.
AB  - The heat-stable enterotoxin b gene (estB) of Escherichia coli was fused to the
      gene for maltose-binding protein (malE). The estB gene was cloned into the pMAL-p
      vector using PCR. The construct consists of the signal sequence of maltose
      binding protein, which directs the export of the fusion protein to the periplasm,
      and the maltose-binding protein fused to the STb polypeptide. A sequence encoding
      a factor Xa cleavage site is present between malE and estB. The fused genes are
      controlled by Ptac, a strong inducible promoter. Following IPTG induction, the
      recombinant strain expressed a 47 kDa protein, which was easily purified from
      osmotic shock fluid by using preparative electrophoresis and electroelution.
      Cleavage of the fusion protein with factor Xa generated the maltose-binding
      protein (42 kDa) and a polypeptide of approximately 5 kDa, corresponding to the
      molecular mass of mature STb. A monospecific polyclonal rabbit antiserum raised
      against purified STb reacted in immunoblot with the fusion protein and the
      cleaved-off peptide. A positive response was observed when testing the osmotic
      shock fluid containing the fusion protein in a rat intestinal loop assay. On
      average, 3-4 mg of MBP-STb protein was recovered per litre of induced recombinant
      strain.

PMID- 8473870
TI  - Cloning, characterization and sequencing of two haemagglutinin genes from
      Eikenella corrodens.
AB  - Eikenella corrodens is emerging as an important human pathogen, in both extra
      oral and periodontal infections. From a clone bank of Eikenella corrodens
      chromosomal DNA produced in Escherichia coli JM109, twenty-two clones expressed
      Eikenella antigens and of these, two expressed functional haemagglutinins. By
      virtue of different restriction maps and a lack of homology by Southern
      hybridization, the two cloned fragments encoding the two haemagglutinins have
      been shown to be distinct. Maxicell analysis revealed that clone 1, carrying
      plasmid pVKR201, produces three Eikenella proteins, one of 31.5 kDa and two of
      approximately 14 kDa each. Expression of each of the proteins appears to be under
      the control of an Eikenella promoter(s). Clone 2, carrying plasmid pVKR301,
      produces two proteins, one of 93 kDa and the second of 17 kDa. Expression of both
      of these proteins in E. coli requires the lac promoter in the vector. By
      preparing a series of subclones and testing each by maxicell analysis and for
      haemagglutination activity, a functional map of the insert of clone 1 was deduced
      and the 31.5 kDa polypeptide identified as the haemagglutinin. Using similar
      methods, the 17 kDa protein was found to be the haemagglutinin of clone 2. The
      nucleotide sequences of both haemagglutinin genes were determined and are
      presented. Computer analysis revealed no homology between the two
      haemagglutinins, and no homology to any previously sequenced proteins. These are
      the first genes of this genus to be cloned and sequenced.

PMID- 8473871
TI  - Cloning and sequencing of two type 4 (N-methylphenylalanine) pilin genes from
      Eikenella corrodens.
AB  - Eikenella corrodens is a Gram-negative microaerophilic rod which is gaining
      recognition as an important human pathogen. We have previously reported the
      cloning and expression in Escherichia coli of a 3.6 kb Eik. corrodens genomic DNA
      fragment which encodes a 31.5 kDa haemagglutinin. Maxicell analysis revealed that
      this fragment also encodes two proteins of approximately 14 kDa. Nucleotide
      sequencing of the 2.2 kb fragment upstream of the haemagglutinin gene revealed
      two open reading frames with strong homology to genes encoding pilin subunit
      proteins of the type 4 or N-methylphenylalanine class. The two pilin genes, ecpA
      and ecpB, are complete and are expressed in E. coli. Southern analysis of ten
      additional Eik. corrodens strains revealed that all possess fragments homologous
      to ecpA. These data represent the first molecular evidence for pili in E.
      corrodens.

PMID- 8473872
TI  - Women and alcohol: use and abuse.
AB  - National surveys of the quantity/frequency of drinking, conducted over the last
      half century, show that the percentage of nonabstaining women has remained at
      about 60%. Although male/female differences in drinking are smaller than they
      were a generation ago, this appears to relate primarily to drinking by young
      adults. Study of social attitudes toward male and female intoxication has
      consistently indicated more disapproval of female intoxication. Alcoholism in
      women has a complex etiology that includes biological factors, positive family
      history, difficulties in impulse control, depression, and drinking by significant
      others in the social environment. Male/female differences in patterns and
      consequences of alcoholic behavior are summarized, as are differences among
      alcoholic women with earlier or later onset.

PMID- 8473873
TI  - The role of obstetric complications in schizophrenia.
AB  - The importance of obstetric complications in sporadic and familial psychoses was
      analyzed in 43 schizophrenic and 28 chronic schizoaffective patients. Patients
      and first-degree relatives were diagnosed using Research Diagnostic Criteria and
      the best-estimate procedure. Mothers of patients were interviewed for histories
      of pregnancy and obstetric complications in their offspring. Patients had more
      often suffered perinatal complications (42%) than their siblings (29%). The risk
      for obstetric complications and secondary cases of psychosis was enhanced in
      relatives of patients with a history of obstetric complications. Siblings with
      obstetric complications had a low incidence of psychoses; therefore, obstetric
      complications could not explain the occurrence of secondary cases of psychosis in
      siblings. Patients with familial psychoses had a higher incidence of obstetric
      complications than did sporadic cases (without reaching statistical
      significance). There was no inverse relationship between the history of obstetric
      complications in patients and the morbid risk of first-degree relatives for
      psychoses. The familial versus sporadic distinction revealed no subgroups where
      obstetric complications were of special relevance.

PMID- 8473874
TI  - Substance abuse in schizophrenia: service utilization and costs.
AB  - Utilization and cost of institutional and outpatient services were prospectively
      measured over 1 year for three groups of schizophrenic patients: current
      substance abusers, past substance abusers, and those without a history of
      substance abuse. Current abusers had significantly greater utilization and cost
      of institutional (hospital and jail) services. Current abusers also had greater
      utilization of emergency services. There were no significant differences between
      the groups in utilization and cost of other services, including psychosocial
      rehabilitation, outpatient treatment (case management, psychotherapy, and
      psychiatric visits), and housing supports. The implications for developing cost
      effective treatments for dually diagnosed individuals are discussed.

PMID- 8473875
TI  - Stability in backward masking performance in schizophrenics, affectively
      disturbed patients, and normal subjects.
AB  - The purpose of the present longitudinal study was to investigate the stability of
      backward masking performance in schizophrenics and nonschizophrenic psychotic
      patients. Twenty-two schizophrenics, eight nonschizophrenics, and 14 normal
      controls were tested three times, with an interval of 1 year between each test
      session. A standard stimulus duration procedure was used. The relative onset
      intervals between the target and the mask was 16.5 msec or 33 msec. A no mask
      condition was presented before the two masking conditions. Results showed that
      masking performance is a stable phenomenon, for both psychiatric groups and for
      normal controls. Significant differences were found between schizophrenics and
      the normal controls, but not between the two psychiatric groups. Vulnerability to
      masking stimuli as a specific characteristic for schizophrenics is, thus, not
      supported in the present study. The results suggest that backward masking deficit
      is an enduring feature of psychotic disturbances.

PMID- 8473876
TI  - The Defense Style Questionnaire.
AB  - The Defense Style Questionnaire has proven of interest as the first questionnaire
      to reliably describe defense styles. The 72-item DSM-III-R-labeled Defense Style
      Questionnaire was administered to 388 controls and 324 patients. Eight
      statistical and two a priori criteria were used in choosing two items to
      represent each of the 20 defenses. A new 40-item Defense Style Questionnaire is
      published together with normative and reliability data on a normal population,
      patients with anxiety disorders, and child-abusing parents. The scores are
      unaffected by the sex of the respondent, but the endorsement of immature defense
      styles decreases with age.

PMID- 8473877
TI  - Long-term mental sequelae of political imprisonment in East Germany.
AB  - This paper presents an assessment of the long-term mental sequelae of prolonged
      stress due to political persecution and imprisonment in the German Democratic
      Republic. Fifty-five former political prisoners with enduring psychiatric
      disorders were examined retrospectively in an exploratory study. The patients'
      experiences before, during, and after imprisonment were investigated using a
      semistructured interview. Psychopathological symptoms were assessed on clinical
      and self-rating scales; diagnostic classification was conducted according to DSM
      III-R. The patients had experienced serious trauma, including psychological
      torture, long-term imprisonment, and solitary confinement. We diagnosed a
      characteristic syndrome involving symptoms of depression and anxiety with
      vegetative complaints and increased arousal. In 35 (64%) patients, the symptoms
      persisted over an extended period without improvement. This syndrome resembles
      psychiatric disorders found after other forms of political persecution. It may be
      concluded that prolonged individually experienced political stress situations,
      even if they are not life-threatening, may have long-term mental sequelae.

PMID- 8473878
TI  - Prospective pilot study of survivors of torture and organized violence: examining
      the existential dilemma.

PMID- 8473879
TI  - Psychometric discrimination between anxiety and depression.

PMID- 8473880
TI  - Haem-peptide-protein interactions: Part 5. The haem undecapeptide microperoxidase
      11 (Fe3+MP-11)/human serum albumin (HSA) reaction in aqueous methanolic solution.
      A simple system demonstrating the effect of hydrophobicity on ligand release from
      a ligand-protein complex.
AB  - Previous studies of the interaction of the haem undecapeptide (MP-11) with
      lipidated human serum albumin in aqueous solution have been extended to a range
      of MeOH/H2O solution compositions. It is demonstrated that the kinetic mechanism
      for the interaction does not change from a simple second- and first-order
      reversible scheme as XMeOH is increased, however while k1--the association rate
      constant is essentially invariant with XMeOH, K-1 increases some 600-fold over
      the range studied. The result is interpreted in terms of increased solvational
      stabilization of MP-11 and transition state as XMeOH increases and it is noted
      that the system provides a simple demonstration of the effect of hydrophobicity
      on facilitating transported ligand release from ligand/carrier protein molecules.

PMID- 8473881
TI  - The transport of aluminum and water across the rat small intestine.
AB  - Aluminum transport across the epithelium of the rat small intestine has been
      investigated to determine factors affecting its absorption and its effect on the
      transport of other substances across the membrane. The intestines were attached
      to a perfusion apparatus and perfused with Krebs-Ringer-bicarbonate buffer
      containing aluminum. The transport of aluminum and buffer ions across the small
      intestine were measured. Phosphate transport was found to be the most
      satisfactory marker for viability. It is impossible to accurately measure the
      aluminum transport across a biological membrane unless the aluminum concentration
      of the solution is stable over the period of measurement. Hence, the solutions
      were stabilized with citrate ions which made them stable over a period of at
      least two hours. The velocity of transport of aluminum across the epithelium
      increased steadily and only became constant after about one hour. The steady
      state value of 0.12 micrograms atom of Al/hr/mg dry tissue compares well with
      that reported in the literature for stable aluminum solutions. Aluminum inhibited
      the transport of water across the membrane, but the inhibition took about two
      hours to reach a steady state of about 50% of the control value. This indicates
      that aluminum-containing medications and foods are able to interfere with the
      absorption of nutrients from the gut. Aluminum salts may therefore be useful to
      prevent rapid dehydration in the treatment of certain diseases such as cholera.

PMID- 8473882
TI  - Cytotoxic and cytostatic activity of copper(II) complexes. Importance of the
      speciation for the correct interpretation of the in vitro biological results.
AB  - The cytotoxicity of some copper(II) compounds against the mouse cancer cell line
      B16, murine L929, human KB cells, and fibroblasts was investigated. All the
      copper(II) systems tested were shown to have pronounced toxicity against
      transformed cells and a cytostatic effect against untransformed cells, i.e.,
      human fibroblasts. A careful speciation of the actual in vitro conditions reveals
      that copper(II) is essentially present as mixed complexes formed with the amino
      acids of the culture medium, [Cu(glutamine)(histidine)] being the main species.
      It was found that the cytotoxic activity is related to the amount of copper(II)
      contained in the tested compounds.

PMID- 8473883
TI  - The inhibition of corrinoid-catalyzed oxidation of mercaptoethanol by methyl
      iodide: mechanistic implications.
AB  - The cobalamin coenzymes (5'-deoxyadenosyl- and methylcobalamin) and their
      cobinamide counterparts (5'-deoxyadenosyl- and methylcobinamide) catalyze the
      oxidation of 2-mercaptoethanol to its disulfide with hydrogen peroxide formation
      under aerobic conditions. The reactions are blocked by methyl iodide. Inhibition
      by methyl iodide is apparently due to the formation of the trans dialkyl
      corrinoids: methyl(adenosyl)cobalamin, dimethylcobalamin,
      methyl(adenosyl)cobinamide, and dimethylcobinamide, respectively. When the
      reaction system is illuminated with visible light, inhibition is released and a
      dramatic enhancement in the rate of oxygen consumption occurs. For reactions
      catalyzed by adenosyl- and methylcobalamin and then inhibited by methyl iodide,
      the rates observed during photolysis approach those obtained with aquacobalamin.
      For reactions catalyzed by adenosyl- and methylcobinamide and then inhibited by
      methyl iodide, the rates observed during photlysis approach those obtained with
      diaquacobinamide. Thus, both trans axial carbon-cobalt bonds in the putative
      dialkyl corrinoid are homolyzed during photolysis. In contrast to these results,
      the catalysis of the aerobic oxidation of 2-mercaptoethanol by aquacobalamin is
      only weakly inhibited by methyl iodide. This observation suggests that
      aquacob(II)alamin is produced during the catalysis of this reaction. Superoxide,
      the anticipated product of the reaction between aquacob(II)alamin and dioxygen,
      is formed during aquacobalamin-catalyzed 2-mercaptoethanol oxidation since
      superoxide dismutase decreases the rate of oxygen consumption by 50%. However,
      the enzyme has no effect on oxygen uptake during reactions catalyzed by cobalamin
      coenzymes and their cobinamide counterparts. These corrinoid catalysts apparently
      transfer two electrons to dioxygen from cobalt(I) intermediates formed during the
      reactions. Nitrogenous bases inhibit corrinoid-catalyzed thiol oxidation by
      competing with 2-mercaptoethanol for axial-ligand coordination sites on the
      catalyst. In contrast to the inhibition observed with methyl iodide, visible
      light has no effect on the inhibition obtained with nitrogenous bases.

PMID- 8473884
TI  - Some potential antitumor 2,2'-dipyridylamine Pt(II)/Pd(II) complexes with amino
      acids: their synthesis, spectroscopy, DNA binding, and cytotoxic studies.
AB  - Four new palladium(II) and platinum(II) complexes of formula [M(dipy)(AA)]+
      (where dipy is 2,2'-dipyridylamine, AA is an anion of glycine or L-alanine, and M
      is Pd(II) or Pt(II)) have been synthesized and characterized with amino acids
      binding as bidentate ligands. These complexes are 1:1 electrolyte in conductivity
      water. Of the above four complexes, the two L-alanine complexes show ID50 values
      against P388 lymphocytic leukemia cells lower than cis
      diamminedichloroplatinum(II), whereas the two glycine complexes show ID50 values
      higher than cisplatin. The interaction of calf thymus DNA with the above
      complexes shows significant spectral changes in the presence of
      [Pt(dipy)(gly)]Cl, [Pd(dipy)(ala)]Cl, and [Pt(dipy)(ala)]Cl and the mode of
      binding between these complexes and DNA seems to be noncovalent.

PMID- 8473885
TI  - Cortical pyramidal neurone loss may cause glutamatergic hypoactivity and
      cognitive impairment in Alzheimer's disease: investigative and therapeutic
      perspectives.

PMID- 8473886
TI  - Differential effects of a phorbol ester on carboxypeptidase E in cultured
      astrocytes and AtT-20 cells, a neuroendocrine cell line.
AB  - Cultured astrocytes have been shown to secrete various neuropeptides and the
      neuropeptide processing enzyme, carboxypeptidase E (CPE). The secretion of CPE
      enzymatic activity from astrocytes has been shown previously to be increased
      approximately twofold by treatment with tetradecanoylphorbol 13-acetate (TPA), a
      phorbol ester. In this study, metabolic labeling with [35S]Met was utilized to
      examine the effect of TPA on the biosynthesis of CPE protein in cultured
      astrocytes and in AtT-20 cells, a pituitary-derived cell line. Treatment of
      astrocytes with 0.1 micrograms/ml TPA for 24 h caused an 80% increase in the
      level of radiolabeled CPE in both the media and the cells, indicating that the
      synthesis of CPE was stimulated by the TPA. AtT-20 cells also secreted more
      radiolabeled CPE in response to TPA, but this increase was offset by a
      proportional decrease in the cellular level of radiolabeled CPE, and synthesis of
      CPE was not stimulated in this cell line. Northern blot analysis demonstrated
      that 0.1 micrograms/ml TPA elevated CPE mRNA by approximately 50% in cultured
      astrocytes but not in AtT-20 cells. Quantitative in situ hybridization studies
      demonstrated that the TPA-induced increase in CPE mRNA expression was largely due
      to increases in the number of cells expressing CPE mRNA, although for astrocytes
      from some brain regions the average level of CPE mRNA per cell was also elevated
      by TPA. These results suggest that astrocytes can be induced to express CPE,
      which is consistent with a role for astrocytes in intercellular signaling.

PMID- 8473887
TI  - Ammonium injection induces an N-methyl-D-aspartate receptor-mediated proteolysis
      of the microtubule-associated protein MAP-2.
AB  - We have shown previously that chronic hyperammonemia increases, in brain, the
      polymerization of microtubules that is regulated mainly by the level and state of
      phosphorylation of microtubule-associated protein 2 (MAP-2). Activation of the N
      methyl-D-aspartate (NMDA) receptor dephosphorylates MAP-2. Because we have found
      that acute ammonia toxicity is mediated by the NMDA receptor, we have tested the
      effect of high ammonia levels on MAP-2 in brain. Microtubules isolated from rats
      injected intraperitoneally with 6 mmol/kg ammonium acetate showed a marked
      decrease of MAP-2. Also, the amount of MAP-2 in brain homogenates, determined by
      immunoblotting, was markedly reduced, presumably by proteolysis. The content of
      MAP-2 was decreased by approximately 75% 1-2 h after ammonium injection and
      returned to normal values after 4 h. Proteolysis of MAP-2 was prevented
      completely by injection of 2 mg/kg MK-801, a specific antagonist of the NMDA
      receptor, suggesting that proteolysis is mediated by activation of this receptor.
      L-Carnitine, which protects rats against ammonia toxicity, also prevented MAP-2
      degradation. Because activation of the NMDA receptor increases [Ca2+]i, we
      determined whether rat brain contains a Ca(2+)-dependent protease that
      selectively degrades MAP-2. We show that there is a cytosolic Ca(2+)-dependent
      protease that degrades MAP-2, but not other brain proteins. The protease has been
      identified tentatively as calpain I, for it is inhibited by a specific inhibitor
      of this protease. Our results suggest that ammonium injection activates the NMDA
      receptor, leading to an increase in [Ca2+]i, which activates calpain I. This, in
      turn, selectively degrades MAP-2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473888
TI  - CBP-18, a Ca(2+)-binding protein in rat brain: tissue distribution and
      localization.
AB  - The distribution of a novel calcium-binding protein with a molecular mass of 18
      kDa (CBP-18) in the rat brain was studied by means of biochemical methods and
      immunohistochemistry on cryostat-sectioned tissue and compared with staining
      patterns of parvalbumin on adjacent sections. The biochemical analysis revealed
      high levels of CPB-18 in cortex and cerebellum, low levels in the lungs, and
      undetectable levels in all other tissues tested. Immunohistochemically, the
      polyclonal rabbit-derived antibody for CPB-18 showed selective affinity with
      periglomerular cells and dendrites in the olfactory bulb. Distinct immunostaining
      of scattered cells and their proximal dendrites was found in the anterior
      olfactory nuclei and in the perirhinal and entorhinal cortex. Strong staining of
      neuropil with recognizable but diffusely outlined cells was observed in the
      retrosplenial cortex, central amygdala, hippocampal rudiment, septum, area
      preoptica, hypothalamus, colliculus superior, and parabrachial nuclei. The
      cerebellum showed strong neuropil staining of both the molecular and the granule
      cell layer. Less intense neuropil staining and a few scattered cells were found
      in the neocortex, the remaining basal forebrain, and in the entire brainstem.
      Immunoreactivity was barely detectable or missing in the striatum, the
      hippocampus, the thalamus, and in the colliculus inferior. Thus, CPB-18 shows a
      unique staining pattern in the CNS, different from all other Ca(2+)-binding
      proteins studied so far.

PMID- 8473889
TI  - Beta-amyloid protein precursor and tau mRNA levels versus beta-amyloid plaque and
      neurofibrillary tangles in the aged human brain.
AB  - To learn whether or not the levels of beta-amyloid protein precursor (APP) and
      tau mRNAs are related to the formation of beta-amyloid and neurofibrillary
      tangles, we quantified these mRNA levels in three cortical regions of 38 aged
      human brains, which were examined immunocytochemically for beta-amyloid and
      tangles. Marked individual variabilities were noted in APP and tau mRNA levels
      among elderly individuals. The mean APP mRNA level was slightly reduced in the
      beta-amyloid plaque (+2) group, but not in the plaque (+) group, compared to the
      plaque (-) group. Some brains in the plaque (-) group showed increased APP
      expression, the extent of which was not seen in the plaque (+) or (+2) group. The
      differences in the mean tau mRNA levels were not statistically significant among
      the tangle (-), (+), and (+2) groups. These results show that beta-protein and
      tau deposition do not accompany increased expression of the APP and tau genes,
      respectively, and thus suggest that factors other than gene expression may be at
      work in the progression of beta-amyloid and/or tangle formation in the aged human
      brain.

PMID- 8473890
TI  - Ethanol-induced aspartate and taurine release from primary astrocyte cultures.
AB  - Exposure of primary astrocyte cultures to isosmotic ethanol from 10-100 mM led to
      both swelling of the cells and release of [3H]taurine and D-[3H]aspartate.
      Exposure to hyperosmotic ethanol, in the same concentration range, caused neither
      swelling nor release. Release was inhibited by the anion transport blocker L
      644,711, already shown to inhibit amino acid release evoked by hypoosmotic or
      high-potassium medium, conditions that also cause astrocytic swelling. Ethanol
      induced release generally showed a decline in response to successive exposures to
      ethanol, and release was not dependent on extracellular calcium. Thus, the
      characteristics of swelling-induced release of amino acids by isosmotic ethanol
      seem to correspond to those of swelling-induced release from astrocytes due to
      exposure to hypotonic or high-K+ media. We discuss whether such effects may
      contribute to CNS damage after head injury and stroke.

PMID- 8473891
TI  - YM-09151-2 but not l-sulpiride induces transient dopamine release in rat striatum
      via a tetrodotoxin-insensitive mechanism.
AB  - The effects of the selective dopamine D2 receptor antagonists YM-09151-2 and l
      sulpiride on the in vivo release of dopamine (DA), L-3,4-dihydroxyphenylacetic
      acid (DOPAC), and homovanillic acid (HVA) in rat striatum were investigated. The
      drugs were injected into the striatum through a microinjection needle attached to
      a dialysis probe. YM-09151-2 (0.1 or 1.0 microgram/0.5 microliter) injected into
      the striatum produced a dramatic rapid-onset transient increase in striatal DA
      release in a dose-dependent manner. However, the DA increase induced by l
      sulpiride (15 or 75 ng/0.5 microliter) was small and of slower onset. An increase
      of DOPAC levels by YM-09151-2 was biphasic: The first peak occurred at 40 min,
      followed by a delayed-onset gradual increase. Slower-onset gradual increases were
      also found in DOPAC levels after l-sulpiride injection and in HVA levels after
      injections of both YM-09151-2 and l-sulpiride. The infusion of tetrodotoxin (TTX;
      2 microM) revealed two different types of DA release mechanisms: The rapid-onset
      transient DA release induced by YM-09151-2 was TTX insensitive, whereas the
      slower-onset DA release induced by l-sulpiride was TTX sensitive. Moreover, the
      rapid-onset transient DA release was Ca2+ independent and was not affected by
      pretreatment with l-sulpiride or nomifensine. Therefore, it is concluded that YM
      09151-2 injected into the striatum produced a transient striatal DA release that
      is independent of D2 receptors and the action potential.

PMID- 8473892
TI  - Casein kinase II activity in the postischemic rat brain increases in brain
      regions resistant to ischemia and decreases in vulnerable areas.
AB  - Casein kinase II (CKII) is a protein kinase acting in the intracellular cascade
      of reactions activated by growth factor receptors, and that has a profound
      influence on cell proliferation and survival. In this investigation, we studied
      the changes in the activity and levels of CKII in the rat brain exposed to 10, 15
      and 20 min of transient forebrain ischemia followed by variable periods of
      reperfusion. The cytosolic CKII activity decreased during reperfusion by
      approximately 30 and approximately 50% in the selectively vulnerable areas,
      striatum and the CA1 region of the hippocampus, respectively. In the resistant
      CA3 region of hippocampus and neocortex, the activity increased by approximately
      20 and approximately 60%, respectively. The postischemic changes in CKII activity
      were dependent on the duration of the ischemic insult. The levels of CKII did not
      change after ischemia, suggesting that the enzyme is modulated by covalent
      modification or is interacting with an endogenous inhibitor/activator. Treatment
      of the cytosolic fraction from cortex of rats exposed to ischemia and 1 h of
      reperfusion with agarose-bound phosphatase decreased the activity of CKII to
      control levels, suggesting that CKII activation after ischemia involves a
      phosphorylation of the enzyme. The correlation between postischemic CKII activity
      and neuronal survival implies that preservation or activation of CKII activity
      may be important for neuronal survival after cerebral ischemia.

PMID- 8473893
TI  - Catecholamines are present in a synaptic-like microvesicle-enriched fraction from
      bovine adrenal medulla.
AB  - "Synaptic-like microvesicles" are present in all neuroendocrine cells and cell
      lines. Despite their resemblance to small synaptic vesicles of the CNS, a
      thorough biochemical characterization is lacking. Moreover, the subcellular
      distribution of synaptophysin, the most abundant integral membrane protein of
      small synaptic vesicles, in adrenal medulla is still controversial. Using
      gradient centrifugation, we were able to compare the distribution of several
      markers for small synaptic vesicles and chromaffin granules. Synaptophysin was
      found at a high density (1.16 g/ml), purifying away from dopamine beta
      hydroxylase and cytochrome b561. Both noradrenaline and adrenaline showed a
      parallel distribution with synaptophysin, suggesting their presence in synaptic
      like microvesicles. Experiments in the presence of tetrabenazine did not
      influence the catecholamine content. Additionally, tetrabenazine binding showed a
      consistent shoulder in the region of synaptophysin. [3H]Noradrenaline uptake was
      blocked by tetrabenazine, but not by desipramine. Also chromogranin A parallels
      the distribution of synaptophysin; however, a localization in the Golgi cannot be
      ruled out. Synaptophysin was shown to undergo very fast phosphorylation, together
      with another triplet protein of approximately 18 kDa. In contrast, the latter
      showed a rather bimodal distribution coinciding with synaptophysin and dopamine
      beta-hydroxylase. Immunoelectron microscopy of synaptic-like microvesicle
      fractions showed an intense labeling for synaptophysin on 60-90-nm organelles.
      Whereas abundant gold labeling for cytochrome b561 was found over the entire
      surface of chromaffin granules, synaptophysin labeling was encountered mostly on
      vesicles adsorbed to granules. We conclude that catecholamines might be stored in
      synaptic-like microvesicles of the chromaffin cell.

PMID- 8473894
TI  - Opioid peptides in the rabbit carotid body: identification and evidence for co
      utilization and interactions with dopamine.
AB  - The rabbit carotid body is a catecholaminergic organ that contains dopamine and
      norepinephrine in a proportion of nearly 5:1. Chronic (15 days) carotid sinus
      nerve denervation or superior cervical ganglionectomy did not modify the carotid
      body dopamine content (5-6 nmol/mg of protein, equivalent to 250 pmol per carotid
      body), but sympathectomy reduced by approximately 50% the norepinephrine content.
      The carotid body has also a very high content of opioid activity (250 equivalent
      pmol of Leu-enkephalin/mg of protein) as measured by a radioreceptor assay that
      detects preferentially delta-opioid activity. In the carotid body the degree of
      opioid posttranslational processing to low-molecular-weight peptides (mostly Leu-
      and Met-enkephalin) is nearly 80%. HPLC identification of opioid peptides
      revealed that the sequences of Met- and Leu-enkephalin were in a proportion of
      nearly 6:1, indicating that the main opioid precursor in the carotid body is
      proenkephalin A. Chronic denervations of the carotid body did not modify the
      levels or the degree of opioid precursor processing. Acute hypoxic exposure of
      the animals (8% O2 in N2; 3 h) resulted in a parallel decrease of dopamine and
      opioid activity, without any change in the degree of opioid processing.
      Norepinephrine levels were not affected by hypoxia. These findings suggest
      corelease of dopamine and opioids during natural hypoxic stimulation. In
      agreement with the analytical data, [D-Ala2, D-Leu5]enkephalin, but not [D-Ala2,N
      Me-Phe4,Gly5-ol]-enkephalin, reduced the in vitro release of dopamine induced by
      low PO2, a high external K+ concentration, and dinitrophenol. Naloxone augmented
      the release response elicited by low PO2 stimulation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8473895
TI  - Effects of chronic hypoxia on opioid peptide and catecholamine levels and on the
      release of dopamine in the rabbit carotid body.
AB  - Carotid body catecholamine and opioid levels were measured in rabbits exposed for
      8 days to an atmosphere of 11% O2 in N2 (PO2 of approximately 80 mm Hg) and
      during an identical period of recovery, i.e., after 8 days of returning to the
      control normoxic atmosphere. Carotid bodies show a decrease in dopamine content
      at day 2. Thereafter, the levels of this biogenic amine increase progressively to
      peak at day 10, that is, 2 days after returning to a normoxic atmosphere.
      Finally, dopamine levels start to decrease and reach prehypoxic control levels at
      day 16, that is, after 8 days of recovery. In contrast, levels of native opioid
      peptides remain unchanged during the whole duration of the experiment, except for
      a decrease at day 2 of the hypoxic exposure. Levels of total opioid peptides are
      also below control values at day 2 of hypoxia, increase above control values on
      returning to a normoxic atmosphere (maximal levels at days 10-12), and later
      decrease to reach prehypoxic levels at day 16. As a result of these changes the
      ratios of dopamine to opioid levels show a progressive increase from day 0 to day
      10 of the experiment and then return to control prehypoxic values. Carotid bodies
      isolated from animals that have been exposed to hypoxia for 8 days synthesize
      [3H]dopamine from its natural precursor [3H]tyrosine at a rate of 175 pmol/mg of
      protein/h, which is about double the rate of synthesis found in the carotid
      bodies of control animals and those allowed to recover for 8 days.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8473896
TI  - Cellular localization of transforming growth factor-alpha mRNA in rat forebrain.
AB  - The cellular localization of transforming growth factor-alpha (TGF alpha) mRNA in
      juvenile and adult rat forebrain was examined using in situ hybridization with a
      35S-labeled cRNA probe. TGF alpha cRNA-labeled neuronal perikarya were
      distributed across many forebrain regions including the olfactory bulb, caudate
      putamen, nucleus accumbens, olfactory tubercle, ventral pallidum, amygdala,
      hippocampal stratum granulosum and CA3 stratum pyramidale, and piriform,
      entorhinal, and retrosplenial cortices. TGF alpha cRNA-hybridizing cells were
      also localized to several thalamic nuclei and to the suprachiasmatic,
      dorsomedial, and ventromedial nuclei of the hypothalamus. In addition, labeled
      cells were present in regions of white matter including the corpus callosum,
      anterior commissure, internal and external capsules, optic tract, and lateral
      olfactory tract. Thus, both neurons and glia appear to synthesize TGF alpha in
      normal brain. Hybridization densities were greater in neuronal fields at 2 weeks
      of age compared with the adult, suggesting a role for TGF alpha in the
      development of several forebrain systems. Our results demonstrating the prominent
      and wide-spread expression of TGF alpha mRNA in forebrain, combined with the
      extremely low abundance of epidermal growth factor mRNA in brain, support the
      argument that TGF alpha is the principal endogenous ligand for the epidermal
      growth factor receptor in normal brain.

PMID- 8473897
TI  - Methamphetamine-induced dopamine overflow and injury to striatal dopamine
      terminals: attenuation by dopamine D1 or D2 antagonists.
AB  - Pharmacological blockade of either D1 or D2 dopamine (DA) receptors prevents
      damage of striatal DA terminals by repeated doses of methamphetamine (m-AMPH).
      Because the substantial DA overflow produced by multiple m-AMPH treatments
      appears to contribute to the subsequent injury, we have investigated the effects
      of blockade of D1 or D2 receptors on m-AMPH-induced DA efflux using in vivo
      microdialysis. Four treatments with m-AMPH (4 mg/kg, s.c., 2-h intervals)
      produced large increases in striatal DA overflow, with particularly marked
      overflow (10 times the basal values) following the fourth injection. Administered
      by themselves, four injections of the D1 antagonist SCH 23390 or the D2
      antagonist eticlopride (0.5 mg/kg, i.p., 2-h intervals) significantly increased
      striatal DA overflow. However, treatment with either SCH 23390 or eticlopride 15
      min before each of four m-AMPH injections attenuated the marked DA peak otherwise
      seen after the fourth m-AMPH injection. These effects on DA overflow were related
      to subsequent DA depletions. Although our m-AMPH regimen produced a 54% reduction
      in striatal DA tissue content 1 week later, pretreatments with either the D1 or
      the D2 antagonist completely prevented subsequent DA content depletions.
      Furthermore, the DA content of striatal tissue remaining 1 week after m-AMPH
      treatment was significantly correlated with the magnitude of the cumulative DA
      overflow during the m-AMPH treatment (r = -0.69). Thus, the extensive DA overflow
      seen during neurotoxic regimens of m-AMPH appears critical to the subsequent
      neurotoxicity, and the neuroprotective action of DA receptor antagonists seems to
      result from their attenuation of stimulant-induced DA overflow.

PMID- 8473898
TI  - Characterization of tritiated noradrenaline release from the rat preoptic area
      with microdialysis in vivo.
AB  - Present techniques are unable to provide a sensitive and accurate index of
      noradrenergic activity in the rat preoptic area. In this study, we have examined
      the brainstem A1 noradrenergic input to the preoptic area using a new technique
      whereby [3H]noradrenaline is preloaded into the preoptic area and release of
      radioactivity from this region is measured subsequently using microdialysis in
      vivo. Electrical stimulation of the ipsilateral A1 area for 20 min at 5, 10, and
      15 Hz evoked significant increases in dialysate radioactivity that were
      repeatable and frequency-dependent. After removal of calcium from the perfusion
      medium, basal release of radioactivity was markedly reduced and the effect of A1
      stimulation abolished. Changing to a 100 mM K+ medium evoked an increase in the
      release of radioactivity that was sixfold greater than that seen after A1
      stimulation. Separation of the dialysate with HPLC showed that 33% of the
      increase in measured radioactivity after A1 stimulation was directly attributable
      to [3H]noradrenaline and the remainder to the metabolites vanillylmandelic acid,
      3,4-dihydroxymandelic acid, and 3,4-dihydroxyphenylglycol. In contrast, the
      increase in radioactivity after K+ depolarization was due almost completely to
      [3H]noradrenaline. Addition of 10 microM clonidine to the perfusion medium
      markedly reduced basal release of radioactivity, but had no effect on evoked
      release following A1 stimulation. Conversely, perfusion with 10 microM yohimbine
      had no effect on basal release, but significantly increased evoked release after
      A1 stimulation. These results now provide a characterization of noradrenergic
      activity in the preoptic area and indicate the importance of the A1 noradrenergic
      input to this region. The technique of measuring radioactivity with microdialysis
      after preloading with [3H]noradrenaline provides a relatively simple, sensitive
      index of noradrenergic activity in vivo with good temporal resolution.

PMID- 8473899
TI  - Elevated stimulatory and reduced inhibitory G protein alpha subunits in
      cerebellar cortex of patients with dominantly inherited olivopontocerebellar
      atrophy.
AB  - Although guanine nucleotide binding proteins (G proteins) are one of the critical
      components of signal transduction units for various membrane receptor-mediated
      responses, little information is available regarding their status in brain of
      patients with neurodegenerative illnesses. We measured the immunoreactivity of G
      protein subunits (Gs alpha, Gi alpha, Go alpha, Gq/11 alpha, and G beta) in
      autopsied cerebellar and cerebral cortices of 10 end-stage patients with
      dominantly inherited olivopontocerebellar atrophy (OPCA) who all had severe loss
      of Purkinje cell neurons and climbing fiber afferents in cerebellar cortex.
      Compared with the controls, the long-form Gs alpha (52-kDa species)
      immunoreactivity was significantly elevated by 52% (p < 0.01) in the cerebellar
      cortex of the OPCA patients, whereas the Gi1 alpha concentration was reduced by
      35% (p < 0.02). No statistically significant differences were observed for Go
      alpha, Gi2 alpha, G beta 1, G beta 2, or Gq/11 alpha in cerebellar cortex or for
      any G protein subunit in the two examined cerebral cortical subdivisions (frontal
      and occipital). The cerebellar Gs alpha elevation could represent a compensatory
      response (e.g., sprouting, reactive synaptogenesis) by the remaining cerebellar
      neurons (granule cells?) to neuronal damage but also might contribute to the
      degenerative process, as suggested by the ability of Gs alpha, in some
      experimental preparations, to promote calcium flux. Further studies will be
      required to determine the actual functional consequences of the G protein changes
      in OPCA and whether the elevated Gs alpha is specific to OPCA cerebellum, because
      of its unique cellular pattern of morphological damage, or is found in brain of
      patients with other progressive neurodegenerative disorders.

PMID- 8473900
TI  - Regulation of protein kinase C activity by sensory deprivation in the olfactory
      and visual systems.
AB  - Environmental regulation of sensory function has provided an important model of
      plastic mechanisms mediating neural information processing. To define potential
      commonalities in information processing in different systems, we investigated
      molecular changes elicited by sensory deprivation in the developing rat olfactory
      and visual systems. Protein kinase C (PKC), an intracellular messenger implicated
      in synaptic plasticity and memory, was analyzed. Initial, developmental studies
      indicated that PKC activity in the soluble and particulate fractions of the
      olfactory bulb increased three- to fourfold from birth to 3 months of age.
      Unilateral olfactory deprivation prevented the developmental increase in both
      soluble and particulate PKC activities in the ipsilateral olfactory bulb and
      piriform cortex, the second-order relay. Phorbol ester binding localized PKC to
      intrinsic neuronal populations and their dendrites in the control and deprived
      bulbs. Moreover, PKC was similarly lower in the visual cortex of dark-reared rats
      than in light-reared controls. The changes in PKC were region specific, as
      activity was unchanged by either treatment in the parietal cortex, a control area
      that does not process primary olfactory or visual information. Our results
      suggest that the important intracellular messenger, PKC, is similarly regulated
      in entirely different sensory systems by different environmental stimuli.
      Consequently, different sensory systems may use common molecular mechanisms to
      process information.

PMID- 8473901
TI  - Complex interactions among second messenger pathways, steroid hormones, and
      protooncogenes of the Fos and Jun families converge in the regulation of the
      nerve growth factor gene.
AB  - Regulation of the expression of the nerve growth factor (NGF) gene has been
      reported previously to be mediated via the protooncogene c-fos. Activation of the
      protein kinase C pathway and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] has also been
      reported to increase the pool of NGF transcripts in L929 fibroblasts. Here we
      show that activation of the cyclic AMP second messenger pathway antagonized the
      effect of phorbol 12-myristate 13-acetate (PMA) or serum on NGF synthesis,
      whereas it enhanced that of 1,25(OH)2D3. A positive effect was also observed when
      serum, PMA, and 1,25(OH)2D3 were added together, but dexamethasone reduced this
      enhancement. There was no close correlation between the increase in c-fos mRNA
      and that in NGF mRNA, suggesting that expression of the c-fos protooncogene is
      not necessarily followed by induction of the NGF gene. Rather, these two genes
      are simultaneously, and not sequentially, induced after forskolin treatment. It
      appears that regulation of the NGF gene depends on a repertoire of multiple
      regulatory AP-1 complexes arising from activation of the second messenger
      pathways. This suggests that NGF gene expression is under the control of a
      complex interplay among second messenger pathways, protooncogenes, and steroid
      hormones such as 1,25(OH)2D3 and glucocorticoids.

PMID- 8473902
TI  - Developmental changes in expression of a 60-kDa somatostatin receptor
      immunoreactivity in the rat brain.
AB  - The neuropeptide somatostatin (SRIF) exerts several important physiological
      actions in the adult CNS through interactions with membrane-bound receptors. SRIF
      expression is developmentally regulated and this regulation is most apparent in
      the cerebellum, where SRIF immunoreactivity is expressed at early postnatal ages
      and then disappears toward adulthood. The transitory nature of SRIF expression at
      a time of major changes in cerebellum suggests that this peptide may have a role
      in cerebellar development. To further investigate the role of the SRIF
      transmitter system during development, we have examined the levels of expression
      of SRIF receptors in the developing rat brain by immunoblotting using antiserum
      selective for a 60-kDa brain SRIF receptor. In whole rat brain, SRIF receptor
      immunoreactivity first appears at embryonic day 13 (E13), is elevated at E16,
      increases at birth, peaks at early postnatal ages, and then gradually declines
      with age. No apparent changes in size of the receptor occur with age. No
      consistent changes in levels of SRIF receptor immunoreactivity are detected from
      early postnatal ages to adulthood in the hippocampus, cerebral cortex, and
      striatum, but levels gradually decline in the hypothalamus. In contrast, SRIF
      receptor immunoreactivity is expressed transiently in cerebellum. SRIF receptor
      immunoreactivity is detectable in cerebellum at E16, increases in levels at
      birth, is apparent from postnatal day 3 to postnatal day 8, and then disappears.
      The transitory nature of SRIF receptor expression in cerebellum is unique and
      parallels the expression of SRIF immunoreactivity in this brain region. These
      findings support the hypothesis that SRIF has a role in cerebellar development.

PMID- 8473903
TI  - Effect of chronic estradiol and progesterone treatments of ovariectomized rats on
      brain dopamine uptake sites.
AB  - Dopamine released from brain nerve terminals is mainly removed from the synaptic
      cleft by an uptake mechanism. Despite their functional importance, modulation of
      the dopamine uptake sites is still not well known. Steroid hormones were shown to
      modulate brain dopamine transmission. The aim of this study was thus to
      investigate in ovariectomized rats the effects of 17 beta-estradiol and
      progesterone treatments on brain dopamine uptake sites. Treatments consisted of
      17 beta-estradiol (10 micrograms/0.2 ml), progesterone (0.72 mg/0.2 ml), 17 beta
      estradiol + progesterone, or the vehicle (0.3% gelatin in saline solution) twice
      daily for 2 weeks. The steroid treatments left the affinity of [3H]GBR 12935
      binding to striatal homogenates unchanged (ovariectomized rats, 0.823 +/- 0.028
      nM), whereas the density was increased by these steroids alone or in combination
      to a similar extent of 16-23%. Chronic treatment of ovariectomized rats with 17
      beta-estradiol, progesterone, or their combination increased to the same extent
      and uniformly [3H]-GBR 12935 binding in the striatum as measured by
      autoradiography; the increase was similar in the substantia nigra pars compacta,
      whereas no steroid effect was observed in the nucleus accumbens and in the
      substantia nigra pars reticulata. In summary, chronic exposure to 17 beta
      estradiol and/or progesterone increased dopamine uptake site density in the
      nigrostriatal dopaminergic system, whereas the nucleus accumbens and the
      substantia nigra pars reticulata were unaffected.

PMID- 8473904
TI  - Locally synthesized phosphatidylcholine, but not protein, undergoes rapid
      retrograde axonal transport in the rat sciatic nerve.
AB  - Retrograde axonal transport of phosphatidylcholine in the sciatic nerve has been
      demonstrated only after injection of lipid precursors into the cell body region.
      We now report, however, that after microinjection (1 microliter) of [methyl
      3H]choline chloride into the rat sciatic nerve (35-40 mm distal to the L4 and L5
      dorsal root ganglia), time-dependent accumulation of 3H-labeled material occurred
      in dorsal root ganglia ipsilateral, but not contralateral, to the injection site.
      The level of radioactivity in the ipsilateral dorsal root ganglia was minimal at
      2 h after isotope injection but was significantly increased at 7, 24, 48, and 72
      h after intraneural isotope injection (n = 3-8 per time point); at these time
      points, all of the radiolabel in the chloroform/methanol extract of the
      ipsilateral dorsal root ganglia was present in phosphatidylcholine. The
      radioactivity in the water-soluble fraction did not show a time-dependent
      accumulation in the ipsilateral dorsal root ganglia as compared with the
      contralateral DRGs, ruling out transport or diffusion of precursor molecules. In
      addition, colchicine injection into the sciatic nerve proximal to the isotope
      injection site prevented the accumulation of radiolabel in the ipsilateral dorsal
      root ganglia. Therefore, this time-dependent accumulation of radiolabeled
      phosphatidylcholine in the ipsilateral dorsal root ganglia is most likely due to
      retrograde axonal transport of locally synthesized phospholipid material.
      Moreover, 24 h after injection of both [3H]choline and [35S]-methionine into the
      sciatic nerve, the ipsilateral/contralateral ratio of radiolabel was 11.7 for 3H
      but only 1.1 for 35S, indicating that only locally synthesized choline
      phospholipids, but not protein, were retrogradely transported.

PMID- 8473905
TI  - Nine residues influence the binding of alpha-bungarotoxin in alpha-subunit region
      185-200 of human muscle acetylcholine receptor.
AB  - Identification of residues in the skeletal muscle nicotinic acetylcholine
      receptor (AChR) that bind snake venom alpha-neurotoxin antagonists of
      acetylcholine [e.g., alpha-bungarotoxin (alpha-BTx)] provides structural
      information about the neurotransmitter binding region of the receptor. Using
      synthetic peptides of the human AChR alpha-subunit region 177-208, we previously
      localized a pharmacologically specific binding site for alpha-BTx in segment 185
      199. To define in more detail the residues that influence the binding of alpha
      BTx to this region, we prepared 16 peptide analogues of the alpha-subunit segment
      185-200, with the amino acid L-alanine sequentially replacing each native amino
      acid. Circular dichroism spectroscopy did not reveal changes in the secondary
      structure of the peptides except for the analogue in which Pro194 was substituted
      with alanine. This implies that any change in alpha-BTx binding could be
      attributed to replacement of the native residue's side chain by alanine's methyl
      group, rather than to a change in the structure of the peptide. The influence of
      each substitution with alanine was determined by comparing the analogue to the
      parental sequence alpha 185-200 in solution-phase competition with native human
      AChR for binding of 125I-labeled alpha-BTx. The binding of alpha-BTx by analogue
      peptides with alanine substituted for Tyr190, Cys192, or Cys193 was greatly
      diminished. Binding of alpha-BTx to peptides containing alanine replacements at
      Val188, Thr189, Pro194, Asp195, or Tyr198 was also reduced significantly (p <
      0.003). An unanticipated finding was that substitution of alanine for Ser191
      significantly increased alpha-BTx binding (p < 0.003).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8473906
TI  - Rat brain glyceraldehyde-3-phosphate dehydrogenase interacts with the recombinant
      cytoplasmic domain of Alzheimer's beta-amyloid precursor protein.
AB  - Abundant senile plaques are a histological hallmark in the brain of Alzheimer's
      disease patients. Such plaques consist of, among many other constituents,
      aggregated beta A4 amyloid peptide. This peptide is derived from an amyloid
      precursor protein (APP) by irregular proteolytic processing and is considered to
      be involved in the development of Alzheimer's disease. To study possible
      interactions of brain proteins with beta A4 amyloid or other fragments of APP,
      beta A4 amyloid and beta A4 amyloid extended to the C-terminus of APP were
      recombinantly produced as fusion proteins termed "Amy" and "AmyC," respectively.
      Using Amy and AmyC affinity chromatography, a 35-kDa protein from rat brain was
      isolated that bound tightly to AmyC but not to Amy, thus indicating an
      interaction of the protein with the C-terminus of APP. This 35-kDa protein was
      identified as the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase
      (GAPDH). Binding of GAPDH to AmyC but not to Amy was confirmed by gel filtration.
      Although AmyC slightly reduced the Vmax of GAPDH, the same reduction was observed
      in the presence of Amy. These findings suggest that the interaction of the
      cytoplasmic domain of APP with GAPDH is unlikely to influence directly the rate
      of glycolysis but may serve another function.

PMID- 8473907
TI  - Difference in the effectiveness of Ca2+ to evoke catecholamine secretion between
      adrenaline- and noradrenaline-containing cells of bovine adrenal medulla.
AB  - Differential adrenaline (Ad) and noradrenaline (NA) secretions evoked by
      secretagogues were investigated using digitonin-permeabilized adrenal chromaffin
      cells, cultured adrenal chromaffin cells, and perfused adrenal glands of the ox.
      In digitonin-permeabilized cells, Ca2+ (0.8-160 microM) caused a concentration
      dependent increase in catecholamine secretion, which was characterized by a
      predominance of NA over Ad secretion. Acetylcholine (10-1,000 microM), high K+
      (14-56 mM), and bradykinin (0.1-1,000 nM) all were confirmed to induce the
      release of more NA than Ad at all concentrations used. There was no apparent
      difference in the ratios of NA/Ad between Ca(2+)-induced catecholamine secretion
      from digitonin-permeabilized cells and those induced by secretagogues from
      cultured cells. Qualitatively the same result was obtained in the secretory
      responses to acetylcholine and high K+ in perfused adrenal glands. These results
      indicate that the effectiveness of Ca2+ for catecholamine secretion is higher in
      the secretory apparatus of NA cells than in that of Ad cells of the bovine
      adrenal medulla. This may be one of the reasons why the secretagogues cause a
      predominance of NA secretion over Ad secretion in the bovine adrenal medulla.

PMID- 8473908
TI  - The chronic administration of nicotine induces cytochrome P450 in rat brain.
AB  - The objective of these studies was to determine whether chronic administration of
      nicotine altered the cytochrome P450 (P450) monooxygenase system in rat brain.
      Male Sprague-Dawley rats received injections of nicotine bitartrate (1.76 mg/kg,
      s.c., twice daily for 10 days), and total cytochrome P450 content, the activity
      of NADPH-cytochrome c reductase, and the activities and relative abundance of
      P4502B1 and P4502B2 (P4502B1/2) were determined in microsomal fractions from rat
      brain. The content of P450 increased significantly (p < 0.02) in all brain
      regions examined from nicotine-injected rats; the largest increase (208% of
      control) was in frontal cortex and the smallest increase (122% of control) in
      cerebellum. The activity of NADPH-cytochrome c reductase was unaltered by
      nicotine administration. Benzyloxyresorufin O-dealkylase (BROD) and
      pentoxyresorufin O-dealkylase (PROD) activities, mediated by P4502B1/2, increased
      significantly (p < 0.02) following nicotine administration; the largest increase
      (213-227% of control) was in frontal cortex. Western blots of microsomal proteins
      indicated that the increase in enzymatic activity was associated with an increase
      in content of P4502B1/2 immunoreactive proteins. In contrast to brain, total P450
      content, activities of NADPH-cytochrome c reductase, BROD, and PROD, and levels
      of P4502B1/2 immunoreactive proteins in liver were unaffected by chronic nicotine
      administration. Results indicate that chronic nicotine administration regulates
      the expression of P4502B1/2 in brain and that at the dose schedule used this
      effect occurs without a demonstrable effect on the hepatic P450 monooxygenase
      system.

PMID- 8473909
TI  - Angiotensin II type 1 receptor mRNA levels in the brains of normotensive and
      spontaneously hypertensive rats.
AB  - The type 1 angiotensin II (AII) receptor (AT1-R) has been implicated in the
      physiological actions mediated by AII in the brain. In view of the reported
      hyperactivity of the brain AII system in the spontaneously hypertensive rat
      (SHR), we compared the expression of AT1-R mRNAs in the brains of normotensive
      [Wistar Kyoto (WKY)] and SHR animals. Northern blot analysis showed about three-
      and approximately 20-fold increases in the levels of AT1-R mRNAs from the
      hypothalamus and brainstem areas, respectively, of the SHR compared with the WKY
      rat brain. This was attributable to greater levels of both AT1A- and AT1B-R mRNA
      subtypes in these areas from the SHR. These observations suggest that increased
      AII receptor levels in SHR brain may, in part, be a result of increased
      expression of the AT1-R gene.

PMID- 8473910
TI  - Identification of the cationic amino acid transporter (System y+) of the rat
      blood-brain barrier.
AB  - Cationic amino acids are transported from blood into brain by a saturable carrier
      at the blood-brain barrier (BBB). The transport properties of this carrier were
      examined in the rat using an in situ brain perfusion technique. Influx into brain
      via this system was found to be sodium independent and followed Michaelis-Menten
      kinetics with half-saturation constants (Km) of 50-100 microM and maximal
      transport rates of 22-26 nmol/min/g for L-lysine, L-arginine, and L-ornithine.
      The kinetic properties matched that of System y+, the sodium-independent cationic
      amino acid transporter, the cDNA for which has been cloned from the mouse. To
      determine if the cloned receptor is expressed at the BBB, we assayed RNA from rat
      cerebral microvessels and choroid plexus for the presence of the cloned
      transporter mRNA by RNase protection. The mRNA was present in both cerebral
      microvessels and choroid plexus and was enriched in microvessels 38-fold as
      compared with whole brain. The results indicate that System y+ is present at the
      BBB and that its mRNA is more densely expressed at cerebral microvessels than in
      whole brain.

PMID- 8473911
TI  - Age-dependent impairment of mitochondrial function in primate brain.
AB  - It has been hypothesized that some of the functional impairments associated with
      aging are the result of increasing oxidative damage to mitochondrial DNA that
      produces defects in oxidative phosphorylation. To test this hypothesis, we
      examined the enzymes that catalyze oxidative phosphorylation in crude
      mitochondrial preparations from frontoparietal cortex of 20 rhesus monkeys (5-34
      years old). Samples were assayed for complex I, complex II-III, complex IV,
      complex V, and citrate synthase activities. When enzyme activities were corrected
      for citrate synthase activities (to account for variable degrees of mitochondrial
      enrichment), linear regression analysis demonstrated a significant negative
      correlation of the activities of complex I (p < 0.002) and complex IV (p < 0.03)
      with age but no significant change in complex II-III or complex V activities.
      Relative to animals 6.9 +/- 0.9 years old (n = 7), the citrate synthase-corrected
      activity of complex I was reduced by 17% in animals 22.5 +/- 0.9 years old (n =
      6) (p < 0.05) and by 22% in animals 30.7 +/- 0.9 years old (n = 7) (p < 0.01).
      Similar age-related reductions in the activities of complexes I and IV were
      obtained when enzyme activities were corrected for complex II-III activity. These
      findings show an age-associated progressive impairment of mitochondrial complex I
      and complex IV activities in cerebral cortices of primates.

PMID- 8473912
TI  - The N-methyl-D-aspartate antagonist MK-801 fails to protect dopaminergic neurons
      from 1-methyl-4-phenylpyridinium toxicity in vitro.
AB  - Recent reports suggest that NMDA receptor antagonists when administered in vivo
      can protect dopaminergic neurons from the toxic actions of MPP+. In the present
      study the possible neuro-protective effects against MPP+ toxicity of the
      noncompetitive NMDA receptor antagonist MK-801 was studied in primary cultures of
      fetal rat mesencephalic dopamine neurons. MK-801 failed to protect dopaminergic
      neurons from MPP+ toxicity at concentrations that completely block NMDA-induced
      toxicity of these same neurons. In contrast to work carried out in cerebellar
      granule cells, MPP+ toxicity of mesencephalic dopamine neurons was unaffected by
      preexposure to subtoxic concentrations of either NMDA or cycloheximide. Our
      findings suggest that the toxic effects of MPP+ on dopaminergic neurons are not
      mediated through a direct interaction with the NMDA subtype of glutamate
      receptor.

PMID- 8473913
TI  - Neuromelanin and nigrostriatal dopamine neuron degeneration.

PMID- 8473914
TI  - Phospholipase D in chromaffin cells?

PMID- 8473915
TI  - Conformations of large cycloalkanes: cyclooctadecane, cyclononadecane and
      cycloicosane.
AB  - The conformations of cyclooctadecane, cyclononadecane, and cycloicosane were
      generated by a stochastic program that works in conjunction with MM2. The shapes
      of the rings are analyzed in terms of previous work by Dale and others, and in
      terms of distributions of energies, torsion angle distributions, and torsion
      angle sequences. A new shape element called the 'nick' has been discovered, and
      it seems to be increasingly important with 18-membered and larger rings.
      Previously suggested relationships between ring size and energy distribution were
      observed, and a geometrical explanation is provided for the relative
      distributions of stable conformations in 16-, 18-, and 20-membered rings.

PMID- 8473916
TI  - GenStar: a method for de novo drug design.
AB  - A novel method, which we call GenStar, has been developed to suggest chemically
      reasonable structures which fill the active sites of enzymes. The proposed
      molecules provide good steric contact with the enzyme and exist in low-energy
      conformations. These structures are composed entirely of sp3 carbons which are
      grown sequentially, but which can also branch or form rings. User-selected enzyme
      seed atoms may be used to determine the area in which structure generation
      begins. Alternatively, GenStar may begin with a predocked 'inhibitor core' from
      which atoms are grown. For each new atom generated by the program, several
      hundred candidate positions representing a range of reasonable bond lengths, bond
      angles, and torsion angles are considered. Each of these candidates is scored,
      based on a simple enzyme contact model. The selected position is chosen at random
      from among the highest scoring cases. Duplicate structures may be removed using a
      variety of criteria. The compounds may be energy minimized and displayed using
      standard modeling programs. Also, it is possible to analyze the collection of all
      structures created by GenStar and locate binding motifs for common fragments such
      as benzene and naphthylene. Tests of the method using HIV protease, FK506 binding
      protein (FKBP-12) and human carbonic anhydrase (HCA-II) demonstrated that
      structures similar to known potent inhibitors may be generated with GenStar.

PMID- 8473917
TI  - FOUNDATION: a program to retrieve all possible structures containing a user
      defined minimum number of matching query elements from three-dimensional
      databases.
AB  - A program is described that searches three-dimensional, structural databases,
      given a user-defined query, in order to retrieve all structures that contain any
      combination of a user-specified minimum number of matching elements. Queries
      consist of three-dimensional coordinates of atoms and/or bonds. Numerous query
      constraints are described which allow the investigator to define the chemical
      nature of the desired structures as well as the environment within which these
      structures must reside. They include: (1) Bonded vs. isolated atom distinction;
      (2) Atom type designation; (3) Definition of subsets with occupancy specification
      (>, =, < X atoms); (4) RMS-fit; (5) Active site volume accessibility of atoms
      linking query elements; (6) Number, atom type, and cyclic structure constraints
      for atoms linking pharmacophoric elements; (7) Automatic error boundary
      adjustment--ad infinitum constraint. To illustrate the capabilities of this
      program, queries based on the crystal structure of a thermolysin-inhibitor
      complex were tested against a subset of the Cambridge Crystallographic Database.
      Several compounds were returned which satisfied various aspects of the query,
      including fitting within the active site. Combination of segments of compounds
      which satisfy partial queries should provide a method for generating unique
      compounds with affinity for sites of known three-dimensional structure.

PMID- 8473918
TI  - Chiral chromatography and multivariate quantitative structure-property
      relationships of benzimidazole sulphoxides.
AB  - Various benzimidazole sulphoxides were chirally resolved employing an amylase
      based chiral stationary phase. The structure-property relationships of these
      compounds were investigated using calculated physicochemical properties,
      molecular modelling and multivariate statistical techniques. A data set of 254
      molecular descriptors was used to represent the series of compounds. Analysis of
      the data set using principal components analysis and non-linear mapping suggested
      that the separation factor of each enantiomeric pair was associated with nine
      molecular properties and, in particular, molar refractivity of the Z substituent
      and the partial charge of atom 6. The separation factor of a sulphoxide not used
      in the analysis was well predicted thus suggesting that these models may be used
      to generalize.

PMID- 8473919
TI  - Nonlinear dependence in comparative molecular field analysis.
AB  - The applicability of the comparative molecular field analysis (CoMFA) approach to
      describe the nonlinear dependence of biological activity on lipophilicity in 3D
      quantitative structure-activity relationships (QSAR) has been demonstrated. The
      results indicate that the CoMFA approach is appropriate for describing nonlinear
      effects in 3D QSAR studies.

PMID- 8473920
TI  - Society of Nuclear Medicine. Proceedings of the 40th annual meeting. Toronto,
      Canada, June 8-11, 1993. Abstracts.

PMID- 8473921
TI  - The chief nurse officer as a board member: an overview.

PMID- 8473922
TI  - Nurse extenders.

PMID- 8473923
TI  - Delegation and the dilemma of the democratic ideal.

PMID- 8473924
TI  - An ethical nursing practice model.
AB  - Providing a framework within which nurses may practice is a challenge for nursing
      executives. The national emphasis on ethical issues and decision making provides
      a compelling argument for incorporating such concepts into practice models. The
      author discusses a nursing practice model based on five ethical principles that
      are applied to all aspects of nursing practice.

PMID- 8473925
TI  - Pediatric hotline. Meeting community needs while conserving healthcare dollars.
AB  - Faced with the challenge of providing cost effective services, administrators at
      the Hospital for Sick Children in Toronto, Canada recognized an opportunity to
      reduce unnecessary emergency visits. A telephone hotline was established to
      provide parents with reassurance and treatment guidelines that allowed them to
      care for their children at home.

PMID- 8473926
TI  - Incorporating nursing assistive personnel into a nursing professional practice
      model.
AB  - A pilot project evaluated the effect of incorporating nursing assistive personnel
      (NAP) into the existing nursing professional practice model at a tertiary care
      university medical center. A plan to use permanent, unit-based NAP was developed,
      implemented, and evaluated. Among the findings were a redistribution of selected
      nursing activities and conditions enhancing the integration of NAP to fulfill
      nonprofessional tasks and thus support the work of the registered nurse.

PMID- 8473927
TI  - Retaining registered nurses in rural community hospitals.
AB  - In rural practice settings where the task of recruiting new employees is
      exceedingly difficult, the first step in surviving the nursing shortage should
      begin with maintaining existing resources. Based on a survey of 2,488 staff
      registered nurses working in rural community hospitals, the authors compare
      personal, demographic, and practice characteristics of nurses by their self
      reported intentions to stay in their present positions. Specific areas of job
      dissatisfaction that best distinguish those who anticipate leaving in 1 year from
      those committed to remaining in their present job for 5 years or more are
      identified.

PMID- 8473928
TI  - The Albrecht nursing model for home healthcare: predictors of health status
      outcomes in working adults.
AB  - The health profile of American adults is heavily influenced by lifestyle
      behaviors. Therefore, working adults have a unique opportunity to take personal
      action to decrease their risk of cancer, heart disease, and other chronic
      illnesses and to improve their health status outcomes. Health status outcomes of
      working adults were evaluated through this quantitative study. Four structural
      variables (demographics, psychologic status, social status, and economic status),
      two modifying variables (access and cost), and three process variables
      (preventive care, including exercise/nutrition/stress management; client
      involvement; and family involvement) were examined as to their relationship to
      health status outcomes (client perception of health, amount of exercise, body
      mass index, and percent body fat). Results support the importance of the
      variables in the Albrecht nursing model in explaining health status outcomes in
      working adults. These factors may therefore be suitable targets for interventions
      to encourage healthy lifestyle behaviors at home. Nursing administrators,
      occupational health nurses, and home health nurses can use these findings to
      guide effective planning for wellness programs in the home and work setting.

PMID- 8473930
TI  - Child care problems of nurses.

PMID- 8473929
TI  - Decreased rehospitalization costs through intermittent nursing visits to nursing
      home patients.
AB  - This study determined if visits by a nurse to patients in contract nursing homes
      would reduce the cost of patient returns to the discharging medical center. The
      authors discuss an approach that reduced readmissions and emergency room visits,
      producing a net savings of $70,394.90.

PMID- 8473931
TI  - Computer simulations of the differentiated pay structure model.
AB  - The differentiated pay structure (DPS) model determines a nurse's base pay on the
      basis of education, position, and expertise level, adjusting that base for part
      time employment, differentials for nonbusiness hours, and single payment bonuses
      to reward longevity. Using computer simulations, the model was tested with data
      from two urban hospitals. The findings show that the model can be applied in a
      manner that is acceptable in terms of budget. By using the DPS model,
      administration can compensate for those objective employee behaviors that
      employers value the most.

PMID- 8473932
TI  - Is there a difference between an RN and an LPN?

PMID- 8473933
TI  - Patient-focused care service models and nursing: perils and possibilities.

PMID- 8473934
TI  - Ethics survey results.

PMID- 8473935
TI  - Work sampling and professional nurses.

PMID- 8473936
TI  - Successful implementation of computer systems: a planned organizational change
      approach.

PMID- 8473937
TI  - Increasing managers' visibility.

PMID- 8473938
TI  - Merit raises: are we paying for performance?

PMID- 8473939
TI  - Determinants of hospital length of stay.
AB  - An example of the inefficiency of cost-based reimbursement is that wide
      variations were observed between hospitals and between regions in the cost of
      treating similar diagnoses, with no apparent differences in quality. To correct
      these variations, the Tax Equity and Fiscal Responsibility Act and its
      concomitant prospective payment system based on DRGs was implemented. However,
      wide variations continued to exist among hospitals and regions in the United
      States. The attempt by the medical profession to refine the prospective payment
      system by severity adjustments has received lukewarm support. The work by
      Halloran et al on the relationship between nursing diagnosis and length of stay
      shows some promise. Studies on nursing intensity have produced mixed results.
      Recently, the Prospective Payment Assessment Commission decided to discontinue
      efforts to develop nursing intensity adjustments for DRG weights. Additionally,
      institutional characteristics, except for discharge planning programs, and
      patient characteristics have exhibited mixed results in attempts to explain
      hospital length of stay. Concern over continuing variations that DRGs and their
      proposed adjustments have been unable to correct led to the formation of the
      Agency for Healthcare Policy and Research, which was brought about by the Omnibus
      Budget Reconciliation Act of 1989. This agency seems to believe that practice
      patterns offer the greatest hope of reducing excessive hospital lengths of stay
      and concomitant costs.

PMID- 8473940
TI  - Building on the past to challenge the future.
AB  - The Council on Graduate Education for Administration in Nursing (CGEAN) was
      established to further the development and improvement of graduate education for
      administration in nursing. The Council seeks to identify the nature and direction
      of education for administration in nursing in various healthcare systems,
      providing guidelines for programs offering administration. A major goal of CGEAN
      is facilitating dialogue between nursing service administrators and graduate
      level educators who are engaged in teaching and research related to
      administration in nursing. This column, sponsored by members of the Council, will
      analyze and respond to position statements and trends related to the delivery of
      health services and graduate education for administrators in nursing.

PMID- 8473941
TI  - Designing for the future.
AB  - The American Organization of Nurse Executives (AONE) is the national organization
      of nurse executives and nurse managers. AONE provides leadership, professional
      development, advocacy, and research to advance nursing practice and patient care,
      promote nursing leadership excellence, and shape healthcare public policy. This
      column, written by officers and executive staff members of AONE, raises issues
      and discusses trends of importance to nursing administrators.

PMID- 8473942
TI  - Nursing department strategy, planning, and performance in rural hospitals.
AB  - Do strategic planning and nursing department strategies explain major differences
      in hospital performance? Answers to this question surfaced in a study of nursing
      directors of rural New Mexico hospitals. The results indicate that managerial
      strategies, cost-control strategies, and strategic planning by the nursing
      department explain differences in net income and operating margin. These results
      imply that nursing directors can take an active role in influencing the strategic
      direction and fiscal achievements of rural hospitals.

PMID- 8473943
TI  - Collaborating to develop a community-based health service for rural homeless
      persons.
AB  - In the current healthcare environment, public health nursing administrators are
      called on to create and manage programs and services while reducing cost and
      improving access. Public health science provides a framework on which to base
      program planning and management. Using this approach, the authors describe the
      establishment of a health services center to meet an identified gap in service to
      homeless persons in a rural area.

PMID- 8473944
TI  - Facilitating innovation at the nursing unit level through cultural assessment,
      Part 1: How to keep management ideas from falling on deaf ears.
AB  - The early hopes and expectations of organizational culture often fail to
      materialize because the nature of organizational culture is not understood. This
      article describes what culture is, explains where culture comes from, and
      analyzes the variety of subcultures that can exist in healthcare organizations.
      In so doing it explores why managerial ideas for change are not automatically
      implemented by organizational members. The importance of assessing a group's
      culture before implementing change is discussed. Tools for assessing the work
      group culture of a nursing unit are presented. Part 2 (May 1993) will describe a
      five-step process to strengthen the forces that drive cultural change and
      overcome forces that resist innovation.

PMID- 8473945
TI  - The organizational culture. Implications for nursing service.
AB  - Research has established positive links between a constructive culture, the
      morale and retention of employees, and the decreased mortality of patients. Given
      these important variables and their ties to organizational culture, it is
      important to understand the culture of nursing service. Even more important are
      the implications that the culture provides for development of strategies to
      enhance the service. For these reasons, this study assessed the organizational
      culture of seven acute care hospitals to provide a background for discussion of
      the implications and strategies to enhance service.

PMID- 8473946
TI  - Development and evaluation of a research-based management intervention. A
      recognition protocol.
AB  - Recognition of work has been positively related to job satisfaction and retention
      of nurses in the research literature. The authors describe the development of a
      research-based management intervention to provide recognition, implementation of
      the intervention by head nurses, and the evaluation of the outcomes.

PMID- 8473947
TI  - Simultaneous discrimination of the spatial frequency and contrast of periodic
      stimuli.
AB  - Discrimination thresholds for spatial frequency and contrast were measured as a
      function of (1) the spatial-frequency bandwidth of the stimuli, (2) the reference
      contrast of the stimuli, and (3) whether the observer knew on which dimension,
      spatial frequency or contrast, the stimuli would differ. Relative bandwidth was
      manipulated by a one-dimensional Gaussian window and varied from 0.25 to 2.0
      octaves. The results of two different tasks were compared. In a single-judgment
      task the observer knew on which dimension the stimuli would differ, and
      discrimination thresholds were measured in a standard two-interval forced-choice
      staircase procedure. In a dual-judgment task the dimension on which the stimuli
      differed varied from trial to trial. In this task the observer made two judgments
      on each trial in a modified two-interval forced-choice procedure: (1) on which
      dimension the stimuli differed and (2) in which interval the stimulus with the
      higher spatial frequency or contrast appeared. Thresholds were measured by five
      interleaved staircases for five reference contrast levels that varied from 0.02
      to 0.32. Thresholds for both spatial frequency and contrast increased with
      increasing stimulus bandwidth and decreased with increasing stimulus contrast.
      Thresholds were, on average, 1.8 times higher in the dual-judgment task than in
      the single-judgment task, independent of the stimulus contrast and the bandwidth.
      A stimulus-uncertainty model is described that accounts for the difference
      between thresholds in the single- and the dual-judgment tasks.

PMID- 8473948
TI  - [Studies on otolaryngeal Chlamydia trachomatis infection province (a case report
      and seroepidemiological study)].
AB  - Recently, chlamydial infection patterns have undergone considerable change.
      Chlamydia trachomatis has, in particular, been described as a major cause of
      sexually transmitted diseases. Because of the more liberal attitude concerning
      sexual life-styles and behavior patterns, the oral cavity and pharynx has been
      increasingly becoming a site of infection for many sexually transmitted diseases.
      In the otolaryngeal region, because of oro-genital sexual relations, C.
      trachomatis infection is presently attracting a great deal of attention. The
      authors report a case of pharyngitis and cervical lymphadenitis due to C.
      trachomatis infection contracted from oral sexual activity. Initially, this was
      suspected to be a case of malignant lymphoma, but histological studies in biopsy
      specimens of the epipharynx and cervical lymph nodes revealed no malignant cells.
      Serum antibody titers against mycoplasma and a number of viruses were not
      elevated while those against C. trachomatis were, based on results of the
      microplate immunofluorescence antibody technique. C. trachomatis antigen was
      demonstrated in pharyngeal scrapings by an isolation method and direct
      immunofluorescence test. In addition, inclusion bodies of C. trachomatis were
      demonstrated in biopsy specimens from the lateral funiculus of the pharynx by
      direct immunofluorescence test using a MicroTrak. The authors studied the
      seroepidemiology of chlamydial infection in healthy controls, patients with acute
      respiratory infection and patients with inflammation or infection in the
      otolaryngeal region. Among adult patients with otolaryngeal inflammation, the
      carrier rate for C. trachomatis specific antibodies was higher than in other
      groups. In females, especially, the carrier rate for C. trachomatis specific
      antibodies was very high.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473949
TI  - [Relationship between cervical osteophytes and globus sensation--a study based on
      altered swallowing function].
AB  - The swallowing function of ten patients showing marked cervical osteophytes were
      studied by double contrast pharyngogram and manometric examinations. In five
      cases in which the pharyngeal clearance was B type according to Shuzaki's
      classification, a significant increase in the maximal swallowing pressure value
      on the oral side ipsilateral to the osteophytes was often observed. In five cases
      in which the pharyngeal clearance showed A + A' type (marked impairment), the
      frequency of significantly decreased maximal swallowing pressure on the oral side
      ipsilateral to the osteophytes and abnormal waveforms of the swallowing pressure
      were high. However, no definite correlation was noted between these changes in
      swallowing function and osteophyte site. Therefore, there are two possible
      outcomes of the changes in swallowing function caused by cervical osteophytes:
      one is a compensatory increase in pharyngeal constriction aimed at maintaining
      relatively good pharyngeal clearance, the other is impaired pharyngeal
      constriction and the pharyngeal clearance. These changes in swallowing function
      would impact on globus sensation.

PMID- 8473950
TI  - [Case report of a foreign body in the nasal cavity: experimental research on
      limited damage].
AB  - We report here a case of serious nasal cavity tissue damage caused by a foreign
      substance, specifically, a button-shaped battery. The patient was a three-year
      old boy who inserted a button-shaped battery into his left nasal cavity. On
      examination, we found necrosis of the nasal mucosa, cartilage and bone. In
      addition, the nasal cavity structure was severely damaged. In a follow-up
      experiment, we inserted a similar button-shaped battery, pre-soaked in a salt
      solution, into a rabbit's nasal cavity and measured daily changes in PH and
      discharge over time. In addition, we assessed how much nasal cavity tissue was
      damaged in a pathological specimen. We found that the chief factor mediating
      tissue damage, among those we tried, was strong base production with low voltage
      discharge. Under these conditions the nasal cavity is damaged in a short time.

PMID- 8473951
TI  - [Cochlear immune injury following direct antigen challenge to the endolymphatic
      sac].
AB  - Following direct KLH antigen challenge to the endolymphatic sac (e. sac) in
      guinea pigs, degeneration of the cochlea was examined histologically by light
      microscopy. Degeneration was seen in 21 out of 140 animals presensitized
      systemically from day 1 to 5 weeks post secondary KLH challenge to the e. sac.
      Degeneration of the organ of Corti, stria vascularis and spiral ganglion cells
      was seen from day 1 in 19, 17 and 7 animals, respectively. There was no increase
      in these degenerative processes during the time course. In the period from day 1
      to day 4, severe bleeding in the perilymphatic space occurred simultaneously with
      cochlear deterioration. Three animals showed perilymphatic fibrosis which was
      noted after the first week post KLH secondary challenge. In contrast, animals
      primarily challenged with KLH (locally administered to the e. sac) showed no
      cochlear degeneration. These results suggest that a locally mounted immune
      response in the e. sac can cause direct immune injury to cochlear tissues.

PMID- 8473952
TI  - [The localization and the function of carbonic anhydrase in the inner ear].
AB  - Carbonic anhydrase (CA) is distributed in a wide variety of animal cells and
      tissues, especially in cells and tissues involved in rapid exchange or transport
      of protons, bicarbonate, or other ions. Although localization of this enzyme and
      its physiological roles in the inner ear have been investigated extensively, full
      clarification has yet to be achieved. We have conducted a histochemical
      investigation of CA localization in the inner ear of the guinea pig by Hansson's
      method, with emphasis on improved fixation. The histochemical reaction for CA
      activity is localized in the outer and inner hair cells of the organ of Corti,
      Deiters' cells or nerve endings, inner pillar cells, Boettcher's cells, stria
      vascularis, spiral ligament, vasculo-epithelial zone and spiral ganglion cells.
      The physiological roles of CA in the inner ear, particularly in relation to the
      production or absorption of endolymph, are discussed in this report.

PMID- 8473953
TI  - [Clinical study of children with nasal allergy].
AB  - Possible factors influencing nasal allergy in children were studied using a
      questionnaire and allergic examination including eosinophil count of nasal
      discharge, IgE RAST score to house dust and provocation test. We investigated
      three groups of children according to the results of allergic examinations. The
      negative group, the equivocal group and the definite group, respectively,
      consisted of 40, 49 and 107 children. We found the prediction value of definite
      group with eosinophil count of nasal discharge, IgE-RAST score and provocation
      test to house dust were respectively 77.0, 89.2 and 78.1%. Bottle feeding and
      history of asthma bronchiale occurred more frequently in the definite group.
      These observations provide epidemiologic and clinical bases for further
      investigations of children with nasal allergy.

PMID- 8473954
TI  - [A case of superficial siderosis of the central nervous system with total
      deafness].
AB  - Superficial siderosis of the central nervous system (SSCN) in a disease
      characterized by chronic deposition of hemosiderin in the leptomeninges, subpial
      tissue, spinal cord, and cranial nerves. Previously the diagnosis of SSCN could
      only be made at autopsy or during a neurosurgical procedure. Now, however, a
      diagnosis of SSCN can be made non-invasively by magnetic resonance imaging (MRI).
      We present the case of a 50-year-old male with SSCN accompanied by bilateral
      sensorineural hearing loss which gradually progressed to total deafness over a
      seven year period. This patient also had associated bilateral caloric weakness
      with episodes of severe recurrent headaches over the two preceding years. The
      deafness and gait disturbance, which were his chief complaints, were followed by
      other neurological manifestations including pyramidal tract signs, anosmia, and
      ageusia. High-field MRI on T-2 weighted images of the CNS showed diffuse marginal
      hypointensity of the cerebrum, brain stem, and cerebellum. Atrophy of the
      cerebellum and brain stem was also apparent. Low signal intensity along the
      proximal segment of the acoustic nerve and the facial nerve was noted from the
      cistern to the internal auditory canal. Neither bilateral transtympanic
      promontory nor round window electrical stimulation elicited any sound sensation.
      In this case it was thought that the acoustic nerve alone or both the acoustic
      nerve and the cochlea were affected by this disease. Consequently, cochlear
      implantation was not indicated. The source of bleeding into the subarachnoid
      space could not be detected despite thorough examination. This diagnosis will be
      made only by physicians who are aware of this rare entity and have knowledge of
      the characteristic clinical pathology.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473955
TI  - [Psycho-physiological study by contingent negative variation (CNV) in
      otolaryngological diseases].
AB  - Contingent negative variations (CNV) were recorded in patients with tinnitus (N =
      20), abnormal sensations of the pharynx and larynx (ASPL) (N = 26) and Meniere's
      disease (N = 19), and compared with those of healthy adults (N = 20) in order to
      investigate the characteristics of their information processing mechanisms in the
      brain. Patients were also subjected to psychological tests: Depression Score and
      the Cornell Medical Index test. CNV (an event-related potential) is a slow
      negative cortical potential shift and can be recorded during two stimuli
      presented at a constant interval under conditions in which the subjects are told
      to press a key as quickly as possible upon an imperative stimulus (S2) following
      a warning stimulus (S1). S1 was a 1kHz tone burst of 300 msec duration at a level
      of 85dB HL. S2 was a light flash. The interstimulus (S1-S2) interval was set at 2
      seconds. The CNV can be divided into three components, early, middle, and late,
      according to latency. Statistical analysis of CNV amplitudes of the three
      components showed the following differences between groups. In tinnitus patients,
      the mean amplitudes of both the early and middle component were significantly
      greater than those in healthy adults (P < 0.05). In ASPL patients, the mean
      amplitudes of the middle component were significantly greater than those in
      healthy adults (P < 0.05). In Meniere's disease, the mean amplitudes of both the
      middle and late component were significantly greater than those in healthy adults
      (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473956
TI  - [Autonomic nervous function of vertiginous patients--assessment by spectral
      analysis of heart rate variability].
AB  - Autonomic nervous function in 68 vertiginous patients and 33 controls was studied
      using power spectral analysis of heart rate variability. First, a system was
      developed which computes the power spectral density (PSD) of beat-to-beat heart
      intervals using a continuous non-invasive finger blood pressure recording
      obtained with the FINAPRESS device. A fast-Fourier transform algorithm was used
      to compute the PSD. In frequencies up to 0.5 Hz, the PSD of heart rate
      variability contains three major components: a low frequency (P1), a middle
      frequency (P2) and a high frequency (P3). Each component was normalized by
      dividing the absolute values by total power (T), and then used as an index of
      each component. Second, the effects of passive tilt, respiratory frequency and
      specific pharmacological sympathetic or parasympathetic blockade on the indices
      of these components were evaluated in the control group. The following results
      were obtained. 1. During passive tilt, the normalized power of P2 was increased,
      whereas that of P3 was decreased. 2. The peak frequency of P3 was consistent with
      the frequency of respiration. 3. Sympathetic blockade decreased the normalized
      power of P2, whereas parasympathetic blockade decreased the normalized power of
      P3. From these results, I concluded that the normalized power of P2 and P3 are
      quantitative markers of sympathetic and vagal nervous activities, respectively.
      Third, the results of spectral analysis in patients were compared with those in
      controls. The following characteristics of autonomic nervous function in
      vertiginous patients were noted. 1. The normalized power of P3 in patients was
      lower than that in controls, suggesting that parasympathetic nervous activity at
      rest was suppressed in patients. 2. The increase of normalized power of P2 with
      passive tilt was suppressed in patients, suggesting suppression of sympathetic
      response to passive tilt. 3. In patients with Meniere's disease, during the
      active period of vertigo attacks, the normalized power of P2, which is an index
      of sympathetic activity, was higher than that in the intervals between vertigo
      attacks. Fourth, with caloric stimulation in the control group, an increase of
      the normalized power of P2 was observed during or after the stimulation, which
      suggests that vestibular stimulation increases sympathetic activity. I therefore
      suggest the following: 1. Decreased parasympathetic activity and suppression of
      sympathetic response were present in the vertiginous patients. 2. Sympathetic
      activity was increased by vertigo attacks in the patients with Meniere's disease.

PMID- 8473957
TI  - [Studies on the morphology and strength of the tympanic membrane after
      experimental myringotomy].
AB  - The tympanic membrane is a biomembrane made of thin vibrant material. The tension
      and strength of the tympanic membrane rely mainly on the radial fibers in the
      lamina propria. Experimental myringotomy by linear incisions were made at right
      angles to the radial fiber bundles in the tympanic membrane of 54 guinea pigs.
      The healing process was observed chronologically by light, polarized light and
      electron microscopy for two years. The mechanical strength of recovery of the
      tympanic membranes were then studied using a microtension tester developed by our
      laboratory. The tensile direction was parallel to the radial fiber bundles of the
      tympanic membrane, and the tensile rate was 1 x 10(-3) m/sec. 1. Light
      microscopic observation showed that the radial fiber bundles did not reconstruct
      continuously even after two years. Polarized light microscopic observation showed
      that parts of the linear incision of the tympanic membrane contained polarized
      fibers in place of the normal radial fibers. Transmission electron microscopic
      observation of the tympanic membranes after four months showed that the radial
      fibers were cut off sharply, but that the lamina propria had regenerated with
      different fibers. Several fibroblasts were also observed. Scanning electron
      microscopic observation through the auditory canal after two years showed that
      thick masses of scar adhered to the site of the experimental incision of the
      tympanic membrane. This scar was composed of several layers of collagen fibers.
      The area of scar adhesion was also observed on the membrane facing the tympanic
      cavity, but it was thinner than the scars on the meatal side.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8473958
TI  - [Practical hearing compensation and an assessment of hearing effect in patients
      with profound hearing loss using hearing aids].
AB  - This investigation was carried out to study practical hearing compensation with
      hearing aids and the correlation between subjective evaluation (questionnaire
      survey) and objective evaluation (speech perception test) as an assessment of
      hearing aid effect in patients with profound hearing loss. 1. Forty-nine patients
      with hearing levels of 90dB or more (23 men and 26 women) were examined. Their
      mean and median hearing levels were 105.9dB (standard deviation: 10.4dB) and
      106.3dB, respectively. The patients ranged in age from 18 to 74, with a mean age
      of 47.4. 2. Subjective evaluation was carried out by a questionnaire survey in
      which the patients chose one of 4 or 5 graded categories in 10 different hearing
      conditions, and three items of "satisfactory", "uneasiness" and "effectiveness".
      Speech sound discrimination ability for vowels and monosyllables, and speech
      intelligibility of words and sentences, were evaluated in audition only (A),
      vision only (V) and a combination of both (A + V), totaling 12 conditions with
      hearing aids as the objective evaluation using video tapes materials. 3. The
      subjective evaluation revealed that 60% of patients with hearing loss of 90-110dB
      understood "one to one conversation in a quiet place". Speech perception was
      poorer in "conversation in a noisy place" than in "conversation in a quiet
      place". Speech perception became poorer in the order of "one to one", "to a few
      people", and "to many people". For subjective feeling, 56.4% answered
      "satisfactory", and for hearing aid effectiveness, 78.7% answered "effective". 4.
      In the objective evaluation, the rates of correct answers were 19.6% in A and
      46.3% in A + V for monosyllables, 19.8% in A and 43.4% in A + V for words, and
      29.5% in A and 60.0% in A+V for sentences. 5. There were significant correlations
      (p < 0.001) between subjective evaluation of "in a quiet place and one to one
      conversation" (among other conditions) and objective evaluations of
      monosyllables, and word and sentence recognition, mostly in A and A + V. These
      results suggest that hearing compensation by hearing aids can be evaluated
      objectively in patients with profound hearing loss when word and sentence
      recognition tests are performed in addition to the monosyllable recognition test,
      and it is more practical if vision is examined in addition to hearing for speech
      perception in patients with profound hearing loss.

PMID- 8473959
TI  - [Immunohistochemical study of proteoglycans and collagens in the mouse cochlear
      duct].
AB  - Immunohistochemical studies of proteoglycans and collagens (type I and type IV)
      in the cochlear duct, and of the effects of cisplatin (CDDP), were performed. In
      cells of the organ of Corti and in the middle layer of the stria vascularis,
      heparan sulfate proteoglycan (HSPG) and collagens (type I and IV) or collagen
      like substances were found. HSPG in these locations appeared to play important
      roles in the production of auditory sense. The tectorial membrane contained HSPG
      and collagens (type I and IV). However, no data supporting the concept that
      elements of the tectorial membrane are derived from interdental cells was
      obtained. In the basilar membrane, no HSPG, chondroitin sulfate (Chs), or
      collagens (type I and IV) were detected. The unique structures containing these
      substances reacted strongly with anti-HS (heparan sulfate), anti-HSPG-CP (core
      protein) and anti-collagen (type I and IV) antibodies that developed in the
      middle layer of the stria vascularis after the administration of CDDP. However,
      no change was observed in the tectorial membrane, the spiral prominence, the
      basilar membrane, or the spiral limbus. The decrease in HSPG in cells of the
      organ of Corti, and the changes in the stria vascularis, may help solve the well
      known contradiction between the severity of morphological damage and of the
      hardness of hearing.

PMID- 8473960
TI  - [Clinical anatomy of the trachea and esophagus].

PMID- 8473961
TI  - Feigning schizophrenic disorders on the MMPI-2: detection of coached simulators.
AB  - The Minnesota Multiphasic Personality Inventory (MMPI) and, more recently, its
      revised version (the MMPI-2) have represented the "gold standard" in the
      psychometric assessment of malingering and other response styles. In this study,
      we provide a stringent test of the MMPI-2 validity indices and their ability to
      detect feigned schizophrenia in four groups of simulators (n = 72). Simulators
      were randomly assigned to one of four conditions: (a) coached on symptoms of
      schizophrenia, (b) coached on strategies for the detection of fakers, (c) coached
      on both symptoms and strategies, or (d) uncoached. Simulators were compared to
      subjects responding under an honest condition (n = 13) and a comparison group of
      schizophrenic inpatients (n = 37). We found knowledge of strategies alone allowed
      many simulators (i.e., one third or more, depending on the validity indices) to
      elude detection. In contrast, knowledge of the disorder appeared less useful to
      simulators in avoiding detection. Coaching on both strategies and symptoms was
      not as effective as strategies alone. Consistent with previous studies, uncoached
      simulators were detected with moderately high levels of accuracy.

PMID- 8473962
TI  - Use of the MMPI to assess the construct validity of the revised Social Anhedonia
      Scale as an index of schizotypy.
AB  - We evaluated the construct validity of the revised Social Anhedonia Scale (SAS;
      Mishlove & Chapman, 1985) through an examination of the Minnesota Multiphasic
      Personality Inventory (MMPI) profiles produced by extreme scorers on the SAS. The
      MMPI classification strategy employed by Moldin, Gottesman, and Erlenmeyer
      Kimling (1987) was used to group profiles with regard to their specificity to
      schizophrenia spectrum disorders. Of 1,124 college students, 58 females and 60
      males had elevated SAS scores. Thirty-five percent of the males and 24.14% of the
      females produced MMPI profiles within the Moldin et al. classification scheme.
      Another 27.59% of females and 23.33% of males had profiles that are sometimes
      associated with schizotypal attributes. Thus, 41.67% of high-SAS males and 48.28%
      of high-SAS females have MMPI profiles that are unlikely to be associated with a
      heightened risk for schizophrenia. Because only a subset of socially anhedonic
      subjects produced schizophrenia spectrum MMPI profiles, it appears that the SAS,
      in isolation, should not be used to identify individuals at risk for
      schizophrenia. The revised SAS, like its predecessor, does not appear uniquely
      related to the schizophrenia spectrum. Unlike Mishlove and Chapman (1985), we did
      not find a gender difference among subjects.

PMID- 8473963
TI  - The MMPI and the MCMI in the evaluation of narcissism in a clinical sample.
AB  - Narcissistic and nonnarcissistic groups of psychiatric patients (n = 35 in each
      group) were formed on the basis of a criterion comprised of clinical judgment and
      scores on the Narcissistic Personality Inventory and compared on the Minnesota
      Multiphasic Personality Inventory (MMPI) and the Millon Clinical Multiaxial
      Inventory (MCMI) profiles and on six special narcissism scales. Significant
      profile differences between narcissists and nonnarcissists were obtained on the
      MMPI and MCMI. Four of the six narcissism scales produced significant differences
      between the two groups.

PMID- 8473964
TI  - The psychometric assessment of alcoholism in forensic groups: the MacAndrew scale
      and response bias.
AB  - Although the MacAndrew Alcoholism scale is the most widely used Minnesota
      Multiphasic Personality Inventory (MMPI) measure of vulnerability to alcohol
      abuse, its accuracy has not been studied in patients intrinsically motivated to
      exaggerate or minimize psychopathology. We examined the usefulness of the MAC in
      predicting alcohol abuse in a forensic clinical sample. Results indicate the MAC
      (a) was not more effective than direct inquiry in this group, (b) scores were
      correlated negatively with minimization and positively with exaggeration for
      subjects with histories of alcohol abuse, (c) offered advantages over direct
      inquiry both in screening for alcohol history (sensitivity) and in confirming it
      (specificity), and (d) scores were only moderately more accurate in valid than in
      minimized or exaggerated MMPI protocols. The results suggest that clinicians
      should use the MAC cautiously, particularly when they suspect motivation to
      minimize psychopathology.

PMID- 8473965
TI  - A profile of personality for a Russian sample: as indicated by the Comrey
      Personality Scales.
AB  - The purpose of our study was to present a personality profile, based on data from
      the Comrey Personality Scales (CPS), for a diverse, Russian sample. The CPS was
      administered to 457 subjects drawn from convenience samples throughout St.
      Petersburg, Russia. In Part 1 of the study, the structure of the Russian sample's
      personality was identified. Data from the CPS were factor analyzed. Findings
      showed strong support for the generalizability of Comrey's (1970) eight-factor
      personality taxonomy to this sample. The CPS's factors derived from the Russians
      were compared and found to be similar in structure to samples derived from
      American, Australian, Brazilian, Israeli, Italian, and New Zealand samples. In
      Part 2, mean differences on the CPS's scales between the Russian sample and the
      American sample were assessed. Results showed that although the structure of the
      Russians' personality was similar to that of the Americans' personality,
      significant differences in the elevation of scale scores did exist. For example,
      as a whole, the Russians tended to be more defensive, lethargic, egocentric, and
      unstable. Contrary to popular expectations, however, the Russians were not more
      conforming.

PMID- 8473966
TI  - Discriminant validity of the Inventory to Diagnose Depression.
AB  - Measures of depression and anxiety correlate highly with one another. It has been
      hypothesized that this shared variance partly reflects poor discriminant
      validity, which could be improved by linking item content more closely to
      diagnostic criteria. We tested this speculation by comparing the Inventory to
      Diagnose Depression (Zimmerman, Coryell, Corenthal, & Wilson, 1986), developed to
      correspond with diagnostic criteria for major depression, with the Beck
      Depression Inventory (Beck, Rush, Shaw, & Emery, 1979) in terms of discriminant
      validity. These measures correlated more strongly with each other than with
      anxiety but did not differ in their relations with anxiety.

PMID- 8473967
TI  - Bipolarity in Jungian type theory and the Myers-Briggs Type Indicator.
AB  - The standard form of the Myers-Briggs Type Indicator (MBTI; Myers & McCaulley,
      1985) was constructed to measure introversion/extroversion, sensing/intuiting,
      and thinking/feeling as single, bipolar dimensions. We tested this assumption of
      bipolarity with a Likert form of the MBTI that allowed for the independent
      assessment of each attitude and function. A total of 106 female and 59 male
      undergraduate and graduate students completed the standard and Likert MBTI forms
      approximately 3 weeks apart. Evidence for the bipolarity of the
      introversion/extroversion dimension was weak, and findings did not support the
      bipolarity of the sensing/intuiting or thinking/feeling dimensions. Results
      provide evidence that high negative correlations within MBTI dimensions are an
      artifact of its forced-choice format. Implications of the findings for typology
      measurement are discussed.

PMID- 8473968
TI  - The factor structure of the Rorschach for adolescent inpatients.
AB  - The factor structure of the Rorschach inkblot test was examined using a sample of
      268 adolescent inpatients (including 105 with conduct disorders and 105 with
      depressive disorders). An initial analysis found a four-factor solution for both
      the conduct-disordered and depressive-disordered groups. However, examination of
      the factor patterns suggested that these groups did not yield significantly
      different factor structures. Thus, for the final analysis all inpatients were
      combined, and a single three-factor solution was found. These factors were
      substantively similar to the initial analysis and were interpreted as consisting
      of (a) struggles with affective expression, (b) general psychological health, and
      (c) perceptual organization.

PMID- 8473969
TI  - The use of the Rorschach to differentiate unipolar and bipolar disorders.
AB  - We compared the Rorschach performance (using the Comprehensive System; Exner,
      1986) of 29 unipolar depressed, 15 bipolar depressed, and 18 bipolar manic
      inpatient subjects (N = 62) classified on the basis of the Research Diagnostic
      Criteria (RDC; Spitzer, Endicott, & Robbins, 1985). The three main groups
      differed from one another on a variety of variables, especially those related to
      ideation and information processing. One finding of particular importance was
      that bipolar depressed subjects, like bipolar manic and unlike unipolar depressed
      subjects, showed a high level of cognitive slippage. These results suggest that
      the Rorschach possesses utility in the differential diagnosis of affective
      disorders.

PMID- 8473970
TI  - A Rorschach study of narcissism, defense, and aggression in borderline,
      narcissistic, and cluster C personality disorders.
AB  - We examined the differences between narcissism, mode of defense, and level of
      aggression on the Rorschach. We also investigated differences in borderline,
      narcissistic, and Cluster C personality disorders by examining responses to
      Rorschach content variables. The Lerner Defense Scale (P. Lerner & H. Lerner,
      1980), the aggressive content section of the Holt (1977) method for assessing
      primary process manifestations, a modified version of Exner's (1986a)
      Egocentricity Index, Wagner's (1965) exhibitionistic M score, and grandiosity
      were scored on the Rorschach protocols of 17 borderline, 17 narcissistic, and 17
      Cluster C personality disorders. Borderlines were found to employ primitive
      defensive structures to a greater degree and severity, show more intense and
      overall aggression as well as more responses on the three forms of aggression in
      the Holt method, and have higher levels of grandiosity. Narcissists evinced
      significantly higher levels of egocentricity than borderlines and higher levels
      of idealization than the Cluster C group. Convergent validity was found on the
      measures of defense and aggression, which showed a strong relationship between
      primitive aggression and primitive defense.

PMID- 8473971
TI  - Validity of the Children's Picture-Frustration Study: a social-cognitive
      perspective.
AB  - We used three studies to examine the validity of hostility scores from the
      Children's Form of the Picture-Frustration (P-F) Study in the context of Dodge's
      (1986) social information-processing model of aggression. Dodge's theory states
      that frustration results in retaliatory aggression only if the frustrated
      individual attributes hostile intent to the frustrator. Further, differences
      between aggressive and nonaggressive children in retaliatory aggression are more
      likely when the frustrator's intent is ambiguous than when the frustrator's
      intent is clear. In Study 1, items on the Children's P-F Study were rated by 237
      children according to how mean they believed the frustrator in each item was.
      Results showed that items varied significantly in the amount of hostility
      portrayed. On the basis of these ratings, items were divided into those in which
      the intent was hostile, nonhostile, or ambiguous. In Studies 2 and 3, we tested
      Dodge's theory that differences between aggressive and nonaggressive children
      would be revealed on those items in which the frustrator's intention is
      ambiguous. In both studies, teacher's ratings of children's retaliatory
      aggression correlated significantly with the scale comprised of the ambiguous
      items but not with the scales comprised of the hostile or nonhostile items. The
      results provide further support to Dodge's theory of aggression and to the use of
      the Children's P-F Study within a social-cognitive perspective.

PMID- 8473972
TI  - Clinical correlates of MMPI depression scales.
AB  - We investigated whether Scale 2 (Depression [D]) and the Wiggins Content Scale of
      Depression (DEP) of the Minnesota Multiphasic Personality Inventory (MMPI) have
      different clinical correlates when only one of these two scales is elevated.
      According, a group of patients who elevated DEP higher than Scale 2 (DEP > 2)
      were compared with a group of patients who elevated Scale 2 higher than DEP (2 >
      DEP). The patients with DEP > 2 were rated as being less severe than the patients
      with 2 > DEP on the following Brief Psychiatric Rating Scales: Somatic Concern
      (SOM), Emotional Withdrawal (WDRA), Depressive Mood (DEP), and Blunted Affect
      (AFF). The patients with DEP > 2 were rated as more severe on Excitement (EXC).
      The patients with DEP > 2 were more likely to receive the Axis I diagnoses of:
      bipolar disorder, manic, and alcohol abuse. Schizophrenia was equally probable
      for patients in the two groups. It appears that these two MMPI scales of
      depression have different clinical correlates when either one scale or the other
      is elevated.

PMID- 8473973
TI  - Screening for maladjustment in college students: an application of receiver
      operating characteristic curve to MMPI scales.
AB  - The ability of two scales derived from the Minnesota Multiphasic Personality
      Inventory (MMPI) to identify emotional maladjustment in a college setting was
      examined. The scales were the College Maladjustment scale (Mt) developed by
      Kleinmuntz (1961) and the Health Opinion Survey based Emotional Disorder scale
      (Ed). Emotional maladjustment was defined by criteria established in the
      Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R];
      American Psychiatric Association, 1987) and assessed through a computerized
      Diagnostic Interview Schedule. Subjects were 94 female and 62 male students, 51
      of whom (33%) met criteria for at least one DSM-III-R disorder. Substance use
      disorders were most frequent (13.5%), followed by anxiety disorders (11.5%) and
      depressive disorders (7.1%). Both Mt and Ed had no relationship to substance use
      disorders but were moderately related to nonsubstance use maladjustment (r
      approximately .47); receiver operating characteristic (ROC) analysis was
      employed, and Mt and Ed proved to be a fair-to-good indicator of nonsubstance use
      maladjustment. Types of decision errors are discussed, and tables provide
      information concerning predictive accuracy across the entire range of scores.

PMID- 8473974
TI  - Content overlap inflates the relation between negative cognition and dysphoria.
AB  - We investigated whether the presence of items assessing negative cognition on the
      Beck Depression Inventory (BDI) inflates the relation between BDI scores and
      measures of negative cognition. In four student samples, we examined the relation
      between measures of self-esteem, dysfunctional attitudes, control beliefs,
      perceived social support, and BDI scores calculated with and without negative
      cognition items. There were significant reductions in the strength of the
      relations between self-esteem, dysfunctional attitudes, and BDI scores when
      overlapping content was removed. Moreover, this was not due to the increase in
      error variance resulting from reducing the number of items on the BDI. Although
      the magnitude decreased, the relation between negative cognition and dysphoria
      remained significant in all comparisons even when overlapping content was
      removed. Thus, although content overlap appears to inflate the relation between
      some measures of negative cognition and dysphoria, it cannot completely account
      for their relation.

PMID- 8473975
TI  - How do individuals remember their past statements?
AB  - It was hypothesized that when it is difficult for people to remember what they
      said previously, they may use their sense of familiarity with a statement to
      determine whether it is one they expressed. In 3 experiments, Ss were asked to
      state whether they had witnessed certain objects in a previous slide
      presentation; they responded aloud with experimentally mandated statements. The
      familiarity of target statements was varied, independent of whether they were
      expressed, through extraneous presentations of the pertinent objects. Later, Ss
      tried to determine whether (Experiments 1 and 2), or how frequently (Experiment
      3), they expressed the target statements. Results supported the hypothesis: Ss
      were more likely to remember making statements concerning the more familiar
      objects than the less familiar objects.

PMID- 8473976
TI  - Effect of temporal perspective on subjective confidence.
AB  - Four studies examined whether people tend to lose confidence in their prospects
      for success the closer they are to the "moment of truth." Study 1 found that
      students think they will do better on their midterm exams when asked on the 1st
      day of class than when asked on the day of the exam. Studies 2 and 4 replicated
      this finding under controlled conditions. Study 3 demonstrated that the same
      effect holds retrospectively: People are more confident that they would have
      performed well at a task long after the time to perform has passed. Data are
      presented indicating that these results stem from a tendency for people to feel
      more "accountable" for their assessments, and thus focus less on the causes of
      success and more on the causes of failure, as the time to perform approaches.
      Implications for the experience of regret are discussed.

PMID- 8473977
TI  - Effects of social support and conflict on adolescent children of alcoholic and
      nonalcoholic fathers.
AB  - Studies of positive and negative social ties usually are done in isolation of
      each other, precluding an understanding of their relative contributions to
      psychological functioning. This research evaluated the effects of adolescents'
      conflict with and social support from key relationships (parents, siblings, and
      best friends) on adolescents' self-esteem, substance use, and externalizing
      symptoms. Ss were 296 adolescents and their parents; 145 families had alcoholic
      fathers, and 151 had nonalcoholic parents. Support and conflict provided by each
      network member showed only a mild negative correlation. Support from parents, but
      not siblings or best friends, was related to adolescents' reports of substance
      use and externalizing. Conflict with parents was consistently related to
      externalizing behaviors. There was no evidence that conflict within a
      relationship neutralizes the effectiveness of the support it provides.

PMID- 8473978
TI  - Dysphoria and decision making: limited information use for evaluations of
      multiattribute targets.
AB  - The hypothesis was that dysphoric relative to nondysphoric individuals use less
      available, relevant information in decision making because of reduced attentional
      resources. Dysphoric and nondysphoric Ss evaluated 70 jobs, each of which was
      described in terms of 5 dimensions (e.g., friendliness of co-workers); there were
      5 possible values for each dimension. In both studies, dysphoric relative to
      nondysphoric Ss used a smaller subset of information, yet did not simplify what
      information was used and did not combine the information in a more simple manner.
      The limited information use was not due to dysphoric Ss' systematically ignoring
      certain dimensions and was evident in both initial and final portions of the
      task. Dysphoric Ss spent as much time and reported using as much information and
      investing as much effort as nondysphoric Ss. Reported effort alone was related to
      actual information use.

PMID- 8473979
TI  - Gender-related traits and gender ideology: evidence for a multifactorial theory.
AB  - Male (n = 95) and female (n = 221) college students were given 2 measures of
      gender-related personality traits, the Bem Sex-Role Inventory (BSRI) and the
      Personal Attributes Questionnaire, and 3 measures of sex role attitudes.
      Correlations between the personality and the attitude measures were traced to
      responses to the pair of negatively correlated BSRI items, masculine and
      feminine, thus confirming a multifactorial approach to gender, as opposed to a
      unifactorial gender schema theory.

PMID- 8473980
TI  - Depression and the impression-formation continuum: piecemeal processing despite
      the availability of category information.
AB  - A study explored depressed-nondepressed differences in impression formation. From
      S. T. Fiske and S. L. Neuberg's (1990) model of impression formation, mildly
      depressed perceivers were hypothesized to engage in more piecemeal processing
      when forming an impression of a target other, even when nondepressed perceivers
      would typically use less effortful, categorical processing. With an idiographic
      technique designed by M. Pavelchak (1989), depressed Ss were shown to use trait
      attributes in evaluating a person, even when induced to categorize the
      individual. Nondepressed Ss relied on category information when available,
      replicating Pavelchak's study. Depressed Ss' results are interpreted as arising
      from a motivation to engage in effortful analysis of social information, stemming
      from feelings of lack of control over life events.

PMID- 8473981
TI  - Integrating bottom-up and top-down theories of subjective well-being: the case of
      health.
AB  - As a means of integrating bottom-up and top-down theories of subjective well
      being (SWB), a framework was proposed that, in part, posits that both objective
      life circumstances and global personality dimensions indirectly affect SWB
      through their effects on the interpretation of life circumstances. This
      proposition was tested both cross-sectionally and longitudinally among a sample
      of approximately 375 men and women. Personality was operationalized in terms of
      the dispositional trait negative affectivity (NA), and the life circumstance
      investigated was health. Strong support was obtained for the hypothesized
      indirect effects of NA and objective health on SWB. Implications of the
      integrative framework for the study of SWB are discussed.

PMID- 8473982
TI  - Memory for positive versus negative life events: theories for the differences
      between happy and unhappy persons.
AB  - Three studies examined the following hypotheses for the relation of subjective
      well-being (SWB) with memory for positive versus negative life events: (a)
      differences in retrieval mood, (b) the incidence of positive and negative events,
      (c) the interpretation of events, and (d) frequency of rehearsal. In Studies 1 (n
      = 420) and 2 (n = 94), the partial correlation of retrieval mood with recall,
      controlling for SWB, was trivial, suggesting that mood had little or no effect on
      recall. Endorsement frequencies of positive minus negative concrete events and
      interpretive events on checklists in Studies 2 and 3 each correlated with SWB (ps
      < .001), suggesting that both incidence and interpretation contributed to the
      recall differences. In Study 3, the recall of 55 Ss from Study 2 was retested
      after an 11-month interval. The lack of an interaction between SWB and recall
      change suggested that rehearsal did not contribute to the recall differences.

PMID- 8473983
TI  - The idiographic nature of human personality: examples of the idiographic self
      concept.
AB  - Arguments are made for the practical and theoretical merits of idiographic
      approaches to personality. In addition, it is argued that idiographic approaches
      to personality afford levels of prediction that cannot be provided by nomothetic
      analyses, and 2 studies of the role of self-investment in interpersonal
      perception are presented in support of this position. Finally, in contrast to
      previous arguments for idiographic approaches, it is suggested that idiographic
      approaches to personality can provide special insight into universal patterns of
      human personality.

PMID- 8473984
TI  - Fibrin sealant adhesive systems: a review of their chemistry, material properties
      and clinical applications.
AB  - Fibrin sealants (FS) are the most successful tissue adhesives to date. They have
      many advantages over adhesive technologies such as cyanoacrylates and marine
      adhesives in terms of biocompatibility, biodegradation and hemostasis. There are
      several commercial products in Europe but none in the United States due to the
      current regulatory stance against pooled plasma blood products. Blood banks and
      interested investigators have implemented single- and patient autologous-donor
      production methods with some success. This article will review the history of FS
      research and development and describe the chemistry of fibrin(ogen) and the
      production of commercial and research products. Fibrin sealant and purified
      fibrin characterization is compared and contrasted. The material and adhesive
      properties are described, and a survey of the clinical applications in which FS
      has been used is included as well.

PMID- 8473985
TI  - Physical properties and testing methods for PTFE cardiovascular patches.
AB  - Patching after endarterectomy, especially carotid artery surgery, is a common
      procedure to repair and close the surgical site. Both synthetic and natural
      materials can be used, but saphenous vein is preferred due to its greater long
      term patency. In situations where it is not possible to use the saphenous vein,
      both Dacron and expanded polytetrafluoroethylene (ePTFE) patches have been used
      successfully. Expanded PTFE patches are readily available, soft and pliable, have
      excellent biocompatibility and do not require preclotting prior to implantation.
      Comparison of two types of ePTFE patches versus natural vessel show that they
      have more than adequate properties for their intended use.

PMID- 8473986
TI  - Surface micromorphology and cellular interactions.
AB  - Contact guidance induced by the topographical properties of the underlying
      substratum is of great importance in morphogenesis and also influences the
      interaction of tissue cells with implanted material. A large body of evidence has
      accumulated since the first detection of this phenomenon in 1910. Several major
      hypotheses have been developed to explain the observed cell behaviour. The
      technological progress enabled researchers to produce pure substrata with a
      defined and controlled surface microgeometry. Based on these specimens, it could
      be demonstrated that cytoskeletal structures and receptors forming focal
      adhesions most likely are involved in contact guidance. In a study using human
      gingival fibroblasts, the reaction of these cells to a regular surface
      microstructure of 1 micron pitch and 1 micron depth was tested. After two days on
      the microstructured samples, all the cells showed a strong alignment to the
      topography of the surface. Transmission electron microscopy revealed that the
      cells either bridged the grooves or conformed to the surface structures. The
      latter confirms earlier investigations with porous subcutaneous implants, where
      the inflammatory reaction and the formation of a fibrous tissue capsule was
      reduced due to enhanced tissue adhesion.

PMID- 8473987
TI  - Protein adsorption--effect of external lubricants at the interface.
AB  - Upon exposure to blood, rapid adsorption of proteins is the initial event at the
      contacting surface, followed by the adhesion of platelets and other blood
      components. Surfaces absorbing albumin appear to possess antithrombotic character
      in discouraging adhesion of platelets. Therefore, for the development of a blood
      contacting device, the interfacial events are extremely important and need
      serious investigation. We have attempted to observe the variations in competitive
      adsorption of fibrinogen and albumin onto the polyetherurethane urea (PEUU)
      surface in the presence of external lubricant, such as calcium stearate and
      silicone fluid coating. It seems, in the presence of such mediators, that
      fibrinogen adsorption is increased relatively with reduction in albumin at the
      surface.

PMID- 8473988
TI  - Role of soft tissue structures as an etiology of hallux limitus.
AB  - The authors establish common mechanical criteria for structures that can
      adversely affect dorsiflexion of the hallux, examine soft tissue anatomical
      structures around the first metatarsophalangeal joint that meet the established
      standards, and propose alternative methods of approaching the deformity
      surgically.

PMID- 8473989
TI  - Shin muscle activity and sports surfaces. An electromyographic study.
AB  - Twelve human subjects were studied to determine the effect of three different
      floor surfaces on the medial shin musculature during stationary running.
      Electromyographic equipment, gated by an accelerometer affixed to the subject's
      shin, was used to separate the impact (eccentric) phase from the propulsive
      (concentric) phase of each running step. Excessive eccentric muscle activity has
      been associated with increased muscle damage, and recent investigations have
      linked medial tibial shin pain with actual structural damage to the muscle
      fascial attachments to the posteromedial aspect of the tibia. Therefore, this
      study tends to verify the previous assumption that running on hard, noncompliant
      sport surfaces would predispose running and dancing athletes to shin muscle
      damage and resultant pain.

PMID- 8473990
TI  - New nonfusion procedure for talocalcaneal coalitions with a fixed heel valgus.
AB  - The authors present a case of bilateral middle facet talocalcaneal coalitions
      with peroneal spasm producing a fixed valgus heel. They introduce a corrective
      procedure used at the Fountain Valley Regional Hospital and Medical Center and
      discuss its application in podiatric surgery. Correction included resection of
      the synostosis and lateral opening wedge heterogenous bone graft in the calcaneus
      to redistribute the body's weight on the heel and centralized over the axis of
      the subtalar joint.

PMID- 8473991
TI  - Navicular drop as a composite measure of excessive pronation.
AB  - The measure of navicular drop has been used as an indicator of pronation at the
      foot. It is defined as the distance the navicular tuberosity moves in standing,
      as the subtalar joint is allowed to move from its neutral position to a relaxed
      position. The purposes of this study were to test the reliability of a method to
      measure navicular drop and to assess the relationships among measures of forefoot
      to rearfoot position, subtalar joint neutral position, and navicular drop. The
      results support traditional biomechanical theory but indicate that other factors
      contribute significantly to navicular drop.

PMID- 8473992
TI  - Anatomical basis for congenital deformities of the lower extremities. Part III.
      The foot and ankle.
AB  - The human foot has been characterized as a miracle of engineering and mechanical
      efficiency. It is a complex organ, both physiologically and structurally. The
      authors present a study of the foot and ankle with emphasis on the anatomy of
      midterm fetuses as revealed by cryomicrotomy.

PMID- 8473993
TI  - Retrospective study of fifth metatarsal fractures.
AB  - On the basis of the authors' results in treating avulsion fractures of the
      tuberosity, immobilization in a short leg weightbearing cast for 4 weeks is the
      preferred treatment. If still symptomatic at 4 weeks, some patients may require
      further immobilization for an additional 1 to 3 weeks. Rarely do these patients
      require surgery. In patients with these types of fractures, no angulation or
      displacement deformity was seen on x-rays, so open reduction was not warranted.
      Although the study does not strongly support the view that delayed healing of
      Jones fractures is associated with weightbearing cast treatment, the authors
      still tend to recommend treatment with a short leg nonweightbearing plaster cast
      for 6 weeks. Patients may not tolerate such treatment for this amount of time. To
      encourage better patient compliance, a minimum of 3 to 4 weeks in a
      nonweightbearing cast followed by 3 weeks in a weightbearing cast is recommended.
      Although open reduction was indicated in a few cases, all patients with Jones
      fractures, aged 20, 22, 24, 24, and 27 years, declined that option. Specifically,
      one patient had a delayed union of the Jones-type fracture (Fig. 4). In spite of
      being young and athletic, and thus at high risk for refracture, he decided
      against open reduction internal fixation and opted for prolonged casting.

PMID- 8473994
TI  - Principles of wound healing and growth factor considerations.
AB  - This review examines some of the important principles in wound repair and
      significant considerations for the use of growth factors. Moisture provides a
      positive influence on the mechanical and hormonal aspects of wounds. Atraumatic
      closure of surgical wounds and postoperative care and the types of wound closure
      are discussed. Cellular proliferation and migration in wounds are central
      features regarding growth factors.

PMID- 8473995
TI  - Neurilemoma presenting as a painless mass on the dorsum of the foot.
AB  - The neurilemoma is a benign neoplasm of Schwann's cells arising from the sheath
      of a nerve. This neoplasm most commonly originates from the flexor surface of the
      body. An unusual presentation of a neurilemoma on the extensor surface of the
      foot was described. The treatment plan was explained, and pathologic
      characteristics were outlined. Trauma as a possible etiology was also described.

PMID- 8473996
TI  - Case of the amazing radiographs.

PMID- 8473997
TI  - Evaluation of the stereoisomers of deprenyl for amphetamine-like discriminative
      stimulus effects in rats.
AB  - The antiparkinsonian agent l-deprenyl, a selective monoamine oxidase (MAO)-B
      inhibitor, is a phenylalkylamine derivative which is metabolized in part to l
      methamphetamine and l-amphetamine. As the clinical use of amphetamine-like
      psychostimulants is limited by their potential for abuse, we evaluated l-deprenyl
      for amphetamine-like discriminative stimulus effects over a range of experimental
      conditions. Male Fisher rats were trained under a 5-response, fixed-ratio
      schedule of stimulus-shock termination or a 10-response, fixed-ratio schedule of
      food-presentation to discriminate between d-amphetamine (1.0 mg/kg i.p.) and
      saline in a two-lever, operant conditioning procedure. Full generalization was
      obtained to l-amphetamine (1.0-2.0 mg/kg), d-deprenyl (10.0-17.0 mg/kg) and l
      deprenyl (17.0 and 30.0 mg/kg) under both the food-presentation and stimulus
      shock termination schedules, and increases in responding on the lever appropriate
      to d-amphetamine were dose-dependent. The dose-effect functions for l
      amphetamine, l-deprenyl and d-deprenyl were shifted slightly to the left under
      the stimulus-shock termination schedule compared to the food-presentation
      schedule. When l-deprenyl (3.0 or 5.6 mg/kg i.p.) was given 30 min before d
      amphetamine it produced a small shift to the left in the dose-effect function for
      d-amphetamine under the food-presentation schedule. l-Deprenyl produced clear
      generalization to the d-amphetamine stimulus only at very high doses of 17.0 to
      30.0 mg/kg, doses about 10-fold higher than those that have a selective action on
      MAO-B vs. MAO-A and which start to have marked rate decreasing actions on food
      reinforced responding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8473998
TI  - Monoamine oxidase-A inhibitors and dopamine metabolism in rat caudatus: evidence
      that an increased cytosolic level of dopamine displaces reversible monoamine
      oxidase-A inhibitors in vivo.
AB  - The effects of reversible inhibitors of monoamine oxidase-A (moclobemide, Ro 41
      1049, both 20 mg/kg, i.p., and brofaromine, 10 mg/kg, i.p.) on the outflow of
      dopamine (DA) and its metabolites (3,4-dihydroxyphenylacetic acid and
      homovanillic acid) as well as of 5-hydroxyindoleacetic acid was investigated by
      trans-striatal microdialysis in rats. These drugs markedly increased the level of
      DA in the dialysis fluid by 100% of basal values and concomitantly reduced the
      output of 3,4-dihydroxy-phenylacetic acid and homovanillic acid by 90%. The
      presence of tetrodotoxin in the perfusion fluid decreased the basal DA outflow
      and virtually abolished the rise in DA efflux after moclobemide administration.
      On the other hand, tetrodotoxin did not counteract the DA outflow induced by Ro 4
      1284 (1 mg/kg, i.p.), a tetrabenazine derivative which rapidly releases DA from
      vesicles and causes a massive increase in the concentration of extravesicular
      amine. The injection of Ro 4-1284 30 min after moclobemide, brofaromine or Ro 41
      1049 induced a 6-fold increase in DA outflow, which was accompanied by a
      transient increase in 3,4-dihydroxyphenylacetic acid levels. This latter effect
      was more marked for moclobemide than for the other two reversible inhibitors
      tested and was not observed in rats given the irreversible inhibitor clorgyline
      (5 mg/kg, i.p.). These results support the view that a large increase in the
      concentration of endogenous substrates in the cytosol might displace reversible
      monoamine oxidase-A inhibitors from the enzyme active sites. Therefore, the
      microdialysis technique seems to be a reliable in vivo method for assessing the
      degree of reversibility of monoamine oxidase inhibitors.

PMID- 8473999
TI  - In vitro and ex vivo inhibitory effects of L- and D-enantiomers of NG-nitro
      arginine on endothelium-dependent relaxation of rat aorta.
AB  - The in vitro and ex vivo inhibitory effects of NG-nitro-L-arginine (L-NNA) and NG
      nitro-D-arginine (D-NNA) on endothelium-dependent relaxations were studied in rat
      aortic rings. L-NNA (3 x 10(-7) to 3 x 10(-5) M) but not D-NNA (3 x 10(-6) to 3 x
      10(-4) M) induced contraction of resting aortic rings and potentiated
      phenylephrine-induced contraction in a concentration-dependent manner. In
      phenylephrine-preconstricted aortic rings, L-NNA (3 x 10(-7) to 3 x 10(-5) M) and
      D-NNA (3 x 10(-6) to 3 x 10(-4) M) concentration-dependently inhibited the
      relaxation response to acetylcholine (ACh) with similar efficacies and IC50
      values of 10(-6) and 3.9 x 10(-5) M, respectively. In addition, both L-NNA (3 x
      10(-5) M) and D-NNA (3 x 10(-4) M) almost totally inhibited the relaxation of
      preconstricted rings by the calcium ionophore A 23187. The inhibitory effects of
      L- and D-NNA remained for at least 4 hr after the preparations were washed out.
      Neither the inhibitory effects of L- and D-NNA on ACh-induced relaxation nor the
      ACh-induced relaxation itself were affected by pretreatment with indomethacin.
      However, pretreatment (10 min) or post-treatment (1 hr later) with L-Arg (10(-3)
      M) completely prevented or markedly reversed the inhibitory effects of L- and D
      NNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474000
TI  - Effects of drugs of abuse and cholinergic agents on delayed matching-to-sample
      responding in the squirrel monkey.
AB  - To study how drugs may disrupt short-term memory function, squirrel monkeys were
      trained to respond under a titrating delayed matching-to-sample schedule of
      reinforcement. Monkeys could respond on each of three keys in an operant chamber.
      At the start of each trial, the 30th response on the center key illuminated each
      of the side keys, one of which matched the stimulus presented on the center key
      (simultaneous matching). A response to the correct (matching) side key turned off
      all stimuli and initiated a delay, the length of which varied as a function of
      ongoing performance. After the delay, stimuli were randomly presented on two of
      the three keys. A response to the key which matched the color on the center key
      before the delay resulted in delivery of a food pellet (delayed matching).
      Incorrect simultaneous or delayed matching responses initiated a timeout. Under
      this procedure, diazepam and scopolamine decreased delayed matching accuracy at
      one or more doses that did not significantly decrease mean delay values, but only
      scopolamine decreased matching accuracy at a dose that did not significantly
      decrease response rates. Cocaine decreased mean delay values after the highest
      dose without affecting matching accuracy. Pentobarbital and methylscopolamine
      decreased matching accuracy and mean and maximum delay values after the highest
      doses. Nicotine and phencyclidine produced small decreases in delayed matching
      accuracy without affecting mean and maximum delay values. Caffeine, morphine,
      physostigmine and neostigmine did not alter matching performance even after doses
      that markedly decreased rates of responding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474001
TI  - Acute opioid dependence in the cardiovascular system of the spinal rat.
AB  - This article analyzes and characterizes the early development of opioid
      dependence in the cardiovascular system of the spinal rat. The main part of the
      study deals with changes in mean arterial pressure and heart rate induced by
      naloxone (NLX) in spinal rats pretreated with single doses of morphine. The
      results show that the cardiovascular system of the spinal rat is highly sensitive
      to the abstinence-precipitating actions of NLX after a single dose of morphine.
      Dose-response curves for precipitated abstinence evaluated as changes in mean
      arterial pressure and heart rate show a gradual increase in maximum followed by a
      progressive shift to the left as dependence progresses. Cardiovascular abstinence
      is mostly mediated by catecholaminergic systems. NLX also precipitates
      noncardiovascular signs of abstinence. Interestingly, morphine-free spinal rats
      gave some abstinence-like responses to NLX, probably because of endogenous
      release of opioids. The spinal rat seems to be a valuable system for a rapid
      quantitative pharmacological characterization of the abstinence-precipitating
      actions of opioid antagonists and for the study of the changes that occur during
      the acute development of opioid dependence.

PMID- 8474002
TI  - Reversal of gallium arsenide-induced suppression of the antibody-forming cell
      response by vehicle supernatants. II. Nature and identification of reversing
      factors.
AB  - Previous studies have demonstrated that several immunological events which are T
      cell mediated are significantly suppressed by a single exposure to gallium
      arsenide (GaAs). In addition, in the in vitro-generated antibody-forming cell
      (AFC) response supernatants from vehicle (VH) cultures were able to time
      dependently reverse suppression induced by either in vivo (200 mg/kg) or in vitro
      (50 microM) exposure to GaAs. The present studies were designed to determine the
      nature and identification of the reversing factors present in VH supernatants. VH
      supernatants (25-100%) were able to dose-dependently reverse suppression of the
      AFC response (from 45% suppression to 48% enhancement of the VH response) induced
      by GaAs exposure (200 mg/kg). Concentration of 24-hr VH supernatants and
      treatment with proteinases revealed that the reversing factors were protein in
      nature with a molecular weight between 5,000 and 50,000 Da. This molecular weight
      range encompasses many of the lymphokines known to be necessary for the
      generation of an immune response. In antibody cultures exposed either in vivo or
      in vitro to VH or GaAs, HT-2 bioassay and antigen capture enzyme-linked
      immunosorbent assays demonstrated that GaAs exposure alters production of
      interleukin (IL)-2, IL-4, IL-5 and IL-6. Interestingly, the alterations in
      lymphokine production differed between the exposure regimes. Direct addition of
      IL-2 to antibody cultures resulted in a dose-dependent (6.25-50 ng/ml) reversal
      of GaAs-induced suppression (in vivo exposure) and was also dependent on the
      concentration of GaAs (50-200 mg/kg). IL-4 suppressed the VH AFC response and
      failed to reverse GaAs suppression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474003
TI  - Differential properties of pre- and postsynaptic 5-hydroxytryptamine1A receptors
      in the dorsal raphe and hippocampus: II. Effect of pertussis and cholera toxins.
AB  - The injection of 1 microgram of pertussis toxin, which inactivates Gi/o proteins,
      in the rat dorsal raphe nearly abolished the responsiveness of serotonin (5-HT)
      neurons to microiontophoretic applications of 5-HT and selective 5-HT1A agonist 8
      hydroxy-2-(di-n-propylamino)-tetralin (8-OH-DPAT) without altering their
      responsiveness to of gamma-aminobutyric acid (GABA). In contrast, the injection
      of 1 microgram of cholera toxin, which causes an activation of Gs proteins, did
      not alter the responsiveness of 5-HT neurons to 5-HT, 8-OH-DPAT or GABA. Such in
      situ injection of either toxin in the dorsal hippocampus decreased by about 90%
      the responsiveness of CA3 pyramidal neurons to microiontophoretic applications
      onto their cell body of 5-HT and 8-OH-DPAT, but not of GABA. The effectiveness of
      the stimulation of the ascending 5-HT pathway in suppressing the firing activity
      of the same neurons, which results from the release of 5-HT at the level of their
      dendritic tree, was also markedly decreased in the cholera toxin-treated rats,
      but intriguingly not in the pertussis toxin-treated rats. These results indicate
      that, on 5-HT neurons, the somato-dendritic 5-HT1A autoreceptor is coupled to
      Gi/o, but insensitive to the persistent activation of Gs proteins. In the CA3
      region of the hippocampus, there would be two subsets of postsynaptic 5-HT1A
      receptors on the pyramidal neurons: those apposed to 5-HT terminals on their
      dendritic tree (denoted intrasynaptic) and those located on their cell body
      (denoted extrasynaptic). The former are cholera toxin sensitive, whereas the
      latter are sensitive to both pertussis and cholera toxins.

PMID- 8474004
TI  - Characterization of vascular postsynaptic neuropeptide Y receptor function and
      regulation. 1. NPY-induced constriction in isolated rat femoral artery rings is
      mediated by both Y1 and Y2 receptors: evidence from benextramine protection
      studies.
AB  - Neuropeptide Y (NPY), a potent pressor agent and vasoconstrictor, is thought to
      contribute to the sympathetically mediated postsynaptic regulation of blood
      pressure primarily through activation of vascular Y1 rather than Y2 NPY
      receptors. However, data are available that conflict with this conclusion. In
      this article, the relative roles of postsynaptic Y1 and Y2 receptors as mediators
      of direct NPY-induced isolated rat femoral artery ring vasoconstriction were
      evaluated through use of selective Y1 and Y2 agonists, [Leu31, Pro34]NPY ([Leu,
      Pro]NPY) and NPY13-36 [NPY(13-36)], respectively, and the NPY receptor antagonist
      benextramine (BXT). NPY, [Leu, Pro]NPY and NPY(13-36) were equipotent as
      vasoconstrictors, and constriction induced by each peptide, but not by the
      calcium channel agonist BAY K 8644 (BAY), was almost completely blocked by 10
      microM BXT. Each of the three peptides also induced self- and cross
      desensitization and protection from BXT blockade, except that [Leu, Pro]NPY
      neither desensitized nor protected NPY(13-36)-associated responses. NPY also
      failed to protect [Leu, Pro]NPY- and NPY(13-36)-elicited constriction, and NPY(13
      36) failed to provide self-protection, from BXT blockade. However, in these
      instances, as opposed to the [Leu, Pro]NPY-NPY(13-36) cross-protection
      experiments, the occurrence of protection was probably masked by the relatively
      large magnitude of desensitization concurrently induced by the protecting
      peptide. Taken together, the present findings suggest that NPY-induced rat
      femoral artery vasoconstriction is mediated by separate, BXT-sensitive,
      postsynaptic Y1 ([Leu, Pro]NPY-activated) and Y2 [NPY(13-36)-activated]
      receptors.

PMID- 8474005
TI  - Effects of quinapril, a new angiotensin-converting enzyme inhibitor, on
      vasoconstrictor activity in the isolated, perfused mesenteric vasculature of
      hypertensive rats.
AB  - Previously, we had reported that 7-day administration of the angiotensin
      converting enzyme inhibitor quinapril markedly reduced electrically evoked
      pressor responses in the isolated, perfused mesenteric vascular bed of the
      spontaneously hypertensive rat (SHR). In the present study, we investigated the
      possibility that quinapril alters postsynaptic vasoconstrictor activity to a
      variety of vasoconstrictive agents. Quinapril (10 mg/kg/day), administered orally
      to SHR for 7 days, significantly reduced the potency and the maximal vasopressor
      response to phenylephrine (2.5-fold and 40%, respectively) and the maximal
      response to serotonin (50%) compared with the responses from vehicle treated SHR.
      In contrast, quinapril had no significant effect on the pressor responses to KCl
      or phorbol ester. Furthermore, an equipotent antihypertensive dose of hydralazine
      (5 mg/kg/day, p.o., for 7 days) exerted no inhibitory effect on the pressor
      responses elicited by phenylephrine, KCl phorbol ester, but significantly reduced
      the maximal response to serotonin. In addition, vasopressor responses to
      phenylephrine were not affected by an acute (i.e., 75 min) infusion of
      quinaprilat, the active metabolite of quinapril. The results suggest that 7-day
      quinapril administration, and not acute treatment, reduces alpha 1 adrenoceptor
      and S2-serotonergic receptor-mediated vasoconstriction. However, quinapril did
      not reduce the vasoconstrictor responses induced by KCl or phorbol ester,
      indicating that those pressor responses that are due to depolarization or protein
      kinase C activation are, in part, independent of angiotensin-converting enzyme
      inhibition. This inhibition of vascular alpha 1 adrenoceptor and S2-serotonergic
      receptor pressor activity may underlie, in part, the long-term antihypertensive
      activity of quinapril in the SHR.

PMID- 8474006
TI  - Mechanism of the bradycardia produced in the cat by the anticholinesterase
      neostigmine.
AB  - Neostigmine evoked bradycardia in vagotomized, propranolol-treated cats. Heart
      rate decreased by 50% with 0.4 +/- 0.2 mg/kg (mean +/- S.D.) i.v. of neostigmine.
      The bradycardia was attenuated after acetylcholine (ACh) depletion in the cardiac
      parasympathetic pathway suggesting ACh release within this pathway was involved.
      The bradycardia was unchanged after preganglionic terminal degeneration
      suggesting ACh release was from cardiac ganglion cells. Edrophonium produced a
      much weaker bradycardia suggesting the anticholinesterase effect of neostigmine
      may not produce the bradycardia. The neostigmine-induced bradycardia was blocked
      by systemic atropine (ED50, 0.005 +/- 0.001 mg/kg), pancuronium bromide (ED50,
      0.033 +/- 0.021 mg/kg), pirenzepine (ED50, 74.7 +/- 7.9 micrograms/kg),
      hexamethonium (ED50, 8.3 +/- 1.6 mg/kg) and d-tubocurarine (ED50, 8.6 +/- 3.0
      micrograms/kg). The doses of hexamethonium and d-tubocurarine that blocked the
      neostigmine-induced bradycardia were significantly higher than required for
      blocking the bradycardia produced by vagus nerve stimulation. Hexamethonium (60
      mg/kg i.v.) had no effect on the bradycardia produced by the muscarinic agonist
      methacholine (100-300 micrograms/kg/min i.v.). The dose of pirenzepine that
      blocked the neostigmine-induced bradycardia was lower than required for blocking
      the bradycardia produced by vagus nerve stimulation. McN-A-343 ([4-hydroxy-2
      butynyl]-1-trimethyl ammonium m-chlorocarbanilate chloride) (1 mg/kg i.v.) did
      not produce bradycardia. These observations suggest neostigmine evokes
      bradycardia by activation of ACh receptors on cardiac ganglion cells producing
      ACh release and activation of cardiac M2 receptors. The low sensitivity of the
      neostigmine-induced bradycardia to pirenzepine, and the failure of McN-A-343 to
      evoke bradycardia, suggest the receptor on cardiac ganglion cells is not an M1
      type.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474007
TI  - (+-)-N6-endonorbornan-2-yl-9-methyladenine (N-0861) and its enantiomers:
      selective antagonists of A1-adenosine receptors in guinea pig isolated atria.
AB  - Adenosine and its metabolically stable analog 5'-N-ethylcarbox-amidoadenosine
      (NECA) induce negative inotropic, chronotropic and dromotrpic actions in the
      heart through activation of A1-adenosine receptors and relaxation of vascular
      smooth muscle through activation of A2-adenosine receptors. In vitro studies were
      carried out in order to determine the potency of the antagonist (+-)-N6
      endonorbornan-2-yl-9-methyladenine (N-0861) and its two component enantiomers,
      WRC-0006(+) and WRC-0007(-), at the A1 receptors in the guinea pig atria and the
      A2 receptors in the guinea pig aorta. N-0861 competitively antagonized the
      negative inotropic responses induced by NECA in the eletrically paced left atrium
      (pKB = 6.24) and the negative chronotropic responses induced by NECA in the
      spontaneously beating right atrium (pKB = 6.29). WRC-0007 was 4-fold more potent
      (pKB = 6.51) than WRC-0006 (pKB = 5.86) at antagonizing the A1-adenosine
      receptors in the guinea pig left atrium. N-0861, WRC-0007 and WRC-0006 at high
      concentrations (> 3 x 10(-5) M) produced direct relaxations of the guinea pig
      aorta that masked to a small extent the A2 receptor antagonism by these
      compounds. The affinities of the antagonists for the A2 receptor in the aorta
      were calculated using the method of pharmacological resultant analysis. N-0861
      was 47-fold less potent at the A2 receptor (pKB = 4.57) than it was at the A1
      receptor. WRC-0006 was 2-fold more potent (pKB = 4.81) than WRC-0007 (pKB = 4.52)
      at the A2-adenosine receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474008
TI  - Cannabinoid structure-activity relationships: correlation of receptor binding and
      in vivo activities.
AB  - Although a receptor exists for cannabinoid drugs, it is uncertain which
      pharmacological actions this receptor mediates. This structure-activity
      relationship investigation was initiated to determine which effects might
      correspond to binding affinity for the cannabinoid receptor, as well as to
      explore the binding requirements of this site. The ability of nearly 60
      cannabinoids to displace [3H]CP-55,940 [(-)-3-[2-hydroxy-4-(1,1-dimethylheptyl)
      phenyl]-4-[3-hydroxy propyl] cyclohexan-1-ol] was determined before establishing
      correlations between receptor affinity and in vivo pharmacological potency.
      Analysis of [3H]CP-55,940 binding indicated a Hill coefficient of 0.97, a Bmax of
      499 pM (3.3 pmol/mg of protein) and an apparent Kd of 924 pM. Closer inspection
      indicated the binding assay exhibited "zone B" characteristics, and use of
      correction equations indicated a true Kd for CP-55,940 of 675 pM. The structure
      activity relationship indicated the importance of side chain structure to high
      affinity binding, with the most potent analogs (K1 < 10 nM) possessing either a
      dimethylheptyl side-chain, a similarly complex branched side chain or a halogen
      substituent at the 5' position. Comparative analysis of K1 values to in vivo
      potency in a mouse model indicated a high degree of correlation between
      parameters for the depression of spontaneous locomotor activity (r = 0.91) and
      for the production of antinociception (r = 0.90), hypothermia (r = 0.89) and
      catalepsy (r = 0.85). Similarly high correlations were demonstrated between
      binding affinity and in vivo potency in both the rat drug discrimination model (r
      = 0.81) and for psychotomimetic activity in humans (r = 0.88).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8474009
TI  - GM1 ganglioside treatment of focal ischemia: a dose-response and microdialysis
      study.
AB  - The efficacy of GM1 ganglioside treatment in stroke was studied in a permanent
      middle cerebral artery occlusion model in the rat. A dose-dependent attenuation
      of infarct size at 24 hr was documented with the maximum effective dose halving
      the volume of the experimental stroke. Delayed administration at 5 min, but not
      15 min, after vessel occlusion was as effective as preocclusion drug
      administration. Morphologic sparing was confined to the cortical penumbra; no
      protection in the ischemic core was found. Morphologically salvaged cortex was
      also metabolically preserved as demonstrated by quantitative measurement of
      glucose utilization. In vivo microdialysis demonstrated an attenuation of
      ischemic-induced glutamate release in the cortex with GM1 administration but no
      effect was found in the caudate. Hypotension did not occur even with doubling of
      the maximally effective dose of GM1. Accordingly, GM1 may be a safe and effective
      treatment for stroke.

PMID- 8474010
TI  - 2-Phenylethoxy-9-methyladenine: an adenosine receptor antagonist that
      discriminates between A2 adenosine receptors in the aorta and the coronary
      vessels from the guinea pig.
AB  - Substituting a methyl group for the ribose moiety of N6-substituted adenosines
      that are selective agonists at the adenosine A1 receptor creates antagonists that
      are A1-selective. Inasmuch as 2-phenylethoxyadenosine is a selective agonist for
      the adenosine A2 receptor, 2-phenylethoxy-9-methyl-adenine (PEMA) was synthesized
      and tested as a potential adenosine A2 receptor antagonist. In guinea pig hearts,
      PEMA antagonized with the same potency (pKB approximately 6.1) the A1-mediated
      negative dromotropic and inotropic actions and the A2-mediated coronary
      vasoactivity of the nonselective adenosine receptor agonist 5'-N
      ethylcarboxamidoadenosine (NECA). PEMA at concentrations up to 30 microM did not
      antagonize the NECA-induced relaxations in guinea pig aortic rings. At
      concentrations exceeding 10 microM, PEMA caused xanthine-insensitive relaxations
      of both the aorta and the coronary vessels. Pharmacological resultant analysis
      revealed A2 receptor antagonism by PEMA in the guinea pig aorta (pKB = 5.2). The
      nonselective adenosine receptor antagonist 8-p-sulfophenyl-theophylline
      antagonized NECA responses in all four assays with equal potency (pKB
      approximately 5.7). Thus, PEMA does not discriminate between A2 receptors in the
      coronary vessels and A1 receptors in the atria of the guinea pig, but it is 10
      fold more potent at antagonizing the A2 receptor in coronaries than the A2
      receptors in the aorta. The data suggest that the A2 receptors in the coronary
      vasculature may be of the A2a subtype, whereas those in the aorta may be of the
      A2b subtype.

PMID- 8474011
TI  - N-aralkyl derivatives of 1-aminobenzotriazole as potent isozyme-selective
      mechanism-based inhibitors of rabbit pulmonary cytochrome P450 in vivo.
AB  - Two N-aralkylated (N-benzyl-and N-alpha-methylbenzyl-) derivatives of 1
      aminobenzotriazole, a mechanism-based inhibitor of cytochrome P450 with low
      isozyme selectivity, were previously shown to be potent and isozyme-selective
      suicide substrates for rabbit and guinea pig pulmonary P450 in vitro (Mathews and
      Bend, 1986; Woodcroft et al., 1990). These three compounds were compared as
      inhibitors in vivo after i.v. administration to rabbits treated with the
      cytochrome P450 inducers beta-naphthoflavone or phenobarbital. By 1 hr after
      administration of N-alpha-methylbenzyl-1-aminobenzotriazole (1 mumol/kg), 80% of
      P450 2Bs-catalyzed benzphetamine N-demethylation in lung of beta-naphthoflavone
      treated rabbits was inactivated and about 35% of P450 was lost without inhibition
      of P450 1A1-catalyzed activity; at a dose of 10 or 100 mumol/kg, this compound
      totally inactivated pulmonary P450 2Bs activity while exerting minimal effects on
      benzphetamine N-demethylation activity (< 20% inhibition) in liver of beta
      naphthoflavone-treated rabbits. N-benzyl-1-aminobenzotriazole was also an isozyme
      and tissue-selective inhibitor of pulmonary P450 2Bs in vivo. Relatively high
      doses (100 mumol/kg) of these compounds were compared in phenobarbital-induced
      rabbits. Virtually all (> or = 95%) of pulmonary P450 2Bs-dependent activity was
      inhibited by the two N-aralkylated compounds (vs. 50% for 1-aminobenzotriazole).
      At this dose, about 25% of hepatic P450 was destroyed by all three compounds,
      whereas 1-aminobenzotriazole and its N-benzyl and N-alpha-methylbenzyl
      derivatives inactivated 20, 50 and 85% of hepatic P450 2Bs-selective
      benzphetamine N-demethylation activity, respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474012
TI  - Expression of ganglia-type nicotinic acetylcholine receptors and nicotinic ligand
      binding sites by cells of the IMR-32 human neuroblastoma clonal line.
AB  - Studies were conducted to ascertain whether cells of the IMR-32 human
      neuroblastoma clone express ligand binding sites and functional responsiveness
      attributable to ganglia-type nicotinic acetylcholine receptors (nAChR) and/or
      neuronal/nicotinic alpha-bungarotoxin binding sites. Some comparative studies
      were conducted using cells of other clonal lines, including BC3H-1 mouse muscle
      line cells that are known to express muscle-type nAChR. Two classes of specific
      binding sites for 3H-labeled acetylcholine ([3H]ACh) and a single class of high
      affinity, specific 125I-labeled alpha-bungarotoxin binding sites are expressed on
      membrane fractions prepared from IMR-32 cells. Radioligand binding to these sites
      on IMR-32 cells is relatively insensitive to blockade by the muscle-type nAChR
      selective inhibitors, succinyldicholine and decamethonium, indicating that they
      are distinct from muscle-type nAChR. [3H]ACh binding to its sites on IMR-32 cell
      membranes is insensitive to blockade by alpha-bungarotoxin, indicating that IMR
      32 cell [3H]ACh and 125I-labeled alpha-bungarotoxin binding sites also can be
      distinguished. Functional nAChR ion channels of the ganglia-type are expressed by
      IMR-32 cells, as assessed by the abilities of nicotinic agonists to stimulate
      86Rb+ efflux, the relatively higher sensitivity of those responses to blockade by
      mecamylamine than by d-tubocurarine, and the inability of alpha-bungarotoxin to
      antagonize nAChR function. These results are consistent with expression by IMR-32
      cells of functional ganglia-type nAChR that correlate with high affinity [3H]ACh
      binding sites as well as expression of a distinct class of neuronal/nicotinic
      alpha-bungarotoxin binding sites that have a ganglia-type pharmacology.

PMID- 8474013
TI  - Antiproliferative and endothelium-dependent vasodilator properties of 1,3-dihydro
      3-p-chlorophenyl-7-hydroxy-6-methyl-furo-(3,4c) pyridine hydrochloride
      (cicletanine).
AB  - The vasodilator and antiproliferative actions of 1,3-dihydro-3-p-chlorophenyl-7
      hydroxy-6-methyl-furo-(3,4c) pyridine hydrochloride (cicletanine) were studied on
      mesenteric resistance arteries and cultured mesenteric artery myocytes of
      spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats.
      Cicletanine (20-200 microM) induced relaxation of endothelium-intact mesenteric
      resistance arteries of SHR and WKY precontracted with norepinephrine. No
      difference in sensitivity was observed (SHR IC50 = 77 +/- 12 microM vs. 83.3 +/-
      7.4 microM for WKY, N.S.). Endothelial denudation of WKY vessels significantly
      attenuated the relaxing action of cicletanine (IC50 + endo = 83 +/- 7.4 microM
      vs. IC50 - endo = 135 +/- 9.7 microM; P < .001) and had a similar, but
      nonsignificant effect on SHR (IC50 + endo = 77 +/- 12 microM vs. IC50 - endo =
      117 +/- 14.5 microM; P = .065). Preincubation of endothelium-intact vessels with
      nitro-L-arginine methyl ester significantly attenuated cicletanine-induced
      relaxation in WKY, but not SHR vessels; 0.1 mM Ba++ had a similar effect.
      Preincubation with 3 microM indomethacin was without effect on relaxation of
      vessels of either strain. Cicletanine (100-1000 microM) inhibited proliferation
      of cultured superior mesenteric artery muscle cells growing in the presence of
      either 10% (SHR IC50 = 440 +/- 24 microM vs. 517 +/- 12 microM for WKY; P < .05)
      or 2% fetal bovine serum. This antiproliferative action was fully reversible,
      partially inhibited by indomethacin in SHR myocytes and was associated with a
      decrease in [3H]thymidine uptake in both strains.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474014
TI  - Epidermal growth factor and transforming growth factor-alpha directly inhibit
      parietal cell function through a similar mechanism.
AB  - Epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha)
      are naturally occurring peptides which are present throughout the
      gastrointestinal tract and are capable of inhibiting gastric acid secretion.
      Although previous studies have suggested that TGF-alpha may serve as an autocrine
      factor regulating parietal cell function, the cellular mechanisms by which it
      exerts its inhibitory action have not been fully elucidated. In addition, no
      systematic comparison has been undertaken of the effects of EGF and TGF-alpha on
      parietal cell function. The aims of the present studies were to compare the
      actions of EGF and TGF-alpha on basal and stimulated acid secretion by isolated
      rabbit parietal cells and to elucidate the intracellular mechanisms by which
      these growth factors inhibit acid secretion stimulated by agents that activate
      the adenylate cyclase and cyclic AMP second messenger system. Although EGF and
      TGF-alpha did not alter basal parietal cell function, they both inhibited
      histamine-stimulated [14C]aminopyrine accumulation in a identical time- and dose
      dependent fashion. The maximal effect of approximately 40% inhibition for
      histamine-stimulated action was achieved with concentrations of 10(-6) M for both
      EGF and TGF-alpha. The inhibitory effect of EGF and TGF-alpha appeared to be at
      the postreceptor level as neither growth factor significantly altered binding of
      histamine to its receptor (H2) on parietal cells. Consistent with this postulated
      mechanism of action, both EGF and TGF-alpha dose-dependently inhibited forskolin
      stimulated aminopyrine uptake with IC50 similar to those required for inhibiting
      the stimulatory effect of histamine. Of note, neither growth factor inhibited
      parietal cell activity stimulated by dibutyryl cyclic AMP.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8474015
TI  - Chronic physical activity alters hepatobiliary excretory function in rats.
AB  - Recent studies have indicated that exercise causes alterations in the
      biotransformation of some xenobiotics and the clearances of antipyrine and
      [14C]aminopyrine. The present study has investigated whether chronic voluntary
      physical activity alters hepatobiliary excretory function by comparing the
      clearance and biliary excretion of model substrates for each of four carrier
      mediated transport systems (anion, uncharged, bile acid and cation; n = 8 for
      each chemical in each group) in active and inactive female rats. The active rats
      had access to running wheels and voluntarily ran 11.2 +/- 0.68 km/day. The active
      rats were fed ad libitum, and ate 37% more food than weight-matched, restricted
      fed sedentary control rats. Basal bile flow was 34% higher in active rats than in
      inactive rats, and excretion of bile acids, cholesterol and phospholipid were
      also increased. The biliary excretion and biliary clearance of the anion,
      indocyanine green, were elevated in active rats, although total clearance and
      serum concentrations were not different due to decreased non-biliary clearance.
      Serum elimination and total clearance of the uncharged substrate, ouabain, were
      elevated in the active rats, due entirely to increased nonbiliary clearance.
      Total clearance of the bile acid, taurocholate, was higher in active rats due to
      an increased biliary clearance. In contrast, there were no differences in either
      the biliary excretion or clearances of the cation, procainamide ethobromide,
      between the two groups of rats. Finally, no differences in volume of distribution
      or elimination half-life were noted between inactive and active rats for any of
      the substrates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474016
TI  - Pharmacological characterization of the renovascular P2 purinergic receptors.
AB  - Isolated rat kidneys, perfused at a constant flow with a nonrecirculated medium,
      were used to investigate the effects of P2 purinergic receptor agonists on renal
      vascular resistance. A potent P2y agonist, 2-methylthio ATP, dilated the kidney
      in a concentration-dependent manner, a response that was similar to that elicited
      by acetylcholine. The vasodilator responses to 2-methylthio ATP and to
      acetylcholine were nearly abolished by N omega-nitro-/-arginine methyl ester, an
      antagonist of nitric oxide formation by endothelial cells. A potent P2x agonist,
      alpha, beta-methylene ATP, constricted the kidney in a concentration-dependent
      manner, and the effect was potentiated by N omega-nitro-/-arginine methyl ester.
      This latter finding suggests that alpha,beta-methylene ATP activates P2y
      receptors, but with such a low potency that any tendency for vasodilation is
      masked by the predominant P2x receptor-induced constriction. Collectively, the
      results indicate the renal vasculature can either constrict or dilate in response
      to P2 purinergic receptor agonists, depending upon which subclass of receptor is
      activated, P2x (constrict) or P2y (dilate). Furthermore, the P2y receptor-induced
      vasodilation appears to be mediated by endothelial cell nitric oxide formation.

PMID- 8474017
TI  - Role of nitric oxide in neurogenic vasodilation of porcine cerebral artery.
AB  - A superfusion bioassay cascade, with porcine pial arteries as donor tissues and
      rabbit aortic rings as detector tissues, was used to examine the role of nitric
      oxide (NO) in cerebral nonadrenergic, noncholinergic neurogenic vasodilation. All
      arteries were mechanically denuded of endothelium. In the presence of atropine (1
      microM) and guanethedine (0.3 microM), transmural nerve stimulation (TNS) of
      cerebral arteries (CA) resulted in a frequency-dependent relaxation of
      phenylephrine-precontracted aortic rings. Relaxation was abolished by
      tetrodotoxin (2 microM) superfused onto and by cold-storage denervation of CA,
      suggesting that a vasodilating factor (VF) of neuronal origin in CA was released
      upon TNS. The VF-induced relaxation was inhibited by NW-nitro-L-arginine (0.3 mM)
      superfused onto CA. This inhibition was reversed by L-arginine (0.3 mM) but not D
      arginine (0.3 mM). Exogenously applied NO onto CA also induced dilations of
      aortic rings in a concentration-dependent manner. The VF- and NO-induced
      dilations, which were abolished by hemoglobin (0.3 microM), and enhanced by
      superoxide dismutase (30 U/ml), declined to the same extent with similar time
      courses from the first to the second aortic ring. These findings indicate that VF
      and NO possess a similar labile nature and half-life, suggesting that VF is NO or
      a related substance. Identical frequency-response curves of TNS (2-16 Hz) and
      concentration-response curves of NO (10-1000 nM) further suggest that < 1000 nM
      of NO was released from CA upon TNS at the maximal frequency used.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8474018
TI  - Barbiturate anesthetics depress the resting K+ conductance of myocardium.
AB  - The intravenous anesthestic thiopental has been previously shown to increase the
      incidence of ventricular arrhythmias, particularly when combined with epinephrine
      and halothane. Recent work based on microelectrode and tension measurements has
      indicated that thiopental may diminish membrane K+ permeability. Utilizing the
      whole-cell patch-clamp technique, we investigated the effect of thiopental on the
      current associated with the resting membrane conductance, the anomalous or inward
      rectifying K+ current (IK1). External application of 30 microM thiopental to frog
      atrial myocytes resulted in a 56 +/- 2% (mean +/- S.E.M.; n = 12 cells) reduction
      in the magnitude of IK1 elicited by a hyperpolarization to -110 mV. The outward
      current component through IK1 channels, evoked by depolarizing voltages above the
      resting potential, was decreased to same extent. The effect of thiopental on IK1
      was concentration-dependent and the time courses of onset and recovery were rapid
      (tau = 10-14 sec). Ramp command potentials from -120 to +60 mV at a rate of 20
      mV/sec revealed that 30 microM thiopental also depressed the delayed outward K+
      current by 25 +/- 4% (n = 4). Examination of other barbiturates revealed that the
      potency in the suppression of IK1 was related to the octanol/water partition
      coefficient, suggesting a lipophilic site of action. Utilizing guinea pig
      ventricular myocytes, we observed a similar level of IK1 depression with
      thiopental, however the rates of onset and recovery were considerably slower than
      with frog atrial myocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474019
TI  - Serotonin-facilitated dopamine release in vivo: pharmacological characterization.
AB  - The receptor specificity of serotonin (5-HT) agonist-induced facilitation of
      dopamine (DA) release was assessed by using in vivo microdialysis. The 5-HT
      receptor selective agonists RU 24969 [5-methoxy-3(1,2,3,6-tetrahydro-4-pyridinyl)
      1H indole succinate], 2-methylserotonin maleate, 5-methoxytryptamine HCl, 8
      hydroxy-2-(di-n-propylamino) tetralin hydrobromide and 1-(2,5-dimethoxy-4
      iodophenyl)-2-aminopropane HCl were perfused through probes located in the
      anterior lateral striata of chloral hydrate-anesthetized rats. The agonists
      increased extraneuronal levels of DA in a dose-dependent manner, suggesting
      receptor selectivity in the order of 5-HT1b > 5-HT4 >> 5-HT2 = 5-HT1a.
      Coperfusion of the 5-HT1 antagonist pindolol with RU 24969 reduced the efficacy
      of RU 24969. The 5-HT2 antagonist ritanserin (6-[2-[4[bis(4
      fluorophenyl)methylene]-1-piperadinyl]- ethyl]-7-methyl-5H-thiazolo[3,2
      a]pyrimidin-5-one) did not antagonize the effect of either 5-HT or 1-(2,5
      dimethoxy-4-iodophenyl)-2-aminopropane HCl on DA levels. MDL 72222 (3-tropanyl
      3,5-dichlorobenzoate) and ICS 205930 (3-tropanyl-indole-3-carboxylate), both 5
      HT3 antagonists, decreased the efficacy of 5-HT. The partial 5-HT4 antagonist ICS
      205930 reduced DA released by perfusion of the 5-HT1/2/4 agonist 5
      methoxytryptamine HCl. Coperfusion of antagonists with agonists indicated
      involvement of 5-HT1 and 5-HT3 receptors and a lack of involvement of 5-HT2
      receptors in the 5-HT-induced facilitation of DA release. Determination of the
      role of 5-HT4 receptors will require additional work with more selective
      ligands.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474020
TI  - Inhibition and induction of cytochrome P450 isoenzymes in rat lung.
AB  - The O-dealkylation of pentoxyresorufin, a substrate for P450 2B1, was decreased
      in lung microsomes from rats dosed with O,O,S-trimethylphosphorodithioate, O,O,O
      trimethylphosphorothioate, bromophos, fenitrothion, p-xylene and 2,4-dichloro-(6
      phenylphonoxy)ethylamine. This activity was decreased by antibodies to P450 2B1
      but unaffected by antibodies to P450 1A1 or 4B1. This reduction reflected both
      inactivation and destruction of P450 2B1; destruction of this protein was
      particularly marked after bromophos and fenitrothion. Pyrazole was the only
      compound in this study to induce the O-dealkylation of pentoxyresorufin. None of
      these compounds altered the rate of ethoxyresorufin O-dealkylation, an indicator
      of P450 1A1 activity, but this activity was induced greatly by both Aroclor and
      beta-naphthoflavone, p-Xylene was the only compound to decrease P450 4B1
      activity, as determined by the N-hydroxylation of 2-aminofluorene. In the liver,
      bromophos, fenitrothion, p-xylene and 2,4-dichloro-(6-phenylphonoxy)ethylamine
      all had marked effects on the O-dealkylation of ethoxyresorufin and
      pentoxyresorufin but, at the dose used, O,O,O-trimethylphosphorothioate and O,O,S
      trimethylphosphorodithioate had minimal effects in this tissue. Thus, both O,O,O
      trimethylphosphorothioate and O,O,S-trimethylphosphorodithioate are exquisitely
      selective inhibitors of pulmonary P450 2B1 activity. Their use, together with
      pyrazole, will facilitate future studies of the pulmonary activation of toxins by
      P450 2B1.

PMID- 8474021
TI  - Mitochondrial and glycolytic dysfunction in lethal injury to hepatocytes by t
      butylhydroperoxide: protection by fructose, cyclosporin A and trifluoperazine.
AB  - In isolated mitochondria, t-butylhydroperoxide (t-BuOOH) and other pro-oxidants
      cause a permeability transition characterized by increased permeability to small
      ions, swelling and loss of membrane potential. Cyclosporin A and trifluoperazine
      inhibit this permeability transition. Here, we investigated the role of the
      mitochondrial permeability transition in lethal cellular injury from t-BuOOH.
      Hepatocytes from fasted rats were isolated by collagenase perfusion, and cell
      viability was assessed by propidium iodide fluorescence. t-BuOOH caused dose- and
      time-dependent cell killing. Fructose, a substrate for glycolytic ATP formation,
      protected at lower (< or = 100 microM), but not at higher concentrations of t
      BuOOH. In fructose-treated cells, oligomycin (10 micrograms/ml) delayed cell
      killing after 100 to 300 microM t-BuOOH, whereas cyclosporin A (0.5 microM) plus
      trifluoperazine (5 microM) even more potently reduced lethal injury. In
      hepatocyte suspensions, 100 microM t-BuOOH caused mitochondrial depolarization as
      determined by release of rhodamine 123. Cyclosporin A plus trifluoperazine in the
      presence of fructose substantially reduced release of rhodamine 123. Similarly,
      in single cultured hepatocytes viewed by laser scanning confocal microscopy, t
      BuOOH caused leakage of rhodamine 123 from mitochondria, an event which preceded
      cell death and which was delayed by fructose in combination with cyclosporin A
      plus trifluoperazine. At 1 mM, t-BuOOH inhibited glycolysis, and fructose in
      combination with either oligomycin or cyclosporin A plus trifluoperazine had only
      a short-lived protective effect. In conclusion, t-BuOOH toxicity was progressive
      with increasing dosages. At low t-BuOOH (< or = 50 microM), mitochondrial ATP
      synthetic capacity was inhibited, but not uncoupled.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474022
TI  - Specificity of substrate and inhibitor probes for human cytochromes P450 1A1 and
      1A2.
AB  - Kinetic and inhibitor studies using cDNA-expressed enzymes and human liver
      microsomes have characterized the specificity of a range of cytochrome P450 (CYP)
      1A substrate and inhibitor probes towards the two isoforms comprising this
      subfamily. Expressed CYP1A1 and CYP1A2 both catalyzed the O-deethylation of
      phenacetin, although the apparent Km was about 4-fold lower for CYP1A2 (25 vs.
      108 microM). Phenacetin O-deethylation exhibited biphasic kinetics in human liver
      microsomes, and the apparent Km for the high-affinity component (9 +/- 6 microM)
      was consistent with the involvement of CYP1A2 in this reaction. The prototypic
      CYP1A xenobiotic inhibitor and substrate probes alpha-naphthoflavone,
      ellipticine, 7-ethoxycoumarin and 7-ethoxyresorufin all inhibited CYP1A1- and
      CYP1A2-mediated phenacetin O-deethylation as well as the high-affinity component
      of human liver phenacetin O-deethylase activity. alpha-Naphthoflavone and 7
      ethoxycoumarin were, however, approximately 10-fold more potent as inhibitors of
      CYP1A2 than CYP1A1. Other putative human CYP1A xenobiotic substrates and
      inhibitors, including caffeine, 5- and 8-methoxypsoralen, nifedipine,
      paraxanthine, propranolol and theophylline similarly inhibited CYP1A1- and 1A2
      catalyzed phenacetin O-deethylation and the high-affinity human liver phenacetin
      O-deethylase. In contrast, the monoclonal antibody MAb 1-7-1, raised against 3
      methylcholanthrene-inducible rat cytochromes 450, almost abolished CYP1A1
      mediated phenacetin O-deethylation, but had no effect on human liver microsomal-
      or CYP1A2-catalyzed phenacetin dealkylation. Together with previous data, the
      results indicate that the majority of human CYP1A xenobiotic inhibitor and
      substrate probes are nonspecific in their recognition of CYP1A1 and CYP1A2,
      although selectivity is apparent for some compounds.

PMID- 8474023
TI  - Plasma stability and pharmacokinetics of radiolabeled deferoxamine-biotin
      derivatives.
AB  - The extraordinary high affinity of biotin for streptavidin may be exploited in a
      two-step in vivo approach for delivering radiolabeled biotin derivatives suitable
      for imaging and therapy to lesion-bound streptavidin-conjugated monoclonal
      antibodies. Compared to the use of directly radiolabeled monoclonal antibodies,
      the two-step approach is desirable because of the fast renal clearance of
      radiobiotin, which reduces in vivo background levels and radiation dose.
      Deferoxamine binds with high-affinity trivalent metals useful for imaging and
      radiotherapy. Three deferoxaminebiotin derivatives were synthesized, radiolabeled
      and their stabilities tested in vitro in dog plasma and in vivo in the dog by an
      avidin binding assay and high-performance liquid chromatography. Defero
      desaminolysyl-biotin (DLB) was unstable, with immediate degradation evident. A
      plasma enzyme, biotinidase, converts biocytin to biotin. DLB closely resembles
      biocytin, and analysis of the urine and plasma suggested rapid degradation of DLB
      to biotin and desaminolsyl-deferoxamine. Defero-biotin, a direct conjugate of
      deferoxamine and biotin, was similarly tested and found to be more stable. Defero
      acetyl-cysteinyl-biotin contains a carboxyl group adjacent to the amide bond
      cleavage site of biotinidase. In vitro at 24 hr in plasma, defero-acetyl
      cysteinyl-biotin was 87% stable, compared to 45% and 15% for defero-biotin and
      DLB, respectively. The pharmacokinetics of the three derivatives were similar,
      with 80% of the injected doses found in the urine at 6 hr; however, only defero
      acetyl-cysteinyl-biotin was present as the intact moiety.

PMID- 8474024
TI  - Induction of tolerance to crotoxin in mice.
AB  - Crotoxin, the major toxic component from the venom of Crotalus durissus
      terrificus is a potent neurotoxin (LD50, i.p., mice, 0.09 mg/kg) which possesses
      phospholipase A2 activity and causes a blockade of neuromuscular transmission. In
      this article, we show that mice injected daily with progressively increasing
      doses of crotoxin develop tolerance to the lethal action of this toxin. Treated
      mice tolerated daily doses of crotoxin 20- to 35-fold higher than the original
      LD50 without the characteristic signs of toxicity. Studies on the isolated
      phrenic nerve-diaphragm preparation in vitro from control (crotoxin-naive) mice
      showed that the exposure to 2 to 10 micrograms/ml crotoxin in the bath produced
      complete transmission blockade in 120 to 150 min. Conversely, the preparations
      from crotoxin-treated mice required crotoxin concentrations in the range of 17.5
      to 100 micrograms/ml to produce complete neuromuscular block, being virtually
      insensitive during 200 min of exposure to 5 to 10 micrograms/ml crotoxin. Phrenic
      nerve-diaphragm preparations of control (crotoxin-naive) and crotoxin-treated
      mice did not show significant differences in sensitivity to the blocking action
      of carbamylcholine, suggesting that induction of tolerance to crotoxin is likely
      a presynaptic event.

PMID- 8474025
TI  - Muscarinic m2 receptors in cerebellar granule cell cultures from rat: mechanism
      of short-term desensitization.
AB  - Cerebellar granule cell cultures of rat express only muscarinic m2 and m3
      receptor subtypes and exhibit the pharmacological profile of muscarinic m2
      receptors that couple to guanine nucleotide binding proteins to inhibit adenylyl
      cyclase. In vivo pretreatment with muscarinic agonists desensitizes the
      muscarinic m2 receptor with 50% complete desensitization within 15 to 20 min.
      After a 1-hr pretreatment with a maximal concentration of carbachol (short-term
      desensitization), m2 receptor responsiveness reappeared after a 1-hr treatment of
      cultures with atropine. However, after a 6-hr pretreatment with carbachol (long
      term desensitization), m2 receptor responsiveness did not reappear after 1-hr
      treatment with atropine. Short-term desensitization was homologous for the m2
      receptor because treatment of cultures with carbachol did not alter gamma
      aminobutyric acidB receptor-mediated inhibition of adenylyl cyclase. Muscarinic
      m2 receptor desensitization was not mimicked by the addition of analogs of cyclic
      AMP, cyclic GMP or diacylglycerol to the cultures. The agonist-induced
      desensitization was not blocked by a cyclic AMP analog, 8-(4-chlorophenylthio)
      cyclic AMP. Pretreatment with antisense oligodeoxynucleotides against the mRNA
      encoding beta adrenergic receptor kinase attenuated the desensitization by
      carbachol (100 microM, 1 hr) of m2 receptors. Irreversible labeling of muscarinic
      m2 and m3 receptors with [3H]propylbenzilycholine mustard followed by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis produced a loss of the
      muscarinic m2 receptor (66-kDa protein), but not the muscarinic m3 receptor (92
      kDa protein). We suspect that the short-term desensitization results from the
      phosphorylation of the muscarinic m2 receptor followed by loss of receptor from
      the plasma membrane.

PMID- 8474026
TI  - Characterization of a decrease in muscarinic m2 mRNA in cerebellar granule cells
      by carbachol.
AB  - Studies involving carbachol (100 microM) treatment of cerebellar granule cells
      for 1, 3, 6, 9, 12 and 24 hr show a decrease in the mRNA encoding for the
      muscarinic m2 receptor. The response was transient, decreasing m2 mRNA by 25 to
      50% in 6 and 9 hr, respectively. The data presented in this work were quantified
      by ribonuclease protection assay, using a [32P]-cRNA probe corresponding to
      nucleotide +1138 to 1650 of the rat m2 muscarinic receptor. Because cerebellar
      granule cells express muscarinic m2 and m3 receptors, we tested whether the
      carbachol-mediated decrease in m2 mRNA resulted from a homologous or heterologous
      activation of muscarinic receptors. At a 1 microM concentration, methoctramine
      specifically blocked the muscarinic m2 receptor and reversed carbachol's action.
      These data suggested that carbachol acts via a possible homologous activation of
      muscarinic m2 receptors. The half-life of the receptor mRNA measured in the
      presence of actinomycin D with and without carbachol were similar. Because
      carbachol treatments decrease the steady-state levels of m2 mRNA without changing
      the half-life of the message, we suggest that a carbachol treatment induces a
      decrease in the transcription of the gene for the muscarinic m2 receptor.

PMID- 8474027
TI  - Thromboxane A2 stimulated signal transduction in vascular smooth muscle.
AB  - Thromboxane A2 (TXA2) is a potent, labile vasoconstrictor which stimulates vessel
      contraction through vascular smooth muscle TXA2 receptors differing from those in
      platelets. We studied TXA2-stimulated events in cultured adult rat aortic smooth
      muscle cells. The stable TXA2 mimetic (15S)-hydroxy-11 alpha,9 alpha
      (epoxymethano)prosta-5Z, 13E-dienoic acid (U46619) competed for TXA2 agonist
      binding to vascular smooth muscle cells with an IC50 of 10 +/- 1 nM. In fura-2
      loaded cells, U46619 increased free cytosolic Ca++ concentration with an EC50 of
      49 +/- 14 nM. The increase in free cytosolic Ca++ was rapid, transient and
      independent of extracellular Ca++ or Ca++ antagonists and thus was due to release
      from intracellular stores. U46619-mediated Ca++ release was temporally associated
      with phosphorylation of myosin light chains, increased accumulation of 1,4,5
      inositol trisphosphate (EC50 = 32 +/- 4 nM) and cytoplasmic acidification from pH
      7.06 +/- 0.01 to 7.00 +/- 0.02 (P = .02). Ca++ release was 53% attenuated by the
      phospholipase C inhibitor, 1-[6-[[17 beta-3-methoxyestra-1,3,5(10)-trien-17
      yl]amino]hexyl]-1H- pyrrole-2,5-dione. In rat aortic rings U46619 caused TXA2
      receptor-mediated contractions (EC50 of 28 +/- 2 nM) which were not attenuated by
      removal of extracellular Ca++ from the superfusion buffer. Together, these
      results suggest that agonist occupation of TXA2 receptors produces vascular
      smooth muscle contraction through initial activation of phospholipase C with
      production of 1,4,5-inositol phosphate, release of intracellular calcium stores
      and phosphorylation of myosin light chains associated with cellular
      acidification, presumably via activation of Ca++ ATPase.

PMID- 8474028
TI  - Effects of a novel calcium antagonist, S-(+)-methyl-4,7-dihydro-3-isobutyl-6-
      methyl-4-(3-nitrophenyl)thieno[2,3-b]pyridine-5-carboxylate (S-312-d), on
      ischemic amino acid release and neuronal injury in stroke-prone spontaneously
      hypertensive rats.
AB  - The effects of a novel dihydrothienopyridine Ca antagonist S-(+)-methyl-4,7
      dihydro-3-isobutyl-6-methyl-4-(3-nitrophenyl)-thieno [2,3-b]pyridine-5
      carboxylate (S-312-d), on the amount of amino acid release during cerebral
      ischemia and delayed neuronal death in the hippocampal CA1 region of stroke-prone
      spontaneously hypertensive rats were studied and compared with those of
      nimodipine. The released amino acids were measured by high-performance liquid
      chromatography after microdialysis. Cerebral ischemia was produced by occlusion
      of the bilateral common carotid arteries for 20 min. Intraduodenal administration
      of 0.3 mg/kg of S-312-d at 60 min before the carotid occlusion significantly
      decreased the ischemic release of glutamate and taurine, but did not influence
      their basal release. However, nimodipine did not inhibit the ischemic glutamate
      release even at a dose of 10 mg/kg. Similar peripheral hemodynamic effects were
      observed before and during bilateral carotid occlusion in groups treated with S
      312-d or nimodipine. During the carotid occlusion, almost no cerebral blood flow
      was observed in either group. Therefore, the inhibitory effect of S-312-d on
      ischemic amino acid release probably arises from its potent direct action on
      neuronal cells. The neuronal cell densities of the CA1 subfield at 7 days after
      20-min bilateral carotid occlusion significantly decreased in the vehicle-control
      group compared with the sham-operated group. Intraperitoneal administration of
      0.1 mg/kg of S-312-d at 60 min before ischemia prevented the decrease of neuronal
      cell density compared with the vehicle control. These results show that S-312-d
      can offer marked neuronal protective effects against ischemic injury.

PMID- 8474029
TI  - Behavioral effects of pentobarbital, lorazepam, ethanol and chlorpromazine
      substitution in pentobarbital-dependent baboons.
AB  - Baboons were given continuous intragastric infusions of 100 mg/kg/day of
      pentobarbital before and during these experiments. The baboons responded under a
      fixed-ratio (FR) 30-response schedule of food presentation from 10:00 A.M. of one
      day to 8:00 A.M. of the next day. Terminating pentobarbital administration (i.e.,
      substituting water for pentobarbital) from 8:00 A.M. of one day to 8:00 A.M. of
      the next day produced large decreases in the number of pellets earned. Repeated
      24-h terminations of pentobarbital administration at 1-week intervals produced
      similar decreases in the pellets earned. In another experiment, the effects of
      terminating pentobarbital administration for several days were examined. The
      number of pellets earned decreased within 2 h of terminating pentobarbital
      administration was maximally suppressed during the first day, and recovered over
      3 to 5 days. When different doses of pentobarbital were substituted for 24 h, the
      disruption of responding seen after pentobarbital termination was attenuated in a
      dose-dependent manner. In another experiment, the effects of substituting
      lorazepam, ethanol or chlorpromazine for pentobarbital for 24 h were examined.
      Lorazepam produced a dose-dependent attenuation of the effects of pentobarbital
      termination, whereas ethanol did not. Chlorpromazine did not attenuate the
      effects of pentobarbital termination in two of the three baboons tested, and
      produced erratic results in the third.

PMID- 8474030
TI  - Induction of cytochrome P450 2B1 in rat liver by the aromatase inhibitor
      aminoglutethimide.
AB  - Aminoglutethimide (AG) is an inhibitor of P450 aromatase and is in clinical use
      for the treatment of estrogen-dependent breast cancer in postmenopausal women. AG
      produces adrenal insufficiency by inhibition of the adrenal P450 cholesterol side
      chain cleavage enzyme, but a number of serious pharmacokinetic interactions have
      been reported between AG and coadministered drugs. The present study was
      undertaken in the rat to assess the modulatory capacity of AG toward P450 enzyme
      activities in vitro and in vivo and to identify the P450 subject to such effects.
      In vivo administration of AG produced a dose-related increase in activities
      attributable to the hepatic P450 enzyme 2B1. Thus, AG administration (25 and 50
      mg/kg, i.p., on 3 consecutive days) resulted in 85 and 100% increases in
      testosterone 16 beta-hydroxylation and 3.3- and 7.4-fold increases in 7
      pentylresorufin O-depentylation (both mediated by P450 2B1) in rat liver; at a
      dose of 5 mg/kg, no effect on these activities was noted. In addition, microsomes
      from rats administered high-dose AG catalyzed increased rates of androst-4-ene
      3,17-dione 16 beta-hydroxylation (from 0.72 +/- 0.10 nmol/min/mg in control to
      3.51 +/- 0.47 nmol/min/mg protein). These findings were confirmed by direct
      immunoquantification of P450 2B1 in hepatic microsomes, by which it was found
      that the content of the enzyme in control fractions (2.4 +/- 0.7 micrograms/mg
      microsomal protein) was increased 2.9- and 6.5-fold by the respective doses of
      AG. In contrast, there was no evidence for increases in two other similarly
      inducible proteins, P450 3A or P450 2C6.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474031
TI  - Mechanism of putrescine transport in human pulmonary artery endothelial cells.
AB  - Effective lung repair requires optimal replication of critical cell populations
      in the lung. Endogenous polyamines such as putrescine, spermidine and spermine
      play important roles in cell proliferation and differentiation, and may arise due
      to intracellular synthesis or transport into the cell. To determine the mechanism
      of polyamine transport in lung endothelial cells, the uptake of putrescine in
      human pulmonary artery endothelial cells was examined. Putrescine (7 nM) uptake
      into the cells approached equilibrium at 1 hr and was inhibited by methylglyoxal
      bis(guanylhydrazone). Kinetic studies revealed that uptake occurred via both a
      high- and low-affinity system. The effect of several amines (700 microM) on the
      15-min uptake of putrescine was examined and a rank order of inhibition was
      determined: methylglyoxal bis(guanylhydrazone) > putrescine > spermine >
      spermidine > gentamicin > mepiperphenidol. alpha-Aminoisobutyric acid, a
      prototype system A amino acid, and tetraethylammonium, an organic cation, had no
      effect. N-ethylmaleimide inhibited transport 71%, whereas dinitrophenol did not.
      A reduction in temperature from 37 degrees C to 5 degrees C resulted in a 42%
      decrease in putrescine transport. Additionally, removing fetal bovine serum from
      the uptake medium reduced transport 38%. These data indicate that human pulmonary
      artery endothelial cells possess a specific transport system for polyamines. An
      improved understanding of this pathway in pulmonary endothelial cells may permit
      development of strategies to facilitate growth and repair of this critical cell
      population.

PMID- 8474032
TI  - Differential properties of pre- and postsynaptic 5-hydroxytryptamine1A receptors
      in the dorsal raphe and hippocampus: I. Effect of spiperone.
AB  - The i.v. administration of the 5-hydroxytryptamine (5-HT)1A antagonist spiperone
      (1 mg/kg) antagonized the suppressant effect of microiontophoretic applications
      of 5-HT and of the selective 5-HT1A agonist 8-OH-DPAT on the firing activity of
      the rat dorsal raphe 5-HT neurons. In contrast, the same dose of spiperone did
      not alter the responsiveness to microiontophoretic applications of 5-HT and 8-OH
      DPAT of pyramidal neurons in the CA3 region of the hippocampus, therefore
      indicating that spiperone does not act as a classical antagonist at these
      postsynaptic 5-HT1A receptors. After two daily injections of spiperone (5 mg/kg,
      i.p.) and a third one immediately before the experiment, the responsiveness of
      CA3 pyramidal neurons to 5-HT applied by microiontophoresis and to that released
      by the electrical stimulation of the ascending 5-HT pathway was markedly reduced.
      After 24, but not 12 or 48 h after a single injection of spiperone (5 mg/kg,
      i.p.), the responsiveness to exogenous and endogenous 5-HT was decreased. Smaller
      doses (1 and 2.5 mg/kg, i.p.) were ineffective. Haloperidol and ketanserin (5
      mg/kg, i.p., 24 h before the experiment) were ineffective in blocking the
      responsiveness of CA3 pyramidal neurons to 5-HT, thereby demonstrating that the
      dopamine D2 and 5-HT2 properties of spiperone could not account for the
      attenuated responsiveness of the hippocampus neurons to 5-HT. Methiothepin (5
      mg/kg, i.p., 24 h before recording), as for spiperone, antagonized the
      suppressant effect of 5-HT applied by microiontophoresis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8474033
TI  - Morphine-induced alterations in thymocyte subpopulations of B6C3F1 mice.
AB  - Morphine has been reported to possess immunosuppressive actions in both in vitro
      as well as in vivo assays of immune function. Our work in female B6C3F1 mice,
      surgically implanted with a 75-mg time release morphine pellet, has confirmed
      previous reports of a rapid loss in the cellularity of the spleen and thymus. To
      evaluate the effect of morphine on the subpopulations of cells in the thymus, two
      color fluorescence flow cytometry studies were performed. Fluorescently
      conjugated monoclonal antibodies specific for the murine cell surface CD4 and CD8
      markers were used to identify the four major subpopulations of thymocytes. These
      studies indicated that morphine pellet-implanted mice suffered a loss in each of
      the four thymocyte subpopulations in comparison to placebo-implanted mice.
      However, the loss (> 90%) in the important CD4+/CD8+ subpopulation of immature
      thymocytes greatly exceeded that which was observed for any other subpopulation.
      Kinetic studies of morphine's effect on the thymocyte subpopulations revealed
      that the maximal depletion of the CD4+/CD8+ cells occurs approximately 4 days
      after pellet implantation. Thymocyte cell populations recovered by 14 days, with
      an increase above placebo for the double positive cells. Naltrexone
      administration blocked thymic alterations, suggesting that these immunologic
      consequences of morphine may be mediated through an opiate receptor. Measurements
      in thymocytes from morphine pellet-implanted mice showed an increased level of
      DNA fragmentation, whereas in vitro exposure to morphine (1-100 microM) produced
      no such increases. This suggests morphine may be working indirectly to induce
      apoptosis of immature thymocytes.

PMID- 8474034
TI  - Respiratory control of sympathetic nerve activity during naloxone-precipitated
      morphine withdrawal in rats.
AB  - In this study, we describe and compare the changes in phrenic nerve discharge and
      vasomotor sympathetic output produced by 1) acute administration of morphine in
      naive rats and 2) naloxone-precipitated withdrawal in morphine-dependent rats.
      Lumbar or splanchnic sympathetic nerve discharge and phrenic nerve discharge were
      recorded along with mean arterial pressure and end-expiratory CO2 in vagotomized,
      urethane-anesthetized, paralyzed and artificially ventilated rats. Acute
      injection of morphine (1 and 5 mg/kg, i.v.) reduced resting mean arterial
      pressure, resting phrenic nerve discharge amplitude, the sympathetic baroreflex
      and the central respiratory drive of sympathetic nerve discharge. Subsequent
      administration of naloxone (1 mg/kg) reversed all cardiorespiratory effects of
      morphine and produced an overshoot, suggesting acute withdrawal. Morphine
      dependent rats displayed a prolonged central inspiratory phase and a higher
      threshold for apnea. Naloxone-induced withdrawal was associated with an increase
      of mean arterial pressure and phrenic nerve discharge amplitude and a large
      reduction in the inspiratory phase. Withdrawal produced three distinct effects on
      sympathetic nerve discharge: 1) sensitization of the baroreflex, 2) large
      increase in the central respiratory drive and 3) selective increase in a
      respiratory-independent component of the splanchnic sympathetic outflow. It is
      concluded that the increase in central respiratory drive is a significant
      component of the sympathoactivation associated with naloxone-induced withdrawal.

PMID- 8474035
TI  - Comparative action of Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2 analogs on intestinal
      motility and nociception in rats.
AB  - Central (i.c.v.) effects of D-Tyr-D-Leu-[N-Me]-Phe-Gln-Pro-Gln-Arg-Phe-NH2
      [(1DME)Y8Fa] and D-Tyr-D-Leu-D-Phe-Gln-Pro-Gln-Arg-Phe-NH2 [(3D)Y8Fa], synthetic
      analogs of Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2 on intestinal myoelectric activity
      and nociception were studied and compared to that of D-Ala2-Met5-enkephalinamide
      in rats. The duration of disruption of intestinal migrating myoelectric
      complexes, induced by p.o. administration of a test meal was significantly
      shortened (P < .01) by (1DME)Y8Fa and (3D)Y8Fa (8, 40 and 80 micrograms/kg) and D
      Ala2-Met5-enkephalinamide (40 and 80 micrograms/kg). The coadministration of any
      two of these drugs, at doses of nonmeasurable effect when given alone (2
      micrograms/kg), has also reduced the duration (P < .01) of the postprandial
      intestinal motor profile. Both separate and combined effects of drugs were
      antagonized by naloxone (1 mg/kg s.c.). In contrast, in the tail-flick test,
      analgesia induced by D-Ala2-Met5-enkephalinamide (40 micrograms/kg i.c.v.) was
      blocked by (1DME)Y8Fa, (3D)Y8Fa (8 micrograms/kg) and naloxone (1 mg/kg s.c.).
      The coadministration of (1DME)Y8Fa and (3D)Y8Fa at doses of no proper effect when
      given alone (8 micrograms/kg) has significantly (P < .01) reduced the latency
      time. This effect was not blocked by naloxone (1 mg/kg s.c.). It is concluded
      that the Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2 analogs, (1DME)Y8Fa and (3D)Y8Fa,
      when given i.c.v. exert effects similar to opiate agonists and antagonists on
      intestinal myoelectrical activity and on nociception, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8474036
TI  - Steady as a rock: does the steady state represent cognitive fossilization?
AB  - A study was performed in which data were obtained from adults and children with
      respect to their control of the inflexional morphology of the Spanish verbal
      system. Results indicate that adults have inferior knowledge of the paradigm
      compared to the children. Based on the types of errors committed, it is argued
      that linguistic knowledge may be more an ability to analogize correctly than to
      follow (unconscious) rules. Implications for GB (Government and Binding) theory
      and first and second language acquisition are discussed.

PMID- 8474037
TI  - [Role of MRI in the diagnosis of kidney cancer].
AB  - The recent technical developments in magnetic resonance imaging (MRI) and the use
      of paramagnetic contrast media (gadolinium compounds) have considerably improved
      the performances of MRI for the detection and characterization of renal tumors.
      MRI does not have specific merits for the diagnosis of the typical form of
      cancer, nor for the detection of small kidney tumors, both being mainly based on
      computed tomography (CT). On the other hand, it can be used for the diagnosis of
      atypical forms of cancers (small, hypovascular, cystic or hemorrhagic cancers)
      which raise problems of differential diagnosis with some pseudotumoral lesions,
      complex cysts and benign tumors. Its complementarity to CT for the
      characterization of an atypical mass results from the signal information it
      provides, from a better contrast resolution, and from the possibility to make
      sections in all planes of space. Except for angiomyolipoma, which has a fatty
      content, there is no really specific MR criterion as present to evidence benign
      renal tumors. Concerning regional extension, CT remains the primary technique of
      choice, as it allows studying the limits of the tumor, the renal compartment ans
      its walls, the renal vein and the inferior vena cava, the neighboring organs and
      the contralateral kidney all together. Its findings allow defining the
      indications of MRI, which, as a complementary exploration, is often decisive to
      assess venous invasion.

PMID- 8474038
TI  - [Consumers of imaging tests].

PMID- 8474039
TI  - [Surgery of hepatic metastases].

PMID- 8474040
TI  - [MRI techniques applied to the diagnosis of hepatic tumors].
AB  - We know that the contrast of MR images can be better than that of CT scans. In
      the spin echo mode, sequences with long TR and long TE provide great contrast,
      while, conversely, sequences with short TR and TE produce images with a greater
      anatomical fidelity. This dual performance, a notion that had never been
      expressed as explicitly in imaging, has led to distinguishing between the roles
      of MRI for detection and tissue characterization (diagnosis and nature). While
      the choice of an appropriate sequence for characterization has apparently been
      made immediately with a modulation of T2 weighting, the selection of a detection
      sequence is less easy. The number of parameters involved (signal-to-noise and
      contrast-to-noise ratios, spatial resolution, artifacts, imaging time) and the
      compromise arrangements needed to take them into account explain the lack of
      consensus as to the optimal sequence for detection. Instead of becoming simpler
      with time, the issue is increasingly complex, as now fast imaging has been
      developed in addition to conventional spin echo imaging, and may even supersede
      it.

PMID- 8474041
TI  - [Radiology and health economics in the USA].

PMID- 8474042
TI  - [Neurocysticercosis of spinal manifestation. Apropos of a case].
AB  - A case of spinal extramedullary cysticercosis with location in basal cisterns is
      reported. It was revealed by a severe sciatalgia and studied with MR imaging
      which is precious for the diagnosis and the follow-up. Cerebral cisternal
      arachnoiditis is the main problem in this racemose form where long medical
      treatment is necessary.

PMID- 8474043
TI  - [Pseudo-tumoral circumscribed myositis ossificans of the thoracic wall.
      Contribution of ultrasonography, x-ray computed tomography and MRI].
AB  - The authors report the main clinical and radiographic aspects of a circumscribed
      myositis ossificans in a 5 year old child located in the thoracic wall, near the
      sternum, stimulating a malignant tumor. CT scan was more contributive than MRI,
      both for diagnosis and survey, because it shows better the progressive peripheral
      calcification typical of the lesion.

PMID- 8474044
TI  - [Mammographic aspects of Aschoff's proliferative centres].
AB  - The pseudotumoral feature of radial scar cause considerable diagnostic problems
      mammographically and at the extemporaneous examination. From a series of 28
      cases, the authors confront their experience with classical mammographic data and
      emphasize: the difficulty in analysing the central area of the radiating
      structure, the possibility of glandular retraction, the relationship between
      spicules and radiolucent linear structures. These radiological criterias do not
      allow us to affirm the diagnosis. Extraction with histological examination of the
      operatory fragment is the only attitude.

PMID- 8474045
TI  - [Role of x-ray computed tomography in the follow-up of the course of Hodgkin's
      disease].
AB  - Fourteen files of patients having had Hodgkin's disease have been analyzed
      retrospectively to assess the justification of systematic surveillance after
      complete remission has been achieved. The data of successive CT exams, compared
      with the findings of clinical and biological studies performed on the same dates,
      confirm the primordial role of imaging, since computed tomography was predictive
      for 7 of 18 events (14 relapses and 4 second progressions). The occurrence of
      subphrenic recurrence in 3 cases for which the initial site was mediastinal leads
      to discussing the merits of a yearly thoraco-abdomino-pelvic examination during
      the two years following complete remission.

PMID- 8474046
TI  - Dental health among homebound elderly.
AB  - Currently, little is known about the oral health status, perceived oral health
      needs, or the extent of dental utilization among community-dwelling, functionally
      dependent elderly. The purpose of this study was to describe the dental health of
      functionally dependent elderly living at home and receiving community-based
      support services. The functional limitations experienced by these elderly living
      at home are comparable to functional limitations experienced by institutionalized
      elderly and these limitations impact on oral hygiene and access to dental care.
      Oral examinations and questionnaires were completed on 50 clients of an urban
      social service agency. Subjects had a mean of 8.8 teeth/person, with 44 percent
      completely edentulous. Two subgroups identified from the questionnaire--those who
      perceived themselves homebound (n = 30) and those who did not (n = 20), did not
      differ by age, gender, education level, or race. Respondents reported being
      homebound an average of 4.5 (+/- 2.9) years. The mean decayed, filled teeth for
      the perceived homebound group was 5.1, and 7.3 for the group that did not
      perceive themselves as homebound, with both groups averaging less than of one
      tooth/person with active root decay. Health care and social policy agendas must
      address the changing scope of oral health needs and limited access to dental care
      experienced by an aging population retaining more of their natural dentition.

PMID- 8474047
TI  - A half-century of community water fluoridation in the United States: review and
      commentary.
AB  - The nearly 50-year history of community water fluoridation is reviewed with the
      major emphasis on the benefits and safety of fluoridation. Other aspects of water
      fluoridation also described include the apparent reduction in measurable
      fluoridation benefits because of the abundance of other fluoride sources, the
      diffusion of fluoridation effects into fluoride-deficient communities,
      preeruptive and posteruptive effects, technical and cost aspects, sociopolitical
      and legal issues that affect the successful fluoridation of communities, and
      alternatives to community water fluoridation. The majority of studies have
      evaluated the effectiveness of water fluoridation on the permanent teeth of
      children, while there are fewer studies on deciduous teeth and in adults; the
      relationship between fluoride ingestion and bone health needs further
      clarification; the sociopolitical issues of fluoridation need to be better
      understood.

PMID- 8474048
TI  - Putting teeth in national health care reform.

PMID- 8474050
TI  - Resolution on community water fluoridation.

PMID- 8474049
TI  - Oral health care for the underserved in the 1990s: the HRSA perspective.

PMID- 8474051
TI  - Periodontal attachment loss in independently living older adults in Ontario,
      Canada.
AB  - This paper describes the periodontal disease experience of a community-dwelling
      population aged 50 years and older, living in four communities in Ontario,
      Canada. The periodontal status of this population was assessed using attachment
      loss and the extent and severity index. Attachment loss was measured at two sites
      on each tooth using a pressure-sensitive periodontal probe. Complete periodontal
      data were obtained on 624 subjects. The mean number of sites per subject was
      37.9. In line with recent US studies, the diagnostic threshold for a diseased or
      previously diseased site was set at 2 mm of loss. The overall mean attachment
      loss was 2.95 mm, with 19.7 percent of subjects having an overall mean attachment
      loss of 4.00 mm or more. The proportion of sites examined with loss of attachment
      of 2 mm or more was 77 percent. The severity of disease, defined as the average
      distance between the base of the sulcus or pocket and a point 1.00 mm apical to
      the cemento-enamel junction in sites with loss of 2 mm or more was 2.44 mm. These
      data indicate that the extent and severity of disease in this population were
      greater than that reported by some recent studies in the US. Taken together, the
      results of these studies suggest that there is some variation in the periodontal
      disease experience of population subgroups across North America.

PMID- 8474052
TI  - Position statement on community water fluoridation.

PMID- 8474053
TI  - Interim policy statement on national health care reform.

PMID- 8474054
TI  - Autoantibodies to nuclear lamins and to intermediate filament proteins: natural,
      pathologic or pathogenic?

PMID- 8474055
TI  - The biology and clinical consequences of articular hypermobility.

PMID- 8474056
TI  - Hypothesis: cartilage catabolic cofactors in human arthritis.
AB  - Cartilage degradation in rheumatoid arthritis (RA) and osteoarthritis (OA) is
      commonly thought to be mediated by interleukin 1 (IL-1) and tumor necrosis factor
      (TNF). However, recent new evidence suggests that IL-1 and TNF on their own do
      not mediate all the cartilage changes seen in RA and OA. We propose that
      cartilage degradation is mediated by a complex network of cytokines, including IL
      1, TNF and at least one cofactor present in synovial fluid.

PMID- 8474057
TI  - Effective treatment of mice with type II collagen induced arthritis with lethal
      irradiation and bone marrow transplantation.
AB  - We examined the effects of irradiation followed by bone marrow transplantation
      (BMT) on type II collagen induced arthritis (CIA) in mice. Either before or after
      the onset of arthritis, the mice were irradiated at levels lethal to cells, then
      given bone marrow cells from normal syngeneic or allogeneic mice. The BMT,
      especially allogeneic BMT, blocked the induction of CIA when administered before
      the onset of arthritis. When administered after CIA had begun, progression of the
      arthritis was significantly suppressed by allogeneic BMT.

PMID- 8474058
TI  - Methotrexate inhibits proliferation but not interleukin 1 stimulated secretory
      activities of cultured human synovial fibroblasts.
AB  - The effect of methotrexate (MTX) on proliferation and on interleukin 1 stimulated
      secretory activities of human synovial fibroblasts in culture was investigated.
      MTX caused a dose dependent inhibition of growth over the concentration range
      0.07-2.2 microM with a half-maximal effect at 0.37 microM. INhibition was
      competitively relieved by coaddition of leucovorin. Cell growth was fully
      restored after MTX pretreatment of 24 h but not after 48 h, even on subsequent
      leucovorin addition. Cell viability was unaffected by MTX treatment. MTX had no
      effect on interleukin 1 stimulated production of prostaglandin E, hyaluronic acid
      and collagenase. Our results raise the possibility that one of the mechanisms
      contributing to the therapeutic effects of MTX in patients with rheumatoid
      arthritis may involve modulation of synovial fibroblast growth.

PMID- 8474059
TI  - Quantitative microfocal radiography detects changes in erosion area in patients
      with early rheumatoid arthritis treated with myocrisine.
AB  - Patients with early rheumatoid arthritis (RA) were randomly divided into those
      receiving gold early (n = 13) or 6 months later (n = 10). They were followed 6
      monthly over 18 months. Mean erosion area in gold and delayed gold, measured from
      macroradiographs, was comparable at baseline and increased significantly over the
      first 6 months. In the second 6 months, gold showed no increase and delayed gold
      an insignificant increase. By the third 6 months both groups showed a decrease.
      On comparing the second 6 months of gold therapy in gold and delayed gold with a
      group of patients with RA of similar disease duration (n = 34) not receiving
      gold, a lower proportion (p < 0.005) had erosion area progression and a higher
      proportion (p < 0.001) erosion repair.

PMID- 8474060
TI  - Immunogenetics of familial rheumatoid arthritis: a study of 41 multicase
      families.
AB  - HLA haplotypes were studied in 41 unrelated families from North India with
      multiple cases of rheumatoid arthritis. Affected sibpairs shared parental HLA
      haplotypes more often than expected (chi 2 = 13.6) according to Mendelian
      segregation. Using the method of sibpair ratio, nonrandom segregation of parental
      haplotypes was observed among affected sibs. HLA-DR4 was observed in 70% of the
      probands while among DR4 negative probands, DR10 occurred more frequently.
      However no specific haplotypic association with the disease was observed in these
      families.

PMID- 8474061
TI  - Treatment of severe rheumatoid arthritis by anti-interleukin 6 monoclonal
      antibody.
AB  - Interleukin 6 (IL-6) appears to be a potential mediator of inflammation that may
      contribute to the pathogenesis of joint inflammation in RA. Anti-IL-6 monoclonal
      antibodies (Mab) may represent a new tool in RA treatment. Five patients with RA,
      after previous anti-CD4 therapy (B-F5) without antimouse immunization were
      included in our open pilot study. The anti-IL-6 Mab (B-E8, IgG1) was given
      intravenously (10 mg/day) for 10 consecutive days in hospital. No side effects
      were noted. Clinical and biological (C-reactive protein) improvement appeared
      during the treatment period. However improvement was transitory (mean: 2 months).
      Unexpectedly serum IL-6 levels increased in 4 patients with this treatment that
      seemed to have antiinflammatory effects. Further studies are required to evaluate
      the real benefit and the mode of action of this Mab.

PMID- 8474062
TI  - Is there an interaction between low doses of corticosteroids and methotrexate in
      patients with rheumatoid arthritis? A pharmacokinetic study in 33 patients.
AB  - A study of methotrexate (MTX) pharmacokinetics with and without prednisolone was
      performed in 33 patients with rheumatoid arthritis. Ten mg im MTX were given on
      Day 0; patients were divided into 3 groups of 11 persons: Group 1: no
      corticosteroid; Group 2: prednisolone 15 mg/day per os from D -3 on; Group 3:
      patients continuing longterm prednisolone treatment (15 mg/day). Groups 1 and 2
      were randomized. MTX plasma concentrations were measured at T 0, 0.25, 0.5, 0.75,
      1, 2, 4, 6, 8, 12 and 24 h using fluorescence polarization immunoassay (TDx
      Abbott). There was no difference between MTX pharmacokinetics of Groups 1 and 2.
      Area under the curve (AUC), Cmax and residual concentration at 24th h were
      higher, while total body and renal MTX clearances were lower in Group 3 vs Groups
      1 and 2. Only the differences in AUC and total clearance were significant (p <
      0.01 and p < 0.05). Tmax and terminal half-life did not differ. Our data suggest
      a possible influence of prednisolone on MTX pharmacokinetics in longstanding
      steroid treated patients. The pharmacological processes that might be involved
      are discussed.

PMID- 8474063
TI  - Dicyanogold (I) is a common human metabolite of different gold drugs.
AB  - Gold based drugs and their metabolites have been characterized using reversed
      phase, ion pairing chromatography with an inductively coupled plasma mass
      spectrometer as an element specific detector. For a patient receiving gold sodium
      thiomalate the principal gold species in the urine is [Au(CN)2]-, which is also
      seen in a low molecular weight infiltrate of the blood. The same compound is also
      identified in the urine and blood of a patient taking auranofin and in patients
      taking solganol. This represents the first identification of a specific gold
      metabolite in biological fluids taken from patients undergoing gold therapy and
      the first evidence that different gold drugs have common metabolites.

PMID- 8474064
TI  - Eosinophilia-myalgia syndrome in patients ingesting a single source of L
      tryptophan.
AB  - OBJECTIVE: To estimate the attack rate for eosinophilia-myalgia syndrome and to
      identify potential risk factors for illness among patients attending a New York
      City medical clinic, who purchased L-tryptophan containing products produced
      exclusively by Showa Denko K.K. METHODS: A case-control design was used. Cases
      and controls purchased L-tryptophan containing products at the medical clinic
      from July 1, 1989--December 1, 1989. All case-patients identified with illness
      onset during the study period were included. Controls were selected by a
      systematic sample of the 683 purchasers of L-tryptophan attending the same
      clinic. RESULTS: Twelve (2.2%) of an estimated 553 L-tryptophan users were case
      patients. Multivariate analysis suggested that lot 2 use (adjusted odds ratio
      [OR] = 35.9), concomitant use of chromium (adjusted OR = 12.3), and concomitant
      use of pyridoxine (adjusted OR = 5.8) were associated with the development of
      illness. Chemical analysis of tablets corresponding to the 3 Showa Denko K.K.
      lots ingested by study participants showed that lot 2 had the highest
      concentration of ethylidenebis (L-tryptophan), a proposed causative agent or
      marker for a causative agent in the eosinophilia-myalgia syndrome. CONCLUSIONS:
      Information from our study of persons exposed to implicated L-tryptophan supports
      the role for a contaminant as the causative agent in the eosinophilia-myalgia
      syndrome and identifies possible cofactors that deserve further study.

PMID- 8474065
TI  - Digital subtraction sialography of the parotid glands in primary Sjogren's
      syndrome.
AB  - Digital subtraction sialography of the parotid glands was performed in 34
      patients with primary Sjogren's syndrome (SS) and 78 patients suspected of having
      primary SS in whom the diagnosis could be excluded (NON-SS). The following
      sialographic features were found more frequently in the patients with primary SS
      than in the NON-SS patients: a sparse overall branching pattern of the ducts,
      progressive widening and irregularity of the duct walls, disappearance of a
      homogeneous parenchyma blush and the occurrence of peripheral acinar dilations.
      The most discriminating findings between the 2 patient groups were the presence
      of acinar dilations and the disappearance of the homogeneous parenchyma blush.
      The sensitivity and specificity of the presence of acinar dilatations were 79 and
      95%, respectively. Both the sensitivity and specificity of the presence of an
      irregular or absent parenchyma blush were 91%. The concurrent finding of acinar
      dilatations and an irregular or absent parenchyma blush had a sensitivity of 77%
      and a specificity of 95%. We conclude that digital subtraction sialography is a
      useful adjunctive diagnostic procedure for primary SS.

PMID- 8474066
TI  - Avascular necrosis of bone and antiphospholipid antibodies in systemic lupus
      erythematosus.
AB  - Of a total of 800 patients with systemic lupus erythematosus, 37 were found to
      have developed avascular necrosis of bone (4.6%). Routine radiological screening
      of all joints was not performed and these 37 represented symptomatic patients
      only. Twenty-seven of these were positive for antiphospholipid antibodies (aPL)
      (73%). Both aPL positive and aPL negative patients had received large doses of
      oral steroids. The frequency of vasculitis and livedo reticularis, as well as
      arterial thrombosis was higher in the aPL positive group, but this did not reach
      statistical significance, perhaps because of the small numbers of patients
      involved. Although the difference in the frequency of thrombocytopenia was more
      marked in the aPL positive group (p < 0.08), once again, this was not
      statistically significant at the 5% level. Since the prevalence of aPL positivity
      in the general lupus population is about 30-40%, the presence of the aPL may be
      associated with an increased tendency to develop avascular necrosis. This is
      supported by recent reports of avascular necrosis occurring in patients with
      primary antiphospholipid syndrome in the absence of previous steroid
      administration.

PMID- 8474067
TI  - Familial systemic lupus erythematosus characterized by digital ischemia.
AB  - We describe a family in which 3 members each developed systemic lupus
      erythematosus complicated by ischemic vasculopathy. The calendar years and
      patient ages of disease onset and the clinical courses were remarkably similar
      for all 3 patients, although their genotypes were not. The potential
      contributions of heredity and environment to the concordance of disease
      expression in this family are discussed.

PMID- 8474068
TI  - Lymphocytes from the site of disease suggest adenovirus is one cause of
      persistent or recurrent inflammatory arthritis.
AB  - The assessment of synovial lymphocyte reactivity to adenovirus antigen
      stimulation was undertaken in patients with persistent or recurrent inflammatory
      arthritis. The 3H-thymidine uptake procedure was employed, incorporating multiple
      microbiological antigens. Five patients were found with repeated maximal
      responses to adenovirus antigen; in one of these adenovirus nucleotide sequences
      were present in a synovial biopsy specimen. It is concluded that adenovirus may
      be one cause of persistent or recurrent inflammatory arthritis.

PMID- 8474069
TI  - 19th century spondyloarthropathy independent of socioeconomic status: lack of
      skeletal collection bias.
AB  - The representativeness of skeletal populations for characterization of the nature
      and frequency of disease could be questioned, as the bias of acquisition is often
      unclear. Examination of 2 proximate early 19th century cemetery populations,
      discordant for socioeconomic status, revealed indistinguishable character and
      frequency of spondyloarthropathy. Joint involvement, number and symmetry of joint
      erosions and fusion and skeletal distribution were indistinguishable in the 2
      populations. It would appear that socioeconomic status does not bias skeletal
      populations, at least with respect to diseases for which no effective treatment
      was available.

PMID- 8474070
TI  - Decreased bone mineral density in HLA-B27 positive members of a family with
      osteogenesis imperfecta.
AB  - We describe a family in which several members had osteogenesis imperfecta (OI)
      and/or were positive for HLA-B27. The proband, who had ankylosing spondylitis and
      OI, had severe osteoporosis with fractures continuing to occur in the late teens.
      Bone mineral density measurements in 5 family members and the proband, revealed
      more severe osteoporosis in those with positive HLA-B27.

PMID- 8474071
TI  - Synovial type (group II) phospholipase A2 in cartilage.
AB  - Phospholipase A2 (PLA2) was produced in E. coli by a recombinant technique using
      a synthetic gene coding for PLA2 found in synovial fluid (SF) of patients
      suffering from rheumatoid arthritis (RA). Polyclonal antibodies were produced
      against the recombinant synovial type PLA2 (syn-PLA2) in a rabbit. The IgG
      fraction of the antiserum was isolated and the specificity was tested by
      immunoblotting. The antiserum detected a protein with an apparent molecular
      weight of 15 kDa in extracts of cartilage, but did not react with PLA2 isolated
      from human pancreas or ascitic fluid. In immunohistochemistry, the anti-syn-PLA2
      antibody decorated chondrocytes and matrix of articular, laryngeal and auricular
      cartilage, but did not decorate synovial tissue or its contained inflammatory
      cells in RA or other human tissues tested (pancreas, liver, thyroid, tonsil,
      lung, nasal polyp, skin, placenta, myometrium, bone). The results show that syn
      PLA2 is present both in articular and extraarticular cartilage and support the
      view that PLA2 found in SF might originate from chondrocytes, and not from
      synovial lining or inflammatory cells.

PMID- 8474072
TI  - The relationship of obesity, fat distribution and osteoarthritis in women in the
      general population: the Chingford Study.
AB  - One thousand and three women aged 45-64 from the Chingford general population
      survey were studied cross sectionally to find the effect of quantity and
      distribution of body fat on the prevalence of radiologically confirmed
      osteoarthritis (OA) in the knee, carpometacarpal (CMC), distal interphalangeal
      (DIP), and proximal interphalangeal (PIP) joints. Obesity was classified as the
      upper tertile of body mass index (BMI kg/m2); the boundaries of the middle
      tertile were 23.4 and 26.4 kg/m2. The age adjusted odds ratio (OR) [and 95%
      confidence interval (CI)] of radiographic OA at the knee comparing the high and
      low tertile of BMI was 6.17 (3.26-11.71) and for bilateral knee radiographic OA
      was 17.99 (6.25-51.73). Comparing the middle and low tertile of BMI, the odds
      ratio for radiographic OA knee was 2.86 (1.44-5.68). For other joints the
      association between BMI and radiographic OA was less strong; the OR at CMC was
      1.71 (1.05-2.78), at DIP was 1.52 (0.90-2.57), and at PIP was 1.23 (0.52-2.91).
      For all joints except PIP these OR increased if the diagnostic criteria included
      knee pain for at least a month, clinically evident swelling at the DIP or PIP,
      and pain or tenderness at the CMC. Recalled weight at age 20 years, or recalled
      maximum weight improved prediction of radiographic OA from current BMI, but
      measurement of fat distribution from circumference of waist, hip and thigh did
      not. Our results confirm that excess body weight is a powerful predictor of OA of
      the knee in middle aged women, and a modest predictor of DIP and CMC OA.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8474073
TI  - Mechanisms of cartilage degradation in inflammatory arthritis: interaction
      between chondrocytes and immunoglobulin G.
AB  - A possible role for immune complexes in the degradation of cartilage (rheumatoid
      arthritis and antigen induced arthritis) has been modelled in vitro by studying
      interactions between cultured bovine chondrocytes and monomeric (M) or heat
      aggregated (HA) IgG. Concentrations of IgG used were within the range of values
      reported in the synovial fluids of rheumatoid joints. ELISA and rosetting assays
      revealed Fc receptor mediated binding of MIgG and HAIgG to chondrocytes that had
      been cultured, but not to freshly isolated cells. Both forms of IgG stimulated
      the production of metalloprotease, but only HAIgG boosted generation of
      superoxide anion and reduced proteoglycan synthesis. HAIgG also stimulated cells
      to produce immunoreactive interleukin 1 although no biological activity was
      apparent. It is concluded that the equivalent behavior of chondrocytes in vivo,
      triggered by immune complexes, could contribute or lead directly to matrix
      degradation.

PMID- 8474074
TI  - A comparative study of clinical signs in fibromyalgia/fibrositis syndrome,
      healthy and exercising subjects.
AB  - Pain threshold to pressure, skinfold tenderness, reactive skin hyperemia and
      tissue compliance were assessed in 60 subjects with fibromyalgia (FS) and 60 pain
      free [total control, (TC)] subjects comprising 30 normal controls (NC) and 30
      exercising fit (FC) subjects. Pain threshold was significantly lower in FS than
      in TC (p = < 0.001) and NC (P = < 0.001). Skinfold tenderness was present in 95%
      of FS and 33% of the NC but was absent in all FC. In patients this tenderness was
      present both in painful and nonpainful sites, and when positive was significantly
      (P = < 0.001) more painful than in controls. Reactive skin hyperemia to pressure
      was significantly (p = < 0.001) increased in patients with FS compared to TC, but
      not to NC. Tissue compliance at trapezius, thoracic and lumbar locations was
      significantly (p = < 0.001) lower in patients than in any other controls. The fit
      subjects significantly differed from the unfit for pain threshold (p = < 0.001),
      reactive skin hyperemia (p = < 0.001), tissue compliance at right trapezius (p =
      < 0.001) and right thoracic (p = < 0.001) levels, and for the skinfold test (p =
      < 0.01). These 4 clinical signs could differentiate patients from controls with a
      mean accuracy of 86%. Our study indicates that there are clinical signs, apart
      from the tender points, which are abnormal in FS that appear to be useful as
      objective signs in the assessment of patients with FS, whether for diagnostic,
      therapeutic or research purposes.

PMID- 8474075
TI  - Performance of scored palpation, a point count, and dolorimetry in assessing
      unsuspected nonarticular tenderness.
AB  - Nonarticular tenderness was measured in 152 patients, 51 with rheumatoid
      arthritis, 50 with psoriatic arthritis, and 51 with human immunodeficiency virus
      infection. Three methods for assessing tenderness were used: a 14-site point
      count, scored tenderness at 10 sites (6 fibrositic and 4 control), and
      dolorimetry at the same 10 sites. The data from the 3 separate measures were
      converted into a common scale of standard deviation units for further analysis.
      There were strong correlations among the 3 measures. In particular, the scored
      tenderness at just 6 fibrositic sites provided as much information about the
      presence and severity of widespread tenderness as the other 2, more complex
      measures. At the interface between nontender and tender, the 2 methods based on
      palpation were significantly more sensitive to differences among individuals,
      than was dolorimetry. However, the palpation scales used did not evaluate
      different degrees of nontenderness. In 102 of the 152 subjects, there were 842
      sites scored zero by palpation, and which showed widely different thresholds of
      tenderness by dolorimetry, significantly associated with diagnosis and sex. For
      screening and epidemiological purposes, scored tenderness at a limited number of
      accessible sites may be adequate and feasible, using the 18 point count of the
      new standard criteria as a gold standard for confirmation. For the assessment of
      generally acting factors affecting tenderness, dolorimetry is currently superior.

PMID- 8474076
TI  - Patient preferences for nonsteroidal antiinflammatory drug related
      gastrointestinal complications and their prophylaxis.
AB  - We conducted a pilot study examining the relative preferences for various
      nonsteroidal antiinflammatory drug associated adverse gastrointestinal events and
      misoprostol prophylaxis for these events. Thirty patients with rheumatoid
      arthritis volunteered to participate. A trained nurse interviewer administered
      the structured pretested interview. Respondents rated 18 hypothetical health
      states on a category rating scale with anchors at 0 (immediate death) and 100
      (full health for life). Linear contrasts were created to test the null hypotheses
      of equal preferences, using t tests for correlated means. Our results suggest
      that respondents place a high value on the avoidance of (in order of decreasing
      importance) surgery, hospitalization, prophylaxis induced diarrhea and
      uncomplicated ulcer requiring outpatient treatment. The avoidance of ulcer
      symptoms (primarily dyspepsia) and the inconvenience of an additional medication
      taken 4 times daily (in the absence of diarrhea) appeared to be substantially
      less important from these patients' perspective. Further work is underway to
      confirm these preliminary findings.

PMID- 8474077
TI  - Assessment of nonarticular tenderness and prevalence of fibromyalgia in children.
AB  - Fibromyalgia syndrome (FS) is most common in midlife, but may be seen at any age.
      Its prevalence and assessment of tenderness in healthy children is not known. We
      assessed 338 healthy schoolchildren for tenderness thresholds and prevalence of
      FS. In all children a point count of 18 tender points (TP) was conducted by thumb
      palpation and tenderness of some of the TP sites as well as control point sites
      was further assessed using a Chatillon dolorimeter. All children and their
      parents were questioned about the presence of widespread pain or aching. Children
      were considered to have FS if they met the American College of Rheumatology (ACR)
      criteria for diagnosis of FS. Of the 338 children, 21 (6.2%) had FS. Thresholds
      of tenderness of 9 TP were 5.0 (1.2) (kg) [mean (standard deviation)] for boys vs
      3.6 (0.8) (kg) for girls (p < 0.001). Thresholds of tenderness of the control
      point sites were 7.1 (1.4) (kg) for boys vs 5.5 (1.1) (kg) for girls (p < 0.001).
      Thresholds of tenderness of TP and control points in the children with FS were
      2.5 (0.4) (kg) and 4.2 (0.5) (kg) vs 4.5 (1.2) (kg) and 6.6 (1.4) (kg)
      respectively in the children without FS (p < 0.001). We suggest that FS is common
      in the pediatric age group. Boys have lower tenderness than girls; children with
      FS have lower thresholds for tenderness both at control and TP compared to the
      subjects without FS.

PMID- 8474078
TI  - Joint hypermobility in pediatric practice--a review.
AB  - It has been well established that joint hypermobility may predispose children to
      the development of joint pain. Joint hypermobility represents an extreme
      variation of normal joint mobility with no underlying connective tissue diseases.
      Its prevalence among children varies from series to series. Evidence that there
      are differences between races and sexes exist. Joint hypermobility diminishes
      markedly throughout childhood and then more slowly during adult life. Although
      quantitative measurements in the assessment of joint hypermobility have been
      described, the criteria defined by Carter and Bird are preferred. Any subject who
      is able to perform 3 or more of the 5 maneuvers devised by these criteria was
      considered to have joint hypermobility. The mechanism in which joint symptoms
      develop is not well understood. Excessive motion or inappropriate physical
      activities that hyperextend the joint capsule, the ligaments and soft tissue
      constituent causing injury. These injuries are manifested by pain. The clinical
      features, prognosis and relevance to pediatric practice are discussed.

PMID- 8474079
TI  - Narcolepsy in systemic lupus erythematosus.
AB  - A 30-year-old woman, diagnosed as having systemic lupus erythematosus at the age
      of 18, presented with excessive sleepiness and cataplectic attacks. Sleep
      laboratory findings were consistent with narcolepsy. To the best of our knowledge
      an association between these 2 diseases has never been reported. The unrelated
      course of narcolepsy and lupus symptoms in our patient suggests a lack of common
      pathogenetic mechanisms and this association is more likely explained by genetic
      factors.

PMID- 8474080
TI  - Systemic lupus erythematosus and chronic intestinal pseudoobstruction.
AB  - We describe the first case of a patient with systemic lupus erythematosus in
      which clinical and radiological features, small bowel manometry and histological
      studies were consistent with the diagnosis of chronic intestinal
      pseudoobstruction. Our patient developed a fatal form of lupus with cerebral
      angiitis and tubulointerstitial lupus nephritis, with no sign of progressive
      systemic sclerosis or dermatopolymyositis. Postmortem examination confirmed the
      presence of an extensive fibrotic process in the muscularis layers, whereas the
      muscularis mucosae and the innervation of the digestive wall were spared.

PMID- 8474081
TI  - Diphosphonate bone scan in an unusual case of rhabdomyolysis: a report and
      literature review.
AB  - We describe a patient with bilobar pneumonia and acute renal failure, whose
      unusual skeletal muscle uptake on technetium methylenediphosphonate bone scan led
      to the diagnosis of rhabdomyolysis. The clinical and serologic findings were most
      consistent with Legionnaires' disease. Radioisotope scanning may occasionally be
      useful in the diagnosis and management of muscle disease, particularly myositis
      and rhabdomyolysis.

PMID- 8474082
TI  - Diffuse chondrolytic arthritis in sickle cell disease.
AB  - A young black man with sickle cell disease with recurrent painful vasoocclusive
      crises developed at 16 years of age a rapid disabling polyarticular chondrolysis
      leading to a bilateral hip arthroplasty in 1 year. Light microscopy showed
      erosion and chondrocyte loss with deep clones in the cartilage and congested
      vessels with extravasation of red blood cells and mononuclear cells in the
      synovium. Electron microscopy of the synovium disclosed partially occluded blood
      vessels and phagocytic cells containing red blood cell debris and crystalline
      hemoglobin-like material. These observations suggest a role for the phagocytic
      cells in the joint destruction.

PMID- 8474083
TI  - Late onset peripheral seronegative spondyloarthropathy: report of two additional
      cases.
AB  - Two more cases of late onset peripheral seronegative spondyloarthropathy (SpA)
      are reported. Like the patients reported by Dubost and Sauvezie, they had
      extensive pitting edema of the lower limbs, constitutional symptoms, elevated
      erythrocyte sedimentation rate and minimal involvement of the axial skeleton with
      marked signs of diffuse idiopathic skeletal hyperstosis.

PMID- 8474084
TI  - Multiple atypical bone involvement in sarcoidosis.
AB  - We describe a patient with right paratracheal and left hilar lymph nodes detected
      by chance on chest radiography that followed a spontaneous remission. However, a
      few months later she complained of multiple scalp nodules. Skull roentgenogram
      and computerized tomogram scan showed multiple osteolytic lesions with increased
      uptake in bone and gallium scans. Lytic lesions were also detected in her right
      mandibular bone and right clavicle. Noncaseating granulomas were demonstrated in
      skull and cervical lymph node biopsies.

PMID- 8474085
TI  - Aortic insufficiency and recurrent valve prosthesis dehiscence in MAGIC syndrome.
AB  - We describe a case of mouth and genital ulcers with inflamed cartilage (nasal and
      ear chondritis) (MAGIC syndrome). Our case was complicated by repeated aortic
      prosthetic valve dehiscence and femoral false aneurysm. The condition was
      resolved by treatment with corticosteroids and azathioprine.

PMID- 8474086
TI  - Drug allergy in Chinese patients with systemic lupus erythematosus.

PMID- 8474087
TI  - IgG antiphospholipid autoantibody in normal human sera is reactive against
      bromelain treated human erythrocytes.

PMID- 8474088
TI  - Responsiveness of outcome measures in rheumatoid arthritis trials.

PMID- 8474089
TI  - Role of erythropoietin in the anemia of chronic disorders.

PMID- 8474090
TI  - Outcome in rheumatoid arthritis.

PMID- 8474091
TI  - Sjogren's syndrome and acute suppurative parotitis.

PMID- 8474092
TI  - Juvenile systemic sclerosis.

PMID- 8474093
TI  - Magnetic resonance imaging is normal in the iliac crest pain syndrome.

PMID- 8474094
TI  - More on tender shins.

PMID- 8474095
TI  - Lack of antineutrophil cytoplasmic antibodies as marker for giant cell arteritis.

PMID- 8474096
TI  - On knee signs, a temperate response.

PMID- 8474097
TI  - Bicyclic compounds as ring-constrained inhibitors of protein-tyrosine kinase
      p56lck.
AB  - A study was undertaken to prepare inhibitors of the lymphocyte protein-tyrosine
      kinase p56lck. Using the known p56lck inhibitor 3,4-dihydroxy-alpha
      cyanocinnamamide (4) as a lead compound, bicyclic analogues were designed as
      conformationally constrained mimetics in which the phenyl ring and vinyl side
      chain of the cinnamamide are locked into a coplanar orientation. Such planarity
      was rationalized to be an important determinant for binding within a putative
      flat, cleftlike catalytic cavity. Bicyclic analogues were prepared using the
      naphthalene, quinoline, isoquinoline, and 2-iminochromene ring systems and
      examined for their ability to inhibit autophosphorylation of immunopurified
      p56lck. The most potent analogues were methyl 7,8-dihydroxyisoquinoline-3
      carboxylate (12) (IC50 = 0.2 microM) and 7,8-dihydroxyisoquinoline-3-carboxamide
      (13) (IC50 = 0.5 microM). Inhibition by 12 was not competitive with respect to
      ATP. These compounds may represent important new structural motifs for the
      development of p56lck inhibitors.

PMID- 8474098
TI  - Structure-activity relationships from molecular similarity matrices.
AB  - An alternative method for determining structure-activity correlations is
      presented. Ligand molecules are described using data matrices derived from the
      results of N by N (each molecule compared to every other) molecular similarity
      calculations. The matrices were analyzed using a neural network pattern
      recognition technique and partial least squares statistics, with the results
      obtained compared to those achieved using comparative molecular field analysis
      (CoMFA). The molecular series used in the study comprised 31 steroids. The
      resultant pattern recognition analysis showed clustering of compounds with high,
      intermediate, and low affinity into separate regions of the neuron output plots.
      The cross-validated correlation coefficients obtained from statistical analyses
      of the matrices against steroid binding data compared well with those achieved
      using CoMFA. These results show that data matrices derived from molecular
      similarity calculations can provide the basis for rapid elucidation of both
      qualitative and quantitative structure-activity relationships.

PMID- 8474099
TI  - Verapamil analogues with restricted molecular flexibility: synthesis and
      pharmacological evaluation of the four isomers of alpha-[1-[3-[N-[1- [2-(3,4
      dimethoxyphenyl)ethyl]]-N-methylamino]cyclohexyl]]-alpha- isopropyl-3,4
      dimethoxybenzene-acetonitrile.
AB  - The synthesis and pharmacological activities of the four isomeric racemates of
      alpha-[1-[3-[N-[1-[2-(3,4-dimethoxyphenyl)ethyl]]-N- methylamino]cyclohexyl]]
      alpha-isopropyl-3,4-dimethoxybenzene-acetoni trile are reported (2a-d). The
      compounds are verapamil analogues with restricted molecular flexibility designed
      to gather information on the active conformation(s) of the parent drug. The
      relative stereochemistry of the four racemates was established by X-ray
      crystallography and by 1H NMR spectroscopy; conformational analysis was supported
      by theoretical calculations. Negative inotropic and chronotropic activities were
      evaluated on guinea pig atria, while vasodilatory activity on smooth muscle was
      tested on guinea pig aortic strips. Binding studies on cat ventricles were
      performed using (-)-[N-methyl-3H]desmethoxyverapamil (D888) as a reference
      ligand. The results seem to support the hypothesis that cardiac depressant and
      vasorelaxant activities are due to different conformations of the verapamil
      molecule.

PMID- 8474100
TI  - Inactivation of monoamine oxidase B by analogues of the anticonvulsant agent
      milacemide (2-(n-pentylamino)acetamide).
AB  - Analogues of the anticonvulsant agent milacemide (1,2-(n-pentylamino)acetamide),
      in which the carboxamide group is changed to a nitrile (2), a carbethoxy group
      (3), a carboxylic acid (4), a cyanomethyl group (5), and a trifluoromethyl group
      (6), were synthesized and tested as substrates and inactivators of monoamine
      oxidase B (MAO B). The carboxylic acid was neither a substrate nor an
      inactivator. The trifluoromethyl compound was not soluble in buffer even when
      organic cosolvents were added, so it could not be tested. All of the other
      compounds were both substrates and time-dependent irreversible inactivators of
      MAO B. A plot of the logarithm of kcat/k(inact) (a measure of the efficiency of
      the inactivators) versus sigma I (Figure 1) shows a linear free energy
      relationship between the inactivator efficiency and the electron-withdrawing
      ability of the substituent. As the electron-withdrawing ability increases, the
      partition ratio decreases indicating that inactivation is becoming more efficient
      relative to substrate turnover to product. Milacemide was the least efficient of
      the compounds tested; the nitrile 2 was the most efficient.

PMID- 8474101
TI  - Studies directed toward the design of orally active renin inhibitors. 1. Some
      factors influencing the absorption of small peptides.
AB  - A systematic evaluation of structure-absorption relationships using a high
      throughput intraduodenal rat screening model has led to the delineation of a set
      of structural parameters that appear to govern bioavailability in a series of
      peptide-based renin inhibitors. Optimum structures, exemplified by 25 and 41,
      incorporated a single, solubilizing substituent at the C- or N-terminus combined
      with a lipophilic P2-site residue. Both inhibitors gave unprecedented plasma drug
      levels upon intraduodenal administration to monkeys, and the calculated
      bioavailability for 41 (14 +/- 4%) is the highest reported for any peptidic renin
      inhibitor.

PMID- 8474102
TI  - Studies directed toward the design of orally active renin inhibitors. 2.
      Development of the efficacious, bioavailable renin inhibitor (2S)-2-benzyl-3-
      [[(1-methylpiperazin-4-yl)sulfonyl]propionyl]-3-thiazol-4-yl-L-alanine amide of
      (2S,3R,4S)-2-amino-1-cyclohexyl-3,4-dihydroxy-6-methylheptane (A-72517).
AB  - Employing a set of empirical guidelines for the design of well-absorbed renin
      inhibitors, we have followed two strategies to improve potency while maintaining
      bioavailability. One process involved incorporation of an extended N-terminal
      residue bearing a weakly basic substituent and is exemplified by compound 25. The
      other approach centered on the inclusion of an N-terminal sulfonamide and
      culminated in the discovery of inhibitor 32 (A-72517). Both 25 and 32 showed
      excellent bioavailability in the rat and ferret (> 25%) and, while subject to
      hepatic elimination in the monkey, were efficacious in this species.

PMID- 8474103
TI  - Potent and selective inhibitors of an aspartyl protease-like endothelin
      converting enzyme identified in rat lung.
AB  - Two structurally distinct series of potent and selective inhibitors of an
      aspartyl protease-like endothelin converting enzyme (ECE) activity identified in
      the rat lung have been developed. Pepstatin A, which potently inhibits the rat
      lung ECE, served as the basis for the first series. Alternatively, selected renin
      inhibitors containing the dihydroxyethylene moiety were shown to be inhibitors of
      rat lung activity. Subsequent modifications improved inhibition of the rat lung
      ECE while eliminating renin activity. Both series of ECE inhibitors demonstrated
      a range of selectivity over Cathepsin D. Water-solubilizing moieties were
      appended onto selected compounds to facilitate in vivo testing. Partial reduction
      of the pressor response to exogenously administered Big ET-1 was observed with
      selected rat lung ECE inhibitors.

PMID- 8474104
TI  - A trans-platinum complex showing higher antitumor activity than the cis
      congeners.

PMID- 8474105
TI  - Age at onset in Huntington's disease and methylation at D4S95.
AB  - Age at onset in Huntington's disease (HD) is variable and is influenced by
      parental sex, paternal age, and genetic background. Several recent models have
      tried to explain this variable expressivity by invoking parental imprinting and
      related aspects of epigenetic inheritance. Some of these mechanisms may result in
      variable DNA methylation at or near the HD gene. We show here that methylation at
      D4S95, a locus tightly linked to the HD gene, is highly variable. A comparison
      between patients with early onset HD, late onset HD, and normal controls showed
      no significant correlation between methylation and age at onset. However, we
      found a significant association of the age of the patient with demethylation at
      D4S95. Older persons tend to have lower levels of methylation at this locus. This
      observation is of interest with regard to studies that show an effect of paternal
      age, or more generally of 'ageing genes', on age at onset in HD.

PMID- 8474106
TI  - Alternative splicing of dystrophin mRNA complicates carrier determination: report
      of a DMD family.
AB  - Carrier determination is important for genetic counselling in DMD/BMD families.
      The detection of altered PCR amplified dystrophin mRNA fragments owing to
      deletions, insertions, or point mutations has increased the possibilities of
      carrier determination. However, problems may occur because of alternative
      splicing events. Here we present a family with a DMD patient characterised by a
      deletion of exons 45 to 54. At the mRNA level we detected a corresponding altered
      fragment which served for carrier determination. The mother and the sister of the
      patient showed the same altered dystrophin mRNA fragment as the patient and are
      therefore carriers. In the mother two additional altered dystrophin mRNA
      fragments were detectable, obviously resulting from alternative splicing in the
      normal allele. The grandmother and two other related females of the patient
      possess only the normal mRNA fragment. In a further female we detected an altered
      fragment owing to an mRNA deletion of exon 44. This fragment is created either by
      alternative splicing or a new mutation. Therefore, the carrier status of this
      female is still ambiguous indicating problems in carrier determination by the
      method of dystrophin mRNA analysis.

PMID- 8474107
TI  - Refining the genetic location of the gene for X linked hydrocephalus within Xq28.
AB  - The most common inherited form of hydrocephalus, X linked hydrocephalus (HSAS),
      is characterised by mental retardation, adducted thumbs, and spastic paraplegia.
      Genetic analysis has mapped the locus for HSAS to subchromosomal band Xq28 within
      a region of approximately 2 megabases of DNA. In order to refine the location of
      the disease gene we have conducted genetic linkage analysis with Xq28 marker loci
      in four additional HSAS families. A lod score of 4.26 with polymorphic marker
      DXS52 (St14) confirms the linkage of HSAS to Xq28. Identification of a
      recombination event between the HSAS gene and Xq28 loci F8C and DXS605 (2-19)
      reduces the size of the interval likely to contain the disease locus to about 1.5
      megabases, the distance between DXS605 and DXS52. The locus for neural cell
      adhesion molecule, L1CAM, maps within this interval and therefore represents a
      candidate gene for HSAS.

PMID- 8474108
TI  - Hereditary anaemias in Portugal: epidemiology, public health significance, and
      control.
AB  - A countrywide prospective study aimed at establishing the prevalence of the
      haemoglobinopathy genes in the Portuguese population was carried out by screening
      15,208 randomly selected blood samples from young males. This male based survey
      provided the opportunity of assessing simultaneously the prevalence of the red
      cell enzyme glucose-6-phosphate dehydrogenase (G6PD) deficiency, thus giving a
      picture of these important hereditary anaemias in Portugal. The results showed a
      low average frequency of beta thalassaemia (0.45%) and haemoglobin S (0.32%)
      carriers as well as G6PD deficiency (0.51%). However, these disorders are
      unevenly distributed throughout the country with a higher prevalence in some
      areas, mainly in the south. The relationship of this pattern of
      haemoglobinopathies to the known haplotypes linked to beta thalassaemia and
      sickle cell disease, relevant historical events, and local selective pressure was
      investigated. Hb D and Hb J are the commonest other structural variants. The
      implemented programme for control of these hereditary anaemias is described.

PMID- 8474109
TI  - Hypohidrotic ectodermal dysplasia, central nervous system malformation, and
      distinct facial features: confirmation of a distinct entity?
AB  - Internal hydrocephalus with partial hypoplasia of the cerebellum was observed in
      a severely mentally retarded boy who showed signs of ectodermal dysplasia.
      Diagnostic considerations are discussed. Reports of the triad mental retardation
      CNS malformation-ectodermal dysplasia are rare. In 1989 we reported a case with
      these signs that shows a striking facial similarity to the case presented here.

PMID- 8474110
TI  - Usher syndrome type I associated with bronchiectasis and immotile nasal cilia in
      two brothers.
AB  - Usher syndrome type I is an autosomal recessive disease characterised by
      congenital sensorineural deafness, involvement of the vestibular system, and
      progressive visual loss owing to retinitis pigmentosa. Here we report the
      association of this disease with bronchiectasis, chronic sinusitis, and reduced
      nasal mucociliary clearance in two sibs and we suggest Usher syndrome type I
      could be a primary ciliary disorder.

PMID- 8474111
TI  - Parental consanguinity in the blepharophimosis, heart defect, hypothyroidism,
      mental retardation syndrome (Young-Simpson syndrome).
AB  - In 1987 Young and Simpson reported a child with hypothyroidism, congenital heart
      disease, severe mental retardation, and striking facial dysmorphism. Two
      subsequent reports have described patients sharing some of the features of their
      case, although in both there were enough discordant features to make it uncertain
      that the same entity was being described. Here we present a female infant with
      virtually identical features to Young and Simpson's original case. Her Caucasian
      parents are first cousins, raising the possibility of autosomal recessive
      inheritance of this new syndrome.

PMID- 8474112
TI  - Aphasia, deafness, or mental retardation.

PMID- 8474113
TI  - Sex differences in the location of a spina bifida lesion.

PMID- 8474114
TI  - Immunotherapy of sepsis.

PMID- 8474115
TI  - Characterisation of a Helicobacter pylori phage (HP1).
AB  - The infection of two Helicobacter pylori strains with a phage-containing
      supernate of the lysogenic H. pylori strain IMMi 290/89 resulted in a lytic cycle
      and propagation of phage HP1. In negatively-stained preparations, the empty phage
      heads measured 55-60 nm in diameter and mature heads measured 50 nm. The
      flexible, striated phage tail was c. 170 nm in length and 9.5 nm in diameter. The
      phage showed a mean density of 1.40 g/cm3 in sucrose-density gradients and
      contained double-stranded DNA c. 22,000 bp in length.

PMID- 8474116
TI  - The role of thymine starvation in the expression of type IV plasmid-encoded
      trimethoprim-resistant dihydrofolate reductase.
AB  - Hyperproduction of the type IV plasmid-encoded dihydrofolate reductase was
      studied in Escherichia coli J62-2 (pUK1123). Hyperproduction of the enzyme was
      shown to occur not simply as a response to a given concentration of trimethoprim
      but also to the presence of thymidine in the medium. Before hyperproduction
      occurred the bacteria began to elongate and die, thus showing the symptoms of
      thymine starvation. Hyperproduction also required the presence of L-methionine,
      adenine and glycine, suggesting that the elevated production of the enzyme was a
      response to the ability of trimethoprim to starve the cell of thymine
      metabolites.

PMID- 8474117
TI  - The induction of trimethoprim resistance encoded by the type IV dihydrofolate
      reductase gene.
AB  - The effect of plasmid pUK1123, which confers low level resistance to trimethoprim
      when tested on solid minimal medium, but also no resistance when tested on
      IsoSensitest agar, was investigated in liquid media. The growth of Escherichia
      coli J62-2, harbouring pUK1123, was unaffected in liquid minimal medium
      containing trimethoprim 10 mg/L. However, in IsoSensitest broth, exposure to this
      drug concentration resulted in bacteriostasis. After an initial delay, resistance
      to trimethoprim was induced in IsoSensitest broth containing trimethoprim 10
      mg/L, by the imposition of thymine starvation. This response was immediately
      reversible when trimethoprim was removed, confirming that resistance resulted
      from induction rather than selection of resistant mutants.

PMID- 8474118
TI  - Immunoglobulin-A detection and the investigation of clinical toxoplasmosis.
AB  - Current serological methods for the investigation of Toxoplasma gondii infection
      are unreliable for the diagnosis of congenital disease, reactivated infection
      associated with the acquired immune deficiency syndrome (AIDS), or the
      determination of the date of onset of infection. An enzyme-linked immunosorbent
      assay (ELISA) and an immunosorbent agglutination assay (ISAGA) were developed for
      the detection of toxoplasma-specific immunoglobulin-A (IgA) and used to
      investigate patients in these three categories. The IgA ISAGA and IgA ELISA were
      found to be reproducible and specific tests. The IgA ISAGA demonstrated enhanced
      sensitivity. Measurement of IgA in patients with toxoplasma-associated
      lymphadenopathy of known duration and AIDS patients with toxoplasma infection was
      of limited value. Detection of specific IgA by ISAGA was more sensitive than
      conventional methods for the diagnosis of congenital toxoplasmosis. We recommend
      the investigation of infant sera with IgA ISAGA. IgA estimation is not indicated
      in other clinical situations.

PMID- 8474119
TI  - Characteristics of an avirulent Campylobacter jejuni strain and its virulence
      enhanced variants.
AB  - The virulence of Campylobacter jejuni for 11-day-old chick embryos is associated
      with the ability to invade the chorio-allantoic membrane, to resist phagocytosis
      and to survive and proliferate in vivo. The pathogenicity of a well characterised
      avirulent C. jejuni strain was enhanced by passaging it intravenously and chorio
      allantoically through chick embryos. The resulting isogenic variants had greatly
      increased ability to survive in vivo. In this study, the morphological and cell
      surface characteristics of the avirulent parental strain were compared with those
      of the more virulent variants to determine whether pathogenicity was associated
      with one or more cell-surface constituents. Changes associated with the increased
      virulence of the two variants included alterations in cultural and cellular
      morphology, loss of flagella, expression of a new outer-membrane protein,
      alterations in cell-surface carbohydrates and decreases in cell-surface
      hydrophobicity.

PMID- 8474120
TI  - Maternal mortality in Mississippi: 1987-1991.
AB  - OBJECTIVE: To characterize the maternal mortality in the state of Mississippi for
      1987-1991 and compare the maternal mortality from 1977-1986 with that of the last
      5 years. STUDY DESIGN: Factors associated with maternal mortality were obtained
      from death certificates, replies to questionnaires, medical records, and autopsy
      reports. RESULTS: The maternal mortality rate in Mississippi for 1987-1991
      (14.1/100,000) was not significantly different than for 1977-1986 (11.8/1000,000;
      P = 0.45). Over the last 5 years there was an increased incidence of direct
      obstetric deaths (50% vs 73%). During 1987-1991, toxemia as a cause of death for
      parturients decreased, while hemorrhage as a cause of maternal death increased.
      There was a rise in the incidence of patient related factors which were avoidable
      and which led to several deaths during 1987-1991. CONCLUSION: The state's
      maternal mortality rate remains stable. Improved patient and health care
      provider's education are necessary to further decrease the incidence of maternal
      death in Mississippi.

PMID- 8474121
TI  - Unsuspected arterial injury.

PMID- 8474122
TI  - Mississippi State Board of Medical Licensure annual report July 1, 1991 through
      June 30, 1992.

PMID- 8474124
TI  - Energetics of ionic contracture in rat-heart papillary muscles.
AB  - Energy dissipation and the bearing of tension during ionic contracture in
      myocardium may not result from one and the same process. To test this,
      comparative indirect and direct microcalorimetry determinations were made in non
      perfused tissue-cell preparations under optimal oxygenation conditions (right
      papillary muscles, high-pO2 superfusion, 30 degrees C) before, during and after
      exposure to low-Na, high-K solutions. Over a 15-min contracture plus 45-min
      recovery cycle, both heat production rate (E), and the indirectly determined heat
      production rate (EO2) which is oxygen uptake multiplied by the overall energetic
      equivalent of O2 for nutrient oxidations, were constantly larger than basal
      rates. The two 60-min time integrals of this increase in metabolic rate were
      equal [30.3 +/- 3.7 and 31.0 +/- 3.9 (SE) J/g muscle wet weight (n = 9) for E and
      EO2 respectively]. During contracture however, E exceeded EO2 by 24% (4.7 +/- 1.7
      J/g), and during the recovery period EO2 exceeded E by 21% (5.4 +/- 2.6 J/g).
      Whereas oxidative recovery of the energy lost by the preparation during 15-min
      contractures was complete, after longer contractures recovery did not occur or
      was incomplete. In keeping with the now prevalent idea that ion--namely Ca-
      transport activities are maintained foremost among cellular ATP-dependent
      processes and consume significant amounts of energy, the present finding that in
      a 15-min ionic contracture myocardium incurs not only some, but the maximum
      oxygen debt still compatible with complete oxidative recovery suggests that
      contracture tension is maintained at low energy cost, essentially by slow-cycling
      or "rigor" bridges as in hypoxic contractures, whereas heat is mainly related to
      intracellular calcium homeostasis.

PMID- 8474123
TI  - Selective activation of cardiac angiotensinogen gene expression in post
      infarction ventricular remodeling in the rat.
AB  - Recent studies in both experimental animals and man have demonstrated the unique
      efficacy of converting enzyme inhibitors to prevent or attenuate ventricular
      remodeling after myocardial infarction. Concomitantly, evidence for a trophic
      role of the renin-angiotensin system (RAS), as well as for the existence of an
      intracardiac tissue-resident RAS, has been presented, raising the question
      whether altered regulation of this cardiac RAS may be associated with the process
      of ventricular remodeling. We conducted the present study to examine whether
      cardiac angiotensinogen gene expression is altered after myocardial infarction.
      Experiments were performed in rats 5 and 25 days after ligation of the left
      coronary artery or sham operation. Coronary artery ligation resulted in relative
      infarct sizes averaging 29% and 36% of total left ventricular mass at 5 and 25
      days and in marked elevations of left ventricular end-diastolic pressure (LVEDP).
      Angiotensinogen mRNA levels, measured by solution hybridization assay and
      confirmed in a second, independent experimental group by RNAse protection assay,
      were significantly elevated in the non-infarcted portion of the left ventricle at
      5 days after infarction when compared to the sham group (22.1 + 3.3 vs. 13.4 +/-
      2.0 fg/microgram total RNA; ratio of densitometric absorbance for
      angiotensinogen/beta-actin: 0.356 +/- 0.041 vs. 0.156 +/- 0.02), and showed a
      significant correlation with infarct size (r = 0.93). At 25 days, angiotensinogen
      gene expression had returned to control values. Similarly, no significant
      differences in angiotensinogen mRNA levels between animals with and without
      infarction were found in other cardiac tissues (atria, right ventricle). Plasma
      renin activity was significantly increased over baseline in the infarct group at
      5, but not at 25 days. Our results demonstrate that acute hemodynamic
      embarrassment early after LV infarction is associated with augmented
      angiotensinogen gene expression. The potential significance of this finding is
      discussed.

PMID- 8474125
TI  - The time course of myocardial glycogenolysis stimulated by glucagon.
AB  - The rate of glycogenolysis was measured using 13C-NMR in vivo in the rat heart
      following a glucagon bolus. Glycogen that had just been synthesized during a 50
      min infusion of D-[1-13C]glucose and insulin was degraded at a rate of 2.5
      mumol/min/g wet wt following a 250 micrograms bolus of glucagon. If a second 50
      min infusion of unlabelled glucose followed the D-[-13C]glucose, the rate of
      mobilization of the labelled glycogen following glucagon was slower (0.52
      mumol/min/g wet wt), indicating that the labeled glycogen was less accessible to
      the activated phosphorylase. Glycogen phosphorylase a (GPa) activity was measured
      in hearts freeze-clamped at intervals after the glucagon bolus. Activity rose
      rapidly to 6-fold basal and then returned to basal over 20-30 min (t1/2 decay of
      phosphorylase activity = 5.1 min). This time course paralleled the exponential
      fall in heart glycogen which followed glucagon (t1/2 = 4.3 min). Throughout the
      post-glucagon period the activity of phosphorylase exceeded the rate of
      glycogenolysis. These findings suggest that the activity of the phosphorylated
      form of glycogen phosphorylase (GPa) is an important but not the sole determinant
      of glycogen breakdown in the heart after a glucagon bolus.

PMID- 8474126
TI  - Alteration of cardiac collagen phenotypes in hypertensive hypertrophy: role of
      blood pressure.
AB  - The myocardium contains a fibrillar collagen matrix that consists primarily of
      type I and type III collagens. There is a marked alteration in the ratio and
      amount of collagen phenotypes in myocardial hypertrophy due to pressure overload.
      The purpose of the present study is (1) to study the effect of antihypertensive
      therapy on collagen phenotypes, if instituted before development of hypertension
      in spontaneously hypertensive rat (SHR), and continued into adult life and (2) to
      study the effects of dissociation of hypertension from hypertrophy, on collagen
      phenotypes in SHRs. The present study shows the effect of two antihypertensive
      drugs, hydralazine and captopril, on collagen phenotypes in SHRs. Both
      hydralazine and captopril effectively controlled blood pressure in SHRs, but only
      captopril regressed hypertrophy and corrected the altered distribution of
      myocardial collagen phenotypes I and III. Untreated SHRs had a collagen type
      I:III ratio of 10.19 +/- 0.27, compared with that of 6.41 +/- 0.30 in
      normotensive WKY (P < 0.001). Captopril-treated SHRs had a collagen type I:III
      ratio of 6.75 +/- 0.37, which did not differ significantly from that in
      normotensive WKY. Hydralazine-treated SHRs had a collagen I:III ratio of 10.07 +/
      0.39, which is similar to the ratio in untreated SHRs. In normotensive rats,
      neither captopril nor hydralazine significantly altered collagen content or the
      ratio of type I:III collagen. Thus captopril, an angiotensin converting enzyme
      inhibitor, not only regressed hypertrophy but also reversed the altered
      distribution of type I and type III collagen whereas hydralazine which
      effectively controlled blood pressure, did not regress hypertrophy and did not
      correct the altered distribution in collagen phenotypes. These studies suggest
      that alteration of collagen phenotypes during hypertensive hypertrophy is
      independent of blood pressure control and myocardial mass.

PMID- 8474127
TI  - Screening mammography: the other side of the coin.

PMID- 8474128
TI  - Managed care: Medicaid--a special case.

PMID- 8474129
TI  - A reformed health-care system: new paradigm centered on prevention.

PMID- 8474130
TI  - Delay between onset of chest pain and arrival to the coronary care unit among
      minority and disadvantaged patients.
AB  - Prehospital delay is an important cause of out-of-hospital coronary mortality. To
      determine the effects of decision time delay in a patient population comprised
      mainly of blacks and the underprivileged, 74 consecutive patients with acute
      chest pain necessitating admission to the coronary care unit in a large urban
      hospital were studied. Delay time from onset of chest pain to the decision to
      seek medical care was markedly prolonged in patients with myocardial infarction
      (n = 24; mean time: 11.3 +/- 18 hours) as well as in patients with chest pain who
      did not develop myocardial infarction (n = 50; mean time: 20.5 +/- 26 hours). In
      addition, transfer time from the emergency room to the coronary care unit was
      likewise unduly long (mean time: 4 +/- 3.8 and 4.1 +/- 6 hours for patients with
      and without myocardial infarction, respectively). This study documents a
      significant delay in the decision time among patients with low socioeconomic
      status, mostly inner-city blacks, and in the transfer time from emergency room to
      the critical care unit in a large public hospital. These findings must be taken
      into consideration when planning strategies to improve the health-care delivery
      system to blacks and the underprivileged and further lend support to the practice
      of initiating thrombolytic therapy in the emergency room.

PMID- 8474131
TI  - Imaging the hepatic lymphatics: experimental studies in swine.
AB  - Magnetic resonance (MR) imaging augmented with 3-D MR reconstruction provides an
      excellent display of the soft tissues and surface anatomy of the human body. The
      excellent anatomical detail of MR images makes this radiographic modality an
      ideal tool to teach anatomy to all health-care professionals. Previous studies of
      the lung and liver in swine revealed that the hepatic lymphatics communicated
      with the visceral pleural lymphatics via the so-called pulmonary ligament, which
      appears as a sheet of visceral pleura containing lymphatics and small blood
      vessels in the swine model. A review of the surgical operative reports at the
      UCLA School of Medicine revealed that the hepatic lymphatics are not connected or
      even ligated during hepatic resections and transplantations. Therefore, the
      authors hypothesized that the unattached lymphatics may be a cause of
      postoperative complications and that interruption of these important lymphatic
      pathways may specifically result in immediate ascites and right pleural
      effusions. Cannulation of the hepatic lymphatics is proposed as a method to
      reduce postoperative complications. The purpose of this research is to
      demonstrate the visual and radiographic display of the hepatic lymphatics in a
      swine model and to provide a means to teach anatomical-pathological correlation.

PMID- 8474132
TI  - A chronicle of racism.

PMID- 8474133
TI  - The effects of prenatal care utilization and maternal risk factors on pregnancy
      outcome between Mexican Americans and non-Hispanic whites.
AB  - This study evaluates the effects of prenatal care classification and levels of
      maternal risk status on pregnancy outcomes in Mexican Americans and non-Hispanic
      whites in Arizona. All live birth certificates from 1986 and 1987 were reviewed
      yielding a total population of 101,206 (26,827 Mexican Americans). The adequacy
      of prenatal care was evaluated based on an index that includes six prenatal care
      groups. Two levels of maternal risk status (low and high) were defined based on a
      series of maternal risk factors. Overall, Mexican Americans had a greater
      proportion of maternal risk factors and a greater proportion of mothers with
      inadequate or no prenatal care compared with non-Hispanic whites. Prematurity and
      macrosomia were more prevalent than low birthweight in Mexican Americans. Low
      risk status and adequate prenatal care regardless of ethnicity were found to be
      associated with a lower prevalence of low birthweight and preterm delivery.
      Whites, however, had a greater variation in the prevalence of low birthweight
      associated with changes in prenatal care utilization and maternal risk status
      compared with Mexican Americans. Finally, logistic regression analysis showed an
      independent effect of prenatal care, maternal risk status, maternal age, and
      maternal birthplace in predicting the overall low birthweight rate in Mexican
      Americans. The implications of these results are discussed relative to the
      usefulness of prenatal care as a health-care intervention in Mexican Americans.

PMID- 8474134
TI  - Shielding at the egress of a 23 mV linear accelerator.
AB  - Radiation shielding is required in radiotherapy accelerators to limit the dose
      equivalent rate from x-rays produced at the target in all directions except that
      of the useful forward directed beam. Calculations were made in terms of weekly
      workload of 50,000 cGy delivered to the isocenter per 5-day week, treating 25
      patients per day at 400 cGy per patient. It is desirable to reduce the total
      exposure at the maze door below 30 Rem (0.30 Sv)/wk assuming full-time occupancy.
      The maze was designed to reduce the neutron dose to an acceptable level by
      slowing the neutrons to thermal velocities and then absorbing them in a low Z
      material in the egress.

PMID- 8474135
TI  - Distribution of lipoprotein phenotypes, cholesterol, and lipids in inner-city
      blacks.
AB  - Lipoprotein phenotypes total cholesterol, high-density lipoprotein (HDL), low
      density lipoprotein (LDL), and triglyceride levels were obtained from blood
      samples of 189 patients attending the Drew Hamilton Clinic in Central Harlem, New
      York, between 1987 and 1988. The study population ranged in age from 7 to 88
      years; 135 of the patients were females and 54 were males. A difference in
      distribution of lipoprotein phenotypes was observed compared with the general
      population of the United States. Sixty-seven percent of blacks in this study were
      Type IIA compared with an estimated 10% of the general US population. Differences
      also were observed for blacks versus the general US population for Type IV (24%
      versus 45%), Type IIB (9% versus 40%), and Type V (0% versus 5%). Types I and III
      were rare in both groups (0% versus < 1%). The increased frequency of Type IIA
      among this predominantly black inner-city population may have implications for
      treatment strategies and prognostic value for predicting the risk of coronary
      heart disease.

PMID- 8474136
TI  - A review of the etiology of breast cancer.
AB  - It is important that physicians be aware of the current theories on the etiology
      of breast cancer. This article reviews some of the more probable etiologic
      factors of breast cancer.

PMID- 8474137
TI  - An abnormal gallbladder presenting as a huge, rounded photon-deficient area in
      radionuclide hepatobiliary imaging.
AB  - Tc-99m DISIDA hepatobiliary imaging was used to evaluate a hemophiliac patient
      presenting with symptoms of acute cholecystitis and gastrointestinal bleeding.
      There was nonvisualization of this abnormal gallbladder even on 6 1/2-hour
      delayed DISIDA images. Instead, a huge photon-deficient area was seen in the
      gallbladder fossa. Ultrasound and computed tomography findings were consistent
      with an enlarged gallbladder filled with blood.

PMID- 8474138
TI  - Listeria-associated pericarditis in an AIDS patient.
AB  - Listeria monocytogenes is a pathogenic, facultative intracellular gram-positive
      rod, generally seen in cell-mediated immunocompromised states. In acquired
      immunodeficiency syndrome (AIDS), it most commonly presents as bacteremia or
      meningitis. An association with pericarditis has not been described previously in
      this group of patients. This article describes a case of pericarditis secondary
      to listeriosis involving a focal pancarditis and necrosis of the A-V node with
      subsequent refractory ventricular tachyarrhythmias in an immunodeficient patient
      presenting with altered mental status. Infectious etiologies should be considered
      for "benign" appearing pericardial effusions in AIDS patients and the diagnosis
      of listeriosis excluded in the presence of "diphtheroid-like" organisms.

PMID- 8474139
TI  - Nightmares.
AB  - Nightmares are unpleasant or frightening dreams that occur sporadically in
      virtually all children. The peak incidence occurs between 3 and 6 years of age.
      Developmental, genetic, psychological, and organic factors have been identified
      as causes of nightmares. Nightmares usually occur in the middle of the night or
      in the early morning when rapid eye movement sleep is more common. The content of
      the nightmare almost always involves a specific danger to the child. On
      awakening, the child is fully alert, may be easily calmed or comforted, and can
      usually recall the details of the nightmare. Sporadic nightmares are common in
      children and require reassurance only. If nightmares are frequent and persistent,
      a psychological evaluation of the child and family is indicated.

PMID- 8474140
TI  - Molecular biology of vertebrate learning: is c-fos a new beginning?
AB  - An elevated expression of c-fos nuclear protooncogene (immediate early gene) has
      been shown repeatedly to correlate with long-term neuronal responses. This paper
      reviews recent data suggesting that neuronal plasticity, including learning and
      memory formation, may involve c-fos expression as well. On the basis of
      biological functions of the Fos protein, well known to be a component of a
      transcription factor, AP-1, (activator protein 1) a hypothesis suggesting a role
      of transcription factors in the integration of information during learning
      processes is proposed.

PMID- 8474141
TI  - Migrated fetal astrocytes modulate nerve growth factor expression in host nucleus
      gracilis of the medulla after grafting in third cervical hindlimb dorsal columns
      of the spinal cord.
AB  - Nerve growth factor (NGF) immunoreactivity in the nucleus gracilis of the medulla
      was quantitated for 90 days after aspiration of the C3 spinal hindlimb dorsal
      columns of 36 adult rats. Half the lesioned animals were a lesion-only group. The
      remaining lesioned animals received an immediate graft of two 1.0-mm pieces of 14
      day gestation fetal rat cervical spinal cord (prelabeled with Phaseolus vulgaris
      leucoagglutinin) into the aspiration pocket (graft group). There were 3 normal
      controls. Groups of animals were analyzed at 7, 14, 21, 30, 60, and 90 days. At
      90 days, NGF immunoreactivity was significantly elevated in the nucleus gracilis
      of lesion-only animals. This increase in NGF immunoreactivity was augmented in
      glial end-feet surrounding neurons and was also observed in the cytoplasm of
      astrocytes and some neurons. Previous experiments have shown that the cluster
      neurons of the nucleus gracilis undergo atrophy at this time with a concomitant
      decrease in hindlimb placement. NGF immunoreactivity (90 days) in grafted
      animals, however, was significantly less than in lesion-only animals (P < 0.05)
      but remained significantly elevated above control animals (P < 0.05). Unlike in
      lesion-only animals, there were no NGF positive neurons in the nucleus gracilis
      of grafted animals. Previous experiments have shown that astrocytes from fetal
      spinal cord grafts migrate to the nucleus gracilis, maintain cluster neuron cell
      size, and improve hindlimb placement at 90 days. The present data indicate that
      modulation of detrimental increases in NGF appeared to be a mechanism by which
      migrated fetal astrocytes can be used as a system for cell therapy.

PMID- 8474142
TI  - Oligodendrocyte proteoglycans: modulation by cell-substratum adhesion.
AB  - The signals that trigger the cytodifferentiation of oligodendrocytes (OLGs) are
      largely unknown. Using as a model system cultures of pure OLGs, we have shown
      that adhesion to a substratum initiates myelinogenesis (Yim SH, Szuchet S, Polak
      PE, J Biol Chem 261:11808-11815, 1986). It was of interest to investigate whether
      components such as proteoglycans (PGs) play any role in the biology of OLGs as it
      pertains to myelinogenesis. We set out to determine first, whether OLGs carry
      PGs; second, the nature of the association of these components with OLG plasma
      membrane; and third, if and how these PGs are modulated by OLG-substratum
      interaction. We compared the expression and characteristics of PGs extracted with
      different solvents from nonattached (B3.f) and attached (B3.fA) OLGs. B3.f and
      B3.fA OLG cultures were labeled with carrier-free 35SO4(2-) in serum-free medium.
      After removing excess label, OLGs were treated with heparin to extract
      susceptible components. Pellets were then exposed to 1% Triton X-100 plus 0.1 M
      NaCl and subsequently to 4 M guanidine-HCl plus 0.5 M NaCl. Solutions containing
      extracted material were characterized by size-exclusion chromatography, SDS-PAGE,
      and enzymatic degradation. Herein we report that (1) OLGs display [35S]PGs on
      their surface within 24 hr of substratum adhesion, and (2) these PGs can be
      operationally classified as peripheral and integral. We further show that the
      peripheral PGs are of high and intermediate size as assessed by size-exclusion
      chromatography and are segregated within the plasma membrane in such a way that
      the species with intermediate mass are extracted while OLGs remain adhered,
      whereas the high-molecular-weight species are only extracted after OLGs have been
      detached. Heparin also dislodges a number of sulfated proteins/Gps. Only a single
      class--high molecular weight--of integral PGs was identified; this PG requires
      guanidine-HCl for extraction. All PGs belong to the heparan sulfate class as
      evidenced by their degradation with heparitinase and their lack of susceptibility
      to chondroitinase ABC. The common theme of our findings is that these
      macromolecules have basal levels of expression in the nonadhered OLGs but undergo
      an adhesion-induced enhancement in their syntheses. We postulate that these PGs
      (1) play a role in OLG-substratum adhesion and hence myelinogenesis, and (2) may
      be determinants in establishing OLG polarity. Such polarization is the first
      overt sign of OLG functional differentiation and occurs prior to any
      morphological differentiation, e.g., extension of processes does not occur until
      48 hr later when the plasma membrane is already polarized.

PMID- 8474143
TI  - A developmentally regulated microsomal protein specific for the pigment
      epithelium of the vertebrate retina.
AB  - In the vertebrate retina, the retinal pigment epithelium (RPE) performs specific
      functions critical to the normal process of vision. Although some of these
      functions are well documented, molecular data are still scarce. Using the RPE
      specific monoclonal antibody RPE9, raised against human RPE cells, we have
      identified a novel 65 kD protein, conserved in mammals, birds, and frogs. This
      RPE-specific protein was found to be nonglycosylated. It was most effectively
      solubilized in the presence of detergent suggesting that it is associated with
      the RPE cell membranes. Its partitioning in the detergent phase of Triton X-114
      and its solubilization in 0.75 M and 1.0 M KCl suggest that it interacts with the
      membrane either through a polypeptide anchor or charged amino acids. Cell
      fractionation by differential solubilization and differential centrifugation
      demonstrated that the protein was preferentially associated with the microsomal
      membrane fraction, where it is the major protein. Developmental expression of
      this 65 kD protein was examined in neonatal rats. Morphologically well
      differentiated RPE cells did not express the 65 kD protein at birth. However,
      expression was detectable at postnatal day 4, that is, one to two days before the
      photoreceptors develop their outer segments, suggesting that the expression of
      the 65 kD protein may be coordinated with other developmental events in the
      intact retina. This is further supported by the fact that RPE cells in confluent
      culture lose the expression of this protein within two weeks, while they maintain
      their characteristic epithelial morphology. Because of its specificity, its
      evolutionary conservation, and its timing of expression, it is possible that this
      protein may be involved in one of the key roles of RPE and as such is an
      important molecular marker for RPE differentiation.

PMID- 8474144
TI  - Localization of neprilysin (EC 3.4.24.11) mRNA in rat brain by in situ
      hybridization.
AB  - The distribution of the messenger RNA (mRNA) coding for neprilysin (EC 3.4.24.11)
      has been studied by in situ hybridization in the adult rat brain. A markedly
      heterogenous distribution among various brain regions was found. A strong signal
      was observed in the glomerular layer of the olfactory bulb, the olfactory
      tubercle, the caudate putamen, the habenular, anterior pretectal,
      interpeduncular, red, dorso tegmental, pontine, and vestibular nuclei, the
      mammillary bodies, the Purkinje cells, and the choroid plexus of the fourth
      ventricle. A large number of areas such as the cortex, the dentate gyrus, the
      hippocampus, the medial terminal nucleus of the accessory tract, the accumbens
      and the arcuate nuclei, the superior and inferior colliculi, and a few regions in
      the thalamus at the mesencephalic level exhibited a moderate or low signal of
      hybridization. The majority of these regions are also known to contain the
      neprilysin protein. On the other hand, the globus pallidus, the substantia nigra,
      and the central gray matter, which show a high or a moderate amount of
      neprilysin, did not contain any neprilysin mRNA. Comparison of the regional
      distribution of neprilysin mRNA with that of its translation product provides
      insight into neprilysin neuronal pathways in the central nervous system.

PMID- 8474145
TI  - Transient increases in neuropeptide Y-like immunoreactivity in dentate hilar
      neurons following fimbria/fornix transection.
AB  - Neurons containing neuropeptide Y (NPY) are numerous in those hippocampal regions
      that receive septal and monoaminergic afferents. To assess the role of these
      afferents in the expression of NPY in hippocampal neurons, the number and
      distribution of perikarya with NPY-like immunoreactivity (NPY-LI) was examined
      quantitatively in the dentate gyrus of adult male rats following unilateral
      transection of the right fimbria/fornix. In unlesioned rats, immunoperoxidase
      labeling for the antibody to NPY was detected mostly in fibers and only a few
      perikarya in the dentate gyrus. Following fornix transections, the number of
      detectable NPY-containing neurons in the hilus of the dentate gyrus ipsilateral
      to the lesion increased at 3 days post-lesion (dpl), peaked at 6 and 9 dpl, then
      returned to basal levels at 14 dpl and 1 and 6 months post-lesion. This elevation
      followed a rostral to caudal gradient. No apparent changes were found in the
      distribution of NPY-labeled neurons at any post-lesion interval studied.
      Moreover, no significant changes at any of the post-lesion times were found in
      the number or distribution of neurons with NPY-LI in the hilus of sham lesioned
      (i.e., ablations of the cortex and anterior hippocampal formation sparing the
      fornix) rats. The observed increases in the number of hippocampal neurons
      containing detectable NPY suggests that the cellular levels of this peptide are
      dependent on pathways travelling through the fornix. The rapid and transient
      increases in NPY are not due exclusively to changes in cholinergic pathways but
      may involve changes in other pathways within the fornix or even indirect
      neurotrophic effects.

PMID- 8474146
TI  - Perinatal morphine treatment inhibits pruning effect and regeneration of
      serotoninergic pathways following neonatal 5,7-HT lesions.
AB  - Lesion of the serotoninergic system in neonate rats is an ideal model for
      assessing the activity of chemical substances capable of affecting neuronal
      plasticity and regeneration (Jonsson et al., Dev Brain Res 16: 171-180, 1984).
      Treatment of newborn rats within 6 hr from birth with the selective neurotoxin
      5,7-dihydroxytryptamine causes degeneration of the most distal serotoninergic
      axons. In our experimental conditions we have observed that after such neurotoxic
      treatment there is spinal cord denervation, which is particularly remarkable in
      the lumbar segment. This degenerative event is followed by gradual regeneration
      of the lesioned axons, with good reinnervation of the entire cord within 8 weeks.
      The degeneration-regeneration process is correlated with a transient
      hyperinnervation of the pons-medulla and hypothalamus by the short collaterals
      (pruning effect), as evidenced by increased serotonin content. Perinatal morphine
      exposure markedly impairs serotonin regeneration in the spinal cord. In addition,
      opiate treated rats are more susceptible to lesions, as shown by the neurotoxin
      induced denervation of the cortex, pons-medulla, and hypothalamus, which does not
      occur in lesioned controls. Therefore, our observations suggest that perinatal
      exposure to morphine affects the plasticity and regeneration of the developing
      serotoninergic system by increasing its susceptibility to neurotoxic lesions and
      reducing its regenerative capacity.

PMID- 8474147
TI  - Phospholipid and phospholipid fatty acid composition of mixed murine spinal cord
      neuronal cultures.
AB  - The phospholipid and phospholipid fatty acid compositions of mixed murine spinal
      cord neuronal cultures are reported. The phospholipid composition was primarily
      comprised of ethanolamine glycerophospholipids (44.8%) and choline
      glycerophospholipids (43.5%). Plasmalogens made up 29.1% of the ethanolamine
      glycerophospholipids (13.0% of the total phospholipids) and 4.5% of the choline
      glycerophospholipids (1.9% of the total phospholipids). Other phospholipids
      ranged from 2.9% for sphingomyelin to 1.0% for phosphatidylinositol 4-phosphate.
      The fatty acid compositions of the ethanolamine glycerophospholipids, choline
      glycerophospholipids, phosphatidylserine, and phosphatidylinositol were also
      determined. The choline glycerophospholipids were the most saturated and
      contained the smallest amount of polyunsaturated fatty acids. The ethanolamine
      glycerophospholipids were the most unsaturated and contained the highest amount
      of polyunsaturated fatty acids. The phospholipids contained minimal amounts of
      20:3 n-9 (Mead acid) and are not considered polyunsaturated fatty acid deficient.
      Thus, for the mixed neuronal spinal cord cultures, the phospholipid fatty acid
      compositions were not polyunsaturated fatty acid deficient and contained a large
      amount of polyenoic fatty acids of both the n-3 and n-6 series.

PMID- 8474148
TI  - The protective effect of 4-hydroxy-2-methyl-N-[2-(tetrazol-5-yl)- phenyl]-2H-1, 2
      benzothiazine-3-carboxamide-1, 1-dioxide monosodium salt (HX-1920) on cisplatin
      induced toxicity in rats.
AB  - The protective effect of 4-hydroxy-2-methyl-N-[2-(tetrazol-5-yl)-phenyl]-2H-1, 2
      benzothiazine-3-carboxamide-1, 1-dioxide monosodium salt (HX-1920) on the
      nephrotoxicity of cisplatin was studied in rats. Effects of HX-1920 on antitumor
      activity and emesis induced by cisplatin were also examined using mice and
      ferrets, respectively. All 10 rats injected with both HX-1920 and LD50 of
      cisplatin survived for 14 days. After 24 hr, co-administration of HX-1920
      significantly increased the urinary excretion of cisplatin in rats. HX-1920 also
      significantly inhibited the cisplatin-induced elevation of urinary N-acetyl-beta
      D-glucosaminidase, blood urea nitrogen and plasma creatinine concentrations in
      rats. HX-1920 had no effect on the number of white blood cell. HX-1920 tended to
      reduce the emesis induced by cisplatin in ferrets. Furthermore, there was no
      difference in the survival curve between the cisplatin group and the HX-1920 plus
      cisplatin group in mice inoculated with P 388 leukemia cells. Thus, HX-1920 did
      not modify the antitumor activity of cisplatin. These results suggest that HX
      1920 has a protective effect on the nephrotoxicity of cisplatin without
      inhibiting its antitumor activity.

PMID- 8474149
TI  - Effects of prenatal aluminum treatment on development and behavior in the rat.
AB  - Developmental and behavioral effects of aluminum administration were studied in
      THA rats. To three groups of pregnant rats were administered single dose of 0,
      900 or 1,800 mg/kg of aluminum chloride on the day 15 of gestation by gavage.
      Significant differences were observed between the aluminum treated offspring and
      controls in terms of body weight, timing of pinna detachment and eye opening, and
      appearances of auditory startle. Slower learning acquisition was observed in
      treated groups. The longer latency and more rearings in the open field test were
      observed in 1,800 mg/kg treated females. These results suggest that single dose
      of aluminum chloride during prenatal period affects the development and behavior
      in rats.

PMID- 8474150
TI  - Toxicity studies of a synthetic antioxidant, 2,2'-methylenebis (4-ethyl-6-tert
      butylphenol) in rats. 2. Uncoupling effect on oxidative phosphorylation of liver
      mitochondria.
AB  - Effects of 2,2'-methylenebis (4-ethyl-6-tert-butylphenol) (MBEBP) on hepatic
      mitochondrial oxidative phosphorylation in vitro, and on hepatic peroxisomal
      enzymes activities and microsomal mixed-function oxidase activities were studied.
      1. A low concentration of MBEBP, less than 50 microM, increased state 4
      respiration and decreased state 3 respiration. However, a higher concentration of
      MBEBP, greater than 100 microM, acted as a respiratory inhibitor. Therefore,
      MBEBP was found to act as an uncoupler of oxidative phosphorylation in rat liver
      mitochondria. 2. MBEBP significantly decreased peroxisomal enzymes, cyanide
      insensitive palmitoyl-CoA oxidizing activity and catalase activity in the livers
      of rats fed 0.2, 1.0 or 5.0% MBEBP for 4 weeks. 3. In microsomal enzyme assay,
      NADPH cytochrome c reductase activity was significantly increased, however,
      cytochrome P-450, cytochrome b5 levels, aminopyrine N-demethylase and benzo [a]
      pyrene hydroxylase activities were not significantly increased in the livers of
      rats fed 1.0 or 5.0% MBEBP for 4 weeks. The weight loss and the decrease of serum
      triglyceride level observed in the MBEBP-treated rats seemed to be caused by its
      uncoupling effects, which might also be the cause of the testicular damage
      induced by MBEBP.

PMID- 8474151
TI  - Hormonal disregulation mechanism in the rat thyroid tumor induced by
      diniconazole.
AB  - To assess the toxicological significance of thyroidal tumor observed slightly in
      a long-term rat study with diniconazole, (E)-1-(2,4-dichlorophenyl)- 4,4-dimethyl
      2-(1,2,4-triazol-1-yl)-1-penten-3-ol, a 3-month subacute feeding study was
      conducted in male Crj: CD (SD) rats by administering diniconazole in diet at
      concentrations of 0, 100, 1,000, or 2,000 ppm. Examinations mainly for thyroid
      functions were performed at Weeks 2, 4 and 13. Measurement of serum hormone
      levels revealed continuous decreases in serum thyroxine (T4) and free T4 levels
      at and above 1,000 ppm and increase in serum thyroid stimulating hormone (TSH)
      level at 2,000 ppm concurrently with liver weight and hepatic UDP
      glucuronyltransferase (UDP-GT) increases at and above 1,000 ppm. No changes were
      observed in serum triiodothyronine (T3) and free T3 levels. Increase in thyroid
      uptake of 125I and organification of 125I in the thyroid at 2,000 ppm and thyroid
      follicular cell hyperplasia at and above 1,000 ppm were also observed. However,
      no compound-related changes were observed in autopsy and organ weight in the
      thyroid. Based on the above results, diniconazole induces increases in the
      hepatic UDP-GT activity and the thyroid hormone excretion from the liver. The
      increased excretion of thyroid hormones causes decrease in serum T4 and free T4
      levels, triggering the feedback mechanism of the pituitary gland, promotion of
      TSH release from the pituitary gland and increase in serum TSH level. The
      increased serum TSH level probably leads to increased 125I uptake of thyroid and
      thyroid follicular cell hyperplasia. Thus, the thyroid tumorigenesis in rats
      treated with diniconazole is due to the secondary overstimulant effect on the
      thyroid by increased serum TSH level. The toxicological significance in humans is
      extremely low and it is unlikely that diniconazole would increase thyroid tumor
      in humans even if diniconazole were to alter normal thyroid hormone level in
      humans.

PMID- 8474152
TI  - Isolation and genetic characterization of ethanol-resistant reovirus mutants.
AB  - To better understand the mechanism(s) by which viruses respond to chemical or
      physical treatments, we isolated a series of mutant strains of reovirus type 3
      Dearing that exhibit increased ethanol resistance. Following exposure to 33%
      ethanol for 20 min, the parental strain exhibited a 5 log10 decrease in
      infectivity. The mutant strains, however, exhibited a 2 to 3 log10 decrease in
      titer following identical treatment. Through the use of reassortant viruses, we
      mapped this increased ethanol resistance mutation to the M2 gene segment, which
      encodes a major outer capsid protein, mu1C. Sequence analysis of mutant M2 genes
      revealed that six of seven unique mutants possessed single-point mutations in
      this gene. In addition, the change in six of seven mutants caused a predicted
      amino acid change in a 35-amino-acid region of the gene product between amino
      acids 425 and 459. The identification of ethanol resistance mutations within a
      discrete region of this outer capsid protein identifies that portion of the
      protein as important in reovirus stability. The presence of viral particles
      possessing altered stability also suggests that subpopulations of viruses may
      possess altered environmental stability, which, in turn, could affect viral
      transmission.

PMID- 8474153
TI  - Multiple viral determinants contribute to pathogenicity of the acutely lethal
      simian immunodeficiency virus SIVsmmPBj variant.
AB  - Simian immunodeficiency virus (SIV) induces an immunodeficiency syndrome similar
      to human AIDS. Although the disease course of SIV-induced immunodeficiency is
      generally measured in months to years, a disease syndrome that results in death
      in 5 to 14 days has been described in pig-tailed macaques infected with the
      SIVsmmPBj (PBj) strain. The purpose of this study was to derive an acutely lethal
      PBj molecular clone in order to study viral genes involved in pathogenesis. Six
      infectious molecular clones were generated; acutely fatal disease was induced by
      experimental inoculation of pig-tailed macaques with virus stocks derived from
      either of two clones, PBj6.6 or PBj14.6. Molecular chimeras were constructed by
      exchange of regions of the genome of PBj6.6 and a nonlethal, related clone,
      SIVsmH4. Only a chimera expressing the PBj genome under the control of a SIVsmH4
      long terminal repeat induced death soon after inoculation. These studies suggest
      that multiple viral genes of PBj are critical for development of acute disease.
      More specifically, the env gene but not the long terminal repeat PBj was required
      for acute disease induction; however env must act in concert with another gene(s)
      of the PBj genome.

PMID- 8474154
TI  - Sequence and characterization of the major early phosphoprotein p32 of African
      swine fever virus.
AB  - The gene encoding protein p32, the most abundant and immunogenic protein induced
      by African swine fever virus at early times of infection, has been mapped in the
      EcoRI C' fragment of the genome of the Vero cell-adapted virus strain BA71V.
      Sequencing analysis has shown the existence of an open reading frame, named
      C'204L, encoding 204 amino acids. The protein is phosphorylated in serine
      residues located in the 115 N-terminal amino acids and was phosphorylated when
      expressed in cells infected with a vaccinia virus recombinant. Protein p32 is not
      glycosylated in spite of the presence of two putative N-glycosylation sites in
      the deduced amino acid sequence of the polypeptide. Immunofluorescence
      experiments have shown that the protein is localized in the cytoplasm of infected
      cells and not in the plasma membrane. In addition, the protein has been found in
      the soluble fraction and not in microsomes from BA71V-infected Vero cells. Low
      levels of the protein have been detected in the medium from infected swine
      macrophages, which probably corresponds to nonspecific release of cytoplasmic
      proteins. The protein encoded by other virus isolates shows different
      electrophoretic mobilities, indicating variability of p32.

PMID- 8474155
TI  - Dominant negative mutants of human T-cell leukemia virus type I Rex and human
      immunodeficiency virus type 1 Rev fail to multimerize in vivo.
AB  - Human T-cell leukemia virus type I (HTLV-I) Rex and human immunodeficiency virus
      type 1 (HIV-1) Rev are essential gene products required for the replication of
      these two pathogenic human retroviruses. Both Rex and Rev act at a
      posttranscriptional level by binding to highly structured RNA-response elements,
      the Rex-response element in HTLV-I and the Rev-response element in HIV-1. Using a
      sensitive in vivo assay of protein-protein interaction, we now demonstrate that
      the HTLV-I Rex and HIV-1 Rev proteins readily form homomultimeric complexes in
      the absence of their cognate RNA-response elements yet fail to form
      heteromultimeric complexes with each other. Dominant negative mutations have been
      identified in both the rex and rev genes which presumably specify a critical
      activation or effector domain in each of these viral transactivators.
      Surprisingly, these dominant negative mutants of Rex and Rev fail to interact in
      vivo. These findings raise the possibility that the binding of nonfunctional
      monomers rather than functional multimers underlies the transdominant phenotype
      of these Rex and Rev mutants. Further, it seems likely that the assembly of
      functional and stable multimers of Rex and Rev in vivo may depend not only on the
      intrinsic multimerization domains of these proteins but also on the binding of a
      bridging cellular cofactor to the related activation domains present in each
      viral transactivator.

PMID- 8474156
TI  - A poxvirus-encoded uracil DNA glycosylase is essential for virus viability.
AB  - Infection of cultured mammalian cells with the Leporipoxvirus Shope fibroma virus
      (SFV) causes the induction of a novel uracil DNA glycosylase activity in the
      cytoplasms of the infected cells. The induction of this activity, early in
      infection, correlates with the early expression of the SFV BamHI D6R open reading
      frame which possesses significant protein sequence similarity to eukaryotic and
      prokaryotic uracil DNA glycosylases. The SFV BamHI D6R open reading frame and the
      homologous HindIII D4R open reading frame from the Orthopoxvirus vaccinia virus
      were cloned under the regulation of a phage T7 promoter and expressed in
      Escherichia coli as insoluble high-molecular-weight aggregates. During
      electrophoresis on sodium dodecyl sulfate-polyacrylamide gels, the E. coli
      expressed proteins migrate with an apparent molecular mass of 25 kDa. The
      insoluble protein aggregate generated by expression in E. coli was solubilized in
      urea and, following a subsequent refolding step, displayed the ability to excise
      uracil residues from double-stranded plasmid DNA substrates, with the subsequent
      formation of apyrimidinic sites. The viral enzyme, like all other characterized
      uracil DNA glycosylases, is active in the presence of high concentrations of
      EDTA, is substrate inhibited by uracil, and does not display any endonuclease
      activity. Attempts to inactivate the HindIII D4R gene of vaccinia virus by
      targeted insertion of a dominant xanthine-guanine phosphoribosyltransferase
      selection marker or direct insertion of a frame-shifted oligonucleotide were
      uniformly unsuccessful demonstrating that, unlike the uracil DNA glycosylase
      described for herpesviruses, the poxvirus enzyme is essential for virus
      viability.

PMID- 8474157
TI  - Sequence, transcriptional mapping, and overexpression of p47, a baculovirus gene
      regulating late gene expression.
AB  - A 2.8-kb region of the Autographa californica nuclear polyhedrosis virus genome
      was sequenced and found to contain an open reading frame (p47) which was capable
      of rescuing a previously characterized temperature-sensitive mutant, ts317 (S.
      Partington, H. Yu, A. Lu, and E. B. Carstens, Virology 157:91-102, 1990).
      Transcriptional mapping demonstrated that an early 4.2-kb RNA encoded the p47
      open reading frame and probably overlapped the 39K delayed-early gene. The p47
      open reading frame was cloned behind the polyhedrin promoter in a baculovirus
      transfer plasmid, which was then used to prepare a recombinant baculovirus
      overexpressing the p47 polypeptide. The overexpressed polypeptide was used to
      prepare p47-specific monoclonal antibodies. These antibodies detected a
      polypeptide of 47 kDa in A. californica nuclear polyhedrosis virus-infected
      cells, demonstrating that p47 is expressed as an authentic viral product. The p47
      gene product was localized to the nucleus of infected cells, supporting the
      hypothesis that it is involved in regulating viral transcription at late times
      postinfection.

PMID- 8474158
TI  - Functional motifs of delta antigen essential for RNA binding and replication of
      hepatitis delta virus.
AB  - The functions of delta antigens (HDAgs) in the replication of hepatitis delta
      virus (HDV) have been identified previously. The small HDAg acts as a
      transactivator, whereas the large HDAg has a negative effect on replication. To
      understand the molecular mechanisms involved in the control of HDV replication,
      we have established a replication system in Huh-7 cells by cotransfecting a
      monomeric cDNA genome of HDV and a plasmid encoding the small HDAg. We
      demonstrate that a leucine repeat in the middle domain of the small HDAg is
      involved in binding to the HDV genome and transactivation of HDV replication.
      When the leucine repeat was disrupted by a substitution of valine for leucine at
      position 115, both RNA-binding and transactivation activity of the small HDAg
      were abolished. In contrast, the binding and transactivation activities were not
      affected when Leu-37 and Leu-44 of the small HDAg were replaced by valines. In
      addition, small and large HDAgs can interact with each other to form protein
      complexes in vitro. The complex formation that may lead to the trans-dominant
      negative regulation of large HDAg in HDV replication is mediated by a cryptic
      signal located between amino acid residues 35 and 65 other than the putative N
      terminal leucine zipper motif. Furthermore, an extra 21-amino-acid extension near
      the N terminus converts the small HDAg into a pseudo-large HDAg with negative
      regulation activity of HDV replication even though the extreme C-terminal residue
      is unchanged.

PMID- 8474159
TI  - Basic amino acids flanking the zinc finger of Moloney murine leukemia virus
      nucleocapsid protein NCp10 are critical for virus infectivity.
AB  - Nucleocapsid (NC) protein NCp10 of Moloney murine leukemia virus is encoded by
      the 3' domain of gag and contains a zinc finger surrounded by basic amino acids.
      During virion assembly, NC protein is necessary for core formation and the NC
      zinc finger is required for the packaging of the genomic RNA dimer. In vitro
      NCp10 has RNA-binding and -annealing activities critical for virus infectivity,
      since NCp10 promotes dimerization of viral RNA containing the Psi packaging
      element and annealing of replication primer tRNA(Pro) to the initiation site of
      reverse transcription (primer-binding site). To investigate the role of the basic
      amino acids flanking the NCp10 zinc finger, neutral residues were substituted for
      the basic amino acids and the effects of these mutations in vivo on virus
      assembly and infectivity and in vitro on the RNA-annealing activity of NCp10 were
      analyzed. Here we report that the substitution of 1 or 2 neutral amino acids for
      the basic residues did not impair the production of mature virions but that
      infectivity was either moderately or strongly attenuated. When more than 2 basic
      residues were replaced by neutral amino acids, viruses were poorly infectious
      because of a severe defect in genomic RNA dimer packaging and initiation of
      reverse transcription. In vitro NCp10-derived peptides with similar mutations
      were chemically synthesized and were found to be either fully or partially active
      or completely inactive. These data indicate that the basic residues flanking the
      zinc finger of NCp10 are required for the production of infectious Moloney murine
      leukemia virus virions.

PMID- 8474160
TI  - Site-directed mutations in the Sindbis virus E2 glycoprotein identify
      palmitoylation sites and affect virus budding.
AB  - The assembly and budding of Sindbis virus, a prototypic member of the alphavirus
      subgroup in the family Togaviridae, requires a specific interaction between the
      nucleocapsid core and the membrane-embedded glycoproteins E1 and E2. These
      glycoproteins are modified posttranslationally by the addition of palmitic acid,
      and inhibitors of acylation interfere with this budding process (M.J. Schlesinger
      and C. Malfer, J. Biol. Chem. 257:9887-9890, 1982). This report describes the use
      of site-directed mutagenesis to identify two of the acylation sites in the E2
      glycoprotein as the cysteines near the carboxyl terminus of the protein which is
      oriented to the cytoplasmic domain of this type 1 transmembrane protein.
      Additional mutations were made at two prolines within a hydrophobic sequence of
      E2 that is highly conserved among several alphaviruses, and the mutant viruses
      were aberrant in assembly and particle formation. These data support earlier
      studies indicating that the native structure of the cytoplasmic domain of E2 is
      essential for proper assembly of this enveloped virus.

PMID- 8474161
TI  - A transcription initiation site for the hepatitis B virus X gene is directed by
      the promoter-binding protein.
AB  - Recent studies have demonstrated the transacting function of the X gene product
      of hepatitis B virus. However, little information is available on the regulation
      of X gene expression. In this report, we first investigate a cellular factor
      regulating X gene transcription by DNA transfection, using the human hepatoma
      cell line HuH-7, which is permissive for HBV replication as well as X mRNA
      transcription. A sequence-specific cellular factor was found to bind to the
      promoter region upstream of the first ATG (nucleotide [nt] 1248) of the X open
      reading frame. DNase I footprinting analysis showed the binding sequence of this
      factor to be situated between nt 1097 and 1119, where an 8-bp palindrome
      structure resides. S1 nuclease analysis of X gene transcripts demonstrated the
      binding site to be adjacent to two major start sites (nt 1117 and 1125) of X
      mRNA. Second, we demonstrate that introduction of a mutation into the binding
      site gives rise to a loss of the binding with a concomitant shift of the
      transcription start site of X mRNA beyond the 8-bp palindrome structure, causing
      it to become more heterogeneous. Thus, the promoter-binding protein appears to be
      involved in directing the transcription initiation site of the X gene toward the
      downstream region of the X promoter when X protein is produced from X mRNA.

PMID- 8474162
TI  - Human immunodeficiency virus type 1 envelope gp120 is cleaved after incubation
      with recombinant soluble CD4.
AB  - Human immunodeficiency virus type 1 (HIV-1) infects human CD4+ cells by a high
      affinity interaction between its envelope glycoprotein gp120 and the CD4 molecule
      on the cell surface. Subsequent virus entry into the cells involves other steps,
      one of which could be cleavage of the gp120 followed by virus-cell fusion. The
      envelope gp120 is highly variable among different HIV-1 isolates, but conserved
      amino acid sequence motifs that contain potential proteolytic cleavage sites can
      be found. Following incubation with a soluble form of CD4, we demonstrate that
      gp120 of highly purified HIV-1 preparations is, without addition of exogenous
      proteinase, cleaved most likely in the V3 loop, yielding two proteins of 50 and
      70 kDa. The extent of gp120 proteolysis is HIV-1 strain dependent and correlates
      with the recombinant soluble CD4 sensitivity to neutralization of the particular
      strain. The origin of the proteolytic activity in the virus preparations remains
      unclear. The results support the hypothesis that cleavage of gp120 is required
      for HIV infection of cells.

PMID- 8474163
TI  - Effects of baculovirus infection on IE1-mediated foreign gene expression in
      stably transformed insect cells.
AB  - Previously, we produced transformed insect cell lines that can express a selected
      foreign protein constitutively, in the absence of baculovirus infection (D. L.
      Jarvis, J. G. W. Fleming, G. R. Kovacs, M. D. Summers, and L. A. Guarino,
      Bio/Technology 8:950-955, 1990). These cells contain stably integrated copies of
      chimeric genes consisting of the promoter from an immediate-early baculovirus
      gene, IE1, and the sequences encoding either human tissue plasminogen activator
      or Escherichia coli beta-galactosidase. Transcription of the integrated genes in
      these cells is specifically controlled by the IE1 promoter. The purpose of this
      study was to determine how baculovirus infection influences IE1-mediated foreign
      protein production by these stably transformed insect cell lines. The results
      showed that viral infection transiently stimulated and then strongly inhibited
      the production of both tissue plasminogen activator, a secreted protein, and beta
      galactosidase, an intracellular protein. These effects reflected virus-induced
      changes in the steady-state levels of RNA produced by the integrated genes.
      Transient assays showed that expression of the viral IEN gene alone could account
      for the increased levels of RNA observed early in infection. The precise
      mechanism accounting for the decreased levels of RNA observed later in infection
      was not determined. However, we obtained evidence that the native IE1 promoter
      remains active throughout infection, which suggested indirectly that the
      integrated IE1 promoter is transcriptionally inactivated at late times of
      baculovirus infection. Thus, the same promoter behaved quite differently late in
      infection, depending on its local environment. Neither methylation nor
      degradation appeared to be responsible for inactivating IE1-mediated expression
      of the integrated genes. The significance of these results with respect to the
      baculovirus-host interaction and the practical applications of stably transformed
      insect cell lines are discussed.

PMID- 8474164
TI  - A Friend virus mutant that overcomes Fv-2rr host resistance encodes a small
      glycoprotein that dimerizes, is processed to cell surfaces, and specifically
      activates erythropoietin receptors.
AB  - The env gene of Friend spleen focus-forming virus (SFFV) encodes a membrane
      glycoprotein (gp55) that is inefficiently (3 to 5%) processed from the rough
      endoplasmic reticulum to form a larger dimeric plasma membrane derivative
      (gp55p). Moreover, the SFFV env glycoprotein associates with erythropoietin
      receptors (EpoR) to cause proliferation of infected erythroblasts [J.-P. Li, A.
      D. D'Andrea, H. F. Lodish, and D. Baltimore, Nature (London) 343:762-764, 1990].
      Interestingly, the mitogenic effect of SFFV is blocked in mice homozygous for the
      Fv-2r resistance gene, but mutant SFFVs can overcome this resistance. Recent
      evidence suggested that these mutants contain partial env deletions that truncate
      the membrane-proximal extracellular domain of the encoded glycoproteins (M. H.
      Majumdar, C.-L. Cho, M. T. Fox, K. L. Eckner, S. Kozak, D. Kabat, and R. W. Geib,
      J. Virol. 66:3652-3660, 1992). Mutant BB6, which encodes a gp42 glycoprotein that
      has a large deletion in this domain, causes erythroblastosis in DBA/2 (Fv-2s) as
      well as in congenic D2.R (Fv-2r) mice. Analogous to gp55, gp42 is processed
      inefficiently as a disulfide-bonded dimer to form cell surface gp42p. Retroviral
      vectors with SFFV and BB6 env genes have no effect on interleukin 3-dependent
      BaF3 hematopoietic cells, but they cause growth factor independency of BaF3/EpoR
      cells, a derivative that contains recombinant EpoR. After binding 125I-Epo to
      surface EpoR on these factor-independent cells and adding the covalent cross
      linking reagent disuccinimidyl suberate, complexes that had immunological
      properties and sizes demonstrating that they consisted of 125I-Epo-gp55p and 125I
      Epo-gp42p were isolated from cell lysates. Contrary to a previous report, SFFV or
      BB6 env glycoproteins did not promiscuously activate other members of the EpoR
      superfamily. Although the related env glycoproteins encoded by dualtropic murine
      leukemia viruses formed detectable complexes with EpoR, strong mitogenic
      signalling did not ensue. Our results indicate that the SFFV and BB6 env
      glycoproteins specifically activate EpoR; they help to define the glycoprotein
      properties important for its functions; and they strongly suggest that the Fv-2
      leukemia control gene encodes an EpoR-associated regulatory factor.

PMID- 8474165
TI  - Comparison of DNA binding and integration half-site selection by avian
      myeloblastosis virus integrase.
AB  - Insertion of the linear retrovirus DNA genome into the host DNA by the virus
      encoded integrase (IN) is essential for efficient replication. We devised an
      efficient virus-like DNA plasmid integration assay which mimics the standard
      oligonucleotide assay for integration. It permitted us to study, by electron
      microscopy and sequence analysis, insertion of a single long terminal repeat
      terminus (LTR half-site) of one plasmid into another linearized plasmid. The
      reaction was catalyzed by purified avian myeloblastosis virus IN in the presence
      of Mg2+. The recombinant molecules were easily visualized and quantitated by
      agarose gel electrophoresis. Agarose gel-purified recombinants could be
      genetically selected by transformation of ligated recombinants into Escherichia
      coli HB101 cells. Electron microscopy also permitted the identification and
      localization of IN-DNA complexes on the virus-like substrate in the absence of
      the joining reaction. Intramolecular and intermolecular DNA looping by IN was
      visualized. Although IN preferentially bound to AT-rich regions in the absence of
      the joining reaction, there was a bias towards GC-rich regions for the joining
      reaction. Alignment of 70 target site sequences 5' of the LTR half-site
      insertions with 68 target sites previously identified for the concerted insertion
      of both LTR termini (LTR full-site reaction) indicated similar GC inflection
      patterns with both insertional events. Comparison of the data suggested that IN
      recognized only half of the target sequences necessary for integration with the
      LTR half-site reaction.

PMID- 8474166
TI  - Competition between baculovirus polyhedrin and p10 gene expression during
      infection of insect cells.
AB  - Polyhedrin and p10 genes are expressed concurrently during the late stage of
      infection. To determine whether any competition occurs between these two genes at
      a transcriptional and/or translational level, a series of Autographa californica
      nuclear polyhedrosis recombinant viruses with deletions of promoter and coding
      sequences of the p10 or polyhedrin gene was constructed. Two modified
      baculoviruses with only one of the very late promoters, single late-promoter
      viruses AcSLP10 and AcSLP33, were made. The polyhedrin gene was used as a
      reporter gene to allow direct comparison between p10 and polyhedrin-driven
      expression. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis
      and [35S]methionine labeling experiments showed that polyhedrin synthesis is
      enhanced in cells infected with baculoviruses carrying only one very late
      promoter. However, this enhancement is more significant when the polyhedrin gene
      is located in its natural site. Dot blot hybridization experiments carried out
      with total cytoplasmic RNA showed that deletion of the p10 promoter resulted in
      an increase of mRNAs derived from the polyhedrin promoter. In contrast, no
      increase of p10-promoted mRNA was detected when the polyhedrin gene promoter was
      deleted.

PMID- 8474167
TI  - Relating structure to function in the hepatitis delta virus antigen.
AB  - Hepatitis delta virus expresses two forms of a single protein, the small (delta
      Ag-S) and large (delta Ag-L) antigens, which are identical except for an
      additional 19 residues present at the C terminus of delta Ag-L. While delta Ag-S
      is required to promote genome replication, delta Ag-L potently inhibits this
      process and also facilitates packaging of the viral genome by envelope proteins
      of the helper virus (hepatitis B virus). Regions within the antigens responsible
      for nuclear localization, RNA binding, and dimerization have been identified, yet
      it is not clear how these particular activities contribute to the ultimate
      replication and packaging phenotypes. Here we report the following findings. (i)
      Although the removal of the nuclear localization signal from either antigen
      resulted in significant cytoplasmic accumulation, both proteins still had access
      to the nucleus. As a consequence, no functional defect was observed with either
      mutant. (ii) The RNA-binding domain, although necessary for delta Ag-S function,
      could be deleted from delta Ag-L without compromising its ability to either
      inhibit replication or promote packaging. (iii) In contrast, the coiled-coil
      dimerization domain was required for both the activation of replication by delta
      Ag-S and the inhibition of replication by delta Ag-L. This region, with an
      additional 20 amino acids C-terminal to it, was necessary and sufficient to
      potently inhibit replication by interacting with the small antigen. (iv) The
      packaging property of delta Ag-L required a C-terminal Pro/Gly-rich region which
      is hypothesized to interact with the hepatitis B virus envelope proteins during
      the assembly process.

PMID- 8474168
TI  - Simian immunodeficiency virus RNA is efficiently encapsidated by human
      immunodeficiency virus type 1 particles.
AB  - Packaging of retroviral RNA is attained through the specific recognition of a cis
      acting encapsidation site (located near the 5' end of the viral RNA) by
      components of the Gag precursor protein. Human immunodeficiency virus type 1 (HIV
      1) and simian immunodeficiency virus (SIV) are two lentiviruses that lack
      apparent sequence similarity in their putative encapsidation regions. We used SIV
      vectors to determine whether HIV-1 particles can recognize the SIV encapsidation
      site and functionally propagate SIV nucleic acid. SIV nucleic acid was replicated
      by HIV-1 proteins. Thus, efficient lentivirus pseudotyping can take place at the
      RNA level. Direct examination of the RNA contents of virus particles indicated
      that encapsidation of this heterologous RNA is efficient. Characterization of
      deletion mutants in the untranslated leader region of SIV RNA indicates that only
      a very short region at the 5' end of the SIV RNA is needed for packaging.
      Comparison of this region with the corresponding region of HIV-1 reveals that
      both are marked by secondary structures that are likely to be similar. Thus, it
      is likely that a similar higher-order RNA structure is required for
      encapsidation.

PMID- 8474169
TI  - Complement-mediated binding of naturally glycosylated and glycosylation-modified
      human immunodeficiency virus type 1 to human CR2 (CD21).
AB  - Particulate glycoproteins lacking sialic acid, such as desialylated enveloped
      viruses, readily activate complement through the alternative pathway. Human
      immunodeficiency virus type 1 (HIV-1) contains two heavily glycosylated and
      partially sialylated envelope glycoproteins: a surface gp120 and a transmembrane
      gp41. The abilities of naturally glycosylated HIV-1 and glycosylation-modified
      HIV-1 to interact with the complement system were examined with a biological
      assay which measured the binding of whole virus particles to cells expressing CR2
      (CD21), the complement receptor found naturally in abundance on follicular
      dendritic cells and immature B cells. HIV-1 IIIB was synthesized in the presence
      or absence of the mannosidase II inhibitor, swainsonine, to give rise to high
      mannose-type, nonsialylated, nonfucosylated carbohydrate moieties. The virus also
      was treated with neuraminidase or endo-beta-galactosidase to remove terminal
      sialic acids. An enzyme immunoassay specific for HIV-1 p24 core protein was used
      to quantitate the amount of virus bound to cell surfaces. Virus particles
      incubated with 1:3-diluted, fresh HIV-1-negative human serum as a source of
      complement readily bound to MT-2 (CD4+ CR2+) and Raji-3 (CD4- CR2+) cells but not
      to CEM (CD4+ CR2-) cells, suggesting that the virus bound to CR2 independently of
      CD4. Compared with heat-inactivated or C3-deficient sera, fresh complement
      increased binding by as much as 62 times for naturally glycosylated virus, and 5
      times more than this for glycosylation-modified virus. Similar observations were
      made with freshly isolated, non-mitogen-stimulated peripheral blood mononuclear
      cells. Additional evidence that HIV-1 bound to CR2 independently of CD4 was
      provided by the fact that binding was blocked by monoclonal antibody OKB7 (anti
      CR2) but not by OKT4a (anti-CD4). Also, the virus bound to transfected K562 cells
      (CD4-) which expressed recombinant human CR2 but did not bind to untransfected
      K562 cells. Results obtained with complement component-deficient sera indicated
      that binding required the alternative complement pathway. Raji-3 and transfected
      K562 cells could not be infected with HIV-1 in the presence of complement,
      suggesting that utilization of CR2 as a receptor in the absence of CD4 does not
      allow virus entry. The demonstration of CR2 as a receptor for HIV-1 in the
      presence of complement, together with the ability to enhance binding by
      desialylation, provides new insights into mechanisms of HIV-1-induced immunity
      and immunopathogenesis.

PMID- 8474170
TI  - Flock house virus: down-regulation of subgenomic RNA3 synthesis does not involve
      coat protein and is targeted to synthesis of its positive strand.
AB  - Flock house virus is a small insect virus with a bipartite RNA genome consisting
      of RNA1 and RNA2. RNA3 is a subgenomic element encoded by RNA1, the genomic
      segment required for viral RNA synthesis (T. M. Gallagher, P. D. Friesen, and R.
      R. Rueckert, J. Virol. 46:481-489, 1983). Synthesis of RNA3 is strongly inhibited
      by RNA2, the gene for viral coat protein. Evidence that coat protein is not the
      regulatory element was obtained by using a defective interfering RNA2 which was
      messenger inactive. It was also found that RNA2 selectively down-regulated
      synthesis of positive-strand RNA3 but not of its complementary negative strand.
      cDNA-generated RNA2 transcripts, carrying four extra nonviral bases at the 3'
      end, failed to repress synthesis of RNA3 but recovered this activity after a
      single passage in Drosophila cells in the presence of RNA1, suggesting that down
      regulation of RNA3 synthesis is controlled by competition with RNA2 for viral
      replicase.

PMID- 8474171
TI  - Analysis of the evolution and variation of the human influenza A virus
      nucleoprotein gene from 1933 to 1990.
AB  - This study examined the evolution and variation of the human influenza virus
      nucleoprotein gene from the earliest isolates to the present. Phylogenetic
      reconstruction of the most parsimonious evolutionary path connecting 49
      nucleoprotein sequences yielded a single lineage. The average calculated rate of
      mutation was 3.6 nucleotide substitutions per year (2.3 x 10(-3) substitutions
      per site per year). Thirty-two percent of these mutations resulted in amino acid
      substitutions, and the remainder were silent mutations. Analysis of virus
      isolates from China and elsewhere showed no significant differences in their rate
      of evolution, genetic diversity, or mean survival time. The nearly constant rate
      of change was maintained through the two antigenic shifts, and there were no
      obvious changes in the number or types of mutations associated with the changes
      in the surface proteins. A detailed comparison of the changes that have occurred
      on the main evolutionary path with those that have occurred on the side branches
      of the phylogenetic tree was made. This showed that while 35% of the mutations on
      the side branches resulted in amino acid changes, only 21% of those on the main
      path affected the protein sequence. These results suggest that although the rate
      of change of the human influenza virus nucleoprotein is much higher than that
      previously described for avian influenza viruses, there are measurable
      constraints on the evolution of the surviving virus lineage. Comparison of the
      nucleoproteins of virus isolates adapted to chicken embryos with the
      nucleoproteins of those grown only in MDCK cells revealed no consistent
      differences between the virus pairs. Thus, although the nucleoprotein is known to
      be critical for host specificity, its adaptation to growth in eggs apparently
      involves no immediate selective pressures, such as are found with hemagglutinin.

PMID- 8474172
TI  - Effects of amino acid changes in the extracellular domain of the human
      immunodeficiency virus type 1 gp41 envelope glycoprotein.
AB  - Changes were introduced into conserved amino acids within the ectodomain of the
      human immunodeficiency virus type 1 (HIV-1) gp41 transmembrane envelope
      glycoprotein. The effect of these changes on the structure and function of the
      HIV-1 envelope glycoproteins was examined. The gp41 glycoprotein contains an
      amino-terminal fusion peptide (residues 512 to 527) and a disulfide loop near the
      middle of the extracellular domain (residues 598 to 604). Mutations affecting the
      hydrophobic sequences between these two regions resulted in two phenotypes. Some
      changes in amino acids 528 to 562 resulted in a loss of the noncovalent
      association between gp41 and the gp120 exterior glycoprotein. Amino acid changes
      in other parts of the gp41 glycoprotein (residues 608 and 628) also resulted in
      subunit dissociation. Some changes affecting amino acids 568 to 596 resulted in
      envelope glycoproteins partially or completely defective in mediating membrane
      fusion. Syncytium formation was more sensitive than virus entry to these changes.
      Changes in several amino acids from 647 to 675 resulted in higher-than-wild-type
      syncytium-forming ability. One of these amino acid changes affecting tryptophan
      666 resulted in escape from neutralization by an anti-gp41 human monoclonal
      antibody, 2F5. These results contribute to an understanding of the functional
      regions of the HIV-1 gp41 ectodomain.

PMID- 8474173
TI  - Use of recombinant baculoviruses in synthesis of morphologically distinct
      viruslike particles of flock house virus, a nodavirus.
AB  - Flock house virus (FHV) is a small icosahedral insect virus of the family
      Nodaviridae. Its genome consists of two messenger-sense RNA molecules, both of
      which are encapsidated in the same particle. RNA1 (3.1 kb) encodes proteins
      required for viral RNA replication; RNA2 (1.4 kb) encodes protein alpha (43 kDa),
      the precursor of the coat protein. When Spodoptera frugiperda cells were infected
      with a recombinant baculovirus containing a cDNA copy of RNA2, coat protein alpha
      assembled into viruslike precursor particles (provirions) that matured normally
      by autocatalytic cleavage of protein alpha into polypeptide chains beta (38 kDa)
      and gamma (5 kDa). The particles were morphologically indistinguishable from
      authentic FHV and contained RNA derived from the coat protein message. These
      results showed that RNA1 was required neither for virion assembly nor for
      maturation of provirions. Expression of mutants in which Asn-363 at the beta
      gamma cleavage site of protein alpha was replaced by either aspartate, threonine,
      or alanine resulted in assembly of particles that were cleavage defective. For
      two of the mutants, unusual structural features were observed after preparation
      for electron microscopy. Particles containing Asp at position 363 were labile and
      showed a strong tendency to break into half-shells. Particles in which Asn-363
      was replaced by Ala displayed a distinct hole in an otherwise complete shell. The
      third mutant, containing Thr at position 363, was indistinguishable in morphology
      from authentic FHV.

PMID- 8474174
TI  - Elimination of L-A double-stranded RNA virus of Saccharomyces cerevisiae by
      expression of gag and gag-pol from an L-A cDNA clone.
AB  - We report that expression of a nearly full-length cDNA clone of the L-A double
      stranded RNA virus causes virus loss in a wild-type strain of Saccharomyces
      cerevisiae. We show that in this system exclusion of the L-A virus is independent
      of the presence of the packaging site or of cis sites for replication and
      transcription and completely dependent on expression of functional recombinant
      gag and gag-pol fusion protein. Thus, this exclusion is not explained in terms of
      overexpression of packaging signals. Mutation of the chromosomal SKI2 gene, known
      to repress the copy number of double-stranded RNA cytoplasmic replicons of S.
      cerevisiae, nearly eliminates the exclusion. We suggest that exclusion is due to
      competition by proteins expressed from the plasmid for a possibly limiting
      cellular factor. Our hypotheses on exclusion of L-A proteins may also apply to
      resistance to plant viruses produced by expression of viral replicases in
      transgenic plants.

PMID- 8474175
TI  - Assembly-defective point mutants of the human immunodeficiency virus type 1 Gag
      precursor phenotypically expressed in recombinant baculovirus-infected cells.
AB  - Two substitution mutants of the human immunodeficiency virus type 1 gag gene
      product were isolated after nitrous acid mutagenesis of a recombinant baculovirus
      expressing a non-N-myristylated, p6-deleted Gag precursor (Pr49). Both mutants
      failed to assemble intracellular Gag virus-like particles, as does the parental
      recombinant, and therefore expressed a self-assembly defective (Sad) phenotype in
      insect cells. The mutations consisted of nonconservative changes involving highly
      conserved hydrophobic residues in the p24 domain, Leu to Pro at position 268
      (L268P) and Leu to Ser at amino acid 322 (L322S). Experimental data suggested
      that the two mutated residues belonged to functionally different regions of the
      Gag precursor. (i) A partial complementation effect between the two mutants for
      Gag precursor assembly was observed in coinfection experiments. (ii) The two
      mutations showed different phenotypes when placed in the N-myristylated context,
      of which only the L268P mutation abolished extracellular budding and release of
      Gag particles at the plasma membrane. Both L268P and L322S mutants had a trans
      dominant negative effect on the intracellular assembly of a non-N-myristylated,
      full-length (Pr55) Gag precursor expressed by a coinfecting recombinant. None of
      the mutants, however, showed any detectable effect in trans on membrane targeting
      and budding of the coexpressed N-myristylated wild-type Gag precursor.

PMID- 8474176
TI  - Truncation of the cytoplasmic domain of the simian immunodeficiency virus
      envelope glycoprotein increases env incorporation into particles and fusogenicity
      and infectivity.
AB  - Growth of macaque simian immunodeficiency virus (SIVmac) in certain cloned human
      T-cell lines, such as HUT.78, selects for isolates containing a premature stop
      codon within the cytoplasmic domain of the transmembrane envelope glycoprotein.
      In contrast, propagation of virus in macaques or in their cultured T cells favors
      replication of virus containing the full-length envelope glycoprotein. To
      elucidate the causes of this phenomenon, we used a human immunodeficiency virus
      pseudotyping system to assess the effects on infectivity of the cytoplasmic
      domains of envelope glycoproteins obtained from SIVmac1A11 and SIVmac239. These
      envelopes contain truncated and full-length cytoplasmic domains, respectively. By
      analyzing human immunodeficiency virus particles containing selectable genes
      pseudotyped with each glycoprotein or with chimeric derivatives, we found that
      truncation of the cytoplasmic domain resulted in a significant advantage in viral
      entry into HUT.78 T cells and CD4+ U87.MG glial cells. Truncation of the
      cytoplasmic domain significantly enhanced both envelope density on particles and
      envelope-mediated cell-to-cell fusion. It is likely that one or both of these
      effects contribute to the observed differences in infectivity and to the
      selection of virions with short cytoplasmic tails in human T cells.

PMID- 8474177
TI  - The RRE of human immunodeficiency virus type 1 contributes to cell-type-specific
      viral tropism.
AB  - As part of a general program investigating the mechanism of the Rev axis of human
      immunodeficiency virus type 1 (HIV-1) autoregulation, a series of proviral HIV-1
      mutants which differ from the parental HXB2 strain at selected positions within
      the RRE were constructed. All of the mutations were designed to perturb the RRE
      by introducing local helix disruptions without altering the coding potential of
      the overlapping envelope open reading frame. Viral replication in various cell
      types was monitored by a cell supernatant reverse transcriptase assay and
      Northern (RNA blot) analysis. All proviral RRE mutants displayed at least some
      impairment in replication. However, the relative impairment varied drastically
      among the various cell types tested. This suggests that the RRE may contribute to
      cell-type-specific viral tropism.

PMID- 8474178
TI  - Sequences downstream of the RNA initiation site regulate human T-cell
      lymphotropic virus type I basal gene expression.
AB  - Sequences which control basal human T-cell lymphotropic virus type I (HTLV-I)
      transcription probably play an important role in initiation and maintenance of
      virus replication. We have identified and analyzed a 45-nucleotide sequence
      (downstream regulatory element 1 [DRE 1]) at the boundary of the R/U5 region of
      the long terminal repeat which is required for HTLV-I basal transcription. The
      basal promoter strength of constructs that contained deletions in the R/U5 region
      of the HTLV-I long terminal repeat were analyzed by chloramphenicol
      acetyltransferase assays following transfection of Jurkat T cells. We
      consistently observed a 10-fold decrease in basal promoter activity when
      sequences between +202 to +246 were deleted. By reverse transcriptase polymerase
      chain reaction RNA analysis, we confirmed that the drop in chloramphenicol
      acetyltransferase activity was paralleled by a decrease in the level of steady
      state RNA. DRE 1 did not affect the level of Tax1 transactivation. Using a gel
      shift assay, we have purified a highly enriched fraction that could specifically
      bind DRE 1. This DNA affinity column fraction contained four detectable proteins
      on sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis: p37, p50,
      p60, and p100. The affinity column fraction stimulated HTLV-I transcription
      approximately 12-fold in vitro. No effect was observed with the human
      immunodeficiency virus or adenovirus major late promoters. Following renaturation
      of the proteins isolated from an SDS-containing gel, p37, but not the other
      protein fractions, was able to specifically bind to DRE 1.

PMID- 8474179
TI  - The NF-kappa B binding site is necessary for efficient replication of simian
      immunodeficiency virus of macaques in primary macrophages but not in T cells in
      vitro.
AB  - We demonstrate here that the nuclear factor-kappa B (NF-kappa B) binding site in
      the simian immunodeficiency virus (SIVmac) long terminal repeat is essential for
      efficient virus replication in primary alveolar macrophages but dispensable for
      efficient replication in primary T cells. Mutation of the NF-kappa B site does
      not seriously impair replication of a T-cell-tropic SIVmac239 or a
      macrophagetropic SIVmacEm* in peripheral blood lymphocytes or established CD4+
      cell lines; however, mutation of the NF-kappa B site prevents efficient SIVmacEm*
      replication in primary alveolar macrophages. These data suggest that efficient
      replication in primary macrophages requires both envelope and long terminal
      repeat determinants.

PMID- 8474180
TI  - Cellular immune response to hog cholera virus (HCV): T cells of immune pigs
      proliferate in vitro upon stimulation with live HCV, but the E1 envelope
      glycoprotein is not a major T-cell antigen.
AB  - T-cell responses of pigs to hog cholera virus (HCV) have reportedly been absent
      or difficult to detect. Therefore, little is known about cellular immunity to
      HCV. In this study, we used an attenuated strain of pseudorabies virus expressing
      the envelope glycoprotein E1 of HCV and purified recombinant E1 to examine
      whether the E1 protein is a target antigen recognized by the T cells of HCV
      immune pigs. We were unable to identify the E1 protein as a major target antigen
      recognized by the T cells of HCV-immune animals. However, such cells proliferated
      in vitro upon stimulation with viable HCV antigen. The lymphoproliferative
      response to HCV was strictly time and dose dependent and could be induced upon
      stimulation by live but not by UV light-inactivated HCV. Depletion studies
      demonstrated that lymphoproliferation depended on the presence of CD2+CD8bright+
      lymphocytes, but CD2+CD4+ cells also contributed to the lymphoproliferative
      response. The primary lymphoproliferative response in animals inoculated with
      10(7) 50% tissue culture infective doses of strain Brescia 2.1.1 was stronger
      than that observed in animals inoculated with 10(3) 50% tissue culture infective
      doses of the Cedipest strain. A remarkable finding was the increase in non
      antigen-specific lymphoproliferation upon inoculation of the animals with HCV
      strains. This immunological phenomenon may mask a specific T-cell response to the
      virus.

PMID- 8474181
TI  - Identification of an amino acid that defines the fusogenicity of mumps virus.
AB  - Recombinant cDNA clones representing the fusion (F) and hemagglutinin
      neuraminidase (HN) proteins of two mumps virus strains different in fusogenicity
      were constructed. Upon transfection of COS7 cells, extensive cell fusion was
      observed only when cells expressed the F protein of the fusing strain together
      with the HN protein derived from either strain. Mutational analyses further
      showed that the amino acid at position 195 of the F protein plays a critical role
      in determining the extent of cell fusion induced by mumps virus, since
      replacement of Ser-195 by Tyr significantly reduced the fusion inducibility of
      otherwise fusion-competent F protein.

PMID- 8474182
TI  - Dilute passage promotes expression of genetic and phenotypic variants of human
      immunodeficiency virus type 1 in cell culture.
AB  - We have studied the extent of genetic and phenotypic diversification of human
      immunodeficiency virus type 1 (HIV-1) upon 15 serial passages of clonal viral
      populations in MT-4 cell cultures. Several genetic and phenotypic modifications
      previously noted during evolution of HIV-1 in infected humans were also observed
      upon passages of the virus in cell culture. Notably, the transition from non
      syncytium-inducing to syncytium-inducing phenotype (previously observed during
      disease progression) and fixation of amino acid substitutions at the main
      antigenic loop V3 of gp120 were observed in the course of replication of the
      virus in MT-4 cell cultures in the absence of immune selection. Interestingly,
      most genetic and phenotypic alterations occurred upon passage of the virus at a
      low multiplicity of infection (0.001 infectious particles per cell) rather than
      at a higher multiplicity of infection (0.1 infectious particles per cell). The
      degree of genetic diversification attained by HIV-1, estimated by the RNase A
      mismatch cleavage method and by nucleotide sequencing, is of about 0.03% of
      genomic sites mutated after 15 serial passages. This value is not significantly
      different from previous estimates for foot-and-mouth disease virus when subjected
      to a similar process and analysis. We conclude that several genetic and
      phenotypic modifications of HIV-1 previously observed in vivo occur also in the
      constant environment provided by a cell culture system. Dilute passage promotes
      in a highly significant way the expression of deviant HIV-1 genomes.

PMID- 8474183
TI  - Induction of the cell cycle in baby rat kidney cells by adenovirus type 5 E1A in
      the absence of E1B and a possible influence of p53.
AB  - From previous studies on the induction of DNA synthesis in quiescent primary baby
      rat kidney cells by adenovirus type 5 (Ad5) E1A deletion mutants, we concluded
      that induction is prevented only when cellular proteins p300 and pRb are both
      uncomplexed with E1A (J.A. Howe, J.S. Mymryk, C. Egan, P.E. Branton, and S.T.
      Bayley, Proc. Natl. Acad. Sci. USA 87:5883-5887, 1990). We have now examined
      induction by these same mutants in virus lacking the E1B region, so that cellular
      p53 was no longer complexed to the E1B 55-kDa protein. E1A mutants that fail to
      bind pRb induced DNA synthesis at a significantly lower level in Ad5 lacking E1B
      than in Ad5 containing E1B. Apparently, therefore, uncomplexed p53 can partially
      replace p300 in cooperating with pRb to suppress DNA synthesis in baby rat kidney
      cells.

PMID- 8474184
TI  - Crystallization of viruslike particles assembled from flock house virus coat
      protein expressed in a baculovirus system.
AB  - Flock house virus coat protein expressed in a baculovirus system spontaneously
      assembles into viruslike particles, which undergo an autocatalytic postassembly
      cleavage equivalent to that of the native virus. Mutations of the asparagine at
      the Asn/Ala cleavage site result in assembly of provirion-like particles that are
      cleavage defective. Crystals of the mutant provirions have been grown, and they
      diffract X rays beyond 3.3-A (0.33-nm) resolution. The crystals are monoclinic
      space group P2(1) (a = 464.8 A [46.48 nm]; b = 333.9 A [33.39 nm]; c = 325.2 A
      [32.52 nm]; beta = 91.9 degrees) with two provirion-like particles per unit cell.
      Thus, it should be possible to determine the high-resolution structure of the
      provirion, which will be compared with the crystal structure of the mature
      authentic virion. This collation should provide mechanistic detail for
      understanding the cleavage event. Moreover, this demonstrates that the
      baculovirus expression system displays sufficient fidelity to permit
      crystallographic analysis of the assembly process of biological macromolecules.

PMID- 8474185
TI  - Gene therapy for brain tumors in trials, correction of inherited disorders a
      hope.

PMID- 8474186
TI  - Novel therapies dominate American Cancer Society's 35th Annual Science Writers
      Seminar.

PMID- 8474187
TI  - For AIDS treatment, vaccines, now think genes.

PMID- 8474188
TI  - From the Centers for Disease Control and Prevention. Update: multistate outbreak
      of Escherichia coli O157:H7 infections from hamburgers--Western United States,
      1992-1993.

PMID- 8474189
TI  - The myth of the abortion trauma syndrome revisited.

PMID- 8474190
TI  - The myth of the abortion trauma syndrome revisited.

PMID- 8474191
TI  - The myth of the abortion trauma syndrome revisited.

PMID- 8474192
TI  - Parental consent for abortion.

PMID- 8474193
TI  - Parental consent for abortion.

PMID- 8474194
TI  - Abortion mortality trends.

PMID- 8474195
TI  - Motor vehicles or firearms: which takes a heavier toll?

PMID- 8474196
TI  - Smoking cessation and risk of stroke in women.

PMID- 8474197
TI  - Smoking cessation and risk of stroke in women.

PMID- 8474198
TI  - Smoking cessation and risk of stroke in women.

PMID- 8474199
TI  - Smoking cessation and risk of stroke in women.

PMID- 8474200
TI  - An outbreak of diarrhea and hemolytic uremic syndrome from Escherichia coli
      O157:H7 in fresh-pressed apple cider.
AB  - OBJECTIVE: Escherichia coli O157:H7 causes hemorrhagic colitis and the hemolytic
      uremic syndrome. In the fall of 1991, an outbreak of E coli O157:H7 infections in
      southeastern Massachusetts provided an opportunity to identify transmission by a
      seemingly unlikely vehicle. DESIGN: Case-control study to determine the vehicle
      of infection. New England cider producers were surveyed to assess production
      practices and determined the survival time of E coli O157:H7 organisms in apple
      cider. RESULTS: Illness was significantly associated with drinking one brand of
      apple cider. Thirteen (72%) of 18 patients but only 16 (33%) of 49 controls
      reported drinking apple cider in the week before illness began (odds ratio [OR],
      8.3; 95% confidence interval [CI], 1.8 to 39.7). Among those who drank cider, 12
      (92%) of 13 patients compared with two (13%) of 16 controls drank cider from
      cider mill A (lower 95% CI, 2.9; P < .01). This mill pressed cider in a manner
      similar to that used by other small cider producers: apples were not washed,
      cider was not pasteurized, and no preservatives were added. In the laboratory, E
      coli O157:H7 organisms survived for 20 days in unpreserved refrigerated apple
      cider. Addition of sodium benzoate 0.1% reduced survival to less than 7 days.
      CONCLUSIONS: Fresh-pressed, unpreserved apple cider can transmit E coli O157:H7
      organisms, which cause severe infections. Risk of transmission can be reduced by
      washing and brushing apples before pressing, and preserving cider with sodium
      benzoate. Consumers can reduce their risk by only drinking cider made from apples
      that have been washed and brushed.

PMID- 8474202
TI  - Association of tuberculosis infection with increased time in or admission to the
      New York City jail system.
AB  - OBJECTIVE: To establish the association between time spent in jail or number of
      jail admissions and development of tuberculosis in a cohort of inmates
      incarcerated without evidence of tuberculosis infection on entry. DESIGN: Nested
      case-control design within a prospective cohort. A cohort of 2636 tuberculin skin
      test-negative inmates incarcerated in 1985 was matched against the Tuberculosis
      Registry of New York City. Each case of tuberculosis reported prior to May 15,
      1992, was assigned to three randomly selected controls from the cohort. We
      determined time spent in jail by reviewing the computer records of the New York
      City Inmate Information System. Conditional logistic regression modeling was
      performed to establish the association of jail time with the development of
      tuberculosis. SETTING: New York City Jail. RESULTS: Sixty inmates developed
      tuberculosis by May 15, 1992. Eighty-five percent of these had pulmonary
      tuberculosis. Univariate analysis identified the number of jail admissions (P =
      .02), age greater than or equal to 30 years (P = .001), and assignment to a
      methadone detoxification unit (P = .001) as significant in predicting
      tuberculosis. Multivariate modeling identified these same variables and jail time
      as significant. One year of jail time increased the odds of tuberculosis to 2.2
      (95% confidence interval, 1.1 to 4.4). CONCLUSION: The demonstrated association
      between jail time or jail admissions and development of tuberculosis suggests
      that the New York City jail system may be an important amplification point in the
      ongoing tuberculosis epidemic, deserving significant public health attention.

PMID- 8474201
TI  - A controlled trial of HA-1A in a canine model of gram-negative septic shock.
AB  - OBJECTIVE: To investigate the therapeutic efficacy and microbiological and
      physiological effects of a human IgM monoclonal antibody (HA-1A) directed against
      the lipid A component of endotoxin in a canine model of sepsis that simulates the
      cardiovascular abnormalities of human septic shock. DESIGN: Blinded, placebo
      controlled 28-day trial. INTERVENTIONS: Purpose-bred beagles were implanted with
      an intraperitoneal clot infected with Escherichia coli O111:B4. At clot
      placement, animals received HA-1A (10 mg.kg-1), control human IgM antibody (10
      mg.kg-1), or control human serum albumin intravenously. All animals were given
      antibiotic and fluid therapy. MEASURES: Survival and microbiological and
      physiological events. RESULTS: Only two (15%) of 13 animals in the HA-1A group,
      compared with eight (57%) of 14 control animals (combined control human IgM
      antibody and control human serum albumin groups) (P = .05), survived 28 days. At
      24 hours, the HA-1A group had lower mean arterial pressure (P = .04) and cardiac
      index (P = .004) and higher lactate levels (P = .05) compared with the combined
      controls group. In addition, these parameters in the HA-1A group were
      significantly more predictive of death. The HA-1A and combined-controls groups
      had similar significant increases in the level of endotoxemia and bacteremia.
      Studies of toxic effects showed no harmful effects of control human IgM antibody
      in infected animals or HA-1A in non-infected animals. CONCLUSION: In a canine
      model of E coli sepsis, HA-1A did not alter levels of bacteremia or endotoxemia
      and actually decreased survival. If these data are relevant to human septic
      shock, HA-1A therapy should be limited until the conditions under which this
      monoclonal antibody has beneficial or deleterious effects are more completely
      defined.

PMID- 8474203
TI  - The nation's changing blood supply system.

PMID- 8474204
TI  - Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac)
AB  - OBJECTIVE: To compare pregnancy outcome following first-trimester fluoxetine
      (Prozac) exposure with pregnancy outcome in two matched control groups.
      Fluoxetine is a new antidepressant used by many young women. Currently, no
      published data exist on its safety in pregnancy. DESIGN: We prospectively
      collected and followed up 128 pregnant women exposed to a mean daily dose of 25.8
      mg (+/- 13 mg) of fluoxetine during the first trimester and compared pregnancy
      outcome with two matched groups of women exposed during the first trimester of
      pregnancy to either nonteratogens or tricyclic antidepressants. RESULTS: Rates of
      major malformations were comparable within the three groups and did not exceed
      those expected in the general population. Women treated with fluoxetine had a
      tendency for increased risk for miscarriage when compared with women exposed to
      nonteratogens (relative risk, 1.9; 95% confidence interval, 0.92 to 3.92). The
      rate of miscarriages in the fluoxetine group was comparable with the tricyclic
      group (13.5% and 12.2% vs 6.8% in the nonteratogens). CONCLUSIONS: Our study
      suggests that the use of fluoxetine during embryogenesis is not associated with
      an increased risk of major malformations. Women exposed to both fluoxetine and
      tricyclic antidepressants tended to report higher rates of miscarriage; further
      studies will be needed to confirm this observation and to separate the effects of
      the psychiatric condition from the associated drugs. Long-term studies will be
      warranted to rule out potential developmental teratology of fluoxetine, which
      affects a central nervous system neurotransmitter.

PMID- 8474205
TI  - Planned Parenthood v Casey. The impact of the new undue burden standard on
      reproductive health care.
AB  - The recent US Supreme Court decision in Planned Parenthood v Casey, by changing
      the legal standard by which restrictions on abortion are evaluated, will have a
      profound effect on access to reproductive health care in the United States. This
      article reviews the Pennsylvania antiabortion restrictions at issue in Casey and
      discusses the ways in which the new constitutional standard fundamentally weakens
      the legal protections previously afforded women and physicians in the 1973 case,
      Roe v Wade. While the majority opinion reaffirmed a woman's right to choose an
      abortion, the opinion opens the door to a multitude of new restrictive abortion
      laws, which diminish, and in some cases completely block, a woman's ability to
      exercise that right. The effect of weakened legal protection will fall most
      heavily on young, poor, minority, and rural women, who will be unable to overcome
      obstacles imposed by mandatory waiting periods, biased counseling, and parental
      notification requirements. The restrictions are also likely to exacerbate the
      shortage of physicians providing abortion services by making the procedure more
      costly and the providers' jobs more dangerous. Finally, the medical community can
      help to ensure women access to comprehensive and competent reproductive health
      care.

PMID- 8474206
TI  - The emergence of Escherichia coli O157:H7 infection in the United States. The
      changing epidemiology of foodborne disease.

PMID- 8474207
TI  - The search for a magic bullet to fight sepsis.

PMID- 8474208
TI  - The future of medicine.

PMID- 8474209
TI  - The future of world health.

PMID- 8474210
TI  - The future of US public health.

PMID- 8474211
TI  - Blood transfusion--a potential source of HIV/AIDS spread.

PMID- 8474212
TI  - Significance of thyroid microsomal antibody in Graves' disease.
AB  - Thyroid microsomal antibody (MsAb) was estimated in 48 patients with Graves'
      disease (15 newly diagnosed, 15 on drugs for about 4 weeks and 18 euthyroid with
      drug treatment) and twenty age and sex matched controls. The diagnosis of Graves'
      disease (GD) was based on clinical history, physical examination and thyroid
      function tests, viz. 131I uptake, thyroid scintigram and serum T3, T4 and TSH
      levels. MSAb was positive in 93.3% of newly diagnosed as well as hyperthyroid GD
      patients on drugs. Eighty-three percent euthyroid GD patients and 20% normal
      controls also showed MSAb positivity. The titres of newly diagnosed patients were
      significantly raised (P < 0.05) than those of euthyroid patients and controls
      indicating the diagnostic as well as prognostic significance of MSAb in Graves'
      disease.

PMID- 8474213
TI  - Acupuncture vs carbamazepine in trigeminal neuralgia.

PMID- 8474214
TI  - Childhood acute respiratory infection in Pakistan.

PMID- 8474215
TI  - Prevalence and pattern of HIV infection in Karachi.
AB  - Two thousand seven hundred and seventy six subjects comprising 844 high risk and
      1932 low risk group were screened for HIV antibodies by ELISA and western blot.
      Eight subjects from high risk group were HIV positive. They included three
      prisoners, two sexually promiscuous, two seafarers and one recipient of blood.
      The highest prevalence of the infection was found in sexually promiscuous group
      (5.40% +/- 7.40) followed by prisoners (1.64% +/- 1.87), multitransfused patients
      (1.0% +/- 1.96) and seafarers (0.66% +/- 0.93). No case of HIV infection was
      found in low risk population group, however, one pregnant women had p24 and p55
      antibodies on western blot.

PMID- 8474216
TI  - The blue rubber bleb syndrome.

PMID- 8474217
TI  - Intussusception in an infant caused by aberrant pancreas.

PMID- 8474218
TI  - Cysticercosis in a Muslim woman.

PMID- 8474219
TI  - Clinical and endocrine features of ultrasound diagnosed polycystic ovary
      patients: the correlation between ovarian volume and androgen activity.
AB  - One hundred and twenty five patients with polycystic ovaries on ultrasonography
      and 17 controls with normal ovaries on ultrasound and regular ovulary cycles
      underwent clinical and endocrine evaluation. Of 125 ultrasound-diagnosed
      polycystic ovary patients (PCO) 49.6% complained about hirsutism, 55.2% had
      menstrual disturbances (46.4% oligomenorrhea, 8.8% amenorrhea), 23.2% had normal
      but irregular cycles and 50.4% had infertility. PCO patients had significantly
      higher mean serum LH, testosterone, androstenedione and DHEAS levels and higher
      mean ovarian volume compared with the control group. Sixty seven percent of PCO
      patients had enlarged ovaries and significantly higher mean serum LH,
      testosterone, androstenedione and DHEAS levels, compared with the PCO patients
      who had ovarian volume within normal range. There was a significant positive
      correlation between ovarian volume and serum LH, testosterone, androstenedione,
      DHEAS levels. Hirsutism, oligomenorrhea, irregular cycles were equally present in
      patients with normal ovarian volume and enlarged ovaries. These results
      illustrate the importance of ovarian volume measurement as an indicator of
      androgen production in PCO patients.

PMID- 8474220
TI  - Merits of posterior lumbotomy approach to the upper urinary tract.
AB  - Posterior lumbotomy incision is anatomically the most straightforward approach to
      the kidney and the upper ureter. A brief description of the operative technique
      is followed by a report of the author's experience with this approach in 38
      operations on the upper urinary tract. The access provided was judged to be
      adequate in 35 (92%) patients although twelve patients (31.5%) required upward
      extension of the incision for the access to become adequate. Thirty-three
      patients (87%) were mobile and did not require analgesia by third postoperative
      day. Average hospital stay was 6 days. Complications occurred in seven patients
      (21%). There was no hospital mortality. This incision is recommended for
      relatively simple operations of upper urinary tract like pyelolithotomy and
      ureterolithotomy.

PMID- 8474221
TI  - Bioburden and theoretical sterility dose calculation for radiation sterilization
      of surgical cotton and bandages.
AB  - The initial bioburden, count of colony forming unit (CFU) was determined on the
      locally manufactured non-sterilized surgical cotton and bandages. In all 489
      tests were conducted on 163 cotton samples and 246 tests on 82 bandage samples.
      The surgical cotton showed an average of 198 microbes with a maxima of 287 and
      minima 94 whereas bandages showed an average of 179 microbes with a maxima of 268
      and minima of 89. In the 20% samples subjected to identification no anaerobic
      microorganism was isolated while the aerobic microorganisms isolated were all
      bacilli. The sterilization dose (SD) for sterility assurance level (SAL) of 10(
      6) was 2.23 Mrads and 2.21 Mrads, whereas the device verification dose (DVD) was
      0.6 and 0.59 Mrads for cotton and bandages respectively as calculated by the
      method proposed by the Sterilization Standard Committee, Association of
      Advancement of Medical Instrumentation (AAMI).

PMID- 8474222
TI  - [Aging and intestinal flora].

PMID- 8474223
TI  - [Senile dementia].

PMID- 8474224
TI  - [Immunological study on Alzheimer's disease using anti-beta-protein monoclonal
      antibodies].
AB  - Monoclonal antibodies (TB1 & TB2), which were obtained by immunization of 24
      amino acids in BALB/c mice, bound specifically to the amyloid senile plaque and
      amyloid-angiopathic lesions of brain tissues of patients with Alzheimer's disease
      (AD) or with senile dementia of Alzheimer type (SDAT), and strongly reacted with
      the 1st part (Asp-Ala-Glu-Phe-Arg-His-Asp) of beta-protein. Western blotting and
      two-dimensional immunoelectrophoresis of cerebrospinal fluid (CSF) and serum
      revealed bands of 125 and 20 kilodaltons. The positive frequency of 125 and 20 KD
      bands detected by two-dimensional immunoelectrophoresis was higher in the serum
      of AD and SDAT patients (12 cases) than in that of normal control patients. ELISA
      employing various anti-amyloid precursor protein (APP) antibodies was performed
      using the extract of the human neuroblastoma cell line (NB39) which produces APP.
      In the near future, we hope to measure APP in CSF and sera from patients with
      Alzheimer's disease.

PMID- 8474225
TI  - [Effect of aging on sensitivity of blood pressure to salt].
AB  - We investigated the correlation between aging and sensitivity of blood pressure
      to salt. 88 non-treated essential hypertensives were divided into four groups:
      less than 40 years old (n = 20), 40-49 years old (n = 20), 50-59 years old (n =
      39), and greater than 60 years old (n = 11). Changes of blood pressure, plasma
      renin activity (PRA), plasma aldosterone concentration (PAC), plasma
      norepinephrine (PNE), and plasma epinephrine (PE) due to salt load were compared
      among four groups. Salt sensitivity of blood pressure was increased with aging,
      and there was a positive correlation between them (r = 0.30, p < 0.01). Decrement
      of PRA due to salt load was decreased with aging, and there was a negative
      correlation between them (r = -0.35, p < 0.05). PCA and PNE were suppressed by
      salt load, and the decrement degrees did not change with age. PE did not change
      by salt load. We conclude that salt sensitivity is increased with age in
      essential hypertensives, and renin-angiotensin system might be involved in it.

PMID- 8474226
TI  - [Prevalence, rate of correct clinical diagnosis and mortality of cancer in 4,894
      elderly autopsy cases].
AB  - The prevalence, rate of correct clinical diagnosis and mortality of cancer were
      analyzed in 4,894 consecutive autopsies at the Tokyo Metropolitan Geriatric
      Hospital from 1972 to 1990. average age and standard deviation of patients was
      78.1 +/- 9.1 years. Cancer was found in 45.5% of patients of 60 years and over,
      and in 49.1% in men and 41.9% in women (p < 0.001). Cancer prevalence decreased
      with advance in age; 50.0% in the sixties, 47.9% in the seventies, 43.2% in the
      eighties and 39.3% in the nineties and over. Multiple cancer was found in
      approximately 12% of patients of 70 years and over. The top three cancer
      incidences were gastric cancer, 15.0%, lung cancer, 10.7% and colon cancer, 5.9%
      in both genders. In men, prostate cancer was next common, followed in orderly
      hepatic cancer, esophageal cancer, gall bladder-bile duct cancer, pancreas
      cancer, renal cancer and urinary bladder cancer. In women, the following order of
      frequency was gall bladder-bile duct cancer, uterus cancer, pancreas cancer,
      hepatic cancer, breast cancer, thyroid cancer, esophageal cancer, renal cancer
      and urinary bladder cancer. The prevalence of gastric cancer, lung cancer,
      hepatic cancer and esophageal cancer was significantly higher in men, while that
      of gall bladder-bile duct cancer was higher in women. The age-related tendencies
      varied among cancers of different organs. Gastric cancer increased up to the
      sixties in men and up to the seventies in women and leveled off after those ages.
      Lung cancer revealed peak prevalence in the sixties and seventies and decreased
      after the age of eighty.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474227
TI  - [Gastric emptying in elderly patients with cerebral vascular diseases and the
      effect of trimebutine].
AB  - The authors investigated gastric emptying in 18 elderly patients with cerebral
      vascular diseases using the acetaminophen method. Subjects were divided into 2
      groups according to their levels of daily activity. One group consisted of 10
      comatose patients (71-92 years old), the other consisted of 8 patients (74-95
      years old) who could walk by themselves. We also investigated gastric emptying in
      6 comatose patients (38-83 years old) because of other diseases such as
      amyotrophic lateral sclerosis and in 11 elder controls (75-95 years old). In
      elderly controls, the acetaminophen concentration at 45 minutes was 9.08 +/- 1.71
      micrograms/ml. In comatose patients due to cerebral vascular diseases, the
      concentration was 3.89 +/- 1.60 micrograms/ml, which showed significantly delayed
      gastric emptying (p < 0.05). In patients with cerebral vascular diseases who
      could walk, the concentration was 6.51 +/- 0.99 micrograms/ml. In comatose
      patients by another diseases, the concentration was 5.82 +/- 1.13 micrograms/ml.
      We suspected that delayed gastric emptying is related to the comatose state.
      Trimebutine significantly (p < 0.01) improved gastric emptying in comatose
      patients with cerebral vascular diseases.

PMID- 8474228
TI  - [Concentrations of multiple neurochemicals in the cerebrospinal fluid of patients
      with senile dementia and the relationship to alpha 1-antichymotrypsin].
AB  - The authors investigated the concentrations of multiple neurochemicals (6 kinds
      of catecholaminergic and 5 kinds of indolaminergic substances) in the lumbar
      cerebrospinal fluid (CSF) of patients with and without senile dementia (13
      Alzheimer type (AD), 7 vascular type (VD), 11 Parkinson's disease (PD) and 9 non
      demented controls (C)) by means of a neurochemical analyzing system (Neurochem,
      ESA). By means of the enzyme-linked immunosorbent assay (ELISA), we also
      determined the concentration of alpha 1-antichymotrypsin (ACT) in the CSF, which
      may be a possible diagnostic biochemical marker of the senile dementia of
      Alzheimer type. ACT in CSF was significantly higher in the AD group. It
      correlated negatively with Hasegawa's dementia scale (HDS) significantly. It also
      correlated negatively with the concentration of HVA significantly and showed
      tendency to correlate with the concentrations of dopamine and the ratio of
      kynurenine and tryptophan (KYN/TRP). Each dementia group showed characteristic
      concentration patterns of neurochemicals (DA, HVA, MHPG/NE, KYN/TRP, and 5-HIAA/5
      HT). Our approach may provide a new quantitative method to diagnose geriatric
      neuropsychological diseases as well as senile dementia.

PMID- 8474229
TI  - [Clinical evaluation of finger blood pressure measurement devices for home-use].
AB  - We evaluated the accuracy of two types of finger blood pressure (BP) measurement
      devices for home-use (EW276 H, NATIONAL Ltd. and HEM 804F, OMRON Ltd.) by
      comparing BP values with upper-arm BP measured with a standard mercury column
      sphygmomanometer in 28 elderly subjects (13 Hypertensives and 15 normotensives).
      The correlation coefficient of systolic BP value and that obtained by each method
      was R2 = 0.5 for EW 276H and R2 = 0.6 for HEM 804F. The higher the systolic BP,
      the greater was the difference between the upper-arm and finger BP values. The
      magnitude of the difference between finger and upper-arm values for systolic BP
      did not correlate with pulse wave velocity. An underestimation of the finger BP
      device in systolic BP was 23.8 mmHg in hypertensives and 7.6 mmHg in
      normotensives for the EW 276H, and 15.3 and 3.5 mmHg, respectively for the HEM
      804F. This study demonstrated a large difference between the finger BP value
      measured with the home-use devices and upper-arm BP value measured with a
      standard mercury sphygmonanometer in elderly hypertensive patients. The
      difference may be due not only to atherosclerotic change, but also to
      methodological factors related to finger BP measurement.

PMID- 8474230
TI  - [A case of megaloblastic anemia with abnormally high urine level of beta
      aminoisobutyric acid].
AB  - A 78-year-old man was admitted to our hospital with anemia and jaundice.
      Hematological studies revealed hyperchromic macrocytic anemia, and biochemical
      studies revealed findings of hemolysis. The folic acid level was low and
      megaloblasts were observed in the bone marrow. From these findings, the patient
      was diagnosed as having megaloblastic anemia due to folic acid deficiency. This
      patient had been a heavy alcohol drinker in the habit of drinking alcohol without
      meals. He began to eat regular meals in the hospital, and the anemia and jaundice
      improved gradually. Since liver cirrhosis was suspected, amino acid analysis of
      the urine was performed, and abnormal excretion of beta-amino-isobutyric acid
      (BAIB) was found. According to the amount of BAIB excreted, the Japanese
      population can be divided into low and high BAIB excretors comprising 65% and
      36%, respectively. BAIB is also considered to reflect dissimilation of thymine.
      The present patient was included in the high excretion group because of the
      abnormally high urine level of BAIB, which was considered to be caused by
      ineffective hematopoiesis in the bone marrow as a result of his megaloblastic
      anemia. For this reason, dissimilation of thymine was considered to have been
      active in this patient.

PMID- 8474231
TI  - [Effective treatment by bifemelane hydrochloride for emotional incontinence and
      regional blood flow in patient with cerebral infarction].
AB  - The authors report that bifermerane hydrochloride treatment improved emotional
      incontinence in patient with cerebral infarction. Before and after bifermerane
      hydrochloride treatment, 99mTc-HM PAO single photon emission CT (SPECT) was
      performed. After treatment, regional cerebral blood flows (CBF) in frontal lobe
      area increased selectively. These findings suggest that emotional incontinence
      and decreased CBF of the frontal lobe area were closely associated in this case.

PMID- 8474232
TI  - [Hyper- nd- hyponatremia in aged subjects].

PMID- 8474233
TI  - Flow-cytometric characterization of cardiac allograft-infiltrating cells
      following MHC class I antigen pretreatment in the mouse.
AB  - Changes in the graft-infiltrating cell population (GIC) induced by Class I MHC
      pretreatment were characterized using flow cytometric analysis. C3H mice received
      10(7) EL4 cells intravenously 14 days prior to transplant with C57BL/10 (H-2b)
      hearts. Transplanted hearts were removed from six recipients in both groups at 4,
      6, 9, 12, 15, and 21 days after transplantation. GICs were harvested and
      incubated with FITC-conjugated Lyt-1 and Lyt-2 and phycoerythrin-conjugated L3T4
      monoclonal antibodies. The proportion of GICs which were Lyt-1, L3T4, or Lyt-2
      positive was similar in both control and pretreated groups at all times
      posttransplant, and all three cell populations exhibited similar changes over the
      course of the study in both groups. At Post-transplant Day (PTD) 9, there were
      significantly more double-staining cells (L3T4+, Lyt2+) in the pretreated group
      than in the control group (8.58 +/- 2.49% vs 4.36 +/- 1.32%, P < 0.05). By PTD
      15, the double-staining cells had increased in pretreated mice to 17.46 +/- 4.36%
      of the total GICs (P < 0.05). The percentage of GICs in EL4-pretreated mice which
      were Lyt-1- was significantly higher at all time points than the percentage of
      L3T4- or Lyt-2- cells, whereas in the control, these cell populations were
      equivalent, implying that in pretreated mice, cells are present which are L3T4+
      or Lyt2+ but Lyt-1-.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474234
TI  - Glutathione depletion alters hepatocellular high-energy phosphate metabolism.
AB  - Oxygen free radicals have recently been implicated as a major cause of tissue
      injury in critically ill patients. Glutathione (GSH) is a potent endogenous
      antioxidant that may be important in minimizing oxidant-induced organ damage.
      However, this tripeptide is depleted during severe illness. In order to determine
      the effect of GSH depletion on hepatic high-energy phosphate metabolism, in vivo
      31P magnetic resonance spectroscopy was used to measure phosphate ratios in male
      Wistar rats given 1 ml/kg of diethylmaleate (DEM), an agent that binds and thus
      depletes tissue GSH, or corn oil vehicle intraperitoneally. Spectra of the liver
      were obtained in noninjected animals (baseline, n = 15) and in rats 2 and 24 hr
      after the intraperitoneal injection of DEM (n = 20) or corn oil (control, n =
      20). These spectra were used to measure hepatocellular pH, phosphomonoester to
      ATP (PME/ATP), and phosphodiester to ATP ratios, measures of hepatocellular
      damage; and the inorganic phosphate (Pi)/ATP ratio, a measure of energy status.
      In addition, tissue GSH, phosphofructokinase, citrate synthase, and beta-OH-acyl
      Co-A dehydrogenase activities as well as hepatocellular ATP were measured in
      vitro in representative liver samples. Hepatic GSH levels were maximally
      depressed by 85% 2 hr after the injection of DEM (6.94 +/- 0.34 vs 0.94 +/- 0.22
      microM/g wet wt, baseline vs 2 degrees DEM). This was associated with a marked
      increase in the PME/ATP and Pi/ATP ratios by 25 and 33%, respectively, and both
      ratios were significantly correlated with the severity of hepatic GSH depletion
      (r = 0.63, P < 0.001 and r = 0.42, P < 0.01, respectively).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8474235
TI  - Durability of the in situ bypass following modification of abnormal vein segment.
AB  - Modification procedures performed during in situ bypass grafting to correct an
      injured or inadequate saphenous vein segment result in a significant increase in
      the incidence of vein graft complications in the follow-up period. Modification
      procedures were performed in 96 in situ saphenous vein bypasses and consisted of
      primary closure (n = 28), vein patch angioplasty (n = 31), or resection and/or
      replacement (n = 37). At 4 years primary patency was 54%, secondary patency was
      73%, and limb salvage was 89%. The incidence of subsequent vein graft stenosis
      and revision or graft failure was similar for grafts requiring vein patch
      angioplasty (7 of 31, 23%), primary repair (9 of 28, 32%), and resection and/or
      replacement (16 of 37, 43%) (p not equal to ns). Only 4 bypass revisions were
      performed for stenosis at the site of the original modification procedure. The
      type of vein graft repair did not significantly affect the primary patency at 18
      months (primary closure, 65%, vein patch angioplasty, 66%, and resection and/or
      replacement, 58%) or the secondary patency at 30 months (primary closure, 80%,
      vein patch angioplasty, 90%, and resection and/or replacement, 77%). Modified
      autogenous conduits maintain patency and limb salvage but are prone to develop
      graft complications in the follow-up period.

PMID- 8474236
TI  - Effect of fibrin glue and opsite on open wounds in DB/DB mice.
AB  - Fibrin glue is a hemostatic and adhesive agent that has been used for many years
      in Europe. It is made by the simultaneous mixing of concentrated fibrinogen
      complex and bovine thrombin reconstituted in a solution of calcium chloride. Upon
      mixing, the final stages of the coagulation cascade are mimicked, resulting in
      formation of a fibrin clot. Fibrin is vital in wound healing because the network
      formed in the wound acts not only as a hemostatic barrier but also as a scaffold
      for migrating cells. In this study, fibrin glue (60 mg/ml) was applied on 6-mm
      diameter circular full-thickness wounds in homozygous, genetically diabetic mice.
      Results showed delayed wound closure as compared to paired control wounds.
      Dilution of the protein concentration of fibrin glue to 1 mg/ml resulted in
      higher histological scores compared to those for wounds treated with 60 mg/ml
      fibrin glue. Finally, the application of an adherent semipermeable dressing
      (Opsite) over the wound per se resulted in delayed wound closure. Delayed closure
      may be due either to mechanical obstruction to the migration or proliferation of
      cells that actively participate in the wound healing process, mechanical
      inhibition of wound contraction, or both.

PMID- 8474237
TI  - The ipsilateral organization of the afferent nerves to the stomach.
AB  - In previous nerve tracing studies we found evidence that the efferent gastric
      vagus nerves supplying the anterior gastric wall had a regional organization. The
      first part of this study aimed to determine whether vagus afferent nerve cells
      supplying the stomach have a regional organization; an ipsilateral pattern of
      innervation was found. Next, selective blockade of the afferent nerves was
      performed and verified by axonal tracing. Animals with afferent blockade were
      stressed to determine the effect of afferent nerve blockade on the gastric stress
      response. After selective blockade of afferent vagus nerves to the anterior
      gastric wall in rats, water-immersion stress was then applied. The part of the
      gastric wall with afferent nerve blockade had fewer acute gastric lesions than
      control animals or the contralateral side of the stomach after 24 hr of stress.
      This study supports the hypothesis that afferent as well as efferent vagus nerves
      have an ipsilateral arrangement. Afferent nerve blockade of the left vagus nerve
      protected the anterior wall of the stomach against stress ulceration.

PMID- 8474238
TI  - Functional evaluation of intrathoracic versus extrathoracic skeletal muscle
      ventricles.
AB  - Skeletal muscle ventricles (SMVs) were constructed from the latissimus dorsi
      muscle in 10 dogs. In Group I (n = 5), SMVs were left in an extrathoracic
      position on the chest wall. In Group II (n = 5), SMVs were placed within the
      chest cavity. After a 3- to 4-week vascular delay period, SMVs were electrically
      preconditioned with 2 Hz continuous stimulation for 6 weeks. At a second
      procedure, SMVs were connected to a mock circulation system, and function was
      evaluated under differing conditions of preload and afterload. SMVs in Group II
      were significantly more compliant, as demonstrated by the end diastolic pressure
      volume relationship, than those in Group I (P < 0.01). SMVs in Group II were also
      capable of generating greater stroke work than those in Group I (P < 0.05). SMVs
      in Group II were also capable of greater stroke work than those in Group I at
      physiologic preloads (P < 0.05). These findings suggest that SMVs placed in an
      intrathoracic position exhibit better diastolic and systolic function.

PMID- 8474239
TI  - Influence of the timing of blood transfusion on experimental tumor growth.
AB  - Blood transfusion prior to renal transplantation improves subsequent renal
      allograft survival, and some experimental studies have shown that allogeneic
      transfusion significantly increases growth of subsequently transplanted tumors.
      The aim of the present study was to examine the influence of the timing of
      transfusion on tumor growth. Six experiments were performed, each with different
      intervals between blood transfusion and inoculation of mice with an immunogenic
      B16 melanoma cell line. Each experiment contained three groups of C57 BL/6J mice
      which received intravenously normal saline, syngeneic blood, or allogeneic blood.
      Allogeneic transfusion 7 and 10 days before, but not at the time of, tumor
      inoculation produced a significant increase in tumor growth. Allogeneic
      transfusion within the first 10 days after tumor inoculation was associated with
      larger and heavier tumors than those observed in animals treated with saline or
      syngeneic blood, although the differences were not always statistically
      significant. Multiple transfusions after tumor inoculation and transfusions in
      animals bearing well-established tumors significantly increased tumor growth. The
      study shows that growth of a transplantable immunogenic murine tumor can be
      increased by prior allogeneic transfusion and, perhaps more importantly, by
      allogeneic transfusions given after the tumor has become established.

PMID- 8474240
TI  - Effect of varying days of tissue plasminogen activator therapy on the prevention
      of postsurgical adhesions in a rabbit model.
AB  - The depression of focal fibrinolytic activity in mesothelial or serosal tissues
      which results from a surgical ischemic insult can lead to the formation of
      permanent fibrinous adhesions. To assess the time course for the prevention of
      adhesion formation by recombinant tissue plasminogen activator (rt-PA), infusions
      of rt-PA were administered to rabbits every 12 hr for a total of 1, 2, 4, or 8
      days. Animals in each rt-PA treatment group received a total cumulative dose of
      16 mg. Control animals received saline with the same corresponding dosing
      regimens as the treated groups. Prior to dosing, all animals had a
      devascularizing injury to the uterine horns performed bilaterally by bipolar
      cauterization of the uterine mesenteric vascular arcade below the horns. A
      catheter was then placed from a subcutaneous port to the intraperitoneal space.
      rt-PA, or saline, was instilled intraperitoneally via the subcutaneous port.
      Adhesions were scored at the second laparotomy by assessing the percentage of the
      involvement of the uterine horns in adhesions. Mean score for adhesion formation
      in each placebo group was 35 to 40%. Mean score (+/- standard error of the mean)
      for rt-PA after 1 day of therapy was 13.1% +/- 3.89; after 2 days of therapy,
      6.3% +/- 1.57; after 4 days of therapy, 3.8% +/- 1.57; and after 8 days of
      therapy, 6.9% +/- 2.3 (P < 0.01 compared to the control grouped mean for each day
      of treatment).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474242
TI  - Practice merging economics.

PMID- 8474241
TI  - Maturational differences in hepatic microhemodynamics in rats.
AB  - Age-related changes in the hepatic microcirculation may contribute to the
      increased susceptibility of the immature liver to microvascular injury. We
      quantified sinusoidal and acinar diameters, sinusoidal red cell velocities
      (VRBC), and sinusoidal volume flows to characterize microhemodynamics of weanling
      and adult rat livers with and without hepatic artery (HA) ligation using
      intravital fluorescence videomicroscopy. Despite a 20% faster heart rate and a
      nearly 20% lower mean arterial and portal vein pressure in weanling rats relative
      to those in the adults, weanling periportal and pericentral sinusoidal velocities
      were approximately 30 and 25% faster, respectively, than those in adults.
      Furthermore, the HA was found to contribute more to maintenance of sinusoidal
      VRBC in the immature liver as demonstrated by a significant decrease in both
      periportal and pericentral VRBC following HA ligation. HA ligation had no effect
      on VRBC of either zone in adults. Zonal volume flow (HA intact), however, was
      maintained independent of age. These results suggest a lower extrasinusoidal
      resistance in the weanling. The 25% shorter acinar diameter that we found in
      weanling livers likely contributes to a lower extrasinusoidal resistance by
      allowing a higher ratio of inflow vessels to volume of tissue. Shorter sinusoidal
      pathways in weanling livers also decreases sinusoidal resistance 1.3-fold
      relative to that in the adult, countering the approximately 1.5 times increase in
      resistance due to the smaller caliber of sinusoidal vessels so that overall
      sinusoidal resistance is not age-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474243
TI  - Anabolic steroid abuse and tooth size-arch dimensions in the rat.
AB  - Anabolic steroids are misused by adolescents and adults to increase muscle mass
      and improve appearance and athletic performance. Since anabolics strongly enhance
      protein synthesis, it was speculated that alterations in tooth size and arch
      length could occur. This study quantified the effects of the anabolic steroid
      nandrolone phenpropionate on these parameters in a rat model. The steroid
      significantly increased mandibular arch length. No difference in mesiodistal
      dimensions of the molars occurred. In consequence, the increased arch dimensions
      combined with unaltered tooth size may result in dental spacing and/or other
      malocclusions.

PMID- 8474244
TI  - The elastic and anelastic behavior of elastomeric impression materials.

PMID- 8474245
TI  - Ludwig's angina: historical perspective.

PMID- 8474246
TI  - Genetic response of microbes to extreme challenges.
AB  - Bacteria are capable of surviving in a wide range of seemingly impossible
      situations. In the main part this is because very large numbers of individual
      cells are involved, so that even very rare mutations will occur often enough to
      solve most acute problems and permit growth. But in addition, bacteria have
      evolved in an environment that has fluctuated so often in the past that they may
      have evolved a group of "last ditch" mechanisms to meet these challenges. These
      include developing a metabolically inactive state; activating previously evolved,
      but silent genes; increasing rates of mutation under dire condition; and favoring
      movement of exogenous and endogenous genetic elements. Some of these processes
      can function to make it appear that directed "Lamarckian" mutations have
      occurred. Together these survival mechanisms constitute the "catastrophe
      insurance" of the cells.

PMID- 8474247
TI  - Computer simulation of tumour cell invasion by a stochastic growth model.
AB  - The structure and function of biological systems are considered to be closely
      related. The present study addresses the question of how histological patterns of
      tumours are related to specific functional properties of the tumour cells. A
      mathematical model was developed, which facilitates the simulation of tumour
      growth and invasion by computer. The degree of cell division, migration and death
      can be interactively set and the simulation results can be observed on the
      screen. Additionally, these basic functional properties of a particular cell can
      be influenced by autocrine and paracrine factors. The study shows that the
      resulting morphological patterns closely depend on the preset functional
      properties of the tumour cells. Furthermore, each autocrine or paracrine factor,
      or combinations of these factors, induce peculiar modifications of the tumour
      pattern. These results provide evidence that histological tumour patterns reflect
      functional properties of the tumour cells and their interaction with the micro
      environment. Qualitative and quantitative comparison of real tumour specimens
      with patterns simulated by computer may thus provide a logical base for a
      functional interpretation of static histological images.

PMID- 8474248
TI  - Unequal cell division as a driving force during differentiation.
AB  - Unequal cell division, leading to daughter cells of different sizes, is a common
      event during development. We have formulated a model that shows how different
      cell sizes can lead to significant differences in the expression of an activator
      gene. The model is based on well-known aspects of the regulation of gene
      expression, specifically the existence of multiple regulatory sites, positive
      autoregulation, and the short half-life of regulatory proteins. Thus the daughter
      cells may follow distinct differentiation pathways even if there were no
      localized determinants in the mother cell.

PMID- 8474249
TI  - Cellular automata approaches to biological modeling.
AB  - We review a number of biologically motivated cellular automata (CA) that arise in
      models of excitable and oscillatory media, in developmental biology, in
      neurobiology, and in population biology. We suggest technical and theoretical
      arguments that permit greater speed and enhanced realism, and apply these to
      several classical examples of pattern formation. We also describe CA that arise
      in models for fibroblast aggregation, branching networks, trail following, and
      neuronal maps.

PMID- 8474250
TI  - Typogenetics: an artificial genetic system.
AB  - Cellular automata are now used to model various natural phenomena. In particular,
      they provide a logical universe in which artificial cells can be embedded in the
      form of propagating virtual automata. In this paper, we propose a molecular
      automaton which is an attempt to implement the "molecular logic of the living
      state" in an artificial biochemistry. This automaton is an artificial genetic
      system composed of two classes of interacting artificial molecules. It was shown
      to be self-replicating and to possess features that are analogous to those of the
      postulated prebiotic molecular systems.

PMID- 8474251
TI  - On the mechanism of long chain fatty acid transport in cardiomyocytes as
      facilitated by cytoplasmic fatty acid-binding protein.
AB  - Fatty acid-binding protein (FABP) is abundantly present in the cytoplasm of the
      cardiomyocyte, i.e. the cell which causes the contractile activity of the heart.
      Although FABP is thought to act as an intracellular long chain fatty acid (FA)
      carrier, definite experimental proof on this putative function has yet to be
      obtained. In the present study, experimental results from several authors were
      combined in an attempt to elucidate the precise physiological function of heart
      type FABP in cardiac FA transport. It was calculated that, under normal
      conditions, the major part of FA in the cardiomyocyte is dissolved in lipid
      bilayers and that the presence of FABP in the heart enhances the aqueous
      solubility of FA more than 700-fold despite the fact that only a minor part (<
      2%) of the total FABP content is then complexed with FA. Moreover, it is shown
      that, as a result of the enhanced cytoplasmic solubility, the FA flux from
      sarcolemma (the cellular membrane of the cardiomyocyte) to mitochondria is
      increased at least 17-fold in the presence of physiological amounts of FABP
      compared with the hypothetical situation in which FABP is absent. These
      calculations indicate the involvement of FABP in the transport of FA from the
      sarcolemma to those mitochondria lying in the innermost region of the
      cardiomyocyte. The extent to which FABP facilitates FA trafficking through the
      cytoplasm of the cardiomyocyte under physiological circumstances remains,
      however, to be established.

PMID- 8474252
TI  - An hypothesis for the periodicity of smallpox epidemics as revealed by time
      series analysis.
AB  - Parish registers have been studied by time series analysis to detect smallpox
      epidemics in England during 1600-1800. Confirmatory evidence was provided by the
      seasonality of child mortality. A 5-year cycle in smallpox epidemics was detected
      in medium-sized, rural towns. Consideration of the mathematics of the dynamics of
      viral diseases suggests that the true interepidemic period where smallpox is
      endemic should be 2-3 years and it is concluded that, in the towns studied, the
      disease was not endemic but that the oscillations were established by 5-year
      cycles of periods of famine associated with high wheat prices. The cross
      correlation function between the two cycles shows zero lag and the input-output
      function shows significant coherence. Another epidemic follows only when a
      sufficient density of susceptibles has been established by births, so that the
      cycles become phase-locked. It is predicted that smallpox (i) was endemic in
      London and other large cities, with 2-3 year epidemics, (ii) was epidemic with a
      5-year oscillation in rural towns, (iii) did not reach epidemic proportions in
      scattered communities.

PMID- 8474253
TI  - Does HIV "piggyback" on CD4-like surface proteins of sperm, viruses, and
      bacteria? Implications for co-transmission, cellular tropism and the induction of
      autoimmunity in AIDS.
AB  - Coinfections of human immunodeficiency virus (HIV), EBV, and HTLV or sperm
      proteins act synergistically to enhance infectivity and replication and expand
      cellular tropism. While some aspects of these synergisms are understood, others
      are not. We have found that membrane or surface proteins of CMV, HTLV, EBV and
      sperm proteins share large regions of similarity with the CD4 protein of T-helper
      lymphocytes. Since HIV uses CD4 as a receptor, it may bind to CD4 homologues on
      CMV, HTLV, EBV or sperm proteins. HIV could then "piggyback" with these viruses
      into cells with which it normally has no tropism. Similarly, HIV may expand the
      cellular tropism of CMV, or EBV. Such a piggyback mechanism may provide insight
      into the formation or presentation of CD4-like antigens from CMV, HTLV, EBV and
      sperm proteins with class II MHC-like antigens on HIV (gp160 and Nef proteins)
      and may break immunological tolerance, inducing the autoimmunity observed against
      both CD4+ and class II MHC+ T cells in AIDS patients.

PMID- 8474254
TI  - In vitro movement of actin filaments over myosin: role of actin and related
      problems.

PMID- 8474255
TI  - Determination of neuronal number and process surface area in organotypic
      cultures: a stereological approach.
AB  - Preparation of nervous tissue as an organotypic culture permits examination of
      nervous system development and interactions between neurons and with their
      environment. In order to evaluate the statistical significance of morphological
      changes, it is necessary to quantify tissue populations and parameters. Recent
      advances in stereology facilitate the gathering of morphometric data, while
      eliminating sources of error associated with traditional methods. Unfortunately,
      the new stereology has been perceived as complex and, therefore, has been slow to
      gain acceptance within neuroscience investigations in general and in vitro
      applications in particular. Here, we present a detailed application of the new,
      unbiased stereology to organotypic hippocampal cultures. These methods allow
      assessment of neuronal survival and morphological plasticity to culture
      conditions with increasing culture age. Neuronal number was assessed from point
      sampled intercepts of cells sampled without bias by the selector procedure in
      vertical sections through hippocampal cultures. Surface area was estimated from
      profile intersects of neuronal processes with a cycloid array. The reference
      volume was determined by the Cavalieri method; this permitted expression of
      results as absolute values rather than as component densities. The importance of
      absolute values to valid interpretation of quantitative data is demonstrated by
      the results for neuronal number. The methods applied here provide a powerful
      approach to quantitation of organotypic cultures, and represent an important
      extension of qualitative studies of cultured nervous tissue.

PMID- 8474256
TI  - A one-step immunohistochemical method for detection of blood-brain barrier
      disturbances for immunoglobulins in lesioned rat brain with special reference to
      false-positive labelling in immunohistochemistry.
AB  - Disturbances of the blood-brain barrier (BBB) following brain lesions lead to
      extravasation of serum proteins that can be detected by immunohistochemical
      methods in tissue sections. Here, extravasated immunoglobulins were visualized by
      a 1-step technique using rabbit anti-rat immunoglobulins conjugated to
      horseradish peroxidase (HRP). This method is associated with a lower background
      staining than the conventional 3-step peroxidase-antiperoxidase (PAP) technique
      using rabbit antibodies against rat whole-serum proteins or immunoglobulins
      (IgG). Further tests using a direct conjugate of rabbit anti-rat immunoglobulins
      to fluorescein isothiocyanate (FITC) showed usefulness of the approach for
      fluorescence microscopy. Additional experiments showed that antibodies directed
      against mouse immunoglobulins as used for detection of mouse monoclonal
      antibodies can cross-react with extravasated rat immunoglobulins. Therefore,
      immunohistochemical studies on lesioned rat brain should routinely include a
      visualization of areas containing extravasated serum proteins including
      immunoglobulins.

PMID- 8474257
TI  - A tactile stimulator for studying motion processing in the somatic sensory system
      of primates.
AB  - A tactile stimulator was built for studying motion processing in the somatic
      sensory system of primates. This stimulator is used for assessing the responses
      of neurons of the somatic sensory system to stimuli moving in any traverse
      distance (range: 2-20 mm), with a variety of velocities (range: 4-120 mm/s),
      forces (range: 0-60 gf), and in any scanning direction. The stimulator is highly
      automated and can be used in combined psychophysical and neurophysiological
      studies in humans and in behaving monkeys.

PMID- 8474258
TI  - A low-cost VGA-based visual stimulus generation and control system.
AB  - A flexible visual stimulus system has been developed for neuroscience research
      that uses low-cost and widely available personal computer hardware. The system
      has many advantages over those that rely upon traditional optical and mechanical
      methods, including size, flexibility and spatiotemporal resolution. The system is
      designed around an IBM-compatible personal computer, equipped with a VGA graphics
      card and a VGA monitor or projector. A set of assembly language routines has been
      developed for the setup and control of the graphics hardware so that images are
      generated and then moved with single pixel/single frame resolution. Two
      variations of this system are described. One version enables a stimulus on the
      display monitor to be imaged directly on the retina in vitro during spike
      recordings; the other variant back-projects an image onto a tangential screen for
      in vivo testing in the awake animal. Using the latter approach, the image can be
      positioned on the retina as the eye continues to move.

PMID- 8474259
TI  - Reduced compartmental models of neocortical pyramidal cells.
AB  - Model neurons composed of hundreds of compartments are currently used for
      studying phenomena at the level of the single cell. Large network simulations
      require a simplified model of a single neuron that retains the electrotonic and
      synaptic integrative properties of the real cell. We introduce a method for
      reducing the number of compartments of neocortical pyramidal neuron models (from
      400 to 8-9 compartments) through a simple collapsing method based on conserving
      the axial resistance rather than on the surface area of the dendritic tree. The
      reduced models retain the general morphology of the pyramidal cells on which they
      are based, allowing accurate positioning of synaptic inputs and ionic
      conductances on individual model cells, as well as construction of spatially
      accurate network models. The reduced models run significantly faster than the
      full models, yet faithfully reproduce their electrical responses.

PMID- 8474260
TI  - Correction for the influence of background muscle activity on stretch reflex
      amplitudes.
AB  - Background muscle activity (BGR) exerts a strong influence on stretch reflex
      amplitudes. While it is considered important to correct for this influence, which
      method best able to eliminate the effects of BGR remains unknown. We have
      therefore compared one previously described and one novel correction method which
      respectively consisted of calculating (1) the difference between reflex amplitude
      and BGR, and (2) the ratio of reflex amplitude to BGR. These correction methods
      were evaluated in a group of 23 healthy individuals. BGR and stretch reflexes
      were recorded from the gastrocnemius muscle of standing subjects who received
      sudden toe-up perturbations of a supporting platform upon which they were
      standing. Calculation of differences markedly reduced the influence of BGR on
      stretch reflex amplitudes in most, although not all, subjects. Calculation of
      ratios failed to correct for BGR in most subjects and caused a net increase in
      the influence of BGR on stretch reflex amplitudes. Because both correction
      methods insufficiently corrected for BGR in normal subjects, we introduce the use
      of analysis of covariance (ANCOVA) to reliably remove the influence of BGR on
      stretch reflex amplitudes. The use of ANCOVA is exemplified by showing that
      stretch reflex amplitudes are enhanced in patients with Parkinson's disease even
      if the influence of high BGR is completely taken into account.

PMID- 8474261
TI  - Real-time imaging of neurons retrogradely and anterogradely labelled with calcium
      sensitive dyes.
AB  - Membrane-impermeant calcium indicator dyes were used to retrogradely label dorsal
      root ganglia, spinal motoneurons and interneurons in the spinal cord of the chick
      embryo. The dyes were also used to label anterogradely primary afferent axons in
      the spinal cord and synaptic endings in the ciliary ganglion. Labelled neurons
      were imaged using digital videomicroscopy. Motoneurons and dorsal root ganglion
      cells exhibited a frequency-dependent change in fluorescence during antidromic
      stimulation. Single antidromic stimuli resulted in fluorescence transients that
      could be resolved in individual cells in real time. In addition, fluorescence
      changes could be recorded in motoneurons during episodes of bursting generated by
      rhythmic synaptic inputs from premotor networks. Stimulus-induced fluorescence
      signals were also detected in axons and synaptic endings labelled anterogradely.
      Optical signals were largely abolished in the absence of extracellular calcium.
      The results show that calcium changes can now be measured in identified
      populations of neurons and presynaptic terminals. The strong dependence of these
      signals on impulse activity suggests that the technique will be useful for
      monitoring the activity of identified neuronal populations. The calcium-dependent
      fluorescence signal probably results from cytosolic dye derived from diffusion
      which may limit the technique to situations in which the dye can be applied close
      (< 1 cm) to cell bodies.

PMID- 8474262
TI  - Mayo legal department.

PMID- 8474263
TI  - Multidimensional visualization in echocardiography: an introduction.
AB  - X-ray films depict three-dimensional objects as shadows in a two-dimensional
      plane; thus, objects become superimposed. Computed tomography and other types of
      tomographic imaging, such as ultrasonography, acquire two-dimensional images of a
      material property within a thin slice. Sequential adjacent two-dimensional
      tomograms can be used to construct three-dimensional displays of objects.
      Visualization, a field of computer science, enables scientists to measure image
      attributes (extraction of features), identify features (classification), separate
      objects from one another (segmentation), and produce comprehensible, information
      dense images from three-dimensional data sets (rendering). A three-dimensional
      rendering of the heart can be used to represent only one component of the heart,
      such as the atrial septum or the ventricular chamber, and can be shaded or
      colored to enhance comprehension. Three-dimensional images rendered sequentially
      over time result in a dynamic four-dimensional display. This report describes
      multidimensional visualization of objects and tissues and specifically discusses
      examples from echocardiography.

PMID- 8474264
TI  - Three- and four-dimensional cardiovascular ultrasound imaging: a new era for
      echocardiography.
AB  - Three-dimensional and four-dimensional ultrasonography were pioneered in the
      1960s yet have been used little clinically. Only recently have advances in
      cardiovascular ultrasound equipment and in digital image storage, manipulation,
      and display techniques made three- and four-dimensional imaging clinically
      feasible. In this report, we review the historical development of these
      technologies during 3 decades to their culmination in current state-of-the-art
      technology. Examples of such multidimensional images are presented, with special
      emphasis on clinical applications. Although several limitations persist, three
      dimensional cardiovascular ultrasonography seems likely to enhance imaging of the
      heart and vessels in a manner similar to the advent of two-dimensional
      echocardiography in the M-mode era. Clinician-scientists will soon be able to
      extract an object, such as the heart, from the body electronically for the
      purpose of anatomic, functional, and histologic analysis without adverse effect
      on the patient.

PMID- 8474265
TI  - Urolithiasis in pediatric patients.
AB  - Urolithiasis in pediatric patients has been perceived as uncommon, and the
      appropriate evaluation and management have been controversial. To determine the
      clinical characteristics, types of stone problems, and outcomes of pediatric
      patients with urolithiasis encountered in a referral center, we retrospectively
      assessed 221 patients (113 girls and 108 boys) with urolithiasis examined at the
      Mayo Clinic between 1965 and 1987. The median age at onset of symptoms was 11
      6/12 years among the female patients and 10 6/12 years among the male patients.
      Analysis of stone constituents in 122 patients showed the proportion of calcium
      oxalate (44.7%), calcium phosphate (23.6%), and cystine (8.1%) stones to be
      similar in all age-groups. Overall, struvite stones were found in 17.1% and uric
      acid stones in 1.6% of patients. Conditions that predisposed to metabolic
      urolithiasis were identified in 115 patients (52%). Hypercalciuria was confirmed
      in 49 of 145 patients (33.8%) and hyperoxaluria in 25 of 124 (20.2%). Eight of 96
      patients had hyperuricosuria, and 5 of 54 had hypocitraturia. Forty-one patients
      (18.6%) had infection-related stones. Of 66 patients with structural anomalies of
      the genitourinary tract, 24 (36%) had metabolic abnormalities and 26 (39%) had
      chronic infection. Among patients with chronic infection, 29% had metabolic
      abnormalities. Of the 221 patients, 148 (67%) had two or more stones during a
      mean follow-up of 59 months. Among 140 patients with 12 months or more of follow
      up, metabolic activity was present in 31 (22.1%) at the time of most recent
      examination. Overall, 166 of 221 children (75.1%) were found to have factors that
      predisposed to urolithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474266
TI  - Phlebotomy--a minimalist approach.
AB  - For each patient, laboratories usually collect more blood than is needed for
      specific determinations. We reviewed the amount of blood collected for laboratory
      measurements for an entire hospital stay of 113 patients admitted during a 1-week
      period to a medical ward or to a medical intensive-care unit in our tertiary-care
      facility. The amount of blood obtained was also compared with the minimal amount
      needed for analysis for 18 of the most frequently ordered laboratory tests in our
      facility. For routine collections, a mean of 45 times the required volume of
      specimen (range, 2 to 102 times) was obtained. For optimal utilization of
      laboratory services, both the positive and the negative consequences of testing
      must be thoughtfully considered. Two potential adverse effects of withdrawal of
      blood for laboratory determinations are iatrogenic anemia and infection.
      Moreover, the cost of care is increased with additional analyses. Practical
      strategies for decreasing the amount of blood collected include an increased
      awareness of ordering practices, a thorough knowledge of the volume of blood
      needed for each laboratory test, experienced phlebotomy personnel, storage of
      blood specimens for potential subsequent use, and communication of accurate
      minimal volumes needed for specific measurements.

PMID- 8474267
TI  - The differential diagnosis of orbital calcification as detected on computed
      tomographic scans.
AB  - We reviewed 350 orbital computed tomographic scans to determine the frequency,
      significance, and differential diagnosis of calcified lesions. Of 171 suitable
      scans that fulfilled the study criteria, 37 (22%) showed calcific densities. The
      most common intraocular lesion that contained calcium was retinoblastoma, and the
      most frequently calcified extraocular masses were vascular lesions (hemangioma,
      lymphangioma, and varix). We describe two orbital tumors--metastatic colonic
      carcinoma and primary orbital malignant melanoma--that previously have not been
      reported as having calcification. The presence of calcification within lesions of
      the lacrimal gland fossa usually, but not always, portends malignant disease.

PMID- 8474268
TI  - Sir Bernard Katz--winner of Nobel Prize in physiology or medicine.

PMID- 8474269
TI  - Liver biopsy diagnosis of homozygous hemochromatosis: a diagnostic algorithm.
AB  - The diagnosis of homozygous hemochromatosis (HH) should be based on appropriate
      findings on liver biopsy specimens. In cases with equivocal morphologic features,
      quantitative tissue iron determination and calculation of the hepatic iron index
      generally enable one to distinguish HH from other types of hepatic iron overload.
      In this article, we describe a diagnostic algorithm that is designed to avoid
      diagnostic errors because of histologic misinterpretation or erroneous, usually
      false-negative, chemical iron studies. The algorithm also delineates a cost
      effective method of using quantitative tissue iron analysis. Diagnostic biopsy
      features of uncomplicated HH include (1) hemosiderosis that involves primarily
      hepatocytes, with or without inactive cirrhosis, and (2) a tissue iron index of
      1.9 or higher. Findings such as prominent fatty changes or lymphocytic piecemeal
      necrosis indicate the presence of HH in conjunction with another complicating
      condition or secondary iron overload in the absence of HH.

PMID- 8474270
TI  - Digital embolization from plaque-related thrombus in the thoracic aorta:
      identification with transesophageal echocardiography and resolution with warfarin
      therapy.
AB  - A 71-year-old man had painful blue toes after an episode of protracted vomiting.
      Abdominal, cardiac, and transesophageal ultrasound studies were performed before
      angiography was considered. A large mobile mass in the proximal descending
      thoracic aorta, which suggested thrombus, was identified by transesophageal
      echocardiography. With no further evaluation, anticoagulant therapy with heparin
      and warfarin was initiated. Three months later, repeated transesophageal
      echocardiography demonstrated only a tiny vestige of the plaque-related mass. The
      pain and discoloration of the toes resolved completely. The advantages and
      disadvantages of the various diagnostic and therapeutic approaches to peripheral
      embolization are discussed.

PMID- 8474271
TI  - Clinical manifestations of lung cancer.
AB  - The initial clinical manifestations of lung cancer are diverse and may occur with
      or without symptoms. Manifestations of pulmonary malignant lesions are produced
      by local growth or invasion, metastatic disease, or paraneoplastic processes.
      Patterns of local invasion such as Pancoast's syndrome or the superior vena cava
      syndrome are relatively uncommon but well recognized. Metastatic lung cancer can
      involve almost any anatomic area by hematogenous, lymphatic, or, occasionally,
      interalveolar dissemination. Complications related to malnutrition, infection,
      electrolyte disturbances, and coexisting diseases influence the initial
      manifestations. Although individual tumor cell types are associated with
      characteristic features, no constellation of findings is pathognomonic for a
      specific histologic variant. Because successful treatment of pulmonary carcinoma
      depends on early detection, awareness of the typical clinical manifestations is
      important.

PMID- 8474272
TI  - Paraneoplastic syndromes associated with lung cancer.
AB  - Paraneoplastic phenomena associated with primary lung cancer have diverse initial
      manifestations and epitomize the systemic nature of human malignant disease. The
      spectrum of clinical features in patients with paraneoplastic syndromes ranges
      from mild systemic or cutaneous disease to hypercoagulability and severe
      neuromyopathic disorders. Although the diagnosis is often one of exclusion, an
      improved understanding of the pathogenesis involved in some of these syndromes
      has provided another means of recognizing the disorders and perhaps treating the
      affected patients. Proposed mechanisms of paraneoplastic processes include the
      aberrant release of humoral mediators such as hormones and hormone-like peptides,
      cytokines, and antibodies. In this update, we review the potential mechanisms,
      diagnosis, and treatment of paraneoplastic syndromes associated with lung cancer.

PMID- 8474273
TI  - Diagnostic tests for lung cancer.
AB  - The goals of diagnostic testing in patients with suspected lung cancer are to
      establish the diagnosis and to determine the stage of the disease so that
      appropriate therapy can be initiated. Unless a patient has hemoptysis, fever, or
      a change in cough as an initial manifestation, resectable lung cancer will seldom
      be diagnosed on the basis of the history. Screening tests--particularly chest
      roentgenography--have usually identified the abnormality. The managing physician
      should then select diagnostic procedures that are associated with low risk and
      that will provide further diagnostic and staging information. A biopsy will
      almost always be necessary before definitive therapy can be planned. In many
      cases, a single procedure--for example, a needle biopsy of a hepatic lesion or
      biopsy of a supraclavicular lymph node--will provide a definitive diagnosis and
      establish the stage of the disease. The roles of cytology, histopathologic
      examination, radiologic studies, and various types of biopsy in the diagnosis of
      lung cancer are reviewed in this report.

PMID- 8474274
TI  - High-resolution computed tomography for obliterative bronchiolitis.

PMID- 8474275
TI  - Three-dimensional echocardiographic reconstruction: from "ice-pick" view to
      virtual reality.

PMID- 8474276
TI  - Importance of metabolic contributions to urolithiasis in pediatric patients.

PMID- 8474277
TI  - [Epidemiology of traveler's diarrhea in Spanish tourists travelling in developing
      countries].
AB  - BACKGROUND: Travellers' diarrhea (TD) is the most frequent problem in travellers
      going to the developing countries. This paper analyses the prevalence of the
      syndrome by geographical areas as well as the risk factors in 2209 Spanish
      travellers to 3 continents. METHODS: Epidemiological data were gathered through a
      personnel interview filled by the travellers during their return trip. Those were
      introduce in a DbaseIII plus computer program and were evaluated through the Epi
      Info program. RESULTS: The overall prevalence of TD found was 41%. The Indian
      subcontinent, the Middle East and Moghreb countries showed a higher prevalence of
      TD. Trekkers and people on boat cruises (Nile and Amazon) had the highest
      prevalence of TD. The consumption of non-carbonic drinks and ice creams was
      significantly associated to TD. Travellers with previous gastrointestinal
      illnesses suffered more TD than others. CONCLUSIONS: Despite the fact that Spain
      in considered an area of intermediate risk for TD we found no significant
      differences in the prevalence of TD in Spanish travellers when compared with
      other published series from developed countries.

PMID- 8474278
TI  - [Clinical efficacy and tolerance to acarbose in the treatment of non-insulin
      dependent diabetic patients].
AB  - BACKGROUND: Acarbose is a pseudotetrasacaride which reversibly and competitively
      inhibits the intestinal alpha-glycosidases leading to a decrease in the increase
      of postprandial glycemia. METHODS: A multicentric double-blind clinical trial (8
      centers), controlled versus placebo, crossover and randomized was carried out in
      90 non insulin dependent diabetic patients under treatment with diet or with diet
      and sulphonilureas. During the first three months of the trial the patients
      received placebo or acarbose randomly. Following one months of wash-out with
      placebo the patients received the inverse medication for 3 more months. During
      the first month of each phase the patients received 3 x 50 mg/day of acarbose or
      placebo and the following 2 months 3 x 100 mg/day. RESULTS: Upon comparison of
      the two treatments significant statistical differences were observed in HbA1 (p =
      0.0115) and in postprandial glycemia (p = 0.0001). There were differences,
      although not significant, in the levels of triglycerides, cholesterol, fasting
      glycemia, and postprandial insulinemia. Episodes of hypoglycemia appeared in 12
      patients and 57 patients referred undesirable gastrointestinal effects.
      CONCLUSIONS: The results of this trial indicate that acarbose may be useful in
      the treatment of non insulindependent diabetic patients since it significantly
      reduces the amount of postprandial glycemia and HbA1.

PMID- 8474279
TI  - [Prospective payment per case and length of stay at coordinated private
      hospitals].
AB  - BACKGROUND: In 1991 the Valencian Health Service (SVS) introduced a system of
      prospective payment per process to reimburse some surgical interventions to
      coordinated private hospitals which, until then, had invoiced by retrospective
      payment per hospital stay. The impact of this change on the mean length of stay
      in seven groups of surgical interventions is evaluated. METHODS: Retrospective
      analysis of the mean stay of 2025 admissions in private hospitals coordinated
      under both systems of payment (payment per process 66%, October 91 to February
      92; payment by stay 64%, March 91 to February 92) for seven groups of surgical
      procedures: cataract surgery, cholecystectomy, hernioraphy, prostate resection,
      tonsillectomy-adenoidectomy, varicose vein and proctologic procedures was carried
      out. RESULTS: Mean hospital stay decreased (mean = 5.4 days; p < 0.001) in all
      the groups reimbursed under PRP (from 72% in proctologic conditions to 43% for
      adenoidectomy-tonsillectomy) avoiding 8727 stays. The coinciding period under
      both systems demonstrated a decrease of mean hospital stay similar to the total
      period. CONCLUSIONS: The coordinated hospitals demonstrated a surprisingly rapid
      capacity to modify their organizative behaviour or influence the styles of
      clinical practice or both to adopt the patterns of length of stay which optimize
      profits according to the system of payment used by the SVS.

PMID- 8474280
TI  - [Rehabilitation in rheumatism. Purpose and reality].

PMID- 8474281
TI  - [Indications for surgery in lumbar herniated disk].

PMID- 8474282
TI  - [Unilateral lung transplantation: the first 2 cases. Group of Lung
      Transplantation of the University General Hospital of the Vall d'Hebron].
AB  - Since 1983 unilateral lung transplantation has become a clinical reality. The
      initial experience of the Hospital General Universitario de la Vall d'Hebron is
      presented with the description of the two first unipulmonary transplants. The
      first was a 20 year-old woman with idiopathic pulmonary fibrosis in whom a left
      unipulmonary transplant was carried out and who, at present is at home following
      the 23rd postoperative month. The second case was a 27 year-old man with
      pneumoconiosis who, at 12 months following the left lung transplantation, carries
      on a normal life. Among the complications observed, the presence of pneumonitis
      by cytomegalovirus in both patients is of note. Stenosis and partial dehiscence
      of the bronchial suture in the first patient and isolation of syncitial
      respiratory virus in the second patient were also observed. The effort and
      integration into a normal life style of the second patient is excellent. In
      contrast, the first patient presents an important postoperative functional
      deterioration secondary to her complications. The present study demonstrates that
      unipulmonary transplantations is a reality in Spain which must be considered by
      all respiratory disease specialists in their daily clinical practise.

PMID- 8474283
TI  - [Treatment of chronic persistent severe asthma: role of methotrexate].

PMID- 8474284
TI  - [New trends in the definition and diagnostic criteria of polycystic ovary
      syndrome].

PMID- 8474285
TI  - [Fulminant meningococcemia treated with antiendotoxin IgM monoclonal antibodies
      (HA-1A)].

PMID- 8474286
TI  - [POEMS syndrome with recurrent and multiple involvement of cranial nerves].

PMID- 8474287
TI  - [The health-care and economic importance of the mean hospital stay].

PMID- 8474288
TI  - [Thymoma and muscular involvement. Differential diagnosis between polymyositis
      and myasthenia gravis].

PMID- 8474289
TI  - [Unusual presentation of Streptococcus bovis endocarditis].

PMID- 8474290
TI  - [Vertebral osteomyelitis caused by Streptococcus agalactiae].

PMID- 8474291
TI  - [Pancreatic pseudocysts after blunt abdominal trauma].
AB  - Pancreatic pseudocyst caused by trauma is rare. Only in 5 of 98 patients on whom
      we operated between 1977 and 1991 for pancreatic pseudocyst were we able to
      detect previous blunt abdominal trauma. In a 4-year-old girl just a slight
      abdominal trauma had given rise to a cyst, while in 2 other patients (aged 9 and
      26 years) pancreatitis occurred after trauma that was treated medically. Two
      patients had to undergo laparotomy immediately after suffering serious abdominal
      blunt injury. Diagnosis was established sonographically, except in one case, in
      which a large cyst was determined to originate from the pancreas, but only
      intraoperatively. The time-span between trauma and treatment of the pseudocyst
      ranged from 3 months to 1 year. Thus, continuous percutaneous suction, which is
      basically considered a promising therapy for cysts in their early stages of
      development, was obviously not feasible in our patients. We therefore carried out
      cysto-jejunostomy with formation of a Roux-en-Y jejunum loop. At follow up 1-10
      years after operation, all patients were asymptomatic and no cyst formation could
      be detected sonographically.

PMID- 8474292
TI  - [100 years of Braun anastomosis].
AB  - Although in his time a well-known and high esteemed surgeon, the data of Heinrich
      Braun's life are nearly forgotten, but his (now 100 year old) description of
      enteroanastomosis as a routine addition to gastroenterostomia made his name
      immortal. The author himself was not too enthusiastic about his idea, because he
      applied the new technique only to a few patients suffering from inoperable
      cancer. Apparently he never thought of the possibility nor expected the great
      success of the combination with the Billroth II operation as it is practised
      nowadays.

PMID- 8474293
TI  - [Extended resection of liver metastases in colorectal cancer].
AB  - Over a 10-year period, 166 patients underwent liver resection with curative
      intent for colorectal secondaries. These included 23 (13.8%) with metastases
      invading to adjacent organs. Diaphragm (n = 9), major omentum (n = 5), portal
      vein/inferior vena cava (n = 3), gallbladder/extrahepatic biliary system (n = 3),
      right adrenal gland (n = 2), and lymph nodes of the hepatoduodenal ligament (n =
      1) were resected en bloc together with the metastases. Operative mortality was
      4.3% (1/23 patients). Intraoperative findings and the pathologist's report led to
      the performance of R0 resection in 14 patients, and microscopic residual disease
      after R1 resection was found in 7 patients; in 2 cases macroscopically visible
      tumour had to be left behind. Median survival for all patients was 14 months and
      was significantly less favourable than in patients who had undergone resection of
      metastases confined to the liver (P = 0.011, long-rank test). The median
      recurrence-free interval was 6.8 months (P = 0.11). Obviously, patients who had
      undergone R0 resection and whose CEA serum levels returned to normal after
      operation benefited the most, and among these a median survival of 17 months was
      recorded. It is concluded that in patients with liver metastases from colorectal
      cancer, invasion of the metastases to adjacent organs has significant
      implications for the prognosis, even if the metastases are resected. It is
      important to detect this situation preoperatively, to avoid subjecting patients
      to a treatment that offers little benefit.

PMID- 8474294
TI  - [Radioimmunoscintimetry for intraoperative lymph node diagnosis in colorectal
      cancer].
AB  - In a prospective study 32 patients with primary colorectal carcinomas were
      studied by means of radioimmunoscintigraphy with the anti-carcinoembryonic
      antigen monoclonal antibody BW 431/26 labelled with either 131I (group 1, n = 17)
      or 99Tc (group 2, n = 15). Scintigraphy of the resected specimen was used as a
      model for intraoperative radioimmunoscintimetry, and all positive lymph nodes
      were marked during the investigation. The results were compared with the data
      yielded by preoperative investigations (CT, MR, endosonography) and checked by
      histology and immunohistochemistry. The analysis (sensitivity, specificity)
      included: type of investigation, time interval from antigen application, type of
      radionuclide, size of lymph nodes investigated, and serum level of CEA. 131I
      Scintigraphy of the resected specimen gave the best results in the detection of
      lymph node metastases (sensitivity 1, specificity 0.57) and was superior to all
      other diagnostic procedures. When the investigation was performed 6-8 days after
      administration of the antibody the specificity improved to 1. The best results
      (sensitivity 1, specificity 0.91) were achieved in small (< 1 cm) lymph node
      metastases. A good correlation between scintigraphic diagnosis and
      immunohistochemical CEA detection was confirmed. Serum levels of CEA had no
      influence on the scintigraphic results. We conclude that intraoperative
      radioimmunodetection of lymph node metastases may improve the radicality in the
      resection of colorectal tumors. The best results are achieved with 131I-labelling
      and with application of the antibody 6-8 days before the operation.

PMID- 8474295
TI  - [Surgical therapy of secondary hyperparathyroidism after kidney transplantation].
AB  - Between April 1986 and January 1992, a total of 22 patients with chronic renal
      failure were operated on for secondary hyperparathyroidism after kidney
      transplantation, and 21 of these patients were normocalcemic postoperatively. In
      1 patient three reductions of autotransplanted parathyroid tissue were performed
      and this patient was still hypercalcemic postoperatively, with a serum calcium of
      2.65 mmol/l. The renal function was not impaired by parathyroidectomy. In 9 of
      the 22 patients subtotal parathyroidectomy was indicated within 4 months after
      renal transplantation because of serum calcium levels over 3.0 mmol/l or severe
      clinical symptoms. Subtotal parathyroidectomy is indicated in patients with
      secondary hyperparathyroidism after renal transplantation with a serum calcium
      over 3.0 mmol/l and severe clinical symptoms and also in patients with slightly
      elevated serum calcium levels after an observation period of up to 12 months.

PMID- 8474296
TI  - [Do nicotine and alcohol abuse effect the occurrence of postoperative bacterial
      infections?].
AB  - In a prospective study we evaluated patients with diagnoses of (1) inguinal
      hernia (n = 57), (2) gall bladder stones (n = 80), and (3) carcinoma of the colon
      (n = 76). The whole group included 213 patients who underwent clean, clean
      contaminated or contaminated operations. All wound infections and postoperative
      bacterial infections such as pneumonia or urinary infection, were recorded. The
      patients were asked for risk factors at the time of hospitalization: 7.1% of all
      patients admitted an intake of alcohol of more than 60 g/day, and 15.6% of the
      patients smoked more than 20 cigarettes/day. We found a four times higher risk of
      postoperative infection for patients with an intake of more than 60 g
      alcohol/day. The rate of infection for smokers of more than 20 cigarettes/day is
      twice as high as for non-smokers or persons who smoke fewer than 20
      cigarettes/day.

PMID- 8474297
TI  - [Therapy of advanced stomach cancer: multivisceral or multimodal?].

PMID- 8474298
TI  - [Orthotopic liver transplantation in the rat].

PMID- 8474299
TI  - [Orthotopic liver transplantation with arterial re-anastomosis in the rat--a
      detailed description of technique and analysis of possible errors].
AB  - Liver transplantation (LTX) in the rat is a frequently used transplantation
      model. In the present study we give a detailed description of the suture
      technique for all anastomoses, except the bile duct, with arterialization of the
      transplanted liver over an aortoceliac segment to the recipient's aorta. Using
      this technique, we finally achieved survival rates of 80%. During the development
      stages, the main cause of death was an exceedingly long anhepatic time (> 20
      min); later on, complications occurred only from insufficient anastomoses. The
      advantage of the suture technique over the cuff technique is that a more
      physiological anastomosis is obtained with less trauma to the recipient when
      using rearterialization. Despite the complicated suture technique, the anhepatic
      time can be well reduced to below 20 min.

PMID- 8474300
TI  - [Clinical and functional results of abdominal rectopexy using different fixation
      principles].
AB  - We report our results with abdominal rectopexy (modified Ripstein procedure,
      Ripstein/Corman) without resection of the colon in 63 patients using lyophylized
      dura-strips, Vicryl gauze or Dexon gauze, as the underlying fixation material for
      the mobilized rectum, presacral fascia and fixation suture material. Forty-five
      of 64 patients (71.4%) were reevaluated by proctoscopic examination and
      questioning; the mean follow-up time was 52.5 months (range 3-136 months).
      Postoperative mortality due to the method was 0%; the mortality was 1.6% (n =
      1/63) in general for the first postoperative 30-day period as a result of cardiac
      complications. There were three complications (4.7%) the durating operation.
      Postoperative morbidity was 25.4% (16/63); infectious complications occurred in
      12.7% (8/63) of cases, with one case of spontaneous closure of a pelvicutaneous
      fistula after intraoperative injury to the rectal wall. Full-thickness rectal
      prolapse appeared after rectopexy in 4.4% (2/45) (dura material alone) and
      mucosal prolapse was seen in 15.5% (7/45) of the follow-up group. Constipation
      was reduced by 28.6% (18/63) to 22.2% during the follow-up. Seventeen of 28
      patients (60.7%) with incontinence showed an improvement; total continence was
      registered in 35.7% (10/28). The increase in continence as a result of abdominal
      rectopexy was significant (Wilcoxon, P = 0.05). The special aspects of being in
      an older age group, having a long history of procidentia, the number of
      deliveries, the length of the preoperative incontinence period all showed no
      influence on the postoperative degree of continence (Spearman's rank
      correlation). In 7/15 cases with persisting incontinence after rectopexy,
      postanal repair (Parks) was efficient in 7/7 cases leading to total or partial
      continence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474301
TI  - [Value of abdominal rectopexy in obstructive disorders of defecation. A
      prospective study using a defecation index, manometry and radiology].
AB  - A prospective clinical, manometric, electromyographic and radiological study was
      conducted to judge the degree of success achieved with anterior-posterior
      rectopexy in 18 female patients suffering from obstructed defecation and varying
      degrees of incontinence. Prior to being operated on, 6 of the patients showed
      symptoms of intussusception, 4 an internal prolapse of the anterior rectum wall,
      and 5 a rectocele at least 2 cm in size; all of them had significant perianal
      descent. The main aim of this study was more precise definition of the pre- and
      postoperative bowel evacuation using a defecation index. This study shows that
      obstructed defecation is significantly associated with a lasting feeling of
      needing to defecate after evacuation, a sensation of incomplete evacuation,
      perianal pain and necessity for manual support during defecation. The patients
      had a mean age of 62 (range, 38-78) years. All underwent anterior-posterior
      rectopexy (Ivalon or Vicryl) with posterior pelvic repair of the puborectalis
      muscle. In 2 patients rectopexy was combined with sigmoidectomy, in 11 cases,
      with left hemicolectomy, and in 2, with subtotal colectomy. The median follow-up
      was 40.8 months (range, 6-66 months). Postoperatively anorectal manometry showed
      a significant increase in the resting anal pressure and the maximum voluntary
      pressure (P = 0.05). Continence was improved in 10 patients (55%), 7 (39%) of
      whom regained normal continence. No significant change in pelvic descent or
      anorectal angle was observed. Only 8 patients reported a complete evacuation of
      the rectum postoperatively.

PMID- 8474302
TI  - [Order in the chaos of classifications of erosions of the gastric mucosa].

PMID- 8474303
TI  - [Thyrotropin releasing hormone: functions and importance in the gastrointestinal
      tract and pancreas].
AB  - Thyrotropin-Releasing Hormone (TRH) was found in the last years to be localised
      also in the gastrointestinal tract and specially in endocrine pancreas. In the
      present review the results from studies concerning the function and the
      perspective of a clinical application of TRH in gastrointestinal diseases shall
      be presented.

PMID- 8474304
TI  - [Treatment of intraperitoneal abscess--ultrasound controlled percutaneous or
      surgical drainage?].
AB  - In a retrospective study the effectiveness of ultrasound guided percutaneous
      drainage (n = 36) was compared with that of surgery (n = 38) in the treatment of
      intraperitoneal abscesses. The treatment was successful in 95% while 5% of the
      patients in both groups died from progressive septic shock; one complication in
      each group occurred. There is a significant difference in terms of hospital stay
      (18 vs. 26 days) that favor the percutaneous treatment.

PMID- 8474305
TI  - [How frequent is the diagnosis of GI metastasis in an endoscopic patient sample
      in general internal medicine clinics> Results of a questionnaire survey of 34
      medical clinics].
AB  - With the aim of analysing the frequency of gastrointestinal (GI) metastases
      identified by endoscopic procedures, a survey was conducted by questionnaire,
      which was completed by 34 of 127 medical departments. Peritoneal carcinosis and
      direct tumor extension were disregarded. One GI metastasis (duodenum) was
      verified among 3477 upper GI tract endoscopies. Primary site was cutaneous
      melanoma. In another case metastatic origin is discussed (esophagus). Considering
      the average frequency of 102 upper GI tract endoscopies performed by the
      collaborating centers, one case of gastroduodenal metastasis could be expected
      every 17 (34) months in these institutions. 1634 examinations of the colon and
      rectum did not reveal any metastatic tumor growth. A longterm study is planned to
      provide further statistically reliable prevalence data.

PMID- 8474306
TI  - [Spontaneous rupture of an umbilical hernia in decompensated liver cirrhosis].
AB  - The case of a spontaneous rupture of an umbilical hernia of a 52 year old
      patient, secondary to cirrhosis of the liver, is described as a rare complication
      of portal hypertension with massive ascites. Additionally a survey of the
      literature is given.

PMID- 8474307
TI  - [Cerebral vasculitis in Crohn disease].
AB  - Central nervous system vasculitis in Crohn's disease. A 36-years old man was
      referred to the hospital because of severe headache, vertigo and right sided
      combined motor-sensory hemiparesis. There was a history of Crohn's disease with
      an acute exacerbation only two months ago. Magnetic resonance imaging detected a
      vascular lesion of the left brainstem and serologic investigations revealed
      circulating immunocomplexes and p-antineutrophil cytoplasmic autoantibodies (p
      ANCA). Further investigations care no evidence of arteriosclerotic
      cerebrovascular disease. These findings therefore suggest that cerebral
      vasculitis secondary to Crohn's disease was the underlying cause of this focal
      neurologic deficit.

PMID- 8474308
TI  - Hypolipidemic effects of nicotinic acid in patients with familial defective
      apolipoprotein B-100.
AB  - Familial defective apolipoprotein B-100 (FDB) is a dominantly inherited disorder
      associated with hypercholesterolemia, in which an amino acid substitution in
      apolipoprotein B-100 results in low-density lipoprotein (LDL) particles that bind
      poorly to the LDL receptor and accumulate in plasma. Patients with FDB described
      to date have been heterozygous for this disorder, and their plasma contains both
      normal and defective-binding LDL particles. We have evaluated the
      hypocholesterolemic effects of nicotinic acid (3 g/d) in four patients with FDB,
      and compared the response to that of nine patients with heterozygous familial
      hypercholesterolemia (FH). Concentrations of LDL decreased by 24% in patients
      with FDB and by 14% in patients with FH. These results support the view that
      drugs which reduce LDL synthesis may be particularly effective in the treatment
      of patients with FDB.

PMID- 8474309
TI  - Age-related changes in hepatic and splenic insulin receptors and serum insulin
      and glucose levels in inbred mice.
AB  - Inbred mice of strains A/J, DBA/1J, and SJL/J were housed and aged in our animal
      colony, and parameters of carbohydrate metabolism were assessed at various ages.
      The patterns of age-related change were both organ- and strain-specific. Age
      related changes in two of the strains were associated with relative carbohydrate
      intolerance. Common to all three strains was a biphasic pattern of change in
      hepatic insulin receptor number, with a decrease in early life and a return to
      earlier levels late in life. In both A/J and DBA/1J mice, there was a sharp
      increase in serum insulin level (twofold to 9.7-fold) that corresponded to the
      decrease in hepatic insulin receptors and was associated with hyperglycemia; no
      significant change in serum insulin or glucose levels was seen in SJL/J mice,
      despite a similar biphasic pattern in hepatic insulin receptor concentration. Age
      related changes in splenic insulin receptors resembled changes in the liver in
      A/J and SJL/J mice, ie, there were synchronous biphasic age-related patterns.
      This was not the case in the spleens of DBA/1J mice, in which we did not observe
      age-related changes. There was no change in insulin receptor affinity with age,
      nor was there any difference in affinity between tissues or mouse strains. The
      pattern of change in hepatic insulin receptors and serum insulin levels was more
      complex than has been previously recognized. We do not know the mechanisms
      responsible for this complex pattern, but it must involve at least two discrete
      age-related events.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474310
TI  - Comparison of the continuously calculated fractional splanchnic extraction of
      insulin with its fractional disappearance using a new double-tracer technique.
AB  - These studies were designed to calculate the fractional disappearance rate (FDR)
      and splanchnic extraction of insulin in response to an exogenous
      (intraperitoneal) input of insulin. A double-tracer technique using insulin
      tritiated on both the A1 and B1 positions was introduced for the measurement of
      hepatic extraction. The A1 tracer, not previously characterized in vivo, was
      compared in terms of its kinetics with H3-B1-insulin and unlabeled insulin. The
      metabolic clearance rates (MCR) of the three insulins were identical, as were the
      decay curves of the two tracers. To measure splanchnic insulin extraction, one
      tracer was infused systemically to evaluate the FDR of insulin, and the second
      was infused into the splanchnic circulation (superior mesenteric artery) and its
      peripheral appearance was calculated. Splanchnic extraction was determined from
      the difference between this rate of appearance and the rate of infusion of the
      mesenteric tracer. After intraperitoneal insulin injection, insulin levels
      increased to peaks of 549 +/- 93 microU/mL (portal vein) and 473 +/- 99 microU/mL
      (inferior vena cava) and decreased to basal levels over 3 hours. The FDR
      decreased from 0.295 +/- 0.051 min-1 to 0.125 +/- 0.026 min-1, and splanchnic
      extraction decreased from 0.534 +/- 0.06 to 0.232 +/- 0.088. The latter returned
      to near-basal values more rapidly than did the FDR. In conclusion, the kinetics
      of insulin both in and out of the steady state have been shown to be nonlinear
      through physiological insulin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474311
TI  - The effects of lactate loading on alanine and glucose metabolism in the conscious
      dog.
AB  - The effect of lactate per se on alanine and glucose metabolism was studied in
      five overnight-fasted conscious dogs. Somatostatin was infused to inhibit
      endogenous pancreatic insulin and glucagon release and the hormones were replaced
      intraportally at basal rates. Saline (n = 5) or lactate (at 25 and 50 mumol.kg
      1.min-1 for 90 minutes each) was infused, and blood samples were taken during the
      last 30 minutes of each 90-minute period. Insulin, epinephrine, norepinephrine,
      and cortisol levels remained unchanged during saline or lactate infusion.
      Glucagon level decreased slightly during lactate (94 +/- 7 to 74 +/- 9 and 79 +/-
      8 pg/mL) and saline (91 +/- 8 to 90 +/- 4 and 81 +/- 11 pg/mL) infusions. There
      were no significant changes in lactate or alanine levels or net hepatic balances
      with saline infusion. Blood lactate level increased from 657 +/- 74 to 1,718 +/-
      126 and 3,300 +/- 321 mumol/L (both P < .05) during the low- and high-lactate
      infusion periods, respectively. The liver produced lactate during the control
      (5.57 +/- 2.92 mumol.kg-1 x min-1) and low-lactate infusion (1.75 +/- 2.58
      mumol.kg-1 x min-1) periods, but consumed lactate (3.89 +/- 3.31 mumol.kg-1 x min
      -1; P < .05) during the high-lactate infusion period.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474312
TI  - Catabolism of low-density lipoprotein is altered in experimental chronic renal
      failure.
AB  - Catabolism of low-density lipoprotein is altered in experimental chronic renal
      failure. In patients with chronic renal failure, cardiovascular disease accounts
      for a significant proportion of all deaths. Several factors contribute to the
      "accelerated" atherosclerosis in this population, including hyperlipidemia, the
      pathogenesis of which is multifactorial. We investigated low-density lipoprotein
      (LDL) metabolism in a remnant model of chronic renal failure in the guinea pig.
      After one and two-thirds nephrectomy, creatinine clearance decreased to one-sixth
      normal. Plasma cholesterol and triglyceride (TG) levels increased with induction
      of renal failure. Analysis of lipoprotein composition disclosed significant TG
      enrichment of both uremic very-low-density lipoprotein (VLDL) and uremic LDL
      compared with control lipoproteins. Plasma clearance of homologous LDL was
      evaluated in turnover studies in control and uremic guinea pigs. To discriminate
      between differences in catabolism related to the uremic lipoprotein particle and
      to the uremic host milieu, a crossover protocol was used comparing the fractional
      catabolic rate (FCR) after simultaneous injection into control and uremic animals
      of 125I-control LDL and 131I-uremic LDL. The FCR of native LDL was slower in
      uremic animals than in controls. In addition, FCR of uremic LDL was significantly
      less than that of control LDL in both groups. Degradation studies in cultured
      fibroblasts indicated substantially reduced degradation of uremic LDL compared
      with control LDL. These results suggest dual abnormalities of LDL catabolism in
      renal failure that are not only related to alterations in clearance mechanisms in
      the uremic environment, but also suggest important functional differences in the
      LDL particle itself isolated from uremic animals.

PMID- 8474313
TI  - Coexistence of increased levels of adiposity, insulin, and blood pressure in a
      young adult cohort with elevated very-low-density lipoprotein cholesterol: the
      Bogalusa Heart Study.
AB  - Clustering and interrelationships of elevated levels (> 75th percentile) of
      adiposity, insulin, blood pressure, and very-low-density lipoprotein cholesterol
      (VLDL-C) were examined in a selected subset (n = 89) of a young adult cohort aged
      18 to 26 years, whose childhood (ages 10 to 18 years) VLDL-C and/or low-density
      lipoprotein cholesterol (LDL-C) levels were in the upper or lower percentiles of
      the distribution. Among the young adults with elevated VLDL-C and LDL-C levels,
      23% had increased adiposity and systolic blood pressure, 17% had increased
      insulin levels and systolic blood pressure, 17% had increased insulin levels and
      adiposity, and 13% had increased insulin levels, adiposity, and systolic blood
      pressure; corresponding values among those with elevated VLDL-C and normal (<
      75th percentile) LDL-C levels were 29%, 18%, 24%, and 18%. As adults, the group
      with elevated VLDL-C and LDL-C levels had increased adiposity (P = .02) and
      systolic blood pressure (P = .002) in comparison to those with normal VLDL-C and
      LDL-C levels, whereas the group with elevated VLDL-C and normal LDL-C levels had
      increased fasting plasma insulin levels (P = .05) and systolic blood pressure (P
      = .007). These 89 individuals had undergone a glucose tolerance test during
      childhood.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474314
TI  - Aerobic versus strength training for risk factor intervention in middle-aged men
      at high risk for coronary heart disease.
AB  - To compare the effects of strength training (ST) to those of aerobic training
      (AT) for coronary heart disease (CHD) risk factor intervention, we studied 37
      previously untrained males (aged 50 +/- 9 years, mean +/- SD) before and after 20
      weeks of either ST (N = 14), AT (walk/jog, N = 13), or no exercise (inactive
      controls, N = 10). Lipoprotein and lipid profiles, blood pressure, and glucose
      and insulin responses to an oral glucose tolerance test (OGTT) were assessed
      before and after the training period in all three groups. The ST program produced
      significant reductions in plasma glucose levels at 60, 90, and 120 minutes (P <
      .05) after glucose ingestion, whereas the AT program resulted in significant
      reductions only at 90 and 120 minutes (P < .05). ST also decreased insulin levels
      during fasting (P < .05) and at 90 and 120 minutes (P < .01) after glucose
      ingestion. AT decreased insulin levels at 90 and 120 minutes (P < .01) after
      glucose ingestion. Both training programs reduced the total area under the
      glucose tolerance curve for glucose (both P < .05) and insulin (both P < .05),
      but there were no significant differences in these changes between the two
      groups. None of the glucose or insulin values were significantly altered in the
      control group. There were no significant changes in lipoprotein and lipid
      profiles or blood pressure in any of the three groups. These results suggest that
      ST and AT have comparable effects on risk factors for CHD.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8474315
TI  - Growth hormone treatment after abdominal surgery decreased carbohydrate oxidation
      and increased fat oxidation in patients with total parenteral nutrition.
AB  - Patients undergoing elective abdominal surgery were double-blindly randomized for
      treatment with growth hormone (GH) 24 IU (n = 9) or placebo (n = 10) the first 5
      postoperative days while receiving total parenteral nutrition (nitrogen, 5.7 +/-
      .1 g/m2; energy, 1,018 +/- 12 kcal/m2, ie, 125% +/- .7% of basal metabolic rate
      [BMR]). Carbohydrate and fat metabolism were evaluated from indirect calorimetry,
      daily blood samples, and forearm substrate-flux studies. Hormone levels in plasma
      or blood were also determined. GH decreased carbohydrate oxidation, increased fat
      oxidation, and increased resting energy expenditure (REE). Free fatty acids
      (FFA), glycerol, and beta-hydroxybutyrate (beta-OH-B) levels increased in both
      arterial and venous plasma, and forearm release of FFA and glycerol increased.
      GH, insulin-like growth factor 1 (IGF-1), and glucagon levels in venous blood
      were also increased in GH-treated patients. Thus, GH induced mobilization and
      utilization of fat, and fat was preferred to glucose for energy requirements in
      patients after abdominal surgery with nutritional support.

PMID- 8474316
TI  - Exercise tolerance is lower in type I diabetics compared with normal young men.
AB  - The present investigation was conducted to study metabolic and hormonal responses
      to prolonged exercise to exhaustion in insulin-dependent diabetic subjects.
      Sixteen healthy subjects (control) and 15 diabetics with no-insulin
      administration for 12 hours were studied. They were submitted to short-term
      exercise to exhaustion on a cycle ergometer at 55% to 60% of maximum oxygen
      consumption (VO2max). Exercise tolerance was significantly lower in diabetic
      subjects (66 +/- 6.7 v 117 +/- 9.4 minutes), and glucose concentration was
      significantly higher in these subjects. At exhaustion, only diabetic subjects
      showed a significant decrease in glycemia (142 +/- 20 v 111 +/- 16 mg/dL).
      Lactate concentration increased significantly during exercise up to 30 minutes,
      but at exhaustion only control subjects showed a reduction. No significant
      difference in free fatty acid (FFA) concentrations was observed between the
      groups during a 30-minute exercise period; however, at exhaustion levels were
      significantly higher in control subjects. Prolactin and C-peptide concentrations
      were significantly lower in diabetic subjects, whereas glucagon concentration was
      higher. No significant differences between the groups were observed for cortisol
      and growth hormone (GH) concentrations. We conclude that (1) diabetic subjects
      show reduced exercise tolerance when no insulin is administered for 12 hours, and
      (2) exercise to exhaustion reduces serum glucose concentrations in insulin
      dependent diabetics.

PMID- 8474317
TI  - In vivo administration of interleukin-1 alpha induces muscle proteolysis in
      normal and adrenalectomized rats.
AB  - The effect on muscle protein turnover of recombinant interleukin-1 alpha (rIL-1
      alpha), 300 micrograms/kg body weight (BW) administered intraperitoneally (IP) in
      three divided doses over 18 hours, was studied in rats. Protein synthesis rate
      was determined by measuring incorporation of 14C-phenylalanine into protein, and
      total and myofibrillar protein breakdown rates were determined by measuring
      release of tyrosine and 3-methylhistidine, respectively, in incubated extensor
      digitorum longus muscles. To assess the role of glucocorticoids in rIL-1 alpha
      related metabolic alterations, plasma levels of corticosterone following rIL-1
      alpha injection and the effect of rIL-1 alpha on muscle protein breakdown in
      adrenalectomized and sham-adrenalectomized rats were determined. Total and
      myofibrillar protein breakdown rates were increased by 45% and 167%,
      respectively, following treatment of normal rats with rIL-1 alpha; muscle protein
      synthesis was not altered by the cytokine. Plasma corticosterone levels were
      markedly elevated following rIL-1 alpha injection, with a maximal level occurring
      at 30 minutes. However, administration of rIL-1 alpha resulted in increased total
      and myofibrillar protein breakdown rates in both adrenalectomized and sham
      adrenalectomized rats. The results suggest that increased muscle proteolysis
      following administration of rIL-1 alpha is independent of glucocorticoids.

PMID- 8474318
TI  - Dose-dependency of the glycemic response to starch-rich meals in non-insulin
      dependent diabetic subjects: studies with varying amounts of white rice.
AB  - The study objective was to determine the dose-response relationships between
      postprandial blood glucose, insulin, and glucagon responses and the amount of
      starch ingested in non-insulin-dependent diabetic (NIDDM) subjects. Three test
      meals were served in random order with a 7-day interval. Mixed meals of 23, 46,
      and 69 g (raw weight) parboiled white rice containing approximately 20, 40, and
      60 g available carbohydrate were served cooked with 167 g meat sauce on 3
      separate days. Patients ingested the meals after a 12-hour fast. Clear-cut dose
      response relationships between the amount of starch ingested and postprandial
      peak blood glucose values (R = .99), glucose response areas (R = .99), and
      insulin response areas (R = .98) were found. Glucose response areas to meals of
      20, 40, and 60 g carbohydrate as white rice differed significantly (P < .05) at
      139 +/- 58, 285 +/- 86, and 453 +/- 113 mmol/L x 280 min, respectively. Insulin
      response areas to meals of 23 g rice (11.382 +/- 2,220 pmol/L x 240 min) were
      significantly lower compared with response areas to 46 g rice (18.138 +/- 3,522
      pmol/L x 240 min) and 69 g rice (21.312 +/- 2,970 pmol/L x 240 min), with the
      latter two values being similar. Glucagon response areas showed an inverse
      pattern to glucose response areas, reaching 3,450 +/- 823, 2,715 +/- 651, and
      2,168 +/- 553 pmol/L x 240 min, but differences did not reach statistical
      significance.

PMID- 8474319
TI  - Beneficial effects of acarbose in the atherosclerosis-prone JCR:LA-corpulent rat.
AB  - The JCR:LA-corpulent rat is a strain exhibiting marked obesity and metabolic
      derangements characterized by hyperlipidemia due to hypersecretion of very-low
      density lipoprotein (VLDL) and severe insulin resistance. The corpulent male rats
      spontaneously develop atherosclerosis and ischemic myocardial lesions. Male
      corpulent rats were treated with acarbose in the presence and absence of sugar
      supplemented diets. The acarbose-treated rats had lower body weights at 3 months
      of age with unaltered food consumption, and a similar effect was seen with a high
      fructose diet. Fasting insulin concentrations were decreased significantly in
      acarbose-treated animals at both 3 and 9 months of age, and the rate of plasma
      glucose disappearance increased at 3 months of age. Acarbose treatment did not
      affect whole-serum triglyceride concentrations, but there were modest decreases
      in cholesterol levels. Sugar-supplemented diets caused no significant changes in
      insulin or glucose concentrations, and caused small increases in nonesterified
      cholesterol only. Fructose- but not sucrose-supplemented diets were associated
      with a significantly decreased frequency of old scarred myocardial lesions. The
      frequency of occurrence of such lesions was also decreased by acarbose treatment.
      This effect of acarbose treatment may reflect improvement in insulin and glucose
      metabolism in treated rats. The decrease in myocardial lesions in fructose-fed
      rats may be secondary to increased carbohydrate metabolism via the pathways
      leading from fructose to triglyceride.

PMID- 8474320
TI  - Effect of glucose, insulin, and hypertonicity on atrial natriuretic peptide
      levels in man.
AB  - To determine the effects of hyperglycemia and hyperinsulinemia on atrial
      natriuretic peptide (ANP) levels in man, we studied normotensive nondiabetic
      volunteers (aged 25 to 63 years) during infusion of insulin and/or 20% dextrose
      (glucose clamp technique) to achieve three different states of
      "glycemia/hyperinsulinemia," as follows: (1) euglycemia for 2 hours during
      infusion of insulin (80 mU.m-2.min-1), resulting in plasma insulin levels of
      approximately 1,200 pmol/L (n = 9); (2) moderate stable hyperglycemia at a level
      of 11 mmol/L (198 mg/dL) for 2 hours, with infusion of glucagon-like peptide-1 (7
      37) amide (GLP-1) during the second hour, which increased endogenous insulin
      responses to approximately 2,100 pmol/L (n = 9); and (3) marked stable
      hyperglycemia at a level of 18.5 mmol/L (330 mg/dL) for 2 hours, with endogenous
      insulin responses of approximately 720 pmol/L (n = 9). In addition, six patients
      with non-insulin-dependent diabetes mellitus were studied with the GLP-1 protocol
      at a hyperglycemic level of 14.5 mmol/L (261 mg/dL). In normal subjects, plasma
      ANP levels increased significantly from 3.0 +/- 0.4 to 4.6 +/- 0.8 pmol/L during
      marked hyperglycemia, but did not change during euglycemia or moderate
      hyperglycemia despite higher insulin levels (P < .01, ANOVA). Sodium excretion
      rates were also highest during the marked hyperglycemic study (125 +/- 14 v 91 +/
      7 v 74 +/- 10 mumol/min, P < .05, marked v moderate hyperglycemia v euglycemia).
      In diabetic subjects, ANP levels increased significantly from 12.5 +/- 4.1 to
      21.1 +/- 5.0 pmol/L during hyperglycemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474321
TI  - Mechanisms of high-density lipoprotein reduction after probucol treatment:
      changes in plasma cholesterol esterification/transfer and lipase activities.
AB  - Probucol treatment results in a significant reduction of plasma high-density
      lipoprotein (HDL) levels. Since the remodeling of HDL within the plasma
      compartment is a crucial determinant of HDL levels, the activities of several
      factors participating in the process, ie, lecithin:cholesterol acyltransferase
      (LCAT), cholesteryl ester transfer protein (CETP), and lipoprotein and hepatic
      lipases (LPL, HL), were evaluated in 15 hypercholesterolemic patients treated
      with probucol (1 g/d) for 8 weeks. Drug treatment was associated with significant
      reductions of HDL cholesterol ([HDL-C] -32%), HDL2-C (-65%), HDL3-C (-22%),
      apolipoprotein (apo)A-I (-27%), and apo A-II (-11%) levels and with the
      accumulation of small HDL in plasma. CETP activity increased by 48%, with minor
      changes in LCAT (-7%), LPL (+4%), and HL (-7%) activities. By linear regression
      analysis, CETP activity correlated inversely with HDL-C, HDL2-C, and apo A-I
      levels (r = -.63, -.52, and -.73, respectively) and with HDL particle size. In
      multivariate analysis, CETP activity was the strongest predictor of HDL-C levels,
      apo A-I levels, and HDL particle size. The hypothetical mechanism of probucol is
      a stimulation of CETP activity, resulting in the formation of triglyceride (TG)
      enriched HDL. These are acted on by HL, leading to the accumulation of small HDL
      in plasma.

PMID- 8474322
TI  - Relationships between lipoprotein(a), lipids, apolipoproteins, basal and
      stimulated fibrinolytic regulators, and D-dimer.
AB  - In 191 newly referred hyperlipidemic patients, our specific aim was to assess
      relationships between levels of lipoprotein(a) [Lp(a)], lipids, apolipoproteins,
      regulators of basal and stimulated fibrinolytic activity, and D-dimer, a measure
      of in vivo fibrinolysis. Lp(a) levels correlated with none of the measures of
      basal fibrinolytic regulators or D-dimer. In 25 patients, levels of stimulated
      regulators of fibrinolytic activity and D-dimer were measured after 10-minute
      cuff venous occlusion. Lp(a) levels again correlated with none of the stimulated
      regulators of fibrinolytic activity or D-dimer. However, both basal and
      stimulated levels of fibrinolytic regulators and D-dimer were closely related to
      other major risk factors for coronary heart disease (CHD) including triglyceride,
      apolipoprotein (apo) A1, apo B, Quetelet index (QI), and sex. By stepwise
      regression in 191 patients, the following standardized partial regression
      coefficients were significant (P < or = .05), and model R2 and P values were as
      follows: basal tissue plasminogen activator (tPA) with apo B-.18, with time .17,
      with QI -.28, R2 = 17%, P < or = .0001; basal plasminogen activator inhibitor
      (PAI) with apo B..25, with time -.15, with QI .17, R2 = 14%, P < or = .0001;
      basal alpha 2-antiplasmin with apo A1.14, with apo B.24, with QI.17, with sex
      .30, R2 = 25%, P < .0001; basal plasminogen with A1.15, with apo B.21, with
      QI.17, with sex.17, R2 = 15%, P < or = .0001; basal fibrinogen with Lp(a).17,
      with QI.21, with sex.26, R2 = 14%, P < or = .0001; D-dimer with sex.15, R2 = 21%,
      P < or = .048. Given the absence of any relationship between Lp(a) levels and
      inhibition or stimulation of fibrinolysis regulators or D-dimer either in the
      basal or stimulated state, we postulate that Lp(a)'s major atherogenic effects
      are mediated by mechanisms other than reduction of fibrinolysis stimulation or in
      vivo fibrinolysis.

PMID- 8474323
TI  - Hypoalphalipoproteinemia: postprandial response of subjects with preprandial
      normotriglyceridemia and hypertriglyceridemia to various diets.
AB  - The effect of a single oral fat meal (60 g fat/m2 body surface area) enriched in
      either saturated (SFA) or polyunsaturated ([PUFA] omega-6 or omega-3) fatty acids
      on postprandial lipoprotein levels was studied in four men with primary
      hypoalphalipoproteinemia (HP) and in four age- and sex-matched controls. Vitamin
      A was included in the meal to label intestinally derived triglyceride-rich
      particles (TRP) with retinyl palmitate (RP). The HP subjects were either mildly
      hypertriglyceridemic (group A) or normotriglyceridemic (group B) and were
      phenotyped for post-heparin lipoprotein lipase (LPL) and hepatic triglyceride
      lipase (HTGL) activities and apolipoprotein (apo) E isoforms. Postprandial total
      plasma triglyceride (TG), high-density lipoprotein (HDL) cholesterol, and RP and
      TG concentrations in the chylomicron (Sf > 1,000) and nonchylomicron (Sf > 1,000)
      fractions were evaluated for 24 hours after the meal. At each time point, HDL
      composition and size and apolipoprotein distributions were also measured.
      Following the SFA meal, HP subjects had maximal plasma TG levels at 8 hours (4
      hours in controls) with a slow return to baseline levels at 12 to 24 hours (8 to
      12 hours for controls). In contrast, after the omega-6 meal plasma TG levels
      decreased in group A subjects, while group B subjects and controls showed only a
      small increase. The results after the omega-6 meal were intermediate between the
      SFA and the omega-3 meal. When compared with group B, subjects in group A showed
      higher levels of RP-associated TRP, slower clearance rates, 30% to 50% lower
      fasting LPL activity, and 1.5-fold to twofold higher fasting plasma apo C-III
      levels. The major preprandial HDL subclass in HP subjects was HDL3, which showed
      a relative decrease in cholesterol esters (CE) and an increase in TG levels
      following the SFA meal. After the omega-3 meal, HDL of group A subjects showed a
      decrease in TG, a reciprocal increase in CE, and either no changes or minor
      changes in phospholipid (PL) and free-cholesterol (FC) levels. The results show
      that HP subjects with mild preprandial hypertriglyceridemia respond to a single
      fat meal differently than subjects with normotriglyceridemia, and that this
      difference is the result of HP in addition to other factors such as low LPL and
      HTGL activities, high plasma apo C-III levels, and apo E2 phenotype.

PMID- 8474324
TI  - Checklist for the methods section of dietary investigations.

PMID- 8474325
TI  - Ketone and lactate metabolism: an exchange of conclusions.

PMID- 8474326
TI  - Ketone and lactate metabolism: an exchange of conclusions.

PMID- 8474327
TI  - In-frame gene fusion.

PMID- 8474328
TI  - Gene expression in cell-free system on preparative scale.

PMID- 8474329
TI  - Cell-free expression vector: use of insect virus translational initiation signal
      for in vitro gene expression.

PMID- 8474330
TI  - Cell-free expression of large collections of cDNA clones using positive-selection
      lambda phage vectors.

PMID- 8474331
TI  - Site-specific mutagenesis in plasmids: a gapped circle method.

PMID- 8474332
TI  - Polymerase chain reaction-based point mutagenesis protocol.

PMID- 8474333
TI  - High-level secretion of heterologous proteins by Bacillus brevis.

PMID- 8474334
TI  - Gene splicing by overlap extension.

PMID- 8474335
TI  - Chemical cleavage of mismatch to detect mutations.

PMID- 8474336
TI  - Vector pPLEX for expression of nonfusion polypeptides in Escherichia coli.

PMID- 8474337
TI  - Expression and screening in yeast of genes mutagenized in vitro.

PMID- 8474338
TI  - Screening of complementary DNA library using radiolabeled antigen.

PMID- 8474340
TI  - Rapid colony hybridization on Whatman 541 paper using oligonucleotide probes.

PMID- 8474339
TI  - Alternatives to X-galactopyranoside in screening recombinant clones based on pUC
      derived plasmid vectors.

PMID- 8474341
TI  - Detection of DNA in Southern blots with chemiluminescence.
AB  - The chemiluminescent detection methods described in this chapter have been
      successfully applied to the detection of plasmid DNA and genomic DNA in Southern
      and sequencing protocols. The high sensitivity and the simplicity of AMPPD are
      instrumental in making the chemiluminescent detection of DNA successful in
      hybridization assays. This detection technique has also been used to detect DNA
      in dot blots and in situ hybridization experiments as well as proteins in enzyme
      linked immunosorbent assays (ELISAs) and Western blots.

PMID- 8474342
TI  - Picogram detection of stable dye-DNA intercalation complexes with two-color laser
      excited confocal fluorescence gel scanner.
AB  - The stable complexes between highly fluorescent, polyfunctional intercalators and
      dsDNA can be used to detect dsDNA in agarose gels at picogram levels and for
      multicolor detection of multiplexed dsDNA fragments. Development of additional
      DNA-binding fluorophores with appropriate spectroscopic properties will expand
      the range of applications. In principle, the DNA-dye intercalation complexes
      represent a more sensitive alternative to an established approach to fluorescent
      labeling and detection of restriction fragments by ligation to single-stranded
      short oligonucleotides labeled with different fluorochromes, followed by
      separation on denaturing polyacrylamide gels. The latter technique gives near
      single-base resolution up to 400 bases and the ability to quantitate fragment
      size up to 2000 bases, and has been successfully applied to cosmid mapping.
      Detection of DNA fragments as intercalation complexes requires that the
      separations be performed on agarose gels under nondenaturing conditions. Such
      conditions have been used for extensive mapping of yeast cosmids with
      postelectrophoresis staining with ethidium bromide. For the patterns on agarose
      gels, the magnitude of the "error window," which specifies how similar two
      fragments must be before the corresponding fragments in different digests are
      paired, was reported to be strongly size dependent. The error window was expanded
      by a factor of 1.3 for fragments from 400 to 600 bp, 1.2 for fragments from 600
      to 800 bp, and 1.1 for fragments from 800 to 1000 bp. Moreover, it was necessary
      to introduce corrections for systematic differences between size estimates taken
      from two different gels. For the multiplexing procedure described here, the size
      estimates for fragments from 600 bp to over 23 kbp were in close agreement with
      actual sizes as determined from DNA sequence (Table I), and certainly within the
      error windows given above. The multiplexing procedure should also minimize errors
      introduced by gel-to-gel variations in mobility, because the standard and
      unknowns are always run in the same lanes. Kohara et al. established a physical
      map of almost the entire Escherichia coli chromosome by analysis of a large
      genomic library. In this case, partial restriction digests were used to generate
      patterns of fragments and the mapping was performed by agarose gel
      electrophoresis. The disadvantage of this approach is that fewer fragments are
      generated. However, this is compensated for by the fact that partial digests
      reveal the order of the fragments produced and thus greatly increase the amount
      of information relevant to the question of overlap between different DNA
      fragments.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8474343
TI  - Alginate as matrix support for yeast artificial chromosome cloning.

PMID- 8474344
TI  - Genome walking by single specific primer-polymerase chain reaction.

PMID- 8474345
TI  - Application of electroporation in recombinant DNA technology.

PMID- 8474346
TI  - Stable high-level gene expression in mammalian cells by T7 phage RNA polymerase.

PMID- 8474347
TI  - Transformation of intact yeast cells by electroporation.

PMID- 8474348
TI  - Optimizing the biolistic process for different biological applications.
AB  - The biolistic process is still rapidly evolving. We do not anticipate further
      major improvements in biolistic apparatus. There will probably still be further
      major improvements in particles, DNA coating, and vectors, as well as significant
      further advances in understanding of biological determinants of cell penetration
      and survival. The technology has currently reached the point at which it can be
      readily and reliably used for a wide range of applications. Given the information
      presented in this chapter, new applications can be optimized fairly readily.

PMID- 8474349
TI  - Chloroplast transformation in Chlamydomonas.

PMID- 8474350
TI  - Foreign gene expression in chloroplasts of higher plants mediated by tungsten
      particle bombardment.

PMID- 8474351
TI  - Generation and analysis of vaccinia virus recombinants.

PMID- 8474352
TI  - Gene transfer into primary and established mammalian cell lines with
      lipopolyamine-coated DNA.

PMID- 8474354
TI  - Molecular basis of cancer: oncogenes and tumor suppressor genes.

PMID- 8474353
TI  - Overproduction of proteins using expression-cassette polymerase chain reaction.

PMID- 8474355
TI  - Efficient adsorption of lysostaphin on bacterial cells of lysostaphin-resistant
      Staphylococcus aureus mutant.
AB  - A simple and efficient method for the purification of staphylolytic endopeptidase
      (lysostaphin) contained in culture supernatant of Staphylococcus simulans biovar
      staphylolyticus strain by adsorption of the enzyme on bacterial cells of
      lysostaphin-resistant S. aureus mutant was successfully devised. Lysostaphin was
      sufficiently absorbed on the heat-killed mutant cells derived from S. aureus
      Cowan I and efficiently eluted by 3 M KSCN. Enzyme preparation obtained by a
      single procedure of the affinity purification was pure enough for practical use.
      The yield of the enzyme was 25 mg from 1 liter culture and recovery rate was 64%.

PMID- 8474356
TI  - Applications of polymerase chain reaction for identification of dengue viruses
      isolated from patient sera.
AB  - A simple and sensitive procedure of reverse transcriptase polymerase chain
      reaction (RT-PCR) was developed previously such that all 4 serotypes of dengue
      viruses could be detected and their serotypes identified simultaneously in a
      single-step procedure. In this study we compared the RT-PCR with a conventional
      immunoperoxidase (PAP) staining method for the identification of dengue viruses
      currently isolated from patient sera. Sixty-six sera taken from dengue
      hemorrhagic fever (DHF) patients were subjected to virus isolation by inoculating
      onto C6/36 cell cultures. Screening for the presence of dengue viruses in culture
      fluids was done after 7 days of incubation by PAP staining using hyperimmune
      rabbit anti-dengue virus antibody as the primary reagent. Dengue viruses in
      positive cultures were further identified for their serotypes by PAP using type
      specific monoclonal antibodies (MAb) and by RT-PCR. Thirty-two out of the 66
      serum specimens tested (48.5%) were positive for dengue viruses. Of these, 5 were
      type 1 (DEN-1), 25 were type 2 (DEN-2) and 2 contained both DEN-1 and DEN-2. All
      cultures that were positive by PAP method were also positive by RT-PCR and vice
      versa. Thus, the results obtained by RT-PCR were in good agreement with those by
      PAP. It is important to point out that while all 5 DEN-1 isolates reacted readily
      with the MAb 1F1, only 2 of them could be identified by the MAb 15F3. Our data
      suggest that antigenic variation among DEN-1 isolates occur frequently and this
      should be taken into consideration in the selection of appropriate type-specific
      MAb for serotyping of dengue viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474357
TI  - Suppression of ADCC by immune complexes formed in vitro in Mycobacterium leprae
      infected mice.
AB  - Antibody-dependent cellular cytotoxicity (ADCC) was assessed in mice infected
      experimentally with Mycobacterium leprae and injected simultaneously with in
      vitro-formed immune complexes (IC). Significant decrease in the ADCC function was
      observed in animals given IC at zero day (0dIC) and 3 months (3mIC) post
      inoculation with M. leprae, when ADCC activity was assessed at 3, 6 and 9 months
      period. From the data obtained we believe that ADCC is suppressed by IC formed in
      vitro.

PMID- 8474358
TI  - Cholera toxin (choleragen)-polymorphonuclear leukocyte interactions: effect on
      migration in vitro and Fc gamma R-dependent phagocytic and bactericidal activity.
AB  - PMNL leukocytosis is a feature common to many types of infectious and
      inflammatory diseases. How PMNL are recruited to tissues is not yet clear
      although it is a question that has considerable clinical importance. We
      investigated the function of PMNL which migrated through an artificial barrier
      (Chinese hamster ovary (CHO) cells, collagen and nylon cloth membrane) subjected
      to CT or choleragenoid treatment toward plain medium (the same RPMI in the upper
      and lower chamber) or medium containing chemotactic factor (fMLP or LPS or ZAS).
      CT treatment significantly (P < 0.01) reduced the Fc gamma R expression on the
      surface of PMNL. The PMNL functions, namely, migration, phagocytic activity and
      intracellular killing of staphylococci, also have been reduced significantly (P <
      0.01). Fc gamma R expression and some functions of PMNL that migrate to
      chemoattractants were reduced, irrespective of the presence or absence of CT;
      however, the inhibitory effect of CT on PMNL function was observed only when PMNL
      migrate to the lower chamber without chemotactic factor. On the other hand
      choleragenoid treatment of CHO cells did not have any significant influence on
      PMNL function and Fc gamma R expression. In conclusion, our experiments
      demonstrate that CT reduces EAFc rosetting and the Fc gamma R-dependent
      phagocytic and bactericidal activity of bovine blood PMNL.

PMID- 8474359
TI  - Inhibitory effect of 8-(N,N-diethylamino)octyl-3,4,5-trimethoxybenzoate
      hydrochloride (TMB-8) on germination of Bacillus cereus T spores.
AB  - Effect of 8-(N,N-diethylamino)octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB
      8), a calcium antagonist, on germination of Bacillus cereus T spores induced by L
      alanine and inosine was investigated. TMB-8 had no effect on the germination of
      heat-activated spores, whereas it inhibited that of nonactivated spores. The TMB
      8 inhibitory effect was antagonized competitively by inosine, but not by L
      alanine. Addition of Ca2+ reversed the inhibitory effect of TMB-8 in a dose
      related fashion. Based on the results, a role of inosine and a site(s) for
      inhibitory action of TMB-8 in the process leading to the germination of
      nonactivated spores were discussed.

PMID- 8474360
TI  - Effects of cytochalasins B and D on Staphylococcus aureus adherence to and
      ingestion by mouse renal cells from primary culture.
AB  - Cytochalasin B (CB) and cytochalasin D (CD), inhibitors of microfilament function
      of host cell, were examined for their effects on Staphylococcus aureus Cowan I
      adherence to and ingestion by several types of the hyperosmolarity-tolerant (HOT)
      cells obtained from primary culture of mouse kidney. Staphylococcal adherence to
      the HOT cells with epithelial appearance was extraordinarily enhanced by the
      treatment of those cells with both 5 micrograms/ml of CB and CD. In particular,
      staphylococci adhered to the periphery rather than the center of each
      cytochalasin-treated cell. Staphylococcal ingestion by all types of the HOT cells
      was markedly inhibited by CD in spite of the enhanced adherence. Contrary to our
      expectation, inhibition by CB was incomplete, and the enhanced adherence of
      staphylococci to CB-treated cells resulted in the enhanced ingestion.

PMID- 8474361
TI  - Fibronectin-binding proteins of a human oral spirochete Treponema denticola.
AB  - Major polypeptides from a human oral spirochete Treponema denticola ATCC 33520
      were examined to demonstrate their ability to bind to human plasma fibronectin by
      immunoblot analysis. Of three main polypeptides separated on sodium dodecyl
      sulfate polyacrylamide gels 53,000-daltons (53-kDa) and 72-kDa surface antigenic
      proteins and a 38-kDa axial flagellar protein showed the ability to bind to
      fibronectin, suggesting that fibronectin on host cells can mediate cytoadherence
      of T. denticola by its binding to the surface proteins or the exposed 38-kDa
      axial flagellar protein.

PMID- 8474362
TI  - Protective activity of antisera against isolates of Borrelia burgdorferi from
      various geographical origins.
AB  - Antisera from rabbits immunized with two Japanese strains of Borrelia
      burgdorferi, HP3 an isolate from Ixodes persulcatus and HO14 an isolate from I.
      ovatus, or the European strain P/Bi isolated from human cerebrospinal fluid (CSF)
      did not passively protect hamsters from challenge with the infectious strain 297,
      a North American isolate from patient CSF. Antisera to strains 297 and B31, a
      North American isolate from I. dammini, however, provided protective effect to
      challenge with strain 297. Immune mice sera in the presence of homologous B.
      burgdorferi antigen induced the production of oxygen intermediates from mouse
      peritoneal exudate cells. Heterologous B. burgdorferi antigen had no effect.
      These results suggest that antigenic properties of Japanese strains are different
      from those of North American and European isolates.

PMID- 8474363
TI  - Genetic transformation in Helicobacter pylori.
AB  - Genetic transformation in Helicobacter pylori was investigated by using its
      chromosomal and plasmid DNAs. Six out of the eight strains exhibited the natural
      competence for incorporation of H. pylori chromosomal DNA, and all the strains
      incorporated the donor DNA efficiently by washing and concentrating the cells
      with a glycerol solution. The much higher frequency of transformation was
      obtained in each strain by means of electroporation. Electroporation experiments
      were also conducted by use of the recombinant DNAs consisting of the H. pylori
      and Escherichia coli plasmids as the donors, and the occurrence of the homologous
      recombination was demonstrated between the incoming H. pylori plasmid-derived
      region and the corresponding region of the originally residing plasmid in H.
      pylori.

PMID- 8474364
TI  - Quality assurance of hospital transfusion practice.

PMID- 8474365
TI  - Monash University Centre for Rural Health.

PMID- 8474366
TI  - The International Association of Bioethics.

PMID- 8474367
TI  - Child homicide--the extreme of child abuse.
AB  - OBJECTIVE: To review cases of fatal child abuse, looking for any characteristic
      features of these cases. DESIGN AND SETTING: A case review of all childhood
      deaths at The Children's Hospital, Camperdown, between January 1976 and December
      1990. Cases with a definite diagnosis of child abuse were extracted. Cases where
      there was only a suspicion of child abuse as the cause of death were not
      included. SUBJECTS: Seventeen cases of fatal child abuse were reviewed with
      emphasis on autopsy findings and sociological data. RESULTS: All children who
      died were less than three years of age; nine were under one year. Seventy-six per
      cent died from head injury and 24% from asphyxia or strangulation. In addition to
      their fatal injuries, 41% had multiple bruises on the trunk and limbs. Thirty
      five per cent had evidence of previous physical abuse. CONCLUSIONS: The commonest
      age for fatal child abuse is the first year of life. When physical abuse occurs
      in children under three years, and particularly under one year, a thorough
      assessment, follow-up and institution of appropriate supportive services are
      essential, as the abuse may be an early warning of a subsequent fatal episode of
      abuse. The introduction of a process of review of child deaths may increase
      awareness of and help prevent fatal child abuse.

PMID- 8474368
TI  - Preoperative autologous blood donation. Linkage of the public and private
      hospital sectors.
AB  - OBJECTIVE: To evaluate the safety and efficacy of a preoperative autologous blood
      donation (PABD) program with liberal patient exclusion criteria. DESIGN:
      Prospective patient accrual from September 1990 to May 1992. SETTING: A PABD
      program in a public tertiary care hospital linked with a specialist orthopaedic
      practice in a private hospital. PATIENTS: One hundred and twenty patients
      consecutively scheduled for orthopaedic surgery were referred for PABD. There
      were 77 women (median age, 63 years) and 43 men (median age, 62 years). One-third
      of patients were 70 or more years old. Coexistent medical disease, mainly
      cardiovascular, was present in 46% of patients and 3% were excluded because of
      coexisting morbidity. Total hip or total knee replacement was performed in a
      private hospital with intraoperative or postoperative blood salvage in 37% of the
      patients. OUTCOME MEASURES: Adverse effects of PABD, autologous blood collected
      and used and homologous blood transfused. RESULTS: One hundred and sixteen
      patients donated 267 units of autologous blood. In 70 patients undergoing total
      hip replacement, 78% donated three and 20% donated two units, with 95% of
      autologous blood being used. In 38 patients undergoing total knee replacement,
      42% donated two units and 55% donated one unit, with 87% of autologous blood
      being transfused. Seventy-eight per cent of all patients only received autologous
      blood. In the remaining patients, homologous blood use was confined to two units
      or less in 80%. Hypotensive episodes associated with phlebotomy occurred in 3% of
      patients, and 13% of patients had preoperative haemoglobin levels ranging from 85
      100 g/L without adverse clinical effects. CONCLUSION: A hospital-based PABD
      program with less strict patient exclusion criteria does not prejudice the
      clinical status of the donors. Its linkage to private hospitals can significantly
      reduce the use of homologous blood in selected elective surgery.

PMID- 8474369
TI  - Improving general practitioner involvement in urban hospitals. Departments or
      divisions of general practice.
AB  - OBJECTIVE: To discover what measures have been taken in urban Australian
      hospitals to involve general practitioners (GPs) in public hospital services.
      DESIGN: A descriptive study. Data were collected by postal survey. SETTING:
      Hospitals in urban areas. MAIN OUTCOME MEASURES: Appointment of GP affiliates or
      associates, existence of departments or divisions of general practice, appointed
      GP liaison positions and formal arrangements for GP shared care and discharge
      planning. RESULTS: Ninety-five of 102 hospitals (93%) responded to a postal
      survey. Sixty-five per cent of respondent hospitals had appointed GP affiliates
      or associates, 32% had a division or department of general practice and 41% had a
      designated GP liaison position. Forty per cent had formal GP shared care programs
      and 14% had formal GP involvement in discharge planning. CONCLUSION: There was a
      high level of adoption of measures to involve GPs in urban hospitals. However,
      only a minority of hospitals had comprehensive measures in place and sufficient
      support for this to occur.

PMID- 8474370
TI  - Assessment and selection of patients for day surgery in a public hospital.
AB  - OBJECTIVE: To describe methods used for adult patient assessment and selection
      for day case surgery at a major Australian teaching hospital. DESIGN: A
      prospective analysis of assessment data and information from the unit's
      computerised database. PATIENTS AND SETTING: Five thousand day patients
      consecutively admitted to the Day Surgical Unit, Royal Adelaide Hospital. MAIN
      OUTCOME MEASURES: The proportion of patients assessed only by trained nursing
      assessment staff was determined and compared with that for patients requiring
      additional anaesthetic assessment before surgery. The percentage of patients
      requiring preoperative investigations was established. Unanticipated hospital
      admission rates were calculated for surgical, anaesthesia-related and social
      reasons. RESULTS: After initial screening by a trained assessment nurse, 46% of
      patients required additional review by an anaesthetist before the day of surgery.
      The remaining 54% were assessed by an anaesthetist on the day of surgery.
      Preoperative investigations were ordered by anaesthetists in 8.5% of all day
      patients. The assessment methods outlined resulted in a 1.28% rate of
      unanticipated hospital admissions. This admission rate was mostly caused by
      complications of surgery (0.94%). Only 0.12% of patients were admitted for
      anaesthesia-related reasons and 0.14% were admitted for social reasons.
      CONCLUSIONS: This cost-effective system allows suitable patients and procedures
      to be identified, with a satisfactory unanticipated hospital admission rate.
      Satisfactory assessment also results in short preoperative waiting periods, fewer
      cancellations, reduced postoperative problems and more satisfied patients. The
      development of an efficient assessment system is aided by the use of a dedicated
      day surgery area with experienced nursing staff, the use of a comprehensive
      patient questionnaire and coordination by experienced day surgery anaesthetists.

PMID- 8474371
TI  - Rheumatic fever and chronic rheumatic heart disease in Yarrabah aboriginal
      community, north Queensland. Establishment of a prophylactic program.
AB  - OBJECTIVE: To establish a program for the prevention of rheumatic fever and
      rheumatic heart disease in a semi-isolated Aboriginal community in far north
      Queensland and to test its efficacy. DESIGN: A prevalence study of acute
      rheumatic fever and chronic rheumatic heart disease was conducted in the
      community in 1985 and subjects with possible acute rheumatic fever were assessed.
      A prophylactic antibiotic program was instituted. Records were kept of the
      prevalence of acute rheumatic fever for six years after the 1985 survey. A second
      survey of the community was held in 1991 to detect chronic rheumatic carditis
      resulting from undetected acute rheumatic fever. SETTING: The Yarrabah Aboriginal
      community in north Queensland (latitude 17 degrees S). The program was conducted
      by the Yarrabah Health Team, a part of the North Queensland Aboriginal Health
      Division. PARTICIPANTS: The whole Yarrabah community (population 1250) was
      invited to participate. In 1985, after the completion of an educational program,
      89% of the community cooperated in the survey. There was no educational program
      before the 1991 survey and the compliance rate was much lower. Importantly,
      however, 87% of the vulnerable group (4-16 year olds) were examined.
      INTERVENTIONS: After the 1985 survey, all community members aged 4-16 years had
      throat swabs taken three times each year. Those with swabs showing Group A
      streptococci were treated; their contacts were also swabbed and treated if Group
      A streptococci were found. RESULTS: Before the institution of the swabbing
      program there were four new cases of acute rheumatic fever each year in the
      Yarrabah community. In the six years after the program was introduced only one
      case of acute rheumatic fever occurred. This was at a time when swabbing had
      temporarily lapsed for a three-month period. CONCLUSIONS: These results support
      the use of a prophylactic antibiotic program in Aboriginal communities as a cost
      effective and efficient method for the prevention of rheumatic fever. The
      cooperation of the community is an integral part of its success and this can be
      obtained by community education.

PMID- 8474372
TI  - A cost-utility approach to the use of 5-fluorouracil and levamisole as adjuvant
      chemotherapy for Dukes' C colonic carcinoma.
AB  - OBJECTIVE: To perform an economic evaluation of the joint use of 5-fluorouracil
      and levamisole as adjuvant chemotherapy in patients with fully resected Dukes'
      Stage C carcinoma of the colon, compared with resection and no chemotherapy. The
      evaluation was prompted by a study (N Engl J Med 1990; 322: 352-358) which
      recommended a new treatment standard for colon cancer: a 52-week course of
      fluorouracil, with levamisole every second week, as adjuvant chemotherapy. This
      recommendation raised several concerns, particularly about the quality of life of
      patients undergoing such a long course of chemotherapy and the costs to the
      health care system. METHODS: The cost of the surgery plus chemotherapy was
      estimated and compared with the cost of surgery alone. Descriptions of quality of
      life were developed from interviews with patients and health professionals, and
      the time trade off technique was then used to derive utility weights from a small
      sample (16) which were used to adjust length of life to reflect quality, in terms
      of a "quality adjusted life year" (QALY). RESULTS: Chemotherapy increases the
      total cost of treating a patient with colon cancer by $7000, from $6000 to
      $13,000. Incorporating quality of life reduced the extra benefit gained from the
      chemotherapy from 2.4 life years to 0.4 QALYs. Thus the result is a cost of
      $17,500 to achieve an extra QALY from this particular treatment. CONCLUSIONS: The
      results of this analysis are only tentative, as the quality of life descriptions
      were not measured over time but from a cross-sectional survey of patients, and
      the valuations of health states were derived from a small sample. However, we
      believe them to be indicative, and conclude that it is perhaps more appropriate
      for the use of chemotherapy to be an option rather than standard treatment until
      further research on these aspects is complete.

PMID- 8474373
TI  - It is HIV: immediate and long-term plans.

PMID- 8474374
TI  - The rational use of the HIV antibody test.
AB  - The clinical skills of the medical profession can be used to identify unsuspected
      HIV infection in a cost-effective way. However, other strategies are needed to
      optimise the detection of HIV infection and achieve the benefits to patients and
      the community that result from detection.

PMID- 8474375
TI  - Liability for failure to diagnose HIV infection and AIDS.
AB  - In the United States a patient has sued a doctor for failing to diagnose AIDS,
      resulting in a two-year delay before correct diagnosis and treatment. At least
      one similar case has been commenced in Australia and more are likely. The time
      has come when courts in this country are likely to find that failure to diagnose
      symptoms of HIV infection and AIDS will constitute negligence.

PMID- 8474376
TI  - Locum in Alice Springs.

PMID- 8474377
TI  - An outbreak of serotype 1 Streptococcus pneumoniae infection in central
      Australia.
AB  - An outbreak of serotype 1 Streptococcus pneumoniae infection involving both
      adults and children occurred in central Australia during the winter months of
      1991. Eighteen patients, mainly Aboriginal men, presented with culture-positive
      serotype 1 bacteraemic pneumonia. In this group, 11 of 12 adults for whom medical
      records were available were alcohol dependent. Thirteen children who were
      separately studied were hospitalised with acute lower respiratory tract
      infection: none had bacteraemia but all had upper airway colonisation by type 1
      pneumococci. Antibiotics taken by 8 of the 13 children before admission to
      hospital may have compromised the isolation of type 1 pneumococci from blood
      cultures. Since the availability of antibiotics, epidemic pneumococcal infection
      is infrequent and has not been reported in Australia. In three outbreaks of type
      1 disease recorded elsewhere crowding and alcoholism were identified as
      contributory factors. In the 16 month period before this outbreak none of 162
      strains of pneumococci isolated from blood (32 strains) and nasopharyngeal
      secretions (130 strains) from Aborigines with acute lower respiratory tract
      infection and meningitis in the Alice Springs region were serotype 1 organisms.

PMID- 8474378
TI  - Renal artery stenosis: current diagnosis and treatment.
AB  - OBJECTIVE: To provide an overview of the current approaches to management of
      renovascular disease. DATA SOURCES: A literature review was performed and key
      references are provided relating to diagnostic tests, particularly captopril
      renography and renal duplex scanning. Options for treatment are reviewed from
      published series to December 1991. We also draw on the experience of our own
      Unit. STUDY SELECTION: Data and opinions from five general reviews of
      renovascular disease, 10 articles on diagnostic tests and five articles relating
      to therapeutic approaches are summarised. CONCLUSION: There is no simple
      screening test for renovascular hypertension that can be applied to an unselected
      population of hypertensive subjects. The diagnosis depends on judicious use of
      non-invasive screening tests in those subjects in whom one suspects, on clinical
      grounds, that there may be an underlying renovascular lesion. Captopril
      renography and duplex scanning of renal arteries are the most reliable non
      invasive screening tests. A team approach with collaboration of hypertension
      specialist/vascular physician, vascular surgeon and experienced interventional
      radiologist is important for rational management and we would emphasise the
      importance of audit procedures.

PMID- 8474379
TI  - Anabolic steroid abuse and cardiac death.
AB  - OBJECTIVE: To examine the relationship between anabolic steroid abuse and cardiac
      death. We report the first two cases in Australia. They are the only reported
      cases in which the anabolic steroid oxymesterone has been detected. This compound
      has never been approved for use in Australia. CLINICAL FEATURES: Two footballers,
      aged 18 and 24, sustained fatal cardiac arrests while at training sessions. Both
      were considered fit and healthy. OUTCOME: Autopsy revealed features of a
      hypertrophic cardiomyopathy in the 18-year-old; the 24-year-old had findings of a
      myocarditis. In both cases the coronary arteries were normal and there was no
      evidence of coronary thrombosis. Urine in both subjects contained the anabolic
      steroid oxymesterone. CONCLUSIONS: There are limited clinical uses for anabolic
      steroids but they are widely abused by athletes in attempts to alter lean body
      mass and strength. Acute non-fatal myocardial infarction was first reported in
      1988 and fatal myocardial infarction in 1990. While a causal relationship is hard
      to prove, it is possible that the anabolic steroid contributed to the increase in
      cardiac size in the first subject and may have increased his responsiveness to
      catecholamines causing an arrhythmogenic event. In the second, the inflammatory
      changes could have provided the focus for an arrhythmia. It would appear that
      anabolic steroid abuse should be considered in any athlete presenting with an
      acute vascular event.

PMID- 8474380
TI  - DNA diagnostic tests: presymptomatic and prenatal.

PMID- 8474381
TI  - Planning bedside teaching--2. Preparation before entering the wards.

PMID- 8474382
TI  - Indoor air quality and sick buildings.

PMID- 8474383
TI  - Laparoscopic vasectomy.

PMID- 8474384
TI  - Passive immunisation against hepatitis C infection.

PMID- 8474385
TI  - Infection and dysuria in women.

PMID- 8474386
TI  - Effectiveness of campaigns to increase Pap smear screening.

PMID- 8474387
TI  - Patterns of elder abuse.

PMID- 8474388
TI  - Modern methods of searching the medical literature.

PMID- 8474389
TI  - Modern methods of searching the medical literature.

PMID- 8474390
TI  - Research problems in general practice.

PMID- 8474391
TI  - Perineal cleansing and individual sterilised packs are not necessary for
      collecting midstream urine specimens.

PMID- 8474392
TI  - Mycoplasma hominis pneumonia.

PMID- 8474393
TI  - The psychoses, schizophrenia and the dementias: a continuum of liability?

PMID- 8474394
TI  - Pulmonary angiography in a non-teaching hospital over a 12-year period.

PMID- 8474395
TI  - Operative assessment and postoperative care in acutely ill patients.

PMID- 8474396
TI  - Haemorrhage after fine-needle aspiration biopsy of an hepatic haemangioma.

PMID- 8474397
TI  - Retropubic extraperitoneal endoscopy.

PMID- 8474398
TI  - Desflurane--a new volatile anesthetic.

PMID- 8474399
TI  - [Behavior of the R-amplitude in ergometric and pharmacologic stress in comparison
      with coronary morphologic findings in patients with coronary heart disease].
AB  - The cause of R-wave amplitude changes in the ECG under load remain unknown. One
      of the possible aetiological factors is myocardial ischaemia. The aim of the
      present study was to investigate possible relationships between amplitude changes
      and transient myocardial ischaemia. In this retrospective study, 89 patients (74
      men, 15 women) were investigated. The results of exercise ECG, a dipyridamole
      test and coronary angiography were available for all patients participating. The
      patients were divided into four groups (group I: patients with relevant coronary
      stenosis [n = 46], group II: patients with no relevant coronary stenoses [n =
      43], group III: patients with pathological results in all three procedures [n =
      29], and group IV: patients with unremarkable findings in all three
      investigations [n = 14] and the R-wave amplitude changes in various phases of
      ergometry and dipyridamole provocation were measured. All four groups showed a
      significance decrease in R-wave amplitude at maximum provocation as compared with
      baseline values. A qualitative analysis of the amplitude changes indicated a
      tendency for them to be dependent on the severity of coronary stenosis. A
      quantitative analysis, however, revealed no significant correlations between the
      R-wave amplitude and ST segment changes or angiographic findings. This means that
      R-wave changes during an exercise ECG or a dipyridamole test do not permit us to
      distinguish between patients with or those without coronary artery stenosis.
      Changes in the R-wave amplitude observed under loading must be due to factors
      other than myocardial ischaemia.

PMID- 8474400
TI  - [Can nuclear magnetic resonance tomography supplement and expand splenic
      diagnosis in malignant systemic diseases? Comparison of nuclear magnetic
      resonance tomography, ultrasound and computerized tomography findings].
AB  - Can magnetic resonance imaging supplement or expand the diagnostic evaluation of
      the spleen in malignant systemic disease? A comparison of magnetic resonance
      imaging, ultrasonography and computed tomography.

PMID- 8474401
TI  - [Comparative study of the pharmacokinetics of amitriptyline oxide and
      trimipramine after single administration in healthy male probands and patients
      with renal failure].
AB  - The pharmacokinetics of the antidepressants amitriptyline oxide and trimipramine
      and their major metabolites amitriptyline, nor-triptyline and
      desmethyltrimipramine, were studied in twelve healthy male subjects (aged from 22
      to 62 years) and twelve patients (aged from 25 to 73 years) with severe renal
      impairment (glomerular filtration rate < 10 ml/min). Oral single doses of 60 mg
      amitriptyline oxide and 50 mg trimipramine, separated by a washout period, were
      administered to all study participants. Blood and urine samples were collected up
      to 120 hours after administration. For trimipramine and desmethyltrimipramine, a
      new HPLC method was developed. The "Fischer Somatic and Undesired Effects Check
      List" was used for the assessment of adverse events. The mean plasma half-life
      and AUC of amitriptyline oxide and its metabolites were significantly higher in
      patients than in healthy adults. For trimipramine the AUC was significantly
      higher in patients. The plasma half-life of trimipramine was longer in patients,
      but statistically not significant. The maximum plasma concentrations for both
      drugs and metabolites were at an average distinctly higher in patients. Clearance
      rate of amitroptylinoxide and trimipramine also differed between the two groups.
      Correlating with these results a high incidence and a longer persistence (in most
      cases > 12 hours) and more pronounced adverse effects were noted in the patient
      group, whereas in volunteers adverse events were only observed up to
      approximately eight hours.

PMID- 8474402
TI  - [Long-term effects of low dosage fish oil on serum lipids and lipoproteins].
AB  - In a prospective and double-blind study, the long-term effects of low dose fish
      oil on serum lipids and lipoproteins was tested in patients with normal or
      moderately elevated serum lipids and compared to the effects of olive oil. The
      compliance to the study medication was evaluated by analysis of serum fatty acids
      and proved to be very good. Dietary supplementation with 9 g fish oil, respective
      3.15 g n-3 fatty acids per day over one year resulted in a decrease of serum
      triglycerides by 26% and increase of HDL-cholesterol by 26%. Treatment with 9 g
      olive oil resulted in an 18% increase of HDL-cholesterol. There was no effect on
      serum-triglyceride levels.

PMID- 8474403
TI  - [Increased plasma endothelin concentrations in patients after liver
      transplantation and in liver cirrhosis].
AB  - Endothelin, one of the most potent vasoconstrictors known today, is released by
      the vascular endothelium. Patients after liver transplantation and patients with
      liver cirrhosis show significantly higher plasma endothelin concentrations and
      significantly reduced results in the quantitative liver function tests (ICG-HL,
      GEC, Lidocaine-HL, MEGX) compared with healthy control persons. The plasma
      endothelin concentrations were better correlated with the more liver bloodflow
      dependent function tests (ICG-HL, Lidocaine-HL) than with the more metabolic
      capacity dependent function tests (GEC, MEGX). As cyclosporine A in vitro can
      increase the liberation of endothelin, we conclude that in patients after liver
      transplantation an endothelin mediated cyclosporine induced hepatotoxicity might
      be the reason for the demonstrated association.

PMID- 8474404
TI  - [Clinical importance of colony stimulating factors].

PMID- 8474405
TI  - [3d generation cephalosporins: clinico-infectiologic evaluation after 10 years].

PMID- 8474406
TI  - [Phytotherapy, an alternative?].

PMID- 8474407
TI  - [Phytotherapy].

PMID- 8474408
TI  - Ureaplasma urealyticum and its role in neonatal lung disease.
AB  - Ureaplasma urealyticum, a species of mycoplasma organisms, is a sexually
      transmitted organism which can cause a pneumonia in premature neonates.
      Ureaplasma urealyticum infection in the neonate occurs secondary to maternal
      transmission of the organism to the neonate. Recent studies show very low birth
      weight neonates with Ureaplasma urealyticum pneumonia are approximately two times
      more likely to develop chronic lung disease. Clinically Ureaplasma urealyticum
      pneumonia presents in a premature neonate and is often coexistent with hyaline
      membrane disease, leukopenia, thrombocytopenia, and continued respiratory
      distress without identification of a causative organism. Diagnosis is generally
      by tracheal aspirate or spinal fluid culture. Ureaplasma urealyticum requires
      specific culture media to grow, and recovery of the organism can take several
      weeks. Clinical management of the infant includes administration of erythromycin
      and meticulous pulmonary toilet. A case study which represents the typical
      presentation of Ureaplasma urealyticum pneumonia is included.

PMID- 8474409
TI  - Reconciliation and healing for mothers through skin-to-skin contact provided in
      an American tertiary level intensive care nursery.
AB  - Feasibility and safety of skin-to-skin contact through the Kangaroo method of
      care in a modern American tertiary intensive care was studied, as well as effects
      of this innovative care on mother's emotional reactions. Eight mother infant
      dyads participated in skin-to-skin contact a minimum of 4 hours each day for six
      days per week during a period of three consecutive weeks. The cognitive
      adaptation framework was used to identify themes in maternal responses. During
      the first week, mothers were preoccupied with childbirth events in attempts to
      understand their sense of loss and victimization. During the second week,
      maternal emotions intensified and manifested in fears for the baby's well-being
      and a need to discuss negative and positive emotional reactions to having a
      premature and sick baby. All mothers requested respite time from skin-to-skin
      contact, so they could deal with their emotional crises. By the third week,
      mothers had an increased sense of meaning, mastery, and self-esteem about what
      had happened to themselves and their infants. Themes of reconciliation and
      healing occurred when mothers placed their infant skin-to-skin in the Kangaroo
      position over the three consecutive weeks that this type of nursing care was
      experienced.

PMID- 8474410
TI  - Prevention of childhood diseases through vaccination.
AB  - Many childhood diseases can be prevented by proper immunization. The purpose of
      this article is to provide information about the risks and benefits associated
      with vaccines used in the United States for children under one year of age.
      Vaccines can be made from live or killed organisms and can stimulate both local
      and systemic immunity. The immunization schedule recommended by the American
      Academy of Pediatrics is presented. Information about the use of routine
      vaccines, their risks and the diseases they prevent, is presented. Vaccines
      included are diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus
      influenzae, influenza viruses and hepatitis B. Research is ongoing to develop new
      vaccines and improve those currently in use.

PMID- 8474411
TI  - The drug-exposed mother and infant: a regional center experience.
AB  - Drug-exposed mothers and infants continue to challenge maternal and infant health
      care resources. The woman who abuses drugs may have a complex social history and
      high resistance to change. Drug use may be intergenerational and long-standing.
      Although cocaine may be a drug of choice, there is often polydrug abuse,
      complicating the assessment of the newborn who may be suffering from an overall
      unstable intrauterine environment due to poor general health and lack of
      nutrition, inadequate prenatal care, and risk of exposure to contaminants from
      street drugs and of infection, including Hepatitis B and HIV. Infants must be
      thoroughly assessed and treated as any newborn at risk. Drug screening and child
      welfare issues are discussed. Hepatitis B immunization is recommended. Ongoing
      assessment of the infant and intervention techniques are described. Since many
      drug-exposed infants go home with their mothers, an integrated plan of care for
      mother and infant may contribute to a therapeutic relationship, facilitate
      maternal attachment behaviors, and motivate maternal rehabilitation. For nurses
      caring for these demanding families, burnout prevention and self-care strategies
      are discussed.

PMID- 8474412
TI  - Communicating compassion: the nursing way.

PMID- 8474413
TI  - Neonatal nursing in Finland.

PMID- 8474414
TI  - 24-hour urine collection device for low birth weight infants.

PMID- 8474415
TI  - Evaluation of cardiac size on the neonatal chest x-ray.
AB  - Cardiac size is only one parameter in the evaluation of the cardiovascular system
      on the neonatal chest x-ray examination. More specific information will be given
      in future columns when specific cardiac defects are discussed. It was our
      intention to present a few basic principles of x-ray interpretation before
      proceeding to the radiologic evaluation of specific disease states. In the next
      few columns we will discuss x-ray findings in infants with respiratory diseases.
      Hyaline membrane disease will be discussed in the next issue.

PMID- 8474416
TI  - Measuring the behavior of high-risk infants.

PMID- 8474417
TI  - Providing learning experiences for student education in the NICU.

PMID- 8474418
TI  - Sodium polystyrene sulfonate (Kayexalate).

PMID- 8474419
TI  - Chlamydia in the neonate.
AB  - Chlamydia trachomatis infections are the most prevalent of all sexually
      transmitted diseases and can be transmitted to the neonate during the birth
      process. Neonatal chlamydial infections include inclusion conjunctivitis and
      chlamydial pneumonia. These infections cause no reported mortality but are
      associated with a high incidence of morbidity in the newborn. Nursing care is
      vitally important in prevention, early detection, and management of neonates with
      chlamydial infections. A knowledge of Chlamydia, its risk factors, clinical
      manifestations, diagnosis, and treatment will assure an improved outcome for the
      entire neonatal population.

PMID- 8474420
TI  - Compendium of animal rabies control, 1993. National Association of State Public
      Health Veterinarians, Inc.
AB  - The purpose of this Compendium is to provide rabies information to veterinarians,
      public health officials, and others concerned with rabies control. These
      recommendations serve as the basis for animal rabies control programs throughout
      the United States and facilitate standardization of procedures among
      jurisdictions, thereby contributing to an effective national rabies control
      program. This document is reviewed annually and revised as necessary.
      Immunization procedure recommendations are contained in Part I; all animal rabies
      vaccines licensed by the United States Department of Agriculture (USDA) and
      marketed in the United States are listed in Part II; Part III details the
      principles of rabies control.

PMID- 8474421
TI  - Recommendations of the Advisory Committee on Immunization Practices (ACIP): use
      of vaccines and immune globulins for persons with altered immunocompetence.

PMID- 8474422
TI  - Populations at risk from air pollution--United States, 1991.

PMID- 8474423
TI  - Nutrition and mortality assessment--southern Sudan, March 1993.
AB  - During the last 5 years of Sudan's decade-long civil war, increased fighting and
      food shortages in southern Sudan have led to displacement of large numbers of
      persons. In late 1992, the United Nations (UN), the government of Sudan, and
      factions of the Sudanese People's Liberation Army negotiated increased access for
      delivery of relief aid to civilians in southern Sudan. To assist in the targeting
      of food and other relief aid, CDC and the U.S. Agency for International
      Development's Office of Foreign Disaster Assistance conducted rapid assessments
      of nutritional status (children aged < 5 years) and mortality (persons of all
      ages) during March 7-19, 1993, at four sites in three states: Ame (Eastern
      Equatoria), Ayod and Kongor (Upper Nile), and Akon (Bahr el Ghazal) (Figure 1).
      This report summarizes findings of the assessments.

PMID- 8474424
TI  - Impact of the expanded AIDS surveillance case definition on AIDS case reporting-
      United States, first quarter, 1993.
AB  - On January 1, 1993, the acquired immunodeficiency syndrome (AIDS) surveillance
      case definition for adolescents and adults was expanded beyond the surveillance
      definition published in 1987 (1) to include all human immunodeficiency virus
      (HIV)-infected persons with severe immunosuppression (< 200 CD4+ T
      lymphocytes/microL or a CD4+ T-lymphocyte percentage of total lymphocytes of <
      14), pulmonary tuberculosis (TB), recurrent pneumonia, or invasive cervical
      cancer. This report reviews AIDS surveillance reports CDC received from local,
      state, and territorial health departments during the first quarter of 1993 and
      summarizes the impact of the changes in the AIDS surveillance case definition.

PMID- 8474425
TI  - Update: dracunculiasis eradication--Nigeria, 1992.
AB  - The reported incidence of dracunculiasis (i.e., Guinea worm disease) in Nigeria
      declined substantially during 1992--the fourth consecutive year in which reports
      of known cases declined. This report summarizes dracunculiasis surveillance data
      for Nigeria and describes progress toward eradication of this disease.

PMID- 8474426
TI  - Linking multiple data sources in fetal alcohol syndrome surveillance--Alaska.
AB  - Although fetal alcohol syndrome (FAS) is a major preventable cause of mental
      retardation in the United States (1), surveillance for this problem is subject to
      at least five constraints: difficulty in identifying the syndrome at birth (2);
      the subjective nature of the diagnosis; variability in the severity and type of
      conditions associated with FAS; age-specific variations in the expression of the
      phenotype; and the lack of specificity in the International Classification of
      Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for FAS. Previous
      studies have documented high rates of FAS among American Indians and Alaskan
      Natives (ANs) (3,4). To better ascertain cases of FAS in Alaska and to determine
      the prevalence of this problem among ANs, the Alaska Department of Health and
      Social Services (ADHSS), the Indian Health Service (IHS), and CDC linked and
      analyzed data from state sources (i.e., birth and death certificates and Medicaid
      claims), an IHS case file, and a private pediatric practice case file. This
      report summarizes the findings from this analysis and presents a preliminary
      minimum FAS prevalence rate for ANs.

PMID- 8474427
TI  - Surveillance for and comparison of birth defect prevalences in two geographic
      areas--United States, 1983-88.
AB  - PROBLEM/CONDITION: CDC and a number of states have developed surveillance systems
      to monitor the birth prevalence of major defects. REPORTING PERIOD COVERED: This
      report covers birth defects surveillance in Metropolitan Atlanta, Georgia and
      selected jurisdictions in California for the years 1983-1988. DESCRIPTION OF
      SYSTEM: The California Birth Defects Monitoring Program and the Metropolitan
      Atlanta Congenital Defects Program are two population based surveillance systems
      that employ similar data collection methods. The prevalence estimates for 44
      diagnostic categories are based on data from 1983 to 1988 for 639,837 births in
      California and 152,970 births in metropolitan Atlanta. The prevalences in the two
      areas are compared adjusting for race, sex and maternal age using Poisson
      regression. RESULTS: Regional differences in the prevalence of aortic stenosis,
      fetal alcohol syndrome, hip dislocation/dysplasia, microcephalus, obstruction of
      the kidney/ureter, and scoliosis/lordosis may be attributable to general
      diagnostic variability. However, differences in the prevalences of arm/hand limb
      reduction, encephalocele, spina bifida, or trisomy 21 (Down Syndrome) are
      probably not attributable to differences in ascertainment because these defects
      are relatively easy to diagnose. INTERPRETATION: Regional differences in prenatal
      diagnosis and pregnancy termination may affect prevalences of trisomy 21 and
      spina bifida. However, the reason for differences in arm/hand limb reduction is
      unknown, but may be related to variability in environmental exposure,
      heterogeneity in gene pool, or random variation. ACTIONS TAKEN: Because of the
      similarities of these data bases, several collaborative studies are being
      implemented. In particular, the differences in the birth prevalence of spina
      bifida and Down Syndrome will focus attention on the impact of prenatal
      diagnosis.

PMID- 8474428
TI  - Influenza--United States, 1988-89.
AB  - PROBLEM/CONDITION: CDC monitors the emergence and spread of new influenza virus
      variants and the impact of influenza on morbidity and mortality annually from
      October through May. REPORTING PERIOD COVERED: This report covers United States
      influenza surveillance conducted from October 1988 through May 1989. DESCRIPTION
      OF SYSTEM: Weekly reports from the vital statistics offices of 121 cities
      provided an index of influenza's impact on mortality; 58 WHO collaborating
      laboratories reported weekly identification of influenza viruses; weekly
      morbidity reports were received both from the state and territorial
      epidemiologists and from 153 sentinel family practice physicians. Nonsystematic
      reports of outbreaks and unusual illnesses were received throughout the year.
      RESULTS: During the 1988-89 influenza season, influenza A (H1N1) and B viruses
      were identified in the United States with essentially equal frequency overall,
      although both regional and temporal patterns of predominance shifted over the
      course of the season. Throughout the season increases in the indices of influenza
      morbidity in regions where influenza B predominated. Only 7% of identified
      viruses were influenza A (H3N2), but not isolations of this subtype increased as
      the season waned and it subsequently predominated during the 1989-90 season.
      During the 1988-89 season outbreaks in nursing homes were reported in association
      with influenza B and A (H3N2), but not influenza A (H1N1). INTERPRETATION: The
      alternating temporal and geographic predominance of influenza strains A (H1N1)
      and B during the 1988-89 season emphasizes the importance of continual attention
      to regional viral strain surveillance, since amantadine is effective only for
      treatment and prophylaxis of influenza A. ACTIONS TAKEN: Weekly interim analyses
      of surveillance data produced throughout the season allow physicians and public
      health officials to make informed choices regarding appropriate use of
      amantadine. CDC's annual surveillance allows the observed viral variants to be
      assessed as candidates for inclusion as components in vaccines used in subsequent
      influenza seasons.

PMID- 8474429
TI  - Production and characterization of antibodies specific for the imidazoline
      receptor protein.
AB  - Polyclonal antibodies were raised in rabbits against a 70-kDa ligand-binding
      protein of the imidazoline receptor purified from solubilized bovine adrenal
      chromaffin cell membranes by ligand affinity chromatography. The antibodies
      labeled a single protein (approximately 70 kDa) in Western blots of bovine
      adrenal chromaffin cell membranes, inhibited 40% of specific [3H]idazoxan binding
      to imidazoline receptors in chromaffin cell membranes, and specifically
      immunoprecipitated 75% of all imidazoline-binding activity of solubilized
      chromaffin cell membrane proteins. The antibodies specifically immunostained
      heterogeneous subsets of cultured bovine chromaffin cells. They stained
      subpopulations of chromaffin cells of rat adrenal medulla but not the cells of
      adrenal cortex. We conclude that the antibodies recognize with high specificity
      and selectivity a approximately 70-kDa binding protein associated with or
      representing the imidazoline receptor that is expressed in mammalian species.
      Highly specific antibodies against the imidazoline receptor protein will permit
      mapping of the distribution of imidazoline receptors in brain and periphery and
      also may be useful as probes in cloning genes encoding the imidazoline receptors.

PMID- 8474430
TI  - Identification of residues important for ligand binding to the human 5
      hydroxytryptamine1A serotonin receptor.
AB  - The functional significance of the conserved amino acids within transmembrane
      regions II and VII of the human 5-hydroxytryptamine (5-HT)1A receptor was
      analyzed by oligonucleotide-directed mutagenesis followed by transient expression
      of the mutated receptor genes in COS-1 cells. The substitution of a conserved
      asparagine at position 396 (transmembrane region VII) with either alanine,
      phenylalanine, or valine resulted in a receptor that did not bind the 5-HT1A
      agonist 8-hydroxy-2-(di-n-[3H]propylamino)tetralin. In contrast, replacement of
      Asn396 with glutamine did not affect agonist binding. In addition, serine
      residues at positions 391 and 393 (transmembrane domain VII) were changed to
      alanine. Changing the less conserved Ser391 to alanine had no effect on ligand
      binding. However, replacement of the conserved Ser393 with alanine reduced ligand
      binding by 86%. Replacement of a conserved aspartate at position 82
      (transmembrane region II) with alanine also produced a receptor without
      detectable agonist binding. Protein immunoblotting detected receptor protein of
      approximately 51 kDa in both wild-type and mutant receptor-expressing cells,
      indicating that these mutations probably did not affect expression or processing
      of the protein. Importantly, the sequence of the human 5-HT1A receptor described
      in this paper differs from the published sequence [Nature (Lond.) 329:75-79
      (1987)] in transmembrane region IV. The present sequence encodes a protein of 422
      amino acids, instead of the 421-amino acid protein that has been described
      previously [Nature (Lond.) 329:75-79 (1987)], and has a change in the sequence in
      transmembrane region IV from ... RPRAL ... to ... RRAAA ..., which corresponds to
      the published sequence [J. Biol. Chem. 265:5825-5832 (1990)] of the rat 5-HT1A
      receptor. Moreover, conversion of the transmembrane region IV sequence of the
      present clone to that of the published sequence by site-directed mutagenesis
      abolished ligand binding to the receptor.

PMID- 8474431
TI  - Regulation of thymidylate synthase in human colon cancer cells treated with 5
      fluorouracil and interferon-gamma.
AB  - The effects of fluorouracil (5-FU) and interferon-gamma (IFN-gamma) on the
      regulation of thymidylate synthase (TS) gene expression were investigated in the
      human colon cancer H630 cell line. By Western immunoblot analysis, TS protein
      levels in H630 cells were increased 3-, 5.5-, 5-, and 2.5-fold after 8-, 16-, 24
      , and 36-hr exposure to 1 microM 5-FU, respectively. When H630 cells were exposed
      to varying concentrations of 5-FU (0.3-10 microM) for 24 hr, increases in TS
      protein up to 5.5-fold were observed. A 24-hr exposure to 1 microM 5-FU resulted
      in a 4.5-fold increase in the level of TS protein, whereas in 5-FU/IFN-gamma
      treated cells TS protein was increased by only 1.8-fold, compared with control
      cells. IFN-gamma treatment alone did not affect TS protein levels, relative to
      control. Northern blot analysis revealed no changes in TS mRNA levels when H630
      cells were exposed either to 1 microM 5-FU for 8-36 hr, to varying concentrations
      of 5-FU (0.3-10 microM) for 24 hr, or to the combination of 5-FU and IFN-gamma.
      Pulse-labeling studies with [35S]methionine demonstrated a 3.5-fold increase in
      net synthesis of TS in cells treated with 1 microM 5-FU, whereas the level of
      newly synthesized TS increased only 1.5-fold in cells treated with 5-FU/IFN
      gamma, compared with control cells. Pulse-chase studies revealed that the half
      lives of TS protein in control and 5-FU-treated cells were equivalent. These
      findings demonstrate that the increase in TS protein after 5-FU exposure and the
      subsequent inhibitory effect of IFN-gamma on TS protein expression are both
      regulated at the post-transcriptional level.

PMID- 8474432
TI  - [3H]PD 140376: a novel and highly selective antagonist radioligand for the
      cholecystokininB/gastrin receptor in guinea pig cerebral cortex and gastric
      mucosa.
AB  - The specific binding characteristics of the novel cholecystokinin (CCK)B/gastrin
      receptor-selective peptoid antagonist radioligand [3H]PD 140376 were investigated
      using membrane homogenates prepared from guinea pig cerebral cerebral cortex and
      gastric fundic mucosa. [3H]PD 140376 (0.01-10 nM) bound to both cerebral cortex
      and gastric gland homogenates with comparable high affinity (Kd, 0.1-0.2 nM) and
      to an apparent single population of sites with Bmax values of 119 and 296 fmol/mg
      of protein, respectively. The level of specific binding, defined as that
      displaced by unlabeled CCK sulfated octapeptide, was routinely between 60 and 70%
      in the cortex and between 50 and 60% in the fundic mucosa. Pharmacological
      characterization of the [3H]PD 140376-labeled binding sites with a series of
      agonist and antagonist ligands selective for each of the CCK receptor subtypes
      demonstrated, in both preparations, an affinity profile consistent with that of
      the CCKB/gastrin receptor. However, Hill slopes for the competition curves for
      the unlabeled agonist ligands against specific [3H]PD 140376 binding were
      significantly less than unity, whereas those for the antagonist ligands,
      including unlabeled PD 140376, were close to unity. The affinity and Hill slope
      for PD 140376 and the related CCKB/gastrin antagonist CI-988 were unaffected by
      the presence of the nonhydrolyzable GTP analogue guanylyl-5'-imidodiphosphate. In
      contrast, guanylyl-5'-imidodiphosphate caused a characteristic decrease in
      affinity and an increase in the Hill slopes towards unity for the agonist ligands
      CCK sulfated octapeptide and pentagastrin. The binding characteristics of
      unlabeled PD 140376 were also unaffected by the presence of the monovalent cation
      sodium. In conclusion, the present study has demonstrated that [3H]PD 140376 is
      the most potent and selective antagonist radioligand yet described for the
      characterization of CCKB/gastrin receptors in the central and peripheral nervous
      systems.

PMID- 8474433
TI  - Human bilirubin UDP-glucuronosyltransferase catalyzes the glucuronidation of
      ethinylestradiol.
AB  - The synthetic estrogen ethinylestradiol is extensively eliminated as glucuronide
      metabolites in humans, but the UDP-glucuronosyltransferases (UGTs) catalyzing
      this reaction have not been identified. Therefore, ethinylestradiol was tested as
      a substrate for cloned human UGTs stably expressed in V79 cell lines. Two cloned
      expressed human enzymes, a bilirubin UGT and a phenol UGT, were observed to
      catalyze the glucuronidation of ethinylestradiol. High performance liquid
      chromatographic analysis of the products formed revealed that the expressed
      bilirubin UGT specifically produced ethinylestradiol-3-glucuronide. In human
      liver microsomes the ratio of 3-glucuronide/17-glucuronide was 97:3. Subsequent
      study of the cloned expressed enzymes and human liver microsomes from Crigler
      Najjar patients by kinetic analysis and by substrate inhibition strongly
      indicated that a human liver bilirubin UGT was largely responsible for
      glucuronidation of ethinylestradiol. These results may provide an explanation for
      jaundice caused by ethinylestradiol in certain susceptible individuals.

PMID- 8474434
TI  - Proto-oncogene FosB: the amino terminus encodes a regulatory function required
      for transformation.
AB  - Overexpression of some members of the Fos gene family, including FosB, leads to
      transformation of established rodent fibroblasts. We have previously shown that
      transformation by FosB requires the presence of a C-terminal transcriptional
      activation domain. We now report that transformation by FosB also requires an
      intact DNA-binding domain composed of the functionally bipartite basic region and
      leucine zipper as well as sequences present in the N terminus that serve a
      regulatory function. Deletion of the N-terminal sequences results in proteins
      impaired in transcriptional activation and transformation. This region does not
      itself function as a transcriptional activation domain but instead regulates the
      transactivation functions present in the FosB-Jun complex. The requirement for
      this N-terminal region can be abolished by the presence of a strong constitutive
      activation domain. The primary sequence of the region that we have defined is
      highly conserved in the Fos family of proteins, suggesting functional
      conservation.

PMID- 8474435
TI  - In vitro definition of the yeast RNA polymerase I enhancer.
AB  - In vitro conditions are reported under which an EcoRI-HpaI fragment of the
      Saccharomyces cerevisiae ribosomal gene spacer will enhance transcription from an
      adjacent RNA polymerase I promoter. Enhancement is largely independent of
      orientation and distance and is proportional to copy number. Mapping experiments
      reveal that two separate regions of the EcoRI-HpaI fragment are independently
      capable of promoter stimulation. These regions appear to correspond to elements
      which have been shown by previous workers to cause enhancement in vivo. Using the
      detergent Sarkosyl to limit the number of rounds of transcription from each
      promoter, we found that the degree of enhancement is similar whether one or many
      rounds of transcription occur. This finding supports a model in which the
      enhancer increases the number of stable promoter complexes but does not alter the
      loading of polymerase on an active promoter. Once the stable promoter complex is
      formed, the enhancer can be physically severed from the promoter with no loss of
      enhancement. Likewise, the upstream activation region of the promoter can be
      severed from the core promoter domain once the stable complex has been formed.
      These results are interpreted to mean that the enhancer functions only to assist
      stable complex formation and, once that is accomplished, the enhancer is
      dispensable.

PMID- 8474436
TI  - Conservation between human and fungal squalene synthetases: similarities in
      structure, function, and regulation.
AB  - Squalene synthetase (farnesyl diphosphate:farnesyl diphosphate
      farnesyltransferase; EC 2.5.1.21) is thought to represent a major control point
      of isoprene and sterol biosynthesis in eukaryotes. We demonstrate structural and
      functional conservation between the enzymes from humans, a budding yeast
      (Saccharomyces cerevisiae), and a fission yeast (Schizosaccharomyces pombe). The
      amino acid sequences of the human and S. pombe proteins deduced from cloned cDNAs
      were compared to those of the known S. cerevisiae protein. All are predicted to
      encode C-terminal membrane-spanning proteins of approximately 50 kDa with similar
      hydropathy profiles. Extensive sequence conservation exists in regions of the
      enzyme proposed to interact with its prenyl substrates (i.e., two farnesyl
      diphosphate molecules). Many of the highly conserved regions are also present in
      phytoene and prephytoene diphosphate synthetases, enzymes which catalyze prenyl
      substrate condensation reactions analogous to that of squalene synthetase.
      Expression of cDNA clones encoding S. pombe or hybrid human-S. cerevisiae
      squalene synthetases reversed the ergosterol requirement of S. cerevisiae cells
      bearing ERG9 gene disruptions, showing that these enzymes can functionally
      replace the S. cerevisiae enzyme. Inhibition of sterol synthesis in S. cerevisiae
      and S. pombe cells or in cultured human fibroblasts by treatment with the 3
      hydroxy-3-methylglutaryl coenzyme A reductase inhibitor lovastatin resulted in
      elevated levels of squalene synthetase mRNA in all three cell types.

PMID- 8474437
TI  - Functional analysis of a stable transcription arrest site in the first intron of
      the murine adenosine deaminase gene.
AB  - Transcription arrest plays a role in regulating the expression of a number of
      genes, including the murine adenosine deaminase (ADA) gene. We have previously
      identified two prominent arrest sites at the 5' end of the ADA gene: one in the
      first exon and one in the first intron (J. W. Innis and R. E. Kellems, Mol. Cell.
      Biol. 11:5398-5409, 1991). Here we report the functional characterization of the
      intron 1 arrest site, located 137 to 145 nucleotides downstream of the cap site.
      We have determined, using gel filtration, that the intron 1 arrest site is a
      stable RNA polymerase II pause site and that the transcription elongation factor
      SII promotes read-through at this site. Additionally, the sequence determinants
      for the pause are located within a 37-bp fragment encompassing this site (+123 to
      +158) and can direct transcription arrest in an orientation-dependent manner in
      the context of the ADA and adenovirus major late promoters. Specific point
      mutations in this region increase or decrease the relative pausing efficiency. We
      also show that the sequence determinants for transcription arrest can function
      when placed an additional 104 bp downstream of their natural position.

PMID- 8474438
TI  - NAB2: a yeast nuclear polyadenylated RNA-binding protein essential for cell
      viability.
AB  - A variety of nuclear ribonucleoproteins are believed to associate directly with
      nascent RNA polymerase II transcripts and remain associated during subsequent
      nuclear RNA processing reactions, including pre-mRNA polyadenylation and splicing
      as well as nucleocytoplasmic mRNA transport. To investigate the functions of
      these proteins by using a combined biochemical and genetic approach, we have
      isolated nuclear polyadenylated RNA-binding (NAB) proteins from Saccharomyces
      cerevisiae. Living yeast cells were irradiated with UV light to covalently cross
      link proteins intimately associated with RNA in vivo. Polyadenylated RNAs were
      then selectively purified, and the covalent RNA-protein complexes were used to
      elicit antibodies in mice. Both monoclonal and polyclonal antibodies which detect
      a variety of NAB proteins were prepared. Here we characterize one of these
      proteins, NAB2. NAB2 is one of the major proteins associated with nuclear
      polyadenylated RNA in vivo, as detected by UV light-induced cross-linking.
      Cellular immunofluorescence, using both monoclonal and polyclonal antibodies,
      demonstrates that the NAB2 protein is localized within the nucleus. The deduced
      primary structure of NAB2 indicates that it is composed of at least two distinct
      types of RNA-binding motifs: (i) an RGG box recently described in a variety of
      heterogeneous nuclear RNA-, pre-rRNA-, mRNA-, and small nucleolar RNA-binding
      proteins and (ii) CCCH motif repeats related to the zinc-binding motifs of the
      largest subunit of RNA polymerases I, II, and III. In vitro RNA
      homopolymer/single-stranded DNA binding studies indicate that although both the
      RGG box and CCCH motifs bind poly(G), poly(U), and single-stranded DNA, the CCCH
      motifs also bind to poly(A). NAB2 is located on chromosome VII within a cluster
      of ribonucleoprotein genes, and its expression is essential for cell growth.

PMID- 8474439
TI  - Multiple regulatory elements contribute differentially to muscle creatine kinase
      enhancer activity in skeletal and cardiac muscle.
AB  - We have used transient transfections in MM14 skeletal muscle cells, newborn rat
      primary ventricular myocardiocytes, and nonmuscle cells to characterize
      regulatory elements of the mouse muscle creatine kinase (MCK) gene. Deletion
      analysis of MCK 5'-flanking sequence reveals a striated muscle-specific, positive
      regulatory region between -1256 and -1020. A 206-bp fragment from this region
      acts as a skeletal muscle enhancer and confers orientation-dependent activity in
      myocardiocytes. A 110-bp enhancer subfragment confers high-level expression in
      skeletal myocytes but is inactive in myocardiocytes, indicating that skeletal and
      cardiac muscle MCK regulatory sites are distinguishable. To further delineate
      muscle regulatory sequences, we tested six sites within the MCK enhancer for
      their functional importance. Mutations at five sites decrease expression in
      skeletal muscle, cardiac muscle, and nonmuscle cells. Mutations at two of these
      sites, Left E box and MEF2, cause similar decreases in all three cell types.
      Mutations at three sites have larger effects in muscle than nonmuscle cells; an
      A/T-rich site mutation has a pronounced effect in both striated muscle types,
      mutations at the MEF1 (Right E-box) site are relatively specific to expression in
      skeletal muscle, and mutations at the CArG site are relatively specific to
      expression in cardiac muscle. Changes at the AP2 site tend to increase expression
      in muscle cells but decrease it in nonmuscle cells. In contrast to reports
      involving cotransfection of 10T1/2 cells with plasmids expressing the myogenic
      determination factor MyoD, we show that the skeletal myocyte activity of
      multimerized MEF1 sites is 30-fold lower than that of the 206-bp enhancer. Thus,
      MyoD binding sites alone are not sufficient for high-level expression in skeletal
      myocytes containing endogenous levels of MyoD and other myogenic determination
      factors.

PMID- 8474440
TI  - Zebra fish myc family and max genes: differential expression and oncogenic
      activity throughout vertebrate evolution.
AB  - To gain insight into the role of Myc family oncoproteins and their associated
      protein Max in vertebrate growth and development, we sought to identify homologs
      in the zebra fish (Brachydanio rerio). A combination of a polymerase chain
      reaction-based cloning strategy and low-stringency hybridization screening
      allowed for the isolation of zebra fish c-, N-, and L-myc and max genes;
      subsequent structural characterization showed a high degree of conservation in
      regions that encode motifs of known functional significance. On the functional
      level, zebra fish Max, like its mammalian counterpart, served to suppress the
      transformation activity of mouse c-Myc in rat embryo fibroblasts. In addition,
      the zebra fish c-myc gene proved capable of cooperating with an activated H-ras
      to effect the malignant transformation of mammalian cells, albeit with diminished
      potency compared with mouse c-myc. With respect to their roles in normal
      developing tissues, the differential temporal and spatial patterns of steady
      state mRNA expression observed for each zebra fish myc family member suggest
      unique functions for L-myc in early embryogenesis, for N-myc in establishment and
      growth of early organ systems, and for c-myc in increasingly differentiated
      tissues. Furthermore, significant alterations in the steady-state expression of
      zebra fish myc family genes concomitant with relatively constant max expression
      support the emerging model of regulation of Myc function in cellular growth and
      differentiation.

PMID- 8474441
TI  - Characterization of cytokine LD78 gene promoters: positive and negative
      transcriptional factors bind to a negative regulatory element common to LD78,
      interleukin-3, and granulocyte-macrophage colony-stimulating factor gene
      promoters.
AB  - Cytokine LD78 is a human counterpart of the mouse macrophage inflammatory protein
      1 alpha/hematopoietic stem cell inhibitor. Promoters of the LD78 alpha and LD78
      beta genes showed similar inducible activities in two leukemic cell lines, K562
      and Jurkat, but the induction mechanisms differed between the two cell lines.
      Further characterization of the LD78 alpha promoter indicated that multiple
      positive and negative regulatory elements are present, some of which are
      differentially required for induction and repression of the promoter activity in
      different cells. One of the negative regulatory elements, ICK-1, functioned in
      both cell lines in the absence and presence of stimulation and was shown to be a
      recognition site for positive and negative transcriptional factors. This ICK-1
      element contained a direct repeat, and similar repeats were also found in the
      negative regulatory elements of hematopoietic growth factor interleukin-3 (IL-3)
      and granulocyte-macrophage colony-stimulating factor (GM-CSF) gene promoters.
      Nuclear extracts from K562 and Jurkat cells formed several protein-DNA complexes
      with the LD78 alpha ICK-1 element, one of which was also observed with the IL-3
      and GM-CSF ICK-1 elements. Results from in vivo and in vitro analyses suggested
      that the protein forming this complex functions as a negative factor. The binding
      affinity of this protein, ICK-1A, to the LD78 alpha ICK-1 element was low and was
      significantly affected by the incubation temperature and the salt concentration
      in the binding buffer. ICK-1B, another protein bound specifically by the LD78
      alpha ICK-1 element, was shown to be a positive factor important for induction of
      the promoter. These results suggested that ICK-1A plays an important role in
      balanced expression of LD78, IL-3, and GM-CSF during hematopoietic cell growth
      and differentiation.

PMID- 8474442
TI  - (CT)n (GA)n repeats and heat shock elements have distinct roles in chromatin
      structure and transcriptional activation of the Drosophila hsp26 gene.
AB  - Previous analysis of the hsp26 gene of Drosophila melanogaster has shown that in
      addition to the TATA box and the proximal and distal heat shock elements (HSEs)
      (centered at -59 and -340, relative to the start site of transcription), a
      segment of (CT)n repeats at -135 to -85 is required for full heat shock
      inducibility (R.L. Glaser, G.H. Thomas, E.S. Siegfried, S.C.R. Elgin, and J.T.
      Lis, J. Mol. Biol. 211:751-761, 1990). This (CT)n element appears to contribute
      to formation of the wild-type chromatin structure of hsp26, an organized
      nucleosome array that leaves the HSEs in nucleosome-free, DNase I-hypersensitive
      (DH) sites (Q. Lu, L.L. Wallrath, B.D. Allan, R.L. Glaser, J.T. Lis, and S.C.R.
      Elgin, J. Mol. Biol. 225:985-998, 1992). Inspection of the sequences upstream of
      hsp26 has revealed an additional (CT)n element at -347 to -341, adjacent to the
      distal HSE. We have analyzed the contribution of this distal (CT)n element (-347
      to -341), the proximal (CT)n element (-135 to -85), and the two HSEs both to the
      formation of the chromatin structure and to heat shock inducibility. hsp26
      constructs containing site-directed mutations, deletions, substitutions, or
      rearrangements of these sequence elements have been fused in frame to the
      Escherichia coli lacZ gene and reintroduced into the D. melanogaster genome by P
      element-mediated germ line transformation. Chromatin structure of the transgenes
      was analyzed (prior to gene activation) by DNase I or restriction enzyme
      treatment of isolated nuclei, and heat-inducible expression was monitored by
      measuring beta-galactosidase activity. The results indicate that mutations,
      deletions, or substitutions of either the distal or the proximal (CT)n element
      affect the chromatin structure and heat-inducible expression of the transgenes.
      These (CT)n repeats are associated with a nonhistone protein(s) in vivo and are
      bound by a purified Drosophila protein, the GAGA factor, in vitro. In contrast,
      the HSEs are required for heat-inducible expression but play only a minor role in
      establishing the chromatin structure of the transgenes. Previous analysis
      indicates that prior to heat shock, these HSEs appear to be free of protein. Our
      results suggest that GAGA factor, an abundant protein factor required for normal
      expression of many Drosophila genes, and heat shock factor, a specific
      transcription factor activated upon heat shock, play distinct roles in gene
      regulation: the GAGA factor establishes and/or maintains the DH sites prior to
      heat shock induction, while the activated heat shock factor recognizes and binds
      HSEs located within the DH sites to trigger transcription.

PMID- 8474443
TI  - In Xenopus laevis, the product of a developmentally regulated mRNA is
      structurally and functionally homologous to a Saccharomyces cerevisiae protein
      involved in translation fidelity.
AB  - We have performed a differential screen of a Xenopus egg cDNA library and
      selected two clones (Cl1 and Cl2) corresponding to mRNA which are specifically
      adenylated and recruited into polysomes after fertilization. Sequence analysis of
      Cl1 reveals that the corresponding protein is 67.5% identical (83% similar) to
      the product of the Saccharomyces cerevisiae SUP45 (also called SUP1 or SAL4)
      gene. This gene, when mutated, is an omnipotent suppressor of nonsense codons.
      When expressed in a sup45 mutant, the Xenopus Cl1 cDNA was able to suppress sup45
      related phenotypes, showing that the structural homology reflects a functional
      homology. Our discovery of a structural and functional homolog in Xenopus cells
      implies that the function of SUP45 is not restricted to lower eukaryotes and that
      the SUP45 protein may perform a crucial cellular function in higher eukaryotes.

PMID- 8474444
TI  - Yeast ribosomal protein L1 is required for the stability of newly synthesized 5S
      rRNA and the assembly of 60S ribosomal subunits.
AB  - Ribosomal protein L1 from Saccharomyces cerevisiae binds 5S rRNA and can be
      released from intact 60S ribosomal subunits as an L1-5S ribonucleoprotein (RNP)
      particle. To understand the nature of the interaction between L1 and 5S rRNA and
      to assess the role of L1 in ribosome assembly and function, we cloned the RPL1
      gene encoding L1. We have shown that RPL1 is an essential single-copy gene. A
      conditional null mutant in which the only copy of RPL1 is under control of the
      repressible GAL1 promoter was constructed. Depletion of L1 causes instability of
      newly synthesized 5S rRNA in vivo. Cells depleted of L1 no longer assemble 60S
      ribosomal subunits, indicating that L1 is required for assembly of stable 60S
      ribosomal subunits but not 40S ribosomal subunits. An L1-5S RNP particle not
      associated with ribosomal particles was detected by coimmunoprecipitation of L1
      and 5S rRNA. This pool of L1-5S RNP remained stable even upon cessation of 60S
      ribosomal subunit assembly by depletion of another ribosomal protein, L16.
      Preliminary results suggest that transcription of RPL1 is not autogenously
      regulated by L1.

PMID- 8474445
TI  - Action of spontaneously produced beta interferon in differentiation of embryonal
      carcinoma cells through an autoinduction mechanism.
AB  - In the current study, we have addressed the role of interferons (IFNs) in
      controlling the differentiation of pluripotent P19 embryonal carcinoma (EC)
      cells. Blocking IFN activity in the culture medium of differentiating cells with
      antibodies leads to a strong decrease in the degree of differentiation. The
      antibodies are active for a relatively short time. During this time, IFN-beta
      mRNA can be detected in the differentiating cells, as can increases of IFN
      stimulation response element-binding activity and NF-KB. The timing of IFN action
      also coincides with the accumulation of cytoplasmic double-stranded RNA (dsRNA)
      and with a drop in dsRNA unwindase-modificase activity. A model for the
      involvement of autoinduction of IFN by intracellular dsRNA in the control of
      differentiation in this system is presented.

PMID- 8474446
TI  - Mechanism of c-myc regulation by c-Myb in different cell lineages.
AB  - Activation of the murine c-myc promoter by murine c-Myb protein was examined in
      several cell lines by using a transient expression system in which Myb expression
      vectors activate the c-myc promoter linked to a chloramphenicol acetyltransferase
      reporter gene or a genomic beta-globin gene. S1 nuclease protection analyses
      confirmed that the induction of c-myc by c-Myb was transcriptional and affected
      both P1 and P2 start sites in a murine T-cell line, EL4, and a myelomonocytic
      line, WEHI-3. Mutational analyses of the c-myc promoter revealed that two
      distinct regions could confer Myb responsiveness in two T-cell lines, a distal
      site upstream of P1 and a proximal site within the first noncoding exon. In
      contrast, only the proximal site was required for other cell lineages examined.
      Five separate Myb-binding sites were located in this proximal site and found to
      be important for c-Myb trans activation. DNA binding was necessary for c-myc
      activation, as shown by the loss of function associated with mutation of Myb's
      DNA-binding domain and by trans-dominant repressor activity of the DNA binding,
      trans-activation-defective mutant. The involvement of additional protein factors
      was addressed by inhibiting protein synthesis with cycloheximide in a conditional
      expression system in which the activity of presynthesized Myb was under the
      control of estrogen. These experiments indicate that de novo synthesis of
      additional proteins was not necessary for c-myc trans activation. Together these
      data reveal two cell lineage-dependent pathways by which c-Myb regulates c-myc;
      however, both pathways are mechanistically indistinguishable in that direct DNA
      binding by Myb is required for activating c-myc whereas neither de novo protein
      synthesis nor other labile proteins are necessary.

PMID- 8474447
TI  - Casein kinase I-like protein kinases encoded by YCK1 and YCK2 are required for
      yeast morphogenesis.
AB  - Casein kinase I is an acidotropic protein kinase class that is widely distributed
      among eukaryotic cell types. In the yeast Saccharomyces cerevisiae, the casein
      kinase I isoform encoded by the gene pair YCK1 and YCK2 is a 60- to 62-kDa
      membrane-associated form. The Yck proteins perform functions essential for growth
      and division; either alone supports growth, but loss of function of both is
      lethal. We report here that casein kinase I-like activity is associated with a
      soluble Yck2-beta-galactosidase fusion protein in vitro and that thermolabile
      protein kinase activity is exhibited by a protein encoded by fusion of a
      temperature-sensitive yck2 allele with lacZ. Cells carrying the yck2-2ts allele
      arrest at restrictive temperature with multiple, elongated buds containing
      multiple nuclei. This phenotype suggests that the essential functions of the Yck
      proteins include roles in bud morphogenesis, possibly in control of cell growth
      polarity, and in cytokinesis or cell separation. Further, a genetic relationship
      between the yck2ts allele and deletion of CDC55 indicates that the function of
      Yck phosphorylation may be related to that of protein phosphatase 2A activity.

PMID- 8474448
TI  - The product of the EMS1 gene, amplified and overexpressed in human carcinomas, is
      homologous to a v-src substrate and is located in cell-substratum contact sites.
AB  - We have previously identified two genes (EMS1 and PRAD1/cyclin D1) in the
      chromosome 11q13 region that are frequently coamplified and overexpressed in
      human breast cancer and in squamous cell carcinomas of the head and neck (E.
      Schuuring, E. Verhoeven, W.J. Mooi, and R.J.A.M. Michalides, Oncogene 7:355-361,
      1992). We now report on the characterization of the 80/85-kDa protein that is
      encoded by the EMS1 gene. Amino acid sequence comparison shows a high homology
      (85%) to a chicken protein that was recently identified as a substrate for the
      src oncogene (H. Wu, A.B. Reynolds, S.B. Kanner, R.R. Vines, and J.T. Parsons,
      Mol. Cell. Biol. 11:5113-5124, 1991). Immunocytochemistry reveals that in
      epithelial cells, the human EMS1 protein is localized mainly in the cytoplasm
      and, to a very low extent, in protruding leading lamellae of the cell. However,
      in carcinoma cells that constitutively overexpress the protein as a result of
      amplification of the EMS1 gene, the protein, except in cytoplasm, accumulates in
      the podosome-like adherens junctions associated with the cell-substratum contact
      sites. The protein was not found in intercellular adherens junctions. Our
      findings, and the previously reported observations in src-transformed chicken
      embryo fibroblasts, suggest that the EMS1 protein is involved in regulating the
      interactions between components of adherens-type junctions. Since amplification
      of the 11q13 region has been associated with an enhanced invasive potential of
      these tumors, overexpression and concomitant accumulation of the EMS1 protein in
      the cell-substratum contact sites might, therefore, contribute to the invasive
      potential of these tumor cells.

PMID- 8474449
TI  - Cell cycle regulation of the yeast Cdc7 protein kinase by association with the
      Dbf4 protein.
AB  - Yeast Cdc7 protein kinase and Dbf4 protein are both required for the initiation
      of DNA replication at the G1/S phase boundary of the mitotic cell cycle. Cdc7
      kinase function is stage-specific in the cell cycle, but total Cdc7 protein
      levels remained unchanged. Therefore, regulation of Cdc7 function appears to be
      the result of posttranslational modification. In this study, we have attempted to
      elucidate the mechanism responsible for achieving this specific execution point
      of Cdc7. Cdc7 kinase activity was shown to be maximal at the G1/S boundary by
      using either cultures synchronized with alpha factor or Cdc- mutants or with
      inhibitors of DNA synthesis or mitosis. Therefore, Cdc7 kinase is regulated by a
      posttranslational mechanism that ensures maximal Cdc7 activity at the G1/S
      boundary, which is consistent with Cdc7 function in the cell cycle. This cell
      cycle-dependent regulation could be the result of association with the Dbf4
      protein. In this study, the Dbf4 protein was shown to be required for Cdc7 kinase
      activity in that Cdc7 kinase activity is thermolabile in vitro when extracts
      prepared from a temperature-sensitive dbf4 mutant grown under permissive
      conditions are used. In vitro reconstitution assays, in addition to employment of
      the two-hybrid system for protein-protein interactions, have demonstrated that
      the Cdc7 and Dbf4 proteins interact both in vitro and in vivo. A suppressor
      mutation, bob1-1, which can bypass deletion mutations in both cdc7 and dbf4 was
      isolated. However, the bob1-1 mutation cannot bypass all events in G1 phase
      because it fails to suppress temperature-sensitive cdc4 or cdc28 mutations. This
      indicates that the Cdc7 and Dbf4 proteins act at a common point in the cell
      cycle. Therefore, because of the common point of function for the two proteins
      and the fact that the Dbf4 protein is essential for Cdc7 function, we propose
      that Dbf4 may represent a cyclin-like molecule specific for the activation of
      Cdc7 kinase.

PMID- 8474450
TI  - An octamer motif contributes to the expression of the retinoic acid-regulated
      zinc finger gene Rex-1 (Zfp-42) in F9 teratocarcinoma cells.
AB  - The message for the zinc finger gene Rex-1 (Zfp-42) is expressed in
      undifferentiated murine F9 teratocarcinoma cells and embryonic stem cells.
      Expression of Rex-1 is reduced at the transcriptional level when F9 cells are
      induced by the addition of retinoic acid (RA) to differentiate. We have isolated
      genomic DNA for the Rex-1 gene (Zfp-42), characterized the gene's structure, and
      mapped the gene to mouse chromosome 8. Promoter elements contributing to the
      regulation of the Rex-1 promoter in F9 cells have been identified. A region
      required for Rex-1 promoter activity in F9 stem cells contains an octamer motif
      (ATTTGCAT) which is a binding site for octamer transcription factor members of
      the POU domain family of DNA-binding proteins. Rex-1 reporter plasmids including
      this octamer site also exhibited reduced expression in F9 cells treated with RA.
      Thus, the octamer motif is a regulatory element required for the activity of the
      Rex-1 promoter in F9 stem cells, and this motif contributes to the negative
      regulation by RA of the transcription of the Rex-1 gene. As an initial
      confirmation of the in vivo relevance of the isolated fragment, a larger Rex-1
      promoter fragment, also containing the octamer site, was able to promote
      expression of the bacterial lacZ gene in mouse embryos at the morula stage.

PMID- 8474451
TI  - Mouse beta-globin DNA-binding protein B1 is identical to a proto-oncogene, the
      transcription factor Spi-1/PU.1, and is restricted in expression to hematopoietic
      cells and the testis.
AB  - The hematopoietic-specific DNA-binding protein B1 binds to the DNA consensus
      sequence AAAGRGGAARYG located twice in intervening sequence 2 of both of the
      mouse beta-globin genes (D. L. Galson and D.E. Housman, Mol. Cell. Biol. 8:381
      392, 1988). B1 was cloned by expression of a murine erythroleukemia (MEL) cell
      cDNA library in transfected COS cells and screening by electrophoretic mobility
      shift analysis. B1 is identical to the proto-oncogene Spi-1/PU.1 (Spi-1), an ets
      family member. Protein-DNA contacts are shown to resemble those of the helix-turn
      helix homeodomain proteins. By Northern (RNA) analysis, we found that Spi-1 mRNA
      is present at low levels during murine CFU-E maturation and is at least 20-fold
      higher in uninduced MEL, a transformed proerythroblast-like cell line which
      contains an activating/transforming insertion of spleen focus-forming virus at
      the Spi-1 locus. Dimethyl sulfoxide-induced MEL cell differentiation decreases
      Spi-1 mRNA to approximately 20% of the uninduced level before commitment occurs.
      In addition to erythroid cells, Spi-1 mRNA is present in B cells, myelomonocytes,
      and mast cells but not in T cells and nonhematopoietic cell types. In situ
      hybridization demonstrated Spi-1 mRNA expression in bone marrow, spleen,
      interstitial nonhepatocytes of the liver, and interstitial nontubular cells of
      the testis. The Spi-1 locus was mapped on human chromosome 11 to the same
      interval as ACP2 (lysosomal acid phosphatase), between the anonymous DNA markers
      D11S33 and D11S14. This region has not yet been found to be associated with a
      human malignancy.

PMID- 8474452
TI  - Cloning and characterization of R-PTP-kappa, a new member of the receptor protein
      tyrosine phosphatase family with a proteolytically cleaved cellular adhesion
      molecule-like extracellular region.
AB  - We describe a new member of the receptor protein tyrosine phosphatase family, R
      PTP-kappa, cDNA cloning predicts that R-PTP-kappa is synthesized from a precursor
      protein of 1,457 amino acids. Its intracellular domain displays the classical
      tandemly repeated protein tyrosine phosphatase homology, separated from the
      transmembrane segment by an uncharacteristically large juxta-membrane region. The
      extracellular domain of the R-PTP-kappa precursor protein contains an
      immunoglobulin-like domain and four fibronectin type III-like repeats, preceded
      by a signal peptide and a region of about 150 amino acids with similarity to the
      Xenopus A5 antigen, a putative neuronal recognition molecule (S. Takagi, T.
      Hsrata, K. Agata, M. Mochii, G. Eguchi, and H. Fujisawa, Neuron 7:295-307, 1991).
      Antibodies directed against the intra- and extracellular domains reveal that the
      R-PTP-kappa precursor protein undergoes proteolytic processing, following which
      both cleavage products remain associated. By site-directed mutagenesis, the
      likely cleavage site was shown to be a consensus sequence for cleavage by the
      processing endopeptidase furin, located in the fourth fibronectin type III-like
      repeat. In situ hybridization analysis indicates that expression of R-PTP-kappa
      in the central nervous system is developmentally regulated, with highest
      expression seen in actively developing areas and, in the adult, in areas capable
      of developmental plasticity such as the hippocampal formation and cerebral
      cortex. The mouse R-PTP-kappa gene maps to chromosome 10, at approximately 21
      centimorgans from the centromere.

PMID- 8474453
TI  - Tissue-specific expression of human CD4 in transgenic mice.
AB  - The gene for the human CD4 glycoprotein, which serves as the receptor for human
      immunodeficiency virus type 1, along with approximately 23 kb of sequence
      upstream of the translational start site, was cloned. The ability of 5' flanking
      sequences to direct tissue-specific expression was tested in cell culture and in
      transgenic mice. A 5' flanking region of 6 kb was able to direct transcription of
      the CD4 gene in NIH 3T3 cells but did not result in detectable expression in the
      murine T-cell line EL4 or in four lines of transgenic mice. A larger 5' flanking
      region of approximately 23 kb directed high-level CD4 transcription in the murine
      T-cell line EL4 and in three independent lines of transgenic mice. Human CD4
      expression in all tissues analyzed was tightly correlated with murine CD4
      expression; the highest levels of human CD4 RNA expression were found in the
      thymus and spleen, with relatively low levels detected in other tissues.
      Expression of human CD4 protein in peripheral blood mononuclear cells was
      examined by flow cytometry in these transgenic animals and found to be restricted
      to the murine CD4+ subset of lymphocytes. Human CD4 protein, detected with an
      anti-human CD4 monoclonal antibody, was present on the surface of 45 to 50% of
      the peripheral blood mononuclear cells from all transgenic lines.

PMID- 8474454
TI  - A U5 small nuclear ribonucleoprotein particle protein involved only in the second
      step of pre-mRNA splicing in Saccharomyces cerevisiae.
AB  - The PRP18 gene, which had been identified in a screen for pre-mRNA splicing
      mutants in Saccharomyces cerevisiae, has been cloned and sequenced. Yeast strains
      bearing only a disrupted copy of PRP18 are temperature sensitive for growth; even
      at a low temperature, they grow extremely slowly and do not splice pre-mRNA
      efficiently. This unusual temperature sensitivity can be reproduced in vitro;
      extracts immunodepleted of PRP18 are temperature sensitive for the second step of
      splicing. The PRP18 protein has been overexpressed in active form in Escherichia
      coli and has been purified to near homogeneity. Antibodies directed against PRP18
      precipitate the U4/U5/U6 small nuclear ribonucleoprotein particle (snRNP) from
      yeast extracts. From extracts depleted of the U6 small nuclear RNA (snRNA), the
      U4 and U5 snRNAs can be immunoprecipitated, while no snRNAs can be precipitated
      from extracts depleted of the U5 snRNA. PRP18 therefore appears to be primarily
      associated with the U5 snRNP. The antibodies against PRP18 inhibit the second
      step of pre-mRNA splicing in vitro. Together, these results imply that the U5
      snRNP plays a role in the second step of splicing and suggest a model for the
      action of PRP18.

PMID- 8474455
TI  - Localization of a bidirectional DNA replication origin in the native locus and in
      episomally amplified murine adenosine deaminase loci.
AB  - Gene amplification is frequently mediated by the initial production of acentric,
      autonomously replicating extrachromosomal elements. The 4,000 extrachromosomal
      copies of the mouse adenosine deaminase (ADA) amplicon in B-1/50 cells initiate
      their replication remarkably synchronously in early S phase and at approximately
      the same time as the single-copy chromosomal locus from which they were derived.
      The abundance of ADA sequences and favorable replication timing characteristics
      in this system led us to determine whether DNA replication initiates in ADA
      episomes within a preferred region and whether this region is the same as that
      used at the corresponding chromosomal locus prior to amplification. This study
      reports the detection and localization of a discrete set of DNA fragments in the
      ADA amplicon which label soon after release of synchronized B-1/50 cells into S
      phase. A switch in template strand complementarity of Okazaki fragments,
      indicative of the initiation of bidirectional DNA replication, was found to lie
      within the same region. This putative replication origin is located approximately
      28.5 kbp upstream of the 5' end of the ADA gene. The same region initiated DNA
      replication in the single-copy ADA locus of the parental cells. These analyses
      provide the first evidence that the replication of episomal intermediates
      involved in gene amplification initiates within a preferred region and that the
      same region is used to initiate DNA synthesis within the native locus.

PMID- 8474456
TI  - Both LyF-1 and an Ets protein interact with a critical promoter element in the
      murine terminal transferase gene.
AB  - Terminal deoxynucleotidyltransferase (TdT) is a template-independent DNA
      polymerase that is expressed transiently during the earliest stages of B- and T
      cell ontogeny. Previously, we characterized the promoter for the murine TdT gene
      and identified a novel DNA-binding protein, called LyF-1, that interacts with a
      DNA sequence element found to be critical for transcriptional activity in
      lymphoid cell lines. Here, we present a more detailed analysis of this 30-bp
      control element, called the TdT D' element, which is centered approximately 60 bp
      upstream of the transcription start site. We found that both the murine and human
      D' elements are recognized by multiple proteins, including LyF-1 and at least two
      Ets family proteins, Ets-1 and Fli-1. Additional protein-DNA interactions were
      identified through studies using unfractionated nuclear extracts, in which the D'
      element was apparently incorporated into a multiprotein complex, possibly
      containing an Ets protein as a core component. By analyzing a series of
      substitution mutations, two adjacent binding sites for LyF-1 were identified in
      the murine D' element, with the Ets protein binding site closely coinciding with
      the proximal, lower-affinity LyF-1 site. Transient transfection analysis with
      these mutations revealed that only a 10-bp region, containing precisely the Ets
      and proximal LyF-1 binding sites, was needed for D' activity. These results
      suggest an important role for an Ets family protein in the expression of the TdT
      gene. The role of LyF-1 is less clear; it might act in conjunction with the Ets
      protein bound at the D' element or it might be unnecessary for D' activity.

PMID- 8474457
TI  - Modulation of exon skipping and inclusion by heterogeneous nuclear
      ribonucleoprotein A1 and pre-mRNA splicing factor SF2/ASF.
AB  - The essential splicing factor SF2/ASF and the heterogeneous nuclear
      ribonucleoprotein A1 (hnRNP A1) modulate alternative splicing in vitro of pre
      mRNAs that contain 5' splice sites of comparable strengths competing for a common
      3' splice site. Using natural and model pre-mRNAs, we have examined whether the
      ratio of SF2/ASF to hnRNP A1 also regulates other modes of alternative splicing
      in vitro. We found that an excess of SF2/ASF effectively prevents inappropriate
      exon skipping and also influences the selection of mutually exclusive tissue
      specific exons in natural beta-tropomyosin pre-mRNA. In contrast, an excess of
      hnRNP A1 does not cause inappropriate exon skipping in natural constitutively or
      alternatively spliced pre-mRNAs. Although hnRNP A1 can promote alternative exon
      skipping, this effect is not universal and is dependent, e.g., on the size of the
      internal alternative exon and on the strength of the polypyrimidine tract in the
      preceding intron. With appropriate alternative exons, an excess of SF2/ASF
      promotes exon inclusion, whereas an excess of hnRNP A1 causes exon skipping. We
      propose that in some cases the ratio of SF2/ASF to hnRNP A1 may play a role in
      regulating alternative splicing by exon inclusion or skipping through the
      antagonistic effects of these proteins on alternative splice site selection.

PMID- 8474458
TI  - Olf-1-binding site: characterization of an olfactory neuron-specific promoter
      motif.
AB  - We report characterization of several domains within the 5' flanking region of
      the olfactory marker protein (OMP) gene that may participate in regulating
      transcription of this and other olfactory neuron-specific genes. Analysis by
      electrophoretic mobility shift assay and DNase I footprinting identifies two
      regions that contain a novel sequence motif. Interactions between this motif and
      nuclear proteins were detected only with nuclear protein extracts derived from
      olfactory neuroepithelium, and this activity is more abundant in olfactory
      epithelium enriched in immature neurons. We have designated a factor(s) involved
      in this binding as Olf-1. The Olf-1-binding motif consensus sequence was defined
      as TCCCC(A/T)NGGAG. Studies with transgenic mice indicate that a 0.3-kb fragment
      of the OMP gene containing one Olf-1 motif is sufficient for olfactory tissue
      specific expression of the reporter gene. Some of the other identified sequence
      motifs also interact specifically with olfactory nuclear protein extracts. We
      propose that Olf-1 is a novel, olfactory neuron-specific trans-acting factor
      involved in the cell-specific expression of OMP.

PMID- 8474459
TI  - Architecture of a yeast U6 RNA gene promoter.
AB  - The promoters of vertebrate and yeast U6 small nuclear RNA genes are structurally
      dissimilar, although both are recognized by RNA polymerase III. Vertebrate U6 RNA
      genes have exclusively upstream promoters, while the U6 RNA gene from the yeast
      Saccharomyces cerevisiae (SNR6) has internal and downstream promoter elements
      that match the tRNA gene intragenic A- and B-block elements, respectively.
      Substitution of the SNR6 A or B block greatly diminished U6 RNA accumulation in
      vivo, and a subcellular extract competent for RNA polymerase III transcription
      generated nearly identical DNase I protection patterns over the SNR6 downstream B
      block and a tRNA gene intragenic B block. We conclude that the SNR6 promoter is
      functionally similar to tRNA gene promoters, although the effects of extragenic
      deletion mutations suggest that the downstream location of the SNR6 B block
      imposes unique positional constraints on its function. Both vertebrate and yeast
      U6 RNA genes have an upstream TATA box element not normally found in tRNA genes.
      Substitution of the SNR6 TATA box altered the site of transcription initiation in
      vivo, while substitution of sequences further upstream had no effect on SNR6
      transcription. We present a model for the SNR6 transcription complex that
      explains these results in terms of their effects on the binding of transcription
      initiation factor TFIIIB.

PMID- 8474460
TI  - Positive and negative modulation of Jun action by thyroid hormone receptor at a
      unique AP1 site.
AB  - We have characterized the putative AP1 site in the backbone of pUC plasmids and
      found unique regulatory effects. The site, which mapped to a 19-bp region around
      nucleotide 37, conferred transcriptional activation by Jun or Jun/Fos that was
      boosted up to fivefold by unliganded thyroid hormone receptor (TR). Thyroid
      hormone changed potentiation of the Jun response by TR into repression. Although
      the plasmid sequence is a near-perfect consensus AP1 site, the perfect consensus
      AP1 site from the human collagenase promoter did not show the same effects.
      Deletion of the ligand binding domain of the TR eliminated the ability of the
      receptor to boost Jun activity, and deletion, mutation, or changes in specificity
      of the DNA binding domain eliminated both its ability to potentiate Jun activity
      and repress with hormone. In vitro Jun/Fos complexes bound the operative plasmid
      fragment, and the presence of TR interfered very little with Jun/Fos binding
      activity. Protein interaction studies in the absence of DNA showed that TR bound
      Jun protein in solution either in the presence or in the absence of hormone.
      These observations suggest a mechanism for synergy and repression by TR through
      modulation of Jun activity: positive when TR is unliganded, and negative when
      hormone is bound. They also suggest that the presence of the plasmid element can
      confound studies of the regulation of linked promoters.

PMID- 8474461
TI  - Expression of the transcriptional activator LAC9 (KlGAL4) in Kluyveromyces lactis
      is controlled by autoregulation.
AB  - The concentration of the transcriptional activator LAC9 (KlGAL4) of Kluyveromyces
      lactis is moderately regulated by the carbon source as is the case for GAL4, its
      homolog in Saccharomyces cerevisiae. Expression of the LAC9 gene is induced about
      twofold in galactose. This induction is due to autoregulation. The LAC9 gene
      product binds to a low-affinity binding site in the LAC9 promoter and moderately
      activates transcription in response to galactose above a basal level. As for the
      LAC9-controlled metabolic genes, induction of LAC9 is inhibited in the presence
      of glucose. This inhibition of induction is a prerequisite for glucose repression
      of the lactose-galactose metabolic pathway. On the other hand, induced LAC9
      levels are required for optimal growth on galactose, since mutating the LAC9
      binding site in the LAC9 promoter resulted in poor growth and reduced expression
      of LAC9-controlled genes. Thus, in addition to the GAL80-dependent regulation by
      protein-protein interaction, the regulation of LAC9 gene expression is an
      important parameter in determining carbon source control of the LAC-GAL regulon.
      Although the mode of control is different, the pattern of LAC9 gene regulation
      resembles that of the S. cerevisiae GAL4 gene, being lower in glucose and glucose
      galactose than in galactose.

PMID- 8474462
TI  - The ADP/ATP carrier is the 32-kilodalton receptor for an NH2-terminally
      myristylated src peptide but not for pp60src polypeptide.
AB  - Membrane binding of pp60src is initiated via its myristylated NH2 terminus. To
      identify a candidate pp60src docking protein or receptor in the membrane, a
      radiolabelled peptide corresponding to the pp60src NH2-terminal membrane binding
      domain was cross-linked to fibroblast membranes and found to specifically label a
      32-kDa protein. This protein was purified by appending an affinity tag to the
      peptide probe so that the cross-linked complex could be isolated via affinity
      chromatography. Microsequencing indicated that the 32-kDa protein was the
      mitochondrial ADP/ATP carrier (AAC). This result was further confirmed by the
      ability of an antibody to the AAC to immunoprecipitate the cross-linked complex,
      by the ability of certain inhibitors of the AAC to block cross-linking, and by
      membrane fractionation to show that complex formation occurred essentially
      exclusively in the mitochondrial fraction. While the AAC bound the myristyl-src
      peptide in a specific manner both in vitro and in vivo, its localization to the
      inner membrane of the mitochondrion precludes its being a pp60src binding
      protein. An analysis of pp60v-src binding in vitro was consistent with this
      expectation. Thus, use of a myristyl-src peptide revealed an unexpected and
      previously unidentified binding capacity of the AAC, most likely related to the
      ability of long-chain fatty acyl coenzyme As to serve as AAC inhibitors. The
      amphipathic nature of the pp60src NH2 terminus suggests alternative strategies
      for uncovering pp60src membrane binding species.

PMID- 8474463
TI  - Overexpression of Myc suppresses CCAAT transcription factor/nuclear factor 1
      dependent promoters in vivo.
AB  - Overexpression of Myc in cells can suppress the transcription of specific genes.
      Because several of these genes have common transcriptional regulatory elements,
      we investigated the possibility that this effect of Myc is mediated through a
      specific transcription factor. In vitro DNA-binding assays detect only one form
      of CCAAT transcription factor/nuclear factor 1 (CTF/NF-1) in quiescent 3T3-L1
      cells. By contrast, quiescent 3T3-L1 cells that stably overexpress either c-Myc
      or N-Myc contain at least three forms of CTF/NF-1. Biochemical characterization
      of the various CTF/NF-1 forms showed that they have the same native molecular
      weight but differ in charge density. The more negatively charged CTF/NF-1 forms
      present in Myc-overexpressing cells are converted into that found in normal cells
      by treatment with acid phosphatase, suggesting that they represent a more
      phosphorylated form of the CTF/NF-1 protein. The various CTF/NF-1 forms have a
      similar DNA-binding affinity. Transfection experiments demonstrated that
      transcription from CTF/NF-1-dependent promoters is specifically suppressed in
      cells that stably overexpress c-Myc. This effect requires CTF/NF-1 binding.
      CTF/NF-1-dependent promoter activity is also suppressed in 3T3-L1 cells during
      active growth (relative to the quiescent state). Interestingly, actively growing
      3T3-L1 cells contain forms of CTF/NF-1 similar to those in quiescent cells that
      stably overexpress c-Myc. Thus, the CTF/NF-1 forms present in cells that express
      high amounts of c-Myc correlate with a lower transcription rate of CTF/NF-1
      dependent promoters in vivo. Our results provide a basis for the suppression of
      specific gene transcription by c-Myc.

PMID- 8474465
TI  - [Treatment of secondary infections in symptomatic HIV-infections in childhood].
AB  - Treatment of secondary infections in HIV infected children represents a problem
      of increasing importance in several children's hospitals. As it is unlikely that
      the AIDS-problem will be solved by itself within the next years it seems
      reasonable to summarize our current knowledge about opportunistic infections in
      order to establish standards for therapy. We will mainly focus on microorganisms
      endemic in Germany.

PMID- 8474464
TI  - The orphan receptor Rev-ErbA alpha activates transcription via a novel response
      element.
AB  - Rev-ErbA alpha (Rev-Erb) is a nuclear hormone receptor-related protein encoded on
      the opposite strand of the alpha-thyroid hormone receptor (TR) gene. This unusual
      genomic arrangement may have a regulatory role, but the conservation of human and
      rodent Rev-Erb amino acid sequences suggests that the protein itself has an
      important function, potentially as a sequence-specific transcriptional regulator.
      However, despite its relationship to the TR, Rev-Erb bound poorly to TR binding
      sites. To determine its DNA-binding specificity in an unbiased manner, Rev-Erb
      was synthesized in Escherichia coli, purified, and used to select specific
      binding-sites from libraries of random double-stranded DNA sequences. We found
      that Rev-Erb binds to a unique site consisting of a specific 5-bp A/T-rich
      sequence adjacent to a TR half-site. Rev-Erb contacts this entire asymmetric 11
      bp sequence, which is the longest nonrepetitive element specifically recognized
      by a member of the thyroid/steroid hormone receptor superfamily, and mutations in
      either the A/T-rich or TR half-site regions abolished specific binding. The
      binding specificity of wild-type Rev-Erb was nearly identical to that of C- and N
      terminally truncated forms. This binding was not enhanced by retinoid X receptor,
      TR, or other nuclear proteins, none of which formed heterodimers with Rev-Erb.
      Rev-Erb also appeared to bind to the selected site as a monomer. Furthermore, Rev
      Erb activates transcription through this binding site even in the absence of
      exogenous ligand. Thus, Rev-Erb is a transcriptional activator whose properties
      differ dramatically from those of classical nuclear hormone receptors, including
      the TR encoded on the opposite strand of the same genomic locus.

PMID- 8474466
TI  - [Chronic metabolic alkalosis in a newborn infant caused by congenital chloride
      diarrhea].
AB  - The case of a female preterm infant (gestational age 36 weeks) is described, who
      presented with abdominal distension, diarrhoea, dehydration and metabolic
      alkalosis at the fifth day of life. After different diagnostic tests had been
      performed, congenital chloride diarrhoea was suspected and chloride
      supplementation was started. However, this diagnosis could not be confirmed,
      until the measurement of electrolytes in faeces had been improved. Then, we found
      the typically elevated fecal chloride concentration (130-153 mmol/l) which
      exceeded the sum of the fecal concentration of sodium (64-90 mmol/l) and
      potassium (28-35 mmol/l). The chloride supplementation was increased to 6
      mmol/kg/d NaCl and 2 mmol/kg/d KCl. The most recent examination at the age of 1
      year revealed the girl to be in good clinical condition, with normal growth and
      psychomotor-development and with no evidence of renal impairment.

PMID- 8474467
TI  - [Complete trisomy 22].
AB  - In a 2 6/12-years-old girl a complete trisomy 22 was verified with the G-banding
      (CTG-technique). She presented with Pierre-Robin-Sequence, cardiac and renal
      malformations, craniofacial dysmorphia and psychomotoric retardation as it often
      occurs in trisomy 22. Additionally, we observed tonic-clonic seizures, remarkable
      dumbles on both elbows and a clavicular anomaly.

PMID- 8474468
TI  - [Early infantile malignant osteopetrosis. Experiences with drug therapy].
AB  - The autosomal recessive form of osteopetrosis becomes manifest in early infancy
      and often is lethal during the first decade of life. In an infant diagnosed at
      the age of eight weeks, a therapy with Calcitriol (Rocaltrol) was initiated with
      the intention to stimulate the osteoclast activity and to improve the bone marrow
      insufficiency. During therapy, a massive diarrhoea has been observed as potential
      and previously undescribed side effect of Calcitriol. Therefore the therapy had
      to be discontinued. A simultaneous trial with Ca-depleted diet did not show any
      effect. In the absence of a suitable donor, a bone-marrow transplantation could
      not be performed. The patient died at the age of five month.

PMID- 8474469
TI  - [Hemolytic-uremic syndrome in pneumococcal meningitis and infection. Importance
      of T-transformation].
AB  - A 4 month old girl developed a severe hemolytic uremic syndrome (HUS) following
      pneumococcal sepsis and meningitis. As a result of the hemolytic anemia and
      thrombocytopenia with associated gastrointestinal bleeding several red blood cell
      and thrombocyte transfusions became necessary. No plasma was transfused to the
      patient and all cellular blood components to be transfused were washed thoroughly
      in order to avoid the administration of eventually dangerous donor anti-T
      antibodies. Continuous peritoneal dialysis was performed for 23 days until
      sufficient spontaneous urine production was resumed. From the start of increased
      hemolysis T-transformation of the patient's red blood cells could be shown;
      bacterial neuraminidase was proven in the patient's serum, which could be
      neutralized in vitro by a commercial intravenous IgG preparation. The direct
      Coombs-Test was negative and no significant amounts of anti-T antibodies were
      detectable in the patient's serum at any stage of the disease. Our observation
      suggest that the T-transformation itself has caused the increased hemolysis and
      not an antigen-antibody (T-anti-T) reaction. In cases of HUS und proven T
      transformation, intravenous IgG preparations should be tried therapeutically to
      inhibit the bacterial neuraminidase.

PMID- 8474470
TI  - [Early detection of critical aortic isthmus stenosis in the neonate].
AB  - Between 1985 and 1992 7 newborns with critical coarctation of the aorta were
      referred with clinical signs of beginning or manifest cardio-vascular shock and
      subsequently underwent a primary operative correction. All of the children were
      noticed by their parents as having unspecific clinical symptoms such as poor
      feeding and tachypnoea. The aim of our clinical effort should be to detect all
      newborns with critical coarctation of the aorta before manifestation of a
      cardiogenic shock, i.e. before the complete closure of the ductus arteriosus.
      This might be possible with a careful clinical examination of the cardio-vascular
      system between the 3rd and 4th day of life and the correct interpretation of
      unspecific early symptoms.

PMID- 8474471
TI  - [Intermediate results of a multicenter study in long-term management of HIV
      exposed and infected children].
AB  - AIM OF THE STUDY: In most cases (about 80%) the HIV-infection of children is
      acquired during pregnancy or birth. Therefore peculiarities for diagnostic
      procedures and in the natural course of the disease can be expected if compared
      to AIDS acquired at adult age. Further interesting questions are the frequency of
      the (vertical) transmission from the infected mother to the child, the influence
      of mother- and/or child-related factors as well as the method of delivery on this
      transmission frequency. METHODS: In order to answer these questions the children
      of HIV-infected mothers since April 1, 1988 have been examined virologically,
      immunologically and clinically since birth by 6 study centers according to a
      standard protocol. The pregnancy data of the mothers have been documented,
      according to uniform criteria. Pre- or perinatally infected children not known to
      be antibody-positive at birth have been separately analysed. RESULTS: The
      frequency of pre/perinatal transmission from the mother to the child is 15.3%,
      the elective caesarean section seems to lower the transmission rate. Mother
      and/or infant related cofactors of the transmission could not be defined. In
      comparison to the control groups of the intrauterine HIV-exposed but not infected
      children, at birth the HIV-infected children were clinically and immunologically
      not ill. During their first months some of the infected children had a
      significant increase of serum IgG. Oral candidiasis, chronic recurrent diarrhoea
      and bacterial infections are indicator symptoms of beginning HIV-disease. The
      Minimum-AIDS-Prevalence in the child's first year is 24%. The relatively late
      AIDS manifestation (3.7 years) and the average value of 28 months of survival in
      retrospective observed children were a remarkable result. CONCLUSION: In general,
      the course of an HIV-infection in children of HIV-positive women in Germany seems
      to be comparable to results in other countries. The frequency of transmission
      from mother to child is relatively low (15.3%) and is an important result for
      maternity care. The caesarean section should be considered. The course of
      pregnancy must be examined more subtly in order to find out the still unclear
      causes of transmission. The Minimum-AIDS-Prevalence of 24% and the frequency of
      HIV-related signs and symptoms of 29% in the child's first year make it necessary
      to observe these children rather closely during this time.

PMID- 8474472
TI  - [Prevalence of drugs in meconium].
AB  - BACKGROUND: The number of newborn infants with symptoms suggesting drug
      withdrawal is increasing. As only part of prenatally exposed infants show typical
      drug withdrawal, and drug-use reported by addicted mothers is often unreliable
      the prevalence of neonates that were exposed to illicit drugs before birth is
      unknown. The purpose of this study was to evaluate prospectively the prevalence
      of drugs in meconium and to define risk factors for intrauterine drug exposure.
      METHODS: During a period of 4 months meconium was collected twice in 420
      nonselected newborn infants. Meconium was analysed with a modified test developed
      for toxicology screening in urine. Information on pre- and postnatal risk factors
      including drug-use during pregnancy was obtained. RESULTS: Among 415 mothers four
      reported illicit drug use and ten licit drug use during late pregnancy. In all
      these infants meconium drug test was positive. After exclusion of these infants
      and of five second twins 401 infants with negative drug history remained. 45 of
      them (11%) had one or two drugs in the meconium: opiate 17x, amphetamine 16x,
      barbiturate 15x, benzodiazepine 3x, cannabinoid 2x, cocaine 1x (in 9 infants two
      substances were detected). None was positive for LSD or phencyclidine. The
      infants with positive drug tests had the following risks compared to those with
      negative tests: prematurity (odds ratio 2.3, 95% confidence interval 1.3-4.3).
      Microcephaly or macrocephaly (2.0:1.01-4.1), Apgar-Score below 5 at 1 min
      (2.4:1.5-5.4), Apgar score below 7 at 10 min (4.0: 1.6-9.9), mother academic
      (2.8:1.2-6.2). CONCLUSIONS: Newborn infants may have been exposed to illicit
      drugs in utero even if their mothers deny drug use and even if they do not show
      withdrawal symptoms. Prematurely born infants and infants with problems in
      postnatal adaptation have an increased risk of having been exposed to drugs.

PMID- 8474473
TI  - [Is homeopathy a false doctrine?].
AB  - We realize that it is virtually impossible to persuade the convinced
      practitioners of any of the pseudo-scientific beliefs. Therefore, it is our aim
      to support those fellow workers and interested laymen, intimidated by the
      contentions of homeopaths by providing them with relevant facts to counter the
      mostly absurd claims put forward by practitioners of alternative medicine. 1. The
      rule of "similarity" is based on incorrect assumptions. 2. Dilution = Dilution A
      dilution is neither a "potentization" nor a "dynamization" nor an "energyzation".
      All these expressions are not based on carefully defined notions or concepts but
      are merely literal creations of homeopaths. It is well known that the "Urtinktur"
      in addition to producing desired effects possesses a substantial number of
      undesired side effects. The reader might wonder why only the beneficial effects
      would be amplified ("potentiated") while all other side effects would happen to
      be attenuated ("diluted"). 3. The only evidence all practitioners of pseudo
      medicine can muster to prove the efficacy of their methods are occasional
      healings following pseudo-medical treatment.

PMID- 8474474
TI  - [Comments on the contribution by E. Rugo and U. Wahn. In vitro studies of
      residual allergen activity of hydrolysate nutrition].

PMID- 8474475
TI  - [Sizes and body proportions of abused children].

PMID- 8474476
TI  - [Procedure in ingestion of batteries].

PMID- 8474477
TI  - [Bronchial asthma].

PMID- 8474478
TI  - PET study on striatal dopamine D2 receptor changes during the progression of
      early Parkinson's disease.
AB  - [11C]Raclopride uptake to dopamine D2 receptors was investigated with positron
      emission tomography (PET) in patients with early Parkinson's disease at the time
      of the diagnosis and after a half-year interval. During this progressive period
      of the disease, the patients received no antiparkinsonian medication. The
      upregulation of striatal D2 receptors, which was seen in all patients already at
      the time of the diagnosis, persisted. Although the patients initially showed
      unilateral disease, they had developed bilateral symptoms by the time of the
      second PET scan, but the disease was still asymmetric. The present results show
      that the relative increase in [11C]raclopride uptake in the striatum
      contralateral to the symptoms as compared with the opposite striatum will be
      preserved even during the progression of the disease, provided that the symptoms
      show clear-cut asymmetry.

PMID- 8474479
TI  - Does tolerance develop to levodopa? Comparison of 2- and 21-H levodopa infusions.
AB  - To determine if acute tolerance to levodopa develops, we compared the response to
      2- and 21-h levodopa infusions with the rate adjusted during the long infusion to
      yield the same plasma concentration as at the end of the 2-h infusion. The
      duration of response after discontinuing the long infusions was briefer than
      after discontinuing the short infusion, suggesting the development of tolerance.
      Furthermore, dyskinesia severity was greater during long infusions. We conclude
      that continuous dopaminergic stimulation with levodopa may not offer optimal
      control of parkinsonism in patients with response fluctuations.

PMID- 8474480
TI  - Effect of adding the D1 agonist CY 208-243 to chronic bromocriptine treatment. I:
      Evaluation of motor parameters in relation to striatal catecholamine content and
      dopamine receptors.
AB  - A group of four cynomolgus monkeys previously rendered parkinsonian by the toxin
      1-methyl-4-phenyl,1,2,3,6-tetrahydropyridine (MPTP) were observed in locomotion
      cages equipped with photocells during four periods of 7 days during which they
      received saline or two doses of the D1 agonist CY 208-243. The larger dose of 0.5
      mg/kg produced a significant increase in locomotion in three of four animals. A
      second group of eight monkeys also previously rendered parkinsonian by MPTP and
      having received no other treatment were given a daily treatment of bromocriptine
      1.66 mg/kg orally daily during 4 weeks. In four of the animals, after a week on
      bromocriptine alone, the D1 agonist CY 208-243 was added in increasing doses of
      0.05, 0.1, and 0.5 mg/kg. The motor response as measured by locomotion, hand
      dexterity, and a disability score improved progressively at least in some of the
      animals on bromocriptine alone. The addition of CY 208-243 produced a more
      striking improvement of all three parameters, which appeared to be dose
      dependent. Biochemical analysis of the brain of these animals plus one control
      and one MPTP untreated monkey showed a > 90% loss of dopamine in the striatum in
      six of the eight treated monkeys. Both D2 and D1 dopamine receptors were
      increased in density by denervation, but both treatments abolished this increase
      for the D2 receptors while increasing the affinity of the D1 receptors.

PMID- 8474481
TI  - Sympathetic skin response and R-R interval variation in Parkinson's disease.
AB  - We investigated autonomic function in patients with idiopathic Parkinson's
      disease (PD) by measuring sympathetic skin response (SSR) and R-R interval
      variation (RRIV). Sixty-two PD patients and 62 age-matched normal subjects were
      recruited. Abnormal SSR was noted in nine (14.5%) PD patients, including three in
      Stage II, three in Stage III, and three in Stage IV, but not in Stage I patients
      or normal subjects. Four of these nine patients had postural hypotension.
      Abnormal SSR was correlated with duration of illness and impotence. In PD
      patients, abnormal SSR may be due to intermediolateral column dysfunction. After
      logarithmic transformation and age adjustment, 19 (31.6%) of 60 PD patients had
      abnormal RRIV during rest and deep breathing. Abnormal RRIV was not related to
      staging or duration of illness. Patients with constipation had significantly
      lower RRIV, indicating parasympathetic dysfunction. RRIV was not affected by
      acute or chronic L-dopa treatment. The agreement between RRIV and SSR in PD
      patients was poor (kappa = -0.07). It appears that abnormal SSR, but not RRIV,
      may be associated with more autonomic disturbances in PD patients.

PMID- 8474482
TI  - Apomorphine test for dopaminergic responsiveness: a dose assessment study.
AB  - The clinical diagnosis of idiopathic Parkinson's disease (IPD) remains difficult
      and is supported by a favorable response to levodopa, while failure to respond
      represents an exclusion criterion. Recently, the response to subcutaneous
      apomorphine has been suggested as a tool in predicting levodopa responsiveness in
      parkinsonian syndromes. We administered apomorphine at doses of 10, 50, and 100
      micrograms/kg subcutaneously against placebo over two consecutive days in 37
      patients with parkinsonism and evaluated the motor response for 90 min after each
      dose. Subsequently, we compared the motor response with the follow-up response to
      levodopa therapy and to a final diagnosis. Twenty-seven patients of 37 showed a
      positive response to apomorphine, and 10 had a negative response. All positive
      responses to the apomorphine test were obtained with 50 or 100 micrograms/kg
      doses. Because of the high frequency of side effects with the dose of 100
      micrograms/kg, 50 micrograms/kg seems more useful. After an adequate period of
      levodopa/carbidopa therapy (12-month follow-up), 29 patients improved; 25 of
      these had demonstrated a positive response to the apomorphine test. The final
      diagnosis of IPD, made on the basis of an exhaustive clinical and
      neuroradiological evaluation and on the response to chronic levodopa therapy, was
      in good agreement with the response to the apomorphine test (predictivity of
      diagnosis, 86.4%). Our data indicate that subcutaneous apomorphine at the dose of
      50 micrograms/kg is a useful tool in the differential diagnosis of parkinsonian
      syndromes.

PMID- 8474483
TI  - Subcutaneous apomorphine in Parkinson's disease: response to chronic
      administration for up to five years.
AB  - Subcutaneous apomorphine, administered by continuous waking-day infusion with
      boluses, or by repeated intermittent injection, was given to 71 parkinsonian
      patients with severe refractory levodopa related on-off fluctuations for 1-5
      years. A mean reduction in daily off period time of approximately 50% was
      maintained, and the incidence of neuropsychiatric toxicity remained low on long
      term follow-up. No clinically significant tolerance or loss of therapeutic effect
      was seen, although increasingly severe on-phase dyskinesias and postural
      instability marred the long-term therapeutic response in many patients. Despite
      these drawbacks, apomorphine, when combined with the peripheral dopamine receptor
      agonist domperidone, represents a significant therapeutic advance in the
      management of late-stage Parkinson's disease and should certainly be considered
      before experimental implantation procedures.

PMID- 8474484
TI  - Nocturnal akathisia in Parkinson's disease: treatment with clozapine.
AB  - We present the results obtained using low doses of clozapine (mean dose 26.4 mg
      at bedtime) in the treatment of nocturnal akathisia in nine patients with
      Parkinson's disease for a mean period of 12.5 months. The results were excellent
      in all the patients. Furthermore, three patients experienced a remarkable
      improvement in rest tremor and in five patients the confusional state that
      accompanied the akathisia also disappeared. No serious side-effects were
      observed. We believe that clozapine is a very useful drug for the relief of
      nocturnal akathisia in parkinsonian subjects.

PMID- 8474485
TI  - Cocaine-related movement disorders.
AB  - We describe four patients, two with Tourette's syndrome, one with the combination
      of idiopathic dystonia and essential-like tremor, and one with tardive dystonia,
      who noted marked exacerbation of their movement disorders after exposure to
      cocaine. These patients provide support for the hypothesis that dopaminergic
      preponderance plays an important role in the pathogenesis of certain hyperkinetic
      movement disorders. Cocaine should be regarded as an important cause or
      precipitant of hyperkinetic movement disorders.

PMID- 8474486
TI  - Tremor due to stroke.
AB  - We report on four patients with unilateral tremor stemming from cerebrovascular
      accidents. In two patients with proven lesions of the thalamus, the tremor was
      irregular and, in addition, there was dystonic posturing of the affected arm.
      Tremor and dystonic posturing had appeared after the stroke. In the other two
      patients tremor had occurred immediately at the onset of the stroke and lasted
      only a few days. The tremors were of small amplitude and high frequency, and
      lesions could not be found on CT or MRI in these two patients. None of our
      patients showed signs of the so-called rubral tremor.

PMID- 8474487
TI  - Assessment of adaptive functioning in Huntington's disease.
AB  - The Huntington's Disease Activities of Daily Living (HD-ADL) scale is a 17-item
      informant-completed instrument for rating adaptive functioning in Huntington's
      disease (HD) patients. To assess the reliability and clinical correlates of the
      HD-ADL, it was administered along with the Mini-Mental State Exam (MMSE) and
      Quantified Neurological Exam (QNE) to 93 HD patients. The HD-ADL has high
      internal consistency (coefficient alpha = 0.91). Principal components factor
      analysis of the HD-ADL revealed four factors (General Functioning, Domestic
      Activities, Home Upkeep, and Family Relationships) accounting for 72% of the
      total variance. MMSE score, motor impairment score, and duration of disease were
      the best predictors of HD-ADL score. Similar results were obtained in an
      independent replication sample of patients. The HD-ADL scores correlate with
      Shoulson and Fahn's total functional capacity (TFC) index (r = -0.89). The HD-ADL
      scale is a reliable and valid instrument for assessing adaptive function in HD
      patients.

PMID- 8474488
TI  - Benign neonatal sleep myoclonus: clinical features and video-polygraphic
      recordings.
AB  - Benign neonatal sleep myoclonus is a syndrome characterized by the occurrence of
      repetitive myoclonic jerks of the extremities exclusively during non-rapid eye
      movement sleep in the early life of healthy newborns. No etiological factors are
      present. The onset is within the first 15 days of life with spontaneous
      disappearance within 3-4 months. These myoclonic events are commonly diagnosed as
      epileptic seizures. We observed 12 newborns with this clinical pattern; the
      follow-up ranges from 12 to 60 months. Long-term videopolygraphic
      electroencephalographic (EEG) monitoring demonstrated normal EEG activity, thus
      confirming that these unusual events were nonepileptic.

PMID- 8474489
TI  - Reflex blepharospasm associated with bilateral basal ganglia lesion.
AB  - A patient with a bilateral striatal lesion secondary to anoxia presented reflex
      blepharospasm associated with parkinsonism and dystonia in the limbs. The blink
      reflex excitability curve was enhanced and the R-2 response prolonged as in
      patients with essential blepharospasm. The findings in this patient support the
      notion that blepharospasm may be secondary to basal ganglia dysfunction through
      abnormal facilitation of reticular formation neurons controlling facial nucleus
      motoneuron excitability.

PMID- 8474490
TI  - Adult onset myoclonic Huntington's disease.
AB  - A patient with adult onset Huntington's disease (HD) and prominent action
      myoclonus is described. Neither epileptiform activity nor electroencephalography
      (EEG) correlates of the movements was found. Unlike the case with most
      (nonmyoclonic) HD patients, centro-parietal components of somatosensory evoked
      potentials (SEPs) were well defined and a clear V2 response was found. Treatment
      with valproic acid greatly reduced myoclonus suggesting that the gamma
      aminobutyric acid (GABA) system might be involved in the pathophysiology of
      myoclonus in HD.

PMID- 8474491
TI  - A case of posttraumatic tremor treated by chronic stimulation of the thalamus.

PMID- 8474492
TI  - MR imaging findings of tremors associated with lesions in cerebellar outflow
      tracts: report of two cases.
AB  - Two cases with severe tremors were studied by means of electromyograms using
      surface electrodes and also by magnetic resonance (MR) imaging. The first case
      was associated with multiple sclerosis and demonstrated a severe postural
      cerebellar tremor and an alternate activation of antagonist muscles in the right
      arm. The second case, with hemorrhage in the brainstem, demonstrated a severe
      tremor at rest and mixed synchronous and alternating activation of antagonist
      muscles in the left forearm. MR imaging studies localized lesions possibly
      responsible for these tremors. In the first case a lesion was located in the
      superior cerebellar peduncle just under the decussation, and in the second case a
      lesion was found between the red nucleus and the thalamus, with possible
      involvement of both the cerebellothalamic and nigrostriatal pathways. The first
      case accords with the theory that a lesion located in the dentate nucleus and its
      projection can cause severe postural cerebellar tremor. The lesion demonstrated
      in the second case may be responsible for "cerebellar tremor at rest" or "static
      (resting) cerebellar tremor."

PMID- 8474493
TI  - Basal ganglia infarction as a possible cause of cervical dystonia.
AB  - Cervical dystonia (CD) is usually an idiopathic disorder that results in abnormal
      movements and painful postures of the neck. Although symptomatic CD caused by
      focal CNS lesions has been described in the literature, it is an exceedingly rare
      phenomenon. We report two women who had an abrupt onset of CD at the ages of 39
      and 68 years. Each patient had rotation of the head to the right and was found to
      have a lacunar infarction in the left putamen on magnetic resonance imaging scan.
      The abrupt onset of symptoms and appropriate location and laterality of the
      cerebral lesions suggest an etiologic link between the infarctions and the
      patients' CD. These cases are the first reports of CD possibly caused by basal
      ganglia infarction.

PMID- 8474494
TI  - Postneuroleptic laryngeal dyskinesias: a cause of upper airway obstructive
      syndrome improved by local injections of botulinum toxin.
AB  - We report a case of laryngeal dyskinesia resulting in severe rest and exercise
      dyspnea. A 51-year-old man treated for 2 years with flupentixol, an incisive
      neuroleptic, developed severe dyspnea due to intermittent, rhythmic, and dystonic
      movements of the vocal cords and upper airway. Local injections of botulinum
      toxin resulted in spectacular regression of laryngeal spasms and major
      improvement in breathing. This case emphasizes the risk of upper respiratory
      dyskinesias associated with neuroleptic treatment and shows the feasibility of a
      new local treatment in this life-threatening disorder.

PMID- 8474495
TI  - Familial idiopathic strio-pallido-dentate calcifications with late onset
      extrapyramidal syndrome.
AB  - A family with autosomal dominant inheritance of idiopathic strio-pallidodentate
      calcifications and late onset of extrapyramidal symptoms is reported. Clinical
      features consisted of parkinsonism in one member and postural tremor in two.
      Depression and dysarthria were present in all cases. All symptomatic members
      showed a peculiar biochemical abnormality consisting of reduced 25-OH vitamin D3
      with normal levels of 1,25(OH)2 vitamin D3, suggesting an inborn error of Vitamin
      D metabolism. The biochemical, clinical, and genetic pattern of this family
      distinguishes this syndrome from the larger group of secondary familial basal
      ganglia calcifications.

PMID- 8474496
TI  - Ataxia without telangiectasia.
AB  - Ataxia telangiectasia (AT) is an autosomal recessive hereditary disorder
      characterized by onset in infancy or childhood of a cerebellar and later
      extrapyramidal disorder associated with telangiectasias and an immune deficit.
      Only a handful of cases have been described in which the features were not
      stereotypic. This report describes a case that is classic except for the absence
      of telangiectasias through age 17. This and other cases suggest that a new, more
      inclusive term be used to describe the syndrome of ataxia with immune deficit
      until the genetic abnormalities in these disorders become identifiable.

PMID- 8474497
TI  - Function of dopamine receptors in young-onset Parkinson's disease: prolactin
      response.
AB  - The basal levels of prolactin (PRL) and their changes after i.v. thyrotropin
      releasing hormone (TRH) administration after bromocriptine (BCT) pretreatment
      (BCT/TRH test) were monitored in 12 patients with young-onset Parkinson's disease
      (PD) (before 40 years of age) and 10 patients with older-onset PD (after 40 years
      of age), as well as in two groups of healthy subjects (10 persons in each), age
      matched with older-onset (control A) and young-onset (control B) parkinsonians.
      The basal PRL levels were normal in both groups of patients. When given after
      BCT, TRH induced a significantly lower PRL increase in older-onset parkinsonians
      than in controls. This response was even more blunted in young-onset patients,
      being significantly more attenuated than in older-onset PD patients.

PMID- 8474498
TI  - Stereotyped hand clasping: an unusual tardive movement disorder.
AB  - We report an 83-year-old woman with vascular parkinsonism who presented with
      stereotyped rhythmical hand-clasping movements after 18 months exposure to
      neuroleptics. Although stereotypical rhythmical orolinguomasticatory and limb
      movements are the most common tardive dyskinesia in the elderly, we feel this
      woman's hand clasping represents another unusual expression of a tardive movement
      disorder.

PMID- 8474499
TI  - Myoclonus and tremor induced acutely by administration of tumor necrosis factor
      in a patient with Ehlers-Danlos syndrome.

PMID- 8474500
TI  - Spasmodic torticollis in multiple sclerosis: significance of an upper cervical
      spinal cord lesion.

PMID- 8474501
TI  - Effect of L-dopa on oculogyric crises in a case of dopa-responsive dystonia.

PMID- 8474502
TI  - Acute and long-term response to apomorphine in cranial dystonia.

PMID- 8474503
TI  - Unilateral blepharospasm stemming from a thalamomesencephalic lesion.

PMID- 8474504
TI  - Acetazolamide therapy of menstrual-related fluctuations in Parkinson's disease.

PMID- 8474505
TI  - Paroxysmal stimulus-sensitive spasmodic torticollis.

PMID- 8474506
TI  - Hemiplegic dystonia associated with regional cortical dysplasia (pachygyria).

PMID- 8474507
TI  - A patient with a resting tremor and a lacunar infarction at the border between
      the thalamus and the internal capsule.

PMID- 8474508
TI  - Persistent parkinsonism and tardive dyskinesia induced by clebopride.

PMID- 8474509
TI  - Unilateral pallidal lesion after acute disulfiram intoxication: a clinical and
      magnetic resonance study.

PMID- 8474510
TI  - Cessation of writer's cramp after stroke.

PMID- 8474511
TI  - Baltic myoclonus and Crohn's disease.

PMID- 8474512
TI  - The development of sex typing in middle childhood.
AB  - The present study examined the development of sex typing during middle childhood,
      using a sample of 558 children aged 5-12 years. The purpose of the study was to
      provide information about the developmental course and stability of various
      aspects of sex typing during this period and to examine the relative
      contributions of cognitive and environmental factors to sex-role development.
      Multiple measures of sex typing were obtained, including indices of personal
      preference, knowledge of stereotypes, and flexibility in the domains of
      activities, occupations, and traits. We also collected information about the
      child's cognitive maturity, exposure to sex-typed models at home, and
      socioeconomic status. Results supported the need for an integrative theory of sex
      role development, incorporating factors emphasized by cognitive-developmental,
      schematic-processing, and social learning theories. Knowledge of stereotypes,
      flexibility, and sex-typed personal preferences all increased with age during
      middle childhood. There were also individual differences in sex typing that were
      stable over a 1-year period. Distinct "cognitive" and "affective" aspects of sex
      typing were identified using a principal components analysis. Cognitive elements
      (flexibility and knowledge of stereotypes) were largely a function of the child's
      cognitive maturity level, although social-environmental factors such as father's
      presence in the home also had some effect. Affective elements (sex-typed
      preferences for activities, occupations, and peers), on the other hand, were
      related more consistently to sex typing of the home environment. Children whose
      mothers frequently modeled "reversed" sex-role behaviors (i.e., traditionally
      "masculine" household and child-care tasks) were less sex typed in their own
      preferences. However, cognitive factors were also important, in that children who
      believed gender stereotypes to be flexible were less sex typed in their choices
      of activities, occupations, and peers. In sum, both cognitive maturation and
      socialization experiences contribute to the development of sex typing during
      middle childhood. Potential practical implications of these findings, as well as
      implications for stereotyping in other social domains such as race and ethnicity,
      are discussed.

PMID- 8474513
TI  - Reducing mortality from colorectal cancer by screening for fecal occult blood.
      Minnesota Colon Cancer Control Study.
AB  - BACKGROUND: Although tests for occult blood in the feces are widely used to
      screen for colorectal cancers, there is no conclusive evidence that they reduce
      mortality from this cause. We evaluated a fecal occult-blood test in a randomized
      trial and documented its effectiveness. METHODS: We randomly assigned 46,551
      participants 50 to 80 years of age to screening for colorectal cancer once a
      year, to screening every two years, or to a control group. Participants who were
      screened submitted six guaiac-impregnated paper slides with two smears from each
      of three consecutive stools. About 83 percent of the slides were rehydrated.
      Participants who tested positive underwent a diagnostic evaluation that included
      colonoscopy. Vital status was ascertained for all study participants during 13
      years of follow-up. A committee determined causes of death. A single pathologist
      determined the stage of each tissue specimen. Differences in mortality from
      colorectal cancer, the primary study end point, were monitored with the
      sequential log-rank statistic. RESULTS: The 13-year cumulative mortality per 1000
      from colorectal cancer was 5.88 in the annually screened group (95 percent
      confidence interval, 4.61 to 7.15), 8.33 in the biennially screened group (95
      percent confidence interval, 6.82 to 9.84), and 8.83 in the control group (95
      percent confidence interval, 7.26 to 10.40). The rate in the annually screened
      group, but not in the biennially screened group, was significantly lower than
      that in the control group. Reduced mortality in the annually screened group was
      accompanied by improved survival in those with colorectal cancer and a shift to
      detection at an earlier stage of cancer. CONCLUSIONS: Annual fecal occult-blood
      testing with rehydration of the samples decreased the 13-year cumulative
      mortality from colorectal cancer by 33 percent.

PMID- 8474514
TI  - Out-of-hospital transcutaneous pacing by emergency medical technicians in
      patients with asystolic cardiac arrest.
AB  - BACKGROUND: Transcutaneous cardiac pacemakers generate electrical stimuli that
      pace the heart through external electrodes that adhere to the chest wall.
      Transcutaneous pacing has been useful in some patients with bradycardia, but its
      efficacy in patients with asystole and full cardiac arrest has been limited,
      possibly because of delays in the initiation of pacing. We studied the efficacy
      of early transcutaneous pacing in patients with out-of-hospital asystolic cardiac
      arrest. METHODS: For three years we provided transcutaneous pacemakers to about
      half the fire districts in a large emergency-medical-services system (the
      intervention group). In these districts, we authorized emergency medical
      technicians (EMTs) to begin transcutaneous pacing in patients with cardiac arrest
      and primary asystole or post-defibrillation asystole. Pacing was done as early as
      possible, before endotracheal intubation or intravenous medication. EMTs in the
      other fire districts (the control group) treated similar patients with basic
      cardiopulmonary resuscitation but without transcutaneous pacing. RESULTS: The
      EMTs in the intervention group initiated transcutaneous pacing in 112 of the 278
      patients with primary asystole. Of these patients, 22 (8 percent) were admitted
      to the hospital, and 11 (4 percent) were discharged. Among the 259 patients
      treated by the EMTs in the control group, 21 (8 percent) were admitted to the
      hospital, and 5 (2 percent) were discharged. The two groups did not differ
      significantly with respect to the rate of hospital admission or survival.
      Survival after early pacing for post-defibrillation asystole was no better than
      survival after pacing for primary asystole. CONCLUSIONS: Transcutaneous pacing
      appears to offer no benefit in patients with asystolic cardiac arrest, even when
      it is performed as early as possible by EMTs in the field. Our data suggest that
      the widespread implementation of early transcutaneous pacing for out-of-hospital
      asystolic cardiac arrest would be ineffective.

PMID- 8474515
TI  - Recent advances in pulmonary medicine (1).

PMID- 8474516
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 19-1993. A 39-year-old man with bilateral renal masses a few
      months after treatment for Hodgkin's disease, stage IIA.

PMID- 8474517
TI  - Colorectal cancer screening comes of age.

PMID- 8474518
TI  - Antimicrobial prophylaxis after tick bites.

PMID- 8474519
TI  - Antimicrobial prophylaxis after tick bites.

PMID- 8474520
TI  - Antimicrobial prophylaxis after tick bites.

PMID- 8474521
TI  - Childhood immunizations.

PMID- 8474522
TI  - Childhood immunizations.

PMID- 8474523
TI  - Childhood immunizations.

PMID- 8474524
TI  - Noninvasive prediction of pulmonary-capillary wedge pressure.

PMID- 8474525
TI  - Noninvasive prediction of pulmonary-capillary wedge pressure.

PMID- 8474526
TI  - Bronchial hyperresponsiveness in heart failure.

PMID- 8474527
TI  - Novel gifts from pharmaceutical companies.

PMID- 8474528
TI  - Retained needle fragments and digital dissection.

PMID- 8474529
TI  - Ultrastructural study of Cryptococcus neoformans by quick-freezing and deep
      etching method.
AB  - The three-dimensional ultrastructure of Cryptococcus neoformans was studied by
      quick-freezing and deep-etching (QF-DE) method. C. neoformans, strain CDC551, was
      cultured on agar. The viable yeast cells (10(7) cells) were inoculated into each
      mouse from the tail vein. Three weeks after the inoculation, the brains of the
      mice were perfused with fixatives, quickly frozen, freeze-fractured, deeply
      etched and rotary shadowed with platinum and carbon. In addition, the viable
      cells of C. neoformans on agar were picked up and quickly frozen, and replica
      membranes were prepared as described above. The ultrastructure of C. neoformans
      was three-dimensionally demonstrated by the QF-DE method. The capsule was
      composed of fine meshworks of microfibrils (10-13 nm in diameter), which were
      directly attached to the cell walls. The capsule of the in vivo yeasts (yeast
      cells in the brain lesion) was thicker than that of the in vitro yeasts (yeast
      cells on agar culture). At the outer part of the cell wall, a particle
      accumulating layer was observed. This layer in vivo was thicker than that in
      vitro. Occasionally, the yeast cells were ingested by phagocytes in the mouse
      brain. Although the cytoplasm of such yeast cells was destroyed, the capsular
      meshworks were well preserved. The ultrastructure of the capsule was the same
      both in cultured and phagocytized yeasts in the cystic lesions of the brains.
      This lack of morphological changes of the capsular meshworks suggests that they
      are resistant to the digestion by phagocytes. This stability of capsular
      structures may provide one of the important pathogenic factors in cystic lesions
      by C. neoformans.

PMID- 8474530
TI  - Two bacteria causing farmer's lung: fine structure of Thermoactinomyces vulgaris
      and Saccharopolyspora rectivirgula.
AB  - The fine structure of Thermoactinomyces vulgaris and Saccharopolyspora
      rectivirgula is described by transmission electron microscopy. These two bacteria
      are the most common microbes causing farmer's lung. The fine structure of hyphae,
      germination of endospores and the details of conidial wall layers of T. vulgaris,
      as well as the fine structure of septate hypha and globose, polygonal conidia of
      S. rectivirgula are described. The conidial wall of T. vulgaris consisted of an
      inner multilayered spore coat, intermediate spore coat and outer spore coat. The
      findings are important for the investigations to find fragments of these bacteria
      in the lungs of exposed patients and experimental animals.

PMID- 8474531
TI  - Dialysable leukocyte extracts modify the course of experimental
      paracoccidioidomycosis in the Syrian hamster.
AB  - The effect of dialysable leukocyte extracts (DLE) obtained from hamsters
      immunized with Paracoccidioides brasiliensis (immune DLE) and from non-immunized
      hamsters (non-immune DLE) was studied in hamsters inoculated with P. brasiliensis
      by the intratesticular route. Treatment with immune or non-immune DLE was started
      during the third week of infection and was repeated at 7, 11, 15 and 19 weeks. A
      group of untreated infected animals was used as control. Animals were submitted
      to the delayed hypersensitivity skin test to P. brasiliensis antigen (PbAg) in
      vivo and assayed in vitro by the macrophage migration inhibition test in the
      presence of Phytohemagglutinin (PHA) and PbAg and by immunodiffusion for specific
      antibody. The animals were sacrificed at 4, 8, 12, 16 and 20 weeks. The
      morphology and extension of the lesions were studied at the inoculation site, and
      in lymph nodes, lungs, liver, spleen and kidneys. In contrast to the controls,
      animals treated with both DLEs maintained a positive cell-mediated immune
      response throughout the experiment and developed less extensive infection with a
      significantly lower number of fungi in the lesions. The results suggest that
      immune and non-immune DLE preparations modified the evolution of experimental
      paracoccidioidomycosis with equal efficiency. This similarity may be explained by
      the immunoregulatory activities of both extracts.

PMID- 8474532
TI  - Characterization of functional responses in A9 cells transfected with cloned rat
      5-HT1C receptors.
AB  - Functional responses to stimulation of rat 5-HT1C receptors expressed in A9 cells
      were studied using whole cell voltage clamp and calcium recording techniques.
      Stimulation of 5-HT1C receptors evoked outward currents clamped at -50 mV. The
      outward currents were reduced when GTP was excluded from the intracellular
      recording solution or when GDP-beta-S was added. 8-Bromo cyclic AMP (5 mmol/l)
      neither produced an effect per se nor affected the 5-HT-induced outward current
      in A9 cells, thus excluding cAMP as a second messenger involved in 5-HT1C
      receptor activation. Phorbol myristic acetate (PMA; 10 mumol/l) did not affect
      the electrical activity of the transfected A9 cells but reduced the 5-HT-induced
      current amplitude to 71 +/- 9% of the control value (n = 12). This indicates that
      activation of protein kinase C does not play a direct role in the 5-HT-induced
      response in these cells. The 5-HT induced currents mainly involved potassium
      ions, although a small contribution of chloride ions was also observed. The 5-HT
      induced current was inhibited by the K+ channel blocking agents
      tetraethylammonium (1 mmol/l), apamin (0,5 mumol/l) and 4-aminopyridine (5
      mmol/l). The 5-HT-induced currents recorded at -50 mV were unaffected by removal
      of extracellular calcium, but inclusion of the calcium chelator BAPTA (5 mmol/l)
      in the intracellular solutions abolished the current. Measurement with the
      calcium indicator Fluo-3 revealed a 5-HT-induced increase in intracellular
      calcium which was not affected by removal of extracellular calcium but declined
      after repeated stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474533
TI  - Heterogeneity of 5-HT receptor subtypes in isolated human femoral and saphenous
      veins.
AB  - Changes in tension were monitored isometrically on helical strips from both
      femoral and saphenous human veins obtained during autopsy and during surgical
      removal of varicose veins respectively. Both venous tissues contracted in
      response to 5-hydroxytryptamine (5-HT), 5-carboxamidotryptamine (5-CT) and 8
      hydroxy-2-(di-n-propylamino) tetralin (8-OH-DPAT). While 5-HT was about 2 times
      more potent in saphenous (pD2 = 7.35) than in femoral veins (pD2 = 7.04), 5-CT
      stimulated the saphenous vein (pD2 = 7.62) at about 20 times lower concentrations
      than were required for stimulation of the femoral vein (pD2 = 6.27). 8-OH-DPAT
      induced venoconstriction only when used at very high concentrations and pD2
      values could not be determined. These data suggested different subtypes and/or
      distribution of 5-HT receptors in both venous preparations. Further evidence for
      this was obtained by the observation that spiperone (a 5-HT receptor blocker with
      high affinity for 5-HT2 and 5-HT1A sites) produced a parallel shift to the right
      of the 5-HT curve in femoral veins but elicited a biphasic displacement of the 5
      HT curve in saphenous veins. In the femoral vein, spiperone showed a pA2 value of
      9.20 +/- 0.08, statistically not different from that calculated for the spiperone
      sensitive 5-HT effect in saphenous vein (pA2 = 9.14 +/- 0.08). The results
      suggest that regional variations in the distribution of 5-HT receptor subtypes do
      exist, human femoral veins possessing mainly 5-HT2 receptors whereas in human
      saphenous veins both 5-HT1-like and 5-HT2 receptors are present.

PMID- 8474534
TI  - Modulation by 5-HT3 and 5-HT4 receptors of the release of 5-hydroxytryptamine
      from the guinea-pig small intestine.
AB  - The effects of agonists and antagonists of 5-hydroxytryptamine (5-HT) receptors
      on the release of endogenous 5-HT from enterochromaffin cells were studied in the
      vascularly perfused isolated guinea-pig small intestine. The experiments were
      done in the presence of tetrodotoxin in order to exclude a neuronally mediated
      influence on 5-HT release. The 5-HT3 receptor agonist 2-methyl-5-HT increased 5
      HT release, and this effect was antagonized by 1 nmol/l tropisetron. Nanomolar
      concentrations of tropisetron, MDL 72,222 and granisetron decreased 5-HT release.
      Ondansetron (0.1 and 1 mumol/l) did not modify 5-HT release. 5-Methoxytryptamine,
      BIMU8 and cisapride concentration-dependently inhibited 5-HT release. BIMU8 was
      more potent than 5-methoxytryptamine. Micromolar concentrations of tropisetron (1
      and 10 mumol/l) enhanced the release, whilst methiothepine (0.1 mumol/l) did not
      affect the release of 5-HT. The results suggest that enterochromaffin cells of
      the guinea-pig ileum do not contain 5-HT1 and 5-HT2 receptors, but are endowed
      with 5-HT3 and 5-HT4 autoreceptors. Activation of the 5-HT3 receptors triggers a
      positive feedback mechanism leading to an increase of 5-HT release. The 5-HT3
      receptors on the enterochromaffin cell differ from neuronal 5-HT3 receptors on
      guinea-pig myenteric plexus by their high affinity for tropisetron and MDL
      72,222, and their very low affinity for ondansetron. Stimulation of 5-HT4
      receptors causes inhibition of release; the inhibitory 5-HT4 receptor mechanism
      appears to predominate.

PMID- 8474535
TI  - Different effects of 1-methyl-4-phenyl-pyridinium (MPP+) on monoamine oxidase of
      dopaminergic terminals in caudate nucleus slices from pigmented and from albino
      rabbits.
AB  - Slices of caudate nucleus from pigmented and from albino rabbits were
      preincubated in vitro for 24 h with different concentrations of the neurotoxic
      compound MPP+. Subsequently, endogenous dopamine (DA) in the slices was
      determined by HPLC. MPP+ (1 and 3.2 mumol/l) was more effective in diminishing DA
      levels in caudate nucleus slices from albino than in slices from pigmented
      rabbits. Following 24 h pretreatment with MPP+, the accumulation of [3H]-DA in
      caudate nucleus slices from pigmented rabbits was either enhanced (at 0.32
      mumol/l, 1 mumol/l and 3.2 mumol/l MPP+) or reduced (at 32 mumol/l MPP+). In
      contrast, MPP+ did not enhance the accumulation of [3H]-DA in caudate nucleus
      tissue from albino rabbits and was more potent in reducing the [3H]-DA content in
      slices from albino than in slices from pigmented rabbits. When the selective type
      A monoamine oxidase (MAO) inhibitor clorgyline was present during pre-incubation,
      but not when the selective type B MAO inhibitor deprenyl was, the concentration
      response curve for MPP+ with caudate nucleus slices from pigmented rabbits was
      similar to that obtained with slices from albino rabbits. Clorgyline and deprenyl
      did not change the effects of MPP+ in caudate nucleus slices from albino rabbits.
      These findings are compatible with the hypothesis that the MAO within
      dopaminergic terminals in the caudate nucleus of pigmented, but not of albino,
      rabbits is of type A since MAO-A is preferentially inhibited by MPP+. In line
      with this hypothesis, the accumulation of the preferential MAO-A substrate [3H]-5
      HT in caudate nucleus slices from pigmented rabbits was about 39% lower than that
      in slices from albino rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474536
TI  - The part played by catechol-O-methyltransferase in the plasma kinetics of 3,4
      dihydroxyphenylglycol and 3,4-dihydroxyphenylalanine in the anaesthetized rabbit.
AB  - The present study, carried out in anaesthetized rabbits, aimed at determining the
      effects of catechol-O-methytransferase (COMT) inhibition on the plasma kinetics
      of infused 3,4-dihydroxyphenylglycol (DOPEG) and 3,4-dihydroxyphenylalanine
      (DOPA) as well as on endogenous plasma noradrenaline, DOPEG, DOPA and 3-methoxy-4
      hydroxyphenylglycol (MOPEG). The plasma kinetics of infused MOPEG were also
      evaluated. To block the function of COMT, 3,4-dihydroxy-4'-methyl-5
      nitrobenzophenone (Ro 40-7592) was given intravenously. Dose-finding experiments,
      in which the drug-induced fall in endogenous plasma MOPEG was used to quantify
      COMT inhibition, indicated that a Ro 40-7592 dose of 3 mg/kg followed by 1.5
      mg/kg every 30 min was sufficient to obtain a virtually complete inhibition of
      COMT. More than 150 min of COMT inhibition were required for endogenous MOPEG to
      disappear from plasma, since the plasma half-life of MOPEG was 54 min. COMT
      inhibition produced marked increases in the plasma levels of endogenous DOPA (1.7
      fold) and DOPEG (3.9-fold) and did not alter endogenous plasma noradrenaline. The
      results concerning the effect of COMT inhibition on the plasma kinetics of
      infused DOPA and DOPEG were as follows: the plasma clearance of DOPA was not
      altered, whereas that of DOPEG fell by 41%; the plasma half-life of DOPA
      increased from 4.9 to 13.0 min and that of DOPEG from 4.8 to 31.0 min; there was
      an increase in the volume of distribution of DOPA (2 to 3-fold) and DOPEG (4 to 5
      fold).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474537
TI  - Effects of catechol-O-methyltransferase inhibition on the plasma clearance of
      noradrenaline and the formation of 3,4-dihydroxyphenylglycol in the rabbit.
AB  - The purpose of this study was to elucidate the finding of Friedgen et al. (1993
      b) that catechol-O-methyltransferase (COMT) inhibition is much more effective in
      increasing the plasma concentration of endogenous dihydroxyphenylglycol (DOPEG)
      than in increasing the plasma concentration of infused DOPEG. To this end,
      reserpine-pretreated rabbits were anaesthetized and infused with noradrenaline
      and/or DOPEG, and the plasma clearances of infused noradrenaline (ClNA) and DOPEG
      (ClDOPEG) as well as the plasma DOPEG response to noradrenaline infusion [as
      reflected by the ratio of the steady-state increase in plasma DOPEG (delta DOPEG)
      to that in plasma noradrenaline (delta NA)] were determined before and after
      blockade of neuronal uptake by desipramine. Experiments were carried out either
      under control conditions or after COMT inhibition by i.v. administration of 3,4
      dihydroxy-4'-methyl-5-nitrobenzophenone (Ro 40-7592). On the assumption that
      rates of neuronal noradrenaline uptake equal steady-state rates of neuronal DOPEG
      formation, the desipramine-sensitive components of ClNA and delta DOPEG/delta NA
      were used to estimate the apparent plasma clearance of DOPEG formed
      intraneuronally (Clf-DOPEG) in response to noradrenaline infusion. ClNA was 83.6
      ml kg-1 min-1 in the absence and 48.1 ml kg-1 min-1 in the presence of
      desipramine. Neither the former nor the latter value was altered after COMT
      inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474538
TI  - Release and disposition of 3H-noradrenaline in the saphenous vein of neonate and
      adult dogs.
AB  - Release of 3H-noradrenaline and formation of 3H-metabolites were studied in the
      saphenous vein of newborn (mean age, 18 h) and adult dogs. Vein strips were
      incubated with 0.23 mumol/l of 3H-noradrenaline during 1 h and washed out for 110
      min; thereafter, the perifusion fluid was collected in 5-min samples. Electrical
      stimulation was applied at 120 min (1 Hz, 2 ms, 100 V, for 5 min). In some
      experiments the tissues were preincubated with 1 mmol/l pargyline (to inhibit
      monoamine oxidase). In these experiments, 12 mumol/l cocaine (to inhibit
      uptake1), 41 mumol/l hydrocortisone (to reduce uptake2) and 50 mumol/l U-0521 (to
      inhibit COMT) were present during the perifusion. 3H-noradrenaline, 3H-DOPEG, 3H
      NMN, 3H-DOMA and 3H-OMDA were separated by column chromatography. The
      noradrenaline content of the tissue was estimated by HPLC followed by
      electrochemical detection. A morphological study was also carried out by light
      and electron microscopy. The endogenous noradrenaline content of the saphenous
      vein was 4.3 times higher in adults than in neonates. The number of varicosities
      was similar in adults and newborns but the number of vesicles per varicosity
      profile was 5 times higher in adults. Hence, the endogenous noradrenaline content
      per vesicle was about the same in adults and newborns. The accumulation of 3H
      noradrenaline per vesicle was about 5 times higher in newborns than in adults. On
      the other hand, the vein wall media of neonates was about 3 times thinner than
      that of adults. The evoked fractional release of tritium was about 10 times
      higher in neonates than in adults, whether the inactivation pathways were blocked
      or not.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474539
TI  - Characterization of the angiotensin II-receptor subtype in the longitudinal
      smooth muscle of the rat portal vein.
AB  - The purpose of the present study was to identify the angiotensin II-receptor
      subtype involved in the enhancement of the amplitude of the phasic contractions
      by angiotensin II in the isolated rat portal vein preparation. At an
      extracellular Ca2+ concentration of 0.9 mmol/l and a K+ concentration of 4
      mmol/l, angiotensin II induced concentration-dependent increases in the amplitude
      of the phasic contractions. The enhancement of phasic contraction amplitude
      caused by angiotensin II was not significantly altered by pretreatment of the rat
      portal vein with indomethacin 10(-5) mol/l or nitro-L-arginine 10(-4) mol/l,
      indicating that neither prostaglandins nor the endothelium derived-relaxing
      factor (NO) are involved. Losartan (DuP 753), a nonpeptide selective AT1-receptor
      antagonist, concentration-dependently shifted the concentration-response curve
      for the effect of angiotensin II on the amplitude of the contractions to the
      right, without reducing the maximal response (pA2 = 8.6, slope = 0.98), thus
      suggesting competitive antagonism at the level of AT1-receptors. By contrast, PD
      123,177, a nonpeptide selective AT2-receptor antagonist, even at 10(-5) mol/l,
      caused no significant change of the phasic myogenic response to angiotensin II,
      indicating the absence of AT2-receptor involvement. Dithiothreitol, a disulfide
      reducing agent which is known to inactivate AT1-receptors in various tissues,
      markedly inhibited (3 mmol/l) or even abolished (5 mmol/l) the contractile
      response of the rat portal vein to angiotensin II, supporting the conclusion that
      these receptors can be classified as AT1-receptors.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474541
TI  - [A hide-and-seek kind of disorder].

PMID- 8474540
TI  - N omega-nitro-L-arginine, an inhibitor of nitric oxide synthesis, decreases
      noradrenaline outflow in rat isolated perfused mesenteric vasculature.
AB  - In the isolated perfused rat mesenteric vasculature with intestine attached N
      omega-nitro-L-arginine (L-NNA) (30 mumol/l), an inhibitor of nitric oxide (NO)
      synthesis from L-arginine, did not alter spontaneous noradrenaline outflow.
      Transmural field stimulation (2-10 Hz) caused a frequency-dependent increase in
      noradrenaline outflow. The evoked overflow was reduced by L-NNA. L-Arginine (0.3
      mmol/l) attenuated the inhibition of noradrenaline overflow by L-NNA. These
      results suggest that NO increases the release of noradrenaline in rat mesenteric
      vasculature.

PMID- 8474542
TI  - [Treatment with estrogens and the risk of gallstone formation].

PMID- 8474543
TI  - [Should the testing policy for the prevention of HIV infections in patients and
      in health care personnel be changed?].

PMID- 8474544
TI  - [AIDS and HIV infection as occupational disease].

PMID- 8474545
TI  - [Iatrogenic HIV infection].

PMID- 8474546
TI  - [Chronic functional constipation in children].

PMID- 8474547
TI  - [The consent discussion for organ donation].

PMID- 8474548
TI  - [Constipation in childhood; evaluation of a diagnostic-therapeutic protocol].
AB  - In 87 children with constipation an assessment was made of the causes, and of the
      effect of treatment. Two subdivisions were made, one by age (< 3 years and > or =
      3 years) and the second into 'own' or 'referred' patients. For the 59 own
      children a diagnostic-therapeutic protocol was used, the three-phase protocol.
      For children over 3 years (n = 29) this policy consists in the first phase of
      anamnesis, physical examination, diet and oral and/or rectal laxatives. In the
      second phase, toilet training is administered in combination with diet and oral
      laxatives. The third phase comprises continuation of the diet and tapering off of
      the laxatives. If no improvement is seen, supplementary examination is carried
      out. In the group of own patients younger than 3 years, supplementary examination
      is already carried out during the first phase. Functional constipation was
      diagnosed in 69% and 98%, respectively, of the 36 patients under 3 years and the
      51 over 3 years. Hirschsprung's disease was diagnosed in 14% and 2%,
      respectively. In the children > or = 3 years with functional constipation the
      three-phase policy was successful in 86% with a mean duration of the treatment of
      9.5 months. The efficiency of diagnostic examination of children over 3 years
      appears to be low, justifying the proposed three-phase policy. In children under
      3 years, on the other hand, limited laboratory examination is necessary during
      the first phase. Examination for the presence of Hirschsprung's disease, by means
      of rectal biopsy or anorectal manometry is indicated if the treatment during the
      first phase is unsuccessful.

PMID- 8474549
TI  - [Chronic constipation in children; good results of biofeedback training as
      supplementary therapy].
AB  - In two children with refractory constipation biofeedback training was
      successfully used as a supplementary therapy. In this treatment, a balloon tied
      to the end of the catheter is inserted into the rectum and inflated with ever
      decreasing amounts of air, so as to increase rectal sensibility. In addition, the
      defaecation pattern is displayed on a monitor. The child learns to control
      contraction and relaxation of the musculature involved in defaecation.

PMID- 8474550
TI  - [Controversies in preventive health care. II. Preconception and prenatal care].

PMID- 8474551
TI  - [The prevention of recurrent erysipelas].

PMID- 8474552
TI  - [Benefit of antibiotics in acute sore throat].

PMID- 8474553
TI  - [Wrong questions, erroneous answers; an absurd choice].

PMID- 8474554
TI  - Age- and seizure-related changes in noradrenaline and dopamine in several brain
      regions of epileptic El mice.
AB  - Noradrenaline (NA) and dopamine (DA) levels in six brain regions of stimulated
      and nonstimulated El (El[s] and El[ns]) mice and their maternal ddY mice were
      determined at various ages and various times after a convulsion. The NA levels in
      the striatum and hippocampus of 12-week-old El[s] and El[ns] mice were lower than
      in ddY mice, and remained lower in 23-week-old El[s] mice, but not in El[ns]
      mice. DA levels were lower in the striatum of El[s] mice than in El[ns] and ddY
      mice at 16 and 23 weeks of age. NA levels decreased during seizure in the
      striatum and hippocampus of El[s] mice, and returned to preconvulsive levels 1 hr
      after convulsion in the striatum and 30 min in the hippocampus. DA levels in the
      striatum of El[s] mice decreased during convulsion and increased from 1 to 10 min
      after convulsion. These changes suggest that the NAergic systems in the striatum
      and hippocampus and the DAergic system in the striatum have important roles in
      relation to seizure susceptibility in El mice.

PMID- 8474555
TI  - The two catalytic components of the 2-oxoglutarate dehydrogenase complex in rat
      cerebral synaptic and nonsynaptic mitochondria: comparison of the response to in
      vitro treatment with ammonia, hyperammonemia, and hepatic encephalopathy.
AB  - The effects of in vitro treatment with ammonium chloride, hepatic encephalopathy
      (HE) due to thioacetamide (TAA) induced liver failure and chronic hyperammonemia
      produced by i.p. administration of ammonium acetate on the two components of the
      multienzyme 2-oxoglutarate dehydrogenase complex (OGDH): 2-oxoglutarate
      decarboxylase (E1) and lipoamide dehydrogenase (E3), were examined in synaptic
      and nonsynaptic mitochondria from rat brain. With regard to E1 the response to
      ammonium ions in vitro (3 mM NH4Cl) was observed in nonsynaptic mitochondria only
      and was manifested by a 21% decrease of Vmax and a 35% decrease of Km for 2
      oxoglutarate (2-OG). By contrast, both in vivo conditions primarily affected the
      synaptic mitochondrial E1: TAA-induced HE produced an 84% increase of Vmax and a
      38% increase of Km for 2-OG. Hyperammonemia elevated Vmax of E1 by 110% and Km
      for 2-OG by 30%. HE produced no effect at all in nonsynaptic mitochondria while
      hyperammonemia produced a 35% increase of Vmax and a 30% increase of Km for 2-OG
      of E1. Both in vivo conditions produced a 20% increase of E3 activity in synaptic
      mitochondria, but no effect at all in nonsynaptic mitochondria. The preferential
      sensitivity of E1 to ammonium chloride in vitro in nonsynaptic mitochondria and
      hyperammonemic conditions in vivo in synaptic mitochondria may play a crucial
      role in the compartmentation of OGDH responses under analogous conditions. These
      results confirm the intrinsic differences between the OGDH properties in the
      synaptic and nonsynaptic brain compartments.

PMID- 8474556
TI  - Regulation of phosphate-activated glutaminase (PAG) by glutamate analogues.
AB  - The ability of structural analogues of glutamate (GLU) to modulate phosphate
      activated glutaminase (PAG) was assessed in the present series of studies. A
      number of GLU receptor agonists and antagonists were tested for their ability to
      inhibit synaptosomal PAG activity. PAG activity was determined by measuring GLU
      formation from 0.5 mM glutamine (GLN) in the presence of 10 mM phosphate. GLU
      analogues at 5-10 mM were found to significantly inhibit PAG activity. It was
      determined that PAG inhibition occurred regardless of whether the GLU analogues
      were receptor agonists or antagonists, however, PAG inhibition was influenced by
      analogue chain length, isomeric form and substituent substitution. The glutamate
      uptake blockers, dihydrokainic acid and DL-threo-beta-hydroxyaspartic acid were
      relatively weak inhibitors of PAG (< 25% inhibition) as were the receptor
      agonists, ibotenic acid and (+-)cis-2,3-piperidine-dicarboxylic acid. Other GLU
      analogues produced inhibition of PAG in the range of 40-70%. PAG inhibition by
      GLU analogues did not appear to differ substantially among the brain regions
      evaluated (cortex, striatum and hippocampus). The endogenous amino acids,
      glycine, taurine and N-acetylaspartic acid, also significantly inhibited PAG
      activity in the 5-10 mM range. The noncompetitive NMDA antagonists, (+)MK801 and
      ketamine, at a concentration of 5 mM, significantly stimulated PAG activity 1.5-2
      fold over control values. The activation of PAG by (+)MK801 was dose-related,
      stereoselective and appeared to result from a synergistic interaction with
      phosphate to enhance substrate (GLN) binding to PAG.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474557
TI  - Neurons respond to hyposmotic conditions by an increase in intracellular free
      calcium.
AB  - The effect of hyposmotic conditions on the concentration of intracellular free
      calcium ([Ca2+]i) was studied in cultured cerebellar granule cells and cerebral
      cortical neurons after loading of the cells with the fluorescent Ca2+ chelator
      Fluo-3. It was found that in both types of neurons exposure to media with a
      decrease in osmolarity of 20 to 50% of the osmolarity in the isosmotic medium
      (320 mOsm) led to a dose dependent increase in [Ca2+]i with a time course showing
      the highest value at the earliest measured time point, i.e. 40 s after exposure
      to the hyposmotic media and a subsequent decline towards the basal level during
      the following 320 s. The response in the cortical neurons was larger than in the
      granule cells but both types of neurons exhibited a similar increase in [Ca2+]i
      after exposure to 50 mM K+ which was of the same magnitude as the increase in
      [Ca2+]i observed in the cortical neurons exposed for 40 s to a medium with a 50%
      reduction in osmolarity. In both types of neurons the blocker of voltage gated
      Ca2+ channels verapamil had no effect on the hyposmolarity induced increase in
      [Ca2+]i. On the contrary, this increase in [Ca2+]i was dependent upon external
      calcium and could be inhibited partly or completely by the inorganic blockers of
      Ca2+ channels Mg2+ and La3+. Dantrolene which prevents release of Ca2+ from
      internal stores had no effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474558
TI  - Depletion of polyamines prevents the neurotrophic activity of the GABA-agonist
      THIP in cultured rat cerebellar granule cells.
AB  - Effects of polyamine depletion by alpha-difluoromethylornithine (DFMO) were
      studied on the GABA-agonist mediated enhancement of the morphological development
      of cultured rat cerebellar granule cells. An increase in the number of neurite
      extending cells and in the cytoplasmic density of organelles relevant for protein
      synthesis was observed upon culturing in the presence of 4,5,6,7-tetrahydro
      isoxazole[5,4-c]pyridin-3-ol (THIP) for 4 days. The intracellular concentrations
      of putrescine, spermidine, and spermine in these cultures were similar to the
      concentrations of the polyamines observed in cultures grown in a plain culture
      medium for 1, 2, 3 or 4 days, respectively. Upon culturing in the simultaneous
      presence of THIP and DFMO, the concentrations of putrescine and spermadine were
      reduced to less than 20% of the levels in the controls. This depletion was
      associated with a severely impaired morphological development of the granule cell
      cultures. Thus, the number of neurite extending cells was reduced to 50% of the
      number in the control cultures upon culturing in the presence of DFMO alone or in
      combination with THIP. Moreover, the THIP mediated increase in the cytoplasmic
      density of rough endoplasmic reticulum, Golgi apparatus and different types of
      vesicles was prevented by the exposure to DFMO.

PMID- 8474559
TI  - Transport of L-lactate by cultured rat brain astrocytes.
AB  - Several reports indicate that lactate can serve as an energy substrate for the
      brain. The rate of oxidation of this substrate by cultured rat brain astrocytes
      was 3-fold higher than the rate with glucose, suggesting that lactate can serve
      as an energy source for these cells. Since transport into the astrocytes may play
      an important role in regulating nutrient use by individuals types of brain cells,
      we investigated the uptake of L-[U-14C]lactate by primary cultures of rat brain
      astrocytes. Measurement of the net uptake suggested two carrier-mediated
      mechanisms and an Eadie-Hofstee type plot of the data supported this conclusion
      revealing 2 Km values of 0.49 and 11.38 mM and Vmax values of 16.55 and 173.84
      nmol/min/mg protein, respectively. The rate of uptake was temperature dependent
      and was 3-fold higher at pH 6.2 than at 7.4, but was 50% less at pH 8.2. Although
      the lactate uptake carrier systems in astrocytes appeared to be labile when
      incubated in phosphate buffered saline for 20 minutes, the uptake process
      exhibited an accelerative exchange mechanism. In addition, lactate uptake was
      altered by several metabolic inhibitors and effectors. Potassium cyanide and
      alpha-cyano-4-hydroxycinnamate inhibited lactate uptake, but mersalyl had little
      or no effect. Phenylpyruvate, alpha-ketoisocaproate, and 3-hydroxybutyrate at 5
      and 10 mM greatly attenuated the rate of lactate uptake. These results suggest
      that the availability of lactate as an energy source is regulated in part by a
      biphasic transport system in primary astrocytes.

PMID- 8474560
TI  - Modulation of a neuronal calmodulin mRNA species in the rat brain stem by
      reserpine.
AB  - Reserpine evokes transsynaptic impulse activity by depleting catecholaminergic
      neurotransmitters in the rat brain. Previous studies suggest a relationship
      between catecholaminergic activity and calmodulin concentration. In this report
      we employ Northern blot analysis to examine the effect of a single subcutaneous
      injection of reserpine on levels of calmodulin mRNA species which are
      preferentially expressed in neurons of the rat brain. Regional differences in
      mRNA levels were also investigated by in situ hybridization and drug-induced
      changes were noted particularly in specific regions of the rat brain stem. The
      riboprobe used in the in situ hybridization study recognized a 4.0 kilobase
      neuronal calmodulin mRNA species (NGB1), which was derived from the rat CaM1
      gene. A calmodulin radio-immunoassay was utilized to demonstrate a drug-induced
      increased in calmodulin protein levels in a region which included the brain stem.

PMID- 8474561
TI  - Spontaneous and evoked release of [3H]taurine from a P2 subcellular fraction of
      the rat retina.
AB  - The effects of spontaneous and evoked [3H]taurine release from a P2 fraction
      prepared from rat retinas were studied. The P2 fraction was preloaded with
      [3H]taurine under conditions of high-affinity uptake and then examined for
      [3H]taurine efflux utilizing superfusion techniques. Exposure of the P2 fraction
      to high K+ (56 mM) evoked a Ca(2+)-independent release of [3H]taurine. Li+ (56
      mM) and veratridine (100 microM) had significantly less effect (8-15% and 15-30%,
      respectively) on releasing [3H]taurine compared to the K(+)-evoked release. 4
      Aminopyridine (1 mM) had no effect on the release of [3H]taurine. The spontaneous
      release of [3H]taurine was also Ca(2+)-independent. When Na+ was omitted from the
      incubation medium K(+)-evoked [3H]taurine release was inhibited by approximately
      40% at the first 5 minute depolarization period but was not affected at a second
      subsequent 5 minute depolarization period. The spontaneous release of [3H]taurine
      was inhibited by 60% in the absence of Na+. Substitution of Br- for Cl- had no
      effect on the release of either spontaneous or K(+)-evoked [3H]taurine release.
      However, substitution of the Cl- with acetate, isethionate, or gluconate
      decreased K(+)-evoked [3H]taurine release. Addition of taurine to the superfusion
      medium (homoexchange) resulted in no significant increase in [3H]taurine efflux.
      The taurine-transport inhibitor guanidinoethanesulfonic acid increased the
      spontaneous release of [3H]taurine by approximately 40%. These results suggest
      that the taurine release of [3H]taurine is not simply a reversal of the carrier
      mediated uptake system. It also appears that taurine is not released from
      vesicles within the synaptosomes but does not rule out the possibility that
      taurine is a neurotransmitter. The data involving chloride substitution with
      permeant and impermeant anions support the concept that the major portion of
      [3H]taurine release is due to an osmoregulatory action of taurine while
      depolarization accounts for only a small portion of [3H]taurine release.

PMID- 8474563
TI  - Stress protein synthesis and accumulation after traumatic injury of crayfish CNS.
AB  - By several days after a crush injury of crayfish CNS, the wound site heals.
      Changes in protein synthesis and accumulation occur at the lesion site and
      nearby. During the first few hours, synthesis of 35, 70, 90, and 150 kDa proteins
      is induced in the injured tissue. By one day, the relative amounts of 70-90 kDa
      proteins increase dramatically, particularly at the crush site and adjacent to
      it. The 70 kDa proteins, which are related to mammalian stress proteins (SPs),
      remain elevated for at least one month in the traumatized region or nearby. The
      crushed tissue contains an SP70 isoform not present in its uncrushed counterpart.
      These biochemical changes may reflect the cellular changes that accompany wound
      healing and/or a cellular stress response to compensate for the lesion. Since
      similar adaptations occur in the mammalian CNS, they may represent a
      phylogenetically conserved attempt to retard or repair CNS tissue deterioration.

PMID- 8474564
TI  - Specificity of calcium-activated neutral proteinase (CANP) inhibitors for human
      mu CANP and mCANP.
AB  - We investigated the relative inhibition of purified human mu CANP and mCANP by
      five cysteine proteinase inhibitors including N-acetyl-Leu-Leu-nor-leucinal (C-I)
      and N-acetyl-Leu-Leu-methioninal (C-II), calpeptin, E64, and leupeptin. Based on
      IC50 measurements, calpeptin and C-I were stronger inhibitors by one to two
      orders of magnitude than C-II, leupeptin or E64. None of the five inhibitors,
      however, exhibited greater specificity for human mu CANP or mCANP. These results
      indicate that, although the inhibition of a given cellular event by these
      compounds may suggest CANP involvement, effects on mu CANP cannot be
      discriminated from those on mCANP.

PMID- 8474562
TI  - Quantitative alterations of S-100 protein and neuron specific enolase in the rat
      nervous system after chronic 2,5-hexanedione exposure.
AB  - The regional changes in quantities of the glial S-100 protein and the neuron
      specific enolase in the rat nervous system have been studied after long-term
      exposure to 2,5-hexanedione. The wet weights of most of the examined nervous
      tissues were found to be reduced, with an extensive effect seen in the brain
      stem. Using dot immunobinding assays, the concentrations of S-100 were found to
      be increased in most of the examined tissues, but unaffected in the brain stem.
      The total amount of S-100 per tissue was markedly reduced in the brain stem. The
      content of neuron specific enolase was reduced only in the brain stem. Thus the
      effects of 2,5-hexanedione on the nervous system varied regionally. The brain
      stem was severely atrophied with a reduction of neuronal as well as of glial
      marker proteins. Other brain regions contained increased glial cell marker
      proteins as signs of progressive astroglial reactions.

PMID- 8474565
TI  - Special issue dedicated to Dr. Claude Baxter.

PMID- 8474566
TI  - Heterogeneous distribution of functionally important amino acids in brain areas
      of adult and aging humans.
AB  - The regional distribution of seven amino acids thought to have inhibitory
      neurotransmitter or neurotransmitter precursor function--GABA, glycine, taurine,
      serine, threonine, phenylalanine, and tyrosine--was determined in 52 discrete
      areas from brain of adult and old humans. Significant heterogeneity was found,
      with 3- to 16-fold differences in levels in the various regions analyzed. The
      patterns of distribution were somewhat different from those in the adult or old
      rat brain. Relatively few changes were seen in old brain. Heterogeneity in
      distribution has to be taken into account in assessing physiological changes in
      amino acid levels and metabolism.

PMID- 8474567
TI  - Taurine in toad brain and blood under different conditions of osmolality: an
      immunohistochemical study.
AB  - The concentrations of taurine in blood and brain regions of the toad Bufo boreas
      have been measured. Most of these values are considerably lower than those found
      in mammals. Using an antibody prepared against conjugated taurine, the
      distribution of taurine in three brain regions of the toad has been visualized.
      The possible osmoregulatory functions of taurine have been investigated by making
      toads hyper- or hypo-osmotic in vivo. Induction of hypoosmolality is accompanied
      by a massive taurine tide in blood plasma, but has no immediate effects upon the
      taurine concentrations in the brain areas studied. However, histochemical
      visualization indicates a marked redistribution of taurine between cellular
      components and extracellular space of brain tissues. This may indicate that
      taurine has an osmoregulatory function in brain tissue under hypo-osmotic
      conditions. Hyperosmolality results in no elevation of the taurine concentration
      in blood plasma of toads, but rather in a very gradual decline of total plasma
      taurine content over a prolonged time period. Histochemical studies reveal little
      change in frontal cortex after 1 hour but deeper staining of many neurons in
      optic lobe accompanied by greater staining in the extracellular fluid. By 3 hours
      there is a depletion of taurine from all compartments of cerebral cortex tissues.
      No evidence of any prolonged direct osmoregulatory role for taurine is indicated
      under hyperosmotic conditions. A possible indirect osmoregulatory function of
      taurine is discussed.

PMID- 8474568
TI  - Modulation by GABA of neuroplasticity in the central and peripheral nervous
      system.
AB  - Apart from being a prominent (inhibitory) neurotransmitter that is widely
      distributed in the central and peripheral nervous system, gamma-aminobutyric acid
      (GABA) has turned out to exert trophic actions. In this manner GABA may modulate
      the neuroplastic capacity of neurons and neuron-like cells under various
      conditions in situ and in vitro. In the superior cervical ganglion (SCG) of adult
      rat, GABA induces the formation of free postsynaptic-like densities on the
      dendrites of principal neurons and enables implanted foreign (cholinergic) nerves
      to establish functional synaptic contacts, even while preexisting connections of
      the preganglionic axons persist. Apart from postsynaptic effects, GABA inhibits
      acetylcholine release from preganglionic nerve terminals and changes, at least
      transiently, the neurochemical markers of cholinergic innervation
      (acetylcholinesterase and nicotinic receptors). In murine neuroblastoma cells in
      vitro, GABA induces electron microscopic changes, which are similar in principle
      to those seen in the SCG. Both neuroplastic effects of GABA, in situ and in
      vitro, could be mimicked by sodium bromide, a hyperpolarizing agent. In addition,
      evidence is available that GABA via A- and/or B-receptors may exert direct
      trophic actions. The regulation of both types of trophic actions (direct,
      receptor-mediated vs. indirect, bioelectric activity dependent) is discussed.

PMID- 8474569
TI  - The role of GABA during development of the outer retina in the rabbit.
AB  - Horizontal cells are among the first to mature in the neonatal mammalian retina
      and they are the first to establish the position of the outer synaptic layer
      which is subsequently formed by invading terminals of both rod and cone
      photoreceptors. During the period of cone synaptogenesis, horizontal cells
      transiently express the full complement of GABAergic properties (uptake, release,
      synthesis and storage of GABA); later during development of rod terminals, these
      properties are down-regulated. Given the reports of GABA's role in other
      developing neuronal systems (for review: 10), we have examined the effect that
      GABA, produced from horizontal cells, might have on photoreceptor maturation in
      rabbit retina. Results from our previous studies show that lesioning the
      horizontal cell with kainic acid in vivo leads to a displacement of cone
      photoreceptor cells and a disappearance of their synaptic terminals, while rod
      cells maintain their normal position and produce an overabundance of terminals.
      Similar effects are seen with the GABA-A receptor antagonists, picrotoxin and
      bicuculline. New evidence from 3H-thymidine studies suggests that the effects of
      kainic acid are specific and that cell division, migration and differentiation in
      other cell types do not appear to be affected. This body of work is summarized
      and possible mechanisms of action are suggested which could account for the
      apparent ability of GABA to help maintain the normal position of cone cell bodies
      and regulate cone synaptogenesis.

PMID- 8474570
TI  - Biochemical correlates to cortical dysplasia, gliosis, and astrocytoma
      infiltration in human epileptogenic cortex.
AB  - The study provides detailed biochemical correlates to the common
      histopathological diagnoses in epilepsy. A dot immunobinding procedure was used
      for quantification of NSE, GFA, S-100, NCAM, NF 68 and NF 200. The material
      consisted of samples from 48 patients either selected for surgical treatment of
      partial epilepsy or for disorders not related to epilepsy. The histopathological
      diagnosis of the epileptic cases was: MCD (mild cortical dysplasia,
      microdysgenesis), gliosis, astrocytoma, ganglioglioma, oligodendroglioma and
      single cases. The concentration in non-epileptic white matter, in per cent of
      that in grey matter was: NSE, 85; GFA, 175; S-100, 117; NCAM, 43; NF 68,227 and
      NF 200, 173. The concentration of NSE as well as of GFA was close to normal in
      the specimens of the MCD and gliosis groups and of one subgroup of the
      astrocytomas. There was a striking inverse relationship of the GFA vs the NSE
      concentrations in the whole material. The concentrations of S-100 showed no such
      inverse relationship to NSE levels. In all the epileptic groups, total NCAM was
      lower than 50% of that of the non-epileptic group. The mean NF 68 and NF 200
      concentration in the gliosis and astrocytoma groups was 75% of that of the non
      epileptic group while the corresponding value for the MCD group was 50%. There
      was a positive correlation of immunochemically determined GFA and the
      histopathological gliosis score in the samples of epileptogenic cortex. There was
      no correlation between the concentration of GFA in the samples and the duration
      of epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474571
TI  - GABA metabolism in the substantia nigra, cortex, and hippocampus during status
      epilepticus.
AB  - The metabolism of GABA and other amino acids was studied in the substantia nigra,
      the hippocampus and the parietal cortex of rats following microinjections of
      GAMMA-vinyl-GABA during status epilepticus induced by lithium and pilocarpine.
      GABA metabolism showed striking regional variations. In controls, both GABA
      concentration and rate of GABA synthesis were highest in the substantia nigra and
      lowest in cortex, as expected. In substantia nigra, status epilepticus resulted
      in a 2 1/2 fold decline in the rate of GABA synthesis and in a 307% increase in
      the turnover time of the GABA pool. In hippocampus, the rate of GABA synthesis
      was not altered significantly, but the turnover time of the GABA pool was 284% of
      controls, and the size of that pool increased to 208% of controls. By contrast,
      in cortex, where seizure activity is limited in this model, the rate of GABA
      synthesis increased to 230% of controls while pool size and turnover time did not
      change. Aspartate concentration decreased in all three brain regions. These data
      suggest that the observed reduction of the rate of GABA synthesis in substantia
      nigra could play a key role in seizure spread in this model of status
      epilepticus.

PMID- 8474572
TI  - Effects of GABAmimetics on electrocorticographic spike discharges induced by
      guanidinoethanesulfonic acid (amidino-taurine) in the rat.
AB  - The effect of guanidinoethanesulfonic acid (GES) on rat electrocorticograms
      (ECoG) and the effects of gamma-aminobutyric acid (GABA) and GABA-agonists on the
      ECoG changes induced by GES were studied. Sporadic spike discharges began 2-5 min
      after 1 mumol GES/10 microliters on filter paper was applied to the pia mater of
      the left sensorimotor cortex; spike discharges extended to the opposite cerebral
      hemisphere 60 min after the onset of the ipsilateral spike discharges. The spike
      discharges with a frequency of 5-10 spikes/min lasted until the end of the 4 hour
      recording. The induced spike discharges were suppressed when the original GES
      soaked filter paper was replaced by one containing GES (1 mumol) supplement
      combined with taurine (1 mumol/10 microliters). GABA (1 mumol) and its receptor
      agonist, muscimol (10 nmol) and (3R)-(-)-4-amino-3-hydroxybutyric acid (1 mumol)
      also suppressed the GES-induced spike discharges when applied topically. Diazepam
      (DZP) (10 mg/kg) suppressed the GES-induced spike discharges 10 min after i.p.
      injection, but phenobarbital (20 mg/kg) increased the frequency and voltage of
      spike discharges 100 min following subcutaneous administration. Intraperitoneal
      injection of either valproate (200 mg/kg) or phenytoin (25 mg/kg), after the
      completion of the spike discharges, showed no effect. These findings suggest that
      neurotransmission or neuromodulatory effects of taurine participate in GES
      induced seizure activity, and that GABAA and DZP receptors may play a role in the
      mechanism that suppresses GES-induced seizures.

PMID- 8474573
TI  - Effects of inhibition of ornithine aminotransferase on thioacetamide-induced
      hepatogenic encephalopathy.
AB  - Repeated administration of thioacetamide (TAA) to CD1 mice produced hepatic
      failure and biochemical and behavioral effects characteristic of hepatogenic
      encephalopathy (HE). The symptoms in mice resembled those previously observed in
      rats after similar treatments. It is, however, obvious that both in rats and mice
      the severity of symptoms depends not only on dose and dosing schedule of TAA, but
      also on strain and body weight (age). Administration of 5-fluoromethylornithine
      (5FMOrn), a selective inactivator of ornithine aminotransferase (OAT),
      significantly reduced mortality, and it ameliorated most of the TAA-induced
      pathologic symptoms, such as hypothermia, decreased locomotor and exploratory
      behavior, pathologic liver function and amino acid patterns. The most prominent
      biochemical consequence of 5FMOrn administration is the elevation of ornithine
      concentrations in tissues, including the brain, and in body fluids. Elevated
      ornithine concentrations are, therefore, the most likely basis for the
      therapeutic effects of 5FMOrn. In agreement with this notion is the enhancement
      of citrulline and urea formation. These findings and the observation that
      administration of ornithine in combination with a branched-chain 2-oxoacid
      ameliorated the pathologic symptoms of portal-systemic encephalopathy suggest
      inhibition of OAT in the treatment of this disease. The liver protective effect
      of 5FMOrn is not yet understood; the enhancement of regenerative processes is a
      likely explanation.

PMID- 8474574
TI  - Ethanol exerts differential effects on high affinity choline uptake in neuron
      enriched cultures from 8-day-old chick embryo cerebral hemispheres.
AB  - Neuronal-enriched cultures were prepared from 8-day-old chick embryo cerebral
      hemispheres and exposed to ethanol (50 mM) from day 4 to 8 in culture. At day 8,
      both control and ethanol-treated cultures were processed for [3H]choline uptake
      in situ. Uptake was performed on cultures containing either Na(+)-plus or Na(+)
      free (Li+) HEPES buffer. Total choline uptake as well as Na(+)-dependent and
      Na(+)-independent choline uptake were calculated. The Km and Vmax were calculated
      using the Lineweaver-Burke analysis. Our analysis of the data revealed that
      ethanol-treated cultures exhibited two values for Vmax, one similar to that found
      in control cultures and one significantly lower than controls. No differences
      were observed in Km values between control and ethanol-treated cultures. We
      interpret the low Vmax to represent a population of cholinergic neurons which
      have been arrested at an immature stage as a result of ethanol insult.

PMID- 8474575
TI  - Asymmetric distribution and down-regulation of the muscarinic acetylcholine
      receptor in rat cerebral cortex.
AB  - The distribution and down-regulation of the muscarinic acetylcholine receptor
      (mAChR) were studied in dissociated cells from right (RCC) and left (LCC)
      cerebral cortex. For this purpose [3H]quinuclidinyl benzilate (QNB) and
      [3H]pirenzepine (Pz), two muscarinic antagonists, were used. The mAChR binding
      sites detected with [3H]QNB were asymmetrically distributed between the two
      hemispheres, the majority being found in the RCC. Asymmetry was also evident in
      the distribution of the mAChR subtypes (M1 and M2) detected with [3H]Pz. Under
      basal conditions the RCC had roughly 50% more M1 subtype than the LCC. The
      pharmacological and kinetic parameters were similar for both antagonists in RCC
      and LCC, indicating that the observed lateralization was due to a different
      density of the receptor rather than to different kinetics of binding of the two
      radioligands. After sustained stimulation with the agonist carbamoylcholine, the
      receptor sites detected with [3H]Pz, i.e. the M1 subtype of mAChR, decreased at a
      higher rate in the RCC (44%) than in the LCC (25% of controls), demonstrating
      that the down-regulation process is more active in the right than in the left
      cortex, and thus implying that there is better coupling between the stimulated
      mAChR and its effector system in the former.

PMID- 8474576
TI  - Effect of acetyl-L-carnitine on extracellular amino acid levels in vivo in rat
      brain regions.
AB  - Acetyl-L-carnitine (ALCAR) was found to have beneficial effects in senile
      patients. In recent years many of its effects on the nervous system have been
      examined, but its mechanism(s) of action remains to be elucidated. We previously
      reported that it causes release of dopamine in the striatum. In the present paper
      we report that ALCAR, when administered at intracerebral sites via microdialysis,
      stimulates the release of amino acids in a concentration-dependent and regionally
      heterogeneous manner. The effect was strong in the striatum and cerebellum, less
      so in the frontal cortex, and weak in the thalamus. Seven amino acids were
      measured: the increase in the level of aspartate, glutamate, and taurine was
      substantial, and the increase in the level of glycine, serine, threonine,
      alanine, and glutamine in the microdialysate was minor. The stimulatory effect of
      ALCAR on the release of amino acids in the striatum was inhibited by the
      muscarinic antagonist atropine, but was not inhibited by the nicotinic antagonist
      mecamylamine. The effect of ALCAR on the levels of most of the amino acids tested
      was independent of the presence of Ca2+ in the perfusate. These results indicate
      that ALCAR, when administered intracerebrally at fairly high concentrations, can
      affect the level and the release not only of such neurotransmitters as
      acetylcholine and dopamine, but also of amino acids.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8474577
TI  - Blood-brain glucose transfer in the mouse.
AB  - The intracarotid injection method has been utilized to examine blood-brain
      barrier (BBB) glucose transport in normal mice, and after a 2-day fast. In
      anesthetized mice, cerebral blood flow (CBF) rates were reduced from 0.86 ml.min
      1 x gm-1 in control to 0.80 ml.min-1 x gm-1 in fasted animals (p > 0.05). Brain
      Uptake Indices were significantly (p < 0.05) higher in fasted (plasma glucose =
      4.7 mM) than control (plasma glucose = 6.5 mM) mice, while plasma glucose was
      significantly lower. The maximal velocity (Vmax) for glucose transport was 1562
      +/- 303 nmoles.min-1 x g-1, and the half-saturation constant (Km =) 6.67 +/- 1.46
      mM in normally fed mice. In fasted mice the Vmax was 2053 +/- 393 nmoles.min-1 x
      g-1 (p > 0.05), and the half-saturation constant (Km =) 7.40 +/- 1.60 mM (not
      significant, P > 0.05). A rabbit polyclonal antiserum to a synthetic peptide
      encoding the 13 C-terminal amino acids of the human erythrocyte glucose
      transporter (GLUT-1) immunocytochemically confirmed that the mouse brain
      capillary endothelial glucose transporter is a GLUT-1 transporter, and
      immunoreactivity was similar in brain endothelia from fed and fasted animals. In
      conclusion, after a 2-day fast in the mouse, we saw significant reductions in
      forebrain weight (7%), and plasma glucose levels (27%). Increased brain glucose
      extraction (25%, p < 0.05), and a 22% increase in the unsaturated permeability
      surface area product (p < 0.05) was also observed.

PMID- 8474578
TI  - Gangliosides in acetylcholine receptor-rich membranes from Torpedo marmorata and
      Discopyge tschudii.
AB  - The ganglioside composition of membranes enriched in nicotinic acetylcholine
      receptor (AChR) from the electric rays Discopyge tschudii and Torpedo marmorata
      has been determined, and compared to that of total electric organ. A ganglioside
      having the chromatographic mobility of GM2 constitutes the major ganglioside
      (approximately 60%) in total D. tschudii electric organ, followed by a component
      with the mobility of GD3 (approximately 10%), and a component running just below
      GD1a (about 12%). Minor constituents running as GM3 (2%) and as
      polysialogangliosides (comprising 8-15%) were also observed. Purified native
      membranes of D. tschudii and T. marmorata displayed a similar profile, except
      that they were richer in a GM1-like component, and the proportion of GM2-like
      gangliosides was lower than that in total electric organ. Using a 125I-cholera
      toxin overlay assay on neuraminidase-treated high-performance thin layer
      chromatograms, the presence of GM1, GD1a and trace amounts of GD1b and GT1 (or
      GQ) were detected in D. Tschudii total membranes. Immunocytochemical trechniques
      showed the co-localization of gangliosides GQ1c/GT1c/GP1c, recognized by the
      monoclonal antibody Q211, and the AChR at the ventral, innervated face of the
      electrocyte.

PMID- 8474579
TI  - Electroconvulsive shock does not modify striatal contents of dopamine in MPTP
      treated mice.
AB  - It has been suggested that the therapeutic response to electroconvulsive therapy
      in depressed patients could be mediated by functional changes in the dopaminergic
      pathways; a favorable response to electroconvulsive therapy was also observed
      recently in patients with Parkinson's disease. To study a possible interference
      of electroconvulsive shock in the course of MPTP-induced parkinsonism in rodents,
      we measured the striatal content of dopamine in MPTP-treated mice that received
      electroconvulsive shock at various intervals in the course of MPTP neurotoxicity.
      Our results showed no immediate or delayed differences in striatal dopamine
      content of animals that received MPTP and electroconvulsive shock when compared
      with animals that received only MPTP, thus suggesting that the strong biological
      effects of MPTP and electroconvulsive shock on the brain may follow different
      biochemical mechanisms.

PMID- 8474580
TI  - Modulation of potassium evoked secretory function in rat cerebellar slices
      measured by real time monitoring: evidence of a possible role for methylfolate in
      cerebral tissue.
AB  - The real time dynamics of K+ evoked neurosecretion in cerebellar slices has been
      monitored electrochemically. In the presence of 5-methyltetrahydrofolate a
      statistically significant diminution in secretory response occurs. Agonists to
      probe the pharmacological basis for this indicate it is not due to voltage
      sensitive Ca2+ channel blockade, nor does it show any similarity of effect with
      kainate, whose receptor is a putative binding site for 5-methyltetrahydrofolate.
      The method is fully validated, although no account is taken of individual
      molecular species. High performance liquid chromatography combined with off line
      microbiological assay could only detect 5-methyltetrahydrofolate in cerebrospinal
      fluid. We therefore discuss our findings in relation to possible cerebral roles
      for cerebrospinal fluid 5-methyltetrahydrofolate in the context of both membrane
      and transmitter related interactions.

PMID- 8474581
TI  - Radio-label and mass determinations of inositol 1,3,4,5-tetrakisphosphate
      formation in rat cerebral cortical slices: differential effects of myo-inositol.
AB  - To investigate the effects of increasing concentrations of myo-inositol
      (inositol) on receptor stimulated [3H]inositol polyphosphate formation in the
      absence of lithium, slices of rat cerebral cortex were incubated with various
      concentrations of [3H]inositol (1 to 30 microM). Carbachol stimulated formation
      of [3H]inositol trisphosphate (InsP3) and [3H]inositol 1,3,4,5-tetrakisphosphate
      (Ins(1,3,4,5)P4) increased several fold when the inositol concentration was
      increased reaching a plateau at approximately 12 microM inositol. Time course
      studies revealed that in the presence of low concentrations of inositol (1
      microM), [3H]InsP3 and [3H]Ins(1,3,4,5)P4 formation in response to carbachol
      stimulation increased slowly over a 10 to 20 min time period, whereas in the
      presence of 4 and 12 microM inositol, carbachol stimulated [3H]InsP3 and
      [3H]Ins(1,3,4,5)P4 formation was rapid and essentially complete within 3 to 5 min
      after carbachol addition. Although the carbachol dose response in 12 microM
      inositol had a much greater maximal efficacy, there was no change in potency.
      Similar to the effects of carbachol on [3H]Ins(1,3,4,5)P4 formation from
      prelabeled phosphoinositides, muscarinic receptor stimulation increased
      Ins(1,3,4,5)P4 mass formation by seven fold. Furthermore, Li+ (8 mM) completely
      inhibited carbachol stimulated increases in Ins(1,3,4,5)P4 mass formation. In
      contrast to the effects of increasing inositol on carbachol stimulated formation
      of radiolabeled inositol phosphates, increasing inositol had no effect upon mass
      formation of Ins(1,3,4,5)P4. These results show that when measuring inositol
      polyphosphate formation by the radiolabeling technique in the absence of Li+,
      increasing the inositol concentration greatly increases the stimulated component
      of [3H]InsP3 and [3H]Ins(1,3,4,5)P4 formation. However, this inositol induced
      increase in agonist stimulated Ins(1,3,4,5)P4 formation is not reflected as an
      increase in mass formation.

PMID- 8474582
TI  - [Cerebral blood flow and oxygen metabolism: estimation by PET; with special
      respect to ischemic cerebrovascular disorders (series 4)].

PMID- 8474583
TI  - [Vasospasm and its outcome after early surgery for ruptured cerebral aneurysms:
      changing pattern of its incidence and outcome during this 9-year period].
AB  - The occurrence and outcome of vasospasm (VS) were analyzed in 240 patients who
      had aneurysm surgery within 7 days of a hemorrhage during 9-year period (1981
      89). Occurrence of VS was evaluated by the appearance of ischemic symptoms, (A)
      with or (B) without CT evidence of infarcts. The surgical outcome was assessed by
      the Glasgow Outcome Scale 6 months postoperatively. The results in the first and
      the latter halves of the period were compared. The overall incidence of VS (A+B)
      was 34.8% (A: 23.5%, B: 11.3%) and 33.6% (A: 15.2%, B: 18.4%) in the first and
      the latter halves, respectively. Thus, VS leading to infarction showed a tendency
      to decrease in the latter half of the period, though the overall incidence of VS
      itself was almost identical in both the first and second halves of the period.
      The results were also analyzed according to preoperative grading based on the
      Glasgow Coma Scale (GCS). The tendency toward decreased severity of VS in the
      latter term was most remarkable in patients with GCS total scores between 14 and
      13. The decreased incidence of severe VS proved to be reflected in decreased
      mortality and in increased rate of good outcome in the latter half of the period.
      In order to confirm whether the results obtained in our clinic are universal, we
      applied the same analysis for control groups in four cooperative double-blind
      clinical trials performed during this period in Japan. The study again showed
      that the rate of infarction has decreased significantly over the decade,
      resulting in the improved surgical outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474584
TI  - [Usefulness and limitation of MR imaging and MR angiography in diagnosis of
      juvenile moyamoya disease].
AB  - Magnetic resonance (MR) images and MR angiograms (MRA) were studied in 20
      childhood cases of moyamoya disease. Both MRI and MRA successfully demonstrated
      moyamoya vessels in the basal ganglia in all cases, with a positive but not
      definite correlation to the conventional angiographic findings. MRI depicted the
      stenotic and occlusive lesions of the carotid fork and horizontal portion of the
      middle cerebral artery effectively. MRA demonstrated some lesions which even MRI
      failed to prove, but it tended to overestimate the lesions. Post-operative state
      of collateral flow and the patency of EC-IC bypass graft could be evaluated as
      accurately with MRA as with conventional angiography, although MRA was limited in
      spatial resolution and evaluation of flow direction. In conclusion, MRI and MRA
      were considered to be useful in the diagnosis of moyamoya disease in stage 3 and
      4, but less effective in the evaluation of its angiographical stage.

PMID- 8474585
TI  - [Clinical application of calculation software of the four rules of arithmetic on
      computed tomography].
AB  - Calculation program software of the four rules of arithmetic in computed
      tomography (CT) has been introduced for clinical purposes since 1990. Evaluation
      of hemodynamic reserve and cerebral autoregulation can be calculated using this
      software in ischemic cerebrovascular diseases and delayed cerebral vasospasm
      after ruptured intracranial aneurysms. Eight hemodynamic maps can be entered and
      calculation based on the four rules of arithmetic can be performed between them
      and shown visually. For example, delta CBF [CBF after administration of
      acetazolamide (B)-CBF before its administration(A)] and % CBF [(B - A)/A x 100]
      maps are useful in evaluation of the capacity of hemodynamic reserve in ischemic
      cerebrovascular diseases. And delta CBF [CBF before induced hypertension using
      intravenous dopamine administration (B)-CBF during induced hypertension (A)] and
      % CBF [(B - A)/A x 100] also can be used in evaluation of cerebral autoregulation
      and decision concerning indication of the need for induced hypertension during
      the period of delayed cerebral vasospasm after subarachnoid hemorrhage.

PMID- 8474587
TI  - [Effects of the cervical spinal cord stimulation on persistent vegetative
      syndrome: experimental and clinical study].
AB  - Influence of spinal cord stimulation (SCS) on electroencephalograms (EEGs) and
      intracerebral neurotransmitters were studied in cats, and clinical usefulness of
      the stimulation was reviewed in patients with vegetative syndrome. Cat spinal
      cords were transdurally stimulated at the second cervical spine for two hours
      with a pulse width of 1.0 milliseconds, a frequency of 200 Hz and an amplitude
      ranging from 10 to 15 volts. EEGs were recorded at the frontal epidural space and
      neurotransmitters in the frontal cortex, such as acetylcholine (ACh), 5
      hydroxyindoleacetic acid (5-HIAA), aspartate, glutamate and gamma-aminobutyric
      acid (GABA), were measured by an in vivo microdialysis method. The background
      activities of the EEGs were increased by 2 Hz after the SCS. The ACh content
      increased to 320% three hours after initiation of the SCS, although the other
      four neurotransmitters did not show any change. Epidural SCS at the upper
      cervical level was applied to 15 vegetative patients for the amelioration of
      their vegetative state. Eleven of the 15 patients were treated later than three
      months after the onset of vegetative state and the other four within three
      months. Three of the 11 patients treated late and one of the four treated early
      escaped from the vegetative state (good group). Some clinical improvements were
      observed in four cases (fair group), two of whom were treated late and the other
      treated early. The other seven patients showed no improvement (no change
      group).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474586
TI  - [MR findings in traumatic cerebrospinal fluid leakage with special reference to
      indications of the need for dural repair].
AB  - Eleven cases of traumatic cerebrospinal fluid (CSF) leakage (8 cases of
      rhinorrhea and 3 cases of otorrhea) were reviewed to discuss magnetic resonance
      (MR) findings and surgical indications of the need for dural repair. Five
      patients had delayed onset of CSF rhinorrhea, 12 to 66 days (mean 28 days) after
      the trauma, and in the remaining 6 patients (3 rhinorrhea and 3 otorrhea) CSF
      leakage was noted on admission. MR study was carried out within 7 days after the
      onset of CSF leakage using a 0.5 tesla imager. In 7 cases of rhinorrhea, MR
      images demonstrated brain herniation into the ethmoid or frontal sinuses and the
      dural defects were repaired with the vascularized periosteum flap taken from the
      frontal bone or the fascia lata. In the operations, brain parenchyma was found to
      be plugged into the fracture line as MR images showed, and also to adhere to the
      margin of dural fistula. In the remaining 4 patients (without the MR findings of
      brain herniation into the paranasal sinuses) spontaneous cessation of CSF leakage
      occurred and their clinical course was good. Spontaneous cessation of CSF leakage
      in these cases may suggest the complete healing of the lacerated dura. However,
      in cases with the brain herniated into the paranasal sinuses CSF leakage may not
      be observed, and natural healing of the dural defect cannot be expected.
      Therefore, such brain herniation indicates the absolute need for dural repair
      even if CSF leakage is not observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474588
TI  - [Markedly dilated cervical carotid arteries in a patient with a ruptured aneurysm
      of the anterior communicating artery: a case report].
AB  - We reported a case of ruptured aneurysm of the anterior communicating artery with
      marked dilatation of bilateral cervical carotid arteries. A 38 year old female
      suffered a subarachnoid hemorrhage. Angiography on admission revealed markedly
      dilated cervical carotid arteries with smooth lumen and a few segmental areas
      with mild constrictions in their entire course up to the carotid canals (their
      maximal sagittal diameters exceeded those of a cervical vertebral body). A
      saccular aneurysm was also seen at the junction of right A1, A2, and Acom.
      External carotid arteries were normal in size. Vertebral arteries were not
      examined because of failures of selective cannulation. The patient was operated
      upon and trapping of Acom was performed. During the operation, no definite
      arteriosclerotic changes were identified in the intracranial arteries.
      Histopathological examination of the surgical specimens revealed marked
      hyperplasia of the smooth muscle of the tunica media with intact internal elastic
      lamina both in a superficial temporal artery and a middle meningeal artery.
      During the operation, pneumothorax developed due to the rupture of bullae in the
      right lung. Past history of this patient disclosed hypertension noted a few years
      previously, and frequent severe bruises following minor trauma. Repeated
      angiography performed three months after the operation disclosed unchanged
      dilatation of the cervical carotid arteries as well as mild intraluminal
      irregularities in the proximal one third of the left renal artery. This patient
      died of pneumonia one year after the operation, but autopsy was not permitted.
      Possible diagnosis of this patient was discussed, with particular emphasis on
      fibromuscular dysplasia and Ehlers-Danlos type IV (arterial, ecchymotic, or Sack
      Barabas type).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474589
TI  - [Eighth cranial neuritis difficult to differentiate from intracanalicular
      acoustic neurinoma on MRI: case report].
AB  - A patient with an enhancing, completely intracanalicular mass on MRI was
      presented. He had noticed progressive hearing loss in the left ear with tinnitus.
      Neurological examination revealed no abnormality except decreased hearing in the
      left ear. There were no other cranial nerve or cerebellar signs. An audiogram
      revealed profound hearing loss on the left ear with no ability of speech
      discrimination. Brainstem auditory evoked response was absent on the left. MRI
      enhanced with gadolinium-DTPA demonstrated an intracanalicular enhancing lesion
      on the left which was presumed to be an intracanalicular acoustic neurinoma. The
      patient underwent a left suboccipital craniectomy. The eighth cranial nerve
      appeared normal in the cerebellopontine angle cistern, and was swollen and
      discolored in the internal auditory canal. It was removed piecemeal. The patient
      remained deaf in the left ear postoperatively. Histopathologically, the lesion
      consisted of edematous nerve fiber and inflammatory cells, but no tumor cell was
      present within the specimen. The patient was diagnosed as having neuritis. The
      clinical time course of symptoms in our patient was not unusual for an acoustic
      neurinoma. It seems that the distinction between an intracanalicular acoustic
      neurinoma and other lesions cannot be made on basis of MR imaging alone. All
      available imaging modalities should be considered before a definitive surgical
      procedure is undertaken.

PMID- 8474590
TI  - [A case of endodermal sinus tumor in the basal ganglia associated with Down's
      syndrome].
AB  - A case of Down's syndrome accompanied by endodermal sinus tumor of the left basal
      ganglia is reported. She was referred to us because of right hemiparesis. A CT
      scan showed a calcified mass in the left basal ganglia, which was well enhanced
      on contrast CT. Emergency removal of the tumor was performed because of its rapid
      growth, intratumoral hemorrhage, and acute hydrocephalus. The histological
      diagnosis established after surgery was endodermal sinus tumor. Alphafetoprotein
      positive cells were seen in the resected tumor by light microscopy. Postoperative
      irradiation was very effective, and the high level of serum alphafetoprotein
      decreased during the course of irradiation. The residual tumor, enhanced on
      contrast CT, was treated by administration of cisplatin and etoposide after
      irradiation. Cases of malignant tumors other than leukemia, which are associated
      with Down's syndrome, are extremely rate. To our knowledge, including three cases
      of germ cell tumor, there have been only nine cases of brain tumors associated
      with Down's syndrome reported previously.

PMID- 8474591
TI  - [Fibromuscular dysplasia with an internal carotid artery web on the angiograms].
AB  - A 58-year-old woman experienced a transient right-sided hemianopsia. She also had
      difficulty finding words and trouble naming parts of objects. On admission, three
      days later, there were no signs of residual neurological deficit. Laboratory
      studies showed findings of neither diabetes mellitus, hypertension nor cardiac
      disease. Her serum cholesterol level was normal. No bruit was heard over the head
      and neck. Preoperative angiograms showed a discrete web (septum) at the left
      internal carotid origin (Fig. 2). 123I-IMP SPECT revealed a decreased areas of
      perfusion mainly in the left middle cerebral artery distribution (Fig. 3A). A
      reconstructive operation was performed. A firm discrete nonatherosclerotic ridge
      (septum) protruding into the vessel lumen was resected. Microscopic examination
      of the surgical specimen demonstrated intimal fibroplasia, a rare subtype of
      fibromuscular dysplasia (FMD). Postoperatively, hypoperfused areas in SPECT were
      improved (Fig. 3B). The patient has been free of symptoms to the present time
      (for about one year). In addition to the rarity of the lesion, the available data
      suggest that web-like subtype of FMD is apt to be associated with an increase in
      the risk of hemodynamic compromise and thromboembolism. Surgical therapy is
      recommended, especially for symptomatic patients.

PMID- 8474592
TI  - [An experience of dissecting cerebral aneurysm of the anterior cerebral artery].
AB  - Intracranial dissecting aneurysms have been reported occasionally in recent
      years. However, excluding dissecting aneurysms which extend from the proximal
      intracranial carotid artery, dissecting aneurysms arising merely in ACA are found
      only rarely. We are reporting here a case of a 42 year-old gentleman who did not
      present any particular causative etiology such as trauma or other basic diseases
      causing arteritis. Our patient is the 8th case, as far as we could find in the
      literature, in which the dissection of the arterial wall originated at the ACA.
      The patient was thought to have a tiny saccular aneurysm at the A 1-2 junction of
      the right ACA associated with vasospasm in the distal ACA on the angiogram. The
      patient had motor weakness on the left side and headache as well as a low density
      area in the territory of the ACA on the CT scan. A craniotomy was performed
      verifying the aneurysm to be dissecting in type without any sign of recent
      subarachnoid hemorrhage in the surrounding structures. No aggressive surgical
      treatment such as trapping of the aneurysm was done because the collateral blood
      circulation in that territory of the distal right ACA seemed to be poor and the
      patient no longer had neurological deficit at the time of operation. The patient
      was treated successfully with antiplatelet therapy. On the follow-up angiogram
      performed 3.5 months after the onset of the illness, we noted the disappearance
      of the abnormal angiographical findings of the dissecting aneurysm and distal
      arterial narrowing (pearl and string sign).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474593
TI  - [A juvenile male prolactinoma: a case report].
AB  - Male prolactinomas often become voluminous and invasive, and also show higher
      serum prolactin levels due to delay of diagnosis. We experienced a case of
      prolactinoma in a 15-year-old boy. He was admitted with a complaint of visual
      disturbance. CT and MRI showed intra- and suprasellar mass with a ring
      enhancement and niveau formation suggesting intratumoral hemorrhage. By the right
      subfrontotemporal approach, subtotal tumor removal was performed, and
      intratumoral hemorrhage was identified. Histological examination confirmed the
      existence of chromophobe adenoma and, furthermore, immunohistochemical study
      revealed the existence of a prolactinoma. The size of the tumor gradually
      diminished with the administration of bromocriptine, and serum prolactin levels
      returned to normal value during the postoperative course. Among all cases of
      prolactinomas reported in previous medical literature only 23 cases of patients
      under 20 years old have been reported. The authors analysed our case of
      prolactinoma along with other infrequent cases where intratumoral hemorrhage was
      especially noticeable.

PMID- 8474594
TI  - [Cavernous angioma in the cerebellopontine angle: a case report].
AB  - A rare case of cavernous angioma (CA) in the cerebellopontine angle (CPA) is
      reported. A 60-year-old female suffered from a right progressive sensorineural
      hearing loss and a successive right facial paresis over 2 years. A small mass was
      detected in her right CPA on CT scans. Both T1- and T2-weighted MR images
      demonstrated an intracanalicular lesion protruding into the CPA as being
      hyperintense. A small red colored lobulated tumor involving the 7th and 8th
      cranial nerves was found in the CPA through the suboccipital approach. The tumor
      contained multiple small hematomas in various stages. Biopsy with evacuation of
      these hematomas was selected to avoid damaging the cranial nerves. Histological
      examination of the specimen disclosed it as CA. Postoperatively her facial
      paresis improved slightly, but her hearing loss remained unchanged. Discussions
      were carried out concerning clinical and neuroradiological features of CA in the
      internal auditory canal and CPA. The present case and a previously reported 17
      cases were the subjects under discussion.

PMID- 8474595
TI  - [A case of penetrating head injury caused by nail-gun].
AB  - A rare case of penetrating head injury caused by a nail-gun was described. A 24
      year-old male was admitted to our hospital due to head injury. He had handled a
      nail-gun at a construction site. On admission the patient was fully conscious
      with no neurological defects. A small wound was observed at the left front
      temporal region. Skull films showed a large nail embedded in the skull cavity. A
      computed tomographic (CT) scan, changing level of window, demonstrated
      intracerebral hematoma, fragment of skull bone and nail. Cerebral angiography
      (CAG) showed extravasation at the left frontal region. Emergency operation was
      performed and his recovery was uneventful. Twenty-two craniocerebral injuries
      caused by nail-guns have been reported in world medical literature but this was
      the first report in Japan. The characteristics of craniocerebral nail-gun
      injuries were less damage and better prognosis compared with gunshot injuries.
      However intracranial infection and vascular injury were possible lethal
      complications. In this case, preoperative examination, such as CT scan and CAG
      was valuable and the early operation for the sake of safety was very effective.

PMID- 8474596
TI  - Third international symposium on amyotrophic lateral sclerosis/motor neuron
      disease (Solihull, Birmingham, England. November 2-4 1992).

PMID- 8474597
TI  - Early central nervous system changes in human immunodeficiency virus (HIV)
      infection.
AB  - Early HIV infection of the CNS, as demonstrated by cerebrospinal fluid studies,
      seems relatively common. However most HIV carriers remain neurologically
      unimpaired during the incubation period. A few psychometric, radiological, and
      electrophysiological studies suggest that neurological abnormalities are present
      at early stages of HIV infection; the findings of these studies are controversial
      and until recently, they have not been supported by neuropathological data. Early
      brain changes, including leptomeningitis and vasculitis with myelin pallor and
      gliosis of the deep white matter are probably secondary to vascular inflammation
      and opening of the blood-brain barrier. Such conclusions are drawn from the
      examination of brains of asymptomatic HIV-positive individuals who died from
      unnatural causes, and of rare cases with acute fatal encephalopathy revealing HIV
      infection. In addition, early experimental simian immunodeficiency virus
      infection and feline immunodeficiency virus encephalopathy have demonstrated
      similar changes to those in man. Although small amounts of viral genome were
      detected by PCR in a few cases, the early changes in the human brain do not seem
      to result from a productive HIV infection of the CNS, as seen in HIV
      encephalitis. The occurrence of a usually asymptomatic and transient
      immunopathological reaction coinciding with early HIV infection of the nervous
      system appears to be more likely.

PMID- 8474598
TI  - Blood-nerve barrier: ultrastructural and endothelial surface charge alterations
      following nerve crush.
AB  - Nerve crush results in an enhanced vascular permeability of the endoneurial
      vessels distal to the lesion. Vascular permeability at the blood-nerve barrier
      (BNB) to serum proteins is influenced by many factors, including anionic surface
      charge, endothelial vesicular transcytosis and the presence or absence of
      fenestrated vessels. Using mice and rats, the present ultrastructural
      investigation examined the effect of nerve crush (axonotmesis) on: (1) the
      distribution of endothelial anionic sites and (2) the appearance of fenestrations
      in endoneurial vessels after 4 and 14 day intervals as demonstrated with cationic
      probes. Transient anionic fenestrations developed in a minority of mouse
      endoneurial vessels in 4-day crushed nerves, but were not found in 14-day crushed
      nerves of mice nor in crushed nerves of rats. The known increase in the
      permeability of endoneurial vessels in rats and mice was not associated with
      reduced luminal labelling with cationic ferritin at physiological pH. At pH 2.0
      the labelling of glycocalyx moieties (such as sialic acid) with cationic
      colloidal gold was disrupted in some epi- and endoneurial vessels of 4-day rats,
      but in a greater proportion after 14 days. The enhanced permeability of the BNB
      during degeneration and regeneration is related to the formation of anionic
      fenestrations in endoneurial vessels of mice and to the reduced and uneven
      distribution of endothelial glycocalyx moieties that are anionic at pH 2.0 in
      rats.

PMID- 8474600
TI  - Adaptation of tibial nerve myelinated fibre parameters to reduced limb length
      caused by irradiation.
AB  - Irradiation of a rat hind limb at 15 days of age caused marked shortening of the
      limb, with a consequent reduction in nerve length. The tibial nerves of the
      irradiated limbs were examined qualitatively and quantitatively, and compared
      with the unirradiated nerve. There was no evidence of fibre degeneration and only
      very occasional myelin abnormalities. Myelinated fibre numbers were very slightly
      reduced, possibly due to irradiation effects on small myelinated fibres.
      Internodal lengths were reduced in proportion to limb length. Mean axon diameters
      were slightly increased, and myelin sheath thickness reduced. This experimental
      model provides a new method of altering nerve fibre parameters without surgical
      intervention.

PMID- 8474599
TI  - Progressive degeneration of motor nerve terminals in GAD mutant mouse with
      hereditary sensory axonopathy.
AB  - The evolution of motor nerve degeneration was examined in gracile axonal
      dystrophy (GAD) mutant mice, which develop initial sensory ataxia and subsequent
      motor paresis. Using the anterior gracilis (AG) muscle, which is innervated at
      two discrete and well-separated endplate zones, we demonstrated that axonal
      degeneration occurred first at motor nerve terminals in the distal endplate zone,
      and then extended gradually from the distal to the more proximal parts of
      affected axons in the intra-muscular nerve trunk. In contrast to the degeneration
      in the distal zone, active degeneration was less marked in the proximal endplate
      zone and, furthermore, most terminal axons had begun to produce regenerating
      sprouts. Ventral horn cells were histologically normal, even at advanced stages.
      These results indicate that, as previously observed in sensory nerves, dying back
      degeneration progresses later in the lower motor neuron system, even within one
      muscle. The mechanism(s) influencing the activation of axonal regeneration are
      discussed. This mutant mouse will be a useful model for the study of regenerating
      phenomena in dying back degeneration of genetically compromised motor neurons, as
      well as for the study of the pathogenesis of hereditary sensory and motor
      neuropathies in man.

PMID- 8474601
TI  - Prediction of specific damage or infarction from the measurement of tissue
      impedance following repetitive brain ischaemia in the rat.
AB  - The development of irreversible brain damage during repetitive periods of hypoxia
      and normoxia was studied in anaesthetized rats with unilateral occlusion of the
      carotid artery (modified Levine model). Rats were exposed to 10 min hypoxia and
      normoxia until severe damage developed. As indices of damage, whole striatal
      tissue impedance (reflecting cellular water uptake), sodium/potassium contents
      (due to exchange with blood). Evans Blue staining (blood-brain barrier [BBB]
      integrity) and silver staining (increased in irreversibly damaged neurons) were
      used. A substantial decrease in blood pressure was observed during the hypoxic
      periods possibly producing severe ischaemia. Irreversibly increased impedance,
      massive changes in silver staining, accumulation of whole tissue Na and loss of K
      occurred only after a minimum of two periods of hypoxia, but there was no
      disruption of the BBB. Microscopic examination of tissue sections revealed that
      cell death was selective with reversible impedance changes, but became massive
      and non-specific after irreversible increase of the impedance. The development of
      brain infarcts could, however, not be predicted from measurements of
      physiological parameters in the blood. We suggest that the development of
      cerebral infarction during repetitive periods of hypoxia may serve as a model for
      the development of brain damage in a variety of clinical conditions. Furthermore,
      the present model allows the screening of potential therapeutic measuring of the
      prevention and treatment of both infarction and selective cell death.

PMID- 8474602
TI  - Neural tube defects in the parietal region of human embryos: failure to close or
      closure-reopening?
AB  - This is a follow-up study to earlier investigations on neural tube defects (NTD)
      in the Kyoto collection of human embryos. It includes an extensive examination of
      abnormal embryos which have been photographed and serially sectioned following
      routine histological preparation. Two new types of NTD are described in the
      parietal region (the roof of the third ventricle) which had previously been
      overlooked. These anomalies were found most commonly in embryos at the
      developmental period. Carnegie stage [CS] 16-23 (embryonic days 38-52).
      Hypotheses are advanced regarding the genesis of NTD and whether encephaloceles
      and NTD are part of a spectrum of malformation. This study also reinforces
      evidence that the occurrence of NTD is significantly higher in the embryonic
      period than at birth. Animal studies, using the guinea-pig are discussed with
      regard to the investigation of hypotheses put forward to explain the genesis of
      NTD.

PMID- 8474603
TI  - A four-layered 'lissencephalic' cortex induced by prenatal X-irradiation in the
      rat.
AB  - A four-layered cortex is produced in the dorsal region of the rat brain, after
      200 cGy X-irradiation at embryonic day 16. The layer 1 is the molecular layer;
      layer 2 is the upper cellular layer which is in continuity with normal layers V
      and VI in the lateral cortex; layer 3 is a sparsely cellular layer; and layer 4
      is the inner cellular layer which is composed of neurons normally committed to
      the upper cortical layers. This failure of neuroblast migration to the upper
      layers is associated with reduced numbers, and morphological abnormalities, of
      radial glial cells in the dorsal cortex. This further supports the idea that
      abnormal interactions between neuroblasts and radial glial cells result in
      abnormal migratory patterns. Since a similar four-layered organization is found
      in human lissencephaly type I, the present results bring new data that can serve
      our better understanding of human cortical malformations.

PMID- 8474604
TI  - Zn-binding globulin in human fetal brain and liver: a marker for passive
      blood/CSF transfer of protein.
AB  - The presence of Zn-binding globulin (ZnbG) during human fetal development was
      studied in cerebrospinal fluid (CSF) and plasma with immunodiffusion methods and
      in brain, CSF, plasma and liver using immunocytochemical methods. At the earliest
      stages examined with immunocytochemistry (5-6 weeks gestation) no staining for
      ZnbG was visible in liver, plasma, CSF or brain. However, the primitive
      mesenchyme exhibited a prominent staining reaction. In late embryonic and early
      fetal stages, staining for the protein was most prominent in the spinal cord,
      brain stem and diencephalon and in the choroid plexuses and marginal and subplate
      zones in the telencephalon. At the cellular level, synaptic strata and
      territories were most strongly stained. The distribution of ZnbG in the early
      developing central nervous system suggests that this protein may be involved in
      the initial establishment of CNS circuitry. Embryonic brain was positive for ZnbG
      well before the protein could be detected in CSF, plasma or liver. The early
      occurrence of ZnbG in brain tissue prior to its presence in liver or plasma also
      suggests that the protein is synthesized in early fetal brain. At the time when
      CSF first became positive (17 weeks gestation), the brain staining had largely
      disappeared. ZnbG in plasma increased throughout gestation to reach 2.6 +/- 0.4
      mg/100 ml at term and subsequently increased to an adult value of 6.8 +/- 1.5
      mg/100 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474605
TI  - Brown-Vialetto-Van Laere syndrome.
AB  - The clinical and pathological findings of a male with the Brown-Vialetto-Van
      Laere syndrome are described. This rare and fatal affection of the nervous system
      involves mainly the brain stem with the prominent and early manifestation of
      sensorineural deafness. Increased awareness and documentation of this disorder
      has added information on the mode of inheritance.

PMID- 8474606
TI  - Neurocytoma/lipoma (neurolipocytoma) of the cerebellum.
AB  - We describe a unique tumour that was removed from the posterior fossa of a woman
      aged 50 years. It was characterized histologically by bland, oval cells with
      fibrillary cytoplasm and by small groups of lipocytes. Immunocytochemical studies
      demonstrated expression of synaptophysin, neuron specific enolase and PGP 9.5,
      but a few cells also expressed glial fibrillary acidic protein and desmin. The
      combination of neuroectodermal and mesodermal features in this tumour is
      discussed in relation to primitive neuroectodermal tumours and neurocytoma.

PMID- 8474607
TI  - Electroencephalographic and neuroimaging findings in neonates undergoing
      extracorporeal membrane oxygenation.
AB  - Electroencephalograms (EEGs) were recorded on 36 infants who were treated with
      arteriovenous extracorporeal membrane oxygenation (ECMO) between 1986 and 1989.
      Twelve of 36 infants had EEGs prior to and during ECMO. Twenty-one infants who
      met ECMO criteria but were treated with mechanical ventilation only served as a
      comparison (COMP) group. Electrographic seizures occurred in 7 of the 36 (19%)
      ECMO patients and in 3 of the 21 (14%) COMP patients. Five of 7 ECMO infants had
      electrographic status epilepticus. Three infants developed electrographic
      seizures during ECMO in association with an acute cerebral injury. These patients
      did not have significant hemispheric predominance in the origin of electrographic
      seizures (2 right, 3 left and 2 bilateral). Repetitive or periodic discharges
      (RPD) with frequencies between 0.5 and 5 Hz were seen after starting therapy in
      23 of the 36 (64%) ECMO patients and 15 of the 21 (71%) of the COMP group. Only
      in the ECMO patients did RPD arise significantly more frequently from the right
      hemisphere (13 right, 4 left and 6 bilateral; p = 0.015). Neuroimaging studies
      showed evidence of ischemic lesion in 8 of the 36 (22%) ECMO patients with
      significantly right-sided predominance (5 right, 1 left and 2 bilateral; p =
      .05). Cerebellar hemorrhages occurred in 3 ECMO patients. Ischemic lesions
      occurred in 3 of the 21 (14%) COMP patients, all occurring on the left side. In
      the ECMO group, severe outcome or death was significantly associated with the
      presence of electrographic seizures, status epilepticus, and suppression-burst
      pattern (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474608
TI  - Effect of the hypoxanthine/xanthine oxidase system on dopamine outflow from rat
      striatal synaptosomes.
AB  - The effect of the oxygen radical generating system, hypoxanthine/xanthine oxidase
      (Hx/XOD), on the spontaneous and potassium-stimulated outflow of the
      neurotransmitter dopamine (DA) from rat striatal synaptosomes was studied. The
      efficacy of some radical scavengers was also tested. DA outflow was measured by
      incubation of [3H]-DA prelabeled synaptosomes (P2) in Krebs-Ringer buffer,
      containing either normal or depolarizing K+ concentrations. The reactions were
      terminated by filtration of the synaptosomes through Sartorius filters. Hx/XOD
      increased the spontaneous DA outflow in a dose and time dependent manner. The
      reduction found in synaptosomal DA content could be explained by disturbances of
      DA uptake or reuptake. The K+ stimulated outflow was not altered by the lower
      doses of Hx/XOD, whereas, when very high doses of Hx/XOD were used, the K+
      stimulated DA outflow was decreased. High doses of Hx/XOD may deplete the
      synaptosomal DA releasable pool, leaving little DA available for extra-stimulated
      outflow by high concentrations of K+. The K(+)-stimulated outflow of DA is a less
      sensitive process against radical attack than the spontaneous release of DA. A
      protective action of catalase, but no effect of superoxide dismutase was
      demonstrated in these experiments.

PMID- 8474609
TI  - Ultrasound measurement of quadriceps muscle in the first year of life. Normal
      values and application to spinal muscular atrophy.
AB  - Using real-time ultrasound imaging normal values were obtained for quadriceps
      muscle thickness and subcutaneous tissue depth in the first year of life from 120
      normal infants. These values were corrected for weight and height by introduction
      of a "correcting factor". In addition, a "modified muscle index" was calculated
      by multiplying the ratio of muscle to subcutaneous tissue thickness with the
      correcting factor and showed a steady increase from birth (mean 2.1) to the end
      of the first year (mean 4.8). The study of 12 patients with spinal muscular
      atrophy type I (SMA I) revealed that 9 out of 12 SMA I patients failed to reach
      the 3rd percentile for the muscle to subcutaneous tissue ratio and 10 out of 12
      were well below the 3rd percentile for the modified muscle index due to their
      muscle atrophy. Only the two youngest SMA I patients aged 4 and 6 weeks reached
      values on the 3rd percentile. In contrast, 10 patients with myopathy and one
      patient with holoprosencephaly showed values within the normal percentiles even
      in the presence of severe clinical muscle weakness and signs of atrophy on muscle
      histology. In the differential diagnosis of early onset myopathy, atrophy of the
      quadriceps muscle during the first months of life in the absence of markedly
      increased echodensity seems to be a pathognomonic finding for SMA.

PMID- 8474610
TI  - MRI of the head in the evaluation of microcephaly.
AB  - Fifty-five patients with microcephaly (head circumference < -2SD) were
      identified. The 55 patients were divided into two groups, consisting of group 1
      (34 cases) in which genetic causes were considered primary, and group 2 (21
      cases) in which intrauterine and/or postnatal acquired factors were thought to be
      responsible. MRI abnormalities were present in 80% of the total series: 68 and
      100% in groups 1 and 2, respectively. In group 1, migration abnormalities were
      the most prominent and mental retardation was the major neurological handicap,
      while in group 2, hydranencephaly and infarction secondary to brain circulatory
      derangements were the most frequently observed abnormalities, with severe
      multiple handicaps such as cerebral palsy, epilepsy and mental retardation seen.
      Head MRI was considered indispensable in the investigation of the causes of
      microcephaly and in determining the neurological prognosis of affected patients.

PMID- 8474611
TI  - Regional cerebral blood-flow measured by HMPAO and SPECT in a 5-year-old boy with
      Landau-Kleffner syndrome.
AB  - We present a 5-year-old boy with Landau-Kleffner syndrome, whose clinical
      manifestations were very similar to cases previously reported in the literature.
      CT and MRI scan failed to document any morphological abnormalities of his brain.
      However, high resolution rCBF imaging by HMPAO and SPECT demonstrated relatively
      low-flow areas in the left middle frontal gyrus and the right
      mesiotemporal/hippocampal region corresponding to the localization of EEG
      changes.

PMID- 8474612
TI  - Carbohydrate-deficient glycoprotein (CDG) syndrome--a new variant, type III.

PMID- 8474613
TI  - Functional hemispherectomy in children.
AB  - Functional hemispherectomy, indicated for the control of pharmacologically
      refractory seizures, has been used at the Montreal Neurological Hospital since
      1974. We have used this technique in 18 children suffering from intractable
      seizures secondary to conditions such as infantile hemiplegia, chronic
      encephalitis, head trauma, cerebrovascular accident, brain dysplasia and Sturge
      Weber angiomatosis. None has developed superficial cerebral hemosiderosis often
      seen following the classical anatomical hemispherectomy. Eighty-two per cent
      (82%) of patients have been seizure-free since hospital discharge while another
      11.5% have had at least 80% reduction in their seizure frequency. Most patients
      have shown an improvement in their intellectual capacity and sociability.

PMID- 8474614
TI  - Sex differences in the maturation of sleep/wake patterns in high risk for SIDS
      infants.
AB  - Male and female high risk for SIDS infants were compared with a group of
      rigorously matched controls in sleep/wake variables during the peak period for
      SIDS, i.e., 2-4 mos. Continuous 24-72 hr. in-hospital recordings yielded data
      based on 3,792 hrs. of electrophysiological activity. The data show that risk
      male infants fail to demonstrate an increase in wakefulness with age and reveal a
      lag in the maturation of REM sleep compared to controls and female risk infants
      during the critical age for SIDS. Significant sex differences within the first
      six months of life are of particular importance because of the consistently
      reported higher incidence of SIDS in males than females. An immature sleep/wake
      organization which occurs differentially in male high risk for SIDS infants
      suggests that a CNS functional disorder is present selectively in male infants as
      a precursor to SIDS. The greater susceptibility of male infants to SIDS
      emphasizes the importance of these data based on unique long-term recordings.

PMID- 8474615
TI  - Stereoselective actions of the isomers of metitepine at 5-HT1D receptors in the
      guinea pig brain.
AB  - The present studies examined the relative antagonist potencies of the optical
      isomers of the 5-HT receptor antagonist metitepine at the 5-HT1D binding site
      labelled by the novel radioligand serotonin-O-carboxymethylglycyl
      [125]iodotyrosinamide ([125I]GTI), and at the terminal 5-HT autoreceptor in
      guinea pig frontal cortex, a proposed model of 5-HT1D receptor activation. The
      pharmacological specificity of the [125I]GTI binding site in guinea pig frontal
      cortex was similar to previously published studies in the bovine cortical 5-HT1D
      recognition site labelled with [3H]5-HT. The (+) isomer of metitepine displaced
      [125I]GTI binding with a lower affinity (64 nM) than did the (-) isomer (18 nM),
      which was equiactive with the racemic mixture. The (-) isomer of metitepine was
      more effective than the (+) isomer at attenuating the inhibitory effects of 5-HT
      and sumatriptan at the guinea pig terminal 5-HT autoreceptor; the apparent pA2 of
      the (-) isomer was 8.0 (sumatriptan) and 7.7 (5-HT) while the apparent pA2 of the
      (+) isomer was 7.1 (sumatriptan) and 6.8 (5-HT). The (-) isomer was more
      effective than the (+) isomer at enhancing stimulated [3H]5-HT release. These
      findings support the identification of the guinea pig 5-HT terminal autoreceptor
      as a 5-HT1D receptor and reinforce the species homology between the 5-HT1B and 5
      HT1D receptors.

PMID- 8474616
TI  - Brainstem serotonin receptors in the guinea pig: implications for myoclonus.
AB  - The brainstem is the locus of serotonin (5-HT)-mediated myoclonus in the guinea
      pig, which is induced by 5-hydroxy-L-tryptophan (L-5-HTP) and indole but not
      piperazine 5-HT receptor agonists. As an initial step in testing the hypothesis
      that one 5-HT receptor subtype mediates this effect, we measured seven 5-HT
      receptor binding sites and the 5-HT uptake site in guinea pig brainstem and
      compared them to the rat. In guinea pig brainstem, the rank order of binding site
      density was: 5-HT transporter site >> 5-HT1D > antagonist-labeled 5-HT2 > 5-HT1A,
      5-HT1C > 5-HT1E > agonist-labeled 5-HT2 binding site. There were fewer 5-HT1A and
      5-HT1C binding sites and 5-HT uptake sites in guinea pig than rat brainstem, more
      5-HT1D and antagonist-labeled 5-HT2 sites, but the differences were 2-fold or
      less. The major species difference was that 5-HT1B sites were virtually
      undetectable in guinea pig brainstem. Limited competition experiments with
      related 5-HT receptor subtype-selective agonists and antagonists suggested that
      the sites in guinea pig brainstem conformed to those described in the rat. 5-HT
      agonist and antagonist dose-threshold and dose maximum-effect data from guinea
      pig myoclonus in vivo were compared with receptor affinities at each receptor
      site in vitro from the literature. No convincing correlation between myoclonus
      and one particular 5-HT site was found. These data indicate the presence of a
      full complement of 5-HT receptor binding site subtypes in guinea pig brainstem
      with some species differences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474617
TI  - Social interaction and elevated plus-maze tests: changes in release and uptake of
      5-HT and GABA.
AB  - Changes in release and uptake of [3H]5-HT and [14C]GABA were compared in slices
      taken from the hippocampus and frontal cortex of rats, left undisturbed in their
      home-cages, or exposed for 5 min to the elevated plus-maze or social interaction
      tests of anxiety. Exposure to the plus-maze decreased cortical GABA function
      (shown by decreased release) and increased hippocampal 5-HT function (shown by
      increased K(+)-evoked release but more markedly by decreased uptake). Compared
      with undisturbed home cage controls, only the high light, familiar condition of
      the social interaction test resulted in a significant increase in K(+)-evoked
      release of both [3H]5-HT and [14C]GABA from the hippocampus. All four social
      interaction test conditions resulted in increases in cortical uptake of [3H]5-HT
      and all but the high light, unfamiliar condition increased cortical uptake of
      [14C]GABA. Analysing the two factors manipulated in the social interaction test,
      unfamiliarity with the test arena resulted in increased uptake of hippocampal
      [3H]5-HT and decreased cortical [14C]GABA, whereas an increase in the level of
      light decreased the cortical uptake of [14C]GABA. The results show that changes
      in presynaptic function occur rapidly in response to a brief exposure to animal
      tests of anxiety. However, only the increased hippocampal release of 5-HT is
      likely to be causally linked to anxiety and the results show that this cannot be
      the sole explanation.

PMID- 8474618
TI  - Subchronic treatment with morphine inhibits the hypertension induced by isolation
      stress in the rat.
AB  - As preliminary evidence for the implication of opioids in the increase in blood
      pressure due to the stress of brief social deprivation, hypertension has been
      shown to be antagonized by acute administration of opiate receptor blockers. As a
      further evidence of involvement of opioids in the hypertensive response to this
      type of stress, cross-tolerance ought to be capable of being demonstrated in
      isolated animals, treated with an opiate. When rats were treated subchronically
      with morphine in the drinking water throughout the isolation period (1-15 days),
      readings of blood pressure did not show any variation, as compared to group
      housed control rats. However, 7 days after withdrawal of morphine readings of
      arterial pressure in the isolated rats increased above the levels of the group
      housed control animals. These findings support the idea that an endogenous opioid
      system is implicated in the induction of readings of high blood pressure due to
      the stress of social deprivation.

PMID- 8474619
TI  - Effect of stobadine on lipid peroxidation and phospholipids in rabbit spinal cord
      after ischaemia.
AB  - Stobadine, a drug with the pyridoindol structure, was compared with thiopental
      and pentobarbital for its ability to inhibit stimulated peroxidation in
      homogenates of spinal cord in vitro. The antioxidative capacity of the drug
      exceeded that of barbiturates more than 100-fold. Stobadine was also shown to
      inhibit the increase in formation of TBA-RS in homogenates of rabbit spinal cord,
      subjected to 20 min ischaemia, to the level comparable with controls.
      Administration of the drug (6 mg kg-1) to animals 5 min before 20 min ischaemia
      had no effect on level of lipid peroxidation products in the spinal cord;
      however, it slowed down stimulated Fe(2+)-dependent peroxidation after in vitro
      incubation of the homogenates and increased the concentration of
      phosphatidylserine and ethanolamine plasmalogens, as compared with non-treated
      animals. Application of stobadine 2 min before the release of an aortic occlusion
      increased the antiradical capacity in homogenates of spinal cord and revealed an
      ameliorating effect on the composition of phospholipids.

PMID- 8474620
TI  - Effect of 4-phenyl-1,2,3,4-tetrahydroisoquinoline on ambulation induced by
      injection of methamphetamine into the nucleus accumbens in rats.
AB  - 4-Phenyl-1,2,3,4-tetrahydroisoquinoline (4-PTIQ) has previously been shown to
      have antagonistic properties to methamphetamine in the spinal cord.
      Administration of 4-PTIQ (5 mg/kg, s.c.) reduced the ambulation induced by
      methamphetamine (0.5 mg/kg, s.c.) in rats. Methamphetamine (3 micrograms),
      injected unilaterally into the nucleus accumbens, increased ambulation. Alone, 4
      PTIQ (10 micrograms) failed to elicit ambulation; however, it inhibited the
      methamphetamine-induced increase in ambulation. The alpha 1-antagonist prazosin
      (0.5 micrograms) or the beta-antagonist propranolol (3 micrograms) showed no
      effect on ambulation induced by methamphetamine. Haloperidol (5 ng), which
      possesses strong dopamine-blocking activity, abolished the ambulation induced by
      methamphetamine. The drug 4-PTIQ had weak affinity for dopamine D1 and D2
      receptors. These results support the possibility that the inhibitory effects of 4
      PTIQ on the ambulation-stimulating effects of methamphetamine, are due to
      blocking of the dopamine-releasing effect of methamphetamine but not due to
      dopamine blocking effects.

PMID- 8474621
TI  - Protective effect of flunarizine and nifedipine alone and in combination with
      anticonvulsant drugs against PTZ-induced seizures in mice.
AB  - The anticonvulsant effect of flunarizine has been compared to that of nifedipine
      in the pentylenetetrazole (PTZ)-induced seizure incidence/latency test and the
      PTZ seizure threshold test in mice. Nifedipine was found to have anticonvulsant
      activity in both models but flunarizine only had an anticonvulsant effect in the
      PTZ seizure incidence/latency test. Interactions with commonly used anti
      epileptic drugs were also examined. In both models, the anticonvulsant effects of
      small doses or carbamazepine and phenytoin were enhanced by flunarizine and the
      effects of small doses of ethosuximide were enhanced by nifedipine. The effects
      of large doses of the anti-epileptic drugs were not further enhanced by either
      flunarizine or nifedipine. It is possible that these findings in mice are
      relevant to the variability of the responses to calcium antagonists as add-on
      therapy for epilepsy in man.

PMID- 8474622
TI  - Effects of acute and subchronic administration of ritanserin on the social
      behaviour of mice.
AB  - The effects of ritanserin on the behaviour of adult male CD1 mice were examined
      after acute intraperitoneal injection (0.1, 0.3 and 0.6 mg/kg) and after
      administration for 12-15 days in the drinking fluid at 1.6 mg/l (0.32 mg/kg
      daily) and 3.1 mg/l (0.7 mg/kg daily). The behaviour of each mouse was examined
      by ethological procedures during 5 min social encounters with an untreated
      partner in an aversive situation, an unfamiliar neutral cage, and in a familiar
      situation, the animal's home cage. Behaviour also was monitored for 5 min in the
      light-dark box. In the acute studies, behavioural observations commenced at 30
      min after injection. In the home cage, ritanserin significantly increased social
      investigation during social encounters and reduced exploratory activity at all
      doses tested, after both acute and subchronic administration. In the neutral
      cage, acutely administered ritanserin increased social investigation and reduced
      non-social activity at all dose levels. Effects were maximal at 0.3 mg/kg, and at
      this dose it also increased aggression. In the neutral cage after subchronic
      administration, ritanserin at both dose levels increased aggression, digging and
      investigation of the substrate and occurrence of the social act, "attend", while
      reducing the time spent in non-social exploration. Ritanserin did not affect
      behaviour in the light-dark box. The significance of these findings relative to
      the anxiolytic and antidepressant effects of ritanserin is discussed.

PMID- 8474623
TI  - Partial 6-hydroxydopamine-induced lesions and haloperidol-induced catalepsy.
AB  - Rats with partial (36%) 6-hydroxydopamine-induced lesions of the striatal
      dopamine system or sham-lesioned controls were tested for duration of catalepsy
      after 1.0, 2.0 and 4.0 mg/kg haloperidol. Thereafter, half of each group was
      given haloperidol (2.0 mg/kg) chronically for 84 days. The cataleptic responses
      to the 3 doses were tested again on days 13-15 and 74-76 of the chronic
      injections. Animals that were lesioned and treated with haloperidol chronically
      had longer durations of catalepsy at the first two dose-response determinations.
      At the third dose-response determination, there were no differences among the 4
      groups. Additionally, all groups displayed an increase in duration of catalepsy
      at the second and third dose-response determinations, relative to the first. The
      increase in haloperidol-induced duration of catalepsy in the lesioned group
      suggests that lower levels of dopamine in the striatum may potentiate
      extrapyramidal side-effects.

PMID- 8474624
TI  - Responses of neurons in bed nucleus of the stria terminalis to
      microiontophoretically applied morphine, norepinephrine and acetylcholine.
AB  - The bed nucleus of the stria terminalis is a basal forebrain nucleus that
      receives inputs from limbic system nuclei and sends projections to several
      hypothalamic and brainstem nuclei, proposed to be involved in the physiological
      response to stressors. The bed nucleus of the stria terminalis also receives
      norepinephrine- (NE), acetylcholine- (ACh) and opiate-containing projections. The
      objectives of this experiment were to examine the effects of
      microiontophoretically applied ACh, NE and morphine sulfate (M) on neurons of the
      bed nucleus in urethane-anesthetized rats and to determine the degree to which
      these systems interact on individual neurons. Acetylcholine was excitatory in 43%
      of the neurons and NE was inhibitory in 70%. Morphine however, elicited two
      distinct types of response--excitation in 24% of the neurons and inhibition in
      28%. Each of these effects was current-dependent and monophasic. Since 77% of
      neurons of the bed nucleus responded to two or more of the drugs used in this
      experiment, statistical analysis was used to determine correlations between
      responses to each of these drugs. This analysis showed that neurons that
      responded to M with excitation also responded to ACh with excitation, while
      neurons that responded to M with inhibition, were nonresponsive to ACh. No
      correlation was found between NE and either M or ACh. Thus, this experiment
      demonstrated the possible effects of noradrenergic, cholinergic and opioid
      innervation on firing rates of neurons of the bed nucleus of the stria terminalis
      and may explain the roles these neurotransmitters play in modulating the response
      to stress.

PMID- 8474625
TI  - Calcium-dependent release of norepinephrine from permeabilized PC12 cells is
      inhibited by approximately 48 and approximately 112 kDa fragments of botulinum
      neurotoxin type E.
AB  - Permeabilized PC12 cells exhibit a Ca(2+)-stimulated norepinephrine secretory
      pathway which is sensitive to botulinum neurotoxin serotypes A, B and E [Lomneth
      R., Martin T.F.J. and DasGupta B. R. (1991) J. Neurochem. 57: 1413-1421]. Two
      novel amino terminal fragments of the 150 kDa neurotoxin serotype E
      (approximately 112 and 48 kDa), produced by digestion with pepsin, were tested in
      permeabilized PC12 cells. The intracellular inhibitory activity of the
      approximately 112 kDa amino terminal fragment, like that of the 150 kDa
      neurotoxin, was progressively enhanced after trypsinization and dithiothreitol
      reduction. The approximately 50 kDa C-terminal half of the heavy chain therefore
      does not contribute to the enhancement of inhibitory activity. The approximately
      48 kDa amino terminal light chain-like fragment completely inhibited release of
      norepinephrine, with an IC50 = 500 pM (more potent than the light chain isolated
      after digestion with trypsin) not requiring reduction with dithiothreitol. These
      results clarify the molecular basis of activation of neurotoxin by trypsin and
      dithiothreitol.

PMID- 8474626
TI  - Cholinesterase inhibitor effects on extracellular acetylcholine in rat striatum.
AB  - The effects of inhibition of cholinesterase on levels of extracellular
      acetylcholine in the striatum of freely moving rats, were investigated with a
      microdialysis technique. Acetylcholine could not be detected under basal
      conditions. However, local administration of the cholinesterase inhibitors
      neostigmine, physostigmine or heptyl-physostigmine through the dialysis probe
      elevated acetylcholine above the detection limit. Complex interactions between
      the effects of local and systemic cholinesterase inhibitors were observed.
      Whereas systemic administration of physostigmine or heptylphysostigmine alone
      increased the extracellular concentration of acetylcholine, they also caused
      acetylcholine to fall below baseline levels, which had been established by
      perfusing physostigmine through the microdialysis probe. These studies
      demonstrate the ability of local inhibition of cholinesterase to affect the
      observation of effects of systemically-administered drugs.

PMID- 8474627
TI  - Synergism between the antinociceptive effects of intrathecal midazolam and
      fentanyl on both A delta and C somatosympathetic reflexes.
AB  - The interaction between the antinociceptive effects of fentanyl and midazolam,
      administered intrathecally (i.t.), was examined in dogs. Midazolam 1 mg (i.t)
      depressed the A delta and C fibre mediated somatosympathetic reflexes to 68.3 and
      85.2% of control values and then reduced the subsequent doses of fentanyl (i.t.)
      required to abolish these reflexes by 50%. After midazolam (1 mg, i.t.) the ED
      values for fentanyl were markedly less than the theoretical predicted additive
      values. This indicates synergism between the effects of fentanyl and midazolam.

PMID- 8474629
TI  - Current bibliographies of neuropeptides prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 8474628
TI  - Effects of indeloxazine on hippocampal CA1 pyramidal cell damage following
      transient cerebral ischemia in the gerbil.
AB  - The effects of indeloxazine on the ischemia-induced death of hippocampal CA1
      pyramidal cells following transient cerebral ischemia were examined in the
      mongolian gerbil. Increased survival of CA1 pyramidal cells was demonstrated in
      animals pre- and post-treated with indeloxazine. Increased survival of CA1
      pyramidal cells was, however, not demonstrated in animals post-treated but not
      pre-treated with indeloxazine. A previous study has demonstrated that
      indeloxazine increases the glucose and adenosine triphosphate (ATP) contents in
      the brain probably through an enhanced capability of oxidative phosphorylation.
      It has been reported that increases in the glucose and ATP contents in the brain
      before ischemia delay the onset of massive ionic fluxes during ischemia. The
      delay in onset of this ionic event may help to protect these cells from death.
      The present data suggest that energy state before ischemia may play an important
      role in the protective effect of indeloxazine.

PMID- 8474630
TI  - Influence of oxytocin on nociception and morphine antinociception.
AB  - In the hot plate test the intracerebroventricular (i.c.v.) injection of oxytocin
      produced a significant decrease in nociception, starting from the dose of 1
      microgram/rat. A comparable effect was obtained with 10-200 times higher
      intraperitoneal (i.p.) doses. The i.c.v. injection of the oxytocin antagonist
      d(CH2)5-Tyr(Me)-[Orn8]-vasotocin, while having no influence per se, completely
      prevented the antinociceptive effect of an equal i.c.v. dose of oxytocin. The
      antinociceptive effect of oxytocin was also prevented by naltrexone, and oxytocin
      caused a small but significant increase of the antinociceptive effect of morphine
      and of its duration. These data indicate that pharmacological amounts of oxytocin
      produce antinociception, that occurs through the activation of oxytocin
      receptors; endogenous opioid systems seem to be involved altogether.

PMID- 8474631
TI  - Characterization of the release and metabolism of delta sleep-inducing peptide
      (DSIP) in the rat brain.
AB  - In the present study, we examined whether delta sleep-inducing peptide (DSIP) was
      (1) secreted from neurons on depolarization and (2) degraded by membrane
      associated peptidases. Incubation of DSIP with rat brain membrane resulted in the
      degradation of DSIP with liberation of tryptophan, an N-terminal amino acid of
      DSIP. Bestatin and puromycin, aminopeptidase inhibitors, significantly inhibited
      the degradation of DSIP and release of tryptophan. The releases of immunoreactive
      DSIP-like substance (irDSIP) from rat brain slices and synaptosomes were
      significantly stimulated by high K(+)-evoked depolarization. The released irDSIP
      was coeluted with native DSIP on gel filtration chromatography. High K(+)-evoked
      release of irDSIP did not show extracellular Ca(2+)-dependency. This Ca(2+)
      independency suggests that the secretory pathway of DSIP may be different from
      that of other neurotransmitters. These results demonstrate that DSIP is released
      from nerve endings on depolarization and inactivated by membrane-associated
      puromycin-sensitive aminopeptidase. Therefore, DSIP may serve as a neuropeptide
      like material in the central nervous systems.

PMID- 8474632
TI  - Increased release of immunoreactive CCK-8 by electroacupuncture and enhancement
      of electroacupuncture analgesia by CCK-B antagonist in rat spinal cord.
AB  - Cholecystokinin octapeptide (CCK-8) in CNS has been shown to function as a
      neuropeptide with potent anti-opioid activity. It hinders opioid analgesia and
      facilitates opioid tolerance. The present study showed that electroacupuncture
      (EA) stimulation produced a marked increase of the CCK-8 immunoreactivity (ir) in
      the perfusate of the rat spinal cord. The increase of CCK-8-ir was most marked in
      response to EA of 100 Hz and 15 Hz, and less marked in response to EA of 2 Hz.
      Since CCK-8 has been shown to possess potent anti-opioid activity at the spinal
      level, blockade of the spinal CCK effect would be expected to potentiate EA
      induced analgesia which is known to be opioid-mediated. Intrathecal (i.t.)
      administration of CCK-B antagonist L-365,260 per se did not affect tail flick
      latency (TFL) to any significant extent, yet it potentiated EA induced analgesia
      in a dose- and frequency-dependent manner. The potentiation was most marked at a
      dose range of 2.5-5.0 ng (i.t.) and at a frequency rank order of 100 Hz > 15 Hz >
      2 Hz. The results suggest that an increased release of CCK-8 following EA may
      limit the effect of opioid peptides, and that the CCK-B receptor mediates the
      anti-opioid effect of CCK-8 in rat spinal cord.

PMID- 8474633
TI  - Evidence for a role of noradrenergic neurons in the increase in concentration of
      preprocholecystokinin-mRNA after cerebral cortex injury in rats.
AB  - A knife cut injuring the meninges and the upper layers of rat neocortex
      transiently increases the levels of preprocholecystokinin-mRNA in the whole
      ipsilateral cortex. 48 h after the injury, the rise in gene expression was
      reduced by the edema-induced increase in tissue pressure which develops after the
      trauma. The beta-adrenoceptor antagonists alprenolol (4 mg/kg) and propranolol (1
      mg/kg), given i.m. 30 min prior to the injury, reduced the increase by 75.6 and
      100%, respectively. In contrast, blockade of alpha-adrenoceptors as well as of
      dopamine and serotonin receptors by respective antagonists did not affect the
      injury-induced increase in levels of preprocholecystokinin-mRNA. These results
      suggest that noradrenergic neurons can contribute via stimulation of beta
      adrenoceptors to the initiation of the injury-induced increase in
      preprocholecystokinin gene expression.

PMID- 8474634
TI  - Effects of calcitonin gene-related peptide on the rabbit electroretinogram.
AB  - In order to better understand the role of Calcitonin gene-related peptide (CGRP)
      in mammalian retina, the dose related effects of human CGRP (hCGRP) on rabbit
      electroretinogram (ERG) were examined in the present study. CGRP was administered
      intraocularly in doses of 0.1, 1.0 and 10.0 micrograms. ERG A- and B-wave as well
      as oscillatory potentials (P1, P2, P3 and P4) were recorded. The highest dose of
      CGRP (10.0 micrograms) significantly increased the amplitudes of the A-wave and
      OP components (P1, P2, P3 and P4) produced by relatively high stimulus intensity.
      The same dose of the peptide also enhanced B-wave amplitude at all intensities
      studied. The effects of the intermediate dose of CGRP (1.0 microgram) on the B
      wave amplitudes were dependent on stimulus intensities. B-wave amplitudes at high
      stimulus intensities were not affected by 1.0 microgram of CGRP but were
      significantly increased with relatively lower stimulus intensities. The
      amplitudes of P3, one of OP components, were significantly increased. However,
      amplitudes of A-wave and other OP components (P1, P2 and P4) were not affected by
      1.0 microgram CGRP. The lowest dose of the peptide (0.1 microgram) did not affect
      any amplitudes of ERG components. Implicit times of A-wave, B-wave and OP
      components were not significantly affected by the different doses of CGRP. Taken
      together, these results indicate that CGRP may play a functional role in
      modulating retinal responses to photic stimulation.

PMID- 8474635
TI  - Acute cocaine treatment decreases oxytocin levels in the rat hippocampus.
AB  - We examined the effects of an acute cocaine treatment on oxytocin levels in the
      whole hippocampus, ventral tegmental area (VTA) and amygdala in ovariectomized
      rats pretreated with 10 micrograms estradiol benzoate. Cocaine treatment
      significantly reduced oxytocin levels both in picograms/area and picograms/mg wet
      weight in the hippocampus but had no significant effect on levels in the VTA and
      amygdala. These data represent the first evidence for the reduction of oxytocin
      levels as a result of an acute cocaine treatment.

PMID- 8474636
TI  - Effect of paraventricular injection of neuropeptide Y on milk and water intake of
      preweanling rats.
AB  - This study investigated the effect of paraventricular nucleus (PVN) injection of
      neuropeptide Y (NPY) on milk and water intake of 2- and 15-day-old sated rats. On
      the day prior to testing, rat pups were removed from their mothers and implanted
      with a cannula directed unilaterally at the PVN. On the following day, each pup
      was implanted with an intra-oral cannula for oral infusion of milk or water that
      could be swallowed or rejected. Following a 1-hour period fo satiation, each pup
      received a PVN injection of saline or a single dose of NPY (23.5-235.0 pmol).
      Milk or water intake was then assessed in a 1-hour test period. Injection of NPY
      into the PVN enhanced milk and water intake equally at 2 days of age. At 15 days,
      NPY produced a significantly greater enhancement of milk than water intake. These
      findings, which are similar to those observed previously with PVN injections of
      norepinephrine (NE), suggest that: (1) NPY receptors in the PVN, like alpha 2
      noradrenergic receptors, are functional very early in the postnatal development
      of the rat; (2) NPY, in addition to its orexigenic effect, produces a small but
      significant dipsogenic effect; and (3) NPY may function cooperatively with NE in
      the PVN to stimulate feeding and drinking beginning at a very early age.

PMID- 8474637
TI  - Pressure autoregulation is intact after arteriovenous malformation resection.
AB  - The loss of autoregulatory control of cerebral perfusion to changes in perfusion
      pressure in tissue remote from an arteriovenous malformation (AVM) has been
      proposed as the mechanism underlying "normal perfusion pressure breakthrough."
      This study is the first direct test of this mechanism. Studies were performed
      during the resection of moderate to large AVMs in 25 patients undergoing 28
      procedures under isoflurane anesthesia. Cerebral blood flow (CBF) was measured
      (xenon-133 method) in the hemisphere adjacent to the nidus before resection after
      dural exposure (pre), after AVM removal before dural closure at spontaneous
      systemic blood pressure (post), and, finally, with the mean arterial pressure
      increased by 20 mm Hg, using phenylephrine (post-BP). AVM resection resulted in a
      significant enhancement of perfusion in the adjacent hemisphere (30 +/- 2 vs. 25
      +/- 1 ml/100g/min, P < 0.01), but no further increase of CBF occurred during
      increased perfusion pressure (30 +/- 2 ml/100g/min). One patient suffered a
      postoperative hemorrhage and another developed intraoperative brain swelling
      during the course of the resection that necessitated staging the procedure. These
      two patients had the highest increases in CBF, but intact pressure
      autoregulation. Preserved autoregulation to increased mean arterial pressure
      after resection does not support a hemodynamic mechanism for the observed
      increase in CBF from before the resection to after the resection. Pathological
      events, however, do appear to be related to increases in hemispheric perfusion.

PMID- 8474638
TI  - Surgical treatment of thalamic arteriovenous malformations.
AB  - The microsurgical excision of arteriovenous malformations located in the thalamic
      region in eight patients is reported. Six were located in the posterior aspect of
      the thalamus and two were located in the anterior. Hemorrhage occurred in all of
      the cases. Hemiparesis, hemianesthesia, and consciousness disturbance were the
      most typical clinical features. The supine position with the anterior
      transcallosal approach was used for anterior dorsal lesions, and the sitting
      position with the posterior interhemispheric approach was used for posterior
      dorsal lesions. Total removal was confirmed by angiography in seven patients, and
      incomplete removal was noted in one patient. There was one death in this group of
      patients. Memory disturbance was the most common postoperative complication. This
      complication showed considerable improvement with time. Other complications
      included homonymous hemianopsia (three patients), hemisensory loss (six
      patients), and transient hemiparesis (one patient). All survivors (seven
      patients) were able to return to their occupation after surgery. The vascular
      input, the location of the malformation, and clinical history are the
      contributory factors concerning operability. With the modern neurosurgical and
      anesthesiological facilities, surgical removal of thalamic malformations in
      selected cases is advisable.

PMID- 8474639
TI  - Subcortical cerebral hemorrhage with reference to vascular malformations and
      hypertension as causes of hemorrhage.
AB  - The authors have reviewed 80 cases of subcortical cerebral hemorrhage, in all of
      which intraoperative examinations during craniotomy or autopsies were performed.
      Cases involving trauma and aneurysm were excluded from the study. The diagnosis
      of subcortical hemorrhage was made by plain computed tomography in all cases. The
      most common cause of hemorrhage was vascular malformation (68%; 56 cases), in 20
      (36%) of which angiographically occult vascular malformations were noted.
      Hypertension was present in 23 (29%) of 80 cases but was the cause of hemorrhage
      in only 9 cases (11%). Hypertension was present in 6 (30%) of 20 angiographically
      occult vascular malformations, all of which were in patients under 65 years. In
      12 (75%) of 16 cases of angiographically occult vascular malformations, prolonged
      high-dose delayed-contrast computed tomography and magnetic resonance imaging
      were able to provide definite diagnostic information. We recommend that patients
      with subcortical cerebral hemorrhage, especially those under age 65, with or
      without hypertension, be carefully examined by prolonged high-dose delayed
      contrast computed tomography and magnetic resonance imaging for the presence of
      angiographically occult vascular malformations causing hemorrhage.

PMID- 8474640
TI  - Clinical studies of de novo aneurysms.
AB  - Although multiple cerebral aneurysms ae well recognized, a new aneurysm has only
      rarely been documented after successful treatment for an aneurysm elsewhere. In
      our consecutive series of 986 patients with intracranial saccular arterial
      aneurysm collected from 1975 to 1990, nine patients who had previously unverified
      (hence, de novo) intracranial aneurysms and ruptures at intervals of 4 to 7.5
      years after clipping of an initial aneurysm are presented here. All nine had
      undergone successful treatment of a previous aneurysm; preoperative and
      postoperative angiography showed not only successful clipping of the first
      aneurysm but also no incidence of multiple aneurysms. These patients had suffered
      from hypertension before their second admission. Seven of the nine patients were
      treated surgically. All patients had experienced angiographical or symptomatic
      vasospasm after the first subarachnoid hemorrhage. In the second admission
      however, seven patients who underwent the surgery for a new aneurysm suffered
      from no vasospasm in spite of the prominent second subarachnoid hemorrhage. Two
      of the nine patients died of primary brain damage due to the hemorrhage and
      underwent necropsy. A histological study of a new aneurysm demonstrated the same
      findings as that of a usual saccular aneurysm. This clinical study of our
      patients suggests that it is important to control blood pressure for protection
      against a new aneurysm formation.

PMID- 8474641
TI  - Cocaine-induced aneurysmal rupture: an emergent negative factor in the natural
      history of intracranial aneurysms?
AB  - Recent statistics from the National Institute on Drug Abuse indicate that cocaine
      abuse continues to be a significant public health problem. Between 1988 and 1990
      at Grady Memorial Hospital in metropolitan Atlanta, Georgia, we identified 12
      patients in whom subarachnoid hemorrhage was temporally related to cocaine abuse.
      All 12 patients had underlying cerebral aneurysms that had ruptured. Currently,
      the incidence of ruptured intracranial aneurysms in patients with cocaine-induced
      subarachnoid hemorrhage is 84.9% (mean age, 31.1 years; overall mortality,
      60.5%). Hypertension is the likely precursive factor in cocaine-induced
      aneurysmal rupture. Cocaine abuse appears to be a significant negative factor in
      the natural history of cerebral aneurysms, especially in young adults. We review
      the epidemiology of cocaine-induced subarachnoid hemorrhage and its effects on
      the cerebral circulation, and suggest guidelines for patient management.

PMID- 8474642
TI  - Surgical treatment of moyamoya disease: operative technique for encephalo-duro
      arterio-myo-synangiosis, its follow-up, clinical results, and angiograms.
AB  - Moyamoya syndrome is defined as the development of collateral anastomosis
      pathways at the base of the brain, associated with chronic progressive stenosis
      of the carotid fork. Both reconstructive vascular surgery and conservative
      strategies are used to treat this syndrome, but the latter cannot prevent the
      disease from progressing. We describe the procedure of encephalo-duro-arterio-myo
      synangiosis (EDAMS), and report the results in 17 patients (28 sides) who
      underwent EDAMS. The clinical symptoms of moyamoya disease include transient
      ischemic attacks, reversible ischemic neurological deficits, stroke, seizures,
      Gerstmann's syndrome, involuntary movements, or mental retardation resulting from
      the lack of cerebral blood flow. The clinical results of EDAMS were poor in one
      patient, fair in two, good in five, excellent in eight, and fair on one side and
      excellent on the other side in one patient. Postoperative angiograms showed
      widespread collateral circulation on the ischemic brain surface in patients
      undergoing EDAMS.

PMID- 8474643
TI  - The significance of subarachnoid hemorrhage after penetrating craniocerebral
      injury: correlations with angiography and outcome in a civilian population.
AB  - Certain clinical factors are considered to have an effect on patient outcome
      after penetrating missile injury. These include bilateral hemispheric injury,
      ventricular hemorrhage, intracerebral hemorrhage, mass effect, and missile or
      bony fragmentation. The relationship of subarachnoid hemorrhage (SAH) after
      penetrating craniocerebral injury and outcome is unknown. In addition,
      controversy exists regarding the role of angiography and the incidence of
      traumatic intracranial aneurysm in this population. Finally, can we assume that
      the incidence of traumatic intracranial aneurysm is equal in military and
      civilian populations, given the absence of penetrating shrapnel injury in
      civilian populations? Now that computed tomography has supplanted angiography as
      the primary diagnostic modality, increasing vigilance on the part of the
      physician and examination of angiography in high-risk patients should allow for
      enhanced outcome. We evaluated 100 patients with a diagnosis of cerebral gunshot
      wound over a 12-month period. All patients were evaluated neurologically at the
      time of admission and had imaging studies. Thirty-one patients with radiological
      evidence of SAH on computed tomography underwent angiography. Angiograms were
      limited to the side of the injury in patients with single-lobe or unilateral
      multilobe injuries and were bilateral in patients with bilateral hemispheric
      involvement. One intracranial aneurysm (3.2%) was documented and treated
      surgically. In those patients who died within 48 hours of admission, 68% had SAH
      as compared with only 17% of those surviving. Outcome was based upon neurological
      evaluation at the time of discharge and at the time of clinical follow-up at 3
      and 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474644
TI  - Sigmoid sinus thrombosis after closed head injury in children.
AB  - In the literature, clinical descriptions of sigmoid sinus thrombosis occurring
      after closed head injury in children are rare. One to 5 days after trauma to the
      back of the head, five children (aged 1 to 7 yr) presented with gait ataxia,
      vomiting, and headache. Trauma was mild in four children. Computed tomography of
      all the children, performed within 5 days after the injury, showed focal
      hyperdensity in the region of the left sigmoid sinus. Four children had extra
      axial hyperdense collections along the left transverse sinus, and three had skull
      fractures adjacent to the left sigmoid sinus. Magnetic resonance imaging (MRI) of
      all the children, performed 2 to 6 days after injury, showed left sigmoid-sinus
      thrombosis and decreased flow or thrombosis within the lateral third of the left
      transverse sinus. All the children had MRI scans 4 to 6 weeks after their
      diagnosis and were followed up for 1 to 12 months. In four children whose
      symptoms subsided completely within 2 to 10 weeks, MRI showed recanalization of
      the sigmoid sinus within 4 to 6 weeks after injury. In one child whose symptoms
      resolved after 6 months, sigmoid-sinus thrombosis persisted with the formation of
      collateral flow. We conclude that traumatic sigmoid-sinus thrombosis should be
      suspected when a child has persistent or delayed gait ataxia and vomiting after
      injury to the back of the head. Computed tomography characteristically
      demonstrated focal hyperdensity within the sigmoid sinus that we term the dense
      sigmoid-sinus sign. Because the sinus recanalized and the symptoms subsided in
      most children within 6 weeks, we conclude that prophylactic medical or surgical
      intervention is not indicated.

PMID- 8474645
TI  - Multimodality monitoring as a guide to treatment of intracranial hypertension
      after severe brain injury.
AB  - Transcranial doppler measurements of blood flow velocity in the middle cerebral
      artery were made during treatment of raised intracranial pressure (ICP) in 22
      patients with severe brain injury. Twenty patients also had continuous
      measurement of arterial and jugular bulb venous oxygen saturation (SJO2). The
      transcranial Doppler parameters studied included both mean flow velocity and
      pulsatility index (PI). Successful treatment was defined as a reduction of ICP to
      less than 20 mm Hg with improvement or preservation of cerebral perfusion
      pressure (CPP) above 60 mm Hg. Successful therapy was associated with a
      significant rise in SJO2 and reduction of cerebral arteriovenous oxygen content
      difference (AVDO2) and PI only when the pretreatment CPP was less than 60 mm Hg.
      An increase in CPP beyond 70 mm Hg did not further improve cerebral oxygen
      delivery and PI, suggesting that autoregulation became a factor above this CPP
      threshold. Treatment failure during administration of hypnotic drugs resulted in
      a reduction in arterial pressure, CPP, SJO2, and mean velocity and in an increase
      in PI and AVDO2, despite a decrease in ICP. CPP is the most important parameter
      to monitor during ICP therapy. It should be maintained above 70 mm Hg in patients
      with severe brain injury.

PMID- 8474646
TI  - Supratentorial low-grade astrocytomas in adults.
AB  - One hundred seventy-nine adult patients with supratentorial low-grade
      astrocytomas were treated during a 10-year period. Retrospectively, a series of
      nine factors were evaluated with simple and multivariate analysis to determine
      their importance in predicting length of survival. Four appear highly significant
      (P < 0.005): age, preoperative Karnofsky Performance Scale score, histological
      grade, and type of surgical removal. Eighty percent of patients with total
      removal were alive at 5 years compared with 50% with incomplete surgery and 45%
      with biopsy. For the group under study, the mean time for recurrence was 52
      months. For patients surviving for more than 1 year, the chance of being
      recurrence free went from 75% at 3 years to 25% at 10 years. Among the entire
      population, the influence of radiotherapy was not obvious: 65% of patients were
      alive at 5 years without radiotherapy compared with 55% with radiotherapy. A
      significant difference appeared only for patients older than 40, with incomplete
      removal (P < 0.05); this difference did not apply to younger patients. The need
      for postoperative radiotherapy in all patients with subtotal removal,
      irrespective of their age, has not been demonstrated by this study.

PMID- 8474647
TI  - Delayed computed tomography contrast enhancement patterns in biopsy proven cases.
AB  - After a stereotactic brain biopsy of intracranial lesions, many neurosurgeons
      routinely obtain a noncontrast computed tomographic scan to rule out hemorrhage.
      We have observed there is often a significant delayed contrast enhancement on
      this postoperative scan, and the pattern of this enhancement frequently differs
      from the preoperative pattern. To assess these changes and to determine if they
      are related to lesion pathology or other clinical factors, the pre- and
      postoperative scans of 89 patients who underwent stereotactic biopsies were
      reviewed. Despite an average time delay of 153 minutes between scans, 81% of the
      lesions enhanced similarly or better on the postbiopsy image. One lesion enhanced
      only on the postoperative image, and in two cases, new lesions were seen
      postoperatively. Ring and other enhancing lesions tended to fill in with time,
      becoming homogeneous. The area of contrast enhancement increased in 83%. The
      borders of the lesions tended to become less sharp with time. No patterns of
      delayed enhancement, which give histologically definitive diagnostic information,
      were found. The tendency toward an increased area of contrast enhancement with
      time suggests that computed tomographic scans taken at the time of contrast
      injection may not show the true extent of the lesion. For patients undergoing
      computed tomography-guided stereotactic biopsies or radiosurgery of poorly
      enhancing lesions, the localization scan might be delayed after the
      administration of contrast medium to improve resolution and target selection.

PMID- 8474648
TI  - Unilateral hemispheric memory and hippocampal neuronal density in temporal lobe
      epilepsy.
AB  - We examined the relationship of preoperative unilateral memory function and
      quantitative hippocampal histology in patients undergoing anterior temporal
      lobectomy for the treatment of complex partial seizures. Recognition memory
      (objects, words, figures) was assessed preoperatively for each hemisphere by the
      intracarotid amobarbital procedure in 23 patients (mean age at the time of
      operation, 30.2 yr; standard deviation, 9.2; mean age at the time of seizure
      onset, 12.3 yr; standard deviation, 8.6) without tumor. Memory scores were the
      total number of items recognized, adjusted for guessing. Histological examination
      of the anterior 20 to 30 mm of hippocampal tissue was accomplished in all
      patients. The degree of unilateral memory impairment ipsilateral to the seizure
      focus was significantly correlated with decreased neuronal density in the hilar
      (r = 0.66, P < 0.001) and dentate granule (r = 0.61, P < 0.002) regions, but not
      in the CA1 (r = 0.10, P = not significant) or CA2-3 (r = 0.35, P = not
      significant) regions. Memory performance with the contralateral hemisphere was
      not significantly correlated with ipsilateral hippocampal densities. These data
      support the role of the hippocampus in human memory and show further evidence of
      hippocampal subfield specificity in the relationship between memory performance
      and neuronal cell loss. Further studies of the dentate granule and hilar regions
      in relation to human memory are warranted.

PMID- 8474649
TI  - Stereotactic percutaneous lumbar discectomy.
AB  - Sixty-nine patients with documented and contained disc herniations underwent
      percutaneous discectomy. The procedure was carried out with a new stereotactic
      device mounted on the floor and positioned over the computed tomographic scanner.
      In each instance, this device provided accurate insertion of the needle and
      localization of the aspiration probe (Nucleotome) within the appropriate area of
      the disc. Aspiration of the herniated nucleus pulposus was accomplished in every
      patient, and no complications were encountered.

PMID- 8474650
TI  - Biomechanical effects of laminectomy on thoracic spine stability.
AB  - Thoracic columns (T1-L1 levels) from 15 fresh human cadavers were used to
      quantify alterations in the biomechanical response after laminectomy. Eight
      specimens were tested intact (Group I); the remaining seven preparations were
      tested after two-level laminectomy (Group II) at the midheight of the column. All
      specimens were fixed at the proximal and distal ends and loaded until failure.
      Force and deformation were collected by use of a data acquisition system. Failure
      of the Group I specimens included compressive fractures with or without posterior
      element distractions, generally at the midheight of the column. Group II
      preparations failed at the superior aspect of laminectomy or at a level above
      laminectomy, suggesting an increased load sharing. Biomechanical responses of the
      Group II preparations were significantly different (P < 0.05) from those of the
      Group I specimens at deformations from the physiological to the failure range. In
      addition, failure forces for Group II preparations were significantly lower (P <
      0.001) than for Group I specimens. The stiffness and energy-absorbing capacities
      of the laminectomized specimens were also significantly different (P < 0.05) from
      those of the intact columns. In contrast, the deflections at failure for the two
      groups were not statistically different, suggesting that the human thoracic spine
      is deformation sensitive. Our data demonstrate that a two-level laminectomy
      decreases the strength and stability of the thoracic spine throughout the loading
      range. Although this is not a practical concern with an otherwise intact
      vertebral column, laminectomy, when other abnormalities such as vertebral
      fracture, tumor, or infection exist, may require stabilization by fusion and
      instrumentation.

PMID- 8474651
TI  - Significance of the rate of systemic change in blood pressure on the short-term
      autoregulatory response in normotensive and spontaneously hypertensive rats.
AB  - Cerebral autoregulation, the physiological regulatory mechanism that maintains a
      constant cerebral blood flow (CBF) over wide ranges of arterial blood pressure,
      was investigated in normotensive and spontaneously hypertensive rats by means of
      laser-Doppler flowmetry. Systemic arterial hypertension was produced at rates
      ranging from 0.02 mm Hg/second to 11 mm Hg/second by constant infusion of
      epinephrine and norepinephrine. Systemic arterial hypotension was produced at
      rates ranging from -0.03 mm Hg/second to -12 mm Hg/second, either by bleeding the
      animals into a reservoir or by compressing the abdomen. In those cases with a low
      rate of change in systemic arterial blood pressure (SABP), the measurements
      lasted for 5 +/- 2 minutes, and in those with a high rate of change in SABP,
      measurements lasted for 40 +/- 30 seconds. The purpose was to record the time of
      onset and course of autoregulation in the basal ganglia in response to slow or
      rapid changes in SABP. CBF in the basal gray matter remained at baseline values
      (i.e., autoregulation was functioning) if the rate of increase of SABP did not
      exceed a critical value (0.10 mm Hg/second in the normotensive rats; 0.35 mm
      Hg/second in the spontaneously hypertensive rats). When hypertension was produced
      at faster rates, CBF followed arterial blood pressure passively, and no
      autoregulatory response was observed for 2 +/- 1 minutes. Hypotension did not
      change the baseline CBF when it was not produced at a rate faster than -0.4 mm
      Hg/second in normotensive rats and -0.15 mm Hg/second in spontaneously
      hypertensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474652
TI  - Nonmuscle arterial constriction after subarachnoid hemorrhage: role of growth
      factors derived from platelets.
AB  - Recent studies have shown that myofibroblasts cultured from spastic arteries
      after subarachnoid hemorrhage (SAH) can produce contractile forces and that
      cerebrospinal fluid obtained from SAH patients accelerates this contraction.
      Myofibroblast-populated collagen lattices were used to evaluate the roles of
      polypeptide growth factors considered to be released from intraluminal
      accumulated platelets. The myofibroblasts, obtained at autopsy from human
      cerebral arteries of victims of vasospasm, caused contractile forces by
      compacting collagen fibrils in the matrix. Transforming growth factor beta 1 (TGF
      beta 1) and platelet-derived growth factors aa and bb (PDGFaa and PDGFbb)
      accelerated this contraction in a dose-dependent manner. In the presence of TGF
      beta 1 at 1 or 10 ng/ml, PDGFaa at 10 ng/ml, or PDGFbb at 10 ng/ml, lattice areas
      were reduced to 69.5 +/- 1.9% (mean +/- standard deviation) (P < 0.001), 63.3 +/-
      0.4% (P < 0.001), 66.5 +/- 3.0% (P < 0.01), or 74.4 +/- 1.7% (P < 0.01) of the
      control on Day 6, respectively. The combination of subthreshold doses of TGF-beta
      1 and PDGFaa created a stimulatory effect that appeared to act synergistically.
      Furthermore, myofibroblast-populated collagen lattices made with cells
      preincubated with TGF-beta 1 showed more rapid compaction with or without the
      presence of stimulants such as post-SAH cerebrospinal fluid. These results
      suggest that, in addition to other possible factors in the post-SAH cerebrospinal
      fluid, growth factors derived from accumulated platelets may play an important
      role in arterial constriction caused by nonmuscle components after SAH, by single
      or multiple mechanisms.

PMID- 8474653
TI  - Risks of anticoagulation therapy after experimental corticectomy in the rat.
AB  - To determine the optimal postoperative interval after which heparin therapy can
      be safely initiated, a rat model for experimental craniotomy and corticectomy was
      developed. In 50 rats (100 lesions), heparin therapy was initiated 1, 2, 3, 5, or
      7 days after standardized bilateral frontal corticectomy and was continued for 7
      days. Intraperitoneally administered heparin, 75 to 100 U/kg.h, was continuously
      given to maintain the activated partial thromboplastin time in one of two ranges:
      therapeutic (1.5-3 times control) or supratherapeutic (> 3 times control). The
      size of intracranial hemorrhage was determined from coronal brain sections by
      automated image analysis. No significant hemorrhage was observed in control
      (saline infusion) animals or in rats receiving therapeutic doses of heparin
      beginning more than 24 hours after surgery. Small (10-50 mm3) and large (> 50
      mm3) hemorrhages were frequent at all intervals up to 5 days in animals with
      supratherapeutic activated partial thromboplastin time (P < 0.01). Judicious
      heparin therapy may be safely initiated at 48 hours after craniotomy and
      corticectomy in rats, whereas supratherapeutic anticoagulation is associated with
      intracranial hemorrhage at intervals of up to 5 days.

PMID- 8474654
TI  - Prevention of postoperative intracerebral hemorrhage with topical recombinant
      factor XIII in the rat.
AB  - Factor XIII is an endogenous clotting factor that retards thrombus degradation by
      cross-linking fibrin. To determine the efficacy of Factor XIII as a topical clot
      stabilizing agent in preventing postoperative hemorrhage associated with
      coagulopathy, a rat model of experimental craniotomy and standardized bilateral
      frontal corticectomy was developed. In 25 rats (50 lesions), recombinant human
      Factor XIII or placebo solution was topically applied to corticectomy cavities
      after hemostasis was achieved; each animal served as its own control. In 20 rats,
      heparin sulfate (100 U/kg.h) was initiated intraperitoneally 3 days after surgery
      and was continually administered by an Alzet pump for 7 days, compared with a
      control group of 5 rats receiving saline intraperitoneally. The volume of
      intracranial hemorrhage was quantitatively determined from coronal sections by
      use of automated image analysis. Large (> 50 mm3) intracerebral hemorrhages were
      significantly more frequent in placebo (60%)- compared with recombinant Factor
      XIII (15%)-treated lesions (P < 0.01) in animals receiving heparin. The topical
      application of clot-stabilizing agents such as Factor XIII may reduce the risk of
      postoperative intracranial hemorrhage, especially in high-risk patients with
      coagulopathy.

PMID- 8474655
TI  - Meningiomas.
AB  - This article reviews the recent literature on the pathogenesis and pathology of
      meningiomas, contemporary techniques of surgical resection, and new nonsurgical
      treatments, including radiation and hormone therapy. Factors predisposing to
      meningioma formation include female sex, previous ionizing radiation, and Type 2
      neurofibromatosis. The first factor may act through the expression of sex hormone
      receptors, especially the progesterone receptor, in these tumors; the other two
      probably act by causing a deletion on Chromosome 22. The pathological
      classifications of meningiomas include the traditional division into histological
      subtypes and the World Health Organization classification that selects
      characteristics that may lead to recurrence. There is an increasing emphasis on
      proliferative indices and other characteristics that may predict aggressive
      behavior in these tumors. On computed tomography, meningiomas are enhancing, well
      marginated, dural-based lesions that may have considerable surrounding edema; the
      cause of the edema is uncertain but may result from secretory products of the
      tumor. Magnetic resonance imaging with enhancement will demonstrate these lesions
      accurately and can be used for three-dimensional reconstruction as well. Computed
      tomography and magnetic resonance imaging have largely replaced angiography in
      the preoperative diagnosis of meningiomas, but angiographic embolization may be a
      useful operative adjunct. Although meningioma surgery is sometimes thought of as
      benign and curative, the reported surgical mortality rate is as high as 14.3% and
      the reported 10-year survival rate after surgery varies from 43 to 77%. Surgery
      has advanced most in the management of suprasellar, cavernous sinus, clivus,
      tentorial, and posterior fossa meningiomas, because new approaches and a better
      understanding of anatomy have allowed more radical resection. There is still
      substantial morbidity associated with surgery in these regions, however, and the
      long-term recurrence rates are still unknown for these new radical techniques.
      For convexity, parasagittal, lateral sphenoid wing, and olfactory groove
      meningiomas, complete resection should be the goal and operative morbidity
      appears to be low. There is a high recurrence rate after surgery. With apparent
      total removal, the recurrence rate varies from 9 to 20% at 10 years, with
      subtotal resection varying from 18.4 to 50%. The degree of resection appears to
      be most important in recurrence, but histopathological features are also
      important. Recently, radiation therapy has been recognized as a useful adjunct to
      surgery, and with radiosurgical techniques may become more important in the
      future. Antiprogesterone therapy appears to have had some success as well, and it
      or other hormonal therapy may be another future option for residual or recurrent
      meningiomas.

PMID- 8474656
TI  - Symptomatic intradural adrenal adenoma of the spinal nerve root: report of two
      cases.
AB  - The second and third cases of an adrenal adenoma involving the intraspinal space,
      a rare location for a lesion that occurs rather commonly at a variety of
      extraneural sites, are reported. The first patient, a 16-year-old girl with a 3
      month history of radicular pain, was found to have an intradural, extramedullary
      mass arising on a spinal nerve root. Its resection resulted in cure. The second
      patient, a 63-year-old woman with a 10-month history of low back pain with
      radiation to both lower extremities, had a similar mass arising from one of the
      nerve roots of the cauda equina. In both cases, ultrastructural examination of
      these demarcated, oncocytic, lipid-rich lesions demonstrated abundant smooth
      endoplasmic reticulum and mitochondria with tubular cristae. The presence of
      steroidogenic enzymes was noted on immunohistochemical examination. The
      literature is reviewed, as is the differential diagnosis of these rare lesions.

PMID- 8474657
TI  - Parasellar epidural hydatid cysts.
AB  - We report two rare cases of parasellar epidural hydatid cysts. Among the 64
      patients with intracranial hydatid cysts we have treated in the past 20 years,
      only these two cases were located epidurally. Because the location and the
      computed tomographic characteristics were so different from the other cysts, the
      preoperative diagnosis was difficult to make. We were unable to remove the cysts
      without rupturing them because they were tightly surrounded. Both patients
      underwent surgery twice because of a recurrence. The treatment of this kind of
      case requires further discussion.

PMID- 8474658
TI  - Hearing impairment resulting from a pineal region meningioma.
AB  - Because of extensive interconnections within the auditory pathways, hearing
      impairment from a central origin is rare. We describe a patient with a large
      pineal region meningioma in whom hearing loss was the predominant symptom. The
      patient promptly recovered hearing after the surgical removal of the tumor. The
      mechanism of this phenomenon is discussed.

PMID- 8474659
TI  - Quadraparesis after a shunting procedure in a case of cervical spinal neurinoma
      associated with hydrocephalus: case report.
AB  - The authors report a rare case of cervical spinal neurinoma in a patient who
      presented with symptoms originating from hydrocephalus. Her symptoms improved
      after a ventriculoperitoneal shunt was inserted, although progressive
      quadraparesis appeared when she began to walk. Magnetic resonance imaging
      revealed a cervical tumor. When it was removed, the patient's quadraparesis
      improved. Associated spinal tumors should be considered in the treatment of
      hydrocephalus of unknown origin.

PMID- 8474660
TI  - Thiamine-deficient encephalopathy in association with aneurysmal subarachnoid
      hemorrhage: a case report.
AB  - An alcoholic man who was admitted with an acute onset of neck pain and confusion
      was diagnosed as suffering from a subarachnoid hemorrhage after rupture of an
      anterior communicating artery aneurysm. Additionally, he showed a bilateral 6th
      nerve palsy of variable extent. The postoperative course was complicated by
      pulmonary edema and adult respiratory distress syndrome. He died on Day 28 after
      admission. At autopsy, surprisingly, the concomitant diagnosis of acute thiamine
      deficient encephalopathy was made. Thiamine had been given only in minimal
      amounts during hospitalization. We describe the striking clinicopathological
      features of this previously undocumented case and consider the relationship
      between the two central nervous diseases.

PMID- 8474661
TI  - Fastigial pressor response observed during an operation on a patient with
      cerebellar bleeding--an anatomical review and clinical significance.
AB  - The fastigial pressor response (FPR) consists of an abrupt rise in blood pressure
      and tachycardia with hyperpneic response. The FPR is an important sign in
      posterior fossa surgery for respiration in postoperative patients. The authors
      experienced a distinct pressor, tachycardiac, and hyperpneic response elicited
      when controlling bleeding using a bipolar coagulator forceps at the subfastigial
      white matter in a 72-year-old man with cerebellar hemorrhage. This response was
      confirmed by bipolar electrodes, which produced a weak current under deeper
      anesthesia by increasing the concentration of enflurane. The postoperative course
      of this patient was uneventful. A FPR was suggested to be mediated by axons
      passing between the nucleus fastigii and the fourth ventricle. These commissural
      fibers mediating the FPR were suggested to be countercurrent efferent pathways
      from both sides of the nucleus parabrachialis lateralis, located at the
      dorsolateral corner of the rostral pons. The authors conclude that the partial
      destruction of the subfastigial commissural fiber bundle did not result in
      permanent respiratory deficit. Fatal respiratory disturbance might be
      anatomically suggested by completely cutting off this fiber bundle.

PMID- 8474662
TI  - Correlation of contralateral stenosis and intraoperative electroencephalogram
      change with risk of stroke during carotid endarterectomy.

PMID- 8474663
TI  - Intramedullary cavernous angiomas of the spinal cord: clinical presentation,
      pathological features, and surgical management.

PMID- 8474664
TI  - Intracavernous cavernous hemangioma: an unpublished but reported case.

PMID- 8474665
TI  - The education of a neurosurgeon: the two cultures revisited.

PMID- 8474666
TI  - [Clinical use of cerebral elastance and intracranial dynamics measurements].
AB  - The treatment of Intracranial Pressure (ICP) requires not only the determination
      of the pressure but also some kind of estimate of the relationship between
      intracranial volume and actual pressure. The measurement of the Pressure Volume
      Index (PVI) offers a quantitative assessment of such a relationship, provided
      that the measurement is safe and accurate. In 98 comatose patients admitted to
      the Intensive Care Unit for the treatment of head injury or subarachnoid
      hemorrhage the ICP was continuously recorded using ventricular or subdural
      catheters. In 68 patients the PVI was measured using the bolus technique every 12
      hours; the intracranial dynamics was assessed according to Marmarou's equations.
      The preliminary part of the work reviewed the methodology: the interobserver
      variability was studied and the differences between the PVI data obtained through
      addition or withdrawal of fluid were determined. The data obtained by different
      observers did not differ substantially, due to the clear establishment of rules
      for the measurement. The PVI data obtained withdrawing fluid were lower than the
      data produced adding volume but the mean PVI calculated after 6 bolus changes of
      the intraventricular volume reached a good correlation coefficient (> 0.8) with
      all the measurements. After that the clinical use of the PVI was tested. The
      patients with a PVI lower than 15 ml showed an increased risk of developing
      intracranial hypertension in the first 72 hours after trauma of SAH. The group of
      patients with an intracranial compliance lower than 0.5 had a mortality rate of
      27.3%, compared with the rate of 14.3% showed by the patients with a greater
      Compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474667
TI  - [Transcranial Doppler in the diagnosis of brain death].
AB  - The delay in the diagnosis of brain death represents a cause of deficiency of
      organs for transplant. In this prospective study we evaluate the role of Doppler
      sonography, to investigate typical velocimetric profiles of brain death, and to
      evaluate the delay between finding the typical profiles and diagnosis expressed
      according to law. In this ongoing study, we evaluated 32 patients affected from
      serious primitive intracranial diseases (Glasgow Coma Scale < or = 7). Of the 32
      patients examined, 18 underwent or still remained in brain death. All the
      patients showed typical profiles, classified in 3 fundamental types. Start of
      monitoring, according to the current law, showed a delay from 12 to 27 hours. The
      authors conclude that Transcranial Doppler and Doppler c.w. represent an early
      and sensitive technique, rightly to include in the procedure of the diagnosis of
      brain death.

PMID- 8474668
TI  - [Multiple organ system failure: analysis of oximetry parameters among survivors
      and non-survivors].
AB  - The authors have studied the relationship between SvO2 and many parameters of
      oxygenation in MOSF patients specially in surviving patients and not surviving
      ones. They found that there is a close correlation between SvO2 and CI in the
      survivors indicates that, in these patients, we can increase cardiac activity to
      improve the cellular demand.

PMID- 8474669
TI  - [Rationalization of transfusional therapy in elective surgery. Our experience].
AB  - The paper reports the authors' experience regarding the rationalisation of
      transfusional therapy. The high risks of infection or damage to the immune system
      have highlighted the need to review the approach used by the anesthetist, surgeon
      or hematologist resulting in major cultural changes and the development of
      methods for the use of autologous blood. The study was carried out by comparing 2
      similar periods of surgical activity in which the sole variant was the different
      attitude of the anesthetist who utilised blood transfusion on the basis of pre,
      intra and postoperative hematocrit values; in addition, the Authors report the
      results obtained in a group of patients enrolled for EIN. They observed that by
      using simple rationalisation a 30% saving, equivalent to 101 blood units, was
      achieved; EIN was performed in 20 patients out of the 32 enrolled with an
      effective 20% saving equivalent to 40 units; calculating the theoretical saving
      which could be obtained by total EIN and rationalisation, a saving of as much as
      58% equivalent to 198 units could be achieved. Even if many aspects still require
      definition, good rationalisation, even using simple techniques, coupled with the
      availability of autologous blood certainly makes blood transfusion safer and less
      expensive.

PMID- 8474670
TI  - [Validity of computer simulation in closed circuit anesthesia].
AB  - Developing a computer program to simulate the uptake, distribution, and
      elimination of inhalational anesthetics allow the anesthesiologist to address
      specific problems, but intense skills are required to translate the involved
      process first into a set of mathematical equations and then into a satisfactory
      computer program. The first step is facilitated by solutions offered in the
      literature. The second step by personal computer program now currently available
      as Gus, this program simulates anesthetic uptake and distribution using a
      numerical model with 12 compartments. Transport of anesthetic agents among the
      compartment occurs via convection of gas and blood during discrete iteration of
      the simulation. As initial clinical validation of the linear 12 compartment basic
      model the current study examined the predictive performance in 20 patients by
      comparing quantitatively the predicted and the measured alveolar concentration
      time profiles after achievement of end tidal concentration of isoflurane (C-alv%)
      injected into a heated chamber (75 degrees) and then transported in closed
      circuit system during mechanical ventilation. With regard to the use of
      isoflurane 20 patients were adequately anesthetized with only 88 ml of liquid
      isoflurane and that is the same in simulation achieved by computer.

PMID- 8474671
TI  - [The major nerve trunks are not the primary action site of intravenous regional
      anesthesia].
AB  - In a patient suffering from a deep penetrating wound of the left forearm and
      radial nerve injury, the administration of intravenous regional anesthesia (IVRA)
      was followed by prompt analgesia of the whole arm while intense pain could still
      be elicited by stimulating radial nerve stump. Complete radial nerve block was
      present 10 min later confirming that initial blockade of nerve terminals
      substantially contributes to IVRA and suggesting that a 10 min delay is indicated
      for optimal analgesia after IVRA whenever a major nerve injury is suspected.

PMID- 8474672
TI  - [Buprenorphine as preanesthetic medication in peridural anesthesia].
AB  - Buprenorphine was used as a preanesthetic drug for peridural anaesthesia. The aim
      of the study was therefore to evaluate the sedative/anxiolitic activity of this
      drug as compared to prometazine and diazepam. Two hundred male patients, divided
      into two groups (A and B), who were to undergo urological surgery under
      peripheral anesthesia, were included in the study: L2/L3 or L3/L4 epidural block.
      The group A patients were premedicated with buprenorphine; the group B patients
      received traditional anesthetic. The following factors were evaluated: the course
      of the AP and CF, the state of intraoperative sedation, the presence of side
      effects and data obtained, elaborated with a statistical test constructed to
      compare the percentages in two independent samples. There were no statistically
      significant variations of the AP and CF in the two groups. Additional sedatives
      were administered to 56.2% of the patients in group B and to only 27.1% in group
      A, premedicated with buprenorphine. Thirty seven percent of the group A patients
      and 10% of the group B patients presented preoperative nausea. The authors
      believe that the buprenorphine/atrophine association should be encouraged for pre
      anesthesia when operations in peridural anesthesia are to be conducted, as it
      provides a state of constant sedation, avoiding rather ineffective
      pharmacological mixtures.

PMID- 8474673
TI  - [Short version of the pain questionnaire: influence of age on the choice of
      terms].
AB  - We proposed the QUID to 1148 persons divided into 5 groups and we looked for
      diversity in the choice of terms in relation to age and sex. The purpose was to
      elaborate one or more short versions of QUID to meet in a specified way, the
      requirements of simplicity, flexibility and specificity that came out from pain
      practice.

PMID- 8474674
TI  - [Group of study SIAARTI of anesthesia and recovery for neurosurgery and
      neurology. Present and future].
AB  - The authors present the results of a survey of anesthesiologists members of the
      "SIAARTI (Societa Italiana di Anestesia, Analgesia, Rianimazione e Terapia
      Intensiva) Committee for anesthesia and critical care in neurosurgery and
      neurology". Among the aims of the survey, was to evaluate when the interest in
      neuroscience of the members of this group started, and the clinical work
      dedicated to neuroanesthesia and critical care. At present, the group has grown
      to 143 members. In the questionnaire 105 members indicated the topic discussed
      for the medical degree thesis, and 87 indicated the thesis discussed for the
      board in anesthesia. As emerged from the topic of the thesis discussed for the
      medical degree, in 47% of the responders the interest in anesthesia began during
      the college. Of this, 6% chose a topic in neuroanesthesia and critical care.
      During the residency, the interest in neuroscience increased to 33%, that is 32
      out of 97 responders discussed a thesis in neuroanesthesia and critical care.
      Forty-eight per cent of the members performs clinical work "exclusively" in
      neuroanesthesia, while 39% does it "mainly", and only 13% works in neurosurgery
      "fiftfully".

PMID- 8474675
TI  - [Spinal activity and brain death].

PMID- 8474676
TI  - [Intensive medicine in a metropolitan area. An epidemiologic study. Multicenter
      Italian Group of Research in Intensive Therapy (GIRTI)].
AB  - This report is an epidemiological study concerning the description of intensive
      care medicine in North Italy. 2710 patients were enrolled in 1988 in 14 ICU. Mean
      admission SAPS was 12.0 +/- 0.1 point, TISS 29.9 +/- 0.2 points; ICU stay 9.1 +/-
      0.2 days; ICU mortality 23% and hospital mortality 30.4%. The higher stay and
      mortality were recorded in patients suffering from chronic illness; mortality was
      significantly related to the severity of the clinical condition and the main
      diagnosis at the ICU admission.

PMID- 8474677
TI  - [Acute voluntary poisoning with propafenone. A clinical case].
AB  - Propaphenone hydrochloride in an antiarrhythmic which belongs to class 1C. In
      recent years it has been widely used in clinical medicine, mainly in the
      treatment of hyperkinetic arrhythmia. Given the enormous quantity of the
      medication taken, the description of the case seemed opportune as well as that of
      the clinical manifestations and electrocardiographic modifications linked to the
      parmakinetic and electrophysiological characteristics.

PMID- 8474678
TI  - [Peridural anesthesia for cesarean section in a patient with inoperable cerebral
      angioma].
AB  - Anaesthesia for caesarean section in patients with cerebral artero-venous
      malformations (CAVM) is a controversial matter. We describe a case of a
      primiparus woman with an inoperable CAVM delivered by CS under epidural
      anaesthesia. Epidural anaesthesia can be a valid alternative to general
      anaesthesia as it provides excellent analgesia allowing an accurate assessment of
      the neurological conditions of the mother and avoiding opioids and/or hypotensive
      drugs, potentially dangerous to the foetus, to blunt the hypertensive response to
      intubation. The accidental dural puncture is to be avoided with extra-careful
      technique. The epidural injection must be made either very slowly or with an
      incremental technique to avoid any increase in intracranial pressure. Hypotension
      must be corrected promptly to maintain cerebral perfusion pressure.

PMID- 8474679
TI  - Neurogenesis persists in the subependymal layer of the adult mouse brain.
AB  - Neurogenesis of olfactory bulb granule cells is known to persist in adult rats
      where, in some strains, the bulbs grow throughout life. In mice, bulb growth
      ceases early in adulthood and here we ask if granule cell neurogenesis persists
      after the bulbs have stopped growing. By injecting adult mice with
      bromodeoxyuridine (BrdU) and allowing short and long survival times, we found
      that new cells form in the subependymal layer and that they migrate subsequently
      into the olfactory bulbs where they acquire the nuclear morphology of granule
      cells and express neuron-specific markers. Using [3H]thymidine, we found that
      most of these adult-generated granule neurons persist within the bulbs for at
      least 16 weeks. This shows the persistence of neurogenesis and neuronal migration
      in adult animals in which the olfactory bulbs have stopped growing.

PMID- 8474680
TI  - Selective release of serotonin by endogenous alkaloids, 1-methyl-6,7-dihydroxy
      1,2,3,4-tetrahydroisoquinolines, (R)- and (S)salsolinol, in the rat striatum; in
      vivo microdialysis study.
AB  - Dopamine-derived 1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinolines, (R)- and
      (S)salsolinol, released an enormous amount of serotonin in the rat striatum; the
      concentration of serotonin increased from undetectable level to 2.53 +/- 0.12 and
      3.69 +/- 0.01 microM after perfusion of (R)- and (S)salsolinol, respectively.
      Salsolinols increased extracellular dopamine level, but to a much lesser degree
      than serotonin. Other naturally occurring isoquinolines with catechol structure
      released serotonin and dopamine, but salsolinols were the most potent and
      selective releaser of serotonin. Serotonin release by salsolinols may be involved
      in some psychiatric symptoms in L-DOPA therapy or alcoholism.

PMID- 8474681
TI  - Investigating the role of anaesthetics on the rostral ventromedial medulla:
      implications for a GABAergic link between ON and OFF cells.
AB  - Two classes of cells in the rostral ventromedial medulla (RVM), ON and OFF, are
      important in the descending modulation of noxious input. It is thought that these
      two cell classes communicate, at a local level, with each other to control the
      RVM's descending modulation. Systemic morphine was given to rats anaesthetized
      with either pentobarbital (a GABA agonist) or with ketamine (a non-competitive
      NMDA receptor antagonist) and xylazine. The spiking activity of the ON and OFF
      cells was recorded. The typical ON cell inhibition by morphine was observed in
      rats under both anaesthetics. However, the OFF cell excitatory response to
      morphine was seen in the ketamine but not in the pentobarbital-anaesthetized
      animals. The implications for a GABAergic connection between these two classes of
      cells are discussed.

PMID- 8474682
TI  - Ischemic neocortical protection with U74006F--a dose-response curve.
AB  - A dose-response curve for the lipid peroxidation inhibitor U74006F was
      established in a rat forebrain ischemia model. Transient forebrain ischemia was
      induced by bilateral carotid occlusion plus controlled hypotension (50 mmHg) for
      10 min. U74006F was administered at doses of 0.3, 1, 3, 7, or 10 mg/kg 30 min
      prior to ischemia. Control animals received vehicle (0.02 M citrate buffer in
      0.8% NaCl). Brains were perfusion-fixed on day 7 post-ischemia for
      histopathological examination. For both the hippocampus and striatum, neuronal
      injury was not significantly different between groups. Within the neocortex
      ischemic neuronal injury was significantly less (P < 0.05) in the 7 mg/kg U74006F
      treated group compared to the control, 1 mg/kg, or 3 mg/kg U74006F-treated
      groups.

PMID- 8474683
TI  - Quinolinic acid lesion of the striatum induces impairment in spatial learning and
      motor performance in rats.
AB  - Injection of quinolinic acid (QA) into the striatum of rats is known to produce
      neuropathological and neurochemical alterations similar to those observed in
      Huntington's disease (HD). One clinical feature of HD patients is cognitive
      impairment. Two weeks after stereotaxic injection of either QA (240 nmol) or
      solvent in rats spatial learning was tested in the Morris water maze. QA lesioned
      animals required more time to find the hidden platform. The swim speed was
      reduced in all trials compared to the controls. The swim distance itself was
      longer and the amount of swim distance along the side wall was significantly
      higher in QA lesioned rats. The present results suggest that QA lesion of the
      striatum leads to deficit in motor performance and in spatial learning.

PMID- 8474684
TI  - Postnatal development of vasoactive intestinal polypeptide-containing neurons in
      the visual cortex of normal and dark-reared rats.
AB  - The effects of dark rearing on the distribution and density of vasoactive
      intestinal polypeptide (VIP)-containing neurons in the visual cortical areas (17,
      18 and 18a) of rats during postnatal development were examined
      immunohistochemically. Two groups of Wistar rats, one reared under normal
      lighting conditions and the other in complete darkness from birth, were used. VIP
      neurons showed a fairly similar distribution in the three visual areas, being
      predominantly present in layers II and III. Their pattern of development was
      found to be similar in the normal and dark-reared animals and was characterized
      by a marked increase from postnatal day (P) 7 to P21, followed by a gradual
      diminution to 24-31% of peak densities. Counts of labeled neurons at all ages
      examined showed that their density was similar in both groups at P7 and P14, but
      progressively greater in dark-reared animals from P21 and thereafter, so that
      they only fell to 38-43% of peak densities. Thus, by 60 days of age densities of
      VIP-labeled neurons in areas 17, 18 and 18a in dark-reared rats were 57%, 49% and
      51% higher than in the corresponding areas of the age-matched control rats. These
      results indicate that the normal decline in the numbers of VIP neurons is not so
      marked under the conditions of dark rearing.

PMID- 8474685
TI  - Properties of single Na(+)-activated K+ channels in cultured central neurons of
      the chick embryo.
AB  - Na(+)-activated K+ channels (IK[Na]) of cultured chick brainstem neurons do not
      run down following excision of inside-out patches, but this occurs within seconds
      to minutes in cultured chick olfactory bulb neurons. IK[Na] channels of chick
      brainstem neurons exhibit a main conductance state of 95-105 pS, and also express
      multiple sub-conductance states. These channels have complex kinetics, with
      multiple closed and main conductance states. The average lifetime of the main
      conductance state is not dependent on the Na+ concentration used to activate the
      channels.

PMID- 8474686
TI  - Beta A4 protein deposition in familial Alzheimer's disease with the mutation in
      codon 717 of the beta A4 amyloid precursor protein gene and sporadic Alzheimer's
      disease.
AB  - Beta A4 protein immunoreactivity in the neocortex and hippocampus of familial
      Alzheimer's disease (AD) including the case with the beta A4 amyloid precursor
      protein (APP) gene mutation in codon 717 (APP717 Val-->Ile) and sporadic cases of
      AD is described. A semi-automatic image analysis system was used to quantify beta
      A4 protein load in the isocortex of the frontal and temporal lobes and in
      subfields of the hippocampus. Immunoreactivity was measured in ten cases of
      sporadic AD and in five cases of familial AD including one in which the APP717
      Val-->Ile mutation was present. Beta A4 protein load, as measured by square
      microns of immunoreactivity per square millimetre of cortex, was similar in the
      frontal and temporal isocortex in both sporadic and familial AD. There was
      greater variation in beta A4 protein load in subfields of the hippocampus but
      these differences were not significant between sporadic and familial cases. In
      the case with the APP717 Val-->Ile mutation. Beta A4 protein load in isocortex
      was greater than the mean for familial and sporadic cases of AD but less than the
      most severe cases of beta A4 protein deposition which were found in sporadic AD.
      In addition, the case with the APP717 Val-->Ile mutation has the same
      cytoskeletal pathology as sporadic cases of AD. The mechanism by which normal and
      mutant APP is processed to produce amyloidogenic fragments remains to be
      determined.

PMID- 8474687
TI  - Evidence for the localization of haemopexin immunoreactivity in neurones in the
      human brain.
AB  - Haemopexin is a 60 kDa serum glycoprotein responsible for the transport of haem
      to tissues such as liver, by receptor-mediated endocytosis, in an analogous
      manner to the iron transport protein transferrin, with recycling of intact
      haemopexin. The immunocytochemical distribution of haemopexin has been
      investigated, using a monospecific polyclonal antiserum to human haemopexin, in
      human brain. Neurones in all the brain regions studied showed immunostaining of
      the soma, axons and dendrites. A few scattered glial cells exhibited positive
      immunostaining. Oligodendrocytes and choroid plexus epithelial cells lacked
      haemopexin immunoreactivity. Thus, haemopexin is present within neurones and we
      propose that this protein may play an important role in haem transport for
      neuronal iron homeostasis.

PMID- 8474688
TI  - Afferent and efferent connections of the thalamic eminence in the axolotl,
      Ambystoma mexicanum.
AB  - Afferent and efferent connections of the thalamic eminence of the axolotl were
      determined using the fluorescent compound DiI as a tracer. The thalamic eminence
      is connected reciprocally with a number of telencephalic and diencephalic areas,
      particularly with the medial pallium, the amygdala and the preoptic region.
      Efferent connections are widespread throughout the ipsilateral diencephalon.
      These findings are discussed in relation to the homology of this nucleus,
      especially its homologue in agnathan brains.

PMID- 8474689
TI  - Coexistence of c-Fos and glucocorticoid receptor immunoreactivities in the CRF
      immunoreactive neurons of the paraventricular hypothalamic nucleus of the rat
      after acute immobilization stress.
AB  - By means of triple immunofluorescence procedures the codistribution and
      coexistence of glucocorticoid receptor (GR), c-Fos and corticotropin-releasing
      factor (CRF) immunoreactive (IR) nerve cell profiles have been analyzed within
      the paraventricular hypothalamic nucleus at various rostrocaudal levels following
      acute immobilization stress (2 h) in the male rat. One population of CRF IR
      neurons is shown to contain both nuclear GR and c-Fos immunoreactivities
      following the stress, while another contains GR immunoreactivity alone. These
      results indicate heterogeneities among parvocellular CRF paraventricular
      hypothalamic nerve cell populations in the response to acute immobilization
      stress.

PMID- 8474690
TI  - Rats do not experience cortical or hippocampal spreading depression as aversive.
AB  - Cortical spreading depression (SD) may produce some symptoms of the aura of
      classical migraine but it is less probable that it can account for the headache.
      The aversiveness of SD was examined in unanesthetized rats. In Exp. 1, rats with
      implanted cortical cannulae were confined in the dark compartment of the step
      through apparatus and repeated waves of SD were elicited in one hemisphere. After
      two such training sessions the rats did not evince passive avoidance of the
      compartment associated with cortical SD. In Exp. 2, thirsty rats with implanted
      hippocampal electrodes were trained to drink from two different spouts A and B.
      Hippocampal SD was elicited when the animal was drinking from spout A but not
      from spout B. Drinking was interrupted shortly after appearance of the SD wave
      and gradually recovered over the subsequent 10 min, but up to ten spout A-SD
      pairings did not change the animal's preference for spout A. It is concluded that
      cortical or hippocampal SD has no immediate or delayed aversive consequences.

PMID- 8474691
TI  - Dissociation of HSP70 and HSC70 heat shock mRNA inductions as an early
      biochemical marker of ischemic neuronal death.
AB  - A significant dissociation of HSP70 and HSC70 heat shock mRNAs after a 10-min
      transient forebrain ischemia in gerbil was found only in the hippocampal CA1
      neurons which eventually die after the initial ischemic insult, while other
      hippocampal neurons such as the dentate granule and the CA3 cells which survive
      ischemia expressed both mRNAs cooperatively. The dissociation was observed as
      early as after 8 h of reperfusion, a period far shorter than 3-4 days, when the
      cell death becomes pathologically evident. Thus, the dissociation may serve as a
      set of early biochemical markers for ischemic neuronal cell death.

PMID- 8474692
TI  - Alterations in vasopressin and oxytocin messenger RNA in the rat supraoptic
      nucleus during dehydration-rehydration evaluated by in situ hybridization and
      northern blotting.
AB  - Male rats were deprived of water for 5 days, and then given water ad libitum for
      3, 7, 10 or 14 days. Plasma osmolarity returned to normal in less than 3 days,
      while pituitary vasopressin (AVP) and oxytocin (OXT) only returned to control
      levels after 14 days. Sections of the supraoptic nucleus (SON) were hybridized
      with 35S-labelled cDNA (OXT) or oligonucleotide (AVP) probes. Relative AVP and
      OXT mRNA contents were quantitated by counting the number of silver grains on a
      large standard area of the SON, then extrapolating this value to the volume of
      the whole SON (deduced from surface areas of all the sections). Dehydration
      significantly enlarged the volume of the SON (x 1.54) and increased the AVP and
      OXT mRNAcontent (x 2). During rehydration, both SON volume and density of silver
      grains were higher than normal for at least 7-10 days, although levels started to
      fall by day 3. The distribution of individual cells according to their silver
      grain densities remained unimodal during the dehydration-rehydration sequence
      with an extension, then a return to normal of the distribution range. Maximum
      sizes of AVP and OXT mRNAs on Northern blots of RNAs extracted from 5 pooled SONs
      were observed on dehydration day 5. The size of these species fell progressively,
      reaching control values by rehydration day 14. We conclude that during
      rehydration, at a time when most of the putative inducers of gene transcription
      are no longer activated, the peptidergic deficit was accompanied by an increased
      level of AVP and OXT mRNAs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474693
TI  - Noxious mechanical stimulation of the hind paws of the anaesthetized rat fails to
      elicit release of immunoreactive beta-endorphin in the periaqueductal grey
      matter.
AB  - As a test of the hypothesis that an animal responds to a severe peripheral
      painful stimulus by a central release of beta-endorphin, antibody microprobes
      were inserted stereotactically into the midbrain of urethane anesthetized rats.
      These microprobes bore antibodies to beta-endorphin immobilized to their outer
      surfaces. While microprobes were in the brain for periods of 10 to 30 min either
      no stimulus was delivered or alligator clamps were applied to both hind paws.
      Microprobes were then incubated with 125I-beta-endorphin. Quantitative image
      analysis of microprobe autoradiographs showed no differences between the no
      stimulus and noxious-stimulus groups. Thus these experiments found no evidence
      for beta-endorphin release following a severe peripheral painful stimulus.

PMID- 8474694
TI  - Centrally administered neuropeptide Y fails to increase food intake but enhances
      hypoalgesia in spontaneously hypertensive rats.
AB  - The effects of intracerebroventricular (i.c.v.) administration of neuropeptide Y
      (NPY1-36) on food intake and pain sensitivity in hot plate test were studied in
      spontaneously hypertensive rats (SHRs) and in normotensive Wistar-Kyoto (WKy)
      rats. In satiated SHRs NPY1-36 failed to significantly increase intake at doses
      that produced a strong effect in satiated WKy rats (0.25-1.25 nmol). Conversely,
      both NPY1-36 and the C-terminal fragment NPY13-36, a putative selective agonist
      for the Y2-receptor for NPY, enhanced the spontaneously occurring hypoalgesia of
      SHRs, having no effect in WKy rats. The present results indicate that the NPY
      central systems involved in the control of regulatory functions are differently
      tuned in SHRs and WKy rats, suggesting possible involvement of these systems in
      the genesis of hypertension.

PMID- 8474695
TI  - Projections from the commissural subnucleus of the solitary tract onto
      catecholamine cell groups of the ventrolateral medulla.
AB  - Efferent projections of the commissural subnucleus of the solitary tract (COM) to
      the ventrolateral medulla were studied in the cat using anterograde labeling with
      biocytin combined with dopamine beta-hydroxylase immunohistochemistry. COM
      neurons were observed to send their axons densely to the areas of distribution of
      respiration-related neurons in the ventrolateral medulla, e.g. ventral
      respiratory group, Botzinger complex. Axon terminals from COM neurons were
      further found in the areas of distribution of catecholamine neurons (C1 and A1
      cell groups), that were distributed in the close vicinity of the reported
      respiration-related areas in the ventrolateral medulla. Putative synaptic
      contacts of axon terminals from COM neurons with catecholamine neurons were often
      observed in the C1 area.

PMID- 8474696
TI  - Reduced increase in plasma renin activity on water-deprivation in blind
      hereditary microphthalmic rats.
AB  - We compared the plasma renin activity (PRA) before and after 24-h water
      deprivation in blind hereditary microphthalmic rats and Donryu rats. In the
      congenitally blind rats with a morphologically abnormal suprachiasmatic nucleus
      (SCN), hypovolemia induced significantly less elevation of the PRA and
      significantly more increase in the hematocrit value than in normal rats. The
      changes after water-deprivation in the blind rats were quite similar to those
      reported in rats with SCN lesions. However, the free-running circadian rhythms
      persisted in these blind rats, whereas those in rats with SCN lesions were
      completely eliminated. Thus, it is likely that SCN cells are involved in
      regulation of the PRA, and that if this is the case these cells are different
      from those containing the circadian pacemaker.

PMID- 8474697
TI  - Alterations in mitochondrial branched-chain amino acid metabolism in brain in
      acute hyperammonemic states.
AB  - Production of 14CO2 and [14C]branched-chain keto acids (BCKA) was determined from
      [U-14C]branched-chain amino acids along with the activities of branched-chain
      amino acid transaminase (BCAA-T) and branched-chain keto acid dehydrogenase (BCKA
      DH) in mitochondria isolated from the cerebral cortex of normal and
      hyperammonemic rats. Results indicated that the production of CO2, but not of
      keto acids, was suppressed while the activities of BCAA-T and BCKA-DH were not
      adversely affected in the mitochondria of hyperammonemic rats. Suppression in the
      oxidation of BCAA in hyperammonemic states was found to be due to increased
      efflux of BCKA from mitochondria.

PMID- 8474698
TI  - Age-related changes in human muscarinic acetylcholine receptors measured by
      positron emission tomography.
AB  - The effects of age on the binding parameters of [11C]N- methyl-4
      piperidylbenzilate ([11C]NMPB), a specific muscarinic cholinergic receptor
      ligand, were studied. Eighteen healthy male volunteers (18-75 years old)
      participated. Regional radioactivity in the brain was followed for 60 min by
      positron emission tomography (PET). Uptake of [11C]NMPB continuously increased in
      all brain areas with the exception of the cerebellum. For the quantification of
      receptor binding, a compartment model, in which radioactivity in the cerebellum
      was used as an input function, was used. The binding parameter, K3, of muscarinic
      acetylcholine receptors in eight brain regions (pons, hippocampus, frontal
      cortex, striatum, temporal cortex, thalamus, occipital cortex, parietal cortex)
      showed an age-related decrease of about 45% over the age range.

PMID- 8474699
TI  - Limited but evident protective effects of MK-801 and pentobarbital on neuronal
      damage following forebrain ischemia in the gerbil under normothermic conditions.
AB  - The purpose of this study was to examine the protective effects of an N-methyl-D
      aspartate receptor antagonist, MK-801, and pentobarbital against neuronal damage
      in a global ischemia model under controlled body temperature. Gerbils were
      subjected to 3 and 5 min of bilateral common carotid artery occlusion. MK-801 (1
      and 5 mg/kg, i.p.), administered 30 min before ischemia, significantly attenuated
      the degeneration of hippocampal CA1 pyramidal cells after 3 min of ischemia in a
      dose dependent manner, but had no such effects after 5 min of ischemia.
      Pentobarbital (40 mg/kg, i.p.) also protected against CA1 damage after 3 min of
      ischemia but not after 5 min of ischemia. Thus, we confirmed the protective
      effects of these agents under normothermic conditions, although these effects
      were limited to shorter periods of ischemia.

PMID- 8474700
TI  - Variations in membrane potential trajectory of post-inspiratory neurons in the
      ventrolateral medulla of the cat.
AB  - In decerebrate cats, intracellular recordings were made in 124 expiratory neurons
      displaying either a plateau-phase of depolarization during post-inspiration or a
      steadily decrementing depolarization throughout expiration. Both groups consisted
      of vagal motoneurons and non-antidromically activated neurons. Five neurons were
      antidromically activated by both vagal and spinal cord stimuli. The pattern in
      membrane potential was changed from one type to another either spontaneously or
      experimentally. The present results suggest that the variable appearance of the
      membrane potential trajectory does not represent the different functional
      category of bulbar post-inspiratory neurons.

PMID- 8474701
TI  - Obesity and body fat distribution in New Zealanders: a pattern of coronary heart
      disease risk.
AB  - AIMS: To describe the prevalence of obesity and the body fat distribution of New
      Zealanders. To discuss this in the context of the coronary heart disease risk.
      METHODS: Body weight and height, body mass index (BMI), waist:hip ratio (WHR) and
      six skinfold measurements were determined for 3204 randomly selected New
      Zealanders who responded to an invitation to a health check (response rate 56%).
      RESULTS: In the study sample BMI generally increased with age. Fifty five percent
      of men and 38 per cent of women aged 18-64 had a BMI exceeding 25, and of these
      13 per cent and 10 per cent were obese (BMI > 30). WHR was greater in men than in
      women of all ages, and a third of the men and a quarter of the women had values
      exceeding 0.9 and 0.8 respectively. Central skinfold measurements (subscapular,
      suprailiac and abdominal) were lowest in young men, but rose markedly with age
      and were similar to women above age 35. Limb skinfolds were lower in men.
      CONCLUSIONS: This survey indicates that a large percentage of New Zealanders are
      overweight or obese and their excess body fat tends to be centrally distributed,
      especially in men. Obesity is thus a significant health problem in New Zealand.

PMID- 8474703
TI  - Measuring consequence of disease.

PMID- 8474702
TI  - Methicillin resistant Staphylococcus aureus (MRSA) in New Zealand 1988-90.
AB  - AIMS: To survey methicillin-resistant Staphylococcus aureus (MRSA) in New Zealand
      during the three years 1988-90. METHODS: Isolates and accompanying
      epidemiological data referred and reported to the New Zealand Communicable
      Disease Centre were analysed. RESULTS: MRSA was isolated from 255 persons, 235
      patients and 20 healthcare staff, over the three years. The majority (84%) of
      persons were, or were recent, hospital patients or staff. Among hospital
      patients, males and patients aged 0 to 14 years were more likely to have MRSA.
      While most (88%) of the 145 strains identified occurred sporadically, three
      caused large outbreaks each involving more than 20 people. A third of the strains
      originated overseas, most commonly Australia or one of the Pacific Islands. The
      rate of MRSA isolation was higher in the North Island than the South Island. Two
      thirds of the MRSA had only a low level of methicillin resistance and were not
      multiresistant. CONCLUSIONS: MRSA continues to be isolated only infrequently in
      New Zealand and has not become endemic in our hospitals.

PMID- 8474704
TI  - Hospital associated costs of treating patients with AIDS.
AB  - AIM: To determine the hospital associated costs of caring for patients with AIDS.
      METHOD: We reviewed the notes of all 40 patients with AIDS admitted to the
      Auckland Hospital infectious disease unit during 1988. We used the resource
      utilisation system (RUS) to determine costs. RESULTS: Costs were maximal in the
      month of diagnosis of AIDS (ca $3500/month), falling thereafter to ca $1000/month
      until they rose again in the last months of life. Total costs were dominated
      initially by inpatient costs but subsequently by the costs of medicines.
      CONCLUSION: The hospital costs associated with the care of AIDS patients are not
      spaced evenly throughout the illness. Extended life will not increase costs
      proportionately.

PMID- 8474705
TI  - Induction of labour with prostaglandin E2; a prospective audit.
AB  - AIMS: To perform a prospective audit of inductions of labour using prostaglandins
      to assess the protocols for induction in use at that time. METHODS: Data on 123
      patients was obtained over a six-week period. Information regarding gestation,
      indication for induction and relevant details of labour and delivery were
      obtained. RESULTS: There were three (2.5%) patients with hyperstimulation and six
      (5%) with failed induction. Nulliparous patients with an unfavourable cervix had
      an increased caesarean section rate (29%) and a prolonged induction to delivery
      interval (mean: 27 hours). CONCLUSIONS: The protocols for induction of labour
      using prostaglandins presently in use appear to be safe although staff need to be
      well informed about the management of hyperstimulation should it occur. Further
      audit of indications for induction of labour and of the caesarean section rate is
      required.

PMID- 8474706
TI  - Prescribing for childhood asthma in the Wellington area: comparison with
      international guidelines.
AB  - AIMS: An international paediatric asthma consensus group has outlined the
      rational approach to the treatment of childhood asthma. We have examined the
      prescription of asthma treatment to children in Wellington to assess to what
      extent these guidelines have been adopted by general practitioners. METHODS:
      During the period 1 May-11 June 1991, the prescriptions for 228 asthmatic
      children, dispensed at 30 randomly selected pharmacies in the greater Wellington
      area, were reviewed. RESULTS: Eighty-four per cent of the children were
      prescribed beta 2 adrenoceptor agonists. Of these, 80% of those under five years,
      and 27% over five years of age, received these agents by the oral route. In
      almost half, these drugs were prescribed on a regular basis. Fifty-two per cent
      of patients were prescribed some form of antiinflammatory therapy (inhaled or
      oral steroids, ketotifen or sodium cromoglycate). Only 2% received sodium
      cromoglycate. CONCLUSION: Although approximately half of these children received
      some form of antiinflammatory therapy, the minimal use of sodium cromoglycate,
      and high frequency of regular scheduled beta 2 adrenoceptor agonist use, suggests
      that the guidelines for asthma management in children may not have been widely
      adopted by primary care physicians in Wellington.

PMID- 8474707
TI  - Complications of termination of pregnancy: a retrospective study of admissions to
      Christchurch Women's Hospital 1989 and 1990.
AB  - AIMS: To review the admissions to Christchurch Women's Hospital with
      complications of termination of pregnancy. To estimate complication rates from
      Christchurch institutions and compare this with the international literature.
      METHODS: Relevant admissions were recorded by admitting staff. The hospital notes
      were retrospectively analysed. The complication rates were estimated from
      Christchurch termination rates in the study period. RESULTS: In 1989 and 1990
      there were 2879 terminations of pregnancy performed in Christchurch. There were
      167 admissions with complications. There was an admission rate of 5.8% and a
      curettage rate of 4.8%, 2.9% were confirmed to have retained products of
      conception. 0.47% required laparoscopy or laparotomy, 0.1% required blood
      transfusion. There was an increased rate of complications after 14 weeks.
      CONCLUSION: Admission rates in Christchurch are similar to those in some studies,
      others suggest that with improved technique and ideal follow up assessment
      readmissions could be reduced.

PMID- 8474708
TI  - Slow acting antirheumatic drugs in rheumatoid arthritis.

PMID- 8474709
TI  - Emotional health, cancer and heart disease.

PMID- 8474710
TI  - Sexually transmitted diseases and HIV testing.

PMID- 8474711
TI  - Video game induced generalised epileptic convulsion.

PMID- 8474712
TI  - Meningococcal immunisation.

PMID- 8474713
TI  - Folic acid and neural tube defects.

PMID- 8474714
TI  - The value of cancer treatment.

PMID- 8474715
TI  - Milkers' chilblains.
AB  - AIM: To report on the clinical features, causative factors, management and
      preventive measures for chilblains of the hands occurring in milkers in the
      Waikato area of New Zealand. METHODS: A review was made of the case notes of all
      patients with milkers' chilblains seen in dermatological practice in Hamilton
      over a ten year period ending in 1991 and follow up interviews were made.
      RESULTS: Eleven milkers were seen with distinctive, at times disabling,
      seasonally-recurring chilblains of the hands. In most patients the chilblains had
      developed early in their milking careers. Difficulty was experienced by both the
      patients and their doctors in recognising the nature of their skin condition.
      Sunlight aggravation of the lesions was a feature. In most patients treatment of
      the presenting episode required time off work and in several patients significant
      scarring resulted. Three patients left dairying because of the chilblains. Those
      who continued received preventive advice but four patients had further lesions in
      subsequent years although these were mild. CONCLUSIONS: Milkers' chilblains are
      uncommon but some cases are misdiagnosed and milder cases may not present for
      medical attention. Morbidity can be significant. Preventive measures are helpful
      but their effect may be limited by the difficulty of wearing gloves for milking.
      The vasodilator nifedipine is suggested as a prophylactic therapy for these
      patients.

PMID- 8474716
TI  - Is it easy collecting ethnicity data in general practice?

PMID- 8474717
TI  - Red cell shape changes following trigger finger fatigue in subjects with chronic
      tiredness and healthy controls.
AB  - AIMS: To investigate the possibility of a correlation between the percentage of
      nondiscocytic erythrocytes and muscle fatiguability in subjects with the symptom
      of chronic tiredness. METHODS: Sixty nine volunteers suffering from persisting or
      intermittent tiredness and 72 healthy controls provided 3-drop samples of venous
      blood for red cell shape analysis before and after inducing fatigue in the
      trigger finger muscles by repeatedly pulling the trigger of an antique revolver.
      Elapsed time and the number of pulls were recorded. A work index was calculated
      from the number of trigger pulls divided by the time in seconds then multiplied
      by the number of trigger pulls. RESULTS: Subjects with tiredness had fewer
      discoid cells (males 62.5% vs 69.2%, p = 0.029; females 65.8% vs 71.8%, p =
      0.002) than controls. They also had fewer trigger pulls (males 62.3 vs 84.0, p =
      0.003; females 29.5 vs 36.8, p = 0.042) and lower "work indices" (males 75.6 vs
      104.7, p = 0.001; females 26.1 vs 39.6, p = 0.001) than controls at the first
      trigger pulling. After 5 minutes rest the number of trigger pulls for males was
      fewer than the controls (56.0 vs 64.2) but the difference was not significant,
      but the female values (24.3 vs 33.2) were significantly different (p = 0.008).
      Work indices for both sexes were significantly different from controls (males p =
      0.020, females p = 0.001). CONCLUSIONS: The association of increased
      nondiscocytes and impaired muscle function could indicate a cause and effect
      relationship. This would be in agreement with the physiological concept of
      fatigue as a consequence of inadequate oxygen delivery.

PMID- 8474718
TI  - The management of peptic ulceration.

PMID- 8474719
TI  - Noninsulin dependent diabetes mellitus.

PMID- 8474720
TI  - Cancer rates.

PMID- 8474721
TI  - Direct antigen test for group A streptococcal pharyngitis.

PMID- 8474722
TI  - Suicide in New Zealand 1950-85.

PMID- 8474723
TI  - Fluoridation.

PMID- 8474724
TI  - Outcome of adults with acquired immunodeficiency syndrome in Auckland 1983-9.
AB  - AIMS: To assess the survival of Auckland residents diagnosed with AIDS between
      1983 and 1989. METHODS: Retrospective case review RESULTS: Sixty nine Auckland
      residents were diagnosed with AIDS between 1983 and the end of 1989, and were
      cared for by the infectious disease unit, Auckland Hospital. The overall median
      survival was 289 days with 48% and 20% surviving at one and two years
      respectively. Survival was longer among those who were infected through
      homosexual contact, were younger, and not known to the infectious disease unit
      prior to the diagnosis of AIDS. Although survival was longer for those diagnosed
      in 1988 compared to earlier years, it was shorter again for those diagnosed in
      1989. Pneumocystis carinii pneumonia, the AIDS defining condition in 63.8% of
      people, was found less frequently in 1989, and overall was associated with a
      longer survival than most of the other AIDS-defining diagnoses. A quarter of the
      people were not known to be infected with HIV prior to the AIDS-defining
      condition. CONCLUSION: In New Zealand, as in other countries, changes in
      treatment strategies of people with HIV infection may impinge on the survival of
      people with AIDS.

PMID- 8474725
TI  - Serum lipid levels in a New Zealand multicultural workforce.
AB  - AIMS: To examine ethnic variations in serum lipid levels and to determine whether
      lipids are related to lifestyle variables in a New Zealand multicultural
      workforce. METHODS: Fasting blood samples were collected from 5671 employed
      people for determination of serum total and HDL cholesterol, triglycerides, and
      LDL cholesterol. Individual exposures over the previous three months to smoking,
      alcohol, leisure time physical activity were recorded, and weight and height were
      measured to calculate body mass index (BMI). RESULTS: Maori and Pacific Islanders
      had lower age-adjusted total and LDL cholesterol levels than Europeans, and these
      differences were increased by controlling for BMI. In contrast, age-adjusted mean
      (SE) HDL cholesterol levels were also lower in Maori (men = 1.17 (0.02); women =
      1.38 (0.03) mmol/L) and Pacific Islanders (men = 1.17 (0.01); women = 1.30 (0.02)
      mmol/L) compared with Europeans (men = 1.20 (0.01); women = 1.47 (0.01) mmol/L),
      but when BMI, smoking and other variables were controlled, levels were
      significantly higher in Maori and Pacific Islanders. With serum triglycerides,
      the pattern was not consistent in Maori and Pacific Islanders. Age-adjusted mean
      levels in Maori (men = 2.25 (0.07) mmol/L; women = 1.53(0.07) mmol/L) were
      significantly higher (p < 0.05) than in Pacific Islanders (men = 1.82 (0.06);
      women = 1.34(0.05) mmol/L) of the same sex. After controlling for BMI and other
      variables, triglyceride levels were also significantly lower in Pacific Islanders
      than in Europeans and Asians. BMI and smoking were positively associated with
      total and LDL cholesterol and triglycerides, and negatively with HDL cholesterol,
      after controlling for alcohol and physical activity. CONCLUSION: Lifestyle risk
      factors, particularly BMI and smoking, are strongly related to serum levels of
      all major lipids. Ethnic variations in coronary heart disease mortality rates in
      New Zealand are more consistent with ethnic variations in triglycerides than with
      variations in the other serum lipids.

PMID- 8474726
TI  - Attitudes to reducing violence towards women: punishment or prevention?
AB  - AIM: To investigate the attitudes of abused and nonabused women to reducing
      physical and sexual violence in the community. METHOD: A random community sample
      of 3000 women was surveyed by postal questionnaire as part of the Otago Women's
      Health Survey. Seventy three percent (n = 1663) of those under 65 replied. As
      well as demographic, mental health and abuse information, responses to the
      question "what steps would you like to see taken to reduce the incidence of
      sexual and physical harm to women and children?" were analysed. RESULTS:
      Education was the most favoured approach to reducing violence in the community,
      followed by increased punishment of the offender. Women who had experienced
      sexual abuse, particularly as children, were more likely to advocate measures
      other than punishment. Rural women, those without formal qualifications and those
      who were not abused were more likely to advocate increased punishment, or made no
      comment. CONCLUSION: The finding that victims of sexual assault were likely to
      report a preference for prevention over punishment highlights the importance of
      representing the views of the community which appear to be at variance with more
      extreme views publicized in the media.

PMID- 8474727
TI  - Radiofrequency ablation of anomalous cardiac pathways: initial experience.
AB  - AIM: To describe the initial experience of radiofrequency ablation of anomalous
      cardiac pathways in patients with supraventricular tachycardias. METHODS: A total
      of 10 patients with refractory supraventricular tachycardias mediated by
      anomalous cardiac pathways underwent electrophysiological assessment and
      attempted pathway ablation. RESULTS: Seven patients with left free wall
      atrioventricular pathways (two concealed) and two patients with dual
      atrioventricular nodal pathways had successful pathway ablations and have had no
      recurrence of arrhythmia. One patient with a concealed posteroseptal
      atrioventricular pathway was not able to be ablated. All patients tolerated the
      initial procedure well, but one developed pericarditis later. CONCLUSION:
      Radiofrequency ablation promises to be an important new technique for the
      management of patients with anomalous cardiac pathways and supraventricular
      tachycardias. Our initial experience has been favourable and comparable to other
      reported series with a high success rate and infrequent complications.

PMID- 8474728
TI  - Inequalities in health and redefining values.

PMID- 8474729
TI  - General practitioners acceptance of the validity of chronic fatigue syndrome as a
      diagnosis.
AB  - AIM: To identify whether general practitioners accept the validity of a diagnosis
      of chronic fatigue syndrome (CFS). METHOD: An anonymous questionnaire was sent
      out to 98 general practitioners in Otago. RESULTS: The clinical validity of
      chronic fatigue syndrome was accepted by 74 (90%); 57 believed they had
      sufficient knowledge about the condition to make a differential diagnosis; 72
      indicated they had had patients with chronic fatigue syndrome in the past; 62
      currently had patients; there is a minimum prevalence rate of 167/100,000 in the
      general practice population; 83 replies were received. CONCLUSION: The 90%
      acceptance rate of chronic fatigue syndrome as a clinically valid diagnosis
      suggests that amongst the Otago general practitioners the controversy had
      receded. The low numbers suggest that they are on the conservative end of the
      diagnostic spectrum.

PMID- 8474730
TI  - The results of tubal surgery in the treatment of infertility in Wellington 1986
      90.
AB  - AIMS: To audit the outcome of tubal surgery performed in Wellington between 1986
      90. To establish the appropriate indications for tubal surgery in terms of likely
      benefit. To compare benefit with other treatment modalities namely in vitro
      fertilisation. METHODS: Data obtained from hospital patient notes, theatre
      records and personal communication. RESULTS: There were 71 patients, 67 of whom
      had been adequately followed up. The total pregnancy rate was 41.8% with an
      overall term pregnancy rate of 29.8%. The success rate was highest with proximal
      tubal occlusion and worst for distal disease and endometriosis. CONCLUSION: The
      outcome of the audit is consistent with results worldwide. Tubal surgery allows
      for natural conception and more than one pregnancy can be conceived as a result.
      It should be considered the first line treatment for proximal tubal disease and
      fimbrial adhesions. In vitro fertilisation however should be offered to those
      with severe distal disease and severe endometriosis.

PMID- 8474731
TI  - The distribution of household expenditures on health care.
AB  - AIMS: To find out whether New Zealand household expenditures on health care
      services vary according to the income of the household. To compare expenditures
      on health care in 1987 with 1991. METHODS: Information about household income and
      expenditure on health services was obtained from the Department of Statistics
      annual household expenditure and income surveys for the 1987 and 1991 financial
      years. Four categories of health expenditure were examined: general practitioner
      fees, dental fees, optician and optometrist fees, and spending on all health
      services combined. RESULTS: Spending on health care is unequally distributed
      across income groups. In particular, the highest income households spend six
      times as much on dental care as the lowest income households. The difference
      between high and low income households in the amount spent on all health services
      was greater in 1991 than in 1987. In 1991 high income households spent 3.6 times
      as much on health services as low income households, compared with three times as
      much in 1987. CONCLUSIONS: High income households spend substantially more on
      health care than do low income households. Households appear to assign a higher
      priority to medical care than dental care, although this may reflect the lack of
      any state subsidy on adult dental care.

PMID- 8474732
TI  - Intrathecal baclofen for the management of severe spasticity.

PMID- 8474733
TI  - Medicine at the fringes.
AB  - Until the new Act is in operation, and assuming it has strong and clear sections
      covering competence, the Medical Council of New Zealand is left with the need to
      manage unorthodoxy as a form of misconduct unless there is a mental health
      problem. Charges of misconduct unless there is a mental health problem. Charges
      of misconduct may arise of there is: harm to patients inadequate information and
      consent including false representation of the theoretical base of diagnostic
      method or management, or the training of the doctor, short cuts in the standard
      methods of diagnosis with the use of unproven and unrecognised methods, treatment
      programmes that are inappropriate, unjustified, unproven or unsupported by a
      substantial body of opinion, or that omit consideration if orthodox methods.
      exploitation in terms of securing patients, financial gain and inadequate
      aftercare.

PMID- 8474735
TI  - Cot death.

PMID- 8474734
TI  - Guidelines for detection and management of dyslipidaemia. Scientific Committee of
      the National Heart Foundation of New Zealand.

PMID- 8474736
TI  - Health reforms.

PMID- 8474737
TI  - New Zealand Multiple Birth Association.

PMID- 8474738
TI  - ACC and the carpal tunnel syndrome.

PMID- 8474739
TI  - Occupational asthma.

PMID- 8474740
TI  - Cholesterol lowering trials and the theory of atherosclerosis.

PMID- 8474741
TI  - AIDS 1992.

PMID- 8474742
TI  - Medical Practitioners Disciplinary Committee: inadequate antenatal management.

PMID- 8474743
TI  - Hospital mergers may threaten access to tubal ligations.

PMID- 8474744
TI  - Liability issues for trauma nurses.

PMID- 8474745
TI  - Informed consent: cautious, calculated candor.

PMID- 8474746
TI  - Technology: nursing the system. A nursing management minimum data set.

PMID- 8474747
TI  - Health reform: the shape of things to come.
AB  - To understand the various legislative initiatives at state and national levels,
      one must know what questions to ask and what issues are raised by each question.
      The questions are: (1) How much shall we reform the system? (2) How quickly shall
      we reform the system? (3) How shall we fund the system? and (4) How shall we
      organize or reorganize the system? If the complex issues these questions raise
      are dealt with quickly, boldly and fairly, meaningful health reform will be
      passed in 1993 and phased in over the next five to seven years.

PMID- 8474748
TI  - Measuring variations in nursing care per DRG.
AB  - A state nurses' association, a state department of health and a consulting agency
      collaborate annually in a special nursing study to develop appropriate measures
      of the relative variation in nursing care associated with each DRG. This activity
      provides a mechanism for professional nurses and the nursing profession to have
      direct input into a state's reimbursement methodology. This methodology is unique
      in the nation and may serve as an important prototype for nurses in other states
      who are seeking recognition of nursing care and services in the DRG reimbursement
      system.

PMID- 8474749
TI  - Clinical pathway development: the Overlake Model.
AB  - Overlake Hospital Medical Center has developed a multi-faceted Care Management
      Model to improve clinical and fiscal outcomes for selected patient populations.
      The Clinical Pathway Component of this model has been applied to high-volume,
      high-loss DRG groups. Success of the program can be attributed to the unique
      multidisciplinary problem solving approach, team building and a focus beyond the
      inpatient hospital stay.

PMID- 8474750
TI  - Salary compression of nursing managers.
AB  - An American Hospital Association survey has shown that rapid escalation of staff
      nurse salaries and benefits, in the wake of local and national shortages, has
      pushed clinical wage structures beyond those that determine the salaries of nurse
      managers and administrators. This leads to difficulty both in recruitment and
      retention of these key personnel. In this hospital, attrition of nurse managers
      into clinical positions has ceased. Their approach makes nurse managers eligible
      for differentials in addition to a modest economic incentive for assumption of
      managerial responsibilities.

PMID- 8474751
TI  - Toward successful compliance with JCAHO standard NC.1.
AB  - Recommendations resulting from a JCAHO survey can be a true blessing as they
      force nursing departments to assess critically their professional practice and
      documentation systems. Systematic preparation, begun at least two years prior to
      the survey, includes Nursing Administration, a Nursing Documentation Task Force
      and all staff nurses. Educational consultants assigned to each unit bring nurses
      up-to-date on nursing process and nursing diagnosis. Mock surveys and cross
      training in chart review prepare staff nurses for confident participation in the
      accreditation process.

PMID- 8474752
TI  - Of mythspinners and mapmakers: 21st century managers.
AB  - The entire character of human experience is unfolding within an epochal change
      event as civilization shifts away from the Industrial Age. The U.S. healthcare
      system, rocked by the same dizzying rate of change, will play a pivotal role in
      the emergence of a new social contract. The coming transformation will require a
      revolutionary change in leadership style: the nursing manager really becomes a
      change agent--challenging, questioning the status-quo and creating an atmosphere
      where self-directed activities, workplace partnerships and shared clinical
      outcomes become the norm.

PMID- 8474753
TI  - Alliance for destiny: education and practice.
AB  - As the whole context of nursing continues to change radically in the face of
      unmet societal needs, nothing short of total revolution will suffice. Nurses must
      take control of nursing practice and be critical of the nation's inadequate "sick
      care" system in order to effect sweeping changes in the scope, availability and
      efficacy of healthcare in the U.S. To do this requires an acknowledgment that
      true nursing education cannot exist without nursing practice. The transformation
      of curriculum must center on caring, which characterizes what nurses really do in
      a medically dominated system focused exclusively on curing.

PMID- 8474754
TI  - Selecting an information system.
AB  - Use of new technology can improve productivity without compromising staff nurse
      time at the bedside. At Borgess Medical Center an interdisciplinary committee co
      chaired by nurses analyzed the information system and documentation procedures
      and developed a plan approved by administration. This resulted in establishment
      of both a sophisticated point-of-care system and an ongoing patient care
      informatics committee to further coordinate automation throughout the hospital.

PMID- 8474755
TI  - Resource management education: an imaginative approach.
AB  - "Outcomes," a resource management game, promotes case management philosophies and
      strategies. This unique approach to teaching offsets the nurses' fear of change
      by learning in a relaxed environment.

PMID- 8474756
TI  - When push comes to shove...

PMID- 8474757
TI  - Productivity presented graphically.
AB  - Tools used in collecting data on nursing workload focus on standards of care,
      time and motion studies and patient care requirements. Since no one tool can
      measure adequately the work of nursing, the number of personnel required to fill
      patient needs is difficult to determine. Thus, a tool with long-term predictive
      ability can be valuable in assisting nursing administrators to determine staffing
      requirements. Any nursing department with a computerized database which can
      produce variance can develop long-term graphical representations of staffing like
      that described in this paper.

PMID- 8474758
TI  - Managing humor: when is it funny--and when is it not?
AB  - A survey of Canadian hospital nurses revealed they differentiate among situations
      in which humor would improve staff working relations. This intimates humor may be
      suitable for reducing nursing stress in some situations but not others.

PMID- 8474759
TI  - Prediction and early diagnosis of preterm labor: a critical review.

PMID- 8474760
TI  - [The prevention of congenital developmental anomalies in rats].
AB  - Preventive administration of Eleutherococcus XXX extract during prenatal and pre
      embryonic periods of development prevents embryotoxic effect of subsequent
      treatment of pregnant rats with ethanol and sodium salicylate. Eleutherococcus
      abolishes embryotoxic and teratogenic effects of ethanol manifested against the
      background of experimental syndrome of iron deficit in pregnant females.
      Mechanism of its antiteratogenic action is probably based on stimulation of cell
      detoxification mechanisms, increase in energy potential of cells, as well as on
      stabilization of structural and functional state of cell membranes.

PMID- 8474761
TI  - [An ultrastructural analysis of the cells of the outer root sheath of the hair
      follicles in mice of the wellhaarig mutant strain].
AB  - Ultrastructure of cells of the outer root sheath (ORS) of the guard hair
      follicles from the dorsal part of the body of 12-day old we/we and +/+ mice was
      studied. Changes observed in the ultrastructure of ORS cells in mutant mice
      included greater vacuolization of the cytoplasm and damaged structure of
      mitochondria accompanied by the absence of crisis. Many cells of the ORS outer
      layer in hair follicles of we/we and +/+ mice showed electron-dense outgrowths
      oriented axo-proximally which suggests their possible involvement in
      transportation of the hair, by contraction of these outgrowths, to the skin
      surface. Possible mechanisms of hair growth in view of these data are discussed.

PMID- 8474762
TI  - [Gametogenesis and zygote and ookinete formation in some haemoproteid species
      (Haemosporidia: Haemoproteidae) of birds in vitro].
AB  - Observations were made through examination of thin blood films which were
      prepared at appropriate intervals from citrated fresh blood of infected birds.
      The comparative description of gametogenesis, zygote and ookinete formation of
      Haemoproteus tartakovskyi, H. belopolskyi, H. fringillae, H. pallidus under the
      light microscope is given for the first time. This process has a general pattern
      for all investigated haemoproteid species. It is shown that macrogametocyte has
      been transformed directly to macrogamete without forming a residual body, as it
      was noted by Desser (1972) for H. (= Parahaemoproteus) velans. The most
      informative signs, which can be used for haemoproteid systematics, were
      determined. Among them microgamete length, zygote structure, morphological
      features of developing ookinete as well as the rate of ookinete formation can be
      pointed out first of all. H. pallidus microgametes are twice shorter than H.
      tartakovskyi, H. belopolskyi, H. fringillae ones. A large clear vacuole is formed
      in zygote of H. fringillae only. The majority of diagnostic features has the
      developing ookinetes. On the basis of ookinetes morphology the investigated
      species of haemoproteids can be determined easily. There were clear differences
      between haemoproteid species on the rate of ookinete formation. The ookinetes of
      H. belopolskyi and H. fringillae are formed for about 12 times more slowly than
      H. pallidus ones, and for about 6 times more rapidly than H. tartakovskyi ones.
      The peculiarities of gametogenesis, zygote and ookinete formation under the
      stable conditions in vitro can be used as usefull additional signs for
      determination of haemoproteid species.

PMID- 8474763
TI  - [The surface of cysts and excysted metacercariae of Opisthorchis felineus studied
      by scanning electron microscopy].
AB  - The structure of cysts of metacercariae of O. felineus has been analyzed. The
      cyst structure appears to have folds, pores and spherical formations providing
      for larval homeostasis. On the tegument of metacercariae thorns are arranged in
      staggered order. They represent 3 to 6 finger-shaped structures. The thorns and
      tegument excreta are secreted. On the surface of the parasite there are single
      and group sensory cupola-shaped and conoid papillae which make a chain around the
      mouth sucker. Polymorphism is revealed in the opisthorchis metacercariae
      structure.

PMID- 8474764
TI  - [The effect of lower cestodes (Pseudophyllidea) on the vital activity of 2-year
      old grass carp].

PMID- 8474765
TI  - [The occurrence of unusual chaetotaxy in III--IV instar larvae of blood-sucking
      mosquitoes from the genus Aedes].
AB  - Larval material on the Aedes mosquitoes of the complex punctor (Far East
      expeditions in 1976-1980) was compared to material preserved in the Zoological
      Institute, Academy of Sciences of Russia. 6 types of aberrations (presence
      absence of accessory hairs on the surface of siphon, their parity, etc.) were
      found. The individual variability and absence of diagnostic validity of these
      accessory hairs are suggested.

PMID- 8474766
TI  - [The antigenic properties of the larvae of Oedemagena tarandi (Hypodermatidae)].

PMID- 8474767
TI  - [Diphyllobothrium skriabini sp. n. (Cestoda: Diphyllobothriidae)--a parasite of
      the bearded seal (Erignathus barbatus Erx.)].
AB  - A new species of cestodes is described from the intestine of Erignathus barbatus
      Erx. The species differs from the other members of the genus in the shape of
      scolex, the character of strobilation and in many other characters. Data are
      given on its morphological variability in different waters: the Greenland and
      East Siberian Seas, the Bering Strait. Two subspecies, D. s. europeum and D. s.
      asiaticum, are erected. The species is named in honour of Professor A. S.
      Skriabin, one of the most outstanding workers in the field of helminthology of
      marine mammals.

PMID- 8474768
TI  - [The distribution of Lernaea cyprinacea (Copepoda: Lernaeidae) in a crucian carp
      population].
AB  - Differences in the infection with copepods and the character of distribution of
      occurrence frequencies of Lernaea in crucian carp depending on the body length
      and sex of the latter are shown. The lowest infection rate with copepods was
      recorded for fishes with body length 8-11 cm as compared to specimens with body
      length 12-18 and 18.5-34 cm. The two latter groups did not differ from each other
      in this index. In males and females whose body length is 8-11 cm as well as in
      females with body length 12-34 cm the occurrence frequencies of Lernaea are
      satisfactorily described by the negative binomial distribution curve. In males
      with body length 12-18 cm the occurrence frequencies of copepods are approximated
      by the binomial distribution curve. On the basis of obtained data it was
      concluded that fishes with a small body length as well as Carassius males and
      females with a greater body length represent three distinct host groups which
      differ in their part of maintaining the number of Lernaea of the host group.

PMID- 8474769
TI  - Diagnosis and treatment of discogenic low back pain.
AB  - Low back pain (LBP) is very prevalent in the general population. Treatment of
      nonradicular back pain, in the absence of deformity, continues to be
      controversial. Recently, anatomic dissections, magnetic resonance imaging
      studies, and the use of provocative discograms (pain-related response during the
      injection similar to the typical pattern of pain reported prior to the procedure)
      have contributed to our understanding of the etiology of discogenic back pain.
      Various techniques of spine fusion, with and without instrumentation, have
      altered the natural history of LBP unresponsive to conservative treatment. This
      review discusses the etiology and diagnosis of discogenic back pain and the
      treatment options available to the spine surgeon.

PMID- 8474770
TI  - Diagnostic imaging of childhood spinal infection.
AB  - Intervertebral disk space infection is common in children and has certain
      clinical and imaging characteristics. Until recently, the diagnosis has largely
      depended on plain roentgenography and/or radionuclide imaging. This article
      emphasizes the role of cross-sectional imaging, including computed tomography and
      magnetic resonance imaging in the evaluation of childhood spinal infections.

PMID- 8474771
TI  - The comprehensive diagnosis of spinal pain. A new psychodiagnostic instrument.
AB  - The psychological assessment of patients suffering back pain has become a
      standard part of comprehensive diagnostic protocol and an accepted responsibility
      of the clinical practitioner. This is for good reason, since research confirms
      the value of psychological evaluation to clinical diagnosis, treatment planning,
      and the outcomes of both medical and surgical treatment. However, the traditional
      psychological tests developed for use with psychiatric patients and in mental
      health settings are not appropriate for nonpsychiatric orthopaedic patients with
      back pain. However, a psychometric instrument has recently been developed for use
      with patients in pain. The Post-Traumatic Personality Profile (P-3) is a 48-item,
      multiple-choice, paper-and-pencil instrument that takes only 15 to 20 minutes.
      This article discusses the psychometric properties of the P-3 and presents a
      typical test interpretation.

PMID- 8474772
TI  - Ruptures of the proximal biceps tendon in middle-aged patients.
AB  - Treatment of ruptures of the proximal biceps tendon has been based on clinical
      observations, with little objective data to substantiate treatment guidelines.
      Evaluation of 25 patients (all > 40 years of age) at an average of 7.9 years
      after injury found few objective or subjective differences between those treated
      nonoperatively and those treated operatively. Only 1 patient (treated
      nonoperatively) was dissatisfied with the result, and her dissatisfaction was
      with a cosmetic defect. Objective manual muscle testing and Cybex II (Cybex
      Corporation, Ronkonkoma, New York) evaluation of 19 patients found no significant
      differences in supination or elbow flexion strength in the two groups.

PMID- 8474773
TI  - Ipsilateral fractures of the femoral neck and shaft.
AB  - The management of ipsilateral fractures of the femoral neck and shaft has proved
      to be a challenge to the orthopaedist. Most major institutions have treatment
      protocols that emphasize early rigid stabilization of the femoral-neck fracture
      to minimize the incidence of avascular necrosis of the femoral head. Since 1985,
      the authors' protocol has been to reduce and stabilize the femoral-neck fracture
      anatomically, followed by treatment of the femoral-shaft fracture. In 1990, we
      began treating this segmental fracture pattern with reconstruction nails. This
      study reviews the cases of 11 patients treated at the Medical College of Georgia
      Hospital from November 1985 to March 1992. Nine of the 11 underwent surgery
      within 12 hours of injury; 4 of these patients were treated with reconstruction
      nails. The mean follow-up was 2 years. Seven of the 11 had a good functional
      outcome, whereas 4 had a fair outcome. The results indicate that patients with
      ipsilateral fractures of the femoral neck and shaft can obtain good results when
      early (< 12 hours) rigid anatomic stabilization of the femoral neck is performed.
      The authors recommend utilizing a reconstruction nail for stabilizing this dual
      fracture whenever possible.

PMID- 8474774
TI  - Combined modality treatment for tumoral calcinosis.
AB  - Tumoral calcinosis is a rare syndrome marked by periarticular and intramuscular
      calcifications. We present the case of a 13-year-old black girl who has received
      treatment since age 2 for tumoral calcinosis with bilateral shoulder involvement.

PMID- 8474775
TI  - Osteochondritis dissecans of the knee in an adult with Stickler syndrome.
AB  - A 35-year-old man with hereditary progressive arthro-ophthalmopathy (Stickler
      syndrome) was treated for osteochondritis dissecans of the knee. As has been
      described in families with this autosomal-dominant connective-tissue disorder,
      phenotypic variation was present in his family; the patient's primary
      manifestations of the syndrome were ocular, but his brother had significant joint
      involvement. Osteochondritis dissecans of the knee may be a component of the
      arthrosis in this syndrome, but in the current case, the occurrence might have
      been coincidental. Stickler syndrome can be manifested by multiple
      musculoskeletal abnormalities, often early in life, and may be mistaken for
      several other diseases.

PMID- 8474776
TI  - Slipped disc.

PMID- 8474777
TI  - A 67-year-old woman with pain and tenderness in the left long finger.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to the orthopaedic surgeon. Initial history,
      physical findings, and roentgenographic examinations are presented along with the
      final histologic and differential diagnoses.

PMID- 8474778
TI  - The use of staples in hand surgery.
AB  - Staples can be used in a variety of surgical procedures on the hand. They provide
      excellent retraction of skin flaps for which sutures would normally be placed,
      and their use often decreases the need for manual retraction.

PMID- 8474779
TI  - Fibular transport in conjunction with Hoffman external fixation of the tibia.
AB  - Tibiofibular synostosis is a salvage procedure commonly used for difficult
      nonunions of the tibia. It may be carried out by means of transfixion screws, a
      bone graft, or fibular transfer using Ilizarov (Smith and Nephews Richards,
      Memphis, Tennessee) or Monticelli-Spinelli (Howmedica Inc, Rutherford, New
      Jersey) devices. This paper describes fibular transfer employing the Hoffmann
      external fixator, which is commonly used in the management of tibial fractures or
      nonunions.

PMID- 8474780
TI  - Facilitating difficult catheter passage.
AB  - Passage of a flexible catheter into a septic flexor tendon sheath can be
      difficult and time consuming because of the catheter's pliability. This article
      discusses a technique for converting the flexible catheter into a semirigid
      stylet.

PMID- 8474781
TI  - Ontogeny of epithelial modulation of airway smooth muscle function in the guinea
      pig.
AB  - The purpose of this study was to investigate the ontogeny of guinea pig airway
      smooth muscle (ASM) responses and the epithelial modulation of these responses.
      Paired tracheal rings from fetal, newborn, and adult guinea pigs were studied.
      One of each pair was denuded of airway epithelium (AE) by gentle rubbing.
      Isometric tension was measured in rings mounted in organ baths filled with Krebs'
      solution. Cumulative dose-response curves were generated by adding either
      acetylcholine (ACh) or histamine over a concentration range of 10(-8)-10(-4) M.
      Significant agent-specific, age-related differences in maximal contraction were
      seen for both ACh and histamine in intact tissues (Ach: for fetus 66.7 +/- 6.2 x
      10(-2) g/mg wet wt, for newborn 51.4 +/- 6.2, for adult 29.3 +/- 2.6; histamine:
      for fetus 46.1 +/- 5.1, for newborn 72.9 +/- 6.0, for adult 25.3 +/- 3.2).
      Similar differences in sensitivity to both agents were observed (EC50 with ACh:
      for fetus 0.80 +/- 0.11 x 10(-6) M; for newborn 0.85 +/- 0.26 x 10(-6) M; for
      adult 1.7 +/- 0.20 x 10(-6) M; EC50 with histamine; for fetus 1.88 +/- 0.50 x 10(
      6) M; for newborn 1.34 +/- 0.16 x 10(-6) M; for adult 3.78 +/- 0.75 x 10(-6) M).
      Removal of AE caused a significant decrease in maximal responses to ACh in fetal
      tissue, a smaller, insignificant one for newborn and a nonsignificant alteration
      for adult tissues. Age-related sensitivity difference was abolished with removal
      of AE to ACh but not to histamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474782
TI  - Nebulized steroid therapy in bronchopulmonary dysplasia.
AB  - The effect of inhaled beclomethasone dipropionate (BEC) was studied in seven
      infants between 7 and 18 months of age with glucocorticoid-dependent
      bronchopulmonary dysplasia. Oral glucocorticoid therapy, pulmonary function,
      growth, daily caloric consumption, blood pressure, blood sugar, blood gases, and
      immunoglobulins were monitored for 3 months before (control period) and 3 months
      after (intervention period) instituting inhaled beclomethasone dipropionate (25
      micrograms/kg/day divided tid) delivered by Pulmoaide with a DeVilbiss nebulizer.
      Acute BEC inhalation produced no change in pulmonary function. During BEC
      treatment, oral glucocorticoid therapy was decreased in all infants, stopped in
      four infants within 3 months and in the other three infants in 4-5 months. Within
      1 month of inhaled BEC the rate of linear growth and weight increased markedly
      (2.2 +/- 1.8 vs 6.4 +/- 2.4 cm/month - mean +/- SD and 9.3 +/- 6.5 vs 18.2 +/-
      7.4 g/day, respectively without change in average daily caloric consumption (113
      +/- 16 vs. 110 +/- 15 cal/kg/day). Immunoglobulins also significantly increased
      during BEC therapy (IgG(Total) 246 +/- 74 vs 463 +/- 111 mg/dL). Pulmonary
      function revealed moderate obstructive pulmonary disease before BEC. After 3
      months of BEC inhalation no significant change occurred although respiratory
      system resistance decreased and the flow at 25% of tidal volume to peak flow
      ratio increased more than predicted by intersession variability. In no infant did
      pulmonary function decline after BEC, nor were any apparent adverse effects noted
      in this small group of patients. In conclusion, inhaled BEC was effective in
      decreasing oral glucocorticoid therapy and in modifying glucocorticoid-induced
      growth suppression in a very small, highly select group of infants with
      bronchopulmonary dysplasia.

PMID- 8474783
TI  - Evaluation of pulmonary functions during pressure-limited manual ventilation in
      preterm neonates.
AB  - Manual ventilation (MAV) or handbagging is a frequent and often life-saving
      procedure for neonates; however, few studies allow for an objective evaluation of
      techniques or possible risks. We compared parameters of ventilation and pulmonary
      mechanics obtained during routine pressure-limited MAV to those obtained during
      spontaneous breathing (SPB) in the same infant at approximately the same time. We
      selected 20 preterm neonates in the recovery phase of respiratory distress
      syndrome who received periodic MAV and were capable of optimum spontaneous minute
      ventilation (> 300 mL/kg/min). During MAV compared to SPB we measured higher
      tidal volume (8.1 +/- 0.5 SE vs. 5.4 +/- 0.4 SE mL/kg, P < 0.001), lower total
      pulmonary compliance (0.65 +/- 0.05 vs. 1.16 +/- 0.11 SE mL/cmH2O, P < 0.001),
      end-inspiratory compliance, higher pulmonary resistance (121 +/- 11 vs. 61 +/- 7
      SE cmH2O/L/s, P < 0.001) and higher peak inspiratory airflow (2.8 +/- 0.2 vs. 1.6
      +/- 0.1 L/s, P < 0.001). Inspiratory time (Ti) was consistently longer during MAV
      (0.49 +/- 0.02 vs. 0.36 +/- 0.02 SE, P < 0.001) such that during MAV the
      difference between actual Ti and minimal effective Ti (fivefold inspiratory time
      constant) was larger (0.29 +/- 0.03 vs. 0.13 +/- 0.03 s, P < 0.05). Our study
      suggests that operator-dependent ventilatory variables such as tidal volume,
      inspiratory time, frequency, and airflow need to be further evaluated in order to
      develop standardized guidelines for the safe administration of MAV. Until then
      the ventilator used for brief or augmented ventilatory support is a reasonable
      alternative to administering MAV by inconsistent standards.

PMID- 8474784
TI  - Late-onset miliary pneumonitis after near drowning.
AB  - We report a 7-year-old pediatric patient with an apparently self-limiting,
      subacute miliary pneumonitis that occurred 6 weeks after a near-drowning accident
      in shallow, muddy water. After biopsy, histological examination revealed
      aspirated foreign bodies (algae and pollen grains) in the affected lung areas and
      a foreign body reaction in the form of a granulomatous inflammation. The lack of
      any detectable infectious agents suggested a causative role of these aspirated
      algae and pollen grains in the development of lung disease.

PMID- 8474785
TI  - International consensus on the management of pediatric asthma: a summary
      statement.

PMID- 8474786
TI  - On exogenous surfactant therapy.

PMID- 8474787
TI  - Effects of air pollution on the respiratory tract of children.
AB  - The effects of air pollution on pulmonary function and respiratory status was
      evaluated in 1,626 school aged children from a European Alpine region. Based on
      measurements of SO2, NO2, and O3 as well as infrared imaging and lichen mapping,
      three zones of exposure were defined. Results of standardized respiratory
      questionnaires, medical examinations, and lung function tests were compared among
      the children in the three different exposure zones. After controlling for age,
      sex, height, socioeconomic status, and exposure to environmental tobacco smoking,
      areas of increased SO2 and NO2 as well as areas of increased ozone (max. half
      hourly mean value, 146 ppb) were significantly associated with decrements of
      forced expiratory volume in 1 s (FEV1) and flow rates at 50 and 75% of vital
      capacity (FEF50, FEF75). In addition, areas with increased ozone had a higher
      prevalence of asthma In all regions, maternal smoking was associated with reduced
      expiratory flow rates and increased prevalence of asthma. The results provide
      evidence that outdoor pollution and exposure to passive smoking are risk factors
      for childhood respiratory health.

PMID- 8474788
TI  - Pulmonary function between 6 and 18 years of age.
AB  - Pulmonary function of children aged 6-18 years is described based on 82,462
      annual measurements of forced vital capacity (FVC), forced expired volume in 1
      second (FEV1), and forced expiratory flow between 25% and 75% of FVC (FEF25-75%)
      from 11,630 white children and 989 black children. Median height, FVC, FEV1,
      FEV1/FVC, and FEF25-75% for each 3 months of age are compared among race and sex
      subgroups. Race- and sex-specific percentile distributions of FVC, FEV1,
      FEV1/FVC, and FEF25-75% are presented for each centimeter of height (growth
      curves). For the same height, boys have greater lung function values than girls,
      and whites have greater ones than blacks. Lung function increases linearly with
      age until the adolescent growth spurt at about age 10 years in girls and 12 in
      boys. The pulmonary function vs. height relationship shifts with age during
      adolescence. Thus, a single equation or the pulmonary function-height growth
      chart alone does not completely describe growth during the complex adolescent
      period. Nevertheless, race- and sex-specific growth curves of pulmonary function
      vs. height make it easy to display and evaluate repeated measures of pulmonary
      function for an individual child. Race-, sex-, and age-specific regression
      equations based on height are provided, which permit the evaluation of growth
      during adolescence with improved accuracy and, more importantly, in comparison
      with previous observations for the same child.

PMID- 8474789
TI  - The effect of age on bronchodilator responsiveness.
AB  - The relationship between age and bronchodilator responsiveness (BDR) in children
      has not been studied using objective parameters. The aim of this study was to
      seek such a relationship in young asthmatic children using dose-response curves
      (DRC). Fourteen asthmatic subjects (age 3-9 years) with a forced expiratory
      volume in 1 sec (FEV1) less than 80% predicted were studied after being trained
      to use a spirometer reliably. Each subject completed a DRC by inhaling 5 doses of
      salbutamol (albuterol) at 15 min intervals until a cumulative total of 6.84 mg of
      salbutamol had been administered. FEV1, forced vital capacity (FVC), and forced
      expiratory flow at mid vital capacity (FEF25-75) were measured before and after
      each nebulization. In addition, arterial oxygen saturation (SaO2) and heart rate
      (HR) were measured in some of the subjects. All lung function parameters, SaO2
      and HR increased significantly between baseline and completion of the DRC. A
      significant age effect on BDR was detected in FEV1 and FVC, with older children
      showing a greater response than young ones. The response had plateaued after the
      maximum dose in the younger but not in the older children. These findings suggest
      that the level of response to a bronchodilator increases significantly with
      increasing age in young asthmatics.

PMID- 8474790
TI  - American Academy of Pediatrics Vitamin K Ad Hoc Task Force: Controversies
      concerning vitamin K and the newborn.

PMID- 8474791
TI  - American Academy of Pediatrics Committee on Early Childhood, Adoption, and
      Dependent Care: Developmental issues in foster care for children.

PMID- 8474792
TI  - American Academy of Pediatrics Committee on Substance Abuse: Role of the
      pediatrician in prevention and management of substance abuse.

PMID- 8474793
TI  - American Academy of Pediatrics Committee on Infectious Diseases: Vitamin A
      treatment of measles.

PMID- 8474794
TI  - Lactic acid and breast-feeding.

PMID- 8474795
TI  - Pediatric poisoning hazards.

PMID- 8474796
TI  - Sepsis and jaundice.

PMID- 8474797
TI  - Stewart smiled.

PMID- 8474798
TI  - Stewart smiled.

PMID- 8474799
TI  - Twins and HIV.

PMID- 8474801
TI  - A call for help.

PMID- 8474800
TI  - HIV and smooth muscle tumors.

PMID- 8474802
TI  - Acetaminophen hepatotoxicity after a prolonged ingestion.

PMID- 8474803
TI  - Cost-effectiveness of screening and cryotherapy for threshold retinopathy of
      prematurity.
AB  - BACKGROUND: Retinopathy of prematurity (ROP) is the leading cause of blindness
      among premature infants. A recent National Eye Institute-sponsored prospective,
      multicenter trial investigating the use of cryotherapy for treatment of ROP
      demonstrates a significant reduction in blindness and low vision for patients
      with sight-threatening (stage 3+) ROP. METHOD: A microsimulation model is
      presented to determine the cost-effectiveness of cryotherapy for ROP. Simulations
      are performed for three subpopulations of premature infants with birth weights
      500 through 749 g, 750 through 999 g, and 1000 through 1249 g, and for three
      screening strategies--weekly, biweekly, and monthly. RESULTS: Appropriately timed
      screening for and treatment of ROP is predicted to result in a gain of 3899 to
      4648 quality-adjusted-life-years and a net governmental budgetary savings of
      $38.3 to $64.9 million for each annual US birth cohort of 28,321 premature
      infants (500 through 1249 g). The cost per quality-adjusted-life-year gained is
      $2488 to $6045, depending on different screening strategies. CONCLUSIONS: Of
      greatest importance is the finding that properly timed screening and treatment
      for ROP is not only cost saving but may save approximately 320 infants per year
      from a lifetime of blindness.

PMID- 8474804
TI  - Exclusive breast-feeding for at least 4 months protects against otitis media.
AB  - OBJECTIVE: This study was designed to assess the relation of exclusive breast
      feeding, independent of recognized risk factors, to acute and recurrent otitis
      media in the first 12 months of life. METHODS: Records of 1220 infants who used a
      health maintenance organization and who were followed during their first year of
      life as part of the Tucson Children's Respiratory Study were reviewed. Detailed
      prospective information about the duration and exclusiveness of breast-feeding
      was obtained, as was information relative to potential risk factors
      (socioeconomic status, gender, number of siblings, use of day care, maternal
      smoking, and family history of allergy). Acute otitis media and recurrent otitis
      media, defined as three or more episodes of acute otitis media in a 6-month
      period or four episodes in 12 months, were the outcome variables. RESULTS: Of the
      1013 infants followed for their entire first year, 476 (47%) had at least one
      episode of otitis and 169 (17%) had recurrent otitis media. Infants exclusively
      breast-fed for 4 or more months had half the mean number of acute otitis media
      episodes as did those not breastfed at all and 40% less than those infants whose
      diets were supplemented with other foods prior to 4 months. The recurrent otitis
      media rate in infants exclusively breast-fed for 6 months or more was 10% and was
      20.5% in those infants who breast-fed for less than 4 months. This protection was
      independent of the risk factors considered. CONCLUSION: These findings suggest
      that exclusive breast-feeding of 4 or more months protected infants from single
      and recurrent episodes of otitis media.

PMID- 8474805
TI  - Factors associated with condom use by sexually active male adolescents at risk
      for sexually transmitted disease.
AB  - OBJECTIVE: The purpose of this study was to identify the predictors of condom use
      in a population of male adolescents at risk for sexually transmitted diseases
      (STDs). DESIGN: Cross-sectional cohort study. SETTING: Clinical sites (school
      based, adolescent and STD clinics) providing reproductive health care to male
      adolescents in a midwestern city. PARTICIPANTS: One hundred sixteen male
      adolescents 15 to 19 years of age were enrolled consecutively. OUTCOME MEASURES:
      Subjects completed a multi-instrument questionnaire examining sexual behaviors,
      attitudes, and beliefs about STDs and condoms, cognitive maturity, and health
      risk behaviors; urethral specimens were cultured for Chlamydia trachomatis and
      Neisseria gonorrhoeae. RESULTS: The median age was 17; 31% were white and 69%
      were African-American. Thirty-seven percent had urethral infections: 21% were
      infected with C trachomatis, 11% with N gonorrhoeae, and 5% with both organisms.
      More than 60% reported some experience with condoms and 23% reported condom use
      at last coitus. Consistent with the Health Belief Model, condom use for STD
      prevention was less likely among those reporting other health risk behaviors
      (odds ratio [OR] = 0.53; 95% confidence interval [CI] = 0.36 to 0.78; P < .001)
      and more STD risk behaviors (OR = 0.65; CI = 0.45 to 0.96; P = .03). Adolescents
      who were more highly motivated (OR = 1.58; CI = 1.09 to 2.30; P = .02) and who
      were more positive about condoms (OR = 1.83; CI = 1.25 to 2.68; P < .001) were
      more likely to report condom use for contraception. Adolescents using condoms for
      acquired immunodeficiency syndrome (AIDS) protection engaged in fewer behavioral
      (OR = .62; CI = 0.42 to 0.92; P = .02) and STD risks (OR = .67; CI = 0.45 to
      0.99; P = .04). Three specific reasons for condom use were highly predictive of
      condom use at last intercourse: STD prevention (OR = 8.9; CI = 3.13 to 25.4; P <
      .001), birth control (OR = 2.1; CI = 1.05 to 4.25; P = .03), and AIDS prevention
      (OR = 2.4; CI = 1.05 to 5.42; P = .03). CONCLUSION: Condom use among adolescent
      males is influenced by perceived benefit, namely prevention of pregnancy &
      avoidance of STDs including AIDS. Nonuse is associated with other risk-taking
      behavior.

PMID- 8474806
TI  - Prevention of progression to severe obesity in a group of obese schoolchildren
      treated with family therapy.
AB  - STUDY OBJECTIVE: To evaluate the effect of family therapy on childhood obesity.
      DESIGN: Clinical trial. One year follow-up. SETTING: Referral from school after
      screening. PARTICIPANTS: Of 1774 children (aged 10 to 11), screened for obesity,
      44 obese children were divided into two treatment groups. In an untreated control
      group of 50 obese children, screened in the same manner, body mass index (BMI)
      values were recorded twice, at 10 to 11 and at 14 years of age. INTERVENTION:
      Both treatment groups received comparable dietary counseling and medical checkups
      for a period of 14 to 18 months, while one of the groups also received family
      therapy. RESULTS: At the 1-year follow-up, when the children were 14 years of
      age, intention-to-treat analyses were made of the weight and height data for 39
      of 44 children in the two treatment groups and for 48 of the 50 control children.
      The increase of BMI in the family therapy group was less than in the conventional
      treatment group at the end of treatment, and less than in the control group (P =
      .04 and P = .02, respectively). Moreover, mean BMI was significantly lower in the
      family therapy group than in the control group (P < .05), and the family therapy
      group also had fewer children with BMI > 30 than the control group (P = .02). The
      reduction of triceps, subscapular, and suprailiac skinfold thicknesses, expressed
      as percentages of the initial values, was significantly greater in the family
      therapy group than in the conventional treatment group (P = .03, P = .005 and P =
      .002, respectively), and their physical fitness was significantly better (P <
      .05). CONCLUSIONS: Family therapy seems to be effective in preventing progression
      to severe obesity during adolescence if the treatment starts at 10 to 11 years of
      age.

PMID- 8474807
TI  - Child day care, smoking by caregivers, and lower respiratory tract illness in the
      first 3 years of life. Group Health Medical Associates.
AB  - BACKGROUND: Day-care attendance has been associated with an increased risk of
      hospitalization for lower respiratory tract illnesses (LRIs). This study
      examines, in a health maintenance organization population of children, the
      associations between child day care and the occurrence of LRIs in the first 3
      years of life. Smoking by caregivers and a possible protective effect of longer
      day-care enrollment in relation to LRIs are also addressed. METHODS: Information
      on day-care arrangements was elicited from 1006 parents of infants for five age
      intervals in the first 3 years of life: birth through 3 months, 4 to 6 months, 6
      to 12 months, 1 to 2 years, and 2 to 3 years. Data on LRIs in the first 3 years
      of life were recorded by pediatricians at the time of the acute illnesses.
      RESULTS: After controlling for other risk factors, the presence of three or more
      unrelated children in the care setting was associated with significant risks of
      LRI of up to twofold or more from 4 months of age to 3 years. Type of care
      setting was not a significant risk factor during this time period. In the third
      year of life, the risk of wheezing LRI in the presence of a smoking caregiver was
      more than threefold for those in another residential home setting. No significant
      protective effect against LRIs in the third year of life associated with longer
      prior day-care enrollment was demonstrated. CONCLUSION: The presence of three or
      more unrelated children in the care setting and the presence of a smoking
      caregiver were significant independent risk factors for LRIs during the first 3
      years of life. Prolonged day-care did not protect against LRIs in the third year
      of life.

PMID- 8474808
TI  - Smoking and the sudden infant death syndrome.
AB  - OBJECTIVE: Maternal smoking has been shown to be a risk factor for sudden infant
      death syndrome (SIDS). The effect of smoking by the father and other household
      members has not previously been examined. METHODS: A large nationwide case
      control study. Four hundred eighty-five SIDS deaths in the postneonatal age group
      were compared with 1800 control infants. RESULTS: Infants of mothers who smoked
      during pregnancy had a 4.09 (95% confidence interval [CI] = 3.28, 5.11) greater
      risk of death than infants of mothers who did not smoke. Infants of mothers who
      smoked postnatally also had an increased risk of SIDS compared with infants of
      nonsmokers and, furthermore, the risk increased with increasing levels of
      maternal smoking. Smoking by the father and other household members increased the
      risk (odds ratio [OR] = 2.41, 95% CI = 1.92, 3.02 and OR = 1.54, 95% CI = 1.20,
      1.99, respectively). Smoking by the father increased the risk of SIDS if the
      mother smoked, but had no effect if she did not smoke. In analyses controlled for
      a wide range of potential confounders, smoking by the mother and father was still
      significantly associated with an increased risk of SIDS. CONCLUSION: Passive
      tobacco smoking is causally related to SIDS.

PMID- 8474809
TI  - Increases in crash involvement and fatalities among motor vehicle occupants
      younger than 5 years old.
AB  - OBJECTIVE: To determine whether increased exposure as car occupants could be a
      major contributor to increases observed in deaths of young children in car
      crashes. DESIGN AND SETTING: Crash data from police reports for Maryland,
      Michigan, Pennsylvania, and Washington for various years from 1982 through 1990
      were examined to compare annual age mix of injured and uninjured occupants in
      crashes involving at least two passenger vehicles. Aggregate national data from
      the Fatal Accident Reporting System were also examined over the same time period
      and compared to population estimates for children younger than 5 years old to
      assess temporal trends in number of occupants in this age group who were involved
      in motor vehicle crashes in which a fatality occurred in fatal crashes and the
      number of them killed in passenger vehicles. RESULTS: In regression analyses for
      each state, the number of car occupants younger than 5 involved in crashes
      increased during the years studied; their percentage among nondriver occupants
      involved also increased. At a national level, similar analyses showed increases
      in the number of occupants younger than 5 involved in crashes in which a fatality
      occurred. CONCLUSIONS: Despite overall increases in the use of restraint devices
      (ie, both child safety seats and adult restraints), fatalities among restrained
      children have increased. Given that exposures to crash environments are
      increasing, clinicians need be aware of the importance of child restraints as a
      means of reducing the likelihood of injury.

PMID- 8474810
TI  - Cost-effectiveness analysis of bicycle helmet subsidies in a defined population.
AB  - OBJECTIVE: To examine the potential effects of bicycle safety helmet cost subsidy
      on bicycle head injury rates and costs. DESIGN: Using empiric data on the
      incidence and costs of bicycle injuries to children, we examined the hypothetical
      effects of various bicycle helmet subsidies in a cost-effectiveness analysis. A
      hypothetical cohort of 100,000 5- through 9-year-olds was followed for 5 years
      after helmet cost subsidization. Sensitivity analyses were done of three
      different levels of safety helmet subsidy ($5, $10, $15), three discount rates
      (2%, 4%, 6%), 10 levels of safety helmet use ranging from 10% to 100%, and the
      occurrence or nonoccurrence of catastrophic head injuries. PATIENTS: Forty-three
      children 5 through 9 years of age and 27 children 10 through 14 years of age with
      head injuries due to bicycling were identified through emergency department
      surveillance of a population of 29,533. SETTING: Group Health Cooperative of
      Puget Sound, a large health maintenance organization. OUTCOME MEASURES: Bicycle
      head injuries prevented and the savings or costs associated with various subsidy,
      safety helmet use, and discount rates. RESULTS: Hypothetically, an increase in
      bicycle helmet use rates to 40% to 50% due to subsidies of $5 or $10 prevents 564
      to 840 head injuries in a cohort of 100,000 5- through 9-year-olds over 5 years.
      Under these conditions and a 2% discount rate, cost savings ranging from $189,207
      to $427,808 will result when catastrophic head injuries are included in the
      analysis. CONCLUSION: Subsidization of bicycle safety helmets to achieve a cost
      of $14 to $20 per helmet and use rates of 40% to 50% will likely prove cost
      effective. Empirical evidence from a Seattle campaign suggests that such helmet
      use rates are achievable.

PMID- 8474811
TI  - Evaluation of two iron-fortified, milk-based formulas during infancy.
AB  - OBJECTIVE: Compare milk-based, iron-fortified formulas containing 7.4 and 12.7
      mg/L iron and breast-feeding during the first year of life. DESIGN: Partially
      randomized, double-blind trial: non-breast-fed infants randomly assigned to
      receive one of two coded formulas, identical except for iron content; infants
      discontinuing breast-feeding between 1 and 8 weeks of age randomly assigned to a
      formula late-start group. SETTING: Five general community pediatric practices in
      Missouri, Indiana, Illinois, and Pennsylvania. PARTICIPANTS: Sample of 347
      healthy, term infants, enrolled within 1 week after birth; 172 included in
      statistical analyses. OUTCOME MEASURES: Length, weight, and indicators of formula
      intolerance recorded at clinic visits; formula consumption, bowel movements,
      stool consistency, and other tolerance indicators recorded by parents on daily
      and weekly report forms; hemoglobin, hematocrit, and serum ferritin, iron zinc,
      and copper measured at 6 and 12 months. RESULTS: No significant differences
      between formula-fed groups in growth, attrition, formula consumption, bowel
      movements, hematocrit, hemoglobin level, and serum iron, zinc, and copper levels
      (P > .05); first 6-month weight and length changes of the breast-fed group
      significantly less than in both formula-fed groups (P < .008); serum ferritin
      level of the formula-fed, high-iron group significantly higher than that of the
      low-iron and breast-fed groups (P < .008), although all groups' values were
      normal; no apparent differences between formula groups in formula tolerance and
      stool characteristics but data were not analyzed statistically. CONCLUSIONS: Milk
      based formulas containing either 7.4 or 12.7 mg/L iron support normal growth and
      iron status of healthy, term, normally fed infants during the first year and both
      are well tolerated and accepted.

PMID- 8474812
TI  - New postnatal growth grids for very low birth weight infants.
AB  - OBJECTIVE: To generate contemporary postnatal growth curves for hospitalized very
      low birth weight infants. DESIGN: Retrospective survey. SETTING: Tertiary
      intensive care nursery. PATIENTS: All surviving singleton, appropriate-for
      gestational age infants with birth weight < or = 1500 g, born January 1, 1987, to
      May 31, 1991, who did not develop necrotizing enterocolitis (N = 205).
      MEASUREMENTS AND RESULTS: Macronutrient intakes and body weights were recorded
      daily, with crown-heel length and occipital-frontal head circumference recorded
      weekly up to 105 days of age or hospital discharge, whichever occurred first.
      Growth curves were generated for four birth weight ranges: 501 through 750, 751
      through 1000, 1001 through 1250, and 1251 through 1500 g. Compared to previously
      published growth curves, the current infants regained birth weight more quickly
      and exhibited larger average daily weight gains. These differences were most
      apparent in infants of lowest birth weight. CONCLUSIONS: The "premature growth
      grid" constructed by Dancis et al more than 40 years ago may no longer be a
      useful standard of early postnatal growth for present-day very low birth weight,
      appropriate-for-gestational-age infants. The new weight curves are a more
      accurate reflection of current in-hospital growth trends, especially for infants
      weighing < or = 1000 g at birth.

PMID- 8474813
TI  - Families on the move and children's health care.
AB  - OBJECTIVE: To evaluate the relationship of family moves to children's health care
      use. DESIGN: Analyses of data from the 1988 National Health Interview Survey of
      Child Health (NHIS-CH). This survey uses a multisite probability cluster
      technique to achieve nationally representative estimates of health and
      demographic characteristics of the US civilian population. PARTICIPANTS: 17,110
      US children and their families who took part in the 1988 NHIS-CH. MEASUREMENTS:
      The 1988 NHIS-CH collected health and demographic data including family mobility
      information on 17,110 US children and their families. This study analyzed the
      relationship of number of family moves to reporting a regular site for preventive
      pediatric health care services, a regular site for pediatric sick care, and
      routine use of emergency departments when a child was sick. RESULTS: Overall, 8%
      of US children were reported to lack a regular site for preventive care services,
      7% a site for sick care, and 3% routinely used an emergency department for sick
      care. However, 14% of children who had moved three or more times lacked a regular
      site for preventive care and 10% lacked a regular site for sick care, compared to
      only 3% of children who had never moved. Children who had moved more than twice
      were three times as likely to lack a regular site for preventive or sick care and
      1.6 times as likely to use an emergency department for sick care, as were
      children who had never moved. CONCLUSIONS: Families with increased mobility are
      more likely to lack a regular site for both preventive and sick care and to use
      emergency departments when their children become ill.

PMID- 8474814
TI  - Risk factors and outcomes for failure to thrive in low birth weight preterm
      infants.
AB  - OBJECTIVE: To determine the epidemiology, clinical characteristics, and outcomes
      for low birth weight (LBW) infants with growth deficiency, or failure to thrive
      (FTT, the term commonly used by pediatric providers to describe growth deficiency
      or faltering in early childhood). DESIGN: Three-year prospective cohort study
      with matched case-control study of outcomes. SETTING: Eight large university
      hospital sites throughout the United States. SAMPLE: 914 LBW infants inborn at
      the sites and meeting study criteria. RESULTS: FTT was a common condition in this
      cohort, with 180 (19.7%) of 914 LBW infants meeting case criteria by 30 months.
      New cases of FTT peaked at 8 months gestation-corrected age. In addition to
      expected differences in growth between infants with and without FTT, infants with
      FTT had lower developmental indices and less stimulating home environments. At 36
      months, FTT infants had lower IQ scores and were much smaller than infants
      without FTT. CONCLUSIONS: Growth deficiency, or FTT, is a common clinical
      condition for those involved in the follow-up care of LBW infants. Worse
      cognitive and growth outcomes were observed for those meeting the restrictive
      case criteria employed in this study. More than 80% of the cases in this LBW
      cohort did not involve any chronic medical disorders, but several biological and
      environmental differences were found between those who developed FTT and those
      who did not.

PMID- 8474815
TI  - Tracking of serum cholesterol and lipoprotein levels from the first year of life.
AB  - OBJECTIVE: To examine the development of tracking of serum cholesterol
      concentration from birth to childhood. DESIGN: In a longitudinal study of healthy
      children, concentrations of total serum cholesterol and triglyceride were
      determined at birth (n = 193); at 2 (n = 192), 4 (n = 192), 6 (n = 190), 7.5 (n =
      118), 9 (n = 188), and 12 months (n = 196); and at 5 years of age (n = 162).
      Concentrations of cholesterol--very-low-density lipoprotein, low-density
      lipoprotein, high-density lipoprotein-2 (HDL2), and HDL3--were determined at 2,
      6, 9, and 12 months (n = 36) and at 5 years (n = 162). RESULTS: The correlation
      coefficients of total cholesterol levels during the first year of life with the
      level at 5 years of age were as follows: at birth .04, at 2 months .36 (P <
      .001), at 4 months .26 (P < .001), at 6 months .28 (P < .001), at 7.5 months .25
      (P < .001), at 9 months .35 (P < .001), and at 12 months .48 (P < .001). The
      correlation for exclusively breast-fed children between 6 months and 5 years of
      age was r = .37, P < .001, while that for children receiving partially breast
      milk, formula, or solid foods was r = .12, P = not significant (NS), and between
      9 months and 5 years r = .38, P < .01, and r = .28, P < .05, respectively. The
      correlation coefficients of the lipoprotein levels between ages 12 months and 5
      years were as follows: low-density lipoprotein cholesterol .58 (P < .001), total
      HDL cholesterol .30 (P < .05), HDL2 cholesterol .34 (P < .05), HDL3 cholesterol
      .17 (P = NS), very-low-density lipoprotein cholesterol .24 (P = NS), total
      triglyceride .37 (P < .05), and triglyceride-very-low-density lipoprotein .37 (P
      < .05). Of the children whose total serum cholesterol level was above the 90th
      percentile at birth, or at 2, 4, 6, 7.5, 9, or 12 months, 6%, 35%, 29%, 30%, 31%,
      33%, and 45%, respectively, were above the 90th percentile at 5 years of age. In
      retrospect, 45% of the children whose serum cholesterol level was above the 90th
      percentile at 5 years were above the 90th percentile at the age of 12 months and
      80% were in the highest quartile. CONCLUSIONS: The results indicate that tracking
      of serum cholesterol concentration during the first year of life is stronger when
      examining children who are receiving a relatively homogenous diet, such as
      exclusive breast-feeding, and weaker as children are weaned to formula and solid
      foods. After the weaning process is completed, children's relative serum
      cholesterol levels have become established and the tracking of serum cholesterol
      is of the same magnitude as for older children and adolescents.

PMID- 8474816
TI  - Dietary approaches for reducing fat intake of preschool-age children.
AB  - STUDY OBJECTIVE: The present study was conducted to determine the effects of
      applying different fat reduction strategies to the overall nutrient profile of
      diets for preschool-age children. DESIGN: Computer modeling techniques were used
      to modify the diets of children (ages 2 through 3 and 4 through 5 years old) to
      meet contemporary dietary recommendations (< 30% of calories from total fat, <
      10% from saturated fatty acids, and < 300 mg of cholesterol daily). Fat reduction
      strategies were applied to a 1-week menu that included preschoolers' favorite
      foods. Strategies applied were replacing high-fat meat exchanges with lean meat
      exchanges (+/- three high-fat meat exchanges per week), replacing higher fat
      milks with skim milk, replacing high-fat meat exchanges with medium-fat meat
      exchanges, using fat-modified products, using low-fat preparation techniques, and
      added fat. All diets were made isocaloric after modifications were applied.
      RESULTS: It is more difficult to meet all recommendations for the 2- and 3-year
      old children. Use of skim milk is the simplest strategy to use for the 4- and 5
      year-old children, although other single strategies are effective. CONCLUSIONS:
      When multiple strategies are effected. Some diets are very low in fat (< 20% of
      calories) and potentially inadequate in energy and nutrients. It is important
      that caregivers know the appropriate foods to choose when modifying fat in
      children's diets to ensure meeting energy and nutrient requirements.

PMID- 8474817
TI  - Infants of less than 1250 grams birth weight at Groote Schuur Hospital: outcome
      at 1 and 2 years of age.
AB  - A prospective 2-year follow-up study of infants with birth weights of less than
      1250 g was undertaken at Groote Schuur Hospital Neonatal Intensive Care Unit. For
      a 12-month period beginning July 1988, all live infants born at Groote Schuur
      Hospital or referred to the Neonatal Intensive Care Unit were included in the
      study cohort. The aim of the study was to document the morbidity, mortality, and
      neurodevelopmental outcome of these infants to 2 years of age. Of 235 liveborn
      infants, 143 (61%) survived to discharge. One hundred twenty-six infants were
      born weighing less than 1000 g; 42% survived to discharge. One hundred nine
      infants weighed 1000 g or more at birth, and 83% survived to discharge. Better
      survival was documented for infants whose mothers attended antenatal care, who
      weighed more than 900 g, and who were of greater than 30 weeks' gestation. Eleven
      infants died in the first 6 months after discharge. One hundred six infants (83%
      of survivors) underwent Griffiths developmental testing and clinical assessment
      at 1 year of age. Ninety-six (91%) of these survivors were seen and tested at 2
      years of age. Of the 106 infants assessed at 1 year of age, 6 infants had
      cerebral palsy, 6 were globally developmentally delayed without signs of cerebral
      palsy, and 1 infant showed significant motor delay with a normal developmental
      quotient. At 2 years of age 1 additional infant had cerebral palsy and 9 more
      infants are likely to be mentally retarded. At 2 years of age the major handicap
      rate was, therefore, 22%. Sixty-nine percent of surviving infants, and all but 1
      of the infants with cerebral palsy, were underweight for gestational age at
      birth. There was a tendency for these underweight-for-gestational-age infants to
      score less well at 2 years of age. Infants who received ventilation and infants
      with a birth weight of less than 1000 g were not found to score less well than
      other infants in the cohort.

PMID- 8474818
TI  - Birth weight and illness severity: independent predictors of neonatal mortality.
AB  - BACKGROUND: Low birth weight is a major determinant of neonatal mortality. Yet
      birth weight, even in conjunction with other demographic markers, is inadequate
      to explain the large variations in neonatal mortality between intensive care
      units. This variation probably reflects differences in admission severity. The
      authors have recently developed the Score for Neonatal Acute Physiology (SNAP),
      an illness severity index specific for neonatal intensive care, and demonstrated
      illness severity to be a major determinant of neonatal mortality. OBJECTIVE: To
      define the relative contributions of birth weight and illness severity to the
      risk of neonatal mortality and to identify other significant independent risk
      factors. METHODS: Logistic regression was used to analyze data from a cohort of
      1621 consecutive admissions to three neonatal intensive care units (92 deaths),
      to test six alternative predictive models. The best logistic model was then used
      to develop a simple additive clinical score, the SNAP Perinatal Extension (SNAP
      PE). RESULTS: These analyses demonstrated that birth weight and illness severity
      are powerful independent predictors across a broad range of birth weights and
      that their effects are additive. Below 750 g, there is an interaction between
      birth weight and SNAP. Other factors that showed independent predictive power
      were low Apgar score at 5 minutes and small size for gestational age. Separate
      derivation and test samples were used to demonstrate that the SNAP-PE is
      comparable to the best logistic model and has a sensitivity and specificity
      superior to either birth weight or SNAP alone (receiver-operator characteristic
      area .92 +/- .02) as well as excellent goodness of fit. CONCLUSION: This
      simplified clinical score provides accurate mortality risk estimates for
      application in a broad array of clinical and research settings.

PMID- 8474819
TI  - Effectiveness of iron-fortified infant cereal in prevention of iron deficiency
      anemia.
AB  - BACKGROUND: Iron deficiency continues to be a common problem among infants
      throughout the world. Iron-fortified formula is effective in preventing iron
      deficiency but the benefit of iron-fortified cereal is controversial. METHODS: We
      compared iron-fortified rice cereal to unfortified rice cereal in infants who
      were exclusively breast-fed for more than 4 months and to iron-fortified formula
      in infants who were weaned to formula before 4 months of age. The design was
      double blind in respect to the presence or absence of fortification iron in the
      cereal or formula and included 515 infants who were followed on the protocol from
      4 to 15 months of age. Rice cereal was fortified with 55 mg of electrolytic iron
      per 100 g of dry cereal and infant formula with 12 mg of ferrous sulfate per 100
      g of dry powder, levels approximating those in use in the United States. Measures
      of iron status were obtained at 8, 12, and 15 months. Infants with hemoglobin
      levels of < 105 g/L were excluded from the study and treated. RESULTS:
      Consumption of cereal reached plateaus at means of about 30 g/d after 6 months of
      age in the formula-fed groups and 26 g/d after 8 months in the breast-fed groups;
      these amounts are higher than the 19-g/d mean intake by the 73% of infants who
      consume such cereal in the United States. Among infants weaned to formula before
      4 months, the cumulative percentages of infants excluded for anemia by 15 months
      were 8%, 24%, and 4%, respectively, in the fortified cereal, unfortified cereal
      and formula, and fortified formula groups (P < .01 unfortified vs either
      fortified group; the difference between the two fortified groups was not
      significant). In infants breast-fed for more than 4 months, the corresponding
      values were 13% and 27%, respectively, in the fortified and unfortified cereal
      groups (P < .05). Mean hemoglobin level and other iron status measures were in
      accord with these findings. CONCLUSION: Iron-fortified infant rice cereal can
      contribute substantially to preventing iron deficiency anemia.

PMID- 8474820
TI  - Intraoperative anaphylaxis to latex.

PMID- 8474821
TI  - Screening urine of 3-week-old newborns: lack of association between sudden infant
      death syndrome and some metabolic disorders.

PMID- 8474822
TI  - Leber's hereditary optic neuropathy as a cause of severe visual loss in
      childhood.

PMID- 8474823
TI  - Spectrum of limb disruption defects associated with chorionic villus sampling.

PMID- 8474824
TI  - A simplified behavioral treatment for trichotillomania: report of two cases.

PMID- 8474825
TI  - Arginase deficiency presenting as cerebral palsy.

PMID- 8474826
TI  - Inhalational nitric oxide therapy for persistent pulmonary hypertension of the
      newborn.

PMID- 8474827
TI  - Diagnosing and treating health: bright futures.

PMID- 8474828
TI  - Multiple reflections.

PMID- 8474829
TI  - A comparison of self-adaptation and cross-adaptation to odorants presented singly
      and in mixtures.
AB  - Fifteen subjects made 450 judgments each by the method of magnitude estimation of
      dimethyl disulfide and hydrogen sulfide after prior exposure to various mixtures
      of them. Exposure to the same odorant clearly affected the perceived intensity of
      it (self-adaptation). By contrast, exposure to the other odorant showed at best a
      small effect (cross-adaptation). Consistent with this, adaptation to a mixture of
      the test odorant and another odorant is proportional to the amount of the test
      odorant in the mixture, and does not exceed that of self-adaptation. These
      results indicate that olfactory adaptation is specific and that the sense of
      smell is more robust than generally assumed.

PMID- 8474830
TI  - Accuracy and consistency of absolute pitch.
AB  - The accuracy and consistency of absolute pitch (AP) judgments have been measured
      on three subjects in two longitudinal studies separated by twenty years. The
      drifts and cyclical variations observed in the earlier study still persisted, and
      an investigation of two other subjects, one of whom was first studied forty years
      ago, suggests that they might undergo similar cyclical variations in their pitch
      perception. Pitch judgments also varied during the day. The detailed observations
      of these nonrandom fluctuations have been used to determine a value for the
      underlying consistency of the AP estimates. When the effects of the daytime
      variations and longer-term drifts were removed, the values for this consistency,
      as measured by the standard deviation, were calculated to be 3.1, 3.4, 3.7, 4.4,
      and 4.5 Hz for the five subjects. When an oscillator was used to produce the
      estimate, the consistency of the judgments was observed to depend on the accuracy
      of those judgments.

PMID- 8474831
TI  - Action categories and the perception of biological motion.
AB  - Johansson filmed walkers and runners in a dark room with lights attached to their
      main joints and demonstrated that such moving light spots were perceived as human
      movements. To extend this finding the detection and recognition of Johansson
      displays of different kinds of movements under three light-spot conditions were
      studied to determine how human actions are perceived on the basis of biological
      motion information. Locomotory, instrumental, and social actions were presented
      in each condition, namely in normal Johansson (light attached to joints), inter
      joint (light attached between joints), and upside-down Johansson. Subjects'
      verbal responses and recognition times were measured. Locomotory actions were
      recognised better and faster than social and instrumental actions. Furthermore,
      biological motions were recognised much better and faster when the light-spot
      displays were presented in the normal orientation rather than upside down.
      Recognition rate was only slightly impaired under the inter-joint condition. It
      is argued that the perceptual analysis of actions and movements starts primarily
      on an intermediate level of action coding and comprises more than just the
      similarity of movement patterns or simple structures. Additionally, coding of
      dynamic phase relations and semantic coding take place at very early stages of
      the processing of biological motion. Implications of these results for computer
      vision, perceptual models, and mental representations are discussed.

PMID- 8474832
TI  - Perceived rigidity and nonrigidity in the kinetic depth effect.
AB  - Stroboscopic simulations of three-dimensional rotating rigid structures can be
      perceived as highly nonrigid. To investigate this nonrigidity effect a sequence
      of either three (experiment 2 and 3) or thirty six frames (experiment 4) was
      used, each consisting of a set of dots with location on the horizontal axis
      corresponding to the parallel projection of a nominally defined helix. Observers
      were asked to judge the angle of rotation of eighty helices defined by the
      factorial combination of eight phase (phi) values (ie difference between the
      sinusoidal path of one dot and its neighbours) and ten different angular
      displacement values (alpha). When in each static frame the dots can be organized
      into curved dotted line (small values of phi), the perceived 3-D helices are
      highly nonrigid. But when shape information is not available in each static frame
      (high values of phi), the helices are perceived as rigid and rotation judgement
      is possible providing that alpha < 15 degrees. It appears that at small values of
      phi observers fail to recover the rigid structure of the helices since the input
      to the structure from the motion process may be distorted.

PMID- 8474833
TI  - Comparison of nine methods of indicating the direction to objects: data from
      blind adults.
AB  - Nine methods of indicating the direction to object locations were tested on
      twenty blind adult subjects. The task was to indicate the location of active
      auditory targets distributed in a semicircle with a 1.7 m radius around the
      subject. Target location, practice, and feedback were systematically varied for
      each method. The greatest accuracy and lowest variability were found for pointing
      methods that used body parts (directing the nose at the target, facing it with
      the chest, and pointing with the index finger) and extensions of body parts
      (pointing with a hand-held cane or with a short stick). Two less accurate methods
      involved rotating a dial. The least accurate methods involved drawing and a
      verbal description in terms of clockface labels. Method interacted significantly
      with target location, and with individual differences. In general, the body-part
      and extension method were affected less than other methods by target location and
      individual differences. The findings suggest that a pointing response that uses
      body part or an extension of a body part is the best choice for experimental or
      diagnostic measurement of object location by blind subjects. Differences between
      the results of this study of blind subjects and auditory localization accuracy in
      sighted subjects are discussed, and the implications for spatial processing in
      the blind are considered.

PMID- 8474834
TI  - The effect of linear vection on manual aiming at memorized directions of
      stationary targets.
AB  - Stationary observers were required to aim manually at either a straight-ahead, or
      a lateral, immobile target (0 degrees and 20 degrees of eccentricity,
      respectively). First, they aimed at a perceptually present target. Second, they
      aimed at the memorized direction of the target. Third, they aimed at the
      memorized direction of the target after a 4 s period of forward sagittal vection.
      The comparisons of the post-vection versus ante-vection aimings at the memorized
      direction of the targets reflect an illusory increase in the eccentricity of the
      lateral target, and no change in the direction of the straight-ahead target.
      These results objectivate the idea that forward sagittal vection (a particular
      case of linear vection) corresponds to an illusion of self-displacement, ie an
      illusory change of body place through space.

PMID- 8474835
TI  - Is a perceived shape based on its retinal image?
AB  - Although the processing of phenomenal shape might be supposed to begin at an
      early stage, with the shape of the retinal image of an object, it is possible
      that it does not begin until a later stage at which the locations of the parts of
      the object have been perceived. Such perceived locations are based on a
      compensation or constancy mechanism that takes account of eye position.
      Ordinarily these two possible bases of shape perception--retinal image and
      perceived location--are confounded. To separate them the parts of a shape were
      presented sequentially, during which time the eyes were in motion. The eye
      movement did not alter phenomenal locations of the parts vis-a-vis one another
      but did yield an entirely different composite retinal image of the parts. Another
      method employed was to change the location of each sequentially presented part
      with respect to a displacing frame of reference. By and large the results
      indicate that the composite shape perceived is based on the perceived location of
      the parts of the object with respect to one another, rather than on the composite
      retinal image.

PMID- 8474836
TI  - The Pulfrich pendulum phenomenon in stereoblind subjects.
AB  - The Pulfrich pendulum phenomenon, in which a pendulum swinging in the
      frontoparallel plane appears to swing in an ellipse when a neutral density filter
      is placed over one eye of the observer, was investigated in stereoblind subjects.
      It was found that such subjects can report the presence of the Pulfrich effect
      although they fail to fuse random-dot stereograms and fail to exhibit interocular
      transfer of the movement aftereffect. These findings suggest that 'stereoblind'
      subjects must retain some residual binocular mechanism for depth perception.
      Three possibilities are considered: (i) the stereoblind may be able to utilise
      contiguous temporal disparities as a cue for depth in the Pulfrich effect; (ii)
      they may retain some residual binocularity, sufficient to reveal the Pulfrich
      effect but not for other more demanding tasks for the binocular mechanisms; and
      (iii) they may retain some coarse magnocellular pathway disparity mechanism
      having lost their high-acuity parvocellular disparity system. There is little
      evidence to support any of these hypotheses, but the third shows promise.

PMID- 8474837
TI  - Visual recognition in the peripheral field: letters versus symbols and adults
      versus children.
AB  - The plot of the form-resolving field (FRF) was obtained by tachistoscopically
      presenting two figures in each stimulus, one in the center of gaze and the other
      in the peripheral field. The figures in the periphery were placed at various
      eccentricities in different presentations. The ensuing plot of average letter
      recognition as a function of eccentricity is the FRF. Only the horizontal
      components of the FRFs were used in the comparisons. Three sets of figures were
      used as stimuli: regular-size letters, large-size letters, and symbols. Three
      groups of subjects were compared: adult ordinary readers, reading children, and
      pre-reading-age children. The last were tested with symbols only. In letter
      recognition, the FRFs for young and adult ordinary readers are similar and fall
      off monotonically and symmetrically with eccentricity, hence conforming with the
      first Aubert-Foerster law (1857). However, the FRFs tested with symbols are
      narrower than those tested with letters of the same sizes and stroke widths,
      which is not in accordance with the first Aubert-Foerster law. In addition, the
      FRFs of symbols are different for each subject group. It is suggested that
      recognition in the peripheral field is not determined by visual acuity alone;
      rather, it is further confined or determined by the visual strategy employed to
      accomplish the task, and its associated distribution of lateral masking.

PMID- 8474838
TI  - Time estimation methods--do they influence prospective duration estimates?
AB  - The validity of an attentional model of prospective time estimation was tested in
      three experiments. In the first experiment two variables were manipulated: (1)
      nontemporal information processing load during the estimated interval, and (2)
      time estimation method, ie production of time simultaneously with the performance
      of a second task, or reproduction of time immediately upon termination of a task
      whose duration has to be measured. As predicted, a positive relationship between
      produced time length and information processing load demanded by a simultaneous
      task, and a negative relationship between reproduced time length and information
      processing load during the estimated interval, were found. The results were
      replicated in a second experiment in which verbal estimates of time were also
      measured and the objective duration of the estimated interval was varied. The
      pattern of results obtained for verbal estimates was similar to that obtained for
      reproduced ones. The results of a third experiment indicated that produced and
      reproduced times were positively correlated with clock time. The results are
      interpreted as supporting an attentional model of prospective time estimation.

PMID- 8474839
TI  - Rocking the role of universities.

PMID- 8474840
TI  - Sex discrimination: how do we tell the difference between male and female faces?
AB  - People are remarkably accurate (approaching ceiling) at deciding whether faces
      are male or female, even when cues from hair style, makeup, and facial hair are
      minimised. Experiments designed to explore the perceptual basis of our ability to
      categorise the sex of faces are reported. Subjects were considerably less
      accurate when asked to judge the sex of three-dimensional (3-D) representations
      of faces obtained by laser-scanning, compared with a condition where photographs
      were taken with hair concealed and eyes closed. This suggests that cues from
      features such as eyebrows, and skin texture, play an important role in decision
      making. Performance with the laser-scanned heads remained quite high with 3/4
      view faces, where the 3-D shape of the face should be easiest to see, suggesting
      that the 3-D structure of the face is a further source of information
      contributing to the classification of its sex. Performance at judging the sex
      from photographs (with hair concealed) was disrupted if the photographs were
      inverted, which implies that the superficial cues contributing to the decision
      are not processed in a purely 'local' way. Performance was also disrupted if the
      faces were shown in photographic negatives, which is consistent with the use of 3
      D information, since negation probably operates by disrupting the computation of
      shape from shading. In 3-D, the 'average' male face differs from the 'average'
      female face by having a more protuberant nose/brow and more prominent chin/jaw.
      The effects of manipulating the shapes of the noses and chins of the laser
      scanned heads were assessed and significant effects of such manipulations on the
      apparent masculinity or femininity of the heads were revealed. It appears that
      our ability to make this most basic of facial categorisations may be multiply
      determined by a combination of 2-D, 3-D, and textural cues and their
      interrelationships.

PMID- 8474841
TI  - What's the difference between men and women? Evidence from facial measurement.
AB  - Human subjects are able to identify the sex of faces with very high accuracy.
      Using photographs of adults in which hair was concealed by a swimming cap,
      subjects performed with 96% accuracy. Previous work has identified a number of
      dimensions on which the faces of men and women differ. An attempt to combine
      these dimensions into a single function to classify male and female faces
      reliably is described. Photographs were taken of 91 male and 88 female faces in
      full face and profile. These were measured in several ways: (i) simple distances
      between key points in the pictures; (ii) ratios and angles formed between key
      points in the pictures; (iii) three-dimensional (3-D) distances derived by
      combination of full-face and profile photographs. Discriminant function analysis
      showed that the best discriminators were derived from simple distance
      measurements in the full face (85% accuracy with 12 variables) and 3-D distances
      (85% accuracy with 6 variables). Combining measures taken from the picture plane
      with those derived in 3-D produced a discriminator approaching human performance
      (94% accuracy with 16 variables). Performance of the discriminant function was
      compared with that of human perceivers and found to be correlated, but far from
      perfectly. The difficulty of deriving a reliable function to distinguish between
      the sexes is discussed with reference to the development of automatic face
      processing programs in machine vision. It is argued that such systems will need
      to incorporate an understanding of the stimuli if they are to be effective.

PMID- 8474842
TI  - Visual size invariance does not apply to geometric angle and speed of rotation.
AB  - The ability of humans to visually estimate geometric angle and speed of rotation
      was examined as a function of the spatial scale of the stimuli. Both properties
      are objectively invariant at different spatial scales, but the results of
      experiments show that the judgement of acute geometric angles as well as that of
      speed of rotation varies strongly and monotonically with the scale of
      presentation. If the image is magnified, the perceived geometric angle and the
      perceived speed of rotation increase. If the image is reduced in size, they
      decrease. This result imposes strong constraints on perceptual theories.

PMID- 8474843
TI  - A general correspondence approach to apparent motion.
AB  - A general framework is considered for how different features of image parts
      determine the perceived direction of apparent motion between these parts as a
      function of their internalized feature weights. It is shown how the compatibility
      and constraints between pairwise part correspondences also play important roles
      in the types of perceived motion between parts; this process is modelled via a
      multivariate constraint-satisfaction procedure.

PMID- 8474844
TI  - Directional bias in the perception of translating patterns.
AB  - Recent findings suggest that the visual system is biased by its past stimulation
      to detect one direction of motion over others. Three experiments were designed to
      investigate whether this bias is mediated by the direction or by the velocity of
      the past stimulation, and whether this bias is offset by contradictory pattern or
      depth information. Observers were presented with two solid or random-dot patterns
      that moved across a display screen in antiphase. As the two patterns reached the
      center of the screen, they became superimposed in such a way that their
      subsequent directions were ambiguous. Results from experiment 1 showed that the
      probability of perceiving these patterns as continuing to move in the same
      directions was significantly greater when they moved at a constant velocity than
      when they moved at a variable velocity. Results from experiments 2 and 3 revealed
      that this directional bias was reversed only gradually as an increasing amount of
      contradictory pattern information was introduced, but that this reversal was
      quite abrupt when a relatively small amount of contradictory depth information
      was introduced. Collectively, these results suggest that a directional bias in
      the perception of moving patterns is mediated not only by the direction of the
      previous stimulation, but also by the velocity of that stimulation. Moreover, the
      analyses of pattern and motion information appear relatively independent during
      the early stages of visual processing, but the analyses of depth and motion
      information appear considerably more interdependent.

PMID- 8474845
TI  - The perception of 3-D rotation from translating sine-wave lines: the reverse of
      the barber-pole illusion.
AB  - An ambiguous moving pattern which gives rise to the reverse of the barber-pole
      illusion is reported. When vertical sine-wave lines translate, vertically and
      endlessly, on a two-dimensional (2-D) plane, one can perceive rotating three
      dimensional (3-D) helixes without the impression of translation. With a single
      sine-wave line, 3-D rotation was seen for about half the exposure period. With
      three sine-wave lines shifted in phase by 120 degrees, this illusion easily arose
      when one fixated a point near the endpoints of the lines, which moved
      horizontally and sinusoidally along the imaginary upper edge of the screen. When
      3-D rotation was seen, the sine-wave lines which were intersecting on a 2-D
      display were perceptually decomposed into pairs of lines separated in depth. On
      fixating a point at the center of the figure, vertical translation was mainly
      seen. Foveal viewing of the horizontal sine movement of the endpoints of the
      lines produces the impression of 3-D rotation and the impression appears to
      provide some specific information towards solving the aperture problem and
      towards reconstructing the whole figure as such.

PMID- 8474846
TI  - The role of depth stratification in the solution of the aperture problem.
AB  - When a plaid pattern composed of a stationary vertical grating and a horizontally
      drifting diagonal grating is shown behind a circular aperture, the pattern
      appears to move coherently in a vertical direction. When the bars of the
      stationary grating are narrower than those of the moving grating, only the latter
      is seen to move, in a direction orthogonal to its orientation (ie diagonal); but
      when the bars of the stationary grating are wider than those of the moving
      grating, vertical motion of the whole plaid predominates. It is argued that, in
      the absence of occlusion information, the motion of a plaid within an aperture
      depends on the unambiguous displacement of inner line terminators at the
      crossings of the two gratings. Relative motion and differences in bar width
      between the two gratings provide information about which set of bars is in front
      of the other. When these sources of information are consistent with each other,
      separation of the two gratings in depth occurs: inner line terminators no longer
      perceptually exist and the direction of motion becomes determined only by
      terminators at the edges, which causes a shift from vertical to orthogonal
      motion. Differences in luminance also provide (asymmetrical) information about
      depth relationships: when darker bars occlude lighter bars, the probability of
      orthogonal motion increases as a function of the difference in luminance, whereas
      when lighter bars are over darker bars, vertical motion prevails.

PMID- 8474847
TI  - The role of parts and spatial relations in object identification.
AB  - An investigation of the role of parts and their spatial relations in object
      identification is reported. At the most general level, two important results were
      obtained. First, proper spatial relations among components of an object are
      critical for easy identification. When parts were scrambled on the page, naming
      times and error rates increased. And, second, the way an object is divided into
      parts (parsed) affects identification only under the most impoverished viewing
      conditions. When subjects had as little as 1 s (and sometimes as little as 200
      ms) to view an object, the way objects were divided into parts had no effect on
      naming times or accuracy. There was no hint of an interaction between type of
      parse and how parts were arranged on the page. This pattern of effects supports
      theories that suggest that objects typically are recognized without being parsed
      into parts. The findings are in agreement with theories suggesting that object
      features (not specifically related to parts) are matched directly with such
      features stored in long-term memory, with the constraint that the features of a
      single object are seen from a single viewpoint.

PMID- 8474848
TI  - Fast and slow blockades of the inward-rectifier K+ channel by external divalent
      cations in guinea-pig cardiac myocytes.
AB  - The present patch-clamp study shows that external Mg2+, Ca2+ and Sr2+ decrease
      the unit amplitude of inward current through the inward-rectifier K+ channel in a
      concentration-dependent manner. Sr2+ produces a voltage-dependent flickering
      block as well, and the fractional electrical distance between the external
      orifice and the Sr2+ binding site (delta) is 0.73. The decrease of unit amplitude
      is reversible and voltage independent while it does not increase the noise level
      on the open-channel current. Unit current decreased by Mg2+ or Ca2+ has a longer
      mean open time, which is inversely proportional to the unit amplitude. External
      Mg2+ does not decrease the amplitude of unit outward current. A surface potential
      shift, measured using voltage-dependent Cs+ block (delta = 1.60), failed to
      explain the current decrease. Therefore, we conclude that (1) the external
      divalent cations cause an extremely fast channel block, which appears as a
      decreased amplitude of the unit current on the recording system; (2) the blocking
      site (fast site) is present near the external orifice of the channel, and it is
      separate from the blocking site (slow site) to which Cs+ and Sr2+ bind.

PMID- 8474849
TI  - Demonstration of a novel apamin-insensitive calcium-activated K+ channel in mouse
      pancreatic B cells.
AB  - The whole-cell configuration of the patch-clamp technique was used to
      characterize the biophysical and pharmacological properties of an oscillating
      K(+)-current that can be induced by intracellular application of GTP[gamma S] in
      mouse pancreatic B cells (Ammala et al. 1991). These K+ conductance changes are
      evoked by periodic increases in the cytoplasmic Ca2+ concentration ([Ca2+]i) and
      transiently repolarize the B cell, thus inhibiting action-potential firing and
      giving rise to a bursting pattern. GTP[gamma S]-evoked oscillations in K+
      conductance were reversibly suppressed by a high (300 microM) concentration of
      carbamylcholine. By contrast, alpha 2-adrenoreceptor stimulation by 20 microM
      clonidine did not interfere with the oscillatory behaviour but evoked a small
      sustained outward current. At 0 mV membrane potential, the oscillating K(+)
      current elicited by GTP[gamma S] was highly sensitive to extracellular
      tetraethylammonium (TEA; 70% block by 1 mM). The TEA-resistant component, which
      carried approximately 80% of the current at -40 mV, was affected neither by
      apamin (1 microM) nor by tolbutamide (500 microM). The current evoked by internal
      GTP[gamma S] was highly selective for K+, as demonstrated by a 51-mV change in
      the reversal potential for a sevenfold change in [K+]o. Stationary fluctuation
      analysis indicated a unitary conductance of 0.5 pS when measured with symmetric
      (approximately 140 mM) KCl solutions. The estimated single-channel conductance
      with physiological ionic gradients is 0.1 pS. The results indicate the existence
      of a novel Ca(2+)-gated K+ conductance in pancreatic B cells. Activation of this
      K+ current may contribute to the generation of the oscillatory electrical
      activity characterizing the B cell at intermediate glucose concentrations.

PMID- 8474850
TI  - Excess divalent cations activate Ca(2+)-mobilizing receptors in pancreatic acinar
      cells.
AB  - In single, enzymatically dissociated, rat pancreatic acinar cells, external
      application of excess divalent cations (Ca2+, Sr2+, Ba2+, Ni2+ and Mg2+ over 50
      mM) induced Ca(2+)-dependent current responses monitored with the whole-cell
      recording technique. Inclusion of either EGTA, heparin or GDP[beta S] in the
      internal solution or treatment of acinar cells with a phorbol ester abolished the
      divalent-cation-induced responses. In contrast, internal inositol trisphosphate
      (InsP3) or GTP[gamma S] potentiated the responses. The results indicate that
      excess divalent cations activate membrane surface receptors or receptor/effector
      complexes, thereby inducing InsP3-mediated Ca2+ mobilization. The mechanism may
      be due to modulation of the receptors by changes in electrical profile through
      indirect action of divalent cations on membrane surface charges, i.e.
      neutralization of anionic charges. This proposal was supported by the evidence
      that the trivalent cation, La3+, and the polyvalent cation, protamine, both at
      much lower concentrations, could induce Ca(2+)-dependent responses, which were
      abolished by internal application of heparin, GDP[ beta S] or a high
      concentration of EGTA or by protein kinase C activation with a phorbol ester.

PMID- 8474851
TI  - Regulation and possible physiological role of the Ca(2+)-dependent K+ channel of
      cortical collecting ducts of the rat.
AB  - In the luminal membrane of rat cortical collecting duct (CCD) a big Ca(2+)
      dependent and a small Ca(2+)-independent K+ channel have been described. Whereas
      the latter most likely is responsible for the K+ secretion in this nephron
      segment, the function of the large-conductance K+ channel is unknown. The
      regulation of this channel and its possible physiological role were examined with
      the conventional cell-free and the cell-attached nystatin patch-clamp techniques.
      Patch-clamp recordings were obtained from the luminal membrane of isolated
      perfused CCD segments and from freshly isolated CCD cells. Intracellular calcium
      was measured using the calcium-sensitive dye fura-2. The large-conductance K+
      channel was strongly voltage- and calcium-dependent. At 3 mumol/l cytosolic Ca2+
      activity it was half-maximally activated. At 1 mmol/l it was neither regulated by
      cytosolic pH nor by ATP. At 1 mumol/l Ca2+ activity the open probability (Po) of
      this channel was pH-dependent. At pH 7.0 Po was decreased to 4 +/- 2% (n = 9) and
      at pH 8.5 it was increased to 425 +/- 52% (n = 9) of the control. At this low
      Ca2+ activity the Po of the channel was reduced by 1 mmol/l ATP to 8 +/- 4% (n =
      6). Cell swelling activated the large-conductance K+ channel (n = 14) and
      hyperpolarized the membrane potential of the cells by 9 +/- 1 mV (n = 23).
      Intracellular Ca2+ activity increased after hypotonic stress. This increase
      depended on the extracellular Ca2+ activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474852
TI  - Na(+)-dependent biotin transport into brush-border membrane vesicles from human
      kidney cortex.
AB  - Renal reabsorption of biotin was investigated in human kidney by means of the
      isolated brush-border membrane vesicle technique. Biotin uptake into the vesicles
      was sodium-dependent producing a typical overshoot when incubated under sodium
      gradient conditions (external concentration greater than internal). This effect
      was not observed in the presence of gradients of KCl, LiCl or choline-chloride,
      nor in the absence of any salt. Using the K+/valinomycin voltage-clamp method
      biotin uptake remained uninfluenced, i.e. was electroneutral, whereas glucose
      uptake (which is known to be electrogenic in kidney of other species) was greatly
      increased. When biotin transport was investigated as a function of external
      sodium concentration a stoichiometic coupling factor of 1 for the Na(+)-biotin-
      cotransport was determined. Increasing the biotin concentration in the incubation
      medium up to 200 mumol/l led to saturation with the kinetic parameters of 31
      mumol/l for the apparent Michaelis constant and 82 nmol g protein-1 30 s-1 for
      the maximal transport rate. Uptake was not saturable in the concentration range
      of 0.001-1 mumol/l. Inhibition of the biotin uptake (25 mumol/l) was observed in
      the presence of 250 mumol/l dethiobiotin, bisnorbiotin, thioctic acid, and
      probenecid, whereas biocytin, propionic acid, lactic acid, succinic acid, citric
      acid, ascorbic acid, primidone and carbamazepine had no effect. We conclude that
      renal biotin reabsorption in human kidney is specifically sodium-dependent,
      saturable and electroneutral. It therefore fulfills the requirements for a
      secondary active carrier-mediated transport system. The results suggest that
      biocytin is not an inhibitor of renal biotin reabsorption.

PMID- 8474853
TI  - Role of microtubules in the adaptive response to low phosphate of Na/Pi
      cotransport in opossum kidney cells.
AB  - The role of microtubules and actin microfilaments in adaptive changes of the
      apical Na-dependent transport of phosphate (Pi) was investigated in opossum
      kidney (OK) cells. Up-regulation of Na/Pi cotransport was achieved by incubating
      OK cells in a medium containing 0.1 mM Pi; down-regulation of Na/Pi cotransport
      was provoked by refeeding adapted cells with 2 mM Pi. Up-regulation of Na/Pi
      cotransport was found to be inhibited by approximately 50% after a pretreatment
      of the cells with the microtubule disrupting agents nocodozole and colchicine;
      indirect immunofluorescence indicated complete depolymerization of the
      microtubular network. No inhibition of the adaptive response was observed after
      treatment of the cells with cytochalasin B to depolymerize actin microfilaments.
      In adapted cells, depolymerization of microtubules by nocodozole led to a
      reversibility of Na/Pi cotransport similar to that observed after refeeding
      adapted cells with 2 mM Pi. No effects of the microtubule disrupting drugs were
      observed on Na/L-glutamic acid transport. Depolymerization of microtubules did
      not prevent parathyroid-hormone-mediated inhibition of Na/Pi cotransport. It is
      concluded that microtubules are (at least in part) involved in the correct
      insertion of newly synthesized apical Na/Pi cotransport systems and that
      microtubules are not involved in the internalization of Na/Pi cotransport
      systems.

PMID- 8474854
TI  - Intracellular pH in renal tubules in situ: single-cell measurements by confocal
      laserscan microscopy.
AB  - Confocal laserscan microscopy with a dual-excitation device was used to record
      intracellular pH (pHi) regulation in rat proximal convoluted tubules
      microperfused in vivo. Cells were loaded with the pH-sensitive, fluorescent dye
      2',7'-bis(carboxyethyl)-5(6)-carboxyfluorescein (BCECF). Single cells could be
      distinguished within the tubules and separate measurements were possible.
      Application of an NH4Cl pulse by peritubular perfusion caused an immediate
      increase in intracellular pH. Intraluminal injection of NH4Cl led to a slower
      increase in intracellular pH. In both cases, cessation of perfusion led to an
      immediate acidification. Peritubular perfusion with 300 microM 4,4'
      diisothiocanatodihydrostilbene-2,2'-disulphonic acid (H2DIDS) caused an
      intracellular alkalinisation. Microperfusion, pH-sensitive dyes and confocal
      laserscan microscopy provide a new non-invasive method to measure intracellular
      pH effectively in individual cells of near-surface structures of the intact
      kidney.

PMID- 8474855
TI  - The Na(+)-dependence of Na(+)-activated K(+)-channels (IK(Na)) in guinea pig
      ventricular myocytes, is different in excised inside/out patches and cell
      attached patches.
AB  - Single Na(+)-activated K(+)-channels were recorded from intact guinea-pig
      ventricular myocytes perfused with Ca-free, Mg-free Tyrode, to increase [Na+]i.
      The activity of these channels increases with the time of perfusion with this
      solution and decreases when the bathing sodium is reduced. The activity of the
      Na(+)-activated K(+)-channel is greater in the cell attached patches than from
      excised cell free patches, at the same [Na+]. It is suggested that this K+
      channel is significantly active in intact cells within the physiological range of
      [Na]i.

PMID- 8474856
TI  - Lymphocyte subsets recirculate from blood to lymph at different rates in
      conscious sheep.
AB  - Lymphocytes migrate and recirculate continuously between blood and lymph. The
      current study compared the migratory properties of lymphocyte subsets by
      labelling lymphocyte surface antigens and analysing simultaneous samples of
      mesenteric lymph, systemic arterial blood and mesenteric venous blood from
      conscious sheep. The lymphocyte output in lymph averaged 5.33 +/- 0.89 x 10(6)
      min-1 (lymph flow rate of 92 +/- 13 microliters min-1, lymphocyte count 61.9 +/-
      10.7 x 10(9) l-1, n = 10) and the proportion of cells which carried the CD4
      antigen (CD4+) was considerably higher in lymph (46 +/- 3%) than in arterial
      blood (23 +/- 2%; p < 0.01, n = 9). This increase was paralleled by a small but
      statistically significant decrease in the percentage of CD4+ cells in mesenteric
      venous blood (20 +/- 2%), as compared with systemic arterial blood (26 +/- 2%; p
      < 0.05, n = 6), which is consistent with the hypothesis that CD4+ cells migrate
      out of the blood vessels, and recirculate through the lymphatics, more readily
      than other lymphocyte subsets.

PMID- 8474857
TI  - Fast K channels are more sensitive to riluzole than slow K channels in myelinated
      nerve fibre.
AB  - The effects of 1-500 microM riluzole, a novel psychotropic agent, were studied on
      the nodal K current of isolated nerve fibres of the frog. When added to the
      external solution, the substance rapidly and reversibly inhibited slow, fast 1
      and fast 2 K components of the tail K current. The concentrations of riluzole
      inducing half maximum reduction of slow, fast 1 and fast 2 K conductances were
      413 microM, 24 microM and 21 microM respectively. It is concluded that the
      substance is about 20 times more effective in blocking fast than slow K channels.

PMID- 8474858
TI  - [CT evaluation of the pelvic cavity after total cystectomy].
AB  - CT scans were performed 40 times in 28 postcystectomy patients to identify the
      type and location of tumor recurrence. Sixteen patients showed tumor recurrence.
      Patients without recurrence showed a complete symmetric pelvis and a thin string
      that looked like an operation scar. Cutaneous ureterostomy showed small tube-like
      structures, and ileal conduit looked like herniation of the ileum. Cases with
      recurrent tumors were divided into 3 patterns, 1) pelvic abscess recurrence, 2)
      anterior abdominal wall thickening, 3) pelvic lateral wall thickening, and
      combinations of these types. The abscess-recurrence type often showed air within
      the mass or a fuzzy contour that could not be differentiated from true
      inflammatory abscess. Anterior abdominal wall thickening was usually accompanied
      with abscess-type recurrence and appeared as thickening of the operation scar.
      Lateral wall thickening was usually seen at the site of the obturator internus
      muscle or obturator node. Patients without recurrence had no complaints except
      for two who had ileus. All patients with recurrence except one had complaints of
      pain, abnormal secretion, or a palpable mass. Because all patients with
      recurrence already had a relatively large tumor at the time of CT, routine follow
      up CT is recommended even if the patient has no complaints.

PMID- 8474859
TI  - [Avascular necrosis of the femoral head: staging by MR imaging].
AB  - Magnetic resonance (MR) images and conventional radiographs were compared in 142
      hips with avascular necrosis, and a staging system for the disease based on MR
      imaging was developed. MR images were classified into three patterns: class I: a
      band of low signal intensity, class II: an area of low signal intensity with
      internal spot (s) of high signal, and class III: an area of low signal intensity
      without internal spots of high signal. Most MR class I lesions were in
      radiographic stage I (normal) or II (sclerotic or cystic changes without
      collapse). Most MR class II lesions were in radiographic stage III (segmental
      collapse), and most MR class III lesions were in stage III or IV (secondary
      degenerative changes). The MR image classification was closely correlated with
      radiographic staging (p < 0.01, using chi square test). We considered that this
      classification closely reflected the different stages of the disease according to
      the histopathology of the bone marrow.

PMID- 8474860
TI  - [Reappraisal of the clinical usefulness of transabdominal ultrasonography for
      advanced colon cancer--a study of tumor detection].
AB  - We evaluated the detectability of colon cancer by using transabdominal
      ultrasonography (US). Fifty-three cases of proven advanced colon cancer were
      examined in this study. Screening by US was carried out in 27 of 53 cases and US
      was performed in all cases after the definite diagnosis. Lesions of the colon
      were examined by using a 3.5 MHz convex and 5 MHz or 7.5 MHz linear probe
      (Yokogawa RT-2800, RT-4600). Localized hypertrophy of the irregular wall of more
      than 10 mm or massive tumor without the normal layered structure was defined as
      colon cancer on US. The rate of detection by screening test was 52%. The
      detection rate by US after definite diagnosis was 75%. A high detection rate was
      obtained in cases with a tumor diameter of more than 4 cm. Eight of 13 cases
      which were not detected by the screening test were visualized by US after
      definite diagnosis. US examination is useful for the detection of certain
      extended lesions of colon cancer. With technical improvements of the examination
      method, it is considered that cancer in the gastrointestinal tract may be
      discovered early on screening tests using US.

PMID- 8474861
TI  - [Sequential MR images of the uterus after Gd-DTPA injection--studies of normal
      volunteers and uterine endometrial malignant tumors].
AB  - To investigate the sequential changes in signal intensity (SI) of normal and
      abnormal uteri, T1 WIs were taken repeatedly after the injection of Gd-DTPA. Six
      volunteers and 19 patients with known uterine body malignancy (18 carcinomas, one
      carcinosarcoma) were examined. The results in volunteers were as follows. In the
      secretory phase, SI of the endometrium was stronger in the late images than in
      the early ones, whereas in the proliferative phase, SI was stronger in the early
      images. SI of the myometrium decreased rapidly and there were no differences in
      SI between menstrual phases. In 17 of 18 endometrial carcinomas, the tumors
      showed hypointensity relative to the myometrium, and the contrast between the
      tumor and the myometrium was better in the early images. In the remaining two
      cases, the tumor showed hyperintensity and the contrast was better in the late
      images. After the injection of Gd-DTPA, the endometrium appeared differently
      according to the menstrual cycle in normal volunteers, and the appearance of
      uterine structures and endometrial malignant tumors changed sequentially. These
      findings must be kept in mind when evaluating uterine diseases by Gd-DTPA
      enhanced MRI.

PMID- 8474862
TI  - [CT findings of diffuse pleural disease--alteration of pleura and extrapleural
      fat].
AB  - This is a comprehensive study on the usefulness of CT in the evaluation of
      diffuse pleural diseases in 114 patients. Alterations of the pleura and
      extrapleural fat were analyzed. The pleural changes were classified into five
      groups: no thickening (group 1), focal thickening (group 2), diffuse smooth
      thickening (group 3), diffuse nodular thickening less than 10 mm (group 4),
      diffuse nodular thickening more than 10 mm (group 5), CT findings of group 1 were
      mostly found in patients with transudatory effusion; group 2 in all patients with
      asbestosis; group 3 in those with empyema; and group 4 and 5 in those with
      malignant pleural diseases. In some cases with malignant pleural diseases and
      asbestosis, mediastinal and/or fissural thickening was present. Circumferential
      pleural thickening (pleural rind) was only seen in malignant pleural diseases.
      Pleural calcification was present in chronic empyema and asbestosis. Increased
      thickness of the extrapleural fat was seen in malignant pleural diseases and
      empyema, but homogeneous increased attenuation of the extrapleural fat might be a
      specific finding in acute empyema. The author concludes that CT is useful in the
      evaluation of pleural changes and alterations of extrapleural fat with diffuse
      pleural diseases, particularly in the pattern recognition based on CT
      classification.

PMID- 8474863
TI  - [The assessment of tumor blood flow factors using dynamic CT--a comparison with
      positron emission tomography].
AB  - The dynamic computed tomography (CT) was performed by using rapid-sequence
      scanning following an intravenous bolus injection of contrast material. Time
      density curve was applied for Gamma variate curve fitting and CT attenuation
      values were applied for two compartment model. The value of 1/CM, k1 and k2 were
      defined as the blood flow factors in this study. The inhalation of C15O2 using
      positron emission tomography (PET) can be useful for determining regional tumor
      blood flow (rBF). CT and PET were performed in twelve patients. The diagnosis was
      malignant lymphoma in four, and others; two liver metastasis, one focal nodular
      hyperplasia of the liver, one dermatofibrosarcoma, one hepatocellular carcinoma,
      one malignant melanoma, one malignant meningioma, one bone metastasis. The
      correlations among rBF, 1/CM, and k1 were good, and better correlations were
      obtained among tumor blood flow factors and rBF in the case of the tumors which
      existed far from air way and/or had low blood flow. The distance from air way
      effected both the value of rBF and tumor blood flow factors. Both the distance
      from air way and pathology caused conflicting results between rBF and tumor blood
      flow factors. Dynamic CT was particularly useful for evaluated the blood flow of
      tumors that had contact with air way.

PMID- 8474864
TI  - [Radiotherapy for vulvar cancer].
AB  - Fifteen patients who had primary vulvar cancer treated with radiotherapy as an
      initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from
      January 1971 to December 1990 are presented. Two patients were stage 0, one stage
      I, three stage II and nine stage III. Nine patients received electron irradiation
      with or without interstitial irradiation and intracavitary vaginal irradiation.
      Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed
      fields including the pelvic nodes and perineum followed by boost irradiation of
      electrons, interstitial irradiation and intracavitary vaginal irradiation. The
      total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on
      average). The actuarial 5-year survival rate of the patients was 43.6%. Complete
      regression (CR) was achieved in 60% of the patients. However, CR was not achieved
      in any of five patients with palpable inguinal nodes. In contrast, all the
      patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine
      CR cases relapsed. First sites of failure were vagina, groin and vulvar region.
      Recurrence occurred more than four years after treatment in three cases. Necrosis
      occurred in five of nine CR cases.

PMID- 8474865
TI  - [Discarding medical images and its evaluation].
AB  - Following a survey of our filing system, the period of storage of medical images
      was generally limited to ten years, a system which was put into execution in
      1990. Film jackets older than ten years are discarded every year, except for
      those registered for permanent storage. Fourteen thousand jackets (6.5% of total)
      have been registered for permanent storage. A follow-up survey has been performed
      to evaluate this system. The survey focused mainly on the frequency of re-issue
      of film jackets, and the rate of access to jackets. Discarded jackets now number
      about 50,000, a reduction of 20%. A total of 405 jackets were re-issued in a year
      due to the re-examination of patients whose jackets had been discarded. The
      annual number of re-called jackets from the repository outside our hospital was
      about 2,200 (about 500 of them were for research work), which corresponded to
      1.5% of the patients re-examined in the radiology department. The new filing
      system has been well integrated into the hospital daily routine. Information cost
      was calculated as a function of access rate to the stored information, and the
      concept of "cost-of-information" was proposed as a measure of cost analysis of an
      information system.

PMID- 8474866
TI  - [Carbon beam irradiation of monolayer cells].
AB  - This study was performed to determine the biological effect of carbon beams on
      mammalian cells (HeLa, RMUG), in comparison with 200 KVp X-rays. Carbon beams
      were generated by the Riken Ring Cyclotron. An increase in the relative
      biological effect (RBE) was observed in both cell lines as the LET of the carbon
      beam increased between 20 and 80 keV/microns. The RBE depended on the size of the
      irradiation dose at the higher LET region, and increasing the dose from 0.8 Gy to
      3.2 Gy decreased the RBE from 2.9 to 2.7. The survival curves of cells irradiated
      with 20 keV/microns carbon beams showed an initial shoulder. When RMUG was
      irradiated at 4 Gy with 200 KVp X-rays, the recovery rate between two split doses
      (6 hour interval) was 1.7. RMUG irradiated with 20 keV/microns carbon beams (4
      Gy) showed a recovery rate of 1.4. Recovery between split dose irradiation was
      observed with both X-ray and carbon beam irradiation; however, the recovery rate
      was lower with carbon beams. Cells irradiated with LET higher than 40 keV/microns
      did not show recovery between split doses.

PMID- 8474868
TI  - Simple technique for placement of Palmaz stent.

PMID- 8474867
TI  - [The correlation between the rise of tumor temperature during hyperthermia
      treatment and tumor blood flow measured by dynamic CT and 15 O gas-positron
      emission tomography].
AB  - This study was designed to determine the correlation between the rise of tumor
      temperature during hyperthermia treatment and the blood flow of the tumors
      measured by dynamic CT (DCT) and 15Ogas-positron emission tomography. In this
      report, we observed 20 patients with malignant tumors which underwent
      hyperthermia treatment. In each case, the temperature of the tumor was monitored
      with a photofiber sensor. DCT's and 15Ogas-positron emission tomographies were
      applied before the hyperthermia treatment. During the DCT, the tumor blood flow
      of each tumor was estimated by by analyzing the time-dependent activity curve
      after a bolus injection. During the 15Ogas-positron emission tomography, the
      tumor blood flow was estimated by the C15O2-steady-state method. The value of the
      tumor blood flow estimated by DCT were proportional to those calculated by the
      15Ogas-positron emission tomography. These values were inversely proportional to
      the rise of the temperature of the tumors during hyperthermia treatment. Our
      results imply that DCT as well as the 15Ogas-positron emission tomography can be
      used for the prediction of the tumor temperature rise during the hyperthermia
      treatment.

PMID- 8474869
TI  - [Evaluation of EC-IC bypass flow by MR angiography using the presaturation
      technique].
AB  - MR angiography studies using the presaturation technique were performed in 7
      patients who had received extra-intracranial (EC-IC) bypass surgery. With
      presaturation on the bypass vessels, disappearance of intracranial vascular
      signals suggests bypass effect. In our studies, good bypass effect was shown in 3
      cases and poor effect in 2 cases, which correlates well to concurrent
      angiography. In two cases, bypass effect was shown only in a few cortical
      branches of MCA, but angiography confirmed recanalization of occluded internal
      carotid artery in one case, and growth of large network of transdural anastomoses
      in the other.

PMID- 8474871
TI  - What can just one nurse do?

PMID- 8474870
TI  - [A study of transsplenic CO2 gas enhanced portal angioechography].
AB  - Transsplenic CO2 gas enhanced portal angioechography was examined. The spleen of
      three dogs was punctured by 23 gauge needle with two side holes. From 5 ml to 20
      ml of CO2 gas was injected into the splenic vein via the splenic parenchyma, and
      elevation of echo level of the liver was observed. Hematoma was not seen at the
      site of puncture. Good image was obtained in the case of 5 ml CO2 injection. In
      one dog with pseudotumor in the liver, the hyperechoic tumor changed into
      negative enhanced nodule after CO2 gas enhancement. Transsplenic CO2 gas enhanced
      portal angioechography is thought to be useful to evaluate hepatic tumors.

PMID- 8474872
TI  - Health care reform: one view of the future.

PMID- 8474873
TI  - Nursing research with African American and Hispanic people: guidelines for
      action.
AB  - In this article we have noted some of the conceptual and methodologic issues and
      challenges involved in conducting research with two ethnic/racial populations. In
      addition, we raised questions and gave recommendations to provide nurse
      researchers with guides as to how they might conceptualize and conduct and
      critique research with two groups. While this is not a strict blueprint, it is
      hoped that the guidelines and recommendations will serve as a focal point about
      which continued discourse and critical thinking about conducting research with
      members of ethnically/racially diverse groups may occur. The complex issues
      presented are not unique to nursing. Researchers from various disciplines have
      enumerated similar issues and, in turn, have been critical of research findings
      with samples of ethnic/racial groups. While a cadre of nurse researchers has
      begun to accept the challenge and to struggle with issues, more--much more--is
      needed. Conducting research with racial/ethnic minority populations in general,
      and African American and Hispanic peoples in particular, is necessary if nursing
      is to fulfill its societal mandate. Historically the scientific base for nursing
      practice has been described as being deficient in areas associated with cultural
      diversity. Few studies with deliberate cross-cultural or multicultural foci
      exist. According to Stevenson, laws of health and nursing must be constructed
      from research conducted with people of multiple cultures so that generalizations
      about health are valid representations of existing realities.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8474874
TI  - Laying claim to caring: nursing and the language of training, 1915-1937.

PMID- 8474875
TI  - Returning to work after childbirth: considerations for health policy.

PMID- 8474876
TI  - Nursing theory in perspective.

PMID- 8474878
TI  - Nursing Times open learning programme. M6: managing the process of providing
      care. Part (iii): Using appropriate resources (continuing education credit).

PMID- 8474877
TI  - Violence as a nursing priority: policy implications. AAN Expert Panel on
      Violence.

PMID- 8474879
TI  - Study reveals isolation and strain in HIV/AIDS workers.

PMID- 8474880
TI  - Animal rites.

PMID- 8474881
TI  - Trust betrayed.

PMID- 8474882
TI  - A private matter.

PMID- 8474883
TI  - Ticket to ride.

PMID- 8474884
TI  - Market forces.

PMID- 8474885
TI  - Goodwill or hard sell?

PMID- 8474886
TI  - Conflicting interests?

PMID- 8474887
TI  - Understanding anti-emetics.

PMID- 8474888
TI  - Safety net.

PMID- 8474890
TI  - Behavioural challenge.

PMID- 8474889
TI  - He, she or it?

PMID- 8474891
TI  - Systems of life. The nervous system. 6.

PMID- 8474892
TI  - The journal of infection control nursing. Auditing problems.

PMID- 8474894
TI  - Management module. M7: evaluation. Part (ii): The practice of evaluation.

PMID- 8474893
TI  - The journal of infection control nursing. Supply-side support.

PMID- 8474895
TI  - Confidentiality paramount in occupational health department.

PMID- 8474896
TI  - Tact urged on gender change.

PMID- 8474897
TI  - Vital support.

PMID- 8474898
TI  - Choice in childbirth.

PMID- 8474899
TI  - Rebel Rowden. Interview by Andrew Cole.

PMID- 8474901
TI  - Body politic. Reviews review.

PMID- 8474900
TI  - Voice of concern.

PMID- 8474902
TI  - Community Care Act. We have lift off!. Interview by John Gilbert.

PMID- 8474903
TI  - Community Care Act. United in uncertainty.

PMID- 8474904
TI  - Ward organization. Beating time.

PMID- 8474905
TI  - Professional development. The chosen few.

PMID- 8474906
TI  - Insignificant others?

PMID- 8474907
TI  - Teamwork. Joint account.

PMID- 8474908
TI  - Live issues--a practical response.

PMID- 8474909
TI  - Patient education. Achieving patient compliance.

PMID- 8474910
TI  - Wound care. Healing the whole person.

PMID- 8474911
TI  - Wound care. Basing care on research.

PMID- 8474912
TI  - Wound care. Preventing infection.

PMID- 8474913
TI  - Wound care. Using air fluidised therapy.

PMID- 8474914
TI  - Wound care. Comparative benefits.

PMID- 8474916
TI  - Dangerous world.

PMID- 8474915
TI  - What makes the marketplace such a good template for NHS?

PMID- 8474917
TI  - Regional cuts.

PMID- 8474918
TI  - Moores' code. Interview by Daloni Carlisle.

PMID- 8474919
TI  - Qualified excess?

PMID- 8474920
TI  - Patient's Charter--charting progress.

PMID- 8474922
TI  - Patient's Charter--power to the people?

PMID- 8474921
TI  - Patient's Charter--name-check.

PMID- 8474923
TI  - Making sense of mini-tracheostomy.

PMID- 8474924
TI  - Infection control. Born in the USSR.

PMID- 8474925
TI  - Live issues--invested interest.

PMID- 8474926
TI  - Live issues--a healthy balance.

PMID- 8474927
TI  - Accident prevention--safe as houses.

PMID- 8474929
TI  - At home with stoma care.

PMID- 8474928
TI  - Nursing development units. Division of labor.

PMID- 8474930
TI  - Stoma care--what can I eat?

PMID- 8474931
TI  - On the road--driving a hard bargain.

PMID- 8474932
TI  - On the road--policy decisions.

PMID- 8474933
TI  - Therapeutic decisions: assessing clinical fit.
AB  - Quality health care has been defined as the maximization of desired outcomes
      while minimizing undesirable consequences. Therefore, the optimal antimicrobial
      agent for a given clinical condition will be one that is the most rapidly
      effective, produces the least patient discomfort, results in minimal disruption
      of the patient's or hospital flora, and causes minimal dissatisfaction with the
      treatment program and its attendant costs. The clinical utility of antimicrobials
      is generally judged on the basis of in vitro activity, kinetic disposition,
      resistance trends, safety, and cost. Fluoroquinolones possess characteristics in
      each of these areas; for example, broad, potent gram-negative spectrum coupled
      with excellent oral absorption and tissue penetration, and relative safety and
      reduced cost compared with parenteral therapy. Drawbacks include the emergence of
      resistance among certain bacteria, particularly staphylococci and Pseudomonas
      aeruginosa, drug interactions that may compromise efficacy, and greater cost than
      other potentially useful oral antimicrobial agents. Indications for the agents'
      use can be categorized as appropriate (gram-negative osteomyelitis, complicated
      urinary tract infection, prostatitis, certain sexually transmitted diseases,
      bacterial gastroenteritis), potential (gastrointestinal tract decontamination in
      granulocytopenic patients, exacerbations of chronic obstructive pulmonary
      disease, nosocomial pneumonia and bacteremia, eradication of certain bacterial
      carrier states), or inappropriate (community-acquired pulmonary infections,
      especially aspiration pneumonitis, serious gram-positive infections,
      uncomplicated urinary tract infection, surgical prophylaxis except prostatic
      surgery). Gram-negative osteomyelitis serves as a model to demonstrate the
      fluoroquinolones as agents for quality health care. Current and future
      investigations should focus on the cost effectiveness and cost utility of the
      agents.

PMID- 8474934
TI  - Drug-drug interactions with fluoroquinolones.
AB  - Antimicrobials of the fluoroquinolone class are involved in a number of
      clinically important drug-drug interactions. Many of these interactions occur
      with all the available agents and exhibit little interpatient variability. In
      contrast, others occur only with specific fluoroquinolones and their extent
      varies markedly among subjects. The oral absorption of all fluoroquinolones is
      significantly impaired when coadministered with aluminum- and magnesium
      containing antacids and sucralfate, as well as with other metal cations such as
      calcium and iron. Concomitant use of these agents, even when dosed several hours
      apart, should be avoided. Enoxacin and ciprofloxacin impair the hepatic
      metabolism of theophylline and caffeine, leading to significantly increased serum
      concentrations. Ofloxacin and lomefloxacin have only minimal effects on xanthine
      metabolism. Case reports suggest that concomitant administration of several
      fluoroquinolones and warfarin, a drug that is also highly metabolized by the
      liver, leads to increased hypoprothrombinemic effects; prospective studies,
      however, failed to confirm this interaction. Clinicians must be aware of these
      and other potential drug-drug interactions with fluoroquinolones for optimal use
      of the agents.

PMID- 8474935
TI  - Maximizing patient outcomes of antiinfective therapy.
AB  - Drug treatment of infectious disease requires consideration of both short- and
      long-term therapy. Although in most settings patients receive antimicrobials for
      acute events, long-term management of certain infections with drugs that delay
      progression of the disease adds a new facet to pharmacotherapy. In the past,
      broad questions regarding efficacy were posed: a drug was evaluated as either
      effective or not effective for a particular disorder. The actual question is, in
      whom is a given drug at a given dosage effective? Antibiotic control,
      restriction, and pharmacokinetic dosing programs have been useful, but they are
      reactive as opposed to proactive. The expensive products of biotechnology and the
      availability of oral drugs with activity exceeding that of parenteral
      antimicrobials require a more expanded scope of clinical pharmacy practice where
      patients are identified for these therapies prospectively using statistical
      models based on disease and other readily identified factors. Predictor variables
      for patient outcomes such as retreatment with other antibiotics,
      rehospitalization, toxicity, and mortality following the use of new drugs should
      be identified. Maximizing these outcome measurements will involve strategies that
      integrate epidemiology and statistical modeling techniques with principles of
      pharmaceutical care.

PMID- 8474936
TI  - Pharmacokinetic considerations in quinolone therapy.
AB  - It is advisable to switch patients from parenteral to oral therapy as soon as
      practical. High volumes of distribution, coupled with relatively low protein
      binding, indicate that the quinolones are widely distributed outside
      extracellular fluid. Interactions with aluminum- or magnesium-containing antacids
      may be avoided by administering the antacids at least 2 hours after quinolone
      dosing. Some quinolones with high bioavailability (e.g., ofloxacin) are absorbed
      as reliably and completely after oral administration as when given parenterally,
      and dosage adjustments for these agents are unnecessary after sequential therapy.
      Treatment strategies may differ according to the route of drug elimination, and
      dosage adjustments are required in patients with renal failure who receive
      quinolones excreted primarily by the kidneys. Theophylline interactions may be
      more problematic in patients given quinolones that are primarily metabolized by
      the liver. Quinolones, which have concentration-dependent killing and a long
      postantibiotic effect, should be administered in the highest tolerated dosage. A
      method to assess the relative antibacterial efficacy of the quinolones uses the
      ratio of the Cmax:MIC90 of the organism, compared with a ratio derived from the
      NCCLS breakpoints for susceptibility.

PMID- 8474937
TI  - Prescribing considerations in fluoroquinolone therapy.
AB  - Comparative trials have shown that the new oral fluoroquinolones are as effective
      as parenteral cephalosporins and other broad-spectrum agents in treating
      infections of the urinary tract, lower respiratory tract, and skin and skin
      structure caused by most gram-negative and selected gram-positive pathogens. The
      agents are also effective in the treatment of prostatitis and osteomyelitis.
      Sequential parenteral to oral therapy has also proved useful, even in patients
      who are severely ill and are in intensive care units. This allows patients to be
      transferred out of intensive care earlier, reduces hospital stay and pharmacy
      costs, and improves quality of life. Because of the high bioavailability (> 95%)
      of ofloxacin, oral and parenteral doses are identical.

PMID- 8474938
TI  - Diagnosis and treatment of community-acquired and hospital-acquired pneumonia.
AB  - The older drugs used to treat pneumonia may still be useful in self-limiting
      infections. Newer antibiotics--augmented penicillins, trimethoprim
      sulfamethoxazole, third-generation cephalosporins, and others--are quite
      effective, but resistance can be a problem, and some patients cannot tolerate the
      adverse events associated with these agents. The fluoroquinolones are effective
      in treating pneumonia because of their broad spectra of activity against gram
      negative and gram-positive organisms, including Streptococcus pneumoniae and
      Haemophilus influenzae. They are rapidly and nearly completely absorbed after
      oral administration; bioavailability ranges up to 100% for ofloxacin and
      lomefloxacin. Concentrations attained in lung tissues and sputum generally exceed
      the minimum inhibitory concentrations for the most common respiratory tract
      pathogens. The quinolones are also well tolerated; most adverse events are mild
      and do not lead to discontinuation of therapy. Ciprofloxacin and ofloxacin are
      available in parenteral as well as oral formulations. The high bioavailability of
      oral ofloxacin (> 95%) allows a patient to be started on the parenteral form in
      the hospital and continued taking the oral form at home with no loss of efficacy,
      but with reduced costs and improved quality of life.

PMID- 8474939
TI  - Urinary tract infections in the elderly.
AB  - Urinary tract infection (UTI) is the most common infectious disease of the
      elderly and is especially prevalent in debilitated, institutionalized older
      individuals. Unlike UTI in younger women, which tends to be related to frequency
      of sexual intercourse and is uncomplicated, in the elderly it is more difficult
      to treat and its pathogenesis is related to abnormal bladder function, bladder
      outlet obstruction, vaginal and urethral atrophy, use of long-term indwelling
      catheters, and puddling related to bed rest. The spectrum of organisms causing
      infection relates to the ecology of the patients' environments; those residing in
      nursing homes and especially with permanent indwelling catheters tend to have a
      greater variety of pathogenic organisms, many of which may be relatively
      antibiotic resistant. Short-course antibiotic therapy is less effective in older
      patients, and relapse or recurrence is more common regardless of the duration of
      treatment. Asymptomatic bacteriuria is common in older patients with abnormal
      bladder function. The clinical significance of asymptomatic bacteriuria generally
      is minor, and treatment is not beneficial.

PMID- 8474940
TI  - Developing drug use evaluation criteria for parenteral fluoroquinolones.
AB  - The basic tenet of pharmaceutical care asserts that the delivery of optimal, cost
      effective pharmacotherapy can be best achieved by identifying, resolving, and
      preventing drug-related problems. Drug use evaluation (DUE) is one of the primary
      tools used to achieve these ends. Fluoroquinolone antimicrobials meet Joint
      Commission criteria for targeting for DUE: the drugs are used in populations at
      high risk for adverse drug reactions, quality assurance or infection control
      committees target them for DUE, the drugs are costly, they may be suspected or
      known to be used inappropriately, and they are prescribed frequently. Outside
      this supplement, no published DUE criteria for parenteral fluoroquinolones
      currently exist. Suggested criteria include use in patients who would otherwise
      be candidates for oral fluoroquinolone therapy (for which published criteria
      exist) but who cannot use the oral route of administration due to
      gastrointestinal conditions predisposing to malabsorption or unavailability of
      the oral route; for severe infections due to gram-negative pathogens; as a
      replacement for aminoglycosides when ototoxicity or nephrotoxicity is a
      substantial risk; targeting to resistant pathogens (i.e., not as empiric
      therapy); and targeting to therapeutic use only (not for prophylaxis). The DUE
      process is crucial for ensuring safe, effective, appropriate, and economical drug
      therapy. It is an effective mechanism for evaluating the use of new agents and as
      an educational tool for clinicians in the postmarketing period.

PMID- 8474941
TI  - Criteria for the use of intravenous ofloxacin in hospitalized adult patients:
      drug use evaluation guidelines.

PMID- 8474943
TI  - The digital revolution and patient self-empowerment.

PMID- 8474942
TI  - Pharmaceutical care and specialty practice.
AB  - The practice of pharmaceutical care is a possible goal for all pharmacists'
      professional maturation. Six issues exist in which pharmaceutical care may
      represent a radical departure from some contemporary clinical practices. Because
      no profession is capable of providing pharmaceutical care singlehandedly at an
      acceptable level of quality, it is necessary to construct systems that organize
      the necessary variety of professionals and patients for managing drug therapy. In
      such a system, pharmacists can organize specialty practice around a strong
      general practice of pharmacy that is able to coordinate drug therapy and manage
      for outcomes, organize around the practice of medicine as if pharmacy were a
      medical specialty, or merge into the organization of a hospital or other
      healthcare organization.

PMID- 8474944
TI  - The effect of training staff in office-based smoking cessation counseling.
AB  - A role for office staff members in smoking cessation counseling has recently been
      recognized and encouraged. We studied the impact of physician-staff team training
      in office-based smoking cessation counseling on staff members in 35 practices in
      Raleigh, North Carolina. Staff members who attended an educational meeting were
      compared with two groups: other staff members in their practices who did not
      attend the meeting and staff in other practices in which no one attended the
      meeting. Baseline attitudes toward and participation in smoking cessation
      activities were not significantly different among the three groups. Four months
      after the training, staff who had personally attended the meeting reported
      greater involvement in counseling activities than either of the two comparison
      groups. Attitudes toward involvement in counseling activities did not change
      significantly over the study period. Training staff members in office-based
      smoking cessation counseling may be a useful step toward increasing staff
      participation in these activities.

PMID- 8474945
TI  - Patient and physician perceptions of their relationship and patient satisfaction:
      a study of chronic disease management.
AB  - This study investigated patient and physician perceptions of their relationship
      and examined how their perceptions related to patient satisfaction. Data are
      based on 134 patient-physician interactions. Study participants included 12
      physicians (five women and seven men) and 134 male patients with a diagnosis of
      diabetes mellitus being seen on an outpatient basis. Information on patient and
      physician demographics, patient's metabolic control and functional status and
      time spent in the interaction were also collected. Results revealed that patients
      with lower levels of education were most satisfied and that physicians who viewed
      the relationship as a patient-physician partnership had more satisfied patients
      than those who viewed the relationship as physician controlled. Findings also
      indicated that physicians' gender and number of years in practice were not
      related to patient satisfaction. Practical implications include: (1) increasing
      attention to physician's perceptions of his or her relationship with individual
      patients and (2) exposing newly trained physicians to partnership types of
      relationships, if future research confirms these findings in chronic disease
      management.

PMID- 8474946
TI  - Promoting preventive care with patient-held minirecords: a review.
AB  - Although patient involvement is essential for the success of all types of
      preventive care, patient involvement in clinical prevention has been limited.
      Patient-held minirecords have recently received support from public health
      authorities, providers and the public as a means to improve patient involvement
      in preventive care for adults. This paper reviews the history and current
      developments in patient-held minirecord use for preventive care. METHODS: A
      literature review was performed using sources obtained from electronically
      searching the Medline database from 1966 to the present and using reference lists
      to obtain secondary sources. The author's collection of privately and
      governmentally produced minirecords was also utilized. FINDINGS: Patient-held
      minirecords have been widely and successfully employed to improve preventive care
      for children, particularly with regard to immunizations. They have not been
      widely used to promote adult preventive care. Several clinical trials have found
      that their use can lead to improved preventive care for the general adult
      population. Potential advantages of patient-held minirecords include: improved
      performance rates of preventive care, improved continuity of preventive care, low
      cost and improved practice promotion for prevention-oriented providers. Potential
      barriers to the use of patient-held minirecords include: the traditional power
      relationship of physicians and patients, physicians' reticence to share records
      with patients and time and effort costs. The optimal characteristics of a patient
      held minirecord for adult preventive care remain to be delineated by research and
      evaluation. SIGNIFICANCE: A patient-held minirecord is an inexpensive, practical
      intervention that can help build patient involvement and improve the quality of
      preventive care for adults as well as children.

PMID- 8474947
TI  - Idiopathic hydropericardium as a cause of death of a preterm neonate.
AB  - We report a case of a very premature infant who died on day 17 of life because of
      clinically unsuspected cardiac tamponade due to a pericardial effusion with no
      gross or microscopic features of myocardial inflammation or perforation. The
      pericardial effusion probably accumulated for 8 days prior to his death, as
      evidenced by chest X-ray films. The only relevant microscopic finding was a
      prominent pericardial and myocardial interstitial edema. Although Staphylococcus
      epidermidis line sepsis, central venous catheter trauma, hypoalbuminemia, anemia,
      and heart failure could be possible contributory factors, no definitive cause of
      the pericardial effusion was found and the etiology of this condition remains
      obscure.

PMID- 8474948
TI  - Antenatal cerebral necrosis in monochorionic twins.
AB  - Antenatal cerebral white matter necrosis occurs relatively frequently in
      monochorionic twins, particularly when one twin has died in utero or in the twin
      twin transfusion syndrome. A case of antenatal cerebral necrosis in both of
      liveborn monochorionic twins is presented. It is proposed that placental artery
      to-artery or vein-to-vein anastomoses may predispose twin fetuses to hemodynamic
      instability. Fluctuations in blood pressure or blood volume may then result in
      cerebral necrosis, without requiring the death of one twin or transfer of a blood
      borne factor from one twin to the other.

PMID- 8474949
TI  - Metastasizing cervical teratoma of the fetus.
AB  - We present one case with a metastasizing cervical teratoma in a newborn infant
      who died of respiratory failure due to extensive cervical tumor masses and
      multiple pulmonary tumor metastases. This case provides evidence that very rarely
      malignant behavior may occur in congenital cervical teratomas, the prenatal
      diagnosis of which may be important for any further therapeutic management.

PMID- 8474950
TI  - Limb reduction defects--autopsy study.
AB  - We present a case-control study of limb reduction defects taken from autopsy
      material of the Pathology Department of the University of Athens from the year
      1986 to 1990. During this period 1725 perinatal autopsies were performed, in
      which 34 neonates were found to have had a limb reduction defect (LRD) (1.97%).
      The cases were divided into five subgroups: transverse, intercalary longitudinal,
      split, and multiple types of LRD. Of all the cases, 44.17% involved the upper
      limb, 41.17% the lower limb, and 14.70% both. Coexisting nonlimb malformations
      were found in 17 cases (50%), 5 with recognized syndromes and 12 with other
      associated defects. Risk factors correlated with LRD were found to be low birth
      weight (2500 g or less) and threatened abortion.

PMID- 8474951
TI  - Gastroesophageal reflux and sudden infant death syndrome.
AB  - The possible role of gastroesophageal reflux in the pathogenesis of the sudden
      infant death syndrome (SIDS) has not yet been clearly defined, although it does
      appear that infants with significant reflux are at greater risk of respiratory
      complications. A study was undertaken to characterize more precisely the
      histological features of esophageal mucosa taken from a series of infants who
      died of SIDS to determine the range of changes present. Full-length strips of
      mucosa were examined microscopically for reflux-related changes of basal layer
      hyperplasia, papillary elongation, and intraepithelial eosinophilia. Eight
      infants (21%) showed changes considered diagnostic of reflux esophagitis, 17
      infants (45%) showed minor nondiagnostic changes, and 13 infants (34%) showed no
      histologic abnormalities. These findings demonstrate considerable morphological
      heterogeneity in a group of infants presenting with sudden and unexpected death.
      The absence of, or presence of only very minor, pathological alterations within
      the esophageal mucosae of 79% of infants suggests that reflux of a degree
      sufficient to cause diagnostic histologic changes is found in only a minority of
      infants presenting with SIDS.

PMID- 8474952
TI  - Histological investigations into the relationship between low birth weight and
      spontaneous bowel damage in the neonatal piglet.
AB  - Experimental models for the study of neonatal necrotizing enterocolitis (NEC)
      using the small for gestational age (SGA), viable, term-delivered piglet have
      recently been described. A spontaneous model, especially of the early phases of
      NEC, has not been reported. Pig litters usually include one or two lethally or
      sublethally SGA "runted" piglets culled from the litters by breeders. We have
      examined four groups of piglets: group A, SGA, lethally runted animals who died
      spontaneously before 12 h postpartum; group B, SGA, sublethally runted animals,
      showing some signs of vitality and left alive for 24 h before culling; group C,
      appropriate for gestation age (AGA) animals subjected to hypoxia and
      hyperviscosity known to induce NEC-like lesions; and group D, AGA control
      animals. Acute, multiorgan pathology common to pre- and dysmature neonates was
      seen in groups A and B. Animals in group B also showed evidence of early
      postnatal complications such as urinary tract infection and diffuse pulmonary
      damage. All animals of groups A and B showed unequivocal early changes in the
      distal ileum, with mucosal and submucosal necrosis, suggestive of ischemic
      injury. One animal in group B had developed mural necrosis involving the whole of
      the submucosa. No similar changes were seen in control group D animals. The very
      SGA, lethally and sublethally runted, spontaneously term-delivered piglet offers
      sufficient spontaneous early NEC-like changes for studies of the early
      pathogenesis of this condition.

PMID- 8474953
TI  - Intrathyroidal parathyroid.
AB  - Fifty-eight human fetal thyroid glands obtained at autopsy were systematically
      studied for the presence of intrathyroidal parathyroid tissue. The latter was
      found in 13 thyroid lobes from 12 fetuses. It was located in a subcapsular
      position in 9 of 58 cases and lying deep in thyroid tissue in 4 of 58. Our
      findings suggest that intrathyroidal parathyroid tissue is not such a rare
      finding and should always be considered especially for the clinical and surgical
      management of patients with primary hyperparathyroidism due to parathyroid
      hyperplasia.

PMID- 8474954
TI  - Polymerase chain reaction facilitates archival autopsy studies of sickle cell
      disease.
AB  - Archival autopsy studies of sickle cell disease have often been hampered by
      inadequate documentation of the genotype. Although the polymerase chain reaction
      (PCR) has been applied to the prenatal diagnosis of sickle cell disease, its use
      has not been reported in archival studies of sickle cell disease. In this study,
      DNAs from formalin-fixed, paraffin-embedded archival tissues were amplified by
      PCR and analyzed by dot-blot hybridization using allele-specific
      oligonucleotides. These S and C genotypes for 9 of 10 archival specimens studied
      blindly were correctly identified by PCR. The tenth specimen consistently failed
      to amplify by PCR, yielding no result. These data demonstrate the utility of PCR
      for retrospective identification of the genotype of sickle cell disease. This
      application of PCR will significantly expand the number of autopsy cases suitable
      for retrospective studies of the morbidity and mortality of sickle cell disease.

PMID- 8474955
TI  - Contemporary approaches toward understanding the pathogenesis of Hirschsprung
      disease.
AB  - Hirschsprung disease (HD), or congenital aganglionosis coli, is a birth defect
      with heterogeneous causes. In an effort to understand the molecular and cellular
      bases for this disorder, researchers have investigated enteric neurodevelopment
      in normal animals and compared these findings with observations of inbred animal
      strains that develop aganglionosis coli due to mutations at specific genetic
      loci. Recent technological advances, including use of retroviral and fluorescent
      lineage makers, immunohistochemical probes, and transgenic mice, have provided
      insights into the origins, behavior, and properties of enteric neuroblasts.
      Experiments with mutant murine embryos indicate that aganglionosis coli results
      from primary failure of neural crest-derived neuroblasts to colonize the distal
      colon. In at least one model, impaired colonization by neuroblasts may be
      secondary to environmental defects restricted to colonic mesenchyme. The
      discovery that human piebald trait, a hereditary disorder with a high incidence
      of HD, is caused by mutations in a growth factor receptor highlights the
      importance of regulatory intercellular interactions between nonneuroblastic
      mesenchyme and neuroblasts during normal development of the enteric nervous
      system. These observations, coupled with advances in molecular genetics, set the
      stage for dramatic progress in this field of research in the near future.

PMID- 8474956
TI  - Nonimmune hydrops fetalis, hydramnios, microcephaly, and intracranial meningeal
      hemangioendothelioma.
AB  - Necropsy findings in a male stillborn at 31 weeks gestational age included
      nonimmune hydrops, hydramnios, and microcephaly secondary to a
      hemangioendotheliomatous malformation at the tentorium. The vascular lesion was
      composed by large and small tortuous endothelium-lined vessels and leiomuscular
      septa. The lesion is thought to be related to the more frequent arteriovenous
      malformation of the vein of Galen.

PMID- 8474957
TI  - Can methylmercury present in fish affect human health?

PMID- 8474958
TI  - The effects of cyclic imides on lipid absorption from the intestine and on bile
      lipids and bile acids of Sprague Dawley rats.
AB  - The cyclic imides, o-(N-phthalimido)acetophenone, 2,3-dihydrophthazine-1,4-dione
      and N(4-methyl phenyl)diphenimide, were evaluated for their effects on bile
      lipids, bile acids, small intestinal absorption of cholesterol and cholic acid
      and liver and small intestinal enzyme activities involved in lipid metabolism.
      The agent at 20 mg/kg/day orally elevated rat bile excretion of lipids, e.g.
      cholesterol and phospholipids, and increased the bile flow rate. These agents
      altered the composition of the bile acids, but there was no significant increase
      in lithocholic acid which is most lithogenic in rats. The three agents did
      decrease cholesterol and cholic acid absorption from isolated in situ intestinal
      duodenum loops in the presence of drug. Hepatic and small intestinal mucosa
      enzyme activities, e.g. ATP-dependent citrate lyase, acyl CoA cholesterol acyl
      transferase, cholesterol-7-alpha hydroxylase, sn-glycerol-3-phosphate acyl
      transferase, phosphatidylate phosphohydrolase, and lipoprotein lipase were
      reduced. However, the cyclic imides did not accelerate HMG-CoA reductase
      activity, the regulatory enzyme for cholesterol synthesis, in a manner which
      would accelerate biliary cholesterol excretion. There was no evidence of hepatic
      cell damage afforded by the drugs based on clinical chemistry values which would
      induce alterations in bile acid concentrations after treatment of the rat.

PMID- 8474959
TI  - Anti-ulcer activity of carbenoxolone and ISF 3401 on PGE2 release in rat gastric
      mucosa.
AB  - We have investigated the ability of carbenoxolone and ISF 3041, a new
      carbenoxolone derivative, to protect the rat gastric and intestinal mucosa
      against lesions induced by acetylsalicyclic acid (ASA) and indomethacin.
      Moreover, we determined the capacity of the rat gastric mucosa to release PGE2
      both in vitro and ex vivo, in the presence or absence of carbenoxolone or its
      analogs. These compounds are effective against lesions induced by ASA and
      intestinal damage induced by indomethacin. The amount of PGE2 obtained from
      incubated rat gastric mucosal pieces by in vitro and ex vivo indicate that
      carbenoxolone and ISF 3401 cause a concentration related increase of PGE2 with
      exception of the highest concentration. Increased prostaglandin content of
      gastric mucosa can partly explain the gastric and intestinal protection of these
      compounds and additional mechanisms could be involved in this action.

PMID- 8474960
TI  - The inhibition of platelet aggregation by activated macrophages is blocked by
      dexamethasone.
AB  - The effect of dexamethasone on the ability of activated J774 macrophages to
      inhibit platelet aggregation was investigated. After 24h incubation with
      lipopolysaccharide and gamma-interferon, J774 cells generated large amounts of
      nitric oxide and inhibited platelet aggregation. Incubation of the cells with
      dexamethasone (0.01-10 microM) caused a concentration-dependent inhibition of
      both the NO2- production and the anti-aggregating activity of the cells. The
      inhibitory effect of dexamethasone was blocked by the glucocorticoid antagonist
      RU 38486. These data suggested that the protective effect of glucocorticoids in
      endotoxin-induced hypotension and their immunosuppressive action may both depend,
      at least in part, on the inhibition by these steroids of the induction of the
      nitric oxide synthase.

PMID- 8474961
TI  - Effects of drugs used in the therapy of detrusor hyperactivity on the volume
      induced contractions of the rat urinary bladder.
AB  - In this study we examined the effects of the drugs most commonly utilized in the
      therapy of overactive detrusor, on the volume-induced contractions of rat urinary
      bladder. Anticholinergics such as propantheline bromide and emepronium bromide,
      as well as oxybutynin decreased the amplitude of the voiding contractions after
      intravenous (i.v.) administration in a dose-dependent way. These
      anticholinergics, on the other hand, generally increased the frequency of the
      contractions. Nifedipine dose-dependently reduced the amplitude of the
      contractions. Flavoxate induced a dose-related decrease in the frequency without
      effects on the amplitude of the peaks. Its main metabolite 3-methylflavone-8
      carboxylic acid (MFCA) was inactive after i.v. administration. Terodiline was
      active on the amplitude and apparently on the frequency of the voiding
      contractions. The alpha-adrenoceptor antagonist prazosin, as well as
      indomethacin, inhibited only the frequency of the voiding contractions. All the
      drugs active in reducing the frequency of the voiding contractions after i.v.
      administration, proved effective also after intracerebroventricular (i.c.v.)
      injection. The model of the volume-induced contractions of rat urinary bladder,
      seems to be a useful tool to evaluate in vivo the effects of a compound on the
      bladder, allowing the possibility of distinguishing among antimuscarinics and
      calcium antagonists, which peripherally decrease bladder contractility, and other
      drugs inducing a decrease in the frequency of the voiding reflex acting on the
      micturition centre(s) in the central nervous system (CNS).

PMID- 8474962
TI  - Picroliv protects against aflatoxin B1 acute hepatotoxicity in rats.
AB  - The hepatoprotective activity of Picroliv, a standardized iridoid glycoside
      fraction of Picrorhiza kurroa, has been investigated by studying the protection
      of biochemical and histological changes induced in livers of rats given single
      oral doses (7 mg/kg) of aflatoxin B1. Administration of aflatoxin B1 resulted in
      a significant increase in 5'-nucleotidase, r-glutamyl transpeptidase, acid
      ribonuclease, total lipids, cholesterol and lipid peroxides in liver and
      transaminases, alkaline phosphatase and bilirubin in serum. However, the activity
      of glucose 6-phosphatase and levels of cytochrome P450, cytochrome b5, DNA, RNA,
      proteins and glycogen in liver and total proteins in serum decreased. The liver
      histology showed ballooned hepatocytes, degeneration, microvesicular fat, focal
      necrosis, bile duct hyperplasia and proliferation of oval and spindle cells in
      portal tracts. When Picroliv (25 mg/kg x 7 days) was given to aflatoxin B1
      toxicated rats, the majority of the biochemical and histological changes were
      significantly protected. The findings indicate a hepatoprotective activity of
      Picroliv against aflatoxin B1 toxicity in rats.

PMID- 8474963
TI  - Temazepam: pharmacological profile of a benzodiazepine and new trends in its
      clinical application.

PMID- 8474964
TI  - Polymorphism of debrisoquine and mephenytoin hydroxylation among Estonians.
AB  - Debrisoquine and S-mephenytoin hydroxylation polymorphisms were studied in 156
      unrelated native Estonians. The hydroxylation phenotypes were assessed by
      coadministration of mephenytoin with debrisoquine or dextromethorphan. The
      frequency of the poor metaboliser phenotype of debrisoquine/dextromethorphan was
      4.5% (95% confidence interval 1.2-7.8%), and that of mephenytoin was 3.9% (95%
      confidence interval 0.9-6.9%) among Estonians, which is very similar to what has
      been reported in other Caucasian populations.

PMID- 8474965
TI  - Toxicity of vitamin D analogues in rats fed diets with standard or low calcium
      contents.
AB  - Sprague-Dawley rats were fed either a standard diet with 0.9/0.7% Ca/P or a
      semisynthetic low-calcium diet with 0.5/0.4% Ca/P and treated orally for 28 days
      with 1 alpha-hydroxycholecalciferol [1 alpha (OH)D3], a synthetic analogue of the
      physiologically active form of vitamin D3, 1 alpha,25-dihydroxycholecalciferol [1
      alpha,25(OH)2D3], at dose levels of 0.2 and 2.0 micrograms kg/day. The high dose
      caused severe hypercalcaemia with retarded growth, nephrosis, and structural bone
      changes in rats fed the standard diet. The same dose caused only slight
      hypercalcaemia without growth retardation or bone changes, and only minimally
      affected the kidneys in rats fed the low-calcium diet. Hypercalcaemia with less
      pronounced pathological changes was found in the standard diet low-dose rats,
      whereas no hypercalcemia or pathological changes were found in the low-calcium
      diet low-dose group. The rats fed the low-calcium diet tolerated 1 alpha(OH)D3 at
      dose levels up to 10 times higher than rats on the standard diet. The use of
      diets low in calcium and low in phosphorus will thus allow the administration of
      higher dosages of vitamin D compounds without causing hypercalcaemia. This may
      permit a better evaluation of the pharmacologic and toxic effects not directly
      associated with the calcium-regulating properties of vitamin D metabolites and
      analogues.

PMID- 8474966
TI  - Tolerance to hexobarbital induced by short-term treatments with diazepam and
      tested with an EEG-threshold test in male rats.
AB  - Male Mol: SPRD rats were treated with 5 or 20 mg/kg of diazepam for 4 days. The
      treatment was repeated at two different ages. Diazepam was either dissolved in
      Intralipid (KABI, Sweden) or dispersed in gummi arabicum. Tolerance induced by
      the treatment was tested with an EEG-threshold technique where hexobarbital was
      infused intravenously on day 1, 4, 7 and 14 of the abstinence. The threshold was
      the dose of hexobarbital needed to induce a burst suppression of 1 sec. or more
      (silent second). After the first diazepam treatment significant increase in the
      hexobarbital threshold doses were recorded in all but one of the diazepam treated
      groups. The pattern varied depending on dose, age and solvent. After the second
      treatment tolerance was seen only when diazepam had been dissolved in Intralipid.
      Short term treatment with diazepam can induce cross-tolerance to hexobarbital
      which probably is due to an increased excitation (physical dependence) in
      abstinence after treatment with diazepam.

PMID- 8474967
TI  - Defective neutrophil function in workers occupationally exposed to lead.
AB  - Chemotaxis and nitroblue tetrazolium reduction were measured in peripheral blood
      neutrophils of workers occupationally exposed to lead. These two neutrophil
      functions were significantly reduced, as compared to controls, even in those
      workers with blood lead levels and urinary delta-aminolevulinic acid (ALA-U)
      concentrations below the currently accepted biological limit values of 60
      micrograms/dl and 6 mg/l, respectively. The immunosuppressive effects of
      relatively low level lead absorption suggests that immune dysfunction may be a
      sensitive indicator of lead exposure.

PMID- 8474968
TI  - Metabolism of prednisone in kidney transplanted patients with necrosis of the
      femoral head.
AB  - Interindividual variation of the metabolism of prednisolone and of the
      susceptibility to glucocorticoids might be possible factors contributing to the
      development of osteonecrosis after renal allotransplantation. As this aspect has
      not been properly investigated previously, we compared, in the present study, the
      metabolism of total and free prednisolone in 6 renal allotransplanted patients
      who subsequently developed osteonecrosis of the femoral head and the metabolism
      of 6 matched controls, who did not develop osteonecrosis. There was no difference
      in age, bodyweight, total serum protein or albumin, or in liver or renal
      function. The baseline cortisol was 54 +/- 23 micrograms in patients with
      necrosis, and 102 +/- 53 micrograms/l in patients without necrosis (n.s.).
      Likewise there was no difference in the peak concentration of prednisolone (420
      +/- 43 vs. 394 +/- 42 micrograms/l, n.s.), the bioavailability (0.57 +/- 0.09 vs.
      0.61 +/- 0.05, n.s.) or in the apparent volume of distribution at steady state
      (Vdss, 0.37 +/- 0.09 vs. 0.37 +/- 0.04 l/kg, n.s.). The clearance of prednisolone
      in patients with osteonecrosis was 33% lower (0.79 +/- 0.11 vs. 1.18 +/- 0.13
      ml/min./kg b.wt., P < 0.05) and t1/2 was correspondingly 33% longer (246 +/- 18
      min. vs. 184 +/- 15 min., P < 0.05) than in patients without osteonecrosis.
      However, there was no difference in the apparent volume of distribution of free
      prednisolone (2.07 +/- 0.36 vs. 1.69 +/- 0.28 l/kg, n.s.), in the t1/2 (152 +/-
      30 vs. 107 +/- 20 min., n.s.), or in the clearance (7.33 +/- 2.12 vs. 7.82 +/-
      1.18 ml/min./kg) between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474969
TI  - 2-Naphthol metabolism and metabolite transport in the isolated guinea pig mucosa:
      further evidence for compartmentation of intestinal drug metabolism.
AB  - As an extension of a previous study on the metabolism of 14C-1-naphthol (1-N) by
      the isolated guinea pig mucosa (Sund & Lauterbach 1986), the isomeric compound 2
      naphthol (2-N, 50-130 nmol/ml) has now been examined. 14C-Labelled drug was added
      to the luminal or contraluminal fluid bathing the two sides of jejunal or colonic
      mucosal sheets in a symmetrical set up. After aerobic incubation for 45 min. at
      37 degrees, the fluid compartments and the tissue were analysed for parent drug
      and metabolites. Like 1-N 2-N was transformed into its sulphate and glucuronide.
      In the jejunum, 2-N was more extensively sulphated than 1-N, whereas in the colon
      the metabolite profiles (sulphate:glucuronide ratio) of the two isomers were
      similar. Generally, the metabolism rate of 2-N, its metabolite profile and
      metabolite transport pattern (lumen: blood distribution ratio) as well as the
      tissue accumulation of parent drug and metabolites, depended on the side of drug
      administration and on the tissue studied. Thus, changing the drug administration
      had a pronounced impact on the jejunal metabolism and transport, but caused only
      minor effects in the colon. In summary, this study emphasizes that drug
      metabolism and metabolite transport differ in the small and large intestine. The
      data further support the hypothesis that jejunal drug metabolism takes place in
      two compartments, of which the most active one is accessible from the lumen side
      and the other from the blood side. The possibility that colonic drug metabolism
      may also involve compartmentation should be considered although the present study
      provided very little evidence for this.

PMID- 8474970
TI  - Increase in antioxidant activity in procainamide-treated rats.
AB  - Recent studies suggest that in vivo procainamide oxidation underlies induction of
      autoimmunity by this drug. Since drug metabolism may be accompanied by generation
      of reactive oxygen species, plasma and liver thiobarbituric acid reacting
      substances (TBARS), activity of erythrocyte and liver superoxide dismutase,
      catalase, selenium-dependent glutathione peroxidase (Se-GPX), and plasma
      antioxidant activity in procainamide treated rats were evaluated. Procainamide
      administration increased liver lipid peroxide levels, intensified the activity of
      liver catalase and erythrocyte superoxide dismutase, as well as plasma
      antioxidant activity. The remaining biochemical parameters in the treated rats
      were within control values, except for the decreased erythrocyte catalase
      activity. We conclude, that the increased activity of free radicals observed in
      the treated rats could contribute to the development of procainamide induced side
      effects.

PMID- 8474971
TI  - Recirculating, retrograde heart perfusion according to the Langendorff method for
      evaluation of MTG--methyl-2-tetradecylglycidate, McNeil 3716--cardiomyopathy.
AB  - Recirculating, retrograde heart perfusion according to the Langendorff method was
      used in an attempt to further elucidate the cardiotoxicity of methyl-2
      tetradecylglycidate (McNeil 3716, MTG) and the eccentric hypertrophy elicited by
      the compound. In subchronic experiments female rats were exposed to MTG 2 x 10
      mg/kg and 2 x 25 mg/kg per day for 4 weeks. At various times hearts were perfused
      ex vivo for up to 2 hr with either 5 mmolar glucose or 0.5 mmolar palmitate as
      substrate. Substrate uptake (glucose or palmitate) and enzyme release (LDH-lactic
      dehydrogenase or CPK-creatine-phosphate kinase) were assessed during perfusion.
      Biochemical analysis (ATP, ADP, AMP, c-AMP, CP, creatine, pyruvate, lactate,
      glucose-6-phosphate, glycogen, phospholipids, triglycerides and non-esterified
      fatty acids) were done in hearts before (drug effect) and after perfusion (stress
      of perfusion). Besides changes in energy metabolism and high-energy phosphate
      production, as observed in previous experiments (Bachmann et al. 1984) massive
      changes were seen in energy reserves in heart tissue (ATP, CP, glycogen,
      phospholipids and triglycerides). As expected, MTG led to significant increases
      also in non-esterified fatty acids content in hearts.

PMID- 8474972
TI  - The relative importance of mutagens and carcinogens in the diet.
AB  - Known mutagens and carcinogens in the diet were compiled and the risk of cancer
      was estimated on the basis of average exposure levels in Switzerland and
      carcinogenic potencies from rodent bioassays. The analysis showed that, except
      for alcohol, the sum of all known dietary carcinogens could only explain a few
      percent of the cancer deaths attributed by epidemiologists to dietary factors.
      The discrepancy was explained by a "carcinogenicity" of excess macronutrients.
      This hypothesis was based on an evaluation of dietary restriction experiments in
      rats and mice, where a dramatic reducing effect on spontaneous tumour formation
      was seen. From these experiments, a "carcinogenic potency" was deduced for food
      in excess (TD50 approximately 16 g/kg per day). Overnutrition in Switzerland was
      converted into excess food intake and the cancer risk estimated on the basis of
      the TD50 value. The resulting risk of 60,000 cases per one million lives would
      allow to explain by overnutrition almost all "diet-related" cancer deaths in
      humans.

PMID- 8474973
TI  - Carcinogenicity and drinking water.
AB  - Water is a powerful solvent that readily dissolves many natural and synthetic
      substances from the environment (e.g. inorganic salts, humic acids and pesticide
      residues). The processes of purification, disinfection and preparation and
      storage necessary to provide and distribute drinking water may introduce further
      chemicals, including some used for these purposes and others derived by
      interaction between them and the compounds of natural origin. The composition of
      drinking water, therefore, is complex and varies between sites and with the
      seasons. Modern technology is employed to minimise the amounts of many of these
      substances, but some may persist, including derivatives generated by halogenation
      and ozonation for disinfection. Some of the substances are genotoxic in the
      laboratory and a few are proven experimental carcinogens--all at much higher
      concentrations than those normally found in a drinking water supply. Many
      ecological and epidemiological surveys have been done to compare the occurrence
      of various types of tumour in man with exposure to different types of drinking,
      but no consistent or reliable association has been found. There are serious and
      probably irremediable methodological weaknesses in these attempts, because of the
      difficulty of defining the nature of the waters consumed over a major part of
      life, and the variable composition of waters. The surveys do not permit even a
      realistic assessment of the upper confidence limit of the exclusion of the risk.
      Thus, although there is some experimental indication of the possible presence of
      carcinogenic substances in most or all drinking waters, and of how they are
      formed, the concentrations are very low and there is no realistic evidence that
      they have caused harm to man.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8474974
TI  - Cancer-protective factors in fruits and vegetables: biochemical and biological
      background.
AB  - Cancer-protective factors are present in several fruits, vegetables and commonly
      used spices and herbs. They can be divided into several different groups, based
      on their chemical structure, e.g. polyphenols, thiols, carotenoids and retinoids,
      carbohydrates, trace metals, terpenes, tocopherols and degradation products of
      glucosinolates (i.e. isothiocyanates, indoles and dithiothiols) and others. Among
      each of these groups of compounds are substances, which may exert their cancer
      protective action by more than one biochemical mechanism. The biochemical
      processes of carcinogenesis are still not known in detail and probably varies
      with the cancer disease in question. Accordingly, the description of the
      biochemical backgrounds for the actions of cancer-protective factors must be
      based on a simplified model of the process of carcinogenesis. The model used in
      this presentation is a generalised initiation-promotion-conversion model, in
      which initiators are thought to be directly or indirectly genotoxic, promoters
      are visualised as substances capable of inferring a growth advantage on initiated
      cells and converters are believed to be genotoxic, e.g. mutagens, clastogens,
      recombinogens or the like. Experimental evidence for the mechanisms of action of
      cancer-protective agents in fruits and vegetables that protect against initiation
      include the scavenging effects of polyphenols on activated mutagens and
      carcinogens, the quenching of singlet oxygen and radicals by carotenoids, the
      antioxidant effects of many compounds including ascorbic acid and polyphenols,
      the inhibition of activating enzymes by some flavonols and tannins, the induction
      of oxidation- and of conjugation (protective) enzymes by indoles, isothiocyanates
      and dithiothiones, the shielding of sensitive structures by some polyphenols and
      the stimulation of DNA-repair exerted by sulphur-containing compounds. Mechanisms
      at the biochemical level in anti-promotion include the antioxidant effects of
      carotenoids and the membrane stabilizing effects reported with polyphenols, the
      inhibition of proteases caused by compounds from soybeans, the stimulation of
      immune responses seen with carotenoids and ascorbic acid and the inhibition of
      ornithine decarboxylase by polyphenols and carotenoids. A few inhibitors of
      conversion have been identified experimentally, and it can be argued on a
      theoretical basis, that many inhibitors of initiation should also be efficient
      against conversion. The mechanisms of anticarcinogenic substances in fruits and
      vegetables are discussed in the light of cancer prevention and inhibition.

PMID- 8474975
TI  - Issues and controversies surrounding qualitative strategies for identifying and
      forecasting cancer causing agents in the human environment.
AB  - Certain chemicals, mixtures of chemicals, exposure circumstances, life-styles and
      personal or cultural habits, occupations, viruses, living conditions, and
      physical agents have been causally associated with cancers in humans. Most
      however are not considered potentially carcinogenic, and the proportion of
      'agents' eventually identified to cause cancer is projected to be relatively low.
      Current methods to identify carcinogenic potential of chemicals rely largely on
      short-term in vitro and in vivo tests, mid- & long-term in vivo assays, molecular
      mechanisms, epidemiological investigations, and structural-activity-effect
      relationships. Thus, the scientific and public health communities must continue
      to utilize available means and concomitantly strive to develop newer methods and
      tools to more easily, quickly, cheaply, and reliably identify carcinogens in the
      human milieu. Since adequate human studies are typically absent, the most useful
      method for identifying potential human carcinogens continues to be long-term
      carcinogenesis experiments. Agents identified as causing cancers in humans have
      been shown to cause cancer in animals, and this knowledge, together with
      similarities in mechanisms of carcinogenesis across species, led to the
      scientific logic and public health strategy that chemicals shown clearly to be
      carcinogenic in animals should be considered as being likely and anticipated to
      present cancer risks to humans. The quest of hazard identification efforts is
      cancer prevention, largely by reducing or eliminating exposures to chemicals that
      cause cancer and other diseases.

PMID- 8474976
TI  - General preventive measures against carcinogenic exposure in the external
      environment.
AB  - Different measures are used to prevent unacceptable carcinogenic exposure from
      different sources in the external environment, be it accumulated carcinogens from
      previous pollution, exposure related to life-style, and exposure related to
      living standards and the organization of the community as a whole. A precondition
      for goal-directed prevention is knowledge of exposures to carcinogens and
      measures to minimize or substitute carcinogens in products and in emissions. One
      of the most significant sources of carcinogens in the outdoor air in many Western
      countries is the traffic, especially diesel-powered vehicles. Necessary
      preventive measures include restriction of carcinogenic exhaust from the
      individual vehicle, plans for the community to diminish transportation needs, as
      well as to changing the usual behaviour of the individual. Unlike exposure to
      carcinogens in the surrounding air, exposure to accumulated carcinogens in ground
      water and in soil at polluted sites may be diminished by the pattern of use.
      International aspects are involved in for instance minimizing the risk of getting
      skin cancer from sunlight. Besides protecting vulnerable individuals there should
      be a global preservation of the ozone layer. Lowering the risk of long
      transported air pollution, like radioactivity from accidents at nuclear power
      stations, demands international efforts to increase safety measures and
      information about accidents.

PMID- 8474977
TI  - On the substitution for carcinogens in the working environment.
AB  - The ultimate solution in prevention of occupational cancer risks would be to
      remove carcinogens from the working environment. Elimination of carcinogenic
      substances can be achieved by replacement of the carcinogen with non
      carcinogen(s) having the same functionality, or by using a different process that
      produces adequate results without the use of carcinogenic agents. This paper
      presents selected methods and tools, which have been used for substitution
      purposes in practice. These are: 1. a strategy for substitution, 2. a tool for
      creating ideas on how to substitute, 3. a software package, SUBTEC, for solving
      some technical and industrial hygiene problems, and 4. a proposal for a strategy
      to deal with organizational and psychological barriers encountered when changes
      are to be introduced.

PMID- 8474978
TI  - Dietary guidelines and food recommendations in Denmark. Nordic Committee of
      Foods, Nordic Council of Ministers, National Research Council, Denmark.
AB  - In Denmark the official dietary guidelines and food recommendations are expressed
      in the Five Dietary advices and the Danish food circle. Such guidelines are
      entirely different from recommendations on nutrient intakes, which are expressed
      in terms of exact values and established through a more formal procedure. Some of
      the most fundamental principles for food recommendations given to the public are
      that they are perceived as consistent and based on a firm consensus, and that
      their relevance and translation into practical action is obvious to the public.
      When the situation in Denmark is compared to these principles the main issue
      turns out to be neither lack of consistency in recommendations issued by
      government agencies and voluntary health organisations, nor is it lack of
      consensus among the experts about the fundamental messages of the guidelines. A
      more important problem is that the public does not distinguish between formal
      recommendations from authorized sources, and a variety of advices from other
      sources as well as non-formal comments from individual scientists. A cause of
      serious concern is the fact that the Danish public seems to lack a realistic
      picture of what the dietary guidelines imply in terms of foods. A number of
      contradictions is built into the process of communicating dietary recommendations
      effectively to the public. These can only be solved if the process is planned on
      a long-term basis.

PMID- 8474979
TI  - Some ethical considerations and the status of dietary advice.
AB  - Dietary guide-lines are currently given to whole populations whether the
      recipients have asked for it or not, and this raises ethical and practical
      problems. If we have not been asked for advice, what right do we have to tell
      people what they "ought" to eat? Are we sufficiently sure of the benefits of
      following our advice? Could we, in fact, be wrong about it? Are we sure of the
      absence of "side effects" of our advice? If not, are we sure that the balance
      between risk and benefit is favourable? Might our advice, in fact, do more harm
      than good? Would it not be better to restrict our advice to those at high risk of
      diet- related cancer? These issues are all discussed. Furthermore, the
      conclusions from the European Cancer Prevention (ECP) symposium and workshop on
      public education on diet and cancer are presented. The major conclusion is that
      the concept of general guide-lines should be abandoned in favour of guide-lines
      targeted to specific groups. In addition, it is concluded that the recent
      evidence had led to considerable confusion regarding dietary fibre and cancer,
      and also regarding dietary fat and cancer. The recent evidence strengthens the
      association between high intake of fresh fruit and vegetables and low risk of
      cancers at a number of sites.

PMID- 8474980
TI  - Legislation by the European Community on carcinogens.
AB  - A brief overview is given of the legislation in the European Community concerning
      the classification and labelling, marketing and use, occupational exposure, etc.
      of carcinogenic agents. This includes data on the regulation of 739 agents which
      have been evaluated for carcinogenicity by the International Agency for Research
      on Cancer and/or the European Community. These data have been collected in a
      computerized data base. Although no comprehensive evaluation of the legislation
      is attempted, it is suggested that a number of carcinogenic agents still need
      attention, and that the labelling requirements should be supplemented with more
      restrictive legislation.

PMID- 8474981
TI  - Regulating carcinogenic risks from foodstuffs: present Danish approaches.
AB  - The aim of the present Danish regulatory toxicological efforts is to identify and
      eliminate human carcinogens introduced in the human food supply directly or
      indirectly through the activity of man. The efforts are directed towards food
      additives, contaminants and food itself, both individual food items and dietary
      habits. The overall goal is to bring down the incidence of cancer. The scientific
      rationale for achieving this goal is discussed based upon recent knowledge. It is
      suggested that more scientific efforts should be directed towards determining the
      qualitative and quantitative role of the natural food constituents in human
      cancer causation.

PMID- 8474982
TI  - Report from the working group on cancer and the non-occupational environment.

PMID- 8474983
TI  - Report from the working group on occupational cancer.

PMID- 8474984
TI  - Report from the working group on diet and cancer.

PMID- 8474985
TI  - Mechanistic modelling and risk assessment.
AB  - Risk Assessment in the United States has been rapidly changing over the last few
      years. The historical methods and endpoints by which risk estimates were derived
      are gradually being replaced by newer methods and a broader spectrum of
      endpoints. For carcinogenic risk assessment, there is movement from the routinely
      used "linearized multistage model" for low dose risk estimation to methodology
      which is more deeply rooted in carcinogenic mechanisms and which allows the
      incorporation of additional data into the estimation of risks in a direct,
      quantitative fashion. There is also a determined effort under way to develop
      methods for assessing risks from exposure based on other endpoints such as
      effects on the immune system and the reproductive system. This paper briefly
      discusses some of the statistical and mathematical issues which will play
      important roles in determining the utility and precision of these new methods for
      estimating risks from environmental exposures.

PMID- 8474986
TI  - The concept of multifactorial etiology of cancer.
AB  - The concept of causes is not just for professional philosophers to discuss. The
      epidemiologists also have to clarify how the concept is used since its meaning
      has profound implications for understanding basic measures of exposure-disease
      association. The concept of cause also has importance when designing a study or
      when analyzing epidemiological data. The paper describes the components cause
      model and its relationship with the mechanism of disease action. A measure of
      interaction is also presented which is based upon the components cause model. The
      common sense concept of causes also plays a fundamental role for the success of a
      health preventive programme according to the Health Belief Model. The component
      cause model may clarify causal patterns in situations when only a few of the
      exposed get the disease which the programme tends to prevent.

PMID- 8474987
TI  - Occurrence of carcinogens in the external environment: epidemiological
      investigations.
AB  - The variation in cancer incidence between European populations indicates that at
      least 50% of the cancer incidence in Denmark may be attributable to environmental
      factors, including factors related to living conditions and lifestyle, and,
      hence, in principle are avoidable. Based on data from epidemiological studies of
      cancer causes, it is estimated that 30-40% of the total cancer burden in Denmark
      could be prevented by application of already available knowledge. Epidemiological
      studies of cancer occurrence in relation to arsenic in drinking-water,
      chlorination of drinking-water, nitrates in drinking-water and ambient air
      pollution are briefly reviewed. Although the causal associations between these
      factors and cancer in humans are hypothetical and unproven, the available data
      allow a rough calculation of the maximum proportion of cancer cases which
      possibly can be caused by these factors. At most, a few percent of the total
      cancer incidence is attributable to these external environmental factors.

PMID- 8474988
TI  - Cancer etiology: agents causally associated with human cancer.
AB  - Cancer is a multifactorial and multistage process, the exact mechanisms of which
      are still only partially known. However, even in the absence of a complete
      understanding of the process of carcinogenesis, we have been able to identify
      several factors which modify the risk of tumour development in humans. These
      include both endogenous and environmental factors, ranging from exposure to a
      single identified chemical to the occupations we follow in order to make our
      living. Cancer prevention strategies may differ in different parts of the world.
      In Europe, lung cancer is responsible for about one fourth of all cancer deaths
      and most of it could be prevented by eliminating tobacco smoking. Other exposures
      that can be controlled include occupational exposures to agents known to cause
      cancer at sites such as lung, bladder, paranasal sinuses, leukaemia, lymphoma and
      liver, as well as exposure to sunlight, known to be associated with both non
      melanocytic and melanocytic skin cancer. Liver cancer is a common cancer in other
      regions of the world where hepatitis B virus (HBV) infection is endemic; in these
      areas, fungal contamination of food is also common. While immunization against
      HBV may be the method of choice in the long run, reduction of exposure to
      aflatoxins might be a more useful intermediate goal in primary prevention because
      of the strong interaction between hepatitis B and aflatoxin exposure on liver
      cancer risk. To date, few chemical agents have been proved to be of etiological
      relevance to cancer in humans at sites such as the breast (with the exception of
      oestrogenic hormones), ovary, colon-rectum and prostate.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8474989
TI  - Chemical carcinogens in the environment: risk assessment for the environment.
AB  - The high priority of chemical carcinogens in environmental monitoring programmes
      is primarily due to a fear of a human exposure to these chemicals. Diseases like
      cancer are, however, also observed in indigenous populations of e.g. fish and
      shellfish, although these effects in general are rare events in the environment.
      High levels of carcinogens seem to be required for an influence on the prevalence
      of cancer, and an influence has almost exclusively been detected on the
      prevalence of liver tumours in populations of bottom-dwelling fish. The most
      important ecological aspect of chemical carcinogens in the environment may be the
      genotoxic potential of the carcinogens. Induced mutations may result in effects
      on survival or growth of the exposed organisms. In germ cells induced mutations
      are transmitted to future generations, resulting in an anthropogenic increase in
      the background mutation rate. The structure and function of the ecosystem is in
      the long run somehow determined by the background mutation rate which raises the
      question whether an increase in the mutation rate is advantageous or
      disadvantageous from a population and evolutionary point of view. To date
      experimental knowledge is hardly available even on the type of changes to be
      expected.

PMID- 8474990
TI  - Risk assessment for people exposed from different environments.
AB  - After the identification of the hazardous intrinsic properties of a carcinogen an
      attempt is made to estimate, if possible, the potency of the carcinogenic effect.
      For the evaluation it is, furthermore, of interest to know the genotoxic
      properties of the chemical. The next step would be to try to estimate the
      potential exposure for people in different environments. This could be intake
      from use of it as an additive in food or occurrence as a contaminant in food,
      drinking water, soil or air. The air exposure might come from contaminants in the
      working environment, in-door air or ambient air. The outcome of the hazard and
      exposure assessments would not be the only factors in a risk assessment or
      suggested limit values. Other factors might be the political-administrative
      background coming from different legal systems, even in the same country, which
      might apply different safety ambitions. This might result in the application of
      different risk levels (1:1 million, 1:10 million) or different safety factors, if
      that approach is used for non-genotoxic animal carcinogens.

PMID- 8474991
TI  - Airborne carcinogens.
AB  - Air pollution has been recognized as a cancer risk for many years. More than
      2,800 different chemicals have been identified in the air or emission sources.
      Only about 10% of these chemicals have been evaluated in bioassays for genetic or
      carcinogenic effects. Hydrocarbons, nitrogen-containing organics, and halogenated
      organics account for nearly 60% of the airborne chemicals that have been studied
      in long term animal cancer bioassays or short-term genetic bioassays. The sources
      that emit the highest number of these potentially carcinogenic chemicals are
      sources involving combustion (e.g., tobacco smoke, automobile exhaust, and coal
      combustion). Quantitative estimates of the risk of airborne carcinogens in
      outdoor air consistently show that polycyclic organic matter (POM) from products
      of incomplete combustion (PICs) make the largest single contribution to human
      cancer risk. Although the POM emissions from various air pollution sources are
      chemically similar and induce cancer by a similar genotoxic mechanism, the cancer
      risk per unit of exposure of these emissions may vary by several orders of
      magnitude. Among these combustion sources motor vehicle emissions account for the
      greatest cancer risk in outdoor air. Environmental tobacco smoke (ETS) and radon
      are the major sources of cancer risk from indoor exposures. There are, however,
      many uncertainties in identifying the important airborne carcinogens and
      quantitating the human cancer risk of air pollution. One important uncertainty is
      the role of atmospheric transformation products in human cancer.

PMID- 8474992
TI  - Cancer and ionizing radiation.
AB  - The carcinogenic effects of ionizing radiation are well documented at high doses
      and high dose rates. The Danish population has always been exposed to ionizing
      radiation from natural sources. In this century exposures from man-made sources
      especially in the medical field have added to the overall exposure of the
      population. Excluding medical exposures and exposures in the working environment
      the exposures of an individual member of the Danish population are essentially
      coming from natural sources especially from radon in dwellings. On average these
      sources give an annual effective dose equivalent of 3 mSv. A risk assessment
      using the latest information on the carcinogenic effects of ionizing radiation
      indicate that these radiation sources could give rise to 300 lung cancer deaths
      (radon) and 250 fatal cancers (other sources) each year in Denmark.

PMID- 8474993
TI  - Cancer and UV-radiation.
AB  - Solar radiation is a well documented risk factor in melanoma and non melanocytic
      skin cancer (i.e. basal cell and squamous cell carcinoma). It has been suspected
      to play a role also for lip cancer and for eye melanoma. Primary prevention
      should include advises to the public about sensible sun exposure. Results of such
      efforts will be apparent only in a long term perspective.

PMID- 8474994
TI  - Carcinogenic chemicals in the occupational environment.
AB  - A survey of occupational carcinogens by the Institute of Occupational Health,
      Finland shows that more than 100,000 workers are exposed to carcinogenic
      substances. The most common exposures are silica, wood dust, tobacco smoke and
      lead compounds. Based on biological monitoring of workers over the years it
      appears that overall lead exposure has decreased but exposure to styrene,
      trichloroethylene and tetrachloroethylene has decreased only slightly or remained
      constant. The biological monitoring data are based on samples sent by the
      workplaces on their initiative presenting no scientifically selected sampling.
      Thus due caution is needed in the interpretation of the trends.

PMID- 8474995
TI  - Availability of data on humans potentially exposed to suspected carcinogens in
      the Danish working environment.
AB  - For the majority of suspected carcinogens only little or no human evidence
      exists, and in general on-going epidemiologic studies fail to address this fast
      growing group of chemicals. A survey based on a Danish occupational surveillance
      system concerning data on present and historical import, production and use of
      the 167 chemicals evaluated by the International Agency for Research on Cancer as
      possible or probable carcinogens, shows that about 110 of these chemicals are on
      the market in Denmark at present. Only 32 are used in industry in relatively
      large quantities. For some of these chemicals it is possible to identify clusters
      of companies, including historical cohorts of potentially exposed workers.
      Measurements of airborne pollutants are available for some few of the suspected
      carcinogens, indicating decreasing time trends and various levels in different
      industries. In spite of some limitations, this information on potential exposure
      has on ad hoc basis been linked to an existing cancer registry based occupational
      surveillance system, and various studies based on the total body of data are on
      going, as a preliminary approach to give at least some human evidence to some
      widespread animal carcinogens.

PMID- 8474996
TI  - Human biological monitoring of occupational genotoxic exposures.
AB  - Human biological monitoring is a valuable tool for exposure assessment in groups
      of persons occupationally exposed to genotoxic agents. If the monitoring activity
      covers genetic material the term genetic monitoring is used. The methods used for
      genetic monitoring are either substance specific, e.g. the quantitation of
      identified DNA-adducts or substance unspecific as is the measurement of DNA
      repair. The sample material used for analysis must be well characterized and
      subject to uniform processing for comparison of the results. Confounding factors
      of smoking, age and sex must be well controlled for and the biomonitoring results
      should preferentially be linked with accurate ambient air monitoring. In persons
      occupationally exposed to styrene the endpoints of DNA-damage and DNA-repair in
      genetic monitoring are methods of choice in exposure situations above the current
      Danish (25 ppm) or Finnish (20 ppm) occupational exposure limit value of styrene
      in ambient air. The consideration of ethical issues in human genetic monitoring
      is an important but often overlooked aspect. This includes the scientific and
      preventional relevance of performing a test on individuals, pre- and post study
      information of donors and confidentiality as well as ownership of the results.

PMID- 8474997
TI  - Cancer risk related to genetic polymorphisms in carcinogen metabolism and DNA
      repair.
AB  - Chemical carcinogenesis involves metabolism in the body of the carcinogen to the
      ultimate carcinogen and its interaction with DNA. There is considerable
      interindividual variation in the metabolic ability to activate as well as
      detoxify the carcinogens and in the ability to repair the carcinogen-DNA adducts.
      In many cases such differences occur as genetic polymorphisms and form the basis
      for variation in susceptibility to carcinogens and thereby to cancer risk. The
      activation mechanism is particularly related to the cytochromes P-450 (CYPs), and
      four of these are known to activate carcinogens: CYP1A1, CYP1A2, CYP2E1, and
      CYP3A4. Increased cancer risk has been related to polymorphisms in the CYPs and
      other activating enzymes. The DNA repair mechanisms show considerable complexity,
      and deficient repair mechanisms in certain human disorders are clearly related to
      increased cancer risk. Yet, there is no unambiguous epidemiological evidence
      available for cancer risk among individuals in general. In vivo methods have to
      be refined and developed for use in epidemiological studies.

PMID- 8474998
TI  - Biological evaluation of protein quality of sorghum as affected by insect
      infestation.
AB  - Protein quality of sorghum grains having 25, 50 and 75% infestation caused by
      mixed population of Trogoderma granarium Everts and Rhizopertha dominica
      Fabricius was biologically evaluated by rat growth and nitrogen balance studies.
      Feeding of diet containing insect infested sorghum grains (50 and 75%) resulted
      in marked decrease in food intake, protein intake, gain in body weight, food
      efficiency ratio, protein efficiency ratio, nitrogen consumption, nitrogen
      absorption, biological value, net protein utilization, dry matter digestibility,
      net protein retention and protein retention efficiency. These parameters showed
      negative association with insect infestation levels. However, 25% level of grain
      infestation did not affect these parameters significantly.

PMID- 8474999
TI  - Studies on some edible wild mushrooms from Nigeria: 1. Nutritional, teratogenic
      and toxic considerations.
AB  - The biological value of 5 mushrooms Chlorophyllum molybditis, Psathyrella
      atroumbonata, Termitomyces robustus, Termitomyces striatus and Volvariella
      esculenta from our collection of wild edible mushrooms were determined using
      weanling rats. C. molybditis supported rapid growth with PER (2.63) higher than
      the casein control (2.50). P. atroumbonata was average in biological performance
      (PER 1.50) while T. robustus and V. esculenta did not support growth at all. Rats
      on T. striatus dried at 60 degrees C for 48 h lost weight rapidly and showed
      pathological signs of toxicity by the second day. All rats on this diet died by
      the fourth day of the experiment. When the diet of T. striatus dried at 90
      degrees C for about 8 h was fed, the rats gained weight marginally but all
      survived. Prolonged storage of T. striatus at 60 degrees C for 5-8 weeks also
      seemed to detoxify the poisonous component such that PER and NPR values were 0.8
      and 2.0 respectively. 2 pairs each of adult rats fed C. molybditis and Tricholoma
      lobayensis diets for 10 days were mated. Rats of C. molybditis diet gave 5 and 6
      litters each and only one of these litters seemed to have retarded growth. Rats
      on T. lobayensis diet did not produce any litters for 14 weeks but the female
      produced off-spring when mated with control male rats.

PMID- 8475000
TI  - Protein quality evaluation of amaranth in adult humans.
AB  - This study was carried out to determine the nutritional quality of the protein of
      amaranth grain submitted to extrusion and popping processes, using cheese protein
      as reference. For the biological evaluation, the short-term nitrogen balance
      index method was followed with 12 experimental adult male human subjects. A Latin
      square series 3 x 3 was used (three periods, three subjects) as an experimental
      design balanced to minimize residual effects by randomly ordering treatments,
      columns and rows. The study consisted of three periods of nine days each. The
      first period started by feeding all subjects a low nitrogen diet, followed by
      increases of the protein level every two days. The levels were 0.2, 0.4, 0.6/g
      protein/kg/day, keeping other nutritional elements constant and adequate,
      including calories, minerals and vitamins. All subjects received all their meals
      using as a source of protein extruded amaranth, popped amaranth or processed
      cheese. Water intake was kept at a rate of 0.8-1.0 ml per calories consumed.
      During the study, the subjects maintained regular physical activity. Amaranthus
      cruentus was utilized. The extruded amaranth was prepared with the Brady Crop
      Cooker under conditions previously established in other studies. The popped
      amaranth was prepared at a 250 degrees C temperature during 15-20 sec. The
      extruded and popped amaranths were provided as a sweet puree and, as all the
      other foods conforming the diets of each subject, they were weighed with 0.1 g of
      accuracy. Diet samples, as well as faeces and urine, were collected daily, which
      were ordered according to period and level of protein, conforming pools to
      determine their nitrogen content by the Kjeldahl method. True digestibility
      results of the protein were 101.4, 89.8 and 85.5% for cheese, extruded amaranth
      and popped amaranth, respectively. The statistical analysis according to the
      Tukey test showed that the true digestibility of the protein was the same for the
      two products of amaranth and different than the digestibility of cheese. Nitrogen
      balance index values from the equation between nitrogen intake and nitrogen
      retained, were 0.97, 0.86 and 0.79 for cheese, extruded amaranth and popped
      amaranth, respectively. The respective values between nitrogen absorbed and
      nitrogen retained were 0.97, 0.98 and 0.96. The Tukey test indicated that for NI
      to NR cheese was statistically different for the two amaranth products, which
      were similar between them. For the relationship NA to NR all values were
      statistically the same.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475001
TI  - Chemical and nutritional evaluation of two amaranth (Amaranthus cruentus)-based
      infant formulas.
AB  - The objective of this study was to calculate, prepare and evaluate the Protein
      Efficiency Ratio (P.E.R.) and Net Protein Utilization (N.P.U.) of two infant
      formulas made with amaranth (Amaranthus cruentus). Both formulas were formulated
      to match a previously developed and tested soy-oats infant formula. No
      significant differences were found between the three formulas with respect to
      corrected Protein Efficiency Ratio (P.E.R.) and Net Protein Utilization (N.P.U.)
      values. Only the product made with the 1-R fraction of amaranth was found to have
      a significantly lower P.E.R. than casein.

PMID- 8475002
TI  - Effects of dry heat treatments to peanut kernels on the functional properties of
      the defatted meal.
AB  - Dry heat treatments at 140 degrees C for 20 min or 160 degrees C for 10 min of
      peanut kernels significantly improved protein solubility, water and oil
      absorptions, foaming capacity and stability, and least gelation concentration of
      the defatted meal. However, heat treatments at 160 degrees C for 30 min or more
      than 30 min period resulted in significant decrease in these properties. Such
      heat treatments significantly decreased the level of albumin and globulin
      fraction with concomitant increase in glutelin fraction in the meal.

PMID- 8475003
TI  - Protein and lysine digestibility and protein quality of cooked Filipino rice
      diets and milled rice in growing rats.
AB  - The protein quality of typical rice-based menu of Filipino preschool child and
      adult and cooked milled rice was assessed for true digestibility (TD), biological
      value (BV) and net protein utilization (NPU) in growing rats. Lysine and energy
      digestibilities were also determined. For the preschool child diet, TD was 88.8%,
      BV 90.0%, and NPU 79.9%. For the adult diet, TD was 87.3%, BV 86.6%, and NPU
      75.5%, whereas cooked rice had 90.0% TD, 82.5% BV and 74.3% NPU. Lysine
      digestibility was 95.4% for preschool child diet, 95.7% for adult diet, and
      100.0% for rice. Digestible energy was 91.3% for preschool child diet, 93.0% for
      adult diet, and 95.3% in rice. Amino acid scores were 100.0% for preschooler
      diet, 92.1% for adult diet, and 62.2% for rice. Protein quality based on amino
      acid score corrected for TD was 88.8% for preschool child diet. 80.4% for adult
      diet, and 56.0% for rice. If based on lysine digestibility instead of TD, protein
      quality would be 7.1% higher.

PMID- 8475004
TI  - Studies on the development of high-protein biscuits from composite flours.
AB  - Composite flours prepared from wheat, greengram, bengalgram and blackgram flours
      were studied for the preparation of biscuits. Protein content of biscuits
      increased as the level of the pulse flours increased. Wheat flour containing
      bengalgram and blackgram flours adversely affected the top grain, texture and
      colour of biscuits. Biscuits made with higher levels of bengalgram (more than
      15%) were tough and difficult to break and required higher compression force.
      Addition of greengram flour did not significantly affect top grain, texture and
      colour of biscuits. The biscuits made from 15% greengram supplemented wheat flour
      scored the highest for flavour characteristics. Thickness, diameter and spread
      ratio of biscuits containing different levels of pulse flours were significantly
      different from control sample. Sensory evaluation scores showed that acceptable
      biscuits can be prepared from wheat flour supplemented with these pulse flours at
      a level of 15 percent.

PMID- 8475005
TI  - Protein, calcium, iron, and amino acid content of selected wild and domesticated
      cultivars of finger millet.
AB  - Two wild and eight domesticated cultivars of finger millet were analyzed to
      determine their proximate composition and calcium, iron, and amino acid content.
      Wide variations were observed in the protein (mean values ranged from 7.5 to
      11.7%), calcium (376 to 515 mg/100 g), and iron (3.7 to 6.8 mg/100 g) content of
      the wild and domesticated cultivars. A wild progenitor of finger millet, E
      coracana subsp. africana was significantly higher in protein than four of the six
      domesticated accessions analyzed. The calcium and iron content of the wild
      progenitor was also significantly greater than that of two domesticated
      cultivars. The wild species was also found to be higher in lysine and five other
      essential amino acids. These results indicate that the nutritional value of
      finger millet may be significantly improved by selective crossbreeding of the
      cereal's wild and domesticated cultivars.

PMID- 8475006
TI  - Breast cancer screening practices among retirement community women.
AB  - BACKGROUND: The purposes of this study were (a) to learn more about the existing
      breast cancer screening practices of women age 65 and older and (b) to identify
      factors related to breast cancer screening. METHOD: A random sample of 752 women
      age 65 and older residing in independent living apartments in eight retirement
      communities was selected to participate in a survey of breast cancer screening
      practices and related factors. A total of 616 surveys were complete, yielding a
      response rate of 82%; of those, 571 of the surveys were administered by
      telephone, with the remaining 45 administered in person. RESULTS: Thirty-eight
      percent of the women reported having had a mammogram within the past year, 53%
      had a clinical breast exam, and 39% reported performing monthly breast self
      examination. The percentage of women reporting either annual clinical breast
      examinations or mammography decreased with increasing age. Results of a logistic
      regression analysis found that having discussed mammography with a physician,
      believing in the need for mammography, having no mammography-related concerns,
      and the combination of personal experience with breast cancer and having had a
      clinical breast examination in the past year were all independently related to
      having had a mammogram within the past year (P < 0.05). CONCLUSION: In order to
      increase older women's participation in screening, particularly in mammography,
      educational interventions need to be developed and directed both to older women
      and to their physicians.

PMID- 8475007
TI  - The effect of physician advice on exercise behavior.
AB  - BACKGROUND: Although sedentariness, a prevalent lifestyle, is recognized as a
      significant risk factor for coronary artery disease and other conditions, little
      is known about the effectiveness of prevention strategies in the primary care
      setting. This study examines the impact of brief, exercise advice-giving by
      family physicians. METHODS: During a 2-month baseline period, patients visiting
      their family physician and who were age 18 or older were queried about their
      exercise habits and attitudes and whether their physician had discussed exercise.
      During the following 2-month experimental phase, the same data were gathered, and
      half the physicians were trained to give brief exercise advice. All patients were
      followed for 1 month. Changes in exercise duration and frequency were the primary
      outcome measures. RESULTS: During baseline, a sizable portion of patients were
      given exercise advice. This was true also of control group patients during the
      experimental phase, although trained physicians gave advice almost twice as
      often. A comparison of the patients receiving advice with those not receiving
      advice revealed significant increases in exercise duration, but not frequency.
      Patient attitudes were responsive to exercise advice. CONCLUSION: Members of
      primary care, adult patient population will increase their duration of physical
      activity in response to physician advice to exercise.

PMID- 8475008
TI  - Oral contraceptive use and the occurrence of gallstone disease--a case-control
      study.
AB  - BACKGROUND: We evaluated the hypothesized transient effect of oral contraceptive
      use on the occurrence of gallstone disease in a case-control study. METHODS: The
      study comprised 82 acute cases, and 249 general population controls, 28 elective
      cases, and 106 radiodiagnosis controls. Risk-period-specific rate ratios were
      estimated by logistic regression analysis. RESULTS: During the first 5 years
      after any year of oral contraceptive use (0- to 5-year risk period) the rate
      ratio was 1.6 (90% confidence interval, 0.83-2.95), and for the 6- to 10- and 11-
      to 20-year risk periods, 1.2 (0.67-2.13) and 1.1 (0.69-1.65), respectively.
      Further evaluation showed substantial confounding by other risk factors. After
      these were controlled for, the rate ratios were 1.1, 1.8, and 1.0 for the
      respective risk periods. When oral contraceptive use had been started recently
      (within 5 years before diagnosis) the rate ratio was 4.8 (0.79-29.7); recent oral
      contraceptive use was not associated with gallstone disease if preceded by 6 or
      more years of oral contraceptive use (rate ratio 0.8 (0.15-4.55)). CONCLUSIONS:
      The results are consistent with a transient effect of oral contraceptive use that
      does not accumulate beyond 10 years of use. However, the substantial confounding
      effect in our study raises the question whether the present and previously
      reported estimates of the effect may be biased by confounding.

PMID- 8475009
TI  - Beneficial effects of sun exposure on cancer mortality.
AB  - For more than 50 years, there has been documentation in the medical literature
      suggesting that regular sun exposure is associated with substantial decreases in
      death rates from certain cancers and a decrease in overall cancer death rates.
      Recent research suggests that this is a causal relationship that acts through the
      body's vitamin D metabolic pathways. The studies reviewed here show that (a)
      sunlight activation is our most effective source of vitamin D; (b) regular
      sunlight/vitamin D "intake" inhibits growth of breast and colon cancer cells and
      is associated with substantial decreases in death rates from these cancers; (c)
      metabolites of vitamin D have induced leukemia and lymphoma cells to
      differentiate, prolonged survival of leukemic mice, and produced complete and
      partial clinical responses in lymphoma patients having high vitamin D metabolite
      receptor levels in tumor tissue; (d) sunlight has a paradoxical relationship with
      melanoma, in that severe sunburning initiates melanoma whereas long-term regular
      sun exposure inhibits melanoma; (e) frequent regular sun exposure acts to cause
      cancers that have a 0.3% death rate with 2,000 U.S. fatalities per year and acts
      to prevent cancers that have death rates from 20-65% with 138,000 U.S. fatalities
      per year; (f) there is support in the medical literature to suggest that the 17%
      increase in breast cancer incidence during the 1991-1992 year may be the result
      of the past decade of pervasive anti-sun advisories from respected authorities,
      coinciding with effective sunscreen availability; and (g) trends in the
      epidemiological literature suggest that approximately 30,000 U.S. cancer deaths
      yearly would be averted by the widespread public adoption of regular, moderate
      sunning.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475010
TI  - Targeting breast and cervical cancer screening to elderly poor black women: who
      will participate? The Harlem Study Team.
AB  - BACKGROUND: Factors associated with participation in breast and cervix cancer
      screening among elderly black women of low socioeconomic status were determined.
      METHODS: Data from a baseline cross-sectional random survey were used together
      with data on whether screening was subsequently completed or refused. The
      subjects were a random sample of women attending an urban public hospital primary
      care clinic for routine medical care with a birth year of 1924 or earlier.
      RESULTS: Among the 271 women in the study group, 70% completed screening. Stated
      intent was the strongest predictor of participation; women who intended to have
      both mammography and Pap testing were 2.7 times more likely to participate than
      those who intended to have neither test (95% confidence interval 1.4, 4.9; P <
      0.01), controlling for age, insurance status, and level of chronic illness. Women
      who had more than three chronic illnesses were twice as likely to participate
      than those with three or fewer illnesses (95% confidence interval 1.1, 3.4 P <
      0.02), controlling for the remaining variables. Other variables, including age,
      history of a recent screening examination, attitudes, or knowledge, were not
      related to participation. Stated intent was the only variable that predicted
      compliance with both mammography and Pap smear completion in separate regression
      models for the individual tests. CONCLUSION: A high proportion of elderly,
      socioeconomically disadvantaged black women will participate in cancer screening
      when it is offered in a primary care setting. Further research on behavioral
      intentions should be conducted to refine interventions designed to enhance the
      use of early cancer detection among vulnerable population groups.

PMID- 8475011
TI  - Impact of a breast cancer screening community intervention.
AB  - BACKGROUND: Efforts to detect breast cancer in its early stages are necessary to
      reduce breast cancer-associated mortality. This study evaluated the impact of a
      multicomponent intervention implemented between 1987 and 1990 to increase a
      community's utilization of breast cancer screening by women over 50 years of age.
      METHODS: The study used a pretest/post-test two-community design, with one
      community assigned as the intervention community and the other as the comparison.
      The intervention consisted of a comprehensive physician involvement component and
      a community education effort. To assess the overall impact of the interventions,
      we measured women's participation in screening via random digit dial telephone
      surveys at three time points, each approximately 18 months apart. RESULTS: Over
      the course of the study, there were dramatic improvements in breast cancer
      screening participation in both communities. However, the intervention city
      showed more improvement in selected variables than did the comparison community
      in the early phases of the project between baseline and midpoint. These included
      increased advice by physicians to have mammograms, increased awareness that
      screening is necessary in the absence of symptoms, increased awareness that many
      women over 50 have mammograms, decreased perception of barriers to clinical
      breast exam, and an increase in the proportion of women having a clinical breast
      exam. In addition, significantly fewer women in the intervention city than in the
      comparison city reported never having had a mammogram at midpoint. CONCLUSIONS:
      The findings demonstrate limited impact of a community intervention during a
      period of increasing adoption of mammography screening, in part, due to this
      rapidly rising secular trend. Additionally, increased activities in the
      comparison community were documented. Therefore, as incidence of screening
      increases, targeted activities aimed at population subgroups are warranted, and
      evaluation designs need to include multiple comparison groups or broader
      geographic random samples.

PMID- 8475012
TI  - Educational attainment and coronary heart disease risk: the Framingham Offspring
      Study.
AB  - BACKGROUND: Efforts to control the continuing epidemic of coronary heart disease
      in the United States have been successful according to certain criteria, such as
      mortality, but by others, such as morbidity, the picture is less clear.
      Documenting whether various subgroups of the population have adopted healthier
      lifestyles that are likely to reduce coronary heart disease risk is essential to
      understanding the status of the epidemic and, most importantly, to formulating
      prevention and health education strategies that will ameliorate its effects.
      METHODS: The Framingham Offspring Study cohort participated in extensive health
      screening protocols to determine their cardiovascular risk. The 2,846 men and
      women who were between the ages of 25 and 64 years and who reported their
      educational attainment level are the subject of this report. RESULTS: Both body
      mass index and cigarette smoking showed inverse relationships to educational
      attainment among both men and women, while reported vigorous leisure time
      physical activity showed a positive relationship to educational attainment.
      However, fitness levels as assessed by treadmill duration were directly related
      to educational attainment only the women. With the exception of total plasma
      cholesterol among women, all coronary heart disease risk factors had most adverse
      levels in the least educated study participants. CONCLUSIONS: This study
      indicates that most components of the coronary heart disease risk profile show
      adverse levels in individuals with low educational attainment.

PMID- 8475013
TI  - Knowledge, attitudes, and personal practices regarding prevention and early
      detection of cancer.
AB  - METHODS: To determine population knowledge, attitudes, and personal practices
      regarding prevention and early detection of cancer, random population samples of
      25- to 74-year-old men and women in six various-sized communities in three upper
      midwestern states (N = 4,915) were administered surveys and interviews during
      1987-1989. RESULTS: Four-fifths of respondents believed cancer to be preventable.
      Knowledge of warning signs/symptoms of cancer and of leading causes of cancer,
      however, was low. Over 95% of women had had a Papanicolaou smear and a clinical
      breast exam or had performed a breast self-exam; 65.7% of those ages 50-65 years
      had had a mammogram. Among men and women ages 50-65 years, 77% had had a digital
      rectal exam; 52.5%, a fecal occult blood test; and 48.3%, a sigmoidoscopy.
      CONCLUSIONS: Conditions are favorable for an increase in mammography, including
      favorable attitudes toward cancer prevention, strong consensus among policy
      making organizations regarding guidelines for obtaining mammograms, and high
      levels of adherence to these recommendations by women who have had at least their
      first mammogram. Challenges now include acceptance of these guidelines by
      physicians, mammogram affordability/availability, and demonstration of
      efficacious, cost-effective, and reliable colorectal/prostate cancer screening
      tests.

PMID- 8475014
TI  - Health practices and disability: some evidence from Alameda County.
AB  - With greater longevity people are increasingly concerned about how to avoid
      disability during their longer lives. Policy decisions concerning ways to extend
      health as well as life have become part of the nation's health agenda.
      Opportunity to examine that issue has arisen in the Alameda County Human
      Population Laboratory. Earlier studies there established seven health practices
      as risk factors for higher mortality: excessive alcohol consumption, smoking
      cigarettes, being obese, sleeping fewer or more than 7-8 hours, having very
      little physical activity, eating between meals, and not eating breakfast.
      Observation now reveals that, taking into account age, gender, physical health
      status, and social network index in 1965, the occurrence of disability was only
      about one-half as great among the cohort survivors in 1974 who reported good
      health practices in 1965 as among those with poor health practices; those with an
      intermediate level of health practices experienced about two-thirds the relative
      disability risk of those with poor health practices. Essentially similar
      relationships prevailed for the 1982/1983 survivors of the original (1965) cohort
      who, upon requestioning, had been found to be without disability in 1974.

PMID- 8475015
TI  - Physician-based diet counseling for cholesterol reduction: current practices,
      determinants, and strategies for improvement.
AB  - BACKGROUND: Physicians face increasing pressure to counsel their
      hypercholesterolemic patients about diet. To design effective physician-based
      treatment programs, a better understanding of current dietary counseling practice
      and its determinants is needed. METHODS: Using a survey previously tested for
      reliability and validity, we examined the relationship of dietary knowledge,
      attitudes, beliefs, organizational barriers, and treatment practices for
      cholesterol management among 60 resident and attending physicians practicing in
      the general medicine clinic of a university medical center that serves primarily
      rural and disadvantaged patients. The survey was administered in October of 1988
      prior to the release of the National Cholesterol Education Program Guidelines.
      RESULTS: The response rate was 100%. Ninety-two percent of physicians surveyed
      believe that dietary treatment effectively lowers cholesterol and 68% feel
      responsible for providing such therapy. However, most (72%) feel ill-prepared to
      give diet counseling, lack confidence in their ability to help patients make
      meaningful dietary changes (95%), and cite organizational barriers, such as
      limited time (72%) or inadequate educational materials (47%). Physicians were
      more likely to report behaviorally focused diet counseling practices if they felt
      prepared to counsel (r = 0.42, P < 0.001), were confident in their counseling
      skills (r = 0.39, P < 0.01), or reported personally following a prudent diet (r =
      0.36, P < 0.01). We discuss the implications of these findings and how they
      should guide the design of physician-based dietary interventions for cholesterol
      reduction.

PMID- 8475016
TI  - [Heat inactivation kinetics of solubilized and immobilized immunoglobulins G].
AB  - The kinetics of thermoinactivation of rabbit antibodies against cortisol (Anti
      COR, 60-82 degrees), sheep antibodies against rabbit immunoglobulins (AB, 65-77
      degrees) in water solution and of AB covalently linked to activated polystyrene
      beads (PSB-AB, 60-77 degrees) was studied by indirect and direct ELISA methods
      using peroxidase-cortisol or peroxidase-rabbit immunoglobulin conjugates to
      detect immunocomplexes for PSB-AB. High stability of ABs and their stabilization
      after immobilization on PSB are shown. The Eact values and thermodynamic
      activation parameters of immunoglobulins thermolysis delta H*, delta S* and delta
      G* were calculated from Arrhenius plots of the effective inactivation rate
      constants versus temperature and compared with the corresponding characteristics
      for other proteins.

PMID- 8475017
TI  - [Biosynthesis of bovine growth hormone in Escherichia coli DH1 cells and its
      purification on a pilot scale].
AB  - The biosynthesis of the bovine growth hormone (BGH) in E. coli DH1 cells
      containing the plasmid pbGH(1-119)ptrp was studied. It was found that BGH
      accumulated in the cytoplasm of bacterial cells as optically dense granules that
      can be isolated by low-speed centrifugation. A fraction of purified protein
      granules was used for further purification of BGH. A purified BGH preparation
      contained two polypeptides with molecular weights of 18,000 and 22,000 D. The
      state of plasmid was investigated during cultivation and storage of the culture.

PMID- 8475018
TI  - [Characteristics of lipids of microbial origin with regard to triglyceride
      composition and comparison of them to plant oils].
AB  - The triacylglycerol composition of lipids isolated from the yeasts Candida
      guilliermondii and C. humicola and of food vegetable oils was investigated by
      HPLC. The triacylglycerol composition of samples was compared using the program
      "Nearest neighbour" and by plotting images with the help of the software package
      STATGRAPHICS. The methods used allow us to conclude that microbial lipids are
      rather promising.

PMID- 8475019
TI  - [Phase equilibria in water-defatted milk proteins-carboxymethylcellulose sodium
      salt systems].
AB  - Phase equilibria in water mixtures of skimmed milk with sodium salt of
      carboxymethylcellulose (CMC) was studied using two degrees of CMC polymerization
      (500 and 200) and substitution (0.8 and 0.5). The increase of the polymerization
      degree from 200 to 500 resulted in a higher protein yield in the protein phase,
      while the decrease of the substitution degree from 0.8 to 0.5 caused a noticeable
      decrease of asymmetry of phase diagrams. The phase separation was accompanied by
      ion exchange: potassium and calcium ions were mainly found in the protein phase.
      The highest yield of milk protein into the protein phase was 85% at a CMC
      concentration of 0.7%. The main protein component of the polysaccharide phase was
      alpha-lactalbumin.

PMID- 8475020
TI  - [Fungal tremorogens].
AB  - Fungi capable of producing tremorgenic secondary metabolites represent species
      from taxonomically diverse and unrelated groups. These fungi are capable of
      contaminating a variety of agricultural commodities such as faragas, corn,
      silage, etc. Various animal diseases suspected or known to be caused by fungal
      tremorgens are paspalum staggers, ryegrass staggers, corn staggers, and Bermuda
      grass tremors. Other syndromes with probable involvement of fungal tremorgens
      were associated with corn silage contaminated with Aspergillus fumigatus and
      beer, cream cheese, a hamburger, and walnuts contaminated with Penicillium
      crustosum. The tremorgens involved in these syndromes (with the exception of the
      moldy silage) although produced by diversely unrelated fungi, contain the same
      basis biologically active chemical nucleus derived from geranylgeraniol and
      tryptophan. In some cases, such as A. flavus and Claviceps paspali, the
      tremorgens appear to be associated exclusively with the sclerotial stage (ergot).

PMID- 8475021
TI  - [Ergot alkaloids and alkaloids from other endophytes, responsible for causing
      toxic syndrome in cattle after eating contaminated grass].
AB  - Different signs of ergotism in livestock associated with animals consuming feed
      grains and pasture grasses infected by Clavicipitaceae (e.g. Balansia spp. and
      Acremonium spp.) have been considered. Endophyte-infected tall fescue causes the
      damage to livestock, and its toxicity and ryegrass in livestock are associated
      with ergopeptide alkaloid ergovaline and indole-isoprenoid lolitrems produced by
      A. coenophialum and A. lolii. The role of another compound attendant to endophyte
      infected fescue such as peramine and loline alkaloid is discussed. Concentration
      of alkaloids depends upon the season and the period of growing plant-host. The
      advantages and the problems of endophyte-grass mutualistic symbiosis in pasture
      conditions are considered. The perspective of genetic manipulation of grass and
      fungus to produce endophyte-infected grasses with stress and insect deterences
      without affecting ruminant health.

PMID- 8475022
TI  - [Tremorogenic mycotoxicosis caused by the fungi Aspergillus clavatus, clinical
      features, pathomorphology, and isolation of metabolites].
AB  - Tremorgenic mycotoxicosis of the fungus Aspergillus clavatus growing on malt
      sprouts under natural and laboratory conditions has been studied. The clinical
      aspect and pathomorphology of the diseases were investigated and a pure culture
      A. clavatus was isolated. Three schemes of cultivation of A. clavatus in
      laboratory conditions were tested to obtain tremorgens. The scheme of cultivation
      in thermostat at 37 degrees for 7 days and then at 30 degrees C for 10 days and
      at 22 degrees for 17 days afterwards was found to be optimal. A metabolite close
      to alkaloids by its physico-chemical characteristics was isolated from the fungus
      studied.

PMID- 8475023
TI  - [The effect of elymoclavine and its derivatives on various enzymes of the
      gastrointestinal tract].
AB  - The influence of elymoclavine, elymoclavine hydrochloride, elymoclavine
      hydrobromide, 2-bromelymoclavine, 2-bromelymoclavine hydrobromide on the initial
      rater of enzymatic hydrolysis of cytidine-2',3'-monophosphate by RNase A and of N
      alpha-benzoyl-DL-tyrosine-p-nitroanilide by alpha-chymotrypsin has been
      investigated. It is shown that all the compounds have the features of various
      types of inhibitors of RNase A and alpha-chymotrypsin with the exception of
      elymoclavine which shows all features of a catalytic activator of RNase A.

PMID- 8475024
TI  - [Propagation of toxigenic fungi and mycotoxins in various grains].
AB  - The frequency of occurrence and toxigenicity of various strains of Aspergillus
      flavus (663 stairs) and of Fusarium spp. (459 strains) isolated from grain of
      various crops from four grain-producing areas were studied. The analysis of
      mycotoxins in 1038 grain samples (wheat, rye, rice and corn) and in 58 samples of
      sun flower seeds collected from commercial batches showed that aflatoxins B1 and
      G1, deoxynivalenol, and zearalenone are the basic microbial contaminants of
      grain, while toxin T-2 and diacetoxyscirpenol were found much more rarely.
      Ochratoxin A, penicillic and kojic acids were found only in several samples. The
      occurrence of the mycotoxins and contamination levels depended on grain-producing
      areas. The risk of mycotoxins invasion in grains was greater in southern humid
      regions of Russia, Kazakhstan and Uzbekistan.

PMID- 8475025
TI  - [Arthrobacter proteinase and its effect on fibrin thrombi].
AB  - Arthrobacteria are producers of proteolytic enzymes. Optimal cultivation
      conditions were determined for Arthrobacter luteus and the mineral composition of
      the culture medium providing active synthesis of proteinase was optimized. The
      proteinase was isolated from the culture liquid of Arthrobacter luteus using
      preparative ion-exchange chromatography on a carboxyl cation exchange resin KMT.
      The enzyme was homogeneous according to gel chromatography on Sephadex G-200 and
      had a molecular weight of 24 kD. The fibrinolytic activity of the proteinase is
      comparable with that of trypsin.

PMID- 8475026
TI  - Identification of Schistosoma haematobium soluble egg antigens that elicit human
      granuloma formation in vitro.
AB  - Schistosoma haematobium soluble egg antigens (SH SEAs) induce intense granulomas
      in human hosts that often culminate in severe disease. In an attempt to identify
      the SH SEA fractions that are responsible for pathology, we combined T-cell
      Western blotting and an in vitro model of granuloma formation. Whole SH SEAs were
      dotted onto nitrocellulose pieces or were separated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and electrotransferred onto nitrocellulose
      paper. Horizontal strips bearing the separated antigens were solubilized in
      dimethylsulfoxide and precipitated in carbonate/bicarbonate buffer. Antigen-free
      and antigen-bearing particles were used to stimulate peripheral blood mononuclear
      cells (PBMCs) obtained from S. haematobium-infected patients and sex- and age
      matched healthy controls to form granulomas in vitro. Whole SH SEA-bearing
      nitrocellulose particles elicited in vitro formation of granulomas by PBMCs from
      infected donors. The response was similar in sensitivity, specificity, and
      reproducibility to that evoked by SH SEA-bound polyacrylamide beads. The results
      obtained in samples form 30 patients and 10 controls tested with SH SEA-separated
      fractions revealed that SEA bands of 84,000, 63,000, 57,000, 55,000, 40,000,
      30,000, and 28,000 Da elicited in vitro granuloma reactions by PBMCs of almost
      all infected patients. Conversely, separated soluble adult-worm antigens failed
      to stimulate PBMCs of infected patients to form granulomas. This study is the
      first to identify the SH SEA fractions that evoke in vitro granuloma formation
      and represents an initial step toward the development of an anti-urinary
      schistosomiasis pathology vaccine.

PMID- 8475027
TI  - Expression of members of the heat-shock protein 70 family in the exoerythrocytic
      stages of Plasmodium berghei and Plasmodium falciparum.
AB  - Exoerythrocytic stages of Plasmodium berghei cultured in HepG2-A16 hepatoma cells
      and those of P. falciparum in human hepatocytes transplanted under the kidney
      capsule of CB-17/ICr scid/scid mice were used to evaluate expression of heat
      shock-related stress proteins. Although undetectable in the sporozoites, the
      expression of proteins similar in sequence of a heat-shock protein of 70 kDa and
      a glucose-regulated protein of 78 kDa was markedly induced in the hepatic stages
      of malaria parasites. Expression of these proteins in the exoerythrocytic stages
      of the malaria parasite warrants a systematic evaluation of their potential role
      in eliciting cellular immune responses directed against infected hepatocytes.

PMID- 8475028
TI  - Effect of various digestive enzymes on the interaction of Toxoplasma gondii with
      macrophages.
AB  - The participation of resident, elicited, and activated macrophage surface
      components during internalization of tachyzoites of Toxoplasma gondii was
      analyzed using neuraminidase, phospholipase C, trypsin, protease, and
      hyaluronidase. Treatment of these macrophages with neuraminidase from Vibrio
      cholerae, phospholipase C from Bacillus cereus and Clostridium perfringens,
      protease, and hyaluronidase prior to their interaction with parasites increased
      the penetration of host cells by T. gondii. Incubation of macrophages with
      trypsin significantly inhibited the uptake of parasites. Our findings confirm
      previous observations that treatment of the macrophages with cytochalasin D under
      conditions that completely block the typical phagocytic process partially
      inhibits infection of the cells by T. gondii. The results of simultaneous
      treatment of the macrophages with enzymes and cytochalasin D suggested that the
      observed enhancement of cell infection by treatment with neuraminidase and
      hyaluronidase was attributable to a classic phagocytic process, whereas that
      obtained using phospholipase resulted from active penetration.

PMID- 8475029
TI  - Pathologic effects of Sphaerospora dicentrarchi Sitja-Bobadilla and Alvarez
      Pellitero, 1992 and S. testicularis Sitja-Bobadilla and Alvarez-Pellitero, 1990
      (Myxosporea: Bivalvulida) parasitic in the Mediterranean sea bass Dicentrarchus
      labrax L. (Teleostei: Serranidae) and the cell-mediated immune reaction: a light
      and electron microscopy study.
AB  - In the present study, the pathogenic effects of Sphaerospora dicentrarchi and S.
      testicularis, histozoic and coelozoic myxosporean parasites of the Mediterranean
      sea bass Dicentrarchus labrax L., respectively, are described. The infection
      caused by the latter, which usually invades the testes and neighboring tissues,
      is considered to represent parasitic castration. S. dicentrarchi seems to be
      harmless except in massive infections, which probably result in organic
      disfunctions. The cellular host reaction generated by S. testicularis depends on
      the location of the parasite and is more intense than that produced by S.
      dicentrarchi. In both sphaerosporoses, macrophages, granulocytes, lymphocytes,
      plasmacytes, and fibroblast-like cells are involved. The role of the different
      immune cells is discussed.

PMID- 8475030
TI  - Echinostoma trivolvis: mating behavior of adults raised in hamsters.
AB  - Echinostoma trivolvis adults grown in golden hamsters were treated in vitro with
      [3H]-tyrosine to label sperm and transplanted to uninfected hamsters alone or
      with four to six unlabeled adults. After 4-5 days, worms were recovered,
      processed for autoradiography, and observed for silver grains over their seminal
      receptacles. Of 11 worms transplanted singly, 6 (55%) self-inseminated. In
      multiple-worm situations, 7 of 12 (58%) labeled worms self-inseminated, and in
      the process the 12 labeled worms inseminated only 5 of 35 (14%) possible
      unlabeled worms. E. trivolvis adults self-inseminated when isolated and both self
      and cross-inseminated in groups, suggesting an unrestricted mating pattern.
      These results were compared with the mating patterns of other digenetic
      trematodes.

PMID- 8475031
TI  - Cloning and sequencing of a cDNA fragment from Plasmodium chabaudi chabaudi that
      contains repetitive sequences coding for a potentially lysine-rich aspartic acid
      rich protein.
AB  - Screening of a cDNA library (prepared in lambda gt11) of the blood stages of
      Plasmodium chabaudi chabaudi (AS) with immune serum has revealed an antigen the
      elicits a strong antibody response in infected mice. The clone (clone 6)
      expressing that antigen contains a 0.7 kb insert and produces a beta
      galactosidase fusion protein of about 150 kDa. In Western blot analysis performed
      on parasite extracts, monoclonal antibodies and polyclonal sera prepared against
      the fusion protein revealed that the fusion protein contains part of a malarial
      protein of 93 kDa. Northern hybridization with clone 6 insert as probe detected a
      plasmodial RNA of about 3.2 kb, which could well code for a protein of this size.
      The insert hybridized to a single EcoRI fragment and a single HindIII fragment in
      genomic Southern blotting, suggesting that the gene is present in one copy in the
      P. chabaudi genome. The DNA sequence of clone 6 insert predicts a hydrophilic,
      acidic polypeptide consisting of seven repeats of 23-34 amino acids rich in
      lysine (24%) and aspartic acid (17.5%).

PMID- 8475032
TI  - Interaction between trophozoites of Entamoeba histolytica and the human
      intestinal cell line HT-29 in the presence or absence of leukocytes.
AB  - Studies on the interaction between trophozoites of Entamoeba histolytica of
      pathogenic or non-pathogenic origin and epithelial cells of the human intestine
      can contribute to the understanding of the pathogenesis of invasive amoebiasis.
      We have examined the interaction of virulent E. histolytica with the human
      colonic carcinoma cell line HT-29. Differentiated HT-29 cells are comparable to
      the mucosa cells to which E. histolytica attaches physiologically. Adherence
      between E. histolytica trophozoites and HT-29 cells was effectively inhibited by
      glycoconjugates containing galactose, indicating the importance of the 170-kDa
      lectin of E. histolytica in binding to intestinal cells. Adherence was not
      significantly inhibited by glycoconjugates containing N-acetyl-glucosamine,
      indicating that the 220-kDa lectin of E. histolytica is not involved in binding
      to HT-29 cells. The destruction of HT-29 cells by pathogenic E. histolytica was
      dependent on adherence. The destruction was enhanced when polymorphonuclear
      granulocytes were added to the E. histolytica trophozoites.

PMID- 8475033
TI  - Effects of microtubule inhibitors on protein synthesis in Plasmodium falciparum.
AB  - At low concentrations, both isomers of tubulozole (C, T) inhibit Plasmodium
      falciparum but only tubulozole C inhibits mammalian cells. Since tubulozole C
      prevents polymerization of mammalian tubulin whereas tubulozole T does not, the
      antimalarial action of tubulozoles may not involve microtubules. The present
      study concerns the inhibition of parasite protein synthesis by the tubulozoles.
      While tubulozoles took 3-4 h to kill parasites in erythrocytic culture, they
      inhibited protein synthesis within 10 min. The concentrations of the drug
      required were, however, too high for this to account for their antimalarial
      action. The microtubule inhibitor colcemid inhibited protein synthesis rapidly
      and at relevant concentrations, but vinblastine did not inhibit protein
      synthesis. Tubulozole T and colcemid inhibited protein synthesis
      posttranscriptionally since they had little effect on RNA synthesis. Analysis of
      labelled parasite proteins by two-dimensional gel electrophoresis showed that
      while it inhibited synthesis of most proteins to the same degree, tubulozole T
      super-inhibited the synthesis of certain proteins. This may cause its
      antimalarial effect at low concentrations.

PMID- 8475034
TI  - Expression of sequences related to c-myc in Entamoeba.
AB  - The evolutionarily conserved proto-oncogene c-myc is involved in both
      proliferation and differentiation processes of higher eukaryotic cells. We report
      here the identification and characterization of sequences homologous to c-myc in
      different Entamoeba species using a fragment of the mammalian c-myc gene as a
      probe. This probe hybridized with fragments of 3.5 and 3.4 kilobases (kb) in E.
      histolytica HindIII of EcoRI digested DNA. In E. invadens it recognized fragments
      of 3.1 and 2.8 kb, and in Laredo strain (reported as E. moshkovskii by Clark and
      Diamond in 1991) the probe hybridized with fragments of 17 kb. The c-myc probe
      identified transcripts of 3.3 and 1.5 kb in E. histolytica, transcripts of 1.8
      and 1.3 kb in Laredo strain, and transcripts of 3.7, 1.8, 1.5 and 1.1 kb in E.
      invadens. Antibodies against a highly conserved region of the c-myc protein
      recognized in E. histolytica polypeptides of 35, 40, and 60 kDa. The expression
      of the 60 kDa polypeptide was temperature-inducible in Laredo strain. In E.
      invadens a 110 kDa strong band was detected by the antibodies. Surprisingly, E.
      invadens myc-like sequences and proteins showed greater homology to mammalian c
      myc gene and proteins. Expression of proteins antigenically related to c-myc
      varied according to the cell cycle phase of E. histolytica. These proteins peaked
      during D, G1, and S phases and declined during G2.

PMID- 8475035
TI  - Phagocytosis and proteinase activity are not related to pathogenicity of E.
      histolytica.
AB  - To examine the relationship between phagocytosis, proteinase activity and
      pathogenicity of axenically grown trophozoites of E. histolytica strain HM-1:IMSS
      four different cultures were used: (1) a culture preserved in our laboratory for
      over 4 years, which lost its pathogenicity 3 years ago; (2) a culture passaged
      several times through hamster liver, which lost its pathogenicity recently; (3) a
      highly virulent culture supplied by another laboratory; and (4) amebas recovered
      from hamster liver abscesses caused by culture 3. Phagocytosis was measured as
      erythrophagocytosis. Proteinase activity was determined on azocasein.
      Pathogenicity was defined as the capacity to cause liver abscesses in hamsters. A
      negative correlation was found between phagocytic activity and pathogenicity,
      since amebas unable to cause liver abscesses had the highest phagocytic activity,
      whereas those recovered from liver abscesses had the lowest phagocytic activity.
      The percent of phagocytic amebas showed wide variations through a 2-month
      observation period, with no change in amebic pathogenicity. No correlation was
      found between the level of proteinase activity and pathogenicity. It is concluded
      that neither phagocytosis nor proteinase activity is an adequate marker of amebic
      pathogenicity.

PMID- 8475036
TI  - Circulating stable antigens at higher levels down-regulate antibody responses to
      Plasmodium falciparum.
AB  - A study involving 169 schoolchildren (5-14 years old) living in Manarintsoa near
      Antananarivo (Madagascar, East Africa) was performed during the seasonal malaria
      transmission period. For the whole population examined, the prevalence of
      Plasmodium falciparum and the rates of spleen enlargement and of circulating
      stable antigen (S-Ag) were found to be 60.9%, 71.7%, and 46.8%, respectively. The
      prevalence of IgG antibody to RESA (ring-infected erythrocyte surface antigen)
      was 42.7% and that of IgG and IgM antibodies to E-Ag (exoantigens) was 44.9% and
      2.9%, respectively. The positive rates for IgG and IgM antibodies to Som-Ag
      (somatic antigen) were 48.5% and 5.9%, respectively. Concerning S-Ag, no
      significant relationship was observed for parasitemia, spleen size, age, or IgM
      antibody responses to exoantigens (E-Ag) or to somatic antigen (Som-Ag). Levels
      of S-Ag were found to be related to IgG antibodies to E-Ag. Our results suggest
      that S-Ag at low levels may participate in the mechanisms involved in the
      development of the IgG antibody responses to E-Ag and to Som-Ag, whereas at a
      comparative population level, higher quantities of S-Ag down-regulate antibody
      responses to P. falciparum. The data we obtained were compared with those
      gathered in another malaria mesoendemic area (Bobo-Dioulasso, Burkina Faso, West
      Africa), where lower levels of S-Ag were found.

PMID- 8475037
TI  - Proteinases resistant to sodium dodecyl sulfate-induced autoproteolysis of
      Entamoeba histolytica HK9 trophozoites.

PMID- 8475038
TI  - Inhibition of Glossina morsitans midgut trypsin activity by D-glucosamine.
AB  - The effect of the amino sugar D-glucosamine on trypsin in crude midgut
      homogenates of Glossina morsitans morsitans was studied in vitro. The results
      showed that the midgut trypsin was specifically and competitively inhibited by D
      Glucosamine. Glucose, fructose, mannose, inositol, galactose, galactosamine, N
      acetyl-D-glucosamine, and methyl-alpha-D-glucosamine were ineffective as
      inhibitors, even at concentrations exceeding 600 mM. D-glucosamine also had a
      similar inhibitory effect on bovine pancreatic trypsin. In both cases, the
      inhibition was incomplete as shown by nonlinear Dixon plots. The Michaelis and
      inhibition constants estimated for the midgut trypsin were 41 +/- 2 microM and 68
      +/- 3 mM, respectively. These results suggest that the susceptibility of tsetse
      flies to trypanosome infection, which is associated with high midgut glucosamine
      levels, could be due to inhibition of trypsin or trypsin-like enzymes by this
      sugar.

PMID- 8475039
TI  - Species and strain differentiation of Eimeria spp. of the domestic fowl using DNA
      polymorphisms amplified by arbitrary primers.
AB  - Eimeria spp. from the domestic fowl were examined for genetic relatedness by the
      random amplified polymorphic DNA (RAPD) assay. Nine different oligonucleotide
      decamers with arbitrary DNA sequences were tested as primers to amplify DNA from
      six Eimeria species infecting chickens. Two strains each of E. acervulina and E.
      tenella were used. Depending on the species/strain-primer combination, between 1
      and 12 DNA segments ranging in size from 0.16 to 4.95 kb were amplified. The two
      strains of E. acervulina showed minor and major differences in their amplified
      DNA patterns, giving a similarity coefficient of 61%. The two strains of E.
      tenella seemed to be more closely related, yielding a similarity coefficient of
      98%. The differences observed between species were greater than those found
      between strains with every primer used, indicating that the RADP assay could be a
      useful tool for the study of relationships among these coccidia. The results
      obtained in this study also indicate the presence of unique, species-specific,
      amplified DNA segments that could be exploited to identify Eimeria species of the
      chicken.

PMID- 8475040
TI  - Molecular astrology: the case of the Myb DNA binding domain.

PMID- 8475041
TI  - Computer modelling of enzyme catalysed reaction mechanisms.

PMID- 8475042
TI  - Engineering cysteine mutants to obtain crystallographic phases with a cutinase
      from Fusarium solani pisi.
AB  - Cutinases are extracellular enzymes involved in the disruption of cutine, an
      insoluble polyester which covers the surface of plants. They belong to a class of
      serine esterases that are able to hydrolyse fatty acid esters and emulsified
      triglycerides as efficiently as lipases, but without displaying interfacial
      activation. Classical crystallographic methods for obtaining heavy-atom
      derivatives failed, so the cutinase structure has been solved exclusively by the
      multiple isomorphous replacement method using four Hg derivatives obtained from
      mutants S4C, S92C, S120C and S129C. Two of these derivatives behaved as expected:
      (i) the cys mutant of the catalytic Ser S120C, located at the surface of the
      active site pocket, leads to a good derivative; and (ii) the Hg atom of the
      derivative obtained with the S92C mutant is completely accessible to the solvent
      and occupies two alternative positions--consequently a poor derivative results.
      In contrast, two mutants show an unexpected behaviour: (i) the Hg atom in the
      S129C mutant was completely buried 10 A below the protein surface and yielded the
      best derivative; and (ii) a poor quality derivative was obtained with the S4C
      mutant. Cys 4 belongs to the disordered propeptide 1-16. The Cys 4 bound Hg atom
      is located in front of the Asp58 side chain, but neither Cys4 nor parts of the
      propeptide are clearly visible in the electron density maps of the derivative
      structure.

PMID- 8475043
TI  - Stabilization of lysozyme by the introduction of Gly-Pro sequence.
AB  - Three mutant lysozymes where the Asp101-Gly102 sequence of lysozyme was converted
      to Asp101-Pro102, Gly101-Pro102 and Pro101-Gly102 were prepared to investigate
      the effect of proline residues on the stabilization of proteins. The free energy
      changes of lysozymes for the unfolding in aqueous solution at pH 5.5 and 35
      degrees C were 10.0, 10.1, 11.0 and 7.7 kcal/mol for wild type, Asp101Pro102,
      Gly101Pro102 and Pro101Gly102 lysozyme respectively. When the energy level in the
      unfolded state of wild type lysozyme was fixed at a standard level, the energy
      levels in the folded state of Asp101Pro102 and Pro101Gly102 lysozymes were found
      to be higher than that of wild type lysozyme on the basis of delta GD(H2O) and
      entropy losses of their polypeptide chains in the unfolded state. The presence of
      some strain in the folded state of these lysozymes was supported by both the
      calculation of conformational energy for a trans-L-prolyl residue [Schimmel, P.R.
      and Flory, P.J. (1968) J. Mol. Biol., 34, 105-120] and the analysis of structures
      of energy-minimized mutant lysozymes. Therefore, it is concluded that the
      formation of the Gly-Pro sequence is effective in avoiding possible strain in the
      folded state of a protein caused by the introduction of proline residue(s).

PMID- 8475044
TI  - Characterization of the DNA binding domain of the mouse IRF-2 protein.
AB  - The DNA binding domain of the interferon regulatory factor-2 protein (IRF-2) has
      been produced and characterized. alpha-chymotrypsin digestion of the purified IRF
      2 protein bound to a synthetic binding site yields a peptide fragment of 14 K in
      molecular weight. N-terminal analysis of this peptide fragment showed that its
      sequence is the same as that of the intact IRF-2. A peptide fragment of
      approximately 14 K, IRF-2(113), which corresponds to the N-terminal 113 amino
      acids of the intact IRF-2 protein, has been expressed in a functional form in
      Escherichia coli. The first methionine was processed during the expression and
      the purified IRF-2(113) thus contains 112 amino acids. DNase I footprinting and
      gel retardation assaying showed that IRF-2(113) binds to a synthetic DNA having
      the consensus binding site and to the upstream regulatory sequence of the IFN
      beta gene as intact IRF-2 does. These results showed that this peptide fragment,
      IRF-2(113), may be a good material for investigation of the DNA binding domain of
      IRF-2 and of the DNA-protein interaction.

PMID- 8475045
TI  - Lysines 72, 80 and 213 and aspartic acid 210 of the Lactococcus lactis LacR
      repressor are involved in the response to the inducer tagatose-6-phosphate
      leading to induction of lac operon expression.
AB  - Site-directed mutagenesis of the Lactococcus lactis lacR gene was performed to
      identify residues in the LacR repressor that are involved in the induction of
      lacABCDFEGX operon expression by tagatose-6-phosphate. A putative inducer binding
      domain located near the C-terminus was previously postulated based on homology
      studies with the Escherichia coli DeoR family of repressors, which all have a
      phosphorylated sugar as inducer. Residues within this domain and lysine residues
      that are charge conserved in the DeoR family were changed into alanine or
      arginine. The production of the LacR mutants K72A, K80A, K80R, D210A, K213A and
      K213R in the LacR-deficient L.lactis strain NZ3015 resulted in repressed phospho
      beta-galactosidase (LacG) activities and decreased growth rates on lactose. Gel
      mobility shift assays showed that the complex between a DNA fragment carrying the
      lac operators and LacR mutants K72A, K80A, K213A and D210A did not dissociate in
      the presence of tagatose-6-phosphate, in contrast to wild type LacR. Other
      mutations (K62A/K63A, K72R, K73A, K73R, T212A, F214R, R216R and R216K) exhibited
      no gross effects on inducer response. The results strongly suggest that the
      lysines at positions 72, 80 and 213 and aspartic acid at position 210 are
      involved in the induction of lac operon expression by tagatose-6-phosphate.

PMID- 8475046
TI  - Engineering cytochrome P-450cam to increase the stereospecificity and coupling of
      aliphatic hydroxylation.
AB  - Site-directed mutants were constructed in cytochrome P-450cam to re-engineer the
      stereochemistry and coupling of ethylbenzene hydroxylation. The reaction with
      wild-type (WT) enzyme produces one regioisomer 1-phenylethanol with 5% reduced
      nicotinamide adenine deoxyribonucleic acid to product conversion of and a ratio
      of 73:27 for the R and S enantiomers respectively. Ethylbenzene was modeled into
      the active site of WT P-450cam in a rigid mode and oriented to optimize either
      pro-R or pro-S hydrogen abstraction. Residues T101, T185 and V247 make extensive
      contacts with the substrate in the static complexes and were therefore chosen for
      site-directed mutagenesis. Single mutants T101M, V247A and V247M are more
      stereospecific producing 89, 87 and 82% (R)-1-phenylethanol respectively. The
      coupling of the reaction is doubled for the single mutants T185L, T185F and
      V247M. In an effort to engineer increased stereospecificity and coupling into a
      single catalyst the T101M, T185F and V247M mutants were combined in a multiple
      mutant of P-450cam. This protein hydroxylates ethylbenzene resulting in an R:S
      ratio of 87:13 for the 1-phenylethanols and 13% coupling of reducing equivalents
      to product. The catalytic stereospecificity and stoichiometry with T101M--T185F-
      V247M does not represent a summation of the changes observed for the single
      mutants. A portion of the individual effects on substrate recognition produced by
      the single substitutions is either eliminated or degenerate within the triple
      mutant.

PMID- 8475047
TI  - Expression of functional papain precursor in Saccharomyces cerevisiae: rapid
      screening of mutants.
AB  - A microbial expression system for the study of the cysteine protease papain has
      been developed as a more useful alternative to the insect cell/baculovirus
      expression system we have previously used. A synthetic papain precursor
      (propapain) gene was expressed in the yeast Saccharomyces cerevisiae under the
      control of the alpha-factor promoter. Efficient expression required fusion of the
      propapain sequence with the yeast alpha-factor prepro region and a yeast host
      cell defective in the synthesis of vacuolar proteases. Surprisingly, the
      glycosylated form of the inactive papain precursor is not secreted, but
      accumulates within the yeast cell. Complete conversion of the intracellular
      zymogen into active mature papain could be achieved in vitro. Purified
      recombinant papain produced by the yeast system has kinetic characteristics
      similar to those of the natural enzyme. An advantage of the yeast expression
      system over the baculovirus/insect cell system is that we can perform mutagenesis
      and screening of papain mutants very efficiently. We have set up a 'one-tube'
      screening procedure for the simultaneous characterization of numerous mutants of
      the papain precursor. Yeast cells are grown and lysed in microtiter plate wells
      and the released papain precursor is then activated to mature papain. This assay
      allows easy discrimination between proteins with close to wild type properties
      and proteins that are not functional. We have applied this assay to investigate
      the spectrum of amino acids which are tolerated at Asn175 of papain using two
      independently derived libraries of mutants at this position. Many amino acid
      substitutions at this position are not accepted; only the reintroduction of Asn
      restored normal function.

PMID- 8475048
TI  - Overexpression and purification of avian ovomucoid third domains in Escherichia
      coli.
AB  - Genetic engineering studies of ovomucoid domains have been hindered by the lack
      of an efficient procedure for overproducing this protein. The novel scheme
      presented here has led to the isolation of chicken ovomucoid third domain
      (OMCHI3) at a level of 22 mg pure protein/l Escherichia coli culture medium. The
      gene coding for OMCHI3 was fused to the 3' end of the gene encoding
      staphylococcal nuclease (SNase). Expression of the chimeric gene was placed under
      control of the strong transcription and translation signals of the phage T7
      promoter. Upon isopropyl-beta-D-galactopyranoside induction, the cells harboring
      the target plasmid efficiently overproduced the protein (30% of the total soluble
      protein). The 56-residue fragment corresponding to OMCHI3 was then liberated by
      cyanogen bromide (CNBr) cleavage at a genetically engineered methionine residue
      located at the nuclease--OMCHI3 junction (OMCHI3 lacks an internal methionine).
      SDS--PAGE, enzyme inhibition studies and NMR spectroscopy all indicated that the
      recombinant OMCHI3 has properties identical to those of OMCHI3 isolated from its
      natural source. The expression system was easily adapted for the production of
      [98% U 15N] OMCHI3. The expression vector was mutated for overexpression of
      turkey ovomucoid third domain (OMTKY3), which differs from OMCHI3 by three amino
      acid substitutions. Since many other avian ovomucoid domains also lack methionine
      residues, this approach should be suitable for large-scale production and isotope
      labeling of homologous proteinase inhibitors with a variety of inhibitory
      specificities.

PMID- 8475049
TI  - Agrobacterium gene transfer: progress on a "poor man's vector" for maize.

PMID- 8475050
TI  - Nuclear magnetic resonance imaging and spectroscopy of human brain function.
AB  - The techniques of in vivo magnetic resonance (MR) imaging and spectroscopy have
      been established over the past two decades. Recent applications of these methods
      to study human brain function have become a rapidly growing area of research. The
      development of methods using standard MR contrast agents within the cerebral
      vasculature has allowed measurements of regional cerebral blood volume (rCBV),
      which are activity dependent. Subsequent investigations linked the MR relaxation
      properties of brain tissue to blood oxygenation levels which are also modulated
      by consumption and blood flow (rCBF). These methods have allowed mapping of brain
      activity in human visual and motor cortex as well as in areas of the frontal lobe
      involved in language. The methods have high enough spatial and temporal
      sensitivity to be used in individual subjects. MR spectroscopy of proton and
      carbon-13 nuclei has been used to measure rates of glucose transport and
      metabolism in the human brain. The steady-state measurements of brain glucose
      concentrations can be used to monitor the glycolytic flux, whereas subsequent
      glucose metabolism--i.e., the flux into the cerebral glutamate pool--can be used
      to measure tricarboxylic acid cycle flux. Under visual stimulation the
      concentration of lactate in the visual cortex has been shown to increase by MR
      spectroscopy. This increase is compatible with an increase of anaerobic
      glycolysis under these conditions as earlier proposed from positron emission
      tomography studies. It is shown how MR spectroscopy can extend this understanding
      of brain metabolism.

PMID- 8475051
TI  - Strategies to protect crop plants against viruses: pathogen-derived resistance
      blossoms.
AB  - Since 1986, the ability to confer resistance against an otherwise devastating
      virus by introducing a single pathogen-derived or virus-targeted sequence into
      the DNA of a potential host plant has had a marked influence on much of the
      research effort, focus, and short-term objectives of plant virologists throughout
      the world. The vast literature on coat protein-mediated protection, for example,
      attests to our fascination for unraveling fundamental molecular mechanism(s), our
      (vain) search for a unifying hypothesis, our pragmatic interest in commercially
      exploitable opportunities for crop protection, and our ingenuity in manipulating
      transgene constructions to broaden their utility and reduce real or perceived
      environmental risk issues. Other single dominant, pathogen-derived plant
      resistance genes have recently been discovered from a wide variety of viruses and
      are operative in an ever-increasing range of plant species. Additional candidates
      seem limited only by the effort invested in experimentation and by our ingenuity
      and imagination. This review attempts to consider, in a critical way, the current
      state of the art, some exceptions, and some proposed rules. The final impression,
      from all the case evidence considered, is that normal virus replication requires
      a subtle blend of host- and virus-coded proteins, present in critical relative
      concentrations and at specific times and places. Any unregulated superimposition
      of interfering protein or nucleic acid species can, therefore, result in an
      apparently virus-resistant plant phenotype.

PMID- 8475052
TI  - Cell-specific regulation of apoptosis by designed enediynes.
AB  - The naturally occurring enediyne antibiotics are a unique class of antitumor
      drugs that combine reactive enediynes with additional structural features
      conferring affinity for DNA. Dynemicin A, in which an enediyne core is attached
      to an anthraquinone group capable of DNA intercalation, readily cleaves double
      stranded DNA. This activity is thought to be the basis of its potent antitumor
      cytotoxicity. To investigate cell-specific mechanisms of cytotoxicity in the
      absence of DNA affinity, we have synthesized a variety of dynemicin-like
      enediynes that lack the anthraquinone moiety. We have found that the cytotoxicity
      of these compounds is dependent on their chemical instability and their
      enantiomeric form. Their selective toxicity results from a potent induction of
      apoptosis primarily in human leukemic cells. A group of synthetic enediynes were
      designed to be highly stable. These compounds were found to inhibit apoptotic
      cell death. This inhibition was observed in competition with the chemically
      unstable enediynes, including dynemicin and calicheamicin. The stable synthetic
      enediynes could also block the apoptotic morphology induced by unrelated
      cytotoxic agents such as cycloheximide, actinomycin D, and ultraviolet radiation.
      The results suggest that the cellular target(s) of synthetic enediynes may play a
      central role in regulating programmed cell death; a specific receptor-ligand
      interaction is proposed.

PMID- 8475053
TI  - T7 RNA polymerase mutants with altered promoter specificities.
AB  - The amino acid at position 748 in T7 RNA polymerase (RNAP) functions to
      discriminate base pairs at positions -10 and -11 in the promoter. We have
      constructed a series of T7 RNAP mutants having all possible amino acid
      substitutions at this position. Surprisingly, most (13/19) substitutions result
      in active RNAPs, and many of these exhibit altered promoter specificities.
      Identification of mutant RNAPs with altered specificities expands the repertoire
      of highly specific phage RNAPs that are available for use in phage RNAP-based
      transcription systems and highlights the complexity of sequence-specific DNA
      recognition.

PMID- 8475054
TI  - Identification and characterization of a nuclease activity specific for G4
      tetrastranded DNA.
AB  - We have identified a nuclease activity that is specific for G4 tetrastranded DNA.
      This activity, found in a partially purified fraction for a yeast telomere
      binding protein, binds to DNA molecules with G4 tetrastranded structure,
      regardless of their nucleotide sequences, and cleaves the DNA in a neighboring
      single-stranded region 5' to the G4 structure. Competition with various G4-DNA
      molecules inhibits the cleavage reaction, suggesting that this nuclease activity
      is specific for G4 tetrastranded DNA. The existence of this enzymatic activity
      that reacts with G4 DNAs but not with single-stranded or Watson-Crick duplex DNAs
      suggests that tetrastranded DNA may have a distinct biological function in vivo.

PMID- 8475055
TI  - Osteocalcin gene promoter-binding factors are tissue-specific nuclear matrix
      components.
AB  - The nuclear matrix appears to play an important role in developmental gene
      expression during osteoblast differentiation. To better understand this role, we
      examined nuclear matrix DNA-binding proteins that are sequence-specific and
      interact with the osteocalcin gene promoter. Multiple protein-DNA interactions
      involving two distinct nuclear matrix proteins occur within the 5' regulatory
      sequences (nt -640 to -430). One of these proteins, NMP-1, is a ubiquitous, cell
      growth-regulated protein that is related to the transcription factor ATF and
      resides in both the nuclear matrix and the nonmatrix nuclear compartment. The
      other protein, NMP-2, is a cell type-specific, 38-kDa promoter factor that
      recognizes binding sites resembling the consensus site for the CCAAT/enhancer
      binding protein C/EBP and is localized exclusively on the nuclear matrix. NMP-1
      and NMP-2 each interact with two nuclear matrix protein-binding elements. These
      elements are present near key regulatory sites of the osteocalcin gene promoter,
      such as the principal steroid hormone (vitamin D)-responsive sequences. Binding
      in this region of the osteocalcin gene promoter suggests transient associations
      with the nuclear matrix that are distinct from the stable interactions of matrix
      attachment regions. Our results are consistent with involvement of the nuclear
      matrix in concentrating and/or localizing transcription factors that mediate the
      basal and steroid hormone responsiveness of osteocalcin gene transcription.

PMID- 8475057
TI  - Dating the genetic bottleneck of the African cheetah.
AB  - The cheetah is unusual among fields in exhibiting near genetic uniformity at a
      variety of loci previously screened to measure population genetic diversity. It
      has been hypothesized that a demographic crash or population bottleneck in the
      recent history of the species is causal to the observed monomorphic profiles for
      nuclear coding loci. The timing of a bottleneck is difficult to assess, but
      certain aspects of the cheetah's natural history suggest it may have occurred
      near the end of the last ice age (late Pleistocene, approximately 10,000 years
      ago), when a remarkable extinction of large vertebrates occurred on several
      continents. To further define the timing of such a bottleneck, the character of
      genetic diversity for two rapidly evolving DNA sequences, mitochondrial DNA and
      hypervariable minisatellite loci, was examined. Moderate levels of genetic
      diversity were observed for both of these indices in surveys of two cheetah
      subspecies, one from South Africa and one from East Africa. Back calculation from
      the extent of accumulation of DNA diversity based on observed mutation rates for
      VNTR (variable number of tandem repeats) loci and mitochondrial DNA supports a
      hypothesis of an ancient Pleistocene bottleneck that rendered the cheetah
      depauperate in genetic variation for nuclear coding loci but would allow
      sufficient time for partial reconstitution of more rapidly evolving genomic DNA
      segments.

PMID- 8475056
TI  - Differentiation-dependent activation of interferon-stimulated gene factors and
      transcription factor NF-kappa B in mouse embryonal carcinoma cells.
AB  - We have recently shown that the adenovirus E1A gene products block interferon
      alpha-induced signal transduction and transcription factor NF-kappa B-mediated
      gene induction. Here we report that the same responses are also blocked in
      undifferentiated F9 teratocarcinoma cells. The block was removed upon cellular
      differentiation and regained upon the introduction of viral E1A into the
      differentiated cells. In undifferentiated cells, interferon-beta failed to induce
      the transcription of interferon-responsive genes because of a lack of activation
      of the cognate trans-acting factors. As a result, in these cells, virus
      replication was not inhibited by interferon. Similarly, in undifferentiated but
      not in differentiated F9 cells, tumor necrosis factor alpha failed to stimulate
      NF-kappa B-mediated transcription of a reporter gene because of a failure in the
      activation of NF-kappa B trans-acting factor. These results suggest that a
      cellular E1A-like activity, present in undifferentiated F9 cells, and adenoviral
      E1A use similar mechanisms for repressing the expression of specific cellular
      genes.

PMID- 8475058
TI  - Lethal thalassemia after insertional disruption of the mouse major adult beta
      globin gene.
AB  - Thalassemias are hereditary anemias caused by mutations that disturb the normal
      1:1 balance of alpha- and beta-globin chains that form hemoglobin. We have
      disrupted the major adult beta-globin gene (b1) in mouse embryonic stem cells by
      using homologous recombination to insert selectable sequences into the gene. Mice
      homozygous for this insertional disruption of the b1 gene (Hbbth-2/Hbbth-2) are
      severely anemic and die perinatally. In contrast, approximately 60% of mice
      homozygous for deletion of the same gene (Hbbth-1/Hbbth-1) survive to adulthood
      and are much less anemic [Skow, L. C., Burkhart, B. A., Johnson, F. M., Popp, R.
      A., Goldberg, S. Z., Anderson, W. F., Barnett, L. B. & Lewis, S. E. (1983) Cell
      34, 1043-1052]. These different phenotypes have implications for the control of
      beta-globin gene expression.

PMID- 8475059
TI  - Conversion of truncated and elongated prion proteins into the scrapie isoform in
      cultured cells.
AB  - The only known component of the infectious prion is a posttranslationally
      modified protein known as the scrapie isoform of the prion protein, PrPSc. Upon
      limited proteolysis, a protease-resistant fragment designated PrP 27-30 is
      formed. Using in vitro mutagenesis, we examined the role of the N and C termini
      in the formation of PrPSc in persistently infected, mouse neuroblastoma (ScN2a)
      cells. Neither deletion of amino acids 23-88, which are also removed by
      proteinase K in the formation of PrP 27-30, nor deletion of the five octapeptide
      repeats within this region altered synthesis of PrPSc. Elongation of PrP with
      one, two, four, or six octapeptide repeats in addition to the five found in wild
      type PrP did not alter the synthesis of PrPSc. Truncation of the C terminus was
      accomplished by substituting a translation stop codon for the predicted
      glycosylinositol phospholipid (GPI) anchor-attachment signal corresponding to
      amino acids 231-254. Expression of this C-terminal PrP mutant in ScN2a cells
      produced PrPSc that appeared to lack a GPI anchor. We conclude that neither the
      GPI anchor nor the N-terminal 66 amino acids are required for the synthesis of
      PrPSc as measured by the acquisition of limited resistance to proteinase K
      digestion. Whether these truncated or elongated PrP molecules are competent to
      participate in the formation of infectious prions remains to be established.

PMID- 8475060
TI  - Calcium influx mediated by the Escherichia coli heat-stable enterotoxin B (STB).
AB  - The heat-stable enterotoxin B (STB) of Escherichia coli is a 48-amino acid
      extracellular peptide that induces rapid fluid accumulation in animal intestinal
      models. Unlike other E. coli enterotoxins that elicit cAMP or cGMP responses in
      the gut [heat-labile toxin (LT) and heat-stable toxin A (STA), respectively], STB
      induces fluid loss by an undefined mechanism that is independent of cyclic
      nucleotide elevation. Here we studied the effects of STB on intracellular calcium
      concentration ([Ca2+]i), another known mediator of intestinal ion and fluid
      movement. Ca2+ and pH measurements were performed on different cell types
      including Madin-Darby canine kidney (MDCK), HT-29/C1 intestinal epithelial cells,
      and primary rat pituitary cells. Ca2+ and pH determinations were performed by
      simultaneous real-time fluorescence imaging at four emission wavelengths. This
      allowed dual imaging of the Ca(2+)- and pH-specific ratio dyes (indo-1 and SNARF
      1, respectively). STB treatment induced a dose-dependent increase in [Ca2+]i with
      virtually no effect on internal pH in all of the cell types tested. STB-mediated
      [Ca2+]i elevation was not inhibited by drugs that block voltage-gated Ca2+
      channels including nitrendipine, verapamil (L-type), omega-conotoxin (N-type),
      and Ni2+ (T-type). The increase in [Ca2+]i was dependent on a source of
      extracellular Ca2+ and was not affected by prior treatment of MDCK cells with
      thapsigargin or cyclopiazonic acid, agents that deplete and block internal Ca2+
      stores. In contrast to these results, somatostatin and pertussis toxin
      pretreatment of MDCK cells completely blocked the STB-induced increase in
      [Ca2+]i. Taken together, these data suggest that STB opens a GTP-binding
      regulatory protein-linked receptor-operated Ca2+ channel in the plasma membrane.
      The nature of the STB-sensitive Ca2+ channel is presently under investigation.

PMID- 8475061
TI  - Assembly of a functional replication complex without ATP hydrolysis: a direct
      interaction of bacteriophage T4 gp45 with T4 DNA polymerase.
AB  - The seven-protein bacteriophage T4 DNA replication complex can be manipulated in
      vitro to study mechanistic aspects of the elongation phase of DNA replication.
      Under physiological conditions, the processivity of DNA synthesis catalyzed by
      the T4 polymerase (gp43) is greatly increased by the interaction of this enzyme
      with its accessory proteins (gp44/62 and gp45) and the T4 single-stranded DNA
      binding protein (gp32). The assembly of this T4 holoenzyme requires hydrolysis of
      ATP by the gp44/62 complex. We demonstrate here that processive T4 holoenzyme
      like DNA synthesis can be obtained without hydrolysis of ATP by simply adding
      gp45 to the T4 DNA polymerase at extremely high concentrations, effectively
      bypassing the ATPase subunits (gp44/62) of the accessory protein complex. The
      amount of gp45 required for the gp43-gp45 heteroassociation event is reduced by
      addition of the macromolecular crowding agent polyethylene glycol (PEG) as well
      as gp32. A chromatographic strategy involving PEG has been used to demonstrate
      the gp43-gp45 interaction. These results suggest that gp45 is ultimately
      responsible for increasing the processivity of DNA synthesis via a direct and
      functionally significant interaction with the T4 DNA polymerase. A corollary to
      this notion is that the specific role of the gp44/62 complex is to catalytically
      link gp45 to gp43.

PMID- 8475062
TI  - Clonal ordering of 17p and 5q allelic losses in Barrett dysplasia and
      adenocarcinoma.
AB  - Both 17p and 5q allelic losses appear to be involved in the pathogenesis or
      progression of many human solid tumors. In colon carcinogenesis, there is strong
      evidence that the targets of the 17p and 5q allelic losses are TP53, the gene
      encoding p53, and APC, respectively. It is widely accepted that 5q allelic losses
      precede 17p allelic losses in the progression to colonic carcinoma. The data,
      however, supporting this proposed order are largely based on the prevalence of
      17p and 5q allelic losses in adenomas and unrelated adenocarcinomas from
      different patients. We investigated the order in which 17p and 5q allelic losses
      developed during neoplastic progression in Barrett esophagus by evaluating
      multiple aneuploid cell populations from the same patient. Using DNA content flow
      cytometric cell sorting and polymerase chain reaction, 38 aneuploid cell
      populations from 14 patients with Barrett esophagus who had high grade dysplasia,
      cancer or both were evaluated for 17p and 5q allelic losses. 17p allelic losses
      preceded 5q allelic losses in 7 patients, both 17p and 5q allelic losses were
      present in all aneuploid populations of 4 patients, and only 17p (without 5q)
      allelic losses were present in the aneuploid populations of 3 patients. In no
      patient did we find that a 5q allelic loss preceded a 17p allelic loss. Our data
      suggest that 17p allelic losses typically occur before 5q allelic losses during
      neoplastic progression in Barrett esophagus.

PMID- 8475063
TI  - A human vascular disorder, supravalvular aortic stenosis, maps to chromosome 7.
AB  - The pathogenesis of vascular disease is unclear, but genetic factors play an
      important role. In this study we performed linkage analyses in two families with
      supravalvular aortic stenosis, an inherited vascular disorder that causes
      narrowing of major arteries and may lead to cardiac overload and failure. DNA
      markers on the long arm of chromosome 7 (D7S371, D7S395, D7S448, and ELN) were
      linked to supravalvular aortic stenosis in both families with a combined
      logarithm of likelihood for linkage (lod score) of 5.9 at the ELN locus. These
      findings indicate that a gene for supravalvular aortic stenosis is located in the
      same chromosomal subunit as elastin, which becomes a candidate for the disease
      gene.

PMID- 8475064
TI  - CD22 associates with the human surface IgM-B-cell antigen receptor complex.
AB  - The B-cell surface molecule CD22, when cross-linked, modulates signaling through
      the surface IgM (sIgM)-B-cell receptor (BCR) complex. Here we analyzed the basis
      of this interaction between CD22 and the human sIgM complex. After lysis of B
      cells or B-cell lines in digitonin, CD22 coimmunoprecipitated a kinase activity
      that in vitro-phosphorylated two polypeptides of 150 and 130 kDa on tyrosine
      residues. By immunoblot analysis with a rabbit anti-serum specific for a
      synthetic peptide of CD22, we found these proteins to be CD22 itself.
      Furthermore, the phosphorylated 150-kDa CD22 was found in the sIgM-BCR complex
      maintained by digitonin, along with Ig alpha/mb-1, Ig beta/B29, and a 75-kDa
      polypeptide precipitated by an antiserum specific to protein-tyrosine kinase
      PTK72. CD22 is likely to be an important signaling partner in the sIgM-BCR
      complex since it is very rapidly and strikingly phosphorylated after sIgM is
      cross-linked and since it contains the antigen recognition homology I (ARHI)
      motif, present in other antigen receptor molecules.

PMID- 8475066
TI  - Direction of handedness linked to hereditary asymmetry of a sensory system.
AB  - Studies on the role of heredity in the transmission of handedness in nonhuman
      mammals have, so far, led to the isolation of mouse strains that differed in the
      lateralized versus ambidextrous use of the forepaw in a food-retrieval task
      (strength of paw preference). Here we report that left versus right use of the
      forepaw (direction of paw preference) is associated with a genetically expressed
      structural asymmetry of a sensory system, the whisker-to-barrel pathway. Mice
      that express whisker pad asymmetry of a direction that corresponds with the
      asymmetry for which they were bred demonstrate an opposite shift in the
      distribution of handedness: a right or left dominance of the whisker pad predicts
      a high proportion of left-handers or right-handers, respectively. Is an altered
      brain circuit--that is, a consequence of the asymmetry of the whisker pad-
      associated with a change in the circuitry that governs handedness? Or,
      alternatively, are there two gene sets responsible for the phenomena that we
      report--one that causes "whiskeredness" and another that causes handedness?

PMID- 8475065
TI  - Beta-arrestin and arrestin are recognized by autoantibodies in sera from multiple
      sclerosis patients.
AB  - Multiple sclerosis (MS), one of the most common chronic neurologic diseases, is
      characterized by the presence of multiple plaques of demyelination throughout the
      central nervous system. Although the etiology of the disease has not been
      established, it is believed to involve autoimmune mechanisms. We have examined
      sera from patients with MS for the presence of antibodies to antigens from brain
      and retina. Immunoblot analysis of soluble fraction of proteins from bovine brain
      revealed a prominent band at 45 kDa stained with sera of 8-14 patients with MS.
      In two patients with MS, serum antibody titers during relapse were higher
      compared with those when the patients were in remission. These antibodies were
      undetectable in cerebrospinal fluid of our MS patients and additionally were
      absent in sera of patients with other neurological diseases and normal control
      subjects. Furthermore, immunoblot analysis of the soluble fraction from bovine
      retinal rod outer segments revealed a prominent protein band at 48 kDa stained
      with MS sera. This antigen was purified to homogeneity from bovine retinal outer
      segments and identified as arrestin. Additionally, sera from MS patients reacted
      with purified beta-arrestin 1, a 45-kDa protein homologous to arrestin that is
      found in various tissues. Using limited proteolysis of arrestin and a competitive
      ELISA test with a synthetic peptide, we identified the recognition site(s) for
      antibodies in sera of MS patients at a dominant immunogenic site on arrestin
      located at the C-terminal region of the molecule. We suggest that the presence of
      circulating antibodies reactive with beta-arrestin or arrestin may be related to
      the course of MS progression.

PMID- 8475067
TI  - Precursor polyprotein for multiple neuropeptides secreted from the suboesophageal
      ganglion of the silkworm Bombyx mori: characterization of the cDNA encoding the
      diapause hormone precursor and identification of additional peptides.
AB  - Peptidergic neurons, which serve as source of various endocrine neuropeptides,
      were identified in the suboesophageal ganglion (SG) and brain of insects. In the
      silkworm Bombyx mori, SG is known to secrete two neuropeptides, diapause hormone
      (DH) responsible for induction of embryonic diapause and pheromone biosynthesis
      activating neuropeptide, which share a pentapeptide amide, Phe-Xaa-Pro-Arg-Leu
      NH2 (Xaa = Gly or Ser), at the C terminus. We have isolated cDNA clones for DH
      from the cDNA library of SG by using oligonucleotide probes. The molecular
      characterization of the cDNA reveals that the mRNA encodes an open reading frame
      consisting of 192 aa residues in which the 24-aa DH peptide is localized at the N
      terminal region just after the signal peptide. A homology search proposed that
      the cDNA encodes pheromone biosynthesis-activating neuropeptide and three other
      neuropeptides [alpha-, beta-, and gamma-SG neuropeptide (SGNP)] in the region
      following DH, all of which are flanked by possible tryptic cleavage sites and
      share the Phe-Xaa-Pro-Arg-Leu-Gly sequence at the C terminus. Northern
      hybridization analysis clearly showed that the gene expression was limited to SG.
      We chemically synthesized alpha-, beta-, and gamma-SGNP and used them to identify
      components in extracts of SG and to examine biological functions, alpha- and
      gamma-SGNP were identified in extracts of SG, and the synthetic beta- and gamma
      SGNP expressed weak DH activity. These results indicate that DH, along with four
      other neuropeptides, is generated from a common precursor polyprotein that is
      encoded by a single mRNA transcribed in neurosecretory cells of SG.

PMID- 8475069
TI  - The alpha aneurism: a structural motif revealed in an insertion mutant of
      staphylococcal nuclease.
AB  - The x-ray crystal structure of a mutant of staphylococcal nuclease that contains
      a single glycine residue inserted in the C-terminal alpha-helix has been solved
      to 1.67 A resolution and refined to a crystallographic R value of 0.170. This
      inserted glycine residue is accommodated in the alpha-helix by formation of a
      previously uncharacterized bulge, which we term the alpha aneurism. A
      conformational search of known protein structures has identified the alpha
      aneurism in a number of protein families, including the histocompatibility
      antigens and hemoglobins.

PMID- 8475068
TI  - Sp-1 binds promoter elements regulated by the RB protein and Sp-1-mediated
      transcription is stimulated by RB coexpression.
AB  - The retinoblastoma (RB) protein is implicated in transcriptional regulation of at
      least five cellular genes, including c-fos, c-myc, and transforming growth factor
      beta 1. Cotransfection of RB and truncated promoter constructs has defined a
      discrete element (retinoblastoma control element; RCE) within the promoters of
      each of these genes as being necessary for RB-mediated transcription control.
      Previously, we have shown that RCEs form protein-DNA complexes in vitro with
      three heretofore unidentified nuclear proteins and mutation of their DNA-binding
      site within the c-fos RCE results in an abrogation of RCE-dependent transcription
      in vivo. Here, we demonstrate that one of the nuclear proteins that binds the c
      fos, c-myc, and transforming growth factor beta 1 RCEs in vitro is Sp-1 and that
      Sp-1 stimulates RCE-dependent transcription in vivo. Moreover, we show that Sp-1
      mediated transcription is stimulated by the transient coexpression of RB protein.
      We conclude from these observations that RB may regulate transcription in part by
      virtue of its ability to functionally interact with Sp-1.

PMID- 8475070
TI  - Separation between cytosolic calcium and secretion in chromaffin cells superfused
      with calcium ramps.
AB  - This paper describes experiments in which cytosolic Ca2+ concentrations ([Ca2+]i)
      and catecholamine release were measured in two populations of chromaffin cells
      stimulated with a solution enriched in K+ (100 mM). Once depolarized, external
      Ca2+ or Ba2+ ions were offered to cells either as a single 2.5 mM step or as a
      ramp that linearly increased the concentration from 0 to 2.5 mM over a 10-min
      period. A clear separation between the changes of the [Ca2+]i and the time course
      of secretion was observed. Specifically, secretion and [Ca2+]i rose in parallel
      when a Ca2+ step was used to reach a peak in a few seconds; however, while
      secretion declined to the basal level, [Ca2+]i remained elevated at a plateau of
      400 nM. With a Ca2+ ramp, only a transient small peak of secretion was observed,
      yet the [Ca2+]i remained elevated throughout the 10-min stimulation period. The
      separation between secretion and [Ca2+]i was observed even when voltage-dependent
      Ca2+ channels were expected to remain open (mild depolarization in the presence
      of 1 microM Bay K 8644). By using Ba2+ steps or ramps, sustained noninactivating
      secretory responses were obtained. The results suggest that the rate and extent
      of secretion are not a simple function of the [Ca2+]i at a given time; they are
      compatible with the following conclusions: (i) A steep extracellular-to-cytosolic
      Ca2+ gradient is required to produce a sharp increase in the [Ca2+]i at
      exocytotic sites capable of evoking a fast but transient secretory response. (ii)
      As a result of Cai(2+)-dependent inactivation of Ca2+ channels, those high
      [Ca2+]i are possible only at early times after cell depolarization. (iii) The
      Cai(2+)-dependent supply of storage granules to the secretory machinery
      cooperates with the supply of Ca2+ through Ca2+ channels to regulate the rate and
      extent of secretion.

PMID- 8475071
TI  - Acquired multicellular-mediated resistance to alkylating agents in cancer.
AB  - EMT-6 murine mammary tumor sublines highly resistant to cyclophosphamide, cis
      diamminedichloro-platinum(II), or N,N',N"-triethylenethiophosphoramide were
      generated in vivo by sequential treatment of tumor-bearing mice with the
      respective drugs. Previous studies demonstrated the drug-resistant phenotypes of
      the sublines were not expressed in vitro when the cells were grown as monolayer
      cultures. We now show that expression of drug resistance--including patterns of
      cross-drug resistance observed in vivo--can be fully recapitulated in vitro when
      the cells are grown under in vivo-like, three-dimensional conditions--namely, as
      multicellular tumor spheroids. Moreover, the spheroids generated from all of the
      drug-resistant sublines manifested a much more compact structure. Immediate drug
      sensitivity testing of single cells released by trypsin treatment from compact
      drug-resistant spheroids revealed that such cells lost much of their drug
      resistant properties. The results suggest a possible mechanism of acquired drug
      resistance in tumors based on the response of a cell population (i.e.,
      multicellular or tissue resistance) as opposed to classic (uni)cellular
      resistance mechanisms.

PMID- 8475072
TI  - Inhibition of rate of tumor growth by creatine and cyclocreatine.
AB  - Growth rate inhibition of subcutaneously implanted tumors results from feeding
      rats and athymic nude mice diets containing 1% cyclocreatine or 1%, 2%, 5%, or
      10% creatine. The tumors studied included rat mammary tumors (Ac33tc in Lewis
      female rats and 13762A in Fischer 344 female rats), rat sarcoma MCI in Lewis male
      rats, and tumors resulting from the injection of two human neuroblastoma cell
      lines, IMR-5 and CHP-134, in athymic nude mice. Inhibition was observed
      regardless of the time experimental diets were administered, either at the time
      of tumor implantation or after the appearance of palpable tumors. For mammary
      tumor Ac33tc, the growth inhibition during 24 days after the implantation was
      approximately 50% for both 1% cyclocreatine and 1% creatine, and inhibition
      increased as creatine was increased from 2% to 10% of the diet. For the other rat
      mammary tumor (13762A), there was approximately 35% inhibition by both 1%
      cyclocreatine and 2% creatine. In the case of the MCI sarcoma, the inhibitory
      effect appeared more pronounced at earlier periods of growth, ranging from 26% to
      41% for 1% cyclocreatine and from 30% to 53% for 1% creatine; there was no
      significant difference in growth rate between the tumors in the rats fed 1% and
      5% creatine. The growth rate of tumors in athymic nude mice, produced by
      implantation of the human neuroblastoma IMR-5 cell line, appeared somewhat more
      effectively inhibited by 1% cyclocreatine than by 1% creatine, and 5% creatine
      feeding was most effective. For the CHP-134 cell line, 33% inhibition was
      observed for the 1% cyclocreatine diet and 71% for the 5% creatine diet. In
      several experiments, a delay in appearance of tumors was observed in animals on
      the experimental diets. In occasional experiments, neither additive inhibited
      tumor growth rate for the rat tumors or the athymic mouse tumors.

PMID- 8475073
TI  - Data base analysis of protein expression patterns during T-cell ontogeny and
      activation.
AB  - We have developed a data base of lymphoid proteins detectable by two-dimensional
      polyacrylamide gel electrophoresis. The data base contains two-dimensional
      patterns and derived information pertaining to polypeptide constituents of
      unstimulated and stimulated mature T cells and immature thymocytes, single-cell
      derived T- and B-cell clones, leukemia cells, and lymphoid cell lines. Using this
      data base, we have compared the protein constituents of mature T cells and
      immature thymocytes before and after mitotic stimulation. A subset of
      polypeptides that are induced in mature T cells following mitotic stimulation
      were found to be constitutively expressed in immature thymocytes. Other
      polypeptides exhibited differences in their expression between mature and
      immature thymocytes in a manner unrelated to proliferation. The identity of
      several constitutively expressed or mitotically induced proteins in lymphoid
      cells was established by microsequencing. These initial findings point to
      significant differences in the molecular pathways leading to proliferation
      between mature and immature T cells. The construction of this database should
      facilitate further studies of lymphoid differentiation and function.

PMID- 8475074
TI  - The p53 protein is an unusually shaped tetramer that binds directly to DNA.
AB  - We have analyzed the size and structure of native immunopurified human p53
      protein. By using a combination of chemical crosslinking, gel filtration
      chromatography, and zonal velocity gradient centrifugation, we have determined
      that the predominant form of p53 in such preparations is a tetramer. The behavior
      of purified p53 in gels and sucrose gradients implies that the protein has an
      extended shape. Wild-type p53 has been shown to bind specifically to sites in
      cellular and viral DNA. We show in this study by Southwestern ligand blotting and
      by analysis of DNA-bound crosslinked p53 that p53 monomers, dimers, and tetramers
      can bind directly to DNA.

PMID- 8475075
TI  - Crystal structure of cyclophilin A complexed with substrate Ala-Pro suggests a
      solvent-assisted mechanism of cis-trans isomerization.
AB  - Cyclophilin is a binding protein for the immunosuppressive drug cyclosporin A and
      is also an enzyme with peptidyl-prolyl cis-trans isomerase activity. The crystal
      structure of cyclophilin A complexed with the substrate Ala-Pro has been
      determined and refined to an R factor of 0.196 at 1.64-A resolution. The
      structure shows that only the cis form of Ala-Pro binds cyclophilin A despite the
      fact that Ala-Pro has an equilibrium majority of the trans form in solution.
      Simulation of the cis-trans isomerization in an ESV10 graphics system suggests a
      solvent-assisted mechanism in which first the peptidyl-prolyl bond is desolvated
      at the ground state by binding to the hydrophobic pocket of the active site, and
      later the intermediate state is stabilized by a hydrogen bond between the
      carbonyl oxygen of the amide bond and a bound water molecule.

PMID- 8475076
TI  - Odor-induced increases in c-fos mRNA expression reveal an anatomical "unit" for
      odor processing in olfactory bulb.
AB  - Expression of the immediate-early gene c-fos was used to evaluate the coordinate
      activation of olfactory bulb neurons by brief exposure to specific odors in the
      alert rat. In situ hybridization to c-fos mRNA was compared to regional increases
      in 2-deoxy-D-[14C]glucose incorporation in an adjacent section analysis. Levels
      of c-fos mRNA in olfactory bulb were high in rats recently removed from their
      home cage but were low in animals placed in a relatively odor-free chamber for 30
      min. Presentation of specific odors to alert rats for as little as 5 min
      increased c-fos mRNA in radially distributed neuronal ensembles that spanned the
      lamina of the main olfactory bulb. The complementary RNA (cRNA)-labeled neuronal
      collectives consisted of cells in the glomerular layer that precisely defined the
      borders of individual glomeruli and underlying tufted, mitral, and granule cells.
      The activated fields were much broader in the granule cell layer than in the
      overlying glomerular layer and thus exhibited a flask-like, as opposed to a
      columnar, contour. The bulbar distribution of cRNA-labeled cell arrays differed
      with different odors and, in the glomerular layer, corresponded to focal regions
      of high 2-deoxy-D-[14C]glucose uptake. Administration of the noncompetitive N
      methyl-D-aspartate receptor antagonist MK801 did not attenuate the odor induction
      of c-fos but, instead, increased c-fos mRNA levels throughout the bulb. We
      propose that the neuronal ensembles expressing increased c-fos mRNA with odor
      stimulation represent principal functional units of sensory processing in the
      main olfactory bulb of the behaving rat.

PMID- 8475077
TI  - Z-DNA binding protein from chicken blood nuclei.
AB  - A protein (Z alpha) that appears to be highly specific for the left-handed Z-DNA
      conformer has been identified in chicken blood nuclear extracts. Z alpha activity
      is measured in a band-shift assay by using a radioactive probe consisting of a
      (dC-dG)35 oligomer that has 50% of the deoxycytosines replaced with 5
      bromodeoxycytosine. In the presence of 10 mM Mg2+, the probe converts to the Z
      DNA conformation and is bound by Z alpha. The binding of Z alpha to the
      radioactive probe is specifically blocked by competition with linear poly(dC-dG)
      stabilized in the Z-DNA form by chemical bromination but not by B-form poly(dC
      dG) or boiled salmon-sperm DNA. In addition, the binding activity of Z alpha is
      competitively blocked by supercoiled plasmids containing a Z-DNA insert but not
      by either the linearized plasmid or by an equivalent amount of the parental
      supercoiled plasmid without the Z-DNA-forming insert. Z alpha can be crosslinked
      to the 32P-labeled brominated probe with UV light, allowing us to estimate that
      the minimal molecular mass of Z alpha is 39 kDa.

PMID- 8475078
TI  - The nucleotide in position 32 of the tRNA anticodon loop determines ability of
      anticodon UCC to discriminate among glycine codons.
AB  - We have investigated the influence of structures in the tRNA anticodon loop and
      stem on the ability of the anticodon to discriminate among codons. We had
      previously shown that anticodon UCC, when placed in the structural context of
      tRNA(Gly1) from Escherichia coli, discriminated efficiently between the glycine
      codons, as required by the wobble rules. Thus, this anticodon read GGA and GGG
      but did not read GGU and GGC, whereas in mycoplasma tRNA(Gly), the same anticodon
      did not discriminate among the glycine codons. We have now determined the reading
      properties of three constructions based on tRNA(Gly1) containing the anticodon
      UCC in different structural contexts. In one of these constructs, tRNA(Gly1-ASL),
      the anticodon loop and stem are the same as in mycoplasma tRNA(Gly). The second
      construct, tRNA(Gly1-AS), has an anticodon stem identical with the mycoplasma
      tRNA(Gly), whereas in the last construct, tRNA(Gly1-C32), the only difference
      from tRNA(Gly1)(UCC) is that the uridine in position 32 of the anticodon loop has
      been replaced by cytidine. These constructs were tested for ability to read
      glycine codons in an in vitro protein-synthesizing system that allowed us to
      monitor separately the reading of each codon. We found that the anticodon UCC,
      when present in tRNA(Gly1-AS), discriminated among the glycine codons, whereas in
      the constructs tRNA(Gly1-ASL) and tRNA(Gly1-C32), the same anticodon had lost its
      ability to discriminate--i.e., it behaved as in mycoplasma tRNA(Gly). These
      results strongly suggest that nt 32 of the anticodon loop of tRNA(Gly1)(UCC)
      decisively influences the reading properties of the anticodon UCC.

PMID- 8475079
TI  - Regulated expression of an insulin-responsive glucose transporter (GLUT4)
      minigene in 3T3-L1 adipocytes and transgenic mice.
AB  - Preliminary studies showed that up to 7 kb of 5' flanking sequence of the insulin
      responsive glucose transporter (GLUT4) gene are insufficient to mediate
      differentiation-induced reporter gene expression in mouse 3T3-L1 preadipocytes.
      To locate the regulatory element(s) responsible for this function, a minigene
      containing the entire GLUT4 gene with substantial 5' and 3' flanking sequence and
      a short segment of foreign DNA (for transcript identification) was constructed
      and transfected into mice and 3T3-L1 preadipocytes at relatively low copy number.
      In transgenic mice the GLUT4 minigene exhibited a pattern of tissue-specific
      expression similar, but not identical, to that of the endogenous gene. In 3T3-L1
      cells expression of minigene mRNA occurred upon differentiation into adipocytes,
      with kinetics virtually identical to that of endogenous GLUT4 mRNA. In both
      cultured adipocytes and transgenic mice, the level of expression of the minigene
      was low relative to that of the endogenous gene. Treatment of minigene
      transfected 3T3-L1 adipocytes with 8-bromo-cAMP, which represses transcription of
      the endogenous GLUT4 gene, also repressed expression of the GLUT4 minigene.
      However, insulin, which down-regulates transcription of the endogenous GLUT4
      gene, failed to normally down-regulate expression of the GLUT4 minigene. These
      findings indicate that the cis-acting elements required for directing tissue
      specific expression (in heart, skeletal muscle, and brown adipose tissue),
      differentiation-induced activation of transcription, and cAMP-induced repression
      of transcription are located within the 14-kb GLUT4 minigene. However, the cis
      elements necessary for maximal tissue-specific expression and for insulin-induced
      down-regulation of expression are not located in the minigene.

PMID- 8475080
TI  - Signal sequence region of mitochondrial precursor proteins binds to mitochondrial
      import receptor.
AB  - An integral mitochondrial membrane protein (p32) of yeast has previously been
      molecularly cloned and sequenced and suggested to function as a mitochondrial
      import receptor. However, this protein has also been proposed to function as
      phosphate translocator [Guerin, B., Bukusoglu, C., Rakotomanana, F. & Wohlrab, H.
      (1990) J. Biol. Chem. 265, 19736-19741; Phelps, A., Schobert, C.T. & Wohlrab, H.
      (1991) Biochemistry 30, 248-252]. Here we have purified p32 after expression of
      its gene in Escherichia coli and assayed its ability to bind to various
      preproteins containing signal sequences for protein translocation into
      mitochondria, chloroplasts, or the endoplasmic reticulum. Our data suggest that
      p32 contains a binding site specific for the signal sequence region of
      mitochondrial preproteins. These data are consistent with the previous assignment
      of p32 as an import receptor and are discussed with regard to the apparently
      conflicting assignment of this protein as phosphate translocator.

PMID- 8475081
TI  - Rapid kinetics of mismatch repair of heteroduplex DNA that is formed during
      recombination in yeast.
AB  - Homothallic switching of yeast mating type (MAT) genes is a highly efficient gene
      conversion process initiated by a double-strand break. The use of a galactose
      inducible HO endonuclease gene has made it possible to analyze the synchronous
      progression of molecular intermediates during recombination. When MATa switches
      to MAT alpha, a 3' single-stranded end of HO-cleaved MAT DNA invades the
      homologous donor, HML alpha, and initiates copying of new DNA sequences. These
      early steps of recombination can be detected by PCR amplification. When
      recombination is initiated in a strain carrying the MATa-stk T-->A base pair
      substitution mutation located 8 bp to the right of the HO endonuclease cleavage
      site, the stk mutation is frequently included in heteroduplex DNA formed between
      MAT and HML and undergoes mismatch correction. We have followed the kinetics of
      mismatch repair of the stk mutation by determining the DNA sequence of the PCR
      amplified early intermediates of recombination. Mismatch correction of
      heteroduplex DNA is quite rapid (t1/2 = 6-10 min) compared to the 60 min required
      to complete repair of the double-strand break. Mismatch repair occurs soon after
      the 3'-ended MAT-stk strand invades HML and forms heteroduplex DNA. Moreover,
      nearly all the correction events are restorations, in which the invading MAT-stk
      strand is corrected to the genotype of the resident HML donor. This rapid
      restoration ensures that the net result will be a gene conversion at the MAT
      locus. Rapid and preferential mismatch repair of heteroduplex DNA has important
      implications in understanding meiotic recombination.

PMID- 8475082
TI  - A regulatory cascade hypothesis for mammalian sex determination: SRY represses a
      negative regulator of male development.
AB  - The mammalian Y chromosome carries the SRY gene, which determines testis
      formation. Here we review data on individuals who are XX but exhibit male
      characteristics: some have SRY; others do not. We have analyzed three families
      containing more than one such individual and show that these individuals lack
      SRY. Pedigree analysis leads to the hypothesis that they carry recessive
      mutations (in a gene termed Z) that allow expression of male characteristics. We
      propose that wild-type Z product is a negative regulator of male sex
      determination and is functional in wild-type females. In males, SRY product
      represses or otherwise negatively regulates Z and thereby allows male sex
      determination. This hypothesis can also explain other types of sex reversal in
      mammals, in particular, XY females containing SRY. Some of these individuals may
      have mutations at the Z locus rendering them insensitive to SRY. Recessive
      mutations (such as the polled mutation of goats) leading to sex reversal are
      known in a variety of animals and might be used to map and ultimately clone the
      human Z gene.

PMID- 8475083
TI  - The role of "indirect" recognition in initiating rejection of skin grafts from
      major histocompatibility complex class II-deficient mice.
AB  - In vitro studies have revealed several pathways by which T cells can respond to
      alloantigens, including CD4+ direct responses to allogeneic class II antigens,
      CD8+ direct responses to allogeneic class I antigens, and CD4+ "indirect"
      responses to peptides of alloantigens presented in association with responder
      class II molecules. In vivo studies of skin graft rejection, however, have so far
      provided clear evidence for the contribution of only the two direct pathways and
      not for indirect recognition. We have used major histocompatibility complex class
      II-deficient mice as donors to test the role of indirect recognition in rejection
      of skin grafts. Class II-deficient skin was always rejected without delay by
      normal recipients. Removal of recipient CD8+ cells (to leave the animals
      dependent on CD4+ function) or depletion of recipient CD4+ cells revealed that
      CD4+ cells were usually involved and sometimes absolutely required in this rapid
      rejection. Since the donor grafts lacked class II antigens, the CD4+ cells must
      have recognized donor antigens presented in association with recipient class II
      molecules. These results therefore indicate that indirect recognition can
      initiate rapid skin graft rejection.

PMID- 8475084
TI  - The two motility systems of Myxococcus xanthus show different selective
      advantages on various surfaces.
AB  - Myxococcus xanthus, a bacterium that forms fruiting bodies, moves by gliding
      motility utilizing dual motility systems that differ both genetically and
      morphologically [system A, having at least 21 genetic loci and moving mainly
      single cells, and system S, having at least 10 genetic loci and moving groups
      (rafts) of cells] [Hodgkin, J. & Kaiser, D. (1979) Mol. Gen. Genet. 172, 177
      191]. In this study, we found that A- and S-gliding-motility systems have
      different selective advantages on surfaces containing different concentrations of
      agar. We observed that colonies of A+S- cells (A-motile cells) swarmed better
      than A-S+ cells (S-motile cells) on relatively firm and dry surfaces (e.g., 1.5%
      agar). In contrast, colonies of A-S+ cells swarmed much better than A+S- cells on
      soft and wet surfaces (e.g., 0.3% agar). Individual A-motile cells moved at a
      rate of 2-4 microns/min on 1.5% agar but they barely moved on 0.3% agar (< 0.5
      microns/min); in contrast S-motile cells moved 3-5 times faster on 0.3% agar than
      on 1.5% agar. Wild-type cells with both A- and S-motility systems were able to
      move well over a wide range of surfaces. These results suggest that dual motility
      systems enable the myxobacteria to adapt to a variety of physiological and
      ecological environments and show similarities in function to the dual motility
      systems of flagellated bacteria such as Vibrio spp.

PMID- 8475085
TI  - Role of nitric oxide in interleukin 2-induced corticotropin-releasing factor
      release from incubated hypothalami.
AB  - Stimulation of corticotropin-releasing factor (CRF) release from the hypothalamus
      by interleukin 2 (IL-2) was recently demonstrated. Cytokines induce nitric oxide
      synthase (NOS), an enzyme that converts L-arginine into L-citrulline and nitric
      oxide (NO). NO is believed to be responsible for the cytotoxic action of these
      agents. The constitutive form of NOS occurs in neurons in the central nervous
      system and NO appears to play a neurotransmitter role in cerebellar and
      hippocampal function. We explored the probability that IL-2 and synaptic
      transmitters might release CRF via NO. The effects of L-arginine, the substrate
      for NOS, and NG-monomethyl-L-arginine (NMMA), a competitive inhibitor of NOS, on
      IL-2-induced CRF release were studied using mediobasal hypothalami (MBHs)
      incubated in vitro in Krebs-Ringer bicarbonate buffer. L-Arginine did not alter
      basal and IL-2-induced CRF release after 30 min of incubation but significantly
      elevated both basal and IL-2-induced CRF release when MBHs were incubated 30 min
      longer, presumably because the endogenous substrate had been depleted after the
      initial 30-min incubation period. In 30-min incubations, both carbachol, an
      acetylcholineomimetic drug, and norepinephrine stimulated CRF release. There was
      an additive effect of incubation of the MBHs in the presence of carbachol (10(-7)
      M) and IL-2 (10(-13) M). On the other hand, coincubation of MBHs with
      norepinephrine (10(-6) M) and IL-2 (10(-13) M) did not produce any additive
      effect. Addition of NMMA, an inhibitor of NOS, at 1 or 3 x 10(-4) M completely
      suppressed IL-2-induced release of CRF as well as that caused by IL-2 plus
      carbachol. In contrast, the release of CRF induced by norepinephrine was not
      blocked by 3 x 10(-4) M NMMA. The data indicate that IL-2 can activate
      constitutive NOS leading to increased NO release, which activates CRF release. It
      appears that NO is also involved in the release of CRF induced by carbachol but
      not by norepinephrine.

PMID- 8475086
TI  - Baculovirus expression of the maize mitochondrial protein URF13 confers
      insecticidal activity in cell cultures and larvae.
AB  - The URF13 protein, which is encoded by the mitochondrial gene T-urf13, is
      responsible for cytoplasmic male sterility and pathotoxin sensitivity in the
      Texas male-sterile cytoplasm (cms-T) of maize. Mitochondrial sensitivity to two
      host-specific fungal toxins (T toxins) is mediated by the interaction of URF13
      and T toxins to form pores in the inner mitochondrial membrane. A carbamate
      insecticide, methomyl, mimics the effects of T toxins on isolated cms-T
      mitochondria. URF13 was expressed in Spodoptera frugiperda (fall army-worm) cells
      (Sf9) in culture and in Trichoplusia ni (cabbage looper) larvae with a
      baculovirus vector. In insect cells, URF13 forms oligomeric structures in the
      membrane and confers T toxin or methomyl sensitivity. Adding T toxin or methomyl
      to Sf9 cells producing URF13 causes permeabilization of plasma membranes. In
      addition, URF13 is toxic to insect cells grown in culture without T toxins or
      methomyl; even a T-toxin-insensitive mutant form of URF13 is lethal to cell
      cultures. Baculoviruses expressing URF13 are lethal to T. ni larvae, at times
      postinjection comparable to those obtained by injecting a baculovirus expressing
      an insect neurotoxin. This result suggests that URF13 could be useful as a
      biological control agent for insect pests. Our data indicate that URF13 has two
      independent mechanisms for toxicity, one that is mediated by T toxin and methomyl
      and one that is independent of these toxins. Similarly, male sterility and toxin
      sensitivity in cms-T maize may be due to independent mechanisms.

PMID- 8475087
TI  - Evidence for interstrand quadruplex formation in the dimerization of human
      immunodeficiency virus 1 genomic RNA.
AB  - Retroviruses package two homologous single-stranded RNA genomes within a gag
      protein-RNA complex. In mature virion particles, the two RNA strands are thought
      to associate primarily through direct RNA-RNA interactions, although the
      structural basis for this stable association is unknown. We now report that a 127
      nucleotide (nt) HIV-1NL4-3 RNA fragment (positions 732-858) encompassing the 5'
      end of the gag gene dimerizes spontaneously under high ionic strength conditions
      in the absence of any protein cofactor. The HIV-1 RNA dimer is dramatically and
      specifically stabilized by the monovalent cation potassium. Thermal dissociation
      of the dimer occurs at 80 degrees C in 100 mM K+ (5 mM Mg2+) but at significantly
      lower temperatures in the presence of either smaller or larger monovalent cations
      (100 mM Li+, 40 degrees C; 100 mM Na+, 55 degrees C; 100 mM Cs+, 30 degrees C).
      Deletion analyses of the 3' end of the 127-nt fragment reveal that an HIV-1 RNA
      fragment as short as 94 nt (732-825) can dimerize spontaneously, but a further 9
      base deletion of the purine-rich sequence, GGGGGAGAA from positions 817 through
      825, eliminates dimerization. These experimental results support a model in which
      HIV-1 RNA dimerizes by forming an interstrand quadruple helix stabilized by
      guanine (and/or purine)-base tetrads in analogy to the well-known dimerization of
      telomeric DNA. We speculate that this structure may also mediate the association
      of genomic HIV-1 RNA in vivo, revealing how RNA itself can achieve the self
      recognition required for subsequent genetic recombination.

PMID- 8475088
TI  - Calmodulin-binding domain of recombinant erythrocyte beta-adducin.
AB  - Adducin is a 200-kDa heterodimeric protein of the cortical cytoskeleton of
      mammalian erythrocytes. Analogs are also abundant in brain and several other
      tissues. In vitro, adducin bundles F-actin and enhances the binding of spectrin
      to actin. Previous studies have established that the beta subunit of adducin
      binds calmodulin (CaM) in a Ca(2+)-dependent fashion with intermediate affinity
      (approximately 200 nM) and that this activity is destroyed by proteolysis. We
      have confirmed the trypsin sensitivity of CaM binding by beta-adducin and the
      existence of a 38- to 39-kDa protease-resistant core. Calpain I digestion
      generates a larger core fragment (49 kDa) that is also devoid of CaM-binding
      activity. Use of recombinant beta-adducin peptides generated from partial cDNA
      clones identified strong CaM-binding activity within the protease-sensitive
      domain in residues 425-461: KQQKEKTRWLNTPNTYLRVNVADEVQRNMGSPRPKTT in single
      letter amino acid codes. This region of the molecule is highly conserved between
      mouse, rat, and human and shares structural features with CaM-binding sequences
      in other proteins. Multiple flanking PEST sequences (sequences rich in proline,
      glutamic acid, serine, and threonine residues that enhance proteolytic
      sensitivity) may contribute to the protease sensitivity of this region. Consensus
      sequences for phosphorylation by cAMP-dependent kinases and by protein kinase C
      (or CaM-dependent kinase) are also found within or near this CaM-binding domain.
      Collectively, these data suggest a structural basis for the regulation of adducin
      by Ca(2+)-dependent CaM binding and possibly by covalent phosphorylation and
      calpain I-mediated proteolysis as well.

PMID- 8475089
TI  - Mapping cis-acting defects in promoters of transcriptionally silent DQA2, DQB2,
      and DOB genes.
AB  - Defects in promoters of the nonexpressed DQA2, DQB2, and DOB genes from the class
      II major histo-compatibility complex were mapped by placing Z and X boxes of
      these silent genes into a synthetic DRA promoter. These conserved upstream
      sequences confer B-cell-specific and gamma-interferon-inducible expression to the
      DRA gene. Since DRA promoters containing the X box from the DQA2 gene and Z boxes
      from DQA2, DQB2, and DOB genes were neither expressed constitutively in B cells
      nor inducible by gamma interferon in fibroblastic cells, these conserved upstream
      sequences are implicated in the transcriptional defects of these silent genes.

PMID- 8475090
TI  - Genetic selection for crescent formation yields mouse strain with rapidly
      progressive glomerulonephritis and small vessel vasculitis.
AB  - We have established a recombinant inbred strain of mouse named spontaneous
      crescentic glomerulonephritis-forming mouse/Kinjoh or SCG/Kj. Mice of this strain
      spontaneously develop rapidly progressive glomerulonephritis. This strain of mice
      was derived from (BXSB/Mp x MRL/Mp-lpr/lpr)F1 hybrid mice by brother x sister
      mating coupled with repeated histopathologic selection for breeding of mice whose
      parents had the highest frequency of crescent formation in the kidneys. In this
      strain of mice, nephritis appears earlier and is more rapidly progressive than in
      any other murine model of systemic lupus erythematosus. Histopathologically, the
      characteristic renal lesions in the mice of this strain express a most dramatic
      form of crescentic glomerulonephritis. The lesions in the kidneys show only
      slight fine granular immune deposits along the glomerular basement membrane
      associated with remarkable extraglomerular proliferation and hemorrhage in
      Bowman's space. Although selection was not based on vasculitis, mice of this
      strain also exhibit a high incidence of necrotizing vasculitis. These vascular
      lesions involve primarily small arteries and arterioles and many organs and
      tissues but spare the kidneys. Thus this form of vasculitis has been found to be
      correlated with the crescentic form of glomerulonephritis but not with lymphoid
      hyperplasia of the spleen. We conclude that, in this strain of mouse, the rapidly
      progressive glomerulonephritis is genetically restricted and that this genetic
      restriction is firmly linked to that responsible for the vasculitis.

PMID- 8475092
TI  - Highly sensitive object location in tissue models with linear in-phase and anti
      phase multi-element optical arrays in one and two dimensions.
AB  - Based upon previous observations of low-frequency photon diffusion waves within
      highly scattering tissue, this paper explores the "near-field" phenomena of such
      waves of approximately 10-cm wavelength with 200-MHz phase modulation equipment.
      Multiple-element source arrays consist of laser diode sources modulated at 180
      degrees out of phase with respect to the other sources. The diffusing waves
      originating from the out-of-phase sources give, in the midplane, an amplitude
      null and a sharp phase transition. These may be observed in a highly scattering
      intralipid medium simulating the breast or brain (0.5% intralipid), 3-5 cm from
      the transmitting laser diodes. In the plane containing the array, there is a high
      sensitivity for a small volume of a hidden absorber (indocyanine green) deep
      within a highly scattering medium; 20 pmol in a volume of 70 microliters can be
      detected. Two-dimensional arrays consisting of four or more elements in two
      orthogonal planes give sensitivity on both axes similar to the one-dimensional
      array. Measurements show that in the presence of a light-absorbing object, the
      amplitude null and the interference plane becomes a curved surface which is
      deflected toward the heterogeneity. The degree of deflection is related to the
      volume and the absorption characteristics of the heterogeneity and provides
      detection of the heterogeneity, and thereby may provide localization information
      for the detection of small tumors within the human breast, or stroke volumes,
      aneurysms, and tumors in the human brain.

PMID- 8475091
TI  - Identification, by protein sequencing and gene transfection, of sgp-60 as the
      murine homologue of CD48.
AB  - We have recently described a murine lymphocyte protein, provisionally termed sgp
      60, which is expressed on virtually all lymphocytes of both T- and B-cell origin.
      A hamster monoclonal antibody to sgp-60 can inhibit interleukin-2 (IL-2)
      production, IL-2-receptor expression, and T-cell proliferation, events normally
      observed after stimulation of T cells with an antibody to the T-cell receptor/CD3
      complex or with the lectin concanavalin A. Our previous studies did not reveal
      the molecular nature of the sgp-60 antigen. Purification of sgp-60 and protein
      sequencing demonstrate that sgp-60 is identical to the CD48 antigen, a ligand for
      the CD2 antigen, which is also called Blast-1 in humans, BCM1 in mice, and OX-45
      in rats. The identity of sgp-60 and CD48 was independently confirmed in gene
      transfection experiments. The anti-sgp-60 monoclonal antibody was selectively
      reactive with COS-7 cells transfected with a BCM1 cDNA clone but not with Kb
      transfected controls. The results of the present report, together with our
      previous functional studies, may have implications for the role of CD2 and CD48
      in murine T-cell activation.

PMID- 8475093
TI  - Molecular evidence that the spiny mouse (Acomys) is more closely related to
      gerbils (Gerbillinae) than to true mice (Murinae).
AB  - Spiny mice of the genus Acomys traditionally have been classified as members of
      the Murinae, a subfamily of rodents that also includes rats and mice with which
      spiny mice share a complex set of morphological characters, including a unique
      molar pattern. The origin and evolution of this molar pattern, documented by many
      fossils from Southern Asia, support the hypothesis of the monophyly of Acomys and
      all other Murinae. This view has been challenged by immunological studies that
      have suggested that Acomys is as distantly related to mice (Mus) as are other
      subfamilies (e.g., hamsters: Cricetinae) of the muroid rodents. We present
      molecular evidence derived from DNA.DNA hybridization data that indicate that the
      spiny mouse Acomys and two African genera of Murinae, Uranomys and Lophuromys,
      constitute a monophyletic clade, a view that was recently suggested on the basis
      of dental characters. However, our DNA.DNA hybridization data also indicate that
      the spiny mice (Acomys) are more closely related to gerbils (Gerbillinae) than to
      the true mice and rats (Murinae) with which they have been classified. Because
      Acomys and the brush-furred mice Uranomys and Lophuromys share no derived
      morphological characters with the Gerbillinae, their murine morphology must have
      evolved by convergence, including the molar pattern previously considered to
      support the monophyly of the Murinae.

PMID- 8475094
TI  - Structure of the human 3-methyladenine DNA glycosylase gene and localization
      close to the 16p telomere.
AB  - We recently reported the presence of four genes lying between the human alpha
      globin gene cluster and the telomere of the short arm of chromosome 16 (16p). We
      now report that one of these genes encodes 3-methyladenine DNA glycosylase, an
      enzyme important in the repair of DNA after damage by alkylating agents. The gene
      comprises five exons, representation of which differs in independently isolated
      cDNA clones. Although the gene is widely expressed, the abundance of its mRNA is
      considerably higher in a colon adenocarcinoma cell line (HT29) than in other cell
      lines that were tested. The major positive erythroid-specific regulatory element
      controlling alpha-globin gene expression lies equidistant between the promoters
      of the alpha-globin genes and the 3-methyladenine DNA glycosylase gene.
      Interestingly, in contrast to the alpha-globin genes, expression of the 3
      methyladenine DNA glycosylase gene is not influenced by the regulatory element in
      the human erythroleukemia cell line K562.

PMID- 8475095
TI  - Enzymatic modification of plasma low density lipoproteins in rabbits: a potential
      treatment for hypercholesterolemia.
AB  - Phospholipase A2 (EC 3.1.1.4) hydrolyzes certain phospholipids of low density
      lipoprotein (LDL). Plasma clearance of phospholipase A2-modified human LDL is up
      to 17 times faster than that of native human LDL in hypercholesterolemic rabbits.
      Modification of blood lipoproteins of hypercholesterolemic rabbits was performed
      by using an extracorporeal circuit containing immobilized phospholipase A2. After
      90-min treatments, nearly 30% decreases in plasma cholesterol concentrations were
      observed. Erythrocyte, leukocyte, and platelet counts showed no net change after
      treatment. This technique does not require any fluid replacement or sorbent
      regeneration and offers a potential approach for lowering serum cholesterol and
      LDL levels.

PMID- 8475096
TI  - Cloning of cDNA encoding Drosophila poly(ADP-ribose) polymerase: leucine zipper
      in the auto-modification domain.
AB  - We have isolated cDNA clones for a Drosophila poly(ADP-ribose) polymerase (PARP;
      EC 2.4.2.30) by screening a lambda gt11 cDNA library with a Drosophila partial
      cDNA fragment. The Drosophila PARP probe was obtained by the polymerase chain
      reaction with heterologous primers deduced from conserved amino acids in the
      mammalian, chicken, amphibian, and fish sequences. The Drosophila PARP mRNA is
      3.2 kb in length and is expressed in the early stages of development. The PARP
      protein of 994 amino acids contains two zinc-finger motifs and an NAD-binding
      motif, which are conserved among different species. Interestingly, the heptad
      leucine repeat in an alpha-helix was found in Drosophila PARP. Alignments of the
      auto-modification domains of various species showed the repeated hydrophobic
      amino acids on the same face of the helix that make the coiled-coil configuration
      in the mammalian and chicken sequences. The presence of a leucine-zipper motif in
      the auto-modification domain suggests that this motif might be responsible for
      protein-protein interaction between PARP and physiological acceptors. PARP may
      have novel functions, possibly involving its homo- and/or heterodimerization with
      other nuclear leucine-zipper proteins and its regulation by ADP-ribosylation.

PMID- 8475097
TI  - Synthesis of a gene for sensory rhodopsin I and its functional expression in
      Halobacterium halobium.
AB  - We have designed, synthesized, and expressed in Halobacterium halobium a gene
      encoding sensory rhodopsin I (SR-I). The gene has been optimized for cassette
      mutagenesis by incorporating 30 unique restriction sites with uniform spacing
      throughout the 720-bp coding region. For expression, the coding region was placed
      downstream of the promoter and translation initiation region of the bacterioopsin
      gene on a selectable vector. This construct encodes SR-I with an extended N
      terminus that includes the 13-amino acid leader sequence and the 8-amino acid N
      terminus of bacterioopsin. To obtain a SR-I- H. halobium strain for expressing
      the synthetic gene, we used homologous recombination to delete the chromosomal
      gene encoding SR-I, sopI. The deletion strain was transformed with the synthetic
      sopI expression vector. Using antibody directed against the C-terminal region of
      SR-I, we detected in transformant membranes a protein with the electrophoretic
      mobility expected for SR-I with a processed N-terminal extension. The synthetic
      gene product was functionally identical to SR-I. Its flash-induced absorption
      difference spectrum and photochemical reaction cycle in membrane envelope
      vesicles were characteristic of SR-I. The protein fully restored phototaxis
      responses in the deletion strain.

PMID- 8475098
TI  - Inhibition of gene expression by triple helix-directed DNA cross-linking at
      specific sites.
AB  - Synthetic oligodeoxynucleotides represent promising tools for gene inhibition in
      live systems. Triple helix-forming oligonucleotides, which bind to double
      stranded DNA, are of special interest since they are targeted to the gene itself
      rather than to its mRNA product, as in the antisense strategy. Triple helix
      forming oligonucleotides can be coupled to DNA-modifying agents and used to
      introduce modifications in the DNA target in a highly sequence-specific manner.
      We have recently designed psoralen-oligonucleotide conjugates, which, upon
      binding to double-stranded DNA sequences via triple helix formation, may be cross
      linked in vitro to both strands of the DNA following UV irradiation. A psoralen
      oligonucleotide conjugate was targeted to the promoter of the alpha subunit of
      the interleukin 2 receptor (IL-2R alpha) gene. The triple helix site overlaps the
      binding site for the transcription factor NF-kappa B, which activates
      transcription from the IL-2R alpha promoter. After UV irradiation, the
      oligonucleotide conjugate becomes cross-linked to the target site and inhibits
      transcription of reporter plasmids transfected in live cells. Inhibition is
      observed when UV-induced cross-linking occurs both in vitro (before transfection)
      and in vivo (after transfection). We directly demonstrate that this inhibitory
      effect is due to triple helix formation at the target site, since a mutant of the
      promoter, to which oligonucleotide binding was inhibited, was not affected by the
      psoralen-oligonucleotide conjugate after UV irradiation. In addition, we
      demonstrate that site-specific cross-linking upstream of the promoter has no
      effect on transcription.

PMID- 8475099
TI  - Oxygen regulation of nifA transcription in vitro.
AB  - In Rhizobium meliloti, transcription of the key nitrogen-fixation regulatory
      genes nifA and fixK is induced in response to microaerobiosis through the action
      of the FixL and FixJ proteins. These two proteins are sensor and regulator
      homologues, respectively, of a large family of bacterial two-component systems
      involved in sensing and responding to environmental changes. A soluble, truncated
      form of the membrane protein FixL, FixL*, has been shown to be a hemoprotein that
      phosphorylates and dephosphorylates FixJ in response to oxygen tension. Here we
      use an in vitro transcription system to prove that FixJ is a transcriptional
      activator of both nifA and fixK and that phosphorylation of FixJ markedly
      increases its activity. Phosphorylation was achieved either by preincubating FixJ
      with FixL* and ATP or by exposing FixJ to the inorganic phospho donor ammonium
      hydrogen phosphoramidate. Both FixJ and FixJ-phosphate formed heparin-resistant
      complexes under the assay conditions used. Lastly, we were able to show that
      anaerobiosis, in the presence of FixL* and ATP, greatly stimulates FixJ activity
      at the nifA promoter with either Escherichia coli or R. meliloti RNA polymerase.
      This use of atmospheric oxygen to control nifA transcription in vitro represents
      a reconstitution of a bacterial two-component signal transduction system in its
      entirety, from effector to ultimate target, by the use of purified components.

PMID- 8475100
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.
AB  - The rpoS gene of Escherichia coli encodes a putative RNA polymerase sigma factor
      that is considered to be the central regulator of gene expression in stationary
      phase. The gene product (sigma 38) was overproduced using the cloned rpoS gene
      and purified to homogeneity. Reconstituted RNA polymerase holoenzyme (E sigma 38)
      was found to recognize in vitro a number of typical sigma 70-type promoters,
      including the lacUV5 and trp promoters. Some, however, were recognized
      exclusively or preferentially by E sigma 70, whereas at least one, fic, was
      favored by E sigma 38. Thus E. coli promoters can be classified into three
      groups: the first group is recognized by E sigma 70 and E sigma 38, but the
      second and third groups are recognized substantially by either E sigma 70 or E
      sigma 38 alone. In contrast to other minor sigma factors, sigma 38 shares a set
      of amino acid sequences common among the principal sigma factors of eubacteria
      and is therefore a member of the RpoD-related protein family. The intracellular
      level of sigma 38 was demonstrated to increase in vivo upon entry into stationary
      phase. These results together indicate that sigma 38 is a second principal sigma
      factor in stationary-phase E. coli.

PMID- 8475101
TI  - Cdc25M2 activation of cyclin-dependent kinases by dephosphorylation of threonine
      14 and tyrosine-15.
AB  - Recent evidence has suggested that human cyclin-dependent kinase 2 (CDK2) is an
      essential regulator of cell cycle progression through S phase. CDK2 is known to
      complex with at least two distinct human cyclins, E and A. The kinase activity of
      these complexes peaks in G1 and S phase, respectively. The vertebrate CDC2/cyclin
      B1 complex is an essential regulator of the onset of mitosis and is inhibited by
      phosphorylation of CDC2 on Thr-14 and Tyr-15. In vitro, CDC2/cyclin B1 is
      activated by treatment with the members of the Cdc25 family of phosphatases. We
      found that, like CDC2, CDK2 is also phosphorylated on Thr-14 and Tyr-15 and that
      treatment of cyclin A or cyclin E immunoprecipitates with bacterially expressed
      Cdc25M2 (the mouse homolog of human CDC25B) increased the histone H1 kinase
      activity of these immune complexes 5- to 10-fold. Tryptic peptide mapping
      demonstrated that Cdc25M2 treatment of cyclin A or cyclin B1 immune complexes
      resulted in the specific dephosphorylation of Thr-14 and Tyr-15 on CDK2 or CDC2,
      respectively. Thus, we have confirmed that Cdc25 family members comprise a class
      of dual-specificity phosphatases. Furthermore, our data suggest that the
      phosphorylation and dephosphorylation of CDKs on Thr-14 and Tyr-15 may regulate
      not only the G2/M transition but also other transitions in the cell cycle and
      that individual cdc25 family members may regulate distinct cell cycle
      checkpoints.

PMID- 8475102
TI  - Transcription factor E2F binds DNA as a heterodimer.
AB  - E2F is a mammalian transcription factor that appears to play an important role in
      cell cycle control. DNA affinity column-purified E2F from HeLa cells reproducibly
      exhibits multiple protein bands when analyzed by SDS/PAGE. After electrophoretic
      purification, electroelution, and refolding of the individual protein components,
      the E2F DNA binding activity of the individual proteins was poor. However, upon
      mixing the individual components together, a dramatic (100- to 1000-fold)
      increase in specific DNA binding activity was observed. The five protein bands
      isolated can be separated into two groups based on apparent molecular mass.
      Optimal reconstitution of activity requires one of the two proteins found in the
      group of larger molecular mass (approximately 60 kDa) and one of the three
      proteins in the smaller-sized group (approximately 50 kDa). The reconstituted
      heterodimer is identical to authentic affinity-purified E2F by three criteria:
      DNA-binding specificity, DNA pattern, and binding to the retinoblastoma gene
      product. A recently cloned protein with E2F-like activity, RBP3/E2F-1, is related
      to the protein components of the group of larger molecular mass, as determined by
      Western blot analysis and reconstitution experiments. These data suggest that
      E2F, like many other transcription factors, binds DNA as an oligomeric complex
      composed of at least two distinct proteins.

PMID- 8475103
TI  - VirA, the plant-signal receptor, is responsible for the Ti plasmid-specific
      transfer of DNA to maize by Agrobacterium.
AB  - Agrobacteria exhibit marked Ti (tumor-inducing)/Ri (root-inducing) plasmid
      specificity in their interaction with the Gramineae. In this study, we have used
      the technique of "agroinfection," in which Agrobacterium-mediated delivery of
      viral genomes into plants is detected by the development of viral disease
      symptoms, to identify the region of the Ti plasmid which is responsible for the
      major differences seen in the ability of nopaline- vs. octopine-type Ti plasmids
      to transfer maize streak virus (MSV) DNA to maize. Introduction of fragments of
      the C58 (nopaline-type) Ti plasmid into strains containing an octopine-type Ti
      plasmid showed that a fragment containing the nopaline-type virA locus was able
      to complement these normally non-agroinfectious strains to high levels of MSV DNA
      transfer. Octopine-type virA mutant strains that express vir genes at high levels
      in the absence of the plant inducing compound acetosyringone also efficiently
      transferred MSV DNA. These findings imply a functional difference between the
      virA gene products encoded by octopine- and nopaline-type Ti plasmids which has a
      profound effect on their ability to mediate DNA transfer to maize.

PMID- 8475104
TI  - Temporal regulation of cyclin A-p107 and p33cdk2 complexes binding to a human
      thymidine kinase promoter element important for G1-S phase transcriptional
      regulation.
AB  - The cyclins are an extensive family of proteins whose cell cycle-dependent
      synthesis is postulated to control multiple events during the cell cycle. The
      synthesis of A-type cyclins begins at the start of S phase. In mammalian cells,
      association with the cdc-type kinases suggests that cyclin A complexes are
      important for DNA replication and regulating other DNA-bound substrates required
      for S phase. We report here that a 25-bp promoter element previously shown to be
      important for the G1-S activation of the human thymidine kinase (htk) promoter in
      growth-stimulated cells is a cellular target of cyclin A and the p33cdk2
      complexes. Though the p33cdk2 and other nuclear factor complexes exhibit
      constitutive binding to the htk G1-S regulatory domain, the binding activity of a
      cyclin A/p107 protein complex is greatly enhanced when the cells enter S phase,
      correlating with the increase in the tk mRNA levels and the replication of DNA.
      The binding activity of the cyclin A complex is maintained throughout S phase.
      Mutation of the DNA sequences on either half of the 25-bp protein binding site
      results in the loss of its ability to compete efficiently in vitro for the htk
      complexes, including that of cyclin A-containing complex. The loss of high
      affinity binding for the htk complexes also substantially reduces the S-phase
      regulation of the htk promoter in vivo. Our results support the hypothesis that a
      cyclin A complex, in association with the p33cdk2 kinase, mediates the S-phase
      regulated transcription of the htk promoter in growth-stimulated cells.

PMID- 8475105
TI  - Brain structures and life-span in primate species.
AB  - In haplorhine primates, when the effect of body weight is removed, brain weight
      is correlated with maximum recorded life-span. In this paper we have analyzed the
      relationships between volumes of specific brain structures and life-span. When
      the effect of body weight is removed, the volumes of many brain structures are
      significantly, positively correlated with maximum recorded life-span. However,
      the volumes of the medulla and most first-order sensory structures do not
      correlate with life-span. The cerebellum is the brain structure that best
      correlates with life-span. Parts of the cerebellum are particularly vulnerable to
      age-related loss of mass in humans. For another measure of the life cycle, female
      reproductive age, a similar set of brain structures is significantly, positively
      correlated (again with the exceptions of the medulla and most first-order sensory
      structures). There are some differences between the structures correlated for
      life-span and female reproductive age. For example, the hippocampus and lateral
      geniculate nucleus correlate with female reproductive age but do not correlate
      with life-span. In strepsirhine primates, when the effect of body weight is
      removed, total brain weight does not significantly correlate with either life
      span or female reproductive age. However, the volumes of some brain structures in
      strepsirhines do correlate with these life-cycle parameters. The centromedial
      complex of the amygdala is the only structure to correlate with life-span in both
      strepsirhine and haplorhine primates. This structure participates in the
      regulation of blood pressure and in the stress response, which may be key factors
      governing life-span.

PMID- 8475106
TI  - Platelet factor 4 binds to interleukin 8 receptors and activates neutrophils when
      its N terminus is modified with Glu-Leu-Arg.
AB  - Amino acid deletion and mutagenesis experiments have indicated that the sequences
      Glu-Leu-Arg (ELR) preceding the first cysteine at the N terminus of interleukin 8
      (IL-8) is required for receptor binding and neutrophil activation. Platelet
      factor 4 (PF4) is structurally related to IL-8 (35% sequence identity) but lacks
      the N-terminal ELR sequence and comparable effects on neutrophils. We introduced
      the ELR sequence at the N terminus of PF4 and found that the modified protein was
      a potent neutrophil activator and attractant. On the other hand, when the ELR
      sequence was introduced into the corresponding positions of two other proteins
      related to IL-8, gamma-interferon-inducible protein IP10 and monocyte
      chemoattractant protein 1, neither of them acquired neutrophil-activating
      properties, indicating that besides ELR additional structural determinants of IL
      8 and PF4 are important for binding to IL-8 receptors. The conservation of these
      binding determinants suggests that PF4 may have evolved from a neutrophil
      activating protein.

PMID- 8475108
TI  - Chirality of DNA supercoiling assigned by scanning force microscopy.
AB  - Reproducible images of pBR322 plasmid molecules have been recorded by scanning
      force microscopy under 1-propanol. Most of the plasmids were found in a coiled
      state. The supercoiled molecules of our samples look like branched or unbranched
      interwound superhelixes. This is consistent with available electron microscopy
      data on circular DNA molecules. By applying a stratigraphic analysis which takes
      advantage of the height information contained in the scanning force microscopy
      images, it is possible to assign the chirality of the local supercoiling of the
      individual molecules.

PMID- 8475107
TI  - Structure-based inhibitor design by using protein models for the development of
      antiparasitic agents.
AB  - The lack of an experimentally determined structure of a target protein frequently
      limits the application of structure-based drug design methods. In an effort to
      overcome this limitation, we have investigated the use of computer model-built
      structures for the identification of previously unknown inhibitors of enzymes
      from two major protease families, serine and cysteine proteases. We have
      successfully used our model-built structures to identify computationally and to
      confirm experimentally the activity of nonpeptidic inhibitors directed against
      important enzymes in the schistosome [2-(4-methoxybenzoyl)-1-naphthoic acid, Ki =
      3 microM] and malaria (oxalic bis[(2-hydroxy-1-naphthylmethylene)hydrazide], IC50
      = 6 microM) parasite life cycles.

PMID- 8475109
TI  - Proliferation, differentiation, and long-term culture of primary hippocampal
      neurons.
AB  - Primary embryonic hippocampal neurons can develop morphologically and
      functionally in culture but do not survive more than a few weeks. It has been
      reported that basic fibroblast growth factor (bFGF) promotes the survival of and
      neurite elongation from fetal hippocampal neurons. We report that bFGF, in a dose
      dependent manner, can induce the survival (50 pg to 1 ng/ml) and proliferation
      (10-20 ng/ml) of embryonic hippocampal progenitor neurons in vitro. In serum-free
      medium containing high concentrations of bFGF, neurons not only proliferated (4
      day doubling time) and differentiated morphologically but also could be passaged
      and grown as continuous cell lines. The neuronal nature of the proliferating
      cells was positively established by immunostaining with several different neuron
      specific markers and by detailed ultrastructural analyses. The proliferative
      effect of bFGF was used to generate nearly pure neuronal cell cultures that can
      be passaged, frozen, thawed, and cultured again. Neurons have been maintained > 5
      months in culture. The ability to establish long-term primary neuronal cultures
      offers the possibility that clonal lines of distinct neuronal cell types may be
      isolated from specific areas of the central nervous system. Such long-term
      neuronal cultures should prove valuable in studying neurons at the individual
      cell level and also in exploring interactions between neurons in vitro. The
      observed dose dependence raises the possibility that cell survival and
      proliferation in vivo may be influenced by different levels of bFGF.

PMID- 8475110
TI  - Adaptation to alcoholic fermentation in Drosophila: a parallel selection imposed
      by environmental ethanol and acetic acid.
AB  - Besides ethanol, acetic acid is produced in naturally fermenting sweet resources
      and is a significant environmental stress for fruit-breeding Drosophila
      populations and species. Although not related to the presence of an active
      alcohol dehydrogenase, adult acetic acid tolerance was found to correlate with
      ethanol tolerance when sensitive (Afrotropical) and resistant (European) natural
      populations of Drosophila melanogaster were compared. The same correlation was
      found when comparing various Drosophila species. Tolerance to acetic acid also
      correlated with the tolerance to longer aliphatic acids of three, four, or five
      carbons but did not correlate with the tolerance to inorganic acids (i.e.,
      hydrochloric and sulfuric acids). These observations suggest that acetic acid is
      detoxified by the conversion of acetate into acetyl-CoA, a metabolic step also
      involved in ethanol detoxification. Future investigations on the adaptation of
      Drosophila to fermenting resources should consider selective effects of both
      ethanol and acetic acid.

PMID- 8475111
TI  - Male-specific expression of mouse sex-limited protein requires growth hormone,
      not testosterone.
AB  - Sex-limited protein (Slp), an isoform of mouse complement component C4, is
      expressed predominantly in liver and nearly exclusively in sexually mature males
      or testosterone-treated females. It is encoded by a gene (C4-Slp) whose hormonal
      dependence has been attributed to an androgen-responsive transcriptional enhancer
      introduced accidentally, alongside the C4-Slp promoter, in the guise of the 5'
      long terminal repeat of an ancient retrovirus. We demonstrate that the pronounced
      rise of C4-Slp mRNA promoted by androgens in the liver is due to nuclear factors
      acting at a transcriptional stage. Curiously, hypophysectomized animals of either
      sex fail to express the gene and are refractory to testosterone. However, gene
      expression at male levels is restored even more promptly by injections of growth
      hormone alone. Additionally, animals carrying an ubiquitously expressed human
      growth hormone transgene lack C4-Slp mRNA and are insensitive to testosterone
      treatment. That growth hormone is sufficient to induce expression in a manner
      independent of androgen-receptor activity is shown by the hormonal treatment of
      Tfm mice. These androgen receptor-defective animals lack C4-Slp mRNA, which
      however can be fully induced by growth hormone injections. We conclude that the
      sexual dimorphism of C4-Slp expression employs liver nuclear mediators distinct
      from those directly instructed by androgens and is brought about by the
      intermittent rise of growth hormone, dictated by testosterone.

PMID- 8475112
TI  - Antibody-mediated protection in mice with lethal intracerebral Cryptococcus
      neoformans infection.
AB  - The fungus Cryptococcus neoformans is an important opportunistic pathogen for
      patients with AIDS. C. neoformans infections frequently involve the brain and are
      often fatal. In the setting of AIDS C. neoformans infections are incurable and
      new treatment strategies are urgently needed. Passive administration of antibody
      is a potential therapeutic option for the prevention and treatment of C.
      neoformans. The IgG1 murine monoclonal antibody 2H1 to the capsular
      polysaccharide of C. neoformans was studied for its ability to modify the course
      of lethal intracerebral cryptococcal infection in mice. Intraperitoneal
      administration of antibody 2H1 resulted in small, yet significant, prolongations
      in the average survival of mice given intracerebral infection and reduced the
      number of C. neoformans colonies in brain tissue. Histopathological examination
      of brain tissues revealed a diffuse cryptococcal meningitis with fewer organisms
      in the brains of mice that received antibody 2H1 than in the control group. Thus,
      systemic administration of a monoclonal antibody can modify the course of lethal
      intracerebral C. neoformans infection in mice by prolonging survival and
      decreasing fungal burden in brain tissues.

PMID- 8475113
TI  - Reactive oxygen species and neutrophil respiratory burst cytochrome b558 are
      produced by kidney glomerular cells in passive Heymann nephritis.
AB  - Reactive oxygen species (ROS) have been implicated in the production of
      glomerular damage in passive Heymann nephritis (PHN), an experimental form of
      membranous nephropathy with neutrophil-independent proteinuria.
      Immunohistochemistry with monoclonal antibodies specific for cytochrome b558 (a
      major component of the oxidoreductase complex of the respiratory burst in
      stimulated neutrophilic granulocytes) showed that this enzyme is localized within
      visceral glomerular epithelial cells (GECs) in a dense, granular pattern in rats
      with PHN and proteinuria. By immunoelectron-microscopy, the cytochrome was found
      in membrane vesicles within the GEC and also extracellularly on the GEC membranes
      facing the glomerular basement membrane (GBM). By immunoblotting, cytochrome b558
      was detected in highest concentration in lysates of isolated glomeruli from
      proteinuric rats. By contrast, only traces were found in normal glomeruli by
      immunohistochemistry. Depletion of complement abolished the expression of the
      cytochrome. Using an ultrastructural cerium-H2O2 histochemistry technique, the
      functional activity of the glomerular ROS-generating system was demonstrated
      exclusively in proteinuric PHN, where H2O2 was found in highest concentration
      within the GBM. These results provide evidence that in rats with PHN and
      proteinuria, the GECs express and externalize respiratory-burst enzymes that
      generate ROS in a manner similar to neutrophilic granulocytes, which could then
      lead to glomerular damage.

PMID- 8475114
TI  - Cloning and expression of heparinase I gene from Flavobacterium heparinum.
AB  - Heparinases, enzymes that cleave heparin and heparin sulfate, are implicated in
      physiological and pathological functions ranging from wound healing to tumor
      metastasis and are useful in deheparinization therapies. We report the cloning of
      the heparinase I (EC 4.2.2.7) gene from Flavobacterium heparinum using PCR. Two
      degenerate oligonucleotides, based on the amino acid sequences derived from
      tryptic peptides of purified heparinase, were used to generate a 600-bp probe by
      PCR amplification using Flavobacterium genomic DNA as the template. This probe
      was used to screen a Flavobacterium genomic DNA library in pUC18. The open
      reading frame of heparinase I is 1152 bp in length, encoding a precursor protein
      of 43.8 kDa. Eleven of the tryptic peptides (approximately 35% of the total amino
      acids) mapped onto the open reading frame. The amino acid sequence reveals a
      consensus heparin binding domain and a 21-residue leader peptide with a
      characteristic Ala-(Xaa)-Ala cleavage site. Recombinant heparinase was expressed
      in Escherichia coli as a soluble protein, using the T7 polymerase pET expression
      system. The recombinant heparinase cleavage of heparin was identical to that of
      native heparinase.

PMID- 8475115
TI  - Lipid modifications of G proteins: alpha subunits are palmitoylated.
AB  - A small number of membrane-associated proteins are reversibly and covalently
      modified with palmitic acid. Palmitoylation of G-protein alpha and beta subunits
      was assessed by metabolic labeling of subunits expressed in simian COS cells or
      insect Sf9 cells. The fatty acid was incorporated into all of the alpha subunits
      examined (alpha s, alpha o, alpha i1, alpha i2, alpha i3, alpha z, and alpha q),
      including those that are also myristoylated (alpha o, alpha i, and alpha z).
      Palmitate was released by treatment with base, suggesting attachment to the
      protein through a thioester or ester bond. Limited tryptic digestion of activated
      alpha o and alpha s resulted in release of the amino-terminal portions of the
      proteins and radioactive palmitate. These data are consistent with palmitoylation
      of the proteins near their amino termini, most likely on Cys-3. Reversible
      acylation of G-protein alpha subunits may provide an additional mechanism for
      regulation of signal transduction.

PMID- 8475116
TI  - Two cell-density domains within the Myxococcus xanthus fruiting body.
AB  - Myxococcus xanthus, one of the simplest of multicellular organisms, develops into
      an organized, multicellular aggregate, called a fruiting body. Examination of the
      internal structure of the nascent fruiting body showed it to consist of a
      hemispherical outer domain of densely packed and ordered cells. Inside this dense
      shell is an inner domain of less ordered cells at 3-fold lower cell density.
      Single cells move in a bidirectional stream in the outer domain, orbiting the
      fruiting body throughout development, whereas in the inner domain, cell movement
      ceases as the fruiting body matures. The fruiting body thus consists of two
      domains, distinguished from each other by differential cell density, cell
      arrangements, and cell movements.

PMID- 8475117
TI  - Immunoglobulin heavy chain enhancer is located near or in an initiation zone of
      chromosomal DNA replication.
AB  - In several animal viruses, enhancers have been implicated in both DNA replication
      and transcriptional activation. The linkage of the two mechanisms appears
      intimate, in that common DNA binding factors can be shared. The immunoglobulin
      heavy chain (Igh) intronic [heavy chain joining region (JH)-mu chain constant
      region (C mu)] enhancer (E mu) is required for tissue-specific transcription of
      Igh genes and is essential for somatic recombination of diversity (D) and J
      segments. We show here that E mu is located at or near an origin of chromosomal
      DNA replication, which is more active in B lymphocytes than fibroblasts. E mu
      does not fulfill two criteria demonstrated for some cellular origins. E mu can
      initiate but not maintain autonomous replicating activity in B cells. E mu is
      unable to impart early replication timing to a transfected VDJ-C mu Igh locus in
      B cells. Instead we propose that E mu-associated ori activity contributes to
      tissue-specific Igh expression through local effects on chromatin structure
      leading to subsequent accessibility of transcription and/or recombination factors
      for the enhancer.

PMID- 8475118
TI  - Locus controlling Bordetella pertussis-induced histamine sensitization (Bphs), an
      autoimmune disease-susceptibility gene, maps distal to T-cell receptor beta-chain
      gene on mouse chromosome 6.
AB  - Pertussis toxin (PTX) is the primary component responsible for eliciting the
      majority of biological activities associated with Bordetella pertussis, including
      the induction of several tissue-adjuvant models of organ-specific autoimmune
      disease. PTX, when administered in vivo, enhances vascular permeability, which is
      made manifest by a concomitant increase in sensitivity to a variety of agents and
      treatments affecting the vascular bed. One such agent is histamine, and the
      response to PTX, as measured by hypersensitivity following vasoactive amine
      challenge, is genetically controlled by the Bphs locus. Susceptibility to the
      induction of both experimental allergic encephalomyelitis (EAE) and experimental
      allergic orchitis (EAO) in mice is associated with, and in the latter case linked
      to, a susceptible allele at this locus. We report here the mapping of the Bphs
      locus to mouse chromosome 6, telomeric of Tcrb and centromeric of Prp (D6Nds8).
      This region also contains a number of loci of immunologic relevance including
      Igk, Ly-2, Ly-3, Il-5r, Ly-35, Ly-4, and Tnfr-2.

PMID- 8475119
TI  - Replacement of germ-line epsilon promoter by gene targeting alters control of
      immunoglobulin heavy chain class switching.
AB  - Recent work has shown that the ability of cytokines to direct immunoglobulin
      heavy chain class-switch recombination to particular heavy chain constant (C)
      region (CH) genes correlates with the induction of specific germ-line CH
      transcripts. To test the role of germ-line transcripts in class switching, we
      have used homologous recombination to mutate the immunoglobulin heavy chain locus
      of the 18.81A20 murine pre-B-cell line. In the parent cell line, the combination
      of interleukin-4 (IL-4) and lipopolysaccharide (LPS) induces germ-line epsilon
      locus transcription prior to class switching to epsilon. The heavy chain locus of
      the mutated cell line contains the immunoglobulin heavy chain enhancer and
      variable region gene promoter in place of the LPS/IL-4-responsive germ-line
      epsilon promoter. The mutant cell line constitutively transcribes the epsilon
      locus in the absence of IL-4. Strikingly, the mutant cell line also switches to
      epsilon in the absence of IL-4. This result demonstrates that, at least in the
      18.81A20 cell line, germ-line epsilon transcription plays a direct role in class
      switching to the epsilon locus. In addition, the ability to change the pattern of
      class switching by altering transcriptional activity indicates that transcription
      of germ-line CH is mechanistically important in regulation of class switching.

PMID- 8475120
TI  - Dystrophin protects the sarcolemma from stresses developed during muscle
      contraction.
AB  - The protein dystrophin, normally found on the cytoplasmic surface of skeletal
      muscle cell membranes, is absent in patients with Duchenne muscular dystrophy as
      well as mdx (X-linked muscular dystrophy) mice. Although its primary structure
      has been determined, the precise functional role of dystrophin remains the
      subject of speculation. In the present study, we demonstrate that dystrophin
      deficient muscle fibers of the mdx mouse exhibit an increased susceptibility to
      contraction-induced sarcolemmal rupture. The level of sarcolemmal damage is
      directly correlated with the magnitude of mechanical stress placed upon the
      membrane during contraction rather than the number of activations of the muscle.
      These findings strongly support the proposition that the primary function of
      dystrophin is to provide mechanical reinforcement to the sarcolemma and thereby
      protect it from the membrane stresses developed during muscle contraction.
      Furthermore, the methodology used in this study should prove useful in assessing
      the efficacy of dystrophin gene therapy in the mdx mouse.

PMID- 8475121
TI  - Probability model for molecular recognition in biological receptor repertoires:
      significance to the olfactory system.
AB  - A generalized phenomenological model is presented for stereospecific recognition
      between biological receptors and their ligands. We ask what is the distribution
      of binding constants psi(K) between an arbitrary ligand and members of a large
      receptor repertoire, such as immunoglobulins or olfactory receptors. For binding
      surfaces with B potential subsite and S different types of subsite
      configurations, the number of successful elementary interactions obeys a binomial
      distribution. The discrete probability function psi(K) is then derived with
      assumptions on alpha, the free energy contribution per elementary interaction.
      The functional form of psi(K) may be universal, although the parameter values
      could vary for different ligand types. An estimate of the parameter values of
      psi(K) for iodovanillin, an analog of odorants and immunological haptens, is
      obtained by equilibrium dialysis experiments with nonimmune antibodies. Based on
      a simple relationship, predicted by the model, between the size of a receptor
      repertoire and its average maximal affinity toward an arbitrary ligand, the size
      of the olfactory receptor repertoire (Nolf) is calculated as 300-1000, in very
      good agreement with recent molecular biological studies. A very similar estimate,
      Nolf = 500, is independently derived by relating a theoretical distribution of
      maxima for psi(K) with published human olfactory threshold variations. The
      present model also has implications to the question of olfactory coding and to
      the analysis of specific anosmias, genetic deficits in perceiving particular
      odorants. More generally, the proposed model provides a better understanding of
      ligand specificity in biological receptors and could help in understanding their
      evolution.

PMID- 8475122
TI  - Human immunoglobulin heavy-chain minilocus recombination in transgenic mice: gene
      segment use in mu and gamma transcripts.
AB  - We (N.L. and L.D.T.) have introduced a human heavy-chain minilocus into mice
      transgenically. Constructs contain 2 heavy-chain variable (VH; psi VH3-105 and
      VH5-251), 10 diversity (D), 6 heavy-chain joining (JH), and either constant (C)mu
      or C mu and C gamma gene segments. Several founder lines were established and
      studied before immunization. Seventy heavy-chain transcripts were cloned and
      sequenced from murine splenic B lymphocytes, and gene-segment use was assessed
      before and after class-switching. In general, the repertoire was "fetal" in
      appearance with little evidence of somatic mutation in any gene segment. The two
      VH gene segments were found rearranged to mu- and gamma-chain C segments, with a
      preference of VH5-251. We observed a preponderance of the most-J-proximal D gene
      (DHQ52) segments among the mu transcripts (44%). The JH gene-segment use mimics
      most patterns seen in human antibodies. Diversification in CDR3 was extensive and
      included clear examples of D inversions and D-D fusions. These data suggest that
      a human immunoglobulin minilocus can undergo recombinatorial processes in a
      manner analogous to that seen in the human fetal/preimmune repertoire. This
      model, in addition to providing a potential source of human monoclonal
      antibodies, is ideal for the study of further questions concerning immunoglobulin
      gene-segment recombination.

PMID- 8475123
TI  - Activated estrogen receptor mediates growth arrest and differentiation of a
      neuroblastoma cell line.
AB  - Several reports demonstrate estrogen receptor involvement in specific brain
      functions. In addition, estrogen receptors are expressed at early stages of brain
      development, suggesting that estrogens or related molecules may play an
      instructive role in the differentiation of specific brain areas. The lack of
      model systems in which these phenomena could be studied prompted us to develop a
      neuroblastoma cell line expressing the estrogen receptor. The cell line expresses
      the hormone receptor at levels compatible with a physiological activity. The
      activated estrogen receptor is capable of blocking proliferation of the cells
      without exerting toxic effects. Following growth arrest, the cells display a
      neuron-like morphology and express tau and synaptophysin, two proteins
      synthesized in differentiating neurons. The cell line generated will provide a
      valuable model system for molecular and biochemical studies of the activity of
      estrogens in neural-derived cells.

PMID- 8475124
TI  - Thrombin-binding DNA aptamer forms a unimolecular quadruplex structure in
      solution.
AB  - We have used two-dimensional 1H NMR spectroscopy to study the conformation of the
      thrombin-binding aptamer d(GGTTGGTGTGGTTGG) in solution. This is one of a series
      of thrombin-binding DNA aptamers with a consensus 15-base sequence that was
      recently isolated and shown to inhibit thrombin-catalyzed fibrin clot formation
      in vitro [Bock, L. C., Griffin, L. C., Latham, J. A., Vermaas, E. H. & Toole, J.
      J. (1992) Nature (London) 355, 564-566]. The oligonucleotide forms a unimolecular
      DNA quadruplex consisting of two G-quartets connected by two TT loops and one TGT
      loop. A potential T.T bp is formed between the two TT loops across the diagonal
      of the top G-quartet. Thus, all of the invariant bases in the consensus sequence
      are base-paired. This aptamer structure was determined by NMR and illustrates
      that this molecule forms a specific folded structure. Knowledge of this structure
      may be used in the further development of oligonucleotide-based thrombin
      inhibitors.

PMID- 8475125
TI  - CTX genetic element encodes a site-specific recombination system and an
      intestinal colonization factor.
AB  - In Vibrio cholerae, the genes encoding cholera toxin (ctxAB) are located on a
      segment of DNA (termed the "core" region) that is flanked by two or more copies
      of a repeated sequence called RS1. Together these DNA units comprise the CTX
      genetic element. Evidence presented here suggests that RS1 sequences encode a
      site-specific recombination system, which allows integration of a suicide plasmid
      carrying RS1 into an 18-base-pair sequence (attRS1) located on the chromosome of
      nontoxigenic V. cholerae strains. Strains of V. cholerae with large deletions
      removing attRS1 and the entire CTX genetic element no longer undergo site
      specific recombination with the RS1 sequence. Additionally, these deletion
      strains show a defect in intestinal colonization. Recombination experiments
      localize the gene responsible for enhancing colonization to a portion of the core
      region of the CTX element. The identified gene encodes a peptide that is highly
      similar in amino acid sequence to the flexible pilin of Aeromonas hydrophila.
      These results have important implications in the construction of stable, live
      attenuated cholera vaccines.

PMID- 8475126
TI  - Efficient transplantation of BCR-ABL-induced chronic myelogenous leukemia-like
      syndrome in mice.
AB  - Lethally irradiated mice reconstituted with bone marrow expressing P210 BCR-ABL
      can develop myeloproliferative syndromes that resemble the initial phase of human
      chronic myelogenous leukemia (CML). Mice that develop the CML-like syndrome can
      be segregated into two groups based on the latency with which the granulocytic
      disease appears--early onset (< 20 weeks) and late onset (> 20 weeks). Only cells
      from mice exhibiting the late-onset CML-like syndrome can efficiently propagate
      the disease when transplanted into sublethally irradiated syngeneic recipients.
      Mice engrafted with late-onset murine CML cells develop a range of hematopoietic
      disorders that originate from multipotent stem cells. The chronic granulocytic
      hyperplasia can be propagated by serial transplantation into secondary and
      tertiary recipient mice. The majority of transplanted mice succumb to acute
      myeloid and B- and T-lymphoid leukemias. These data support the idea that late
      onset murine CML originates from a multipotent progenitor cell with a high
      replicating capacity. The inability to transplant the disease from mice
      developing the early-onset CML-like syndrome suggests that this disorder may
      originate from more differentiated progenitor cells with limited replication
      capacity that have undergone clonal expansion but are not immortalized. Although
      both early- and late-onset CML-like syndromes exhibit granulocytic hyperplasia,
      these disorders represent distinct diseases that appear to originate from
      different hematopoietic cell types. The late-onset CML-like disease and transfer
      to secondary recipients provides a useful murine model with features of the
      chronic and acute phases of human CML.

PMID- 8475127
TI  - Structure and evolutionary implications of a "cysteine-rich" Campoletis
      sonorensis polydnavirus gene family.
AB  - For successful parasitization, the female Campoletis sonorensis endoparasitic
      wasp injects a polydnavirus into its host, Heliothis virescens, during
      oviposition. Viral gene expression induces immunosuppression and alters
      development of the host. We report here that three abundantly expressed genes,
      VHv1.1, WHv1.0, and WHv1.6, describes a polydnavirus "cysteine-rich" gene family
      which may be important in inducing these host manifestations. These genes have a
      similar primary gene structure and their proteins contain cysteine motifs
      characteristic of snail ion-channel ligands, the omega-conotoxins. Like the omega
      conotoxins, the intercysteine amino acid residues are hypervariable with only
      three identical amino acids in all motifs. The conservation of this domain in the
      three viral genes may reflect an important functional role for these viral
      proteins in the parasitization of H. virescens. The three genes also contain
      introns similar in sequence at comparable positions in their 5' untranslated
      leaders and coding sequences. VHv1.1 contains two cysteine motifs, and each motif
      is interrupted by an intron at the same position as in the cysteine motifs of
      WHv1.0 and WHv1.6. Intron 2 sequences of WHv1.0 and WHv1.6 are 92% identical,
      while the immediately flanking exon sequences encoding the cysteine motifs are
      only 76% identical. This provides an example of nuclear pre-mRNA introns which
      are more conserved than flanking exons among members of a gene family.

PMID- 8475128
TI  - Cognition-activated low-frequency modulation of light absorption in human brain.
AB  - Animal model studies indicate light-absorption changes of the exposed animal
      brain in response to visual stimulation. Here we report observations of red-light
      absorbance changes, attributable to repetitive blood concentration changes in
      response to stimulation in the human brain frontal region by a cognitive process.
      These responses are observed as low-frequency recurrence of changes by Fourier
      transform analysis and are attributed to blood concentration change stimulated by
      the increased metabolic rate of brain tissue in cognitive function. A simple,
      portable dual wavelength spectrophotometer was attached noninvasively to the
      human forehead to measure the low frequency and power spectra of fluctuations of
      absorbances attributed to variations of brain blood concentration in the frontal
      region. The responses are associated with brain activity in responses to problem
      solving of analogies presented visually that require an associative function in
      the frontal region. The method of subtraction of test -rest Fourier transforms
      minimizes the arterial pulse frequency contributions and identifies specific
      frequencies--for example, 0.8, 1.6, 1.8 Hz in 24 of 28 tests of nine individuals
      (85%). Tests in which no increased brain activity was elicited (rest-rest) showed
      small differences. It is concluded that low-frequency recurrences of brain
      activity linked to blood concentration increases can be detected in human
      subjects with an optical device of potentially for simplified tests of cognitive
      function in the 0- to 3-Hz region and with modifications for wider band
      recordings in localized tissue volumes by time-resolved spectroscopy.

PMID- 8475129
TI  - Tetrahydrobiopterin and cytokines.
AB  - Biosynthesis of tetrahydrobiopterin starts from guanosine triphosphate by the
      action of guanosine triphosphate cyclohydrolase I, which yields the first
      intermediate, 7,8-dihydroneopterin triphosphate. This compound is then converted
      by subsequent enzymes, 6-pyruvoyl tetrahydropterin synthase and sepiapterin
      reductase, to tetrahydrobiopterin, the biologically active metabolite. Cytokines
      such as gamma-interferon or tumor necrosis factor-alpha strongly stimulate the
      activity of guanosine triphosphate cyclohydrolase I in murine and human cells,
      yielding a potentiation of intracellular tetrahydrobiopterin concentrations. In
      human cells, particularly in human monocytes and macrophages, the low activity of
      6-pyruvoyl tetrahydropterin synthase leads to the additional accumulation of
      neopterin derivatives, which leak from the cells after dephosphorylation and are
      found increased in body fluids of humans with diseases challenging cell-mediated
      immunity. A functional role for the stimulation of tetrahydrobiopterin
      biosynthesis by cytokines is the formation of a limiting cofactor required for
      the enzymatic conversion of L-arginine to citrulline and nitric oxide.

PMID- 8475130
TI  - Persistent left ventricular dysfunction after cocaine treatment in rabbits.
AB  - The present study was undertaken to determine whether the diminished cardiac
      performance associated with cocaine administration persists after the drug has
      been eliminated from the body. Cocaine (5 or 10 mg/kg iv) was administered to
      conscious (n = 7) or pentobarbital-anesthetized (n = 7) rabbits, respectively.
      Seven conscious and seven anesthetized control rabbits received the saline
      vehicle. Two and one-half hours later, the hearts were removed from the animals
      and perfused under cocaine-free conditions. Left ventricular (LV) contractility
      was evaluated by plotting steady-state LV systolic and diastolic pressures as a
      function of LV end-diastolic volume (preload). LV systolic performance was
      diminished in a dose-related manner in hearts isolated from cocaine-treated
      rabbits, but was statistically different from control only at the higher cocaine
      dose (P < 0.05). In a second set of experiments, hearts (n = 6) were isolated,
      and their LV function was evaluated before, during, and after cocaine exposure.
      In these experiments, cocaine was added to the perfusate in increments to produce
      concentrations of 5, 10, and 15 mg/liter. After LV function was evaluated at the
      highest cocaine dose, cocaine-free perfusion conditions were restored, and LV
      function was reevaluated. In these experiments, cocaine produced a dose-dependent
      decrease in LV function that readily reversed when cocaine-free perfusion was
      reinstated. We conclude that cocaine diminishes LV contractility, and that the
      diminished cardiac performance may not readily reverse after in vivo exposure.
      Moreover, the rapid restoration of cardiac performance after exposure to cocaine
      in vitro suggests that the mechanism operating in vivo involves more than a
      simple direct action on the myocyte. Catecholamine cardiotoxicity does not appear
      to be a primary factor.

PMID- 8475132
TI  - Prolactin binds to human endometrial fibroblasts and inhibits mitogenicity of an
      endometrial carcinoma extract.
AB  - Uterine endometrial carcinoma has been reported to synthesize and secrete a
      putative peptide mitogen that elicits a potent proliferative response in
      endometrial fibroblasts. The extract from endometrial carcinoma stimulated
      [3H]thymidine incorporation into human endometrial fibroblasts in a dose
      dependent manner. Concomitant exposure of the fibroblasts to prolactin (PRL) led
      to a remarkable inhibition of the extract-stimulated mitogenic activity of the
      fibroblasts. This inhibition was dependent on PRL dose, and maximal effect
      occurred at 1 microM of PRL. PRL (10 nM) suppressed an apparent maximal activity
      of the extract by 50%, and the half-maximal stimulated effect of the extract on
      thymidine incorporation was observed at the same concentration in the absence or
      presence of PRL. This noncompetitive manner may imply that PRL acts at a stage
      after the interaction of the mitogen in the extract with the specific receptor
      for mitogen. When the fibroblasts were first exposed to the extract for 12 hr and
      then to PRL, PRL suppressed the mitogenic activity with no lag. The rapid growth
      inhibitory effect of PRL was mimicked by prostaglandin E1, but the combination of
      both types of ligand was not additive in the inhibitory action on growth. PRL and
      prostaglandin E1 may inhibit a similar mitogenic signaling cascade. Specific
      receptor sites for PRL were detected in the endometrial fibroblasts, showing high
      binding affinity (Kd = 16.1 nM) and low binding capacity (Bmax = 1.59 pmol/mg
      protein). Treatment of the fibroblasts with the endometrial carcinoma extract
      induced no changes in the level of PRL receptor, excluding the possibility that
      PRL competes for the binding sites with the mitogen. These findings would suggest
      that PRL may block the mitogenic activity of the fibroblasts stimulated by the
      endometrial carcinoma-derived mitogen via a PRL receptor-mediated mechanism,
      perhaps prostaglandin production.

PMID- 8475131
TI  - Exposure of platelet fibrinogen receptors by zinc ions: role of protein kinase C.
AB  - Previous studies demonstrated that Zn2+ at a concentration of 50 microM increases
      the number of fibrinogen receptors exposed on ADP-stimulated platelets and that
      higher concentrations of Zn2+ induce platelet aggregation that appears to be
      mediated by receptors associated with the glycoprotein IIb/IIIa complex. The
      purpose of this study was to identify the mechanism by which Zn2+ modulates
      exposure of fibrinogen receptors on the surface of human washed platelets. We
      determined that Zn2+ (300-800 microM)-induced platelet aggregation that was not
      accompanied by the release of [14C]serotonin was not blocked by ADP scavenging
      enzymes and 5'-p-fluorosulfonylbenzoyl-adenosine, an affinity label for ADP
      binding sites, but it was inhibited by disintegrins, staurosporine, and EDTA.
      Zn2+ (50-200 microM) showed a synergistic effect on platelet aggregation and
      platelet release caused by ADP and N,N,N',N'-tetrakis(2
      pyridylmethyl)ethylenediamine, a Zn2+ chelator, and inhibited ADP-induced
      platelet aggregation that was reversed by Zn2+ (50 microM). Zn2+ (200 microM)
      increased the number of fibrinogen binding sites and the affinity of albolabrin
      (a disintegrin isolated from Trimeresurus albolabris snake venom that has been
      shown to bind to the fibrinogen receptor) on ADP-activated platelets. On the
      other hand, Zn2+ (100-800 microM) did not increase fibrinogen binding to the
      purified receptor. Incubation of platelets with Zn2+ (200 microM) resulted in the
      phosphorylation of a 47-kDa protein that was blocked by staurosporine, an
      inhibitor of protein kinase C. In conclusion, Zn2+ ions activate protein kinase C
      and enhance fibrinogen receptor exposure on the surface of platelets stimulated
      by ADP.

PMID- 8475133
TI  - Differential effects of glycosylated and nonglycosylated prolactin on islet cell
      division and insulin secretion.
AB  - A growing body of evidence suggests that prolactin (PRL) is a potent regulator of
      the structure and function of the islets of Langerhans, but PRL is a polymorphic
      hormone that exists in several molecular forms. Therefore, it is important to
      know whether glycosylated PRL, a major structural variant of the hormone in
      several species, has an effect different from that of the nonglycosylated PRL on
      islet function. This in vitro study examined the differential effects of
      glycosylated and nonglycosylated porcine PRL on cell division and insulin
      secretion from neonatal rat islets, and compared these results with those
      produced by homologous rat PRL. The nonglycosylated porcine PRL produced modest
      stimulation of cell division and insulin secretion from rat islets, but
      glycosylated porcine PRL had no significant effects. The stimulations produced by
      nonglycosylated porcine PRL were much weaker in comparison to those produced by
      the homologous rat PRL. The results show differential effects of the two
      structural variants of porcine PRL on rat islet function. Although these findings
      must be confirmed in a homologous system, the results present the possibility
      that the structural form of the PRL molecule available to the islet tissue may be
      crucial for its normal functioning.

PMID- 8475134
TI  - Calories, cell proliferation, and proviral expression in autoimmunity and cancer.

PMID- 8475135
TI  - Legionella pneumophila induced tumor necrosis factor production in permissive
      versus nonpermissive macrophages.
AB  - The ability of an opportunistic intracellular bacterial pathogen, Legionella
      pneumophila, to induce tumor necrosis factor (TNF) in macrophages from
      susceptible A/J or resistant BDF1 and BALB/c mice was determined. Cultures of
      peritoneal elicited macrophages from these mouse strains produced TNF in response
      to the Legionella. The TNF levels produced by the macrophages stimulated with
      either heat-killed Legionella vaccine or lipopolysaccharide were similar and dose
      dependent, although the amount of TNF produced by macrophages from permissive A/J
      mice was 2- to 4-fold higher than that produced by macrophages from the
      nonpermissive mice. Similar differences in TNF levels occurred when macrophages
      from either permissive or non-permissive mice were infected with viable
      Legionella. The TNF levels produced by the A/J mouse macrophages increased as a
      function of time after infection, with a peak of activity on Day 1 or 2,
      depending upon the initial concentration of the bacteria. Infection of the A/J
      mouse macrophages with avirulent Legionella resulted in induced levels comparable
      to those induced by a virulent strain. Although it is widely believed that TNF
      production by mouse macrophages is related to resistance to infections, the
      results of this study did not show a relationship between TNF production by
      macrophages in vitro and resistance versus susceptibility of the macrophage donor
      mouse strain to Legionella infection.

PMID- 8475136
TI  - Magnetic resonance imaging and morphometric quantitation of cartilage histology
      after chronic infusion of interleukin 1 in rabbit knees.
AB  - Cartilage pathology in rabbit knees was monitored by noninvasive magnetic
      resonance imaging (MRI) and evaluated using morphometric histologic measurements.
      Infusion of rabbit knees with the cytokine interleukin 1 induces cartilage
      degradation and inflammation. A miniosmotic pump was implanted subcutaneously to
      deliver interleukin 1 through a polyethylene catheter inserted into the rabbit
      knee. Rabbit knees were imaged using MRI and prepared for histologic examination
      at 5 and 12 days after chronic infusion of interleukin 1. MRI obtained 0.7-mm
      sections for three-dimensional reconstruction of cartilage image. Cartilage
      deterioration near the site of infusion was visible on MRI. MRI measurements
      indicated a reduction in cartilage thickness. Histology revealed a loss of
      staining of cartilage matrix proteoglycan, synovial hypertrophy, and perichondral
      bone resorption. Morphometric analysis of cartilage histology indicated a
      reduction in both cellularity (chondrocytes/m mu 2 area) and cell to matrix area
      ratio. These observations suggest that a loss of proteoglycan, an early event in
      cartilage degeneration, can be detected by MRI.

PMID- 8475137
TI  - Factors affecting secretory protein production in primary cultures of rat
      hepatocytes.
AB  - Previous studies suggest that protein synthesis in the liver may be influenced by
      alterations in hepatic proteolysis and gluconeogenesis. Since proteolysis and
      gluconeogenesis are accelerated in acute stress states (especially when
      associated with nutrient deprivation), these alterations may substantially affect
      hepatic protein synthesis, the integrity of which is important for host survival.
      In the present study, we have investigated albumin secretion and glucose
      production in primary cultures of rat hepatocytes in response to nutrient
      limiting conditions, including amino acid depletion, proteolysis inhibition, and
      augmented gluconeogenesis. In nonlimiting nutrient culture medium containing 10
      times the normal plasma amino acid concentrations, hepatocytes produced 8.05 +/-
      1.62 micrograms/plate-hr of albumin. Short-term (5 hr) inhibition of cellular
      protein degradation with the lysosomal protease inhibitor leupeptin did not
      influence albumin production, but caused a profound reduction (17-41%) when amino
      acid supply was reduced to the physiologic range (1.5-0.5 times, respectively).
      This indicates the need for active proteolysis for the maintenance of secretory
      protein production during nutrient limitation. Similarly, leupeptin inhibited
      glucose production by 22-30% at physiologic (1.5 times and 0.5 times,
      respectively) amino acid concentrations. Additionally, hepatocyte glucose
      production could be augmented 168% by epinephrine (2 microM) in 10 times medium,
      but this response was markedly depressed by leupeptin. Similar catecholamine
      mediated effects, but of a smaller magnitude, were noted at lower medium amino
      acid concentrations. These findings indicate that hepatocyte albumin and glucose
      production are associated with the common factor of active cellular proteolysis,
      probably through the regulation of amino acid supply. However, protein synthesis
      exhibits a higher priority, since stimulated hepatocyte glucose production did
      not substantially alter albumin secretion.

PMID- 8475138
TI  - Uptake and utilization of DL-5-[methyl-14C] tetrahydropteroylmonoglutamate by
      cultured cytotrophoblasts associated with neural tube defects.
AB  - A significant advance in the primary prevention of neural tube defects (NTD) is
      the recent finding that the periconceptional supplementation with folate has a
      72% preventive effect against recurrence of NTD. However, failure of folate
      supplements to prevent all recurrences supports the multifactorial causation
      hypothesis, with inherited components exerting their influence, possibly through
      defects of storage, transport, or metabolism of folate. We have assessed the
      kinetics of DL-5-[methyl-14C]tetrahydropteroylmonoglutamate ([14C]MTHF) uptake
      and incorporation into the nucleic acid and protein pools by NTD-associated and
      control trophoblasts cultured in a medium lacking thymidine and other DNA
      precursors. We report a significant initial "lag" in the rate of incorporation of
      14C label into the nucleic acid pool in NTD-associated trophoblasts. This we
      attribute to a defect in the de novo pathway of folate metabolism and its
      associated pathways, including the pathway for methionine synthesis, although the
      rate of incorporation of 14C label into the protein pool was not significantly
      different from that of the control cells. We discuss the possible pathways
      involved in the transfer of the label from the methyl group of [14C]MTHF to the
      nucleic acid pool, and argue that a slightly (but significantly) reduced rate of
      uptake into the NTD-associated cells is a reflection of the lag in incorporation
      into the nucleic acid pool. It is concluded that in the absence of thymidine,
      most of the NTD-associated trophoblasts require a longer period than controls to
      adjust to utilization of [14C]MTHF for synthesis of DNA, a period that could be
      crucial for completion of neural tube embryogenesis. We suggest that these
      findings could offer a way to a marker for risk of NTD.

PMID- 8475139
TI  - Uptake of ketone bodies in perfused hindquarter and kidney of starved,
      thyrotoxic, and diabetic rats.
AB  - To elucidate the peripheral disposal of ketone bodies in hyperketonemia
      accompanied with starvation, hyperthyroidism, or diabetes mellitus, the uptake of
      acetoacetic acid (AcAc) and beta-hydroxybutyrate (BOHB) was investigated in the
      perfused hindquarter and kidney of starved, thyrotoxic, and diabetic rats.
      Thyrotoxicity was induced by daily subcutaneous injection of thyroxine (100
      micrograms/kg/day) for 7 days, and diabetes mellitus was induced by
      intraperitoneal streptozotocin (50 mg/kg) injection. Plasma concentration of AcAc
      and BOHB was significantly higher in starved, thyrotoxic, and diabetic rats than
      in controls. The hindquarter or kidney of rats was perfused with synthetic medium
      containing 0.2 or 1.5 mM AcAc or BOHB for 30 min at a flow rate of 0.5 ml/g
      muscle wt/min or 3.2-3.5 ml/kidney/min, respectively. In perfused hindquarter,
      the uptake of AcAc and BOHB was significantly reduced in starved and diabetic
      rats, but not in thyrotoxic rats. In perfused kidney, the uptake of AcAc and BOHB
      was not significantly different between the experimental and control rats. These
      results suggest that in starvation or diabetes mellitus, disposal of AcAc and
      BOHB was impaired in the hindquarter but not in the kidney, and that disposal of
      AcAc and BOHB by hindquarter and kidney was not impaired in thyrotoxic rats.

PMID- 8475140
TI  - Strain-dependent differences in vertebral bone mass, serum osteocalcin, and
      calcitonin in calcium-replete and -deficient mice.
AB  - The effects of dietary calcium intake on vertebral bone mass, composition, and
      turnover (calcium deposition and resorption) were determined in 10- and 14-week
      old C57BL/6 (small) and SENCAR (large) mice. Total vertebral mass, percent ash,
      calcium, magnesium, and phosphorus were higher in SENCAR mice than in C57BL/6
      mice at 10 weeks of age and after being fed 0.02% or 0.6% dietary calcium for 4
      additional weeks. Relative calcium deposition was higher in C57BL/6 than in
      SENCAR mice, while relative calcium resorption was similar in both strains. The
      rate of resorption was higher in mice fed 0.02% dietary calcium than in those fed
      0.6% dietary calcium. Thus, C57BL/6 mice gained vertebral calcium, while it
      remained unchanged or declined in SENCAR mice under conditions of both calcium
      depletion and calcium repletion. Serum osteocalcin (an index of bone formation)
      was higher in C57BL/6 mice than in SENCAR mice. Mathematically significant
      correlations between osteocalcin levels and vertebral calcium resorption and the
      net vertebral calcium loss were observed only in SENCAR mice. The serum
      calcitonin concentration was correlated with the amount of vertebral calcium
      resorbed in SENCAR mice, but not in C57BL/6 mice. Thus, vertebral resorption and
      formation are more tightly coupled in 10- to 14-week-old SENCAR mice than in
      C57BL/6 mice. In addition, remodeling appears to dominate vertebral calcium
      dynamics in SENCAR mice, while growth dominates in C57BL/6 mice during this
      period. Rodents have frequently been dismissed as potential models of bone aging
      based on the expectation that continued growth, rather than remodeling, dominates
      skeletal dynamics. These data clearly demonstrate that increases in body mass
      ("growth") are not invariably associated with continued vertebral growth. In this
      murine model, both heredity and dietary calcium intake modulate vertebral bone
      mass, turnover dynamics, and composition at sexual maturity. These differences in
      the development and regulation of vertebral bone mass in small C57BL/6 and large
      SENCAR mice suggest that animal, as well as clinical, models provide useful
      insights into the cellular and hormonal mechanisms of somatotype-dependent
      vertebral growth.

PMID- 8475141
TI  - Effects of casein and soy protein on accumulation of cholesterol and dolichol in
      rat liver.
AB  - A diet containing 15% (w/w) fat and 20% (w/w) of either casein (CAS) or soy
      protein (SOY) was fed to 4-week-old rats for a period of 18 months. The effects
      of these dietary proteins on the accumulation of cholesterol and dolichol in
      livers were studied. After 1 month, the amount of liver cholesterol was about 5
      mg/g of liver. After an additional 5 months of feeding, there was a slight
      decrease in cholesterol per gram of liver (3.6 mg/g of liver in CAS-fed rats and
      2.6 mg/g of liver in SOY-fed rats). However, after 18 months, there were a
      remarkable increase (7.5 mg/g of liver) in CAS-fed rats and only a slight
      increase in SOY-fed rats. The proportions of liver cholesterol ester in rats fed
      the CAS diet were 60-70% of the total cholesterol during the experimental period,
      but in the case of the SOY diet, only rats fed the diet for 1 month showed a high
      level, 70%, of cholesterol ester. The amounts of liver dolichol in rats fed the
      CAS and SOY diets after feeding for 18 months were 60 micrograms and 47
      micrograms of liver, respectively. There was a 1.5-fold increase in both diets
      for a period of 18 months. The proportions of liver dolichyl fatty ester in rats
      fed the CAS diet were 35-40% of the total dolichol during the experimental
      period, but in the case of the SOY diet, only rats fed the diet for 1 month
      showed a high level, 36%, of dolichyl fatty ester. The proportions of dolichol
      ester in rats fed the SOY diet were 25-30% after 6 and 18 months of feeding.
      These observations indicated that the SOY diet depresses the accumulation of both
      liver dolichol and cholesterol.

PMID- 8475142
TI  - An investigation of hydrocolloids.

PMID- 8475143
TI  - State of the art of wound care. A survey of wound management practice in nursing
      homes.

PMID- 8475144
TI  - Tariff anomalies prevent appropriate care.

PMID- 8475145
TI  - A sensitive response without discrimination. Drug misuse in children and
      adolescents.
AB  - 1. Increasing numbers of children are becoming dependent on substances. 2.
      Although the Children Act 1989 gives children the right to refuse treatment,
      nurses must take steps to gain their trust and confidence. 3. Staff, working with
      children who misuse drugs need support and guidance. 4. Recommendations are set
      out which aim to enable health professionals to respect clients' confidentiality
      and to meet the requirements of the UKCC Code of Conduct.

PMID- 8475146
TI  - A positive response to an adverse reaction. Diagnosis and management of food
      intolerance in children.
AB  - 1. Food intolerance is a reproducible abnormal reaction to food or food
      components which is not psychologically based. 2. It is straightforward to
      identify immediate hypersensitivity, but delayed reactions (4-27 hours) are more
      difficult. 3. The main foods causing reactions are wheat, milk, chicken, eggs,
      fish and shellfish, but any food can cause a reaction in a sensitised individual.
      4. The solution to the problem relies on identification of the causative food(s)
      and its total elimination from the diet.

PMID- 8475147
TI  - Are we meeting clients' needs? Nursing audit in continence care.
AB  - 1. It is becoming increasingly more important to measure processes and outcomes
      of care. 2. Clients' needs, expectations and satisfaction should be measured as
      part of continence care. 3. Locally developed tools produce a high level of
      enthusiasm and commitment.

PMID- 8475148
TI  - An investigative approach. An overview of randomised controlled trials of
      alternating pressure supports.
AB  - 1. Large-celled alternating pressure mattresses are more effective than small
      celled mattresses in preventing pressure necrosis. 2. Mattresses must be
      sufficiently robust not to break down in use. 3. Clinical trials are often faulty
      and therefore need to be read carefully. 4. Control regimens must be fully
      described.

PMID- 8475149
TI  - How do we keep in time? Understanding human circadian rhythms.
AB  - 1. Circadian rhythms tend to have a periodicity of 20-28 hours. Physiological
      variables such as body temperature, blood pressure, and intraocular pressure show
      fluctuations over each 24-hour period. 2. Circadian rhythms have an endogenous
      component produced by a 'clock' inside the body, and an exogenous component
      produced by our rhythmic lifestyle and environment. 3. An understanding of
      circadian rhythmicity is relevant to nurses, as variations in physiological
      parameters may have implications for patient care and treatment. 4. Discussion of
      circadian rhythmicity and its implications should be included in Project 2000
      courses to increase understanding of how we 'keep time'.

PMID- 8475150
TI  - Osteopathy--an aid to the healing process.
AB  - 1. Osteopaths deal primarily with the dysfunction of joints and the resulting
      effects. 2. Osteopaths believe that the body is able to heal itself and that
      their role is to aid this process. 3. Spinal dysfunction has wide-ranging effects
      on all bodily systems. 4. Osteopaths use a wide variety of techniques, not just
      supposedly painful manipulations, and treat both spinal and non-spinal problems.

PMID- 8475151
TI  - A drama of growth and recognition. Drama in therapy with abused children.
AB  - 1. Psychodrama is a form of psychotherapy which uses drama as its main medium. 2.
      It has four main stages: warm-up, action, sharing and re-integration. Each stage
      has therapeutic elements in its own right. 3. Psychodrama is adaptable to a
      variety of settings and situations. 4. It has various forms, such as sociodrama
      and monodrama, and is separate from drama therapy, which centres on metaphor and
      its relationship with drama, although the two can often be used in partnership.

PMID- 8475152
TI  - An open approach to a delicate subject: management of diabetes-related sexual
      problems.
AB  - 1. Diabetes nurse specialists need to help people with diabetes towards better
      sexual health. 2. Management of a change in practice takes time, and nurses need
      support and encouragement to effect this. 3. A survey was devised to encourage
      nurses to identify their feelings about diabetes-related impotence. 4. An open
      approach is required to enable people with diabetes to speak freely about their
      impotence.

PMID- 8475153
TI  - A bridge from hospital to home. The role of the community liaison neonatal nurse.
AB  - 1. Community liaison neonatal nurses (CLNN) play an invaluable role in preparing
      parents for the early discharge of preterm babies. 2. The CLNN role enables
      babies to be discharged who would normally remain in hospital for months. 3.
      Preterm babies generally thrive at home, gaining weight and receiving the
      necessary stimuli for development. 4. CLNNs can help relieve parent anxiety and
      stress as well as avoid high hospital readmission rates.

PMID- 8475154
TI  - Reap the benefits of a cooperative approach. Understanding interdisciplinary
      teamwork.
AB  - 1. For a variety of people, teamwork is effective for nursing interaction. 2.
      Teamwork can benefit patients and staff if careful planning of team policies is
      undertaken. 3. Teamwork requires agreed values, aims and objectives together with
      commitment of members. 4. Lack of commitment to teamwork reduces quality care, is
      wasteful of resources and contradicts the UKCC Code of Professional Conduct.

PMID- 8475155
TI  - Private grief but a shared experience.

PMID- 8475156
TI  - [Synthesis and biological activity of 1,5-diaryl-3-alkylamino-4-carboxymethyl-2,5
      dihydropyrrol-2-ones and 1,5-diaryl-4-carboxymethyltetrahydropyrrol-2,3-diones].
AB  - By interaction of alpha-ketoglutaric acid with Schiff bases 1,5-diaryl-3
      arylamino-4-carboxymethyl-2,5-dihydropyrrol-2-ones 1 were obtained. Hydrolysis of
      the latter, carried out with hydrochloride acid gave 1,5-diaryl-3-hydroxy-4
      carboxymethyl-2,5-dihydropyrrol-2-ones 2. On treatment of 2 with aryl-amines the
      starting compounds 1 were yielded. All compounds were tested for their
      antiphlogistic activity.

PMID- 8475157
TI  - Hypolipidemic activity of 1-acyl- and 1,2-diacyl-3,5-pyrazolidinediones.
AB  - A series of substituted 1-acyl- and 1,2-diacyl-3,5-pyrazolidinediones were found
      to have hypolipidemic properties lowering both serum cholesterol and triglyceride
      levels in rodents. For optimal activity of the pyrazolidinediones, both nitrogen
      atoms of the ring needed to be substituted preferentially with MeCO groups. This
      compound lowered rat VLDL but did not elevate HDL cholesterol content.

PMID- 8475158
TI  - White beeswax microspheres: a comparative in vitro evaluation of cumulative
      release of the anticancer agents fluorouracil and ftorafur.
AB  - White beeswax microspheres were investigated as a vehicle for the controlled
      release of anticancer agents. The in vitro diffusion of fluorouracil (1) and its
      prodrug ftorafur (2) was studied. The transfer rate constants from simulated
      gastro-intestinal juices to simulated plasma, throughout artificial wall lipid
      membranes, were defined. The constant's values suggested that the two drugs are
      poorly absorbed from stomach and main absorption occurred in the intestinal
      tract. Microspheres of 1 and 2 were prepared by a meltable dispersion of white
      beeswax and a wetting agent. The method is simple, inexpensive, rapid and
      reproducible. The drug release from the prepared microspheres was evaluated in
      vitro. More than 95% of the isolated microspheres were of particle size range 100
      425 microns. The average drug content was 4%. Drug dissolution was greatly
      retarded as a result of microsphere formation.

PMID- 8475159
TI  - Synthesis and in vitro antimicrobial activities of some 4-acetylantipyrine N2-(3
      substituted-4-phenylthiazoline-2-ylidene)hydrazone derivatives.

PMID- 8475160
TI  - Photooxygenation of some potentially skin-photosensitizing hydroxyfurocoumarins.
      Part 2: Xanthotoxol and bergaptol.

PMID- 8475161
TI  - [Determination of hydroxyprogesterone caproate in serum with HPLC].

PMID- 8475162
TI  - [Acute toxicity in the "yeast test" of thalidomide, taglutimide and supidimide].

PMID- 8475163
TI  - [The combination of epirubicin with d-verapamil and/or tamoxifen in cell
      cultures].

PMID- 8475164
TI  - Study of local anaesthetics. Part 101: Correlation between k' and values of
      surface and infiltration anaesthesia activity.

PMID- 8475165
TI  - Hydroxyproline content in chick embryos following the intraamniotical injection
      of ibuprofen.

PMID- 8475166
TI  - Pharmacological actions of a new procyanidin polymer from Pistacia lentiscus L.

PMID- 8475167
TI  - Reactions of 5-aryl-furan-2,3-diones with acylmethylenetriphenylphosphoranes:
      synthesis and biological activity of 3(2H)-furanone derivatives.
AB  - The Wittig reaction of 5-aryl-furan-2,3-diones 1 with
      acylmethylenetriphenylphosphoranes 2 conducted by heating under reflux in benzene
      solutions, proceeded regiospecifically to afford 2-acylmethylene-5-aryl-3(2H)
      furanones 5 in good yields. When the starting compounds 1 and 2 were allowed to
      react at room temperature, the stable intermediate 5-aryl-2-hydroxy-2
      triphenylphosphoranylidenemethyl-3(2H)-furanone s 15 were yielded. The latter
      adducts underwent triphenylphosphine oxide elimination on heating to form the
      same olefins 5. The structural assignments of the synthesized compounds were made
      on the basis of their spectral data and X-ray analysis for 5a. Some of the
      compounds obtained exhibit antimicrobial activity and one compound of the 3(2H)
      furanone series exhibited anticonvulsant activity.

PMID- 8475168
TI  - Vascular derived growth factors: cell biology, pathophysiology, and pharmacology.

PMID- 8475169
TI  - Caffeine as an analgesic adjuvant: a review of pharmacology and mechanisms of
      action.

PMID- 8475170
TI  - Neutral endopeptidase 24.11: structure, inhibition, and experimental and clinical
      pharmacology.

PMID- 8475171
TI  - Modulation and dynamics of phase properties in phospholipid mixtures detected by
      Laurdan fluorescence.
AB  - Steady-state and dynamic fluorescence properties of 6-lauroyl-2
      dimethylaminonaphthalene (Laurdan) have been used to ascertain the coexistence of
      separate phase domains and their dynamic properties in phospholipid vesicles
      composed of different mole ratios of dilauroyl- and dipalmitoyl
      phosphatidylcholine (DLPC and DPPC, respectively). The recently introduced
      generalized polarization together with time-resolved emission spectra have been
      utilized for detecting changes. The results indicate the coexistence of
      phospholipid phase domains in vesicle compositions in the range between 30 mol%
      and 70 mol% DPPC in DLPC. Below and above these concentrations a homogeneous
      phase is observed, with averaged properties. In the case of coexisting phase
      domains, the properties of each individual phase are largely influenced by the
      presence of the other phase. Implications on fluctuations between the coexisting
      phases and on the size and shape of domains are discussed.

PMID- 8475172
TI  - Use of sensitized fluorescence for the study of the exchange of subunits in
      protein aggregates.
AB  - The exchange of subunits between oligomer protein particles depends upon a cycle
      of dissociations and associations. To examine the dynamics of these cycles we
      have employed two methods based on the transfer of excitation energy between
      fluorochromes attached to different subunits of protein oligomers, at various
      temperatures and pressures. In the heterotransfer method, identical solutions
      independently labeled with two different fluorophores, donor D and acceptor A,
      are mixed. The fluorescence spectrum permits the determination of the subunit
      exchange by the increase in A and decrease in D fluorescence as mixed AD
      oligomers are formed. In the homotransfer method the aggregates are labeled with
      fluorescein to the extent that, ideally, each subunit carries a fluorophore. The
      emission is strongly depolarized because sufficiently often it takes place after
      a transfer to a fluorophore oriented differently from the one originally excited.
      Both dissociation and subunit exchange with unlabeled material result in an
      increase in polarization and can be independently determined by the homotransfer
      method. Both homo- and heterotransfer have been employed in the study of the
      effect of temperature on the stability of the aggregates and the relation between
      the rate of dissociation and the rate of exchange when dissociation of oligomers
      is induced by hydrostatic pressure.

PMID- 8475173
TI  - Fluorescence investigations of albumin from patients with familial dysalbuminemic
      hyperthyroxinemia.
AB  - Familial dysalbuminemic hyperthyroxinemia (FDH) is an autosomal dominant syndrome
      in which clinically euthyroid patients have elevated total thyroxine levels.
      These high serum thyroxine levels are traceable to altered binding of thyroxine
      to the patient's albumin. Albumin from FDH patients and normal volunteers have
      been purified. Reverse-phase and ion-exchange high performance liquid
      chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis on
      the FDH-human serum albumin (HSA) samples show a single band that comigrates with
      normal HSA. In both protein solutions the intrinsic fluorescence, upon 280 nm
      excitation, is predominantly due to the single tryptophan residue. The quantum
      yield of this intrinsic fluorescence in the FDH-HSA solutions is, however,
      reduced relative to that of HSA. Furthermore, the "average" lifetime value of the
      tryptophan emission in the FDH-HSA sample is less than that of normal HSA,
      consistent with its reduced quantum yield. The binding of thyroxine to both
      albumins effectively quenches the tryptophan emission probably via a nonradiative
      energy transfer mechanism. Time-resolved data suggest that the albumin from the
      dysalbuminemic patients is actually an approximately equimolar mixture of normal
      HSA and FDH-HSA indicative of heterologous expression. Quenching of the intrinsic
      HSA and FDH-HSA fluorescence by serial additions of thyroxine showed enhanced
      quenching of FDH-HSA relative to HSA at any T4 to albumin mole ratio, therefore
      supporting earlier reports of increased thyroxine affinity to FDH-HSA.

PMID- 8475174
TI  - Lipid phases in renal brush border membranes revealed by Laurdan fluorescence.
AB  - Steady-state fluorescence properties of 6-dodecanoyl-2-dimethylaminonapththalene
      (Laurdan) have been used to determine the coexistence of separate lipid-phase
      domains in apical brush border membrane vesicles isolated from the rat renal
      cortex. The temperature dependence of generalized polarization has been utilized
      to quantitate the lipid phases. Finally, the effect of cholesterol enrichment on
      these parameters has been studied. The results indicate the coexistence of lipid
      phase domains in brush border membranes based on the values of the generalized
      polarization and assuming that the membrane state can be described by coexistence
      of gel and liquid crystalline state. At 37 degrees C, approximately 19-32% of the
      brush border membrane lipids are in the gel phase, and cholesterol enrichment
      causes a further concentration-dependent increase in the gel phase of brush
      border membrane lipids.

PMID- 8475175
TI  - Interaction of the peptide hormone adrenocorticotropin, ACTH(1-24), with a
      membrane model system: a fluorescence study.
AB  - The peptide hormone adrenocorticotropin and a related peptide were studied in
      solution and in interaction with a model system of membranes (small unilamellar
      vesicles of dipalmitoylphosphatidylcholine and 17%
      dimyristoylphosphatidylglycerol) via fluorescence spectroscopy. In aqueous
      solution, intramolecular distances between the fluorescent residues R(Tyr2-Trp9)
      = 9.2 A and R(Trp9-Tyr23) > or = 18 A were obtained, in agreement with molecular
      models. Interaction of the peptide with the negatively charged membrane is
      evident from the alteration of the Trp photophysical parameters (quantum yield,
      fluorescence spectra and anisotropy), with a partition constant between the
      lipidic and aqueous phase of Kp = 1-2 x 10(3). The existence of two populations
      of Trp in the membrane, which are distinctly accessed by acrylamide, was
      concluded from the tryptophan fluorescence quenching study; the two fractions are
      located near the membrane interface as inferred from its fluorescence quenching
      by the 5-doxylstearate and 16-doxylstearate lipophilic quenchers. This result is
      further supported by energy transfer experiments to the 3-(9-anthroyloxyl)stearic
      acid and 12-(9-anthroyloxyl)stearic acid probes.

PMID- 8475176
TI  - Use of Laurdan fluorescence in studying plasma membrane organization of
      polymorphonuclear leukocytes during the respiratory burst.
AB  - The changes in plasma membrane polarity of polymorphonuclear leukocytes (PMN)
      during the activation of the respiratory burst were investigated by measuring the
      steady-state fluorescence emission spectra of 2-dimethylamino(6-lauroyl)
      naphthalene (Laurdan), which is known to be incorporated at the hydrophobic
      hydrophilic interface of the bilayer, displaying spectral sensitivity to the
      polarity of its surroundings. Laurdan shows a marked steady-state emission blue
      shift in nonpolar solvents, with respect to polar solvents. Our results show a
      blue shift of the fluorescence emission spectra of Laurdan during activation of
      PMN with phorbol myristate acetate or N-formyl-methionyl-leucyl-phenylalanine.
      These results suggest that the activation of the respiratory burst of PMN is
      accompanied by a decrease in polarity in the hydrophobic-hydrophilic interface of
      the plasma membrane.

PMID- 8475177
TI  - Detection of radical ion intermediates in flavin-photosensitized pyrimidine dimer
      splitting.
AB  - Photosensitized splitting of cis-syn- and trans-syn-1,3-dimethyluracil dimers by
      2',3',4',5'-tetraacetylriboflavin in acetonitrile containing a trace of
      perchloric acid was studied by laser flash photolysis. Protonation of the flavin
      prior to excitation resulted in excited singlet and triplet states that
      abstracted an electron from the dimers and yielded the protonated flavin radical
      (FlH2.+), which was detected by absorption spectroscopy. Electron abstraction by
      the excited singlet state predominated over abstraction by the triplet state.
      Approximately one-third to one-half of the excited states quenched by the trans
      syn dimer yielded FlH2.+, the balance presumably undergoing back electron
      transfer within the geminate radical ion pair generated by the initial electron
      transfer. A covalently linked dimer-flavin exhibited very inefficient flavin
      radical ion formation, consistent with the known low efficiency of dimer
      splitting in this system. These results constitute the first identification of a
      flavin radical ion intermediate in photosensitized pyrimidine dimer splitting.

PMID- 8475178
TI  - Influence of the peptide bond on the singlet molecular oxygen-mediated (O2[1
      delta g]) photooxidation of histidine and methionine dipeptides. A kinetic study.
AB  - The dye-sensitized photooxidation of L-histidine (His) and L-methionine (Met) and
      their simplest dipeptides with glycine (Gly) (His-Gly, Gly-His Gly-Met) and Met
      methyl ester (Met-ME) mediated by singlet molecular oxygen (O2[1 delta g]) was
      studied. The overall rate constants in acetonitrile-H2O (kt) for O2(1 delta g)
      quenching were measured by time-resolved phosphorescence detection. In H2O a
      competitive kinetic method was employed. In both solvents the reactive rate
      constants (kr) were determined to discriminate between the overall and physical
      contributions to the quenching. The kinetic and mechanistic aspects of the
      interaction are discussed. For His-Gly, the peptide bond has practically no
      effect on the kinetics of photooxidation. For Gly-His the overall rate constant
      is much higher than that for His and His-Gly, in both H2O and acetonitrile-H2O.
      The main contribution to kt (for Gly-His) is the physical quenching of O2(1 delta
      g). In water the kt/kr ratio for free His and His-Gly is 1.0, reaching a value of
      2.0 in the organic solvent-H2O mixture. The rates of -NH2 loss upon sensitized
      photooxidation in all cases parallel the trend of kr values. The main results for
      the His series indicate that: (1) a polar environment favors autoprotection (i.e.
      an increase in the contribution of physical quenching) against photodynamic
      effects; (2) only the rate constant for reactive interaction with O2(1 delta g)
      does not depend on the location of the peptide bond involving His. For Met
      derivatives the kt values are higher in both solvents than that for free
      Met.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475179
TI  - The effect of mercuric ions on the excited states of DNA-intercalated ethidium
      bromide.
AB  - The first excited triplet state of DNA-intercalated ethidium bromide is produced
      with a quantum yield of 0.01 +/- 0.002 on irradiation at 532 nm. A difference
      extinction coefficient of 1.5 +/- 0.2 x 10(3) m2 mol-1 is measured for the
      triplet state at 380 nm. Mercuric ions quench the first excited singlet state of
      DNA-intercalated ethidium bromide via induced spin orbit coupling to give an
      increased yield of ethidium triplet states. The same mercuric ion that quenches
      the singlet state then quenches the triplet state, via the same mechanism, with a
      rate constant of ca 3.5 x 10(3) s-1. An upper limit for the rate of detachment of
      Hg2+ from its binding site in DNA may be fixed at ca 10(3) s-1.

PMID- 8475180
TI  - Spectroscopic properties of potential sensitizers for new photodynamic therapy
      start mechanisms via two-step excited electronic states.
AB  - Three substituted tetraazaporphyrins, octa-(4-tert-butylphenyl)
      tetrapyrazinoporphyrazine, tetra-(4-tert-butyl)phthalocyanine and tetra-(4-tert
      butyl)phthalocyanatomagnesium(t4-PcMg), were spectroscopically checked in
      solutions and liposomes with respect to suitability as potential sensitizers of a
      possible new start mechanism for photodynamic therapy (PDT) from a stepwise
      excited higher singlet state. This PDT start mechanism was recently proposed to
      overcome the problem of O2 (1delta2)-caused cutaneous phototoxicity in PDT. By
      means of absorption and fluorescence measurements as well as nonlinear absorption
      investigation, transient spectroscopy and lasing experiments, compound t4-PcMg
      was found to have the most appropriate properties: Based on a high fluorescence
      quantum yield (phiF1 = 0.84) and a very low crossing to the triplet (phiISC =
      0.05), two higher excited states can be effectively populated both by two
      stepwise absorption transitions at 674nm consecutive absorption transitions at
      684 and and 710 nm. Moreover, t4-PcMg incorporates into liposomes very well with
      spectroscopic properties similar to those in solution.

PMID- 8475181
TI  - Photophysical properties of 3,3'-dialkylthiacarbocyanine dyes in homogeneous
      solution.
AB  - The photophysical properties of 3,3'-dialkylthiacarbocyanine iodides and
      chlorides were measured in various solvents. It was found that photoisomerization
      and fluorescence are the major contributors to the deactivation of the excited
      singlet state; intersystem crossing occurs with only a very low efficiency. In
      ethanol, a triplet yield of 0.004 and a singlet oxygen quantum yield of 0.002
      were determined. The photophysical parameters of these dyes are not substantially
      influenced by the length of the alkyl chain or the size of the halide counterion.
      The substitution of an ethyl with an octadecyl-chain only slightly hinders
      photoisomerization, and the replacement of the chloride with an iodide reduces
      only marginally the fluorescence lifetimes and fluorescence quantum yields in
      chloroform. A significant external heavy-atom effect is observed using
      dibromoethane as a solvent: triplet and singlet oxygen yields increase 7-10-fold,
      and the triplet lifetime decreases from 55 microseconds to 15 microseconds.

PMID- 8475182
TI  - Time-gated fluorescence imaging for the diagnosis of tumors in a murine model.
AB  - A system for time-gated fluorescence imaging was used to perform measurements on
      tumor-bearing mice treated with hematoporphyrin derivative (HpD). The aim of the
      study was to define the potential of this technique in the diagnosis of tumors by
      taking advantage of the long fluorescence lifetime of the exogenous dye with
      respect to the decay times of the natural fluorescence. After the administration
      of three different drug doses (5, 10 and 25 mg/kg body weight), fluorescence
      images were acquired at various uptake times (from 2 h to 10 d), to determine the
      best instrumental conditions and experimental procedure for the detection of
      tumors in the murine model considered. The optimal fluorescence contrast between
      the tumor area and the surrounding healthy tissue was found at 12 h after the
      administration of either 5 or 10 mg/kg HpD and was anticipated at 8 h for the
      highest drug dose. In this optimum condition, the tumor region could be
      identified even after the injection of 5 mg/kg HpD. A better fluorescence
      contrast was always obtained in 15 ns-delayed images with respect to synchronous
      ones.

PMID- 8475183
TI  - Involvement of drug-derived peroxides in the phototoxicity of naproxen and
      tiaprofenic acid.
AB  - Photodegradation of naproxen and tiaprofenic acid in aqueous buffered solutions
      leads to decarboxylated products with ethyl, 1-hydroxyethyl and/or acetyl side
      chains. The photomixtures obtained in the presence of oxygen were clearly more
      toxic to cultured hepatocytes than those obtained under anaerobic conditions.
      This effect was more noticeable in the case of naproxen. Based on the composition
      of the oxygenated photomixtures and the relative toxicity of the different
      photoproducts, it is possible to account for most of the observed toxicity in the
      case of tiaprofenic acid but not in the case of naproxen. This is explained as a
      result of the presence of drug-derived peroxidic species in the photomixtures and
      their contribution to the observed toxicity. Peroxides were determined by the
      peroxidase-catalyzed oxidation of dichlorodihydrofluorescein to its fluorescent
      analog. The amount of peroxides present in naproxen photomixtures was much higher
      than in the case of tiaprofenic acid. A dose-dependent depletion of intracellular
      glutathione was observed when hepatocytes were incubated with peroxide-containing
      naproxen photomixtures. This effect was prevented by the addition of catalase or
      N-acetylcysteine to the culture medium.

PMID- 8475184
TI  - The unusual UVA-dependent antiviral properties of the furoisocoumarin,
      coriandrin.
AB  - The novel furoisocoumarin, coriandrin, which was found recently to possess an
      interesting combination of photobiological properties, was investigated for
      antiviral activity in the presence and absence of UVA (long-wavelength
      ultraviolet radiation). In contrast to results obtained with other antiviral
      furocoumarins, such as 8-MOP (8-methoxypsoralen), coriandrin was much more
      phototoxic to the RNA-virus Sindbis virus than to the DNA-virus murine
      cytomegalovirus, although both viruses were substantially more sensitive to this
      compound than they were to 8-MOP. Human immunodeficiency virus, HIV-1, was also
      susceptible to coriandrin + UVA. Another unexpected finding was that viruses
      without membranes were completely resistant to coriandrin. This suggests that a
      membrane component was a target for the compound. The antiviral activity of
      coriadrin was profoundly inhibited by serum components in the reaction mixtures,
      which suggests that the compound may have a strong affinity for certain protein
      or lipid materials, although maximal interference was only obtained when all
      components of the reaction mixture, virus, coriandrin and serum, were irradiated
      simultaneously. Thus it appears that coriandrin has unusual antiviral properties
      that would not be predicted from its chemical similarity to furocoumarins.

PMID- 8475185
TI  - Benzo- and tetrahydrobenzo-psoralen congeners: DNA binding and photobiological
      properties.
AB  - Four new benzo- and tetrahydrobenzo-psoralens have been examined in their
      reversible interaction toward DNA and in their DNA-photobinding properties. These
      compounds were also examined for their ability to produce singlet oxygen and in
      vivo skin photosensitization reaction. Fluorescence and equilibrium dialysis
      measurements show that the complexation ability of benzoderivatives is remarkably
      high. Binding is less effective in the case of the tetrahydrocongeners. All
      compounds photoreact quite effectively to DNA. The photoadducts were obtained by
      enzymatic hydrolysis of drug-modified DNA and were characterized by high
      performance liquid chromatographic elution techniques. The 3,4 position
      represents the unique photoreactive site for benzopsoralens. Denaturation
      renaturation experiments confirm that the benzoderivatives are purely
      monofunctional, while the tetrahydrocongeners form interstrand cross-links, even
      though to a remarkably lesser extent than 8-methoxypsoralen (8-MOP). The new
      compounds, in the presence of long-wavelength ultraviolet radiation, are very
      moderately effective in forming reactive oxygen species; they are ineffective in
      promoting oxidation of tyrosine and 3-(3,4-dihydroxyphenyl)alanine to dopachrome
      and melanin. Skin photosensitizing experiments on guinea pigs indicate that benzo
      and tetrahydrobenzopsoralen derivatives are almost devoid of any phototoxic
      effects. Thus, this class of compounds appears to be interesting for the
      development of new, less phototoxic chemotherapeutic agents that interact with
      DNA better than 8-MOP.

PMID- 8475186
TI  - An ultraviolet radiation action spectrum for immediate pigment darkening.
AB  - The wavelength dependence for immediate pigment darkening (IPD) was investigated
      by exposing the midback skin of volunteers to a series of incremental fluences of
      narrow waveband radiation isolated by band-pass filters in the 310-400 nm region.
      The threshold IPD fluence for each waveband was determined by visual assessment
      of the skin responses immediately after each exposure. The action spectrum,
      constructed from the mean threshold fluences, was broad and extended from 320 nm
      to 400 nm with a peak at around 340 nm. No IPD could be evoked at 310 nm, even
      after erythemogenic fluences. The spectrum was similar in each of the three skin
      types investigated (III, IV, V). The broad nature of the action spectrum within
      the UVA region suggests that IPD may serve as an alternative endpoint for
      measuring photoprotection against these wavelengths.

PMID- 8475187
TI  - DNA nicking by ultraviolet radiation is enhanced in the presence of iron and of
      oxygen.
AB  - Double-stranded covalently closed circular supercoiled DNA (ccc DNA) from plasmid
      pUK 9 was irradiated in vitro at defined wavelengths in the UV region (290, 313
      and 365 nm). The nicking was monitored by electrophoresis on agarose gels,
      ethidium staining and densitometric quantitation of supercoiled and relaxed
      moieties. At the explored wavelengths, the dose required for introducing one nick
      per million phosphodiester bonds diminishes with increased concentration of added
      ferric iron, whereas the effect of cupric iron is practically negligible. Adding
      metal chelators or bubbling argon prior to the irradiation results in a dramatic
      increase in the dose required for introducing one nick per million phosphodiester
      bonds. Taken together, these results seem to indicate that iron and oxygen play a
      role as cofactors in the UV-induced nicking of ccc DNA in vitro.

PMID- 8475188
TI  - Seasonal trends in erythemal and carcinogenic ultraviolet radiation at mid
      southern latitudes 1989-1991.
AB  - A network of solar carcinogenic/erythemal ultraviolet radiometers has been
      established in New Zealand. Daily integrated irradiances of this biologically
      harmful ultraviolet radiation for 1989, 1990 and 1991 are reported from
      radiometers located at Wellington (41 degrees S) and Christchurch (43.5 degrees
      S) and for 1990 and 1991 from the Auckland (37 degrees S) radiometer. Although
      the monitoring program has not been running sufficiently long to discern any long
      term changes in levels of solar ultraviolet radiation, shorter term trends are
      apparent, which are attributed to a seasonal cycle in levels of ozone at
      midlatitudes and changes in atmospheric aerosols.

PMID- 8475189
TI  - Determining the optimal dose of Photofrin in miniswine atherosclerotic plaque.
AB  - The purpose of this study was to determine the lowest dose of Photofrin (P) that
      would produce a 3:1 or greater ratio between atherosclerotic (AS) and control
      arterial walls. Aortoiliac AS was created in 24 Yucatan miniswine by a
      combination of balloon endothelial injury and 2% cholesterol and 15% lard diet
      for 7 weeks. Arteriography was then performed to demonstrate AS lesions.
      Following this, swine were given intravenously P in one of the following single
      dosages: 2.5, 1.0 or 0.5 mg/kg. Twenty-four hours later, swine were sacrificed
      and aortoiliac and control carotid artery segments removed and photographed with
      ultraviolet light to differentiate fluorescent from nonfluorescent areas.
      Arterial specimens were submitted for histologic analysis and chemical extraction
      for determination of fluorescence using a spectrofluorometer. Tissue
      concentration (ng/g tissue) of P from AS vessels were: Group I, 130.4 +/- 82.7;
      Group II, 10.0 +/- 1.2; and Group III, 9.1 +/- 0.6, respectively (P < 0.05).
      Ratios of P concentration in AS: control vessels were: Group I, 8.1 +/- 13.7;
      Group II, 1.1 +/- 0.2; and Group III, 0.9 +/- 0.1, respectively (P < 0.05). These
      results demonstrated that a P dose of 2.5 mg/kg provided at least a 3:1 ratio
      between AS: control artery wall.

PMID- 8475190
TI  - Molecular changes during the photooxidation of alpha-crystallin in the presence
      of uroporphyrin.
AB  - Singlet oxygen reacts preferentially with three amino acids in proteins, His, Trp
      and Met. In order to study the specific molecular events that result from such
      oxidations, calf alpha-crystallin was photooxidized in the presence of
      uroporphyrin and the reactions were investigated by high performance liquid
      chromatography peptide mapping using a photodiode array detector followed by fast
      atom bombardment mass spectrometry (FAB-MS). From these studies, the following
      conclusions can be inferred: (1) Upon photooxidation residue Met-68 of the B
      chain is oxidized to Met sulfoxide, whereas residue Trp-60 remains intact. (2)
      Two of the 16 His residues in alpha-crystallin are photooxidized with an apparent
      pKa of ca 7.0 (3) FAB-MS analysis suggests that residue Lys-166 close to the C
      terminal end of the A chain forms a cross-link with the His-7 residue close to
      the N-terminal end of the A chain. This may be either an inter- or intramolecular
      cross-link.

PMID- 8475191
TI  - Photon emission by bacteria challenged with phenylacetaldehyde. A possible
      distinction between gram-positive and gram-negative bacteria.
AB  - With all bacteria tested, addition of phenylacetaldehyde leads to light emission.
      The latter is markedly stronger with gram-negative bacteria, presumably because
      they possess a thinner wall and an extra external lipophilic membrane. Consistent
      with this explanation, the bactericidal effect of phenylacetaldehyde is also
      stronger with gram-negative bacteria. The spectrum of the emitted light shows
      maximal emission in the 500 nm region and is very similar to that observed when a
      protein (bovine serum albumin), free amino acids or isopropylamine reacts with
      phenylacetaldehyde.

PMID- 8475192
TI  - Laser-light induced chromosome aberrations in Chinese hamster cells.
AB  - Wild-type Chinese hamster cells CHO K1 and their radiosensitive mutant xrs5 were
      irradiated at 308 nm, using light pulses of a XeCl excimer laser with total
      energy fluences of 0.1 kJ/m2 to 4.08 kJ/m2. Chromosome-type and chromatid-type
      chromosome aberrations have been observed at pulse irradiances of 2.5 x 10(7)
      W/m2 and 1.7 x 10(8) W/m2, indicating that in mammalian cells DNA double-strand
      breaks occur already in this irradiance range. The results obtained with laser
      irradiation are compared with X-ray irradiation.

PMID- 8475193
TI  - Action spectra for the trans to cis photoisomerisation of urocanic acid in vitro
      and in mouse skin.
AB  - Urocanic acid (UCA) is a major UV chromophore in the upper layers of the skin
      where it is found predominantly as the trans isomer. UV irradiation induces
      photoisomerisation of trans-UCA to cis-UCA which has been shown to mimic some of
      the immunosuppressive properties of UV exposure. We examined the wavelength
      dependence for trans-UCA to cis-UCA photoisomerisation in vitro and in mouse skin
      in vivo over the spectral range 270-340 nm. The resulting action spectra were
      very similar with maximal effectiveness at 300-315 nm and equal activity at 270
      nm and 325-330 nm, demonstrating that UVA-II radiation (320-340 nm) is efficient
      at UCA photoisomerisation. These action spectra differed markedly from the trans
      UCA absorption spectrum in vitro and also the reported action spectrum for UV
      suppression of contact hypersensitivity in mice. These findings suggest that the
      relationship between cis-UCA formation in skin and UV-induced immunosuppression
      may be complex.

PMID- 8475194
TI  - Endothelins: multifunctional renal peptides.

PMID- 8475195
TI  - Cardiovascular regulatory mechanisms in advanced age.

PMID- 8475196
TI  - Cognitive neuropsychiatry?

PMID- 8475197
TI  - A prospective study of delirium in elderly patients admitted to a psychiatric
      hospital.
AB  - Seventy consecutive elderly patients meeting the DSM-III criteria for non-alcohol
      delirium were examined during the acute stage and followed to four years later.
      The mean age of the patients at the beginning of the index admission was 74.8 +/-
      6.4 years. The most common aetiologies for delirium were stroke, infections and
      metabolic disorders. Coexistent structural brain disease predisposing to delirium
      was found in 57 cases (81%). During the index admission, the cognitive
      dysfunction associated with delirium ameliorated significantly (mean +/- S.D.
      Mini Mental State Examination score 9.7 +/- 6.6 at admission and 13.9 +/- 7.2 at
      discharge, P < 0.001), but during the follow-up period of four years progression
      of the basic central nervous system disease was observed together with declining
      cognition and deteriorating functions of daily living. Four patients died during
      the index admission and 42 patients during the follow-up period. In decreased
      patients there was a statistically significant connection between the levels of
      cognitive functioning and functions of daily living at the end of the index
      admission and the life span after delirium.

PMID- 8475198
TI  - Emotional distress and fatigue in coronary heart disease: the Global Mood Scale
      (GMS).
AB  - Evidence indicates that emotional distress has a long-term impact on morbidity
      and mortality in patients with coronary heart disease (CHD), and that symptoms of
      depression, fatigue, and reduced energy may identify high-risk patients. This
      study was designed to: (1) devise a sound and practical measure of emotional
      distress in CHD patients; (2) examine the relationship between emotional distress
      and fatigue following CHD; and (3) examine changes in emotional distress as a
      function of cardiac rehabilitation. A sample of 478 men with CHD (mean age = 57.8
      +/- 8.7 y) filled out questionnaires 3-6 weeks following a myocardial infarction
      (N = 110), bypass surgery (N = 302), or coronary angioplasty (N = 66).
      Statistical analyses of 56 Dutch mood terms were used to produce the 20-item
      Global Mood Scale (GMS) which measures negative affect (characterized by fatigue
      and malaise), as well as positive affect (characterized by energy and
      sociability), in patients with CHD. The GMS was found to be a reliable scale
      (alpha > 0.90; r > 0.55 over a 3-month period), and correlations with existing
      measures of emotional functioning and self-deception indicated its convergent and
      discriminant validity. Most importantly, fatigue was not related to
      cardiorespiratory fitness in a subset of 140 patients, but clearly was associated
      with negative affect. Consistent with the self-efficacy model, scores on the GMS
      mood scales improved significantly as a function of rehabilitation (P < 0.0001).
      Although symptoms of emotional distress are easily explained away by situational
      factors, previous research suggests that failure to recognize the clinical
      significance of these symptoms in CHD patients may result in the delay of much
      needed intervention. The current findings suggest that the GMS is a theoretically
      and psychometrically sound measure of emotional distress in CHD patients, and
      that this scale is sufficiently sensitive to assess change.

PMID- 8475199
TI  - Acting on delusion: a review.
AB  - The paper reviews the link between delusional beliefs and behaviour. The
      literature pertaining to the link between normal beliefs and behaviour is briefly
      examined, emphasizing the predominance of psychological and philosophical
      contributions to the topic. The psychiatric literature describing actions
      consequent upon delusional beliefs is then reviewed. In conclusion, those aspects
      of psychosis, distinct from delusional beliefs themselves, which may affect the
      likelihood of a given belief being acted upon, are discussed.

PMID- 8475200
TI  - Parasuicide: features of repetition and the implications for intervention.

PMID- 8475201
TI  - Parental 'affectionless control' as an antecedent to adult depression: a risk
      factor refined.
AB  - It has been well established that individuals with a history of depression report
      their parents as being less caring and more overprotective of them than do
      controls. 'Affectionless control' in childhood has thus been proposed as a risk
      factor for depression. Evidence is presented from a logistic regression analysis
      of data from a volunteer community sample that lack of care rather than over
      protection is the primary risk factor. No evidence for an interaction effect of
      low care and over-protection was found.

PMID- 8475202
TI  - Aetiology of anxiety and depressive disorders in an inner-city population. 1.
      Early adversity.
AB  - A survey of an inner-city population of working-class and single mothers is
      described and the prevalence of anxiety and depression reported using two related
      diagnostic schemes, Bedford College caseness and DSM-III-R. This acts as an
      introduction to an analysis which indicates that adverse experiences in childhood
      and adolescence (involving parental indifference, and sexual and physical abuse)
      considerably raise risk of both depression and anxiety conditions (with the
      exception of mild agoraphobia and simple phobia) in adult life.

PMID- 8475203
TI  - Aetiology of anxiety and depressive disorders in an inner-city population. 2.
      Comorbidity and adversity.
AB  - An earlier paper documented that adverse experiences in childhood and adolescence
      considerably raise risk of both depressive and anxiety conditions (with the
      exception of mild agoraphobia and simple phobia) in adult life. This paper deals
      with the same inner-city women with children at home. Consideration of adverse
      experiences throughout adulthood as a whole (excluding the period just before
      onset) particularly involving major prior losses suggests that rather different
      aetiological processes may be involved. Depression appears to be often linked to
      experiences of major loss in adulthood as a whole and to be particularly
      susceptible to shortcomings in the quality of ongoing social support. For anxiety
      only early adverse experiences appeared to be critical. (However, the onset of
      both conditions is often provoked by a severely threatening event in the most
      recent period--particularly 'loss' in depression, and 'danger' in anxiety.)
      Finally the critical role of early experience for both anxiety and depression
      explains to a considerable extent why they so often occur together; and social
      factors not studied in the present enquiry may account for some of the remaining
      unexplained comorbidity.

PMID- 8475204
TI  - Psychiatric disorders in relation to medical illness among patients of a general
      medical out-patient clinic.
AB  - In many patients clinical care in general medical settings is complicated by the
      presence of psychiatric disorders in addition to the presenting physical
      symptoms. In the present study the prevalence and type of psychiatric disorders
      was assessed in relation to the medical diagnostic findings in a general internal
      medicine out-patient clinic. The Present State Examination, a standardized
      psychiatric interview, was used to detect psychiatric disorders in 191 newly
      referred patients. Psychiatric disorders were found to be particularly prevalent
      among patients with medically ill-explained or unexplained symptoms. The
      prevalence of psychiatric disorders was 15% for patients with a medical
      explanation for their presenting symptom, 45% for patients with ill-explained and
      38% for those with unexplained symptoms. Approximately 40% of the patients with
      psychiatric disorders met DSM-III-R criteria for somatization disorder or
      hypochondriasis, suggesting that these disorders contributed in particular to
      general medical out-patient referrals.

PMID- 8475205
TI  - An early Dutch study of deja vu experiences.
AB  - In 1904 and 1906, Heymans reported the results of two prospective questionnaire
      surveys on deja vu experiences and depersonalization in a sample of mainly
      students. Deja vu experiences appeared to be more frequent than episodes of
      depersonalization. Emotional sensitivity, unstable mood fluctuations, apathetic
      episodes and irregular working rhythm emerged as predisposing personality traits.
      With the exception of the working rhythm, these traits were more prominent among
      the respondents with episodes of depersonalization than among those with deja vu
      experiences. Heymans inferred that these findings supported his hypothesis that
      deja vu experiences and depersonalization both resulted from the diminishing or
      disappearance of a sense of familiarity due to a momentary reduction of
      psychological energy. A re-analysis of Heymans' data partly confirmed his
      findings and conclusions as to the predisposing factors. The authors conclude
      that his studies and his hypothesis have been hitherto undervalued and would
      deserve more attention.

PMID- 8475206
TI  - Detection of eating disorders in a small rural town: an epidemiological study.
AB  - The occurrence of eating disorders among 517 school girls (11 to 20 years of age)
      in a small rural Italian town was studied using a three-stage prospective
      procedure. The screening stage was aimed at defining risk and sub-risk groups.
      One year later, the risk group (N = 44) and a random sample of the sub-risk (N =
      25) and of the screen-negative group (N = 32) were interviewed to detect cases of
      anorexia/bulimia nervosa. The case registers of four hospitals over a period of 3
      years were investigated to detect any additional cases that may have been
      overlooked in the survey. A minimum point prevalence rate of 1.30% clinical
      anorexia nervosa, 1.30% sub-clinical anorexia nervosa and 0.87% sub-clinical
      bulimia nervosa was found for age 15 and above. No case of clinical bulimia
      nervosa was detected. For age 15 and below no clinical or sub-clinical cases were
      found. All cases of (sub-)clinical eating disorder initially belonged to the
      predefined sub-risk and risk groups. Because of the low positive predictive value
      of any single risk factor, this study shows that early case detection can be
      improved by using multiple risk indices. In this rural area the prevalence was as
      high as in metropolitan or urban areas. Urban-rural differences should be
      assessed in further studies.

PMID- 8475207
TI  - The ability of trainee general practitioners to identify psychological distress
      among their patients.
AB  - It is argued that a general practitioner's ability to make accurate ratings of
      psychological distress is partly determined by the rate at which patients emit
      cues that are indicative of such distress. This study addresses the behaviours of
      doctors which influence the rates at which patients emit such cues. Consultations
      were videotaped involving six General Practice Vocational Trainees, three of them
      poor, and three of them able identifiers of emotional illness. Consultations were
      selected so that each trainee was rated interviewing 4 patients with low GHQ
      scores, and 4 patients with high scores. Behaviours are described which lead to
      increased cue emission and which are also practised more frequently by able
      identifiers, while other behaviours reduce cue emission and are practised less
      frequently by them. Another set of behaviours is no more frequent among the able
      identifiers, but when practised by able identifiers is associated with increased
      cue emission by the patients, and when practised by poor identifiers with
      unaltered or decreased cue emission. Interviews that are 'patient-led' are
      associated with increased rates of cue emission, while those that are 'doctor
      led' are associated with lower rates. The implications of these findings for
      training doctors working in general medical settings are discussed.

PMID- 8475208
TI  - Influences upon attendance at out-patient facilities--the contribution of linear
      logistic modelling.
AB  - The research on attendance at out-patient psychiatric facilities has produced
      conflicting evidence that provides little guidance for the practitioner. It is
      suggested that inadequate data exploration could explain some of the discrepant
      findings. Analyses of multi-way tables using linear-logistic models were
      undertaken to demonstrate patterns of association that cannot be revealed through
      the use of simple chi-square tests on two-way contingency tables. The variables
      chosen for these analyses were those that have produced conflicting findings in
      the literature on children's attendance at child guidance facilities.

PMID- 8475209
TI  - Rehabilitation and staffing levels in a 'new look' hospital-hostel.
AB  - The present study examined the utility of a new hospital-hostel with low staffing
      levels. Results showed that the hostel was able to maintain 9 of the 10 initially
      transferred patients and has been able to provide some improvements in their
      quality of life. However, unlike highly staffed hospital-hostels, it was not able
      to decrease patients' disabilities. Implications of this are discussed in
      relation to staffing levels and practices.

PMID- 8475210
TI  - Some psychometric properties of the CAMCOG.
AB  - The CAMCOG, the cognitive section of the Cambridge Examination for Mental
      Disorders of the Elderly (CAMDEX), was administered twice to 53 patients with a
      clinical diagnosis ranging from no dementia to severe dementia. The stability of
      the total CAMCOG score was high (0.97). Patients with less than moderate dementia
      were differentiated well by the total score and by subscales with a range of more
      than 8 points, except when education was low or age was higher than 78. Because
      performance on most (sub)scales is modified by age and education level,
      stratified norms are desirable. Only the Praxis subscale, and specifically
      performance on drawing tasks, appeared to be influenced by depression.

PMID- 8475211
TI  - The role of the practice nurse in the management of depression in general
      practice: treatment adherence to antidepressant medication.
AB  - This pilot study demonstrated the feasibility of providing practice nurse support
      as an adjunct to standard general practitioner treatment to patients with
      depressive disorders prescribed antidepressant medication. With respect to the
      measures used and pilot study objectives identified, there were no statistically
      significant differences between the study groups in treatment adherence to the
      prescription of antidepressant medication or in the incidence and severity of
      adverse events to medication. Large-scale randomized controlled trials are in
      progress to assess the effectiveness of practice nurse interventions in the
      management of depressive illness in general practice.

PMID- 8475212
TI  - The Research Unit of the Servizio di Psicologia Medica at the Institute of
      Psychiatry of the University of Verona, 1980-1991.

PMID- 8475213
TI  - A linkage study of schizophrenia with DNA markers from the long arm of chromosome
      11.
AB  - We report the results of a collaborative linkage study using 12 polymorphic
      markers (9 loci) from the long arm of chromosome 11, and 24 families multiply
      affected with schizophrenia and other closely related disorders. This region is
      of interest because several families have been reported in which balanced
      translocations involving 11q apparently co-segregate with psychotic illness. In
      addition, the dopamine D2 receptor, porphobilinogen deaminase, and tyrosinase
      genes map within the region studied and may be aetiologically involved in
      schizophrenia. We have primarily analysed genotypic data by the LOD score method
      using a range of single gene models. In order to minimize error due to mis
      specification of genetic parameters we have analysed data from markers at
      candidate gene loci by the non-parametric extended sib-pair method in addition to
      the LOD score method. Our results suggest that most of the region can be excluded
      from containing a gene of major effect in the aetiology of this disease.

PMID- 8475214
TI  - A computerized magnetic resonance imaging study of corpus callosum morphology in
      schizophrenia.
AB  - The hypothesis tested was that, in schizophrenia, corpus callosum size would be
      reduced, particularly in the region responsible for communication between both
      temporal lobes. This is supported by knowledge of: (a) anatomical homotopicity
      and functional specialization of fibres within the corpus callosum; (b) evidence
      linking structural and functional deficits of the corpus callosum and left
      temporal lobe with schizophrenia; and (c) that temporal lobe neuronal fibres pass
      through the middle region of the corpus callosum. Brain area and corpus callosum
      areas, widths and length were measured on mid-sagittal MRI scans using a computer
      outlining method. Scans from 30 schizophrenics and 44 normal subjects were
      compared. Mid-sagittal brain area, corpus callosum area, length and anterior
      widths were reduced in the schizophrenic group compared with controls. A
      significant area difference between schizophrenics and controls was seen in the
      mid-corpus callosum which communicates between the temporal lobes, including the
      superior temporal gyri. In schizophrenics, corpus callosum area reduction was not
      accounted for by brain area shrinkage alone. Differences between the two groups
      were accounted for by comparisons between males only. These findings support the
      hypothesis and the possibility that localized abnormalities of bilaterally
      connected brain regions might have secondary effects on their homotopically
      distributed fibres within the corpus callosum.

PMID- 8475215
TI  - Growth hormone and physiological responses to clonidine in depression.
AB  - Clonidine (1.3 micrograms/kg) was administered to 62 control and 55 depressed
      patients free of psychoactive drugs for at least 7 days and fasted overnight.
      Growth hormone (GH), pulse, blood pressure and sedation were measured every 15
      min for 1 h before and 2 h after clonidine infusion. GH response did not differ
      significantly between control and depressed subjects overall or when divided by
      sex. The systolic hypotensive and sedative responses were blunted in depressed
      subjects compared with controls; these effects appeared to be secondary to
      residual antidepressant drugs since the differences were only significant for
      those depressed subjects with short drug-free intervals. No differences between
      depressed subjects and controls were seen in diastolic hypotensive or bradycardic
      responses and no differences in GH, cardiovascular or sedative responses were
      found between endogenous and non-endogenous depressed subjects.

PMID- 8475216
TI  - Memory for visuospatial patterns in Alzheimer's disease.
AB  - Immediate memory for visuospatial information was assessed in patients affected
      by Alzheimer-type dementia but with unimpaired visuo-perceptual functions.
      Patients were given two tasks: one was a traditional visuospatial memory task
      (Corsi's block tapping test), the second explored specifically immediate memory
      for visuospatial patterns. The experiment was conducted in two parallel groups of
      patients in Italy and the United States, each with its own appropriate sample of
      normal control subjects. Results showed a specific deficit of visual working
      memory in demented patients, even in a task in which control subjects achieved
      error-free performance. These data are interpreted in the light of the Working
      Memory Model, and suggest that in dementia the functions of the Visuospatial
      Scratchpad, unlike the functions of the verbal subsystems, may be impaired.

PMID- 8475217
TI  - The biology of autism.

PMID- 8475218
TI  - Learning and memory in monozygotic twins discordant for schizophrenia.
AB  - Learning and memory were assessed in 24 monozygotic (MZ) pairs of individuals
      discordant for schizophrenia or delusional disorder and seven normal pairs of MZ
      twins. On declarative memory tasks, the affected group displayed a pattern that
      might best be characterized as dysmnesic in that they performed significantly
      worse than the discordant unaffected group on story recall, paired associated
      learning, and visual recall of designs, but they learned over time, had
      relatively preserved recognition memory, and did not show profoundly accelerated
      rates of forgetting. Effortful, volitional retrieval from the lexicon, measured
      by verbal fluency, was also compromised in the affected group. On the other hand,
      procedural learning of the motor skill in a pursuit rotor task was relatively
      intact in the affected group. Comparisons of the normal group and unaffected
      group indicated that the latter group had very mild impairments in some aspects
      of episodic memory, namely, immediate and delayed recall of stories and delayed
      recall of designs. It is highly unlikely that the impairments observed in the
      affected group can be attributed to differences in genome, family environment,
      socioeconomic circumstance, or educational opportunity, as all of these were
      controlled by the twin paradigm. Rather, the impairments appear to be related to
      the intercession of disease. The neuropsychological profile is consistent with
      frontal lobe and medial temporal lobe dysfunction, as noted in this sample as
      well as other samples of schizophrenic singletons. Significant correlations
      between many measures of memory and global level of social and vocational
      functioning within the discordant group were also found. Thus difficulties in
      rapidly acquiring new information and propitiously retrieving old information may
      burden patients with schizophrenia in many of the transactions of everyday life.

PMID- 8475219
TI  - Working memory in clinical depression: an experimental study.
AB  - This study compared clinically depressed subjects with normal controls on a range
      of working memory tasks. The findings suggested the articulatory loop and
      visuospatial sketch pad components of working memory to be unimpaired in
      depression. On a range of clinical tasks likely to involve central executive
      function, depressed subjects showed impairment only on some tasks.

PMID- 8475220
TI  - Neuropsychological evidence of reductions on left frontal tests with hypnosis.
AB  - Individuals with high and low susceptibility to hypnosis were compared in a
      baseline condition and after instructions of hypnosis on tests of anterior left
      and right hemispheric functions--word fluency to letter categories, word fluency
      to semantic categories, design fluency and bilateral finger tapping dexterity.
      With hypnosis high susceptibles showed a reduction in word generation to letter
      categories, no significant change in word generation to semantic categories, an
      improvement in design fluency, and bilateral reductions in finger tapping
      dexterity. Low susceptibles showed the opposite changes except for the
      improvement in design fluency. These results, together with correlational
      results, were interpreted as evidence of central inhibitory processes,
      particularly of the left hemisphere, in response to instructions of hypnosis in
      high susceptibles.

PMID- 8475221
TI  - Psychoneuroendocrinology on the move.

PMID- 8475222
TI  - Cortisol reaction in success and failure condition in endogenous depressed
      patients and controls.
AB  - The authors studied differences in cortisol response to controllable and
      uncontrollable stress and its relationship to Seligman's theory of learned
      helplessness in hospitalized unipolar depressed patients (11 nontreated, acutely
      depressed; 11 treated patients) and 11 age and sex matched controls hospitalized
      for traumatic surgery. Control and lack of control were achieved by induction of
      success and failure in a simple number addition test and applied in balanced
      order on 2 consecutive days. Saliva cortisol samples were collected before and
      after the test. No group differences in baseline cortisol levels were observed.
      Cortisol increased after uncontrollable and decreased after controllable stress
      in control patients, whereas cortisol decreased after both conditions in the
      acutely depressed group and less so in the treated group, although they were as
      emotionally upset after failure as controls. Thus, the normally observed ability
      of the neuroendocrine system to discriminate between controllable and
      uncontrollable stress deteriorates with increasing severity of depression.

PMID- 8475223
TI  - Oral contraceptives and the dexamethasone suppression test.
AB  - Among other confounding factors, the influence of the intake of estrogen
      containing oral contraceptives on the dexamethasone suppression test (DST)
      results has never been specifically studied. Therefore, we performed 1 mg DSTs in
      14 healthy women taking oral contraceptives and 14 age-matched women taking no
      oral contraceptives. Mean 0800h basal total cortisol was significantly higher
      among the women taking contraceptives than in the control group, whereas mean
      free cortisol did not significantly differ. At 1600h following DST, no
      significant difference existed between the two groups. Two subjects taking
      contraceptives and one control subject were considered DST nonsuppressors. These
      results confirm the powerful influence of oral contraceptives on basal total
      cortisol levels but suggest a lack of significant influence on DST results.

PMID- 8475224
TI  - Effect of chronic bromocriptine treatment on psychological profile of patients
      with PRL-secreting pituitary adenomas.
AB  - Hyperprolactinaemic patients are characterized by an altered psychological
      profile, positively modified by the administration of dopaminergic drugs. This
      would suggest that the same neurochemical disorder is responsible for both
      hyperprolactinaemia and abnormal psychological profile in these patients. To
      identify depression, anxiety, and aggressiveness, nine women affected by
      prolactin (PRL)-secreting pituitary adenomas were studied before and after 6 and
      12 mo of bromocriptine therapy, by the use of different psychometric tests (Mean
      Minnesota Multiphasic Personality Inventory [MMPI], State-Trait Anxiety Inventory
      [STAI], and State and Trait Aggressiveness Scale [STAS]). As a group, the
      patients did not show any depressive, anxious, or aggressive tendencies.
      Furthermore, no significant modifications were observed during dopaminergic
      treatment. Patients bearing PRL adenomas seem to be characterized by a
      dopaminergic background different from that found in functional
      hyperprolactinaemia. This hypothesis could explain the different psychological
      configuration and behavior in response to the administration of dopaminergic
      compounds.

PMID- 8475225
TI  - Effect of regularity of exposure to chronic immobilization stress on the
      circadian pattern of pituitary adrenal hormones, growth hormone, and thyroid
      stimulating hormone in the adult male rat.
AB  - Circadian variation of serum levels of adrenocorticotropin hormone (ACTH),
      corticosterone, growth hormone (GH), and thyroid-stimulating hormone (TSH) were
      studied in three groups of adult male rats exposed to chronic intermittent
      immobilization stress (IMO) for 2 hr daily under different schedules. IMO
      resulted in reduced food intake, body weight loss, and increased adrenal weight.
      ACTH levels were not affected but corticosterone levels were increased in all IMO
      rats as compared to control ones during the diurnal phase of the circadian cycle.
      IMO decreased serum GH and TSH levels but the circadian pattern of secretion was
      influenced in a complex way depending on the specific pattern of daily exposure
      to IMO. Differences observed between the IMO groups were not caused by
      differences in food intake because its circadian rhythm was very similar in all
      IMO groups. These results suggest that regularity of exposure to immobilization
      alters in a complex fashion circadian GH and TSH rhythms.

PMID- 8475226
TI  - Delta sleep-inducing peptide administration does not influence growth hormone and
      prolactin secretion in normal women.
AB  - The aim of this study was to analyze the effects of delta sleep-inducing peptide
      (DSIP) on growth hormone (GH) and prolactin (PRL) secretion in eight healthy
      women with normal cycles (aged 17-36 years). GH and PRL secretion was studied in
      five women after DSIP (25 micrograms/kg bw IV over 30 min), arginine chlorhydrate
      (0.5 g/kg bw IV over 30 min) and simultaneous DSIP plus arginine chlorhydrate
      administration. In three other women the circadian rhythm of GH and PRL was
      studied during DSIP (25 micrograms/kg bw from 2130h to 2230h) and placebo IV
      infusion. Serum GH and PRL levels were normal under basal conditions and no
      effects were noted after the infusion of DSIP. The GH and PRL circadian rhythm
      was not modified by DSIP administration. DSIP did not influence GH and PRL
      responsiveness to arginine chlorhydrate. We found that at dosages which are known
      to modify ECG patterns, DSIP is unable to modify spontaneous or arginine
      chlorhydrate-induced GH and PRL secretion.

PMID- 8475227
TI  - Perimenstrual complaints in women complaining of PMS, menorrhagia, and
      dysmenorrhea: toward a dismantling of the premenstrual syndrome.
AB  - Four groups of women were compared in terms of their perimenstrual symptoms,
      reported menstrual blood loss and period pain, and neuroticism scores: three
      patient groups were referred to a Gynaecology Outpatient Clinic because of
      menorrhagia (N = 101), PMS (N = 104), dysmenorrhea (N = 56), and a control group
      (N = 105). The three patient groups showed considerable overlap in a number of
      symptoms. This has led us to postulate three factors contributing to
      perimenstrual complaints: a) a 'timing factor' linked to the ovarian cycle; b) a
      'menstruation factor,' associated with the buildup of the endometrium and its
      shedding; and c) a 'vulnerability factor,' one aspect of which, 'neuroticism,'
      was measured in this study. Depressive symptoms, which were the most important in
      leading women to seek help for their PMS, were related to all three factors.
      Depressive mood changes seemed to be linked to the 'timing factor' but were
      noticeably worse and more prolonged in women with high neuroticism, heavy
      bleeding, or severe pain. One premenstrual symptom, food craving, was of
      considerable interest. This was weakly related to neuroticism, not apparently
      affected by the 'menstruation factor' and differed in severity between those in
      the PMS group and the other three groups. It is potentially relevant that both
      carbohydrate craving and depression are linked to serotonergic changes in the
      brain, which may prove to be particularly marked in the late luteal phase.

PMID- 8475228
TI  - Case report: recurrent pseudocyesis in a male patient with psychosis,
      intermittent hyponatremia, and polydipsia.
AB  - This report describes a case of recurrent pseudocyesis in a man with psychosis,
      intermittent hyponatremia, and polydipsia. The pseudocyesis was documented on
      three separate occasions coinciding with bouts of acute hyponatremia and rapid
      weight gain stemming from ingestion of large amounts of water. In contrast, no
      pseudocyesis was elicited during intervening normonatremic states. Abdominal
      distention, neuropsychological deterioration, and worsening of psychosis during
      acute hyponatremia are considered as contributing factors to the pseudocyesis.

PMID- 8475229
TI  - Aerobic exercise and the placebo effect: a controlled study.
AB  - An experiment was conducted with 48 healthy young adults engaged in a supervised
      10-week exercise program to determine whether a placebo effect is involved within
      the exercise-psychological enhancement connection. Based on an expectancy
      modification procedure, one-half of the subjects were led to believe that their
      program was specifically designed to improve psychological well-being
      (experimental condition) whereas no such intervention was made with the second
      half (control condition). Expectations for psychological benefits and aerobic
      capacity (VO2max) were measured before and after completion of the program. Self
      esteem, as the indicator of psychological well-being, was measured on four
      specific occasions: at the beginning, after the fourth and seventh weeks, and
      upon completion of the training program. The results showed similar significant
      increases in fitness levels in both conditions. Moreover, self-esteem was
      significantly improved over time in the experimental but not in the control
      condition. These findings provide evidence to support the notion that exercise
      may enhance psychological well-being via a strong placebo effect. Implications of
      the results with regard to exercise prescription are discussed.

PMID- 8475230
TI  - Dependence between apolipoprotein E phenotypes and temperament in children,
      adolescents, and young adults.
AB  - The association of apolipoprotein E (apoE) polymorphism with temperament and Type
      A behavior was studied in 1577 randomly selected healthy children, adolescents,
      and young adults during a follow-up period of 9 years. Temperament was correlated
      with apoE phenotypes. Motor activity, even hyperactivity, in childhood and mental
      vitality in adolescence and young adulthood increased significantly with the apoE
      phenotypes in the order of E2/2, E3/2, E4/2, E3/3, E4/3, and E4/4. However,
      global Type A behavior was not associated with the order of apoE phenotypes. The
      findings suggest the importance of additional studies on genetic factor and
      temperament.

PMID- 8475231
TI  - Psychosocial factors associated with cardiovascular reactivity in older adults.
AB  - This study examined associations of psychosocial factors with cardiovascular
      reactivity in two groups of men and women--spouse caregivers of individuals with
      Alzheimer's disease (M age = 69.4 N = 82) and controls (M age = 68.5, N = 78)
      group-matched for age and gender. Cardiovascular responses to an emotional task
      (speech sample about one's spouse) yielded higher systolic and diastolic blood
      pressures (SBP, DBP) than a spoken cognitive task, which in turn yielded higher
      BPs and heart rate (HR) than the baseline rest period. HR was greater in response
      to the two tasks than in response to the baseline period, but it did not differ
      across tasks. Regression models of SBP, DBP, and HR reactivity in response to the
      two tasks demonstrated that after controlling for hypertension and gender,
      combinations of hostility, anger expression, avoidance coping, Type A behavior
      and Expressed Emotion (criticism) explained more reactivity in response to the
      emotional (8-12%) than the cognitive task (4-7%). Caregivers were more reactive
      than controls only if they were hypertensive. Psychosocial factors may be as
      important in explaining reactivity in older adults as in younger adults.

PMID- 8475232
TI  - Psychophysiological responses to exercise in type A/B men.
AB  - Previous research concerning physical exercise has yielded mixed results with
      regard to the possible influence of the Type A behavior pattern (TABP) on ratings
      of perceived exertion. However, almost all studies have been performed in the
      confined space of a laboratory. Few have studied the influence of an individual's
      behavior pattern outdoors in the field where most everyday exercise takes place.
      Hence, the present study compared three groups of subjects: one group with
      pronounced TABP, one showing very little TABP, and finally one intermediate group
      exhibiting an average level of Type A behavior. The results indicate that there
      are distinct and statistically significant differences between the groups. Type A
      individuals underestimate their degree of perceived exertion at comparable levels
      of heart rate. Thus, an individual's behavior pattern ought to be considered when
      ratings of perceived exertion are used to quantify exercise intensity.

PMID- 8475233
TI  - Type A behavior, tension, and ambulatory cardiovascular reactivity in workers
      exposed to noise stress.
AB  - Recent negative findings regarding differences in blood pressure (BP) and heart
      rate (HR) reactivity at work between Type A and Type B workers may stem from the
      failure to note the stressors to which they were exposed. In this naturalistic
      study, an objective work stressor--varying levels of ambient noise--was
      individually monitored among 123 normotensive males. We examined the relationship
      of Type A behavior (assessed by the Thurstone Temperament Schedule) to ambulatory
      BP and HR reactivity under high and low noise conditions. We also tested the
      hypothesized mediating function of tension arousal. Results of multiple
      regression analyses indicated that when workers were exposed to high noise levels
      (> or = 80 dB(A)), Type A behavior was positively related to diastolic BP (p =
      0.029) and HR reactivity (p = 0.0001), even after adjusting for clinic values,
      time of measurement, worker activities, and body position during measurement.
      When the same workers were exposed to low noise levels, the results were not
      significant. This suggests that noise constitutes a stressor for Type A
      individuals, and highlights the importance of noting the actual stressor-exposure
      condition. In addition, Type A individuals reported high tension, noted
      concurrently with the ambulatory measurements. Tension arousal was also related
      to BP and HR reactivity. Adding the tension variable to the above regressions
      weakened the relationship between Type A behavior and BP and HR reactivity. Thus,
      the tension experienced by Type A workers exposed to noise stress may have served
      as a mediator of cardiovascular reactivity.

PMID- 8475234
TI  - Cynical hostility and cardiovascular reactivity during self-disclosure.
AB  - Recent research suggests that hostility might contribute to the development of
      coronary heart disease (CHD) and other illnesses. One potential mechanism linking
      hostility and health is exaggerated physiological reactivity to social stressors.
      Given that mistrust and suspiciousness are closely related to this trait, the
      self-disclosure of personal information regarding a stressful experience may
      elicit heightened reactivity in hostile persons. To evaluate this hypothesis,
      undergraduate men (N = 60) classified as high or low on the Cook and Medley
      Hostility (Ho) Scale were randomly assigned to either a self-disclosure or a
      nondisclosure condition. Consistent with prediction, among subjects participating
      in the self-disclosure discussion task, hostile individuals displayed
      significantly greater blood pressure reactivity compared with subjects low in
      hostility. These results support the psychophysiological reactivity model of
      hostility and health, and underscore the potential importance of social context
      in the psychosomatic process.

PMID- 8475235
TI  - Hostility and differences between clinic, self-determined, and ambulatory blood
      pressure.
AB  - This study examined the role of personality factors in differences between three
      methods of assessing blood pressure (clinic, self, ambulatory) in 45 patients
      with mild hypertension. The data were obtained after the patients were withdrawn
      from antihypertensive medications and had achieved stable clinic diastolic blood
      pressure levels of 95 to 110 mm Hg, averaged over three visits in 2 to 4 weeks.
      Significant differences were obtained in systolic blood pressure (SBP) and
      diastolic blood pressure (DBP) as a function of method of assessment. These
      differences in both systolic blood pressure (SBP) and diastolic blood pressure
      (DBP) were associated with individual differences in the total score and several
      subscales of the Buss-Durkee Hostility Inventory (Assault, Resentment, Guilt),
      but not in anxiety, depression, or other characteristics. High hostile subjects
      had consistently high blood pressure values in both clinic, self, and ambulatory
      recordings. Low hostile subjects were significantly lower in self-recorded blood
      pressure readings taken at home and in ambulatory recordings, compared with
      clinic values. Implications of these findings for "white coat hypertension" are
      discussed.

PMID- 8475236
TI  - Psychiatric education improves internists' knowledge: a three-year randomized,
      controlled evaluation.
AB  - Trainees were randomized into four groups: (1) control; (2) consult; (3) liaison;
      or (4) consult-plus-liaison to evaluate the psychiatric knowledge gained after
      two different training programs for primary care residents. Consult was a 1-month
      rotation on the Psychiatry Consultation Service. Liaison consisted of 31-hour
      workshops over 1 year. Consult-plus-Liaison refers to both training programs,
      experienced in consecutive years. An oral examination was administered before and
      after training. The analysis of variance and tests of simple effects revealed
      significant training effects for both groups. The effect size of training was
      greater for residents exposed to both programs, compared with either one alone.
      The two different training programs were both effective in improving the
      psychiatric knowledge of primary care residents and exposure to both programs
      proved superior to either one alone.

PMID- 8475237
TI  - Psychiatric symptoms in systemic lupus erythematosus: an update.
AB  - Twenty-one studies on the prevalence and type of psychiatric symptoms in systemic
      lupus erythematosus (SLE) are reviewed and evaluated. Substantial differences in
      prevalence of psychiatric symptoms in SLE-patients (from 17%-71%) have been
      reported. Of the investigated methodological aspects, differences in assessment
      techniques appeared to be the main source of the variability in findings.
      Although various types of psychiatric symptoms have been observed, depression is
      most frequently reported. There was no consistent relationship between the
      occurrence of psychiatric symptoms and other symptoms of SLE. However, the data
      suggest an association with (the patient's perception of) illness severity and
      with the experience of psychosocial stressors. Studies applying control groups
      (patients with other chronic diseases (e.g., rheumatoid arthritis) showed
      striking similarities between both patient groups with respect to prevalence and
      type of psychiatric symptoms. There is some evidence, however, indicating that a
      small proportion of the psychiatric symptomatology, in particular psychosis, is
      related to neurological dysfunction in SLE.

PMID- 8475238
TI  - Quality standards in the NHS.

PMID- 8475239
TI  - Orthoptic screening for three- and four-year-olds.

PMID- 8475240
TI  - Measles outbreak in Fife: which MMR policy?
AB  - The introduction of measles, mumps and rubella vaccine (MMR) into the United
      Kingdom childhood immunisation schedule has resulted in a substantial reduction
      in the incidence of all three diseases. None the less, there have recently been
      outbreaks of measles in parts of the country which have a record of high MMR
      uptake among young children. In these outbreaks it is mainly older children who
      have been affected. This report documents such an outbreak in Fife, an area with
      a very high MMR uptake among two-year-old children (96%). The current policy of
      giving MMR vaccine only once to children at 15 months of age may not be
      sufficient to enable the United Kingdom to achieve the WHO target of measles
      elimination by the year 2000. Other possible strategies to achieve this objective
      are discussed.

PMID- 8475241
TI  - Guidelines for local research ethics committees: distinguishing between patient
      and population research in the Multicentre Research Project.
AB  - A multicentre population research study was undertaken, involving ethical
      approval from 28 local research ethics committees. The major problems encountered
      were delays, which fell into three categories: requests to complete separate
      application forms, delay in processing applications and additional requests for
      patient and consultant consent. We examine these sources of delay in the context
      of the recently published DoH guidelines for local research ethics committees.
      Our findings reveal that there is not only an absence of adequate guidelines for
      multicentre research studies but that the new guidelines for local research
      ethics committees fail to distinguish between patient research and the population
      study.

PMID- 8475242
TI  - Car occupant restraint use in Fife: an observational study.
AB  - Today road traffic accidents pose a major public health problem with a
      significant number of deaths and injuries among drivers and passengers of all
      ages. As part of road safety strategy in Fife the Health Board and Regional
      Council have carried out an observational study of 7,885 occupants in 4,292 cars
      to determine the extent of appropriate restraint use in the region. Overall
      restraint use for urban and non-urban sites was found to be 80%. In car drivers
      restraint use was 94%. Passengers in all rear seat positions were observed to
      have a significantly lower level of restraint use, 33% overall compared with 92%
      overall in the front (chi 2 2,827.9, P << 0.001), with usage of restraint
      declining with increasing age. Particular problems noted were: the much lower use
      of restraint among children travelling to and from school, the use of restraint
      inappropriate to children's age, and the significantly lower level of restraint
      among taxi drivers and their passengers compared with other cars (chi 2 114.9, P
      << 0.001). These findings have implications for the promotion of restraint use
      for all car occupants.

PMID- 8475243
TI  - Routine or selective school entry medicals: a review of current literature.
AB  - A review of recent literature on school entry medicals (SEMs) assessed whether
      selective medicals were as effective and/or cheaper than routine medicals. Data
      were compared with prospective data from the author's 'patch' on a one-year
      cohort of routine SEMs. Routine medicals showed that 40-50% of school entrants
      had health problems but selective systems detected fewer. Districts with high
      morbidity were less able to detect problems early but effective child health
      surveillance was not related to the number of new problems at SEM. Selection did
      not reduce costs and could increase costs in deprived areas. The SEM is an
      opportunity for health education which is valued by parents. On present evidence,
      selection for medicals at school entry cannot be recommended.

PMID- 8475244
TI  - Survey of the opinions of general practitioners about health services in a rural
      setting.
AB  - OBJECTIVES: Using a tested survey protocol, to obtain under comparable
      circumstances the opinions and subjective assessments of general practitioners
      regarding health care services in a contrasting rural health district, to obtain
      indications of those services which, by reason of the opinions of general
      practitioners in relation to their quantity and quality, might benefit from
      further enquiry or even detailed assessment and, as in the previous survey, to
      facilitate the close working with general practitioners without which population
      based needs assessment and further enquiry and research into the development of
      healthcare services will be handicapped. DESIGN: A postal questionnaire survey of
      all general practitioners in the health district. SETTING: North Lincolnshire
      health district. SUBJECTS: One hundred and forty eight general practitioners, of
      whom 104 responded, two by letter only. MAIN OUTCOME MEASURES: Scores of quantity
      and of quality for 24 hospital services and 32 community services. The frequency
      with which services were identified as a priority for improvement, and written
      comments about the services surveyed. RESULTS: Most services were thought by
      general practitioners to be adequate or better in both quantity and quality,
      involving a surprising degree of agreement. In only six of the 56 services were
      these considered by more than 50% of the doctors responding to be inadequate or
      grossly inadequate in quantity, and in only eight services were these found by
      more than 15% of doctors to be poor or very poor in quality. Complaints about
      quantity of service were more frequent than complaints about quality of service,
      and community services received more complaints from general practitioners about
      both quality and quantity than the hospital services. The services most general
      practitioners wanted improved were orthopaedics, psychiatry, physiotherapy and
      chiropody. CONCLUSIONS: This survey confirmed the suitability of the postal
      questionnaire for assessing the impressions of general practitioners about both
      the quantity and quality of services available in their support. Consistent
      agreement between general practitioners about the services surveyed parallel a
      comparable survey undertaken in a largely urban area, showing close similarities
      with the results of this survey with only relatively minor local variations. The
      results provide pointers for health needs assessment of key services.

PMID- 8475245
TI  - Assessment of the effectiveness of primary health care interventions in the
      control of three intestinal nematode infections in rural communities.
AB  - In a 30 months' longitudinal study, primary health care intervention was
      effective in reducing the prevalence of three common intestinal nematode
      infections (Ascaris lumbricoides, Trichuris trichiura and Necator americanus) in
      three communities. This was achieved by training school leavers and auxiliary
      aides as microscopists, health inspectors and field assistants and deploying them
      to provide screening, surveillance, environmental sanitation, and mass-expulsion
      chemotherapy (MEC). Post-control surveillance confirmed that the prevalence of
      these infections had been greatly reduced. The prevalence of Ascaris lumbricoides
      had declined from 49.3% (pre-intervention) to 10.5% (post-intervention). Hookworm
      had fallen from 31.4% (pre-intervention) to 4.1% (post-intervention) and whipworm
      from 40.7% (pre-intervention) to 6.5% (post-intervention). Overall percentage
      decreases of 78.7%, 86.9% and 84.0% were recorded for Ascaris lumbricoides,
      Necator americanus and Trichuris trichiura respectively. The initial decline in
      prevalence was due to the MEC campaign, but the improved sanitation and health
      education presumably reduced the reinfection rate. If the entire population
      participated, periodic repetition of the mass expulsion therapy campaign at
      appropriate intervals combined with continued attention to environmental hygiene
      and prolonged health education could bring these infections under control within
      a few years.

PMID- 8475246
TI  - A case-control study of congenital hip dislocation.
AB  - In this study we have investigated various epidemiological factors which may be
      related to congenital dislocation of the hip (CDH). Eighty-one cases born during
      the period 1st January 1988 to 31st August 1990, with four matched controls per
      case, were identified from consultants' records held at the Queen's Medical
      Centre and City Hospital, Nottingham. One hundred and twenty-four subjects who
      were referred to a new Hip Instability Clinic with suspected CDH, but not
      diagnosed or treated for CDH, were also included as a third group. Information
      about the mother's pregnancy, previous medical history and family history was
      collected from obstetric records kept at the two hospitals. Multigravidae and
      similarly multiparous women had a statistically significantly reduced risk of
      having a baby with CDH. The relative risks were 0.55 (95% confidence interval
      0.33, 0.93) and 0.53 (95% confidence interval 0.31, 0.91) respectively. The
      method of delivery was also of importance. Babies born by Caesarean section or in
      breech position had an increased risk of CDH which was statistically significant.
      Using addition clinical information obtained from subjects attending the Hip
      Instability Clinic we also found that cases were more likely to have a family
      history of CDH than subjects who were screened for CDH but found to be normal.

PMID- 8475247
TI  - A mathematical formalism describing the yield of radiation-induced single- and
      double-strand DNA breaks, and its dependence on radiation quality.
AB  - The purpose of this paper is to describe mathematically the observed dependence
      of the number of DNA single-strand breaks (SSBs) per unit dose on radiation
      quality (e.g., LET) by invoking the concept of matrix saturation (i.e., the fact
      that a nucleotide can be the site of one SSB only and therefore further local
      energy deposition is wasted), and to show that, based on this, one obtains a
      characteristic variation of the yield of DNA double-strand breaks with variation
      of LET, in qualitative agreement with certain experimental determinations. The
      formalism developed here makes use of methodology from the field of integral
      geometry, introduced by Kellerer [Radiat. Prot. Dosim. 31, 9-16, 1990] in
      microdosimetry.

PMID- 8475248
TI  - Evidence for induction of DNA double-strand breaks at paired radical sites.
AB  - Isolated plasmid pBR322 DNA was irradiated in the gas explosion apparatus in the
      presence of 10 mmol dm-3 GSH. By varying the time of the oxygen shot relative to
      the 5-ns pulse of electrons, the chemical repair kinetics of the oxygen-dependent
      free-radical precursors of DNA single- and double-strand breaks (SSBs and DSBs)
      can be determined. The first-order repair rate of the SSB precursors was 1370 s-1
      in comparison to 2900 s-1 for DSB precursors. Under these conditions the oxygen
      enhancement ratio for SSBs was 3.0 in comparison to 7.5 for DSBs. This twofold
      difference in chemical repair rate may be interpreted on the basis of the free
      radical precursor of a DSB consisting of two radicals, one on either strand of
      the DNA. With the chemical repair of one or other of these radicals by hydrogen
      atom donation from GSH, a DSB is not produced. This process will occur at twice
      the rate of the chemical repair of an SSB precursor consisting of a single
      radical. These data are consistent with the concept that DSBs are formed at the
      sites of clustered energy depositions with the production of a paired radical.

PMID- 8475249
TI  - Comments on the distribution of clonogens in irradiated tumors.

PMID- 8475250
TI  - On the radiation-acoustic effect in radiobiology.

PMID- 8475251
TI  - Potentiation of photodynamic therapy by mitomycin C in cultured human colon
      adenocarcinoma cells.
AB  - The effects of photodynamic therapy (PDT) alone and in combination with Mitomycin
      C (MMC) on WiDr cells, a human colon adenocarcinoma cell line, were investigated.
      The addition of MMC increased the cytotoxicity of PDT. The presence of MMC
      resulted in a reduction or a removal of the shoulder of the PDT survival curves
      as well as an increase in their slopes. Increasing with the concentrations of MMC
      from 0.01 to 0.025 micrograms/ml, the cytotoxic effects of the two treatments
      changed from additivity to supra-additivity as judged by comparing dose-response
      curves for each treatment alone with survival curves after combination therapy
      and by isobologram analysis. The cytotoxicity of MMC could also be enhanced by a
      practically nontoxic treatment of PDT (8% cell inactivation). The cytotoxicities
      of MMC and PDT in combination were found to be dependent on the sequence of the
      two treatments. When MMC (> or = 0.02 micrograms/ml) and Photofrin II were given
      simultaneously for 16 h and then followed by irradiation, the combination was
      found to be more effective than when MMC was given to the cells immediately after
      PDT and kept in the medium for 16 h. Possible mechanisms of the combination
      effects of PDT and MMC are discussed briefly.

PMID- 8475252
TI  - Sequential analysis of the pathogenesis of plutonium-induced pulmonary neoplasms
      in the rat: morphology, morphometry, and cytokinetics.
AB  - Light microscopy, morphometry, and cytokinetic techniques were used to examine
      the dynamics of plutonium-induced pulmonary proliferative lesions and neoplasms
      in rats at several intervals to 450 days after inhalation exposure to aerosols of
      239PuO2. Maximal increases in alveolar and bronchiolar epithelial cell labeling
      were seen at 30 days; decreasing subsequently, the levels remained elevated above
      control indices. Focal proliferative epithelial lesions developed in the lung by
      180 days and before the onset of pulmonary neoplasms. Pulmonary neoplasms,
      predominantly adenocarcinomas and squamous cell carcinomas, were initially
      observed at 308 days. The proliferative lesions progressed through a succession
      of morphological changes leading to the development of neoplasms. The volume
      density (fraction) and epithelial surface area of foci of alveolar epithelial
      hyperplasia increased progressively between 180 and 450 days after exposure, in
      contrast to the other proliferative lesions. We conclude that plutonium-induced
      pulmonary neoplasms develop through a succession of focal proliferative lesions
      that represent developmental preneoplastic lesions. Progressive increases in
      volume and epithelial surface area of the alveolar epithelial hyperplasias
      suggest that they may be more at risk for neoplastic transformation than the
      other histological types of proliferative foci.

PMID- 8475253
TI  - A study of radiation necrosis and edema in the canine brain using positron
      emission tomography and magnetic resonance imaging.
AB  - Radiation injury, a major hazard of central nervous system (CNS) radiotherapy,
      was investigated using sequential studies with positron emission tomography (PET)
      and magnetic resonance imaging (MRI) in beagle dogs with both helium and neon-ion
      hemibrain irradiation. All dogs receiving 7.5-11 Gy of neon showed no signs of
      radiation injury to 3 years after irradiation. Dogs receiving > or = 13 Gy neon
      or helium succumbed to radiation necrosis and died 21-32 weeks after irradiation.
      The findings of imaging studies for all dogs who succumbed to radiation necrosis
      were normal until 3-6 weeks before death. Sequential studies were performed using
      0.5 T MRI spin-echo and inversion recovery imaging sequences, and high-resolution
      (2-3 mm) PET with 18F deoxyglucose and 82Rb. The same axial slices (within 1-2
      mm) were imaged repeatedly (weekly) after irradiation until death. The earliest
      CNS changes were seen as decreased metabolic activity in the cortex of the
      irradiated hemisphere with PET or an increase in signal intensity in the
      periventricular white matter on T2-weighted spin-echo imaging on MRI. From the
      time this increase in signal intensity was first observed, T1 and T2 values
      increased steadily in both the gray and white matter until death. The changes in
      white matter were consistently greater than those in gray matter. The results of
      PET, MRI, and histopathological examinations support the theory that both
      cellular and vascular mechanisms are involved in radiation necrosis.

PMID- 8475254
TI  - Differential response of the permeability of the rat liver canalicular membrane
      to sucrose and mannitol following in vivo acute single and multiple exposures to
      microwave radiation (2.45 GHz) and radiant-energy thermal stress.
AB  - Both acute and chronic exposures to microwave radiation altered the function of
      the rat canalicular membrane. A single acute exposure to microwave radiation [80
      mW/cm2, 2.45 GHz, continuous wave, 30 min exposure (SAR approximately equal to 72
      W/kg)] or a matched radiant-energy thermal load, both designed to raise core body
      temperature approximately 3 degrees C, decreased the permeability of the
      canalicular membrane of male Sprague-Dawley rats to sucrose. The change in
      canalicular membrane permeability was demonstrated by a significant increase in
      the percentage of [3H]sucrose recovered in bile following its administration by a
      segmented retrograde intrabiliary injection. Similar acute exposures to microwave
      and radiant-energy thermal sources produced no significant alterations in
      canalicular membrane permeability to [14C]mannitol. In both acute exposure
      protocols, a rapidly reversible increase in bile flow rate was observed. Four
      exposures (30 min/day x 4 days) to either microwave radiation (80 mW/cm2) or a
      matched radiant-energy thermal load resulted in a significant depression in bile
      flow rate at normothermic temperatures. Animals receiving multiple exposures to
      microwave radiation had significant decreases in canalicular membrane
      permeability to both [3H]sucrose and [14C]mannitol, while similar exposure to
      radiant-energy thermal load alone altered canalicular membrane permeability to
      [3H]sucrose. An examination of the hepatic clearance of sucrose and mannitol
      following acute microwave exposure demonstrated no significant differences. Thus
      acute single exposure to microwave and radiant-energy thermal loads produced
      similar alterations in canalicular membrane permeability. Conversely, multiple
      exposures produced nonreversible changes in bile flow rate and canalicular
      membrane permeability, with microwave exposure producing greater alterations in
      the function of the canalicular membrane than an equivalent radiant-energy
      thermal load.

PMID- 8475255
TI  - Temporal modulation of TGF-beta 1 and beta-actin gene expression in pig skin and
      muscular fibrosis after ionizing radiation.
AB  - Although radiation-induced fibrosis has long been characterized by excess
      fibroblast proliferation and extracellular matrix deposition, the origin of cell
      activation in these complications of radiotherapy or radiation accidents is still
      controversial. The present work was designed to test the hypothesis that the
      abnormal production of TGF-beta 1 in irradiated tissues results in continuous
      signals for tissue repair and long-term cell activation. We examined gene
      expression of this growth factor in a well-characterized pig model of radiation
      induced fibrosis, using Northern-blot and slot-blot hybridizations and indirect
      immunofluorescence. We found that the TGF-beta 1 mRNA level was increased 19-fold
      in the irradiated skin during the early erythematous phase, which started 3 weeks
      after irradiation. During the later phases of fibrosis, from 6 to 12 months after
      irradiation, the TGF-beta 1 gene was highly expressed in the repaired skin and
      the underlying muscular fibrotic tissue, with 10- and 8-fold maximal increases,
      respectively. In addition, we found that the beta-actin mRNA level was increased
      in the fibrotic tissue. Immunostaining for TGF-beta 1 revealed the presence of
      the protein in endothelial cells of capillaries, in myofibroblasts, and in the
      collagenous matrix of the fibrotic tissue. These results suggest that TGF-beta 1
      may be one of the key cytokines involved in the cascade of events that leads to
      radiation-induced fibrosis, at both early and late stages.

PMID- 8475256
TI  - On the equivalent dose for Auger electron emitters.
AB  - Radionuclides that emit Auger electrons are widely used in nuclear medicine
      (e.g., 99mTc, 123I, 201Tl) and biomedical research (e.g., 51Cr, 125I), and they
      are present in the environment (e.g., 40K, 55Fe). Depending on the subcellular
      distribution of the radionuclide, the biological effects caused by tissue
      incorporated Auger emitters can be as severe as those from high-LET alpha
      particles. However, the recently adopted recommendations of the International
      Commission on Radiological Protection (ICRP) provide no guidance with regard to
      calculating the equivalent dose for these radionuclides. The present work, using
      spermatogenesis in mouse testis as the experimental model, shows that the
      lethality of the prolific Auger emitter 125I is linearly dependent on the
      fraction of the radioactivity in the organ that is bound to DNA. This suggests
      that the equivalent dose for Auger emitters may have a similar linear dependence.
      Accordingly, a formalism for calculating the equivalent dose for Auger emitters
      is advanced within the ICRP framework.

PMID- 8475257
TI  - Effects of in vivo heart irradiation on myocardial energy metabolism in rats.
AB  - To investigate the effect of in vivo heart irradiation on myocardial energy
      metabolism, we measured myocardial adenosine nucleotide concentrations and
      mitochondrial oxygen consumption in left ventricular tissue of rats 0-16 months
      after local heart irradiation (20 Gy). At 24 h and 2 months no difference in
      myocardial adenosine nucleotide concentration was apparent between irradiated and
      control hearts. The total myocardial adenosine nucleotide concentrations in
      irradiated hearts compared to those of nonirradiated controls tended to be lower
      from 4 months onward. The rate of oxidative energy production (state 3
      respiration) in irradiated hearts was significantly reduced compared with that of
      age-matched controls from 2 months onward. Moreover, as a result of aging, a time
      dependent decrease in the rate of oxidative energy production was observed in
      both irradiated and control hearts (P < 0.001). The respiratory control index
      (RCI = oxygen consumption in state 3/oxygen consumption in state 4) in irradiated
      hearts was not different from the RCI measured in age-matched control animals.
      During the period of study the RCI diminished significantly with age in both
      groups (P < 0.005). The number of oxygen atoms used per molecule of ADP
      phosphorylated (P/O ratio) was not influenced by the irradiation. The P/O ratio
      for the NAD(+)-linked substrates remained unchanged at a value of about 3 during
      the period studied. At 6 months after irradiation activities of myocardial
      enzymes such as lactate dehydrogenase, creatine kinase, citrate synthase, and
      cytochrome c oxidase were reduced. The reduction in myocardial energy production
      and the changes in energy supplies provide a mechanism to explain impaired
      contractility after local heart irradiation.

PMID- 8475258
TI  - Amelioration of radiation nephropathy in rats by dexamethasone treatment after
      irradiation.
AB  - The effect of 20 Gy intraoperative bilateral local kidney irradiation was
      compared in rats treated after irradiation with dexamethasone and untreated rats.
      Ninety days after irradiation, body weights, WBC, RBC, hematocrit, and renal
      function (plasma urea nitrogen concentration and retention of
      ethylenediaminetetraacetic acid) were measured. The animals were then sacrificed
      and the kidneys were analyzed for water and hydroxyproline content and examined
      histologically. Local kidney irradiation reduced animal growth, prevented renal
      growth, decreased renal mass and renal function, and increased the water and
      hydroxyproline content of the kidneys. Histopathological examination revealed
      glomerular damage (atrophy, decreased RBC and endothelial cells, increased
      mesangial matrix), tubular damage (epithelial denudation, congestion with hyalin
      casts), and increased concentration of interstitial cells. Dexamethasone
      treatment significantly ameliorated the effects of kidney irradiation on body
      weights, renal mass, renal function, and the development of anemia. Dexamethasone
      had no effect on radiation-induced edema or fibrosis as measured by the water and
      hydroxyproline content of the kidneys. Dexamethasone-treated irradiated kidneys
      had significantly less damage to the glomeruli and tubules. The results suggest
      that dexamethasone is cytoprotective and prevents the destruction of the nephron.

PMID- 8475259
TI  - Depth-dose equivalent relationship for cosmic rays at various solar minima.
AB  - Galactic cosmic rays (GCR) pose a serious radiation hazard for long-duration
      missions. In designing a lunar habitat or a Mars transfer vehicle, the radiation
      exposure determines the shielding thickness, and hence the weight of spacecraft.
      In designing a habitat one has to focus on the worst-case radiation flux and its
      uncertainties. Using the spherically symmetric diffusion theory of the solar
      modulation of GCR, and data on the differential energy spectra of hydrogen,
      helium, oxygen, and iron from 1965 to 1989, it has been shown that the flux is
      determined by the diffusion parameter which is a function of the time in the
      solar cycle. This analysis also showed that the fluxes in the 1954 and 1976-1977
      solar minima were similar and higher than those in 1965. In this paper, we have
      extended the spherical solar modulation theory back to 1954. These results show
      that the 1954-1955 GCR flux was nearly the same as that from 1976 to 1977 and
      that the 1965 flux values were nearly the same as those in 1986. Using this
      theory we have obtained the GCR spectra for all the nuclei and calculated the
      depth dose as a function of aluminum thickness. Using the ICRP 26 value for the
      quality factor, and the 1976-1977 spectra, it is shown that the shielding
      required to stay below 0.5 Sv is 17.5(-3)+8 g cm-2 of aluminum, and 9(-1.5)+5 g
      cm-2 to stay below 0.6 Sv. The calculated dose equivalent using the ICRP 60
      values for quality factors is about 15% higher than that calculated using the
      ICRP 26 value. However, the errors on the quality factor itself may be
      substantial and are not taken into account.

PMID- 8475260
TI  - A longitudinal study of growth and development of stature among prenatally
      exposed atomic bomb survivors.
AB  - Growth retardation due to exposure to the atomic bomb has been evaluated using
      repeated measurements of stature from 10 to 18 years of age. A highly significant
      growth retardation due to the DS86 uterine dose was observed in all trimesters
      combined and in the first and second trimesters of pregnancy. In the first
      trimester, all parameter estimates based on a linear (L) or linear-quadratic (L
      Q) dose-response relationship were negative in relation to the DS86 uterine dose.
      The positive dose estimate in the second trimester is small and close to the
      control level. Statistically significant difference was determined by a
      multivariate test statistic examining whether or not a set of two- or three
      parameter estimates including a constant term related to an L or L-Q dose
      response relationship was different from zero. A radiation-related growth
      retardation was demonstrable as a longitudinal result of the repeated
      measurements of stature. The dose effect in the third trimester was not
      significant under either the L or the L-Q model. The relationship between birth
      weights and repeated measurements of stature in adolescence is discussed based on
      the results obtained by a growth curve analysis.

PMID- 8475261
TI  - Radiology and the law, with an emphasis on interventional radiology.

PMID- 8475262
TI  - Another look at the radiology relative value scale.

PMID- 8475263
TI  - Radiology relative value scale, physician payment reform, and the U.S. health
      care policy agenda.

PMID- 8475264
TI  - Flat adenomas: what you can't see can hurt you.

PMID- 8475265
TI  - Pediatric radiology: flexibility, viability, credibility, and opportunity.

PMID- 8475266
TI  - Patient-focused care: radiology department beware.

PMID- 8475267
TI  - The radiology relative value scale: its development and implications.
AB  - In a proactive response to federal government cost-containment pressures, the
      radiology profession, under the leadership of the American College of Radiology
      (ACR), in 1988 developed a relative value scale (RVS) for radiologic procedures.
      Like earlier radiology RVSs, its relative values reflected the physician work and
      practice costs involved in each procedure. The RVS was constructed by using (a)
      three types of data (magnitude estimation, charges, and practice costs) obtained
      by means of surveys and (b) expert consensus panels involving participants from
      all fields and many organizations in radiology. The RVS was accepted, essentially
      in toto, by Medicare. Subsequently, the RVS has required much work to correct
      errors by Medicare and the insurers that administer it, to improve procedure
      codes, and to develop codes and relative values for new procedures. By moving
      proactively, radiology preserved fee-for-service against a major threat, reduced
      payment cuts from those that seemed to be impending, and gained a unique degree
      of control over its payments. However, the new payment system is complex and does
      not reward efficacy, cost-effectiveness, or quality.

PMID- 8475268
TI  - Dynamic contrast-enhanced CT of the liver: comparison of contrast medium
      injection rates and uniphasic and biphasic injection protocols.
AB  - To determine the effect of contrast medium injection rate and biphasic versus
      uniphasic bolus on hepatic parenchymal enhancement at computed tomography (CT),
      105 patients were randomized into four protocols. Hepatic and aortic enhancement
      curves were measured for each protocol. The optimal scanning interval (the
      duration between onset of a desired hepatic enhancement threshold and decline of
      enhancement below the threshold or onset of the equilibrium phase) and contrast
      enhancement index (CEI) (area under the hepatic enhancement curve above a desired
      threshold during the nonequilibrium phase) were the primary determinants of
      merit. Measurements were performed at hepatic enhancement thresholds between 10
      and 60 HU. At most thresholds of hepatic enhancement, optimal scanning intervals
      were significantly longer and CEIs were significantly higher for the biphasic
      protocols than for the uniphasic protocols (P < .03). A biphasic injection with a
      high initial flow rate produces high peak contrast enhancement but delayed onset
      of equilibrium and thus provides a longer optimal scanning interval.

PMID- 8475269
TI  - Interstitial hyperthermia of colorectal liver metastases with a US-guided Nd-YAG
      laser with a diffuser tip: a pilot clinical study.
AB  - Ultrasound (US)-guided interstitial hyperthermia performed with the neodymium
      yttrium aluminum garnet laser with a diffuser tip involves placement of a laser
      fiber in solid tissue followed by irradiation from within the center of the tumor
      to be treated. The authors previously described the development of a US-guided
      technique that permits simultaneous interstitial laser irradiation and
      temperature measurements, with real-time US monitoring. With the use of a
      dedicated diffuser tip modification of the bare laser fiber, it has proved
      possible to produce spherical coagulations with a diameter comparable to that of
      liver metastases of clinical relevance. This technique was used in 11 patients
      with 16 colorectal liver metastases, 12 of which were radically ablated. Real
      time US and interstitial temperature monitoring during treatment had a positive
      predictive value of 86% and negative predictive value of 100% in judging the
      final result. The technique is feasible, effective, and safe, but the effect on
      patient survival must be tested in future randomized clinical studies.

PMID- 8475270
TI  - Hepatic metastases: interstitial laser photocoagulation with real-time US
      monitoring and dynamic CT evaluation of treatment.
AB  - Fifty-five liver metastases in 21 patients were treated with interstitial laser
      photocoagulation (ILP). Tumors were irradiated with a neodymium yttrium aluminum
      garnet laser via optical fibers passed through 19-gauge needles inserted under
      ultrasound (US) guidance. Heating of the tumor was evident at real-time US as an
      expanding and coalescing echogenic zone around the needle tips. After ILP,
      dynamic computed tomography (CT) showed laser-induced necrosis as a new area of
      nonenhancement. Necrosis of tumor volume was more than 50% in 82% (45 of 55) of
      the tumors, and 100% necrosis was achieved in 38% (21 of 55). Metastases smaller
      than 4 cm in diameter were treated more effectively and required fewer treatment
      sessions than did those larger than 4 cm. Complications were minor and included
      severe pain in four cases, persistent pain for up to 10 days in 11 cases, and
      asymptomatic subcapsular hematoma (four cases) and pleural effusion (six cases)
      seen with CT. ILP is safe and effective for liver tumor destruction, and US and
      CT are useful in different aspects of treatment monitoring.

PMID- 8475271
TI  - Self-localization in US of appendicitis: an addition to graded compression.
AB  - Graded-compression ultrasound (US) of the right lower quadrant (RLQ) has been a
      valuable addition to the diagnostic evaluation of acute appendicitis. In an
      effort to expedite the sonographic evaluation and improve diagnostic accuracy, a
      method of self-localization was added to the standard graded-compression
      examination. A total of 236 patients with signs of appendicitis were studied.
      Eighty-five percent (121 of 142) of the patients with proved appendicitis were
      able to decisively self-localize their pain. Of the patients without appendicitis
      who still had significant disease in the RLQ, 88% (29 of 33) were able to self
      localize their pain, with an accuracy rate of 86% for significant disease. Among
      patients without significant disease, only 15% (nine of 61) self-localized their
      pain. This "sonographic self-localization sign" reduced the time of the
      examination and was a valuable addition to standard graded-compression US of the
      appendix.

PMID- 8475272
TI  - Gastrocolic fistulas: the increasing role of aspirin.
AB  - Eight patients had gastrocolic fistulas depicted on barium studies at the
      authors' hospital during a 10-year period between 1982 and 1992. Seven of those
      patients (88%) had benign disease, including aspirin-induced gastric ulcers of
      the greater curvature (n = 4), granulomatous colitis (n = 1), tuberculosis (n =
      1), and a penetrating anastomotic ulcer after partial gastrectomy (n = 1). The
      remaining patient had a malignant gastrocolic fistula caused by carcinoma of the
      transverse colon. Two patients (25%) experienced classic symptoms of gastrocolic
      fistulas (ie, feculent vomiting or foul-smelling eructations), but the other six
      (75%) experienced abdominal pain or other nonspecific clinical findings. In the
      four patients who were taking aspirin, upper gastrointestinal examinations
      revealed giant penetrating ulcers of the greater curvature that communicated with
      the superior border of the transverse colon via a fistula. Three of these
      patients exhibited marked clinical improvement after conservative medical
      treatment and did not need surgery. This experience suggests that aspirin-induced
      gastric ulcers of the greater curvature have become a more common cause of
      gastrocolic fistulas than is carcinoma of the stomach or transverse colon.

PMID- 8475273
TI  - Gastric and esophageal varices: 20-MHz transnasal endoluminal US.
AB  - To image esophageal and gastric varices qualitatively and to measure esophageal
      varices quantitatively, 29 patients with portal hypertension underwent transnasal
      esophageal and gastric ultrasonography (US). Twenty-three patients underwent
      standard endoscopy. Endoluminal US demonstrated the varices as anechoic areas
      with communications in the submucosal, periesophageal, and perigastric regions,
      as well as ascites visualized through the gastric wall. Interobserver variation
      between two investigators for measurements of the largest esophageal varix in
      each patient was r value of .99 for diameter, r value of .99 for cross-sectional
      surface area, and r value of .98 for circumference. Endoscopy for evaluation of
      gastric varices had a sensitivity of 48% and a specificity of 50% and for
      evaluation of esophageal varices had a sensitivity of 94% and a specificity of
      17%. Periesophageal and perigastric varices could not be visualized at endoscopy.
      Transnasal esophageal US, a new imaging technique with which to detect and
      measure esophageal varices, is a more sensitive modality than endoscopy for the
      detection of gastric varices.

PMID- 8475274
TI  - Colorectal adenomas: inflammatory changes that simulate malignancy after laser
      coagulation--evaluation with transrectal US.
AB  - To evaluate the assumption that inflammatory changes in the rectal wall after
      treatment of colorectal adenoma with photocoagulation may simulate malignant
      infiltration, the findings were reviewed in 23 follow-up examinations performed
      with transrectal ultrasound (TRUS) in 17 patients with benign adenoma. Special
      attention was given to the appearance of the wall layers underneath the adenoma.
      After partial coagulation, changes in the colorectal wall were usually seen on
      TRUS scans obtained early in follow-up; sometimes the thickened muscle layer had
      an irregular outer margin. In three of the 13 early examinations, lesions
      mimicked malignancy. To correlate these findings with histologic proof, an
      experimental study was performed: Colorectal specimens from pigs were examined
      with ultrasound (US) and microscopy. The abnormal sonographic appearance of
      specimens on US scans was caused by an inflammatory reaction in the deep wall
      layers; concomitant serositis appeared to be responsible for the malignancy
      mimicking irregular outer margin. In screening for malignancy in colorectal
      adenoma, TRUS may cause overstaging during the first 6 weeks after polypectomy or
      after a session of laser treatment and should be avoided.

PMID- 8475275
TI  - CT findings after percutaneous biliary procedures.
AB  - A prospective study was performed to determine the frequency, type, and extent of
      abnormalities depicted with computed tomography (CT) after percutaneous biliary
      procedures (PBPs). Abdominal CT scans were obtained 24-72 hours after the PBP in
      31 consecutive cases in 29 patients. Fifteen abnormalities were proved with CT in
      14 patients (45%), as follows: subcapsular hematoma (two patients), subcapsular
      or perihepatic fluid collection (three patients), intrahepatic hematoma (three
      patients), nonspecific intrahepatic fluid collection (three patients),
      subcutaneous hematoma at the puncture site (one patient), free intraperitoneal
      air (one patient), intraperitoneal collection of contrast material (one patient),
      and inadvertent transxiphoid catheter tract (one patient). Only five of these
      patients had clinically apparent post-PBP complications that could be explained
      with CT findings. The 14 patients with positive CT findings required more needle
      passes (mean, 8.3 vs 4.6) during the PBP, had a difficult PBP more often (five
      patients [36%] vs four patients [27%]), and had more frequent placement of an
      internal-external drain (nine patients [64%]) than those with negative findings
      (eight patients [53%]). Positive findings on CT scans are common after a PBP and
      often are not associated with clinical symptoms.

PMID- 8475276
TI  - Minute nonpolypoid adenomas of the colon depicted with barium enema examination.
AB  - To evaluate the usefulness of barium enema examination for detection of small
      nonpolypoid adenomas, the barium enema study findings were reviewed in patients
      with flat or depressed adenomas of the colon 3-5 mm in diameter that had been
      initially found during colonoscopy and that had been diagnosed as adenomas at
      histologic analysis. Eleven of the 21 nonpolypoid adenomas were depicted on
      radiographs; they tended to be located on the left side of the colon. The 10
      other lesions were not detected retrospectively on barium enema radiographs. The
      radiographic findings in the depicted lesions included smooth, round, radiolucent
      areas; in seven of these lesions, round or irregular barium flecks were also
      seen. The radiolucent areas were attributed either to slightly elevated growth of
      adenomas or to surrounding hyperplasia of nonneoplastic glands; the central
      barium fleck seemed to conform to depressed areas within adenomas. Barium enema
      examination can demonstrate nonpolypoid adenomas of the colon, even though
      colonoscopy seems superior to barium enema examination for detection of these
      lesions.

PMID- 8475277
TI  - Abdominal staging of thoracic Hodgkin disease: CT-lymphangiography-Ga-67 scanning
      correlation.
AB  - A retrospective study was performed to assess whether lymphangiography and
      gallium-67 scanning were complementary to computed tomography (CT) in abdominal
      staging of disease in 94 patients with early-stage thoracic Hodgkin disease. In
      51 patients with surgical or follow-up correlation, the spleen was involved in
      16% (n = 8), the spleen and lymph nodes in 22% (n = 11), and only lymph nodes in
      2% (n = 1). In these 51 patients, none of the imaging modalities had greater than
      50% sensitivity for the detection of nodal involvement. The overall accuracy was
      similar (71%-82%) for each modality. Analysis of subgroups of patients with lymph
      nodes measuring less than 10 mm, 10-19 mm, or 20 mm or greater at CT revealed
      that lymphangiography and gallium scanning added little to the positive or
      negative predictive values of CT. The sensitivity of CT for detection of splenic
      disease was 11% (two of 19). On the basis of surgical or follow-up correlation in
      51 patients, the authors conclude that lymphangiography and gallium scanning
      offer minimal or no complementary benefit.

PMID- 8475278
TI  - Upper inferior vena caval anastomotic stenosis in liver transplant recipients:
      Doppler US diagnosis.
AB  - Ultrasound (US) is routinely used as a screening tool for liver transplant
      dysfunction. Its use in the detection of significant vascular complications of
      liver transplantation such as thrombosis or stenosis of the hepatic artery and
      portal vein is well recognized. Its role in the detection of anastomotic stenosis
      of the inferior vena cava (IVC) has not been defined. The authors present US
      findings in five patients with such stenosis. The gray-scale and Doppler findings
      in all cases consisted of loss of normal hepatic vein and IVC periodicity. Some
      studies also showed distention of the hepatic veins and IVC and a high-velocity
      jet at the anastomosis, and in one case the stenosis was visualized with color
      Doppler US. While there are other causes of absent periodicity in the hepatic
      veins, this finding in the appropriate clinical setting may be a sensitive
      indicator of upper IVC anastomotic stenosis.

PMID- 8475279
TI  - Hepatic artery: effect of a meal in healthy persons and transplant recipients.
AB  - Thirty healthy volunteers and 12 liver allograft recipients (two with cirrhotic
      changes seen at microscopy) were given a standard meal. Doppler sonography of the
      right and left hepatic arteries, the superior mesenteric artery, and the portal
      vein was performed. The change in hepatic arterial resistance was evaluated with
      the resistive index (RI). After the standard meal, portal venous flow increased
      in both the healthy volunteers and allograft recipients (more so in the latter
      group). Superior mesenteric arterial RI decreased in all subjects. A postprandial
      increase in hepatic arterial RI, likely reflecting constriction of the hepatic
      artery, was seen in both groups. It was absent in the two patients with recurrent
      transplant cirrhosis. These results show the importance of examining hepatic
      arterial flow in the fasting subject, since high resistance after a meal may be
      falsely interpreted as a sign of disease. Absence of a postprandial change in
      resistance of the hepatic artery could signal abnormal liver function.

PMID- 8475280
TI  - Survey of reproductive health among female MR workers.
AB  - Epidemiologic data were obtained to evaluate potential risks from exposure to the
      static and time-varying magnetic fields used in magnetic resonance (MR) imaging.
      A questionnaire sent to women workers in more than 90% of clinical MR facilities
      in the United States addressed menstrual-reproductive experiences, work
      activities, and potential confounders (eg, age, smoking, alcohol use). In 1,915
      completed questionnaires, 1,421 pregnancies were reported: 280 occurred in an MR
      worker (technologist or nurse), 894 in an employee in another job, 54 in a
      student, and 193 in homemakers. Comparing MR-worker pregnancies with those
      occurring in employees at other jobs, a relative risk ratio of 1.27 (95%
      confidence interval [CI], 0.92-1.77) was found for spontaneous abortions; for
      conception taking more than 12 months, 0.90 (CI, 0.54-1.51); for delivery before
      39 weeks, 1.19 (CI, 0.76-1.88); for birth weight below 5.5 lb (2.5 kg), 1.01 (CI,
      0.50-2.04); and for male gender of the offspring, 0.99 (CI, 0.80-1.22).
      Adjustment for maternal age, smoking, and alcohol use also failed to markedly
      change any of the associations. These results suggest that there is not a
      substantial increase in these common adverse reproductive outcomes.

PMID- 8475281
TI  - Coronary arteries: three-dimensional MR imaging with fat saturation and
      magnetization transfer contrast.
AB  - Magnetic resonance imaging of the coronary arteries is a particularly difficult
      task because of the small size of the vessels and the motion of the heart during
      the cardiac and respiratory cycles. The authors developed a non-breath-hold three
      dimensional (3D) technique to accomplish this goal. Imaging was performed with
      voxel sizes of 1.50-4.50 mm3. This allows for excellent multiplanar
      reconstruction to view the coronary arteries from any angle. The short echo time
      usually makes blood isointense with surrounding tissue since inflow enhancement
      is weak with a thick-slab 3D method. This problem is overcome by applying fat
      saturation and magnetization transfer contrast techniques to suppress the signals
      of fat and myocardium surrounding the coronary arteries. Respiratory motion
      artifacts are reduced by taking four acquisitions and averaging the data. The
      authors acquired the first 3-10 cm of both the left and right coronary arteries
      in most cases in 7-10 minutes with single slab coverage. Acquisition of multiple
      slabs should further increase the length of coverage of the coronary arteries.
      Further improvements will occur when respiratory gating is used.

PMID- 8475282
TI  - Phase-contrast cine MR angiography in chronic liver disease.
AB  - Thirty-one patients with portal venous hypertension underwent phase-contrast cine
      magnetic resonance (MR) angiography to validate the technique for assessment of
      main portal vein patency and blood flow direction. Correlative findings from
      Doppler ultrasonography, conventional angiography, and surgery were acquired in
      30, 17, and 16 patients, respectively. Findings from MR angiography correlated
      well with those of the other methods for determining portal vein patency and flow
      direction. The main portal vein was patent in 29 patients and was thrombosed in
      two patients at MR angiography. With the use of a 40-mm slab projection
      acquisition that required 5 minutes, the splenic and superior mesenteric veins,
      as well as extensive varices (when present), were seen in the majority of cases.
      Phase-contrast cine MR angiography is an accurate method of rapidly assessing
      morphologic characteristics, patency, and flow direction of the portal venous
      system and thus is a useful method for evaluating the condition of patients with
      chronic liver disease.

PMID- 8475283
TI  - Creation of transjugular intrahepatic portosystemic shunts with the wallstent
      endoprosthesis: results in 100 patients.
AB  - One hundred patients underwent transjugular intrahepatic portosystemic shunt
      (TIPS) creation for variceal bleeding (n = 94), intractable ascites (n = 3),
      hepatorenal syndrome (n = 2), and preoperative portal decompression (n = 1).
      Shunts were completed in 96 patients. Portal vein pressure was reduced from 34.5
      mm Hg +/- 7.6 (standard deviation) to 24.5 mm Hg +/- 6.2; the residual portal
      vein-hepatic vein gradient was 10.4 mm Hg +/- 0.9. Acute variceal bleeding was
      controlled in 29 of 30 patients. Of the 96 patients who underwent successful TIPS
      creation, 26 have died and 22 have undergone liver transplantation; the remaining
      48 patients have survived an average of 7.6 months. Variceal bleeding recurred in
      10 patients. Fifteen patients developed shunt stenosis (n = 6) or occlusion (n =
      9). Patency was reestablished in eight of the nine occluded shunts. Seventeen
      patients developed new or worsened encephalopathy. The authors conclude that TIPS
      creation is an effective and reliable means of lowering portal pressure and
      controlling variceal bleeding, particularly in patients with acute variceal
      bleeding unresponsive to sclerotherapy and patients with chronic variceal
      bleeding before liver transplantation.

PMID- 8475284
TI  - Inversion-recovery fast spin-echo MR imaging: efficacy in the evaluation of head
      and neck lesions.
AB  - To compare the efficacies of fast spin-echo (FSE) and inversion-recovery FSE
      (IRFSE) magnetic resonance (MR) imaging in evaluating head and neck disorders,
      the authors evaluated 46 lesions in 23 consecutive patients. Twenty-seven lesions
      were related to neoplasms; 19 lesions resulted from infectious, allergic, or
      radiation-induced inflammation. Conventional T1-weighted, FSE, and IRFSE images
      were obtained in all patients. The FSE and IRFSE images were qualitatively
      compared in an unblinded manner for conspicuity of lesion margins and extent.
      IRFSE imaging improved conspicuity of 22 lesions (48%) and showed equal
      conspicuity of 18 (39%). IRFSE imaging proved most useful for small lesions with
      long T2 relaxation times that were surrounded by fat. IRFSE imaging improved
      visibility of small optic nerve gliomas, salivary gland inflammation, peripheral
      nerve tumors, and small lymph nodes. Early changes secondary to spread of tumor
      across fascial planes were also well visualized with IRFSE sequences. In six
      lesions (13%) that did not have long T2 relaxation times, the FSE images provided
      better conspicuity. The authors conclude that by improving conspicuity of small
      lesions adjacent to or surrounded by fat, IRFSE sequences can supplement FSE
      sequences in imaging the head and neck.

PMID- 8475285
TI  - Epidural hematoma of the lumbar spine: 18 surgically confirmed cases.
AB  - The authors report 18 cases of surgically proved spontaneous epidural hematoma of
      the lumbar spine. The clinical findings in spontaneous epidural hematoma were
      identical to those in acute disk herniation. Underlying disk abnormalities were
      common; the majority of hematomas (14 of 18, 78%) were associated with small
      concomitant disk herniations or underlying annular tears. The magnetic resonance
      imaging and computed tomographic findings were similar to those in extruded/free
      fragment disk herniation. The strong coincidence between epidural hematoma and
      underlying disk disruption (annular tear or herniation) leads the authors to
      postulate that spontaneous epidural hematoma results from tearing of fragile
      epidural veins lying adjacent to the displaced anulus or nucleus.

PMID- 8475286
TI  - Alzheimer disease: depiction of increased cerebral myo-inositol with proton MR
      spectroscopy.
AB  - To define altered metabolites in the brain of patients with probable Alzheimer
      disease (AD) of two brain regions, localized in vivo hydrogen-1 magnetic
      resonance (MR) spectroscopy was performed with a short echo time (30 msec) in 11
      elderly patients and 10 healthy age-matched subjects. The patients had mild to
      moderate dementia, assessed with standard neuropsychological tests. Two
      abnormalities in the patients' cerebral cortex were defined: When compared with
      healthy subjects, the patients showed a 22% increase (P = .005) (approximately
      equal to 1.5 mmol/kg) in myo-inositol (MI) and an 11% decrease (P = .005) in
      residues of N-acetyl (NA), a putative neuronal marker. The elevation of MI in
      patients with mild to moderate AD suggests that abnormalities in the inositol
      polyphosphate messenger pathway occur early in the natural history of AD. The
      combination of high MI and low NA at examination with H-1 MR spectroscopy shows
      promise as an early diagnostic test for AD.

PMID- 8475287
TI  - Contrast-enhanced transcranial Doppler US with a new transpulmonary echo contrast
      agent based on saccharide microparticles.
AB  - The purpose of this first patient study (phase II) was to evaluate the clinical
      usefulness of a new echo contrast agent at transcranial Doppler ultrasonography
      (US). Twenty patients were selected from a group of 242 patients undergoing
      conventional transcranial Doppler US who had low (n = 18) or absent (n = 2)
      Doppler signals from the middle cerebral artery (MCA). The extent and duration of
      Doppler signal increase was measured in 30 MCAs and in 14 basilar arteries
      following the intravenous injection of a transpulmonary galactose microparticle
      suspension (SH U 508 A) at three concentrations (200, 300, and 400 mg/mL).
      Doppler waveform analysis became possible in 93% (28 of 30) of the MCAs following
      injection. The maximal increase in average Doppler signal intensity (11 dB at 200
      mg/mL, 15 dB at 300 mg/mL, and 17 dB at 400 mg/mL) and the increase in average
      duration of the signal enhancement (163 seconds at 200 mg/mL, 219 seconds at 300
      mg/mL, and 240 seconds at 400 mg/mL) depended on contrast agent concentration.
      Doppler waveform analysis became possible in 79% (11 of 14) of the basilar
      arteries. The intravenous injection of this new echo contrast agent markedly
      increases Doppler signal intensity in patients with nondiagnostic results at
      conventional Doppler US.

PMID- 8475288
TI  - Sacral meningeal cysts: evaluation with MR imaging.
AB  - It is often difficult for the radiologist to determine if a given sacral
      meningeal cyst is causing symptoms. Radiographic criteria for identifying cysts
      likely to be symptomatic are needed. Using conventional magnetic resonance (MR)
      imaging along with a specifically designed flow-sensitive sequence, the authors
      characterized 24 cysts (19 patients) with respect to diameter and communication
      with the subarachnoid space. They found no significant difference in size between
      symptomatic and asymptomatic cysts (P > .05) but did observe a clear-cut
      disparity in the context of communication: Five of five asymptomatic cysts were
      shown to communicate on MR flow studies, while seven of seven symptomatic cysts
      were not shown to communicate. The authors propose that flow-sensitive MR imaging
      is useful in differentiating communicating from noncommunicating sacral meningeal
      cysts and that this information may be of value in classifying these lesions as
      more or less likely to be symptomatic.

PMID- 8475289
TI  - Cerebral perfusion in children: detection with dynamic contrast-enhanced T2*
      weighted MR images.
AB  - Cerebral perfusion dynamics were assessed with dynamic contrast material-enhanced
      T2*-weighted magnetic resonance (MR) imaging in 33 subjects aged 3-20 years.
      Group A (n = 20) had sickle cell anemia without clinical evidence of
      cerebrovascular disease. Group B (n = 13) consisted of 12 patients with
      cerebrovascular disease and homozygous sickle cell anemia and one patient without
      that anemia. All subjects underwent conventional MR imaging and a dynamic study
      in which a spoiled gradient-echo pulse sequence was used to generate images
      (acquisition time, 2.5 seconds) during injection of a compact bolus of
      gadopentetate dimeglumine (0.1 mmol/kg). For qualitative analysis, the dynamic
      images were displayed in cine mode. Group A demonstrated symmetric sequential
      region patterns of loss of signal intensity within 10 seconds of injection. Group
      B exhibited signal loss asymmetries that corresponded to cerebrovascular lesions
      on conventional MR images. Quantitative analysis enabled estimation of
      hemodynamic parameters, including relative cerebral blood volume, relative
      cerebral blood flow, and mean transit time. This method of assessment of cerebral
      perfusion dynamics complements conventional MR imaging.

PMID- 8475290
TI  - Joint effusion in children with an irritable hip: US diagnosis and aspiration.
AB  - Ninety-six children with an irritable hip possibly representing septic arthritis
      underwent clinical and laboratory evaluation, radiography, and ultrasonography
      (US). Forty had normal US scans; none were later shown to have septic arthritis,
      although three had osteomyelitis. Fifty-six children had effusion at US. Thirty
      one of these underwent US-guided aspiration, two unsuccessfully. On the basis of
      results of aspirate analysis, 15 of these 31 patients underwent surgical
      drainage, and septic arthritis was diagnosed in all 15. The mean peripheral white
      blood cell (WBC) count was not significantly higher in patients with septic
      arthritis (n = 21) than in patients with toxic synovitis (n = 24) (P = .44).
      However, the erythrocyte sedimentation rate and synovial fluid WBC count were
      significantly greater in those with septic arthritis than in those with toxic
      synovitis (P = .002 and P < .0001, respectively). Clinical evaluation,
      radiographs, and sonograms together determined the need for US-guided aspiration.
      US-guided aspiration allowed selection of only those with septic arthritis for
      operative drainage and shortened that procedure. Negative sonograms allow
      exclusion of septic arthritis but not osteomyelitis.

PMID- 8475291
TI  - "Recall" pneumonitis: adriamycin potentiation of radiation pneumonitis in two
      children.
AB  - The radiographic findings in two children with acute "recall" pneumonitis,
      associated with administration of Adriamycin (doxorubicin hydrochloride) and
      actinomycin D at variable intervals after local radiation therapy, were presented
      to emphasize the unique radiographic appearance and clinical course. A 10-year
      old girl underwent radiation therapy 9 weeks after completing an initial cycle of
      chemotherapy. Within hours of the resumption of chemotherapy, she was in clinical
      respiratory distress. Chest radiography showed a well-defined area of alveolar
      consolidation in the periphery of the right lung corresponding to the area of
      radiation. Shortness of breath and right chest rales developed in a 15-year-old
      boy within 12 hours of the resumption of chemotherapy 6 weeks after radiation
      therapy was completed. Chest radiography showed an alveolar infiltrate extending
      from the apex to the base of the right lung corresponding to the area of
      radiation. Symptoms may be confused with an infectious pathogenesis; thus,
      knowledge of the history of radiation therapy and the radiation port is important
      in initiating treatment with steroids rather than antibiotics.

PMID- 8475292
TI  - Prospective evaluation of patients with suspected hip fracture and indeterminate
      radiographs: use of T1-weighted MR images.
AB  - To assess the diagnostic efficacy of T1-weighted magnetic resonance (MR) images
      when findings on radiographs of the hip are indeterminate, 20 patients with
      suspected hip fracture and indeterminate radiographs were prospectively
      evaluated. MR imaging was performed with surface coil technique; one coronal T1
      weighted (repetition time msec/echo time msec = 400/19) MR image was obtained.
      The total charge for the examination was $448 (compared with the following usual
      charges: radionuclide bone scan, $455; tomography, $299; and computed tomography,
      $797). When MR imaging and clinical outcome were used as the standard of
      reference, the prospective accuracy of MR imaging in diagnosis of the presence or
      absence of hip fracture was 100% (20 correct diagnoses). All MR studies were
      diagnostic. Of the 13 patients with fracture (eight with trochanteric and five
      with subcapital fracture), 10 patients (77%) underwent surgery and three patients
      (23%) received conservative treatment. T1-weighted MR images can enable diagnosis
      or exclusion of hip fracture whenever radiographs are indeterminate. The imaging
      time is approximately 7 minutes, and the cost of the examination can be made
      competitive with costs of other advanced imaging examinations.

PMID- 8475293
TI  - Abnormalities of articular cartilage in the knee: analysis of available MR
      techniques.
AB  - In an attempt to improve the detection of chondral abnormalities with magnetic
      resonance imaging, a fat-suppressed three-dimensional gradient-recalled
      acquisition in the steady state (GRASS) and spoiled GRASS (SPGR) sequence was
      optimized by study of five cadaveric knee specimens. Results with this optimized
      sequence then were compared with results with three spin-echo (T1-, proton
      density-, and T2-weighted) and two three-dimensional gradient-recalled echo
      sequences (GRASS and non-fat-suppressed SPGR) in the assessment of naturally
      occurring abnormalities of the patellofemoral compartment in 10 cadaveric knees.
      Results with the optimized fat-suppressed SPGR sequence were significantly better
      (P < .02) than results with the other five sequences and had a sensitivity of
      96%, a specificity of 95%, and an accuracy of 95%. In addition, normal cartilage
      consistently appeared as a trilaminar structure with the fat-suppressed SPGR
      sequence, a feature that appeared to help in identification of chondral lesions.

PMID- 8475294
TI  - Hooked acromion: prevalence on MR images of painful shoulders.
AB  - An association between the morphology of the acromion and the occurrence of
      rotator cuff tear (RCT) has been suggested by findings at both pathologic
      examination and routine radiography. As a tomographic technique, magnetic
      resonance (MR) assessment of acromial shape may be more accurate than routine
      radiography. The authors studied acromial morphology on sagittal oblique MR
      images of a control population (47 shoulders), of patients with isolated
      impingement (30 shoulders), and of patients with full-thickness RCTs (34
      shoulders) to assess the association of acromial shape with disorders of the
      rotator cuff. Acromions were classified as flat (type 1), smoothly curved (type
      2), or hooked (type 3). Data were collected by two observers, blinded to clinical
      and surgical information, who acted in consensus. Patients with RCT had a
      significantly increased prevalence of type 3 acromions compared with control
      patients (62% vs 13%, P < .001). Type 3 acromions tended to be more prevalent in
      the group with impingement (30%, P = .17). There was no significant difference in
      the distribution of acromion types among control patients with respect to age or
      gender.

PMID- 8475295
TI  - Intravertebral vacuum cleft: changes in content after supine positioning.
AB  - Sequential radiographic and magnetic resonance (MR) imaging examinations were
      performed in nine patients with an intravertebral vacuum cleft indicative of
      avascular necrosis. Progressive changes in the content of the cleft occurred
      within an hour after the patients were placed in a supine position. Initially,
      the cleft showed a gaslike pattern during extension of the spine, with a
      radiolucent band on radiographs and a signal void on MR images. Later, the vacuum
      phenomenon disappeared on radiographs, and a fluidlike high-signal-intensity
      pattern appeared on T2- or T2*-weighted MR images, suggestive of a slow fluid
      inflow within the intravertebral cleft. Because the recognition of a vacuum cleft
      in a collapsed vertebral body helps avoid confusion with malignancy or infection,
      it is important to search for this in examinations performed immediately after
      supine positioning.

PMID- 8475296
TI  - Multicentric fibromatosis with metaphyseal dysplasia.
AB  - A new association between multicentric fibromatosis and a bone dysplasia is
      reported. Three patients are described, each of whom had multicentric
      fibromatosis of the lower extremity and a skeletal dysplasia. One of the patients
      had dysplastic changes restricted to the involved extremity. The other two had
      dysplastic changes of all the long bones. The dysplasia consisted predominantly
      of undertubulation reminiscent of the findings seen in Pyle disease. No clinical
      or radiographic abnormalities of the marrow were found in any of these patients.
      It is believed that this association represents mesenchyme that is predisposed to
      develop both dysplastic bone changes and tumor.

PMID- 8475297
TI  - MR imaging of the breast with rotating delivery of excitation off resonance:
      clinical experience with pathologic correlation.
AB  - An investigative study was undertaken to determine the potential for a new
      magnetic resonance (MR) imaging technique, RODEO (rotating delivery of excitation
      off resonance), for use as a diagnostic imaging tool for the breast. The RODEO
      technique provides fat suppression with T1 weighting and is ideal for gadolinium
      enhanced breast imaging. It is a short repetition time, steady-state sequence for
      high-resolution three-dimensional acquisitions and provides a clinically
      efficient imaging time of approximately 5 minutes for 128 sections. Imaging
      findings were correlated with serially sectioned pathologic specimens in 30
      breasts with 47 malignant and 27 benign lesions. MR imaging had a sensitivity of
      94% and a specificity of 37%. MR imaging depicted additional cancers not seen at
      mammography in 11 of the 30 patients (37%). The lesions not seen at mammography
      varied in size from 3 mm to 12 cm. RODEO MR imaging may be used to improve
      diagnosis of breast cancer in patients with mammographically dense breasts or
      silicone implants/injections and to stage disease in patients who are candidates
      for lumpectomy.

PMID- 8475298
TI  - Preoperative needle localization in the breast: utility of local anesthesia.
AB  - Eighty-nine consecutive patients undergoing needle localization at two facilities
      were alternately assigned to "local-anesthesia" (n = 46) and "no-local
      anesthesia" (n = 43) groups. Those in the local-anesthesia group received 1-2 mL
      lidocaine hydrochloride 1% subcutaneously at the expected site of insertion of
      the localizing needle. All patients were asked to rate the level of pain they
      experienced from the procedure as a whole by using a 10-cm horizontal visual
      analog pain scale. Data about patient age, menopausal and menstrual status,
      average daily caffeine intake, and whether the patients considered mammography to
      be a painful procedure were collected. Patients who did not receive local
      anesthesia had a lower mean pain score (2.52) than those who did (3.27, P = .18).
      Premenopausal patients in the second half of their menstrual cycle at the time of
      the procedure had a significantly higher pain score than those in the first half
      (3.54 vs. 1.70, P = .05). Patients who considered mammography a painful procedure
      reported a higher level of pain than those who did not (3.79 vs 2.38, P = .012).
      There was no relationship between age, caffeine intake, or menopausal status and
      pain experienced.

PMID- 8475299
TI  - US-guided automated large-core breast biopsy.
AB  - To evaluate the efficacy of ultrasound (US)-guided automated large-core
      percutaneous needle breast biopsy, biopsy of 181 ultrasonographically suspicious
      breast lesions was performed by using a long-throw biopsy gun and 14-gauge
      needles with continuous US guidance. A "freehand" technique with either 5.0- or
      7.5-MHz linear-array transducers was used. Needle core diagnoses were compared
      with surgical diagnoses in the 49 lesions subsequently surgically excised. The
      remaining 132 cases were followed for 12-36 months. Agreement between needle-core
      and surgical diagnoses in the 49 lesions was 100%. This group included 34 cancers
      (28 infiltrating ductal, two mucinous, one mixed infiltrating ductal and lobular,
      and one each of intraductal, infiltrating lobular, and tubular carcinoma). To
      date, no cancers have been found in the other 132 cases. The procedure time
      averaged 20 minutes, and no complications occurred. With an accuracy approaching
      that of excisional biopsy, US-guided needle core biopsy provides an alternative
      to surgery.

PMID- 8475300
TI  - Pulmonary nodules: detection with thick-section spiral CT versus conventional CT.
AB  - Spiral volumetric computed tomography (CT) with single breath-hold technique was
      compared with conventional sequential CT in 39 patients. The spiral CT protocol
      consisted of a 10 mm/sec table feed during a 24-second breath hold at 145 mA,
      with reconstruction of images at 10-mm intervals; one (n = 21) or two (n = 18)
      sequences were necessary to screen the complete lung. Conventional CT was
      performed with a 1-second scan time, 145 mA, and contiguous 10-mm-thick sections.
      In the 39 patients studied with each technique, no lung nodule was detected in
      three, two had a single nodule, and 29 had multiple nodules. Two patients with
      normal findings at chest radiography and three with a solitary pulmonary nodule
      at conventional CT had multiple nodules at spiral CT. Mean number of nodules per
      patient was significantly higher with spiral versus conventional CT (18 +/- 4.5
      vs 12.6 +/- 3.2 [mean +/- standard error of the mean], P = .01) as were the
      number of nodules less than 5 mm in diameter per patient (12.7 +/- 3.7 vs 8.4 +/-
      2.3, P < .05) and 5-10 mm in diameter (2.9 +/- 0.9 vs 2.4 +/- 0.8, P < .05).
      Respiratory motion artifacts were never observed with spiral CT although they
      were present on four conventional CT scans.

PMID- 8475301
TI  - Improved parameters for unsharp mask filtering of digital chest radiographs.
AB  - Observer performance with four unsharp mask filtering algorithms for storage
      phosphor chest radiographs was compared with that with conventional screen-film
      radiographs in the detection of three types of simulated lung disease: nodules,
      fine lines, and micronodule clusters. Previously studied parameter sets (small
      [1.4-mm] and medium [5-mm] filter masks) and two new parameter sets (large [2.5
      cm] and ultralarge [7-cm] masks) were compared by means of receiver operating
      characteristic analysis. With medium and small masks, nodule detection was
      inferior to that achieved with other modes. Use of ultralarge masks decreased the
      detection of lines compared with detection with conventional screen-film
      radiographs. Although detection of micronodule clusters was worse with digital
      images than with conventional screen-film radiographs, results with large and
      ultralarge masks were better than with small masks. Overall, filtering with large
      masks was best suited for simultaneously matching linear, nodular, and
      micronodular structures. These results suggest that lesion-specific processing of
      digital chest images is not necessary.

PMID- 8475302
TI  - Interpretation of subtle interstitial lung abnormalities: conventional versus
      storage phosphor radiography.
AB  - To evaluate the reliability of storage phosphor radiography (SR) in diagnosis of
      subtle interstitial lung abnormalities, the differences among radiologists in
      interpreting conventional screen-film radiographs and full-size and minified SR
      images obtained in 80 patients were studied. Forty patients had subtle
      interstitial lung abnormalities and 40 had no lung abnormalities. Seven chest
      radiologists and seven residents evaluated the images by using a five-point
      presence of abnormality scale. Results were evaluated with receiver operating
      characteristic technique. For all observers, no significant differences were
      observed among the three image types. For the chest radiologists, significant
      differences were observed between conventional radiographs and the two SR formats
      (P < .01). Furthermore, perceptual accuracy was best with conventional
      radiographs evaluated by chest radiologists. Overall performance with SR and
      conventional radiography was identical for diagnosis of abnormalities, but
      detection performance was significantly dependent on observer experience (P < .01
      for chest radiologists and P > .01 for residents). For chest radiologists,
      critically important information may be lost with commercially available SR.

PMID- 8475303
TI  - Carcinomatous solitary pulmonary nodules: evaluation of the tumor-bronchi
      relationship with thin-section CT.
AB  - To investigate the value of computed tomography (CT) for depicting the
      relationship between carcinomatous solitary pulmonary nodules and the bronchial
      tree and predicting the results of various bronchoscopic biopsy techniques, the
      authors retrospectively reviewed CT scans from 27 consecutive patients with
      solitary pulmonary nodules associated with a positive bronchus sign. All patients
      underwent bronchoscopy and transbronchial biopsy. Macroscopic demonstration of
      the tumor-bronchi relationship was obtained in 18 patients. Five basic types of
      tumor-bronchus relationships were identified with CT: (a) bronchus cut off by the
      tumor, (b) bronchus contained within the tumor, (c) bronchus compressed by the
      tumor, (d) thickening and smooth narrowing of the bronchus leading to the tumor,
      and (e) thickening and irregular narrowing of the bronchus leading to the tumor.
      The diagnostic yield of transbronchial forceps biopsy and bronchial brushing was
      significantly higher in nodules characterized by a cut-off or contained bronchus.
      Transbronchial needle aspiration was performed in six patients, and results were
      positive in five, all of whom had a compressed or thickened bronchus. These
      results confirm that yield of transbronchial biopsy is determined by the type of
      tumor-bronchus relationship and the biopsy technique performed.

PMID- 8475304
TI  - Incomplete interlobar fissures: bronchovascular analysis with CT.
AB  - Thin-section computed tomographic scans of both lungs in 154 patients, including
      seven cadavers, with lung cancer (n = 37), diffuse (n = 32) or inflammatory (n =
      30) lung disease, other proved or suspected disease (n = 23), or healthy lungs (n
      = 32) were analyzed to determine the frequency of incomplete interlobar fissure
      (IIF). An IIF was defined as a discontinuous linear shadow that remained in
      contact with the chest wall. An IIF was found in 128 of 154 right lungs (83.1%)
      and 77 of 154 left lungs (50.0%). Some bronchovascular structures crossed or
      passed through two contiguous lobes in the fused area. The most common
      bronchovascular structure associated with an IIF was a pulmonary vein; this
      association was found in 87 right lungs (56.5%) and 20 left lungs (13.0%). An IIF
      was traversed by a pulmonary artery in only seven right lungs and 13 left lungs
      or by a bronchus in only three lungs. It is concluded that recognition of an IIF
      might improve understanding of the spread of pulmonary disease.

PMID- 8475305
TI  - Retrograde catheterization of the ureter without cystoscopic assistance:
      preliminary experience.
AB  - Standard angiographic techniques were applied to fluoroscopically directed
      retrograde guide wire or catheter placement into the distal ureter without
      cystoscopic assistance. The procedure was successful in five of the seven initial
      attempts, with no complications. Retrograde pyelography and stent placement were
      accomplished for a benign posttraumatic ureteral stricture, a proximal ureteral
      calculus, and three malignant ureteral strictures. Percutaneous nephrostomy was
      obviated in all successful cases. Fluoroscopy time averaged less than 3 minutes.
      Mild intravenous sedation was used, and the procedure was well tolerated. This
      initial experience suggests that this method may be useful for a variety of
      endourologic procedures, as well as for routine retrograde pyelography.

PMID- 8475306
TI  - Placement of a wire mesh prosthesis in the external urinary sphincter of men with
      spinal cord injuries.
AB  - The authors report their experience with an intraurethral prosthetic stent as an
      alternative treatment for detrusor-external urethral sphincter dyssynergia
      (DESD). A sphincter prosthesis was inserted into the membranous urethra of 25 men
      with spinal cord injuries, DESD, and elevated voiding pressure. Bladder voiding
      pressure decreased from 87 cm H2O +/- 23 to 27 cm H2O +/- 11 in 12 months (P <
      .001). There was a significant decrease in residual urine volume 12 months after
      prosthesis placement, from 122 mL +/- 77 to 33 mL +/- 19 (P < .01); bladder
      capacity remained relatively unchanged, from 174 mL +/- 84 to 230 mL +/- 92 (P <
      .57). No deleterious effects were seen in renal or erectile function. Migration
      of three prostheses occurred 1 day to 6 weeks after insertion. One additional
      complication, pyelonephritis, occurred in a patient with preexisting
      vesicoureteral reflux, necessitating reimplantation of bilateral ureters. The
      intraurethral wire mesh prosthesis, with its simplicity of placement and minimal
      associated morbidity, offers a potential alternative to external sphincterotomy.

PMID- 8475307
TI  - Transurethral balloon dilation of the external urinary sphincter: effectiveness
      in spinal cord-injured men with detrusor-external urethral sphincter dyssynergia.
AB  - The authors investigated balloon dilation as a minimally invasive alternative to
      transurethral external sphincterotomy for the treatment of detrusor-external
      urethral sphincter dyssynergia (DESD). Seventeen spinal cord-injured men with
      voiding pressures greater than 60 cm H2O underwent balloon dilation of the
      external sphincter to 90 F at 4 atm of pressure for 10 minutes. The mean voiding
      pressures before and 12 months after dilation were 83 cm H2O +/- 35 and 37 cm H2O
      +/- 15, respectively (P = .008). There was a significant decrease in residual
      urine volume, from 163 mL +/- 162 to 68 mL +/- 59 (P = .05), whereas bladder
      capacity remained relatively unchanged at 253 mL +/- 181 and 230 mL +/- 97 (P =
      .30). Complications included one case of postoperative bleeding necessitating
      transfusion, two treatment failures, and one bulbous urethral stricture. Fourteen
      of the 17 patients (82%) now void without the aid of an indwelling catheter or
      alternative therapy. Balloon dilation has no detrimental effect on erectile
      function and may improve fertility.

PMID- 8475308
TI  - Abnormal renovascular impedance in patients with hepatic cirrhosis: detection
      with duplex US.
AB  - The purpose of this study was to determine whether duplex ultrasound (US) can
      allow detection of early impairment of renal function in patients with hepatic
      cirrhosis. The authors calculated the pulsatility index (PI) and resistive index
      (RI) by using duplex US in 17 patients with cirrhosis and ascites but with normal
      renal function (group A), in 16 patients with cirrhosis but no ascites (group B),
      in 20 with chronic hepatitis (group C), in six with peritoneal carcinomatosis
      (group D), and in 16 healthy control subjects (group E). All patients had normal
      renal function on the basis of blood urea nitrogen and serum creatinine values.
      PI and RI were higher (P < .001) in group A patients than in others. Cirrhotic
      patients with ascites had renal vasoconstriction even in the absence of
      clinically apparent renal impairment and full-blown hepatorenal syndrome.
      Impaired renal perfusion plays a key role in sodium and fluid accumulation in
      patients with liver disease. On the basis of these results, duplex US is useful
      in pathophysiologic and clinical studies in such patients.

PMID- 8475309
TI  - Interpretation of CT studies: single-screen workstation versus film alternator.
AB  - A prototype single-screen workstation with a 2,048 x 2,560-pixel high-brightness
      monitor, 0.11-second image display time, and simple ergonomic design was compared
      to a conventional horizontal film alternator in diagnostic interpretation of
      chest computed tomography (CT) studies. Four radiologists used either the
      workstation or film alternator in interpretation of studies obtained in 10
      patients. A counterbalanced within-subject repeated measures experimental design
      was used. Response times were analyzed for both methods of interpretation. Grades
      of excellent, acceptable, and unacceptable were assigned by a blinded "grader" to
      reports of the radiologists. The average time needed for an interpretation at the
      workstation was 5.65 minutes. No interpretations were graded unacceptable.
      Retrospective power analysis showed that 16 observers rather than four would have
      been required to show that use of the workstation was faster than the alternator.
      With this 95% confidence interval, the workstation interpretation time is
      clinically equivalent to that with the alternator. These data show that this type
      of workstation has practical application in interpretation of CT, magnetic
      resonance imaging, and ultrasound studies.

PMID- 8475310
TI  - Crohn disease: prone-angled compression view in radiographic evaluation.
AB  - A prone-angled compression radiographic view was compared with traditional
      radiographs in 17 patients with suspected Crohn disease. The angled view was
      clearly superior to the posteroanterior view in visualization of disease in the
      terminal ileum and small bowel and was superior to spot radiographs in six of 10
      patients with disease in the small bowel. This view can be a valuable adjunct
      when small bowel loops overlap in the pelvic area.

PMID- 8475311
TI  - A complication involving a braided hook-wire localization device.
AB  - At the authors' institution, needle localization of breast lesions with a braided
      hook wire involves the wire being cut 1-2 cm from the point of entry before
      dissection, to avoid contamination of the sterile field with the nonsterile
      portion of wire. During dissection, the wire is brought through the skin into the
      area of dissection. In one patient, fragments of wire filaments were left within
      the breast. Braided hook wires must be cut cleanly, the cut surface should be
      wiped before dissection, and the surgical area should be cleansed before closure.

PMID- 8475312
TI  - Cine scintigraphy for gastrointestinal bleeding.

PMID- 8475313
TI  - Is it possible to diagnose a tear at arthrography or MR imaging?

PMID- 8475314
TI  - Guide-wire-directed detachable balloons.

PMID- 8475315
TI  - Identification of atypical skin calcifications.

PMID- 8475316
TI  - Pharmacokinetic aspects of antidepressant treatment in the elderly.
AB  - 1. Physiological and metabolic changes with ageing may affect the
      pharmacokinetics of antidepressant drugs. 2. Pharmacokinetic parameters following
      single doses of antidepressants in the elderly tend to be altered compared with
      younger subjects. 3. Elimination half-life tends to be prolonged for most
      antidepressant drugs in the elderly due to decreased clearance and increased
      volume of distribution. 4. Steady-state plasma concentrations tend to be
      increased in elderly patients. 5. Inter-individual differences usually account
      for the majority of the variance in kinetic parameters rather than an effect of
      ageing per se. 6. The increased propensity for side effects in the elderly is
      probably due to pharmacodynamic rather than pharmacokinetic alterations with age.

PMID- 8475317
TI  - Genetic models in the study of alcoholism and substance abuse mechanisms.
AB  - 1. Vulnerability to substance abuse is an important emerging issue. Some related
      factors are the relationship between propensity to self-administer a drug and
      neurosensitivity to that drug; similarities and differences between various
      models of drug seeking behavior; and the commonality of drug-seeking behavior
      across drugs and genotypes, that is, whether reinforcement from and abuse of
      alcohol and other drugs define variations within a single behavioral phenomenon,
      or whether reinforcement and abuse must be individually defined for each
      substance involved. 2. Findings related to these issues are now being obtained
      from the areas of pharmacogenetics and operant drug self-administration. 3. The
      results indicate that reinforcement from alcohol and other drugs is only
      moderately related to preference for alcohol and other drugs. In addition,
      neurosensitivity to drugs appears to have little influence on whether that drug
      will come to serve as a positive reinforcer for any given individual or animal.
      Indeed, the critical factor appears to be the individual organism's innate
      propensity to find a particular drug reinforcing. 4. Initial findings also show
      that genotypic patterns of reinforcement from ethanol appear to correlate highly
      with patterns of reinforcement from cocaine and opiates. 5. From these findings
      it is concluded that there exist important genetic determinants of drug
      reinforced behavior; reinforcement is an important and independent effect of
      several psychoactive drugs; and drug seeking behaviors maintained by ethanol,
      cocaine and opiates may have at least some common biological determinants.

PMID- 8475318
TI  - Digital period analysis of EEG in depression: periodicity, coherence, and
      interhemispheric relationships during sleep.
AB  - 1. Interhemispheric EEG differences were compared between 12 symptomatic
      depressed outpatients, 12 asymptomatic patients and 12 normal controls during two
      consecutive nights in the Sleep Study Unit. 2. EEG was quantified using digital
      period analysis (DPA), a time-domain analysis of successive polarity changes
      (zero-cross) and instances of zero slope (first derivative), yielding percent
      time in each frequency band. 3. The degree of hemispheric asymmetry (L-R) was
      computed for delta, beta and theta percentages from REM, Stage 2 and Slow-Wave
      (SW) sleep. 4. Normals showed small asymmetries throughout sleep with largest
      differences in SW, with no consistent relationship between right and left
      activity and sleep stage. 5. Both depressed groups showed largest asymmetries in
      REM sleep, with significantly more beta, theta and delta in the right hemisphere
      consistently. None of the 24 depressed patients showed greater left hemisphere
      activity throughout sleep.

PMID- 8475319
TI  - 3H-spiperone binding capacity in mononuclear cells: a family study.
AB  - 1. A family study was carried out using a putative biological vulnerability trait
      in families of schizophrenics and schizoaffective indexprobands to investigate,
      if the clinical phenotype and a biological marker for schizophrenia are
      cosegregating within families. 2. The binding capacity of the dopamine antagonist
      spiperone to mononuclear cells was investigated in 21 indexprobands and a total
      of 147 first and second degree relatives. 3. Increased binding capacity could be
      found in 17 indexprobands and in their affected relatives, independently from
      clinical diagnosis and in 22% of their normal relatives. 4. No increased binding
      capacity was found in 4 indexprobands and in their affected relatives and not n
      any of the unaffected relatives. These results indicate, that increased spiperone
      binding may cosegregate with the risk for functional psychoses and that families,
      loaded with psychiatric disturbances may be distinguished on a biological basis.

PMID- 8475320
TI  - Interleukin-1 alpha and interleukin-2 in cerebrospinal fluid of schizophrenic
      subjects.
AB  - 1. It has been postulated that the interrelated processes of neurodegeneration,
      neuroplasticity, and neuroimmunological abnormalities may play a role in the
      pathophysiology of schizophrenia. Since, interleukins are produced in the central
      nervous system and have cytokine and growth promoting properties, they are an
      obvious choice to consider in these neural processes. 2. Cerebrospinal fluid
      obtained from schizophrenic patients, on and off medications, and from normal
      controls was assayed for interleukin-1 alpha (IL-1 alpha) and interleukin-2 (IL
      2) using a sensitive enzyme-linked immunoassay. 3. IL-1 alpha concentration were
      below the detection limits of the assay in both controls and schizophrenics. 4.
      IL-2 levels were under 1 ng/ml CSF in nearly all subjects. There was no
      significant difference in IL-2 levels between medicated and medication-free
      schizophrenics or when patients were compared to controls.

PMID- 8475321
TI  - Abnormal lateralization in finger tapping and overt aggressive behavior.
AB  - 1. The relationship between abnormal cerebral lateralization and overt aggressive
      behavior was examined in 41 violent psychiatric patients in a maximum-security
      hospital. 2. Cerebral lateralization was measured using the Finger Oscillation
      Test from the Halstead-Reitan Neuropsychological Battery, and aggressive behavior
      was measured during a six-month period of hospitalization using the Overt
      Aggression Scale. 3. Patients with the most abnormal pattern of lateralization
      exhibited the highest frequency as well as the highest severity of overt
      aggressive behavior. This pattern could not be explained by the influence of age,
      race, IQ, history of head trauma, brain damage, or psychiatric diagnosis. History
      of seizures, alcohol abuse, and drug abuse, however, were found to be intervening
      variables in the lateralization-aggression link. Once their influence was removed
      using analysis of covariance, there was no relationship between lateralization
      and aggression. 4. The results suggest that it is unlikely that there is a direct
      causal relationship between abnormal lateralization and aggressive behavior.

PMID- 8475322
TI  - Amnestic effects of triazolam and other hypnotics.
AB  - 1. The effects of a number of hypnotics were compared to a range of results
      collected for triazolam on objective measures of CNS sedation (critical flicker
      fusion) and short-term memory function (memory scanning). 2. Assessments taken
      after the drugs had been administered but prior to the onset of sleep showed that
      in comparison to placebo most of the compounds were effective sedatives and this
      correlated highly (r = 0.734, p < 0.04) with amnestic effects found at the same
      time, suggesting that general CNS sedation is a major component of anterograde
      amnesia. 3. Residual effects assessed the morning after the hypnotics had been
      used showed a similar relationship (r = 0.896, p < 0.005). 4. The distribution of
      results indicates that 0.25 mg triazolam has an acute amnestic profile which is
      similar to other hypnotics, but possesses a distinct lack of residual effects.

PMID- 8475323
TI  - The detection of age-related decrease of dopamine D1, D2 and serotonin 5-HT2
      receptors in living human brain.
AB  - 1. Using positron emission tomography and 11C-N-methylspiperone and 11C-
      SCH23390, dopamine D1 and D2 receptors, and serotonin 5-HT2 receptors in human
      brain were evaluated in living healthy age different subjects. 2. Dynamic
      analysis of PET data indicated that these receptor binding abilities decreased
      with aging in healthy humans.

PMID- 8475324
TI  - Alprazolam in panic disorder: a retrospective analysis.
AB  - 1. The charts of 78 panic disorder outpatients treated with alprazolam (mean dose
      4.30 mg/day, mean duration 31.9 months) were reviewed for demographics, past
      history (including substance abuse and major depression), and evidence of
      alprazolam abuse. In addition, the patients were evaluated by Clinical Global
      Index for improvement at last contact. 2. Moderate to significant recovery was
      found in 77% of patients. Major depression was seen in 41%. Depressed patients
      were more likely to have coexisting agoraphobia and a past history of alcohol
      abuse than non-depressives. 3. There was no DSM-III-R anxiolytic abuse, but 12%
      showed unauthorized use of the alprazolam. These subjects were three times more
      likely to have a history of drug abuse than non-misusers. 4. These results
      indicate that alprazolam is effective in the long-term treatment of panic
      disorder, but that prolonged management may be required. Further, the data raise
      concerns about use in panic patients with substance abuse histories.

PMID- 8475325
TI  - Relation between long-lasting amounts of excitatory amino acid and its neuronal
      uptake system in cultured cerebellar granule cells under hypoglycemia.
AB  - 1. Basal release of amino acids (Glu, Gln, Gly and Tau) in cultures of rat
      cerebellar granule cells was detected at 3 days in vitro (DIV). The amounts of
      Gln and Gly released increased according to days of culture. Moreover, the
      amounts of Glu in a glia poor culture of granule cells tended to be higher than
      those in glia rich cultured cells, while Gln, Gly and Tau concentrations were
      lower in glia poor cells than in glia rich cells. 2. After depolarization induced
      by high KCl, amounts of all measured amino acids significantly rose to more than
      1.5 times their basal values. The increased values obtained in a glia rich
      culture of granule cells were higher than those in a glia poor culture of cells
      throughout all cultured days. 3. Under deprivation of glucose, most
      concentrations of amino acids in the medium, especially Gln concentration,
      increased by 50 mM KCl were lower than those seen under normal conditions. Such
      lesser efflux examined under hypoglycemia was much more clearly recognized in
      glia rich cultures than in glia poor cultures. However, the amounts of Glu at 10
      and 14 DIV, and also Gly and Tau amounts at 10 DIV were significantly higher than
      those seen in the cultures of glia poor cells under normal conditions. 4. The
      dosage of 10 microM Glu-induced [Ca2+]i accumulation was inhibited by several
      different types of Ca antagonists and scopolamine. Meanwhile, the dosages of the
      tested drugs, except for scopolamine, required for blocking Glu-induced [Ca2+]i
      accumulation under hypoglycemia were less than those required under normal
      conditions. These results suggest that neuronal death induced hypoglycemia might
      be caused by the dysfunction of the neuronal, but not glial, Glu uptake system,
      and that some Ca antagonists might be useful in preventing the neuronal death
      caused by hypoglycemia.

PMID- 8475326
TI  - Effects of thyroid state on preference for and sensitivity to ethanol in Fischer
      344 rats.
AB  - 1. It has been reported by several groups that thyroid status can alter ethanol
      preference in rats. However, results using different methods and different
      strains of rats have not been consistent. 2. In this study, thyroidectomy or T4
      augmentation was used to produce hypothyroidism or hyperthyroidism, respectively,
      in adult male Fischer-344 rats. 3. Preference for weak solutions (4 or 5%) of
      ethanol or tap water and ethanol-induced sedation and hypothermia were compared
      in hypothyroid, hyperthyroid and euthyroid rats. 4. No significant differences in
      preference indices (the ratios of ethanol to total liquid consumed) among the
      three groups were observed; however, for ethanol to contribute a greater portion
      of total calories ingested by hypothyroid rats than by euthyroid or hyperthyroid
      rats. 5. The duration of sleep resulting from a single i.p. injection of 2.5
      mg/kg ethanol was increased (by 34%) in hyperthyroid rats and decreased (by 16%)
      in hypothyroid rats compared to euthyroid controls. Only the effect of
      hyperthyroidism was significant at the 0.05 level. 6. Colonic temperatures
      differed with thyroid state (hyperthyroid > euthyroid > hypothyroid) but the
      decrease produced by ethanol did not differ by thyroid state. 7. Observed
      differences in ethanol-induced sedation are consistent with differences in brain
      TRH levels and effects on neurotransmitter systems associated with different
      thyroid states.

PMID- 8475327
TI  - Use of Edinburgh Postnatal Depression Scale in a North American population.
AB  - 1. The authors mailed the Edinburgh Post-natal Depression Scale to 308 women at
      six weeks postpartum. 2. It was completed and return by 185 women (60.0%). 3.
      Thirty-two of them (17.4%) scored 12 and above, the threshold reported to
      identify most women with postpartum depressive disorder.

PMID- 8475328
TI  - [Structure and expression of actin genes].

PMID- 8475329
TI  - [Construction of helical structure by lipids and related compounds].

PMID- 8475330
TI  - [Observation of biological materials by STM/AFM--principles and present status of
      applications].

PMID- 8475331
TI  - [Antisense strategies come of age].

PMID- 8475332
TI  - [A protease having a lectin-like domain: structure and function of rarobacter
      protease I, a yeast-lytic enzyme].

PMID- 8475333
TI  - [Detection of RNA packaging signal of HIV-1 and its application for a novel AIDS
      therapy].

PMID- 8475334
TI  - [Colorectal cancer. A study of 133 surgical cases].
AB  - The author studied the medical records of 133 patients who underwent surgery for
      adenocarcinoma of the colon or rectum in the Metropolitan Hospital Complex
      Arnulfo Arias Madrid from June 1972 to July 1992. In 9 (6.7%) the tumor was
      staged as Dukes A, in 49 (36.8%) as Dukes B; in 60 (43.1%) as Dukes C and in 10
      (16.7%) as Dukes D. The anatomical location of the tumor was the cecum in 9
      (6.7%), the ascending colon in 3 (2.3%), the sigmoid colon in 44 (33%) and the
      rectum in 41 (31.6%). Of the rectal carcinomas 24 (58.5%) were in the inferior
      one third, 10 (24.3) were in the middle and 7 (17%) in the superior third. It is
      evident that nearly two thirds of the tumors were within reach of the digital
      rectal examination of the sigmoidoscopic examination. The parents ranged from 21
      to 89 years of age and their median age was 63 years. 73 patients were women and
      60 were men. 60.5% of the women and 39.5% of the men had carcinoma of the colon.
      The sexual prevalence of carcinoma of the rectum was different: 5% were in men
      and 43% were in women. 2.2% of the tumors were synchronous and 4% were
      metachronous. The author discusses the number, type and indications for the
      surgical procedures used. There were no perioperative deaths. The 5 year survival
      for adenocarcinomas of the colon was 100% for those patients with tumors staged
      as Dukes A, 78.5% for the Dukes B, 61.1% for the Dukes C and 0% for those staged
      as Dukes D. For the rectal adenocarcinomas the 5 year survival was 100% for those
      patients with tumors in Stage Dukes A, 57.1%, for those in Dukes B, 33.3 for
      those in Dukes C and 0% in those in Dukes D. These results indicate that these
      patients are seen in an advanced stage and point to the urgent need to make the
      diagnosis in early, curable stages. The low incidence of tumors in stage Dukes A
      indicates an indifference of the patients and/or the doctors to the symptoms and
      signs of this disease. The most frequent symptoms, in descending order were:
      bleeding on defecation (all types), change in bowel habits (diarrhea or
      constipation), abdominal pains, tenesmus and anemia (with its different clinical
      manifestations). Other symptoms were a palapable abdominal mass, feces with
      bloody mucus and rectal prolapse on defecation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475335
TI  - [10 years of nosocomial infections at the Santo Tomas Hospital].
AB  - The incidence of nosocomial urinary tract infections (UTI) in the medical
      services of Santo Tomas Hospital from 1980 to 1985 was 56% in Neurology Section,
      73% in cardiology and 74% in nephrology. These percentages declined, with
      epidemiological surveillance, to 21%, 31% and 53% respectively, for the period
      between 1986 and 1990. In the surgical services the incidence of nosocomial UTI
      was 85% in urology and 15% in general surgery, from 1980 to 1985. The incidence
      remained unchanged in urology (81%) and general surgery (17%) despite
      epidemiological surveillance, but decreased in neurosurgery (from 55% to 37%) for
      the period between 1986 and 1990. Between 1985 and 1990, Staphyloccocus aureus
      was the most frequently isolated bacterium from surgical wounds (34%) and from
      patients with intravenous catheters (23%). Pseudomonas aeruginosa was the most
      frequently isolated bacterium in nosocomial UTI (26%) and respiratory tract
      infections (45%) and in patients with nosocomial septicemia, it was a species of
      Klebsiella.

PMID- 8475336
TI  - [Familial calculous cholecystopathy].
AB  - The history and laboratory examination of the parents of six families with a
      history of biliary showed that five mothers and one father had cholelithiasis.
      Two of the mothers also had exogenous obesity and diabetes mellitus, and one
      mother also had lipid abnormalities. Among the 21 children of the same families,
      one son had cholelithiasis; 5 children (4 women and one man) had cholelithiasis
      and exogenous obesity; 10 (9 women and one man) had cholelithiasis, exogenous
      obesity and diabetes mellitus; two (one man and one woman) had cholelithiasis,
      exogenous obesity and lipid abnormalities; one son had cholelithiasis and
      diabetes mellitus, and one son had cholelithiasis and lipid abnormality. Among
      the 18 grandchildren of these families, 3 (2 women and one man) had
      cholelithiasis; 5 granddaughters had cholelithiasis and exogenous obesity; 2
      grandsons had cholelithiasis, exogenous obesity and diabetes mellitus; 2
      grandsons had cholelithiasis and lipid abnormality; one grandson had
      cholelithiasis, diabetes mellitus and hyperuricemia; one grandson had
      cholelithiasis, exogenous obesity, lipid abnormalities and hyperuricemia, and one
      grandson had exogenous obesity and diabetes mellitus. Finally, of the
      greatgrandchildren, one girl had cholelithiasis.

PMID- 8475337
TI  - [Evaluation of 4 immunobiochemical/molecular methods for the identification of
      Trypanosoma cruzi and Trypanosoma rangeli strains].
AB  - In American man can be infected with two trypanosomes: Trypanosoma cruzi, the
      etiological agent of Chagas' disease and Trypanosoma rangeli, a suspected
      nonpathogenic parasite. In this communication are presented 4 methods in order to
      improve the current knowledge about the specific identification of these
      parasites. Using the SDS-PAGE technique it was possible to differentiate between
      T. rangeli. and T. cruzi based in at less 4 protein bands with a relative
      molecular weights of 93, 77-73, 63 and 54-52 KDa. These polypeptides were found
      only in T. rangeli electrophoretic profiles. An ELISA test showed that the
      antigenic composition found in the enzyme cisteine proteinase (cruzipain) is
      specific for T. cruzi epimastigotes. Antigenic analysis by Western blot assay,
      proved that T. rangeli and not T. cruzi present antigenic bands with a Mr of 142,
      63, 54, 51, 49, 43, 39 and 24 KDa. Finally, using the Southern blot procedure, it
      was confirmed that SAPA, a DNA sequence originally identified in the T. cruzi,
      genome, is absent in T. rangeli nuclear DNA. These initial observations revealed
      that it is possible to identify both parasites using the described methods,
      however further works are required to clarify the biochemical, immunological and
      molecular relationship between T. rangeli and T. cruzi.

PMID- 8475338
TI  - [Choledochal cysts. Review and presentation of 2 girls with perforated cyst].
AB  - The clinical record is reported of two female girls, 4 1/2 and 5 1/2 years old,
      who were reported in 1988 at the Children's Hospital in this City with diagnosis
      of perforated Cholodochal supurated cyst and who were asymptomatic when they left
      the hospital. It is mentioned that another four patients had been operated in the
      same hospital, between 1981 and 1987, with choledochal cyst diagnosis.

PMID- 8475339
TI  - [Bioessay with brine Artemia to predict antibacterial and pharmacologic
      activity].
AB  - The Brine Shrimp Test (BST) is a simple and inexpensive method to test
      cytotoxity, to biodirect phytochemical fractionation of natural products and as a
      predictor for antitumor and pesticidal activity. In this work, the BST test, an
      antibacterial test and the rat hippocratic screening test were used on 25 plant
      extracts and fractions, to evaluate the correlation, if any, between the BST and
      the others. Preliminary results show that the BST is not a predictor of
      antibacterial activity nor the hippocratic screening test.

PMID- 8475340
TI  - [First report in Panama on Nerocila californica Schioedte and Meinert 1881
      (Isopoda: Cymothoidea) in Sciaenops ocellatus (L) (Pisces: Sciaenidae)].
AB  - One juvenile specimen of the isopod Nerocila californica (acuminata form) was
      found on the skin of a cage-raised red drum, Sciaenops ocellatus, in Aguadulce,
      Cocle Province. This finding is the first report of the occurrence of Nerocila
      californica as ectoparasitic of fishes on the Pacific side of the Republic of
      Panama.

PMID- 8475341
TI  - [Vasovagal syncope: the value of tilt-table testing in the evaluation of loss of
      consciousness].
AB  - Syncope, an eminently frequent syndrome, has multiple and varied causes. Its
      diagnosis is important in view of the poor prognosis of cardiac syncopes and also
      of the morbidity and discomfort associated with the other etiologies.
      Unfortunately, the cause eludes us in half the patients so that a clear prognosis
      and effective therapy can be given to only a few patients. Tilt-table testing,
      alone or with isoproterenol, is now considered as a noninvasive, sensitive and
      specific method for identifying patients predisposed to vaso-vagal syncope, a
      major cause of syncope of unknown origin. Tilt-table testing also helps in
      tracking many pathologies contributing to syncopes. In the absence of a universal
      treatment of vasovagal syncope, tilt-table testing has revealed itself as a
      contributory guide to the best possible treatment.

PMID- 8475344
TI  - [Linear opacities in the abdomen].

PMID- 8475343
TI  - [Renal transplantation at the Free University of Brussels].
AB  - From the data collected in 1,041 renal transplantations performed at the
      Universite Libre de Bruxelles between 1965 and 1992, the time-evolution of the
      results is described. At 5 year, patient's survival rate increased from 37%
      during the 1965-69 period to 95% since 1985 whereas total graft survival rate,
      which was only 13% during the 1965-69 period, reaches 65% at the present time.
      Among the factors responsible for the progress in the results since 1980,
      immunosuppressive therapy is the strongest: the best results are currently
      obtained by the use of triple therapy associating corticosteroids, azathioprine
      and cyclosporine, combined or not with the prophylactic administration of OKT3
      monoclonal antibody. Future development of new immunosuppressive protocols, more
      specific and more potent, is emphasised, as well as the need to promote
      transplantation from a living related donor to meet the current shortage of
      organs.

PMID- 8475342
TI  - [Neonatal abstinence syndrome: current and future aspects].
AB  - Pregnant heroin-addicted women constitute a major social problem that should not
      be ignored. Newborns may develop a neonatal abstinence syndrome (NAS). They
      present with behavioural troubles running a typical clinical course. The level of
      severity of NAS will be accurately determined, leading to definition of the most
      appropriate therapy. The best therapeutic formula appears to be paregoric elixir,
      mixed with phenobarbital if necessary. Least severe cases can be easily
      controlled by appropriate surrounding conditions. Pharmacological as well as
      physiopathological effects of opiates are described. Little is known about the
      long-term effects of opiate exposure; they apparently include frequent
      instrumental troubles. At the present time, the rapid intervention of a
      multidisciplinary team is recommended, taking charge of the mothers who should
      receive methadone in progressively tapering doses.

PMID- 8475345
TI  - [Erroneous parallels].

PMID- 8475346
TI  - [The concept of ergotherapy: joint protection and remedial device].
AB  - Joint protection is an important, unfortunately often neglected method of
      treatment for various rheumatological conditions. With theoretical and practical
      working methods, the occupational therapist conveys valuable information
      regarding the successful treatment of threatening joint deformity and efficient
      pain reduction.

PMID- 8475347
TI  - [Understanding of and coping possibilities in chronic rheumatoid arthritis in a
      family setting].
AB  - Results of a Swiss study dealing with the coping potential of patients suffering
      from rheumatoid arthritis and their family members are presented. Patients and
      their families have their own understanding of rheumatic disease which must be
      respected by the physicians. Whereas women are prone to suffer in a passive
      manner, men more often tend to be more heroic. It is recommendable to counsel
      occasionally family members of rheumatic patients to diminish stress and to give
      precise informations to protect from over-responsibility.

PMID- 8475348
TI  - [Modern rheumatism surgery: prospects, hazards, results].
AB  - The conservative management of rheumatoid arthritis (RA) the value of which is a
      symptomatic or at best a pathogenetic one, has failed to achieve a decisive
      breakthrough in the past 25 years. By contrast the orthopedic-surgical management
      of RA has proved able to rehabilitate patients who would otherwise gradually lose
      their independence. The close cooperation between rheumatologists and
      orthopedists in specific rheumatoid arthritis centers and the recruitment of
      specially trained therapeutic teams have boosted the recent progress in this
      field. However, the main responsibility for the patient continues to lie with the
      rheumatologist. Operative procedures are only considered when despite a well
      conducted conservative treatment signs of progressive articular destruction
      appear; they do not interrupt the conservative management, but are a completion
      of it. The art of the rheumatology-surgeon reveals itself in his ability to set
      up a clear-cut therapeutic plan with priorities. In particularly complex cases
      the indication will require a team discussion, which includes the occupational
      therapist who has previously assessed the patient's handicap in the performance
      of ADL and will be centered around the patient, whose motivation is of crucial
      importance to the success of our efforts. Throughout the many years of active
      practice and by performing thousands of operations--preventive (e. g.
      synovectomies) as well as reconstructive ones (e. g. arthroplasties)--we have
      gained a vast experience in different operative procedures, which we have come to
      divide into three categories. Whenever possible we start with an operation
      regarded as particularly promising, thus overcoming the patient's understandably
      reserved attitude towards surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475349
TI  - [Value of physiotherapy in chronic rheumatoid arthritis].
AB  - The main reasons for the importance of physiotherapy in treatment of rheumatoid
      arthritis are the biomechanical and neurophysiological factors, influencing not
      only joint function but also trophism. The dependence of the mechanical
      structural differentiation of all parts of the joint from the regular practical
      usage, which is clinically obvious and can be pathophysiologically explained,
      enables us to use successfully all types of functional therapies. The treatment
      principle of calisthenics and ergotherapy must always again be derived from the
      therapy-relevant principles of joint physiology: the requirement of normal joint
      sensory; physiological instability; continuous activity for nutrition and
      structural differentiation; taking into consideration receptor sensitization
      during arthralgia; therapeutic usage of regeneration potency within its limits;
      and to avoid the unphysiological of an arthritis. The sketchy presentation of the
      hand's biomechanic lets us recognize easily the generation and prophylactics of
      the most important deformities: the so-called zig-zag deformities--button hole,
      swan neck, scoliosis of the hand, the subluxation, particularly those towards
      palmar, and the radial deviation of the carpus. In praxis we are searching for
      stabile joint positions, and we try to avoid lax joint positions to transmit
      force; also we are looking for early recognition of subluxations resp.
      deformities to train the joints, to fight reflex-dystrophic after-pain, the usage
      of orthotic devices, and finally treatment resp. prophylactics of contractures.
      Also part of physiotherapy are supporting and accompanying passive
      physiotherapeutic measures, therapeutic sport and handling of chronic states of
      pain. The sense and importance of all three supporting each other therapeutic
      concepts, will also be pointed out.

PMID- 8475350
TI  - [Diagnosis and therapy of Lyme arthritis].
AB  - Several distinct patterns of rheumatic manifestations can be seen throughout the
      course of Lyme borreliosis: intermittent and migratory musculoskeletal pain
      without objective findings, intermittent arthritis, chronic erosive arthritis,
      and joint deformities under affected skin in acrodermatitis chronica atrophicans.
      Commonly, Lyme arthritis is a late disease manifestation. A clinical history of
      extra-articular disease manifestations is the most reliable key to Lyme
      arthritis. However, arthritis often occurs without antecedent early-disease
      manifestations. The diagnostic significance of serological findings suggesting
      Lyme arthritis must be considered carefully with regard to the typical clinical
      features of Lyme arthritis and its potential differential diagnoses. Otherwise,
      Lyme arthritis will be frequently over-diagnosed. Lyme arthritis can be cured
      with antibiotics. However, treatment failures occur with any of the hitherto
      recommended regimens.

PMID- 8475351
TI  - [Acute-stage para- and tetraplegia].
AB  - A quarter of a century ago, in October 1964, the first spinal cord injury center
      in Switzerland was opened at Geneva University Hospital. At that time all para-
      and tetraplegics were classified as "high-risk" patients. Early mortality,
      covering the initial four weeks following trauma, was still around 15%. The
      available resources for diagnostic assessment were limited to clinical
      examination and neuroradiological assessment (subsequently improved by the
      introduction of tomography and gas myelography). A great many patients suffered a
      deteriorated neurological level due to inadequate, multiple transfers between
      hospitals. Most patients who are paralyzed following a road-traffic accident show
      severe polytrauma. Their chances of survival and functional recovery have greatly
      improved in recent years due to efficient emergency transport by helicopter,
      admission to an intensive care unit (respiratory therapy, prophylactic
      anticoagulation, gastrointestinal cytoprotection, prevention of pressure sores,
      etc.) and a comprehensive medico-surgical team approach (orthopedic surgeons,
      neurosurgeons, ICU specialists, internists, etc.). Evaluation of the spine and
      spinal cord by NMR and CT scan allows precise assessment of the extent of CNS
      damage and provides additional guide-lines regarding efficient surgical
      reposition and spinal fusion. Ongoing experimental research in neurophysiology
      and neurobiochemistry of the brain and spinal cord is presently yielding some
      interesting results which hold out new hopes for functional recovery in some
      specific types of incomplete spinal cord trauma.

PMID- 8475352
TI  - Pathophysiological alterations in the central nervous system due to trauma.
AB  - Neurotrauma is the largest cause of death and severe disability in young adults.
      In this review, the pathophysiological processes which damage the brain and
      spinal cord, both acutely, and hours to days after injury, are discussed.
      Secondary, delayed damage is the major cause of bad outcome in at least 40% of
      patients, with severe head injury. Diffuse damage to axons, hypoxic-ischaemic
      damage to neurons and astrocytes, contusions, intracranial haematomas, and brain
      swelling are discussed. The prospect for improving outcome by pharmacological
      therapy, and the current status of head injury trials are presented.

PMID- 8475353
TI  - [Role of isotope methods in the evaluation of cardiac function in intensive
      care].
AB  - Radioisotopic cardiac investigation techniques still have a limited role in
      intensive care units, mainly due to cumbersome traditional equipment, even if in
      some cases favourable local circumstances exist, such as the proximity of a
      nuclear medicine unit or the availability of a mobile gamma camera. Nevertheless,
      nuclear techniques show a number of interesting features, mainly related to the
      fact that measurements of cardiac chamber volumes and of their variations can be
      directly derived from activity counts, without any geometrical hypothesis as it
      is necessary for other methods such as contrast angiography or echocardiography.
      The whole cardiac cycle (its systolic part as well as its diastolic part) can
      therefore be evaluated. In addition, since the blood pool labelling remains
      stable for a long period after a single tracer injection, continuous monitoring
      of critically ill patients becomes possible. In this case it is no longer the
      gamma camera imaging system which may be used but rather a very sensitive
      miniature detector associated with a computerized data acquisition system,
      allowing beat-by-beat assessment of cardiac activity. The development of this
      device raises specific problems related to detection geometry, elimination of
      extracardiac background and stability of the probe positioning on the patient's
      thorax, but it is clear that such a system merits its place in an intensive care
      unit in the near future.

PMID- 8475354
TI  - Imaging strategies in the detection and evaluation of ARDS.
AB  - Considerable evidence has accumulated indicating that the chest radiograph is the
      most reliable imaging technique to evaluate the severity of lung edema in
      patients with established ARDS. Recently, the radiographic approach has been
      validated by direct comparison of an x-ray score of edema with the densitometric
      analysis of lung CT scan images. CT scanning may prove useful in quantitating the
      amount of residual healthy lung and in evaluating the effectiveness of PEEP in
      patients with acute respiratory failure. The application of CT scanning in these
      patients should be further expanded. Special effort should be made to evaluate
      unanesthetized, spontaneously breathing patients and to correlate CT quantitative
      data with the simultaneous analysis of portable chest radiographs in order to
      enhance the physician's ability to extract valuable, physiologic information from
      the chest film in critically ill patients. In order to improve the survival rate
      of patients with ARDS, methods are needed which detect ARDS at its earliest
      clinical stage. A number of radioisotopic techniques have been developed, based
      on the evaluation of the leakiness of the alveolar-capillary barrier either from
      the vascular or from the airspace side. Clearance of aerosolized DTPA from
      airspaces, although extremely sensitive, is not specific for ARDS in as much as
      factors other than lung injury may equally affect the rate of DTPA clearance from
      the lung. External detection of transvascular protein flux may serve as
      noninvasive means to assess the integrity of the lung microvascular endothelial
      barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475355
TI  - [Imaging in blunt abdominal trauma].
AB  - Sonography has largely replaced peritoneal lavage in the initial evaluation of
      blunt abdominal trauma. Computed tomography is the imaging modality of choice for
      further evaluation of hemodynamically stable patients. It can be used effectively
      to visualize multiple injuries in various anatomic regions in one single study.
      CT is particularly helpful in detecting intra- or retroperitoneal hemorrhage and
      in defining the extent of injuries to the spleen, the liver, and the kidneys.
      Traumatic injuries to the pancreas, bowel, and mesentery can be assessed.
      Angiography plays a major role in the diagnosis and therapeutic embolization of
      exsanguinating hemorrhage associated with pelvic fractures.

PMID- 8475356
TI  - Treatment of septic shock with antibodies to tumour necrosis factor.
AB  - The high mortality associated with septic shock has prompted intensive study of
      the pathophysiological basis of this syndrome in an effort to better understand
      the processes that lead to tissue injury. One important outcome of this work has
      been the recognition that the cytokine tumour necrosis factor (TNF) is an
      important mediator of endotoxin-induced lethality. Accordingly, studies were done
      which showed that antibodies to TNF could protect animals from death in a variety
      of model systems, and based on these findings, clinical studies were initiated.
      This paper reviews the present status of clinical trials of anti-TNF in sepsis.
      These antibodies appear to be safe, and preliminary experience suggests that they
      may be effective in some patients with the sepsis syndrome. A final assessment of
      efficacy must await the large, placebo-controlled trials that are now in
      progress.

PMID- 8475357
TI  - [Hemodynamic improvement during therapy using the intravascular oxygenator
      (IVOX)].
AB  - The intravascular oxygenator (IVOX) is a new device which is implanted in the
      vena cava sup. and inf. where it oxygenates the blood and removes CO2. We report
      on its successful use in a young patient with severe pneumonia. This 21-year-old
      female was admitted to hospital with acute respiratory distress due to
      pneumococcal pneumonia and sepsis following chickenpox. Considering the rapidly
      progressive course with severe hypoxia and shock, PaO2/PaCO2 values of 6.5/6.4
      kPa on mechanical ventilation with an FiO2 of 1.0 and a PEEP of 13 mbar, we
      decided to implant an intravascular oxygenator. Besides rapid improvement of
      oxygenation, we observed remarkable recovery of cardiovascular function such as
      an increase in mean arterial pressure and mixed-venous saturation, while the dose
      of vasopressors could be decreased. The intravascular oxygenator was removed
      without problems after 29 days of continuous use, when pulmonary function allowed
      an FiO2 of 0.45. The patient was discharged from the intensive care unit after 99
      days in a good neurological and stable cardiovascular state.

PMID- 8475358
TI  - [Unexpectedly prolonged thrombin time].
AB  - The thrombin time assay is able to detect abnormalities of the terminal phase of
      plasmatic coagulation. The differential diagnosis of thrombin time prolongation
      includes (1) inhibition of the added thrombin by exogenous heparin or endogenous
      heparin-like anticoagulant, seldom by acquired antibovine thrombin antibodies,
      (2) qualitative fibrinogen disorders (congenital and acquired dysfibrinogemia,
      (3) quantitative fibrinogen disorders (hypo- and afibrinogenemia), and (4)
      delayed fibrin polymerization due to fibrin/fibrinogen degradation products,
      paraproteins or seldom acquired antibodies against fibrinogen.

PMID- 8475359
TI  - [Closure of patent ductus arteriosus using interventional catheterization].
AB  - Percutaneous closure of patent ductus arteriosus can be performed with the
      Rashkind technique. This procedure has been performed in 16 patients in Geneva
      since 1989. The age of the patients varied from 2 to 44 years (4 boys, 7 girls,
      and 5 women). Pulmonary hypertension was present in only 1 child. A 12 mm
      Rashkind umbrella was used in 11 patients with ductus of < or = 4 mm inner
      diameter, while a 17 mm umbrella was used in 5 cases for larger ducts. Ductus
      closure was carried out through a transvenous femoral approach in 15 cases, while
      in 1 patient a transarterial approach was employed because of impossibility of
      passing the ductus from the pulmonary artery. There was neither mortality nor
      morbidity in this series. The aortography performed just after device placement
      showed total ductus occlusion in 8 patients and partial closure in 8 others. The
      follow-up by color Doppler showed disappearance of the residual shunt in 4 of
      these 8 patients. Prophylaxis of bacterial endocarditis is therefore no longer
      necessary in 13 patients with complete ductus closure. Our experience with this
      technique confirms its efficacy and the possibility it offers of avoiding
      thoracotomy in the vast majority of patients with a patent ductus arteriosus.
      Further miniaturization of the device and delivery system should make it
      applicable in the neonatal period.

PMID- 8475360
TI  - [Long-term effect of amiodarone therapy following myocardial infarct in patients
      with complex ventricular arrhythmias].
AB  - In the BASIS study, an improvement in 1 year survival of patients with
      asymptomatic complex ventricular arrhythmias with low-dose amiodarone was shown
      in comparison with an untreated control group. To assess whether this beneficial
      effect would last for a longer follow-up despite discontinuation of amiodarone
      therapy after one year, we assessed long-term survival and mode of death in the
      91 survivors of the first year in the amiodarone treatment group and the 99
      survivors in the control group by phone calls to private physicians, patients and
      hospitals. During a median follow-up of 72 (55-125) months, 184/193 patients
      (95%) could be reached. Causes of death during the follow-up were sudden (6 vs
      14), non-sudden cardiac (8 vs 9), non cardiac (5 vs 9) and unknown (7 vs 6) in
      patients initially treated with amiodarone versus the control group respectively.
      The probability of death after 84 months was 30% in the amiodarone group and 45%
      in the control group, and was significantly lower in amiodarone treated patients
      with respect to all deaths (p = 0.024) as well as cardiac deaths (p = 0.027).
      This mortality reduction was only due to amiodarone treatment during the first
      year after the index infarction, whereas the survival curves did not differ
      significantly during the late follow-up. Thus, the risk of cardiac death is low
      after the first year after myocardial infarction and may not justify continued
      antiarrhythmic therapy in patients with initially complex asymptomatic
      ventricular arrhythmias.

PMID- 8475361
TI  - [Prenatal diagnosis of arrhythmias and associated congenital cardiac
      abnormalities using ultrasonography].
AB  - Cardiac arrhythmias are one of the most frequent indications for a 2D and Doppler
      fetal echocardiographic assessment (DE). If accompanied by a non-immune fetal
      hydrops, arrhythmias (A) involve an increased risk of intrauterine death. Some A
      and mainly the bradyarrhythmias (BA) can be the first sign of major cardiac
      malformation (CM). In a series of 404 pregnancies between week 17 and 40 of
      gestation (mean 27.6 weeks), a Doppler echocardiography was carried out; in 137
      (35%) fetuses (F) this examination was based on the indication of arrhythmia. 33
      (24.2%) of these fetuses showed a cardiac malformation. Bradyarrhythmias were
      found in 20 F; 5 had a complete AV-block including, 4 with an important cardiac
      abnormality (TU, complete AV-canal, corr. TGV). SVT's and auricular flutters (AF)
      made transplacental treatment necessary in 4 fetuses (1 AF, 3 SVT); they had no
      major cardiac malformation. PAC's were present in 59 pregnancies of which several
      had minor or major anomalies. Doppler echocardiography served to define the
      arrhythmia and the structural cardiac malformation, but also to follow
      transplacental treatment. These investigations have allowed us to schedule
      delivery under neonatal surveillance. After birth, 5 neonates had to be treated
      for persistent dysrhythmia (5 SVT, 2 complete AB-blocks), and 10 for a major
      cardiac malformation.

PMID- 8475362
TI  - [Acetylsalicylic acid-induced generalized pustulosis].
AB  - We report the case of a 55-year-old patient with recurrent episodes of
      generalized pustulosis and febrile temperatures. Histological examination
      revealed subcorneal and spongiform pustules. After a 4 years' course acute
      exanthematous generalized pustulosis, induced by acetylsalicylic acid was
      diagnosed. Clinical features, differential diagnosis and causative agents of this
      rare drug reaction are discussed.

PMID- 8475363
TI  - [Oxygen therapy and prematurity: lessons from the past].
AB  - The history of oxygen therapy in the newborn clearly demonstrates the importance
      of the methodology used in clinical research. It has revealed the tragic mistakes
      which haunt every clinician confronted with pathology of unknown etiology. It has
      allowed us to determine the relative strength of the methods used in the search
      for various etiologies: passive or active observation, retrospective or
      prospective study and prospective randomized controlled trial. In addition,
      history has illustrated the danger of utilization of statistical tests in the
      absence of controlled interventions. The aim of this paper is to familiarize the
      practising physician with the basic concepts of epidemiology. This should allow
      him to be a better judge of the quality of recommendations made by "authorities".
      In the future, clinical epidemiology should be an essential part of medical
      training.

PMID- 8475364
TI  - [Concerning:"Moderate Paget's disease treated with pamidronate (ADP): experience
      in 43 patients with a single 60 mg perfusion of various duration of 1-to-24
      hours" by D. Thiebaud at al. (Schweiz. med. Wschr. 1992; 122:1889-1894)].

PMID- 8475365
TI  - Determination of chromium in blood and serum: evaluation of quality control
      procedures and estimation of reference values in Danish subjects.
AB  - This paper describes analytical methods to estimate environmental and
      occupational exposure levels of chromium in blood and serum by Zeeman atomic
      absorption spectrometry. Also reported is an internal quality control procedure
      involving a combination of an online quality control and subsequent statistical
      evaluation of the quality control results to evaluate the performance of the
      analytical methods. The solubilization of the blood by the proteinase Subtilisin
      A resulted in a recovery of chromium of 106 +/- 4.5%; the uncertainty was
      approximately 10% at a chromium level of 1 microgram l-1. The detection limit
      (LOD) for chromium in serum was 0.17 micrograms l-1 and 0.20 micrograms l-1 for
      chromium in blood. The LODs were sufficiently low for the determination of
      chromium in a large fraction of reference populations not occupationally exposed.
      The present study indicates that reference values for chromium in blood and serum
      are low but within the range in recent investigations, i.e. 0.04-0.35 micrograms
      l-1 in serum and 0.12-0.34 micrograms l-1 in human whole blood. The fraction of
      reference values below LOD was between 0.45 and 0.57 for chromium in serum and
      blood. Consequently, the reference populations were described by distribution
      free one-sided tolerance intervals and the precision of the estimation of the
      tolerance intervals was expressed as coverage intervals. The 95% one-sided
      tolerance limit calculated for chromium in serum was 0.60 micrograms l-1 with the
      coverage interval (95 +/- 4.8) percent at a probability of 0.95. Thus, the
      probability was 0.975 that the tolerance interval covers at least 90.2% of the
      distribution. In addition, the probability was 0.025 that the tolerance interval
      covers more than 99.8% of the population. It was only possible to calculate the
      90% tolerance interval for chromium in blood with the coverage interval at 0.90
      probability. The one-sided tolerance interval for chromium in blood was 0.37
      micrograms l-1 with the coverage interval (90 +/- 9.9) percent at a probability
      of 0.90.

PMID- 8475366
TI  - Dietary intake of copper, chromium and zinc in Tarragona Province, Spain.
AB  - The dietary intake of copper, chromium, and zinc from foods in Tarragona Province
      (NE Spain) was determined by means of two different methods: the total diet study
      and the duplicate diet study. In the total diet study, a total of 375 food
      samples were analyzed, whereas duplicates of food consumed weekly by 20 families
      were analyzed for copper, chromium and zinc concentrations. Pulses were the group
      with the highest levels of the three elements; vegetables and fruits which are
      basic items in the 'Mediterranean diet', contained low concentrations of these
      metals. Total intakes of copper, chromium and zinc were 1156.3, 124.6 and 7522.9
      micrograms day-1, respectively. On the other hand, the total intake of the
      elements obtained through the duplicate diet study was 1119.8 micrograms day-1
      for copper, 129.0 micrograms day-1 for chromium, and 6800.1 micrograms day-1 for
      zinc. The daily intake of copper and zinc by the population of Tarragona Province
      is lower than the usually recommended values, while the intake of chromium is
      closer to those values.

PMID- 8475367
TI  - Leaded windows as a source of lead within homes.
AB  - Corrosion of 'cames', i.e., the lead binding or decorative strips in leaded
      windows, is a significant, but previously unreported source of lead within older
      homes. Surfaces close to the leaded windows are highly contaminated with lead but
      the content of lead in dust diminishes rapidly within the first 2 m away from the
      window and is minimal after 3 m. The dust near the window was identified, using X
      ray diffraction, as mainly composed of basic lead carbonate. Condensation water
      on leaded windows contains appreciable lead whereas for unleaded windows it is
      negligible. The exterior surface of unleaded windows contains more lead than the
      interior surface but the converse is true for leaded windows. A laboratory
      simulation suggested that corrosion by window condensate was likely to be the
      principal mechanism by which lead entered the home environment.

PMID- 8475368
TI  - Contributions of risk factors to elevated blood and dentine lead levels in
      preschool children.

PMID- 8475369
TI  - Analysis of chlorophenoxy acids and other acidic contaminants in food crops.
AB  - Several chlorophenoxy acids and chlorinated phenols were determined by means of
      gas chromatography in contaminated samples of cereals. Extraction of plant matrix
      with acetone/water mixture followed by alkaline hydrolysis was proved to be
      suitable for isolation of both free and conjugated residues. The use of
      pentafluorobenzyl bromide for volatilization of analytes, despite of enhanced ECD
      response, cannot be recommended for routine analysis. Methylation with either
      methanol/sulphuric acid or methanol/BF3 reagent can substitute diazomethane-based
      esterification procedure. Mass fragmentography provided the highest selectivity
      of detection, moreover good sensitivity--5 ppb--was achieved in this way. Even
      methyl derivatives of monochlorinated analytes could be, contrary to GC/ECD
      analysis, quantitated at this level.

PMID- 8475370
TI  - Pesticide residues in food in Switzerland.
AB  - Every year, official Swiss laboratories are involved in the analysis of about
      8000 food commodities in the context of pesticide residue surveys. Between 90 to
      100 different active ingredients are found normally in total foodstuffs analysed
      and more than 6% of the investigated samples have a contamination level exceeding
      the federal tolerance limits. No real improvement in what concerns the quality of
      food with respect to pesticide contamination has been observed these last years.

PMID- 8475371
TI  - Study of multi-residue methods for the determination of selected pesticides in
      groundwater.
AB  - A study of different multi-residue methods for the determination of pesticides in
      groundwater samples was made by comparing several extraction procedures which
      included liquid-liquid partitioning and solid-phase extraction. The effect of
      extraction conditions, such as organic solvent, volume ratio, addition of NaCl
      and pH, were studied. Recoveries, detection and determination limits, as well as
      precision of the procedures for several replicates were obtained. The pesticides
      studied were selected taking into account their application on citrus groves in
      the Plana of Castellon (Spain). These compounds included organochlorine
      pesticides (lindane, dicofol, chlorfenson and tetradifon), organophosphorous
      (dimethoate, fenitrothion and methidathion) and phenoxyacid herbicides (MCPA and
      2,4-D). Analysis were carried out by high resolution gas chromatography using a
      dual detection system (ECD and NPD), as well as by high performance liquid
      chromatography (HPLC) with UV detection. This procedure was applied to several
      groundwater samples from Castellon province (Spain).

PMID- 8475372
TI  - Determination of phenoxyacid herbicides in drinking water at the ppt-level by
      liquid chromatography and on-line selective preconcentration.
AB  - On-line precolumn sample handling using an anion-exchanger is applied to
      preconcentrate phenoxyacid herbicides in aqueous samples prior to their LC
      separation. Since direct percolation of large sample volumes through the ion
      exchanger has to be avoided owing to the high content of inorganic anions in
      natural waters, a two-step preconcentration is carried out: phenoxyacids are
      concentrated in their neutral (acidic) form by percolation of natural samples at
      pH 1 first through a precolumn packed with the copolymer-based PRP-1 sorbent.
      Then, the PRP-1 precolumn is coupled on-line with a second one packed with the
      anion-exchanger and 3 ml of deionised water with 35% of acetonitrile allows the
      phenoxyacids to be desorbed from the PRP-1 sorbent and reconcentrated on the
      anion-exchanger in their ionic form. The content of the anion-exchanger is
      analysed on-line by coupling with a C18 analytical column and elution is made
      with a water-acetonitrile gradient. Detection limits in drinking water from a 500
      ml sample are between 15 and 35 ng/l (ppt) and identity of phenoxyacids is
      reinforced by the fact that analytes are preconcentrated by the anion-exchanger.
      This methodology can be fully automated.

PMID- 8475373
TI  - Mutagenic and carcinogenic pesticides used in the agricultural environment of
      Gaza Strip.
AB  - More than 100 metric tons of formulated pesticides (about 75 pesticides) are used
      annually in Gaza Strip. It was found that 19 of these pesticides, that have been
      used, are internationally suspended, cancelled and banned pesticides. About 1100
      cases of cancer have been registered in Gaza Strip (1979-1983). The distribution
      of cancer types among those patients are lymphoma and hematological malignancy,
      breast, head and neck, gastrointestinal malignancy, reproductive system, urinary
      system, soft tissue tumors, brain tumors and others. Consequently, the
      introduction and heavy use of pesticides and other toxic substances in the Gaza
      Strip environment is suspected to correlate with the growing incidence of cancer
      and other abnormalities in the nation. Precise determination of the effects of
      chronic exposure is, therefore, urgently needed.

PMID- 8475374
TI  - Direct injection into the HPLC column for monitoring the behaviour of xenobiotics
      in biological media. II. Behaviour of cymoxanil in fungus and locust and of E
      destruxin in locust.
AB  - Multidimensional chromatographies (MDC) implying either a single column with an
      unique packing designed for providing several separation modes such as internal
      surface reversed-phase (ISRP), or C1 large pores particles, or multi-column
      switching technique using the previous supports as guard columns, allow fast and
      easy direct monitoring of pesticides into plant or animal biological media. In
      such a way, the comparative study of the agricultural fungicide cymoxanil in two
      strains of Botrytis cinerea of different sensitivities gave concordant
      conclusions with the previous work using radiolabelled cymoxanil and TLC.
      Moreover, as a comparison, a study of the metabolism of this xenobiotic was also
      followed in animal biological fluids likely to contain peptidases. In locust or
      lobster haemolymph, an unusual isomerization into a cyclic compound was thus
      demonstrated accompanying the classical peptidase-depending metabolism generally
      observed in plants. The same chromatographic approaches were tested and compared
      for monitoring the metabolism of the natural insecticide toxin E-destruxin in
      insects. A detoxication process leading to the less toxic E-diol destruxin was
      evidenced in the organs or haemolymph of the locust Locusta migratoria chosen as
      a model of non-target insects.

PMID- 8475375
TI  - The use of biological methods for pesticide monitoring.
AB  - Since it has been recognized that analytical surveillance of surface waters for
      pesticides is very expensive, time consuming and does not allow a complete
      characterization of all parent compounds and their metabolites, it is proposed to
      employ aquatic organisms for screening water samples on the basis of their
      toxicity. Toxic effects on target organisms should indicate the occurrence of
      specific classes of pesticides, in this way helping the analyst in the choice of
      analytical procedures. This approach was tentatively applied to river Po waters
      (Italy) in order to evaluate the contribution of different classes of pesticides
      to global river pollution.

PMID- 8475376
TI  - Optimization of a monoclonal antibody-based enzyme immunoassay for the detection
      of terbuthylazine.
AB  - The application of immunoassays in pesticide residue analysis is of increasing
      interest due to the sensitivity, simple handling and fast throughput of samples.
      For a wide application of these assays, a sufficient supply of standardized
      antibodies over a long period of time is necessary. The monoclonal antibody
      technology is solving this problem with an increasing number of cell lines which
      produce antibodies against different pesticides. Hybridomas were produced by cell
      fusion of spleen cells from mice immunized with dichloroatrazine conjugated to
      bovine serum albumin and mouse myeloma cells (PAI-B3 Ag8I). After screening with
      a competitive enzyme immunoassay, a monoclonal antibody that was specific for
      terbuthylazine and was produced by a permanent hybridoma cell line was selected
      for immunoassay development and optimization. For this purpose, an antigen- and
      antibody-immobilized ELISA technique was improved by varying the test parameters.
      Comparing both methods, the latter turned out to be superior (50% binding = 0.8
      microgram/l, detection limit = 0.14 microgram/l).

PMID- 8475377
TI  - DNA fingerprinting report.

PMID- 8475378
TI  - DNA fingerprinting report.

PMID- 8475379
TI  - Drug companies join forces in search for AIDS therapy.

PMID- 8475380
TI  - NIH budget. A new kind of earmarking.

PMID- 8475381
TI  - PCR enzyme patent challenged.

PMID- 8475382
TI  - Secrets of secretion revealed.

PMID- 8475383
TI  - Molecular basis for specific recognition of both RNA and DNA by a zinc finger
      protein.
AB  - Transcription factor IIIA (TFIIIA) from Xenopus oocytes binds both the internal
      control region of the 5S ribosomal RNA genes and the 5S RNA transcript itself.
      The nucleic acid binding domain of TFIIIA contains nine tandemly repeated zinc
      finger motifs. A series of precisely truncated forms of this protein have been
      constructed and assayed for 5S RNA and DNA binding. Different sets of zinc
      fingers were found to be responsible for high affinity interactions with RNA and
      with DNA. These results explain how a single protein can exhibit equal affinities
      for these two very different nucleic acids.

PMID- 8475384
TI  - Knotting of a DNA chain during ring closure.
AB  - The formation of knotted species on random ring closure of two DNAs that are 5.6
      kilobase pairs (kbp) and 8.6 kbp in length was measured, and these data were used
      to calculate the effective DNA helix diameter as a function of sodium ion and
      magnesium ion concentration. In the presence of more than 50 mM magnesium ion,
      interactions between DNA segments appear to be attractive rather than repulsive.
      The free energy of formation of relaxed trefoil and figure-eight DNA knots and of
      supercoiled trefoil DNA knots was also evaluated.

PMID- 8475385
TI  - Negative regulation of G1 in mammalian cells: inhibition of cyclin E-dependent
      kinase by TGF-beta.
AB  - Transforming growth factor-beta (TGF-beta) is a naturally occurring growth
      inhibitory polypeptide that arrests the cell cycle in middle to late G1 phase.
      Cells treated with TGF-beta contained normal amounts of cyclin E and cyclin
      dependent protein kinase 2 (Cdk2) but failed to stably assemble cyclin E-Cdk2
      complexes or accumulate cyclin E-associated kinase activity. Moreover, G1 phase
      extracts from TGF-beta-treated cells did not support activation of endogenous
      cyclin-dependent protein kinases by exogenous cyclins. These effects of TGF-beta,
      which correlated with the inhibition of retinoblastoma protein phosphorylation,
      suggest that mammalian G1 cyclin-dependent kinases, like their counterparts in
      yeast, are targets for negative regulators of the cell cycle.

PMID- 8475386
TI  - Regulation of TCR signaling by CD45 lacking transmembrane and extracellular
      domains.
AB  - The CD45 protein is a transmembrane tyrosine phosphatase that is required for
      normal T cell receptor (TCR)-mediated signaling. A chimeric complementary DNA
      encoding the intracellular enzymatically active portion of murine CD45 preceded
      by a short amino-terminal sequence from p60c-src was transfected into CD45- T
      cells. Expression of this chimeric protein corrected most of the TCR signaling
      abnormalities observed in the absence of CD45, including TCR-mediated enhancement
      of tyrosine kinase activity and Ca2+ flux. Thus, the enzymatically active
      intracellular portion of CD45 is sufficient to allow TCR transmembrane signaling.

PMID- 8475387
TI  - Rescue of signaling by a chimeric protein containing the cytoplasmic domain of
      CD45.
AB  - Surface expression of the CD45 tyrosine phosphatase is essential for the T cell
      antigen receptor (TCR) to couple optimally with its second messenger pathways.
      CD45 may be required to dephosphorylate a TCR-activated protein tyrosine kinase,
      which then transduces an activation signal from the TCR. A chimeric molecule that
      contained extracellular and transmembrane sequences from an allele of a major
      histocompatibility class I molecule and cytoplasmic sequences of CD45 restored
      TCR signaling in a CD45-deficient mutant T cell line. Thus, expression of the
      complex extracellular domain of CD45 is not required for the TCR to couple to its
      signaling machinery.

PMID- 8475388
TI  - [Structure, physiology and physiopathology of the ureter].
AB  - The function of the ureter is to transport urine from the renal pelvis toward the
      bladder and to protect the renal parenchyma from distally generated backflow and
      back pressure. The ureter manifests peristaltic activity and can adapt its
      mechanical characteristics to diuresis amount. The changes in ureteral function
      resulting from obstruction are dependent on the degree and duration of
      obstruction. Even the rate of urine flow, the mechanical and anatomic properties
      of the ureter, the nature of disease process and the age of the patient influence
      the response of the ureter to obstruction. It is the purpose of this report to
      correlate the anatomic and physiologic properties of the ureter with normal and
      pathologic clinical situations.

PMID- 8475389
TI  - [Ureteral malformations in the adult].
AB  - Ureteral malformations that concern adults are very few. The aim of this review
      is to value the real clinical incidence and to illustrate etiology, diagnosis and
      therapeutical management advised in the literature.

PMID- 8475390
TI  - [Ureteritis].
AB  - We relate our experience about ureteritis, especially non specific ureteritis.
      The traumatic, radiation ureteritis will be discussed in others chapters. Most
      cases of ureteritis are infective, and may be due to any of the organism normally
      found in urinary tract infections, particularly Escherichia Coli, staphylococci,
      streptococci, enterococci, proteus and pyocyaneus. It is really primary, but it
      usually ascending from an associated cystitis, descending from pyelonephritis, or
      due to direct spread from and adjacent inflammatory lesion such as appendicitis
      or salpingitis. The infection may also reach the ureter by lymphatic spread,
      particularly from the prostate and seminal vesicles. Any associated abnormalities
      of the ureter, such as stricture, megaloureter, ureterocele, and so on, will
      naturally predispose to infective ureteritis. As ureteritis is rarely primary,
      the first step in treatment must be toward the elucidation and cure of any
      underlying lesion. Thus calculi, cystitis, pyelitis, and so on, will need
      appropriate therapy, and this in itself will considerably improve or cure the
      ureteritis, and specially in the more acute cases. In the chronic cases with
      stricture formation, dilation or even excision of the stenosed portion may be
      required. For the treatment of the strictures we want emphasize the role of the
      ureteral stenting thinking its use is necessary to preserve the renal function.

PMID- 8475391
TI  - [Primary ureteral neoplasia].
AB  - From 1983 to 1992, 29 patients with primitive ureteral tumors have been recovered
      in our department. All the tumors were urothelial. Urography, spontaneous and
      selective urinary cytology, retrograde ureteropyelography permitted a correct
      diagnosis in 86% of them. Ureteroscopy is not performed routinely but only when
      conventional radiology is doubtful or a conservative treatment can be proposed.
      Controlled trials on endoscopic therapy of ureteral tumours are very few and even
      if our results are encouraging we believe that this therapeutic option is
      effective and safe only in selected case and nephroureterectomy is the treatment
      of choice.

PMID- 8475392
TI  - [Controversies on the subject of traumatic lesions of the ureter].
AB  - The injuries to the ureter, whether from external trauma or iatrogenic, are rare.
      Some problems are common to this type of pathology, independently from the causes
      of injuries. It is necessary a prompt diagnosis of the lesion to avoid the urinar
      leakage, the infection and the fibrosis of the ureteral's stumps. If the
      diagnosis is not prompt, the clinical pattern may be silent for some days; after,
      many complications will arise up: sepsis, urinomas and fistulas. When the lesion
      is incomplete, and there is no devascularization, the urine drainage alone,
      positioned above the level of the lesion, is indicated for spontaneous repairing.
      When the ureteral tissue loss is extensive, it is not enough a simple anastomosis
      between the ureteral's stumps; in these cases is necessary a more complex repair
      surgery or ureteral substitution.

PMID- 8475393
TI  - [Ureteral complications in the treatment of gynecologic diseases].
AB  - Ureteral injuries are an uncommon complication after gynecological procedures.
      The Authors consider separately direct lesions during surgery and those following
      radiotherapy. For both these situations preventive criteria, which permit a lower
      incidence in ureteral injuries, are considered. Early diagnosis and
      intraoperative repair are the most important tool for surgical lesions while the
      exact stage of neoplasm and N.E.D. status are fundamental for lesions resulting
      from radiation therapy. In our opinion, best treatment of stable lesions is
      surgery, while endourology is not usually a definitive treatment and has only a
      temporary and palliative role.

PMID- 8475394
TI  - [The ureter in urinary diversion].
AB  - Ureteral pathology is reviewed in 297 urinary diversions, which were performed
      consecutively in our Department, in the last 9 years. Either cutaneous or
      intestinal anastomosis stricture was the most common complication. Our attempts
      to cure definitely this problem by endourological techniques were unsatisfactory.
      So the Authors conclude that surgery is usually the best option.

PMID- 8475395
TI  - [Controversies concerning the treatment of ureteral complications following
      kidney transplantation].
AB  - The ureteral complications after renal transplantation are urine leakage,
      stenosis and vesicoureteral reflux. The treatment is influenced by
      immunosuppression and difficult surgery (for bleeding and fibrosis). We report 8
      cases with ureteral complication after renal transplantation. Stenosis were
      present in 5 cases: we performed ureterocystoneostomy by Politano-Leadbetter
      technique in 4 and pyelocystoanastomosis in 1. Vesicoureteral reflux were present
      in 3 cases: we preformed ureterocystoneostomy by Politano-Leadbetter technique in
      2 and endoscopic infiltration with teflon of ureterovesical junction in 1. At
      present all patients have a normal renal function and absence of urinary tract
      infection.

PMID- 8475396
TI  - [Idiopathic retroperitoneal fibrosis].
AB  - Idiopathic retroperitoneal fibrosis is generally held to be uncommon. Its
      etiology is unknown. The disease continues to present with early bilateral
      ureteric involvement. Nowadays imaging techniques permit so a timely diagnosis to
      preserve and reduce renal damage. The optimum method of management is still
      controversial. Controversies on pharmacological, endourological and surgical
      treatment are debated. The advantages of various types of surgery are reviewed.
      In the urological department of the Civic Hospital in Brescia from February 1984
      to June 1992, 87 patients (6 females and 2 males) with IRP were observed.
      Surgical treatment was combined with corticosteroids in 6 patients. Ureterolysis
      was performed with omental wrapping in 5 patients, with ureteric
      intraperitonealisation in 2 other ones. In the last case an ileal loop
      replacement was performed. In 5 out of 8 patients the ureteral stricture was
      resected and a termino-terminal anastomosis was necessary. Long-term follow-up is
      satisfactory. The authors conclude that omental wrapping is the safest method of
      choice.

PMID- 8475397
TI  - [The value of sonography in ruptures of the rotator cuff].
AB  - In 375 patients ultrasonography of the rotator cuff was carried out before
      operation. All the patients underwent acromioplasty, either alone or with
      additional repair of a full-thickness tear. The ultrasound findings were then
      compared with the intraoperative findings. Two hundred and seventy-two tears of
      the rotator cuff were seen on ultrasonography, and in 262 cases this was
      confirmed at operation. In 103 patients no rupture was diagnosed by ultrasound,
      but in 26 of these cases a full-thickness tear was detected on operation. These
      figures yield sensitivity of 91%, specificity of 89% and accuracy of 90%; the
      positive predictive value was 96%, the negative predictive value 75%. In most
      cases of incorrect evaluation the size of the tears was underestimated by
      ultrasonography.

PMID- 8475398
TI  - [Nuclear magnetic tomography in shoulder dislocation].
AB  - Sixty-two patients with anterior shoulder dislocations were examined by magnetic
      resonance imaging (MRI). After a primary dislocation, 30 patients showed 23 (77%)
      tears of the glenoid labrum, 13 (45%) anterior-inferior separation of the
      capsula, 24 (83%) Hill-Sachs lesions, 6 fractures of the greater tuberosity and 4
      glenoid rim fractures. Thirty-two patients with recurrent shoulder dislocation
      had 14 (44%) tears and 15 (47%) defects of the glenoid labrum, 16 (50%) anterior
      inferior separation of the capsula, 28 (88%) Hill-Sachs lesions and 3 glenoid rim
      fractures. MRI permits complete non-invasive documentation of glenohumeral
      instability if joint effusion is present. In the absence of joint effusion,
      diagnostic accuracy can be improved by application of a contrast medium.

PMID- 8475399
TI  - [Passive stabilizers of the glenohumeral joint. A biomechanical study].
AB  - Passive glenohumeral joint stability was tested in ten cadaveric shoulder
      specimens, before and after venting of the intra-articular space. Force
      displacement diagrams were measured with anterior, posterior and inferior
      excursion, in the neutral position, in 90 degrees of abduction and in a
      combination of 90 degrees of abduction and 90 degrees of external rotation.
      Displacement at 50 N prior to venting averaged 11.17 +/- 6.48 mm posteriorly,
      7.15 +/- 5.51 mm anteriorly and 3.41 +/- 3.73 mm inferiorly. Venting of the joint
      increased displacement by 47% anteriorly, 49% posteriorly and 61% inferiorly. In
      addition, mathematical model calculation was used to estimate the destabilizing
      force present at the glenohumeral joint capsule during physiological arm motion.
      This force approximated 970 N, clearly more than passive stabilizers alone can
      provide. It is therefore assumed that in addition to passive glenohumeral joint
      stabilization, significant active forces are effective during arm motion.

PMID- 8475400
TI  - [Blood supply to the cervical spinal cord and possible therapeutic consequences
      in cervical spinal cord injuries].
AB  - The study was designed to demonstrate the blood supply to the cervical cord
      through radicular branches and was carried out in 23 human cadavers into which
      preparations were injected by the intra-articular route. One corrosion cast of
      the head and neck showed extravertebral anastomotic pathways. After removal of
      the vertebral bodies and discs from C1 to D3, the anterior spinal artery and
      radicular branches were identified and dissected back to their origins from the
      vertebral, deep or ascending cervical arteries. Twelve preparations had only one
      or two radicular branches reaching the cervical spinal cord. If there is
      traumatic compression of an ascending branch a high risk of ischaemic damage to
      cranial areas of the spinal cord arises. The blood supply to the cervical
      enlargement of the spinal cord was provided by branches of the deep cervical
      artery in eight preparations, but only in one by branches of the vertebral
      artery. We therefore plead for decompression of the anterior spinal artery and
      the spinal cord and for sufficient arterial blood pressure, and give our reason
      for these demands.

PMID- 8475401
TI  - [The course of intracranial pressure during respirator weaning after severe
      craniocerebral trauma].
AB  - To analyze the characteristics of hemodynamic parameters and cerebral dynamics,
      the courses of intracranial pressure (ICP), cerebral perfusion pressure (CPP),
      mean arterial blood pressure (MAP) and PaCO2 were analyzed retrospectively in 29
      patients with severe head injury, comparing periods before and after the
      ventilatory mode was changed from controlled mechanical ventilation to
      spontaneous breathing with continuous positive airway pressure. Measurements were
      done before and after changing of the ventilation. Patients were allocated either
      to group I (n = 22, ICP remained stable: 18 +/- 2 mm Hg in both periods of
      observation) or group II (n = 7, ICP increased from 25 +/- 3 mm Hg to 33 +/- 4 mm
      Hg, P < 0.05). While changes of MAP did not reach significant levels in either
      group, concomitant changes in CCP appeared in group II (67 +/- 2 mm Hg to 60 +/-
      2 mm Hg). Based on the observation of relatively high incidence of ICP increases
      and deterioration of CPP during weaning from ventilator, it is recommended that
      continuous ICP monitoring should be continued.

PMID- 8475402
TI  - [Repeated routine determination of pulmonary microvascular permeability after
      polytrauma].
AB  - We present a technique to measure pulmonary microvascular permeability for
      albumin in patients with multiple trauma by means of bronchoalveolar lavage
      (BAL). Routine laboratory tests for the analysis of BAL fluids are used. The
      results were clinically validated in 10 healthy volunteers and 12 patients with
      multiple trauma in a first prospective study. Additionally, another 11 severely
      traumatized and 24 less traumatized patients were evaluated in a second
      prospective study. Normal values (> 0.09 +/- 0.02), posttraumatic physiological
      ranges (< 0.35), and a "high risk" range (> 0.5) for pulmonary microvascular
      permeability for albumin were developed. There was a high correlation between the
      first posttraumatic values of pulmonary microvascular permeability and the
      required duration of intensive care treatment (r = 0.81), the duration of
      continuous mandatory ventilation (r = 0.78) and the mean lung injury score by
      Murray (r = 0.76). We conclude that the presented method is harmless and useful
      to describe the post-traumatic course of pulmonary microvascular permeability.

PMID- 8475403
TI  - [Rupture of the anterior cruciate ligament. Current status of treatment].
AB  - This article summarizes the present knowledge on the diagnosis of and treatment
      rationales for ruptures of the anterior cruciate ligament (ACL) of the knee.
      There is an increasing incidence of this injury due to the high number of persons
      involved in dynamic sports. The most significant diagnostic criterion is a
      positive pivot shift associated with a pathological anterior translation of the
      tibia in slight flexion of the knee. Instrumented testing of the knee is becoming
      increasing important and is standard in follow-up studies. A survey of the
      literature at present delineates very clearly the importance of an intact ACL for
      homeostasis of the knee. Loss of this structure leads to a high incidence of
      secondary meniscus tears with consecutive osteoarthritis of the knee. All valid
      studies also indicate an involuntary decrease of activity in the patients after
      loss of the ACL. Risk factors for early decompensation of the knee are a young
      age, high activity level, rupture of the collateral ligaments, congenital laxity,
      varus morphotype and high initial laxity. Primary repair of the ACL is possible,
      but results in stable ligament healing in only a limited percentage of cases.
      Reconstruction of the ACL with a free patellar tendon graft has become the
      standard procedure for many surgeons. ACL reconstruction can be performed either
      arthroscopically or through a "miniarthrotomy" with comparable results. Augmented
      repair or reconstruction using autologous flexor tendons is an alternative in
      certain cases. Augmentation with allogeneic material and the use of tendon
      allografts are still experimental and should be restricted to centers that can
      perform strict follow-up studies. The rehabilitation program after implantation
      of a patellar tendon graft can be accelerated markedly without endangering joint
      stability. Crutches are necessary only for the first 2-3 weeks. The success rate
      in terms of objective stability with an autologous patellar tendon graft is high,
      although specific disadvantages such as chronic patellar pain and a risk for loss
      of motion must be considered.

PMID- 8475404
TI  - [Pediatric femoral shaft fracture in the 6-14 year age group. A retrospective
      therapy comparison between conservative treatment, plate osteosynthesis and
      external stabilization].
AB  - The optimal choice between operative and conservative therapy in the treatment of
      femur shaft fractures in school age children remains controversial. Between 1985
      and 1991, 34 children aged 6-14 years were treated in our institution for
      fractures of the femoral shaft: 8 were treated conservatively with traction,
      while 10 underwent plate fixation and 15 external fixation. The 34 cases were
      analyzed retrospectively. In the conservatively treated group a plate
      osteosynthesis become necessary in 2 patients because of delayed union and
      fracture malalignment. Hospitalization was the longest in these children,
      although their concomitant injuries were the least extensive. In the group with
      plating there were no serious complications but open surgery is needed for two
      major operations for insertion and removal. The average time on crutches after
      plate fixation was 56 days. In the group treated by external fixation four
      secondary plate osteosyntheses were performed, two at an early stage because of
      unacceptable fracture malalignment and two others because of fracture instability
      after removal of the fixateur. The stay in hospital was the shortest in this
      group. The 11 children who had been completely managed by external fixation
      achieved walking without crutches in the shortest time, viz. 15 days after the
      operation on average. The average time to removal of the fixateur was 67 days.
      Review was possible in 27 of the 28 children who had been completely managed by
      the initial treatment method. All had unlimited hip and knee motion. Two children
      in the conservative treatment group were seen on radiographical examination to
      have a varus angulation of more than 10 degrees. In the plate and fixator group
      no malalignment was present.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475405
TI  - Targeted drug delivery.

PMID- 8475406
TI  - Clinical pharmacokinetics and pharmacodynamics of anticancer drugs in children.
AB  - Pharmacokinetic variability in children with cancer is substantial and confounds
      drawing conclusions regarding optimal therapy based only on dose-response
      relationships. Careful pharmacokinetic studies performed during drug development
      in conjunction with an assessment of patient characteristics, such as age, renal
      and hepatic function, and concomitant therapy, is essential for defining those
      factors that may alter drug disposition. By integrating pharmacokinetic studies
      with measures of efficacy and toxicity, a pharmacodynamic framework can be
      established for guiding therapy to minimize differences in systemic exposure
      among subpopulations of patients (eg, impaired renal function and neonates). In
      selected instances when pharmacokinetic variability cannot be predicted by
      patient covariates, the potential for individualizing dosages based on patient
      specific pharmacokinetic parameters is now a clinically feasible option. The need
      for and benefits of incorporating such strategies into routine therapy represents
      an exciting area for further clinical research.

PMID- 8475407
TI  - Regional chemotherapy.

PMID- 8475408
TI  - Individualizing dosing of cancer chemotherapy.

PMID- 8475409
TI  - Cancer pharmacology in the elderly.

PMID- 8475410
TI  - Cellular pharmacodynamics of anticancer drugs.

PMID- 8475411
TI  - Drug resistance modulation in the laboratory and the clinic.

PMID- 8475412
TI  - Interactions of chemotherapy and radiation.

PMID- 8475413
TI  - Chemotherapy drug interactions with biological agents.

PMID- 8475414
TI  - New horizons in our understanding of the spinal physiology and pharmacology of
      pain processing.
AB  - Advances in the management of pain are predicated on the development of our
      understanding of the underlying systems. This report briefly reviews the
      peripheral and central substrates that define several mechanisms whereby
      peripheral mechanical, thermal, and chemical stimuli are encoded. Of particular
      interest is the growing appreciation of the changes in spinal function that occur
      with peripheral nerve injury and with repetitive small afferent input. These
      changes may serve to provide insight into a variety of pain states that are
      refractory to conventional management approaches.

PMID- 8475415
TI  - Interpretation of research results.

PMID- 8475416
TI  - Interpoint squared distance as a measure of spatial clustering.
AB  - The expectation and variance for the mean interpoint squared distance are
      presented. In order to evaluate these expressions it is necessary to calculate
      the moments of a bivariate uniform distribution defined over an arbitrary
      polygon. Expressions for these moments are presented, allowing the mean
      interpoint squared distance to be used as a measure of spatial clustering. The
      distribution and power of this test statistic is explored on the unit square, and
      the spatial distribution of 11 cases of non-Hodgkin's lymphoma is investigated to
      illustrate an application of the approach.

PMID- 8475417
TI  - Reporting by parents of longstanding illness in their adolescent children.
AB  - Parents' proxy reports of longstanding illness in their 15 year children are
      compared with the young people's own reports, both overall and between different
      reporting contexts; mother alone, father alone and both parents together. Parents
      over-report longstanding, but not limiting longstanding, illness in comparison to
      self report. There is no evidence of differential over-reporting by reporting
      context, but a number of differences are found in the likelihood of disagreement
      between these reporting contexts. The gender of the young person influences the
      relationship between proxy and self reports.

PMID- 8475418
TI  - Enhancing appropriate drug use: the contribution of herbal medicine promotion. A
      case study in rural Thailand.
AB  - The article presents the results of an exploratory study conducted in Thailand in
      1988, comparing the results of two approaches to encourage the use of herbal
      medicine as a safe and cheap alternative to pharmaceuticals. The study included
      one government programme using a clinic-oriented approach and one non
      governmental programme using a community-oriented approach. Drug use in response
      to illness episodes was surveyed among households in two villages covered by each
      programme and hospital out-patient prescription records were sampled. Herbal
      medicines were used to treat 14.8% and 14.0% of the illness-episodes in the
      villages taking part in the clinic-oriented programme and to treat 62.1% and
      29.7% of the episodes in the villages covered by the community-oriented
      programme. Herbs are mostly used after a prior treatment with pharmaceuticals has
      failed. Only 12.4% of out-patient prescriptions from the hospital in the
      government programme included herbal drugs, compared to 47.3% of prescriptions
      from the hospital in the non-governmental programme. The results of the study
      suggest that a community-oriented approach can most effectively influence the
      pattern of drug use in self-care. Complementary to the community-oriented
      approach, the government should support efforts to change the prescribing
      attitude of physicians and include training in traditional medicine in medical
      curricula.

PMID- 8475419
TI  - Negotiating autism: relations between parents and treatment staff.
AB  - This study examines the relationship between parents of autistic children and the
      treatment centre staff at a state autistic association. There are three main
      points of disagreement between parents and staff including: the prospect of a
      cure, the nature of the child's affection, and the uniqueness of the child and
      how this is related to the possibility of institutionalisation. The nature of
      these disagreements, and the means by which they are negotiated, are examined and
      discussed.

PMID- 8475420
TI  - The impact of childhood living conditions on illness and mortality in adulthood.
AB  - The aim was to explore the relationships between indicators of economic and
      social problems in childhood on the one hand and illness and mortality in
      adulthood on the other. In 1968 a representative sample of the Swedish population
      born 1906-1951 were interviewed about their childhood living conditions, among
      other things. Four indicators of adverse childhood living conditions were
      included. Two of these reflect economic circumstances (economic hardship; a large
      family, defined as four or more siblings), and two reflect social conditions
      (broken family; conflicts in the family). In 1981, 13 years later, this sample
      was re-interviewed. This allows for illness in 1981 to be related to reports of
      childhood conditions given in 1968. A follow-up of mortality for the period 1981
      1984 was also conducted. When one controls for age, sex and father's social
      class, those exposed to economic as well as social problems during childhood are
      found to have a considerably higher risk of being ill as adults. Of the four
      factors analysed, conflicts in the family during upbringing is that most strongly
      related to illness later in life, as well as with mortality. Having a broken
      family, and, to some extent, economic hardship during childhood, are also clearly
      associated with illness later in life. These results also hold true when all four
      factors are included simultaneously in the model, and remain relatively unchanged
      when controlling for mental illness in 1968.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475421
TI  - Socioeconomic disadvantage and child morbidity: an Australian longitudinal study.
AB  - While an extensive body of literature has demonstrated an association between
      socioeconomic status and child mortality, there have been relatively few papers
      which discuss the impact of socioeconomic inequality on child morbidity. This
      absence of data is partly attributable to methodological problems (need for large
      samples, the difficulty of assessing morbidity) and partly to the absence of
      relevant official health statistics. This paper reports results from the Mater
      University of Queensland Study of Pregnancy (MUSP) and its outcomes. The sample
      comprises 8556 consecutive pregnancies, of which over 90% were followed up to
      birth. Of those mothers giving birth, approx. 70% of children were successfully
      given a health assessment five years after the birth (mothers report of the
      child's health using a set of standard indicators). The results indicate a
      consistent pattern with the children of the most socioeconomically disadvantaged
      mothers manifesting the worst health. Thus children living in socioeconomic
      disadvantage have a higher rate of health service utilisation, more chronic
      health problems and poorer dental health. The paper discusses some social
      policies for redressing these inequalities.

PMID- 8475422
TI  - Breastfeeding and weaning in a poor urban neighborhood in Cairo, Egypt: maternal
      beliefs and perceptions.
AB  - Maternal beliefs and perceptions about breastfeeding and weaning were
      investigated in a series of in-depth, open-ended interviews with 20 mothers of
      infants aged 2-12 months in a poor neighborhood of metropolitan Cairo during July
      September 1990. The traditional pattern of breastfeeding well into or through the
      second year of life is changing rapidly, although essentially all mothers still
      wish to breastfeed and do so at least initially. Beliefs and behaviors reported
      varied somewhat by rural/urban origins of the mother herself, but exhibited
      consensus on many issues. The ability to breastfeed successfully is perceived to
      be a blessing, and to require maturity, patience and a sense of responsibility.
      The quantity and quality of breast milk are believed to be influenced by a wide
      variety of factors including the childs age and individual characteristics, the
      psychological and physical state of the mother, and her diet. Mothers reported a
      number of behaviors that are perceived to influence the quality of breast milk
      including changes in their diet when the infant was ill and behaviors designed to
      optimize the humoral qualities (hot/cold, light/heavy) of the milk.
      Supplementation with sugar water beings very early, and gradual introduction of
      other foods generally is begun soon after 40 days of age. Mixed formula and
      breastfeeding is commonly perceived to increase the nutritional quality of the
      childs diet. Weaning is ideally related to developmental milestones (walking,
      complete dentition) but often occurs early due to a variety of factors including
      maternal illness, desire for another pregnancy, and perceptions that breast milk
      may be inadequate. Weaning is perceived to be a difficult and dangerous
      transition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475423
TI  - Property rights and payment to patients for cell lines derived from human
      tissues: an economic analysis.
AB  - The increasing potential for commercial applications in biotechnology has given
      rise to new legal and ethical questions with regard to ownership of human tissue.
      As the potential value of human cells and tissue has risen, so have donors' calls
      for a share in the profits. However, in a recent California ruling (John Moore vs
      the Regents of the University of California), the court once again held to its
      traditional position that individuals do not hold property rights in their own
      tissue and cells. We will show that, in the rare case where tissue value may be
      determined prospectively, a one-time payment (and, hence granting a property
      right) is efficient. Moore is such a case. In general, however, the transactions
      costs of granting full property rights to donors of tissue and cells outweigh the
      benefits of such a change in policy.

PMID- 8475424
TI  - Social inequality in health--the role of the healthy worker effect.
AB  - Current occupational status is frequently used as an indicator of position in the
      socioeconomic structure in analyses of health inequalities. People outside the
      work-force are thereby ignored. One may hypothesize that due to a 'healthy worker
      effect' economically active people are a positively selected health group and
      that health-related exits from the labour marked are concentrated among low
      socioeconomic groups. One may therefore expect that this system of classification
      will show artificially small differences in health between socioeconomic groups.
      Analyses of material from a nation-wide representative survey and a complete set
      of mortality statistics confirm these expectations. When previously employed are
      included among currently employed, the differentials in health between the
      extreme groups in the occupational hierarchy widen. The system of classification
      has only a moderate impact on the main conclusion regarding men. For women,
      however, the conclusion depends more heavily on how they are classified. If one
      relies only on current occupation, small or inconsistent patterns emerge.
      Inclusion of previously employed has the effect of showing that low status women
      suffer from poorer health than high status women. This applies to several
      measures of health, i.e. morbidity, restricted activity and mortality.

PMID- 8475425
TI  - Construction of a socio-economic index to facilitate analysis of health data in
      developing countries.
AB  - In order to plan, implement and monitor health interventions for the most
      deprived sector of the population, it is necessary to identify socioeconomic
      groups at risk. Multiple Correspondence Analysis was used to construct a socio
      economic index based on data collected from a sample of 2698 households in South
      West district of the Ugandan Republic in 1988. This study is a part of the
      baseline survey done by the Government of Uganda in collaboration with UNICEF.
      Its aim was to reduce the incidence of death of children below 5 years from
      diarrhea. Two factorial axes, representing respectively the socio-cultural and
      the anthropological conditions, explained more than 80% of the total variability.
      Among the 11 variables employed the most useful in characterizing the socio
      economic classification were: father's occupation, parent's literacy, father's
      professional position and ownership of a radio. A classification in 7 levels was
      obtained. The first two levels are characterized as professionals and civil
      servants. The bottom two levels include households where both parents are
      illiterate and where father's primary activity is agricultural at a subsistence
      level. The three middle levels represent a transitional situation. In order to
      classify the family into the different levels, the other related variables, such
      as father's professional position or ownership of radio or father's religion or
      presence of latrine proved to be very useful. A flow chart which identifies which
      level a household belongs to was constructed. A general and valid observation is
      that families classified into the last two levels (6 and 7) constituted the
      population at risk for health conditions.

PMID- 8475426
TI  - Health effects of discontinuities in female employment and marital status.
AB  - The discontinuities that characterize women's work histories are also a factor in
      women's marital histories. Family obligations and childbearing contribute to
      women's unique employment histories, which include intermittent labor force
      participation and mobility between employers. While research has increasingly
      focussed on the effect of labor force participation on women's health, little
      attention has been given to the effect of the consistency or the stability of
      labor force participation on health. The purpose of this paper is to examine 15
      years of employment histories and marital status changes among a cohort of women
      and to determine the cumulative effect of these histories on subsequent morbidity
      and self-reported health. The cohort of 556 women examined in this study were
      interviewed as part of a household interview survey completed in 1970-71, and
      resurveyed via a mail-out questionnaire, in 1985-86. Medical record data for the
      full 15 years of the study have been linked with the survey data. The findings
      suggest that work discontinuities and marital status discontinuities are
      unrelated to morbidity during the study period. However, two or more changes in
      marital status are related to poor self-reported health at follow-up.

PMID- 8475427
TI  - Medical slang and its functions.
AB  - Medical slang is analyzed in the developmental perspective of the physician's
      career. More than 300 terms gathered by ethnographic methods are classified by
      social categories: (1) the setting--various types of hospitals and facilities,
      (2) the players--care-givers and care-receivers, (3) the social processes-
      patient admission, diagnosis, treatment and discharge, and (4) death and dying.
      Slang usage generally begins during the third year of medical school when
      students rotate among clinical services and peaks during the internship year.
      Male and female clinicians are similar in slang usage. Five psychosocial
      functions of medical slang are discussed.

PMID- 8475428
TI  - Health needs, demand for health services and expenditure across social groups in
      Italy: an empirical investigation.
AB  - The shortage of empirical studies on socio-economic factors influencing demand
      for health care and inequalities across social groups is dramatic in the case of
      Italy. The present study aims at discussing these issues, although its results
      are to be considered mainly methodological, given the small dimension of the
      sample (n = 807). A survey was carried out in a 'qualitative' sample of 9 Local
      Health Units of different Italian regions. Attention was paid to report every
      'illness episode', considered as a cause of demand for health services, within
      the reference period (4 weeks) in order to properly link health needs with
      utilization of health services and relative expenditure. The assessment of health
      status across social groups, using 4 different indicators, shows the weakest
      social groups as the most vulnerable. The same groups report higher per capita
      health services uses and expenditures than their morbidity conditions would
      require. Assuming equity to be defined as 'equal use for equal need' a particular
      use-need ratio is developed (i.e. health services used per illness episode) able
      to capture the 'intensity' of health services use and expenditure per need. The
      'over-equity' towards the less favoured groups is interpreted as a possible
      accomplishment of the N.H.S. fundative goals. A structural model of determinants
      of health services utilization, carried out through the LISREL technique (R2 =
      0.36), confirms the irrelevance of the social variables with respect to need
      variables.

PMID- 8475429
TI  - Deep venous thrombosis after spinal surgery.
AB  - Eighty-six consecutive patients undergoing spinal surgery were studied with
      preoperative and postoperative compression ultrasonography of the lower
      extremities to identify acute deep venous thrombosis. Compression stockings were
      the only method of prophylaxis. Postoperative deep venous thrombosis developed in
      five patients (6%). Serial ultrasound scanning revealed propagation of the
      thrombus proximal to the knee in one patient, who was the only patient to be
      anticoagulated. There were no statistically significant differences in the
      incidence of deep venous thrombosis compared to the type of procedure, age, sex,
      length of operation, or duration of bed rest. In conclusion, deep venous
      thrombosis distal to the inguinal ligament is unusual after spinal surgery. Given
      the potential complications of anticoagulation, we recommend only mechanical
      prophylaxis.

PMID- 8475430
TI  - Nonoperative treatment in burst fractures of the lumbar spine (L2-L5) without
      neurologic deficits.
AB  - A retrospective review of 20 patients treated nonoperatively for burst fractures
      of the lumbar spine (L2-L5) was performed. All patients were neurologically
      intact at the time of injury. Follow-up averaged 3.9 years with a range of 2.1 to
      9.1 years. Fourteen patients were men and six were women. The average age at
      injury was 35.8 years (8-67 years). Sixty-five percent of the injuries were the
      result of motor vehicle accidents and 35% falls from height. Fifty-five percent
      were two-column injuries and 45% three-column injuries. Kyphotic deformity
      averaged 8 at injury (-7 to 30) and 9.6 at follow-up (-8 to 33). Computed
      tomography scans were performed in nine patients during evaluation of injury.
      Spinal canal compromise averaged 40% (18-75%). Eighteen patients (90%) were
      considered to have a good to excellent functional outcome, whereas two patients
      had a fair outcome. No patient had a poor outcome. In no patient did neurologic
      deterioration or symptomatic spinal stenosis develop. Twenty-five percent of
      patients had no back pain, 70% mild back pain, and 5% moderate back pain. No
      patient was totally incapacitated by pain. Of those employed, all returned to
      full-time work. Nonoperative treatment should be considered as an alternative in
      the treatment of lumbar burst fractures (L2-L5) in patients presenting without
      initial neurologic deficits.

PMID- 8475431
TI  - Optoelectronic evaluation of trunk deformity in scoliosis.
AB  - In this study, truncal deformity in patients with scoliosis was evaluated by
      circumferential scanning using an optoelectronic device (Optronic Torsograph,
      Anima Corp., Tokyo, Japan). This device generates cross-sectional skin surface
      topography at 10 axial levels to provide a three-dimensional representation of
      truncal shape. Ninety-three patients with suspected idiopathic scoliosis were
      evaluated with conventional Cobb measurements, and their parameters were computed
      using the device's measurements. The geometric cross-sectional indexes correlated
      poorly with the Cobb angle and were highly variable during repeated measurements.
      The optoelectronic device's angle, a measure of centroid curvature, correlated
      highly with the Cobb angle for primary spinal curves. The highest correlation was
      observed in thoracolumbar curves. This optoelectronic device has clinical
      relevance as a method for further scoliosis screening and monitoring the
      progression of spinal curvature in a patient.

PMID- 8475432
TI  - Spinal involvement in children and adolescents with Gaucher disease.
AB  - Nineteen patients with type I Gaucher disease with spinal involvement first
      diagnosed during childhood, were followed for 2 to 24 years (average 9 years),
      and their clinical and radiologic history reviewed. Patients presented with three
      types of pain: mild pain that was defined as nonspecific, severe pain due to bone
      crisis, and pain associated with vertebral collapse. Collapse of vertebra
      occurred gradually anywhere along the thoraco-lumbar spine, and usually more than
      one vertebra was involved. In three patients, rectangular collapse was noted. Six
      patients suffered from central vertebra collapse, and two from anterior wedge
      compression. Further vertebral collapse with signs of root and cord compression
      developed in three patients as they grew. Awareness to the possibility of
      progressive vertebral collapse and periodic follow-up might prevent severe
      complications.

PMID- 8475433
TI  - Progressive scoliosis with vertebral rotation after lumbar intervertebral disc
      herniation in a 10-year-old girl.
AB  - A case report of a 10-year old girl with a herniated disc is presented. The most
      significant symptoms were progressive scoliosis with a flat back and
      paravertebral muscle spasm. An absent H reflex on the left and an increased
      latency of the somatosensory-evoked potentials of the left posterior tibial nerve
      were found. The computed tomographic scan of the lumbar spine showed a large
      central left-sided disc protrusion at the L5-S1 level. Our case presents the
      youngest patient with documented intervertebral disc herniation and the only one
      with severe scoliosis and vertebral rotation. The curve was not structural
      because it improved with surgery and an orthosis was not necessary.

PMID- 8475434
TI  - Congenital anomaly of the second cervical vertebra predisposing to progressive
      cervical myelopathy. A case report.
AB  - The authors describe a previously unreported constellation of developmental
      anomalies of the C2 vertebra, which predisposed to the development of cervical
      myelopathy in a young patient. The embryology of the vertebral column is reviewed
      briefly, and the origin of each anomaly of the C2 vertebra is traced to one of
      the two early stages in development as follows: 1) the formation of the
      mesenchymal vertebra or 2) its induction to cartilage. This case emphasizes the
      importance of congenital stenosis in the development of cervical myelopathy in
      young patients. The outcome is favorable when it is treated aggressively.

PMID- 8475435
TI  - Mechanical process and growth cartilages. Essential factors in the progression of
      scoliosis.
AB  - This study showed that the worsening of scoliosis was the result of a mechanical
      phenomenon. The key feature in this mechanical process was the finding that
      cuneal deformation affects only part of the vertebral body. The onset of
      scoliotic curvature occurred as a result of intervertebral motions. However, the
      worsening was essentially caused by deformation of the vertebral bodies. After
      the onset of scoliosis, the orientations of the vertebrae were modified in all
      three planes, and as a result, the spine became mechanically unstable. As a
      result of this mechanical instability, intervertebral pressures no longer were
      distributed equally but were concentrated at the junction of the growth
      cartilages of the vertebral body, near the pedicle on the concave side. Osseous
      growth was perturbed in this area, the vertebra became deformed, and the
      vertebral body became wedge shaped. These cuneal deformations resulted in a
      relative change of position between adjacent vertebral bodies and led to a
      worsening of the scoliotic curve without involving any articular motion. This
      phenomenon occurred mostly in the apical region because of the geometric shape of
      the curvature.

PMID- 8475436
TI  - Neuromorphometric changes in the ventral spinal roots in a scoliotic animal.
AB  - The morphologic changes were investigated in the ventral and dorsal spinal nerve
      roots in a strain of white leghorn chickens that genetically was predisposed to
      have idiopathic scoliosis. In the ventral spinal roots in chickens with scoliotic
      curves, small myelinated fibers were increased in number and appeared in
      clusters. The number of small fibers did not correlate with the degree or the
      duration of the deformity. In 8 of the 15 chickens of the genetic scoliotic
      strain that did not have spinal curves, changes in the myelinated fibers, similar
      to those in chickens with scoliotic curves, were seen. These findings suggest
      that abnormalities in the myelinated fibers of the ventral spinal nerve roots may
      be the primary genetic lesion that, with variable penetrance, influences the
      development of scoliosis.

PMID- 8475437
TI  - The migration of a Harrington rod after cervical fusion.
AB  - A patient was treated for an anterior dislocation of C4 on C5 with an open
      reduction and Harrington rod hook fixation. The compression rod dislodged and
      migrated through the foramen magnum into the cerebellum 4 years later. This case
      represents an unusual complication of Harrington rod instrumentation in the
      cervical spine.

PMID- 8475438
TI  - The effect of multilevel laminectomy on the cervical spine of growing cats. An
      experimental study.
AB  - This experiment was undertaken to observe the effect of multilevel laminectomy on
      the cervical spine of growing cats. Wide cervical laminectomy was done from C3 to
      C6 on 24 immature cats and 24 mature cats. Cervical kyphosis gradually developed
      in the growing cats postoperatively after 4 months; normal cervical curves were
      maintained in the mature cats. Corporal subluxation at the kyphotic segment was
      detected postoperatively after 4 months, but the characteristic wedge-shaped
      deformity of the vertebral body of the swan-neck deformity was not detected using
      serial radiographs during the 12-month observation period. Histologically, there
      was no evidence of thinning or early fusion of the anterior part of the physis
      throughout the observation period. Post-laminectomy kyphosis developed as the
      result of forward subluxation of vertebral bodies because of the destabilizing
      surgery.

PMID- 8475439
TI  - The effects of quadriceps fatigue on the technique of lifting.
AB  - A biomechanical analysis was performed of lifting before and after fatiguing the
      quadriceps muscles. The hypothesis tested was that when the quadriceps muscles
      were fatigued the lifter would change lifting technique from more of a squat
      (leg) lift to more of a stoop (back) lift to decrease the demand on the
      quadriceps muscles. The hypothesis was broadly supported, and three variables
      changed significantly with fatigue: trunk angular velocity, which increased, and
      knee moment integral and hip angles, which both decreased. These changes are all
      consistent with a change from more of a squat toward a stoop technique. The fact
      that the technique of lifting changes with quadriceps muscle fatigue underlines
      the importance of the physiologic condition of these muscles and suggests that
      rehabilitation of low-back-injured workers should include the quadriceps muscles.
      The amount of work performed should be controlled to avoid the development of
      local muscle fatigue and subsequent changes in performance.

PMID- 8475440
TI  - The effect of imposed leg length difference on pelvic bone symmetry.
AB  - This study was designed to examine the effect of varying degrees of imposed leg
      length difference on symmetry of the innominate bones in healthy college women
      with relatively equal leg lengths. Subjects' leg length was determined by
      clinical and roentgenographic procedures. Position of the innominate bones with
      and without lifts under one foot was measured with respect to the transverse
      plane using the Waterloo Spatial Motion and Recording Technique (WATSMART;
      Northern Digital, Inc., Waterloo, Ontario, Canada), which allows very high
      spatial resolution. Our results show that posterior innominate bone rotation
      occurs on the side of the lengthened limb, and anterior rotation occurs on the
      shorter limb. The amount of pelvic obliquity increased in an approximately linear
      fashion as the leg length difference was increased from 2/8 to 7/8 inch. Some
      individual differences were evident.

PMID- 8475441
TI  - Percutaneous biopsy in the anterior thoracic spine.
AB  - Over a 24-month period, seven patients have undergone nine diagnostic closed
      percutaneous biopsies of thoracic vertebral body lesions. Seven of the nine
      biopsies were performed using the Craig trephine biopsy set. All seven biopsies
      provided diagnostic material. Two biopsies were performed with 22-gauge needles
      and aspiration technique. One provided diagnostic material. The only complication
      was a small pneumothorax that spontaneously resolved. Current editions of
      orthopedic texts give mixed recommendations as to the route of vertebral body
      biopsy in the thoracic spine. Most recommend open rather than percutaneous
      biopsy, particularly above T10. Review of current orthopedic literature, however,
      reveals overwhelming support for the use of closed biopsy techniques as the
      procedure of choice for tissue diagnosis of thoracic vertebral body lesions. As
      in this limited series, the reported positive biopsy ratio is high and the
      complication rate acceptably low.

PMID- 8475442
TI  - Magnetic resonance imaging evaluation of the spine with metal implants. General
      safety and superior imaging with titanium.
AB  - We studied the cases of 15 patients who underwent postoperative magnetic
      resonance imaging evaluation after being treated with metal spinal implants.
      Spine stabilization was required in traumatic injuries for eight patients, cancer
      destruction in four patients, late cervical subluxation in one patient,
      spondylosis in one patient, and spondylolisthesis in one patient. A variety of
      stainless steel and titanium spinal implants were used. The images were evaluated
      for spinal and implant positioning and artifact production. Both stainless steel
      and titanium implants were imaged safely and there was no evidence of implant
      migration of local tissue-heating effect. The titanium spinal implants allowed
      postoperative spine imaging without the significant image distortion
      characteristic of the stainless steel implants. The stainless steel implants
      created significant artifact that impaired the usefulness of the magnetic
      resonance imaging evaluation.

PMID- 8475443
TI  - Closed reduction of traumatic cervical spine dislocation using traction weights
      up to 140 pounds.
AB  - The purpose of this study was to demonstrate that Gardner-Wells skull tong
      traction up to 140 lb was both safe and effective in reducing dislocation,
      without fractures, of facet joints involving the C4-C7 vertebral bodies when
      applied by experienced practitioners in a spinal cord injury center under close
      scrutiny. Twenty-four awake patients were selected for the study (age range, 16
      82 years). These patients were evaluated for the number of millimeters (7-17 mm)
      of dislocation as measured from the posterior aspect of the superior vertebral
      body to the posterior aspect of the inferior vertebral body at the level of
      injury. The maximum weight required to produce the reduction of the facet joints
      and the time from the onset of traction were recorded. The patients' neurologic
      status was monitored before traction, after each increment in weight applied, and
      after reduction. Careful examination of motor function and sensation was done and
      recorded at each interval. The 24 patients with cervical spine dislocation of the
      facet joints underwent successful reduction with traction weights (range, 10-140
      lb). Seventeen patients required weights of more than 50 lb. The traction
      procedures lasted for a period of 8-187 minutes per procedure. Worsening
      neurologic status did not occur in any of the patients involved in this
      study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475444
TI  - Dysphagia complications in ankylosing spinal hyperostosis and ossification of the
      posterior longitudinal ligament. Roentgenographic findings of the developmental
      process of cervical osteophytes causing dysphagia.
AB  - This is the first report of the process of formulation of a cervical osteophyte
      causing dysphagia. The patient had ankylosing spinal hyperostosis and OPLL and
      was followed radiographically for a long time before the onset of dysphagia. The
      radiological observation suggested that dysphagia was produced when the immobile
      part of the esophagus was compressed by the anterior projecting cervical
      osteophyte. The immobility of the esophagus is an important factor in determining
      whether dysphagia occurs. Another possible contributing factor to dysphagia in
      this patient was the ossification of the cervical anterior and posterior
      longitudinal ligaments. The OPLL affected intervertebral segmental motion and
      induced the formation of anterior projecting cervical osteophytes.

PMID- 8475445
TI  - Automated percutaneous lumbar discectomy as treatment for lumbar disc disruption.

PMID- 8475446
TI  - Spinal tuberculosis with translational instability.

PMID- 8475447
TI  - Chronic spontaneous cervical epidural hematoma. Report of a case presenting with
      only radicular symptoms.

PMID- 8475448
TI  - Bilateral traumatic L4 pedicular fractures in a healthy male athlete. A case
      report.

PMID- 8475449
TI  - Magnetic resonance demonstration of the cervical spine after anterior discectomy
      using acrylic cement.

PMID- 8475450
TI  - The effect of lower limb ischemia on somatosensory evoked potentials during
      spinal surgery. Report of two cases and review of the literature.

PMID- 8475452
TI  - Awards and recognition in science: a distortion of reality.

PMID- 8475451
TI  - Comments on the direction of blood flow in the central placental vessel in the
      rat.

PMID- 8475453
TI  - Blueprint for the prevention of birth defects in the year 2000.

PMID- 8475454
TI  - Occurrence of embryotoxicity in mouse embryos following in utero exposure to 2'
      deoxycoformycin (pentostatin).
AB  - Previous investigations had shown that i.p. injection of 2'-deoxycoformycin (dCF;
      pentostatin; 5 mg/kg) on either E7 or E8 into pregnant mice results in a 61-81%
      resorption rate at E17. The incidence of visible gross malformations among the
      surviving conceptuses was exceptionally low (3%) at the time of necropsy on E17
      and was unrelated to dCF dose (Knudsen et al., Teratology, 40:5-626, '89;
      Teratology, 45:91-103, '92). These findings demonstrated the embryotoxicity of
      dCF but provided no clues as to the site(s) of dCF action. To define the lesion
      site(s), we have now examined embryos at 72 h (E10), 96 h (E11), and 120 h (E12)
      following administration of a highly embryotoxic dose of 5 mg dCF/kg to dams on
      E7. Deoxycoformycin caused multiple abnormalities and growth retardation, and the
      temporal sequence between maximal abnormal embryo incidence and resorption
      frequency was established. The quantitative data show that the maximal occurrence
      of abnormal embryos on E10 (71%) was followed by a maximal resorption rate on E12
      (78%). There was a strong correlation (r = -0.82; P < 0.05) between the rapid
      decline of percent abnormal embryos over E10-E12 and the simultaneous increase in
      resorption rate, with linear regression analysis showing nearly equal but
      opposite slopes (-31.2% vs. +35.8% per gestational day, respectively). This
      suggests that one or more of the abnormalities seen at E10 is associated with the
      death and resorption of the embryo at E12. The dCF treatment perturbed a wide
      spectrum of developmental events, including neural tube closure, craniofacial and
      limb development, turning of the embryo, and growth retardation. None of the
      individual abnormalities, however, can quantitatively account for the high
      percentage of dead and resorbed embryos. Therefore, the specific cause of dCF
      induced embryolethality is not clear. There is evidence both for direct dCF
      toxicity at specific embryonic sites as well as for a generalized retardation in
      the rate of development.

PMID- 8475455
TI  - Comparative teratogenicity and metabolism of all-trans retinoic acid, all-trans
      retinoyl beta-glucose, and all-trans retinoyl beta-glucuronide in pregnant
      Sprague-Dawley rats.
AB  - When single large equimolar doses (0.38-0.41 mmol/kg BW) of all-trans retinoic
      acid (RA), all-trans retinoyl beta-glucose (RBGL), and all-trans retinoyl beta
      glucuronide (RBG) are administered orally in oil on day 8.5 of pregnancy to
      Sprague-Dawley rats, RA and RBGL proved highly teratogenic, whereas RBG was not.
      Indeed, fetuses from RBG-treated dams were 16% heavier (P < 0.01) than control
      fetuses. After dosing with RA and RBGL, RA appeared in large amounts within 0.5 h
      in the maternal plasma and within 1.0 h in the embryo. In contrast, orally
      administered RBG seemed to be absorbed much more slowly, to be converted very
      slowly to RA, and not to accumulate either as RBG or as RA in the embryo. When
      incubated in vitro with embryos and attached membranes, however, both all-trans
      RBG and all-trans RA were partially converted to 13-cis RA. The nonteratogenicity
      of RBG, in contrast to RA, seems to be due to a much slower rate of GI
      absorption, a slow rate of hydrolysis to RA, a limited passage from the maternal
      circulation into the embryo, and a lower inherent toxicity.

PMID- 8475456
TI  - Importance of early exposure to 13-cis retinoic acid to induce teratogenicity in
      the cynomolgus monkey.
AB  - The teratogenic potential of 13-cis retinoic acid (13-cis RA) was further
      assessed in cynomolgus macaques (Macaca fascicularis) following exposure to two
      different regimens during the preorganogenic period to determine the influence of
      time of treatment on the 13-cis RA malformation syndrome established previously
      (Hummler et al., Teratology, 42:263-272, 1990). In experiment (Exp) 1, 13-cis RA
      was orally administered once daily (2.5 mg/kg) on gestational day (GD) 16-25 and
      twice daily (2 x 2.5 mg/kg) on GD 26-27. In Exp 2, the same oral dose was
      administered once daily on GD 10-20 and twice daily on GD 21-24. Although the ear
      was affected at about the same incidence (6/9, 67%) in Exp 1 as previously
      reported, the defects were less severe. Except for hypoplastic vermis of the
      cerebellum (2/9, 22%), no other defects were seen. In Exp 2, the teratogenic
      effects of 13-cis RA on the craniofacial skeleton (1/9, 11%), external ear (5/9,
      56%), and heart (2/9, 22%) were similar to that reported by Hummler et al.;
      however, no thymus or cerebellar malformations were observed. Analysis of the
      three different treatments (GD 16-27 in Exp 1, GD 10-24 in Exp 2, and GD 10-27 in
      Hummler et al.) suggests that the sensitive periods in the macaque are 1)
      craniofacial skeleton and heart GD 10-24, 2) thymus and cerebellum > GD 24, and
      3) external ear GD 16-24, although the defects are less severe following the
      shorter exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475457
TI  - Omphalocele and gastroschisis: a collaborative study of five Italian congenital
      malformation registries.
AB  - During 1984-1989, 116 cases of omphalocele and 42 cases of gastroschisis were
      detected among 736,760 consecutive births in the area covered by five Italian
      congenital malformation registries. The prevalence rate was 1.6 per 10,000 for
      omphalocele and 0.6 per 10,000 for gastroschisis. Three additional cases were
      detected among spontaneous abortions, giving a total of 117 cases of omphalocele
      and 44 of gastroschisis. No variations in prevalence rates were observed among
      registries. A cluster of omphalocele was found in 1989 in Firenze. All cases were
      sporadic except for one infant with two sibs with Beckwith-Wiedemann syndrome. A
      predominance of male infants was observed for both defects. This study confirms
      the very young maternal age for isolated gastroschisis as compared to that for
      omphalocele and controls. Birth weight and the percentage of small-for-date is
      different among isolated gastroschisis, omphalocele and controls. Associated
      anomalies occurred in 45 cases of omphalocele and 11 cases of gastroschisis. Our
      data confirm the association of omphalocele with trisomies 13 and 18. Twelve
      cases of omphalocele and gastroschisis with associated limb defects were
      classified as limb body wall complex. The possible differences in etiopathology
      between omphalocele and gastroschisis, both isolated and associated, are
      discussed.

PMID- 8475458
TI  - Development of in vitro fertilized mouse embryos exposed to ethanol during the
      preimplantation period: accelerated embryogenesis at subtoxic levels.
AB  - This study examined the effects of ethanol (EtOH) on mouse preimplantation
      development using an in vitro culture method. Embryos at the 1-cell, 2-cell, or 4
      cell stage were exposed for 24 h to medium containing EtOH, then further cultured
      without EtOH to determine their ability to form blastocysts and to eventually
      hatch from the zona pellucida. EtOH exposure either arrested or enhanced normal
      development, depending on dose and embryonic stage of exposure. Exposure of 1
      cell and 2-cell embryos to 1.6% (w/v) EtOH decreased blastocyst formation and
      hatching, and exposure of 1-cell embryos to 0.4% EtOH inhibited their
      development. At 0.1%, EtOH had an opposite effect, causing an increase in the
      percent blastocyst formation of treated 1-cell and 2-cell embryos. Neither
      inhibition nor stimulation of blastocyst formation occurred in 4-cell embryos
      exposed to 0.1-1.6% EtOH. Using an in vitro outgrowth model of implantation,
      embryos that reached the blastocyst stage were further tested for their ability
      to produce differentiated trophoblast cells. Blastocysts previously exposed to
      0.1% EtOH during the 1-cell stage appeared to form adhesive trophoblasts earlier
      than control embryos, indicating that EtOH exposure can induce precocious
      differentiation of the trophoblast cells. The EtOH treated blastocysts contained
      significantly more cells than control blastocysts. These results indicate that
      EtOH can alter preimplantation development by either inhibiting or accelerating
      cell growth and differentiation.

PMID- 8475459
TI  - Renal dysplasia, megalocystis, and sirenomelia in four siblings.
AB  - First degree relatives of infants with bilateral renal agenesis or dysplasia have
      an increased risk of renal abnormalities including renal agenesis. We report a
      family in which four successive offspring exhibited a previously undescribed
      combination of congenital lethal renal disorders: bilateral renal dysplasia,
      megalocystis secondary to urethral obstruction and, sirenomelia with associated
      renal agenesis.

PMID- 8475460
TI  - Intermittent pattern of neural tube closure in two strains of mice.
AB  - Development of the neural tube is often described as a continuous process that
      begins in the cervical region of the embryo and proceeds both rostrally and
      caudally. Examination of neural tube closure in the cranial region of LM/Bc and
      SWV/Bc mice revealed an intermittent pattern with four distinct areas of closure.
      Closure I begins at the level of somites 1-3 and proceeds bidirectionally.
      Closure II is initiated at the prosencephalic-mesencephalic border and also
      proceeds bidirectionally. Closure III is unidirectional, beginning adjacent to
      the stomodeum and proceeding caudally to meet closure II. Finally, closure IV
      takes place over the rhombencephalon where it meets closure II to complete
      rostral neural tube closure. In these two strains of mice anterior neural tube
      closure progressed as somite number increased. However, the SWV strain required a
      longer gestational time to develop equal numbers of somites and therefore to
      complete closure. In light of the intermittent pattern of closure observed in
      mice, the development of the rostral nervous system in other mammals, including
      humans, should be reconsidered.

PMID- 8475461
TI  - The developmental toxicity of inhaled methanol in the CD-1 mouse, with
      quantitative dose-response modeling for estimation of benchmark doses.
AB  - The developmental toxicity of the alternative motor vehicle fuel methanol was
      assessed in mice by the inhalation route. Pregnant CD-1 mice were exposed to
      1,000, 2,000, 5,000, 7,500, 10,000, or 15,000 ppm methanol for 7 hr/day on days 6
      15 of gestation. Sham-exposed controls were exposed to filtered air under similar
      conditions. Additional control groups were left in their home cages either
      unhandled or food-deprived for 7 hr/day to match the food deprivation experienced
      by the exposed mice. Dams were observed twice daily and weighed on alternate days
      during the exposure period. Blood methanol concentrations were determined in some
      mice on gestation days 6, 10, and 15. On day 17, the remaining mice were weighed
      and killed and the gravid uteri removed. Implantation sites, live and dead
      fetuses and resorptions were counted, fetuses were examined externally and
      weighed as a litter. Half of each litter was examined for skeletal morphology and
      the other half of each litter was examined for internal soft tissue anomalies.
      One dam died in each of the 7,500, 10,000, and 15,000 ppm methanol exposure
      groups, but no dose-response relationship was evident for maternal death. The
      sham-exposed and food-deprived controls as well as all methanol exposed dams
      gained less weight than did unexposed dams fed ad libitum, but methanol did not
      exacerbate this effect. Significant increases in the incidence of exencephaly and
      cleft palate were observed at 5,000 ppm and above, increased embryo/fetal death
      at 7,500 ppm and above (including an increasing incidence of full-litter
      resorptions), and reduced fetal weight at 10,000 ppm and above. A dose-related
      increase in cervical ribs or ossification sites lateral to the seventh cervical
      vertebra was significant at 2,000 ppm and above. Thus, the NOAEL for the
      developmental toxicity in this study was 1,000 ppm. A log-logistic dose response
      model was applied to the incidence data for exencephaly, cleft palate, resorption
      and cervical rib, and maximum likelihood estimates (MLEs) and benchmark dosages
      (BDs, the lower 95% confidence interval of the MLEs) corresponding to 1% and 5%
      added risk above background were calculated. The MLE for 5% added combined risk
      of having either exencephaly or cleft palate or being resorbed was 3667 ppm, and
      the corresponding BD was 3,078 ppm. For cervical rib, the 5% added risk values
      for the MLE and BD were 824 and 305 ppm, respectively. The BDs for 1% added risk
      were 1915 ppm for exencephaly, cleft palate or resorption, and 58 ppm for
      cervical rib.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475462
TI  - Developmental toxicity of caffeine in the larvae of Xenopus laevis.
AB  - To examine the developmental toxicity of caffeine, Xenopus larvae just after
      hatching, were continuously exposed to 100-2,000 mg/L caffeine for 48 hours.
      Caffeine interfered with development of Xenopus larvae at a concentration of 100
      mg/L and above in a concentration-dependent manner. Characteristic external
      abnormalities, such as shortened body with wavy fins, were observed, the severity
      of which was clearly concentration dependent. These larvae were frequently
      accompanied by abnormal body flexure and edema in the fin. Light microscopy
      revealed that exposure to caffeine induced severe damage in the myotome and
      neural tube, and at higher concentrations, the epidermal tissue was also
      affected. Myoblasts showed wide intercellular spaces, and their cytoplasm lost
      uniform staining. Ultrastructural studies of myoblasts revealed distinct
      myofibril disorganization and degeneration, and mitochondrial alterations. In the
      neural tube, cells at the dorsal part of tube showed wide intercellular spaces
      and some of them were segregated to the peripheral region. Furthermore, vacuole
      like structures of various sizes appeared in the white matter. The outer layer of
      epithelial cells in the epidermis were vacuolated and swollen. With regard to the
      pathogenesis of myofibril damage, caffeine appeared to cause a disturbance of
      intracellular calcium regulation, by releasing calcium ions from the sarcoplasmic
      reticulum, and the mitochondrial changes observed in myotomal cells were
      considered to be reflective of this increased intracellular calcium ion levels.
      It is speculated that caffeine interferes with cell adhesion in the myotome and
      neural tube by affecting calcium ion regulation.

PMID- 8475463
TI  - Embryotoxic effects of chlorobutanol in cultured mouse embryos.
AB  - Chlorobutanol (CB) is a commonly used preservative which is added to numerous
      pharmaceutical preparations, and it is the active ingredient in certain oral
      sedatives and topical anesthetics. Chlorobutanol has demonstrated adverse effects
      in adult tissues, but CB has not been previously investigated for its effect on
      the developing whole embryo. The method of whole-embryo culture was used in this
      study to expose mouse embryos during two stages of organogenesis to CB at final
      concentrations of 0 (control), 10, 25, 50, 100, and 200 micrograms/ml. Embryos
      were evaluated for heart rate (HR), malformations, and somite number, and embryos
      and visceral yolk sacs (VYSs) were assayed for total protein content as a measure
      of overall growth. Neurulating (3-6 somite) embryos were malformed and growth
      retarded by exposure to CB concentrations > or = 25 micrograms/ml, with decreased
      VYS growth at > or = 50 micrograms/ml and decreased HR at > or = 100
      micrograms/ml CB. Early limb-bud stage (20-25 somite) embryos were malformed at
      CB concentrations > or = 50 micrograms/ml and growth retarded at > or = 100
      micrograms/ml, with decreased VYS growth at 200 micrograms/ml and decreased HR at
      > or = 100 micrograms/ml CB. Thus, CB produces dysmorphogenesis in mouse embryos
      in vitro, and neurulating embryos are somewhat less sensitive than early limb-bud
      stage embryos. The concentrations of CB that interfere with normal embryonic
      development are within the range of human blood levels measured following
      multiple doses of CB. Preparations containing CB should be used with caution
      during pregnancy, particularly when repeated dosing may allow accumulation of CB
      to potentially embryotoxic levels.

PMID- 8475465
TI  - Young maternal age and smoking during pregnancy as risk factors for
      gastroschisis.
AB  - Three maternal risk factors (maternal age, cigarette smoking, and infant's month
      of birth) have been reported to be associated with fetal gastroschisis. In order
      to study these risk factors further, a prospective population-based study was
      designed, using 62,103 consecutive second-trimester singleton pregnancies
      enrolling in a maternal serum alpha-fetoprotein screening program between January
      1, 1980 and April 30, 1989. Gastroschisis occurred in 21 of those pregnancies.
      Pregnancies in women younger than 20 years of age were at 7.3 times greater odds
      for being affected with gastroschisis than pregnancies in women aged 25 or older
      (95% confidence interval 2.4 to 22). For pregnant women aged 20 to 24 years, the
      odds were 1.9 times greater (95% confidence interval 0.7 to 5.0). Pregnant women
      who smoked cigarettes were at 2.1 times greater odds than non-smokers (95%
      confidence interval 0.9 to 4.8). When these smoking data were combined with
      smoking data from two other published studies, the consensus odds ratio was 1.6
      (95% confidence interval 1.2 to 2.2). Infant's month of birth was not associated
      with gastroschisis. Evidence from the present study and other published studies
      clearly establishes a greater risk for fetal gastroschisis in pregnant women
      younger than age 20, even after adjustment for smoking status. Cigarette smoking
      also appears to be a risk factor, when data from this and two previously
      published studies are combined.

PMID- 8475464
TI  - The role of oxygenation in embryotoxic mechanisms of three bioreducible agents.
AB  - Many xenobiotics used in the treatment of hypoxic pathogens and tumors require
      reductive bioactivation under anaerobic conditions for maximal effectiveness
      and/or toxicity. A number of agents of this type have been shown to be
      teratogenic in vitro and/or in vivo. Early conceptuses may be vulnerable to these
      agents because they exist in a relatively anaerobic environment and have the
      capacity to perform reductive metabolism. It has been hypothesized that the
      single electron redox potential of bioreducible agents plays a dominant role in
      the capacity to induce anomalies. We examined the in vitro embryotoxicity in rats
      of three bioreducible drugs of similar redox potential under normoxic and hypoxic
      conditions as well as the capacity of those drugs to redox cycle and to damage
      DNA in embryonic tissue. Adriamycin, mitomycin C, and niridazole were shown to
      have differential embryotoxic responses in vitro to altered oxygenation. Studies
      of the bases of drug action showed (1) Adriamycin induces DNA strand breaks at
      concentrations that correlate well with embryolethality; (2) Mitomycin C does not
      induce strand breaks, but its dysmorphogenicity is increased by hypoxia; and (3)
      Niridazole does not produce DNA damage but appears to induce asymmetric
      malformations by depleting embryonic oxygen through redox cycling. Together the
      studies show that dysmorphogenic and embryolethal effects may result from
      separate mechanisms and that oxygenation plays an important role in those
      mechanisms.

PMID- 8475466
TI  - Skeletal development following heat exposure in the rat.
AB  - The effects of gestation day (GD) 10 heat exposure in the rat were studied to
      determine the temperature-response relationship for the induction of skeletal and
      other defects. Conscious pregnant rats (Experiment 1) were exposed to various
      temperatures in a warm air chamber. Body temperature was measured using a rectal
      probe, and these measurements were confirmed as representing core body
      temperature in separate animals using telemetric procedures. Those animals whose
      core body temperature was raised to 41-41.9 degrees C had over 90% malformed pups
      (examined at postnatal day (PND) 3), and a 25% reduction in the percent of live
      pups per litter. Animals whose temperature was raised to 39.2-40.9 degrees C had
      a low incidence of pups with similar types of malformations. The primary types of
      malformations were of the axial skeleton, consisting of fusions and other
      abnormalities of the ribs and vertebral elements, and a decrease in the total
      number of ribs and centra. The acute maternal effects of these temperature
      increases were signs of heat exhaustion during and 1-2 hr after exposure, but
      there were no permanent changes in weight gain or other signs. When temperatures
      were raised to > or = 42 degrees C, all maternal animals died. In a second study
      (Experiment 2), pregnant rats (from a different supplier) were anesthetized to
      determine the effect of reducing maternal stress and were exposed to heat as in
      Experiment 1. Those animals whose core body temperature was raised to 42-42.5
      degrees C for 5 min had pups with similar responses to those in Experiment 1 at
      41-41.9 degrees C, although the reduction in litter size was not as great.
      Animals whose temperature was raised to 41 degrees C had a much lower incidence
      of pups with similar defects, and animals whose temperature was raised to 43
      degrees C did not survive. A more detailed analysis of the skeletal defects in
      Experiment 2 showed rib and vertebral malformations that appear to be related to
      the stage of somite development at the time of exposure.

PMID- 8475467
TI  - Embryonic development in vitro following short-duration exposure to heat.
AB  - Gestation day (GD) 10 rat embryos (10-12 somites) were exposed in vitro for 10 to
      25 minutes at 42 or 43 degrees C and evaluated 24 hrs later for alterations in
      growth and specific morphological parameters, using a modified Brown-Fabro (Brown
      and Fabro: Teratology, 24:65-78, '81) scoring system that allowed evaluation of
      development relative to gestational age. At 42 degrees C, crown-rump length
      appeared to be particularly sensitive, responding to only 10 mins exposure. A 15
      min exposure resulted in decreased total protein, somite number and morphological
      score. No system was uniquely sensitive, since all parameters demonstrated some
      degree of response. Rather, systems affected were those that would be developing
      most rapidly at this time in gestation. At 43 degrees C, all of the parameters
      measured were affected by a 10-min exposure. These results demonstrate
      alterations in vitro after much shorter exposure periods than previously reported
      on GD10, which may be due, in part, to the use of a modified scoring system that
      permitted the evaluation of graded individual end point changes relative to
      gestational age. The response patterns demonstrated a clear temperature- and
      exposure duration-dependency, with a shift from a more shallow duration-response
      curve to a more dramatic inhibition of development as temperature increased from
      42 degrees C to 43 degrees C.

PMID- 8475468
TI  - [Substitute drug treatments with methadone].
AB  - Methadone maintenance treatment for patients with opiate addiction, started in
      the Canton of Basel in 1980, today includes more than 600 patients, with a marked
      increase since 1987 due to a change in inclusion criteria following the spreading
      of HIV infections. Data from 500 patients, gathered in 1991/92 on
      sociodemographic and treatment characteristics, emphasize the long-term aspect of
      the methadone maintenance treatment and the necessity of an intensive
      psychosocial treatment.

PMID- 8475469
TI  - [The Basel dependence study].
AB  - In a survey of 177 patients of several outpatient departments and private
      practices in the area of Basel there were 23% with a dependence syndrome
      according to the diagnostic guidelines of ICD-10. Sedatives and hypnotics were
      the mostly mentioned psychotropic substances in this group. In a second survey
      six to twelve months later 80% of the initial study group were reassessed,
      focusing on referrals of the patients with a dependence syndrome to institutions
      specialized for the treatment of addiction. In most cases these patients were
      still treated at the previous institution; there were only a few referrals.
      Improvements concerning the increase of the referral rate to competent
      specialized institutions for patients with addiction seems possible by
      implementation of a decentralized consultation liaison service for outpatient
      departments, hospitals and also private practitioners in a mobile form.

PMID- 8475470
TI  - [EMG abnormalities in REM sleep of addicted patients].
AB  - EMG abnormalities such as short muscle twitches and marked increase of muscle
      tone can be identified during REM sleep. We compared the polysomnographic
      parameters of ten alcoholic patients who were sober and medication-free for at
      least four weeks, five methadone-substituted politoxicomanic patients (MSP) and
      ten healthy control patients. The alcoholics and the MSP showed significantly
      more twitches than the control patients, and the MSP had significantly more tonus
      increase than the alcoholics and the controlled. The polysomnographic measures
      differed significantly between the groups in sleep architecture. The alcoholics
      had significantly less slow-wave sleep (SWS) and more REM sleep, the MSP had a
      longer REM latency and more of stage 2. Dividing all subjects along the median of
      the two EMG abnormalities, the group which showed a high number of twitches had
      significantly less SWS with a compensatory increase of stage 2. The two EMG
      measures, which were scored additionally, may provide a useful additional
      information in the differentiation of sleep disturbances in alcoholic and
      methadone-substituted patients. The interaction between the occurrence of these
      EMG abnormalities and the other polysomnographic measures in our study needs
      further clarification.

PMID- 8475471
TI  - [Beta-carbolines (harman/norharman) are increased in heroin dependent patients].
AB  - Endogenous substances resulting from interactions between alcohol and possibly
      opioid metabolites and neurotransmitters (dopamine, indolamines) are mediators of
      the pathochemical process towards dependence. Beta-carbolines are increased in
      alcoholics and--according to our own results--in heroin-addicts. Still unclear is
      the impact of other psychopathological disturbances like states of anxiety or
      depression; unclear is also, if it has to be interpreted as state, trait or
      residual marker of the dependence syndrome.

PMID- 8475472
TI  - [Acamprosate--a stabilizing factor in long-term withdrawal of alcoholic
      patients].
AB  - In a one-year double-blind-treatment study with acamprosat (six months with and
      six months without substance) the efficiency of this new medicament could be
      proved. The number of relapses in the treatment group was significantly lower
      during the first 30 days with a trend to further 150 days. The substance caused
      very few side effects.

PMID- 8475473
TI  - [The importance of work and unemployment for the long-term outcome and
      rehabilitation of drug dependent patients].
AB  - Physicians generally have to deal with therapy and less with rehabilitation of
      diseases. Employment and the necessary capacity and skills are to be focused on
      therapeutically in every second drug addict or alcoholic. The continuation of
      work is an important aim of secondary and tertiary prevention. Some general
      psychosocial aspects concerning this topic are discussed.

PMID- 8475474
TI  - [Drugs and violence].
AB  - The physician is confronted with victims of drug-related violence in emergency
      situations, especially in excitations (cocaine) or alcohol-induced intoxications.
      Moreover, the topic of drug-related violence should not only engage
      criminologists, specialists in legal and forensic medicine, but also every doctor
      because of the implications concerning interactions of drugs and society in which
      the medical profession ist deeply involved.

PMID- 8475475
TI  - [Future prospects in treatment of drug dependent patients].
AB  - During the last 25 years, an important evolution in therapeutic-rehabilitative
      strategies for drug addicts was observed. Many inputs came from social
      pedagogics. Great demands are again put on the medical profession in relation to
      AIDS and substitution programs. In the future the engagement of the medical
      profession will be required more again, particularly the psychosocial competence
      of doctors as well as the medical-biological research.

PMID- 8475476
TI  - Studies on the pharmacokinetics and pharmacodynamics of recombinant hirudin (rHV2
      Lys 47) after intravenous and subcutaneous administration in dogs.
AB  - In recent years, the pharmacological and biochemical characterization of hirudins
      has taken a major upswing due to the availability of this natural polypeptide in
      recombinant form. Despite this, the current knowledge on the pharmacokinetics and
      pharmacodynamics of recombinant hirudin (rH) appears to be incomplete. The
      present study was designed to investigate the relationship between plasma
      concentrations of rH with corresponding antithrombin responses after intravenous
      (i.v.) and subcutaneous (s.c.) administration in dogs. Four male, Mongrel dogs
      were each injected with an i.v. (bolus) dose (1 mg/kg) of one specific variant of
      rH, i.e. rH with a lysine residue in position 47 (rHV2-Lys 47). The dogs were
      injected with a s.c. dose (1 mg/kg) of rHV2-Lys 47 after one week. After each
      dose, blood was collected at different time intervals, plasma separated and
      stored at -70 degrees C. Plasma concentrations of rHV2-Lys 47 were determined
      using an enzyme-linked immunosorbent assay (ELISA) method and pharmacokinetic
      parameters were determined using standard non-compartmental methods. The ex vivo
      antithrombin activity of the drug was measured using activated partial
      thromboplastin time (APTT), calcium-thrombin time (Ca++TT) and a chromogenic anti
      IIa assay. The results from this study indicate that the pharmacokinetic behavior
      of rHV2-Lys 47 is strongly influenced by the route of administration. In all
      three functional assays used, a significant correlation was obtained after i.v.
      administration between plasma concentrations and corresponding responses over the
      time period of the study when compared to s.c. administration. The results are
      indicative of a probable structural and functional modification of this rH
      variant after s.c. administration which may be responsible for the altered
      pharmacokinetics and pharmacodynamics after s.c. dosing.

PMID- 8475477
TI  - Relationship of plasminogen activator inhibitor-1 with plasma insulin, glucose,
      triglyceride and cholesterol in Chinese patients with diabetes.
AB  - Plasminogen activator inhibitor-1 (PAI) activity, plasma insulin, glucose,
      cholesterol and triglyceride (TG) concentrations were determined in 32 Chinese
      diabetic patients (mean age 61.4 yr) and 41 healthy controls (mean age 64.5 yr)
      to establish the relationships between these parameters. Insulin, glucose,
      cholesterol and triglyceride levels were significantly higher in the diabetics,
      whereas no significant difference of PAI activity was noted between groups. PAI
      activity was not affected by the increase of plasma insulin, cholesterol, TG or
      glucose. We have shown that PAI activity in Chinese diabetics was not affected by
      the common pathologic changes found in diabetes. This might be one of the reasons
      why fibrinolytic activity is not impaired in Chinese diabetics.

PMID- 8475478
TI  - Effects of annexin V on the activity of the anticoagulant proteins C and S.
AB  - The effects of annexin V on the anticoagulant activity of activated protein C
      (APC) and protein S were examined. Although annexin V did not influence the
      amidolytic potential of APC, it inhibited both APC and protein S function in a
      factor Va inactivation assay. Competition experiments demonstrated that annexin V
      inhibits protein S binding to phospholipid vesicles in a dose-dependent manner.
      These results demonstrate that annexin V effectively interferes with the
      anticoagulant arm of the hemostatic system.

PMID- 8475479
TI  - High levels of histidine-rich glycoprotein and thrombotic diathesis. Report of
      two unrelated families.
AB  - Two new families with history of thrombosis and high levels of histidine-rich
      glycoprotein (HRG) are described. The propositus of family 1 died of massive
      pulmonary embolism at age 34. Among his relatives, the mother and the maternal
      grandmother had suffered from deep and superficial vein thrombosis in their
      youth. A maternal aunt had several episodes of superficial vein thrombosis (SVT).
      High levels of HRG were found in the mother, three siblings and two nephews. In
      the second family, the proposita suffered from spontaneous deep vein thrombosis
      (DVT) at age 24. The paternal grandmother and a paternal aunt had several
      episodes of SVT and DVT. Also in this family, high levels of HRG cosegregated
      with thrombotic symptoms. These new families confirm that genetically transmitted
      high levels of HRG could be associated to familial and juvenile thrombophilia.

PMID- 8475480
TI  - The effect of a long-acting recombinant hirudin (PEG-hirudin) on experimental
      disseminated intravascular coagulation (DIC) in rabbits.
AB  - Reproducible disseminated intravascular coagulation in rabbits was provoked by
      two intravenous injections 24 hours apart of endotoxin from Salmonella
      enteritidis. There were mild symptoms of DIC before the second injection which
      considerably increased thereafter. In detail there was a sharp drop of the
      platelet count and a considerable diminution of Antithrombin III, of Protein C,
      Plasminogen and Antiplasmin as well as an appearance of fibrin monomer complexes
      and an increase of the aPTT. When PEG-hirudin in a single dose of 1 mg/kg BW was
      given simultaneously with the second injection of endotoxin the following
      alterations were observed: The drop of the platelet count and of the activities
      of Antithrombin III, Protein C, Plasminogen and Antiplasmin was significantly
      less pronounced. The fibrin monomer complexes were lower and the aPTT was less
      prolonged. The thrombin time, however, as a sign of a direct action of hirudin on
      thrombin was considerably more prolonged than in the controls. The combined
      effect of these alterations strongly points in the direction of a favourable
      influence of PEG-hirudin on the course of DIC. It is of special interest that 6 h
      after the intravenous injection of PEG-hirudin its full effect on the thrombin
      time was still detectable. This is apparently due to a longer half-life in
      circulation of PEG-hirudin than of natural hirudin.

PMID- 8475481
TI  - Effects of Policosanol on platelet aggregation in rats.
AB  - Policosanol is the trivial name of a mixture of high molecular weight alcohols
      isolated from sugar cane, wherein octacosanol is the main component. The effects
      of Policosanol treatment on rat platelet aggregation were studied. Depending on
      the dose, Policosanol (5-20 mg/kg, perorally) inhibited the decrease in
      circulating platelet counts and collagen-induced malondialdehyde concentration in
      plasma. In rat clotted whole blood thromboxane B2 formation was inhibited by
      Policosanol (25 mg/kg). Policosanol (50-200 mg/kg, single doses) inhibited ADP
      induced platelet aggregation in platelet-rich plasma, while lower doses (25
      mg/kg) did not change responses to ADP significantly. However, rats treated with
      this dose (25 mg/kg) for 4 weeks showed a significant inhibition of platelet
      aggregation in PRP when a submaximal ADP concentrations was administered.

PMID- 8475482
TI  - Histidine-rich glycoprotein changes during pregnancy in a woman with genetically
      transmitted high levels of the protein and thrombotic diathesis.

PMID- 8475483
TI  - [Ethical aspects of keeping companion animals, an empirical and normative
      analysis].

PMID- 8475484
TI  - [Talking about this and that].

PMID- 8475485
TI  - [Various aspects and experiences relating to the current control of Newcastle
      disease].

PMID- 8475486
TI  - [Cat flu vaccine with Chlamydia psittaci].

PMID- 8475487
TI  - [Effectiveness of kennel cough vaccines].

PMID- 8475488
TI  - A fast PCR-SSP method for HLA-DQ generic typing.

PMID- 8475489
TI  - A novel diabetes-susceptibility HLA haplotype is present in the Croatian
      population.

PMID- 8475490
TI  - B*1401 encodes the B64 antigen: the B64 and B65 splits of B14 differ only at
      residue 11, a buried amino acid.

PMID- 8475491
TI  - Genes for insulin-dependent diabetes mellitus (IDDM) in the major
      histocompatibility complex (MHC) of African-Americans.
AB  - Mapping the MHC-associated susceptibility and resistance factors for insulin
      dependent diabetes mellitus (IDDM) has been difficult due to the strong linkage
      disequilibrium within the HLA-DR-DQ region. Previous analyses have suggested that
      the study of IDDM-associated haplotypes in different races might be useful for
      identifying the responsible genes. We have performed complete HLA class II
      genotyping to study susceptibility and resistance to IDDM in 34 randomly selected
      African-American IDDM patients and 69 ethnically-matched controls. IDDM patients
      showed highly significant increases of DRB1*0301, DRB1*0401, DRB1*0405,
      DQA1*0301, DQA1*0302, DQB1*0201 and DQB1*0302. Analysis of DQA1-DQB1 associations
      showed that DQA1*03 combined with both DQB1*0201 and DQB1*0302 gave the highest
      odds ratio, suggesting a synergistic effect due to formation of heterodimers
      encoded both in cis and in trans. Among the subsets of DR4, only DRB1*0401 and
      DRB1*0405 were increased in diabetic patients. Interestingly, DQB1*0602 and
      DQB1*0301, which have previously been thought to encode resistance factors in
      Caucasians, were not significantly decreased and, after removal of known
      susceptibility haplotypes, were found to have essentially identical frequencies
      in patients and controls.

PMID- 8475492
TI  - Structural diversity in the HLA-A10 family of alleles: correlations with
      serology.
AB  - The HLA-A10 crossreacting group consists of the A25, A26, A34, A43 and A66
      antigens. Here, we report allelic sequences for A43 and for 2 subtypes of both
      A26 and A34. Combining these results with previously determined sequences for
      A25, A26 and A66 enables molecular comparison of all the serologically defined
      A10 antigens. They form a closely related and well-defined group of alleles which
      may have originated with A*2601. Patterns of serological crossreactivity are
      correlated with sequence and a public epitope shared by A33 and members of the
      A10 family is localized to residues R62 and N63. The A*2501, A*4301 and A*6601
      alleles appear to have derived from A*2601 by single gene conversion events with
      other HLA-A alleles. In the case of A*4301, the donor allele was probably an A29
      allele as A*4301 has a small element of sequence in the alpha 1 helix (residues
      L62 and Q63) uniquely shared with A29. The chimaeric structure of A43 explains
      the reactivity of A43 molecules with both A10 and A29 alloantisera. The rare
      Oriental variant of A26 (A26v*) is encoded by an allele (A*2602) that differs
      from A*2601 by a unique nucleotide substitution which changes aspartate to
      asparagine at position 116 in the floor of the peptide binding groove. Thus
      A*2602 is a functionally distinct allele that originated by a point mutation.
      Alleles encoding A34 and A66 antigens are found to have very similar structures,
      explaining the difficulty in their serological definition.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8475493
TI  - A comparative study of HLA-DRB1 typing by standard serology and hybridization of
      non-radioactive sequence-specific oligonucleotide probes to PCR-amplified DNA.
AB  - A double-blind study was carried out to evaluate the relative performance and
      reliability of the PCR/SSOP assay compared to conventional serological typing in
      identifying HLA-DR alleles. A total of 268 consecutive samples were entered into
      the study. In 14 (5.2%) of the cases, HLA-DR serology could not be performed due
      to poor cell viability, while in seven (2.6%) of the cases, PCR/SSOP typing could
      not be performed due to poor amplification or to contamination with exogenous
      DNA. Among samples that were successfully typed by both methods, serologic typing
      correctly identified 455/465 (97.9%) DR antigens, while PCR/SSOP correctly
      identified 464/465 (99.8%) DR alleles (p = 0.0117, McNemar's test). The majority
      of discrepancies in serologic typing resulted from a lack of discriminative
      alloantisera to identify DR6 or DR103. For the overall sample set (N = 268),
      serology provided accurate results in 244 (91.0%) cases, while PCR/SSOP provided
      accurate results in 260 (97.0%) cases (p = 0.0037). The results of this study
      demonstrate that PCR/SSOP typing for HLA-DRB1 alleles provides results that are
      equal to or surpass serological typing for HLA-DR antigens. In addition, the
      PCR/SSOP approach offers the advantages of better reagent availability, lower
      cost, more rapid turn-around time, and greater accuracy, all of which would
      warrant its use as an HLA typing method of choice.

PMID- 8475494
TI  - Transcription analysis of non-HLA genes within or flanking the class II region in
      a B-cell line from an HLA-SCID patient.

PMID- 8475495
TI  - A new HLA-DR4 allele with a DR11 alpha-helix sequence.

PMID- 8475496
TI  - Teratogenic phase specificity of butyl benzyl phthalate in rats.
AB  - Pregnant rats were given butyl benzyl phthalate (BBP) by gastric intubation at a
      dose of 0.6, 0.75 or 1.0 g/kg on days 7-9, 10-12 or 13-15 of pregnancy. While
      treatment with BBP on days 7-9 or 13-15 at doses of 0.75 and 1.0 g/kg was
      significantly teratogenic, no evidence of teratogenicity was detected when BBP
      was given on days 10-12. The incidence of malformed fetuses was proportional to
      the dose of BBP. Treatment on days 7-9 with BBP at doses of 0.75 g/kg and above
      caused a significant increase in the number of skeletal malformations, such as
      fusion of the cervical vertebral arches and deformity of the thoracic vertebrae,
      but neither external nor internal malformations. Treatment on days 13-15 with two
      higher doses of BBP resulted in a significantly increased incidence of fetuses
      with external and skeletal malformations such as cleft palate and fusion of the
      sternebrae. The highest incidence of malformed fetuses occurred after treatment
      with BBP on days 13-15. It could be concluded that the susceptibility to the
      teratogenicity of BBP varies with the developmental stage at the time of
      administration.

PMID- 8475497
TI  - Strain differences in the response of Fischer 344 and Sprague-Dawley rats to
      monocrotaline induced pulmonary vascular disease.
AB  - The pyrrolizidine alkaloid (PA) monocrotaline (MCT) is thought to be activated in
      the liver to monocrotaline pyrrole (MCTP) which is then transported to the lungs
      where it causes a pulmonary vascular syndrome characterized by elevated pulmonary
      artery pressure and right ventricular hypertrophy. We have found that, as opposed
      to Sprague-Dawley (SD) rats, Fischer 344 (F344) strain rats are resistant to the
      ventricular hypertrophy and pressure changes induced by MCT. To determine whether
      this strain difference might be related to differences in hepatic activation of
      MCT to MCTP, we compared the response of SD and F344 rats to treatment with MCT
      or MCTP. We determined right ventricular pressure and ventricular weight ratios
      with each treatment for each strain. We also compared subjective lesion scores of
      histopathologic changes characteristic of MCT pneumotoxicity. Sprague-Dawley rats
      treated with either MCT or MCTP had elevated right ventricular pressures (Control
      13 +/- 1 mmH2O, MCTP 29 +/- 3 mmH2O, MCT 24 +/- 2 mmH2O) and increased right
      ventricular weight ratio (RV/LV + S) of 0.30 +/- 0.01 (Control), 0.44 +/- 0.05
      (MCTP), 0.44 +/- 0.02 (MCT). Histopathologic evaluation demonstrated that
      significant alveolar septal fibrosis, edema and type II cell hypertrophy was
      induced by both PAs in both rat strains but that F344 rats had significantly less
      vascular medial hypertrophy and adventitial inflammation than SD rats. MCTP
      treated SD rats had similar vascular and parenchymal alterations as those treated
      with MCT but with a lesser inflammatory component. We conclude that the strain
      differences in cardiac and pulmonary vascular responses to MCT also occur with
      MCTP treatment. This, combined with the similarity in alveolar parenchymal
      response to both PAs in both strains, suggests that these differences are related
      to the pulmonary vascular response rather than differences in hepatic metabolism.

PMID- 8475498
TI  - Protection against paraquat-induced toxicity with sulfite or thiosulfate in mice.
AB  - The toxicity of the herbicide paraquat in mice, measured by the single dose LD50
      after 7 days, was significantly decreased by coinjection of thiosulfite (1 g/kg;
      one time per day for 3 days) or sulfite (0.2 g/kg; one time per day for 3 days).
      However, the toxicity of paraquat was not changed by coinjection of sulfate (1
      g/kg; one time per day for 3 days). The body weight of mice was significantly
      decreased by paraquat treatment (30 mg/kg, i.p.). However, the decrease of body
      weight was abolished by coinjection of thiosulfate or sulfite but not by
      coinjection of sulfate. On the other hand, paraquat significantly decreased
      reduced glutathione contents in liver. The depletion of the glutathione contents
      was also abolished by coinjection of thiosulfate or sulfite but not by
      coinjection of sulfate. These results suggest that the preventive effect against
      paraquat-induced toxicity with thiosulfate or sulfite may involve the glutathione
      dependent detoxication in mice.

PMID- 8475499
TI  - Extrarenal and direct renal actions of atractyloside contribute to its acute
      nephrotoxicity in pentobarbital-anesthetized dogs.
AB  - Acute extrarenal and renal changes were noted following the intravenous
      administration of atractyloside (ATR) (12.97 and 32.40 mumol/kg) to spontaneously
      respiring, pentobarbital-anesthetized dogs. Severe hypoglycemia, respiratory
      depression and hypoxemia developed within 2 h. These extrarenal changes were
      accompanied by adverse changes in renal function, ultrastructural damage to S1,
      S2 and S3 cells of the proximal tubule and to thick ascending limb cells and an
      impaired ability of the kidneys to respond to a known diuretic--ethacrynic acid
      (EA). Mechanical ventilation of ATR-treated pentobarbital-anesthetized dogs
      circumvented the development of hypoxemia and all but eliminated the toxicity to
      S3 and thick ascending limb cells, thereby establishing that ATR's extrarenal
      actions contributed to its nephrotoxicity. On the other hand, direct renal
      actions of ATR were evident following its administration into the renal artery;
      certain important extrarenal effects were minimized, while adverse changes in
      renal function and ultrastructure of S1 and S2 cells were noted primarily in the
      ipsilateral kidney. The high degree of variability associated with ATR's systemic
      toxicity was confirmed and a similar degree of variability in its renal toxicity
      was established. Our results emphasize the importance of evaluating the
      extrarenal effects produced by any toxicant when determining its nephrotoxic
      potential.

PMID- 8475500
TI  - Examination of the structure-toxicity relationships of L-cysteine-S-conjugates of
      halogenated alkenes and their corresponding mercapturic acids in rat renal tissue
      slices.
AB  - Rat kidney slices were produced using a modified version of a mechanical tissue
      slicer. The slices were incubated with various concentrations of L-cysteine
      conjugates and mercapturic acids of halogenated alkenes in a submersion
      incubation system. The slices showed a time- and concentration-dependent toxicity
      to the nephrotoxic conjugates. The five L-cysteine conjugates tested: S-(1,2
      dichlorovinyl)-L-cysteine (1,2-DCVC), S-(1,1,2,2-tetrafluoroethyl)-L-cysteine
      (TFEC), S-(1-chloro-1,2,2-trifluoroethyl)-L-cysteine (CTFEC), S-(1,1-dichloro-2,2
      difluoroethyl)-L-cysteine (DCDFEC) and S-(1,1-dibromo-2,2-difluoroethyl)-L
      cysteine (DBDFEC) were more toxic compared to the corresponding mercapturic
      acids. Comparing the in vitro toxicity data with the in vivo data for the same
      compounds results in similar ranking for the relative nephrotoxicity of the
      conjugates.

PMID- 8475501
TI  - Reduction of hepatic phosphoenolpyruvate carboxykinase (PEPCK) activity by
      2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is due to decreased mRNA levels.
AB  - We have previously shown that the rate of hepatic gluconeogenesis is reduced in
      TCDD-treated rats and that this decrease in carbohydrate production is associated
      with a dose-dependent reduction of the activity of PEPCK, the rate limiting
      enzyme of gluconeogenesis. This derailment of glucose metabolism has been
      suggested to be the critical lesion in acute TCDD toxicity. To further elucidate
      the mechanism of decreased PEPCK activity we performed Northern blot analyses
      using a cDNA probe complementary to a portion of the mRNA coding for PEPCK. We
      have demonstrated that 4 and 8 days after TCDD treatment (125 micrograms/kg,
      p.o.) liver PEPCK mRNA in Sprague-Dawley rats was decreased to very low levels as
      compared to vehicle-treated and pair-fed control animals. This decline of PEPCK
      mRNA was paralleled by decreased levels of PEPCK protein, as revealed by Western
      blot analyses and was accompanied by a reduction in the enzymatic activity of
      PEPCK. These results indicate that the decrease of PEPCK activity by TCDD is most
      likely the result of decreased expression of the PEPCK gene. These together with
      previous results also suggest that many of the physiological responses occurring
      in TCDD-treated animals (reduced feed intake, decreased insulin, increased
      corticosterone, increased glucagon and cAMP levels) which would normally
      stimulate PEPCK gene expression, are ineffective. Furthermore tryptophan 2,3
      dioxygenase (TdO) activity, which is regulated in a very similar fashion to PEPCK
      activity, is also reduced after TCDD treatment, suggesting a common mechanism by
      which TCDD alters the regulation of these enzymes. P-450 1A1 mRNA and related
      EROD activity were maximally induced under the conditions of these experiments
      and represent a positive control for TCDD-related alterations of gene expression.
      However, because of differences in the dose-response characteristics of TCDD
      induced reduction of PEPCK activity and induction of EROD activity an involvement
      of the Ah receptor in the reduction of PEPCK activity cannot be postulated.

PMID- 8475502
TI  - Assessment of genotoxicity of two anti-parkinsonian drugs (selegiline
      hydrochloride and bromocriptine mesylate) in vivo in mouse bone marrow cells.
AB  - Selegiline hydrochloride (1-deprenyl) and bromocriptine mesylate (2-bromo-alpha
      ergocryptine) are two drugs that have shown considerable promise in the treatment
      of Parkinson's disease. The in vivo mouse bone marrow micronucleus assay was used
      to examine their clastogenic and cytotoxic potential in human clinical dose
      range. Our results indicate that both drugs failed to induce significant number
      of micronuclei and were not cytotoxic at any of the doses tested, in vivo in
      mouse bone marrow cells, at doses as high as 16-times the clinical dose used in
      humans.

PMID- 8475503
TI  - Production of polyclonal antibodies against 1,1'-ethyliden bis[L-tryptophan]
      (EBT), a potential contaminant causing eosinophilia-myalgia syndrome (EMS).
AB  - Eosinophilia-myalgia syndrome (EMS) is thought to be caused by the intake of
      contaminated L-tryptophan products. 1,1'-Ethyliden bis[L-tryptophan] (EBT) is one
      of the contaminants in the L-tryptophan products and is thought to be a possible
      cause of EMS. In the present study we report that anti-EBT antibodies are
      generated by immunizing rabbits with the low molecular weight substance, EBT
      (molecular weight 434). These antibodies may be available tools for elucidating
      the mechanisms responsible for the outbreak and/or development of EMS.

PMID- 8475504
TI  - The effects of chronic lead exposure on reactivity to frustrative nonreward in
      rats.
AB  - Prior to straight runway training two groups of rats received lead exposure (500
      ppm via the drinking water) for 106 days. Two additional groups of animals
      received access to plain tap water. An 80-trial runway acquisition phase followed
      an initial 60-day fluid exposure phase. During acquisition one lead-exposed group
      and one water-exposed group received 50% partial reinforcement training, while
      the remaining animals received continuous reinforcement training. An 80-trial
      extinction phase immediately followed acquisition. Acquisition results were
      characterized by superior performance by the continuous reinforcement animals.
      The partial reinforcement animals took significantly longer to extinguish the
      alleyway response than did the continuous reinforcement animals. Moreover, the
      lead-exposed, partial reinforcement animals took longer to extinguish in the goal
      section of the runway than did the water-exposed, partial reinforcement animals.
      Conversely, the lead-exposed, continuously reinforced animals displayed
      significantly more rapid goal-measure extinction than did the water-exposed,
      continuously reinforced animals. When interpreted by the classic frustration
      theory [1,2], these latter two findings are supportive of a heightened emotional
      reaction being promulgated by lead exposure.

PMID- 8475505
TI  - Zinc protection against cadmium-induced destruction of the monolayer of cultured
      vascular endothelial cells.
AB  - The effect of zinc on the destruction of vascular endothelial cell monolayer
      caused by cadmium was investigated using bovine aortic endothelial cells in a
      culture system. It was histologically revealed that cadmium-induced de
      endothelialized area formation was markedly prevented by zinc. Zinc prevented
      cadmium-induced detachment of [3H]thymidine-labeled endothelial cells from the
      monolayer. Although cadmium increased the activity of lactate dehydrogenase in
      the medium, a marker of nonspecific cell damage, zinc markedly suppressed it. On
      the other hand, zinc significantly prevented cadmium-induced decrease in the
      incorporation of [3H]thymidine into the acid-insoluble fraction of the growing
      cells. From these results, it was suggested that impairment of the endothelial
      cell monolayer caused by cadmium is protected by zinc; this protection was
      postulated to be due to both a reduction of the cell detachment caused by cadmium
      induced nonspecific cell damage and a decrease in cadmium inhibition of the cell
      proliferation which would help the repair of de-endothelialized areas.

PMID- 8475506
TI  - Allylamine enhances c-Ha-ras protooncogene expression in rat aortic smooth muscle
      cells.
AB  - Studies were conducted to evaluate the mechanisms involved in the deregulation of
      proliferative control induced by allylamine (AAM) in rat aortic smooth muscle
      cells (SMCs). Subcultured SMCs from animals treated with AAM (70 mg/kg) or tap
      water for 20 days were processed for measurements of [3H]thymidine incorporation
      and c-Ha-ras mRNA levels. Pre-confluent AAM cells stimulated with 10% fetal
      bovine serum exhibited enhanced mitogenic responsiveness relative to control
      cells. Decreased [3H]thymidine incorporation was observed in post-confluent
      cultures of both cell types relative to pre-confluent counterparts. A 5-fold
      increase in c-Ha-ras transcript levels was observed in pre-confluent/cycling
      cultures of AAM cells relative to controls. C-Ha-ras expression was markedly
      reduced in post-confluent cultures of both cell types as compared to pre
      confluent counterparts. No difference between control and AAM cells was observed
      during G1-synchronization of pre- or post-confluent cultures. These results
      suggest that the enhanced proliferative capacity induced by AAM is associated
      with alterations in cell cycle-related expression of the c-Ha-ras protooncogene.

PMID- 8475507
TI  - Selenium lethality: role of glutathione and metallothionein.
AB  - Male Sprague-Dawley rats (200-300 g) were pretreated (i.p.) with diethylmaleate
      (DEM; 3.1 mmol/kg) or propylene glycol (PG). After 1 h, three PG and three DEM
      groups received saline or sodium selenite (Se: 0.8 or 1.6 mg/kg) i.p. Eighty to
      one hundred percent mortality occurred within 3 h after Se in DEM-pretreated
      groups. Except for one PG and one DEM group, which were sacrificed after 1 h, the
      remaining groups received saline or Se (1.6 mg/kg) 25 h after pretreatment. No
      mortality occurred within 3 h after Se. Liver and kidney GSH decreased at 1 h,
      while liver MT increased at 28 h. The changes are related to Se-induced
      lethality.

PMID- 8475508
TI  - Prophylactic effect of methylprednisolone against cisplatin-induced
      nephrotoxicity in rats.
AB  - Male Sprague-Dawley rats were intravenously injected with 6.5 mg/kg of cisplatin
      combined with a subcutaneous methylprednisolone (MP) injection to study the
      prophylactic effects of steroid hormone on cisplatin-induced nephrotoxicity. In
      Expt. 1, the rats were injected twice with either 10, 20 or 50 mg/kg of MP4 and 0
      h prior to the cisplatin injection and in Expt. 2, they were given a single
      injection of 100 mg/kg of MP either 24, 4, 2 or 0 h prior to the cisplatin
      injection. In Expt. 1, elevations of the BUN and serum creatinine levels caused
      by the cisplatin were dose-dependently inhibited by the administration of MP. In
      the second experiment, BUN and serum creatinine levels in rats which were
      pretreated with MP 4 or 2 h prior to the cisplatin injection were significantly
      lower than those in rats which received cisplatin alone. Our preliminary results
      suggest that pretreatment with MP is an effective means of protection against
      cisplatin-induced nephrotoxicity.

PMID- 8475509
TI  - Subcellular and gel chromatographic distribution of manganese in the mouse brain:
      relation to the chemical form of chronically-ingested manganese.
AB  - The subcellular distribution of manganese and the binding characteristics of
      manganese to protein in the mouse brain were examined on G-75 Sephadex gel
      columns. Four manganese compounds were included at 2 g/kg in each food eaten by
      ddY mice for 12 months. The cerebral cortex manganese concentrations in the
      virtually insoluble manganese compounds were significantly higher than those in
      the control group. The brain striatal subcellular distribution and gel
      chromatographic profiles of manganese were similar among the divalent manganese
      compounds. On the contrary, the behaviour of MnO2 was little different from the
      divalent manganese compounds. There was more manganese associated with fast
      migrating ligands in the striatal cytosol of the manganese-exposed group than in
      the control groups.

PMID- 8475510
TI  - Three generation toxicity study of butylated hydroxytoluene administered to mice.
AB  - Butylated hydroxytoluene (BHT) was administered to mice, from 5 weeks of age of
      the F0 generation to the weaning of the F2 generation, in the diet at levels of 0
      (control), 0.015, 0.045, 0.135, and 0.405%, and some reproductive and
      neurobehavioural parameters were measured. There was no consistent significant
      effect on number of litters, litter size, and litter weight at birth for each
      generation. The body weight of the pups of the 0.015% BHT group was increased at
      birth and during the lactation period for each generation. In the F2 generation,
      the body weights of the pups of other treatment groups were increased during the
      lactation period, particularly at postnatal day (PND) 21. In the neurobehavioural
      parameters, a few parameters were increased in treatment groups; i.e., surface
      righting at PND 7 in the F1 generation, surface righting at PND 4 and negative
      geotaxis at PND 7 in the F2 generation. The dose levels of BHT in this study
      showed little adverse effect on reproductive and neurobehavioural parameters on
      mice.

PMID- 8475511
TI  - Induction of hepatic polyamines by di(2-ethylhexyl)phthalate in rats.
AB  - Wistar male albino rats, weighting 125-150 g, were administered di(2
      ethylhexyl)phthalate (DEHP) orally at 250, 500, 1000 and 2000 mg/kg body weight
      diluted in groundnut oil consecutively for 14 days. Spermidine and spermine of
      the livers were separated by thin-layer chromatography and quantitatively
      estimated by spectrofluorometry. DEHP exposure led to a significant increase in
      the absolute and relative weights of the liver at the 1000 and 2000 mg/kg dose
      levels. Spermidine and spermine levels were induced significantly in a dose
      dependent manner. The increase in spermidine was greater as compared to that of
      spermine. Our results manifest that DEHP significantly induces the levels of
      hepatic polyamines.

PMID- 8475512
TI  - Effect of protein kinase-C inhibitor on estradiol-induced deoxyribonucleic acid
      synthesis in rats.
AB  - Effect of polymyxin B (PMB, protein kinase C inhibitor) on estradiol-induced
      thymidine incorporation into uterine DNA was studied in ovariectomized rats.
      Administration of estradiol to ovariectomized rats enhanced thymidine
      incorporation to uterine DNA 15-fold. Pretreatment of rats with PMB 1 hour before
      the administration of estradiol had a dose-dependent inhibitory effect on
      estradiol induced response. PMB had no effect on the basal levels of thymidine
      incorporation. The inhibitory effect of PMB was also observed with prostaglandin
      F2 alpha (PGF2 alpha)-induced thymidine incorporation. Time-course experiments
      indicate that PMB was effective in alleviating estradiol-induced response when
      administered 1 hour before or 5 minutes after estradiol administration. However,
      PMB did not antagonize estradiol-induced response when administered at 2, 4, 8,
      and 12 hours after estradiol administration. Polymyxin E (PME), which differs
      from PMB by one conservative amino acid substitution in the ring structure and is
      devoid of PKC activation, did not decrease estradiol- or PGE2 alpha-enhanced
      thymidine incorporation. It is concluded that estradiol-induced protein kinase-C
      activation may play a role in the stimulation of thymidine incorporation into
      uterine DNA and that this effect occurs within the first 2 hours of estradiol
      administration.

PMID- 8475513
TI  - Synthesis and biochemical studies of estrone sulfatase inhibitors.
AB  - The synthesis and biochemical evaluation of estrone sulfatase inhibitors are
      described. Inhibitors were designed through modifications of the substrate
      estrone sulfate. An in vitro assay using the microsomal fraction isolated from
      human term placenta was used to evaluate sulfatase inhibitory activity. All the
      inhibitors (except sulfonyl chloride analog) exhibited low inhibitory activities
      in the screening assay. Sulfonyl chloride analog is a strong inhibitor, which
      caused 91.5% inhibition of the enzymatic activity at 300 microM.

PMID- 8475514
TI  - 3 alpha-hydroxy-5 alpha-pregnan-20-one is the only active anesthetic steroid in
      anesthetized mouse brain.
AB  - It was demonstrated that the anesthetic steroid 3 alpha-hydroxy-5 alpha-pregnan
      20-one mediates the loss of the righting response (LRR) in mice, in contrast to
      its metabolites, which are formed in vivo. To reach these conclusions, it was
      necessary to quantitate levels for 3 alpha-hydroxy-5 alpha-pregnan-20-one and its
      metabolites at the time of LRR. Methods were used that blocked the production of
      essentially all of the metabolites. Chromatography of brain extracts by thin
      layer chromatography and high-performance liquid chromatography after anesthesia
      with 3 alpha-hydroxy-5 alpha-[3H]pregnan-20-one showed only a single peak that
      corresponded to 3 alpha-hydroxy-5 alpha-[3H]pregnan-20-one.

PMID- 8475515
TI  - Steroids 51. An improved synthesis of ORG 2058 and the synthesis of [3H]ORG 2058.
AB  - 16 alpha-Ethyl-21-hydroxy-19-norpregn-4-ene-3,20-dione (ORG 2058) is a ligand
      widely used in progesterone receptor assays. An improved synthesis of the
      compound is reported, starting from norethisterone acetate. The preparation of
      the tritiated radioligand [3H]ORG 2058 is also described.

PMID- 8475516
TI  - Synthesis of potential C27-intermediates in bile acid biosynthesis and their
      deuterium-labeled analogs.
AB  - In connection with studies of alternative pathways in bile acid biosynthesis,
      potential intermediates in a pathway starting with 27-hydroxylation of
      cholesterol have been prepared in natural and deuterated forms. Established
      methods were used to prepare 27-hydroxycholesterol and 3 beta-hydroxy-5
      cholestenoic acid. Clemmensen reduction of kryptogenin in unlabeled and
      deuterated solvents yielded 27-hydroxy-cholesterol and 16-oxo-5-cholestene-3
      beta,27-diol, which were separated by adsorption chromatography on Unisil. The
      labeled 27-hydroxycholesterol and 3 beta-hydroxy-5-cholestenoic acid derived from
      it consisted of molecules with seven (50%), six (20%), and eight (20%) deuterium
      atoms, and unlabeled molecules were not detected. The acetates of 27
      hydroxycholesterol and methyl 3 beta-hydroxy-5-cholestenoate were 7 alpha
      hydroxylated in a copper-catalyzed reaction with tert-butylperbenzoate, and the
      products were purified by chromatography on Unisil. The 7 beta-epimers were
      obtained as side products. Labeled 3 beta,7 alpha-dihydroxy-5-cholenoic acid was
      prepared in the same way from 3 beta-hydroxy-5-[2,2,4,4,23-2H5]-cholenoic acid.
      The 3-oxo-delta 4 analogs of the 3 beta-hydroxy-delta 5 compounds were prepared
      by oxidation with cholesterol oxidase. The labeled products had the same isotopic
      composition as the starting materials. Gas chromatographic retention indices and
      mass spectral characteristics of the trimethylsilyl ether derivatives of the
      neutral steroids and the methylated acids are given for all compounds.

PMID- 8475517
TI  - Sex-specific response of bone cells to gonadal steroids: modulation in
      perinatally androgenized females and in testicular feminized male rats.
AB  - We have found previously that rat diaphyseal bone in vivo, as well as rat embryo
      calvaria cells in culture, show a sex-specific response to gonadal steroids in
      stimulation of creatine kinase (CK)-specific activity, and the rate of
      [3H]thymidine incorporation into DNA; male-derived cells responded only to
      testosterone or to dihydrotestosterone (DHT), whereas female-derived cells were
      stimulated exclusively by estradiol (E2). In this study, we tested whether
      developmental hormone manipulation could alter this sex specificity. We showed
      that diaphyseal bone of prenatally or neonatally androgenized female rats
      responds to a single injection of either E2 (5 micrograms/rat) or DHT (50
      micrograms/rat) at 3-4 weeks postandrogenization. This response of androgenized
      female diaphyseal bone to androgen gradually declines; 3 months posttreatment,
      diaphyseal bone no longer responds to DHT and reverts to its original sex
      specificity. Rat embryo calvaria cell cultures prepared from female fetuses
      androgenized in utero showed the same lack of hormonal specificity, that is, the
      cells responded to both E2 (30 nM) or DHT (300 nM). Cells derived from the male
      siblings of the prenatally androgenized rats were not affected and responded only
      to DHT. In contrast to experiments in utero, in vitro administration of
      testosterone (1 microM) or E2 (1 microM) to calvaria cells from female embryos
      failed to cause the cells to respond to DHT. Androgen receptor-deficient (Tfm)
      male rats, which have approximately 10% of the normal response to androgens, also
      showed a response to both testosterone and E2 in comparison to their normal male
      siblings, whose bones responded only to androgens.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8475518
TI  - New delta 8- and delta 8(14)-5 alpha,6 alpha-epoxysterols from the marine sponge
      Spongia officinalis.
AB  - Six new delta 8- and delta 8(14)-5 alpha,6 alpha-epoxysterols (1-6) have been
      isolated from a collection of the Mediterranean sponge Spongia officinalis. The
      structures of the new metabolites, isolated as diacetate derivatives, have been
      determined by spectral analyses and an x-ray diffraction experiment performed on
      the diacetyl derivative of 1.

PMID- 8475519
TI  - An improved synthesis of 18-norandrost-4-ene-3,17-dione.
AB  - We describe the synthesis of 13 beta- and 13 alpha-H-18-nor-androst-4-ene-3,17
      dione (1a and 1b) from 18-hydroxyprogesterone (18-->20) hemiketal, via the 18
      acetoxy-17 beta-hydroxyandrost-4-en-3-one formed by a modified Baeyer-Villiger
      reaction. Saponification of 18-acetoxyandrost-4-ene-3,17-dione with sonication,
      then retroaldolization in the presence of a formaldehyde trap, methone, afforded
      the mixture of 1a and 1b with 80% yield in a "one-pot" procedure and at room
      temperature. This yield was greatly improved, compared with the already published
      procedure.

PMID- 8475520
TI  - Sexual networking in provincial Thailand.
AB  - Thailand is currently experiencing a major HIV epidemic, spread primarily through
      heterosexual contact. Patronage of prostitutes is relatively common. In-depth,
      open-ended interviews were conducted in a Central Thai province with a purposive
      sample of 181 urban men who had had sexual relations with at least two different
      women during the prior year. Additional qualitative information is provided by
      interviews with 50 women. The most common network pattern for men was a
      combination of commercial and noncommercial sexual relationships. Men reported
      that they commonly used condoms when they engaged in sex with prostitutes, but
      condom use was lowest for men who were the most frequent patrons. In
      noncommercial, nonmarital relationships, men screen partners for risk rather than
      practice safe sex, and condom use is generally low. Persons involved in
      noncommercial sexual networks are largely unaware that their partner may link
      them to a larger network of sexual contacts and associated risks of HIV
      infection. Men who have both commercial and noncommercial sexual partners can be
      found throughout the social strata. A program that focuses only on the closed
      commercial sex network will address only partially the real risk situations.

PMID- 8475521
TI  - Human rights and reproductive choice.
AB  - A central challenge in developing reproductive health strategies is giving real
      meaning to the right of couples and individuals to determine, freely and
      responsibly, the number and spacing of their children. This article places the
      right of reproductive choice in legal and historical contexts, highlights salient
      issues that arise in trying to formulate international standards for its
      enforcement, and examines two particularly thorny issues: the tension between
      demographic priorities and reproductive choice and the tension between
      international standards and local custom/religion. The article calls on health
      professionals to participate actively in the elaboration of reproductive rights,
      both through their immediate work in the health-care field and through
      involvement in the international policymaking process that will take place in
      three upcoming international conferences.

PMID- 8475522
TI  - Population policy in South Africa.
AB  - This report examines the current state and likely future directions of population
      policy in South Africa with particular reference to family planning activities
      set against the background of apartheid and its demise. In the apartheid era,
      population policy was perceived by most blacks as an instrument for the control
      of their number and movements. Recently, policy has been adjusted by the national
      Population Development Program in response to the changing sociopolitical
      situations in the country. A national post-apartheid population policy is likely
      to retain many of the components of this new program. However, a future nonracist
      and democratic society would probably invite a review of population activities in
      the country and raise wider issues concerning rationales, organization, and
      strategies for the delivery of family planning in South Africa.

PMID- 8475523
TI  - The client's view of high-quality care in Santiago, Chile.
AB  - The meaning of quality of care for the women who receive reproductive health
      services at a family planning and maternal and infant care clinic in Santiago,
      Chile, was examined to describe the clinic's service from the women's point of
      view. A participatory research project with the staff of the clinic was
      conducted. The central part of that study, reported here, consisted of interviews
      with 60 of the 330 women who came to the clinic during two weeks in June 1991.
      The women defined high quality of care as "being treated like a human being."
      Among specific elements of care they identified were cleanliness, promptness and
      availability of service, time made available for consultation, learning
      opportunities for themselves and their partners, and cordial treatment. Clients'
      view of quality of care must be supplemented by professional judgments about how
      well services meet clients' needs. But the client's view is determinant if
      improvements are to result in greater acceptance and sustained use of the
      services offered. The issues identified by the clients involve only minor costs
      for the clinic.

PMID- 8475525
TI  - Why do projections of the cost of family planning differ so widely?

PMID- 8475524
TI  - Sexual activity, family life education, and contraceptive practice among young
      adults in Banjul, The Gambia.
AB  - This report presents results from a 1986-87 two-stage probability sample survey
      of 2,507 young men and women aged 14-24 living in the Greater Banjul region of
      The Gambia. Although premarital sexual activity was common and began at an early
      age, lack of knowledge and limited access to modern contraceptives were obstacles
      to the use of family planning. Of all ever sexually active single persons, only
      21 percent of the young women and 7 percent of the young men had practiced
      contraception at the time of first intercourse. Almost half of the sexually
      active young adults had ever used contraceptives, with oral contraceptives and
      condoms being the methods most widely known and used. Results of logistic
      regression analyses show that attendance at family life education lectures in
      school had significant positive relationships to both knowledge and use of
      contraceptives among the young people surveyed. The study presents encouraging
      evidence that acceptance of modern contraceptive use is beginning to take hold
      among young people in urban Banjul.

PMID- 8475526
TI  - Peru 1991/1992: results from the Demographic and Health Survey.

PMID- 8475527
TI  - Suicide prediction revisited.
AB  - Data from a 1983 prospective study of suicide in a cohort of 4800 psychiatric
      inpatients were reanalyzed using logistic regression, which is more appropriate
      for a binary outcome. The results were the same as in the previous study: too few
      of the subsequent suicides were identified and there were too many false
      positives to make this procedure useful. Several additional "artificial" logistic
      regression analyses were done: one series randomly removed increasing numbers of
      nonsuicide cases to increase the base rates; another series added an increasingly
      powerful hypothetical "test." Both of these maneuvers helped, but fell well short
      of perfection.

PMID- 8475528
TI  - Dysfunctional attitudes and suicidal ideation in psychiatric outpatients.
AB  - To determine if specific sets of dysfunctional attitudes were related to suicidal
      ideation, the 100-item Dysfunctional Attitude Scale (DAS) was administered to 908
      psychiatric outpatients along with the Beck Depression Inventory (BDI),
      Hopelessness Scale (BHS), Self-Concept Test (BST), and Scale for Suicide Ideation
      (SSI). The SSI was used to classify the outpatients into 97 (10.7%) suicide
      ideators and 811 (89.3%) nonideators, and the DAS was scored for nine subscales
      described by Beck, Brown, Steer, and Weissman (1991). None of the DAS subscales
      discriminated the ideators and nonideators or was significantly related to SSI
      total scores of the suicide ideators after controlling for sex, age, diagnosis of
      a mood or panic disorder, comorbidity, presence of a personality disorder, a
      history of a past suicide attempt, the BDI, the BHS, and the BST. The
      contributions of sets of dysfunctional attitudes for identifying and explaining
      suicidal ideation were overshadowed by a history of a past suicide attempt and
      hopelessness.

PMID- 8475529
TI  - Narcissistic crises of aging and suicidal despair.
AB  - After reviewing some of the dangers inherent in oversimplifying the nature of
      suicide for public education purposes, a model (the "wedding-cake model") of
      elderly suicide is outlined. This model is derived from a community-based
      psychological autopsy study. It is hypothesized that elderly persons who die by
      suicide have a lifelong character fault that remains invisible until aging life
      changes force the issue into the open.

PMID- 8475530
TI  - Suicide causation: pies, paths, and pointless polemics.
AB  - Most people readily agree that suicide is caused by a complex web of many
      different factors. However, for many people the concept of a single event
      resulting from the combined effect of a constellation of different factors
      (multiple causation) is imperfectly understood. Unfortunately, a naive
      understanding of multiple causation can lead to needless arguments about what
      "really" causes suicide, and pointless debate about the "right" point for
      preventive intervention. In this paper, I review several simple conceptual models
      of multiple causation as they relate to suicide prevention. I suggest that a more
      explicit understanding of the nature of multiple causation has the potential to
      obviate some of these misguided arguments and to facilitate cooperative
      prevention efforts among person who choose to apply their energies at different
      points in the causal chain of suicide.

PMID- 8475531
TI  - Factor composition of the Suicide Intent Scale.
AB  - An exploratory analysis of the Suicide Intent Scale was performed on a sample of
      98 psychiatric inpatients who had made suicide attempts. The factor analysis was
      performed using a method for polychotomous data, and resulted in a two-factor
      solution. The Lethal Intent factor contained items pertaining to the subjective
      level of lethal intent, while the Planning factor contained items largely related
      to objective planning for the attempt. Preliminary analysis of these factors
      suggest that the Suicide Intent Scale can be used to evaluate two separate
      aspects of suicidal behavior.

PMID- 8475532
TI  - Adolescent suicidal risk: psychological, problem solving, and environmental
      factors.
AB  - This study examined the life stress and problem-solving interactional model of
      suicide proposed by Clum, Patsiokas, and Luscomb (1979). Thirty-three
      hospitalized suicidal adolescents were compared with 21 adolescents hospitalized
      for other psychiatric problems and with 89 controls. The assessment battery was
      composed of psychological measures, problem-solving measures, and environmental
      and family measures. The discriminant analyses revealed that the suicide group
      could be discriminated from the psychiatric control group but not from the high
      school control group. Unexpectedly, life stresses did not contribute to the
      identification of current suicide risk. The results suggest the importance of
      assessing suicide risk at the time of admission to minimize any subsequent
      changes in the risk group.

PMID- 8475533
TI  - Dreams and suicide.
AB  - The dreams of suicidal patients are contrasted to those of nonsuicidal, depressed
      patients. The dreams of suicidal patients often reveal wishes for revenge,
      punishment, reunion, fusion, and rebirth. Confusions between the patient's body
      and that of others are suggested by the dreams of some suicidal patients. Dreams
      in suicidal individuals may portray disintegration of the self (self-state
      dreams). The phenomenon of transparency in suicidal dreams is discussed as it
      pertains to Rorschach studies.

PMID- 8475534
TI  - The media and suicide: a nonadditive model, 1968-1980.
AB  - Unlike previous work, the present investigation tests a nonadditive model of the
      suggestion/imitation. Suicide stories are predicted to have the greatest effect
      on suicide in times of high suicidogenic conditions. The latter are measured in
      terms of unemployment. Data on the American monthly suicide rate are analyzed
      using Cochrane Orcutt techniques. While support was found for the nonadditive
      model based on an interaction effect between media stories and the rate of
      unemployment, it did not prove more powerful than an additive model. Future work
      is needed, however, for a systematic testing of the nonadditive thesis.

PMID- 8475535
TI  - Suicide in mental disorder.

PMID- 8475536
TI  - Suicide deaths in males during morning hours.

PMID- 8475537
TI  - Enhancement of allograft survival by combination RS-61443 and DUP-785 therapy.
AB  - Current maintenance immunosuppressive therapy consists of cyclosporine in
      combination with prednisone and azathioprine. Unfortunately these agents are
      associated with significant side effects resulting in post-transplant morbidity
      and mortality. Therefore, the search for new immunosuppressive agents is
      essential, not only to improve the results after organ transplantation but
      equally important to reduce morbidity. Recently two new antiproliferative drugs,
      RS-61443 (RS) and DUP-785 (DUP), have become available. RS (mycophenolate
      mefotil), a semisynthetic derivative of mycophenolic acid, inhibits purine de
      novo synthesis by noncompetitively and reversibly inhibiting inosine
      monophosphate dehydrogenase. DUP (brequinar sodium) inhibits pyrimidine synthesis
      by reversibly inhibiting dehydroorotate dehydrogenase. We evaluated
      subtherapeutic combination RS and DUP therapy in the rat (ACI-->LEW) heterotopic
      heart allograft model. Median graft survival with no treatment, RS (20
      mg/kg/day), DUP 3 mg/kg (3x /week), or DUP 6 mg/kg (3x/week) was 6.5, 11.5, 9.5
      and 14.5, respectively. Median graft survival with combination therapy (RS 20
      mg/kg, DUP 6 or 3 mg/kg 3x/week) was 133 days and 121 days, respectively.
      Furthermore, mean survival following cessation of all therapy at 100 days
      posttransplant was dramatically prolonged to 65.7 +/- 43.8 days in animals
      receiving combination therapy (RS 20 mg/kg/day, DUP 6 mg/kg 3x/week). Despite the
      potent immunosuppressive activity, recipients treated with combination therapy
      demonstrated no side effects and gained body weight during the treatment. To
      determine if low-dose combination therapy was effective in reversing ongoing
      rejection, treatment was delayed until the 5th postoperative day. Four of 5
      recipients (80%) receiving RS monotherapy (60 mg/kg/day), 5 of 5 recipients
      (100%) receiving DUP monotherapy (12 mg/kg/day), and 4 of 5 grafts (80%)
      receiving combination therapy (RS 40 mg/kg/day and DUP 6 mg/kg/day) survived over
      21 days. Our results demonstrated that combination therapy significantly
      prolonged graft survival, and that the progression of advanced rejection was
      halted immediately. RS and DUP combination may provide a potent immunosuppressive
      therapy in clinical transplantation.

PMID- 8475538
TI  - Prolongation of canine intestinal allograft survival with RS-61443, cyclosporine,
      and prednisone.
AB  - The efficacy of RS-61443 and cyclosporine utilized either alone or in combination
      was assessed in both a segmental heterotopic and total orthotopic canine
      intestinal transplant model. Twenty-eight dogs underwent segmental (150-cm)
      heterotopic intestinal transplants and five dogs total orthotopic transplants.
      Five heterotopic groups were compared: group 1, no immunosuppression; group 2,
      cyclosporine and prednisone; group 3, RS-61443, cyclosporine and prednisone;
      group 4, RS-61443 and prednisone; and group 5, RS-61443 and subtherapeutic
      cyclosporine. Group 3 animals achieved a median survival of 136 days, while the
      median survivals of groups 1, 2, 4, and 5 were < or = 10 days (P < .001). Twenty
      deaths in groups 1 through 5 were secondary to allograft rejection, two were due
      to infection, and two were unexplained. Four animals in group 3 were sacrificed,
      one at 83 days due to diarrhea and weight loss and three at the termination of
      the study. The median survival of five dogs undergoing total orthotopic
      transplantation (group 6) was 27.0 days and was significantly longer than groups
      1, 4, and 5 (P < .01). No dog in this group had intestinal rejection--however,
      four were sacrificed due to weight loss and one died of malnutrition. The
      combination of RS-61443 and cyclosporine significantly prolonged intestinal
      allograft survival in both the heterotopic and orthotopic transplant models.
      Clinically, this combination may be promising for both combined liver-intestinal
      and isolated intestinal transplantation.

PMID- 8475539
TI  - Prolonging discordant xenograft survival with anticomplement reagents K76COOH and
      FUT175.
AB  - The guinea pig heart, when transplanted into the rat heterotopically, is rejected
      within 30 min via activation of the alternative complement pathway. Natural
      antibody does not contribute to rejection. This xenotransplantation model was
      used to assess the effect of anti-complement reagents on discordant xenograft
      survival. In vivo administration of K76COOH (K76) to rats induced only slight
      suppression of factors B and D and a marked decrease of C3, leading to the
      depression of ACH50 (reflecting the potency of the alternative pathway). On the
      other hand, FUT175 (FUT) reduced C3 activity by about 80% and inhibited factor B
      activity nearly 100% < 1 hr after the administration, but inhibited factor D
      activity only marginally. FUT abrogated ACH50 for > 6 hr. Of note, the xenograft
      beating time was prolonged approximately 3 times by FUT but not by K76,
      suggesting that direct inhibition of plasma serine protease factor B results in
      the complete suppression of ACH50 and graft survival. The administration of both
      K76 and FUT resulted in the longest graft survival, but the effects of these
      reagents were abolished by additional antigraft antibody. Anticomplement reagents
      that block factor B and C3 are therefore effective for prolongation of discordant
      xenograft survival when the graft rejection is associated with the complement
      alternative pathway.

PMID- 8475540
TI  - Treatment of severe diabetes mellitus for more than one year using a vascularized
      hybrid artificial pancreas.
AB  - We report the successful application of a hybrid artificial pancreas device for
      the treatment of severe diabetes mellitus induced by total pancreatectomy in two
      dogs. Control of the blood sugar was achieved for more than 1 year in these two
      animals without any immunosuppressive therapy. Although exogenous insulin was
      required therapy. Although exogenous insulin was required during the latter part
      of the study period, removal of the devices resulted in a rapid increase in the
      fasting blood sugar levels and the exogenous insulin requirements (P < 0.001
      versus weeks 1-52 in both dogs). Metabolic studies, postexplant in vitro studies,
      and histologic analyses confirmed islet cell survival and insulin production by
      the devices. This hybrid artificial pancreas has a clear clinical potential for
      islet cell transplantation without immunosuppression.

PMID- 8475541
TI  - Islet allograft, islet xenograft, and skin allograft survival in CD8+ T
      lymphocyte-deficient mice.
AB  - Despite extensive study, the immunologic mechanisms mediating allograft rejection
      have not been completely defined. In the current study, we evaluated the T cell
      subsets important in islet allograft, skin allograft, and islet xenograft
      rejection using a genetically engineered line of mice deficient in beta 2
      microglobulin expression. Because these mice lack cell surface MHC class I
      expression, they are deficient in T cells of the CD8 subset (class I-restricted
      cytotoxic T cells). Pancreatic islet allografts transplanted to CD8+ T cell
      deficient recipients showed prolonged survival compared with controls. No
      prolongation was observed in the survival of pancreatic islet xenografts or in
      the survival of skin allografts transplanted to the CD8+ T cell--deficient hosts.
      We conclude that CD8+ T cells play a prominent role in islet allograft, but not
      islet xenograft or skin allograft, rejection in mice.

PMID- 8475542
TI  - Nonhuman primate responses to murine and humanized OKT4A.
AB  - A nonhuman primate antimurine response (MAMA) has been observed in 17 cynomolgus
      renal allograft recipients of murine OKT 4A. Neither cyclosporine, nor total
      lymphoid irradiation, nor donor bone marrow preparation inhibited this
      antixenogeneic response. In an attempt to alter the antimurine basis of the
      response, a humanized chimeric OKT4A (IgG4) containing the entire variable
      portion of the murine OKT4A and a humanized CDR grafted OKT4A mAb sharing only
      the Complementarity Determining Region from the murine OKT4A, were administered
      to 8 cynomolgus allograft recipients. MAMA was detected in each recipient. In
      contrast to sera from recipients of murine OKT4A, sera from recipients of
      humanized OKT4A displayed no reactivity to other murine mAbs. MAMA specificity
      did not assay constant (C) region differences between the murine and humanized
      mAb; however, C region homology in humans should preclude a human antimouse
      antibody (HAMA) to the Fc portion of a humanized mAb. Furthermore, cynomolgus
      recipient serum levels of the humanized OKT4A mAb were maintained (> 1
      microgram/ml) for a longer period than following treatment with murine OKT4A
      (murine < 12 days versus between 12 and 24 days for the humanized). If the HAMA
      response to humanized mAb in future clinical trials, were to be predictably anti
      idiotypic, then the opportunity for treatment with sequential mAbs of differing
      idiotypes would be retained. Moreover, these current studies also suggest that
      humanized construction may influence the duration of therapeutic mAb levels.
      Thus, anti-idiotypic reactivity may not be as consequential to the clinical
      administration of humanized mAb to allograft recipients.

PMID- 8475543
TI  - Livers from fasted rats acquire resistance to warm and cold ischemia injury.
AB  - Successful liver transplantation is dependent upon many factors, one of which is
      the quality of the donor organ. Previous studies have suggested that the donor
      nutritional status may affect the outcome of liver transplantation and
      starvation, due to prolonged stay in the intensive care unit, may adversely
      affect the liver. In this study we have used the orthotopic rat liver transplant
      model to measure how fasting the donor affects the outcome of liver
      transplantation. Rat livers were preserved with UW solution either at 37 degrees
      C (warm ischemia for 45-60 min) or at 4 degrees C (cold ischemia for 30 or 44
      hr). After preservation the livers were orthotopically transplanted and survival
      (for 7 days) was measured, as well as liver functions 6 hr after transplantation.
      After 45 min of warm ischemia 50% (3 of 6) animals survived when the liver was
      obtained from a fed donor about 80% (4 of 5) survived when the liver was obtained
      from a three-day-fasted donor. After 60 min warm ischemia no animal survived (0
      of 8, fed group). However, if the donor was fasted for 3 days 89% (8 of 9) of the
      animals survived for 7 days. Livers cold-stored for 30 hr were 50% viable (3 of
      6) and fasting for 1-3 days did not affect this outcome. However, if the donor
      was fasted for 4 days 100% (9 of 9) survival was obtained. After 44-hr
      preservation only 29% (2/7) of the recipients survived for 7 days. If the donor
      was fasted for 4 days, survival increased to 83% (5/6). Liver functions, bile
      production, and serum enzymes were better in livers from the fasted rats than
      from the fed rats. Fasting caused a 95% decrease in liver glycogen content. Even
      with this low concentration of glycogen, liver viability (animal survival) after
      warm or cold ischemia was not affected, and livers with a low glycogen content
      were fully viable. Thus liver glycogen does not appear to be important in liver
      preservation. This study shows that fasting the donor does not cause injury to
      the liver after warm or cold ischemia. In fact, the livers appeared to be better
      able to tolerate ischemia when obtained from fasted rats. Thus donor nutritional
      status may be an important factor for outcome of liver transplantation. Livers
      from fasted donors may be capable of tolerating long-term preservation better
      than livers from fed donors.

PMID- 8475544
TI  - Assessment of purine metabolism in human renal transplantation.
AB  - Cortical levels of nucleotides and their degradation products from 42
      transplanted human kidneys have been studied. Biopsies were performed during
      renal harvesting just before cooling, at the end of cold storage, and following
      reinstallment of renal blood circulation. ATP levels fell, and AMP and
      degradation products (inosine monophosphate [IMP], inosine, adenosine, and
      hypoxanthine) increased during cold storage and returned to near-normal values 30
      min after recirculation. The major degradation product found was hypoxanthine,
      indicating very poor xanthine oxidase activity in human kidneys. The sum of
      adenine nucleotides (ATP+ADP+AMP) did not significantly decrease after cold
      storage, but adenylate energy charge (ATP+1/2ADP/ATP+ADP+AMP) was reduced to
      half, being recovered in implanted kidneys. The sum of adenine nucleotides was
      significantly reduced after implantation. The rate of acute tubular necrosis was
      higher in kidneys preserved for more than 30 hr. Kidneys with acute tubular
      necrosis had significantly lower levels of the total pool of adenine nucleotides
      at reperfusion, but there was no correlation between incidence of acute tubular
      necrosis and ATP or other metabolite levels in the kidneys before or during cold
      preservation. The success of human kidney transplantation does not seem to depend
      only on the pool of residual nucleotides at the end of cold storage but on other
      factors that determine the ability of the cell to recover a normal energy state
      after reperfusion.

PMID- 8475545
TI  - A rat fatty liver transplant model.
AB  - A rat model of fatty liver transplantation has been developed to study primary
      nonfunction in fatty liver grafts. ACI rats were fed with a diet deficient in
      choline and methionine for 7, 14, 28, and 42 days. Fat content in the
      pretransplant livers was examined by gas chromatography and histology. The main
      constituent of the fatty droplets was determined to be triglyceride. The
      triglyceride concentration reached a maximum by day 14 and remained constant for
      an additional 28 days. Histology revealed an absence of necrosis in 14- and 28
      day fatty livers but scattered hepatocytic necrosis and inflammation in 42-day
      fatty livers. After being given cold (UW stored, 4 degrees C) or warm (37 degrees
      C) ischemia, the fatty liver was orthotopically transplanted into normal ACI
      rats. The one-week survival of fatty liver grafts after 6, 12, 18, and 24 hr cold
      preservation was 5/5, 5/6, 3/8, 0/6 for 14-day fatty liver and 5/5, 4/6, 0/8, 0/6
      for 42-day fatty livers. The survival of normal liver grafts was 5/5, 6/6, 5/9,
      2/8, respectively. Increased survival rate was correlated with the absence of
      hepatocytic necrosis. The survival after 15 and 30 min warm ischemia prior to
      transplant was 5/5, 2/6 for normal liver grafts and 4/7, 0/6 for 28-day fatty
      liver graft, respectively. Fatty livers were less resistant to damage induced by
      cold or warm ischemia.

PMID- 8475546
TI  - The effect of immunosuppression on pre-existing cancers.
AB  - This study of 939 pre-existing malignancies that occurred in 913 renal transplant
      recipients showed that in 823 patients the tumors were treated prior to or at
      transplantation, in 78 after transplantation, at an unspecified time in 20, while
      18 received no treatment. Of patients treated pretransplantation 185 (22%)
      developed recurrences posttransplantation. Low recurrence rates (0-10%) occurred
      with incidentally discovered renal tumors; lymphomas; and testicular, uterine
      cervical, and thyroid carcinomas. Intermediate recurrence rates (11-25%) occurred
      with carcinomas of the uterine body; Wilms' tumors; and carcinomas of the colon,
      prostate, and breast. High recurrence rates (> or = 26%) occurred with carcinomas
      of the bladder, sarcomas, malignant melanomas, symptomatic renal carcinomas,
      nonmelanomatous skin cancers, and myelomas. Overall 53% of 185 recurrences
      occurred in patients treated 0-24 months pretransplantation, 34% in patients
      treated 25-60 months pretransplantation, and 13% in patients treated > 60 months
      pretransplantation. Of 78 patients whose cancers were first treated after
      transplantation, 27% developed recurrences. However, 63% did not do so in follow
      ups averaging 53 months. A two-year waiting period between treatment of cancer
      and transplantation is justified for most neoplasms except for incidentally
      discovered renal carcinomas, in situ carcinomas, and possibly focal neoplasms (a
      small single focus), low-grade bladder cancers, and basal cell skin cancers. In
      these cases no waiting period is necessary. On the other hand, a waiting period >
      2 years is necessary for most malignant melanomas, breast carcinomas, and
      colorectal carcinomas. Conflicting data are presented as to whether
      immunosuppression affects growth of existing tumor cells but most of the evidence
      suggests acceleration of neoplastic growth.

PMID- 8475547
TI  - A randomized, prospective, double-blinded trial of cyclosporine vs. OG37-325 in
      cadaveric renal transplantation--a preliminary report.
AB  - The efficacy of cyclosporine is documented, but it has side effects that are
      troublesome. Another compound, OG37-325, has been identified that appears to have
      similar efficacy, but less nephrotoxicity. This study was designed to address the
      benefits and toxicities of cyclosporine and OG37-325 in a prospective,
      randomized, double-blinded trial in cadaveric renal transplant recipients. The
      preliminary results demonstrate similar outcomes in terms of patient and graft
      survival, but suggest less nephrotoxicity in the OG37-325-treated patients.
      Longer follow-up will delineate the utility of OG37-325 in solid-organ
      transplantation.

PMID- 8475548
TI  - Risk factors for chronic rejection in renal allograft recipients.
AB  - Chronic rejection is a major barrier to long-term renal allograft survival.
      Cyclosporine, though effective at reducing graft loss to acute rejection, has had
      little impact on the incidence of chronic rejection. Between June 2, 1986 and
      January 22, 1991, 587 kidney-alone transplants (566 patients) were performed, and
      had been entered into our renal transplant database and had at least 1 year of
      follow-up: 103 with biopsy-proven chronic rejection (37 living-related donor, 66
      cadaver) and 484 without chronic rejection (236 LRD 248 CAD). The 5-year patient
      survival was 84% for recipients with biopsy-proven chronic rejection vs. 89%
      without (P = .08). The 5-year graft survival was 31% for recipients with biopsy
      proven chronic rejection vs. 81% without (P < .0001). Using multivariate
      analysis, we determined the impact on the incidence of chronic rejection of these
      variables: transplant number, age at transplant (< 18 years, 18 to 50 years, > 50
      years), gender, human leukocyte antigen matching, peak and transplant panel
      reactive antibody, acute rejection episodes, infections (including
      cytomegalovirus, viral, and bacterial), donor age, and CsA dosage at 1 year (< 5
      mg/kg vs. > or = 5 mg/kg). Logistic regression models were fit to the data using
      a forward stepwise selection procedure. In this analysis, risk factors included
      an acute rejection episode (P < .001), CsA dosage < 5 mg/kg/day at 1 year (P =
      .007), infection (P = .023), female gender (P = .042), and retransplant (P =
      .103). Individual analyses were done for CAD and LRD recipients. For both groups,
      important variables were acute rejection, infection, CsA dosage at 1 year, and
      age at transplant. In conclusion, acute rejection, CsA dosage < 5 mg/kg/day at 1
      year, and infection are the major risk factors for the development of chronic
      rejection, suggesting that chronic rejection may be the result of inadequate
      immunosuppression (acute rejection episodes and low CsA dosage) or the production
      of inflammatory cytokines (infections).

PMID- 8475549
TI  - Half-life and risk factors for kidney transplant outcome--importance of death
      with function.
AB  - Transplant center outcome is being increasingly scrutinized, so it is critical to
      have a consistent approach to data analysis. Standard practice has been to
      include death with function as a graft loss. But doing so may obscure other
      important risk factors and make it difficult to compare centers. To document this
      data analysis problem, we studied half-life and risk factors for long-term graft
      survival in 2230 kidney transplant recipients who had > or = 1 year of function.
      Four separate Cox regression analyses were done, differing in how death with
      function is considered: death with function considered a graft loss (analysis 1);
      all deaths censored (analysis 2); definitively non-transplant-related deaths
      censored, i.e., deaths from infection, malignancy, or cardiac problems analyzed
      as a graft loss (analysis 3); and definitively non-transplant-related as well as
      cardiac deaths censored (analysis 4). For each analysis, variables included
      immunosuppressive protocol, age at transplant, donor source, diabetes, gender,
      transplant number (primary vs. retransplant), and HLA ABDR mismatches (0 vs. > or
      = 1 mismatch). There were important differences in risk factors, depending on how
      death with function is considered. For example, when all deaths are considered a
      graft loss, age > 50, cadaver donor source, diabetes, retransplantation, and > 0
      antigen mismatch were found to be risk factors for long-term graft survival.
      However, when all deaths are censored, age > 50, cadaver donor source,
      retransplantation, and diabetes were no longer risk factors. In fact, age > 50
      was associated with significantly better graft survival when all deaths are
      censored (analysis 2), suggesting that the increased graft loss seen in these
      patients is nonimmunologic. Similarly, t1/2 is markedly different for different
      patient subgroups depending on how death with function is considered. For
      example, nondiabetic living donor (non-HLA-identical) recipients > 50 have a t1/2
      of 9 +/- 1 years when death with function is considered a graft loss; for the
      same group, t1/2 is 62 +/- 28 years when death with function is considered. For
      diabetic patients < or = 50, when death with function is considered a graft loss,
      t1/2 is 9 +/- 0.9 years for living donor recipients and 7 +/- 0.7 years for
      cadaver donor recipients. For the same patients, when death with function is
      censored, t1/2 is 27 +/- 4 years for living donor recipients and 24 +/- 4 years
      for cadaver donor recipients. Our analysis suggests that death with function
      needs to be considered in analyzing kidney transplant outcomes.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8475550
TI  - Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney
      and pancreatic islet cell transplantation.
AB  - An increased frequency of kidney rejection has been reported in diabetic patients
      who have simultaneous pancreas and kidney transplantation compared with patients
      who have a kidney transplant alone. Kidney graft outcome is similar in the two
      groups. The mechanism for increased kidney graft rejection with a simultaneous
      pancreas graft is not clear. It is ascribed to the immunogenicity of the exocrine
      pancreas that initiates migration of activated cells from the peripheral blood
      that are entrapped in the kidney. Since the volume of the transplanted tissue is
      less in islet transplantation (usually < 2 ml) than in pancreas transplantation,
      one might not expect an increased frequency of kidney rejection in islet cell
      recipients. We looked at biopsy-proven kidney rejection episodes in patients who
      had combined kidney and islet transplants and compared this with the frequency of
      rejection in diabetic and nondiabetic patients who underwent a kidney transplant
      alone under the same immunosuppression. Diabetic patients who had kidney islet
      transplants (n = 9) had a higher frequency of rejection (100%) compared with
      diabetic patients (n = 107, 55.1%) and nondiabetic patients (n = 327, 65%) who
      had a kidney transplant alone. The 1-year graft and patient survival rates were
      not different among the groups. Although the number of patients is small, it
      would appear that transplantation of a low volume of islet cells with high purity
      can lead to an increased frequency of kidney rejection. This is unlikely to be
      explained solely on the basis of fewer antigen matches in these recipients but
      may reflect the inherent immunogenicity of the purified islet preparations.
      Alternatively, there may be an effect of their direct infusion into the portal
      vein.

PMID- 8475551
TI  - Tumor necrosis factor alpha in human kidney transplant rejection--analysis by in
      situ hybridization.
AB  - Macrophagic infiltration and necrosis of rejected kidney transplants represent
      two pejorative patterns. It has been assumed that the macrophagic toxicity is
      mediated partly by secretion of tumor necrosis factor alpha. On the other hand,
      TNF is also involved in many inflammatory and immunological phenomena. We thus
      evaluated the expression of TNF mRNA by in situ hybridization in 6 rejected
      kidney transplants using a radiolabeled TNF-c DNA probe. Then the synthesis of
      TNF alpha protein was studied by immunohistochemistry using an anti-TNF alpha
      antibody. In severely rejected kidney grafts, TNF mRNA is expressed in some
      monomorphic infiltrating cells, mostly located in the deepest part of the cortex
      and around the tubes. These cells do not bind other probes, such as dopa
      decarboxylase DNA or preproenkephalin RNA. They are also recognized by a
      monoclonal antibody directed against TNF alpha. What is more, this antibody binds
      with some glomerular endothelial and tubular epithelial cells that do not express
      TNF mRNA. These cells are likely target cells for TNF. In the normal kidney,
      there are no cells expressing TNF-alpha mRNA.

PMID- 8475552
TI  - Renal transplantation following immunoadsorption in highly sensitized recipients.
AB  - Five highly sensitized patients, with panel reactivity greater than 80% for 1.75
      5 years, were treated by extracorporeal staphylococcal protein-A
      immunoadsorption, prednisolone, and cyclophosphamide. The five patients underwent
      treatment of 18-40 (mean 31) liters of plasma, respectively in 4-7 (mean 5.6)
      sessions. This reduced the titer of cytotoxic antibodies to sensitizing antigens
      to < 1/8 in all cases and abolished reactivity to crossreacting antigens. Two
      patients required retreatment following resynthesis of cytotoxic antibodies. All
      five patients have been transplanted, and four of these now have stable serum
      creatinines of 168 mumol/L at 34 months, 208 mumol/L at 29 months, 96 mumol/L at
      5 months, and 125 mumol/L at 3 months posttransplantation. One patient had
      primary graft dysfunction due to acute tubular necrosis; the kidney was removed
      after eight weeks and showed cortical necrosis without evidence of acute
      rejection.

PMID- 8475553
TI  - Steroid withdrawal from long-term immunosuppression in liver allograft
      recipients.
AB  - Corticosteroids were withdrawn from the immunosuppressive regimen of 168/197
      (85%) of liver transplant patients who survived for more than three months. In
      14, steroids were restarted for reasons other than rejection. The remaining 154
      patients were evaluated for the occurrence of rejection and graft loss. Risk
      factors for the development of rejection after steroid withdrawal were assessed.
      There were 13 episodes of rejection in 12 (7.8%) grafts; 7 (4.5%) experienced
      acute cellular rejection, and 6 (3.9%) developed chronic ductopenic rejection.
      All cases of acute rejection resolved with high-dose steroids. Graft and patient
      loss due to chronic rejection was 3 (1.9%) and 2 (1.3%), respectively. Chronic
      rejection resolved in 1 patient, 1 was successfully retransplanted, and in the
      other 2 the principal cause of death was recurrent tumor. None of the risk
      factors examined (primary indication for transplant, severity of previous acute
      rejection, use of OKT3, retransplantation, ABO blood group donor/recipient match,
      CMV infection, and CsA mono versus CsA and AZA double therapy) were associated
      with the development of chronic rejection poststeroid withdrawal. The prevalence
      of side effects, after steroid withdrawal, was low; 66% of patients never
      required antihypertensive medication; 14% experienced a significant septic
      episode, and only 4 died with sepsis as the major factor. There were no fungal
      sepsis and no new cases of diabetes. Withdrawal of corticosteroids after 3 months
      can be successfully achieved in the majority of liver allograft recipients and is
      associated with a low rate of rejection, graft loss, and complications
      attributable to immunosuppressive medication.

PMID- 8475554
TI  - Complement activation during liver transplantation.
AB  - Twelve patients with end-stage liver disease undergoing liver transplantation
      were studied regarding complement activation and formation of anaphylatoxins (C3a
      and C5a) and terminal C5b-9 complement complexes (TCC) after reperfusion of the
      grafted liver. Blood samples for complement variables (C1INH, C3, C4, C5, C3a,
      C5a, and TCC) were drawn preoperatively, before the anhepatic phase, 1 min
      before, and 2, 15, and 60 min after the start of reperfusion of the grafted
      liver. Activation of complement was observed during the operation. The C1INH, C3,
      C4, and C5 plasma concentrations decreased during the entire operation while the
      anaphylatoxin C3a and the terminal C5b-9 complement complex increased after the
      reperfusion of the grafted liver. Activation of complement with the formation of
      biologically active substances like anaphylatoxins and terminal C5b-9 complement
      complexes may be one explanation for circulatory complications often seen in
      patients undergoing orthotopic liver transplantation.

PMID- 8475555
TI  - Hepatic retransplantation in New England--a regional experience and survival
      model.
AB  - Hepatic retransplantation (reTx) offers the only alternative to death for
      patients who have failed primary hepatic transplantation (PTx). Assuming a finite
      number of donor organs, reTx also denies the chance of survival for some patients
      awaiting PTx. The impact of reTx on overall survival (i.e., the survival of all
      candidates for transplantation) must therefore be clarified. Between 1983 and
      1991, 651 patients from the New England Organ Bank underwent liver
      transplantation, and 73 reTx were performed in 71 patients (11% reTx rate). The 1
      year actuarial survival for reTx (48%) was significantly less than for PTx (70%,
      P < 0.05). This survival varied, dependent on the interval of time following PTx
      in which the reTx was performed (0-3 days, 57% survival; 4-30 days, 24%; 30-365
      days, 54%; and > 365 days, 83%). Patients on the regional waiting list had an 18%
      mortality rate while awaiting transplantation. These results were incorporated
      into a mathematical model describing survival as a function of reTx rate,
      assuming a limited supply of donor livers. ReTx improves the 1-year survival rate
      for patients undergoing PTx but decreases overall survival (survival of all
      candidates) for liver transplantation. In the current era of persistently
      insufficient donor numbers, strategies based on minimizing the use of reTx,
      especially in the case of patients in whom chances of success are minimal, will
      result in the best overall rate of patient survival.

PMID- 8475556
TI  - Risk factors for primary dysfunction after liver transplantation--a multivariate
      analysis.
AB  - In a retrospective analysis on 323 orthotopic liver transplant procedures
      performed between July 1984 and October 1991 the incidence of two forms of
      primary dysfunction (PDF) of the liver: primary nonfunction (PNF), and initial
      poor function (IPF) were studied. The incidence of PDF was 22% (73/323) with 6%
      PNF (20/323) and 16% IPF (53/323), while 78% (250/323) had immediate function
      (IF). Occurrence of both IPF and PNF resulted in a higher graft failure rate (P <
      0.001), retransplantation rate (P < 0.001), and patient mortality (P < 0.003)
      within the first three months after OLTx. Univariate analyses of donor and
      recipient factors and their influence on PDF demonstrated that longer donor
      hospitalization (> 3 days), older donor age (> 49 years), extended preservation
      times (> 18 hr), and fatty changes in the donor liver biopsy, as well as reduced
      size livers, younger recipient age, and renal insufficiency prior to OLTx,
      significantly affected the incidence of IPF and PNF. Multivariate analysis of
      potential risk factors showed that reduced-size liver (P = 0.0001), fatty changes
      on donor liver biopsy (P = 0.001), older donor age (P = 0.009), retransplantation
      (P = 0.01), renal insufficiency (P = 0.02), and prolonged cold ischemia times (P
      = 0.02) were independently associated with a higher incidence of IPF and PNF. No
      statistical correlation was found between PDF and etiology of ESLD, nutritional
      status of the recipient, UNOS status, and Child-Pugh classification in this
      study. We conclude that PNF and IPF are both separate clinical entities that have
      a significant effect on outcome after OLTx. Routine donor liver biopsies are
      recommended to decrease the rate of IPF and PNF. The combination of risk factors
      shown to be significant for PDF should be avoided--and, if that is not possible,
      the only variable that can be controlled, the preservation time, should be kept
      as short as possible.

PMID- 8475557
TI  - Probable antibody-mediated failure of two sequential ABO-compatible hepatic
      allografts in a single recipient.
AB  - Two sequential ABO-compatible orthotopic liver allografts failed, despite
      excellent initial posttransplant function, in a patient with preformed donor
      specific alloantibodies. There was no evidence of cell-mediated rejection.
      Retrospective crossmatching of recipient serum, obtained immediately prior to the
      first transplant, revealed the presence of lymphocytotoxic antibodies directed
      against donor class I HLA B17, at a titer of greater than 1:32,768. Similarly,
      lymphocytotoxic antibodies directed against the second donor's class I HLA A2
      phenotype were detected on retrospective crossmatching utilizing both the three
      wash Amos technique (TWA-CDC), and the anti-human immunoglobulin augmented
      technique (AHG-CDC), at a titer of greater than 1:32,768. Anti-class I specific
      alloantibodies were eluted from both failed liver grafts at titers of 1:256. The
      hepatic necrosis in zones 3 and 2 that were observed on histologic examination,
      and the profound refractory consumptive thrombocytopenia subsequent to each
      transplant may have been the result of antibody-mediated rejection by preformed
      lymphocytotoxic antibodies. Despite the liver's remarkable capacity to withstand
      antibody-mediated injury, primary humoral rejection following ABO compatible
      liver transplantation may occur if extremely high titers of performed
      allospecific lymphocytotoxic antibodies are present.

PMID- 8475558
TI  - Evidence that intraoperative prostaglandin E1 infusion reduces impaired platelet
      aggregation after reperfusion in orthotopic liver transplantation.
AB  - Recent investigations measuring platelet aggregation during 10 orthotopic liver
      transplantations showed a significant decrease in platelet aggregation
      immediately after reperfusion and in the perfusate. As prostaglandin E1 has been
      shown to exhibit a beneficial effect in the treatment of ischemic injury of the
      liver, we investigated in a prospective, randomized, and open study the effect of
      PGE1 infusion during OLT on platelet function. Ten patients were randomized to
      receive a continuous PGE1 infusion (PG group) and another ten patients served as
      controls. Platelet function was determined ex vivo by measuring the adenosine
      diphosphate-, collagen-, and ristocetin-induced aggregation in platelet-rich
      plasma. A significantly higher platelet aggregability was measured in the PG
      group throughout the whole operation for ADP (1 and 2 mumol/L) and collagen (0.5
      micrograms/ml). The same was true for collagen (1 microgram/ml) and ristocetin
      (1.2 mg/ml) after reperfusion. Not only the postreperfusional decrease in
      platelet aggregation but also the decline in platelet count that occurred in the
      control group could be prevented greatly by PGE1 infusion. In the perfusate,
      released from the liver graft vein by flushing with arterial blood, a
      significantly lower platelet aggregability was seen in comparison with the
      systemic circulation before reperfusion in the control group, a difference that
      was not found when PGE1 infusion was given intraoperatively. However, blood
      product requirements during OLT were comparable in both groups. In conclusion,
      PGE1 therapy during OLT preserves platelet function and prevents the drop in
      platelet count observed in the control group after revascularization.

PMID- 8475559
TI  - Right phrenic nerve injury in orthotopic liver transplantation.
AB  - Right hemidiaphragm paralysis has been previously documented in patients after
      orthotopic liver transplantation (OLT) and it may contribute to the development
      of postoperative pulmonary problems. It has been postulated that a crush injury
      to the right phrenic nerve during OLT is the cause of dysfunction of the right
      hemidiaphragm. To assess the incidence and effect of right phrenic nerve injury
      after OLT, we prospectively studied 48 adult liver recipients. Twelve patients
      who underwent liver resection (LR), in whom the suprahepatic vena cava was not
      clamped, were used as a comparison group. Diaphragm excursion by ultrasound and
      pulmonary function were performed preoperatively and postoperatively;
      transcutaneous phrenic nerve conduction studies were performed postoperatively.
      Right phrenic nerve injury and hemidiaphragm paralysis occurred in 79% and 38% of
      the liver recipients but not after LR. Conduction along the right phrenic nerve
      was absent in 53% and reduced in another 26%. Left phrenic nerve conduction and
      left hemidiaphragm excursion were normal in both liver recipients and the
      patients who had LR. Liver recipients with no conduction in the right phrenic
      nerve had a significantly greater decrease in vital capacity in the supine
      position (29 +/- 9.8%) compared with those with some conduction (14 +/- 6.9%, P <
      0.001). However, neither the time on the ventilator nor the hospital stay was
      significantly different in the latter two groups. Complete recovery of phrenic
      nerve conduction and diaphragm function took until nine months in some patients.
      Right phrenic nerve injury is common after OLT and it is the cause of right
      hemidiaphragm dysfunction.

PMID- 8475560
TI  - Hepatic lidocaine metabolism and complications of cirrhosis. Implications for
      assessing patient priority for hepatic transplantation.
AB  - The number of patients awaiting hepatic transplantation continues to exceed organ
      donation. As a result, many liver transplant candidates will develop life
      threatening complications of their liver disease and not survive the
      pretransplant waiting period. Recent studies have demonstrated that hepatic
      lidocaine metabolism into monoethylglycinexylidide (MEG-X) can predict
      pretransplant survival. The present study was performed to determine if MEG-X
      could also predict pretransplant complications and thereby be useful in
      stratifying persons being evaluated for hepatic transplantation. A total of 57
      patients with biopsy-proven cirrhosis underwent MEG-X testing. Of 57 patients, 30
      (53%) developed life-threatening complications of their liver disease--i.e.,
      variceal bleeding, grade II hepatic encephalopathy or worse, and spontaneous
      bacterial peritonitis. MEG-X values were greater in persons without complications
      of liver disease than in persons with complications (25.7 +/- 2.9 versus 14.7 +/-
      1.4 ng/ml, respectively). No patients with MEG-X greater than 30 ng/ml developed
      a major complication. No significant difference in any of the standard liver
      function tests existed between persons who developed complications and patients
      who did not. In this group of 57 patients, 4 (7%) died from complications of
      cirrhosis. Mean MEG-X for patients who died (5.5 +/- 1.6 ng/ml) was significantly
      less (P < 0.05) than observed for other patient groups. All patients who died had
      MEG-X values below 10 ng/ml. This suggests that MEG-X testing could be an
      extremely useful test in the evaluation of patients for hepatic transplantation
      by identifying persons at increased risk for developing complications of chronic
      liver disease.

PMID- 8475561
TI  - Prolongation of cardiac xenograft survival by depletion of complement.
AB  - Complement (C) activation is thought to be critical for the hyperacute rejection
      of xenografts. We investigated the role of C in the rejection of discordant
      cardiac xenografts by studying outcome in recipients depleted of C, using a
      highly purified form of cobra venom factor (CVF) in both a small (guinea pig [GP]
      to-rat) and large (pig-to-baboon) animal model. A single dose of 30 or 60 units
      CVF given i.v. to rats completely abrogated hemolytic C activity for up to 72 hr.
      The lack of hemolytic C activity correlated with nearly undetectable serum levels
      of C3. Doses of 30 U/kg daily or 60 U/kg every other day over a 7-day period
      sustained C depletion without morbidity or mortality. Rats receiving GP cardiac
      xenografts during CVF therapy had significantly prolonged xenograft survival (88
      +/- 10 hr in CVF-treated rats vs. 18.6 +/- 7.2 min in control rats, P < 0.001).
      Rats that rejected GP xenografts at 4 days posttransplant had higher levels of
      anti-GP antibodies than control rats, without hemolytic C activity at rejection.
      This rise in xenoreactive Ig reflected an increase in circulating IgG and IgM
      against GP antigens recognized before transplantation. Histologic analysis of GP
      cardiac xenografts taken from CVF-treated rats revealed leukocyte and monocyte
      margination along blood vessels, beginning at 12 hr posttransplant. Progressive
      cell infiltration, interstitial hemorrhage, and necrosis were observed over the
      next 72 hr. Rejected GP xenografts showed diffuse deposition of IgM and fibrin
      within blood vessels but no evidence of C3 deposition. A nonspecific pattern of
      IgG deposition was noted. CVF was tested in baboons. Complete C depletion was
      achieved with a dose of 60 U/kg, and was not associated with any morbidity or
      mortality. Xenotransplantation of a pig heart was performed in one baboon
      receiving CVF, 60 U/kg/day, for 2 consecutive days. Xenograft survival was
      prolonged to 68 hr, compared with 90 +/- 30 min in control baboons. Lack of
      hemolytic activity was noted during engraftment and at rejection. Histology
      showed evidence of vascular rejection. Immunopathology showed diffuse deposition
      of IgM, fibrin, and C4, and absence of C3 or membrane attack complex. We conclude
      that highly purified CVF can achieve marked C depletion with minimal morbidity
      and no associated fatalities. CVF alone can significantly prolong discordant
      cardiac xenograft survival. In the GP-to-rat model, the improvement in graft
      survival achieved with CVF was better than with conventional immunosuppression or
      isolated acute antibody depletion.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475562
TI  - Prolonged survival of rat orthotopic liver allografts after intrathymic
      inoculation of donor-strain cells.
AB  - Permanent donor-specific tolerance to tissue or organ allografts can be readily
      achieved without immunosuppression by administration of donor lymphohematopoietic
      cells to neonatal rodents. In adult recipients, however, induction of
      transplantation tolerance by this strategy generally requires intensive
      cytoablative conditioning of the recipient. We have now demonstrated that
      intrathymic inoculation of donor bone marrow or hepatic cells in conjunction with
      a single dose of antilymphocyte serum is effective in prolonging survival of DA
      rat orthotopic liver allografts in LEW strain recipients, which ordinarily
      rapidly reject such transplants. The unresponsive state achieved is donor
      specific, as evidenced by the failure of intrathymic inocula of third-party WF
      cells to promote survival of LEW recipients of orthotopic DA liver allografts.
      Moreover, intravenous administration of the donor cells fails to extend liver
      allograft survival, demonstrating that the inoculum must be present in the thymus
      to promote unresponsiveness. Established DA liver allografts induced a state of
      systemic tolerance in LEW hosts, allowing their subsequent acceptance of donor
      strain skin allografts. We hypothesize that the unresponsive state achieved by
      intrathymic inoculation of donor cells may result from the deletion or functional
      inactivation of alloreactive clones in a thymus bearing donor alloantigens. In
      this regard, cells of the macrophage/dendritic lineage (descendants of the bone
      marrow inoculum or hepatic Kupffer cells) may play a critical role by promoting
      thymic microchimerism and exerting modulatory effect on T cell development.

PMID- 8475564
TI  - Do donor cells function as veto cells in the induction and maintenance of
      tolerance across an MHC disparity in mixed lymphoid radiation chimeras?
AB  - Mixed lymphoid chimeras can be established across H-2b-->H-2d by injection of
      C57BL/6J (B-6) donor bone marrow cells into BALB/c hosts conditioned by sublethal
      irradiation, 235 cGy x3. These chimeras are specifically tolerant to both donor
      and host alloantigens. Tolerance cannot be broken even by injection of 4 x 10(8)
      normal BALB/c spleen cells (SC), suggesting a suppressor mechanism. In contrast
      to conventional suppression, however, in which suppressors are syngeneic to the
      cells they suppress, tolerance can be transferred only by cells of the allogeneic
      donor allotype (1,2). Thy 1+ cell depletion eliminates the capacity of the donor
      population to transfer tolerance and markedly reduces the capacity of B-6 BMC to
      induce tolerance (3). In the present studies spleen cells from tolerant chimeras
      (CSC), when coinjected in a 1:1 ratio, reduced the high GVHD mortality induced in
      irradiated H-2d/b F1 hybrids by injection of 2 x 10(7) normal BALB/c SC alone (P
      < .01). When coinjected at a 5:1 ratio CSC eliminated the GVHD mortality and
      weight loss induced by 5 x 10(6) BALB/c SC (P < .01). Depletion of B-6 cells from
      CSC removed their capacity to inhibit the GVHD induced by normal BALB/c SC. In
      contrast to conventional suppression, which requires the continued presence of
      suppressor cells, the BALB/c cells isolated from CSC, although unable to inhibit
      the GVHD of normal BALB/c SC, remained nonreactive against the H-2b allotype for
      a prolonged period following depletion of the B-6 cells. This prolonged response
      reduction dependent upon some interaction with allogeneic donor cells--which, in
      turn, are specifically nonreactive to host antigens--is compatible with a veto
      mechanism.

PMID- 8475563
TI  - Induction of donor-specific tolerance to cardiac but not skin or renal allografts
      by intrathymic injection of splenocyte alloantigen.
AB  - We have recently found that donor-specific tolerance to a cardiac allograft can
      be achieved after the intrathymic (i.t.) injection of donor splenocytes and a
      single intraperitoneal injection of rabbit antirat lymphocyte serum. The present
      study evaluated whether the tolerance induced by splenocytes injected i.t. could
      also prevent the rejection of kidney and skin allografts. Male Buffalo (RT1b)
      rats were given 25 x 10(6) fully MHC-mismatched unfractionated Lewis (RT1l)
      splenocytes by i.t. injection plus 1 ml of ALS i.p. and 21 days later underwent a
      Lewis heterotopic cardiac, orthotopic renal, or skin transplant. Lewis i.t.
      injection induced a donor-specific tolerance with indefinite cardiac allograft
      survival (> 153.1 days) in 88% of the recipients without the need for further
      immunosuppression, while renal and skin allograft survival was prolonged (kidney
      14.8 days vs. control 7.8 days; skin 11.6 days vs. control 9.2 days) but were
      still rejected. Buffalo recipients with a long-surviving Lewis cardiac allograft
      after Lewis i.t. injection were still able to reject a third-party heterotopic
      ACI (RT1a) cardiac allograft in normal time (7.0 days), but did not reject a
      second Lewis cardiac allograft (> 100.0 days). In contrast, however, Buffalo
      recipients with long-surviving Lewis cardiac allografts did reject a Lewis skin
      allograft in normal time (10.0 days) and a Lewis renal allograft in a prolonged
      manner (17.6 days) without causing the rejection of the Lewis cardiac allografts.
      These data support the important role tissue-specific non-MHC antigens may play
      in the rejection of kidney and skin allografts.

PMID- 8475565
TI  - The mechanism of unresponsiveness to allografts induced by rapamycin and
      rapamycin/cyclosporine treatment in rats.
AB  - The mechanisms by which rapamycin (RAPA) and/or cyclosporine induce
      unresponsiveness to allografts were investigated in a rat model. Buffalo (BUF, RT
      1b) heart allografts were rejected by Wistar-Furth (WFu, RT-1u) recipients at a
      mean survival time (MST) of 6.5 +/- 0.5 days. A 14-day course of RAPA (0.8 mg/kg)
      delivered intravenously by an osmotic pump prolonged BUF allograft survival to
      76.1 +/- 23.4 days (P < 0.001). Adoptive transfer of 30-50 x 10(6) spleen and
      lymph node T cells that had been isolated on day 40 postgrafting from CsA- or
      RAPA/CsA-treated hosts into lightly irradiated (6 Gray) secondary WFu recipients
      prolonged BUF graft survival from 9.8 +/- 1.2 to 29.2 +/- 11.0 (P < 0.01) and
      58.2 +/- 38.9 days (P < 0.004), respectively. T cells transferred from animals
      treated with RAPA alone failed to prolong graft survival. In contrast, sera
      isolated on day 40 postgrafting from WFu primary hosts treated with RAPA alone or
      with the RAPA/CsA combination, but not with CsA alone, extended the survival of
      BUF hearts: 3 ml serum from RAPA-treated hosts prolonged BUF heart survival to
      76.6 +/- 31.3 days (P < 0.002) and from RAPA/CsA-treated hosts to 47.1 +/- 12.8
      days (P < 0.001). The effect of serum was immunologically specific: it did not
      prolong the survival of third-party outbred Sprague Dawley heart allografts.
      Although the IgM fraction (0.2 mg) purified from the serum of RAPA-treated
      recipients was ineffective (10.6 +/- 0.8 days; NS), an equal amount of the IgG
      fraction significantly (P < 0.002) prolonged BUF heart allograft survival to 26
      days (n = 4). Thus, hosts treated with RAPA or a RAPA/CsA combination develop IgG
      antibodies that mediate the unresponsive state toward allogeneic heart
      allografts.

PMID- 8475566
TI  - The synergistic interactions in vitro and in vivo of brequinar sodium with
      cyclosporine or rapamycin alone and in triple combination.
AB  - The rigorous median-effect analysis was used to assess the interactions between
      cyclosporine and drugs that inhibit nucleotide synthesis pathways. Using in vitro
      proliferation assays wherein human lymphocytes were triggered by
      phytohemagglutin, anti-CD3 monoclonal antibody, or mixed lymphocyte reactions,
      CsA was shown to display additive interactions with 6-mercaptopurine (6-MP),
      mizorbine (MZB), and mycophenolic acid (MPA), and a synergistic interaction with
      brequinar (BQR). In the in vitro assays, BQR contributed a further synergistic
      effect to the double-drug combination CsA/rapamycin (RAPA). Of the four
      inhibitors of nucleotide synthesis pathways, only BQR noncompetitively inhibited
      IL-2-stimulated proliferation of the CTLL-2 cell line. Using the in vivo assay of
      heterotopic Buffalo (BUF, RT-1b) cardiac allografts in Wistar-Furth (WFu, RT-1u)
      hosts, oral administration of BQR displayed about 100% bioavailability--which,
      like the bolus intravenous (i.v.) mode, was eight-fold more effective than
      continuous i.v. infusions. Furthermore median-effect analysis of serial amounts
      of orally administered BQR demonstrated that it contributes synergistically to
      the immunosuppressive effects of intravenously delivered CsA/RAPA (0.5/0.01
      mg/kg/day). The degree of synergism was proportionate to the extent of the
      immunosuppression. These findings document the potency of the CsA/RAPA/BQR triple
      drug combination and suggest that the synergistic effects may permit dose
      reductions of each component, thereby mitigating toxicities resulting from the
      large amounts of individual agents necessary to achieve allo-unresponsiveness.

PMID- 8475567
TI  - Evidence for a nonclassical pathway of graft rejection involving interleukin 5
      and eosinophils.
AB  - The role of IL-5 and eosinophils in allograft rejection was studied in human
      liver allograft recipients. Liver allograft biopsies were analyzed for intragraft
      IL-5 gene expression, and the percentages of eosinophils and plasma cells within
      the portal infiltrate as well as peripheral eosinophil levels were determined.
      The majority of allografts with evidence of rejection had concomitant IL-5 mRNA
      and eosinophilia, while no resolving or nonrejecting allografts had simultaneous
      IL-5 mRNA and eosinophilia. In fact, rejecting liver allografts that contain IL-5
      mRNA and eosinophils also contain infiltrating cells that produce the cytotoxic
      mediator major basic protein. In contrast, intragraft plasma cell and peripheral
      eosinophil levels did not correlate with the histopathologic status of the
      allograft. Cyclosporine and FK506 had similar effects on the frequency of IL-5
      gene expression in rejecting and nonrejecting allografts. However, OKT3 appeared
      to profoundly modulate IL-5 gene expression, since 0 of 11 biopsies obtained
      during OKT3 treatment for rejection contained IL-5 transcripts. These
      observations raise the possibility of a cellular pathway of liver allograft
      rejection mediated by IL-5-activated eosinophils.

PMID- 8475568
TI  - Alloantigen-dependent endothelial phenotype and lymphokine mRNA expression in
      rejecting murine cardiac allografts.
AB  - Recent studies suggest that graft microvascular endothelia may play an important
      role in the regulation of rejection. Alloantigen-dependent changes in
      microvascular endothelial phenotype may be associated with differences in
      infiltrate function in allografts vs. isografts, as reflected in alloantigen
      specific CTL accumulation and cytokine production. To correlate cytokine
      production with differences in microvascular endothelial phenotype during
      allograft inflammation, we used PCR to identify cytokine mRNAs isolated from
      pooled cardiac isografts and allografts on days 1, 3, and 5 after
      transplantation. Graft microvascular endothelia express an inflamed phenotype
      associated with wound healing and the repair of tissue damage due to mechanical
      trauma, ischemia, and/or reperfusion injury--i.e., high levels of ICAM-1
      expression and MECA-32 mAb reactivity. By day 1 in both isografts and allografts,
      mRNAs for the cytokines IL1 alpha, IL6, TNF, LT, and TGF beta are upregulated or
      induced. By the third day in cardiac allografts, an antigen-dependent endothelial
      phenotype is expressed, characterized by the presence of cell surface VCAM-1.
      Concomitantly, mRNAs for the lymphokines IL2 and IFN gamma are detected, followed
      by IL4 mRNA by day 5. The expression of VCAM-1 by allograft endothelia may
      influence the inflammatory process, by physically recruiting specific T cell
      subpopulations into the response and/or by delivering additional signals to the
      infiltrating cells. Eventually, these and other regulatory events occurring at
      these early times initiate a process that later results in alloreactive tissue
      destruction.

PMID- 8475569
TI  - The human antiporcine cellular repertoire. In vitro studies of acquired and
      innate cellular responsiveness.
AB  - Discordant xenogeneic transplantation offers a potentially unlimited source of
      donor organs from easily bred, nonendangered, physiologically compatible animals,
      but has been limited by the inevitable occurrence of hyperacute rejection (HAR).
      The potential existence of cell-mediated discordant graft rejection has remained
      obscured by HAR, and hence is incompletely understood. To define the cellular
      elements capable of recognition of and subsequent response against discordant
      tissue in a clinically applicable species combination, we have studied the in
      vitro interaction of human peripheral blood lymphocytes against 3 porcine B
      lymphoblastoid cell lines and 6 primary porcine endothelial cell populations. PBL
      from all individuals tested (n = 10) proliferated in response to culture for 72
      hr in xenogeneic mixed lymphocyte culture (XMLC) with cell lines expressing
      porcine MHC (SLA) class II antigens, while endothelial cultures lacking SLA class
      II generally failed to evoke a response. The proliferative response to class II
      positive cells was attenuated by addition of anti-SLA class II antibody but not
      by anti-SLA class I antibody. Two endothelial populations expressing class II
      stimulated an inhibitable proliferative response. The magnitude of the short-term
      proliferative xenogeneic response was similar to that evoked by fully mismatched
      allogeneic human B lymphoblastoid stimulators. Additionally, extended XMLC was
      performed with PBL from 3 individuals. All populations responded with continued
      proliferation when repeatedly stimulated by porcine cells. This was characterized
      not only by T cell growth, but by prominent NK cell growth as well. Elucidation
      of the TCR V beta chain usage patterns by semiquantitative PCR documented
      selection of TCR transcripts from gene family V beta 2 in each group,
      complemented by a heterogeneous mixture of other transcripts including V beta
      17.1, 20.1, and 6.1, suggesting that direct human TCR binding of porcine cells
      occurs, and that it is likely to be an individualistic response complemented by a
      more homogeneous NK response. A 51Cr release assay was utilized to demonstrate
      that unprimed PBL could also lyse porcine target cells. This cytotoxic response
      was maintained despite the complete removal of T cells, suggesting that porcine
      directed NK cell activity is present prior to the maturation of any T cell
      response. Cytolysis was also demonstrated in serum-free medium and thus was not
      mediated solely by antibody-dependent cellular cytotoxicity. Chinese hamster
      ovary cells transfected with the human T cell receptor accessory molecule CD4
      were used to study the ability of this molecule to stabilize the interaction
      between the human TCR and SLA class II.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475570
TI  - Use of donor beta 2-microglobulin-deficient transgenic mouse liver cells for
      isografts, allografts, and xenografts.
AB  - Donor graft major histocompatibility complex class I antigens are targets for
      both allogeneic and xenogeneic rejection. Mice homozygous for beta 2
      microglobulin gene disruption express reduced amounts of surface MHC class I
      antigens. Liver cells from such mutant mice were transplanted into isogeneic,
      allogeneic, and xenogeneic recipients to evaluate the potential of these animals
      as transplant donors. The survival of allografts of transgenic 129 mouse liver
      cells in 15 immunocompetent and histoincompatible mouse recipients (BALB/c, D1.C)
      was only slightly improved 30 days after transplantation relative to normal 129
      mouse allografts. These results could be attributable: (1) to host natural killer
      cell-mediated lysis of donor MHC class I antigen-deficient cells; (2) to donor
      liver cell MHC class I determinants that are reduced but not eliminated serving
      as rejection targets; (3) to the plentiful host supply of serum beta 2
      microglobulin reconstituting the graft and restoring donor MHC class I. Culture
      studies confirmed the ability of exogenous human and bovine beta 2-microglobulin
      to restore rapidly MHC class I antigen expression on transgenic cells. Because
      cell surface exchange of beta 2-microglobulin is less efficient between species
      with divergent beta 2-microglobulin sequences, the survival of transgenic 129
      mouse liver cells in guinea pig (60% beta 2-microglobulin identity) and Xenopus
      (34% beta 2-microglobulin identity) hosts was investigated. Significant
      prolongation of MHC class I antigen-deficient liver cell xenografts was
      apparently only in Xenopus hosts. Furthermore, transplants of transgenic 129
      mouse liver cells into isogeneic normal 129 mouse recipients showed evidence of
      rejection in seven of nine recipients, suggesting that transgenic donor cells
      also may be susceptible to lysis by host natural killer cells.

PMID- 8475571
TI  - Low-dose rapamycin potentiates the effects of subtherapeutic doses of
      cyclosporine to prolong renal allograft survival in the mongrel canine model.

PMID- 8475572
TI  - 31P magnetic resonance spectroscopy of the isolated human donor liver-
      feasibility in routine clinical practice and preliminary findings.

PMID- 8475573
TI  - Regeneration of the native liver after heterotopic liver transplantation for
      fulminant hepatic failure.

PMID- 8475574
TI  - Five-to-seven-day kidney preservation with aspirin and furegrelate.

PMID- 8475575
TI  - Evidence that thyroxine (T-4) is effective as a hemodynamic rescue agent in
      management of organ donors.

PMID- 8475576
TI  - Physiological models of orthotopic liver transplantation in the rat.

PMID- 8475577
TI  - [The independent variability of different karyotypic characteristics during the
      spontaneous neoplastic evolution of mouse embryo fibroblasts].
AB  - The dynamics of some karyotype characteristics throughout the spontaneous
      neoplastic evolution of embryonal fibroblasts of different mouse strains was
      studied using a differential staining of chromosomes. The independent variability
      of chromosome modal numbers, the number of polyploid cells in the cell line, the
      number of chromosomal rearrangements within one cell, the activity of formation
      of different types of chromosomal rearrangements and the activity of interactions
      of the homologous chromosomes in 15 studied cell lines were revealed. Possible
      levels of variability regulations of different karyotype characteristics are
      discussed.

PMID- 8475578
TI  - [The cytodifferentiation of the rat spinal cord and neocortical neural elements
      when implanted into a peripheral nerve].
AB  - Using electron microscopy, a study was made of the dynamics of development of the
      cerebral cortex and spinal cord in 14-day-old rat embryos implanted into the
      sciatic nerve of mature rats. It is shown that the implanted neural elements of
      the cortex and spinal cord survive for 8 months and differentiate from
      neuroepithelial cells and neuroblasts into young and mature neurons. In addition,
      the synaptogenesis and myelination were studied. Mature synapses in implants of
      the spinal cord were detected in 14 days, and in implants of the cortex in 21
      days. The spinal cord and cortex implants displayed the first myelinated axons in
      21 and 30 days, resp. Implants of the fetal spinal cord became mature earlier
      than the cortex implants. It has been stated that the processes of synaptogenesis
      and myelination in implants continue longer than in situ.

PMID- 8475579
TI  - [A possible pathway for mitogenic signal transmission during the contact
      stimulation of the multiplication of cultured cells].
AB  - Cultured cells of the Japanese quail embryo were labeled with 3H-glucosamine,
      fixed, suspended and inoculated into built-up cultures of the homologous cells.
      The transfer of insoluble components of labeled cell surface into the cells of
      underlaying cell sheet was revealed. A decrease in the cell incubation
      temperature up to 4 degrees C blocks the process. The exchange of cell surface
      sites between contacting cells seems to be one of the possible ways of
      information transmission from one cell into another during contact regulation of
      cell proliferation.

PMID- 8475580
TI  - [The participation of endonuclease in the formation of extrachromosomal DNA and
      the possible mechanisms of the occurrence of gene amplification].
AB  - We examined the extrachromosomal DNA (exDNA, Hirt fraction) in ethidium bromide
      sensitive and resistant cells of line L929. The exDNA amount is greater in the
      latter. The amount of exDNA in L929 cells makes 0.19% of the total cellular DNA;
      the exDNA amounts in cells, resistant to 5 and 50 micrograms/ml ethidium bromide
      are 0.22 and 0.33%, resp. Using labelling by BudR, it is shown that approximately
      16% exDNA in L cells constituted amplified sequences to be excreting to the
      culture medium. The Zn-independent endogenous nuclease is activated in the
      resistant cells. The treatment with cycloheximide (50 micrograms/ml) resulted in
      the increase in the exDNA amount and in the activation of Zn-independent
      endonuclease. The data obtained suggested that the activation of Zn-independent
      endonuclease may lead to the increase in the exDNA amount and determine
      presumably a high rate of cell adaptability to environmental conditions.

PMID- 8475581
TI  - [The oxidative phosphorylation system of BHK-21 cells in suspension cultivation].
AB  - The state of the oxidative phosphorylation system in intact and digitonin-treated
      BHK-21 cells in the lag-, logarithmic and stationary growth phases has been
      studied. It is shown that during the growth of cell culture the rates of oxygen
      uptake and the extent of coupling of oxidation and phosphorylation change
      significantly.

PMID- 8475582
TI  - [Extraordinary dangerous psychiatric patients].

PMID- 8475583
TI  - [Decrees of dangerousness].
AB  - According to the Danish Civil Commitment Law, very dangerous psychotic patients
      can be transferred from a general psychiatric department to the only psychiatric
      maximum security institution in Denmark. Denmark passed a new Mental Health Act
      in 1989, and according to this "decrees of dangerousness" are issued by the
      Ministry of Justice, followed by a court hearing. The Ministry of Justice asks
      the Danish Medico-Legal Council for a statement in all such cases. The number of
      patients who are transferred to the Maximum Security Institution according to
      these rules has increased greatly, the average number per year in the seventies
      being two to three patients, while in 1990, 11 patients were transferred. In the
      period 1985 to 1990, 39 cases concerning "decrees of dangerousness" were
      submitted to the Medico Legal Council. The Council did not find the conditions
      fulfilled in five cases, one case was invalidated by the court, and in two cases
      the requests were withdrawn. The increase in the number of "decrees of
      dangerousness" was equally divided between younger patients, i.e. up to 29 years
      old, the average duration of illness being about three years and elderly
      patients, i.e. 30 years or older the average duration of illness in this group
      being about 13 years. The majority of the patients suffered from schizophrenia.
      Among the younger patients, 11 of 18 had alcohol and/or drug abuse, which was
      only seen among three of the 21 elderly patients. Drug abuse increases the risk
      of dangerous behaviour among schizophrenics, and drug abuse among younger
      schizophrenics might be part of the explanation for the increasing number of
      "decrees of dangerousness".(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475584
TI  - [Syphilis meets AIDS. Syphilis seen in relation to the AIDS epidemic--a review].
AB  - The incidence of syphilis in Denmark has changed within the last ten years. From
      being a relatively common disease at the end of the 1970's and beginning of the
      1980's, the incidence has fallen considerably. It is assumed that the change is
      connected with the emergence of AIDS and the resulting increase in information
      and attention to sexually transmitted diseases. In the USA, after a fall in the
      beginning of the 1980's, the incidence of syphilis has risen markedly,
      particularly among heterosexual coloured people in large cities. Recently, there
      have been some reports claiming atypical syphilis in patients with HIV-infection.
      To date there are no controlled investigations to corroborate this notion.
      Seronegative syphilis or delayed seropositivity has been reported in certain
      immunosuppressed AIDS patients. Otherwise the syphilis serology of HIV-infected
      patients does not seem to differ essentially from HIV-negative patients. All
      patients with HIV infection should be counselled about syphilis and offered a
      test for syphilis, just as patients with syphilis should be encouraged to be
      tested for HIV antibody after informed consent.

PMID- 8475585
TI  - [Barrett esophagus].
AB  - Barrett's oesophagus is a complication of chronic gastrooesophageal reflux
      disease and occurs in eight percent of patients with reflux symptoms. The
      diagnosis is made by endoscopy with biopsy. Dysplasia and early adenocarcinoma
      may involve only very small irregular areas of the oesophageal mucosal surface.
      Biopsies should therefore be taken from each quadrant at 1-2 cm intervals. The
      prevalence of dysplasia is about five to 16 percent, while the prevalence rate of
      oesophageal adenocarcinoma ranges from nought to ten percent and the incidence is
      one case per 87 patients years. No consensus concerning the treatment strategy
      for patients with metaplasia and low grade dysplasia has been achieved, because
      there is no conclusive proof as yet that screening programmes reduce the
      mortality from adenocarcinoma. Patients with high grade dysplasia should be
      controlled with endoscopy and biopsies every sixth month. Flow cytometry seems to
      be able to identify a subset of patients with an increased risk of oesophageal
      adenocarcinoma.

PMID- 8475586
TI  - [WR in patients with secondary syphilis and HIV infection].
AB  - In recent years, there have been sporadic reports of aberrant manifestations of
      syphilis and a changed syphilis serology in AIDS patients, which might indicate
      difficulties in diagnosing the infection and monitoring the response to
      penicillin treatment. Six male patients aged 25 to 42 years with asymptomatic HIV
      infection and secondary syphilis were retrospectively compared with a control
      group of seven HIV-negative males aged 26 to 52 years with secondary syphilis.
      All patients presented with macular-papular exanthema of secondary syphilis; in
      all cases it was also their first episode of the disease. The median WR titre was
      13 (range 11 to 20) in syphilis patients with HIV and nine (8 to 14) in the
      control group (p = 0.1). The median time until WR was found non-reactive after
      penicillin was four months (3 to 16) and five months (3 to 9), respectively (p =
      0.8). Thus, in this small series there was no statistically significant
      difference in the WR-titres of asymptomatic HIV positive and HIV negative
      patients with secondary syphilis, although there was a tendency towards initially
      higher WR titre in the HIV group, as reported by others.

PMID- 8475587
TI  - [Complications of second-look surgery for ovarian cancer].
AB  - All complications were registered in 139 consecutive second-look operations for
      ovarian cancer. Forty-one complications were registered in 33 patients, none
      lethal. The most frequent complications were anaemia requiring blood-transfusion
      (10.7%) and acute cystitis (4.3%). Other complications were seen with frequencies
      between 0.7 to 2.8 percent. No differences with respect to complications were
      found between patients with residual tumour versus those without, nor between
      patients where only biopsies were taken versus those who had organs removed.
      Although the patients were in clinical complete remission, 53% were found to have
      residual disease at second-look operation.

PMID- 8475588
TI  - [Duodenal cancer--illustrated by 5 cases, with special consideration to
      symptomatology, diagnosis and treatment].
AB  - Over a period of 30 months we have seen five patients with duodenal cancer (four
      adenocarcinomas and one carcinoid-tumour). All patients are presented with a
      brief history of vague and non-specific symptoms. Diagnosis was established by
      endoscopy and biopsies. In one case, a Whipple's procedure was performed, and the
      patient is without evidence of tumour recurrence eight months later. Three
      patients could only be offered palliative surgery, of these, one is still alive
      two years after the operation, one (the patient with a carcinoid tumour) died
      three months postoperatively, and the third has only just recently been operated.
      The fifth patient died ten days after the diagnosis was confirmed, without any
      specific treatment. The different diagnostic methods available as well as the
      treatment and prognosis of duodenal cancer are discussed. We conclude that: 1)
      despite improved diagnostic procedures, the diagnosis of duodenal cancer is still
      difficult and delayed due to vague and non-specific symptoms, 2) the diagnostic
      procedure is endoscopy and biopsy. 3) the treatment is surgery and 4) the
      prognosis is poor in the majority of patients.

PMID- 8475589
TI  - [The MMR vaccination: no effect of feedback of vaccination scores in general
      practice].
AB  - The purpose of this study was to assess the effect of graphic feed-back of
      vaccination scores (VS) for vaccination against measles, mumps and rubella (MMR)
      at the age of 15 months among practices in a Danish county. The study was
      designed as an intervention study, comparing VS for each practice with VS for the
      other practices in the county. The feed-back was evaluated qualitatively by use
      of a postal questionnaire. A majority of the 73 responding practices welcomed the
      graphic feed-back, regarded it as easily understood and requested similar
      information on an annual basis in the future. In 13 (18%) of the practices, the
      calculated VS was lower than the doctors had expected. The most frequent
      explanation for this discrepancy, given by 4 practices, was incorrect
      registration of the vaccination. Twenty-one percent of the practices had taken
      action to improve their performance after receiving the feed-back, but there was
      no significant improvement in VS in this group. In practices with low VS (< 70%)
      before intervention, there was no significant change in VS. The total VS for all
      practices in the county was 89% before and 88% after intervention. In conclusion,
      the feed-back had no observable effect on VS. Registration errors may explain why
      some practices had low VS. Feed-back with performance indicators may have better
      quantitative effect if accompanied by qualitative measures.

PMID- 8475590
TI  - [The role of hospital management in quality assurance activities at Danish
      hospitals].
AB  - Quality assurance (QA) has been a main topic of debate within the Danish health
      care system over the last few years. In order to study the effects of this debate
      we conducted a survey of QA activities in all hospitals. This article is
      concerned with the role of the central hospital management in QA. Thirty-nine
      percent (forty-one) of hospital managements returned the questionnaire. Thirty
      two managements had initiated QA work in their hospitals, especially on topics
      concerning health care personnel, administration and organisation. Twenty-four
      managements had created goals for quality, only rarely were the goals followed up
      by quantitative methods. Seven managements had a special budget for QA
      activities. Those hospital managements who have initiated QA in their hospitals
      have selected key topics in order to facilitate the implementation of QA.

PMID- 8475591
TI  - [The role of hospital personnel in quality assurance activities at Danish
      hospitals].
AB  - Over the last few years there has been considerable activity concerning quality
      assurance (QA) in health care. In order to investigate the actual consequences,
      we mailed a questionnaire to all Danish hospital managements, asking them to
      distribute it to leading doctors and nurses. 349 questionnaires from 51 hospitals
      were returned. The questionnaire was concerned with QA-activities, topics and
      methods, organisational aspects and attitudes amongst the professionals. Forty
      eight percent of all hospitals, evenly distributed over all hospital and
      department categories, were represented in the survey. Fifty percent of
      respondents were doctors, 40% nurses. Eighty-seven percent had started quality
      assurance activities, typically clinically oriented research where doctors were
      concerned, and typically projects concerning communication with patients when
      initiated by nurses. Both groups had many projects concerning personnel policy,
      especially educational aspects. 3% of the activities were concerned with patient
      satisfaction. Knowledge of quality assurance principles was not yet widespread
      among the professionals, but 87% expressed positive attitudes. There is a need to
      define the concept of QA and to spread knowledge of QA-methods, if a systematic
      approach to QA is to be implemented.

PMID- 8475592
TI  - [Lateral ligament ruptures of the ankle joint in young athletes].
AB  - Treatment of lateral ligament rupture of the ankle has previously been primarily
      surgical. Immobilisation in a plaster cast has recently become more usual, and
      gradually this treatment is partially being replaced by immobilisation in
      adhesive elastic bandage. Operation of younger, athletic patients with large
      ruptures is, however, still recommended. It is inexpedient to operate these
      patients. They will be delayed for several weeks in their return to sport.

PMID- 8475593
TI  - [Low density lipoprotein (LDL) receptor-related protein internalizes and degrades
      uPA-PA1 complexes and is essential for embryo implantation].

PMID- 8475594
TI  - [Local treatment of aphthae].

PMID- 8475595
TI  - [Syphilis and contact tracing in the USA].

PMID- 8475596
TI  - SPECTRA: a system for processing electron images of crystals.
AB  - SPECTRA is a program system that combines well tested and familiar algorithms and
      advanced graphics tools for (i) the display and indexing of the Fourier transform
      of images of crystalline specimens, (ii) refinement of the reciprocal lattice,
      (iii) output of amplitudes and phases of reflections and (iv) lattice distortion
      correction through cross-correlation map analysis. Because of the ease of
      identifying and indexing reflections, the user can include many reflections for
      reciprocal lattice refinement, leading to more accurate lattice determination.
      Automatic indexing is much faster than entering indices by hand, with less
      operator error. The user can run the procedure that corrects for lattice
      distortions with either standard parameters or storable parameters tailored to a
      particular specimen. SPECTRA's primary function is as a control program which
      acts as an interface between existing programs and the user. It was written in C
      with routines for the display, user interface and peak list search. Communication
      between the separate processes that make up SPECTRA is via the UNIX pipe
      mechanism and command files, the latter so that users may run, test or replace
      them or even run them as stand-alone programs outside this system.

PMID- 8475597
TI  - Cryo-crinkling: what happens to carbon films on copper grids at low temperature.
AB  - A study of the surface flatness of carbon films on copper grids used for cryo
      electron microscopy has been carried out using a Hitachi S-900 low-voltage SEM.
      Dramatic changes in flatness were observed after cooling from room temperature to
      -170 degrees C. The changes were similar both for carbon films that had been
      floated from a mica surface and for those initially deposited on the surface of
      plastic films. Results demonstrate that films prepared on copper grids that
      appear flat at room temperature become extensively, but reversibly, puckered at 
      170 degrees C. The linear thermal expansion coefficient (alpha) for copper is
      16.2 x 10(-6)/degrees C and the puckering can be explained by assuming that the
      coefficient for amorphous carbon is substantially less. Measurements on grids
      made of titanium, molybdenum and tungsten (coefficients 8.5, 5 and 4.5 x 10(
      6)/degrees C, respectively) showed significantly less puckering.

PMID- 8475598
TI  - Thickness determination of biological thin sections by multiple-least-squares
      fitting of the carbon K-edge in the electron energy-loss spectrum.
AB  - We show that the local thickness of biological thin sections can be measured by
      fitting the electron energy-loss spectrum of the plurally scattered carbon K
      edge, and that such measurements are consistent with the results obtained by a
      conventional method based on the relationship t/lambda alpha ln(It/I0). The new
      method allows the simultaneous measurement and/or mapping of both local thickness
      and core-level excitations (e.g. Ca L-edge) in this energy range (280-400 eV)
      without requiring the measurement of the zero-loss and the valence/plasmon
      excitations.

PMID- 8475600
TI  - Collection of papers dedicated to Professor Elmar Zeitler on the occasion of his
      65th birthday.

PMID- 8475601
TI  - Measurement of low calcium concentrations in cryosectioned cells by parallel-EELS
      mapping.
AB  - Electron energy loss spectroscopy (EELS) in the scanning transmission electron
      microscope provides a high sensitivity for microanalysis of certain important
      biological elements such as calcium whose physiological concentrations in cells
      are rather low. Application of parallel-EELS mapping to the analysis of freeze
      dried cryosections of rapidly frozen tissue provides a means of detecting small
      amounts of calcium in structures with diameter approximately 50 nm. Detector
      pattern noise due to channel gain variations can be reduced by acquiring
      difference spectra at each pixel. By segmenting nitrogen maps that reflect the
      structure through the protein distribution it is possible to sum spectra from
      specific compartments. These are then processed by fitting reference spectra for
      the Ca L23-edge and the carbon background. It has been found that useful data can
      be collected at 100 keV beam energy from freeze-dried cryosections of cerebellar
      cortex cut to nominal thickness of 100 nm. The analysis results in a sensitivity
      of +/- 0.4 mmol Ca/kg dry weight with a total acquisition time of 400 s, a
      significant improvement over that achievable with energy-dispersive X-ray
      spectroscopy.

PMID- 8475599
TI  - Use of radial density plots to calibrate image magnification for frozen-hydrated
      specimens.
AB  - Accurate magnification calibration for transmission electron microscopy is best
      achieved with the use of appropriate standards and an objective calibration
      technique. We have developed a reliable method for calibrating the magnification
      of images from frozen-hydrated specimens. Invariant features in radial density
      plots of a standard are compared with the corresponding features in a "defocused"
      X-ray model of the same standard. Defocused X-ray models were generated to mimic
      the conditions of cryo-electron microscopy. The technique is demonstrated with
      polyoma virus, which was used as an internal standard to calibrate micrographs of
      bovine papilloma virus type 1 and bacteriophage phi X174. Calibrations of the
      micrographs were estimated to be accurate to 0.35%-0.5%. Accurate scaling of a
      three-dimensional structure allows additional calibrations to be made with radial
      density plots computed from two- or three-dimensional data.

PMID- 8475602
TI  - Concentration evaluation of chromatin in unstained resin-embedded sections by
      means of low-dose ratio-contrast imaging in STEM.
AB  - Quantitative STEM with the imaging mode of ratio-contrast was investigated in
      order to evaluate the local concentration of DNA in situ for different kinds of
      DNA plasms in terms of intracellular packing densities (p.d.). The ability of
      ratio imaging to suppress thickness variations provided the basis to use
      unstained sections from cryofixed and freeze-substituted material. The DNA p.d.
      within the nucleoid of E. coli was determined to be about 100 mg ml-1.
      Quantitative data concerning the p.d. of DNA in condensed eukaryotic chromatin
      assuming equal amounts of DNA and protein were evaluated for the first time:
      approximately 400 mg ml-1 chromatin which corresponds to 200 mg ml-1 DNA. The
      p.d. of DNA in chromosomes from the dinoflagellate Amphidinium carterae, a
      eukaryote devoid of histones and with only small relative amounts of histone-like
      protein, was also found to be of the order of 200 mg ml-1. The highest p.d. of
      DNA was measured for the head of the bacteriophage T4 with more than 800 mg ml-1,
      in fair agreement with previous calculations. The results provide further support
      for a condensation mode of low protein chromatins that involves a liquid
      crystalline organization of the DNA filaments.

PMID- 8475603
TI  - Flopping polypeptide chains and Suleika's subtle imperfections: analysis of
      variations in the electron micrograph of a purple membrane crystal.
AB  - Patch averaging, a method of data analysis combining correlation averaging with
      multivariate statistical analysis, was applied to a high-resolution image of a
      purple membrane thin crystal. The observed variational patterns fall in two
      categories: non-crystallographic, related to small electron-optical distortions
      of the microscope, and crystallographic, conceivably related to variations in the
      locations of flexible segments of the polypeptide chain on the surface of the
      membrane.

PMID- 8475604
TI  - Prospects for using an IVEM with a FEG for imaging macromolecules towards atomic
      resolution.
AB  - Specimen preparation and imaging techniques for biological macromolecules have
      been improved to the point where attention to the electron-optical imaging
      conditions becomes a significant factor for achieving high resolution. A field
      emission gun (FEG) can provide an illumination source with a better spatial and
      temporal coherence suitable for imaging near atomic resolution. Our computational
      analysis of carbon film images taken between Scherzer focus and 1.1 microns
      underfocus (20x Scherzer focus) with the Hitachi 200 kV microscope with a cold
      field emission gun shows detectable contrast beyond 3.5 A resolution. In
      biological imaging, a large defocus is often used to optimize the low-resolution
      contrast in order to facilitate the subsequent steps in computer reconstruction.
      An intermediate-voltage electron microscope (IVEM) would optimize the contrast at
      high resolution by reducing the temporal coherent effects. In theory, the IVEM
      would give a greater depth of field so that large macromolecular assemblies such
      as viruses and cellular structures can be interpreted and reconstructed reliably
      using the projection approximation. These experimental and theoretical
      considerations provide a rationale for designing a future IVEM with a FEG
      suitable for biological macromolecule imaging close to atomic resolution.

PMID- 8475605
TI  - Size of the export channel in the flagellar filament of Salmonella typhimurium.
AB  - The size of the putative export channel in the bacterial flagellar filament
      appears small (25 A) in studies done by electron microscopy but large (60 A) in
      studies done by X-ray diffraction. We have undertaken additional studies by
      electron microscopy to examine some of the possible causes of the difference. A
      comparison of three-dimensional image reconstructions of native and reconstituted
      filaments rules out the presence or absence of flagellin monomers in the export
      channel as the source of the variation in apparent channel size. The channel seen
      in reconstructions from both kinds of filaments is 25 A in diameter. The
      difference in the previous studies is more probably a result of artifacts
      introduced in either the X-ray or the electron microscopical methodology.
      Comparisons of three-dimensional reconstructions from images of filaments
      embedded in various stains (anionic, cationic and neutral) and in ice, taken at a
      range of defocuses, rule out the two most likely sources of artifact in electron
      microscopy (i.e., staining artifacts and defocus phase contrast). Based on these
      studies we suggest that the channel seen in the image reconstructions is free of
      exported flagellin monomers, that its true diameter is about 25 A, and,
      therefore, that the flagellin monomer must be unfolded to pass along it.

PMID- 8475606
TI  - [Urinary diversion: pathophysiological principles].

PMID- 8475607
TI  - [Diagnostic evaluation of acute scrotum--testicular perfusion scintigraphy].
AB  - The method of and the results obtained with testicular scintigraphy in the
      differential diagnosis of acute scrotal pain are described. Both sensitivity and
      specificity were found to be high and in excess of 90%. Misinterpretation of
      findings is rare and is seldom reported except in case reports. Normal findings
      usually genuinely reflect absence of disease, and only in the case of suboptimal
      imaging conditions they might correspond to a false-negative finding in the
      presence of acute torsion. Chronic torsion may be missed on scintigraphy because
      of intermediate normalization of arterial perfusion at the time of the
      investigation. Missed torsion presents a characteristic activity pattern. The
      halo sign is a proven sign of avitality of the testicle. Orchitis and
      epididymitis are correlated with hyperperfusion and hyperaemia and are reliably
      diagnosed by scanning. When testicular scintigraphy is needed immediate
      availability is essential. In a nuclear medicine department with standard
      equipment, the investigation can be started within 5 min; it takes about 15 min
      to perform and the findings can be evaluated within another 5 min. Acute
      testicular torsion that has already been reliably diagnosed by clinical
      examination is not an indication for testicular perfusion scintigraphy. This
      diagnostic procedure is, however, valuable if the clinical findings are equivocal
      and, especially, if a conservative treatment is planned.

PMID- 8475608
TI  - [Immunoscintigraphy in inflammatory and malignant diseases. anti-leukocyte and
      anti-tumor antibodies].
AB  - Antibody-labelled granulocytes, antigranulocyte antibodies and radiolabelled
      immunoglobulin can reliably visualize foci of infection; their use in urologic
      inflammatory disorders is rare. In the diagnosis of urologic tumours anti-CEA
      immunoscintigraphy of urinary bladder cancer seems to be superior to conventional
      imaging techniques in sensitivity and specificity. Experience with
      immunoscintigraphy in non-seminomatous germ cell tumours and prostate cancer are
      limited; immunoscintigraphy of renal cell cancer is still in the experimental
      stage in clinical medicine.

PMID- 8475609
TI  - [Follow-up after kidney transplantation. Sequential functional scintigraphy with
      technetium-99m-DTPA or technetium-99m-MAG3].
AB  - Complications following renal transplantation are associated with transplant
      dysfunction; their frequency and the nonspecificity of clinical symptoms
      underscore the importance of choosing the correct diagnostic procedure.
      Sequential function scintigraphy with technetium-99m-MAG3 is noninvasive and
      facilitates the diagnosis of different types of organ rejection, of drug-induced
      malfunction and of surgical complications.

PMID- 8475610
TI  - [Nuclear medicine diagnosis of adrenal gland diseases].
AB  - Localization procedures are required in adrenal diseases after biochemical
      confirmation of hormonal excess. Whereas computed tomography, ultrasound and--in
      rare cases--also magnetic resonance are needed to image the morphological
      abnormalities and the anatomy of neighbouring structures, adrenocortical and
      adrenomedullary scintigraphy is dependent on a functioning adrenal gland.
      Adrenocortical scintigraphy has the advantage of being able to differentiate
      between unilateral adenoma and bilateral hyperplasia in patients with primary
      hyperaldosteronism. It is of minor significance in patients with Cushing's
      syndrome or hyperandrogenism. In patients with catecholamine-producing tumours
      scintigraphy with radioiodine-labelled meta-iodobenzylguanidine (MIBG) may detect
      intra- and extra-adrenal, uni- and bilateral or multilocular, benign and
      malignant lesions. In patients with malignant but inoperable phaeochromocytoma,
      therapy with high doses of MIBG may improve clinical symptoms and reduce tumour
      volume.

PMID- 8475611
TI  - [Diagnosis of urine transport disorders. Diuresis renography].
AB  - Congenital urinary tract malformations are frequently the cause of urinary
      transport disturbances. However, not all the malformations or obstructions
      presenting sonographically as hydronephrosis have to be treated surgically. The
      Whitaker test, an invasive diagnostic procedure to establish the urodynamic
      relevance of an obstruction, does not provide a reliable estimate of prognosis;
      spontaneous cures in cases of obstruction have been reported. Diuresis renography
      offers several advantages as compared with the Whitaker test, for example a more
      physiological basis, less observer dependency, better reproducibility and--last
      but not least--non-invasiveness. However, diuresis renography has to be carried
      out according to a strictly standardized protocol. Sufficient hydration (20 mg/kg
      body weight) and bladder catheterization (to rule our reflectory transport
      disturbances) are mandatory. Today, 123I-OIH or 99mTc-MAG3 are the
      radiopharmaceuticals of choice; the activity for children has to be reduced in
      relation to body surface. To stimulate diuresis, furosemide (0.5-1 mg/kg of body
      weight) has to be given. For the evaluation of diuresis renography, sequential
      scintigrams as well as functional curves have to be used. It is strongly
      recommended that diuresis renography be combined with clearance determinations
      separately for the two kidneys. The interpretation of diuresis renography should
      not rely only on quantitative curve parameters but--above all--on visual analysis
      of the functional curves. However, in cases of proven obstruction, diuresis
      renography--like the Whitaker test--cannot accurately predict the prognosis in
      any individual case. If renal function is normal and there is no difference
      between the left and the right kidney, a wait-and-see attitude seems to be
      justified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475612
TI  - [Combined ultrasound and roentgen localization in ESWL. Initial clinical
      experiences].
AB  - Interdisciplinary use of extracorporeal shock-wave lithotripsy with sonographic
      or fluoroscopic guidance has become a routine procedure in clinical practice, for
      both urolithiasis and cholecystolithiasis. Therefore, newly developed systems
      with combined locating devices are gaining in importance. A primary
      sonographically guided lithotripter was extended by a mobile X-ray system. The
      results were compared with those obtained with a first-generation lithotripter.
      The results show that sufficient disintegration of stones throughout the urinary
      tract is possible with both systems. The retreatment rate with both lithotripters
      was 30% when stone size was comparable. No essential differences in treatment
      time, shockwave energy and pain were found. The easy localisation of radiolucent
      stones, convenient positioning of the patient and successful localisation of
      ureteral stones near to the spine are advantages of the MPL 9000 X. On the other
      hand, the technically simpler fluoroscopy system and greater ease of electrode
      changing are advantages of the HM3 Lithotripter. Altogether, differences in the
      application of the two systems are slight and insignificant except in special
      cases.

PMID- 8475613
TI  - ["Single potential analysis of cavernous electric activity" (SPACE). Findings
      before and after surgical dissection of the cavernous nerves within the scope of
      radical prostatectomy].
AB  - Single potential analysis of cavernous electric activity (SPACE) is said to give
      information on the integrity of the central and peripheral parts of the autonomic
      nervous system insofar as it is involved in erectile function. A total of 30
      patients who underwent radical prostatectomy with simultaneous severance of the
      cavernous nerves as treatment for locally advanced cancer were investigated by
      SPACE before and after the operation. The findings were compared to the those
      recorded on two different dates in 20 age-matched men who had not undergone
      surgery and in whom there was no evidence of any lesion of the autonomic nervous
      system. Even in this control group, few reproducible results were found.
      Nevertheless, with reference to the items "number of wedges" (i.e. monophasic
      elements with amplitudes of 25-100 microV) and "maximum amplitudes" of SPACE
      potentials there was a more than change correlation of the values on the two test
      dates, which was not found in the prostatectomy group. Although this difference
      between the two groups investigated was statistically significant, these findings
      cannot be interpreted as an effect of autonomic denervation of the cavernous
      bodies. This is attributed to the fact that the postoperative results in the
      prostatectomy group were more similar to the findings in the control group than
      to the preoperative measurements taken while the autonomic innervation was still
      intact. Therefore, our investigations lead us to conclude that routine
      application of SPACE as a direct check on the integrity of the autonomic nerve
      fibres involved in erectile dysfunction is not justified at present.

PMID- 8475614
TI  - [Autotransplantation of the kidney. Indications and results].
AB  - Renal autotransplantation is an established but rarely used therapy in cases of
      renal vessel lesions, tumours of the kidney and ureter, long-distance ureter
      lesions, complex nephrolithiasis and retroperitoneal fibrosis. The indications
      and results of renal autotransplantation are discussed using three case reports
      and compared to the literature. In cases of central intrarenal tumours and
      aneurysms of the kidney, autotransplantation is indispensible in order to save
      the organ. For long-distance ureter lesions as well as for retroperitoneal
      fibrosis, autotransplantation of the kidney gives excellent results. In difficult
      clinical situations ileum segment interposition is an alternative treatment.

PMID- 8475615
TI  - [Quantitative nuclear medicine kidney diagnosis with kidney tubule traversing
      radioisotopes].
AB  - In modern nuclear medicine, renal function scintigraphy has been improved and its
      range of applications extended by the development of new radiopharmaceuticals
      (iodine-123-hippuran, technetium-99m-MAG3) combining the properties of short half
      life, favourable radiation energy and high renal clearance. Three significant
      advantages recommend the use of scintigraphic methods: 1. Being non-invasive and
      non-nephrotoxic, the examinations do not affect the patient. The radiation
      exposure the patient is subjected to is about the same as with a comparable X-ray
      investigation or, with respect to the reproductive glands, even lower. Allergic
      reactions do not occur. 2. In contrast to the situation with other imaging
      methods, the functional defect itself (and not only secondary changes in the
      morphology) can mostly be detected. Not only diffuse alterations, but also
      defined functional lesions of a small part of a kidney, can be diagnosed. 3.
      Various renal parameters can be calculated more accurately than with any other
      routine clinical method. The radioisotopic methods discussed yield reliable
      results with excellent reproducibility concerning glomerular filtration rate,
      effective renal plasma flow, side-to-side functional ratio, renal perfusion, and
      urine drainage. Most of these parameters can be obtained by means of a single
      investigation. These radioisotopic methods make it possible to detect or exclude
      a wide range of functional lesions of the kidneys and the urinary tract, which
      are often due to non-specific symptoms. In addition, they allow answers to highly
      specific clinical and scientific questions in nephrology and urology.

PMID- 8475616
TI  - [Nuclear medicine diagnosis and therapy in urology. Diagnosis of bone
      metastases].
AB  - Bone scintigraphy with 99mtechnetium-labelled polyphosphonates is the most
      sensitive test for early detection of skeletal metastases. Bone metastases are a
      major factor in prognosis and have a considerable influence on the therapy
      selected. In patients with prostate cancer, we recommend routine bone
      scintigraphy in the initial staging. Follow-up bone scans are indicated whenever
      a patient develops pain, an elevated level of acid phosphatase, or a rise in
      prostate specific antigen (PSA). Routine bone scans are not necessary for the
      initial staging of patients with renal cell carcinomas, bladder carcinomas and
      testicular tumours. Scans should be routinely performed, however, in patients
      with bone pain or elevated alkaline phosphatase or when radiological findings are
      inconclusive. Bone scanning is necessary in patients with neuroblastoma, both for
      the initial diagnosis and during follow-up in all cases with known skeletal
      involvement. In addition, bone scintigraphy should be performed in cases of
      recurrent or suspected malignant phaeochromocytoma as a complement to
      scintigraphy with iodine-123- or iodine-131-MIBG, respectively. Even though
      skeletal scintigraphy is a very sensitive test, it lacks specificity. This can be
      compensated, however, by careful interpretation of the scan in the light of the
      patient's history and the clinical findings. As a positive side-effect, bone
      scanning--especially in the form of multiphase scintigraphy--may detect renal
      abnormalities, concurrent diseases or complications in the upper or lower urinary
      tract. If scintigraphic findings are doubtful, plain film radiographs are
      required or, in selected cases, bone biopsy must be performed.

PMID- 8475617
TI  - [Biochemical and physiologic properties of strains of Propionibacterium acnes
      isolated from the rumen of calves and lambs].
AB  - Nineteen strains of Propionibacterium acnes isolated from the rumen wall of
      calves and lambs were subjected to examinations. Their biochemical
      characteristics and antibiotic resistance were evaluated while 10 strains were
      sensitive to all tested antibiotics. Urease activity was recorded in 20% of the
      examined strains with the mean value 3.42 +/- 0.97 nkat/ml/h. Proteolytic
      activity was observed in all the examined strains. The mean value of lactate
      dehydrogenase activity was 4.96 +/- 1.01 nkat/ml. The production of volatile
      fatty acids in the course of glucose fermentation was also tested. On the basis
      of the values of adherence index the strains were evaluated as medium adherent
      with affinity to rumen epithelial cells.

PMID- 8475618
TI  - Isolation and functional studies on feline bone marrow derived macrophages.
AB  - In this report, we describe an in vitro culture method for feline bone marrow
      cells, which yields large numbers of quiescent macrophages after 14 days of
      culture. The bulk of the cultured cell population consists of macrophages as
      assessed by morphology, macrophage specific cytochemistry, and phagocytosis. The
      remaining cells were lymphocytes, bone marrow stromal cells, fibroblasts and
      occasional polymorphonuclear leukocytes. While resting cells produced no
      detectable interleukin 1, stimulation with lipopolysaccharide (LPS) induced the
      production of biologically active interleukin 1. After 6 h LPS stimulation, mRNA
      for tumor necrosis factor alpha and interleukin 1 beta was detectable. The
      absence of mRNA in unstimulated cells indicates cultured macrophages were not
      activated until stimulated by LPS or plastic adherence. This approach provides a
      useful means to measure potential modulatory effects by virus infections or other
      agents upon feline macrophage gene expression.

PMID- 8475619
TI  - Effects of hypothyroidism with treatment of an anti-thyroid drug,
      propylthiouracil on immune responses in chickens.
AB  - The effect of a wide range of doses of propylthiouracil (PTU, 0.01-5%) on the
      immune responses of young male chickens was examined. One-day-old chickens were
      rendered hypothyroid by PTU supplemented in the feed for 4 weeks. At all doses
      PTU treatment caused a significant dose-related reduction in body weight (except
      at 0.01%) and in relative lymphoid organ weights. Skin response to
      phytohemagglutinin (PHA) was significantly greater in the chickens treated with
      low doses of PTU (0.01-0.1%) and significantly less in the chickens treated with
      high doses of PTU (1.5-5%) than that in control chickens. Number of splenic
      plaque forming cells (PFC) to sheep red blood cells (SRBC) was significantly
      increased in the chickens treated with low doses of PTU. Concentrations of serum
      3,3',5-triiodothyronine (T3) and thyroxin (T4) were significantly lower in the
      chickens treated with all doses of PTU. Addition of T3 to the feed supplemented
      with 0.01% PTU replaced the serum T3 concentration and reduced the skin response
      to PHA and the number of the splenic PFC. These data confirm our previous
      observations that a low dose of PTU enhances and a high dose suppresses the
      immune responses of young male chickens.

PMID- 8475620
TI  - In vitro and ex vivo responses of bovine lymphocytes to hypodermin C, an enzyme
      secreted by Hypoderma lineatum (insect oestridae).
AB  - The aim of this work was to determine if Hypodermin C (HC), an enzyme secreted by
      Hypoderma spp. larvae during their migration, is able to depress the lymphocyte
      response to mitogens and antigens. HC, when added to the lymphocyte culture, was
      able to influence the response of naive-calf lymphocytes to phytohemagglutinin.
      Secondly, injections of HC to uninfested and previously-infested cattle did not
      modify the proliferative response of the lymphocytes of these animals to
      mitogens. Thirdly, injections of HC to infested cattle did not negatively
      influence the specific humoral and cellular responses.

PMID- 8475621
TI  - An analysis of 38 cases of low-grade cerebral astrocytoma in adults.
AB  - We retrospectively reviewed 38 cases of low-grade non-pilocytic astrocytoma
      diagnosed at the Charleston Area Medical Center between 1957 and 1987. All
      patients underwent craniotomy (total resection in 8 and subtotal in 24) or
      stereotactic needle biopsy (6 patients). Twenty-eight patients (74%) received
      radiotherapy, 25 of whom received > or = 5,000 cGy. The median survival of all
      patients was 46 months and nine patients (24%) survived > or = 5 years. Patients
      under age 40 had a longer survival than those age 40 or older (59 months vs. 30.5
      months, p < .05). There was no significant difference in mean survival between
      those who received and those who did not receive radiotherapy after incomplete
      surgical resection (49 months vs. 53 months, p = 1.00). Of the 29 deaths, 15 were
      due to malignant transformation to a high-grade glioma and 12 to recurrent low
      grade glioma. Since the role of radiotherapy is unclear, it is important that
      patients with low-grade glioma participate in clinical trials.

PMID- 8475622
TI  - Indications for carotid endarterectomy.
AB  - Stroke is a major health problem in the United States. Carotid endarterectomy has
      been performed to prevent stroke in symptomatic and asymptomatic patients with
      carotid atherosclerosis. The rationale for this approach has been questioned
      recently and several studies were begun to determine the proper role of surgery.
      The initial results from studies of symptomatic patients demonstrate that surgery
      is urgently indicated if stenosis is at least 70%, but not if it is less than
      30%. Patients with intermediate amounts of stenosis are still being evaluated.
      Early evidence suggests that surgery is not indicated for asymptomatic patients,
      but two major trials are still in progress. Surgeons performing this procedure
      must demonstrate low perioperative morbidity and mortality. In addition, the use
      of ultrasound as a screening procedure is being re-evaluated. We suggest rapid
      referral and evaluation of symptomatic patients with angiography, and treatment
      of asymptomatic patients with aspirin.

PMID- 8475623
TI  - Nd:YAG laser surgery of venous malformations.
AB  - Venous malformations are prevalent in the head and neck. These anomalies are
      difficult to eradicate by conventional methods due to excessive bleeding and
      imprecise excision. This article details how the success rate for treating low
      flow venous malformations was 100% in 24 patients who underwent Nd:YAG surgery.

PMID- 8475624
TI  - Making sense.

PMID- 8475625
TI  - If elective abortion is not wrong, nothing is wrong.

PMID- 8475626
TI  - [Diabetes mellitus and carbohydrate metabolism in primary hyperparathyroidism].
AB  - It is generally known that patients with primary hyperparathyroidism (pHPT)
      feature disturbances in carbohydrate metabolism and hypertension. The incidence
      and prevalence of frank diabetes mellitus is significantly increased in these
      patients. The etiology and pathogenesis of the vascular and metabolic aberrations
      in this condition are still unclear. Glucose intolerance in pHPT is characterized
      by severe insulin resistance associated with pancreatic beta cell hypersecretion
      of insulin. Hypercalcemia is thought to be mainly responsible for the impaired
      glucose metabolism. However, several studies demonstrated that hypophosphatemia
      can also induce insulin hypersecretion and impair peripheral glucose uptake.
      Hypertension in primary hyperparathyroidism is mainly attributed to
      hypercalcemia. However, high peripheral insulin levels are also proposed to
      contribute to the development of essential hypertension and hyperinsulinemia per
      se is regarded as an important independent cardiovascular risk factor. After
      parathyroidectomy and decrease of the calcium levels to within the normal range,
      the blood pressure levels of the patients with pHPT normalised very quickly,
      whereas normalization of the high peripheral insulin levels was only found in a
      subgroup of patients. Thus, hypercalcemia seems to be mainly responsible for
      hypertension in primary hyperparathyroidism. Another important, yet unresolved
      issue is the question as to whether or to which extent the disturbances in
      glucose homeostasis are reversible after surgical correction of pHPT. At an early
      stage of the disease, insulin resistance and insulin hypersecretion are fully
      reversible after parathyroidectomy, whereas in patients with long-standing
      primary hyperparathyroidism and severely impaired glucose tolerance the metabolic
      disturbances will only partially improve. These results argue for improved
      screening to identify asymptomatic patients with primary hyperparathyroidism and
      for early surgical intervention in this disease.

PMID- 8475627
TI  - [Serum magnesium, serum potassium and arrhythmia profile in patients with acute
      myocardial infarct].
AB  - In 176 patients with acute myocardial infarction (AMI) serum magnesium
      concentration (MGK) and serum potassium concentration (KK) were analysed during
      the first 48 hours after AMI. The patients rhythm was continuously recorded. In a
      subgroup of 70 patients a signal averaging-ECG was performed. 4.5% of the
      patients had a low, 55.7% a normal and 39.8% a high MGK. 14.8% of the patients
      had a low, 80.1% a normal and 5.1% a high KK. Ventricular arrhythmias > or = Lown
      IV b were found in 25% of the patients with low MGK, in 38.8% with normal and in
      52.9% with high MGK. 50% of the patients with low, 62.2% with normal and 61.3%
      with high MGK had late potentials. There was no relation between hypomagnesemia
      and ventricular arrhythmias as between hypomagnesemia and late potentials. Thus,
      hypomagnesemia in AMI patients is rare and does not correlate with ventricular
      arrhythmia or delayed ventricular potentials.

PMID- 8475628
TI  - Bone mineralization and plasma concentrations of electrolytes in healthy subjects
      after exposure to hypokinesia and hyperhydration.
AB  - The objective of this investigation was to determine bone mineralization and
      concentrations of electrolytes in blood plasma of physically conditioned
      volunteers after exposure to hypokinesia (decreased number of steps/day) and
      daily hyperhydration. The studies were performed on 30 physically conditioned
      volunteers (mean VO2 max 67 ml/kg-1 x min-1 age range 19-24 years) after exposure
      to 364 days of hypokinesia (HK). Prior to their exposure to HK all volunteers
      were long-distance runners who covered on average 10,000 steps per day. All
      subjects were divided into three equal groups: the 1st group was subjected to HK
      and consumed daily fluid and salt supplements (water 26 ml/kg body weight and
      sodium chloride 0.16 g/kg body weight), the 2nd group submitted to pure HK, and
      the 3rd group continued to engage in long-distance running and served as control.
      For the hypokinetic effect the 1st and 2nd group of volunteers were restricted to
      an average of 1000 steps/day. After exposure to HK the changes in bone
      mineralization and blood plasma concentrations of magnesium and calcium were
      determined. In hyperhydrated volunteers bone mineralization increased and content
      of electrolytes in blood plasma decreased, while in hypokinetic volunteers the
      electrolyte levels increased significantly and bone mineralization decreased
      significantly. It was concluded that daily fluid an salt supplementation may be
      used to attenuate changes in bone mineralization and blood plasma concentrations
      of electrolytes induced by prolonged restriction of motor activity of highly
      trained athletes.

PMID- 8475629
TI  - [Measuring drinking water fluoridation in Vorarlberg].
AB  - A pilot study was undertaken in Vorarlberg to determine the concentration of
      fluoride ions in drinking water. The results showed that 91.3% of the population
      was supplied by drinking water containing under 0.3 ppm fluoride and the
      remaining 8.7% by drinking water containing 0.3-0.6 ppm fluoride. Hence, the
      fluoride concentration was too low to prevent caries in all areas of Vorarlberg.
      Exogenous fluoridation of the drinking water or table salt in all districts of
      Vorarlberg is discussed. Measurements are planned for the whole of Austria, which
      may lead to a general recommendation for fluoridation of the water or salt
      nationwide.

PMID- 8475630
TI  - [Anaphylactic reaction in streptokinase therapy].
AB  - Streptokinase is used worldwide as thrombolytic agent. Indications are deep vein
      thrombosis, arterial thrombosis and embolism, arteriovenous cannula occlusions,
      acute coronary artery thrombosis, and acute renal vein thrombosis. The major
      drawback in comparison with other thrombolytic drugs is its antigenicity.
      Allergic reactions have been reported but the underlying mechanisms have not yet
      been fully elucidated. A 58 year-old man with acute myocardial infarction
      developed an anaphylactic reaction immediately after commencement of
      streptokinase infusion, although immunological laboratory findings were not
      affected. The patient had no history of prior exposure to streptokinase,
      infections with streptococci, or chronic allergic reactions. 2 months after
      streptokinase therapy increased plasma levels were detected of specific IgG
      antibodies to streptokinase. The levels of specific IgE antibodies to
      streptokinase and other anti-streptococcal antibodies were within the normal
      range. A prick test performed 4 months later with 100 I.U. streptokinase was
      unremarkable. The problems of such allergic reactions are discussed on the basis
      of this case report and a review of the literature.

PMID- 8475631
TI  - [Etiology and pathogenesis of type I diabetes].
AB  - A large body of evidence supports the hypothesis that type I diabetes is an
      autoimmune disease. The development of type I diabetes can conceptually be
      divided in three stages: 1. genetic susceptibility, 2. pretype I diabetes with
      beginning beta-cell destruction and insulitis, and 3. clinical overt type I
      diabetes. During stage 2, an unknown "triggering event" leads to inflammation and
      active autoimmunity towards beta cells. In this chapter, recent developments
      concerning genetics and environmental factors, pathogenic mechanisms, prediction,
      and immunotherapy of type I diabetes will be reviewed.

PMID- 8475632
TI  - [Metabolic syndrome--bridge to type II diabetes].
AB  - The metabolic syndrome (syndrome X) is characterized by elevated insulin levels,
      obesity of the android type, disturbed lipid metabolism with increased
      triglycerides (VLDL elevated, HDL decreased) and an association with
      hypertension. The cause of this syndrome appears to be an insulin resistance of
      the skeletal muscle. The molecular mechanism leading to skeletal muscle insulin
      resistance is not understood, however an abnormality of signal transduction from
      the insulin receptor to glycogen synthase is suggested. It is believed that this
      syndrome represents a potentially prediabetic situation. Furthermore it is
      believed that this syndrome gives rise to cardiovascular complications in certain
      predisposed populations.

PMID- 8475633
TI  - [Educating the diabetic patient as a basis for therapy].
AB  - Since the late 1970's, diabetes therapy has been revolutionized and, in fact, new
      treatment strategies have been initiated by patient education and the resulting
      self-monitoring of the patient. The modern management of the chronic lifelong
      disease diabetes mellitus not only requires the prescription of the appropriate
      nutritional and pharmacologic regimen by the physician, but also intensive
      education and counselling of the patient. It is the diabetic himself who
      ultimately has to secure the treatment as given by the physician in daily life
      and--in so doing--has to provide a great deal of self-care and self-control.
      Meeting the individual treatment goal is largely dependent upon the cooperation
      and motivation of the patient, with the physician as both the sympathetic and
      critical counterpart. Today, education is the indispensible prerequisite for the
      limited well-being and health of diabetics and, at this end, education is equal
      to therapy.

PMID- 8475634
TI  - [Nutritional therapy in diabetes mellitus].
AB  - Most aspects of the nutritional therapy of diabetes mellitus apply equally to
      IDDM and NIDDM patients and are also appropriate for people with high risk of
      cardiovascular diseases. A restriction of energy, a reduction of saturated fatty
      acids as well as of alcoholic drinks and simple sugars are the most important
      measures. This modification of nutritional intake together with increased fibre
      consumption is not only appropriate to avoid hyperglycaemia in diabetic patients
      but has also its benefits in patients presenting with the metabolic syndrome
      (possible reduction of hyperinsulinaemia, hypertension and
      hyperlipoproteinaemia). Diabetic patients should have regular screening for
      microalbuminuria. At first signs of an early stage of nephropathy patients should
      be advised to restrict their protein intake. About 50% of daily energy intake
      should be derived from carbohydrates and fat intake should be no more than 35% of
      total energy (saturated fatty acids less than 10% of energy). Carbohydrate
      exchange units are usually not necessary in NIDDM patients. In addition diabetes
      specialty foods are not an essential part of the nutritional therapy. The success
      of the nutritional therapy in diabetic patients is substantially dependent upon
      qualified counselling and education of the patients by the physician (as far as
      possible with the assistance of a dietitian).

PMID- 8475635
TI  - [Differential therapy with oral antidiabetic drugs].
AB  - The more than 3 million type II diabetics in Germany constitute a true
      therapeutic challenge. Type II diabetes mellitus is part of the so-called
      metabolic syndrome characterized by the problem of insulin
      resistance/hyperinsulinemia. Treatment of type II diabetes aims at reducing
      insulin resistance. Oral antidiabetic management must be based on diabetic diet,
      in conjunction--if needed--with monotherapy with acarbose or metformin. Only
      after exhausting these principles of management, acarbose or metformin may be
      combined with sulfonylurea. Primary monotherapy with insulinotropically acting
      sulfonylureas is, in most cases, no longer appropriate as we are learning more
      about the pathophysiology of metabolic syndrome.

PMID- 8475636
TI  - [Combination therapy of oral antidiabetic drugs with insulin].
AB  - The treatment of type II diabetes should not only concentrate on blood glucose
      levels but also should take symptoms like insulin resistance, hyperinsulinemia,
      low HDL-cholesterol, high VLDL, and systemic hypertension into consideration.
      These symptoms are well described by the metabolic syndrome and are known to be
      risk factors of macroangiopathy. In obese type II diabetic patients weight loss
      by caloric restriction is the most essential therapeutic step. Retarding
      intestinal carbohydrate uptake glucosidase-inhibitors are able to lower
      postprandial blood glucose levels without stimulating insulin secretion. The
      biguanide metformin is suitable to diminish peripheral insulin resistance,
      gluconeogenesis, and intestinal glucose absorption on cellular mechanisms others
      than betacytotropic effects. In non obese type II diabetic patients sulfonylureas
      are advantageous because of meal related stimulation of endogenous insulin which
      runs the physiological way with first pass through the liver. Therefore,
      sulfonylurea treatment should be continued when secondary failure indicates the
      need for exogenous insulin. In accordance with the course of type II diabetes in
      secondary failure insulin should be added to sulfonylureas in as small amounts as
      possible to ameliorate poor metabolic control. Thus iatrogenic hyperinsulinemia
      and resulting insulin resistance can be largely avoided. If there is any long
      term benefit when different oral antidiabetic agents are administered together
      with insulin has to be evaluated in further clinical studies.

PMID- 8475637
TI  - [Reliable and new aspects of insulin therapy].
AB  - New findings concerning the dynamic of insulin secretion, insulin action and
      pharmacokinetics of insulin preparations have caused a complete change of insulin
      therapy in diabetes mellitus (basis-bolus-concept). At the same time, the
      discrepancy between insulin substitution and physiologic conditions becomes
      evident. Even the use of human insulin or the development of insulin-pens and 
      pumps does not influence that fact. From the beginning of insulin therapy till
      now the subcutaneous injection of insulin is the safest and easiest way of
      application. By means of modified insulins (bioengineering) the physico-chemical
      process of insulin resorption could be elucidated in the last 4 years. In
      clinical experiments the intraperitoneal and nasal insulin administration is
      tested extensively. In the field of the intensified insulin therapy including
      near normoglycemic therapeutic goals the awareness of hypoglycemia is of
      particular importance.

PMID- 8475638
TI  - [Diabetic microangiopathy].
AB  - On the whole, diabetic microangiopathy can be understood as the clinical renal
      retinal syndrome. About 10% of all diabetics die of end-stage renal failure, more
      frequent in IDDM. With an incidence of 14% diabetic retinopathy is one of the
      major causes of blindness in adulthood. In the non-proliferative state, the
      pathological changes are limited to the retina, whereas the alterations affect
      both retina and vitreous in the proliferative state. Photocoagulation is the
      treatment of choice. If photocoagulatory treatment is not possible because of
      cataract, vitreous surgery (pars-plana vitrectomy) could improve visual
      prognosis. The clinical features hypertension, proteinuria and finally renal
      failure define the term "diabetic nephropathy". The increased intraglomerular
      pressure is the main pathological alteration of incipient nephropathy.
      Microalbuminuria essentially determines the prognosis: in IDDM it concerns the
      incidence of a manifest nephropathy, in NIDDM the excessively increased incidence
      of cardiovascular mortality. Sonographically, the kidneys are large with bright
      and wide parenchyma. Along with the development of end-stage renal disease the
      kidney size diminishes. According to Mogensen, nephropathy is divided into five
      stages: Stage 1, the early stage, is defined by hypertrophy and hyperfiltration.
      Stage 2 shows incipient structural changes without any clinical findings. Stage 3
      is characterised by persistent microalbuminuria. Stage 4 leads to increasing
      renal failure and stage 5 to end-stage renal disease and the necessity of
      dialysis treatment. Incipient nephropathy demands a strict treatment of both
      hypertension and diabetes. In the meantime, ACE inhibitors are the treatment of
      choice. In case of dialysis treatment continuous ambulant peritoneal dialysis
      (CAPD) is usually preferred.

PMID- 8475639
TI  - [Macroangiopathy in diabetes mellitus].
AB  - Although there is no evidence of effectiveness of interventional trials
      concerning macroangiopathy in diabetes mellitus, the focus of primary prophylaxis
      is based on the treatment of risk factors and optimal adjustment of metabolic
      parameters. This should contain the prophylaxis of the diabetic foot (foot care,
      teaching, pressure bearing) in the neuro-ischaemic risk patient. In the secondary
      prophylaxis acetylsalicylic acid has been proven as effective in the cerebral,
      cardial, and peripheral vascular regions in different dosages. The aim of the
      symptomatic therapy is the improvement of the peripheral vascular disease
      symptoms, which could mean an improvement of the pain-free walking distance or
      the avoidance of an extremity-threatening ischaemic syndrome. The therapeutic
      range includes a structured exercise programme, conservative medical treatment,
      catheter procedures, and bypass surgery as well as amputation. The different
      procedures are mainly dependent on the general condition of the in many cases
      multimorbid patients, the clinical stage, the psychological burden and the
      angiologic status. There should be always an interdisciplinary discussion, which
      helps to find the right therapeutic decision. All the therapeutic activities
      should be seen under the guideline of an improvement in the quality of life.

PMID- 8475640
TI  - [Hypertension and diabetes mellitus].
AB  - Numerous surveys have shown that in industrial countries diabetic subjects
      develop hypertension more frequently than non-diabetic persons. In fact, three
      typical hypertension forms in these patients can be discerned: essential, renal,
      and isolated systolic hypertension. In type 2-diabetes (NIDDM) hypertension can
      be seen in close association with obesity, glucose intolerance, lipid changes,
      and insulin resistance within the framework of the metabolic syndrome. The
      increased incidence of hypertension in type 1-diabetes (IDDM) is a result of
      development of diabetic nephropathy. In the elderly type 2-diabetics particularly
      frequently isolated systolic hypertension is present which reflects increased
      arterial stiffness and loss of vascular distensibility. In hypertension
      progression of both macrovascular disease and microangiopathy is increased
      whereby interaction of hyperglycemia and hypertension seems to be the main risk
      factor. In most hypertensive diabetic patients drugs will be necessary to lower
      blood pressure in a therapeutical range. There are several effective substances
      available which should be prescribed individually according to the needs and
      accompanying conditions in these patients.

PMID- 8475641
TI  - [Autonomic neuropathies in diabetes mellitus: diagnosis--therapy--risks].
AB  - Autonomic neuropathy is a complication of diabetes which is observed in about 20%
      of all patients. This complication is often not adequately diagnosed. Neuropathy
      is a syndrome of various diseases that is classified according to the organs
      involved in the clinical picture. For the diagnosis of autonomic neuropathy
      besides the careful examination of the patient (metabolic and neurologic status,
      diabetic complications) a number of specific tests are available i.e.
      cardiovascular reflex tests and some other organ-specific tests. The review
      attempts to give an update of the presently used diagnostic approaches. As far as
      the therapy of all forms of neuropathy is concerned the careful control of blood
      glucose of the diabetic patient is still the only therapy which counteracts
      specifically the pathogenesis of autonomic neuropathy. There is however a number
      of drugs available which are useful for symptomatic therapy. Their effectiveness
      is discussed in this review. There is no doubt that diabetic autonomic
      neuropathies will have consequences for long-term prognosis and quality of life.

PMID- 8475642
TI  - Interrelations between electrical and biochemical processes in ischemic porcine
      livers at low temperature.
AB  - Recently it has been shown that during liver ischemia at 25 degrees C the
      presence of glycogen, by supporting glycolytic supply, not only retards ATP decay
      but also leads to a corresponding delay of the rise of the electrical impedance
      of the ischemic organ. A sudden rise of impedance during ischemia is supposed to
      indicate the closure of gap junctions. Although similar effects on energy state
      do exist at low temperature, the impact of glycogen on the electrical impedance
      under storage conditions has still to be evaluated. Therefore, in a model with
      protected porcine livers, we examined the intraischemic effects of a preischemic
      glucose and potassium feeding on impedance changes, lactate production and ATP
      content at a storing temperature of 5 degrees C. Impedance was measured both in
      the low frequency alpha- and the higher frequency beta-dispersion range. In
      addition, the same parameters were determined in a group of unprotected livers.
      In this group all animals had received glucose and potassium orally prior to
      ischemia. Whereas in case of preischemic glucose feeding the rise of impedance in
      the range of the beta-dispersion (e.g. 5kHz) roughly coincided with the
      exhaustion of ATP, the corresponding impedance changes in the protected group
      without a glucose premedication only occurred when glycolysis had already stopped
      and ATP had reached basal values for some hours. In contrast, in the alpha
      dispersion range the impedance changes in the latter group just began at the time
      when ATP became exhausted and lactate production ceased.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8475643
TI  - [Computer systems in gastroenterologic endoscopy. An analysis of current
      availability on the Austrian market].
AB  - Five systems for computerized documentation (ADAM-Fujinon, ENDOBASE-Olympus,
      MEDASYS-Pentax, MEPAS-Fritsch & Jirak, OPTAMED-Krotlinger) are compared in their
      different functions: configuration of system, software, communication, structure
      of program, user guidance, data-protection, data back-up, patient registration,
      preparation for examination, terminology setup, report generation, image filing,
      statistic, system adjustments, costs. This paper should be a help in buying a
      computer-aided system. All systems fulfil the three basic requirements for a
      computer-aided documentation in gastrointestinal endoscopy: database, image
      filing, report generation. Actually none of the programs can be favoured.
      Peculiarities, weakness and strength of the different programs are discussed. The
      principle of the scoring-method in choosing a system is explained.

PMID- 8475644
TI  - Inflamed pancreatic pseudocyst: optimization of pseudocyst fluid culture
      technique.
AB  - A serious complication of pancreatitis, inflamed pseudocyst is associated with
      considerable morbidity and relatively high mortality rate. In this study chronic
      pancreatic pseudocyst fluid was cultured by the conventional method as well as by
      a method of bedside inoculation of blood culture bottles with pseudocyst fluid.
      The conventional method grew bacteria in only 26 (65%) of 40 patients with
      chronic pancreatic pseudocyst, whereas the blood culture bottles grew bacteria in
      38 (95%) patients (p < 0.001). The blood culture bottle method also resulted in
      more rapid detection of bacterial growth (p < 0.001). Inoculation of pseudocyst
      fluid into the blood culture method seems more sensitive than the conventional
      method in detecting inflamed pancreatic pseudocyst probably due to the low
      pseudocyst concentration of bacteria observed in this study.

PMID- 8475645
TI  - [Obstructive jaundice after granade splinter injury 49 years ago].
AB  - The present case report describes a 69 year old man who was admitted because of
      severe pain in the right upper abdomen by condition after a Billroth II resection
      of the stomach and a obstructive icterus. The reason was a common bile duct stone
      with a central shell splinter. Due to purulent cholangitis with inflammatory
      stenosis of the distal ductus choledochus endoscopic removal of the stone was
      only successful in repeated attempts.

PMID- 8475646
TI  - [Blind loop of the large intestine--bypass enteropathy or diversion colitis?].
AB  - Investigating three patients with longstanding diarrhoea, severe abdominal
      bloating and cramps revealed an exclusion of the right hemicolon in all patients
      and additionally of the terminal ileum in one of them. The anastomosis of the
      ileo-colic bypass, performed decades ago due to complicated appendicitis, was
      stenotic in two of them. Because a classical blind-loop-syndrome could not be
      proven, the functional disorder is described as a clinical entity characterized
      by signs of bypass-enteropathy and diversion-colitis. The importance of the
      radiological examination for diagnosis and therapy-planing is emphasized, because
      endoscopically and histologically Crohn's disease might be suspected. The
      surgical reintegration of the bowel into the orthograde continuity of the
      intestinal tract is recommended as the causative treatment. Symptoms disappear
      completely and patients win normal health even after some decades, because the
      morphological signs of inflammation are reversible and bowel function is not lost
      during the exclusion.

PMID- 8475647
TI  - [Physiologic regulation of gastric acid secretion].
AB  - Physiological regulatory mechanisms of gastric acid secretion are the basis for
      all those studies which attempt to analyze the pathophysiological role of acid
      secretion. The major stimulus of parietal cell function is food intake which acts
      via activation of cephalic-vagal and gastric mechanisms. Cephalic phase of acid
      secretion is augmented predominantly by acetylcholine and gastrin while histamine
      is of major importance during the gastric phase. A contribution of neuropeptides
      located in the ex- and intrinsic nervous system such as enkephalin, beta
      endorphin, gastrin-releasing peptide and neuromedin C ist most likely, however,
      their exact physiological role remains to be determined especially in man.
      Following maximal acid secretion parietal cell function is turned down which is
      paralleled by the decrease of intragastric pH. The mechanisms responsible for
      this effect originate in the stomach and small intestine. In contrast to the
      stimulatory factors the physiologically relevant inhibitors of acid secretion are
      less well known. Hormones such as somatostatin, glucagon-like peptide-1 (7-36)
      NH2 and peptide YY are presumably of importance. The role of secretin, GIP, CCK
      and neurotensin is somewhat more controversial and remains to be examined in
      greater detail in humans. Especially the synergistic action of gastrointestinal
      hormones is virtually unknown. The increasing knowledge of the complex regulatory
      mechanisms in the stomach should result in new perspectives for the pathogenesis
      of peptic ulcer disease.

PMID- 8475648
TI  - [Nitric oxide (NO): a new, endogenous protective mechanism in gastrointestinal
      mucosa?].

PMID- 8475649
TI  - [Use of sclerotherapy in patients with esophageal varices. Guidelines of the
      German Society of Digestive and Metabolic Diseases].

PMID- 8475650
TI  - [Reproducibility of the signal-averaged, high-pass filtered electrocardiogram].
AB  - In order to test the reproducibility of the signal-averaged electrocardiogram
      (SAECG) using Simson's method (high-pass filter cutoff frequency 25 Hz,
      orthogonal leads, recording of 133 s per lead), 121 patients were examined. In
      all patients, two signal-averaged ECGs were performed on the first day of the
      study immediately after each other, using identical electrode position. In a
      subgroup of 47 patients, the same procedure was repeated 3 days later. There was
      no difference between the mean values of conventionally calculated averaging
      parameters (heart rate, QRS-duration, root-mean-square voltage in the terminal 40
      ms of the highly amplified and filtered QRS-complex [V40], the low amplitude
      signal duration under 40 microV in the terminal portion of the QRS-complex [LAS],
      total root-mean-square voltage of the QRS-complex), both with regard to immediate
      and short-term reproducibility. Thus, conventionally calculated averaging
      parameters are well reproducible.

PMID- 8475651
TI  - [Therapy of ventricular tachyarrhythmia with implantable
      cardioverters/defibrillators--mortality and complications using epicardial
      electrodes].
AB  - Technical improvements of third generation implantable cardioverter
      defibrillators (ICD) like antitachycardia pacing modalities lead to an extended
      use of ICDs, not only in patients with aborted sudden cardiac death, but also in
      patients with hemodynamically tolerable ventricular tachycardia. In addition,
      anticipated results of current prospective studies might indicate the
      prophylactic use of ICDs in patients with high risk for sudden cardiac death, but
      without documented ventricular tachyarrhythmias. This report reviews mortality
      and complications associated with the ICDs with epicardial defibrillation leads.
      Mortality is separated in cardiac death, sudden cardiac, arrhythmogenic "not so
      sudden" cardiac death, and overall mortality. Pulmonary complications and
      infections are related to the underlying disease and the surgical procedure.
      Device- and lead-related complications, high defibrillation thresholds, pacemaker
      interactions, inappropriate shocks, arrhythmic effects, syncope, and psychosocial
      problems are reported, respectively.

PMID- 8475652
TI  - [Diagnostic value of intravascular ultrasound diagnosis in peripheral
      arteriosclerotic blood vessel changes].
AB  - Intravascular ultrasound is an adjunct for the diagnosis of atherosclerotic
      peripheral vessels. In this in-vitro study, 69 segments of human peripheral
      arteries were fixed in formalin, examined with intravascular ultrasound and
      pathomorphologically evaluated. Sensitivity, specificity, both positive and
      negative predictive value and accuracy of intravascular ultrasound for the
      detection of irregular lumen contours, intraarterial structures and intimal
      thickening were determined for each of four quadrants. Sonographic features
      (echogeneity, homogeneity, shadowing of echoes) were compared to the architecture
      of lesions. Intravascular ultrasound detected regular (normal) lumen contours
      with high specificity (96.5%), a sensitivity of 65.0%, and an accuracy of 88.4%;
      intraluminal structures were detected with a sensitivity of 88.6%, a specificity
      of 97.8%, and an accuracy of 96.4%. Most atherosclerotic lesions could be
      localized with a sensitivity of 86.1%, a specificity of 99.1%, and an accuracy of
      86.9%. Slight intimal thickening was detectable with a sensitivity of 85.9%, a
      specificity of 87.8%, and an accuracy of 86.2%. Comparison of sonographic
      features and the pathomorphological architecture of atherosclerotic lesions
      revealed that fibrous, atheromatous, and complex lesions without calcification
      did not show shadowing of echoes. The majority of fibrous or atheromatous lesions
      presented with homogeneous echoes; these lesions showed hypo-, hyper- and
      normodense echoes. The homogeneity of echoes did not help to identify the
      different components of combined atherosclerotic lesions. Thus, intravascular
      ultrasound is able to detect irregular lumen contours, intraluminal structures,
      and intimal thickening, but further sonographic criteria are needed to identify
      the architectural structure of combined lesions.

PMID- 8475653
TI  - [Detection of pacemaker electrode infection using intravascular ultrasound].
AB  - The case of a 60-year-old man who developed fever 14 months after last
      implantation of a DDD pacemaker system is reported. Though staphylococcus
      epidermidis could be identified in several blood cultures, transthoracic and
      transesophageal echocardiograms and scintigraphy with antibodies to human
      leucocytes could not identify any focus of infection. The percutaneous
      intravascular and intracavitary ultrasound examination clearly demonstrated a
      vegetation within the subclavian vein, being attached to the ventricular lead;
      within that segment of the vein the atrial lead showed a small hyperdense
      structure. Further vegetations along the leads within the right atrium and
      ventricle could be ruled out. Subsequent removal of the pacemaker system caused
      resolution of the signs of inflammation.

PMID- 8475654
TI  - [Limitation of Doppler echocardiography in evaluation of aortic valve
      prostheses]].
AB  - Doppler echocardiography has been widely used as a noninvasive method to evaluate
      valvular heart diseases. However, the diagnostic impact of Doppler
      echocardiography in the evaluation of prosthetic valves is discussed
      controversially. Reasons are, on one hand, the high variabilities of
      transvalvular gradients observed for normal prosthetic devices and, on the other
      hand, results of experimental in vitro studies demonstrating an impressive
      discrepancy between Doppler-echocardiographic and invasive measurements of the
      transvalvular gradients in prosthetic valves. In a prospective study, we
      evaluated 11 out of 335 patients after aortic valve replacement who demonstrated
      an elevated transvalvular gradient over the prosthetic valve. Eight patients had
      a St. Jude medical prosthesis (19-23 mm), two patients had a Medtronic Hall
      prosthesis, and one patient a Bjork-Shiley prosthesis. The maximal instantaneous
      gradient measured by Doppler-echocardiography was 74 +/- 15 mmHg, the mean
      gradient was 47 +/- 12 mmHg. The prosthetic orifice area calculated by the
      continuity equation using the left ventricular outflow tract diameter was 0.86 +/
      0.25 cm2, and that calculated by using the prosthetic ring diameter was 0.98 +/-
      0.23 cm2. None of the patients had a severe aortic valve regurgitation. All
      patients were clinically asymptomatic. Transesophageal echocardiography and x-ray
      showed a normal prosthetic function. Angiographic examination performed in seven
      patients showed a peak-to-peak gradient of 26 +/- 9 mmHg, and demonstrated a
      marked discrepancy between Doppler-echocardiographic and invasive results. These
      results confirm the clinical limitations of Doppler echocardiography to
      distinguish between normal and disturbed prosthetic function.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8475655
TI  - [Follow-up angiography after balloon dilatation of aortic isthmus stenoses in
      adults].
AB  - Between May 1985 and April 1991, 30 patients (seven females and 23 males) 14 to
      54 years old (median, 25 years) underwent balloon angioplasty for unoperated
      native (n = 26) or recurrent postoperative (n = 4) coarctation of the aorta.
      28/30 patients had systemic hypertension (RR > 140/90 mmHg). Dilatation of the
      stenotic segment could be achieved in 28/30 patients. The residual pressure
      gradient was > 30 mmHg in six patients. In 2/4 patients with recurrent
      coarctation the balloon had ruptured, while dilatation was successful in the
      other two patients. The mean diameter of the stenotic segment increased from 5.8
      +/- 2.7 mm to 11.9 +/- 2.5 mm and the peak pressure gradient decreased from 61 +/
      18 mmHg to 20 +/- 13 mmHg. Complications were a small hemorrhagic pleural
      effusion in one patient and a groin hematoma in another patient. Clinical follow
      up studies with retrograde catheterization of the aorta and angiography were
      performed in all 28 patients with dilated coarctation, 6 months to 6 years after
      the procedure, representing a total follow-up time of 72 (average, 2.6) patient
      years. Multiple follow-up studies (n = 2-4) were performed in 17/28 patients. In
      one patient the first angiogram revealed aneurysm formation while a small bulge
      was seen in two others. Intra-aortic pressure measurements revealed a peak
      gradient of < 30 mmHg in 24/28 patients with a mean of 14 +/- 10 mmHg. The blood
      pressure was normal in 23/28 patients. In the other five patients whose pressure
      gradients were 7, 30, 30, 35, and 60 mmHg moderate hypertension
      persisted.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475656
TI  - [Ambulatory blood pressure monitoring: significance of blood pressure variability
      for progression of heart hypertrophy].
AB  - It is known that ambulatory blood-pressure monitoring gives a better prediction
      of target organ damage and prognosis than clinical blood pressure. Many studies
      have found a closer correlation for ambulatory blood pressure with left
      ventricular hypertrophy than clinical blood pressure. One question that is
      discussed controversely is whether the variability of blood pressure is also a
      determinant of target organ damage independent of the average level. In 52
      patients with elevated casual blood pressure a 24-h ambulatory blood-pressure
      measurement (Space Labs 90202) was performed and left ventricular hypertrophy was
      evaluated by M-mode echocardiography. The following parameters of blood pressure
      variability were calculated from the profiles: the standard deviation of the mean
      value, the variation coefficient and the parameter of variability as proposed by
      Schachinger et al. Furthermore a Fourier analysis of the blood pressure data was
      performed to quantify blood pressure variability. We found no statistically
      significant correlation between blood pressure variability and left ventricular
      mass. However, systolic and diastolic blood pressure level showed a significant
      correlation with left ventricular hypertrophy (r = 0.45 and r = 0.49, p < 0.05).
      Thus, blood pressure variability as calculated from the ambulatory, non-invasive
      blood pressure monitoring is a poor predictor for secondary damage of the heart.

PMID- 8475657
TI  - [Diagnostic blood flow changes in the outflow tract of the left ventricle. A
      Doppler echocardiography study of arterial hypertension].
AB  - In patients with arterial hypertension we analyzed left ventricular filling by
      pulsed wave (PW) Doppler in the left ventricular inflow and outflow tract (LVIT
      and LVOT resp.). Separately, we determined the optimal position of flow analysis
      within the LVOT. We investigated 20 normals (N) and 37 patients with hypertension
      present for more than 1 year and consistently above 160/95 mm Hg. There was no
      evidence of other diseases. Echocardiographic signs of left ventricular
      hypertrophy were present in 20 (H1) and absent in 17 patients (H2). The mean age
      was 50 years in all groups. We analyzed the velocities (V) and velocity time
      integrals (F) of the E- and A-waves, respectively, as well as their ratios [E
      wave (Ve,Fe), A-wave (Va,Fa), Ve/Va, Fe/Fa]. In the LVOT, we determined the end
      diastolic A*-wave (A-wave propagated from LVIT to LVOT) and the S-wave (systolic
      flow) [A*-wave (Va*,Fa*), S-wave (Vs,Fs), Va*/Vs, Fa*/Fs]. Altered flow patterns
      were detected more sensitively in the LVOT as compared to the LVIT, even without
      detectable hypertrophy: In the LVIT Va was significantly different in H1 as
      compared to N (0.62 +/- 0.15 m/s in H1 vs. 0.52 +/- 0.13 m/s in N; p < 0.05),
      while H2 and N were comparable. For Ve/Va the same results were obtained (0.97 +/
      0.33 in H1 vs. 1.29 +/- 0.40 in N; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475658
TI  - [Consensus conference "Therapy of chronic heart insufficiency" inaugurated by the
      Munich Collegium for Therapy Research e.V. together with the German Society for
      Cardiovascular Research].

PMID- 8475659
TI  - [The functional bases for the formation of sensory system interaction in
      ontogeny].
AB  - The study of the mechanisms of the intersensory interaction and its development
      in the postnatal ontogenesis. The first proved evidence of participation of the
      intracortical inhibition mechanisms in the processes of heterosensory interaction
      on the cortical level. The study of formation in kittens of the heterosensory
      interaction on the neurons of the sensorimotor cortex area has established the
      correlation of the process with the interconnected maturing of the afferent
      entries to this cortex area, and the system of intracortical inhibition.
      Correlation was established between the time of development of the heterosensory
      interactions on neurons of the sensorimotor cortex area in ontogenesis and the
      age period when injury of the sensorimotor cortex destroys the ability of animals
      to produce a conditioned reflex to a complex heteromodal signal in case of
      inhibiting reactions to its components. Discussion of the problem of input of the
      cortical level to the process of heterosensory interaction in different phases of
      ontogenesis.

PMID- 8475660
TI  - [Evolutionary physiology and related sciences].
AB  - A brief historical review of development of the evolutionary physiology as an
      independent discipline. Description of the problems and methodology of the
      evolutionary physiology in the historical perspective. Interrelation of the
      evolutionary physiology and the related physiological and biological disciplines,
      specific features of the evolutionary physiology as an independent research
      discipline. The proceedings of 10 workshops on the evolutionary physiology, and
      the national and international bibliographic publications on evolution of the
      organic world are used to demonstrate the structure and the changes in time of
      the thematic spectrum explored by the evolutionary physiology.

PMID- 8475661
TI  - [The problem of the stability of living systems and its evolutionary and
      morphofunctional bases].
AB  - Stability of the living matter is not only a morphological problem, but also a
      physiological-behavioral problem. Analysis of data accumulated in this field is
      the topic of this study. Contradicting the existing assumptions, it has shown
      that the taxonomic stability is not a casuistic phenomenon, but an important
      independent and widespread law of evolution providing for conservation without
      modification of the structures and functions for sometimes tens and hundreds
      millions of years. This is the first publication of the concept of the material
      substratum of this phenomenon. The study has established that the stability of
      the orders of mammals persisting despite the variability of the somatic organs in
      many representatives, and conservation of this separation even in case of
      transition into the aquatic habitat are due to the regulating mechanism
      represented by the nervous system of animals and man. This is, in particular,
      reflected in the specific structural and physiological mechanisms on the
      subcortical and cortical levels (visual system and neocortex). The study
      questions the concept of the origin of mammals from a single root of primary
      insectivorous ancestors on the basis of the discovered cytoarchitectural
      differences in the visual system and neocortex, and also the most recent
      paleontological data. In view of that the author emphasizes the independent
      principle of cytoarchitectural organization of the above brain formations in each
      order, and their stable separation during the established paleontological
      history. This phenomenon is interpreted as a major evidence of the principle of
      stability in the evolution process.

PMID- 8475662
TI  - [The role of macrophages during the formation of regulatory connections between
      the immune, nervous and endocrine systems in the course of an immune response].
AB  - The study explores the current understanding of the role of macrophages in the
      process of formation of the regulatory relations in the immune, nervous, and
      endocrine systems during the immune reactions. Discussion of the effects of the
      factors of macrophagal origin on the afferent section of the nervous system, on
      production of neuromediators of the sympathetic and parasympathetic sections of
      the vegetative nervous system, on production of neuropeptides and the functional
      activity of adrenals, and of the influence of the neuroendocrine system on the
      mononuclear phagocytes. Discussion of the role of macrophages in the intersystem
      regulation of the immune reaction.

PMID- 8475663
TI  - [Prof. B. P. Babkin, scientist and humanist of Russia and Canada].

PMID- 8475664
TI  - [Rheumatism, Zipperlein and Pfotengram: therapy of rheumatic diseases in the
      course of time].

PMID- 8475665
TI  - [Indications, problems and results of dynamic compression spondylodesis in
      rheumatic atlanto-axial instability].
AB  - 37 patients suffering from rheumatoid atlanto-axial dislocation underwent
      operations with the dynamic compression spondylodesis from 1982 until 1990 at the
      Department of Neurosurgery of the University Hospital of Giessen and Essen. They
      were examined with an average of 2 years after the operation. The clinical and
      radiological follow up and the complications are reported. Because of the results
      the indication of the surgical treatment was modified. In the case of an extended
      peridental inflammatory pannus with osteolysis of the dens and vertical
      dislocation of the axis a occipito-cervical fusion is indicated.

PMID- 8475667
TI  - Combined interferon alfa-2a and cytosine arabinoside as first-line treatment for
      chronic myeloid leukemia.
AB  - Thirty patients with chronic myeloid leukemia in chronic phase and less than 1
      year from diagnosis were treated with a combination of interferon alfa-2a (IFN) 9
      million units daily continuously and intermittent low-dose cytosine arabinoside
      (Ara-C) 20 mg/m2 daily for 21 days every 42 days. The leukemia was controlled
      initially with hydroxyurea prior to commencing IFN and Ara-C. The treatment was
      continued for at least 12 months after which time nonresponders were withdrawn
      from the trial and responders continued on IFN alone. The median duration of
      follow-up is 14 months (range 10-53 months). Hematological response was assessed
      by clinical and laboratory parameters and cytogenetic response was assessed by
      regular bone marrow chromosome analysis. A complete hematological response
      occurred in 28/30 patients (93%). A complete cytogenetic response (no detectable
      Philadelphia chromosome-positive metaphases) was present on at least one occasion
      in 9/30 (30%), a partial cytogenetic response (between 1 and 34% Philadelphia
      chromosome-positive metaphases) in 7/30 (23%) and a minor response in 4/30 (13%),
      giving an overall cytogenetic response rate of 67%. Significant side effects
      included mucositis, nausea, cytopenia and depression. Side effects could be
      managed by dose reduction or temporary cessation and were tolerable in most
      patients, but in 1 patient this led to withdrawal from the trial due to severe
      depression. Two patients have transformed, 1 to acute lymphoblastic leukemia and
      1 to accelerated phase. Two patients have died after exiting the study, both from
      complications of allogeneic bone marrow transplantation. In conclusion, these
      results are superior to the results using IFN alone and indicate the need for a
      randomized study.

PMID- 8475666
TI  - [Joint loose bodies in both upper ankle joints in neural muscular atrophy of the
      Charcot-Marie-Tooth-Hoffmann type (hereditary motor sensory neuropathy I)].
AB  - A case is reported in which a patient with Charcot-Marie-Tooth-Hoffmann disease
      (HMSN I) complained about bilateral ankle pain, stiffness and swelling.
      Radiologically multiple loose bodies in both ankle joints were detectable. The
      etiology of loose bodies or secondary chondromatosis is still unclear. Different
      reasons are discussed. Regarding the case reported on here we discuss possible
      etiological connections and pathophysiological pathways that may explain
      influence of Charcot-Marie-Tooth-Hoffmann disease (hereditary motor sensory
      neuropathy I) on the development of loose bodies at both ankle joints.

PMID- 8475669
TI  - The role of all-trans-retinoic acid in the treatment of acute promyelocytic
      leukemia.
AB  - All-trans-retinoic acid (ATRA) has demonstrated in vivo and in vitro that it
      could differentiate leukemic cells in acute promyelocytic leukemia (APL). ATRA
      yields complete remission (CR) rates of approximately 90% in newly diagnosed and
      first relapsing APL, in APL resistant to one or two courses of chemotherapy,
      whereas patients in second and subsequent remissions often have only partial
      remissions. The use of ATRA in APL is associated with two major drawbacks: (1)
      the risk of rapidly rising leukocyte counts, leading to the 'retinoic acid
      syndrome' which may be fatal if the increase in leukocytes is not reversed and
      (2) almost universal relapse, if no intensive chemotherapy is administered after
      CR achievement. Preliminary results, however, suggest that ATRA followed by
      intensive chemotherapy has improved the outcome of newly diagnosed APL, by
      slightly increasing the CR rate but also by reducing the risk of relapse, as
      compared to chemotherapy alone.

PMID- 8475668
TI  - Interleukin-2 +/- lymphocytes as consolidative immunotherapy after autologous
      bone marrow transplantation for hematologic malignancies.
AB  - Patients who undergo autologous bone marrow transplantation (ABMT) for advanced
      hematologic malignancies experience a high relapse rate. Therapy with interleukin
      2 (IL-2) +/- lymphokine-activated killer (LAK) cells has induced clinical
      responses in some patients with advanced malignant lymphoma (ML) or acute
      myelogenous leukemia (AML). It is postulated that IL-2 +/- LAK cells represents a
      potentially non-cross-resistant therapeutic modality which might prevent or delay
      relapses if used as consolidative immunotherapy after ABMT, at a time of minimal
      residual disease. Therefore, we first studied the reconstitution of IL-2
      responsive LAK precursor cells after ABMT and found them in the circulation as
      early as 3 weeks after ABMT. A phase Ib clinical trial was then performed which
      identified a tolerable IL-2 regimen which could be administered early after ABMT
      and which could induce immunomodulatory effects. We then initiated a clinical
      trial to determine the feasibility of generating and administering autologous LAK
      cells using this IL-2 regimen after ABMT for 16 patients with ML. The results
      show that IL-2+LAK therapy early after ABMT is feasible but is more toxic than IL
      2 alone. Patients with AML on the phase I IL-2 trial and with ML on the IL-2+LAK
      protocol were evaluated for tumor status. Of 8 patients with AML in first relapse
      or at a later stage who underwent ABMT and received IL-2, 2 have relapsed, while
      6 remain in complete remission 26+ to 40+ (median 28+) months after ABMT. Of 16
      patients with ML considered at high risk for relapse who were treated with
      ABMT+IL-2+LAK, 5 have relapsed, while 11 remain in complete remission at 6+ to
      21+ (median 10+) months after ABMT. The results in both trials are quite
      encouraging and appear to be better than those in nonrandomized historical
      controls at our institution. Prospectively randomized trials of IL-2 versus no IL
      2 after ABMT in such patients are being initiated to assess definitively the
      effect, if any, on the relapse rate.

PMID- 8475670
TI  - Roferon-A in combination with Tigason in cutaneous T-cell lymphomas.
AB  - In cutaneous T-cell lymphomas (CTCL; mycosis fungoides and Sezary syndrome), the
      standard therapies tend to be effective but not curative. Single drug therapy
      with either interferon-alpha or retinoids shows a response rate of about 45%. In
      this article, we report the results obtained in the treatment of CTCL with a
      combined therapy. To date, four clinical studies have been carried out using a
      combination of low doses of interferon-alpha and retinoids for treatment in the
      early stages of CTCL. The mechanism of action of this combination therapy is
      unknown.

PMID- 8475671
TI  - Use of interferon alfa-2a to treat hematologic relapse of chronic myelogenous
      leukemia after bone marrow transplantation.
AB  - The use of recombinant human alpha interferon (IFN) to treat relapse of chronic
      myelogenous leukemia (CML) in chronic phase after bone marrow transplantation
      (BMT) was studied in a prospective trial. Relapse was defined as > 90% metaphases
      containing the Philadelphia chromosome (Ph) and hematologic abnormalities
      consistent with chronic phase CML. In the initial 18 patients, all received
      allogeneic marrow, 17 from a related donor, 1 from an unrelated donor. Only 1
      patient received T-depleted marrow initially. Three patients had relapsed after
      second BMT. IFN was started at 3 x 10(6) IU/m2/day and escalated to the maximum
      tolerated dose or to a maximum of 6 x 10(6) IU/m2/day. Elevated white blood
      counts and platelet counts were controlled in 14 of 16 and 6 of 6 patients,
      respectively. Six patients (33%) have had a complete disappearance of the Ph
      (cytogenetic complete response) and 2 have had a partial response (cytogenetic
      partial response < 35% Ph+ metaphases but > 0%) on at least one sample. Six
      patients had no significant response after 9-12 months and 4 patients developed
      clinical accelerated phase or blast crisis after 3-6 months. IFN controlled the
      blood counts in 75% of patients. Of 4 patients with a sex marker, the Ph-
      population was of donor origin in 3 and of host origin in 1. Clonal cytogenetic
      abnormalities other than the Ph were present in 13 patients and did not predict
      for lack of response to IFN. IFN effectively produces hematologic control in the
      majority of patients and suppresses the Ph clone in up to one third. A trial of
      IFN treatment in an earlier stage of relapse is indicated.

PMID- 8475672
TI  - [On the 70th birthday of Prof. Dr. Rudolf Hofer].

PMID- 8475673
TI  - [Beta-carotene, vitamin A and carrier proteins in thyroid diseases].
AB  - The conversion of beta-carotene (provitamin A) to 2 molecules of vitamin A
      (retinol) is accelerated by thyroxine and hyperthyroidism, respectively. The
      characteristic yellow tint of the skin in hypothyroidism is due to hyper-beta
      carotenemia. Both in hyper- and hypothyroidism in a retinol deficiency has been
      observed in literature. In a series of 36 patients (16 hyper-, 8 hypo-, and 12
      euthyroid) serum samples were analyzed for retinol and beta-carotene levels (high
      pressure liquid chromatography) as well as retinol binding protein (radial immune
      diffusion), prealbumin (nephelometry), and serum zinc values (atomic absorption
      spectrometry) were established. The beta-carotene serum level in the hypothyroid
      group (mean 1.1 microgram/ml) was significantly higher (p < 0.05) in relation to
      euthyroid controls (0.6 microgram/ml), the hyperthyroid group showed
      significantly lower values (0.3 microgram/ml). RBP and prealbumin concentrations
      were significantly lower (p < 0.05) in hyperthyroid as against eu- and
      hypothyroid patients. Surprisingly, in all 3 groups the retinol levels were not
      significantly different, although the hyperthyroid group was slightly lower (0.6
      microgram/ml) than the mean value of 0.7 micrograms/ml in the other groups. A
      vitamin A and protein rich food, customary in Central Europe, seems to rule out
      any vitamin A deficiency both in hyper- and hypothyroidism. However, the beta
      carotene values are significantly higher in hypothyroidism, while in
      hyperthyroidism they were lower. As intrahepatic zinc content plays an important
      role in the synthesis of RBP and its secretion together with retinol, we also
      analyzed this component: The serum zinc levels in hyperthyroid patients were
      clearly higher (79.1 micrograms/dl) than in the hypothyroid group with 57
      micrograms/dl (p < 0.05).

PMID- 8475674
TI  - [TBG isoforms in the course of hyperthyroidism].
AB  - In 7 hyperthyroid patients on the one hand thyroxine-binding globulin (TBG) was
      determined by commercially available radioimmunoassay and on the other hand TBG
      isovariants were established by means of isoelectric focusing. For assessment
      blood samples were taken upon admittance to our hospital and 2 and 4 weeks
      thereafter, respectively, during antithyroid drug treatment. A comparative series
      of 10 euthyroid subjects were equally evaluated. Both groups showed no
      significant differences of TBG values at onset and in the course of antithyroid
      treatment. However, TBG isovariants showed significant decreases in anionic bands
      (pH 4.25 to 4.45) whereas a significant increase in cathodic bands (pH 4.55 to
      4.65) at onset of treatment compared to the euthyroid control group could be
      observed. During the course of antithyroid treatment the values of TBG-isobands
      reversed reaching the pattern of normal group. In contrast to the recent research
      by Hashizume et al. we observed no reduction in TBG level in hyperthyroid
      patients although a significant shift in the TBG isovariants could be
      established. Due to the antithyroid treatment prescribed, the TBG isovariants
      finally reached the normal pattern of euthyroid controls.

PMID- 8475675
TI  - [Modification of maximal binding capacity and radio-T3/T4 distribution by
      carbamazepine and diclofenac].
AB  - Marked changes in plasma thyroid function parameters due to medication have been
      described in literature. We, therefore, studied the influence of routine
      administration of carbamazepine and diclofenac upon the radio T3/T4 distribution
      to specific thyroid transport proteins as well as their maximal binding capacity
      (MBC) for T4. Both drugs have been found to lead to changes in T3 and T4
      distribution but not to any influence upon MBC. The parameters of thyroid
      function mostly revealed reduced FT3 and FT4 values while bTSH was affected only
      by carbamazepine administration.

PMID- 8475676
TI  - [Initial experiences using SPECT cameras with multiple detector heads].
AB  - User acceptance testing of newly installed gamma cameras is mandatory in order to
      verify manufacturers' specifications and to ensure optimal image quality.
      Acceptance test procedures are widely standardized today and are carried out
      following commonly accepted test protocols. Two new triple head gamma cameras
      have been installed during the last year at the Department of Nuclear Medicine of
      the Vienna University Hospital. For acceptance testing of these cameras a
      modified and expanded version of the commonly used test protocol for single head
      SPECT systems has been employed. Details of the tests that have been carried out
      and a comparison of the results obtained for both cameras are presented.
      Furthermore, some specific problems that are encountered during acceptance
      testing of multiple head systems are discussed. In particular it has been noted
      that some important tests of intrinsic camera parameters cannot be carried out,
      which makes a complete verification of vendors' specifications impossible. In
      spite of these problems the acceptance test system for multiple head cameras
      presented in this work was sufficient for establishing proper working conditions
      for clinical use.

PMID- 8475677
TI  - [Iodine supply and struma in Austria].
AB  - Austria is an iodine deficient area as are most parts of Europe. Goiters were
      always a natural phenomenon. In 1924 goiter prevalence in school children was 45
      to 47% and a first attempt was made with iodized salt. This iodized salt (5 mg
      NaI/kg salt) was not used widely and goiter prevalence remained unchanged for
      decades. Therefore, in 1963, salt iodized with 10 mg KI/kg was introduced by law
      in a semi-mandatory way: Non-iodized salt was allowed to be sold only by special
      request. Consequently, in 1982, 68% of the total salt sold was iodized salt,
      goiter prevalence dropped to 1.5% in first graders, hypothyroidism in newborns
      was 1:4,600 and cretinism disappeared. However, in 18 years old females, goiter
      prevalence was still 13%, and in adults up to 30%. Investigations in various
      regions of Austria showed that iodine supplementation was insufficient with a
      mean urinary excretion of 42 to 75 micrograms I/g Cr. Therefore the Austrian
      Society of Nuclear Medicine (ONG) demanded the raise of the iodine content of
      salt to 20 mg KI/kg. Finally, in 1990 a new law was issued by the Government
      following this proposal. In 1992, investigations were done in various regions of
      Austria demonstrating a normalized iodine excretion of 129 to 177 micrograms I/g
      Cr. Further prospective and retrospective studies will be done by the ONG.

PMID- 8475678
TI  - [Diagnosis of lung embolism].
AB  - Although lung scanning has been performed for nearly 3 decades, the diagnosis of
      pulmonary embolism (PE) still remains problematic. Only about 20% of all autopsy
      proven cases of PE have been diagnosed during life time. Biello, and later
      authors of the PIOPED study defined 3 probability levels for
      perfusion/ventilation (inhalation) scan interpretation in comparison with
      pulmonary angiography: High probability (about 90% PE), indeterminate (27 to 50%
      PE) and low probability (about 5% PE). If the scan results are in the high and
      low probability group, the diagnostic procedure can be stopped. However, in the
      indeterminate group including 36 to 52% of all patients, diagnosis should be
      confirmed by pulmonary angiography. This diagnostic procedure is not well
      accepted by clinicians, only 0 to 15% of all patients suspected of PE undergo
      angiography. The diagnostic problem is more complicated due to the large amount
      of clinically silent PE (39 to 59% of all PE). The inclusion of the diagnosis of
      thrombosis ("thromboembolism") into the diagnosis of PE increases the pre-test
      probability for PE to 55 to 60% (= prevalence of PE in patients with deep vein
      thrombosis). According to Bayes' theorem, the post test probability then exceeds
      95%. Without considering thrombosis, the pre-test probability is very low and
      therefore the post-test probability of a pathologic scan is markedly lower than
      50%.

PMID- 8475679
TI  - [Primary and follow-up studies of patients with carcinoid metastases using indium
      111 octreotide--rational use of Sandostatin].
AB  - Carcinoids may express Somatostatin receptors. Therefore, a Somatostatin
      analogue, In-111 Octreotide (OctreoScan), was used for their demonstration. A
      total of 6 patients who presented with radiologically verified carcinoid
      metastases was examined. In order to control tumor progress, 4 of these patients
      were reexamined within a period of 3 to 11 months. All of the radiological
      findings were confirmed scintigraphically, except some small retroperitoneally
      located lymph nodes. The follow-up examinations of 2 patients revealed additional
      metastases by scintigraphy only. There were no false positive results. The
      results of OctreoScan scintigraphy may be used for predicting the success of
      receptor-specific therapies and therefore, permit the rational and efficient
      application of Sandostatin.

PMID- 8475680
TI  - [Immunoscintigraphy for detection of inflammatory perioperative foci].
AB  - The aim of our study was to evaluate the clinical usefulness of a monoclonal
      antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected
      perioperative septic foci. The MAB is directed against the nonspecific
      crossreacting antigen (NCA 95) which has been found on the surface of human
      neutrophil granulocytes and which represents a murine immunoglobulin isotype of
      IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi)
      Tc-99m. Data acquisition followed 4 and 18 to 24 hours after administration by a
      digital Anger camera (APEX 409A, Elscint). 53 patients were investigated (31
      female, 22 male; average age 39 years), 4 patients were twice, 1 patient was 3
      times evaluated, which results in a total of 59 studies. 45 patients experienced
      operation within 12 hours after our investigation, which resulted in 36 true
      positive, 5 true negative, 3 false negative, and 1 false positive findings. This
      means a sensitivity of 92%, and specificity of 83%. Immunoscintigraphy with
      granulocyte antibodies can be performed at any time, the preparation of the
      radiopharmaceutical is simple, the image quality is high; the obtained
      information concerning localization and size of perioperative septic infections
      permits the determination of the optimal point of time for surgical intervention.
      The accumulation of activity was visible as early as 4 hours post application.
      SPECT would enhance the diagnostic accuracy, but this technique cannot be applied
      in all such patients.

PMID- 8475682
TI  - [Iodine content of thyroid tissue in the Styrian population].
AB  - The iodine concentration was determined in 89 thyroid tissue samples of post
      mortem examination material of thyroid healthy persons in dependency to the age.
      Before the 22nd week little iodine is stored in the fetal thyroid gland (median
      and range: 24 micrograms/g wet weight [0 to 27 micrograms/g]). From the 23rd week
      on the concentration is significantly higher (p = 0.004). There is a further
      increase of iodine concentration in the first 6 months of life, with a median
      concentration of 171 micrograms/g (75 to 808 micrograms/g). With a median of 599
      micrograms/g (464 to 699 micrograms/g) the iodine concentration in the second
      year of life is comparable with that of adults (640 micrograms/g [218 to 2772
      micrograms/g]). From the 60th year of life the median concentration is 462
      micrograms/g (155 to 2100 micrograms/g), but this decrease is not statistically
      significant. Additionally the iodine concentration was determined in 7
      topographically defined regions of 28 thyroid glands. The median iodine
      concentration did not differ in the 7 regions, but the iodine content in one and
      the same thyroid gland differed from region to region. Therefore in the healthy
      thyroid gland no regions exist, which have generally stored less iodine than
      others. However, no conclusion can be drawn from the iodine concentration of one
      biopsy to the whole iodine concentration of the organ.

PMID- 8475681
TI  - [Radiosynovectomy with dysprosium-165 iron hydroxide].
AB  - Treatment of chronic rheumatoid synovitis (RS) is directed to control the
      inflammatory process causing pain and disability. Radiation synovectomy is
      suggested to be an alternative to surgical treatment, but its clinical use has
      been restricted because of significant leakage (> 10%) associated with the use of
      the standard radionuclide 90-Yttrium (used as 90-Yttrium silicate colloid) and
      because of its long physical half-life of 64 hours prolonging the patients' stay
      in the hospital. 165-Dysprosium possesses promising nuclear properties for the
      treatment of patients suffering from RS. The maximum soft tissue penetration of
      its beta-particles is 5.7 mm which is the range being necessary to penetrate the
      inflamed synovia. Using as carrier ferric hydroxide macroaggregates (DFH) 165-Dy
      is expected to minimize the cumulative radiation dose to non-target organs by its
      very low leakage. Animal studies were performed in 13 rats and 6 rabbits to
      obtain the rationale and safety data for its clinical evaluation. These studies
      revealed that 98.2 +/- 0.6% of the injected dose remained in the joint with a
      nontarget organ uptake of less than 0.1%. Clinical results were obtained from 8
      patients with rheumatoid arthritis. 24 hours after injection scintigraphy was
      performed over the treated joint and the liver region revealing no detectable
      leakage of the injected activity from the joint. Blood pool activity was also
      assessed revealing a leakage of 0.02% of the dose injected in the knee 24 hours
      after injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475683
TI  - [Combined therapy with cyclosporin A and cortisone in endocrine Basedow endocrine
      orbitopathy: successful use in compressive optic neuropathy].
AB  - This study reports our experience with a combined treatment with cyclosporin A
      (Cy A) and cortisone in patients with Graves' ophthalmopathy (GO), all of whom
      had compressive optic nerve disease (CON). The therapy was performed in 8
      patients (6 females, age range: 40 to 76 years) with normal liver and kidney
      function and classical Graves' disease, except for 1 male, who had normal thyroid
      function and no detectable thyroid antibodies. 5 patients were euthyroid on
      methimazole, 2 patients were off thyrostatic treatment for 5 and 2 years. 3
      patients have had high-dose cortisone (100 mg/die) treatment for GO before the
      study. Visual field defects were reported by the patients 1 week before start of
      therapy and evaluated by computerized visual field measurements (CVFM). The
      treatment consisted of Cy A in a dose which aimed at through levels between 100
      and 300 ng/ml (RIA method) for 2 to 6 months and of methylprednisolone in a
      starting dose of 1 mg/kg body weight, tapered gradually to a maintenance dose of
      10 mg/day for 6 to 12 months. CON disappeared completely in all patients. The
      thickening of affected eye muscles decreased in 5 patients, disappeared in 1 and
      remained unchanged in 2 patients. The shortest period for a measurable effect
      (either by echography or by CVFM, performed every week the first month and then
      every 3 months) was 1 week; the longest 1 month. The follow-up of the patients
      (range 6 months to 2.5 years) showed a relapse only in 1 patient. 2 patients were
      lost to follow-up 1 year after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475684
TI  - Sleep in Parkinson's disease.
AB  - Two major sources of dissatisfaction with the quality of life among Parkinsonian
      patients are the "locomotor disability" and the "nature of their sleep". The main
      focus of research was directed towards the locomotor disability, but in the last
      two decades some progress has been made towards the understanding of sleep in PD
      patients. Sleep in Parkinson's disease is light and fragmented due to an
      increased skeletal muscle activity, disturbed breathing, impaired biological
      rhythm and REM-nonREM variations of the dopaminergic receptor sensitivity.

PMID- 8475685
TI  - Assessment of response fluctuations in Parkinson's disease by ambulatory wrist
      activity monitoring.
AB  - The aim of this study was to examine the influence of response fluctuations with
      dyskinesia on the 24-h motor activity pattern and measures of diurnal and
      nocturnal activity and immobility. Motor activity was recorded during 5
      successive days in 5 patients with advanced Parkinson's disease (PD) suffering
      from severe response fluctuations with dyskinesia, as well as in 10 PD patients
      with a stable levodopa response and 10 healthy subjects. The 24-h motor activity
      pattern of the patients with response fluctuations provides insight into the
      relationship between the therapeutic regimen and 1) the frequency and duration of
      "on" and "off" periods, 2) the severity of the dyskinesias, and 3) the degree of
      sleep disruption. In accordance with the severity of their motor fluctuations,
      patients with response fluctuations showed a large intra- and interindividual
      variability of diurnal motor activity measures. Overall, the nocturnal motor
      activity measures in the patients with response fluctuations indicated a severely
      disturbed sleep when compared with the two control groups. Factors as simplicity
      and the potential to record unrestrained motor activity for several days
      continuously in all settings, make activity monitoring a welcomed acquisition in
      the assessment of response fluctuations in PD.

PMID- 8475687
TI  - Rising mortality from motor neurone disease: an explanation.
AB  - There is considerable debate about the increasing mortality from motor neurone
      disease (MND). However, examination of the relationship between increased life
      expectancy (through decreased general mortality) and increased mortality in both
      England and Wales and the United States indicates a close association between the
      two variables. Using a statistical model, defined sub-populations susceptible to
      MND can be identified in both countries. The size of such a sub-population has
      been estimated from the 1989 mortality data to be approximately 160,000 people in
      England and Wales. The proportion of this sub-population dying from MND has
      increased over the last 30 years, rather than, as previously, dying at an earlier
      age from other conditions. On this basis, deaths from MND are expected to
      increase by a further 20% in this sub-population between 1991-2021 because of
      continuing changes in life expectancy. MND is a condition made increasingly
      visible in mortality statistics through decreased general mortality, rather than
      one in which the underlying population at risk has substantially changed.
      Aetiological extrapolations from the data indicate that susceptibility to the
      disease is acquired early in life, and that it is unlikely, given the relative
      stability of the underlying sub-population, that either changed environmental
      circumstances or artifactual factors can account in themselves for the rise in
      mortality.

PMID- 8475686
TI  - Paired choice reaction tasks in patients with Parkinson's disease.
AB  - Simple reaction, single choice reaction, and paired choice reaction tasks were
      examined in 11 patients with Parkinson's disease (PD) and 12 controls. Subjects
      were given an auditory go/no-go signal in the single choice reaction task, and
      paired visual and auditory go/no-go signals in the paired choice reaction task.
      The response following the auditory go/no-go signal was analyzed. The reaction
      and movement times were prolonged in patients with PD. Differences between simple
      and choice reaction times in PD patients did not differ from those in control
      subjects. The difference in movement time between simple and paired choice
      reaction tasks in PD patients was longer than that in control subjects, although
      the difference between simple and single choice reaction tasks was not
      significant between PD and control subjects. Sequential choices of visual and
      auditory stimulation may disturb the motor activity in PD patients.

PMID- 8475688
TI  - IgG subclass deficiency in amyotrophic lateral sclerosis.
AB  - In order to get to clues about T-cell independent versus T-cell dependent immune
      mechanism in ALS, we measured IgG subclasses in 25 ALS-patients: 16 patients had
      deficiency of T-cell dependent expressed IgG1 or IgG3 or both with essentially
      normal levels of T-cell independent expressed IgG2 and IgG4. Ten of these
      patients had no prior treatment and five of these 10 had normal total IgG. Six
      patients had some immunosuppressive treatment before measurements of subclasses
      were done and all of them had deficiency of total IgG. Eight of 14 patients who
      underwent a d-xylose breath test, had evidence of small bowel overgrowth, which
      was confirmed by cultures of duodenal aspirate. IgG1 and IgG3 are T-cell
      dependent antibodies against protein antigens with close linkage on chromosome
      14. The findings suggest a defect in the IgG subclass expression in ALS.

PMID- 8475689
TI  - Increased water self-diffusion in chronic plaques and in apparently normal white
      matter in patients with multiple sclerosis.
AB  - A new method for measurement of water self-diffusion compensating for zeroth and
      first order movements was used to study the apparent diffusion coefficient (ADC)
      in 15 patients with chronic multiple sclerosis (MS) and in two patients with
      acute MS. Ten healthy volunteers served as controls. A significantly higher ADC
      was found within chronic plaques compared to the apparently normal white matter
      of the chronic patients. The ADC was higher in the acute plaques compared to the
      chronic plaques. The ADC in apparently normal white matter of the chronic
      patients were significantly higher than in white matter of healthy volunteers. We
      hypothesize that an increase of the ADC in plaques may be related to an increase
      in the extracellular space due to oedema and demyelination. The increased ADC in
      apparently normal white matter suggests that there may be a change in the
      composition of the white matter of chronic MS patients, perhaps related to oedema
      and expanded extracellular space.

PMID- 8475690
TI  - Clinical neurological findings among metal degreasers exposed to chlorinated
      solvents.
AB  - Among industrial solvents in present use trichloroethylene belongs to those which
      have been the concern of most neurological and occupational investigations since
      the beginning of this century. Reports on a broad spectrum of neurotoxicity are
      however mostly based on case-studies and accidental circumstances. The object of
      this study was to examine clinical neurological manifestations after long-term
      exposure to degreasing solvents, mainly trichloroethylene. The population was 99
      metal degreasers, the design a historical cohort study. The most marked finding
      was a highly significant dose-response relation between solvent exposure and
      motor dyscoordination--a finding that was retained after multivariate control of
      relevant confounders. Vibration thresholds increased by solvent exposure at
      bivariate level, but the multivariate analysis showed that age was explaining
      most of the increase. No significant cranial nerve dysfunction was found.

PMID- 8475691
TI  - Clinical outcome and brain MRI four years after carbon monoxide intoxication.
AB  - Brain damage from carbon monoxide intoxication has not been extensively studied
      with magnetic resonance imaging. We report the clinical outcome and brain
      magnetic resonance imaging in three individuals simultaneously exposed to toxic
      levels of carbon monoxide four years previously. Lesions are seen in multiple
      locations and do not correlate well with the clinical condition.

PMID- 8475692
TI  - Minor structural brain changes in young drug abusers. A magnetic resonance study.
AB  - Twenty-three drug abusers and seventeen controls underwent clinical neurological
      examinations and magnetic resonance imaging (MRI) of the brain. The drug abuse
      encompassed cannabis, inhalants, opiates, psychedelics, amphetamines, and cocaine
      but not necessarily all drugs in all persons. The drug abuse was always combined
      with heavy alcohol consumption. One drug abuser had abnormal neurological
      findings which consisted of lower limb ataxia and 3 others had mild imbalance.
      MRI examinations did not show differences in width of the third, fourth or
      lateral ventricles nor the diameter of the cerebral aqueduct but the drug abusers
      had significantly smaller vermes cerebelli compared to controls. White matter
      changes also occurred more often in the drug abuser group. These findings are not
      consistent with known side-effects of the narcotic drugs but more probably a
      result of very high alcohol consumptions in parallel with drug abuse. Alcohol is
      clearly a much more potent brain toxic agent than are the most commonly abused
      narcotic drugs.

PMID- 8475693
TI  - Importance of cerebral pan-angiography for detection of multiple aneurysms in
      patients with aneurysmal subarachnoid haemorrhage.
AB  - In the Danish Aneurysm Study 948 patients had a ruptured intracranial aneurysm
      (RA) revealed by cerebral angiography. Unilateral carotid angiography (UCA) with
      or without vertebral angiography (VA) demonstrated the RA in 206 patients, and 16
      (7.8%) unruptured aneurysms (UA) were disclosed by UCA and 1 UA by VA. In 740
      patients with at least bilateral carotid angiography (BCA) 164 UA (22.2%) were
      disclosed by BCA and 10 by VA. I.e. the number of UA demonstrated in patients
      with RA is not only doubled by BCA compared to ipsilateral UCA, but tripled
      demonstrating that an additional UA is more likely situated on the opposite side
      of the RA. Pan-angiography (or at least BCA) is therefore recommended in patients
      with RA.

PMID- 8475694
TI  - Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine
      treatment.
AB  - Efficacy and tolerability of the new antiepileptic drug oxcarbazepine, was
      evaluated in a retrospective multicentre study. The records of all 947 epilepsy
      patients treated with oxcarbazepine in the eight participating centres from 1981
      through 1990 were examined. The median daily dose of oxcarbazepine was 30 mg/kg
      in children, 18 mg/kg in adults, and 15 mg/kg in elderly patients, given b.i.d.
      or t.i.d. The mean plasma levels of the main active metabolite of oxcarbazepine
      was 88, 79, and 68 mumol/l in children, adults, and elderly, respectively. In
      patients shifted to oxcarbazepine treatment, seizure frequency was unchanged in
      51-66%, 32-48% had a decrease, and 1-10% an increase in seizure frequency,
      considering the individual seizure types separately. Adverse events were reported
      in one third of patients, most frequently affecting the CNS (dizziness: 6%;
      sedation: 6%; fatigue: 6%). Rash was reported in 6% of patients, half of these
      patients had previously had an allergic reaction to carbamazepine. Hyponatremia
      was found in about a quarter of the patients from whom data were available. No
      congenital malformations were seen in nine live-born, first trimester
      oxcarbazepine-exposed children.

PMID- 8475695
TI  - The stereotactic biopsy diagnosis of focal intracerebral lesions in AIDS
      patients.
AB  - Focal intracerebral lesions were biopsied stereotactically in 23 adult HIV
      infected patients, the main indication for which was the failure to respond to
      anti-toxoplasma treatment. A cerebral disease was the initial or main complaint
      in 19 of them. In 22 of 25 stereotactic approaches, a clear-cut morphological
      diagnosis could be established (9 primary brain lymphoma, 7 necrotizing
      toxoplasma encephalitis, 5 progressive multifocal leukoencephalopathy, 1 HIV
      encephalitis, 3 unspecific tissue changes). In 7 of 8 deceased patients, autopsy
      confirmed the bioptical diagnosis. The high diagnostic yield was related to the
      strategy of the stereotactic method and the sample size (3 to 4 consecutive
      samples along the stereotactic track including the marginal zones, 1 cm long
      tissue cylinders). Formalin fixation and paraffin embedding of the samples
      provide the possibility of serial sections and special stainings
      (immunohistochemistry, in-situ hybridization) and kill the HIV. Stereotactic
      brain biopsy is a highly accurate diagnostic tool to ascertain the nature of
      focal intracerebral lesions in selected AIDS patients.

PMID- 8475696
TI  - Abnormal arginine-vasopressin secretion and water metabolism in patients with
      postviral fatigue syndrome.
AB  - Water metabolism and the responses of the neurohypophysis to changes in plasma
      osmolality during the water loading and water deprivation tests were studied in
      nine patients with postviral fatigue syndrome (PVFS) and eight age and six
      matched healthy control subjects. Secretion of arginine-vasopressin (AVP) was
      erratic in these patients as shown by lack of correlation between serum and urine
      osmolality and the corresponding plasma AVP levels. Patients with PVFS had
      significantly low baseline arginine-vasopressin levels when compared with healthy
      subjects. Patients with PVFS as a group also showed evidence of increased total
      body water content. These results may be indicative of hypothalamic dysfunction
      in patients with PVFS.

PMID- 8475697
TI  - Gait disorders of multi-infarct dementia. CT and clinical correlation.
AB  - Twenty-five patients with various types of gait disorders of multi-infarct
      dementia (MID) were reported. The types of gait disorders consisted of lower body
      parkinsonism (LBP) plus ataxia (6 patients), LBP plus apraxia (5 patients), and a
      combination of LBP plus ataxia and apraxia (14 patients). Hypertension occurred
      in 23 (92%) of the 25 patients. Nevertheless, individual stroke risk factors and
      the locations of infarcts were not significantly different between the subgroups.
      Ventriculomegaly and "leuko-araiosis" as demonstrated by computed tomography
      occurred in more than 80% of patients in each subgroup. Atrophy of the superior
      vermis was seen in 16 (80%) of 20 patients with ataxia as compared to 2 (40%) of
      the 5 patients without ataxia (p < 0.005). These data suggest that LBP and
      apraxia of MID were probably determined by the presence of ventriculomegaly or
      leuko-araiosis or both, and the presence of ataxic component of gait disorder
      most probably indicates the presence of vermian atrophy.

PMID- 8475698
TI  - Localized cranial hyperostosis of meningiomas: a result of neoplastic enzymatic
      activity?
AB  - Cranial hyperostosis is a common secondary manifestation of intracranial
      meningiomas. This may occur with or without neoplastic invasion, apart or even
      remote from the growth. Alkaline phosphatase (AP) is one of many enzymes produced
      by meningiomas and is known to possess indirect ossifying properties.
      Meningiomatous cranial hyperostosis could possibly be mediated by a humoral
      mechanism. This hypothesis was tested using chemical and histochemical
      determination of the occurrence of the enzyme in a series of hyperostosing and
      non-hyperostosing meningiomas. In the hyperostosing type the content of AP was in
      average more than three times as high as in the non-hyperostosing type. The
      results thus are in favour of the induction hypothesis.

PMID- 8475699
TI  - Suprascapular neuropathy restricted to the infraspinatus muscle in volleyball
      players.
AB  - Six volleyball players developed weakness and atrophy of the infraspinatus muscle
      on the dominant side. Electromyography (EMG) disclosed denervation and motor unit
      loss restricted to the infraspinatus muscle, the supraspinatus and other shoulder
      muscles remaining normal. Infraspinatus neuropathy may occur as a professional
      hazard in volleyball players. A lesion of the suprascapular nerve at the
      spinoglenoid notch is implied.

PMID- 8475700
TI  - The role of signal transduction in the delayed necrosis of the hippocampal CA1
      pyramidal cells following transient ischemia.
AB  - A short period of cerebral ischemia leads to necrosis of the hippocampal CA1
      pyramidal cells. Until recently no mechanisms contributing to this selective
      vulnerability were known. During the last decade an increasing amount of research
      has been concentrated on identifying signs of disturbed signal transduction in
      these neurons after ischemia. The present thesis is a review of these studies
      with some emphasis on my own contributions to the field. Gerbil and rat models of
      transient global ischemia are the most frequently employed. In order to produce
      the selective necrosis the main arteries to the brain are occluded for 5-20
      minutes. In the rat it is often also necessary to lower the blood pressure. It
      takes 2-7 days of recirculation before the CA1 pyramidal cells become necrotic.
      The studies show that the necrosis can be attenuated or aggravated by drugs
      acting as inhibitors or enhancers of signal transduction--also if administered
      shortly after ischemia. The necrosis can be similarly influenced by lesions of
      excitatory or inhibitory afferent neurons. The protective effect of the lesion
      however, can be due to the lesion-induced decrease in metabolism. During ischemia
      there is an increase in the extracellular concentration of several excitatory and
      inhibitory neurotransmitters as well as in intracellular second messengers. Some
      of the latter also show an increase during recirculation. In vitro
      autoradiographic studies of receptor proteins show either unchanged or diffusely
      distributed downregulation of the ligand binding to the various extra- and
      intracellular receptor proteins following ischemia and early recirculation. A
      second decrease is seen in the CA1 at the time of and probably secondary to the
      necrosis. The IP3 receptor decrease appears during the first minutes of
      recirculation and lasts for up to 14 days. The protective lesion of the
      excitatory afferents from CA3 also leads to a decrease in IP3 binding. The
      changes in receptor regulation are not accompanied by increased postischemic
      electrophysiological activity in the CA1. In vivo autoradiographic mapping of the
      regional cerebral metabolic rate of glucose show increased metabolism in the CA1
      during the first hour of recirculation compared to the rest of the brain were it
      is depressed. This relative hypermetabolism is not seen if the CA1 has been
      deprived of its primary source of excitatory afferents. A later secondary
      increase seen in the more or less necrotic CA1 pyramidal cell layer is probably
      due to macrophage activity. In situ hybridization and immunohistochemical studies
      on the expression of c-fos mRNA and protein respectively has been used to depict
      neurons with increased activity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8475701
TI  - Visual functions in a Swedish population of dyslexic and normally reading
      children.
AB  - Eighty-six 9-year old dyslexic children were carefully matched to controls with
      regard to age, sex, class in school, and intelligence and thorough visual
      functions tests and eye examinations were performed. As a group the dyslexic
      pupils exhibited a lower distance as well as near visual acuity both with
      monocular and binocular viewing. Furthermore, the dyslexic pupils had a lower
      contrast sensitivity at the lower and higher spatial frequencies. These
      differences were all statistically significant. However, no statistically
      significant differences between the two groups could be observed regarding
      refractive errors or contrast sensitivity in the middle spatial frequency range.
      Although some eyes were amblyopic, any severe eye anomalies or diseases were not
      found in any of the investigated children.

PMID- 8475702
TI  - Oculomotor functions in a Swedish population of dyslexic and normally reading
      children.
AB  - Eighty-six nine-year-old dyslexic children were matched to control children with
      regard to age, sex, class in school, and intelligence. Orthoptic and eye movement
      analysis were performed on all children. It was concluded that the dyslexic
      pupils did not differ significantly from control children in terms of strabismus,
      accommodation, stereo acuity, vergence function or ocular dominance. Eye movement
      recordings did not show any qualitative differences between the groups in
      vergence dynamics during synoptophore investigations.

PMID- 8475703
TI  - Tonometry in the general practice setting (I): Tono-Pen compared to Goldman
      applanation tonometry.
AB  - Intraocular pressure was measured in 132 consecutive patients over the age of 20
      in a general practice with two general practitioners (GP). Tono-Pen tonometry was
      compared to Goldmann applantation tonometry in a masked, randomized design. Also,
      agreement between Tono-Pen measurements by the GPs and the ophthalmologist was
      estimated. Both mean difference between Tono-Pen and Goldmann applantation
      measurements and mean differences between Tono-Pen readings made by GPs and
      ophthalmologist were less than 1 mmHg. Ninety-five percent limits of agreement
      between the two methods were approximately -4.5 mmHg and 5.5 mmHg, and between
      observers approximately -4 mmHg and 5 mmHg. The Tono-Pen was agreeable both to
      patients and physicians. The GPs made as accurate measurements as the
      ophthalmologist. The wide limits of agreement are clinically much more important
      than the small differences between means. Random variation was much greater than
      systematic variation. Wide limits of agreement will apply to all known methods of
      clinical tonometry.

PMID- 8475704
TI  - Tonometry in the general practice setting (II): Which cut-off point for referral-
      for which patients?
AB  - A tonometry study comparing Tono-Pen with Goldmann applanation tonometry in a
      general practice setting revealed four cases of ocular hypertension in 132
      patients. Two of the 4 patients required further ophthalmological care after
      referral. None of these patients, but 4 patients with no ocular hypertension,
      would have been referred for follow-up if referral had been made on the basis of
      the single reading made by the general practitioner. Tonometry readings are
      subject to considerable random variation, and the implications for a cut-off
      policy in general practice is discussed. Associations between ocular hypertension
      and known risk factors are weak and offer limited help in selecting asymptomatic
      patients for measurement. Systematic screening should not be a routine. The cut
      off point should be kept low to avoid false reassurance of glaucoma patients,
      possibly as low as 17 mmHg. Multiple measurements may limit the number of
      referrals if the readings remain low.

PMID- 8475705
TI  - Elevated serum sialic acid in idiopathic acute iridocyclitis.
AB  - We measured the serum levels of sialic acid in 12 patients with idiopathic acute
      iridocyclitis and 18 normal controls. Sialic acid levels were significantly
      elevated in the patients with idiopathic acute iridocyclitis. Since animal
      studies have shown that intraocular inflammation alone cannot elevate serum level
      of sialic acid, the result of our study suggest that idiopathic acute
      iridocyclitis may be a multiorgan disease with systemic effects.

PMID- 8475706
TI  - Optic disc diameter influences the ability to detect glaucomatous disc damage.
AB  - We studied the influence of optic disc diameter on the diagnostic power of
      subjective disc evaluation of glaucoma. One hundred and thirteen colour disc
      photographs of 91 patients with primary open angle glaucoma and 174 photographs
      of 89 randomly selected normal subjects were studied. Five ophthalmologists
      independently classified all eyes as glaucomatous or normal by disc appearance
      using a masked forced choice design. Sensitivities and specificities varied
      strongly as a function of disc diameter. Overall sensitivity for recognizing
      glaucoma by disc inspection was 58% in small discs, 72% in the middle group and
      85% in the group of large discs. These differences were significant, and the odds
      of recognizing a glaucomatous disc as such increased by a factor of 2.07 between
      each group. Overall specificity was 99.6% in small discs, 95% in the middle
      group, and 79% in large normal discs. Thus, larger discs were more likely to be
      classified as glaucomatous whether they were glaucomatous or not, while small
      discs were more likely to be classified as normal.

PMID- 8475707
TI  - A case of ocular brucellosis: importance of vitreous specimen.
AB  - Brucellosis is a rare cause of uveitis, seen more often in developing countries.
      We report a case of ocular brucellosis, where diagnosis was confirmed with a high
      Brucella agglutination titer in the vitreous specimen. The case was treated by
      pars plana vitrectomy and antibiotics. We believe that a vitreous specimen is
      very important in the diagnosis of ocular brucellosis.

PMID- 8475708
TI  - Mikulicz syndrome and disease: 2 case reports highlighting the difference.
AB  - We present 2 case reports highlighting the essential differences between Mikulicz
      syndrome and Mukulicz disease. A review of the literature appears to show some
      confusion over the terminology and we therefore also present an historical
      account of the evolution of the two terms and review their relative merits and
      relationship with other disorders. In conclusion, we would not advocate the use
      of the term Mikulicz syndrome and suggest that Mikulicz disease be replaced by
      the title 'Benign Lymphoepithelial Lesion'.

PMID- 8475709
TI  - The prevalence of diabetic retinopathy in northwest Spain. An epidemiological
      study of diabetic retinopathy in Galicia. I.
AB  - The prevalence of retinopathy was studied in a group of 1179 diabetic patients
      attending 11 diabetologic centres in Gallica (Northwest of Spain). The age of the
      patients was 61.7 +/- 13.8 years, 43.8% were males and 56.2% females. The
      patients had had diabetes from 8.4 +/- 7.5 years, 30.4% were being treated with
      insulin, and 69.6% with oral antihyperglycaemics. 16.1% were aged under 40 years
      at onset as against 83.9% aged over 40 years. The prevalence of retinopathy was
      44.7, in the whole group. Stepwise multiple regression analysis identified
      treatment time since onset and age at onset as the factors affecting prevalence,
      which was 61.8% in the insulin-treated subgroup vs 37% among those treated with
      oral antihyperglycaemics (p < 0.0001). The prevalence of proliferative diabetic
      retinopathy was 5.8% in the whole group.

PMID- 8475710
TI  - The postnatal development of the oscillatory potentials of the electroretinogram
      V. Relation to the double peaked a-wave.
AB  - The postnatal development of the double peaked a-wave and its relation to the
      oscillatory potentials of the rat electroretinogram was studied. The split a-wave
      appeared one day later than the first oscillatory activity. The appearance and
      maturation of the positivity between the two a-waves (a-hump) was found to be
      similar to that of the first oscillatory potential, and the development of the
      second a-wave showed similarities to that of the second oscillatory potential.
      Thus, we conclude that the double peaked a-wave is closely related to the
      appearance of the two first oscillatory potential. Secondly, the division of the
      a-wave in the immature animal may be caused by the intrusion of the first
      oscillatory potential. Thirdly, the presence of a split a-wave before spontaneous
      opening of the lid seems to indicate a state of comparatively progressed maturity
      of neuronal adaptation.

PMID- 8475711
TI  - The proliferative response during regeneration of a ringshaped defect in the
      corneal epithelium.
AB  - The aim of the present study was to investigate the regenerative ability of the
      central corneal epithelium in an in vivo situation, as previous studies have been
      contradictory regarding the proliferative potential of these cells. Paracentral
      ringshaped defects were made in rat corneal epithelium, using filter paper soaked
      in n-heptanol. Cell counts, labelling indices and mitotic rates were measured in
      sections from the corneal and the adjacent conjunctival epithelium 12 and 28 h
      after the injury. The cell counts indicated that also central corneal epithelial
      cells migrate in the early phase of wound healing. No proliferative response was
      seen in the central corneal epithelium after 12 h. At 28 h both the peripheral
      and central corneal cells showed an enhanced labelling index, while the mitotic
      rate only was increased in the periphery. Different cell cycle times and
      different levels of differentiation of the cell population across the cornea may
      explain the delayed proliferative response in the central cornea.

PMID- 8475712
TI  - Cell kinetics of normal and healing rat corneal epithelium during organ culture.
AB  - Local epithelial proliferation in corneal, limbal, and conjunctival rat
      epithelium was investigated during organ culture of corneo-scleral shells, by
      relating the number of tritium labelled cells to the total number of cells
      (labelling index). The changes in labelling index after a mechanically induced
      central corneal abrasion were also studied. Local labelling indices were measured
      2 h, 1, 2, 4 and 7 days after incubation. The average labelling index increased
      in un-abraded specimens 4-fold after 4 days of incubation, while the total number
      of cells only decreased 30-50%. In eyes with a central corneal abrasion the
      labelling index increased 10-fold in the surrounding epithelial cells after 1
      day. The labelling index of the limbal and conjunctival epithelial cells
      increased to the same extent after 2 days of incubation. The finding of a reduced
      total number of cells and an increased cell proliferation in un-abraded eyes may
      be explained by increased loss of mature cells normally producing growth
      inhibitory substances (chalones). Alternatively, the culture medium may contain
      an excess of growth-stimulatory substances. The results also suggest that the
      proliferative response spreads in a centrifugal direction during in vitro healing
      of a central corneal abrasion.

PMID- 8475713
TI  - The effect of age on human corneal thickness. Statistical implications of power
      analysis.
AB  - The corneal thickness of 108 human subjects, ranging from 17 to 75 years of age,
      was measured using ultrasound pachometry. One central, four mid-peripheral and
      four peripheral corneal positions along the vertical and horizontal meridians
      were assessed using ultrasound pachometry. No significant differences were found
      in the thicknesses of the central, midperipheral or peripheral cornea with
      increasing age using analysis of variance. These results suggest that ageing has
      no significant effect on human corneal thickness between the ages of 16 to 75
      years. However the high Type II error probability (beta = 0.90) suggests that 108
      subjects (18 in each age group) were insufficient to adequately answer the
      question. Thus power analysis may help explain the conflicting reports available
      in literature. The diversity in data interpretation may be due to the
      statistically small sample sizes used in most studies. Power analysis shows that
      at least 80 subjects are needed in each age group (480 subjects in total) before
      a statistically reliable test of the null hypothesis is possible. This study
      emphasizes the importance of power analysis in calculating an adequate sample
      size.

PMID- 8475714
TI  - The effect of age on the edema response of the central and mid-peripheral cornea.
AB  - Corneal edema was induced by a 2-h closed-eye wear of a thick hydrogel contact
      lens. Corneal edema production and edema recovery responses were measured in the
      central and mid-peripheral (3 mm inferior) cornea of 10 younger (20.4 +/- 2.0
      years) and 10 older (69.0 +/- 3.4 years) subjects using optical pachometry. The
      amount of edema produced was not significantly different between the two corneal
      locations nor between the two age groups. The edema recovery rates of the central
      and mid-peripheral cornea were not significantly different in either the younger
      or older group. The edema recovery rates at both corneal positions were
      significantly faster in the younger group than in the older group. The results of
      this study suggest that the mechanisms that control edema production and recovery
      in the inferior mid-peripheral cornea are similar to those previously described
      in central and temporal mid-peripheral locations. Ageing appears to influence the
      edema production and recovery mechanisms of both the central and mid-peripheral
      cornea in similar ways.

PMID- 8475715
TI  - Break-up time and lissamine green epithelial damage in 'office eye syndrome'. Six
      month and one-year follow-up investigations.
AB  - Break-up time and lissamine green epithelial damage were re-investigated among 90
      office workers after six months in 60 and after one year in 73. There was fairly
      good correlation with a rank correlation of about 0.40 between both break-up time
      and lissamine green staining epithelial damage at the initial investigation and
      at the two re-investigations. All correlations were found highly statistically
      significant. The results indicate that the manifestation of dry eyes in office
      workers to a great extent is chronic and without seasonal variation, at least as
      long as the subject remains in the office environment.

PMID- 8475716
TI  - Further evaluation of a method used for investigation of toxic drug effects.
      Effect of gentamicin on rabbit corneal endothelium.
AB  - Further evaluation of a method suitable for investigation of toxic drug effect
      was performed. Rabbit corneas kept in organ culture were exposed to gentamicin
      for 24 h, and their weights were recorded. The weight increase observed in all
      specimens was significantly higher (p < 0.0001) in the corneas exposed to
      gentamicin 0.6 mg/ml (n = 7) than in the controls (n = 14). This was not the case
      for the corneas exposed to 0.3 mg/ml and 0.1 mg/ml. The accuracy of each weight
      recording was tested by repeated recordings. The standard deviation (SD) was less
      than 1%, and there was no significant difference between series performed by two
      different recorders. The reproducibility of the test was focused upon by
      calculating the SD of the control group, and by comparing the present results
      with the results of a control group in a recently published study (Medin 1992).
      The SD was approximately 2.8%, and no significant difference was found.

PMID- 8475717
TI  - Assessment of tear drainage by fluorescein dye disappearance test after
      experimental canalicular obstruction.
AB  - Controversy exists about the role of upper and lower canaliculi in tear drainage.
      Fluorescein dye disappearance test was used to evaluate tear drainage after
      experimental obstruction of upper, lower, neither or both canaliculi in 18
      subjects by hydroxypropil cellulose rods. When both canaliculi were occluded
      marked impairment was noted in all subjects (p < 0.05). Monocanalicular
      obstruction (either upper or lower) generally resulted in minimal impairment in
      most of the cases. Only 11% of upper canalicular obstruction and 20% of lower
      canalicular obstruction resulted in marked impairment. There was no significant
      difference between upper and lower canalicular obstruction (p < 0.05). In this
      study it is concluded that both upper and lower canaliculus have equal importance
      in tear drainage.

PMID- 8475718
TI  - Evaluation of gray scale steps on Scheimpflug photographs.
AB  - A method for the calibration of gray scale density in a Scheimpflug photograph
      was established. Based on the result of statistical analysis, it was found that
      variability in the film emulsion was insignificant if the measuring area > or =
      0.01 mm2. Each lens image should be calibrated with the reference gray scale in
      the same photograph. Photometric readings of the lens image was converted to gray
      scale levels. This conversion can be obtained from fitting photometric readings
      of the gray scale as a function of gray scale steps with a third order
      polynomial. Adopting this calibration procedure, 95% of estimated nuclear
      densities are within +/- 3-5% of the real value.

PMID- 8475719
TI  - On the Stiles-Crawford effect and ocular imagery.
AB  - To study the modifying effect on spherical aberration of the retinal directional
      sensitivity (the Stiles-Crawford effect), ocular imagery was simulated by
      computer ray-tracing in a phakic and a pseudophakic model eye. The Stiles
      Crawford effect was found to reduce the distance between the paraxial focus and
      the effective least blur focus. The modifying effect on spherical aberration was
      found to be insignificant for pupil sizes below 4 mm, and to increase in
      magnitude above this size. For an 8 mm pupil, the effective focus was found to
      move 0.3 mm and 0.2 mm toward the paraxial focus for the phakic and the
      pseudophakic eye, respectively. This corresponded to a shift of 1.0 D and 0.6 D
      in the spectacle plane, respectively. The modifying effect of the retinal
      directional sensitivity should be taken into account in the theory of ocular
      refraction and in objective keratometry and refractometry.

PMID- 8475720
TI  - The effect of topical steroid on postoperative corneal edema and endothelial cell
      loss after intracapsular cataract extraction.
AB  - In a prospective study of 89 patients the postoperative corneal edema and
      endothelial cell count was studied after cataract extraction. A double blind
      investigation was performed as the patients during the first 6 postoperative days
      were treated with three different types of eye-drops: Maxidex, Pred-Forte 1% or
      placebo, all containing Benzalkonium Chloride 0.004%. The content of steroid in
      Maxidex and Pred-Forte was equivalent. We found no significant difference in
      estimates of endothelial cells in the three groups postoperatively. Corneal edema
      was less in the two groups treated with steroid. There was no significant
      difference between the two postoperative groups (p > 0.05) treated with Maxidex
      and Pred-Forte. The group treated with Pred-Forte showed significantly less
      postoperative corneal edema, calculated as the graphical area represented by the
      increase of central corneal thickness (CCT) after operation.

PMID- 8475721
TI  - The ultrastructure of Elschnig's pearls in a pseudophakic eye.
AB  - The giant cells forming the Elschnig pearl mass after extracapsular cataract
      extraction are derived from lens epithelium. They are interconnected by gap
      junction and desmosome-like structures. They stain homogenously and show few
      organelles. Active autolysis was demonstrated in some regions. The
      ultrastructural features of the giant cells in this type of secondary cataract
      share many of the characteristics of fiber cells. Because of profound changes in
      the environment postoperatively, these cells have developed other shapes and
      characteristics than normal lens fiber cells.

PMID- 8475722
TI  - IOL power mislabelling.
AB  - Prompted by four cases of IOL power mislabelling, a method was developed which
      allowed the measurement of the IOL power using a keratometer. The principle of
      operation was to measure the curvature of the steepest surface of the IOL through
      a minus lens by which the size of the mires was brought into the measuring range
      of the keratometer. With this method the IOL power was checked in three random
      IOL samples from three companies. Although no large errors in IOL power labelling
      were encountered in these samples, the error of labelling was found to differ
      significantly between the companies. It was concluded, that poor manufacturing
      control of IOL power may add to the sources of error in IOL power prediction.

PMID- 8475723
TI  - Human vertical eye movement responses to earth horizontal pitch.
AB  - The vertical eye movements in humans produced in response to head-over-heels
      constant velocity pitch rotation about a horizontal axis resemble those from
      other species. At 60 degrees/s these are persistent and tend to have non
      reversing slow components that are compensatory to the direction of rotation. In
      most, but not all subjects, the slow component velocity was well characterized by
      a rapid build-up followed by an exponential decay to a non-zero baseline. Super
      imposed was a cyclic or modulation component whose frequency corresponded to the
      time for one revolution and whose maximum amplitude occurred during a specific
      head orientation. All response components (exponential decay, baseline and
      modulation) were larger during pitch backward compared to pitch forward runs.
      Decay time constants were shorter during the backward runs, thus, unlike left to
      right yaw axis rotation, pitch responses display significant asymmetries between
      paired forward and backward runs.

PMID- 8475724
TI  - Postural control and age.
AB  - We quantified the effect of vision, pressoreceptor function and proprioception on
      the postural stability at different ages. Altogether 212 healthy volunteers (ages
      from 6 to 90 years) were examined by using a computerised force platform. The
      sway velocity (SV) was measured with eyes open and eyes closed during quiet
      stance on a bare platform and a foam plastic covered surface. In addition, to
      study the proprioceptive system, pseudorandom vibration perturbation was applied
      on the calf muscles. The SV showed a U-shaped curve: the children and the oldest
      swayed most. Equilibrium was most stable around 50 years. The visual system was
      of most importance for balance control in the old. The children were sensitive of
      pressoreceptor and proprioceptive perturbation, indicating the importance of
      these systems for their postural control.

PMID- 8475725
TI  - Voluntary eye movement tests in patients with insulin-dependent diabetes
      mellitus.
AB  - Eye movement tests (saccade tests: reaction time, peak velocities and accuracy,
      and the eye tracking test) were studied in 53 insulin-dependent diabetic (IDDM)
      patients and 42 randomly selected non-diabetic control subjects, aged between 20
      and 40 years. All subjects had central visual acuity of at least 0.1 in one eye,
      and none had ophthalmoplegia. The reaction time was longer and the accuracy
      decreased in the saccade test in diabetic patients as compared to control
      subjects. Peak velocities tended to be slower in diabetic patients, but no
      significant differences between diabetic and non-diabetic subjects were observed.
      The maximum eye movement velocities were reduced at all target velocities in
      diabetic patients as compared to control subjects. These findings can be
      explained on the basis of many potential disturbances in the central nervous
      system. Only the duration of diabetes had a clear association with maximum smooth
      pursuit eye movement velocities in the eye tracking test. Microvascular
      complications (retinopathy, nephropathy), autonomic neuropathy or metabolic
      control (high fasting blood glucose and glycated hemoglobin A1c) had no clear
      association with the results of eye movement tests. In conclusion, insulin
      dependent diabetes mellitus deteriorates the visuomotor responses.

PMID- 8475726
TI  - The otolithic organ in the developing chick embryo. Scanning electron microscopic
      study on the utricular macula.
AB  - The long and short axes of utricular maculae were measured to calculate growth
      curves using an ocular micrometer under stereomicroscope. The mean lengths of the
      long and short axes on the 6th incubation day were 0.06 mm and 0.05 mm,
      respectively. Thereafter: 1.00 mm and 0.74 mm on the 11th incubation day; 1.34 mm
      and 1.03 mm on the 15th incubation day; and on hatching 1.51 mm and 1.07 mm,
      respectively. The surface structure, particularly the otoconia and the sensory
      hairs of the utricular maculae, on the 4.5th incubation day to the 7th post
      hatching day of White Leghorn chicks were observed with a scanning electron
      microscope (SEM). A number of microvilli and primary cilium on the inner surface
      of the otocyst were found between the 4.5th and the 5th incubation day. Immature
      sensory hairs appeared on the 5th incubation day. The polarity of the sensory
      hairs became evident on and after the 9th incubation day. Mature sensory hairs
      were seen all over the utricular maculae between the 1st and the 3rd post
      hatching day. Mature sensory hairs were mainly seen near the striola, and
      immature ones peripherally. Then, the various forms in the maturation phase of
      sensory hairs were seen between the striola and the periphery. These arrangements
      suggest some process of maturity from the peripheral region to the central
      striola region. Immature otoconia were first seen on the 6th incubation day.
      Mature otoconia were recognized on and after the 11th incubation day, and they
      were observed on the whole surface of the utricular maculae. Global substances on
      the macula with a rough surface and spongy structure were observed suggesting
      otoconial precursors transforming themselves into otoconial crystals.

PMID- 8475727
TI  - Effects of electrical stimulation of the superior cervical ganglion on cochlear
      blood flow in guinea pig.
AB  - It has been proposed that cochlear blood flow (CBF) is controlled in part by the
      sympathetic nervous system. In the present study the effect of electrical
      stimulation of the superior cervical ganglion (SCG) on CBF in guinea pigs was
      investigated using laser Doppler flowmetry (LDF). Animals were anesthetized with
      diazepam and fentanyl and the SCG was exposed. A custom-designed bipolar cuff
      electrode was fixed around the ganglion and 1 ms biphasic current pulses were
      injected at 0.15 mA to 1.5 mA, 6 Hz. Bilateral CBF was monitored, while the
      ganglion was stimulated for 3 or 5 min before and after the ascending sympathetic
      trunk and nerve branches from SCG were sectioned. Electrical stimulation of 0.5
      mA caused the ipsilateral CBF (CBFi) to decrease 11.7% +/- 1.3 from the baseline
      (BL), while the contralateral CBF (CBFc) increased slightly due to the change in
      systemic blood pressure (BP). A linear relation was observed between the level of
      current stimulation and evoked reduction in CBF. Cervical sympathetic trunk
      section (between the SCG and the middle cervical ganglion) did not influence the
      pattern or the amplitude of CBF change in response to electrical stimulation of
      SCG. Sectioning the efferent fibers of the medial inferior and medial superior
      branch of the SCG only minimally reduced the amplitude of the CBF decrease evoked
      by electrical stimulation. However, sectioning the superior lateral branch
      abolished this decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475728
TI  - Cytotoxic effects on hair cells of guinea pig cochlea produced by pneumolysin,
      the thiol activated toxin of Streptococcus pneumoniae.
AB  - The cytolytic toxin, pneumolysin, from the gram positive bacterium, Streptococcus
      pneumoniae, when perfused through the scala tympani of the guinea pig cochlea
      reduced the amplitude of both the compound action potential and the cochlear
      microphonic potential. When the surface of the organ of Corti was examined by
      scanning electron microscopy, both inner and outer hair cells and supporting
      cells were found to be damaged. Inner hair cells and outer hair cells of row 3
      were the most susceptible to damage by pneumolysin, followed by row 2 and then by
      row 1 of the outer hair cells. Damage to hair cells included disruption and
      splaying of stereocilia, loss of stereocilia and complete dissolution of hair
      bundles. Apical surfaces of hair cells and supporting cells were torn, pitted and
      cratered with shrinkage and tearing of cell boundaries. Within the dose range
      perfused (0.05-1 micrograms/microliters in a 10 microliters aliquot), the
      magnitude of the physiological and anatomical lesions was concentration
      dependent. The cytotoxic effects of pneumolysin reported here may be clinically
      significant factors in deafness caused by meningitis and otitis media in humans.

PMID- 8475729
TI  - The MRL-lpr/lpr mouse: a potential model of autoimmune inner ear disease.
AB  - Most attempts at developing a model of autoimmune inner ear disease have focused
      on the immunization of healthy animals with cochlear tissue. We have chosen an
      alternate route of studying this entity utilizing the MRL-lpr/lpr (Lupus) mouse,
      an animal known to spontaneously develop multisystemic, organ nonspecific
      autoimmune disease. We report on the auditory pathology found in animals at early
      stages of this systemic disease. At the onset of clinical signs of illness
      (cachexia, weight loss, lethargy) animals were sacrificed and their cochleas and
      kidney prepared for morphologic analysis. Significant pathology was seen in the
      MRL/lpr animals involving the basal and middle turns of the cochlea which could
      not be correlated with the presence or degree of glomerulonephritis. Findings
      included outer and inner haircell degeneration, strial edema and degeneration,
      and an acellular infiltrate in the tunnel of Corti. Cochlear pathology was not
      found in control animals. Thus, at early stages of systemic disease, MRL/lpr mice
      manifest significant cochlear pathology not seen in control animals. The
      implications of these results with regard to the pathogenesis of these lesions as
      well as their clinical relevance are discussed.

PMID- 8475730
TI  - Evidence of direct communication of bone marrow cells with the endolymphatic sac
      in experimental autoimmune labyrinthitis.
AB  - In experimental autoimmune labyrinthitis, we found that the guinea pigs
      sensitized with bovine inner ear antigen (IEAg) developed cellular infiltration
      within the endolymphatic sac (E. sac). In this study, we investigated the
      distribution of immune mediated cells within bony vascular channels. The
      channels, which are normally found around the E. sac, are tiny and contain few
      immune-mediated cells. In contrast, in guinea pigs sensitized with IEAg bony
      vascular channels were large and contained immune-mediated cells. We hypothesize
      that immune-mediated cells in these channels are the result of the immune
      response directed against inner ear antigen, and that some immune-mediated cells
      seen in the E. sac during inner ear inflammatory events have migrated from the
      adjacent bone marrow.

PMID- 8475731
TI  - Torsion of the human semicircular canals and its influence on their angular
      relationships.
AB  - We used a computer-aided three-dimensional reconstruction and measurement method
      to measure torsion of the the semicircular canals (SCCs) in 10 normal human
      temporal bones from 10 individuals (3 months to 76 years old). Torsion of each
      SCC was measured as the angle between the "standard line" (the line connecting
      the ampullated and nonampullated ends of the SCC) and the plane of greatest SCC
      torsion. Torsion was greatest for the anterior SCC (16.4 +/- 3.6 degrees),
      followed by the lateral SCC (9.5 +/- 6.7 degrees) and the posterior SCC (8.5 +/-
      4.2 degrees). The angles between the overall plane described by each SCC and the
      other SCCs between the anterior and lateral, the anterior and posterior, and the
      posterior and lateral SCCs were also measured and were found to be 78.7 +/- 10.0,
      107.9 +/- 5.5, and 87.3 +/- 6.9 degrees, respectively. Finally the angles between
      the torsion plane of each SCC and the others were measured and found to be 92.6
      +/- 15.4, 95.8 +/- 11.2, and 90.9 +/- 8.3 degrees, respectively. These results
      indicate that on average torsion in the SCCs tend to bring the angle between
      pairs of SCCs close to a right angle. This tendency to have a right angle between
      SCCs is thought to promote optimal vestibular function. Speculation is offered
      regarding the etiology of the greater torsion of the anterior SCC.

PMID- 8475732
TI  - X-ray microanalytical determination of P, S and K concentrations in the
      gelatinous membrane of the utricle.
AB  - Electron probe X-ray microanalysis was used to determine the concentrations of P,
      S and K (Cp, CS, CK) in the gelatinous membrane of the mouse utricle. The
      otolithic membranes were plunge-frozen in liquid N2, freeze-dried and carbon
      coated. Quantitative analysis was carried out with an energy dispersive detector
      using the peak-to-background ratio method and different concentrations of KH2PO4
      and K2SO4 salts dissolved in dextran solutions to calibrate the microprobe. P, S
      and K were measured and their concentrations plotted as bar graphs to study the
      frequency distributions. Regression analysis revealed a dependence between the
      concentrations of P and K (CK = 1454.10 - 2.83 CP, r = -0.68745, p < 0.05), and P
      and S (CS = 43.18 + 0.23 CP, r = 0.66949, p < 0.05); however, no correlation was
      found between CK and CP (r = -0.25424). The findings obtained in the present
      study show an inverse relationship between P and K ions, and direct relationship
      between P and S in the gelatinous membrane of the utricle.

PMID- 8475733
TI  - Bone tissue kinetics in the surgically disarticulated dog incus.
AB  - The incus of the right ear from 4 growing mongrel dogs was surgically
      disarticulated and left in the middle ear space. The external auditory canal was
      then filled with teflon paste and sutured. After 6 weeks (D-6 group) and 13 weeks
      (D-13 group) the animals were sacrificed. The right experimental incus and the
      left control one were embedded in methyl methacrylate and sectioned in single 50
      microns-thick sections according to the principal axis of the two processes. On
      the microradiographs of each section we evaluated the thickness of the body and
      of both processes and the percentage area of the primary channels of the
      secondary osteons and that of the appositional bone tissue. The thickness of the
      body and of the two processes was more pronounced in all the experimental
      incuses, in which 6% (in D-6) and 8% (in D-13) of the total area were occupied by
      new appositional woven bone. In the body of the D-13 group, 9% of the pre
      existing bone was substituted by secondary osteons. The results indicate that the
      incus react to the variations of mechanical stimuli.

PMID- 8475734
TI  - Eustachian tube compliance in sniff-induced otitis media with effusion. A
      preliminary study.
AB  - Compliance and ventilatory functions of the eustachian tube (ET) were examined in
      20 ears with sniff-induced otitis media with effusion (OME) and 16 ears with
      traumatic perforation of the eardrum (control) by the forced response test (FRT)
      including the compliance test, and by the inflation-deflation test. The tubal
      compliance showed no significant difference between two groups in the FRT. The
      inflation test revealed that the forced opening pressure was significantly lower
      in the sniff-induced OME group than in the controls. In the FRT, the active
      ventilatory dysfunction was also revealed to be significantly more common in the
      sniff-induced OME. These results suggested that most of the ETs with sniff
      induced OME seemed to have excessive patency and poor active opening ability, but
      may not be hypercompliant or "floppy".

PMID- 8475735
TI  - Secretory IgA-, IgG- and C3b-coated bacteria in the nasopharynx of otitis-prone
      and non-otitis-prone children.
AB  - The proportions of secretory IgA (SIgA)-, IgG- and C3b-coated bacteria obtained
      from a well-defined area on the posterior wall of the nasopharynx (NPH) close to
      the Eustachian tube were determined. Samples taken from 25 otitis-prone (OP) and
      25 non-otitis-prone (NOP) children with normal serum levels of IgA and IgG were
      evaluated using an immunofluorescence assay. Both groups harboured significantly
      more nasopharyngeal bacteria coated with IgG than with SIgA (p < 0.001). The OP
      children had significantly fewer SIgA-coated bacteria (p < 0.05) but more C3b
      coated bacteria (p < 0.01) in the NPH than the NOP children had. No significant
      difference was noted between the two groups regarding IgG coating. The occurrence
      of Branhamella catarrhalis in the NHP was more pronounced in the OP group (p <
      0.05). No significant differences in the occurrence of other middle ear pathogens
      (Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus) or
      quantitative dominance of pathogens were noted between the two groups. Deficiency
      in SIgA coating of the nasopharyngeal bacteria may contribute to the otitis-prone
      condition.

PMID- 8475736
TI  - The relationship between nasal airway resistance and middle ear pressure in
      subjects with acute upper respiratory tract infection.
AB  - Middle ear pressure and nasal airway resistance were measured over 7 1/2h in 8
      subjects (age 18-32) with symptomatic acute upper respiratory tract infection.
      The mean middle ear pressure was -13 +/- 1.5 daPa (s.e.m.) with a range between
      65 to -140 daPa. The mean total nasal resistance was 0.4 +/- 0.02 Pa/cm3/s
      (s.e.m.) with a range between 0.20 to 1.28 Pa/cm3/s. Unilateral nasal airway
      resistance exhibited reciprocal fluctuations with a range between 0.18-3.60
      Pa/cm3/s. The mean difference between the highest and lowest unilateral nasal
      resistance values for each subject was 1.48 +/- 0.22 Pa/cm3/s (n = 16). No
      correlation was found between unilateral nasal airway resistance and middle ear
      pressure. Total nasal airway resistance had an inverse correlation with middle
      ear pressure r = 0.32, r2 = 0.11, n = 176 (p < 0.001). The results indicate that
      the generation of a negative middle ear pressure in acute upper respiratory tract
      infection occurred in a manner consistent with intermittent obstruction of the
      Eustachian tube and gradual middle ear gas absorption. Rapid increases in middle
      ear pressure and the generation of a positive middle ear pressure were associated
      with nose blowing. No evidence was found to support the hypothesis that negative
      middle ear pressures are associated with sniffing.

PMID- 8475737
TI  - Acute frontal sinusitis: etiological factors and treatment outcome.
AB  - A retrospective analysis of patients with acute frontal sinusitis treated at
      Kuopio University Hospital between 1981 and 1990 was performed to define
      etiological factors, clinical course and response to treatment. The study
      comprised 91 patients, 67 men and 24 women, aged from 9 to 65 years with a mean
      age for men of 32 years and for women of 29 years. Thirty-nine patients (43%) had
      previously been suffering from seasonal or chronic rhinitis, which in 22 was
      allergic, in 15 vasomotoric and in 2 due to intolerance to acetylsalicylic acid.
      In one case there was a recent and in another an old nasal trauma. Forty-seven
      patients (52%) were hospitalized, the others treated as outpatients. All received
      medical treatment. In 49 patients (54%) there was contemporary maxillary
      sinusitis which was treated with irrigations. Nasal polyps were detected and
      removed in 18 patients (20%). Anterior ethmoidectomy was made in 11 patients
      (12%) and trephination of the diseased frontal sinus to avoid complications in 8
      patients (9%). No complications occurred. In 5 patients (5%) acute frontal
      sinusitis recurred once and a chronic course was seen in another 5 patients of
      whom 3 had chronic allergic and one vasomotor rhinitis.

PMID- 8475738
TI  - Localization of site of obstruction in snorers and patients with obstructive
      sleep apnea syndrome: a comparison of fiberoptic nasopharyngoscopy and pressure
      measurements.
AB  - The site of obstruction in the upper aerodigestive tract in 20 snorers and/or
      patients with obstructive sleep apnea syndrome was determined by two methods:
      fiberoptic nasopharyngoscopy with the Muller manoeuvre and continuous, nocturnal
      pressure measurements in the upper aerodigestive tract supplemented with
      recording of O2 saturation and oro-nasal air-flow. Identical results were
      obtained by both methods in only 5 (25%) of the patients, whilst in 11 (55%)
      obstruction was recorded in the pharynx by the pressure method which could not be
      demonstrated by the Muller manoeuvre. The latter method is not sufficiently
      accurate and should no longer be used in the pre-treatment assessment of this
      group of patients. Measurement of pharyngeal pressure, O2 saturation and air-flow
      are recommended in the diagnostic work-up.

PMID- 8475739
TI  - Irradiation of rabbit submandibular glands. Histology and morphometry after 15
      Gy.
AB  - Irradiation of rabbit submandibular glands with a single absorbed dose of 15 Gy
      caused tissue damage which persisted 4 and 10 months later. The injuries were
      studied by histology, measurement of gland weights and histomorphometry.
      Reduction of gland weight due to hypoplasia and missed weight gain were seen and
      the proportions of the three major intralobular compartments of the glands were
      altered being dependent on the interval between radiation exposure and
      observation time. The size of the lobules was reduced and extralobular fibrosis
      in the hilar region increased. The seromucous acini were partly atrophied, with
      successively changed architecture and reduced size of the granules. The serous
      tubules showed pronounced reduction of the granules at 4 months and a remarkable
      adenomatous regeneration at 10 months post irradiation. The striated ducts were
      almost unaffected during the observation time. Arteriolar changes were slight to
      moderate, and there was scarcely any capillary damage. The numbers of intra- and
      extralobular plasma cells were increased.

PMID- 8475740
TI  - T3N0 glottic carcinoma: DNA S-phase as a predictor of the outcome after
      radiotherapy.
AB  - In consecutive series of 326 laryngeal cancer patients, of 29 (9%) with stage
      T3N0 glottic carcinomas, 23 achieved complete local remission after curative
      radiotherapy and form the basis of the present investigation. Flow cytometry
      determinations of DNA-ploidy status and the S-phase fraction, and a
      "histopathological malignancy grading system" were evaluated as possible patient-
      and/or tumor-related predictors of local recurrence. Twelve patients (52%) were
      continuously disease-free after radiotherapy, whereas 10 (43%) manifested local
      recurrence, and one distant metastasis. The radiotherapy delivered to patients
      who later suffered from a local recurrence did not differ from those being
      continuously disease-free. The frequency of local recurrence was significantly
      correlated to patients whose primary tumours manifested a low S-phase fraction (p
      < 0.05). A low S-phase fraction may indicate slowly proliferating tumour-cells,
      which become more radioresistant on exposure to a series of fractionated doses,
      as their reassortment into sensitive phases will be proportionately slower.

PMID- 8475741
TI  - Tissue culture of the organ of Corti.
AB  - In 1975, Sobkowicz et al. (1) described long-term organotypic cultures of the
      organ of Corti of the newborn mouse. This paper provides detailed methods for
      dissection and maintenance of the isolated organ of Corti with its corresponding
      segment of spiral ganglion in culture. Descriptions and illustrations of cellular
      characteristics of the developing organ are carefully documented. The work is
      based on 19 years of experience and over one thousand cultures. Review of the
      literature and the application of the technique to research on the inner ear are
      provided.

PMID- 8475742
TI  - Dynamics of transcapillary fluid transfer and plasma volume during lower body
      negative pressure.
AB  - Lower body negative pressure (LBNP) is a stimulus frequently used to study reflex
      circulatory responses in humans. Studies have provided data on LBNP-induced blood
      pooling; however, the possibility that LBNP also might be associated with an
      important loss of plasma fluid has attracted little attention. Therefore this
      problem was analysed in male volunteers exposed to prolonged (10 min) high (70-75
      mmHg) LBNP. Data on LBNP-induced blood pooling that were more reliable than in
      previous literature were also provided. LBNP caused early pooling of more than
      870 ml of blood. Rapid filtration of plasma into the exposed tissues occurred
      throughout LBNP. The cumulative oedema in the legs and buttocks averaged as much
      as 460 ml, and additional quite large volumes of plasma apparently accumulated in
      other parts of the lower body. Concomitantly, there was compensatory absorption
      of extravascular fluid in the upper body. The net decrease in plasma volume (PV)
      was still large and averaged 491 +/- 29(SE) ml. Two aspects of the demonstrated
      process of transcapillary fluid fluxes and PV decline may be emphasized. Firstly,
      in conjunction with the primary large redistribution of intravascular volume, it
      certainly implies that LBNP is a potent stimulus as also indicated by a
      progressive increase in heart rate (HR) and a progressive decline in systolic
      pressure throughout experimental intervention. In fact, LBNP-induced circulatory
      stress clearly has bearings on the extreme hypovolaemic situation provided by the
      pressure-bottle haemorrhage technique used in animals. Secondly, it not only
      offers an interesting example of the dynamics of PV but appears to have more
      general validity with regard to states characterized by gravitational shifts of
      blood (hydrostatic load), like upright exercise and quiet standing.

PMID- 8475743
TI  - Lung to blood passage of albumin and a nonapeptide after intratracheal
      instillation in the young developing pig.
AB  - The passage via the lower respiratory tract of the macromolecule, bovine serum
      albumin (BSA, mol. wt = 67000) and the nonapeptide, 1-deaminocysteine-8-D
      arginine vasopressin (dDAVP, mol. wt = 1067), was assessed for 240 h after
      intratracheal instillation in young, developing pigs. The plasma levels of
      immunoreactive BSA increased with time, reaching a maximum between 36-86 h after
      instillation, and the main portion of BSA in plasma appeared intact, as assessed
      by crossed immunoelectrophoresis. The dDAVP levels reached a maximum after 1-3 h.
      The time to reach maximal plasma levels increased with the age of the pig for
      BSA, while no such effect was observed for dDAVP. The total lung passage, as
      calculated by dividing the area under the plasma level-time curve obtained after
      intratracheal instillation with that obtained after intravenous administration
      (elimination curve), showed no significant differences with age for BSA (21.8 +/-
      9.0% in the newborn, 15.1 +/- 8.0% in the 2-day-old and 16.1 +/- 4.2% in the 70
      day-old pigs). For dDAVP, a significant decrease in the total passage was
      obtained with age, from 74.6 +/- 9.4% in the newborn pigs to 44.1 +/- 13.3%, in
      the 2-day-old pigs (P < 0.001), and to 23.6 +/- 7.1% (P < 0.01) in the 70-day-old
      pigs. The study showed that the marker molecules, BSA and dDAVP, passed over the
      porcine lung into the blood circulation in high amounts, apparently inversely
      related to their molecular size. The total lung passage of dDAVP, but not that of
      BSA, was affected by changes with age, indicating that these two markers might
      traverse the lung epithelium via different routes that are differently affected
      during postnatal development.

PMID- 8475744
TI  - Morning increase in whole blood viscosity: a consequence of a homeostatic
      nocturnal haemodynamic pattern.
AB  - In a series of studies, we have shown that in non-human primates there is a
      consistent overnight fall in cardiac output and central venous pressure, and a
      rise in total peripheral resistance. This haemodynamic pattern is associated with
      a higher haematocrit level in the morning suggesting that these changes in the
      circulation are homeostatic adjustments to a nighttime fall in plasma volume. The
      present study was designed to test the hypothesis that in the morning whole blood
      viscosity also is higher. Whole blood viscosity was measured at shear rates of
      450, 225, 90, 45, and 22.5 s-1 in each of six monkeys, on four occasions, at 2
      week intervals, at 17.00 and 09.00 h the next morning. The average haematocrit
      was 4.2% higher in the morning than in the previous evening (P < 0.01). Viscosity
      decreased monotonically at progressively higher shear rates but was always
      significantly higher in the morning than in the evening (P < 0.01 at all shear
      rates). When viscosity was adjusted by covarying for haematocrit level, the
      morning/evening differences became non-significant. However, the morning/evening
      differences in linear trend of shear stress as a function of shear rate
      persisted. These findings add further support to our hypothesis that the
      nocturnal haemodynamic pattern in non-human primates is related to a reduction in
      plasma volume, and they also suggest that the morning rise in haematocrit is a
      major contributing factor to the elevated viscosity.

PMID- 8475745
TI  - Much more potent baroreflex sympathetic control of vascular resistance in the
      resting human limb than previously believed.
AB  - The concept that, in man, the sympathetic control of the resting limb vascular
      resistance is truly limited and thus strikingly different from animal species,
      was challenged in the present study. Analyses were performed in healthy male
      volunteers of reflex forearm vascular resistance changes evoked by lower body
      negative pressure (LBNP) ranging from low (15 mmHg) to high and barely tolerated
      (85 mmHg) levels. Graded LBNP was associated with graded increases in resistance.
      At high 85 mmHg LBNP the responses were pronounced with a rise in forearm
      resistance to no less than 120 mmHg ml-1 min 100 + ml soft tissue, on average,
      corresponding to a 377% increase above control. This drastic response seemed
      entirely neurogenic in origin and calculations, based on the likely assumption
      that a similar response occurred in all skeletal muscle and skin/(subcutaneous
      fat), showed that it permitted a marked increment in total systemic vascular
      resistance because of the fact that these tissues constitute so large a
      proportion of the body mass. The conclusion was reached that the studied tissues
      may serve as main targets for powerful homeostatic reflexes. It is also
      suggested, in contrast to current views, that the high-pressure arterial rather
      than the low-pressure cardio-pulmonary baroreceptors may be the main mediators of
      haemodynamically important vasoconstrictor responses.

PMID- 8475746
TI  - A search for arteriovenous anastomoses in human skin using ultrasound Doppler.
AB  - The possible existence of arteriovenous anastomoses (AVAs) in skin regions of the
      head and thorax has been investigated using the synchronous vasomotion of the
      AVAs. Simultaneous pairs of blood velocity recordings were made using pulsed,
      bidirectional Doppler ultrasound. In each pair of registrations, blood velocity
      was recorded in a reference artery supplying a skin area known to contain AVAs
      (the radial artery) together with one of four other arteries investigated, i.e.
      the facial artery, the angular artery, the temporal artery, and the cutaneous
      branches of the lateral thoracic artery. The typical large, regular fluctuations
      in blood velocities caused by synchronous vasomotion in the AVAs in the skin of
      the hand and fingers were observed invariably in the radial artery. Similar flow
      variations were found in the angular artery. The fluctuations in this and the
      radial artery were, in turn, found to be synchronous. However, we have not been
      able to find the flow pattern characteristic of AVA vasomotion in the temporal
      artery or in the cutaneous branches of the lateral thoracic artery. These results
      show that the skin area of the nose supplied by the angular artery contains AVAs.
      These AVAs partly may explain the important role of face skin in temperature
      regulation. These results also support the earlier assumptions that there are no
      or very few AVAs in the skin areas supplied by the temporal artery and the
      cutaneous branches of the lateral thoracic artery.

PMID- 8475747
TI  - Plasma potassium concentration and doppler blood flow during and following
      submaximal handgrip contractions.
AB  - The aim of the present study was to investigate the time-course of blood velocity
      in the forearm during and following isometric handgrip contractions and to reveal
      a possible temporal relationship between the circulatory response and venous
      effluent potassium concentration ([K]) not only during contractions but also
      during the post-exercise recovery period. Contractions of 15% maximal voluntary
      contraction (MVC) and 30% MVC with and without 3 min of arterial occlusion
      following the contractions were studied. All contractions induced a significant
      increase in venous plasma [K] from an average resting level of 4.0 to 5.0 mM
      during 15% MVC and 5.8 mM during 30% MVC. Blood velocity increased from a resting
      level of 0.07 to 0.22 m s-1 and 0.36 m s-1 during 15% and 30% MVC, respectively.
      MVC of 30% always elicited a larger blood velocity and [K] response than 15% MVC.
      Following the contractions hyperaemia was elicited. Recovery of the local blood
      velocity was markedly slower than the K recovery, since [K] remained
      significantly above resting level for only 25 s following 15% MVC and 45 s
      following 30% MVC, while blood velocity remained elevated for 2 min and more than
      7 min following 15 and 30% MVC, respectively. Further, a larger hyperaemia
      following the occlusion was elicited as compared to the contraction without
      occlusion, in spite of [K] being lower immediately after the occlusion period
      than immediately after the contraction. Finally, [K] decreased below resting
      level in the recovery period while the blood velocity remained elevated.
      Therefore, the present study showed that the venous plasma [K] is not causally
      related to the prolonged post-exercise hyperaemia. The skin temperature remained
      unchanged during the contractions, while during the recovery period the skin
      temperature increased for several minutes. The major part of the temperature
      increase was likely to be due to conductance of heart from muscles to skin
      surface as a consequence of muscle hyperaemia.

PMID- 8475748
TI  - Association of breathing movements to the variability of heart rate and blood
      pressure in foetal lambs.
AB  - Heart rate (HR) variability and arterial blood pressure (BP) variability were
      analysed as functions of foetal breathing movements (FBMs) by means of power
      spectral analysis in seven foetal lambs during the third trimester of gestation.
      No evidence of FBM-related changes, either in mean HR, mean systolic or diastolic
      arterial pressures, were found. Mean arterial pulse pressure, HR variability, and
      BP variability increased during FBMs. The increase in BP variability occurred at
      frequencies higher than 0.35 Hz, i.e. those of FBMs. The increase in HR
      variability occurred at 0.07-1.0 Hz, i.e. at every frequency band except the
      lowest one. Thus, the increase in HR variability was not frequency-specifically
      related to FBMs. During FBMs the periodic variability of HR at frequencies > 0.35
      Hz was only 10% of total HR variability. We suggest that the FBM-related changes
      of BP variability may be mediated by direct peripheral, hydraulic mechanisms. HR
      changes involve autonomic control systems: the vagal component of baroreflex
      seems to be relatively insensitive, whereas the very slow vasomotor component of
      HR variability is dominant.

PMID- 8475749
TI  - Functional and biochemical effects of a K(+)-ionophore on the isolated perfused
      rat heart.
AB  - Valinomycin, a K(+)-specific ionophore, influenced function and metabolism of
      isolated perfused rat hearts in a dose-dependent fashion. At a concentration of
      0.05 micrograms ml-1 in perfusion fluid a 50% reduction of heart rate (HR) and a
      90% reduction in max dP/dt were observed. These effects were paralleled by a
      substantial decrease of myocardial energy charge from about 0.80 to 0.20. A 2.5
      fold increase in tissue lactate concentration indicated an increased rate of
      glycolytic activity. Low ATP combined with high ADP and AMP levels as found in
      these valinomycin-treated hearts is known to promote phosphofructokinase activity
      and may explain the elevated lactate levels. A significant increase in the
      concentrations of adenosine, IMP and inosine was observed as well.

PMID- 8475750
TI  - An age-related type IIB to IIX myosin heavy chain switching in rat skeletal
      muscle.
AB  - A novel fast-twitch motor unit type, called the IIX-myosin heavy chain (MHC)
      motor unit, identified by the glycogen depletion technique together with a series
      of monoclonal antibodies (mAbs) specific for MHCs, has been isolated recently in
      the rat tibialis anterior muscle. In young animals, this unit has physiological,
      biochemical and morphometrical properties which separate it from the IIA- and IIB
      MHC motor units. In old age, on the other hand, the IIX-MHC units display
      physiological, biochemical and morphometrical properties resembling the IIB-MHC
      motor units. Based on these results it was proposed that a transition from IIB to
      IIX motor units occurs during ageing. In an attempt to clarify this point, the
      MHC composition was identified by 6% SDS-PAGE and immunoblotting analysis, using
      specific mAbs antibodies, in the same fast-twitch tibialis anterior muscles in
      young (3-6 months, n = 9) and old (20-24 months, n = 16) rats from which the
      single motor units had been identified previously. The IIX-MHC comigrates
      together with the IIA-MHC band in 6% SDS-PAGE and only two MHC bands are observed
      in the rat tibialis anterior muscle, i.e. the IIA-IIX- and IIB-MHC bands. A
      significant increase (P < 0.001) in the average relative amount of the IIA-IIX
      MHC was observed in the old (45 +/- 17%) as compared to the young (23 +/- 4%)
      animals, accompanied by a corresponding decrease in IIB-MHC content. It was
      demonstrated in immunoblotting analysis that only trace amounts of IIA-MHC were
      detectable in the IIA-IIX-MHC band in both young and old TA muscles, indicating a
      substantial increase in the IIX-MHC content in old age. Thus, the present results
      together with previous observations at the motor unit level strongly support an
      age-related motor unit transition from type IIB- to IIX-MHC.

PMID- 8475751
TI  - Gross efficiency of muscular work during step exercise at -15 degrees C and 21
      degrees C.
AB  - In an effort to assess the effect of ambient temperature on the gross efficiency
      (Effg) of step exercise 12 subjects performed a modified step test either at -15
      degrees C or 21 degrees C ascending to three different heights (corresponding to
      light, moderate and heavy work), for 20 min each with a frequency of 18 steps min
      1. Heart rate (HR), rectal temperature, skin temperatures and heat flux from skin
      were continuously measured. Oxygen consumption was measured during the last 5 min
      of each step height and perceptions of thermal sensation were recorded. The
      results indicate that, while using conventional clothing adequate in these
      temperatures, Effg is altered in a contradictory manner. At -15 degrees C Effg
      increased with increasing work load, whereas at 21 degrees C it decreased when
      the work load increased. The highest Effg (heavy work at -15 degrees C and light
      work at 21 degrees C) values are reflected as rather similar rectal temperatures.
      (37.4-37.7 degrees C) and identical mean skin temperatures (32.8 degrees C) as
      well as the same (slightly warm) thermal sensation of the legs. At -15 degrees C
      the lowest Effg in light work was probably due to the need to warm up the
      muscles. At 21 degrees C, on the contrary, the activation of heat dissipation
      systems was probably responsible for the lowest Effg in heavy work.

PMID- 8475752
TI  - Relationship between blood buffering properties, erythrocyte pH and water
      content, in gray seals (Halichoerus grypus).
AB  - The separated plasma of gray seals (Halichoerus grypus) has an unusually high non
      bicarbonate buffering capacity (beta NB = d[HCO3-]/dpH = -21 Slykes; Slyke = mmol
      l-1 pH unit-1). To examine whether this represents a trait of mammalian
      carnivora, or is related instead to deep diving, we examined blood from dog and
      killer whale, respectively. The beta NB of separated plasma of dog was typically
      low (-4 to -8 Slykes), as in other mammals, whereas that of the whale (-13.5
      Slykes), while significantly higher than dog, was not nearly as high as in seal.
      As one would theoretically predict of a blood system with exceptionally high
      extracellular buffering and functional anion exchange across the erythrocyte
      membrane, there was little difference in the buffer slope between true plasma and
      whole blood of seal. This appears to be a novel pattern of CO2 carriage in
      mammals. Erythrocyte ion concentrations were similar to other mammalian
      carnivora, with intracellular sodium concentration being high and potassium low.
      The red cell water content was unaffected by changes in oxygen saturation and
      tended to decrease when extracellular pH decreased below 7.4. Apart from the
      comparatively elevated Bohr factor, -0.518 as a function of extracellular pH and 
      0.550 as a function of red blood cell pH, the blood oxygen binding properties
      were similar to terrestrial mammals of similar size.

PMID- 8475753
TI  - Muscle vitamin E levels following acute submaximal exercise in female rats.

PMID- 8475754
TI  - Sequential changes in the splanchnic circulation during continuous endotoxin
      infusion in sedated sheep: evidence for a selective increase of hepatic artery
      blood flow and loss of the hepatic arterial buffer response.
AB  - On-line recording of the sequential changes in systemic, pulmonary, mesenteric,
      hepatic and renal circulations during onset of endotoxaemia and at 24 h of
      established hyperdynamic sepsis were evaluated in seven chronically instrumented
      and sedated sheep receiving a continuous intravenous infusion of Escherichia coli
      endotoxin (20 ng min-1 kg-1). A transient and significant (P < 0.05) pulmonary
      arterial vaso-constriction was noted after 13 +/- 4 min, and was followed
      immediately by a simultaneous significant decrease of coeliac trunk, superior
      mesenteric artery, and portal vein blood flow to below 50% of baseline values.
      The superior mesenteric artery and portal vein blood flows partially recovered
      pre-endotoxin levels to 69 and 75% of baseline, respectively, after 70 min of
      endotoxin infusion. In contrast, the coeliac trunk blood flow remained reduced
      for a more prolonged period of time, but then completely recovered baseline
      values at 100 min. The response of the hepatic artery was biphasic, and consisted
      of a transient (5-10 min) vasoconstriction at 40 min followed by transitory
      increase of hepatic artery blood flow reaching a maximum of 921% of baseline
      values at 102 min. Contrasting with the early changes observed in mesenteric
      vascular resistances mostly unrelated to systemic haemodynamics, the response of
      the renal vasculature appeared to be more dependent on changes of renal perfusion
      pressure. A follow-up at 24 h revealed that the continuous intravenous infusion
      of endotoxin reproduced some of the most characteristic features of human sepsis
      with increased cardiac output and decreased vascular resistances of all vascular
      beds. We conclude that hepatic artery blood flow is selectively and considerably
      increased in early endotoxaemia in sheep independently of changes in portal vein
      blood flow, suggesting a disregulation of the physiologic hepatic arterial buffer
      response, most probably secondary to an increased liver oxygen demand required
      for phagocytosis, transport, and digestion of the the sudden overload of
      bacterial endotoxins.

PMID- 8475755
TI  - Vascular characteristics influence the aortic ultrasound Doppler signal: computer
      and hydraulic model simulations.
AB  - There is an increasing demand for non-invasive methods for the assessment of left
      ventricular function. Ultrasound Doppler methods are promising, and the early
      systolic flow velocity signal immediately distal to the aortic valve has been
      used clinically for this purpose. However, the signal is influenced not only by
      left ventricular ejection but also by systemic vascular characteristics. Their
      relative contribution to the time-velocity signal has not been analysed in depth
      previously. A theoretical analysis, based on a three-element Windkessel model,
      neglecting peripheral outflow in early systole and assuming linear pressure rise,
      was therefore tested in computer and hydraulic model simulations where peripheral
      outflow was included. Significant changes in early aortic flow velocity
      parameters were found when vascular characteristics were altered. As predicted by
      the theory, with a standardized aortic valve area and aortic pressure change, the
      simulations confirmed that maximal flow velocity is related to compliance of the
      aorta and the large arteries, and that maximal acceleration is inversely related
      to the characteristic impedance of the aorta. Therefore, maximal velocity and
      acceleration can be used for assessment of left ventricular function only in
      situations where vascular characteristics can be considered relatively constant
      or where they can be estimated.

PMID- 8475756
TI  - Selective brain cooling in resting and exercising Norwegian reindeer (Rangifer
      tarandus tarandus).
AB  - The threshold body core temperature for selective brain cooling (SBC) as well as
      the slope of brain cooling were determined in three Norwegian reindeer (Rangifer
      tarandus tarandus) during rest and during exercise. Brain temperature was
      measured in the hypothalamus (Thypo) and blood temperature (Tblood) was measured
      either in the right carotid artery or in a few cases in the right atrium of the
      heart. During rest the animals were subjected to ramp-like increases of Tblood by
      means of a thermostatically controlled water circulated heat exchanger (HE)
      introduced into the rumen via a chronically implanted rumen cannula. During
      exercise the animals ran on a treadmill at a speed of between 5.5-8.0 km hr-1 and
      a slope of 13.5 degrees for periods of 30-60 min. The elevation of Tblood during
      both rest and exercise resulted in significant amounts of SBC. The mean threshold
      for SBC (Thypo = Tblood) during rest was 38.7 degrees C. The threshold for SBC
      was elevated significantly to 39.5 degrees C during exercise. The mean slope of
      SBC (increase of SBC per degree increase of Tblood) was 0.82 both during rest and
      exercise.

PMID- 8475757
TI  - Charge density of renal interstitium.
AB  - The charge density of renal interstitium was analysed from the volume of
      distribution of negative native albumin as compared with neutralized albumin,
      labelled with 125I and 131I, respectively. The experiments were conducted by
      infusing the two probes intravenously at a rate which kept the plasma
      concentrations stable. The concentration in renal hilar lymph, C(lymph)(t), will
      then obey the function C(lymph)(t) = C(lymph)(t infinity) (1-exp-Kt), where
      C(lymph)(t infinity) is the steady state concentration and K the time constant
      for passage of the tracer through the renal interstitium--the former is dependent
      on the permeability of the peritubular capillary membrane, whereas the time
      constant is inversely related to the interstitial distribution volume of the
      tracers. The lymph-to-plasma concentration ratio (L/P-ratio) of negative, native
      albumin was found to be lower than that of neutralized albumin, a finding
      suggesting that the peritubular capillary membrane is negatively charged.
      Regarding the interstitium, it was calculated from the respective time constants,
      K, that the interstitium/lymph concentration ratio of negative native albumin was
      0.96 +/- 0.06 of that of neutralized albumin. This suggests the presence of
      negative fixed charges repelling negative native albumin. However, since the
      calculated charge density of -1.8 +/- 1.2 mEq l-1 was not significantly different
      from zero, it is concluded that the renal interstitium is uncharged. This does
      not, however, rule out the possibility that, for example, negative groups are
      fixed to the interstitial matrix, merely that the average fixed charge density of
      renal interstitial fluid is negligible.

PMID- 8475758
TI  - Endurance training increases skeletal muscle lactate transport.
AB  - Lactate accumulation in skeletal muscle is reduced after a period of endurance
      training. Explanations for this phenomena include the increased oxidative
      capacity of the muscle, a reduction in lactate production, and increased lactate
      clearance. Muscle membrane transport of lactate can be seen to be a fundamental
      aspect of such clearance, and transmembrane lactate flux may well be an important
      aspect of the training response in skeletal muscle. Therefore, the lactate
      transport capacity in skeletal muscle sarcolemmal membranes in endurance-trained
      and sedentary rats was investigated. Training consisted of 6 weeks of
      progressively increased treadmill exercise. Twenty-four hours before being
      killed, both the trained and sedentary animals completed a brief exercise bout.
      Studies of lactate transport (zero-trans) were conducted using highly purified
      sarcolemmal vesicles. When low concentrations of L-lactate (1 mM) were used a
      59.4% increase in lactate transport was observed (P < 0.05). However, when a high
      concentration of lactate (50 mM) was used no change in lactate transport was
      found (P > 0.05). Several interpretations are possible for these observations:
      (1) that there is an alteration in the Km but not the Vmax of the lactate
      transport system in skeletal muscle membranes; and (2) that specific changes
      occur in selected isoforms of the lactate transport protein which may co-exist in
      muscle.

PMID- 8475759
TI  - Intravenous saline infusion in rat increases hyaluronan efflux in intestinal
      lymph by increasing lymph flow.
AB  - The output of hyaluronan in mesenteric lymph was studied in anaesthetized rats to
      allow estimation of the turnover rate. The duodenum/jejunum contained 45
      micrograms of this glycosaminoglycan per g wet tissue weight. In fasted rats the
      concentration of hyaluronan in postnodal lymph averaged 15 micrograms ml-1 and
      the mean efflux was 2.1 micrograms h-1, corresponding to a daily removal of 10%
      of the intestinal hyaluronan content. An intravenously injected bolus of 0.9%
      saline 4 ml 100 g-1 followed by an infusion of the same amount per hour increased
      the hyaluronan concentration in lymph transiently to 22 micrograms ml-1. During
      the 8-h i.v. infusion the hyaluronan output remained five times above control due
      to the high lymph flow. Water and hyaluronan content of the small intestine
      remained unaltered despite the saline load, the maintained tissue level of
      hyaluronan suggests an increased rate of synthesis.

PMID- 8475760
TI  - Effect of allopurinol on myocardial purine release after total ischaemia in
      isolated rat heart.

PMID- 8475761
TI  - Blood plasma kinetics of arginine-vasopressin in camels.

PMID- 8475762
TI  - Neural representations for sensory-motor control, I: Head-centered 3-D target
      positions from opponent eye commands.
AB  - This article describes how corollary discharges from outflow eye movement
      commands can be transformed by two stages of opponent neural processing into a
      head-centered representation of 3-D target position. This representation
      implicitly defines a cyclopean coordinate system whose variables approximate the
      binocular vergence and spherical horizontal and vertical angles with respect to
      the observer's head. Various psychophysical data concerning binocular distance
      perception and reaching behavior are clarified by this representation. The
      representation provides a foundation for learning head-centered and body-centered
      invariant representations of both foveated and non-foveated 3-D target positions.
      It also enables a solution to be developed of the classical motor equivalence
      problem, whereby many different joint configurations of a redundant manipulator
      can all be used to realize a desired trajectory in 3-D space.

PMID- 8475763
TI  - On Fitts's and Hooke's laws: simple harmonic movement in upper-limb cyclical
      aiming.
AB  - Can discrete, single-shot movements and continuous, cyclical movements be reduced
      to a single concept? In the classical, computational approach to human motor
      behaviour, cyclical aimed movement has generally been considered to derive from
      discrete primitives through a concatenation mechanism. Much importance,
      accordingly, has been attached to discrete-movement paradigms and to techniques
      allowing the segmentation of continuous data. An alternative approach, suggested
      by the nonlinear dynamical systems theory, views discreteness as a limiting case
      of cyclicity. Although attempts have been made recently to account for discrete
      movements in dynamical terms, cyclical paradigms have been favoured. The
      concatenation interpretation of cyclical aimed movement is criticized on the
      ground that it implies a complete waste of mechanical energy once in every half
      cycle. Some kinematic data from a one-dimensional reciprocal (i.e., cyclical)
      aiming experiment are reported, suggesting that human subjects do save muscular
      efforts from one movement to the next in upper-limb cyclical aiming. The
      experiment demonstrated convergence on simple harmonic motion as aiming tolerance
      was increased, an outcome interpreted with reference to Hooke's law, in terms of
      the muscles' capability of storing potential, elastic energy across movement
      reversals. Not only is the concatenation concept problematic for understanding
      cyclical aimed movements, but the very reality of discrete movements is
      questionable too. It is pointed out that discrete motor acts of real life are
      composed of complete cycles, rather than half-cycles.

PMID- 8475764
TI  - Neuromotor noise and poor handwriting in children.
AB  - In this article Power Spectral Density Analysis of the velocity profile of
      handwriting tasks is applied to estimate movement noise in poor and proficient
      writers. It is hypothesized that poor writers are less effective in the
      inhibition of neuromotor noise. Evidence for this theory is found in an analysis
      of electronically sampled handwriting movements of 48 children from grade 2, 3
      and 4 (mean ages 8, 9 and 10, resp.). Twenty-four were poor and 24 were good
      writers, as judged by their teachers. Subjects were matched on age, sex,
      handedness and educational level. They performed handwriting tasks consisting of
      simple garlands and arcades, or meaningless words built from the letters 'e', 'n'
      and 'm'. In the tasks stroke accuracy, size and rotational direction were
      systematically varied. The results reveal that movement times were not different
      between the two groups, but poor writers and good writers used different movement
      strategies. Movements of the less proficient children were larger and were
      produced with higher movement velocities. Power Spectral Density Analysis
      disclosed that handwriting movements of poor writers were substantially more
      noisy than those of proficient writers, with a consistent peaking of the noise
      energy in that region of the spectrum which is representative for neuromotor
      tremor. Also, poor writers were less successful in adapting the level of noise to
      increased accuracy demands of the tasks. The results support the view that
      deviant biomechanical strategies might be responsible for deficient motor
      performance.

PMID- 8475765
TI  - The role of proprioceptive information for the production of isometric forces and
      for handwriting tasks.
AB  - A patient showing a total loss of all the large sensory myelinated fibers but
      intact peripheral motor system produced simple isometric force pulses and more
      complex tasks like handwriting and drawing. Overall, the patient was able to
      perform the isometric force task with an accuracy that approached that of normal
      subjects. The writing tasks, however, proved to be more challenging. In absence
      of vision, the different forms and cursive trajectories forming letters
      (morphocinetic components) were preserved but their localization within the
      constraints of the graphic space (topocinetic components) were severely impaired.
      These results demonstrate that, in absence of visual information, proprioceptive
      information is necessary to calibrate the hand in space.

PMID- 8475766
TI  - Acquired agraphia caused by focal brain damage.
AB  - Motor and linguistic aspects of writing were evaluated in 31 subjects with focal
      damage in 1 of 3 regions of the left hemisphere: (1) dorsolateral frontal lobe
      sparing primary motor cortex (group FL), (2) parietal lobe (group PL), or (3)
      temporal lobe (group TL). A standard procedure was used to evaluate writing for
      grapheme formation, spatial arrangement, spelling, word selection, grammar, and
      perseveration. It was predicted that agraphia would be observed in all 3 groups,
      and that the most severe impairments would be associated with frontal lobe
      damage, particularly in aspects of writing dependent on sequencing (grapheme
      formation, spelling, and grammar). It was found that agraphia was common in all
      groups, particularly in the acute epoch, and that all groups showed considerable
      recovery of writing by the chronic epoch. Few differences were found between
      groups. However, the FL group was impaired on spelling and grammar relative to
      the PL group in the acute epoch and impaired on grammar relative to the TL group
      in the chronic epoch. The findings are consistent with the notion that writing
      relies on a distributed neuroanatomical network, which acts in concert to link
      fragments of visuomotor activity with component linguistic elements.

PMID- 8475767
TI  - Neurocomputing aspects in modelling cursive handwriting.
AB  - This paper describes a distributed modelling framework of the motor control
      processes that underly the planning of cursive handwriting. The model, that
      focuses on the hypothetical functions of the posterior parietal cortex combines a
      paradigm of self-organization (for building robust and coherent maps of the
      different motor spaces) with relaxation dynamics (for run-time incorporation of
      task constraints) and non-linear integration (for a smooth integration between
      via-points).

PMID- 8475768
TI  - A model for reaching control.
AB  - In this paper we propose that reaches are made to target postures which are
      selected by evaluating stored postures. Target postures are chosen by taking a
      weighted average of the stored postures, where the weights assigned to the stored
      postures depend on their effectiveness for the task. Movements from starting
      postures to target postures are achieved by reducing the distance, in joint
      space, between the two. The form of the movement depends on drive (assumed to
      decrease as less distance remains) and inertia. The model predicts the Power Law
      of learning, compensation for immobility of joints, changes in limb contributions
      depending on movement speed, asymmetric bell-shaped velocity profiles, velocity
      amplitude relations, Fitts' Law, and position-dependent variations in hand-path
      curvature. Planned extensions of the model may broaden its application-for
      example, to handwriting.

PMID- 8475769
TI  - Phonological and orthographic demands in the production of handwriting.
AB  - In an experimental handwriting task, with two parts, we varied the phonological
      and orthographic complexity of visually presented nonwords. Twelve adult subjects
      had to write these nonwords in shorthand as well as in Latin script. Phonological
      complexity was varied by presenting a nonword which included two identical vowel
      characters. These were either phonologically similar (simple condition) or
      phonologically different (complex condition). Orthographic complexity was varied
      by using nonwords which either have a graphemic format for shorthand that
      corresponds with the graphemic format that is applied for Latin script (simple
      condition) or a graphemic format for shorthand which is discrepant from the Latin
      script format (complex condition). It appeared that a higher degree of
      phonological and orthographic complexity led to a slower and less fluent
      performance in graphemes that preceded the actual locus of complexity of the
      nonword. Furthermore, complexity effects were by far the strongest under the
      production of shorthand. The results are interpreted from the point of view of a
      psychomotor theory of handwriting, which assumes that the spelling process of
      visually presented nonwords may follow a phonological or an orthographic
      (sublexical) route. The finding that orthographic complexity interferes with the
      production of a phonologically oriented task such as shorthand is interpreted as
      evidence in favour of an interactive transmission of information between these
      two processing routes.

PMID- 8475770
TI  - Does the production of letter strokes in handwriting benefit from vision?
AB  - In earlier studies the involvement of vision in handwriting was suggested by the
      finding that the production of a letter sequence in a condition without vision
      took more time and resulted in larger letter trajectories. The present study
      raises the question whether vision has an impact on the production of the
      individual up- and downstrokes constituting the letters. More specifically, the
      aim is to examine whether vision is employed either during the completion of a
      movement, or concurrent with the entire course of a stroke movement. Adult
      writers produced the letter sequence lelele under a no-vision and a vision
      condition, the latter serving as a base-line condition. It was found that
      movement time and trajectory size of acceleration and deceleration phases of a
      stroke movement increased under no vision, the magnitude of which depended on
      letter type. Letter e, with a smaller size and more frequently used in Dutch
      writing than letter l, was less affected by the no-vision condition. Although,
      close examination of downstrokes produced in later letter positions of the
      sequence revealed that the acceleration as compared to the deceleration phase
      took proportionally less time, the general finding was that increments in time
      and size proved to be equally distributed across entire stroke movements.

PMID- 8475771
TI  - Changes in motor planning during the acquisition of movement patterns in a
      continuous task.
AB  - Changes in the planning and execution of movements were studied as a function of
      practice on a continuous motor task. Twelve subjects learned to move a pen
      through a cut-out square and maze patterns with their eyes closed. Maze patterns
      consisted of six, eight, ten, or twelve segments that were connected by
      intersections. Task performance was studied during six blocks. Although the mazes
      could be traced continuously in a clockwise direction, selecting a wrong turn at
      an intersection resulted in coming to a dead end. Performance at intersections
      was analyzed by determining the number of correct (and incorrect) turns following
      mechanically forced stops and the number of correctly planned and executed turns
      without any halt. In addition, movement time and pause duration were analyzed.
      With practice an increase in the number of correctly executed turns indicated
      that subjects gradually learned to group segments into chunks of increasing size.
      It was found that up to eight segments could be organized and executed as a
      single unit. Finally, with practice a non-linear performance improvement was
      found, suggesting that the learning process proceeded through qualitatively
      different learning stages. It is concluded that within five minutes subjects
      gradually changed their movement strategy from a sequential, trial-and-error mode
      in which planning and execution occurred segment by segment, to a mode in which
      concurrent planning was realized, i.e. in which the planning of oncoming segments
      occurred concurrently with the execution of segments.

PMID- 8475772
TI  - Exploitation of elasticity as a biomechanical property in the production of
      graphic stroke sequences.
AB  - In the present study we report several findings which indicate that subjects
      exploit elasticity of muscles and tendons as a biomechanical property of the
      motor system in the execution of graphic stroke sequences. The drawing movements
      of 15 right-handed subjects were analyzed, who copied a geometrical pattern
      consisting of four line segments. Three of these segments were connected by an
      acute and an obtuse angle. A first analysis concerning stroke-direction
      preferences shows that subjects tended to produce final strokes in preferred
      movement directions and obeyed an end-state stability constraint. Subsequently,
      we analyzed the copying movements with respect to (1) pauses at acute and obtuse
      angles, (2) local deviations in angle size, and (3) size variations of the
      strokes surrounding the angles. The results reveal a higher incidence of pauses
      at obtuse than at acute angles. Furthermore, a local sharpening of angles was
      found which was most pronounced at obtuse angles. Finally, systematic size
      variations of the strokes surrounding the angles were found. The results are
      considered to reflect the functional use of elasticity during task performance.
      It is concluded that biomechanical properties of the motor system significantly
      influence higher-order preparatory processes involved in multi-trajectory
      control.

PMID- 8475773
TI  - Effects of lexicality and trigram frequency on handwriting production in children
      and adults.
AB  - Recent studies of handwriting have shown that linguistic variables, such as
      phonology or lexicality, influence various aspects of the production of letter
      sequences. Following a previous experiment, in which a facilitation effect of
      words over pseudowords has been documented both in children and in adults, an
      experiment is reported concerning the effect of lexicality and of trigram
      frequency on handwriting production at different levels of handwriting mastery.
      In this experiment, 8- to 12-year-old children and adults were asked to write
      words, pseudowords ending with a frequent trigram, and pseudowords ending with a
      nonfrequent trigram. Results show that in adults there is a facilitation effect
      of words over pseudowords and of frequent trigrams over nonfrequent trigrams. In
      children, no clear effect of lexicality or trigram frequency could be observed.
      Developmental trends show that major changes in children's handwriting occur
      between 8 and 10 years, whereas only minor modifications are observed between 10
      and 12 years.

PMID- 8475774
TI  - Analysis of actual and mental movement times in graphic tasks.
AB  - This paper reports on a study of movement times and movement time variability of
      graphic gestures which were executed either physically or mentally. The results
      revealed that temporal parameters for actual as well as mental graphic movements
      in the same subject and for the same hand were very similar, irrespective of the
      writing amplitude. It is suggested that the programming of motor acts, whether
      they are physically executed or only virtually, share to a considerable extent
      the same timing mechanism.

PMID- 8475775
TI  - Evaluating the special role of time in the control of handwriting.
AB  - Claims that time has a special role in the control of writing and the specific
      claim that writing time is absolutely invariant across changes in writing size
      are evaluated in two experiments. The first examined writing time for 24
      undergraduate subjects who produced the string eyleyl with the dominant hand or
      arm in blocked repetitions having different vertical size targets. These
      variations produced small but systematic changes in writing time. The second
      experiment explored whether the small range of writing-time variation observed in
      experiment 1 was due to structural or strategic limitations. This experiment
      showed, for four undergraduate subjects, that writing time can be varied
      precisely across a wide range (0.6 to 1.66 of 'normal') while maintaining shape
      and vertical size constant. Taken together, these experiments suggest that,
      although relative stroke timing is approximately maintained, absolute timing is
      not critical to writing. The limited range of writing times typically observed
      should, rather, be ascribed to a strategic gradient that, along with other
      influences, broadly defines preferred writing times. This paper also describes a
      new application of Generalized Procrustes Analysis of shape, and this procedure
      is applied to the trajectories generated in both experiments. Although several
      small failures are noted, these analyses generally confirmed previous claims that
      shape is invariant across changes in writing time, size, and writing with the
      hand versus the arm. This result is a necessary buttress to the conclusions just
      described. Shape variability was also assessed in these analyses. This
      variability soared as writing time was reduced from normal, but showed only a
      small, insignificant increase as writing time was increased from normal. There
      were also small, predictable changes in spatial variability across changes in
      size and effector.

PMID- 8475776
TI  - Generalized representation of handwriting: evidence of effector independence.
AB  - Previous analyses of writing data have provided qualitative evidence of temporal
      and spatial similarities across muscle effectors. In order to further explore the
      notion of effector independence in handwriting a single case study approach was
      adopted that employed quantitative analyses. A left-handed individual who lost
      his left hand and forearm in an automobile accident and wore a myoelectric arm
      was tested. After his accident he learned to write with the right hand developing
      this skill for 8 years. Once he was fitted with the myoelectric arm he began
      again to write with the left hand. Thus, the acquired writing patterns of both
      hands reflect two well-learned skills which utilize different muscle effectors.
      Wright's NAME-EQUATION paradigm (1990) was utilized which required the subject to
      write his name and the equation X + Y = Z with the dominant, non-dominant hand
      and the elbow of the dominant arm. A control subject was also tested. For the
      subject wearing a myoelectric arm (primary subject), kinematic and handwriting
      analysis revealed astonishing similarities between the different effectors
      tested. For the control subject, the obtained results showed that as the
      effectors changed so did the handwriting kinematics. The collective findings
      support the hypothesis that motor programs, the directives that guide skilled
      movement, can be generalized across different effectors, but only after
      considerable practice.

PMID- 8475777
TI  - Invariant properties between stroke features in handwriting.
AB  - A handwriting pattern is considered as a sequence of ballistic strokes.
      Replications of a pattern may be generated from a single, higher-level memory
      representation, acting as a motor program. Therefore, those stroke features which
      show the most invariant pattern are probably related to the parameters of the
      higher-level representation, whereas the more noisy features are probably related
      to the parameters derived at the lower levels (top-down hierarchy). This
      hierarchy of invariances can be revealed by the signal-to-noise ratio (SNR), the
      between-parameter correlations, and the between-condition correlations.
      Similarly, at the higher level a sequence of strokes may act as a unit from which
      individual strokes are derived (sequence hierarchy). This hierarchy of
      invariances can be revealed by the between-stroke correlation, which forms a
      weaker criterion than rescalability, which has been rejected mostly. Previous
      research showed that vertical stroke size has higher SNRs and higher between
      condition correlations than stroke duration or peak force, whereas the latter two
      features were also negatively correlated. This suggested that vertical stroke
      size is a higher-level parameter than the other two. The present research largely
      confirmed this top-down hierarchy and even for upstrokes and downstrokes
      separately. Downstrokes were more invariant than upstrokes in terms of vertical
      stroke size. However, contrary to the vertical stroke size, the horizontal stroke
      size was not invariant. Both vertical and horizontal sizes showed substantial
      between-stroke correlations. In contrast, the stroke durations did not show any
      between-stroke correlations. This suggests that stroke segmentation is reliable
      in spite of the discrete sampling of the handwriting movements.

PMID- 8475778
TI  - Looking at handwriting generation from a velocity control perspective.
AB  - This paper presents a model that explains the origin of the asymmetric bell
      shaped velocity profiles generally observed in handwriting and other rapid
      movements. Applying the central limit theorem to describe the converging behavior
      of a sequence of dependent neural and muscular networks, it is shown that
      velocity profiles can be described by log-normal curves. An analysis-by-synthesis
      experiment is reported to support the model and to specify its mathematical
      implementation. Practical implications of this approach are discussed at the end
      of the paper to provide an analytical definition of a stroke, to clarify the
      concept of fluency and to suggest a powerful method for segmenting complex
      movements, particularly cursive script.

PMID- 8475779
TI  - In vitro effect of ascorbic acid on neutrophil-endothelial cell interaction.
AB  - The effect of different concentrations (0.06, 0.6 and 6.0 mmol/L) of ascorbic
      acid on neutrophil-endothelial interaction was studied using an in vitro model of
      human umbilical cord vein endothelial cells and human neutrophils. The aim of the
      study was to determine changes in chemiluminescence response of neutrophils
      during adherence to endothelial cells. Because adherence of neutrophils to
      endothelial cells is an essential component in inflammatory processes leading to
      endothelial cell injury, the influence of ascorbic acid on adherence and
      endothelial cell injury have been investigated. Production of oxygen-derived
      metabolites, measured by chemiluminescence response of neutrophils, decreased
      significantly in the presence of 6 mmol/L ascorbic acid during coincubation of
      neutrophils and endothelial cells (p < 0.025). The adherence of neutrophils to
      endothelial cells was significantly decreased at a concentration of 6 mmol/L (p <
      0.0005). The inhibition of neutrophil adherence to endothelial cells was
      correlated with a diminished neutrophil-mediated endothelial cell injury during
      incubation with 6 mmol/L ascorbic acid (p < 0.0005). The present results indicate
      that ascorbic acid might exert a protective effect on neutrophil-mediated
      endothelial cell injury by decreasing adherence of neutrophils to endothelial
      cells and by scavenging reactive oxygen metabolites. Moreover, the current
      investigation points to probable protective effect of ascorbic acid on oxidant
      mediated cell damage in diseases (e.g., Adult Respiratory Distress Syndrome).

PMID- 8475780
TI  - Determination of serum oxalate using peroxyoxalate chemiluminescence of free
      oxalic acid.
AB  - We describe a new sensitive and specific method for determination of oxalate in
      human serum. By using the chemiluminescence decay of monoperoxyoxalic acid very
      low concentrations of oxalate (200 nmol/L) can be determined. The mean serum
      oxalate level in apparently healthy controls was 14.5 +/- 8.5 mumol/L.
      Supplementation of ascorbic acid leads to an increase in serum oxalate level.
      While serum oxalate concentrations of calcium oxalate stone formers (x = 16.4 +/-
      9.8 mumol/L) are not significantly different from the control group, an extreme
      increase of serum oxalate is evident in haemodialysis patients. The serum oxalate
      concentration decreased during dialysis treatment from 141.4 +/- 32.1 mumol/L to
      36.4 +/- 12.7 mumol/L.

PMID- 8475781
TI  - Flow injection chemiluminescence study of acridinium ester stability and kinetics
      of decomposition.
AB  - Decomposition of phenyl acridinium-9-carboxylate is monitored using
      electrogenerated chemiluminescence in a flow system. The formation of the
      pseudobase from the acridinium ester [AE] is described by rate = k'1[AE] +
      k''1[AE][OH-]0.5, where k'1 = 0.020 +/- 0.006 s-1 and k''1 = 2.1 +/- 0.8 (L/mol)
      0.5 s-1. Irreversible decomposition of the pseudobase is described by rate =
      k'2[AE][OH-], where k'2 = 20.1 +/- 3.8 (L/mol s). These kinetic equations, plus
      measurement of variation in emission intensity for constant acridinium ester
      concentration, are used to predict the resulting emission intensity v. pH
      behaviour given various contact times (in the 0.25 to 25 s range) for the
      acridinium ester to be in an alkaline solution prior to initiation of the
      chemiluminescence reaction.

PMID- 8475782
TI  - Separation of pH, dilution, ionic strength and chemical matrix effects for
      biological monitoring of urines with the Microtox test using nicotine, cotinine
      and reference urines.
AB  - The aim was to investigate the factors influencing light emission from
      Photobacterium phosphoreum in the Microtox test to interpret bioassay results for
      urine. Four reference urines were assessed as reference materials for the
      bioassay. Nicotine and cotinine were investigated as urinary markers for tobacco
      exposure. The optimum luminescence conditions were: 1.85%-3.25% NaCl, 0.33-0.58
      mol/L ionic strength, and pH 5.8-6.7. Low pH values and high concentration of
      toxic trace metals were important factors in this study. Unexpected toxicity for
      a Standard Reference Material was attributed to zinc contamination. Nicotine and
      cotinine together exhibited antagonistic effects in 2% saline but this could not
      be observed in the urines because of substantial urine toxicity. Thus practical
      urinary biological monitoring with the Microtox test necessitates excretion of
      metabolites and compounds that are much more toxic than the urine components.
      Also, separation of the effects of physical factors like pH, ionic strength and
      dilution is essential before chemical toxicity effects can be assigned. This is
      the first report of Microtox EC50 values for nicotine and cotinine. The results
      have application to environmental samples since analyses are often uncontrolled
      relative to pH, ionic strength and dilution.

PMID- 8475783
TI  - [Significance exercise-induced ST elevation in patients with myocardial
      infarction].
AB  - In 52 patients with previous myocardial infraction, 49 men and 3 women (mean age
      56 +/- 7.1 years) the significance of ST-segment elevation during the stress
      test, was evaluated. Of the 52 patients 15 (29%) showed St-segment elevation and
      37(71%), showed no alteration of the ST-segment. Extension of coronary disease,
      degree of obstruction, wall motion abnormalities and the presence of residual
      ischemia were evaluated by coronary angiography, technetium-99M pyrophosphate
      imaging and exercise TL-201 scintigraphy. From the results of the study one may
      conclude that, in patients with previous myocardial infraction exercise, ST
      segment elevation is a consequence of sub-occlusion of the left anterior
      descending coronary artery with severe ventricular dysfunction either in patients
      with one or multiple vessel disease.

PMID- 8475784
TI  - [Tomodensitometry and radioisotopic methods in the study of unilateral lung
      hyperlucencies of vascular origin].
AB  - Among the causes of the radiological entity known as unilateral or total
      hyperlucent lung is the decreased blood flow in the lungs. Unilateral and total
      hyperlucent lung results, among other factors, from the decreased intrapulmonary
      blood flow. Classically, the diagnosis and haemodynamic evaluation of these
      situations were usually made through invasive methods: right heart catheterism to
      perform angiopneumography and pressure evaluations as well as oximetry at several
      levels of the vascular network, thoracic aortography eventually associated with
      selective arteriography to detect the abnormalities of the systemic thoracic
      circulation. In this context, the authors propose for the diagnosis and study of
      this pathology, a new non-invasive methodology. In order to achieve this propose,
      we studied 8 patients, all of them performed clinical and laboratory evaluations,
      chest chi-ray, electrocardiographic and functional respiratory exams, as well
      angiopneumography, thoracic aortography tomodensitometry including qualitative
      (to study the lung arterial vasculature) and quantitative (to evaluate CT density
      of each lung in Hounsefield unit and two radioisotopic tests, including a
      ventilation/perfusion study with 133 chi e and HAM-99mTc, through an original
      software--four parameter histograms allowing simultaneous information of
      ventilation and perfusion at the pixel level and estimation of the V/Q; the other
      is the pulmonary gating through which it is possible to identify and quantify the
      arterio-arterial shunts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475785
TI  - [Medical research financing].

PMID- 8475786
TI  - [Medical research in Portugal: the geniuses and the structures, the myths and
      common sense].
AB  - There was recently a growth in the funds allocated directly to scientific
      programs and projects and in particular to infrastructures (buildings and large
      pieces of equipment). It is very likely that this investment will continue to
      grow as a result of the development policies of the EEC applied to its less
      developed members. The recent experience with the Science Program, the main
      factor in this evolution, has demonstrated that the bottleneck in our scientific
      development is at the level of the allocation of funds (management). Hence, the
      nonrealistic Regulations of the Program, the allocation of funds to ghost
      institutions and the inability to distribute the funds allocated to the Program.
      The Program was conceived based on problem oriented and not on research oriented
      strategies. In the case of medical research this choice is not supported by the
      recent history of research in this area or by the experience of countries such as
      the UK or the USA. Funding of medical research in this country should be based on
      the identification of a talented scientist with a good research program and on an
      inventory of the productivity, potentialities and needs of existing institutions.
      We should seek the support of foreign scientists and of Portuguese scientists
      living abroad for the technical evaluation of projects but they should not be
      asked to provide global strategies of investment in Portuguese science.

PMID- 8475787
TI  - [Errors in medicine].
AB  - The author discusses the different kinds of errors that may be committed in
      clinical practice. The socioeconomic and professional factors that make doctors
      particularly vulnerable are briefly reviewed.

PMID- 8475788
TI  - [Superior mesenteric artery syndrome. Report of 2 clinical cases].
AB  - The authors describe two cases of the superior mesenteric artery syndrome. The
      diagnosis was made by radiology and both were treated surgically. They emphasize
      the most relevant symptoms (epigastric pain and vomiting) and the characteristic
      radiological signs which permit the diagnosis (marked to-and-fro peristalsis in
      the duodenum with extrinsic compression of the third part and proximal dilatation
      ending abruptly). Although the conservative measures are sufficient in most
      cases, those presented in this paper, both needed surgery.

PMID- 8475789
TI  - Age- and gender-related changes in body composition in Japanese subjects.
AB  - Age-dependent changes in body composition, namely a decrease in bone mass and
      lean mass and a reciprocal increase in fat mass, are often observed in normal
      populations. The recent development of dual-energy x-ray absorptiometry (DXA)
      made it possible to analyze bone mineral content (BMC), fat mass (fat), and lean
      body mass (LBM) more precisely and easily. We measured BMC, fat, and LBM in
      Japanese subjects by DXA to describe the changes in body composition with aging
      in the Japanese population. A total of 34 female (aged 20-74) and 34 male (aged
      18-78) volunteers were divided into three groups according to their age: young
      (18-22 years), middle-aged (39-48 years), and old (61-78 years). Mean values for
      body height (BH), body weight (BW), and body mass index (BMI) of the subjects
      were very similar to Japanese normative values. The BMI of the middle-aged group
      was the highest of all groups of both sexes. BMC decreased significantly with
      aging in females but not in males. A decrease in LBM and a reciprocal increase in
      fat were found between young and middle-aged males but not in females. The
      correlation between BMC and LBM tends to be greater in males than in females. On
      the other hand, the correlation between BMC and fat was greater in females than
      males. These results demonstrate the age- and gender-related difference in body
      components in Japanese subjects. DXA may be useful for the analysis of body
      composition in different age and sex groups.

PMID- 8475790
TI  - Expression of alpha v and beta 3 integrin subunits in rat osteoclasts in situ.
AB  - Recent findings suggest that the vitronectin receptor, a member of the integrin
      family, plays an important role in the attachment of osteoclasts to bone matrix.
      We report here the localization by in situ hybridization of the mRNA for the
      alpha and beta subunits of the vitronectin receptor in rat bone sections. To
      generate the rat-specific RNA probes used in this study, we cloned cDNA fragments
      of integrin chains alpha v, beta 3, and beta 5 by the polymerase chain reaction
      from rat cDNA. These fragments share 86-91% homology with the respective human
      sequences. In situ hybridization localized the alpha v and beta 3 mRNAs to
      regions undergoing extensive bone resorption. The histologic appearance and
      prestaining of bone sections for tartrate-resistant acid phosphatase (TRAP)
      indicated the presence of these mRNAs in osteoclasts. These observations support
      immunohistochemical findings that osteoclasts express high levels of the
      vitronectin receptor, confirm the identity of this receptor as integrin alpha
      v/beta 3, and suggest that osteoclasts may actively synthesize these molecules.

PMID- 8475792
TI  - Recombinant human transforming growth factor beta 1 modulates bone remodeling in
      a mineralizing bone organ culture.
AB  - TGF-beta 1 increases cell proliferation and collagen synthesis in osteoblast-like
      cells and bone organ cultures. However, the effects of TGF-beta 1 on bone
      resorption remain contradictory. Therefore, the exact role that this growth
      factor plays in the process of bone remodeling is still not clear. We studied the
      effects of recombinant human TGF-beta 1 (rhTGF-beta 1) on bone formation and
      resorption in a mineralizing bone organ culture system. Parietal bones from 20
      day-old fetal rat calvariae were cultured up to 7 days in serum-free BGJb medium.
      They responded to a 1 day pulse or continuous treatment of rhTGF-beta 1 with dose
      dependent increases in dry weight, [3H]thymidine ([3H]TdR) incorporation, and
      collagen synthesis. In contrast, rhTGF-beta 1 reduced the calcium content of the
      bones. This is not due to increased bone resorption but rather to failure of
      calcium deposition. The following responses occurred at 1 nM rhTGF-beta 1. Dry
      weight was increased 25-50% after 6 days in culture. DNA synthesis was increased
      to a maximum at day 1, reaching twofold of the control level. Adding hydroxyurea
      at day 0 reduced [3H]TdR incorporation in rhTGF-beta 1 treated bones to 20% of
      the control and indomethacin abrogated the increase in [3H]TdR stimulated by
      rhTGF-beta 1 to the control level. Both treatments completely blocked the
      increase in dry weight induced by rhTGF-beta 1 at day 6. rhTGF-beta 1 stimulated
      collagen synthesis to reach its maximum at day 2, with a twofold increase in
      [3H]proline incorporation. Basal alkaline phosphatase activity fell continuously
      in culture, reaching 35% of day 0 level at day 6. Enzyme activity was not altered
      by rhTGF-beta 1. Morphologic observations by light and electron microscopy
      confirmed these findings. In summary, rhTGF-beta 1 altered bone remodeling by
      increasing organic components and decreasing calcification in a mineralizing bone
      organ culture system.

PMID- 8475791
TI  - Longitudinal study of bone mass in end-stage renal disease patients: effects of
      parathyroidectomy for renal osteodystrophy.
AB  - The effectiveness of parathyroidectomy (PTHX) for the control of secondary
      hyperparathyroidism was assessed in 46 adult end-stage renal disease (ESRD)
      patients whose bone mineral content at the midshaft and distal radius was
      measured using single-photon absorptiometry (SPA) every 6 months before and after
      the surgery. They were compared to 46 age-, race-, and sex-matched ESRD patient
      controls who had not undergone surgery but who had had at least five SPA studies
      at similar intervals. Presurgery midradius bone mass was significantly lower for
      PTHX patients compared to controls. Comparing changes in bone mass of PTHX
      patients across surgery to controls in comparable time periods showed that PTHX
      patients lost significantly less bone mass after surgery. Similar results were
      obtained when rates of change in bone mass were evaluated. When patient
      characteristics were examined, the effect of surgery was found to be diminished
      in elderly patients and in oophorectomized patients. It is concluded that PTHX
      can have a salutary effect on renal osteodystrophy in the appendicular skeleton,
      but factors other than bone mass also need to be considered in identifying those
      patients who will benefit from surgery.

PMID- 8475793
TI  - High-dose estrogen inhibits bone resorption and stimulates bone formation in the
      ovariectomized mouse.
AB  - In this study, we have investigated estrogen's capacity to regulate bone
      formation and resorption in the ovariectomized mouse, evaluating the dose and
      site dependence of estrogen action on bone modeling and remodeling surfaces. To
      quantitate bone resorption, the skeletons of fifty 8-week-old Swiss-Webster mice
      were prelabeled with [3H]tetracycline (3H-T) before initiation of treatment
      protocols. Ovariectomies (OVX) and sham surgeries were performed 3 days after the
      final 3H-T injection, and the animals were assigned to treatment groups and
      injected once per week for 4 weeks with one of the following doses of 17 beta
      estradiol (E2): sham/oil vehicle (SV), OVX/oil vehicle, OVX/50 micrograms E2,
      OVX/250 micrograms E2, and OVX/500 micrograms E2. To assess bone formation,
      fluorochrome labels were administered 9 and 2 days before sacrifice. At the
      conclusion of the 4 week protocol, the femora and thoracic vertebrae were removed
      to quantitate the levels of bone resorption based on the skeletal retention of 3H
      T. The tibiae were excised for histomorphometric evaluation of the proximal
      metaphyses and middiaphyses. Indicative of increased bone resorption, vehicle
      treated OVX animals had significantly reduced levels of 3H-T in femora and
      vertebrae compared to SV mice. This result was consistent with histomorphometric
      data showing a 49% decrease in cancellous bone area of the proximal tibiae in the
      OVX/oil-treated group. Treatment of OVX animals with 50 micrograms E2 was
      sufficient to maintain 3H-T levels in vertebrae at SV values, with higher E2
      doeses leading to a dose-dependent increase in the retention of 3H-T at this
      site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475794
TI  - Bone formation periods studied with triple tetracycline labels in women with
      postmenopausal osteoporosis.
AB  - In adult cancellous bone, cyclic remodeling occurs in discrete locations (BMUs,
      or basic multicellular units). Some aspects of these remodeling cycles are still
      not clear. Only about half the osteoid surface normally has tetracycline labels;
      the remainder is thought to be immature or in a resting phase. This study was
      designed to test the assumption that pauses occur during the bone formation
      periods. Iliac crest bone biopsies were performed in 84 women with postmenopausal
      osteoporosis. The subjects were given three tetracycline labels; the middle label
      had a distinctive color. The osteoid surface was 10 +/- 6% of the bone surface;
      the range was 0.6-24.4%. The mineralizing surface was 42 +/- 26% of the osteoid
      surface. Immature osteoid was 7.6 +/- 5.3% of the osteoid surface. There were no
      BMUs with the first and third tetracycline label but without the middle
      demeclocycline label. The expected length of double 1-3 label, based on an
      assumption that unlabeled mature osteoid was temporarily in a resting phase, was
      significantly higher than the observed length (68 +/- 77 microns/mm2 tissue area
      versus 0, p < 0.0001). The mean active formation period was 77 +/- 16 days
      calculated by standard methods but was only 55 +/- 26 days when calculated by
      label escape (p < 0.001). The correlation coefficient between these two methods
      was only modest (r = 0.27, p < 0.01). The failure to find any double 1-3 labels
      despite abundant triple labels provides strong evidence against the presence of
      pauses in bone mineralization between 3 and 34 days.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8475795
TI  - Bone mineral density and parameters of bone metabolism in patients with
      acromegaly.
AB  - To assess the effect of chronically elevated plasma growth hormone (GH) levels on
      bone metabolism and bone mineral density (BMD), 16 patients (10 females and 6
      males) with a mean age of 49.1 +/- 13.2 years (range 33-68) with active
      acromegaly were studied and compared to a control group of 16 sex- and age
      matched subjects. BMD of the lumbar spine and two different sites of the proximal
      femur were measured by dual-energy x-ray absorptiometry (Norland XR-26). In the
      acromegalic patients the mean plasma GH concentration was 30.1 +/- 11.1
      micrograms/liter, and the mean plasma somatomedin C (SMC) concentration was 6.5
      +/- 1.5 U/liter. Mean serum osteocalcin (OC) levels (14.3 +/- 1.1 versus 7.2 +/-
      0.4 ng/ml, p < 0.001) as well as the urinary hydroxyproline excretion (OHP; 8.8
      +/- 1.4 versus 2.7 +/- 0.3 mg, p < 0.0001) were significantly higher in the
      acromegalic patients than in the control subjects. In the acromegalic patients
      BMD was significantly elevated in the two examined regions of the proximal femur,
      that is, the femoral neck (1.06 +/- 0.05 versus 0.86 +/- 0.03 g/cm2, p < 0.05)
      and Ward's triangle (0.92 +/- 0.06 versus 0.76 +/- 0.03 g/cm2, p < 0.02), whereas
      the BMD of the lumbar spine was not significantly different from that of control
      subjects. Among the patients with acromegaly a significant positive correlation
      between serum OC concentrations, on the one hand, and urinary OHP excretion (r =
      0.7, p < 0.004) as well as BMD in the proximal femur (r = 0.64, p < 0.007), on
      the other hand, could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475796
TI  - CGRP radioreceptor assay: a new diagnostic tool for medullary thyroid carcinoma.
AB  - The quantitative analysis of immunoreactive calcitonin (iCT) is the assay of
      choice for diagnosis and follow-up of patients with medullary thyroid carcinoma
      (MTC). However, in a small percentage of patients with MTC or C cell hyperplasia
      (CCH), basal and stimulated iCT levels may not be significantly elevated. In
      these patients, calcitonin gene-related peptide (CGRP) radioreceptor assay (RRA)
      can be used complementary to immunoassay for CT (or katacalcin) for prompt
      diagnosis of MTC and CCH. CGRP RRA is a robust, rapid, sensitive, and specific
      determinant of "receptor-recognized" CGRP (RR-CGRP; intact molecule of CGRP)
      either in plasma or in tissue extracts. Plasma RR-CGRP levels rose > 100% 2-5
      minutes after stimulation with intravenous pentagastrin (calcium or oral alcohol)
      (p < 0.001), whereas iCGRP levels were raised to a lesser degree (p < 0.01). In
      six patients who had a false positive iCT response after pentagastrin or had
      raised basal iCT levels measured with a two-site immunoradiometric assay, RR-CGRP
      showed only a minimal change. On the other hand, in patients with CCH (true
      positive, n = 8), iCT was increased by only 40% after pentagastrin but RR-CGRP
      levels rose by 140% (p < 0.001). No change in iCT or RR-CGRP levels in plasma
      were detected in healthy normal volunteers after administration of pentagastrin.
      Therefore, in addition to the plasma iCT levels, RR-CGRP would resolve some of
      the difficult diagnostic problems associated with MTC and likely improve the
      specificity and sensitivity of identifying CCH.

PMID- 8475797
TI  - Regulation of expression of the chondrocytic phenotype in a skeletal cell line
      (CFK2) in vitro.
AB  - We have examined in vitro the spontaneous and regulated expression of phenotypic
      characteristics associated with differentiated chondrocytes in an established
      skeletal cell line (CFK2) derived from fetal rat calvariae. Extended culture of
      CFK2 cells resulted in the appearance of glycosaminoglycans and type II collagen
      in the cell layer in association with the formation of focal nodes of cells. In
      addition, induction of mRNA-encoding link protein, cartilage-specific
      proteoglycan core protein, and thrombospondin was observed in the differentiated
      population (dCFK2 cells). The expression of these mRNAs was present for at least
      two passages after subculturing the dCFK2 cells. The dCFK2 cells also
      demonstrated enhanced parathyroid hormone (PTH)-stimulated adenylate cyclase
      activity. Proliferation of CFK2 cells was stimulated by the peptide regulatory
      factors EGF and PTH and inhibited by the steroidal agents dexamethasone and
      retinoic acid. EGF and retinoic acid inhibited the formation of cell foci and
      glycosaminoglycan deposition and the expression of mRNA-encoding link protein. In
      contrast, PTH and dexamethasone enhanced the formation of focal cellular nodes
      and augmented matrix deposition and link protein mRNA expression. These studies
      therefore show that the CFK2 cell line can serve as a nontransformed model of rat
      chondrocytic cells in which both induction and regulation of the expression of
      cartilaginous matrix components can be observed. This line thereby provides a
      unique renewable source of chondrocytic precursor cells and an excellent in vitro
      model for evaluating temporal and environmental control of chondrocyte
      differentiation and cartilage matrix production.

PMID- 8475798
TI  - Ultrastructural immunolocalization of noncollagenous (osteopontin and
      osteocalcin) and plasma (albumin and alpha 2HS-glycoprotein) proteins in rat
      bone.
AB  - The high-resolution, postembedding protein A-gold immunocytochemical technique
      was used to visualize the distribution of two noncollagenous bone proteins,
      osteopontin (OPN) and osteocalcin (OC), and two plasma proteins, alpha 2HS
      glycoprotein (alpha 2HS-GP) and albumin (ALB), in sections of Lowicryl K4M
      embedded rat tibial and alveolar bone. In the primary spongiosa of the
      metaphysis, a seam of organic material (lamina limitans) that labeled intensely
      with OPN and OC antibodies was observed at the bone/calcified cartilage interface
      just below the zone of vascular invasion of the growth plate. With deposition of
      bone matrix proper by osteoblasts in this region and its subsequent
      mineralization, extensive areas of bone were heavily labeled with anti-OPN, anti
      OC, and anti-alpha 2HS-GP antibodies, where the majority of gold particles were
      associated with amorphous, electron-dense patches of organic material throughout
      the mineralized bone. In the unmineralized osteoid, substantially less labeling
      was observed, and where occasional mineralization loci were dispersed throughout
      the osteoid layer, these sometimes showed a concentration of gold particles. ALB
      labeling, on the other hand, was moderate and generally diffuse throughout the
      mineralized bone matrix and the osteoid. In alveolar bone, labeling patterns were
      generally similar to those found in tibial bone. Particularly striking in
      alveolar bone, however, was an intense anti-OPN labeling of (1) the lamina
      limitans at cell-lined bone surfaces, including that surrounding cell processes
      and osteocytes, (2) cement (reversal, resting) lines, and (3) the perilacumar
      matrix of some osteocytes. In summary, these data suggest that certain plasma
      proteins, such as alpha 2HS-GP, interact with bone matrix proteins, such as OPN
      and OC, at sites of tissue mineralization and that the presence of OPN in
      mineralized bone and at bone surfaces (lamina limitans) and cement lines has a
      multifunctional role, including regulation of mineralization and mediation of
      cell dynamics during endochondral and intramembranous bone modeling and
      remodeling.

PMID- 8475799
TI  - Protein kinase C-activating domains of parathyroid hormone-related protein.
AB  - N-terminal fragments of PTH-related protein (PTHrP), PTHrP-(1-34), and PTHrP-(1
      40) stimulated both adenylyl cyclase and a mechanism that increases membrane
      associated protein kinase C (PKC) activity in ROS 17/2 rat osteosarcoma cells.
      There were two peaks in the PKC response to the N-terminal PTHrP fragments: one
      peak was obtained with picomolar and the other with nanomolar PTHrP
      concentrations. The PKC-stimulating picomolar concentrations of the PTHrP
      fragments did not detectably stimulate adenylyl cyclase, but the nanomolar
      concentrations did. Since a similar two-peak response of PKC activity was
      obtained with PTHrP-(28-34), the single, N-terminal PKC activation domain of the
      PTHrP is in the same 28-34 region of the molecule as that of PTH despite this
      region having different primary amino acid sequences in the two hormones. Unlike
      PTH, PTHrP has a second PKC activation domain, as indicated by the ability of
      picomolar concentrations of the PTHrP-(107-111) fragment to stimulate maximally
      membrane-associated PKC activity in the osteosarcoma cells.

PMID- 8475800
TI  - Volume regulation of the brain tissue--a survey.
AB  - Though the brain bulk has been considered to be constant in several pressure
      homeostasis studies, the central nervous tissue may be responsible for the
      accommodation of extracerebral masses exceeding the volume regulation capacity of
      the cerebral blood and cerebrospinal fluid. Volume buffering of the nervous
      tissue may even be functioning in parallel, in conjunction with the "fluid"
      compartments. Of the existing volume regulatory models, the following are
      discussed: osmotic feedback (buffering) preventing major fluid shifts in osmotic
      or pressure disequilibrium at the blood brain barrier (BBB), and the 4
      compartment model, which under steady-state conditions can be regarded as an
      analogue of systemic tissue volume regulation, i.e. secretion of fluid at the
      BBB, bulk flow of interstitial space fluid (ISF) in the brain and absorption via
      the cerebrospinal fluid (CSF). The most recent data are presented, confirming
      that accommodation of space occupation by the nervous tissue is achieved via
      shrinkage of the extracerebral fluid (ECF), while the cell volume remains
      relatively constant. These findings confirm Hakim's classical hypothesis, based
      on biomechanical considerations, that the brain behaves like a sponge. The data
      presented in this survey point to a more general hypothesis: the brain
      interstitial space can vary in volume according to physiological and pathological
      stress, within certain bounds this being a reversible process which does not
      affect brain function. The potential role of the central neuro-endocrine system
      in brain volume regulation is discussed. Vasopressin (AVP) and atriopeptin (ANP)
      probably, function within the brain via a paracrine mechanism, as physiological
      regulators of brain cell and ISF volume.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475801
TI  - Penetration of fusidic acid into human brain tissue and cerebrospinal fluid.
AB  - Penetration of fusidic acid into brain tissue in six patients and cerebrospinal
      fluid in seven patients was determined. Tissue samples, taken during surgery
      revealed drug levels at about 7% of simultaneous serum concentrations. In
      contrast, cerebrospinal fluid concentrations were below 1% of serum levels. Since
      serum- and tissue levels of fusidic acid were far above the minimal inhibitory
      concentration (MICs) of staphylococci and streptococci, and since it has a long
      serum half-life of about 10 hours, it is a promising candidate for prophylaxis in
      neurosurgery.

PMID- 8475803
TI  - Selective angiography for early aneurysm detection in acute subarachnoid
      haemorrhage.
AB  - In a consecutive series of 312 surgical aneurysm cases more than 90% of the
      patients reached neurosurgical expertise within 48 hours from bleeding. Computed
      tomography permitted prediction of the assumed rupture site based on blood clot
      location in the majority (86%) of cases. This target vascular territory was
      usually investigated by selective angiography and in 9 out of 10 patients an
      aneurysm, ultimately shown to be the correct source of bleeding, was
      demonstrated. In 14% of the cases the source of bleeding could not be established
      thus calling for complete four vessel studies. It is concluded that limited
      angiographic studies are compatible with preserving a high surgical standard in
      cases unequivocally exhibiting a localizing clot pattern on the CT scan. Though
      suboptimal in a general sense, incomplete vascular studies, if four vessel
      angiography is not obtainable without delay or risk, should not delay earliest
      possible clipping of ruptured aneurysms to avoid the devastating effects of
      recurrent bleeds.

PMID- 8475804
TI  - Interest and necessity of combined neuroradiological and neurosurgical treatment
      in some cases of dural arterio-venous fistulae.
AB  - The authors report 3 observations of dural arterio-venous fistula cured by
      combined neuroradiological and neurosurgical intervention. In the first case, the
      shunt affected the left lateral sinus. Repeated embolizations failed whilst
      intracranial hypertension developed, as a consequence of flux in the opposite
      lateral sinus and in the sagittal sinus. Surgical intervention, consisting in
      isolation of the transverse sinus, led to complete cure, after a one month delay.
      In the second case, the shunt was adjacent to the sagittal sinus, right parietal,
      and had led to an intracerebral haematoma, by rupture of an arterialized cortical
      vein. Embolizations alone could not cure the fistula which therefore had to be
      excised. In the third case, the shunt was located in the falx, at the parieto
      occipital junction, and was responsible for arterialization of cerebral veins in
      the right parieto-occipital region. For this reason, after failure of
      endovascular treatment, the fistula was coagulated, with subsequent complete
      cure. These three cases illustrate the different types of drainage of such
      arterio-venous fistula, and their corresponding neurological symptoms and signs,
      complications and risks, that required a radical-not only clinical, but also
      anatomical-cure. This aim was achieved when embolizations were accompanied by
      direct surgical attack.

PMID- 8475802
TI  - Stereotactic aspiration of brain abscesses: is this the treatment of choice?
AB  - Despite a reduction in the mortality of patients with brain abscess since the
      introduction of the computed tomography (CT) scanner, controversy persists as to
      the preferred method of treatment for this condition. Eleven patients were
      treated by CT guided stereotactic aspiration of pus and appropriate antibiotic
      therapy. A total of 14 aspirations were performed. Ten abscesses were
      supratentorial and one was in the posterior fossa. In 9 patients a bacterial
      cause was identified while in 2 a fungus was identified. A good outcome was
      achieved in 7 patients but 3 patients died. Another elderly patient remains
      disabled at home. The deaths occurred in severely systemically ill patients with
      poor conscious levels on admission. Only one patient has epilepsy, controlled
      with anticonvulsants while another has not had further seizures since abscess
      treatment a year ago. Stereotactic aspiration should be considered the treatment
      of choice in all but the most superficial and largest cerebral abscesses,
      although the mortality of this condition in the severely ill remains high.

PMID- 8475805
TI  - Unruptured intracranial arteriovenous malformations with hereditary haemorrhagic
      telangiectasia. Neurosurgical treatment or not?
AB  - Clinical decision analysis is applied to treatment decisions for three patients
      with unruptured familial intracranial arteriovenous malformations (AVMs) in
      association with hereditary haemorrhagic telangiectasia (HHT). The grades of the
      AVMs--according to Spetzler--were 1-0-0 (two patients aged 12 and 14) and 2-0-1
      (one patient aged 43). The AVM in one patient (graded 1-0-0) was operated on
      without sequelae. In the decision analysis, life expectancy is used as an outcome
      measure, with and without quality of life adjustment and discounting for time
      preference. It is concluded that neurosurgical treatment is the optimal strategy
      for all three patients. Because no conclusive data are available concerning the
      natural history and neurosurgical treatment of unruptured AVMs, we recommend the
      prospective application and testing of AVM grading systems. General treatment
      guidelines balancing the lifetime risk of haemorrhage, risk of incomplete
      extirpation and surgical mortality and morbidity are given. The analysis suggests
      that patients with low-graded AVMs which have not bled should be treated
      surgically, unless they are older than 60 years and have an increased risk of
      incomplete extirpation.

PMID- 8475806
TI  - "Z" flow hydrocephalus shunt, a new approach to the problem of hydrocephalus, the
      rationale behind its design and the initial results of pressure monitoring after
      "Z" flow shunt implantation.
AB  - The over-drainage of CSF after shunt implantation, particularly when the patient
      is in the vertical posture, is well documented. Problems associated with it are
      negative pressure syndrome (postural headache and postural irritability),
      abnormal skull size, craniosynostosis and subdural haematoma. The pressure
      gradient in the vertical position between the cranial cavity and the right atrium
      is 15 to 20 cm of water and between the cranial and peritoneal cavity it is 25 to
      32 cm of water and both these are much higher than those needed for the optimum
      functioning of a conventional shunt. The need, therefore, has been for a self
      regulating device that can adjust itself to any change of posture from horizontal
      to vertical and vice versa and regulate the flow of CSF from the cranial cavity.
      "Z" Flow hydrocephalus shunt system has this in-built self-regulating mechanism
      to prevent over drainage of CSF and the resultant abnormal low pressure in the
      cranial cavity. The rationale behind the functioning of "Z" Flow hydrocephalus
      shunt system has been discussed, its design has been described and illustrated
      and the results of pressure monitoring after Z Flow shunt implantation in five
      adult patients have been detailed. As the opening pressures of the "Z" Flow shunt
      system are 15-29 cm of water, it has been found to prevent over-drainage of CSF
      and maintain intraventricular pressure within normal limits.

PMID- 8475807
TI  - Conservative management of epidural haematomas. Prospective study of 15 cases.
AB  - Conservative management of epidural haematoma (EDH) depends on a balance between
      expansion and resorption rate of the clot. 15 patients with EDH whose CT scans
      demonstrated a small EDH and were asymptomatic or with minor symptoms or with a
      delayed diagnosis were treated conservatively. The thickness of haematoma ranged
      between 4.9-40.8 mm. In two patients, the haematoma extended from the posterior
      fossa to the supratentorial region. In 7 patients, additional intracranial
      pathology was detected. None of the patients had neurological deterioration on
      follow up. The second CT was performed on second day at the earliest, in fourth
      week at the latest. We conclude that the patients with EDH who are neurologically
      stable during the first 24 hours after trauma, with small EDH and with minor or
      no symptoms or signs, might be candidates for conservative management. An
      absolute precondition for conservative management is close supervision of the
      patient.

PMID- 8475808
TI  - Intra-operative transluminal angioplasty of the supra-aortic vessels.
AB  - Intra-operative transluminal angioplasty of supra-aortic vessels was performed in
      9 patients. All subjects had lesions which were considered difficult or
      impossible to operate upon. In 2 patients a proximal occlusion of the left
      subclavian artery was dilated. Seven subjects showed severe stenoses of the supra
      aortic vessels: common carotid artery: 1, internal carotid artery: 2, external
      carotid artery: 1, external carotid artery prosthetic graft: 1, brachiocephalic
      trunk: 1, vertebral artery: 1. All patients suffered from symptoms which
      corresponded to the site of the lesions in question. Intra-operative angioplasty
      was primarily successful in all 9 patients. Re-occlusion occurred within a few
      days in both patients who underwent angioplasty of the subclavian artery. Six of
      the seven subjects with stenotic lesions remained free of symptoms and of
      restenosis. In the case of dilatation of a prosthetic graft of the external
      carotid artery asymptomatic occlusion developed within 8 weeks. In selected cases
      intra-operative angioplasty is a potentially valuable alternative in the
      treatment of surgically inaccessible lesions of the supra-aortic vessels.

PMID- 8475809
TI  - Studies on supratentorial subdural bleeding using a porcine model.
AB  - A porcine model for an acute lethal arterial subdural bleeding in man is
      presented. Blood from the abdominal aorta was led via an electronic drop recorder
      into a collapsed intracranial subdural rubber balloon. Systemic arterial pressure
      (SAP), two intracranial pressures and 6 other vital parameters were monitored
      continuously in spontaneously breathing (n = 4) and mechanically ventilated (n =
      4) pigs. In both animal groups bleeding caused an immediate rise in intracranial
      pressures (ICP) with transtentorial pressure gradients developing. As a result
      the cerebral perfusion pressures (CPP) decreased progressively, leading to an
      isoelectric EEG. In spontaneously breathing animals, the pressure changes
      resulted in apnoea within 2-4 minutes, irregularities in heart rhythm and in a
      marked rise in SAP (the Cushing reaction). A final collapse of all pressures
      occurred after 222 +/- 68 sec at a mean bleeding volume of 10.3 +/- 1.9 ml. In
      contrast, in mechanically ventilated animals, the course of bleeding was less
      dramatic. No change in cardiac rhythm or rise in SAP appeared despite a larger
      mean bleeding volume (12.0 +/- 1.6 ml). Instead, SAP slowly fell, reaching a
      level of approximately 40 mm Hg within 1 hour, while CPP concomitantly decreased
      from 120 mm Hg to 15 mm Hg. The findings in this and in a parallel study are
      explained in terms of the intracranial volume tolerance concept (Zwetnow et al.
      1986). The beneficial effect of assisted ventilation on the course of subdural
      bleeding is multifactorial, involving both metabolic and mechanical mechanisms.

PMID- 8475810
TI  - Lipid peroxide level increase in experimental hydrocephalus.
AB  - The aetiology of incomplete adrenergic denervation and reduction in the number
      and caliber of the cerebral vessels in hydrocephalus is still obscure. Stretching
      of the blood vessels alone is far from explaining these major vascular changes.
      Previous studies have shown that increased lipid peroxidation produces toxic
      effects on vessels. This experimental study was designed to investigate the
      possible aetiology of vascular changes in hydrocephalic rats with special
      reference to lipid peroxidation. Hydrocephalus was induced by injecting 50 mg/Kg
      sterilized kaolin suspension into the cisterna magna in 10 rats (Group A). A sham
      operation was performed for Group B. After three weeks the rats were
      anaesthetized and perfused transcardially. The brains were dissected, and cut to
      visualize the degree of hydrocephalus. The arteries of the circle of Willis were
      removed for light microscopic examination and the brains were kept for the
      measurement of lipid peroxidation levels. Light microscopic studies of cerebral
      arteries in hydrocephalic rats revealed spastic vessels with folding and
      corrugation of the lamina elastica. The level of lipid peroxidation in group A
      (260 +/- 9.129 nmol TBAR/gr wet tissue) was significantly higher than that of
      group B (106 +/- 3.59 nmol TBAR/gr wet tissue). It is suggested that vascular
      changes observed in hydrocephalic rats may be due to the high level of lipid
      peroxidation, which in turn may be the consequence of ischaemia caused by the
      hydrocephalus related stretching of cerebral vessels.

PMID- 8475811
TI  - Experimental basilar artery spasm caused by autologous blood application: effects
      of clot removal and topical nicardipine.
AB  - In 24 albino New-Zealand rabbits spasm of the basilar artery was produced by
      local application of autologous blood. The effects of blood and blood clot
      removal or topical nicardipine, each alone and in combination of both methods,
      were studied and compared to untreated controls. As well clot removal alone as
      topical application of nicardipine without clot removal resulted in some, but
      statistically not significant, enlargement of the spastically narrowed basilar
      artery. Only the combination of both methods caused a significant vasodilatation,
      up to almost normal diameter range.

PMID- 8475813
TI  - Titanium Riechert head ring for MR stereotaxy. Technical note.
AB  - Magnetic Resonance has become the preferred neuro-imaging modality. To fully take
      advantage of the high anatomical resolution the Riechert stereotactic system was
      adapted for use in Magnetic Resonance Stereotaxy. The head ring which until
      recently was made of an aluminum alloy has been replaced by an unsegmented head
      ring of pure titanium without changing the dimensions and fixation mode. No
      significant misregistration due to eddy currents has been noticed. Minor
      distortion induced by the titanium head ring can be corrected mathematically.
      Thus the geometric information is limited only by the pixel resolution of the MR
      image.

PMID- 8475812
TI  - Degenerative changes in the internal elastic lamina relating to the development
      of saccular cerebral aneurysms in rats.
AB  - In order to investigate the developmental mechanism of saccular cerebral
      aneurysms, changes in the internal elastic lamina at the junction of the anterior
      cerebral artery and the olfactory artery were electronmicroscopically studied in
      6 control and 6 experimental rats undergoing ligation of the left carotid artery
      and branches of both renal arteries. In the control group, spontaneous
      destructive changes occurred on the luminal side of the internal elastic lamina
      and progressed from the luminal towards the abluminal side as the elastic lamina
      advanced to the apex. Close to the apex, these changes invaded and disrupted the
      whole elastic lamina. The elastic lamina was replaced by sparsely lined up lumps
      of elastic tissue in the walls of early aneurysmal alterations, and was atrophied
      and disappeared totally in the walls of aneurysmal alterations that had reached
      an advanced stage. These spontaneous changes were in agreement with reports in
      the literature and our own previous investigations. From the findings in the
      experimental rats it becomes likely that the aneurysmal changes in the elastic
      lamina are exaggerated forms of the normal catabolic metabolism. Therefore its
      synthesis on the abluminal side no longer balances with the catabolism on the
      luminal side. It is strongly suggested that aneurysmal alterations progress from
      the luminal towards the abluminal side of arterial walls and that the lytic
      process of elastase might play a role in the degenerative changes in aneurysmal
      development.

PMID- 8475814
TI  - A ruler for depth measurements during stereotactic operations. A technical note.

PMID- 8475815
TI  - Lipoma of the cerebral cortex: case report.
AB  - The first clinically diagnosed and successfully operated case of a symptomatic
      lipoma involving the cerebral cortex is reported. The patient presented with
      severe headaches and recurring focal seizures with secondary generalization.
      Computer tomography scan and magnetic resonance imaging suggested a left
      frontoparietal lipoma. After undergoing a craniotomy and tumor excision, the
      patient has shown resolution of headaches and seizures at 1-year follow-up.
      Lipomas of the cerebral cortex should be excised if symptomatic and accessible.

PMID- 8475817
TI  - [Variables associated with psychosocial adaptation of chronic renal patients
      undergoing treatment].
AB  - 101 patients being treated for end-stage renal failure were studied in order to
      get the variables that are involved with psychosocial adaptation. Stepwise
      logistic regression analysis was made using the psychosocial adaptation as a
      dependent variable, determined by the Axis V of the D.S.M-III. 40 patients were
      found socially-adapted and 61 were not. Nine variables were related with the
      psychosocial adaptation: marital status, religious belief, education level,
      occupation, means of transportation to get to the treatment center, self-image
      before the sickness, C factor of 16 PF, the age and the evaluation of treatment
      by the patient. From the statistical analysis and from the interpretation of
      sings and values of the related variables, the influence of them on the
      psychosocial adaptation was demonstrated.

PMID- 8475816
TI  - Randomized placebo-controlled trial of single-dose antibiotic prophylaxis with
      fusidic acid in neurosurgery.
AB  - In neurosurgery, the antibiotic prophylaxis of choice has not yet been
      determined. The ideal drug should have an appropriate antimicrobial spectrum and
      favourable pharmacokinetic properties. In addition it should be nontoxic and easy
      to apply. We therefore conducted in 90 patients a prospective, randomized,
      placebo-controlled, double-blind trial in clean neurosurgery at increased risk of
      wound infection using a single pre-operative dose of 500 mg fusidic acid. Fusidic
      acid is a steroid-like antibiotic with a serum half-life of about 10 hours and
      excellent activity against gram-positive bacteria, including methicillin
      resistant staphylococci. The neurosurgical infection rates for craniotomies,
      posterior fossa surgery and implantation of foreign bodies were 2.4% in the
      treatment group and 9.1% in the placebo group, respectively. This difference is
      statistically significant at a 95% confidence level.

PMID- 8475818
TI  - [Temporal stability of the anelasticoendosthymia index].
AB  - The authors have researched the test-retest reliability for the
      Anelasticoendosthenia Index. Data show good correlations. The agreement for two
      evaluations (Kw = 0.89) and the success probability in 2nd evaluation respect
      first one (mu = 0.98) are good.

PMID- 8475819
TI  - [An electromagnetic problem].
AB  - Induced psychotic disorder in infrequent. We report a case in which four members
      of the same family were affected. The bibliography is reviewed and certain
      etiological factors implicated in our case are discussed.

PMID- 8475820
TI  - [The Short-Form impairment index (SFII) in schizophrenic patients].
AB  - The SFII (Short-Form Impairment Index, Horton and cols, 1986) was used to assess
      cognitive impairment in patients with DSM-III-R diagnosis of schizophrenia and
      its relationship to the positive and negative schizophrenic symptoms was studied.
      Two samples of DSM-III-R schizophrenic patients were studied. The first sample
      was composed of 30 consecutively inpatients admitted by recrudescence of their
      symptoms. The second was composed of 19 patients that were attending to a Day
      Psychiatric Hospital by recrudescence of their symptoms or by socio-familiar
      dysfunctions. The SFII included three subtest: the "Trail Making" Form B, and
      cubes and digit symbol from the WAIS, that were converted to typical scores
      adjusted to age (Reitan, 1973). The positive and negative schizophrenic symptoms
      were assessed by the Andreasen scales (SAPS y SANS). No differences in
      epidemiological variables were found between both samples. Higher cognitive
      impairment (lower SFII) and higher negative symptoms were significantly
      correlated in both samples. This result suggests that the SFII could be a good
      marker of cognitive functioning in schizophrenic patients in postacute samples
      and also in mixed schizophrenic patients (acute and defectual population). The
      SFII presented some limitations in our young samples derived from their age
      corrected values.

PMID- 8475821
TI  - [Rheumatoid arthritis: various psychosomatic aspects].
AB  - The rheumatoid arthritis has been considered as a model for the psychosomatic
      approach in Medicine. The authors present a research in this perspective, trying
      to evaluate some psychological variables using appropriated rating scales: the
      self concept, the coping mechanisms and some symptoms like anxiety and
      depression. A group of diabetics insulin-dependents was the control group.

PMID- 8475822
TI  - [Extracellular matrix in the sclera].

PMID- 8475823
TI  - [Cytotoxic effects of diclofenac sodium].
AB  - The authors studied the cytotoxic effect of diclofenac sodium, a prostaglandin
      synthetic inhibitor, on Chang's cultured human conjunctival cells. Diclofenac
      sodium inhibited cell growth dose-dependently. Although cell growth was
      interrupted 12 hrs later by one minute of exposure to a 0.1% solution of
      diclofenac sodium, the cells began to grow again 24 hrs later. Twenty-four hours
      later, a one-minute exposure to a 0.1% solution of diclofenac sodium revealed no
      cytotoxic effects electron microscopically. The effect on the cell cycle of
      exposure to 0.1% diclofenac sodium was studied using a flow cytometer. Twelve
      hours after exposure to diclofenac sodium, DNA histograms showed a broader G1
      peak, and increase in mitotic phase cells and dead cells with a low DNA content
      on the left of the G1 peak. 24 hrs later, the number of dead cells and DNA
      synthetic phase cells increased and mitotic cells gradually decreased, almost
      disappearing within 48 hrs.

PMID- 8475824
TI  - [Passive length-tension curves of extraocular muscles after botulinum toxin
      injection].
AB  - Botulinum A toxin was injected into the superior rectus muscles of albino
      rabbits. Length-tension curves of detached superior rectus muscles were
      continuously measured with a length and tension measuring device developed by the
      author. The device consists of a strain gauge for measuring passive length
      tension, and a position encoder equipped with an eddy current motor. The passive
      load of the muscle injected with Botulinum A toxin was significantly less than
      that of control muscle a week after the injection, however, it was greater than
      that of control muscle in 2 or 3 weeks after the injection. The compliance of the
      treated muscle was significantly less than that of control muscle at 3 weeks
      after the injection.

PMID- 8475825
TI  - [Induction of prostaglandin E2 by interleukin 1 in human lens epithelial cells].
AB  - The authors proposed the hypothesis that pseudophakic inflammation, including the
      fibrin reaction, may be caused by interleukin (IL)-1, IL-6, other cytokines
      and/or prostaglandins (PGs), synthesized by residual lens epithelial cells (LEC).
      In testing our hypothesis, we have already detected IL-1 alpha, IL-6 and PGE2 in
      the culture media of human LEC obtained by capsulotomy during cataract surgery.
      In this paper, we studied the time course of PGE2-synthesis and interaction
      between IL-1 and PGE2. PGE2 concentration was measured by radioimmunoassay in the
      culture media to which rabbit antihuman IL-1 polyclonal antibody was added after
      culture for 6 h, 1 day, 1, 2, 3, 4, 5 and 6 weeks. There was no increase of PGE2,
      whereas in the untreated control culture media significant increase of PGE2 was
      confirmed. The results show that the antihuman IL-1 polyclonal antibody
      suppressed PGE2-synthesis. Thus, IL-1 induces PGE2 synthesis in human LEC
      culture.

PMID- 8475826
TI  - [Adrenergic influence on the outflow facility and the ciliary muscle of
      enucleated bovine eyes].
AB  - In an effort to understand the aqueous outflow mechanism, the author compared
      changes in the outflow facility with the response of ciliary muscle, using fresh
      bovine eyes. Neither epinephrine nor isoproterenol alone increased the outflow
      facility, regardless of their concentrations. However, theophylline, caffeine,
      isobutylmethylxanthine (IBMX), and other phosphodiesterase (PDE) inhibitors,
      increased facility in a dose-dependent manner. Epinephrine alone neither relaxed
      the tone nor inhibited the nerve-mediated contraction of bovine ciliary muscle.
      Theophylline and IBMX relaxed the tone and inhibited the nerve-mediated
      contraction, whereas N-ethylmaleimide, iodoacetamide and iodoacetic acid also
      inhibited the nerve-mediated contraction, and elevated the tone of the ciliary
      muscle. All PDE inhibitors tested increased the outflow facility and inhibited
      the nerve-mediated contractions of the ciliary muscle, however, the effect of
      such drugs on the ciliary muscle tone varied. These results suggest that PDE
      inhibition may increase the conventional outflow of aqueous humor. PDE inhibitors
      has much greater influence on and around the outflow channels, from the viewpoint
      of change of outflow facility and ciliary muscle contraction.

PMID- 8475827
TI  - [Participation of non-major histocompatibility complex gene in experimental
      autoimmune uveitis].
AB  - It is known that the susceptibility of experimental autoimmune uveitis (EAU) is
      controlled by both major histocompatibility antigen complex (MHC) and non-MHC
      genes. In this report, we studied the role of non-MHC gene in the induction of
      EAU. LEW, WKAH, (LEW x WKAH) F1 and (LEW x WKAH) F2 rats were examined for their
      incidence and severity to develop EAU by immunization with bovine S-antigen (S
      Ag). We found that all LEW rats developed severe EAU within 2 weeks after
      immunization, but no WKAH rat did. Most F1 rats developed mild inflammation in 3
      4 weeks after immunization. A quarter of F2 rats developed EAU within 2 weeks,
      half of them developed it in 3-6 weeks after immunization, and the others did
      not. These findings suggest that only one non-MHC gene controls the
      susceptibility to S-Ag induced EAU in rats.

PMID- 8475828
TI  - [Analysis of blood flow velocity of ophthalmic artery with color Doppler imaging.
      1. Studies on normal human eyes].
AB  - Color Doppler imaging was used to analyze the blood flow velocity of the
      ophthalmic artery (BVA) by measuring the pulse wave of flow velocity in the
      ophthalmic artery of normal subjects. Maximum systolic BVA (Vmax), minimum end
      diastolic BVA (Vmin), time-averaged BVA (Vmean), Pourcelot index (RI) and
      pulsatility index (PI) were determined using color Doppler imaging. The
      coefficients of reproducibility of Vmax, Vmin, Vmean, RI and PI were 10%, 9%,
      15%, 4% and 14%, respectively, when analyzed twice at one-hour intervals. There
      was no significant difference between the values of the right eye and that of the
      left eye in each case. The averages of Vmax, Vmin, Vmean, RI and PI of 33 normal
      eyes were 25.4 +/- 7.6 cm/sec, 6.3 +/- 2.3 cm/sec 16.7 +/- 6.6 cm/sec, 0.75 +/-
      0.052, 1.19 +/- 0.25 (mean +/- S.D.), respectively, Vmax, Vmin and Vmean
      decreased significantly with age (Vmax:linear correlation coefficient r = -0.65,
      p < 0.001; Vmin: r = -0.61, p < 0.001, r = -0.64, p < 0.001. RI did not change
      with age. PI increased significantly with age (r = 0.30, p < 0.05).

PMID- 8475829
TI  - [Effects of intraocular pressure on the optic nerve head in albino rabbits].
AB  - The effects of intraocular pressure (IOP) on the blood flow in the laminar
      portion of the optic nerve head in adult albino rabbits were investigated
      employing the hydrogen clearance method. The blood flow volume at the normal IOP
      level of 15 mmHg was 119.0 +/- 25.0 ml/min/100 g (mean +/- S.D.). When the IOP
      was raised every 30 minutes from 5 mmHg to 15, 25, 35, 45 and 55 mmHg in a
      stepwise fashion, the mean blood flow volume at 5 mmHg was almost the same as the
      volume at 15 mmHg, but a significant linear decrease was observed at 35 mmHg or
      more. The decreased blood flow returned to the initial level when the raised IOP
      was restored to normal. When the IOP was raised to 55 mmHg, the optic nerve
      potential (ONP) amplitude decreased and the peak latency became gradually
      prolonged with time, and finally the ONP became almost impossible to measure
      after 30 minutes, before remarkable changes were noted on the electroretinogram.
      However, quick recovery of the ONP was recognized within 5 minutes after
      returning to a normal IOP level of 15 mmHg. These findings indicate that vascular
      changes might have an important effect on the optic nerve head function or action
      potential.

PMID- 8475830
TI  - [Spectral sensitivities on monochromatic backgrounds].
AB  - The spectral sensitivities of cone mechanisms were measured on monochromatic
      backgrounds and the results were compared with the Stiles II-mechanism. Narrow
      band interference filters with dominant wavelengths of 430 nm and 700 nm were
      used for background light. The pattern of the spectral sensitivity curve on a 430
      nm background with a retinal illuminance of 530 photopic trolands was similar to
      that of the Stiles II 5-mechanism (long wavelength-sensitive cones). The pattern
      of the spectral sensitivity curve on a 700 nm background with a retinal
      illuminance of 530 photopic trolands showed two peaks. The peak in the short
      wavelength region coincided with that of the short wavelength-sensitive cones and
      the peak in the middle and long wavelength regions coincided with the Stiles II 4
      mechanism (middle wavelength-sensitive cones). As a result, it was suggested that
      this method is useful to investigate color information processing in both normal
      and color-defective observers.

PMID- 8475831
TI  - [Potential laser hazards to bystanders during photocoagulation].
AB  - The authors measured reflected laser beams delivered by slit-lamp photocoagulator
      and binocular indirect ophthalmoscope laser delivery systems, to evaluate
      potential hazards to the eyes of bystanders. 514 nm laser beams were used;
      reflected laser beams were measured by a light power meter (Advantest: TQ8210).
      Reflected lasers were found to be hazardous at 1 meter from whitish tile when a
      0.75 Watt laser beam was delivered by the binocular ophthalmoscope laser system,
      as in an operating room. At 1 meter from a wall in a photo-coagulating room for
      out-patients, the reflected laser beam was found to be well below hazardous
      levels. Reflections at 40 cm from a non-laser-coated Goldmann 3-mirror contact
      lens were 2.66 mW/cm2, which exceeds the exposure limits, when 0.3 W laser was
      delivered by the slit-lamp photocoagulator. This decreased 85-90% when the laser
      was reflected from a laser-coated lens. From the point of view of safety, it is
      recommended that laser surgeons replace non-laser-coated lenses with laser-coated
      ones.

PMID- 8475832
TI  - [Histopathology of corneal plaque in vernal keratoconjunctivitis].
AB  - The author reported 2 cases of vernal keratoconjunctivitis with corneal plaque
      showing a white board-like appearance. Conventional medications were not
      effective in both cases and during the course of the disease corneal ulcer
      developed followed by formation of corneal plaque. After the plaque spontaneously
      peeled off, or were surgically removed, the ulcers of both cases healed. The
      histological specimens from the 2 cases were examined by light and electron
      microscopy. The plaques showed lamellae-like structures, and formed alternate
      accumulation of hyaline-like material and another amorphous material. No cell
      components, such as corneal epithelial cells, keratocytes, or fibroblasts, were
      found either on the surface of and within the plaques. The corneal epithelial
      cells and/or eosinophils, however, were found at the edge of the plaque. These
      findings may suggest that these corneal plaques were formed by repeated episodes
      of deposition and that corneal epithelial cells and eosinophils may have been
      involved.

PMID- 8475833
TI  - [Perimetric glare test and evaluation of intraocular lenses].
AB  - Twelve normal control phakic eyes together with a number of other pseudophakic
      groups each consisting of 6 eyes were enrolled in this study of spatial and
      quantitative measurement of glare disabilities in the static visual field
      (Perimetric Glare Test) using an OCTOPUS 500E automated perimeter with an
      attached glare source. These groups were a 6 mm no hole lens group, a 6 mm 4 hole
      lens group, a 5.5 x 6.5 mm 2 hole lens group, a 5.0 x 6.0 mm no hole lens group
      and a diffractive multifocal group. Glare disabilities in the visual field were
      minimum in the control group. The 6 mm no hole lens group and the diffractive
      multifocal group showed no statistical significance compared the control group.
      Groups with the two types of ovoid lens and the 6 mm 4 hole lens group showed a
      statistically higher degree and a greater extent of glare disabilities in the
      static visual field than the control group. Careful selection of appropriate
      patients to receive implants of small efficient optic IOLs, such as IOLs with
      positioning holes and ovoid lenses, according to the preoperative pupil size
      under scotopic or mesopic condition and efficient lens optic size are important
      in order to reduce hole and edge glare. The diffractive multifocal IOLs group
      showed a slightly higher degree and a greater extent of glare than the control
      group and the 6 mm no hole monofocal lens group but the difference was very small
      and statistically insignificant. Therefore the effects of diffractive
      microstructure on glare disabilities were considered to be slight and clinically
      acceptable.

PMID- 8475834
TI  - [Analysis of the effect of PC-IOL implantation on intraocular pressure control in
      glaucoma eyes using the life-table method].
AB  - Cataract extraction and posterior chamber intraocular lens (PC-IOL) implantation
      were carried out in 21 primary angle glaucoma (POAG) and 26 primary angle closure
      glaucoma (PACG) eyes in which preoperative intraocular pressure (IOP) was well
      controlled with medication. The postoperative IOP on the first postoperative day
      was significantly higher than the preoperative level in POAG eyes, while no
      significant difference was seen in PACG eyes. The postoperative IOP was
      significantly lower than the preoperative level at 3 and 6 months postoperatively
      in POAG eyes and at 1-12 months postoperatively in PACG eyes. Medication did not
      differ significantly pre- and postoperatively. In 64 +/- 11% (SE) of POAG and 63
      +/- 15% of PACG the status of IOP control did not worsen at 2 years. Overall, 70%
      of the eyes the status of IOP control improved postoperatively, and this was
      maintained for 2 years in 44 +/- 12%. The present result implies that in primary
      glaucoma, PC-IOL implantation surgery does not need to be combined with glaucoma
      surgeries when the IOP was satisfactory controlled and the stage of disease was
      not advanced.

PMID- 8475835
TI  - [Glaucoma-like disc without increased intraocular pressure or visual field loss
      and early stage normal-tension glaucoma disc].
AB  - The optic disc topography of 11 eyes of 11 glaucoma-like discs without increased
      intraocular pressure or visual field loss was compared with that of 11 eyes of 11
      relative early stage normal-tension glaucomas. There were no statistically
      significant differences between the two groups in terms of optic disc parameters
      measured with a Rodenstock Optic Nerve Head Analyzer Plus, except that the
      inferior quadrant of the neuroretinal rim area of the normal-tension glaucoma
      discs was significantly smaller than that of the glaucoma-like discs. Also, in
      the Humphrey automated visual field, only the superior part of the Total
      Deviation score of normal-tension glaucoma eyes corresponding to the inferior
      disc changes was significantly lower than that of glaucoma-like discs. When the
      data of the two groups were pooled, the inferior quadrant of the neuroretinal rim
      area significantly correlated with the visual field loss in the group of eyes
      with a rim area smaller than 0.198 mm2. These results seem to suggest that some
      of the glaucoma-like discs might be early normal-tension glaucoma.

PMID- 8475836
TI  - [Clinical evaluation of UF-021 ophthalmic solution in glaucoma patients
      refractory to maximum tolerable therapy].
AB  - UF-021 ophthalmic solution, a novel prostaglandin-related therapeutic agent for
      glaucoma, was additionally applied to the eyes in intractable cases of primary
      open angle glaucoma (14 cases, 21 eyes) and ocular hypertension (1 case, 2 eyes)
      in which intraocular pressure (IOP) had not been kept under satisfactory control
      even with combined drug therapy by conventional, existing anti-glaucoma agents
      including sympathetic beta-blockers. Decrease of IOP by UF-021 ophthalmic
      solution (0.12%) in the treated eyes was observed from not less than one month
      after the initial application by 3 mmHg and more in about 85%, and by 5 mmHg and
      more in about 76% of the enrolled patients, respectively. The IOP reduction
      induced by the additional application of UF-021 was sustained for more than 6
      months, resulting in successful avoidance of surgical operations in many
      patients. When UF-021 ophthalmic solution was applied concurrently with various
      anti-glaucoma agents including carbonic anhydrase inhibitors, it caused no
      controversial side-effects and yielded therapeutic efficacy for a prolonged
      period. These findings suggest that UF-021 can yield IOP-reducing activity
      through a novel pharmacological mechanism different from other existing drugs. In
      conclusion, UF-021 ophthalmic solution is extremely useful for the treatment of
      glaucoma.

PMID- 8475837
TI  - [A five-year follow-up of the effect of postoperative 5-fluorouracil
      subconjunctival injections on the surgical outcome of trabeculectomy].
AB  - The effects of postoperative subconjunctival 5-fluorouracil (5-FU) injections on
      the surgical outcomes of trabeculectomy were studied after a 5-year follow-up in
      263 eyes of glaucoma patients by the life table analysis. The success probability
      (%) to maintain the postoperative intraocular pressure (IOP) less than 21 mmHg
      without medication was 58.2 for primary open angle glaucoma (POAG), 54.8 for
      secondary glaucoma (SG) and 27.8 for refractory glaucoma, that with or without
      medication was 92.5 for POAG, 87.4 for SG and 57.5 for refractory glaucoma. The
      success probability (%) to maintain the postoperative IOP less than 16 mmHg
      without medication was 55.2 for POAG, 49.8 for SG and 24.5 for refractory
      glaucoma, that with or without medication was 77.9 for POAG, 66.8 for SG and 26.9
      for refractory glaucoma. In each type of glaucoma, the difference between the 5
      FU treated and the control groups was highly significant (p < 0.01 or less, log
      rank test). Corneal epithelial defect was noted in 38.8%, but no late
      complications, for example, perforation or necrosis of sclera, were observed.
      These results indicate that we can use postoperative subconjunctival 5-FU without
      risk of serious complications.

PMID- 8475838
TI  - [The sub-classification of pre-proliferative diabetic retinopathy].
AB  - The authors divided 155 eyes (106 cases) affected by pre-proliferative diabetic
      retinopathy into three sub-groups according to the severity of retinopathy and
      followed them for one year. The criteria for and numbers of eyes in each group
      were as follows; 1) mild type with soft exudate and without apparent non-perfused
      areas on fluorescein angiography (39 eyes). 2) moderate type with soft exudate
      and demonstrable non-perfused areas (103 eyes). 3) severe type with soft
      exudates, non-perfused areas and venous beading (13 eyes). The proportion
      undergoing photocoagulation was 23% in the mild type, 81% in the moderate type
      and 100% in the severe type. None of the eyes in the mild type underwent
      photocoagulation unless they advanced to a more severe type. Nine eyes of the
      mild type which progressed to moderate type during the follow-up period underwent
      focal photocoagulation. Panretinal photocoagulation was performed in 29% of
      moderate type eyes and 77% of severe type eyes. The courses of these three sub
      groups were analyzed after one year of follow up. The proportion developing
      proliferative retinopathy was 0% in mild type, 17% in moderate type and 46% in
      severe type. Based on the above results, we conclude that the sub-classification
      we propose in this paper can be applied in managing patients with pre
      proliferative diabetic retinopathy.

PMID- 8475839
TI  - [Proteoglycan abnormality in a nanophthalmos sclera].
AB  - We examined a scleral specimen obtained from a nanophthalmos eye with uveal
      effusion at the surgery, using cuprolinic blue (CB) dye binding and electron
      microscopy. The nanophthalmic sclera was separated into two areas electron
      microscopically. One was an area composed of tightly packed collagen fibers, the
      other with irregularly arranged collagen fibers. In irregular areas, several
      abnormal findings, such as twisting or fraying, were detected in collagen fibers,
      which were surrounded by fine fibrous materials. Furthermore, CB-positive
      materials were fewer in number and less in size and electron density around the
      collagen fibers and in fine fibrous materials than in the normal eye. Since the
      nanophthalmic sclera in this study showed some abnormalities both in collagen
      fibers and in proteoglycans, we suggest that the function and/or interaction of
      both of these were abnormal, which might be related to the onset of uveal
      effusion.

PMID- 8475840
TI  - [Histological observations on the sclera in uveal effusion].
AB  - The author performed sclerectomy in six cases of uveal effusion syndrome and
      examined the excised sclera histologically. From the findings of the sclera
      during the surgery and histological findings of the excised sclera, uveal
      effusion syndrome was divided into three groups: 1) nanophthalmos, 2) non
      nanophthalmos with hypertrophic sclera, 3) non-nanophthalmos with normal thick
      sclera. In all cases, glycosaminoglycans were found to be deposited around the
      scleral collagen fibers. In the nanophthalmic eyes (group 1) and non
      nanophthalmic eyes with the hypertrophic sclera (group 2), much
      glycosaminoglycans were demonstrated around the collagen bundles and enlarged the
      collagen bundle spaces. In these groups, sclerectomy procedures were successful
      and, based on the successful result of the operation, the cause of uveal effusion
      was considered to be disturbance of outflow of intraocular fluid through the
      hypertrophic sclera. In non-nanophthalmic eyes with normal thick sclera (group
      3), few glycosaminoglycans was demonstrated around the collagen bundles with less
      abnormality, and sclerectomy procedure was not effective. In this group, the
      occurrence of uveal effusion was another cause but abnormal sclera.

PMID- 8475841
TI  - [A case of benign epithelioma of the ciliary body].
AB  - A 34-year-old woman showed a partially pigmented, greyish-white mass at a
      position of 1 o'clock behind the iris of her left eye. The lens equator was
      compressed and focal opacity had developed. The adjacent ciliary processes and
      zonules were intact. Photocoagulation was not effective and dense cataract
      gradually developed, so we performed extracapsular cataract extraction and
      partial iridocyclectomy. The tumor was nonencapsulated, nodular and myxomatous in
      appearance, arising from the pars plicata. Histological examinations revealed
      that the tumor was composed of nonpigmented cells and a small number of pigmented
      cell clusters. The cells were arranged like cords or gland-like structure with
      intervening myxomatous, fibrillar, and partially hyalinous interstitium. There
      was no finding of malignancy. The tumor showed similar microscopic structure and
      findings of mucous stains of normal ciliary nonpigmented epithelium and internal
      basement membrane, so a diagnosis of benign epithelioma was made.

PMID- 8475842
TI  - Mepron for AIDS-related pneumonia.

PMID- 8475843
TI  - Dispensing biotechnology products.

PMID- 8475844
TI  - What is UNIX?

PMID- 8475845
TI  - A practical billing and payment plan for cognitive services.

PMID- 8475846
TI  - Dealing with stress on the job.
AB  - Pharmacists are urged to take an important first step toward effective stress
      management by considering five questions: How do you know if stress is a problem
      for you? What is causing most of your stress? Is your supervisor aware of the
      problem? How do you deal with stress? What can you do to reduce the impact of
      stress? Because uncontrolled job stress has been associated with serious negative
      consequences, pharmacists owe it to themselves to explore strategies that they
      can use to manage stress in their lives.

PMID- 8475847
TI  - Can a community pharmacist add value to prescriptions?

PMID- 8475848
TI  - Consumers' evaluation of value-added pharmacy services.
AB  - One proposal for community pharmacies to survive in an increasingly competitive
      market is to offer services that consumers want and need. This study examined the
      effects of such a value-added pharmacy services (VAPS) program implemented at 19
      experimental pharmacies; another 16 pharmacies served as a control group. The
      study found that patrons of VAPS pharmacies received more pharmacy services and
      were more likely to report that the pharmacist talked to them about their
      medication than patrons of control pharmacies. This study demonstrates that a
      value-added services program can have an impact on pharmaceutical services.

PMID- 8475849
TI  - OBRA '90: turning a challenge into an opportunity.

PMID- 8475850
TI  - Antiacne products--no benzoyl peroxide.

PMID- 8475851
TI  - On-line continuing education.

PMID- 8475852
TI  - Getting information about biotechnology products.

PMID- 8475853
TI  - New drugs of 1992.

PMID- 8475854
TI  - FDA OTC advisory group needs practitioners.

PMID- 8475855
TI  - How to communicate with physicians.

PMID- 8475856
TI  - Improving your patient counseling skills.
AB  - This article has offered several suggestions to help begin the process of
      improving patient counseling skills. Recommendations for changing how to think
      about patient communication and for developing new communication skills were
      discussed. It would be comforting if the idea of improved patient counseling
      could be packaged in an easy-to-learn, three-step program. It would be convenient
      if learning patient counseling skills could be achieved by simply attending a
      lecture or reading an article. Programs and articles are good starting points,
      but improving patient counseling skills requires a good deal of motivation,
      knowledge, and practice. My sense from the feedback I have received, after
      working with pharmacy students and practitioners for almost 15 years, is that
      those prepared to commit themselves to a program of improvement have benefited
      personally and professionally. How quickly they developed their skills has
      varied, and the degree of effectiveness among them may be somewhat different;
      however, the ultimate issue is that they all were able to improve.

PMID- 8475857
TI  - Ethical decision making in pharmacy practice.

PMID- 8475858
TI  - PMA survey cites advances in AIDS research.

PMID- 8475859
TI  - Legislation needed for chains to change.

PMID- 8475860
TI  - Dose-related efficacy and bleeding complications of double-chain tissue
      plasminogen activator in acute myocardial infarction. The Wellcome Tissue
      Plasminogen Activator Study Group.
AB  - Although the efficacy of recombinant tissue-type plasminogen activator (rt-PA) in
      acute myocardial infarction has been demonstrated, little formal dose-ranging
      information is available. This study examined the use of duteplase, the double
      chain rt-PA subsequently used in the Third International Study of Infarct
      Survival, in a multicenter trial of 267 patients with evolving acute myocardial
      infarction assigned to receive 1 of 6 weight-adjusted doses. The primary end
      point was infarct vessel patency after 90 minutes of drug infusion. Patency was
      defined as Thrombolysis in Myocardial Infarction trial grade 2 or 3 perfusion,
      and was determined by an independent core laboratory masked to treatment
      assignment. Patency was present in 48% of patients receiving the lowest dose
      range and 78% of those receiving the highest, with an association between
      thrombolytic dose and patency (p = 0.009). The frequency of serious bleeding
      complications also correlated with the total dose of rt-PA infused (p = 0.003).
      Bleeding complications were primarily related to instrumentation; blood loss
      requiring transfusion or otherwise deemed clinically significant occurred in 12%
      of patients (central nervous system hemorrhage occurred in 1.1%). Thus, higher
      doses of rt-PA are associated both with increased efficacy and increased risk of
      serious bleeding complications. Weight-adjusted dosing may provide an optimal
      risk-benefit ratio for thrombolysis during acute myocardial infarction.

PMID- 8475861
TI  - Influence of reperfusion induced by thrombolytic treatment on natural history of
      left ventricular regional wall motion abnormality in acute myocardial infarction.
AB  - Although several studies have investigated left ventricular (LV) function after
      reperfusion interventions, it is still unclear whether benefits result from
      successful therapy or whether such benefits only reflect the natural history of a
      subgroup of patients with acute myocardial infarction (AMI). This study evaluates
      the unique effect of thrombolytic therapy on the natural history of regional LV
      wall motion dysfunction. One hundred seventy-six patients with AMI were studied:
      82 patients (group A) underwent conventional treatment and 94 (group B)
      thrombolytic therapy. LV regional improvement, evaluated by changes in echo score
      between admission and predischarge examination, was present more frequently in
      group B (28%) than in group A (17%). Furthermore, improved patients in group B
      had higher admission echo scores (7.5 +/- 3.5 vs 6.3 +/- 3.1), a prevalence of
      anterior AMI (68 vs 30.1%) and a higher rate of coronary patency (92 vs 58% in
      patients who had no improvement). In group A patients the rate of coronary
      patency was similar in those who did (46.1%) and did not have (36.1%)
      improvement. Observations at 12 to 18 months showed similar data in group A
      patients and in group B patients without improvement, whereas a marginal
      additional improvement was observed in group B patients who had in-hospital
      improvement. These observations demonstrate that LV function recovery is more
      frequent and marked in treated than in untreated patients. Follow-up results
      suggest a prolonged beneficial effect of thrombolytic treatment on LV function.
      The highest rate of coronary patency in improved group B patients underline the
      role of reperfusion on natural history of LV dysfunction after AMI.

PMID- 8475862
TI  - Occurrence of hypotension during streptokinase infusion in suspected acute
      myocardial infarction, and its relation to prognosis and metoprolol therapy.
AB  - In all patients who received streptokinase infusion for strongly suspected acute
      myocardial infarction in 1 hospital during 1989 to 1990, the occurrence of
      hypotension during infusion is described and related to prognosis. In 54% of
      patients, the beta blocker metoprolol was simultaneously administered
      intravenously. The median systolic blood pressure (BP) before infusion was 135 mm
      Hg, and the median value for the lowest systolic BP recorded during infusion was
      100 mm Hg (p < 0.001). A positive correlation between systolic BP before
      streptokinase and the lowest systolic BP during infusion was found (r = 0.53; p <
      0.001). Among patients administered streptokinase and metoprolol, 23% had
      systolic BP < 90 mm Hg, and 12% had < 80 mm Hg at any time during infusion;
      corresponding values for patients administered streptokinase only were 47 and
      30%, respectively. Patients with the lowest systolic BP < 80 mm Hg during
      infusion had a mortality during the first 2 weeks of 22 vs 11% for those with
      between 80 and 100 mm Hg, and 8% for those with > 100 mm Hg (p < 0.001). However,
      in a multivariate analysis the systolic BP before infusion rather than the lowest
      systolic BP during infusion was independently associated with death. It is
      concluded that although patients with low systolic BP during streptokinase
      infusion have a high mortality, the level of systolic BP before infusion is more
      strongly associated with the outcome. Simultaneous use of intravenous beta
      blockade does not increase the occurrence of hypotension during streptokinase
      infusion.

PMID- 8475863
TI  - Mechanism and significance of precordial ST-segment depression during inferior
      wall acute myocardial infarction associated with severe narrowing of the dominant
      right coronary artery.
AB  - The mechanism and significance of precordial ST depression during inferior wall
      acute myocardial infarction (AMI) is debated. This study assessed the location
      and extent of arterial perfusion distribution responsible for this
      electrocardiographic finding. Intracoronary thallium-201 was injected in 11
      patients with 1-vessel right coronary disease to delineate perfusion distribution
      that was quantitated by a new angiographic distribution score. The angiographic
      score correlated with posterior (r = 0.84), posterolateral (r = 0.88) and total
      (r = 0.73) extent of intracoronary thallium distribution. The angiographic
      distribution score was related to electrocardiographic changes in 16 patients
      showing an inferior ST-segment elevation during angioplasty (7 with and 9 without
      precordial ST depression), of which 6 received intracoronary thallium injection.
      None had thallium distribution in the anterior or septal segment, but there was a
      trend toward a greater angiographic distribution score and posterior segment
      thallium score in patients with precordial ST depression. In another 77 patients
      with inferior wall AMI due to right coronary occlusion (24 with concomitant left
      anterior descending narrowing), precordial ST depression was present in 16 with
      and 31 without left anterior descending narrowing (p = NS). The angiographic
      distribution score was higher in those with than without precordial ST depression
      (0.59 +/- 0.10 vs 0.44 +/- 0.11, p < 0.001) in both patients with and without
      left anterior descending disease. The magnitude of both inferior ST elevation and
      precordial ST depression correlated with the angiographic distribution score, but
      only precordial ST depression was independently related in multivariate
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475864
TI  - Comparison of long-term outcome after acute myocardial infarction in patients
      never graduated from high school with that in more educated patients. Multicenter
      Investigation of the Limitation of Infarct Size (MILIS).
AB  - The clinical course of 363 patients with acute myocardial infarction who did not
      complete high school education was compared with that of 453 who completed at
      least high school. Both the in-hospital and 4-year mortality rates were markedly
      greater for the less educated than for the more educated patients (13 vs 5% [p <
      0.001], and 36 vs 17% [p < 0.001]). Adverse baseline characteristics were
      partially responsible for the increased in-hospital (p = 0.059 after adjustment)
      and long-term (p = 0.024 after adjustment) mortality. The less educated patients
      were not as likely to quit smoking after acute myocardial infarction as were the
      more educated ones (38 vs 49%; p < 0.05). Patients who continued smoking had a
      greater mortality than did those who quit (24 vs 15% [p < 0.05] for less
      educated, and 10 vs 4% [p < 0.05] for better educated). Therefore, greater effort
      should be directed to smoking cessation among the high-risk group of less
      educated patients. However, the smoking continuation was responsible for only a
      small portion of the mortality difference, suggesting unidentified causes of
      mortality, such as lack of compliance with therapy and possible social isolation.
      Despite the high-risk status of the less educated patients, cardiac
      catheterization tended not to be performed as frequently as in the more educated
      patients after discharge from the hospital (16 vs 21%; p < 0.06 at 6 months).

PMID- 8475865
TI  - Comparison of magnetic resonance imaging studies with enzymatic indexes of
      myocardial necrosis for quantification of myocardial infarct size.
AB  - To evaluate the potential of gadolinium-diethylene triamine pentaacetic acid
      (DTPA)-enhanced magnetic resonance imaging (MRI) in the quantification of infarct
      size in patients with a first acute myocardial infarction, 24 patients with a
      first acute myocardial infarction were studied by electrocardiographic gated MRI
      at a mean of 4.3 days after the acute event. Multislice, single-phase, T1
      weighted, spin-echo MRI in the true short-axis plane was performed 20 minutes
      after intravenous injection of gadolinium-DTPA (0.15 mmol/kg of body weight).
      Circumscript myocardial regions of increased signal intensity on gadolinium-DTPA
      enhanced images were considered to be infarcted. Infarct size (in g) was
      determined using Simpson's rule, and was compared with that based on cumulative
      release of alpha-hydroxybutyrate dehydrogenase activity in plasma and with peak
      creatine kinase-MB level in plasma. Infarct size quantified with MRI correlated
      well with "enzymatic" infarct size (in g equivalents) (y = 0.99 x + 0.71; r =
      0.93; p = 0.0001) and peak creatine kinase-MB levels (r = 0.72; p = 0.002). It is
      concluded that gadolinium-DTPA-enhanced MRI enables accurate quantification of
      infarct size in patients with a first acute myocardial infarction.

PMID- 8475866
TI  - Effect of enhanced preload with head-out water immersion on exercise response in
      men with healed myocardial infarction.
AB  - Head-out water immersion shifts venous blood to the central vasculature and heart
      and subsequently increases cardiac preload. In healthy men, cardiac output and
      stroke volume are greater during upright leg cycle exercise in water than on
      land. Heart rate is similar during work loads < 50% of peak oxygen consumption
      but is decreased in water at higher work intensities. To determine if men with
      myocardial infarction (MI) show a similar response, 15 men with a documented MI
      exercised upright on a leg cycle ergometer on land and immersed in water (31 +/-
      1 degree C) to the level of the shoulders. Heart rate, cardiac output (carbon
      dioxide rebreathing procedure) and oxygen consumption were measured at rest and
      at work loads corresponding to approximately 40, 60 and 75% of peak oxygen
      consumption in both environments. At rest, cardiac output and stroke volume were
      elevated (p < 0.05) in water. During exercise, heart rate, cardiac output and
      stroke volume did not differ between water and land. When subjects were given
      beta-blocking medications (n = 8) and subjects with exercise-induced ST-segment
      depression (n = 5) were separately excluded from the analysis, water immersion
      still did not significantly change exercise responses. These results suggest that
      MI alters the normal cardiac response to increased preload during exercise. The
      alteration may involve reduced myocardial compliance or near-complete use of the
      Frank-Starling reserve, or both, during land exercise.

PMID- 8475867
TI  - Does the myocardium become "stunned" after episodes of angina at rest, angina on
      effort, and coronary angioplasty?
AB  - To assess whether myocardial stunning occurs after brief periods of ischemia,
      global and regional ventricular function assessed by radionuclide angiography was
      studied in 52 patients. Patients were divided into 3 groups according to the type
      of ischemic episodes. Group 1 consisted of 15 patients studied before, during and
      after episodes of angina at rest. Seventeen patients studied immediately before
      and after coronary angioplasty constituted group 2. Group 3 consisted of 20
      patients with stable angina studied before, during and after exercise-induced
      ischemia. Medical therapy was discontinued 48 hours before the study in all
      patients except those undergoing coronary angioplasty who were receiving
      diltiazem 180 mg/day. No difference in baseline ejection fraction was found
      between groups, whereas peak filling rate was statistically lower in group 3
      patients. Evidence of left ventricular dysfunction during ischemia was seen in
      patients in groups 1 and 3, whereas transient ischemia was documented by ST
      segment displacement and/or typical chest pain during balloon inflation in group
      2. Persistence of systolic or diastolic dysfunction was not observed in any of
      the 3 groups in the recovery phase after ischemia. In conclusion, transient
      ischemia caused either by a primary reduction in oxygen supply (angina at rest,
      coronary angioplasty) or by an increase in oxygen demand (angina on effort) did
      not reproduce the phenomenon of systolic and diastolic stunning observed in
      animal experiments, although in all patients the ischemia was of sufficient
      duration and severity to induce marked ventricular dysfunction. The search for
      stunned myocardium should be extended to other different clinical models
      characterized by prolonged ischemia such as unstable angina or myocardial
      infarction.

PMID- 8475868
TI  - Exercise thallium scintigraphy versus high-dose dipyridamole echocardiography
      testing for detection of asymptomatic restenosis in patients with positive
      exercise tests after coronary angioplasty.
AB  - The usefulness of high-dose (< or = 0.84 mg/kg over 10 minutes) dipyridamole
      echocardiography testing was compared with that of exercise thallium-201
      scintigraphy in detecting restenosis (> 70% lumen reduction) in 50 asymptomatic
      patients with ST-segment depression during maximal exercise testing 3 months
      after successful coronary angioplasty. Dipyridamole echocardiography testing and
      exercise thallium scintigraphy showed a similar sensitivity (75 vs 83%; p = NS)
      and specificity (90 vs 84%; p = NS) for the detection of restenoses, which
      occurred in 12 patients. It is concluded that dipyridamole echocardiography
      testing is as accurate as exercise thallium testing for the noninvasive detection
      of severe restenosis in patients with exercise-induced asymptomatic ST-segment
      depression after successful angioplasty. Furthermore, the site, extent and
      severity of the thallium perfusion defects during exercise are correlated to
      those of the dyssynergy during dipyridamole echocardiography.

PMID- 8475869
TI  - Once-daily, extended-release gemfibrozil in patients with dyslipidemia. The Lopid
      SR Work Group I.
AB  - This randomized, parallel-group, multicenter clinical trial compared a newly
      developed, once-daily, extended-release formulation of gemfibrozil (Lopid SR) and
      gemfibrozil twice daily (Lopid) in terms of lipid-regulating effects and
      toxicity. Patients were men and women with elevations of low-density lipoprotein
      cholesterol and low levels of high-density lipoprotein cholesterol. The trial
      consisted of a 1-week screening period, an 8-week diet baseline period (Step One
      Diet), and a 24-week double-blind treatment period (extended-release gemfibrozil
      1,200 mg once daily vs gemfibrozil 600 mg twice daily). At the end of the trial,
      the 2 treatment groups showed comparable improvements in all primary lipid
      factors: mean percent changes in triglyceride, high-density lipoprotein
      cholesterol, and low-density lipoprotein cholesterol were -32, +10 and -10% for
      extended release (n = 325) and -36, +11 and -10% for twice daily (n = 330). The
      90% confidence interval for the relative difference between the treatment means
      fell within the equivalence bounds of +/- 35% for all 3 factors, demonstrating
      equivalence of efficacy. Adverse events were reported at low rates and were
      similarly distributed in frequency and intensity between treatment groups; they
      were preponderantly mild or moderate, and gastrointestinal effects were the most
      frequent. The once-daily formulation of gemfibrozil may afford better control of
      dyslipidemia through improved compliance by patients who have this asymptomatic
      disease.

PMID- 8475870
TI  - Comparison of frequency of aggravation of ventricular tachyarrhythmias after
      implantation of automatic defibrillators using epicardial versus nonthoracotomy
      lead systems.
AB  - The time of onset of 4,471 episodes of ventricular tachycardia (VT) or
      fibrillation (VF) in 40 of 65 patients with an implantable cardioverter
      defibrillator (ICD) with endocardial defibrillation electrodes (group 1) and in
      53 of 123 with epicardial defibrillation electrodes (group 2) was analyzed to
      examine whether the incidence of VT/VF immediately after surgery is greater than
      during further follow up and whether the site of lead placement exerts an
      influence on the occurrence of these arrhythmias. Actuarial survival rates free
      of VT/VF were 77, 65, and 54% at 1, 3 and 6 months, respectively, for group 1,
      and 84, 66 and 52%, respectively, for group 2. The probability of VT/VF was
      increased only during the first week after surgery; in that week, 12.8% of all
      patients had VT/VF, without significant differences between groups 1 and 2. Until
      the end of the first month, this percentage increased to 23%, whereas only 12 to
      15% of patients had VT/VF during subsequent months. In 19 patients with third
      generation devices capable of terminating tachycardias by overdrive pacing, 326
      of 412 VT/VF episodes occurring in the first week after surgery were terminated
      by antitachycardia pacing, and only 86 had to be terminated by cardioversion or
      defibrillation. No postoperative exacerbation of inappropriate ICD therapies was
      observed in any group; 2 to 5% of patients per month received ICD therapies for
      atrial fibrillation or sinus tachycardia. Patients who received appropriate ICD
      therapies in the first week after surgery were at high risk of recurrence of
      VT/VF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475871
TI  - Assessment of quality of life as observed from the baseline data of the Studies
      of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy.
AB  - The improvement of aspects of a patient's quality of life may be as important as
      prolonging survival in evaluating clinical trials of heart failure. The purpose
      of this study was to analyze the psychometric properties of the baseline measures
      from the quality-of-life substudy from the Studies of Left Ventricular
      Dysfunction (SOLVD) trial. The measures included the 6-Minute Walk Test, Dyspnea
      Scale, Living with Heart Failure, Physical Limitations, Psychologic Distress and
      Health Perceptions, as reported by both patients and staff. Cognitive
      functioning, such as Vocabulary, Digit Span and Trails Making, was also assessed.
      Patients were classified as New York Heart Association class I (n = 158) versus
      II or III (n = 150). The internal consistencies (i.e., reliabilities) of the self
      report measures were high, except for the Health Perceptions of Class II or III
      patients. Reliability of the SOLVD quality-of-life battery was confirmed by
      significantly better life quality among New York Heart Association class I
      patients versus class II or III patients combined on the Walk Test, Physical
      Limitations, Dyspnea, Living with Heart Failure, Psychologic Distress and staff
      perceptions of patient health. In accordance with prior studies, the measures
      were uncorrelated with left ventricular ejection fraction. By demonstrating
      strong internal consistencies, reliability based on physician reports, and
      independence of ejection fraction levels, use of this quality-of-life assessment
      battery in this and other clinical trials of compromised ventricular functioning
      is supported.

PMID- 8475872
TI  - Rapid assessment of aortic regurgitation and left ventricular function using cine
      nuclear magnetic resonance imaging and the proximal convergence zone.
AB  - In patients with aortic regurgitation (AR), knowledge of the severity of AR, and
      the degree of left ventricular (LV) dysfunction are important for optimal
      management. Previous nuclear magnetic resonance (NMR) studies to assess these
      parameters used multiple tomographic planes that are time-consuming to obtain and
      analyze, and thus not cost-effective. In addition, these studies assessed the
      severity of AR by looking simply at the size of the regurgitant jet, a parameter
      that relates only poorly to regurgitant volume. The present study evaluates a
      rapid, single-plane, cine NMR approach (scan time < 10 minutes), and a new
      grading system for AR that is based on the presence, size and persistence of not
      only the regurgitant jet, but also the zone of proximal signal loss. Compared
      with color Doppler echocardiography (n = 42), the NMR approach detected AR with a
      specificity of 100% and a sensitivity of 95%. NMR regurgitant jet area correlated
      well with color Doppler regurgitant jet area (n = 20; r = 0.81; p < 0.01), but
      did not discriminate well between all grades of AR as compared with x-ray
      contrast aortography (n = 14). Using the new NMR grading criteria, AR grade by
      NMR was in accordance with aortographic grade in 12 patients, differing by only 1
      grade in the remaining 2 patients. NMR grade was in accordance within 1 grade of
      Doppler in all patients compared (n = 20). LV volumes and ejection fraction using
      this single-plane approach correlated well with a previously validated, NMR
      biplane approach (r > 0.87; n = 18).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8475873
TI  - Comparison of active infective endocarditis involving a previously stenotic
      versus a previously nonstenotic aortic valve.
AB  - No previous studies, either clinical or morphologic, have compared findings in
      patients with active infective endocarditis (IE) involving a previously stenotic
      versus a previously nonstenotic aortic valve. Clinical and cardiac necropsy
      findings were analyzed in 96 patients with active IE involving the aortic valve.
      Of the 96 patients, 25 (26%) had active IE superimposed on a previously stenotic
      aortic valve and 71 (74%) on a previously nonstenotic aortic valve. The patients
      with stenotic aortic valves compared with those with nonstenotic aortic valves
      had significantly higher mean ages (61 vs 47 years), a higher percentage > 60
      years of age (52 vs 24%), a higher percentage of men (92 vs 73%), a higher
      frequency of an absent or unknown predisposing factor to infection (68 vs 38%), a
      lower frequency of a precordial murmur of aortic regurgitation (44 vs 79%), a
      lower percent with a long duration (> 60 days) of signs and symptoms of active IE
      (4 vs 23%), a larger mean heart weight (594 vs 514 g), a higher percentage with
      aortic valve calcific deposits (100 vs 24%), and a higher frequency of associated
      ring abscess (84 vs 52%). Thus, active IE superimposed on a stenotic aortic valve
      differs in some features compared with active IE on a nonstenotic aortic valve.
      Because ring abscess is so common when active IE involves a stenotic aortic valve
      in adults, operative intervention at an early stage may be warranted.

PMID- 8475874
TI  - Morphologic basis for obstruction to right ventricular outflow in hypertrophic
      cardiomyopathy.
AB  - The mechanism by which obstruction to right ventricular (RV) outflow occurs in
      patients with hypertrophic cardiomyopathy (HC) is not well understood. To clarify
      this issue, 5 severely symptomatic patients (aged 18 to 55 years, mean 30) with
      HC and marked subpulmonic obstruction (basal peak systolic pressure gradients 60
      to 118 mm Hg) were studied. Four patients also had obstruction to left
      ventricular outflow (maximal basal or provocable pressure gradient 12 to 110 mm
      Hg). The RV outflow obstruction in each patient resulted from greatly
      hypertrophied musculature comprised of crista supraventricularis, moderator band
      or trabeculae. Operative resection of portions of this muscle resulted in
      abolition or substantial reduction of the RV outflow gradient (to 0 to 11 mm Hg)
      in the 3 patients with both pre- and postoperative hemodynamic studies. The left
      ventricular wall and ventricular septum also were massively thickened (32 to 40
      mm) in each patient. These findings support the view that marked RV outflow tract
      obstruction in patients with HC is due to greatly hypertrophied RV muscle, and
      that operative resection will relieve the outflow gradients and normalize RV
      systolic pressure. The muscular RV hypertrophy causing obstruction appeared to
      constitute a primary and excessive hypertrophic process involving both
      ventricles.

PMID- 8475875
TI  - Left ventricular wall tension and stress during exercise in athletes and
      sedentary men.
AB  - This investigation examines the hypothesis that hypertrophy attenuates wall
      stress during exercise, when left ventricular wall tension is highest and most
      likely to contribute to hypertrophy. Upright bicycle exercise was performed by 17
      endurance-trained male athletes and 15 sedentary men. M-mode echocardiograms were
      obtained during submaximal exercise at predetermined heart rates. At all levels
      of exercise, at a matched heart rate, wall tension was higher in athletes than in
      sedentary subjects. In both groups, wall tension increased with exercise, then
      plateaued. Wall stress did not differ significantly in athletes and sedentary
      subjects at rest and at heart rates of 110 and 150 beats/min, although a
      difference was observed at a heart rate of 130 beats/min. Wall stress decreased
      in both athletes and sedentary subjects with exercise. In conclusion, left
      ventricular hypertrophy caused wall stress in athletes to be maintained at values
      similar to sedentary subjects during exercise as well as at rest.

PMID- 8475876
TI  - Usefulness of the impedance cardiogram to reflect left ventricular diastolic
      function.
AB  - The impedance diastolic waveforms, early O wave (zO) and late A wave (zA), were
      evaluated, and their relation to diastolic mitral flow patterns under changes in
      loading conditions was assessed. Eight normal subjects and 9 patients with
      Doppler evidence of delayed ventricular relaxation were studied with simultaneous
      transmitral Doppler flow and computerized, ensemble-averaged, impedance
      cardiography in the supine position. Thirty-degree, head-down and head-up tilt
      were performed to alter preload. Peak Doppler early diastolic velocity (E) and E
      integral were preload-dependent in both normal and abnormal groups (p < 0.003),
      but were not significantly different between patients and normal subjects. Peak
      Doppler late diastolic velocity (A) and A integral, although significantly
      different between groups (p < 0.001), did not vary significantly with tilt. E/A
      ratio was significantly different between groups in all positions (p < 0.006).
      Impedance zA was preload-dependent (p < 0.001) in both groups and significantly
      different between groups (p < 0.05). Impedance zO was also preload-dependent (p <
      0.003), but not significantly different between groups. Impedance zO correlated
      with Doppler peak E (r = 0.64; p = 0.001). Impedance zA did not correlate with
      Doppler A. Impedance cardiography diastolic waveforms can be altered by position
      and may reflect changes in vena caval or pulmonary vein volume flow, or both.
      This technique, in combination with Doppler mitral flow patterns, may be useful
      in evaluating diastolic function.

PMID- 8475877
TI  - Effect of operator experience on outcome of radiofrequency catheter ablation of
      accessory pathways.

PMID- 8475878
TI  - Validity of the Minnesota Living with Heart Failure questionnaire as a measure of
      therapeutic response to enalapril or placebo.

PMID- 8475879
TI  - Coronary arterial patterns in double-outlet right ventricle.

PMID- 8475880
TI  - Ejection characteristics in primary pulmonary hypertension.

PMID- 8475881
TI  - Role of transesophageal echocardiography in diagnosis and management of central
      pulmonary artery thromboembolism.

PMID- 8475882
TI  - Effects of bilateral hystero-salpingo-oophorectomy on exercise-induced ST-segment
      abnormalities in young women.

PMID- 8475883
TI  - Validation study of a Doppler-tipped angiographic catheter for measurement of a
      coronary flow reserve.

PMID- 8475884
TI  - Thrombolytic therapy for acute myocardial infarction in a 110-year-old man.

PMID- 8475885
TI  - Temporary DDD pacing after surgically induced heart block.

PMID- 8475886
TI  - Successful management of labor and delivery in primary pulmonary hypertension.

PMID- 8475887
TI  - ISIS-3 and GISSI-2: no survival advantage with tissue plasminogen activator over
      streptokinase, but a significant excess of strokes with tissue plasminogen
      activator in both trials.

PMID- 8475888
TI  - Effects of the individual saturated fatty acids on serum lipids and lipoprotein
      concentrations.
AB  - A mixture of dietary saturated fatty acids raises the serum total cholesterol
      concentrations compared with a diet of isoenergetic amounts of carbohydrates.
      Saturated fatty acids are not all equally hypercholesterolemic: stearic acid
      (18:0) and saturated fatty acids with < 12 carbon atoms are thought not to raise
      serum cholesterol concentrations. This suggest that the cholesterol-raising
      properties of saturated fatty acids should be attributed solely to lauric acid
      (12:0), myristic acid (14:0), and palmitic acid (16:0). These three saturated
      fatty acids, however, may have different effects on serum total-cholesterol
      concentrations as well. Results from controlled dietary experiments suggest that
      lauric acid (12:0) is less, and myristic acid (14:0) probably more,
      hypercholesterolemic than palmitic acid (16:0). Effects of the different
      saturated fatty acids on the distribution of cholesterol over the various
      lipoproteins are largely unknown, but it is suggested that stearic acid lowers
      HDL cholesterol concentrations relative to other saturated fatty acids. At
      present, however, too many questions are unanswered to quantitate these
      differences.

PMID- 8475889
TI  - Lipid peroxidation: its mechanism, measurement, and significance.
AB  - An increased concentration of end products of lipid peroxidation is the evidence
      most frequently quoted for the involvement of free radicals in human disease.
      However, it is likely that increased oxidative damage occurs in most, if not all,
      human diseases and plays a significant pathological role in only some of them.
      For example, peroxidation appears to be important in atherosclerosis and in
      worsening the initial tissue injury caused by ischemic or traumatic brain damage.
      Oxidative stress can damage many biological molecules; indeed, proteins and DNA
      are often more significant targets of injury than are lipids, and lipid
      peroxidation often occurs late in the injury process. Many assays are available
      to measure lipid peroxidation, but no single assay is an accurate measure of the
      whole process. Application of simple diene-conjugate and thiobarbituric acid
      (TBA) assays to human tissues and body fluids can produce artifacts. An HPLC
      based TBA test can eliminate some of these artifacts.

PMID- 8475890
TI  - Apolipoprotein metabolism: a stable-isotope approach.
AB  - Lipids are the major fuel of the body. Efficient functioning as an energy source
      dictates that lipids must be transportable in the plasma from the point of
      synthesis and assembly to the storage depots and finally to the tissues to
      provide energy through oxidative metabolism. Complex lipid forms are transported
      through the plasma as lipoprotein particles. These particles, secreted from the
      intestine and liver, have nonpolar outer surface composed of cholesterol,
      phospholipids, and apolipoproteins. Apolipoproteins are essential for the
      production, secretion, and continued structural integrity of the various
      lipoprotein particles and thus play a pivotal role in the control mechanisms of
      lipid transport. Apolipoproteins regulate specific enzyme activities and modulate
      plasma lipoprotein clearance through receptor-mediated processes. Quantitative
      information regarding the rates of synthesis and catabolism of apolipoproteins is
      vital to an understanding of their metabolism in health and disease. General
      considerations are followed by a specific use of stable-isotope methodology to
      quantitative the rate of synthesis of very-low-density-lipoprotein apolipoprotein
      B-100 (VLDL apo B-100) in control and familial-combined-hyperlipidemic (FCHL)
      patients.

PMID- 8475891
TI  - The regulatory, informational, and immunomodulatory roles of fat fuels.
AB  - Fat oxidation provides a fuel for many tissues and it provides an important
      signal to decrease glucose utilization and oxidation in muscle and so conserve
      glucose for essential organs such as the brain. The control of fatty acid
      oxidation is achieved in part through its plasma concentrations, which may be
      precisely controlled by the triacylglycerol-fatty acid substrate cycle, which can
      also, if oxidation is taken into account, be viewed as a branch point in this
      important pathway. Branch points may provide precision in regulation if one of
      the fluxes at the branch is low compared with the other flux. Both branch points
      and substrate cycles are energetically expensive and may account for some of the
      increases in energy expenditure in conditions of injury, burns, and sepsis and in
      the postexercise condition. Fatty acids, through effects on plasma free
      tryptophan concentrations and hence 5-hydroxytryptamine concentrations in the
      brain, may play a role in central fatigue. Polyunsaturated fatty acids are
      claimed to have immunosuppressive properties. Work has been done to provide a
      biochemical analysis of how they might influence some functions of cells of the
      immune system.

PMID- 8475892
TI  - Free fatty acids and exercise.
AB  - Although the great explorers were well aware that eating fat was an efficient way
      to meet their large energy demand, it was not until some decades into this
      century that it could be demonstrated that lipids are metabolized directly by
      contracting skeletal muscles. The 1950s produced the first studies with [14C]
      tagged fatty acids (FAs), proving that fat is transported into the cell as FAs.
      An FA-transporting protein that is present in the sarcolemma and in the
      cytoplasma has been identified. For FA transport into the mitochondria, carnitine
      and carnitine transferase are needed. It is still unclear how the use of lipids
      as an energy source for the muscle during exercise is limited. The supply of free
      fatty acids (FFAs) far exceeds what is taken up by the muscle. Seldom more than 2
      4% of the amount of FFAs delivered to an exercising limb is taken up by the
      muscles and only part of it is oxidized. Physical training induces changes that
      enhance the uptake of FAs by the contracting muscles, and a larger fraction of
      this uptake is oxidized, but it is not yet clear which mechanism is behind this
      adaptation. What is known is that this uptake occurs despite no elevation in the
      amount of FA supplied to the limb.

PMID- 8475893
TI  - Food quotient, respiratory quotient, and energy balance.
AB  - This paper reviews evidence that the macro-nutrient composition of the diet and
      the maintenance of energy balance are correlated. Intervention studies show that
      subjects lose weight on low-fat diets and gain weight on high-fat diets.
      Descriptive studies show that overweight subjects eat relatively more fat but
      have the same total energy intake as nonoverweight subjects. The body has a
      limited ability to oxidize fat compared with its ability to oxidize carbohydrate
      and protein. The conclusion is that becoming overweight can be prevented by
      reducing the fat content of the diet. Studies on nutrient utilization show a
      ready increase in carbohydrate oxidation whereas fat oxidation does not change
      after meals enriched with, respectively, carbohydrate or fat. However, in the
      long term, the respiratory quotient (RQ) is closer to the food quotient (FQ) for
      subjects eating high-fat diets than it is for subjects eating high-carbohydrate
      diets. For high-carbohydrate diets, the RQ is lower than is the FQ, indicating
      that subjects must mobilize body fat. This is supported by data on body weight
      loss in subjects changing from a standard maintenance diet to a low-fat diet,
      even while energy intake was increased with nearly 20%. Direct evidence for a
      higher energy expenditure for low-fat diets is not yet available.

PMID- 8475894
TI  - Energy balance or fat balance?
AB  - Under normal conditions, carbohydrate, protein, and alcohol are not converted to
      fat. Glycogen and protein stores are closely controlled, and increasing the
      intake of nonfat nutrients stimulates their oxidation rates proportionally. Thus,
      chronic imbalance between intake and oxidation of nonfat nutrients cannot lead to
      obesity. On the other hand, fat stores are not controlled and their capacity for
      expansion is enormous. Because an increase in fat intake does not stimulate fat
      oxidation, a positive fat balance results, which has the potential to become
      chronic. Obesity is therefore due to a long-standing positive fat balance, which
      may simply be due to a high-fat diet. The use of the fat-balance equation instead
      of the energy-balance equation adds another option for the treatment of obesity-
      that of changing the quality of the diet, ie, lowering the fat content.

PMID- 8475895
TI  - Dietary fat and the control of energy intake: evaluating the effects of fat on
      meal size and postmeal satiety.
AB  - Three separate experiments in lean subjects confirmed that a 1.52-MJ (362-kcal)
      carbohydrate supplement at breakfast suppressed appetite 90 min later but had no
      effect on a test meal given after 270 min. A 1.52-MJ (362-kcal) fat supplement
      produced no detectable action on measures of appetite at any time point.
      Therefore, fat and carbohydrate do not have identical effects on the appetite
      profile. In a further study in obese subjects, a novel experimental design was
      used to assess the satiating efficiency and compensatory response of fat. Eating
      from a range of either high-fat or high-carbohydrate foods, obese subjects
      voluntarily consumed twice as much energy from the fat items, thereby indicating
      a weak action of fat on satiation. In turn, this large intake of fat exerted a
      disproportionately weak effect on satiety. These studies suggest that the
      appetite-control system may have only weak inhibitory mechanisms to prevent the
      passive overconsumption of dietary fat. The results indicate how this action
      could induce a positive energy balance and lead to a gradual upward drift in body
      mass index.

PMID- 8475896
TI  - Cytotoxicity and genotoxicity of lipid-oxidation products.
AB  - The autoxidation of unsaturated lipids contained in oils, fats, and food and the
      endogenous oxidative degradation of membrane lipids by lipid peroxidation result
      in the formation of a very complex mixture of lipid hydroperoxides, chain
      cleavage products, and polymeric material. Experimental animal studies and
      biochemical investigations lend support to the hypothesis that lipid-oxidation
      products, ingested with food or produced endogenously, represent a health risk.
      The oral toxicity of oxidized lipids is unexpectedly low. Chronic uptake of large
      amounts of such materials increases tumor frequency and incidence of
      atherosclerosis in animals. 4-Hydroxynonenal, a chain-cleavage product resulting
      from omega 6 fatty acids, disturbs gap-junction communications in cultured
      endothelial cells and induces several genotoxic effects in hepatocytes and
      lymphocytes. Although the concentrations of the aldehyde needed to produce these
      effects are in the range expected to occur in vivo, their pathological
      significance is far from clear. Recent findings strongly suggest that in vivo
      modification of low-density lipoprotein by certain lipid-peroxidation products
      (eg, 4-hydroxynonenal and malonaldehyde) renders this lipoprotein more
      atherogenic and causes foam-cell formation. Proteins modified by 4-hydroxynonenal
      and malonaldehyde were detected by immunological techniques in atherosclerotic
      lesions.

PMID- 8475897
TI  - Increased risk of cardiovascular disease at suboptimal plasma concentrations of
      essential antioxidants: an epidemiological update with special attention to
      carotene and vitamin C.
AB  - For the prolongation of life expectancy and reduction of ischemic heart disease
      (IHD) dietary guidelines generally recommend lowering saturated mammalian fat
      with partial replacement by vegetable oils and increasing generously vegetables,
      legumes, and fruits, which provide more essential antioxidants. Plasma
      antioxidants as assayed in epidemiological studies of complementary type (ie the
      cross-cultural MONICA Vitamin Substudy reevaluation considering the "Finland
      Factor", the Edinburgh Angina-Control Study, and the Basel Prospective Study)
      consistently revealed an increased risk of IHD (and stroke) at low plasma
      concentrations of antioxidants, with the rank order as follows: lipid
      standardized vitamin E >> carotene = vitamin C > vitamin A, independently of
      classical IHD risk factors. Decreasing IHD risk through nutrition may be possible
      when plasma concentrations have the following values: > 27.5-30.0 mumol vitamin
      E/L, 0.4-0.5 mumol carotene/L, 40-50 mumol vitamin C/L and 2.2-2.8 mumol vitamin
      A/L. Thus, previous prudent regimens may now be updated, aiming at an optimal
      status of all essential and synergistically linked antioxidants.

PMID- 8475898
TI  - Omega-3 fatty acids: essential fatty acids with important biological effects, and
      serum phospholipid fatty acids as markers of dietary omega 3-fatty acid intake.
AB  - Serum phospholipid eicosapentaenoic (PL-EPA) and docosahexaenoic acid (PL-DHA)
      concentrations are associated with the dietary intake of omega 3 fatty acids. PL
      EPA and PL-DHA concentrations measured 4 y apart in 211 diabetic patients were
      highly correlated, with Spearman correlation coefficients of 0.49 (p = 0.0001)
      and 0.64 (p = 0.0001), respectively. PL-DHA was positively associated with Bayley
      psychomotor and mental developmental indexes (PDI and MDI, respectively) in
      preterm infants. Using multiple-regression analysis, 64% (R2 = 0.639; p = 0.0001)
      of PDI variance was explained by 1/DHA and weight at 1 y, whereas 82% (R2 =
      0.816; p = 0.0001) of MDI variance was explained by weight at 1 y, Apgar score,
      1/DHA, and 1/EPA. 1/DHA was negatively correlated with PDI and MDI, whereas 1/EPA
      was positively correlated with MDI. The results suggest that infant formulas
      should contain preformed DHA, and that a too-high supply of EPA in addition to
      DHA might be harmful in preterm infants.

PMID- 8475899
TI  - Effects of supplementation with omega 3 long-chain polyunsaturated fatty acids on
      retinal and cortical development in premature infants.
AB  - Deficiency of omega 3 long-chain polyunsaturated fatty acids (LCPUFAs) in
      vertebrates produces subtle adverse effects on visual and neural function.
      Preterm infants 1) are deprived of vital intrauterine fat accretion during late
      pregnancy, 2) must rely solely on formula for fatty acid supplies if not
      breastfed, and 3) may have limited postnatal desaturase activity. In a study to
      evaluate the necessity of dietary omega 3 LCPUFAs, preterm infants were fed human
      milk, corn-oil-based formula (omega 3 fatty acid deficient), soy-oil-based
      formula (rich in precursor fatty acids), or marine-oil-supplemented formula
      (containing docosahexaenoic acid). At 36 and 57 wk postconception, the LCPUFA
      profiles in red blood cell lipids were nearly equivalent in the human-milk and
      marine-oil groups whereas the corn-oil group had markedly lower values for omega
      3 fatty acids. Rod photoreceptor function was significantly less mature in the
      corn-oil group compared with the human-milk and marine-oil-enriched groups in
      early postnatal development (36 wk). The corn-oil group also had impaired visual
      acuity at both 36 and 57 wk. The potential benefit of omega 3 LCPUFA-enriched
      full-term formula is discussed. The study supports a role for omega 3 LCPUFAs as
      required nutrients for the optimal maturation of visual and cortical function in
      preterm infants.

PMID- 8475900
TI  - A tribute to Dr. Henry Rappaport.

PMID- 8475901
TI  - Immunophenotyping of lymphomas and leukemias in paraffin-embedded tissues.

PMID- 8475902
TI  - Flow-cytometric DNA analysis in the diagnosis and prognosis of lymphoma.

PMID- 8475903
TI  - The uses of molecular biology in hematopathology. Oncogenes as diagnostic markers
      in non-Hodgkin's malignant lymphoma.

PMID- 8475904
TI  - Reactive lymphadenopathies and atypical lymphoproliferative disorders.

PMID- 8475905
TI  - The lymphadenopathy of HIV infection.

PMID- 8475906
TI  - Malignant disorders of small lymphocytes. Small lymphocytic lymphoma,
      lymphoplasmacytic lymphoma, and chronic lymphocytic leukemia: their clinical and
      laboratory relationship.

PMID- 8475907
TI  - Lymphomas of follicles. Mantle cell and follicle center cell lymphomas.

PMID- 8475908
TI  - Monocytoid B-cell lymphoma.
AB  - Monocytoid B-cell lymphoma is a distinct clinicopathologic entity occurring
      primarily in the lymph nodes of elderly patients. Its unique features compared
      with other low-grade lymphomas are also its characteristic morphologic features.
      These are its rare leukemic conversion and infrequent bone marrow involvement,
      and its relatively common association with autoimmune disease. Although MBCL is
      believed to be a low-grade, indolent type of lymphoma, its progression to high
      grade lymphoma warrants close follow-up of patients.

PMID- 8475909
TI  - Peripheral T-cell lymphoma. Morphologic and immunologic observations.

PMID- 8475910
TI  - Unresolved issues concerning Hodgkin's disease and its relationship to non
      Hodgkin's lymphoma.

PMID- 8475911
TI  - Composite lymphoma and related disorders.
AB  - Lymphomas evolve over time, usually from the small-cell to the large-cell
      category, and from follicular histologic characteristics to diffuse architecture.
      The histologic characteristics of lymphomas may be discordant in patients with
      multiple sites of involvement. When different types of lymphomas are encountered
      in a single organ or tissue, they are designated as CLs in the Working
      Formulation of NHL. The most common CLs consist of different subsets of
      follicular center cell lymphomas, usually one with low-grade follicular
      histologic characteristics and another with diffuse architecture and/or more
      aggressive cytologic features. These lymphomas now are considered to represent
      different phases of clonal evolution rather than representing a coincidental
      simultaneous occurrence of two unrelated lymphomas. Whether B-cell large-cell
      lymphoma coexisting with another B-cell lymphoma, namely, the nodular variant of
      lymphocyte-predominant Hodgkin's disease, also represents clonal evolution
      requires further study. Composite lymphomas consisting of a B-cell lymphoma and a
      T-cell lymphoma are extremely rare. The histogenetic implications for a clonal
      relationship between component subsets in these and other equally rare
      combinations remain uncertain. The CLs should continue to be recognized because
      (1) the component morphologic subsets may have entirely different natural
      histories, requiring different treatment modalities although they may be clonally
      related; and (2) the study of such cases may provide us with information
      regarding the complex interrelationship of the lymphoid system and its clonal
      evolution. The morphologic definition for CL of the Working Formulation should
      continue to be used whenever possible, with addition of appropriate immunologic
      and/or molecular-genetic data.

PMID- 8475912
TI  - Mycosis fungoides. Diagnosis and pathogenesis.

PMID- 8475913
TI  - Reactive histiocytic disorders.

PMID- 8475915
TI  - Splenic lymphoid hyperplasias versus lymphomas/leukemias. A diagnostic guide.
AB  - An accurate diagnosis of a lymphoid infiltrate in the spleen is based on several
      essential factors. 1. The spleen must be well fixed and the sections of high
      technical quality. 2. The pathologist has to be congnizant of the predominant
      distributional features, whether primarily in the white or in the red pulp, of
      the various lymphoid infiltrates that result in splenomegaly. 3. A differential
      diagnostic scheme also should be based on the predominant histologic pattern and
      cell type. 4. Immunophenotypic and occasionally molecular genetic studies are
      imperative for refinement and verification of the histologic diagnosis.

PMID- 8475914
TI  - Extranodal lymphoid disorders.

PMID- 8475916
TI  - Chronic lymphoproliferative disorders involving blood and bone marrow.

PMID- 8475917
TI  - Immunophenotypic analysis of acute leukemia.

PMID- 8475919
TI  - Pathology in the 1990s.

PMID- 8475918
TI  - Issues in the pathology and diagnosis of the chronic myeloproliferative disorders
      and the myelodysplastic syndromes.
AB  - We have attempted to discuss some of the issues that interest pathologists who
      are involved in the diagnosis of CMPD and MDS. In most cases, correlation of the
      clinical findings with the findings in the blood and marrow will allow the
      morphologist to arrive at a proper diagnosis. Nevertheless, there will continue
      to be cases that are difficult to classify, or in which the clinical features are
      out of keeping with the morphologic features. These cases are challenging and
      thought-provoking, and the application of newer diagnostic techniques, such as
      molecular genetics, may provide important insights.

PMID- 8475920
TI  - The reformation of Medicare and its effect on pathology.
AB  - Medicare policies have gradually restricted the scope of pathologist services
      payable under the rules applicable to physician services. Recent changes applying
      relative value scales has provided an opportunity for national standardization of
      pathology codes, and has permitted the introduction of clinical pathology
      interpretations as compensable physician services.

PMID- 8475922
TI  - Collaborative strategies for survival.
AB  - Pathology and laboratory medicine face major challenges, including multiplying
      government regulations, increasing competition, decreasing reimbursement, and
      loss of directorial control. Other industries facing similar threats have found
      solutions in a variety of collaborative strategies. Several examples of
      laboratory collaboration and a template for evaluation of potential joint
      operations are presented. Successful strategies will make it easier to handle
      meddlesome regulations, increase productivity and decrease costs, allow
      pathologists to retain control, and make the laboratory more profitable and
      competitive.

PMID- 8475921
TI  - View from Washington. Reimbursement and regulatory trends.

PMID- 8475923
TI  - The impact of regulatory changes on medical technology.

PMID- 8475924
TI  - Facing managed care's challenge to pathology.

PMID- 8475925
TI  - The changing relationship between clinicians and the laboratory medicine
      specialist in the managed care era.
AB  - Largely because of increased health-care costs, a variety of managed-care
      programs have been developed, and payment plans based on capitation will probably
      predominate in the future. Capitated, per-case, or per diem payment plans alter
      the traditional independence of health-care providers from the payment system. In
      these systems, clinical laboratory use becomes a resource to be managed, rather
      than a neutral third party or a source of income. Under capitated payment
      systems, clinicians will be motivated to reevaluate their own clinical laboratory
      resource use. Successful laboratory medicine specialists will understand these
      trends as well as the impact of newer payment plans on the relationship between
      themselves and clinicians, and develop new strategies to work with clinical
      colleagues to effect change.

PMID- 8475926
TI  - Pathophysiology and diagnosis of gastroesophageal reflux disease.
AB  - The pathophysiology and diagnosis of gastroesophageal reflux disease (GERD) are
      discussed. GERD is a clinical syndrome involving the reflux of gastric contents
      into the esophagus. It is distinguished from the reflux that occurs normally in
      the general population. A low pressure exerted by the lower esophageal sphincter
      (LES) and inappropriate spontaneous relaxation of the LES may contribute to the
      development of GERD. Other possible contributory factors are increased intra
      abdominal pressure and impaired esophageal clearance. The amount and
      concentration of refluxed gastric acid, proteolytic enzymes, and bile acids are
      among the determinants of the extent of esophageal injury. Heartburn is a
      specific symptom of GERD. Other symptoms include coughing, wheezing, hoarseness,
      epigastric pain, and regurgitation. Upper-GI roentgenography, endoscopy, biopsy,
      24-hour ambulatory pH monitoring, and esophageal manometry have been used to
      diagnose and evaluate the disease. The complications of GERD are strictures,
      hemorrhaging, perforation, aspiration, and Barrett esophagus. The causes of GERD
      are incompletely understood, but low LES pressure seems important. GERD may lead
      to serious complications. A broad array of diagnostic approaches is available.

PMID- 8475927
TI  - Susceptibility of low-density lipoprotein to oxidative modification.

PMID- 8475928
TI  - Susceptibility of small, dense, low-density lipoproteins to oxidative
      modification in subjects with the atherogenic lipoprotein phenotype, pattern B.
AB  - PURPOSE: To test whether low-density lipoprotein (LDL) from subjects with an
      atherogenic lipoprotein phenotype characterized by small, dense LDL (pattern B)
      demonstrates greater susceptibility to oxidative modification than LDL from
      subjects exhibiting primarily larger, more buoyant LDL particles (pattern A).
      PATIENTS AND METHODS: Measures of susceptibility to oxidative modification were
      compared in six density subfractions of LDL isolated from pattern A and pattern B
      subjects. Seven male and three female pattern A subjects and five male and two
      female pattern B subjects, classified on the basis of peak LDL particle size,
      were studied. Plasma lipid and lipoprotein levels, apolipoprotein B, mean LDL
      particle diameter, lag phase, and rate of oxidation after initiation of oxidation
      by copper sulfate were measured. RESULTS: The lag time, a measure of resistance
      to oxidative modification, was inversely related (p < 0.001) to LDL density in
      both groups of subjects, without an independent effect of phenotype. The fraction
      that had the major LDL peak had a shorter lag time (p < 0.05) in pattern B than
      in pattern A. Pattern B subjects also demonstrated an increased rate of oxidation
      (p < 0.005) in fraction 1, which includes remnants of triglyceride-rich
      lipoproteins. CONCLUSIONS: The increased atherogenic risk associated with the
      pattern B phenotype may result in part from increased concentrations of
      lipoprotein subpopulations that are relatively susceptible to oxidative
      modification.

PMID- 8475929
TI  - Risk of human immunodeficiency virus infection among emergency department
      workers.
AB  - PURPOSE: To estimate (1) the prevalence of human immunodeficiency virus (HIV)
      infection in emergency department (ED) patients, (2) the frequency of blood
      contact (BC) in ED workers (EDWs), (3) the efficacy of gloves in preventing BC,
      and (4) the risk of HIV infection in EDWs due to BC. PATIENTS AND METHODS: We
      conducted an 8-month study in three pairs of inner-city and suburban hospital EDs
      in high AIDS incidence areas in the United States. At each hospital, blood
      specimens from approximately 3,400 ED patients were tested for HIV antibody.
      Observers monitored BC and glove use by EDWs. RESULTS: HIV seroprevalence was 4.1
      to 8.9 per 100 patient visits in the 3 inner-city EDs, 6.1 in 1 suburban ED, and
      0.2 and 0.7 in the other 2 suburban EDs. The HIV infection status of 69% of the
      infected patients was unknown to ED staff. Seroprevalence rates were highest
      among patients aged 15 to 44 years, males, blacks and Hispanics, and patients
      with pneumonia. BC was observed in 379 (3.9%) of 9,793 procedures; 362 (95%) of
      the BCs were on skin, 11 (3%) were on mucous membranes, and 6 (2%) were
      percutaneous. Overall procedure-adjusted skin BC rates were 11.2 BCs per 100
      procedures for ungloved workers and 1.3 for gloved EDWs (relative risk = 8.8; 95%
      confidence interval = 7.3 to 10.3). In the high HIV seroprevalence EDs studied, 1
      in every 40 full-time ED physicians or nurses can expect an HIV-positive
      percutaneous BC annually; in the low HIV seroprevalence EDs studied, 1 in every
      575. The annual occupational risk of HIV infection for an individual ED physician
      or nurse from performing procedures observed in this study is estimated as 0.008%
      to 0.026% (1 in 13,100 to 1 in 3,800) in a high HIV seroprevalence area and
      0.0005% to 0.002% (1 in 187,000 to 1 in 55,000) in a low HIV seroprevalence area.
      CONCLUSIONS: In both inner-city and suburban EDs, patient HIV seroprevalence
      varies with patient demographics and clinical presentation; the infection status
      of most HIV-positive patients is unknown to ED staff. The risk to an EDW of
      occupationally acquiring HIV infection varies by ED location and the nature and
      frequency of BC; this risk can be reduced by adherence to universal precautions.

PMID- 8475930
TI  - Attempts to eradicate methicillin-resistant Staphylococcus aureus from a long
      term-care facility with the use of mupirocin ointment.
AB  - PURPOSE: To assess the impact of the use of mupirocin ointment on colonization,
      transmission, and infection with methicillin-resistant Staphylococcus aureus
      (MRSA) in a long-term-care facility. PATIENTS AND METHODS: All 321 residents of a
      Veterans Affairs long-term-care facility from June 1990 through June 1991 were
      studied for MRSA colonization and infection. MRSA-colonized patients received
      mupirocin ointment to nares in the first 7 months and to nares and wounds in the
      second 5 months. The effect of mupirocin use on MRSA colonization and infection
      was monitored. All S. aureus strains isolated were tested for the development of
      resistance to mupirocin. RESULTS: A total of 65 patients colonized with MRSA
      received mupirocin ointment. Mupirocin rapidly eliminated MRSA at the sites
      treated in most patients by the end of 1 week. Weekly maintenance mupirocin was
      not adequate to prevent recurrences--40% of patients had recurrence of MRSA.
      Overall, MRSA colonization in the facility, which was 22.7% +/- 1% prior to the
      use of mupirocin, did not change when mupirocin was used in nares only (22.2% +/-
      2.1%), but did decrease to 11.5% +/- 1.8% when mupirocin was used in nares and
      wounds. Although colonization decreased, roommate-to-roommate transmission and
      MRSA infection rates, low to begin with, did not change when mupirocin was used.
      Mupirocin-resistant MRSA strains were isolated in 10.8% of patients. CONCLUSIONS:
      Mupirocin ointment is effective at decreasing colonization with MRSA. However,
      constant surveillance was required to identify patients colonized at admission or
      experiencing recurrence of MRSA during maintenance treatment. Long-term use of
      mupirocin selected for mupirocin-resistant MRSA strains. Mupirocin should be
      saved for use in outbreak situations, and not used over the long term in
      facilities with endemic MRSA colonization.

PMID- 8475931
TI  - Infarct site-related mortality in patients with recurrent myocardial infarction.
      SPRINT Study Group.
AB  - PURPOSE: The purpose of this study was to determine the effect of acute and old
      myocardial infarction (MI) sites on early (15 days) mortality in patients with a
      second MI. PATIENTS AND METHODS: Data are derived from the SPRINT 2 study
      population that included 1,161 consecutive patients with acute MI, aged 50 to 79
      years, recruited from 14 coronary care units in Israel between November 1985 and
      July 1986. Two hundred twenty-six of these patients (19.5%) had a previous MI
      prior to the index acute MI. Sixty-two patients were excluded from the analysis
      either because the MI site was not of anterior or inferior location, or because
      of incomplete data. In the 164 (73%) remaining patients, acute and old MI
      locations were determined to be either anterior or inferior and were accordingly
      divided into 4 groups: acute anterior-old anterior (Group 1-23 patients); acute
      anterior-old inferior (Group 2-86 patients); acute inferior-old anterior (Group 3
      34 patients); acute inferior-old inferior (Group 4-21 patients). RESULTS:
      Significant differences in clinical parameters among the four groups included a
      higher proportion of Q-wave MI (p = 0.04), severe congestive heart failure during
      admission (p = 0.04), and markedly elevated serum lactate dehydrogenase levels (p
      = 0.05) in Group 3. High-degree atrioventricular block (p = 0.001) and
      cardiogenic shock (p = 0.05) also developed more often in this group during
      hospitalization. Twenty-three patients (14%) died within 15 days. Death rates in
      the acute anterior (Group 1 plus Group 2) and the acute inferior (Group 3 plus
      Group 4) groups were 11% versus 20%, respectively (NS). However, death rate
      variability across the four groups was statistically significant (p = 0.018),
      with the highest mortality observed in Group 3 (old anterior-acute inferior MI
      29%). Multivariate analysis identified acute inferior MI following old anterior
      MI as a strong independent predictor of early death (relative odds vis-a-vis
      other combinations 5.0, 95% confidence interval 1.5 to 16.6). CONCLUSION: This
      study identifies a subgroup of patients with acute inferior MI at high risk for
      early mortality. It is possible that such patients would benefit from early
      reperfusion therapy.

PMID- 8475932
TI  - Circadian variation and possible external triggers of onset of myocardial
      infarction. SPRINT Study Group.
AB  - PURPOSE: To determine whether a circadian pattern in onset of symptoms existed
      and possible external triggers were implicated in the precipitation of acute
      myocardial infarction (AMI). PATIENTS AND METHODS: One thousand eight hundred
      eighteen consecutive patients with AMI hospitalized in 14 of the 21 existing
      coronary care units in Israel during the study period were assessed. RESULTS: The
      frequency of onset of symptoms by 6-hour intervals showed a predominant morning
      peak (6 AM to noon) (32%, p < 0.01) in comparison with the other three 6-hour
      intervals of the day. The preponderance of the morning peak persisted for
      subgroup analysis by gender (males 32%, females 31%); age (less than or equal to
      65 years--32%; greater than 65 years--33%); diabetes mellitus (present or absent,
      32%). However, patients with peripheral vascular disease and those with stroke in
      the past had a predominant evening peak. Possible external triggers of onset of
      AMI were present in 10% of patients. Exceptional heavy physical work, violent
      quarrel at work or at home, and unusual mental stress were the three most
      frequent possible external triggers reported immediately before or within the 24
      hours preceding pain onset. Patients with possible external triggers were more
      likely to be males (85%) and were somewhat but not significantly younger (63.1
      years) in comparison with patients without external triggers (73% and 64.3 years
      respectively). CONCLUSIONS: In a large group of consecutive patients with AMI, a
      predominant cyclic morning peak of pain onset was found in comparison with the
      other hours of the day. Possible external triggers precipitating AMI were
      involved in a minority of cases, suggesting that endogenous changes occurring in
      the morning hours are generally responsible for the increased rate of myocardial
      infarction occurring after awakening.

PMID- 8475933
TI  - Genetic predisposition to hypertension facilitates blood pressure elevation in
      hemodialysis patients treated with erythropoietin.
AB  - PURPOSE: This study investigated the hypothesis that a genetic predisposition to
      hypertension is involved in the etiology of the elevation in blood pressure
      induced by human recombinant erythropoietin (rHuEPO). PATIENTS AND METHODS: Blood
      pressure changes after 10 weeks of treatment with rHuEPO were compared between 26
      patients with a positive family history of hypertension and 27 with a negative
      family history. RESULTS: Mean blood pressure was significantly increased in
      patients with a positive family history of hypertension (+8.8 mm Hg, p < 0.001).
      In contrast, the change was not significant in those whose family history was
      negative (+1.8 mm Hg, not significant). The mean blood pressure of 14 of 26
      patients with a positive family history of hypertension increased by more than
      10%, whereas such an increase occurred in only 2 of 27 patients with a negative
      family history (p < 0.001). The two groups were similar in terms of the total
      dose of rHuEPO given, the degree to which their anemia improved, and their basal
      blood pressures. CONCLUSION: It appears that hemodialysis patients with a
      positive family history of hypertension are susceptible to developing
      hypertension during treatment with rHuEPO.

PMID- 8475934
TI  - Hemodynamic effects of altitude exposure and oxygen administration in chronic
      obstructive pulmonary disease.
AB  - PURPOSE: Cardiovascular events are the leading cause of death during air travel.
      Because patients with chronic obstructive pulmonary disease (COPD) develop severe
      hypoxemia at altitude, we sought to determine whether changes in systemic
      hemodynamics may contribute to health risks during hypobaric hypoxia. PATIENTS
      AND METHODS: We recorded radial artery catheter blood pressure, cardiac
      frequency, and cardiac ectopy in 18 men (aged 68 +/- 6 years, mean +/- SD) with
      severe COPD (forced expiratory volume in 1 second 0.97 L +/- 0.32 L) at sea
      level, after 45 minutes of steady-state hypobaric hypoxia at 2,438 m in a
      hypobaric chamber, and after oxygen supplementation at 2,438 m. RESULTS: Mean
      arterial pressure (mm Hg), systolic blood pressure (SBP), diastolic blood
      pressure, and pulsus paradoxus during acute hypobaric exposure did not differ
      from baseline. During oxygen supplementation, SBP declined (p = 0.028). Decreases
      in pulsus paradoxus and pulse pressure were noted on oxygen (p < 0.05). We found
      no changes in cardiac frequency. Cardiac ectopy was uncommon; for one subject,
      ectopy increased with hypobaric hypoxia and decreased with oxygen administration.
      CONCLUSION: Vasopressor responses to hypoxia do not add to the risk of air travel
      in patients with severe COPD. Supplemental oxygen may cause beneficial
      hemodynamic changes in patients with COPD during acute hypobaric exposure.

PMID- 8475935
TI  - Ulcer risk factors: interactions between Helicobacter pylori infection,
      nonsteroidal use, and age.
AB  - PURPOSE: To evaluate the influence of Helicobacter pylori, nonsteroidal anti
      inflammatory drug (NSAID) use, tobacco and alcohol use, age, gender, ethnic
      group, and the indication for endoscopy on the frequency of gastric and duodenal
      ulcers in patients referred for upper endoscopy. PATIENTS AND METHODS: One
      thousand eighty-eight consecutive patients without prior antrectomy or active
      bleeding at endoscopy who were able to provide a history were interviewed prior
      to endoscopy, and antral biopsies were performed for H. pylori at endoscopy.
      Variables were tested for univariate association with duodenal or gastric ulcer
      and those variables with p < 0.25 were included in the logistic regression model
      building. RESULTS: One hundred seven patients had duodenal ulcer, 97 had gastric
      ulcers, and 5 had both. Significant risk factors in the final model for duodenal
      ulcer were H. pylori, history of previous ulcer, male gender, bleeding, and pain
      at presentation (p < 0.001), whereas alcohol was associated with a decreased risk
      (p = 0.026). H. pylori presence (p = 0.011), aspirin use (p = 0.009), and
      bleeding (p = 0.012) were associated with gastric ulcer in the final model;
      esophageal symptoms were associated with decreased risk of gastric ulcer (p =
      0.003). NSAID use was associated with gastric ulcers only in those over 55 (p <
      0.05), especially whites, and in nonwhites without prior ulcer. There was no
      interaction between H. pylori and NSAIDs. CONCLUSIONS: H. pylori was associated
      with an increased risk of duodenal and gastric ulcers. Aspirin increases the risk
      for gastric ulcer in patients of all ages, whereas nonaspirin, nonsteroidal use
      increases the risk for gastric ulcers to varying degrees in patients over age 55,
      depending on race and history of ulcer.

PMID- 8475936
TI  - Effect of nifedipine on physiologic shunting and oxygenation in chronic
      obstructive pulmonary disease.
AB  - PURPOSE: To assess changes in physiologic shunting and oxygenation following
      short-term treatment with nifedipine in patients with pulmonary hypertension
      secondary to chronic obstructive pulmonary disease. PATIENTS AND METHODS: Changes
      in pulmonary vascular pressure, pulmonary vascular resistance, venous admixture,
      and systemic arterial oxygen tension following sublingual administration of 20 mg
      of nifedipine were studied in 18 patients (13 men, 5 women; mean age of 59.7 [SD
      7.2] years) using Swan-Ganz catheterization. These patients had a mean peak
      expiratory flow rate of 112 (SD 27) L/min (mean 22.2 [SD 12.2]% of predicted
      value), mean forced expiratory volume in 1 second (FEV1) of 0.84 (SD 0.23) L
      (mean 31.2 [SD 8.5]% of predicted value), mean FEV1/forced vital capacity ratio
      of 31.6 (SD 4.5), and mean carbon monoxide diffusing capacity of 6.8 (SD 1.96)
      mmol/min/kPa. RESULTS: There was a significant decrease in mean pulmonary
      vascular resistance (562 to 371 dyne sec.cm-5) and a significant reduction in the
      mean pulmonary arterial pressure (mean 32.8 to 23.6 mm Hg). Pulmonary venous
      admixture, however, increased significantly from the baseline mean of 44.6% (SD
      16.1) to a mean of 56% (SD 15.6), and the mean arterial oxygen tension decreased
      from 5.8 (SD 1.3) kPa to 4.5 (SD 0.8) kPa at 60 minutes following drug
      administration (p < 0.001). CONCLUSION: The role of nifedipine in the treatment
      of pulmonary hypertension secondary to chronic bronchitis may be limited because
      of its deleterious effect on venous admixture.

PMID- 8475937
TI  - Thyroid hormone resistance syndromes.
AB  - The thyroid hormone resistance syndromes are disorders in which the body's
      tissues are resistant to the effects of thyroid hormone. Generalized resistance
      to thyroid hormone (GRTH) is characterized by resistance in the pituitary gland
      and in most or all of the peripheral tissues. Affected individuals have elevated
      serum thyroid hormone levels and inappropriately normal or elevated thyroid
      stimulating hormone (TSH) but are usually clinically euthyroid and require no
      treatment. Selective pituitary resistance to thyroid hormone (PRTH) is
      characterized by resistance in the pituitary gland but not in peripheral tissues.
      Patients have elevated serum thyroid hormone levels and normal or elevated TSH
      levels and are clinically thyrotoxic. Therapy is usually necessary, but current
      choices are not completely satisfactory. Selective peripheral resistance to
      thyroid hormone (PerRTH) is characterized by resistance in peripheral tissues but
      not in the pituitary. The only patient thus far described had normal serum
      thyroid hormone and TSH levels but was clinically hypothyroid and improved with
      thyroid hormone administration. All of these disorders are probably more common
      than is generally recognized and are often misdiagnosed and inappropriately
      treated. GRTH, in most cases studied, results from a mutation in the thyroid
      hormone receptor beta gene causing an amino acid substitution in or a partial or
      complete deletion of the thyroid hormone-binding domain of the receptor. The
      causes of PRTH and PerRTH remain to be determined.

PMID- 8475938
TI  - Spontaneous splenic rupture complicating anticoagulant or thrombolytic therapy.
AB  - PURPOSE: To characterize the clinical course and outcomes of reported cases of
      splenic hemorrhage during thrombolytic or anticoagulant therapy. METHODS: The
      Medline, EMBASE (Excerpta Medica), BIOSIS, and SCISEARCH databases for English
      and foreign literature between 1966 and 1991 were searched. All reports of
      patients with documented splenic hemorrhage during anticoagulant therapy or
      thrombolytic therapy were reviewed. Foreign language manuscripts were translated
      into English. RESULTS: Seventeen cases of splenic hemorrhage associated with
      anticoagulant or thrombolytic therapy were found. In one case, there was minor
      antecedent trauma; in the remaining cases, hemorrhage was spontaneous. Mortality
      overall was 24% and was more likely in patients with splenic hemorrhage after
      thrombolytic therapy (50%) than in patients receiving long-term anticoagulants
      (9%). Splenectomy was performed in 12 of 13 survivors. CONCLUSIONS: Splenic
      hemorrhage associated with anticoagulant or thrombolytic therapy is a rare
      entity. It may be lethal, especially when associated with lytic therapy. Reversal
      of the anticoagulated or lytic state and emergent splenectomy are the treatment
      of choice. Splenic hemorrhage can mimic acute myocardial infarction and
      cardiogenic shock and must be considered when the condition of cardiac patients
      receiving lytic or anticoagulant drugs suddenly deteriorates.

PMID- 8475939
TI  - Net worth.

PMID- 8475940
TI  - Reversible parkinsonism and asymptomatic hypocalcemia with basal ganglia
      calcification from hypoparathyroidism 26 years after thyroid surgery.

PMID- 8475941
TI  - Strongyloides hyperinfection in patients coinfected with HTLV-I and S.
      stercoralis.

PMID- 8475942
TI  - Rhabdomyolysis and hypophosphatemia.

PMID- 8475943
TI  - Treatment of Wilson's disease with zinc XII: dose regimen requirements.
AB  - A considerable body of data is now available indicating the efficacy and lack of
      toxicity of zinc treatment of Wilson's disease. Dose-response studies have shown
      that regimens of 50 mg of elemental zinc 3 times a day (50 mg x 3), 25 mg x 3,
      and 50 mg x 2 are effective, but 25 mg x 2 and 50 mg x 1 are not adequately
      effective. These studies indicate that 75 mg a day is close to the minimally
      effective dose, but do not address the question of necessary dose frequency. In
      the current study, the authors have used the minimally effective daily dose, 75
      mg, and studied this daily dose in regimens of 25 mg x 3, 37.5 mg x 2, and 75 mg
      x 1 in treatment of four patients with Wilson's disease. These data have been
      supplemented with additional data from 11 patients treated with 25 mg 3 times a
      day and with data from 2 patients treated with 75 mg once a day. Efficacy was
      evaluated by 10-day copper balance and absorption of orally administered
      64copper. The findings indicate that a daily dose of 75 mg must be divided into
      at least two doses to be effective, and that the 64copper procedure is more
      sensitive to zinc dose than copper balance.

PMID- 8475944
TI  - Differential responses of human papillary and reticular fibroblasts to growth
      factors.
AB  - Differences in the responses to growth factors of normal fibroblasts and
      scleroderma fibroblasts have been demonstrated previously. Because human dermal
      fibroblasts are heterogeneous populations, whether known differences between
      papillary and reticular dermal fibroblasts could account for the noted
      differences between normal and scleroderma fibroblasts was investigated.
      Papillary dermal fibroblasts were grown from a dermatome section of normal skin
      from an adult donor. Reticular dermal fibroblasts were cultured from punch biopsy
      specimens taken from the same location. In vitro, papillary dermal fibroblasts
      proliferated more rapidly, had a higher mitotic index and reached greater density
      at confluence, confirming previous observations. The reticular dermal fibroblasts
      were more dendritic. Reticular dermal fibroblasts had higher rates of tritiated
      thymidine uptake and larger increases in mitotic index in response to isoforms of
      platelet-derived growth factor (PDGF). The characteristic response of scleroderma
      fibroblasts, potentiation of the mitogenicity of PDGF AA by transforming growth
      factor-beta (TGF-beta), was not observed in either cell type. Therefore, the
      phenotypic characteristics of scleroderma fibroblasts cannot be explained by an
      unusual admixture of papillary and reticular fibroblasts.

PMID- 8475945
TI  - Heparin-associated thrombocytopenia: a critical review and pooled analysis.
AB  - The purpose of this study is to determine the incidence of heparin-associated
      thrombocytopenia (HAT) for various subgroups of heparin exposed patients and the
      impact of study quality on the reported incidence. Articles were identified using
      a Medline search, a manual search of the Index Medicus, and a review of article
      references. Key data included heparin type, administration route, indication,
      treatment duration, outcome criteria, incidence, and platelet count reliability.
      The pooled incidence estimate in studies requiring a repeatedly abnormal platelet
      count was compared with estimates from studies not requiring a repeated platelet
      count. The results showed that there were no adequately designed studies to
      estimate the incidence of HAT-related thrombosis or hemorrhage. The pooled
      incidence of HAT in studies requiring a reproducibly lowered platelet count (<
      100,000/microL) was 3/281 (1.1%) with intravenous porcine heparin and 4/140
      (2.9%) with intravenous bovine heparin. This difference was not statistically
      significant. The incidence of HAT with intravenous bovine heparin was
      significantly lower in studies that required a repeated platelet count. The
      incidence of HAT with heparin administered subcutaneously was small (0%) and in
      those studies requiring a repeatedly abnormal platelet count, there was no
      difference between porcine and bovine heparin. The authors concluded that the
      incidence of HAT is < 3% with intravenous heparin and extremely low for
      subcutaneous heparin. Study quality may influence the reported incidence of HAT.

PMID- 8475946
TI  - Effects of enalapril on ventricular volumes and neurohumoral status after
      inferior wall myocardial infarction.
AB  - The activation of the sympathetic nervous system and the renin-angiotensin
      aldosterone system and its beneficial modification with the use of angiotensin
      converting enzyme inhibin after inferior wall myocardial infarction (MI) was
      evaluated. Fifty patients with acute inferior MI were randomly assigned to
      receive 5 mg per day of either enalapril or placebo after admission. Blood tests
      for neurohormone levels and echocardiograms were performed at initial examination
      and 4 weeks later. Baseline characteristics were similar in the two groups. Four
      weeks after randomization, patients treated with enalapril had lower end
      diastolic volume (146 +/- 29 vs 167 +/- 15 ml; p = 0.04), end-systolic volume (56
      +/- 18 vs 107 +/- 17 ml; p = 0.03), serum norepinephrine levels (320 +/- 93 vs
      465 +/- 77 pg/ml; p < 0.01), angiotensin II levels (18 +/- 6 vs 54 +/- 11 pg/ml;
      p < 0.01), and atrial natriuretic polypeptide levels (106 +/- 9 vs 122 +/- 17
      pg/ml; p = 0.05) than patients given placebo. The incidence of heart failure
      after MI was also lower in this group (4% vs 16%; p = 0.009). Results show that
      there is early neurohumoral activation in the course of acute inferior wall MI.
      Enalapril reduces neurohumoral levels and preserves ventricular volumes. These
      effects were associated with a reduction in the incidence of heart failure 4
      weeks after MI in these patients.

PMID- 8475947
TI  - Use of the Rand Structured Implicit Review Instrument for Quality of Care
      Assessment.
AB  - The Rand Structured Implicit Review Instrument is a 27-item instrument that rates
      process quality of care for patients with five common illnesses. This study
      reports on the use of this instrument for hospitalized patients with long lengths
      of stay. A total of 120 medical records were reviewed by multiple physician
      reviewers for patients discharged with congestive heart failure, acute myocardial
      infarction, and pneumonia. Mean inter-rater reliability was assessed for a
      subsample of six records by kappa score. A multiple regression analysis was used
      to estimate the relationship between process ratings for the quality of
      documentation, assessment, monitoring, and therapy and overall quality of care
      scores, controlled for physician judgments about patients' prognosis and selected
      patient characteristics. Each reviewer also evaluated the instrument. Mean kappa
      for trichotomized ratings of quality of care was 0.50. The majority of all
      quality of care ratings were in the good or very good range (77.5%). The full
      regression model, including process subscale quality ratings, prognostic items,
      and patient characteristics, accounted for 38% of the total variance in the
      quality of care ratings. Items measuring the quality of assessment (p < 0.0001),
      therapy (p < 0.02) and monitoring (p < 0.01) were significant. Physicians
      accepted the use of such a form moderately well. The Rand quality of care form
      shows consistency in rating overall quality of care and individual dimensions of
      quality. Achieving a high level of inter-rater reliability is difficult with
      implicit review. By focusing on specific areas of potentially deficient care,
      structured review instruments can improve clinical quality improvement efforts.

PMID- 8475948
TI  - Case report: gastric angiolipoma with chronic hemorrhage and severe anemia.
AB  - Lipomas are benign tumors that are common in other sites but rare in the stomach.
      They are usually submucosal and, when symptomatic, are most often accompanied by
      gastrointestinal hemorrhage. Angiolipoma is a not uncommon benign lipomatous
      neoplasm with a characteristic vascular component that almost exclusively occurs
      in the subcutaneous tissue. A case of gastrointestinal angiolipoma, which appears
      to be only the second one reported, is discussed. The patient, a 69-year-old man,
      presented with signs and symptoms of chronic hemorrhage and severe anemia
      (hemoglobin 6, hematocrit 19.9). The patient's condition was found to have
      resulted from ulceration of the gastric mucosa overlying a submucosal
      angiolipoma, and the anemia resolved after local surgical resection of the tumor.
      Electron microscopic studies supported the light microscopic diagnosis of
      angiolipoma. The absence of fibrin thrombi in this and other nonsubcutaneous
      angiolipomas and the possible significance of the vascularity of these tumors is
      discussed. The literature regarding gastric lipoma and angiolipoma is reviewed.

PMID- 8475949
TI  - Case report: pentamidine and polymorphic ventricular tachycardia revisited.
AB  - Pentamidine isethionate has been associated with ventricular tachyarrhythmias,
      including torsade de pointes. This article reports two cases of this complication
      and reviews all reported cases to date. Pentamidine-induced torsade de pointes
      may be related to serum magnesium levels and hypomagnesemia may synergistically
      induce torsade. Torsade de pointes occurred after an average of 10 days of
      treatment with pentamidine. In these patients, no other acute side effects of
      pentamidine were observed. Torsade de pointes can be treated when recognized
      early, possibly without discontinuation of pentamidine. When QTc interval
      prolongation is observed, early magnesium supplementation is advocated.

PMID- 8475950
TI  - Lead nephropathy, gout, and hypertension.
AB  - The EDTA (calcium disodium edetate) lead mobilization test revealed lead as the
      probable cause of renal disease in industrial lead workers and in patients with
      gout or essential hypertension. The data reviewed here demonstrate persistence of
      lead nephropathy in the contemporary scene despite the introduction of modern
      industrial and environmental exposure standards. Renal function and biopsy
      studies showed that lead nephropathy is a chronic tubulointerstitial renal
      disease with modest proteinuria which frequently presents with hyperuricemia,
      gout and hypertension. Only evaluation of body lead stores by either the EDTA
      lead mobilization test or by x-ray fluorescence is helpful in diagnosing lead
      nephropathy. While chelation therapy is safe and helpful in reversing early lead
      nephropathy, the best treatment is prevention. These studies further raise the
      possibility that chronic environmental lead poisoning and associated renal
      disease and hypertension may be a more widespread problem than suspected.
      Assessment of the true extent of chronic lead poisoning requires large scale
      epidemiological studies.

PMID- 8475951
TI  - Not to decide is to decide.

PMID- 8475952
TI  - Specialization in obstetrics and gynecology--changing standards.

PMID- 8475953
TI  - Bright seashells on the sand.
AB  - In obstetrics and gynecology residency education is a fixed prescription, whereas
      the world of practice leads physicians in diverse directions. Nonetheless,
      obstetrics and gynecology has so far resisted the proliferation of
      subspecialties. The future scope of our specialty will be defined by the changing
      healthcare needs of women. These will be driven by changing demographics and an
      emphasis on preventive and primary care. Residency education and, to a lesser
      extent, forms of practice will have to change to meet women's needs.

PMID- 8475954
TI  - Cystic fibrosis mutations in white and black Americans: an approach to
      identification of unknown mutations with implications for cystic fibrosis
      screening.
AB  - OBJECTIVE: We sought to define the frequency of common cystic fibrosis mutations
      in white and black American probands from our geographic region. STUDY DESIGN:
      Mutation analysis was performed for delta F508, G551D, G542X, R553X, S549N, an d
      N1303K. For probands with undetermined mutations single-stranded conformational
      polymorphism analysis was performed. RESULTS: Among 40 white subjects with cystic
      fibrosis 26 (65%) were homozygous for delta F508, 10 (25%) were heterozygous for
      delta F508 and another unknown mutation, and two were homozygous for unknown
      mutations. Among 10 black probands one was homozygous for delta F508, seven (70%)
      were heterozygous for delta F508 and another unknown mutation, and one was
      homozygous for unknown mutations. Single-stranded conformational polymorphism
      analysis for selected exons was performed for 11 probands with unknown mutations.
      One mutation was detected in a white proband. Sequencing of this exon showed the
      mutation to be Q493X. CONCLUSIONS: Thirty percent of white subjects and 80% of
      black subjects carried unknown mutations. In one family single-stranded
      conformational polymorphism was informative in identifying an undetermined cystic
      fibrosis mutation.

PMID- 8475955
TI  - Low-dose aspirin therapy to prevent preeclampsia.
AB  - OBJECTIVE: Our aim was to test the hypothesis that acetylsalicylate (aspirin)
      treatment reduces the incidence or severity of pregnancy-associated hypertension.
      STUDY DESIGN: Patients were nulliparous, healthy, and with a singleton gestation
      at between 20 and 22 weeks' gestation. A sample size of 600 patients was
      calculated on the basis of p < or = 0.05 and 90% power of observation. A 2-week
      placebo-controlled "run-in" was used to select compliant patients. Randomization
      occurred at 24 weeks, with 60 mg of aspirin or placebo treatment from
      randomization to delivery. RESULTS: Follow-up was maintained on 99% of the
      patients. The randomized patients had a 94% pill compliance index. At
      randomization, serum thromboxane medians were similar in both groups. Thromboxane
      B2 levels in the aspirin group decreased significantly from baseline at 29 to 31
      weeks, 34 to 36 weeks, and at delivery as compared with an overall increase in
      the placebo group. Preeclampsia developed in five of 302 women (1.7%) who
      received aspirin versus 17 of 302 (5.6%) who received the placebo (p = 0.009).
      Preeclampsia was severe in one aspirin and in six placebo recipients (p = 0.06).
      CONCLUSION: Daily ingestion of 60 mg of aspirin beginning at 24 weeks' gestation
      significantly reduced the occurrence of preeclampsia.

PMID- 8475956
TI  - Maternal caffeine consumption and fetal behavior in normal third-trimester
      pregnancy.
AB  - OBJECTIVE: Our aim was to perform a longitudinal cohort study of 20 normal third
      trimester pregnancies to observe whether the level of long-term maternal caffeine
      ingestion influenced fetal behavior. STUDY DESIGN: By dietary history 10 normal
      pregnant women were categorized as "high" caffeine consumers (> 500 mg/day, group
      H) and 10 as "low" caffeine consumers (> 200 mg/day, group L). Between 30 and 40
      weeks biweekly 2-hour continuous ultrasonographic observations of fetal heart
      rate; breathing activity; and eye, trunk, and extremity movements were conducted.
      Maternal caffeine levels were determined at each session, and fetal states were
      identified and their duration quantified. Data were compared by analysis of
      variance by means of repeated measures or t tests. RESULTS: When compared with
      group L fetuses, group H fetuses spent similar mean time in state 1F (quiet
      sleep), less mean time in state 2F (active sleep), and much greater mean time in
      state 4F (arousal). The mean time spent in no state decreased significantly in
      group L, was unchanged in group H, and was similar for both groups at term. Both
      groups had similar mean numbers of state changes at all gestational ages studied.
      Mean maternal serum caffeine levels in group H were always significantly higher
      than those in group L. CONCLUSION: Evolving fetal behavior may be influenced by
      the level of maternal caffeine consumption during the last trimester.

PMID- 8475957
TI  - Acute hemodynamic and respiratory effects of amniotic fluid embolism in the
      pregnant goat model.
AB  - OBJECTIVE: Our purpose was to determine the acute-phase central hemodynamic and
      respiratory effects of raw, filtered, filtered and boiled, and meconium
      containing amniotic fluid. STUDY DESIGN: Pregnant goats (Capra hircus) in the
      last one third of pregnancy were given freshly collected autologous amniotic
      fluid in a volume of 2.5 ml/kg of body weight. Observations were then made at 10,
      30, 60, 120, and 180 minutes after amniotic fluid embolism. Pulmonary artery
      catheters and femoral artery lung water catheters were placed for specimen and
      data collection. RESULTS: Marked pressor responses were observed in both the
      pulmonary and systemic circulations with all amniotic fluid infusions. The
      pressor response was similar with raw, filtered, and filtered and boiled amniotic
      fluid. The pressor response seen with amniotic fluid containing meconium was
      significantly greater than that seen with the other forms. No significant effects
      were observed on cardiac or respiratory function except in the meconium group,
      where transient left ventricular dysfunction was accompanied by an acute increase
      in extravascular lung water and dysoxia. CONCLUSIONS: The Capra hircus model is
      appropriate for the further study of amniotic fluid embolism. The acute pressor
      effects are transient and involve both the systemic and pulmonary circulations.
      Left ventricular dysfunction and dysoxia were observed only with embolism of
      amniotic fluid containing meconium.

PMID- 8475958
TI  - The effect of growth factors on the proliferation of human endometrial stromal
      cells in culture.
AB  - OBJECTIVE: Development of ectopic implants of endometriosis is associated with
      both an inflammatory response by macrophages and endometrial stromal cell
      proliferation. Macrophages are capable of releasing a variety of inflammatory
      mediators, including growth factors. To assess the impact of such factors on
      endometrial tissue, we have studied the effects of recombinant growth factors,
      fibroblast growth factor, epidermal growth factor, transforming growth factor
      alpha, and inflammation mediators transforming growth factor-beta, and tumor
      necrosis factor-alpha on human endometrial stromal cell proliferation. STUDY
      DESIGN: Increasing concentrations of these compounds were added to cultures of
      primary, secondary, and long-term stromal cells and the cells were harvested at
      24, 48, and 72 hours. RESULTS: Epidermal growth factor, transforming growth
      factor-alpha, transforming growth factor-beta, and fibroblast growth factor
      induced a statistically significant, dose-dependent increase in stromal cell
      thymidine uptake of 1.5- to fivefold. The cytokine tumor necrosis factor had no
      effect alone, but the combination of fibroblast growth factor and tumor necrosis
      factor had a synergistic effect, increasing cell proliferation 25% to 84% over
      fibroblast growth factor alone. CONCLUSION: The stromal cell response to a wide
      range of cell growth effectors and the potential of mediators like tumor necrosis
      factor-alpha to synergize suggest that such macrophage-secretory products may
      contribute to proliferation of endometrial implants in vivo.

PMID- 8475959
TI  - Gestational diabetes: predictors of subsequent disordered glucose metabolism.
AB  - OBJECTIVE: We tested the hypothesis that the development of abnormal glucose
      metabolism after gestational diabetes can be predicted readily by means of
      available clinical variables. STUDY DESIGN: Three hundred fifty nonpregnant
      former gestational diabetic women delivered during the previous 10 years
      underwent glucose tolerance tests. Variables including body mass index before the
      index pregnancy, pregnancy glucose tolerance test values, gestational diabetes
      treatment, complications, gestational age at diagnosis of gestational diabetes,
      and time elapsed since pregnancy were analyzed with logistic regression. RESULTS:
      Variables that distinguished subjects who later developed diabetes or impaired
      glucose tolerance included prepregnancy body mass index (28.5 +/- 7 versus 25 +/-
      5 kg/m2, p < 0.001) and fasting glucose on the pregnant oral glucose tolerance
      test (109 +/- 20 vs 92 +/- 15 mg/dl, p < 0.001). Logistic results with these two
      variables plus time since the index pregnancy predict subsequent glucose
      tolerance test abnormality by the following equation: estimated risk = 1/[1 + e-(
      10.37 + 0.04 (fasting plasma glucose) + 0.08 (body mass index) + 0.03 (months
      since delivery))]. CONCLUSION: The risk for subsequent glucose abnormality among
      individuals with previous gestational diabetes is quantifiable based on
      prepregnant body mass index and fasting plasma glucose during pregnancy.

PMID- 8475960
TI  - A randomized trial of low-dose heparin and intermittent pneumatic calf
      compression for the prevention of deep venous thrombosis after gynecologic
      oncology surgery.
AB  - OBJECTIVE: Our aim was to determine the relative efficacy and complications of
      low-dose heparin and intermittent pneumatic calf compression for the prevention
      of postoperative venous thrombosis in patients undergoing surgery for gynecologic
      malignancy. STUDY DESIGN: Randomized trial comparing 107 patients treated with
      low-dose heparin to 101 patients treated with intermittent pneumatic calf
      compression was performed. All patients were evaluated with iodine-125 fibrinogen
      scanning of the legs. Clinical and laboratory variables associated with bleeding
      complications were recorded prospectively. RESULTS: Venous thrombosis was
      diagnosed in seven patients receiving low-dose heparin and in four receiving
      intermittent pneumatic calf compression (p = 0.54). Low-dose heparin patients
      received more blood transfusions postoperatively (p = 0.02), had increased volume
      of retroperitoneal drainage (p = 0.02), and the activated partial thromboplastin
      time was more frequently prolonged (p = 0.001). CONCLUSIONS: Low-dose heparin and
      intermittent pneumatic calf compression provide similar reduction in reducing the
      incidence of postoperative venous thrombosis. However, low-dose heparin is more
      frequently associated with postoperative bleeding complications.

PMID- 8475961
TI  - Adaptive immune responses during murine pregnancy: pregnancy-induced regulation
      of lymphokine production by activated T lymphocytes.
AB  - OBJECTIVE: We hypothesized that the lymphokine production by splenocytes and
      decidual lymphocytes would be altered because of changes in immunoregulation
      during pregnancy. STUDY DESIGN: Splenocytes and decidual lymphocytes were
      isolated from syngeneic and allogeneic pregnant mice at different times of
      gestation. The lymphocytes (10(7) cells/ml) were stimulated with anti-CD3
      antibody, and culture supernatants were assayed for several lymphokines,
      including interleukin-2, interferon-gamma, interleukin-4, interleukin-6,
      granulocyte-macrophage colony-stimulating factor, and interleukin-3. Statistical
      analysis was by analysis of variance or paired t test. RESULTS: Activated
      splenocytes produced significantly less interleukin-2 and more interleukin-4,
      interleukin-6, and interleukin-3 as murine pregnancy advanced. Production of
      interferon-gamma and granulocyte macrophage colony-stimulating factor by
      activated splenocytes peaked in the first 8 to 14 days of pregnancy. Stimulated
      decidual lymphocytes produced modest amounts of interleukin-6, granulocyte
      macrophage colony-stimulating factor, and interleukin-3 during pregnancy but no
      interleukin-2, interferon-gamma, or interleukin-4. Similar results were found for
      both syngeneic and allogeneic matings. CONCLUSIONS: Our findings indicate that
      splenocyte lymphokine production favors interleukin-4 production over interleukin
      2 production. This finding suggests that antibody production would be enhanced
      and cytotoxic cellular immune responses inhibited during pregnancy. These changes
      occurred regardless of mating partner, suggesting that the specific antigenic
      stimulus during normal pregnancy does not regulate lymphokine production.
      Activated splenocytes and decidual lymphocytes were found to differ in their
      capacity to produce lymphokines, indicating that the decidua constitutes a
      distinct and unique immunologic microenvironment.

PMID- 8475962
TI  - The effect of acetaminophen on prostacyclin production in pregnant women.
AB  - OBJECTIVE: The purpose of this study was to determine if acetaminophen decreased
      prostacyclin production by endothelial cells in culture and by pregnant women.
      STUDY DESIGN: The effect of acetaminophen on endothelial cells in culture was
      determined by the addition of acetaminophen in concentrations of 10 and 100
      micrograms/ml with comparison to control and indomethacin at 10 micrograms/ml.
      Prostacyclin production was estimated in 24 and thromboxane A2 production in six
      third-trimester pregnant women by measurement of excretion of urinary metabolites
      before and after ingestion of either 1000 mg of acetaminophen or placebo.
      RESULTS: Compared with control (549 +/- 61 pg/well, mean +/- SD), production of
      prostacyclin in vitro was significantly inhibited by acetaminophen at 10
      micrograms/ml (321 +/- 25) and 100 micrograms/ml (257 +/- 14). This inhibition is
      similar to inhibition by 10 micrograms/ml of indomethacin (228 +/- 11). Excretion
      of prostacyclin metabolite was significantly lower after ingestion of
      acetaminophen (2233 +/- 446 vs 1246 +/- 199 pg/mg creatinine, mean +/- SEM) but
      unchanged after ingestion of placebo (1745 +/- 304 vs 1712 +/- 211). There was no
      difference in response between normal and hypertensive women, and there was no
      effect of acetaminophen on thromboxane metabolite excretion. CONCLUSION:
      Acetaminophen in typical oral doses results in reduced production of prostacyclin
      by endothelial cells in culture and in a reduction in prostacyclin, but not
      thromboxane, production in pregnant women.

PMID- 8475963
TI  - Alterations in vitamin D and calcium metabolism with magnesium sulfate treatment
      of preeclampsia.
AB  - OBJECTIVE: Our purpose was to determine the effects of magnesium sulfate therapy
      on preeclamptic women and their fetuses with regard to the hormones and ions
      involved with calcium homeostasis, including 1,25-dihydroxyvitamin D, 25
      hydroxyvitamin D, parathyroid hormone, and calcium. STUDY DESIGN: The study group
      comprised 15 preeclamptic women at term treated with magnesium sulfate during
      labor. Controls were seven normal women in term labor. The hormones and ions were
      measured in maternal blood obtained at the onset of labor and at delivery and in
      umbilical venous (fetal) blood. RESULTS: Baseline maternal levels of 25
      hydroxyvitamin D and parathyroid hormone were lower in preeclamptics than in
      controls. Magnesium infusion led to significant elevations in magnesium, 1,25
      dihydroxyvitamin D, 25-hydroxyvitamin D, and parathyroid hormone levels and
      lowered calcium concentrations. Fetuses of treated subjects demonstrated
      reductions in serum total and ionized calcium and elevations of 1,25
      dihydroxyvitamin D and parathyroid hormone. CONCLUSION: Magnesium sulfate
      infusion causes reductions in both maternal and fetal calcium levels. Both mother
      and fetus respond with increased 1,25-dihydroxyvitamin D and parathyroid hormone
      levels, which may prevent more severe maternal, fetal, and neonatal hypocalcemia.

PMID- 8475964
TI  - Transitional cell carcinoma of the ovary: a matched control study of advanced
      stage patients treated with cisplatin-based chemotherapy.
AB  - OBJECTIVE: The purpose of this study was to compare patients with advanced-stage
      transitional cell carcinoma of the ovary with those who had poorly differentiated
      serous carcinoma for surgical response and survival. STUDY DESIGN: Sixty-two
      patients with transitional cell carcinoma were identified through a retrospective
      review and were matched with serous carcinoma patients for stage and residual
      disease. All patients received cisplatin-based chemotherapy. End points selected
      for analysis were surgical response, progression-free survival time, and survival
      time. Univariate and multivariate regression analyses were also performed.
      RESULTS: The surgical complete response rate for patients with transitional cell
      carcinoma was 37%, compared with 11% for those with serous carcinoma (p < 0.001).
      The survival time was significantly longer for the patients with transitional
      cell carcinoma (median 52.3 vs 22.0 months) (p < 0.001). Multivariate analyses
      strengthened these findings. CONCLUSION: Transitional cell carcinoma of the ovary
      is significantly more chemosensitive and associated with a better prognosis than
      the more common serous carcinoma.

PMID- 8475965
TI  - Estrogen and interrupted progestin: a new concept for menopausal hormone
      replacement therapy.
AB  - OBJECTIVE: We tested a new hormone replacement formulation based on the
      hypothesis that interrupted administration of progestin in the presence of
      continuous estrogen would result in receptor up-regulation and resensitization of
      target tissues to both estrogen and progestin. As a result, symptom control might
      be possible with lower doses of steroids and in the absence of withdrawal
      bleeding. STUDY DESIGN: Forty postmenopausal women were entered in a 6-month
      pilot study, including an 18-month extension. They received piperazine estrone
      sulfate 0.75 mg daily. Norethindrone 0.35 mg daily was added in 3-day phases,
      alternating with progestin-free phases of 3 days. There was no steroid-free
      withdrawal period. We examined symptom control, bleeding patterns, endometrial
      protection, and lipid profiles in the women over the 24 months of the study.
      RESULTS: Hot flushes were completely eliminated in 76% of women, and 80% had no
      bleeding by 6 months. There were three dropouts. Thirty-three women elected to
      continue after the first 6 months and completed 24 months on therapy for a
      compliance rate of 82.5%. No endometrial hyperplasia was seen on serial biopsies,
      and no changes occurred in lipids except for a small but statistically
      significant decrease in high-density lipoproteins and triglycerides at 24 months.
      CONCLUSION: Our preliminary results of low bleeding rates, good symptom control,
      and endometrial protection suggest that hormone replacement with low-dose
      estrogen and interrupted progestin is effective and may lead to improved
      compliance in menopausal women.

PMID- 8475966
TI  - Maternal risk factors and their influence on fetal anthropometric measurements.
AB  - OBJECTIVE: Our purpose was to determine if and when maternal risk factors and
      fetal sex have an impact on specific fetal anthropometric measurements assessed
      by ultrasonography. STUDY DESIGN: Serial ultrasonographic examinations were
      performed on 1205 fetuses of indigent multiparous women who ultimately gave birth
      at term. Femur length, abdominal circumference, and head circumference
      measurements were obtained at mean gestational ages of 18, 25, 31, and 36 weeks,
      and an estimated fetal weight was calculated. At birth the infant was weighted
      and head circumference, abdominal circumference, femur length, and crown-heel
      length measurements were made. Regression analyses were used to determine the
      effect on each measurement of maternal race, height, body mass index,
      hypertension, weight gain, smoking, previous low birth weight, and fetal sex.
      RESULTS: Acting through their effect on head circumference, abdominal
      circumference, and fetal length, each of the risk factors and female sex were
      shown to have a negative effect on fetal weight. The timing of the impact, its
      magnitude, and the specific anthropometric measurement affected were different
      for each of the risk factors. CONCLUSIONS: The impact of maternal risk factors
      and fetal sex on estimated fetal weight has been demonstrated to occur first in
      specific gestational age windows and is mediated through effects on specific
      fetal anthropometric measurements.

PMID- 8475967
TI  - Deoxyribonucleic acid analysis facilitates the pretreatment identification of
      high-risk endometrial cancer patients.
AB  - OBJECTIVE: Our purpose was to assess the proficiency with which cytometrically
      determined deoxyribonucleic acid variables from pretreatment curettage specimens
      identify patients at high risk for extrauterine disease or posttreatment relapse.
      STUDY DESIGN: Flow cytometrically determined deoxyribonucleic acid ploidy, S
      phase fraction, deoxyribonucleic acid index, and proliferative index were
      assessed in 140 paraffin-embedded curettage specimens containing endometrial
      carcinoma. RESULTS: Although clinical staging identified only 19% of patients
      with advanced disease, 46% of surgical stages III and IV were aneuploid, 69% had
      an S-phase fraction > or = 9%, and 69% had a proliferative index > or = 14%.
      Documented recurrences and cancer-related deaths correlated with nondiploid
      patterns (29% of 140, 50% of recurrences, 54% of deaths), S-phase fraction > or =
      9% (41% of 140, 67% of recurrences, 75% of deaths), and proliferative index > or
      = 14% (45% of 140, 73% of recurrences, 79% of deaths). Deoxyribonucleic acid
      index (< 1.5 vs > 1.5) provided additional stratification of aneuploid tumors (p
      < 0.01). Multivariate analysis identified the proliferative index as the most
      cogent independent prognostic factor (p < 0.01). CONCLUSION: Deoxyribonucleic
      acid ploidy and proliferative activity in pretreatment curettage specimens
      identified the majority of patients at high risk for extrauterine metastasis and
      relapses.

PMID- 8475968
TI  - Affinity labeling identifies histidine at the active site of human placental 3
      beta-hydroxysteroid dehydrogenase and steroid 5-->4-ene-isomerase.
AB  - OBJECTIVE: Our aim was to determine if the multifunction enzyme, 3 beta
      hydroxysteroid dehydrogenase and steroid 5-->4-ene-isomerase has one or more
      active sites to effect dehydrogenase and isomerase activities. STUDY DESIGN: This
      steroid, which we have purified to homogeneity from human placental microsomes,
      was inactivated by the affinity labeling steroid, 2 alpha-bromo[2'
      14C]acetoxyprogesterone. The amino acids that were radioalkylated in the absence
      and presence of the dehydrogenase substrate pregnenolone were identified.
      RESULTS: Pregnenolone completely abolished the inactivation of dehydrogenase.
      Histidine was localized in the active site of 3 beta-hydroxysteroid dehydrogenase
      because the radiolabel disappeared from enzyme inactivated in the presence of
      pregnenolone. Cysteine, a major radiolabeled product (80%) in the absence of
      pregnenolone, was decreased twofold in incubations that contained pregnenolone.
      Neither pregnenolone nor the isomerase substrate 5-androstene-3,17-dione
      protected isomerase from inactivation by the affinity alkylator. CONCLUSION: This
      observation contradicts coexisting, separate binding sites, one for each
      activity. Rather, a conformation shift around one binding region prompted by
      products of the dehydrogenase reaction may create the isomerase activity.

PMID- 8475969
TI  - Preterm birth prevention: where are we?
AB  - OBJECTIVE: The purpose of this study was to review the current approaches to
      preventing preterm delivery. STUDY DESIGN: The problem of preterm birth was
      assessed by reviewing the different components that play a role in preterm birth
      prevention, excluding infection, antibiotic treatment, and tocolytic treatment.
      RESULTS: Prevention of preterm labor must initially discriminate those at risk.
      Positive predictive values of various approaches are currently not adequate
      enough to warrant intervention. Prevention modalities, in part because of poor
      prediction, are mostly unproved. Accurate diagnoses of preterm labor remains
      difficult and confuses analyses of tocolytic agents. Cervicovaginal fetal
      fibronectin, perhaps in combination with cervical evaluation, shows promise.
      Early detection programs remain controversial, but most reviews indicate that
      daily patient contact with high-risk patients gives cause for some optimism.
      Antenatal maternal glucocorticoid treatment at specific gestational ages improves
      neonatal outcome. CONCLUSION: The incidence of preterm birth is rising in the
      country. However, improved definition of the various components of the problem
      has provided an improved understanding of the problem. There is a new continuing
      effort and a search for new and innovative ways to address this vexing national
      problem.

PMID- 8475970
TI  - Are physical activity and employment related to preterm birth and low birth
      weight?
AB  - OBJECTIVE: The purpose of this study was to review the validity of published
      studies that consider modifying physical activity during pregnancy to decrease
      preterm births and low birth weight. STUDY DESIGN: Presented is a critical review
      of extant literature, both case-control studies and studies of pregnant women
      followed up in cohort fashion. RESULTS: Studies both showing and not showing an
      association between employment and adverse outcome exist. However, no randomized
      trials have been reported. The most plausible associations exist for prolonged
      standing, long working hours, and lifting heavy objects. CONCLUSION: Until the
      biologic basis of parturition is known, definitive conclusions are probably not
      possible. Proposals to require pregnancy leave for all employees seem premature.
      However, physicians must be sensitive to dilemmas faced by some employees and
      encourage voluntary leave for those placed in positions characterized by
      occupational fatigue.

PMID- 8475971
TI  - Antibiotics in the treatment of preterm labor.
AB  - OBJECTIVE: Clinical evidence for a relationship between chorioamnionitis and the
      onset of preterm labor, supported by well developed biochemical models of that
      interaction, motivated a review of prospective, randomized trials of antibiotic
      use in its prevention. STUDY DESIGN: A literature search was made of antibiotic
      trials applied to women at risk for preterm labor and with a clinical diagnosis
      of preterm labor after premature preterm rupture of membranes. A review of two
      retrospective case-control studies conducted on pregnant women with positive
      cultures for Chlamydia trachomatis is also included. RESULTS AND CONCLUSION:
      Results of antibiotic use in women with preterm premature rupture of membranes
      supports significant prolongation of the interval from rupture of membranes to
      delivery and improvement and neonatal outcome in treated patients.

PMID- 8475972
TI  - Low target birth weight or growth retardation? Umbilical Doppler flow velocity
      waveforms and histometric analysis of fetoplacental vascular tree.
AB  - OBJECTIVE: The placental vascular architecture of small-for-gestational-age
      fetuses seems to have an impact on the flow patterns in the umbilical arteries.
      STUDY DESIGN: Blood flow velocity waveforms of the umbilical arteries were
      measured by Doppler ultrasonography in nine small-for-gestational-age fetuses
      with elevated systolic/diastolic ratios of the umbilical arteries, seven small
      for-gestational-age fetuses with normal flow patterns, and 14 appropriate-for
      gestational-age fetuses with normal flow patterns. After delivery
      histomorphometric placental investigations were performed. RESULTS: Reduced end
      diastolic flow velocities were significantly associated with both a reduction of
      vascularization within the terminal villi and adverse diffusion conditions,
      indicating insufficient functional maturity. The perfusion and diffusion capacity
      of small-for-gestational-age placentas with normal umbilical artery flow velocity
      waveforms was similar or even slightly better compared with the appropriate-for
      gestational-age control values. CONCLUSION: These data suggest that Doppler flow
      velocimetry in the umbilical arteries is predictive of a vascular lesion within
      the placentas of small-for-gestational-age fetuses.

PMID- 8475973
TI  - Osteoporotic fractures and the recurrence of thromboembolism during pregnancy and
      the puerperium in 184 women undergoing thromboprophylaxis with heparin.
AB  - OBJECTIVE: To study the effect of long-term treatment during gestation with
      heparin on the incidence of osteoporotic fractures and thromboembolic recurrence.
      STUDY DESIGN: Long-term subcutaneous prophylaxis with heparin twice daily in
      pregnancy was prescribed for 184 women, during a decade because of an increased
      risk of thromboembolism. The dosage of heparin was adjusted to anti-factor Xa
      activity or activated partial thromboplastin time and different regimens were
      given, depending on the risk of recurrence. RESULTS: For the total group the mean
      dosage of heparin ranged from 13,000 to 40,000 IU per 24 hours (mean 19,100 IU
      per 24 hours), and the average duration of treatment was 25 weeks. Symptomatic
      osteoporotic fractures of the spine occurred post partum in four women, for whom
      the mean dosage of heparin ranged from 15,000 to 30,000 IU per 24 hours (mean
      24,500 IU per 24 hours), and the duration of treatment ranged from 7 to 27 weeks
      (mean 17 weeks). In spite of prophylaxis with heparin, thromboembolic
      complications occurred in five women. They had either nonsatisfactory
      concentrations of heparin according to our regimen or were later diagnosed as
      having a coagulation disorder known to increase the risk of thromboembolism.
      CONCLUSION: Osteoporotic vertebral fractures were found in 2.2% of the women, and
      a relationship to the amount of heparin was indicated, although fractures were
      not avoided during low-dose, short-term prophylaxis. Recurrence of
      thromboembolism occurred in 2.7% of the patients, but if a strict heparin
      adjustment had been performed, recurrence could probably have been prevented.

PMID- 8475974
TI  - Relationship of circadian rhythms of uterine activity with term and preterm
      delivery.
AB  - OBJECTIVE: Our aim was to document the presence or significance of circadian
      uterine activity rhythms in pregnant women who delivered at term and preterm.
      STUDY DESIGN: We measured uterine activity in 19 women divided into a control
      group (low risk for preterm labor, term delivery, n = 7), a group at high risk
      for preterm labor, term delivery (n = 6), and a group at high risk for preterm
      labor, preterm delivery (n = 6). Patients were hospitalized for 24 hours every 2
      weeks from 26 weeks' gestation until delivery. Uterine activity was measured
      continuously by external tocodynamometer. RESULTS: Patients delivering at term
      demonstrated a nocturnal surge (4 to 7 AM) in uterine activity the last 80 days
      before delivery (p < 0.05, analysis of variance). Patients delivered preterm
      showed an initial nocturnal surge of uterine activity similar to those delivered
      at term, but this disappeared 24 days before delivery (p > 0.05, analysis of
      variance). CONCLUSION: Uterine activity nocturnal surges normally precede term
      delivery. These surges are lost in women who deliver prematurely.

PMID- 8475975
TI  - Effect of intravenous beta-sympathomimetic tocolysis on human fetal serum
      erythropoietin levels.
AB  - OBJECTIVE: The major stimulus for erythropoietin production is tissue hypoxia. We
      sought to investigate the relationship of beta-sympathomimetic administration for
      tocolysis and fetal serum erythropoietin. STUDY DESIGN: Umbilical cord blood was
      obtained from infants whose mothers received intravenous beta-sympathomimetic
      tocolysis and who were delivered at < or = 34 weeks' gestation. Serum
      erythropoietin was measured by radioimmunoassay. On the basis of the presumed 2-
      to 4-hour half-life of fetal erythropoietin, the infants were divided into two
      groups. In group 1 (n = 16) beta-sympathomimetic therapy was discontinued < 24
      hours before delivery; in group 2 (n = 11) it was discontinued > or = 24 hours
      before delivery. RESULTS: Group 1 fetuses had significantly higher erythropoietin
      levels than did group 2 fetuses (37.3 vs 13.9 mU/ml, p = 0.02). The duration of
      beta-sympathomimetic tocolysis and the maximum infusion rate were not different.
      The two groups did not differ in gestational age, birth weight, route of
      delivery, presence of labor, or duration of first or second stage of labor.
      CONCLUSIONS: We speculate that intravenous beta-sympathomimetic tocolytic therapy
      stimulates fetal erythropoietin production by decreasing fetal oxygenation as a
      result of the reversible fetal metabolic effects of the tocolysis. These data
      suggest that beta-sympathomimetic tocolysis should be undertaken cautiously if
      fetal compromise is suspected, fetal well-being should be assessed carefully if
      tocolysis is undertaken, and treatment should be discontinued promptly if a clear
      benefit is not realized.

PMID- 8475976
TI  - Massive hydronephrosis mimicking theca lutein cysts in association with partial
      hydatidiform mole.
AB  - We present an unusual case of partial hydatidiform mole in which extensive,
      multiple cystic structures encompassing the entire right abdomen and pelvis,
      initially thought to represent theca lutein cysts, were subsequently shown to
      consist of massive unilateral right hydronephrosis. Percutaneous nephrostomy
      decompression bypassing the ureteropelvic obstruction revealed functional renal
      parenchyma.

PMID- 8475977
TI  - Malignant ventricular arrhythmias in eclampsia: a comparison of labetalol with
      dihydralazine.
AB  - OBJECTIVE: Our aim was to assess the impact of beta-adrenergic blockade during
      the peripartum period on the previously observed high incidence of ventricular
      arrhythmias in eclamptic parturients. STUDY DESIGN: An open, randomized
      comparison of intravenous labetalol versus dihydralazine was conducted in 40
      eclamptic subjects in the peripartum period. Cardiac rhythm was assessed by
      blinded analysis of a 24-hour Holter record by means of the Lown classification
      of arrhythmias. RESULTS: There was a significantly higher incidence of serious
      ventricular arrhythmias in patients receiving dihydralazine (81%) than in those
      receiving labetalol (17%, p < 0.0001). Patients receiving labetalol showed a
      significant decrease in mean heart rate (p < 0.0001), whereas patients receiving
      dihydralazine showed a significant increase (p < 0.0001). CONCLUSION: The
      introduction of beta-adrenergic blockade into peripartum hypertensive management
      of eclampsia significantly reduced the incidence of dangerous ventricular
      arrhythmias. Myocardial oxygen supply/demand ratio may be improved by beta
      blockade.

PMID- 8475978
TI  - Trends in cesarean section use in California, 1983 to 1990.
AB  - OBJECTIVE: Our aim was to assess recent trends in cesarean section use in
      California. STUDY DESIGN: California discharge abstract data on hospital
      deliveries in 1983 through 1990 (379,759 to 587,508 annual deliveries) were used
      to analyze time trends by indication, age, race, and payment source. RESULTS:
      California cesarean section rates increased annually from 21.8% in 1983 to 25.0%
      in 1987 and then decreased to 22.7% by 1990. Similar patterns were noted for all
      age and race or ethnicity groups. Primary cesarean section rates increased from
      15.2% in 1983 to 17.9% in 1987, then decreased to 16.2% by 1990. Declines in
      repeat cesarean section rates continued throughout 1983 through 1990,
      accelerating after 1987. For both primary and repeat cesarean section rates, time
      trends after mid-1987 were significantly different than those for 1983 to 1987.
      CONCLUSION: After increasing from 1983 to 1987, California cesarean section rates
      declined from 1988 to 1990. Existing payment source differences in cesarean
      section use increased in magnitude from 1983 to 1990, with privately insured
      women consistently having the highest cesarean section rates.

PMID- 8475979
TI  - Effect of early pregnancy on maternal regional cerebral blood flow.
AB  - OBJECTIVE: The purpose of this study was to assess the effect of early pregnancy
      on maternal regional cerebral blood flow. STUDY DESIGN: We studied 10 pregnant
      women at 7 to 19 weeks' gestation by the xenon 133 washout technique by means of
      single-photon emission computed tomography the day before the abortion was
      induced and then again at a mean of 42.8 days after the abortion. RESULTS: Blood
      flow in the cerebral hemispheres decreased after the abortion, with a decline of
      8.1% (p < 0.001). Each regional decrease was as follows: 7.6% (p < 0.01) in the
      frontal lobe, 9.1% (p < 0.01) in the temporal lobe, 12.9% (p < 0.001) in the
      parietal lobe, 9.8% (p < 0.01) in the basal ganglia, and 16.7% (p < 0.001) in the
      cerebellum. There was no significant difference in blood flow in the occipital
      lobe before versus after the abortion. CONCLUSION: Maternal regional cerebral
      blood flow was increased in early pregnancy compared with the nonpregnant state,
      except in the occipital lobe.

PMID- 8475980
TI  - Intraobserver and interobserver variability of the amniotic fluid index.
AB  - OBJECTIVE: We assessed intraobserver and interobserver variations in the
      performance of the amniotic fluid index. STUDY DESIGN: A total of 34 women in the
      third trimester with intact membranes were examined twice by each of three
      examiners. The amniotic fluid index was measured once by each of the three
      examiners in order, then repeated by each examiner in the same order. Numeric
      displays on the video terminal screen were covered so that the examiners were
      blinded to actual measurement values. Results were recorded on hard copy for
      later data analysis. A senior investigator supervised all examinations to monitor
      consistency of technique. RESULTS: Overall, the coefficient of variation for
      amniotic fluid index measurements varied from 10.8% within examiners to 15.4%
      between examiners. Both between and within variation of absolute differences
      increased as the amniotic fluid index value increased, while the percent
      difference decreased. Simply repeating the test by the same examiner will
      decrease the coefficient of variation significantly. CONCLUSION: Although
      intraobserver and interobserver variability cannot be eliminated, its impact can
      be minimized by use of the same examiner for serial studies.

PMID- 8475981
TI  - Platelet-activating factor treatment of human spermatozoa enhances fertilization
      potential.
AB  - OBJECTIVE: The purpose of this study was to evaluate the effects of platelet
      activating factor treatment on human spermatozoa fertilizing capability, as
      assessed by the zona-free hamster penetration assay. STUDY DESIGN: Twenty-three
      semen specimens were divided into two groups on the basis of initial motile sperm
      count greater or less than 20 x 10(6)/ml. Each sample served as its own treatment
      control. Twice-washed spermatozoa were treated with 1 x 10(-7) mol/L of platelet
      activating factor before performing the sperm penetration assay. For the two
      groups the percent penetrations and penetration index were compared with the
      paired t test, and an independent t test was used to compare parameters between
      groups. RESULTS: Significant enhancement of both percent penetrations (p <
      0.0001) and penetration index (p < 0.005) were noted on platelet-activating
      factor treatment in both groups. Enhancement of both indices were noted to be
      independent of initial motile sperm counts. CONCLUSION: Platelet-activating
      factor treatment of human spermatozoa may be of potential therapeutic value in
      certain cases of asthenospermia or fertilization failure in human in vitro
      fertilization.

PMID- 8475982
TI  - Transforming growth factor-beta 2 prevents preterm delivery induced by
      interleukin-1 alpha and tumor necrosis factor-alpha in the rabbit.
AB  - OBJECTIVES: The purpose of the study was to determine whether preterm parturition
      in the rabbit can be induced by intraamniotic injection of proinflammatory
      cytokines, interleukin-1 alpha and tumor necrosis factor-alpha, and whether
      transforming growth factor-beta 2, an inhibitor of the cytokine-induced
      prostaglandin synthesis, modifies the effect of these cytokines. STUDY DESIGN:
      New Zealand White rabbits were injected in each amniotic cavity on day 24 of
      gestation with one of the following: a combination of interleukin-1 alpha (150
      ng) and tumor necrosis factor-alpha (1.25 micrograms), 50 ng of transforming
      growth factor-beta 2 concomitantly with interleukin-1 alpha and tumor necrosis
      factor-alpha, or vehicle. In the first study the animals were observed for signs
      of delivery until day 29 of gestation. In the second study the effect of
      transforming growth factor-beta 2 (50 ng/fetus) on the rate of premature delivery
      was evaluated. In the third study the concentrations of prostaglandin E2 and
      13,14-dihydro-15-keto-prostaglandin F2 alpha were measured in the amniotic fluid
      on day 27 of gestation. The statistics used were Fisher's exact test, the chi 2
      test, and the Mann-Whitney U test. RESULTS: Altogether 61 of 191 fetuses (32%)
      were born prematurely in the interleukin-1 alpha-tumor necrosis factor-alpha
      group, whereas only two of 161 fetuses (1.2%) (p = 0.0001) and one of 159 (0.6%)
      (p = 0.0001) were born prematurely in the interleukin-1 alpha-tumor necrosis
      factor-alpha-transforming growth factor-beta 2 group and in the control group,
      respectively. Of the 23 animals injected with interleukin-1 alpha and tumor
      necrosis factor-alpha, six (26%) delivered all of their fetuses prematurely
      versus none in the other groups (p = 0.02). None of the 88 fetuses in the
      transforming growth factor-beta 2 group were born prematurely. The prostaglandin
      E2 concentrations in the amniotic fluids were higher in the interleukin-1 alpha
      tumor necrosis factor-alpha group than in the interleukin-1 alpha-tumor necrosis
      factor-alpha-transforming growth factor-beta 2 group (p = 0.05) or in the control
      group (p = 0.02). CONCLUSIONS: Preterm parturition can be provoked in the rabbit
      by intraamniotic injections of interleukin-1 alpha and tumor necrosis factor
      alpha. Transforming growth factor-beta 2 prevents the cytokine-induced increase
      in premature delivery.

PMID- 8475983
TI  - Histocompatibility antigens and pregnancy outcome.

PMID- 8475984
TI  - Severe pregnancy-induced hypertension and blood pressure control during general
      anesthesia: nitroglycerin or opioids, the logical choice?

PMID- 8475985
TI  - Laparoscopic surgery: experiment or expedient?

PMID- 8475986
TI  - Colposcopy and rape.

PMID- 8475987
TI  - Middle cerebral artery flow velocity waveforms and fetal compromise.

PMID- 8475988
TI  - Hyperbaric oxygenation for necrotizing fasciitis.

PMID- 8475989
TI  - Psychological sequelae of childhood sexual abuse: relevant in subsequent
      pregnancy.

PMID- 8475990
TI  - CD44 and hyaluronan expression in human cutaneous scar fibroblasts.
AB  - Fibrotic disorders of skin and other organs are typically associated with an
      abnormal accumulation of extracellular matrix. This study focuses on a matrix
      constituent, hyaluronan-which is known to be altered in fibrotic disorders of
      skin- and on CD44, a cell adhesion molecule and putative receptor for hyaluronan.
      Tissue samples were obtained from biopsies of human normal skin, normal cutaneous
      scar; and hypertrophic cutaneous scar. After culturing, cells were studied by
      single- and double-labeling immunohistochemistry using the two anti-CD44
      monoclonal antibodies, BU-52 and J173, and a biotinylated hyaluronan binding
      complex probe, b-HABR. Certain cultures were pretreated with Streptomyces
      hyaluronidase to assess the dependency of CD44 expression on the presence of
      endogenous hyaluronan. CD44 expression, both in the presence and the absence of
      exogenous hyaluronan, was quantitated by radioimmunobinding assay. Overall
      glycosaminoglycan synthesis and identification of hyaluronan were accomplished by
      precursor incorporation assays and by quantitative cellulose acetate
      electrophoresis. CD44 was found to be a normal human adult fibroblastic antigen
      whose expression is markedly increased for hypertrophic scar fibroblasts compared
      with normal skin fibroblasts. Although hyaluronan was found to be the predominant
      glycosaminoglycan constituent of the pericellular matrix for these fibroblasts,
      CD44 attachment to the cell surface is neither mediated by hyaluronan nor is the
      presence of hyaluronan a prerequisite for CD44 expression. Exogenous hyaluronan
      induced a decline in measurable CD44 expression for normal skin fibroblasts but
      not for hypertrophic scar fibroblasts. These observations are compatible with
      current understanding of the way cells manage the hyaluronan economy of the
      extracellular matrix and emphasize phenotypic heterogeneities between fibroblasts
      derived from normal versus scar tissues.

PMID- 8475991
TI  - A 34-kd protein with strong homology to ras-like proteins inhibits epidermal
      growth factor activity.
AB  - Epidermal growth factor (EGF) and its analog, transforming growth factor-alpha,
      are felt to be important in oncogenesis. When malignant rabbit fibroma virus
      infects RK-13 rabbit kidney cells, a 34-kd protein that inhibits the effects of
      EGF on certain target cell lines is produced. We have purified this protein using
      high-pressure liquid chromatography and gel electrophoresis. This purified
      protein abolishes EGF-induced cellular proliferation. It also causes the EGF
      receptor-bearing A431 carcinoma cell line to stop proliferating in vitro. This
      purified 34-kd EGF inhibitor (EGFI) redirects cellular protein phosphorylation in
      the presence or absence of EGF. Whereas EGF increases phosphorylation of cellular
      proteins in normal rat kidney cells, clone 49F, and A431 EGFI generally decreases
      it. Both EGF and EGFI cause increased protein production in A431 and normal rat
      kidney cells. The major species of protein synthesized by cells seem invariant to
      EGFI, with or without EGF. The partial protein sequence of two fragments of EGFI
      shows striking similarity to two ras like proteins. Possible means by which such
      a ras-like protein might inhibit EGF-induced cellular proliferation are
      discussed. Therefore, a purified 34-kd ras-like protein inhibits EGF-induced
      cellular proliferation and changes the targets for cellular protein
      phosphorylation. Studies are in progress to characterize this protein further,
      both structurally and functionally.

PMID- 8475992
TI  - Neoplasia of the ampulla of Vater. Ki-ras and p53 mutations.
AB  - Eleven tumors of the ampulla of Vater (5 stage IV and 2 stage II adenocarcinomas,
      1 stage II papillary carcinoma, 1 neuroendocrine carcinoma, and 2 adenomas, one
      with foci of carcinoma) were examined for Ki-ras and p53 gene mutations by single
      strand conformation polymorphism analysis and direct sequencing of polymerase
      chain reaction-amplified DNA fragments. Ki-ras mutations were found in one
      adenocarcinoma and in the adenoma with foci of carcinoma, both involving mainly
      the intraduodenal bile duct component of the ampulla. Seven cases showed p53 gene
      mutations: four advanced-stage adenocarcinomas, the papillary carcinoma, the
      neuroendocrine carcinoma, and the adenoma with foci of carcinoma. Nuclear
      accumulation of p53 protein was immunohistochemically detected in the
      morphologically high-grade areas of the five cancers harboring a p53 gene
      missense point mutation. The adenomas, the two frame shift-mutated cancers, and
      the adenomatous and low-grade cancer areas of mutated carcinomas were
      immunohistochemically negative. Our data suggest that in ampullary neoplasia 1)
      p53 mutations are common abnormalities associated with the transformation of
      adenomas and low-grade cancers into morphologically high-grade carcinomas, and 2)
      Ki-ras mutations are relatively less frequent and might be restricted to tumors
      originating from the bile duct component of the ampulla.

PMID- 8475993
TI  - Multiple tumor types appear in a transgenic mouse with the ras oncogene.
AB  - A transgenic mouse strain with the zeta-globin promoter and the vHa-ras oncogene
      develops an array of mesenchymal and epithelial neoplasms described here. The
      predominate mesenchymal tumors were dermal spindle cell tumors, which resembled
      malignant fibrous histiocytomas found in humans. They were associated with
      hepatosplenomegaly and developed beneath squamous papillomas. The
      hepatosplenomegaly was associated with infiltrates of cells that tended toward
      myelocytic or monocytic differentiation. Other epithelial tumors included
      keratoacanthomas and squamous cell carcinomas. Squamous cysts, some with squamous
      cell carcinomas, of the salivary glands and mammary carcinomas were also found.
      Odontogenic tumors, which sometimes differentiated into ameloblastomas, were one
      of the more unusual tumor types observed. Other, less frequent tumors were also
      noted. The tumors described here are a potentially valuable experimental resource
      that may lead to an understanding of malignant fibrous histiocytoma-like lesions,
      odontogenic tumors, and tumor progression.

PMID- 8475994
TI  - Mesothelial cell proliferation after instillation of long or short asbestos
      fibers into mouse lung.
AB  - The relationship of asbestos deposition in the lung to subsequent cell
      proliferation at the pleural surface is not clear. The present study examines DNA
      synthesis by various pulmonary cells, particularly those at the pleura after
      intratracheal injection of 0.1 mg crocidolite to mice using: 1) long fibers (> 20
      mu), which are deposited in bronchiolar regions and induce fibrosis; 2) short
      fibers (< 1 mu), which reach alveoli but do not induce fibrosis. Mice also
      received 2 microCi/g tritiated thymidine 1 hour before death at intervals to 16
      weeks. Short fibers induced only a small increase in labeling of bronchiolar
      epithelial and interstitial cells, which subsided by 5 days, when a small
      increase in labeled mesothelial and subpleural cells was seen. In contrast, long
      fibers damaged the bronchiolar epithelium and became incorporated into connective
      tissue. During regeneration, 12% of cells were labeled at 3 days and labeling was
      greater than controls to 4 weeks. Increased peribronchiolar labeling of
      fibroblasts and interstitial macrophages was seen around long fibers, and
      increased DNA synthesis by mesothelial and subpleural cells was found. Up to 2%
      of mesothelial cells were labeled 1 week after long fibers compared to near zero
      in controls. No long fibers were found at the pleura. Activation of interstitial
      macrophages in response to long crocidolite fibers is associated with fibroblast
      proliferation. It is now suggested that mesothelial cells may also be stimulated
      by cytokines from activated interstitial macrophages that diffuse across the
      interstitium, without requiring actual fiber translocation to the pleura.

PMID- 8475995
TI  - Suppression of local and systemic responses in streptococcal cell wall-induced
      acute inflammation of the air pouch by cyclosporine A. Comparison with the
      effects of two anti-inflammatory bis-benzimidazoles.
AB  - Injection of streptococcus group A cell wall-derived peptidoglycan polysaccharide
      into a subcutaneous air pouch causes local outpouring of neutrophils and
      macrophages and distant hemopoietic proliferation in spleen and bone marrow.
      Cyclosporine A (CyA) suppressed neutrophil accumulation and all cell lines of
      hemopoiesis. trans-1,2-Bis(5-amidino-2-benzimidazolyl)ethene (BBE) also
      interfered with neutrophil exudation, yet reduced only the erythroid component of
      the hemopoietic process. The ethane analogue of BBE, on the other hand, did not
      prevent neutrophil emigration, but held down splenic erythropoiesis and
      myelopoiesis. All three compounds stimulated streptococcus group A cell wall
      derived peptidoglycan polysaccharide uptake by pouch macrophages. CyA being the
      least active, BBE and its ethane analogue also produced a shift of wear-and-tear
      pigment from large numbers of small splenic macro-phages into small numbers of
      large macrophages. The pouch model is very useful in the study of anti
      inflammatory compounds and has furnished the first evidence of CyA interference
      with massive neutrophilic infiltration and with hemopoietic signals.

PMID- 8475996
TI  - Gingival mononuclear cells from chronic inflammatory periodontal tissues produce
      interleukin (IL)-5 and IL-6 but not IL-2 and IL-4.
AB  - A unique characteristic of the localized inflammatory tissue in the periodontium
      (e.g., adult periodontitis [AP]) is the accumulation of IgG (IgG1 > IgG2 > IgG3 >
      or = IgG4) followed by IgA plasma cells (IgA1 > IgA2). However, the exact
      molecular mechanisms contributing to these elevated B-cell responses at the local
      disease site are still unknown. Thus, this study has examined the production of
      cytokines of importance in B-cell responses, e.g., interleukin (IL)-2, IL-4, IL
      5, and IL-6 by gingival mononuclear cells (GMC) isolated from patients in severe
      stages of AP. These cytokines were assessed at the protein and messenger (m)RNA
      levels to understand their importance for the observed increased B-cell responses
      present in these tissues. Among the four cytokines tested by respective cytokine
      specific, polymerase chain reaction and dot-blot hybridization, high levels of IL
      5- and IL-6-specific mRNA were noted in GMC freshly isolated from AP patients. On
      the other hand, specific message for IL-2 and IL-4 were not present. Further, the
      analysis of culture supernatants of GMC also revealed that cells from AP patients
      spontaneously produced IL-5 and IL-6 but not IL-2 and IL-4. In contrast, when
      peripheral blood mononuclear cells isolated from the same patients were examined
      for these cytokines, no detectable levels of mRNA or secreted cytokines were
      noted. These results showed that GMC from localized inflammatory tissues in
      severe stages of AP possess a distinct cytokine profile represented by high
      levels of IL-5 and IL-6 mRNA expression and protein synthesis, whereas IL-2 and
      IL-4 were not detected. Further, this study supports the concept that AP is a
      localized inflammatory disease, because GMC from the inflamed tissue actively
      produce IL-5 and IL-6, whereas peripheral blood mononuclear cells from the same
      patients do not.

PMID- 8475997
TI  - Effects of interferon-gamma on primary cultures of human brain microvessel
      endothelial cells.
AB  - Primary cultures of human brain microvessel endothelial cells were used to study
      the effects of human recombinant interferon-gamma (IFN-gamma) on cerebral
      endothelium in vitro. Incubation of monolayers with various concentrations of IFN
      gamma (10 to 200 U/ml) for 12 to 96 hours induced surface expression of class II
      major histocompatibility complex (Ia) antigen in a time- and concentration
      dependent manner. In immunogold-stained cultures, labeling was observed as early
      as 12 hours, was maximal after 48 hours, and persisted at plateau levels in the
      continuous presence of the cytokine. Expression was blocked by coincubation with
      anti-IFN-gamma antibody and was reversed 4 days following removal of IFN-gamma
      from the culture media. Endothelial cells treated with IFN-gamma for 3 to 4 days
      became spindle-shaped, extensively overlapped, and frequently formed cellular
      whorls. These changes did not occur in the presence of anti-IFN-gamma antibody
      and reversed upon removal of IFN-gamma from the media. The morphological
      alterations were associated with increased permeability of confluent monolayers
      to macromolecules as compared with untreated cultures. The results of these
      studies indicate that human brain microvessel endothelial cells respond to in
      vitro cytokine stimulation by undergoing profound morphological, functional, and
      permeability changes. We conclude that cerebral endothelium may play an important
      role in the initiation and regulation of lymphocyte traffic across the blood
      brain barrier in inflammatory disorders of the human central nervous system.

PMID- 8475998
TI  - Reversibility of mild to moderate ischemic injuries in the isolated rat heart. A
      characterization by 31P-NMR and by physiological and ultrastructural indices.
AB  - We have studied cardiac function, metabolism, and ultrastructure during
      reperfusion after global ischemia of short duration (6 and 12 minutes) in
      isolated rat hearts. Our aim was to obtain more detailed information on the
      reversibility of changes following presumedly mild and moderate ischemic injuries
      by use of multiple time-based indices. In a modified Langendorff perfusion
      system, hearts were subjected to 24 minutes of control perfusion and 6 or 12
      minutes of ischemia followed by 1.5 or 24 minutes of reperfusion. During the
      experiments we monitored left ventricular developed pressure (LVDP), heart rate,
      and coronary flow rate, and intracellular phosphocreatine (PCr), inorganic
      phosphate (P(i)), pH, and ATP by 31P nuclear magnetic resonance spectroscopy. The
      number of cells with sarcolemmal and nuclear injuries was counted. Our main
      findings during 24 minutes of reperfusion following 6 and 12 minutes of ischemia
      were 80% versus 53% recovery of LVDP at the end of reperfusion, an increased PCr,
      80% versus 65% recovery of ATP, and a rapid versus slower recovery of pH.
      Ultrastructural examination revealed sarcolemmal and unclear abnormalities at the
      end of ischemia, these alterations being fully (rapidly versus more slowly)
      reversible during reperfusion. According to these findings, there was a
      dissociation between an essentially normal ultrastructure, and a depressed
      recovery of LVDP, reduced ATP, and an overshoot of PCr upon 24 minutes of
      reperfusion after 12 minutes of ischemia. This may indicate a postischemic
      dysfunction closely related to stunning.

PMID- 8475999
TI  - Influence of the estrous cycle on the development of upper genital tract
      pathology as a result of chlamydial infection in the guinea pig model of pelvic
      inflammatory disease.
AB  - Guinea pigs were infected intravaginally with the chlamydial agent of guinea pig
      inclusion conjunctivitis at varying times during the estrous cycle. Genital tract
      tissues were collected 30 days after infection and processed for
      histopathological analysis. No difference was seen in the course of lower genital
      tract infection. However, a significantly greater percentage of tissues from
      animals infected on day 11 of the cycle were found to have chronic inflammation
      and fibrosis in the mesosalpinx compared to those from animals infected on day 6
      or day 16. In addition, a significantly greater percentage of oviduct tissues
      from day 11-infected guinea pigs had marked tubal dilatation when compared to
      oviducts from day 6-or day 16-infected animals. The increased incidence of
      pathological changes was also noted in the endocervix, uterine fundus, and
      uterine horns but not the exocervix. These data indicate that the time of the
      estrous cycle and the corresponding hormonal influences may be an important
      influence on the development of upper genital tract disease.

PMID- 8476000
TI  - Pathology and molecular diagnostics: issues of structure and organization.

PMID- 8476001
TI  - Geographic variation of six dermatoglyphic traits in Eurasia.
AB  - We describe the geographic variation patterns of six dermatoglyphic traits from
      144 samples in Eurasia. The methods of analysis include computation of
      interpolated surfaces, one-dimensional and directional correlograms, correlations
      between all pairs of surfaces, and distances between correlograms. There are at
      least two, probably three, distinct and significant patterns of variation. 1) A
      general NW-SE trend for pattern intensity, the main line index, and frequency of
      hypothenar patterns. 2) A trend from the Middle East to the north and east for
      frequency of axial triradius and of accessory interdigital triradii. 3) A patchy
      pattern for frequency of the thenar-interdigital 1. The results are compatible
      with a diffusion process between Europe and the peoples of Northern Asia, and
      possibly with a radiation of populations from the Middle East. The hypothesis of
      diffusion processes is supported by substantial interpopulation correlations
      between dermatoglyphic traits that contrast sharply with largely negligible
      intralocality correlations.

PMID- 8476002
TI  - Temporal craniometric changes from the Jomon to the Modern period in western
      Japan.
AB  - Temporal changes in morphometric features of human cranial remains from the late
      Jomon period (1500 B.C.-300 B.C.) to the Modern period (1900-1950 A.D.) in
      western Japan are examined. The results of univariate and multivariate analysis
      indicate that the Yayoi people (300 B.C.-300 A.D.), characterized by high faces
      and tall stature, show morphological discontinuity with the earlier Jomon people,
      who exhibit lower faces and shorter stature. This discontinuity contrasts with
      the relatively continuous changes among populations after the Yayoi. Comparing
      these changes with those documented in the Kanto region of eastern Japan
      indicates there are significant regional differences in the degree and rate of
      transformation in certain cranial features, especially facial height, between the
      two regions. Differences in cranial shape between the two regions become apparent
      during the Yayoi period and these differences tend to diminish thereafter. The
      most plausible explanation for these observed changes is the introduction of new
      genes, coinciding with the arrival of new immigrants from the Asian continent in
      the northern Kyushu-Yamaguchi region at the beginning of the Yayoi period.
      Further testing of this hypothesis will be necessary before definitive
      conclusions can be reached regarding the appearance of modern Japanese.

PMID- 8476003
TI  - Human dental arch shape evaluated by euclidean-distance matrix analysis.
AB  - Form differences between biological structures can be evaluated using several
      approaches. When landmark data are available, a recently proposed method
      (euclidean-distance matrix analysis) seems to be able to differentiate between
      size and shape differences. This method also localizes those areas which differ
      most between the two structures. We have applied it to analyze the sexual
      dimorphism in dental arch form in a sample of 50 men and 45 women. Subjects
      ranged in age between 20 and 27 years, and had sound dentitions. Fourteen
      landmarks, corresponding to the centers of gravity (centroids) of the occlusal
      surfaces of all permanent teeth (right second molar to left second molar), were
      individualized on the dental casts of subjects. All the possible linear distances
      between pairs of teeth were computed, thus creating four mean form matrices (one
      for each arch within sex). Gender differences were tested by using euclidean
      distance matrix analysis. No significant differences were demonstrated in the
      shape of arches, while male arches proved to be slightly bigger than female
      arches.

PMID- 8476004
TI  - New method of three-dimensional analysis of bipedal locomotion for the study of
      displacements of the body and body-parts centers of mass in man and non-human
      primates: evolutionary framework.
AB  - The current biomechanical interpretation of the chimpanzee's bipedal walking
      argues that larger lateral and vertical displacements of the body center of mass
      occur in the chimpanzee's "side-to-side" gait than in the human striding gait.
      The evolutionary hypothesis underlying this study is the following: during the
      evolution of human bipedalism one of the necessary changes could have been the
      progressive reduction of these displacements of the body center of mass. In order
      to quantitatively test this hypothesis, it is necessary to obtain simultaneously
      the trajectories of the centers of mass of the whole body and of the different
      body parts. To solve this problem, a new method of three-dimensional analysis of
      walking, associated with a volumetric modelling of the body, has been developed
      based on finite-element modeling. An orthogonal synchrophotographic device
      yielding four synchronous pictures of the walking subject allows a qualitative
      analysis of the photographic sequences together with the results of their
      quantitative analysis. This method was applied to an adult man, a 3-year-old girl
      and a 9-year-old male chimpanzee. Our results suggest that the trajectory of the
      body center of mass of the human is distinguished from that of the chimpanzee not
      by a lower movement amplitude but by the synchronization of the transverse and
      vertical displacements into two periodic curves in phase with one another. The
      non-human primate uses its repertoire of arboreal movements in its bipedal
      terrestrial gait, provisionally referred to as a "rope-walker" gait. We show that
      the interpretation of a "side-to-side" gait is not applicable to the chimpanzee.
      We argue that similarly this interpretation and the initial hypothesis presuppose
      a basic symmetric structure of the gait, in relation to the sagittal plane of
      progression, similar to the human one. This lateral symmetry of the right and
      left displacements of the center of gravity, in phase with the right and left
      single supports of walking, is probably a very derived feature of the human gait.
      We suggest that low lateral and vertical displacements of the body center of mass
      are not indicative of a progressive bipedal gait and we discuss the new
      evolutionary implications of our results.

PMID- 8476005
TI  - Brief communication: gut morphology of Callithrix nigriceps and Saguinus labiatus
      from western Brazilian Amazonia.
AB  - Quantitative data on the gut proportions of the recently-described black-headed
      marmoset (Callithrix nigriceps) from western Brazilian Amazonian are presented.
      Like other marmosets, C. nigriceps exhibits a relatively large caecum and colon
      associated with adaptations for gummivory. The degree of gut specialisation
      recorded is greater than that for any other platyrrhine for which quantitative
      data are available. Gum was found in the stomach contents of all four individuals
      examined, although the fruit/seeds of as many as seven different plant taxa were
      also encountered, in addition to insects of six different orders. Gut proportions
      of two Saguinus labiatus from the same region were typical of the more
      frugivorous tamarins, and stomach contents included only fruit and insects.
      Relative gut proportions of both species were closely similar to those of
      congeners from the same region.

PMID- 8476006
TI  - Brief communication: measurement size, precision, and reliability in craniofacial
      anthropometry: bigger is better.
AB  - In this paper we examine the results of an intraobserver measurement error study
      involving 49 craniofacial variables that ranged in size from less than 1 cm to
      approximately 20 cm. Repeat measurements were taken on 10 male and 10 female
      adult subjects (19-59 years old). Our focus is on the relationship between
      measurement size and measurement error across the 49 variables. We found that the
      size of the variable showed no relationship with the magnitude of the error as
      measured by the technical error of measurement. When the error was expressed as a
      coefficient of relative variation (Malina et al.: Vital and Health Statistics,
      Series 11, No. 23. Washington, DC: US Department of Health and Human Services,
      1973), this quantity was negatively associated with the size of the measurement.
      Conversely, reliability (Fleiss: The Design and Analysis of Experiments. New
      York: John Wiley & Sons, 1986) was positively correlated with measurement size.
      We did not find effects of scale (Marks et al.: Am. J. Epidemiol. 130:578-587,
      1989) within the individual measurements. Thus, for the range of size of the
      craniofacial measurements in this study, measurement size must be added to the
      list of factors such as ease of locating landmarks, measurement technique, and
      systematic bias in the application of the technique that can affect precision and
      reliability in anthropometry.

PMID- 8476007
TI  - Squamosal suture of cranium KNM-WT 17000.

PMID- 8476008
TI  - Functional significance of an ossified mandibular symphysis: a reply.

PMID- 8476009
TI  - Technical note: on the measurement of direct vs. projected anthropometric
      lengths.

PMID- 8476010
TI  - Blockers of voltage-gated K channels inhibit proliferation of cultured brown fat
      cells.
AB  - Cultured brown fat cells have both voltage- and Ca(2+)-activated potassium
      channels. We tested whether potassium channel activity is necessary for brown fat
      proliferation by growing adipocytes and preadipocytes from neonatal rat brown fat
      in the presence of potassium channel blockers. Whole cell patch-clamp experiments
      showed that verapamil, nifedipine, and quinine block the voltage-gated potassium
      current (IK,V) with micromolar affinity. Ca(2+)-activated currents (IK,NE) could
      be activated by micromolar intracellular Ca2+ concentrations and were blocked by
      nanomolar concentrations of apamin. Both IK,V and IK,NE are blocked by millimolar
      concentrations of tetraethylammonium (TEA). Under standard culture conditions,
      the number of cells showing the multilocular morphology characteristic of brown
      fat cells doubled in 3-5 days. Continuous exposure to 100 nM norepinephrine had
      no effect on this process. Cell proliferation was inhibited by TEA, quinine, or
      verapamil. The inhibition was dose dependent, with concentrations for half-block
      of cell proliferation similar to the Kd values for block of IK,V. Apamin, which
      selectively blocks IK,NE, had no effect on cell growth. These results suggest
      that functional voltage-gated potassium channels, but not Ca(2+)-activated
      potassium channels, may be necessary for the normal proliferation of brown fat
      cells in culture.

PMID- 8476011
TI  - Unbiased estimates of quantal release parameters and spatial variation in the
      probability of neurosecretion.
AB  - A procedure was developed for dealing with two problems that have impeded the use
      of quantal parameters in studies of transmitter release. The first, involving
      temporal and spatial biasing in the estimates for the number of functional
      release sites (n) and probability of release (p), was addressed by reducing
      temporal variance experimentally and calculating the bias produced by spatial
      variance in p (var(s)p). The second, involving inaccuracies in the use of nerve
      evoked endplate potentials (EPPs), was circumvented by using only miniature EPPs
      (MEPPs). Intracellular recordings were made from isolated frog cutaneous
      pectoris, after decapitation and pithing of the animals, and the concentration of
      K+ ([K+]) was raised to 10 mM to increase the level of transmitter release. The
      number of quanta released (m) by the EPP was replaced by the number of MEPPs in a
      fixed time interval (bin), and 500 sequential bins used for each quantal
      estimate. With the use of 50-ms bins, estimates for var(s)p were consistently
      negative. This was due to too large a bin (and introduction of undetected
      temporal variance) because the use of smaller bins (5 ms) produced positive
      estimates of var(s)p. Increases in m, n, and p but not var(s)p were found in
      response to increases in [K+] or [Ca2+]/[Co2+]. La3+ (20 microM) produced
      increases in m and n, which peaked after 20 min and declined toward zero. There
      were also large increases in p and var(s)p, which peaked and declined only to
      initial control values. The increase in var(s)p was presumed to reflect La(3+)
      induced release of Ca2+ from intracellular organelles. The results suggest that
      this approach may be used to obtain unbiased estimates of n and p and that the
      estimates of var(s)p may be useful for studying Ca2+ release from intraterminal
      organelles.

PMID- 8476012
TI  - Stable expression of the cardiac sodium-calcium exchanger in CHO cells.
AB  - A line of Chinese hamster ovary (CHO) cells called CK1.4 was produced by
      transfection with the gene for the bovine cardiac Na(+)-Ca2+ exchanger. CK1.4
      cells stably expressed substantial exchange activity and exchanger protein as
      shown by immunoprecipitation. Exchange activity was quantified as 45Ca2+ influx
      that depended on both increasing intracellular Na+ and lowering the concentration
      of external Na+. Replacing external Na+ with K+ slightly increased 45Ca2+ uptake
      by CK1.4 cells with basal Na+ and greatly increased 45Ca2+ uptake by Na(+)-loaded
      cells. Neither exchange activity nor exchanger protein was detected in the
      nontransfected parental line. By contrast to CK1.4 cells, replacing external Na+
      with K+ decreased 45Ca2+ uptake in the nontransfected cells whether or not they
      were Na+ loaded. Changes in cytosolic free Ca2+ determined with fura-2 were
      consistent with the 45Ca2+ uptake data. Analysis of poly(A)(+)-RNA by Northern
      blot confirmed that CK1.4 cells, but not the parental line, expressed the
      exchanger. Expression of the exchanger was also observed in aortic myocytes and a
      renal epithelial cell line (LLC-MK2) but not in other lines of renal epithelial
      cells (MDCK, LLC-PK1) or human dermal fibroblasts. The cardiac exchanger produced
      substantial 45Ca2+ efflux from CK1.4 cells in response to hormone-evoked release
      of stored Ca2+. CK1.4 cells are an attractive model for studies of the regulation
      of the cardiac exchanger because they stably express sufficient exchanger for
      biochemical and immunological analysis.

PMID- 8476013
TI  - Functional expression of the rat anion exchanger AE2 in insect cells by a
      recombinant baculovirus.
AB  - We used baculovirus to transiently express a rat anion exchanger (AE2) in
      Spodoptera frugiperda (Sf9) insect cells. No detectable Cl(-)-HCO3- exchange
      activity was observed in wild type or sham-infected Sf9 cells, monitored using
      2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein, a pH-sensitive fluorescent
      dye. Functional expression of anion exchange activity in the AE2 recombinant
      baculovirus-infected cells was observed within the first day after infection and
      sustained over the next 3 days. The expressed AE2 anion exchange activity was Na+
      independent and could be reversibly and irreversibly inhibited by the specific
      anion exchange inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS). The
      reversible inhibition was sensitive to the concentration of DIDS, with a half
      inhibition of 4 microM. These results indicate that the rat AE2 protein produced
      in the recombinant baculovirus-infected insect cells is inserted into the plasma
      membrane in a biologically active form that appears suitable for functional
      studies of AE2.

PMID- 8476014
TI  - Supernatant of endothelial cells exposed to laminar flow inhibits mesangial cell
      proliferation.
AB  - We investigated the effects of culture medium conditioned with endothelial cells
      exposed to hemodynamic shear forces on modulation of mesangial cell (MC) growth.
      Confluent monolayers of bovine aortic endothelial cells, grown in medium
      containing 10% fetal calf serum, were exposed to static or to laminar flow
      conditions for 24 h using a cone-and-plate device. Endothelial cell-conditioned
      medium was used to study the growth of bovine MC by [3H]thymidine uptake. The
      proliferative response of MC to fresh medium (containing 10% fetal calf serum)
      and to culture medium from endothelial cells under static flow [66.7 +/- 34.1 vs.
      73.9 +/- 30.0 counts/min (cpm) x 10(-3)] was comparable. In contrast, medium
      conditioned with endothelial cells exposed to laminar shear stress of 8 dyn/cm2
      almost completely abolished MC proliferation (5.8 +/- 6.9 cpm x 10(-3), P <
      0.01). To establish whether this effect is due to endothelial cell production of
      a substance that inhibits MC proliferation or simply to metabolization of serum
      growth factors in the culture medium, we performed shear stress experiments using
      serum free medium and we added 10% fetal calf serum after shear exposure just
      before the proliferation assay. In this condition a significant antiproliferative
      effect of endothelial cell supernatant under laminar flow was obtained (27.7 +/-
      23.4 vs. 68.8 +/- 45.8 cpm x 10(-3), laminar vs. static, P < 0.05), suggesting
      that endothelial cells under shear stress effectively produce a factor that
      inhibits MC proliferation. These results would suggest that local glomerular
      capillary blood flow could play a role in the regulation of MC mitogenesis.

PMID- 8476015
TI  - Transport of lactate and other monocarboxylates across mammalian plasma
      membranes.
AB  - Transport of L-lactate across the plasma membrane is of considerable importance
      to almost all mammalian cells. In most cells a specific H(+)-monocarboxylate
      cotransporter is largely responsible for this process; the capacity of this
      carrier is usually very high, to support the high rates of production or
      utilization of L-lactate. The best characterized H(+)-monocarboxylate transporter
      is that of the erythrocyte membrane, which transports L-lactate and a wide range
      of other aliphatic monocarboxylates, including pyruvate and the ketone bodies
      acetoacetate and beta-hydroxybutyrate. This carrier is inhibited by alpha
      cyanocinnamate derivatives and some stilbene disulfonates and has been identified
      as a protein of 35-50 kDa on the basis of purification and specific labeling
      experiments. Other cells possess similar alpha-cyanocinnamate-sensitive H(+)
      linked monocarboxylate transporters, but in some cases there are significant
      differences in the properties of these systems, sufficient to suggest the
      existence of a family of such carriers. In particular, cardiac muscle and tumor
      cells have transporters that differ in their Km values for certain substrates
      (including stereoselectivity for L- over D-lactate) and in their sensitivity to
      inhibitors. Mitochondria, bacteria, and yeast also possess H(+)-monocarboxylate
      transporters that share some properties in common with those in the mammalian
      plasma membrane but are adapted to their specific roles. However, there are
      distinct Na(+)-monocarboxylate cotransporters on the luminal surface of
      intestinal and kidney epithelia, which enable active uptake of lactate, pyruvate,
      and ketone bodies in these tissues. This article reviews the properties of these
      transport systems and their role in mammalian metabolism.

PMID- 8476016
TI  - Sorting and recycling efficiency of apical insulin binding sites during
      endocytosis in proximal tubule cells.
AB  - Intracellular traffic and recycling of apical insulin binding sites are examined
      in isolated, perfused proximal tubules. The endocytic binding sites were specific
      as revealed by 90% reduction in 125I-labeled insulin binding by 10(-5) M insulin.
      The traffic was followed by developing a chemical cross-linking method to
      covalently label the binding sites. Only 3% of cross-linked insulin-gold was
      transported to the lysosomes, reflecting high sorting and recycling efficiency.
      Correspondingly, only 4% of cross-linked 125I-insulin was degraded, and only 5%
      of the electron microscopy-autoradiographic grains was associated with lysosomes.
      No label was transferred to the Golgi apparatus; thus neither lysosomes nor Golgi
      apparatus is involved in the recycling. In contrast, approximately 40% of non
      cross-linked ligand was transferred to the lysosomes. Tubules first pretreated
      with cross-linker and then perfused with insulin-gold or 125I-labeled insulin
      like growth factor I revealed lysosomal accumulation and degradation at control
      levels. Thus the cross-linker does not interfere with membrane or protein
      processing. The study also provides evidence for a vesicular transtubular
      transport because insulin-gold was transcytosed to the basolateral part of the
      cells and to the intracellular spaces (0.5%). In contrast cross-linked label was
      never observed in intercellular spaces, suggesting sorting of apical binding
      sites, a mechanism contributing to maintenance of cell polarity. In conclusion,
      traffic, sorting, and recycling of binding sites take place with high efficiency.

PMID- 8476017
TI  - Endocytosis in proximal tubule cells involves a two-phase membrane-recycling
      pathway.
AB  - The aims of the present study were to examine the initial events of endocytosis
      with respect to migration, internalization, and recycling of protein binding
      sites on the luminal plasma membrane of genuine renal proximal tubule cells (not
      cultured cells), and in particular the sequential involvement of dense apical
      tubules (DAT). Isolated rabbit proximal tubules were first perfused at low
      temperature (9 degrees C) with insulin-gold to label the binding sites and then
      with disuccinimidyl suberate (DSS) for 20 min to covalently cross-link insulin
      gold and binding sites. The tubules were subsequently perfused for 4-30 min at 25
      or 37 degrees C before fixation to follow the pathways of the binding sites. The
      present experimental approach allowed a temporal separation of the subcellular
      processes involved in endocytosis. The identity and organization of the different
      organelles were certified by serial sectioning of the experimental tubules. In
      tubules fixed directly at low temperature after cross-linking the label was
      located on the microvilli membranes and in plasma membrane invaginations. The
      labeling of microvilli decreased with time of perfusion at 25 degrees C in
      parallel with a simultaneous increase of labeling of invaginations, suggesting
      lateral migration of the binding sites. The invaginations pinched off from the
      surface to form endocytic vesicles. The binding sites were subsequently
      trafficked either to 1) tubular elongations from endocytic vesicles or small
      vacuoles, which again form DAT, or 2) in a later sequence trafficked to larger
      vacuoles, from which tubular elongations and DAT also form. The elongations
      formed the DAT that transported binding sites back to the luminal plasma
      membrane. Lysosomes and Golgi apparatus were not involved in membrane recycling.
      Thus the present study provides evidence for a two-phase recycling pathway of
      membrane proteins involved in endocytosis.

PMID- 8476018
TI  - Ca transport by plasma membrane and intracellular stores of gastric cells.
AB  - The relative Ca transport activities (i.e., of both pumps and leaks) of carbachol
      releasable intracellular stores and the basolateral plasma membrane of gastric
      parietal cells were studied using digital image processing of fura-2
      fluorescence. Cells were treated with either carbachol (a cholinergic agonist) or
      thapsigargin (an inhibitor of microsomal Ca-adenosinetriphosphatase) or a
      combination of the two. Ca-free solutions were used to selectively investigate
      intracellular store release and plasma membrane pump activity, whereas Ca
      containing solutions were used to investigate Ca influx and refilling of the
      intracellular pool. In the resting cell depletion of the intracellular pool in Ca
      free solutions was 15-fold faster than control in the presence of thapsigargin,
      indicating the efficient (> 90%) recycling of leaked Ca by the store Ca pump.
      Stimulation with carbachol increased the rate of pool depletion by 70-fold, and
      this Ca flux out of the internal store was ten times larger than the flux across
      the plasma membrane. Thus the internal store has ten times greater fluxes (both
      leaks and pumps) than the plasma membrane during resting and stimulated
      conditions. After carbachol removal (i.e., reloading) the permeability of the
      internal store decreases, whereas increased influx across the plasma membrane
      persists until the store is refilled. Cytoplasmic Ca does not increase during
      refilling because the intracellular store pump operates eightfold faster than the
      plasma membrane pump, effectively sequestering Ca as quickly as it enters the
      cell.

PMID- 8476019
TI  - Stimulation of prostaglandin synthesis by human endothelial cells exposed to
      hypoxia.
AB  - In ischemic organs, arachidonic acid (AA) metabolites and mostly prostaglandins
      (PGs) have been found to be released in high amounts. The mechanism for this AA
      metabolism activation and its physiological implications are not clear. Because
      endothelial cells are an important source of PGs and because they seem to be very
      rapidly affected by ischemia, we developed an in vitro model where human
      endothelial cells were submitted to hypoxia. An important specific activation of
      phospholipase A2 was observed during hypoxia, which was concomitant with a rise
      in cytosolic calcium concentration. Endothelial cells synthetize in normal
      conditions as a mean 1.42, 1.00, 7.69, and 26.92 ng/mg proteins of, respectively,
      PGE2, PGD2, PGF2 alpha, PGI2. An important increase of about five- to ninefold in
      the synthesis of the four PGs was observed during hypoxia, which followed the
      same kinetics as the PLA2 activation. This increase in PG synthesis was sensitive
      to cyclooxygenase inhibitors. During reoxygenation, PG synthesis decreased back
      to the basal level of resting cells, suggesting that cells were able to recover
      their homeostasis after hypoxia. These observations indicate that endothelial
      cells exposed to oxygen deprivation are a major source of PGs and could
      contribute to the high amounts of PG released in vivo in ischemic organs.

PMID- 8476020
TI  - Steroid hormone stimulation of Na+ transport in A6 cells is mediated via
      glucocorticoid receptors.
AB  - The A6 cell line derived from the toad kidney forms polarized, highly
      differentiated epithelial monolayers in culture and has been utilized as an
      experimental model for studying regulation of transepithelial Na+ transport by
      aldosterone. In the present study we evaluated the specific role(s) of
      glucocorticoid and mineralocorticoid receptors in mediating this enhanced
      electrogenic Na+ transport, which was measured experimentally as an increase in
      short-circuit current (Isc). Our data demonstrate that specific glucocorticoid
      agonists (100 nM), including RU 28362 and RU 26988, elicit "mineralocorticoid
      like" increases in Isc that are blocked by the glucocorticoid antagonist RU 38486
      but are unaffected by mineralocorticoid antagonists including RU 28318 and RU
      26752. The stimulatory effects of aldosterone (100 nM) were also blocked by RU
      38486 and not by mineralocorticoid antagonists. These data extend earlier studies
      suggesting that in this cell line aldosterone mediates its physiological effects
      via binding with relatively low affinity (dissociation constant Kd congruent to
      25-50 nM) to glucocorticoid receptors, despite the presence of apparently normal
      mineralocorticoid receptors. Our in vitro biochemical studies also demonstrate
      that A6 glucocorticoid receptor complexes can be thermally activated or
      transformed to DNA binding forms which exhibit altered elution profiles from
      anion-exchange resins. Thus, based on several criteria, these amphibian
      glucocorticoid receptors appear very similar to classical mammalian receptors and
      are capable of mediating all of the stimulatory effects of aldosterone on net Na+
      transport.

PMID- 8476021
TI  - TNF-alpha induces endothelial cell F-actin depolymerization, new actin synthesis,
      and barrier dysfunction.
AB  - Tumor necrosis factor-alpha (TNF-alpha) influences pulmonary vascular endothelial
      barrier function in vitro. We studied whether recombinant TNF-alpha (rTNF-alpha)
      regulates endothelial barrier function through actin reorganization.
      Postconfluent bovine pulmonary artery endothelial cell monolayers were exposed to
      human rTNF-alpha (1,000 U/ml) and evaluated for 1) transendothelial [14C]albumin
      flux, 2) F-actin organization with fluorescence microscopy, 3) F-actin
      quantitation by spectrofluorometry, and 4) monomeric G-actin levels by the
      deoxyribonuclease I inhibition assay. rTNF-alpha induced increments in
      [14C]albumin flux (P < 0.04) and intercellular gap formation at > or = 2-6 h.
      During this same time, the endothelial F-actin pool decreased (P = 0.0064), with
      reciprocal increases in the G-actin pool (P < 0.0001). Prior F-actin
      stabilization with phallicidin protected against the rTNF-alpha-induced
      increments in G-actin (P < 0.002) as well as changes in barrier function (P <
      0.01). Prior protein synthesis inhibition enhanced the rTNF-alpha-induced
      decrement in F-actin (P < 0.0001), blunted the G-actin increment (P < 0.002), and
      increased rTNF-alpha-induced changes in endothelial barrier function (P < 0.003).
      Therefore, rTNF-alpha induces pulmonary vascular endothelial F-actin
      depolymerization, intercellular gap formation, and barrier dysfunction. rTNF
      alpha also increased total actin (P < 0.02) and new actin synthesis (P < 0.002),
      which may be a compensatory endothelial cell response to rTNF-alpha-induced F
      actin depolymerization.

PMID- 8476022
TI  - Cytosolic free calcium regulation in response to acute changes in intracellular
      pH in vascular smooth muscle.
AB  - This study examined the mechanisms whereby alterations of intracellular pH (pHi)
      impact on free cytosolic calcium (Cai2+) in cultured rat aortic vascular smooth
      muscle cells (VSMC) assayed in the presence of HCO3/CO2. Rapid cell
      alkalinization, effected by the exposure to NH4Cl or removal of CO2 from the
      superfusate, produced a rapid increase in Cai2+. The rise in Cai2+ was markedly
      diminished when sarcoplasmic reticulum (SR) Ca2+ stores had been depleted by
      prior exposure to arginine vasopressin (AVP) in Ca(2+)-free media or when SR
      release and reuptake of Ca2+ were blocked by the addition of 3,4,5
      trimethoxybenzoic acid 8-(diethylamino)octyl ester (TMB-8), but was unaffected by
      the removal of external Ca2+ or inhibition of Ca2+ entry using NiCl2. Cell
      acidification also resulted in a rapid increase in Cai2+. This Cai2+ increase was
      most apparent when pHi was very low (< 6.6) and was unaffected by removal of
      external Ca2+ or NiCl2 addition. Unlike the effect of cell alkalinization, the
      increase in Cai2+ associated with cell acidification was not prevented by
      pretreatment with AVP or TMB-8. We conclude that, in cultured VSMC, acute
      intracellular alkalinization and, to a lesser extent, acidification result in
      release of Ca2+ from internal stores. Alkalinization increases Cai2+ by promoting
      its release from a store which is AVP and TMB-8 sensitive, most likely the SR.
      Cell acidification increases Cai2+ from an intracellular store(s) that is neither
      AVP nor TMB-8 sensitive. The increase in Cai2+ produced by cell acidification may
      be explained on the basis of cell buffering such that, as cytosolic H+ increases,
      it displaces Cai2+ from internal buffers with similar affinities for Ca2+ and H+.

PMID- 8476023
TI  - Cytosolic pH sensitivity of an expressed human NHE-1 Na(+)-H+ exchanger.
AB  - These studies examined the effects of protein kinase C activation and calmodulin
      inhibition on the amiloride-sensitive NHE-1 isoform of the Na(+)-H+ exchanger in
      defined host cells. Our objective was to define differences in the cellular
      regulatory responses using a specified isoform of the Na(+)-H+ exchanger.
      Suspended cells were loaded with 2',7'-bis(carboxyethyl)-5,6-carboxyfluorescein
      (BCECF) and preacidified to a cytosolic pH of 6.2. Wild-type mouse Ltk- cells,
      human A-431 cells, and mutant mouse fibroblasts stably transfected with the human
      NHE-1 isoform (LAP+ cells) were examined to define the maximal rate of transport
      (Vmax) in response to 140 mM external Na+, the Hill stoichiometric coefficient,
      and the cytosolic pH at which the NHE-1 isoform was half-maximally stimulated
      (pH50). The mouse NHE-1 isoform had a greater affinity for cytosolic H+ than the
      human NHE-1 isoforms. Calmodulin antagonism with N-(6-aminohexyl)-5-chloro-1
      naphthalenesulfonamide reduced the Vmax and shifted the pH50 in the acidic
      direction, especially in the A-431 cells. Protein kinase C stimulation had a
      similar effect in A-431 cells and little effect in the wild-type (Ltk-) and
      transfected (LAP+) mouse cells. While the NHE-1 isoform contains several
      potential phosphorylation sites, the cellular milieu in which the isoform is
      expressed has an important effect on the modulation of NHE-1 activity.

PMID- 8476024
TI  - Extracellular ATP-induced regulation of epidermal growth factor signaling in
      cultured renal LLC-PK1 cells.
AB  - We investigated the effect of extracellular ATP on the interaction of epidermal
      growth factor (EGF) with its receptor in cultured renal epithelial cells, LLC
      PK1. Pretreatment with ATP, but not adenosine, inhibited the binding of 125I
      labeled EGF. The inhibition demonstrated by ATP resulted from a decrease in the
      affinity of EGF receptors for its ligand, with no change in the number of EGF
      receptors. Incubation of phorbol 12-myristate 13-acetate (PMA) for 30 min
      mimicked the ATP-mediated inhibition. On the other hand, prolonged pretreatment
      with PMA, which leads to disappearance of protein kinase C activity, reversed the
      inhibition. In addition, pretreatment with the protein kinase C inhibitor 1-(5
      isoquinoline sulfonyl)-2-methylpiperazine prevented the ATP-mediated inhibition.
      ATP triggered an increase in inositol 1,4,5-trisphosphate levels and
      translocation of protein kinase C from cytosol to membranes, consist with the
      stimulation of phospholipase C and the activation of protein kinase C. These
      results demonstrate that extracellular ATP attenuates the ligand binding affinity
      of EGF receptor via the stimulation of phospholipase C, leading to the activation
      of protein kinase C in the LLC-PK1 cells.

PMID- 8476025
TI  - Protective effects of adenosine in the perfused rat heart: changes in metabolism
      and intracellular ion homeostasis.
AB  - Increased concentrations of intracellular H+, Na+, and Ca2+ have been observed
      during ischemia, and these ionic alterations have been correlated with several
      indexes of cell injury in a number of studies. Recently, adenosine was proposed
      to play a role in ischemic preconditioning, since adenosine antagonists block the
      protective effects of these brief intermittent periods of ischemia and reflow. In
      this study we evaluated the protective effects of adenosine (20 microM) on high
      energy phosphate metabolism, H+ and Ca2+ accumulation, and glycolytic rate during
      30 min of no-flow ischemia. Adenosine was observed to slow the onset of
      contracture (7.0 +/- 0.9 min) and to improve left ventricular developed pressure
      (62 +/- 7% of initial) during reperfusion compared with untreated hearts (5.0 +/-
      0.6 min and 18 +/- 5%, respectively). Intracellular Ca accumulation at the end of
      30 min of ischemia was higher in the untreated (2,835 +/- 465 nM) than in the
      adenosine-treated (2,064 +/- 533 nM) hearts, while intracellular pH fell more in
      the untreated (5.85 +/- 0.17) than in the adenosine-treated hearts (6.27 +/-
      0.16). Glycolytic rate and the rate of ATP decline were significantly attenuated
      in the adenosine-treated hearts during ischemia. Thus adenosine treatment slowed
      the rate of metabolism and delayed the accumulation of H+ and Ca2+ during
      ischemia, resulting in better recovery of function upon reflow.

PMID- 8476026
TI  - Expression of vascular permeability factor/vascular endothelial growth factor in
      normal rat tissues.
AB  - Vascular permeability factor (VPF)/vascular endothelial growth factor (VEGF) is a
      approximately 43-kDa secreted protein that has been shown in bioassays to induce
      endothelial proliferation, angiogenesis, and capillary hyperpermeability. VPF has
      been suggested to play an important role in the physiology of normal vasculature.
      To further elucidate the natural functions of VPF in vivo, the expression of VPF
      in normal tissues was examined using Northern blot analysis and in situ
      hybridization histochemistry. VPF mRNA is expressed in the brain, kidney, liver,
      lung, and spleen of the healthy adult rat. On Northern blots, the relative
      abundance of VPF mRNA observed in these tissues was highest in the lung and
      lowest in the spleen. As determined by in situ hybridization, the patterns of VPF
      expression are organ specific. Hybridization of an antisense VPF probe was
      concentrated in the cerebellar granule cell layer of the brain and in the
      glomeruli and tubules of the kidney. In the liver and lung, intense hybridization
      was observed homogeneously throughout both tissues, demonstrating that VPF mRNA
      is present in virtually every hepatocyte and pulmonary alveolar cell.
      Hybridization to the spleen was weaker and more diffuse. The widespread
      expression and organ-specific distribution of VPF mRNA in normal rat tissues
      supports the suggestion of an extensive role for this factor in the physiology of
      normal vasculature.

PMID- 8476027
TI  - Estrogen-induced left ventricular chamber enlargement in ewes.
AB  - We studied the chronic effect of administration of a single large intramuscular
      dose of 17 beta-estradiol on left ventricular chamber size and output in the ewe.
      Fourteen oophorectomized ewes were successfully instrumented and studied, with
      measurements made of left ventricular, aortic, right and left atrial pressures,
      left ventricular stroke volume, and left ventricular minor axis dimension.
      Unanesthetized ewes were studied before and 1, 2, and 3 wk after intramuscular
      administration of 0.6 mg/kg 17 beta-estradiol (7 ewes) or 1.5 ml sesame oil
      placebo (7 ewes). Left ventricular end-diastolic pressure-end-diastolic dimension
      (LVEDP-EDD) and left ventricular end-diastolic pressure-stroke volume (LVEDP-SV)
      relationships were quantified during graded inferior vena caval occlusion and
      volume infusion. Left ventricular end-diastolic diameter was larger after
      estrogen but not after placebo administration. The LVEDP-EDD relationship shifted
      progressively rightward, indicating left ventricular chamber enlargement in the
      estrogen group but was unchanged in the placebo group. The plateau limb of the
      LVEDP-SV relationship in the estrogen group shifted up from a mean stroke volume
      of 77.1-89.5 ml/beat and did not change in the placebo group. We conclude that
      administration of a single large intramuscular dose of 17 beta-estradiol resulted
      in left ventricular chamber enlargement and increased stroke volume in the ewe.

PMID- 8476028
TI  - Whole body and splanchnic oxygen consumption and blood flow after oral ingestion
      of fructose or glucose.
AB  - The contribution of the splanchnic tissues to the initial 2-h rise in whole body
      energy expenditure after ingestion of glucose or fructose was examined in healthy
      subjects. Indirect calorimetry and catheter techniques were employed to determine
      pulmonary gas exchange, cardiac output, splanchnic blood flow, splanchnic oxygen
      uptake, and blood temperatures before and for 2 h after ingestion of 75 g of
      either fructose or glucose in water solution or of water only. Fructose ingestion
      was found to increase total oxygen uptake by an average of 9.5% above basal
      levels; the corresponding increase for glucose was 8.8% and for water only 2.5%.
      The respiratory exchange ratio increased from 0.84 in the basal state to 0.97 at
      45 min after fructose ingestion and rose gradually after glucose to 0.86 after
      120 min. The average 2-h thermic effect, expressed as percent of ingested energy,
      was 5.0% for fructose and 3.7% for glucose (not significant). Splanchnic oxygen
      consumption did not increase measurably after ingestion of either fructose or
      glucose. The arterial concentration of lactate rose, arterial pH fell, and PCO2
      remained essentially unchanged after fructose ingestion. Glucose, but not
      fructose, elicited increases in cardiac output (28%) and splanchnic blood flow
      (56%). Fructose, but not glucose, increased arterial blood temperature
      significantly. It is concluded that both fructose and glucose-induced
      thermogenesis occurs exclusively in extrasplanchnic tissues. Compared with
      glucose, fructose ingestion is accompanied by a more marked rise in CO2
      production, possibly reflecting an increased extrasplanchnic oxidation of lactate
      and an accumulation of heat in the body.

PMID- 8476029
TI  - Impact of conceptus mass on glucose disposal rate in pregnant women.
AB  - The impact of an increasing fetal and placental mass on maternal glucose disposal
      rate (GDR) was studied in 17 pregnant women. Eleven pregnancies were singleton
      pregnancies, five were twin and one was a triplet pregnancy. Both the maternal
      fasting glucose concentration [Glc] and the total fetal and placental weight (W)
      were significantly correlated with an increased maternal GDR. Glucose
      concentration and conceptus weight were interdependent. The multiple linear
      regression of glucose disposal rate on glucose concentration and total weight is
      given by GDR = -1.573 + 0.176W + 0.932[Glc] +/- 0.24, r2 = 0.52, P < 0.01. These
      data are utilized to estimate the glucose utilization rate of the human conceptus
      at a fasting glucose concentration of 3.9 mM with a range of 10-15 mg.kg-1.min-1.
      Maternal GDR increases with increasing glucose concentration at a rate similar to
      that reported for newborn infants, consistent with a high glucose utilization by
      the uterus.

PMID- 8476030
TI  - Role of cytosolic calcium in regulation of cytoskeletal gene expression by
      insulin.
AB  - Insulin and calcium ionophores rapidly stimulated transcription of the
      cytoskeletal beta- and gamma-actin genes in serum-deprived rat H4-II-E hepatoma
      cells. The calcium ionophore A23187 (1 microM) stimulated transcription of the
      beta-actin gene by 7.3-, 5.4-, and 2.6-fold and the gamma-actin gene by 5.9-, 5.6
      , and 2.6-fold at 15, 30, and 60 min, respectively. Ionomycin (1 microM)
      similarly increased beta- and gamma-actin transcription. Insulin stimulated beta
      actin transcription 11.4-fold and gamma-actin 8.4-fold at 30 min. alpha-Tubulin
      transcription was induced by both insulin and calcium ionophores but to a lesser
      degree. The effects of A23187 or ionomycin together with insulin for 30 min were
      no greater than those of insulin alone. Insulin alone, however, did not
      significantly increase measurable intracellular calcium concentrations in fura-2
      loaded cells. When cytosolic calcium was chelated using quin2 acetoxymethyl
      ester, the ability of A23187 to increase beta- and gamma-actin transcription was
      completely abolished, whereas insulin's ability to stimulate actin transcription
      was only partially inhibited. This suggests that the regulation of gene
      transcription by insulin may include calcium-dependent pathways but strongly
      implies that calcium-independent pathways are also utilized.

PMID- 8476031
TI  - Time of day of birth and absence of endocrine and uterine contractile activity
      rhythms in sheep.
AB  - To determine whether 24-h rhythms characterize hormone secretion and uterine
      activity in the pregnant sheep, blood samples were drawn every 1-4 h for 48 h
      from ewes and fetuses from day 120 of gestation to term. Repetitive 24-h rhythms
      were absent for cortisol, progesterone, and prolactin in maternal and fetal
      circulation and for hourly mean uterine contraction rate and amplitude. To test
      whether photoperiod or pineal melatonin contributes to the absence of rhythms,
      pineal-intact and pinealectomized ewes and their fetuses were studied in reverse
      photoperiod. Again, there was little evidence to suggest 24-h endocrine rhythms
      except for prolactin in two fetuses by cosinor analyses. Prolactin concentrations
      were increased in pinealectomized ewes and their fetuses. In the apparent absence
      of rhythms, 20 of 21 pineal-intact ewes gave birth at night; however, 6 out of 7
      pinealectomized ewes gave birth during the day. Thus photoperiod and the maternal
      pineal gland profoundly influenced the time of day of birth in the absence of
      circadian endocrine or uterine activity rhythms.

PMID- 8476032
TI  - Postprandial plasma triacylglycerols in rats under alpha 1-adrenergic blockade.
AB  - The present studies evaluated the effect of prazosin, a selective alpha 1
      adrenergic antagonist, on some metabolic determinants of triacylglycerol-rich
      lipoproteins. Plasma triacylglycerols (TG), TG secretion rate, TG removal rate,
      plasma insulin, and glucose were evaluated postprandially in animals fed a high
      sucrose meal. In the fasted state plasma TG, glucose, and insulin concentrations
      were minimally affected by prazosin. There was a significant postprandial
      elevation in plasma TG levels that was larger after ingestion of a meal
      containing corn oil than after intake of a fat-free meal. Prazosin totally
      blunted the postprandial elevation in plasma TG independently of the presence (P
      < 0.004) or absence of dietary fat (P < 0.01). In the postprandial phase after
      ingestion of a fat-free, high-sucrose meal, prazosin decreased the rate of
      secretion of TG into the circulation (-54%, P < 0.0003) and accelerated twofold
      the clearance of an injected fat emulsion (P < 0.02). The postprandial elevations
      in plasma insulin and glucose were significantly potentiated by administration of
      prazosin before intake of the fat-free meal. These results indicate that prazosin
      prevented the postprandial elevation in plasma TG that followed the ingestion of
      a high-sucrose meal. The results also demonstrate that the alpha 1-blocker
      exerted its action both by decreasing TG secretion and by increasing the rate of
      removal of circulating TG.

PMID- 8476033
TI  - Methods for assessment of the rate of onset and offset of insulin action during
      nonsteady state in humans.
AB  - Measurement of glucose turnover under non-steady-state conditions has proven
      problematic. When the mass of the glucose pool is not changing (i.e., glucose
      concentrations are constant) non-steady-state error can be minimized if all
      glucose entering the circulation has the same specific activity as plasma
      [radioactive infused glucose (hot-GINF) method]. Alternatively, a second tracer
      can be used to measure the effective volume of glucose [variable-pV method of
      Issekutz (T. Issekutz, R. Issekutz, and D. Elahi. (Can. J. Physiol. 52:215-224,
      1974)]. To determine whether these techniques provide concordant assessments of
      insulin action under non-steady-state conditions, glucose turnover was measured
      in six subjects. After initiation of insulin (0.6 mU.kg-1 x min-1), both methods
      indicated similar rates of suppression of hepatic glucose release, which was
      complete by approximately 100-120 min. In contrast, the traditional fixed-pV
      method of Steele (R. Steele, J. Wall, R. DeBodo, and N. Altszuler. Am. J.
      Physiol. 187:15-24 1956) underestimated turnover (P < 0.01) resulting in apparent
      complete suppression of glucose release within approximately 40 min (P < 0.01 vs.
      other methods). The hot-GINF and variable-pV methods also yielded similar
      estimates of turnover after discontinuation of insulin. Both indicated that
      resumption of hepatic glucose release was slower (P < 0.01) and fall of glucose
      uptake faster (P < 0.01) than suggested by the fixed-pV method. Thus both the hot
      GINF and variable-pV methods avoid non-steady-state error introduced by the fixed
      pV method and provide concordant assessments of the rate of onset and offset of
      insulin action.

PMID- 8476034
TI  - Hepatic and extrahepatic insulin action in humans: measurement in the absence of
      non-steady-state error.
AB  - The isotope dilution technique has been extensively used to assess insulin action
      in humans. To determine if nonsteady state (NSS) has led to erroneous estimates
      of hepatic and extrahepatic insulin sensitivity, we measured glucose turnover in
      healthy subjects during infusion of insulin at rates of 0.25, 0.6, and 2.0 mU.kg
      1.min-1. Turnover was calculated using Steele's traditional NSS equations [fixed
      effective volume (pV) method] as well as with methods [radioactive infused
      glucose (hot-GINF) or variable pV] designed to minimize NSS error. In contrast to
      the fixed-pV method, both the hot-GINF and variable-pV methods indicated that
      several hours were required for suppression of hepatic glucose release at all
      insulin concentrations and that small increases in plasma insulin (approximately
      100 pmol/l) had comparable effects on glucose disappearance and hepatic glucose
      release. Nevertheless, despite these differences, when turnover during the final
      hour of the insulin infusions was plotted vs. the prevailing insulin
      concentration, all three methods yielded similar insulin dose-response curves for
      suppression of hepatic glucose release. Thus despite previous errors in
      measurement of glucose turnover, the widely accepted belief that the human liver
      is exquisitely sensitive to small changes in insulin is correct.

PMID- 8476035
TI  - Effects of protein restriction and acute refeeding on leucine and lysine kinetics
      in young men.
AB  - To explore the effects of altered protein intake on the uptake and utilization of
      dietary amino acids in human subjects, six healthy male Massachusetts Institute
      of Technology students were studied during three dietary periods each of 9 days,
      with tracer infusion studies conducted on days 8 and 9. During one period the
      diet provided a generous protein intake (1.5 g.kg-1.day-1) and during the other
      two a low-protein intake (0.1 g.kg-1.day-1). Tracer infusions (fed state) were
      given while subjects received either a liquid formula, supplying the prior
      protein intake or (on day 9) a generous intake. Combinations of [2H3]Leu and
      [13C]Leu and of [15N]Lys and [2H4]Lys were given via continuous intravenous or
      intragastric infusion for 4 h to estimate leucine kinetics and the first-pass
      splanchnic uptake of tracer. Dietary-induced changes in leucine flux and
      oxidation were similar irrespective of the tracer and/or route of administration
      and sampled pool (leucine or KIC) used for calculation. Estimates of absolute
      changes in the rates of leucine disappearance via nonoxidative metabolism
      (protein synthesis) and of appearance via protein breakdown depended on the route
      of [13C]Leu administration. However, it appears that both altered rates of
      protein synthesis and breakdown contribute to the adaptations required in the
      body nitrogen economy when protein intakes are restricted and subsequently
      resupplied. From the intragastric [13C]Leu protocol, the first-pass splanchnic
      uptake of tracer was the same (approximately 30%) for generous, low-protein, and
      refed conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476036
TI  - Lowering plasma free fatty acid levels improves insulin action in conscious
      pregnant rabbits.
AB  - Acute elevation in plasma free fatty acid (FFA) levels in nonpregnant rabbits
      simulates some aspects of insulin resistance observed in late pregnancy. The aim
      of this study was therefore to evaluate whether lowered FFA induced by nicotinic
      acid (NA) infusion can improve insulin action in pregnant rabbits. To assess
      insulin sensitivity we applied euglycemic hyperinsulinemic clamp without (control
      study) or with concomitant NA infusion (NA study; infusion started 150 min before
      the glucose clamp) in conscious virgin and pregnant rabbits after an 18-h fast. A
      primed constant infusion of [3-3H]glucose was used to measure total glucose
      disposal and hepatic glucose production. Hyperinsulinemia, in association with NA
      infusion (NA study) brings about a significantly greater stimulation of total
      glucose disposal in both pregnant (approximately 30%) and nonpregnant
      (approximately 35%) rabbits compared with the control study. A more pronounced
      inhibition of hepatic glucose production occurred in NA study in pregnant rabbits
      (approximately 30 vs. approximately 10%) but it did not reach a statistical
      significance, whereas there was a total inhibition in nonpregnant rabbits. We
      conclude that acute decrease in plasma FFA levels mainly improves insulin action
      at the site of glucose utilization. These results therefore suggest that elevated
      FFA would contribute to the peripheral insulin resistance in late pregnancy.

PMID- 8476037
TI  - Effects of muscle activity and fiber composition on glucose transport and GLUT-4.
AB  - We examined glucose uptake and GLUT-4 in rat muscles [soleus (Sol), plantaris
      (PL), extensor digitorum longus (EDL), tibialis anterior, and the red and white
      gastrocnemius (WG)]. In the normally innervated perfused rat hindlimb muscles the
      proportion of oxidative fibers was highly correlated with the muscle's insulin
      stimulated 3-O-methyl-D-glucose (3-MG) uptake (R2 = 0.78) and GLUT-4 content (r =
      0.94). Insulin-stimulated 3-MG uptake and GLUT-4 were also highly correlated (R2
      = 0.996). In 3-day denervated muscles, insulin-stimulated 3-MG uptake was reduced
      in all six muscles (-41 to -14.6%, P < 0.05), and GLUT-4 content was also reduced
      (-87.5 to -34.9%), except in the WG and EDL (P > 0.05). A very high correlation
      was observed between the decrements in GLUT-4 (%) and the decrements in 3-MG
      uptake (%; r = 0.99). The relatively greater loss in muscle activity (%) due to
      denervation in the Sol compared with the PL coincided with the reductions (%) in
      GLUT-4 and 3-MG uptake. These studies demonstrate that glucose uptake and GLUT-4
      are regulated by insulin-independent means, namely the oxidative capacity of the
      muscle and the normal activity level of the muscle.

PMID- 8476038
TI  - Sleep-promoting effects of growth hormone-releasing hormone in normal men.
AB  - Growth hormone-releasing hormone (GHRH) promotes rapid-eye-movement (REM) and non
      REM sleep in animals, but there is little direct evidence for a hypnogenic action
      of GHRH in humans. In the present study, the possible somnogenic effects of
      intravenous bolus injections of a dose of GHRH eliciting physiological elevations
      of GH secretion in healthy young men were investigated. GHRH (0.3 micrograms/kg
      body wt) was given in early sleep [i.e., 1st slow-wave (SW) period], late sleep
      (i.e., 3rd REM period), and early sleep after sleep deprivation until 0400 h
      (i.e., 1st SW period). In the absence of sleep deprivation, injection of GHRH in
      early sleep did not modify SW sleep but increased REM sleep. GHRH administration
      in the third REM period was followed by a marked decrease of wake and an almost
      10-fold increase in SW sleep. When GHRH was administered during the first SW
      period after sleep deprivation until 0400 h, the duration of wake decreased. Thus
      GHRH has sleep-promoting effects in young adults, particularly when given at a
      time of decreased sleep propensity.

PMID- 8476039
TI  - Contribution of muscle and liver to glucose-fatty acid cycle in humans.
AB  - To examine the influence of elevated free fatty acid (FFA) levels on hepatic
      glucose production (HGP) and oxidative and nonoxidative pathways of glucose
      metabolism, 12 healthy subjects participated in two euglycemic insulin-clamp
      studies performed with and without infusion of Intralipid plus heparin. To
      elucidate the role of skeletal muscle in this putative interaction, we performed
      muscle biopsies for the measurement of activities of glycogen synthase (GS),
      pyruvate dehydrogenase (PDH), and carnitine palmitoyltransferase (CPT). Infusion
      of Intralipid plus heparin caused an increase in plasma FFA concentrations and
      rate of lipid oxidation (measured by indirect calorimetry) that was not inhibited
      by insulin. Suppression of HGP by insulin was impaired by elevated plasma FFA
      levels. Furthermore, the increase in plasma FFA was associated with a 20%
      reduction in total glucose metabolism (P < 0.01), which was completely accounted
      for by a reduction in the rate of glucose oxidation. Although the fractional
      activity of GS was increased by insulin, elevation of plasma FFA had no influence
      on this key enzyme of glycogen synthesis. In addition, the activities of PDH and
      CPT were uninfluenced by the elevation of FFA, suggesting that oxidative
      processes in skeletal muscle were not a major target for the operative glucose
      fatty acid cycle under the current conditions. Taken together, the data indicate
      that the interaction between FFA and glucose metabolism also involves impaired
      suppression of HGP by insulin.

PMID- 8476040
TI  - Effect of amino acids alone or with insulin on muscle and liver protein synthesis
      in adult and old rats.
AB  - This study was carried out to analyze age-related changes on amino acid and
      insulin effects on muscle and liver protein synthesis. Conscious male rats, aged
      12 (adult) and 24 (old) mo, were infused for 90 min with either saline, amino
      acids, or amino acids with insulin and glucose. Protein synthesis was measured
      during the last 15 min of infusion (flooding dose of valine with L-[2,3,4
      3H]valine). Gastrocnemius protein mass was 29% lower in old rats than in adults.
      However, basal muscle absolute synthesis rates were unchanged with age, and
      fractional synthesis rates (FSR) were increased. Amino acids significantly
      stimulated muscle FSR to a similar extent (18-20%) in adult (P < 0.01) and old
      rats (P = 0.03 when variability introduced by muscle atrophy was taken into
      account by a variance-covariance analysis). Insulin did not elicit any additional
      effect. Liver protein synthesis did not change with age or in response to
      infusions. We conclude that, despite an age-related loss of muscle proteins,
      capacity of muscle protein synthesis to be stimulated is preserved with age.

PMID- 8476041
TI  - Carbonic anhydrase III in obese Zucker rats.
AB  - Proteins from 5- to 7-wk-old lean and obese Zucker rats were separated by one
      dimensional sodium dodecyl sulfate (SDS) and two-dimensional SDS-isoelectric
      focusing-polyacrylamide gel electrophoresis. Laser densitometry revealed an
      obesity-related decrease in the concentration of a 28-kDa cytosolic adipocyte
      protein, the most abundant protein in adipocytes from lean Zucker rats.
      Microsequencing revealed the identity of this protein to be carbonic anhydrase
      III (CA III). The identity and obesity-related decrease was further confirmed
      using isoform-specific antisera and CA III enzyme activity measurements made by
      18O mass spectrometry. Immunoblotting studies also revealed that CA III is
      present in at least two charge isoforms in adipocytes. Our data indicate that
      lean Zucker rat adipocytes may represent the richest source of CA III in nature
      (24% of the cytosolic protein content). An obesity-related decrease in both the
      concentration and activity of CA III was observed in two lipogenic tissues, liver
      and white fat, but not in soleus muscle. Adipocyte CA III activity was no longer
      depressed when hyperinsulinemic obese rats were made insulin deficient by
      streptozotocin injection. This suggests that the obesity-related decrease in CA
      III may be related to the hyperinsulinemia as well as to the insulin
      hyperresponsiveness that adipocytes from obese Zucker rats of this age display.

PMID- 8476042
TI  - Alterations in hypothalamic NPY and CRF in anorexic tumor-bearing rats.
AB  - Regional hypothalamic concentrations of neuropeptide Y (NPY) and corticotropin
      releasing factor (CRF), respectively a stimulant and an inhibitor of feeding
      behavior, were investigated in hypothalamic nuclei in rats carrying the Yoshida
      sarcoma. Tumor-bearing rats (n = 10), non-tumor-bearing controls (n = 10), and
      food-restricted rats (n = 10), which did not carry tumors but were pair-fed to
      match the reduced food intake of the tumor-bearing group, were studied after 10
      days. NPY concentrations in the arcuate nucleus (ARC, the main site of NPY
      synthesis) were significantly increased above controls (P < 0.01) in both tumor
      bearing and food-restricted groups. However, NPY concentrations in the
      paraventricular nucleus (PVN, an NPY-sensitive site of NPY release) showed
      opposing changes, with a 25% decrease (P = 0.052) in the tumor-bearing but a 48%
      increase (P < 0.01) in the food-restricted group. CRF concentrations in both the
      PVN and the ARC were significantly reduced (P < 0.01) in the food-restricted
      group, but remained close to control values in the tumor-bearing group (P not
      significant). Changes in hypothalamic appetite-regulating neuropeptides in cancer
      anorexia, which may result from the action of cytokines produced by a host
      defense response or the tumor itself, may account for reduced feeding. Such
      changes may include impaired activity of NPY or failure of CRF activity to be
      suppressed after underfeeding and weight loss.

PMID- 8476043
TI  - Energy metabolism and adenine nucleotide degradation in twitch-stimulated rat
      hindlimb during ischemia-reperfusion.
AB  - The purpose of this study was to characterize twitch tension and energy
      metabolism in ischemic, stimulated rat hindlimb to determine its suitability as a
      rapid time course model of ischemia-reperfusion injury. After 15 min
      equilibration, rat hindlimbs were stimulated (1-Hz twitches, 0.2 ms pulse
      duration, 15 V) for 5 min (control, n = 8). This twitch protocol was maintained
      throughout the ischemic and reperfusion periods. The control period was followed
      by 5, 20, or 40 min of ischemia (ligation of femoral artery and vein) or 40 min
      of ischemia with 0, 5, or 20 min of reperfusion (removal of ligature). The soleus
      [89% slow oxidative (SO)] and the white gastrocnemius [WG; 91% fast glycolytic
      (FG)] were analyzed for phosphocreatine (PCr), adenine nucleotides, glycogen, and
      glycolytic intermediates. Ischemia was characterized by progressive decreases in
      twitch tension, high-energy phosphagens, total adenine nucleotides (TAN), and
      glycogen. Also, energy metabolism was altered at a greater rate in WG than in
      soleus. Reperfusion resulted in a recovery in PCr and lactate, with little change
      in ATP, TAN, or glycogen. The inability to resynthesize adenine nucleotides and
      glycogen during reperfusion is characteristic of damaged skeletal muscle. The
      extent of the metabolic alterations in SO and FG muscles during twitch
      stimulation was comparable with previously reported noncontracting ischemia
      protocols of 2-4 and 4-7 h in length, respectively. The present study
      demonstrates that twitch stimulation of ischemic skeletal muscle is a useful
      model for inducing rapid metabolic changes and an ischemic insult comparable to
      prolonged noncontracting ischemia-reperfusion models.

PMID- 8476044
TI  - Dietary lysine requirement of young adult males determined by oxidation of L-[1
      13C]phenylalanine.
AB  - Lysine requirement was determined in seven adult males by examining the effect of
      varying dietary lysine intake on phenylalanine flux and oxidation under dietary
      conditions of adequate energy and phenylalanine (14 mg.kg-1 x day-1) and excess
      tyrosine (40 mg.kg-1 x day-1). Phenylalanine flux was determined from primed,
      constant intravenous infusions of L-[1-13C]phenylalanine (1.2 mg.kg-1 x day-1)
      and L-[ring-2H5]phenylalanine (0.5 mg.kg-1 x day-1) and measurement of isotopic
      enrichments of phenylalanine in plasma. Phenylalanine flux was not affected by
      graded increases in dietary lysine intake or by the isotope infused. Mean
      phenylalanine conversion to tyrosine was low (3.4%) and not significantly
      affected by lysine intake. Phenylalanine oxidation, estimated from the rate of
      13CO2 released in expired air during the infusion of L-[1-13C]phenylalanine,
      decreased linearly as lysine intake increased to a break point that was
      interpreted as the mean dietary lysine requirement (37 mg.kg-1 x day-1). At
      lysine intakes of > 37 mg.kg-1 x day-1 phenylalanine oxidation was low and
      constant. Plasma lysine concentrations supported this estimate of requirement.
      These data show that: 1) indicator amino acid oxidation can be used as a new
      method to determine amino acid requirements of humans and 2) the lysine
      requirement of adult males is three times greater than the World Health
      Organization recommendation of 12 mg.kg-1 x day-1.

PMID- 8476045
TI  - Type I collagen gene regulation and the molecular pathogenesis of cirrhosis.
AB  - Cirrhosis is characterized by an increased deposition of extracellular matrix
      proteins, including type I collagen. Type I collagen is a product of two genes,
      alpha 1(I) and alpha 2(I), which are generally coordinately regulated. Since
      expression of type I collagen genes is increased during cirrhosis, understanding
      the structure and function of the regulatory components of the type I collagen
      genes should provide insight into the molecular pathogenesis of cirrhosis. This
      review will analyze the collagen alpha 1(I) gene with respect to chromatin
      structure, DNA methylation, regulation by agonists, and DNA-protein interactions.

PMID- 8476046
TI  - Motor cycles with phase III in antrum are associated with high motilin levels and
      prolonged gallbladder emptying.
AB  - We examined the relationship of interdigestive gallbladder emptying with the
      different phases of the migrating motor complex (MMC) and with plasma levels of
      cholecystokinin (CCK) and motilin. In 10 volunteers 20 cycles of the MMC were
      recorded. In 11 cycles phase III occurred in antrum and duodenum (group 1). In
      nine cycles phase III was observed only in duodenum (group 2). In group 1
      gallbladder emptying started at 30% of total cycle length and continued until the
      end of the cycle. Maximal gallbladder emptying was 33.3 +/- 3.3% (SE). In group 2
      gallbladder emptying also started at 30% of total cycle length but ended at 60%.
      Maximal gallbladder emptying in this group was 24.3 +/- 3.1% (P < 0.05). Motilin
      levels were higher in group 1 than in group 2 during phase IIB (240.1 +/- 28.5
      and 142.1 +/- 30.9 pg/ml, respectively, P < 0.05) and during phase III (210.8 +/-
      24.3 and 93.5 +/- 12.5 pg/ml, respectively, P < 0.05). We conclude that: 1) phase
      III activities starting in the antrum are preceded by greater and prolonged
      gallbladder emptying, higher motilin levels, and higher intraduodenal bile acid
      concentrations than phase III activities starting in the duodenum and 2) no
      relationship between interdigestive gallbladder motility and CCK levels could be
      demonstrated.

PMID- 8476047
TI  - Prostaglandin E2 downregulates Kupffer cell production of IL-1 and IL-6 during
      hepatic regeneration.
AB  - The mammalian liver possesses the ability to regenerate to its original size
      after a 70% partial hepatectomy (PHx). The capacity of rat Kupffer cells (KC)
      isolated at specific intervals after PHx to produce interleukin (IL)-1, IL-6, and
      prostaglandin E2 (PGE2) in response to endotoxin [lipopolysaccharide (LPS)]
      stimulation was evaluated in standard RPMI 1640 (1,200 microM L-arginine) and
      arginine-depleted RPMI 1640 (< 10 microM L-arginine) media. Because KC function
      in an environment in which high arginase activity results in negligible L
      arginine levels, the 10 microM L-arginine RPMI 1640 was used to simulate the
      hepatic microenvironment. Regenerating liver KC 12-120 h after PHx responded to
      LPS with a significantly greater (P < 0.05) production of IL-1 and IL-6 in
      standard RPMI 1640. This enhancement of regenerating liver KC to produce IL-1 and
      IL-6 was increased (P < 0.05) by placing these same KC in 10 microM arginine RPMI
      1640 culture media. During the same time period, regenerating liver KC produced
      significantly elevated (P < 0.01) PGE2, again with greater differences in the low
      arginine media. In vivo KC PGE2 blockade by indomethacin (5 mg/kg) significantly
      (P < 0.05) inhibited hepatic regeneration. When the cyclooxygenase inhibitor
      indomethacin (10 microM) was added to cultures, the production of PGE2 by KC was
      prevented, and in arginine-depleted cultures, IL-1 and IL-6 production was
      upregulated (P < 0.05). We conclude that during hepatic regeneration, KC IL-1 and
      IL-6 production is elevated and is controlled in an autoregulatory fashion by
      elevated KC PGE2 production.

PMID- 8476048
TI  - Reconstitution of intestinal Na(+)-phosphate cotransporter.
AB  - The rabbit intestinal brush-border membrane Na(+)-phosphate cotransporter was
      purified from sodium dodecyl sulfate (SDS)-brush-border membrane vesicles (BBMV)
      protein (SDS-treated Ca(2+)-precipitated BBMV) by a three-column chromatography
      protocol. The purification included a preparative scale chromatofocusing
      chromatography column over the pH range from 7.4 to 4 after solubilization in 3
      [(3-cholamidopropyl)-diamethylammonia]-1-propanesulfonate (CHAPS), a
      chromatofocusing column over the pH range from 5.6 to 4 after solubilization in n
      octyl glucoside, and gel filtration chromatography on a Sephacryl S-200 column.
      Verification of Na(+)-phosphate cotransporter purification involved substrate
      affinities, substrate stoichiometry, and inhibitor sensitivity after
      proteoliposome reconstitution and SDS-polyacrylamide gel electrophoresis (PAGE).
      After gel filtration Na(+)-dependent phosphate uptake was 3,300-fold enriched
      compared with the cell homogenate. A single 130-kDa polypeptide was visualized by
      SDS-PAGE under reducing conditions using silver stain. The coenrichment of this
      130-kDa polypeptide and proteoliposome reconstituted Na(+)-dependent phosphate
      uptake suggest that the intestinal brush-border membrane Na(+)-phosphate
      cotransporter has been purified and proteoliposome reconstituted.

PMID- 8476050
TI  - The computer as referee in the analysis of human small bowel motility.
AB  - The aim of this study was to determine whether visual analysis of graphic records
      of small bowel motility is a reliable method of discriminating pressure events
      caused by bowel wall contraction from those of extraenteric origin and to compare
      this method with computerized analysis. Each of six independent observers was
      supplied with the same pair of records of 1 h of fasting diurnal duodenojejunal
      motility, acquired with a 3-channel ambulant data-logging system; one record
      included many artifacts due to body movement while the other did not. The
      observers were asked to identify and classify pressure events and to measure the
      duration and amplitude of "true" contractions. A computer program for on-line
      analysis is described; the algorithm was designed to overcome the problems of a
      variable baseline and sudden changes in pressure due to body movements that are
      unavoidable in prolonged recording from the small bowel of ambulant subjects. For
      regular contractions (phase III of migrating motor complex) there was good
      agreement between observers but not for irregular contractions, particularly when
      movement artifacts were abundant. When the observers were asked to repeat the
      analysis 6 mo later, there was poor agreement with their original identification
      of irregular contractions and artifacts. There was, however, good agreement
      between the computer analysis, which was totally reproducible, and the median
      decisions of the observer group; this agreement supports the validity of our
      computer algorithm. We conclude that computer analysis is not merely a valuable
      ergonomic aid for analysis of large quantity of data acquired in prolonged
      ambulatory monitoring, but also that, even for brief recordings, it provides a
      standard of reproducibility unmatched by "expert" inspection. Visual analysis is
      unreliable and thus susceptible to subjective bias; this may, in part, account
      for conflicting reports of small bowel motility under similar conditions reported
      by different workers in our own and other laboratories.

PMID- 8476049
TI  - Intestinal permeability in allergic rats: nerve involvement in antigen-induced
      changes.
AB  - In vivo uptake of the probe 51Cr-labeled EDTA from the jejunum of egg albumin
      (EA)-sensitized rats was compared with controls at baseline and after
      intraluminal antigen challenge. Probe recovery in blood was 60-80% greater in
      sensitized animals during the baseline period, suggesting that sensitization
      resulted in increased intestinal permeability. Sensitized, but not control, rats
      demonstrated a 15-fold increase in 51Cr-EDTA uptake after intraluminal antigen;
      no change occurred with an unrelated protein. Macromolecular recovery was also
      enhanced in sensitized animals, since serum levels of immunoreactive EA were
      elevated 14-fold compared with controls. Antigen challenge was accompanied by
      biochemical (protease release) and morphological (reduced numbers) evidence of
      mast cell degranulation in sensitized rats. The neurotoxin tetrodotoxin (applied
      directly to ligated jejunal segments) inhibited EA-induced uptake of 51Cr-EDTA
      and antigen. In isolated jejunum from sensitized rats, tetrodotoxin reduced
      secretory responses to luminal, but not serosal, antigen. These results indicate
      that neural factors may influence the uptake of molecules from the gut lumen
      during intestinal anaphylaxis.

PMID- 8476051
TI  - Kainic acid injection into medullary raphe produces gastric lesions through the
      vagal system in rats.
AB  - There is little evidence of a role of nuclei in the brain stem, other than the
      dorsal motor nucleus of the vagus nerve in the medulla oblongata, in terms of
      central mechanisms for gastric ulcer formation. Recent reports suggest that the
      medullary raphe nuclei may be involved in the central regulation of gastric
      functions such as gastric acid secretion and motility. In the present study, we
      examined whether neurons in the nucleus raphe obscurus (NRO) played a significant
      role in the formation of gastric ulcers with the use of Sprague-Dawley rats.
      First, we determined whether excitation of the medullary raphe resulted in the
      development of gastric lesions. Chemical stimulation of neurons in the NRO by
      kainic acid produced gastric erosions within 4 h in 24-h fasted rats. Saline
      tested under the same conditions did not modify the integrity of the gastric
      mucosa. It was also demonstrated that kainic acid injection outside the raphe
      obscurus boundaries failed to develop gastric lesions. Next, we examined the
      effects of the vagal system on the gastric lesion formation induced by
      stimulation of the raphe nucleus. Bilateral gastric branch vagotomies completely
      prevented the development of the raphe nucleus-provoked gastric mucosal damage.
      All these results suggest, for the first time, that excitation of neurons in the
      medullary raphe obscurus induces gastric ulceration through vagal stimulation.

PMID- 8476052
TI  - Duodenal lipid inhibits gastric acid secretion by vagal, capsaicin-sensitive
      afferent pathways in rats.
AB  - Neural and endocrine pathways mediate the inhibitory effects of intestinal fat on
      gastric acid secretion. To study whether vagal and/or spinal afferent nerves
      contribute to the neural component of the enterogastric reflex, the sensory
      neurotoxin capsaicin was applied topically either to the vagus nerves bilaterally
      or to the celiac-superior mesenteric ganglia in rats with chronic gastric and
      duodenal fistulas. In lightly restrained, awake rats acid secretion was
      stimulated for 2 h by continuous intragastric perfusion with 8% peptone and was
      measured by extragastric titration to pH 5.5. Duodenal lipid perfusion (0-20%)
      during the 2nd h caused inhibition of peptone-stimulated acid output. Acid output
      was inhibited by 81% during 5% lipid perfusion of the duodenum and was restored
      after capsaicin treatment of the vagus nerves. In contrast, capsaicin treatment
      of the celiac ganglion did not alter the acid inhibitory response to any dose of
      intestinal lipid. Basal and maximum acid outputs were not significantly different
      among rats treated by either method with capsaicin. The neural component of the
      enterogastric reflex in awake rats is mediated in part by a capsaicin-sensitive,
      vagal-afferent neural reflex.

PMID- 8476053
TI  - Adenosine is a mediator of ethanol-induced gastric vasodilation in dogs.
AB  - The purpose of this study was to assess the role of histamine, adenosine, and
      prostaglandins as mediators of ethanol-induced gastric vasodilation. In an ex
      vivo segment of canine stomach, vasodilation occurred within the first minute of
      replacing luminal saline with ethanol (40% vol/vol). Ethanol caused vascular
      resistance to progressively decrease by approximately 53% compared with control
      values. In other experiments, intra-arterial infusion of histamine (300 ng/ml) or
      adenosine (30 micrograms/ml) to the gastric segment produced similar degrees of
      vasodilation as observed with ethanol. The response to these vasodilators could
      be markedly attenuated with specific antagonists of these substances (histamine:
      pyrilamine plus cimetidine; adenosine: 8-phenyltheophylline). In our final
      experiments, indomethacin or histamine- or adenosine-receptor antagonists were
      given before application of topical ethanol. Indomethacin or histamine
      antagonists had no significant effect on the time course or magnitude of ethanol
      induced vasodilation. In contrast, pretreatment with 8-phenyltheophylline
      significantly reduced changes in vascular resistance during exposure to luminal
      ethanol. These results suggest that locally released adenosine is an important
      mediator of ethanol-induced vasodilation in the canine stomach under these
      conditions.

PMID- 8476054
TI  - Continuous measurement of rat gastric blood flow using Doppler flowmeter.
AB  - We describe the use of pulsed Doppler flowmetry to permit continuous measurement
      of gastric blood flow in the anesthetized rat. The aims of this study were: 1) to
      assess the stability of blood flow during Doppler flowmetry; 2) to assess the
      ability of Doppler flowmetry to record rapid, transient blood flow changes; and
      3) to validate Doppler flowmetry against an established blood flow measurement
      technique using labeled microspheres. Measurements over 3-h periods with a
      Doppler probe placed on the left gastric artery showed that there was an initial
      30-min stabilization period; after this the mean percentage coefficient of
      variation, indicating intraindividual variability for blood flow, was < 10% for
      the remaining 150 min. The infusion of norepinephrine produced rapid, transient
      blood flow changes, including the typical "autoregulatory escape" and
      "postinfusion hyperemia," both of which were detected by Doppler flowmetry. The
      accuracy of pulsed Doppler flowmetry in measuring gastric blood flow was
      established by the demonstration of a highly significant agreement between blood
      flow measured by the Doppler flowmetry and microsphere techniques. These data
      indicate that pulsed Doppler flowmetry is an accurate method for the continuous
      measurement of left gastric artery blood flow in the rat.

PMID- 8476055
TI  - Different relationships between cellular ATP and hepatic uptake among
      taurocholate, cholate, and organic anions.
AB  - Effects of cellular ATP content on uptake of cholate (CA) and organic anions
      (OAs; dibromosulfophthalein and benzylpenicillin) by isolated rat hepatocytes
      were investigated and were compared with that on taurocholate (TCA). Within 5 min
      of exposure to metabolic inhibitors (MIs), cellular ATP content fell to less than
      one-fifth of the control value, and the initial velocity of the total uptake of
      CA, Na(+)-independent uptake of CA and TCA, and the uptake of the OAs dropped in
      parallel with the decrease in cellular ATP. Whereas for the total uptake of TCA,
      the initial uptake remained virtually unchanged for a 5-min incubation with the
      MIs; a significant decrease in uptake was observed only after longer incubation
      times. Under variously ATP-decreased conditions, the initial velocity of the
      total uptake of CA and OAs was demonstrated to have a saturable relation to
      cellular ATP content, irrespective of exposure time to MIs. A difference in the
      Na(+)-dependent uptake of TCA and CA was also observed in terms of the inhibitory
      effect of the organic anion pravastatin. That is, the inhibition by pravastatin
      was partial for TCA uptake but almost complete for CA uptake. These findings
      suggest the following. 1) The mechanism of Na(+)-dependent CA uptake is different
      from that of TCA. 2) The Na(+)-independent uptake of bile acids and organic
      anions may be driven either by ATP hydrolysis (primary active transport) or by an
      as yet unidentified ion gradient that dissipates more rapidly than the Na+
      gradient.

PMID- 8476056
TI  - Gastrin and CCK activate phospholipase C and stimulate pepsinogen release by
      interacting with two distinct receptors.
AB  - Both gastrin and cholecystokinin (CCK) can stimulate pepsinogen release from
      chief cells, but controversy exists about the receptors or intracellular
      mediators involved. In the present study, we prepared isolated chief cells from
      guinea pig stomach (> 90% pure) to investigate the ability of gastrin and CCK to
      alter cell function. The COOH-terminal octapeptide of CCK (CCK-8) caused an
      eightfold increase in pepsinogen release (EC50, 54 nM). Both CCK-8 and gastrin
      increased inositol phosphates, with CCK-8 (1 microM) and gastrin (3 microM)
      causing a 40- and 14-fold increase in [3H]IP1, 10- and 6-fold for [3H]IP2, and 8-
      and 4-fold for [3H]IP3. CCK-8 caused a half-maximal increase in [3H]IP3 at 2 nM,
      and the dose-response curve was monophasic, whereas with gastrin the curve was
      biphasic, with an EC50 of the initial component (20% maximal) at 38 nM and the
      second component at 10 microM. L-364,718 (0.1 microM) inhibited the secondary
      increase seen with gastrin concentrations > 10 nM. The CCK-A-selective agonist A
      71378 was 85-90% as efficacious as CCK-8 and was equally potent. With 0.1 microM
      L-364,718, A-71378 caused no increase in [3H]inositol phosphates until > 10 nM,
      whereas CCK-8 caused 15% of maximal increase at concentrations > 0.3 nM. Similar
      results were obtained with cytosolic calcium measured using fura-2 or on CCK-8-
      or gastrin-stimulated pepsinogen release. These results demonstrate that gastrin
      and CCK-8 can alter chief cell function by interacting with either a CCK-A or CCK
      B/gastrin receptor. Both receptors are coupled to phospholipase C and cause
      changes in inositol phosphates, cytosolic calcium, and pepsinogen release;
      however, the intracellular amplification differs between the two receptor
      subtypes. Activation by CCK-related peptides of the CCK-A receptor subtype
      accounts for 85-90% of the maximal changes in cellular function, and activation
      of the CCK-B/gastrin receptor accounts for 10-20% of maximal changes.

PMID- 8476057
TI  - Downregulation of neutral endopeptidase (EC 3.4.24.11) in the inflamed rat
      intestine.
AB  - Intestinal inflammation induced by the nematode Trichinella spiralis is
      accompanied by increased intestinal concentrations of substance P, a mediator of
      inflammation and a stimulant of smooth muscle contraction, and by intestinal
      hypermotility. The expression of neutral endopeptidase (NEP), a cell surface
      enzyme that degrades substance P in the extracellular fluid, was examined in the
      inflamed intestine. NEP enzymatic activity, measured by a fluorometric assay, was
      reduced by 84-fold in jejunal mucosa-circular muscle and by 12-fold in jejunal
      longitudinal muscle-myenteric plexus within 6 days after infection with T.
      spiralis. The downregulation was unaffected by treatment with betamethasone and
      was still observed in athymic animals. NEP protein levels, examined by Western
      blotting, confirmed the loss of NEP from inflamed tissue. The specific activity
      for degradation of substance P was reduced by sixfold in jejunal mucosa-circular
      muscle and by twofold in jejunal longitudinal muscle-myenteric plexus of rats
      infected with T. spiralis compared with uninfected controls. Thus the
      downregulation of NEP resulted in reduced substance P degradation, which may
      contribute to functional abnormalities of the inflamed intestine.

PMID- 8476058
TI  - pH-dependent nonlysosomal proteolysis contributes to lethal anoxic injury of rat
      hepatocytes.
AB  - Our aim was to test the hypothesis that pH-dependent nonlysosomal proteolysis is
      a key mechanism culminating in lethal anoxic injury of rat hepatocytes. Although
      lysosomal proteolysis was suppressed during anoxia, total nonlysosomal
      proteolysis was increased twofold compared with aerobic controls. Extracellular
      acidosis inhibited total nonlysosomal proteolysis and improved cell survival
      during anoxia. Indeed, we found a direct highly significant linear relationship
      between cell death and total nonlysosomal proteolysis as modulated by changes in
      the extracellular pH (r = 0.99, P < 0.01). Glycolytic generation of ATP from
      fructose during anoxia suppressed total nonlysosomal proteolysis and improved
      cell survival. An increase in a pH-dependent calpain-like protease activity was
      also identified during anoxia, but calpain-like protease activity only accounted
      for 16% of total nonlysosomal protease activity. In addition, the calpain
      protease inhibitor Cbz-Leu-Leu-Tyr-CHN2 only partially protected against cell
      killing despite complete inhibition of calpain-like protease activity. These data
      suggest that pH-dependent total nonlysosomal proteolysis contributes to lethal
      cell injury during anoxia. However, calpain protease activity only partially
      contributes to total nonlysosomal protease activity and cell death.

PMID- 8476059
TI  - Asialoglycoprotein receptor mRNAs are expressed in most extrahepatic rat tissues
      during development.
AB  - The expression of an asialoglycoprotein receptor, comprised of a major (R-1) and
      minor (R-2/3) component, was characterized in various rat tissues during
      postnatal development. Two R-1 mRNA subspecies were identified in the liver by
      Northern blots. The 1.4-kb form, which was the predominant subspecies in the
      liver, was detected in small amounts only in the stomach and kidney. The 1.7-kb
      mRNA, however, was present in all extrahepatic tissues examined. R-1 mRNA content
      in the liver increased by only 38% during the suckling period, but the
      extrahepatic R-1 mRNA had a dramatic biphasic developmental pattern with the
      highest levels at birth and after weaning. The R-2/3 mRNA was present as a single
      species on Northern blot in the liver and in a restricted number of extrahepatic
      tissues (salivary glands, ileum, and kidney) but was detected in most tissues by
      polymerase chain reaction. The R-2/3 mRNA content in the liver increased fourfold
      after birth but was consistently low in the other tissues. [57Co]cobalamin
      haptocorrin binding activity was present in all extrahepatic tissues examined,
      although only at a level 2-5% of hepatic binding. Binding affinities of the adult
      kidney brush-border membranes (1.9 x 10(9) M-1) and the adult liver plasma
      membranes (2.4 x 10(9) M-1) were comparable. On Western blot, < 4% of adult liver
      R-1 content and a relatively larger amount of R-2/3 were detected in all four
      extrahepatic tissues examined. Thus the low binding activity in extrahepatic
      tissues correlates with the presence of both receptor subunits, which are closely
      related to or identical with the hepatic receptor subunits.

PMID- 8476060
TI  - Effects of autonomic antagonists and growth factors on activity-mediated
      hyperplasia of rat parotid.
AB  - Administration of the autonomic antagonists atropine (1 mg/kg body wt),
      propranolol (2 mg/kg body wt), and phenoxybenzamine (2 mg/kg body wt) before the
      dietary change from all liquid to solid chow prevented an increase in uptake of
      [3H]thymidine into DNA of rat parotid gland associated with this dietary change.
      Administration of either the cholinergic antagonist alone or the adrenergic
      antagonists alone produced partial inhibition. The effects of complete autonomic
      blockade were not reversed when nerve growth factor (NGF) or epidermal growth
      factor (EGF) was given immediately after administration of antagonists. The
      effects of complete autonomic blockade were similar to those seen with surgical
      removal of the autonomic nerves to the parotid. The increased levels of beta 1-4
      galactosyltransferase seen with the dietary change were not evident in rats given
      both muscarinic and adrenergic antagonists before the change to solid food nor
      did NGF or EGF reverse these inhibitory effects. Histological observation showed
      that the surgically denervated gland was morphologically less homogenous than the
      gland of rats given the antagonists and had infiltrating connective tissue.
      Nonetheless, with the reduced acinar cell pool, the [3H]thymidine uptake of the
      denervated parotid and that of antagonist-injected animals was similar.

PMID- 8476061
TI  - Hepatic intracellular pH during the prereplicative period following partial
      hepatectomy.
AB  - To investigate the hypothesis that the regenerating liver undergoes intracellular
      alkalinization during the prereplicative period, we measured intracellular pH
      (pHi) after partial hepatectomy in the rat. pHi was studied in livers from female
      Wistar rats perfused in situ with buffer containing HCO3-/CO2. The multiple
      indicator-dilution technique was used to determine pHi from the distribution
      volume of dimethyloxazolidine-2,4-dione (DMO). Perfusion conditions influenced
      pHi. There was a curvilinear relationship between pHi and flow rate and a linear
      relationship between pHi and temperature. Under equivalent perfusion conditions
      there were no significant differences between pHi in normal livers (7.27 +/-
      0.02) and that following partial hepatectomy (7.27 +/- 0.03 at 0 h, 7.27 +/- 0.04
      at 4 h, 7.28 +/- 0.03 at 8 h, and 7.31 +/- 0.02 at 24 h) or sham surgery (7.27 +/
      0.04 at 4 h, 7.33 +/- 0.08 at 24 h). Therefore intracellular alkalinization does
      not occur following partial hepatectomy and is unlikely to be a signal for
      regeneration.

PMID- 8476062
TI  - Complement activates Kupffer cells and neutrophils during reperfusion after
      hepatic ischemia.
AB  - The hypothesis that complement factors may be involved in the postischemic
      activation of Kupffer cells (KC) and polymorphonuclear neutrophils (PMN) was
      investigated in a model of hepatic ischemia (45 min) and reperfusion in male
      Fischer rats in vivo. Depletion of serum complement before ischemia resulted in a
      significant attenuation of the KC-induced oxidant stress (enhanced oxidation of
      plasma glutathione) and also prevented the accumulation of PMNs in the liver
      during the initial reperfusion period of 1 h. Complement activation through
      injection of cobra venom factor (CVF; 75 micrograms CVF/kg) also induced enhanced
      oxidation of plasma glutathione and accumulation of PMNs in the liver. Isolation
      of KC and PMNs from the liver 1 h after CVF treatment demonstrated a similar
      priming effect for stimulation with phorbol myristate acetate and opsonized
      zymosan as was observed in the postischemic liver. Complement-depleted animals
      and animals pretreated with the soluble human complement receptor type 1 (BRL
      55730; 22.5 mg/kg) accumulated significantly less PMNs in the postischemic livers
      during longer reperfusion periods (24 h) and sustained significantly less injury.
      It is concluded that complement is involved in the induction of a KC-induced
      oxidant stress, the priming of KC and PMNs for enhanced reactive oxygen
      generation, and the continuous accumulation of PMNs in the liver during
      reperfusion.

PMID- 8476063
TI  - Adenine nucleotide degradation in ischemic rabbit lung tissue.
AB  - The aim of the study was to determine the pathways and site of adenosine
      triphosphate (ATP) catabolism during lung ischemia, which thus far are largely
      unknown. For this purpose we used the isolated rabbit lung. Rabbit lungs were
      flushed in situ with a modified Krebs-Henseleit solution (60 ml/kg), the deflated
      heart lung blocks were isolated, immersed in saline solution, and stored at 37
      degrees C. In group I (normothermic ischemia; n = 6) tissue content of ATP
      decreased progressively from 9.42 +/- 0.58 mumol/g dry wt to 3.42 +/- 0.24
      mumol/g dry wt after 30 min of ischemia and further to 0.51 mumol/g dry weight
      after 4 h. Hypoxanthine was the major catabolite (92% of the nucleoside and
      purine base fraction at 4 h ischemia). Adenosine did not accumulate (preischemic
      0.08 +/- 0.02 mumol/g dry weight vs. 0.13 +/- 0.01 mumol/g dry weight; P > 0.05).
      AMP accumulated, but also inosine monophosphate (IMP), which was undetectable
      before ischemia, increased significantly during ischemia. To determine the
      breakdown pathway of AMP, 400 microM of the adenosine deaminase inhibitor EHNA
      was added to the flush solution in group II (n = 6). During ischemia, ATP
      breakdown was unaltered but adenosine became the major catabolite (2.8 times the
      concentration of hypoxanthine at 4 h ischemia). By pretreatment of the rabbits
      with the nucleoside transport inhibitor R 75231 (group III; n = 6) no effect was
      observed on the concentrations during ischemia of inosine and hypoxanthine and
      only a minor increase of adenosine was found. Cytochemical localization of
      nucleoside phosphorylase revealed activity predominantly in the endothelial
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476064
TI  - Effects of gastrin-releasing peptide and analogues on guinea pig nasal mucosal
      secretion.
AB  - The effects of gastrin-releasing peptide (GRP), bombesin, GRP-(1-16) and GRP-(21
      27) on guinea pig nasal mucosal secretion were studied in vivo. GRP, bombesin,
      and GRP-(21-27) induced significant secretion of total protein, albumin, and
      alkaline phosphatase. GRP induced significant secretion at lower concentrations
      (10(-11) and 10(-10) M) than were required for bombesin and GRP-(21-27) (10(-7)
      M). GRP-(1-16) did not stimulate secretion, indicating that the COOH-terminal
      region of GRP contained the secretagogic principle. Capsaicin, a stimulant of
      nociceptive sensory nerves, stimulated GRP release into nasal secretions. These
      data suggest that GRP is present in guinea pig nasal mucosa and that the COOH
      terminal region of GRP may regulate mucosal macromolecule secretion.

PMID- 8476065
TI  - Characterization of L-arginine transport by pulmonary artery endothelial cells.
AB  - The transport of L-arginine by porcine pulmonary artery endothelial cells (PAECs)
      was characterized. Uptake of 50 microM L-arginine was time dependent and linear
      in the presence and absence of sodium, with approximately 70% of uptake occurring
      via a carrier-mediated Na(+)-independent process. Kinetic studies of saturable
      Na(+)-independent transport revealed two transport components: a high-affinity
      transporter [Michaelis constant (Km) = 304 +/- 23 microM, maximal transport
      velocity (Vmax) = 679 +/- 34 pmol.mg protein-1.30 s-1], and a low-affinity
      carrier (Km = 3.9 +/- 1.0 mM, Vmax = 2.8 +/- 0.7 nmol/mg protein-1.30 s-1).
      Saturable Na(+)-independent uptake of 50 microM L-arginine transport showed no
      significant variation in uptake between pH 6.0 and 8.0 and was blocked by the
      system y+ substrates L-arginine, L-homoarginine, L-lysine, and L-ornithine. Na(+)
      dependent L-arginine transport occurred via a single high-affinity system (Km =
      62 +/- 3 microM, Vmax = 211 +/- 24 pmol.mg protein-1.30 s-1) which was
      significantly inhibited by L-arginine, L-lysine, L-ornithine, L-leucine, L
      alanine, L-cysteine, and L-glutamine, but not by 2-methylaminoisobutyric acid.
      Na(+)-dependent arginine uptake was pH and hormone insensitive, and lithium did
      not substitute effectively for sodium. These data are consistent with mediation
      of high-affinity arginine transport by PAECs via Na(+)-independent system y+ and
      Na(+)-dependent system BO,+.

PMID- 8476066
TI  - Cu,Zn superoxide dismutase in vascular cells: changes during cell cycling and
      exposure to hyperoxia.
AB  - Conditions that generate reactive oxygen species elevate Cu,Zn superoxidase
      dismutase (SOD) in endothelial cells (EC) concomitant with decreased cellular
      proliferation. The current studies were undertaken with both vascular EC and
      smooth muscle cells (SMC) to compare the influences of cellular proliferation
      with those of hyperoxia on induction of Cu,Zn SOD. To assess cell cycling alone,
      EC and SMC were growth arrested, then released from arrest. Cell cycling was
      monitored by [3H]thymidine incorporation, counts, and flow cytometry. SOD
      catalytic activity was measured spectrophotometrically and SOD protein by enzyme
      linked immunosorbent assay. A digoxigenin-labeled probe was used to quantify SOD
      mRNA by Northern analysis. EC reached the S phase of the cell cycle in 18 h and
      completed one cycle in 24-30 h, whereas SMC took 24-30 h to reach the S phase and
      48 h to complete one cycle. Cu,Zn SOD mRNA for both EC and SMC was very low
      during the Go/G1 phase, peaked during the S phase, and then reverted to lower
      values as cells progressed through their cycles. Cu,Zn SOD activity and
      immunoprotein content showed corresponding changes to those of mRNA. Exposure to
      hyperoxia (95% O2) delayed the entry of released cells into the S phase of the
      cell cycle and blocked the cells in the S or G2 phase, but induced Cu,Zn SOD mRNA
      before the S phase and caused persistence of elevation of Cu,Zn SOD mRNA as cells
      progressed through their cycles. Exposure to hyperoxia also induced Cu,Zn SOD
      mRNA in growth-arrested cells within 24-48 h. Thus our studies support roles for
      both cells cycle dependency and reactive oxygen species in the induction of Cu,Zn
      SOD.

PMID- 8476067
TI  - Hydraulic conductivity of ischemic pulmonary venules.
AB  - We report the first determination of lung endothelial barrier properties in
      ischemic, nonreperfused microvessels. We quantified the endothelial barrier in
      terms of hydraulic conductivity (Lp) in single pulmonary venules (diameter 20-50
      microns) of isolated blood perfused lungs (dog, rat), held at constant inflation
      pressure (5 cmH2O) with a gas mixture containing 21% oxygen. Lp were determined
      by our split-drop technique in which an oil drop is first microinjected into a
      venule and then split by microinjection of a protein solution. Lp was interpreted
      from measurements of the rate of oil drop movement. Baseline Lp recorded in the
      first 30 min of perfusion averaged 3.4 +/- 0.9 x 10(-7) ml/(cm2.s.cmH2O). Then,
      in two separate groups of venules in which we established 1.3 +/- 0.1 h and 3.4
      +/- 0.8 h of ischemia, we determined Lp which were, respectively, 145 +/- 6.5 and
      308 +/- 13% above baseline (P < 0.05). We conclude that ischemia alone, in the
      absence of reperfusion, significantly deteriorates the lung endothelial barrier.

PMID- 8476068
TI  - Cell surface carbohydrates modulate neutrophil adherence to alveolar type II
      cells in vitro.
AB  - We characterized the influence of phosphorylated sugars and cell surface sialic
      acids on the adherence of human polymorphonuclear leukocyte (PMN) to rat alveolar
      type II cell (ATII cells) and human-derived A549 cell monolayers in vitro.
      Percent adherence of radiolabeled polymorphonuclear leukocytes was assessed after
      incubating cells with the carbohydrates, enzymes, or lectins to be tested.
      Lactose-1-phosphate (Lact1P) and maltose-1-phosphate (Malt1P) (10 mM) inhibited
      adherence of PMN to ATII cells and A549 cells. Maximal inhibition followed
      treatment of both PMN and rat ATII cells and amounted to 85 +/- 7% with Lact1P
      and 92 +/- 3% with Malt1P. Inhibition was concentration dependent. Incubation of
      PMN with mannose-6-phosphate reduced adherence to rat ATII cells and A549 cells
      by 36 +/- 11 and 39 +/- 8%, respectively. Maximal concentrations of sugars did
      not alter cellular viability. Neuraminidase-induced desialilation of ATII cells
      increased adherence of PMN by 36 +/- 7% to rat ATII cells and by 86 +/- 18% to
      A549 cells. Masking of terminal sialic acids on rat ATH cells with Limulus
      polyphemus agglutinin (100 micrograms/ml) increased adherence by 50 +/- 2%. These
      results indicate that cell surface carbohydrates are involved in the regulation
      of the adhesive interaction between PMN and ATII cells in vitro.

PMID- 8476069
TI  - Interleukin-8: an important chemoattractant in sputum of patients with chronic
      inflammatory airway diseases.
AB  - Sputum from patients with cystic fibrosis, bronchiectasis, and chronic bronchitis
      contains neutrophils and neutrophil proteases, which have been implicated in the
      pathophysiology of mucus hypersecretion in airways. We asked whether interleukin
      8 (IL-8), a potent neutrophil chemoattractant, might be involved in recruiting
      neutrophils into airways of patients with cystic fibrosis, bronchiectasis, and
      chronic bronchitis. We found significant neutrophil chemotactic activity in
      sputum obtained from these patients. The IL-8 concentrations that we measured in
      sputum of patients with cystic fibrosis (7.1 +/- 1.0 x 10(-9) M, mean +/- SE),
      bronchiectasis (9.6 +/- 2.9 x 10(-9) M), and chronic bronchitis (2.8 +/- 1.0 x
      10(-9) M) have been reported to cause significant chemotaxis in vitro and in
      airways in vivo, whereas concentrations measured in induced sputum from healthy
      subjects (1.1 +/- 0.3 x 10(-10) M) do not. A monoclonal antibody to IL-8
      significantly inhibited the chemotactic activity in patients' sputum by 75-98%,
      but not in induced sputum from healthy subjects (9%). We conclude that IL-8 is an
      important chemotactic factor in sputum of patients with cystic fibrosis,
      bronchiectasis, and chronic bronchitis, and we suggest that IL-8 accounts, at
      least in part, for neutrophil recruitment into airways of patients with these
      diseases.

PMID- 8476070
TI  - Pulmonary surfactant protein A stimulates chemotaxis of alveolar macrophage.
AB  - Pulmonary surfactant modulates several functions of alveolar macrophages
      including phagocytosis, killing, and chemotaxis. We hypothesized that the
      reported stimulatory effect of surfactant on macrophage migration was mediated by
      one of the surfactant proteins, SP-A. We found that macrophage migration was
      stimulated by SP-A in a concentration-dependent manner. A concentration of 105
      micrograms SP-A/ml enhanced migration approximately 10-fold. Heat treatment or
      reduction and alkylation of SP-A reduced its stimulatory effect. A checker-board
      analysis showed that SP-A stimulated migration primarily by enhancing chemotaxis
      (directed movement) rather than chemokinesis (random movement). The interaction
      of SP-A with macrophages may be mediated at least partly by the collagen-like
      domain of SP-A. We speculate that SP-A may play a multifunctional role in
      regulating pulmonary immune response by stimulating multiple macrophage
      functions.

PMID- 8476071
TI  - Cholesterol, macrophages, and gene expression of TGF-beta 1 and fibronectin
      during nephrosis.
AB  - Hypercholesterolemia aggravates experimental progressive glomerular injury.
      Evidence suggests the infiltrating glomerular macrophage (M phi) is a potential
      effector mechanism for the noxious effects of hypercholesterolemia. Because
      transforming growth factor (TGF)-beta 1 is secreted by activated M phi s and also
      stimulates fibronectin production by glomerular cells, we evaluated the kinetics
      of gene expression for these moieties in glomeruli isolated from nephrotic rats
      at 3, 7, 11, and 42 days after the delivery of puromycin aminonucleoside (PA). We
      also assessed whether cholesterol feeding, which raises the glomerular M phi
      number, alters the glomerular mRNA levels for TGF-beta 1 and fibronectin.
      Glomerular mRNA levels for TGF-beta 1 and fibronectin in nephrotic rats exhibited
      a biphasic temporal pattern, decreasing significantly below control at 3 and 7
      days after PA but increasing significantly at 11 and 42 days after PA. The
      upregulated gene expression for TGF-beta 1 and fibronectin at 11 days after PA
      temporally corresponded to the phase of mesangial M phi infiltration in this
      model. Cholesterol feeding to both normal and nephrotic rats significantly
      increased glomerular TGF-beta 1 and fibronectin mRNA levels at 11 days after PA.
      Immunohistochemical labeling for M phi s and intracellular TGF-beta 1
      demonstrated both mesangial and cortical interstitial localization with the TGF
      beta1-positive cells possessing M phi nuclear morphology. These findings identify
      a novel interaction between hypercholesterolemia, augmented glomerular M phi
      accumulation, and upregulated glomerular TGF-beta 1 and fibronectin gene
      expression. These perturbations within the acutely injured glomerulus constitute
      an early pathobiological determinant for the later development of mesangial
      matrix expansion and glomerulosclerosis.

PMID- 8476072
TI  - Urea induces Egr-1 and c-fos expression in renal epithelial cells.
AB  - The membrane-permeant solute urea, in concentrations present in the mammalian
      renal medulla, increased expression at the mRNA level of two immediate-early gene
      (IEG) transcription factors, Egr-1 and c-fos, in a time- and dose-dependent
      fashion in confluent growth-suppressed Madin-Darby canine kidney (MDCK) cells.
      This upregulation occurred in the absence of both cytotoxicity and an inhibition
      of protein synthesis, two potential nonspecific inducers of IEG expression. These
      findings were of interest because we have previously shown that hyperosmotic
      stress induced by the functionally membrane-impermeant solute NaCl increased
      expression of these IEG, whereas hyperosmotic stress induced by the membrane
      permeant solute glycerol failed to do so. The urea-induced increase in Egr-1 mRNA
      expression was not secondary to enhanced message stability as determined by
      actinomycin D experiments and is therefore likely a consequence of urea-induced
      transcriptional activation. Augmented Egr-1 expression in response to urea
      treatment was also observed in another renal epithelial cell line, LLC-PK1, but
      not in other cell types examined. Therefore cells of renal epithelial origin may
      be uniquely capable of responding to hyperosmotic urea with increased expression
      of IEG transcription factors, and this increase is likely transcriptionally
      mediated.

PMID- 8476073
TI  - Urea selectively induces DNA synthesis in renal epithelial cells.
AB  - Hyperosmotic stress with the functionally impermeant solute NaCl has been shown
      by us and others to inhibit cell growth and DNA synthesis. Several lines of
      evidence suggest that urea, the other principal renal medullary solute, may exert
      a growth-promoting effect on renal epithelial cells. Among these is the finding
      that urea upregulates expression at the mRNA level of two growth-associated
      immediate-early genes, Egr-1 and c-fos. In the present study, urea, in
      concentrations characteristic of the renal medulla, increased [3H]thymidine
      incorporation approximately threefold in confluent, growth-suppressed Madin-Darby
      canine kidney (MDCK) cells, whereas another readily membrane-permeant solute,
      glycerol, did not. Urea also overcame the inhibitory effect of hyperosmotic NaCl
      on DNA synthesis. The urea-induced increase in [3H]thymidine incorporation was
      also evident in the renal epithelial LLC-PK1 cell line, but not in renal
      nonepithelial and epithelial nonrenal cell types examined. In addition, it was
      associated with a 15% increase in total DNA content measured fluorometrically at
      24 h of treatment. There was, however, no associated increase in cell
      proliferation as measured by cell number, total protein content, or cell cycle
      distribution. Urea also failed to induce polyploidy or aneuploidy. Therefore
      cells of renal epithelial origin may be uniquely capable of responding to
      hyperosmotic urea with increased DNA synthesis through an undefined and
      potentially novel mechanism.

PMID- 8476074
TI  - Effects of anemia on morphology of rat renal cortex.
AB  - Information on morphological and functional effects of anemia in kidney is
      scarce, although this organ plays a major role in erythropoietin production,
      which is strongly stimulated in anemia. We undertook a morphological study of
      kidneys of anemic rats. Anemia was induced by X-irradiation and subsequent
      injection of a hemolytic drug. The most striking effects of anemia on renal
      morphology were damages in the proximal tubule and a volume increase of the
      peritubular space. These effects were evident only in the cortical labyrinth.
      Morphometry showed that the enlargement of the peritubular space reflected an
      increase of the volumes of both capillaries and interstitium. The structural
      changes in the cortical interstitium were associated with increased activity of
      the ecto-5'-nucleotidase in the fibroblasts. We suggest that hypoxia accounts for
      most of the observed alterations. The hypoxic proximal tubule might release the
      nucleotide AMP, which would be hydrolyzed to adenosine by the ecto-5'
      nucleotidase in the interstitium. Adenosine has been reported to trigger the
      synthesis of erythropoietin and the growth of blood capillaries.

PMID- 8476075
TI  - Transforming growth factor-beta inhibits phosphate transport in renal epithelial
      cells.
AB  - The effect(s) of transforming growth factor-beta (TGF-beta) on Pi transport was
      investigated in confluent opossum kidney (OK) epithelial cells. TGF-beta induced
      a time- and concentration-dependent decrease in the initial rate of sodium
      dependent Pi, but not alanine, transport. This selective inhibitory effect on Pi
      transport was largely reversible and was not associated with a rise in adenosine
      3',5'-cyclic monophosphate production. The reduction in Pi uptake was also
      independent of changes in extracellular calcium concentrations and prostaglandin
      synthesis. TGF-beta-mediated Pi transport inhibition appeared to involve neither
      pertussis toxin-sensitive G protein(s) nor augmented protein kinase C activity.
      However, the probable role of a serine/threonine protein kinase in signal
      transduction was supported by the considerable attenuation of TGF-beta effect by
      H-7. Furthermore, the TGF-beta-induced Pi transport reduction was blunted by
      cycloheximide and abolished by actinomycin D. In conclusion, TGF-beta selectively
      inhibits the activity of the sodium-dependent Pi transport system present in the
      apical membrane of renal epithelial cells. This action appears to be exerted via
      an unprecedented inhibitory pathway that might involve a serine/threonine protein
      kinase and alterations in the transcriptional and translational processes.

PMID- 8476076
TI  - Sex differences in control of renal outer medullary circulation in rats: role of
      prostaglandins.
AB  - A calibration technique was developed to quantify blood flow changes in the renal
      cortex and outer medulla in rats using platinum needle electrodes sensing partial
      pressure of locally generated hydrogen. Measurements were made in male and female
      rats to investigate sex differences in the humoral control and autoregulation of
      regional renal circulations. In males, both cortical and outer medullary blood
      flows were efficiently auto-regulated above an arterial pressure of 100 mmHg. The
      converting-enzyme inhibitor quinapril increased blood flow by 20% in both kidney
      zones, and inhibition of prostaglandin synthesis by indomethacin did not change
      the flow. In females, similar results were obtained only for the cortex; the
      medulla had a different response pattern. The blood flow was not autoregulated in
      the experimental pressure range up to 120 mmHg; quinapril did not change the
      flow, but indomethacin decreased the flow by 16% and at the same time restored
      its autoregulation capacity. We conclude that: 1) the medulla of female rats has
      a high basal level of vasodilator prostaglandins, which interferes with blood
      flow autoregulation in this kidney area, and 2) medullary flow in female rats is
      little affected by endogenous angiotensin.

PMID- 8476077
TI  - Maintenance of endothelin-induced renal arteriolar constriction in rats is
      cyclooxygenase dependent.
AB  - Influence of arachidonate cyclooxygenase (COX) products on endothelin (ET)-evoked
      renal vasoconstriction was assessed. In microperfused rat afferent (AA) and
      efferent arterioles (EA), indomethacin had no effects on the maximal contraction
      of both AA and EA by ET, but reduced the duration of ET-induced constriction in
      both arterioles. ET infusion to rats in vivo resulted in a selective increase in
      efferent but not afferent arteriolar resistance, leading to a dramatic increase
      in transcapillary hydraulic pressure difference. Glomerular filtration rate
      (GFR), which fell progressively during infusion of ET alone, was markedly
      preserved by COX inhibition, but not during selective thromboxane A2 antagonism.
      In isolated glomeruli, release of prostaglandin (PG) F2 alpha in response to 10(
      6) mol/l ET exceeded that the PGE2 by a ratio of 3.2. Collectively, these data
      provide strong evidence that locally released COX products, possibly PGF2 alpha,
      play a key role in sustaining ET-induced renal arteriolar constriction. COX
      inhibition leads to acute vasorelaxation of AA despite continued ET
      administration, without affecting EA constriction in vivo, thereby resulting in a
      dramatic reversal of the effects of ET on GFR.

PMID- 8476078
TI  - Effect of hyperosmolality on production and mRNA expression of ET-1 in inner
      medullary collecting duct.
AB  - The effects of hyperosmolality on the production and mRNA expression of
      endothelin-1 (ET-1) in inner medullary collecting duct (IMCD) were examined in
      the present study. Osmolality in incubation media was changed from 290 to 490 or
      690 mosmol/kgH2O by adding NaCl, urea, mannitol, or raffinose. A preliminary
      experiment was carried out using tubule suspension from the inner medulla.
      Hyperosmolality by NaCl stimulated ET-1 accumulation in rats (from 323.5 +/- 76.3
      to 478.0 +/- 108.4 and 573.7 +/- 47.8 pg.mg protein-1 x 24 h-1 in 290, 490, and
      690 mosmol/kgH2O, respectively) and rabbits. In contrast, hyperosmolality by urea
      markedly decreased ET-1 accumulation and hyperosmolality by mannitol showed no
      effect on it. We next examined whether hyperosmolality changes ET-1 mRNA. After
      incubation in isotonic or hypertonic solution for 6 h, ET-1 mRNA was determined
      using reverse transcription and polymerase chain reaction (PCR) in microdissected
      IMCD and glomerulus. Hyperosmolality by NaCl and raffinose significantly
      increased the PCR products of ET-1 mRNA in IMCD, whereas mannitol did not. The
      stimulatory effect of hyperosmolality by NaCl on ET-1 mRNA expression was not
      observed in glomerulus. Our data suggested a stimulatory effect of
      hyperosmolality on production and mRNA expression of ET-1 in IMCD but not in
      glomerulus.

PMID- 8476079
TI  - Effect of phosphorus restriction on renal response to oral and intravenous
      protein loads in rats.
AB  - Dietary phosphorus restriction ameliorates renal injury in rats. This may be due
      to changes in renal hemodynamics, including those factors associated with protein
      induced hyperfiltration. To test this, we measured inulin clearance (CIn), p
      aminohippuric acid clearance (CPAH), mean arterial blood pressure, and renal
      vascular resistance (RVR) 1 h before and 100 min after either oral gavage of 2 g
      bovine serum albumin or intravenous infusion of 5% glycine in female Sprague
      Dawley rats previously fed for 3-8 wk a 0.5% or a 0.1% phosphorus diet. Baseline
      CIn, CPAH, blood pressure, and RVR were similar. After albumin gavage, CIn rose
      20% (P < 0.01) for the 0.5% phosphorus group but did not change for rats fed the
      0.1% phosphorus diet. Other measured parameters, including plasma glucagon and
      renin activity, were not influenced by dietary phosphorus content. In contrast,
      during intravenous infusion of glycine, hyperfiltration was induced in phosphorus
      restricted rats. Thus dietary phosphorus restriction ablates oral protein but not
      intravenous amino acid-induced hyperfiltration, suggesting a gut-mediated
      mechanism for the former. These data highlight the potential importance of
      dietary phosphorus as a mediator of renal hemodynamics.

PMID- 8476080
TI  - Prostanoids promote pial arteriolar dilation and mask constriction to oxytocin in
      piglets.
AB  - We determined effects of oxytocin on piglet pial arterioles and the role of
      prostanoids in mediating arteriolar responses. Anesthetized piglets were equipped
      with closed cranial windows, and arteriolar diameter was measured using
      intravital microscopy. Pial arterioles were exposed to 10(-10) to 10(-4) M
      oxytocin. Cerebrospinal fluid (CSF) levels of prostaglandin E2 (PGE2) and 6
      ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) were determined using
      radioimmunoassay. Baseline diameter was 110 +/- 4 microns and increased to 120 +/
      6 microns at 10(-8) M (9 +/- 3%, n = 20). CSF levels of PGE2 were 697 pg/ml
      during baseline and increased to 1,685 +/- 316 pg/ml during 10(-6) M, 2,243 +/-
      327 pg/ml during 10(-5) M, and 2,941 +/- 500 pg/ml during 10(-4) (n = 6). CSF
      levels of 6-keto-PGF1 alpha were 354 +/- 73 pg/ml during baseline and increased
      to 734 +/- 168 pg/ml at 10(-5) M and to 836 +/- 167 pg/ml at 10(-4) M (n = 5).
      After inhibition of prostaglandin synthesis by indomethacin (5 mg/kg i.v.),
      oxytocin constricted at all doses, starting at 10(-10) M (5 +/- 2%) and
      continuing to constrict at 10(-4) M (24 +/- 2%, n = 14). We conclude that: 1)
      piglet pial arterioles respond to relatively low levels of oxytocin, 2) local
      presence and/or production of prostanoids promotes dilation, and 3) endogenous
      prostanoids prevent constriction of pial arterioles to oxytocin. Our results
      suggest that oxytocin could play a role in the regulation of cerebral
      hemodynamics.

PMID- 8476081
TI  - Initiation of cardiac hypertrophy in response to thyroxine is not limited by age.
AB  - We examined the role of age in the initiation of thyroxine-induced (T4) cardiac
      hypertrophy. T4 (0.4 mg/kg sc) was administered to prepubescent (2 mo), young
      adult (6 mo), and senescent (24 mo) Fischer 344 rats for 4 days. While
      significant increases in left ventricular (LV) mass and RNA/LV were evident at 4
      days in all T4-treated groups, the elevation in RNA/LV occurred earlier (2 days)
      in the senescent group. A 0.2-mg/kg dose of T4 elevated RNA values within 24 h in
      senescent, but not in prepubescent, rats. LV norepinephrine levels were measured
      to determine whether it plays a role in this model of cardiac hypertrophy. When
      synthesis of this catecholamine was blocked with alpha-methyl-p-tyrosine, tissue
      levels fell significantly in all groups, and the decrement was similar in T4
      treated and control rats in the two younger groups. We conclude that: 1) the
      initiation of T4-induced cardiac hypertrophy is not compromised in senescent
      rats, 2) hearts of senescent rats respond earlier and to a lower dose of T4 than
      young rats, and 3) the cardiac hypertrophy that occurs in hyperthyroidism is not
      due to enhanced levels of available cardiac norepinephrine.

PMID- 8476082
TI  - Effect of residual stress on transmural sarcomere length distributions in rat
      left ventricle.
AB  - It has been previously shown that the myocardium in the walls of the unloaded
      passive left ventricle (LV) is not stress free. To assess the functional
      significance of residual stress in the ventricular wall, we compared the
      transmural distributions of sarcomere length (SL) in specimens of rat LV
      myocardium fixed in the unloaded (residually stressed) and stress-free states.
      When a cross-sectional ring cut from the equatorial region of the freshly
      arrested rat hearts was cut radially to relieve residual stress, it sprang open
      into an arc with a mean opening angle of 45 +/- 15 degrees (SD) (n = 8). During
      immersion fixation in glutaraldehyde, the opening angle increased 9.3 +/- 7.1
      degrees (SD) overall. SLs were measured at 16 equally spaced transmural locations
      from the free wall in the stress-free tissue sections and were compared with
      control measurements from adjacent cross-sectional rings in which residual stress
      had not been relieved. Average SL for the stress-free tissue (n = 11) was 1.84 +/
      0.05 (SD) microns and for the unloaded tissue was 1.83 +/- 0.06 (SD) microns.
      However, analysis of covariance on the pooled data showed that the transmural
      distributions were significantly different (P < 0.0001). Whereas SL was uniform
      across the wall in the stress-free state with a mean gradient of -0.014 +/- 0.044
      (SD) microns/total wall thickness, there was a significant decrease (P = 0.001)
      in SL from epicardium to endocardium in the intact unloaded tissue [slope = 
      0.114 +/- 0.054 (SD) microns/total wall thickness].(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8476083
TI  - Effects of neurotensin and neuropeptide Y on coronary circulation and myocardial
      function in dogs.
AB  - This study analyzed the effects of the neuropeptides, neurotensin, and human and
      porcine analogue, neuropeptide Y, in anesthetized open-chest dogs. The left
      anterior descending coronary artery was cannulated and perfused at constant
      pressure via a blood reservoir. Flow to the coronary cannula was measured by an
      electromagnetic flowmeter, and regional segment lengths were measured by
      sonomicrometer crystals. Neurotensin injected into the coronary cannula resulted
      in a dose-dependent increase of coronary flow; neuropeptide Y resulted in a
      decrease of coronary flow. Because these changes in flow were not explained by
      systemic hemodynamic effects or alterations in regional myocardial function, they
      were considered to be coronary dilatation or constriction. Coronary dilatation by
      neurotensin was not prevented by alpha- or beta-adrenoceptor blockade but was
      completely abolished by indomethacin or by lowering coronary perfusion pressure
      to 35 mmHg when depressed systolic segment shortening indicated myocardial
      ischemia. Coronary constriction by neuropeptides Y persisted at coronary
      perfusion pressure of 35 mmHg and was only attenuated by indomethacin. We
      conclude that in contrast to systemic effects, coronary vasodilatation by
      neurotensin is mediated by a prostanoid product of cyclooxygenase. Preactivation
      of the prostaglandin system may explain why neurotensin lost its coronary dilator
      effect during myocardial ischemia. Neuropeptide Y may elicit coronary
      constriction in addition to mechanic reduction of coronary flow resembling severe
      coronary stenosis.

PMID- 8476084
TI  - Cerebral blood flow responsivity to CO2 in anesthetized chronically diabetic
      dogs.
AB  - The effect of diabetes mellitus on the cerebrovascular response to CO2 is
      unclear. We examined the effects of diabetes on cerebral blood flow (CBF) and
      cerebral oxygen uptake (CMRO2) during CO2 alterations. Four groups of dogs were
      studied: nondiabetic, normoglycemic controls; non-diabetic acute hyperglycemia;
      diabetic (pancreatectomy) with high-dose insulin treatment to maintain blood
      glucose between 4.0 and 6.0 mM; and diabetic with low-dose insulin treatment to
      maintain blood glucose at 13.2 +/- 0.4 mM. Six weeks after either sham surgery or
      pancreatectomy, dogs were anesthetized with fentanyl (50 micrograms/kg) plus
      pentobarbital (10 mg/kg), and microsphere determinations of CBF were made during
      normo-, hypo-, and hypercapnia. On the day of the study, arterial glucose levels
      in the control, acute hyperglycemia, and high- and low-dose insulin diabetic
      groups were 4.0 +/- 0.3, 14.9 +/- 2.5, 3.3 +/- 0.8, and 13.3 +/- 0.7 mM,
      respectively, at control. The corresponding baseline CMRO2 levels were 2.8 +/-
      0.2, 3.0 +/- 0.2, 4.1 +/- 0.4, and 4.0 +/- 0.3 ml O2.100 g-1 x min,1, and the
      values in both diabetic groups were higher than control. Normocapnic CBF in the
      acute hyperglycemia, high-dose insulin, and low-dose insulin groups was elevated
      from control (54 +/- 3, 50 +/- 3, 51 +/- 3 vs. 36 +/- 1 ml x 100 g-1 x min-1) and
      cerebrovascular resistance was lower (2.24 +/- 0.15, 2.51 +/- 0.14, 2.38 +/- 0.21
      vs. 3.35 +/- 0.18 mmHg.ml-1 x 100 g.min). CBF responses to both hypercapnia and
      hypocapnia were similar among groups. Thus both acute hyperglycemia and diabetes
      decrease cerebrovascular resistance and increase CBF.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8476085
TI  - Effects of atrial fibrillation on left and right atrial dimensions, pressures,
      and compliances.
AB  - The effects of atrial fibrillation on left and right atrial dimensions,
      pressures, and compliances were examined in two groups of seven barbiturate
      anesthetized open-chest pigs. Atrial diameters and pressures were recorded during
      atrioventricular (AV) pace and thereafter during atrial fibrillation. Both
      rhythms were studied with constant ventricular rate after complete AV block. Left
      atrial maximal diameter, which appeared at the end of the atrial filling phase,
      decreased from 32.4 (28.9-36.7; median and 95% confidence interval) to 31.3 (28.4
      35.7) mm after induction of atrial fibrillation. The right atrial maximal
      diameter also decreased, although not significantly. Atrial pressure at the peak
      of the v wave rose from 7.0 (5.5-8.5) to 9.6 (8.3-11.2) mmHg in the left atrium
      and from 5.0 (4.3-5.6) to 7.3 (6.2-8.7) mmHg in the right atrium. Left and right
      atrial chamber stiffness constants increased from 0.25 (0.19-0.48) to 0.41 (0.28
      0.66) mm-1 and from 0.21 (0.11-0.31) to 0.33 (0.30-0.39) mm-1, respectively.
      Instantaneous diastolic atrial compliance decreased in both atria after induction
      of atrial fibrillation. Thus, during atrial fibrillation with regular ventricular
      rate, changes in atrial diameter, pressure, and compliance take place.

PMID- 8476086
TI  - Fluorescent properties of rat cardiac trabeculae microinjected with fura-2 salt.
AB  - We have measured force, sarcomere length, and Ca2+ during twitches in rat cardiac
      trabeculae. To avoid the difficulties associated with fura-2/acetoxymethyl ester
      (AM), fura-2 salt was iontophoretically microinjected into the preparation using
      a single impalement site; this is possible because fura-2 diffuses through the
      gap junctions between cells. By use of this method, the estimated peak of the
      [Ca2+] transient during a twitch was not statistically different at different
      sarcomere lengths: 875 +/- 92 nM at a sarcomere length of 2.15 microns vs. 905 +/
      67 nM at a sarcomere length of 1.65 microns (means +/- SD, n = 10). When
      trabeculae were loaded using fura-2/AM, the estimated peak of the [Ca2+]
      transient at a sarcomere length of 2.15 microns was 540 +/- 180 nM (means +/- SD,
      n = 5). The time course of the Ca2+ transients at different sarcomere lengths is
      qualitatively similar, but small systematic differences were observed during the
      relaxation period. On the other hand, the duration of twitch force increases
      dramatically as the muscle length is increased. As a result, when the trabeculae
      were held at short muscle lengths, the temporal relationship between force and
      the Ca2+ transient resembled the relationship between cell shortening and the
      Ca2+ transient measured in isolated myocytes. At longer lengths the temporal
      relationship between force and the Ca2+ transient more closely resembles that
      obtained in papillary muscles using aequorin.

PMID- 8476087
TI  - Propionyl-L-carnitine limits chronic ventricular dilation after myocardial
      infarction in rats.
AB  - To determine whether propionyl-L-carnitine (PLC) administration ameliorates
      ventricular remodeling after myocardial infarction, we performed coronary
      occlusion in rats and examined the long-term effects of the drug 19-24 wk after
      surgery. In view of the well-established role of angiotensin-converting enzyme
      (ACE) inhibitors in the reduction of ventricular dilation after infarction, the
      therapeutic impact of oral PLC (60 mg/kg) was compared with that of enalapril (1
      mg/kg). Infarct size measured planimetrically was found to be comparable in
      untreated, PLC-treated, and enalapril-treated rats, averaging 40-46% of the left
      ventricular free wall. Heart weight was increased 14, 16, and 11% with no
      treatment, with PLC, and with enalapril, respectively. The relationship between
      left ventricular filling pressure and chamber volume demonstrated that PLC and
      enalapril significantly prevented the expansion in cavitary size after
      infarction. These protective influences were observed throughout the range of
      filling pressures measured, from 0 to 30 mmHg. At a uniform reference point of
      filling pressure of 4 mmHg, untreated infarcted hearts showed an expansion in
      ventricular volume of 2.17-fold (P < 0.0001). Corresponding increases in this
      parameter after PLC and enalapril were 36 and 43%, respectively, both not
      statistically significant. Moreover, PLC was capable of reducing the alterations
      in myocardial compliance associated with myocardial infarction. In conclusion,
      PLC reduces the magnitude of decompensated eccentric hypertrophy produced by
      myocardial infarction in a manner similar to that found with ACE inhibition.

PMID- 8476088
TI  - Arteriolar endothelium-dependent vasodilation occurs during endotoxin shock.
AB  - Endotoxin shock has been reported to alter endothelial structure as well as
      function of large arteries from in vitro experiments. Cremaster muscle arteriolar
      dilator reactivity of pentobarbital-anesthetized rats was determined by
      videomicroscopy at control and 30, 90, 150, and 210 min after intravenous
      infusion of Escherichia coli endotoxin (6 mg/kg, 1-h period). The dilator
      response was tested by intra-arterial injections of 90 ng acetylcholine (ACh). At
      control A1, A2, and A3 arterioles dilated 45, 21, and 34%, respectively.
      Postendotoxin arterial pressure decreased progressively, the A1 arterioles
      constricted (P < 0.05), A2 diameters were unchanged and A3 diameters increased.
      Postendotoxin ACh dilations averaged 28, 23, and 25%. A1 dilation was
      significantly (P < 0.05) less than at control. Methylene blue (2.5 mg ia)
      attenuated the ACh response at control, but after endotoxin an intense downstream
      vasoconstriction resulted in stasis and reduced survival time occurred.
      Hydroquinone (HQ) partially blocked the responses to ACh postendotoxin. HQ
      significantly increased the survival time postendotoxin. It is evident
      postendotoxin that the endothelia of arterioles are functional and able to
      release nitric oxide (NO) throughout the entire survival period. The
      microvascular release of NO and the dilation response to ACh were substantially
      attenuated by methylene blue and HQ. The latter may block the more lethal effects
      of the inducible NO synthase.

PMID- 8476089
TI  - Effects of corticotropin-releasing factor on isolated rat heart activity.
AB  - We investigated effects of bolus administration of corticotropin-releasing factor
      (CRF) on parameters of cardiac activity in isolated working rat hearts. Effects
      at a dose of 5 micrograms of CRF were compared in hearts perfused with Krebs
      Henseleit solution, norepinephrine (NE, 10(-9) M), propranolol (3 x 10(-6) M), NG
      nitro-L-arginine (L-NNA, 3 x 10(-5) M), or indomethacin (3 x 10(-5) M). CRF
      increased coronary flow for > 30 min (P < 0.01) with maximum increases of 31.7%,
      suggesting a prolonged vasodilatory action of the peptide. CRF, in addition,
      induced transient (lasting < 10 min) increases in maximum aortic pressure and
      oxygen consumption (P < 0.01), suggesting an inotropic action of the peptide.
      Perfusions of NE and propranolol did not change the cardiac response to CRF. L
      NNA, inhibiting release of endothelium-derived relaxant factor (EDRF), and
      indomethacin diminished the vasodilatory response to CRF, as indicated by
      significantly shortened increases in coronary flow after CRF (P < 0.05).
      Indomethacin also enhanced peak increases in maximum aortic pressure after CRF (P
      < 0.01). The data confirm direct effects of CRF on cardiac activity. They also
      suggest that the mediation of coronary vasodilation by CRF involves the
      endothelial release of prostacyclin and EDRF.

PMID- 8476090
TI  - Recovery of myocardial function after repetitive episodes of reversible ischemia.
AB  - The question of whether recovery of regional myocardial function after
      repetitive, reversible ischemia differs from recovery after a single episode of
      myocardial ischemia remains controversial. Therefore, eight conscious dogs were
      instrumented with ultrasonic dimension transducers and left ventricular
      micromanometers. Each animal underwent (in random sequence, 72 h apart) a single
      15-min left anterior descending coronary arterial (LAD) occlusion and two 15-min
      LAD occlusions separated by 1 h of reperfusion. The preload recruitable work area
      (PRWA; the area beneath the regional stroke work vs. end-diastolic length
      relationship) quantified regional myocardial performance. Repetitive ischemia
      significantly delayed recovery of PRWA over the first 24 h (P < 0.05). Although
      postischemic myocardial creep resolved rapidly after single occlusion, double
      occlusion prevented recovery of creep during the first 4 h of reperfusion. The
      recovery time course of PRWA paralleled the resolution of myocardial creep,
      suggesting that creep contributed significantly to delayed functional recovery
      and that myocardial "stunning" after repetitive ischemia may result in part from
      interaction between postischemic diastolic properties and systolic dysfunction.

PMID- 8476091
TI  - Endothelium-derived relaxing factor inhibits norepinephrine contraction of fetal
      guinea pig arteries.
AB  - As in the adult circulation, the endothelium may play an important role in
      determining fetal vascular tone. The purpose of this study was to determine the
      influence of the endothelium on norepinephrine- and phenylephrine-induced
      contraction of pulmonary and carotid arteries from near-term fetal guinea pigs.
      Isometric contractions of isolated rings to the cumulative addition of
      norepinephrine (10(-9)-10(-5) M) were measured before and after 1) endothelium
      removal, 2) NG-monomethyl-L-arginine (L-NMMA; 10(-4) M) to inhibit endothelium
      derived relaxing factor (EDRF), 3) methylene blue (10(-5) M) to inhibit guanylate
      cyclase, 4) oxyhemoglobin (3 x 10(-6) M) to bind EDRF, and 5) indomethacin (10(
      5) M) to inhibit cyclooxygenase. All treatment effects were measured in
      endothelium-intact segments. The maximal norepinephrine contraction of fetal
      pulmonary (40 +/- 8% KCl, n = 7) and carotid (13 +/- 7% KCl, n = 7) arteries was
      much less (P < 0.05) than the maximal contraction to 120 mM KCl. Treatments that
      inhibit the action of EDRF increased contraction of both fetal pulmonary and
      carotid arteries. L-NMMA also increased contraction to phenylephrine.
      Indomethacin had no effect on the contractile responses to norepinephrine of
      either artery. Thus EDRF inhibits alpha-adrenoceptor-stimulated contraction of
      fetal pulmonary and carotid arteries and may attenuate the constrictor
      responsiveness of the fetal circulation in vivo.

PMID- 8476092
TI  - Single delayed rectifier potassium channels from rabbit coronary artery myocytes.
AB  - Cell-attached patches from rabbit coronary artery single smooth muscle cells
      contained two distinct potassium channel types, namely a large conductance
      calcium-activated potassium channel and a smaller voltage-activated potassium
      channel representing the delayed rectifier (IK). When a physiological potassium
      ion gradient was used, the average slope conductance of single IK channels was
      7.26 pS. The time course of activation measured from ensemble averages was well
      fit by a single exponential raised to the power of 2 and was voltage dependent.
      Experiments were then performed with potassium (140 mM) on both sides of the
      membrane to resolve single IK channel currents during deactivation. Ensemble
      averages of this activity were well described by a two-component exponential, and
      the time constants were voltage dependent. Mean open times were significantly
      shorter during deactivation than during activation. Closed time distributions
      typically had two components. These kinetic characteristics were used in testing
      various state models for voltage-dependent potassium channels.

PMID- 8476093
TI  - Effects of epoxyeicosatrienoic acids on isolated hearts and ventricular myocytes.
AB  - Effects of cytochrome P-450 metabolites of arachidonic acid, epoxyeicosatrienoic
      acids (EETS; 5,6-EET, 8,9-EET, 11,12-EET, and 14,15-EET), were examined in
      isolated guinea pig hearts and ventricular myocytes. Addition of 1-16 ng/ml EETs
      to normal isolated hearts produced no effects on contractility or coronary
      pressure. In hearts subjected to 60 min of low-flow ischemia, impairment of
      contractility and declines in heart rate and coronary perfusion pressure were
      similar in the presence or absence of 1 ng/ml EETs. However, in the presence of
      either 5,6- or 11,12-EET, recovery was delayed for the first 10 min only. No
      significant differences were found in any group regarding heart rate, coronary
      perfusion pressure, or energy metabolite content after 30 min of reperfusion. In
      myocytes, both 5,6- and 11,12-EET (100 pg/ml, 1.0 ng/ml, and 20 ng/ml)
      significantly increased cell shortening as well as intracellular calcium
      concentrations, whereas 8,9- or 14,15-EET was without effect on these parameters.
      These results describe for the first time the direct effects of various EETs on
      cardiac cell function as well as their ability to modulate some of the myocardial
      responses to postischemic reperfusion. The results suggest a potential role for
      these substances in the response of the heart to pathological insult.

PMID- 8476094
TI  - TNF-alpha release in endotoxemia contributes to neutrophil-dependent pulmonary
      edema.
AB  - We examined whether the generation of tumor necrosis factor (TNF-alpha) after
      lipopolysaccharide (LPS) challenge contributes to increases in lung vascular
      permeability and water content. Guinea pig lungs perfused at constant flow with
      Ringer-albumin solution (0.5 g/100 ml) were challenged for 120 min with LPS
      (Escherichia coli; final concentration 33 ng/ml; n = 5). Lung effluent samples
      were assayed for TNF-alpha activity using the modified L-929 fibroblast cytolytic
      assay. TNF-alpha concentrations increased in a time-dependent manner with a peak
      value of 100 +/- 20 pg/ml noted 90-120 min after LPS. Human neutrophils
      [polymorphonuclear leukocytes (PMN; 2 x 10(7)] added to the perfusion solution
      after endotoxin challenge (n = 5) produced a threefold increase in lung tissue
      myeloperoxidase (MPO) activity over control values. PMN, added after LPS and
      activated using phorbol 12-myristate 13-acetate (PMA; 5 x 10(-9) M; n = 6),
      produced three- to sixfold increases in mean pulmonary arterial pressure (Ppa)
      and pulmonary capillary pressure (Pcap), wet weight-to-dry weight ratio (W/D),
      and the pulmonary capillary filtration coefficient (Kf,c) over control values (P
      < 0.05). Activation of PMN with PMA in non-LPS-challenged lungs produced only
      threefold increases in Ppa and Pcap and did not change W/D and Kf,c. Infusion of
      an anti-TNF-alpha antibody before the LPS challenge reduced by approximately 50%
      the increases in Ppa, Pcap, MPO content, Kf,c, and lung wet weight gain (P <
      0.05). Therefore, endotoxin-induced TNF-alpha generation in lungs significantly
      contributes to pulmonary sequestration of PMN. Activation of the sequestered PMN
      increases pulmonary vascular permeability and tissue water content.

PMID- 8476095
TI  - Trauma-hemorrhage and resuscitation in the mouse: effects on cardiac output and
      organ blood flow.
AB  - Although mice are widely used for the study of immune consequences of hemorrhage,
      the changes of cardiac output (CO) and blood flow (BF) in response to trauma and
      hemorrhage in this species have not been well defined. To study this,
      nonheparinized C3H/HeN mice (n = 6 per group) underwent laparotomy (i.e., trauma
      induced), were bled to a mean arterial pressure of 35 mmHg, and maintained for 90
      min by withdrawing more blood or returning Ringer lactate. The animals were then
      resuscitated with four times the volume of maximal bleedout in the form of Ringer
      lactate over 60 min. Sham-operated mice underwent the same procedure but were
      neither bled nor resuscitated. At the end of hemorrhage, 60 min
      postresuscitation, or corresponding time after sham operation, CO and BF were
      determined by radioactive microspheres. Results indicate that CO and BF decreased
      significantly at the end of hemorrhage. Resuscitation, however, restored CO and
      BF in various organs except the brain and skeletal muscle. Despite this, 9 of 16
      mice died within 6 days postresuscitation, whereas none of sham mice died (n = 16
      per group in this additional study). Therefore, we have developed a
      nonheparinized model of trauma-hemorrhage and resuscitation in mice that is
      associated with late mortality. Furthermore, the microsphere technique provides a
      reliable method for assessing CO and BF in mice. Thus it may be possible to study
      the correlation between cardiovascular and immunologic alterations under such
      conditions.

PMID- 8476096
TI  - Spontaneous contractions of isolated bat wing venules are inhibited by luminal
      flow.
AB  - The hypothesis that spontaneous contractions of bat wing venules could be
      modulated by luminal flow was tested. Single venules (114 +/- 5 microns diam)
      from the wings of anesthetized pallid bats were dissected, cannulated, and
      pressurized in vitro. A dual reservoir system was used to independently control
      luminal pressure and flow. In the absence of flow, and with pressure set to 10
      cmH2O, all venules contracted spontaneously at rates between 20 and 40
      cycles/min. Pressure elevation over the range of 3-10 cmH2O caused a rapid
      increase in contraction frequency and decrease in amplitude; pressure reduction
      caused a rapid decrease in contraction frequency and increase in amplitude. In
      contrast, initiation of flow resulted in a delayed and gradual reduction of
      contraction amplitude and/or frequency (sometimes to zero). The net effect of
      flow was to increase mean diameter and decrease the product of frequency x cross
      sectional area. Flow-induced inhibition of venular contraction was eliminated by
      endothelial denudation but persisted in the presence of NG-monomethyl-L-arginine
      (10(-4) M) or indomethacin (10(-5) M) in concentrations that blocked the effects
      of exogenously applied ATP or arachidonic acid, respectively. The flow-induced
      venular response also persisted in the presence of superoxide dismutase (55
      U/ml). Denuded venules responded to flow when placed downstream (i.e., perfused
      in series) from venules with intact endothelium. These results indicate that
      luminal flow can modulate the contractile function of bat wing venules via
      release of a transferable substance from the endothelium. The exact nature of the
      substance is not yet known but it does not appear to be classical endothelium
      derived relaxing factor, a prostaglandin, or an oxygen radical.

PMID- 8476097
TI  - L-arginine analogues blunt prostaglandin-related dilation of arterioles.
AB  - The effects of arginine analogues, inhibitors of endothelium-derived nitric oxide
      synthesis, on dilation of arterioles in response to various vasoactive substances
      were studied. At 65 mmHg intravascular pressure, isolated arterioles of rat
      cremaster muscle developed tone spontaneously and achieved control diameters
      similar to those observed in vivo (84.1 +/- 2.0 microns vs. passive diameter:
      161.3 +/- 3.4 microns). Acetylcholine (ACh, 5 x 10(-8) M), sodium nitroprusside
      (SNP, 5 x 10(-8) M), arachidonic acid (AA, 10(-7) M), prostaglandin E2 (PGE2, 10(
      9) M), and adenosine (ADO, 10(-6) M) were added to the Krebs bicarbonate buffer
      solution, suffusing the vessels. The peak vasodilator effects of all agents were
      studied before and after the administration of various doses of N omega-nitro-L
      arginine (L-NNA; 10(-5), 10(-4), and 10(-3) M), which significantly reduced, in a
      dose-dependent manner, the basal diameter of arterioles by 3.6, 15.2, and 18.9%,
      respectively. The lowest concentration of L-NNA significantly inhibited
      arteriolar dilations to ACh by approximately 26%. Higher concentrations of L-NNA
      and N omega-monomethyl-L-arginine (L-NMMA; 10(-4) M) caused a further significant
      reduction in the dilation to ACh (to approximately 47%) and also significantly
      reduced dilator responses to AA and PGE2. In the presence of the highest
      concentration of L-NNA (10(-3) M), dilation to SNP and ADO were also
      significantly reduced. Removal of endothelium abolished dilation to ACh and AA
      but did not alter that to SNP, PGE2, or ADO.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476098
TI  - Acute resetting of the carotid sinus baroreflex by aortic depressor nerve
      stimulation.
AB  - The effect of prolonged aortic depressor nerve (ADN) stimulation on carotid sinus
      baroreflex regulation of arterial pressure (AP) and renal sympathetic nerve
      activity (RSNA) was examined in anesthetized rabbits. Ramp increases in carotid
      sinus pressure (CSP) were repeated before and after 5 min of bilateral ADN
      stimulation. One minute after ADN stimulation the curve relating AP to CSP had
      shifted up and to the right, characterized by significant increases (P < 0.05) in
      the maximum (91 +/- 2 to 101 +/- 3 mmHg; mean +/- SE), midpoint (118 +/- 7 to 125
      +/- 8 mmHg CSP), and minimum (45 +/- 3 to 53 +/- 4 mmHg) of the AP reflex curve.
      There was a parallel shift downward of the curve relating RSNA to CSP,
      characterized by significant decreases in the maximum [100 +/- 0 to 66 +/- 8% of
      maximum control RSNA value (%max)], the range (90 +/- 2 to 59 +/- 8%max), and the
      gain (-1.0 +/- 0.2 to -0.5 +/- 0.1%max/mmHg) of the RSNA reflex curve. Values
      returned to control within 10 min of cessation of ADN stimulation. These results
      suggest that central neurons processing baroreflex information from one set of
      mechanoreceptors can be reset by convergent signals arising from another
      baroreceptor site.

PMID- 8476099
TI  - Characterization of CBF response to somatosensory stimulation: model and
      influence of anesthetics.
AB  - We investigated the cerebral blood flow (CBF) response to somatosensory
      stimulation. Stimulation of neuronal activity was performed by deflection (2-3/s)
      of the mystacial vibrissae in rats over a period of 60 s, and regional cortical
      CBF was measured continuously in the contralateral somatosensory cortex with
      laser-Doppler flowmetry. CBF within the somatosensory cortex was studied through
      the parietal bone thinned to translucency (n = 7) or through a closed cranial
      window with the dura mater removed (n = 7). In addition, the differential effect
      of anesthetics (halothane-N2O, n = 5; thiobutabarbiturate, n = 5; and alpha
      chloralose, n = 7) on the CBF response to stimulation was investigated. After a
      rapid increase after stimulation onset (maximum reached within 2-3 s), CBF
      remained above baseline with a slight tendency to decrease despite continued
      stimulation. On termination of stimulation, CBF fell to near prestimulation
      values within 2-3 s. The following mean CBF responses above baseline during the
      60-s stimulation period were obtained: halothane-N2O anesthesia, 25.4 +/- 5.9%;
      thiobutabarbiturate anesthesia, 10.6 +/- 2.4%; and alpha-chloralose anesthesia,
      16.9 +/- 2.3 (through the translucent bone) and 16.2 +/- 2.9% (closed cranial
      window, dura removed). We conclude that coupling of CBF to neuronal function has
      a very high temporal resolution (< 3 s) and that whisker deflection in rats
      provides a physiological stimulus to study coupling with laser-Doppler flowmetry.

PMID- 8476100
TI  - Continuous assessment of hemodynamic control by complex demodulation of
      cardiovascular variability.
AB  - Usefulness of complex demodulation (CDM) in assessing the frequency components of
      cardiovascular variability was assessed and, subsequently, this technique was
      utilized to determine the time-dependent responses of the low-frequency (LF) and
      high-frequency (HF) amplitudes of heart rate and blood pressure variabilities
      during postural tilt. CDM provides the time-dependent changes in amplitude of a
      particular frequency component on a continuous basis. Analysis of simulated data
      showed that CDM has sufficient frequency resolution to separately measure LF and
      HF amplitudes with a time resolution < 15 s and that CDM is robust to alterations
      in the frequency of the components. Analysis of actual data during postural tilt
      test in 23 young healthy subjects demonstrated that the HF amplitude of heart
      rate, an index of cardiac parasympathetic tone, rapidly decayed with head-up tilt
      (P < 0.01) and increased quickly showing an overshoot with tilt back to the
      supine position (P < 0.01). The LF amplitude of blood pressure, an index of
      vasomotor sympathetic activity, showed marked rhythmic fluctuation at an interval
      of 48-100 s during head-up tilt (P < 0.01), synchronizing with similar
      fluctuation in the LF amplitude of heart rate (P < 0.01). These results suggest
      that CDM can be used to provide a continuous assessment of cardiovascular
      variability components and that the dynamic responses of autonomic circulatory
      control to upright posture result in a phasic modulation of LF amplitude.

PMID- 8476101
TI  - Near-wall excess of platelets induced by lateral migration of erythrocytes in
      flowing blood.
AB  - In this study we present experimental data on the inhomogeneous distribution of
      platelets in polyethylene tubes (200 microns diam) based on the inverse Fahraeus
      effect for platelets. It is shown that platelets are expelled toward the red
      blood cell-depleted marginal layer near the tube wall by mutual interaction with
      erythrocytes. By means of a straightforward model, the near-wall concentration of
      platelets could be estimated from measurements on the average tubular platelet
      concentration. The marginal layer originates from the hydrodynamic interaction of
      the deformable erythrocytes with the tube wall. If the tube diameter is large
      compared with the size of the erythrocytes, the lateral migration effects can
      effectively be scaled on the absolute distance between the erythrocytes and the
      tube wall. This results in the main conclusion that the near-wall concentration
      of platelets is significantly enhanced up to about seven times the average
      concentration, practically irrespective of the tube diameter in the range of 100
      500 microns. Where comparable, the results of this study are in accordance with
      experimental data of other authors.

PMID- 8476102
TI  - Modulation of cerebral arterial tone by endothelium-derived relaxing factor.
AB  - This study was designed to further elucidate the role of the endothelium in
      regulation of cerebral vascular smooth muscle tone. Dose-dependent
      vasoconstrictive effects of serotonin (5-HT) were examined in endothelium-intact
      and endothelium-denuded ring segments prepared from canine basilar and middle
      cerebral arteries. Some preparations were pretreated with 10(-5) M N omega-nitro
      L-arginine (L-NNA), an agent that inhibits the production of L-arginine-derived
      nitric oxide, one of the compounds proposed to be endothelium-derived relaxing
      factor. L-NNA alone elicited marked dose-dependent increases in tension in
      endothelium-intact preparations; a significantly smaller response was seen in
      endothelium-denuded preparations. The effects of L-NNA on endothelium-intact
      preparations were partially reversed by washing and treatment with L-arginine.
      The maximum tension induced by 5-HT was approximately doubled by removal of the
      endothelium as well as by L-NNA treatment of endothelium-intact preparations; a
      slight increase in maximum tension occurred in endothelium-denuded preparations
      treated with L-NNA. The concentration of 5-HT producing half-maximal contraction
      (ED50) was not affected by L-NNA. These data suggest that L-arginine-derived
      nitric oxide modulates canine cerebral arterial tone in both the resting state
      and during contraction with 5-HT.

PMID- 8476103
TI  - Comparison of conduit vessel and resistance vessel reactivity: influence of
      intimal permeability.
AB  - Arterioles of hamster cheek pouches are less reactive to luminal application of
      small hydrophilic agents than to adventitial application. To explore possible
      longitudinal variations in response sidedness, we compared reactivity of isolated
      vessels from carotid arteries to first-order arterioles. Concentration-response
      curves for luminally or adventitially applied phenylephrine (PE) were
      constructed. Arterioles were 274-fold less responsive when PE was in luminal vs.
      adventitial responsiveness decreased as vessel diameters increased, from 24-fold
      in inferior saccular arteries to 18-fold in external maxillary arteries and,
      finally, to 3-fold in common carotid arteries. Differences in response to luminal
      or adventitial application of PE could be eliminated in arterioles by perfusion
      with 3-[(3-cholamidopropyl)-dimethylammonio]-1-propanesulfonate (CHAPS), which
      disrupts membrane integrity. Treatment with CHAPS also increased the transmural
      movement of sodium fluorescein across arteriolar vessel walls. We conclude that a
      diffusion barrier exists in arterial walls, that there is a longitudinal
      variation in this barrier as expressed by the differences in movement of small
      hydrophilic molecules from lumen to smooth muscle cell layers, and that the site
      of the barrier is likely to be at the endothelial cell membrane.

PMID- 8476104
TI  - Distribution, propagation, and coordination of contractile activity in
      lymphatics.
AB  - The propagation and coordination of lymphatic contractions were studied in the
      mesentery of the rat small intestine using in situ microscopic observation.
      Indexes of lymphatic diameter were simultaneously measured at two adjacent
      lymphangions in spontaneously contracting lymphatics (n = 51). Diameter index,
      contraction frequency, and the percentage of the intersegmental contractions that
      were propagated and coordinated (PP) were determined at both sites. The
      conduction velocity of the contractile activity and the percentage of the
      coordinated contractions that were propagated both antegrade to the direction of
      lymph flow and retrograde to the flow stream were determined. The results
      indicate that 1) 80-90% of the lymphatic contractions in the vessels we evaluated
      were propagated, 2) the wave of contractile activity propagated both centrally
      and peripherally, and 3) the conduction velocity of the contractile activity was
      approximately 4-8 mm/s. We tested the hypothesis that gap junctional
      communication is responsible for the coordination of the contractile event. To
      accomplish this, we used the gap junction blockers n-heptanol and oleic acid. PP
      was 90 +/- 4% under normal conditions and fell to a minimum value of 55 +/- 7%
      during the gap junction blockade. These results indicate that gap junctional
      communication played an important role in the propagation and coordination of
      contractions that occurred in spontaneously active lymphatics.

PMID- 8476105
TI  - Constrained optimization of ventricular efficiency in normal and failing hearts.
AB  - Optimal ventriculoarterial coupling, in terms of maximal energetic efficiency,
      was recently analyzed by analytic and experimental studies. Whereas for normal
      hearts the analytic predictions agreed well with measured data, failing hearts
      were found to operate remote from the predicted optimal conditions. An analysis
      of optimal coupling is developed in the present study, based on constrained
      optimization. The constraints are based on the concept that the system must
      comply with physiological requirements (restrictions) under all conditions.
      Optimization using the mean pressure as a constraint yielded results similar to
      the unconstrained case in the normal heart but different with the failing heart:
      in the failing heart the optimal arterial elastance was found to be larger than
      the ventricular elastance, whereas the opposite was predicted by the
      unconstrained optimization. If an additional constraint on the end-systolic
      pressure is used, a unique solution of the coupling state is obtained. The
      predicted coupling ratio was found to match published data from normal subjects
      and heart failure patients, where in the latter group it was found to be remote
      from the optimal efficiency state. An increase in ventricular contractility and
      reduction in afterload were shown to shift the nonoptimal coupling state toward
      the optimal one. This prediction complies with the use of inotropic agents and
      vasodilators as the mainstay of heart failure treatment. This study may provide a
      convenient framework of analysis for the assessment of the ventriculoarterial
      coupling and for the evaluation of the cardiovascular effects of specific drug
      treatments.

PMID- 8476106
TI  - Progressive feline pressure-overload: noninvasive assessment correlates with
      abnormalities in single cells.
AB  - Serial echocardiography and Doppler were used to monitor the progression of
      pressure-overload produced by banding the ascending aortas of young cats. The
      peak Doppler gradient across the band increased (as the animals grew in size)
      from 42 +/- 4.2 mmHg at 1 wk to 78 +/- 4.5 mmHg at 2-3 mos. Echocardiographic
      measurements of septal wall thickness increased significantly at 1 wk. Global
      ventricular function was unaltered in banded cats versus shams at each time
      point. However, in the subgroup of animals with an aortic-constricted area of <
      0.025 cm2 at 1 wk, fractional shortening decreased by 40% at 2-3 mos. Contractile
      abnormalities were present in isolated myocytes from hypertrophied hearts.
      Mechanical function was more profoundly depressed in cells from hearts with
      echocardiographic evidence of ventricular decompensation. Echocardiographic and
      Doppler studies assessed cardiac size and function and identified indexes
      predictive of global and cellular myocardial dysfunction. The use of noninvasive
      techniques as a predictor of failure makes the feline model of progressive left
      ventricular pressure-overload useful for studies of cellular and molecular
      factors regulating not only the development of cardiac hypertrophy but also the
      transition from compensated hypertrophy to myocardial failure.

PMID- 8476107
TI  - Loss of cardiac myofibrils: mechanism of contractile deficits induced by taurine
      deficiency.
AB  - It is well established that taurine deficiency is associated with myocardial
      contractile dysfunction; however, the mechanism is unknown. As a follow-up to
      finding reduced force generation in taurine-depleted rat cardiac trabeculae,
      using either calcium or strontium activation, this study examined alterations in
      ventricular fine structure and contractile proteins in animals made taurine
      deficient by in vivo treatment with a taurine transport antagonist,
      guanidinoethane sulfonate. Observations of ventricular ultrastructure showed
      disordered contractile filaments and clear losses of myofibrillar bundles in
      association with taurine deficiency. Biochemical analyses of ventricular
      contractile proteins using polyacrylamide gel electrophoresis confirmed losses of
      the major sarcomeric proteins, myosin and actin. These findings provide a
      possible mechanism for the contractile deficits and cardiomyopathy described in
      taurine-deficient animals.

PMID- 8476108
TI  - Chemically induced hypotension increases PGE2 release and depresses macrophage
      antigen presentation.
AB  - Hemorrhagic shock causes severe depression of macrophage functions and is
      associated with increased susceptibility to sepsis. Because hemorrhagic shock and
      resuscitation encompasses several pathophysiological conditions, such as
      hypotension, low-flow conditions, hypoxia, and reperfusion injury, it remains
      unknown whether severe hypotension in the absence of blood loss has any adverse
      effects on macrophage functions. To study this, systemic arterial hypotension was
      induced in C3H/HeN mice for 15 min by intravenous infusion of sodium
      nitroprusside or ATP-MgCl2. Peritoneal macrophages (PM) was harvested 20 h later
      with lavage. Antigen presentation was measured by coculturing PM with the
      D10.G4.1 Th cell clone. Tumor necrosis factor (TNF), interleukin (IL)-6, IL-1,
      and prostaglandin (PG) E2 levels in supernatants of PM stimulated with
      lipopolysaccharide were measured with bioassays or radioimmunoassay. Systemic
      arterial hypotension resulted in a significant decrease of PM capacity to present
      antigen. Although the release of TNF, IL-6, and IL-1 by PM was unaltered after
      hypotension, PGE2 release by PM was significantly elevated compared with the
      control group. These data indicate that chemically induced systemic arterial
      hypotension without blood loss leads to a depression of antigen presentation,
      which may be caused by elevated release of the immunosuppressive eicosanoid PGE2.

PMID- 8476109
TI  - Neurogenic control of renal function in response to graded nonhypotensive
      hemorrhage in conscious dogs.
AB  - The reflex control of plasma renin activity (PRA) and urinary sodium excretion
      (UNaV) was evaluated in 13 dogs instrumented for chronic study and maintained on
      a normal sodium intake (40 meq/day). Graded blood volume depletion of 14 (BVD1)
      and 21% (BVD2) of the estimated total blood volume was used to activate renal
      sympathetic nerve activity (RSNA), and experiments were conducted before and
      after bilateral renal denervation (DNX). In dogs with innervated kidneys,
      nonhypotensive BVD1 increased RSNA 40.9 +/- 10.9% (P < 0.05) above control. Blood
      volume depletion increased PRA from 1.95 +/- 0.52 to 3.5 +/- 0.57 ng.ml-1 x h-1
      and decreased UNaV from 58.2 +/- 10.1 to 35.5 +/- 4.3 mu eq/min without changing
      renal blood flow or glomerular filtration rate. BVD2 failed to further activate
      RSNA (52.0 +/- 16.7%) but did increase PRA to 4.85 +/- 0.83 ng.ml-1 x h-1 and
      decreased UNaV to 17.9 +/- 2.7 mu eq/min. Renal DNX (n = 13) abolished both the
      PRA and antinatriuretic responses to BVD1 and BVD2. Thus volume-invoked reflex
      activation of RSNA, but not altered renal hemodynamics, mediates, activation of
      PRA and antinatriuresis. This neurogenic control of renal function may be
      critical to the rapid regulation of extracellular fluid volume, via alterations
      in urinary excretion.

PMID- 8476110
TI  - Glomerular hemodynamics in aortocaval fistula rats: role of renin-angiotensin
      system.
AB  - To investigate intrarenal hemodynamics of aortocaval, arteriovenous (AV)-fistula
      rats and the effect of angiotensin-converting-enzyme (ACE) inhibition,
      micropuncture studies were obtained before and after administration of quinapril
      (100 micrograms.kg-1 x min-1), an ACE inhibitor. AV fistula produced by needle
      multipuncture was characterized by elevated left ventricular end-diastolic
      pressure (LVEDP), lower mean arterial pressure, and increased left and right
      ventricular weights. Effective renal plasma flow was lower in AV-fistula rats,
      and single-nephron glomerular filtration rate (SNGFR) and plasma flow (SNPF) were
      reduced. Single-nephron filtration faction (SNFF), stop-flow pressure, and
      glomerular pressure (PG) were increased. The lower SNGFR and SNPF and higher PG
      and SNFF were associated with higher afferent and efferent arteriolar resistances
      (RA and RE) and lower ultrafiltration coefficient (Kf). LVEDP correlated
      positively with with RA, RE, and SNFF (all P < 0.01) and negatively with SNGFR (P
      < 0.05) and SNPF (P < 0.01). After quinapril these variables returned toward
      normal. Thus this method for producing AV fistula was useful in creating mild and
      moderately severe cardiac failure (CHF). Intrarenal hemodynamics of AV were
      characterized by increased PG and SNFF and lower SNGFR and SNPF associated with
      increased RA and RE and lower Kf and SNPF correlated and with severity of CHF.
      Restoration of intrarenal hemodynamics to or toward normal with quinapril
      supports an important pathophysiological role of renin-angiotensin system in this
      CHF.

PMID- 8476111
TI  - Mechanisms of acute hemoconcentration in bullfrogs in response to hypoxemia.
AB  - Three general mechanisms have been proposed to explain rapid increases in red
      blood cell concentration in vertebrates in response to hypoxia: spleen emptying,
      red blood cell swelling, and decreases in plasma volume. We have experimentally
      tested these potential mechanisms for the hemoconcentration of red blood cells
      associated with hypoxemia in cold (10 degrees C), submerged bullfrogs. The mean
      increase of hematocrit was approximately 1.4-fold (the increase was highly
      variable between individual frogs) when arterial oxygen saturation was reduced
      from 80% to 8% by lowering ambient O2 partial pressure (PO2). The largest
      response was seen when arterial oxygen saturation was below 33% (a saturation
      that is not unusual in submerged amphibians). There was no difference between
      hematocrit increases during hypoxemia in spleen-ligated compared with sham
      operated frogs submerged in hyperoxic, normoxic, and hypoxic water, suggesting
      that spleen emptying is not the primary mechanism. Increased hematocrit was not
      due to red blood cell swelling: mean corpuscular hemoglobin concentration
      increased slightly as hematocrit increased, indicating that red blood cells
      shrank slightly rather than swelling. Plasma volume, measured in a separate group
      of animals by dilution of 51Cr-labeled autologous red blood cells, decreased
      almost 50% during hypoxemia, closely correlated with a mean increase of 1.76-fold
      of hematocrit. We thus conclude that the hematocrit increase seen during
      hypoxemia in bullfrogs is caused by a loss of plasma volume. This has important
      implications for cardiovascular function, since blood viscosity, oxygen carrying
      capacity, and cardiac output are all affected by changes in plasma volume.

PMID- 8476112
TI  - Decreased perfusion pressure modulates renin and ANG II type 1 receptor gene
      expression in the rat kidney.
AB  - To determine whether decreased perfusion pressure affects the abundance and
      distribution of renin and its mRNA and the expression of the angiotensin II type
      1 (AT1) receptor gene within the kidney, adult male Sprague-Dawley rats were
      subjected to aortic coarctation proximal to the renal arteries (Coarc, n = 8) and
      compared with sham-operated rats (Sham, n = 6). Renal renin distribution was
      determined by immunocytochemistry using a specific polyclonal antibody against
      rat renin. Renin mRNA was assessed by in situ hybridization to a 35S-labeled
      oligonucleotide complementary to rat renin mRNA. Kidney AT1 mRNA levels were
      determined by Northern analysis using a 1,133-base pair rat AT1 cDNA. Femoral
      arterial blood pressure, measured 24 h after surgery, was lower in Coarc than in
      Sham rats (75 +/- 5.4 vs. 122 +/- 2.3 mmHg, P < 0.05). Aortic coarctation
      increased the percent of juxtaglomerular apparatuses (%JGA) containing renin and
      its mRNA (85 +/- 2.5 and 66 +/- 2.8 vs. 49 +/- 5.3 and 36 +/- 1.7%, Coarc vs.
      Sham, P < 0.05) and the intensity of hybridization signals (497 +/- 89 vs. 71 +/-
      12 grains/JGA, Coarc vs. Sham, P < 0.05). In addition, recruitment of renin gene
      expressing cells was observed along afferent arterioles in Coarc rats, whereas
      renin and its mRNA were limited to the JGAs in Sham rats. Renal AT1 receptor gene
      expression was threefold lower in Coarc than in Sham rats. We conclude that
      reduction of perfusion pressure after abdominal aortic coarctation acutely
      enhances renin gene expression and downregulates AT1 receptor gene
      expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476113
TI  - Regional adrenergic regulation of ion transport across the isolated porcine
      gallbladder.
AB  - The regional transport properties of the porcine gallbladder epithelium were
      studied using Ussing chambers in which tissues were bathed in porcine Ringer
      solution. Under basal conditions, tissues from the neck absorbed Na and Cl.
      Fundic tissues also absorbed Na, but net Cl transport was not different from
      zero. Serosal norepinephrine (NE; 0.1 microM) stimulated Na and Cl absorption in
      the neck but only Cl absorption in the fundus. The effects of NE on Na and Cl
      transport were blocked by pretreatment with yohimbine, suggesting that alpha 2
      adrenoceptors mediate the transport-related actions of this neurotransmitter.
      Serosal isoproterenol (0.1 microM) produced a tetrodotoxin-insensitive,
      propranolol-sensitive increase in the short-circuit current (Isc) in fundic
      tissues but not in tissues from the neck. The beta 2-adrenergic agonist
      salbutamol produced a response similar to that of isoproterenol. However, the
      beta 1-adrenergic agonist dobutamine had no effect. Isoproterenol was 5.8-fold
      more potent than salbutamol in increasing the Isc. A possible explanation for the
      regional effects of beta-agonists is that beta-adrenoceptors are localized to
      epithelial cells in the fundic region. These results and results obtained
      previously suggest regional differences in basal Na and Cl transport across the
      porcine gallbladder epithelium and that both alpha 2- and beta 2-adrenoceptors
      act to regulate ion transport in this tissue.

PMID- 8476114
TI  - Restricted food access and light-dark: impact of conflicting zeitgebers on
      circadian rhythms of the rabbit.
AB  - Free-running circadian rhythms of rabbits were exposed to a 11:55-11:55-h light
      dark (LD) schedule. After complete entrainment (63 +/- 22 days), the
      predominantly nocturnally active rabbits were exposed to an additional zeitgeber,
      restricted food access (RF), which was imposed during the light period. In five
      animals RF had the same period (T) as the LD cycle (23:50 h), and in five other
      animals TRF was 24:10 h. At a period of 23:50 h for both zeitgebers, the rhythms
      of four animals were stably entrained to RF, while in one animal a component of
      the rhythm broke away from RF and entrained to the LD zeitgeber. In animals
      exposed to zeitgebers of different periods most of the activity rhythm also
      entrained to RF, but 20 +/- 7% of the activity entrained to the LD zeitgeber. The
      light-entrained activity component merged with the RF component when the
      zeitgebers crossed, and decomposition occurred when the phase difference exceeded
      4-6 h. The results indicate that two circadian oscillator systems exist in the
      rabbit, one entrained by light-dark cycles and the other by feeding-fasting
      cycles. Both exert common control over a number of overt behavioral rhythms.

PMID- 8476115
TI  - Effects of estrogen on gluconeogenesis and related parameters in male rainbow
      trout.
AB  - To investigate the effects of estrogen, the hormone responsible for
      vitellogenesis, on gluconeogenesis, male rainbow trout were implanted with 17
      beta-estradiol or given a sham procedure. Plasma glucose concentration in
      estrogenized fish was 50% of the control fish (6.4 mM). Glucose synthesis from
      physiological concentrations of alanine was 0.08 mumol.g cells-1 x h-1 compared
      with 0.20 mumol.g cells-1 x h-1 in control fish; synthesis from physiological
      concentrations of lactate was reduced by over 50% (0.88 vs. 0.36 mumol.g cells-1
      x h-1) in implanted fish. Gluconeogenesis from 5 mM lactate was also
      significantly depressed in implanted fish. Oxidation of alanine, serine, and
      lactate was not significantly affected by estrogen implantation. The maximum
      clearance velocity of a key enzyme negatively regulating gluconeogenesis,
      pyruvate kinase, was 3.03 mumol.g cells-1 x h-1 in estrogen (E2) implanted fish
      compared with 7.83 mumol.g cells-1 x h-1 in control fish. No significant
      differences in plasma insulin or glucagon were found in the two groups. We
      conclude that estrogen depresses gluconeogenesis and that this reduction
      contributes to the lower plasma glucose concentration seen in vitellogenic trout.

PMID- 8476116
TI  - Organ specificity of the dopamine1 receptor/adenylyl cyclase coupling defect in
      spontaneously hypertensive rats.
AB  - The coupling between the dopamine1 (DA1) receptor and the G protein/adenylyl
      cyclase (AC) enzyme complex is defective in the proximal convoluted tubule (PCT)
      of 20-wk-old spontaneously hypertensive rats (SHRs). Because this coupling defect
      could have been due to desensitization secondary to elevated renal dopamine
      levels in the adult animal, we studied the interaction between DA1 receptors and
      AC in PCT of rats as early as 3 wk of age, a time when renal dopamine levels are
      similar in SHRs and their normotensive controls (Wistar-Kyoto rats, WKYs).
      Maximum receptor density did not change with age and was similar in WKYs and SHRs
      in all the age groups studied (3, 8, and 20 wk). Basal-, forskolin-, and guanyl
      nucleotide-stimulated AC activities were also similar in WKYs and SHRs and did
      not change with age. However, the DA1 agonist-stimulated AC activity was greater
      in WKYs than in SHRs and increased with age in WKYs but not in SHRs. Moreover,
      the ability of a nonhydrolyzable analogue of GTP, Gpp(NH)p, to enhance DA1
      agonist (SND-919-C12, 1 microM)-stimulated AC activity increased with age in WKY
      but not in SHRs. To determine if the defect noted in the PCT of SHRs is due to a
      defective D1A receptor gene, parallel studies were performed in the striatum,
      since this receptor is expressed predominantly in the latter tissue. In contrast
      to the results in PCT, radioligand binding and AC studies in striatum revealed no
      differences between WKYs and SHRs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476117
TI  - The effect of a low essential fatty acid diet on hibernation in marmots.
AB  - We investigated the effect of an essential fatty acid (EFA)-deficient diet on
      hibernation patterns in yellow-bellied marmots (Marmota flaviventris). Fatty acid
      (FA) analysis of white adipose tissue (WAT) from animals maintained for 2 mo on
      the EFA-deficient diet suggested that little or no EFAs were present in the
      gonadal or omental fat depots. Hibernation about lengths of the EFA-deficient
      animals were significantly shorter (P < 0.01) than control animals. Stated
      another way, these animals aroused twice as frequently compared with control
      animals and used more energy to survive winter. Analysis of WAT composition and
      blood samples revealed that animals were highly lipolytic during winter.
      Furthermore, the release of FAs was not random: linoleate (cis-9,cis-12
      octadecadienoic acid; 18:2, a diene EFA) was significantly (P < 0.05) under
      represented in venous outflow from the gonadal WAT pad based on the percentage of
      this species in WAT. The concentration of saturated FAs was higher than that
      predicted from the WAT-FA composition. We conclude that linoleate is
      preferentially retained within WAT and that concentrations of this EFA may
      influence hibernation behavior. Thus EFAs may have a thermoregulatory role in
      hibernation in addition to their role as essential precursors for physiologically
      important lipids after hibernation is over.

PMID- 8476118
TI  - Changes in extracellular [K+] and [Ca2+] induced by anoxia in neonatal rabbit
      medulla.
AB  - Ion-selective microelectrodes were used to record levels of extracellular K+ and
      Ca2+ concentrations ([K+]o and [Ca2+]o, respectively) and the changes evoked by
      anoxia in the medulla of anesthetized ventilated newborn rabbits, 1-14 days of
      age. Resting levels of [K+]o showed significant decline with increasing age. The
      mean initial level of [K+]o was 6.5 +/- 0.3 mM for the 1st neonatal wk and 5.1 +/
      0.4 mM for the 2nd wk. Brief periods of N2 inhalation (1-3 min) induced
      reversible increases in [K+]o that were smaller with progression of maturity. The
      duration of the initial increase (phase I) in [K+]o was twofold greater during
      the 1st wk than the 2nd wk. At the maximal steady-state level of change (phase
      III), [K+]o increased by 1.8 +/- 0.2 mM during wk 1 and by 0.9 +/- 0.1 mM during
      wk 2. Large transient bursts of increase were frequently observed during both
      early and recovery phases of the sustained [K+]o accumulation. Resting levels of
      [Ca2+]o also showed age dependence. The mean values during early neonatal days 1
      3, compared with days 7-10, were 3.7 +/- 0.3 and 2.4 +/- 0.6 mM, respectively.
      Anoxia evoked multiphasic decreases in [Ca2+]o that were largest in the youngest
      pups. Early transient falls of 0.5 +/- 0.1 mM occurred at times similar to those
      for the earliest increases of [K+]o and negative focal potentials; larger
      decreases (0.9 +/- 0.2 mM) were recorded after reoxygenation.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8476119
TI  - Functional adaptation of different rat skeletal muscles to weightlessness.
AB  - The adaptation to weightlessness of two postural muscles, the slow soleus (SOL)
      and the fast gastrocnemius lateralis (GL), and a fast muscle used in movements,
      the extensor digitorum longus (EDL), was studied on five adult Wistar rats. The
      animals exposed to 14-day spaceflight aboard COSMOS 2044, designated as flight
      (F), were compared with synchronous (S) animals. The experiments were performed
      on single skinned fibers whose functional properties were studied. After
      weightlessness, the SOL exhibited two populations of fibers according to their
      Sr2+ affinities: 40% remained slow (Fs) and 60% acquired fast-type properties
      (Ff). Both S and F GL and EDL showed a single distributed population of fast
      fibers. SOL fibers atrophied insofar as they showed a significant reduction in
      fiber diameter and absolute maximal tension Po (mg) but not in Po expressed in
      kg/cm2. GL fibers showed no change in fiber diameter but a decrease in Po in mg
      and kg/cm2. EDL fibers were not atrophied by weightlessness. The tension/Ca
      concentration relationships of the Ff SOL and F GL fibers were shifted to the
      right, indicating a decrease in their Ca2+ affinity. An increase in the
      contraction kinetics was described for the SOL fibers after weightlessness,
      whereas no significant modification was found for the GL and EDL. Collectively,
      the data suggested that the adaptive changes subsequent to weightlessness were
      more dependent on the muscle function than on the fiber type, since both postural
      SOL and GL were modified.

PMID- 8476120
TI  - Immunochemical characterization and localization of endothelin ETB receptor.
AB  - A highly specific antiserum was raised against purified bovine endothelin ETB
      receptor and used to determine the tissue distribution of the receptor subtype
      ETB and to localize the receptor immunohistochemically in the kidney, adrenal
      gland, lung, cerebellum, and pituitary gland whose functions are known to be
      under strong influence of endothelin. The antiserum raised in a rabbit
      specifically recognized the receptor band on Western blot analysis of membrane
      proteins. Furthermore, it immunoprecipitated only ETB, establishing its ETB
      specificity. By determination of the percentage of the total number of the
      endothelin receptors that is immunoprecipitable with the antiserum, the amounts
      of the ETB relative to those of the ET receptors were found to vary from tissue
      to tissue: lung (70%), cerebellum (55%), pituitary gland (50%), kidney (25%),
      adrenal gland (10%), and testis (< 2%). This means that, in the lung, ET is the
      major form, whereas in the testis, ETA is predominant, comprising >95% of the
      receptors. Immunohistochemical examination of tissue sections revealed
      endothelium localization of the ETB endothelin receptor.

PMID- 8476121
TI  - Cardiovascular change and hypothalamic norepinephrine release in response to
      environmental stress.
AB  - The major objective of this study was to compare the magnitude and duration of
      cardiovascular (CV) responses to acute environmental stresses with the associated
      patterns of noradrenergic activity in the paraventricular nucleus (PVN) and
      posterior nucleus (PH) of the hypothalamus. Simultaneous microdialysis samples of
      extracellular norepinephrine (NE) were collected at 5-min intervals from PVN and
      PH and the CV responses were recorded before, during, and for 15 min after acute
      shaker (cage oscillation) stress or inhalation of ether vapor in freely moving
      rats. Five minutes of shaker stress, 60 and 150 cycles/min, elicited pressor
      responses coupled with increases in dialysate NE from both PVN and PH in a
      frequency-dependent manner. Tachycardia occurred at 150 but not 60 cycles/min.
      Ten minutes after 60 cycles/min and 15 min after 150 cycles/min, NE efflux in PH
      was still increased, whereas in PVN it returned to control as had arterial
      pressure and heart rate. Ether vapor elicited a transient CV response but a
      continuing efflux of NE in PH and PVN. Urethan anesthesia raised baseline values
      of dialysate NE in PH and PVN but significantly attenuated cardiovascular and
      dialysate NE responses to shaker stress. We conclude that acute environmental
      stress simultaneously elicits CV responses and the efflux of NE from PVN and PH
      but, during or after stress, CV values may return to control levels while NE
      efflux remains elevated in PVN and/or PH.

PMID- 8476122
TI  - Water uptake in stimulated cat skeletal muscle.
AB  - Isolated vasodilated cat hindlimb skeletal muscles were perfused at constant flow
      and stimulated at 4 Hz for 2-4 min in three studies. Water uptake rates were
      measured gravimetrically or calculated from venous protein concentration changes.
      Venous plasma sodium, potassium, chloride, and osmolality were also measured.
      Maximum water uptake rates averaged 1.8 +/- 0.2 (SE) ml.min-1 x 100 g-1, reaching
      twice that in some experiments. Water uptake continued after stimulation had
      ceased. Constant-flow perfusion maintained a constant capillary pressure that was
      corroborated by measurements of arterial and venous perfusate pressures. Water
      uptake rate was not influenced by hematocrit but was highly correlated with
      plasma flow rate. The evidence strongly suggests that small-molecule osmotic
      pressure was the primary pressure causing the transcapillary water flux. Venous
      plasma sodium and chloride concentrations increased almost as much as protein
      (108 and 87% of the protein increase, respectively), as would be expected when
      water fluxes are driven by small-molecule osmotic pressure. Peak potassium efflux
      averaged 36 +/- 3 mu eq.min-1 x 100 g-1, but potassium did not contribute
      significantly to the osmotic gradient.

PMID- 8476123
TI  - Mismatch between lipid mobilization and oxidation: glycerol kinetics in running
      African goats.
AB  - Glycerol kinetics and total fatty acid (FA) oxidation of trained African pygmy
      goats were measured by continuous infusion of [2-3H]glycerol and indirect
      calorimetry during treadmill exercise at 40, 60, and 85% maximal O2 consumption
      (VO2max). Our main goals were 1) to determine whether rates of FA mobilization
      and utilization are eventually matched as exercise intensity increases, thereby
      minimizing reesterification to supply more FA to working muscles, and 2) to test
      the hypothesis that lipolytic rate is proportional to aerobic capacity by
      comparing low-aerobic goats with published values from highly aerobic dogs and
      humans. Mean rate of glycerol release in the circulation (Ra glycerol) was 3.83
      +/- 0.11 at rest, 7.69 +/- 0.88 at 40% VO2max, reached a maximum of 15.32 +/-
      0.95 at 60% VO2max, and returned to 10.53 +/- 0.76 mumol.kg-1 x min-1 at 85%
      VO2max. Lipolytic rate did not match total FA oxidation, implying that Ra
      glycerol cannot be used as an index of FA utilization, even during intense
      exercise. A large fraction of total FA released by lipolysis was reesterified at
      60 and 85% VO2max, showing that FA mobilization does not limit whole animal FA
      oxidation at these intensities. Comparing goat, dog, and human responses reveals
      that mammalian lipolytic rate is scaled with aerobic capacity. High- and low
      aerobic species exercising at the same %VO2max mobilize FA in exact proportion
      with their metabolic rate, suggesting that the relative contribution of FA to
      total energy provision is independent of VO2max.

PMID- 8476124
TI  - Membrane properties of organum vasculosum lamina terminalis neurons recorded in
      vitro.
AB  - Intracellular recordings of organum vasculosum lamina terminalis (OVLT) neurons
      were obtained from superfused explants of rat hypothalamus. Most (32 of 34) OVLT
      neurons displayed a low threshold spike response during depolarizing pulses
      applied from holding membrane potentials negative to -70 mV. In 17 of 34 cells,
      electrical stimulation of the supraoptic nucleus area evoked antidromic
      responses. In 20 of the 34 cells, 8 of which were antidromically driven,
      identical stimuli also revealed either excitatory (n = 12) or inhibitory (n = 5)
      or mixed (n = 3) postsynaptic potentials. Axonal projections to the ipsilateral
      supraoptic nucleus were confirmed afterwards using reconstruction of Lucifer
      yellow-filled cells. A 10-40 mosmol/kgH2O increase in the osmolality of the
      superfusion media by addition of NaCl or mannitol prompted a membrane
      depolarization of 2-10 mV in each of nine OVLT neurons tested. These results
      indicate that OVLT neurons project to the supraoptic nucleus and possess
      intrinsic properties capable of influencing their excitability. Because neurons
      in OVLT depolarize consequent to elevations in media osmolality, the OVLT may
      provide a means by which hyperosmotic stimuli influence neuroendocrine function.

PMID- 8476125
TI  - Effect of chronic electrical stimulation on GLUT-4 protein content in fast-twitch
      muscle.
AB  - Insulin- and contraction-stimulated skeletal muscle glucose transport is governed
      largely by the GLUT-4 isoform of the glucose transporter. Recently, it has been
      demonstrated that denervated muscle has decreased GLUT-4 protein content,
      suggesting that regulation of GLUT-4 protein is related to neuromuscular
      activity. However, until now the effects of the opposite situation, enhanced
      neuromuscular activity, could only be speculated on from exercise training
      studies. In the present investigation the effect of chronic low-frequency
      electrical stimulation (10 Hz, 8 h/day) on GLUT-4 protein content and citrate
      synthase activity was determined in the predominantly fast-twitch plantaris.
      Chronic electrical stimulation enhanced GLUT-4 protein content and citrate
      synthase activity in the muscles stimulated for 10-20 days. Electrical
      stimulation lasting 30-40 days resulted in no further enhancement of GLUT-4
      protein content while citrate synthase activity continued to increase. Further
      prolongation of electrical stimulation (60-90 days) resulted in a plateauing of
      citrate synthase activity. The results suggest that increased neuromuscular
      activity can act independently of systemic changes to increase total GLUT-4
      protein content. They also suggest that both GLUT-4 protein content and citrate
      synthase activity are positively related to increased neuromuscular activity but
      that their rates of increase differ substantially.

PMID- 8476126
TI  - Object relations issues in the treatment of the preoedipal character.
AB  - It was through tolerance of Ms. D.'s infantile rage (i.e., rage against reality
      and its limits) that the analyst was able to open up a dialogue with the patient
      that could lead to a developmental mourning process. The same was true for the
      borderline character, Ms. A.! The interpersonal dialogue between analyst and
      analysand, which had both empathic and interpretive functions, allowed Ms. D. to
      reactivate her capacities for an intrapsychic dialectic gained during infancy. In
      her case, as well as in that of Ms. A., the initiation of an internal dialectic
      allowed for a mourning process to unfold. It is proposed that this internal
      dialectic is evidence of the existence of the psychic structure necessary to
      promote both mourning and the mutuality of interpersonal dialogue. The inability
      to mourn, generally seen in narcissistic and borderline characters, can be seen,
      therefore, not only as a failure in psychic structure formation, but also as a
      failure in psychic structure function that is due to intrapsychic defense.

PMID- 8476127
TI  - Understanding chronic bulimia: a four psychologies approach.

PMID- 8476128
TI  - A psychoanalytic view of cross-cultural passages.

PMID- 8476129
TI  - The horror reaction and its importance.

PMID- 8476130
TI  - Women and men in conversation: normal or neurotic?

PMID- 8476131
TI  - Creativity and psychosis in scientific research.

PMID- 8476132
TI  - Freud, three operas, and the affair with Minna Bernays: a reply to O'Brien's
      interpretation of operatic allusions.

PMID- 8476133
TI  - [Long-term evaluation of spinal cord electric stimulation in peripheral vascular
      disease].
AB  - We reported an study about the Electric Medullar Stimulation on Peripheral
      Vascular Pathology, in cases of critical Ischaemia of lower limbs. Short-time and
      longtime results are exposed. Arteriopathies included into the study were:
      arteriosclerosis, "mixed arteriopathy and TAO". Examination was made by Doppler
      Ultrasonography.

PMID- 8476134
TI  - [Importance of the evaluation of cerebral vasoreactive capacity in the indication
      for carotid endarterectomy].
AB  - In order to evaluate the outcome of endarterectomy, we estimated the cerebral
      vasoreactive capacity in 3 main patient groups with carotid artery disease: A.
      occlusion, B. high-grade, and C. low-grade carotid stenosis. The results showed
      that certain proportion of patients with reduced CVC can be distinguished in the
      each investigated groups, indicating thus, those patients in whom endarterectomy
      can benefit. Our study provides evidence that acetazolamide test with TCD
      measuring may be used to assess the CVC before and after endarterectomy. Carotid
      endarterectomy improves CVC in patients who had compromised cerebral perfusion
      reserve before operation. We suggest that the endarterectomy can also benefit in
      the patients with carotid occlusion and low grade stenosis if CVC is estimated.

PMID- 8476135
TI  - [Hemodynamic bases for the automatized quantification of the degree of
      obstruction in peripheral arteries in diabetic patients].
AB  - In order to improve the early diagnosis of arterial occlusions, we tried to
      establish the basis of an automatized system that allowed the study of the
      hemodynamic features of diabetic patients in the different stadii of their
      disease. Fifty-four patients with Diabetes Mellitus Type II were included in the
      study. In all of them, arterial flow curves were carried out at different levels:
      femoral, popliteal, pedia and tibial posterior arteries of both lower limbs. In
      the distal arteries of patients with hemodynamic injury, normal values of Maximal
      Systolic Velocity (Max A), Maximal Diastolic Velocity (Max D), Peurcelot's
      resistance (PR), pulsatility index (PI) and spectral band (SB), were found.

PMID- 8476136
TI  - [Renal duplex: clinical usefulness].
AB  - It is the purpose of this report to focus attention on the clinical usefulness of
      Renal Duplex for the diagnosis of patients with vasculo-renal diseases in terms
      of: 1. Accuracy of Duplex/Angiography in the measurement of the renal stenosis
      degree. 2. Correlationship between Duplex ans Isotopic Renogram with respect to
      the study of the parenchyma's perfusion. 3. The effect of the inhibitors of the
      conversor enzyme (Captopril) on the Doppler signal of the parenchyma, comparing
      it with the results from the captopril test about the peripheral plasmatic renin
      activity and the isotopic renogram, in patients with vasculo-renal HTA. Results
      obtains by Duplex and Angiography were compared in 92 renal arteries from 46
      patients. For both technics, three degrees of stenosis were established: 0-59%,
      60-99% and occlusion. The Duplex technique identified 49/54 stenosis < 60%, 28/33
      stenosis > 60% and 5/5 occlusions (Kappa 0.8). Sensibility and specificity of
      Duplex for the diagnosis of stenosis > 60% were, respectively, 89.5% and 90.7%;
      with an exactness of 90.2%. The angiographies showed stenosis > 60% in 23
      patients with HTA (diastolic pressures > 100 mmHg). In all of the patients, a
      measurement of the plasmatic renin activity, an isotopic renogram and a Doppler
      of the interlobar arteries basal and post-captopril, were performed. The
      correlationship between Duplex and isotopic renogram with respect to the
      measurement of the relative renal perfusion was statistically significant (r =
      0.91; p < 0.0001). The captopril test for renin and isotopic renogram were
      positives for 5 patients (4 with unilateral stenosis an 1 with bilateral
      stenosis). All of them showed severe stenosis (> 80%).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8476137
TI  - [Long-term course of arterial traumatisms in children. Analysis of 31 cases].
AB  - Thirty children, 17 boys and 13 girls, with 31 arterial traumatisms, were
      studied. The follow-up period ranged from 4 to 166 months. The purpose of this
      study was to analyze the long term results. The etiology in 19 cases was
      accidental (61.3%) and iatrogenic in 12 (38.7%). Upper limbs were affected in 15
      cases, lower limbs in 13. The arterial traumatism affected the supra-aortic
      truncus in 2 patients and the renal artery in one other. Arteriographies were
      carried out in 7 cases (22.6%). Twenty-three patients (74.2%) underwent surgical
      procedures. The rest of the patients were managed conservatively. No amputations
      were needed. Three patients died by no vascular causes. The long-term results
      were good in terms of permeability and absence of major sequels. We conclude that
      IAT (Infantile Arterial Traumatisms) are potentially graves; therefore an early
      diagnosis and a specialized care of patients, without rigid protocols of
      management, are needed. The uncertain prognosis of IAT obligate to a clinical
      follow-up.

PMID- 8476138
TI  - [Complete reconstructions without intermediate anastomoses].
AB  - Results from 9 complete reconstructions without intermediate anastomosis (8
      patients) are presented. In five cases a by-pass from femoral artery to the
      contralateral popliteal (infra or supra-rotuliar) arterial prosthesis was
      performed. In other case a by-pass from the aorta artery to the third popliteal
      section was placed. Other by-pass was performed from the branches of an axillo
      bifemoral by-pass to the third popliteal section. The last case was an axillo-bi
      popliteal by-pass. All the patients presented a severe ischemia (III and IV
      Fontaine stadii). Eight millimeter PTFE grafts were used. The distal anastomosis
      should always be performed in vessels with a low distal resistance.

PMID- 8476139
TI  - Safety and efficacy of total thyroidectomy for differentiated thyroid carcinoma:
      a 20-year review.
AB  - Controversy continues to exist regarding the optimal extent of resection for
      differentiated thyroid carcinoma (DTC). Subtotal thyroidectomy has been advocated
      by some authors in expectation of lower complication rates, while others advocate
      total thyroidectomy to achieve better cure rates. To examine this issue, the
      medical records of 124 patients who underwent total thyroidectomy for DTC were
      retrospectively reviewed. Total thyroidectomy was the initial procedure in 115
      patients, while nine patients had complete thyroidectomy following some type of
      subtotal resection. Concomitant procedures were performed in 47 patients. Ninety
      papillary, 20 mixed papillary-follicular variant, one Hurthle cell type, and 13
      follicular carcinomas were performed. Tumors were bilateral or multicentric in 40
      patients, with metastases present in one-third of patients at the same time of
      initial operation. Permanent hypoparathyroidism developed in two patients, and
      permanent ipsilateral recurrent laryngeal nerve palsy occurred in one patient,
      for an overall significant complication rate of 2.4 per cent. Tumor recurrence
      was noted at a mean of 19 months postoperatively in 14 patients. Ninety-six
      patients received adjuvant postoperative radioiodine therapy to ablate residual
      functioning thyroid tissue or suspected metastases. We conclude that total
      thyroidectomy as treatment for differentiated thyroid carcinoma carries a low
      rate of morbidity, treats occult contralateral disease, and should facilitate
      radioiodine scanning and ablation of residual functioning thyroid tissue or
      metastatic disease.

PMID- 8476140
TI  - Bilateral neck exploration for primary hyperparathyroidism.
AB  - Controversy about the operative approach for primary hyperparathyroidism has
      prompted a review of our operative experience since 1980. We treated 73 patients
      with primary hyperparathyroidism during this 10-year period, all of whom
      underwent bilateral neck exploration in which the surgeons attempted to locate
      all parathyroid tissue. Thirty-eight patients (52%) were found to have a solitary
      adenoma, while 35 (48%) patients had multiple gland pathology. There were two
      cases of persistent hypercalcemia because of a synchronous parathyroid hormone
      secreting malignancy in one patient and aberrant fifth gland adenoma in the other
      patient. Without bilateral neck exploration, about one-half of the patients in
      our series would not have been cured of primary hyperparathyroidism. Because of
      the high incidence of multiple parathyroid gland involvement, we conclude that
      thorough bilateral neck exploration must be considered the goal for surgical
      treatment of primary hyperparathyroidism.

PMID- 8476141
TI  - Cause and current management of reoperative hyperparathyroidism.
AB  - We reviewed 137 cases of hyperparathyroidism followed for 6-72 months to
      determine the reasons for failure and to outline the successful management of
      reoperative hyperparathyroidism. Of 127 patients treated initially at Thomas
      Jefferson University Hospital, three required reoperation (2.4%) and 10 were
      referred with recurrent or persistent hyperparathyroidism. Reasons for failure
      were a missed gland in eight cases (62%), an ectopic gland in two cases (15%),
      supernumerary glands in two cases (15%), and malignant degeneration of an
      autotransplant in one case (8%). One patient had shortterm hypoparathyroidism
      requiring vitamin D supplementation (5.6%), but there were no injuries to the
      recurrent laryngeal nerves. We conclude that adequate knowledge of the location
      of normal and ectopic glands with meticulous search will reduce most
      reoperations, and, with identification of all four glands and routine cervical
      thymectomy in multigland disease, the rate should be less than 5 per cent.
      Patients requiring reoperation should undergo noninvasive localization studies
      and, if equivocal, selective venous sampling for parathyroid hormone. The major
      complication rate should be less than 10 per cent.

PMID- 8476142
TI  - Management of patients diagnosed as acute intestinal obstruction secondary to
      adhesions.
AB  - In an attempt to define an optimal strategy for managing small bowel obstruction
      secondary to adhesions, we reviewed 116 such cases encompassing a 5-year period
      at Hackensack Medical Center. Ninety-five patients underwent a trial of
      nonoperative treatment with a 35 per cent failure rate necessitating operation.
      This result was not influenced by the type of enteral tube used for decompression
      or predictable on the basis of initial clinical or laboratory findings.
      Significant complications occurred in those patients delayed more than 48 hours.
      The classic signs were poor indicators of strangulation. Patients with small
      bowel obstruction secondary to adhesions should be operated upon early (within 24
      hours) but may be treated nonoperatively for 24 to 48 hours, provided that no
      signs of strangulation are present or develop. Failure to show improvement during
      this 48-hour period requires immediate operative intervention. The group as a
      whole would have benefited if early operation were done routinely.

PMID- 8476143
TI  - Shotgun wounds to the abdomen.
AB  - In 1963 Sherman and Parrish (Sherman RT, Parrish RA. Management of shotgun
      Injuries: A Review of 152 Cases. J Trauma 1963;3:76-86) classified shotgun wounds
      into three types based upon distance and penetration. Because distances are often
      unknown, we redefined Sherman's groups by pellet scatter. Type I patients had >
      25 cm of scatter, Type II had < 25 cm but > 10 cm, and Type III had < 10 cm.
      Seventy-one abdominal shotgun wound patients were admitted over 8 years. Eight
      tangential wounds were managed by local wound care. Of the remaining 63, 27 were
      Type I, 10 were Type II, and 26 Type III. Two Type II and six Type III patients
      died within 24 hours. All required laparotomy. Nine of the Type I patients
      required laparotomy; eight had peritoneal signs and one had progressive abdominal
      tenderness, hypotension, and intra-abdominal pellets. Eighteen Type I patients
      without peritoneal signs were observed without complications. Type III patients
      suffered more vascular injuries and presented more frequently with hypotension
      than Type II patients. Of the patients surviving greater than 24 hours, Type IIIs
      received more transfusions and stayed longer in the intensive care unit and
      hospital than Type IIs. They also suffered more complications than Type IIs.
      Seven Type III patients required complicated reconstruction of the abdominal
      wall. Classification of abdominal shotgun injuries using pellet spread is a more
      useful system in determining patient management and prognosis compared to systems
      based on distance. Type II and III abdominal shotgun injuries require laparotomy,
      debridement of soft tissue injuries and frequently reconstruction of abdominal
      wall defects. Type I injuries can be managed effectively using signs of
      peritoneal irritation or progressive abdominal tenderness as the best indicator
      of the need for operation.

PMID- 8476144
TI  - Nonmalignant ectopic thyroid tissue.
AB  - Benign ectopic thyroid tissue is a rare entity. The etiology is related to the
      embryological development and maturation of the thyroid gland. It is important to
      consider metastatic thyroid carcinoma when ectopic thyroid tissue is identified.
      We present two cases of nonmalignant ectopic thyroid tissue.

PMID- 8476145
TI  - Acute acalculous cholecystitis following open heart surgery.
AB  - We undertook a retrospective study designed to ascertain the frequency of acute
      acalculous cholecystitis (AAC) following open heart surgery. In the study period
      1982-1990, 22 of 6393 patients following open heart surgery were recognized to
      have developed AAC, an incidence of 0.34%. The majority of patients (16/22)
      presented within the first postoperative week. Vague right upper quadrant
      physical findings, nonspecific changes in the liver function chemistries and
      unexplained sepsis frequently led to radiologic evaluations. Ultrasonography was
      the most valuable radiologic study, with a diagnosis sensitivity of 82%.
      Technetium cholescintography can serve as a useful adjunct when interpreted in
      the context of other clinical findings. Cholecystectomy was performed in 20
      patients and cholecystostomy in two. Nine (41%) patients had gangrenous
      gallbladders with frank perforation in two. A specific preoperative diagnosis was
      made in 19 patients (86%). Fifteen patients survived for a mortality rate of 32%.
      In 12 of 15 survivors (80%), the diagnosis of AAC was established and laparotomy
      performed within 48 hours of first clinical suspicion. Gangrene and perforation
      were seen in 87% of patients in whom surgery was delayed. AAC is a life
      threatening condition especially in critically ill patients. Experience suggests
      that early diagnosis and operative intervention are the key elements of
      treatment. Delay of operative management on the grounds of recent cardiac surgery
      is not justified.

PMID- 8476146
TI  - The role of endoscopic retrograde cholangiopancreatography: sphincterotomy versus
      common bile duct exploration as a primary technique in the management of
      choledocholithiasis.
AB  - 253 patients underwent diagnostic or therapeutic intervention for a presumed
      diagnosis of choledocholithiasis. In 104 (mean age, 60 years) the diagnosis was
      confirmed by endoscopic retrograde cholangiopancreatography (ERCP) or common bile
      duct exploration (CBDE). Of this group, 70 patients first underwent a total of
      102 attempts at endoscopic sphincterotomy (ERCP-S). Success (clearing the common
      duct of stones) was achieved in 43 patients (61%), though an average of 1.5 ERCP
      S/patient was required (maximum of four per patient). Of the 27 in whom ERCP-S
      failed, 20 went on to CBDE, which was successful in 18. Significant morbidity
      occurred in 12 (17%) ERCP-S patients, including hemorrhage. There were no deaths.
      Of the 34 patients who first underwent CBDE, 30 were cleared of common duct
      stones (88%). ERCP-S was subsequently employed to retrieve retained stones in
      three patients. Significant morbidity was documented in three (9%). No patients
      required perioperative blood transfusion. There were no deaths. While there is,
      as expected, a lower initial success rate with ERCP-S than with CBDE, the fact
      that ERCP-S is a less invasive procedure than is CBDE justifies its preferential
      utilization. However, patients must be informed that successful ERCP-S may
      require multiple visits to the endoscopy suite. Furthermore, the morbid
      consequences of ERCP-S, particularly hemorrhage, cannot be understated.

PMID- 8476147
TI  - Laparoscopic hernia repair: a preliminary report.
AB  - Advances in laparoscopic technique have provided the opportunity to perform
      preperitoneal herniorrhaphy and potentially avoid the morbidity associated with
      open techniques. From January 1991 to May 1992, two primary surgeons repaired 63
      inguinal hernias (42 indirect, 20 direct, 1 femoral) on 48 patients using a
      standardized laparoscopic technique. The hernia defect was visualized
      laparoscopically, and the peritoneum anterior to the defect was incised. The
      hernia sac was dissected from the inguinal canal. The hernia defect was then
      loosely packed with rolled 1 x 6-inch polypropylene mesh (average number of rolls
      used was 3.4). A sheet of polypropylene mesh (average 5 x 8 cm) was then placed
      over the mesh rolls and the hernia defect and anchored with an endostapler. The
      peritoneum was closed over the mesh sheet with standard laparoscopic clips. There
      were 44 males and 4 females in the study group. The mean age was 55 years (range,
      17-89 years). The mean follow-up was 5.8 months (range, 1-12 months). Thirty
      three patients underwent unilateral hernia repair, and 15 patients underwent
      bilateral hernia repair. Clinically unsuspected contralateral hernias were
      identified at the time of laparoscopy in seven patients. The mean duration of
      surgery was 118 minutes (range, 80-165 minutes) for bilateral hernia repair, and
      70 minutes (range, 45-100 minutes) for unilateral hernia repair. All patients
      with laparoscopic hernia repairs were treated on a same-day or less-than-24-hour
      in-hospital stay. Complications were designated as minor, moderate, or severe.
      There were 14 minor complications, which included subcutaneous hematomas at the
      trocar site, scrotal ecchymosis, groin swelling emphysema, and testicular
      asymmetry.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476148
TI  - Delayed repair of congenital diaphragmatic hernia.
AB  - Early reports of improved survival in newborns with congenital diaphragmatic
      hernias (CDH) utilizing extracorporeal membrane oxygenation (ECMO) and/or a
      delayed repair (DR) approach have been tempered by recent failures to document
      such an improvement. We have used ECMO to salvage emergently repaired patients
      with CDH since January 1984. From January 1990 to January 1991, we treated 16 CDH
      patients with mechanical ventilation and other supportive techniques until
      persistent pulmonary hypertension of the newborn resolved. We compared this DR
      group to 19 patients emergently repaired from February 1987 to December 1989. Of
      the 19 emergently repaired patients, 16 had a best post ductal (BPD) PO2 > 50 mm
      Hg. Eight patients survived (42 per cent of all and 50 per cent of those with a
      BPD PO2 > 50). Thirteen required ECMO and six of these survived. Five of six ECMO
      survivors had significant ECMO complications, and ECMO was "inappropriately"
      performed on three of six nonsurvivors. Of the 16 DR patients, nine achieved a
      BPD PO2 > 50 mm Hg and seven survived (44 per cent of all and 78 per cent of
      those with a BPD PO2 > 50). Seven required ECMO and four of these survived. All
      survivors in both groups had a BPD PO2 > 90 mm Hg. Delayed repair did not improve
      survival statistics for CDH with early respiratory distress at our hospital but
      it has allowed stratification of potential survivors, fewer inappropriate ECMO
      cannulations, and many fewer ECMO complications.

PMID- 8476149
TI  - Retroperitoneal hematoma following femoral arterial catheterization: a serious
      and often fatal complication.
AB  - Retroperitoneal hematoma (RPH) following cardiac catheterization is an infrequent
      (0.15% incidence) but morbid complication. During a 13-month study period, 11
      patients with a significant RPH requiring operative intervention were identified.
      The mean transfusion requirement was 8.7 units, with two deaths as a consequence
      of their RPH. Adjunctive cardiac procedures included percutaneous transluminal
      coronary angioplasty (five), stent placement (one), and thrombolysis (two). Two
      patients had RPH following aortography. Suspicion of RPH was most frequently
      prompted by a falling hematocrit (73%), with hypovolemic shock (systolic blood
      pressure < 90) in 64%. Lower quadrant or flank pain occurred in four patients.
      Lower extremity pain occurred in five patients due to femoral nerve compression.
      Of six patients with a preoperative femoral nerve palsy, complete resolution
      occurred in four cases. RPH following femoral arterial puncture is a cause of
      significant morbidity, particularly in the anticoagulated patient.
      Postcatheterization anticoagulation and high arterial puncture were the principal
      risk factors (p < 0.001). Early recognition is essential and should be prompted
      by a falling hematocrit, lower abdominal pain, or neurological changes in the
      lower extremity. There should be a low threshold for performing abdominopelvic CT
      scans in such patients. Management of RPH must be individualized: 1) patients
      with neurological deficits in the ipsilateral extremity require urgent
      decompression of the hematoma, 2) anticoagulation should be stopped or minimized,
      3) hematoma progression by serial CT necessitates surgical evacuation and repair
      of the arterial puncture site.

PMID- 8476150
TI  - The medical legal implications of following mammographic breast masses.
AB  - Delay in breast cancer diagnosis continues to account for the highest percentage
      of medical malpractice cases in the United States. A retrospective, computer
      aided study was undertaken to investigate a number of parameters used in making
      medical-legal decisions in missed breast cancer cases. Over a 5-year period, 435
      women with invasive breast cancers were registered at the Comprehensive
      University Breast Cancer Center. A close correlation between mammographic and
      final histologic size was verified (R = 0.74). In 5-mm increments, starting with
      a 1.0-mm tumor, there was an increasing percentage of positive nodes identified
      with increasing size of the tumor. Major percentage increases in frequency of
      positive nodes were noted at tumor sizes of 11 and 21 mm. This corresponded to an
      increasing number of recurrences and a decreasing 5-year disease-free survival
      (DFS) between consecutive 5-mm increments, although the differences were not
      significant. A multivariate regression analysis confirmed that the most important
      predictor of DFS was lymph node status (p = 0.0046) and not tumor size. After
      adjusting for lymph node status, tumor size was not significant. It is concluded
      that a period of observation, in which a breast cancer may increase in size is
      not substandard care since tumor size, after accounting for lymph node status is
      not significant at predicting DFS.

PMID- 8476151
TI  - Fournier's gangrene: historic (1764-1978) versus contemporary (1979-1988)
      differences in etiology and clinical importance.
AB  - Experience with 11 cases of Fournier's gangrene during the decade 1979-1988,
      prompted this review of the English language literature to determine whether
      there have been changes in demography, etiology, and outcome, as compared to
      cases dating to 1763. All cases were evaluated according to age, sex,
      bacteriology, etiology, and outcome. In the decade 1979-1988, 449 cases were
      reported. The average age of the patients was 49.8 years; with 14 per cent
      occurring in females. Synergistic polymicrobial infections were present in all
      cases. The most commonly reported etiologies were colorectal (33%), idiopathic
      (26%), and genitourinary (21%). Mortality associated with colorectal etiology was
      highest (33%, p < 0.05). Female mortality (49%) was not significantly greater
      than male mortality (17%), when obstetrical etiology was excluded. Overall
      mortality was 22%. Comparison with 386 cases of Fournier's gangrene reported
      between 1763 and 1978 reveals that the mean age of patients remains relatively
      low, and males continue to predominate. The pathophysiologic aspects of this
      disease appear similar in both sexes. The mortality rate from colorectal sources
      is significantly greater than from other common causes. Neither the introduction
      of antibiotics nor the development of newer ones has reduced mortality
      significantly. In spite of newer diagnostic techniques, the etiology remains
      unclear in over one-fourth of cases.

PMID- 8476152
TI  - The spleen and its vasculature in pancreatitis: CT findings.
AB  - The spleen and its vasculature are susceptible to damage from pancreatic
      inflammatory exudates. Fourteen patients were identified who demonstrated splenic
      or splenic vascular involvement from pancreatitis on computed tomography.
      Findings included intra- and perisplenic inflammatory fluid collections (n = 6),
      acute splenic hematomas (n = 3), splenic infarction (n = 1), splenic artery
      pseudoaneurysm (n = 1), and splenic vein thrombosis (n = 6). Eight of the 14
      patients went on to urgent interventions including percutaneous catheter drainage
      (n = 2) and transcatheter embolotherapy (n = 6) based on the CT findings.

PMID- 8476153
TI  - Primary leiomyosarcoma of the greater omentum: case report and review of the
      literature.
AB  - Omental leiomyosarcomas are rare intra-abdominal tumors. This report describes a
      case of primary leiomyosarcoma of the greater omentum discovered on abdominal CT
      scan. The mass was removed via laparotomy and an omentectomy performed. At 2
      years postoperatively there is no sign of tumor recurrence or metastasis.

PMID- 8476154
TI  - Necrotizing fasciitis secondary to discoid lupus erythematosus.
AB  - Necrotizing fasciitis (NF) is an uncommon, but devastating, disease with a
      significant morbidity and mortality, unchanged in the last several decades. This
      case report is the first successful management of a patient with NF secondary to
      discoid lupus erythematosus. A review of the literature describes current
      concepts of etiology, pathophysiology, diagnosis, and treatment of NF. This case
      report represents a growing class of patients at increased risk of NF due to
      iatrogenic immune compromise.

PMID- 8476155
TI  - Comparison of continuous single layer polypropylene anastomosis with double layer
      and stapled anastomoses in elective colon resections.
AB  - The documented leak rate of the continuous single layer polypropylene (CSLP)
      anastomosis in elective colon resection is 0-6 per cent. It is more cost
      effective than stapling (S), and should be faster and easier to perform than the
      double-layer (DL) technique. However, there have been no reported series
      comparing the outcome of the CSLP anastomosis with the DL and S techniques. We
      reviewed the charts of 100 patients with elective colon resections. Eighty-four
      had data sufficient for analysis. There were 44 CSLP, 21 DL, and 19 S. The groups
      were comparable with respect to 12 preoperative variables. Proportionately more
      large-small bowel anastomoses were performed in the S group, and no patient in
      the S group was actively taking steroids. Clinical outcome was assessed. All
      leaks were clinically apparent and documented with contrast enema or laparotomy.
      The leak rate for the CSLP was 6.8 per cent (3/44). Two of the three patients
      with leaks were taking steroids. There were two leaks in the DL group (9.5%), one
      of which was taking steroids, and no leaks in the S group. The difference in leak
      rate between the three groups was not statistically significant. The average cost
      for CSLP at our institution is $4.00 compared with $8.00 and $35.00 for the DL
      and S, respectively. We conclude that the CSLP is a reasonable and safe
      alternative to DL and S anastomoses.

PMID- 8476156
TI  - Primary papillary thyroid carcinoma presenting as cervical lymphadenopathy: the
      operative approach to the "lateral aberrant thyroid".
AB  - In contrast to a few follicles arranged in a wedge-shaped segment at the
      periphery of a lymph node, a significant amount of thyroid tissue in a cervical
      lymph node is considered evidence of metastatic thyroid carcinoma. In a
      consecutive series of 243 patients with papillary carcinomas, 52 presented with
      lateral cervical masses that proved to be lymph nodes with metastatic thyroid
      carcinoma, in the absence of readily palpable thyroid nodularity. The metastatic
      disease was demonstrated by excisional biopsy in 40 patients and fine needle
      aspiration cytology in 12 patients. Thirty-two (of the 52) underwent further
      diagnostic work-up, consisting of radionuclide scintigraphy and ultrasonography,
      with the demonstration of abnormalities consistent with a thyroid neoplasm in 75
      per cent (24/32) of these patients. The remaining 20 patients had no additional
      studies except for chemical thyroid function evaluation. The operative treatment
      in all 52 patients was total thyroidectomy and unilateral or bilateral modified
      neck dissections, when extensive cervical adenopathy was encountered. Papillary
      thyroid carcinoma, ranging in size from 2 to 14 mm, was found in the lobe
      ipsilateral to the presenting cervical node metastasis, in all specimens. In
      addition, contralateral cervical lymph node metastases were found in five (10%)
      of these patients, with no evidence of thyroid carcinoma in the corresponding
      thyroid lobe. With a mean follow-up period of 9 years, all patients are alive
      with no evidence of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476157
TI  - Recurrent hyperparathyroidism due to parathyroid autografts: incidence,
      presentation, and management.
AB  - Recurrent hyperparathyroidism (HPT) occurs in a small percentage of patients
      undergoing parathyroidectomy for primary HPT and is usually due to inadequate
      excision of hyperfunctioning parathyroid tissue in the neck, a missed ectopic and
      hyperplastic parathyroid, or, less commonly, parathyroid carcinoma and
      parathyroid autografts. In order to determine the incidence, clinical
      characteristics, and outcome of patients with recurrent HPT due to parathyroid
      autografts, we reviewed our experience with 604 consecutive patients operated on
      for primary HPT between 1965 and 1989. One hundred of these patients received
      parathyroid autografts consisting of portions of one or more parathyroid glands.
      Three patients with autografts, placed in the sternocleidomastoid muscle,
      developed recurrent HPT due to their autografts for an incidence of 3 per cent.
      Recurrent disease was diagnosed between 62 and 113 months with an average of 89
      months. The autotransplants in all three of these patients were from hyperplastic
      or adenomatous parathyroid tissue. Two patients had a history of neck
      irradiation. Preoperative thallium scans accurately localized the
      hyperfunctioning parathyroid tissue in all three patients. At operation, the
      hyperfunctioning autografts had grown into a discrete mass with a single vascular
      pedicle and were resected. Histologic examination disclosed either hyperplastic
      or adenomatous tissue, and corresponded to the histology and location of the
      original tissue transplanted in each case. Follow-up ranges from 12 to 67 months,
      with an average of 48 months. All patients remain cured and none require oral
      calcium supplementation. We conclude that graft-dependent recurrent HPT is due to
      the autotransplantation of hyperplastic or adenomatous parathyroid tissue and
      that thallium scanning is instrumental for diagnosis and localization.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476158
TI  - Anastamoses and bifurcations of the recurrent laryngeal nerve--report of 1177
      nerves visualized.
AB  - One thousand seventy-seven recurrent laryngeal nerves were observed in 719
      patients. Seven hundred forty-seven nerves bifurcated or trifurcated over 0.5 cm
      inferior to the cricoid cartilage (63%). Of these, 170 patients had bilateral
      nerve bifurcations. Thirty-nine per cent of the patients had bilateral
      bifurcations when one side bifurcated. Eleven patients had direct laryngeal
      nerves, two of which bifurcated. Five of these 11 patients also had a recurrent
      and direct laryngeal nerve. Seven patients had recurrent laryngeal nerves, all on
      the right side, receiving branches directly from the vagus nerve 6-14 cm from the
      cricoid. Damage to any filaments to or from the recurrent laryngeal nerve can
      cause vocal cord paralysis. Damage to branches to the esophagus from the
      recurrent laryngeal nerve can cause dysphagia.

PMID- 8476159
TI  - Management of pulmonary blastoma in children.
AB  - Pulmonary blastoma is a rare neoplasm, accounting for 0.5 per cent of all primary
      malignant pulmonary tumors. The clinical features, radiologic findings, and
      management of five children with pulmonary blastoma are described. The
      female/male ratio was 4:1. Mean age at presentation was 34 months, with a mean
      duration of symptoms of 1.8 months. Fever and cough were the most common
      symptoms. Opacification of the right lung field with mediastinal shift to the
      left was the predominant roentgenologic feature. The tumor involved the right
      chest in all patients. Thoracotomy was performed in all patients to establish the
      diagnosis. Two patients underwent complete resection at the initial operation, an
      incomplete resection was performed in one patient. Delayed complete resection was
      performed in another patient. All the patients received combination chemotherapy
      and one patient also received radiotherapy for primary disease. Two patients with
      histologic and immunohistochemical evidence of striated muscle differentiation
      were treated as rhabdomyosarcomas. Both these patients have survived for 24 and
      67 months after diagnosis. The tumor recurred in three patients. Recurrence was
      treated with a combination of surgery, chemotherapy, and radiotherapy. Overall
      disease-free survival rate was 40 per cent. Long-term follow-up and additional
      patients are required to provide prognostic information.

PMID- 8476160
TI  - Peliosis of the spleen: a rare cause of spontaneous splenic rupture with surgical
      implications.
AB  - Peliosis is a rare entity, formerly seen almost exclusively at autopsy, which
      most commonly involves the liver and less frequently the spleen. We present the
      sixth reported case of splenic peliosis discovered at surgical exploration and
      discuss the relevant findings and background of this condition, which may become
      an important issue for the surgeon.

PMID- 8476161
TI  - Pneumothorax in AIDS patients: operative management.
AB  - Acquired immunodeficiency syndrome (AIDS) is a devastating disease. Pneumocystis
      carinii pneumonia (PCP) is a major clinical manifestation of AIDS. A 2-year
      experience with eight operations for PCP-associated pneumothorax in seven AIDS
      patients was reviewed. Initial treatment was tube thoracostomy in all cases.
      Operation was performed because of inability to expand the lung and/or persistent
      air-leak. Time from insertion of the initial chest tube to operation was 9-66
      days (mean, 33 days). Pulmonary air leaks were closed with surgical staples
      and/or sutures. Chest tubes were removed 3-16 days after surgery (mean, 8.5
      days). There were no cases of postoperative respiratory insufficiency and there
      were no deaths. Patients were discharged from the hospital 6-18 days after
      surgery (mean, 13 days). The postoperative hospital stay was substantially
      shorter than the preoperative period of nonoperative therapy (13 vs. 33 days).
      Follow-up is complete in six of the seven patients. Three patients died of AIDS 4
      8 months after surgery (mean, 6 months). Three patients are alive 7-14 months
      after operation (mean, 11 months). Operative management of PCP-associated
      pneumothorax is effective and can be performed with low morbidity and mortality.
      We conclude that surgery should be considered as an early option in AIDS patients
      with PCP-associated pneumothorax.

PMID- 8476162
TI  - Endoscopic tattooing of the colon: clinical experience.
AB  - Nonpalpable lesions of the colon can be difficult to locate intraoperatively. We
      have demonstrated in an experimental study in dogs that the colon can be
      endoscopically "tattooed" by injecting dye through a flexible needle into the
      wall of the colon. At laparotomy, the resulting "tattoo" is then visible on the
      serosal surface of the bowel. This technique allows precise surgical localization
      of endoscopically identified lesions simply by visualizing the dye. Our initial
      clinical experience tattooing 15 colonic lesions in 12 patients is presented. In
      all patients, the endoscopically injected dye (1 per cent indocyanine green) was
      easily visualized on the serosal surface of the colon at surgery. The dye
      remained at the site of injection for at least 36 hours allowing tattooing to be
      performed the day before surgery. No significant complications were encountered
      with only one patient developing an inflammatory reaction at the site of
      injection. This experience demonstrates the clinical utility of endoscopic
      tattooing of the colon to permit accurate intraoperative localization of small or
      nonpalpable lesions.

PMID- 8476163
TI  - Ambulatory pH monitoring in the management of reflux.
AB  - Ambulatory pH monitoring is a useful tool in the diagnosis and treatment of
      different esophageal and pharyngeal complaints. We have studied its use in an
      office setting in 15 patients with suspected gastroesophageal reflux disease
      (GERD). The patients were monitored for at least 18 hours while wearing a two
      channel probe at home. Data obtained confirmed severe GERD in 6 patients and
      chest pain without GERD in 2 patients. Two patients continued to have symptoms in
      spite of appropriate therapy, while 2 untreated patients had symptoms of GERD
      with normal pH studies. We feel this technique is relatively safe and cost
      effective and causes minimal disruption of the patient's life-style, while
      enabling the physician to monitor therapy and help achieve a good therapeutic
      outcome.

PMID- 8476164
TI  - Auricular cartilage grafts in laryngotracheal reconstruction.
AB  - Introduction of the anterior cricoid split (decompression) and laryngotracheal
      reconstruction with costal cartilage graft has resulted in the successful
      management of many cases of subglottic stenosis. However, the procedure does not
      allow uniform extubation, and laryngotracheal reconstruction with costal
      cartilage may be too aggressive for neonates. We have explored the use of
      autogenous auricular cartilage graft in laryngotracheal reconstruction. Its high
      rate of success and low morbidity have enabled us to expand the indications. We
      report our experience in 23 patients with auricular cartilage grafts.

PMID- 8476165
TI  - Stroboscopic videolaryngoscopy: a comparison of fiberscopic and telescopic
      documentation.
AB  - The clinical value of stroboscopic videolaryngoscopy (SVL) for the evaluation of
      laryngeal disorders has been emphasized. Some investigators advocate the use of a
      flexible fiberscope, while others recommend the use of a rigid telescope for SVL.
      In order to determine which procedure is more useful for clinical diagnosis, the
      senior author (E.Y.) performed both fiberscopic and telescopic SVL on 120
      consecutive patients who complained of hoarseness. Equipment used included the
      Olympus ENF-P3 fiberscope, the Nagashima SFT-1 rigid telescope, the Nagashima LS
      3A laryngostroboscope, and color video cameras. Our study indicated that
      stroboscopic images produced by telescopic SVL were superior to those from
      fiberscopic SVL in the majority of cases. The purpose of this paper is to compare
      fiberscopic and telescopic SVL, to evaluate the advantages and disadvantages of
      fiberscopic and telescopic SVL, and to present the authors' recommendations.

PMID- 8476166
TI  - Rigid bronchoscopy balloon catheter dilation for bronchial stenosis in infants.
AB  - Stenosis of the tracheobronchial tree can be a life-threatening problem.
      Management options for symptomatic stenosis include serial dilation, cryotherapy,
      laser resection, and open surgical correction. Recently, balloon angioplasty
      catheters have been used to dilate stenotic airway segments. The experience in
      infants is limited and has for the most part utilized guide wires and fluoroscopy
      for balloon placement. We present two infants with symptomatic bronchial stenosis
      who underwent endoscopic angioplasty balloon catheter dilation. Operative
      technique involved catheter placement under direct vision with a rigid
      bronchoscope. Catheters (6F) with 8-mm-diameter balloons were used. Balloon
      expansion was controlled with a hand-held manometer. Both infants demonstrated
      significant lumen size improvement intraoperatively and marked clinical
      improvement postoperatively, substantiated by endoscopy and radiographs. One
      infant has required one repeat dilation and has subsequently been asymptomatic.
      The other infant has had no further respiratory problems. Our technique, using a
      rigid bronchoscope with direct visualization of catheter placement, obviates the
      need for guide wires and C-arm fluoroscopy as previously described. Endoscopic
      placement enables direct visualization of balloon position, and fine adjustments
      are possible if further dilation is necessary. Rigid bronchoscopic balloon
      catheter dilation can be a successful technique for bronchial stenosis and should
      be considered prior to attempting more invasive surgical correction.

PMID- 8476167
TI  - Eighteenth Daniel C. Baker, JR, Memorial Lecture. Art and science of laryngeal
      photography.
AB  - Photography of the pharynx, larynx, and trachea has exercised the ingenuity of
      laryngologists and photographers for 100 years. There have been many successful
      methods. The most reliable and versatile modern system uses a 35-mm single frame,
      single lens reflex camera with Hopkins telescopes and a synchronized, automatic
      exposure, computer-controlled, remote electronic flash generator. The technique
      described, which has been used by the author for many years, not only allows
      excellent visualization and reliable documentation, but yields consistently
      reproducible photographs under all conditions.

PMID- 8476168
TI  - Teflon injection: pointers and pitfalls.
AB  - Our objective is to clarify the procedure used in a series of 335 cases of
      injection of paralyzed vocal cords. Over 29 years, questions have arisen about
      the procedure, mostly from trainees. They relate to timing, indications, method,
      and follow-up. Results of the procedure, when properly performed, have been
      highly successful. Where indications are appropriate, injection is usually
      uncomplicated, relatively safe, and done with minimum instrumentation. This is
      our response, in a question-and-answer format, to the most frequent queries.

PMID- 8476169
TI  - Pendred's syndrome.
AB  - Although 5% of all cases of congenital deafness are caused by Pendred's syndrome,
      there are few reports in the literature. Seven patients with Pendred's syndrome
      in three families living in the same village were detected. For that reason, the
      syndrome is reviewed in light of the literature. The sex distribution of the
      patients with Pendred's syndrome and their families was recorded. We tested for
      thyroxine, triiodothyronine, thyroid-stimulating hormone, triiodothyronine resin
      uptake, and perchlorate, and performed caloric testing. In one patient, subtotal
      thyroidectomy was performed. In the histopathologic study, a thyroid nodule
      filled with colloid was found. Chromosome studies showed no anomalies in any
      patient. Five of the patients were deaf-mutes. We observed that the parents were
      cousins in all three families. These families also had healthy children, and the
      existence of the syndrome in both sexes points to an autosomal recessive trait.

PMID- 8476170
TI  - Comparison of functional endoscopic sinus surgery under local and general
      anesthesia.
AB  - We present a retrospective comparison of intravenous sedation and general
      anesthesia techniques employed at New York University-Bellevue Medical Center for
      functional endoscopic sinus surgery. Some authors have stressed the use of local
      anesthesia with intravenous sedation in order to avoid complications and reduce
      blood loss. We have reviewed 232 patients who underwent 401 consecutive
      ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of
      patients, carried an estimated blood loss of 23 mL per side. General anesthesia
      was associated with an average blood loss of 58 mL per side. The rate of
      operative complications for local anesthesia was 8.7% per patient, with a 1.6%
      rate of major complications per side. General anesthesia carried an overall
      complication rate of 2.4% per patient, with no major complications. General
      anesthesia is a relatively safe and viable option for endoscopic sinus surgery
      that in selected cases may be preferable to local anesthesia.

PMID- 8476171
TI  - Aerodynamic assessment of the speech of adults undergoing multichannel cochlear
      implantation.
AB  - This investigation was designed to evaluate the aerodynamic characteristics of
      the speech of adult multichannel cochlear implant (Nucleus, 21-channel)
      recipients. Five adults with an acquired profound sensorineural hearing loss were
      tested before implantation, immediately following implantation, and 3, 6, 9, and
      12 months after implantation. A commercially available computerized pressure-flow
      instrumentation system was employed to assess the respiratory, laryngeal,
      velopharyngeal, and oral articulatory subsystems of speech of the implantees. The
      results of the investigation indicated 1) a slight increase in airflow rate
      values for sustained vowel /a/phonation after implantation, 2) a slight increase
      in duration of sustained vowel phonation from the preimplant period to the last
      postimplant period, 3) an increase in laryngeal airway resistance after
      implantation that resulted from a larger increase in estimated transglottal
      pressure than in transglottal airflow, 4) maintenance of normal velopharyngeal
      closure in oral-nasal contrastive contexts, and 5) slight increases in oral
      orifice area for fricative syllable utterances following implantation. Individual
      strategies for coordinated control of the speech mechanism appear to be potent
      variables to consider when assessing speech production.

PMID- 8476172
TI  - Angiolymphoid hyperplasia with eosinophilia (histiocytoid hemangioma): evaluation
      of treatment options.
AB  - Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular
      proliferative lesion of unknown cause. In this report, a case is presented of a
      patient who was confirmed to be positive for human immunodeficiency virus and in
      whom the lesion had shown rapid accelerated growth. The case is used to
      illustrate a variety of therapeutic techniques and to evaluate the effectiveness
      of the various alternatives in the treatment of this unusual clinical problem.
      Long-term follow-up after radical excision of the tumor mass is presented.

PMID- 8476173
TI  - Effects of nasal allergen challenge on dynamic viscoelasticity of nasal mucus.
AB  - The effects of nasal provocation on the rheologic properties of nasal mucus were
      investigated in patients with allergic rhinitis provoked by house dust. The
      elastic modulus (G') and the dynamic viscosity (eta') of nasal mucus were
      determined by an oscillating sphere magnetic rheometer. Before and after the
      allergen challenge, G' increased, whereas eta' decreased with increasing
      oscillatory frequency; these findings indicate that the nasal mucus under these
      conditions is a non-newtonian fluid and has the cross-linked gel-like nature
      typical of mucus. Both G' and eta' values after nasal provocation were
      significantly lower than before. The values of G' and eta' after allergen
      challenge were in the optimal viscoelasticity range for mucociliary transport.

PMID- 8476174
TI  - Lymphoma of the sphenoid sinus presenting as an expansile mass.

PMID- 8476175
TI  - Peripheral epithelial odontogenic tumors.
AB  - Peripheral epithelial odontogenic tumors are the extraosseous equivalents of the
      much more often encountered central gnathic odontogenic tumors. The peripheral
      tumors arise in the mandibular or maxillary gingiva from the surface mucosa or
      dental lamina rests in the submucosa. Ameloblastoma is the most common histologic
      type. It, like all other peripheral epithelial odontogenic tumors, follows a
      benign, nonaggressive clinical course.

PMID- 8476177
TI  - Epidemiology and oral manifestations of HIV infection.

PMID- 8476176
TI  - Lengthening of congenital limb length discrepancy using callotasis: early
      experience of the Hospital for Sick Children.
AB  - Seventeen patients were reviewed after callotasis lengthening for congenital limb
      length discrepancy. The average age at lengthening was 10.8 years. Length
      discrepancy before lengthening ranged from 4.5 cm to 12 cm for the leg, and 24 mm
      to 30 mm for the forearm. At completion of the lengthening process, all but one
      patient had their discrepancy corrected successfully. The difficulties
      encountered were classified into problems, obstacles and complications. All
      patients suffered from superficial infection, but in only one case did this
      become a complication, resulting in a residual femoral discrepancy of 2 cm. Of
      the other three patients who suffered a complication, one fractured through the
      newly formed bone. The fracture was treated conservatively. In two further
      femoral lengthenings, the fixator had to be exchanged under general anaesthesia
      because it had reached its maximum excursion. Callotasis appears to be a safe and
      reliable method for correcting congenital limb length discrepancy in children.

PMID- 8476178
TI  - Surgical audit without autopsy: tales of the unexpected.
AB  - To establish our current practice and the potential value of the autopsy in
      general surgery, a retrospective review of general surgical autopsies was
      performed at one district general hospital from January 1989 to August 1991.
      There was considerable interconsultant variation in autopsy practice with a low
      25% overall autopsy rate reflecting a low autopsy request rate. There were
      discrepancies between the clinical and pathological cause of death in 40 (63%)
      cases. There were important discrepancies which may have changed management in
      life in 18 (28%) autopsies, 7 (39%) of which were untreated visceral
      perforations. Autopsy is an important part of the surgical audit and will
      disclose considerable unsuspected pathology. Present autopsy rates are low and
      need to be improved. The unexpected finding of seven untreated visceral
      perforations requires further study.

PMID- 8476179
TI  - Strap muscles in thyroid surgery: to cut or not to cut?

PMID- 8476180
TI  - General surgeons' attitudes to the treatment and prevention of abdominal
      adhesions.
AB  - A questionnaire survey of general surgeons was undertaken to estimate the
      incidence of abdominal adhesions as a clinical problem and to establish current
      attitudes to the treatment of adhesional bowel obstruction and the prevention of
      adhesion formation. Replies were received from 362 of 416 surgeons (response rate
      87%). In all, 76% (95% confidence limits, 72%-80%) of surgeons operate upon at
      least two patients each year with adhesional small bowel obstruction and 31% (26
      36) operate upon more than five patients. More than five patients are admitted
      each year with suspected adhesional bowel obstruction by 64% (59-69) of surgeons
      and 35% (30-40) of surgeons found adhesions to be a problem during a non-adhesion
      related laparotomy in more than five patients each year. This represents an
      estimated annual incidence of between 12,000 and 14,000 adhesion-related clinical
      problems in the United Kingdom. A number of preventive measures, such as the
      wearing of starch-free gloves (78% of surgeons; 95% CL 74%-82%), peritoneal
      lavage (68%; 63-73) and placement of the omentum beneath the wound closure (90%;
      87-93) are generally accepted, whereas routine wetting of swabs (39%; 34-44) and
      the role of non-essential adhesiolysis (49%; 44-54) are controversial. Routine
      small bowel plication (1%; 0-2) and intubation (2%; 0-5) are rarely used. This
      survey gives an indication of the large burden on patients and the health
      services caused by abdominal adhesions, and demonstrates surgeons' wide variety
      of approaches to both the treatment and prevention of adhesion formation.

PMID- 8476181
TI  - Gastrointestinal disruption and vertebral fracture associated with the use of
      seat belts.
AB  - Seat belts have been shown to be beneficial in reducing the type and severity of
      injuries sustained in road traffic accidents. The association of vertebral and
      visceral injuries, although previously described, is rare. This and various other
      confounding factors may make diagnosis of the visceral injury difficult. We
      describe four cases of combined vertebral and visceral injury caused by the use
      of seat belts. The pathogenesis of the injury and subsequent management are
      discussed.

PMID- 8476182
TI  - 'Diabetic tibial disease': the case for revascularisation.
AB  - Diabetic patients with critical ischaemia of the lower limb are frequently
      considered to have unreconstructable vascular disease. In the presence of a
      palpable popliteal pulse they are often labelled as having 'small vessel
      disease'. In nine patients (mean age 69 years) with 'diabetic tibial disease' and
      critical ischaemia we have avoided major amputation using short vein bypasses.
      All revascularisations remained patent at a mean follow-up of 32 months (range 12
      60 months). Diabetic patients with critical ischaemia should at the very least
      undergo arteriography to ensure that the possibility of successful distal
      revascularisation is not feasible before amputation is performed. However, if
      arteriography fails to demonstrate patent distal vessels and limb salvage is
      considered practical, Doppler insonation of the tibial and pedal vessels should
      be performed.

PMID- 8476183
TI  - Fractures of the sternal body.

PMID- 8476184
TI  - Fractures of the sternal body.

PMID- 8476185
TI  - A prospective comparison of laparoscopic versus open cholecystectomy.

PMID- 8476186
TI  - A prospective comparison of laparoscopic versus open cholecystectomy.

PMID- 8476187
TI  - The value of water-soluble contrast radiology in the management of acute small
      bowel obstruction.

PMID- 8476188
TI  - The value of water-soluble contrast radiology in the management of acute small
      bowel obstruction.

PMID- 8476189
TI  - The NHS reforms so far.

PMID- 8476191
TI  - Breast disease and the general surgeon. II. Effect of audit on the referral of
      patients with breast problems.
AB  - OBJECTIVES: To determine the number of patients with breast problems referred to
      general surgical clinics in a district general hospital and to assess the effect
      of changes implemented following the previous study on waiting time,
      investigations performed, and management of the patients. DESIGN: Two prospective
      outpatient audits with patient details recorded on questionnaires by the medical
      staff. SETTING: The general surgical outpatient clinics of a single general
      surgical firm at Newbury District Hospital, Berkshire. PATIENTS: Those patients
      attending the above clinics during two 3-month periods, 1 October to 31 December
      1989 (Study 1), and 16 April to 19 July 1990 (Study 2). RESULTS: Of new
      referrals, 25% were for a breast problem. The waiting time fell from a median of
      22 days in Study 1 to 10 days in Study 2. There was no significant difference
      between the studies for the proportion of each type of investigation performed.
      Between 80% and 85% of new patients did not need admission for an operation;
      however, of those operations performed, 65% were for carcinoma. The number of
      patients diagnosed as having carcinoma was the same in the two studies.
      CONCLUSIONS: That 25% of new, and up to 40% of follow-up patients seen in a
      general surgical clinic have breast problems. Many patients do not regard their
      symptoms as worrying and will not attend early clinic appointments even if these
      are offered. Writing to patients and general practitioners with the results of
      investigations ensures quicker receipt of the diagnosis and treatment plan, and
      reduces follow-up attendance. Only 15-20% of new patients need admission for an
      operation, and carcinoma is found in only 13-17%. Open access to the clinics does
      not result in general practitioners referring patients unnecessarily with breast
      problems.

PMID- 8476190
TI  - Breast disease and the general surgeon. I. Referral of patients with breast
      problems.
AB  - OBJECTIVES: To determine the proportion of all new and follow-up patients
      referred to general surgical outpatient clinics with breast problems. To
      ascertain how long these patients wait for an appointment and how many require
      investigation or admission for operation. To review our management of patients
      with breast problems in the clinic and to determine the ratio of benign breast
      disease to malignancy. DESIGN: A 3-month prospective outpatient survey with
      patient details recorded on questionnaires completed by the medical staff.
      SETTING: The general surgical outpatient clinics of this firm at Battle Hospital,
      Reading, and Newbury District Hospital, Berkshire. PATIENTS: Those patients
      attending the above clinics during the 3-month period 1 October to 31 December
      1989. RESULTS: In all, 693 new patients and 554 follow-up patients were seen. Of
      the new patients, 119, and of the follow-up patients 140 were seen for a breast
      complaint. At Battle Hospital 16% of all new patients presented with a breast
      problem, while at Newbury Hospital the figure was 24%. Of the follow-up patients
      at Battle Hospital, 23% were seen for a breast problem, and 41% at Newbury. The
      overall median waiting time for a new outpatient appointment was 21 days. No
      investigations were needed in 22% of the patients. The remaining 93 patients had
      investigations and a total of 70 mammograms and 53 fine needle aspirations for
      cytology were performed. The mean cost of investigations per patient investigated
      was estimated at 27 pounds. Of new patients, 58% were discharged from the clinic
      after a single consultation, and investigations as necessary. In 79% of the
      patients admitted for an operation, the decision to admit was made on the basis
      of the initial history and examination alone. Of new patients, 84% did not need
      admission and were managed in the clinic. In all, 14 breast carcinomas were
      diagnosed--12% of new patients with breast problems. CONCLUSIONS: The figures
      suggest that 24% of new patients and 41% of follow-up patients attending a
      general surgical clinic are seen for a breast problem. The waiting time for new
      appointments is unacceptably long. Most new patients do not require admission for
      an operation. Only 12% of new patients referred with a breast problem were found
      to have a carcinoma.

PMID- 8476192
TI  - Splenic cysts: changes in diagnosis, treatment and aetiological concepts.
AB  - Splenic cysts are generally considered as either true epidermoid cysts or false
      pseudocysts. The former are thought to be congenital while the latter are
      reputedly post-traumatic. However, a number of important features are common to
      both types of cysts and this classification may need revision. The recognition of
      the importance of the spleen, together with developments in imaging and operative
      surgery have led to significant changes in the management of splenic cysts.
      Accurate preoperative diagnosis and localisation together with increasing
      awareness of splenic conservation techniques should now ensure that, whenever
      possible, cysts can be eradicated without resort to total splenectomy. We present
      four patients who illustrate various aspects of this condition.

PMID- 8476193
TI  - The Angelchik prosthesis behaves as a fundoplication.
AB  - It is not known why the Angelchik prosthesis prevents gastro-oesophageal reflux.
      A review of 53 barium meal examinations in 39 patients with the prosthesis showed
      that in 43 examinations the prosthesis was below the diaphragm. In 38 of these a
      small knuckle of stomach had herniated through the prosthetic ring alongside the
      oesophagus, forming a small intra-abdominal para-oesophageal hernia. Radiological
      reflux occurred in only one patient with such a hernia. In the remaining five
      examinations where the prosthesis was correctly situated in the abdomen, there
      was no hernia within the prosthetic ring and reflux occurred in three. In ten
      examinations the prosthesis had migrated into the mediastinum. None of these
      showed a hernia and reflux occurred in eight. It is suggested that the Angelchik
      prosthesis results in the formation of a small para-oesophageal hernia within a
      loosely fitting ring within the abdomen and this is a requirement for the success
      of the Angelchik prosthesis. Radiographically the intra-abdominal para
      oesophageal hernia inside the prosthesis results in buttressing of the intra
      abdominal oesophagus in a manner similar to a fundoplication.

PMID- 8476194
TI  - The use of Coca-Cola in the management of bolus obstruction in benign oesophageal
      stricture.
AB  - Oesophageal stricture is a complication of oesophageal reflux and may itself be
      complicated by bolus obstruction. We reviewed the records of patients presenting
      with dysphagia and who were found to have benign oesophageal strictures. We
      studied the outcome of bolus obstruction in 13 episodes affecting eight patients.
      In six episodes Coca-Cola was administered on the day before endoscopy, and in
      all these patients the bolus had cleared. In seven episodes nothing was
      administered before endoscopy, and in all seven a bolus was evident at endoscopy.
      In five of these seven the bolus was removed piecemeal and in each of these
      instances the endoscope had to be passed between two and five times. In the
      remaining two instances the procedure was abandoned and the patients returned to
      the ward for the administration of Coca-Cola. At subsequent endoscopy these
      patients were found to be clear of any bolus. These results suggest that the
      administration of Coca-Cola (or other aerated drinks) may clear a bolus in the
      acutely obstructed oesophagus.

PMID- 8476196
TI  - Opportunities for research in surgical training.

PMID- 8476195
TI  - Surgical discharge summaries: improving the record.
AB  - The problem area of communication between hospital and general practitioners may
      potentially be improved by the advent of new information technology. The
      introduction of a regional computer database for general surgery allows the rapid
      automated production of discharge summaries and has provided us with the
      opportunity for auditing the quality of old and new styles of discharge
      communication. A total of 118 general practitioners were sent a postal
      questionnaire to establish their views on the relative importance of various
      aspects of patient information and management after discharge. A high response
      rate (97%) indicated the interest of general practitioners in this topic. The
      majority (73%) believed that summaries should be delayed no more than 3 days. The
      structured and shortened new format was preferred to the older style of discharge
      summary. The older format rarely arrived within an appropriate time and its
      content was often felt to be either inadequate (35%) or excessive (7%) compared
      with the new format (8% and 1%, respectively). The diagnosis, information given
      to the patient, clinic date, list of medications and investigations were
      considered the more important details in the summary. Improvements in the
      discharge information were suggested and have subsequently been incorporated in
      our discharge policy. The use of new information technology, intended to
      facilitate clinical audit, has improved our ability to generate prompt, well
      structured discharge summaries which are accepted by the general practitioners.

PMID- 8476197
TI  - The organisation of general surgery services in a population.

PMID- 8476198
TI  - Localization of the alpha 3 beta 1 integrin in some common epithelial tumors of
      the ovary and in normal equivalents.
AB  - Monoclonal antibodies (mAbs) against cultured human ovary carcinoma cells were
      produced. We obtained 7 mAbs which reacted diffusely with carcinoma of the ovary
      but only weakly with vessels and the surface epithelial layer of normal ovary.
      Biochemical characterization of these mAbs indicated that 3 out of 7 were
      specific for the alpha 3 chain of the Vla-3 integrin, a receptor for fibronectin,
      collagen and laminin. Using one of these mAbs, we have studied, by
      immunohistochemical methods, the distribution of alpha 3 beta 1 integrin in
      mucinous, serous and endometrioid cystoadenocarcinoma of the ovary and in their
      normal equivalent: endocervical, tubal and endometrial epithelia. The results
      show that alpha 3 beta 1 is present in cell-cell contact areas and more
      abundantly at the junction between epithelial cells and basement membrane in
      endocervical, tubal epithelia, in epithelium lining the cavity of the uterus and
      in surface epithelium of the ovary. However, endometrial glands showed only weak
      and fragmented positivity at the basal pole of the cells. 26 out of 31 ovarian
      cancers studied, expressed the alpha 3 beta 1 integrin. However, basal
      localization, typical of normal epithelia, is not prominent or disappears in
      tumors and is replaced by a more diffuse reaction with variable
      immunohistochemical staining of the neoplastic cells. Furthermore, a comparative
      analysis of the expression of alpha 3 beta 1 and its ligands, laminin (LM),
      fibronectin (FN) and collagen IV (Coll IV), demonstrated that basal polarization
      of Vla-3 was always correlated with the presence of laminin and Coll IV,
      intrinsic components of the basement membranes.

PMID- 8476199
TI  - Effects of sodium ascorbate (vitamin C) and 2-methyl-1,4-naphthoquinone (vitamin
      K3) treatment on human tumor cell growth in vitro. II. Synergism with combined
      chemotherapy action.
AB  - The growth inhibitory effects of a combined application of sodium ascorbate
      (Vitamin C) and 2-methyl-1,4-naphthoquinone (Vitamin K3) together with various
      chemotherapeutic agents has been examined on in vitro cultured human endometrial
      adenocarcinoma (AN3CA) cells. Combined vitamin treatment and chemotherapy in well
      defined conditions of cell confluence and at the dose levels applied result in a
      synergistic effect on growth inhibition. The combined vitamins when reaching
      their own synergistic cytotoxicity levels frequently obscure the additional
      synergistic effects attributable to the chemotherapeutic agents. Apart from the
      specific cytotoxic characteristics of the chemotherapeutic drugs examined, the
      formation of reactive oxygen radicals during treatment, possibly accentuated by
      less defined secondary mechanisms, appears essentially responsible for the
      observed stimulated cytotoxicity.

PMID- 8476200
TI  - Antimetastatic activity induced by Clostridium butyricum and characterization of
      effector cells.
AB  - The effects of a bacterial vaccine, heat-killed Clostridium butyricum MII 588
      cells, on the metastasis of B16-F10 melanoma in BDF1 mice was investigated. The
      vaccine stimulated natural killer (NK) cell cytotoxic activity against YAC-1
      target cells, which peaked at 72 hr after the pretreatment, whereas maximum
      macrophage cytotoxic activity was obtained on days 9 to 11. These stimulated
      cytotoxic activities were also observed in B16-F10 tumor-bearing BDF1 mice. The
      important role of stimulated NK cells and/or macrophage in the antimetastatic
      effect was confirmed using Anti-asialo GM1 antibody, whole body x-ray irradiation
      and carrageenan treatment. In addition, the vaccine could induce a high titer of
      interferon-gamma (IFN-gamma), an important lymphokine which may account for a
      significant portion of its antimetastatic activity.

PMID- 8476201
TI  - Chromosomal changes and correspondingly altered proto-oncogene expression in
      human gliomas. Value of combined cytogenetic and molecular genetic analysis.
AB  - A combined cytogenetic and molecular genetic study was performed to analyze seven
      primary brain tumors: one oligoastrocytoma WHO-grade II, one anaplastic
      astrocytoma grade III, one anaplastic astrocytoma grade III/IV and four
      glioblastomas by G-banding and RNA dot blotting. A normal karyotype was found in
      the oligoastrocytoma. One of the two anaplastic astrocytomas (male) contained
      cells with a normal karyotype and cells with a Y-chromosomal loss, and the other
      one showed structural abnormalities too complex for complete analysis in mostly
      polyploid cells. Two of the four glioblastomas had few and the other two multiple
      chromosomal changes such as +7, +20, -8, -9 del(9)(p21), -10, del(10)(q24), 
      13,14, del(17)(p21), -22, add(3)(q13), double minutes and marker chromosomes.
      Compared to normal brain, all tumors had an increased EGFr and both anaplastic
      astrocytomas as well as three glioblastomas a decreased H-ras expression. The two
      glioblastomas with multiple chromosomal changes showed increased EGFr, Ki-ras,
      myb, mos and myc, decreased H-ras and N-ras and unchanged levels of abl, src and
      sis. Both the cytogenetic and molecular genetic findings are compatible even in
      the case of chromosomal losses, where the genes on the remaining allele may be
      responsible for dominant gene regulation mechanisms which result in a
      protooncogene overexpression. Our findings indicate that, apart from proto
      oncogene overexpression, other mechanisms, e.g. tumor suppressor gene
      inactivation, are important for glial tumorigenesis. Karyotypic analysis makes it
      possible to search specifically for genetic events still unknown but arising from
      particular chromosomal changes.

PMID- 8476202
TI  - Detection of DNA polymerase-beta gene expression by competitive polymerase chain
      reaction in human ovarian carcinoma cells.
AB  - The reliability of the competitive polymerase chain reaction (competitive PCR)
      for the detection and quantitation of gene expression in small tumor samples was
      evaluated. DNA polymerase-beta gene expression was detected in human ovarian
      cancer cell lines displaying a different degree of cisplatin resistance. The
      level of DNA polymerase-beta cDNA in the resistant cell line was threefold that
      of the parental sensitive line. Our results indicate that competitive PCR is a
      reproducible and sensitive method to detect differences in gene expression in
      small samples and open the possibility of using this approach to detect DNA
      polymerase beta cDNA in small samples from clinical tumors.

PMID- 8476203
TI  - Complete regression of advanced liposarcoma of the anterior chest wall with
      interferon-alpha and tumor necrosis factor-alpha.
AB  - This paper reports a case of complete regression of a liposarcoma in a 62-year
      old Japanese man who, in August 1986, presented with a giant subcutaneous tumor
      of the right anterior chest wall. Local radiotherapy and conventional
      chemotherapy were initially performed; however, the tumor did not respond at all.
      He then received cytokine treatment (interferon-alpha and tumor necrosis factor
      alpha). Nineteen months after cytokine treatment, the mass disappeared totally.
      The patient has been in complete remission for five years without recurrence and
      with no additional treatment. This suggests that the use of interferon-alpha and
      tumor necrosis factor-alpha in combination may be an effective and promising
      modality for liposarcomas which are refractory to the conventional anticancer
      treatments.

PMID- 8476204
TI  - In vitro cytotoxicity and differential cellular sensitivity of new N-methyl and N
      propargyl urea and nitrosourea derivatives of diamino acids against sixty human
      NCI tumor cell lines.
AB  - The in vitro cytotoxicity and differential cellular sensitivity of a series of
      new N-methyl and N-propargyl urea and nitrosourea derivatives of diamino acids
      were determined in the National Cancer Institute's primary antitumor drug screen.
      These compounds have a level of cytotoxic activity comparable to BCNU, CCNU and
      Methyl-CCNU. In this series of diamino acid derivatives, the N-nitroso group does
      not seems to be essential to the in vitro activity of these compounds. The N
      Propargyl derivatives have shown significantly more differential cellular
      sensitivity than the N-Methyl derivatives. Hence, the N-Propargyl group seems to
      induce more cell line specificity in our compounds. Based on their in vitro
      cytotoxic activity and mostly their pattern of differential cellular sensitivity,
      two compounds described in this work have been selected by the NCI for further
      development. These compounds are currently being screened in animal models.

PMID- 8476206
TI  - Glyoxalase activities in human tumour cell lines in vitro.
AB  - The activities of glyoxalase I (EC 4.4.1.5) and glyoxalase II (EC 3.1.2.6) were
      measured in 3 human non-malignant and 28 tumour cell lines. The activity of
      glyoxalase I was in the range 321-8751 mUnits/mg of protein. The glyoxalase
      I/glyoxalase II activity ratio was in the range 7-147; glyoxalase I activity was
      always markedly greater than glyoxalase activity. There was no significant
      difference between glyoxalase activities in non-malignant and tumour cell lines.
      The activity of glyoxalase I was within and above the range found in normal human
      tissues and the activity of glyoxalase II was within the range and below that
      found in normal human tissues.

PMID- 8476205
TI  - Butyramide and monobutyrin: growth inhibitory and differentiating agents.
AB  - Butyramide and monobutyrin were chosen for study as neutral compounds that might
      exhibit some of the growth inhibitory and differentiating effects of butyrate.
      Inhibitory effects on DNA synthesis in hepatoma cells and on cellular
      proliferation in mouse erythroleukemia cells were observed. Induction of
      differentiation by butyramide and monobutyrin was seen in mouse erythroleukemia
      cells as monitored by increased synthesis of hemoglobin and H1 zero histone.
      Butyramide and monobutyrin were less effective inducers of hemoglobin synthesis
      than butyrate but their neutral character may offer an advantage in the induction
      of tumor cell differentiation.

PMID- 8476207
TI  - Ag-NORs related to flow cytometry, morphometry and prognosis in patients with
      pancreatic cancer.
AB  - The number of silver stained nucleolar organiser regions (Ag-NORs) was enumerated
      in the biopsy specimens of 73 patients with human pancreatic adenocarcinoma. The
      number of Ag-NORs was related to histological features, S-phase fraction (SPF),
      DNA ploidy, morphometric nuclear features, clinical stage and survival. Grade I
      tumours had on average fewer Ag-NORs (mean +/- SD, 5.2 +/- 2.0) than grade II
      (mean +/- SD, 5.9 +/- 1.6) or grade III (mean +/- SD, 6.6 +/- 2.6) tumours.
      Patients with low SPF (0-7%) values had lower mean Ag-NORs counts (5.7 +/- 1.0)
      than patients with a high SPF (7%) (6.6 +/- 2.0) (p = 0.05) and the number of Ag
      NORs was related almost significantly to mitotic index (p = 0.09). The Ag-NORs
      were not related significantly to DNA ploidy or to clinical stage. In survival
      analysis the number of Ag-NORs predicted prognosis significantly (p = 0.03). From
      the results we conclude that Ag-NORs are related to several malignant features in
      human pancreatic adenocarcinoma and that the number of Ag-NORs predicts survival.

PMID- 8476208
TI  - Growth inhibitory activity of S12363, a novel vinca alkaloid derivative on human
      melanoma cell lines.
AB  - The growth inhibitory activity of S12363, a new antineoplastic agent which
      belongs to the vinca alkaloid group incorporating an amino-phosphonate (bioester
      of valine), was studied on six human melanoma cell lines with different
      phenotypic characteristics and in vitro growth rates. S12363 was compared with
      vinblastine (VBL), vincristine (VCR) and vindesine (VDS) using the MTT assay.
      Inhibition was time- and dose-dependent. Overall, IC50 values ranged from 24
      6770nM and 4.6-11.6 nM for the reference drugs and for S12363 respectively, after
      exposure for 1 hr. All the vinca alkaloids were more active when cells were
      exposed continuously for 72 hrs, inhibition by S12363 was greater than the
      reference drugs (p < 0.05 in 15/18 comparisons). The activities of VDS and S12363
      were also compared using the clonogenic assay. IC50 values ranged from 45-500 nM
      and 17-75 nM respectively. On a molar basis, S12363 was significantly more active
      than VDS (ANOVA p < 0.0001). The shape of the cell survival curve obtained with
      S12363 was exponential, whereas that of VDS was of the exponential-plateau type.
      Furthermore, survival with higher concentrations of S12363 was inversely related
      to cells seeded. Cell cycle analysis showed these compounds to block cells in
      G2+M after exposure to their respective IC50 concentrations for 1 hr. This effect
      was obtained using a lower S12363 concentration. In summary, S12363 proved to be
      18-83 times more active than the reference drugs in the MTT and 3-11 times more
      active than VDS in the clonogenic assay. Its high potency and dissimilar cell
      survival profile indicate that this compound possesses different biological
      properties, and therefore merits further in vivo evaluation.

PMID- 8476209
TI  - Role of N-linked glycosylation in cell-cycle progression and initiation of DNA
      synthesis in tumor-transformed human fibroblasts.
AB  - In this study we show that proliferation of cycling tumor-transformed human
      fibroblasts (line 90VAV1) is blocked specifically in G1 by HMG CoA reductase
      inhibition. This inhibition also resulted in a drastic depression of N-linked
      glycosylation, measured as incorporation of radioactive glucosamine into acid
      insoluble material. Following addition of mevalonate to cells arrested by HMG CoA
      reductase inhibitors, the depression of N-linked glycosylation was overcome and
      the cells initiated DNA synthesis. However, if the mevalonate-induced increase in
      protein glycosylation was prevented, due to addition of tunicamycin (an inhibitor
      of N-linked glycosylation), the cells were not able to proliferate. If instead
      tunicamycin was added 4 h after the addition of mevalonate, the cells synthesized
      DNA normally. Upon addition of tunicamycin, to cycling cells the progression
      through G1 was blocked in a similar way to that following HMG CoA reductase
      inhibition. Taken together, our data provide strong evidence for involvement of N
      linked glycosylation in the mevalonate-controlled cell cycle progression and
      growth activation of tumor-transformed human fibroblasts.

PMID- 8476210
TI  - Creation of ultra-rare restriction sites in intact eucaryotic chromosomes
      mediated by bacterial methylases: an approach to sequencing and analyzing tumor
      and normal genomes.
AB  - The limited restriction of eucaryotic chromosomes would facilitate our
      understanding of the aberrant genomes of genetic diseases and cancer. We have
      described methods for methylating eucaryotic chromosomes embedded in agarose
      plugs. We now describe how Cla I methylase can be utilized in a methylation
      dependent restriction cleavage with Dpn I to restrict eucaryotic genomes into a
      limited number of fragments. We have restricted the genomes of Saccharomyces
      cerevisiae at four sites and cleaved the three chromosomes of Schizosaccharomyces
      pombe into eleven fragments. Unlike the recently published methodologies using
      DNA sequences inserted into procaryotic and eucaryotic genomes, the methodologies
      described here use unaltered eucaryotic genomes for highly limited restriction.
      This methodology has applications in speeding, simplifying, and reducing the cost
      of sequencing the human genome.

PMID- 8476211
TI  - NK cells from mammary tumor bearing mice do not exert natural killer activity but
      function as antibody dependent cellular cytotoxicity effectors.
AB  - We have previously found that natural killer (NK) activity is profoundly
      decreased in BALB/c mice bearing large mammary tumors. Kinetic studies showed
      that after 14 days of tumor implantation a reduction of 25-40% of NK cytotoxicity
      can be observed and by 21 days only very low levels of NK reactivity can be
      detected in the spleens of tumor bearers. Phenotypic analyses of the splenic NK
      cells of tumor bearing mice revealed that they have similar density, granularity
      and comparable levels of NK 2.1 antigen on their surfaces as compared to NK cells
      from normal mice. However, in tumor bearers there was a shift from a high surface
      asialo GM1-bearing NK population to low-density surface asialo GM1-positive
      bearing cells. Phenotypically characterized NK cells were quantitated to test the
      possibility that splenic NK cells from tumor bearers migrated to other organs and
      were therefore at lower levels in the spleen. No significant differences were
      observed in the percentages of NK cells from spleens from normal and tumor
      bearing mice. Using single cell conjugate assays it was found that there was no
      impairment in the capacity of NK from tumor bearers to bind the NK-sensitive Yac
      1 cells, however, this event did not result in lysis of the target cells. To
      elucidate whether the lytic machinery of the tumor bearers' NK cells was
      inactivated, their capacity to effect antibody dependent cellular cytotoxicity
      (ADCC) was evaluated. In contrast to the results observed when NK activity was
      evaluated, NK cells from tumor bearing mice exerted higher levels of ADCC than
      their normal counterparts and they had a higher expression of Fc receptors on
      their surfaces. These results suggest that the depression of NK activity observed
      in tumor bearing mice occurs at a triggering step that is not necessary for the
      activation of the NK effectors via the Fc receptor and that no major impairment
      of the lytic machinery occurs during mammary tumorigenesis.

PMID- 8476212
TI  - Disillusionments and hopes in the field of biological response modifiers.
AB  - A number of new approaches are currently being investigated throughout the world
      which aim at the better simulation of immunoregulation by different BRM's.
      However it must be accepted that a remarkable difference exists between the
      positive results obtained with BRM's in experimental tumor systems and current
      clinical experiences. It is suggested that the treatment of preneoplastic lesions
      and immunoprevention of cancer could be a more rational aim for the application
      of BRM's than the treatment of advanced neoplastic diseases. This hypothesis is
      based primarily on the theoretical understanding of the immune system as a
      biological mechanism whose "natural" function is to eliminate "minimal deviation"
      cells when they occur as regular biological events during cell multiplication.
      BRM's should be considered first of all as bioregulators for the maintenance and
      restoration of cellular and tissue homeostasis.

PMID- 8476213
TI  - Influence of preoperative performance status on survival time of patients with
      advanced gastric cancer following noncurative resection.
AB  - The relationship between preoperative performance status (PS) and the survival
      time of 152 patients with gastric cancer was determined following macroscopic
      noncurative resection and postoperative chemotherapy. There were no preoperative
      differences in laboratory data between the patients who led a normal life or
      those with a fully ambulatory performance status (PS 0 or 1) and those who were
      often bedridden (PS 2 or 3). Neither was there any difference between the groups
      with regard to clinicopathological factors. The doses of drugs prescribed were
      lower for patients with PS 2-3. There was no difference in the occurrence of drug
      toxicity between the groups. The patients with PS 0-1 had a significantly longer
      survival time than did those with PS 2-3 (P < 0.05). PS, a factor more easily
      measured than the stage of disease at the time of admission, correlates with
      survival time. We interpret our findings to mean that for patients with gastric
      cancer who are symptom-free or who are ambulatory with symptoms, clinical trials
      of drugs may prolong survival time.

PMID- 8476214
TI  - Relative activities of thymidylate synthetase and thymidine kinase in human
      mammary tumours.
AB  - Thymidylate synthetase (TS) and thymidine kinase (TK) are known to catalyse the
      methylation of dUMP for the de novo synthesis of dTMP and the phosphorylation of
      thymidine for the salvage synthesis of dTMP in the pyrimidine pathway,
      respectively. High activities of TS and TK have been observed in rapidly
      proliferating tissues. In the present study, both enzyme activities were measured
      in 8 specimens of normal mammary tissues, 12 fibroadenomas and 10 adenocarcinomas
      in the human breast. The average activities of TS in fibroadenomas and
      adenocarcinomas were approximately 5- and 7-fold that in normal mammary tissues,
      respectively. The average activities of TK in fibroadenomas and adenocarcinomas
      were 4- and 14-fold that in normal mammary tissues, respectively. Thus, DNA
      synthesis in benign and malignant mammary tumors may be relatively predominant in
      de novo and salvage pathways, respectively.

PMID- 8476215
TI  - Effects of OK-432 on in vitro secondary responses of the non-adherent cells to IL
      2 and OK-432 in cancer patients without tumor burden.
AB  - We examined the effect of OK-432 intracutaneous injection on the in vitro
      responses of non-adherent cells to IL-2 and OK-432, along with changes in
      lymphocyte subpopulations, in early cancer patients who underwent surgery. We
      found that 1) repeated injections of OK-432 resulted in an enhancement of LAK
      activity, the peak of which was seen between 7 and 10 days after the first
      administration, 2) this augmentation of LAK activity was not associated with
      changes in lymphocyte subpopulations CD8+ CD11- and CD8+ CD11+ phenotypes, and 3)
      the cytotoxic activity of lymphocytes stimulated in vitro with OK-432 did not
      show a definite change in specific pattern after in vitro OK-432 treatment. These
      findings indicate that repeated injections of OK-432 over a period of a week
      effectively enhanced LAK activity.

PMID- 8476216
TI  - Effects of thaliblastine on cytotoxicity and DNA damage in drug-sensitive and 
      resistant rat ovarian tumor cells treated with cisplatin.
AB  - Combination effects of cisplatin (DDP) and thaliblastine (TBL) in DDP-sensitive
      (0-342) and -resistant (0-342/DDP) rat ovarian tumor cells were investigated. TBL
      alone, at either 40 or 80 micrograms/ml, exerted higher cytotoxicity in the DDP
      resistant 0-342/DDP cells than in the parental sensitive 0-342 cells in growth
      inhibition assay (% inhibitions: 12.5 and 42.8 in 0-342 cells vs. 37.5 and 66.1
      in 0-342/DDP cells, at 40 and 80 micrograms/ml of TBL, respectively). TBL at 40
      micrograms/ml showed an additive effect with DDP in the sensitive cells, while a
      synergistic cytotoxicity was observed in the resistant subline when the two drugs
      were used in combination, as exhibited by either % inhibition or cell viability.
      At 80 micrograms/ml of TBL, however, the combination effects were less than
      additive (infraadditive) in both lines, but still this treatment was more
      cytotoxic in 0-342/DDP cells. Alkaline elution assay showed that DDP induced
      higher DNA interstrand crosslings (ISCL) in 0-342 cells, while TBL produced DNA
      single strand breaks (SSB) in a dose-dependent manner in the resistant line but
      not in the sensitive cells. Combination of these two compounds resulted in a
      dramatic increase of DNA-SSB in 0-342/DDP cells. It is tentatively concluded that
      TBL might have some potential in combination with DDP to conquer the resistance
      in clinical use, which may result from its selective SSB-inducing activity in the
      resistant cells.

PMID- 8476217
TI  - Growth inhibitory substances in human breast cyst fluid.
AB  - Women who have breast cysts with intracystic Na/K < 3 may have a higher risk of
      breast cancer than those with intracystic Na/K > 3. Low/undetectable
      concentrations of TNF alpha and IL-4, both of which have been shown to inhibit
      growth of human breast cancer cell lines, were found in the majority of breast
      cyst fluid samples. Intracystic oestradiol concentrations were significantly
      higher in the low electrolyte ratio group than in the high electrolyte ratio
      group. Imbalance between growth stimulatory and growth inhibitory substances in
      cystic breast disease may be an explanation for the higher risk of breast cancer
      particularly in the low electrolyte ratio group.

PMID- 8476218
TI  - Heterogenic properties of clonal cell lines derived from canine mammary
      carcinomas and sensitivity to tamoxifen and doxorubicin.
AB  - Five clonal cell lines were established from each of 3 cell lines derived from 3
      primary malignant canine mammary tumors. The clonal lines in each series were
      compared with one another and to the respective parent cell line with regard to
      cellular morphology, growth on plastic, cloning efficiency (CE) and colony sizes
      in soft agar, estrogen and progesterone receptor (ER, PR) status, and response to
      tamoxifen or doxorubicin in clonogenic assays. The most remarkable differences
      observed among the cell lines were in CE, colony sizes, and sensitivity to
      doxorubicin. The clonal line which contained measurable ER, had a shift in colony
      size distribution to smaller colonies when exposed to tamoxifen or tamoxifen with
      estradiol that may have been estrogen-receptor mediated.

PMID- 8476219
TI  - Influence of syngeneic (anti-idiotypic) antibody responses on biodistribution and
      tumour localisation of murine monoclonal antibodies and fragments.
AB  - Balb/c mice were immunised with three different syngeneic monoclonal antibodies
      (Mabs). Following injection of radiolabelled Mabs into mice with anti-antibody
      responses they were cleared from the circulation, predominantly to the liver, due
      to the formation of immune complexes. Anti-antibody titres as low as 1/100 were
      virtually as effective as 1/3,000 in perturbing biodistribution of Mabs. There
      were no effects against isotype matched control Mabs. There was a much lesser
      effect against Fab or F (ab')2 of one Mab, although these did form immune
      complexes in the circulation of immune mice. With Fab of another Mab its blood
      survival was actually prolonged, due to immune complex formation. With this Fab,
      although blood survival was prolonged, localisation into human tumour xenografts
      expressing its target antigen in Nude mice was reduced by pre-treatment with
      immune serum. These studies show that syngeneic (anti-idiotypic) responses have a
      detrimental effect on the pharmacokinetics of Mabs, but with more diverse effects
      on their fragments. With fragments the indication is that even when
      biodistribution is not grossly perturbed, tumour recognition may still be
      restricted.

PMID- 8476220
TI  - An analysis of vincristine-resistance in BHK cells pretreated with 1-beta-D
      arabinofuranosylcytosine.
AB  - As with SV40-transformed BHK cells (1), pretreatment of BHK cells with 1-beta-D
      arabinofuranosylcytosine (araC) very markedly enhanced the resistance frequency
      to N-phosphonoacetyl-L-aspartate (PALA) but only modestly increased the
      resistance frequency to vincristine (VCR). AraC pretreatment of cells that
      already had moderate VCR-resistance again only modestly enhanced the resistance
      frequency at a higher VCR concentration. By contrast, delaying the addition of
      VCR to BHK cells by 7-24 hours after pretreatment with araC increased the
      enhancement of VCR-resistance frequency to a level comparable to the enhancement
      of PALA-resistance frequency. VCR-resistant clones isolated without or after araC
      pretreatment were analysed for amplification of the multidrug resistance (mdr)
      gene. One of four clones isolated by single-step selection with no araC
      pretreatment and four of six clones isolated after araC pretreatment showed
      amplification of the mdr gene. All VCR-resistant clones tested were cross
      resistant to actinomycin D and VCR-resistance was inhibited by treatment with
      verapamil.

PMID- 8476221
TI  - Human lung and bladder carcinoma tumors as compared to their adjacent normal
      tissue have elevated AP-1 activity associated with the retinoblastoma gene
      promoter.
AB  - Examination of the nucleotide sequence of the retinoblastoma (Rb) promoter
      revealed the presence of a DNA region highly homologous to the recognition site
      for the cellular transcription factor AP-1. A pair of complementary
      oligonucleotides containing the AP-1 site was synthesized and used in gel
      retardation assays to determine the role of the AP-1 protein in the regulation of
      the Rb gene expression. Using nuclear extracts from Hela cells as well as from
      lung and bladder tumors, we found specific binding of the AP-1 protein to this
      oligonucleotide. This binding is elevated in Hela cells, in 10/13 lung and 3/8
      bladder tumors as compared to adjacent normal tissue. These results suggest that
      AP-1 could be implicated in Rb gene transcriptional regulation through its
      interaction with the AP-1 binding site of the Rb gene promoter.

PMID- 8476222
TI  - Antiplasmid and carcinogenic molecular orbitals of benz[c]acridine and related
      compounds.
AB  - Effect of K- and L- molecular orbital regions on expression of antiplasmid and
      carcinogenic activity was studied with various benz[c]acridine derivatives,
      tricyclic compounds (acridine orange, phenothiazines) and dibenzoazepine
      (imipramine). Antiplasmid compounds showed the out-of-phase of molecular orbital
      in the L-region. On the other hand, mutagenic and carcinogenic compounds showed
      the out-of-phase in the L-region, and their energy was accumulated in the K
      region of the molecular orbitals. The present study suggests that the molecular
      orbitals responsible for the expression of antiplasmid and carcinogenic effects
      might be basically different.

PMID- 8476223
TI  - Postgastrectomy anticancer chemotherapy for stage IV gastric cancer equally
      tolerable for patients under and over age 65.
AB  - We compared the survival time and drug toxicity between patients with stage IV
      gastric cancer who were over and under 65 years. All had undergone gastric
      resection followed by treatment with mitomycin C and a fluorinated pyrimidine.
      There were no differences in prognostic factors or doses of drugs prescribed
      between the two groups, nor were there differences in survival rates or
      toxicities. As advanced chronological age is not sufficient justification to
      limit or withhold treatment with anticancer drugs, postoperative chemotherapy
      should be designed for patients with gastric cancer, regardless of age.

PMID- 8476224
TI  - 5'-Nor-anhydrovinblastine (Navelbine) has an anti-invasive effect on MO4 mouse
      fibrosarcoma cells in vitro and in vivo.
AB  - 5'-nor-anhydrovinblastine (Navelbine) is a hemisynthetic Vinca alkaloid for which
      a selectivity for mitotic microtubules has been demonstrated. In previous
      studies, we have demonstrated an anti-invasive effect of other Vinca alkaloids.
      Here the results of in vitro and in vivo assays concerning the effect of 5'-nor
      anhydrovinblastine on growth and invasion of MO4 cells are presented. It is
      demonstrated that at cytostatic concentrations, 5'-nor-anhydrovinblastine also
      has an anti-invasive effect.

PMID- 8476225
TI  - Modulation of biological responses of normal human mononuclear cells by
      antiestrogens.
AB  - The effect of three non-steroidal antiestrogens, Tamoxifen, Toremifene and ICI
      164, 384, on various aspects of the immune response was studied in cultures of
      normal peripheral mononuclear blood cells. The drugs differ somewhat in their
      effect on the functions tested (pokeweed mitogen-induced immunoglobulin synthesis
      and cell proliferation, mixed lymphocyte reaction, Interleukin 2 (IL 2)
      synthesis, IL 2 receptor expression and Tumor Necrosis Factor (TNF alpha)
      synthesis). However, all three are immunosuppressive. On the other hand, ICI 164,
      384 and Tamoxifen were stimulatory for TNF alpha production by adherent cells
      which may prove as an additional feature in antiestrogen treatment.

PMID- 8476226
TI  - Evaluation of S12363, a novel vinca alkaloid drug in the treatment of advanced
      malignant melanoma. A phase II study.
AB  - We conducted a phase II study with the new vinca alkaloid derivative S12363 in
      ten patients with metastatic malignant melanoma. Six patients had been pre
      treated with other cytotoxic agents and all had received Vindesine. Four patients
      had no prior systemic treatment before entry into the study. S12363 was well
      tolerated subjectively, the main toxicity being haematological. Despite
      encouraging in vitro observations, no objective responses to S12363 have been
      documented in these patients with the doses and schedule used in this study.
      S12363 appears to have no clinically useful activity in metastatic malignant
      melanoma.

PMID- 8476227
TI  - Chemoprevention by indomethacin of N-butyl-N-(4-hydroxybutyl)-nitrosamine-induced
      urinary bladder tumors.
AB  - The effects of indomethacin on the development of N-butyl-N-(4-hydroxybutyl)
      nitrosamine (OH-BBn)-induced urinary bladder tumors were evaluated in male BDF
      mice. Preliminary feeding studies revealed that the highest non-toxic dose of
      indomethacin was 15 mg/kg of AIN-76A diet; thus, dose levels of 15 and 7.5 mg/kg
      of diet were selected to determine the chemopreventive efficacy of this agent.
      Diet supplementation with indomethacin was initiated when the mice were 49 days
      old and continued for the duration of the study. Starting one week after
      indomethacin treatment, OH-BBN was administered 1x/week for eight weeks. Upon
      termination of the study (180 days after the initial carcinogen administration),
      all tumors in the urinary bladder were removed and classified histologically.
      Mice receiving carcinogen and no indomethacin supplementation had a 24% incidence
      of urinary bladder tumors; mice receiving 7.5 mg/kg and 15 mg of indomethacin had
      a 5% and 0% incidence of urinary bladder tumors, respectively. The significant
      reduction of OH-BBN-induced urinary bladder tumors by indomethacin is consistent
      with previous suggestions that prostaglandin synthesis inhibitors are effective
      inhibitors of carcinogenesis.

PMID- 8476228
TI  - Antitumor activity and interleukin-1 induction by tannins.
AB  - The relationships between structures, antitumor activities and interleukin-1 (IL
      1) induction by fifteen tannins were studies. When tannins (10 mg/kg) were
      intraperitoneally injected into mice once, 4 days before intraperitoneal
      inoculation of S-180 cells, tellimagrandin II, rugosin A, hirtellin B, oenothein
      B and oenothein A, which have only tellimagrandins I or II units in their
      molecules, had significant antitumor activity. Although casuarictin and its
      related tannins were ineffective, agrimonin, which is a dimer, had a strong
      effect, as previously reported. On the other hand, monomeric ellagitannins such
      as tellimagrandins I and II, rugosin A and casuarictin also increased IL-1 beta
      production from human peripheral macrophages in vitro by 2-fold over the non
      stimulated basal production and oligomeric ellagitannins with strong antitumor
      activity more potently stimulated the IL-1 beta induction. Other tannins having
      no antitumor activity induced less IL-beta. This study indicates that oligomeric
      ellagitannins, which consist of tellimagrandin I or II, casuarictin or their
      related structure units, have antitumor activity and induce IL-1 beta.

PMID- 8476229
TI  - Cytotoxic activity of fusaric acid on human adenocarcinoma cells in tissue
      culture.
AB  - When cultured human normal WI-38 fibroblasts were exposed to 500 microM fusaric
      acid (5-butylpicolinic acid), cell proliferation ceases. The majority of the WI
      38 cells remained in a quiescent G1(G0) state and viable for approximately 30 to
      48 h. The effect of fusaric acid on WI-38 cell growth was slowly reversible after
      removal of the agent from the culture media. In contrast, within 24 h of exposure
      to 500 microM fusaric acid, most of the human colon adenocarcinoma LoVo cells
      were blocked at random in the cell cycle and approximately 80% of the cells were
      dead after 30 h. Three additional human colorectal adenocarcinoma cell lines,
      denoted SW48, SW480, and SW742, were also sensitive to the inhibitory and
      cytotoxic effects of fusaric acid. Of all the cell lines tested, the human
      mammary adenocarcinoma cell line MDA-MB-468 was the most sensitive to the growth
      inhibitory and cytotoxic effects of fusaric acid. Further experiments with MDA-MB
      468 cells demonstrated that fusaric acid is a potent inhibitor of DNA synthesis.
      Fusaric acid also inhibited the growth of human epidermoid carcinoma KB cells and
      showed cytotoxic actions for this cell line but its effects on cell viability
      were not as pronounced. The results presented here indicate that fusaric acid has
      potent anti-proliferative activity in vitro on various normal and cancer cell
      lines and suggest that it exhibits some cytotoxic specificity for growing and
      confluent colorectal adenocarcinoma and mammary adenocarcinoma cell lines.

PMID- 8476230
TI  - Pharmacokinetic studies of chloroethylnitrosocarbamoyl-amino acid derivatives in
      vivo and in vitro.
AB  - The in vitro chemosensitivity of MAC 15A ascites cells to CNC-alanylalanine and
      CNC-glycinemethylamide was assessed using a clonogenic assay system. In vitro
      stability studies and in vivo pharmacokinetics were performed using a reversed
      phase HPLC technique. Initial concentrations of CNC-alanylalanine and CNC
      glycinemethylamide of 5.2 micrograms ml-1 and 3.2 micrograms ml-1 respectively,
      were required for a 70% reduction in colony formation of MAC 15A cells in vitro.
      The concentrations of active alkylating species generated were calculated from
      the drug half-lives in tissue culture medium. On this basis, a 70% cell kill was
      achieved by equivalent concentrations of 10.8 microM CNC-alanylalanine and 10.6
      microM CNC-glycinemethylamide. Analysis of drug levels following intraperitoneal
      administration revealed that CNC-alanylalanine was cleared more slowly from the
      peritoneal cavity producing a greater drug concentration at the site of the
      ascitic MAC 15A tumour. These results suggested that the superior activity of CNC
      alanylalanine over CNC-glycinemethylamide against MAC 15A in vivo could be
      attributed mainly to differences in the pharmacokinetic behaviour of the two
      drugs following intraperitoneal administration and that CNC-alanylalanine might
      have a role in the treatment of local peritoneal disease.

PMID- 8476231
TI  - Influence of acetylsalicylic acid on antibody-dependent cellular cytotoxicity
      (ADCC) of peritoneal macrophages.
AB  - Very recent evidence indicates that, in addition to its already known analgesic,
      anti-inflammatory, antipyretic, and platelet-aggregation-inhibiting properties,
      acetylsalicylic acid (ASA) exerts a positive influence on the immune system.
      Therefore, its action on murine peritoneal macrophages was investigated in the
      present study. Various ASA concentrations (50-200 micrograms/ml) failed to have
      any stimulating or inhibiting effect on antibody-dependent cellular cytotoxicity
      (ADCC) and on the binding capacity of macrophages from various levels of
      activation against SW 707 tumor cells. Furthermore, no time dependence of the
      stimulation was observed over a period of up to 48 hrs. These results suggest
      that the reported positive effect of ASA on the immune system, manifested by
      increased production of interleukins and interferon, is due to an interaction of
      macrophages and lymphocytes and not to a direct increase in macrophage activity.

PMID- 8476232
TI  - Interactions between oestradiol and danazol on the growth of gastrointestinal
      tumour cells.
AB  - The gastrointestinal tumour cell lines, MKN45G and C146 possessed oestrogen
      receptors (ER) of affinities 1.8 x 10(-8) and 5.2 x 10(-9) M respectively. C146
      and MKN45G had enhanced proliferation in the presence of oestradiol (10(-8) and
      10(-10) M). Fifty-six percent (5/9) of primary gastric and colorectal tumours had
      their proliferation enhanced by oestradiol. The anti-steroidal drug, danazol,
      inhibited the basal growth of MKN45G (10 micrograms ml-1 45% of the untreated
      control), C146 (10 and 5 micrograms ml-1, 20 and 48% of control, respectively)
      and 3/9 GI primary tumours (10 micrograms ml-1). Danazol competed with 3 [H]
      Oestradiol for binding to ER on MKN45G and C146, at concentrations from 10 to 1
      micrograms ml-1.

PMID- 8476233
TI  - Antibiotic therapy for chronic infection of pseudomonas in the lung.
AB  - Chronic Pseudomonas aeruginosa lung infection is an endobronchiolitis
      characterized by the microcolony mode of growth (biofilm). Early colonization is
      treated with oral ciprofloxacin combined with colistin inhalation. Chronic
      infection is treated with "maintenance chemotherapy" consisting of beta-lactam
      antibiotics and tobramycin intravenously in combination with colistin inhalation
      four times yearly.

PMID- 8476234
TI  - Pathogenesis and pathophysiology of bacterial meningitis.
AB  - Despite the availability of bactericidal antibiotics with potent in vitro
      activity against the major meningeal pathogens, the morbidity and mortality from
      bacterial meningitis remains unacceptably high. Animal models have proven to be
      extremely valuable in the study of the pathogenesis and pathophysiology of
      bacterial meningitis, with the hopes of providing new information that may lead
      to an improved outcome from this disorder. Bacterial meningitis usually begins
      with nasopharyngeal colonization by a new organism, followed by invasion and
      bacteremia. Subsequently there is central nervous system invasion, although the
      exact site and mechanism of meningeal invasion are unknown. The generation of an
      intense subarachnoid space inflammatory response, induced by release of bacterial
      virulence factors and/or inflammatory cytokines, contributes to many of the
      pathophysiologic consequences of bacterial meningitis, including cerebral edema,
      increased intracranial pressure, and alterations of cerebral blood flow.
      Attenuation of this inflammatory response (e.g. by co-administration of
      antiinflammatory agents) may diminish many of these pathophysiologic consequences
      of meningitis, and perhaps improve morbidity and mortality from this disorder.

PMID- 8476235
TI  - Role of bacterial cytotoxins in hemolytic uremic syndrome and thrombotic
      thrombocytopenic purpura.
AB  - Bacterial cytotoxins, which are produced by Shigella dysenteriae 1 and certain E.
      coli serotypes, kill mammalian cells by inhibiting protein synthesis. They have
      been related to hemolytic uremic syndrome and thrombotic thrombocytopenic
      purpura, probably by initial insult to vascular endothelial cells. This insight
      opened new avenues of research and possible interventions.

PMID- 8476236
TI  - Role of insulin resistance in human disease (syndrome X): an expanded definition.
AB  - Resistance to insulin-mediated glucose uptake is characteristic of individuals
      with impaired glucose intolerance or non-insulin-dependent diabetes, and it also
      occurs commonly in patients with high blood pressure. The physiological response
      to a decrease in insulin-mediated glucose uptake is an increase in insulin
      secretion, and as long as a state of compensatory hyperinsulinemia can be
      maintained, frank decompensation of glucose tolerance can be prevented. However,
      it is likely that the defect in insulin action and/or the associated
      hyperinsulinemia will lead to an increase in plasma triglyceride and a decrease
      in high density lipoprotein-cholesterol concentration, and high blood pressure.
      It seems likely that the cluster of changes associated with resistance to insulin
      mediated glucose uptake comprise a syndrome, which plays an important role in the
      etiology and clinical course of patients with non-insulin-dependent diabetes,
      high blood pressure, and coronary heart disease.

PMID- 8476237
TI  - Nonatheromatous arterial thrombosis.
AB  - In contrast to venous thrombi, which are caused primarily by reduced blood flow
      and are composed predominantly of fibrin and red cells, arterial thrombi
      characteristically result from elevated shear stress at sites of vascular injury
      and are composed predominantly of platelets. Arterial thrombosis is therefore
      typically caused by abnormalities of platelets and/or the vessel wall. Disorders
      characterized by a propensity to arterial thrombosis due primarily to
      abnormalities of platelets include the myeloproliferative disorders, those due to
      vessel wall abnormalities include homocystinuria and the inflammatory
      vasculopathies, while those probably due to a combination of platelet and vessel
      wall abnormalities include heparin-associated thrombocytopenia and thrombosis and
      the antiphospholipid antibody syndrome.

PMID- 8476238
TI  - Physiologic role of the normal pericardium.
AB  - Because of the characteristics of the parietal pericardial tissue, the intact
      pericardial sac has a limited reserve volume, becoming relatively non-compliant
      when the heart volume is at the high end of the normal physiologic range.
      Pericardial restraint of the heart is best considered as a contact force.
      Measured with flattened balloons, the magnitude of pericardial contact pressure
      is probably several mmHg less than right atrial pressure. The diastolic pressure
      volume relationship of the right ventricle, and to a lesser degree of the left
      ventricle, shifts downward following pericardiectomy. In dogs, the pericardium
      has been shown to limit maximal cardiac output. Some disease states associated
      with a rapid increase in total heart volume, including subacute mitral
      regurgitation and right ventricular infarction, demonstrate an increased
      pericardial influence on cardiac filling.

PMID- 8476239
TI  - Primary repair and autotransplantation of cardiac valves.
AB  - The aortic valve is a beautifully designed and balanced structure with precise
      opening and closing mechanisms. Its design probably cannot be improved upon by
      man-made mechanical devices, no matter how ingenious. It is logical to use human
      valves as replacements because of their superior structural configuration. Their
      chief difficulties are in the troubles of the learning curve of the surgeon to
      achieve a competent mechanism and the hazard of infection. The pulmonary
      autograft or translocation of the pulmonary valve to the aortic position offers
      many advantages, and the long-term results are good. Conservative repair and
      reconstruction of the aortic valve are increasing in popularity but have a
      relatively limited application. The mitral valve has a less precise and more
      adjustable type of mechanism and generous leaflet coaptation. These features make
      it more amenable to repair, as demonstrated in the clinical series of the
      technique. Repair is clearly preferable to replacement at present. The tricuspid
      valve is eminently suitable for reconstruction, but late results are not very
      good. The disappointing outcome, however, reflects more the severity of
      underlying cardiac pathology than the effectiveness of the repair.

PMID- 8476240
TI  - Epidermolysis bullosa.
AB  - Epidermolysis bullosa is a group of genetically determined diseases characterized
      by abnormal fragility of the skin and mucosa. In this chapter, we review current
      thinking about classification, pathogenesis, and molecular genetics, and we
      discuss management guidelines.

PMID- 8476241
TI  - Management of primary hyperparathyroidism.
AB  - Primary hyperparathyroidism is a common disease that can be accurately diagnosed
      and effectively treated in most patients. The diagnosis is established by a
      persistent elevation of serum calcium and parathyroid hormone and by clinical
      evaluation. Surgery is the appropriate treatment, and preoperative localization
      procedures are seldom indicated. Selected patients with mild disease may be
      followed by procedures devised to identify deterioration of skeletal,
      neurological, and renal function. The accurate diagnosis and effective treatment
      of primary hyperparathyroidism are rewarding clinical experiences for the
      endocrinologist and surgeon.

PMID- 8476242
TI  - Prognostic factors and therapeutic decisions in axillary node-negative breast
      cancer.
AB  - The incidence of node-negative breast cancer is increasing, and it is becoming a
      more commonly encountered clinical problem. Prognostic factors such as tumor
      size, histopathological characteristics, receptor status, proliferative markers,
      biochemical alterations, and gene abnormalities can be useful in assessing the
      risk of cancer recurrence after primary local therapy. By accurately assessing
      the risk of recurrence, informed decisions can be made about whether or not to
      treat with adjuvant systemic therapy.

PMID- 8476243
TI  - Chronic inflammatory demyelinating polyradiculoneuropathy.
AB  - Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) represents an
      important acquired condition characterized by progressive, symmetrical, proximal
      and distal weakness. Muscle stretch reflexes are depressed and sensory loss is
      variable. Patients may have mild to severe weakness and may require assisted
      ambulation or wheelchairs. Rarely do patients require respiratory support.
      Laboratory features include nerve conduction changes and nerve biopsy pathology
      indicative of demyelination. Cerebrospinal fluid protein is characteristically
      elevated without pleocytosis. The condition is responsive to immunosuppressive
      therapy, especially prednisone and plasmapheresis (plasma exchange). CIDP
      frequently follows a chronic or relapsing course.

PMID- 8476244
TI  - Primary sclerosing cholangitis.
AB  - Primary sclerosing cholangitis (PSC) is an inflammatory disease of unknown
      etiology. It affects the biliary system and is characterized by fibrosis and
      progressive obliteration of extrahepatic and intrahepatic bile ducts. Its
      frequent coexistence with antibody-mediated diseases, certain human leukocyte
      antigens, and altered lymphocyte mechanisms suggests a strong autoimmune and
      genetic etiology. Other conditions such as recurrent cholangitis, acquired
      immunodeficiency syndrome, previous bile duct surgery, bile duct anomalies, or
      biliary stone disease may result in similar clinical patterns and radiologic
      profiles. PSC can be asymptomatic and slowly progressive over years, or it may
      develop rapidly with an inexorable progression to cirrhosis and portal
      hypertension. Clinical and biochemical abnormalities may suggest PSC, but it is
      the characteristic radiological pattern that secures the diagnosis. Once viewed
      as a rare entity, the widespread use of radiological and endoscopic methods have
      increased physician awareness. There is no successful medical treatment for PSC.
      While traditional surgical approaches have been directed at the relief of
      cholangitis and biliary obstruction, liver transplantation has emerged as
      definitive therapy for patients with PSC complicated by cirrhosis or recurrent
      bouts of cholangitis.

PMID- 8476245
TI  - Anti-inflammatory therapy for asthma.
AB  - Asthma is now recognized to be a chronic inflammatory disease of the airways,
      involving mast cells, eosinophils, and T lymphocytes. Treatment of asthma should
      therefore be based on anti-inflammatory agents rather than bronchodilators.
      Choices include inhaled corticosteroids, which are highly effective in all
      patients, and cromolyn sodium and nedocromil sodium, which are effective in
      patients with mild asthma. It is likely that the earlier and more widespread use
      of anti-inflammatory drugs will reduce the unacceptably high morbidity and
      mortality of asthma and prevent irreversible chronic airflow obstruction in
      patients with severe disease.

PMID- 8476246
TI  - Recombinant erythropoietin.
AB  - Erythropoietin is the only hematopoietic growth factor that behaves like a
      hormone. Produced in the kidneys and the liver, erythropoietin interacts with
      erythroid progenitor cells in the bone marrow to promote their proliferation and
      maintain their viability. Erythropoietin production is regulated at the level of
      its gene by tissue oxygenation; hypoxia or anemia stimulates erythropoietin
      production, and erythrocytosis suppresses it, but never completely. The plasma
      erythropoietin concentration reflects erythropoietin production and can be used
      to define erythropoietin-deficient states in which anemia may be amenable to
      correction by administration of recombinant human erythropoietin.

PMID- 8476247
TI  - Bone marrow transplantation for Hodgkin's disease and lymphoma.
AB  - The treatment of patients with high-dose chemotherapy and autologous
      transplantation for recurrent or high-risk lymphomas has greatly expanded over
      the past few years. With the use of new supportive care measures such as newer
      antibiotics and hematopoietic growth factors, the morbidity and mortality rate
      associated with this therapy have diminished. This in turn has allowed successful
      use of the therapy earlier in the disease course, with resultant increases in
      disease-free survival rates. Future trials will strive to utilize new therapies
      and supportive care measures to improve on the results even further.

PMID- 8476248
TI  - Diagnosis and treatment of osteoporosis.
AB  - Osteoporotic bone fractures are a significant public health problem resulting in
      substantial morbidity and for those who suffer a hip fracture, a significant one
      year mortality. Bone densitometry provides an important measure of fracture risk
      and the newer techniques are useful in the management of individuals with
      osteoporosis. Estrogen administration will preserve bone mass in postmenopausal
      women, and the optimal intake of calcium and vitamin D is being evaluated. Newer
      agents such as calcitonin and bisphosphonates may provide potent therapies for
      preventing bone loss. This review focuses on bone densitometry as a diagnostic
      tool and on the use of therapeutic agents for osteoporosis.

PMID- 8476249
TI  - Cellular mechanisms of acute ischemic injury in the kidney.
AB  - Hypoxic injury to tubular cells represents an early event in acute renal failure.
      Although important advances have been made in the understanding of hypoxic injury
      at the cellular level (e.g. loss of cell polarity, production of free radicals,
      calcium entry, and the activation of genes for protection or regeneration), the
      basic mechanisms responsible for organ failure remain elusive. The renal medulla,
      working on the brink of anoxia and being the site of concentration for many
      toxins, may be an important target for the synergistic events of hypoperfusion
      and nephrotoxic exposure that often precede human acute renal failure.

PMID- 8476250
TI  - Neuromodulation techniques for medically refractory chronic pain.
AB  - Advances in our knowledge of the physiology of pain transmission and modulation
      have created new surgical options for the control of chronic pain. The pain
      modulation network can be activated by administration of spinal opiates or by
      electrical stimulation of the nervous system with transcutaneous, peripheral
      nerve, spinal cord, and deep brain stimulation. The theoretical basis and the
      clinical applications of neurostimulation for the treatment of medically
      intractable chronic pain are reviewed.

PMID- 8476251
TI  - Control of brain volume during hyperosmolar and hypoosmolar conditions.
AB  - The brain is particularly vulnerable to disturbances of body fluid osmolality.
      Studies in animals indicate that brain adaptation to osmotic stresses is a very
      complex process involving transient changes in water content and sustained
      changes in electrolyte and organic osmolyte contents. Appreciation of the nature
      of the adaptation process enables a better understanding of the marked variations
      in neurological sequelae that characterize hyper- and hypoosmolar states and
      provides a basis for more rational therapy.

PMID- 8476252
TI  - Diabetic nephropathy: pathogenesis and treatment.
AB  - Diabetic nephropathy is a leading cause of end-stage renal disease. Recently,
      there have been developments in understanding the role of risk factors and
      pathogenetic features such as genetic predisposition, systemic and
      intraglomerular hypertension, the effects of glycemic control, glomerular
      hypertrophy, and basic biochemical alterations in cellular metabolism, as well as
      correlations in morphology and function. These are reflected in newer approaches
      to preventive and palliative therapy.

PMID- 8476253
TI  - Laparoscopic therapy of cholelithiasis.
AB  - Laparoscopic cholecystectomy has emerged as the treatment of choice for
      symptomatic cholecystolithiasis. Results will improve and complications rates
      decrease as surgeons gain experience in the method. New developments will permit
      a complete laparoscopic approach to cholelithiasis.

PMID- 8476254
TI  - Malignant melanoma.
AB  - Malignant melanoma is the most rapidly increasing cancer in Caucasians throughout
      the world. The increased incidence is due to greater sun exposure arising from
      changes in clothing habits and life-styles over the past fifty years. Most
      melanomas arise in preexisting moles in sun-exposed sites and may spread rapidly
      via the vascular system if not detected and removed early. Treatment of
      disseminated disease is unsatisfactory, with most patients dying of refractory
      brain metastases.

PMID- 8476255
TI  - Interleukin-2 receptor-directed therapies: antibody-or cytokine-based targeting
      molecules.
AB  - With the exception of certain hematologic malignancies, the high affinity
      interleukin-2 (IL-2) receptor is only transiently expressed during the brief
      antigen-triggered proliferative burst of lymphocytes. Hence, we wondered whether
      administration of anti-IL-2 receptor (IL-2R) monoclonal antibody (mAb) or
      chimeric IL-2 toxins would provide a utilitarian way to achieve immunosuppression
      aimed directly at activated lymphocytes, or whether this approach could be used
      to treat IL-2R+ leukemia/lymphoma. Studies in preclinical autoimmune and
      transplant models indicate that this approach can be effective. The results of
      open, uncontrolled studies provide preliminary evidence that a chimeric IL-2
      toxin is well tolerated at doses that may induce improvement in patients with IL
      2R+ leukemia/lymphoma, as well as in patients with refractory rheumatoid
      arthritis or new-onset diabetes mellitus.

PMID- 8476256
TI  - Special aspects of neuropsychiatric illness in women: with a focus on depression.
AB  - Many depressive disorders predominate in women. Other psychiatric disorders more
      prevalent in women than men often occur concomitantly with depression. A variety
      of these disorders show a premenstrual patterning of symptoms and are responsive
      to antidepressants. Migraine headaches are also more common in women, show a
      premenstrual patterning, and are responsive to antidepressants. Other
      neuropsychiatric and endocrine-related disorders predominating in women are
      discussed in this review. Greater attention to the special aspects of
      neuropsychiatric disorders in women may improve diagnosis and treatment.

PMID- 8476257
TI  - Atherosclerosis regression, plaque disruption, and cardiovascular events: a
      rationale for lipid lowering in coronary artery disease.
AB  - In the Familial Atherosclerosis Treatment Study (FATS), the reduction in clinical
      events (75%) far outweighed the modest frequency and magnitude of lesion
      regression observed among those receiving intensive lipid-lowering therapy. To
      understand this result, the disruptive changes in plaque that trigger clinical
      events (cardiac death, myocardial infarction, unstable angina) are described.
      Data are presented in support of the idea that the clinical benefits of lipid
      lowering therapy are best explained by stabilization, by depletion of lipid, of
      the "dangerous" subpopulation of lipid-rich plaques that are often associated
      with only mild or moderate coronary narrowing.

PMID- 8476258
TI  - Prophylactic antibiotics in surgery.
AB  - Prophylactic antibiotics can decrease the incidence of postoperative wound
      infections in indicated procedures. The accepted indications for administering
      prophylactic antibiotics have been clean-contaminated procedures and prosthesis
      insertion, but new indications are evolving that consider wound contamination
      together with anesthetic risk and relative duration of the operation. A
      prophylactic antibiotic is chosen on the basis of its activity against endogenous
      flora likely to be encountered, its toxicity, and its cost, in that order. Potent
      antibiotics used for serious infections are generally not used for prophylaxis. A
      maximum dose of a prophylactic antibiotic is given preoperatively so that
      effective tissue concentration is present at and after the time of incision. In
      the absence of infection, antibiotics should not be continued beyond the
      operative day. Regimens for specific procedures are discussed.

PMID- 8476259
TI  - The diagnosis and treatment of panic disorder.
AB  - Panic attacks and panic disorder often first present in the emergency room or to
      the family practitioner. The presentation and differential diagnosis of this
      disabling disorder are described in this review, together with the etiology and
      health effects of the syndrome. Both medication and psychological treatments are
      described, as are the indications, side effects, and expected outcome for each
      therapy alone and in combination.

PMID- 8476260
TI  - Endothelial dysfunction in coronary artery disease.
AB  - The endothelium is a physical barrier between the blood and vascular smooth
      muscle, a source of enzymes activating and deactivating cardiovascular hormones
      and a site of production of relaxing and contracting factors. In addition, the
      endothelium is a source of growth inhibitors and promoters of vascular smooth
      muscle cells. Monoaminooxidase deactivates catecholamines and serotonin.
      Angiotensin converting enzyme transforms angiotensin I into angiotensin II and
      breaks down bradykinin into inactive products. Nitric oxide is a potent
      vasodilator and inhibitor of platelet function that under most circumstances is
      released together with prostacyclin, which exerts similar effects. Both
      substances play an important protective role in the coronary circulation in that
      they cause continuous vasodilation and inhibition of platelet function. In
      addition, the endothelium is a source of contracting factors such as endothelin
      1, thromboxane A2, and endoperoxides. Endothelium-derived growth inhibitors
      include heparin (sulfates) and transforming growth factor beta 1, while basic
      fibroblast growth factors and platelet-derived growth factor and possibly
      endothelin promote proliferation. Because of its strategic anatomic position, the
      endothelium is a primary target for injuries and cardiovascular risk factors. In
      particular, aging, low density lipoproteins, hypertension, diabetes, and ischemia
      alter endothelium function. In arterial coronary bypass grafts, the release of
      nitric oxide is more pronounced than in vein grafts. Alterations of endothelial
      function may contribute to vasospasm, thrombus formation, and vascular
      proliferation and in turn myocardial ischemia, all common events in patients with
      coronary artery disease.

PMID- 8476261
TI  - Aging--causes and defenses.
AB  - Recent studies have shown that chromosomes shorten as cells divide and become
      senescent. Also, deletions in mitochondrial DNA increase markedly with advancing
      age, presumably secondary to damage from oxygen radicals. Since host defenses
      against environmental factors also become attenuated, the molecular damage
      associated with aging may increasingly perturb normal homeostasis and increase
      the susceptibility to disease and disability. Such age-associated dysfunctions
      can be targeted and interrupted.

PMID- 8476262
TI  - Current approaches in the treatment of Parkinson's disease.
AB  - Treatment options for patients with Parkinson's disease have rapidly expanded in
      the last five years. They now include pharmacologic therapies designed not only
      to improve parkinsonian symptoms, but also to prevent disease progression. In
      addition, neurosurgical options and other novel treatment strategies are being
      developed and may become clinically useful in the next decade. This chapter
      addresses current and evolving Parkinson's disease medications, future surgical
      interventions, and specific strategies for maximizing patient motor abilities.

PMID- 8476263
TI  - Idiopathic pulmonary fibrosis.
AB  - Idiopathic pulmonary fibrosis kills half of its victims within five years of
      diagnosis. Currently available treatment regimens are disappointing, and the
      incidence of the disease appears to be increasing. Newer techniques of imaging
      coupled with laboratory advances in molecular and cellular biology may produce
      new strategies for modulating the disease process. This article explores new
      approaches to the diagnosis and management of idiopathic pulmonary fibrosis.

PMID- 8476264
TI  - Antioncogenes and human cancer.
AB  - Multiple genetic lesions are thought to transform a normal cell into a malignant
      one, and both dominant and recessive genetic effects have been identified in this
      process. Antioncogenes (or tumor suppressor genes) act in a recessive manner, in
      which both maternal and paternal alleles need to be inactivated to abrogate
      normal function. The identification of these lesions is giving us insight into
      the regulatory pathways in the cell and may translate into future improvements in
      prevention, diagnosis, prognosis, and therapy of human cancer.

PMID- 8476265
TI  - Angioplasty for acute coronary syndromes.
AB  - The acute ischemic syndromes (unstable angina and acute myocardial infarction)
      are often treated with percutaneous transluminal coronary angioplasty.
      Angioplasty should be considered in patients with unstable angina refractory to
      medical therapy and in those with evidence for ischemia after medical
      stabilization. Direct or primary angioplasty is indicated in patients with acute
      myocardial infarction with contraindications to thrombolytic therapy and is a
      reasonable alternative even in those eligible for thrombolytics. While there is
      no role for immediate angioplasty of a patent infarct-related artery following
      thrombolysis, rescue angioplasty of persistently occluded arteries may be
      beneficial, although further studies are needed.

PMID- 8476267
TI  - Diagnosis and treatment of obsessive compulsive disorder.
AB  - Obsessive compulsive disorder (OCD) is a common anxiety disorder that appears to
      be due to a disturbance in central serotonergic functioning. Drugs, such as
      clomipramine, that inhibit neuronal reuptake of serotonin are effective in
      treating OCD. Behavioral therapy techniques are also effective.

PMID- 8476266
TI  - Methods, successes, and failures of smoking cessation programs.
AB  - Addictive and conditioning processes interact to make cigarette smoking a common,
      lethal behavior that is highly resistant to change. In addition to addiction and
      conditioning, smoking is maintained by a wide range of forces, ranging from
      social modeling and advertising to the politics and economics of international
      trade. Parallel to this wide range of causes of smoking, interventions to
      encourage smoking cessation range from simple information and suggestions to
      smoking cessation classes, to nicotine replacement, to community or national
      campaigns that promote nonsmoking. Clinicians can make contributions throughout
      this range of activities, from the consulting room to political advocacy. While
      no one of these is highly successful on its own, together they have prompted
      almost 50% of smokers to quit, an impressive accomplishment.

PMID- 8476268
TI  - Serum transferrin receptor.
AB  - The transferrin receptor plays a critical role in iron metabolism by precisely
      controlling the flow of transferrin iron into body cells. A soluble truncated
      form of the receptor can be detected in human serum using sensitive immunoassays,
      and the initial clinical experience with this new measurement indicates that it
      reflects the total body mass of tissue receptor. Serum receptor levels rise
      significantly with tissue iron deficiency and the heightened demand for iron
      associated with expansion of the erythroid marrow. The serum receptor provides a
      quantitative measure of functional iron deficiency and distinguishes the
      associated anemia from that of chronic disease. If iron deficiency is excluded,
      the serum receptor provides a quantitative measure of total erythropoiesis that
      is more sensitive and less invasive than bone marrow examination currently used
      to assess red cell precursor mass. Performed in conjunction with serum ferritin
      measurements, the serum receptor will be useful in establishing the true
      prevalence of iron deficiency anemia in population studies.

PMID- 8476269
TI  - Utility of gene rearrangements in lymphoid malignancies.
AB  - Molecular genetic study of lymphoid neoplasms by Southern blotting or polymerase
      chain reaction permits the ready detection of gene rearrangements. Clonal
      rearrangements of immunoglobulin and T-cell receptor genes identify neoplasms of
      B- and T-cell lineage, respectively. Additionally, lymphoma-specific chromosome
      translocations involving oncogenes are detected with the same molecular
      techniques. Probes are currently available to study the c-myc translocations of
      Burkitt's lymphoma, the bcl-2 translocations of follicular lymphomas, and the bcl
      1 translocations of centrocytic lymphoma.

PMID- 8476270
TI  - The biology of the eosinophilic leukocyte.
AB  - The eosinophil is characterized by specific cytoplasmic granules that contain a
      series of cationic toxins able to kill many targets, including helminths,
      protozoa, bacteria, and other cells. In bronchial asthma, considerable evidence
      exists that the eosinophil releases granule proteins, especially the major basic
      protein (MBP), which in turn mediate tissue abnormalities. Among eosinophil
      activating factors, IL-5 has been associated with helminth infection and
      hypersensitivity diseases and would appear to be an attractive target for
      pharmacological intervention.

PMID- 8476271
TI  - Scaphocephaly in a prehistoric skeleton from Harappa, Pakistan.
AB  - Irregularities of cranial suture closure resulting in scaphocephaly are
      documented for a number of prehistoric and historic human populations of the
      eastern and western hemispheres, but what may be the first recorded case from
      southern Asia appeared during the 1987 archaeological field season at the Indus
      Valley Civilization site of Harappa, Pakistan. The female specimen with this
      condition also exhibits indicators of developmental abnormalities in the
      postcranial skeleton. These features are discussed in the context of assessing
      anatomical and ontogenetical relationships of craniostenostic eccentricities with
      abnormalities of facial, dental and postcranial regions of the skeletons of
      scaphocephalic individuals.

PMID- 8476272
TI  - Odontometry of Lithuanian paleopopulations.
AB  - In 3443 teeth of 418 adults (224 males, 194 females) from Lithuanian crania of
      the 1st and 2nd millennia A.D., vestibulolingual (VL) and mesiodistal (MD)
      diameters of each tooth were measured on the right side. The samples showed a
      marked stability during the millennia, measurements being typical for a
      mesodontic population. Definite sexual dimorphism of teeth measurements was
      established. A method for sex estimation from dental measurements is proposed.

PMID- 8476273
TI  - Age estimation from teeth using soft X-ray findings.
AB  - Soft X-ray photos of 68 premolars and 98 molars from 102 males and 64 females
      were taken to measure the length (mm) of the corona (CL) and the length of
      coronal pulp cavity (CPCL). Then the coronal index CI = CPCL x 100/CL after Ikeda
      et al. (1985) was computed for each tooth and regressed on the actual age of the
      individuals to obtain equations that allow estimation of age in unknown bodies
      and isolated teeth. The correlation coefficients ranged from -0.73 (female
      molars) to -0.89 (female premolars). No significant differences were observed in
      age estimation using sex-specific equations.

PMID- 8476274
TI  - Polymorphism of properdin factor B (Bf) in some Italian populations.
AB  - In order to contribute to the definition of a map of the distribution of Bf
      polymorphism in Italy, we typed numerous population samples (for a total of 2033
      individuals) from several regions of Italy: provinces of Bologna, Potenza and
      Matera, middle Sangro valley (Chieti) and northern, central and southern
      Sardinia. A new method was used which consisted of cellulose acetate
      electrophoresis followed by immunofixation and staining with Coomassie blue. The
      results obtained highlight marked differences in the distribution of Bf
      phenotypes and allele frequencies in Italy. To be noted in particular are the
      relatively high incidence of the Bf*S allele and the low incidence of Bf*F in
      Potenza and the significantly different pattern of the Sardinian samples compared
      to those from mainland Italy. This may be due to the low incidence in Sardinia of
      the Bf*S allele and above all to the exceptionally high frequency of the Bf*F1
      variant.

PMID- 8476275
TI  - Directional and fluctuating asymmetry in the palmar interdigital ridge-counts.
AB  - Directional and fluctuating asymmetry of the palmar interdigital ridge-counts (c
      d, b-c and a-b) was evaluated using a sample of 1186 male and 1042 female
      Germans. The c-d and b-c ridge-counts show higher right side values while the a-b
      count shows a higher left side value. Sex differences in asymmetry are
      significant, females exhibiting larger left values than males for all three
      counts. Directional asymmetries of the different areas exhibit weak negative
      correlations. Fluctuating asymmetry (magnitude of L-R) is highest for the c-d
      count, followed by the a-b. Both c-d and a-b ridge-counts exhibit a significant
      quadratic relationship between magnitude of L-R and R+L, but b-c does not. The
      quadratic relationship shows that individuals with extreme phenotypes are more
      asymmetrical than those closer to the mean. This in turn may be interpreted to
      mean that fluctuating asymmetry is a reflection of developmental stability.

PMID- 8476276
TI  - Arm folding, hand clasping and dermatoglyphic asymmetry in Bulgarians.
AB  - Arm folding and hand clasping have been analysed in 2100 Bulgarians, 1050 of
      either sex. In both traits, significant preponderance of the left type over the
      right one was revealed. Also, in both traits the excess of the left type is more
      pronounced in females but this sexual heterogeneity is significant only in the
      arm folding. Examination of the possible association between arm folding and hand
      clasping showed the independence between both asymmetries. On the other hand, the
      comparison between both sexes concerning distributions of the four possible
      combinations of types revealed statistically significant sexual dimorphism in
      this respect. Two kinds of dermatoglyphic asymmetry, directional and relative,
      have been investigated and comparisons have been made between right and left
      claspers and between right and left folders, each sex separately and finger-by
      finger. Although statistically significant differences are not numerous, they
      have been discussed from the point of view of the importance of relationships
      between functional and morphological asymmetries.

PMID- 8476277
TI  - [The upper hearing limit. A study of its dependence on age and sex with
      consideration of endogenous and exogenous factors].
AB  - In order to determine the upper limit of the audible frequency range as well as
      its age-dependency we have examined 198 persons whose ages varied from 3 to 90
      years of which 111 were women. To correct for potential errors that might occur
      due to other factors which may differ from the age only, an additional 28
      variables have been recorded besides the measurement of high-tone perception. The
      hearing experiment was based on the monaural exposition of a monofrequent test
      signal. Its frequency was continuously varied whereas the sound pressure level
      was kept as constant as possible. The results show a strong dependency of upper
      frequency limit at a given sound level with the age and some sex-differences. All
      the rest of possibly interfering variables (i.e. noise-exposition or ototoxic
      drugs) remained below the threshold of statistical significance. The
      approximately linear relationship between the age and the ability of high
      frequency perception shows a more pronounced and earlier loss of sensitivity (to
      high frequencies) in males than in females.

PMID- 8476278
TI  - Effects of acetate, propionate, and butyrate on the thermophilic anaerobic
      degradation of propionate by methanogenic sludge and defined cultures.
AB  - The effects of acetate, propionate, and butyrate on the anaerobic thermophilic
      conversion of propionate by methanogenic sludge and by enriched propionate
      oxidizing bacteria in syntrophy with Methanobacterium thermoautotrophicum delta H
      were studied. The methanogenic sludge was cultivated in an upflow anaerobic
      sludge bed (UASB) reactor fed with propionate (35 mM) as the sole substrate for a
      period of 80 days. Propionate degradation was shown to be severely inhibited by
      the addition of 50 mM acetate to the influent of the UASB reactor. The inhibitory
      effect remained even when the acetate concentration in the effluent was below the
      level of detection. Recovery of propionate oxidation occurred only when acetate
      was omitted from the influent medium. Propionate degradation by the methanogenic
      sludge in the UASB reactor was not affected by the addition of an equimolar
      concentration (35 mM) of butyrate to the influent. However, butyrate had a strong
      inhibitory effect on the growth of the propionate-oxidizing enrichment culture.
      In that case, the conversion of propionate was almost completely inhibited at a
      butyrate concentration of 10 mM. However, addition of a butyrate-oxidizing
      enrichment culture abolished the inhibitory effect, and propionate oxidation was
      even stimulated. All experiments were conducted at pH 7.0 to 7.7. The
      thermophilic syntrophic culture showed a sensitivity to acetate and propionate
      similar to that of mesophilic cultures described in the literature. Additions of
      butyrate or acetate to the propionate medium had no effect on the hydrogen
      partial pressure in the biogas of an UASB reactor, nor was the hydrogen partial
      pressure in propionate-degrading cultures affected by the two acids.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476279
TI  - Ecological and genetic analysis of copper and streptomycin resistance in
      Pseudomonas syringae pv. syringae.
AB  - Strains of Pseudomonas syringae pv. syringae resistant to copper, streptomycin,
      or both compounds were recovered from symptomless and diseased tissue of four
      woody hosts in three nurseries in Oklahoma. In strains resistant to copper and
      streptomycin (Cur Smr), resistance to both compounds was cotransferred with a
      single plasmid which was either 68, 190, or 220 kilobase pairs (kb). All Cus Smr
      strains contained a 68-kb conjugative plasmid. Cur Sms strains contained one
      plasmid which varied in size from 60 to 73 kb. All conjugative plasmids which
      transferred streptomycin resistance contained sequences homologous to the strA
      and strB Smr genes from the broad-host-range plasmid RSF1010. The Smr determinant
      was subsequently cloned from a 68-kb Cur Smr plasmid designated pPSR1. A
      restriction map detailing the organization of the homologous Smr genes from pPSR1
      and RSF1010 and cloned Smr genes from P. syringae pv. papulans and Xanthomonas
      campestris pv. vesicatoria revealed the conservation of all sites studied. The
      Cur genes cloned from P. syringae pv. tomato PT23 and X. campestris pv.
      vesicatoria XV10 did not hybridize to the Cur plasmids identified in the present
      study, indicating that copper resistance in these P. syringae pv. syringae
      strains may be conferred by a distinct genetic determinant.

PMID- 8476280
TI  - Biodegradation and biotransformation of groundwater pollutant mixtures by
      Mycobacterium vaccae.
AB  - Mycobacterium vaccae can catabolize a number of major groundwater pollutants.
      When added singly, acetone, cyclohexane, styrene, benzene, ethylbenzene,
      propylbenzene, dioxane, and 1,2-dichloroethylene can be catabolized by M. vaccae.
      Catabolism of a number of these chemicals was monitored by gas-chromatographic
      analysis. Gas-chromatographic analysis indicated that the products of benzene
      degradation are phenol and hydroquinone. The products of chlorobenzene and
      ethylbenzene degradation are 4-chlorophenol and 4-ethylphenol. The extent that
      some compounds were catabolized when present as mixtures was also investigated.
      When toluene and benzene were present concomitantly, toluene was catabolized and
      benzene oxidation was delayed. Although toluene promoted the degradation of
      styrene, a lower rate of toluene degradation occurred when styrene was present.
      Both 4-chlorophenol and 4-ethylphenol had an antagonistic effect on the ability
      of M. vaccae to degrade other aromatic compounds. Studies with [14C]benzene
      indicated that M. vaccae can mineralize small amounts of this compound. These
      results suggest that components in mixtures may have a positive or a negative
      effect on the rates of biodegradation of other pollutants.

PMID- 8476281
TI  - Elimination of Escherichia coli O157:H7 in meats by gamma irradiation.
AB  - Undercooked and raw meat has been linked to outbreaks of hemorrhagic diarrhea due
      to the presence of Escherichia coli O157:H7; therefore, treatment with ionizing
      radiation was investigated as a potential method for the elimination of this
      organism. Response-surface methods were used to study the effects of irradiation
      dose (0 to 2.0 kGy), temperature (-20 to +20 degrees C), and atmosphere (air and
      vacuum) on E. coli O157:H7 in mechanically deboned chicken meat. Differences in
      irradiation dose and temperature significantly affected the results. Ninety
      percent of the viable E. coli in chicken meat was eliminated by doses of 0.27 kGy
      at +5 degrees C and 0.42 kGy at -5 degrees C. Small, but significant, differences
      in radiation resistance by E. coli were found when finely ground lean beef rather
      than chicken was the substrate. Unlike nonirradiated samples, no measurable
      verotoxin was found in finely ground lean beef which had been inoculated with
      10(4.8) CFU of E. coli O157:H7 per g, irradiated at a minimum dose of 1.5 kGy,
      and temperature abused at 35 degrees C for 20 h. Irradiation is an effective
      method to control this food-borne pathogen.

PMID- 8476282
TI  - Role of growth phase and ethanol in freeze-thaw stress resistance of
      Saccharomyces cerevisiae.
AB  - The freeze-thaw tolerance of Saccharomyces cerevisiae was examined throughout
      growth in aerobic batch culture. Minimum tolerance to rapid freezing (immersion
      in liquid nitrogen; cooling rate, approximately 200 degrees C min-1) was
      associated with respirofermentative (exponential) growth on glucose. However,
      maximum tolerance occurred not during the stationary phase but during active
      respiratory growth on ethanol accumulated during respirofermentative growth on
      glucose. The peak in tolerance occurred several hours after entry into the
      respiratory growth phase and did not correspond to a transient accumulation of
      trehalose which occurred at the point of glucose exhaustion. Substitution of
      ethanol with other carbon sources which permit high levels of respiration
      (acetate and galactose) also induced high freeze-thaw tolerance, and the peak did
      not occur in cells shifted directly from fermentative growth to starvation
      conditions or in two respiratorily incompetent mutants. These results imply a
      direct link with respiration, rather than exhaustion of glucose. The role of
      ethanol as a cryoprotectant per se was also investigated, and under conditions of
      rapid freezing (cooling rate, approximately 200 degrees C min-1), ethanol
      demonstrated a significant cryoprotective effect. Under the same freezing
      conditions, glycerol had little effect at high concentrations and acted as a
      cryosensitizer at low concentrations. Conversely, under slow-freezing conditions
      (step freezing at -20, -70, and then -196 degrees C; initial cooling rate,
      approximately 3 degrees C min-1), glycerol acted as a cryoprotectant while
      ethanol lost this ability. Ethanol may thus have two effects on the cryotolerance
      of baker's yeast, as a respirable carbon source and as a cryoprotectant under
      rapid-freezing conditions.

PMID- 8476283
TI  - Biodegradation of a synthetic lubricant by Micrococcus roseus.
AB  - A bacterium that was able to utilize Emkarate 1550 (E1550), a synthetic lubricant
      ester, as the sole source of carbon was isolated. The isolate was tentatively
      identified as Micrococcus roseus. The components of the E1550 ester, octanoate,
      decanoate, and 1,1,1-tris(hydroxymethyl)propane (TMP), were detected in the
      culture medium of cells growing on the ester. The TMP tertiary alcohol
      accumulated during growth and was not utilized by this isolate. The detection of
      the components of the ester in the supernatant of cultures indicated that one of
      the first steps in its degradation was cleavage of the ester bonds. Esterase
      activity was significantly enhanced in cells grown on E1550 compared with
      esterase activity measured in cells grown on acetate.

PMID- 8476284
TI  - Dynamics, spread, and persistence of a single genotype of Pseudomonas syringae
      relative to those of its conspecifics on populations of snap bean leaflets.
AB  - A rifampin-resistant strain of Pseudomonas syringae (R10) was introduced onto
      bean plants grown in field plots to examine the processes of growth, spread, and
      survival of a single genotype relative to the dynamics of its conspecifics on
      populations of individual leaflets. R10 was applied to four plots (400, 200, 100,
      and 50 m2), each of which was centered in a quadrant of a bean field (90 by 90
      m). Population sizes of the species P. syringae and of R10 were determined on
      each of 25 individual leaflets collected from the largest plot (A) at
      approximately weekly intervals during a 10-week period following application. The
      spread of R10 from all plots was monitored by leaf imprinting of individual
      leaflets collected at sites along four transects, each of which bisected two of
      the plots. The introduced strain was a dominant component of the species for
      about 5 weeks postinoculation on leaflets from plot A. Although the population
      sizes of R10 remained at about 5.0 to 5.5 log10 CFU per leaflet, the strain
      became a progressively minor component of the species as the population sizes of
      its conspecifics continued to increase during the latter part of the growing
      season. In general, a positive correlation was found for the population sizes of
      R10 and its conspecifics on individual leaflets collected throughout the growing
      season. This result suggests that large numbers of R10 early in the growing
      season did not exclude the colonization of bean leaflets by its conspecifics. It
      is apparent that the species pool comprised genotypes that were more fit than R10
      under the conditions that prevailed during the latter part of the growing season.
      By 6 weeks postinoculation, R10 was detected at all sites sampled within the
      unsprayed areas of the field. However, it was present as a minor component of the
      species. The persistence of R10 throughout the winter and into the following
      growing season was monitored in plot A, which was plowed and replanted with wheat
      in the fall. R10 was detected on some of the samples (wheat seedlings or soil)
      taken at approximately monthly intervals from November to June of the following
      year. In June, the field was plowed and replanted with beans. We could not detect
      R10 on emerging bean seedlings in plot A. The results demonstrate that the
      successful spread and persistence of an introduced bacterium do not necessarily
      lead to the establishment of large populations of the bacterium in adjacent
      untreated areas or on its host plant in subsequent growing seasons.

PMID- 8476285
TI  - Microbial production of D-malate from maleate.
AB  - To produce D-malate from maleate by a microbial reaction, we screened a number of
      maleate-utilizing microorganisms for enzyme activity by an intact cell system.
      The strain which showed the best productivity among the 440 strains tested was
      identified taxonomically as Arthrobacter sp. strain MCI2612. The optical purity
      of the malate produced by this strain was 100% D type. The culture and reaction
      conditions for the production were studied for this strain. Addition of amino
      acids such as L-proline, L-histidine, and L-arginine to the culture medium
      promoted the formation of reaction activity as well as cell growth. Under optimum
      conditions, 87 g of D-malate per liter was produced in 20 h. The yield was 72
      mol%.

PMID- 8476286
TI  - Cloning of a novel cryIC-type gene from a strain of Bacillus thuringiensis subsp.
      galleriae.
AB  - A novel cryIC-type gene was isolated from a strain of Bacillus thuringiensis
      subsp. galleriae. A new polymerase chain reaction (PCR) technique with a set of
      several oligonucleotide primer pairs specific to the cryIC gene was used to
      screen a number of B. thuringiensis strains. PCR amplified several DNA fragments
      ranging from 100 bp to 1 kb for B. thuringiensis strains containing a cryIC gene.
      PCR fragments amplified from the Bacillus thuringiensis subsp. galleriae HD29 DNA
      differed from the fragments amplified from other cryIC-containing strains,
      indicating strain HD29 contained a novel cryIC-type gene. To isolate crystal
      genes homologous to cryIC, an HD29 gene library was probed with a 984-bp fragment
      of the amino-terminal coding region of the cryIC gene cloned from Bacillus
      thuringiensis subsp. aizawai HD229. A putative toxin gene was isolated from a
      phage that hybridized strongly to the cryIC probe. Translation of the putative
      toxin DNA sequence revealed an open reading frame of 1,176 amino acids whose
      predicted molecular mass was 132.8 kDa. Comparisons of the toxin gene sequence
      with sequences of other cry genes indicated that this gene is a subclass of
      cryIC. We propose to designate this gene cryIC(b). In Escherichia coli, the
      cryIC(b) gene produced a protein of approximately 130 kDa toxic to Spodoptera
      exigua and Trichoplusia ni.

PMID- 8476287
TI  - Rapid isolation and sequencing of purified plasmid DNA from Bacillus subtilis.
AB  - We report two methods for isolation of plasmid DNA from the gram-positive
      bacterium Bacillus subtilis. The protoplast alkaline lysis procedure was
      developed for general use, and the protoplast alkaline lysis magic procedure was
      developed for isolation of DNA for sequencing. Both procedures yielded large
      amounts of high-quality DNA in less than 1 h, while current protocols require 4
      to 7 h to perform and give lower yields and quality. Plasmid DNA was obtained
      from strains containing either high- or low-copy-number plasmids. In addition,
      the procedures were easily adapted to yield large amounts of plasmid DNA suitable
      for sequencing from another gram-positive organism, Staphylococcus aureus.
      Further, we demonstrated that neither chloramphenicol, used for plasmid
      selection, nor the mutation recE4 reduced plasmid DNA yield from the strains we
      examined.

PMID- 8476288
TI  - Detection of Xanthomonas campestris pv. citri by the polymerase chain reaction
      method.
AB  - pFL1 is a pUC9 derivative that contains a 572-bp EcoRI insert cloned from plasmid
      DNA of Xanthomonas campestris pv. citri XC62. The nucleotide sequence of pFL1 was
      determined, and the sequence information was used to design primers for
      application of the polymerase chain reaction (PCR) to the detection of X.
      campestris pv. citri, the causal agent of citrus bacterial canker disease. Seven
      18-bp oligonucleotide primers were designed and tested with DNA from X.
      campestris pv. citri strains and other strains of X. campestris associated with
      Citrus spp. as templates in the PCR. Four primer pairs directed the amplification
      of target DNA from X. campestris pv. citri strains but not from strains of X.
      campestris associated with a different disease, citrus bacterial spot. Primer
      pair 2-3 directed the specific amplification of target DNA from pathotype A but
      not other pathotypes of X. campestris pv. citri. A pH 9.0 buffer that contained
      1% Triton X-100 and 0.1% gelatin was absolutely required for the successful
      amplification of the target DNA, which was 61% G+C. Limits of detection after
      amplification and gel electrophoresis were 25 pg of purified target DNA and about
      10 cells when Southern blots were made after gel electrophoresis and probed with
      biotinylated pFL1. This level of detection represents an increase in sensitivity
      of about 100-fold over that of dot blotting with the same hybridization probe.
      PCR products of the expected sizes were amplified from DNA extracted from 7-month
      old lesions from which viable bacteria could not be isolated. These products were
      confirmed to be specific for X. campestris pv. citri by Southern blotting. This
      PCR-based detection protocol will be a useful addition to current methods of
      detection of this pathogen, which is currently the target of international
      quarantine measures.

PMID- 8476289
TI  - Purification of Pseudomonas putida acyl coenzyme A ligase active with a range of
      aliphatic and aromatic substrates.
AB  - Acyl coenzyme A (acyl-CoA) ligase (acyl-CoA synthetase [ACoAS]) from Pseudomonas
      putida U was purified to homogeneity (252-fold) after this bacterium was grown in
      a chemically defined medium containing octanoic acid as the sole carbon source.
      The enzyme, which has a mass of 67 kDa, showed maximal activity at 40 degrees C
      in 10 mM K2PO4H-NaPO4H2 buffer (pH 7.0) containing 20% (wt/vol) glycerol. Under
      these conditions, ACoAS showed hyperbolic behavior against acetate, CoA, and ATP;
      the Kms calculated for these substrates were 4.0, 0.7, and 5.2 mM, respectively.
      Acyl-CoA ligase recognizes several aliphatic molecules (acetic, propionic,
      butyric, valeric, hexanoic, heptanoic, and octanoic acids) as substrates, as well
      as some aromatic compounds (phenylacetic and phenoxyacetic acids). The broad
      substrate specificity of ACoAS from P. putida was confirmed by coupling it with
      acyl-CoA:6-aminopenicillanic acid acyltransferase from Penicillium chrysogenum to
      study the formation of several penicillins.

PMID- 8476290
TI  - Influence of alternative electron acceptors on the anaerobic biodegradability of
      chlorinated phenols and benzoic acids.
AB  - Nitrate, sulfate, and carbonate were used as electron acceptors to examine the
      anaerobic biodegradability of chlorinated aromatic compounds in estuarine and
      freshwater sediments. The respective denitrifying, sulfidogenic, and methanogenic
      enrichment cultures were established on each of the monochlorinated phenol and
      monochlorinated benzoic acid isomers, using sediment from the upper (freshwater)
      and lower (estuarine) Hudson River and the East River (estuarine) as source
      materials. Utilization of each chlorophenol and chlorobenzoate isomer was
      observed under at least one reducing condition; however, no single reducing
      condition permitted the metabolism of all six compounds tested. The anaerobic
      biodegradation of the chlorophenols and chlorobenzoates depended on the electron
      acceptor available and on the position of the chlorine substituent. In general,
      similar activities were observed under the different reducing conditions in both
      the freshwater and estuarine sediments. Under denitrifying conditions,
      degradation of 3- and 4-chlorobenzoate was accompanied by nitrate loss
      corresponding reasonably to the stoichiometric values expected for complete
      oxidation of the chlorobenzoate to CO2. Under sulfidogenic conditions, 3- and 4
      chlorobenzoate, but not 2-chlorobenzoate, and all three monochlorophenol isomers
      were utilized, while under methanogenic conditions all compounds except 4
      chlorobenzoate were metabolized. Given that the pattern of activity appears
      different for these chlorinated compounds under each reducing condition, their
      biodegradability appears to be more a function of the presence of competent
      microbial populations than one of inherent molecular structure.

PMID- 8476291
TI  - Some characteristics of a proteinase from a thermophilic Bacillus sp. expressed
      in Escherichia coli: comparison with the native enzyme and its processing in E.
      coli and in vitro.
AB  - Proteinase Ak.1 was produced during the stationary phase of Bacillus sp. Ak.1
      cultures. It is a serine proteinase with a pI of 4.0, and the molecular mass was
      estimated to be 36.9 kDa by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE). The enzyme was stable at 60 and 70 degrees C, with
      half-lives of 13 h and 19 min at 80 and 90 degrees C, respectively. Maximum
      proteolytic activity was observed at pH 7.5 with azocasein as a substrate, and
      the enzyme also cleaved the endoproteinase substrate Suc-Ala-Ala-Pro-Phe-NH-Np
      (succinyl-alanyl-alanyl-prolyl-phenylalanine p-nitroanalide). Major cleavage
      sites of the insulin B chain were identified as Leu-15-Tyr-16, Gln-4-His-5, and
      Glu-13-Ala-14. The proteinase gene was cloned in Escherichia coli, and expression
      of the active enzyme was detected in the extracellular medium at 75 degrees C.
      The enzyme is expressed in E. coli as an inactive proproteinase at 37 degrees C
      and is converted to the mature enzyme by heating the cell-free media to 60
      degrees C or above. The proproteinase was purified to homogeneity and had a pI of
      4.3 and a molecular mass of 45 kDa. The NH2-terminal sequence was Ala-Ser-Asn-Asp
      Gly-Val-Glu-, showing the exact signal peptide cleavage point. Heating the
      proenzyme resulted in the production of active proteinase with an NH2-terminal
      sequence identical to that of the native enzyme. The characteristics of the
      cloned proteinase were identical to those of the native enzyme.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476292
TI  - Exopolysaccharide production in biofilms: substratum activation of alginate gene
      expression by Pseudomonas aeruginosa.
AB  - Reporter gene technology was employed to detect the activity of an alginate
      promoter of Pseudomonas aeruginosa when the organism was grown as a biofilm on a
      Teflon mesh substratum and as planktonic cells in liquid medium. Alginate
      biosynthetic activity was determined with a mucoid cell line derived from a
      cystic fibrosis isolate and containing an alginate algC promoter fused to a lacZ
      reporter gene. Reporter activity was demonstrated with chromogenic and
      fluorogenic substrates for beta-galactosidase. Expression of algC was shown to be
      upregulated in biofilm cells compared with planktonic cells in liquid medium.
      Gene up-expression correlated with alginate biosynthesis as measured by Fourier
      transform infrared spectroscopy, uronic acid accumulation, and alginate-specific
      enzyme-linked immunosorbent assay. The algC promoter was shown to have maximum
      activity in planktonic cultures during the late lag and early log phases of the
      cell growth cycle. During a time course experiment, biofilm algC activity
      exceeded planktonic activity except during the period immediately following
      inoculation into fresh medium. In continuous-culture experiments, conversion of
      lacZ substrate was demonstrated microscopically in individual cells by
      epifluorescence microscopy.

PMID- 8476293
TI  - Enhanced mineralization of polychlorinated biphenyls in soil inoculated with
      chlorobenzoate-degrading bacteria.
AB  - An Altamont soil containing no measurable population of chlorobenzoate utilizers
      was examined for the potential to enhance polychlorinated biphenyl (PCB)
      mineralization by inoculation with chlorobenzoate utilizers, a biphenyl utilizer,
      combinations of the two physiological types, and chlorobiphenyl-mineralizing
      transconjugants. Biphenyl was added to all soils, and biodegradation of 14C
      Aroclor 1242 was assessed by disappearance of that substance and by production of
      14CO2. Mineralization of PCBs was consistently greatest (up to 25.5%) in soils
      inoculated with chlorobenzoate degraders alone. Mineralization was significantly
      lower in soils receiving all other treatments: PCB cometabolizer (10.7%);
      chlorobiphenyl mineralizers (8.7 and 14.9%); and mixed inocula of PCB
      cometabolizers and chlorobenzoate utilizers (11.4 and 18.0%). However, all
      inoculated soils had higher mineralization than did the uninoculated control
      (3.1%). PCB disappearance followed trends similar to that observed with the
      mineralization data, with the greatest degradation occurring in soils inoculated
      with the chlorobenzoate-degrading strains Pseudomonas aeruginosa JB2 and
      Pseudomonas putida P111 alone. While the mechanism by which the introduction of
      chlorobenzoate degraders alone enhanced biodegradation of PCBs could not be
      elucidated, the possibility that chlorobenzoate inoculants acquired the ability
      to metabolize biphenyl and possibly PCBs was explored. When strain JB2, which
      does not utilize biphenyl, was inoculated into soil containing biphenyl and
      Aroclor 1242, the frequency of isolates able to utilize biphenyl and 2,5
      dichlorobenzoate increased progressively with time from 3.3 to 44.4% between 15
      and 48 days, respectively. Since this soil contained no measurable level of
      chlorobenzoate utilizers yet did contain a population of biphenyl utilizers, the
      possibility of genetic transfer between the latter group and strain JB2 cannot be
      excluded.

PMID- 8476294
TI  - Testing of some assumptions about biodegradability in soil as measured by carbon
      dioxide evolution.
AB  - Conversion to CO2 upon incubation in aerobic soil is one of the standard test
      procedures to assess biodegradability. It may be measured with unlabeled test
      compounds in biometer flasks. In this case, the background CO2 evolution by
      unamended soil is subtracted from the CO2 evolution by the amended soil and the
      resulting net CO2 evolution becomes the measure of biodegradation. Alternately,
      14CO2 release from radiocarbon substrates is measured to assess biodegradability.
      Both approaches measure ultimate (complete) biodegradation and bypass the
      theoretical and technical limitations of residue analysis. This report examines
      the underlying assumptions that, except for carbon content, conversion percentage
      to CO2 is relatively independent of chemical composition, that CO2 production is
      proportional to the amount of added test compound, and that the background CO2
      evolution of the soil is not influenced by the test substance. Work with
      unlabeled and radiolabeled substrates proved the first two assumptions to be
      essentially correct. However, more than half of net CO2 production may represent
      the mineralization of biomass and soil organic matter, some of it unrelated to
      the test compound. The soil microbial community in its nongrowing steady state
      appears to convert a much lower percentage of a radiocarbon substrate to 14CO2
      than a growing soil community that responds to a substantial substrate addition.
      These findings may help to improve test methods and may aid in the interpretation
      of test results.

PMID- 8476295
TI  - Degradation of poly(3-hydroxyoctanoic acid) [P(3HO)] by bacteria: purification
      and properties of a P(3HO) depolymerase from Pseudomonas fluorescens GK13.
AB  - Twenty-five gram-negative bacteria and one gram-positive bacterium capable of
      growing on poly(3-hydroxyoctanoic acid) [P(3HO)] as the sole source of carbon and
      energy were isolated from various soils, lake water, and activated sludge. Most
      of the isolates degraded only P(3HO) and copolymers of medium-chain-length (MCL)
      hydroxyalkanoic acids (HA). Except for the gram-positive strain, which was able
      to hydrolyze P(3HO) and poly(3-hydroxybutyric acid) [P(3HB)], no isolate was able
      to degrade polymers of short-chain-length HA, such as P(3HB) or poly(3
      hydroxyvalerate) [P(3HV)]. All strains utilized a large variety of monomeric
      substrates for growth. All gram-negative strains, but not the gram-positive
      strain, accumulated poly(hydroxyalkanoic acids) (PHA), consisting of MCL HA, if
      they were cultivated under accumulation conditions. One strain, which was
      identified as Pseudomonas fluorescens GK13 (biovar V), was selected and the
      extracellular P(3HO) depolymerase of this strain was purified from the culture
      medium of P(3HO)-grown cells by chromatography with Octyl-Sepharose CL4B and by
      gel filtration with Superose 12. The relative molecular weights of the native and
      sodium dodecyl sulfate-treated enzymes were 48,000 and 25,000, respectively. The
      purified enzyme hydrolyzed P(3HO), copolymers of MCL HA, and para-nitrophenyl
      esters of fatty acids. P(3HB), P(3HV), and characteristic substrates for lipases,
      such as Tween 80 or triolein, were not hydrolyzed. The P(3HO) depolymerase of P.
      fluorescens GK13 was insensitive to phenylmethylsulfonyl fluoride and
      dithioerythritol, unlike other PHA depolymerases. The dimeric ester of 3
      hydroxyoctanoic acid was identified as the main product of enzymatic hydrolysis
      of P(3HO).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476296
TI  - Biodegradability and mechanical properties of poly-(beta-hydroxybutyrate-co-beta
      hydroxyvalerate)-starch blends.
AB  - Wheat starch granules and poly-(beta-hydroxybutyrate-co-beta-hydroxyvalerate)
      [P(HB-co-HV), (19.1 mol% HV)] were blended at 160 degrees C. Increasing the
      starch content from 0 to 50% (wt/wt) decreased the tensile strength of P(HB-co
      HV) from 18 MPa to 8 MPa and diminished flexibility as Young's modulus increased
      from 1,525 MPa to 2,498 MPa, but overall mechanical properties of the polymer
      remained in a useful range. A mixed microbial culture required more than 20 days
      to degrade 150-microns-thick samples of 100% P(HB-co-HV), whereas samples
      containing 50% (wt/wt) starch disappeared in fewer than 8 days. Starch granules
      degraded before P(HB-co-HV) did. Aerobic degradation proceeded more rapidly than
      anaerobic degradation.

PMID- 8476297
TI  - Expression and secretion of Bacillus amyloliquefaciens alpha-amylase by using the
      yeast pheromone alpha-factor promoter and leader sequence in Saccharomyces
      cerevisiae.
AB  - Replacement of the regulatory and secretory signals of the alpha-amylase gene
      (AMY) from Bacillus amylolique-faciens with the complete yeast pheromone alpha
      factor prepro region (MF alpha 1p) resulted in increased levels of extracellular
      alpha-amylase production in Saccharomyces cerevisiae. However, the removal of the
      (Glu-Ala)2 peptide from the MF alpha 1 spacer region (Lys-Arg-Glu-Ala-Glu-Ala)
      yielded decreased levels of extracellular alpha-amylase.

PMID- 8476298
TI  - Rapid identification of bacteria on the basis of polymerase chain reaction
      amplified ribosomal DNA spacer polymorphisms.
AB  - To facilitate genus and species level identification of a broad range of bacteria
      without the requirement of presumptive identification, we have developed a
      unified set of primers and polymerase chain reaction conditions to amplify spacer
      regions between the 16S and 23S genes in the prokaryotic rRNA genetic loci.
      Spacer regions within these loci show a significant level of length and sequence
      polymorphism across both genus and species lines. A generic pair of priming
      sequences was selected for the amplification of these polymorphisms from highly
      conserved sequences in the 16S and 23S genes occurring adjacent to these
      polymorphic regions. This single set of primers and reaction conditions was used
      for the amplification of 16S-23S spacer regions for over 300 strains of bacteria
      belonging to eight genera and 28 species or serotypes, including Listeria,
      Staphylococcus, and Salmonella species and additional species related to these
      pathogenic organisms. When the spacer amplification products were resolved by
      electrophoresis, the resulting patterns could be used to distinguish all of the
      species of bacteria within the test group. Unique elements in the amplification
      product patterns generally clustered at the species level, although some genus
      specific characteristics were also observed. On the basis of the results obtained
      with our test group of 300 bacterial strains, amplification of the 16S-23S
      ribosomal spacer region is a suitable process for generating a data base for use
      in a polymerase chain reaction-based identification method, which can be
      comprehensively applied to the bacterial kingdom.

PMID- 8476299
TI  - Secondary metabolites resulting from degradation of PR toxin by Penicillium
      roqueforti.
AB  - PR toxin is a secondary metabolite of the fungus Penicillium roqueforti. It is
      lethal to rats, mice, and cats. Usually, the amount of PR toxin in the culture
      medium decreases from its maximum on day 15 to zero within 3 to 4 days. We found
      that two were secondary metabolites produced in the culture medium of this fungus
      while the production of PR toxin was decreasing. We isolated and purified the two
      compounds in pure and colorless crystalline form. On the basis of elemental
      analysis and mass, 1H and 13C nuclear magnetic resonance, infrared, and UV
      spectroscopies, the two compounds were identified as PR-imine (C17H21O5N) and PR
      amide (C17H21O6N). The structures of both compounds and of PR toxin (C17H20O6)
      were closely related, and the peak production of PR toxin appeared earlier than
      those of PR-imine and PR-amide. Moreover, PR toxin was transformed to PR-imine
      when PR toxin was incubated with the culture medium on a given culture day. Thus,
      we propose that PR toxin is degraded into PR-imine and PR-amide in the culture
      medium of P. roqueforti.

PMID- 8476300
TI  - Colonization of broiler chickens by waterborne Campylobacter jejuni.
AB  - Chickens on a broiler farm in southern England were found to be colonized with
      Campylobacter jejuni of a single serotype, Lior 1 Penner 4. The farm was the sole
      supplier of a local slaughterhouse associated with a campylobacter outbreak in
      1984 caused by this serotype. The serotype persisted on the farm for at least 18
      months after the outbreak; its prevalence in the human population served by the
      farm remained high until it disappeared from the farm in 1986. The possible
      sources and routes of transmission of C. jejuni to the broilers on the farm were
      investigated. The results showed that vertical transmission, feed, litter, small
      mammals, and environmental or airborne cross-contamination between sheds or
      successive crops could be excluded as persistent sources of C. jejuni. The
      predominant source of C. jejuni on the farm was shown to be the water supply.
      Direct microscopy and fluorescent antibody methods revealed presumptive
      campylobacters throughout the farm's water system. Campylobacter-free chickens
      raised in an animal house and given water from the farm supply became colonized
      with the serotype of C. jejuni endemic on the farm (Lior 1 Penner 4). An
      intervention program based on water chlorination, shed drinking system cleaning
      and disinfection, and withdrawal of furazolidone from feed reduced the proportion
      of birds colonized with campylobacter from 81 to 7% and was associated with a
      1,000- to 10,000-fold reduction in campylobacters recoverable from the carcasses.
      Two months after the end of the intervention program colonization of the birds
      returned to high levels (84%), indicating that there was a temporal association
      between intervention and reduced colonization with C. jejuni. Investigations
      continue to establish the general applicability of these findings.

PMID- 8476301
TI  - Quality of community drinking water and the occurrence of late adverse pregnancy
      outcomes.
AB  - The relationship between community drinking water quality and the occurrence of
      late adverse pregnancy outcomes was investigated by conducting a case-control
      study among women who delivered infants during August 1977 through March 1980 at
      Brigham and Women's Hospital in Massachusetts. The water quality indices were
      compared among 1,039 congenital anomaly cases, 77 stillbirth cases, 55 neonatal
      death cases, and 1,177 controls. Trace element levels were gathered from routine
      analyses of public water supplies from the communities in which the women resided
      during pregnancy. It was observed that, after adjustment for confounding, the
      frequency of stillbirths was increased for women exposed to chlorinated surface
      water (OR 2.6 95% CI 0.9-7.5) and for women exposed to detectable lead levels (OR
      2.1; 95% CI 0.6-7.2); the frequency of cardiovascular defects was increased
      relative to detectable lead levels (OR 2.2, 95% CI 0.9-5.7); and the frequency of
      central nervous system defects was increased relative to the highest tertile of
      potassium (OR 6.3, 95% CI 1.1-37.3). The frequency of ear, face, and neck
      anomalies was increased in relation to detectable silver levels (OR 3.3, 95% CI
      0.9-12.2), but the frequency decreased relative to high potassium levels (OR 0.2,
      95% CI 0.1-0.7). The frequency of neonatal deaths was decreased relative to
      detectable fluoride levels (OR 0.4, 95% CI 0.2-1.0), and the frequency of
      musculoskeletal defects was decreased relative to detectable chromium levels (OR
      0.4, 95% CI 0.2-1.0). The majority of these associations were not stable
      statistically. Further research is needed to corroborate these findings.

PMID- 8476302
TI  - Exposure misclassification due to residential mobility during pregnancy in
      epidemiologic investigations of congenital malformations.
AB  - This study addressed the question of how maternal migration between conception
      and birth affects estimates of risk in studies of congenital malformations when
      movement is related to the exposure. For example, in studying the potential
      association between proximity to a chemical waste site and the occurrence of
      birth defects, incorrect inferences might be drawn if maternal residence at birth
      was used as a surrogate for exposure at conception in the case when a significant
      amount of media attention influenced some women to move away from the site after
      becoming pregnant. A simple statistical model is proposed that defines the
      distance to a fixed exposure point measured at birth as a function of the
      distance to the point measured at conception, the probability of movement, the
      direction of movement, and the distance moved. Bias is the difference between the
      expected results when distance is measured at birth versus conception. The amount
      of bias can be substantial for movement patterns that may be likely to occur.
      This simplified model was used in an effort to explore and better understand the
      relationships between maternal migration and risk.

PMID- 8476303
TI  - Hepatitis A epidemics from utility sewage in Ocoee, Florida.
AB  - The 1988-1989 hepatitis A epidemic in the Palms section of Ocoee, Florida,
      followed sewage overflows and involved 39 cases and a fetal death. Of the 18
      index cases (i.e., the first hepatitis illness in a household), each had a
      history of contact with sewage-contaminated stormwater and no other known contact
      with the infection. Illnesses varied from mild to severe; 20 people reported that
      diarrhea, abdominal pain, varying degrees of ascites, and other symptoms
      continued for 2 y after the initial illness. Health injuries up to 20 y of lost
      life, measured by CEA-Clinical Epidemiological AnalysisSM, were found. Public
      records of rainfall and sewage flows provide evidence of massive stormwater entry
      into the utility system, which periodically appears to have flushed sewage from
      the utility lift station into residential areas.

PMID- 8476304
TI  - Lead and child development.

PMID- 8476305
TI  - Lead and child development.

PMID- 8476307
TI  - Bronchial responsiveness to methacholine in swine confinement building workers.
AB  - Bronchial responsiveness to methacholine was measured in 60 swine confinement
      building workers selected from 461 subjects who participated in a recent
      epidemiologic survey on the respiratory impact of exposure to this environment.
      Subjects were divided into the following four groups: group 1, asymptomatic with
      normal spirometry (n = 16); group 2, asymptomatic with forced expiratory volume
      in one second/forced vital capacity (FEV1.0/FVC) < 95% predicted (n = 17); group
      3, presence of chronic bronchitis with normal respiratory function (n = 13); and
      group 4, both symptomatic and FEV1.0/FVC < 95% predicted (n = 14). Each subject
      answered a questionnaire and had a physical examination, PA and lateral chest
      films, lung volumes and DLCO measurements, and a methacholine bronchoprovocation
      test. Ages were similar in each group. Physical examination, chest x-rays, and
      DLCO were normal in all subjects. Values of total lung capacity (TLC) for
      subjects in group 4 were higher than those of subjects in group 3, and
      respiratory volume (RV) values of group 4 subjects were higher than those found
      for all other groups. The provocation dose of methacholine (PC20) was lower for
      group 4, and the number of subjects with PC20 < 16 mg/ml was greater in this
      group than in the other groups. We conclude that only swine confinement building
      workers with both symptoms of chronic bronchitis and abnormal spirometry have an
      increased bronchial responsiveness to methacholine; however, it is uncertain
      whether the bronchial responsiveness demonstrated is directly related to the
      subjects' employment.

PMID- 8476306
TI  - Lung cancer: a prospective study of smoking, occupation, and nutrient intake.
AB  - A cohort study of lung cancer was conducted among 7,961 Japanese-American men who
      were interviewed and examined during 1965-1968. Information was collected about
      their smoking history, occupation, and nutrient intake. After 22 y, 227 incident
      cases of lung cancer were identified. Cigarette smoking significantly increased
      lung cancer risk. The relative risk (RR) was 3.1 for past smokers and 11.4 for
      current smokers, compared with never smokers. We separated lung cancer cases
      according to histological type, and it was found that current smokers had a RRs
      of 16.0 for squamous/small-cell carcinoma and 6.8 for adenocarcinoma of the lung.
      Unskilled manual workers had a significantly higher risk (RR = 1.5; 95%
      confidence interval, 1.1-2.2) for lung cancer than workers who were engaged in
      nonmanual occupations. There was no association between lung cancer and the 24-h
      intake of total calories, protein, fat, dietary cholesterol, carbohydrates, and
      alcohol, but this may have resulted from the limitations of a 24-h dietary
      questionnaire.

PMID- 8476308
TI  - Paraquat poisoning in southern Mexico: a report of 25 cases.
AB  - Paraquat is a bipyridyl herbicide used world-wide. Although accidental and
      deliberate ingestions of lethal doses have been reported from many countries, no
      case has ever been described in Mexico. The authors report on 25 cases of
      Paraquat poisoning in the state of Chiapas, Mexico, that occurred between 1988
      and 1990. Eighty percent of the cases were men, and 64% of the cases died.
      Alcohol intoxication or suicidal intent were factors at the time of Paraquat
      ingestion in 75% of the cases. The majority of cases had learned to use Paraquat
      from a friend; none had been instructed by a professional. Eighty percent of
      cases did not know the dilution for the proper use of the herbicide, and none
      kept the herbicide in its original container. Attention to the law, redesign of
      the Paraquat packaging, and educational efforts directed at populations at risk
      might reduce the occurrence of poisoning in this region.

PMID- 8476309
TI  - Toxicological and immune findings in workers exposed to pentachlorophenol (PCP).
AB  - Pentachlorophenol (PCP) is a pesticide used worldwide in industrial and domestic
      applications. Data available on the effects of technical-grade PCP on the immune
      system are insufficient and equivocal; some data indicate inhibitory effects,
      whereas others suggest stimulating effects. This study was performed to evaluate
      toxicological and immune findings in 32 subjects who had prolonged exposure to
      PCP in a wood factory and in 37 controls. PCP concentrations were determined in
      plasma and urine of all subjects. Lymphocyte subsets of CD3-, CD4-, and CD8
      positive cells were evaluated, and the proliferative response of peripheral blood
      mononuclear cells (PBM) to mitogens was assessed. The results suggested the
      absence of major laboratory and clinical signs of PCP-dependent immune
      deficiency. A weak effect of long-term exposure to PCP on the functional immune
      response could not be ruled out because of the finding of a decreased response to
      5% PHA in the high-exposure group. A weak effect against hepatocyte membrane was
      evidenced by the finding of raised serum concentration of glycocholic,
      taurodeoxycholic, and glycochenodeoxycholic acids in subjects directly exposed to
      PCP for more than 10 y.

PMID- 8476310
TI  - A case-control study of carcinomas of the nose and paranasal sinuses in the
      woolen textile manufacturing industry.
AB  - A population-based case-control study was conducted in Biella, which is located
      in northwestern Italy, to investigate the reported association between sinonasal
      carcinomas and woolen fabrics production. The study included 33 cases diagnosed
      during 1976-1988 (14 adenocarcinomas, 11 epidermoid carcinomas, 3 other specified
      carcinomas, 1 unspecified carcinoma, and 4 cases without histologic confirmation)
      and 131 controls. No association was found with smoking. As reported previously,
      excess risks were observed in wood and furniture workers (odds ratio [OR] = 4.4,
      95% confidence interval [95% CI] = 1.41-13.4) and in the leather industry (OR =
      3.5, 95% CI = 0.6-20.3). Odds ratios in the wood and furniture industry were 22.0
      (95% CI = 4.4-124.0) for adenocarcinomas and 0.9 (95% CI = 0.4-8.3) for
      epidermoid carcinomas. No association was found with the woolen textile or
      garment industries (OR = 0.8, 95% CI = 0.2-2.8), nor with farming, construction,
      metal works, and transport. Odds ratios for the textile industry did not vary
      with length of exposure or histologic type. Power for detecting an odds ratio of
      3.0 at the 95% level of significance was 40%.

PMID- 8476312
TI  - Positive connectedness in the psychiatric nurse-patient relationship.
AB  - Positive connectedness in the psychiatric nurse-patient relationship is believed
      to enhance the effectiveness of the therapeutic relationship. The psychiatric
      nurse's experience of connectedness to patients is examined in this study, and
      factors contributing to the development of a positive connectedness are explored
      using structured interviews.

PMID- 8476311
TI  - Environmental exposure and lifestyle predictors of lead, cadmium, PCB, and DDT
      levels in Great Lakes fish eaters.
AB  - A previously characterized cohort of 115 Great Lakes fish eaters and 95 non-fish
      eating regional controls was reexamined in 1989. Levels of blood lead and cadmium
      and serum PCB and DDT were measured. Lifestyle characteristics, including recent
      and historic fish consumption, were evaluated as predictors of contaminant levels
      using multivariate regression analysis. Significantly elevated serum PCB and DDT
      levels were observed in fish eaters, compared with controls. Historic fish
      consumption, rather than recent consumption, was identified as the primary
      predictor of current serum levels. Mean blood lead and cadmium were also
      significantly higher in fish eaters than in controls. However, the primary
      predictors of lead and cadmium were behavioral exposures--specifically smoking
      and self-reported occupational and recreational exposure-rather than fish
      consumption. These findings illustrate the importance of evaluating a variety of
      possible sources when investigating human exposure to environmental contaminants.

PMID- 8476313
TI  - Nursing diagnoses for psychiatric patients in China.
AB  - This report describes the development of a preliminary Chinese psychiatric
      classification system with nine categories and 211 separate diagnoses, and the
      corresponding diagnostic interview that enables psychiatric nurses in China to
      systematically assess the presence or absence of the various diagnoses. Using
      this interview with 30 representative inpatients, the authors identified 152 of
      the 211 (72%) diagnoses. On average, each patient was given 26 different nursing
      diagnoses. The interrater reliability of the four nurses who independently coded
      the diagnostic interview for these 30 patients was excellent: in over 77% of the
      identified diagnoses the generalized kappa was greater than 0.75. These findings
      show that further work on this classification of nursing diagnoses is warranted.

PMID- 8476314
TI  - Nursing staff and patient perceptions of the ward atmosphere in a maximum
      security forensic hospital.
AB  - The purpose of this study is to describe the factors influencing nursing staff
      and patients' perceptions of the ward atmosphere in a maximum security forensic
      hospital. The study used the Ward Atmosphere Scale to identify specific factors.
      Findings indicate that structure and compliance with ward routine and behavioral
      standards are the most important factors in perceptions of the ward atmosphere.
      Also, despite the emphasis on security and the ever-present potential for
      violence, nursing staff were able to maintain a therapeutic ward atmosphere.

PMID- 8476315
TI  - Social factors and depression in late life.
AB  - Depression is a common mental health problem facing the elderly that is often
      overlooked and subsequently untreated by health care professionals. Recognition
      of the problem can be aided by knowledge of the causes or at least the factors
      associated with it. Identification of specific social factors has important
      implications for geropsychiatric nursing practice, education, and research. The
      major social factors associated with depression in late life are reviewed. The
      contributions of social factors to the onset, course, and duration of depression
      are presented. Future research directions are also discussed.

PMID- 8476316
TI  - Is there life after suicide? The systemic belief approach for "survivors" of
      suicide.
AB  - Following suicide of a loved one the lives of survivors can be plagued with
      anger, sadness, shame, guilt, health problems, and agonizing questions. This
      report presents the Systemic Belief approach to assisting survivors. A case
      example illustrates the influence beliefs have on survivors' lives. Constraining
      beliefs are challenged and facilitative beliefs are coevolved through the healing
      impact of family systems nursing interventions such as therapeutic letters,
      interventive questions, rituals, and reflecting teams.

PMID- 8476317
TI  - [Critical review of the bibliographic references of "Archivos Espanoles de
      Urologia"].
AB  - Due to the lack of Spanish journals or publications with a rather strong
      "impact", which is basically determined by the number of times a publication is
      cited, we attempted to corroborate the widely held view that very little
      reference is made to the Spanish literature. On analyzing all the articles
      published in "Archivos Espanoles de Urologia" during 1990 (182 articles with a
      total of 3,324 references), we found that only 13.61% of the references were from
      Spanish journals, books or Congresses held in Spain, which dropped to 10.3% if
      the books or communications delivered at meetings are excluded. Approximately 30%
      of the articles did not have a single reference from a Spanish publication.
      Furthermore, the articles submitted by foreigners rarely included any reference
      from the Spanish literature. Finally, the Journal of Urology (USA), which
      accounted for over 20% of the references, was the most cited.

PMID- 8476318
TI  - [Renal oncocytoma].
AB  - We report on three cases of renal oncocytoma that had been diagnosed and treated
      between 1986 and 1991. We underscore the difficulty in making the differential
      diagnosis from a renal adenocarcinoma and its higher incidence.
      Anatomopathological studies undertaken retrospectively have contributed further
      insight into its histological features and have shown it to be less uncommon.

PMID- 8476319
TI  - [Verrucous carcinoma of the penis: our caseload].
AB  - Verrucous carcinoma, a tumor that encompasses approximately 5% of all penile
      neoformations, is a variant of squamous cell carcinoma which is benign and has a
      peculiar histological behaviour. We report on three patients aged 57, 80 and 84
      years with this tumor type who underwent surgery (circumcision in one case and
      partial penectomy in the remaining two cases). The literature is briefly reviewed
      and the epidemiological, clinical, diagnostic and therapeutic aspects are
      discussed.

PMID- 8476320
TI  - [Distal urethral obstruction in girls: a diagnosis to keep in mind].
AB  - Although obstruction of the distal urethra is uncommon in the female, it should
      not be discarded if the patient is a young girl who consults for symptoms as
      diverse as enuresis, frequency and urgency, urinary infections, etc. Such a case
      is reported herein. The patient underwent internal urethrotomy which resolved the
      obstruction and eliminated the symptoms.

PMID- 8476321
TI  - [Post-vasectomy semen in 313 males. Statistical analysis, medical aspects, legal
      implications].
AB  - The results of semen examination in 313 vasectomized males are presented. A
      quantitative analysis of the semen samples was performed according to the WHO
      criteria and the centrifugate of the entire ejaculate was studied. At the first
      semen examination, which was performed three months after the procedure, the
      sperm count per ml was negative in 210 patients (83.7%), positive (all non-motile
      and dead) in 41 (16.3%). Sixty-two patients did not send a sample. Those cases
      with a positive first examination had a regular examination every two months. At
      five months 90.8% of these cases had a negative count per ml. 3.6% of the
      patients required 7-10 months to have a negative count. It took longer for the
      older patients to have a negative count, the difference being statistically
      significant with respect to the younger patients. Examination of the centrifugate
      revealed spermatozoa in 24.3% of the samples with a negative sperm count per ml,
      although these were all non-motile and dead, except for one case who had motile
      spermatozoa at 3 months. There were no pregnancies or revasectomies. Some legal
      aspects relative to patient examination and follow-up are discussed.

PMID- 8476322
TI  - [Experience with the determination of LDH-X in seminal plasma as diagnostic and
      prognostic factor in varicocele].
AB  - We studied the biochemical and functional properties of semen to evidence markers
      of diseases concerning fertility. We examined LDH especially isoenzyme LDHx in
      semen of patients with varicocele, diagnosed by clinical evaluation and doppler
      velocimetry. The existence of this enzyme is closely associated with active
      spermatogenesis. In conditions of testicular disease as in varicocele, a major
      diffusion of LDHx into the seminal plasma may occur as a reaction of the
      seminiferous epithelium. We evaluated 50 patients (10 normospermic patients, 20
      affected by varicocele, 9 azoospermic patients, 11 oligo-astenospermic patients).
      We observed that the LDHx concentration in seminal plasma is proportional to the
      severity of the clinical damage. The follow up after spermatic vein ligation of
      the patients affected by varicocele demonstrated that these patients improved to
      the normal clinical parameters, associated to a decrease of the concentration of
      LDHx values.

PMID- 8476323
TI  - [Hydraulic dilatation of urethral stenosis controlled with ultrasonography. A new
      approach].
AB  - The present study describes the ultrasound control of water dilatation for
      urethral stenosis. In our view, the door is open to future developments of water
      dilatation protocols for urethral strictures.

PMID- 8476324
TI  - [Renal adenocarcinoma in the isthmus of a horseshoe kidney].
AB  - A case of renal adenocarcinoma localized to the isthmus of a horseshoe kidney is
      described. We underscore the importance of complementary US and/or CT to
      urography to study the acquired pathologies of the horseshoe kidney because the
      pyelocaliceal distribution of these kidneys may not facilitate correct
      identification of certain space occupying lesions. The angiographic study is
      considered essential for planning surgery for this type of lesion.

PMID- 8476325
TI  - [Angioma of the glans, report of 2 cases].
AB  - We present two cases of angioma of the glans penis and we reviewed this disease
      entity from a clinical and therapeutic points of view, classically understood as
      a proliferative process of a malformative nature. However, both cases that are
      described can be interpreted as true vascular tumors of a benign nature.

PMID- 8476326
TI  - [Spontaneous extravasation of urine at the pyelo-caliceal level. Spontaneous
      urinomas].
AB  - We present two cases of spontaneous rupture of the excretory tract within the
      context of reno-ureteral colic due to lithiasis. We comment on the etiopathogenic
      aspects and underscore the need for emergency evaluation in patients with very
      severe nephric colic and/or symptoms of peritoneal irritation (ileus, abdominal
      guarding), and temporary urinary diversion must be performed via nephrostomy as a
      palliative procedure for the symptoms and to avoid complications.

PMID- 8476327
TI  - [Transitional cell neoplasm of the bladder in childhood: presentation of a
      clinical case].
AB  - A case of urothelial carcinoma of the bladder in a 13-year-old boy is reported.
      As observed in the literature, it is an extremely rare condition in children. The
      importance of gross or microscopic hematuria, which is often the only sign of
      this condition, is underscored. The authors comment on the possible follow-up
      modalities in relation with the characteristics of this tumor type in young
      patients. Although it is more invasive (anesthesia, trauma) than US or urinary
      cytology, cystoscopy is more precise. Because recurrence is extremely rare, it
      can be performed once a year.

PMID- 8476328
TI  - [Trigeminal neuralgia. First manifestation of adenocarcinoma of the prostate].
AB  - We report a case of adenocarcinoma of the prostate that had been incidentally
      discovered during patient evaluation for trigeminal nerve neuralgia refractory to
      treatment. Analysis revealed the underlying cause of neuralgia was tumor
      metastasis to the mandible, which had caused irritation of the fifth nerve. The
      patient was treated with complete androgenic block and his symptoms improved
      simultaneously with partial remission of metastasis.

PMID- 8476329
TI  - [Spontaneous rupture of excretory tract caused by calculous impact].
AB  - Herein we describe a case of spontaneous rupture of the fornix with urinary
      extravasation, an uncommon urological condition arising from a sudden increase of
      intraluminal pressure due to a calculus in the terminal ureter. The
      etiopathogenesis, follow-up and therapeutic approach are discussed.

PMID- 8476330
TI  - [Tumor growth fraction and its relationship with morphology of transitional
      carcinoma of the bladder].
AB  - Papillary transitional cell carcinoma of the bladder (PTCCB) is characterized by
      a high recurrence rate with infiltration of bladder wall and surrounding tissues.
      The outcome is poor in 10-20% of the cases and these cannot be detected by
      conventional methods. Different methods have been utilized to identify this high
      risk patient group, such as the tumor growth factor (TGF). This is obtained with
      the KI-67 antibody, which identifies a nuclear protein in the cells in the active
      cellular cycle (G1, G2, S and mitosis). TGF represents the percentage of KI-67
      positive tumor cells. The aims of the present study were: 1) to determine the
      correlation of the histological features and TGF in PTCCB; 2) to determine the
      percentage, if any, of superficial low grade lesions with a high TGF. Thirty-one
      transurethral biopsies of patients with PTCCB were analyzed to determine the
      histological grade (following the criteria described by Ash), wall infiltration
      (according to the IUAC criteria) and TGF (using the PAP technique). The study
      revealed 16 (52%) were low grade and 15 (48%) were high grade tumors, 20 (64.5%)
      were superficial (PTa-PT1), 9 (29%) were deep (PT1-PT4) and the degree of wall
      infiltration could not be determined in two cases. Of the 20 superficial tumors,
      15 (75%) had a low (0-15%) and 5 (25%) had a high (> or = 16%) TGF. The 9 cases
      with deep infiltration of the bladder wall (PT2-PT4) had a high TGF.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476331
TI  - Modulith SL20--development and clinical experience.
AB  - A third generation lithotripter was developed incorporating the advantages of
      high disintegrative efficacy, anaesthesia-free treatment, combined sonographic
      and fluoroscopic localization system as well as a multifunctional table for
      interdisciplinary use. The shock wave generator consists of a cylindrical-shaped
      electromagnetic coil with a paraboloid reflector. The waves are coupled by means
      of a water cushion and an impedance adapted foil in which the patient is
      comfortably positioned. Stones are localized by an in-line ultrasound probe or
      fluoroscopically by the integrated C-arm. Preclinical trials using the in-vitro
      stone model demonstrated the superior disintegrative capacity. The in-vivo animal
      studies evaluated the dose-dependent and reversible kidney trauma, which was
      comparable to that induced by other lithotripters. The clinical evaluation of the
      Modulith SL since 1988 was divided into three phases with different technical
      equipment. It was indicated that sonographic stone localization enables treatment
      of nearly all kidney stones and 12% of the ureteric calculi. As preference was
      given to in situ disintegration of all ureteral stones, X-ray targeting became
      necessary. By increasing the generator voltage in the third phase together with
      advanced experience, the disintegration rate (94%) was improved. The number of
      auxiliary measures after ESWL (11%) and treatment time (average 39 min) was
      decreased. Eighty-eight percent of our patients were stone-free at follow-up. The
      experience demonstrated that this lithotripter is also easy to handle for
      gallbladder stones and highly effective (82%) in treatment of endoscopically non
      extractable bile duct stones.

PMID- 8476332
TI  - Patterns of sexuality in a high-risk sample: results from a survey of new intakes
      at a county jail.
AB  - Described the sexual habits and behaviors in a sample of individuals thought to
      be at high risk for infection with the AIDS virus. The sample is drawn from new
      arrestees at a county jail in the San Francisco Bay Area. Results indicate that
      the individuals in this sample are very sexually active: The majority began their
      sexual activities at a young age; most are currently in a primary relationship;
      and a large proportion report having had two or more sexual partners in the last
      12 months. Furthermore, for the most part, the patterns of sexual behavior
      reported by respondents did not differ on the basis of gender. Although it was
      true that men tended to initiate intercourse at an earlier age than women, men
      and women did not differ with respect to the numbers of sexual partners reported
      in the last year, frequency of vaginal intercourse, frequency of anal
      intercourse, or in the distribution of sexual risk-taking. Overall, women in this
      sample are very much like men in terms of their sexual behavior.

PMID- 8476333
TI  - Ambiguous stimuli: sex is in the eye of the beholder.
AB  - It is usually assumed that sexual material is easily identifiable by its content.
      The present study investigated whether subjects could be led to interpret
      ambiguous material as sexual or not via simple instructions. Thematically
      ambiguous written text was presented to 269 subjects. The principal independent
      variable was the content of advance information. Advance information was designed
      to suggest that the accompanying text had either a sexual or a nonsexual theme.
      After reading the story and completing an intervening task, subjects completed
      recall and recognition tasks based on the text. These data were used to determine
      the theme or story interpretation given by subjects. The information contained in
      the advance organizers influenced subjects' memories for and interpretations of
      the ambiguous story. When the story was preceded by introductory information that
      suggested sexual content, subjects tended to attribute sexual meaning to the
      story. Other subjects attributed a nonsexual meaning to the same text when it was
      preceded by nonsexual information. Findings suggest that under certain
      conditions, sex is in the "eye of the beholder."

PMID- 8476334
TI  - Orgasm in the postoperative transsexual.
AB  - The dearth of information regarding organism in postoperative transsexuals
      prompted the authors to study its prevalence. The sample consisted of 14 male-to
      female (M-F) and 9 female-to-male (F-M) postoperative transsexuals. The
      relationship of orgasm to sexual and general satisfaction was explored via a
      specially designed questionnaire. Orgastic capacity declined in the M-F group and
      increased in the (F-M) group. Despite the decrease in orgasm in the M-F group,
      satisfaction with sex and general satisfaction with the results of surgery were
      high in both groups. General satisfaction of 86% replicates other studies.
      Frequency of sex increased by 75% in the M-F group and by 100% in the F-M group.
      A phalloplasty does not appear to be a critical factor in orgasm or in sexual
      satisfaction. The general conclusion is reached that it is possible to change
      one's body image and sexual identity and be sexually satisfied despite inadequate
      sexual functioning.

PMID- 8476335
TI  - A factor analysis of the Klein sexual orientation grid in two disparate samples.
AB  - Many researchers interested in sexual orientation can be separated into two
      camps: The "lumpers," who try to reduce sexual classifications to as small a
      number of categories as possible, and the "splitters," who try to show
      differences among groups and individuals that make classification schemes
      increasingly difficult and/or intricate. We report factor analyses of the Klein
      Grid (a questionnaire with 21 sexual orientation items) to see how many factors
      emerge in two samples of strikingly different origins. In both samples, the first
      factor to emerge loaded substantially on all of the Klein Grid's 21 items. This
      factor accounted for a majority of the variance. In both samples, a second,
      correlated factor emerged which indexed a separation between most of the items
      and those having to do with social and/or emotional preferences. In both samples,
      a third correlated factor also emerged, but this factor differed between the two
      populations: one refined the social/emotional distinction and the other
      distinguished ideal behavior from past and current behavior. We conclude on the
      basis of our analysis that both the lumpers and the splitters are correct.

PMID- 8476336
TI  - Gender differences in masturbation and the relation of masturbation experience in
      preadolescence and/or early adolescence to sexual behavior and sexual adjustment
      in young adulthood.
AB  - A comparison of male and female masturbation practices was undertaken in a sample
      of university students to determine if the long-standing finding that young adult
      men in this country masturbate more than young adult women was still evident in
      the 1980s. Despite the efforts in the past quarter century to encourage women in
      our society to take greater responsibility for their own bodies and their own
      sexuality and to engage in more sexual self-exploration and self-stimulation,
      results show that women continue to masturbate much less than men. Twice as many
      men as women had ever masturbated and the men who masturbated did so three times
      more frequently during early adolescence and young adulthood than the women who
      masturbated during these same age periods. A second purpose of this study was to
      determine whether having masturbation experience during preadolescence and/or
      early adolescence was related to intercourse experience, sexual satisfaction,
      sexual arousal, or sexual difficulties in relationships during young adulthood.
      No such linkage was observed, suggesting that early masturbation experience is
      neither beneficial nor harmful to sexual adjustment in young adulthood.

PMID- 8476337
TI  - Effects of antihypertensive drugs atenolol and nifedipine on sexual function in
      older men: a placebo-controlled, crossover study.
AB  - Investigated the adverse sexual effects of two antihypertensive drugs, atenolol
      and slow-release nifedipine, in a placebo-controlled, randomized, crossover
      study. Subjects were 16 older men (mean age = 66.6 years, SEM = 1.4) with mild to
      moderate hypertension. Subjects completed daily self-reports on 13 measures of
      sexuality: frequency of desire, coitus, noncoital partner sex, masturbation,
      morning erections, spontaneous erections, orgasms in coitus and masturbation,
      firmness of morning, masturbatory and coital erections, and subjective pleasure
      in coitus and masturbation. Except for a significant decrease in masturbatory
      erectile firmness with nifedipine therapy, variables did not differ between the
      two drug treatments or between either drug and placebo. Although the sample was
      relatively small, small differences between treatment means suggest that these
      antihypertensive agents are fairly benign relative to sexual function in men.

PMID- 8476338
TI  - Palatal and mandibular arch morphology in 47,XYY men and in other sex-chromosome
      anomalies.
AB  - Dimensions of the maxilla and mandible were studied in 47,XYY men and their first
      degree male relatives, and the results compared with similar studies of other sex
      chromosome anomalies. An extra Y chromosome in 47,XYY men caused an increase in
      palatal growth transversely and anteroposteriorly and in mandibular arch length
      anteroposteriorly compared to normal men. Palatal height and mandibular width
      were smaller with this chromosome pattern. Increase in the number of sex
      chromosomes is associated with changes in palatal and mandibular arch dimensions,
      more often an increase than a decrease. The findings support earlier observations
      that the palate becomes shallower with the addition of an X chromosome. It is
      also apparent that the influence of X and Y chromosomes differs, at least
      regarding the magnitude of metric changes.

PMID- 8476339
TI  - The effect of different strontium concentrations on the efficacy of chlorhexidine
      fluoride-strontium gel in preventing enamel softening in vitro.
AB  - The effects were compared of strontium concentrations of 0, 15, 50 and 250
      parts/10(6) in chlorhexidine(0.20%)-fluoride(0.16%) gel in preventing the
      softening of bovine enamel during bacterial fermentation. Fresh Streptococcus
      sobrinus cells were suspended in a buffer solution (pH 6.0) with 3.3% sucrose and
      centrifuged as a plaque-like layer on the top of enamel slabs covered with 10
      microliters gel. AFter 24 h incubation, the pH fall of the fluid was
      significantly smaller in all test groups than in the placebo group. Strontium
      seemed to have an inhibitory effect on the pH fall. All test gels significantly
      prevented softening and dissolution of enamel during bacterial fermentation,
      which was directly related to strontium concentration. The amounts of calcium and
      phosphorus in the cells and fluid after incubation were the smallest in the group
      with 250 parts/10(6) strontium. In a second experiment without bacteria, new
      enamel slabs were covered with 10 microliters gel containing chlorhexidine and
      NaF with 0 and 250 parts/10(6) strontium to study the protective effect of
      strontium. After 24 h gel treatment, each enamel slab was dissolved in 1 ml 0.1 M
      lactic acid, pH 5.0, for 2 h. Significantly less calcium and phosphorus were
      dissolved from the enamel in both test groups than in the control and placebo
      groups. However, the placebo gel also prevented calcium and phosphorus
      dissolution significantly. These results suggest that the addition of strontium
      to chlorhexidine-fluoride gel improves the ability of this combination to prevent
      caries-like enamel softening. The inhibition of bacterial acid production by the
      strontium-containing gel may explain this enhanced protection of enamel.

PMID- 8476340
TI  - Digastric muscle response as a function of knowledge of the task to be performed.
AB  - Whether the motor programme executed by the digastric muscles during a forceful
      bite is modified according to a subject's expectation that the resistance between
      the teeth will change was investigated. There were two experimental conditions:
      (1) tracking a ramp (drawn on an oscilloscope screen) by biting (isometrically)
      on a force transducer and holding it at 120 N, and (2) tracking the same ramp
      with a sudden unloading at 100 N. There were two groups of experiments: (1)
      control experiments in which subjects underwent a sudden and unexpected unloading
      of the jaw, and (2) experiments in which subjects were previously informed
      whether or not there was to be an unloading. In all experiments the subjects co
      contracted their digastric muscles during the bite as compared to the state at
      rest. The subjects' responses fell into the three different types: (i) those who
      varied the level of tonic digastric activity only as a function of the
      experimental condition, (ii) those who co-contracted the digastric muscles at the
      same time as the masseter muscles, and (iii) those who changed the contraction
      pattern of the digastric muscles as a function of the experimental condition. If
      modulation of the digastric muscles occurred this is a 'feedforward' strategy
      mainly based on immediate past performance.

PMID- 8476341
TI  - Glossopharyngeal-hypoglossal nerve reflex of the frog in metamorphosis.
AB  - In adult frogs, a reflex discharge is elicited from the hypoglossal nerve by
      mechanical and chemical stimuli to the centre of the tongue surface and
      electrical stimuli to the glossopharyngeal nerve innervating tongue. However,
      there has been no report concerning the embryological stage at which this reflex
      develops. The metamorphosis of a frog is divided into three parts,
      premetamorphic, metamorphic and climax stage. In the climax stage, the forelimbs
      are lengthened and the tail gradually shortened. The glossopharyngeal-hypoglossal
      nerve reflex arose in the early climax stage, during which the tongue appeared on
      the floor of the mouth. At this stage, the conduction velocities of the first
      compound action potential of the glossopharyngeal and hypoglossal nerves were
      about 8.7 and 9.3 m/s, respectively. The latency of the reflex was long,
      especially the central latency. The response of the glossopharyngeal nerve and
      the reflex discharge from the hypoglossal nerve upon mechanical stimulation of
      the tongue were smaller in the tadpole than in the adult frog. As metamorphosis
      proceeded, the conduction velocity of these nerves increased; the latency
      shortened, especially the central latency; the reflex response to mechanical
      stimulus increased. These results suggest that, although the glossopharyngeal
      hypoglossal nerve reflex is developed in the early climax stage, it is completed
      only in the adult frog. Therefore, adult frogs living mainly on land may reject
      and swallow prey by this reflective tongue movement.

PMID- 8476342
TI  - Cariogenic potential of pooled plaque fluid from exposed root surfaces in humans.
AB  - The composition of pooled plaque fluid from exposed root surfaces of five
      population samples was determined before and at selected times (3, 7 and 15 min)
      after a 5 and 10% sucrose rinse. Subjects were 45-65 yr old, had exposed, sound
      root surfaces, and were grouped according to root caries status [caries-free
      (CF), no root caries history; caries-positive (CP), recorded root caries
      experience]. Samples were obtained only from the sound surfaces of the CF and CP
      subjects after overnight fasting. Plaque samples from each subgroup were pooled
      under mineral oil and maintained on ice. Plaque fluid was then isolated by
      centrifugation and analysed for organic acids and inorganic ions (ion
      chromatography), and pH (microelectrodes). From these data, the degree of
      saturation [DS(TM)] in plaque fluid with respect to tooth mineral (TM) was
      calculated. Before exposure to sucrose, plaque fluids from the CF and the CP
      subgroups had similar ionic compositions. These fluids were also found to be
      supersaturated with respect to tooth mineral. After exposure to sucrose, a rapid
      decrease in plaque fluid pH was observed, which corresponded primarily to lactic
      acid production. For all times examined, mean pH and DS(TM) values were lower and
      lactic acid concentrations were higher in the CP than the CF samples. Lower
      values of DS(TM) suggest that plaque fluid from CP subjects had a measurably
      greater cariogenic potential. Calcium concentrations also increased significantly
      and to comparable levels in all plaque fluid samples after sucrose exposure,
      despite lower acid production in CF samples.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476343
TI  - A thin bite-force transducer with three-dimensional capabilities reveals a
      consistent change in bite-force direction during human jaw-muscle endurance
      tests.
AB  - The construction of a 2 mm-thick bite-force transducer, capable of measuring the
      magnitude and direction of a bite force in three dimensions, is described. The
      transducer is programmed to display the properties of a bite force on a computer
      monitor. A preliminary study was designed to test its performance. This took the
      form of endurance tests on three human subjects: the test was repeated on one
      subject. The direction of a sustained maximum incisal bite force was monitored
      while subjects clenched for as long as possible on the transducer. The initial
      bite force was directed about 10-15 degrees forward of the vertical. During the
      test the magnitude of the bite force was kept roughly constant but, for all four
      tests, its direction gradually changed until at the failure point it was nearly
      vertical. The consistency of the results suggests that the transducer is
      sufficiently accurate to be a useful tool for studying human jaw mechanics.

PMID- 8476344
TI  - Retardation of mouse odontoblast differentiation by heparin in vitro.
AB  - The effect of heparin was studied histologically and immunohistochemically. Tooth
      germs from 15-day-old mouse embryos were cultured with or without heparin. After
      6 days of culture in control medium, mesenchymal cells underlying the inner
      enamel epithelium had differentiated into odontoblasts and secreted predentine.
      In medium with heparin, mesenchymal cells were undifferentiated. In medium with
      other glycosaminoglycans such as chondroitin sulphate, dermatan sulphate or
      hyaluronate, tooth germs were similar to those in control medium, as were those
      in medium with heparin-Sepharose absorbed serum. After 12 days of culture in the
      heparin medium, mesenchymal cells in some cusps had differentiated into
      odontoblasts and secreted predentine but in other cusps remained
      undifferentiated. Immunohistochemically, exogenous heparin did not prevent the
      deposition of type IV collagen, laminin and fibronectin in the basement membrane
      and extracellular matrix. These results suggest that exogenous heparin retards
      differentiation of odontoblasts but not by disruption of the basement membrane
      nor inactivation of heparin-binding growth factors present in serum.

PMID- 8476345
TI  - A comparison between sieving and optical scanning for the determination of
      particle size distributions obtained by mastication in man.
AB  - Mixtures of particles of different sizes, as obtained after chewing, were
      analysed. Coarse, medium and fine mixtures of particles of an artificial
      (Optosil) test food were used. Mixtures of Optosil particles of known form and
      size (half-cubes) were used to validate the analytical methods. The results of
      both methods were described by particle size distributions based on the volume of
      the particles. Complete agreement between methods was found for the mixtures of
      half-cubes. In order to determine the median particle size by volume from the
      results of optical scanning an assumption on the form of the chewed particles had
      to be made. Using the assumption that, on average, the particles resemble spheres
      a slight overestimate of the median particle size was obtained for scanning as
      compared to sieving. It can be concluded that, although different aspects of the
      fragmented particles are measured, sieving and optical scanning are both adequate
      methods for quantifying mixtures of chewed food particles and yield similar
      results for the degree of particle size reduction.

PMID- 8476346
TI  - A comparison between data analysis methods concerning particle size distributions
      obtained by mastication in man.
AB  - Three mixtures of chewed food particles (coarse, medium and fine) were quantified
      by measuring the particle sizes with an optical scanning device. The particle
      sizes were described by three different particle-size distributions: a cumulative
      volume, a volume and a number distribution. The median particle size was
      determined from each of the distribution functions. Suitability for
      characterizing a mixture of chewed food particles was tested, showing that the
      median particle size as obtained from a cumulative volume (or weight)
      distribution should be preferred. It was shown to be the most sensitive measure
      for characterizing mixtures of chewed food.

PMID- 8476347
TI  - Diverse firing properties of single motor units in the inner and outer portions
      of the guinea pig anterior digastric muscle.
AB  - Microwire recordings from the histochemically heterogeneous inner compartment of
      the guinea pig anterior digastric muscle (ADG) revealed tonic firing of single
      motor units, which were spontaneously active and could also be recruited
      following orofacial afferent stimulation and during rhythmic jaw movements (RJM).
      As units with tonic firing were not observed in the homogeneously fast-twitch
      outer ADG, the tonic units were classified as slow-twitch motor units. Irregular
      patterns of motor-unit firing at variable frequencies were observed after
      orofacial stimulation and during RJM in the outer and inner compartments. The
      irregular firing pattern of units in the fast-twitch outer compartment was
      characterized by shorter and less variable bursts than that of units in the
      heterogeneous inner compartment. A phasic, centrally driven firing pattern was
      observed during RJM in outer and inner ADG units. The firing frequency of some of
      these units was modulated during the rhythmical bursts. It is suggested that, as
      in limb muscles, functionally specialized ADG motor units are recruited in an
      orderly sequence, starting with spontaneously active, slow-twitch units in the
      inner compartment, continuing with fast-twitch units recruited upon enhancement
      of the synaptic drive (as in the case of orofacial stimulation), and ending with
      massive, rhythmical recruitment of slow- and fast-twitch units during RJM.

PMID- 8476348
TI  - Comparative cephalometric analysis in patients with X-chromosome aneuploidy.
AB  - The influence of abnormal sex-chromosome constitution on cranial growth, shape
      and position of the craniofacial structures was analysed. Reduced cranial growth
      was found in women with Turner's syndrome (45 XO chromosome constitution) and in
      men with Klinefelter's syndrome (47 XXY chromosome constitution). Lack of or an
      extra X chromosome produced opposite effects on cranial-base flexion, jaw
      displacement and maxillary and mandibular inclination to the anterior cranial
      base. An extra X chromosome affected deviation in sagittal jaw relation while
      lack of an X chromosome influenced mandibular shape.

PMID- 8476349
TI  - Effects of retinol on the temporal expression of transforming growth factor-alpha
      mRNA in the embryonic mouse mandible.
AB  - Development of the mouse embryonic mandible from days 9 to 14 involves tissue
      interactions in the formation of bone, cartilage, salivary glands and teeth.
      Growth factors may play an important role in these interactions. Epidermal growth
      factor (EGF) mRNA expression has been characterized and its presence has been
      shown to be necessary for odontogenesis. In addition, retinol alters the pattern
      of dental lamina formation; this effect is correlated with an alteration of the
      expression of the mRNA for this mitogen (EGF). Transforming growth factor-alpha
      (TGF alpha) mRNA expression has now been characterized by polymerase chain
      reaction for this entire period of development (days 9-14). Although the mRNA is
      present at the same time as EGF (days 9 and 10 only), retinol does not alter the
      expression of this mitogen as it does EGF. This suggests that retinoids may act
      to control the proliferative pattern of the dental lamina through EGF expression
      and not TGF alpha expression, although mRNAs for both mitogens are present at the
      same time.

PMID- 8476350
TI  - Frequency selectivity in noise-damaged cochleas.
AB  - Measures of auditory threshold and masked threshold were obtained at six
      audiometric test frequencies along with cochleograms on a total population of 363
      noise-exposed chinchillas. Seventy animals were chosen from this sample and were
      separated into five relatively homogeneous groups based upon the amount of
      permanent threshold shift and sensory cell losses the animals incurred. Tuning
      curve (TC) metrics were compared to the mean preexposure TC metrics for each
      group and to the reference preexposure TC metrics obtained from the sample of 363
      animals. These data show that in animals with relatively little hearing loss
      changes in TC metrics can provide evidence for noise-induced sensory cell losses
      and that the low frequency slope of the TC is a sensitive index of trauma.

PMID- 8476351
TI  - Progressive hearing loss in hard-of-hearing children.
AB  - A group of 92 children with bilateral sensorineural hearing loss has been
      followed up over a period of up to 15 years from the time that an initial
      reliable audiogram was obtained. This group was studied in order to determine the
      frequency of occurrence of progressive hearing loss and the relationship of the
      progressive to the presumed etiology of hearing loss. Progression of hearing loss
      was demonstrated in 21 children out of the 92 children studied. This progression
      of hearing loss was either bilateral or unilateral, and no evident relationship
      could be found between the presumed etiology of hearing loss and its
      progressivity.

PMID- 8476352
TI  - Structure of perceived handicap in middle-aged males with noise-induced hearing
      loss, with and without tinnitus.
AB  - By using a modified stepwise regression analysis technique, the structure of self
      perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing
      loss was described. Handicap was related to three clusters of variables,
      reflecting individual, environmental, and socioeconomic aspects, and 60% of the
      variance in self-perceived handicap was explained by the representatives of these
      clusters: i.e. 'acceptance of hearing problems', 'social support related to
      tinnitus' and 'years of education'. Tinnitus had no impact of its own on self
      perceived handicap and only a modest portion (36%) of the variance in tinnitus
      annoyance was explained by 'sleep disturbance' and 'auditory perceptual
      difficulties'.

PMID- 8476353
TI  - Test-retest variability of the auditory brainstem response to bone-conducted
      clicks in newborn infants.
AB  - The variability of the auditory brainstem response (ABR) to bone- and air
      conducted clicks was investigated utilizing a test-retest paradigm with 20 normal
      full-term newborn infants. ABRs to bone-conducted clicks at 15 and 30 dB nHL and
      air-conducted clicks at 30 dB nHL were obtained. The delivery of the bone
      conducted signal was controlled. ABR wave V latencies were measured from each
      test-retest stimulus condition. The results indicated no statistically
      significant difference in test-retest variability of ABR wave V latencies or
      amplitudes between bone- and air-conducted clicks. ABRs to bone-conducted clicks,
      under controlled clinical conditions, are as reproducible and reliable as ABRs to
      air-conducted clicks in newborn infants.

PMID- 8476354
TI  - Normal infant and adult auditory brainstem responses to bone-conducted tones.
AB  - Auditory brainstem responses (ABRs) were recorded to 500- and 2000-Hz bone
      conducted (BC) tones from normal infants and adults. Infant ABR thresholds for
      the 500-Hz BC tones are significantly lower than their thresholds to 2000-Hz BC
      tones. Infant wave V latencies to 500-Hz BC tones are significantly shorter than
      those of adults, whereas infant and adult responses to 2000-Hz BC tones are
      similar in latency, suggesting that the effective intensity of the BC tones may
      be 9-17 dB greater for infants than for adults. A marked asymmetry between the
      ipsilaterally and contralaterally recorded wave V is seen for infant responses to
      500- and 2000-Hz tones at all intensities; this asymmetry is not as evident in
      adults, except near threshold.

PMID- 8476355
TI  - Resistance to synthetic pyrethroids in South Australian populations of sheep lice
      (Bovicola ovis).
AB  - Lice were collected from 71 flocks detected as infested at market inspection in
      1990 and 1991, from 16 flocks where resistance was suspected and from 31 flocks
      from Kangaroo Island. Susceptibility to cypermethrin was measured by a treated
      surface technique and survival of lice at 5 ppm or greater was taken as an
      indication of resistance. The prevalence of resistance was 34% in louse
      populations from the market inspection sample, 50% in flocks in which resistance
      was suspected and 68% in flocks from Kangaroo Island. Most resistance factors
      were in the range 1 to 20 although one louse population with a resistance factor
      of 91 was found on Kangaroo Island.

PMID- 8476356
TI  - Evaluation of an ultrasonic Doppler probe for pregnancy diagnosis in cattle.
AB  - The use of an ultrasonic Doppler probe for pregnancy diagnosis was evaluated.
      Data from the examination of 1115 cattle were analysed. Comparison of the probe
      with manual rectal palpation by an experienced clinician yielded a sensitivity of
      92.8 +/- 1.6% (+/- 95% confidence interval) and a specificity of 75.8 +/- 7.4%.
      This level of accuracy was found to be insufficient to recommend the probe be
      used by farmers for the diagnosis of pregnancy.

PMID- 8476357
TI  - The surgical correction of a deviated anterior maxilla in a horse.
AB  - The surgical correction of facial deformities of the horse have rarely been
      undertaken. The surgical and medical management of submucous clefting of the
      anterior maxilla in a young colt is described.

PMID- 8476358
TI  - Intestinal parasites in dogs from an aboriginal community in New South Wales.

PMID- 8476359
TI  - Survival by sheep body lice (Bovicola ovis) after plunge dipping in synthetic
      pyrethroid lousicides.

PMID- 8476360
TI  - Diagnosis of highly pathogenic avian influenza in chickens: Bendigo 1992.

PMID- 8476361
TI  - Early history of veterinary education in Victoria.

PMID- 8476362
TI  - The threat of rabies introduction and establishment in Australia.

PMID- 8476363
TI  - Polymerase chain reaction and other laboratory techniques in the diagnosis of
      long incubation rabies in Australia.
AB  - Blood and post-mortem tissues from a 10-years-old girl were submitted to the
      Australian Animal Health Laboratory. Clinical signs and histopathological lesions
      had suggested a diagnosis of rabies, but, an unusually long incubation period of
      at least 5 years did not encourage such a diagnosis. Serological examinations by
      the rapid fluorescent focus inhibition test revealed a dramatic increase in
      rabies virus-neutralising antibody during the 10-day period of hospitalisation.
      The results of a fluorescent antibody test on brain smears, and an
      immunoperoxidase test on formalin-fixed sections of brain were also consistent
      with a diagnosis of rabies. Attempts to isolate virus were unsuccessful.
      Polymerase chain reactions (PCRs) were conducted on a 10% suspension of a post
      mortem sample from the patient's brain, using primers based on the published
      sequence of the Pasteur virus strain of rabies virus. 413 and 513 bp fragments
      from the nucleoprotein gene and a 403 bp fragment from the glycoprotein gene were
      amplified. Subsequent sequencing of these fragments, and comparison with
      equivalent regions of known rabies viruses, confirmed that the fragments
      originated from a virus belonging to the rabies virus serotype. This case
      demonstrated the advantage of using a range of laboratory techniques to obtain a
      definitive diagnosis. In particular, a PCR-based test may allow a diagnosis, even
      in the face of conditions that preclude virus isolation such as apparently
      occurred in this case. Finally, this case demonstrated that an unusually long
      incubation period should not discourage a tentative clinical diagnosis of rabies.

PMID- 8476364
TI  - The incidence and severity of intercarpal ligament damage in the equine carpus.
AB  - The arthroscopic findings in 104 intercarpal joints in 76 horses were reviewed to
      determine the incidence and severity of changes in the medial intercarpal
      ligament. Damage to the intercarpal ligament was observed in 43 joints in 35
      horses, ranging from mild fraying of the edges of the ligament to complete
      disruption of all fibres. This represented an incidence of 41% of joints being
      affected. In 9 joints examined arthroscopically primarily as a further diagnostic
      procedure, ligament damage was evident in all cases. In horses undergoing
      arthroscopic surgery primarily for the treatment of osteochondral chip or slab
      fractures, there was some correlation between the severity of articular cartilage
      damage and the presence of ligament damage.

PMID- 8476365
TI  - Restriction-endonuclease analysis of Australian isolates of Leptospira
      interrogans serovar hardjo from cattle with agalactia and abortion.
AB  - Polyacrylamide gel electrophoresis and agarose gel electrophoresis were used to
      resolve restriction endonuclease digests of 20 Australian Isolates of Leptospira
      interrogans cultured from urine samples of cattle with agalactia and abortion.
      The restriction endonuclease profiles of 19 isolates closely matched the profiles
      of L interrogans serovar hardjo subtype hardjobovis reference strains. The
      remaining isolate had a different restriction profile from subtype hardjobovis
      and subtype hardjoprajitno reference strains and was serologically identified as
      serovar pomona. Silver staining of polyacrylamide gels gave enhanced resolution
      of restriction fragments compared with the traditional method of ethidium bromide
      staining of agarose gels.

PMID- 8476366
TI  - Body fluid alterations during head-down bed rest in men at moderate altitude.
AB  - To determine the effects of hypoxia on fluid balance responses to simulated zero
      gravity, measurements were made in six subjects (acclimatized to 5,400 ft; 1,646
      m) before and during -5 degrees continuous head-down bed rest (HDBR) over 8 d at
      10,678 ft. The same subjects were studied again at this altitude without HDBR as
      a control (CON) using a cross-over design. During this time, they maintained
      normal upright day-time activities, sleeping in the horizontal position at night.
      Fluid balance changes during HDBR in hypoxia were more pronounced than similar
      measurements previously reported from HDBR studies at sea level. Plasma volume
      loss (-19% on day 6) was slightly greater and the diuresis and natriuresis were
      doubled in magnitude as compared to previous studies in normoxia and sustained
      for 4 d during hypoxia. These changes were associated with an immediate, but
      transient rise in plasma atrial natriuretic peptide (ANP) to day 4 of 140% in
      HDBR and 41% in CON (p < 0.005), followed by a decline towards baseline.
      Differences were less striking between HDBR and CON for plasma antidiuretic
      hormone and aldosterone, which were transiently reduced by HDBR. Plasma
      catecholamines showed a similar pattern to ANP (+122%) in both HDBR and CON,
      suggesting that elevated ANP and catecholamines together accounted for the
      enhanced fluid shifts with HDBR during hypoxia.

PMID- 8476367
TI  - Effects of prolonged head-down bed rest on physiological responses to moderate
      hypoxia.
AB  - To determine the effects of hypoxia on physiological responses to simulated zero
      gravity, cardiopulmonary and fluid balance measurements were made in 6 subjects
      (acclimatized to 5,400 ft) before and during 5 degrees head-down bed rest (HDBR)
      over 8 d at 10,678 ft and a second time at this altitude as controls (CON). The
      VO2max increased by 9% after CON, but fell 3% after HDBR (p < 0.05). This
      reduction in work capacity during HDBR could be accounted for by inactivity. The
      heart rate response to a head-up tilt was greatly enhanced following HDBR, while
      mean blood pressure was lower. No significant negative impact of HDBR was noted
      on the ability to acclimatize to hypoxia in terms of pulmonary mechanics, gas
      exchange, circulatory or mental function measurements. No evidence of pulmonary
      interstitial edema or congestion was noted during HDBR at the lower PIO2 and
      blood rheology properties were not negatively altered. Symptoms of altitude
      illness were more prevalent, but not marked, during HDBR and arterial blood gases
      and oxygenation were not seriously effected by simulated microgravity. Declines
      in base excess with altitude were similar in both conditions. The study
      demonstrated a minimal effect of HDBR on the ability to adjust to this level of
      hypoxia.

PMID- 8476368
TI  - Effects of 28-day isolation (ESA-ISEMSI'90) on blood pressure and blood volume
      regulating hormones.
AB  - The aim of this study was to determine what effects social isolation and
      confinement stress had on the volume regulating hormones. In six healthy male
      subjects, during a 28-d isolation and confinement study (ESA-ISEMSI'90),
      hematocrit, blood pressure and resting heart rate, plasma cortisol, renin,
      aldosterone, arginine vasopressin levels besides the electrolyte (Na+, K+)
      balance and plasma creatinine were measured. During the confinement, an elevated
      systolic blood pressure (p < 0.01) was observed together with an increase in MHPG
      corresponding to an elevated mental work load. The pattern displayed by volume
      regulating hormones (increased values for renin, aldosterone (p < 0.05) and
      arginine vasopressin) was not only characteristic of confinement stress but also
      reflected changes in the water and electrolyte metabolism. The increased
      creatinine levels seen throughout the study were regarded as consequences of
      hypohydration, and an enhanced muscular catabolism due to reduced physical
      activity. A similar pattern of hormone modifications was obtained in a head down
      tilt of the same duration, indicating that some of the described modifications
      are probably related to isolation and confinement stress.

PMID- 8476369
TI  - Changes in body fluid compartments during hypohydration and rehydration in heat
      acclimated tropical subjects.
AB  - Body fluid compartments at different levels of graded hypohydration and partial
      rehydration were determined using radiotracers in 28 heat-acclimated, male
      volunteers from tropical regions of India, in hot dry conditions in a climatic
      chamber. These subjects were hypohydrated to varying degrees (i.e., 1%, 2%, 3%,
      and 4% body mass deficit) by moderate work in hot conditions in a climatic
      chamber maintained at 45 degrees C dry bulb temperature and 30% relative
      humidity. Rehydration study was carried out only in those subjects who were
      hypohydrated to 3% and 4% body mass and who were brought back to 2% level of
      hypohydration by receiving a calculated amount of water. Up to the 2% level of
      hypohydration, a major contribution towards sweat loss was observed from the
      interstitial fluid (ISF) compartment. At higher levels of hypohydration, no
      further significant loss from ISF was seen, though significant losses in
      intracellular fluid (ICF) and plasma volume (PV) were apparent. The present study
      also found that at the 4% hypohydration level, a maximum fluid contribution was
      met by the ICF compartment. Significant increases observed in sweat K+ at 3 and
      4% also indicate the ICF mobilization, which is rich in K+ ions. On partial
      rehydration, the ISF compartment held the repletion fluid in excess, and was
      found to be enough to restore sweat rate to euhydration level. This study clearly
      indicates that sudorific gain is achieved with partial restoration alone in
      subjects hypohydrated to 3 and 4% levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476370
TI  - Postural stabilization on a moving platform oscillating at high frequencies.
AB  - The effect of a fore-aft oscillating platform on postural stability was studied
      in nine healthy volunteers. The force platform technique was used with automatic
      analysis that evaluated the position of the center point of force as a function
      of time. The duration of stimulation lasted 90 s and the perturbation frequencies
      ranged from 8 to 24 Hz, and were given at constant rms acceleration of 4 m/s2.
      When compared with a vibration-free baseline stance, horizontal vibration of the
      platform caused significantly worse postural stability in all subjects. Test
      frequencies of 8 and 10 Hz produced greater sway velocities than perturbation at
      frequencies of 14 and 16 Hz. The results indicate that horizontal perturbation of
      the support surface leads to postural instability that is frequency-dependent.

PMID- 8476371
TI  - Muscle mitochondrial density after exhaustive exercise in dogs: prolonged
      restricted activity and retraining.
AB  - The effect of exhaustive treadmill exercise on mitochondrial density (MD) and
      ultrastructural changes in quadriceps femoris muscle was studied in 7 normal,
      healthy, male mongrel dogs (2-4 years, 15-20 kg) before and after restricted
      activity (RA) (2 months for 5 dogs, 5 months for 2 dogs), and following a
      subsequent 2-month exercise retraining period (2-months group). Mean (+/- S.E.)
      time to exhaustion in the 2-month group decreased from 177 +/- 11 min before to
      90 +/- 16 min (delta = -49%, p < 0.05) after RA; retraining increased tolerance
      to 219 +/- 36 min (delta = +24%, p < 0.05) above the pre-RA and 143% (p < 0.05)
      above the post-RA time. Post-RA exhaustion time in the 5-months group was 25 and
      45 min (35 +/- 10 min). Muscle samples taken after RA showed abnormalities
      indicative of degeneration, which were reversed by retraining. Resting MD
      decreased (p < 0.05) from a control level of 27.8% to 14.7% (2 months) and 16.3%
      (5 months), and was restored to 27.1% (NS) after retraining. Exhaustive exercise
      caused an increase in MD under control conditions and after RA, but not following
      retraining. Disruption of mitochondria after exercise was evident after 5-months
      confinement. Factors causing mitochondrial changes and eventually their
      disruption during exercise after restricted activity are not related as much to
      the state of fatigue as to the pre-exercise quality of the muscle modified by
      disease or training.

PMID- 8476372
TI  - Alcoholism and treatment in airline aviators: one company's results.
AB  - Airline transport pilots are at risk for alcoholism, although prevalence
      statistics are not known. (Alcoholism is used to mean alcohol dependence as
      defined in DSM-III-R.) Whether their prevalence of alcoholism is consistent with
      that of the general population's, less, or possibly enhanced by psychological
      vulnerabilities, is considered. However, the development and implementation of
      this job-based, peer-oriented alcohol treatment can be an asset to pilot career
      progression and airline pilot retention. According to a retrospective analysis of
      identified aviators, 87% of alcoholic pilots of this major airline returned to
      flight duties after substance abuse treatment. Relapse occurred in 13% of those
      accepting treatment. Early identification and treatment of the substance-abusing
      aviator can be enhanced by encouraging teamwork between pilots, union, airline
      management, flight surgeons, and employee assistance program professionals.

PMID- 8476373
TI  - Unregulated self-medication in an ambulatory surgery population.
AB  - The objective of this study was to determine whether unregulated self-medication
      in an ambulatory surgery population was a significant problem in terms of the
      incidence and nature of drugs detected. We asked 67 consecutive patients who
      presented for elective ambulatory surgery at a university medical center to
      volunteer for serum and urine testing with the assurance of confidentiality. All
      patients denied nonprescription drug use. Initial testing was for amphetamines,
      barbiturates, benzodiazepines, cocaine, opiates, phencyclidine (PCP),
      tetrahydrocannabinol (THC) and alcohol. Of the 64 patients who agreed to be
      tested, 16 patients tested positive for at least one of the above substances; 4
      patients demonstrated residua of 2 or 3 substances. No distinctive characteristic
      of those with evidence of drug use could be identified. We believe that the 25%
      of patients who tested positive in this group is a conservative estimate of
      possible unrecognized drug use. We have demonstrated a significant incidence of
      substance abuse in the ambulatory surgery environment. These findings have
      serious safety implications, and a higher awareness of possible nonprescription
      drug use in this environment is needed in medical and support personnel.

PMID- 8476374
TI  - Bibliographic guide to publications in aerospace medicine and related topics.
AB  - This bibliographic guide is a comprehensive listing of international publications
      (books) in Clinical Aerospace Medicine, Operational Aerospace Medicine, Aerospace
      Physiology, Environmental Medicine/Physiology, Diving Medicine/Physiology,
      Aerospace Human Factors, as well as other important topics directly or indirectly
      related to aerospace medicine. This guide will be useful as a primary source of
      consultation for bibliographic information; especially to those colleagues who
      are in their formative years, and to those who do not have easy access to
      computer-aided literature search systems. This bibliographic guide does not
      constitute a recommendation or an endorsement of any of the publications listed
      herein and the merits or limitations of each publication should be judged by the
      reader.

PMID- 8476375
TI  - Cases from the aerospace medicine residents' teaching file. Case #53. Retained
      renal calculi.

PMID- 8476376
TI  - A survey of blood lipid levels of airline pilot applicants.

PMID- 8476377
TI  - Chronic effects of trimipramine, an antidepressant, on hippocampal synaptic
      plasticity.
AB  - The effects of trimipramine (TRIM), an antidepressant agent, on both the
      induction and the maintenance of long-term potentiation (LTP) was investigated in
      area CA1 of hippocampal slice preparations. Chronic administration (7-9 days) of
      TRIM in rat caused a large reduction in the magnitude of LTP induced by a theta
      burst stimulation (TBS) paradigm. Results indicate that the reduction of LTP
      produced by trimipramine does not seem to result from major changes in the
      physiological properties of the slice preparations. First, paired-pulse
      facilitation was not impaired following the drug administration suggesting that
      transmitter release was not modified in TRIM-treated slices. Second, the burst
      responses evoked by high-frequency stimulation exhibited the typical buildup of
      depolarization, which is due to both a reduction of IPSPs and the activation of
      NMDA receptors. Finally, the treatment did not change the amount of short-term
      potentiation induced by TBS nor did it modify the component of excitatory
      postsynaptic potentials (EPSPs) mediated by the activation of NMDA receptors,
      suggesting that the NMDA receptor functions remained intact in TRIM-treated
      slices. Taken together the present data suggest that the loss of LTP maintenance
      in TRIM-treated animals is more likely the result of the disruption by
      trimipramine of cellular processes that follow LTP induction. In addition, the
      results provide evidence for a possible correlation between the reduction in LTP
      expression and learning deficits produced by chronic administration of
      trimipramine.

PMID- 8476378
TI  - Continuous recognition of spatial and nonspatial stimuli in hippocampal-lesioned
      rats.
AB  - The present experiments compared the performance of hippocampal-lesioned rats to
      control rats on a spatial continuous recognition task and an analogous nonspatial
      task with similar processing demands. Daily sessions for Experiment 1 involved
      sequential presentation of individual arms on a 12-arm radial maze. Each arm
      contained a Froot Loop reinforcement the first time it was presented, and latency
      to traverse the arm was measured. A subset of the arms were repeated, but did not
      contain reinforcement. Repeated arms were presented with lags ranging from 0 to 6
      (0 to 6 different arm presentations occurred between the first and the repeated
      presentation). Difference scores were computed by subtracting the latency on
      first presentations from the latency on repeated presentations, and these scores
      were high in all rats prior to surgery, with a decreasing function across lag.
      There were no differences in performance following cortical control or sham
      surgery. However, there was a total deficit in performance following large
      electrolytic lesions of the hippocampus. The second experiment employed the same
      continuous recognition memory procedure, but used three-dimensional visual
      objects (toys, junk items, etc., in various shapes, sizes, and textures) as
      stimuli on a flat runway. As in Experiment 1, the stimuli were presented
      successively and latency to run to and move the object was measured. Objects were
      repeated with lags ranging from 0 to 4. Performance on this task following
      surgery did not differ from performance prior to surgery for either the control
      group or the hippocampal lesion group. These results provide support for Kesner's
      attribute model of hippocampal function in that the hippocampus is assumed to
      mediate data-based memory for spatial locations, but not three-dimensional visual
      objects.

PMID- 8476379
TI  - Social condition affects the courtship behavior of male ring doves with posterior
      medial hypothalamic lesions.
AB  - Following bilateral lesions to the posterior medial hypothalamus (homologue of
      the mammalian ventromedial nucleus), adult male ring doves regain full courtship
      behavior and the ability to stimulate female egg-laying when housed continuously
      with females. Males with PMH lesions housed singly and only tested periodically
      with females continue to show deficits in courtship. These findings suggest that
      the social environment present in adulthood itself can directly influence
      recovery from brain lesions. They also demonstrate the importance of PMH in the
      mediation of male ring dove courtship behavior.

PMID- 8476380
TI  - Spontaneously hypertensive rats (SHR) readily learn to vary but not repeat
      instrumental responses.
AB  - When spontaneously hypertensive rats (SHR) and Wystar-Kyoto normotensive control
      rats (WKY) were rewarded in a 12-arm radial maze (Experiment 1), the SHRs varied
      their arm choices more, making fewer repetition errors than the WKYs. Similarly
      when rewards depended on variable sequences of responses on two levers in an
      operant chamber (Experiment 2), SHRs' sequences were more variable than those of
      WKYs. A requirement for response variability was then combined with a requirement
      to repeat selected responses in the radial maze (Experiment 3) and operant
      chamber (Experiment 4). WKYs learned to repeat more readily than the SHRs,
      whereas SHRs varied more readily. Thus, when subjects had to repeat responses,
      SHRs were at a disadvantage, but when variability was adaptive, SHRs excelled.
      The high variability of SHRs, together with their difficulty in learning to
      repeat, may have parallels in children diagnosed with attention deficit disorder
      with hyperactivity (ADDH).

PMID- 8476381
TI  - Alterations to the pattern of ultrasonic calling after prenatal exposure to
      aluminium sulfate.
AB  - Pregnant CBA mice were exposed to aluminium sulfate at a dose of 200 mg/kg body
      wt injected intraperitoneally during Days 10 to 13 of gestation. We used a
      variety of ethological measures, which have been shown to be sensitive indicators
      of toxicants, to assess effects on the mother and the behavioral development of
      pups. Prenatal aluminium resulted in a reduction in the rate of ultrasonic
      calling by pups accompanied by a shift in the timing of peak calling; treated
      pups exhibited decreased growth and delays in neurobehavioral development. The
      treatment received by a pup's foster mother was also found to influence
      development. We recommend ultrasonic calling as a sensitive measure in studies of
      behavioral teratogenicity.

PMID- 8476382
TI  - D-cycloserine attenuates scopolamine-induced learning and memory deficits in
      rats.
AB  - The muscarinic antagonist scopolamine (SCOP; 1.0 mg/kg, ip) impaired both the
      acquisition of a learning task in the Morris water maze (MWM) and choice accuracy
      in the T-maze reinforced alternation procedure in rats. Acetylcholinesterase
      inhibitors (AChEIs) have been shown to attenuate these deficits. D-Cycloserine
      (DCS), a partial agonist at the strychnine-insensitive glycine site on the N
      methyl-D-aspartate (NMDA) receptor complex, was investigated for its effects on
      SCOP-induced dementia in the MWM and T-maze paradigms. Combined administration of
      SCOP and DCS (3.0, 10.0, or 30.0 mg/kg, ip; 30 min pretreat) significantly
      reversed SCOP-induced deficits in the T-maze as measured by percentage correct
      choices. In addition, DCS (3.0 or 10.0 mg/kg, ip) significantly attenuated SCOP
      induced deficits in the MWM as measured by latency to find the submerged
      platform. For comparison, the long-acting acetylcholinesterase inhibitor
      galanthamine (GAL) was tested in the T-maze (1.25, 2.5, or 5.0 mg/kg, ip) and the
      MWM (2.5 or 5.0 mg/kg, ip). GAL attenuated SCOP-induced deficits in both learning
      and memory models similar to DCS. These data suggest that the strychnine
      insensitive partial glycine agonist, D-cycloserine, may be efficacious in disease
      states of central cholinergic hypofunction such as Alzheimer's disease.

PMID- 8476383
TI  - The depth profile of electrically induced tectal sustained potential shift
      responses in the goldfish (Carassius auratus).
AB  - Tectal sustained potential shifts (SPSs) were recorded in response to electrical
      stimulation of the tectal surface in immobilized goldfish using saline-filled
      glass microelectrodes. The peak amplitudes of surface recorded SPS responses were
      negative, this negativity declining with increasing tectal depth, reversing in
      polarity at a depth of ca. 350 microns and subsequently increasing in positivity.
      These opposing SPS polarities are attributed to field potentials generated by the
      source and sink of extracellular K+ ([K+]e) redistribution through a functional
      syncitium of radially connected glia.

PMID- 8476384
TI  - Effect of the tail ganglion on swimming activity in the leech.
AB  - In the medicinal leech, Hirudo medicinalis, isolated segmental nerve cords are
      capable of generating swimming activity. The role played by the head and tail
      ganglia in regulating the expression of swimming activity by the segmental nerve
      cord was evaluated by comparing swimming activity in nerve cord preparations with
      and without the head and tail ganglia attached. Several swim properties were
      examined, including length of induced swim episodes, ability to initiate swim
      episodes, swim cycle period, and phase. We found that, in general, the presence
      of the tail ganglion attached to isolated nerve cords countered the effects
      produced by the head ganglion on swimming activity. Moreover, we observed that
      the tail ganglion itself provides excitatory drive to the swim generating system.
      Thus, the inputs from the head and tail ganglia influence significantly the
      expression of swimming activity.

PMID- 8476385
TI  - A role for hippocampus in the utilization of hunger signals.
AB  - The hippocampus is generally regarded as an important anatomical substrate for
      learning and memory (e.g., Eichenbaum, Otto, & Cohen, Behavioral and Neural
      Biology, 57, 2-36, 1992; Squire, Psychological Review, 99, 195-231, 1992). In the
      present research, we provide evidence that the hippocampus is also involved with
      another function--utilization of hunger state signals. Rats with selective
      ibotenate lesions of the hippocampus were found to be impaired in their ability
      to discriminate between the interoceptive sensory consequences of food
      deprivation and satiation. At the same time the ability of these rats to
      discriminate between different exteroceptive cues was unaffected. These results
      suggest that deficits in discriminative performance were specific to
      interoceptive state stimuli. In addition, hippocampal-damaged rats also seemed
      unable to use their food deprivation stimuli as signals to engage in normal
      feeding behavior. Our results argue that although the hippocampus may be
      important for learning and memory processes, it also deserves consideration as a
      neural substrate for the regulation of food intake and perhaps other functions
      which involve interoceptive signals.

PMID- 8476386
TI  - Memory expression is blocked by the infusion of CNQX into the hippocampus and/or
      the amygdala up to 20 days after training.
AB  - Bilateral infusion of CNQX (0.5 microgram) into the amygdala and the dorsal
      hippocampus prior to a retention test blocked the expression of step-down
      inhibitory avoidance in rats 6, 13, or 20 days after training. Retention test
      performance recovered 90 min after the infusions. Pretest intrahippocampal CNQX
      (0.5 microgram) blocked the expression of habituation to a novel environment
      measured 20 days after training. The data suggest that memory expression depends
      on non-NMDA receptor-mediated mechanisms, perhaps the expression of LTP, up to at
      least 20 days after acquisition. These mechanisms operate in the hippocampus in
      both tasks and in the amygdala in the avoidance task.

PMID- 8476387
TI  - Chronic administration of alcohol in the developing rat: expression of functional
      tolerance and alcohol olfactory aversions.
AB  - Three experiments were designed to evaluate the acquisition and expression of
      tolerance to ethanol in preweanling rats. Administrations were begun on Postnatal
      Day 13 (PD13) and continued, on alternating days, through PD23. Following either
      three or five administrations of a 2.5 g/kg dose of ethanol, animals expressed
      tolerance to the motor-impairing consequences of acute ethanol, as measured
      through attenuated latencies to perform a righting reflex. However, no tolerance
      was evident when it was assessed through the hypothermic response to ethanol
      delivery (Experiment 1). The results of subsequent experiments suggested that
      this tolerance was not due to lower levels of ethanol in the blood and brain of
      the chronically exposed subjects (Experiment 2) nor to the development of
      behavioral tolerance, such as learning to perform the motor task in the presence
      of intoxication (Experiment 3). Additional tests determined that tolerance level
      did not alter the infant rats' ability to learn about the orosensory cues
      associated with ethanol delivery. Specifically, tests confirmed previous studies
      that an aversion to ethanol odor was formed as a result of the chronic
      administration procedure, presumably due to the animals associating the
      orosensory properties of eliminated ethanol during intoxication with the aversive
      consequences of this state. These results provide evidence that tolerance can
      develop in the preweanling rat, and that at least one measure (righting reflex)
      can be used to assess its development early in life.

PMID- 8476388
TI  - A test of the equal-environment assumption in twin studies of psychiatric
      illness.
AB  - The traditional twin method is predicated on the equal-environment assumption
      (EEA)--that monozygotic (MZ) and dizygotic (DZ) twins are equally correlated in
      their exposure to environmental events of etiologic importance for the trait
      under study. In 1968, Scarr proposed a test of the EEA which examines the impact
      of phenotypic similarity in twins of perceived versus true zygosity. We apply
      this test for the EEA to five common psychiatric disorders (major depression,
      generalized anxiety disorder, phobia, bulimia, and alcoholism), as assessed by
      personal interview, in 1030 female-female twin pairs from the Virginia Twin
      Registry with known zygosity. We use a newly developed model-fitting approach
      which treats perceived zygosity as a form of specified familial environment. In
      158 of the 1030 pairs (15.3%), one or both twins disagreed with the project
      assigned zygosity. Model fitting provided no evidence for a significant influence
      of perceived zygosity on twin resemblance for any of the five disorders. Although
      limited in power, these results support the validity of the EEA in twin studies
      of psychiatric disorders.

PMID- 8476389
TI  - Testing hypotheses about direction of causation using cross-sectional family
      data.
AB  - We review the conditions under which cross-sectional family data (e.g., data on
      twin pairs or adoptees and their adoptive and biological relatives) are
      informative about direction of causation. When two correlated traits have rather
      different modes of inheritance (e.g., family resemblance is determined largely by
      family background for one trait and by genetic factors for the other trait),
      cross-sectional family data will allow tests of strong unidirectional causal
      hypotheses (A and B are correlated "because of the causal influence of A on B"
      versus "because of the causal influence of B on A") and, under some conditions,
      also of the hypothesis of reciprocal causation. Possible sources of errors of
      inference are considered. Power analyses are reported which suggest that multiple
      indicator variables will be needed to ensure adequate power of rejecting false
      models in the presence of realistic levels of measurement error. These methods
      may prove useful in cases where conventional methods to establish causality, by
      intervention, by prospective study, or by measurement of instrumental variables,
      are unfeasible economically, ethically or practically.

PMID- 8476390
TI  - Analyzing twin resemblance in multisymptom data: genetic applications of a latent
      class model for symptoms of conduct disorder in juvenile boys.
AB  - A model based on the latent class model is developed for the effects of genes and
      environment on multivariate categorical data in twins. The model captures many
      essential features of dimensional and categorical conceptions of complex
      behavioral phenotypes and can include, as special cases, a variety of major locus
      models including those that allow for etiological heterogeneity, differential
      sensitivity of latent classes to measured covariates, and genotype x environment
      interaction (G x E). Many features of the model are illustrated by an application
      to ratings on eight items relating to conduct disorder selected from the Rutter
      Parent Questionnaire (RPQ). Mothers rated their 8- to 16-year-old male twin
      offspring [174 monozygotic (MZ) and 164 dizygotic (DZ) pairs]. The impact of age
      on the frequency of reported symptoms was relatively slight. Preliminary latent
      class analysis suggests that four classes are required to explain the reported
      behavioral profiles of the individual twins. A more detailed analysis of the
      pairwise response profiles reveals a significant association between twins for
      membership of latent classes and that the association is greater in MZ than DZ
      twins, suggesting that genetic factors played a significant role in class
      membership. Further analysis shows that the frequencies of MZ pairs discordant
      for membership of some latent classes are close to zero, while others are
      definitely not zero. One possible explanation of this finding is that the items
      reflect underlying etiological heterogeneity, with some response profiles
      reflecting genetic categories and others revealing a latent environmental risk
      factor. We explore two "four-class" models for etiological heterogeneity which
      make different assumptions about the way in which genes and environment interact
      to produce complex disease phenotypes. The first model allows for genetic
      heterogeneity that is expressed only in individuals exposed to a high-risk
      ("predisposing") environment. The second model allows the environment to
      differentiate two forms of the disorder in individuals of high genetic risk. The
      first model fits better than the second, but neither fits as well as the general
      model for four latent classes associated in twins. The results suggest that a
      single-locus/two-allele model cannot fit the data on these eight items even when
      we allow for etiological heterogeneity. The pattern of endorsement probabilities
      associated with each of the four classes precludes a simple "unidimensional"
      model for the latent process underlying variation in symptom profile in this
      population. The extension of the approach to larger pedigrees and to linkage
      analysis is briefly considered.

PMID- 8476391
TI  - Factors modulating preferences of female house mice for males differing in t
      complex genotype: role of t-complex genotype, genetic background, and estrous
      condition of females.
AB  - The present study investigates factors mediating odor and social preferences in
      female house mice (Muc domesticus) based on the t-complex genotype of males.
      Previous studies in this laboratory showed that females prefer the odors of wild
      type (+/+) males over those that carry lethal genes (+/t). The purpose of this
      study was to determine the genetic, hormonal, and environmental factors that
      regulate these preferences. The variables examined include t-complex genotype,
      genetic background, estrous condition of test females (+/+ or +/t), and genotype
      of the test female's parents. Results indicate that female preferences for +/+
      males are dependent upon the t-complex genotype and estrous condition of test
      females. Only +/t females in estrus showed preferences for +/+ males. Estrous
      cycle condition effects were seen in both wild (+/+w5) and inbred (129
      +/tw5)females. Homozygous females (+/+) and diestrous females of both genotypes
      did not demonstrate preferences for either +/+ or +/t males.

PMID- 8476392
TI  - Bi- and multivariate analyses of diallel crosses: a tool for the genetic
      dissection of neurobehavioral phenotypes.
AB  - The genetic-correlational approach provides a very powerful tool for the analysis
      of causal relationships between phenotypes. It appears to be particularly
      appropriate for investigating the functional organization of behavior and/or
      causal relationships between brain and behavior. A method for the bivariate
      analysis of diallel crosses that permits the estimation of correlations due to
      environmental effects, additive-genetic effects, and/or dominance deviations is
      described, together with a worked-out example stemming from a five times
      replicated 4 x 4 diallel cross between inbred mouse strains. The phenotypes
      chosen to illustrate the analysis were locomotor activity and rearing frequency
      in an open field. Large, positive additive-genetic and dominance correlations
      between these two phenotypes were obtained. This finding was replicated in
      another, independently executed, diallel cross.

PMID- 8476393
TI  - A maximum-likelihood model-fitting approach to conducting a Hayman analysis of
      diallel tables with complete or missing data.
AB  - A method is presented for conducting a Hayman analysis of non-replicated diallel
      tables using a maximum-likelihood (ML) model-fitting approach, rather than a
      traditional analysis of variance (ANOVA) approach. Hayman's linear model for a
      diallel analysis is used to generate a table of expected cell means. This table
      of expected cell means is fit to a table of observed cell means, and the fit is
      assessed using a chi-square value. Often data collected from diallel crosses fail
      to meet the underlying assumptions of ANOVA. The ML method makes no assumptions
      about equal cell sizes or homogeneity of variance. Thus, the ML method for
      diallel analysis provides some statistical advantages over ANOVA methods. The ML
      method also offers the advantage of having the ability to analyze diallels with
      missing cells. Using the ML method, incomplete diallel tables can be analyzed,
      and the partitioning of all the sources of variation in a diallel table is still
      accomplished from the remaining crosses. These advantages make the ML method an
      attractive approach for extracting the maximum amount of information from a
      diallel table.

PMID- 8476394
TI  - Bidirectional selection for female receptivity in Drosophila melanogaster.
AB  - A wild population of Drosophila melanogaster was subjected to selection for high
      and low female receptivity. Selection was only applied in females on the basis of
      the mating times observed in a 30-min period. We applied a selection paradigm
      that allowed us to conclude that females unmated after 30 min correspond to the
      truncated upper tail of the distribution underlying mating times. Selection was
      successful, with mean mating times of about 5 min for the high lines, 35 min for
      the low lines, and 12 min for the control. Receptivity of the selection lines
      remained steady after 42 generations of relaxed selection, suggesting a lack of
      natural selection on receptivity in laboratory conditions. We also found a clear
      relationship between high or low receptivity and high or low frequency of
      hybridization with D. simulans males, emphasizing the role of female receptivity
      in maintaining isolation with its sibling species D. simulans.

PMID- 8476395
TI  - Female song preference and the period gene in Drosophila.
AB  - Mutations at the period (per) locus in Drosophila melanogaster alter rhythmic
      components of the male courtship song. We have examined the mating speed of
      females homozygous for mutant per alleles when presented with artificial mutant
      songs. Mutant females retain a preference for wild-type over mutant songs, thus
      male song and female preference are probably under separate genetic control. In
      contrast, per-mutant females from an established laboratory stock which had been
      maintained for nearly two decades appear to have an enhanced response to the
      corresponding mutant song in that they no longer discriminate against mutant
      song. These results are discussed in terms of the "genetic coupling" and
      "coevolution" theories of complementarity between male and female components of
      communication system.

PMID- 8476396
TI  - Identification of stimuli that mediate experience-dependent modification of
      homosexual courtship in Drosophila melanogaster.
AB  - A naive, sexually mature D. melanogaster male tested with a young, sexually
      immature male will perform vigorous courtship, but the mature male will perform
      much less courtship if he is subsequently tested with a second young male. This
      phenomenon is called experience-dependent courtship modification (EDCM). We have
      shown that exposure to either or both of the two courtship-stimulating pheromones
      that immature males synthesize is sufficient to induce EDCM.

PMID- 8476397
TI  - The effect of anesthesia on the photoresponses of four sympatric species of
      Drosophila.
AB  - Five isofemale strains from each of four sympatric species, Drosophila immigrans,
      D. repleta, D. melanogaster, and D. affinis, were lightly anesthetized with
      ether, CO2, Flynap, or cold temperature. The photoresponse of each treatment
      group was measured in an open field and a Y-tube apparatus. Relative light values
      were compared with those of the unanesthetized control groups of each species, as
      well as among the different treatments themselves and among species. Significant
      differences between species were apparent for all treatments in the Y-tube and
      for all treatments except ether and CO2 in the open field. Response to anesthesia
      may differ between species due, in part, to their differing genotypes. Comparing
      treatment groups within species in the Y-tube design, all species except D.
      melanogaster showed significant differences between treatments. In the open
      field, only D. affinis was significantly affected. Particularly in the Y-tube,
      anesthetized flies generally differed significantly from the controls, indicating
      that the use of anesthesia during a behavioral study could cause deviations in
      behavior from that of normal unanesthetized flies.

PMID- 8476398
TI  - Putting the family back in the child.
AB  - As clinicians and scientists we see daily the close tie between parental
      competence and emotional functioning and how children succeed with many of life's
      stressors. Inadequate attention has been paid to the theoretical underpinnings of
      predicting children's emotional reactions to stress from a systems perspective.
      Longitudinal developmental studies of parental influence on children's ability to
      cope with life's frustrations, through reciprocal interactions and genetic
      predispositions, are mandatory. Theoretical frameworks are already developed
      which must be drawn on to derive the best predictions of when and how to involve
      our child patients with family support. The current essay will attempt to bridge
      family systems and social network theories to the understanding of children's
      coping with medical stressors.

PMID- 8476399
TI  - Reality monitoring in obsessive-compulsive disorder.
AB  - Individuals with obsessive-compulsive disorder (OCD) often doubt whether they
      have performed an action or merely imagined having performed it. Such doubts
      suggest that OCD patients may have deficits in reality monitoring--the ability to
      distinguish memories of doing from memories of imagined doing. We compared the
      reality monitoring abilities of OCD checkers, OCD noncheckers and normal control
      Ss. Although we found no evidence of reality monitoring deficits in OCD patients,
      they tended to express less confidence in their memories relative to control Ss.
      These findings suggest that obsessional doubt may reflect deficits in memory
      confidence rather than deficits in memory per se.

PMID- 8476400
TI  - Cognitive processes in social phobia.
AB  - Social phobics, anxious controls and non-patient controls took part in a brief
      videotaped conversation with a stooge in order to investigate the cognitive model
      of social phobia. Thoughts, behaviour, and attention during the conversation were
      assessed. Compared to the control groups, social phobics had more negative self
      evaluative thoughts, performed less well, and systematically underestimated their
      performance. There were no differences in attention between the three groups.
      Content analysis of thought sampling data from the conversation, and from three
      hypothetical situations, revealed that few of the negative thoughts reported by
      social phobics explicitly mentioned evaluation by other people. This suggests
      that social phobics may not closely monitor other people's responses in social
      situations and hence that their thoughts are not data driven. The results are
      discussed in relation to the cognitive model of social phobia and suggestions are
      made for improvements in the treatment of social phobia.

PMID- 8476401
TI  - Somatic symptoms and panic attacks: a retrospective study of learning
      experiences.
AB  - Individuals with panic attacks evaluate physical anxiety symptoms as dangerous
      and tend to respond to them with fear. In a retrospective questionnaire study, we
      explored childhood and adolescent learning experiences with respect to somatic
      symptoms of panickers. Compared to normal controls (N = 61), patients with panic
      disorder (N = 121), infrequent panickers (N = 86) and patients with other anxiety
      disorders (N = 38) reported more frequent instances prior to age 18 when they had
      experienced symptoms like dizziness, shortness of breath, palpitations or nausea,
      accompanied by special attention from their parents and instructions to restrain
      from strenuous or social activities. The differences were due to higher symptom
      frequencies in the anxiety groups. All anxiety groups reported more frequent
      uncontrolled behavior of their parents than controls. Patients with panic
      disorder and infrequent panickers reported that their parents had suffered more
      frequently from physical symptoms typical of anxiety than patients with other
      anxiety disorders or normal controls. Panickers, but not patients with other
      anxiety disorders, had observed sick-role behavior related to panic symptoms in
      their parents more often than controls. Panic attack Ss reported a higher number
      of household members suffering from chronic illnesses than controls and patients
      with other anxiety disorders. No group differences were found in the reported
      behavior of parents when Ss had colds. Overall, the results point to the role of
      severe illnesses and physical symptoms typical of anxiety in significant others
      in the history of Ss with panic attacks. These experiences during childhood and
      adolescence may contribute to their belief that physical symptoms are dangerous.
      In contrast, there was no specificity for panic with respect to the Ss' own
      physical symptoms or cold-related symptoms.

PMID- 8476402
TI  - Group cognitive-behavioral treatment of panic disorder.
AB  - The present study examined the efficacy of an 8-wk, cognitive-behavioral group
      treatment for panic disorder. Patients meeting DSM-III-R criteria for panic
      disorder with or without agoraphobia were randomly assigned to treatment (N = 34)
      or delayed treatment control (N = 33). The treatment consisted of: (a) education
      and corrective information; (b) cognitive therapy; (c) training in diaphragmatic
      breathing; and (d) interoceptive exposure. At posttreatment, 85% of treated Ss
      were panic free, compared to 30% of controls. Treated Ss also showed clinically
      significant improvement on indices of anxiety, agoraphobia, depression and fear
      of fear. Recovery, as estimated conservatively by the attainment of normal levels
      of functioning on each of the major clinical dimensions of the disorder (i.e.
      panic, anxiety and avoidance), was achieved in 64% of the treated Ss and 9% of
      the controls. At the 6 month follow-up, 63% of the treated patients met criteria
      for recovery. These findings mirror those from recently-completed trials of
      individually-administered cognitive-behavioral treatment, and suggest that CBT is
      a viable alternative to pharmacotherapy in the treatment of panic disorder.

PMID- 8476403
TI  - Helpless behavior.
AB  - In the present research, we investigated helpless behavior and the responses it
      elicits from others. Study One used the act-frequency approach to develop a self
      report measure of prototypically helpless behaviors. In a sample of college
      students (n = 75), this measure was validated against ratings by others. Many of
      the prototypically helpless behaviors we identified were interpersonal in nature,
      implying that they entail dependency and perhaps manipulativeness. In Study Two,
      we asked young adult (n = 249) Ss how they responded to people who showed varying
      amounts of helplessness. The most frequent response was trying to help the
      helpless individual feel better. As the frequency of helpless behavior increased,
      people were less likely to try to make him or her feel better, less likely to go
      along with the helpless individual, more likely to become angry and more likely
      to ignore or avoid this individual. Implications of these results for
      applications of the learned helplessness model were discussed, in particular the
      need to be cautious in assuming that all instances of observed passivity are good
      examples of learned helplessness.

PMID- 8476404
TI  - Psychological aspects of irritable bowel syndrome: comparisons with inflammatory
      bowel disease and nonpatient controls.
AB  - Patients with irritable bowel syndrome (IBS) (n = 121) were compared to 46
      patients with inflammatory bowel disease (IBD), and to 45 nonpatient controls on
      a variety of psychological tests and on symptomatology. The most consistent
      finding was the ordering of group psychological test means such that, on 11 of 14
      measures, IBS patients scored higher than IBD patients, who in turn scored higher
      than the nonpatient controls. The two patient groups differed significantly only
      on measures of anxiety with the IBS patients scoring significantly higher on all
      three measures. IBS patients also reported significantly more severity of
      abdominal pain than the IBD patients; while IBD patients reported more episodes
      of diarrhea, they did not rate them as significantly more severe than did the IBS
      patients. Various other parameters of the IBS population are also explored and
      implications for treatment and future study are discussed.

PMID- 8476405
TI  - The revised Stroop color-naming task in social phobics.
AB  - Information processing was examined in a sample of social phobic individuals
      using a revised version of the Stroop color-naming task. In the first of two
      experiments, the response latencies of social phobics and matched community
      controls were compared when color-naming socially threatening words, physically
      threatening words and color words. Social phobics demonstrated greater response
      latencies regardless of type of stimulus word and additional interference in
      color-naming social threat words compared to the control group. The second
      experiment examined the cognitive structural change that has been hypothesized to
      accompany successful treatment of individuals with an anxiety disorder. Social
      phobics who were treated with cognitive-behavioral group therapy, phenelzine or
      pill placebo were classified as treatment responders or nonresponders, and their
      latencies to color-naming on the Stroop task were compared. Treatment responders
      showed a significant reduction in latencies to color-name social threat words (vs
      matched control words) while nonresponders did not. This effect was not
      demonstrated with color words or physically threatening words. Clinical
      implications and future research directions are discussed.

PMID- 8476406
TI  - Identification of trichotillomania cue profiles.
AB  - To explore the usefulness of emotional and environmental cues in distinguishing
      different patterns and potential subtypes of hair pulling in trichotillomania, we
      looked at the responses of 75 chronic hair pullers who had identified relevant
      cues for hair pulling from a 339 item list. Principal components analysis
      suggested two independent components which were important to hair pulling, one
      distinguished by negative affective states (NA), and the other by sedentary
      activities and contemplative attitudes (S). High NA scores were related to hair
      pulling which was the focus of the Ss' attention, as well as with increased
      prevalence of lifetime obsessive compulsive disorder, other anxiety disorders,
      current and past depression, and obsessive compulsive personality disorder. High
      SA scores were related to a history of major depression only. Weighted scores on
      these components may be useful in further elaborating the phenomenology of
      trichotillomania and designing appropriate treatment interventions.

PMID- 8476407
TI  - The role of worrisome thinking in the suppression of cardiovascular response to
      phobic imagery.
AB  - Speech-fearful subjects repeatedly imagined a phobic image while heart rate and
      subjective reports of fear were monitored. Subject groups differed according to
      the type of mental activity that preceded each image. One group thought about a
      relaxing situation (Relaxation) and one group engaged in worrisome thinking
      (General-Worry). Three other groups were pre-trained to worry during their pre
      image mentation periods with an emphasis on: (a) the thoughts; (b) the images; or
      (c) the affect experienced during worry. Cardiovascular effects occurred only on
      the first image presentation. Thought-Worry produced significantly less heart
      rate response than did Relaxation; the other worry conditions fell
      nonsignificantly between these two groups. Within-group correlations between
      heart rate response to the image and the reported predominance of thought
      relative to imagery during the preceding mentation period showed that: (a)
      greater worrisome thinking in General-Worry was related to less cardiovascular
      response; and (b) greater relaxed thinking in Relaxation was associated with
      greater cardiovascular response. These results support the hypothesis that it is
      the worrisome thinking aspect of worry that may inhibit the emotional processing
      of phobic material and that Gray's mismatch theory of anxiety elicitation may
      account for these effects.

PMID- 8476408
TI  - Outcome profiles in the treatment of unipolar depression.
AB  - Treatment efficacy is typically evaluated by examining group means and pre-post
      change scores. Although informative, such analyses may obscure individual or
      subgroup differences in response (outcome profiles). The present study used two
      different methods to define treatment outcome profiles--rationally-derived
      criteria (Frank et al., Archives of General Psychiatry 48, 851-855, 1991) and
      dynamic clustering--to evaluate four treatments of unipolar depression: behaviour
      therapy, amitriptyline, psychodynamic psychotherapy and relaxation training
      (attention placebo). The profiling methods yielded similar results. Regardless of
      treatment, the majority of patients displayed either a recovery or nonremission
      outcome profile, with relatively few instances of remission followed by a
      recurrence of depression. These findings challenge the view that any of the
      treatments are associated with a strong tendency to relapse, at least over the 3
      month follow-up period. To further characterize the major outcome profiles,
      discriminant analysis was performed. Results indicated that recovery and
      nonremission profiles differed in that the latter was associated with a longer
      and more severe index episode and greater neuroticism. A number of variables,
      including family history of depression and therapists' prediction of outcome,
      failed to distinguish recovered from unremitted patients.

PMID- 8476409
TI  - Assessing reliable and clinically significant change in social phobia: validity
      of the social phobia and anxiety inventory.
AB  - The ability of the Social Phobia and Anxiety Inventory (SPAI) to measure change
      as a function of treatment for social phobia was assessed. In addition to
      determining treatment sensitivity of the SPAI, changes over the course of
      treatment were examined to determine if they were reliable and clinically
      significant. The results indicated that although a number of measures showed
      statistically significant change, only on the SPAI was that change reliable and
      clinically significant. The use of outcome measures that are reliable and
      clinically significant for social phobia as well as other disorders is discussed.

PMID- 8476410
TI  - Two novel tachykinin-related neuropeptides in the echiuroid worm, Urechis
      unicinctus.
AB  - Two novel neuropeptides, urechistachykinin I (H-Leu-Arg-Gln-Ser-Gln-Phe-Val-Gly
      Ser-Arg-NH2) and urechistachykinin II (H-Ala-Ala-Gly-Met-Gly-Phe-Phe-Gly-Ala-Arg
      NH2), were isolated from the ventral nerve cords of the echiuroid worm, Urechis
      unicinctus. These peptides showed a contractile action on the inner circular body
      wall muscle of the animal. Their amino acid sequences were found to be
      significantly homologous with those of the vertebrate and insect tachykinins. The
      urechistachykinins potentiated spontaneous rhythmic contractions of the cockroach
      hindgut.

PMID- 8476411
TI  - Heterologous expression of the serotonin 5-HT1A receptor in neural and non-neural
      cell lines.
AB  - Stable expression of neuronal receptors in cell lines of neural origin is
      important for studies of neurotransmitter mediated signal transduction. We have
      achieved this for the first time in three cell lines which are derived from
      various tissues of neural origin (hippocampus, HN2; chinese hamster brain
      explant, NCB-20; rat dorsal root ganglion, F-11). Following electroporation
      assisted transfer of a construct containing the hippocampal serotonin 5-HT1A
      receptor (5-HT1AR) DNA, one neural cell line, NG-108-15 (murine neuroblastoma x
      C6 glioma), failed to express the transfected activity, while three others as
      well as the non-neural CHO (chinese hamster ovary) cells expressed high levels of
      the receptor. Upon normalization to coexpressed human beta-hexosaminidase B
      activity, it was found that the human 5-HT1AR, which is normally concentrated in
      the hippocampus and at a lesser density in the brain, was expressed at the
      highest level (15.7 x 10(4) receptors/cell) in the HN2 followed by the NCB-20
      (8.3 x 10(4) receptors/cell), F-11 (4.4 x 10(4) receptors/cell) and lastly the
      non-neuronal CHO (4.2 x 10(4) receptors/cell) cells. Ten-twelve days after
      passage, a striking increase in expression of the receptor was observed only in
      the cell lines of neural origin. By contrast, there was no appreciable increase
      in expression of the transfected 5-HT1AR in the non-neural CHO cells over time.
      This late increase in expression was eliminated in cells which had been
      maintained in low glucose (1 g/L) for the first two days after passage, thus
      establishing a vital role of glucose in expression of the transfected 5-HT1AR in
      cell lines of neural origin. In all cases the 5-HT1AR was negatively coupled to
      adenylate cyclase, as evidenced by an agonist mediated decrease in prostaglandin
      E1 stimulated cyclic AMP levels.

PMID- 8476412
TI  - Transactivation of cellular promoters by an integrated hepatitis B virus DNA.
AB  - A new Hepatitis B virus(HBV) DNA integrant clone DA2-6, isolated from a human
      hepatocellular carcinoma(HCC) genomic library, was tested for its ability to
      transactivate expression of other genes. DA2-6 consists of 3.7 kb flanking
      cellular sequences and an integrated 2.8 kb HBV DNA which covers the region of
      preS, S, and the 3' truncated X. Using a chloramphenicol acetyltransferase (CAT)
      assay, a number of cellular and viral promoters were transactivated by DA2-6, and
      the spectrum of transactivational effect was the same as that by the wild type X
      gene of the virus. Deletion mutant analyses indicated that the transactivation
      function of DA2-6 is expressed by the region that encodes a truncated X-cell
      fusion product.

PMID- 8476413
TI  - Onset of new catalytic activity in immobilized spores of Aspergillus ochraceus TS
      due to in situ germination: C17-C20 lysis accompanies 11 alpha-hydroxylation of
      steroid.
AB  - The change in product pattern during transformation of progesterone by calcium
      alginate entrapped spores of Aspergillus ochraceus TS (A. ochraceus TS) due to
      germination in situ is reported. While progesterone was transformed exclusively
      to its 11 alpha-hydroxy derivative by both free and immobilized spores of A.
      ochraceus TS, the latter germinated in situ by yeast extract furnished 11 alpha
      hydroxyprogesterone and C19 steroids during transformation under identical
      conditions. The characterization of metabolite(s) and the pathway proposed
      demonstrated that delta 1-dehydrogenation and lysis of C17-C20 bond are
      apparently two independent reactions. The change in product profile due to
      activation of immobilized spores is believed to be caused by accumulation of
      compatible solutes in the biocatalyst which had relatively low water content.

PMID- 8476414
TI  - The mitochondrial DNA mutation at 8993 associated with NARP slows the rate of ATP
      synthesis in isolated lymphoblast mitochondria.
AB  - Mitochondria were prepared from three lymphoblast cell lines from patients with
      high percentage copy numbers of the human mtDNA 8993 mutation and compared to
      those prepared from related and non-related control cell lines. Rates of ATP
      synthesis with pyruvate/malate, succinate/rotenone, ascorbate/N'N'N'N'
      tetramethyl phenylene diamine were reduced to 67%, 58% and 54% of the control
      rates, respectively. The backward reaction measured as oligomycin sensitive
      ATPase was reduced to an average of 42% of that in controls. This mutation which
      changes a conserved leucine to an arginine in the putative membrane proton
      channel of mitochondrial ATPase effectively reduces the overall rate of oxidative
      phosphorylation.

PMID- 8476415
TI  - Biochemical characterisation of the isolated Anc2 adenine nucleotide carrier from
      Saccharomyces cerevisiae mitochondria.
AB  - The yeast mitochondrial adenine nucleotide carrier isoform encoded by the ANC2
      gene has been specifically expressed in a yeast strain disrupted for the two
      other genes, ANC1 and ANC3. Isolation of the carrier in a functional form was
      achieved by utilisation of a mixture of two detergents, dodecylmaltoside and
      Emulphogen. The intrinsic fluorescence of the Anc2 protein was specifically and
      rapidly enhanced upon addition of the transportable nucleotides ADP and ATP.
      Fluorescence enhancement was prevented or reversed by the addition of a
      stoichiometric amount of CATR. Addition of CATR alone elicited a dose-dependent
      decrease of fluorescence. The ANC2-specific yeast stain offers the means to study
      a single ADP/ATP carrier, with a well-defined amino acid sequence, suitable for
      analysis of substrate- or inhibitor-induced conformational changes.

PMID- 8476416
TI  - Enhancement of the stability and activity of aspartase by random and site
      directed mutagenesis.
AB  - Enzymatic generation of mutant libraries for random mutagenesis of aspartase gene
      from E. coli J2 was made. A mutant enzyme with 4-fold increase in aspartase
      activity was found. It is stable at pH7.5-9.0 (wild-type: pH7.0-8.0); heat
      stability and alpha-helicity are higher than those of the wild-type. By using
      site directed mutagenesis, the aspartase was activated by replacement of Lys-126
      with an arginine residue. The mutation produced functional alterations without
      appreciable structure changes. The optimum pH for the mutant enzyme is 8.5. The
      stable pH range is 7.0-9.0. Heat stability is higher than that of the wild-type
      one. Activity of the mutant enzyme is about 5-fold as much as that of wild-type
      one.

PMID- 8476417
TI  - Occurrence of prenylated proteins in plant cells.
AB  - In this paper evidence is presented for the occurrence of prenylated proteins in
      plants. When spinach leaves were incubated in the presence of [3H]mevalonate non
      extractable lipids were found in the protein fraction after extraction with
      organic solvents. Alkaline hydrolysis liberated phytol, polyprenyl phosphates-11
      15 and also, in contrast to animal cells, polyprenols-11-15. Complete removal of
      farnesol and geranylgeraniol required the cleavage of thioether linkages by
      iodomethane. The results indicate that several polyisoprenoid lipids in plant
      cells are covalently bound to proteins. So far a protein fraction dominated by
      one or more proteins in the 23 kDa region has been identified.

PMID- 8476418
TI  - Interleukin 3 promotes histamine synthesis in hematopoietic progenitors by
      increasing histidine decarboxylase mRNA expression.
AB  - Interleukin 3 (IL-3) is a potent stimulator of histamine production by cells from
      murine hematopoietic organs. We demonstrate herein that this phenomenon results
      from increased histidine decarboxylase (HDC: EC 4.1.1.22) activity in progenitor
      enriched bone marrow cells (around 5% of the total bone marrow) isolated from the
      low density layers of a discontinuous Ficoll gradient. HDC levels are markedly
      enhanced after a 24 h incubation with IL-3 while a 4 h exposure results only in a
      slight activation. It results from increased expression of the mRNA coding for
      HDC, as assessed by Northern blot analysis after a 24 h incubation with IL-3. At
      the same time point and after a 4 h stimulation, we have evaluated the percentage
      of cells in this population which express HDC mRNA in response to IL-3, using in
      situ hybridization with the antisense riboprobe. We have thus established that
      enhanced HDC mRNA expression occurs in a small immature subset representing from
      5 to 8% of the progenitor-enriched bone marrow cells.

PMID- 8476420
TI  - Prediction of structurally conserved regions of D-specific hydroxy acid
      dehydrogenases by multiple alignment with formate dehydrogenase.
AB  - We propose a multiple alignment of the sequence of formate dehydrogenase with the
      D-specific 2-hydroxy acid dehydrogenases family. Structurally conserved regions
      are predicted for those sequences corresponding to important regions of the
      catalytic and the coenzyme binding domains defined from the known three
      dimensional structure of the formate dehydrogenase, namely the nicotinamide
      binding site (beta D to beta F) and the beta A-loop-alpha B region containing the
      typical glycine pattern of the adenosine binding site, the catalytic
      histidine/aspartic acid pair and an arginine probably involved in the interaction
      with the carboxyl group of the substrate.

PMID- 8476419
TI  - In vivo delivery of human alpha 1-antitrypsin gene to mouse hepatocytes by
      liposomes.
AB  - The pTG7101 plasmid containing the full length human alpha 1-Antitrypsin was
      encapsulated in large (142 +/- 15 nm of diameter) and small (54 +/- 11 nm of
      diameter) liposomes and administered i.v. to mice (80 ng/mouse). Control animals
      were treated with empty (small and large) liposomes plus free DNA and with the
      liposome solvent buffer. The immunohistochemical results on liver cryosections
      and cytophotometric analysis of hepatocyte chromophore absorbance, after
      peroxidase reaction, indicated that significant presence of immunoreactive human
      alpha 1-antitrypsin was present 7 days after mice treatment with encapsulated DNA
      in small liposomes but not when large liposomes were used. This effect was
      observed in a great number of liver parenchymal cells. These results agree with
      the observation that only small liposomes have easy access to hepatocytes and
      support the idea that small liposomes are appropriate vehicles for in vivo
      delivery of specific genetic material to liver parenchymal cells, with high
      efficiency.

PMID- 8476421
TI  - Expression of soluble and insoluble fibronectin in rat aorta: effects of
      angiotensin II and endothelin-1.
AB  - This study has investigated the influence of the vasoconstrictor peptides
      angiotensin II (Ang II) and endothelin-1 (ET-1) on fibronectin expression by
      vascular smooth muscle cells (VSMC). In confluent, quiescent cultures of VSMC,
      Ang II and ET-1 elevated fibronectin mRNA levels in a time- and dose-dependent
      fashion. ET-1 and Ang II also induced a time-dependent expression of
      immunoreactive fibronectin in cultures of aortic organoids, and for both peptides
      the fibronectin immunoreactivity was most prominent within those medial smooth
      muscle cell layers close to the vessel lumen. Immunoprecipitation of
      biosynthetically labelled fibronectin elaborated by cultured VSMC revealed a
      predominant expression of soluble fibronectin in response to Ang II, whereas for
      ET-1 the newly synthesized fibronectin was predominantly incorporated into the
      extracellular matrix deposit of the cells. These findings indicate that Ang II
      and ET-1 may exert disparate effects on smooth muscle cell phenotype and
      migration.

PMID- 8476422
TI  - Photoacoustic detection of photosensitized oxygenations in highly absorbing
      samples.
AB  - A photoacoustic (PA) study of the relaxation processes of the excited states of
      photosensitizers in the presence of oxygen and chemical acceptors is described.
      It has been predicted theoretically that the ratio of PA amplitudes with and
      without acceptor depends on two parameters alpha and beta, related to the
      sensitizer and to the acceptor properties, respectively. Experimental studies
      were carried out on solutions of hematoporphyrin IX and methylene blue. The
      addition of an acceptor, specific to the singlet oxygen, like tetramethyl
      ethylene or furfuryl alcohol, appears to decrease significantly the photoacoustic
      signal amplitude within the band of absorption.

PMID- 8476423
TI  - A chicken embryo model to study the growth of human uveal melanoma.
AB  - In vitro cultured human uveal and skin melanoma cells were injected into the
      chicken embryonal eye at a stage when the immune system was not yet mature. The
      melanoma cells were accepted as part of the organism by the host. Even single
      melanoma cells could be traced by morphological methods as well as by
      immunohistochemical markers, such as S100, HMB-45, NKI/C3 and HNK-1. We found
      tumors in 20 and 40 percent of the embryos injected with uveal melanoma and skin
      melanoma, respectively. The embryos did not exhibit abnormal development of the
      eye as a result of the microinjection and had a high survival rate (90 and 60%,
      respectively) during embryogenesis. With this model for uveal melanoma the growth
      and possibly the metastatic behavior of human uveal melanoma cells can be
      studied.

PMID- 8476424
TI  - HuMig: a new human member of the chemokine family of cytokines.
AB  - Characterization of lymphokine-activated genes in mouse macrophages led to the
      identification previously of Mumig, an interferon-gamma-inducible murine gene
      that encodes a member of the chemokine family of cytokines. The Mumig cDNA probe
      was used to screen a cDNA library prepared from cultures of the THP-1 human
      monocytic cell line that had been treated with interferon-gamma. This led to the
      identification of Humig, a new human member of the chemokine gene family. Humig
      is induced in THP-1 cells and in peripheral blood mononuclear cells by interferon
      gamma but not by interferon-alpha or by lipopolysaccharide. Analysis of mouse and
      human genomic DNAs suggested that the Mumig and Humig genes are true mouse-human
      homologues. The Humig mRNA encodes a predicted secreted HuMig protein of 103
      residues, M(r) 11,725.

PMID- 8476425
TI  - Structure and expression of novel protein-tyrosine kinases, Emb and Emt, in
      hematopoietic cells.
AB  - Two novel tyrosine kinase cDNAs were obtained from murine mast cells. These
      kinases, Emb and Emt, constitute a novel tyrosine kinase subfamily which may also
      include Tec, a kinase preferentially expressed in liver, and Dsrc28, a fruit fly
      kinase. Both lack hydrophobic stretches characteristic of the transmembrane
      domains found in growth factor receptor tyrosine kinases and carboxyl-terminal,
      negative regulatory tyrosine residue found in Src family kinases. In addition to
      the Src homology region 2 (SH2) and SH3 domains characteristic of the Src family
      kinases and other signaling molecules, Emb and Emt share a similar amino-terminal
      domain comprised mainly of two repeat segments. The emb 2.7-kb transcript was
      expressed in mast cells, myeloid cells and B lymphocytes while the emt 4.6-kb
      mRNA in mast cells, myeloid cells and T lymphocytes. The evidence for in vitro
      tyrosine kinase activity of Emb and Emt proteins is also provided.

PMID- 8476426
TI  - Survival of cancer patients on therapy with coenzyme Q10.
AB  - Over ca. 25 years, assays in animal models established the hematopoietic
      activities of coenzyme Q's in rhesus monkeys, rabbits, poultry, and children
      having kwashiorkor. Surprisingly, a virus was found to cause a deficiency of
      CoQ9. Patients with AIDS showed a-"striking"-clinical response to therapy with
      CoQ10. The macrophage potentiating activity of CoQ10 was recorded by the carbon
      clearance method. CoQ10 significantly increased the levels of IgG in patients.
      Eight new case histories of cancer patients plus two reported cases support the
      statement that therapy of cancer patients with CoQ10, which has no significant
      side effect, has allowed survival on an exploratory basis for periods of 5-15
      years. These results now justify systematic protocols.

PMID- 8476427
TI  - Midkine, a novel neurotrophic factor, is present in senile plaques of Alzheimer
      disease.
AB  - An affinity purified antibody specific for midkine (MK) stained senile plaques in
      the brain of Alzheimer disease (AD) patients. After formic acid treatment, plaque
      staining was dramatically enhanced, and almost all beta-amyloid protein (BAP)
      deposits were also immunoreactive for MK. MK-immunoreactivity was not observed in
      normal cellular components nor in other pathological lesions including tangles in
      AD brain. Control brain sections were not immunoreactive for MK. The presence of
      MK in AD brain but not in control brain was confirmed by Western blotting. MK
      appears to be involved in the pathological process leading to senile plaque
      formation.

PMID- 8476428
TI  - A neuropeptide Y locus on chromosome 4 cosegregates with blood pressure in the
      spontaneously hypertensive rat.
AB  - Recent advances in molecular biology have allowed the study of the candidate
      genes for essential hypertension. To identify the genes responsible for basal
      blood pressure in the spontaneously hypertensive rat strain, the rat model of
      genetic hypertension, we performed a cosegregation analysis between the genotype
      and blood pressure in a set of male F2 progeny obtained from SHR and Wistar-Kyoto
      rats, a reference normotensive strain. Our investigation revealed that a locus on
      the chromosome 4 cosegregates with the blood pressure in SHR, especially at
      neuropeptide Y locus. The degree of cosegregation with all values of blood
      pressure without sodium loading was moderate but consistent. We propose that
      neuropeptide Y locus on chromosome 4 is a new candidate for the hypertensive
      effect in original SHR.

PMID- 8476429
TI  - Absence of 2'-deoxy-GTP in adult brain tubulin.
AB  - Nerve growth factor can stimulate incorporation of 2'-deoxy-GTP into the non
      exchangeable nucleotide sites in tubulin and cytoskeletal microtubules of PC12
      pheochromocytoma cells and embryonic chick dorsal root ganglion neurons [J. M.
      Angelastro and D. L. Purich (1992) J. Biol. Chem. 267, 25685-25689]. We replaced
      and hydrolyzed exchangeable-site GTP and GDP in adult bovine brain tubulin by
      incubation with the non-hydrolyzable nucleotide analogue 5'-guanylyl
      methylenediphosphonate and alkaline phosphatase, thereby allowing us to analyze
      the non-exchangeable guanine nucleotides for GTP and dGTP. HPLC analysis reveals
      no evidence of dGTP in adult tubulin, suggesting further that the appearance of
      dGTP in tubulin and microtubules may be a characteristic of recently dividing
      neurons in response to nerve growth factor.

PMID- 8476430
TI  - Tumor necrosis factor-alpha increased the integrin alpha 2 beta 1 expression and
      cell attachment to type I collagen in human dermal fibroblasts.
AB  - Cell adhesion molecules of human dermal fibroblasts play an important role in the
      processes of wound healing. The effects of tumor necrosis factor- alpha (TNF) on
      the expression of integrin beta 1 subfamily in human dermal fibroblasts were
      examined. TNF preferentially induced the expression of alpha 2 beta 1 integrins,
      receptors for collagen and laminin, in a time and dose dependent manner. Cell
      attachment to type I collagen increased by the treatment with TNF. However, cell
      attachment to fibronectin and laminin was not increased. This TNF-induced cell
      attachment could be reduced significantly by anti-integrin alpha 2 beta 1
      antibody. Antibodies against receptors other than alpha 2 beta 1 integrin did not
      significantly reduce cell attachment. These data suggest that the increased
      attachment of human dermal fibroblasts to type I collagen appears to be mediated
      predominantly through the augmentation of integrin alpha 2 beta 1 expression by
      TNF.

PMID- 8476431
TI  - Apoptosis of lung cancer cells caused by some anti-cancer agents (MMC, CPT-11,
      ADM) is inhibited by bcl-2.
AB  - To determine whether the apoptotic cell death induced by anti-cancer agents could
      be inhibited by bcl-2, we established a bcl-2-transfected human small cell lung
      cancer cell line, SBC-3/Bcl2. SBC-3/Bcl2 showed higher resistance to ADM, CPT-11
      and MMC compared with the parental line SBC-3, with relative resistance values of
      3.4, 7.6 and 5.7, respectively. However, there was no difference in sensitivity
      to CDDP, VP-16, ACNU, MTX and taxol between SBC-3 and SBC-3/Bcl2. Agarose gel
      electrophoresis showed typical DNA fragmentation of SBC-3 following treatment
      with CPT-11 or MMC, in a concentration-dependent manner. In contrast, the same
      concentration of the drugs did not induce DNA fragmentation in SBC-3/Bcl2.
      Treatment with CDDP resulted in the same degree of DNA fragmentation in SBC-3 and
      SBC-3/Bcl2. These studies indicate that bcl-2 can modulate the cytotoxicity of
      some anti-cancer agents by inhibiting the process of apoptosis.

PMID- 8476432
TI  - A novel adenylyl cyclase sequence cloned from the human erythroleukemia cell
      line.
AB  - The polymerase chain reaction (PCR) was used to detect several forms of adenylyl
      cyclase (AC's) expressed in human erythroleukemia (HEL) cells. Degenerate
      oligonucleotide primers were synthesized based on the conserved sequences in the
      C2a area of the AC's. HEL cells were found to contain mRNA for type III and type
      VI AC. In addition, a novel AC message was identified. The cloned sequence,
      excluding primer areas, represented 69 amino acids with most similarity to rat
      AC's II and IV. Northern analysis of RNA from HEL cells demonstrated a 6.7
      kilobase message. RNase protection assays revealed that in HEL cells the novel AC
      mRNA was dominant compared to types III and VI. Human embryonic kidney cells
      (HEK293) were also used a source of mRNA to synthesize cDNA for PCR reactions.
      The HEK293 cells were found to contain message corresponding to type II, III, VI
      AC as well as the novel AC message. The novel AC message was also detected in
      human brain tissue and was most abundant in the caudate, cerebellum and
      hippocampus. The smallest amount of novel AC mRNA in the tested brain tissue was
      found in the cortex. The mRNA for the novel AC was relatively abundant in human
      liver.

PMID- 8476433
TI  - Molecular basis of impaired pyruvate kinase isozyme conversion in erythroid
      cells: a single amino acid substitution near the active site and decreased mRNA
      content of the R-type PK.
AB  - Conversion of pyruvate kinase (PK) isozymes from M2- to R-PK has been observed
      during erythroid cell maturation. To understand this mechanism, we analyzed the
      PK gene of a R-PK deficient patient, in whose erythrocytes the M2-PK was
      persistently expressed. A point mutation, 1102 GTC-->TTC was identified in the R
      PK cDNA, and it caused a single amino acid substitution from 368Val-->Phe. The
      residue is very close to the 372nd Gln, the putative binding site of the
      monovalent cation (K+). The impaired K+ binding would cause the decreased
      affinity for phosphoenolpyruvate, consequently the variant PK may be extremely
      unstable. Although the proband's other PK allele did not have any structural
      change, the R-PK mRNA level in reticulocytes was decreased. These findings
      suggested that both the structural mutation near the active site and the
      decreased mRNA level of the R-PK were responsible for the disorder.

PMID- 8476434
TI  - Flavor constituents in cola drinks induce hepatic DNA adducts in adult and fetal
      mice.
AB  - Mice given one of several widely consumed cola drinks in place of drinking water
      for up to 8 weeks developed significant levels of covalent liver DNA adducts in a
      time dependent manner, as measured by 32P-postlabeling. These adducts were not
      detected in mice given tap water or one of 3 non-cola beverages. Adducts
      chromatographically identical to those induced by cola drinks were detected in
      mice treated with extracts of nutmeg or mace, spices from the nutmeg tree
      (Myristica fragrans Houttuyn), or with myristicin (1-allyl-5-methoxy-3,4
      methylenedioxybenzene), the major spice constituent of nutmeg. In addition, small
      amounts of adducts derived from the hepatocarcinogen safrole (1-allyl-3,4
      methylenedioxybenzene), a minor constituent of nutmeg, were observed. Liver DNA
      adducts were also detected in fetal liver when pregnant mice were intubated with
      myristicin. Possible implications of these findings for human health are
      discussed.

PMID- 8476435
TI  - Expression of the dystrophin gene in cultured fibroblasts.
AB  - The dystrophin whose defect is responsible for Duchenne and Becker muscular
      dystrophies is present in muscle, brain and cerebellum. We describe here the
      detection of dystrophin in human cultured skin fibroblasts, L809 cells and murine
      3T6 cell line. Dystrophin transcripts initiated at the muscle specific first exon
      can also be amplified by cDNA-PCR from various fibroblastic cells. The expression
      of the dystrophin gene in fibroblasts could account for some abnormalities
      observed in patient's fibroblast cultures.

PMID- 8476436
TI  - A potent anti-metastatic activity of tumor invasion-inhibiting factor-2 and
      albumin conjugate.
AB  - Tumor invasion-inhibiting factor-2 (IIF-2) peptide was chemically conjugated to
      albumin with 1-ethyl-3(3-dimethylaminopropyl)-carbodiimide hydrochloride. The
      molar ratio of the covalently linked IIF-2 peptide and albumin in the purified
      conjugate was 1.4 +/- 0.4, as determined with a radioactive peptide. The
      conjugate inhibited the invasion of HT1080 and B16FE7 cells in vitro at 40- to 60
      fold lower concentrations than IIF-2 peptide. Scatchard analysis of binding data
      demonstrated that the IIF-2-albumin conjugate bound to HT1080 and B16FE7 cells
      with Kd values of 240 and 340 nM, respectively. The conjugate suppressed the lung
      colonization of B16FE7 cells more effectively than the IIF-2 peptide in an
      experimental metastasis. These results indicate that the covalent linkage of the
      IIF-2 peptide to a carrier macromolecule provides a structure that enables this
      peptide to exhibit increased inhibitory action in cancer cell invasion and
      metastasis, and that IIF-2 exerts its inhibitory action on invasion by binding to
      a specific binding site on the tumor cell surface.

PMID- 8476437
TI  - On the purity of 3X-recrystallized bovine alpha-chymotrypsin.
AB  - The results of an electrospray-mass spectrometric analytical study of aqueous
      solutions of fifteen commercial samples of 3X-recrystallized bovine alpha
      chymotrypsin are presented and discussed. It was found that only six samples were
      predominantly alpha-chymotrypsin and that two samples contained no alpha
      chymotrypsin at all. The remaining seven samples were found to be mixtures of
      alpha-chymotrypsin with other chymotrypsins and, in some cases,
      neochymotrypsinogens. The majority of the results are rationalised in terms of
      previously postulated and/or observed products of proteolytic activation of
      bovine chymotrypsinogen A. However, evidence is also presented for the presence
      in many of the samples of three new serine proteases, of significantly lower
      molecular masses than alpha-chymotrypsin, which cannot at present be explained.
      The paper is concluded with a brief discussion of the implications of the
      analytical findings for enzymological studies.

PMID- 8476438
TI  - Protective role of hemopexin on heme-dependent lung oxidative stress.
AB  - Tert-butyl hydroperoxide (t-BOOH)-dependent chemiluminescence of perfused rat
      lungs increased by almost 500% upon addition of heme (from 297 +/- 28% to 1204 +/
      125% of control, p < 0.01 vs no heme). Preincubation with hemopexin
      significantly decreased the heme-stimulated chemiluminescence to 779 +/- 155% of
      control (p < 0.01) When hemopexin was replaced with rat albumin heme-stimulated
      chemiluminescence decreased to 1007 +/- 104% (not significantly different from
      results with heme alone). In vitro studies showed that hemopexin did not decrease
      chemiluminescence from bovine serum albumin oxidation (493 +/- 94% compared to
      292 +/- 81% of control in the absence of hemopexin) and that the heme-hemopexin
      mixture also emitted light when exposed to t-BOOH (264 +/- 66% of control). These
      results suggest that hemopexin specifically inhibits some of the oxidative
      reactions catalyzed by free heme and may have a protect tissue oxidation in
      conditions in which heme release occurs (i.e., stroke).

PMID- 8476440
TI  - Adverse reproductive outcomes and occupational exposures among nurses: an
      investigation of multiple hazardous exposures.
AB  - 1. The increasing numbers of pregnant women and women of childbearing age who are
      employed and exposed to hazardous substances pose occupational health concerns.
      2. The findings of this study indicate the importance of not minimizing concern
      about exposure to radiation. Radiation monitoring should be implemented to a
      greater extent, and methods to measure low dose chronic radiation exposure should
      be developed. 3. Synergy between the adverse reproductive effects from multiple
      workplace factors among nurses, including but not limited to radiation, video
      display terminal use, and chemotherapeutic agents, warrants further evaluation.

PMID- 8476441
TI  - Implementing a university campus wellness model.
AB  - 1. Using a model to plan the development of a wellness program may enhance
      program success. The wellness model could be used as a basic framework to
      implement a health promotion program at any worksite. 2. The University Wellness
      model depicts an individual in control and riding toward wellness. The six
      dimensions in the model represent a holistic view of the individual. These
      dimensions consider the physical, occupational, spiritual, social, intellectual,
      and emotional aspects of the person to illustrate how these factors impact on the
      wellness concept. 3. This model may apply and be of significance to other
      workplace situations to increase worker productivity and decrease employer costs.

PMID- 8476439
TI  - A system for studying the effect(s) of familial Alzheimer disease mutations on
      the processing of the beta-amyloid peptide precursor.
AB  - Three different point mutations have been observed in some familial Alzheimer's
      disease pedigrees at a unique valine, Val717, near the carboxyl end of the beta
      Amyloid Peptide Precursor (beta APP). The effects of these mutations on the
      processing and cellular functions of beta APP can best be determined in the
      absence of the normal form(s) of the protein. We have used targeted mRNA
      degradation by a trans-acting hammerhead ribozyme to cleave and inactivate beta
      APP expression in vitro. The consensus ribozyme cleavage site, 5'GUC decreases
      X3, matches the Val717 nucleotide sequence in beta APP mRNA. Introduction of FAD
      point mutations which change Val717 decrease the rate of ribozyme cleavage by
      more than three orders of magnitude. Thus, ribozyme targeting of this site should
      allow the study of protein processing in vivo. Furthermore, a ribozyme targeted
      to mutant beta APP mRNA (Val717-->Ile) cleaved the mutant sequence 300-fold
      faster than the normal sequence. This suggests that ribozymes might lower mutant
      beta APP mRNA levels in FAD cells.

PMID- 8476442
TI  - Managing crises and trauma in the workplace: how to respond and intervene.
AB  - 1. Health care, human resource, and employee assistance provider professionals
      must be aware of the impact of trauma in the workplace. 2. Critical Incident
      Stress (CIS) refers to the work and situations that emergency service
      professionals face on a regular basis. Trauma in the workplace refers to a work
      setting, such as an industrial accident, personal injury/illness, or crime taking
      place in a work setting. The death or injury of an employee outside of the
      workplace is also considered traumatic for employees. 3. Victims of witnesses of
      a traumatic incident, a violent crime, physical maltreatment, or sexual abuse may
      experience Posttraumatic Stress Disorder (PTSD). Individuals of all ages are
      vulnerable to PTSD. 4. Unresolved CIS or a workplace trauma may result in PTSD
      for the involved individuals if not handled appropriately.

PMID- 8476443
TI  - Occupational health nursing in Finland.
AB  - Occupational health nursing in Finland is based on activities stated by the
      Occupational Health Care Act. Moreover, the occupational health nurse provides
      services that are based on agreements between the employer and the occupational
      health center. Occupational health nursing emphasizes preventive measures, such
      as the clarification of health hazards and job related risk factors, the
      arrangement of health examinations, health education, and organization of first
      aid. Occupational health nurses in Finland participate in continuing education at
      least every 5 years. In 1991 the option of specializing in Occupational Health as
      a part of the Masters of Health Care program became available at universities.

PMID- 8476444
TI  - OSHA's new standard: exposure to bloodborne pathogens.
AB  - Most health care workers in the U.S. are covered by OSHA's new standard on
      bloodborne pathogens exposure. Individual states that have their own occupational
      agency must enact a Standard that is at least as strict. Key elements of the
      Standard include an exposure control plan, universal precautions, engineering
      controls that stress sharps safety, personal protective equipment, exposure
      evaluation and follow up, and training. Employers are required to offer the
      hepatitis B vaccine free of charge to employees. Employees who decline the
      vaccine must sign a declination form. An OSHA inspection for compliance with this
      Standard will include review of records, a workplace walk through, and interviews
      with employees. OSHA has already cited and fined some workplaces for not
      complying with the Standard.

PMID- 8476446
TI  - Hiring practices and the occupational health nurse manager.

PMID- 8476445
TI  - Evaluating a federal health and fitness program: indicators of improving health.

PMID- 8476447
TI  - All nurses need to use research findings to guide their practice.

PMID- 8476448
TI  - Diagnosis and misdiagnosis of poisoning with the cyanide precursor acetonitrile:
      nail polish remover or nail glue remover?
AB  - Accurate diagnosis of acetonitrile ingestion is critical to management. Often
      this involves differentiating nail polish remover (acetone) from nail glue
      remover (acetonitrile). Initial symptoms of acetonitrile ingestion are
      indistinguishable from those of acetone and common alcohols. However,
      acetonitrile is metabolized to cyanide, producing severe delayed toxicity.
      Acetonitrile produced increased serum osmolality and osmolal gap, but these
      findings are non-specific and normal values cannot rule out potentially fatal
      exposure. Acetone, but not acetonitrile, was detectable in urine or serum with
      Acetest tablets; both were unreactive with a ketone dipstick. Acetone and
      acetonitrile could be detected with routine gas chromatography methods for
      alcohols. Both substances had identical retention times on the widely used
      stationary phase, 5% Carbowax 20M on graphitized carbon, and with GasChrom 254.
      Three other systems afforded unique retention times, but acetonitrile was easily
      mistaken for ethanol in two. Physicians and laboratories must take care to avoid
      misdiagnosis of acetonitrile ingestion as exposure to acetone, ethanol or another
      alcohol.

PMID- 8476449
TI  - Reliability of prehospital rating scales for case severity and status change.
AB  - The purpose of this report is to determine the reliability and sensibility of the
      currently available prehospital rating scales by a prospective evaluation of
      ambulance call reports using generalizability methodology. Sequential samples of
      emergency call data from the Hamilton Base Hospital Paramedic program database
      were used to sample calls randomly for a two-phase study. Phase I and II used
      blinded ambulance call report forms presented to six rates during three sessions
      in each phase. Generalizability (reliability) coefficients were then generated to
      determine the degree of reliability for the scales in both phases of the study.
      The generalizability coefficients for all scales are substantial or excellent
      using the standards commonly applied to agreement statistics. The conclusion of
      the study is that all ambulance officers can use the prehospital scales reliably.
      The reliability of these general measures is one of the parameters that will
      allow us to evaluate where basic and advanced prehospital care have an impact on
      overall patient outcome.

PMID- 8476450
TI  - Diagnostic and therapeutic utility of flumazenil in comatose patients with drug
      overdose.
AB  - From July 1, 1990 and June 30, 1991, 61 unconscious patients with drug
      intoxication were prospectively enrolled into this study in order to evaluate the
      efficacy and safety of flumazenil in the management of this patient population.
      Flumazenil was injected intravenously as a 0.3-mg bolus in the first minute
      followed by 0.2-mg and 0.3-mg doses every minute until a total dose of 1 mg was
      given or until the patient responded. The Glasgow coma scale and a sedation-level
      scoring system were checked prior to and at 1, 5, and 30 minutes after the dose
      eliciting response or on completion of the full dose of flumazenil. The patients
      were divided into two groups based on their response to flumazenil: group 1,
      responders (N = 55), and group 2, nonresponders (N = 6). Eleven patients from
      group 1 allowed us to retrieve drug information from these patients once mental
      status had recovered and patients were treated accordingly. In two cases
      endotracheal intubation and artificial ventilation were rendered unnecessary by
      the use of flumazenil. No undesirable hemodynamic effects were noted after
      flumazenil injection in this study, although none of the patients overdosed on
      antidepressants. Flumazenil may serve as a useful diagnostic and therapeutic tool
      in the management of selected cases of drug-induced coma.

PMID- 8476451
TI  - An evaluation of automated defibrillation and manual defibrillation by emergency
      medical technicians in a rural setting.
AB  - We show that automated external defibrillation training of emergency medical
      technicians (EMTs) is less time consuming than manual defibrillation training,
      and hypothesize that both improve survival from sudden cardiac death. Data on 91
      cardiac arrests over 27 months among five basic life support services was
      collected before EMT-defibrillation (EMT-D) training. Subsequently, seven BLS
      services were trained in EMT-D using either manual difibrillation or automated
      external defibrillation technology, and 55 sudden cardiac death patients were
      entered after training. Manual defibrillation required 11 more hours per student
      in initial training. Survival to hospital discharge improved from two of 91
      patients (2.2%) in the series before EMT-D training to nine of 55 patients
      (16.4%) after EMT-D training (P = .001). Improved survival was correlated with
      shorter prehospital defibrillation times, 8.84 minutes, when EMTs performed
      defibrillation versus 16.3 minutes before training when EMTs awaited advanced
      life support defibrillation (P < .001). To enhance equipment familiarity we
      allowed EMTs to apply three-lead electrode monitors to all medical/cardiac
      patients during transport (surveillance). There were six emergency medical
      service-witnessed "surveillance" arrests and three arrests survived to hospital
      discharge (50% survival). This group represented 33% of all survivors in the
      series. We recommend automated external defibrillation training for EMTs.
      Improved survival in sudden cardiac death cases in well-run emergency medical
      service systems should result from EMT-D training. Finally, we recommend that
      routine "surveillance" of high-risk patients during transport by defibrillation
      capable EMTs be considered in EMT-D programs, rather than limiting EMT-D only to
      units capable of rapid "man-down" response.

PMID- 8476452
TI  - The efficacy and safety of a continuous albuterol protocol for the treatment of
      acute adult asthma attacks.
AB  - We performed a prospective study over a 6-month period to test the efficacy and
      safety of a continuous nebulized albuterol protocol for the treatment of acute
      adult asthma attacks. All patients 18 years or older presenting to the emergency
      department with acute asthma attacks were begun by the triage nurse on the
      protocol of three continuous albuterol (2.5 mg) nebulizer treatments.
      Pretreatment and posttreatment peak flow, respiratory rate, pulse, and blood
      pressure were documented and patients gave a pretreatment and posttreatment
      rating of the clinical severity of their attack using a (1 to 10) visual analog
      scale. In addition, all adverse effects were noted. Seventy-six patients were
      entered in the study. The average age was 44 years (range, 20 to 82 years).
      Pretreatment and posttreatment peak flow, respiratory rate, pulse, blood
      pressure, and clinical severity were compared using the paired t test. Patients
      showed statistically significant increases in peak flow (128 to 292; P < .0001)
      and statistically significant decreases in respiratory rate (27 to 20; P <
      .0001); pulse, 103 to 94 (P < .0001); clinical severity, 7.8/10 to 1.8/10 (P <
      .0001); and blood pressure, 141/82 to 132/77 (P < .001). Adverse effects were
      minimal. Two patients (2.6%) felt flushed, three patients (4%) felt jittery, and
      one patient (1.3%) had a sensation of palpitations. We conclude that a continuous
      nebulized albuterol protocol is both extremely efficacious and safe for the
      treatment of acute adult asthma attacks.

PMID- 8476453
TI  - The effect of scrubbing and irrigation with normal saline, povidone iodine, and
      cefazolin on wound bacterial counts in a guinea pig model.
AB  - This study examines the effects of povidone iodine, normal saline, and cefazolin
      alone and after scrubbing on bacterial counts in contaminated animal lacerations.
      Twelve albino guinea pigs each received four lacerations inoculated with a
      standard inoculum of Staphylococcus aureus. Twelve hours after inoculation, each
      wound was biopsied to ensure contamination and then either treated or left as an
      untreated control. One wound on each animal was an untreated control. The
      remaining three lacerations on six pigs were irrigated with cefazolin (CZ)
      solution, normal saline, or 1% (wt/vol) povidone iodine solution (PI). Three
      lacerations on another six pigs were treated with 20% poloxamer 188 scrub (scrub)
      alone, scrub followed by PI irrigation (SCR/PI), or scrub followed by CZ
      irrigation (SCR/CZ). Quantitative bacteriology was performed on tissue biopsies 2
      hours (time 1), 7 hours (time 2), and 12 hours (time 3) after irrigation.
      Posttreatment counts for PI, CZ, and normal saline irrigation were not different
      from control or one another (P > .05). Bacterial counts for SCR/PI were
      significantly lower than control (P < .05) for all posttreatment biopsies (1.8 to
      2.9 mean log(10) decrease). SCR/CZ was significantly lower than control (P < .05)
      at times 2 and 3 only (1.7 to 2.0 mean log(10) decrease). In this guinea pig
      model, cleansing 12-hour-old lacerations contaminated with S aureus using SCR/PI
      or SCR/CZ significantly reduced bacterial counts over 12 hours.

PMID- 8476455
TI  - The influence of perceived risk of exposure to human immunodeficiency virus on
      medical students' planned specialty choices.
AB  - The purpose of this report is to determine the influence of the acquired
      immunodeficiency syndrome (AIDS) epidemic on medical students' training and
      career plans through a prospective, anonymous self-administered survey of 10
      Likert-scaled (1 strongly agree to 5 strongly disagree) responses to statements
      assessing attitude toward patients with human immunodeficiency virus (HIV),
      adequacy of knowledge and experience with HIV, and influence of HIV on career
      choices. The study was done at a major AIDS referral university teaching
      hospital. The participants were first- through fourth-year medical students in
      spring 1990. A 72% (of 451 students) response revealed that both surgery and
      emergency medicine were perceived as high risk of exposure specialties. Students
      indicated an overall willingness to care for HIV-positive patients (mean, 2.54)
      and a general adequacy of knowledge and experience (mean 2.54). The AIDS epidemic
      has had little influence for training, future career, and practice locations
      (mean, 4.06). Responses differed by class year. The later class years were more
      willing to care for HIV patients (P < .001) and indicated more knowledge and
      experience with HIV (P < .001). Influence on career, training and practice
      location choices were without class trend. In contrast to some studies, this
      group of medical students had relatively positive attitudes toward patients with
      HIV and were not particularly influenced by the AIDS epidemic regarding career
      choices.

PMID- 8476454
TI  - Resuscitation decision making by New Mexico emergency medical technicians.
AB  - The extent to which Emergency Medical Service personnel are placed in situations
      in which difficult cardiopulmonary resuscitation decisions must be made has been
      poorly explored. Further, it is not known whether this kind of decision making is
      troubling to emergency medical technicians. Although it is likely that emergency
      medical service systems handle withholding cardiopulmonary resuscitation in a
      variety of ways, the authors chose to examine a cross-section of New Mexico
      emergency medical technicians. Using a survey instrument, emergency medical
      technicians of all training levels, representing several emergency medical
      service systems around the state were asked how many times in their career they
      had been in a situation in which cardiopulmonary resuscitation had been withheld
      without a direct physician order. Of 310 individuals surveyed, 211 (66.8%)
      responded that this had occurred at least once. When asked whether they had been
      troubled by one of these situations, 86 of 211 (41%) individuals responded "yes."
      When a variety of demographic factors were evaluated, only training to the
      paramedic level was identified as being an independent predictor of those who
      were troubled (P = .019). Emergency medical technician training, protocols, and
      do not resuscitate programs may need to be expanded to give further guidance to
      prehospital personnel when making difficult resuscitation decisions.

PMID- 8476456
TI  - Nasal septal abscess: an unusual complication of nasal trauma.
AB  - Injuries to the nasal septum may occur as a result of injuries to the nose. A
      case of nasal septal abscess, an unusual complication of nasal trauma, is
      presented. The pathophysiology, clinical course, and treatment of this disorder
      are discussed. This case demonstrates the need for careful evaluation of the
      nasal septum in all cases of nasal trauma.

PMID- 8476457
TI  - Retropharyngeal abscess in an afebrile child.
AB  - A case of retropharyngeal abscess in a child is reported. The patient was
      nontoxic appearing, afebrile, and had minimal symptoms. The case is used to
      highlight the high index of suspicion that may be necessary to diagnose the
      condition. Diagnostic approaches, emergency treatment, and disposition of
      patients are discussed.

PMID- 8476458
TI  - Venous air embolism following orogenital sex during pregnancy.
AB  - Venous air embolism is an infrequent complication of pregnancy but may occur if
      air is blown into the vagina during orogenital sex. Air passes beneath the fetal
      membranes and into the circulation of the subplacental sinuses, invariably
      causing death to both mother and fetus within minutes. Reported is the case of a
      nonfatal air embolism following vaginal air insufflation in the 38th week of
      pregnancy. The hospital course was complicated by hypotension, metabolic
      acidosis, acute neurologic changes, and emergency caesarean section with eventual
      fetal demise. Clinical and laboratory abnormalities as well as treatment measures
      are discussed. Familiarity with this syndrome is essential if prompt and
      appropriate therapy is to be rendered.

PMID- 8476459
TI  - Cervical spine trauma in children: Part I. General concepts, normal anatomy,
      radiographic evaluation.

PMID- 8476460
TI  - Emergency cardiac pacing.

PMID- 8476461
TI  - Cases in electrocardiography.

PMID- 8476462
TI  - Ketamine dissociative sedation in pediatric emergency medical practice.

PMID- 8476463
TI  - The role of emergency medicine in a teaching hospital: decision making in an
      uncontrolled environment.

PMID- 8476464
TI  - Severe reaction to "natural testosterones": how safe are the ergogenic aids?

PMID- 8476465
TI  - Unusual complication of central venous catheterization.

PMID- 8476466
TI  - Blunt abdominal trauma due to a goat assault.

PMID- 8476467
TI  - Prolonged bradyasystole and seizures following intravenous adenosine for
      supraventricular tachycardia.

PMID- 8476468
TI  - Assessment of acute iron poisoning by laboratory and clinical observations.
AB  - A survey of medical records at a tertiary children's medical center was performed
      to determine whether selected laboratory and clinical observations and the serum
      iron concentration exceeding the total iron-binding capacity serve as indicators
      of acute iron poisoning. Patients were hospitalized for treatment of iron
      poisoning during January 1976 through June 1992. A total of 128 patients were
      identified; 92 met selection criteria and 65 had a serum iron concentration and
      total iron-binding capacity obtained simultaneously. The present study was unable
      to confirm that vomiting, diarrhea, leukocytosis, hyperglycemia, and
      radiopacities were associated with a serum iron concentration in excess of 300
      micrograms/dL (54 mumol/L); only one observation, coma, was associated (P < .02)
      with a serum iron greater than 500 micrograms/dL (90 mumol/L). Coma,
      radiopacities, leukocytosis, and an elevated anion gap will be concurrently
      present (predictive value positive = 100%) when the serum iron concentration is
      greater than 500 micrograms/dL; moreover, they will be absent collectively
      (predictive value negative = 95%) when the serum iron concentration is below 500
      micrograms/dL. Individually, these signs and symptoms have a low positive
      predictive value, but the absence of any one of these variables is likely to be
      associated with serum iron concentrations less than 500 micrograms/dL (predictive
      value negative > or = 93%). The ratio of serum iron concentration to the total
      iron-binding capacity was not associated with symptoms of systemic iron toxicity
      or presence of vin rose urine after parenteral deferoxamine administration. A
      serum iron concentration in excess of the total iron-binding capacity may not
      identify patients with serious iron poisoning.

PMID- 8476469
TI  - The ferning and nitrazine tests of amniotic fluid between 12 and 41 weeks
      gestation.
AB  - Most studies investigating the usefulness of ferning and nitrazine methods for
      detecting the presence of amniotic fluid following ruptured amniotic membranes
      have employed samples from vaginal pooling. Reported accuracies are 84 to 100%
      for the ferning test and 87 to 97% for the nitrazine test. Our study was designed
      to determine if these tests are applicable throughout gestation. Samples were
      obtained from amniocenteses between 14 and 42 weeks. Part I: Of 112 samples
      allowed to dry on a slide for 3 minutes only, 86.6% were ferning positive and
      100% were nitrazine positive. Flame-drying increased the presence of ferning to
      96.4%. Part II: 363 samples were allowed to dry completely for up to 10 minutes.
      All samples were ferning and nitrazine positive. Part III: 17 samples were tested
      for ferning and nitrazine at 1 hour, and again at 1 week. Sixty-six samples were
      tested within 1 week and again at 2 weeks. All samples remained ferning and
      nitrazine positive. Therefore optimal analysis of suspected amniotic fluid occurs
      when specimens are air-dried for 10 minutes. These tests may be reliably
      performed at gestations of 12 to 41 weeks.

PMID- 8476470
TI  - Sonographic measurement of the fetal iliac bone: growth and relation to femur
      length in assessment of gestational age.
AB  - Diagnostic ultrasonography has given us the opportunity to diagnose several
      congenital malformations in utero. Skeletal dysplasias is a heterogeneous group
      of disorders of the skeleton. Although disorders of bone growth are often
      diagnosed in utero, it is usually a general diagnosis because the exact syndrome
      cannot be specified. This is due to the fact that many anomalies of the skeleton
      have similar features. The wing of the iliac bone can be either affected or
      normal in skeletal dysplasias and its appearance may help in the differential
      diagnosis. This study was undertaken to establish values for the width of the
      iliac bone wing during normal gestations and thus enable us to use it in the
      evaluation of fetal growth and the recognition of specific congenital anomalies.

PMID- 8476471
TI  - Ultrasonic evaluation of kidney volume in term and preterm infants.
AB  - Kidney volume in relation to gestational age, birthweight, and height was
      determined in 121 infants, 58 females and 63 males, with gestational ages from 23
      to 43 weeks (mean, 33.3) and birthweight from 430 to 4600 gm (mean, 1982 gm). The
      kidney volume was measured using a real-time linear computed ultrasound scanner,
      with a 5 MHz transducer. The renal volume was calculated from outer kidney
      diameters using the volume formula for an ellipsoid. In the infants studied, mean
      volume of the right kidney was 6.0 ml (range, 1.4 to 13.8 ml), and of the left
      kidney 6.6 ml (range 1.5, to 15.6 ml), with no significant difference. A highly
      significant correlation was found between the volume of both kidneys and either
      gestational age, or birthweight, or height, with r values ranging from 0.81 to
      0.92. The best correlation was observed with birthweight. No significant
      difference was found between males and females.

PMID- 8476472
TI  - Is fetal blood sampling associated with increased beta-endorphin release into the
      fetal circulation?
AB  - This study was conducted to determine whether fetal blood sampling during the
      second trimester is associated with changes in circulating fetal beta-endorphin
      (BE) concentrations. We measured BE concentrations in 68 paired fetal and
      maternal blood samples obtained between 18 and 28 weeks' gestation. Patients were
      divided into a control group (n = 50), if the fetal blood samples were obtained
      by a single umbilical cord puncture, or multiple insertion group (n = 18), if
      multiple cord punctures were required to obtain a sample. The mean (+/- SE) fetal
      BE value for the multiple insertion group was significantly higher than BE levels
      from the control group (771.2 +/- 79.2 pg/ml versus 107.1 +/- 11.7 pg/ml; p <
      0.001]. This elevation did not appear to be related to acidosis, since no
      differences in fetal umbilical pH were observed between the two groups. Fetal BE
      levels from the control but not from the multiple insertion group significantly
      correlated with maternal values (Spearman rank r = 0.59; p < 0.001 vs r = -0.08;
      p > 0.5). In neither group did fetal BE levels correlate with gestational age.
      These findings indicate that multiple cord punctures at the time of fetal blood
      sampling are associated with significant increases in BE release. Furthermore,
      although a maternal or placental contribution to steady state circulating fetal
      BE cannot be excluded, it would seem that the fetus itself is the primary source
      of elevated circulating BE levels following multiple cord punctures.

PMID- 8476473
TI  - Corticotropin-releasing hormone and cortisol in cord plasma in relation to
      gestational age, labor, and fetal distress.
AB  - Concentration of corticotropin-releasing hormone (CRH) has earlier been found to
      increase greatly in maternal plasma during the last trimester of normal pregnancy
      and even more in preeclampsia. This CRH is thought to be of placental origin, and
      it may stimulate maternal or fetal pituitary adrenal axis. We studied CRH in
      umbilical cord venous plasma in relation to gestation, labor, and fetal distress.
      There was a great maternal-to-fetal concentration difference in plasma CRH
      levels, a hundredfold at term pregnancy, suggesting that the placenta releases
      CRH mainly into the maternal rather than into the fetal circulation. Length of
      gestation or the mode of delivery did not affect CRH levels in cord plasma. Cord
      CRH levels were higher (median, 24.1, range, 14.2 to 67 pmol/liter) in six
      preterm infants with chronic fetal distress, born to mothers with severe
      preeclampsia and in nine infants born after premature rupture of membranes
      (median, 17.0, range, 7.65 to 53 pmol/liter), than in 12 preterm control infants
      born after uncomplicated pregnancy (median, 6.3 range, 1.0 to 27.5 pmol/liter).
      No significant correlation was found between CRH and cortisol levels in cord
      plasma. Increased cortisol levels in cord plasma were associated with spontaneous
      vaginal delivery but not with chronic fetal distress. These findings demonstrated
      that placental release of CRH into the fetal circulation may be increased in
      pregnancy complications with chronic fetal distress but failed to prove any
      relationship between placental CRH and fetal adrenal function.

PMID- 8476474
TI  - Doppler flowmeter-assessed circadian rhythms in neonatal cardiac function, family
      history, and intrauterine growth retardation.
AB  - This study examines the circadian variation of aortic blood flow velocity,
      acceleration, and distance of stroke, assessed every 4 hours for 24 hours by
      Doppler ultrasound in 88 human newborns. Groups 1 and 2 involve neonates with a
      negative family history of high blood pressure or myocardial infarction monitored
      during the first day or between the second and tenth days postpartum,
      respectively; groups 3 to 6 are 2- to 10-day-old babies with a positive family
      history of high blood pressure (group 3) or of myocardial infarction (group 4) or
      with a negative family history and intrauterine growth retardation (group 5) or
      born prematurely (group 6). Cosinor analyses demonstrate a circadian rhythm for
      all variables in groups 2 and 5 (p < 0.001), with overall high values occurring
      around 17:40. In group 2, a circadian rhythm remains demonstrable in boys and
      girls considered separately, and mostly so in arbitrary subgroups of different
      sizes, with only slight differences in rhythm parameters among them. These
      results show that, with relatively small samples, reproducible circadian rhythms
      of cardiac function can be detected shortly after birth in neonates with a
      negative family history of high blood pressure or myocardial infarction.

PMID- 8476475
TI  - Direct stimulation of urokinase, plasmin, and collagenase by meperidine: a
      possible mechanism for the ability of meperidine to enhance cervical effacement
      and dilation.
AB  - Current hypotheses suggest that the degradation of cervical collagen and elastin
      leads to cervical effacement and dilation during labor. The collagenolytic
      activity is thought to be initiated through the conversion of latent
      (pro)collagenase to active collagenase by the plasmin formed from plasminogen or
      by other proteases similarly formed from their inactive zymogens. We presently
      demonstrate that meperidine stimulates the activity of several enzymes in the
      proteolytic cascade leading toward proteolysis of connective tissue proteins.
      Meperidine in its therapeutic concentration range produces a 26% stimulation of
      urokinase activity on substrate S-2444, a 39% stimulation of plasmin activity on
      substrate S-2551, and a 33% stimulation of collagenase activity on 14C-labeled
      globin substrate. These direct effects on the enzyme activities are noted in
      vitro with the purified enzymes and were confirmed with several small molecular
      weight chromogenic substrates and with 14C-globin protein substrate. Oxytocin at
      levels found during active labor fails to stimulate the in vitro activity of
      purified urokinase, plasmin, collagenase, trypsin, or tissue-type plasminogen
      activator. The effect of meperidine on the proteolytic enzymes suggests that its
      ability to promote cervical effacement and distention during labor may be at
      least partially due to a meperidine-induced stimulation of cervical proteases.

PMID- 8476476
TI  - Obstetric and neonatal outcome in fetuses with absent end-diastolic velocities of
      the umbilical artery: a case-controlled study.
AB  - Absence of end-diastolic velocities (AEDV) is the most severe waveform
      abnormality detected by Doppler ultrasound examination of the umbilical artery.
      It is associated with fetal hypoxemia and acidemia. If AEDV predisposed to more
      neonatal complications, then it might be an indication for earlier delivery. This
      was investigated in 21 preterm fetuses with AEDV who were matched for gestational
      age at delivery with 21 with end-diastolic velocities. All fetuses were delivered
      electively before 36 weeks' gestation of mothers who were hypertensive. The fetal
      heart rate (FHR) variability, birthweight, and umbilical arterial blood pH were
      significantly lower in the AEDV group. However, the neonatal outcomes were
      similar except for less severe hyaline membrane disease and lower initial
      platelet counts in the AEDV group. At present, fetuses with umbilical arterial
      AEDV need not be delivered earlier than indicated by the FHR pattern, nor should
      neonatal management be altered on the basis of antenatal AEDV.

PMID- 8476477
TI  - Respiratory compliance assessed from chest expansion and inflation pressure in
      ventilated neonates.
AB  - We evaluated a bedside method of assessing respiratory compliance from chest
      expansion, which is judged by eye and classified into three tidal volume
      categories, and from the inflation pressure read on the respirator's manometer.
      Compliance assessed by this method was compared with the compliance measured by
      the injection technique in 45 randomly chosen newborns ventilated for various
      diseases. The compliance assessed from chest expansion and inflation pressure
      correlated significantly with the measured compliance (r = 0.86, p < 0.001).
      Interobserver reliability was acceptable for clinical practice and improved
      within 6 months of training (weighted kappa = 0.67 versus 0.86). Within ten
      individuals, changes of compliance assessed by this method were also
      significantly correlated with those of measured compliance (r = 0.85, p < 0.01).
      This method, termed "optical compliance," is instantaneously and always available
      for all patients on ventilators without any additional apparatus and thus might
      improve the assessment of respiratory function in routine care and emergency
      situations.

PMID- 8476478
TI  - Acid-base significance of meconium discovered prior to labor.
AB  - Although the significance of meconium in the amniotic fluid diagnosed during
      labor remains problematic, there is little information regarding the significance
      of meconium discovered prior to labor. The present study consisted of 40 term
      pregnancies with meconium found at amniocentesis for lung maturity (n = 7) or
      elective cesarean section (n = 33) and 40 uncomplicated, control pregnancies with
      clear amniotic fluid at elective cesarean section. The mean umbilical artery (UA)
      blood pH was 7.26 in the meconium group and 7.28 in the control group. Overall,
      the frequency of fetal acidemia (UA pH < 7.20) was 15% (6 of 40) of the infants
      in the meconium group versus 8% (3 of 40) in the control group (p = 0.24). All
      nine of these infants had a respiratory acidosis defined as a UA blood pH less
      than 7.20 with normal bicarbonate and elevated carbon dioxide pressure.
      Importantly, none of the neonates had metabolic acidemia and all had
      uncomplicated hospital courses. All of the pregnancies reported were promptly
      delivered because of meconium and we therefore cannot recommend nonintervention
      when meconium is diagnosed in the antepartum period. Meconium discovered prior to
      labor is not necessarily a marker of immediate or chronic fetal compromise.

PMID- 8476479
TI  - Placental chorioangioma: prenatal diagnosis and clinical significance.
AB  - We report the prenatal diagnosis of placental chorioangioma in a 32-week
      intrauterine pregnancy associated with polyhydramnios and enlarged fetal cardiac
      size that resulted in intrauterine fetal death. Ultrasound appearance,
      pathophysiology, and clinical significance of this entity are discussed.

PMID- 8476480
TI  - The frequency of hypoglycemia in full-term large and small for gestational age
      newborns.
AB  - Although various authors recommend screening for hypoglycemia in large for
      gestational age (LGA) and small for gestational age (SGA) newborns, the frequency
      of hypoglycemia in these infants, using a recent definition of hypoglycemia, and
      the proper duration of screening are not documented. We determined chromogen test
      strip blood glucose values at ages 1, 2, 3, 6, 12, 24, 36, and 48 hours in full
      term LGA and SGA infants whose mothers were not diabetic. Serum glucose
      determination was immediately done if a test strip reading was less than 40
      mg/dl. Hypoglycemia was defined as a serum glucose less than 35 mg/dl at less
      than 3 hours of age, less than 40 mg/dl at 3 to 24 hours of age, and less than 45
      mg/dl at more than 24 hours of age. The frequency of hypoglycemia in LGA infants
      was 8.1% (95% confidence interval [CI] 5.0 to 11.2%), and in SGA infants, 14.7%
      (95% CI 9.8 to 19.6%). The mean age at which hypoglycemia occurred was 2.9 hours
      (range, 0.8 to 8.5) in LGA infants, and 6.1 hours (range, 0.8 to 34.2) in SGA
      infants. There were no differences in other possible risk factors between the
      hypoglycemic and euglycemic infants except that in SGA infants meconium-stained
      amniotic fluid (40% vs 20%, p = .001), maternal preeclampsia (27% vs 8%, p =
      0.0056), and male sex (29% vs 9%, p = 0.029) were more common in hypoglycemic
      than in euglycemic infants. These data suggest that screening for hypoglycemia in
      LGA infants whose mothers are not diabetic may be stopped after 12 hours, but
      should continue for 48 hours in SGA infants.

PMID- 8476481
TI  - The extremely low birthweight infant: the twenty-first century dilemma.
AB  - The survival rate of very low birthweight infants (weighing less than 1500 gm)
      has dramatically increased over the past two decades. Consequently, high-tech
      intensive care is offered to an increasing number of infants with borderline
      viability, previously considered as miscarriages. We reviewed the most recent
      literature on the results of intensive care used in the subgroup of extremely low
      birthweight infants, weighting less than 750 gm or 800 gm. Since definitions,
      management policies, and follow-up reports in this group of newborns are not
      consistent, the important statistical variables of incidence, mortality, and
      morbidity are incomplete and severely biased. In the past decade there was a
      growing tendency toward using a more active approach in caring for these infants.
      Most of the success is among the infants weighing 750 to 800 gm, with a survival
      rate in the range of 33 to 62%. However, the overall improvement in survival is
      small, with an extremely poor outlook for infants below 600 gm. The morbidity
      rate in the survivors is alarmingly high, reaching 70% and most common in infants
      with birthweight less than 600 gm. The available data show that virtually for
      every "healthy" surviving extremely low birthweight infant there is also at least
      one surviving child who is moderately to severely handicapped. The overall
      consequences and implications of high-tech care of these borderline viability
      infants, once considered as nonviable, are not necessarily improved over those of
      the former, less aggressive, approach. Since these results have grave
      consequences for the involved families and society, we urgently need to involve
      these parties more actively in decision making.

PMID- 8476482
TI  - Vasopressinase-altered vasopressin elevates arterial pressure in anesthetized
      rats.
AB  - Transient diabetes insipidus of pregnancy (TDIP) is associated with elevated
      activity of vasopressinase, a plasma enzyme that opens the vasopressin (AVP) ring
      to produce a linear peptide that we have named vasopressinase-altered vasopressin
      (VAV). VAV may play a role in the pathogenesis of the arterial hypertension
      associated with TDIP. We sought to determine if VAV elevates arterial pressure,
      the potency of VAV relative to that of AVP, and whether the peptide binds to the
      vascular AVP receptor. AVP was incubated with vasopressinase and VAV was
      separated from residual AVP by high-pressure liquid chromatography. Intravenous
      bolus administration of VAV or AVP to ganglionic blocked rats produced dose
      dependent increases in arterial pressure, with VAV demonstrating approximately
      6000-fold lower potency than AVP. Vasopressin receptor blockade abolished the
      response to both AVP and VAV. These results suggests that high levels of VAV may
      contribute to the hypertension seen in TDIP.

PMID- 8476483
TI  - Acquired tracheoesophageal fistula in a premature infant.
AB  - A fatality from an acquired tracheoesophageal fistula (TEF) in a very low
      birthweight premature infant is presented. Neonatal tracheal and esophageal
      injuries related to endotracheal (ET) intubation are discussed. The infant had
      important risk factors for the development of subglottic stenosis: birthweight
      less than 1000 gm, prolonged positive pressure ventilation, and repeated ET
      intubation. The pathologic examination was consistent with acquired fistula
      formation resulting from a combination of preexisting subglottic stenosis and
      prolonged and repeated ET intubation. The recognition of clinical signs of an
      acquired TEF, as observed in our patient, followed by expeditious diagnostic
      testing may be lifesaving.

PMID- 8476484
TI  - Raised serum gravidin levels are associated with pregnancy-induced hypertension.
AB  - It has recently been reported that synthesis of the vasodilatory prostaglandin,
      prostacyclin, is decreased in human pregnancy-induced hypertension (PIH).
      Prostaglandin production is regulated mainly by the enzyme phospholipase A2. We
      report here that serum levels of a potent phospholipase A2 inhibitor (gravidin)
      were elevated during early pregnancy in women who later developed PIH compared
      with those who remained normotensive throughout pregnancy. It is suggested that
      high circulating levels of this potent phospholipase inhibitor may account for
      the reported decrease in prostacyclin synthesis and contribute to the development
      of pregnancy-induced hypertension.

PMID- 8476485
TI  - Survival in an infant with a prenatally diagnosed Meckel syndrome variant.
AB  - An infant with occipital encephalocele and unilateral multicystic kidney,
      diagnosed prenatally, was considered to have a variant of the Meckel syndrome
      (MS). This case is exceptional in that the infant was alive and healthy following
      surgical repair of the encephalocele, with normal function of the unaffected
      kidney, at age 5 months. Based on this experience, in fetuses or infants with MS,
      thorough evaluation of both kidneys is imperative prior to suggesting either
      termination of pregnancy, or withholding of life-sustaining medical treatment in
      infants already delivered.

PMID- 8476486
TI  - Prolonged survival of two anencephalic infants.
AB  - Two infants with anencephaly survived for 7 and 10 months without the need for
      prolonged assisted mechanical ventilation. One infant prospectively fulfilled all
      four criteria of the Medical Task Force on Anencephaly, making diagnosis almost
      certain. Prolonged survival of anencephalic infants is important not only to
      provide adequate counseling, but also for its relevance to organ transplantation.

PMID- 8476487
TI  - Thermoregulation of pregnant women during aerobic exercise on land and in the
      water.
AB  - Seven women in their 25th week of pregnancy exercised for 20 minutes on a cycle
      ergometer at 70% of their maximal heart rate on land and in the water (30 degrees
      C) to compare thermoregulatory responses. Rectal temperatures increased 0.5 +/-
      0.1 degrees C during the land trial and only 0.2 +/- 0.1 degrees C during the
      water trial (p < 0.05). Mean body temperature rose 0.6 +/- 0.2 degrees C during
      the land trial, but declined -0.3 +/- 0.1 degrees C during the water trials (p <
      0.05). Land exercise caused greater heat storage and sweat loss. The results
      suggest that normal pregnant women can maintain thermal balance during 20 minutes
      of exercise at 70% maximal heart rate, whether on land or in the water. Thus, for
      normal, average fit, pregnant women who wish to participate in a moderate
      exercise program, heat stress is probably not a major concern.

PMID- 8476488
TI  - General anesthesia for surgical repair of intracranial aneurysm in pregnancy:
      effects on fetal heart rate.
AB  - A 30-year-old nulliparous woman underwent surgery for a ruptured aneurysm of the
      left vertebral artery in gestational week 27. The fetal heart rate (FHR) was
      monitored continuously with an abdominal Doppler transducer. Anesthesia was
      induced with midazolam, fentanyl, and thiopental and maintained with fentanyl,
      isoflurane, and nitrous oxide 67% in oxygen. Surgery was performed under moderate
      hypotension (mean arterial pressure +/- 70 mmHg) and moderate hyperventilation
      (arterial carbon dioxide pressure +/- 33 mmHg). There was a complete
      disappearance of FHR variability without decelerations or bradycardia. In the
      night following surgery, the patient was sedated with large parenteral doses of
      midazolam and fentanyl. Despite this sedation, some FHR variability reappeared
      within 40 minutes after discontinuation of the inhalation anesthetics. After
      discontinuation of parenteral midazolam and fentanyl, normal FHR variability
      returned within 60 minutes. In week 41 of pregnancy, a healthy girl of 4015 gm
      was born.

PMID- 8476489
TI  - Mathematical modeling of fetal organ growth using the Rossavik growth model: II.
      Adrenal gland.
AB  - Growth of the fetal adrenal gland has been monitored by measurements of the
      circumference (AGC) and area (AGA) of the adrenal gland from 16 to 40 weeks
      menstrual age. Growth curves for these parameters have been determined using a
      Rossavik growth curve models [P = c(t)k + s(t)]. R2 values of 86.2 and 91.1% were
      obtained for AGC and AGA, respectively. Variability analysis indicated a
      progressive increase in variability with menstrual age for these two parameters.
      Variability data were used with the growth curve models to determine standard
      curves for AGC and AGA. These standard curves provide a superior means for
      evaluating the adrenal growth in the fetus and the fetal status in utero in high
      risk pregnancies.

PMID- 8476490
TI  - Building antibodies from their genes.

PMID- 8476491
TI  - [Expression of recombinant proteins in the milk of transgenic animals].
AB  - The bulky production of recombinant proteins can be achieved by procaryotes or
      eucaryotes cells. Cells from higher eucaryotes may be required when proteins have
      to be modified post-transcriptionally (glycosylation phosphorylation, cleavage,
      folding...). Cells from higher vertebrates in culture are used to prepare
      proteins like human factor VIII and erythropoietin. The use of transgenic
      organism has been suggested to reach the same goal. Indeed a whole living
      organism allows a very potent amplification, the number of cells involved in the
      biosynthesis of the recombinant proteins being very numerous and in the best
      metabolic conditions. Biological fluids (blood, milk, insect hemolymph, egg
      white...) and possibly organs from transgenic animals are a priori the best
      sources of recombinant proteins. Blood is abundant and it is a by-product of
      slaughter house. Its composition is relatively complex and the circulating
      recombinant proteins may heavily alter health of animals. Milk is very abundant,
      its composition is relatively simple, it is poor in proteolytic enzymes and it
      can be collected easily. Hemolymph from insects is relatively scarce. Egg white
      will be a possible source of recombinant proteins, when transgenesis has become
      more accessible in birds. Organs from transgenic animals should be solicited only
      when a particular cell type is required for the biosynthesis of the recombinant
      proteins. Milk appears therefore, presently, as the best source of recombinant
      proteins from transgenic animals. About 15 public and private laboratories try to
      use these techniques. They consist in preparing vectors containing regulatory
      regions of one of the milk proteins genes and the coding part (cDNA or gene) of
      the corresponding proteins to be produced. The transfer of these gene constructs
      to mouse, rabbit, sheep, goat, pig, shows that these techniques are indeed very
      promising. A single protein, human alpha 1-antitrypsin produced in milk of
      transgenic sheep, has presently reached the preparation at an industrial scale.
      This method has two theoretical limitations: 1) some of the proteins secreted in
      milk may be not matured as their native counterparts. Experiments carried out so
      far (about 20 proteins has been produced at an experimental scale) indicate that
      the mammary cell is able to achieve glycosylation in a correct way; 2) a
      significant proportion of the recombinant proteins migrate from the alveolar
      compartment of the mammary gland to blood circulation and they can alter health
      of lactating animals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8476492
TI  - Viral inactivation and reduction in cellular blood products.
AB  - Even though the risks associated with the transfusion of blood products are lower
      than ever before, considerable efforts are being employed to improve the safety
      of the blood supply. Based upon available data, a six log (99.9999%) reduction in
      virus level from screened and tested blood components should significantly reduce
      or eliminate the risk of post-transfusion infection. The objective has been to
      identify "generic" methods, that is, one that would be applicable to all virus.
      For red cells, physical and chemical approaches have been studied; for platelets,
      the approaches have been limited to chemical. The physical methods include
      depletion of leukocytes by filtration, removal of plasma by washing, and viral
      inactivation by heat. Among the chemicals investigated to inactivate or help
      displace virus are ozone, detergents, and hypochlorous acid. Several
      photochemicals have also received intensive investigation: merocyanine 540, a
      benzoporphyrin derivative, aluminum phthalocyanine, and methylene blue. For
      platelets, photochemical inactivation methods using merocyanine 540, and two
      psoralen derivatives, 8-methoxypsoralen (8-MOP) and aminomethyl trimethyl
      psoralen (AMT), have also been studied. Approaches which include washing are not
      suitable. For the most part, either viral removal or inactivation has been
      insufficient, or red cell or platelet damage unacceptable. However, there are a
      few indications that at least inactivation of a specific virus, such as HIV, may
      be possible without major cell damage. These studies are in their early stages
      and significant work remains. If feasibility is clearly shown in vitro, it is
      likely that in vivo primate studies to demonstrate safety and efficacy will be
      required.

PMID- 8476493
TI  - [Industrial pasteurization of plasma and criteria of quality].
AB  - The approach followed in the design of a large-scale pasteurization treatment (60
      degrees C for 10 hours in the liquid state) of fresh frozen plasma is presented.
      Various aspects thought to influence the viral safety of such a product are
      discussed. They are based largely upon the fact that, although it is subjected to
      a specific viral inactivation treatment, this plasma does not benefit from any
      fractionation steps known to participate in the potential elimination of
      infectious agents during the manufacture of plasma derivatives. Consequently, the
      plasma is obtained from regular plasmapheresis donors, and the plasma donations
      used to make the pool must be negative for anti-HIV-1 and -2, anti-HCV, anti-HBc,
      anti-HTLV-1 and -2, HBs antigen and parvovirus B19 antigen, and have a normal
      level of ALT. The batch size is limited to 100 plasma units to limit the
      potential infectious risk associated with very large batches, especially if an
      infectious agent, resistant to pasteurization, is present. Pasteurization has
      been chosen for this procedure, as applied to plasma derivatives, has been shown
      to inactivate a broad spectrum of viruses, both enveloped and non-enveloped. The
      process is relatively simple. The frozen plasma units are opened, and the plasmas
      are mixed and thawed at 30 degrees C to avoid the formation of cryoprecipitate.
      The liquid plasma is transferred to a sterilized container and stabilizers are
      added. The mixture is then transferred to the pasteurization unit to be heat
      treated at 60 degrees C for at least 10 hours under gentle mixing. Following
      cooling, the mixture is ultrafiltered to eliminate the stabilizers and to
      concentrate the plasma pool to its initial volume. The plasma is sterile
      filtered, then dispensed into bottles and frozen. Virus validation of this
      pasteurization process, carried out by independent virology laboratories, have
      confirmed the ability of the process to inactivate more than 4 to 6 logs of non
      enveloped or enveloped, DNA or RNA, viruses, including HIV-1 and Sindbis virus,
      in less than 5 hours of heat-treatment. The biological characteristics of the
      pasteurized plasma include a good preservation (75 to 95%) of the activity of
      clotting factors, including FI, FV, FVIII, FXI, and FXIII, and protease
      inhibitors. The overall clottability of the plasma, as expressed by the APTT, is
      almost unchanged.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8476495
TI  - [The behavior of Penicillium spores in air filters for automobile interiors.
      Testing of germination and propagation under static and dynamic test conditions
      using microscopic and microbiologic methods].
AB  - Microbiological tests show, that 3-layer car-air filters (Polycarbonate
      microfiber type AF 901) are not a substrate for fungi frequently present in
      outdoor air. Microscopical investigations of the filter samples, which were
      exposed to Penicillium spores under static and dynamic conditions show no growth
      and no germination. The particles of dust which are trapped in the car-air
      filter, have no components with fungicidal effect, but include substances for
      inhibition of spore germination. In static model experiments (without air stream)
      already driven car-air filters were tested and fungal growth was obtained by very
      high concentrations of substrate and spores. On the other hand, however, in
      dynamic tests (with air stream) fungal growth cannot be detected, because the
      liquid humidity is absent.

PMID- 8476494
TI  - [Environmental medicine group diagnosis of children--studies from 1982 to 1990.
      Review].
AB  - In the period of 1982-1990 a total of 5760 children (2893 boys, 2816 girls) were
      examined in the frame-work of the Clean Air Programme Rhine-Main: from the
      polluted Rhine-Main area 2511 children (Wiesbaden 1682, Frankfurt since 1985,
      825), from the control areas 3153 children (Freiburg area 1937, Starnberg area
      1316). Healthy children living in the industrialised Rhine-Main area exhibited
      alterations of the following parameters compared with healthy children living in
      the less polluted control areas: Long-term alterations, enlarged and fissured,
      rough palatine tonsils, palpably enlarged cervical and mandibular lymph nodes,
      Short-term alterations, erythrocyte count: from 1981-1988 relatively smaller
      numbers, from 1988-1990 equalized to the scatter range of controls, hemoglobin
      values: corresponding to erythrocyte counts, activity of lymphocyte nucleoli:
      increased until 1985, later on equalized, lymphocyte count: reduced, T8
      suppressor cell count: decreased, chemiluminescence of granulocytes: increased,
      palatine tonsils: altered microbial contamination with contact germs, altered
      physiological resident flora, heavy metals (Pb, Cd) in hair: from 1982-1990
      increased, then slowly reduced corresponding to the results of the ambient air
      analyses. These findings indicate an increased inclination for reaction of the
      healthy juvenile organism in the sense of biological adaptation to long-term
      stress, i.e. living for years in an area with air pollution, and are also in good
      agreement with the measuring values characterising the ambient air quality.

PMID- 8476496
TI  - Comparison of glass wool and glass powder methods for concentration of viruses
      from treated waste waters.
AB  - Enumeration of cultivable virus particle in sewage requires the samples to be
      concentrated. Two adsorption-elution methods, the glass wool cartridge method and
      the glass powder fluid layer method were compared. Firstly, it was demonstrated
      that virus could be readily recovered from the head, first 25 ml, of eluate of
      glass wool rather than from a reconcentration of the entire eluate, either by
      organic flocculation: 83% of positivity vs 44% respectively or double
      precipitation by PEG: 85% of positivity vs 61% respectively. Concentration on
      glass wool allowed the rescue of a greater number of positive samples (33/35)
      than on glass powder (16/35) as well as a higher mean titer of indigenous
      viruses, respectively 19 MPNCU/l vs 6 MPNCU/l (F1(34) = 36.02, P < 0.0001).
      Enteroviruses were the most frequently isolated viruses: found in 34/35 samples
      by either method, in 32/35 samples by glass wool, and in 14/35 samples by glass
      powder. Of the 12 enterovirus types identified by either method, a majority was
      Echovirus 6 (10 samples), Echovirus 11 (7 samples), Coxsackievirus B5 (4 samples)
      and also Coxsackievirus A7, A16, A21, B1, B6, Echovirus 1, 4, 12 and 19.
      Adenovirus types 1 and 5 were isolated from 4 samples by either method.

PMID- 8476497
TI  - Prevalence of Legionella species, serogroups, and monoclonal subgroups in hot
      water systems in south-eastern Germany.
AB  - To study the contamination of hot water systems in south-eastern Germany 75
      houses were selected and water samples were collected from peripheral hot water
      taps, shower heads and in a few cases from central water storage tanks. A total
      of 661 water samples were cultured. 186 (27.7%) were positive for legionellae. In
      68% of hospitals, 50% of outpatients departments, 58% of dental offices, 85% of
      public buildings and 65% of private households in large buildings legionellae
      could be isolated. Most samples contained legionellae in the range of 1-100
      colony forming units (cfu) per ml, the highest concentration was 4000 cfu/ml.
      Isolated strains were typed using absorbed rabbit sera prepared against the ATCC
      type strains by the indirect immunofluorescence test. Legionella pneumophila
      serogroup 1, 2, 5, 6, and 10 strains were further subtyped using monoclonal
      antibodies. A total of 1548 colonies were serotyped. If the same species,
      serogroup and subtype in a given water system was considered to be the same
      strain, 77 different strains were isolated. 31 buildings contained one, 11
      buildings two, 3 houses three and one building six different strains. 72 strains
      belonged to the species Legionella pneumophila and 5 strains were non-pneumophila
      species. Legionella pneumophila serogroups 1, 3, 6, and 10 were most frequently
      isolated with 22%, 14%, 16% and 18%, respectively. Among the serogroup 1 strains,
      the monoclonal subgroup Bellingham was the most commonly found.

PMID- 8476498
TI  - [Epidemic occurrences of multiresistant Acinetobacter baumannii strains in a
      neonatal intensive care unit].
AB  - In a period of nine months (May 1991 to January 1992), 39 infants were colonized
      with Acinetobacter baumannii in a paediatric intensive care unit. Colonization
      was observed mainly in premature infants, weighing between 680 g and 2,000 g, who
      were artificially ventilated. Shortly after birth, A. baumannii was isolated
      regularly from tracheal washings, and less frequently from other material, such
      as gastric juice, catheter tips, and umbilical swabs. In older children or
      adults, the bacteria were found only in very low frequency. In the intensive care
      unit, A. baumannii could be isolated from tap water, sinks, water traps of the
      ventilation devices, the inner wall of incubators, and from the hands of medical
      personnel. Patients strains of A. baumannii, and those isolated monitoring the
      intensive care unit had an identical biochemical profile and a similar pattern of
      antimicrobial resistance, as well as a similar reaction in other typing methods.
      Anti-infective measures are discussed.

PMID- 8476499
TI  - The influence of culture conditions on the susceptibility of Salmonella
      typhimurium in the Salmonella mutagenicity test.
AB  - To determine the variability of tester strain susceptibility in the Salmonella
      mutagenicity assay and to optimize the culturing procedure we examined the
      influences of the overnight culture period (12-16 h), the use of an additional
      short-term culturing procedure (1-4 h) and the Salmonella density (cfu/plate) on
      the rate of revertants per plate. As tester strains we used Salmonella
      typhimurium TA97, TA98, TA100 and TA102. As shown previously for other microbial
      genotoxicity short-term tests (i.e. with Escherichia coli PQ37), we observed the
      highest susceptibility of the Salmonella strains, i.e. the highest amounts of
      revertants per plate, when using a 12 h overnight culture followed by a 2 h short
      term culturing procedure. We calibrated the bacterial count to 100 x 10(6) cfu
      per assay by photometric measurement (600 nm). Initially, we used 0-1 nmole 2,4,7
      trinitro-9-fluorenone with S. typhimurium TA97, 0-15 nmole daunomycin with strain
      TA98, 0-25 nmole sodium azide with strain TA100 and 0-15 nmole
      methylmethanesulfonate with strain TA102 as reference compounds in the standard
      plate incorporation test. Subsequently, to evaluate the results of the culturing
      procedure variations we examined 22 well-known mutagenic and direct-acting (-S9
      mix) compounds out of different chemical classes using both the standard and a
      modified culturing procedure. The comparison of these results showed a 64% (for 4
      nitroquinoline-N-oxide) to 421% (for sodium azide) increased amount of revertants
      for the modified test protocol.

PMID- 8476500
TI  - [Biological safety investigation of the production of human insulin using
      genetically altered E. coli K-12 cells. 2. Plasmid transfer by mobilization and
      cointegrate formation under environmental conditions].
AB  - Plasmid transfer by mobilization and cointegrate formation was tested with
      expression plasmids for human insulin in laboratory media and in river water
      samples. Plasmid pLIZP4 which carries a nic/bom sequence could only be mobilized
      after cloning of mobilization genes. Plasmid mobilization could be detected in
      laboratory media only, not in river water samples. The Nic/Bom plasmid pSW3 could
      be transferred by cointegrate formation in laboratory media at 30 degrees C and
      37 degrees C, not at room temperature or in river water. The results allow the
      conclusion that no transfer of the plasmids pLIZP4 and pSW3 will take place by
      mobilization or cointegrate formation under environmental conditions.

PMID- 8476502
TI  - Peptide nucleic acids (PNAs): potential antisense and anti-gene agents.
AB  - The binding of peptide nucleic acids (PNAs) T10-LysNH2, T5CT4-LysNH2 and T2CT2CT4
      LysNH2 to double-stranded DNA targets A10, A5GA4 and A2GA2GA4 was studied by
      nuclease S1 probing. It is found that the PNAs bind preferentially to their
      complementary targets, weaker to targets containing one mismatch and not to
      targets containing two mismatches. Using an RNA polymerase T3 in vitro
      transcription system, it is found that a PNA T10-LysNH2 bound downstream from the
      promoter causes transcription elongation arrest at the PNA binding site only when
      the PNA is bound to the template strand. Finally, it is shown that primer
      extension by Taq DNA polymerase on a single-stranded template is arrested at an
      occupied PNA T10 binding site. These results are discussed in relation to PNAs as
      potential anti-sense and anti-gene drugs.

PMID- 8476503
TI  - Stabilities of duplexes and triplexes of dA19 + dT19 with alternating
      methylphosphonate and phosphodiester linkages.
AB  - Results from UV thermal melting, polyacrylamide gel electrophoresis and circular
      dichroism (CD) experimetns are used to compare stabilities of complexes formed
      from 1:1 and 1:2 molar ratio mixtures of dA19 or dA*P19 (alternating
      phosphodiester and methylphosphonate linkages on the A chain) with dT19 or dT*P19
      (alternating phosphodiester and methylphosphonate linkages on the T chain).
      Complexes formed from 1:1 and 1:2 molar ratio mixtures of dA*P19 with dT19 are
      more stable than the respective unmodified 'parent' complexes, but less stable
      than complexes of dA*19 (17 methylphosphonates on the A chain) + dT19. At 0.1 M
      Na+ complexes containing dT*P19 are less stable than those with dT19, yet more
      stable than complexes containing the highly modified dT*19 (17 methylphosphonates
      on the T chain). A value of 2.6 kcal/mol base triplets is calculated for delta H
      of dA19.2dT19-->dA19.dT19+dT19.

PMID- 8476501
TI  - Growth inhibition of human tumor cell lines by antisense oligonucleotides
      designed to inhibit p120 expression.
AB  - The human nucleolar antigen p120 was detected with an anti-p120 monoclonal
      antibody (MAbp120) in most human malignant tumors (Freeman et al., Cancer
      Research, 48, 1244-1251, 1988). Stable transfection of the sense p120 cDNA caused
      malignant transformation of NIH/3T3 cells in vitro, and the antisense p120
      constructs markedly delayed the growth of these transformed cells (Perlaky et
      al., Cancer Research, 52, 428-436, 1992). Several p120 antisense phosphorothioate
      oligonucleotides designed to hybridize with different regions of the p120
      sequence were screened on human tumor cell lines in vitro. Marked growth
      inhibition of HeLa, LOX and HRCC cell lines was found, particularly with
      antisense p120 oligonucleotide ISIS 3466 in combination with N-[1-(2,3
      dioleyloxy)propyl]-N,N,N-trimethylammonium chloride (DOTMA); oligonucleotide ISIS
      3466 is complementary to a non-translated region at the 3' end of the molecule.
      Preliminary in vivo studies on human LOX ascites tumor in nude mice showed marked
      inhibitory effects on tumor growth by the antisense oligonucleotide ISIS 3466 in
      the presence of DOTMA when treated on alternate days.

PMID- 8476504
TI  - Delivery of antisense oligonucleotides by poly(L-lysine) conjugation and liposome
      encapsulation.

PMID- 8476505
TI  - Antiviral effect of TNF-alpha and IFN-gamma secreted from a CD8+ influenza virus
      specific CTL clone.
AB  - We observed that an influenza-specific cytotoxic T lymphocyte (CTL) clone (B7B7)
      stimulated with peptide-antigen could produce TNF-alpha and IFN-gamma
      simultaneously. The culture supernatant containing both TNF-alpha and IFN-gamma
      of antigen-stimulated CTL clone B7B7 significantly enhanced the lysis of
      influenza A/PR/8 virus-infected L-M2d6 cells or Meth A cells. Enhanced lysis of
      influenza virus-infected cells by the supernatants was inhibited by pretreatment
      of the supernatant with antimurine TNF-alpha antibody and antimurine IFN-gamma
      antibody. In addition to a single CTL clone, we observed that bulk-cultured CTLs
      were able to produce TNF and IFN when incubated with target cells. These results
      suggest that the protective mechanism mediated by TNF-alpha and IFN-gamma
      secreted from CTL may be possible in the course of an influenza infection.

PMID- 8476506
TI  - Antibodies to polymerized albumin in woodchuck hepatitis virus infection.
AB  - Polymerized human serum albumin may play a role in the entry of hepatitis B virus
      into hepatocytes, and antibodies to polyalbumin that frequently appear during
      acute hepatitis may aid the process of viral clearance. We developed an enzyme
      linked immunosorbent assay for antibodies to polymerized woodchuck albumin to
      enable us to evaluate further the role of these antibodies in an animal model
      system. Sera from 17 uninfected adult woodchucks and 8 newborns showed no binding
      to control plates coated with woodchuck transferrin, woodchuck albumin, or
      polymerized human serum albumin. One of 8 newborn animals demonstrated a
      significant antibody titer to polymerized woodchuck albumin, and 16 of 17 adults
      without evidence of prior woodchuck hepatitis virus infection had measurable
      serum antibody titers. Antibodies to polymerized woodchuck albumin could be
      adsorbed by prior incubation with the antigen. In 2 animals subjected to
      experimental infection, significant rises in polyalbumin antibody were seen. When
      4 adult woodchucks were immunized with woodchuck polyalbumin, significant
      increases in antibody titer were observed in 2 of the 4 animals. Of the 4
      immunized and 4 controls subsequently challenged with woodchuck hepatitis virus,
      7 became viremic and all 8 developed antibody to woodchuck hepatitis virus core
      antigen. We conclude that naturally occurring antibodies to polymerized woodchuck
      albumin are observed in most adult woodchucks in the absence of woodchuck
      hepatitis virus infection and do not seem to confer immunity against infection
      with this virus.

PMID- 8476507
TI  - A comparison of human immunodeficiency virus (HIV) seropositivity and hepatitis B
      surface antigenemia (HBs Ag) among the same group of apparently healthy pregnant
      women in Lagos, Nigeria: a preliminary report.
AB  - Two hundred and fifty apparently healthy pregnant women attending the Obstetrics
      and Gynecology Clinic of the Lagos University Teaching Hospital (LUTH), Lagos,
      Nigeria were screened for a comparison of the prevalence of HIV seropositivity
      and hepatitis B surface antigenemia (HBs Ag) amongst them. The Karpas AIDS cell
      test for HIV seropositivity and Bioman Hepatitis test kits were used as described
      by the manufacturers. HIV seropositive cases were confirmed using the Western
      blot test. Results revealed that out of the 250 pregnant women screened, 2 (0.8%)
      and 11 (4.4%) were HIV-1 and HBs Ag seropositive, respectively. However, the same
      2 pregnant women now constituting 2 (18.2%) of the 11 HBs Ag positive pregnant
      women were simultaneously HIV-1 seropositive. Antibody to HIV-2 was not recorded
      in all HIV seropositive cases. This is the first report on the simultaneous
      prevalence of HBs Ag and HIV seropositivity among apparently healthy pregnant
      women in Lagos, Nigeria.

PMID- 8476509
TI  - Perinatal transmission of hepatitis B virus in Senegal, west Africa.
AB  - We studied 152 healthy pregnant women and their 156 newborns for markers of
      hepatitis B virus (HBV) infection in Dakar, Senegal. Of these, 120 mothers (79%)
      had antibodies to the hepatitis B core antigen (anti-HBc), 21 (13.8%) were
      hepatitis B surface antigen (HBs Ag) positive, including 2/21 (9.5%) hepatitis B
      core-associated antigen (HBe Ag) positive and 1/21 (4.7%) HBV DNA positive. At
      birth, 11 (7%) infants were HBs Ag positive; 9/11 had an HBs Ag positive mother.
      Ten of these HBs Ag positive-born infants were investigated at 6-7 months: 5 were
      strongly HBs Ag positive and developed antibodies to HBs Ag, HBc Ag or HBe Ag;
      these 5 (3.2% of the total) probably became chronic carriers of HBV. The 5 others
      were HBs Ag negative and 4/5 did not develop antibodies against HBV Ag; HBs Ag
      positivity at birth was likely due to contamination of the mother's blood. Thirty
      one of the 145 HBs Ag negative-born infants were studied at 6-7 months and
      remained HBs Ag negative. However, 5 (16%) showed evidence of HBV infection
      occurring between 0 and 6 months, as shown by the development of antibodies to
      HBs Ag, HBc Ag, and/or HBe Ag. Despite the low prevalence of HBV DNA and HBe Ag
      in HBs Ag positive African mothers, this study shows the occurrence of perinatal
      transmission of HBV in West Africa, in contrast with previous studies. Perinatal
      HBV transmission could explain the HBV vaccination failure recently reported in
      children in Senegal.

PMID- 8476508
TI  - Diminished influenza A virus-specific MHC class I-restricted cytotoxic T
      lymphocyte activity among elderly persons.
AB  - Influenza A virus-specific MHC class I-restricted cytotoxic T lymphocyte (CTL)
      activities among young and elderly adults were compared. Peripheral blood
      lymphocytes from 10 young adults, (mean age 27 +/- 2.4 years) and elderly persons
      (mean age 71 +/- 1.6 years) were stimulated with influenza A/Taiwan/1/86 (H1N1)
      virus for 7 days and assayed for lytic activity against A/Taiwan, A/Shanghai
      (H3N2), and B/USSR virus-infected autologous target cells. Young adults exhibited
      significantly higher influenza A cross-reactive CTL activity against A/H1N1 and
      A/H3N2 target cells when compared to aged persons. This was true at all effector
      to-target cell ratios tested. Negligible lysis of B/USSR-infected target cells or
      nonautologous A/Taiwan-infected cells was observed. The number of leukocytes
      recovered per milliliter of blood was also significantly higher in young adults
      than in old donors; however, the percentage of CD45+ (common leukocyte antigen),
      CD3+ (T cells), CD4+ (T helper), and CD8+ (T cytotoxic/suppressor) as well as the
      CD4+/CD8+ ratios was similar in both groups. Depletion of cells with monoclonal
      antibodies indicated that the effector cells were CD8+ T cells. Serum
      neutralizing antibody (Nt Ab) titers were similar among young and elderly persons
      and there was no correlation between Nt Ab and CTL activity. These results
      demonstrate a reduced influenza virus-specific MHC class I-restricted CTL
      activity among elderly persons. The deficiency in this cell-mediated immune
      function may contribute to the morbidity and mortality from influenza virus
      infections in this population.

PMID- 8476510
TI  - Induction of antihemagglutinin antibodies by polyclonal antiidiotype antibodies.
AB  - Antiidiotypic antibodies can be envisioned as an alternative approach in the
      development of vaccines against influenza virus, which exhibits natural antigenic
      variations. In our work, we obtained two polyclonal cross-reactive anti-Id
      antibodies against PY102, VM113, and VM202 mAbs, which in turn are specific
      respectively for PR8 virus and laboratory-induced virus variants (PY102-V1 and
      VM113-V1). With these cross-reactive anti-Id antibodies, we were able to elicit
      anti-HA antibodies in mice. In comparing the anti-HA antibody response in animals
      injected with anti-Id antibodies to those immunized with PR8 influenza virus, we
      demonstrated that the HI titer was higher after virus immunization and that the
      PR8 virus boost was more efficient in this group. Our results showed that the
      polyclonal cross-reactive anti-Id antibodies were more efficient than the
      individual anti-Ids at eliciting responses. At the same time, we demonstrated
      that PR8-primed T cells, cultured with B cells from animals immunized with anti
      Id antibodies, were able to produce anti-PR8 antibodies subsequent to stimulation
      with influenza virus.

PMID- 8476511
TI  - Changes in the cytotoxic T-cell repertoire of HIV-1-infected individuals:
      relationship to disease progression.
AB  - The repertoire of antigen-specific receptors expressed on T lymphocytes is shaped
      by fixed genetic and variable environmental selective pressures. Recent
      technological advances have enabled the analysis of T-cell receptor (TCR)
      expression in the context of selective pressures arising through normal immune
      system development and also through pathological features of disease. The
      pathological features of acquired immune deficiency syndrome (AIDS) are reflected
      by selective depletion of particular T lymphocyte subsets and expansion of
      others. An important question concerning the immunopathogenesis of AIDS is
      whether or not the perturbation of the CD4+ and CD8+ T-cell subsets following
      infection with human immunodeficiency virus (HIV) is selective based on TCR
      variable (V) region gene expression. To address this question, we have
      functionally analyzed TCR V gene expression on CD8+ cytotoxic T lymphocytes from
      HIV-1-infected individuals. This was done using monoclonal antibodies against
      individual TCR V regions to trigger redirected cytolysis in 51Cr release assays.
      The percent specific lysis induced by each antibody functionally measures the
      representation of the TCR V region gene product it is specific for. Relative to
      non-HIV-infected controls and asymptomatic HIV-infected individuals with only
      moderate CD4 lymphocyte depletion, HIV-infected individuals with low CD4
      lymphocyte counts exhibited skewed patterns of TCR V region representation.
      Therefore, the perturbation within the CD8+ cytotoxic T lymphocyte repertoire in
      HIV infection appears to be selective based on TCR V region usage, increasingly
      so as disease progresses. The TCR V genes affected varied between different HIV
      infected individuals and skewing detected in functional assays was not always
      apparent by flow cytometric analysis. These results suggest that HIV infection
      causes generalized effects on the T-cell repertoire, which are reflected in the
      relative TCR V gene representation of the CD8+ cytotoxic T lymphocyte population
      in peripheral blood.

PMID- 8476512
TI  - Fractals and foods.
AB  - Fractal geometry and related concepts have had only a very minor impact on food
      research. The very few reported food applications deal mainly with the
      characterization of the contours of agglomerated instant coffee particles, the
      surface morphology of treated starch particles, the microstructure of casein gels
      viewed as a product limited diffusion aggregation, and the jagged mechanical
      signatures of crunchy dry foods. Fractal geometry describes objects having
      morphological features that are scale invariant. A demonstration of the self
      similarity of fractal objects can be found in the familiar morphology of
      cauliflower and broccoli, both foods. Processes regulated by nonlinear dynamics
      can exhibit a chaotic behavior that has fractal characteristics. Examples are
      mixing of viscous fluids, turbulence, crystallization, agglomeration, diffusion,
      and possibly food spoilage.

PMID- 8476513
TI  - Effect of manufacturing factors, composition, and proteolysis on the functional
      characteristics of mozzarella cheese.
AB  - Shredding and melting characteristics are vital to the function of low-moisture
      Mozzarella cheeses that are used as ingredients for pizza and related foods.
      Newly manufactured Mozzarella melts to a tough, extremely elastic, and somewhat
      granular consistency with limited stretch that is unacceptable for pizza.
      However, during the first few weeks of refrigerated storage, a dramatic
      transformation occurs as the unmelted cheese becomes softer and the melted cheese
      becomes more viscous, less elastic, and highly stretchable. Thus, the cheese
      attains optimal functionality for pizza. Over longer periods, Mozzarella becomes
      excessively soft and fluid when melted and is no longer acceptable for pizza. Low
      moisture Mozzarella is correctly viewed as a cheese that requires aging. The
      functional characteristics of low-moisture Mozzarella are due initially to the
      chemical composition, including fat, moisture, NaCl, and mineral contents, and
      the structure of the paracasein curd matrix that is established during
      manufacture. Changes in functional characteristics during aging are directly
      related to proteolysis rate and possibly proteolytic specificity. Proteolysis
      during aging is influenced by manufacturing factors such as starter culture,
      coagulant, and stretching temperature, and possibly to indigenous proteases in
      the cheesemilk such as plasmin.

PMID- 8476514
TI  - [Safe handling of cytostatic agents].

PMID- 8476515
TI  - [Nursing documentation: consensus in practice. Introduction].

PMID- 8476516
TI  - [Nursing documentation: consensus in practice (1). Its application in stage 1:
      Mr. De Langen].

PMID- 8476517
TI  - [Management of trauma caused by sexual assault and incest].

PMID- 8476518
TI  - [The force of our product instead of the power of the hierarchy].

PMID- 8476519
TI  - [WIP (Workgroup Infection Prevention), or: campaign against hospital infection.
      Infection control: knowing is one, doing is two. Interview by Toine de Graaf].

PMID- 8476520
TI  - [Careless nursing care].

PMID- 8476521
TI  - [Team work in the general psychiatric hospital].

PMID- 8476522
TI  - [Medica 93: from high tech to BIG (Professions in Individual Health Care)].

PMID- 8476523
TI  - [Pass it in, Pass it on: the nurse as 'Bellringer'].

PMID- 8476524
TI  - [Nursing documentation: Consensus in practice. Its application in stage 2: Jan].

PMID- 8476526
TI  - [The why of nursing diagnosis].

PMID- 8476525
TI  - ['Care about your Profession' or: towards greater self-assurance].

PMID- 8476527
TI  - [Environment and care (9). Nuisance as a disturbance of health experience].

PMID- 8476528
TI  - Acute phase response of rabbit to HgCl2 and CdCl2.
AB  - A variety of changes occur in the rabbit under metal stress which include the
      appearance of the acute phase protein, C-reactive protein in the serum and
      significant reduction in the serum titres of albumin and acetylcholinesterase.
      The phospholipid profile is positively correlated with the higher degree of
      tissue necrosis encountered in mercury treated rabbit. Cadmium and mercury
      treatments evoke a similar response pattern in rabbit differing only in the
      degree of change.

PMID- 8476529
TI  - Relationship between asthma and allergic antigens in rural houses.
AB  - Asthma is one of the most frequent and common diseases in China. It seriously
      threatens the health of the population. It is evident that mites present in rural
      houses may serve as an allergic antigen. In our survey, we have found several
      kinds of mites in farmers' houses in the northeastern part of China which have
      very close relation with asthmatic diseases. Investigations in rural houses
      further proved that the cause of asthma is certainly related with the allergic
      antigen of mites. The methods of prevention and control of mites are enumerated.

PMID- 8476530
TI  - Estimation of acute toxicity of ammonium sulphate to the fresh water catfish,
      Heteropneustes fossilis I. Analysis of LC50 values determined by various methods.
AB  - The acute toxic effects of ammonium sulphate to fresh-water catfish,
      Heteropneustes fossilis (H. fossilis) have been studied by determining LC50
      values with 95% confidence limits, by the graphic method, the logistic method,
      the Spearman and Karber method and the trimmed Spearman-Karber method. The
      trimmed Spearman-Karber method was found the most ideal for ammonium salt
      toxicity test. The flaws in the trimmed Spearman-Karber method are also
      discussed.

PMID- 8476531
TI  - Ultrastructural study of moniliformin induced lesions of myocardium in rats and
      mice.
AB  - Effects of moniliformin on the ultrastructure of the myocardium of mice and rats
      were studied. Mice were given moniliformin orally at a dose of 29.46 mg.kg-1 the
      LD50. One h after dosing, lesions of the mitochondria of the myocardial cells
      were found which became more severe in 2 and 3 h. Ultrastructural lesions were
      also observed in the myofibrils and sarcolemma. Rats were given moniliformin
      orally at the dosage of 6 mg.kg-1 once daily for 56 d. Lesions of mitochondria
      and myofibrils were relatively mild. In the myocardiac specimens taken from the
      21d post-toxin administration, lesions of the sarcolemma became more obvious.
      These moniliformin-induced lesions were similar to the ultrastructural changes in
      the myocardium of patients with Keshan disease. Our findings indicate that there
      may be a close and important relationship between moniliformin intoxication and
      Keshan disease.

PMID- 8476532
TI  - Estimation of acute toxicity of ammonium sulphate to the fresh-water catfish,
      Heteropneustes fossilis. II. A histopathological analysis of the epidermis.
AB  - The toxicity of 4000 ppm (96 h LC50 value) of the inorganic fertilizer ammonium
      sulphate on the epidermis of Heteropneustes fossilis (H. fossilis) at different
      intervals of time has been studied. The destruction induced by the ammonium salt
      is massive. Secretion of a copious amount of slime from the goblet mucous cells
      leading to the exhaustion and/or shedding and subsequent disappearance is perhaps
      the first reaction to the toxicity of the irritant. Later, the polygonal
      epithelial cells of the outermost layer show cyclic stages of necrosis and
      sloughing followed by their regeneration and repair. The contents of the club
      cells show enormous shrinkage and condensation with subsequent replacement of
      their areas with a hazy substance. In the earlier stages of exposure,
      regeneration takes place quickly, side by side with the degenerative changes at
      different stages of experimentation. Later after 8 to 10 d, the degenerative
      changes slow down and the epidermis appears identical to that of the normal skin.
      Goblet mucous cells also showed several cyclic increases followed by decreases in
      number and activity.

PMID- 8476533
TI  - Tissue distribution of [3H]-nicotine in rats.
AB  - This study was conducted in adult male Sprague--Dawley rats to determine the
      distribution of [3H]-nicotine in blood and tissues following a bolus injection
      and a constant infusion of pure nicotine. The animals were anesthetized and
      injected with either 0.5 ml of nicotine solution or given a constant infusion of
      the same nicotine solution with identical amounts of radioactive nicotine. After
      sacrifice, blood, brain, trachea, salivary gland, esophagus, lung, heart, liver,
      fundus, antrum, spleen, pancreas, duodenum, jejunum, ileum, cecum, colon,
      kidneys, adrenal gland, and testes were collected and measured for radioactivity
      by scintillation counting. The distribution of nicotine was found highest in
      kidneys by both routes of administration. Higher accumulations were also found in
      salivary and adrenal glands, fundus, antrum, duodenum, jejunum, ileum and colon.
      Retention of nicotine via constant infusion was significantly higher in
      esophagus, fundus antrum, spleen, cecum, pancreas, testes, heart and muscle when
      compared with bolus injection. Six-fold increase in retention of blood levels of
      nicotine were found with constant infusion. (P < 0.05). The results indicate that
      longer retention of nicotine occurs in blood and other specific tissues such as
      esophagus, fundus, antrum, spleen, cecum, pancreas, testes, heart and muscle via
      constant exposure. These data may implicate the predisposition of these tissues
      to pathologic manifestations.

PMID- 8476534
TI  - Human toxicosis caused by moldy rice contaminated with fusarium and T-2 toxin.
AB  - This is the first report on human toxicosis in China caused by moldy rice
      contaminated with Fusarium and T-2 toxin due to heavy rainfall during rice
      harvest season. One hundred and sixty-five persons ate the moldy rice and ninety
      seven persons fall ill of food poisoning. The incidence was 58.8% and latent
      period was 10-30 min. The chief symptoms were nausea, dizziness, vomiting,
      chills, abdominal distension, abdominal pain, thoracic stuffiness and diarrhea.
      The fungi isolated from the moldy rice were predominantly Fusarium heterosporum
      (F. heterosporum) and F. graminearum. T-2 toxin was found in these moldy rice and
      the highest level was 420 ppb. The chief causative agent of intoxication was T-2
      toxin.

PMID- 8476535
TI  - Non-genotoxic carcinogens. Approaches to their risk assessment.
AB  - Epidemiological studies support the idea that most human cancers are related to
      chemicals present in the human environment. In turn, chemicals are believed to
      cause cancer via either genotoxic or non-genotoxic mechanisms. There were
      described in literature several simple, rapid and inexpensive short term tests to
      reasonably predict the genotoxic nature of chemicals but in contrast, there is no
      reliable test or battery of tests available to predict the carcinogenicity of non
      genotoxic compounds and this poses a major problem to their risk assessment. In
      addition, there are conflictive opinions about risk assessment needs for both
      classes of carcinogens. Some workers believe that for non-genotoxic carcinogens,
      thresholds for exposure can be drawn while others do not. In this review, the
      reasons behind both of these opinions and the present hypotheses about the
      mechanism of action of non-genotoxic carcinogens are described and analyzed in
      relation to future needs.

PMID- 8476536
TI  - Effects of intermediate metabolites of 37 xenobiotics on the catalytic activities
      of reconstituted cytochrome P-450IIB1 and P-450IA1 enzyme systems.
AB  - Direct effects of intermediate metabolites of 37 different xenobiotics on the
      catalytic activities of both reconstituted cytochrome P-450IIB1 and P-450IA1
      enzyme systems were studied by determination of NADPH oxidation at various
      intervals after initiation of the reaction. The results showed that cytochrome P
      450IIB1 isozyme was much more likely than cytochrome P-450IA1 isozyme to be
      attacked by the reactive intermediates formed by some xenobiotics with smaller
      molecular weight and lose its catalytic activities. These xenobiotics were carbon
      tetrachloride, chloroform, carbon disulfide, benzene, parathion, methylparathion,
      methyldursban and dimethylnitrosamine. In contrast, however, steadily increasing
      metabolic activities were observed towards benzo(a)pyrene, 3-methylcholanthrene
      and polychlorinated biphenyls in reconstituted cytochrome P-450IA1 enzyme system
      as the reaction time prolonged within 4 min. The method discussed in this paper
      could be used as a simple and convenient way to observe directly the
      autocatalytic destruction of P-450 enzymes by some chemical agents.

PMID- 8476537
TI  - Feeding supplemental iodine to adult mink; effect on thyroid hormones in adult
      and offspring.
AB  - We fed adult mink diets containing supplemental iodine, from 0 to 320 ppm, for
      one or seven months prior to breeding. Blood samples collected from the adults
      and their offspring (kits) at 4 wk post-partum were assayed for total thyroxine
      (T4), triiodothyronine (T3), reverse T3 (rT3), and T4-binding indices. As
      expected T4 concentrations of the adult and kit mink varied inversely with the
      level of supplemental iodine. In addition, T3 and rT3 concentrations decreased
      gradually in kits from the long-term experiment in response to the increased
      dietary iodine of the dams. T3 concentrations of kits from dams fed iodine short
      term decreased markedly while rT3 concentrations were elevated greatly in
      response to increased dietary iodine of the dam. These decreases in hormone
      levels are due to serum iodine blocking the thyroid uptake of iodine and
      subsequent decrease of hormone synthesis. Excess iodine may also block the effect
      of thyroid stimulating hormone. The T4-binding indices of the adults, in general,
      were depressed, while the T4-binding indices of the kits were more variable.
      These effects are probably due to fluctuations in thyroglobulin.

PMID- 8476538
TI  - Effect of pesticides on growth of rhizobia and their host plants during
      symbiosis.
AB  - Effect of various pesticides (insecticides, fungicides and herbicides) has been
      studied on growth and efficiency of symbiotic properties of 3 fast growing
      Rhizobium sp. under green house conditions. The results revealed adverse effects
      on plant growth and nitrogen fixing capacity as measured by dry weight and total
      nitrogen content of plants infected with pesticide treated Rhizobium. Of the
      pesticides tested, herbicides were found to be more effective on the above
      parameters than the insecticides and fungicides.

PMID- 8476539
TI  - Relative abundance and the relationships between aniline, phenol and catechol
      degraders in fresh water.
AB  - Relative abundance and relationships between aniline, phenol and catechol
      degraders were investigated in unpolluted and polluted fresh waters in Osaka
      prefecture, Japan. Phenol and catechol degraders were found more frequently
      compared to aniline degraders. The results indicate that these degraders were
      more abundant in polluted waters than in unpolluted waters. Aniline degraders
      isolated from the Ina River water showed a higher capability of degrading
      catechol than phenol. Analysis on sequence homology among these three kinds of
      degraders indicated a possible relationship between aniline degraders and certain
      strains of both catechol and phenol degraders.

PMID- 8476540
TI  - Collateral axons of cholinergic pontine neurones projecting to midline,
      mediodorsal and parafascicular thalamic nuclei in the rat.
AB  - The organization of collateral axons projecting from neurones in the pontine
      laterodorsal tegmental nucleus (LDTg) has been examined using combinations of
      retrograde neuronal tracers with immunocytochemical markers for the acetylcholine
      synthesizing enzyme choline acetyltransferase (CHAT), focussing on projections to
      the midline, mediodorsal and parafascicular thalamic nuclei and the ventral
      tegmental area. 25-59% of LDTg neurones projecting to the mediodorsal nucleus
      provided collaterals to the midline nuclei. Virtually all (87-96%) of these
      double retrogradely labelled neurones appeared cholinergic. 9-18% of LDTg
      neurones projecting to the parafascicular nuclei also provided a collateral to
      the midline nuclei and 50-78% of these double retrogradely labelled neurones
      stained for CHAT. 26-29% of the single LDTg neurones which projected collaterals
      to both the mediodorsal and midline nuclei, were found to project a third
      collateral to the ventral tegmental area. These anatomical findings, taken
      together with functional evidence, suggest that cholinergic terminals arising
      from LDTg are involved in coordinating thalamic mechanisms of brain state
      control; and in regulating dopaminergic pathways, both directly and via the
      thalamus.

PMID- 8476541
TI  - Differential organization of synapses immunoreactive to phenylethanolamine-N
      methyltransferase or neuropeptide Y in the parvicellular compartments of the
      hypothalamic paraventricular nucleus of the rat.
AB  - The parvicellular compartments of the paraventricular nucleus of the hypothalamus
      (pPVN) contains particularly high concentrations of neuropeptide (NPY)-containing
      fibres of two main cellular origins including (i) neurons of the medulla
      oblongata, most of which co-store phenylethanolamine-N-methyltransferase (PNMT),
      the enzyme characterizing adrenergic neurons, and (ii) non-catecholaminergic
      neurons of the mediobasal hypothalamus. The aim of the present study is to
      compare the fine organization of the two types of axons terminating in the pPVN.
      Immunocytochemistry at light and electron microscope levels was used to study
      both the density and the ultrastructural organization of NPY- and PNMT
      immunoreactive fibres in the pPVN of animals bearing surgical lesions disrupting
      axonal pathways from the hindbrain or from the sublying mediobasal hypothalamus.
      The brainstem knife-cut induced a strong decrease (65%) in the numerical density
      of PNMT fibres innervating the pPVN, but was without significant effects on the
      density of NPY fibres. On the other hand, the hypothalamic knife-cut induced an
      80% decrease in the density of NPY fibres within the PVN without affecting the
      number of PNMT fibres. The electron microscope study showed that in the control
      pPVN contralateral to the lesions, the majority (64%) of PNMT synapses were
      asymmetric axo-dendritic synapses, whereas the majority (67%) of NPY synapses
      form symmetric contacts with both dendrites and perikarya of the hypothalamic
      nucleus. By contrast, after a hypothalamic knife-cut, the majority (66%) of NPY
      synapses identified in the pPVN exhibited features of asymmetric synapses. These
      data indicate that the large majority of NPY-immunoreactive fibres detected
      within the pPVN arise from non-catecholaminergic neurons located in the
      mediobasal hypothalamus and mainly form symmetric synapses on neurons of the
      pPVN, whereas only a minority of them arise from hindbrain regions, and like PNMT
      fibres innervating this nucleus preferentially form asymmetric axo-dendritic
      synapses.

PMID- 8476542
TI  - Neuropeptides in the human celiac/superior mesenteric ganglionic complex: an
      immunohistochemical study.
AB  - The occurrence of vasoactive intestinal polypeptide (VIP), peptide histidine
      isoleucine (PHI), calcitonin gene-related peptide (CGRP), substance P (SP),
      somatostatin (SOM), galanin (GAL) and enkephalins (ENK) is studied in the human
      celiac/superior mesenteric ganglionic complex of pre- and full-term newborns, and
      adult subjects by means of immunohistochemistry. The antisera used labelled nerve
      fibres and terminal-like networks for each examined peptide, as well as VIP- and
      SOM-positive postganglionic neurons. Differences in the relative amount and
      density of the structures immunoreactive to the various peptides were observed.
      Moreover, variations in the amount and type of labelled elements were appreciable
      for each peptide when specimens from subjects at perinatal and adult ages were
      compared. Double-labelling immunofluorescence for SP and each other peptide
      showed that co-localization with SP is very frequent for CGRP, moderate to scarce
      for GAL and SOM, and rare to absent for PHI, VIP and ENK. VIP-, ENK- and CGRP
      immunolabeled perikarya bearing the morphological features of the small intensely
      fluorescent (SIF) cells occurred in the organ. The presence of a paraganglion in
      one of the specimens examined allowed the detection of VIP- and ENK-positive cell
      bodies and VIP-, ENK-, SP- and GAL-like immunoreactive varicose nerve fibres in
      it. The results obtained provide substantial morphological data in support of the
      involvement of the examined peptides in the chemical interneuronal signalling in
      the human celiac/superior mesenteric ganglia.

PMID- 8476544
TI  - Primary care (another view)

PMID- 8476543
TI  - Allocating health care resources. The vexing case of rehabilitation.
AB  - The allocation of resources to rehabilitation is beset with many difficulties.
      Among them are the general crisis in the American health care system and the
      problem of how to make a case for the role of rehabilitation. Rehabilitation must
      be prepared to show how and why it is a good medical and social investment in
      relation to other needs. Rehabilitation has played a secondary role in the
      American health care system because of overemphasis on curative and life
      extending medicine. Rehabilitation must work to show that money invested in
      caring is as well spent as money aiming at the extension of life. It must also
      establish a fresh new vision of health care in general as well as illustrate
      where rehabilitation stands in a more integrated and coherent health care system.
      Improved quality of life, which rehabilitation can provide, is as important as
      saving and extending life.

PMID- 8476545
TI  - Physical medicine and rehabilitation. Trends in academic productivity.
AB  - Numerous authorities have emphasized the need for expanding the quantity and
      quality of physical medicine and rehabilitation (PM&R) research and academic
      productivity. Thus far, however, attempts to evaluate academic productivity have
      involved the manual sampling of relevant specialty journals. This approach
      greatly underestimates productivity. By conducting a computer-facilitated search
      for PM&R-related publications and then contacting the most academically prolific
      PM&R departments to verify the computer-generated data, it was found that
      computer search strategies more accurately estimate PM&R academic productivity.
      PM&R publication activity increased by 15% in the United States and 46%
      internationally over the period 1988 to 1990. At least 76% of the United States
      residency programs in PM&R had scientific publications over this period. With
      ever increasing emphasis placed on academic productivity, the trend of increasing
      productivity can only be expected to continue in the future.

PMID- 8476546
TI  - Geriatrics training in physical medicine and rehabilitation.
AB  - A survey was conducted to determine the level of training in geriatrics in
      physical medicine and rehabilitation (PM&R) residency training programs.
      Questionnaires were sent to 76 accredited programs in 1989 with a 63% (48/76)
      response rate. Results show that 49% of patients cared for by PM&R residents in
      inpatient settings are 65 years of age or older, and 42% of patients cared for in
      ambulatory settings are in the same age group. Of PM&R programs, 30% have
      physician faculty who are geriatric "specialists." PM&R residents have a
      significant exposure to elderly patients in the consultation role. Less exposure
      to elderly patients occurs in distinct geriatric rehabilitation and geriatric
      medicine programs or units. Among 10 medical specialties, PM&R programs compare
      well in terms of teaching about the topics and the personnel that are important
      in geriatrics. This is due in part to an obvious overlap between the content of
      rehabilitation medicine and that of geriatrics. Furthermore, there is moderate
      interest in PM&R in developing fellowship training in geriatric rehabilitation.
      The need for more academic faculty who are geriatric "specialists," as well as
      the need for increasing PM&R exposure to distinctly geriatric settings as a part
      of training, is apparent.

PMID- 8476547
TI  - Segmental v dermatomal somatosensory-evoked potentials. Normal intertrial
      variation and side-to-side comparison.
AB  - Although segmental and dermatomal somatosensory evoked potentials have been used
      in the diagnosis of lumbosacral radiculopathy, the unilateral or bilateral normal
      intertrial variation of these responses has not been investigated. Furthermore,
      there exists little consensus on how many sequential trials for a single nerve or
      dermatome are optimal and how to use the data generated from these trials.
      Without investigation of these basic parameters, determination of what
      constitutes a normal somatosensory-evoked potential (SEP) is difficult. In 29
      normal subjects, the ipsilateral intertrial variations, arithmetic mean side-to
      side differences and maximum potential side-to-side differences with stimulation
      of the superficial peroneal sensory nerve, sural nerve and L5 and S1 dermatomes
      with respect to P1 and N1 latencies and peak-to-peak amplitudes were
      investigated. Considerable ipsilateral intertrial variation was observed and side
      to-side comparisons revealed a further increase in this inherent variation
      regarding the above measured parameters. The maximum potential side-to-side
      differences were even more remarkable than the mean side-to-side differences. For
      these results and others presented, a method of evaluating SEP parameters whereby
      the arithmetic mean of two sequential trials for both latency and amplitude is
      presented that attempts to minimize the normal, inherent variation. We also
      suggest an additional parameter with which to evaluate SEPs: the maximum side-to
      side latency difference. Only through the use of a consistent methodology can
      segmental or dermatomal SEPs be utilized in a reliable diagnostic manner.

PMID- 8476548
TI  - Performance profiles of the functional independence measure.
AB  - The functional independence measure (FIM) is used to determine the degree of
      disability that patients experience and the progress that they make through
      programs of medical rehabilitation. Rasch analysis is a statistical technique for
      constructing interval measures from ordinal data that was applied to derive FIM
      measures. The major factors that are taken into account to produce FIM measures
      are the relative difficulty in performance of FIM items and the ability of the
      persons tested. Our analyses showed the relative difficulties that patients
      experienced in performing items in the FIM. There were two dominant patterns of
      difficulty, one for motor FIM items and the other for cognitive FIM items. The
      patterns were consistent across impairment groups, although not identical. Of the
      motor items, eating and grooming were easiest whereas stair climbing, tub/shower
      transfers and locomotion were most difficult. Of the cognitive items, expression
      and comprehension were easiest and problem solving was the most difficult. The
      patterns of difficulty in performing FIM items are illustrated by analysis of the
      following impairment groups: for motor items, orthopedic conditions, stroke with
      left hemiparesis and spinal cord dysfunction; for cognitive items, orthopedic
      conditions, brain dysfunction, stroke with right hemiparesis and spinal cord
      dysfunction. By understanding patterns of difficulty in performing FIM items
      according to types of impairment and levels of function, clinicians may more
      precisely design treatment programs, use services and predict outcomes of medical
      rehabilitation.

PMID- 8476550
TI  - Drug-induced dystonia in a patient with C4 quadriplegia. Case report.
AB  - Prochlorperazine, a piperazine phenothiazine, is a commonly used anti-emetic that
      blocks dopamine receptors in the central nervous system. Prochlorperazine causes
      various extrapyramidal syndromes, with the incidence in the inpatient population
      estimated to be 0.5 to 0.8%. These side effects are typically manifested by motor
      dysfunction and easily observed on physical examination. We report the case of an
      18-year-old male with C4 complete quadriplegia who developed an acute dystonic
      reaction isolated to the tongue during short-term treatment with
      prochlorperazine. This case demonstrates the importance of maintaining a high
      level of suspicion in the spinal cord population, considering that many key
      physical findings may be absent below the level of function.

PMID- 8476549
TI  - Rehabilitation medicine consultation in persons hospitalized with AIDS. An
      analysis of thirty cases.
AB  - This retrospective study outlines interventions taken as a result of
      rehabilitation medicine consultation in persons hospitalized with human
      immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome
      (AIDS). The medical records of 30 persons with HIV infection consecutively
      referred for rehabilitation medicine consultation over a one-year period were
      reviewed. The sample was composed primarily of white, homosexual males with a
      mean age of 38.5 (SD, 8.5) years and a mean length of AIDS diagnosis of 14.6 (SD,
      14.1) months. Rehabilitation medicine evaluation resulted in additional diagnoses
      in four cases (13.3%), prescriptions for new medications in 8 (26.7%), physical
      modalities/devices in 9 (30.0%) and referrals to occupational, physical and
      speech therapies in 26 (86.7%), 24 (80.0%) and 3 (10.0%) patients, respectively.
      Interventions were often directed toward deconditioning, painful peripheral
      neuropathy and fatigue. Mean survival after rehabilitation consultation was
      approximately 23 weeks. No intervention was novel or unusual suggesting that
      current knowledge is sufficient to manage much of the disability associated with
      HIV infection. This study concludes that rehabilitation medicine can contribute
      to the management of persons hospitalized with AIDS. Further research should
      address efficacy of intervention, fatigue as a source of disability and the value
      of early rehabilitation intervention.

PMID- 8476552
TI  - Regulatory aspects of modified release dosage forms: in vivo/in vitro
      correlations.

PMID- 8476551
TI  - Physiologic considerations in the determination of optimum interelectrode
      distance for the antidromic recording of compound sensory nerve action
      potentials. Commentary.

PMID- 8476553
TI  - [Microbiological validation of a film system for monitoring total aerobic
      bacteria on surfaces and laboratory garments in controlled areas].
AB  - The microbiological control of the environment is a real issue inside the
      pharmaceutical production plants. Actually the most used methods are the Contact
      Plates and the Swabs. The purpose of this study is to evaluate the performance of
      a new "ready to use" method called Petrifilm SM (produced by 3M Laboratories).
      Petrifilm consists of a dry-rehydratable growth medium coated on a flexible film.
      Petrifilm is tested in comparison with Swabs and Contact Plates to monitor the
      microbiological pollution on labs surfaces and operator's overalls. The results
      obtained are comparable with the above mentioned methods, but with important
      advantages being less bulky, considerably time saving and highly reproducible.
      Hence, we think that Petrifilm S, can be successfully used instead of the other
      two more traditional methods.

PMID- 8476555
TI  - [The use of transgenic animals in the evaluation of the genotoxic properties of
      compost chemicals].

PMID- 8476554
TI  - X-ray fluorescence determination of bromine traces in pharmaceutical formulations
      containing sodium diclofenac.
AB  - The X-ray fluorescence spectroscopy (XRF) on solid samples is applied to the
      organic bromine impurities assay on pharmaceutical formulations of sodium
      diclofenac (DCF). A wide range of Br contents (7-1564 ppm) in the tablets is
      obtained, depending on manufacturer source and batch preparation. As the
      impurities concern only the sodium diclofenac employed, and the presence of Br
      might be a toxicity index arising from the synthetic procedure, the assay of each
      DCF batch is suggested.

PMID- 8476556
TI  - [Biopharmaceutics and pharmacokinetics. 5. Distribution].

PMID- 8476557
TI  - HLA and I.

PMID- 8476558
TI  - Defensins: antimicrobial and cytotoxic peptides of mammalian cells.
AB  - Defensins are antimicrobial and cytotoxic peptides that contain 29-35 amino acid
      residues, including six invariant cysteines whose intramolecular disulfide bonds
      cyclize and stabilize them in a complexly folded, triple-stranded beta-sheet
      configuration. Generated by the proteolytic processing of 93-95 amino acid
      precursor peptides, the constitute > 5% of the total cellular protein in human
      and rabbit neutrophils (polymorphonucleated neutrophils--PMN) and are also
      produced by rabbit lung macrophages and by mouse and rabbit small intestinal
      Paneth cells. Despite their prominence in rat PMN, defensins are not found in
      murine PMN. The antimicrobial spectrum of defensins includes gram positive and
      gram negative bacteria, mycobacteria, T. pallidum, many fungi, and some enveloped
      viruses. Defensins exert nonspecific cytotoxic activity against a wide range of
      normal and malignant targets, including cells resistant to TNF-alpha and NK
      cytolytic factor. They appear to kill mammalian target cells and microorganisms
      by a common mechanism, which involves initial electrostatic interactions with
      negatively charged target cell surface molecules (likely the head groups of polar
      membrane lipids), followed by insertion into the cell membranes which they
      permeabilize, forming voltage-regulated channels. In addition to their
      antimicrobial and cytotoxic properties, some defensins act as opsonins, while
      others inhibit protein kinase C, bind specifically to the ACTH receptor and block
      steroidogenesis or act as selective chemoattractants for monocytes. Defensins are
      a newly delineated family of effector molecules whose contribution to host
      defense, inflammation, and cytotoxicity may be considerable for humans, even
      though it is unlikely to be revealed by experimentation with mice.

PMID- 8476559
TI  - Immunity to intracellular bacteria.
AB  - Intracellular bacteria are endowed with the capacity to survive and replicate
      inside mononuclear phagocytes (MP) and, sometimes, within certain other host
      cells. MP are potent effectors cells that are able to engulf and kill many
      bacterial invaders. Therefore, intracellular bacteria had to exploit potent
      evasion mechanisms that allow their survival in this hostile environment. At the
      early phase, natural killer cells activate antibacterial defense mechanisms.
      During intracellular persistence, microbial proteins are processed and presented,
      thus initiating T cell activation. By secreting interleukins, CD4 alpha/beta TH1
      cells activate MP, converting them from a habitat to a potent effector cell; TH2
      dependent activities seem to be of minor importance. Cytolytic CD8 T cells
      represent a further element of protection. In the case of Listeria monocytogenes,
      the gene products responsible for virulence and for the introduction of antigens
      into the MHC class I pathway are being characterized. Increasing evidence points
      to a role of gamma/delta T lymphocytes in antibacterial immunity, although their
      precise function remains to be elucidated. Protection in the host is a local
      event focussed on granulomatous lesions. MP accumulate at the site of microbial
      growth and become activated through the CD4 T cell-interleukin-MP axis. Lysis of
      incapacitated MP and other host cells by CD8 T cells allows release and
      subsequent uptake by more efficient phagocytes, thus contributing to host
      protection. At the same time, lysis of host cells promotes microbial
      dissemination and causes tissue injury, which represent pathogenic aspects of the
      same mechanism. Research on the immune response against intracellular bacteria
      not only helps us to better understand how the immune system deals with "viable
      antigens" in constant trans-mutation, it also forms the basis for the rational
      design of control measures for major health problems.

PMID- 8476560
TI  - Peptides naturally presented by MHC class I molecules.
AB  - MHC class I molecules are peptide receptors of stringent specificity which
      however still allow millions of different ligands. This is achieved by the
      following specificity characteristics summarized as allele specific peptide
      motifs: Peptides are of defined length, depending on the class I allele (either 8
      or 9 residues; exceptions have been observed). Typically, 2 of the 8 or 9
      positions are anchors that can only be occupied by a single amino acid residue,
      or by residues with closely related side chains. Location and characteristics of
      anchors vary with class I alleles. The C terminus of the peptide ligands is
      frequently an aliphatic or charged residue. Such allele-specific class I peptide
      ligand motifs, known so far for H-2Kd, Kb, Kk, Kkm1, Db, HLA-A*0201, A*0205, and
      B*2705, are useful to predict natural T cell epitopes. The latter can be
      determined by extraction from cells recognized by the T cell of interest. It is
      not known how the class I ligands are produced in the cell, although speculative
      models exist. The peptide specificity of class I molecules and experimental
      evidence indicate that T cells are tolerant to only a small fraction of the
      expressed genomic sequences and are not tolerant to the remainder. The function
      of class I molecules is to present a collection of self-peptide samples at the
      cell surface for surveillance by T cells.

PMID- 8476561
TI  - The IL-2 receptor complex: its structure, function, and target genes.
AB  - Proliferation of T lymphocytes is triggered by the interaction of IL-2 with its
      specific receptor following T lymphocyte activation. The receptor for IL-2
      consists of at least three distinct subunits, the alpha chain (IL-2R alpha), the
      beta chain (IL-2R beta), and the gamma chain (IL-2R gamma). Although the role of
      IL-2R gamma in IL-2 signalling remains unclear, IL-2R beta is the subunit
      critical for receptor-mediated signalling. Because IL-2R beta lacks any apparent
      catalytic motifs, IL-2R beta may be physically or functionally coupled to other
      signalling molecules. Structure-function studies of IL-2R beta have revealed that
      at least two distinct cytoplasmic regions of IL-2R beta are involved in IL-2
      induced cellular signalling. The "serine-rich" region of IL-2R beta was
      identified as a region critical for IL-2-induced mitotic signalling from
      experiments in which IL-2R beta mutant cDNAs lacking a particular cytoplasmic
      region or regions were expressed in an IL-3-dependent mouse pro-B cell line (BAF
      B03). Meanwhile, another cytoplasmic region of IL-2R beta, the "acidic" region,
      is responsible for its physical association with an src-family protein tyrosine
      kinase (PTK), p56lck and is critical for activating the p56lck PTK following IL-2
      stimulation. It is now evident that IL-2R beta is linked to at least two
      intracellular signalling pathways that mediate nuclear proto-oncogene induction.
      One pathway is linked to tyrosine phosphorylation events, mediated by a src
      family protein tyrosine kinase (PTK), and that pathway leads to the induction of
      the c-fos, c-jun, and other genes of this family. Another pathway leads to c-myc
      gene induction by an as yet unknown mechanism. We discuss the complex signalling
      machinery that links the cell surface receptor to the nuclear events.

PMID- 8476562
TI  - The molecular descent of the major histocompatibility complex.
AB  - In the last few years, more than 500 primate major histocompatibility complex
      (Mhc) genes or parts thereof have been sequenced. The extraordinary sequence
      information is used here to draw conclusions about the manner of Mhc evolution.
      The Mhc genes are found to evolve at a relatively slow rate with the regularity
      of a clock. It takes from 1 to 6 million years for a new mutation to be
      incorporated into an Mhc allele, and the mutation rate is comparable to that of
      most other primate genes. The nonsynonymous sites coding for the peptide-binding
      region (PBR) are under relatively weak positive selection pressure (selection
      coefficient of a few percent only); the nonsynonymous non-PBR sites are under
      moderate negative selection pressure. The positive pressure is probably provided
      by parasites and is responsible for the trans-species persistence of allelic
      lineages at functional Mhc loci for more than 40 million years.

PMID- 8476563
TI  - Differential regulation of murine T lymphocyte subsets.
AB  - Signaling pathways in T lymphocytes have been incompletely characterized. It is
      evident that differences exist among the T cell subsets. We have defined several
      distinct mechanisms that affect differentially the activities of murine T
      lymphocyte clones representing various CD4+ and CD8+ subsets: Interferon-gamma
      (IFN-gamma) inhibits proliferation of but not lymphokine production by TH2 cells.
      IL-10 inhibits antigen-presenting cell (APC)-induced lymphokine production by TH1
      cells but not by TH2 cells. Murine TH1 and TH2 clones proliferate optimally in
      response to distinct APC populations. TH1 and TH2 clones utilize different TCR
      associated signaling pathways. High concentrations of antigen (or anti-TCR mAb)
      inhibit IL-2-induced proliferation (but not lymphokine production) by TH1 and
      cytolytic T lymphocyte (CTL) clones only. Exposure of TH1 clones (but not TH2
      clones or CD8+ CTL clones) to IL-2 induces unresponsiveness to antigen. TH1 and
      TH2 clones as well as CD8+ clones can be cytolytic, but not all T cells use the
      same cytolytic mechanisms. CD4+ clones from some mouse strains are not cytolytic
      if they do not secrete IFN-gamma. Understanding the mechanisms that
      differentially regulate the various kinds of T cells, in addition to providing
      insights into the molecular events associated with activation of those subsets,
      should facilitate modulation of their activities in vivo, making it possible to
      influence favorably the outcome of disease processes.

PMID- 8476564
TI  - Gene therapy of the immune system.
AB  - Many applications of somatic gene therapy relate to the immune system. Several
      forms of inherited immunodeficiencies are candidates for treatment by gene
      transfer. Adenosine deaminase (ADA) deficiency causes a form of severe combined
      immunodeficiency. Stable gene transfer and expression of human ADA has now been
      obtained in hematopoietic stem cells of mice and, more recently, in large
      animals. The human ADA has also been introduced and expressed in the primitive
      human hematopoietic progenitor cells that initiate long-term bone marrow culture.
      Clinical trials of gene therapy for ADA deficiency have been initiated. The
      initial protocols were aimed at the correction of peripheral blood T lymphocytes,
      but recent strategies are attempting ADA gene transfer into peripheral blood or
      bone marrow stem cells. Other immunodeficiencies that may soon be amenable to
      somatic gene therapy include leukocyte adhesion deficiency and chronic
      granulomatous disease. Gene therapy may also be applied to the treatment of
      acquired disorders. In theory, the hematopoietic stem cells of a human
      immunodeficiency virus (HIV)-infected patient could be genetically modified and
      used to reconstitute an HIV-resistant hematopoietic system. Various strategies
      are currently being investigated to achieve this "intracellular immunization"
      against HIV. These include the transfer of genes encoding recombinant soluble CD4
      molecules, suicide genes under the control of HIV-inducible promoter, and anti
      HIV ribozymes. Gene transfer could also be used in the treatment of cancer to
      increase the immune response of the host, to activate prodrugs specifically in
      tumors, or to protect normal tissues against the toxicities of conventional
      treatment. Recent progress in all of these applications of gene therapy is
      reviewed here.

PMID- 8476565
TI  - T cell-dependent B cell activation.
AB  - B cells obtain help from T cells in the antibody response by acting as antigen
      specific antigen presenting cells. A direct signal through binding of antigen to
      membrane Ig can enhance B cell antigen presentation and T-dependent B cell
      activation, but is not required for a productive interaction between a small
      resting B cell and a differentiated helper T cell. As a result of helper T cell
      recognition of antigen on the B cell surface, the T cell becomes activated and in
      turn activates the B cell. T cell help has two components: lymphokines which act
      as growth and differentiation factors for B cells, and additional signals which
      require cell contact and enable B cells to respond to lymphokines. Contact help
      activity is regulated like lymphokine synthesis and secretion. Because contact
      help activity is retained by fixed, activated helper T cells and plasma membranes
      prepared from activated T cells, contact help is likely to be owing to new
      proteins expressed as membrane-bound lymphokines or activation antigens on helper
      T cells. Once induced, contact help can be delivered to B cells independently of
      recognition of antigen/class II MHC. A newly identified activation antigen of
      helper T cells, a ligand for the B cell differentiation antigen, CD40, is a key
      component of contact help. The roles of other T and B cell membrane molecules in
      contact help are reviewed.

PMID- 8476566
TI  - Immunoglobulin class switch recombination.
AB  - A B lymphocyte that produces the immunoglobulin heavy (H) chain mu may switch to
      the production of another heavy chain class: gamma, epsilon, or alpha. Since the
      new heavy chain retains the original variable (V) region, antigenic specificity
      is maintained. The switch is accompanied by a large deletion of DNA at the heavy
      chain locus. To explain how this deletion is generated, three models have been
      proposed: recombination between homologs, unequal sister chromatid exchange, and
      looping out and deletion. While none of the predicted recombination products of
      the first two models have been found, both by-products of looping out--inversions
      and circular DNA--have been isolated. Thus looping out and deletion appears to be
      the appropriate model to explain the genetic events leading to the immunoglobulin
      heavy chain class switch. One requirement for switching may be transcription of
      the constant (C) region to which the cell switches. The switch rearrangement is
      catalyzed by a switch recombinase, and the isolation of the components of this
      putative enzyme system is in progress. Although the switch deletion is an
      accepted fact, the discussion is enlivened by scenarios for switching without DNA
      rearrangement; such suggestions include processing at the RNA level and trans
      splicing.

PMID- 8476567
TI  - The molecular basis of allorecognition.
AB  - Until recently it was generally assumed that the focus of T cell receptor
      recognition of allogeneic MHC molecules was the polymorphic regions on the
      molecule that differed between responder and stimulator. It is now clear that all
      T cell recognition, including self-tolerance and allorecognition, involves both
      the MHC molecule and its associated peptide ligand. Polymorphic residues located
      within the peptide binding groove of the MHC and inaccessible to the T cell
      receptor can profoundly affect selection and recognition of bound peptides. These
      peptide differences between histoincompatible individuals greatly amplify the
      antigenic impact of MHC polymorphism and result in the high frequency of
      alloreactive cells. Evidence for the role of peptides in allorecognition is
      reviewed.

PMID- 8476568
TI  - The biochemistry and cell biology of antigen processing and presentation.
AB  - T lymphocytes with alpha beta receptors recognize antigen in association with the
      polymorphic products of the class I and class II loci of the major
      histocompatibility complex (MHC). This presentation of antigen results from the
      intracellular generation of protein fragments, and the binding and transport to
      the cell surface of these peptides in stable association with the MHC class I and
      class II molecules. Each class of MHC molecule appears specialized for capture of
      peptides present in a particular intracellular compartment. We describe here the
      structural basis of peptide-MHC molecule interaction, the differences in
      biochemical behavior that focus the two classes of MHC molecules on peptides of
      distinct size and location, and the cell biology of MHC molecule transport,
      peptide generation, and intracellular movement. The importance of conformational
      changes accompanying peptide binding that affect subunit stability of MHC
      molecules, and the relationship between these changes and the handling of
      proteins by intracellular chaperones, are emphasized as key features in the
      operation of the class I and class II presentation pathways.

PMID- 8476569
TI  - Regulation of lymphocyte function by protein phosphorylation.
AB  - Variations in protein phosphorylation provide the predominant means of enzymatic
      regulation now known in biological systems, especially in the regulation of
      signal transduction from cell surface receptors. Analysis of these signaling
      pathways has proceeded especially rapidly in lymphocytes, in part because these
      cells can be isolated with relative ease and can in many cases be maintained in
      vitro for prolonged periods as clonal populations. During the past few years,
      both biochemical and genetic evidence has been adduced indicating that the
      antigen receptors of T and B lymphocytes associate functionally with nonreceptor
      protein tyrosine kinases. Similar data implicate protein tyrosine kinases in
      signaling from the CD4 and CD8 coreceptors and the beta chain of the IL-2
      receptor. Protein serine/threonine kinases and several different phosphatases
      also participate in the intracellular propagation of antigen receptor-derived
      signals. Here we review the lymphocyte surface receptors that are believed to act
      by altering protein phosphorylation, the kinases and phosphatases that are
      believed to regulate signal transduction in lymphocytes, and the implications of
      these results for the broader study of cell signaling mechanisms.

PMID- 8476570
TI  - Immunological memory.
AB  - The past five or six years has seen a resurgence of interest in immunological
      memory. Areas in which important advances have been made of late or in which
      problems in understanding persist are covered here: (i) Selection of virgin B
      cells for entry into the peripheral pool. (ii) Expression of immunoglobulin
      isotypes and other markers on memory B cells. (iii) Development of memory B cells
      as a separate lineage from primary response B cells. (iv) Sites of production of
      memory B cells. (v) Signals that rescue mutating B cells in germinal centers,
      forming the basis of affinity selection, and programming further differentiation.
      (vi) The myriad markers of memory T cells, in particular CD45R isoforms. (vii)
      Selective migration pathways of memory T cells and its possible molecular basis.
      (viii) The lifespan of memory cells and factors that influence their long-term
      survival. The data accumulated during this period which have vastly increased our
      understanding of memory have at the same time highlighted unresolved problems
      that could block further progress in the field. The thorny question that we
      cannot at present answer is: How does a memory cell differ from an activated cell
      and, in the case of T cells, from an effector cell? The problem bears on the
      interpretation of any study that sets out to correlate memory phenotype with
      memory function. Immunologists may have donned an intellectual straitjacket in
      their search for the memory cell.

PMID- 8476571
TI  - Origin of murine B cell lineages.
AB  - Until recently, the hematopoietic stem cells (HSC) that appear early in ontogeny
      were thought to constitute a homogeneous, self-replenishing population whose
      developmental potential remains constant throughout the life of the animal.
      Studies reviewed here, however, demonstrated clear differences in the
      developmental potential of fetal and adult progenitor populations (including FACS
      sorted HSC). These studies, which chart the ability of various progenitor sources
      to reconstitute functionally distinct B cell populations, define three B cell
      lineages: B-1a cells (CD5 B cells), derived from progenitors that are present in
      fetal omentum and fetal liver but are largely absent from adult bone marrow; B-1b
      cells ("sister" population), derived from progenitors that are present in fetal
      omentum, fetal liver, and also in adult bone marrow; and conventional B cells,
      whose progenitors are missing from fetal omentum but are found in fetal liver and
      adult bone marrow. B-1a and B-1b cells share many properties, including self
      replenishment and feedback regulation of development. These B cell studies, in
      conjunction with evidence for a similar developmental switch for T cells and
      erythrocytes, suggest that evolution has created a "layered" immune system in
      which successive progenitors (HSC) reach predominance during development and give
      rise to differentiated cells (B, T, etc) responsible for progressively more
      complex immune functions.

PMID- 8476572
TI  - Transcriptional regulation of T cell receptor genes.
AB  - The diverse lineages of the mammalian hematopoietic system including both B and T
      lymphocytes are derived from a single mesodermal progenitor, the pluripotent bone
      marrow stem cell. The coordinate transcriptional regulation of sets of lineage
      specific genes is one of the important molecular mechanisms underlying
      hematopoietic lineage determination and differentiation. The immunoglobulin and T
      cell receptor (TCR) genes have been used as model systems to study lineage
      specific transcriptional regulation during lymphoid development. This review
      summarizes our current understanding of the regulation of TCR gene expression
      during thymocyte ontogeny. Expression of each of the TCR genes is controlled by T
      cell-specific transcriptional enhancers that bind partially overlapping sets of
      ubiquitous and lymphoid-specific transcription factors. These include members of
      both the ATF/CREB family of basic-leucine zipper proteins and the Ets
      protooncogene family, as well as the T cell-specific zinc finger transcription
      factor, GATA-3, and the T cell-specific high mobility group proteins TCF-1 and
      TCF-1 alpha/LEF-1. The identification of binding sites for these same
      transcription factors in a number of additional T cell-specific genes suggests
      that they may play important roles in the coordinate regulation of gene
      expression that specifies the development of the T cell lineages. Recent studies
      of the TCR alpha and gamma genes have suggested that negative regulatory elements
      of transcriptional silencers may also play an important role in controlling the
      lineage-specific expression of these genes. On going studies are designed to
      clarify the role of each of the TCR enhancer binding proteins in regulating T
      cell development in vivo, to more precisely define the interactions between the
      TCR enhancer binding proteins, and to elucidate the molecular mechanisms
      underlying transcriptional silencer activity.

PMID- 8476573
TI  - The molecular cell biology of interferon-gamma and its receptor.
AB  - The last ten years have seen an explosive growth in our understanding of IFN
      gamma. The cloning of the cDNAs for IFN gamma and its receptor have made
      available large amounts of highly purified recombinant IFN gamma and soluble IFN
      gamma receptor. In addition, highly specific neutralizing monoclonal antibodies
      have been generated to both of these proteins. Using these reagents, IFN gamma
      and the IFN gamma receptor have been characterized on a molecular basis.
      Structure-function studies carried out on these proteins have identified key
      molecular regions that are required for biologic activity. Moreover, a great deal
      is now known concerning the physiologic role that IFN gamma plays in vivo. In
      this review we focus on the new developments in the areas of IFN gamma
      biochemistry and biology and pay particular attention to the IFN gamma receptor
      and three aspects of IFN gamma biology that are of special interest to
      immunologists: host defense, inflammation, and autoimmunity.

PMID- 8476574
TI  - The Ly-49 and NKR-P1 gene families encoding lectin-like receptors on natural
      killer cells: the NK gene complex.
AB  - Natural killer cells lyse tumor and virally infected cells in a specific manner
      that has not been molecularly characterized. Target cell expression of major
      histocompatibility complex (MHC) class I molecules is correlated with target cell
      resistance to natural killing. A mechanism to explain this observation is that NK
      cells may display two types of recognition and activation molecules that have
      opposing functions when bound to target cell ligands. One type of surface
      receptor such as the NKR-P1 molecule may activate NK activity whereas the other,
      represented by the mouse Ly-49 molecule, may engage target cell MHC molecules and
      inhibit cytotoxicity by transducing "negative" signals. NKR-P1 and Ly-49 are
      structurally related, and they are encoded by genetically linked loci in a
      chromosomal region, termed the NK gene complex (NKC), on distal mouse chromosome
      6. Target cell susceptibility to natural killing may be dependent upon specific
      ligand-receptor interaction with these activating or inhibitory NKC-encoded
      molecules.

PMID- 8476575
TI  - Gamma/delta cells.
AB  - Before TCR rearrangements, T cell progenitors are committed not only to the alpha
      beta and gamma delta T cell lineage but also to various subsets of both lineages.
      In the mouse, distinct gamma delta T cell subsets can develop in the fetal
      thymus, the adult thymus, or independently of a thymus, probably in intestinal
      epithelia. The two subsets that develop in the fetal thymus home to and are
      maintained throughout adult life in the skin and the mucosa of the uterus,
      vagina, and tongue. They are monospecific. This unusual restriction in receptor
      repertoires is the result of severe limitations in the generation of diversity in
      the fetal progenitors of these subsets and the thymic selection. After birth, one
      gamma delta T cell subset appears in the blood, spleen, and lymph nodes and one
      in the intestinal epithelia. The receptor repertoires of these subsets are
      characterized by the preferential usage of particular V gamma gene segments and
      extensive junctional diversity. Several murine and human gamma delta T cell
      clones have been shown to recognize classical MHC class I and class II proteins
      or MHC class I-like proteins, and in very few cases the presented peptides are
      known. We suspect that the various murine gamma delta T cell subsets interact
      with different antigen presenting cells which utilize different antigen
      presenting proteins and reside in different tissues. The function of gamma delta
      T cells remains unknown. Preliminary results of experiments with gene knock out
      mice which lack either alpha beta T cells or gamma delta T cells or both suggest
      that gamma delta T cells do not function as helper cells in humoral immune
      responses but may complement alpha beta T cells in the defense against various
      microorganisms.

PMID- 8476576
TI  - T cell responses to pre-erythrocytic stages of malaria: role in protection and
      vaccine development against pre-erythrocytic stages.
AB  - Malaria remains a leading cause of human morbidity and mortality due to the
      inability of insecticides and chemotherapy/chemoprophylaxis to eliminate the
      vectors or disease caused by this protozoan parasite. In an effort to develop new
      methods of control, vaccines targeted to the various stages of the complex life
      cycle of Plasmodium have been developed. This review describes recent advances in
      the elucidation of cell-mediated immune mechanisms directed against sporozoites
      and liver stages of malaria parasites, their role in protection, and their
      relation to vaccine development. Recent data on the molecular basis of sporozoite
      liver cell interaction are presented, and these may provide new approaches for
      chemoprophylaxis and immunoprophylaxis. We describe the role of the
      circumsporozoite protein, the major sporozoite surface antigen, in sporozoite
      movement and as a target of humoral immunity. The recognition of the
      circumsporozoite protein by human T cells is reviewed with emphasis on cytotoxic
      T cells and immune resistance against the exo-erythrocytic stage of the parasite.
      Earlier concepts regarding the polymorphisms of the circumsporozoite protein, the
      immunological relevance of this polymorphism, and predictions regarding vaccine
      development are reevaluated on the basis of recent data from different malaria
      endemic areas. Non-CS sporozoite antigens and liver stage antigens are discussed
      as potential targets for immune intervention. Recent experimental approaches such
      as multiple antigen peptides, recombinant live vectors, and new more potent
      adjuvants are considered for the development of more effective malaria vaccine
      formulations.

PMID- 8476577
TI  - Endothelial-leukocyte adhesion molecules.
AB  - One decade ago, vascular endothelium was commonly considered a "non-stick" lining
      of blood vessels that functioned only to prevent blood coagulation and to
      separate the vascular space from tissues. By comparison to many other cell types,
      endothelial cells were thought to be less active, less complex, and less
      interesting. Since that time, research concerning the endothelium has expanded
      dramatically and produced a new image of the vascular lining as an active
      participant in a wide variety of pathophysiological processes, including
      inflammation and immunity. Nowhere has the excitement been more intense than in
      the study of the molecular mechanisms of leukocyte adhesion to endothelium.
      Recent efforts resulted in the identification, characterization, and cloning of
      multiple endothelial cell-surface glycoproteins that support adhesion through an
      interaction with specific ligands (or counter-receptors) on leukocytes. The
      selectins, two of which are found on endothelium and one on leukocytes, support
      adhesion through the recognition of carbohydrates. Endothelial members of the
      immunoglobulin superfamily including ICAM-1 and VCAM-1/INCAM-110 bind to
      leukocyte cell-surface integrins. In various combinations, these and other
      molecules support leukocyte adhesion to the vessel wall and extravasation, key
      steps in our response to infection and tissue injury.

PMID- 8476578
TI  - The role of autoantibodies in autoimmune disease.
AB  - In autoimmune diseases, autoantibodies may be the actual pathogenetic agents of
      the disease, the secondary consequences of tissue damage, or the harmless
      footprints of an etiologic agent. Establishing a pathogenetic role for
      autoantibodies requires that they meet stringent criteria. It appears that the
      location of the presumptive target antigen most critically influences the
      pathogenetic potential of autoantibodies. Autoantibodies directed against cell
      surface targets, such as hormone receptors, are clearly pathogenetic; those
      directed against extracellular targets, such as circulating molecules or
      extracellular matrix, may or may not cause any damage. Those apparently directed
      against intracellular targets are usually not pathogenetic unless it can be
      clearly demonstrated (a) that the antigen is released from within the cell so
      that it can bind onto a cell surface receptor or other extracellular location,
      such as proteinase 3; (b) that the antigen moves to an aberrant site on the cell
      surface, such as, perhaps, the small ribonucleoprotein antigen Ro; or (c) that a
      cross-reactive molecule, the actual target, such as the membrane ribosomal P-like
      protein, is at an accessible location.

PMID- 8476579
TI  - Effectiveness and safety of ofloxacin in chronic otitis media and chronic
      sinusitis in adult outpatients.
AB  - A multicentric study was conducted to evaluate the clinical efficacy and
      tolerance of ofloxacin in the treatment of chronic sinusitis and chronic otitis
      (CSOM) in outpatients. Two hundred milligrams of ofloxacin was administered twice
      a day orally for 12 days in 198 patients with chronic sinusitis and 215 patients
      with CSOM. Cultures for bacteriology were carried out before treatment. The
      spectrum of pathogens sensitive to ofloxacin included Staphylococcus aureus,
      Pseudomonas aeruginosa, Proteus mirabilis and Haemophilus influenzae. Higher
      concentrations of ofloxacin were obtained at sites of infection than in serum.
      Favorable results were achieved clinically in 93.7% of chronic sinusitis cases
      and 93.9% of CSOM cases. Adverse effects occurred in only 4.1% of cases. These
      results support the use of ofloxacin as the drug of first choice in the treatment
      of chronic sinusitis and CSOM in adult outpatients.

PMID- 8476580
TI  - Granulation tissue concentrations of ofloxacin after oral administration in
      invasive external otitis.
AB  - Following the fourth dose of 400 mg orally administered ofloxacin, simultaneous
      external ear canal granulation tissue and serum ofloxacin concentrations were
      estimated in 15 patients with invasive external otitis. The granulation tissue
      concentration was 2.2 (range 1.17-4.34) times higher than the serum concentration
      and 3.73 (range 1.95-11.00) times higher than the MIC90 of ofloxacin against
      Pseudomonas aeruginosa.

PMID- 8476581
TI  - Clinical experiences with ofloxacin sequential therapy in chronic ear infections.
AB  - Quinolones are the drugs of first choice in therapy of chronic ear infections
      with multiresistant bacteria, especially because of their efficacy against
      various Pseudomonas species and their lack of ototoxicity. According to clinical
      experience, best results can be obtained after application of the sequential
      treatment schedule. To verify this, 61 patients with acute exacerbations of
      chronic ear infections were treated sequentially with ofloxacin. After a single
      dose of 400 mg ofloxacin intravenously, the treatment was continued orally with
      400 mg once a day over 7 days. Microbiological and serological examination was
      performed just prior to and 1 week after treatment. Predominant bacteria isolated
      from the patients' ears were Pseudomonas aeruginosa, Staphylococcus aureus,
      Proteus spp. and Enterobacteriaceae spp. Following treatment, infections were
      cured in 23% of cases and 59% showed improvement. Eighteen percent of the cases
      were persistent, mainly due to epitympanic chronic otitis media, which was an
      indication for surgical intervention. In general, sequential therapy with
      ofloxacin revealed encouraging clinical results based on improved patient
      compliance with the treatment schedule recommended.

PMID- 8476582
TI  - Antibiotic treatment of sinusitis in general practice. A double-blind study
      comparing ofloxacin and erythromycin.
AB  - The present study compared ofloxacin and erythromycin in a double-blind study
      with parallel groups for clinical efficacy and the number and severity of adverse
      reactions in patients treated in general practice for acute or chronic sinusitis.
      All patients lived in medium-sized to large towns and rural districts in the
      northern and western parts of Sealand, Funen and eastern Jutland, Denmark. Three
      hundred and nineteen patients were enrolled in the study, of whom 280 were
      clinically evaluable. From this total number, 136 patients were treated with
      ofloxacin (31 males and 105 females) and 144 patients were treated with
      erythromycin (40 males and 104 females). Following administration of either
      ofloxacin 400 mg once daily or erythromycin 500 mg twice daily for 7-14 days,
      94.9% of the ofloxacin-treated group and 94.4% of the erythromycin-treated group
      were cured of their infections. There was no difference in clinical efficacy.
      Complications occurred in 18 of 155 patients in the ofloxacin-treated group and
      32 of 164 in the erythromycin-treated group (P < 0.05), corresponding to 27 and
      45 symptoms respectively (P < 0.01). This difference in adverse reactions
      principally involved gastrointestinal symptoms, i.e. 19 in the ofloxacin-treated
      group and 41 in the erythromycin-treated group (P < 0.01). Present findings show
      that the two antibiotics are comparable as to clinical efficacy, but the
      frequency of adverse reactions is significantly higher in the erythromycin
      treated group due to the greater incidence of gastrointestinal adverse reactions.

PMID- 8476583
TI  - The microbiology of acute and chronic sinusitis and otitis media:a review.
AB  - There exists no real controversy about the role of aerobic bacteria in acute
      sinusitis and in acute otitis media. The "infernal trio" Streptococcus
      pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are by far the most
      common pathogens in these acute infections. On the contrary, there is still much
      debate about the normal flora of the paranasal sinuses and the middle ear,
      although there are some reports of the presence of anaerobes and aerobes in the
      majority of the normal paranasal sinuses. In chronic sinusitis bacteriological
      cultures show a greater variation than those in acute sinusitis. Nonetheless, it
      is demonstrated in most studies that besides the "infernal trio" additional
      bacteria are present, including anaerobes and gram negative bacteria. In otitis
      media with effusion (OME) we find the same bacteria as in acute otitis media
      (AOM) and a pathologic flora in the nasopharynx seems to be important for both
      AOM and OME. In chronic otitis cultures are nearly always positive and reveal
      Pseudomonas species, Klebsiella pneumoniae, Staphylococcus aureus, Proteus
      species and anaerobes.

PMID- 8476584
TI  - Concentrations of ofloxacin in ear and nasal tissues.
AB  - The results of two kinetic studies examining soft tissue, cartilage and bone
      after uptake of oral ofloxacin [administered as 200 mg twice daily (study I/nose)
      or 400 mg once daily (study II/ear)] show that antibiotic concentrations lie
      within the therapeutic range. Findings demonstrate that 400 mg ofloxacin daily is
      a compliance-enhancing and effective approach to the treatment of ENT-related
      infections, in particular those caused by problem organisms such as Pseudomonas
      aeruginosa.

PMID- 8476585
TI  - A rapid procedure for mRNA extraction from a large number of samples.

PMID- 8476586
TI  - "Easypreps": fast and easy plasmid minipreparation for analysis of recombinant
      clones in E. coli.

PMID- 8476587
TI  - Multiplexed minipreps for rapid screening of large numbers of recombinant DNA
      clones.

PMID- 8476588
TI  - Optimized PEG method for rapid plasmid DNA purification: high yield from "midi
      prep".

PMID- 8476589
TI  - Simplified isolation of chromosomal and plasmid DNA from yeasts.

PMID- 8476590
TI  - Simplified purification of single-stranded DNA for dideoxynucleotide chain
      termination DNA sequencing.

PMID- 8476591
TI  - A simplified method of extracting DNA from gradient-purified bacteriophage
      lambda.

PMID- 8476592
TI  - Cesium chloride or column preparation? An electron microscopical view of plasmid
      preparations.

PMID- 8476593
TI  - Importance of DNA quality for transfection efficiency.

PMID- 8476594
TI  - Rapid shuttle plasmid preparation from yeast cells by transfer to E. coli.

PMID- 8476595
TI  - Improving the efficiency of mutagenesis during oligonucleotide-directed in vitro
      mutagenesis.

PMID- 8476596
TI  - An internal indicator for alkaline denaturation of double-stranded DNA in dideoxy
      sequencing reactions.

PMID- 8476597
TI  - Enhanced chemiluminescence with catalyzed reporter deposition for increasing the
      sensitivity of western blotting.

PMID- 8476598
TI  - An inexpensive approach to ultracentrifugation of small volume suspensions.

PMID- 8476599
TI  - Three-base pair resolution of DNA fragments on agarose: application to delta F508
      analysis in cystic fibrosis.

PMID- 8476600
TI  - Post-hybridization recovery of membrane filter-bound DNA for enzymatic DNA
      amplification.
AB  - We describe here a simple and rapid method for enzymatic DNA amplification using
      DNA template recovered from membrane filters previously used in hybridization
      analysis. This is done by first solubilizing membrane pieces carrying DNA of
      interest in dimethyl sulfoxide, followed by isopropanol precipitation and
      polymerase chain reaction amplification. The source of membrane-bound DNA
      successfully tested includes plasmid and human leukocyte DNA and DNA immobilized
      on bacterial colony filters and plaque lifts. The sensitivity of the procedure is
      such that DNA recovered from 0.5 microgram of filter-bound total human DNA was
      enough for PCR amplification of a 0.3-kb fragment. Our protocol will be useful
      for recycling of scarce DNA samples for cloning and sequencing purposes.

PMID- 8476601
TI  - Denaturing HPLC purification of tritylated oligonucleotides using
      tetraethylammonium hydroxide.
AB  - Purification of oligonucleotides by HPLC is limited by association between
      failure sequences and full-length oligonucleotide. We describe a protocol for
      denaturing purification of 5'-dimethoxytritylated oligonucleotides that ensures
      that separation of tritylated and non-tritylated species will not be complicated
      by strand association. Fully denaturing conditions are produced by the use of
      tetraethylammonium hydroxide, which is a basic reagent with ion-pairing
      properties similar to triethylammonium acetate. The method also includes two
      other convenient features: a) the option of loading the crude oligonucleotide
      without removing concentrated ammonium hydroxide and b) detritylation on the
      column with separation of dimethoxytrityl alcohol.

PMID- 8476602
TI  - Purification of epithelial-type transforming growth factor by micro-preparative
      electrophoresis chromatography.
AB  - The purification and recovery of biologically active epithelial-type transforming
      growth factor (TGFe) is described. In the final phase of purification,
      micropreparative electrophoretic chromatography was employed using a Tris-glycine
      sodium dodecyl sulfate buffer system in an automated instrument. Briefly,
      partially purified protein preparations were separated in 2.5 x 50 mm, 10%
      polyacrylamide gel in electrophoresis tubes installed in the apparatus,
      electrophoresed under constant current of 1.5 mA for 400 min and recovered by
      automated fractionation and collection of the eluant from the tube gel. Aliquots
      of the eluted fractions were assayed in a biological system using SW-13 cell
      growth stimulation as an indicator of the presence of biologically active TGFe.
      Using the above procedure, TGFe was purified to within 95% homogeneity as
      assessed by silver-stained sodium dodecyl sulfate polyacrylamide gel
      electrophoresis.

PMID- 8476603
TI  - Syringe safety modification for neat TFA delivery.

PMID- 8476604
TI  - Analysis of synthetic oligodeoxyribonucleotides by capillary gel electrophoresis
      and anion-exchange HPLC.
AB  - Polyacrylamide slab gel electrophoresis has been traditionally used for the
      analysis of synthetic oligodeoxyribonucleotides. As the demand for
      oligonucleotides of high purity has increased, a need for additional high
      resolution analytical techniques has arisen. This report describes the principles
      and application of capillary gel electrophoresis and high-performance liquid
      chromatography for the analysis of synthetic DNA varying in base composition and
      length. From the results of a series of comparative experiments, the relative
      advantages and disadvantages of each technique are discussed.

PMID- 8476605
TI  - Screening for point mutations by semi-automated DNA sequencing using sequenase
      and magnetic beads.
AB  - We have established an improved method for detecting point mutations by semi
      automated DNA sequencing of PCR fragments generated from genomic DNA. The method
      employs magnetic beads to create immobilized single-stranded DNA templates, and
      the sequencing reaction is performed with Sequenase. This method is superior to
      sequencing with Taq DNA polymerase because the uniform peak height with Sequenase
      makes heterozygosity easily detectable as double peaks that are half the normal
      height. Detection of heterozygosity by this method is illustrated by sequencing a
      180-bp fragment of the human apolipoprotein B gene. This fragment contains codon
      3500, where a point mutation (3500CGG-->CAG) is found in subjects with the
      autosomal dominant disease familial defective apolipoprotein B. The nonuniform
      peak height with Taq DNA polymerase makes it more difficult to detect
      heterozygosity. This is also illustrated by sequencing a 278-bp fragment of the
      low-density lipoprotein receptor gene.

PMID- 8476606
TI  - Plasmid rescue from transgenic mouse DNA using LacI repressor protein conjugated
      to magnetic beads.
AB  - A method for the efficient rescue of lac operator containing plasmids from
      transgenic mouse genomic DNA is described. The method is based on the high
      affinity of the LacI repressor protein for the lac operator sequence. Using the
      LacI repressor protein conjugated to magnetic beads, more than 95% of plasmid
      sequences could be purified from restriction enzyme digested genomic DNA. After
      circularization, the plasmids were introduced into Escherichia coli by means of
      electroporation. Since the plasmid was cloned into a bacteriophage lambda vector,
      the efficiency of plasmid rescue could easily be compared with in vitro
      packaging. Our results indicate that plasmid rescue is about 25 times more
      efficient. Application of this method should be especially useful with transgenic
      mouse models harboring LacZ plasmid shuttle vectors for studying spontaneous or
      induced mutations in vivo.

PMID- 8476607
TI  - Matrix effects in the derivatization of amino acids with naphthalene
      dicarboxaldehyde, 9-fluorenylmethyl chloroformate and phenylisothiocyanate.
AB  - Pre-column derivatizations of amino acids often present two major challenges: 1)
      automation, due to the multi-step manipulations for pH control, reagent addition,
      mixing and extraction, and 2) effect of matrices in the sample such as salts,
      buffers and surfactants. Both issues have been addressed in a previous
      publication on derivatization methods using 9-fluorenylmethyl chloroformate
      (FMOC) and phenylisothiocyanate (PITC). In this paper, a third method of
      derivatization, which has recently been developed and published, was studied to
      address the same issues. The derivatization reagent, naphthalene-2,3
      dicarboxaldehyde (NDA), is a modification from o-phthalaldehyde (OPA) and yields
      more stable derivatives with high fluorescence efficiencies. An autosampler was
      programmed to mix amino acid samples with cyanide and NDA reagent, allow a
      programmed reaction time and finally inject onto the HPLC. To study sample matrix
      effects, amino acid samples were spiked with various concentrations of Tris-HCl,
      phenol, citrate, sulfosalicylic acid, sodium chloride and sodium dodecyl sulfate.
      The recoveries of amino acids in varied sample matrices were compared to pure
      amino acid standards. The matrix effects using the NDA method were similar to
      those using the FMOC method. Comparisons of all three methods (NDA, FMOC and
      PITC) are discussed and tabulated.

PMID- 8476608
TI  - Sample preparation for HPLC by Centricon ultrafiltration.
AB  - Peptides and other bioactive materials can be purified from complex biological
      sources by reverse-phase high-performance liquid chromatography (RP-HPLC),
      provided the mixture is suitably prepared before injection onto an HPLC system.
      Ultrafiltration offers a convenient and rapid sample preparation technique with
      numerous advantages over alternative methods such as conventional gel filtration
      chromatography. We demonstrate the use of ultrafiltration as an HPLC sample
      preparation step in the purification of peptides bound to class I major
      histocompatibility complex (MHC-I) membrane proteins. When ultrafiltration was
      performed with a Centricon-10 ultrafiltration device, peptides were efficiently
      separated from the alpha (45 kDa) and beta 2m (12 kDa) chains of MHC-I proteins
      and could be subjected to HPLC without further treatment. Furthermore, even
      samples as crude as whole cell lysates or supernatants could be prepared for HPLC
      in a single ultrafiltration step, affording a remarkably straightforward route to
      the purification of biologically important peptides.

PMID- 8476609
TI  - Circadian clock functions localized in xenopus retinal photoreceptors.
AB  - A circadian oscillator that regulates visual function is located somewhere within
      the vertebrate eye. To determine whether circadian rhythmicity is generated by
      retinal photoreceptors, we isolated and cultured photoreceptor layers from
      Xenopus retina. On average, 94% of the viable cells in these preparations were
      rod or cone photoreceptors. Photoreceptor layers produced melatonin rhythmically,
      with an average period of 24.3 hr, in constant darkness. The phase of the
      melatonin rhythm was reset by in vitro exposure of the photoreceptor layers to
      cycles of either light or quinpirole, a D2 dopamine receptor agonist. These data
      indicate that other parts of the eye are not necessary for generation or
      entrainment of retinal circadian melatonin rhythms and suggest that rod and/or
      cone photoreceptors are circadian clock cells.

PMID- 8476610
TI  - Circadian regulation of iodopsin gene expression in embryonic photoreceptors in
      retinal cell culture.
AB  - A circadian clock regulates a number of diverse physiological functions in the
      vertebrate eye. In this study, we show that mRNA for the red-sensitive cone
      pigment, iodopsin, fluctuates with a circadian rhythm in chicken retina.
      Transcript levels increase in the late afternoon just prior to the time of cone
      disc shedding. Furthermore, iodopsin mRNA levels are regulated similarly by a
      circadian oscillator in primary cultures of dispersed embryonic chick retina.
      Nuclear run-on experiments show that the circadian regulation of iodopsin
      transcript abundance occurs at the level of gene transcription. Our results
      provide a demonstration of clock-regulated gene expression in a vertebrate
      preparation maintained in cell culture.

PMID- 8476611
TI  - Molecular mechanisms of pain: serotonin1A receptor agonists trigger
      transactivation by c-fos of the prodynorphin gene in spinal cord neurons.
AB  - By using spinal cord neurons cultured in chemically defined medium, a double
      labeling procedure, and blockage with antisense oligonucleotides, we show that
      induction of c-fos and the subsequent transactivation of the prodynorphin gene
      are coupled events, triggered by serotonin1A receptor agonists. Addition of the
      specific 1A agonist 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OH-DPAT) to the
      culture, at concentrations similar to that needed for transactivation of the
      prodynorphin gene, also significantly increases cAMP levels. Furthermore, in rats
      depleted of serotonin by intrathecal administration of 5,7-dihydroxytryptamine,
      the induction of prodynorphin after noxious stimulation is dramatically decreased
      compared with the induction in sham-operated rats. These results suggest that the
      expression of the prodynorphin gene in spinal cord is under the control of the
      raphe-spinal efferents containing serotonin.

PMID- 8476612
TI  - Axotomy-induced neurofilament phosphorylation is inhibited in situ by
      microinjection of PKA and PKC inhibitors into identified lamprey neurons.
AB  - Close axotomy of identified lamprey neurons induces phosphorylation of
      somatodendritic neurofilaments (NFs), followed by ectopic regeneration of
      neurofilamentous sprouts from the dendrites. We used in situ intracellular
      microinjection to study the mechanism of axotomy-induced NF phosphorylation. We
      found that inhibitors of protein kinase C (PKC) and protein kinase A (PKA) block
      somatodendritic NF phosphorylation for up to 15 days when injected at the time of
      axotomy. Injection of PKA catalytic subunit, diacylglycerol, or okadaic acid
      induces somatodendritic NF phosphorylation in intact neurons with the same time
      course as close axotomy. These results suggest that transient activation of PKC,
      PKA, and/or serine phosphatase inhibition by axotomy triggers persistent
      intracellular changes that may be related to polarity loss in these neurons.

PMID- 8476613
TI  - Subcellular localization of tau mRNA in differentiating neuronal cell culture:
      implications for neuronal polarity.
AB  - A primary neuronal cell culture derived from whole brains of fetal rats was used
      to analyze the subcellular localization of tau mRNA, employing nonisotopic
      detection by in situ hybridization. The culture exhibited a developmental
      differentiation pattern previously described for neuronal cells in vivo; i.e., a
      transition from immature to mature tau isoforms as well as segregation of tau
      into the axons. Our results demonstrate that unlike tubulin mRNA, which is
      confined to cell bodies, or MAP2 mRNA, which extends into dendrites, tau mRNA was
      observed to enter the proximal portion of the axon. This sorting of tau mRNA
      might explain how the tau protein could be selectively delivered to the axon and
      could have important implications for the development of neuronal polarity.

PMID- 8476614
TI  - Opioid peptide modulation of Ca(2+)-dependent K+ and voltage-activated Ca2+
      currents in bovine adrenal chromaffin cells.
AB  - Opioid peptides are abundantly expressed in the adrenal medulla, and there is
      evidence that they may be released presynaptically or as medullary paracrine
      agents. To assess the physiological relevance of these observations, we
      investigated opioid effects on ionic currents from cultured bovine adrenal
      chromaffin cells. Under whole-cell path-clamp conditions, opioid peptides, acting
      via a mu-type opioid receptor, strongly potentiated the large conductance Ca(2+)
      dependent K+ (BK) channel current. Opioids also inhibited voltage-activated Ca2+
      currents. Application of opioid peptides to the extracellular face of outside-out
      patches also increased opening activity of single BK channels, suggestive of
      tight receptor-channel coupling. This potentiating effect on BK current, combined
      with the inhibition of Ca2+ current, indicates that opioids may have an
      inhibitory influence on secretory activity of the adrenal medulla. The widespread
      distribution of the BK channel class suggests that the significance of its
      modulation by opioids could also extend beyond the adrenal gland.

PMID- 8476615
TI  - Effect of lumbar epidural anesthesia on ventilatory response to hypercapnia in
      young and elderly patients.
AB  - STUDY OBJECTIVE: To examine the influence of age on resting ventilation, arterial
      blood gas tensions, and the ventilatory response to hypercapnia in lumbar
      epidural anesthesia. DESIGN: Clinical study using groups of young and elderly
      patients. SETTING: Surgical operation center of a university hospital. PATIENTS:
      Seven young (average age 39 years) and seven elderly (average age, 69 years)
      unpremedicated patients undergoing lower abdominal surgery. INTERVENTIONS:
      Patients were administered lumbar epidural anesthesia with 10 ml of 2% lidocaine.
      MEASUREMENTS AND MAIN RESULTS: Resting ventilation, arterial blood gas tensions,
      and ventilatory response to hypercapnia were measured before and 20 minutes after
      the block. Regarding the ventilatory response to hypercapnia, the mean slope of
      the hypercapnic response curve [change in minute ventilation (VE) divided by
      change in end-tidal partial pressure of carbon dioxide (PETCO2)] increased
      significantly following the epidural block, by 16% in the young patients and by
      23% in the elderly patients, and the mean VE at a PETCO2 of 55 mmHg (VE55) also
      increased significantly, by 16% in the young subjects and by 26% in the older
      subjects. These changes in delta VE/delta PETCO2 and VE55 were statistically
      equivalent between the two age-groups. CONCLUSIONS: The effects of lumbar
      epidural anesthesia on resting ventilation, arterial blood gas tensions, and
      ventilatory response to hypercapnia were not affected by age.

PMID- 8476616
TI  - Improved postoperative analgesia with morphine added to axillary block solution.
AB  - STUDY OBJECTIVE: To determine whether the addition of morphine to the axillary
      block local anesthetic solution provides improved or prolonged postoperative
      analgesia. DESIGN: Prospective, randomized, double-blind clinical trial with 24
      hour follow-up. SETTING: Ambulatory unit of a large academic referral center.
      PATIENTS: Consecutive healthy volunteers scheduled for elective upper extremity
      surgery. INTERVENTIONS: Patients in the treatment group (AX) were given
      intravenous (IV) saline and had morphine 0.1 mg/kg added to their axillary block
      solution. Control subjects (CT) received morphine 0.1 mg/kg IV and had saline
      added to their axillary block solution. All axillary blocks were performed using
      0.55 ml/kg of 1.5% lidocaine with epinephrine 1:200,000. MEASUREMENTS AND MAIN
      RESULTS: During the first 24 hours after surgery, visual analog scale (VAS)
      scores, supplementary analgesic (oxycodone 5 mg with acetaminophen 500 mg) use,
      and complications were recorded. Both groups had similar VAS scores throughout
      the study. In the 24-hour postoperative study period, AX patients required
      approximately half as many doses (median, 2 doses; range, 0 to 7 doses of
      supplemental analgesic as CT patients (median, 4 doses; range, 0 to 12 doses).
      There were no major complications in either group. CONCLUSIONS: The addition of
      morphine 0.1 mg/kg to the local anesthetic axillary block solution provided
      improved postoperative analgesia without an increased frequency of side effects
      or major complications.

PMID- 8476617
TI  - Interpleural analgesia with bupivacaine following thoracotomy: ineffective
      results of a controlled study and pharmacokinetics.
AB  - STUDY OBJECTIVE: To evaluate intrapleural analgesia with bupivacaine following
      partial pulmonary resection and to determine pharmacokinetic parameters of
      bupivacaine with epinephrine. DESIGN: Prospective, randomized study. SETTING:
      Thoracic surgical clinic of a university-affiliated general hospital. PATIENTS:
      Eighteen consecutive patients (13 men, 5 women) scheduled for pulmonary surgery
      by posterolateral thoracotomy. INTERVENTIONS: Bupivacaine was administered
      through an intrapleural catheter as a bolus dose of either 40 ml of 0.25%
      bupivacaine with epinephrine (0.5 mg per 100 ml of solution) (n = 10) or 20 ml of
      0.5% bupivacaine with epinephrine (0.5 mg per 100 ml of solution) (n = 8) up to
      three times daily for a maximum time of 4 days. MEASUREMENTS AND MAIN RESULTS:
      Subjective evaluation of pain was performed using the visual analog scale (VAS)
      before and after each injection by response to spontaneous pain, coughing, deep
      breathing, and incision palpation. Maximum peak concentration (C Max) and maximum
      time to reach the peak concentration (T Max) were assessed after the first and
      last injections. Although VAS pain score decreased significantly, pain relief was
      not sufficient. C Max and T Max after the first and last injections were not
      significantly different between the two groups. In each group, C Max after the
      last injection was significantly higher than after the first injection.
      CONCLUSIONS: Intrapleural analgesia conducted with 40 ml of 0.25% bupivacaine
      with epinephrine or 20 ml of 0.5% bupivacaine with epinephrine was insufficient
      for pain, despite high plasma bupivacaine concentration.

PMID- 8476618
TI  - A comparison of desflurane and isoflurane in prolonged surgery.
AB  - STUDY OBJECTIVE: To compare desflurane with isoflurane in several anesthetic
      situations. DESIGN: Intubating conditions, hemodynamic response to intubation,
      maintenance hemodynamics, and speed of recovery from desflurane and isoflurane
      anesthesia were evaluated. In addition, interaction with a muscle relaxant at low
      and high concentrations of the anesthetics were compared. SETTING: Thomas
      Jefferson University Hospital. PATIENTS: Thirty-two patients who received general
      anesthesia for lengthy, mostly orthopedic procedures. INTERVENTIONS: Immediately
      after induction with thiopental sodium, desflurane or isoflurane in nitrous oxide
      oxygen was administered via face mask. Anesthesia was deepened until end-tidal
      concentration reached 1.7 minimum alveolar concentration (MAC). The trachea was
      intubated without the aid of a muscle relaxant. Heart rate (HR) and blood
      pressure (BP) were recorded before and at 1, 2, 4, 5, and 10 minutes after
      intubation. Noninvasive cardiac output (CO) and systemic vascular resistance
      (SVR) were determined while the patient was awake, immediately before intubation,
      and at 5 and 10 minutes after intubation. Following intubation, the concentration
      of desflurane or isoflurane was lowered until the end-tidal concentration reached
      0.65 MAC (low-MAC group), 1.25 MAC (high-MAC group), or 0 MAC (control group).
      Pancuronium bromide in 0.005 mg/kg doses was administered incrementally until T1
      (first twitch of train-of-four) was depressed more than 90%. ED50 and ED95 for
      pancuronium with balanced anesthesia and for desflurane or isoflurane in low and
      high MACs, as well as speed of recovery, were determined. The time to
      responsiveness and awakening also was determined. MEASUREMENTS AND MAIN RESULTS:
      There was no significant difference between desflurane and isoflurane in
      intubating conditions or in BP or HR response to tracheal intubation. Both
      anesthetics increased HR significantly during induction. BP rose with desflurane
      at the preintubation point; other points showed no difference. A hyperdynamic
      response of increased HR and BP above 20% of baseline values was seen more
      frequently with desflurane (n = 7) than with isoflurane (n = 1). CO was elevated
      at all times after induction for low and high concentrations of both drugs, while
      SVR decreased over the same time with no significant difference between drugs.
      ED50 and ED95 for pancuronium were similar under desflurane and isoflurane at
      both low and high MAC, but they were significantly lower than under balanced
      anesthesia. Awakening times were similar for desflurane and isoflurane.
      CONCLUSIONS: Desflurane is similar to isoflurane in providing anesthesia for
      intubation and maintenance. Desflurane tends to increase HR and occasionally
      causes a hyperdynamic response during rapid deepening of anesthesia. It is very
      similar to isoflurane in its interaction with pancuronium.

PMID- 8476619
TI  - Continuous caudal anesthesia for inguinal hernia repair in former preterm
      infants.
AB  - STUDY OBJECTIVE: To determine the feasibility of continuous caudal anesthesia
      with 2-chloroprocaine in conscious former preterm infants undergoing inguinal
      hernia repair. DESIGN: Prospective study. SETTING: University-affiliated
      children's hospital. PATIENTS: Ten former preterm infants, ASA physical status II
      and III, who were 35 to 49.5 weeks postconceptional age at the time of surgery.
      INTERVENTIONS: Caudal anesthesia was administered via an indwelling catheter
      using a loading dose of 1 ml/kg (30 mg/kg) of 3% 2-chloroprocaine, followed by
      incremental doses of 0.3 ml/kg (9 mg/kg) to achieve a level of T4 to T2. The
      block was maintained by a minimum infusion rate of 30 mg/kg/hr (1 ml/kg/hr) of
      the same local anesthetic solution. MEASUREMENTS AND MAIN RESULTS: The mean
      cumulative dose of 2-chloroprocaine was 2.8 +/- 1.0 ml/kg/hr (84 +/- 30 mg/kg/hr)
      infused over a mean duration of 95 +/- 35 minutes. Serum cholinesterase
      concentration and plasma 2-chloroprocaine concentration were measured in five
      infants. CONCLUSIONS: Three percent 2-chloroprocaine can be used effectively for
      continuous caudal anesthesia in conscious, former preterm infants for inguinal
      hernia and penoscrotal surgical procedures lasting 85 to 170 minutes.

PMID- 8476620
TI  - Hemodynamic stability and patient satisfaction after anesthetic induction with
      thiopental sodium, ketamine, thiopental-fentanyl, and ketamine-fentanyl.
AB  - STUDY OBJECTIVE: To examine three commonly used anesthetic induction regimens
      (thiopental sodium, ketamine, and thiopental plus fentanyl) and one newly
      described regimen (ketamine plus fentanyl) with respect to hemodynamic stability
      and patient satisfaction. DESIGN: Randomized, double-blind study. SETTING:
      University-affiliated Veterans Administration Hospital. PATIENTS: Forty-eight ASA
      physical status I and II patients (47 males, 1 female) scheduled for surgery
      requiring general anesthesia. INTERVENTIONS: Patients were randomized to one of
      four groups to receive intravenous injections of thiopental 5 mg/kg (Group 1),
      ketamine 1.5 mg/kg (Group 2), thiopental 3 mg/kg plus fentanyl 4 to 6
      micrograms/kg (Group 3), or ketamine 0.5 mg/kg plus fentanyl 4 to 6 micrograms/kg
      (Group 4) for induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Heart rate
      (HR) and mean arterial pressure (MAP) were measured during anesthetic induction.
      Evaluation of patient satisfaction/dissatisfaction and
      pleasantness/unpleasantness by the Anesthesia Experience Rating (AER) was carried
      out the day following surgery. Groups 3 and 4 showed the least increase from
      their baseline values in both HR and MAP after tracheal intubation, but only
      Group 4 exhibited no statistically significant change in hemodynamic parameters
      after induction but before intubation (p < 0.05). AER showed a higher level of
      pleasantness in Group 3 as compared with Group 2 (p < 0.03) and higher levels of
      satisfaction in Groups 3 (p < 0.03) and 4 (p < 0.02) as compared with Group 2.
      CONCLUSION: The combination of ketamine plus fentanyl provides superior
      hemodynamic stability with excellent patient satisfaction.

PMID- 8476621
TI  - Ectasis and pallor of peripheral airways during mechanical ventilation.
AB  - STUDY OBJECTIVE: To evaluate morphologic changes in peripheral airways associated
      with positive-pressure ventilation (PPV). DESIGN: Single-blind study. SETTING:
      Intensive care unit of a university hospital. PATIENTS: Ten patients who required
      mechanical ventilation due to acute respiratory failure but had no history of
      prior pulmonary disease. INTERVENTIONS: Seventeen fiberoptic bronchoscopy
      procedures were performed using a fine fiberoptic bronchoscope of 1.8 mm outside
      diameter. MEASUREMENTS AND MAIN RESULTS: The main morphologic findings were
      pallor and ectasis. Increased secretions, pigmentation, and stenosis or collapse
      in peripheral airways also were observed. Patients with ectasis were more likely
      to have had prolonged mechanical ventilation (17 +/- 9 days) as compared with
      those patients without ectasis (9 +/- 5 days). CONCLUSION: The structural
      alterations in peripheral airways noted in patients on prolonged PPV suggest that
      barotrauma may be more widespread than previously recognized.

PMID- 8476622
TI  - Adult epiglottitis and postobstructive pulmonary edema in a patient with severe
      coronary artery disease.
AB  - Epiglottitis is a rare cause of upper airway obstruction that may lead to death
      in the adult. We report the case of a patient with severe coronary artery disease
      with adult epiglottitis who required emergency endotracheal intubation. Relief of
      the airway obstruction was followed by the development of postobstructive
      pulmonary edema. The literature is reviewed and the following recommendations are
      made: Patients with adult epiglottitis should be intubated in the presence of any
      respiratory signs or symptoms. All others should be observed in an intensive care
      unit with a skilled anesthesiologist available to carry out emergency
      endotracheal intubation. Inhalation induction with halothane in oxygen should be
      considered initially; failing that, rigid bronchoscopy, tracheostomy, or
      transtracheal ventilation should be available. Postobstructive pulmonary edema
      should be anticipated after relief of airway obstruction has occurred; it can be
      treated with fluid restriction, diuretics, and continuous positive airway
      pressure.

PMID- 8476623
TI  - Crawford W. Long: pioneer physician in anesthesia.
AB  - Crawford W. Long first used ether as an anesthetic on March 30, 1842. This
      article examines factors in his education and practice that prompted his
      discovery. Included in the discussion are some of the circumstances that caused
      Long to delay publication of his experience with ether, as well as the impact of
      the "ether controversy" on his life.

PMID- 8476624
TI  - High-cost, high-tech medicine: are we getting our money's worth?
AB  - Increasingly stringent fiscal restraints on the spending for health care, driven
      by the scarcity of health resources, has introduced a need to apply cost
      containment measures to nearly all aspects of medical care. Intelligent cost
      containment measures must include application of disciplined logic to the
      decision making process of when to use high-tech, high-cost interventions. Such
      decision making depends upon knowledge of the basic concepts of economic and cost
      benefit analyses, outcome (benefit) studies, and some principles of decision
      threshold analysis. These basic principles are reviewed, and the potential impact
      of application of strategies for cost containment in the operating room and the
      intensive care unit is discussed.

PMID- 8476625
TI  - Moving toward value-based anesthesia care.

PMID- 8476626
TI  - Coagulation studies in the preeclamptic parturient: a survey.
AB  - STUDY OBJECTIVE: To delineate current practice with regard to how coagulation
      status is evaluated before induction of regional anesthesia in the preeclamptic
      parturient, with the goal of defining appropriate testing. DESIGN: A confidential
      survey was mailed to the chairmen of all 113 anesthesiology residency training
      programs in the United States listed in the American Medical Association's
      American Medical Graduation Education guide, to be passed on to the director of
      obstetric anesthesia. SETTING: Academic institutions providing obstetric
      anesthesia services in the United States. INTERVENTIONS: Following the original
      study, there was no additional follow-up or intervention. MEASUREMENTS AND MAIN
      RESULTS: The 21-question survey explored institutional characteristics such as
      the number of deliveries, the use of regional anesthesia, and the laboratory
      tests required prior to placement of a regional anesthetic in the mildly or
      severely preeclamptic parturient under two degrees of operative urgency. In the
      74 programs entered into the analysis, we found that regional anesthesia was used
      in the majority of cesarean sections and more than half of the vaginal
      deliveries. In an urgent situation, most of the programs required no test of
      coagulation status in the mild preeclamptic parturient and only a platelet count
      in the severe preeclamptic parturient. CONCLUSIONS: In the majority of academic
      programs in the United States, we found that the evaluation of coagulation status
      in the preeclamptic parturient was based primarily on a platelet count. A review
      of the literature supports this pattern of testing.

PMID- 8476627
TI  - Mechanisms of eosinophil recruitment.
AB  - As with other types of leukocytes, mechanisms that function to enable the
      recruitment of eosinophils into specific sites of immune reactions involve a
      complex and cumulative interplay of many molecules and pathways. No single
      chemoattractant is specific for eosinophils, but rather various chemoattractants
      active on eosinophils can also elicit migration of other specific cell types.
      Humoral mediators causing eosinophil migration include C5a and platelet
      activating factor, whereas cytokines active as eosinophil chemoattractants
      include interleukin (IL)-2, IL-3, IL-5, granulocyte/macrophage colony-stimulating
      factor, lymphocyte chemoattractant factor, and RANTES. Eosinophils utilize
      several pathways to adhere to vascular endothelial cells, including binding to
      intercellular adhesion molecule-1, E-selectin, and vascular cell adhesion
      molecule-1 (VCAM-1). The lack of binding of neutrophils to VCAM-1 and the
      enhanced expression of VCAM-1 elicited by IL-4 contribute to preferential
      eosinophil accumulation. Eosinophil recruitment is dependent not only on ligands
      expressed on eosinophils and molecules inducible on endothelial cells but also on
      processes active during transendothelial migration and extravascular migration in
      the extracellular spaces.

PMID- 8476628
TI  - Pathogenesis of Pneumocystis carinii pneumonia.

PMID- 8476629
TI  - Enhanced secretion of immune-modulating cytokines by human lung fibroblasts
      during in vitro infection with Mycoplasma fermentans.
AB  - Fibroblasts may play an important role in the modulation of immune and
      inflammatory responses through elaboration of cytokines. To test this hypothesis,
      human lung fibroblasts were isolated from transbronchial biopsy specimens and
      assayed for production of interleukin-6 (IL-6) and granulocyte/macrophage colony
      stimulating factor (GM-CSF). The sources of fibroblasts included lung allografts,
      recipient lungs obtained at time of transplant, and normal lung tissue removed
      during tumor resection. During the course of these studies, several early-passage
      fibroblasts from transplant recipients were observed to contain mycoplasma (MP)
      like organisms as detected by extranuclear fluorescent staining with Hoechst
      33258. Positive staining cultures were associated with isolation of Mycoplasma
      fermentans. IL-6 and GM-GSF as measured by ELISA were found to be elevated over
      50-fold in conditioned medium from MP-infected fibroblasts as compared with
      noninfected lines. Treatment of cells with mycoplasma removal agent (MRA)
      eliminated extranuclear Hoechst fluorescence and significantly reduced the
      production of these cytokines. Tumor necrosis factor-beta (TNF-beta) induction of
      IL-6 and GM-CSF was amplified synergistically in infected cultures. No additional
      production of IL-6 or GM-CSF was observed in infected cultures treated with
      interferon-gamma (IFN-gamma) despite the ability of IFN-gamma to modestly induce
      IL-6 in uninfected cultures. Thus, in vitro infection of lung fibroblasts with MP
      represents a potent stimulus for the production of inflammatory cytokines and,
      therefore, necessitates rigorous control for these organisms in cell culture
      studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476630
TI  - Cytokines contribute to airway dysfunction in antigen-challenged guinea pigs:
      inhibition of airway hyperreactivity, pulmonary eosinophil accumulation, and
      tumor necrosis factor generation by pretreatment with an interleukin-1 receptor
      antagonist.
AB  - The role of pro-inflammatory cytokines in an animal model of allergic lung
      disease was examined by use of an interleukin-1 receptor antagonist (IL-1ra) and
      a specific bioassay for tumor necrosis factor (TNF). Ovalbumin-sensitized guinea
      pigs exhibit a marked bronchial hyperreactivity (assessed by airway
      responsiveness to intravenous histamine) and pulmonary eosinophil accumulation
      (assessed by bronchoalveolar lavage) 24 h after challenge with aerosolized
      antigen. Exposure of animals to an aerosol of IL-1ra (50 micrograms over 30 min)
      immediately before antigen challenge resulted in a marked protection against
      bronchial hyperreactivity and pulmonary eosinophil accumulation compared with IL
      1ra vehicle-pretreated animals. Additionally, we report for the first time
      generation of TNF bioactivity in the bronchoalveolar lavage of antigen-challenged
      animals, which was significantly reduced in animals exposed to aerosolized IL-1ra
      before challenge. These studies point to a key role for the cytokines IL-1 and
      possibly TNF in the pulmonary changes observed during allergic airway disease.

PMID- 8476631
TI  - Alveolar macrophage release of tumor necrosis factor during murine Pneumocystis
      carinii pneumonia.
AB  - Tumor necrosis factor-alpha (TNF-alpha), a proinflammatory cytokine produced
      principally by mononuclear cells, is released in response to a variety of
      pulmonary pathogens. We hypothesized that release of TNF in the lung is a normal
      part of the host response to intratracheal challenge with Pneumocystis carinii.
      To test this hypothesis, we measured TNF in bronchoalveolar lavage fluid (BALF)
      in normal and CD4-depleted mice at various intervals in acute and chronically
      infected animals. To assess the cell of origin and the control of TNF release in
      the lung, we measured mRNA for TNF by a competitive polymerase chain reaction and
      assessed the capacity of adherence-enriched cells to produce TNF in vitro in
      response to lipopolysaccharide. Our data demonstrate that TNF peaks at 3 h in
      both control and CD4-depleted mice after acute challenge with P. carinii and this
      increase in TNF precedes the influx of inflammatory cells into the lung. TNF
      levels in BALF return to undetectable levels by day 3. In chronically infected
      animals, there is a 5-fold increase in mRNA for TNF in adherent cells which is
      associated with an increased capacity to release TNF in vitro. These data suggest
      that TNF is a normal host response to P. carinii infection; however, there is no
      difference in acute TNF release between control animals that clear their
      infection and CD4-depleted animals that develop chronic infection. TNF is
      upregulated in chronically infected animals, but CD4 depletion results in the
      loss of additional host factors essential for resolution of this infection.

PMID- 8476632
TI  - Isolation and partial characterization of subpopulations of alveolar macrophages,
      granulocytes, and highly enriched interstitial macrophages from rat lung.
AB  - The contribution of interstitial macrophages (IM) to lung defense, homeostasis,
      and pathophysiology is for the most part unknown. Studies on this cell type are
      difficult because they are not readily accessible in large numbers or in high
      purity. In the present work, various nonenzymatic and enzymatic methods were
      compared with the aim of isolating and characterizing pure populations of lung
      IM. The results of our studies demonstrate that most procedures currently used to
      isolate IM yield subpopulations of alveolar macrophages (AM) or IM highly
      contaminated by AM and granulocytes. We found that lavage of the lung yielded
      only one half of the total AM present in the tissue. The remainder of the AM
      could only be obtained by extensive washing of cut and disaggregated lung tissue,
      which is considered by some investigators to be an effective procedure for IM
      isolation. According to our results, cells recovered by lavage and washing of cut
      and disaggregated lung tissue were morphologically and histochemically identical,
      were strongly positive for nonspecific esterase, highly phagocytic, and appeared
      to represent subpopulations of AM with apparently varying degrees of adherence to
      the alveolar walls. We also found that IM could be obtained in high purity by
      sequential digestion of the remaining lung tissue with 60 and 175 IU/ml of
      collagenase followed by selective adherence. Digestion of the tissue with 60
      IU/ml of collagenase resulted in a highly enriched population of granulocytes and
      also reduced their contamination in the IM population. The resulting IM were
      distinct from AM by morphology and histochemistry. Like AM, these cells displayed
      Fc receptor-mediated phagocytosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476633
TI  - Endothelin in human nasal mucosa.
AB  - Endothelin (ET), a potent vasoconstrictor and bronchoconstrictor peptide
      synthesized by endothelial and epithelial cells, was examined for its potential
      functions in human inferior turbinate nasal mucosal tissue by four techniques:
      (1) immunoreactive ET was localized in the mucosa by immunohistochemistry; (2)
      receptors for ET were identified by autoradiography employing [125I]ET; (3) ET-1
      mRNA was localized by in situ hybridization; and (4) the secretory functions of
      ET were examined by the release of mucous and serous cell products after the
      addition of ET to human nasal turbinates in short-term cultures. Specific ET-1
      immunoreactive material was found most extensively in small muscular arteries and
      in serous cells in submucosal glands. ET-1 was also found to a lower extent in
      the walls of venous sinusoids. [125I]ET-1 binding sites were localized by
      autoradiography to submucosal glands and to venous sinusoids and small muscular
      arterioles. mRNA for ET-1 was found most extensively in the venous sinusoids and
      to a lesser extent in small muscular arteries. In mucosal explant cultures, ET-1
      and ET-2 stimulated lactoferrin and mucous glycoprotein release from serous and
      mucous cells, but ET-3 was inactive. The observations indicate that in the human
      nasal mucosa, ET is present in the vascular endothelium and the serous cells in
      submucosal glands and acts on glandular ET receptors to induce both serous and
      mucous cell secretion. It is also likely that ET plays a role in the regulation
      of vasomotor tone.

PMID- 8476634
TI  - Retinoic acid and calcium regulation of p53, transforming growth factor-beta 1,
      and transforming growth factor-alpha gene expression and growth in adenovirus 12
      SV40-transformed human tracheal gland epithelial cells.
AB  - Vitamin A and calcium are important regulators of growth and differentiation of
      epithelial cells and are intimately involved in preneoplastic and neoplastic
      transformation. It has been proposed that their effects are mediated by
      autocrine/paracrine positive and negative regulators of growth. The objectives of
      this investigation were to examine the effects of all-trans retinoic acid (RA)
      and Ca2+ on cell proliferation, anchorage-independent growth (AIG), and on the
      expression of transforming growth factor-alpha (TGF-alpha), transforming growth
      factor-beta 1 (TGF-beta 1), and p53 tumor suppressor genes in human tracheal
      gland epithelial (HTGE) cells immortalized by adenovirus 12-simian virus 40 (Ad12
      SV40) hybrid. Cells exhibiting the transformed phenotype, AIG, were maintained in
      serum-free culture conditions. Calcium effects were examined at 0.15, 0.50, 1.0,
      and 2.0 mM concentrations. The effects of RA were determined with 10(-9), 10(-7),
      and 10(-6) M concentrations. Gene expression was examined by Northern and Western
      analyses. Ca2+ had no significant effect on cell proliferation, but it enhanced
      the expression of TGF-beta 1 gene and slightly inhibited p53 expression. Ca2+ had
      no effect on TGF-alpha. RA inhibited both cell proliferation and AIG growth,
      which was accompanied by enhanced expression of p53. RA had no significant effect
      on the expression of TGF-alpha and TGF-beta 1 genes. These results demonstrate
      that RA regulates growth of HTGE cells mainly by upregulating the p53 gene; Ca2+,
      which enhances TGF-beta 1 expression, had no effect on growth.

PMID- 8476635
TI  - Auto-induction of transforming growth factor-beta in human lung fibroblasts.
AB  - The type beta transforming growth factors (TGF-beta s) are a family of potent
      cytokines with diverse effects on proliferation, differentiation, turnover of
      extracellular matrix components, oncogene expression, and other aspects of
      cellular phenotype. Unlike lung fibroblasts of certain species, unstimulated
      human lung fibroblast lines produce little or no TGF-beta in culture. However,
      TGF-beta has been reported to autoregulate its own production in certain human
      tumor cells and in rodent cell lines. To test whether this phenomenon is
      operative in fibroblasts from normal human lung tissue, confluent cultures of
      IMR90 normal fetal lung fibroblasts were exposed to TGF-beta. Cultures were
      exposed briefly to purified TGF-beta 1 under serum-free conditions and secretion
      of newly synthesized TGF-beta over the ensuing 72 h was determined by
      immunoblotting and bioassays made specific with the use of neutralizing
      antibodies. Steady-state levels of mRNA for TGF-beta 1 were detected by Northern
      and slot blot hybridization analysis of total cellular RNA. The 2.5 kb TGF-beta 1
      mRNA species rose within 1.5 h of exposure of IMR90 cells to TGF-beta 1 and
      reached maximal levels after 16 h. Increased levels of TGF-beta were detected in
      conditioned medium 9 h after the start of the exposure. Thereafter, TGF-beta
      continued to accumulate at an elevated rate (90 +/- 7 versus < or = 15 pg/10(6)
      cells/h in uninduced cells) for up to 72 h. As little as 1 ng/ml TGF-beta 1 auto
      induced TGF-beta secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476636
TI  - Submucosal tissues modulate the bioelectric properties of airway epithelium.
AB  - Exposure of isolated canine tracheal epithelium to acetylcholine (Ach) increased
      transepithelial conductance (GT) and short-circuit current (ISC). Qualitatively
      different responses were obtained when the epithelium was studied as a part of an
      intact posterior tracheal membrane that contained smooth muscle. Ach decreased
      GT, did not affect ISC, and induced a 2-fold increase in measured tension. In
      these tissues, baseline GT was enhanced compared with that of isolated
      epithelium. Indomethacin inhibited the Ach-induced responses of isolated
      epithelium but did not alter the responses of intact airway tissue. The
      epithelial origin of these electrophysiologic responses was confirmed in
      experiments that showed that denudation of intact tracheal tissue greatly
      increased base-line GT, eliminated ISC, abolished the electrophysiologic response
      to Ach, and enhanced Ach-induced smooth muscle constriction. The qualitatively
      different responses to Ach of intact tracheal membrane and epithelium alone
      suggest that the behavior of airway epithelia in the whole animal may be
      significantly different from that observed in conventional in vitro studies of
      isolated epithelia.

PMID- 8476638
TI  - Display and perception of ultrasound images.

PMID- 8476637
TI  - Characterization and gene sequence of the precursor of elafin, an elastase
      specific inhibitor in bronchial secretions.
AB  - Human bronchial mucous secretions have been shown to contain inhibitors of serine
      proteinases secreted by neutrophils. The role of these inhibitors is probably to
      control the enzymes secreted in the airways and in the lung interstitium. Three
      of these inhibitors have been identified and characterized: alpha 1-proteinase
      inhibitor, mucus proteinase inhibitor, and elafin. The elafin molecule, a 6.0 kD
      inhibitor of serine proteinases shows homology with mucus proteinase inhibitor.
      We recently isolated both molecules in bronchial secretions. In this report, we
      present evidence for the existence of a precursor of the elafin molecule. We have
      cloned and sequenced the gene for this precursor and show that it is composed of
      three exons. The coding information for a 117 amino acid precursor protein of
      elafin (inclusive of the signal peptide) is contained in the first two exons.
      This was confirmed at the mRNA and protein levels. By Northern Blot analysis we
      detected a 800 bp long product, and by immunoaffinity we detected in sputum and
      in cultured epithelial cell supernatant (NCI-H322 cell line) a 12 kD protein
      species cross-reacting with anti-elafin IgG. The finding of possible cross
      linking function for the precursor in addition to its antiproteinase activity
      indicates a possible role for this molecule as a cross-linker agent in the
      extracellular matrix.

PMID- 8476639
TI  - Ultimate limits in ultrasound image resolution.

PMID- 8476640
TI  - Blood flow quantitation: waveform analysis, volume measurement, tumor flow, and
      the role of color imaging.

PMID- 8476641
TI  - Ultrasound picture archiving and communication systems.
AB  - In this chapter, we discussed the concept of PACS infrastructure and the methods
      of implementing an ultrasound PACS. An ultrasound PACS differs from other
      radiologic PACS modules in several aspects. First, ultrasound image acquisition
      requires the interaction from the operator to initiate the image capture process.
      Second, ultrasound display requires pseudocolor to show flow images. Third,
      ultrasound examinations include dynamic studies that generate many images in real
      time. The last feature is difficult to achieve even with current technology. One
      method is to explore video transmission, storage, and display technology. We have
      researched and implemented a fiber optic broadband video system for transmitting,
      archiving, and displaying CT and MR images in real-time. This system connects
      three CT and three MR scanners in three buildings including the CHS and the MP
      over a distance of about 2.5 km. We believe this technology can be extended for
      real-time video ultrasound image transmission, archiving, and display.

PMID- 8476642
TI  - Impact of safety considerations on ultrasound equipment design and use.

PMID- 8476643
TI  - Quality management of ultrasound diagnosis.

PMID- 8476644
TI  - Probes as used in cardiology with emphasis on transesophageal and intravascular
      applications.

PMID- 8476645
TI  - Ultrasound contrast agents.

PMID- 8476646
TI  - Advances in imaging techniques.

PMID- 8476647
TI  - Speckle reduction.

PMID- 8476648
TI  - Three-dimensional imaging.

PMID- 8476649
TI  - Needle guidance techniques.

PMID- 8476650
TI  - Techniques for color-flow imaging.

PMID- 8476651
TI  - [The pyramidal tract in man].

PMID- 8476652
TI  - [SPECT (single photon emission computed tomography) findings in 4 cases of
      neuronal migration disorders].
AB  - We report SPECT findings in four children with various types of neuronal
      migration disorders. SPECT of a patient with heterotopia showed a protrudent
      abnormal shadow into the centrum semiovale, the density of which was same as that
      of normal gray matter. The function and the metabolism of heterotopia appear same
      as those of the normal gray matter. SPECT of a patient with pachygyria showed
      decreased blood flow in the areas of thickened cortex. This finding seems to
      indicate hypofunction of those lesions. SPECT of a patient with
      hemimegalencephaly showed an increased blood flow in the ipsilateral hemisphere
      and decreased blood flow in the contra-lateral hemisphere. In the literature,
      increased contents of neuronal elements in the affected site and arterio-venous
      shunt with cardiac failure have been reported in hemimegalencephaly. These
      pathologies may be related to our SPECT findings. SPECT of a patient with
      cortical dysplasia showed extensive lesions of decreased blood flow which was
      more wide spread than abnormal lesions detected by MRI. SPECT may be more
      sensitive than MRI to detect cortical dysplasias.

PMID- 8476653
TI  - [Detection of codon 72 polymorphism of p53 gene from blood and loss of
      heterozygosity in brain tumors using polymerase chain reaction].
AB  - p53 gene which is known as a tumor suppressor gene locates in chromosome 17p and
      has a polymorphism at codon 72 (Arginine CGC-->Proline CCC). In this study, we
      examined the frequency of polymorphism and of heterozygosity in Japanese, and the
      loss of p53 gene in brain tumor tissues of the patients with heterozygosity using
      a novel method. The frequencies of heterozygosity, arginine type, proline type
      were 43%, 42% and 15%, respectively. Heterozygosity was observed in 15 out of 32
      patients with brain tumors and loss of heterozygosity (LOH) in these 15 cases was
      demonstrated in 40%. Although we are not certain whether LOH of p53 region is
      inevitable process of oncogenesis of some brain tumors, some false negative
      results may occur. This quick technique requires small amount of samples and no
      radioactive isotope, therefore, can be applied to detect mutation and LOH
      occurred in p53 region in terms of the genesis and progression of human
      neoplasms.

PMID- 8476654
TI  - [Brain injury induced by continuous infusion of endotoxin in rats--protective
      effects of methylprednisolone on intracerebral blood vessels].
AB  - Hemorrhagic intracerebral lesions, analogous to multiple punctate hemorrhagic
      necrosis seen in the brain of human disseminated intravascular coagulation (DIC),
      can be induced in rats by continuous intravenous infusion of E. coli endotoxin
      lipopolysaccharide (ET) at 88.5 micrograms/hour. The occurrence of cerebral
      lesions increases with time of ET infusion initially, but levels off after 120
      hours of the continuous administration. To investigate protective effects of
      methylprednisolone (MP) against intracerebral vascular injury, 122 male rats were
      divided into the basic endotoxemic rats without MP medication (Group 1), and MP
      medication of 0.2mg/kg body weight, 1.0mg/kg, 2.0mg/kg and 20.0mg/kg immediately
      before induction of endotoxemia (Groups 2-5), one dose of 20.0mg/kg MP at 48
      hours and 2 doses at 48 and 72 hours after induction of endotoxemia (Groups 6-7),
      and 3 doses each of 2.0mg/kg, 20.0mg/kg and 100.0mg/kg MP for 3 days immediately
      before and at 24 and 48 hours after induction of endotoxemia (Groups 8-10). All
      surviving rats were autopsied after 120 hours of ET infusion and histologic
      sections were made. Multiple hemorrhagic intracerebral lesions developed in 83%
      (10/12) of Group 1 rats, whereas the frequency of brain lesions in Groups 4, 5,
      8, 9 and 10 was significantly lower than that in Group 1 (p < 0.05). Electron
      microscopically, the frontal lobe cortex of Group 1 after 120 hours of ET
      infusion showed subendothelial dilatation containing macrophages, and
      perivascular accumulation of erythrocytes (diapedesis). In contrast, the frontal
      lobe cortex of Group 5 revealed no appreciable electron microscopic changes of
      intracerebral blood vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476655
TI  - [Diagnosis of intracranial occlusive vascular disease and evaluation of
      extracranial-intracranial (EC/IC) arterial bypass using three-dimensional
      magnetic resonance angiography].
AB  - The three-dimensional time-of-flight (TOF) magnetic resonance angiograms (MRA)
      were studied to evaluate its accuracy in the assessment of the intracranial
      carotid occlusive lesions, collateral circulation and also the patency of
      extracranial-intracranial (EC/IC) arterial bypass surgery. All occlusive lesions
      of the intracranial major arteries seen in conventional angiograms were revealed
      clearly with MRA. However MRA had its practical limitation in the evaluation of
      the leptomeningeal anastomosis (collateral circulation) probably due to the
      deterioration of contrast in its slow flow and saturation effect of the
      magnetization. In addition to that, MRA often exaggerated the severity of the
      stenotic lesions, mostly in severe cases. The post-operative state of collateral
      flow and the patency of EC/IC bypass could be evaluated as properly with MRA as
      with conventional angiography, although MRA was limited in spatial resolution and
      evaluation of flow direction. In conclusion, MRA was considered t be a reliable
      non-invasive modality as a screening examination for the evaluation of the
      carotid occlusive disease and as the follow-up study of the post-operative
      patients with EC/IC bypass surgery.

PMID- 8476656
TI  - [Experimental study on immunotherapy of meningeal gliomatosis with monoclonal
      antibody].
AB  - Recently extension of malignant glioma to the spinal cord (meningeal gliomatosis:
      MG) has been described with increasing frequency as the advancement of the
      therapy for brain tumor. However, the study for clinicopathological features of
      MG has not been established and its therapy has still been difficult. We tried to
      produce experimental models of MG using nude mice and study experimental
      immunotherapy with human monoclonal antibody (CLN-IgG MoAb). U87-SC1 human glioma
      cells (5 x 10(5) in 20 microliters) were inoculated transcutaneously into the
      cisterna magna of BALB/c nu/nu mice using a 27-gage needle. Daily weights,
      neurological findings and survival time were examined. MRI scan was performed
      after neurological deterioration and histological examination was also performed
      after death. CLN-IgG MoAb was used for treatment and 15 nude mice which were
      inoculated with tumor cells into the cisterna magna (Day 0) were divided into
      three groups of 5 mice each. Group A was control group which received saline into
      the cisterna magna, Group B and C received 50 micrograms of CLN-IgG into the
      cisterna magna on Day 2 or Day 7 following inoculation of tumor cells. Efficacy
      of experimental immunotherapy was statistically evaluated by the difference of
      median survival time (MST) among three groups. All of the nude mice lost weight
      within 4 or 5 days after inoculation of tumor cells and developed paraplegia or
      tetraplegia with incontinence and died. MRI of the nude mice which showed
      neurological deteriorations revealed ventricular dilatation, infiltration of
      tumor cells to the spinal cord and spread of tumor cells into the subarachnoid
      space.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476657
TI  - [Central neurocytoma--report of a case].
AB  - The authors present a case of central neurocytoma in a 23-year-old male with
      increased intracranial pressure syndrome. Computed tomographic (CT) scans and
      magnetic resonance images showed a large tumor mass with no evidence of
      calcification in the right lateral ventricle extending towards the third
      ventricle. A right transcortical-transventricular approach was performed and the
      tumor was totally removed. The postoperative course was uneventful and no further
      treatment was administered. CT shows no evidence of tumor recurrence after the
      six months from his surgery. Light microscopic findings suggested a diagnosis of
      oligodendroglioma. However, ultrastructural examinations demonstrated many dense
      core or clear vesicles, microtubules and synaptic like structures within the
      abundant cytoplasmic processes of the tumor cells which suggested neuronal
      differentiation. Immunohistochemical examinations showed the tumor cells to be
      positive for neuron-specific enolase, sporadically positive for synaptophysin,
      and negative for glial fibrillary acidic protein. The final histological
      diagnosis was central neurocytoma. Central neurocytoma was first described by
      Hassoun et al, in 1982. Since then, 96 cases have been reported in the
      literatures. Their clinicopathological features, neuroradiological findings and
      prognosis are discussed.

PMID- 8476658
TI  - [Forty-six-year-old woman with progressive external ophthalmoplegia and limb
      weakness].
AB  - We report a 46-year-old female who presented progressive ophthalmoplegia and limb
      weakness. She was well until the age of 15 years when there was an onset of
      bilateral deafness. She became completely deaf by 20 years of age. She noted an
      onset of weakness in her legs when she was 27-years-old and of ptosis at 34 years
      of age. She was admitted to our hospital when she was 41-years-old. Neurological
      examination revealed near total ophthalmoplegia, bilateral ptosis, dysphagia,
      generalized muscle atrophy and weakness of approximately 4/5 degree, facial
      grimacing, athetotic movements in four limbs. Laboratory examinations revealed
      increase in blood lactate and pyruvate levels and diffuse low density change in
      the cerebral white matter in CT scans. She was thought to have a mitochondrial
      encephalomyopathy. She was discharged for follow-up, but her clinical course was
      that of a relentless deterioration. She was readmitted to our service in December
      1989. She showed further progress in her weakness and muscle atrophy. Otherwise
      neurological examination was essentially similar to the previous one. Her cranial
      CT scans showed low density changes in striatum, thalamus and midbrain in
      addition to the white matter. Enzyme activities of the electron transport
      complexes revealed a moderate decrease in the succinatecytochrome c reductase
      activity, and the Southern blot analysis of mtDNA revealed multiple deletions in
      mitochondrial genomes. Two months after her admission, she developed
      bronchopneumonia, and expired on March 13th, 1990. Post-mortem examination
      revealed diffuse pallor of myeline in the cerebral white matter in K-B staining.
      A marked neuronal loss and gliosis were observed in putamen bilaterally. Skeletal
      muscles showed typical changes of mitochondrial myopathies with ragged-red fibers
      in Gomori-Trichrome staining, and crystalline inclusion bodies by electron
      microscopic observations. Some neurogenic atrophies were also seen. Oculomotor
      nuclei appeared intact. It was thought that she had an incomplete form of Kearns
      Sayre syndrome. The patient was discussed in a neurological CPC of the
      departments of Neurology and Pathology of Juntendo University School of Medicine.

PMID- 8476659
TI  - [Clinical subtypes of Parkinson's disease].

PMID- 8476660
TI  - ["Pure akinesia" and progressive supranuclear palsy].

PMID- 8476661
TI  - [Involuntary movement due to vascular lesion in the basal ganglia].

PMID- 8476662
TI  - [Molecular genetic aspects of basal ganglia diseases].

PMID- 8476663
TI  - [Neuropsychological investigation in multiple sclerosis].
AB  - We studied neuropsychological performance in 10 patients with multiple sclerosis
      (MS). Neuropsychological test batteries consisted of Mini-Mental State
      Examination, Digist Span, Paired Associate Learning Test (PAL), Benton Visual
      Retention Test, Kohs Block-Design Test, Digit Symbol Subtest in WAIS, 'Kanahiroi"
      Test, Verbal Fluency and Wisconsin Card Sorting Test. In accordance with cerebral
      lesions on MRI, patients were divided into three groups. A: Multiple-confluent
      lesions, B: Discrete lesions, C: No lesion. In MS patients as a whole,
      performance of PAL, "Kanahiroi" Test and Verbal Fluency were significantly
      impaired compared with 10 age and education matched normal controls (p < 0.05),
      while other tests were not. In four out of five patients of A group, more than
      four neuropsychological tests showed below mean -2SD score of normal controls,
      whereas in patients of B and C group, less than three neuropsychological tests
      showed below -2SD score of normal controls. In conclusion, severity of cognitive
      impairment in patients with MS correlated with lesion extent on MRI. Patients
      with MS exhibited significant cognitive impairment on tasks of recent memory and
      mental processing speed. It is suggested that MS patients show the features of
      subcortical dementia.

PMID- 8476664
TI  - [SPECT evaluation of effect of cerebral vasodilator by the subtraction method
      using Tc-99m HMPAO].
AB  - The effects of cerebral vasodilator are generally evaluated by observing whether
      the clinical improvement is applicable after the period of the drug
      administration. This report describes a novel approach to the evaluation for the
      effect of the drug using Tc-99m HMPAO. Consecutive brain Tc-99m HMPAO studies
      before and after a cerebral vasodilator, Ibudilast, administration were performed
      within 5 hours on 10 patients with cerebral infarction at chronic state. Five
      patients showed increased perfusion nearby the affected vascular territories
      after the po administration of Ibudilast. Significant changes in the brain
      perfusion pattern were determined using an image subtraction technique. This
      consecutive Tc-99m HMPAO subtraction SPECT technique seems to be useful for
      evaluating the therapeutic effect of cerebral vasodilator. This method can be
      performed within a short period of time, safely and sensibly.

PMID- 8476665
TI  - [A new operational method of functional neurosurgery combining micro-recording
      and MRI stereotaxy for the treatment of Parkinson's disease].
AB  - We have developed a new operational method for stereotactic functional
      neurosurgery using MRI stereotaxy combined with microelectrode recording. MRI
      stereotaxy shows us the individual variations of thalamic configurations. The
      tentative target points were determined using the MRI stereotaxy assisted
      software system which revised the distortion of MRI images. Consequently, the
      accuracy and safety of the microelectrode recording were increased. This, in
      turn, increased the accuracy of stereotactic thalamotomy while producing
      encouraging operational outcomes. The effectiveness of stereotactic thalamotomy
      for Parkinson's disease was confirmed by these excellent operative results. The
      symptoms improved and the dosage of medications, including L-DOPA, decreased.
      Furthermore, our results indicate that the distributing area of deep sensory
      neurons in the thalamus extended more posteriorly and upward than previously
      expected. Therefore, the functional and anatomical similarity between the human
      and monkey thalamus was reaffirmed. In this report, based on the above data, we
      reevaluated the neural mechanism of tremor and the role of stereotactic
      functional neurosurgery for Parkinson's disease.

PMID- 8476666
TI  - [Correlation between induction of ischemic tolerance and expression of heat shock
      protein-70 in the rat hippocampus].
AB  - We investigated the correlation between protection against ischemic neuronal
      damage by preconditioning with sublethal ischemia and the expression of heat
      shock protein-70 (HSP70). Three minutes of forebrain ischemia in the rat induced
      by four-vessel occlusion and 3 days of reperfusion was followed by 6, 8, and 10
      minutes of ischemia. Seven days after the second ischemia, the brains were used
      for histology. Two hours, 1, 3, and 7 days after 3 or 6 minutes of ischemia, the
      brains were used for immunohistochemistry with an antibody raised against HSP70.
      Three minutes of ischemia produced no neuronal damage in the hippocampus. Six, 8,
      and 10 minutes of ischemia produced severe neuronal damage to CA1. However, CA1
      neurons were preserved in animals subjected to 6 and 8 minutes of ischemia
      following preconditioning with 3 minutes of ischemia. Immunostaining showed that
      HSP70 was induced in the CA1 subfield 3 days after 3 minutes of ischemia. HSP70
      was stained in the CA1, CA3, and CA4 subfields 1 and 3 days after 6 minutes of
      ischemia with or without preconditioning. However, HSP70 was also stained in CA1
      2 hours and 7 days after 6 minutes of ischemia following preconditioning. These
      results strongly suggest that stress response induced by sublethal ischemia
      protects against ischemic neuronal damage. However, the protection was not seen
      when HSP70 synthesis was delayed. Presence of HSP70 during and immediately after
      ischemia may be critical for the protection against ischemic neuronal damage
      following preconditioning.

PMID- 8476667
TI  - [Two cases of well-known syndrome due to midbrain-brain stem hemorrhage--Weber's
      syndrome and one and a half syndrome].
AB  - Two cases of well-known syndrome due to midbrain-brain stem hemorrhage without
      having a history of hypertension were reported. Case 1 is a 62-year-old female,
      presenting Weber's syndrome due to midbrain hemorrhage and diagnosed as Moyamoya
      disease angiographically. Case 2 is a 24-year-old-male, presenting One and a half
      syndrome due to brain stem hemorrhage from a brain stem cavernous angioma, which
      was diagnosed angiographically and by magnetic resonance imaging (MRI). Left
      hemiparesis seen in case 1 had improved by conservative therapy but no
      improvement could be obtained in the oculomotor nerve palsy. In case 2, hematoma
      was aspirated surgically for the purpose of decompression and his neurological
      symptoms improved markedly. Their pathogenesis and pathophysiology were also
      discussed.

PMID- 8476668
TI  - [Alcoholic cerebellar degeneration with pyramidal sign--in relation to alcoholic
      myelopathy].
AB  - Two cases of alcoholic cerebellar degeneration with pyramidal sign were reported.
      Patient 1 with alcohol dependence syndrome was a 46-year-old woman. After the
      alcohol abuse of about eight years, she complained of gait disturbance. The gait
      disturbance progressively worsened in about two months and she could not ambulate
      freely by herself. Neurological examination revealed nystagmus, ataxic and
      spastic gait, slight weakness and spasticity of the lower extremities,
      hyperreflexia of the extremities, bilateral Babinski's signs, and incoordination
      of the lower extremities. Examination of liver function and serum B12 was normal.
      Cranial CT scan and MRI revealed atrophy of the cerebellar vermis and dorsal part
      of the cerebellum. Though neurological signs slightly improved after the
      admission to our hospital and the abstinence from alcohol abuse, ataxic gait and
      hyperreflexia of the extremities have continued. Patient 2 was a 58-year-old man.
      He was a heavy drinker, but was not a patient with alcohol dependence syndrome.
      After the heavy drinking of about 40 years, he complained of gait disturbance.
      The gait disturbance had progressively worsened in about four months.
      Neurological examination revealed ataxic gait, hyperreflexia of the lower
      extremities, and bilateral Babinski's signs. Laboratory examination revealed
      slight liver dysfunction with minimal GPT and moderate gamma-GTP elevation.
      Examination of serum B12 was normal. Cranial CT scan and MRI revealed atrophy of
      the cerebellar vermis. Though bilateral Babinski's signs disappeared after the
      abstinence from heavy drinking, ataxic gait and hyperreflexia of the lower
      extremities have continued. Alcoholic myelopathy without hepatic cirrhosis was
      rarely reported. In the relation of alcoholic cerebellar degeneration to
      alcoholic myelopathy, our cases are interesting and important.

PMID- 8476669
TI  - [Unusual CT and MRI appearance of the epidermoid tumor--a case report].
AB  - We reported a case of epidermoid tumor with unusual findings on CT and MRI. A 41
      year old woman was admitted because of headache. On admission she had no
      neurological deficits. CT revealed a lobular homogenous high-dense mass with a
      sharp margin in the mid-portion of the posterior fossa. The mass was shown as a
      low signal intensity on both T1- and T2-weighted MRI. An encapsulated mass
      containing "motor oil" like viscid fluid was removed by surgical operation.
      Histological examination revealed epidermoid cyst. CT-dense epidermoid tumor was
      discussed with referring to the literature.

PMID- 8476670
TI  - [A case of transtentorial upward herniation due to cerebellar infarction
      manifesting upward gaze palsy as an initial sign].
AB  - Transtentorial upward herniation is a rare complication of cerebellar infarction
      and its development indicates an emergency and necessity of posterior cranial
      fossa decompression. A 63-year-old man with a history of myocardial infarction
      was admitted to the hospital complaining of sudden onset of vertigo and headache.
      Neurological examination revealed marked upward gaze palsy, right blepharoptosis,
      facial weakness, hearing loss on the left side and ataxia of the left upper and
      lower extremities. A few hours later, he rapidly lost consciousness and MRI
      revealed massive infarction in the left cerebellar hemisphere and transtentorial
      upward herniation. Immediate surgical decompression of the posterior cranial
      fossa was performed, thereafter patient gradually improved. This case suggests
      that upward gaze palsy is an important initial sign of transtentorial upward
      herniation with massive cerebellar infarction.

PMID- 8476672
TI  - The technical matter of product standards.

PMID- 8476673
TI  - Mike Grace talks to Geoff Garnett.

PMID- 8476671
TI  - [A 24-year-old man presenting Garcin syndrome and paraplegia].
AB  - We report a 24-year-old man who presented unilateral multiple cranial nerve
      involvements followed by progressive paraplegia. The patient expired after
      developing DIC and pneumonia. Post-mortem examination revealed Ewing's sarcoma
      originated in the pubic bone with extensive metastases including the clivus which
      was responsible for his cranial nerve lesions. The patient was well until 24
      years of age when he noted an onset of pain and a mass in the pubic region. The
      histology of the biopsy specimen of the tumor suggested Ewing's sarcoma. He was
      treated with chemotherapy and local radiation. A year after, he noted an onset of
      nuchal pain, difficulty in tongue movement, dysarthria, deafness in the left ear,
      and diplopia. On admission to our hospital in July 1990, neurological examination
      revealed an alert and intelligent Japanese male in no acute distress. The
      olfactory to the trigeminal nerves appeared intact. He showed complete abducens
      nerve palsy, facial weakness, mild deafness, and weakness of the soft palate, the
      sternocleidomastoid muscle and the tongue, all on the left side. The remainder of
      the neurological examination was unremarkable except for dysesthesia along the
      left C8 and Th1 dermatoms. Radiological examination revealed a 10 x 10 cm
      sclerotic mass in the public bone and a high signal mass lesion between the
      clivus and the pons in the T2-weighted MRI. His clinical course was complicated
      by acute paraplegia with anesthesia below the Th4 dermatom, DIC, and respiratory
      distress due to plural effusion. Post-mortem examination revealed a necrotic and
      hemorrhagic tumor in the pubic bone. The histology was consistent with Ewing's
      sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476674
TI  - Putting the pilot scheme into practice.
AB  - If we accept that in the future audit is going to be a fact of life and the
      probability is that optional schemes will, in time, be replaced by compulsory
      participation, then input by general practitioners at this pilot stage should be
      a good investment for the future.

PMID- 8476675
TI  - 'A survey of disease changes observed on dental panoramic tomographs taken of
      patients attending a periodontology clinic'.

PMID- 8476677
TI  - 'Rampant caries--a new threat?'.

PMID- 8476676
TI  - 'Dentist provided the best third molar service'.

PMID- 8476678
TI  - Single dose instructions.

PMID- 8476679
TI  - 'Freedom of choice'.

PMID- 8476680
TI  - Specialist practice for minor oral surgery: a comparative audit of third molar
      surgery.
AB  - Cost efficiency of removing third molars in a practice specialising in minor oral
      surgery was compared to that of a hospital oral surgery department. A total of
      100 patients treated in each locality were prospectively audited during the
      financial year 1989-90. Surgical complexity, waiting time, complications and
      patient satisfaction were compared. The hospital cases were costed individually
      and compared to fees received for the patients treated in the practice. The
      practice fees were also compared to average expenses as assessed by the Dental
      Rates Study Group Inland Revenue Enquiry. Patients were treated more promptly and
      at a lower cost in the specialist practice with no adverse effect on quality as
      assessed by complications and patient satisfaction. Surgical complexity was not a
      contraindication to practice treatment but some patients may be better treated in
      hospital because of medical or social circumstances. Patient charges for
      treatment carried out under General Dental Service regulations are a serious
      impediment to the viability of a specialist oral surgery practice.

PMID- 8476681
TI  - Complete denture prescription--an audit of performance.
AB  - The quality of clinical records obtained during the various stages of complete
      denture construction was assessed in a survey conducted in five large dental
      laboratories in 1989. The most common fault in approximately half of 188 upper
      and 158 lower impressions was overextension in the labial and buccal sulci. Of
      the 87 occlusal records examined, the rims indicated the intended incisal
      relationship in about 50% of cases. The border of the eventual denture was
      defined by the technician rather than by the dentist in most instances. The post
      dam was prescribed by the dentist in only 16% of the 50 trial dentures inspected.
      It is argued that a major cause of the lack of prescription is the level of the
      NHS fee, coupled with the fact that the laboratory expenses are deducted from
      that fee.

PMID- 8476682
TI  - Criterion based audit in prosthetic dentistry.
AB  - A criterion based retrospective audit into the provision of complete dentures in
      an undergraduate teaching programme has been produced. This consisted of a series
      of questions related to the treatment of the patient and the satisfaction or
      otherwise expressed about the treatment. The audit revealed where treatment had
      been successful according to the established criteria. It has been found that an
      audit of this nature is demanding of clinicians' time but does show where
      improvements can be made in patient management which will result in better health
      care. Clinical audit is now recognized as forming an important part of health
      care. It is applicable to all areas of dentistry, ie general dental practice, the
      community dental services and the hospital services, and to all specialities eg
      prosthetics, orthodontics etc. An audit programme needs careful planning and a
      pilot study is worthwhile to indicate areas of difficulty. This audit has been
      used in an undergraduate training programme, however, the process by which the
      audit has been assembled is an example of how an audit could be established in
      any area of dentistry, provided that the criteria are modified to make them
      relevant to the clinical speciality.

PMID- 8476683
TI  - The first 100 cases: a personal audit of orthodontic treatment assessed by the
      PAR (peer assessment rating) index.
AB  - The first 100 consecutively started cases treated by a specialist registrar in
      orthodontics were examined and pre- and post-study models were scored using the
      peer assessment rating (PAR) index. The PAR index proved both simple and
      reproducible to use: 92 cases had post-treatment records available, 91 patients
      registered a drop in PAR score, and one patient registered an increase. Of these
      92 patients, 38 (41%) were greatly improved, 43 (47%) were improved, and 11 (12%)
      were made worse or no different (ie they failed to achieve a 30% drop in PAR
      score). Of the factors examined, only the appliance type used was significantly
      related to PAR score change. Of the 11 cases apparently made worse, individual
      examination revealed that four of these represented beneficial occlusal changes
      but due to limited treatment goals they did not register as improved using the
      PAR index according to previously agreed criteria. The PAR index measures 'good
      tooth position' which, although very important, is not the only factor in
      orthodontic treatment. The use of the PAR index to detect 'good' and 'bad'
      orthodontic treatment is not without problems. Its use in mixed dentition and
      adjunctive orthodontic treatments may not always be appropriate.

PMID- 8476684
TI  - What is BS5750?

PMID- 8476685
TI  - [The international in nursing. Nursing home with foreign nurses].

PMID- 8476686
TI  - [The international in nursing. Health education crosses cultural barriers].

PMID- 8476687
TI  - [The international in nursing. Swedish nursing education].

PMID- 8476688
TI  - [The international in nursing. Master's Degree in the USA?].

PMID- 8476689
TI  - [The international in nursing. Study trip to Canada].

PMID- 8476690
TI  - [The international in nursing. When nurses are immigrants].

PMID- 8476691
TI  - [The international in nursing. Minimum data-set for nursing].

PMID- 8476692
TI  - [Prisoner inmates in the security department--observation and report].

PMID- 8476693
TI  - [Meaningful and interesting work].

PMID- 8476694
TI  - [Self-esteem--necessary for nursing competence!].

PMID- 8476696
TI  - [Cetiprin tablets: a model preparation?].

PMID- 8476695
TI  - [Home nursing--two nursing cultures in open health care].

PMID- 8476697
TI  - [Work environment--why do things move so slowly in the health sector?].

PMID- 8476698
TI  - [My childbirth experience].

PMID- 8476699
TI  - [The international in nursing. Unequal cultures and traditions].

PMID- 8476700
TI  - Synthesis and application of N,N-bis-(1-adamantyloxycarbonyl) amino acids.
AB  - The preparation of novel bis-(1-adamantyloxycarbonyl) amino acid derivatives has
      been undertaken and their properties studied. Among them, the p-nitrophenyl
      esters were subsequently applied to the stepwise synthesis of Leu-enkephalin. In
      the last coupling step, some hydantoin formation was encountered but it could be
      nearly completely overcome by working with more concentrated solution. The
      preparation of a tyrosine derivative presented special problems owing to the
      existence of the phenolic group in the precursor. The relative stability of 1
      adamantyloxycarbonyl as N- and O-protecting groups was also studied.

PMID- 8476702
TI  - Prognostication in children with renal disease--with emphasis on IgA nephropathy.

PMID- 8476701
TI  - Follow-up of renal function and urinary protein excretion in childhood IgA
      nephropathy.
AB  - Renal haemodynamics and urinary protein excretion (UPE) were investigated in 36
      patients with IgA nephropathy more than 3 years after renal biopsy (mean interval
      6.3 +/- 0.5 years). At follow-up, 39% of patients had a reduced glomerular
      filtration rate (GFR) and 11% endstage renal failure. Twenty-five percent had
      albuminuria, and a further 25% microalbuminuria. All albuminuric patients had
      GFRs below the mean, and 78% of the albuminurics had a reduced GFR. However, non
      albuminurics also had decreased GFRs and GFR tended to fall with the duration of
      the disease in this group of patients. On comparing the histological changes in
      the biopsies with haemodynamic and UPE studies performed 6 years later, we found
      significant correlations between the extent of segmental glomerular sclerosis and
      GFR, effective renal plasma flow, urinary albumin and IgG excretion,
      respectively. Histological grading correlated with the same variables. Of the 4
      uraemic patients, 2 were nephrotic at presentation, while the other 2 had a
      nephritic onset of disease and later developed heavy proteinuria. Three of their
      biopsies showed > or = 10% segmental glomerulosclerosis. Juvenile IgA nephropathy
      is not a harmless disease. Our results indicate that these children should be
      carefully monitored with adequate GFR measurements and urine protein analyses.

PMID- 8476703
TI  - Maintenance immunosuppression therapy and outcome of renal transplantation in
      North American children--a report of the North American Pediatric Renal
      Transplant Cooperative Study.
AB  - The North American Pediatric Renal Transplant Cooperative Study collects
      extensive data on all transplants entered into its registry. For this study we
      evaluated 568 cadaver kidney and 492 live-donor recipients with graft function at
      30 days post transplant. Utilizing maintenance immunosuppressive therapy at 30
      days post transplant, we evaluated patient and graft outcome, mortality and
      morbidity over the first 6 months post transplant. For cadaver kidney recipients,
      36 patients were receiving prednisone and azathioprine (PA), 114 were maintained
      on prednisone and cyclosporine (PC) and 418 were on prednisone, cyclosporine and
      azathioprine (PCA). Patients receiving PA had a greater incidence of rejection
      prior to 30 days, a greater incidence of hospitalization for rejection and for
      hypertension over the next 6 months and a greater loss of allograft in the first
      6 months compared with the other two groups. The only difference noted between PC
      and PCA was a lower serum creatinine in the PCA group at 6 months. For living
      related kidney recipients, there were 78 patients maintained on PA, 97 on PC and
      317 on PCA. Again patients receiving PA had a higher rate of hospitalization for
      rejection and a higher rate of graft loss. When patients receiving PC were
      compared with those receiving PCA, no differences were noted in the 6-month serum
      creatinine values, but a greater percentage of PCA patients were receiving
      antibiotics on day 30. We conclude that PA is poor therapy for both groups, PCA
      is ideal therapy for cadaver kidney recipients, but no beneficial effects are
      noted when PCA is used over PC for live-related donor kidney transplants.

PMID- 8476704
TI  - Correlation of ultrasound and renal scintigraphy in children with unilateral
      hydronephrosis in primary workup.
AB  - Ultrasound accurately detects hydronephrosis in infants and children, while
      nuclear medicine techniques quantify relative renal function in addition to
      characterizing the urodynamic relevance of hydronephrosis. This prospective study
      was undertaken to examine the relationship between ultrasound morphological
      findings and relative renal function, quantified with dynamic 99mtechnetium
      mercaptotriacetylglycine imaging, in the initial diagnostic workup of children
      with unilateral hydronephrosis. The ultrasound grade of hydronephrosis and
      relative renal function ipsilateral to the hydronephrosis were inversely related,
      indicating that with more severe hydronephrosis ultrasound fails to estimate the
      potential reduction of relative kidney function. Because renal function is not
      necessarily affected by hydronephrosis, renal scintigraphy is indicated to assess
      the functional status of hydronephrotic kidneys.

PMID- 8476705
TI  - IgG and IgA classes of anti-neutrophil cytoplasmic autoantibodies in a 13-year
      old girl with recurrent Henoch-Schonlein purpura.
AB  - We describe a 13-year-old girl with recurrent Henoch-Schonlein purpura whose
      symptoms were precipitated by upper respiratory tract infections. Her serum was
      positive for both IgG and IgA classes of anti-neutrophil cytoplasmic
      autoantibodies by immunofluorescence. The titers of both autoantibodies
      correlated with disease activity. The immunopathology underlying these findings
      is discussed.

PMID- 8476706
TI  - What is the current recommendation in the management of covert (significant)
      bacteriuria in infants and preschool children?

PMID- 8476707
TI  - Acute noncrescentic poststreptococcal glomerulonephritis presenting with
      pulmonary hemorrhage.
AB  - We report a child with acute poststreptococcal noncrescentic glomerulonephritis
      and pulmonary hemorrhage. This patient demonstrates that: (1) poststreptococcal
      noncrescentic glomerulonephritis in children can be associated with pulmonary
      hemorrhage, (2) an expeditious renal biopsy in patients with acute or rapidly
      progressive glomerulonephritis and pulmonary hemorrhage can establish an early
      diagnosis and provide timely guidance for treatment, and (3) although not proven
      by controlled studies, the intravenous administration of methylprednisolone in
      our patient may have been effective in the treatment of pulmonary hemorrhage.

PMID- 8476708
TI  - Persistent microscopic haematuria without proteinuria.

PMID- 8476709
TI  - Body growth in urinary tract malformations.
AB  - Body height and height velocity were analysed in 54 children with obstructive
      urinary tract malformations over a mean period of 8.7 years, using new
      auxological methods. At the time of diagnosis, 9% of patients had a height of
      more than 2 standard deviations below the normal mean. Mean relative height
      changed significantly from the first to the last observation, the standard
      deviation score (SDS) increasing from -0.16 to +0.36 in patients with
      hydronephrosis compared with normal children (P < 0.05) and from -0.63 to +0.02
      SDS in those without hydronephrosis (P < 0.005). The pathogenesis of the
      described growth disturbance is not clear. Stepwise multiple regression analysis
      pointed to a possible link between the duration of antibiotic treatment and the
      recovery of growth capacity, but improved growth could not clearly be attributed
      to any medical or surgical treatment. The synchronized average growth velocity
      curve was similar to that of healthy children and showed a normal pubertal spurt.
      Final height and target height calculated from parents' height differed only
      slightly from that of the normal population.

PMID- 8476710
TI  - Alport's syndrome and hereditary motor and sensory neuropathy type I--an
      unfortunate coincidence.
AB  - A 15-year-old boy with Alport's syndrome and hereditary motor and sensory
      neuropathy type I is described. An association between hereditary motor and
      sensory neuropathy and a nephropathy has been reported in 12 cases in the
      literature. Although showing features in common with Alport's syndrome and with a
      familial tendency, these 12 cases are clinically and histologically distinct from
      our patient who is the unfortunate inheritor of two genetic disorders, one
      maternally and one paternally derived. Recognition of an association between
      nephropathy and neuropathy, although rare, is important.

PMID- 8476711
TI  - Hypercholesterolemia in children with cystinosis.
AB  - Ten children with cystinosis had their diet, serum creatinine, and total
      cholesterol (averaged in 6-month blocks and normalized by calculating a z score
      (TCz)] monitored for a mean of 5 years. The TCz scores were elevated in boys (P <
      0.01) but not girls (P = 0.67). The boys had elevated TCz scores for 58% of their
      29 pre-transplantation years of follow-up, rising as early as 1 year of age at a
      mean rate of 0.67 standard deviations per year. Cystinotic boys had higher TCz
      scores than children with other tubular disorders (P < 0.025). All 4 cystinotic
      boys who developed renal insufficiency had a rise in TCz scores at a rate greater
      than control children with comparable renal impairment. Two cystinotic boys
      received a renal transplant; subsequent TCz scores were markedly lower, but
      remained elevated. The nutritional status of cystinotic children deteriorates
      after 3 years of age: they have decreased fat stores, elevated TCz scores and
      consume high fat diets insufficient in total calories. In summary, cystinotic
      boys have marked, progressive hypercholesterolemia which improves after renal
      transplantation.

PMID- 8476712
TI  - Renal and biliary abnormalities in a new murine model of autosomal recessive
      polycystic kidney disease.
AB  - Current models of autosomal recessive polycystic kidney disease (ARPKD) fail to
      demonstrate biliary abnormalities in association with renal cysts. We therefore
      studied a new murine model of ARPKD in which dual renal tubular and biliary
      epithelial abnormalities are present. Affected homozygous animals typically die 1
      month postnatally in renal failure with progressively enlarged kidneys. Renal
      cysts shift in site from inner cortical proximal tubules at birth to collecting
      tubules 20 days later, as determined by segment-specific lectin binding.
      Increased numbers of mitosis were demonstrated in proximal and collecting tubular
      cysts. In addition, epithelial hyperplasia was demonstrated morphometrically in
      the intra- and extrahepatic biliary tract of affected animals. The number of
      intrahepatic biliary epithelial cells was increased by 50% on postnatal day 5 and
      by 100% on postnatal day 25 (P < 0.01). Despite an increased frequency of
      "chaotic" portal areas in mice with renal cysts, no intrahepatic cysts or shape
      abnormalities of the biliary lumen were detected using biliary casts and
      morphometry. Additionally there was nonobstructive hyperplastic dilatation of the
      extrahepatic biliary tract which was linked in all animals to the presence of
      renal cysts. The hyperplastic abnormalities in both renal and biliary epithelium
      make this new mouse strain a good model for the study of the dual organ cellular
      pathophysiology of ARPKD.

PMID- 8476713
TI  - Growth of uremic infants on forced feeding regimens.
AB  - Infants born with congenital renal insufficiency generally grow poorly during the
      first years of life and incur a height deficit that is rarely regained. Actual
      energy and protein requirements have not been determined for these children. In
      12 infants with creatinine clearances less than 70 ml/min per 1.73 m2, growth and
      nutrient intakes were monitored during the first 2 years of life. Forced feeding
      regimens after 3 months of age, including gastrostomy in 3 patients, were
      necessary to maintain energy intakes near 100% of the recommended dietary
      allowance (RDA). Protein intakes averaged in excess of 140% RDA. Linear growth
      did not correlate with either energy or protein intakes, suggesting that neither
      was a limiting factor to growth. Length velocity standard deviation score (LV
      SDS) did not correlate with degree of renal insufficiency at any age, but average
      LV-SDS did relate significantly and inversely to C-terminal parathyroid hormone
      (PTH) levels. Growth parameters, including LV-SDS and weight velocity SDS (WV
      SDS) were lowest at 6 months of age. Weight and length SDS followed with a
      maximum decline at 12 months of age. While weight for length SDS remained normal
      and WV-SDS showed recovery during the 2nd year, LV-SDS remained negative. Length
      SDS stabilized near--2 SDS. In summary, these data suggest that the major height
      deficit in infants with renal insufficiency is incurred during the first 6 months
      of life. Ponderal indices suggested that very early nutritional deficits may have
      been a primary contributor to subsequent height deficits.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8476714
TI  - Aminoglycoside ototoxicity in pediatric patients receiving long-term peritoneal
      dialysis.
AB  - We evaluated 14 children on long-term peritoneal dialysis for ototoxicity
      associated with aminoglycoside (AG) therapy. Baseline evaluation of all patients
      and 7 controls included pure-tone audiometry (PTA) and click-evoked auditory
      brain stem response (ABR). Nine patients had repeat PTA and ABR evaluations and
      vestibular testing 1 year after study entry. Five patients had an additional
      assessment following intraperitoneal AG therapy. The baseline auditory function
      of the patients was significantly poorer than controls at 6.0 and 8.0 kHz by PTA
      (P < 0.05), whereas the results of ABR testing were not different. Of the 14
      patients, 4 (28%) had hearing loss, 3 of whom had a history of intravenous AG
      therapy. In contrast, none of the patients who received intraperitoneal AG
      therapy only, or without a history of AG therapy, had hearing loss (P < 0.005).
      There was no evidence of progressive loss of hearing acuity with time or
      associated with intraperitoneal AG therapy. One patient had findings of
      vestibular dysfunction. We conclude that children receiving peritoneal dialysis
      are at risk of AG ototoxicity. While intraperitoneal administration of AG may be
      associated with less ototoxicity than intravenous administration, further study
      is necessary to verify this finding and close monitoring of AG levels remains
      mandatory irrespective of the route of administration. PTA rather than click
      evoked ABR appears to be the best indicator of abnormal hearing acuity in this
      population.

PMID- 8476715
TI  - Disodium ethylenediaminetetraacetate: adverse effects in dialyzed children.
AB  - The present report describes untoward effects of disodium
      ethylenediaminetetraacetate (EDTA) in three of six pediatric patients treated
      with continuous cycling peritoneal dialysis, in whom this agent was infused
      intravenously to lower serum ionized calcium levels during dynamic testing of
      parathyroid gland function. Patients developed an influenza-like syndrome
      characterized by fever rhinorrhea, cough, sneezing, and lacrimation. All symptoms
      disappeared within 24 h. A similar degree of hypocalcemia was induced with sodium
      citrate, an alternative hypocalcemic agent, in the same patients without side
      effects. Sodium citrate, rather than EDTA, should be used to induce hypocalcemia
      when assessing parathyroid gland dynamics in children with end-stage renal
      disease.

PMID- 8476716
TI  - Social support, family variables, and compliance in renal transplant children.
AB  - The relationship between family functioning, social support, and medication
      compliance in 32 renal transplant children and their parents was examined.
      Results indicated that children whose fathers gave more emotional support or were
      more informative were less compliant with azathioprine and cyclosporine (P < 0.05
      for both). Children from families experiencing numerous stresses were also found
      to be less compliant with azathioprine (P < 0.05). Finally, compared with older
      children, younger children were found to be less compliant with cyclosporine (P <
      0.005). Implications for predicting child adherence and for future research
      relating to compliance with multidrug regimens are discussed.

PMID- 8476717
TI  - Operating characteristics of pediatric continuous arteriovenous hemofiltration in
      an animal model.
AB  - Continuous arteriovenous hemofiltration (CAVH) is an increasingly popular
      technique in the care of critically ill children. The operating characteristics
      of the available circuits are largely unknown. Prior to introducing CAVH into our
      pediatric intensive care unit, we investigated the performance of three CAVH
      circuits: CAVH with postfilter dilution, CAVH with prefilter dilution (CAVHpre)
      and CAVH with dialysis counterflow. Using a neonatal lamb model, we measured
      filter blood flow (QB), ultrafiltrate rate (QU), arterial, venous and
      ultrafiltrate compartment pressures, oncotic pressure, plus urea levels in blood
      and ultrafiltrate fluid for the three CAVH circuit designs. Transmembrane
      pressure and urea clearance were calculated for various values of QB after
      varying a clamp on the arterial side of the circuit. The major finding,
      applicable to all circuits, was the wide variability of QB. Constant attention
      was required in order to obtain a consistent QB. Fluid clearance was effective
      with all three circuits. Urea clearance averaged 5-10 ml/min and was principally
      dependent on QU and independent of QB. The addition of dialysis counterflow did
      not increase urea clearance. The most convenient circuit we tested was CAVHpre,
      but the problem of unstable QB is common to all unpumped arteriovenous filtrate
      circuits. It is a major limiting factor in the practical application of this
      technology to critically ill children.

PMID- 8476718
TI  - Cerebral vasculitis in acute post-streptococcal glomerulonephritis.
AB  - Neurological complications in acute post-streptococcal glomerulonephritis (APSGN)
      have been traditionally attributed to hypertensive encephalopathy. A 9-year-old
      girl with biopsy-documented APSGN developed seizures at a time she was
      normotensive and biochemically well balanced. Computed tomography of her brain
      was consistent with vasculitis, a finding which was also clinically supported by
      apparent vasculitic involvement of other organ systems. All clinical, laboratory
      and radiological abnormalities resolved with recovery from the APSGN. We suggest
      that on rare occasions neurological complications in APSGN may result from
      involvement of the central nervous system in multiorgan transient vasculitis.

PMID- 8476720
TI  - Relapsing gross haematuria in Munchausen syndrome.
AB  - A 10-year-old female with relapsing gross haematuria and Munchausen syndrome is
      reported, emphasizing the rarity of this situation in children and the difficult
      diagnostic pathway. A careful personality study of the patient and family members
      is absolutely necessary in order to proceed with diagnosis and successful
      treatment.

PMID- 8476719
TI  - Treatment with a combination of low-density lipoprotein aphaeresis and
      pravastatin of a patient with drug-resistant nephrotic syndrome due to focal
      segmental glomerulosclerosis.
AB  - Results of recent animal studies have lent support to the hypothesis that
      hyperlipidaemia may contribute to renal injury. This report documents the case of
      a 15-year-old boy with drug-resistant nephrotic syndrome due to focal segmental
      glomerulosclerosis (FGS) who showed an improvement in renal function and
      proteinuria as a result of treatment with low-density lipoprotein aphaeresis (LDL
      A) combined with pravastatin. Although further work is required to determine the
      efficacy of lipid-lowering therapy in progressive glomerular disease in humans,
      the combination of LDL-A and pravastatin is likely be included in the choice of
      treatment modalities available for patients with drug-resistant nephrotic
      syndrome due to FGS.

PMID- 8476721
TI  - Masking of physicians in the Growth Failure in Children with Renal Diseases
      Clinical Trial.
AB  - Masking--hiding identities of treatments from the patient, physician and/or
      statistician--is a critical element in clinical trials. Wherever possible,
      masking is implemented to eliminate observational bias or systematic error. In
      this paper, general concepts of masking in clinical trials are examined. Specific
      masking procedures used in the "Growth Failure in Children with Renal Diseases"
      (GFRD) Clinical Trial are described. A method to evaluate the "success" of this
      masking procedure for physicians is introduced. For each randomized patient at
      each clinical center, the clinic director was asked to predict which treatment
      (1,25-dihydroxyvitamin D3 or dihydrotachysterol) was assigned. Results showed
      that 72% of responses initially indicated "absolutely no idea" of treatment.
      Additional analyses revealed that the number and percentage of "correct" guesses
      were essentially equal for the two treatment groups and that a patient's time on
      treatment did not affect the mask. We conclude that the mask of physicians in the
      GFRD Clinical Trial was well maintained.

PMID- 8476722
TI  - Management of primary hyperoxaluria: efficacy of oral citrate administration.
AB  - The prognosis of primary hyperoxaluria (PH) is not only related to endogenous
      oxalate production and the response (if any) to pyridoxine (in type I), but is
      greatly influenced by extrarenal factors like dehydration. The earlier the
      diagnosis of PH, the better the chances of improving the prognosis in individual
      patients. Measures to enhance the solubility of calcium oxalate are important.
      Besides ensuring at all times a generous fluid intake (> 2 l/m2), administration
      of alkali citrate (0.15 g/kg), which has not been advocated so far in PH, appears
      very promising. We studied the effect of sodium citrate in six patients with PH.
      Mean urinary citrate excretion (mmol/day per 1.73 m2) without oral citrate was
      very low (0.57) and rose to 2.49 with citrate administration. This was
      accompanied by a significant decrease in the calcium oxalate saturation
      (calculated by equil 2) from 11.7 to 6.9 (P < 0.05). Treatment in five patients
      over 10-36 months resulted in improved (1) or stabilized (4) renal function and
      reduced passage of stones. Additional measures include restriction of salt and of
      oxalate-rich food. We conclude that long-term administration of alkali citrate is
      beneficial in patients with PH.

PMID- 8476723
TI  - Should liver transplantation be performed before advanced renal insufficiency in
      primary hyperoxaluria type 1?
AB  - Primary hyperoxaluria type 1 (PH1) is a rare recessive autosomal inborn error of
      glyoxylate metabolism leading to oxalate retention, the first target of which is
      the kidney. The disease is caused by a defect of the liver-specific peroxisomal
      enzyme alanine: glyoxylate aminotransferase. Patients with pyridoxine-resistant
      forms of PH1 usually require organ replacement therapy, i.e. liver
      transplantation to supply the deficient enzyme and/or kidney transplantation to
      replace the affected organ. The current experience of the management of PH1 has
      emphasized two main points: (1) end-stage renal failure must be avoided since it
      increases dramatically the risk of systemic involvement, (2) the correction of
      oxalate overproduction and organ overload requires the removal of the host liver.
      Practical attitudes towards these ideas are difficult to assess and an
      individualized strategy is therefore required. Isolated kidney transplantation
      should be limited to adult patients with late-onset and a mild course of the
      disease. The present experience of combined liver-kidney transplantation was
      gained mainly in adult patients with severe systemic involvement; the 3-year
      patient survival rate recently increased to 82%. This figure might be improved if
      the procedure were performed earlier while the glomerular filtration rate (GFR)
      is above 25 ml/min per 1.73 m2. Isolated liver transplantation should be
      considered in carefully selected children with severe forms of pyridoxine
      resistance (PH1) before GFR has dropped to less than 30 ml/min per 1.73 m2; it
      seems to be indicated especially in the presence of a rapid decline of GFR in the
      preceding year.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476724
TI  - Human immunodeficiency virus nephropathy.
AB  - Varying components of the syndrome of human immunodeficiency virus nephropathy
      (HIVN) have been described, the most pertinent including proteinuria/nephrotic
      syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic
      kidneys, rapid progression to end-stage renal disease (ESRD), and no response to
      treatment regimens. The diagnosis of HIVN requires identification of excessive
      proteinuria or albuminuria, determined by a total protein excretion on a timed
      urine collection or a high protein/creatinine ratio in a random specimen. Various
      pathological lesions have been found in HIVN. The lesion of focal and segmental
      sclerosis (FS/FSS) is most characteristic in adults and usually is associated
      with a rapid demise. FS/FSS also has been described in approximately one-half of
      the pediatric patients reported in the literature (31/64). Despite progression to
      ESRD, the clinical course in children with HIVN is less fulminant than in adults.
      Other reported histological findings include primarily mesangial hyperplasia as
      well as minimal change, focal necrotizing glomerulonephritis or lupus nephritis,
      and hemolytic uremic syndrome. In addition to glomerular pathology, interstitial
      findings of dilated tubules filled with a unique proteinaceous material,
      atrophied tubular epithelium, and interstitial cell infiltration are very common.
      On electron microscopy, most investigators have found tubuloreticular inclusion
      bodies in endothelial cells of glomerular capillaries. Treatment of patients who
      develop ESRD remains highly controversial. Most adult patients treated with
      hemodialysis have succumbed rapidly; peritoneal dialysis has been better
      tolerated. Transplantation in patients with HIV infection must be considered to
      be tentative, with reports of acceleration towards full blown acquired
      immunodeficiency syndrome in some and uneventful 5-year survival in
      others.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476726
TI  - A 6-year-old black boy with fever and gross hematuria. Acute pyelonephritis.

PMID- 8476725
TI  - Complement and glomerulonephritis--an update.
AB  - The complement (C) system in man and its relationship to disease has been the
      subject of intensive research. In this review, we update the information
      concerning the nature of the various C components, and present some of the
      similarities between structure and function of the C components and their
      respective genes. The clinical problems which are encountered in individuals with
      acquired C abnormalities and with a genetically determined deficiency of a single
      component provide helpful clues to understanding the affected patients and the
      possible functional importance of the particular deficient component. The steady
      progress in identifying both normal variants of C components and the gene defects
      which produce C deficiencies offers the prospect of correlating structure of the
      C components with possible pathogenic roles in disease. Genetically determined C
      abnormalities are more commonly recognized during childhood. An appreciation of
      the basic aspects of the C system is a helpful tool for the pediatric
      nephrologist.

PMID- 8476727
TI  - Normal serum uric acid concentrations for age and sex and incidence of renal
      hypouricaemia in Japanese school children.

PMID- 8476728
TI  - Indomethacin treatment in children with daytime frequency micturition.

PMID- 8476729
TI  - Normal levels of urinary brush border antigens and other tubular markers in
      children.

PMID- 8476730
TI  - The immunology of scabies.
AB  - Individuals with scabies react to bites by generating a cell-mediated immune
      response at the bite site. This elicits a very itchy papule that is often
      excoriated. Sometimes ulcerated papules, vasculitis, and nodules develop as a
      result of other immunologic reactions in skin. Immunologic reactions mediated by
      antibodies of the immunoglobulin G (IgG), IgM, and especially, IgE classes may
      also be involved. None of these reactions have been shown to eliminate all mites
      from the skin surface, but locally these reactions may prevent the epidemic
      multiplication of scabies' organisms on the skin surface, as observed in some
      patients with crusted scabies.

PMID- 8476731
TI  - Scabies research: another dimension.
AB  - The life cycle of canine scabies has been studied extensively. Currently studies
      are focusing on mite behavior, physiological requirements, host specificity, mite
      survival, and clinical complications of scabies. Investigations are giving
      insight into immunologic responses to infestation and cross-reactivity with house
      dust mites. A diagnostic blood test or vaccine may become a future reality, if a
      unique antibody response can be isolated. Can scabies transmit the human
      immunodeficiency virus (HIV)? This controversial area needs prompt definitive
      exploration.

PMID- 8476732
TI  - Delusions of parasitosis.
AB  - The fixed belief that one is infested with living organisms, in the absence of
      any objective evidence that such infestation exists, is termed "delusions of
      parasitosis." For most patients, this is a "monosymptomatic" disorder because
      there is no evidence of psychotic ideation in other areas of their lives. This
      overall normality of thought processes, together with exceptional strength of
      conviction regarding infestation, makes confirmation of a suspected diagnosis
      difficult. We want, and need, to be certain that a true infestation is not
      missed. This requires careful history taking, thorough examination of the skin,
      microscopic review of the material brought in by the patient and, occasionally,
      biopsy of lesions identified by the patient as "bite" sites. Establishment of a
      diagnosis is difficult enough, but it is even more difficult (usually impossible)
      to convince the patient that there are no "bugs" present. Attempts to have the
      patient visit a psychiatrist are virtually always rebuffed, leaving the clinician
      no choice but to begin therapy. Pimozide, a blocker of dopamine receptors,
      represents the pharmacological treatment of choice. The use of this drug is
      usually quite helpful, but relapse frequently occurs when treatment is stopped.
      For patients who will not take the drug, and for those who fail treatment, the
      best that can generally be achieved is the provision of a supportive environment.
      In such a setting, many of these patients eventually shift to a less troublesome
      chronic phase of their disease during which the delusion partially or even
      completely slips into the subconsciousness thus allowing for more normal daily
      functioning.

PMID- 8476733
TI  - Mite infestations other than scabies.
AB  - Scabies is clearly the primary medical problem involving mites. However,
      regionally, there is a broad variety of other dermatoses associated with mite
      exposure, which in some areas vastly exceed the incidence of scabies. Also,
      scabies is characterized by a cyclical occurrence that is unusual in other mite
      infestations and mite-associated dermatoses. Many of these have seasonal or
      regional characteristics, which will be discussed. The clinical aspects of mite
      infestation will primarily be dealt with, and the basic anatomy and biology of
      the mites will be ignored.

PMID- 8476734
TI  - Papular urticaria.
AB  - The diagnosis of papular urticaria has evolved over the years and has many
      synonyms. Its most common present day usage relates to a cutaneous reaction
      presumably from an apparent exposure to insects. The evolving science in this
      area is allowing a better understanding of potential sources including newer
      tools to look at antigens from insect proteins injected after bites from flying
      insects and some other environmental arthropods. Insight to etiology is important
      and can be partially determined by clinical history and clinical pattern of
      symptoms. The usual approach in practice is to treat symptomatically first while
      investigating etiologies. Increasing appreciation of the role of environmental
      mites and ectoparasites has allowed us more precision in diagnosis to
      specifically treat the cause. The primary challenge in therapy often relates to
      the achievement of the goal of symptom relief. This is often difficult because of
      the chronicity of the syndrome when the patient is seen by a specialist. Both the
      search for etiology and symptomatic relief often need to be aggressive to achieve
      the desired therapeutic benefit for the patient.

PMID- 8476735
TI  - Zoonoses of dermatological interest.
AB  - The zoonoses are those diseases transmitted from animals to humans. Although
      commonly thought to be infectious in origin such as scabies or dermatophytosis,
      inflammatory processes may also be zoonotic. Contact dermatitis may result from
      allergens being carried from animals to humans. Although the scabies mite is
      somewhat species specific, various mites sometimes have the opportunity of
      producing skin disease on man (ie, canine scabies, porcine scabies, and feline
      scabies [notoedric mange]); cheyletiellosis is caused by a similar mite, often
      found in rabbits. The index case of superficial fungal infections may be the
      household pet, whereas the cause of flea bite dermatitis (papular urticaria) may
      be the lack of an animal, resulting in the flea choosing a human for feeding.
      Understanding zoonotic skin diseases will improve the clinician's diagnostic
      skills. Both the human and animal patient will then receive more effective
      treatment in a quicker fashion.

PMID- 8476736
TI  - Scabies in AIDS.
AB  - Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) will
      be the most common disease triggering crusted (Norwegian) scabies. Scabies should
      be suspected in any atypical itching (or non) rash in HIV/AIDS patients. Attempt
      to prove the diagnosis by doing a skin scraping, or if negative, a skin biopsy.
      Unusual forms of scabies in HIV/AIDS can be divided into crusted scabies and
      atypical (exaggerated) scabies. Therapy requires the sequential use of
      scabicides, usually over a longer period than is required to clear an ordinary
      case of scabies. Compliance is a concern, and the scabicides are best
      administered under supervision whenever possible. Isolating the index patient and
      treating the environment of patients with crusted or atypical scabies is much
      more significant than in ordinary scabies. The transmission in hospitals of
      ordinary scabies from an index patient with crusted scabies to other patients,
      health care workers, etc, is common. Protective measures and early diagnosis and
      therapy are essential.

PMID- 8476737
TI  - Global health situation. V). Noncommunicable diseases, disability.

PMID- 8476738
TI  - Potentiation of the pressor response to stress by tolbutamide in dogs.
AB  - Tolbutamide has previously been shown to amplify the pressor effects of
      "exogenous" catecholamines in conscious dogs, possibly due to sensitization of
      the alpha 1-adrenoreceptor-mediated vasoconstriction. The objective of this study
      was to examine if tolbutamide also amplifies the pressor effects of "endogenous"
      catecholamines released during psychological stress (classical Pavlovian aversive
      conditioning). Experiments were conducted in beta-adrenoreceptor-blocked
      (propranolol, 1 mg/kg, i.v.) conscious dogs (n = 4) trained in classical aversive
      conditioning. Conditioning was accomplished by following a tone (CS+) with a 1/2
      second shock; another tone (CS-) was not followed by any shock and served as
      control. With saline pretreatment, aversive conditioning (i.e., CS+) increased
      mean arterial pressure (MAP) only by approximately 4.7% when compared to CS-,
      whereas with tolbutamide (45 mg/kg, i.v.) pretreatment, the increase in MAP
      induced by CS+ beyond what was induced by the CS- (approximately 6.2%) was
      significantly (p < 0.05) larger than that with saline pretreatment. In isolated
      canine femoral arterial segments (n = 4), the vasoconstrictor effect of
      phenylephrine (an alpha 1-agonist) at 5 x 10(-6) M (which was the EC50 value) was
      amplified by 2 x 10(-2) M of tolbutamide from 54.0 +/- 2.0% to 66.9 +/- 2.1%. In
      conclusion, tolbutamide amplifies the pressor effects of "endogenous"
      catecholamines in conscious dogs, possibly by sensitization of the alpha 1
      adrenoreceptor-mediated vasoconstriction. This mechanism of action is novel and
      has not been reported with other agents.

PMID- 8476739
TI  - Pavlovian conditioning in human skilled motor behavior.
AB  - The role of Pavlovian contingencies in human skilled motor behavior was
      investigated in three experiments by means of a new conditioning preparation. In
      Experiment 1 the present method was shown to be appropriate for the study of
      associative learning. Subjects who experienced a standard delay configuration
      performed significantly more conditioned responses than subjects who received
      either backward conditioning or random pairings. Stimulus generalization was
      shown to be slight in two additional groups. Subsequent experiments examined
      conditioning with multiple conditioned stimuli (CSs). In particular, in
      Experiment 2 some reciprocal overshadowing was demonstrated when two conditional
      stimuli (tone and vibration) were compounded. Experiment 3 investigated blocking.
      Blocking was less than expected, however. Subjects' perceptions of the stimuli
      and reaction time data suggest that a certain proportion had shifted their
      attention to the added element of the CS compound. Results are discussed in
      relation to other studies on Pavlovian learning in humans and animals, which are
      concerned with "stimulus selection."

PMID- 8476740
TI  - Effects of transient coronary artery occlusion on canine intrinsic cardiac
      neuronal activity.

PMID- 8476741
TI  - Acute versus chronic post-traumatic stress disorder.
AB  - A photographic lens and filter model is presented which outlines six steps
      between a person's perception of stressful life events and their possible
      eventual development of an illness. Persons developing acute post-traumatic
      stress disorder differ markedly in their processing of early steps in the model
      compared to those who go on to suffer from chronic post-traumatic stress
      disorder. Persons with the acute disorder, with high likelihood of recovery,
      generally have had enriching early life experiences, use psychological defenses
      to a moderate degree, and demonstrate ample coping capabilities. Those going on
      to the chronic disorder, who frequently don't recover, often report impoverished
      early life experiences, employ psychological defenses to an extreme degree, and
      show a paucity of coping skills. These differences are illustrated by histories
      from survivors of a terrorist bombing and by observations made by the author of
      returned prisoners of war and civilian hostages.

PMID- 8476742
TI  - Effects of transient coronary artery occlusion on canine intrinsic cardiac
      neuronal activity.
AB  - In order to further elucidate the regulatory function of canine epicardial
      neurons, the effects of transient coronary artery occlusion on their spontaneous
      activity was studied. Fifty-eight individual, spontaneously active units were
      identified by means of their action potential configurations in specific loci of
      atrial and ventricular epicardial fat of 10 anesthetized dogs. The activity of 49
      of the units was modified by one minute of coronary artery occlusion. Twenty-four
      of the 49 responding units exhibited increased activity and 37 decreased activity
      during coronary artery occlusions. Activity changes were sometimes, but not
      always, associated with decreased left ventricular intramyocardial systolic
      pressure. During reperfusion, the activity of 6 units was increased compared to
      control levels, even though ventricular pressures remained the same. Following
      acute decentralization, 48% of previously active units generated spontaneous
      activity; the activity of 89% of these was altered during coronary artery
      occlusion despite the fact that overall cardiodynamics were unchanged. Following
      hexamethonium administration, the activity generated by 9 of 10 spontaneously
      active units was modified by coronary artery occlusion. It is concluded that
      transient coronary artery occlusion can modify the activity generated by
      intrinsic cardiac neurons, such modification involving central and peripheral
      neuronal interactions.

PMID- 8476743
TI  - A review of neuroendocrine and neurochemical changes associated with static and
      extremely low frequency electromagnetic field exposure.

PMID- 8476744
TI  - Hypothesis: the nasal fatigue reflex.
AB  - Natural selection results in adaptations. I suggest that unexplained fatigue may
      be an adaptive response to nasal impairment. For macrosmatic animals, intact
      olfaction is necessary to detect predators. In such animals, any reflex (e.g.,
      fatigue) triggered by nasal dysfunction that limited exposure would offer great
      survival advantage. The "fatigued" animal would remain in its protected
      environment, unexposed to hungry carnivores, while the nose healed. In humans,
      clinical syndromes associated with unexplained fatigue (chronic fatigue syndrome,
      tension fatigue syndrome, allergic fatigue, neurasthenia, etc.) are characterized
      by symptoms that, in part, are nasal in origin. The older medical literature does
      describe the resolution of fatigue in neurasthenia after nasal treatments. Nasal
      reflexes in animals do cause significant systemic effects, including an
      inhibition of muscle action potentials that is, perhaps, analogous to the "heavy
      limbed" sensation of those with fatigue. Furthermore, reflexes similar to the one
      proposed do exist in humans: the diving reflex presumably served our amphibian
      ancestors well as an oxygen conserving technique with submersion, but serves no
      known useful function now. Other human nasopharyngeal reflexes with profound
      cardiovascular and systemic effects are well described but only occasionally
      studied. The proposed nasal fatigue reflex should be examined as a possible
      ancient adaptive response to nasal malfunction.

PMID- 8476746
TI  - Tissue-specific promoters regulate aromatase cytochrome P450 expression.
AB  - In the human, estrogen biosynthesis occurs in several tissue sites, including
      ovary, placenta, adipose, and brain. Recent work from our laboratory has
      indicated that tissue-specific expression of aromatase cytochrome P450
      (P450arom), the enzyme responsible for estrogen biosynthesis, is determined, in
      part, by the use of tissue-specific promoters. Thus the expression of P450arom in
      human ovary appears to utilize a promoter proximal to the translation start-site.
      This promoter is not utilized in placenta but instead, the promoter used to drive
      aromatase expression in placenta is at least 40 kb upstream from the
      translational start-site. In addition, there is a minor promoter used in the
      expression of a small proportion of placental transcripts which is 9 kb upstream
      from the start of translation. Transcripts from these promoters are also
      expressed in other fetal tissues including placenta-related cells such as JEG-3
      choriocarcinoma cells, hydatidiform moles, and other fetal tissues such as fetal
      liver. On the other hand, in adipose tissue expression of P450arom may be
      achieved by yet another, adipose-specific promoter. The various 5'-untranslated
      exons unique for expression driven by each of these promoters are spliced into a
      common intron/exon boundary upstream from the translational start-site. This
      means that the protein expressed in each of the various tissue-specific sites of
      estrogen biosynthesis is identical.

PMID- 8476747
TI  - Diverse mechanisms of control of aromatase gene expression.
AB  - The synthesis of estrogens from androgens is catalyzed by a microsomal cytochrome
      P450 termed aromatase (P450arom). The expression of this enzyme is highly
      regulated in both a developmental and cell-type specific fashion. We have chosen
      to examine the molecular basis of aromatase gene regulation by studying two
      models of aromatase expression: the Sebright bantam chicken and the R2C rat
      Leydig tumor cell line. In the first model, affected (Sebright) chickens express
      aromatase in many extragonadal tissues, while normal Leghorn chickens express
      aromatase only in the ovary and hypothalamus. Our studies have demonstrated that
      in normal chickens the site of transcription initiation is located approx. 147
      nucleotides upstream of the initiator methionine. While Sebright animals also
      express aromatase mRNA initiated at an analogous initiation site in the ovary, a
      distinctive species of aromatase mRNA is also detected and is present in ovary
      and extragonadal tissues. This mRNA contains an identical coding sequence, but
      contains an alternatively spliced 5' noncoding exon that is derived from a
      distinctive promoter. The second model, the R2C Leydig tumor cell line, provides
      ample contrast. This cell line expresses high basal levels of aromatase (150-200
      pmol/h/mg protein) that is suppressed with administration of 8 bromo cAMP or
      forskolin but the activity is not altered by glucocorticoids or epidermal growth
      factor treatment. Despite this distinctive pattern of regulation, at least three
      species of aromatase mRNA are detected in Northern blots, each of which is also
      detected in rat ovary. Primer extension and S1 nuclease assays indicate that both
      granulosa cells and R2C cells utilize a promoter that is located approx. 97
      nucleotides upstream of the initiator methionine. These studies suggest that the
      "ovarian" promoter is evolutionarily conserved in both rats and chickens. These
      results further imply that the genetic mechanisms controlling the diversity of
      aromatase expression among tissues and among different species are likely to fall
      into two groups: those that employ distinctive promoters and alternative splicing
      and those that effect different patterns of regulation through a common
      ("ovarian") promoter.

PMID- 8476748
TI  - Structure-function studies of human aromatase.
AB  - Site-directed mutagenesis experiments have been carried out to determine the
      structure-function relationship of human aromatase. By sequence comparison, the
      region in aromatase that corresponds to the distal helix of cytochrome P-450cam
      has been identified to be Gln-298 to Val-313. Eight aromatase mutants with
      changes in this region, i.e. C299A, E302L, P308F, D309N, D309A, T310S, T310C, and
      S312C, have been generated using a mammalian cell stable-expression system. The
      results from site-directed mutagenesis studies indicate that the region
      containing Gln-298 to Val-313 is indeed a very important part of the active site
      of aromatase. The catalytic properties of P308F, D309N, and D309A have been
      examined in detail and are discussed. Active site-directed labeling is also an
      important approach to investigate the structure-function relationship of
      aromatase. HPLC-linked electrospray mass spectrometry is indicated as a useful
      technique for the characterization of active site-directed probe-modified enzyme.
      The mass spectral analysis of aromatase suggests that aromatase is glycosylated.

PMID- 8476745
TI  - The independent roles of diet and serum lipids in the 20th-century rise and
      decline of coronary heart disease mortality.
AB  - Risk factors are causally related to coronary heart disease (CHD), but in widely
      varying historic, geographic, socioeconomic, and individual relationships. Serum
      cholesterol is only one of many risk factors that, even when considered together
      in prospective studies, account for well under half of the CHD incidence. It is
      neither primarily regulated by the diet nor significantly related to it. Many
      findings discordant with widespread beliefs about a causal role of the diet in
      CHD are reviewed. It may be concluded that dietary fats are largely not
      responsible for relationships of serum cholesterol to CHD, or for its 20th
      century rise and decline.

PMID- 8476749
TI  - Steroidal inhibitors as chemical probes of the active site of aromatase.
AB  - Androstenedione analogs containing 7 alpha-substituents have proven to be potent
      inhibitors of aromatase in human placental microsomes, in MCF-7 mammary cell
      cultures, and in JAr choriocarcinoma cells. Recent investigations have focused on
      the use of mechanism-based inhibitors, such as 7 alpha-substituted 1,4
      androstadienediones, to biochemically probe the active site of aromatase.
      Inhibition kinetics were determined under initial velocity conditions using
      purified human placental cytochrome P450arom protein in a reconstituted system.
      Derivatives of 1,4-androstadiene-3,17-dione and 1,4,6-androstatriene-3,17-dione
      exhibited high affinity in the purified enzyme system. 7 alpha-(4'
      Amino)phenylthio-1,4-androstadiene-3,17-dione, abbreviated 7 alpha-APTADD,
      demonstrated rapid time-dependent, first-order inactivation of reconstituted
      aromatase activity only in the presence of NADPH. The apparent Kinact for 7 alpha
      APTADD is 11.8 nM, the first-order rate of inactivation is 2.72 x 10(-3) sec-1,
      and the half-time of inactivation at infinite inhibitor concentration is 4.25
      min. The values for the rate constant and half-time of inactivation are similar
      to those observed in the placental microsomal assay system. Further studies were
      performed with radioiodinated 7 alpha-(4'-iodo)phenylthio-1,4-androstadienedione,
      7 alpha-IPTADD, and the reconstituted aromatase system. Incubations with [125I] 7
      alpha-IPTADD were followed by protein precipitation, solvent extraction, and
      column chromatography. Analysis of the isolated cytochrome P450arom by gel
      electrophoresis and autoradiography demonstrated the presence of only one
      radioactive band, which corresponded to the protein staining band for cytochrome
      P450arom. HPLC radiochromatographic analysis of the isolated cytochrome P450aroM
      confirmed the presence of only one radioactive peak coeluting with the u.v. peak
      for cytochrome P450arom. Peptide mapping analysis by reverse-phase HPLC of
      digested inhibitor-cytochrome P450arom complex demonstrates that the radioactive
      inhibitor is covalently bound to a lipophilic fragment. In summary, these
      inhibitors produced enzyme-catalyzed inactivation of reconstituted aromatase
      activity, and radioiodinated 7 alpha-IP-TADD binds covalently to the cytochrome
      P450arom.

PMID- 8476750
TI  - Studies on the mechanism of aromatase and other cytochrome P450 mediated
      deformylation reactions.
AB  - Aromatase is a microsomal cytochrome P450 that converts androgens to estrogens by
      three sequential oxidations. The isolation of the 19-hydroxy and 19-oxo androgens
      suggests that the first two oxidations occur at the C19 carbon. However, the
      mechanism of the third oxidation, which results in C10--C19 bond cleavage, has
      not been determined. Two proposed mechanisms which remain viable involve either
      initial 1 beta-hydrogen atom abstraction or addition of the ferric peroxy anion
      from aromatase to the C19 aldehyde. Semiempirical molecular orbital calculations
      (AM1) were used to study potential reaction mechanisms initiated by initial 1
      beta-hydrogen atom abstraction. Initially, the energetics of carbon--carbon bond
      cleavage of the keto and enol forms of C1-radicals were studied and were found to
      be energetically similar. A mechanism was proposed in which the 19-oxo
      intermediate is subject to initial nucleophilic attack by the protein. The
      geometry of the A-ring in the androgens is between that for the 1-radicals and
      estrogen, suggesting that some transition state stabilization for the homolytic
      cleavage reaction can occur. More recently, studies on liver microsomal
      cytochrome P450 mediated deformylation of xenobiotic aldehydes supports
      mechanisms involving an alkyl peroxy intermediate formed by addition of the
      ferric peroxy anion from aromatase to the C19 aldehyde. Although this
      intermediate could proceed through several different concerted or non-concerted
      pathways, one non-concerted pathway involves the heterolytic cleavage of the
      dioxygen bond resulting in an active oxygenating species (iron-oxene) and a diol.
      The diol could then undergo hydrogen atom abstraction followed by homolytic
      carbon--carbon bond cleavage as in the mechanisms modeled previously. When this
      cleavage was modeled for seven aldehydes, a good correlation with reported
      experimental aldehyde turnover numbers was obtained. However, when dialkoxy
      derivatives of the aldehydes are subject to microsomal metabolism, the rates of
      carbon-carbon cleavage products do not approach the rates of deformylation of the
      aldehyde analog.

PMID- 8476751
TI  - Mechanistic studies on aromatase and related C-C bond cleaving P-450 enzymes.
AB  - Some P-450 systems, notably aromatase and 14 alpha-demethylase catalyse not only
      the hydroxylate reaction but also the oxidation of an alcohol into a carbonyl
      compound as well as a C-C bond cleavage process. All these reactions occur at the
      same active site. A somewhat analogous situation is noted with 17 alpha
      hydroxylase-17,20-lyase that participates in hydroxylation as well as C-C bond
      cleavage process. The C-C bond cleavage reactions catalysed by the above enzymes
      conform to the general equation: [formula: see text] It is argued that all three
      types of reaction catalyzed by these enzymes may be viewed as variations on a
      common theme. In P-450 dependent hydroxylation the initially formed FeIII-O-O.
      species is converted into FeIII-O-OH and the heterolysis of the oxygen-oxygen
      bond of the latter then gives the oxo-derivative for which a number of canonical
      structures are possible; for example FeV = O<==>(+.)FeIV = O<==>FeIV-O.. One of
      these, FeIV-O. behaves like an alkoxyl radical and participates in hydrogen
      abstraction from C-H bond to produce FeIV-OH and carbon radical. The latter is
      then quenched by the delivery of hydroxyl radical from FeIV-OH. The latter
      species may thus be regarded as a carrier of hydroxyl radical. We have proposed
      that the C-C bond cleavage reaction occurs through the participation of the FeIII
      O-OH species that is trapped by the electrophilic property of the carbonyl
      compound giving a peroxide adduct that fragments to produce an acyl-carbon
      cleavage. Scientific developments leading up to this conclusion are considered.
      In the first author's views, "The study of mechanisms is not a scientific but a
      cultural activity. Mechanisms do not aim at an absolute truth but are intended to
      be a "running" commentary on the status of knowledge in a field. As the
      structural knowledge in a field advances Mechanisms evolve to take note of the
      new findings. Just as a constructive "running" commentary provides the stimulus
      for higher standards of performance, so Mechanisms call for better and firmer
      structural information from their practitioners".

PMID- 8476752
TI  - Mechanism of human placental aromatase: a new active site model.
AB  - Based on Akhtar's ferric peroxide mechanism and on recent studies in our own
      laboratory, we present a detailed proposal for aromatase action. This picture can
      account for the known stereochemical consequences at C-19 observed by others
      using isotopes of hydrogen and oxygen. The postulated process involves anchoring
      of the 19-hydroxymethyl and 19-oxo groups at the active site by a glutamate
      residue, which also serves to activate the 19-oxo group for attack by ferric
      peroxy species in the third oxidative step.

PMID- 8476754
TI  - A-ring bridged steroids as potent inhibitors of aromatase.
AB  - The design and syntheses of androstenedione derivatives with bridges spanning the
      2,19-, 3,19-, 4,19- and 6, 19-positions are described. 2,19-Bridged compounds
      bearing hydroxyl groups on the two-carbon bridge (3a and 3b) were designed as
      stable carbon analogs of potential lactol intermediates in the enzymatic
      conversion of androgens to estrogens. Compounds 3a and 3b are competitive
      inhibitors of aromatase. Pyran 25 is a potent, time-dependent inhibitor of
      aromatase with partial NADPH dependence. These data suggest a mechanism of
      inhibition for 25 which involves both tight-binding competitive and mechanism
      based components, with the former predominating. The sulfur, amino, and all
      carbon analogs of pyran 25 were prepared. Thiopyran 36, piperidine 42 and the all
      carbon analog 47 are also time-dependent inhibitors of aromatase. Compound 47 is
      the most potent inhibitor and its time-dependent inhibition is not NADPH
      dependent. The kinetics of piperidine 42 suggest uncompetitive inhibition.

PMID- 8476753
TI  - A detailed molecular model for human aromatase.
AB  - Using a variety of techniques, including sequence alignment, secondary structure
      prediction, molecular mechanics and molecular dynamics, we have constructed a
      model for the three-dimensional structure of P-450arom (human aromatase) based on
      that of P-450cam, the only cytochrome P-450 enzyme for which the crystal
      structure is known. The predicted structure is found to be in good agreement with
      current experimental data; both direct, from site-directed mutagenesis studies,
      and indirect, from the consideration of the structures and activities of known
      substrates and inhibitors.

PMID- 8476755
TI  - Structure-activity relationships and binding model of novel aromatase inhibitors.
AB  - The use of aromatase inhibitors is an established therapy for oestrogen-dependent
      breast cancer in postmenopausal women. However, the sole commercially available
      aromatase inhibitor, aminoglutethimide, is not very selective. We have therefore
      developed fadrozole hydrochloride and CGS 20,267, which are both currently under
      clinical evaluation. This report will present an analysis of structure-activity
      relationships in the azole series of inhibitors and give an account of the
      further optimization of our development compounds, starting from CGS 20,267 over
      CGP 45,688 and leading to CGP 47,645, the most potent aromatase inhibitor in vivo
      reported to date. In addition, on the basis of comparisons of these azole-type
      inhibitors with the most potent steroidal inhibitors published in the literature,
      we propose a CAMM-generated model describing the relative binding modes of these
      two classes of compounds at the active site of the enzyme.

PMID- 8476756
TI  - Regulation of the rat aromatase gene in ovarian granulosa cells and R2C Leydig
      cells.
AB  - Aromatase cytochrome P450 is regulated in granulosa cells of ovarian follicles by
      the synergistic action of FSH and steroids. The effect of FSH can be mimicked by
      forskolin suggesting that transcription of the aromatase gene is regulated by
      cAMP. In contrast, aromatase is constitutively expressed in the rat R2C Leydig
      cells. To characterize the functional regions of the promoter in these two cell
      types, a fragment containing 534 bp of the aromatase promoter sequence and
      various deletion mutants were ligated to a reporter gene, chloramphenicol acetyl
      transferase and used in transient transfection assays. The results suggest that
      the region between -176 and -31 bp is essential both for cAMP regulation in
      granulosa cells and constitutive expression in R2C cells. Nuclear proteins from
      granulosa and R2C cells specifically bind the -176 fragment in an electrophoretic
      mobility shift assay. Binding was completed by an oligonucleotide (-90/-66 bp)
      containing a hexameric sequence, AGGTCA, which has been found in the promoters of
      other steroidogenic genes. These results suggest that cAMP regulation and
      constitutive expression of the rat aromatase promoter requires sequences between 
      176 and -31 bp, particularly the sequence AGGTCA at -82/.-77 and nuclear proteins
      binding to these sequences.

PMID- 8476757
TI  - Local regulation of primate granulosa cell aromatase activity.
AB  - Granulosa cells produce inhibin and activin, proteins implicated in the local
      regulation of preovulatory follicular development. To assess interactions among
      FSH, LH, inhibin and activin on primate granulosa cell aromatase activity, we
      studied primary granulosa cell cultures from the ovaries of the common marmoset
      (Callithrix jacchus), a monkey with an ovarian cycle similar in length to the
      human cycle. The distinctive action of activin was augmentation of gonadotropin
      responsive aromatase activity throughout antral follicular development. FSH
      stimulated aromatase activity in granulosa cells from immature follicles was
      augmented many fold by picomolar amounts of activin. In cell cultures from
      preovulatory follicles, the presence of activin stimulated basal aromatase
      activity in the absence of gonadotropin, as well as augmenting the action of LH.
      Thus, locally produced activin has the potential to modulate aromatase activity
      in developing ovarian follicles. By contrast, inhibin or inhibin alpha-subunit
      purified from bovine follicular fluid had minimal effects on aromatase activity.
      The only significant effect was slight suppression of FSH-inducible aromatase
      activity in granulosa cells from immature follicles at an inhibin concentration
      of 100 ng/ml. The finding that inhibin has a negligible effect on aromatase
      activity in granulosa cells from mature follicles suggests that it is unlikely to
      exert a physiologically significant influence on aromatase activity in vivo.
      However, evidence from other studies suggests that inhibin might affect
      aromatization indirectly through acting locally to modulate thecal androgen
      (aromatase substate) production. Therefore, both inhibin and activin have the
      potential to contribute at different levels to paracrine and autocrine regulation
      of follicular oestrogen synthesis.

PMID- 8476758
TI  - Interactions between FSH, estradiol-17 beta and transforming growth factor-beta
      regulate growth and differentiation in the rat gonad.
AB  - Estradiol-17 beta (E2) is a mitogen in vivo for the proliferation of granulosa
      cells in the rat ovary. E2 is synthesized by the preovulatory follicle through a
      series of gonadotrophin-dependent events: LH stimulates thecal cells to
      synthesize androgens (androstenedione and testosterone) which are substrates for
      FSH-induced aromatization to estrogens in granulosa cells. More recently, we have
      found that transforming growth factor-beta (TGF-beta) stimulates DNA synthesis in
      rat granulosa cells in vitro and this effect is augmented by FSH. Since E2 is a
      mitogen in vivo and TGF-beta is the only known growth factor to stimulate
      proliferation in vitro, the possible link between the actions of E2 and TGF-beta
      were examined. E2 stimulated the secretion of a TGF-beta-like factor by rat
      granulosa cells in culture, and with time DNA synthesis was stimulated. The
      mitogenic action of E2 was enhanced in the presence of FSH, and attenuated by a
      neutralizing antibody to TGF-beta. The latter observations have identified TGF
      beta as the "missing-link" in the mitogenic actions of E2 on rat granulosa cells.
      In addition to the growth-promoting actions of TGF-beta plus FSH, TGF-beta
      enhanced FSH-induced aromatase activity. Consequently, FSH plus TGF-beta
      stimulates both the proliferation and aromatization capacity of rat granulosa
      cells. We propose that interactions between FSH, E2 and TGF-beta lead to the
      exponential increase in serum E2 levels that occurs during the follicular phase
      of the cycle. Similarly, FSH stimulates the aromatization of exogenous androgens
      to estrogen by Sertoli cells isolated from immature rat testes, and there is a
      correlation between FSH-induced aromatization and mitotic activity. We have shown
      that FSH plus TGF-beta stimulates DNA synthesis in Sertoli cells. Since E2
      increases the secretion of TGF-beta by Sertoli cells, interactions between FSH,
      E2 and TGF-beta may provide the mitogenic stimulus for Sertoli cells during the
      prepubertal period. In summary, our findings suggest that the estrogen-induced
      growth of rat granulosa cells is mediated through the production of TGF-beta,
      which acts as an autocrine regulator of proliferation. We also propose that the
      growth-promoting actions of FSH on Sertoli cells may depend upon a cascade series
      of events involving estrogens and TGF-beta.

PMID- 8476759
TI  - Regulation of the aromatase activity of human placental cytotrophoblasts by
      insulin, insulin-like growth factor-I, and -II.
AB  - Studies to be reviewed were stimulated by the clinical observation, albeit
      controversial, that diabetic pregnancy may be associated with lower serum
      oestrogen levels than nondiabetic pregnancy. Pregnant diabetic women are usually
      intensively treated with insulin to maintain euglycemia, frequently resulting in
      peripheral hyperinsulinemia. The placenta, which is the primary source of
      oestrogens during pregnancy, would be exposed to this elevation in circulating
      insulin levels. Similarly, insulin-like growth factors (IGFs), which are
      synthesized and secreted by placental tissues and could influence placental
      function in an autocrine or paracrine fashion, may be elevated in diabetic
      pregnancy. We will review studies, which show that (i) insulin, insulin-like
      growth factor-I (IGF-I), and -II inhibit the aromatase activity of human
      cytotrophoblasts, (ii) these peptides can inhibit aromatase by activation of
      their respective receptors, and (iii) the potency of IGF-II in suppressing
      aromatase greatly exceeds that of either insulin or IGF-I. Finally, evidence will
      be reviewed, which suggests that inositol-glycan mediators ('second messengers')
      serve as the signal transduction system for insulin's inhibition of aromatase
      activity. Hence, placental exposure to increased concentrations of insulin and/or
      IGFs in the pregnant diabetic woman may result in inhibition of aromatase
      activity and decreased serum oestrogen levels.

PMID- 8476760
TI  - Estrogen production by fetal rat gonads.
AB  - Aromatase activity in fetal rat testes and ovaries was demonstrated by the
      conversion of tritiated testosterone or 19-hydroxyandrostenedione into estrone
      and estradiol, which were identified and quantified by double isotopic dilution
      and recrystallization to constant specific activity. Testes formed mostly
      estradiol, ovaries mostly estrone. Aromatase activity was stimulated by cAMP in
      both the testes and ovaries as early as 17 days of fetal life. Stimulation by FSH
      was noted at this same stage in the testis, but not before 3-4 days after birth
      in the ovary. LH was without effect on aromatase activity in both kinds of
      gonads. Basal estrogen secretion was non-existent or undetectable in both the
      testes and ovaries in fetal stages. In the presence of cAMP and as early as 17
      days of fetal life, the testes released estradiol, as early as 14 days the
      ovaries released estrone. Estrogen secretion was stimulated by LH and FSH at
      fetal stages in the testis and at infantile stages in the ovary. Responsiveness
      to gonadotrophins closely followed the appearance of the receptors.

PMID- 8476761
TI  - Estrogen productivity of endometrium and endometrial cancer tissue; influence of
      aromatase on proliferation of endometrial cancer cells.
AB  - Aromatase, estrone (E1) sulfatase and E1 sulfotransferase activities were
      examined in endometrium and endometrial cancer tissue preparations. Aromatase and
      E1 sulfatase activities in endometrial cancer tissues were found to be
      significantly higher than in normal endometrial tissues. However, E1
      sulfotransferase activity did not differ between benign and malignant tissue. We
      also examined the effect of testosterone (T) on aromatase activity and tritiated
      thymidine uptake (DNA synthesis) in various cultured cervical or corpus
      endometrial cancer cell lines (OMC-4, HHUA, Ishikawa, HEC-59). The results
      demonstrated that only the HEC-59 cell line had high aromatase activity and
      increased its DNA synthesis in response to T. This increase of DNA synthesis by T
      was not suppressed by simultaneous addition of cyproterone acetate, but was by
      tamoxifen. These data suggest that in situ estrogen production in endometrial
      cancer tissue is biologically important and that aromatase in cancer cells may
      contribute partially to cell proliferation if androgen substrate is provided.

PMID- 8476762
TI  - Multiple functions of aromatase and the active site structure; aromatase is the
      placental estrogen 2-hydroxylase.
AB  - Androgen aromatase was found to also be estrogen 2-hydroxylase. The substrate
      specificity among androgens and estrogens and multiplicity of aromatase reactions
      were further studied. Through purification of human placental microsomal
      cytochrome P-450 by monoclonal antibody-based immunoaffinity chromatography and
      gradient elution on hydroxyapatite, aromatase and estradiol 2-hydroxylase
      activities were co-purified into a single band cytochrome P-450 with approx. 600
      fold increase of both specific activities, while other cytochrome P-450 enzyme
      activities found in the microsomes were completely eliminated. The purified P-450
      showed M(r) of 55 kDa, specific heme content of 12.9 +/- 2.6 nmol.mg-1 (+/- SD, n
      = 4), reconstituted aromatase activity of 111 +/- 19 nmol.min-1.mg-1 and
      estradiol 2-hydroxylase activity of 5.85 +/- 1.23 nmol.min-1.mg-1. We found no
      evidence for the existence of catechol estrogen synthetase without concomitant
      aromatase activity. The identity of the P-450 for the two different hormone
      synthetases was further confirmed by analysis of the two activities in the stable
      expression system in Chinese hamster ovarian cells transfected with human
      placental aromatase cDNA, pH beta-Aro. Kinetic analysis of estradiol 2
      hydroxylation by the purified and reconstituted aromatase P-450 in 0.1 M
      phosphate buffer (pH 7.6) showed Km of 1.58 microM and Vmax of 8.9 nmol.min-1.mg
      1. A significant shift of the optimum pH and Vmax, but not the Km, for placental
      estrogen 2-hydroxylase was observed between microsomal and purified preparations.
      Testosterone and androstenedione competitively inhibited estradiol 2
      hydroxylation, and estrone and estradiol competitively inhibited aromatization of
      both testosterone and androstenedione. Estrone and estradiol showed Ki of 4.8 and
      7.3 microM, respectively, for testosterone aromatization, and 5.0 and 8.1 microM,
      respectively, for androstenedione aromatization. Androstenedione and testosterone
      showed Ki of 0.32 and 0.61 microM, respectively, for estradiol 2-hydroxylation.
      Our studies showed that aromatase P-450 functions as estrogen 2-hydroxylase as
      well as androgen 19-, 1 beta-, and 2 beta-hydroxylase and aromatase. The results
      indicate that placental aromatase is responsible for the highly elevated levels
      of the catechol estrogen and 19-hydroxyandrogen during pregnancy. These results
      also indicate that the active site structure holds the steroid substrates to face
      their beta-side of the A-ring to the heme, tilted in such a way as to make the 2
      position of estrogens and 19-, 1-, and 2-positions of androgens available for
      monooxygenation.

PMID- 8476763
TI  - Aromatase immunoreactivity in the rat brain: gonadectomy-sensitive hypothalamic
      neurons and an unresponsive "limbic ring" of the lateral septum-bed nucleus
      amygdala complex.
AB  - The aromatase (estrogen synthetase) enzyme catalyzes the conversion of androgens
      to estrogens in peripheral tissues, as well as in the brain. Our study aimed at
      comparing the brain distribution of aromatase-immunoreactive neurons in male and
      female, normal and gonadectomized rats. Light microscopic immunostaining was
      employed using a purified polyclonal antiserum raised against human placental
      aromatase. Two anatomically separate aromatase-immunoreactive neuronal systems
      were detected in the rat brain: A "limbic telencephalic" aromatase system was
      composed by a large population of labeled neurons in the lateral septal area, and
      by a continuous "ring" of neurons of the laterodorsal division of the bed nucleus
      of stria terminalis, central amygdaloid nucleus, stria terminalis, and the
      substantia inominata-ventral pallidum-fundus striati region. The other,
      "hypothalamic" aromatase system consisted of neurons scattered in a dorsolateral
      hypothalamic area including the paraventricular, lateral and dorsomedial
      hypothalamic nuclei, the subincertal nucleus as well as the zona incerta. In
      addition, a few axon-like processes (unresponsive to gonadectomy) were present in
      the preoptic-anterior hypothalamic complex, the ventral striatum, and midline
      thalamic regions. No sexual dimorphism was observed in the distribution or
      intensity of aromatase-immunostaining. However, 3 days, 2, 3, 8, 16, or 32 weeks
      after gonadectomy, aromatase-immunoreactive neurons disappeared from the
      hypothalamus, whereas they were still present in the limbic areas of both sexes.
      The results indicate the existence of two distinct estrogen-producing neuron
      systems in the rat brain: (1) a "limbic ring" of aromatase-labeled neurons of the
      lateral septum-bed nucleus-amygdala complex unresponsive to gonadectomy; and (2)
      a sex hormone-sensitive "hypothalamic" aromatase neuron system.

PMID- 8476764
TI  - Aromatase activity in the rat brain: hormonal regulation and sex differences.
AB  - The intracellular conversion of testosterone to estradiol by the aromatase enzyme
      complex is an important step in many of the central actions of testosterone. In
      rats, estrogen given alone, or in combination with dihydrotestosterone, mimics
      most of the behavioral effects of testosterone, whereas treatment with
      antiestrogens or aromatase inhibitors block facilitation of copulatory behavior
      by testosterone. We used a highly sensitive in vitro radiometric assay to analyze
      the distribution and regulation of brain aromatase activity. Studies using
      micropunch dissections revealed that the highest levels of aromatase activity are
      found in an interconnected group of sexually dimorphic nuclei which constitutes a
      neural circuit important in the control of male sexual behavior. Androgen
      regulated aromatase activity in many diencephalic nuclei, including the medial
      preoptic nucleus, but not in the medial and cortical nuclei of the amygdala.
      Additional genetic evidence for both androgen-dependent and -independent control
      of brain AA was obtained by studies of androgen-insensitive testicular-feminized
      rats. These observations suggest that critical differences in enzyme
      responsiveness are present in different brain areas. Within several nuclei, sex
      differences in aromatase induction correlated with differences in nuclear
      androgen receptor concentrations suggesting that neural responsiveness to
      testosterone is sexually differentiated. Estradiol and dihydrotestosterone acted
      synergistically to regulate aromatase activity in the preoptic area. In addition,
      time-course studies showed that estrogen treatment increased the duration of
      nuclear androgen receptor occupation in the preoptic area of male rats treated
      with dihydrotestosterone. These results suggest possible ways that estrogens and
      androgens may interact at the cellular level to regulate neural function and
      behavior.

PMID- 8476765
TI  - Aromatase: neuromodulator in the control of behavior.
AB  - Estrogens are required for both the organization of the brain in early
      development and adult behavior. Two approaches have been used in our laboratory
      to study the behavioral role of brain aromatase. First, brain metabolism of
      testosterone (T) has been related to behavior in the same individual using a well
      established neuroendocrine model, the ring dove, in which estradiol-17 beta (E2)
      has specific effects on brain mechanisms of male behavior. Aromatase in preoptic
      area (POA) (a) has a high activity (Vmax) and strong substrate binding affinity
      (Km < 5 nM), (b) is regulated by both androgens and estrogens, and the type of
      regulation differs according to brain area, (c) is influenced by products of an
      endogenous inactivating pathway, 5 beta-reduction; 5 beta-dihydrotestosterone and
      other 5 beta-reduced metabolites appear to be non-genomic regulators of the brain
      aromatase. Preoptic aromatase activity is also influenced by photoperiod and
      socio-sexual stimuli. The codistribution of regulated aromatase activity and
      estrogen receptor cells is found to be T-dependent. Our second approach has been
      to relate the aromatase system to developmental sex differences in brain
      structure and behavior of the Mongolian gerbil. Neonatal gerbil aromatase is
      relatively active in the POA, but has a weaker T substrate-binding affinity (Km =
      30 nM) than the dove. T acting via its metabolite, E2, masculinizes the sexually
      dimorphic area of the hypothalamus; the differentiating effect is asymmetric. We
      suggest that the regulation of the brain aromatase system may be lateralized
      during steroid-sensitive periods of development.

PMID- 8476766
TI  - Brain aromatase and the control of male sexual behavior.
AB  - The activational effects of testosterone (T) on male copulatory behavior are
      mediated by its aromatization into estradiol. In quail, we have shown by
      stereotaxic implantation of steroids and metabolism inhibitors and by
      electrolytic lesions that the action of T and its aromatization take place in the
      sexually dimorphic medial preoptic nucleus (POM). The distribution and regulation
      of brain aromatase was studied in this species by product-formation assays
      measuring aromatase activity (AA) in microdissected brain regions and by
      immunocytochemistry (ICC). Aromatase-immunoreactive (ARO-ir) neurons were found
      in four brain regions: the POM, the septal region, the bed nucleus of the stria
      terminals (BNST) and the tuberal hypothalamus. ARO-ir cells actually outline the
      POM boundaries. ARO-ir material is found not only in the perikarya of neurons but
      also in the full extension of their cellular processes including the axons and
      the presynaptic boutons. This is confirmed at the light level by the
      demonstration of immunoreactive fibers and punctate structures in brain regions
      that are sometimes fairly distant from the closest ARO-ir cells. A lot of ARO-ir
      cells in the POM and BNST do not contain immunoreactive estrogen receptors (ER
      ir) as demonstrated by double label ICC. These morphological data suggest an
      unorthodox role for the enzyme or the locally formed estrogens. In parallel with
      copulatory behavior, the preoptic AA decreases after castration and is restored
      by T to levels seen in sexually mature males. This probably reflects a change in
      enzyme concentration rather than a modulation of the activity in a constant
      number of molecules since the maximum enzymatic velocity (Vmax) only is affected
      while the affinity (Km) remains unchanged. In addition, T increases the number of
      ARO-ir neurons in POM and other brain areas suggesting that the concentration of
      the antigen is actually increased. This probably involves the direct activation
      of aromatase transcription as demonstrated by RT-PCR studies showing that
      aromatase mRNA is increased following T treatment of castrates. These activating
      effects of T seem to result from a synergistic action of androgenic and
      estrogenic metabolites of the steroid. The anatomical substrate for these
      regulations remains unclear at present especially in POM where ARO-ir cells do
      not in general contain ER-ir while androgen receptors appear to be rare based on
      both [3H] dihydrotestosterone autoradiography and ICC. Transynaptic mechanisms of
      control may be considered. A modulation of brain aromatase by catecholamines is
      also suggested by a few pharmacological studies.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8476767
TI  - Molecular and cellular physiology of aromatase in the brain and retina.
AB  - Due to exceptionally high brain aromatase activity, teleost fish are advantageous
      for studying neural aromatase regulation, localization, and physiology. To
      determine the molecular mechanism of enhanced expression, we have isolated,
      cloned and sequenced a 3 kb full-length aromatase cDNA from a goldfish (Carassius
      auratus) brain library using a human placental aromatase cDNA as probe. The
      deduced sequence of goldfish aromatase is 510 amino acids (predicted Mw, 58 kDa)
      with 69% overall sequence similarity, when compared to human placental aromatase,
      and higher homologies in presumptive functional domains. A major 3 kb mRNA
      species was abundant in brain and low or non-detectable in non-neural tissues,
      reflecting the order of enzyme activities. To determine the cellular basis of
      high enzyme activity in goldfish brain, a human placental aromatase antibody was
      used to immunolocalize labeled cells. This antibody immunoprecipitated a single
      56 kDa in vitro translation product of goldfish brain poly(A+)RNA and revealed
      discrete clusters of intensely stained neurons, processes, and terminals
      concentrated in, but not limited to, reproductive brain centers. Close proximity
      of aromatase- and androgen receptor-positive neurons in certain regions provides
      anatomic evidence of a functional relationship between direct and indirect
      pathways of neural androgen action. Aromatase-positive neurons and fibers formed
      interconnected networks in novel loci (e.g. retina-->optic tract-->optic tectum),
      and catalytic activity was confirmed biochemically in these tissues, indicating
      that neuroestrogen may have a role in visual input and integration. Availability
      of goldfish-specific nucleotide and antibody probes will facilitate further
      studies using this model.

PMID- 8476768
TI  - Aromatase in the human testis.
AB  - Low levels of testicular estrogen synthesis have been reported in a number of
      species, but the cellular localization has not been unequivocally established. To
      study aromatase in the human testis, we have combined immunocytochemistry with
      direct measurement of enzyme activity in the testicular 6 microns cryosections.
      Thus, the functionality of the immunoreaction and its sensitivity can be assessed
      in quantitative terms. Testes were obtained from immediate autopsy from men aged
      18-53 years, from surgery from two patients with prostatic cancer (67 and 74
      years) and from two normal children aged 8 months and 3 years at autopsy. Benign
      testicular sex cord tumors were also examined from two unrelated patients aged 5
      and 8 years with gynecomastia and diagnosed with Peutz-Jeghers syndrome. Our
      results consistently showed low to moderate staining intensity of immunoreactive
      aromatase in comparison to that of normal human placental cryosections.
      Immunoreactive aromatase was only present in the interstitial Leydig cells and
      absent from the Sertoli cells of all normal adult testes showing spermatogenesis.
      Aromatase activity correlated well with the intensity of the immunostain.
      However, there was no obvious relationship between the level of aromatase
      activity and increasing age. Generally higher levels were present in testes of
      young men (18-22 years). No immunostain in any cell type was detected in one 33
      year-old patient with testicular cancer. In the testes of the two normal
      prepubertal boys, no immunostaining was observed. However, intensely stained
      Sertoli cells as well as high aromatase activity were observed in the testicular
      tumors of the patients with Peutz-Jeghers syndrome. Our results suggest that
      Leydig cells are the source of aromatase in normal men but that Sertoli cells may
      express this enzyme under abnormal conditions. The combined methods for measuring
      enzyme activity and immunoreactive aromatase are suitable for application to
      tissues expressing low levels of aromatase.

PMID- 8476769
TI  - Local aromatase activity in human breast tissues.
AB  - The presence of oestradiol in malignant breast cells is considered to be an
      important factor in the promotion of growth of the tumor. Therefore the
      regulation of the local high intra-tissue oestradiol concentrations, regardless
      of plasma concentrations, has been investigated. Experimental evidence suggests
      that in situ biosynthesis of oestrogens is at least partly responsible for the
      local accumulation of these steroids. In this paper we report further data on
      measurements in fatty and tumor tissues of local aromatase activities and of
      concentrations of substrates and products of this enzyme. Data are given on
      localization of aromatase and on steroid concentrations in tumors and in adipose
      tissues dissected from different quadrants of breasts with malignant tumors. In
      adipose tissues small variations in steroid concentrations in fatty tissues were
      found. No tumor-directed gradients in the adipose tissue-concentrations of the
      androgens dehydro-epiandrosterone, 5-androstene-3 beta, 17 beta-diol, 4
      androstene-3,17-dione and testosterone and of the oestrogens oestradiol, oestrone
      and their sulfates could be detected. Furthermore no consistent pattern could be
      recognized in the aromatase activities in the fatty tissues dissected from tumor
      bearing and non-affected quadrants of the same breast. No correlations between
      aromatase activity measured in vitro and product concentrations in vivo were
      found. Therefore the mechanisms for regulation of the local oestradiol levels in
      breast tissues remain unknown.

PMID- 8476770
TI  - Prognostic significance of aromatase and estrone sulfatase enzymes in human
      breast cancer.
AB  - The aromatase and estrone sulfatase enzymes are important sources of local
      synthesis of biologically active estrogens in human breast cancer. Significant
      intratumoral aromatase activity was detected in 91/145 (63%) of tumors and
      estrone sulfatase was detected in 93/104 (89%) of tumors. There was no
      relationship between aromatase activity and tumor size, site, nodal status,
      menopausal status or estrogen receptor status. There was a significant
      correlation between the aromatase activity and histological grade, with an excess
      of aromatase-positive in the high grade tumors (P = 0.03). There was a marginally
      inverse correlation between the aromatase activity and time to relapse (P < 0.1),
      a significant correlation between aromatase activity and survival after relapse
      (P < 0.05) but not with overall survival (P > 0.1). Intratumoral estrone
      sulfatase activity was not significantly correlated to any putative prognostic
      factors, nor with time to relapse nor overall survival time.

PMID- 8476771
TI  - Control of aromatase activity in breast cancer cells: the role of cytokines and
      growth factors.
AB  - The aromatase complex has a key role in regulating oestrogen formation in normal
      and malignant breast tissues. Using dexamethasone-treated fibroblasts, derived
      from breast tumours, breast tumour cytosol and breast tumour-derived conditioned
      medium (CM) markedly stimulate aromatase activity. The cytokine, interleukin-6
      (IL-6) has been identified as a factor present in CM which is capable of
      stimulating aromatase activity. To examine whether IL-6 may have a role in vivo
      in regulating breast tissue aromatase activity, IL-6 production and aromatase
      activity in breast tumour and adipose tissue from breast quadrants were examined.
      In 5/6 breasts examined so far, aromatase activity was highest in adipose tissue
      in the breast quadrant containing the tumour or on which the tumour impinged.
      There was a significant correlation (P < 0.05, Kendall's rank correlation)
      between IL-6 production and aromatase activity in these breast tissues. It is
      concluded that IL-6 may have an important role in regulating aromatase activity
      in breast tissues.

PMID- 8476772
TI  - Effect of androstenedione on growth of untransfected and aromatase-transfected
      MCF-7 cells in culture.
AB  - Aromatase is present in human breast tumors and in breast cancer cell lines
      suggesting the possibility of in-situ estrogen production via the androstenedione
      to estrone and estradiol pathway. However, proof of the biologic relevance of
      aromatase in breast cancer tissue requires the demonstration that this enzyme
      mediates biologic effects on cell proliferation. Accordingly, we studied the
      effects of the aromatase substrate, androstenedione, on the rate of proliferation
      of wild-type and aromatase-transfected MCF-7 breast cancer cells. Androstenedione
      did not increase cell growth in wild-type MCF-7 cells which contained relatively
      low aromatase activity and produced 4-fold more estrone than estradiol. In
      contrast, aromatase-transfected cells contained higher amounts of aromatase,
      produced predominantly estradiol, and responded to androstenedione with enhanced
      growth. An aromatase inhibitor fadrozole hydrochloride, blocked the proliferative
      effects of androstenedione providing evidence for the role of aromatase in this
      process. As further evidence of the requirement for aromatase, cells transfected
      with the neomycin resistance expression plasmid but lacking the aromatase cDNA
      did not respond to androstenedione. These studies provide evidence that aromatase
      may have a biologic role for in-situ synthesis of estrogens in breast cancer
      tissue.

PMID- 8476773
TI  - Biological characterization of A-ring steroids.
AB  - Hydroxylated 2,19-methylene-bridged androstenediones were designed as potential
      mimics of enzyme oxidized intermediates of androstenedione. These compounds
      exhibited competitive inhibition with low micromolar affinities for aromatase.
      These inhibitory constants (Ki values) were 10 times greater than the 2,19
      methylene-bridged androstenedione constant (Ki = 35-70 nM). However, expansion of
      the 2,19-carbon bridge to ethylene increased aromatase affinity by 10-fold (Ki =
      2 nM). Substitution of a methylene group with oxygen and sulfur in this expanded
      bridge resulted in Ki values of 7 and 20 nM, respectively. When the substituent
      was an NH group, the apparent inhibitory kinetics changed from competitive to
      uncompetitive. All of these analogs exhibited time-dependent inhibition of
      aromatase activity following preincubation of the inhibitor with human placental
      microsomes prior to measuring residual enzyme activity. Part of this inhibition
      was NADPH cofactor-dependent for the 2,19-methyleneoxy- but not for the 2,19
      ethylene-bridged androstenedione. The time-dependent inhibition for these four
      analogs was very rapid since they exhibited tau 50 values, the t1/2 for enzyme
      inhibition at infinite inhibitor concentration, of 1 to 3 min. These A-ring
      bridged androstenedione analogs represent a novel series of potent steroidal
      aromatase inhibitors. The restrained A-ring bridge containing CH2, O, S, or NH
      could effectively coordinate with the heme of the P450 aromatase to allow the
      tight-binding affinities reflected by their nanomolar Ki values.

PMID- 8476774
TI  - Anti-tumor and endocrine effects of non-steroidal aromatase inhibitors on
      estrogen-dependent rat mammary tumors.
AB  - The non-steroidal aromatase inhibitor CGS 20,267, at maximally effective doses in
      non-tumor bearing adult female rats, elicits endocrine effects mimicking those
      seen after surgical ovariectomy and thus induces a "medical" ovariectomy. We now
      report on studies characterizing the anti-tumor and endocrine effects of three
      orally active non-steroidal aromatase inhibitors, CGS 20,267, CGP 45,688 and CGP
      47,645, in adult female rats bearing estrogen-dependent DMBA-induced mammary
      tumors. Doses ranging from 3 to 3000 micrograms/kg were given by gavage once
      daily for 6 weeks. After 6 weeks of treatment, the ED50 for suppression of tumor
      volume was 10-30, 100 and 3-10 micrograms/kg for CGS 20,267, CGP 45,688 and CGP
      47,645, respectively. The maximally effective dose for anti-tumor efficacy was
      300, 1000 and 100 micrograms/kg for each of the three inhibitors, respectively.
      The observed potent anti-tumor efficacy was accompanied by potent endocrine
      effects. Thus, disruption of ovarian cyclicity (at maximal doses rats remained in
      constant diestrus) was observed in all animals from the 2nd or 3rd week of
      treatment to the end of the 6-week treatment period. Uterine weight, at the
      maximally effective doses for each of the three inhibitors, was suppressed to
      between 42 and 28% of pre-treatment levels. This suppression was similar to the
      suppression of uterine weight (27% of pre-treatment) seen after ovariectomy.
      Serum estradiol concentrations in rats treated with 300 micrograms/kg CGS 20,267
      were significantly suppressed to 12% of pre-treatment levels and serum
      luteinizing hormone (LH) concentrations were elevated 3 to 4-fold over pre
      treatment levels. Thus the potent anti-tumor efficacy seen with each of the three
      non-steroidal aromatase inhibitors was accompanied in each case by a variety of
      endocrine effects corresponding to those seen after ovariectomy.

PMID- 8476775
TI  - Distribution of aromatase activity in cultured neurons and glia cells.
AB  - Aromatase plays a crucial role in the mechanism of action of testosterone in the
      central nervous system. Nevertheless, the exact cellular localization of this
      enzymatic complex within the different cell populations of the brain is still
      uncertain. In the experiments described here the presence of aromatase (assayed
      by the tritiated water method) has been evaluated in the two main cellular
      components of the brain: neurons and glia. Neurons, mixed glial cells, type 1
      astrocytes, were obtained in cultures; oligodendrocytes were prepared by gradient
      ultracentrifugation. The results indicate that, among the different cells tested,
      only neurons possess a significant degree of aromatase activity, while the
      enzymatic activity is extremely low in mixed glial cell and in astrocyte
      preparations. Oligodendrocytes seem to be completely inactive in this respect.

PMID- 8476776
TI  - Action of endogenous steroid inhibitors of brain aromatase relative to fadrozole.
AB  - To study mechanisms of aromatase inhibition in brain cells, a highly effective
      non-steroidal aromatase inhibitor (Fadrozole; 4-[5,6,7,8-tetra-hydroimidazo- (1,5
      a)-pyridin-5-yl] benzonitrile HCl; CGS 16949A) was compared with endogenous C-19
      steroids, known to be formed in the preoptic area, which inhibit oestrogen
      formation. Using a sensitive in vitro tritiated water assay for aromatase
      activity in avian (dove) preoptic tissue, the order of potency, with testosterone
      as substrate was: Fadrozole (Ki < 1 x 10(-9) M) > 4-androstenedione > 5 alpha
      androstanedione > 5 alpha-dihydrotestosterone (Ki = 6 x 10(-8) M) > 5 beta
      androstanedione > 5 beta-dihydrotestosterone (Ki = 3.5 x 10(-7) M) > 5 alpha
      androstane-3 alpha,17 beta-diol (Ki = 5 x 10(-6) M) > 5 beta-androstane-3 beta,17
      beta-diol. Five other steroids, 5 beta-androstane-3 alpha,17 beta-diol, 5 alpha
      androstane-3 beta,17 beta-diol, progesterone, oestradiol and oestrone, showed no
      inhibition at 10(-4) M. The kinetics indicate that endogenous C-19 steroids show
      similar competitive inhibition of the aromatase as Fadrozole. Mouse (BALB/c)
      preoptic aromatase was also inhibited by Fadrozole. We conclude that endogenous C
      19 metabolites of testosterone are effective inhibitors of the brain aromatase,
      and suggest that they bind competitively at the same active site as Fadrozole.

PMID- 8476777
TI  - Competitive product inhibition of aromatase by natural estrogens.
AB  - In order to better understand the function of aromatase, we carried out kinetic
      analyses to assess the ability of natural estrogens, estrone (E1), estradiol
      (E2), 16 alpha-OHE1, and estriol (E3), to inhibit aromatization. Human placental
      microsomes (50 micrograms protein) were incubated for 5 min at 37 degrees C with
      [1 beta-3H]testosterone (1.24 x 10(3) dpm 3H/ng, 35-150 nM) or [1 beta-3H,4
      14C]androstenedione (3.05 x 10(3) dpm 3H/ng, 3H/14C = 19.3, 7-65 nM) as substrate
      in the presence of NADPH, with and without natural estrogens as putative
      inhibitors. Aromatase activity was assessed by tritium released to water from the
      1 beta-position of the substrates. Natural estrogens showed competitive product
      inhibition against androgen aromatization. The Ki of E1, E2, 16 alpha-OHE1, and
      E3 for testosterone aromatization was 1.5, 2.2, 95, and 162 microM, respectively,
      where the Km of aromatase was 61.8 +/- 2.0 nM (n = 5) for testosterone. The Ki of
      E1, E2, 16 alpha-OHE1, and E3 for androstenedione aromatization was 10.6, 5.5,
      252, and 1182 microM, respectively, where the Km of aromatase was 35.4 +/- 4.1 nM
      (n = 4) for androstenedione. These results show that estrogen inhibit the process
      of androgen aromatization and indicate that natural estrogens regulate their own
      synthesis by the product inhibition mechanism in vivo. Since natural estrogen
      binds to the active site of human placental aromatase P-450 complex as
      competitive inhibitors, natural estrogens might be further metabolized by
      aromatase. This suggests that human placental estrogen 2-hydroxylase activity is
      catalyzed by the active site of aromatase cytochrome P-450 and also agrees with
      the fact that the level of catecholestrogens in maternal plasma increases during
      pregnancy. The relative affinities and concentration of androgens and estrogens
      would control estrogen and catecholestrogen biosynthesis by aromatase.

PMID- 8476778
TI  - Relationship between aromatase activity and steroid receptor levels in ovarian
      tumors from postmenopausal women.
AB  - Aromatase activity, as well as steroid receptors, exists in nonfunctional ovarian
      tumors. Steroid receptor status has been reported to be related to prognosis in
      ovarian cancer patients. We determined aromatase activity and progesterone
      receptor (PR) and estrogen receptor (ER) levels in 43 ovarian tumors obtained
      from postmenopausal women. Aromatase activity was detected in 35 tumors (81%), PR
      in 21 tumors (49%) and ER in 13 tumors (30%). Eighty-three percent (10/12) of
      mucinous cystadenoma tissues showed positive PR with high aromatase activity,
      while 93% (13/14) of malignant tumors showed negative PR and low aromatase
      activity. Aromatase activity was detected in 95% (20/21) of PR-positive tumors,
      being greater than in PR-negative tumors (P < 0.002). There was a positive
      correlation between aromatase activity and PR (rs = 0.49, P < 0.001). However,
      there was no correlation between aromatase activity and ER. In 17 patients (43%),
      the serum estradiol level was higher than 30 pg/ml and there was a positive
      correlation among estradiol, estrone, androstenedione and testosterone. However,
      serum steroid levels were not correlated with aromatase activity, PR or ER.
      Aminoglutethimide inhibited aromatase activity of benign and malignant ovarian
      tumors, uterine myoma, choriocarcinoma cells and purified human placental P
      450arom in a similar manner. These results suggest that aromatase activity is
      correlated with PR in ovarian tumors of postmenopausal women. In addition to
      steroid receptor status, aromatase activity may be a useful prognostic factor in
      ovarian cancers.

PMID- 8476779
TI  - Aromatase activity and the effect of estradiol and testosterone on DNA synthesis
      in endometrial carcinoma cell lines.
AB  - Human endometrial and breast carcinoma cell lines were examined for aromatase
      activity and the effects of sex steroids (estradiol and testosterone) on DNA
      synthesis. Aromatase activity was high (greater than 500 fmol/10(7) cells/24 h)
      in the cell lines MCF-7 and OMC-2, moderate (100-499 fmol/10(7) cells/24 h) in
      the cell lines HEC-59 and Ishikawa, and low (less than 100 fmol/10(7) cells/24 h)
      in the HHUA cell line. A substantial stimulation of DNA synthesis by estradiol
      (10(-9)M) was observed in cell lines HEC-59, OMC-2, and MCF-7, with an increase
      in [3H]thymidine uptake of over 250%. The Ishikawa cell line was stimulated
      moderately (115-249%). No estradiol-induced increase in DNA synthesis was
      observed in HHUA. Responsiveness of DNA synthesis to testosterone was observed in
      cell lines that showed the greatest response to estradiol, namely HEC-59, OMC-2,
      and MCF-7. Otherwise, estrogen-responsiveness did not always correlated with a
      significant aromatase activity. These data suggest that some but not all
      endometrial carcinomas may possess an aromatase-dependent growth stimulating
      system.

PMID- 8476780
TI  - Growth suppression of MCF-7 human breast cancer cells by aromatase inhibitors: a
      new system for aromatase inhibitor screening.
AB  - In our previous study we found that MCF-7 cells possess aromatase activity and
      stimulate estrogen receptor-mediated growth. The pathways through which androgens
      are converted to estrogens by aromatase and estrogens interact with estrogen
      receptors contribute significantly to growth stimulation. The administration of
      aromatase inhibitor results in suppression of growth stimulation by androgens.
      This system enabled us to assess directly the biological activities of aromatase
      inhibitors. Aromatase activity was inhibited in a dose-dependent manner by the
      addition of aminoglutethimide and CGS 16949A, competitive inhibitors, and of 14
      alpha-hydroxy-4-androstene-3,6,17-trione and 4-hydroxy-androstenedione, mechanism
      based inhibitors. After preincubation with mechanism-based inhibitors, aromatase
      activity was significantly suppressed, whereas after preincubation with
      competitive inhibitors, it was adversely increased. These effects were
      concentration- and time-dependent. Preincubation with competitive inhibitors
      resulted in augmentation of subsequent androgen stimulation of thymidine
      incorporation, while preincubation with mechanism-based inhibitors resulted in
      diminished stimulation by subsequent androgen administration. These results
      suggest that in MCF-7 cells competitive inhibitors adversely induce aromatase and
      accelerate the subsequent androgen stimulation of DNA synthesis. Suicide
      inhibitors are more effective than competitive inhibitors. This system will be
      useful for aromatase inhibitor screening.

PMID- 8476781
TI  - MCF-7 human breast carcinomas in nude mice as a model for evaluating aromatase
      inhibitors.
AB  - While hormone-dependent, mammary tumors induced with carcinogens (DMBA or NMU) in
      intact rats have been used extensively for studying aromatase inhibitors, there
      is currently no suitable model to investigate their effects in human breast
      cancers in vivo. While hormone responsive tumors can be formed in the athymic
      mouse using human breast carcinoma MCF-7 cells, due to the low ovarian estrogen
      production, tumor growth is induced with estradiol supplementation. Thus, this
      model is unsuitable for studies of aromatase inhibitors. We have induced tumors
      without the need for estrogen supplementation by co-inoculating MCF-7 cells with
      Matrigel, a basement membrane preparation, into intact athymic mice. In one
      experiment, 45 days after inoculation, mice were assigned to the control group or
      4-hydroxyandrostenedione (4-OHA) (1 mg/day s.c.) treatment for 52 days. Tumor
      volumes in the control mice increased 672%, whereas tumor volumes in the treated
      mice did not change significantly (178.9 +/- 16.2 to 336.6 +/- 120 mm3). In the
      second experiment, 55 days after inoculation, groups of mice were treated with
      the antiestrogen, tamoxifen (5 micrograms/day s.c.) or vehicle (controls). Tumor
      volumes in the control mice increased 325% in 58 days, whereas there was no
      significant change in tumor volume in the tamoxifen treated group (338.8 +/- 55.3
      to 330.6 +/- 84.9 mm3). The results suggest that (1) the tumors resulting from
      MCF-7 cells co-inoculated with Matrigel are estrogen-dependent and (2) tamoxifen
      and 4-OHA were effective in suppressing growth of these tumors. The results
      suggest that this model should be useful for evaluating the effects of aromatase
      inhibitors and for comparing breast cancer treatments.

PMID- 8476782
TI  - Substituted 1-[benzofuran-2-yl)-phenylmethyl]-imidazoles as potent inhibitors of
      aromatase in vitro and in female rats in vivo.
AB  - Substituted 1-[(benzofuran-2-yl)-phenylmethyl]-imidazoles are a new class of
      potent aromatase inhibitor with in vitro IC50 values < 10 nM for certain members
      using human placental enzyme. At a dose of 2 mg/kg in PMSG-stimulated rats,
      selected compounds effectively reduce the oestradiol levels by 82-98%.

PMID- 8476783
TI  - Inhibitory effect of combined treatment with the aromatase inhibitor exemestane
      and tamoxifen on DMBA-induced mammary tumors in rats.
AB  - The antitumor effect of exemestane (FCE 24304), an irreversible aromatase
      inhibitor, given alone or in combination with tamoxifen, was investigated in rats
      with 7,12-dimethylbenzanthracene (DMBA)-induced mammary tumors. The compounds
      were given once daily, 6 days a week for 4 weeks. Exemestane, given at the dose
      of 20 mg/kg/day s.c., induced 26% complete (CR) and 18% partial (PR) tumor
      regressions, compared to 0% CR and 6% PR observed in controls. Tamoxifen, given
      at 1 mg/kg/day p.o., induced 16% CR and 13% PR. The combined treatment caused 41%
      CR and 16% PR, thus resulting in a higher antitumor effect than either single
      treatment. The appearance of new tumors was reduced by each single treatment and
      almost totally prevented by the combined treatment. Serum prolactin (PRL) levels,
      assayed 4 h after the last dose, were unchanged in the group treated with the
      combination, whereas tamoxifen alone caused a slight increase of serum PRL. These
      results indicate that estrogen deprivation through aromatase inhibition and
      estrogen receptor antagonism causes a better inhibition of DMBA-induced mammary
      tumors than either treatment modality alone.

PMID- 8476784
TI  - Org 33201: a new highly selective orally active aromatase inhibitor.
AB  - Org 33201 has been selected as a very potent aromatase inhibitor. The compound is
      an enantiomer of a SC2H5 substituted imidazoylethylphenalene. Org 33201 inhibited
      human aromatase activity for 50% at a concentration of 2.2 x 10(9) mol/l. More
      than 200-fold higher concentrations were needed for the inhibition of other
      cytochrome P-450 enzymes. In vivo the compound was active in rats (ED50 = 0.035
      mg/kg) and dogs (1 mg/kg gave 70% inhibition) after oral administration. It can
      be concluded that Org 33201 is a potent and highly selective orally active
      aromatase inhibitor.

PMID- 8476785
TI  - The efficacy of CGS 20267 in suppressing estrogen biosynthesis in patients with
      advanced stage breast cancer.
AB  - The pharmacologic inhibition of aromatase activity has been the focus of clinical
      trials in patients with advanced stage breast cancer. Recent developments with
      imidazole compounds that inhibit aromatase activity suggest their clinical use as
      potent inhibitors of estrogen biosynthesis in postmenopausal breast cancer
      patients. In this Phase I, open-label, dose-range finding study, we examined the
      inhibitory potency of CGS 20267 on blood and urine levels of estradiol, estrone
      and estrone sulfate in 8 patients with metastatic breast cancer. Studies included
      evaluation of adrenal and thyroid function to look for evidence of general
      hydroxylase inhibition at dose levels effective for aromatase blockade. Patients
      were administered CGS 20267 at doses of 0.1 and 0.25 mg, once a day in ascending
      doses over a 12-week period. Preliminary data reveal that CGS 20267 elicits a
      striking suppression in plasma estradiol, estrone and estrone sulphate which was
      observed in some patients as quickly as within 24 h of the first dose. Estrogen
      suppression of over 90% was achieved within 2 weeks of therapy. No alterations in
      either baseline or ACTH (cortrosyn) stimulated cortisol and aldosterone levels
      were observed through the 12 weeks of therapy. In addition, 24 h urine sodium and
      potassium values were not appreciably altered during therapy. We conclude that
      CGS 20267 is a potent, specific inhibitor of estrogen biosynthesis in
      postmenopausal patients with metastatic breast cancer and effectively reduces
      blood and urine estrogens to undetectable levels.

PMID- 8476786
TI  - Aminoglutethimide (AG) and hydrocortisone (HC) in bone metastases: a
      retrospective study.
AB  - The response rate in bone metastases in 57 patients treated with
      aminoglutethimide and hydrocortisone was retrospectively assessed. All the X-rays
      were reviewed by two senior radiologists. A response was observed in 23% of the
      patients, a stabilization in 32%. The survival was not different whether a
      response or stabilization was observed. Conversely, survival was significantly
      worse in patients who experienced a progressive disease.

PMID- 8476787
TI  - Festschrift in honor of the 60th birthday of Dr. Allan S. Hoffman: Part 1.

PMID- 8476788
TI  - Allan S. Hoffman--overview and appreciation.

PMID- 8476789
TI  - Introduction of amine groups on poly(ethylene) by plasma immobilization of a
      preadsorbed layer of decylamine hydrochloride.
AB  - In order to introduce amine groups on poly(ethylene) (PE) surface, PE surfaces
      were preadsorbed with decylamine hydrochloride (DA.HCl) and subsequently treated
      with an argon plasma. It was shown by XPS (X-ray Photoelectron Spectroscopy),
      that approximately half of the preadsorbed (mono)layer was immobilized and that a
      substantial part (60-70%) of the incorporated nitrogen containing groups were
      amine groups. The availability of the surface amine groups for reactions was
      investigated by applying a gas phase reaction with 4-trifluoromethylbenzaldehyde
      and by a reductive methylation reaction in aqueous solution with 14C
      formaldehyde. A maximal number of reactive amine groups was found after a plasma
      treatment time of 2 s. The reductive methylation reaction was used to estimate
      the surface concentration of amine groups resulting in a typical surface
      concentration of 1 x 10(-6) mol/m2 after a plasma treatment time of 2 s.

PMID- 8476790
TI  - Surface properties of RGD-peptide grafted polyurethane block copolymers: variable
      take-off angle and cold-stage ESCA studies.
AB  - Variable take-off angle and cold-stage ESCA measurements were utilized to analyze
      the surface composition of five polyurethane block copolymers. The polymers
      studied included a PTMO-polyurethane control, a carboxylated version of the
      control polyurethane, and three different peptide grafted (GRGESY, GRGDSY, and
      GRGDVY) polyurethanes. On dry samples the nitrogen signal detected using ESCA
      decreased with increasing take-off angle (i.e. as the specimen was probed closer
      to the surface) for all five polymers. This was believed to be due to the
      depletion of nitrogen-containing urethane hard segments at the surface. For all
      five polymers, the surface nitrogen concentration, associated with the hard
      segment, increased upon hydration. A greater increase of nitrogen concentration
      was observed for the peptide grafted polymers which suggests that grafting of the
      hydrophilic peptides to the polyurethane augments the hard segment enrichment at
      the surface upon hydration. Upon dehydration, the nitrogen concentration
      decreased for all five polymers suggesting migration of the more hydrophobic PTMO
      soft segment to the surface. In vitro endothelial cell adhesion showed an
      increase of cell attachment on prehydrated RGD-containing peptide grafted
      polyurethanes, but not on the other polymers. This result suggests an enhancement
      of peptide density at the aqueous interface, in good agreement with the ESCA
      studies.

PMID- 8476791
TI  - Mechanism of cytoplasmic calcium changes in platelets in contact with polystyrene
      and poly(acrylamide-co-methacrylic acid) surfaces.
AB  - Changes in cytoplasmic free calcium levels ([Ca2+]i) in platelets in contact with
      polystyrene (PSt) and poly(acrylamide-co-methacrylic acid) (PAAmMAc) particles
      were evaluated and results were compared with those from two representative
      biological calcium agonists; thrombin and calcium ionophore A23187. PSt particles
      stimulated a steep increase in cytoplasmic calcium levels in platelets as much as
      thrombin and A23187. Serratia protease-treated platelets showed a steep increase
      in [Ca2+]i by PSt particles, suggesting that PSt surfaces can initiate platelet
      activation independent of a glycoprotein Ib (GPIb)-mediated pathway. By contrast,
      dibucaine-treated platelets showed little increase in [Ca2+]i by PSt particles,
      indicating that microfilament assembly, including binding of GPIb with actin
      binding protein, should be required for platelet activation in contact with PSt
      surfaces. PAAmMAc particles induced little increase in cytoplasmic calcium levels
      in platelets. However, PAAmMAc particle-treated platelets demonstrated little
      response to thrombin in terms of an increase in [Ca2+]i and ATP release,
      suggesting the possibility that PAAmMAc surfaces may regulate [Ca2+]i by
      influencing platelet metabolism. Furthermore, sodium azide-treated platelets
      showed an increase in [Ca2+]i in platelets when contacting PAAmMAc particles,
      supporting the suggestion that PAAmMAc surfaces could regulate platelet
      functions. Fluorescence polarization measurements using 1,6-diphenyl-1,3,5
      hexatriene-loaded platelets revealed that PAAmMAc particles increased membrane
      fluidity in platelets, which may be due to physicochemical interaction with
      PAAmMAc surfaces.

PMID- 8476792
TI  - Surface modification of polymeric biomaterials with poly(ethylene oxide),
      albumin, and heparin for reduced thrombogenicity.
AB  - Appropriate surface modification has significantly improved the blood
      compatibility of polymeric biomaterials. This article reviews methods of surface
      modification with water-soluble polymers, such as polyethylene oxide (PEO),
      albumin, and heparin. PEO is a synthetic, neutral, water-soluble polymer, while
      albumin and heparin are a natural globular protein and an anionic polysaccharide,
      respectively. When grafted onto the surface, all three macromolecules share a
      common feature to reduce thrombogenicity of biomaterials. The reduced
      thrombogenicity is due to the unique hydrodynamic properties of the grafted
      macromolecules. In aqueous medium, surface-bound water-soluble polymers are
      expected to be highly flexible and extend into the bulk solution. Biomaterials
      grafted with either PEO, albumin, or heparin are able to resist plasma protein
      adsorption and platelet adhesion predominantly by a steric repulsion mechanism.

PMID- 8476793
TI  - Cell-attachment activities of surface immobilized oligopeptides RGD, RGDS, RGDV,
      RGDT, and YIGSR toward five cell lines.
AB  - Tetrapeptides, Arg-Gly-Asp-Ser (RGDS), Arg-Gly-Asp-Val (RGDV), and Arg-Gly-Asp
      Thr (RGDT), respectively, appearing in the cell-attachment domains of
      fibronectin, vitronectin, and collagen, and pentapeptide Tyr-Ile-Gly-Ser-Arg
      (YIGSR) appearing in B1 chain of laminin, were synthesized by liquid-phase
      procedure. Bioactivities of RGD, RGDX (X = S, V and T), YIGSR, and YIGSR-NH2 as
      cell recognition determinants were investigated by cell-attachment test using
      these oligopeptides immobilized to ethylene-acrylic acid copolymer (PEA) film.
      The cell lines used were A431, NRK, CHO-K1, HeLa.S3, and RLC-16 cells. It was
      found that the residue X in RGDX plays an important role for cell-attachment
      activity of RGDX, and, regarding YIGSR, introduction of NH2 residue at the C
      terminal of the pentapeptide enhances the cell-attachment activity.

PMID- 8476794
TI  - Physico-chemical surface characterization of hyaluronic acid derivatives as a new
      class of biomaterials.
AB  - Three hyaluronic acid derivatives with different types and/or percentages of
      esterification, were analyzed by means of static contact angle measurements, SEM,
      ESCA, ATR/FT-IR, WAXS, DSC and TGA. The physico-chemical characterization of the
      three different samples, in both dry and wet state, was provided in terms of
      surface and bulk properties. ESCA and infrared analyses showed that the surface
      composition of all samples differs from that of the bulk. The hydrophilic
      hydrophobic character of the samples changed according to the chemical
      composition as shown by ESCA and contact angle measurements. Both infrared and
      contact angle measurements reveal that surface restructuring occurred upon
      hydration for all the samples and the greater the hydrophilic character of the
      sample, the greater and faster the restructuring phenomenon. A clear picture of
      the different types of chemical groups has been established at different depth
      for the three materials.

PMID- 8476795
TI  - Release behavior of bioactive agents from pH-sensitive hydrogels.
AB  - Controlled release systems of theophylline, proxyphylline and oxprenolol.HCl
      exhibiting modulated drug delivery were prepared by using pH-sensitive anionic
      copolymers of 2-hydroxyethyl methacrylate with acrylic acid or methacrylic acid.
      Drug release studies were carried out in simulated biological fluids. The initial
      drug release rates and the drug release mechanisms were dependent upon the pH and
      ionic strength of the buffer solution as well as its salt composition. Initial
      drug diffusion coefficients in these swelling-controlled release systems were
      calculated from the release curves; they were of the order of 10(-7) cm2/s and
      were dependent upon the degree of swelling. The drug release mechanism was non
      Fickian in all the dissolution media studied. Lowest release rates were observed
      for drug release from nonionized polymer networks in agreement with the
      relationship between ionization, swelling and drug release.

PMID- 8476796
TI  - Identification of proteins absorbed to hemodialyser membranes from heparinized
      plasma.
AB  - The protein layers formed during contact of plasma with hemodialysis membranes
      were studied. Dialysers having membranes of cellulose acetate (CA), saponified
      cellulose ester (SCE), cuprophane (CUP), polymethylmethacrylate (PMMA), and
      polyacrylonitrile (PAN) were used. Heparinized human plasma was recirculated
      through the dialysers for four hours. They were then rinsed and the proteins
      adsorbed to the membranes were eluted with 2% SDS. The yields of protein from the
      different membranes increased in the order: PMMA < CA < SCE < CUP < PAN. This is
      the probable order of increasing hydrophilicity. SDS-PAGE and Western blots were
      performed on the dialyser eluates. The blots were positive for most of the twenty
      proteins tested for. There were some interesting differences in adsorption
      patterns among the different membrane materials, notably for high molecular
      weight kininogen (HMWK), plasminogen and the C3 component of complement. HMWK was
      intact in the eluates from CA, CUP and SCE, whereas on PMMA and PAN there was
      evidence of cleavage, suggesting that activation of the contact phase of
      coagulation was more extensive on the latter two materials. Intact plasminogen
      was visible on all the blots. However, low molecular weight fragments were
      visible in the PAN eluates, suggesting activation of the fibrinolytic pathway.
      Low molecular weight fibrinogen fragments eluted from PAN membranes support this
      conclusion. C3 was visible in the blots obtained for all membrane materials, and
      the data suggest that complement is activated by all the membranes. A C3 fragment
      at about 30 kD (possibly C3d) was seen in the blots for the cellulosic membranes
      but not for PMMA or PAN.

PMID- 8476797
TI  - Properties controlling the diffusion and release of water-soluble solutes from
      poly(ethylene oxide) hydrogels. 1. Polymer composition.
AB  - This study examines the state of water-association with poly(ethylene oxide), as
      evidenced by diffusivity, in a series of crosslinked polyurethanes made from
      poly(ethylene glycols) of a range of molecular weights. As a subsidiary
      underpinning exercise the correlation of diffusivity with water content at
      relatively high levels of swelling (> 45%) using a variety of semi-empirical
      equations was analyzed. Three water-soluble compounds with similar molecular
      weights and which exhibit minimal interaction with the polymer, as shown by their
      partition coefficients, were chosen for this part of the research programme.
      These were proxyphylline, morphine hydrochloride and caffeine. The best
      statistical correlations of the data were obtained for plots of: (a) diffusivity
      against weight percent water; and (b) log diffusivity against the reciprocal of
      the weight percent of water in the hydrogels. Proxyphylline results for the high
      levels of swelling compositions were augmented with data from lower swelling
      compositions and a clear break in the slope of diffusivity against percentage of
      water in the swollen hydrogel was obtained. This indicated a change in the nature
      of the diffusion at this point. The probability of this transition point
      corresponding to a change for diffusion through water bound as trihydrate to
      diffusion in free water is discussed.

PMID- 8476798
TI  - The no-fault panacea?

PMID- 8476799
TI  - Pre-eclampsia and cytokine induced oxidative stress.

PMID- 8476800
TI  - Classifying perinatal death: experience from a regional survey.
AB  - OBJECTIVE: To examine problems encountered in classifying perinatal death using
      the systems proposed by Hey et al. (1986) and Cole et al. (1986). SUBJECTS: 451
      deaths from a regional perinatal mortality survey of which 293 had a post mortem
      examination. METHODS: Documents from each death were reviewed by four assessors,
      one from each discipline, selected randomly from a pool of obstetricians,
      paediatricians, general practitioners and midwives. Each assessor classified the
      cause of death blind to the others. The degree of agreement between assessors was
      calculated for the full and shortened obstetric and fetal-neonatal
      classifications using the kappa statistic for inter-rater agreement. RESULTS: The
      kappa statistic, which is a measure of the proportion of agreement above chance,
      gave a value of 0.55 for the full obstetric classification and 0.58 for the full
      fetal and neonatal classification when all four assessors made an assignment. An
      assignment was omitted in 6.2%, but the kappa value of zero for these omissions
      suggested that this was a nonsystematic result due to random protocol violations.
      The grouped (shortened) classifications generated a higher kappa value of 0.62
      for the nine point obstetric system and 0.67 for the six point fetal and neonatal
      (New Wigglesworth) system. Post mortem had little effect on agreement. The best
      agreement levels observed were for congenital anomaly. CONCLUSION: This survey
      highlighted the complexity of the 22 and 24 point classifications, the uneven
      distribution of deaths within their categories, and the variable levels of
      agreement between professionals classifying deaths, thus questioning the validity
      of individual maternity units of health districts generating local data in this
      degree of detail for comparative purposes in regional and national statistics.
      Grouping the original categories led to greater agreement particularly for the
      New Wigglesworth classification. The role of post mortems in clarifying the cause
      of fetal and neonatal death needs further investigation.

PMID- 8476801
TI  - Pregnancy after renal transplantation: 25 years experience in Spain.
AB  - OBJECTIVE: To study the outcome of pregnancy in renal transplant patients in
      Spain. DESIGN: A retrospective review based on two consecutive national
      inquiries. SETTING: Departments of Obstetrics and Gynaecology and Renal
      Transplant Units in Spain. SUBJECTS: Pregnant women who had renal transplants
      between 1965 and 1989. MAIN OUTCOME MEASURES: From the preliminary inquiry the
      frequencies of miscarriage, therapeutic abortion, preterm birth, fetal
      malformation, twins, stillbirths, neonatal deaths and loss of maternal renal
      function were recorded. The subsequent, more detailed inquiry provided additional
      information including donor type, previous rejection episodes and interval
      between rejection and pregnancy, previous creatinine level, previous hypertension
      and development of hypertension in pregnancy, developments during labour and
      delivery and the occurrence of intra uterine growth retardation and low birth
      weight. RESULTS: The preliminary inquiry yielded information about 133
      pregnancies. The miscarriage rate was 10% and the therapeutic abortion rate was
      16%. Of the 99 pregnancies that continued, 46% ended before term and 53%
      progressed to term. The perinatal mortality rate was 107.8 per 1000 and 4% of the
      infants had minor congenital malformations. The second inquiry yielded more
      detailed data about 66 pregnancies. There were no therapeutic abortions and 12%
      of the pregnancies ended in miscarriage. Among the 58 pregnancies that reached >
      or = 28 weeks gestation, preterm birth occurred in 28 (48%) and intra uterine
      growth retardation occurred in 17 (29%). Among 48 women with normal renal
      function before pregnancy, the perinatal mortality rate was 68 per 1000, the
      miscarriage rate was 8% and in 10 of these women (21%) renal function was
      impaired after pregnancy. In contrast, among 18 women with impaired renal
      function before pregnancy, the perinatal mortality rate was 142 per 1000, the
      miscarriage rate was 22% and in six of these women (33%) renal function
      deteriorated after the pregnancy. Impairment of renal function was most common in
      women with hypertension during pregnancy or with rejection episodes during the
      year before conception. CONCLUSIONS: Women with a renal transplant can have a
      successful pregnancy, but there are definite risks for both mother and fetus.
      Pregnancy should be discussed with the woman and encouraged only if there is good
      renal graft function.

PMID- 8476802
TI  - A randomised trial of 45 minutes and 15 minutes incremental oxytocin infusion
      regimes for the induction of labour in women of high parity.
AB  - OBJECTIVE: To investigate whether in women of high parity induction of labour
      using a regimen of intravenous oxytocin, increasing incrementally at 45 min
      intervals, is safer than one increasing at 15 min intervals. SETTING: University
      of Benin Teaching Hospital, Department of Obstetrics and Gynaecology, Benin City,
      Nigeria. DESIGN: Randomised controlled trial. SUBJECTS: Ninety women of parity 5
      or more requiring induction of labour by infusion of oxytocin were randomly
      allocated to incremental increases at either 45 min intervals (experimental
      group) or 15 min intervals (control group). MAIN OUTCOME MEASURES: Mode of
      delivery; complications of labour and delivery (uterine rupture, precipitate
      labour, hyperstimulation, postpartum haemorrhage, perineal tears, puerperal
      pyrexia); number of days spent in hospital. RESULTS: The 45 min incremental
      regimen resulted in longer induction-delivery intervals (estimate of difference
      in population medians 2 h, 95% confidence interval (CI) 1-4 h); less precipitate
      labour (odds ratio (OR) 0.09, 95% CI 0.03-0.30); less uterine hyperstimulation
      (OR 0.23, 95% CI 0.09-0.59); and a reduced length of hospital stay (estimate of
      difference in population medians 3 days, 95% CI 2-5 days). With the 45 min
      interval regimen there was a reduction in the occurrence of uterine rupture,
      postpartum haemorrhage, perineal tears and puerperal pyrexia, but these
      differences did not reach statistical significance. CONCLUSION: For the induction
      of labour in women of high parity the infusion rate of oxytocin should be
      increased every 45 min rather than every 15 min until contractions occur three
      times in 10 min and this infusion rate of oxytocin is maintained until delivery.

PMID- 8476803
TI  - Randomised comparison of routine versus highly selective use of Doppler
      ultrasound in low risk pregnancies.
AB  - OBJECTIVE: To help answer the question: should Doppler ultrasound of the
      umbilical circulation be made available to all pregnant women as part of their
      routine antenatal care? DESIGN: A randomised trial. SETTING: St James's
      University Hospital, Leeds. SUBJECTS: 2025 low risk primigravid women. MAIN
      OUTCOME MEASURES: Obstetric intervention rates and short term neonatal morbidity.
      RESULTS: The incidence of abnormal Doppler was low (1.7%) with complete absence
      of end diastolic flow in only 0.3% of cases. No significant differences could be
      demonstrated between control and study women in any of the outcomes measured.
      CONCLUSION: This study did not demonstrate any benefit or harm from Doppler
      ultrasound as a routine screening test for all low risk women, whereas our
      previous studies have suggested that it is useful in high risk pregnancies. Any
      marginal returns on extending access to Doppler ultrasound from high risk to all
      women must be small. Since this test has excellent performance characteristics
      (sensitivity and specificity) for the prediction of fetal hypoxia and acidosis
      our results call into question the cost to benefit ratio of all tests designed to
      predict these outcomes in low risk women.

PMID- 8476804
TI  - Intra-observer and inter-observer reliability of the pulsatility index calculated
      from pulsed Doppler flow velocity waveforms in three fetal vessels.
AB  - OBJECTIVE: Study of the intra observer and inter observer reliability of the
      pulsatility index, calculated from pulsed Doppler recordings of three fetal
      vessels. DESIGN: Flow velocity waveforms (FVW) were recorded from the umbilical
      artery, the fetal descending aorta and the fetal internal carotid artery. Intra
      observer reliability was assessed in six fetuses; ten repeated measurements were
      performed by one observer. Inter-observer reliability was studied in 14 fetuses;
      two observers performed two repeated measurements in each fetus. SETTING: A
      tertiary referral hospital. SUBJECTS: High risk pregnancies with a gestational
      age ranging from 29 to 42 weeks. MAIN OUTCOME MEASURES: Analysis of variance with
      repeated measurements and a graphical method were used for data analysis. Intra
      observer repeatability was expressed as Intraclass Correlation Coefficient
      (IntraCC). Inter-observer agreement was expressed as Interclass Correlation
      Coefficient (InterCC). RESULTS: IntraCC for umbilical artery, descending aorta
      and internal carotid artery were 0.91, 0.78, and 0.54, respectively. InterCC
      values for these vessels were 0.39, 0.45 and 0.34, respectively. No systematic
      differences between the two observers except for the fetal descending aorta, were
      apparent. IntraCC decreased remarkable when fetuses with absent end diastolic
      velocities were excluded from the analysis. CONCLUSION: The pulsatility index
      (PI) used for fetal measurements has a poor reliability. This is of serious
      concern when clinical use of FVW measurements is considered as a diagnostic tool.

PMID- 8476805
TI  - Fetal cerebral Doppler in the recognition of fetal compromise.
AB  - OBJECTIVE: To establish reference ranges for the human fetal middle cerebral
      artery pulsatility index (MCA PI) for the local obstetric population, and to
      compare computerised antenatal fetal heart rate (FHR) analysis with the MCA PI as
      indicators of fetal compromise. DESIGN: Prospective data collection for selected
      patients. SETTING: High risk pregnancy unit of a teaching hospital. SUBJECTS:
      Group 1 consisted of 18 healthy women with uncomplicated singleton pregnancies.
      Group 2 consisted of 27 women admitted to the high risk pregnancy unit over a 9
      month period with intrauterine growth retardation and other related problems; all
      these women were delivered by prelabour caesarean section. INTERVENTION: Serial
      Duplex sonography to determine fetal MCA PI in Groups 1 and 2. Serial FHR
      analysis using computerised numerical techniques in Group 2 only. MAIN OUTCOME
      MEASURES: Serial MCA PI values from 24 to 39 completed weeks of gestation in
      Group 1. Comparison of serial MCA PI values with FHR analysis in relation to
      fetal outcome in Group 2. RESULTS: In Group 1 the MCA PI diminished significantly
      as gestation advanced from 1.73 (SD 0.25) at 24 weeks to 1.38 (SD 0.26) at 39
      weeks (P < 0.01). In Group 2 eleven babies were hypoxaemic at delivery: all had
      low MCA PI values while only nine had an abnormal FHR prior to delivery.
      CONCLUSION: In normal pregnancy, there is a fall in the fetal MCA PI with
      advancing gestation which probably reflects a decreasing vascular resistance to
      fetal cerebral blood flow. Hypoxaemia at delivery appeared to be better
      recognised by the fetal MCA flow velocity waveform than the FHR analysis. This
      increased sensitivity, however, was achieved at the expense of a reduced
      specificity. Larger studies are needed to confirm the findings of this
      preliminary investigation.

PMID- 8476806
TI  - Abnormal cervical cytology following large loop excision of the transformation
      zone: a case controlled study.
AB  - OBJECTIVES: To determine factors that may predict cytological outcome at 6 months
      following large loop excision of transformation zone (LLETZ) for cervical intra
      epithelial neoplasia (CIN) and to investigate the outcome in women with
      continuing cytological abnormality. DESIGN: Case controlled retrospective study.
      SETTING: Dudley Road Hospital, Birmingham and Midland Hospital for Women.
      SUBJECTS: Fifty-eight women with abnormal follow up cytology and a control group
      of 116 women. MAIN OUTCOME MEASURES: The relation between pretreatment and
      treatment factors and cytological outcome, and the relation between cytology and
      histology in women who had biopsies for persistent abnormal cytology. RESULTS:
      Univariate and stepwise logistic regression analysis showed that the number of
      sectors of atypical transformation zone (lesion size) and the excision margin
      status of the large loop excision specimen are of prognostic importance for the
      prediction of cytological abnormality at the 6 month follow up visit. Sixteen
      women have undergone further cervical biopsy. Of the five cases of persistent
      CIN, four had cytological changes showing moderate or severe dyskaryosis. Of the
      11 women with koilocytosis or normal histology, 10 had mild dyskaryosis or
      borderline changes on their follow up cytology. CONCLUSION: Lesion size and
      excision margin status are important correlates of follow up cytology when
      treating patients for CIN with LLETZ. All women with abnormal cervical cytology
      at follow up should undergo colposcopic assessment. Excision biopsy is indicated
      if follow up cytology shows moderate or severe dyskaryosis, especially if still
      present 12 months after treatment.

PMID- 8476807
TI  - Is HIV infection associated with an increase in the prevalence of cervical
      neoplasia?
AB  - OBJECTIVE: To test the hypotheses: (1) that HIV infection predisposes to cervical
      intraepithelial neoplasia (CIN); (2) that this CIN is a result of HIV related
      immunosuppression; and (3) that this CIN is a result of immunosuppression causing
      increased expression of the potentially oncogenic viruses, human papilloma virus
      (HPV), Epstein Barr virus (EBV) and herpes simplex virus (HSV). DESIGN: A matched
      cross sectional study. SETTING: The Department of Gynaecological Oncology, The
      Samaritan Hospital, London; the Department of Genitourinary Medicine, St Mary's
      Hospital, London; and the Family Planning Clinic, Claremont Terrace, Glasgow.
      SUBJECTS: Fifty HIV seropositive women enrolled from the Genitourinary Medicine
      Department and the Drug Dependency Unit at St Mary's Hospital, London, and the
      Unit of Infectious Diseases at Ruchill Hospital, Glasgow. Forty-three HIV
      seronegative controls enrolled from the Department of Genitourinary Medicine at
      St Mary's Hospital, matched against 43 of the seropositive women for age, age at
      first intercourse, lifetime number of sexual partners, and smoking habit. MAIN
      OUTCOME MEASURES: Associations between CIN, as detected by cytology and
      histology, and HIV infection. Association was also sought between CIN and
      immunosuppression, as measured clinically by T4 cell number, beta-2-microglobulin
      and p24 antigen. Associations of these with: (1) HPV, as detected by Southern
      blot testing and the polymerase chain reaction; (2) EBV, as detected by Southern
      blot testing; and (3) HSV, as detected by tissue culture of endocervical swabs,
      was also studied. RESULTS: There was no significant difference in the prevalence
      of CIN or oncogenic viruses between HIV seropositive and seronegative women in
      the absence of immunosuppression. If the HIV infected women showed signs of
      immunosuppression, the prevalence of CIN was increased. No association was shown
      between detection of HPV, EBV and HSV and immunosuppression or CIN. CONCLUSION:
      HIV infection may only be associated with an increased risk of CIN when
      immunosuppression is present.

PMID- 8476808
TI  - Type III collagen content in the skin of postmenopausal women receiving
      oestradiol and testosterone implants.
AB  - OBJECTIVE: To investigate the effect of subcutaneous oestradiol and testosterone
      on the proportion of type III collagen in the skin of postmenopausal women.
      DESIGN: A cross sectional comparison. SETTING: Dulwich Hospital menopause clinic.
      SUBJECTS: Fourteen untreated women and 11 women who had received subcutaneous
      oestradiol and testosterone for a median 8.0 years (range 3-14). Ten of the
      untreated women received subcutaneous hormone implants and the effect on skin
      collagen was studied prospectively. MEASUREMENTS: The proportion of type III
      collagen in skin biopsies taken from the lateral aspect of the thigh. RESULTS:
      The median type III collagen content in the skin of the women who had received
      hormone replacement therapy (25.4%, range 21.4-30.2) was significantly higher (P
      < 0.01) than in the untreated women (19.6%, range 18.2-28.8). The proportion of
      type III collagen in the skin of 10 untreated women increased significantly (P <
      0.01) from a median of 19.9% (range 18.2-23.9) to 22.4% (range 20.5-31.5)
      following 6 months of treatment with hormone implants. CONCLUSION: This study
      indicates an increase in the proportion of type III collagen in women receiving
      hormone replacement therapy.

PMID- 8476809
TI  - Laparoscopic ovarian diathermy: an effective treatment for anti-oestrogen
      resistant anovulatory infertility in women with the polycystic ovary syndrome.
AB  - OBJECTIVE: To determine the long term efficacy of laparoscopic ovarian diathermy
      in the management of refractory anovulatory infertility in women with the
      polycystic ovary syndrome. DESIGN: Open study of 50 women treated over a period
      of 3 years and 3 months, with follow up until 18 months after the last woman was
      treated. SETTING: Teaching Hospital. SUBJECTS: Fifty consecutive women with
      refractory anovulatory infertility (mean duration 5.3 (SD 3.5) years). All had
      been treated unsuccessfully with anti-oestrogens and more than half with
      gonadotrophins. INTERVENTIONS: Laparoscopic ovarian diathermy. MAIN OUTCOME
      MEASURES: Ovulatory cycles and pregnancies. RESULTS: Forty-three women (86%)
      ovulated following ovarian diathermy; the mean time to ovulation was 23 (SD 6.2)
      days. Three nonresponders ovulated following anti-oestrogen treatment to which
      they were previously resistant. Thirty-three women have conceived 58 pregnancies;
      22 had no treatment other than ovarian diathermy prior to their first post
      operative conception; in seven an anti-oestrogen was given because of lengthening
      cycles; two were treated elsewhere with gonadotrophins without prior
      postdiathermy anti-oestrogen therapy and conceived; four had the operation
      repeated and two of these conceived. Twenty-six women conceived within the first
      8 post-operative months. Forty-two pregnancies ended in the birth of normal live
      healthy babies, eight are ongoing and eight miscarried. Of the 22 women who had
      no pelvic abnormality other than polycystic ovaries, 19 (86%) have had one or
      more successful pregnancies. CONCLUSION: Laparoscopic ovarian diathermy is a very
      effective treatment for anti-oestrogen resistant anovulatory infertility in women
      with the polycystic ovary syndrome and should be considered as the next step in
      those who fail to respond to anti-oestrogen treatment.

PMID- 8476810
TI  - Adverse effects on sperm movement characteristics in women with minimal and mild
      endometriosis.
AB  - OBJECTIVE: To test the effect of peritoneal fluid from infertile women with
      minimal or mild endometriosis on sperm movement characteristics in comparison
      with fertile and infertile women with no endometriosis. DESIGN: A prospective
      observer-blind trial. SETTING: Academic infertility department. SUBJECTS: 57
      women undergoing diagnostic laparoscopy or laparoscopic sterilisation. MAIN
      OUTCOME MEASURES: Changes in sperm movement characteristics in semen samples
      provided during routine infertility investigation or from sperm donors. Computer
      assisted semen analysis (CASA) performed using a Celltrack-S system. RESULTS:
      Significant reductions in linearity (P < 0.05), amplitude of lateral head
      displacement (P < 0.01), straight line velocity (P < 0.01), and curvilinear
      velocity (P < 0.01) (but not percentage motility) were observed. CONCLUSIONS:
      Peritoneal fluid from women with minimal or mild endometriosis adversely effects
      sperm movement characteristics in comparison to fertile women.

PMID- 8476811
TI  - Pressor, heart rate and plasma catecholamine responses to noradrenaline in
      pregnant and nonpregnant women.
AB  - OBJECTIVE: To study cardiovascular responses to noradrenaline during early
      pregnancy. DESIGN: Administration of incremental intravenous infusions of
      noradrenaline under basal conditions. SETTING: University Hospital, Nottingham.
      SUBJECTS: Nineteen women admitted for termination of pregnancy in first or second
      trimester and 18 nonpregnant women as control subjects. INTERVENTIONS: Recordings
      of blood pressure and heart rate responses during the infusion of noradrenaline.
      Blood samples taken before, during and after the infusion. MAIN OUTCOME MEASURES:
      Evoked responses of systolic and diastolic blood pressure and heart rate at
      steady state during the noradrenaline infusion. Plasma catecholamine
      concentrations measured by high performance liquid chromatography. RESULTS: There
      were no significant differences between the evoked pressor responses to
      noradrenaline in pregnancy compared to the nonpregnant state, but there was a
      lesser bradycardia in response to a standardised change in blood pressure.
      Neither basal plasma catecholamine concentrations nor those achieved during
      infusion of noradrenaline differed between pregnant and nonpregnant women. Thirty
      minutes after discontinuance of the infusion there was a persistent elevation of
      heart rate in all women, although plasma catecholamine concentrations had
      returned to basal levels. In pregnant women, systolic and diastolic blood
      pressures were also elevated at this time, compared to preinfusion levels.
      CONCLUSION: Cardiovascular regulatory mechanisms are altered in pregnancy with a
      diminution in the bradycardic response to a pressor challenge evoked by
      noradrenaline and a delayed recovery from that challenge.

PMID- 8476812
TI  - Cardiovascular autonomic reflexes in mid-pregnancy.
AB  - OBJECTIVE: To study the physiological responses to noninvasive cardiovascular
      autonomic function tests in normal pregnancy. DESIGN: Cardiovascular autonomic
      responses in 60 women at 22 to 29 weeks gestation and 62 nonpregnant women were
      investigated using the Valsalva manoeuvre as well as orthostatic, quiet
      breathing, deep breathing, and isometric handgrip tests. RESULTS: Compared with
      nonpregnant women, those who were pregnant showed significantly lower heart rate
      variability during normal breathing and a blunted tachycardic reaction to blowing
      during the Valsalva manoeuvre. The vagally controlled biphasic heart rate
      response to standing was also attenuated in the pregnant group. CONCLUSIONS: The
      cardiovascular responses were blunted in mid-pregnancy indicating a decrease in
      parasympathetic cardiovascular control.

PMID- 8476813
TI  - Supernumerary fallopian tubes.

PMID- 8476814
TI  - Spontaneous rupture of the uterine artery in pregnancy.

PMID- 8476815
TI  - Reversal of fetal benzodiazepine intoxication using flumazenil.

PMID- 8476816
TI  - Sensitivity of pocket Doppler fetal heart detectors in early pregnancy: a
      comparative study.

PMID- 8476817
TI  - Short term psychological outcome of surgical intervention for endometriosis.

PMID- 8476818
TI  - The House of Commons Health Committee Report on the Maternity Services. A
      personal view.

PMID- 8476819
TI  - Sweeping of the membranes is an effective method of induction of labour in
      prolonged pregnancy: a report of a randomised trial.

PMID- 8476820
TI  - Platelets in pregnancy induced hypertension.

PMID- 8476821
TI  - Do we need randomised trials of antenatal tests of fetal wellbeing?

PMID- 8476822
TI  - Platelets and pregnancy.

PMID- 8476823
TI  - A national survey to assess current use of computerised information systems in
      obstetrics.
AB  - OBJECTIVE: To ascertain the number and type of obstetric computer systems (OCS)
      in Great Britain, and to ascertain user satisfaction with these systems. DESIGN:
      A postal questionnaire was circulated to every consultant obstetrician in Great
      Britain at the beginning of 1992. MAIN OUTCOME MEASURES: Information was sought
      on the hardware, software and uses of obstetric computer systems. Satisfaction
      with, benefits and problems of the system were also assessed. RESULTS: There was
      an 87.5% response rate. Of the 264 units questioned, 100 units reported that they
      had a computer system. Sixty-five units used terminals connected to a mainframe
      or minicomputer and 17 used stand-alone personal computers (PCs). Local area
      networks (LANs) were used in 19 units and wide area network (WANs) in 22 units.
      Software varied from commercial turnkey systems to in-house systems. The quoted
      annual running cost ranged from 50 pounds to 48,000 pounds. Most units were
      satisfied with their system. Problems included slow operating times,
      unreliability, user unfriendliness, deficiencies in training and inadequate
      customer support services. CONCLUSIONS: Obstetric computer systems are now coming
      into widespread use. Despite problems, the use of such systems is likely to
      increase. This survey establishes a database for those units who are considering
      acquiring or changing their computer system for the purpose of audit or research.

PMID- 8476824
TI  - Memory loss during pregnancy.
AB  - OBJECTIVE: To investigate possible impairment of memory during pregnancy. DESIGN:
      The performance of pregnant women in a variety of tests of memory was compared to
      that of controls. SETTING: The Bristol Maternity Hospital. SUBJECTS: Forty-eight
      volunteer pregnant women attending for routine antenatal checks were compared to
      19 nonpregnant controls. MAIN OUTCOME MEASURES: Subjectively perceived rating of
      memory impairment, objective measures of recall, recognition and priming memory.
      RESULTS: Pregnant and control groups were given a series of tests of memory at
      the end of which they were asked to rate their own memory at present compared to
      some weeks ago (when they were not pregnant). Of the pregnant women 39 out of 48
      (81%) rated their current memory as being impaired; only three out of 19 (16%) of
      the control subjects did so. Objective tests revealed that the pregnant group was
      significantly impaired in the recall of lists of words, particularly when
      learning was incidental rather than explicit. The pregnant group was also
      significantly impaired in two measures of priming memory. No significant deficit
      was found in recognition. The deficits were found for both primigravid and
      multigravid women, and were present in all trimesters of pregnancy. CONCLUSIONS:
      The majority of women believe their memory to be impaired during pregnancy.
      Objectively, during pregnancy there is significant impairment of memory as tested
      by recall or by priming, but not by recognition. The pattern of memory loss
      differs from that of other amnesic conditions. Information imparted to pregnant
      patients may not be retained as well as might be expected.

PMID- 8476825
TI  - Retrospective analysis of platelet numbers and volumes in normal pregnancy and in
      pre-eclampsia.
AB  - OBJECTIVE: To determine the distribution of platelet volumes and numbers through
      pregnancy, and to compare these to changes in platelet volumes and numbers in
      women with pre-eclampsia. SUBJECTS: Four hundred twenty-eight women with normal
      pregnancy from whom four or more platelet measurements were available were
      identified. 74 women with pre-eclampsia (blood pressure > or = 140/90 mmHg, at
      least 0.5 g protein/24 h urine collection) from whom platelet measurements were
      available between 27 and 30 weeks of gestation were identified. RESULTS: Mean
      platelet volume and platelet number remained constant in normal pregnancies
      between the first trimester and the end of pregnancy. A persistent increase of >
      or = 0.8 fl (> or = 90th centile) in mean platelet volume was found in 14 out of
      15 pre-eclamptic patients between 24 weeks and 38 weeks of gestation and in only
      13 of 428 normal pregnant individuals. Platelet numbers were decreased by > or =
      50 x 10(9)/l (i.e. to less than the 10th centile) in 12 of the 15 patients with
      pre-eclampsia. 10% of the normal pregnant population showed a similar decline in
      platelet numbers showing that changes in platelet numbers may be a less accurate
      assessment of the development of pre-eclampsia. CONCLUSION: We suggest that
      longitudinal determination of platelet volumes may be of use in identifying those
      women at risk of pre-eclampsia.

PMID- 8476826
TI  - Hypnosis: practical applications and theoretical considerations in normal labour.
AB  - OBJECTIVE: To assess the effects of hypnotherapy on the first and second stages
      of labour in a large group of pregnant women. DESIGN: A semi-prospective case
      control study in which women attending antenatal clinics were invited to undergo
      hypnotherapy. SUBJECTS: One hundred twenty-six primigravid women with 300 age
      matched controls, and 136 parous women having their second baby with 300 age
      matched controls. Only women who had spontaneous deliveries were included.
      SETTING: Aberdare District Maternity Unit, Mid Glamorgan, Wales. INTERVENTION:
      Six sessions of hypnotherapy given by a trained medical hypnotherapist during
      pregnancy. OUTCOME MEASURES: Analgesic requirements, duration of first and second
      stages of labour. RESULTS: The mean lengths of the first stage of labour in the
      primigravid women was 6.4 h after hypnosis and 9.3 h in the control group (P <
      0.0001); the mean lengths of the second stage were 37 min and 50 min,
      respectively (P < 0.001). In the parous women the corresponding values were 5.3 h
      and 6.2 h (P < 0.01); and 24 and 22 min (ns). The use of analgesic agents was
      significantly reduced (P < 0.001) in both hypnotised groups compared with their
      controls. CONCLUSION: In addition to demonstrating the benefits of hypnotherapy,
      the study gives some insight into the relative proportions of mechanical and
      psychological components involved in the longer duration of labour in primigravid
      women.

PMID- 8476827
TI  - Prediction of fetal acidaemia in pregnancies complicated by maternal diabetes
      mellitus by biophysical profile scoring and fetal heart rate monitoring.
AB  - OBJECTIVE: To determine whether computer assisted fetal heart rate analysis or
      the biophysical profile score can provide noninvasive prediction of fetal
      acidaemia. DESIGN: Cross sectional study. SETTING: Harris Birthright Research
      Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
      SUBJECTS: Forty-one women with pregnancies complicated by diabetes mellitus.
      INTERVENTIONS: Fetal heart rate (FHR) monitoring with computer assisted analysis,
      biophysical profile score (BPS) and cordocentesis for measurement of umbilical
      venous blood glucose concentration and blood gases, up to 24 h before delivery at
      27 to 39 weeks gestation. RESULTS: The mean umbilical venous blood pH was
      significantly lower than the normal mean for gestation, and was below the 5th
      centile in 18 pregnancies, including all six cases where the mother had
      nephropathy and hypertension. The mean pO2 was not significantly different from
      the normal mean for gestation. There were significant associations between fetal
      acidaemia and both the BPS (r = 0.46, P < 0.01) and FHR variation (r = 0.42, P <
      0.01). However, of the 12 acidaemic fetuses of non-nephropathic mothers, nine had
      normal BPS and six had normal FHR variation. CONCLUSIONS: In pregnancies
      complicated by maternal diabetes mellitus, BPS and FHR variation are of limited
      value in the prediction of fetal blood pH.

PMID- 8476828
TI  - Chirality in the umbilical cord.
AB  - OBJECT: To determine the chiral varieties of the vascular helix of the umbilical
      cord and find their normal proportions. DESIGN: Differences between the sexes
      were tested by a chi 2 test and the hypothesis that left-handed types occur in
      50% of cases was tested using the binomial distribution. SETTING: United Arab
      Emirates. SUBJECT: Gulf Arab singletons from consecutive normal births, 100 male
      and 100 female. RESULTS: Left-handed helices predominate at 76.5%; right-handed
      contribute 15.5%; mixed forms, where both chiralities co-exist, were found in
      6.5%; indeterminable chirality due to poor helix formation, or varices, reached
      1.5%. A significant sex difference could not be established. Chiral generation,
      on genetic and mechanical-rotational hypotheses, is discussed. CONCLUSION: The
      chirality of the cord is easily determined and is the sole distinguishing feature
      of the cord. Chirality should be entered in the birth record and in pathological
      descriptions for whatever value it may have in relation to fetal, or postnatal,
      characteristics and morbidity.

PMID- 8476829
TI  - Randomised controlled trial comparing endometrial resection with abdominal
      hysterectomy for the surgical treatment of menorrhagia.
AB  - OBJECTIVE: To evaluate the effectiveness of endometrial resection as a surgical
      treatment for menorrhagia. DESIGN: Randomised controlled trial. SETTING:
      Gynaecology department at a teaching hospital. SUBJECTS: Two hundred women
      needing surgical treatment for menorrhagia between January 1990 and May 1991.
      After withdrawal of four women 97 underwent hysterectomy and 99 underwent
      endometrial resection. MAIN OUTCOME MEASURES: Patient satisfaction 4 months after
      surgery; post-operative complications; length of hospital stay; duration of time
      before return to work, normal daily activities and sexual intercourse; change in
      premenstrual symptoms. RESULTS: The difference in patient satisfaction between
      endometrial resection (84 out of 99) and abdominal hysterectomy (89 out of 95)
      just reached statistical significance in favour of abdominal hysterectomy at 4
      months after surgery (difference = 9%, 95% confidence intervals (CI) 1.1%-17.5%).
      Post-operative morbidity, length of hospital stay and time taken to return to
      work, normal daily activities and sexual intercourse were significantly less in
      the endometrial resection group. However, the premenstrual symptoms of
      dysmenorrhoea, bloating and breast tenderness were less frequent after
      hysterectomy. CONCLUSION: In the short term, endometrial resection was almost as
      satisfactory as abdominal hysterectomy for the surgical treatment of menorrhagia,
      and was associated with less morbidity. However, even at 4 months after surgery,
      there was a failure rate of at least 10% in those in whom endometrial resection
      appeared complete. Longer term comparative studies are necessary before the
      widespread introduction of endometrial resection as an alternative to abdominal
      hysterectomy for the surgical treatment of menorrhagia.

PMID- 8476830
TI  - An economic evaluation of transcervical endometrial resection versus abdominal
      hysterectomy for the treatment of menorrhagia.
AB  - OBJECTIVE: To evaluate the relative health service cost of endometrial resection
      versus abdominal hysterectomy for the treatment of menorrhagia and the value
      women attach to their health state before and after surgery. DESIGN: A
      prospective economic evaluation running alongside a randomised controlled trial.
      SETTING: The gynaecology department of a teaching hospital. SUBJECTS: 200 women
      requiring surgical treatment of menorrhagia between January 1990 and May 1991;
      after withdrawals, 97 women underwent hysterectomy and 99 underwent endometrial
      resection. MAIN OUTCOME MEASURES: The total health service cost of managing women
      in the two arms of the trial until 4 months after their operation. The change in
      women's valuation of their health state a fortnight after and a minimum of 4
      months after surgery relative to that 1 month prior to their operation. RESULTS:
      Total health service costs are significantly higher amongst abdominal
      hysterectomy patients (mean 1059.73 pounds) than amongst endometrial resection
      patients with a mean difference of 499.68 pounds (95% CI 432 pounds-567 pounds).
      This significant difference exists under alternative assumptions about the
      difference in lengths of stay in hospital between the two treatment groups and
      the hotel cost per in-patient day. On a scale of 0 to 100, relative to a month
      before surgery, there is a statistically significant difference in favour of
      endometrial resection between the two groups in the increase in value women
      attach to their health state at a fortnight after surgery (mean difference 11.2;
      95% CI 0.6-21.7), but not at a minimum of 4 months after surgery (mean difference
      7; 95% CI -17.4 to 3.4). CONCLUSIONS: On the basis of health service resource
      cost up to 4 months after surgery, endometrial resection has a cost advantage
      over abdominal hysterectomy. However, given the fact that a subgroup of women
      requires retreatment due to resection failure and that this study considers a
      relatively short period of follow up, the long term costs and benefits of
      endometrial resection need to be evaluated before widespread diffusion is
      justified.

PMID- 8476831
TI  - Flow cytometric studies of ploidy and proliferative indices in the Yorkshire
      trial of adjuvant progestogen treatment of endometrial cancer.
AB  - OBJECTIVE: To estimate whether flow cytometric indices provide independent
      measures of prognosis or predict response to prophylactic progestogens in
      endometrial cancer. DESIGN: Endometrial tumour specimens were retrieved and
      analysed by flow cytometry from 257 women who had been randomly allocated in a
      previous trial to receive prophylactic progestogen in addition to conventional
      therapy for endometrial carcinoma. SETTING: Fourteen district and two teaching
      hospitals in West Yorkshire. SUBJECTS: Women developing primary endometrial
      cancer between 1975 and 1983. MAIN OUTCOME MEASURES: Tumour ploidy status and
      proliferative indices and the relation of these to tumour stage and grade, to
      prognosis and to response to progestogens. RESULTS: Ploidy status and
      proliferative indices were related to tumour stage, grade and patient survival
      but were not independent predictors of survival. They did not predict patients
      who would respond to progestogens although there was a nonsignificant trend
      towards patients with diploid tumours surviving longer after progestogen
      treatment. CONCLUSIONS: Flow cytometry adds little to established prognostic
      indicators for endometrial cancer.

PMID- 8476832
TI  - Early discharge following vaginal hysterectomy.
AB  - OBJECTIVE: To assess the feasibility of discharging selected patients home within
      72 h of vaginal hysterectomy. DESIGN: Women for whom vaginal hysterectomy was
      planned and who were invited to take part. Those who accepted were visited at
      home by a staff nurse experienced in gynaecology to assess home conditions and
      family support. If these were suitable, the general practitioner was informed and
      invited to comment. If the operation was uneventful women were discharged on the
      third post operative day and visited at home by the nurse until the seventh day.
      SETTING: Leeds Western Health Authority. MAIN OUTCOME MEASURES: The number of
      minor complications requiring treatment by the general practitioner, the
      readmission rate and the acceptability to the woman and her family. RESULTS: For
      11 out of 61, home conditions proved unsuitable for early discharge. In six of
      the remaining 50, abdominal hysterectomy proved preferable to vaginal. Thirty
      women were discharged home on the third day after vaginal hysterectomy, five on
      the fourth and seven on the fifth. Two developed urinary tract infections,
      treated by their general practitioners. Two required readmission to hospital.
      Twenty-eight of 30 discharged on the third post operative day and nine of 12
      discharged on the fourth or fifth post operative day were enthusiastic about the
      scheme. CONCLUSIONS: Early discharge following uncomplicated vaginal hysterectomy
      in selected patients appears to be a safe procedure, appreciated by the majority
      of women. Its adoption as a routine procedure would enable the surgical
      throughput in a unit to be maintained on a smaller bed complement.

PMID- 8476833
TI  - Does elective cryopreservation of all embryos from women at risk of ovarian
      hyperstimulation syndrome reduce the incidence of the condition?
AB  - OBJECTIVES: To analyse the incidence and factors associated with the ovarian
      hyperstimulation syndrome (OHS) in our IVF/GIFT programme before and after the
      introduction of a strategy to cryopreserve all embryos from women judged to be at
      risk. DESIGN: Two hundred forty-one consecutive IVF/GIFT cycles from January to
      December 1989. SETTING: Specialist fertility unit, Manchester, UK. INTERVENTIONS:
      Pituitary suppression was effected by a daily subcutaneous injection of buserelin
      (500 micrograms) beginning 7 days before the expected menses. The ovarian
      stimulation was with variable amounts of human menopausal gonadotrophin.
      Ovulation was induced with 10,000 i.u. human chorionic gonadotrophin (hCG). From
      January to May (period A), gametes/embryos were replaced and 2000 i.u. hCG given,
      irrespective of the serum oestradiol (E2) concentration. From June to December
      (period B), all the embryos from women with an E2 > 3500 pg/ml on the day of
      ovulatory trigger were electively cryopreserved. MAIN OUTCOME MEASURES: Serum E2,
      features of moderate or severe OHS, clinical pregnancies. RESULTS: The OHS
      occurred in 10/105 (9.5%) and 12/136 (8.8%) cycles in periods A and B,
      respectively. Fewer women (6% versus 60%, P < 0.05) who had their embryos
      cryopreserved developed severe OHS compared with women with an E2 > 3500 pg/ml
      who became pregnant after gamete/embryo transfer in period A. The main factors
      associated with the development of OHS were serum E2 concentrations > 3500 pg/ml,
      whether gamete/embryos were replaced and the additional hCG given, the occurrence
      of a pregnancy and the presence of polycystic ovary disease. CONCLUSION: The
      elective cryopreservation of all embryos from women with high E2 levels reduced
      the severity, but not the incidence of symptomatic OHS.

PMID- 8476834
TI  - Findings on lipid peroxidation and antioxidant function in hypertensive
      complications of pregnancy.
AB  - OBJECTIVE: To assess lipid peroxidation and antioxidant function in hypertensive
      complications of pregnancy. DESIGN: Cross sectional study comparing pre-eclamptic
      and control patients. SETTING: Tampere University Hospital, Finland. SUBJECTS:
      Twenty healthy women with normal, uncomplicated pregnancy; 23 women with severe
      pre-eclampsia; 20 women with mild pre-eclampsia; and 13 women with pregnancy
      induced hypertension. MAIN OUTCOME MEASURES: Conjugated dienes; thiobarbituric
      acid--reactive material or malondialdehyde (MDA); fluorescent chromolipids (FCL);
      glutathione peroxidase (GSHPx); selenium; uric acid; and vitamin E. RESULTS:
      Lipid peroxidation assessed by the appearance of conjugated dienes and
      malondialdehyde was significantly increased in the hypertensive patients as
      compared with control patients. Lipid peroxidation products also showed high
      correlation to the level of blood pressure, but failed to show significant
      relation to the outcome of the fetus. The activities of erythrocyte and plasma
      glutathione peroxidase were increased in severe pre-eclampsia, and high levels of
      plasma or platelet glutathione peroxidase were found to have some association
      with fetal growth retardation or asphyxia. CONCLUSIONS: Our findings give support
      to those few studies considering lipid peroxidation as an important factor in the
      pathogenesis of pre-eclampsia. The rise in antioxidants is probably of
      compensatory nature responding to the increased peroxide load in pre-eclampsia
      and may reflect the severity of the disease.

PMID- 8476835
TI  - Fetal pleural effusion following maternal indomethacin therapy.

PMID- 8476836
TI  - Post partum haemorrhage secondary to Marfan's disease of the uterine vasculature.

PMID- 8476837
TI  - Indomethacin use to control gross polyhydramnios complicating triplet pregnancy.

PMID- 8476838
TI  - Percutaneous nephrostomies in women with cervical cancer.

PMID- 8476839
TI  - Combined laparoscopic and micro-laparotomy removal of benign cystic teratomata.

PMID- 8476841
TI  - Is obstetric and neonatal outcome worse in fetuses who fail to reach their own
      growth potential?

PMID- 8476840
TI  - Simplifying laparoscopic surgery for ectopic pregnancies.

PMID- 8476842
TI  - Genital tract infections associated with the intrauterine contraceptive device
      can be reduced by inserting the threads into the uterine cavity.

PMID- 8476843
TI  - Genital tract infections associated with the intrauterine contraceptive device
      can be reduced by inserting the threads into the uterine cavity.

PMID- 8476844
TI  - The cytological detection of persistent cervical intraepithelial neoplasia after
      local ablative treatment: a comparison of sampling devices.

PMID- 8476845
TI  - Solution conformation of the (+)-cis-anti-[BP]dG adduct in a DNA duplex:
      intercalation of the covalently attached benzo[a]pyrenyl ring into the helix and
      displacement of the modified deoxyguanosine.
AB  - This paper reports on the solution structure of the (+)-cis-anti-[BP]dG adduct
      positioned opposite dC in a DNA oligomer duplex which provides the first
      experimentally based solution structure of an intercalative complex of a
      polycyclic aromatic hydrocarbon covalently bound to the N2 of deoxyguanosine. The
      combined NMR-energy minimization computation studies were undertaken on the (+)
      cis-anti-[BP]dG adduct embedded in the same d(C5-[BP]G6-C7).d(G16-C17-G18)
      trinucleotide segment of the complementary 11-mer duplex studied previously with
      the stereoisomeric trans adducts. The exchangeable and nonexchangeable protons of
      the benzo[a]pyrenyl moiety and the nucleic acid were assigned following analysis
      of two-dimensional NMR data sets in H2O and D2O solution. The solution structure
      of the (+)-cis-anti-[BP]dG-dC 11-mer duplex has been determined by incorporating
      intramolecular and intermolecular proton-proton distances defined by upper and
      lower bounds deduced from NOESY data sets as restraints in energy minimization
      computations. The benzo[a]pyrene ring of [BP]dG6 is intercalated between intact
      Watson-Crick dC5.dG18 and dC7.dG16 base pairs in a right-handed DNA helix. The
      benzylic ring is in the minor groove while the pyrenyl ring sacks with flanking
      dC5 and dC7 bases on the same strand. The deoxyguanosine ring of [BP]dG6 is not
      Watson-Crick base paired but displaced into the minor groove with its plane
      parallel to the helix axis and stacks over the sugar ring of dC5. The dC17 base
      on the partner strand is displaced from the center of the helix toward the major
      groove by the intercalated benzo[a]pyrene ring. This intercalative structure of
      the (+)-cis-anti-[BP]dG-dC 11-mer duplex exhibits several unusually shifted
      proton resonances which can be readily accounted for by the ring current
      contributions of the deoxyguanosine and pyrenyl rings of the [BP]dG6 adduct.
      Several phosphorus resonances are shifted to low and high field of the
      unperturbed phosphorus spectral region and have been assigned to internucleotide
      phosphates centered about the [BP]dG6 modification site. These studies define the
      changes in the helix at the central trinucleotide segment needed to generate the
      intercalation site for the covalently bound (+)-cis-anti-[BP]dG adduct.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8476846
TI  - Site-directed alterations to the geometry of the aspartate transcarbamoylase zinc
      domain: selective alteration to regulation by heterotropic ligands, isoelectric
      point, and stability in urea.
AB  - Structural aspects requisite for allosteric function in the regulatory chain of
      aspartate transcarbamoylase were explored by site-specific amino acid insertion
      or substitution within the zinc domain in the region of contact between the
      catalytic and regulatory chains. Amino acid substitution at two positions yielded
      enzymes which retained a maximum velocity similar to that of the wild-type enzyme
      but responded differently from the native enzyme in the presence of regulatory
      nucleoside triphosphates. A change of zinc coordinate amino acid C109 to
      histidine and a change of E119 to aspartic acid resulted in enzymes which
      demonstrated synergistic inhibition by CTP and UTP but not inhibition by CTP in
      either phosphate buffer or a morpholino-based tri-partate (TP) buffer at pH 7. At
      pH 8.3, where there is a higher proportion of T-state conformers in the native
      enzyme, the mutants diverged from their similar kinetic behavior. C109H remained
      an enzyme which was not inhibited by CTP but was still inhibited by CTP+UTP.
      E119D was inhibited by both CTP and CTP+UTP. Activation of the mutants by ATP was
      found to vary either with pH or with phosphate as a buffer component. C109H was
      activated by ATP in phosphate, while in TP at either pH 7 or 8.3 its activation
      by ATP was diminished or absent. E119D was activated by ATP in phosphate at pH 7
      or in TP at pH 8.3, but not in TP at pH 7. In TP at pH 7, where neither mutant
      was activated by ATP, the S values and Hill coefficients of the unliganded mutant
      enzymes resembled those of the ATP-liganded wild-type enzyme. While neither
      mutation would be predicted to alter the net charge of the holoenzyme,
      differences in the isoelectric point of the mutants were observed if phosphate
      was present. This result suggests that the isoelectric point of aspartate
      transcarbamoylase is conformationally dependent and that the mutants exist in an
      altered conformation. In addition, the stabilities of both mutant holoenzymes
      were reduced substantially from those of the wild-type enzyme in 4 M urea. C109H
      was more stable at pH 8.25 in a Tris buffer; E119D was more stable at pH 7 in the
      phosphate buffer. Potential effects of these mutations on the active site
      chemistry and geometry are discussed.

PMID- 8476847
TI  - Molecular dynamics simulations of the unfolding of apomyoglobin in water.
AB  - Molecular dynamics simulations of apomyoglobin have been conducted in aqueous
      solution for 350 ps at 25 degrees C and for 500 ps in two different runs at 85
      degrees C. The structures obtained at the higher temperature display properties
      similar to those of molten globules. Close agreement is obtained between the
      computed structural models and experimental data on the helical content of both
      native apomyoglobin and the low-pH unfolding intermediate. The results also
      suggest explanations for the surprising observations on the effects of mutations
      at the interface of the A, G, and H helices. Detailed analyses of the final
      structures and the unfolding pathways at high temperature clearly show that the
      most stable alpha-helical regions are those in contact with other helices.

PMID- 8476848
TI  - Complete nucleotide sequence of the antithrombin gene: evidence for homologous
      recombination causing thrombophilia.
AB  - Antithrombin is the principle regulator of thrombin and other blood coagulation
      proteinases. It is a member of the serpin family of proteinase inhibitors. The
      genomic sequence of the antithrombin locus has been completed, revealing a gene
      spanning 13,477 base pairs from the transcription start site to the poly(A)
      addition signal. Nine complete and one partial Alu repeat elements were
      identified within the introns of the gene, with all but one orientated in the
      reverse direction. Inherited deficiency of antithrombin is associated with a
      venous thrombotic tendency. Restriction fragment mapping of the antithrombin
      genes in an individual with type I antithrombin deficiency identified an
      intragenic deletion in one allele. Localization of the deletion breakpoints
      involved restriction analysis and direct sequencing of amplified DNA spanning the
      deletion site. The deletion removed 2761 base pairs, affecting exon 5 and
      flanking introns, with the deletion ends contained within the left components of
      two Alu elements. It is likely, therefore, that the deletion arose by homologous
      recombination between the two Alu elements.

PMID- 8476849
TI  - Transforming the Escherichia coli Trp repressor into a site-specific nuclease.
AB  - The Escherichia coli Trp repressor has been converted into an operator-specific
      nuclease by alkylating cysteine-49, inserted by site-directed mutagenesis, with 5
      (iodoacetamido)-1,10-phenanthroline. In the presence of copper ion and thiol,
      high yields (> 50%) of double-stranded breaks of DNA are observed after a 20-min
      reaction. The high cleavage efficiency of this derivatized protein (Trp repressor
      E49C-OP) can be attributed to the proximity of cysteine-49 to the minor groove,
      the site of the C-1H of the deoxyribose and the target of the oxidative nuclease
      activity of (1,10-phenanthroline)copper. Since sequence position 49 is close to
      the protein's C2 dyad axis and adjacent to the minor groove, Trp repressor E49C
      OP reacts with the operator DNA near the binding site of this symmetry locus of
      the protein. The patterns of scission of the trpR, aroH, and trpEDCBA operators
      (a) confirm the orientation of the repressor to the operator predicted from the X
      ray study of a cocrystal (Otwinowski et al., 1988) and (b) support the model for
      tandem binding of the repressor to the trpR, aroH, and trpEDCBA operators based
      on DNase I footprinting and methylation interference (Kumamoto et al., 1987).
      There are one, two, and three binding sites for the repressor on the trpR, aroH,
      and trpEDCBA operators, respectively. In addition to providing a novel approach
      to studying the interactions of DNA binding proteins, 1,10-phenanthroline
      derivatized proteins such as Trp repressor E49C-OP may be useful as rare cutters
      in the analysis of high molecular weight DNAs, especially if their binding
      specificities can be altered.

PMID- 8476850
TI  - The acidic phosphoproteins from Saccharomyces cerevisiae ribosomes. NH2-terminal
      acetylation is a conserved difference between P1 and P2 proteins.
AB  - Isoelectrofocusing gels of acidic ribosomal proteins from most yeast strains
      reveal the presence of up to 10 bands which are the product of only 4 genes. The
      proteins have been characterized by NH2-terminal amino acid sequencing, specific
      antibodies, HPLC, and by taking advantage of acidic protein-defective yeast
      strains obtained by gene disruption methods. The four most basic proteins
      coincide with the phosphorylated and dephosphorylated forms of the YP2 proteins,
      YP2 alpha and YP2 beta, formerly named L44 and L45. Amino-terminal sequencing has
      shown that these two polypeptides have free amino-terminal ends starting at the
      first methionine residue. The bands defined earlier as L44' correspond to the
      phosphorylated and dephosphorylated processed forms of protein YB1 beta lacking
      the first eight amino acids. The formation of this truncated YP1 beta form seems
      to be stimulated by salt during protein extraction and is also favored by some
      modifications at the amino termini of the protein. On the other hand, the
      previously uncharacterized band, called Ax, corresponds to an NH2-terminal
      acetylated form of YP1 beta which starts at the serine in the second position of
      the nucleotide-derived sequence. Finally, the most acidic band is the
      phosphorylated product of the fourth acidic protein gene. This protein, called
      YP1 alpha, which is very poorly stained by silver and Coomassie blue, has not
      been characterized in detail previously. It is also monophosphorylated in the
      ribosome and, like YP1 beta, is present as an NH2-terminal acetylated form
      starting at the second serine residue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476851
TI  - GC base sequence recognition by oligo(imidazolecarboxamide) and C-terminus
      modified analogues of distamycin deduced from circular dichroism, proton nuclear
      magnetic resonance, and methidiumpropylethylenediaminetetraacetate-iron(II)
      footprinting studies.
AB  - The DNA binding properties of a series of imidazole-containing and C-terminus
      modified analogues 4-7 of distamycin are described. These analogues contain one
      to four imidazole units, respectively. Data from the ethidium displacement assay
      showed that these compounds bind in the minor groove of DNA, with the relative
      order of binding constants of 6 (Im3) > 7 (Im4) > 5 (Im2) > 4 (Im1). The reduced
      binding constants of these compounds for poly(dA-dT) relative to distamycin,
      while they still interact strongly with poly(dG-dC), provided evidence of GC
      sequence acceptance. The preferences for GC-rich sequences by these compounds
      were established from a combination of circular dichroism (CD) titration, proton
      nuclear magnetic resonance (1H-NMR), and
      methidiumpropylethylenediaminetetraacetate-iron(II) [MPE.Fe-(II)] footprinting
      studies. In the CD studies, these compounds produced significantly larger DNA
      induced ligand bands with poly(dG-dC) than poly(dA-dT) at comparable ligand
      concentrations. 1H-NMR studies of the binding of 5 to d-[CATGGCCATG]2 provided
      further evidence of the recognition of GC sequences by these compounds, and
      suggested that the ligand was located on the underlined sequence in the minor
      groove with the C-terminus oriented over the T residue. MPE footprinting studies
      on a GC-rich BamHI/SalI fragment of pBR322 provided unambiguous evidence for the
      GC sequence selectivity for some of these compounds. Compounds 4 and 7 produced
      poor footprints on the gels; however, analogues 5 and 6 gave strong
      footprints.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476852
TI  - Mechanism of intercalation into the DNA double helix by ethidium.
AB  - The mechanism of intercalation into DNA double helices by ethidium has been
      analyzed by temperature-jump relaxation and stopped-flow measurements using
      fluorescence detection. Artifacts due to field- or flow-induced alignment have
      been eliminated by measurements under magic angle conditions; the theoretical
      basis for suppression of orientation effects resulting from external forces is
      given for the case of fluorescence measurements. Excluded site effects have been
      avoided by restriction to low degrees of binding. The temperature-jump relaxation
      observed for ethidium binding to DNA could be described by single exponentials
      under most conditions. The reciprocal time constants increased linearly with the
      DNA concentration, leading to association rate constants of 2.7 x 10(6) M-1 s-1
      at 12 degrees C. These rate constants are virtually independent of the DNA chain
      length for samples with 200, 500, 4228, and 30,000 base pairs, showing that the
      rate is controlled by reaction and not by a diffusive process. At high DNA
      concentrations around 200 microM, an additional relaxation effect with an
      amplitude opposite to the main one is observed which is probably due to some
      conformational change of the DNA-ethidium complex. The results obtained by
      stopped-flow measurements are consistent with those from T-jump measurements, but
      owing to higher amplitudes and better signal to noise ratios, the stopped-flow
      data clearly require two exponentials for satisfactory representation. The
      reciprocal time constants for both processes increase linearly with the DNA
      concentration. The simplest mechanism consistent with this result involves
      parallel formation of two different complexes with a direct transfer of ethidium
      between the binding sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476853
TI  - Structural and sequence elements required for the self-cleaving activity of the
      hepatitis delta virus ribozyme.
AB  - The hepatitis delta virus (HDV) is a subviral RNA that contains a self-cleaving
      activity that is similar to the ribozyme activity found in certain plant
      pathogens. However, the sequences surrounding the cleavage site are unrelated to
      the hammerhead or hairpin ribozyme motifs, and it is considered to be a distinct
      ribozyme type. We made site-specific changes within two regions of the smallest
      contiguous HDV sequence that has optimal activity and kinetically analyzed the
      data at different temperatures to determine the potential roles of the residues.
      We distinguish between those changes that affect the rate of catalysis and those
      that promote the formation of inactive structures. We find that nucleotides +45
      to +72 downstream from the cleavage site, which can form a hairpin structure, are
      dispensable for catalytic activity but that they enhance the cleavage efficiency.
      Nucleotides +17 to +19 and +28 to +30 form Watson and Crick base pairs that are
      important for activity, but the actual sequence is not critical. In contrast, the
      nucleotides between +21 and +26 are important for activity, and they may be
      involved in significant tertiary interactions.

PMID- 8476854
TI  - Multiple protein-binding domains and functional cis-elements in the 5'-flanking
      region of the human pyruvate dehydrogenase alpha-subunit gene.
AB  - We have characterized the 5'-flanking region of the alpha-subunit gene of the
      human pyruvate dehydrogenase (E1). DNase I footprinting with rat liver nuclear
      extracts identified 7 major protein-binding domains termed P1 through P7 in a 796
      base pair DNA fragment (base pairs -763 to +33). P1 through P4 are clustered in
      the -221/+33 region. These protein-binding domains contain several known
      consensus sequences such as a TATA box, CAAT box, Sp1, and CRE, which all have
      previously been implicated in the constitutive transcription of several genes.
      Oligonucleotide competition studies indicate that oligonucleotides specific for
      CTF/NF-1 and Sp1 displaced the nuclear proteins bound to the CAAT box (within P3)
      and an Sp1 site (within P4), respectively. Several other well-characterized and
      purified transactivators (c-Fos, c-Jun, C/EBP, AP-2, and Sp1) have been shown to
      bind to the -221/+33 region. Other elements located upstream of the -221/+33
      region, which includes nuclease protection domains P5-P7, are required for
      enhanced promoter activity of the 796 bp sequence. Promoter activity was measured
      by transient expression of a chloramphenicol acetyltransferase gene ligated to
      deletion fragments of the 5'-flanking region. Crucial element(s) for promoter
      activity and complex DNA-nuclear protein interactions were confined within a
      region spanning -221/+33. This region also retained more than 75% of the promoter
      activity of the 796 bp sequence. Additionally, this promoter region shows
      characteristics of both facultative and housekeeping gene promoters, suggesting
      complex transcriptional regulation.

PMID- 8476855
TI  - Tests of a model for promoter recognition by T7 RNA polymerase: thymine methyl
      group contacts.
AB  - The DNA-dependent RNA polymerase from bacteriophage T7 is highly specific for a
      17 base promoter sequence. Interactions between T7 RNA polymerase and its
      promoter DNA have been probed using modified oligonucleotides and a steady-state
      kinetic assay. The incorporation of deoxyuridine in place of thymidine at
      individual sites in the promoter sequence results in the replacement of an
      exocyclic methyl group by hydrogen (effectively removing the thymine methyl).
      This substitution has been placed individually at each of the thymines in the T7
      consensus promoter. Many of these substitutions do not affect binding or
      catalysis; however, the thymine methyl group at position-6 is critical to
      recognition. The kinetic parameter Km increases approximately 10-fold while kcat
      is only slightly affected, suggesting that this thymine methyl is critical to
      binding specificity, but not to the kinetics of initiation. Two methyl groups
      near the start site on the template strand (at positions -1 and -3) also
      contribute to promoter specificity, while nearby methyl groups on the nontemplate
      strand do not. The implications of these results are discussed with respect to
      recent models for promoter binding.

PMID- 8476856
TI  - Identification of specific contacts in T3 RNA polymerase-promoter interactions:
      kinetic analysis using small synthetic promoters.
AB  - The T7, T3, and SP6 RNA polymerases recognize very similar, yet distinct,
      promoter sequences. The high homology among the promoter sequences suggests that
      differential promoter recognition must derive from relatively small changes in
      the protein. Steady-state kinetic analyses of transcription from the T3 consensus
      promoter and from promoters modified in the region critical to specific
      recognition reveal details concerning which functional groups contribute to this
      recognition. Modifications include base pair substitutions, single base
      substitutions (mismatches), and simple functional group modifications at unique
      sites in the promoter. The results show that T3 RNA polymerase recognizes the
      amino group on the nontemplate cytidine in the major groove at position -10,
      while the identity of the base on the template strand is less critical to
      binding. In contrast, recognition at position -11 allows a greater range of
      modifications and seems to have a more complex recognition. The results do not
      seem to be consistent with a single recognition contact at this position;
      however, some groups may be ruled out as simple recognition contacts. While major
      groove modifications weaken binding at positions -10 and -11, the removal of an
      exocyclic amino group from the minor groove at either position does not disrupt
      binding, further supporting a model for promoter recognition in which the enzyme
      binds to one face of closed duplex DNA in this region. The effects of these
      changes in the DNA structure on the kinetics of initiation are compared to
      complementary results from the T7 system.

PMID- 8476857
TI  - Kinetic analysis of T7 RNA polymerase transcription initiation from promoters
      containing single-stranded regions.
AB  - T7 RNA polymerase is highly specific for the initiation of transcription from a
      relatively small consensus promoter sequence. Previous footprinting studies
      suggested that the enzyme binds specifically to a fully closed duplex form of the
      promoter, recognizing functional groups along one face of the helix [Muller, D.
      K., Martin, C. T., & Coleman, J. E. (1989) Biochemistry 28, 3306-3313]. Steady
      state kinetic analysis of oligonucleotide-based promoters shows that removal of
      the nontemplate strand completely within the message region of the DNA (positions
      +1 through +5) results in no change in binding (as reflected in the parameter Km)
      and a 2-fold increase in kinetics (as reflected in kcat). Further deletion of the
      nontemplate strand as far upstream as position -4 has no effect on binding, and
      although deletion upstream through position -6 weakens binding, specific
      initiation continues at a high rate. The temperature dependence of the initiation
      kinetics shows a single apparent activation energy of approximately 26 kcal/mol
      for the fully duplex promoter. Similar measurements on the promoter lacking the
      nontemplate strand in the message region show that less than 10% of this barrier
      is related to melting of the downstream region of the promoter. These results
      lead us to revise the previous model for recognition to include specific binding
      to a form of the promoter which is duplex upstream of about position -6 and
      melted downstream through the start site. Within the melted region, the
      polymerase interacts significantly only with the template strand of the promoter
      DNA.

PMID- 8476858
TI  - Molecular mechanisms regulating the production of collagenase and TIMP in U937
      cells: evidence for involvement of delayed transcriptional activation and
      enhanced mRNA stability.
AB  - We have used the human promonocyte-like U937 cell line as a model to study the
      regulation of interstitial collagenase and tissue inhibitor of metalloproteinases
      (TIMP) during mononuclear phagocyte development. Our results show that
      differentiation of U937 cells with exposure to 12-O-tetradecanoylphorbol 13
      acetate (TPA) induces a temporally delayed (16-24 h) but marked increase in the
      biosynthesis and secretion of interstitial collagenase and TIMP. Similarly,
      steady-state mRNA levels for both proteins rose dramatically during the period of
      exposure, but again after considerable time delay (12-16 h). For interstitial
      collagenase, induction was transcriptionally regulated as demonstrated by nuclear
      run-on experiments, and required the synthesis of proteins as indicated by
      cycloheximide treatment. However, transcriptional activation of collagenase was
      never observed prior to 10-12 h; since c-fos is rapidly induced in U937 cells and
      largely disappears by 2 h (Mitchell et al., 1985), our data strongly suggest that
      collagenase induction in this system cannot be explained simply or entirely by an
      AP-1-dependent mechanism. Although TIMP steady-state mRNA levels also increased
      substantially with cellular differentiation, no transcription was detected by run
      on experiments. However, TPA exposure markedly prolonged the half-life of TIMP
      mRNA from 4 h to > 20 h. While cycloheximide treatment completely blocked TPA
      mediated induction of collagenase mRNA, it only marginally interfered with
      simultaneously induced TIMP mRNA levels. Our results demonstrate that
      differentiation of U937 monocytic cells is accompanied by markedly enhanced
      production of both interstitial collagenase and TIMP. However, there are
      multiple, and perhaps differing, molecular mechanisms regulating these responses.

PMID- 8476859
TI  - Cloning, sequencing, and expression in Escherichia coli of the gene coding for
      malate dehydrogenase of the extremely halophilic archaebacterium Haloarcula
      marismortui.
AB  - The gene coding for the enzyme malate dehydrogenase (MDH) of the extremely
      halophilic archaebacterium Haloarcula marismortui was isolated and sequenced. The
      enzyme is composed of 303 amino acids, and its molecular mass is 32,638 Da. The
      deduced amino acid sequence of the enzyme was found to be more similar to the
      sequence of L-lactate dehydrogenase (L-LDH) from various sources than to the
      sequence of other MDHs. The structural gene was cloned in the Escherichia coli
      expression vector pET11a, and large amounts of a soluble but inactive form of the
      enzyme were produced upon its induction. Activation of the enzyme was obtained by
      increasing the salt concentration to 3 M NaCl. The recombinant protein was
      purified to homogeneity and shown to be indistinguishable from the native enzyme
      isolated from halobacteria. These findings present the first example of the
      successful expression of a halobacterial gene coding for a soluble protein in
      Escherichia coli and its recovery as a functional enzyme. Site-directed
      mutagenesis was employed to modify Arg100 on the enzyme to Gln. This modification
      produced an enzyme that has considerably higher specificity for pyruvate (the
      substrate of L-LDH) than for oxaloacetate (the substrate of MDH). The mutation
      also caused a modification in the relative activities of the enzyme at different
      salt concentrations. The greater similarity of the amino acid sequence of the
      halobacterial MDH to that of L-LDHs than to that of MDHs sheds light on the
      molecular evolution of these enzymes.

PMID- 8476860
TI  - Three-state denaturation of DnaK induced by guanidine hydrochloride. Evidence for
      an expandable intermediate.
AB  - The denaturation of the heat shock protein DnaK induced by guanidine
      hydrochloride (Gdn-HCl) was investigated by circular dichroism, fluorescence,
      size-exclusion HPLC, and dynamic light scattering. DnaK unfolding takes place in
      two discrete steps. The midpoint (Cm) of the first transition (0.5 M) was shifted
      to higher denaturant concentrations (0.8 M) in the presence of Mg/ADP or Mg/ATP,
      whereas the second transition (Cm = 1.6 M) was unaffected by nucleotides. An
      intermediate state which continuously expands with increasing Gdn.HCl
      concentration was observed; its relation to molten globules is discussed. In
      addition, a direct correlation between molecular volume and ellipticity at 222 nm
      was found, regardless of the conformational state (native, intermediate,
      unfolded); the implications of these findings are discussed. The unfolding of
      DnaK is best explained by a hierarchical model of unfolding.

PMID- 8476861
TI  - Engineered disulfide bonds as probes of the folding pathway of barnase:
      increasing the stability of proteins against the rate of denaturation.
AB  - Disulfide bridges have been introduced into barnase to act as probes of folding.
      One disulfide (between residues 85 and 102) links two loops known to pack
      together early in the folding pathway. A second disulfide bond (between residues
      43 and 80) links two elements of secondary structure known to pack together only
      after the rate-determining step of folding. The disulfide-bridged proteins are
      more stable than wild-type by 4.1 and 1.2 kcal mol-1, respectively. The kinetics
      of unfolding and refolding of the mutant proteins has been measured, and a
      comparison of the disulfide proteins and their corresponding dithiol forms has
      been made by use of thermodynamic cycles. These data have been used to construct
      folding profiles of the disulfide proteins. The disulfide bond engineered into
      the part of the protein that folds early confers stability upon the intermediate
      and transition states of folding. The protein with a disulfide bond connecting
      parts of the protein that fold late is not stabilized until the protein reaches
      its final folded form. Conversely, in the unfolding pathway, the rate of
      unfolding of this mutant is lowered considerably. This points to a method of
      decreasing the rate of denaturation of proteins that are used in medical and
      biotechnological applications: elements of structure that unfold in or before the
      rate-determining step of overall unfolding may be stabilized and so slow down the
      overall unfolding process. The barnase mutant linked between Cys 43 and Cys 80,
      for example, unfolds 20 times slower than wild-type and 170 times slower than the
      reduced protein.

PMID- 8476862
TI  - The activity of the tissue inhibitors of metalloproteinases is regulated by C
      terminal domain interactions: a kinetic analysis of the inhibition of gelatinase
      A.
AB  - The cloning and expression of the full-length tissue inhibitor of
      metalloproteinase 2 (TIMP-2), delta 187-194TIMP-2, and delta 128-194TIMP-2 and
      the purification of these inhibitors and a cleaved version of TIMP-2 lacking nine
      C-terminal amino acids (delta 186-194TIMP-2) are described. The mechanism of
      inhibition of gelatinase A by the TIMPs was investigated by comparing the
      kinetics of association of TIMP-1, TIMP-2, the C-terminal deletions, and the
      mutants of both TIMPs which consisted of the N-terminal domain only. The full
      length TIMPs inhibited gelatinase A rapidly with association constants of 3.2 x
      10(6) M-1 s-1 for TIMP-1 and 2.1 x 10(7) M-1 s-1 for TIMP-2 at I = 0.2. The C
      terminal peptide of TIMP-2 is proposed to exist as an exposed "tail" responsible
      for binding to progelatinase A and for increasing the rate of inhibition of
      active gelatinase A through electrostatic interactions with the C-terminal domain
      of the enzyme. The C-terminal domains of both TIMP-1 and TIMP-2 participate in
      low-affinity interactions with the C-terminal domain of gelatinase A which
      increase the rate of association by a factor of about 100 in both cases.

PMID- 8476863
TI  - Direct evidence for the exploitation of an alpha-helix in the catalytic mechanism
      of triosephosphate isomerase.
AB  - In previous work, we have shown that the first (and, presumably, the second) pKa
      of the active-site histidine-95 in triosephosphate isomerase has been lowered by
      about 2 units [Lodi, P. J., & Knowles, J. R. (1991) Biochemistry 30, 6948-6956].
      One reason for the perturbed pKa of this residue appears to be its location at
      the N-terminus of a short alpha-helix that runs from residues 95 to 102.
      Fortuitously, the residue at the C-terminus of this helix is also a histidine
      residue (histidine-103), and the existence of a histidine side chain at each end
      has allowed us directly to implicate the helix in the perturbation of the pKa
      value of histidine-95. 15N NMR titration studies of the native enzyme and 13C NMR
      titration studies of the denatured enzyme show that while the pKa of histidine-95
      is lowered by a least 2 units in the folded versus the unfolded state, the pKa of
      histidine-103 is raised by about 0.6 unit on protein folding. These complementary
      effects on the pKa values of histidine-95 and histidine-103 suggest that the
      alpha-helix is indeed responsible for the perturbation of the pKa values. The
      larger effect on the pKa of histidine-95 is readily rationalized in terms of the
      local structure of the enzyme. The disparity in the perturbation for the two
      histidine side chains illustrates how an alpha-helix can be functionally utilized
      by proteins, directly to affect (as in the present case) the chemistry of
      catalysis by an enzyme.

PMID- 8476864
TI  - Analysis of enzyme specificity by multiple substrate kinetics.
AB  - Multiple approaches for screening large sets of compounds for a specific function
      are of growing interest. The use of substrate mixtures to characterize the
      specificity of enzymes has been limited so far to compounds with similar kinetic
      parameters, because the data were analyzed by applying the kinetics of two
      competing substrates. In this study we introduce a statistical method for the
      analysis of reactions with many competing substrates which makes use of the
      specific features of multiple substrate kinetics. It is assumed that the relative
      concentrations of all substrates in a mixture can be monitored by high
      performance liquid chromatography or a similar technique. Relative second-order
      rate constants, i.e., kcat/KM values, can be calculated for all substrates in the
      mixture from the resulting data set. The calculation uses the fact that there is
      a relationship between the concentrations of all pairs of substrates in the
      mixture. As a result, the precision of the calculated parameters is increased and
      the range of kinetic constants that can be obtained from one experiment is
      considerably expanded. Simulations demonstrate that the precision in the kinetic
      parameters increases with the number of substrates in the mixture. In fact,
      estimation of ratios of rate constants can be improved (or made possible) for
      substrates with order of magnitude differences in reactivity by adding "dummy"
      substrates with intermediate reactivities, even though the rate constants for
      dummy substrates are themselves of no intrinsic interest.

PMID- 8476865
TI  - Mapping the S' subsites of serine proteases using acyl transfer to mixtures of
      peptide nucleophiles.
AB  - We have developed a rapid and convenient procedure for the characterization of
      the S' subsite specificity of serine proteases. A mixture of peptide nucleophiles
      is incubated with the enzyme in the presence of excess of a specific ester
      substrate. The decrease in each nucleophile concentration is monitored by high
      performance liquid chromatography analysis of the dansylated mixture. Relative
      kinetic parameters for each nucleophile in the mixture are then calculated using
      a new statistical algorithm that relates all pairs of nucleophiles. As a first
      application, we investigated the S'1 subsite specificity of chymotrypsin,
      trypsin, and a recently described trypsin mutant, Tr-->Ch[S1 + L1 + L2] with
      chymotrypsin-like primary specificity [Hedstrom, L., Szilagyi, L., & Rutter, W.
      J. (1992) Science 255, 1249-1253]. For this purpose 21 peptide nucleophiles of
      the general structure H-Xaa-Ala-Ala-Ala-Ala-NH2 were prepared by multiple solid
      phase synthesis, where Xaa represents D-alanine, citrulline, and all natural
      amino acids except cysteine. Relative second-order rate constants for the enzyme
      catalyzed acyl transfer to these nucleophiles were determined over a range of
      10(2). Chymotrypsin and trypsin have markedly different S'1 specificities. The
      order of preference in chymotrypsin-catalyzed acyl transfer reactions is
      positively charged > aliphatic > aromatic >> negatively charged, D-Ala, Pro P'1
      side chain. Trypsin prefers hydrophobic residues, but like chymotrypsin aliphatic
      residues are better than aromatic residues in P'1 position. The S'1 specificity
      of the mutant Tr-->Ch[S1 + L1 + L2] is similar to the specificity of trypsin;
      however, P'1 aromatic residues have low reactivity characteristic of
      chymotrypsin.

PMID- 8476867
TI  - Pulmonary surfactant-associated protein SP-B has little effect on acyl chains in
      dipalmitoylphosphatidylcholine dispersions.
AB  - Synthetic human pulmonary surfactant-associated protein SP-B has been interacted
      with chain-perdeuterated dipalmitoylphosphatidylcholine (DPPC-d62) in aqueous
      dispersions, and the dispersions were investigated by magnetic resonance
      spectroscopy. The protein caused only small perturbations of the deuterium
      magnetic resonance spectra in the gel and liquid-crystal states. In an amount of
      11% by weight in DPPC, it produced a small reduction in the magnitude of the
      first moments of the spectra in the gel and a small increase (approximately 5%)
      in their magnitude in the liquid crystal. In the liquid crystal the protein was
      observed to cause a similar effect on all portions of the acyl chain, as observed
      by its proportional shifting of splittings obtained from "dePaked" spectra. Using
      data from circular dichroism spectra, the protein was found to be about 45% alpha
      helical in methanol and in DPPC dispersions. alpha-Helical content was not
      significantly changed by the presence of 2 mM calcium or by the packing state of
      the acyl chains. The presence of the protein enhanced the adsorption rate of
      lipid into the air-water interface when dispersions of lipids or lipid plus SP-B
      were injected below the interface. The results could be consistent with the
      protein interacting with the lipid near the head groups or arranging itself
      around the edges of bilayer discs, or a combination of the two orientations.

PMID- 8476866
TI  - Effect of Na+ and nucleotide on the stability of solubilized Ca(2+)-free Ca
      ATPase from scallop sarcoplasmic reticulum.
AB  - In membranous scallop sarcoplasmic reticulum, the alkali metal cations Na+ and K+
      and nucleotide together promote dimer formation by the Ca(2+)-free Ca-ATPase and
      stabilize the enzyme activity [Kalabokis, V. N., Bozzola, J. J., Castellani, L.,
      & Hardwicke, P. M. D. (1991) J. Biol. Chem. 266, 22044-22050]. The dependence of
      stabilization of the Ca(2+)-free membranous scallop Ca-ATPase on Na+
      concentration does not show saturation and may involve several superimposed
      effects. In order to assess the contribution of dimer toward stabilization, i.e.,
      determine the relative importance of intra- and intermolecular effects on
      stabilization, the influence of varying Na+ concentration and nucleotide on the
      decay of enzyme activity of the Ca(2+)-free detergent-solubilized Ca-ATPase was
      studied. Loss of enzyme activity on removal of Ca2+ with EGTA was associated with
      loss of capacity for phosphorylation by ATP, a Ca(2+)-dependent function.
      Stabilization of the soluble Ca(2+)-free enzyme by Na+ showed major differences
      from that seen with the membranous enzyme. The extent of stabilization of the
      Ca(2+)-free soluble enzyme by Na+ showed clear saturation with increasing Na+
      concentration. In contrast to the Ca(2+)-free membranous enzyme, which is
      inactivated at pH 7.0 with biphasic first-order kinetics, loss of enzymatic
      function by the solubilized Ca-ATPase at pH 6.92, 0 degrees C, followed
      monophasic first-order kinetics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476868
TI  - Properties of a high-potential flavin analogue and its use as an active site
      probe with clostridial flavodoxin.
AB  - The reduction potential of flavin bearing a methylsulfonyl moiety (MeSO2) in
      place of a methyl group at position 8 is increased by more than 150 mV as
      compared with normal flavin. This substitution is accompanied by a substantial
      increase in reactivity with various reductants, including NADH, and greatly
      (10(3)-fold) enhanced susceptibility toward nucleophilic attack by sulfite at
      N(5). 1,5-Dihydro-8-(methylsulfonyl)riboflavin exhibits two intense, well
      resolved absorption bands (lambda max = 310, 362 nm) in a region where most other
      reduced flavins exhibit weak, characterless absorption. This unusual spectrum is
      attributable to a shift of pi-electron density from the N(5) atom into the
      benzene ring. It is observed only with reduced flavins bearing a strongly
      electronegative substituent (MeSO2, CN) at the 8-position. The effect is
      abolished by replacing the hydrogen at N(5) with a bulky group, like sulfite,
      which interferes with sp2 hybridization at N(5). Reaction of 8-MeSO2-substituted
      flavins with thiols results in nucleophilic displacement of MeSO2- in a reaction
      that is about 10(3)-fold faster than an analogous nucleophilic displacement
      reaction observed with 8-halo-substituted flavins. The flavin ring acts as a
      redox switch in controlling electrophilicity at the 8-position, as judged by the
      fact that the displacement reactions are observed only with the oxidized flavins.
      Initial studies to evaluate 8-MeSO2-substituted flavins as active site probes
      were conducted with flavodoxin from Clostridium beijerinckii MP. 8-MeSO2FMN is
      rapidly bound to apoflavodoxin, accompanied by absorbance and fluorescence
      changes similar to those observed for FMN binding. 1,5-Dihydro-8-MeSO2FMN
      flavodoxin exhibits spectral properties (lambda max = 323, 382 nm) similar to
      those of the corresponding free flavin, except for a bathochromic shift due to a
      change in the polarity of the flavin environment. As judged by peak resolution
      and intensity, the spectral properties of 1,5-dihydro-FMN flavodoxin (lambda max
      = 311, 362 nm) appear to lie about midway between those observed for the free 1,5
      dihydro forms of FMN versus 8-MeSO2FMN. This suggests that the protein
      environment may favor enhanced resonance delocalization of pi-electron density
      into the benzene ring of bound 1,5-dihydro-FMN, as compared with the free flavin.
      This hypothesis is consistent with previous NMR studies and with a proposal that
      electron transfer from reduced flavodoxin to other redox proteins occurs through
      this region of the ring. 8-MeSO2FMN bound to flavodoxin reacts readily with
      exogenous thiols but does not react with sulfite.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8476869
TI  - Functionally important domains of the large hydrophilic loop of CP47 as probed by
      oligonucleotide-directed mutagenesis in Synechocystis sp. PCC 6803.
AB  - The chlorophyll a-binding protein CP47 serves as core antenna to photosystem II
      (PS II). The predicted topology of CP47 exhibits six membrane-spanning regions
      and a large hydrophilic loop (loop E) which roughly includes 200 residues (255
      455) and is presumably exposed to the lumenal side of the thylakoid membrane.
      Several lines of experimental evidence suggest that loop E might be involved in
      binding or stabilizing functional manganese in the catalytic site of water
      oxidation or in interacting with the extrinsic PS II-O protein (the 33-kDa
      manganese-stabilizing protein). To scan loop E for functionally important
      domains, oligonucleotide-directed mutagenesis has been used to introduce
      deletions of 3-8 residues in conserved and charged regions of loop E. In
      addition, one single-site mutation of the only histidine present in loop E was
      created (H343L). Domains deleted in delta 1 (I265-F268), delta 2 (T271-K277),
      delta 4 (T304-L309), delta 5 (F311-N317), and delta 12 (D440-P447) are required
      for stable assembly of functional PS II complexes. Deletion of domains delta 3
      (K277-E283) and delta 11 (R422-E428) significantly reduces the level of assembled
      PS II and impairs photoautotrophic growth and oxygen evolution. Deletion of
      domain delta 8 (A373-D380) enhances the susceptibility to photoinhibition. In
      contrast, deletion of domains delta 6 (G333-I336), delta 7 (K347-R352), delta 9
      (V392-Q394), and delta 10 (D416-F420) and mutation of H343 to leucine do not seem
      to severly interrupt PS II structure and function, although all mutants exhibit a
      slightly decreased stability of PS II as compared to the wild type. Thus,
      selected domains of the large hydrophilic loop of CP47 are important for PS II
      structure and function. With respect to possible sites of interaction between
      loop E of CP47 and the extrinsic PS II-O protein, our results indicate that none
      of the deletions in the region from residue 330 to 420 (delta 6, delta 7, delta
      8, delta 9, delta 10) completely interrupts a functional association of the
      manganese-stabilizing protein to PS II, although the binding characteristics
      might be changed in some cases.

PMID- 8476870
TI  - Structure-function relationship of a recombinant human galactoside-binding
      protein.
AB  - A galactoside-binding lectin (hL-31) containing a collagen-like sequence was
      identified in human tumor cells. It was found to be the homologue of the IgE
      binding protein, the macrophage cell-surface Mac-2 antigen, and the murine CBP35,
      RL-29, and mL-34 lectins. Here we report on the expression in Escherichia coli
      and functional analysis of recombinant hL-31 (rhL-31). The rhL-31 was purified in
      one step through an asialofetuin affinity column. The rhL-31 was reactive to anti
      lectin antibodies and retained its lactose-dependent hemagglutination of trypsin
      treated glutaraldehyde-fixed rabbit erythrocytes. The rhL-31 elutes from an
      affinity column as a 31-kDa monomer and undergoes homodimerization at relatively
      high protein concentrations, comparable to those used to mediate
      hemagglutination. Electron microscopy showed that the rhL-31 appears as a Y
      shaped structure. Lactoperoxidase-catalyzed iodination of murine tumor cell
      surface proteins followed by collagenase treatment revealed that the lectin is
      probably a peripheral membrane protein whereby both the amino and the carboxy
      termini are exposed on the outer cell membrane. These results point to the
      membrane disposition and orientation of the lectin and suggest a mechanism for a
      structure-function relationship of lectin activity.

PMID- 8476871
TI  - Mechanisms of mutation by oxidative DNA damage: reduced fidelity of mammalian DNA
      polymerase beta.
AB  - Reactive oxygen species, produced in cells by a variety of mechanisms, damage DNA
      and cause mutations. To characterize the types of mutations produced in mammalian
      cells, we copied DNA damaged by reactive oxygen species with mammalian DNA
      polymerase beta. Double-stranded circular M13mp2 DNA containing a 361-nucleotide
      single-stranded gap within the lacZ gene was damaged by aerobic incubation with
      Fe2+ and H2O2. The gap then was filled by purified recombinant rat DNA polymerase
      beta, and the DNA was transfected into Escherichia coli. Mutations within the
      nonessential lacZ gene for beta-galactosidase were identified by reduced alpha
      complementation. In this system, oxidative damage increased the mutation
      frequency within the target region by an average of 4.3-fold. At certain sites,
      the base substitution rate is nearly 300 times greater than would be expected to
      result from a random distribution of damage. The oxidatively induced mutations
      fall into two categories: those apparently caused by direct miscoding of modified
      DNA and those associated with enhanced misincorporation at prexisting polymerase
      specific hot spots. The latter group may be due to a conformational change in the
      DNA caused by oxidative modification and could be indicative of a novel mutagenic
      mechanism.

PMID- 8476872
TI  - Cholesterol screening in the adolescent.
AB  - Guidelines for screening populations for hypercholesterolemia are controversial.
      In pediatric patients, screening has been targeted to those with a family history
      of hypercholesterolemia or early myocardial infarction. Because specific
      guidelines for adolescents have not been developed, we undertook a study of
      cholesterol screening in 224 consecutive patients (mean age, 14.8 +/- 2.2 years;
      range, 11-20 years). In this study, 33 (14.7%) adolescents had levels above 185
      mg/dL; 71 (32.7%) of the patients reported a positive family history for early
      myocardial infarction or elevated lipids. A positive family history obtained from
      the adolescent patient had a 36% sensitivity, 69% specificity, 17% positive
      predictive value, and an 87% negative predictive value compared with elevated
      cholesterol level. A positive history reported by the parent had a 65%
      sensitivity, 46% specificity, 16% positive predictive value, and an 89% negative
      predictive value. A positive family history obtained from either parent or
      adolescent had a 45% sensitivity, 69% specificity, 19% positive predicative
      value, and 89% negative predictive value. Family history by the adolescent was
      significantly different from parental history (p < 0.001). Family history is a
      poor predictor for cholesterol level in adolescents.

PMID- 8476873
TI  - A developmental approach to sexuality education: implications for medical
      practice.
AB  - Medical professionals are increasingly expected to address issues of sexuality
      and acquired immunodeficiency syndrome (AIDS) with young patients and their
      parents. Focus group interviews were conducted with parents (n = 43) and
      adolescents (n = 800) to determine the preferred physician role regarding
      families and sexual development. Parents believed that a physician was an
      appropriate expert to assist in preventing negative risk behaviors (e.g., drugs,
      alcohol, sexual intercourse) and emphasized the importance of the physician
      developing a comfortable relationship early on with parents and youth to allow
      for reciprocal dialogue about sensitive topics. Parents also commented that
      physicians generally appeared uncomfortable when discussing personal issues
      (viz., sexuality) and frequently lacked communication skills (e.g., use of open
      ended questions or statements) to foster conversation. Youth identified
      physicians as a logical source of information about sexuality but felt hesitant
      to ask questions that might prompt value-based discussion. Youth also expressed
      concern about confidentiality in the doctor-patient relationship. Adolescents
      desired physicians to be more "askable" than they are perceived to be. Guidelines
      are offered for strengthening office interactions and improving communication
      skills.

PMID- 8476874
TI  - A pilot study of AIDS education and counseling of high-risk adolescents in an
      office setting.
AB  - Little is known about interventions in office practices aimed toward reducing
      behaviors that put adolescents at risk for human immunodeficiency virus (HIV)
      acquisition. We therefore targeted a pilot study of HIV education and counseling
      to high-risk adolescents. Ninety adolescent patients (mean age, 17.6 +/- 2.0
      years) were interviewed in a hospital-based adolescent clinic by two physicians
      and randomized to two groups: 1) a standard care group that was interviewed about
      high-risk behaviors at 0 and 2 months; and 2) an intervention group that was
      similarly interviewed but was also given a detailed discussion about HIV risks
      and prevention. At follow-up (mean, 2.6 +/- 0.8 months), 25% of patients reported
      less sexual activity (standard care, 32%; intervention, 18%) toward a trend. The
      reduction in mean number of partners per month was 0.4 +/- 0.9, (p = 0.0001).
      Fifty-four percent of the patients reported that they used condoms more often
      than previously with no significant difference between the two groups. Use of
      condoms ("always use") increased in both groups significantly (p = 0.03 standard
      care, p = 0.02 intervention). Use of condoms at last intercourse increased in the
      intervention group (37% to 42%, p = 0.03). In the interval, there were no
      significant differences between the groups in the number of newly diagnosed
      sexually transmitted diseases or in the number of patients seeking HIV testing.
      The number of patients stating that they shared needles decreased from 3 to 0.
      Both the intervention and standard care groups reported a reduction in high-risk
      behaviors that was temporally related to the discussion of this subject in the
      clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476875
TI  - The SAPHO syndrome in a 16-year-old boy: coincidence of acne conglobata and
      osteoarthritis.
AB  - A 16-year-old boy developed arthritis and osteitis (anterior thoracic wall, ankle
      of left foot, spinal column) within 5 weeks of an exacerbation of acne. Both the
      local skin condition and the locomotory system improved after treatment, but
      sternocostoclavicular hyperostosis persisted. The syndrome of acne, pustulosis,
      hyperostosis, and osteitis (SAPHO syndrome) identified in 1987, represents an
      entity usually classified as one of the seronegative spondylarthrites close to
      ankylosing spondylarthritis and psoriatic arthritis.

PMID- 8476876
TI  - The four "R's"--the need for research in the schools.

PMID- 8476877
TI  - Substance use among adolescents with diabetes mellitus: preliminary findings.
AB  - Alcohol and drug use frequency was assessed by means of an anonymous, self
      administered questionnaire in 79 diabetic adolescents who attended a diabetic
      sleep away camp. More than half of the participants reported using tobacco or
      alcohol at least once and 12%-25% reported greater that five times use in their
      lifetime. The overall frequency of drug and alcohol use was less than the general
      adolescent population. A modified Michigan Alcohol Screening Test (MAST) was used
      to evaluate abnormal drinking patterns, and 40%-50% of 12- and 16-year-old
      campers had an abnormal score, indicating that almost one-quarter of diabetic
      teens drink dangerously. There was a high correlation between campers who use
      drugs or alcohol and a positive family history of alcohol or substance abuse. Few
      campers perceived alcohol or drug use to affect their diabetic control, and the
      majority believed their control to be good to excellent, thus demonstrating the
      impact of denial in diabetic adolescent substance use. Adolescent diabetic
      assessments should include a psychosocial history, with emphasis on patterns of
      substance use, family substance abuse, and use of the MAST to identify high-risk
      individuals.

PMID- 8476878
TI  - Changes in adolescents' knowledge and attitudes about AIDS over the course of the
      AIDS epidemic.
AB  - We compared AIDS-related attitudes of junior and senior high school students from
      1988 to 1991 and across grade level to examine how effectively schools are
      addressing AIDS. Attitudes measured included knowledge and social anxiety about
      AIDS, as well as perceptions of vulnerability to HIV infection. Junior high
      school students (grades 7-9) were sampled three times, from 1989 to 1991. High
      school students (grades 10-12) were sampled four times, from 1988 to 1991. The
      1991 junior high school sample had lower AIDS knowledge scores than the 1989
      sample. Conversely, the 1991 high school sample had more accurate knowledge than
      earlier groups. With respect to grade level, 9th graders had more accurate
      knowledge than 7th and 8th graders, but knowledge did not increase from 10th
      through 12th grade. Anxiety about interacting with a person with AIDS and
      perceptions of vulnerability to HIV infection were unrelated to either sampling
      time or grade level. It is concluded that it will be important to redouble
      efforts to educate adolescents about AIDS and that particular attention needs to
      be paid to young adolescents.

PMID- 8476879
TI  - School-based clinic use and school performance.
AB  - School-based health clinics (SBCs) have been promoted as an innovative approach
      to providing adolescent health care. The present study examined the effect of a
      SBC on academic success. We studied the effect of clinic registration and use on
      students' absence, suspension, withdrawal, and graduation or promotion rates in
      an alternative high school for students who were not able to succeed in
      traditional educational programs. On average, these 322 high-risk students
      attended school only 56% of the time; 24% were suspended; and only 26% graduated
      or were promoted. The 189 (59%) students who were registered to use the clinic
      and the 159 (49%) who actually used the clinic were as likely to be absent or to
      be suspended as non-registered students. However, students who used the clinic
      were significantly more likely to stay in school, and to graduate or be promoted
      than students who were not registered for the clinic. This relationship was
      strongest for black males; those who used the clinic were nearly three times
      [odds ratio = 0.35; 95% confidence interval (CI) = (0.16-0.78)] more likely to
      stay in school than those who did not use the clinic. In multiple linear
      regression models predicting school performance, only clinic use and percent of
      enrolled days absent were significantly associated with graduation/promotion, and
      these two variables predicted 23% of the variance in promotion status.

PMID- 8476880
TI  - Parental response to identification of elevated blood pressure or cholesterol
      following school-based screening.
AB  - The objective of this study was to identify factors that influenced compliance
      with a recommendation for reevaluation of an elevated cholesterol or blood
      pressure level following a school-based screening examination. A questionnaire
      was developed and mailed to parents of 103 5th- through 8th-grade students who
      had received such a recommendation. A total of 72 usable questionnaires were
      returned. There were no significant physiologic, health, or demographic
      differences between the respondents and the nonrespondents. Of the respondents,
      38 (53%) had their child's cholesterol or blood pressure level reevaluated. There
      were no differences in mean levels of total cholesterol or blood pressure between
      those reevaluated and those who were not. The factor most often associated with
      compliance was parents' reported concern about their children's health. Of note
      was the apparent lack of action by many physicians when presented with blood
      pressure and cholesterol values above recommended levels. Further study is needed
      to determine appropriate interventions to enhance compliance.

PMID- 8476881
TI  - Immunofluorescence of endomyocardial biopsy specimens: methods and
      interpretation.
AB  - On the basis of our experience with prospective observation of immunofluorescence
      microscopy in 5775 biopsy specimens from 335 consecutively followed heart
      transplant cases, we describe the immunofluorescent method in detail and the
      potential artifacts and method of interpretation of the findings. A strategy for
      use of the method on the basis of the experience of the authors is proposed.

PMID- 8476882
TI  - Laboratory-clinical correlates of time-associated lesions in the vascular
      immunopathology of human cardiac allografts.
AB  - Ninety cardiac allograft recipients were studied for clinical and functional
      parameters during a 40-month period. Baseline histologic and immunocytochemical
      data were obtained from donors' hearts before transplantation, and serial
      endomyocardial biopsy specimens were studied histologically for cellular
      infiltrates and immunocytochemically for complement and immunoglobulin deposits
      and for components of the hemostatic, fibrinolytic, and natural anticoagulant
      pathways. Results were grouped according to the time from transplantation: the
      first 3 months, 4 to 21 months, and 22 to 40 months. Each group was evaluated for
      most frequently obtained immunocytochemical findings and results relevant to
      clinical-laboratory cooperation in patient management. During the first 3 months,
      findings of biopsy specimens from allografts that subsequently were going to be
      problem cases revealed depleted tissue plasminogen activator in arteriolar smooth
      muscle cells, and recipient IgM that was deposited on donor endothelium of stable
      grafts was diminished or absent in unstable allografts. In addition, vascular
      deposits of activated complement components were identified in 50 of 70
      allografts. From 4 through 21 months after transplantation, vascular deposits of
      complement rarely were identified (even in patients who previously had positive
      biopsy specimens), and the principal vascular lesion was fibrin deposits with
      impaired anticoagulant pathways and inadequate fibrinolysis, usually without
      associated cellular infiltrates. From 22 through 40 months after transplantation,
      the principal vascular lesion was graft-induced atherosclerosis. These
      immunocytochemically defined qualitative and quantitative changes in unstable or
      failing allografts form a time-related spectrum of lesions that encompasses the
      emerging diagnostic entity of vascular rejection.

PMID- 8476883
TI  - Vascular rejection in heart transplantation: clinical correlation, treatment
      options, and future considerations.
AB  - Vascular rejection injures the vascular endothelium in cardiac allografts in the
      absence of significant intramyocardial lymphocytic infiltration. When compared
      with cellular rejection, vascular rejection occurs earlier after transplantation,
      is more resistant to immunosuppressive augmentation, causes more allograft
      dysfunction, and is associated with a higher frequency of allograft loss. Between
      January 1990 and October 1992, acute hemodynamically significant vascular
      rejection developed in 13 of 170 patients (8%). Endomyocardial biopsy specimens
      revealed the typical findings of endothelial cell activation, immune complex
      deposition, and interstitial fibrin deposition in the absence of significant
      lymphocytic infiltration. All patients had clinical evidence of allograft
      dysfunction. In addition to high-dose corticosteroids, all patients received
      cyclophosphamide as an oral pulse for 4 days and underwent plasmapheresis for 3
      consecutive days. Eight patients received OKT3 (n = 6) or antilymphoblast
      globulin (n = 2), and nine patients underwent systemic anticoagulation. Six
      patients required inotropic therapy for hemodynamic instability. Although one
      patient died during the initial episode, rejection resolved and left ventricular
      function returned to normal in 12 of 13 patients. However, vascular rejection
      recurred in three patients, two of whom subsequently died. Two other patients
      died during late follow-up because of noncompliance. Eight patients remain alive
      with normal allograft function and angiographically normal coronary arteries.
      Whereas the addition of cyclophosphamide and plasmapheresis may improve the
      outcome of vascular rejection, the results of treatment with currently available
      treatment modalities remain unacceptably poor.

PMID- 8476884
TI  - Role of humoral immunity in acute cardiac allograft dysfunction.
AB  - To elucidate the pathogenic mechanisms of acute allograft dysfunction that is not
      caused by acute cellular rejection, we have studied the clinical and
      immunopathologic characteristics of 11 heart transplant recipients who had acute
      allograft dysfunction in the absence of interstitial mononuclear cell infiltrates
      on endomyocardial biopsy samples. Six of eleven patients (54%) had a striking
      increase in levels of anti-HLA antibodies in close temporal proximity with the
      episode of acute allograft dysfunction. Cardiac allograft function improved in
      all patients with intensification of immunosuppression.

PMID- 8476885
TI  - Vascular rejection in heart transplant recipients.
AB  - Antibody medicated (vascular) rejection has recently been described in heart
      transplantation. We report our experience with vascular rejection in a series of
      62 patients who did not receive perioperative lymphocyte antibody therapy. Sixty
      five rejections were reported, of which 58 (89%) were pure cellular; five (8%)
      had both cellular and vascular components, and two (3%) had only vascular
      rejection. Vascular rejection was very common in patients in whom hemodynamic
      compromise developed, and hemodynamic compromise was significantly more common in
      vascular than cellular rejection. Treatment for vascular rejection included
      plasmapheresis, intravenous methylprednisolone, and cyclophosphamide. Only one
      death occurred in this series, and that occurred in a patient with vascular
      rejection where the diagnosis and initiation of therapy were delayed. The role of
      vascular rejection in patients with hemodynamic compromise is discussed.

PMID- 8476886
TI  - Patients who die awaiting heart transplantation.
AB  - In the United States, heart donor availability has increasingly failed to keep
      pace with rising demand. Transplant data were obtained from the United Network
      for Organ Sharing for 1988, 1989, and 1990 and by survey of 50 heart
      transplantation centers, which performed 1932 transplantations between 1983 and
      1989. According to the United Network for Organ Sharing, 512 patients on the
      waiting list died in 1988; 527, in 1989; 650, in 1990, and if present trends
      continue more than 800 will have died in 1991. Similar numbers of patients were
      inactivated or removed from the list each year. Only 49% of patients (1647 of
      3390) on the heart transplant waiting list at some time in 1988 underwent the
      procedure in that year. For 1989 the figure fell to 42% (1630 of 3915 patients).
      Survey data revealed a threefold increase in the ratio of the number of patients
      who died/number of patients who underwent transplantation from 0.07 in 1983 to
      0.21 in 1989 and in the ratio (number of patients who died+number of patients who
      were removed from the list)/number of patients who underwent transplantation from
      0.12 in 1983 to 0.38 in 1989. The major causes of death among waiting patients
      were congestive heart failure (46%) and arrhythmia (29%). From 1983 to 1989, 55%
      (134 of 243) of those patients with documented urgency status died in the
      intensive care unit; 45% (109 of 243) died elsewhere. Waiting time for patients
      dying in the intensive care unit rose from 10.7 days in 1985 to 50.3 days in
      1989; patients dying out of the intensive care unit waited 103.7 days in 1985 and
      85.6 days in 1989. In conclusion, the number and proportion of potential
      recipients who die awaiting heart transplantation is increasing every year.
      Congestive heart failure and arrhythmia are the major causes of death, and
      similar numbers of patients die in and out of the intensive care unit.

PMID- 8476887
TI  - Prostaglandin E1-induced moderation of elevated pulmonary vascular resistance.
      Survival on waiting list and results of orthotopic heart transplantation.
AB  - Forty-three consecutive patients who were being treated with digitalis,
      angiotensin converting enzyme inhibitors, and diuretics were evaluated for
      orthotopic heart transplantation. After right heart catheterization in patients
      with more than 3 Wood units or with a mean pulmonary artery pressure higher than
      30 mm Hg (n = 13; group 1), prostaglandin E1 (PGE1) therapy was initiated at a
      dosage of 5 ng/kg/min and was increased stepwise (mean maintenance dosage, 35
      ng/kg/min) until side effects (joint pain, digital edema) occurred. After 6 days
      of PGE1 administration, dosage decreased stepwise. One week after PGE1 was
      stopped, right heart recatheterization was performed, and the patients were
      listed on the waiting list. Hemodynamic data significantly improved in PGE1
      treated patients. Patients without pulmonary hypertension (group 2, n = 30) were
      put directly on the waiting list. No oversized or local donor was required for
      transplantation. Eight of 13 patients in group 1 underwent transplantation. The
      other five patients died while on the waiting list. In group 2, 15 patients
      underwent transplantation, and 15 patients died while on the waiting list. A
      prolonged mean survival time on the waiting list (6.0 versus 3.1 months, p <
      0.005) was noticed in group 1. PGE1 was administered after orthotopic heart
      transplantation whenever indicated; no death was related to right ventricular
      failure in group 1. The results after orthotopic heart transplantation in
      patients treated with PGE1 were comparable to the control group. PGE1 therapy
      enabled us to perform orthotopic heart transplantation on patients with pulmonary
      hypertension at a comparable risk with normal heart transplant recipients.

PMID- 8476888
TI  - Pulmonary vasodilation after heart transplantation. A comparison among
      prostacyclin, sodium nitroprusside, and nitroglycerin on right ventricular
      function and pulmonary selectivity.
AB  - The aim of this study was to compare the effects of prostacyclin on central
      hemodynamics and right ventricular function to the more widely used vasodilators,
      sodium nitroprusside and nitroglycerin, and to investigate whether prostacyclin
      is more selective to the pulmonary vascular bed compared to sodium nitroprusside
      and nitroglycerin in patients after heart transplantation. Hemodynamic
      measurements were made after the operation in the intensive care unit with a
      pulmonary artery fast-response ejection fraction/volumetric thermodilution
      catheter. The aim was to maintain mean arterial pressure around 70 mm Hg with
      each drug. After a 10-minute infusion of each drug at a stable infusion rate,
      central hemodynamic variables and right ventricular end-diastolic volume, end
      systolic volume, and ejection fraction were measured or derived in triplicate.
      The average infusion rates of sodium nitroprusside, nitroglycerin, and
      prostacyclin were 3.3 +/- 1.7 micrograms/kg/min, 6.6 +/- 1.8 micrograms/kg/min,
      and 12.4 +/- 1.7 ng/kg/min, respectively. Cardiac output, stroke volume, right
      ventricular end-diastolic volume, and central filling pressures were highest for
      prostacyclin compared to both nitroglycerin and sodium nitroprusside. Pulmonary
      vascular resistance was lower for prostacyclin compared to nitroglycerin but was
      comparable to that of sodium nitroprusside. Systemic vascular resistance was
      lowest for prostacyclin compared to both sodium nitroprusside and nitroglycerin.
      The pulmonary vascular resistance/systemic vascular resistance ratio used as an
      index of pulmonary selectivity did not differ between the vasodilators. The right
      ventricular ejection fraction did not differ among the three drugs.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476889
TI  - Utilization of pediatric donors salvaged by cardiopulmonary resuscitation.
AB  - The efficacy of using infant donors with an extended cardiopulmonary
      resuscitation (CPR) history was investigated. Eight heart transplantations with
      donors who had no or minimal (less than 10 minutes) history of CPR (group A) and
      seven heart transplantations with donors with extended CPR history (35 to 125
      minutes; mean, 59 minutes; group B) were compared for peak myosin levels after
      transplantation, and systolic and diastolic cardiac function in the first week
      after transplantation. All donor hearts had normal hemodynamics in the early
      postoperative period. No significant differences were found between the groups
      with regard to age of donors, age of recipients, donor heart ischemic time, and
      cardiac function in the first week after transplantation. In group B, peak myosin
      levels were 1.4, 4.6, 7.0, 11.3, 14.8, 20.2, and 21.3 ng/ml. These values were
      significantly (p < 0.05) higher than those in group A but represented only
      minimal myocardial damage when compared with the values in previous myocardial
      infarction studies. Although donors with a history of protracted CPR had higher
      efflux of myosin light chains perioperatively, hemodynamic recovery suggests that
      use of pediatric donor heart grafts after prolonged CPR is safe and efficacious.

PMID- 8476890
TI  - Reliable noninvasive rejection diagnosis after heart transplantation in
      childhood.
AB  - Rejection diagnosis was exclusively handled with noninvasive techniques in 16
      children (mean age, 8.6 +/- 5.7 years; range, 0.9 to 15.2 years) over a total
      follow-up period of 18.3 patient years. No endomyocardial biopsies were
      performed. Intramyocardial electrogram recordings and echocardiographic
      investigations were used as two noninvasive techniques for rejection diagnosis.
      Daily noninvasive telemetric monitoring of the overnight intramyocardial
      electrogram was the major diagnostic guideline. The intramyocardial electrogram
      signal of the sleeping child was transmitted to a bedside receiver by an
      implanted telemetric pacemaker. The QRS amplitude was automatically analyzed and
      transferred to the in-hospital computer via a telephone modem connection.
      Rejection was diagnosed when QRS amplitude fell more than 8% below average
      baseline levels for 3 successive days, which was the indication for hospital
      admission. Medical antirejection treatment was instituted only if
      echocardiography showed impaired early diastolic left ventricular relaxation
      concomitant with a QRS-amplitude loss. The echocardiographic criterion was a
      prolongation of the parameter Te (Te is defined as the time span between onset of
      diastole and peak relaxation velocity of left ventricular wall) by more than 10
      milliseconds compared to previous intraindividual values. Survival after a mean
      follow-up time of 13.7 months (range, 2 to 57 months) is 100%. A total of 22
      rejection episodes were treated. During the first 6 postoperative months, the
      incidence of rejection requiring treatment was 1.4 episodes per patient. In
      patients at home, distant monitoring detected 13 episodes of a significant QRS
      amplitude drop, which led to hospital readmission. In eight children,
      echocardiography was likewise positive, and rejection treatment was instituted.
      One child with positive intramyocardial electrography received antirejection
      treatment because of clinical evidence of rejection, although echocardiography
      was negative. In three instances, systemic infection was associated with the QRS
      voltage loss. In one child a reason for QRS-complex reduction could not be
      identified. One rejection episode was treated on the grounds of clinical signs
      and positive echocardiography without a significant QRS-voltage drop. We conclude
      that distant noninvasive rejection monitoring based on meticulous application of
      the techniques described is a safe procedure. Daily monitoring of QRS amplitude
      in patients at home is an excellent safeguard against overlooking significant
      rejection episodes. This is of special importance in infants and children, in
      whom routine endomyocardial biopsy cannot be performed. Distant overnight
      monitoring minimizes psychosocial disturbance during follow-up after heart
      transplantation.

PMID- 8476891
TI  - Is cyclosporine toxic to the heart?
AB  - Cardiotoxicity caused by cyclosporine was studied in experimental rats by the
      uptake of radiopharmaceuticals (technetium 99m-labeled pyrophosphate and indium
      111-labeled antimyosin) and histologic examination of heart tissues. A dose of 50
      mg/kg (body weight) of cyclosporine and an equal volume of vehicle (cremophor-EL)
      were injected into the rats subcutaneously for 7 or 11 consecutive days. A
      statistically significant difference (p < 0.05) was noted between the uptake of
      the radiopharmaceuticals in the hearts of cyclosporine-treated rats compared to
      the control rats. For 99mTc pyrophosphate, the cardiac uptake ratios of
      cyclosporine-treated rats to control rats were 2.13 and 4.08 for 7-day and 11-day
      treatment periods, respectively. For 111In antimyosin, the ratios were greater
      than 2 for both 7-day and 11-day treatment periods. Histologically, vacuoles were
      found in single or focal groups of myocytes with interstitial edema in the hearts
      of cyclosporine-treated rats compared to the control rats. The results of both
      the uptake of the radiopharmaceuticals and the histologic evidence indicate cell
      injury in the hearts of cyclosporine-treated rats. Cyclosporine therefore seems
      to be toxic to the heart tissue.

PMID- 8476892
TI  - Does short-course induction with OKT3 improve outcome after heart
      transplantation? A randomized trial.
AB  - OKT3 is often used routinely for induction immunotherapy or selectively to avoid
      acute cyclosporine nephrotoxicity in heart transplant recipients at high risk for
      immediate postoperative kidney failure. It has not been shown in a randomized
      trial to be useful in patients at low risk for early kidney failure. We
      randomized 30 patients with a serum creatinine level of less than 1.4 mg/dl
      before heart transplantation to be treated with triple-drug immunotherapy with
      cyclosporine, which was started before surgery, (group 1) or to be treated with
      OKT3 for 4 to 6 days after surgery with oral cyclosporine, which was started
      between days 2 and 4, after renal function had stabilized (group 2). Follow-up
      for 6 months revealed no significant differences in the total number of rejection
      episodes, total number of infections, or in the serum creatinine level. Four
      patients in group 1 and five patients in group 2 have had no rejection. OKT3
      showed a trend to delay time to first rejection (p = 0.10), as has been reported
      for the 14-day induction course of OKT3. A short course of OKT3 induction in
      heart transplant recipients at low risk for immediate postoperative kidney
      failure prolongs the time to first rejection for most patients but does not
      appear to reduce the total incidence of rejection in the first 6 months after
      heart transplantation.

PMID- 8476893
TI  - Urodilatin, a new therapy to prevent kidney failure after heart transplantation.
AB  - Kidney failure after heart transplantation still remains a crucial problem,
      especially when cyclosporine is used for early postoperative immunosuppressive
      therapy. To preserve good renal function during immunosuppression with
      cyclosporine, urodilatin (CDD/ANP-95-126), the kidney-born analogue to the
      circulating cardiac peptide hANP (CDD/ANP-99-126), was given for the first time
      as a long-term, low-dose infusion in addition to the usual drug therapy
      immediately after heart transplantation. From November 1990 to January 1992, 47
      patients (44 men and three women; mean age, 51 years) were treated by a 20 ng/kg
      body weight/min infusion for 96 hours after heart transplantation. Renal function
      and hemodynamic parameters of these patients were compared with a group of 40
      patients (34 male and six female; mean age, 50 years) as controls, who underwent
      heart transplantation from May 1990 to November 1991. Both groups did not differ
      significantly with respect to age, sex, indication for heart transplantation, and
      preoperative renal function. With urodilatin treatment, renal function was
      significantly improved with lower peak plasma creatinine (1.83 +/- 0.1 versus
      2.47 +/- 0.19 mg/dl; p = 0.003), lower peak serum urea (118 +/- 7 versus 178.3 +/
      10.3 mg/dl; p = 0.0036) and absence of hemodialysis (0% versus 10%; p = 0.026).
      Additionally, adequate diuresis was maintained although furosemide was reduced by
      more than 50% (p = 0.005) on each day of urodilatin treatment. Mean central
      venous pressure was significantly lower (-2 mm Hg; p = 0.02) during application
      of urodilatin, despite reduction of vasodilator therapy with nitroglycerin by
      about 50% (p = 0.02). Because of the significantly improved renal function and
      beneficial hemodynamic effects, the recommendation is therefore to introduce
      urodilatin in the postoperative treatment protocol after heart transplantation.

PMID- 8476894
TI  - Vascular lesions in biopsy specimens devoid of cellular infiltrates: qualitative
      and quantitative immunocytochemical studies of human cardiac allografts.
AB  - Biopsy specimens from 80 cardiac allografts were studied immunocytochemically
      with nine antibodies selected to identify cellular, immunologic, and vascular
      aspects of rejection. Results from these experiments were converted to a numeric
      base and used to calculate rejection indexes for each of these aspects of
      rejection. Pretransplantation biopsy specimens of donor hearts were studied to
      determine normal values, and clinical, catheterization, and conventional biopsy
      findings were used to classify patients as stable or unstable. The standard
      deviation of cellular and immunologic reaction indexes were overlapping for
      stable and unstable patients, but the vascular indexes for these patient groups
      were significantly different, suggesting that vascular damage defines clinical
      instability in cardiac allograft recipients. To study the vascular index in the
      absence of cellular infiltrates, biopsy specimens from 80 allografted hearts were
      selected to represent 40 patients with cellular infiltrates and 40 patients
      devoid of infiltrates. The results of this analysis revealed no difference in the
      vascular index between hearts that contained or did not contain infiltrates; the
      spectrum of vascular damage between the groups ranged from trivial to severe,
      suggesting that vascular damage was not dependent on cellular infiltrates.
      Concluding that these were independent events was not possible, however, because
      none of the hearts continuously were devoid of cellular infiltrates. Two groups
      of patients with significantly different vascular indexes then were studied for a
      systemic manifestation of coagulation by measurement of their thrombin times. The
      group with low vascular index was found to have significantly prolonged thrombin
      times compared to the group with high vascular index, and a trend to less
      prolongation of thrombin times was observed in another group with high cellular
      index. The relation of these results with cardiac allograft vasculopathy is not
      established, but the results suggest hitherto unexplored roles for quantitative
      expressions of hemostasis, fibrinolysis, and anticoagulation in the
      pathophysiology of vascular disease in allografts.

PMID- 8476895
TI  - Identification of a subpopulation of reactive large granular mononuclear cells in
      allogeneic heart transplantation.
AB  - This study is designed to test the hypothesis that specific morphologic
      attributes of peripheral blood mononuclear cells, measurable by flow cytometry,
      are correlated with the timing and the intensity of allograft injury during the
      development of heart rejection. A pig model of major histocompatibility complex
      mismatched heterotopic heart transplantation with (n = 5) and without (n = 5)
      cyclosporine administration was monitored serially be telemetered
      electrocardiography and endomyocardial biopsies. Flow cytometric analysis of
      peripheral blood mononuclear cells revealed the emergence of a discrete
      subpopulation of peripheral blood mononuclear cells (7.8% +/- 1.0% and 8.5% +/-
      0.9% before transplantation to 16.5% +/- 1.3% and 19.4% +/- 3.0% after
      transplantation in the untreated and the cyclosporine-treated groups,
      respectively, p < 0.05), exhibiting characteristic changes in forward and 90
      degree light scatter, indicative of increased cell size and granularity, and
      possibly representing monocytes or large granular lymphocytes. Lymphocyte cell
      surface-marker studies indicated that 62% of these cells are DH59B+
      (monocyte/granulocyte). Because intracellular free calcium is an important second
      messenger in lymphocyte activation we measured intracellular free calcium by flow
      cytometry using fluo-3. This subpopulation of cells was found to have similar
      intracellular free calcium when compared to normal-sized lymphocytes (104 +/- 7
      nmol/L versus 101 +/- 5 nmol/L, respectively). We conclude that this lymphocyte
      subset detected by flow cytometry represents specifically reactive cells that are
      associated with incipient allograft rejection.

PMID- 8476896
TI  - Reproducibility of the acute rejection diagnosis in human cardiac allografts. The
      Stanford Classification and the International Grading System.
AB  - Transplantation has become an accepted treatment of many cardiac end-stage
      diseases. Acute cellular rejection accounts for 15% to 20% of all graft failures.
      The first grading system of acute cellular rejection, the Stanford
      Classification, was introduced in 1979, and since then many other grading systems
      have evolved. Most recently, the International Grading System was introduced in
      The Journal of Heart and Lung Transplantation. In this study the interobserver
      reproducibility of both the Stanford Classification and the International Grading
      System is evaluated using Kappa statistics. Three observers evaluated 168
      endomyocardial biopsy specimens according to the Stanford Classification and 100
      endomyocardial biopsy specimens according to the International Grading System.
      The evaluation was carried out blindly. Kappa values of 54.1% and 51.5%,
      respectively, were obtained, both significantly above zero but not optimal. In
      addition to the interobserver reproducibility analysis of the two grading
      systems, the International Grading System is discussed. In the original
      description of the grading system terms such as focal, multifocal, and aggressive
      infiltrates and myocyte damage and myocyte necrosis are used. These terms create
      some difficulties in understanding or interpreting the various grades. The main
      problem is to distinguish between grade 1A and grade 3A. Despite the
      difficulties, the grading system is easy to use, but a revision is needed.

PMID- 8476897
TI  - Gastrointestinal complications and endoscopic findings in heart transplant
      patients.
AB  - To determine the scope of gastrointestinal complications in heart transplant
      recipients, we examined the frequency and nature of gastrointestinal
      complications by reviewing the indications and findings of endoscopic and
      surgical procedures involving the gastrointestinal tract in 159 patients. All
      patients were treated with prednisone, azathioprine, and cyclosporine after
      transplantation. Sixty-seven patients (42%) had gastrointestinal symptoms
      significant enough to warrant either endoscopic, radiologic, or surgical
      procedures. Forty-seven patients (30%) underwent esophagogastroduodenoscopy or
      upper gastrointestinal roentgenography with a high frequency of esophagitis,
      gastritis, duodenitis, and gastroduodenal ulcers. Thirty-two patients (20%)
      underwent barium enema or endoscopic procedures of the lower gastrointestinal
      tract, with the most frequent findings being benign polyps and colitis.
      Opportunistic infections, especially with cytomegalovirus, were frequent and were
      only diagnosed by endoscopic procedures, indicating an advantage of endoscopy
      over barium studies in these patients. Twenty-three patients (15%) underwent
      surgical procedures for gastrointestinal complications with 2.5% mortality.
      Hence, significant gastrointestinal complications that are common in heart
      transplant recipients, can be safely managed surgically when surgical
      intervention is indicated.

PMID- 8476898
TI  - Ophthalmic complications after heart transplantation.
AB  - To ascertain the ophthalmic complications after heart transplantation, the
      authors reviewed 59 patients who had been referred to the ophthalmology
      department during a 4-year period and were subsequently followed for at least 1
      year. Twenty-five patients (43%) were found to have lens changes in one or both
      eyes, which is typical of prolonged oral corticosteroid therapy. In three
      patients (5.2%) posterior subcapsular cataract formation progressed to a level
      where cataract surgery was required. In two patients (3.4%) cytomegalovirus
      retinitis developed within 6 months of the transplantation, and significant
      irreversible visual loss occurred. Retinal vascular changes were found in 22
      patients (37.3%), including 18 patients with hypertensive retinopathy and one
      patient with background diabetic retinopathy. During the period of observation, a
      central retinal vein occlusion developed in one patient, an anterior ischemic
      optic neuropathy developed in one patient, and bilateral occipital lobe
      infarctions developed in one patient. Older patients and those with a longer
      survival time after transplantation were more likely to have ophthalmic
      complications (p = 0.04). Although these results indicate a low incidence of
      sight-threatening complications after heart transplantation, early referral of
      patients with visual symptoms is important. Those involved with the care of heart
      transplant patients should be aware of ocular complications secondary to immune
      suppression and underlying cardiovascular disease.

PMID- 8476899
TI  - Thromboxane A2 mediates reperfusion injury after heart preservation.
AB  - To assess the role of the eicosanoid thromboxane A2, a potent vasoconstrictor and
      platelet activator, in reperfusion injury after heart preservation, donor rats (n
      = 18) were anesthetized, and their hearts were rapidly excised, arrested with
      cardioplegic solution, and fitted with a left ventricular balloon. Seven hearts
      were subjected to 45 minutes of ischemia at 15 degrees C, simulating
      implantation, (group 1) during which the carotid and jugular vessels of support
      rats were cannulated for ex vivo blood reperfusion. Remaining hearts were
      preserved in 4 degrees C saline solution for 3 hours followed by 45 minutes at 15
      degrees C (group 2, n = 11). Before reperfusion of group 2 hearts, support rats
      received either vehicle (group 2a, n = 6) or thromboxane A2 receptor antagonist
      SQ29548 (0.2 mg/kg) (group 2b, n = 5). After 1 hour of reperfusion, left
      ventricular peak-systolic pressure and end-diastolic pressure were measured in
      all hearts at incremental ventricular volumes. The slope of the peak-systolic
      pressure-volume relation and the volume-axis intercept of the end-diastolic
      pressure-volume relation were also measured. No significant differences were
      noted in mean peak-systolic pressure, at any left ventricular volume, nor slope
      of the peak-systolic pressure-volume relation between groups, indicating that
      neither preservation nor SQ29548 treatment affected systolic contractile
      performance in this model. Through all left ventricular volume, however, end
      diastolic pressure was significantly lower (p < 0.05) in group 2b compared to
      group 2a, and overall did not differ significantly from group 1.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8476900
TI  - Functional recovery in rabbit heart after preservation with a blood cardioplegic
      solution and perfusion.
AB  - Thirty-five isolated rabbit hearts were subjected to 60 minutes of storage after
      cardiac arrest with high K+ crystalloid cardioplegic solution at 5 degrees C.
      They were divided into five groups (n = 7 per group) according to the
      preservative protocol: group I (simple immersion in 0 degrees C normal saline
      solution), group II (simple immersion in 30 degrees C blood cardioplegic
      solution), group III (immersion and perfusion in 30 degrees C blood cardioplegic
      solution), group IV (simple immersion in 10 degrees C blood cardioplegic
      solution), and group V (immersion and perfusion in 10 degrees C blood
      cardioplegic solution). After storage for 1 hour, cardiac function, tissue water
      content, and the number of hearts capable of ejecting against a 100 cm H2O column
      afterload were recorded and compared among the five groups. Cardiac function in
      group II was not different from group I. Aortic pulse pressure and left
      ventricular developed pressure were lower in group II than in group III, IV, or
      V. Aortic developed pressure was higher in groups III and V (p < 0.05). Tissue
      water content in group I was significantly higher than in groups II, III, and V
      (p < 0.05). All hearts in groups III and V could eject against a 100 cm H2O
      afterload after preservation (p < 0.05 versus groups I, II, and IV). Factorial
      analysis among the groups using blood cardioplegic solution showed that either
      hypothermia or perfusion alone or the combination was a protective factor in
      providing functional recovery of stored hearts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476902
TI  - Activation of the alternative pathway of complement in hyperacute xenograft
      rejection of rabbit hearts by human blood.
AB  - Isolated rabbit hearts were perfused as autoperfusing working preparations with
      human blood to simulate discordant hyperacute xenograft rejection. Perfusion with
      unmodified human blood resulted in immediate thrombotic failure of the hearts.
      This process was initiated by immunoglobulin M heterophile human anti-rabbit
      antibody, mediated by the classic pathway of complement and platelet-activating
      factor, and effected by platelets. Prevention of this process resulted in organ
      damage by another process occurring at about 20 minutes. Removal of heterophile
      antibody from the perfusing blood had no effect on this second event, but
      specific inactivation of the alternative pathway of complement prevented its
      generation despite normal titers of antibody and normal classic pathway activity.
      Studies of the deposition of components of the human complement system on the
      endothelium of the xenoperfused hearts confirm a role for the alternative pathway
      of complement in xenograft rejection in this discordant species combination.

PMID- 8476901
TI  - Magnetic resonance spectroscopy for assessing myocardial rejection in the
      transplanted rat heart.
AB  - Traditionally, detection of heart rejection after heart transplantation is based
      on histologic grading of endomyocardial biopsy specimens. The value of magnetic
      resonance spectroscopy for determining heart rejection was assessed in rejecting
      and nonrejecting isografts and allografts using energy-rich phosphate
      spectroscopy. In 46 rats a heterotopic abdominal heart transplantation was
      performed, and animals were divided into the following groups: six isografts (no
      rejection), five untreated allografts (severe rejection), and 35 immunosuppressed
      allografts (mild to moderate rejection). One week after transplantation magnetic
      resonance spectroscopy was performed, and data were correlated to histologic
      findings (rejection grades according to Stanford and the New International
      Working Formulation classifications and relative volume of viable myocardium).
      Magnetic resonance spectroscopy allows detection of moderate to severe rejection
      with significant alterations in the energy-rich phosphates such as a decrease in
      the ratio of phosphocreatine/inorganic phosphate, phosphomonoester/inorganic
      phosphate, and beta-adenosine triphosphate/inorganic phosphate. A significant
      correlation was found between spectroscopic changes (phosphocreatine/inorganic
      phosphate) and histologic rejection (correlation coefficient r = 0.47, p < 0.005)
      and/or the amount of relative volume of viable myocardium and
      phosphocreatine/inorganic phosphate (r = 0.58) or beta-adenosine
      triphosphate/inorganic phosphate (r = 0.63), respectively. In conclusion magnetic
      resonance spectroscopy permits detection of moderate to severe degrees of heart
      rejection with a sensitivity of 85% and a specificity of 61%. Changes in the
      energy-rich phosphates correlate with the histologic grading of heart rejection
      and the relative volume of viable myocardium. Magnetic resonance spectroscopy
      appeared to be a valid technique for detecting myocardial rejection after heart
      transplantation in the reported experimental model.

PMID- 8476903
TI  - Single lung transplantation for cystic fibrosis: is it an option? Cystic Fibrosis
      Transplant Study Group.
AB  - A 15-year-old girl with end-stage lung disease from cystic fibrosis underwent a
      bilateral lung transplantation. Infarction of the left lung allograft required
      its removal on day 10. The patient went on to have an uneventful recovery except
      for a prolonged air leak from the right allograft of approximately 29 days. The
      left pleural cavity opacified with time with no clinical or radiologic evidence
      of empyema. The patient was discharged on day 35 in good condition. On a follow
      up examination 6 months after transplantation, she appeared to be functioning
      extremely well with a single lung allograft. This case report challenges the
      conventional wisdom that bilateral pneumonectomy and single lung transplantation
      are not an option to be considered for patients with cystic fibrosis or
      bronchiectasis.

PMID- 8476904
TI  - The role of transbronchial biopsies in the management of lung transplant
      recipients.
AB  - We examined the utility of the transbronchial biopsy in the management of 53 lung
      transplant patients. One hundred thirty-three protocol biopsies were performed to
      ascertain the frequency and nature of abnormalities in clinically stable or
      asymptomatic patients; 128 diagnostic biopsies were performed in clinically ill
      patients to assess the morphologic abnormalities before the institution of
      therapy, and 105 biopsies were performed to assess the response to therapy.
      Histologic evidence of acute rejection was found in 24% of the protocol biopsies,
      and infection was found in 17%. Twenty-five patients with grade 1 or grade 2
      perivascular infiltrates in protocol biopsies did not receive antirejection
      therapy. Follow-up biopsy in these patients showed spontaneous resolution of the
      infiltrates in 19% and increased infiltrates in 6. Only two of these patients
      became clinically ill, representing "progression" to clinical rejection in only
      8% of the nontreated patients. Forty percent of the biopsies performed to rule
      out acute rejection or infection had histologic features of acute rejection, and
      another 23% had features of infection. Treatment of patients with clinical and
      histologic evidence of rejection was associated with rapid resolution of clinical
      symptoms in nearly 90% of the patients, but follow-up biopsies showed residual
      infiltrates compatible with ongoing or resolving rejection in 52%. Despite repeat
      antirejection therapy in some patients, these infiltrates persisted for an
      average of 30 days after the diagnostic biopsy. Follow-up biopsies also showed
      asymptomatic infection, usually cytomegalovirus pneumonitis, which often
      persisted for weeks despite the lack of symptoms. Perivascular infiltrates
      compatible with acute rejection were also found in 38% of biopsy specimens with
      evidence of infection. These perivascular infiltrates resolved with antibiotic
      treatment alone in nearly 50% of the patients with these features. Although
      perivascular mononuclear cell infiltrates are the cardinal histologic feature of
      acute rejection, similar infiltrates occur in patients who apparently have
      infection alone and other patients who have both infection and rejection;
      infiltrates compatible with minimal, mild, and moderate acute rejection also
      occur in clinically asymptomatic patients. These histologic findings are a
      challenge to both the pathologists' and the clinicians' skills in the management
      of the lung transplant patient.

PMID- 8476905
TI  - Monocrotaline-induced pulmonary vascular disease after contralateral lung
      transplantation in the rat.
AB  - To test a hypothesis that reduction in pulmonary perfusion pressure and flow
      affect underlying vascular disease, pulmonary pathology was studied in
      monocrotaline-treated rats undergoing single lung transplantation. Inbred rats
      were treated with 40 mg/kg (group T1, n = 6) and 80 mg/kg of monocrotaline (group
      T2, n = 9), received a left lung isograft 2 and 4 weeks after medication, and
      were killed 4 and 6 weeks after single lung transplantation, respectively. For
      each group, rats receiving the same amount of monocrotaline (M1, M2) or vehicle
      (N1, N2) served as controls. Monocrotaline-treated rats developed pulmonary
      vascular disease and right heart failure, resulting in severe exercise
      intolerance in M1 or death in M2 unless single lung transplantation had been
      carried out. At death, pulmonary blood flow was directed toward the left lung
      isograft, and the retained right lung received a significantly reduced fraction
      of cardiac output. Right to left ventricular weight ratio was significantly
      reduced in both groups as compared to the respective control rats, suggesting
      reduced perfusion pressure. Although thickness of media in small pulmonary
      arteries (media/radius) was normal (34% +/- 4%) in the lung isografts, it was
      significantly increased in the contralateral lung (group T1, 45% +/- 5%; group
      T2, 48% +/- 3%), which was not significantly different from that of monocrotaline
      treated control rats, respectively (group M1, 47% +/- 7%; group M2, 49% +/- 6%).
      Although single lung transplantation reduced perfusion pressure and flow toward
      the monocrotaline-treated native lung, it failed to affect vascular morphology
      significantly.

PMID- 8476906
TI  - Surgical management of infective endocarditis after heart-lung transplantation.
AB  - Bacterial endocarditis after heart-lung transplantation has not been described.
      We report Staphylococcus aureus bacterial endocarditis in a 12-year-old boy after
      heart-lung transplantation. He was found to have an apparently free vegetation in
      his left ventricle, which was surgically removed. After a stormy postoperative
      period, he successfully recovered and remains well after 6 months.

PMID- 8476907
TI  - Serum cytokine levels in heart allograft recipients: correlation with findings on
      endomyocardial biopsy.
AB  - The ability to detect rejection of human cardiac allografts depends on
      endomyocardial biopsy diagnosis. Because cytokines are known to mediate allograft
      rejection events, we chose to examine serum levels of specific cytokines and
      receptors (interleukin-2 [IL-2], IL-2 receptor [IL-2R], and tumor necrosis factor
      alpha [TNF-alpha]) and to correlate those levels with findings on endomyocardial
      biopsy. Sequential sera samples from 23 cardiac allograft recipients were
      examined for the cytokine levels mentioned, and data correlated with findings on
      endomyocardial biopsy. Briefly, no statistically correlation of serum cytokine or
      receptor levels with the stage of allograft rejection was found. When sequential
      serum cytokine levels were determined in patients experiencing humoral and
      cellular allograft rejection events, the levels of TNF-alpha appeared to
      correlate well with endomyocardial biopsy findings. IL-2 and IL-2R levels in two
      patients who never experienced rejection were elevated on occasion, but TNF-alpha
      levels were always negative. In summary, measurement of serum cytokine (IL-2, IL
      2R) levels in cardiac allograft recipients does not appear to correlate with
      findings on endomyocardial biopsy; however, elevated levels of TNF-alpha appear
      to predict more severe humoral allograft rejection episodes and may be helpful in
      this regard.

PMID- 8476908
TI  - Monitoring rejection in infants after heart transplantation.

PMID- 8476909
TI  - Two-year follow-up of a heart transplant patient being treated with cyclosporine
      and ketoconazole.

PMID- 8476910
TI  - Effect of oxidant exposure on monkey intestinal brush-border membrane.
AB  - This study looks at the effect of oxidant exposure on changes in structural
      components and functional properties of monkey intestinal brush-border membrane
      vesicles (BBMV). These membranes were found resistant to iron-dependent lipid
      peroxidation as judged by measurement of various parameters such as formation of
      malonaldehyde (MDA) and conjugated diene and depletion of total arachidonic acid,
      tocopherol and membrane-associated protein thiol groups. Free radicals generated
      by thermal decomposition of 2,2'-azobis(2-amidinopropane) dihydrochloride (ABAP)
      which does not require iron, were capable of inducing lipid peroxidation in this
      membrane. Fluorescence polarisation studies used to assess the physical state of
      the membrane lipids after exposure to various free radical generating systems
      showed that ABAP could decrease the fluidity of BBMV whereas other systems had no
      effect. Exposure of BBMV to ABAP or cumene hydroperoxide decreased the glucose
      and amino acid transport. BBMV had a high content of nonesterified fatty acids as
      part of the total lipids and removal of these free fatty acids by treatment with
      fatty acid free albumin made the membranes susceptible to iron-dependent
      peroxidation. These studies suggest that intestinal epithelial cell membranes are
      resistant to iron-dependent lipid peroxidation due to the presence of membrane
      associated free fatty acids. Possibly lipid peroxidation may play a less
      significant role in damage to these cells.

PMID- 8476911
TI  - Annexin I interactions with human neutrophil specific granules: fusogenicity and
      coaggregation with plasma membrane vesicles.
AB  - The interactions of annexin I with specific granules isolated from human
      neutrophils were investigated. Unfractionated cytosol induced Ca(2+)-dependent
      granule self-aggregation and fusion of granules with model phospholipid vesicles.
      High Ca2+ concentrations were required for these processes (500-600 microM for
      the half-maximal rate of granule self-aggregation; 100-200 microM for the half
      maximal rate of fusion with phospholipid vesicles). These activities were
      inhibited by a monoclonal antibody specific for annexin I and immunodepletion of
      cytosol by this antibody greatly reduced activity, implicating annexin I as the
      major mediator of these processes in neutrophil cytosol. The fact that the Ca2+
      concentration dependences differed for different membranes suggests that
      specificity may be controlled by the type of intracellular membrane involved and
      the local Ca2+ concentration. Trypsin treatment of granules enhanced the rate of
      fusion of phospholipid vesicles with granules, suggesting that access to
      phospholipids in the granule membrane may be modulated by granule proteins or
      that a fusogenic protein factor in the granule membrane is activated by trypsin
      treatment. Coaggregation of specific granules with plasma membrane vesicles
      mediated by Ca2+ and annexin I was suggested by the fact that granules
      preincubated with Ca2+, cytosol and plasma membrane vesicles blocked the fusion
      of subsequently added phospholipid vesicles with the plasma membrane vesicles.
      These data suggest a role for annexin I as part of a multiprotein system involved
      in membrane-membrane contact necessary for exocytosis of specific granules in
      human neutrophils.

PMID- 8476912
TI  - Coupling of ligands to liposomes independently of solute entrapment: observations
      on the formed vesicles.
AB  - Bovine serum albumin (BSA), employed as a model ligand, was covalently linked
      (about 16% of the amount used) to small unilamellar vesicles (SUV) composed of
      phospholipid, cholesterol and N-(p-aminophenyl)stearylamide (APSA) (molar ratios
      1:1:0.05). SUV with bound BSA were then used to generate dehydration-rehydration
      vesicles (DRV) in the presence of tetanus toxoid and/or carboxyfluorescein (CF).
      Nearly all of the SUV-bound BSA (about 15% of the original amount) was recovered
      in the multilamellar DRV formed, with a considerable proportion (42-62%) of the
      ligand becoming available on the outer bilayers. This apparent spatial
      reorientation of BSA within DRV also caused the entrapped toxoid to shift to some
      extent to the liposomal surface. There was no significant difference in the z
      average mean size between DRV with and without coupled BSA (543 and 555 nm
      diameter, respectively). Percent number diameter distribution data revealed that
      71.2 (BSA-free) and 76.4% (BSA-containing DRV) of the vesicles had diameters of
      about 300-440 and 330-420 nm, respectively. However, in terms of percent mass
      diameter distribution, 69.5% (BSA-free) and 65.2% (BSA-containing DRV) of the
      mass was in vesicles with corresponding ranges of diameter of 1381-2975 and 1086
      2840 nm. Vesicle size heterogeneity in both preparations was confirmed by freeze
      fracture electron microscopy which also indicated that structures with or without
      bound BSA, were mostly vesicular of the multilamellar type. Judging from CF
      latency values, ligand-bearing DRV were stable on incubation with blood plasma at
      37 degrees C for 24 h. Stability was, however, reduced significantly when the
      amount of ligand bound was excessive. The present approach allows for the
      coupling of ligands to and the entrapment of antigens and other labile solutes in
      liposomes independently, thus avoiding potential damage of such solutes by the
      coupling reagents.

PMID- 8476914
TI  - Uptake and transport of fluorescent derivatives of dolichol in human fibroblasts.
AB  - We are using fluorescent derivatives to visualize the endocytic transport of
      dolichol intermediates from the cell surface to the lysosome, and to estimate
      their rate of turnover within the lysosome. Anthroyl dolichol and anthroyl [1
      14C]dolichol were synthesized and purified by chromatography on silica and C18
      Sep-Paks followed by high-performance liquid chromatography on C18. The
      successful synthesis of anthroyl polyisoprenoid alcohols was confirmed by the use
      of uv-visible spectrometry and by fluorescence spectrometry. The purified esters
      were taken up into Ham's media containing 10-30% fetal calf serum or
      alternatively reconstituted into phospholipid liposomes for delivery to human
      fibroblasts in culture. The uptake of fluorescent dolichol esters into the cells
      and into lysosomes was demonstrated using fluorescence microscopy. The
      localization of anthroyl dolichol in lysosomes was further documented by
      simultaneously labeling fibroblasts with anthroyl dolichol and FITC-dextran a
      recognized lysosomal marker. Fibroblasts generally showed several groupings
      (domains) of lysosomes, some were dually labeled while others were labeled
      exclusively with either anthroyl dolichol or FITC-dextran. Labeling with anthroyl
      dolichol was very slow relative to labeling of the same fibroblasts with FITC
      dextran suggesting that anthroyl dolichol acts as a labeling agent for
      intracellular membranes, particularly those of the lysosome while the dextran
      fluorescence is presumably of lysosolic origin. Several types of experiments were
      done with anthroyl [1-14C]dolichol to establish that the fluorescence seen in
      lysosomes represents anthroyl dolichol. Anthroyl dolichol appears to enter
      fibroblasts intact, since we were unable to recover any free [1-14C]dolichol from
      total lipid extracts of (i) media used for the uptake of anthroyl dolichol or
      (ii) the media removed from cells labelled for 42 h. In addition, attempts to
      hydrolyze anthroyl [1-14C]dolichol in vitro using whole fibroblast homogenates at
      pH 4.0 and 7.5 were unsuccessful, even though the fibroblasts expressed acid
      lipase activity using 4-methylumbelliferyl palmitate as substrate.

PMID- 8476913
TI  - Function of intracellular [Ca2+]i in exocytosis and transbilayer movement in
      human platelets surface-labeled with the fluorescent probe 1-(4
      trimethylammonio)phenyl)-6-phenyl-1,3,5-hexatriene.
AB  - Ellipsometry indicated that 1-(4-(trimethylammonio)phenyl-6-phenylhexa-1,3,5
      triene (TMA-DPH) bound to platelets in a reversible and saturable way.
      Accordingly, the fluorescence intensity (F) of a suspension of TMA-DPH-labeled
      platelets was described as a quantity, determined by the amount of TMA-DPH bound
      to the platelet surface. Most platelet activators elevated F to a degree that
      correlate well with the secretion of serotonin evoked by these activators. The
      increase in F levels reflected the increase in outer membrane surface area
      following exocytosis. However, activators that evoked prolonged (> 2.5 min) and
      strong (> 600 nM) elevations of cytosolic [Ca2+]i increased F to levels that were
      much higher than expected from the maximal increase in surface area due to
      exocytosis. This high increase in F was caused by inward transbilayer movement of
      TMA-DPH over the plasma membrane and the subsequent labeling of cytosolic
      membrane sides. The kinetics of exocytosis and changes in cytosolic [Ca2+]i were
      studied by stopped-flow mixing of platelets with agonist. Thrombin-induced
      exocytosis had a delay of only 3 s, which was shortened when external CaCl2 or
      ADP was present. This correlated well with a faster rise in [Ca2+]i in the
      presence of CaCl2 or ADP, indicating that exocytosis was linked in time to
      elevation of [Ca2+]i. By itself, ADP was unable to evoke exocytosis and it
      elicited a [Ca2+]i transient of much shorter duration than thrombin, but with
      similar maximum. We concluded that both exocytosis and transbilayer movement were
      associated with elevation of [Ca2+]i: exocytosis required a moderate, relatively
      prolonged rise and transbilayer movement was accompanied by a stronger rise of
      even longer duration. Influx of external Ca2+ was essential for transbilayer
      movement, but not for exocytosis.

PMID- 8476915
TI  - Na(+)-dependent and -independent uridine uptake in an established renal
      epithelial cell line, OK, from the opossum kidney.
AB  - The characteristics of Na(+)-dependent and Na(+)-independent uridine uptake at 22
      degrees C were determined for monolayers of OK renal epithelial cells. The
      majority of uridine influx in subconfluent to early confluent (day 1
      postconfluency) OK monolayers was mediated via a facilitated-diffusion pathway
      (apparent Km 160 +/- 41 microM, Vmax 610 +/- 100 pmol/mg protein per min). This
      system was inhibited with high affinity by nitrobenzylthioinosine (NBMPR) (IC50
      value 1.5 nM) and by purine and pyrimidine nucleosides. Specific [3H]NBMPR
      binding sites were detected in OK monolayers (apparent Kd 0.67 +/- 0.25 nM, Bmax
      90 +/- 19 fmol/mg protein) yielding a turnover number for the carrier of 112
      uridine molecules/site per s at 22 degrees C. Na(+)-dependent uridine uptake was
      minor in subconfluent OK monolayers, but increased 8-fold with time after
      confluency reaching a stable plateau at 8 days postconfluency. Inhibition of
      Na(+)-dependent 1 microM uridine uptake by inosine, guanosine, adenosine and
      uridine was biphasic with approx. 40% of the total uptake inhibited with high
      affinity (IC50 value 2 to 14 microM). Concentrations of thymidine and cytidine up
      to 1 mM had no effect on Na(+)-dependent uridine uptake and no Na(+)-dependent
      thymidine influx by confluent OK monolayers was detected. Using cell monolayers
      grown on a permeable filter support, Na(+)-dependent uridine uptake occurred
      preferentially from the apical surface. This high affinity component of Na(+)
      dependent uridine uptake is suggested to represent the Na(+)-dependent purine
      preferring N1 nucleoside transporter. The Na+/uridine stoichiometry for this
      system was consistent with 1:1. The remaining component of Na(+)-dependent
      uridine uptake was inhibited by some nucleosides, such as guanosine and inosine,
      with low affinity (IC50 values of 0.6 to 5 mM). Other nucleosides showed little
      specific inhibition. We propose that this component of uridine uptake represents
      a mutated carrier that binds nucleosides but is defective in the translocation of
      permeant.

PMID- 8476916
TI  - Human immunodeficiency virus type 1 (HIV-1) fusion with model membranes: kinetic
      analysis and the role of lipid composition, pH and divalent cations.
AB  - The kinetics and extent of HIV-1 fusion with model membranes was studied. HIV-1
      was labeled with octadecyl rhodamine B chloride, and fusion was monitored
      continuously as the dilution of the probe into target membranes. The results were
      analyzed by a mass action model which yielded good simulations and predictions
      for the kinetics and final extents of fluorescence increase. The model determined
      the percent of virions capable of fusing and rate constants of fusion,
      aggregation and dissociation. Ultrastructural analysis of the virus and reaction
      products by electron microscopy also provided evidence of HIV-1 fusion with
      membranes lacking CD4. HIV-1 fusion activity depends on the target membrane lipid
      composition according to the sequence: cardiolipin (CL) > > phosphatidylinositol
      > CL/dioleoylphosphatidylcholine (DOPC) (3:7), phosphatidic acid >
      phosphatidylserine (PS), PS/cholesterol (2:1) > PS/PC (1:1),
      PS/phosphatidylethanolamine (1:1) > DOPC, erythrocyte ghosts. Reduction of pH
      from 7.5 generally enhances the rate and extent of HIV-1 fusion. Physiologically
      relevant concentrations of calcium stimulate HIV-1 fusion with several liposome
      compositions and with erythrocyte ghost membranes. The fusion products of HIV-1
      with liposomes consist of a single virus and several liposomes. The mass action
      analysis revealed that, compared to intact virions, the fusion products show a
      striking reduction in the fusion rate constant. Like influenza and Sendai
      viruses, HIV-1 fusion with membranes containing its own envelope glycoprotein(s)
      is strongly inhibited. Unlike these viruses, HIV-1 fusion is promoted by
      physiological levels of calcium. HIV-1 fusion with liposomes is qualitatively
      similar to simian immunodeficiency virus fusion.

PMID- 8476917
TI  - The effect of positive and negative pH-gradients on the stability of small
      unilamellar vesicles of negatively charged phospholipids.
AB  - The stability of small unilamellar vesicles (SUV) made from negatively-charged
      phosphatidate by ultrasonication or pH-jump has been investigated. As criteria
      for the vesicle stability are used: (I) the bilayer integrity as judged from the
      permeability of the fluorescent probe carboxyfluorescein (CF) and (II) the
      susceptibility of the phospholipid vesicles to fusion as judged by gel filtration
      and freeze-fracture electron microscopy. Egg phosphatidate SUV (PA-SUV) whose
      internal cavity is in equilibrium with the dispersion medium are strictly
      speaking thermodynamically unstable by these criteria. They may, however, be
      regarded as stable from a practical point of view. CF-release is observed with a
      half-time of 14 days and also some vesicle fusion, particularly at low
      temperature (4 degrees C). The small effects observed, e.g., the small tendency
      of the vesicles to undergo fusion is probably due to the high surface charge
      density of PA bilayers. A main finding of this work is that the same positive pH
      gradient which is used in the pH-jump method to drive the formation of SUV from
      large phosphatidic acid bilayer sheets has a stabilizing effect on the resulting
      PA-SUV. Stabilization is achieved by positive pH-gradients of about two pH-units
      or more with the pH of the external medium exceeding the pH of the vesicle
      cavity. Under these conditions, up to about 8 weeks no significant loss of
      entrapped CF and no fusion of SUV was observed both at 4 degrees C and room
      temperature. In contrast, a reverse or negative pH-gradient of several pH units
      applied to PA-SUV (with the external pH being lower than that of the vesicle
      cavity) destabilizes PA-SUV. Such a gradient can be shown to lead to a dramatic
      perturbation of the lipid bilayer packing as evident from a significant increase
      in CF permeability. The local perturbation of the phospholipid bilayer is
      accompanied by massive vesicle fusion which is prominent at low temperature (4
      degrees C).

PMID- 8476918
TI  - Membrane heterogeneity in isolated rat hepatocytes and liver plasma membrane
      subfractions: a comparative study using DPH and its cationic derivative TMA-DPH.
AB  - The fluorescence decay of 1,6-diphenyl-1,3,5-hexatriene (DPH) and of 1-(4
      trimethylammonium-phenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) has been studied in
      hepatocytes isolated from rat liver and in isolated plasma membrane subfractions
      (cLPM, canalicular membranes and bLPM, basolateral membranes) using frequency
      domain fluorometry. The decay has been analyzed either by using a model of
      discrete exponential components or a model that assumes a continuous distribution
      of lifetime values in order to study different aspects of membrane heterogeneity.
      The results obtained by the two analyses are practically superimposable but the
      distributional approach allows an evaluation of membrane heterogeneity through
      the width of the distribution that has shown particularly significant differences
      when freshly hepatocytes are compared with in vitro aged hepatocytes. Moreover,
      the comparison of the distributional analysis of the two probes has shown in cLPM
      a tendency to higher values of the main lifetime component and a narrower
      distribution width with respect to bLPM. These results indicate changes of
      membrane domain organization that have been discussed in relation with the
      specific lipid composition that characterizes the two membrane subfractions. Our
      results indicate that frequency domain fluorometry may be used to study membrane
      heterogeneity in intact cells and isolated membranes.

PMID- 8476919
TI  - Targeting and delivery of bactericide to adsorbed oral bacteria by use of
      proteoliposomes.
AB  - Proteoliposomes having surface-bound succinylated concanavalin A (s-conA) have
      been prepared from a range of phospholipid mixtures by sonication (SUV) and
      reverse phase evaporation (REV) covering a range of size (weight-average diameter
      (dw)) from approx. 35 to 310 nm and weight-average number of protein molecules
      per liposomes (Pw) from approx. 50 to 3000. The targeting of the proteoliposomes
      to adsorbed biofilms of the bacteria Streptococcus sanguis and Streptococcus
      mutans has been assessed from the extent of inhibition of an enzyme-linked
      immunosorbent assay (ELISA) for bacterial cell surface antigens. The surface
      bound lectin enhances targeting relative to 'naked' liposomes of comparable
      concentration by factors of 2-50 depending on the liposomal lipid composition and
      Pw. The effect of the bactericide Triclosan on the thermal properties and
      permeability characteristics of liposomes has been studied. At and above a molar
      ratio of Triclosan to lipid of 0.6, Triclosan eliminates the gel to liquid
      crystalline phase transition in dipalmitoylphosphatidylcholine (DPPC) containing
      liposomes and increases the bilayer permeability of both liposomes and
      proteoliposomes to D-glucose. The proteoliposomes have been used to deliver
      Triclosan to S. sanguis biofilms and the inhibition of growth of the bacteria
      after treatment with liposomally delivered Triclosan has been determined using a
      microtitre plate re-growth assay and compared with growth inhibition by 'free'
      Triclosan. It is shown that for short exposure times (1 to 2 min)
      proteoliposomally delivered Triclosan is a more effective growth inhibitor than
      free Triclosan. The results are discussed in terms of the targeting, retention
      and subsequent release of Triclosan into the bacterial biofilms.

PMID- 8476920
TI  - Membrane potential determination in large unilamellar vesicles with hexakis(2
      methoxyisobutylisonitrile)technetium(I).
AB  - The accumulation of the lipophilic cation hexakis (2
      methoxyisobutylisonitrile)technetium (99mTc-MIBI) within large unilamellar
      vesicles made from egg phosphatidylcholine was examined as a function of time and
      membrane potential (Em). Equilibrium distribution occurred within minutes at 30
      degrees C. The transmembrane distribution of Tc-MIBI was measured at Em = 0 mV
      and at a series of negative membrane potentials. The distribution of Tc-MIBI was
      in close agreement with the Nernst equation for passive distribution of a
      permeant ion across a bilayer, permitting the membrane potential to be predicted
      from Tc-MIBI distribution. In this respect, Tc-MIBI behaves similarly to other
      radioprobes of membrane potential, but with unique properties including high
      specific activity (10(9) Ci/mol), rapid kinetics of distribution, low potential
      independent binding, and short half-life (6.02 h). The results indicate a
      mechanism for tissue accumulation of Tc-MIBI in vivo that may in part account for
      its utility in clinical imaging of ischemic myocardium.

PMID- 8476921
TI  - Baclofen (beta-p-chlorophenyl-gamma-aminobutyric acid) transport across rat
      jejunum.
AB  - Intestinal transport of baclofen (beta-(p-chlorophenyl)-gamma-aminobutyric acid)
      in the rat has been examined in vitro. Influx of baclofen across the brush-border
      membrane (JmcBacl) and steady-state accumulation by everted segments of the
      intestine were measured. JmcBacl could be accounted for as the sum of a saturable
      process with a maximum rate of approx. 10-20 nmol cm-2 h-1 and a K1/2Bacl of
      approx. 0.3 mM and a diffusive contribution with a permeability of 0.073 cm h-1.
      JmcBacl was Na(+)- and Cl(-)-independent. The steady state distribution ratio
      between the intracellular space of the everted segments and incubation fluid was
      1.0 +/- 0.1 (n = 12). Inhibition tests demonstrated that the Na(+)- and Cl(-)
      independent, passive, but saturable fraction of baclofen transport can not be
      mediated by any of the known amino acid carriers of the rat small intestine.
      Preliminary results suggests that qualitatively baclofen transport in guinea-pig
      and rabbit is also by facilitated transport.

PMID- 8476922
TI  - Mesophase formation by ceramides and cholesterol: a model for stratum corneum
      lipid packing?
AB  - Previous X-ray diffraction and electron microscopy experiments have suggested
      that there is an unusual double bilayer structure formed by stratum corneum
      lipids, with a lamellar spacing of about 131 A (White, S.H., Mirejovsky, D. and
      King, G.I. (1988) Biochemistry 27, 3725-3732; Hou, S.Y.E., Mitra, A.K., White,
      S.H., Menon, G.K., Ghadially, R. and Elias, P.M. (1991) J. Invest. Dermatol. 96,
      215-223; Bouwstra, J.A., De Vries, M.A., Gouris, G.S., Bras, W., Brussee, J. and
      Ponec, M. (1991) J. Controlled Release 15, 209-220). Two contradictory models
      have been proposed for this structure. In the Downing model, used to explain
      electron microscopy observations, acylceramides are vital, acting as a 'lynch
      pin' and holding the lipid layers together (Swartzendruber, W.C., Kitko, D.J.,
      Madison, K.C. and Downing, D.T. (1989) J. Invest. Dermatol. 92, 251-257).
      Alternatively, to explain X-ray diffraction results from intact corneum, protein
      intercallation into the lipid bilayers is suggested, since an electron dense
      region wider than can be accounted for by lipid headgroups alone, is required
      (Bouwstra, J.A., De Vries, M.A., Gouris, G.S., Bras, W., Brussee, J. and Ponec,
      M. (1991) J. Controlled Release 15, 209-220). Thus, existing models require the
      presence of either acylceramides or protein. We describe how a similar structure
      can be prepared in vitro using mixtures of cholesterol and ceramides. Cholesterol
      induces a novel double-bilayer structure in ceramides II, and IV. This result is
      in conflict with the existing literature which cites acylceramides, or protein as
      instrumental in maintaining the in vivo structure of the phase. Characterisation
      has been carried out using optical microscopy and synchrotron X-ray diffraction.

PMID- 8476923
TI  - Functional analysis of the promoters of the human CaMIII calmodulin gene and of
      the intronless gene coding for a calmodulin-like protein.
AB  - More than 1 kb of the 5'-flanking DNA of the human CaMIII calmodulin gene and of
      the calmodulin-like protein (CLP) gene have been sequenced. Notable features are
      the absence of a TATA-box and the presence of AGGGA elements in both upstream
      regions, the presence of several sequences with homology to known regulatory
      elements (cAMP-, retinoic acid- and interferon-responsive elements) in the CLP
      gene, and a high G + C-content and several putative Sp1-factor-binding sites in
      the CaMIII gene. 1 kb of the CaMIII upstream region was driving high-level growth
      hormone (hGH) reporter gene expression in human teratoma and monkey COS cells.
      Promoter activity dropped to about 30% and 10% when only 252 bp and 114 bp,
      respectively, of the CaMIII sequence were present. In contrast to the CaMIII
      promoter, the CLP gene upstream region was driving hGH expression only in human
      teratoma, but not in monkey COS cells. Addition of retinoic acid to the
      transfected cells had minimal effects on both promoters, leading to a 10-30%
      decrease of activity. The results show that the human CaMIII gene contains a
      strong and ubiquitously active promoter, whereas the promoter of the intronless
      CLP gene appears to be regulated in a cell-specific manner.

PMID- 8476924
TI  - Effects of N-terminal truncations upon chloroplast NADP-malate dehydrogenases
      from pea and spinach.
AB  - Using the purification procedure of Fickenscher and Scheibe (Biochim. Biophys.
      Acta 749 (1983), 249-254) and a modification of the method, we produced a series
      of NADP-MDH forms from spinach and pea-leaf extracts that were characterized by a
      stepwise shortening of the N-terminal sequences. Limited proteolysis of the
      enzymes resulted in the generation of even shorter forms. Immunoprecipitation of
      the NADP-MDH from crude extracts revealed that the sequences of the intact
      enzymes from pea, spinach and maize started at a position (Ser) identical with
      that established for the Sorghum enzyme (Cretin, C., et al. (1990) Eur. J.
      Biochem. 192, 299-303). Spinach NADP-MDH isolated by conventional methods was
      shown to represent the intact form. Thus, the kinetic, regulatory and structural
      properties of the various truncated forms could be compared with those of an
      intact form. Removal of 5 or 11 amino acids, as occurred during isolation of the
      pea NADP-MDH, was without any significant effect. The enzymes were all dimeric
      and still exhibited the characteristic redox-regulatory properties. However,
      removal of 31 and 37 amino acids using aminopeptidase K resulted in the formation
      of active monomers characterized by only slightly lowered affinities towards the
      substrates, a shift of their pH optimum from 8 to 7, the loss of oxaloacetate
      inhibition and an increased maximal velocity. Although these forms lacked most or
      all of the N-terminal extra-peptide, including the 2 cysteines involved in redox
      modification, they were still sensitive to the redox-potential. However, the low
      concentration of thiol required for immediate and complete restoration of any
      lost activity (40 mM beta-mercaptoethanol) suggested that this reaction might not
      be relevant for redox-regulation in vivo.

PMID- 8476925
TI  - Activation of the hydroxylase of sMMO from Methylococcus capsulatus (Bath) by
      hydrogen peroxide.
AB  - Hydrogen peroxide can activate the non-heme binuclear iron-containing hydroxylase
      of soluble methane monooxygenase (sMMO) from Methylococcus capsulatus (Bath) in
      the catalysis of oxidation of methane and other sMMO substrates. The reductase,
      protein B, O2 and NADH are normally required for catalytic activity, but can be
      replaced by H2O2 serving as the source of both oxygen and electrons for the
      reaction. Similar results have been observed in a different strain of MMO from
      Methylosinus trichosporium OB3b (Andersson, K.K., Froland, W.A., Lee, S.-K. and
      Lipscomb, J.D. (1991) New J. Chem. 15, 410-415). The Km,app for H2O2 was found to
      be 66 mM. Labelled oxygen experiments show that the oxygen atom in the product in
      the peroxide driven system is derived from H2O2 and not O2. Using C2-C5 alkanes
      and 2-butene as substrates it was shown that the product distribution differed in
      the complete sMMO and H2O2-driven systems, indicating that more than one pathway
      is available to the enzyme. Protein B, which is required for catalytic activity
      in the complete system, was found to be an inhibitor of the hydroxylase/H2O2
      system. It was also observed that protein B not only affected the activity, but
      also the selectivity of carbon hydroxylation with 2-methylbutane as substrate.

PMID- 8476926
TI  - Kinetic studies on the reactions of separated a, b and c subunits of Panulirus
      interruptus deoxy-hemocyanin with hydrogen peroxide.
AB  - The kinetics of the H2O2 oxidation of separated a, b and c subunits (75 kDa, 657
      amino acids) of the arthropod Panulirus interruptus hemocyanin (Hc), in the deoxy
      Cu(I)2 state, have been studied at 25 degrees C, I = 0.100 M (NaCl). Solutions of
      oxyHc provide small equilibrium amounts of the deoxy reactant deoxyHc + O2<-
      >oxyHc (K approx. 10(5) M-1). The reaction is of interest because H2O2 is one of
      the few molecules which is able to access the active site and oxidise deoxyHc to
      the metHc Cu(II)2 state. The reaction was studied at pH values in the range 6.8
      9.6. Traces of Ca2+ (and other 2+ ions) are controlled by addition of EDTA (5
      mM). With or without EDTA hexamer forms are present at the lower pH values. At pH
      > 8.3 and with EDTA added, a and b (3% sequence difference) give monomer forms.
      The hexamers are however retained at the higher pH values if Ca2+ (10 mM) is
      added. As in the corresponding studies of deoxyHc with O2, rate constants for
      subunit c (42% sequence differences) show no variation with pH and the hexamer is
      retained over the whole pH-range explored. Rate constants for the reactions of
      H2O2 with the different monomer and hexamer deoxyHc forms of a, b, and c are in
      the range 1-75 M-1 s-1. A mild pseudo-catalase activity of metHc leading to
      reformation of oxyHc also contributes to the reaction.

PMID- 8476927
TI  - Tyrosinatable and non-tyrosinatable tubulin subpopulations in rat muscle in
      comparison with those in brain.
AB  - Using immunobinding and enzymatic assays we determined in rat muscle extracts the
      proportion of tyrosinatable tubulin, that is, tubulin that participates in the
      tyrosination/detyrosination cycle. We found that in muscle, in contrast with
      nervous tissue, practically all tubulin molecules are tyrosinatable. In the case
      of rat brain the non-tyrosinatable tubulin pool accounts for about 50% of the
      tubulin. In addition, isolectrofocusing of 14C-tyrosinated tubulin from brain and
      muscle extracts revealed a different composition in tyrosinatable tubulin
      isotypes. One of the isotypes, which in muscle accounts for 86% of the 14C
      tyrosinated tubulin species, was detyrosinated by the action of tubulin
      carboxypeptidase faster than the rest of the 14C-tyrosinated tubulin isotypes
      taken in whole. In the case of brain extract, that isotype accounts for only 16%
      of the labeled tubulin.

PMID- 8476928
TI  - Expression in Escherichia coli of the 36 kDa domain of poly(ADP-ribose)
      polymerase and investigation of its DNA binding properties.
AB  - We have expressed in Escherichia coli the 36 kDa domain of the human poly(ADP
      ribose) polymerase. This polypeptide comprises the C-terminal part of the DNA
      binding domain, as well as the automodification region of the enzyme, but lacks
      the zinc-finger motifs of the N-terminal region and the C-terminal catalytic
      domain. By probing the crude E. coli protein extracts with radioactive DNA probes
      (South-Western blots), we have shown that the 36 kDa domain binds a DNA probe of
      222 bp but does not bind a shorter probe of 66 bp. This interaction is stronger
      when the polypeptide is fused to the 55 kDa catalytic domain of the enzyme.

PMID- 8476929
TI  - Comparison of several new chromogenic galactosides as substrates for various beta
      D-galactosidases.
AB  - The kinetic characteristics of beta-galactosidases from bovine liver and testes,
      Escherichia coli, Aspergillus niger and Jack bean were studied using five newly
      developed colorimetric substrates. All the chromophores released by enzyme
      hydrolysis had high extinction coefficients in the visible region of the
      spectrum. Varying amounts of substrate inhibition were found with each of these
      substrates (VBzTM-Gal, VLM-Gal, VLPr-Gal, VQM-Gal and VQPr-Gal), but this was not
      a significant problem if the correct assay conditions were used. The substrates
      attached particularly tightly to the active centre of E. coli beta-D
      galactosidase resulting in low Km values. The data suggest that the chemical
      properties of the heterocyclic portion of the aglycone distant from the
      glycosidic oxygen do not affect the substrate specificity and the substrate
      inhibition can be attributed to interactions not involving the catalytic site.
      When the product of the maximum observed velocity (Vm) and the molar absorption
      coefficient is calculated for each substrate, the relative merits of the
      substrates for the assay of each enzyme can be assessed. The beta-D
      galactosidases from fungal and bacterial sources hydrolysed the substrates most
      efficiently, indicating that they may be of particular value in areas of
      molecular biology and biotechnology.

PMID- 8476930
TI  - Oxidized and Met358-->Leu mutated alpha 1-proteinase inhibitor as substrates of
      Pseudomonas aeruginosa elastase.
AB  - This paper investigates the catalytic activity of Pseudomonas aeruginosa elastase
      using the bait region of the alpha 1-proteinase inhibitor as a substrate. The
      bacterial enzyme cleaves the Pro357-Met358 bond of the wild-type inhibitor and
      the recombinant Met358 inhibitor and the Pro357-Leu358 bond of the recombinant
      Met358-->Leu inhibitor with kcat/Km values of 9 x 10(4) M-1 s-1, 1.4 x 10(5) M-1
      s-1 and 3.5 x 10(5) M-1 s-1, respectively. In contrast, the N-chlorosuccinimide
      oxidized inhibitor (Met351 and Met358 = methionine sulfoxides) is cleaved at the
      Glu354-Ala355 position with a significantly lower rate (kcat/Km = 10(4) M-1 s-1).
      The pH optimum for the cleavage of the native, the oxidized, the Met358-->Leu
      mutated inhibitor, and 2-aminobenzoyl-Ala-Gly-Leu-Ala-4-nitrobenzylamide, a
      synthetic Pseudomonas elastase substrate are, 6.0, 7.0, 6.5 and 5.8,
      respectively. We conclude that P. aeruginosa elastase readily hydrolyzes
      substrates with P'1 methionine or alanine residues and that its pH optimum is not
      as alkaline as usually thought.

PMID- 8476931
TI  - Ligand affinities in mutant metmyoglobins.
AB  - Ligand binding to the wild-type and a series of mutant porcine myoglobins,
      expressed and purified from Escherichia coli cells, has been studied using UV-VIS
      absorption spectroscopy. The proximal pocket mutation, F7 Ser-->Leu (F7), causes
      an increased affinity for OH- and N3- binding to metmyoglobin. A hydrogen bond
      between the F7 serine residue and the imidazole side-chain of the proximal
      histidine has been removed by this mutation. It is suggested that this allows the
      imidazole group to reorientate, reducing the steric clash between itself and the
      haem pyrrole nitrogen atoms and leading to a shortening of the bond between the
      proximal histidine and the haem iron. Other conformational changes further away
      from the haem pocket have also been induced, but the mutant still crystallizes
      under the same conditions as for the wild-type protein. A series of distal pocket
      mutants, E11 Val-->Thr (VT), E7 His-->Val (HV) and a mutant with both of these
      substitutions (M2) all have greatly reduced the OH- and N3- binding affinity.
      These effects have been interpreted by considering several factors: the changed
      stability of the aquometmyoglobin form, hydrogen-bond formation between the
      ligand and the E7 residue, and electrostatic repulsion between the ligand and the
      E11 threonine residue.

PMID- 8476932
TI  - Characterization of yeast EF-1 alpha: non-conservation of post-translational
      modifications.
AB  - Elongation factor 1 alpha (EF-1 alpha) is an abundant cellular protein and its
      amino-acid sequence has been inferred from numerous organisms, including
      bacteria, archaebacteria, plants and animals. In large measure, it would appear
      that the overall structure has probably been maintained given the 33% identity
      and 56% similarity of Escherichia coli EF-Tu with human EF-1 alpha. Chemical
      sequencing of EF-Tu and EF-1 alpha has revealed that these proteins are post
      translationally modified. In order to assess the possible function of these
      modifications, we have chemically sequenced the EF-1 alpha from the lower
      eukaryote Saccharomyces cerevisiae (yeast). To our surprise, the methylation
      pattern of yeast EF-1 alpha was quite different from either rabbit or brine
      shrimp EF-1 alpha with only the trimethyllysine at position 79 conserved although
      the yeast protein is 81% identical to rabbit EF-1 alpha. A dimethyllysine was
      observed at position 316 which corresponds to a trimethyllysine in brine shrimp
      and rabbit EF-1 alpha. The other positions in yeast EF-1 alpha which were
      methylated were unrelated to the other six possible positions for modification
      observed in brine shrimp or rabbit EF-1 alpha. In addition, the unique glyceryl
      phosphorylethanolamine observed in mammalian EF-1 alpha and suspected in brine
      shrimp EF-1 alpha was not found in yeast EF-1 alpha.

PMID- 8476933
TI  - Molecular dynamics study of the stability of staphylococcal nuclease mutants:
      component analysis of the free energy difference of denaturation.
AB  - The stability of two mutants G88V (Gly-88-->Val) and A69T (Ala-69-->Thr) of
      staphylococcal nuclease was analyzed by molecular dynamics simulations. The
      calculated free energy differences of denaturation for G88V and A69T were -1.1
      and -2.8 kcal/mol, respectively. These values are in good agreement with the
      experimental values. The free energy differences divided into electrostatic and
      van der Waals components were analyzed. These two mutants are mainly destabilized
      due to van der Waals interactions. There is little difference between the
      electrostatic contribution to the free energy change in the native state and that
      in the denatured state. In each mutant structure, a small cavity appears in the
      vicinity of the perturbed residue. It is suggested that intramolecular van der
      Waals interactions of the mutants are weaker than those of the wild-type.
      Furthermore, analyses of the contributions of each residue near the perturbed
      residue and of water to the free energy difference of denaturation suggest that
      the interaction between water and the perturbed residue plays a very important
      role in the stability of staphylococcal nuclease, and that a small hydrophobic
      core consisting of the three aromatic rings (Tyr-27, Phe-34, Phe-76) and the side
      chain of Met-32 is also important for the stability.

PMID- 8476934
TI  - Renaturation of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides
      after denaturation in 4 M guanidine hydrochloride: kinetics of aggregation and
      reactivation.
AB  - In 4 M guanidine hydrochloride (GdnHCl), the dimeric enzyme glucose-6-phosphate
      dehydrogenase from Leuconostoc mesenteroides (G6PD) dissociated to subunits and
      was extensively unfolded. Rapid dilution of this high GdnHCl concentration
      allowed G6PD to partially renature, as measured by enzyme reactivation, to a
      level which depended on the conditions employed. The fraction of the enzyme which
      did not renature aggregated and precipitated out of solution, a process which
      could not be substantially prevented by stabilizing additives. Based on the
      enzyme concentration dependence of the reactivation yield and on a comparison of
      the aggregation and reactivation rates, it was determined that aggregation and
      reactivation compete kinetically for a partially-folded intermediate only very
      early in the process, during the rapid GdnHCl-dilution step. The kinetics of G6PD
      reactivation were sigmoidal, indicating that this process involves more than one
      rate-limiting reaction. The kinetics depended on enzyme concentration in a higher
      than first-order manner, indicating that association of subunits is one of the
      rate-limiting reactions. A renaturation mechanism compatible with these
      observations is described, which involves a bi-unimolecular (subunit association
      folding) reaction sequence, with rate constants equal to 2.19 microM-1 min-1 and
      0.140 min-1, respectively. This mechanism involves an inactive, dimeric, G6PD
      folding intermediate, a species whose existence has recently been established by
      equilibrium denaturation experiments (Plomer, J.J. and Gafni, A. (1992) Biochim.
      Biophys. Acta 1122, 234-242).

PMID- 8476935
TI  - Immunologic evidence for three isoforms of AMP deaminase (AMPD) in mature
      skeletal muscle.
AB  - Four rabbit polyclonal antisera to purified AMP deaminase (AMPD) isozymes were
      used to precipitate homogenate AMPD activity from dissected gracilis, soleus and
      gastrocnemius muscles of the cat, rabbit, rat, mouse, Rhesus monkey, human and
      toad. The antisera were also tested against other unusual muscles: autonomically
      innervated striated muscle of the upper esophagus (UEM), skeletal muscle of
      patients with myo-AMPD deficiency and extraocular muscles (EOM) of humans and
      Rhesus monkeys. The reference antiserum, M, prepared against human psoas muscle
      AMPD, precipitated > 90% AMPD from all primate skeletal muscles tested, and from
      type-2 muscles of all mammals tested, but < 75% from cat and rodent soleus, toad
      gastrocnemius and primate UEM, EOM and myo-AMPD deficient muscles. Thus, a second
      isozyme was clearly indicated. Antibody B, against rat liver and kidney AMPD, had
      no effect with any muscle specimen. Antibody C, against rat heart AMPD, produced
      additive precipitation of AMPD from soleus of rat and mouse, while antibody E1,
      against human red cell (and heart) AMPD, produced additive AMPD precipitation
      from toad gastrocnemius, cat soleus and muscles of several AMPD-deficient humans.
      A second AMPD isozyme thus accounted for as much as 25% of total activity in some
      animal red muscles, but no more than 5% in human mixed muscles. At least one more
      isozyme is needed to account for muscle AMPD unreactive with all antibodies
      tested in rabbit soleus, toad gastrocnemius and primate UEM and EOM. A list is
      appended of the approximate AMPD activity in various human cells and tissues.

PMID- 8476936
TI  - Perspectives on linkage of primary health care and substance abuse treatment.

PMID- 8476937
TI  - Current pharmacotherapies for cocaine abuse: a review.
AB  - This article attempts to summarize the results of clinical trials on various
      pharmacotherapies for cocaine abuse described in the literature. A wide variety
      of drugs have been used for cocaine abuse. They include drugs for the treatment
      of coexisting psychiatric disorders, cocaine antagonists, dopamimetic agents, L
      dopa/carbidopa, the amino acids tyrosine and tryptophan, antidepressants,
      anticonvulsants, and antabuse-like drugs. Emphasis is placed throughout this
      review on how extensively each drug has been tested, how successful each drug has
      proven to be in treating cocaine abuse, and on which drugs require further
      investigation.

PMID- 8476938
TI  - 1990-1991 survey of pharmacotherapies used in the treatment of cocaine abuse.
AB  - In order to assess the usefulness of pharmacotherapeutic agents in cocaine
      treatment, all 3,631 physician members of the American Society of Addiction
      Medicine (ASAM) were surveyed. Five hundred and two physicians indicated use of
      pharmacotherapies, involving treatment experiences with approximately 79,760
      patients for cocaine detoxification, and with 37,166 patients for cocaine
      abstinence maintenance. For both detoxification and abstinence maintenance, the
      four most commonly prescribed medications were amantadine, bromocriptine,
      desipramine, and l-tryptophan. As expected, these four medications were also the
      preferred treatment by a majority of physicians expressing any preference. Some
      relatively new medications are also being tried for the treatment of cocaine
      abuse, specifically carbamazepine, fluoxetine, and Tropamine.

PMID- 8476940
TI  - Public policy statement on the role of Medical Review Officers.

PMID- 8476939
TI  - General medical care and the addictions.

PMID- 8476941
TI  - Public policy statement, on addiction medicine and health insurance reform.

PMID- 8476942
TI  - Laboratory tests for rapid screening of drugs of abuse in the workplace: a
      review.
AB  - The use of rapid, on-site drug detection devices is reviewed. These tests permit
      the detection of various psychoactive substances in urine, and are easily used by
      nonskilled personnel. Saliva tests are available for detection of alcohol. These
      rapid tests have varying degrees of accuracy, and it is recommended that positive
      outcomes for all rapid tests be verified by standard laboratory procedures. The
      tests have potential use in the emergency room, doctor's office, drug treatment
      program, and the work place. When access to formal laboratory testing is limited
      by either time or location, an easily portable test can give critical
      information. A number of commercially available tests are reviewed for method,
      accuracy, advantages and disadvantages. Consequently, the interested practitioner
      should be able to find a suitable screening test from among the tests reviewed.

PMID- 8476943
TI  - Alcoholism in a coronary care unit population.
AB  - To estimate prospectively the concordance between diagnoses of alcoholism by a
      physician and by use of a questionnaire-type screening test in patients in a
      coronary care unit, we studied 608 patients admitted to a coronary care unit in a
      5 1/2-month period. The results from the Self-Administered Alcoholism Screening
      Test (SAAST) were compared with the diagnoses by physicians recorded in the
      medical records for the same patients. A strong association (P < 0.001) existed
      between the clinicians' identification of an alcohol problem and the SAAST scores
      indicative of such a problem. However, 23 (4.2%) patients were identified as
      alcoholics by the SAAST but not by clinicians, and 16 (2.9%) patients were
      identified as alcoholics by clinicians but not by the SAAST. The SAAST was well
      accepted in this coronary care unit and can complement and extend the clinicians'
      impression, although each approach may identify some patients that the other will
      miss. Routine use of the SAAST in the coronary care unit or other hospital
      settings is feasible and, with appropriate clinician assessment and physician
      involvement, should yield more complete evaluation and case finding for
      alcoholism.

PMID- 8476944
TI  - Women at high risk of HIV infection from drug use.
AB  - The purpose of this project was to study women at high risk for contracting AIDS
      from intravenous drug use or from sexual contact with addicts. Characteristics of
      the population, differences between HIV+ and HIV- women, substance abuse in
      primary caretakers of this high risk population, and changes in drug use when
      learning of HIV status were investigated. Subjects were mothers at high risk for
      contracting HIV, whose children were referred to a pediatric AIDS clinic of a
      large urban hospital because of AIDS risk factors. HIV testing revealed that 27
      women were HIV+ and 13 were HIV-. The most common source of infection reported by
      the HIV+ women was sexual contact (17 subjects), with the remainder reporting
      that they were unsure of the source or reported intravenous drug use as their
      source of infection. There were significant differences between HIV+ and HIV-
      mothers with regard to the presence and impact of substance abuse in their own
      primary caretakers before age 16. Substance abuse in the parents of subjects was
      apparently reflected in behaviors reflecting health risk in subsequent
      generations. Subjects did not report changes in AIDS risk behavior when informed
      of their own HIV status or that of their children.

PMID- 8476945
TI  - Protective and risk factors associated with drug use among Hispanic youth.
AB  - Analysis of data from a nationally representative sample of Hispanic youths age
      12-17 and their parents was done to investigate the impact of a number of
      variables on youths' drug-using behavior. The significance of youth, household,
      and parental characteristics were tested using measures of youth drug use as
      dependent variables in regression models. Parents' attitudes and use of licit and
      illicit drugs were found to play an important role in their children's drug use
      behavior. The results also provide some support for the hypothesis that Hispanic
      children whose parents are more acculturated into American society are at higher
      risk of using drugs. Youths of Mexican origin, youths living outside large
      metropolitan areas, and females were found to be more likely to use drugs. The
      results provide supportive evidence that for drug prevention education programs
      to be effective with Hispanic youths, they must be family oriented.

PMID- 8476946
TI  - Barbarians at the gates.

PMID- 8476947
TI  - [The status of the direct magnifying x-ray technique in orthopedics].
AB  - 22 patients suffering from different orthopaedic disease patterns were x-rayed
      with direct x-ray magnification with focus diameters between 0.012 and 0.100 mm.
      This yielded improved resolution of detail structures, especially in tumours and
      aseptic bone necroses. Due to the relatively low efficiency of the x-ray tube
      (conditioned by the physics of the x-ray equipment), however, exposure times of
      several seconds were required, and the voltage had to be higher than in
      conventional x-ray procedure. This resulted in lack of sharpness due to movement
      and to a loss in contrast. Hence, the clinical use of focus diameters below 0.1
      mm does not seem to be meaningful.

PMID- 8476948
TI  - [CT arthrography of the shoulder joint].
AB  - Double-contrast CT arthrography of the shoulder is an imaging modality of great
      diagnostic accuracy with regard to glenohumeral instabilities. The purpose of
      this study is to describe the technique of the method and to demonstrate normal
      and pathological conditions in detail. Finally, its diagnostic value compared to
      other imaging modalities is outlined.

PMID- 8476949
TI  - [A stress fracture following osteosarcoma in a child--differential diagnosis].
AB  - 1 1/2 years following resection of an osteosarcoma of the right proximal fibula,
      pain and roentgenologic lesions of the right tibia at exactly the same level were
      first of all suspicious of tumour relapse. Analysis of the findings of
      conventional films revealed the diagnosis of stress fracture.

PMID- 8476950
TI  - [The infiltrating angiolipoma--a rare soft tissue tumor with a malignant
      appearance].
AB  - Angiolipomas are rare benign soft tissue tumours that are mostly encapsulated by
      fibrous tissue. A case of an infiltrating angiolipoma with mixed vascularisation,
      not surrounded by a capsule, is described. Differentiation between lipoid
      degenerated fibromas, lipoid histiocytoses and haemangiomas is radiologically
      possible with an extensive security and enables an adequate choice of the
      surgical procedure.

PMID- 8476951
TI  - [An arteriovenous fistula following laminectomy--sonographic diagnosis].
AB  - In a 36-year-old woman, 10 years after laminectomy, a tentative diagnosis of
      arteriovenous shunt between the right iliac artery and vein, a rare complication
      of this procedure, was made on the basis of ultrasonographic findings. The signs
      consisted of dilatation of the iliac vein and of the inferior vena cava, a
      vascular bruit and tactile fremitus in the abdomen. In addition, cardiac
      enlargement and slight tricuspid and mitral incompetence in the absence of
      cardiac insufficiency were noted. After angiographic verification of the
      diagnosis the anomaly was corrected surgically.

PMID- 8476952
TI  - [Pulmonary sequestration: use of MR-angiography].
AB  - The confirmation of the diagnosis of intralobar pulmonary sequestration usually
      requires angiographic demonstration of the systemic arterial supply, and venous
      drainage. Magnetic resonance angiography (MR angiography) is a new, non-invasive
      imaging modality for examinations of the vasculature. In this report we describe
      its successful application in intralobar pulmonary sequestration demonstrating
      the feeding systemic artery, including its intrapulmonary branching, and the type
      of the venous return.

PMID- 8476953
TI  - [Bilateral pneumothorax, pneumomediastinum and pneumoperitoneum following
      unilateral percutaneous lung biopsy].
AB  - Case report on a 53-year old male patient; after transthoracic resection of the
      oesophagus a unilateral percutaneous biopsy of a newly developed round focus of
      the lung led to a bilateral pneumothorax (as well as a pneumomediastinum and a
      pneumoperitoneum). After transthoracic surgery the described alterations have
      also to be taken into account as possible complications of a unilateral
      percutaneous lung-biopsy.

PMID- 8476954
TI  - [Minimal invasive surgery, maximum results].

PMID- 8476955
TI  - [Injuries of the thoracic skeleton].
AB  - Injuries of the thoracic skeleton are an important indicator of other, relevant
      traumatic changes after a polytrauma. Most fractures occur in the ribs, followed
      by fractures of the clavicle, the scapula and the sternum. Because of their high
      kinetic energy, car accidents are the main reason for thoracic fractures. The
      basic radiologic tool is the a.p. projection of the thorax in supine position; in
      addition, other conventional x-ray examinations or computed tomography are
      performed. Most thoracic fractures are treated conservatively, only in few cases
      (instability of the thorax, risk of pseudoarthrosis, incongruence of joint
      surfaces) surgical procedures are used.

PMID- 8476956
TI  - [Imaging of the normal anatomy of the hand using high resolution magnetic
      resonance tomography and surface coils].
AB  - Magnetic resonance imaging can visualize the soft tissue and the bone marrow of
      the hand. High spatial resolution requires the use of a surface coil. Signal-to
      noise contrast was measured and compared for 3 different coils. Optimal results
      were obtained with a surface coil with a diameter of 8.5 cm. The wrist and the
      fingers of 10 volunteers each were examined. Images with a high spatial
      resolution and a good signal/noise contrast were obtained, enabling the
      delineation of small structures like Gynon's channel and the median nerve.

PMID- 8476957
TI  - [Clinical magnetic resonance spectroscopy: feasibility and methods using whole
      body tomographs].
AB  - MR Spectroscopy offers the unique possibility of monitoring the metabolism of
      various organs non-invasively. Using examples of 1H and 31P MR spectra,
      experimental and commercially available techniques are presented and evaluated
      with regard to their potential clinical application. An example of a 1H human
      brain spectrum with a pathological lactate level illustrates the requirements for
      MRS examinations in terms of spatial and spectral resolution. STEAM, Spin-Echo,
      and Chemical Shift Resolved Imaging (CSI) techniques for 1H MRS are compared. In
      the field of 31P MRS, typical CSI spectra of the brain and liver are presented.
      First experimental results with a new double-oblique 3D-CSI technique for
      measurement of PCr/ATP ratios of different anatomical regions of the human heart
      are shown. The advantages of using double-resonance techniques for Nuclear
      Overhauser Enhancement (NOE) and decoupling are shown by the example of the
      phosphodiesters of the liver. The energy metabolism of skeletal muscle under
      exercise is resolved with 5 sec/spectrum, showing breakdown and synthesis of
      photocreatine (PCr) and inorganic phosphate (Pi). Appropriate instrumentation and
      technique are available to many clinics today; great interest now is directed
      towards the diagnostic value of MRS for certain indications.

PMID- 8476958
TI  - Factors associated with hepatitis B infection.
AB  - Men and women patients not previously immunized or tested, attending the Adelaide
      (South Australia) STD clinic from 1988-1991, were tested for hepatitis B
      infection, and potential risk factors detected by multiple logistic regression.
      Of 7055 men and 3425 women patients tested 811 (11.5%) men and 250 (7.3%) women
      were seropositive. Among men seropositivity was associated with being Asian (odds
      ratio (OR) = 14.5), being Aboriginal (OR = 2.2), homosexual behaviour (OR = 3.8),
      intravenous drug use (OR = 3.2) being over 24 (OR = 2.7), previous STD (OR =
      1.8), being unemployed (OR = 1.3) and having sex outside the state in the past 3
      months (OR = 1.3). Among women seropositivity was associated with being Asian (OR
      = 10.3), being Aboriginal (OR = 2.4), intravenous drug use (OR = 3.8), being over
      24 (OR = 1.6) and having vaginal discharge or dysuria (OR = 1.4). Seropositivity
      was not independently associated with being a prostitute or having multiple sex
      partners in the past 3 months. Among seropositive individuals, risk factors were
      not readily identifiable for 15% of men and 43% of women. Univariate analysis may
      provide misleading indicators of risk factors because of the confounding
      influence of other factors, particularly intravenous drug use. In selective
      vaccination campaigns the target group should be determined on the basis of local
      circumstances. In South Australia this group should include men with an STD. The
      success of selective campaigns will be jeopardized by the failure to identify
      risk factors in many of those who become infected, and in such situations
      universal vaccination or widespread screening may be more appropriate strategies.

PMID- 8476959
TI  - Contraceptive practices in HIV seropositive females in Ireland.
AB  - A questionnaire was administered to a cohort of 130 HIV seropositive women
      attending the Department of Genitourinary Medicine, St James's Hospital, Dublin,
      in order to establish their current contraceptive practices. Forty (42%) of the
      sexually active women did not use reliable contraception; 55 (57%) used a method
      reliable in fertility control only, and 21 (22%) used a method reliable in terms
      of both partner and congenital transmission. The intravenous drug users were less
      likely to use reliable contraception, 9 (39%), in comparison to the heterosexual
      group 14 (70%), P < 0.05. The heterosexual group were more likely to use condoms
      consistently, 7 (35%) in comparison to one (4%) of intravenous drug users, P <
      0.02. Nineteen children, 3 borne to heterosexual mothers and 16 borne to
      intravenous drug-using mothers were HIV seropositive after 18 months.

PMID- 8476960
TI  - Roxithromycin compared to doxycycline in the treatment of genital chlamydial
      infection and non-specific urethritis.
AB  - A single-blind randomized follow-up study was conducted to evaluate the efficacy
      and tolerance of roxithromycin 300 mg once a day compared to doxycycline 200 mg
      day 1 and 100 mg day 2-10 in the treatment of genital chlamydial infection in men
      and women and non-specific urethritis (NSU) in men. A total of 211 patients (200
      men and 11 women) between 18 and 46 years were enrolled. The women were excluded
      from the efficacy analysis because of the low number, but were included in the
      tolerance analysis. The clinical (clearance of polymorphonuclear leucocytes in
      urethral smears) and bacteriological response was evaluated one and 11 days after
      the treatment. Of 113 included men with chlamydial infection, 105 (93%) and 96
      (85%) were evaluable on respective follow-up visits and of 87 included men with
      NSU, 74 (85%) and 64 (74%) were evaluable one and 11 days after treatment,
      respectively. The bacteriological eradication rate immediately after the
      treatment in chlamydia positive patients was 92.7% and 100% for roxithromycin and
      doxycycline, respectively, and 91.8% and 100% at follow-up. The clinical cure
      rate of all evaluable patients was 83.1% and 80.7% for roxithromycin and
      doxycycline, respectively, one day after the treatment and 80.5% and 85.3% for
      the two drugs, respectively, 11 days after treatment. None of these observed
      differences was statistically significant. The diagnosis did not influence the
      clinical response rate with either drug. Probable and possible drug-related side
      effects were more common after doxycycline than after roxithromycin, 35% and 19%
      respectively (P = 0.0032).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476961
TI  - Restricting personal behaviour: case studies on legal measures to prevent the
      spread of HIV.
AB  - People infected with HIV who persist in exposing others to infection through
      negligent, reckless, or criminal activity create a legal and ethical dilemma for
      public officials. Protection of the public health requires balancing the rights
      of infected people with the expectations of society. When reasonable efforts fail
      to obtain the voluntary cooperation of infected individuals, Colorado law permits
      health officers to restrict their behaviour. Since 1986, at least 20 people who
      were aware of their infection are known to have exposed others to HIV in Colorado
      Springs, Colorado. Restrictive measures have been initiated in 14 cases to date.
      Presented here is an overview of Colorado law, selected case studies, and a
      summary of its strengths and shortcomings.

PMID- 8476963
TI  - Investigation of haematospermia.

PMID- 8476962
TI  - Anonymized sero-survey of HIV in a genitourinary medicine clinic population.
AB  - An anonymized sero-survey of the prevalence of HIV antibody was performed at an
      inner city Genitourinary medicine clinic in Birmingham. In 1991 8686 patients
      undergoing routine serological syphilis tests were anonymously tested for HIV
      antibodies once during the year. Demographic information was recorded for each
      sample but they were otherwise unlinked. There were 31 samples which tested
      positive for anti-HIV 1 from this group compared with 13 diagnosed by concomitant
      voluntary named testing. Sero-prevalence rates of 0.17% for women and
      heterosexual men and 4.37% for homosexual/bisexual men were found. No drug users
      tested positive. The survey provided evidence of occult disease outside the
      recognized risk behaviour patterns of homosexual men and injecting drug users
      outside London.

PMID- 8476964
TI  - Is pediculosis pubis a recurrent disease in some men?

PMID- 8476965
TI  - Cervical neoplasia and sexually transmitted diseases among prostitutes in Oviedo,
      Spain.

PMID- 8476966
TI  - The incubation period of first episode genital herpes.

PMID- 8476967
TI  - Streptococci and the genital tract.
AB  - Streptococci of Lancefield Group B (GBS) are known to cause maternal sepsis and
      neonatal infection, whereas streptococci Lancefield Group A (GAS) cause vulvo
      vaginitis in both children and adults. Prevalence of SGB colonization of the
      lower genital tract of normal women is between 4-18%, with higher rates found in
      hospital personnel and delivery rooms. Such high carriage rates may be a
      significant factor in nosocomial transmission of GBS to neonates. Symptomatic
      infection is uncommon and usually secondary to other pathological states.
      Amnionitis is a complication of vaginal carriage of GBS and there is now evidence
      that chorioamnionitis is associated with pre-term labour and its attendant
      problems. GBS infection of the male genitalia has also been described.
      Intrapartum chemoprophylaxis has been shown to prevent early onset GBS disease of
      the neonate. Prevalence of GAS in the genital tract is lower than that for GBS,
      but is more likely to be symptomatic. The response to penicillin is usually
      prompt. Optimal drug regimens need to be determined, particularly for use in
      pregnancy.

PMID- 8476968
TI  - The role of aerosol pentamidine prophylaxis.
AB  - Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection
      in patients with AIDS, occurring in 80% and recurring in 50% of patients within
      12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+
      cell count is < 200 x 10(6)/l or 20% of the total lymphocyte count, or after an
      episode of PCP. The most effective prophylactic agent currently is trimethoprim
      sulphamethoxazole and should be the drug of choice but alternatives such as
      aerosol pentamidine are being increasingly used for patients who cannot tolerate
      this combination or other oral preparations. If aerosol pentamidine is used and
      administered via a Respigard II Marquest nebulizer, the dosage should be higher
      than the currently recommended monthly dosage of 300 mg.

PMID- 8476969
TI  - A review and update on adult syphilis, with particular reference to its
      treatment.
AB  - Syphilis has become less common in Europe in the last decade, but has once again
      become a major problem in the USA, and remains so in many developing countries.
      Several treponemal genes have now been cloned and expressed in Escherichia coli,
      allowing study of treponemal proteins. The importance of cell mediated immunity
      in syphilis has been demonstrated in animal models. A diagnosis of syphilis is
      usually confirmed by dark-field microscopy or serological tests. Seroconversion
      may be delayed in HIV infected individuals. A positive reaginic test in
      cerebrospinal fluid (CSF) has a high specificity but low sensitivity in the
      diagnosis of neurosyphilis. Indeed, virulent treponemes can be identified in CSF
      samples which have negative reaginic tests, normal cell counts and protein
      levels. In the CSF, the FTA-Abs test has a high sensitivity but low specificity
      for neurosyphilis. Penicillin remains the treatment of choice for all stages of
      syphilis, although it penetrates the blood brain barrier poorly. Treatment with
      intramuscular benzathine penicillin 2.4 million units stat, or 600,000 units
      procaine penicillin daily does not produce treponemicidal levels within the CSF.
      However, the incidence of neurosyphilis is low in immunocompetent patients
      treated with such regimens during early syphilis. Acceptable alternatives in
      penicillin-allergic patients include ceftriaxone and doxycycline. Erythromycin is
      not recommended as it has produced unacceptably high rates of treatment failure.
      Recently, a strain of macrolide-resistant Treponema pallidum was isolated from a
      patient with secondary syphilis. For the treatment of neurosyphilis,
      treponemicidal levels of penicillin can be achieved in the CSF using 2.4 million
      units procaine penicillin daily with concurrent probenecid 500 mg 4 times a day,
      or an intravenous infusion of benzyl penicillin 12-24 million units daily. Early
      syphilis can be treated adequately over 10 days, but 21 to 28 days is appropriate
      for late syphilis. In HIV-infected patients syphilis may present atypically with
      initially negative serological tests. Treatment of early syphilis in HIV-positive
      patients has been associated with the early development of neurosyphilis. It is
      advisable to treat all patients co-infected with HIV with an antibiotic regimen
      that achieves adequate levels within the CSF.

PMID- 8476970
TI  - Case definitions for paediatric AIDS: the Zambian experience.
AB  - For the purpose of surveillance of the acquired immunodeficiency syndrome (AIDS)
      in developing countries, the World Health Organization (WHO) has recommended
      criteria for the clinical case definition of AIDS in adults and children. In a
      preliminary examination of children in Zambia a number of patients with obvious
      AIDS did not fit the published WHO case definition for paediatric AIDS. Based on
      this the Zambia National AIDS Surveillance Committee designed local criteria for
      the clinical case definition of paediatric AIDS. We compared the Zambian criteria
      with the WHO criteria for the diagnosis of paediatric AIDS by studying 134
      consecutively admitted children to one of the paediatric wards at the University
      Teaching Hospital in Lusaka. Twenty-nine of the patients were HIV-1 seropositive
      and 105 were HIV-1 seronegative. Among the 29 HIV-seropositive patients, the
      Zambian criteria identified 23, and the WHO criteria identified 20 children as
      having AIDS. The 105 HIV-seronegative children were classified as having AIDS in
      9 cases by the Zambian criteria and in 38 cases by the WHO criteria. These
      results give the Zambian criteria for the diagnosis of AIDS a sensitivity of
      79.3%, a specificity of 91.4% and a positive predictive value of 86.8% compared
      to a sensitivity of 69%, specificity of 64% and a positive predictive value of
      38% for the WHO criteria. The current WHO criteria are inadequate for the
      diagnosis of paediatric AIDS. The need to refine the WHO criteria for the
      diagnosis of paediatric AIDS is discussed.

PMID- 8476971
TI  - How often do condoms break or slip off in use?
AB  - Men attending 3 sexually transmissible disease clinics and a university health
      service in Sydney were given a questionnaire asking how many condoms they had
      used in the past year and how many broke during application or use or slipped
      off. Respondents were 544 men aged 18 to 54 years. Of these, 402 men reported
      using 13,691 condoms for vaginal or anal intercourse; 7.3% reportedly broke
      during application or use and 4.4% slipped off. Men having sex with men reported
      slightly higher slippage rates than those having sex with women. Breakage and
      slippage were unevenly distributed among the sample: a few men experienced very
      high failure rates. A volunteer subsample reported 3 months later on condoms
      supplied to them: 36 men used 529 condoms, of which 2.8% broke during application
      or use and 3.4% slipped off. Many of these failures pose no risk to the user,
      especially those occurring during application, as long as they are noticed at the
      time, but failure may discourage future use. Research is needed to identify user
      behaviours related to breakage.

PMID- 8476973
TI  - Determining the prevalence of neurosyphilis in a cohort co-infected with HIV.
AB  - A retrospective study of 767 HIV positive patients from a large urban public
      hospital, 238 of whom were co-infected with syphilis, was performed to determine
      the prevalence of neurosyphilis. A prevalence of 3% of neurosyphilis in the co
      infected cohort was demonstrated. The 7 cases of neurosyphilis ascertained were
      of the early stage variety, with cranial nerve involvement the predominant focal
      deficit. Of the 5 cases presenting after initial diagnosis and treatment of
      syphilis, 4 were felt to be inadequately treated. An overall prevalence of 1%
      (7/767) was determined for the entire HIV(+) cohort. The majority of the cases of
      syphilis (90%) were characterized as latent syphilis. Based on these findings,
      the authors recommend routine CSF examination in all patients who are HIV
      positive and who present with latent syphilis. Treatment regimens should be
      maximized in an effort to reduce the prevalence of neurosyphilis in such a co
      infected cohort.

PMID- 8476972
TI  - Sexual behaviour and use of the condom by men attending gay bars and clubs in
      Glasgow and Edinburgh.
AB  - How widespread are the safer forms of sexual behaviour reportedly adopted by male
      homosexuals in recent years? A questionnaire was completed by 173 and 83 gay men
      attending gay bars and clubs in Edinburgh and Glasgow respectively. Comparisons
      were made between those who reported using the condom (n = 137, [54%]) and those
      who did not (n = 119, [46%]). Sixty percent of respondents reported more than 5
      partners during the previous year. Condom use was much less common among men with
      less than 5 years' experience as a practising homosexual. Less than one-fifth of
      respondents reported always using a condom during anal intercourse. Orogenital
      contact without a condom was reported by 84% of all respondents, and unprotected
      anal intercourse by 40%, (over 30% for those who used condoms). About one-third
      of condom users but only 14% of non-users thought they were at risk of catching
      HIV because of their sexual behaviour, although 80% of users and 70% of non-users
      said their lifestyles had been affected by the HIV epidemic. While there were
      some encouraging signs of behaviour change, unprotected anal sex is still widely
      practised. Gay bars and clubs represent important venues for conveying the safer
      sex message.

PMID- 8476974
TI  - A new method for analysis of heart rate variability: counting statistics of 1/f
      fluctuations.
AB  - 1/f fluctuations in heart rate are usually measured spectral analysis using Fast
      Fourier Transform. Here, we introduce a new method based on counting the number
      of QRS complexes in time intervals delta t of various length. For a 1/fb spectrum
      the variance of counts in delta t follows a power-law as delta t1+b. This method
      is applied to analyze long term fluctuations in heart rate variability in 10
      healthy men. The results show periods of 1/f fluctuations with interpolated
      periods of white noise during night hours.

PMID- 8476975
TI  - Neural organization of the locomotive oscillator.
AB  - We study the relation of neural development, organization, and activity to
      behavior. We provide a model of the locomotive oscillator, a neural system
      supplying alternating stimulation to extensor and flexor muscles creating an
      oscillatory motion. We propose a protocol by which this neural system starting
      from unstructured, unconnected neural populations develops structure and
      function. The protocol is studied by both computer simulation and mathematical
      analysis. Our main results are 1. The locomotive oscillator self-organizes and
      maintains its organization, assuming certain properties of the neural
      populations. 2. Imperfections disturbing the functional adequacy of the neural
      populations may lead to the deterioration and disappearance of the oscillatory
      behavior. 3. The locomotive oscillator may fail to organize if the development is
      not staged in time.

PMID- 8476976
TI  - A neural network model for kindling of focal epilepsy: basic mechanism.
AB  - A simple neural network model is proposed for kindling--the phenomenon of
      generating epilepsy by means of repeated electrical stimulation. The model
      satisfies Dale's hypothesis, incorporates a Hebb-like learning rule and has low
      periodic activity in absence of shocks. Many of the experimental observations are
      reproduced and some new experiments are suggested. It is proposed that the main
      reason for kindling is the formation of a large number of excitatory synaptic
      connections due to learning.

PMID- 8476977
TI  - A neural model for nonassociative learning in a prototypical sensory-motor
      scheme: the landing reaction in flies.
AB  - Nonassociative learning is an important property of neural organization in both
      vertebrate and invertebrate species. In this paper we propose a neural model for
      nonassociative learning in a well studied prototypical sensory-motor scheme: the
      landing reaction of flies. The general structure of the model consists of sensory
      processing stages, a sensory-motor gate network, and motor control circuits. The
      paper concentrates on the sensory-motor gate network which has an agonist
      antagonist structure. Sensory inputs to this circuit are transduced by chemical
      messenger systems whose dynamics include depletion and replenishment terms. The
      resulting circuit is a gated dipole anatomy and we show that it gives a good
      account of nonassociative learning in the landing reaction of the fly.

PMID- 8476978
TI  - The relationship between smoothness and performance during the practice of a
      lower limb obstacle avoidance task.
AB  - The relationship between performance (movement time) and smoothness was examined
      as subjects (n = 8) practiced a simple lower limb obstacle avoidance task.
      Smoothness was quantified by endpoint 3D jerk-cost, partitioned into magnitudinal
      and directional components. Data were collected with two WATSMART cameras at a
      sampling rate of 200 Hz for three sets of two trial blocks, including trials 1,
      2, 13, 14, 25, and 26. Ten practice trials were performed between blocks of
      recorded trials. A DLT method was used to reconstruct 3D position coordinates of
      the fifth metatarsal of the subject's right (dominant) foot, considered to be the
      endpoint. After the data were smoothed with a fourth order, zero lag Butterworth
      filter, the time period was normalized so that a comparison of jerk-cost could be
      made between trials. Very rapid decreases in both movement time and jerk-cost
      measures were followed by gradual decreases, indicating that the movement became
      smoother as performance improved. Correlation coefficients between movement time
      and the various components of jerk-cost ranged from 0.70 to 0.78, supporting the
      hypothesis that moving more smoothly enables a person to move more rapidly during
      an obstacle avoidance task.

PMID- 8476979
TI  - Oscillatory binocular system and temporal segmentation of stereoscopic depth
      surfaces.
AB  - A dynamical neural network model of binocular stereopsis is proposed to solve the
      problem of segmentation which remains ambiguous even when the problem of
      binocular correspondence is solved. Being compatible with the recent
      neurophysiological findings (Engel et al. 1991), the model assumes that neural
      cells show oscillatory activities and that segmentation into a coherent depth
      surface is coded by synchronization of activities. Employing appropriate
      constraints for segmentation, the present model shows proper segmentation of
      depth surfaces and also solves segmentational ambiguity caused by a gap. It is
      newly shown that binocularly-unmatched monocular cells are discriminated in
      temporal segmentation of monocular cells caused by recurrent interactions between
      monocular and binocular cells. Integrative interactions with the other visual
      components through temporal segmentation are also discussed.

PMID- 8476980
TI  - Rapid synchronization through fast threshold modulation.
AB  - Synchronization properties of locally coupled neural oscillators were
      investigated analytically and by computer simulation. When coupled in a manner
      that mimics excitatory chemical synapses, oscillators having more than one time
      scale (relaxation oscillators) are shown to approach synchrony using mechanisms
      very different from that of oscillators with a more sinusoidal waveform. The
      relaxation oscillators make critical use of fast modulations of their thresholds,
      leading to a rate of synchronization relatively independent of coupling strength
      within some basin of attraction; this rate is faster for oscillators that have
      conductance-based features than for neural caricatures such as the FitzHugh
      Nagumo equations that lack such features. Computer simulations of one-dimensional
      arrays show that oscillators in the relaxation regime synchronize much more
      rapidly than oscillators with the same equations whose parameters have been
      modulated to yield a more sinusoidal waveform. We present a heuristic explanation
      of this effect based on properties of the coupling mechanisms that can affect the
      way the synchronization scales with array length. These results suggest that the
      emergent synchronization behavior of oscillating neural networks can be
      dramatically influenced by the intrinsic properties of the network components.
      Possible implications for perceptual feature binding and attention are discussed.

PMID- 8476981
TI  - Presynaptic and postsynaptic competition in models for the development of
      neuromuscular connections.
AB  - In the establishment of connections between nerve and muscle there is an initial
      stage when each muscle fibre is innervated by several different motor axons.
      Withdrawal of connections then takes place until each fibre has contact from just
      a single axon. The evidence suggests that the withdrawal process involves
      competition between nerve terminals. We examine in formal models several types of
      competitive mechanism that have been proposed for this phenomenon. We show that a
      model which combines competition for a presynaptic resource with competition for
      a postsynaptic resource is superior to others. This model accounts for many
      anatomical and physiological findings and has a biologically plausible
      implementation. Intrinsic withdrawal appears to be a side effect of the
      competitive mechanism rather than a separate non-competitive feature. The model's
      capabilities are confirmed by theoretical analysis and full scale computer
      simulations.

PMID- 8476982
TI  - Constants underlying frequency changes in biological rhythmic movements.
AB  - When an animal increases or decreases the frequency of its limb motions, how
      should the transformation in timing be characterized? It has been hypothesized
      that the transformation is adiabatic, even though the biological conditions are
      nonconservative and non-rate-limited (Kugler and Turvey 1987). An adiabatic
      transformation requires that the rhythmic system's action (energy/frequency) and
      entropy production remain time-invariant throughout the transformation. The non
      conservative adiabatic hypothesis was evaluated through an experiment on human
      rhythmic hand movements. On each trial, a subject began at a prescribed frequency
      and then, over a 30 s interval, increased (or decreased) the frequency
      continuously at will. For each subject, on each increasing and decreasing trial,
      cycle kinetic energy was a linear function of cycle frequency with a negative
      energy intercept. By the adiabatic hypothesis, the slope of the function defines
      the constant action and the intercept defines the constant dissipation - changes
      in cycle frequency incur no changes in energy dissipated per cycle. Slopes and
      intercepts were correlated suggesting a common basis for the two constants, and
      the variety of cycle amplitude-cycle duration relations were in agreement with
      the nonmonotonic, nonlinear space-time function predicted by the hypothesis. The
      possibilities of addressing aspects of the data through (a) muscle modeled as a
      continuum of Kelvin bodies with a continuous relaxation spectrum, and (b) various
      classes of autonomous differential equations, were discussed. Most importantly,
      the discussion focused on the puzzling independence of energy cost and speed
      exhibited by locomoting animals differing in morphology, physiology, size, and
      taxa. It was suggested that the independence may reflect a very general principle
      - adiabatic transformability of biological movement systems.

PMID- 8476983
TI  - A model of the saccadic sensorimotor system of salamanders.
AB  - A model of the saccadic system of salamanders on the basis of
      electrophysiological and anatomical results is presented. The model includes
      centers found to be significant for the guidance of saccades in these
      comparatively simple vertebrates. In particular, these are the optic tectum, the
      bulbar reticular formation and the motor system. The latter consists of two pairs
      of neck-muscles, an epaxial and a hypaxial one driven by their respective
      motoneurons. The model includes a visual, a sensori-motor, and a motor level. At
      the sensory level, the retinal coordinates are transferred to the optic tectum to
      establish an orthogonal map of visual angles. A secondary visual map of the
      ipsilateral eye with a pointsymmetrical organization exists in addition. The
      premotor system of the tectum was modelled according to an ensemble-coding
      principle. Thus, local activation of the visual map results in recruitment of an
      appropriate number of tectal premotor units. Simulation of the model reproduces
      correct metric properties of salamander saccades under varying stimulus
      presentations.

PMID- 8476984
TI  - Bistability, switches and working memory in a two-neuron inhibitory-feedback
      model.
AB  - It was reported earlier that an inhibitory-feedback network inspired by
      neostriatal circuitry may exhibit a bistable character and spontaneous switching
      phenomenon within the neuronal activity. In the presence of noise and external
      excitation, a few local neurons switch "on" and generate streams of impulses
      while other neurons remain quiescent. In time, the existing "on" neurons
      spontaneously switch "off" and other neurons switch "on". In this paper we
      examine the nature of the bistability and switching phenomenon using a simple
      model consisting of two mutually inhibitory neurons. For nonspiking neuron model,
      described by a system of nonlinear differential equations, we present a simple
      bifurcation analysis, which follows the birth and annihilation of two stable
      fixed points when model parameters are varied. We show that both nonspiking and
      spiking models may have two stable states, but only spiking neurons exhibit
      switching. The mechanism of switching for model spiking neurons, described by an
      equivalent RC circuit with a number of currents, is analyzed using computer
      simulations. It is shown that switching can be described by a two-state Markov
      chain with one parameter, which depends on the set of model physiological
      parameters, such as duration of afterhyperpolarization (AHP), maximum and the
      time duration of inhibitory post-synaptic potentials (IPSP's) and amplitude of
      the neuron noise input. "On" and "off" states of the model can be rapidly changed
      by localized excitatory input and the network then sustains the pattern of "on"
      and "off" states. That is, such a network can be used as a programmable memory
      device.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8476985
TI  - A diffusion model of a neuron and neural nets.
AB  - In the paper a diffusion model of a neuron is treated. A new, less restrictive
      than usually, condition of applicability of a diffusion model is presented. As a
      result the point-process-to-point-process model of a neuron is obtained, which
      produces an output signal of the same kind as the accepted input signals.

PMID- 8476986
TI  - A neural model of the dynamic activation of memory.
AB  - We study an Attractor Neural Network that stores natural concepts, organized in
      semantic classes. The concepts are represented by distributed patterns over a
      space of attributes, and are related by both semantic and episodic associations.
      While semantic relations are expressed through an hierarchical coding over the
      attribute space, episodic links are realized via specific synaptic projections.
      Due to dynamic thresholds expressing neuronal fatigue, the network's behavior is
      characterized by convergence toward the concept patterns on a short time scale,
      and by transitions between the various patterns on a longer time scale. In its
      baseline, undamaged state, the network manifests semantic, episodic, and random
      transitions, and demonstrates the phenomenon of priming. Modeling possible
      pathological changes, we have found that increasing the 'noise' level or the rate
      of neuronal fatigue decreases the frequency of semantic transitions. When neurons
      characterized by large synaptic connectivity are deleted, semantic transitions
      decay before the episodic ones, in accordance with the findings in patients with
      Alzheimer's disease.

PMID- 8476988
TI  - Cartilage mechanics and morphology, synovitis and proteoglycan fragments in
      rabbit joint fluid after prosthetic meniscal substitution.
AB  - The effects of meniscal substitution with a Dacron or Teflon prosthesis on rabbit
      knee-joint cartilage were studied by indentation tests, gross and histological
      inspection, analysis of proteoglycan fragments in joint fluid and an evaluation
      of synovial changes. Cartilage mechanics and cartilage morphology were similarly
      abnormal after meniscectomy and meniscal substitution. The elevated
      concentrations of proteoglycan fragments in joint fluid and the more severe
      synovial changes in joints with a meniscal substitute, as compared to
      meniscectomy, probably resulted from irritation of the artificial implant, but
      also reflected the remaining effects from the necessary bone drilling. In this
      short-term experiment, the use of an artificial meniscal substitute could not
      prevent cartilage degeneration after meniscectomy.

PMID- 8476987
TI  - Emergence of orientation selective simple cells simulated in deterministic and
      stochastic neural networks.
AB  - The processing of visual data in area 17 of the mammalian cortex is mainly
      performed by cells with receptive fields which are tuned to different
      orientations of input stimuli. The mechanisms underlying the emergence of
      receptive field properties of orientation selective cells are not well understood
      up to now. Recently, some models for the prenatal development of the receptive
      fields of orientation selective simple cells have been proposed, which emerge in
      neural networks trained by Hebb type unsupervised learning rules. These models,
      however, use different network architectures and are restricted to the case of
      identical input neurons. In this work, a biologically motivated neural network
      model with a general architecture is presented. It is trained with a Hebb type
      updating rule and with uncorrelated input. The input neurons are identified with
      retinal ganglion cells and exhibit mature Mexican hat type receptive fields. If
      the receptive fields of the input neurons have identical properties
      (deterministic model), a set of parameter domains is found, which characterize
      different kinds of receptive field maturation behaviour of the network. Results
      obtained by other authors with similar models are contained in this description
      as special cases. In addition, the more general and rarely investigated
      stochastic model, where random variations of the parameters describing the
      receptive fields of the input neurons occur, is investigated. A high sensitivity
      of the network against these random variations is obtained. In case of large
      variations of receptive field parameters of the ganglion cells, a qualitatively
      new kind of maturation behaviour appears. A significant part of the synaptic
      connections from ganglion cells to the cortical cell is removed and small simple
      cell receptive fields with only few lobes emerge. The stochastic model is found
      to provide a better description of the size, scatter and structure of receptive
      fields present in biological systems, than the deterministic model.

PMID- 8476989
TI  - TiN coating: surface characterization and haemocompatibility.
AB  - The left ventricular assist device under consideration is based on the principle
      of the Maillard-Wankel rotary pump. The construction materials must meet
      stringent requirements. Titanium nitride was chosen for its surface properties
      and graphite for its bulk characteristics. The purpose of this study was to
      characterize the chemical vapour deposition titanium nitride coating via
      morphology, roughness, crystallinity, chemical composition, to report and discuss
      the results of in vitro haemocompatibility tests (protein adsorption, platelet
      retention, haemolysis) and to discuss physico-chemical and biological results.
      This chemical vapour deposition titanium nitride coating is well tolerated by the
      blood despite its surface irregularities, and appears as a good candidate
      material after improvements.

PMID- 8476990
TI  - In vitro assessment of bacterial adhesion to Hydromer-coated cerebrospinal fluid
      shunts.
AB  - The adherence of five strains of Staphylococcus epidermidis and one strain of S.
      aureus to both untreated and Hydromer-coated silicone rubber cerebrospinal fluid
      shunts was studied in vitro using epifluorescent image analysis. All five strains
      of S. epidermidis showed similar levels of adherence to untreated shunts, whilst
      S. aureus adhered slightly better. The Hydromer coating, a hydrogel material
      which creates a hydrophilic layer on the shunt surface, was found to reduce
      bacterial adhesion levels by approximately 90% in the six strains of bacteria
      tested. Unfortunately, uniform coverage of the shunt surfaces (particularly
      internally) with Hydromer coating was not achieved during sample preparation.
      Bacterial adhesion levels in such areas were identical to untreated controls.
      This may pose problems in the in vivo use of Hydromer-coated shunts.

PMID- 8476991
TI  - Complement activation by polymethyl methacrylate minimized by end-point heparin
      attachment.
AB  - After intraocular lens implantation, despite good clinical results, many cataract
      patients develop a chronic uveitis, caused by an inflammatory response to the
      implant. One way to improve the biocompatibility of the intraocular lens is to
      modify the surface by end-point heparin attachment. This study shows that
      complement activation caused by poly(methyl methacrylate) can be diminished by
      end-point heparin attachment, as demonstrated by a significant reduction in the
      generation of C3a and fluid phase terminal complement complexes. It suggests that
      assessment of complement activation is a good indicator of the biocompatibility
      of intraocular lenses.

PMID- 8476992
TI  - Influence of block copolymers on the adsorption of plasma proteins to
      microspheres.
AB  - SDS-PAGE in combination with densitometry has been used to evaluate the
      adsorption of plasma and serum proteins to polystyrene microspheres (PS) coated
      with block copolymers of the poloxamer and poloxamine series. The protein
      resistant nature of coated PS was demonstrated for these systems when incubated
      in dilutions of plasma and serum. The total amount of protein and the type of
      proteins adsorbed were dependent on the plasma and serum incubation concentration
      used. At 0.3% serum concentrations the total amount of protein adsorbed was found
      to be related to the polyoxyethylene (PEO) chain length of the block copolymer,
      whilst at 0.3% or 50% plasma concentrations a relationship was shown between the
      polyoxypropylene (PPO) chain and the plasma protein adsorption for the range of
      block copolymers studied. Immunoblotting studies revealed the adsorption of
      immunoglobulin G, complement C3, transferrin and fibronectin to all microspheres
      previously incubated in 50% serum and plasma, whilst fibrinogen was also adsorbed
      after incubation in 50% plasma; with similar quantities of each protein adsorbed
      to PS and block copolymer-coated PS.

PMID- 8476993
TI  - Regulation by sulphonate groups of complement activation induced by hydroxymethyl
      groups on polystyrene surfaces.
AB  - Reducing the complement-activating capacity of a polymer surface is important in
      improving its blood compatibility. Polystyrene surfaces bearing hydroxymethyl
      (CH2OH) groups activate the alternative pathway of complement. This activation
      depends strongly on the density of the groups. Polystyrene surfaces bearing
      sulphonate (SO3-) groups adsorb proteins, resulting in an apparent activation.
      Polystyrene surfaces bearing both types of groups in close proportions are not
      activators in human serum, due to the adsorption of a protein of the alternative
      pathway, which has a protecting effect, not found when a polymer surface bearing
      hydroxyl groups is mixed in serum with another polymer surface bearing SO3-
      groups. In the presence of purified proteins of alternative pathway, C3
      convertase activity can be created on each of these surfaces by deposition of
      C3b, but their susceptibility to inactivation by regulatory proteins H and I
      depends on the types of chemical groups present on the surface and whether the
      surfaces were passivated or not before C3b deposition.

PMID- 8476994
TI  - Soft tissue reaction to collagen-immobilized porous polyethylene: subcutaneous
      implantation in rats for 20 wk.
AB  - Collagen-immobilized porous polyethylene, in which the immobilization was through
      covalent bonding, and virgin porous polyethylene were implanted subcutaneously in
      rats from 1 to 20 wk. The results were the ingrowth of the connective tissue into
      collagen-immobilized porous polyethylene was rich and contained a low level of
      inflammatory cellular infiltration compared with that of virgin porous
      polyethylene. The material-tissue interface showed that the living body
      originated collagen fibres were firmly anchored into the immobilized collagen
      layer. These results suggested that covalent immobilization of collagen on to the
      biomaterial surface is useful in promoting the ingrowth of soft tissue and the
      tissue adhesion.

PMID- 8476995
TI  - Histopathological and immunological investigations of synthetic fibres and
      structures used in three prosthetic anterior cruciate ligaments: in vivo study in
      the rat.
AB  - Three types of prosthetic anterior cruciate ligaments were investigated by
      enzymatic and histological analysis of the tissue surrounding each implant and
      immunologically by a cytofluorometric analysis of T-cell populations in the
      peripheral blood of rats. Two of the prostheses had a braided construction, one
      made from polyester and the other from high performance polyethylene fibres. The
      third type also contained high performance polyethylene fibres, but had been
      manufactured in a knitted construction (Raschel high performance polyethylene).
      Five specimens from each prosthesis were implanted intraperitoneally in rats by a
      trocar for different periods of time up to 4 wk. A control group of rats
      underwent the surgery, but not the implant. No modification in peripheral T-cell
      populations was induced by the presence of any implant. Whilst the levels of acid
      phosphatase and esterase activity appeared to have increased slightly following
      implantation of any of the prostheses, such increases were not highly
      significant. Histologically, all three materials induced an intense acute
      inflammatory reaction at 3 d which gave way to a typical chronic response after 4
      wk. The only major difference between the prostheses was that after 4 wk the
      polyester fibres exhibited less inflammation, and the surrounding tissue was more
      mature, more vascularized and more densely infiltrated with collagen than with
      the two high performance polyethylene implants. In conclusion, all three devices
      provided satisfactory biocompatibility in terms of cellular and healing response.

PMID- 8476996
TI  - Cell seeding in porous transplantation devices.
AB  - Porous laminated discs of 1.35 cm diameter and thickness of 0.5 cm fashioned from
      biodegradable polymers were used as scaffolds for the transplantation of isolated
      cell populations. The distribution of cells seeded in these devices via injection
      was modelled with a system of dyed polymeric microparticles. Optimization of
      parameters related to device design and surgical injection conditions was carried
      out to maximize the device volume effectively employed in cell transplantation.
      The area of distribution on the top surface of each device was determined by
      image analysis techniques and used as a measure of the spatial distribution of
      injected particles. For poly(L-lactic acid) devices of porosity of 0.83 and
      median pore diameter of 166 microns seeded with 6 microns beads under standard
      injection conditions, the average surface area of distribution was 44.45% (+/-
      3.36%). The device pore size was found to be a crucial determinant of particle
      distribution, whilst particle size in the range of 1-10 microns was not found to
      be important for the devices tested. Application of these results to the seeding
      of hepatocyte suspensions was made.

PMID- 8476997
TI  - Imaging surfaces of hydrophilic contact lenses with the atomic force microscope.
AB  - Soft contact lens (SCL) surfaces were imaged with atomic force microscopy (AFM).
      High-resolution images of unworn SCL were obtained under nearly physiological
      medium. We present images of surfaces of collagen bandage lens under dry or
      aqueous conditions and of SCL of different water content and fabrication
      processes. Roughness parameters were determined. AFM studies of surfaces of SCL
      are expected to provide useful information on the hydrogel surfaces.

PMID- 8476998
TI  - Biocompatibility of polyoxymethylene (Delrin) in bone.
AB  - The bone tissue reaction to bulk polyoxymethylene (Delrin) was studied in eight
      adult albino rabbits followed for up to 5 months after insertion of implants into
      the tibial metaphyses. Each animal received two implants, one of pure Delrin, the
      other a 'mosaic' plug with alternating areas of commercially pure titanium and
      Delrin. At the passage through the cortex, a direct bone-Delrin contact was seen
      in more than half of the cases, but the contact was usually limited in extent. At
      the same time, in virtually all sections, a foreign-body reaction with
      macrophages and giant cells was prominent. It was concluded that bulk Delrin has
      inferior biocompatibility to titanium, and the advisability of using Delrin as a
      biomaterial for bone anchorage is questionable.

PMID- 8476999
TI  - Poly(L-lactide): a long-term degradation study in vivo. Part III. Analytical
      characterization.
AB  - Three poly(L-lactides) with different molecular weights were synthesized as solid
      blocks from the melt. Two batches were ground and small specimens were produced
      by injection moulding. The third block was processed by machining, yielding
      crystalline parts. All were implanted as small rods into the dorsal muscle of
      rats. The implants were recovered, weight loss was determined, and the samples
      analysed. The samples degraded very fast, reaching the same molecular weight
      level after 20 wk, then degraded simultaneously. Analysis showed differences
      depending on the solid state of the polymer. The differences in the degradation
      behaviour of the amorphous and crystalline samples can be explained by assuming a
      simple hydrolysis as the main degradation mechanism, affecting the whole polymer,
      if in an amorphous state, but only the amorphous domains in a crystalline
      polymer.

PMID- 8477000
TI  - Intramedullary nailing of the cortical bone osteotomies in rabbits with self
      reinforced poly-L-lactide rods manufactured by the fibrillation method.
AB  - Right femoral, cortical bone osteotomies of 42 rabbits were fixed with
      fibrillated, self-reinforced (SR) poly-L-lactide (PLLA) rods, 4.5 mm in diameter.
      Follow-up times were from 3 to 48 wk. None of the rods broke during this period.
      There was one non-union at three weeks and one non-union at 12 weeks.
      Radiographic, histologic, microradiographic and oxytetracyclic fluorescence
      studies showed normal healing. Shear load carrying capacity of the osteotomy
      plane was measured from 30 bone samples; the shear force at breaking increased
      during the follow-up time to 450 N, while the mean shear force of intact, left
      side control femurs was 440 N. Before shear tests of the bones, the SR-PLLA rods
      were taken away from the medullary cavities of the femurs. The rods were also
      tested mechanically. About 25% of the initial 136 MPa shear-strength of the rods
      was left after 24 wk. The results show that fibrillated SR-PLLA rods are strong
      enough to be used in intramedullary nailing of femoral cortical bone osteotomies
      in rabbits.

PMID- 8477001
TI  - Physical-mechanical effects of Nd:YAG laser on the surface of sound dental
      enamel.
AB  - Human dental enamel samples were irradiated using a 5 kHz Q-Switched Nd:YAG
      laser. An increase in Knoop microhardness and modification of the membrane
      permselectivity were detached. These results and the changes observed by SEM, can
      be connected with the fusion of the enamel surface.

PMID- 8477002
TI  - Elastin patches.

PMID- 8477003
TI  - Sources and role of iron in lipid peroxidation.

PMID- 8477004
TI  - Immunochemical detection of liver protein adducts of the nonsteroidal
      antiinflammatory drug diclofenac.
AB  - Serious idiosyncratic hepatic injury has been associated with the use of many
      nonsteroidal antiinflammatory drugs, including the widely prescribed agent
      diclofenac. In order to investigate the possibility that covalent protein adducts
      of reactive metabolites of diclofenac might be responsible for the hepatotoxicity
      produced by this drug, we have developed a polyclonal antibody that can recognize
      such adducts in tissues. Immunoblotting revealed that protein adducts of reactive
      metabolites of diclofenac of 50, 70, 110, and 140 kDa were formed in the livers
      of mice treated with diclofenac. In the future, it will be determined whether
      these adducts can cause hepatotoxicity by either a hypersensitivity or metabolic
      mechanism. Similar approaches may be used to study the protein adducts and
      mechanisms of hepatotoxicity of other nonsteroidal antiinflammatory drugs.

PMID- 8477005
TI  - Chemical characterization and toxicity of dihydro derivatives of nodularin and
      microcystin-LR, potent cyanobacterial cyclic peptide hepatotoxins.
AB  - Dihydro derivatives of nodularin (1) and microcystin-LR (4), potent cyclic
      peptide hepatotoxins isolated from Nodularia spumigena and Microcystis
      aeruginosa, respectively, were prepared by sodium borohydride reduction of the
      dehydroamino acid residues. The two stereoisomers of both dihydronodularin (2 and
      3) and dihydromicrocystin-LR (5 and 6), isolated by reversed-phase HPLC, showed
      similar toxicity to each other [ip in mice, LD50 = 150 (2), 150 (3), 85 (5), and
      100 (6) micrograms/kg]. The stereochemistries of the reduced amino acids obtained
      by acid hydrolysis of dihydronodularin and dihydromicrocystin-LR [respectively,
      alpha-(methylamino)butyric acid and N-methylalanine] were determined by GC on a
      permethylated beta-cyclodextrin capillary column as their trifluoroacetyl methyl
      ester derivatives. Authentic L- and DL-N-methylamino acids were prepared to
      compare directly with the natural amino acids. Deuterated derivatives were also
      prepared using sodium borodeuteride (98 atom % D), and the location (beta) and
      percentage (78-84%) of the deuterium incorporation were determined.

PMID- 8477006
TI  - Reaction of nontoxic, potentially chemopreventive purinethiols with a direct
      acting, electrophilic carcinogen, benzo[a]pyrene-7,8-diol 9,10-epoxide.
AB  - Several nontoxic purinethiols have been shown to block the ability of the
      carcinogen 7-r,8-t-dihydroxy-9-t,10-t-oxy-7,8,9,10-tetrahydrobenzo[a]pyrene
      (BPDE) to bind covalently to DNA in Chinese hamster ovary cells. Two of these
      compounds also block BPDE-induced tumorigenesis in a two-stage mouse skin
      carcinogenesis model. The suggested mode of action of the purinethiols is through
      scavenging the electrophilic carcinogen by way of covalent reaction with the
      purinethiol. In the present work, we demonstrate that a series of five
      purinethiols (2,6-dithiopurine, thiopurinol, 6-thioxanthine, 2-mercaptopurine,
      and 9-methyl-6-mercaptopurine) react covalently in vitro with BPDE. The adducts
      formed have been characterized by UV-visible spectroscopy, solvent partitioning,
      and NMR spectroscopy; they result from addition of the thiol moiety at the 10
      carbon of BPDE. Studies of the effects of Tris buffer and temperature on product
      ratios at completion of reaction indicate that the two major reaction pathways,
      hydrolysis of the epoxide and adduct formation, do not share a common rate
      determining step. This suggests that the reaction mechanism for adduct formation
      is through SN2 attack of the thiol moiety at the 10 position of BPDE. The
      activation energies for the reaction of 5-purinethiols with various combinations
      of substituents at the 2 and 6 positions are all very similar, implying closely
      similar transition states. For compounds with a low pKa (2,6-dithiopurine, 2
      mercaptopurine, and 6-thioxanthine) the most important reactant at physiological
      pH is the thiolate anion. However, for compounds with pKa's above 8, the
      physiologically important reactions appear to be more complicated.

PMID- 8477007
TI  - N-nitroso-N-methylvinylamine: reaction of the epoxide with guanyl and adenyl
      moieties to yield adducts derived from both parts of the molecule.
AB  - N-Nitroso-N-methylvinylamine was synthesized and treated with dimethyldioxirane
      to produce 1-(N-nitrosomethylamino)oxirane. 1-(N-Nitrosomethylamino)oxirane had a
      t1/2 of < 5 s in buffer at neutral pH and 23 degrees C. This epoxide reacted with
      Ado to form 1,N6-etheno(epsilon-)Ado. It also reacted with DNA to form products
      arising from the oxirane portion of the molecule [N7-(2-oxoethyl)Gua,N2,3-epsilon
      Gua, and 1,N6-epsilon-dAdo] and the methyl group (N7-methylGua). NADPH-fortified
      rat liver microsomes oxidized N-nitroso-N-methylvinylamine to form 1,N6-epsilon
      Ado in the presence of Ado. Further, 1,N6-epsilon-Ado was also formed in
      microsomal incubations containing N-nitroso-N-methylethylamine, indicating that
      desaturation of the ethyl moiety occurs to form a vinyl group and then an
      epoxide. When NADPH-fortified microsomes were incubated with N-nitroso-N
      methylvinylamine, HCHO was formed, and when DNA was included in incubations, 1,N6
      epsilon-dAdo and N7-methylGua were isolated from DNA. In the cases of both HCHO
      and N7-methylGua, product formation was similar to the levels seen with N-nitroso
      N,N-dimethylamine and N-nitroso-N-methylethylamine.

PMID- 8477008
TI  - Possible role of thioformamide as a proximate toxicant in the nephrotoxicity of
      thiabendazole and related thiazoles in glutathione-depleted mice: structure
      toxicity and metabolic studies.
AB  - In mice depleted of GSH by treatment with buthionine sulfoximine (BSO),
      thiabendazole (TBZ) causes renal injury characterized by an increase in serum
      urea nitrogen (SUN) concentration and by tubular necrosis. Previous studies have
      shown that TBZ requires metabolic activation before it produces nephrotoxicity
      and that the structure contributing to the toxicity of TBZ is the thiazole moiety
      of the molecule. TBZ and its thiazole analogues were examined for the ability to
      increase SUN concentration and serum alanine aminotransferase activity in GSH
      depleted mice. Unsubstituted thiazole and thiazoles with 4- and/or 5-, and no 2-,
      substituents caused marked increases in SUN concentration, suggesting
      nephrotoxicity. Furthermore, the nephrotoxic potency of these thiazoles decreased
      with the increasing number and bulk of the 4- and/or 5-substituents. On the other
      hand, the target organ (the kidney or liver) and the toxic potency of 4
      methylthiazoles were markedly altered with the type of substituents at the 2
      position. These observations and the known toxicity of thiono-sulfur compounds
      led us to the hypothesis that the nephrotoxic thiazoles, which lack 2
      substituents, would undergo microsomal epoxidation of the C-4,5 double bond and,
      after being hydrolyzed, the resulting epoxide would then be decomposed to form
      thioformamide, a possibly toxic metabolite. Evidence for this hypothesis was
      provided by the results that thioformamide and tert-butylglyoxal as the
      accompanying fragment were identified as urinary metabolites in mice dosed with 4
      tert-butylthiazole and that thioformamide caused a marked increase in SUN
      concentration when administered to mice in combination with BSO.

PMID- 8477009
TI  - Hepatic cytochrome P450 2B-type induction by ethyl/phenyl-substituted congeners
      of phenobarbital in the rat.
AB  - As part of an investigation of the structural requirements for the induction, by
      phenobarbital-type inducers, of a coordinate pleiotropic response consisting of
      increases in hepatic cytochrome P450 2B (P450 2B) activity, increases in other
      phase I and II enzyme activities, and liver hypertrophy, we have examined a
      series of analogues of phenobarbital in which the ethyl/phenyl substitution at
      the sp3 carbon of the parent molecule was kept constant while the heterocyclic
      portion of the molecule was modified. The induction of hepatic P450 2B protein
      and ethoxy-, pentoxy-, and (benzyloxy)resorufin O-dealkylation activities, and
      epoxide hydration activity and liver/body weight ratio increase were examined in
      male F344/NCr rats fed the various congeners for 14 days at doses equimolar to
      500 ppm phenobarbital. Increases in the measured parameters were maximal in rats
      fed phenobarbital or 5-ethyl-5-phenylhydantoin. The responses to primidone or 2
      ethyl-2-phenylsuccinimide were approximately 65% of maximal, while glutethimide
      yielded a response approximately 50% of maximal. Induction of this response in
      rats fed the ring-opened and decarboxylated analogues, (ethylphenylacetyl)urea
      and 2-ethyl-2-phenylmalonamide, were < 25% of maximal. 5-Ethyl-5
      phenyloxazolidinedione caused minimal increases in the measured end points when
      administered at a dose equimolar to 500 ppm phenobarbital. The profound
      differences among the congeners in ability to induce P450 2B protein and
      associated catalytic activities were not due to differences in food consumption
      by the various groups of rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477010
TI  - Pharmacodynamics of cytochrome P450 2B induction by phenobarbital, 5-ethyl-5
      phenylhydantoin, and 5-ethyl-5-phenyloxazolidinedione in the male rat liver or in
      cultured rat hepatocytes.
AB  - The pharmacodynamics of rat hepatic cytochrome P450 2B (P450 2B) induction by
      phenobarbital (PB) and two structural congeners, dl-5-ethyl-5-phenylhydantoin
      (EPH) and dl-5-ethyl-5-phenyloxazolidinedione (EPO), were investigated. The in
      vivo induction of P450 2B was probed in F344/NCr rats by measuring immunoreactive
      hepatic P450 2B1 protein and by assaying the hepatic 16 beta-hydroxylation of
      testosterone and O-dealkylation of (benzyloxy)- and pentoxyresorufin. The
      induction of (benzyloxy)resorufin O-dealkylation activity was also measured in
      adult rat hepatocyte cultures exposed to the three xenobiotics. The concentration
      of xenobiotic at the putative active site in the in vivo studies was approximated
      by measuring serum total xenobiotic levels, while in the hepatocyte culture
      studies, the nominal xenobiotic concentration in the culture medium was used.
      Concentration-dependent induction of P450 2B activities was observed in the in
      vivo and hepatocyte culture studies. The in vivo ED50 values for P450 2B
      induction were approximately 110, approximately 100, and approximately 3000
      dietary ppm (14 days administration) for PB, EPH, and EPO, respectively. The in
      vivo EC50 values for P450 2B induction were approximately 9, approximately 6, and
      approximately 130 microM (total serum) for PB, EPH, and EPO, respectively. In
      cultured rat hepatocytes, the ED50 values for induction of (benzyloxy)resorufin O
      dealkylation activity were 14.5, 14.2, and 108 microM for PB, EPH, and EPO,
      respectively. These data indicate that pharmacodynamic results obtained with
      cultured hepatocytes represent a good qualitative and quantitative approximation
      of the in vivo hepatic responses in male rats caused by PB-type
      inducers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477011
TI  - Investigation of the mechanistic basis of N,N-dimethylformamide toxicity.
      Metabolism of N,N-dimethylformamide and its deuterated isotopomers by cytochrome
      P450 2E1.
AB  - Dimethylformamide (DMF) is an industrial solvent with hepatotoxic properties. The
      toxicity of DMF has been associated with its metabolism to S-(N
      methylcarbamoyl)glutathione (SMG). The major urinary metabolite of DMF is N
      (hydroxymethyl)-N-methylformamide (HMMF). HMMF undergoes oxidation in the formyl
      moiety, possibly via the intermediacy of its hydrolysis product N-methylformamide
      (NMF), and the reactive intermediate thus generated reacts with glutathione to
      yield SMG. Experiments were conducted to elucidate enzymatic details of the
      metabolism of DMF. Generation of HMMF from DMF in microsomes from rats which had
      received acetone, an inducer of cytochrome P450 2E1, was increased by 175% over
      that observed in control microsomes. In liver microsomes from 4 humans the
      metabolism of DMF to HMMF was inhibited by a monospecific antibody against rat
      liver P450 2E1, and the metabolic rates were correlated with those of NMF to SMG,
      a process known to be mediated via P450 2E1. DMF was also metabolized by purified
      rat liver P450 2E1. The kinetic parameters which characterize the metabolism of
      DMF or its deuterated isotopomers to the respective HMMF isotopomers, of HMMF to
      SMG and of NMF to SMG in liver microsomes, were computed from Eadie-Hofstee
      plots. The affinity of DMF for the metabolizing enzyme in rat liver microsomes is
      considerably higher (apparent Km = 0.20 mM) than that of NMF (Km = 4.28 mM) or of
      HMMF (Km = 2.52 mM). The respective values observed with human microsomes are
      very similar. The apparent Km values for the N-methyl oxidation of N,N
      dimethyldeuterioformamide ([2H1]DMF) and N,N-bis(trideuteriomethyl)formamide
      ([2H6]DMF) in rat microsomes are 0.14 and 0.21 mM, respectively. The apparent
      Vmax for the oxidation of [2H1]DMF is similar to that computed for DMF, and the
      Vmax for [2H6]DMF is less than half of that computed for DMF. The kinetic
      deuterium isotope effect (KDIE) on DMF metabolism was determined in incubations
      with rat microsomes in three ways: (i) the noncompetitive intermolecular KDIE by
      the ratio of Vmax/Km for DMF to Vmax/Km for [2H6]DMF, (ii) the competitive
      intermolecular KDIE as the quotient of metabolic products HMMF to N
      (hydroxydideuteriomethyl)-N-(trideuteriomethyl)formamide in incubations of DMF
      together with [2H6]DMF, and (iii) the intramolecular KDIE as the quotient of the
      ratio of N-(hydroxymethyl)-N-(trideuteriomethyl)formamide to N
      (hydroxydideuteriomethyl)-N-methylformamide generated from N-(trideuteriomethyl)
      N-methylformamide ([2H3]DMF). The respective values were found to be (i) 2.4,
      (ii) 5.0, and (iii) 5.2. DMF inhibited the oxidation of NMF or HMMF to
      SMG.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477012
TI  - Bihaptens with 5- and 6-methyl-substituted alkylcatechols and methylene lactone
      functional groups: tools for hapten (allergen or tolerogen)-protein interaction
      studies.
AB  - In order to investigate hapten-protein interactions in vivo, potential skin
      sensitizers 1-3, with two different haptenic ends, (a) a catechol, a 5
      methylcatechol, and a 6-methylcatechol respectively, and (b) an alpha-methylene
      gamma-butyrolactone moiety, separated by a straight 10-carbon chain, have been
      prepared and used to sensitize guinea pigs. Related "monohapten lactones" 19-21,
      containing an electrophilic alpha-methylene-gamma-butyrolactone moiety connected
      to the protected catechol structures, and "monohapten catechols" 25-27,
      containing a reduced alpha-methyl-gamma-butyrolactone linked to the catechol,
      also have been prepared. Bihaptens 1 and 2 which were found to have very close
      biological activities appear to react with proteins through the catechol ring,
      indicating a low importance of the C-6 position in the binding of catechols with
      amino acids. In contrast, bihapten 3 was found to react through both the catechol
      and lactone ring. The influence of amino and thiol binding sites on the
      biological activity (allergy or tolerance) as well as the influence of the
      sensitizing method are discussed.

PMID- 8477013
TI  - Formation, characterization, and immunoreactivity of lysine thioamide adducts
      from fluorinated nephrotoxic cysteine conjugates in vitro and in vivo.
AB  - Fluorinated nephrotoxic cysteine conjugates undergo bioactivation via the beta
      lyase pathway to thionoacetyl fluorides (TAF), the putative reactive
      intermediates. The TAF derived from S-(1,1,2,2,-tetrafluoroethyl)-L-cysteine
      (TFEC) difluorothionoacetylates amine nucleophiles found in proteins and lipids.
      A specific antisera, raised against (trifluoroacetamido)lysine adducts formed in
      vivo after halothane treatment, has previously been used to localize TFEC-derived
      protein adducts immunohistochemically, and a good correlation between adduction
      and toxicity was demonstrated. Interestingly, thioamide formation is facilitated
      by acyl-transfer catalysts such as imidazoles and phenols. However, although
      putative lysine adducts have been reported to be formed from the related TAF
      derived from S-(2-chloro-1,1,2-trifluoroethyl)-L-cysteine (CTFC), protein adducts
      derived from CTFC metabolism have not been completely characterized. In the
      present investigation we characterize (chlorofluorothionacetamido)lysine (CFTAL)
      adduct formation during S-(2-chloro-1,1,2-trifluoroethyl)-L-cysteine (CTFC)
      metabolism, both in vitro and in vivo. Our data indicate that formation of CTFC
      derived lysine thioamides was not as dependent on nucleophilic catalysis as
      observed for TFEC, and this appears to be due to an apparent greater reactivity
      of the TAF resulting in a higher trapping efficiency in the absence of catalyst.
      Also, qualitative and quantitative differences in the structures and time course
      of CTFC versus TFEC adduct breakdown were observed. Antibodies raised against the
      halothane metabolite protein adduct (trifluoroacetamido)lysine cross-react with
      specific mitochondrial proteins from the kidneys of TFEC-treated rats. Using this
      antibody, we have found that the pattern of adducted proteins from TFEC- and CTFC
      treated Fischer rats was similar, but the intensity was considerably lower after
      treatment with equimolar concentrations of CTFC in vivo.

PMID- 8477014
TI  - Inhalation-based anesthetic techniques are the key to early extubation of the
      cardiac surgical patient.

PMID- 8477015
TI  - The effect of a cardiac surgical recovery area on the timing of extubation.
AB  - The anesthetic and postoperative management of cardiac surgical patients was
      modified to achieve an early return to spontaneous ventilation. A total of 278
      patients were studied to determine the effect of this change. Patients in group I
      (n = 198) were managed in a cardiac surgical recovery area according to the new
      policy. Group II (n = 80) was a comparable group of patients operated upon before
      this change. The median duration of postoperative ventilation was reduced from 5
      hours in group II to 1 hour in group I, and the time to extubation was reduced
      from 7 hours to 2 hours, respectively. There were no major postoperative
      complications resulting from this change. The factors that influence the duration
      of postoperative ventilation are discussed.

PMID- 8477016
TI  - Infusion of propofol versus midazolam for sedation in the intensive care unit
      following coronary artery surgery.
AB  - The use and the hemodynamic effects of propofol and midazolam were studied during
      titrated continuous infusions to deep sedation (sedation level 5: asleep,
      sluggish response to light glabellar tap or loud auditory stimulus) following
      coronary artery surgery. The drugs were compared in 30 ventilated patients in an
      open randomized study. The duration of infusion was approximately 570 minutes in
      both groups. After a loading dose of propofol (1 mg/kg) or midazolam (0.07
      mg/kg), the infusion rates were 2.71 +/- 1.13 mg/kg/h and 0.092 +/- 0.028
      mg/kg/h, respectively. An analgesic infusion of sufentanil was also given in both
      groups. In the midazolam group, to maintain the predetermined level of sedation,
      more frequent additional bolus doses (4.7 +/- 1.8; P < 0.001) and infusion rate
      adjustments (5.3 +/- 1.6; P < 0.001) were required than for similar sedation in
      the propofol group (2.3 +/- 1.0 bolus doses and 3.3 +/- 1.2 adjustments). The
      time from stopping sedation to patient responsiveness was 11 +/- 8 minutes in the
      propofol group and 72 +/- 70 minutes in the midazolam group (P < 0.001), and the
      time from stopping sedation to extubation was 250 +/- 135 minutes and 391 +/- 128
      minutes (P < 0.014), respectively. Following the loading dose of propofol, there
      was a fall in blood pressure (BP) (mean from 80 +/- 11 mmHg to 67.5 +/- 10 mmHg;
      P < 0.05). After approximately 15 minutes, BP started to rise but remained below
      pretreatment level throughout sedation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477017
TI  - Postoperative analgesia and sedation following pediatric cardiac surgery using a
      constant infusion of ketamine.
AB  - Constant rate infusions of ketamine supplemented with intermittent doses of
      midazolam were given postoperatively to 10 children in order to provide analgesia
      and sedation during mechanical ventilation after cardiac surgery as well as
      during weaning from the ventilator and during spontaneous breathing. The aims of
      the study were to determine the pharmacokinetics of ketamine and evaluate the
      suitability of ketamine as an analgesic and sedative in postoperative pediatric
      cardiac patients. The children were between one week and 30 months old. Five
      children were given 1 mg/kg/h of ketamine and five children had 2 mg/kg/h. Blood
      was sampled during infusion and up to 24 hours after infusion for plasma
      concentrations of ketamine and the main plasma metabolite, norketamine, which
      were determined by gas chromatography and were compared to the degree of
      sedation. The children were arousable when ketamine concentrations were below 1.0
      to 1.5 micrograms/mL. Plasma ketamine concentrations at steady state were within
      a narrow range for each infusion regimen and the calculated pharmacokinetic
      parameters were similar. Mean plasma clearance of ketamine was 0.94 +/- 0.22
      L/kg/h. The elimination half-life was 3.1 +/- 1.6 hours, but in some children
      late samples indicated an even longer elimination half-life. Norketamine did not
      reach a steady state, but at the end of the infusion, the mean plasma
      concentration was higher than that of ketamine. The elimination half-life of
      norketamine was estimated to be 6.0 +/- 1.8 hours. Both ketamine infusion
      regimens were supplemented with midazolam and provided similarly acceptable
      analgesia and sedation during mechanical ventilation and during and after weaning
      from the ventilator.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477018
TI  - Intrathecal morphine during thoracotomy, Part I: Effect on intraoperative
      enflurane requirements.
AB  - The ability of intrathecal morphine to reduce the anesthetic requirements during
      thoracotomy was investigated. Twenty-four patients scheduled for thoracic surgery
      were studied. Anesthesia was induced with thiamylal sodium, 4 mg/kg, fentanyl,
      100 micrograms, and 100 mg of succinylcholine. Prior to skin incision, 12
      patients received intrathecal injection of 12 micrograms/kg of preservative-free
      morphine sulfate (ITM), while the remaining 12 patients served as controls. The
      ITM was given undiluted at the L3-4 or L4-5 level. Anesthesia was maintained
      solely with enflurane, titrated to keep mean arterial pressure within 15% of the
      preoperative values. Vecuronium was given as required for relaxation. No
      additional narcotics were administered. Throughout the procedure, end-tidal (ET)
      enflurane concentration was recorded at 15-minute intervals from the mass
      spectrometer (Perkin Elmer). The intraoperative mean ET concentration of
      enflurane was significantly reduced in the ITM group beginning 1 hour after the
      injection (1.19 +/- .45% in the control group versus 0.73 +/- 0.08% in the ITM
      group). The enflurane requirements, expressed as percent end-tidal
      enflurane/hour, were significantly less in the ITM group for the duration of the
      procedure (0.8 +/- .17 v 1.08 +/- .22, respectively). In conclusion, when
      administered prior to skin incision for post-thoracotomy pain control,
      intrathecal morphine reduces intraoperative enflurane requirements.

PMID- 8477019
TI  - Intrathecal morphine during thoracotomy, Part II: Effect on postoperative
      meperidine requirements and pulmonary function tests.
AB  - The ability of intrathecal morphine (ITM) to reduce post-thoracotomy pain and
      meperidine requirements was investigated. Thirty adult patients scheduled for
      thoracic surgery were studied. Following induction with thiamylal sodium and
      succinylcholine, anesthesia was maintained with 100 micrograms of fentanyl,
      vecuronium, and enflurane. Prior to skin incision, 16 patients received
      intrathecal morphine, 12 micrograms/kg, injected at the L3-4 or L4-5 level. The
      other 14 patients were controls. Postoperatively, patients were evaluated for
      pain scores and the total doses of meperidine required over 24 hours. The
      patients in the ITM group required significantly less meperidine compared to the
      control group (59 +/- 68 v 167 +/- 97 mg, respectively) and had lower pain scores
      (1.4 +/- 1.1 v 2.4 +/- 0.9 mg, respectively). There were no serious side effects
      attributable to ITM. It is concluded that ITM is an effective adjunctive
      treatment for control of post-thoracotomy pain.

PMID- 8477020
TI  - Transesophageal two-dimensional echocardiographic analysis of right ventricular
      systolic performance indices during coronary artery bypass grafting.
AB  - Sixteen patients (aged 59 +/- 14 years) undergoing coronary artery bypass surgery
      were evaluated to delineate the intraoperative course of transesophageal
      echocardiographic right ventricular (RV) systolic performance indices. Pre
      induction data included thermodilution RV ejection fraction (RVEFTD), 0.43 +/-
      0.13, RV end-diastolic volume index (EDVI), 110 +/- 33 mL/m2, cardiac index (CI),
      3.4 +/- 1.0 L/min/m2, RV end-diastolic pressure (EDP), 7.1 +/- 4.2 mmHg, and mean
      pulmonary artery pressure (PAP), 21 +/- 6 mmHg. Eleven patients had significant
      right coronary artery (RCA) disease (> 70% occlusion). Five patients arrived with
      an ongoing nitroglycerin infusion (1 to 3 micrograms/kg/min), which was
      maintained intraoperatively. Echocardiographic measurements included longitudinal
      axis (LA) and short-axis (SA) planimetered area excursion fractions (2DLA and
      2DSA, respectively) and LA maximal major and minor axis shortening fractions (max
      majorLA and max minorLA, respectively). Hemodynamic measurements included RVEFTD,
      EDVI, CI, EDP, and PAP. Measurements were determined following
      induction/endotracheal intubation, following sternotomy/pericardiotomy, and after
      cardiopulmonary bypass (CPB) with the chest open. All patients were maintained on
      vasodilator therapy post-CPB (nitroglycerin, 1 to 3 micrograms/kg/min [N = 16]
      and nitroprusside, 0.5 to 4.5 microgram/kg/min [N = 4]) post-CPB. Two patients
      received inotropic support (epinephrine, 0.2 to 0.3 microgram/kg/min). CPB was
      associated with significant decreases in max major axisLA and 2DLA (P < 0.05) as
      compared to measurements determined prior to CPB. Maximum major axisLA values pre
      CPB were 0.35 +/- 0.06 and 0.33 +/- 0.08 versus post-CPB values of 0.24 +/-
      0.08.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477021
TI  - The relationship between "normal" transesophageal color-flow Doppler-defined
      tricuspid regurgitation and thermodilution right ventricular ejection fraction
      measurements.
AB  - Twenty coronary artery revascularization patients, aged 58 +/- 15 years, were
      studied intraoperatively to define the impact of Doppler-defined tricuspid
      regurgitation on measurement of thermodilution right ventricular ejection
      fraction (50 msec response pulmonary artery catheter). Right ventricular function
      was also estimated using a measurement technique independent of flow patterns
      across the tricuspid valve (transesophageal two-dimensional echocardiographic 5.0
      MHz phased-array transducer). Measurements included transverse plane long- and
      short-axis planimetered area ratio, respectively, and tricuspid annular plane
      systolic excursion ratio (ratio = end-diastolic minus end-systolic value divided
      by end-diastolic value). Data were expressed as thermodilution-echocardiographic
      gradients, ie, thermodilution ejection fraction minus long-axis planimetered area
      ratio, short-axis planimetered area ratio, and tricuspid annular plane systolic
      excursion ratio, respectively. Tricuspid regurgitation was quantified by color
      flow Doppler perimetry of maximal regurgitation jet area and analysis of
      transduced right atrial pressure waveform. Doppler estimates were expressed as
      absolute values and as a function of corresponding atrial area (tricuspid
      regurgitation index = planimetered jet area divided by right atrial area). Data
      were obtained following endotracheal intubation, sternotomy, pericardiotomy,
      cardiopulmonary bypass, and chest closure. Data were evaluated by regression
      analysis, with separate analyses performed for each time period. Profiles were
      unassociated with right atrial pressure waveform abnormalities. There was no
      significant relationship between thermodilution ejection fraction variance values
      and tricuspid regurgitation jet area or regurgitation index, respectively. In
      each measurement period, thermodilution-echocardiographic gradients were also
      unrelated to the tricuspid regurgitation estimates.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8477022
TI  - Low risk of gastroesophageal injury associated with transesophageal
      echocardiography during cardiac surgery.
AB  - Transesophageal echocardiography (TEE) has increasingly been used in cardiology
      and cardiac surgery with few reported complications. This study was undertaken to
      determine whether TEE is associated with an increased incidence of
      gastroesophageal (GE) bleeding or postoperative GE symptoms of anorexia,
      dysphagia, or sore throat. Forty-one patients who underwent TEE during cardiac
      surgery and 40 control patients who underwent cardiac surgery without TEE were
      prospectively followed. In addition, a retrospective chart review of 200 patients
      who underwent TEE during cardiac surgery was also performed. The following
      information was derived from the patient interviews and chart reviews: (1) The
      development of both frank and occult upper gastrointestinal tract (UGI) bleeding;
      (2) the patient's preoperative anticoagulation status; and (3) the patient's
      subjective complaints of anorexia, dysphagia, or sore throat. The incidence of
      postoperative occult or frank UGI bleeding was not increased in the groups who
      underwent TEE. Additionally, the incidence of postoperative GE symptoms was
      comparable in the three groups. These findings are discussed in the context of
      reported complications associated with UGI endoscopy. Based on this analysis,
      recommendations for the safe performance of TEE have been provided.

PMID- 8477023
TI  - Percutaneous pericardiocentesis versus subxiphoid pericardiotomy in cardiac
      tamponade due to postoperative pericardial effusion.
AB  - In a retrospective study, 42 patients with acute cardiac tamponade due to
      pericardial effusion were evaluated following cardiac surgery, and the
      pericardial fluid was drained by one of two alternative methods: two-dimensional
      echocardiographic-guided pericardiocentesis (2D-echo) or subxiphoid surgical
      pericardiotomy. During the first period (from 1982 to 1986), one of the two
      methods was chosen by the treating physicians, whereas in the second period (from
      1986 to 1991), 2D-echo-guided pericardiocentesis was the treatment of choice.
      Percutaneous pericardiocentesis was performed using local anesthesia in 29
      patients. A Tuohy needle was inserted at the left xipho-costal junction and, when
      fluid was obtained, 6 mL of saline solution was injected during 2D-echo contrast
      monitoring, and a multiple-hole, 6F, 30-cm catheter was inserted by means of a
      guidewire and positioned into the posterior pericardium, as near as possible to
      the atrioventricular groove. Complete drainage of pericardial fluid by
      percutaneous pericardiocentesis was obtained in 26 patients (89%). This procedure
      also allowed the evacuation of posterior and loculated effusions. Complications
      included two right ventricular punctures, which were immediately recognized by 2D
      echo contrast and produced no serious consequences. Sixteen patients who
      underwent surgical pericardiotomy had complete evacuation of pericardial fluid
      without major complications (two of them suffered atrial arrhythmias during the
      procedure). The average amount of fluid drained, as well as the localization of
      the effusions, were the same for both groups. 2D-echo-guided pericardiocentesis
      was found to be a useful, safe, and simple technique. It can be used as an
      alternative treatment to subxiphoid pericardiotomy for cardiac tamponade due to
      postoperative pericardial effusions.

PMID- 8477024
TI  - Potential risks of high-dose epinephrine for resuscitation from ventricular
      fibrillation in a porcine model.
AB  - The arterial plasma concentrations and hemodynamic effects of epinephrine, 10
      micrograms/kg, IV (group A, N = 8) and 50 micrograms/kg, IV (group B, N = 8) were
      compared in a porcine resuscitation model after 3 minutes of circulatory arrest
      induced by ventricular fibrillation. All animals in group A were successfully
      resuscitated after 4.9 +/- 2.8 minutes and 2.8 +/- 1.6 defibrillations. In group
      B, only 6 of 8 animals were successfully resuscitated after 6.3 +/- 1.1 minutes
      and 4.0 +/- 2.7 defibrillations (mean +/- SD). During CPR, cardiac output (CO),
      left ventricular systolic pressure (LVSP), and mean arterial pressure (MAP) were
      nearly identical in the groups. The hemodynamic situation during the first hour
      after restitution of spontaneous circulation in group B was characterized by a
      significantly higher heart rate, combined with significantly lower values for
      cardiac inotropy, CO, LVSP, and MAP compared to group A. Mean arterial peak
      epinephrine concentrations (group A 197 +/- 133 ng/mL, group B 1173 +/- 298
      ng/mL) were approximately fivefold higher in group B. After resuscitation, plasma
      concentrations returned to baseline levels within 7 minutes in group A and 15
      minutes in group B. Later hemodynamic differences between the groups are thereby
      attributed to a detrimental impact of high-dose epinephrine on the heart during
      resuscitation.

PMID- 8477025
TI  - Regional distensibility, chamber stiffness, and elastic stiffness constant in
      halothane and propofol anesthesia.
AB  - Nine mongrel dogs were acutely instrumented in order to investigate cardiac
      stiffness at end-diastole while left ventricular circumferential lengths were
      measured at two different sites (near-apical region and near-basal region). Two
      hundred mL of autologous blood were infused and then withdrawn to create
      different volume loading conditions. Four different anesthetic settings were
      tested: two concentrations (0.7% and 1.7%) of halothane, and two infusion rates
      (0.2 mg/min/kg, and 0.4 mg/min/kg) of propofol. Three parameters of cardiac
      stiffness were calculated: distensibility, chamber stiffness (Kp), and elastic
      stiffness constant (k). Chamber stiffness and elastic stiffness constant were
      smaller in the apical region than the basal region under halothane anesthesia at
      both the 0.7% and 1.7% concentrations. There were no regional differences in
      elastic stiffness constant (k) under propofol anesthesia at either infusion rate.
      However, Kp was smaller in the apical region at the low propofol infusion rate.
      There were no significant differences in Kp and k between the anesthetic agents,
      or with the increase in concentration of either agent. However, when both agent
      and concentration were taken into consideration, an increase in stiffness was
      observed with deepening halothane, but not propofol anesthesia. These results
      show that assessment of diastolic function must take into consideration both
      regional differences and the anesthetic agent, because the latter may alter such
      differences and, thus, alter diastolic function.

PMID- 8477026
TI  - Use of a modified van der Pol's oscillator to construct ventricular pressure
      volume relations.
AB  - Ventricular pressure-volume (PV) loops provide information about ventricular
      function. Methodologic constraints have limited derivation of PV loops to the
      laboratory. The present study addresses derivation of PV loops from a direct left
      ventricular pressure measurement and left ventricular volume derived from
      continuous cardiac output. The measurements were performed in vivo in intact,
      innervated, normal canine hearts. Data from a total of 5 dogs and 13 different
      cardiac work states were analyzed. A nonlinear oscillator, a van der Pol's
      oscillator, described the PV relationships. Comparison of left ventricular stroke
      work derived from the van der Pol's oscillator model with that obtained from
      ultrasound transducers sutured directly to the myocardium demonstrated a linear
      correlation, close to the identity line, with R2 = 0.90. Modelling of LV PV loops
      by this technique was similar to loops derived by experimental measurements. This
      technique could lead to increased clinical uses for PV relationships.

PMID- 8477027
TI  - Major obstruction of the right mainstem bronchus caused by placement of a right
      axillary roll.

PMID- 8477028
TI  - The use of high-frequency jet ventilation during post-lung transplantation
      surgery.

PMID- 8477029
TI  - Unusual central venous catheter placement in a patient with congenital heart
      disease.

PMID- 8477030
TI  - Severe neurologic injury following bidirectional Glenn shunt.

PMID- 8477031
TI  - Refractory postoperative torsades de pointes syndrome successfully treated with
      isoproterenol.

PMID- 8477032
TI  - Antihypertensive drug treatment in the perioperative period.

PMID- 8477033
TI  - Case 1--1993. Emergency use of cardiopulmonary bypass for resuscitation from CPR
      resistant cardiac arrest.

PMID- 8477034
TI  - Right ventricular ejection fraction catheter: toy or tool? Pro: a useful monitor.

PMID- 8477035
TI  - Right ventricular ejection fraction catheter: toy or tool? Con: a premature step.

PMID- 8477036
TI  - An unusual transesophageal echocardiogram. Atrial septal aneurysm with patent
      foramen ovale.

PMID- 8477037
TI  - Pulmonary artery catheterization after transesophageal echocardiography: what
      should the sequence be?

PMID- 8477038
TI  - Thoracic epidural analgesia for cardiac surgery.

PMID- 8477039
TI  - Catastrophic cardiopulmonary bypass accident.

PMID- 8477040
TI  - Comments on dynamic cardiomyoplasty.

PMID- 8477041
TI  - Atrio-ventricular groove rupture diagnosed by perioperative transesophageal
      echocardiography.

PMID- 8477042
TI  - Thumb in cheek? Sensory reorganization and perceptual plasticity after limb
      amputation.
AB  - We describe a patient who initially suffered from carpal tunnel syndrome that was
      alleviated by surgery. Subsequently, the patient's right arm was amputated and a
      phantom limb emerged. Stimuli applied to different areas of the face gave rise to
      sensations that were referred to the phantom by precise topographic mapping. This
      perceptual mapping of the (phantom) hand onto the face area modelled the form of
      prior pathology due to carpal tunnel syndrome. The findings have implications for
      the relief of phantom pain.

PMID- 8477043
TI  - Perception of neck rotation assessed by 'remembered saccades'.
AB  - A new technique for the assessment of cervical afferent function is described. It
      is based on the perception of trunk rotation around the earth-fixed head and
      assessed by the accuracy of eye saccades in the direction of trunk displacement.
      It was found that normal subjects were able to locate trunk position accurately
      (mean error 15%), independently of trunk displacement amplitude (10-40 degrees)
      or velocity (5-40 degrees s-1). It is concluded that normal man has accurate
      perception of trunk rotation and that neck-spinal afferents carry a tonic signal
      with efficient access to the ocular motor system. A patient with absent
      vestibular function showed identical results to those of normal subjects; this
      suggests that the enhancement of the cervico-ocular reflex observed in such
      patients is not mediated by an increase in neck-spinal afferent sensitivity.

PMID- 8477044
TI  - The sneeze: maturation of the reflex in kittens.
AB  - This is the first study to compare the influence of nasal afferent stimulation on
      inspiratory and expiratory muscle activity during sneezing, in kittens and adult
      cats. In kittens, we demonstrate that nasal afferent stimulation does not
      reinforce inspiratory activity prior to the expiratory thrust as it normally does
      in adult cats. These stimulations evoke an active expiration similar to but
      weaker than the expiratory thrusts observed under the same conditions during
      sneezing in adult cats. Sneezing can be elicited from three weeks of life. Among
      the different hypotheses discussed, the most likely explanation appears to be the
      immaturity of medullary respiratory connections.

PMID- 8477045
TI  - High frequency (60-90 Hz) oscillations in primary visual cortex of awake monkey.
AB  - It has been proposed that synchronized oscillations play a key role in perceptual
      feature linking and sensory integration. This idea was supported by the discovery
      of strongly synchronized stimulus-specific oscillations in the visual cortex of
      anaesthetized cats. The 'synchronization hypothesis' was controversial because in
      the visual cortex of awake monkeys either only weak or no oscillations were
      found. We have now recorded high amplitude synchronized oscillation at the level
      of spike activity and local field potential from the primary visual cortex of an
      awake monkey. The dominant frequencies (70-80 Hz) were considerably higher than
      those observed previously in cats and monkeys (30-50 Hz). However, stimulus
      specificities of the oscillations were comparable to and amplitudes even higher
      than those in cats.

PMID- 8477046
TI  - Responses to Ca2+ of two types of excitatory junctional potentials in cricket
      muscles.
AB  - Cricket (Gryllus bimaculatus) abdominal muscle 202 produced both small and large
      excitatory junctional potentials (EJPs) depending on the intensity of the
      stimulation to the nerve. Abdominal muscle 203 generated only small EJPs. The
      large EJPs, the threshold of which was always slightly higher than the small
      EJPs, were more sensitive to the Ca2+ concentration at which they were evoked and
      to concentration changes. There were no marked differences between the two
      muscles regarding the electrical properties of the muscle fibre membrane and the
      quantal size of the transmitter. The causes of the differences between the two
      types of EJPs in these muscles are discussed.

PMID- 8477047
TI  - Subtelencephalic visual discrimination in selected lines of Japanese quail.
AB  - We studied visual discrimination capabilities of the avian brain stem in genetic
      lines of Japanese quail artificially selected for unconditional approach
      preference for blue, red or an achromatic pattern stimulus. Complete
      telencephalectomy did not abolish approach behavior and visual discrimination.
      Our data indicate that visual feature extraction and motor coordination related
      to early approach preferences in birds may be mediated by brain stem and thalamic
      circuitries which do not require input from higher level visual and motor
      regions.

PMID- 8477048
TI  - Cortical astrocytosis in juvenile rhesus monkeys infected with simian
      immunodeficiency virus.
AB  - The pattern of expression of GFAP immunoreactivity in astrocytes of the juvenile
      rhesus monkey cortex was examined following infection with simian
      immunodeficiency virus (SIV). Blocks of cerebral cortex plus subjacent white
      matter from saline- and formalin-perfused brain were examined by peroxidase
      linked immunochemical and immunofluorescence staining of deparaffinized sections.
      Strong GFAP immunoreactivity was found in astrocytic cells in both uninfected and
      SIV-infected juvenile macaque in the subpial cerebral cortex and in subcortical
      white matter, where GFAP-positive cells were abundant. GFAP staining of cortical
      layers 2-6 on the other hand was weak or absent in three uninfected controls and
      one infected animal without cognitive impairment, but moderate to strong in
      animals productively infected with SIV that demonstrated cognitive and/or motor
      impairment. These data demonstrate a cortical locus of astrocytic activation in
      rhesus monkeys infected with primate immunodeficiency virus isolate SIVB670
      which, like HIV-1 in man, causes motor/cognitive impairment as well as
      immunodeficiency disease.

PMID- 8477049
TI  - Inhibition of nitric oxide synthesis impairs autoregulation of local cerebral
      blood flow in the rat.
AB  - The effect of intravenous administration of NG-monomethyl-L-arginine (L-NMMA, 30
      mg kg-1), a specific inhibitor of nitric oxide (NO) synthesis, on the
      autoregulation of local cerebral blood flow (LCBF) was examined in the rat using
      the [14C]iodoantipyrine autoradiographic method. LCBF was significantly lower in
      various superficial regions such as the cerebral cortices and cerebellar cortex
      and in several deep brain regions in animals with haemorrhagic hypotension
      induced after L-NMMA infusion (the L-NMMA + HEM group) compared with animals
      without haemorrhagic hypotension after L-NMMA infusion (the L-NMMA group). The
      present findings suggest that NO synthesis may play a crucial role in the
      autoregulation of LCBF in response to a reduction in blood pressure in the
      cerebral cortices, cerebellar cortex and several deep brain regions.

PMID- 8477050
TI  - Muscarinic cholinoceptive reticular mechanisms and parabrachial neuron discharge:
      a novel experimental approach.
AB  - This study examined the hypothesis that cholinergic receptor mechanisms within
      the gigantocellular tegmental field (FTG) of the medial pontine reticular
      formation can cause state-dependent changes in the firing rates of parabrachial
      nuclear complex (PBNC) neurons. Using intact, unanesthetized cats, long-term
      recordings were obtained from single PBNC neurons following FTG administration of
      cholinergic agonists and antagonists. We show that the state-dependent decrease
      in PBNC cell discharge reported in this study can be attributed to muscarinic
      mechanisms within the FTG. Our pharmacological blocking results further suggest
      that diminished PBNC discharge was mediated by non-M1 muscarinic receptors in the
      FTG. This study demonstrates the usefulness of combining long-term neuronal
      recordings in the PBNC with multiple pharmacological manipulations within the
      FTG.

PMID- 8477051
TI  - Effect of streptozotocin-diabetes on the level of VIP mRNA in myenteric neurones.
AB  - The effect of streptozotocin-induced diabetes on the production of vasoactive
      intestinal polypeptide messenger RNA in the myenteric neurones of 8 weeks
      diabetic rat intestine was examined using in situ hybridization. Total ganglion
      cell number per length (mm) of tissue section was measured using NADH diaphorase
      histochemistry. Although ganglion cells were more numerous in the control
      preparations compared with diabetic samples, a significantly greater number of
      vasoactive intestinal polypeptide messenger RNA-containing cells was detected in
      the diabetic tissues. These observations suggest that there is either a decrease
      in the breakdown of vasoactive intestinal polypeptide messenger RNA or an
      increase in its synthesis in myenteric neurones of diabetic rat intestine.

PMID- 8477052
TI  - Ibogaine induces glial activation in parasagittal zones of the cerebellum.
AB  - Ibogaine, an indole alkaloid, has been proposed for treatment of drug addiction,
      yet its mechanism, site of action, and possible neurotoxicity have not been
      determined. Since neuronal injury is known to activate neurologlial cells, we
      investigated potential neurotoxic effects of this drug in rats by examining
      expression of specific glial markers. After treatment with ibogaine (100 mg kg-1
      i.p.; 1-3 doses), we observed increased cytochemical markers in both microglia
      (OX-6, OX-42, W3/25) and astrocytes (GFAP), associated with striking morphologic
      changes in these cells. Activated glial cells were restricted to longitudinally
      oriented, parasagittal stripes within the vermis of cerebellar cortex. The
      ibogaine-induced activation of cerebellar glial cells is highly suggestive of
      neuronal degeneration, most likely of Purkinje cells.

PMID- 8477053
TI  - Interleukin-2 regulates monoamine and opioid peptide release from the
      hypothalamus.
AB  - The present study determined whether interleukin-2 (IL-2) and IL-2 receptors are
      present in the adult rat hypothalamus. In addition, we determined whether IL-2 is
      involved in the regulation of neurotransmitter release from hypothalamic slices.
      In the hypothalamus, the highest levels of endogenous IL-2 and IL-2 receptors
      were localized to the median eminence and arcuate nucleus. Application of
      exogenous IL-2 to hypothalamic slices produced significant decreases of potassium
      (25 mM)-evoked [3H]noradrenaline release (24%) without significantly affecting
      the evoked release of [14C]glutamate, [14C]5-hydroxytryptamine, [3H]dopamine or
      [3H] gamma-amino butyric acid. In addition, IL-2 increased the potassium-evoked
      release of methionine-enkephalin (by 78%) and beta-endorphin (by 38%) from
      hypothalamic slices without affecting the release of leucine-enkephalin. In
      contrast, the spontaneous release of neurotransmitters and neuropeptides was not
      affected by exogenous IL-2. Overall, the findings of this study suggest that
      hypothalamic IL-2 is an endogenous neurokine that may be of consequence to the
      regulation of hypothalamic function.

PMID- 8477054
TI  - MK-801 sensitizes rats to pilocarpine induced limbic seizures and status
      epilepticus.
AB  - High doses of pilocarpine are known to produce prolonged seizure activity in
      rats. Previous studies show that pretreatment with LiCl will sensitize rats to
      the convulsant effects of pilocarpine. Here we report that the anti-epileptogenic
      and anticonvulsant drug MK-801 (dizocilpine) paradoxically also sensitizes rats
      to pilocarpine induced limbic seizures and limbic status epilipticus (LSE). If
      rats were pretreated with MK-801, normally subconvulsive doses of pilocarpine
      rapidly produced LSE. LSE could be prevented by co-administration of either
      atropine or diazepam with MK-801.

PMID- 8477055
TI  - The cholinergic marker Chol-1 is selectively localized in nerve terminals.
AB  - The subcellular distribution of the cholinergic-specific gangliosidic Chol-1
      antigens in rat brain has been compared with that of total ganglioside as a
      marker for neural plasma membranes, particle-bound choline acetyltransferase
      (ChAT) as a synaptosomal marker, and supernatant ChAT as a marker for neuronal
      perikaryal cytoplasm. Over 50% of brain Chol-1 was recovered in a synaptosome
      fraction prepared by a standard density-gradient method. The specific
      concentration of Chol-1 relative to protein or major gangliosides was also
      highest in the synaptosome fraction and low in a supernatant fraction which
      contained most of the neuronal plasma membrane fragments. ChAT was likewise
      mainly recovered in the synaptosome fraction but its relative concentration there
      was significantly less than that of Chol-1 (p < 0.01).

PMID- 8477056
TI  - Semantic process in kana word reading: activation studies with positron emission
      tomography.
AB  - Regional cerebral blood flow was measured by positron emission tomography to
      study changes during Japanese kana word or kana non-word reading tasks. The main
      cortical activation was observed bilaterally in the lateral and medial occipital
      gyri, and the left posterior inferior temporal area in both kana word and kana
      non-word tasks. In addition, the kana word task activated the right posterior
      inferior temporal area. Comparison of the mean regional cerebral blood flow
      increases revealed that the kana word task activated the left posterior inferior
      temporal area more than the kana non-word task, suggesting the role of the
      semantic process as well as the morphological one in this area.

PMID- 8477057
TI  - Opioid regulation of gonadotropin-releasing hormone gene expression in the male
      rat brain as studied by in situ hybridization.
AB  - It is well documented that gonadotropin-releasing hormone (GnRH) release is
      negatively regulated by opiates. In order to investigate the role of opiates in
      the regulation of GnRH gene expression in the rat brain, we studied the effects
      of chronic administration of the opioid drug morphine and an opiate receptor
      antagonist naloxone on GnRH mRNA levels as measured by in situ hybridization.
      Four-day treatment with morphine (40 mg kg day-2) produced a 44% decrease in the
      number of silver grains overlying GnRH neurones. Conversely, naloxone (4 mg kg
      day-2) also administered during 4 days increased by hybridization signal by 22%.
      The concomitant administration of morphine and naloxone completely prevented the
      effect of morphine on GnRH gene expression indicating the inhibitory influence of
      morphine is likely to be mediated by opioid receptors. The present data clearly
      indicate that opiates can inhibit not only the release of GnRH and consequently
      LH secretion but also the biosynthesis of the neuropeptide as evaluated by mRNA
      level measurements.

PMID- 8477058
TI  - Treatment of standard risk acute lymphoblastic leukemia in children with the
      Tokyo Children Cancer Study Group (TCCSG) L84-11 protocol in Japan.
AB  - During the period June 1984 through February 1989, 207 children, newly diagnosed
      with standard-risk acute lymphoblastic leukemia (ALL), were treated with the
      Tokyo Children Cancer Study Group L84-11 protocol. The patients were randomized
      into two regimen groups (S1 and S2). All patients received identical induction
      therapy with vincristine, prednisolone, and L-asparaginase. For central nervous
      system (CNS) prophylaxis, the patients in regimen S1 received cranial irradiation
      (18 Gy) and intrathecal chemotherapy starting at 5 weeks, while those in regimen
      S2 received this therapy starting at 24 weeks. Consolidation consisted of cyclic
      therapy with vincristine and dexamethasone, and then, after 128 weeks, with
      medium-dose methotrexate, CNS chemoprophylaxis, and dexamethasone. Regimen S2
      employed early consolidation with three doses of medium-dose methotrexate and CNS
      chemoprophylaxis. The treatment duration was 3.5 years. Complete remission was
      achieved in 96.0% and 99.0% of the patients in regimens S1 and S2, respectively.
      Event-free survival (EFS) rates were 80.0 +/- 3.5% in total, 74.5 +/- 5.7% in
      regimen S1, and 85.1 +/- 5.7% in regimen S2 at a median follow-up of 42 months (<
      85 months). There was no significant difference in the EFS between the two
      regimens. As compared with recently reported results of treatment for this
      disease, our protocol can yield similar EFS rates with mild toxicity.

PMID- 8477059
TI  - Re-analysis of prognosis in refractory anemia alone, with ring sideroblasts, and
      with excess of blasts.
AB  - Based on 473 primary cases of refractory anemia (RA), RA with ring sideroblasts
      (RARS), or with an excess of blasts (RAEB), new staging systems for overall
      survival, leukemic transformation, and nonleukemic death were developed. The
      reproducibility of these new staging systems, our former staging systems for
      leukemic transformation and nonleukemic death, and that for overall survival
      provided by Sanz et al. (Blood 1989;74:395-408), were estimated using a total of
      132 patients with RA, RARS, or RAEB (test sample). The correlation of risk ratios
      of the test sample from our system and that of Sanz et al. was poor (tau = 0.24;
      Kendall rank correlation). Our risk ratio was a significant (p = 0.0012)
      continuous covariate of the Cox model life-table analysis in the test sample but
      that of Sanz et al. was not. The new and previous staging systems for leukemic
      transformation were highly similar (tau = 0.7) and risk ratios of both systems
      were significant in the test sample (p = 0.00046 and 0.0017, respectively). Based
      upon the new system, patients at high risk for leukemic transformation RA or RARS
      were identified as males, with bone marrow myeloblasts higher than 2.5%, abnormal
      granules in the granulocytes, and circulating erythroblasts. Their cumulative
      leukemic transformation rate exceeded 50% within 2 years from presentation. The
      new and previous systems for nonleukemic death were moderately correlated (tau =
      0.47). The risk ratios of both systems were significant in the test sample (p =
      0.00012 and 0.000024, respectively) but failed to stratify test sample patients
      into three distinct risk groups. In conclusion, our new staging systems for
      overall survival and leukemic transformation were reproducible in RA, RARS, or
      RAEB patients and will be useful especially in identifying high-risk patients
      with RA or RARS, who are considered to be at lower risk by the FAB
      classification.

PMID- 8477060
TI  - An infant with both autoimmune neutropenia and idiopathic thrombocytopenia with
      IgG2/IgA deficiency.
AB  - We report an infant with autoimmune neutropenia (AIN), idiopathic
      thrombocytopenia (ITP), and IgG2/IgA deficiency. The patient was referred to our
      hospital at 5 months of age because of epistaxis and generalized petechiae.
      Physical examination revealed moderate hepatosplenomegaly. A complete blood count
      revealed a platelet count of 2.0 x 10(3) cells/microliters, and a white cell
      count of 3,600 cells/microliters, with severe neutropenia (less than 1% bands and
      segmented cells). Neutrophils and platelets adhering to megakaryocytes were
      decreased in the bone marrow. Tests for serum neutrophil-binding IgG (NB-IgG) and
      platelet-associated IgG (PA-IgG) were positive. A diagnosis of both AIN and ITP
      was made and therapy with intact-type gamma-globulin and prednisolone was
      initiated. Improvement occurred, but was temporary. A lack of serum IgA and IgG2
      was noted during the clinical course. The patient has not been susceptible to
      bacterial infections but has had a severe clinical course with rubella and
      chickenpox.

PMID- 8477061
TI  - MDR1 (multidrug resistance) gene expression in adult acute leukemia: correlations
      with blast phenotype.
AB  - Resistance to multiple chemotherapeutic agents is related to the production of P
      glycoprotein, a transmembrane drug efflux pump that is encoded by the multidrug
      resistance gene (MDR1). To detect low-level or heterogenous expression of the
      MDR1 gene in acute leukemia, we have developed sensitive, specific and semi
      quantitative protocols for measuring levels of MDR1 mRNA, based on the polymerase
      chain reaction. Using this assay, we screened blasts from 20 patients with
      untreated adult acute leukemia for evidence of MDR1 gene expression. The level of
      MDR1 mRNA was normalized to beta 2-microglobulin mRNA and was defined by
      reference to the highly resistant trimetrexate-selected leukemia cells MOLT
      3/TMQ200 (1.80). MDR1 mRNA was observed in 14 out of 20 patients. Higher MDR1
      mRNAs were observed in three patients with phenotypes of undifferentiated or
      minimally differentiated nonlymphocytic acute leukemia, as compared with other
      types of acute leukemia (0.98 vs. 0.25). In contrast, lower MDR1 mRNAs were found
      in five patients with acute promyelocytic leukemia, as compared with other types
      of acute leukemia (0.08 vs. 0.45). These findings suggest that MDR1 gene
      expression is correlated with the leucocyte differentiation stage of leukemia.
      MDR1 gene expression may, in part, explain the responsiveness to chemotherapy in
      these distinct subtypes of acute leukemia.

PMID- 8477062
TI  - Cutaneous granulocytic sarcoma at the exit site of Hickman indwelling venous
      catheter.
AB  - An unusual case of cutaneous granulocytic sarcoma (chloroma) developing at the
      exit site of a Hickman indwelling venous catheter in a patient with acute
      myelogenous leukemia (AML) is described. The possible role of the venous catheter
      in the development of this tumor at this unusual site is discussed.

PMID- 8477063
TI  - Macrophage colony-stimulating factor (M-CSF) enhances complement component C3
      production by human monocytes/macrophages.
AB  - The third complement component, C3, is an important factor in the host defense
      mechanism in which monocytes/macrophages participate as the primary phagocytes.
      Monocytes/macrophages are the principal extrahepatic producers of C3, and this C3
      production is thought to be regulated by several cytokines. In the present study,
      we demonstrated that human macrophage colony-stimulating factor (M-CSF) enhanced
      C3 production by human peripheral monocytes in serum-free culture. Analytical
      immunoblot and ELISA showed that the presence of M-CSF increased the production
      of intracellular pro-C3 and extracellular C3 for 24 h in a dose-dependent manner.
      To confirm the rapid effect of M-CSF on C3 production, we performed metabolic
      labeling of C3 with [35S]methionine. The production of [35S]C3 for the first 6 h
      in the presence of M-CSF was also increased as compared to that in the absence of
      M-CSF. In addition to the previously reported effects of M-CSF on
      monocytes/macrophages, such as the enhancement of C3 receptor expression and C3
      receptor-mediated phagocytosis, we consider that the effects of M-CSF
      demonstrated in this study are of importance in the local immune system
      organization of C3 and monocytes/macrophages.

PMID- 8477064
TI  - A comparative study of CHOP versus MEVP (mitoxantrone, etoposide, vindesine,
      prednisolone) therapy for intermediate-grade and high-grade non-Hodgkin's
      lymphoma: a prospective randomized study.
AB  - To evaluate a new combination chemotherapy with mitoxantrone (MXT), etoposide (VP
      16), vindesine (VDS), and prednisolone (MEVP therapy) as a front-line
      chemotherapy for non-Hodgkin's lymphoma (NHL), a prospective randomized study
      comparing this therapy (28 patients) with CHOP therapy (29 patients) was
      conducted in 57 patients with intermediate-grade or high-grade NHL with stages II
      IV. The MEVP therapy consisted of 10 mg/m2 of MXT intravenously on day 1, 2 mg/m2
      of VDS intravenously on day 1, 200 mg/m2 of VP-16 orally on days 1-3, and 40
      mg/m2 of prednisolone orally on days 1-5. This regimen was repeated every 3 weeks
      for up to 10 courses. Complete responses (CR) were achieved in 17 (63.0%) of the
      27 evaluable patients treated with MEVP therapy, and in 20 (71.4%) of the 28
      evaluable patients treated with CHOP therapy. Relapse-free survival rates and
      overall survival rates at 3 years were 58.8% and 46.4%, respectively, for the
      MEVP group and 70.0% and 54.0%, respectively, for the CHOP group.
      Granulocytopenia was more severer and associated infection episodes were more
      frequent in the MEVP group. MEVP therapy was effective as a front-line
      chemotherapy for intermediate- and high-grade NHL, although it was not superior
      to CHOP therapy in treatment effect and was not less toxic than CHOP.

PMID- 8477065
TI  - Ultrastructural analysis of a human megakaryocytic leukemia cell line (CMK11-5)
      in response to platelet agonists.
AB  - To further characterize the ultrastructure of the human megakaryocytic leukemia
      cell line, CMK, and its subclone CMK11-5, was observed. Stimulation with platelet
      agonists, ADP, thrombin, and collagen caused enlargement of vacuoles, projections
      of the cell surface, appearance of fibrous material in the enlarged vacuoles, and
      loss of alpha granules. We also found that horseradish peroxidase (HRP)
      incorporated into the granular structures of the cell could be transported out of
      the cell. The activation of CMK cells by platelet agonists indicates that human
      megakaryocytes may be activated in thrombotic states. CMK with particular
      megakaryocytic properties is a useful cell model for studying megakaryocytic
      function.

PMID- 8477066
TI  - An abnormal protein C (protein C Yonago) with an amino acid substitution of Gly
      for Arg-15 caused by a single base mutation of C to G in codon 57 (CGG-->GGG).
      Deteriorated calcium-dependent conformation of the gamma-carboxyglutamic acid
      domain relevant to a thrombotic tendency.
AB  - Protein C Yonago is a dysfunctional protein C characterized by defective
      anticoagulant activity determined by a coagulation assay and normal amidolytic
      activity measured on a synthetic substrate S-2366 (Iijima et al., Thromb Res
      1991;63:249-257). We have identified a single point mutation of C to G in codon
      57 (CGG-->GGG) of the gene for protein C Yonago by genetic analysis utilizing the
      polymerase chain reaction. The mutation should have resulted in an amino acid
      substitution of Gly for Arg at position 15 of the light chain of mature protein
      C. No mutations were found in nucleotides spanning the putative gamma-carboxylase
      recognition site or gamma-carboxyglutamic acid residues of protein C. Protein C
      Yonago was non-reactive to monoclonal antibodies JTC-1 and -3 that solely
      recognized the calcium-dependent conformation of the gamma-carboxyglutamic acid
      domain. This indicated that the mutation had critically perturbed the highly
      conserved structure of the gamma-carboxyglutamic acid domain. Thus, the calcium
      dependent conformation required for the phospholipids binding to exert the
      physiological functions of protein C may not have been elicited normally in this
      abnormal protein C, resulting in defective generation of anticoagulant activities
      in plasma. Consequently, no anticoagulant activities may have been generated in
      vivo.

PMID- 8477067
TI  - [Signal characteristics of malignant and benign lesions in dynamic 2D-MRT of the
      breast].
AB  - In a retrospective study of 400 dynamic MR examinations of the breast the
      signal/time ratio of 62 histopathologically correlated lesions (19 benign, 42
      malignant) was evaluated. Points of evaluation were initial signal enhancement
      (1st and 2nd minute), post-initial signal appearance (2nd to 5th minute) and
      signal distribution (homogeneous, marginal). Based on these criteria, a point
      system was defined to help in the assessment of lesions in dynamic breast-MR
      imaging. The overall sensitivity of this method was 95.3%, the specificity to
      89.5% and the accuracy to 93.5%. Pitfalls resulted in two cases of non-invasive
      carcinoma and in two patients with fibroadenoma.

PMID- 8477068
TI  - [MR tomographic functional analysis of the left ventricle].
AB  - The following contribution presents a continuous MRT analysis of the contraction
      and relaxation processes of healthy left ventricles giving reference values for
      contraction and relaxation velocities. For the total ventricle we have Vsyst. r.
      total = 342 +/- 47% LVEDV/sec and Vdiast. r. total = 303 +/- 59% LVEDV/sec. In
      relation to the end-diastolic (tomographic) volume (EDSV) significantly greater
      changes in volume per unit of time were measured apically compared to basal
      (systolic: 411 +/- 89% EDSV/sec apical vs 261 +/- 35% EDSV/sec basal; diastolic:
      810 +/- 145% EDSV/sec apical vs 245 +/- 70% EDSV/sec basal). Occurrence of the
      end-systolic minimal volumes of apical tomographic layers was delayed against the
      total ventricle by 22.4 +/- 7.9% t syst. Within the ventricle there was
      systolically a redistribution of the proportions of volume from apical to basal.

PMID- 8477069
TI  - [Detection of chronic recurrent pulmonary emboli using spiral-CT].
AB  - Chronic recurrent pulmonary emboli may lead, in rare cases, to progressive
      pulmonary arterial hypertension which cannot be treated medically. These patients
      may be helped by bilateral pulmonary thrombendarterectomy. The value of spiral CT
      in the diagnosis of this condition was demonstrated in 31 patients. In 12
      patients, thrombi could be shown to be the cause of the pulmonary arterial
      hypertension. Indirect criteria were vascular occlusions, changes in calibre and
      mural irregularities which were shown in varying degrees in all patients. In 22
      of 31 patients there was non-homogeneity of perfusion with greater opacification
      of the perfused lung parenchyma. In 11 patients scars related to pleural surfaces
      were seen. Typical changes of right heart insufficiency (cardiomegaly, widened
      central pulmonary arteries) were shown in all patients by CT.

PMID- 8477070
TI  - [Invagination in adults].
AB  - Intussusceptions in adults are rare. With the increasing use of sonography, CT
      and improved methods for examining the small bowel, they are now diagnosed more
      frequently before operation. If one considers the possibility, acute
      invaginations can be readily diagnosed by sonography or barium examination; the
      CT appearances are pathognomonic. In long-standing cases it may be difficult to
      separate the oedematous small bowel walls from each other. The "duck bill"
      narrowing is a sign of chronic invagination.

PMID- 8477071
TI  - A modified per os double contrast examination of the colon in the elderly.
AB  - A modified per os double contrast examination of the colon was used in 62 elderly
      patients in whom conventional barium enema had been unsuccessful. We created
      endogenous gas generation instead of air insufflation by per os administration of
      a special mixture containing barium sulfate, lactulose and gastrografin. Good
      quality double contrast images of the colon were obtained after 12 hours in 59 of
      the 62 patients. The sensitivity of the method was 100% in 6 patients suffering
      from carcinoma and in 15 patients suffering from diverticular disease. However,
      the method failed to demonstrate small solitary polyps in 5 patients and it was
      also negative in another 27 patients. 7 of these had negative endoscopy and in
      the remaining a definite diagnosis was not established by any other method. It
      seems that this method may become an alternative for investigation of suspected
      colonic pathology in the elderly patients with difficulty in retaining the barium
      enema.

PMID- 8477072
TI  - [Pancreatic metastases: sonographic and computed tomographic findings].
AB  - We analysed sonographic (n = 19) and CT (n = 15) findings in 19 patients with
      intrapancreatic metastases (solitary: n = 8, multiple: n = 11) from solid
      tumours. The diagnosis was confirmed either histologically (n = 5) or by the
      follow-up showing decrease of the size of the lesion due to chemotherapy (n = 3)
      or progression without specific therapy (n = 11). Clinically or serologically
      organ-related symptoms were found in 5 cases, whereas the rest of the patients
      were free of symptoms. Sonographically the metastases appeared hypoechogeneic
      compared to normal pancreatic parenchyma. In 15 cases CT at the time of
      sonographic investigation demonstrated hypodense intrapancreatic lesions (8/15)
      or bulging of the organ contour without differences in density (2/15). In some
      patients (5/15) sonographically detected metastases measuring less than 2 cm were
      not discovered via CT. In a patient with known malignancy multiple
      intrapancreatic lesions must be considered as metastases. Differential diagnosis
      includes diffusely growing pancreatic carcinoma, haemorrhagic necrotising
      pancreatitis and focal infiltrates due to malignant lymphoma.

PMID- 8477073
TI  - [A liver tumor model in the rat suitable for experimental MRT].
AB  - A malignant tumour was implanted in the livers of 205 rats in the context of an
      experimental MRT project. The implantation technique of the Novikoff hepatoma is
      described. Within 10 days of implantation a solitary one-centimetre intrahepatic
      tumour develops; it is a hypovascular tumour with an invasive periphery and
      central tumour necrosis. The tumour model is distinguished by a high success rate
      of 91.1% and is suitable for experimental MRT studies of liver tumours.

PMID- 8477074
TI  - [Magnetic resonance tomographic diagnosis of periarticular cystic space-occupying
      lesions in the knee joint].
AB  - The MR images of the knee joint of 100 successively examined patients were
      evaluated in retrospect with regard to periarticular cystic lesions. There were
      18 popliteal cysts, 8 meniscal cysts and 4 ganglion cysts. Localisation and
      internal structure of the lesions were of main importance in respect of
      differential diagnosis. All meniscal cysts were associated with horizontal
      meniscal tears. Spin-echo and 3D gradient-echo images did not enable
      differentiation because of signal intensity values. A spin-echo sequence with
      long repetition time in double-echo technique was best suited to assess the
      periarticular cystic lesions as well as the intraarticular pathological changes
      which were often concomitant.

PMID- 8477075
TI  - [Aneurysmal bone cyst or giant cell tumor. The value of x-ray diagnosis for
      differential diagnosis].
AB  - Depending on analysis of radiographic morphology, location and patient's age of
      72 aneurysmal bone cysts (ABC) and 47 giant cell tumours (GCT), the following
      criteria suggest an ABC with a high positive predictive value: location in the
      diaphysis (100%), in the shaft (92%), in the metaphysis or metadiaphysis (86%),
      patient younger than 17 years (97%) and growth rate grade Lodwick-IA (88%). GCT
      were selected via the following criteria: epimetaphyseal location (82%) and
      growth rate grade Lodwick-II (100%). In 14% of the cases, differential diagnosis
      between both entities is radiologically impossible.

PMID- 8477076
TI  - [Functional imaging of the brain using low dose gadolinium-DTPA and Turbo-FLASH
      sequences].
AB  - A method for measuring regional blood volume and flow is described based on the
      reduced relaxation time following intravenous injection of Gd-DTPA. The optimal
      Gd dose and other parameters were first determined using turbo-flash sequences
      and a dilution phantom. A single maximum was found for a Gd-DTPA concentration of
      4 mmol/l. Taking account of normal heart/time volumes and in order to stay below
      this arterial value Gd-DTPA was injected as a bolus at the rate of 1 mmol/sec.
      From the phantom measurements there appears to be a functional connection between
      measured signal intensity and Gd concentration. The method was applied to 15
      patients with cerebral tumours, using altogether 26 perfusion examinations. The
      results from 4 patients are given as examples; in these, blood volume and flow
      were calculated for each pixel in a 128 x 128 matrix. It was found that the Gd
      DTPA injected is sufficient to be shown with certainty in the grey and white
      matter and that this is able to demonstrate pathological changes in a functional
      manner. Comparison with Gd-DTPA doses such as are used for morphological imaging
      (typically, 10 mmol corresponding to 0.1 mmol/kg body weight) has shown that
      doses above 1.6 mmol may lead to distortion of the concentration curves.

PMID- 8477077
TI  - [Dynamic cranial CT in ischemic cerebral lesions].
AB  - 58 patients with recent transient or permanent neurologic deficits of with proven
      carotid stenoses were examined by dynamic CT at the level of the internal
      capsule. In the presence of cerebral infarcts there was marked delay in the
      time/density curve with reduced peaks. Abnormal perfusion could be demonstrated
      by early examinations before definite morphological changes were seen. With
      transient ischaemic attacks there were no significant changes in perfusion; in
      the presence of carotid stenoses the results were variable. The perfusion
      abnormalities in the hemispheres shown by dynamic cranial CT could be confirmed
      to some extent by 99mTc-HMPAO-SPECT.

PMID- 8477078
TI  - MRI of acoustic schwannoma: a retrospective study of 89 tumours.
AB  - Magnetic resonance imaging (MRI) is now considered the diagnostic study of choice
      for evaluation of patients with suspected acoustic schwannoma. This retrospective
      study of 118 MR examinations presents an analysis of the MR findings of 89
      acoustic tumours in 86 patients. The method of examination included precontrast
      and gadolinium(Gd)-enhanced MRI in 72 and plain MRI in 14 patients. The common MR
      appearances of acoustic schwannomas were: on T1-weighted images (WI) isointense
      (36%) or slightly hypointense (64%) relative to the brainstem; intense and
      homogeneous contrast enhancement in 62%; the shape of the tumour was round or
      oval in 71%; the tumour was centred at/or located in the internal auditory canal
      (IAC) in 80%. The small acoustic schwannomas were mostly round or oval in shape
      and showed homogeneous signal intensity (SI) both before and after Gd. The larger
      acoustic tumours were more heterogeneous in morphology and SI. The significance
      of these and other signs, early diagnosis and differential diagnosis are
      discussed.

PMID- 8477079
TI  - [The importance of magnetic field strength in the MR diagnosis of multiple
      sclerosis: a comparison of 0.5 and 1.5 T].
AB  - The value of magnetic resonance (MR) to establish the diagnosis of multiple
      sclerosis (MS) is well known. This study was undertaken to compare MR imaging of
      the brain of MS patients at high (1.5T) and mid (0.5T) field strength. 25
      patients with MS underwent two consecutive MR studies within one hour, each
      consisting of axial proton density and T2-weighted spin-echo images. Lesions in
      the supratentorial white matter and corpus callosum and those in the brain stem
      and cerebellum were separately counted. At 1.5T significantly more lesions were
      seen than at 0.5T (p < 0.05). Although T2-weighted images at 1.5T added
      significant information compared to images obtained at 0.5T, in none of our 25
      patients the diagnosis was missed at 0.5T. However, at 1.5T dissemination in
      space was better demonstrated, suggesting MR scanning with high field-units to be
      favourable in patients with clinically suspected MS.

PMID- 8477080
TI  - [Experiences in the use of video conferencing equipment in large auditoriums
      during clinical conferences].

PMID- 8477081
TI  - [Erosion and bronchopleural fistula of an oleothorax caused by a TBC cavern].

PMID- 8477082
TI  - [Subperiosteal osteoid osteoma--a rare cause of "unclear" wrist pain].

PMID- 8477083
TI  - Olfactory neuroblastoma: radiological features.

PMID- 8477084
TI  - [Dissection of the vertebral artery. Demonstration in MRT].

PMID- 8477085
TI  - [Doppler studies of soft tissues and bones. A new field for sonography?].

PMID- 8477086
TI  - Age-related changes in the hemostatic system.
AB  - The increased incidence of arterial thromboembolism in the elderly has prompted
      investigation of age-related changes in the hemostatic system. Aging is
      associated with increased plasma levels of fibrinogen, factor VII and factor
      VIII, which have been shown to be risk factors for thrombotic disease in five
      large epidemiological studies. An increased responsiveness to different
      aggregating stimuli, elevated levels of beta-thromboglobulin and an increased
      production of thromboxane A2 were reported in the platelets of the elderly. These
      alterations are associated with modifications of platelet membrane lipid
      composition (namely an increase in the cholesterol/phospholipid ratio and a
      decrease in linoleic acid) with possible related changes in membrane fluidity.
      Moreover, a decrease in the number of platelet prostacyclin and thromboxane A2
      receptors was observed with aging. Fibrinolytic activity is impaired in the
      elderly, probably due to an increase in plasminogen activator inhibitor 1.
      Interestingly, hypercoagulability has been demonstrated by an increase in the
      activation markers of the coagulation cascade (mainly fibrinopeptide A and
      prothrombin activation fragment F 1 + 2). Finally, clinical and experimental
      evidence suggests that endothelium could play a central role in hemostatic
      alterations which determine a thrombophilic state in the elderly.

PMID- 8477087
TI  - Clinical applications of immunoglobulin free light chain estimations.
AB  - The relevance of free light chain assays to diagnosis, staging, treatment and
      prognosis assessment in B-cell disorders (including myeloma, chronic lymphocytic
      leukaemia, and lymphoma), multiple sclerosis and diabetes is discussed and their
      actual and potential use is examined.

PMID- 8477088
TI  - Distribution of lecithin-cholesterol acyltransferase in normolipidemic and
      dyslipidemic plasma.
AB  - Plasma lecithin-cholesterol acyltransferase levels and cholesterol esterification
      rates have been reported to be different between normolipidemic and dyslipidemic
      subjects. Since apolipoprotein A-I is the presumed primary physiological
      activator of lecithin-cholesterol acyltransferase, the distribution of the enzyme
      among A-I-containing lipoprotein particles and A-I-free plasma in normolipidemic
      and dyslipidemic subjects was examined. A-I-containing lipoprotein particles with
      and without apolipoprotein A-II were isolated from plasma by immunoaffinity
      chromatography, and the lecithin-cholesterol acyltransferase mass in these
      particles and in the A-I-free plasma was quantified by radioimmunoassay. The
      plasma lecithin-cholesterol acyltransferase concentration was comparable between
      normolipidemic men (5.9 +/- 1.1 micrograms/ml, n = 15) and women (5.8 +/- 1.1
      micrograms/ml, n = 19), with 71 +/- 8% located in particles without
      apolipoprotein A-II, 17.6 +/- 6% in particles containing A-II, and 12 +/- 6% in
      the A-I-free plasma. In patients with elevated cholesterol (n = 12), triglyceride
      (n = 10), and with renal failure (n = 15) plasma levels of the enzyme were
      significantly higher (6.7 +/- 1.2, 6.9 +/- 1.3, and 6.6 +/- 1.3 micrograms/ml,
      respectively) (P < 0.05). In all three patient groups, a higher proportion of the
      enzyme (27 +/- 12%, 33 +/- 12%, and 19 +/- 9%) was not apo A-I associated. This
      phenomenon was also observed in plasma samples after incubation at 37 degrees
      C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477089
TI  - Soluble interleukin-2 receptor in hairy-cell leukemia: a reliable marker of
      disease.
AB  - The CD25 molecule, which corresponds to the p55 alpha chain of the interleukin-2
      receptor, is strongly expressed by neoplastic cells in hairy-cell leukemia and is
      released in large amounts in the soluble form which is detectable in serum. In
      order to assess the reliability of the soluble interleukin-2 receptor as a
      disease marker in the management of patients with hairy-cell leukemia, we
      investigated serum levels in 35 untreated patients and in 2 patients with the
      hairy-cell leukemia variant. In 21 of 35 patients soluble receptor levels were
      also monitored during and after recombinant interferon-alpha therapy. Clinical
      and hematological parameters were also assessed. Soluble interleukin-2 receptor
      levels were extremely high at the time of diagnosis in patients with typical
      hairy-cell leukemia [32,722 +/- 27,001 vs. 331 +/- 145 units/ml in controls (mean
      +/- SD)], but not in patients with the leukemia variant. A progressive decrease
      in soluble interleukin-2 receptor levels paralleled the clinical response to
      treatment, although normal values were never detected, even in patients who
      achieved an apparent complete remission. After recombinant interferon-alpha
      discontinuation, disease recurrence was accompanied by a progressive increase to
      pre-treatment soluble receptor levels. Overall, a close correlation was found
      between soluble interleukin-2 receptor values and total tumor burden (r = 0.84, P
      < 0.001). On the basis of these data, soluble interleukin-2 receptor should be
      regarded as a key marker in the management of patients with hairy-cell leukemia.

PMID- 8477090
TI  - Isotypes of human vaccinal antibodies to the Vi capsular polysaccharide of
      Salmonella typhi.
AB  - The immunoglobulin class and IgG subclass distribution of anti-Vi antibodies
      elicited by vaccination with a single injection of the purified polysaccharide or
      three injections of the inactivated whole cell typhoid vaccine was examined using
      an immunoenzymatic assay. The two vaccines induced antibody responses of similar
      magnitude and the predominant subclass of IgG antibodies was IgG1.

PMID- 8477091
TI  - Antibody-mediated neutropenia following bone marrow transplantation.
AB  - Unexpected neutropenia following allogeneic or autologous bone marrow
      transplantation may be caused by graft rejection, intrinsic stem cell failure,
      infection, graft-versus-host disease, relapse of the underlying neoplasm, or drug
      induced myelosuppression. Over the past decade an increasing number of reports
      have documented that the differential diagnosis also includes antibody-mediated
      neutropenia, a syndrome distinct from conventional graft rejection. In contrast
      to many of the other common causes of unexpected post-transplant neutropenia,
      antibody-mediated neutropenia usually responds well to treatment with
      corticosteroids, plasma exchange, intravenous immunoglobulin, splenectomy, or
      other similar measures.

PMID- 8477093
TI  - [Characteristics of day service center clients and their families based on their
      medical conditions].
AB  - Clients utilizing day service centers in Hokkaido, and their families were
      surveyed for the purpose of analyzing present conditions of health, ADL level,
      family structure, motivation, activities, and changes in physical and
      psychosocial status. The average age of subjects was 76 years old with women
      generally being older than men. Most were living with their families. As to
      disease, cerebrovascular diseases were most common followed by hypertension and
      spinal-articulation diseases. Women had more hypertension problems compared to
      men who had more cerebrovascular conditions. Effectiveness of these day service
      programs were seen in the improvement of psychological functions. Persons with
      cerebrovascular disease had greater participation in functional rehabilitation
      training programs, and their ADL skills were improved.

PMID- 8477092
TI  - Serotonergic mechanisms are involved in the hemostatic action of erythropoietin
      in uremic patients.
AB  - Recombinant human erythropoietin was administered to 12 patients with end-stage
      renal failure on long-term hemodialysis. They responded to the therapy with a
      shortening of the prolonged bleeding time, starting from the 1st week of therapy,
      before a significant increase in hemoglobin concentration was achieved. We also
      observed an increase in the activity of tissue plasminogen activator and a
      decrease in the activity of its inhibitor. There were no changes in platelet
      count but a significant increase in blood and platelet serotonin concentration
      was found. The shortening of the prolonged bleeding time before the correction of
      the anemia correlated with the rise in blood and platelet serotonin concentration
      during erythropoietin therapy. We suggest the possible involvement of an
      serotonergic mechanism in the hemostatic action of recombinant human
      erythropoietin.

PMID- 8477094
TI  - [Effects of typhoon-caused power failure on medical care facilities].
AB  - In the evening of September 27, Typhoon 19 passed Yamaguchi prefecture. The wind
      velocity exceeded anything that the local meteorological observatory has ever
      recorded so far in this area. When the typhoon was off shore near Yamaguchi
      prefecture, the gale brought down many electric-light poles around Hofu city with
      power failure in Hofu city continuing for more than a week. At the same time the
      total number of emergency patients in Hofu area was the most in the prefecture.
      Because the power failure continued for many days, there was more indirect damage
      attributable to this power failure than the damage related directly to the
      typhoon. The capacity of the emergency electric power generator equipment
      installed in the Central prefectural hospital in Hofu city is the largest in
      Yamaguchi prefecture. Even while electric power failed completely in the Hofu
      city area, treatment of most of the emergency patients at this hospital was
      possible. There is no hospital that has as large an electric generator as the
      Central hospital has. Had this typhoon hit in another area, the ensuring
      confusion which might have occurred at hospitals in that area would have put many
      patients in danger with the power failure in many hospitals. Power consumption
      needs in hospitals have increased over that expected on the time the hospital was
      built. Therefore, the electric power generators installed in hospitals are of the
      times very small and unable to cope with massive electrical outage.

PMID- 8477095
TI  - [A study on drinking and problem drinking in tuberculosis patients].
AB  - Drinking and problem drinking were studied in 43 tuberculosis patients with the
      following results. The results of the KAST (Kurihama Alcoholism Screening Test)
      revealed that 10% of the patients were severe problem drinkers (diagnosed as
      alcohol dependent syndrome), 7% of the patients had drinking problems and 17%
      were potential problem drinkers. These percentages are higher than those of the
      general adult population. In the cases having higher KAST scores, the time
      between the onset of subjective symptoms and the first medical examination were
      long, but the time between the first medical examination and diagnosed
      tuberculosis was short. Severe tuberculosis patients showed higher KAST scores.
      It was assumed that tuberculosis patients who drink too heavily or are problem
      drinkers, were apt to put off consulting a physician, and as a result, the
      condition of tuberculosis would be more severe when they finally did see a
      physician. In the field of tuberculosis prevention and medical treatment,
      professionals should pay more attention to drinking and alcoholism. The need to
      stay sober is important in both preventing relapses and supporting recovery from
      tuberculosis.

PMID- 8477096
TI  - [Smoking habit of health professionals].

PMID- 8477097
TI  - [An analysis of community mental health services at public health centers in the
      Tokyo metropolitan area--services for 727 new cases during 5 years in Bunkyo
      Ward].
AB  - For an overview of the community mental health services at Public Health Centers
      (PHCs), cases were statistically analyzed from the aspect of 3 points: the
      situation of psychiatric treatment at initial contact (psychiatric treatment),
      the person who had been living with the case at first contact (living style) and
      the person who contacted the PHC first (first contact person). During
      approximately 5 years, 463 new cases contacted the 2 PHCs in Bunkyo-Ward for
      consultation. Among them, 132 were under psychiatric treatment, 324 under no
      treatment and 7 unknown. Additionally, 264 were found to be registered on
      official documents, some of whom received PHC services after being listed. The
      percentage of schizophrenic cases in the psychiatric treatment group at first
      contact were higher than in the non-treatment group. More cases with psychiatric
      treatment were visited by PHN than without treatment. There were great
      differences in the first contact person among the groups classified according to
      living style. Especially, in the non psychiatric group, the percentage of the
      first contact person being other than family and relative was higher in the group
      who had been living alone than any other groups. Percentages of personal
      interview of a case, consultation by a psychiatrist in PHCs, and visiting the
      home of a case were different among the groups classified by psychiatric
      treatment, living style and first contact person. However, no difference in
      services outcome (total number of contacts made by a cases, relatives of cases,
      and other related persons), or present service utilization (continuing,
      discontinued, completed) among the groups classified by psychiatric treatment,
      living style, and first contact person was seen.

PMID- 8477098
TI  - [Depressive states and their correlates in elderly people living in a rural
      community].
AB  - In order to determine the prevalence of depressive symptomatology among the
      elderly in Japan, and examine relevant factor, a comprehensive survey was
      conducted. Subjects were 695 men and women aged 65 years and over in a rural
      village of Akita Prefecture. The Japanese version of the 20-item Center for
      Epidemiologic Studies Depression Scale (CES-D) was used as the measure of
      depressive symptomatology. The main results were as follows: 1. The score
      distribution was skewed to the right, more so than those in preceding studies
      from the United States. The prevalence of depression according to a CES-D cut
      point of 16 or greater was 5.3%. Neither age nor sex differences in prevalence
      were found. 2. Risk factors for circulatory disease such as blood pressure, ECG
      findings, chest X-P and blood components were not found to be related to CES-D
      score. Only the eye-ground change according to the Scheie's S classification was
      directly and significantly related to depression. 3. Those who had been treated
      for stroke over a year prior to the survey tended to have higher CES-D scores.
      Neither history of hypertension nor heart disease was associated with CES-D
      score. 4. Depression was more common among those who had experienced admission to
      hospitals over a year prior to the survey or who had suffered from hearing
      impairment or visual impairment. Low activities of daily living directly and
      significantly affected CES-D scores.

PMID- 8477099
TI  - [An epidemiological study of allergic conjunctivitis].
AB  - An epidemiological study focusing on the home environment and lifestyle was
      conducted in order to analyze the differences between a group of patients with
      allergic conjunctivitis only and a group with other allergic diseases associated
      with allergic conjunctivitis. Subjects were five hundred and sixty-four patients
      who visited the Ophthalmologic Clinic of Tokai University Hospital during 1990,
      and for controls 200 households were randomly selected from an elementary school
      list in Yokohama city. RAST score was measured in 102 patients. A mailed
      questionnaire was sent to 240 patients chosen at random and to 200 controls.
      Sixty patients and 139 controls responded to the questionnaire. RAST score showed
      no statistical difference between patients with allergic conjunctivitis only and
      patients with other allergic diseases associated with allergic conjunctivitis.
      Analysis of associations between RAST score and seasonal symptoms, showed very
      strong positive reactions to pollens in patients with seasonal symptoms. On the
      other hand, in patients with constant symptoms during the year, reaction was very
      strong to house dust and mite. Epidemiological factors causally associated with
      allergic conjunctivitis were compared among the controls, patients with allergic
      conjunctivitis only (Group I), patients with other allergic diseases (Group II)
      and all patients (Group III). Compared to controls, Groups II and III had
      significantly higher prevalence of past history of skin itching and inflammatory
      symptoms (p < 0.05 and p < 0.01, respectively). Group II subjects showed more
      frequent use of carpets, when compared to the controls (p < 0.05). The use of
      Japanese mattress (futon) was more frequent in Group II and III than controls (p
      < 0.05 for both comparisons).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477100
TI  - The prisoner's prisoner: the theme of voluntary imprisonment in the staff of
      correctional facilities.
AB  - The staff of correctional facilities voluntarily work in prisons. It seems
      plausible that the professionals, officers, and administrators engaged in such
      employment may have unconscious feelings of a desire or need for punishment. This
      topic does, in fact, appear common in the jokes and casual conversation in such
      facilities, perhaps indicating such an underlying theme. Indeed, those employees
      who were willing to discuss their experience in more depth corroborated the
      hypothesis. A sense of a need or desire for punishment in a staff's members may
      profoundly affect the prisoner's transference with the staff, and the staff's
      countertransference. These feelings may affect the many important decisions of
      correctional and clinical staff in prisons and related settings.

PMID- 8477101
TI  - Rule-Out and Rule-In scales for the M test for malingering: a cross-validation.
AB  - Previous research found the M test to have limited utility for the screening of
      malingering. Subsequently, Rogers et al. attempted to improve the test's
      discriminative ability by developing an alternative scoring procedure-Rule-In and
      Rule-Out scales. These scales showed promising results as a brief screener for
      malingering with hit rates as high as 95 percent. The present study cross
      validated their proposed decision rules, but found lower rates of classification
      accuracy. The most conservative decision rule (i.e., to maximize detection of
      malingerers) only identified 72.7 percent of the malingerers with a false
      positive rate of 50.8 percent.

PMID- 8477102
TI  - The validity of the M test in a residential forensic facility.
AB  - The validity of the M Test as a screening measure for malingering was assessed in
      a residential forensic treatment center. Clinically, malingering was recognized
      by the treatment staff as a significant problem among incompetent to proceed
      (ITP) defendants in this setting. A total of 79 ITP defendants completed the M
      Test under standard instructions. To assess the predictive validity of the M
      Test, its sensitivity and specificity were determined using three separate
      measures of malingering status. Using the original scoring procedure, the results
      provided estimates of sensitivity of 11, 31, and 29 percent and estimates of
      specificity of 67, 70, and 69 percent, respectively, for the three malingering
      status measures. A revised scoring procedure improved the sensitivity estimates
      to the statistically significant level of 86 percent for the malingering status
      measure that was defined as feigned or grossly exaggerated psychotic symptoms.
      The pattern of correlations between the M Test scales and a variety of other
      clinical measures suggested that, in this forensic treatment setting, the
      subject's pattern of responses to the M Test was primarily determined by the
      severity of cognitive impairment of that subject.

PMID- 8477103
TI  - Post-traumatic stress disorder and the law: critical review of the new frontier.
AB  - Since its debut in the psychiatric nomenclature in 1980, post-traumatic stress
      disorder (PTSD) has had a dramatic impact on criminal and civil jurisprudence.
      PTSD has created a cottage industry among both criminal and negligence attorneys
      and mental health practitioners. The diagnosis first achieved public notoriety
      when it was introduced as a new basis for the insanity defense. More recently
      "syndrome evidence" of the subtypes and variations of PTSD have encroached on the
      substantive criminal law of self-defense. In addition, the diagnosis may have an
      impact on such traditionally legal and factual determinations as the credibility
      of witnesses and may undermine conservative tort doctrine that attempts to cabin
      psychic injury. The emerging legal area of victims' rights has been strengthened
      and paradoxically divided by PTSD. Yet the newly defined disorder of PTSD has not
      borne such a heavy forensic burden easily. Indeed the diagnosis poses for
      psychiatry some of the very problems it supposedly solves for legal purposes,
      including the illusory objectivity of the causative traumatic event and the
      expert's dependence upon the victim's subjective and unverifiable reports of
      symptomatology for the diagnosis.

PMID- 8477104
TI  - Psychophysiologic testing for post-traumatic stress disorder: forensic
      psychiatric application.
AB  - The validity of the post-traumatic stress disorder (PTSD) diagnosis is limited by
      both the illusory objectivity of the traumatic event and the subjectivity of the
      ensuing syndrome. These limitations are especially problematic in the forensic
      setting. Psychophysiologic measurements may strengthen PTSD's forensic value by
      offering a more objective assessment technique for cases that find their way into
      the courtroom. Based upon the results of published research studies conducted in
      a range of military and civilian, PTSD and non-PTSD subjects, psychophysiologic
      data can provide evidence helping to establish or refute the presence of the DSM
      III-R PTSD arousal criteria, as well as aid psychiatric experts in estimating the
      probability of the disorder's presence in a given claimant. Psychophysiologic
      testing should be viewed as one component of a multimethod forensic psychiatric
      evaluation for PTSD. It is likely that it will soon be offered and, given current
      legal standards, admitted as evidence in civil and criminal litigation.

PMID- 8477105
TI  - An agenda for quality improvement in forensic mental health consultation.
AB  - Recent developments in quality assurance in health care have embraced the total
      quality management approach to industrial quality control. Setting a goal of
      "continuous quality improvement" for medical care, this approach features special
      attention to the process and systems of care provision. Applying this approach to
      the specialty of forensic mental health consultation yields a variety of
      potential ways of improving care, by articulating common problems in the
      consultation process that might respond to the total quality management approach.
      These problems include the setting of appropriate goals for forensic evaluation,
      and selecting cases for attention on the basis of those goals; determining
      appropriate standards for thoroughness and validity in the use of evaluation
      techniques; and establishing clear expectations regarding the provision of mental
      health services beyond the consultation process itself. Creating
      interdisciplinary teams at various levels of administration of trial courts and
      mental health agencies can provide contexts for reviewing cases, with the aim of
      discovering problems in these areas, educating professionals across boundaries
      about sources of problems, and developing clearer and more consistent standards
      of practice to reduce problems and improve quality of service.

PMID- 8477106
TI  - Appropriate short-term risk in psychiatry and the law.
AB  - Effective treatment decisions sometimes require substantial risk of short-term
      harm, which can be shown after-the-fact to have been preventable, thereby
      carrying some liability risk. To err on the side of short-term comfort or safety,
      however, may greatly increase the overall and long-term risks. For instance, to
      intrusively restrain a borderline patient from threatened acting out, may (1)
      fuel a regressive cycle that heightens future risk, (2) deprive the clinician of
      therapeutic leverage, and/or (3) so disrupt the treatment system that other
      patients unnecessarily suffer. Long-term thinking is not always convincing to
      judge or juror, because of less direct causal connections; hence, there is
      pressing need to develop rational criteria for when it should hold sway. Two
      competing trends of legal doctrine are relevant: risk-benefit analysis
      (utilitarian) and absolute values (absolutist). Presumptions of appropriate short
      term risk separately weigh five relevant factors, in interaction with one
      another: imminent safety, long-term risk, voluntariness of other agent,
      therapeutic boundaries, and social values. Forensic psychiatrists are advised to
      take a stronger stand in support of short-term risk, when needed to enhance long
      term safety and optimal standards of care.

PMID- 8477107
TI  - Multiple personality disorder: scientific and medicolegal issues.
AB  - Despite the intense study it has received since its inclusion in DSM-III,
      multiple personality disorder (MPD) largely remains an unvalidated construct.
      Definitional problems remain (there is not even agreement in the field as to
      whether a diagnosis of MPD truly means the existence of more than one
      personality), while the vagueness and liberality of existing criteria give the
      clinician little guidance in diagnosis. In forensic settings, diagnosis of MPD is
      even more problematic, since there is substantial evidence that the disorder
      cannot currently be phenomenologically distinguished from malingering. It also
      remains to be demonstrated that evaluators can determine whether alter
      personalities, if they exist, are truly unaware of each other, lack control over
      other alters' behavior, or are unable to know right from wrong.

PMID- 8477108
TI  - Indochinese patients in the civil commitment process.
AB  - This paper examines in detail the involvement of a group of Indochinese patients
      in the Oregon Civil Commitment process in the calendar years of 1985 and 1986.
      The authors found that there was no apparent difference in the rate of commitment
      as contrasted to the overall commitment rate of the general population. The
      results also indicated that there was heavy reliance on the Indochinese
      Psychiatric Program and staff to divert the involuntary Indochinese patients out
      of the commitment process. Furthermore, comparing the involuntary Indochinese
      patients to a randomly selected cohort of Indochinese patients hospitalized in
      the same period revealed no differences in demographic data, diagnosis, and
      treatment history except that the involuntary group was significantly younger and
      predominantly male. Finally, the follow-up study of the two cohorts showed high
      rates of hospitalization, noncompliance, and treatment drop-out.

PMID- 8477109
TI  - Excluding personality disorders from the insanity defense--a follow-up study.
AB  - Examining the effects of Oregon's statutory reform excluding personality
      disordered individuals from the insanity defense, we previously identified a
      study sample of insanity acquittees, each of whom was given a primary diagnosis
      of a personality disorder during subsequent evaluation at the state hospital. In
      the present study we explore the relationship between that diagnosis and the
      pretrial psychiatric diagnosis presented to the trial court. By reading the
      forensic mental health evaluations used at trial we found that 50 percent of our
      study sample of 34 personality disordered patients were diagnosed with psychotic
      disorders, affective disorders, retardation, and organic brain disorders. In
      addition to investigating the diagnosis offered as evidence at trial, we
      performed assessments of 38 mental health reports using published standards for
      forensic evaluation reports. We found compliance rates in the various categories
      ranged from 8 to 84 percent with a mean of 45 percent. We question the value of
      the mental health input to these trials, and believe that the data tend to
      validate past aspersions of forensic practice.

PMID- 8477110
TI  - Surgery for acid suppression in the 1990s.

PMID- 8477111
TI  - Acid suppression and the gastric flora.

PMID- 8477112
TI  - Postmarketing surveillance and the examination of the long-term safety of
      antiulcer drugs.

PMID- 8477113
TI  - Single-dose effect of enteric-coated aspirin on platelet function and thromboxane
      generation in middle-aged men.
AB  - OBJECTIVE: To evaluate the effect of a single dose of enteric-coated aspirin
      (ECA) in three different dosages on platelet function and thromboxane generation
      in middle-aged men. DESIGN AND METHODS: In a nonblind, nonplacebo-controlled,
      crossover study, a single dose of ECA (50, 250, or 1000 mg) was given in a tablet
      form to a group of healthy, middle-aged men. Ten subjects, aged 50-67 years,
      volunteered to participate in this study. Platelet functions including bleeding
      time, platelet aggregation, adenine nucleotides, beta-thromboglobulin, platelet
      factor 4, thromboxane generation, and aspirin measurement were determined.
      RESULTS: Before ECA ingestion, the intracellular adenine nucleotides (adenosine
      triphosphate, adenosine diphosphate) were decreased, and both beta
      thromboglobulin and platelet factor 4 were increased. These observations
      suggested that platelets were activated in vivo in middle-aged men. These
      findings returned to normal within 8 hours after the ingestion of ECA, and
      maintained normal for at least two days. Bleeding time was significantly
      prolonged at 8 and 24 hours compared with that before ingestion of ECA 1000 mg (p
      < 0.05). The generation of platelet thromboxane was maximally inhibited by
      approximately 40 percent in the samples 8 hours after ECA ingestion. Abnormal
      values of adenine nucleotides, beta-thromboglobulin, and platelet factor 4
      returned to normal within 8 hours. Arachidonic acid-induced platelet aggregation
      was inhibited compared with that before treatment (p < 0.01) and the inhibitory
      effect was maintained for at least three days. Adenosine diphosphate- and
      epinephrine-induced aggregations were less inhibited than those induced by
      arachidonic acid. Inhibitory effects of ECA on platelet aggregation were dose
      dependent. CONCLUSIONS: Our study indicates that platelets are activated in
      middle-aged men and that a single dose of ECA 50 mg is safe and can inhibit
      thromboxane synthesis and platelet aggregation. These results suggest that a
      daily dose of ECA 50 mg may be useful for blocking platelet activation and
      preventing thrombosis.

PMID- 8477114
TI  - Subcutaneous absorption kinetics of two highly concentrated preparations of
      recombinant human growth hormone.
AB  - OBJECTIVE: The relative bioavailability of two highly concentrated (12 IU/ml)
      formulations of biosynthetic human growth hormone (GH) administered
      subcutaneously was compared. DESIGN: A randomized, crossover study. Conventional
      GH therapy was withdrawn 72 hours before each study period. There was a washout
      period of at least four weeks between the study periods. SETTING: Participants
      were recruited from an outpatient clinic and were hospitalized during the two
      study periods. PATIENTS: Fourteen GH-deficient patients (mean age 25.2 y, range
      14-54). One patient was excluded from data analysis because of signs of
      endogenous GH secretion. INTERVENTIONS: At the start of each study period, GH 3
      IU/m2 was injected subcutaneously. The two formulations, PenFill and PenSet,
      differ in the buffers used and in the relative content of mannitol and glycine.
      Serum profiles of GH were monitored frequently for 24 hours. Samples were taken
      every 30 minutes for 6 hours and then hourly. MAIN OUTCOME MEASURES:
      Bioavailability (F) and absorption dynamics of human GH were measured. The
      relative absorption fractions estimated from the areas under the individual serum
      concentration curves from 0 to 24 hours, and the observed time (Tmax) to reach
      the maximum concentration (Cmax) were determined. Short-term metabolic effects of
      GH on insulin-like growth factor (IGF-I), glucose, and insulin were determined.
      RESULTS: The geometric mean (SD) of F was 0.910 (1,236). The 90 percent
      confidence interval was 0.819-1.010. Mean (+/- SD) of Cmax was 12.65 +/- 5.89 and
      12.58 +/- 4.40 ng/mL for PenFill and PenSet, respectively. Corresponding values
      for Tmax were 5.49 +/- 1.55 and 5.89 +/- 1.79 hours for PenFill and PenSet,
      respectively. There was a considerable interindividual variation, but the
      relative absorption fraction did not significantly differ from 1 (p = 0.13).
      Neither Cmax (p = 0.74) nor Tmax (p = 0.58) of the two formulations was
      significantly different. Injection of the two formulations induced similar
      increments in serum IFG-I (p = 0.48). Serum insulin and blood glucose
      concentrations were not significantly different. CONCLUSIONS: There is no
      significant difference between the absorption kinetics and short-term metabolic
      effects of these two highly concentrated formulations of biosynthetic GH. The two
      formulations are bioequivalent.

PMID- 8477115
TI  - Stability of famotidine in polyvinyl chloride minibags and polypropylene syringes
      and compatibility of famotidine with selected drugs.
AB  - OBJECTIVE: (1) to determine the stability of famotidine 200 micrograms/mL in
      admixtures with dextrose 5% injection (D5W) and NaCl 0.9% injection (NS) in
      polyvinyl chloride (PVC) minibags and polypropylene syringes, at room temperature
      (22 degrees C), protected and unprotected from light for 15 days; and (2) to
      evaluate the visual compatibility of famotidine with 34 selected drugs for four
      hours at room temperature. DESIGN: Concentration of famotidine samples was
      determined on day 0 and again on days 3, 6, 9, 12, and 15 by a stability
      indicating HPLC. Inspection for visual and pH changes was also performed at these
      time intervals. RESULTS: More than 95 percent of the day 0 famotidine
      concentration remained in all samples over the 15-day study period. During this
      period, all samples remained clear and colorless and no change in absorbance at
      450 and 540 nm was observed. The pH of the samples also remained unchanged.
      Famotidine 2000 micrograms/mL was found to be compatible with 33 selected drugs;
      only furosemide was found to be incompatible. A white precipitate was observed
      when an equal volume of famotidine 2000 micrograms/mL in NS was mixed with
      furosemide 3000 micrograms/mL in D5W. The concentration of famotidine in the
      supernatant gradually decreased during the 4-hour study period. At 0.5, 1.0, 2.0,
      and 4.0 hours after mixture of famotidine with furosemide, famotidine
      concentrations were 97.5, 23.6, 21.7, and 17.2 percent of the initial famotidine
      concentration, respectively. CONCLUSIONS: Our results show that famotidine 200
      micrograms/mL was stable in admixture with D5W and NS in PVC minibags and
      polypropylene syringes when these solutions were stored at room temperature,
      protected and unprotected from light for 15 days. Famotidine 2000 micrograms/mL
      in NS was compatible with 33 of the drugs, and was incompatible with furosemide.

PMID- 8477116
TI  - Fluconazole-cyclosporine interaction: a dose-dependent effect?
AB  - OBJECTIVE: To present cases supporting the hypothesis that fluconazole inhibition
      of cyclosporine metabolism is dose-dependent. DESIGN: Case reports. PATIENTS AND
      INTERVENTIONS: One renal-pancreatic transplant patient taking fluconazole 100 and
      300 mg/d for 37 and 17 days, respectively; four bone marrow transplant recipients
      taking fluconazole 100 mg/d as antifungal prophylaxis and five other concurrent
      nonmatched recipients whose antifungal prophylactic agent is nystatin mouthwash.
      All of these patients underwent transplantation during the same period. RESULTS:
      There was a sharp rise in cyclosporine trough concentration (ng/mL),
      concentration:dose ratio (ng.mL-1/mg.kg-1), and serum creatinine concentration
      (mumol/L) in the renal-pancreatic transplantation patient taking fluconazole 300
      mg/d. No such increase occurred at 100 mg/d. No significant alterations in
      cyclosporine concentration:dose ratio were seen in the patients undergoing bone
      marrow transplantation and receiving fluconazole 100 mg/d. CONCLUSIONS: The case
      of the renal-pancreatic transplantation patient shows a characteristic
      interaction profile, and it supports the hypothesis of a dose-dependent
      interaction between cyclosporine and fluconazole. Given the nephrotoxic potential
      of the immunosuppressant drug, dosage reduction and closer monitoring of
      cyclosporine concentrations and/or renal function in patients receiving
      fluconazole dosages greater than 200 mg/d must be considered.

PMID- 8477117
TI  - Excretion of bupropion in breast milk.
AB  - OBJECTIVE: To measure the excretion of bupropion and its metabolites in breast
      milk. A secondary objective was to determine whether the drug accumulated in the
      nursing infant. CASE SUMMARY: Milk and plasma samples were collected from a woman
      taking bupropion 300 mg/d in divided doses who was breastfeeding her 14-month-old
      son. A single plasma sample was collected from the infant. RESULTS: After a 100
      mg dose, the peak bupropion breast milk concentration measured at two hours was
      0.189 micrograms/mL. Milk-to-plasma ratios ranged from 2.51 to 8.58 over a six
      hour interval. Two of three metabolites also were measured in milk. Bupropion and
      its metabolites were not detected in the single plasma sample obtained from the
      infant. CONCLUSIONS: Bupropion accumulates in human breast milk in concentrations
      much higher than in maternal plasma. Two metabolites are also excreted into the
      milk. Neither bupropion nor its metabolites were detected in the infant's plasma,
      indicating that accumulation did not occur in this infant.

PMID- 8477118
TI  - Possible case of procainamide-induced intrahepatic cholestatic jaundice.
AB  - OBJECTIVE: To describe a possible case of procainamide-induced intrahepatic
      cholestatic jaundice that was recognized six weeks after the initiation of
      procainamide therapy and to summarize the five previously reported cases. CASE
      SUMMARY: A 77-year-old woman with a history of hypertension, insulin-dependent
      diabetes mellitus, temporal arteritis, and Wolff-Parkinson-White syndrome who had
      taken procainamide for six weeks presented to the hospital with disorientation
      and acute renal and hepatic dysfunction. In addition to disorientation, scleral
      icterus, and diffuse maculopapular rash, her physical examination was generally
      normal. There was no evidence of fever, nausea, vomiting, lymphadenopathy, or
      eosinophilia. Her liver enzyme concentrations increased significantly from
      baseline (beginning of procainamide therapy). Her N-acetylprocainamide (NAPA)
      concentration was elevated to 52 mg/L upon admission. Procainamide was
      discontinued and her NAPA concentration returned to within normal limits in two
      days. Diagnostic tests were performed to rule out active hepatitis, vasculitis,
      and liver malignancies. After procainamide was discontinued and prednisone
      treatment was started, she became more oriented and her liver enzyme
      concentrations slowly improved. DISCUSSION: Only five cases of procainamide
      induced liver abnormalities have been previously reported; these included
      granulomatous hepatitis and intrahepatic cholestasis. The mechanism for liver
      dysfunction is not known; however, it is proposed to be a delayed
      hypersensitivity reaction. Clinical hallmarks of hypersensitivity include fever,
      eosinophilia, rash, and lymphadenopathy; nausea and vomiting also may be present.
      Of the five reported cases, all experienced fever and only one experienced
      pruritus. No patients had eosinophilia or lymphadenopathy. Because of the
      temporal increase in liver enzyme concentrations after six weeks of procainamide
      therapy, we believe that this case represents another possible procainamide
      induced hypersensitivity reaction. CONCLUSIONS: Procainamide-induced liver
      dysfunction can occur from one day to six weeks after initiation of the drug and
      may subside one day to several weeks after discontinuation of therapy. Symptoms
      may include nausea, vomiting, rash, and fever. Liver enzyme concentrations are
      abnormal. It is important to recognize the possibility of such a reaction early
      so that procainamide therapy can be discontinued promptly to avoid further liver
      damage.

PMID- 8477119
TI  - Hepatotoxicity associated with cisplatin chemotherapy.
AB  - OBJECTIVE: To report a case of possible cisplatin-associated hepatotoxicity. CASE
      SUMMARY: A 69-year-old man received three cycles of cisplatin (100 mg/m2) and
      fluorouracil (1000 mg/m2/d for five days) for management of squamous cell
      carcinoma of the head and neck. Liver enzyme concentrations were within normal
      limits prior to each cycle of therapy but the aspartate aminotransferase, alanine
      aminotransferase, alkaline phosphatase, and lactate dehydrogenase concentrations
      increased on the second day of each cycle. The concentrations began to decline on
      day 3 of each course, despite continued fluorouracil administration, and returned
      to normal by day 10. The patient's antiemetic therapy included metoclopramide in
      cycle 1 and ondansetron in cycles 2 and 3, which may have contributed to the
      enzyme elevations. DISCUSSION: Case reports of cisplatin-associated
      hepatotoxicity are reviewed. An association between cisplatin administration and
      hepatotoxicity is proposed in this patient. CONCLUSIONS: This patient may have
      experienced cisplatin-induced liver damage. Metoclopramide and ondansetron may
      have contributed to this effect.

PMID- 8477120
TI  - Prevalence and descriptors of aspirin use as an antiplatelet agent in two New
      England communities.
AB  - OBJECTIVE: To determine the overall prevalence of aspirin use as an antiplatelet
      agent in a population-based sample of respondents between the ages of 18 and 64
      years, and to describe their sociodemographic characteristics. DESIGN: Data were
      derived from five biennial cross-sectional household surveys conducted between
      1981 and 1990 in two southeastern New England communities by the Pawtucket Heart
      Health Program. Individuals reporting aspirin use as an antiplatelet agent were
      identified using data from a structured medication interview. RESULTS: The
      prevalence of aspirin use per 1000 population was 2.5 (95 percent confidence
      interval [CI] 0.5, 4.4), 5.0 (95 percent CI 2.4, 7.6), 7.8 (95 percent CI 4.6,
      11.0), 7.5 (95 percent CI 4.3, 10.6), and 11.8 (95 percent CI 7.1, 16.5) in the
      first through the fifth survey periods, respectively (p = 0.0002). The prevalence
      of aspirin use per 1000 men increased from 4.9 (95 percent CI 0.6, 9.1), 8.7 (95
      percent CI 3.3, 14.1), 12.3 (95 percent CI 6.1, 18.5), 8.5 (95 percent CI 3.5,
      13.5) to 23.2 (95 percent CI 13.4, 32.9) for the first through the fifth survey
      periods, respectively. The corresponding prevalence rates of aspirin use per 1000
      women were 0.7 (95 percent CI 0, 2.1), 2.43 (95 percent CI 0.05, 4.80), 4.6 (95
      percent CI 1.4, 7.8), 6.6 (95 percent CI 2.7, 10.6), and 2.7 (95 percent CI 0,
      5.7). Both a gender trend (p = 0.0002) and a survey trend (p = 0.0001) were
      detected. A gender-survey interaction was not found. CONCLUSIONS: In this
      population, aspirin use was reported primarily by middle-aged men who had
      coexisting cardiovascular disease as indicated by concurrent medications. Aspirin
      use as antiplatelet therapy increased in the population-based samples of two New
      England communities over the past nine years, with slightly more than one percent
      of the respondents reporting its use in the fifth cross-sectional survey
      conducted in 1989-1990. This finding may reflect the publication of important
      clinical trials near the time the survey was performed and subsequent
      dissemination of the findings both in the professional and lay press.

PMID- 8477122
TI  - Naloxone and dementia.

PMID- 8477121
TI  - Reversible seizures and mental status changes in a dialysis patient on isoniazid
      preventive therapy.
AB  - OBJECTIVE: To report a case of reversible seizures and mental status changes in a
      dialysis patient given preventive isoniazid therapy. CASE SUMMARY: A 66-year-old
      woman on continuous ambulatory peritoneal dialysis (CAPD) was given isoniazid
      prophylaxis following a purified protein derivative (PPD) reaction greater than
      20 mm in duration. Oral administration of isoniazid 300 mg/d was started and four
      days later she was admitted to the hospital for confusion, lethargy, and focal
      seizures that began 24 hours after initiation of therapy. All medications were
      discontinued with the exception of oral pyridoxine 50 mg/d. Dialysis was withheld
      to determine if the seizures were medication induced rather than uremia related.
      Seizures and mental status changes were reversed with pyridoxine. Dialysis was
      restarted after the symptoms resolved. CONCLUSIONS: Preventive therapy against
      tuberculosis with isoniazid should be stressed throughout the medical community.
      Isoniazid has adverse effects including hepatitis and peripheral neuropathy
      (common) and convulsions (rare). Our experience suggests that additional
      supplementation with pyridoxine 50 mg/d should be given routinely to prevent
      adverse reactions in uremic patients.

PMID- 8477123
TI  - Medroxyprogesterone in osteoporosis.

PMID- 8477124
TI  - Nabumetone: a "nonacidic" nonsteroidal antiinflammatory drug.
AB  - OBJECTIVE: To review the pharmacology, pharmacokinetic disposition, dosage
      recommendations, adverse effects, drug interactions, and efficacy of nabumetone
      in patients with selected rheumatic disorders and soft-tissue injuries. DATA
      SOURCES: Data from scientific literature were extracted, evaluated, and
      summarized for presentation. A MEDLINE search was conducted using the following
      indexing terms: antiinflammatory agents, nonsteroidal, nabumetone, rheumatoid
      arthritis (RA), and osteoarthritis (OA). Studies evaluating nabumetone reported
      in articles, abstracts, or proceedings involving human subjects were considered
      for inclusion. STUDY SELECTION: Special consideration was given to clinical
      studies using double-blind, randomized, parallel, controlled designs. Studies
      comparing the effectiveness and safety of nabumetone with placebo and other
      nonsteroidal antiinflammatory drugs (NSAIDs) were included. DATA EXTRACTION: Data
      from human studies published in the English language were evaluated. Trials were
      assessed according to study design, sample size, and description of outcomes.
      DATA SYNTHESIS: Nabumetone is a nonacidic prodrug that is metabolized to an
      active nonsteroidal antiinflammatory moiety, 6-methoxy-2-naphthylacetic acid (6
      MNA). 6-MNA is a structural analog of naproxen. Like naproxen and other NSAIDs, 6
      MNA possesses analgesic, antipyretic, and antiinflammatory activity, 6-MNA has a
      prolonged elimination half-life, ranging from 17 to 74 hours, which allows for
      once-daily dosing. The efficacy of nabumetone for treating symptoms of RA and OA
      has been established in controlled clinical trials. Nabumetone also has been
      studied in ankylosing spondylitis and soft-tissue injuries. Adverse effects
      associated with nabumetone are similar to those associated with other NSAIDs.
      Gastrointestinal reactions occur most frequently in the form of abdominal pain or
      indigestion, nausea, or vomiting. Central nervous system adverse effects occur
      less frequently, and are followed in order of occurrence by rashes. CONCLUSIONS:
      Nabumetone is a prodrug metabolized to an active metabolite structurally related
      to naproxen. Studies have demonstrated the efficacy of nabumetone, but no
      advantages over the many other NSAIDs now available.

PMID- 8477125
TI  - Cetirizine: a new, nonsedating antihistamine.
AB  - OBJECTIVE: To introduce cetirizine, a nonsedating antihistamine, and discuss its
      mechanism of action, chemistry, clinical and comparative trials, and adverse
      effects. DATA SOURCES: An English-language literature search of MEDLINE was
      conducted. STUDY SELECTION: Human clinical trials were selected for evaluation.
      DATA SYNTHESIS: Cetirizine, an investigational agent and a potent histamine1
      antagonist is a piperazine derivative and carboxylated metabolite of hydroxyzine.
      As a second-generation, nonsedating antihistamine, cetirizine is associated with
      fewer adverse effects compared with first-generation antihistamines. It appears
      to be at least as effective as the other nonsedating antihistamines in the
      treatment of allergic rhinitis, chronic idiopathic urticaria, and pollen-induced
      asthma. The recommended adult dosage of this agent is 5 or 10 mg/d. CONCLUSIONS:
      Clinical studies indicate that cetirizine may be more beneficial in some ways
      than other available agents. Two of these advantages are a rapid onset of action
      and a once-daily dosing regimen. Future postmarketing surveillance is warranted
      to further document these findings.

PMID- 8477126
TI  - Stroke prophylaxis: hypertension management and antithrombotic therapy.
AB  - OBJECTIVE: To review trials involving risk factor management and pharmacologic
      therapy for the prevention of stroke. DATA SOURCES: English-language literature
      published between 1966 and 1992 was analyzed; pertinent literature is reviewed.
      STUDY SELECTION: Studies that evaluated the impact of risk factor management on
      prevention of vascular events were selected. In addition, trials assessing the
      safety and efficacy of pharmacologic intervention in primary and secondary stroke
      prevention were evaluated. DATA EXTRACTION: Trials were evaluated for their
      ability to demonstrate a decrease in stroke occurrence. DATA SYNTHESIS: Various
      trials were analyzed in several categories. Studies evaluating risk factor
      management of hypertension and cardiogenic cerebral emboli were reviewed and
      recommendations made based on a consensus of these trials. The use of
      antiplatelet agents in stroke prevention was addressed by a review of pertinent
      trials and meta-analyses. CONCLUSIONS: The control of risk factors and the use of
      antiplatelet agents significantly reduces the risk of vascular events. Benefit
      from different therapies may be specific to certain patient populations and
      recommendations are made for these patients.

PMID- 8477127
TI  - Vancomycin pharmacokinetics in neonates and infants: a retrospective evaluation.
AB  - OBJECTIVE: To evaluate the frequency with which current loading and maintenance
      vancomycin dosages achieve target serum concentrations based on pharmacokinetic
      parameters obtained after the initial dose. Also, to identify the daily
      vancomycin dosage necessary to achieve target serum concentrations at steady
      state and to determine if any relationships exist between vancomycin
      pharmacokinetic parameters and various patient characteristics. SETTING: Neonatal
      intensive care unit (NICU) at Georgia Baptist Medical Center. PATIENTS/METHODS:
      Twenty-three infants with suspected or documented gram-positive infection who
      received intravenous vancomycin between July 1990 and November 1991 were included
      in this retrospective analysis. Gestational age range from 23 to 41 weeks and
      postconceptional age (PCA) at the time of the study ranged from 26 to 46 weeks.
      Vancomycin therapy was initiated with a loading dose of 15 mg/kg, followed by a
      maintenance dosage of 20-30 mg/kg/d, which was usually given as 10 mg/kg q8-12h.
      All vancomycin doses were administered using a syringe pump. Peak and trough
      serum concentrations were obtained following the first dose. Vancomycin
      pharmacokinetic parameters were determined using a one-compartment model. Infants
      receiving indomethacin within two weeks prior to study were analyzed separately
      (group 2, n = 4). All other infants were included in group 1 (n = 19). RESULTS:
      For group 1, vancomycin clearance (Cl), volume of distribution (Vd), and half
      life were (mean +/- 1 SD) 0.072 +/- 0.032 L/kg/h, 0.52 +/- 0.08 L/kg, and 5.6 +/-
      1.6 hours, respectively. For both groups, loading doses provided 1-hour
      postinfusion peak concentrations of 25-35 mg/L in one of every two infants
      studied, whereas only three percent of initial maintenance doses were projected
      to provide desired peak and trough concentrations at steady-state. For group 1,
      the mean daily dosage necessary to provide target peak (25-35 mg/L) and trough (5
      10 mg/L) concentrations at steady-state was larger than that initially prescribed
      (29.6 +/- 13.1 vs. 22.2 +/- 4.7 mg/kg/d). For group 2, the mean daily dosage
      required to achieve target peak and trough concentrations at steady-state was
      smaller than that initially prescribed (14.8 +/- 4.3 vs. 20.0 +/- 0.1 mg/kg/d)
      and was exactly half of that required for group 1. Excellent correlations were
      observed between PCA and vancomycin Cl (L/h) (r = 0.92; p < 0.0001), body weight
      and Vd(L) (r = 0.94; p < 0.0001), body weight and vancomycin Cl (L/h) (r = 0.85;
      p < 0.0001), PCA and Vd (L) (r = 0.89; p < 0.0001), and body surface area and Vd
      (L) (r = 0.93; p < 0.0001) for group 1. Moderate correlations were also noted
      between PCA and Cl relative to body weight (L/kg/h), postnatal age and Cl
      (L/kg/h), and PCA and vancomycin dosage requirements (mg/kg/d). No linear
      correlation was observed between any patient characteristic and Vd standardized
      for body weight. CONCLUSIONS: Our data demonstrate the need for a more accurate
      method of estimating initial vancomycin dosage requirements in this NICU
      population. Although some of the relationships revealed in this study could be
      used to determine vancomycin dosage for infants in the range of approximately 30
      36 weeks PCA, we hesitate to suggest this approach presently because of the
      potential limitations of our study design. Further prospective study is needed to
      confirm these observations. In addition, further study is necessary to describe
      the time course of the interaction between vancomycin and indomethacin in infants
      with successful and unsuccessful closure of their patent ductus arteriosus.

PMID- 8477128
TI  - Prospective surveillance of imipenem/cilastatin use and associated seizures using
      a hospital information system.
AB  - OBJECTIVE: To develop computerized methods to monitor and recommend dosage
      changes for patients treated with excessive dosages of imipenem/cilastatin (I/C)
      and to determine the incidence of I/C-associated seizures in our patient
      population. DESIGN: Prospective observational and interventional study of all
      patients admitted to LDS Hospital and treated with I/C from May 1, 1987, through
      June 30, 1991. SETTING: LDS Hospital, Salt Lake City, UT, a 520-bed, tertiary
      care center associated with the University of Utah School of Medicine. PATIENTS:
      Using a hospital information system we developed computerized algorithms to
      identify and monitor patients receiving I/C. These algorithms screened the
      computer-stored medical records of all inpatient admissions for I/C prescription
      orders. Computer-decision support algorithms estimated the renal function of each
      I/C-treated patient and provided suggestions when dosages were determined to be
      excessive. Additional computer-generated alerts identified patients who were
      receiving anticonvulsants concomitantly with I/C or whose therapy reflected
      dosage changes in the previous 24 hours. A list of all I/C-treated patients with
      alerts was reviewed daily by a clinical pharmacist and prescribing physicians
      were contacted if the computer-generated suggestions were clinically relevant.
      MAIN OUTCOME MEASURE: The number and characterization of I/C-associated seizures.
      RESULTS: From May 1, 1987, through June 30, 1991, we prospectively monitored
      107,600 patients of whom 1951 were treated with I/C. The following risk factors
      for I/C-associated seizures were observed in the I/C-treated population: CNS
      disease (6 percent), seizure disorders (0.6 percent), and abnormal renal function
      (70 percent). The observational and interventional methods employed in this study
      resulted in 79 percent of the patients receiving I/C dosages appropriate for
      their corresponding renal function. During the 50-month study period, we detected
      four seizures (0.20 percent) in the I/C-treated patients. All 4 patients were
      receiving I/C dosages that were excessive with respect to their renal function.
      CONCLUSIONS: Our rate of seizure (0.2 percent) was lower than the 1-2 percent
      rate reported in the literature despite the fact that more than 70 percent of the
      patients who received I/C had risk factors for seizure. We believe that
      appropriate dosing of I/C results in a low rate of associated seizures. Computer
      assisted monitoring of I/C dosages in relation to renal function resulted in a
      reduced incidence of seizures.

PMID- 8477129
TI  - Therapeutic drug monitoring in ambulatory care.
AB  - There is a growing emphasis on developing ambulatory care services in an attempt
      to minimize healthcare costs through preventive medicine and outpatient
      therapeutic management. This creates an environment that can greatly benefit from
      a pharmacist-managed ambulatory TDM service. The implementation of a pharmacist
      managed TDM service can improve patient care, contain the cost of healthcare, and
      enhance the education of pharmacy/medical students and physicians. The
      opportunity exists for further development of clinical pharmacy services to
      positively influence patient care in the ambulatory care setting. This
      development, however, may be hindered by inadequate reimbursement for services
      and lack of documentation to support the beneficial impact of clinical pharmacy
      services on patient outcome. Methods of documenting clinical pharmacists'
      interventions and outcome must be developed in order to obtain reimbursement for
      these services.

PMID- 8477130
TI  - Triazolam and nitrazepam use in elderly outpatients.
AB  - OBJECTIVE: To determine adverse reactions and effects on sleep among three groups
      of patients: those taking triazolam, those taking nitrazepam, and a control
      group. DESIGN: Telephone interviews. PATIENTS: Forty-seven patients taking
      triazolam, 36 taking nitrazepam, and 40 control patients. All study participants
      were outpatients over 60 years of age. RESULTS: The rate of awakening in the
      middle of sleep was not significantly different among patients taking triazolam
      (61.7 percent) and those taking nitrazepam (69.4 percent). Incidence of nocturia,
      the primary reason for awakening, was not significantly different between
      triazolam- (36.2 percent) and nitrazepam-taking patients (41.7 percent). The rate
      of having difficulty falling back to sleep was significantly different among
      triazolam (62.1 percent) and nitrazepam (8 percent), and triazolam and control
      (11.1 percent) groups (p < 0.01). No difference was evident, however, between
      nitrazepam and control groups. CONCLUSIONS: Patients taking nitrazepam have less
      difficulty returning to sleep compared with those who take triazolam. Thus, for
      elderly patients who awaken because of nocturia, nitrazepam may be more
      appropriate therapy.

PMID- 8477131
TI  - Treatment of idiopathic thrombocytopenic purpura using a dose of immunoglobulin
      based on lean body mass.

PMID- 8477132
TI  - Reversible renal insufficiency following ketorolac therapy.

PMID- 8477134
TI  - Outcome and income.

PMID- 8477133
TI  - Weight gain induced by long-term propranolol treatment.

PMID- 8477135
TI  - Gender differences in pain and cardiovascular responses to forearm ischemia.
AB  - OBJECTIVE: To examine gender-related differences in pain and cardiovascular
      responses to forearm ischemia. DESIGN: Forearm ischemia was produced by the
      submaximal effort tourniquet procedure. Participants performed 2 min of dynamic
      hand exercise at 30% maximum grip strength. Forearm ischemia was maintained until
      the report of ischemic pain tolerance or until 20 min elapsed. Arterial blood
      pressure, heart rate, and verbal reports of ischemic pain were assessed at 2 min
      intervals. SUBJECTS: Thirty four male and 33 female participants of similar age.
      RESULTS: The times to ischemic pain onset and ischemic pain tolerance were
      similar for both male and female participants. However, during the ischemic
      period, females reported ischemic pain to be more intense and of greater
      unpleasantness than male participants. The relative changes in arterial blood
      pressure and heart rate during the exercise and occlusion period were equivalent
      for both male and female participants. In contrast, arterial blood pressure
      responses during the postexercise ischemic period were gender-dependent. Arm
      ischemia evoked pressor responses in male participants and either a decrease or
      no change in arterial pressure in female participants. Changes in arterial
      pressure during the postexercise ischemic period were significantly and
      positively correlated with verbal measures of ischemic pain for male subjects but
      not for female subjects. CONCLUSIONS: The data demonstrated that gender
      influences both the sensory and the cardiovascular responses to a tonic noxious
      stressor.

PMID- 8477136
TI  - Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled
      analgesia.
AB  - OBJECTIVES: We designed a clinical study to determine: a) the safety and efficacy
      of patient-controlled analgesia (PCA) therapy in children and adolescents
      undergoing major operations, b) if the use of a concurrent opioid infusion
      improved the efficacy of conventional PCA therapy, and c) if nurse control of the
      PCA device was a useful alternative in the intensive care unit (ICU) setting.
      DESIGN: Subjects were randomly assigned to receive morphine sulfate for
      postoperative pain relief via intermittent PCA boluses on demand or PCA plus a
      continuous infusion (PCA + CI). Children (n = 12) who were unable to use the PCA
      device because of inadequate development level or upper extremity weakness were
      assigned to a nurse-controlled analgesia (NCA) group. SETTING: In the ICU of a
      university-based pediatric teaching hospital. PATIENTS: Fifty-four children and
      adolescents underwent elective scoliosis surgery. INTERVENTIONS: The PCA devices
      were connected to the patient's i.v. catheter immediately after surgery. Morphine
      sulfate was administered on demand by either the patient or an ICU nurse for pain
      relief during the first 72 h after the operation. MAIN OUTCOME MEASURES: Pain
      scores were recorded simultaneously by both the nurse and the patient using
      standardized visual analog scales. Opioid analgesic usage, side effects, and
      therapeutic interventions were recorded by the ICU nurse. RESULTS: There were no
      differences between the PCA and PCA + CI groups with regard to morphine use, pain
      relief, side effects, or patient satisfaction. Nurses consistently underestimated
      their patient's level of pain, and children in the NCA groups received less
      morphine per kilogram than those who self-administered their own analgesic
      medication. CONCLUSIONS: Both PCA and NCA were safe and efficient methods of
      analgesic administration in the pediatric ICU setting. However, use of a
      concurrent opioid infusion with PCA therapy did not provide any clinically
      significant advantages over intermittent bolus doses of the analgesic medication
      after scoliosis surgery. For patients unable to use a conventional PCA device,
      NCA is an acceptable alternative for the management of acute pain in the ICU
      setting.

PMID- 8477137
TI  - The prediction of return to the workplace after Multidisciplinary Pain Center
      treatment.
AB  - The prediction of return to the workplace after Multidisciplinary Pain Center
      (MPC) treatment has become a major research area. To delineate the variables that
      predict this outcome, the authors reviewed 164 multidisciplinary variables
      studies. Of these, 79 addressed work as an outcome variable. Twenty-six studies
      attempted to identify patient variables predicting return to the workplace. These
      latter studies were critically inspected for eight methodological criteria: pain
      location, follow-up time interval, response percentage and follow-up method,
      return to work subcategorization, vocational movement, univariate vs.
      multivariate statistics, multi-colinearity and variance, and statistical
      treatment of dropouts. In addition, other disability studies besides those in the
      chronic pain area were reviewed for return to the workplace predictor variables.
      Of these 26 studies, only a few appeared to satisfy the criteria examined. In
      addition, many studies were in conflict with one another on whether a variable
      was predictive. The review of the nonchronic pain/disability prediction
      literature yielded a large number of potential predictors that related to the
      work area. It is unclear which variables or set of variables predict return to
      the workplace after MPC treatment. Chronic pain studies may be neglecting the
      work area as an important source of return to the workplace predictor variables.

PMID- 8477138
TI  - Pain-relevant support as a buffer from depression among chronic pain patients low
      in instrumental activity.
AB  - OBJECTIVE: This study examined the hypothesis that among chronic pain patients
      lacking participation in activities, perceived pain-relevant spousal support
      would act to compensate for a low level of social reinforcement and provide a
      buffer against depression. DESIGN: Hierarchical regression analyses were
      conducted to examine the relative and cumulative effects of support and activity,
      and their interactions, in the prediction of depression severity. SETTING: The
      study setting was a training and research oriented Veterans Administration
      Medical Center. PATIENTS: Participants were 105 married, male chronic pain
      patients evaluated for a comprehensive pain management program. MAIN OUTCOME
      MEASURE: Depression severity was measured by the Beck Depression Inventory.
      RESULTS: Three categories of activity, and perceived interference of pain
      accounted for significant proportions of the variance in depression severity
      scores beyond that accounted for by age and pain severity. Support was not
      predictive of depression. Interactions between interference and support, and
      between two of the specific activities and support added significantly to the
      prediction of depression. CONCLUSIONS: Results are consistent with a buffering
      model of social support in which perceived spousal support among chronic pain
      patients appears to moderate the potentially deleterious effects of a low level
      of activity.

PMID- 8477139
TI  - Behavioral management of chronic pain and excess disability: long-term follow-up
      of an outpatient program.
AB  - OBJECTIVE: To assess the overall efficiency of an outpatient behavioral
      rehabilitation program for excess disability and chronic pain and to describe the
      program staff, treatment components and outcomes in sufficient detail to
      facilitate comparison with similar programs. DESIGN: Eight-year follow-up study
      of patients referred and treated. SETTING: Outpatient primary care and
      multispecialty group medical practice. PATIENTS: 354 of 421 unselected patients
      referred for the behavioral management of excess disability, who completed the
      treatment program and participated in follow-up. INTERVENTIONS: 15-20 sessions of
      physical and occupational therapy, 5-10 sessions of biofeedback, and one or two
      family sessions all based upon behavioral techniques described by Fordyce and by
      Roberts. MAIN OUTCOME MEASURES: Questionnaires, including analog scales,
      administered before treatment and at 1, 6, 12, and 24 months posttreatment.
      RESULTS: Patients (n = 67) who dropped out did not differ systematically from
      those who participated (n = 354). The treatment program resulted in a marked and
      enduring reduction of pain, and a statistically and clinically significant
      improvement in patients' ability to function at work and in the home. Patients
      overwhelmingly endorsed the program. CONCLUSIONS: A brief, inexpensive,
      outpatient behavioral rehabilitation program for chronic pain and excess
      disability can achieve a clinically significant and lasting reduction of pain and
      improvement in function at work and at home.

PMID- 8477140
TI  - The effects of multidisciplinary pain management treatment on locus of control
      and pain beliefs in chronic non-terminal pain.
AB  - OBJECTIVE: To determine whether chronic pain patients' beliefs and attributions
      about pain control are amenable to change in a short-term inpatient
      multidisciplinary pain management program. DESIGN: Non-randomized consecutive
      sample with prospective, before-after treatment. SETTING: Pain-management,
      tertiary care center in a major U.S. city. PATIENTS: All adult patients (n = 50)
      who were treated in an inpatient multidisciplinary pain management center were
      contrasted with those of a control group of 46 adult patients who were treated in
      an outpatient pain center. OUTCOME MEASURES: Pain Locus of Control Scale, the
      Pain Beliefs and Perceptions Inventory, subjective pain intensity, and medication
      usage were measured before and after treatment. RESULTS: Statistically
      significant posttreatment changes were found for the treatment group, but not the
      control group. Patients who completed the inpatient pain management program
      reported significant decreases in subjective pain intensity despite
      discontinuation of narcotic analgesics. Patients in the treatment group showed an
      increased sense of personal control over their pain and substantial decreases in
      attributions of pain control to powerful others and chance. Patients in the
      treatment group also showed a significant reduction in their endorsement of the
      belief that their pain was a mysterious phenomenon. CONCLUSIONS: Chronic non
      terminal pain patients' beliefs about pain and attributions of pain control are
      amenable to change in a short-term inpatient multidisciplinary pain management
      program. These results suggest that an intensive multidisciplinary program
      involving psychotherapy might be more effective in treating chronic pain patients
      similar to those in this study than outpatient treatment without psychotherapy.

PMID- 8477141
TI  - Physical fitness in the management and prevention of chronic pain.

PMID- 8477143
TI  - Use of standardized notes on laser-printed labels for acute pain management
      rounds.

PMID- 8477142
TI  - Topical capsaicin and burning pain.

PMID- 8477144
TI  - In response to RSD article by Drs. Gibbons and Wilson.

PMID- 8477145
TI  - Postmenopausal breast cancer. Drug therapy in the 1990s.
AB  - In summarising current drug treatment strategies for postmenopausal women with
      breast cancer, it is essential to emphasise that we are dealing with a group of
      diseases that are treatable, and that appropriate treatment decisions will give
      longer disease-free intervals for patients with early breast cancer, and better
      control with better survival for patients with advanced (i.e. locally advanced
      and/or metastatic) disease. Women greater than 65 years of age have a predictably
      better response to hormone treatment versus women less than 65 years of age.
      Hormone treatment may, therefore, be considered as primary treatment or as
      adjuvant treatment after limited surgery. Hormone treatment is also the treatment
      of first choice for elderly patients with advanced disease. For middle-aged women
      (45 to 65 years of age), various patient factors are important in predicting the
      value of treatment. Estrogen receptor (ER) status is prognostic of survival
      irrespective of treatment. Patients with ER-positive disease have a better
      prognosis than those with ER-negative disease, both in the adjuvant setting and
      in the face of metastatic disease. This is because ER-positive tumours tend to
      grow slower. The availability of the serotonin type 3 (5-hydroxytryptamine;5-HT3)
      antagonists, which effectively control nausea and vomiting in most patients, make
      chemotherapy combinations more acceptable, and combination chemotherapy can more
      readily be considered as first treatment option both as adjuvant treatment and
      for treatment of advanced disease. For patients with organ metastases there is no
      doubt that combined chemotherapy treatment is indicated.

PMID- 8477146
TI  - Mental health in nursing homes. Perspectives on the use of medication.
AB  - Most elderly persons in nursing homes and residential care have mental disorders;
      up to 75% have dementia. Depression and behavioural problems are common. There
      are big differences between institutions in the proportion of residents
      prescribed psychotropic medication. A review of the literature suggests that
      antipsychotics and benzodiazepines are modestly effective in diminishing
      agitation in some dementing patients. Antidepressants may be underutilized, but
      clear guidelines about which depressed individuals should receive them are
      lacking. Attention should be given to ways of improving the environment within
      these homes, in order to relieve depression and anxiety, and to increase life
      satisfaction and self-esteem, before commencing psychotropic medication to deal
      with mental disturbances. Shortage of trained staff and inappropriate design of
      nursing homes are factors associated with behavioural disturbance in some cases.
      Special dementia care units are a desirable option for a minority of residents.
      Involvement of pharmacists and medical directors in monitoring effects, adverse
      side effects, possible interactions and appropriateness of medications in nursing
      homes is recommended.

PMID- 8477147
TI  - Drug-induced depression in the aged. What can be done?
AB  - Over 10% of medically ill elderly persons have concurrent major depression, and
      medical illness is the most influential stressor contributing to depression in
      old age. The contribution of prescribed medications to depression in the
      medically ill is poorly understood. Most information on drug-induced depression
      is derived from case reports; 43 classes of medications have been implicated,
      including reserpine, beta-blockers, levodopa, corticosteroids, and
      antipsychotics. However, large rigorously performed studies of some drugs,
      particularly antihypertensives, suggest that drug-induced depression is uncommon
      and idiosyncratic. There is no evidence that age is an independent risk factor
      for drug-induced depression. However, elderly persons are the largest consumers
      of prescribed drugs, and the burden of drug-induced depression is carried by the
      old. Because of the frequency of atypical presentations of mental disorders in
      the elderly, drug-induced depression is often misdiagnosed. Nevertheless, basic
      principles of geriatric medicine offer useful guidance to clinicians in
      evaluating the complex interrelationships between prescribed medications and
      depression. We recommend an approach that includes regular inquiry into the
      common symptoms of mood disorders, vigilance in assessing the contribution of
      drugs in their development, but scepticism in assessing a depressive episode as
      caused only by medication.

PMID- 8477148
TI  - Multicentre study of l-alpha-glyceryl-phosphorylcholine vs ST200 among patients
      with probable senile dementia of Alzheimer's type.
AB  - A multicentre, randomised, controlled study compared the efficacy of l-alpha
      glyceryl-phosphorylcholine (alpha GPC) and ST200 (acetyl-l-carnitine) among 126
      patients with probable senile dementia of Alzheimer's type (SDAT) of mild to
      moderate degree. Efficacy was evaluated by means of behavioural scales and
      psychometric tests. The results showed significant improvements in most
      neuropsychological parameters in the alpha GPC recipients. Improvements also
      occurred in the ST200 recipients but to a lesser extent. Tolerability was good in
      both groups. These positive findings require replication in larger, double-blind,
      longitudinal studies coupling clinical and biological determinations.

PMID- 8477151
TI  - On the nomenclature and classification of anti-asthma drugs.

PMID- 8477149
TI  - Nicardipine. A review of its pharmacology and therapeutic efficacy in older
      patients.
AB  - Nicardipine is a second generation dihydropyridine calcium antagonist which
      selectively inhibits vascular smooth muscle contraction. In elderly patients, the
      drug has demonstrated clinical efficacy in the management of hypertension, angina
      pectoris and ischaemia-related cerebrovascular disease. In particular,
      nicardipine effectively controls blood pressure in elderly hypertensive patients
      with or without coexistent disease. In noncomparative trials, a regimen
      containing nicardipine has been associated with an improvement of symptoms in
      hypertensive patients with concurrent coronary artery, cerebrovascular or
      peripheral vascular disease, while in essentially 'healthy' elderly hypertensive
      patients, nicardipine monotherapy has resulted in improved indices of mobility
      and cognitive function. As yet, however, there is no evidence that nicardipine
      (and/or other calcium channel antagonists) decreases cardiovascular morbidity and
      mortality in elderly patients, as has been demonstrated for more established
      antihypertensive therapies, namely diuretics and/or beta-blockers. The
      pharmacokinetic properties of nicardipine in elderly hypertensive patients appear
      to be similar to those in younger patients. The main adverse events associated
      with nicardipine in the elderly are related to the vasodilator properties of the
      drug and include pedal oedema, headache and flushing. However, the drug does not
      exacerbate spontaneous postural hypotension in the elderly, nor does it adversely
      affect the coronary artery disease risk profile, even in patients with type II
      diabetes mellitus. In summary, widespread clinical experience in the elderly
      indicates that nicardipine monotherapy or a regimen containing nicardipine is
      useful for the treatment of hypertension, particularly in patients with
      coexistent coronary artery, cerebrovascular or peripheral vascular disease.
      Nicardipine monotherapy has also demonstrated efficacy in angina pectoris and
      shown promise in the management of ischaemia-related cerebrovascular diseases,
      notably subarachnoid haemorrhage.

PMID- 8477150
TI  - Can thiazide diuretics be recommended routinely to reduce hip fracture risk?

PMID- 8477152
TI  - Comparison of a phospholipid-based protein-free surfactant and a natural bovine
      surfactant (SURVANTA) during pressure and volume-controlled ventilation in an
      improved rabbit fetus model.
AB  - During pressure- or volume-controlled ventilation different surfactant
      preparations were compared in an improved rabbit fetus model. Based on a self
      designed software program, this model enables on-line registration of lung
      mechanics and heart rate in up to ten fetuses. Using a commercially available
      bovine lung surfactant (SURVANTA) as standard, we compared animals treated with a
      protein-free surfactant preparation containing only phospholipids, PL
      (dipalmitoylphosphatidylcholine:palmitoyloleoylphosphatidylglycerol++ +,
      DPPC:POPG 70:30) plus palmitic acid (PA) with an untreated ventilated control
      group. During pressure-controlled ventilation the insufflation pressure (IP) was
      decreased and increased stepwise with and without positive end-expiratory
      pressure (PEEP). SURVANTA was significantly more potent than PL plus PA and both
      differed significantly from the untreated controls. With additional PEEP the
      differences between SURVANTA and PL+PA disappeared but the differences to the
      controls were still present. We found that, with additional PEEP, active natural
      surfactants lead to ECG-irregularities, which indicates that PEEP influences
      pulmonary and cardiovascular function and compromises the benefits of surfactant
      therapy. Also during volume-controlled ventilation SURVANTA was superior to PL+PA
      and the untreated controls. In order to raise the level of activity of pure PL
      mixtures to that of natural bovine surfactants, we suggest that a surface active
      protein (probably SP-C) must be added to such mixtures.

PMID- 8477153
TI  - Inhibition of leukotriene synthesis: new therapy in asthma?

PMID- 8477154
TI  - Effect of cromakalim on KCl-, noradrenaline- and angiotensin II-induced
      contractions in the rat pulmonary artery.
AB  - The effect of cromakalim on vascular reactivity was studied in rat isolated
      pulmonary arterial strips. Cromakalim (0.1-1 microM) inhibited contractions
      induced by low (20-30 mM) KCl concentrations in a concentration-dependent manner.
      It had no effect on those elicited by 60-100 mM KCl. However, a higher
      concentration of cromakalim (10 microM) slightly decreased (-5 to -10%) KCl
      efficacy. Contractions induced by noradrenaline (NA, 0.01-1 microM) and
      angiotensin II (AII, 0.5-50 nM) were reduced by cromakalim (0.1-10 microM). The
      maximal response to NA and AII was decreased by 54 +/- 6.4% and 70 +/- 5.8% (n =
      5), respectively, in the presence of 10 microM cromakalim. The inhibitory effect
      of cromakalim was not dependent on the presence of vascular endothelium. After
      blockade of calcium influx by verapamil (10 microM), cromakalim had no further
      effect on NA- and AII-induced contractions. Cromakalim (0.1-1 microM) had no
      effect on the amplitude of the transient contraction evoked by NA and AII in
      Ca(2+)-free solution. The inhibitory effect of cromakalim (1 microM) was reversed
      by glibenclamide (1-10 microM) and phentolamine (5-100 microM) which, however,
      did not alter the relaxant effect of verapamil (1 microM), papaverine (1 microM)
      or theophylline (1 mM). Contractions induced by NA and AII in the presence of
      tetraethylammonium (TEA, 10 mM) were also depressed by cromakalim. These results
      show that cromakalim is a potent anticonstrictor agent in the pulmonary
      circulation. As in other smooth muscles, its mechanism of action involves an
      interaction with potassium channels at the vascular smooth muscle cell membrane
      level.

PMID- 8477155
TI  - Relaxant effects of the potassium channel activators BRL 38227 and pinacidil on
      guinea-pig and human airway smooth muscle, and blockade of their effects by
      glibenclamide and BRL 31660.
AB  - The airways relaxant effects and mechanism of action of the potassium channel
      activators BRL 38227 and pinacidil have been compared in guinea-pig and human
      airways. BRL 38227 was a potent relaxant in guinea-pig isolated trachealis (IC50
      = 4.9 x 10(-7) M against spontaneous tone) and human isolated bronchi (IC50 =
      4.75 x 10(-7) M against histamine-induced tone) and was eight- and six-fold more
      potent respectively than pinacidil. The relaxant effects of both compounds were
      shown to be markedly attenuated by glibenclamide (10(-5) M) and BRL 31660 (10(-5)
      M), with the nature of the blockade being species/tissue dependent. Glibenclamide
      (20 mg/kg iv) also inhibited the protective effects of BRL 38227 (50
      micrograms/kg iv) and pinacidil (500 micrograms/kg iv) on histamine-induced
      changes in airways resistance and dynamic compliance in the anaesthetized guinea
      pig, although the effects were short-lived. That both BRL 38227 and pinacidil
      owed their relaxant effects to potassium channel activation was supported by
      their ability to stimulate 42/43K efflux from guinea-pig trachealis preloaded
      with the radiotracer at concentrations of 10(-7) - 10(-5) M and 10(-5) M
      respectively. Pretreatment with either glibenclamide (10(-5) M) or BRL 31660 (10(
      5) M) ablated the response to both compounds. These studies show that two
      mechanistically distinct potassium channel blockers, glibenclamide and BRL 31660,
      do not substantially differentiate between the actions of BRL 38227 and
      pinacidil, although differences do occur, particularly at high concentrations in
      vitro.

PMID- 8477156
TI  - Leukotrienes and histamine mediate IgE-dependent contractions of human bronchi:
      pharmacological evidence obtained with tissues from asthmatic and non-asthmatic
      subjects.
AB  - Isolated human bronchi were challenged with anti-human IgE or specific allergen.
      The mediators of allergic constriction were characterized by pharmacological
      interventions. Experiments were performed on more than 180 preparations obtained
      from 48 non-asthmatic subjects and on 44 bronchial preparations from six
      asthmatic subjects. Addition of antihistamines (mepyramine and metiamide) to the
      organ bath abolished the response to exogenous histamine, but failed to alter the
      dose-response relationship of the reaction to cumulative challenge with rising
      titres of anti-IgE. On the other hand, pretreatment with drugs which blocked the
      action (receptor antagonists FPL55712, L-648,051 and ICI 198,615) or formation
      (biosynthesis inhibitors: U-60,257 and MK886) of leukotrienes consistently
      resulted in clear-cut inhibition of the allergic constriction in bronchi from
      both asthmatic and non-asthmatic subjects. In the presence of the most effective
      inhibitors (ICI 198,615 and MK886), the response to anti-IgE was depressed by
      more than 60%. In contrast, the cyclooxygenase inhibitor indomethacin and the
      antagonist of platelet activating factor (PAF) WEB 2086, failed to alter the
      response, indicating that prostanoids and PAF do not mediate IgE-dependent
      constriction of human bronchi. After the leukotriene antagonist ICI 198,615 had
      rendered the bronchi insensitive to exogenous leukotrienes, the residual
      component of the contractile response to anti-IgE was completely abolished by
      addition of antihistamines. Similar abolition of the Schultz-Dale reaction in
      bronchi of two allergic asthmatic patients was noted when antihistamines were
      administered together with ICI 198,615 or MK886. In conclusion, the leukotrienes
      appear to be the major and singularly most important mediators of the
      contraction, whereas histamine accounts for its minor residual component.

PMID- 8477157
TI  - Lower body temperatures in infants delivered by caesarean section than in
      vaginally delivered infants.
AB  - Clinical experience suggests that infants delivered by caesarean section have
      difficulties maintaining normal body temperature during the first hours after
      birth. To test this hypothesis, body and skin temperatures were measured and
      compared in healthy full-term caesarean section and vaginally delivered newborn
      infants. The babies were studied during the first 90 min after birth. Axillary
      and skin temperatures were significantly higher in the vaginally delivered group
      than in infants delivered by caesarean section. Infants born by non-elective
      caesarean section were slightly warmer during the first 90 min after birth
      compared to infants born by elective caesarean section. There were no significant
      differences in temperatures between infants cared for in a cot as compared to
      those cared for in an incubator. An incubator creates a physical barrier between
      babies and parents and incubator care might cause parental anxiety. Thus the
      routine of putting healthy, full-term caesarean section infants in incubators can
      be abandoned from a thermoregulatory point of view.

PMID- 8477158
TI  - Antigen and antibody assays in the aetiological diagnosis of respiratory
      infection in children.
AB  - The diagnostic efficacy of two methods--demonstration of seroconversion in paired
      sera and detection of antigen in clinical specimens--was evaluated in 183
      children with respiratory syncytial, parainfluenza or adenoviral, or pneumococcal
      respiratory tract infection. Viral infection was diagnosed in 46 (37%) of the 125
      cases by antigen assay alone, in 36 (29%) by antibody assay alone and in 43 (34%)
      by both methods. In respiratory syncytial viral infections, antigen assays were
      more often positive than antibody assays; 80% of the cases were antigen positive
      and 63% solely antigen positive. In parainfluenza and adenoviral infections,
      antigen assays were not as useful; a positive result was seen in 59% and 44% of
      cases, respectively. Pneumococcal infection was diagnosed in 25 (30%) of the 84
      cases by antigen assay alone, in 54 (64%) by antibody assay alone and in only 5
      (6%) by both methods. Thus nearly all pneumococcal infections were diagnosed by
      only one method. The efficacy of antigen and antibody assay was clearly dependent
      on the age of the patients. In infants less than six months of age, nearly all
      (27 (90%)) of the 30 infections were diagnosed by antigen detection; 25 solely by
      antigen detection. In older patients, antigen and antibody assays supplemented
      each other. We conclude that antigen detection should be used as the primary
      method for the diagnosis of viral or pneumococcal respiratory tract infection. In
      infants, antigen detection is the only reliable method of microbial diagnosis. In
      addition, antigen detection is the method of rapid microbial diagnosis. In
      pneumococcal infections, the sensitivities of antigen detection methods are not
      sufficient; this is an important area for further research.

PMID- 8477159
TI  - Carnitine metabolites in infants with cystic fibrosis: a prospective study.
AB  - Acylcarnitine is low in cord blood in patients with cystic fibrosis, suggesting
      that fatty acid metabolism is disturbed in utero. Carnitine metabolites (total,
      free, short- and long-chain acylcarnitine) were measured prospectively in 23
      newly diagnosed infants with cystic fibrosis treated with a carnitine-containing,
      predigested formula for 6-12 months. Total (p < 0.002), free (p < 0.004), and
      long-chain (p < 0.001) plasma concentrations of carnitines were significantly
      less than controls (n = 48) at diagnosis. Total and free concentrations were
      corrected with nutritional management, whereas short- and long-chain
      acylcarnitines remained unchanged. By three years of age all plasma
      concentrations of carnitine metabolites were significantly less than controls
      despite a carnitine-containing diet. Urinary carnitine metabolites were increased
      at diagnosis and follow-up. The physiological significance of these observations
      in cystic fibrosis is unknown, but could be compatible with disturbed regulatory
      control with resultant increased utilization.

PMID- 8477160
TI  - Magnetic resonance and the diagnosis of short stature of hypothalamic-hypophyseal
      origin.
AB  - Magnetic resonance imaging was performed in 23 patients with short stature (7 had
      multiple pituitary hormone defect, 11 had isolated growth hormone deficiency and
      5 had normal variant short stature) to investigate if there is a relation between
      magnetic resonance findings and results of endocrine tests. Magnetic resonance
      imaging of patients with multiple pituitary hormone deficiency or with serious
      isolated growth hormone deficiency (growth hormone < 3 micrograms/l) revealed an
      interrupted pituitary stalk and ectopic neurohypophysis or a mass. In patients
      with less serious isolated growth hormone deficiency (growth hormone > 3
      micrograms/l) or with normal variant short stature, the technique revealed a
      normal or hypoplastic hypophysis. Magnetic resonance appears to be a useful
      second-level diagnostic tool in defining the type of alteration in growth defects
      of endocrine origin.

PMID- 8477161
TI  - Coronary risk factors in children of parents with premature coronary artery
      disease.
AB  - In order to assess the value of family history of premature coronary artery
      disease as a criterion for coronary risk factor screening, a group of 53 children
      with such a family history was selected. We determined various coronary risk
      factors in these children in comparison to 33 controls. Statistically significant
      differences were observed in apoprotein concentrations but not in concentrations
      of lipids, lipoproteins or glucose, or in blood pressure or body mass index. The
      ratio between apoprotein B and apoprotein AI was the best discriminator between
      the two groups. The predictive value of family history is more reliable for
      detecting abnormal apoprotein ratio than for detection of hypercholesterolemia.
      We conclude that if abnormal apoprotein levels during childhood are found to be a
      valued predictor of premature coronary artery disease, then family history of
      premature coronary artery disease can be used to select children for
      determination and assessment of their coronary risk.

PMID- 8477162
TI  - Energy and nutrient intakes in congenital heart disease.
AB  - Children with congenital heart disease may have significant growth retardation,
      which in part may be caused by insufficient dietary intake. Data on energy and
      nutrient intake were collected using a 14-day dietary record by weighing, in 22
      children with congenital heart disease (mean age 39 months, range 12-126 months),
      prior to corrective operation. When viewed in relation to actual weight, energy
      intake averaged 88% (SD 17%) of that recommended by the FAO/WHO/UNU. Energy
      intakes and weight SD scores were significantly correlated (r = 0.55, p < 0.01).
      Protein intake was generally high, and even sufficient to allow catch-up growth.
      The majority of the children did not meet the recommendations for iron, zinc,
      calcium, or vitamins D, E, C, B1 or B6. Parents should be advised to give their
      children vitamin/mineral supplements, and to supply extra energy to children with
      failure to thrive.

PMID- 8477163
TI  - Randomized trial of umbilical arterial catheter position: clinical outcome.
AB  - In order to determine if umbilical arterial catheter position affects the
      incidence of necrotizing enterocolitis, clinical outcome was analysed in 308
      infants whose umbilical arterial catheter had been randomly allocated to a high
      (n = 162) or a low (n = 146) position. Necrotizing enterocolitis was classified
      as suspected or confirmed; all renal, lower limb and local catheter complications
      were also recorded. High umbilical arterial catheters were in place for longer
      than low catheters, provided more samples and were removed as an emergency less
      often. Lower limb blanching and cyanosis were more common with low catheters.
      Eleven cases of confirmed necrotizing enterocolitis occurred in the "high" group
      and nine in the "low" group. One case of fatal aortic thrombosis was encountered
      in the high group. Positioning umbilical arterial catheters in a high position
      allowed longer functional use and did not increase the incidence of necrotizing
      enterocolitis.

PMID- 8477164
TI  - Cessation of smoking during pregnancy improves foetal growth and reduces infant
      morbidity in the neonatal period. A population-based prospective study.
AB  - All pregnant women in Uppsala county in 1987 were questioned on three different
      occasions about smoking habits, socio-demographic factors and obstetric history.
      After delivery, information was collected regarding their children. Twenty
      percent of the mothers continued to smoke during pregnancy, while 8% stopped
      smoking. The mean birth weight of infants of smokers was 3378 g and of non
      smokers 3589 g. The difference was significant (p < 0.001) and persisted after
      statistical adjustment for maternal age, parity and educational level. Perinatal
      morbidity (admission to the Department of Neonatology) was higher in the smoking
      group (11.4% versus 8.8%, p < 0.05). The proportion of infants with a birth
      weight less than 2500 g and that of small-for-gestational-age infants were 60%
      and 100% greater, respectively, in the smoking group. The mean birth weight and
      perinatal morbidity rate in infants of mothers who stopped smoking were almost
      identical to those in infants of non-smokers. Cessation of smoking improves
      foetal growth and perinatal health.

PMID- 8477165
TI  - Surfactant inhibition in experimental meconium aspiration.
AB  - Human meconium components were separated into a water-methanol soluble phase
      containing mainly proteins and bilirubin and a chloroform soluble phase
      containing free fatty acids, triglycerides and cholesterol. Various amounts of
      original meconium, the water-methanol soluble fraction or the chloroform soluble
      fraction were added to standard suspensions of porcine surfactant (Curosurf). In
      a pulsating-bubble or Wilhelmy-balance system, meconium and its subfractions
      inhibited surfactant activity, but the chloroform soluble fraction had the
      highest specific inhibitory activity. Original meconium in saline (130 or 65
      mg/ml) was instilled into the airways of ventilated near-term newborn rabbits
      (dose 6 ml/kg). Lung-thorax compliance was reduced by 38% in animals aspirating
      the higher dose and by 27% in the low-dose group. Histological sections showed
      intra-alveolar accumulation of fine meconium particles in experimental animals,
      but no plugging of larger airways. We conclude that respiratory failure from
      meconium aspiration may be mediated, in part, by inactivation of surfactant.

PMID- 8477166
TI  - One-sided high-frequency oscillating ventilation in the treatment of neonatal
      unilateral pulmonary emphysema.
AB  - We describe a preterm infant (31 weeks' gestation) with unilateral pulmonary
      emphysema. Bronchoscopy showed no bronchial obstruction. After 20 days of right
      sided high-frequency oscillating ventilation, the emphysema in the left lung had
      completely resolved and the patient could be extubated.

PMID- 8477167
TI  - Early treatment with nasal continuous positive airway pressure in very low-birth
      weight infants.
AB  - During 1988 and 1989, a regional cohort of 81 infants with birth weights less
      than 1501 g were treated with oxygen only (n = 11), early continuous positive
      airway pressure (CPAP) (n = 68) or mechanical ventilation from birth (n = 2). We
      used an easily applicable lightweight CPAP system with nasal prongs and a gas jet
      supplemented with ventilator treatment if necessary, but with conservative
      criteria for ventilator treatment with tolerance of high PCO2. A total of 65
      infants (80%) survived to discharge, 61 of whom were supported solely with CPAP
      or oxygen. Nineteen infants (26%) developed periventricular-intraventricular
      haemorrhage, but only 4 survivors (6%) developed prognostically significant
      bleedings grade 2-4. No survivors had bronchopulmonary dysplasia. Follow-up at 12
      39 months of age revealed definite disabilities in 6 (10%) and suspected
      disabilities in 2 of 62 long-term survivors. The results suggest that treatment
      by early CPAP with nasal prongs with tolerance of high PCO2 may be effective and
      lenient in most infants more than 25 weeks' gestation.

PMID- 8477168
TI  - Chronic lung disease of preterm infants in Finland is not associated with
      Ureaplasma urealyticum colonization.
AB  - The occurrence of Ureaplasma urealyticum and Mycoplasma hominis in the airways
      and the association of these microorganisms with chronic lung disease was studied
      in preterm infants with a gestational age less than 30 weeks. Tracheal aspirates
      from 49 preterm infants were cultured; 14 (29%) infants were positive for U.
      urealyticum, and 1 (2%) was positive for M. hominis. Of the 16 patients who
      developed lung disease, 6 (38%) were positive for U. urealyticum, while the
      expected number of Ureaplasma-positive patients in this group, based on the
      overall incidence of Ureaplasma, was 4.6. On the other hand, 8 patients were
      positive for U. urealyticum but did not develop chronic lung disease, nor did
      samples taken from 10 patients with chronic lung disease show any Ureaplasma
      growth. From these data we conclude that colonization of the airways with U.
      urealyticum has no significant role in the development of chronic lung disease in
      preterm infants in the Finnish (Caucasian) population.

PMID- 8477169
TI  - Urinary malondialdehyde concentration in preterm neonates: is there a
      relationship to disease entities of neonatal intensive care?
AB  - In a retrospective study, urinary malondialdehyde concentration in 45 preterm
      neonates (25-35 weeks' gestation) during their first month of life was measured
      by HPLC. Urine was collected on different days of life as a 3-h sample. The
      frequency of urine collection and measurement varied between one (n = 22) and
      seven times (n = 8) per child. The study group was divided into three categories
      according to birth weight: low-birth-weight infants (LBW) (n = 16), very low
      birth-weight infants (VLBW) (n = 17) and extremely low-birth-weight infants
      (ELBW) (n = 12). Urinary malondialdehyde concentration was highest in the ELBW
      group: 1.15 (0.66, 2.12) mumol/l (median and quartiles) versus 0.58 (0.34, 1.18)
      mumol/l in the VLBW and 0.60 (0.40, 1.06) mumol/l in the LBW groups (ELBW versus
      VLBW, p < 0.005; ELBW versus LBW, p < 0.02). In oxygen-treated neonates,
      significantly higher malondialdehyde values were found compared to those without
      supplementary oxygen (0.89 (0.48, 1.74) versus 0.58 (0.32, 0.89) mumol/l; p <
      0.005). Likewise, a higher malondialdehyde concentration was found in infants
      requiring mechanical ventilation (intermittent mandatory IMV or high frequency
      ventilation) compared to those breathing spontaneously (intermittent mandatory
      ventilation: 0.80 (0.42, 1.66); p > 0.05 and high frequency ventilation: 1.20
      (0.83, 2.13); p < 0.001 versus 0.57 (0.33, 0.88) mumol/l). Malondialdehyde
      concentrations correlated significantly with FiO2 values of the individual
      patients (r = 0.22; p < 0.02). Comparing urinary malondialdehyde concentrations
      in infants with and without bronchopulmonary dysplasia, a significantly higher
      malondialdehyde concentration was found in the former group (0.96 (0.51, 2.07)
      versus 0.60 (0.32, 0.98) mumol/l; p < 0.005)).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477170
TI  - Children of alcoholic parents.

PMID- 8477171
TI  - Nasal continuous positive airway pressure: experiences with a new technical
      approach.

PMID- 8477172
TI  - No evidence for seasonality of congenital hypothyroidism in The Netherlands.

PMID- 8477173
TI  - Growth hormone hypersecretion in Sotos' syndrome?

PMID- 8477174
TI  - A case of Burkitt's lymphoma presenting with digital ischaemia.
AB  - Paraneoplastic syndromes are rare in paediatric oncology. This report describes a
      four-year-old Cantonese child whose sole presenting symptom was acrocyanosis who
      was found to have Burkitt's lymphoma in association with the presence of positive
      antinuclear antibodies, antineutrophil cytoplasmic antibodies, antiendothelial
      antibodies and elevated serum immunoglobulin G concentrations. Digital ischaemia
      has not been described as a presenting symptom of Burkitt's lymphoma, although
      this association has been reported in 25 patients with other malignancies.

PMID- 8477175
TI  - Cardiovascular responses to various autonomic tests in males and females.
AB  - The results of cardiovascular autonomic reflex tests on 224 healthy, randomly
      selected subjects were analysed to study possible sex differences in the
      autonomic responses. The heart rate response to the Valsalva manoeuvre (Valsalva
      ratio) was greater in females over 50 years than in males of the same age (1.58
      +/- 0.34 vs. 1.44 +/- 0.30, p < 0.05). The heart rate response to deep breathing
      (E/I ratio) was higher in females under 50 years than in males under 50 years
      (1.37 +/- 0.17 vs. 1.34 +/- 0.18, p < 0.001). The diastolic blood pressure
      response to isometric handgrip was higher in males under 50 years than in females
      of the same age (p < 0.05). Although there were sex differences in the magnitude
      of the responses, the effect of age was similar in males and females and
      accelerated attenuation of the autonomic responses could not be demonstrated with
      increasing age. It can be concluded that significant sex differences exist in
      cardiovascular autonomic responses. The implication of such differences need
      consideration.

PMID- 8477177
TI  - Clinical autonomic research--looking back, and also ahead to 1993.

PMID- 8477176
TI  - Vascular and electromyographic responses evoked in forearm muscle by isometric
      contraction of the contralateral forearm.
AB  - There is controversy over whether isometric contraction of the forearm evokes
      vasoconstriction or vasodilatation in the muscles of the contralateral forearm.
      In the present study we have investigated in normal man, the effects of isometric
      contraction of one arm at 75, 50 and 25% maximum voluntary contraction (MVC) on
      arterial pressure, heart rate, blood flow and vascular resistance of the
      contralateral forearm and on electromyographic (EMG) activity recorded from that
      same arm with sensitive, surface electrodes. When EMG activity was not being
      recorded from the 'resting' arm, isometric contraction of the contralateral arm
      for 2 min evoked increases in arterial pressure and heart rate whose magnitudes
      were graded with % MVC and an increase in forearm blood flow and a decrease in
      forearm vascular resistance at 75, 50 and 25% MVC, indicating vasodilatation.
      Further experiments in which EMG activity was recorded from the 'resting' arm
      demonstrated that the decrease in forearm vascular resistance evoked by 75% MVC
      was associated with a substantial increase in EMG activity of the extensor and
      flexor muscles of that arm. By contrast, when forearm contraction was performed
      at 75% MVC whilst subjects viewed the EMG activity in the 'resting' arm on an
      oscilloscope and kept EMG activity minimal, vascular resistance increased in that
      arm, indicating vasoconstriction. Further, when subjects performed contraction at
      25% MVC whilst showing minimal EMG activity in the contralateral arm, vascular
      resistance in that same arm increased (from 78 +/- 16 to 124 +/- 29
      mmHg/ml/min/100 ml tissue). These results are discussed in relation to those of
      previous studies. We propose, that in normal man, isometric contraction of the
      forearm evokes primary vasoconstriction in the muscles of the contralateral
      forearm, but that this response may be overcome by muscle vasodilatation
      occurring secondary to unintended muscle contraction or as part of the alerting
      response to acute stress.

PMID- 8477178
TI  - Bronchodilator effects of oxitropium bromide, fenoterol, and their combination in
      normal subjects.
AB  - Oxitropium bromide is a quaternary anticholinergic compound based on the
      scopolamine molecule instead of atropine. The purpose of this study was to
      compare the bronchodilator effects of oxitropium, a beta 2-agonist fenoterol, and
      their combination, on basal bronchomotor tone in normal subjects. Partial flow
      volume curve (PEF25), was measured as an index representing bronchomotor tone.
      The cumulative dose-response curve of oxitropium bromide inhaled from a metered
      dose inhaler was determined in eleven normal subjects. Measurement of PEF25 was
      repeated every 1 h for 8 h after inhalation of oxitropium (200 micrograms),
      fenoterol (200 micrograms), their combination or placebo in six normal subjects
      in a randomized, single-blinded, placebo-controlled, cross-over manner. As the
      percentage increase in PEF25 by 200 micrograms of oxitropium (45 +/- 6%) was
      equivalent to nearly 80% of that by dose of 1,600 micrograms (58 +/- 8%), the
      dose of 200 micrograms is thought to be appropriate. The group mean percentage
      increase in the PEF25-time course curve was significantly greater after treatment
      with the combination than with placebo (p < 0.001) and fenoterol (p < 0.001) but
      not with oxitropium bromide, while the increase in PEF25 following the
      combination was significantly greater than that following oxitropium bromide
      after 2 and 3 h. These findings indicate that in normal subjects oxitropium has a
      powerful bronchodilator effect and that the addition of oxitropium to fenoterol
      caused greater bronchodilation in normal subjects.

PMID- 8477179
TI  - Double-blind placebo controlled randomized trial of indomethacin on urodynamic
      values measured by radionuclide imaging.
AB  - The effect of the prostaglandin synthetase inhibitor, indomethacin on urodynamic
      values measured by radionuclide imaging was studied in 17 men in a double-blind
      placebo controlled randomized trial. Measurements were made of voiding time, time
      for 50% emptying, average flow rate, ejection fraction, post-void residual urine
      volume, voided volume, and total bladder volume. Statistical analyses indicated
      no placebo-indomethacin differences between the two groups. Although
      prostaglandins are thought to contribute to the act of micturition by maintenance
      of bladder tone and contractility, our studies indicate that a standard dose of
      the prostaglandin inhibitor, indomethacin, did not affect the voiding component
      of bladder function. Patients need not discontinue prostaglandin inhibitors and
      other non-steroidal anti-inflammatory drugs with such effects prior to urodynamic
      testing.

PMID- 8477180
TI  - Comparison of the bronchodilator activities of oxitropium bromide, fenoterol, and
      their combination in patients with chronic obstructive pulmonary disease and
      bronchial asthma.
AB  - The effects of an antimuscarinic agent, oxitropium bromide (200 micrograms), a
      beta-2 adrenoceptor agonist, fenoterol (200 micrograms), and their combination,
      were compared in ten patients with chronic obstructive pulmonary disease and ten
      patients with bronchial asthma, in a placebo-controlled, single blind crossover
      trial. In patients with chronic obstructive pulmonary disease, oxitropium and
      fenoterol produced a significant and similar degree of bronchodilatation. The
      duration of the bronchodilator effect was 3 h after oxitropium and 4 h after
      fenoterol, respectively. The combination of oxitropium and fenoterol produced a
      significantly greater degree of bronchodilatation than either drug alone. The
      duration of bronchodilatation in combination was 7 h and was considerably longer
      than that of each drug alone. In patients with bronchial asthma, oxitropium and
      fenoterol also caused bronchodilatation. Their combination produced a
      significantly greater degree of bronchodilatation than when either drug was used.
      The duration of the bronchodilator effects were 5 h after oxitropium, 4 h after
      fenoterol and 5 h after the combination. We conclude that the combination of
      oxitropium and fenoterol causes greater bronchodilatation in patients with
      chronic obstructive pulmonary disease and bronchial asthma than when compared to
      each drug alone. In the former, the duration of bronchodilatation is additionally
      prolonged. These combination effects may be of value in the clinical management
      of these common respiratory disorders.

PMID- 8477181
TI  - The influence of aspirin on plasma and platelet catecholamine levels, and
      platelet function in normal man.
AB  - The aim of the study was to determine whether aspirin influences sympathoadrenal
      output in normal human subjects. Plasma and platelet adrenaline and noradrenaline
      levels were measured before and after chronic administration of oral aspirin (300
      mg per day for 7 days). Catecholamine concentrations measured immediately
      following aspirin did not differ from control (pre-treatment) values. Platelet
      noradrenaline and plasma adrenaline levels were, however, significantly increased
      2 weeks after cessation of treatment. Platelet TxB2 generation was significantly
      reduced following aspirin treatment indicating that platelet cyclooxygenase had
      been inhibited. Catecholamine concentrations did not correlate with TxB2
      generation. In vitro platelet aggregation induced by ADP, adrenaline and collagen
      was reduced after aspirin providing additional confirmation of cyclooxygenase
      inhibition. However, the in vivo markers of platelet function, beta-TG and PF4
      were unaffected. These data do not provide convincing evidence for an action of
      aspirin on sympathoadrenal outflow, either directly or via a prostaglandin
      (thromboxane) mediated effect, although this does not exclude a later, delayed
      effect. There was no evidence for interactions between thromboxane, catecholamine
      levels in plasma and platelets, and platelet function.

PMID- 8477182
TI  - Physical manoeuvres that reduce postural hypotension in autonomic failure.
AB  - A young female with autonomic failure is described. She successfully reduced the
      symptoms of orthostatic hypotension by application of physical manoeuvres like
      leg-crossing, bending forward and placing a foot on a chair. The beneficial
      effects of these manoeuvres can be explained by a small (10-15 mmHg) increase in
      mean arterial pressure to a level just sufficient to maintain adequate cerebral
      blood flow. The underlying common mechanism appears to be an increase of thoracic
      blood volume by translocation of blood from the vascular beds below the diaphragm
      to the chest. Instruction in these physical manoeuvres should be part of the
      management programme to reduce the disabilities arising from postural hypotension
      in patients with autonomic failure.

PMID- 8477183
TI  - Non-invasive continuous cardiovascular monitoring in the vasodepressor form of
      carotid sinus hypersensitivity--confirmation of its value.

PMID- 8477184
TI  - 1H and 15N resonance assignments and solution secondary structure of oxidized
      Desulfovibrio vulgaris flavodoxin determined by heteronuclear three-dimensional
      NMR spectroscopy.
AB  - Sequence-specific 1H and 15N resonance assignments have been made for all 145 non
      prolyl residues and for the flavin cofactor in oxidized Desulfovibrio vulgaris
      flavodoxin. Assignments were obtained by recording and analyzing 1H-15N
      heteronuclear three-dimensional NMR experiments on uniformly 15N-enriched
      protein, pH 6.5, at 300 K. Many of the side-chain resonances have also been
      assigned. Observed medium-and long-range NOEs, in combination with 3JNH alpha
      coupling constants and 1HN exchange data, indicate that the secondary structure
      consists of a five-stranded parallel beta-sheet and four alpha-helices, with a
      topology identical to that determined previously by X-ray crystallographic
      methods. One helix, which is distorted in the X-ray structure, is non-regular in
      solution as well. Several protein-flavin NOEs, which serve to dock the flavin
      ligand to its binding site, have also been identified. Based on fast-exchange
      into 2H2O, the 1HN3 proton of the isoalloxazine ring is solvent accessible and
      not strongly hydrogen-bonded in the flavin binding site, in contrast to what has
      been observed in several other flavodoxins. The resonance assignments presented
      here can form the basis for assigning single-site mutant flavodoxins and for
      correlating structural differences between wild-type and mutant flavodoxins with
      altered redox potentials.

PMID- 8477185
TI  - Sequence-specific 1H and 15N resonance assignments and secondary structure of GDP
      bound human c-Ha-Ras protein in solution.
AB  - All the backbone 1H and 15N magnetic resonances (except for Pro residues) of the
      GDP-bound form of a truncated human c-Ha-ras proto-oncogene product (171 amino
      acid residues, the Ras protein) were assigned by 15N-edited two-dimensional NMR
      experiments on selectively 15N-labeled Ras proteins in combination with three
      dimensional NMR experiments on the uniformly 15N-labeled protein. The sequence
      specific assignments were made on the basis of the nuclear Overhauser effect
      (NOE) connectivities of amide protons with preceding amide and/or C alpha
      protons. In addition to sequential NOEs, vicinal spin coupling constants for
      amide protons and C alpha protons and deuterium exchange rates of amide protons
      were used to characterize the secondary structure of the GDP-bound Ras protein;
      six beta stands and five helices were identified and the topology of these
      elements was determined. The secondary structure of the Ras protein in solution
      was mainly consistent with that in crystal as determined by X-ray analyses. The
      deuterium exchange rates of amide protons were examined to elucidate the dynamic
      properties of the secondary structure elements of the Ras protein in solution. In
      solution, the beta-sheet structure in the Ras protein is rigid, while the second
      helix (A66-R73) is much more flexible, and the first and fifth helices (S17-124
      and V152-L171) are more rigid than other helices. Secondary structure elements at
      or near the ends of the effector-region loop were found to be much more flexible
      in solution than in the crystalline state.

PMID- 8477186
TI  - Amino acid type determination in the sequential assignment procedure of uniformly
      13C/15N-enriched proteins.
AB  - Experiments and procedures are described that greatly alleviate the sequential
      assignment process of uniformly 13C/15N-enriched proteins by determining the type
      of amino acid from experiments that correlate side chain with backbone amide
      resonances. A recently proposed 3D NMR experiment, CBCA(CO)NH, correlates C alpha
      and C beta resonances to the backbone amide 1H and 15N resonances of the next
      residue (Grzesiek, S. and Bax, A. (1992) J. Am. Chem. Soc., 114, 6291-6293). An
      extension of this experiment is described which correlates the proton H beta and
      H alpha resonances to the amide 1H and 15N resonances of the next amino acid, and
      a detailed product operator description is given. A simple 2D-edited constant
      time HSQC experiment is described which rapidly identifies H beta and C beta
      resonances of aromatic or Asn/Asp residues. The extent to which combined
      knowledge of the C alpha and C beta chemical shift values determines the amino
      acid type is investigated, and it is demonstrated that the combined C alpha and C
      beta chemical shifts of three or four adjacent residues usually are sufficient
      for defining a unique position in the protein sequence.

PMID- 8477187
TI  - A general method for assigning NMR spectra of denatured proteins using 3D
      HC(CO)NH-TOCSY triple resonance experiments.
AB  - A general approach for assigning the resonances of uniformly 15N- and 13C-labeled
      proteins in their unfolded state is presented. The assignment approach takes
      advantage of the spectral dispersion of the amide nitrogen chemical shifts in
      denatured proteins by correlating side chain and backbone carbon and proton
      frequencies with the amide resonances of the same and adjacent residues. The 1H
      resonances of the individual amino acid spin systems are correlated with their
      intraresidue amide in a 3D 15N-edited 1H,1H-TOCSY-HSQC experiment, which allows
      the spin systems to be assigned to amino acid type. The spin systems are then
      linked to the adjacent i-1 spin system using the 3D H(C)(CO)NH-TOCSY experiment.
      Complete 13C assignments are obtained from the 3D (H)C(CO)NH-TOCSY experiment.
      Unlike other methods for assigning denatured proteins, this approach does not
      require previous knowledge of the native state assignments or specific
      interconversion rates between the native and denatured forms. The strategy is
      demonstrated by assigning the 1H, 13C, and 15N resonances of the FK506 binding
      protein denatured in 6.3 M urea.

PMID- 8477188
TI  - Contributions from hydration of carboxylate groups to the spectrum of water
      polypeptide proton-proton Overhauser effects in aqueous solution.
AB  - Nuclear Overhauser effects (NOE) were measured between water protons and protons
      of the glutamic acid side chain of the bicyclic decapeptide c-[Arg-Arg-Cys-Asn
      Ala-Glu-Ala-Cys-Lys-Gly] in aqueous solution. Positive NOEs were observed between
      the gamma CH2 group of Glu and the water resonance, with similar NOE intensities
      at pH 2.0 and pH 6.3 in both the laboratory frame and the rotating frame of
      reference. These results indicate that the residence times of the hydration water
      molecules near the side-chain methylene protons are shorter than 500 ps for both
      the charged form and the uncharged form of Glu, and hence comparable to the water
      residence times near uncharged amino acid side chains. Furthermore, this study
      shows that the acidic proton in protonated carboxylic acid groups is not likely
      to interfere with the observation of polypeptide-hydration water NOEs, which is
      in contrast to the hydroxyl protons of the side chains of serine, threonine and
      tyrosine.

PMID- 8477189
TI  - Detection of gene rearrangements in reactive lymphoid processes.
AB  - We report the immunohistologic and the genotypic analysis of lymph node biopsies
      from 23 cases of reactive processes, and two cases of atypical
      lymphoproliferations (AL). Clonal gene rearrangements were detected in 5 cases of
      proven reactive processes as well as in both AL, in which no signs of malignancy
      were detected during the phenotypic analysis. No patient, apart from the two AL
      cases, showed any progression to malignancy during a follow-up period of 28-43
      months after the initial biopsy.

PMID- 8477190
TI  - Long-term treatment of chronic myelogenous leukemia with different interferons:
      results from three studies.
AB  - 131 patients with Philadelphia (Ph') chromosome positive chronic myelogenous
      leukemia (CML) were treated with interferon (IFN) alpha or a combination of IFN
      alpha and IFN gamma. In study, 1, 13 not pretreated and 41 pretreated patients,
      48 in chronic phase disease, 6 in accelerated phase, received 4 x 10(6) U/m2 IFN
      alfa-2b initially. After achievement of hematologic remission, the individually
      minimum effective dose was used for maintenance. There was no response in acute
      phase disease. Of the 48 patients with chronic phase disease, 22 achieved a
      hematologic remission (HR), 13 a partial HR (PHR), and 13 did not respond (NR) to
      IFN. No major cytogenetic response occurred in these patients, but two patients
      achieved a major molecular response in Southern blots, whereas PCR tests were
      positive. In a further randomized study, CML patients without prior therapy were
      treated initially with 4 x 10(6) U/m2 IFN alpha alone (arm A) or in combination
      with 50 micrograms IFN gamma (arm B). For maintenance, the maximum tolerable dose
      of IFN alpha was given (up to 10 x 10(6) U/day). Thirteen patients in arm A (54%)
      and 14 (56%) patients in arm B achieved a HR, 7 patients (29%) in arm A and 6
      patients (24%) in arm B a PHR. No response could be induced in 4 patients (17%)
      of arm A and 5 patients (21%) of arm B. Major cytogenetic responses were observed
      in 5 (20%) patients of arm A and 5 patients (20%) of arm B. Major molecular
      responses were observed in 3 patients of arm A and 5 patients of arm B.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8477191
TI  - Increased risk of neurological relapse in acute lymphoblastic leukemias with high
      levels of cerebrospinal fluid thymidine kinase at diagnosis.
AB  - Cerebrospinal fluid thymidine kinase (CSF-TK) was measured at diagnosis in 62
      patients with acute lymphoblastic leukemia (ALL) without initial neurological
      manifestations, who achieved a complete remission after chemotherapy. During the
      follow-up period, 10 patients developed central nervous system (CNS) involvement.
      At the onset of the disease mean CSF-TK levels in these subjects were found to be
      significantly higher than those observed in patients without subsequent CNS
      complications. In particular, 7/10 (70%) of these patients who presented CSF-TK
      levels above the upper limit of normal (1.4 U/microliters) had evidence of a
      neurological relapse, while 49/52 (94.2%) of subjects with presenting CSF-TK
      levels of up to 1.4 U/microliters did not develop a neurological leukemic disease
      (p < 0.00001). The white blood cell count at diagnosis was significantly
      increased, but not directly correlated to CSF-TK levels, in the group with CNS
      involvement, while age, serum thymidine kinase levels and lactic dehydrogenase,
      FAB classification or immunophenotype were not different in patients with or
      without neurological relapse. In conclusion, increased levels of CSF-TK at
      presentation correlate with a high risk of subsequent CNS involvement in patients
      with responsive ALL.

PMID- 8477192
TI  - Myelomonocytic antigens are rarely expressed on B-lymphocytic leukemia cells.
AB  - In the light of recent observations reporting that B-lymphocytic leukemia (B-CLL)
      cells may express a variety of myelomonocytic antigens, 28 patients with B-CLL
      and B-leukemic lymphocytic lymphoma were studied for the presence of these
      antigens using monoclonal antibodies to detect CD13, CD33, CD15 and CD14.
      Analysis of immunofluorescence (IF) was carried out by two procedures; one which
      employed the standard conventional method of gating used in our laboratory for
      flow cytometry, while the other procedure increased the sensitivity of the
      analysis, by moving the marker for IF to the left, so as to widen the gate to
      include more cells with low IF. Using the conventional methodology, the mean
      proportion of cells considered positive was less than 3% for any of the 4 markers
      studied. In only a few patients were 5% or more of the B-CLL cells positive for
      some of the markers studied (3 patients with 6.2-11.3% CD13+; 2 with 6.0-9.6%
      CD14+, and one with 11.8% CD15+ cells). No case had more than 2.5% + CD33+ cells.
      The second procedure with a wider gate to enhance sensitivity for less positive
      cells, increased the number of positive cells for any of the markers in only 4
      patients. These results are contradictory to others reported recently, and some
      of the possible causes for this discrepancy are discussed. It is suggested that
      more useful data may be obtained if the level of staining intensity and patterns
      of positive staining are documented in the future.

PMID- 8477193
TI  - Functional differences of T cells in B-chronic lymphocytic leukemia.
AB  - B cell chronic lymphocytic leukemia (B-CLL) is a disease characterized by an
      accumulation of monoclonal lymphocytes of B cell origin. Although the neoplastic
      process involves the B lymphocyte compartment, phenotypic and functional defects
      within the T lymphocyte population implicate their possible role in the
      pathogenesis of the disease. We analyzed the functional and morphological
      integrity of T lymphocytes from the peripheral blood of 64 patients with B-CLL.
      The activation of B-CLL T cells after PHA stimulation was determined by measuring
      [3H]-thymidine incorporation, assessing cell numbers in parallel cultures, and by
      monitoring the lymphocyte subsets during 9 days of cultivation. Our results
      indicate the presence of three functionally different populations of T cells in
      the peripheral blood of B-CLL patients. We present evidence for an increased
      proliferative potential of T lymphocytes from a group of patients with B-CLL.

PMID- 8477194
TI  - Differentiation and growth modulation of myeloid leukemia cells by the protein
      kinase C activating agent bryostatin-1.
AB  - Bryostatin-1 (Bryo), a macrocyclic lactone of the sea water bryozoan Bugula
      neritina, is a potent activator of protein kinase C and was found to exhibit
      antineoplastic activity in several systems. We studied the effect of Bryo on
      differentiation and growth modulation of human myeloid leukemia cell lines and
      freshly explanted blood cells from patients with myeloid leukemia. Alterations at
      the molecular level and phenotypic changes triggered by Bryo were similar, but
      not identical, to those induced by phorbol esters. Bryo was able to inhibit
      cellular proliferation as evidenced by [3H]-thymidine uptake and induced
      morphological changes associated with monocytic differentiation. In studies using
      continuous cell lines, the glucocorticoid dexamethasone was unable to prevent the
      Bryo-induced growth inhibition or the induced phenotypic changes. However, in
      fresh myeloid blood cells dexamethasone attenuated these Bryo-triggered effects.
      Our own data taken together with reports from the literature reviewed here
      suggest the following conclusions: (i) Bryo, while lacking tumor promoting
      activity, is able to induce differentiation in maturation arrested leukemia
      cells; (ii) it exhibits selective antiproliferative properties in normal or
      malignant hematopoietic cells and supports growth of multipotent stem cells.
      These features might qualify Bryostatin-1 as a potential candidate for promising
      research and possibly for future clinical applications.

PMID- 8477195
TI  - Clinical spectrum of autoimmune haemolytic anaemia in patients with chronic
      lymphocytic leukaemia.
AB  - Autoimmune haemolytic anaemia (AIHA) is a frequent complication of chronic
      lymphocytic leukaemia (CLL). The course of AIHA in CLL is quite variable and
      unpredictable. We report 9 patients who showed three distinct clinical patterns.
      Three patients had a single episode of AIHA which responded rapidly to oral
      prednisolone. Three others had a relapsing course often associated with a rising
      lymphocyte count which responded to a combination of prednisolone and cytotoxic
      drugs. The remaining three patients showed very little response to either form of
      treatment and continued to have haemolytic anaemia for the remainder of their
      lives. Development of AIHA did not appear to be associated with any particular
      stage of the disease and only patients with the third type of AIHA seemed to have
      a short survival.

PMID- 8477196
TI  - Pure red cell aplasia following ABO mismatched marrow transplantation for chronic
      lymphocytic leukemia: response to antithymocyte globulin.
AB  - Pure red cell aplasia was observed in a 28 year old woman following a major ABO
      mismatched allogeneic bone marrow transplant for chronic lymphocytic leukemia. No
      evidence of red blood cell production was observed for more than one year
      following transplant despite the absence of high isohemagglutinin titers.
      Treatment with antithymocyte globulin resulted in prompt restoration of
      reticulocytosis. Therapy with antithymocyte globulin should be considered in
      these instances when red cell aplasia follows mismatched allogeneic marrow
      transplantation.

PMID- 8477197
TI  - Serum erythropoietin and circulating BFU-E in patients with multiple myeloma and
      anaemia but without renal failure.
AB  - In 30 patients with multiple myeloma (MM) and mild to moderate anaemia (mean Hb
      107 g/l, 95% confidence limit (CL) 102-113) but no evidence of renal failure
      (serum creatinine < 110 mumol/l), serum erythropoietin (EPO) showed significant
      inverse logarithmic correlation with the haemoglobin level (r = -0.57, p =
      0.001). The observed/expected ratio of log-EPO in patients with MM (mean 0.96, CL
      0.89-1.04) was similar to that of 119 subjects (mean 1.01, CL 0.96-1.05) with or
      without anaemia (mean Hb 116 g/L, CL 110-121) but without renal failure. The
      concentration of circulating erythroid progenitors (BFU-E) in 10 MM patients in
      plateau phase was significantly reduced (mean 0.70 x 10(5)/l of blood, CL 0.34
      1.06) compared to that of 8 normal controls (mean 3.57, CL 1.60-5.55, p = 0.011)
      In vitro sensitivity of the BFU-E to EPO in the patients with MM was comparable
      to that of the normal controls. It appears that in MM there is an appropriate EPO
      response to anaemia but even in the plateau phase the number of circulating BFU-E
      is reduced, reflecting a degree of marrow failure. However, the progenitors are
      normally sensitive to EPO in such patients, and therapeutic doses of EPO may
      correct the anaemia by a pharmacological rather than a physiological effect.

PMID- 8477198
TI  - Erythroleukemia and myelodysplastic syndromes: an historical appraisal and a
      personal view.

PMID- 8477199
TI  - Chronic myelomonocytic leukaemia (CMML)--a myelodysplastic or myeloproliferative
      syndrome?
AB  - Chronic myelomonocytic leukaemia (CMML), a disorder belonging to the group of
      myelodysplastic syndromes, has a number of peculiar features which raise the
      question as to whether it should be considered a distinct entity in its own
      right. The problems associated with its classification and diagnosis are
      discussed in this report using all currently available tools from clinical data
      to molecular genetics, including morphology, histology, cellular biology and
      cytogenetics. Three groups of patients can be identified (isolated monocytosis
      with a mild degree of dysplasia, severe cytopenia and the most frequent type with
      proliferative symptoms dominating the clinical picture). The latter group is
      close to atypical chronic myeloid leukaemia and perhaps these two entities should
      be regarded as a single one. Classification of the disease is further complicated
      by the possibility of evolution from one subgroup into another one and by the
      finding that CMML can also arise as a disorder secondary to other
      myeloproliferative (MPS) or myelodysplastic (MDS) syndromes. No specific marker
      of the disease has been identified by cytogenetics or molecular biology. Due to
      all these facts, we believe that CMML should perhaps be viewed more pragmatically
      by considering the use of prognostic factors that could at least help to define
      different groups of patients who may require different therapeutic strategies. We
      conclude that CMML is a heterogeneous syndrome with features of both MPS and MDS,
      encompassing primary and secondary stem cell disorders and varying widely in its
      clinical presentation. This heterogeneity should stimulate the search for
      reliable predictors of evolution which would allow a better definition of CMML
      subtypes based on prognostic factors.

PMID- 8477200
TI  - Therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia:
      possible use of interferon on the basis of some novel concepts.
AB  - Current understanding of molecular genetics enables the establishment of new
      categories based on pathogenesis. Philadelphia (Ph) chromosome-positive leukemia
      has been reclassified into two molecularly distinct subsets, and the
      leukemogenesis at the cell level might be linked to the molecular changes.
      Therefore, treatment for leukemia patients with Ph chromosome could be based on
      the molecular characteristics. In this review, we discuss the strategy of
      treating patients with Ph-positive acute lymphoblastic leukemia and the benefit
      of the combined modality of interferon and chemotherapy.

PMID- 8477201
TI  - Myelodysplasia, vasculitis and anti-neutrophil cytoplasm antibodies.
AB  - A cutaneous or systemic vasculitis occurs in myelodysplasia as well as in
      myeloproliferative and lymphoproliferative disorders. The most common lesion is a
      leucocytoclastic vasculitis, with neurological or joint involvement occurring
      less often. The vasculitis may appear contemporaneously with or precede the
      clinical onset of the blood dyscrasia. Occasionally the lesions respond
      dramatically to the use of steroids but in general, patients with vasculitis have
      a worse prognosis than those with uncomplicated myelodysplasia. Vasculitis and
      myelodysplasia appear together too often for the association to be coincidental
      and the vasculitis in most cases cannot be attributed to intercurrent infections,
      therapeutic agents or a pre-existing rheumatological disorder. While
      autoantibodies are frequently present in myelodysplasia, and ANA and anti
      neutrophil cytoplasm antibodies (ANCA) are found in other vasculitides, neither
      of these antibodies is associated with the vasculitis of myelodysplasia. There
      has however been one report of ANCA in Sweet's syndrome a non-vasculitic skin
      condition that also occurs in the myelodysplastic syndromes.

PMID- 8477202
TI  - Megakaryocytic ploidy in myelodysplastic syndromes.
AB  - The megakaryocytic ploidy was microfluorometrically measured in 12 normal
      controls and 15 myelodysplastic syndrome (MDS) patients using DAPI (4',6
      diamidino-2-phenylindole) staining after destaining of the Wright-Giemsa (WG)
      stain. MDS patients had slightly more immature megakaryocytes when compared with
      normal controls. The megakaryocytic ploidy distribution had a peak at 16N in
      normal controls, at 8N in the 11 of the 15 MDS patients, and at 4N in the
      remaining 4 patients, which is suggestive of impaired polyploidization in MDS
      patients. In MDS, micromegakaryocytes were shown not to be immature but much more
      impaired in polyploidization than non-micromegakaryocytes. However, there was no
      difference in the megakaryocytic ploidy pattern among the type of the
      modification of Feinendegen' classification in each case for both the normal
      controls and the MDS patients, suggesting that the megakaryocytic ploidy is
      probably determined at the maturation level of the megakaryoblasts or the
      precursor cells. The study of megakaryocytic ploidy before and after therapy in
      the case of refractory anemia with excess of blasts might suggest that the
      remission of MDS patients might be qualitatively different from that seen in
      acute leukemia patients. Furthermore, the DNA histogram of the megakaryocytes
      from one of the two MDS patients obtained by the new method, which is able to
      determine the amount of DNA in the immunologically identified megakaryocytes
      microfluorometrically, using the monoclonal anti-glycoproteins IIb/IIIa antibody
      on bone marrow smears, showed a shift towards small ploidy compared with those
      defined on the basis of WG staining. This finding indicates that the
      micromegakaryocytes or the megakaryoblasts which could not be identified
      morphologically can be identified immunologically.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8477204
TI  - Cisplatin-CBV with autologous bone marrow transplantation for relapsed Hodgkin's
      disease.
AB  - The use of high-dose cyclophosphamide, carmustine, and etoposide (CBV) with
      autologous bone marrow transplantation (ABMT) results in long-term disease-free
      survival of about 30% in patients with relapsed Hodgkin's disease. Laboratory and
      clinical data show that cisplatin is synergistic with etoposide and carmustine,
      with non-overlapping extramedullary toxicity. Twenty-one patients with relapsed
      Hodgkin's disease that had progressed after both MOPP-like and ABVD-like regimens
      were treated with CBV plus cisplatin (90 mg/m2) and ABMT. The CR rate was 55%;
      the three-year disease-free and overall survival were 29% and 38% respectively;
      these results are comparable to prior experience with CBV. Performance status was
      strongly correlated with achievement of CR, survival, and time to treatment
      failure. Nephrotoxicity was seen in 3 patients, and ototoxicity in 1 patient.
      Although cisplatin could be added to CBV with minimal additional toxicity, the
      results obtained in this small patient population were not better than those of
      the earlier regimen. A larger trial in patients not previously exposed to
      cisplatin may better define the role of its addition to CBV.

PMID- 8477203
TI  - The rationale of therapy with mitoxantrone in non-Hodgkin's lymphoma. The Non
      Hodgkin's Lymphoma Co-operative Study Group, (NHLCSG) Italy.
AB  - In order to evaluate the role of Mitoxantrone in the therapy of non-Hodgkin's
      lymphoma (NHL) (intermediate-high grade malignancy) a series of successive phase
      II-III studies were performed in a multicenter cooperative group. The first phase
      II study consisted of Mitoxantrone alone administered at 14 mg/m2 i.v. on day 1
      and repeated every 3 weeks for six times. Fifteen refractory or relapsed patients
      (pts) entered the study, and an overall response of 54% (CR 4 pts, PR 4 pts) was
      obtained. 7 pts progressed or remained stable disease (NR). The second phase II
      consisted of Mitoxantrone in combination with Etoposide and Prednisone (VeMP).
      Twenty pts were treated and a complete remission (CR) of 50% with 1 partial
      remission (PR) were obtained with an overall response of 55%. The third phase II
      study consisted of 13 pts with refractory or relapsed disease treated with
      Mitoxantrone, Cis-platinum, Etoposide and Prednisone (CEMP); an overall response
      of 62% was obtained with an acceptable toxicity. This was not superior to other
      conventional salvage regimens. On this background a phase III study with VEMP
      (Etoposide, Cyclophosphamide, Mitoxantrone, Prednisone) was started as first line
      therapy for pts presenting one or more of following criteria: Performance Status
      (P.S.) 2-3, aggressive histology at stage I-IIE or advanced stage in old pts, low
      grade histology with B-symptoms stage in III-IV, age over 65 years. Until now 64
      pts entered this study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477205
TI  - Is recombinant human erythropoietin treatment in myelodysplastic syndromes
      worthwhile?
AB  - It has been recently demonstrated that erythropoietin increases the haemoglobin
      levels in anemia secondary to chronic renal failure. Moreover some recent
      experiences also suggested a possible role in the treatment of MDS. From April
      1990 to April 1992, 23 patients (16 males and 7 females, median age 63.5 years)
      affected with low risk myelodysplastic syndrome (MDS) were treated with
      recombinant human erythropoietin (rHuEPO) to ameliorate Hb levels and
      transfusional requirement. All patients received high doses of rHuEPO (800 U/Kg
      weekly s.c. in 2-3 divided doses, for 3 months). A complete remission, defined as
      stable normalization of Hb level, was achieved in 1/23 patients. This patient had
      refractory anemia, by FAB criteria. A partial response, defined as stable
      increase of Hb levels > or = 1 g/dl and/or reduction of transfusional requirement
      > or = 50% lasting at least 3 months, was achieved in 7/23 patients. Patients
      with a partial response received rHuEPO at increased dosages (1200 U/Kg weekly
      s.c. 2-3 times): 1/7 achieved a complete response, 4/7 remained stable and 2/7
      decreased to pre-therapy Hb value. These results suggest that rHuEPO may be a
      promising therapeutic tool for some MDS patients.

PMID- 8477206
TI  - Host tumor infiltrating lymphocytes in B cell non-Hodgkin's lymphomas.
AB  - Tumor-infiltrating T lymphocytes (TIL-T) were quantitated by three color flow
      cytometry in cell suspensions from excisional biopsy specimens of 43 B cell non
      Hodgkin's lymphomas (NHL) and 8 benign lymphoid hyperplasias (BLH) to identify
      potential differences in host T cell responses. We quantitated three TIL-T
      subsets: CD3+CD4+CD8- (helper-inducer), CD3+CD4-CD8+ (suppressor-cytotoxic) and
      CD3+CD25-HLADr+ (long term activated TIL-T) and compared them in three diagnostic
      groups: BLH, low grade B cell NHL (LG NHL) and intermediate-high grade B cell NHL
      (IG-HG NHL). The following results were obtained: Mean percentage +/- s.e. of
      activated TIL-T for BLH, LG-NHL and IG-HG NHL: 10.3 +/- 1.9, 23.2 +/- 4.6 and
      38.8 +/- 9.5, respectively. Mean percentage +/- s.e. of suppressor-cytotoxic TIL
      T for same groups: 13.9 +/- 1.5, 14.9 +/- 1.9 and 34.4 +/- 4.5, respectively.
      Mean percentage +/- s.e. of helper-inducer TIL-T cells for the same groups was
      38.2 +/- 12.7, 32.1 +/- 7.2 and 22.5 +/- 4.6, respectively. Helper/suppressor
      ratio +/- s.e. for same groups was 3.0 +/- 1.1, 2.4 +/- 0.6 and 1.3 +/- 0.4,
      respectively. Activated and suppressor-cytotoxic TIL-T percentage progressively
      increased from BLH toward IG-HG NHL. The percentage of these two TIL-T subsets
      were significantly higher in IG-HG NHL than in BLH and LG-NHL (P < 0.0007,
      0.0002, 0.0001 and 0.0260 for the comparisons TIL-T in BLH vs IG-HG NHL and LG
      NHL vs IG-HG respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477207
TI  - Cytolytic (TIA-1+) tumor infiltrating lymphocytes in B cell non-Hodgkin's
      lymphomas. SWOG Central Repository Members.
AB  - TIA-1 is a monoclonal antibody (mAb) that identifies cytolytic cells. We studied
      eleven B cell non-Hodgkin's lymphomas (NHL) of low grade, eleven B cell NHL of
      intermediate-high grade, and 10 benign lymphoid hyperplasias (BLH) to investigate
      potential differences in the number of host cytolytic tumor infiltrating
      lymphocytes (TILs). Frozen sections were immunostained with TIA-1 mAb and the
      number of immunoreactive cells (TIA-1+) per mm2 of tissue was quantitated within
      reactive or neoplastic lymphoid follicles or random areas of diffuse NHL. The
      number of TIA-1+ cells/mm2 was significantly higher in intermediate and high
      grade B cell NHL than in low grade NHL or BLH with means +/- se of 1377.8 +/-
      173, 866.2 +/- 92.3 and 774.1 +/- 76.2, respectively (p < 0.0183 and p < 0.0125).
      There was no significant difference between BLH and low grade NHL. The increased
      number of TIA-1+ TILs in B cell NHL of intermediate and high grade suggests the
      possibility of a host cytolytic immune response versus the tumor. Paradoxically,
      B cell tumors of worst biological outcome contained more cytolytic TILs.
      Functional defects of host cytolytic TILs in NHL patients should be investigated
      in future studies.

PMID- 8477208
TI  - Treatment of extrahepatic portal venous obstruction.

PMID- 8477209
TI  - Amphotericin B in resistant kala-azar in Bihar.
AB  - BACKGROUND: During the recent epidemic of kala-azar in Bihar, we identified a
      group of patients who were unresponsive to the two commonly used drugs--sodium
      stibogluconate and pentamidine. We evaluated the use of amphotericin B in these
      patients because it has been shown to be active in experimental animals against
      amastigotes and promastigotes, it has been found to be useful in South American
      patients and is now recommended by the World Health Organization as a second line
      drug. METHODS: We selected 300 patients who were unresponsive to sodium
      stibogluconate and pentamidine (out of 500 patients with kala-azar confirmed by
      demonstration of Leishmania donovani bodies in their splenic aspirates).
      Amphotericin B was given in a dose of 1 mg/kg body weight on alternate days
      starting with 0.05 mg/kg body weight with daily increments till a 1 mg dose was
      reached. A total dose of 20 mg/kg was given initially and repeated if the
      parasites persisted. The investigations done before and after treatment were
      splenic or bone marrow aspiration, measurement of the spleen and liver size, body
      weight, total and differential white cell counts, haemoglobin level, total serum
      protein, blood urea, serum creatinine, serum potassium, blood sugar, serum
      alanine and aspartate transaminase, electrocardiography and a chest X-ray. The
      efficacy of treatment was assessed at the end of treatment and after 6 months of
      follow up. RESULTS: After treatment with amphotericin B, 298 (99%) of the
      patients had been cured of their disease as evidenced by the disappearance of
      fever, reduction of hepatosplenomegaly, clearance of the parasites from the
      spleen and bone marrow and an absence of relapse on 6 months of follow up. Two
      hundred and sixty-eight (89%) patients required 1 g of the drug, 24 (8%) required
      1.5 g and 6 (2%) required 2 g. All patients had shivering and fever during the
      infusion. Two had a cardiac arrest from which they could not be revived. Other
      complications included anorexia, stomatitis, jaundice, hypokalaemia and a rise in
      blood urea. However, these were only mild and improved after treatment was
      stopped. CONCLUSION: Amphotericin B is an effective drug for patients with kala
      azar unresponsive to treatment with sodium stibogluconate and pentamidine, but it
      should be administered under close medical supervision.

PMID- 8477210
TI  - Community health awareness among recent medical graduates of Bombay.
AB  - BACKGROUND: Since Independence in 1947, the need for reorientation of our western
      style, hospital-based, urban-oriented medical education has been well recognized
      and much discussed but little action has been taken to make it more community
      based. Against a background of 40 years of debate, we conducted a study of 342
      medical graduates commencing their internship training in one government and two
      municipal medical colleges to assess the effects of medical education on them.
      METHODS: A questionnaire was administered to examine recent interns' awareness of
      some aspects of community health, their perceptions of the concept of Primary
      Health Care and their knowledge of rational prescriptions for minor ailments and
      for major illnesses of public health importance. RESULTS: We found a lack of
      basic health information among recent medical graduates, an apathy towards
      matters of public health importance, and gaps in their knowledge of curative care
      and rational prescribing. CONCLUSION: We suggest that there is a need not only to
      effect changes in the curriculum but also to assess whether these changes might
      lead to the making of doctors more suited to work in our villages.

PMID- 8477211
TI  - Tropical pulmonary eosinophilia in an Orissa village.
AB  - BACKGROUND: Tropical pulmonary eosinophilia is usually seen in areas endemic for
      filariasis. It affects only a small proportion of the population at risk and
      microfilaria are rarely demonstrated in the peripheral blood. The actual
      prevalence of the tropical pulmonary eosinophilia syndrome has not been
      previously studied in an area endemic for filariasis. METHODS: We screened the
      population of a village in the Puri district of Orissa, where filarial infection
      is endemic, to determine the prevalence of tropical pulmonary eosinophilia by
      clinical examination measuring the absolute eosinophil counts, performing a chest
      X-ray and examining the stools for the presence of the parasite. Sera from
      symptomatic cases who had an eosinophil count above 2000 per cmm were further
      tested for filarial specific IgG and total IgE and the results compared with
      control sera obtained from 15 age- and sex-matched normal individuals. RESULTS:
      We were able to screen 1754 (91%) out of 1918 villagers who were more than 5
      years old and found 69 cases who had typical clinical features of tropical
      pulmonary eosinophilia. Only 6 (0.34%) of these had eosinophil counts above 3000
      per cmm and were considered to have the disease. Only 2 of the 6 had associated
      filarial lesions, one had microfilaraemia and 3 had typical chest X-ray changes.
      The mean (+/- SD) titres for filaria specific IgG (0.355 +/- 0.315 v. 0.120 +/-
      0.092) and total IgE (0.455 +/- 0.316 v. 0.114 +/- 0.075) were significantly
      higher in cases with tropical pulmonary eosinophilia than in control subjects.
      The level of eosinophilia was related neither to the patients' immune status nor
      to the severity of the radiological lesions. All cases recovered after therapy
      with diethylcarbamazine. CONCLUSION: Tropical pulmonary eosinophilia is not
      uncommon in this community in Orissa where filariasis is endemic. However, the
      syndrome is rarely associated with clinical filarial lesions.

PMID- 8477212
TI  - Antibiotics in febrile neutropenia: a randomized prospective comparison of two
      combinations.
AB  - BACKGROUND: Problems of initial empirical antibiotic therapy in febrile
      neutropenia are further complicated by other factors such as cost and the pattern
      of infective organisms in a particular institution. We, therefore, conducted a
      randomized study comparing the efficacy of two sets of antibiotics which differed
      in their spectrum of action, availability and price. METHODS: Sixty episodes of
      febrile neutropenia in 40 patients who were not on any prophylactic antibiotics
      were randomized into one of two arms--cefotaxime and gentamicin or ciprofloxacin
      and gentamicin. Depending upon the response by 72 hours, they were crossed over
      to the other arm or continued with the same combination. Empirical antifungal
      therapy was added in those who did not become afebrile. RESULTS: Infection was
      documented either clinically, bacteriologically or radiologically in 42% of the
      febrile episodes. The commonest organism isolated was Klebsiella and the
      commonest organism producing bacteraemia was the Staphylococcus. The temperature
      was reduced to normal without cross-over in 53% of the febrile episodes with
      cefotaxime and gentamicin and in 60% with ciprofloxacin and gentamicin (p >
      0.05). After cross-over the temperature came down in 30% of the episodes with
      cefotaxime and gentamicin (initial combination) and 40% with ciprofloxacin and
      gentamicin (initial combination; p > 0.05). The overall response rate without
      empirical antifungal therapy was 83% in the patients on cefotaxime and gentamicin
      (initial combination; p > 0.05). While both the arms of the study had a 100%
      response rate, there was no significant difference between the efficacy of the
      antibiotic combinations. The ciprofloxacin-gentamicin combination is one-third as
      expensive as cefotaxime-gentamicin and is more readily available. CONCLUSION: We
      recommend the use of ciprofloxacin and gentamicin as the initial drug combination
      and cefotaxime and gentamicin only when the former is not effective.

PMID- 8477213
TI  - The immunohistochemistry of solid tumours: potential problems for new
      laboratories.
AB  - Immunohistochemistry has become an important tool for tumour typing and has the
      potential to improve the histopathological diagnosis of neoplasms. However, the
      large number of publications on the different aspects of the technology are often
      contradictory. In many instances the immunochemical reactions may not be
      reproducible and can create problems in the diagnosis of certain tumours. The use
      of optimal materials and techniques enhance the sensitivity, specificity and
      reproducibility of these methods. In this article we discuss the common problems
      of tissue preparation, and antigenic variation, distribution and presentation.
      However, immunopathological diagnosis has to be accompanied by an in-depth and
      fundamental understanding of basic immunochemistry and diagnostic
      immunohistochemistry has to be interpreted in the context of a standard clinical
      and histopathological examination.

PMID- 8477214
TI  - Inhaled corticosteroids in childhood bronchial asthma.

PMID- 8477215
TI  - Standard-dose and high-dose epinephrine in cardiac arrest.

PMID- 8477216
TI  - 'Cannabis-induced psychosis' may obscure paranoid schizophrenia.

PMID- 8477217
TI  - Adverse drug interactions.

PMID- 8477218
TI  - The bioavailability of drugs.

PMID- 8477219
TI  - The Maharashtra Medical Council.

PMID- 8477220
TI  - Letter from Ethiopia.

PMID- 8477221
TI  - Organ transplants: time to buy and sell?

PMID- 8477222
TI  - Letter from Glasgow.

PMID- 8477223
TI  - The transplantation of human organs bill 1992.

PMID- 8477224
TI  - Scientific dishonesty in Indian Biomedical Research.

PMID- 8477225
TI  - Supreme court judgment on self-financing colleges.

PMID- 8477226
TI  - Prejudice against reservation.

PMID- 8477227
TI  - The tragedy of needless pain.

PMID- 8477228
TI  - Observing the brachial artery through a pressure cuff.
AB  - A technique is described which enables ultrasonic imaging of the brachial artery
      whilst pressure is applied via a pressure cuff. This involves a new instrument--a
      sphygmomanometer, which uses water as opposed to air as the pressure medium, in
      order to permit ultrasonic imaging through the cuff. The technique was found to
      be acceptable in the clinical setting, and gave a measurement of the systolic
      blood pressure which correlated with the conventional cuff measurement in eleven
      elderly subjects (r = 0.89, p < 0.001). The technique should have an important
      role to play in studying the origin of differences which occur between direct and
      indirect blood pressure measurements.

PMID- 8477229
TI  - Development of a neural network screening aid for diagnosing lower limb
      peripheral vascular disease from photoelectric plethysmography pulse waveforms.
AB  - An artificial neural network (ANN) was trained to classify photoelectric
      plethysmographic (PPG) pulse waveforms for the diagnosis of lower limb peripheral
      vascular disease (PVD). PPG pulses from the lower limbs, and pre- and post
      exercise Doppler ultrasound ankle to brachial systolic blood pressure ratio
      measurements were obtained from patients referred to a vascular investigation
      laboratory. A single PPG pulse from the big toe of each leg was processed and
      normalized, and used as input data to the ANN. The ANN outputs represented the
      diagnostic classifications (normal, significant PVD and major PVD) and the ANN
      was trained with the ankle to brachial pressure indices (ABPI). The ANN structure
      consisted of an input layer (50 neuron units from the PPG pulse input), a single
      hidden layer (15 neurons) and an output layer (3 neurons for the PVD diagnoses).
      The back-propagation learning algorithm was used to train the ANN for 500 epochs
      with a PPG training set of pulses from 100 legs. Test data for network assessment
      comprised pulses from a further 50 legs (20 normal and 30 PVD, of which 15 were
      categorized as having major disease). A network sensitivity of 93% and
      specificity of 85% was achieved with respect to the Doppler ABPI standard, giving
      a diagnostic accuracy of 90%. The results of this study indicate that a neural
      network can be trained to distinguish between PPG pulses from normal and diseased
      lower limb arteries. The simplicity of PPG measurement and neural network
      classification holds promise for the screening of lower limb arterial PVD.

PMID- 8477230
TI  - A comparison of methods for estimating left ventricular volumes from radionuclide
      ventriculography.
AB  - An accurate reproducible measurement of left ventricular volume is important in
      the evaluation of cardiac disease. Four methods of left ventricular volume
      measurement by radionuclide ventriculography have been compared and their
      reproducibility assessed in a patient group. The methods studied were a geometric
      method, a method based on count data alone and two methods which require a blood
      sample and an estimate of ventricular depth. The accuracy of absolute volumes is
      difficult to determine due to the lack of a 'gold standard'. The method using
      count data alone was found to give reproducible results. Volumes can be
      calculated quickly and easily from data acquired in a standard radionuclide
      ventriculogram. End systolic volumes calculated using this method clearly
      separated normal and abnormal patient groups.

PMID- 8477231
TI  - A system for monitoring temperature distribution in bed and its application to
      the assessment of body movement.
AB  - For the assessment of body movements during sleep, a system for monitoring the
      temperature in bed was developed. The system consists of 16 temperature sensors
      and a data logger with a memory card. Fifteen of the temperature sensors were
      arranged in line 6 cm apart on a flat cable. The temperatures at these 15 points
      in the bed, and the room temperature measured by the additional sensor, were
      stored on the memory card at predetermined intervals. The data were transferred
      into a microcomputer and analysed. Changes in posture and body movement were
      recognizable from the changes in the temperature profile, and well visualized
      using a three-dimensional display of the successive temperature profiles in the
      bed. The time of body movement was estimated from the derivative of the
      temperature profile. Comparison between this estimation and the video recording
      showed good agreement. The linear arrangement of the sensors provides a high
      resolution temperature profile during sleep.

PMID- 8477232
TI  - Digital fundus imaging using a scanning laser ophthalmoscope.
AB  - While many systemic diseases have ophthalmic manifestations with visible
      pathological features affecting the fundus, diabetic eye disease is of particular
      interest. There are many advantages in using digital image analysis to quantify
      the extent of retinal pathology in diabetes particularly to monitor its
      progression. However, the usual method of imaging involves photographing the
      retina using a fundus camera. Not only does this require that the photographs be
      digitized prior to analysis, but the resulting illumination across the image is
      non-uniform and this creates problems in digital image analysis. This paper
      describes the construction of a scanning laser ophthalmoscope interfaced to a
      computer, which has a number of significant advantages for digital retinal
      imaging. Firstly, it has better uniformity of illumination than the fundus camera
      and operates at much lower light levels. Secondly, it permits imaging at various
      wavelengths with no consequent degradation in image quality; in particular, the
      value of imaging at infrared wavelengths to give greater tissue penetration is
      demonstrated. Finally, by introducing the capability for confocal imaging,
      tomographic images can be taken, improving the perceptibility of features
      situated deep in the retina. Typical images are shown to demonstrate the
      potential of this instrument.

PMID- 8477233
TI  - Review of seven cardiac electrophysiology stimulators.
AB  - Seven cardiac electrophysiology stimulators from four manufacturers (Biotronik,
      Bloom, Digitimer and Medtronic) in common current use are reviewed. The
      stimulators differ in the features provided and the design adopted to achieve
      these features. The number of output channels ranges from one to four, the number
      of extra-stimuli available ranges from two to six, and these can be delivered as
      a variety of sequences. Some of the stimulators (Digitimer and Bloom) are modular
      while others (Biotronik and Medtronic 532 series) are of an integrated design
      comprising a single physical unit. The design of the Medtronic EP-2 has both
      integrated and modular characteristics. The features of the stimulators
      associated with input, output, control and the user interface are specifically
      reviewed. The features are also compared against the published recommendations of
      the American Heart Association. In addition, a summary of stimulator user
      comments from a number of electrophysiology centres is presented. All of the
      stimulators fulfil, or are close to fulfilling, basic electrophysiological
      requirements, but some provide more complex facilities such as would be required
      by specialist centres.

PMID- 8477234
TI  - The direct measurement of glomerular filtration rate from the continuous
      monitoring of DTPA clearance.
AB  - A method of measuring glomerular filtration rate is proposed, intended for use
      during gamma camera renography and involving the continuous monitoring of DTPA
      activity in blood, a single blood sample, and a urine collection. Data obtained
      from experiments using a CsI scintillation detector are presented and used to
      demonstrate the validity of the method. In a comparison with a direct measurement
      of renal clearance of DTPA the proposed method showed an average overestimate of
      13% compared to an overestimate of 30% for an uncorrected single-compartment
      model calculation of filtration rate. Some limited data using a gamma camera to
      monitor the DTPA activity in blood are also presented.

PMID- 8477235
TI  - [Migration of cells from neocortical transplants].

PMID- 8477236
TI  - [Preliminary results in the use of the binemic structure of human chromosomes].

PMID- 8477237
TI  - [Primary structure of the triple block RNA genes of the Plantago asiatica mosaic
      virus].

PMID- 8477238
TI  - [A phototested chemical sensor element based on a field transistor].

PMID- 8477239
TI  - The magic of surgery.

PMID- 8477240
TI  - Intraoperative evoked potentials: an overview.
AB  - Over the past decade the application of neurophysiologic monitoring techniques
      has been a major factor in decreasing the incidence of neurologic dysfunction
      following orthopedic, vascular, and neurosurgical operations. This article
      focuses on the common neurophysiologic monitoring modalities and their basic
      intraoperative applications.

PMID- 8477241
TI  - Use of vasoconstrictors in anesthesia.
AB  - The increased use of local anesthetic procedures in the busy operating room (OR)
      environment both within a hospital setting and for outpatient procedures has made
      it increasingly important for all those who provide health care during the
      perioperative period to become familiar with these local anesthetic agents. The
      use of vasoconstrictor agents in combination with local anesthetic solutions is
      discussed, including their pharmacology, dosage, side effects, and
      contraindications to their use. Also noted are important anesthetic drug
      interactions with vasoconstrictor agents as they are used in combination with
      local anesthesia and general anesthetic agents.

PMID- 8477242
TI  - Regional anesthesia: considerations for the perioperative nurse.
AB  - Recent literature suggests that regional anesthesia can improve outcome and
      decrease hospital stay and costs. Through a better understanding of regional
      anesthesia, the perioperative nurse specialist can be an invaluable asset to both
      the patient and anesthesiologist. This article discusses the indications and
      limitations of the more common regional anesthetic techniques.

PMID- 8477243
TI  - Anesthetic considerations for neonatal and infant patients.
AB  - Selected topics in anesthesia that are intended to assist the perioperative nurse
      in caring for the neonate and infant during surgery are addressed in this
      article. Issues discussed include airway management, physiological differences
      between infants and adults, fluid management, and monitoring.

PMID- 8477244
TI  - Malignant hyperthermia: perioperative considerations.
AB  - In no situation is perioperative patient advocacy more important than when a
      smoothly running case is interrupted by an episode of malignant hyperthermia
      (MH). An understanding of the demographics, manifestations, and clinical
      interventions can enable the perioperative nurse to respond in an appropriate
      manner.

PMID- 8477245
TI  - General anesthesia: what the perioperative nurse needs to know.
AB  - General anesthesia represents a critical experience for the surgical patient. The
      implications of general anesthesia for perioperative nursing care are extensive
      and complex. The surgical patient's needs require the perioperative nurse to
      possess knowledge of the basic principles of general anesthesia and its
      complications.

PMID- 8477246
TI  - Conscious sedation: implications for perioperative nursing practice.
AB  - Administration of intravenous conscious sedation is one of the many issues facing
      perioperative nurses. This article explains in detail the implications conscious
      sedation holds for perioperative nurses. Topics covered include the use of
      pharmacological agents, nonpharmacological interventions, and acquisition of
      monitoring skills.

PMID- 8477247
TI  - Assistive personnel in the perioperative setting: changing the paradigm.

PMID- 8477248
TI  - Anesthesia pharmacology for general endotracheal anesthesia.
AB  - The multiple of pharmacological agents and the proliferation of new anesthetic
      drugs make it incumbent on the perioperative nurse to keep abreast of those areas
      of pharmacology that impact on their care of the surgical patient. This article
      provides relevant information about agents used in a general anesthetic
      technique. Included is the pharmacodynamics of induction agents, skeletal muscle
      relaxants, inhalation agents, and opioids.

PMID- 8477249
TI  - My orthopedic mentor.

PMID- 8477250
TI  - Industry's contribution to quality orthopedic care.
AB  - The orthopedic industry complies with strict manufacturing standards when
      producing orthopedic implants. Adherence to these standards assures the surgeon,
      nurse, and patient of the highest quality implants both in their material
      composition and in their manufacturing processes so that the maximum benefit can
      be achieved from the surgical procedure.

PMID- 8477251
TI  - Infection prevention and management in orthopedic surgery.
AB  - With all the technological advances made in orthopedic surgery over the years,
      infection remains the most prevalent postoperative complication. Nationwide
      figures from the American College of Surgeons demonstrate an infection rate in
      orthopedic surgery between 5% and 7% for clean cases. The minimum infection rate
      is 1%. The important principle to remember is that there is no substitute for
      strict adherence to standard, well-known aseptic surgical techniques for all
      surgical procedures.

PMID- 8477252
TI  - Postoperative care of the orthopedic patient.

PMID- 8477253
TI  - Malignancies of the musculoskeletal system.
AB  - Malignant bone tumors (sarcomas) are uncommon but diverse in presentation and
      biological behavior. Major advances in diagnostic imaging, histologic evaluation,
      operative strategies, and adjuvant therapies have contributed to limb-sparing
      surgical procedures and improved patient survival rates.

PMID- 8477254
TI  - Sports medicine: anterior cruciate ligament injuries.
AB  - Newer techniques in anterior cruciate ligament surgery and accelerated
      rehabilitation has significantly altered the recovery process as well as the
      degree of functional recovery and the long-term prognosis. In most cases full
      recovery can be expected within 6 to 12 months following injury. Although great
      emphasis is placed on rapid progress in physical therapy and rehabilitation, it
      is also important to provide the necessary emotional support during this period
      of disability and altered functional state.

PMID- 8477255
TI  - The shoulder: common clinical problems.
AB  - The diagnosis and management of shoulder pain presents a challenge to health care
      professionals. Shoulder problems affect the quality of life for many people by
      impacting on activities of daily living and on job performance. For these people
      a variety of treatment modalities, including surgery, exist. This article
      presents an overview of common shoulder problems and some of the nonsurgical and
      surgical treatment modalities that can be used to relieve these problems.

PMID- 8477256
TI  - Laser applications in orthopedics.
AB  - The use of lasers has made a significant impact on surgery. Various types of
      lasers are available for use in orthopedics. A successful laser program
      identifies perioperative considerations, applications/modalities, and
      reimbursement issues. As this technology expands, more clinical applications will
      be utilized.

PMID- 8477257
TI  - Recovery and banking: allograft bone.
AB  - Orthopedic surgeries often require bone grafts to replace lost bone. When using
      the patients own bone is not an option--by choice or dictated by the type or
      quantity of preferred graft material--bone from a tissue bank may be the answer.
      A call is made and the order is placed. However, bone grafts are not manufactured
      like metal implants; they were once a part of a living human being. This article
      explains the special role tissue banks perform in providing bone and connective
      tissue grafts.

PMID- 8477258
TI  - Standardization and management of orthopedic implants.
AB  - Because the price of orthopedic implants has soared to astronomical heights, and
      insurance companies are paying less for surgical procedures, institutions must
      find ways of decreasing their costs and reducing their overhead. In the operating
      room the orthopedic nurse manager can be instrumental in reducing the amount of
      implant inventory by collecting and reporting data concerning shelf life of
      implants and coordinating new product trials and evaluation periods to decrease
      the number of implant systems to one or two.

PMID- 8477259
TI  - Molecular basis of type I (tyrosinase-related) oculocutaneous albinism: mutations
      and polymorphisms of the human tyrosinase gene.
AB  - Type I (tyrosinase related) oculocutaneous albinism (OCA) results from mutations
      of the tyrosinase gene on chromosome 11q that lead to reduced or absent melanin
      pigment synthesis. The phenotype of Type I OCA is broad, ranging from a total
      lack to only a moderate reduction of melanin, and the phenotypic variation is
      associated with different mutant alleles at the tyrosinase locus. A total of 36
      mutations have been identified in Type I OCA including 24 missense, 4 nonsense,
      and 8 frameshift mutations. The majority of affected individuals have been
      compound heterozygotes with different maternal and paternal alleles. Six
      polymorphic sites for haplotype analysis have been identified in the tyrosinase
      gene including 2 in the promoter region, 2 in the coding region associated with
      alternative amino acids in the protein, and 2 RFLPs in the first intron.

PMID- 8477260
TI  - Detection of more than 94% cystic fibrosis mutations in a sample of Belgian
      population and identification of four novel mutations.
AB  - We have analysed 194 Belgian CF chromosomes using a variety of techniques: delta
      F508 was detected by polyacrylamide gel electrophoresis; dot blotting of PCR
      products was used to identify the mutations G542X, 1717-1 G-->A, and N1303K;
      molecular defects in exons 2, 3, 4, 5, 6b, 7, 11, 12, 13, 14a, 14b, 17b, 19, 20,
      and 21 were screened for by DGGE. We identified 17 mutations, which accounted for
      94.3% of the Belgian CF chromosomes. Four novel mutations and a novel
      polymorphism were characterized. The detection of such a high proportion of
      Belgian CF mutations is important in understanding the functional role of the
      molecule and in improving prenatal and genetic diagnosis of CF.

PMID- 8477261
TI  - Temperature sensitivity of aberrant RNA splicing with a mutation in the G+5
      position of intron 37 of the gene for type III procollagen from a patient with
      Ehlers-Danlos syndrome type IV.
AB  - A single-base mutation in intron 37 of the gene for type III procollagen (COL3A1)
      was found in a proband with the type IV variant of Ehlers-Danlos syndrome. Probe
      protection experiments with S1 nuclease and RNA from fibroblasts incubated at 37
      degrees C demonstrated that about 35% of the total mRNA or about 70% of the mRNA
      from mutated allele was spliced by exon skipping. The effects of the mutation
      were temperature-sensitive in that the amount of RNA from the mutated allele that
      was spliced by exon skipping was 87.1 +/- 7.7% at 31 degrees C, 70.1 +/- 6.5% at
      37 degrees C, and 85.4 +/- 11.1% at 42 degrees C. The effects of temperature on
      aberrant RNA splicing were, therefore, the reverse of those reported for four
      previous mutants in collagen genes. The increase in abnormal RNA splicing when
      the temperature was raised from 31 degrees to 37 degrees C seen with previously
      reported mutants suggested that RNA-RNA hybridization of U1snRNA to the 5'-splice
      site in the substrate may be limiting in the processing of transcripts from the
      mutated alleles, since RNA-RNA hybridizations become less favorable at higher
      temperatures. The decrease in abnormal RNA splicing seen here when the
      temperature was raised from 31 degrees to 37 degrees C suggested that protein-RNA
      or protein-protein binding steps become rate limiting with the G+5 mutation in
      intron 37 of the COL3A1 gene.

PMID- 8477262
TI  - Identification of mutations in Danish choroideremia families.
AB  - We have searched for mutations in the choroideremia gene (CHM) in patients from
      12 Danish families in which CHM is segregating. Employing polymerase chain
      reaction (PCR), single strand conformation polymorphism (SSCP) analysis, and
      direct DNA sequencing, different mutations have been identified in 6 patients.
      All the mutations will interfere with the correct translation of the mRNA
      predicting a truncated protein or no gene product at all.

PMID- 8477263
TI  - Molecular characterization of beta-thalassemia in Egyptians.
AB  - We sought to determine the spectrum of mutations producing beta-thalassemia in
      Egypt using genomic PCR and a variety of mutation-screening procedures. Thirty
      four beta-thalassemia and three Hb S/beta-thalassemia patients originating from
      different regions of Egypt were studied, and the causative mutation was found in
      69 of 71 (97%) beta-thalassemia genes. Four mutations accounted for 78% of beta
      thalassemia genes in this population; IVS-1, nt 110 (41%), IVS-1 nt 6 (13%), IVS
      1, nt 1 (13%), and IVS-2, nt 848 (11%). The latter allele, a C-A mutation at the
      third nucleotide of an acceptor site consensus sequence, has been described
      previously only in one Egyptian, one Iranian, one Tunisian, and one Black
      American patient. Nine other alleles each accounted for 1-3% of beta-thalassemia
      genes. Among these was one codon 27 allele (Hb Knossos), two frameshift 106/107
      alleles previously seen only in a Black American, and a rarely observed mutation
      in the distal promoter region of the beta-globin gene, -87 (C-A). Our results
      suggest that from a molecular genetic standpoint a beta-thalassemia prevention
      program based on carrier screening and prenatal diagnosis can be implemented in
      Egypt. In couples at risk for beta-thalassemia, the causative mutation should be
      identifiable in both members in 92% and in one member in the remaining 8%.

PMID- 8477264
TI  - Deletions with inversions: report of a mutation and review of the literature.
AB  - Herein we report a 10.9 kb deletion and a 95 bp inversion in a patient with
      severe hemophilia B (factor IXHB209). With the addition of factor IXHB209, three
      of six characterized deletions in the factor IX gene are now known to include
      inversions. A high frequency of combined deletions and inversions has not
      previously been described in a human gene.

PMID- 8477265
TI  - Detection of point mutations in the p53 gene: comparison of single-strand
      conformation polymorphism, constant denaturant gel electrophoresis, and
      hydroxylamine and osmium tetroxide techniques.
AB  - A comparison was made between the 3 most commonly used techniques for the
      detection of point mutations: single-strand conformation polymorphism (SSCP),
      constant denaturant gel electrophoresis (CDGE), and hydroxylamine and osmium
      tetroxide used in amplification mismatch cleavage analysis (HOT). Using human DNA
      samples containing known mutations in the p53 gene, SSCP detected 90% of
      mutations (18/20), CDGE detected 88% (15/17) pre-decoding of the samples but 100%
      when the mutations were known and the CDGE conditions optimized, and the HOT
      technique was 100% accurate, although 1 mutation was missed through careless
      examination of the gel. The positive and negative aspects of each of the
      techniques are considered and suggestions are made regarding the particular
      situations in which each of them is most useful.

PMID- 8477266
TI  - A rapid and reliable PCR method for genotyping the ABO blood group.
AB  - The ABO blood group has been used extensively as a marker in population studies,
      epidemiology, and forensic work. However, until the cloning of the gene, it was
      not possible to determine the genotype of group A and B individuals without
      recourse to family studies. We have developed a method to determine the ABO
      genotype directly from human DNA using multiplex PCR and restriction enzyme
      analysis. Two PCR fragments spanning positions 258 and 700 of the cDNA sequence
      are amplified. The site at position 258 allows us to differentiate the O allele
      from the A and B alleles. The site at position 700 allows us to distinguish the B
      allele from the A and O alleles. Analysis at the two sites thus allows us to
      distinguish the three alleles. The multiplex PCR product is digested separately
      with four enzymes, two for each of the sites. The pair of enzymes for each site
      cut in a reciprocal fashion. Whereas one enzyme for each site is theoretically
      sufficient for genotyping, the use of complementary pairs of enzymes prevents the
      assignment of a false genotype as a result of false negative or partial
      digestion. This method is fast and reliable, does not rely on probing of blots,
      and should be widely applicable.

PMID- 8477267
TI  - A deletion/insertion mutation in the IDUA gene in a Libyan Jewish patient with
      Hurler syndrome (mucopolysaccharidosis IH).

PMID- 8477268
TI  - G6PD "campinas:" a deficient enzyme with a mutation at the far 3' end of the
      gene.

PMID- 8477269
TI  - Sexual abuse and eating disorders: a review.
AB  - Studies investigating a possible relationship between sexual abuse and eating
      disorders have reported highly discrepant results. Some variability can be
      accounted for by methodological issues including diagnostic criteria, study
      design, and assessment techniques. The heterogeneity of an eating disordered
      population, especially regarding the comorbidity of eating pathology and
      personality disorder, is also a factor. Overall results suggest that around 30%
      of eating disordered patients have been sexually abused in childhood, a figure
      that is relatively comparable to rates found in normal populations. For some
      patients there may be a direct link between sexual trauma and eating pathology,
      but in general sexual abuse is best considered a risk factor in a biopsychosocial
      etiological model of eating disorders. Complex associations between trauma, self
      regulatory deficits, and psychopathology require further research.

PMID- 8477270
TI  - Demographic and clinical correlates of selective information processing in
      patients with bulimia nervosa.
AB  - Demographic and clinical correlates of interference with color-naming words
      related to eating, weight, and shape were investigated in 75 patients with
      bulimia nervosa. Interference with color-naming was related to two measures,
      overall level of psychiatric symptoms and frequency of purging. Multiple
      regression analysis showed that frequency of purging, and not level of general
      psychiatric symptoms, was the best predictor of interference. Thus, as would be
      predicted by cognitive theories, interference appears to be most closely related
      to features specific to bulimia nervosa rather than to measures of general
      psychopathology.

PMID- 8477271
TI  - Adaptation to severe chronic hypokalemia in anorexia nervosa: a plea for
      conservative management.
AB  - Severe hypokalemia may constitute a life-threatening medical emergency. In the
      group of purging eating disorder patients, potassium blood levels tend to be
      chronically low while physical signs and symptoms may be absent. Nevertheless,
      these patients are frequently subjected to vigorous supportive treatment and
      often an aggressive diagnostic workup. We present a chronic purging anorexia
      nervosa patient in whom potassium blood levels reach a low of 1.6 mmol/L in the
      absence of physical symptoms. Purging eating disorder patients adapt to chronic
      hypokalemia. We believe the clinical/medical approach to this electrolyte
      disturbance in chronic eating disorder patients should be different from the
      approach to patients suffering from acute hypokalemia.

PMID- 8477273
TI  - Recent research bibliography.

PMID- 8477272
TI  - Eating pathology in bulimia nervosa.
AB  - Degree of eating pathology in bulimia nervosa was assessed using the Eating
      Behavior Rating Scale (EBRS) across three videotaped eating sessions. Twelve
      bulimic and 12 non-eating disordered subjects participated in this study. All
      subjects were filmed during a baseline meal (ad libitum), a high-calorie meal,
      and a low-calorie meal (both fixed amounts). Mean EBRS scores were significantly
      higher for bulimics (12.6 +/- 1.7) than for controls (3.9 +/- 0.9), suggesting a
      higher degree of eating pathology in these patients. Affect during eating was
      significantly more negative in the bulimic patients. EBRS and affect scores were
      significantly correlated [r (11) = .813, p < .01]. Bulimics had a slower rate of
      eating than controls and took significantly longer to initiate eating. Scores of
      pathological eating correlated with scores on the Eating Attitudes Test and the
      Bulimic Investigatory Test-Edinburgh, indicating a relationship between objective
      measures of pathological eating and self-report measures of eating disorder
      symptoms.

PMID- 8477274
TI  - Assessment of binge eating in obese patients.
AB  - Obese patients entering a weight control program were classified as binge eaters
      if they reported uncontrolled consumption of what others would regard as an
      unusually large amount of food at least once a week for the previous month. Binge
      eaters differed significantly from nonbingers across a broad range of eating and
      weight-related characteristics assessed using a self-report version of the Eating
      Disorder Examination. Attitudinal differences were marked. The results provided
      no support for the view that obese binge eaters have a pattern of general
      "addictiveness" to psychoactive substances or other activities.

PMID- 8477275
TI  - Patients with bulimia nervosa who fail to engage in cognitive behavior therapy.
AB  - Although cognitive behavioral treatment is the treatment of choice in bulimia
      nervosa, patients' response is variable. A minority of patients do not respond at
      all and some never engage in treatment. This paper concerns the latter group. A
      case series of six such patients with whom treatment could not be initiated is
      compared with a group who received a full course of treatment. The group with
      whom treatment could not begin were found to have a longer history of disorder,
      to report excessive laxative abuse, to have more severe depressed mood and a
      greater dissatisfaction with their body weight. In addition, they were more
      likely to have abused psychoactive substances, engaged in episodes of self-harm,
      and have a lower self-esteem. They were also more likely to be diagnosed as
      having borderline personality disorder. Patients presenting with the wide range
      of difficulties characteristic of this group require a more intensive form of
      treatment than standard outpatient cognitive behavior therapy.

PMID- 8477276
TI  - Pregnancy and eating disorders: a review and clinical implications.
AB  - Pregnancy and eating disorders is a subject that has received relatively little
      attention in the literature. Yet, several serious complications have been found
      in both the mother and the fetus when a woman with an eating disorder becomes
      pregnant. In this paper the literature is reviewed for both anorexia nervosa and
      bulimia nervosa and suggestions for future research are offered. Clinical
      implications for the treatment of the pregnant eating disordered patient are
      discussed.

PMID- 8477277
TI  - Comorbidity of bulimia and substance abuse: perceptions of family of origin.
AB  - Clinical characteristics and perceptions of family of origin were examined in 16
      bulimic women with comorbid alcohol abuse or dependence, 17 women with bulimia
      alone, and 30 normal controls. Family Environment Scale self-report and Family
      Environment Q-sort analysis of taped semi-structured interviews about family
      environment revealed that while there were no differences across groups in global
      family environment items, differences existed in specific parental
      characteristics. Fathers of bulimic women (with or without alcohol abuse or
      dependence) were perceived as being significantly more seductive than fathers of
      normal controls. Bulimic women (with or without alcohol abuse or dependence)
      tended to view their mothers as more neurotic and to have experienced less
      enjoyment in their maternal role. Mothers of bulimic women with alcohol abuse
      tended to place the greatest emphasis on weight, exercise, and appearance.

PMID- 8477278
TI  - An investigation of the influence of dieting and self-esteem on dietary
      disinhibition.
AB  - Recent research on the eating behavior of restrained eaters following a dietary
      preload indicates that both dieting and self-esteem may influence consumption.
      While Polivy, Heatherton, and Herman (Journal of Abnormal Psychology, 97, 354
      356, 1988) found a forced preload to lead to increased consumption by low self
      esteem restrained eaters, Lowe, Whitlow, and Bellwoar (International Journal of
      Eating Disorders, 10, 461-471, 1991) found restrained dieters to decrease their
      consumption following a dietary preload. The current study was designed to
      investigate the influences of self-esteem and dieting on the eating behavior of
      restrained eaters while in a negative mood state. Subjects were 80 normal weight
      undergraduate women in a 2 x 2 x 2 design (Restrained/Unrestrained by
      Success/Failure by Low Self-Esteem/High Self-Esteem). Current dieting, though not
      self-esteem, was found to influence consumption. Restrained dieters consumed
      significantly less in a negative mood state than when in a positive mood state,
      while nondieters, irrespective of restraint status, consumed comparable amounts
      in both mood states.

PMID- 8477279
TI  - The measurement of restraint: confounding success and failure?
AB  - The present study examined the concept of restrained eating as measured by the
      Restraint Scale and the restrained eating section of the Dutch Eating Behaviour
      Questionnaire. The results showed that when answering questionnaires, subjects do
      not differentiate between items relating to attempts at dieting and actual
      restrictive behavior and that restrained eating can be conceptualized in terms of
      both successful and failed restraint. In addition, the results suggest that
      subjects who report high scores on both these measures of restraint represent a
      population of dieters prone to overeating behavior. The results are discussed in
      terms of the population selected by measures of restrained eating and in relation
      to the definition of restraint.

PMID- 8477280
TI  - Fluctuations in body satisfaction across situations.
AB  - Although the variable nature of body image was underscored by Schilder (The image
      and appearance of the human body. New York: International Universities Press,
      1950), few investigators have addressed the stability of body image or its
      sensitivity to variation in environmental or situational conditions. Most
      researchers have assumed that body image is a stable characteristic. The present
      study was designed to investigate the situational specificity of body
      satisfaction, one facet of body image. One hundred forty-four undergraduate women
      indicated their degree of body satisfaction in general and in the following four
      situations: (a) walking by a group of attractive men and women at the beach in a
      bathing suit, (b) having a conversation with a close female friend over lunch,
      (c) getting dressed to go to school in privacy, and (d) trying on bathing suits
      in the dressing room of a department store. Body satisfaction varied
      significantly across the four situations for all body parts except the face,
      hair, and hands. Additionally, body satisfaction scores were found to reflect how
      subjects felt about their bodies when they were being especially self-critical,
      rather than how they felt in "everyday" situations.

PMID- 8477281
TI  - Generality in the errors of estimation of body image.
AB  - An aspect of the considerable research on the association between eating
      disorders and discrepancies in body image estimation is the extent, if at all,
      that such discrepancies could be due to a more general tendency to show a
      positive or negative bias in estimation of the size of objects. One hundred
      female subjects, without known eating disorder, estimated the width of their own
      bodies (head, shoulders, waist, and hips), of another person's body (waist and
      hips), of four commercial packages, and of a cylinder. Errors in estimation,
      computed as algebraic differences from the true value, were computed, and all
      error means were found to be positive. Correlations between the error scores were
      all positive. Factor analysis of the correlations between the 11 error scores
      indicated a substantial general factor plus a bipolar factor, or alternatively
      two positively correlated factors referring to human body or physical measures.
      Results were interpreted as supporting the notion of a broad general tendency to
      enhance or diminish estimations of the width of familiar objects including
      estimations of the width of own body parts. The relevance of this finding to
      eating disorders was discussed.

PMID- 8477282
TI  - Toward an empirically derived typology of obese persons: derivation in a
      nonclinical sample.
AB  - The purpose of this research was to empirically derive a typology of obese
      persons and validate a typology derived in earlier research (Allison & Heshka
      [1991] International Journal of Obesity). Biological, behavioral, and
      psychological variables were assessed through survey among 719 (641 females, 78
      males) obese members of The National Association to Advance Fat Acceptance
      (NAAFA). All variables were subjected to principal components analyses which
      extracted 12 biological and 12 psychological components. A two-cluster solution
      from a k-means clustering on biological components was replicated via Ward's
      method. Agreement between the solutions was significant (Phi = .33, Kappa = .19,
      p < .05). The solution was validated through entering psychological component
      scores into discriminant analysis. One significant function (p < .001)
      substantially separated the clusters. A component measuring early onset/familial
      history powerfully discriminated between the clusters. Early onset obese were
      more obese, more active, and restricted caloric intake to a greater degree. Late
      onset obese were more likely to be "settled down," engage in substance abuse, eat
      at night, and have diabetes (p < .05). Results were substantially consistent with
      those of prior research.

PMID- 8477283
TI  - Binge eating disorder: its further validation in a multisite study.
AB  - Binge eating disorder (BED) is a new eating disorder that describes the eating
      disturbance of a large number of individuals who suffer from recurrent binge
      eating but who do not regularly engage in the compensatory behaviors to avoid
      weight gain seen in bulimia nervosa. This multisite study of BED involved 1,785
      subjects drawn from 18 weight control programs, 942 subjects from five nonpatient
      community samples, and 75 patients with bulimia nervosa. Approximately 29% of
      subjects in weight control programs met the criteria for BED. In the nonpatient
      community samples BED was more common than purging bulimia nervosa. The validity
      of BED was supported by its strong association with (1) impairment in work and
      social functioning, (2) overconcern with body/shape and weight, (3) general
      psychopathology, (4) significant amount of time in adult life on diets, (5) a
      history of depression, alcohol/drug abuse, and treatment for emotional problems.

PMID- 8477284
TI  - The classification of recurrent overeating: the "binge eating disorder" proposal.
AB  - It has been suggested that a new diagnostic category be added to the section on
      eating disorders in DSM-IV. This new diagnosis has been termed binge eating
      disorder. In this article we argue that for two main reasons it would be a
      mistake to include binge eating disorder in DSM-IV: first, too little is known
      about binge eating and other related forms of recurrent overeating to justify its
      inclusion in DSM-IV; and second, its inclusion would be a source of diagnostic
      confusion. We argue that it is premature to crystallize this specific subgroup
      from amongst those who recurrently overeat and that to do so would impede the
      acquisition of knowledge rather than enhance it. We advocate a research strategy
      that involves studying broad samples of those with recurrent overeating rather
      than narrow ones.

PMID- 8477285
TI  - Binge eating disorder should be included in DSM-IV: a reply to Fairburn et al.'s
      "the classification of recurrent overeating: the binge eating disorder proposal".
AB  - Extensive recent research supports a proposal that a new eating disorder, binge
      eating disorder (BED), be included in DSM-IV. BED criteria define a relatively
      pure group of individuals who are distressed by recurrent binge eating who do not
      exhibit the compensatory features of bulimia nervosa. This large number of
      patients currently can only be diagnosed as eating disorder not otherwise
      specified (EDNOS). Recognizing this new disorder will help stimulate research and
      clinical programs for these patients. Fairburn et al.'s critique of BED fails to
      acknowledge the large body of knowledge that indicates that BED represents a
      distinct and definable subgroup of eating disordered patients and that the
      diagnosis provides useful information about psychopathology, prognosis, and
      outcome (Fairburn, Welch, & Hay [in press]. The classification of recurrent
      overeating: The "binge eating disorder" proposal. International Journal of Eating
      Disorders.) Against any reasonable standard for adding a new diagnosis to DSM-IV,
      BED meets the test.

PMID- 8477286
TI  - Anorexia nervosa "restricters" who purge: implications for subtyping anorexia
      nervosa.
AB  - It has not been clear from earlier studies whether it is binge eating per se or
      the compensatory behaviors frequently associated with binge eating (i.e., self
      induced vomiting and/or laxative abuse) that provide the most relevant marker for
      subclassifying anorexia nervosa. The current study addressed this question by
      comparing the clinical and psychological features of three groups of anorexia
      nervosa patients: "pure restricting" patients who do not binge (by definition)
      and who also do not purge (AN-R, N = 116); "restricting-purging" patients who
      engage in purging behavior (AN-RP, N = 74); and anorexia nervosa "bulimics" who
      binge eat as defined in earlier studies (AN-B, N = 190). While all three groups
      displayed similar levels of psychological disturbance on many variables, the
      overall pattern of findings indicates that the AN-RP group displays significantly
      more psychopathology than the AN-R group and their profile of disturbance is very
      similar to that observed with the AN-B group. Thus, anorexia nervosa patients who
      purge, regardless of whether or not they report objective binge episodes, may be
      meaningfully distinguished from nonpurging patients. These results, combined with
      the medical risks associated with purging behaviors and the formidable problems
      associated with the definition of binge eating, support a sub-typing system for
      anorexia nervosa based on the presence or absence of purging rather than binge
      eating.

PMID- 8477287
TI  - Dissociative experiences and trauma in eating disorders.
AB  - This study explores the relationship between traumatic experiences and
      dissociative phenomena in a large group of eating disorder patients (N = 98).
      Traumatic experiences were assessed by means of a self-report questionnaire and a
      clinical interview; dissociative experiences were assessed with the newly
      developed self-reporting Dissociation Questionnaire (DIS-Q). About 25% of the
      patients reported to have experienced traumatic events in their personal life and
      this subgroup had significantly higher scores on the DIS-Q, compared with normal
      control subjects. About 12% of our patient sample mentioned dissociative
      experiences to a degree as high as in a group of patients with dissociative
      disorders. Amnesia turned out to be the most specific characteristic in trauma
      induced dissociation. These data suggest that trauma-induced dissociative
      experiences may play an important role in the development of a subgroup of
      patients with an eating disorder.

PMID- 8477288
TI  - The use of electroconvulsive therapy in patients with intractable anorexia
      nervosa.
AB  - The history of the treatment of anorexia nervosa includes the majority of
      psychological and somatic therapies devised by psychiatrists, psychologists, and
      general physicians. We review the history of one of these treatments, electrical
      convulsive therapy (ECT), and discuss three patients treated with ECT for primary
      anorexia nervosa. Two had a positive response to this treatment, one did not. She
      later responded favorably to a course of treatment with fluoxetine.

PMID- 8477289
TI  - Food intolerance in patients with chronic fatigue.
AB  - Intolerance to various foods is reported often by patients seeking evaluation for
      chronic fatigue, a common symptom in primary care practice. To assess the
      prevalence and significance of this phenomenon we studied 200 consecutive
      patients with chronic fatigue who were given a comprehensive medical and
      psychiatric evaluation. Intolerance to foods from at least three different groups
      was reported by 27 patients (13.5%). We compared these patients with 27 age- and
      gender-matched patients from the same cohort of fatigued patients. Physical
      examination and laboratory testing showed few abnormalities in either group. The
      two groups were similar with respect to the duration and severity of fatigue,
      lifetime depressive symptoms, and prevalence of current depressive disorders (67%
      vs. 63%) and anxiety disorders (11% vs. 15%). Patients with multiple food
      intolerance had more lifetime functional somatic symptoms (p < .05) and a
      significantly higher (33% vs. 7%) prevalence of somatization disorder (p < .025).
      These data suggest that intolerance to multiple foods is probably not a cause or
      the effect of chronic fatigue, but rather one of the manifestations of the
      somatization trait expressed in these patients.

PMID- 8477290
TI  - The effects on eating of dietary restraint, anxiety, and hunger.
AB  - In this study a comparison was made between the amounts eaten by restrained and
      unrestrained eaters following an anxiety-induction procedure. Subjects' level of
      perceived hunger was assessed and the interactive effects on eating of anxiety
      and perceived hunger were examined. Results revealed a significant three-way
      interaction. Unrestrained subjects did not alter their eating in response to
      either anxiety or hunger. When relaxed, restrained subjects ate more when hungry
      than when not hungry. However, in restrained subjects, anxiety appeared to
      counteract the disinhibiting effect of hunger, so that anxious hungry subjects
      ate less than relaxed hungry subjects and the same amount as relaxed subjects who
      were not hungry.

PMID- 8477291
TI  - The self-image of adolescent patients with eating disorders.
AB  - Forty German adolescent anorectic patients were assessed with regard to self
      image components as measured by the Offer Self-Image Questionnaire (OSIQ). The
      profile of this group deviated negatively from the German standardization group
      of healthy subjects on measures of impulse control, emotional tone, body image,
      social relationships, sexual attitudes, and psychopathology. In addition, the
      OSIQ profile of this German sample was remarkably similar to the profiles of
      samples reported in two American studies. Finally, it was found that inpatient
      treatment served to improve the psychological condition of the patients with
      regard to certain but not all self-image components. Despite a trend of
      improvement, some of the scores did not fully normalize in this sample.

PMID- 8477292
TI  - Dietary zinc intake of vegetarian and nonvegetarian patients with anorexia
      nervosa.
AB  - Anorexia nervosa (AN) and zinc deficiency, found most frequently in young
      females, have a number of symptoms in common. These include weight loss,
      alterations in taste and appetite, depression, and amenorrhea. Approximately half
      of anorexia nervosa patients (ANs) are vegetarian (VANs), a practice that may
      increase their risk for zinc deficiency. This study compared the dietary intake
      of zinc and related nutrients in 9 outpatient VANs with that of 11 outpatient
      nonvegetarian patients with anorexia nervosa (NVANs). VANs reported significantly
      lower (p < .05) dietary intakes of zinc, fat, and protein, and a significantly
      higher (p < .05) intake of calories from carbohydrates than NVANs. There were no
      significant differences between the groups in dietary intake of calories,
      calcium, copper, iron, or magnesium. These findings indicate that zinc intake
      should be routinely assessed in VANs and that zinc supplementation of their diets
      may be indicated.

PMID- 8477293
TI  - Multiple personality in eating disorder patients.
AB  - Although the overlap between childhood sexual and physical abuse and eating
      disorders is well known, little work has been done on the sequelae of childhood
      trauma in eating disorder patients. Dissociative phenomena are common in adult
      survivors of childhood abuse, with multiple personality disorder (MPD) being the
      most extreme form of dissociative disorder. We describe two women who presented
      for inpatient treatment of eating disorders who were subsequently found to have
      MPD. Because the eating pathology in these patients contained atypical features
      related to the MPD process, uncovering MPD was critical in the treatment of their
      eating behavior. MPD should be considered in any atypical or treatment-resistant
      eating disorder patient.

PMID- 8477294
TI  - Case report of anorexia nervosa associated with Wilson's disease.
AB  - Wilson's disease is a recessively inherited disorder of copper metabolism with
      prominent hepatic, hematopoietic, central nervous system (CNS), and ocular
      involvement. Psychiatric manifestations are notoriously variable. The following
      case history of a patient with both anorexia nervosa and Wilson's disease is
      presented and discussed in the context of organic CNS lesions associated with
      anorexia nervosa-like syndromes.

PMID- 8477295
TI  - Eating disorder in a 6-year-old Asian girl with ethyl malonic adipic aciduria.
AB  - Accurate data are not available for the prevalence of eating disorders amongst
      the Asian population in Britain. Only a handful of cases have been reported in
      the literature [Bhadrinath (1990). British Journal of Psychiatry, 156, 565-568.]
      suggested that it is an uncommon phenomenon despite Dolan's recent finding
      [Dolan, Lacey, & Evans (1990). British Journal of Psychiatry, 157, 523-528.] that
      there were elevated Eating Attitudes Test (EAT) scores in a sample of young Asian
      adults compared with Caucasians. We report a case of an Asian girl with a rare
      inborn error of metabolism and an eating disorder.

PMID- 8477296
TI  - The impact of sexual and physical abuse on eating disordered and psychiatric
      symptoms: a comparison of eating disordered and psychiatric inpatients.
AB  - The authors compared rates of physical and sexual abuse in women with eating
      disorders (N = 102) and general psychiatric disorders (N = 49). Relationships
      between sexual abuse and severity of eating disordered and psychiatric symptoms
      were also examined. While high rates of sexual abuse were found in the eating
      disordered sample, these rates were not significantly higher than those found in
      the general psychiatric population. No relationship between a history of sexual
      abuse and severity of eating disordered symptoms was found. However, within the
      eating disordered group, sexually abuse subjects reported more severe psychiatric
      disturbances of an obsessive and phobic nature than nonabused subjects. These
      findings suggest that while sexually abusive experiences may be related to
      increased psychological distress, they do not serve to increase eating disordered
      symptomatology.

PMID- 8477297
TI  - Association of sexual abuse and borderline personality disorder in eating
      disordered women.
AB  - It has been shown that sexual abuse is associated with the eating disorders,
      particularly those with a bulimic component. Existing research suggests that
      borderline personality disorder (or the cluster of behaviors behind this
      diagnosis) may be a mediating factor in that link. However, there is no evidence
      of specific patterns of association between the three phenomena. The present
      report studies these links in a case series of 115 eating-disordered women. It is
      shown that the links between and reported sexual abuse and borderline personality
      disorder vary according to the nature of the eating disorder. In particular, they
      were associated in anorexia of the bulimic subtype, but not in bulimia nervosa or
      in restrictive anorexia. The possible therapeutic implications of these findings
      are discussed.

PMID- 8477298
TI  - Bulimia nervosa: a population-based study of purgers versus nonpurgers.
AB  - There has been recent interest in the possibility of dividing bulimia nervosa
      into two subtypes based on the method of weight prevention utilized by the
      individual. In an attempt to see if such a division is justified, this study
      compared 54 purging bulimics with 69 nonpurging bulimics ascertained from a
      population-based register of Virginia female twins. A bulimic was defined as a
      "purger" if she engaged in vomiting or laxative abuse. These two groups were
      examined on a variety of demographic, weight, and personality measures after
      controlling for the presence of obesity. No significant differences were found
      between the two groups on any of the variables examined.

PMID- 8477299
TI  - Self-treatment of bulimia nervosa: a pilot study.
AB  - Twenty-eight patients with ICD-10 bulimia nervosa or atypical bulimia nervosa
      were given a cognitive-behavioral treatment handbook and were reassessed 4-6
      weeks later. On a clinician-rated global improvement scale 12 patients had much
      improved and 8 patients had somewhat improved. Fifteen patients were abstinent of
      vomiting or laxatives at reassessment as opposed to five patients before
      treatment. Of the 21 patients who were bringing before treatment, 7 had a 75-100%
      reduction of binges and 5 had a 50-75% reduction of binges. Patients' nutritional
      knowledge increased significantly. A patient-administered hand-book may be a
      useful first intervention in the treatment of patients with bulimia nervosa.

PMID- 8477300
TI  - Expressed emotion in the investigation of eating disorders: a review.
AB  - Expressed Emotion (EE) is a measure of family interaction that has been shown to
      be useful for the investigation of many psychiatric disorders. This paper
      describes why it is appropriate to use it for the investigation of eating
      disorders. There is discussion of the findings that the levels tend to vary
      between the different eating disorders. The relationship between EE and treatment
      response is discussed. Suggestions are made for further research.

PMID- 8477301
TI  - Emotion and eating in obesity? A critical analysis.
AB  - Psychosomatic theories hold that the obese abnormally increase eating in response
      to emotional distress. Empirical support for this assertion has come mainly from
      self-report studies. A review of the literature for methodological rigor reveals
      that many studies previously considered supportive are substantially flawed with
      regard to control groups, failure to control Type-I error rate, and the
      possibility of confounding of social desirability and other response sets with
      self-reports of emotional eating. Five alternative conceptualization of the
      obesity-emotional eating association are presented along with suggested research
      which would elucidate the nature of this frequently reported connection.

PMID- 8477302
TI  - A problematic counter-regulation experiment: implications for the link between
      dietary restraint and overeating.
AB  - The current study failed to find any evidence of laboratory counter-regulation
      amongst restrained eaters given a preload, regardless of the measures of dietary
      restraint used to classify subjects, including dieting status on the day of the
      study. Furthermore, there was no evidence to suggest that high restrainers
      characteristically overeat or experience a sense of loss of control over eating
      in naturalistic settings. These findings indicate that the link between dietary
      restraint and overeating or bulimic episodes is, at most, a weak one. Future
      investigations must incorporate more detailed and sensitive measures of both
      restraint and overeating if analogue studies are to be useful for understanding
      the process involved in clinically significant episodes of overeating or binge
      eating.

PMID- 8477303
TI  - Effects of high calorie preloads on selective processing of food and body shape
      stimuli among dieters and nondieters.
AB  - Preloaded and nonpreloaded dieters (restrained eaters) and nondieters
      (unrestrained eaters) completed a modified version of the Stroop task to measure
      selective biases in cognitive processing. In two separate studies, a milkshake
      preload led to increased cognitive interference for body shape words, especially
      for restrained eaters. There were no differences between restrained and
      unrestrained eaters in Stroop interference for either common or forbidden food
      words, whether subjects were preloaded or not. Taken together, these results
      indicate that chronic dieting is associated with selective processing of body
      shape words.

PMID- 8477304
TI  - Body Shape Questionnaire: derivation of shortened "alternate forms".
AB  - The 34-item Body Shape Questionnaire (BSQ) has demonstrated sound psychometric
      properties in all samples reported to date (including this study). However, the
      unidimensional nature of the 34 items suggests that the BSQ may be unnecessarily
      long for use in studies when body disparagement is not the main focus of
      investigation. This study of 342 adult women presents two 16-item "alternate
      forms" of the BSQ which showed equivalent means and excellent internal
      consistency in both derivation and replication samples. Two 8-item scales were
      also derived. The 34-, 16-, and 8-item versions showed equivalent convergent and
      discriminant validation against the Eating Attitudes Test (EAT)-26 and other
      parameters. We suggest that use of these 16-item versions may be more efficient
      than the original BSQ where body disparagement is not the sole focus of a study,
      or where a repeated measures design is employed. Furthermore, the 8-item versions
      are sufficiently robust to be used as "alternate forms" where speed of completion
      and economy are of the essence.

PMID- 8477305
TI  - Body image changes during early adulthood.
AB  - Results from recent studies on body image have revealed differences between
      college-age individuals and older samples. In this study, adults 17 to 40 years
      old were evaluated for their body dissatisfaction on the Figure Rating Scale.
      Females had higher levels of body dissatisfaction than males and these
      differences did not diminish with age. However, consistent with physical changes
      in adulthood, current and ideal ratings became more discrepant with age.
      Interestingly, for women, affective and cognitive dimensions of body
      dissatisfaction became more consistent. Research on early adulthood personality
      development is used to help explain these results.

PMID- 8477307
TI  - Proceedings of the British Pharmacological Society Meeting. 5-7 January 1993.
      Abstracts.

PMID- 8477306
TI  - Dreams of death: Von Weizsacker's Dreams in so-called endogenic anorexia: a
      research note.
AB  - Viktor Von Weizsacker's paper "Dreams in so-called endogenic Magersucht
      (anorexia," first published in the Deutsche Medizinische Wochenschrift in 1937
      (translation in M. Kaufman & M. Heiman [1964]. Evolution of psychosomatic
      concepts: Anorexia nervosa: A paradigm (pp. 181-197), New York: International
      Universities Press, has been described as a noteworthy and historically important
      contribution to the recognition of anorexia nervosa as a psychosomatic illness.
      Von Weizsacker analyzed the dreams of patients he was treating for "endogenous
      anorexia" (magersucht). He claimed that in the bulimic phase his patients
      experienced nightmares dealing with themes of death, but that in the anorectic
      phases of restricted eating more pleasant dreams dealt with themes of blissful
      contentment. The authors draw current attention to his work as another early
      example of the treatment of the theme of death and death symbolism in the
      literature on eating disorders, and suggest some reappraisal of von Weizsacker's
      interpretations of his own material.

PMID- 8477308
TI  - Effectiveness of haematuria clinics.

PMID- 8477309
TI  - Spontaneous rupture of renal tumours presenting as surgical emergency.
AB  - A study of renal tumours filed in the pathology department of a regional hospital
      in Hong Kong during 1971-1990 showed 6 cases of surgical emergency due to
      spontaneous rupture of the kidney by tumour. All occurred as a complication of
      renal angiomyolipoma, a rare tumour or hamartoma. A literature review showed that
      the renal tumour most frequently reported to cause spontaneous rupture was renal
      carcinoma. Chinese patients appear to have more renal ruptures due to
      angiomyolipoma than to renal carcinoma. It is proposed that intra-operative
      frozen section diagnosis should be sought, when this can be safely performed, in
      cases of rupture of the kidney by tumour. Surgery aiming at conserving functional
      renal parenchyma is appropriate for benign lesions such as angiomyolipoma.

PMID- 8477310
TI  - Aspects of hypertension in renal allograft recipients. A study of 1000 live renal
      transplants.
AB  - A retrospective study of 1000 live renal transplants was performed in order to
      assess the factors associated with hypertension in renal transplant recipients.
      The prevalence of hypertension prior to transplantation was 48%. The need for
      antihypertensive drugs decreased in 43%, increased in 31% and remained the same
      in 26%. The presence of hypertension before transplantation, rejection episodes,
      transplant renal artery stenosis and native kidney disease were the main factors
      associated with post-transplant hypertension. An algorithm for the management of
      post-transplant hypertension is suggested.

PMID- 8477311
TI  - Audit of catheter management provided by District Nurses and Continence Advisors.
AB  - District Nurses and Continence Advisors were surveyed by post to audit their
      management of long-term indwelling catheters. They were asked to outline,
      anonymously, their management strategies in response to common specified catheter
      related problems. The responses to each question were graded for the
      appropriateness of strategy from A (best) to E (worst) by previously formulated
      criteria. Completed questionnaires were returned from all 10 Welsh Continence
      Advisors and 73 of 139 (53%) District Nurses in South Glamorgan regularly
      involved in catheter care. A greater proportion of Continence Advisors' than
      District Nurses' responses were graded A or B in all problem areas specified. In
      patients with marked bacteriuria, 60% of Continence Advisors but only 11% of
      District Nurses would assess whether the patient was ill; 53% of District Nurses
      would treat with antibiotics without such assessment. Whereas most nurses
      investigating suprapubic pain would consider catheter blockage, only one-third
      would consider further history taking or examination, and only 1 District Nurse
      considered constipation or detrusor spasm. Although two-thirds of nurses
      sometimes used bladder washouts, few considered them effective and most were
      aware of the potential risks. Thus wide variations were found in the community
      nursing management of indwelling catheters and care may frequently be suboptimal.
      Appropriate management guidelines should be developed and disseminated.

PMID- 8477312
TI  - Is impaired perception of bladder filling during cystometry a sign of neuropathy?
AB  - The sensation of bladder filling during cystometry was evaluated in 627
      consecutive patients. The groups of patients with various patterns of impaired
      sensation included significantly more patients with confirmed neuropathy than did
      the group whose perception of bladder filling was normal. When sensation was
      absent, or only 1 of 3 types was reported by patients without known neuropathy,
      further investigation revealed abnormal afferent innervation of the lower urinary
      tract in 35%. These data suggest the need for further neurological evaluation in
      such patients.

PMID- 8477313
TI  - The incidence of bladder cancer in the black foot disease endemic area in Taiwan.
AB  - A high incidence of bladder cancer (23.53/100,000 population per annum from 1981
      1985) was found in an endemic area of peripheral vascular disease known as black
      foot disease (BFD) on the southwest coast of Taiwan. The average incidence of
      bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same
      period. The incidence of female bladder cancer (21.10/100,000) in this area was
      also high. The ratio of male to female bladder cancer in the BFD endemic area and
      the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area
      (2.75) and elsewhere around the world. The high content of arsenic and the high
      concentration of a "fluorescent substance" in artesian well water in this area
      are the only 2 related factors identified so far. Determination of the actual
      carcinogen requires further investigation.

PMID- 8477314
TI  - Bromodeoxyuridine labelling of transitional cell carcinoma of the bladder--an
      index of recurrence?
AB  - Nineteen patients with newly diagnosed transitional cell carcinoma of the bladder
      consented to receive an intravenous bolus of bromodeoxyuridine (BrdUrd) 3 to 6 h
      prior to transurethral resection of bladder tumour. Routine paraffin embedded
      sections were stained with anti-BrdUrd monoclonal antibody in order to determine
      the S phase fraction of the bladder tumours and to correlate this with tumour
      grade, category and the development of recurrence during follow-up. BrdUrd
      labelling of nuclei was reliably detected in 100% of the tumours. The mean
      labelling index of Ta tumours (n = 8) was 3.14%; in T1 tumours (n = 7) it was
      8.6% and in T2-3 tumours (n = 4) it was 16.4%. A similar correlation was found in
      association with tumour grade. The patients were followed up for a mean of 23
      months (range 18-30). Seven of the 15 superficial tumours recurred during the
      period of follow-up. These tumours had a mean labelling index (at diagnosis) of
      8.4%, whereas the tumours that did not recur had a mean labelling index of 3.4%.
      The in vivo determination of BrdUrd uptake in transitional cell carcinoma of the
      bladder may be useful in predicting which superficial tumours are likely to recur
      following resection and so rationalise both the time to follow-up and
      intravesical chemoprophylaxis.

PMID- 8477315
TI  - Multivariate analysis of progression in superficial bladder cancer.
AB  - A total of 217 patients with superficial bladder cancer (SBC) category Ta-T1 were
      retrospectively analysed for tumour progression and prognostic factors; 46% of
      patients presented with recurrences, 13% with increasing grades of anaplasia and
      12% with progression in tumour category. The mean annual index of recurrences was
      0.7 +/- 0.1; 4% of patients died from tumour progression and the overall 5-year
      survival rate was 88% +/- 5.3. Factors that influenced progression significantly
      were peritumoural dysplasia, inflammatory infiltrate, residual tumour following
      transurethral resections, increasing grade of anaplasia and index of recurrences
      > 0.7. Multivariate statistical analysis revealed that only tumour category and
      increasing grade of anaplasia had significant prognostic value. Increasing grade
      of anaplasia predicts the likelihood of tumour progression with a 91% global
      predictive capacity. Thirty percent of patients with tumour progression did not
      have an increasing grade of anaplasia. Among these 87% were Ta, 50% were GI and
      the mean index of recurrences was 0.9. All were conservatively treated and 87%
      are alive. Among the patients with an increasing grade of anaplasia and tumour
      progression the mean index of recurrences was 1.7; 67% developed muscle
      infiltrating cancer and 7% metastatic spread without local progression; 64% of
      these patients died from cancer. An increasing grade of anaplasia affects
      prognosis. It defines patients with a high risk of tumour progression and tumour
      related death, especially those with T1 bladder cancer.

PMID- 8477316
TI  - Randomised study of the effect of midnight versus 0600 removal of urinary
      catheters.
AB  - A randomised controlled trial was undertaken to determine the effects of midnight
      removal of urinary catheters on patients' voiding patterns and subsequent
      discharge from hospital. Patients whose urinary catheters were removed at
      midnight showed a greater volume of initial void than those whose catheters were
      removed at the usual time of 0600. Removal of urinary catheters routinely at
      midnight permits earlier assessment of patients' voiding, which may allow for
      earlier discharge from hospital.

PMID- 8477317
TI  - Hormonal treatment of obstructed kidneys in patients with prostatic cancer.
AB  - A review of 1288 patients with previously untreated prostatic cancer revealed 209
      patients (16%) with ureteric obstruction; the obstruction was bilateral in 36%.
      The effect of hormonal treatment was assessed in 88 patients with 120 obstructed
      kidneys: 77 patients had androgen deprivation or hormonal medication alone and 11
      patients needed percutaneous nephrostomy or ureteric catheters in addition.
      Drainage improved in 58% of the kidneys. The diverting catheter was withdrawn in
      9 of the 11 patients after a median of 4 weeks. In all, 95% of patients were
      discharged. The patients with hormonal therapy alone survived for a median of 26
      months (range 1-111), while the patients who also needed diversion survived for a
      median of 13 months (range 1-28). The median time spent at home was 24 months (0
      102) and 10 months (0-23) respectively, presumably reflecting the worse general
      condition of the patients who required diversion.

PMID- 8477318
TI  - New, self-expanding, self-retaining temporary coil stent for recurrent urethral
      strictures near the external sphincter.
AB  - Strictures near the external sphincter are a cause for concern. They can be
      managed by manipulation (e.g. urethral dilatation) or by anastomotic
      urethroplasty. Permanently implanted metallic stents have recently been used to
      treat recurrent urethral strictures. This report presents the results of using a
      temporary metallic coil stent (UROCOIL-S) in 20 patients with recurrent
      bulbomembranous strictures. In 13 patients the stent was left in place for 10
      months and was then removed by a simple manipulation. After a mean follow-up of
      10 months (range 3-14), the stricture recurred in only 1 patient. The use of a
      temporary (but long-term) stent for the treatment of urethral stricture is a new
      approach and the results are encouraging.

PMID- 8477319
TI  - Results and complications of urethroplasty and its future.
AB  - A consecutive series of 200 patients undergoing urethroplasty has been reviewed
      to assess the results and complications of surgery and thereby assess the role of
      urethroplasty in the treatment of urethral strictures with particular reference
      to the current interest in intraluminal "stenting" of strictures. Anastomotic
      urethroplasty for post-traumatic strictures and "patch" urethroplasty for post
      infective strictures give satisfactory results which at present do not seem to be
      bettered by any other form of treatment. Urethroplasty for so-called "ischaemic"
      strictures gives less satisfactory results which could almost certainly be
      improved upon by intraluminal "stenting" or some other novel form of treatment.
      The incidence of impotence, temporary and permanent, after urethroplasty is
      probably greater than is generally realised and the aetiology of this
      complication warrants serious investigation as this is the single most important
      limiting factor in urethroplasty.

PMID- 8477320
TI  - Treatment of vesicoureteric reflux. Results of a prospective study.
AB  - Between 1982 and 1986, 96 children with non-obstructive vesicoureteric reflux
      were included in a prospective study. Three patients withdrew from the study and
      results are therefore presented on 93 children with 135 refluxing ureters who
      were followed up for at least 5 years. Initially, all children with reflux grade
      III or less received antibiotic treatment only. Those with reflux grade IV were
      randomised to antibiotic treatment alone versus surgery plus antibiotic
      treatment; the primary treatment of reflux grade V was reimplantation. In 85
      ureters treated by antibiotics only, reflux disappeared in 64 cases and was
      reduced in 12. In 50 ureters treated by reimplantation, reflux was cured in 46
      cases and no severe ureteric obstruction was seen. Conservative management of
      reflux grade IV was less successful than surgery. The results of conservative,
      non-surgical treatment of reflux grades I-III were satisfactory, but for grades
      IV and V surgery should be the treatment of choice if detrusor instability has
      been excluded.

PMID- 8477321
TI  - Female genito-urethroplasty and submucosal periurethral collagen injection as
      adjunctive procedures for continence in the exstrophy-epispadias complex.
      Preliminary results.
AB  - Continence is the main goal in the treatment of patients with bladder exstrophy
      and prognosis is necessarily long-term. Over an 8-year period, 44 patients
      presented with bladder exstrophy and/or incontinent epispadias. Twenty-five
      bladder closures (7 secondary), 23 male urethroplasties, 19 bladder neck (BN)
      reconstructions and 6 bladder augmentations were performed in these patients. In
      18 children 2 additional procedures were employed in the last 3 years: female
      genito-urethroplasty (15) and submucosal periurethral collagen injection (11).
      Eight children underwent both procedures. Genito-urethroplasty and collagen
      injection were performed before BN reconstruction in 6 and 5 cases respectively,
      in order to increase bladder outlet resistance. The submucosal injection was
      performed at 3, 9 and 12 o'clock in the BN or sphincteric urethra, using 0.75 to
      2.5 ml of cross-linked bovine collagen. Continence in the children who underwent
      the complete staged reconstruction was good in 58%, fair in 32% and poor in 11%.
      Following female genito-urethroplasty and periurethral collagen injection,
      bladder capacities increased by 25%. These complementary procedures are effective
      in increasing outlet resistance and bladder capacity in patients with exstrophy
      and/or epispadias; they may improve continence and lessen the need for further
      bladder augmentation.

PMID- 8477322
TI  - Apparent bilateral duplication of the vas deferens.

PMID- 8477323
TI  - Stabbing, haematuria, dysfunctional platelets and meningism: delayed recognition
      of Munchausen's syndrome.

PMID- 8477324
TI  - Peri-stomal varices: an unusual cause of bleeding from an ileal conduit.

PMID- 8477325
TI  - "Zig Zig Chug Chug"--a new urological symptom.

PMID- 8477326
TI  - Catheter psychosis.

PMID- 8477327
TI  - Congenital renal arteriovenous fistula.

PMID- 8477328
TI  - Recurrent right loin pain due to an accessory ureter.

PMID- 8477329
TI  - Suprapubic insertion of a Foley catheter: the forgotten technique.

PMID- 8477330
TI  - Cholecysto-nephroplasty.

PMID- 8477331
TI  - Unusual drainage of the bladder with a prostatic spiral in situ.

PMID- 8477332
TI  - Exclusive: revolutionary new design in catheter bag technology.

PMID- 8477333
TI  - Removal of retained Foley catheter.

PMID- 8477334
TI  - Re: Urological complications following live donor kidney transplantation: effect
      of urinary schistosomiasis.

PMID- 8477335
TI  - Re: Screening for bacteriuria in urological patients using reagent strips.

PMID- 8477336
TI  - Re: Renogastric fistula.

PMID- 8477337
TI  - The evolution of chemoreception in squamate reptiles: a phylogenetic approach.
AB  - Recent advances in the field of squamate reptile chemoreception have been
      paralleled by the growth and preeminence of cladistics in the field of
      systematics, but for the most part, workers in the former have failed to
      incorporate the conceptual and informational advances of the latter. In this
      paper, I attempt a preliminary rapprochement by combining the methods of
      phylogenetic systematics and current hypotheses of squamate relationships with an
      overview of squamate chemosensory biology. This purely phylogenetic approach
      leads to a number of falsifiable generalizations about the evolution of
      chemoreception in squamates: 1) Evolution of this system is conservative rather
      than plastic, reflecting to a large extent suprafamilial attributes rather than
      adaptation to local conditions; 2) Anguimorphs are highly chemosensory and teiids
      show convergence with this group; 3) Tongue-flicking, a bifurcated tongue tip, a
      vomeronasal (VNO) mushroom body, and a complete circular muscle system in the
      tongue are a correlated character complex associated with the attainment, in
      squamates, of a direct VNO-oral connection and the loss of a VNO-nasal
      connection; 4) There is little support for a visual-chemosensory dichotomy within
      Squamata; 5) Gekkotans are allied with Autarchoglossa, both phylogenetically and
      in terms of chemosensory biology; 6) Iguania are highly variable in chemosensory
      development; iguanids represent the primitive iguanian condition, while agamids
      and chamaeleonids have secondarily reduced or lost their chemosensory abilities;
      7) Apparent contradictions in chemosensory behavior among iguanids probably
      represent intrafamilial divergence; 8) Ecological correlates within Iguanidae and
      other taxa might be spurious, resulting from historical factors unrelated to the
      adaptations in question; 9) The mechanical demands of lingual food prehension
      have constrained chemosensory evolution in Iguania; chemosensory evolution within
      Scleroglossa was permitted by the liberation of the tongue from this ancestral
      role.

PMID- 8477338
TI  - The comparative imperative: genetics and ontogeny of chemoreceptive prey
      responses in natricine snakes.
AB  - Reptiles offer a rich diversity for the study of chemoreception, and snakes are a
      particularly appropriate group for comparative, evolutionary, genetic,
      developmental, and mechanistic studies. A long-term program of research is
      described that attempts to integrate these approaches, focusing on the widespread
      North American genus Thamnophis (Natricinae). Prior to their first meal, neonatal
      snakes respond to aqueous surface substances from species-typical prey with
      increased tongue-flicking and open-mouth attacks; these responses are mediated by
      the vomeronasal organ. Such responses predict what prey snakes will eat and can
      also predict relative prey preference. Species, population, litter, and
      individual differences exists and are important at different levels of analysis.
      Chemoreceptive responses are heritable, although they may show different
      developmental trends. Some species respond to prey types they do not eat in
      nature. In the earthworm specialist, T. butleri, response to fish chemicals can
      be interpreted as a chemoreceptive response inertially inherited from ancestral
      species, decoupled from prey capture techniques, and in the process of being
      lost. Ontogeny and experience can modify behavior of the neonate in various ways.
      Feeding experience can alter response to some prey more than others, and ambient
      prey odor may shift prey preference. Psychophysical studies show that prey
      preference and threshold sensitivity to prey chemicals can be independent and
      differ between closely related species, indicating that neural tissue is devoted
      to recognition of specific types of prey. In site choice tests, garter snakes can
      also discriminate between feces derived from conspecific snakes fed similar or
      different diets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477339
TI  - Overview of the main and accessory olfactory bulb projections in reptiles.
AB  - The present account is a review of the main and accessory olfactory bulb
      projections in reptiles. From previous studies by means of the classical
      degeneration techniques and recent studies using the autoradiographic method or
      the Phaseolus vulgarus-leucoagglutinin (PHA-L) tracing technique, it has become
      evident that, in the brain of reptiles, the vomeronasal and main olfactory
      systems are segregated. Moreover, the PHA-L studies have demonstrated that the
      main olfactory bulbs project not only to the anterior olfactory nucleus, the
      olfactory tubercle, and the lateral cortex, but also to the rostral portions of
      the external and central amygdaloid nuclei. The latter studies also provided
      evidence that, apart from a massive projection to the nucleus sphericus, at least
      in some reptilian species, the accessory olfactory bulbs project to the caudal
      portion of the central amygdaloid nucleus and the bed nucleus of the stria
      terminalis. A comparison of the olfactory projections between the various
      reptilian species studied revealed a considerable variation in the course of the
      main olfactory bulb efferents that reach the contralateral hemisphere.

PMID- 8477340
TI  - Fiber connections of the amygdaloid formation of the lizard Podarcis hispanica.
AB  - The amygdaloid formation of the lizard Podarcis hispanica can be divided into
      three main groups of nuclei on the basis of their input from the main and
      accessory olfactory bulbs: the vomeronasal amygdala, the olfactory amygdala and
      the dorsal amygdaloid group, the latter group receiving afferents from neither
      the main (MOB) or the accessory olfactory bulb (AOB). The vomeronasal amygdala
      has a centrifugal projection to the AOB, an important commissural connection to
      the contralateral vomeronasal amygdala, a minor projection to nucleus accumbens,
      and a bilateral projection to the lateral cortex. The olfactory amygdala displays
      a bilateral afferents from the MOB, receives a contralateral afferent, and is
      reciprocally connected with the lateral cortex. Moreover, it receives an
      important input from the vomeronasal amygdala. The dorsal amygdaloid group
      receives projections from the other two amygdaloid groups, multimodal inputs from
      the anterior dorsal ventricular ridge and the dorsal cortex, and a putative
      cholinergic input from the basal telencephalon. Moreover, it is the site of
      origin of a prominent bilateral amygdalo-striatal projection that extends to the
      bed nucleus of the stria terminalis and the so-called amygdalo-striatal
      transition area, through which it may control both visceral and motor activities.
      The main extratelencephalic output of the amygdala courses through the stria
      terminalis and terminates in the ventromedial hypothalamic nucleus. The
      extratelencephalic afferents of the amygdala arise from several hypothalamic and
      anterior thalamic nuclei, from the mesencephalic and rhombencephalic aminergic
      cell groups, and from the rhombencephalic parabrachial nucleus.

PMID- 8477341
TI  - Chemical delivery to the vomeronasal organs and functional domain of squamate
      chemoreception.
AB  - While evidence exists that many squamate behaviors are released by chemical
      stimuli, the specific sensory system that detects such stimuli and mediates
      subsequent behavior has been determined infrequently. Techniques and experimental
      approaches that have been used to determine the roles that the main olfactory and
      vomeronasal systems play in mediation of specific behaviors are discussed.

PMID- 8477342
TI  - Central and endocrine aspects of tongue-flicking and exploratory behavior in
      Anolis carolinensis.
AB  - Tongue-flicking in reptiles is frequently seen to increase in novel habitats and
      is presumed to involve the acquisition of chemical information. Like most
      behavioral patterns, however, tongue-flicking has both multiple causes and
      multiple functions, only some of which involve chemosensation. This paper
      describes units of exploratory behavior, including use of the tongue, in a
      microsmatic lizard, the green anole, Anolis carolinensis. This species employs
      its tongue in a manner suggestive of chemosensory exploration, but it possesses
      modest peripheral chemosensory organs and reduced central representation of
      chemosensory target cell groups. Further, specific elements of exploratory
      behavior are affected differently by treatments that involve altering levels of
      stress-sensitive hormones, androgen, and central catecholamines. Such
      differential responses suggest that exploratory behavior is an ensemble of
      individual units, some of which are selectively sensitive to specific
      physiological elements of the stress response and of elevated arousal.

PMID- 8477343
TI  - Odorized air current trailing by garter snakes, Thamnophis sirtalis.
AB  - The response of adult red-sided garter snakes, Thamnophis sirtalis parietalis, to
      airborne odor trails was studied. An airtight T-maze was used, through which a
      constant airflow was drawn by a vacuum pump. The arms of the 'T' provided a
      choice between earthworm extract and distilled water. Experiment 1 tested the
      snake's responses to varying concentrations of earthworm extract. Snakes
      accurately trailed the extract at tested concentrations (0.0, 0.01, 0.1, 1, 10,
      100%). At ten percent concentration, tongue-flick rate and speed along the maze
      increased significantly above lower levels, suggesting the existence of a
      threshold concentration. A correlation between mean tongue-flick rate and mean
      speed was demonstrated. Experiment 2 tested the effect of differentially blocked
      vomeronasal ducts on a snake's ability to trail. When both ducts were blocked, no
      trailing was observed, suggesting that vomeronasal stimulation is required.
      Blocking a single duct resulted in a significant number of snakes turning to the
      side of the functioning duct, suggesting that the tongue-vomeronasal system may
      function as a chemotaxic system.

PMID- 8477344
TI  - Chemosensory orientation behavior in juvenile sea turtles.
AB  - It has been widely believed for several decades that hatchling sea turtles
      imprint to chemical cues characteristic of their natal beach and use this
      information as part of a repertoire of mechanisms enabling their return to the
      same beach for mating and nesting. This has proven very difficult to test.
      Although the imprinting theory is conceptually simple, functionally it is quite
      complex. This involves not only chemical imprinting of nestlings but growth and
      migration to habitats where the adults are found, long-term memory of their
      earlier chemical exposure, reproductive maturation, and homing. A few studies
      have been conducted to examine these elements of the imprinting theory.
      Experiments involving the exposure of embryos and hatchlings to chemicals suggest
      that juvenile turtles 'imprint' to the chemical environment of their nest. This
      can be termed chemical imprinting. Loggerhead turtles, Caretta caretta, and
      ridley turtles, Lepidochelys kempi, appear to be attracted to chemicals
      (morpholine and natural seawater, respectively) to which they were exposed as
      embryos. The strongest support for chemical imprinting is that six-month-old
      green turtles, Chelonia mydas, exposed to either morpholine or 2-phenylethanol in
      the nest and for a period of time after hatching, respond similarly to the
      chemical to which they were exposed as nestlings. Although chemical imprinting
      does not 'prove' the imprinting theory of turtle homing, it is a necessary
      component of the theory not previously examined.

PMID- 8477345
TI  - Prairie rattlesnakes (Crotalus viridis) respond to rodent blood with chemosensory
      searching.
AB  - In Experiment I, homogenized rodent tissue was applied to the lips of prairie
      rattlesnakes (Crotalus viridis). This treatment produced elevated rates of tongue
      flicking compared to controls that received water, but the elevations seen
      following stimulation with homogenate were not as large as those seen after
      snakes struck prey. In Experiment II, water, rodent blood, and integumentary cues
      were applied to the lips of rattlesnakes, and only blood resulted in elevated
      rates of tongue flicking. We conclude that blood is a critical component of the
      homogenate. It is hypothesized that detection of blood during predatory strikes
      may be a causal element in the triggering of strike-induced chemosensory
      searching, a typical component of rattlesnake predatory behavior.

PMID- 8477346
TI  - Chemical recognition of kingsnakes by crotalines: effects of size on the
      ophiophage defensive response.
AB  - When confronted by an ophiophagous (snake-eating) kingsnake, venomous snakes of
      the subfamily Crotalinae exhibit a suite of defensive responses including head
      hiding, thrashing, and an unusual response termed 'body bridging'. Other
      responses observed, such as biting and 'freezing', are more general in nature and
      can occur in a variety of contexts. Various crotalines of differing sizes were
      tested for their responses to kingsnakes (Lampropeltis getulus). Responses of
      individuals were recorded for up to 18 months. The results indicate that, if
      habituation can be overcome by periodically allowing a kingsnake to confront but
      not harm the crotaline, the response is dependent on the size of the crotaline,
      in that smaller specimens (< 0.9 m) respond readily, while larger snakes (> 1.0
      m) tend not to respond. The size of the kingsnake apparently does not have an
      effect on the crotaline response. These data appear to resolve apparent conflicts
      in the literature regarding whether certain species respond to ophidian
      ophiophages. In addition, hexane extracts of kingsnake skin were fractionated
      using an alumina column. The various fractions obtained were tested to determine
      which elicited the defensive response. Activity was found only in the most non
      polar fraction. Preliminary analysis by gas chromatography/mass spectrometry
      indicated that this fraction contained straight and branched, saturated and
      polyunsaturated long-chain hydrocarbons.

PMID- 8477347
TI  - Chemoreception in crocodilians: anatomy, natural history, and empirical results.
AB  - Anatomical and behavioral aspects of chemoreception in crocodilians are reviewed.
      Extant crocodilians possess valvular nostrils regulated by smooth muscles; paired
      nasal cavities, each with three conchae; and flaps closing the rear of the
      buccopharyngeal passage to channel inspired air through the nasopharyngeal duct.
      Olfaction is enhanced by gular pumping, whereby the floor of the pharynx is
      alternately lowered and raised to pulse air through the nasal cavity. Taste buds
      occur on the tongue, palate, and pharyngeal walls. Crocodilians in nature or in
      semi-natural enclosures locate distant carrion or concealed meat, implying
      chemoattraction to food. The American alligator exhibits underwater head-waving
      and mouth-opening in response to aqueous and chloroform extracts of meat.
      Alligators increase gular pumping in response to the scents of various meats,
      indicating that they detect food chemicals by olfaction. Paired gular and
      paracloacal glands on the integument of crocodilians are thought to produce
      pheromones. Juvenile crocodilians exhibit heightened gular pumping in response to
      airborne skin gland secretions. Observations of adults suggest that gular and
      paracloacal glands produce chemical signals used in mating and/or nesting
      activities, but behavioral responses to skin gland exudates are too poorly
      documented to ascribe pheromonal properties.

PMID- 8477348
TI  - Chemical and behavioral studies of femoral gland secretions in iguanid lizards.
AB  - Comparative studies on the chemistry and behavioral significance of femoral gland
      secretions in desert iguanas (Dipsosaurus dorsalis) and green iguanas (Iguana
      iguana) are reviewed. Field and laboratory studies suggest that femoral gland
      secretions function in conspecific recognition and range marking. In desert
      iguanas, secretions are of low volatility and may be detected initially using
      long-range ultraviolet visual cues. In contrast, green iguana secretions contain
      a diversity of volatile lipids and appear to be localized by chemoreception.
      Interspecific differences in femoral gland chemistry may reflect adaptations to
      the diverse climatic conditions of arid desert and tropical forest environments.

PMID- 8477349
TI  - Chemical ecology of the red-sided garter snake, Thamnophis sirtalis parietalis.
AB  - The red-sided garter snake, Thamnophis sirtalis parietalis is an ideal model for
      the study of chemical or pheromonal communication in vertebrates. Results of long
      term field and laboratory investigations of the chemical ecology of these unusual
      animals is summarized. These studies include a description of the
      characterization of the female attractiveness pheromone that serves to induce
      male courtship behavior. The male sex recognition pheromone system that
      identifies males as inappropriate individuals to court is also described. She
      males, individual males that are courted as if they were females, seem to possess
      semiochemical components intermediate to both males and females. Finally,
      investigations of the species-specific nature of these pheromones indicate that
      chemical differences exist in the methyl ketones of all species examined to date.

PMID- 8477350
TI  - Mechanisms of recognition in necrotrophic and biotrophic mycoparasites.

PMID- 8477351
TI  - Classification of heterobasidiomycetous yeasts: characteristics and affiliation
      of genera to higher taxa of heterobasidiomycetes.

PMID- 8477352
TI  - Antifungal effect of bean endochitinase on Rhizoctonia solani: ultrastructural
      changes and cytochemical aspects of chitin breakdown.
AB  - A chitinase, purified to homogeneity from ethylene-treated bean leaves, was
      applied to actively growing mycelial cells of Rhizoctonia solani to evaluate a
      potential antifungal activity. Light microscopic investigations at 30-min
      intervals following enzyme exposure revealed the induction of morphological
      changes such as swelling of hyphal tips and hyphal distortions. More precise
      information concerning fungal cell alteration was obtained by ultrastructural
      observation and cytochemical detection of chitin distribution in fungal cell
      walls. Chitin breakdown was found to be an early event preceding wall disruption
      and cytoplasm leakage. The large amounts of chitin present in the walls of
      control R. solani cells and the rapid chitin hydrolysis upon chitinase treatment
      lead us to suggest that this polysaccharide is one of the main components of this
      fungal cell wall and is readily accessible to chitinase, especially in the apical
      zone. By 60 min after enzyme treatment, labeled molecules were observed in the
      vicinity of some fungal cells, suggesting the release of chitin oligosaccharides
      from fungal cell walls. The antifungal activity of the bean chitinase on cells of
      R. solani grown in culture is discussed in relation to the potential of
      genetically modified transgenic plants to resist attack by R. solani through an
      antimicrobial activity in planta.

PMID- 8477354
TI  - Firearms control.

PMID- 8477353
TI  - Accumulation of factor F395 in nifNE mutants of Klebsiella pneumoniae.
AB  - The nifNE gene products of Klebsiella pneumoniae are required for the in vivo and
      in vitro synthesis of the iron-molybdenum cofactor (FeMo-co) of nitrogenase.
      Derepression of nifNE mutants for nitrogenase resulted in the accumulation of a
      small molecule, factor F395. Factor F395 is protein associated in vivo. We report
      here initial spectral characterization of this factor.

PMID- 8477355
TI  - Firearms control.

PMID- 8477356
TI  - Multicultural medicine.

PMID- 8477357
TI  - Balancing home and facility care.

PMID- 8477358
TI  - Physician infection and its consequences.

PMID- 8477359
TI  - Physician infection and its consequences.

PMID- 8477360
TI  - Prohibiting the sale of tobacco.

PMID- 8477361
TI  - Postpartum contraception: informed choice.

PMID- 8477362
TI  - Of AIDS and other plagues.

PMID- 8477363
TI  - Primary prevention of neural tube defects: notice from the HPB.

PMID- 8477364
TI  - The era of genetic medicine.

PMID- 8477365
TI  - Workshop on clinical practice guidelines: summary of proceedings. Department of
      Health Care and Promotion, Canadian Medical Association.

PMID- 8477366
TI  - Demand-side medical education: educating future physicians for Ontario.
AB  - Initiated by Associated Medical Services (AMS), Educating Future Physicians for
      Ontario is a 5-year collaborative project whose overall goal is to make medical
      education in Ontario more responsive to that province's evolving health needs. It
      is supported by AMS, the five universities with medical schools or academic
      health sciences centres and the Ontario Ministry of Health. The project's five
      objectives are to (a) define the health needs and expectations of the public as
      they relate to the training of physicians, (b) prepare the educators of future
      physicians, (c) assess medical students' competencies, (d) support related
      curricular innovations and (e) develop ongoing leadership in medical education.
      There are several distinctive features: a focus on "demand-side" considerations
      in the design of curricula, collaboration within a geopolitical jurisdiction
      (Ontario), implementation rather than recommendation, a systematic project
      evaluation plan and agreement as to defined project outcomes, in particular the
      development of institutional mechanisms of curriculum renewal as health needs and
      expectations evolve.

PMID- 8477367
TI  - Antituberculous drug resistance in Manitoba from 1980 to 1989.
AB  - OBJECTIVES: To estimate the magnitude of antituberculous drug resistance and
      identify the risk factors for its development in tuberculosis patients in
      Manitoba over a 10-year period. As well, to examine the clinical course of the
      patients whose initial or subsequent isolates of Mycobacterium tuberculosis were
      resistant to one or more drugs. DESIGN: Comparison of drug-resistant and non-drug
      resistant cases of tuberculosis. SETTING: Manitoba. PATIENTS: All people with
      tuberculosis reported to the Central Tuberculosis Registry of Manitoba between
      Jan. 1, 1980, and Dec. 31, 1989. MAIN OUTCOME MEASURES: Of 1478 cases of active
      tuberculosis 1086 were culture positive, and drug susceptibility testing was
      performed in these cases. The clinical course, including outcome of treatment, of
      all drug-resistant cases was described. RESULTS: Of 1086 culture-positive cases
      of tuberculosis 77 (7.1%) were drug resistant. Odds ratios suggested that the
      risk of drug resistance was significantly higher among the immigrants than among
      the other Canadians. Compared with the other Canadians the risk of drug
      resistance was 9.9 times greater among the immigrants in whom tuberculosis
      developed within the first year after arrival in Canada and 5.4 times greater
      among the immigrants in whom it developed 2 to 5 years after arrival in Canada.
      Of the 71 patients with drug-resistant disease whose type of resistance was known
      62% had never taken antituberculous drugs before and 38% had. Most (91%) of the
      77 cases of drug-resistant disease were resistant to first-line drugs, especially
      isoniazid and streptomycin. Thirty-two (42%) of the 77 cases were resistant to
      two or more first-line drugs. Of patients with drug-resistant disease a subgroup
      of 10 had disease that became resistant to several drugs over the 10-year period.
      The outcome of treatment in these individuals was poor, and they presented a
      particular public health problem. CONCLUSION: Resistance to one or more first
      line antituberculous drugs continues to complicate the treatment of tuberculosis
      and may facilitate the spread of the disease.

PMID- 8477368
TI  - Canadian outpatients and advance directives: poor knowledge and little experience
      but positive attitudes.
AB  - OBJECTIVE: To examine the knowledge of, previous experience with, attitudes
      toward and perceived barriers to completing advance directives among outpatients
      at two general medicine clinics. DESIGN: Cross-sectional questionnaire
      administered in face-to-face structured interviews. SETTING: General internal
      medicine outpatient clinics at a university teaching hospital. PATIENTS: One
      hundred and five adult outpatients who could communicate in spoken English and
      who consented to be interviewed. RESULTS: Of 167 patients approached, 58 were
      excluded because they could not communicate in spoken English, and 4 refused to
      participate. Of the remaining 105 patients, 17 (16%) knew about living wills, 12
      (11%) about durable powers of attorney for health care and 4 (4%) about advance
      directives. Twenty-three (22%) had thought about their preferences for life
      sustaining treatment, 20 (19%) had discussed them, none had written them down,
      and 45 (43%) had thought about choosing a proxy. Sixty-one (58%) wanted to think
      about their preferences for treatment, 65 (62%) wanted to discuss them, 32 (30%)
      wanted to write them down, and 80 (76%) wanted to choose a proxy. The perceived
      barriers to completing an advance directive were inability to write, the belief
      that an advance directive was unnecessary, a fatalistic attitude, previous
      discussion of preferences, a desire to leave the decision to doctors, uncertainty
      about preferences, a desire to discuss preferences rather than document them, a
      desire to wait until the situation arose, a desire to write down preferences in
      the future and a desire to avoid thinking about preferences or advance
      directives. Respondents with more knowledge of life-sustaining treatments were
      more likely to want to complete an advance directive. CONCLUSIONS: Outpatients
      have positive attitudes toward advance directives, but their knowledge and
      experience are limited. These data underscore the need for patient education and
      for policies to eliminate the barriers to completing advance directives that
      patients face.

PMID- 8477369
TI  - Acute hypercalcemia and severe bradycardia in a patient with breast cancer.

PMID- 8477370
TI  - Some thoughts on medical education. 1929.

PMID- 8477372
TI  - The Association of Canadian Medical Colleges: Commemorating 50 years of the
      ACMC's contributions to medical education.

PMID- 8477371
TI  - The university, the hospital and the mission of the ACMC.

PMID- 8477373
TI  - The Association of Canadian Medical Colleges and how it grew.
AB  - The Association of Canadian Medical Colleges has evolved over the 50 years of its
      existence in ways that could not have been anticipated by its founders who, none
      the less, would approve of the mature adult their infant has become. Both
      undergraduate and postgraduate medical education in Canada are now on a firmer
      and more rational base than would have been possible without the guidance and
      direction provided by a national body capable of resisting regional and sectarian
      pressures. Credit for this achievement must go to those who were responsible for
      the creation of the secretariat in the early 1960s. The vision of Wendell
      Macleod, the first chief executive officer, led to the development of the
      association's strong research arm, and his charm and wisdom created a smoothly
      operating and loyal staff. The record of the organization is a tribute to its
      staff and to the wisdom and foresight of its Council of Deans and Board of
      Directors.

PMID- 8477374
TI  - ACMC: past, present and future.
AB  - In this article, the president of the Association of Canadian Medical Colleges
      (ACMC) and its director of research review the issues that have confronted ACMC
      since its inception: the founding of ACMC; development of the clinical teaching
      unit; creation of the Medical Research Council and expansion of the research
      mission; the Royal Commission on Health Services and the founding of new
      faculties of medicine; ACMC's in-house research program; accreditation and ACMC's
      links with medical education in the United States; and French-language medical
      education in Canada. The review points out the perennial nature of many of these
      issues, and how often perceived solutions to the problems later become problems
      themselves. It ends on the optimistic note that ACMC can successfully meet the
      challenges of the future.

PMID- 8477375
TI  - Canadian medical schools before ACMC.
AB  - The earliest medical schools were established to supplement apprenticeship, the
      only route to practice available in colonial Canada. By 1885, eight medical
      schools were trying to accommodate the volume of new scientific information
      flowing from Europe. In 1910, when Flexner evaluated the schools against the
      Johns Hopkins model, some were woefully deficient, but by 1928 all had achieved
      Class A rating. The 1921 discovery of insulin in Toronto gave impetus to
      scientific research and, possibly, influenced the formation and funding of the
      National Research Council in 1934. Clinical specialization expanded, leading in
      1929 to the establishment of the Royal College of Physicians and Surgeons of
      Canada to accredit training and certify graduates. The Association of Canadian
      Medical Colleges was formed at a meeting of deans to discuss a federal offer of
      funding and to accelerate the graduation of physicians for the war effort.

PMID- 8477376
TI  - Universities and medical schools: reflections on a half-century of Canadian
      medical education.
AB  - After 50 years of accelerated development, universities and medical schools have
      entered a period of uncertainty and instability. The Flexnerian paradigm of
      medical education, rooted in biomedical science and conducted under the aegis of
      a university, reached its apotheosis by the late 1960s and the early 1970s.
      Fuelled by the introduction of comprehensive, government-sponsored health care
      insurance and advances in technology, the demand for health care professionals
      and for access to facilities increased sharply. Medical education, research and
      advanced clinical services expanded dramatically aided by the emergence of
      academic health sciences centres and accompanied by a wave of medical curriculum
      reform. Now medical schools must strike a dynamic balance in responding to the
      continued expansion of knowledge and technology, the demand for social equity and
      the exigencies of prolonged fiscal constraint. They must also balance the
      biological and sociological approaches to medicine in establishing the
      foundations for the future development of Canadian medical education.

PMID- 8477377
TI  - The academic medical centre: an idea whose time has come.
AB  - Interdependence of faculties of medicine or health sciences and teaching
      hospitals is central to the academic medical centre's three "products":
      education, research and clinical service. Whether a voluntary association,
      partnership, joint venture or single entity, the strength of the association of
      member institutions must lie in mutual dependency. With the potential of reducing
      costs and increasing effectiveness through administrative efficiency and
      rationalization, especially of planning and setting priorities, the academic
      medical centre can outstrip its individual member institutions in contributing to
      the solution of Canada's present and future challenges in health care.

PMID- 8477378
TI  - The role of academic health sciences centres in international health.
AB  - For many years, Canadian academic health science centres have been active in
      international health. This brief review describes the activities of the Canadian
      Society for International Health, the Canadian University Consortium for Health
      in Development, and McGill, McMaster and Ottawa universities. Three principles
      are derived from these examples. Health must be placed in the broader context of
      development, and international health initiatives must be intersectoral. Canadian
      universities can make a distinctive and important contribution to health and
      development internationally, but this requires a clear commitment to scientific
      excellence and social responsibility. Finally, Canadian institutions, as
      representatives of the North, have much to learn through collaboration and
      partnerships with institutions in the South.

PMID- 8477379
TI  - An American's view of Canadian medical education.
AB  - Undergraduate medical education in Canada and the United States is remarkably
      similar, except for the fact that Canadian medical schools are supported by their
      provincial governments. However, the systems diverge sharply at the postgraduate
      level. In Canada, the number and specialty mix of residents are negotiated by
      medical schools in response to educational and social needs; in the United
      States, these factors are largely determined by hospital service needs. The
      Canadian systems of accreditation, certification and payment for medical
      education after graduation are much simpler than those of the United States, and
      the accreditation and certification systems are more objective. In addition, the
      US system promotes subspecialization and a costly specialty imbalance, whereas
      Canada's system has achieved an appropriate balance of specialists and
      generalists. In general, Canadian medical education appears to be simpler, more
      accountable and more socially responsive.

PMID- 8477380
TI  - History of specialty residency funding in Canada.
AB  - Specialty residency training in Canada has evolved from its origin in teaching
      hospitals through an era dominated by universities to the present when public
      accountability is emerging as a dominant influence. The predominant educational
      strategies, including experimental learning, role modelling, continuum of
      training, independent thinking, self-directed learning and research experiences,
      have been influenced by the diversity of roles expected of the resident,
      including that of an employee, a student, a teacher and, more recently, a part of
      the policy instrument of governments in controlling physician resources.

PMID- 8477381
TI  - Academic family medicine in Canada.
AB  - Fifty years ago family practice in Canada had no academic presence. Stimulated by
      a number of general practitioners and with the support of the Canadian Medical
      Association, the College of General Practitioners of Canada (CGPC) was founded in
      1954. In 1962, conferences on education for general practice attended by the
      Association of Canadian Medical Colleges and the CGPC led to pilot postgraduate
      residencies in family practice supported by Department of National Health and
      Welfare. The first certification examination was held in 1969 and, by 1974, all
      Canadian medical schools had a family medicine residency program. Today
      departments of family medicine contribute substantially to undergraduate
      education in all 16 schools. In Canada, the medical profession, governments and
      the medical schools have demonstrated the importance they place on appropriate
      education for family physicians.

PMID- 8477382
TI  - The clinical teaching unit in transition.
AB  - The clinical teaching unit (CTU), a distinctively Canadian concept, has served
      Canadian academic medicine well over the past 30 years. Times have changed
      considerably since the concept was first defined by the Association of Canadian
      Medical Colleges in 1962. Many proposals and ideas of Evans, Chute and Morley in
      their description of the CTU, clinical education and the practice of medicine
      remain relevant today. The concept of learning by doing, under supervision, in a
      relatively controlled academic environment is still valid. However, we must
      either expand our concept of the traditional CTU to make it consistent with the
      contemporary broad practice of medicine or maintain the current model as
      complementary, but not necessarily central, to an expanded paradigm of clinical
      education.

PMID- 8477383
TI  - A student-centred, problem-based curriculum: 5 years' experience.
AB  - In 1987, the University of Sherbrooke's school of medicine implemented a student
      centred, problem-based learning (PBL) curriculum. The experience of the first 5
      years is reviewed; program goals, the schedule of learning activities, the
      instructional format and assessment of student learning are described. The new
      program is more demanding of teachers and requires better faculty training in
      pedagogy. No new financial resources have been available. The preclinical reform
      has led to revision of the clerkship, where sessions on clinical reasoning are
      now based on the PBL philosophy. Student reactions to the program are reported.
      The Sherbrooke experience has demonstrated that it is both possible and feasible
      to shift from a traditional to a problem-based curriculum.

PMID- 8477384
TI  - Canadian experience with structured clinical examinations.
AB  - The use of structured clinical examinations to improve the evaluation of medical
      students and graduates has become significantly more common in the past 25 years.
      Many Canadian medical educators have contributed to the development of this
      technique. The Canadian experience is reviewed from the introduction of simulated
      standardized patients and objective-structured clinical examinations to more
      recent developments and the use of such examinations for licensure and
      certification.

PMID- 8477385
TI  - Health research in Canada: a shifting paradigm.
AB  - A personal review of medical research in Canadian medical schools over the past
      25 years reveals extraordinary contributions. Over this time, medical research
      evolved from a by-product of faculty members to a commitment that determines the
      future success of a medical faculty. The increasing competition for health
      research funding and the high standards created internationally have changed the
      way research is organized in our medical faculties. Current trends include a move
      toward group and thematic research, an increased role of research institutes and
      the development of strategic partnerships with industry. Because of the need for
      more planning and more critical and timely review of research efforts, the
      benefits of collaboration enhance the quality and competitiveness of a medical
      faculty. A broadened vision of the Medical Research Council and provincial
      foundations and the need to increase resources for research foreshadow even
      greater change.

PMID- 8477386
TI  - Canadian medical education: 50 years of innovation and leadership.
AB  - Over the past 50 years, many Canadian medical educators have pursued ideas and
      visions, as individuals in the 1950s and 1960s and later in partnership with
      various national bodies. Relations between universities and national medical
      organizations have been productive in dealing with issues of postgraduate
      education and clinical assessment, in particular. From 1970 to 1990, strong
      education offices and formally trained educators led to many successes in the
      areas of research in cognition, continuing medical education and clinical
      assessment. Canadian medical education has now achieved international recognition
      for its work in all aspects of the continuum of the physician's education through
      vision, initiative and cooperation.

PMID- 8477388
TI  - Life in the ER: wild nights, mounting stress and mid-40s burnout.

PMID- 8477387
TI  - Pondering the future.
AB  - Despite growing tensions as the Canadian health care system evolves, the system
      will survive over the next decade and strengthen its societal objectives,
      sometimes dragging physicians along. With the shift of the intellectual centre
      away from the universities, research and researchers will find funding security
      but career insecurity in the private sector. The independent investigator will
      become rare as "big science" becomes the norm, and basic science departments will
      have a decade of confusion as they struggle for a new place in the renewed
      medical schools. The move toward problem-based, community-oriented medical
      education will be completed, clinical faculty will become salaried and the
      smaller numbers of graduates will be more controlled in their practices. Medicine
      as a profession will adopt a renewed philosophical framework and will broaden in
      its scope to the benefit of Canadians.

PMID- 8477389
TI  - Move to decentralize FP residencies may help solve MD maldistribution problems.

PMID- 8477390
TI  - Getting them off nicotine.

PMID- 8477391
TI  - "TB voyages" into High Arctic gave MDs a look at a culture in transition.

PMID- 8477392
TI  - A case for caring.

PMID- 8477393
TI  - Brucellosis: a medical rarity that used to be common in Canada.

PMID- 8477394
TI  - Many of Britain's disillusioned doctors are leaving medicine behind.

PMID- 8477395
TI  - Experiences in China shed new light on Eastern medicine.

PMID- 8477396
TI  - Cultural awareness in the context of terminal illness.
AB  - While cultural awareness provides direction for planning effective nursing
      interventions at all stages of health and illness, this article specifically
      addresses applications for patients who are terminally ill. Professional nurses
      encounter unique challenges in caring for terminally ill patients. Assisting
      patients to achieve an "appropriate death" requires communication and
      collaboration among patients, family members, and professional caregivers. Since
      patients and their families represent many systems of complex beliefs and values,
      nurses must be aware of the impact of cultural pluralism on nursing assessment
      and intervention in terminal illness. Reordering priorities and redistributing
      resources have been identified as new approaches in caring for terminally ill
      patients and their families. Two concepts that cut across all cultural boundaries
      are loss and grief. Expressions of loss and grief take on a variety of forms
      among members of diverse cultures. It is critical that nurses recognize,
      understand, and respect each family's culture-specific patterns with regard to
      terminal illness. Understanding the culture will lead to the design of culturally
      appropriate nursing care for patients and families. Culture brokerage is defined
      as an act of translation, where messages, instructions, and belief systems are
      exchanged between cultural groups. This strategy has the potential to increase
      understanding among those with diverse cultural backgrounds, resulting in
      increased patient/family satisfaction within the supportive care setting.
      Consonance between patients' needs and nurses' understanding of those needs will
      lead to more culturally appropriate intervention strategies.

PMID- 8477397
TI  - Oncology nurse and physician attitudes toward aggressive cancer treatment.
AB  - Oncology nurses (n = 57) and oncology physicians (n = 40) employed in the same
      hospital completed the Cancer Attitude Questionnaire. Significant differences (p
      < or = .001) between nurse and physician attitudes were evident on the two major
      subscales addressing the issues of (a) aggressiveness of treatment/de-emphasis of
      socioemotional aspects of care and (b) the importance of patient-family
      attitudes. Physicians' attitudes were significantly more favorable on the first
      subscale; nurses' attitudes were significantly more favorable on the second.
      Implications of these findings as indicators of potential nurse-physician
      conflict are discussed.

PMID- 8477398
TI  - A nursing intervention for early detection of spinal cord compressions in
      patients with cancer.
AB  - This article reviews the current literature regarding spinal cord compression
      including its prevalence and presenting signs and symptoms; increases an
      awareness of the potentially severe effects of spinal cord compression; and
      describes a model for patient educational intervention focusing on early warning
      signs of spinal cord compression. With increased understanding of the nature and
      effects of spinal cord compression, nurses may effectively intervene to minimize
      the severity of the neurological deficits.

PMID- 8477399
TI  - Reducing the incidence of stomatitis using a quality assessment and improvement
      approach.
AB  - Stomatitis occurs in approximately 40% of the patients receiving systemic
      administration of chemotherapy and cancer treatments such as radiation to the
      head and neck. The presence of stomatitis affects the course of treatment and a
      patient's quality of life. An oncology nursing unit developed a quality
      assessment and improvement indicator addressing stomatitis. Oral cavity
      screening, dental consultations, oral care techniques, and patient teaching were
      included in the nursing interventions, which resulted in a marked reduction of
      new cases of stomatitis.

PMID- 8477400
TI  - Evaluation of high-risk smoking practices used by the homeless.
AB  - The purpose of this study was to evaluate the prevalence of high-risk smoking
      practices in a homeless population. High-risk cigarette smoking practices include
      misuse of tobacco products or alternative methods of cigarette smoking that
      increase the likelihood of ingestion of toxic substances and infectious agents
      that can potentiate the hazards associated with cigarette smoking. An 84-item
      questionnaire was developed by the researcher to measure these practices. Fifty
      six male and three female homeless people were interviewed in downtown Los
      Angeles. The most common high-risk smoking practices were cigarette sharing
      (86%); smoking cigarettes remade from discarded cigarette butts and filters
      (71%); smoking cigarettes remade by others (63%); smoking discarded cigarette
      butts (63%); blocking filter vents (24%); using things other than tobacco, such
      as discarded cigarette filters and drugs, in remaking cigarettes (22%); and
      smoking discarded cigarette filters (19%). These high-risk smoking practices pose
      a greater risk of exposure to toxins trapped in filters and tobacco remains and
      increase the threat of infectious disease transmission. The long-term effects of
      high-risk smoking practices among the homeless have potential economic
      implications for society.

PMID- 8477401
TI  - The role of the data manager in clinical cancer research. An opportunity for
      nurses.
AB  - A clinical trial is a research study conducted in humans and designed to answer
      specific questions using scientifically controlled methods. These trials require
      considerable effort to assure that the data obtained are reliable, reproducible,
      and readily available. Data managers play a key role in this research effort. A
      nurse with a clinical background, computer knowledge, and some experience in the
      research environment is well suited for the role of data manager. The data
      manager performs a variety of tasks in this position that will enhance the
      quality of the data gathered in a research study. These responsibilities include
      designing forms, monitoring protocol accrual, abstracting data, entering data
      onto protocol-specific forms and/or specifically designed computerized data-entry
      screens, assuring the quality and the integrity of the data, and providing
      investigators with interim and summary reports. In addition, the data manager can
      be responsible for the management of a computerized clinical data base system,
      including the training of users and the designing of basic reports for the
      investigators. A nurse, functioning as a data manager, who understands research
      methodology, is detail oriented, and is well organized, could be a valuable asset
      to the clinical trials team in the successful management of any clinical study.

PMID- 8477402
TI  - Safe tan. An oxymoron.
AB  - Skin cancer may be a very preventable malignancy, yet the incidence is increasing
      at an epidemic rate. Solar ultraviolet radiation is the major carcinogenic agent.
      The expression "a good healthy tan" is a contradiction; tanning is the biological
      process of the skin responding to injury. Regular use of a properly selected and
      applied sunscreen is one of the essential primary prevention strategies for
      reducing the incidence of skin cancer. Nurses can be instrumental in helping
      patients/clients understand the dangers of suntanning and the need for protection
      against solar ultraviolet radiation (UVR).

PMID- 8477403
TI  - Cancer chemotherapy: intravenous administration.

PMID- 8477404
TI  - Development of an intervention to restore attention in cancer patients.
AB  - Developing interventions to maintain or restore attentional capacity during
      demanding phases of illness will help promote effective functioning in people
      with cancer. This study tested the effects of an experimental intervention aimed
      at maintaining or restoring attentional capacity in 32 women during the 3 months
      after surgery for localized (Stage I or II) breast cancer. The intervention was
      designed to minimize or prevent attentional fatigue through regular participation
      in activities that engage fascination and have other restorative properties.
      Attentional capacity was assessed using objective and subjective measures at four
      time points, approximately 3, 18, 60, and 90 days after breast cancer surgery.
      After the first observation, subjects were randomly assigned to receive the
      intervention (n = 16) or not to receive intervention (n = 16). Repeated measures
      ANOVA showed a significant interaction of experimental intervention and time on
      attentional capacity. Specifically, subjects in the intervention group showed
      significant improvement in attentional capacity over the four time points, while
      the nonintervention group showed a pattern of inconsistent performance over time.
      Findings suggest that nurses can intervene to maintain or restore attentional
      capacity in women after surgery for localized breast cancer. The theoretical
      basis for further development of attention-restoring interventions in patients
      with cancer is discussed.

PMID- 8477405
TI  - The use of therapeutic massage as a nursing intervention to modify anxiety and
      the perception of cancer pain.
AB  - The purpose of this exploratory study was to examine the effects of therapeutic
      massage (consisting of effleurage, petrissage, and myofascial trigger point
      therapy) on pain perception, anxiety, and relaxation levels in hospitalized
      patients experiencing significant cancer pain. Thirty minutes of therapeutic
      massage was administered on two consecutive evenings to nine hospitalized males
      diagnosed with cancer and experiencing cancer pain. The subjects' self-reports of
      pain and relaxation (measured by Visual Analogue Scales) as well as anxiety
      (measured by the Spielberger State Anxiety Inventory) were recorded before and
      immediately after the intervention. The objective physiologic measures of heart
      rate, respiratory rate, and blood pressure were obtained before, immediately
      after, and, finally, 10 min after the massage intervention. Massage therapy
      significantly reduced the subjects' level of pain perception (average = 60%) and
      anxiety (average = 24%) while enhancing their feelings of relaxation by an
      average of 58%. In addition to these subjective measures, all physiological
      measures (heart rate, respiratory rate, and blood pressure) tended to decrease
      from baseline, providing further indication of relaxation. In conclusion,
      although the exact mechanism is not known, therapeutic massage is a beneficial
      nursing intervention that promotes relaxation and alleviates the perception of
      pain and anxiety in hospitalized cancer patients.

PMID- 8477406
TI  - Pharmacological basis of immunotherapy in autoimmune diseases.
AB  - The clinical development of immunomodulatory agents for the treatment of
      autoimmune diseases is an arduous process. This can be explained by the fact that
      the true pathogenic mechanism of the disease(s) is unknown. Moreover, the
      properties and pharmacokinetic profile of these immunomodulatory agents are
      different from other classic therapeutic compounds. The aim of this brief review
      is to discuss a number of general aspects of the clinical pharmacology of i.v.
      immune globulin as well as more recent immunotherapeutic approaches such as anti
      cytokine therapy, which are currently being applied in the immunotherapy for
      neurologic and rheumatic autoimmune disorders such as myasthenia gravis, chronic
      inflammatory demyelinating polyneuropathy, and rheumatoid arthritis. A better
      understanding of the interaction of the therapeutic compound and the host immune
      response, the knowledge of its kinetic profile, and the development of surrogate
      markers of clinical efficacy should help in designing randomized and blinded
      clinical trials that will ultimately determine the optimal therapeutic regimen.

PMID- 8477407
TI  - Reproducibility of motor effects induced by successive subcutaneous apomorphine
      injections in Parkinson's disease.
AB  - We performed a crossover study of apomorphine-induced motor response
      reproducibility in 10 parkinsonian patients with the "on-off" phenomenon. On 2
      separate days, each patient received two successive identical s.c. apomorphine
      injections, the second injection being randomly administered either 10 or 80 min
      after the end of the first apomorphine-induced motor benefit. Latency (12.3 +/-
      4.5 min) and duration (61.9 +/- 13.3 min) of motor effects were similar in all
      tests. A transient worsening of the parkinsonian state after a motor improvement
      induced by apomorphine occurred in most of the patients. Therefore, the duration
      and severity of the "off" period after a motor improvement does not seem to
      influence the efficacy of a second apomorphine administration.

PMID- 8477408
TI  - Effects of bromocriptine in human narcolepsy.
AB  - Bromocriptine, a preferential D2 receptor agonist, was administered to six human
      narcoleptic patients during a double-blind, cross-over study. Laboratory sessions
      consisted of two all-night polysomnographic recordings and three daytime tests of
      vigilance: the Analogue Vigilance Scale (AVS), the Maintenance of Wakefulness
      Test (MWT), and the Four-Choice Reaction Time Test (FCRTT). No change in
      nocturnal sleep organization, daytime somnolence, or psychomotor performance was
      observed during bromocriptine administration. Periodic limb movements in sleep
      (PLMS) were significantly reduced during bromocriptine condition. These results
      suggest that D2 receptors are unlikely to play a major role in the
      physiopathology of human narcolepsy, and support the hypothesis that dopaminergic
      mechanisms are involved in PLMS.

PMID- 8477409
TI  - Response to L-DOPA in multiple system atrophy.
AB  - A poor response to L-DOPA in addition to parkinsonian, cerebellar, and autonomic
      signs is commonly regarded as indicative of clinical multiple system atrophy
      (MSA). We compared the motor response to a single oral administration of 250 mg L
      DOPA/25 mg carbidopa in eight MSA patients and eight Parkinson's disease (PD)
      patients with the "on-off" phenomenon, evaluating L-DOPA peripheral
      pharmacokinetics. Motor response was consistently good in all PD patients, but
      only four MSA patients had a (moderate) response. Pharmacokinetic parameters did
      not differ between the groups. The varying extent of putaminal damage could be
      responsible for the differing motor response to L-DOPA in MSA patients.

PMID- 8477410
TI  - The effect of catechol-O-methyl transferase inhibition by entacapone on the
      pharmacokinetics and metabolism of levodopa in healthy volunteers.
AB  - We studied the effect of inhibiting the enzyme catechol-O-methyltransferase
      (COMT) by a novel COMT inhibitor, entacapone, on the pharmacokinetics and
      metabolism of levodopa in 12 healthy male volunteers. Single increasing oral
      doses of entacapone (50-400 mg) were administered concomitantly with a single
      oral dose of levodopa/carbidopa (100/25 mg). The subjects were treated with
      carbidopa (100 mg t.i.d.) for 1 day prior to the administration of study drugs.
      Plasma concentrations of levodopa; its metabolites 3-O-methyldopa (3-OMD), 3,4
      dihydroxyphenylacetic acid (DOPAC), and homovanillic acid (HVA); as well as
      carbidopa and entacapone were determined for pharmacokinetic calculations.
      Entacapone dose-dependently increased the area under the plasma concentration
      time curve (AUC) of levodopa; the increase was 65% after the 400 mg dose of
      entacapone. Neither Cmax nor Tmax of levodopa was statistically significantly
      influenced by entacapone. Entacapone dose-dependently decreased the AUC of 3-OMD,
      maximally by 58%. The AUC of DOPAC was statistically significantly increased but
      no change in the AUC of HVA was observed after entacapone. No drug-related
      adverse events or hemodynamic effects were observed. The in vivo biochemical
      effects of entacapone indicate that it is an orally active COMT inhibitor and
      that it may improve the therapeutic efficacy of levodopa in Parkinson's disease.

PMID- 8477411
TI  - Relation between clinical efficacy and pharmacokinetic parameters after
      sublingual apomorphine in Parkinson's disease.
AB  - Apomorphine was administered sublingually in two single doses (0.3 and 0.6 mg/kg)
      to seven patients with idiopathic Parkinson's disease (PD) to assess the relation
      between clinical efficacy, dosage, and pharmacokinetic parameters of apomorphine.
      On day 1 and day 3, patients were given 0.3 mg/kg and 0.6 mg/kg of apomorphine,
      respectively (3 mg tablets). Before apomorphine administration and during the
      following 4 h, motor score was assessed by measuring tremor, akinesia scores,
      rising from a chair, and walking speed. The delay to turn on was not different
      between the two doses but after the 0.3 mg/kg dose, only three patients turned
      on, whereas all the patients treated with 0.6 mg/kg turned on. Apomorphine (0.3
      mg/kg) induced a shorter duration of the "on" period than 0.6 mg/kg (0.3 mg/kg:
      24.2 +/- 14.6 min; 0.6 mg/kg: 86.7 +/- 14.9 min). The time to obtain the peak
      plasma concentration (tmax) obtained with the two doses were not different (0.3
      mg/kg: 31.5 +/- 3.4 min; 0.6 mg/kg: 38.3 +/- 2.8 min). Peak plasma concentrations
      (Cmax) and areas under the curve (AUC) were significantly higher after 0.6 mg/kg
      than 0.3 mg/kg (Cmax: 0.3 mg/kg: 7.5 +/- 3.2 ng/ml; 0.6 mg/kg: 22.7 +/- 3.6
      ng/ml; p < 0.01; AUC: 0.3 mg/kg: 929 +/- 109 ng/ml/min; 0.6 mg/kg; 2,277 +/- 209
      ng/ml/min; p < 0.01). There was a significant linear correlation between the
      duration of therapeutic effect, AUC, and Cmax (r = 0.86, p < 0.01 for AUC; r =
      0.63, p < 0.05 for Cmax). These results show that sublingual apomorphine could be
      of interest in the treatment of "off" phases in parkinsonian patients with motor
      fluctuations.

PMID- 8477412
TI  - A pilot controlled study of fluoxetine for obsessive-compulsive symptoms in
      children with Tourette's syndrome.
AB  - We carried out a double-blind, randomized, parallel-groups clinical trial of
      fluoxetine (20-40 mg/day) and placebo in 11 children with Tourette's syndrome
      (TS) and associated obsessive-compulsive symptoms (OCS). The treatment period
      lasted 4 months. No significant differences between treatment groups were
      observed for measures of OCS. Fluoxetine therapy, however, was associated with a
      trend toward some improvement in tic severity, attentional abilities, and social
      functioning. Given these observations and the limitations of this pilot study,
      which include selection biases, small sample size, and significant placebo
      effects, the efficacy of fluoxetine in children with TS deserves further larger
      scale investigation.

PMID- 8477413
TI  - Encephalopathy associated with bismuth subgallate therapy.
AB  - A 74-year-old man developed paranoid ideation, memory impairment, and defective
      gustatory and olfactory function while on bismuth subgallate therapy for use as a
      colostomy deodorant. Twenty-four-hour urine bismuth was elevated at 889
      micrograms/day, and whole blood bismuth concentration was 67 micrograms/L. The
      patient improved after discontinuation of bismuth subgallate; there was
      resolution of paranoid behavior and gustatory and olfactory functions improved.
      Follow-up whole blood bismuth concentration was 21 micrograms/L 4 weeks after
      cessation. Altered gustatory and olfactory function have not been previously
      reported with bismuth intoxication.

PMID- 8477414
TI  - Immunopharmacologic therapy in myasthenia gravis.
AB  - Immunotherapy is frequently employed in treatment of patients with myasthenia
      gravis. Different regimens are not based entirely on controlled or comparative
      studies. There are few clear guidelines for choosing a particular
      immunomodulating agent and timing of its introduction. In this article, we have
      tried to summarize known information about the immunopharmacologic agents used
      for the treatment of patients with myasthenia gravis.

PMID- 8477415
TI  - Increased projection of MHC and tumor antigens in murine B16-BL6 melanoma induced
      by hydrostatic pressure and chemical crosslinking.
AB  - The B16-BL6 melanoma, like most spontaneously arising tumors, is poorly
      immunogenic and expresses low levels of major histocompatibility complex (MHC)
      antigens. Treatment of cells of this tumor in vitro by hydrostatic pressure in
      the presence of adenosine 2',3'-dialdehyde (oxAdo), a membrane-impermeant
      crosslinker, caused elevated projection of MHC and a specific tumor antigen as
      demonstrated by flow-cytometric analysis. Maximum projection of both the MHC and
      the tumor antigens could be reached by application of 1200 atm for 15 min in the
      presence of 20 mM oxAdo. It is not yet clear whether this passive increase in
      availability of antigens on the cell surface originated from a dormant pool of
      antigens in the plasma membrane or from pressure-induced fusion of antigen-rich
      intracellular organelles (e.g. the endoplasmic reticulum). The immunogenic
      properties of the antigen-enriched B16-BL6 cells are described in the following
      paper.

PMID- 8477416
TI  - Induction of cell-mediated immunity against B16-BL6 melanoma in mice vaccinated
      with cells modified by hydrostatic pressure and chemical crosslinking.
AB  - In the preceding paper we have demonstrated an increase in presentation of both
      major histocompatibility complex antigens (MHC) and a tumor-associated antigen of
      the weakly immunogenic B16 melanoma by a straight-forward technique. The method
      consists in modulating the tumor cell membrane by hydrostatic pressure and
      simultaneous chemical crosslinking of the cell-surface proteins. In B16-BL6
      melanoma, the induced antigenic modulation was found to persist for over 48 h,
      which permitted the evaluation of the ability of modified B16-BL6 cells to induce
      immunity against unmodified B16-BL6 cells. In the present study, we have shown
      that a significant systemic immunity was induced only in mice that were immunized
      with modified B16-BL6 melanoma cells, whereas immunization with unmodified B16
      BL6 cells had only a marginal effect when compared to the results in control sham
      immunized mice. The induced immunity was specific since a single immunization
      affected the growth of B16-BL6 tumors but had no effect on MCA 106, an
      antigenically unrelated tumor. The addition of interleukin-2 to the immunization
      regimen had no effect on the antitumor responses induced by the modified B16-BL6
      cells. The cell-mediated immunity conferred by immunization with treated B16-BL6
      cells was confirmed in experiments in vitro where splenocytes from immunized mice
      could be sensitized to proliferate by the presence of B16-BL6 cells. In addition,
      the altered antigenicity of these melanoma cells appeared to correlate with their
      increased susceptibility to specific effectors. Thus, 51Cr-labeled B16-BL6 target
      cells, modified by pressure and crosslinking, in comparison to control labeled
      target cells, were lysed in much greater numbers by effectors such as lymphokine
      activated killer cells and allogeneic cytotoxic lymphocytes (anti-H-2b), while
      such cells remained resistant to lysis by natural killer cells. Our findings
      indicate that the physical and chemical modifications of the tumor cells that are
      described here may be considered as a simple yet effective method for the
      preparation of tumor vaccines, which could be applied in tumor-bearing hosts.

PMID- 8477417
TI  - Adoptive immunotherapy of advanced melanoma patients with interleukin-2 (IL-2)
      and tumor-infiltrating lymphocytes selected in vitro with low doses of IL-2.
AB  - Freshly isolated tumor-infiltrating lymphocytes (TIL) from stage IV melanoma
      patients were cultured for 2 weeks with low doses of interleukin-2 (IL-2; 120
      IU/ml), to select potentially for tumor-specific lymphocytes present in the
      neoplastic lesion, followed by high doses (6000 IU/ml) to achieve lymphocyte
      expansion. TIL were serially analyzed for their expansion, phenotype and
      cytotoxic activity against autologous and allogenic tumor cells. A preferential
      lysis of autologous melanoma cells was obtained in long-term cultures of 7/13
      cases (54%), while the remaining ones showed a major-histocompatibility-complex
      unrestricted, lymphokine-activated-killer(LAK)-like activity at the time of in
      vivo injection. Sixteen patients with metastatic melanoma were infused with TIL
      (mean number: 6.8 x 10(9), range: 0.35 x 10(9)-20 x 10(9)) and IL-2 (mean dose:
      130 x 10(6) IU, range: 28.8 x 10(6)-231 x 10(6) IU); 1 complete and 3 partial
      responses were observed in 12 evaluable patients (response rate 33%). In all
      responding patients, injected TIL showed an in vitro preferential lysis of
      autologous tumor cells, while in no cases were TIL with LAK-like activity
      associated with a clinical response. The mean autologous tumor cytotoxic activity
      of TIL at the time of in vivo injection was significantly higher in responding
      patients in comparison to nonresponding ones, suggesting that a marked and
      preferential cytolysis of autologous tumor cells is associated with the
      therapeutic efficacy of TIL.

PMID- 8477418
TI  - Heterogeneous binding and killing behaviour of human gamma/delta-TCR+ lymphokine
      activated killer cells against K562 and Daudi cells.
AB  - Effector-target conjugates, formed by coincubation of lymphokine-activated killer
      (LAK) cells with either K562 or Daudi cells, were separated from single cells by
      Percoll sedimentation. The occurrence of various CD molecules (CD3, CD56, CD57,
      CD16, gamma/delta-TCR) was compared in both fractions. Only LAK cells expressing
      the gamma/delta T cell receptor (TCR) were found in a significantly increased
      percentage in fractions containing conjugates indicating that gamma/delta-TCR+
      LAK cells were preferably bound to target cells at the time of separation. In
      order to determine whether gamma/delta-TCR+ LAK cells also show a preferred
      killing activity against the targets, cultures enriched with or depleted of
      gamma/delta-TCR+ cells were established. Against K562 cells, gamma/delta-TCR(+)
      enriched cultures showed a greatly reduced killing activity compared to LAK bulk
      cultures or cultures depleted of gamma/delta-TCR+ cells. Using Daudi cells as
      targets the enriched fraction revealed a slightly increased killing activity
      compared to bulk cultures or depleted fractions. Preincubation of gamma/delta
      TCR+ LAK cells with anti-gamma/delta or anti-CD3 mAb resulted in a distinct
      increase of the killing activity against K562 cells, but in only a slightly
      enhanced activity against Daudi cells. It is postulated that gamma/delta-TCR+ LAK
      cells use the same adhesion mechanism for both targets but that only Daudi cells
      express a specific ligand for the gamma/delta-TCR. Occupation of the gamma/delta
      TCR/CD3 complex by mAb, however, seems to substitute for the absent epitope on
      K562 cells by eliciting stimulatory signals in gamma/delta-TCR+LAK cells which,
      in combination with the binding stimulus, trigger cytolytic activity.

PMID- 8477419
TI  - Development of a bispecific monoclonal antibody against a gallium-67 chelate and
      the human melanoma-associated antigen p97 for potential use in pretargeted
      immunoscintigraphy.
AB  - A bispecific monoclonal antibody (bsmAb) has been developed against the human
      melanoma-associated antigen p97 and an octahedral gallium chelate (Ga-HBED) using
      the hybrid hybridoma technology. As tetradomas were expected to produce a maximum
      of ten different molecular species of immunoglobulins, the bispecific antibody
      was purified from this mixture by consecutive protein A affinity and cation
      exchange chromatographic techniques. Although it was established by sodium
      dodecyl sulphate/polyacrylamide gel electrophoresis that the heavy (H) and light
      (L) chains of the two parental immunoglobulins were mismatched in the bispecific
      antibody, results from cell enzyme-linked immunosorbent assay indicated
      significant dual specific binding to both the melanoma cells and 67Ga-HBED. Other
      in vitro techniques further confirmed that the bsmAb Bi 5-56-II-17 still retained
      about 30%-40% simultaneous binding capacity to both the antigens, as would have
      been expected in a bsmAb that has ideally matched H and L chains. Preliminary in
      vivo experiments using nude mice bearing the human melanoma xenografts showed
      that the bsmAb Bi 5-56-II-17 was able to target the radioactive gallium chelate
      to the tumours twice as efficiently compared to the monospecific, bivalent
      gallium chelate antibody.

PMID- 8477420
TI  - Dentistry as portrayed in motion pictures and television.

PMID- 8477421
TI  - Dental finances improved in the 1980s.

PMID- 8477422
TI  - Insurance Reimbursement Matters. The role of the dental team in the evaluation
      and treatment of a new or recall patient.

PMID- 8477423
TI  - Methicillin-resistant Staphylococcus aureus: a crisis in infection control.

PMID- 8477424
TI  - Apex locators: a systematic approach for usage.

PMID- 8477425
TI  - Choice of dental practice is indicative of personality traits.

PMID- 8477426
TI  - Anterior tooth replacement using a two-component resin-bonded bridge.

PMID- 8477427
TI  - Management of child behavior in the dental environment.

PMID- 8477428
TI  - Desktop publishing: how to use it in your practice.

PMID- 8477429
TI  - Clinical criteria used to select an articulator.

PMID- 8477430
TI  - An unusual complication resulting from a Gow-Gates mandibular block.

PMID- 8477431
TI  - The telephone: friend or foe.

PMID- 8477432
TI  - Tuberculosis in the 1990s: current implications for dentistry.

PMID- 8477433
TI  - Office sterilization and asepsis procedures (OSAP) research foundation.

PMID- 8477434
TI  - Update on heat sterilization and sterilization monitoring.

PMID- 8477435
TI  - Selection and use of threaded pins: a review.

PMID- 8477436
TI  - Procedure-specific infection-control recommendations for dentistry.

PMID- 8477437
TI  - Partial glossectomy--a treatment for lymphangioma of the tongue.

PMID- 8477438
TI  - Dental air-powered handpieces: selection, use, and sterilization.

PMID- 8477439
TI  - Care and repair of porcelain veneers.

PMID- 8477440
TI  - Infection control in the dental laboratory: concerns for the dentist.

PMID- 8477441
TI  - X-rays: detailed answers to frequently asked questions.

PMID- 8477442
TI  - T cell antigen receptor signal transduction: a tale of tails and cytoplasmic
      protein-tyrosine kinases.

PMID- 8477443
TI  - Parallel DNA triplexes, homologous recombination, and other homology-dependent
      DNA interactions.

PMID- 8477444
TI  - Mice with a null mutation of the TGF alpha gene have abnormal skin architecture,
      wavy hair, and curly whiskers and often develop corneal inflammation.
AB  - Mice homozygous for a disrupted transforming growth factor alpha (TGF alpha) gene
      are healthy and fertile, although some older mice show evidence of corneal
      inflammation. In contrast with TGF alpha +/- and +/+ animals, TGF alpha -/- mice
      have a pronounced waviness of the coat. Histological examination of the skin from
      TGF alpha -/- mice reveals a dramatic derangement of hair follicles. Mice with a
      disrupted TGF alpha gene also have curly whiskers, first evident on the day of
      birth. The phenotype of TGF alpha -/- mice is remarkably similar to that of the
      mouse mutant waved-1 (wa-1). Offspring resulting from crosses between TGF alpha 
      /- and wa-1 mice display the curly whisker-coat phenotype, indicating that the
      basis of the wa-1 phenotype is a mutation in the TGF alpha gene. These
      observations suggest that TGF alpha plays a pivotal role in determining skin
      architecture and in regulating hair development.

PMID- 8477445
TI  - TGF alpha deficiency results in hair follicle and eye abnormalities in targeted
      and waved-1 mice.
AB  - To explore the physiological roles of transforming growth factor alpha (TGF
      alpha), we disrupted the mouse gene by homologous recombination in embryonic stem
      cells. Homozygous mutant mice were viable and fertile, but displayed pronounced
      waviness of the whiskers and fur, accompanied by abnormal curvature,
      disorientation, and misalignment of the hair follicles. Homozygous and, to a
      lesser extent, heterozygous mice displayed eye abnormalities of variable
      incidence and severity, including open eyelids at birth, reduced eyeball size,
      and superficial opacity. Histological examination revealed eyelid and anterior
      segment dysgenesis, corneal inflammation and scarring, and lens and retinal
      defects. Although TGF alpha deficiency affected skin and eyes, wound healing in
      these tissues was not impaired. Similar hair and eye defects have been previously
      associated with the recessive mutation waved-1 (wa-1), and Northern analysis
      revealed reduced expression of TGF alpha in wa-1 mice. Crosses between wa-1
      homozygotes and TGF alpha-targeted mice confirmed that wa-1 and TGF alpha are
      allelic.

PMID- 8477446
TI  - The proto-oncogene bcl-2 can selectively rescue neurotrophic factor-dependent
      neurons from apoptosis.
AB  - Apoptosis plays an important role in regulating cell numbers in a wide variety of
      tissues during development. The product of the bcl-2 gene inhibits apoptosis in
      certain cells of the myeloid and lymphoid lineages and is expressed in many cells
      that have an extended life span. To assess the role of bcl-2 in neuronal
      apoptosis, we microinjected a bcl-2 expression vector into neurotrophic factor
      deprived embryonic neurons. Sensory neurons that depend for survival on one or
      more members of the nerve growth factor family of neurotrophic factors (nerve
      growth factor, brain-derived neurotrophic factor, and neurotrophin-3) were
      rescued by bcl-2, whereas ciliary neurotrophic factor (CNTF)-dependent ciliary
      neurons were not. Sensory neurons, however, became refractory to bcl-2 after
      exposure to CNTF. These findings indicate that at least two death pathways
      operate in neurons that are distinguished by their susceptibility to bcl-2.
      Neurons may die by either pathway, depending on the factors to which they have
      been exposed.

PMID- 8477447
TI  - Integrins alpha v beta 3 and alpha v beta 5 promote adenovirus internalization
      but not virus attachment.
AB  - Adenovirus contains a heterodimeric protein complex consisting of 186 kd fiber
      protein that mediates high affinity virus attachment to cells and a 400 kd
      pentavalent subunit (penton base) that contains five Arg-Gly-Asp sequences,
      implying a role for integrins in adenovirus infection. We demonstrate that the
      vitro-nectin-binding integrins alpha v beta 3 and alpha v beta 5 promote viral
      infection in a novel way since antibodies against these receptors or soluble
      penton base block virus internalization without affecting attachment. Moreover,
      adenovirus binds to cultured cells lacking alpha v integrins but fail to become
      internalized, thus restricting infection of these cells. Transfection of alpha v(
      ) cells with a cDNA encoding alpha v results in the expression of integrins alpha
      v beta 3 and alpha v beta 5 and allows virus internalization and infection. These
      data indicate that adenovirus attachment and uptake into cells are separate but
      cooperative events that result from the interaction of distinct viral coat
      proteins with a receptor for attachment and alpha v integrin receptors for
      internalization.

PMID- 8477448
TI  - An alternative pathway for yeast telomere maintenance rescues est1- senescence.
AB  - Yeast cells lacking a functional EST1 gene show progressive shortening of the
      terminal G1-3T telomeric repeats and a parallel increase in the frequency of cell
      death. Although the majority of the cells in an est1- culture die, a minor
      subpopulation survives the potentially lethal consequences of the est1 mutation.
      We show that these est1- survivors arise as a result of the amplification and
      acquisition of subtelomeric elements (and their deletion derivatives) by a large
      number of telomeres. Hence, even when the primary pathway for telomere
      replication is defective, an alternative backup pathway can restore telomere
      function and keep the cell alive.

PMID- 8477449
TI  - Identification of the functional subunit of a dimeric transcription activator
      protein by use of oriented heterodimers.
AB  - We have constructed heterodimers consisting of two subunits: one CAP subunit that
      has a nonfunctional activating region but wild-type DNA binding specificity, and
      one CAP subunit that has a functional activating region but non-wild-type DNA
      binding specificity. We have oriented the heterodimers on lac promoter DNA by use
      of promoter derivatives that have DNA sites for CAP consisting of one wild-type
      half site and one non-wild-type half site, and we have analyzed the abilities of
      the oriented heterodimers to activate transcription. Our results indicate that
      transcription. Our results indicate that transcription activation requires the
      activating region of only one subunit of CAP: the promoter-proximal subunit. The
      oriented heterodimers method of this report should be generalizable to other
      dimeric transcription activator proteins.

PMID- 8477450
TI  - Functional analysis of a growth factor-responsive transcription factor complex.
AB  - Serum response factor (SRF) forms a ternary complex at the c-fos serum response
      element (SRE) with an accessory factor, Elk-1. We constructed altered-binding
      specificity derivatives of SRF and Elk-1 that form a ternary complex at a
      mutated, inactive SRE; like Elk-1, the Elk-1 variant only binds its target as
      part of a ternary complex with SRF. Simultaneous expression of these SRF and Elk
      1 derivatives restores serum-regulated activity to the mutated SRE in transfected
      cells. Efficient transcriptional activation is dependent on the regulated
      phosphorylation of Elk-1 C-terminal MAP kinase sites and requires the C-terminal
      sequences of SRF as well as SRF sequences that mediate ternary complex formation.
      These experiments provide direct evidence that SRF and Elk-1 functionally
      cooperate in the ternary complex at the SRE to regulate transcription.

PMID- 8477451
TI  - Mutations in U1 snRNA bypass the requirement for a cell type-specific RNA
      splicing factor.
AB  - Previous studies have demonstrated that efficient splicing of the primary
      transcript of the yeast MER2 gene requires the MER1 protein, which is produced
      only in meiotic cells. A genetic selection was devised to recover second-site
      mutations that bypass the requirement for MER1 in MER2 RNA-splicing. This
      selection identified a mutation in SNR19, the gene for U1 snRNA. The suppressor
      mutation affects the first residue in U1 snRNA, allowing this nucleotide to base
      pair with the eighth nucleotide in the MER2 intron. This base in MER2 lies
      outside the conserved hexanucleotide that defines the 5' splice site in yeast.
      The MER2 5' splice site (GUUCGU) differs from the consensus in yeast (GUAYGU) at
      the third position. When this nucleotide is mutated to restore the consensus,
      base pairing with U1 snRNA is increased and the requirement for MER1 is
      alleviated.

PMID- 8477452
TI  - Yeast extracellular proteases.
AB  - Many species of yeast secrete significant amounts of protease(s). In this
      article, results of numerous surveys of yeast extracellular protease production
      have been compiled and inconsistencies in the data and limitations of the
      methodology have been examined. Regulation, purification, characterization, and
      processing of yeast extracellular proteases are reviewed. Results obtained from
      the sequences of cloned genes, especially the Saccharomyces cerevisiae Bar
      protease, the Candida albicans acid protease, and the Yarrowia lipolytica
      alkaline protease, have been emphasized. Biotechnological applications and the
      medical relevance of yeast extracellular proteases are covered. Yeast
      extracellular proteases have potential in beer and wine stabilization, and they
      probably contribute to pathogenicity of Candida spp. Yeast extracellular protease
      genes also provide secretion and processing signals for yeast expression systems
      designed for secretion of heterologous proteins. Coverage of the secretion of
      foreign proteases such as prochymosin, urokinase, and tissue plasminogen
      activator by yeast in included.

PMID- 8477453
TI  - Zymomonas mobilis--science and industrial application.
AB  - Zymomonas mobilis is undoubtedly one of the most unique bacterium within the
      microbial world. Known since 1912 under the names Termobacterium mobilis,
      Pseudomonas linderi, and Zymomonas mobilis, reviews on its uniqueness have been
      published in 1977 and 1988. The bacterium Zymomonas mobilis not only exhibits an
      extraordinarily uniqueness in its biochemistry, but also in its growth behavior,
      energy production, and response to culture conditions, as well as cultivation
      techniques used. This uniqueness caused great interest in the scientific,
      biotechnological, and industrial worlds. Its ability to couple and uncouple
      energy production in favor of product formation, to respond to physical and
      chemical environment manipulation, as well as its restricted product formation,
      makes it an ideal microorganism for microbial process development. This review
      explores the advances made since 1987, together with new developments in the pure
      scientific and applied commercial areas.

PMID- 8477454
TI  - Phylogenetic analysis of the myosin superfamily.

PMID- 8477455
TI  - Flagellar radial spoke: a model molecular genetic system for studying organelle
      assembly.

PMID- 8477456
TI  - Primary and secondary chick heart fibroblasts: fast and slow-moving cells show no
      significant difference in microtubule dynamics.
AB  - Highly motile chick heart fibroblasts in primary culture (1 degree CHFs)
      gradually convert into much slower-moving secondary (2 degrees) cells. The
      polarized movement of the latter, but not the former, cell type has been found to
      be dependent on an intact microtubule (MT) network [Middleton et al., 1989, J.
      Cell Sci. 94:25-32]. To investigate the comparative stability of the MT networks
      of 1 degree s and 2 degrees s, turnover was investigated by microinjection of
      biotin-labeled brain tubulin to act as a reporter. MTs in both cell types were
      found to be very dynamic, with the MT networks effectively disassembled by about
      30 min in 1 degree CHFs and 60 min in 2 degrees CHFs, with mainly MT fragments
      remaining beyond these times. All MTs and fragments were found to have turned
      over by 1 h in 1 degree CHFs and 80 min in 2 degrees s. Because 2 degrees CHFs
      were found to be on average six times larger than 1 degree s, the difference in
      MT turnover time was considered largely due to the size difference. For both 1
      degree and 2 degrees cells, the more slowly turning over MTs were generally curly
      and perinuclear in distribution, resembling stable MTs in other systems, but they
      appeared significantly earlier in CHFs. However, no discrete subpopulations of
      slower turning over MTs were found to be associated with either the leading edges
      or the processes of either cell type. In addition, no major differences were
      identified in the patterns of modified alpha-tubulin along the MTs or of MT cold
      or drug stability. It is concluded that MTs do not have a direct structural or
      skeletal function in maintaining a polarized 2 degrees CHF cell shape, but rather
      play an ancillary role.

PMID- 8477457
TI  - Reactivation of demembranated, cytosol-free ram spermatozoa.
AB  - A procedure for preparing cytosol-free ram sperm models was developed. Sperm are
      introduced to a Triton X-100-containing demembranation medium layered on top of a
      discontinuous Percoll gradient. After brief exposure to the demembranating
      solution, the sperm are separated from the detergent-soluble components by
      centrifugation through a 55% Percoll layer, finally collecting on top of a 90%
      Percoll cushion from where they are recovered. Optimum conditions consisted of
      Triton X-100 at 0.20% and a demembranation time of 35 sec. Cross-sections of
      midpieces and principal pieces of the demembranated sperm were examined by
      electron microscopy. With 0.20% Triton X-100 in the demembranation medium, 86% of
      the cross-sections showed no plasma membranes and the rest had broken plasma
      membranes. The remaining tail structures appeared to be morphologically intact.
      Assay of phosphoglucose isomerase as a marker enzyme confirmed that at least 98%
      of the cytosolic protein was removed. Ram sperm models obtained by this procedure
      could be reactivated, and the percent motility and beat parameters were similar
      to those of the intact sperm. Reconstitution with the detergent-soluble
      components was neither required for, nor enhanced, reactivation. Therefore,
      demembranated ram sperm do not require a detergent-soluble protein factor for
      reactivation.

PMID- 8477458
TI  - Elastic properties of titin filaments demonstrated using a "freeze-break"
      technique.
AB  - A "freeze-break" technique (Trombitas, K.: Acta Biochim. Biophys. Hung. 6:419
      427, 1971) and immunoelectron microscopy were used to study the elastic
      properties of titin filaments. Small bundles of freshly prepared rabbit psoas
      muscle fibers were quickly frozen and broken under liquid nitrogen to fracture
      sarcomeres in planes perpendicular to the filament axis, in each of various
      regions along the sarcomere. The still-frozen specimens were thawed during
      fixation to allow elastic filaments to retract. The broken specimens were then
      labelled with monoclonal anti-titin antibodies against an unique epitope in the I
      band. The titin epitopes were normally positioned symmetrically about the Z-line.
      However, in sarcomeres broken at the A-I junction, the epitopes no longer
      remained symmetrical: the titin filaments in the broken half-sarcomere retracted,
      independently of the thin filaments, forming a dense band just near the Z-line.
      The retracted density apparently did not reach the Z-line; retraction stopped at
      the level of the so-called N1-line. In sarcomeres broken at the Z-line level, the
      titin filaments retracted in the opposite direction. In this case the titin
      epitope retracted all the way to the ends of the thick filaments. It appears then
      that titin molecules form elastic filaments that are independent of thin
      filaments in most of the I-band. Near the Z-line, however, the titin filaments
      either have an inelastic domain or associate firmly with the thin filaments at
      the N1-line level.

PMID- 8477459
TI  - [New findings in chronic granulomatous disease].
AB  - Chronic granulomatous disease is a rare hereditary disease characterized by
      repeated infections affecting in particular the skin, lymph nodes and internal
      organs. Histological examination in the affected tissues reveals a granulomatous
      inflammation. The aetiological agents of infection are most frequently
      staphylococci, G-bacteria, Candida and Aspergillus. From the immunological aspect
      it is an inborn immunodeficiency affecting professional phagocytes (monocytes and
      granulocytes) which are unable to kill some ingested microorganisms. The
      molecular basis of the defect is affection of the NADPH oxidase enzyme complex at
      various sites which explains the genetic heterogeneity of the disease. The
      condition is usually manifested in early childhood, it has a variable course; if
      untreated, the affected subjects frequently die in child age. By early diagnosis
      of the disease and suitable therapy the quality of life of the patients can be
      improved, serious complications can be prevented and the patients may reach adult
      age. The submitted paper is a review of contemporary knowledge of the disease, in
      particular its molecular basis and ensuing classification, as well as possible
      diagnosis and treatment of the disease. Several case-histories are presented.

PMID- 8477460
TI  - [Detection and reduction of mental and motor disorders in childhood. 2.
      Fundamentals and risks in longitudinal research in pediatrics].
AB  - The study characterizes basic types of longitudinal research designs for the long
      term follow-up of children in health and disease. First the authors mention
      briefly the principles and disadvantages of cross-sectional research designs.
      Then they present a detailed account of methods of longitudinal research
      projects, evaluation of their advantages and their risks. Roughly fifty-year
      experience with longitudinal designs indicates that this pretentious research
      strategy can provide an overall view of developmental trends as regards changes
      of the health status of children in the ontogenetic perspective and contribute to
      improvement of health care of the child population.

PMID- 8477461
TI  - [Neurologic findings in mild mental retardation].
AB  - The author subjected to neurological examination all children from a special
      school for retarded children (39 children, 22 boys, 17 girls). All children had a
      positive neurological finding. Central hypotonic syndrome was revealed most
      frequently--31 children; static tremor of the upper extremities--11 children and
      static tremor of the lower extremities--8 children. Minor cerebellar
      symptomatology was found in 10 children, developmental dyspraxia-dysgnosia in 6
      children. Sixteen children were related (brother and sister, two sisters and
      cousins, etc.)

PMID- 8477462
TI  - [Rhythm disorders after acute viral myocarditis].

PMID- 8477463
TI  - [Acute tubulointerstitial nephritis as a manifestation of furantoin poisoning].

PMID- 8477464
TI  - [An unusual cause of respiratory failure. Bronchobiliary fistula].
AB  - The authors describe the treatment of a patient with an inborn bronchobiliary
      fistula. The ex post finding that the fistula had two insertions in the bronchus
      called in the final stage for a combined thoraco-abdominal approach with
      resection of the right lower pulmonary lobe with ligature of the fistula beneath
      the diaphragm. Although inborn bronchobiliary fistulae are very rare, they must
      be considered in the differential diagnosis of causes of chronic respiratory
      distress syndrome in children. Early diagnosis and adequate surgical treatment
      make it possible to prevent serious chronic cardiorespiratory disease.

PMID- 8477465
TI  - [ACE inhibitors--a potential new group of drugs for treatment of kidney
      diseases].
AB  - ACE inhibitors, which till recently were used almost exclusively for treatment of
      cardiovascular diseases, are becoming a perspective group of drugs also in the
      treatment of nephropathies. It was found that they are effective in particular in
      the treatment of proteinuria of varying origin and have also a marked
      renoprotective effect and are therefore recommended to retard progression of
      renal failure. They reduce intraglomerular hypertension, increase glomerular
      filtration and the renal blood flow, and it is assumed that they can retard
      progression of chronic glomerulonephritis and diabetic nephropathy. We may expect
      already in the near future that their therapeutic application will be
      substantially extended also in clinical nephrology.

PMID- 8477466
TI  - [Surfactant in the therapy of idiopathic respiratory distress syndrome].

PMID- 8477467
TI  - [An approach to the differential diagnosis of dilatation of the caliceal-pelvic
      system in children].
AB  - The authors submit suggestions for the differential diagnostic procedure in
      dilatation of the calico-pelvic system in children involving consecutive
      application of non-invasive methods to methods pretentious for the patient. In
      the second part they present a review of recent findings regarding visualization
      techniques of the hollow renal system.

PMID- 8477468
TI  - [Cooperation between the pediatrician and orthopedist in the diagnosis of
      congenital hip dislocation].
AB  - The author summarizes the principles of clinical diagnosis, referring to
      experience assembled in an investigation comprising more than 35,000 neonates
      during past years. The submitted pattern could be a practical instruction for
      examination of the hip joints by paediatricians--neonatologists. The author
      emphasizes the fact that the diagnosis of complete dislocation unless irreponible
      is very easy, and being a clinically very obvious defect, it should not be
      missed. In other countries the trend predominates to ensure examination of the
      hip joints of neonates by paediatricians-neonatologists for whom this examination
      is a matter of routine. The author outline possibilities of ultrasonographic
      examination, static as well as dynamic. In large towns it proved useful to
      establish an ultrasonographic examination room where some 4000 infants aged 2-3
      weeks are examined. The hitherto used classification of ultrasonic examination is
      not quite reliable in view of "over-diagnosis" and thus to unnecessary therapy
      which can lead--as any abduction therapy--to complications such as avascular
      necrosis. Paediatricians-neonatologists should master the clinical problem and be
      aware of the responsibility for early clinical diagnosis to enable orthopaedists
      to specify indication for early treatment based on ultrasonographic examination.

PMID- 8477469
TI  - [Personal experience with the use of Rulid (roxithromycin) in children less than
      1 year of age].
AB  - The authors give an account of the use of Roxithromycin (preparation Rulide) in
      children of the youngest age group, i.e. in infants. From January 1989 to April
      1992 they treated 24 children under 5 weeks to 12 months of age with
      Roxithromycin. Roxithromycin was administered in amounts from 5 to 10 mg/kg after
      12-hour intervals in the course of 4 to 12 days. In 22 children a favourable
      clinical effect was observed, in two children antibiotic treatment had to be
      changes because there was no clinical response. Undesirable effects, i.e.
      vomiting, during Roxithromycin were observed only in two children. In no instance
      was it necessary to discontinue treatment.

PMID- 8477470
TI  - [HLA antigens in patients with celiac disease].
AB  - In 104 non-related children with coeliac disease, all from northern Moravia, the
      authors assessed the distribution of HLA antigens class I and II and compared the
      findings with a control group. They revealed a positive association between HLA
      A1 (62% sick subjects as compared 27% healthy ones), B8 (68% as compared with
      18%), DR3 (66% as compared with 14%) and DQw2 (79% as compared with 23%). In HLA
      antigens class II there is a higher relative risk of the disease for subjects
      with antigens DR3 and DQw2 and a higher aetiological fraction for the
      investigated antigens.

PMID- 8477471
TI  - [Epidemiology of childhood cerebral palsy in Slovakia].
AB  - In the 5.3 million population of Slovakia the author investigated by means of
      questionnaire screening the prevalence and incidence of cerebral palsy in
      children. The questionnaires were processed in collaboration with child
      neurologists and district paediatricians from all 38 Slovak districts. The author
      revealed that in 1990 child neurologists recorded 6,214 1-14-year-old children
      with the diagnosis of cerebral palsy, i.e. the motor form. The prevalence of
      cerebral palsy in children in Slovakia is 4.9 and the incidence 9.0. The
      assembled data are valuable in the system of comprehensive care of children with
      cerebral palsy, for establishment of an early diagnosis and early rehabilitation
      treatment.

PMID- 8477472
TI  - [Immunologic findings in children with abnormal reactions after vaccination].
AB  - In a group of 89 children with abnormal reactions after administration of the
      mixed vaccine against diphtheria, tetanus and whooping cough, after the mixed
      vaccine against diphtheria and tetanus, the live measles vaccine and oral
      poliovaccine, a detailed analysis was made of the case-history, and basic
      parameters of cellular and humoral immunity were examined. In these children the
      intensity of post-vaccination reactions was beyond the range of accepted criteria
      of mild and medium reactions or complications. In 17.3% of the children with an
      abnormal reaction after the mixed vaccine against diphtheria, tetanus and
      whooping cough a reduced IgA level was proved, while in the control group a
      reduced level was found only in 3.3%. 50% of the children who developed an
      abnormal reaction after the oral poliovaccine and the mixed vaccine against
      diphtheria, tetanus and whooping cough and at the same time some relative
      suffered from clinical signs of atopia, a reduced number of E rosettes of
      lymphocytes was recorded. 80% of the children who developed an abnormal reaction
      after the measles vaccine and some relative suffered from atopic disease, had low
      titres of specific antibodies against tetanic toxoid. Evidence was provided that
      children with certain precisely defined abnormal reactions after vaccination
      suffered significantly more frequently from reduced immune reactivity than
      children examined because of a suspected immunity defect.

PMID- 8477473
TI  - [Biostim in the treatment of recurrent respiratory diseases in children].
AB  - The authors treated with Biostim (Roussel Uclaf Co., France) 20 children aged 3
      to 15 years with relapsing and chronic diseases of the respiratory system. A
      favourable clinical effect was observed in 45% and improvement in 40% of the
      patients. In the investigated immunological indicators the response to treatment
      Biostim was manifested in the antibody immunity by a reduction of IgE values (P <
      0.01) and of IgM (P < 0.05). As to cellular immunity, there was a significant
      increase of the phagocytic activity (P < 0.05). The tolerance of the preparation
      was very good.

PMID- 8477474
TI  - [Chronic cough in childhood--diagnosis and therapy].

PMID- 8477475
TI  - [Neonatal sepsis--still a real problem].
AB  - Neonatal sepsis is characterized by bacteraemia and clinical symptoms caused by
      microorganisms or their toxic products. The authors pay attention to
      epidemiological and predisposing factors, to the aetiology, pathogenesis,
      clinical signs and conditions for assessment of the diagnosis of neonatal sepsis
      as well as its therapy and prognosis.

PMID- 8477476
TI  - [Development of neonates at risk].
AB  - From a group of 2542 children followed up for a prolonged period the authors
      selected several groups of risk neonates and compared their subsequent
      development with that of a control group from the same cohort. In the selected
      risk groups the authors evaluated anamnestic data of the mothers, somatic and
      neuropsychic development of the children. They compared also the psychomotor
      development of the children in the first years of life, their school attendance
      and progress, mean values of IQ and various mental deviations, as compared with
      children of the control group. By comparison with the incidence of analogous
      disorders the authors wanted to assess the ratic risks from early stages in later
      developmental disorders.

PMID- 8477477
TI  - [Familial incidence of the EMG syndrome].

PMID- 8477478
TI  - [Incidence of rheumatic fever in Slovakia during the last 20 years].
AB  - The incidence of rheumatic fever has a declining trend in Slovakia. In 1972 there
      were 26.7 primary attacks and 8.7 relapses per 100,000 children aged 0-14 years,
      in 1990 there are 0.5 primary attacks and 0.4 relapses and in 1991 0.4 primary
      attacks and no relapses. The interregional (former regions) distribution was to
      the disadvantage of eastern parts but gradually this was evened out. Rheumatic
      fever occurs in girls and boys, in the majority mild arthritis forms are involved
      with unequivocal regression of carditic-arthritic forms. The decline can be
      ascribed to the rising socio-economic standard and health care.

PMID- 8477479
TI  - [Detection and prevention of mental and motor disorders in childhood. 3. Synopsis
      of a longitudinal study].
AB  - The submitted study is a brief account of theoretical and methodological
      solutions of a research project "Detection and reduction of sensory and motor
      disorders in childhood". In this research project the effectiveness of preventive
      examinations is assessed. It is focused on obtaining objective data on the
      incidence and prevalence of sensory and motor disorders. The authors describe the
      strategic aims, organization of data collection and processing. The empirical
      data should contribute to the rational development of preventive, therapeutic and
      rehabilitation procedures in paediatrics.

PMID- 8477480
TI  - [Air pollution and the occurrence of recurrent respiratory tract diseases in
      children during the first years of life].
AB  - The authors investigate in a group of 211 children aged 2-6 years, incl. in
      particular a group of 33 2-year-old ones, in 1990 and checked in 1991 at two
      sites in Bratislava--a town with a varying concentration of NOX, SO2, dustiness
      and dust fallout--their influence on the incidence, type and course of relapsing
      respiratory disease. In both sites the concentrations of the mentioned noxious
      substances were beneath levels admitted by hygienists. In the place with higher
      concentrations, in particular of NOX, a significantly higher number of serious
      forms of relapsing respiratory diseases was recorded and an adverse course of the
      diseases in 2-6 year-old children and in particular in the 2-year-old ones.

PMID- 8477481
TI  - [Hylak Forte drops in the treatment of atopic eczema in children].
AB  - The authors describe a group of 14 children with atopic eczema where to common
      Hismanal or Zaditen treatment in tablet form Hylak forte drops were added (L.
      Merckle Co.). After two months treatment the authors observed regression of
      subjective and objective complaints in 10 children. As to the investigated
      immunological parameters, they observed normal phagocyte activity of granulocytes
      and in the majority of children a decline of circulating immune complexes. This
      creates prerequisite conditions for reducing the costs of treatment and for
      starting aimed specific hyposensitization.

PMID- 8477482
TI  - [Therapeutic approach to the treatment of acute asthma in childhood].
AB  - Acute deterioration of bronchial asthma with development of dyspnoea which
      involves the risk of failure of vital functions call for rapid and specialized
      therapeutic action which will prevent further deterioration of the condition and
      an as rapid as possible return of pulmonary functions to the range of normal
      values. In the treatment of acute asthma in the field as well as in in-patient
      departments different procedures are applied frequently based on tradition of the
      given department. In the submitted paper the author recapitulates recent views on
      the role of different procedures and the most frequently used drugs. The basis of
      modern therapy of acute asthma is above all inhalation treatment, high and
      frequent doses of beta 2-adrenergic preparations in particular during the initial
      stages of treatment and anti-inflammatory treatment with steroids. Theophyllines
      are considered drugs of second choice, the administration of infusions is also of
      limited importance. To ensure early treatment of acute asthma satisfactory and
      skilled cooperation of the patient and his closest surroundings is essential.
      Early therapeutic response to a deteriorating condition can substantially reduce
      the risk of development of serious conditions and reduce the need of hospital
      treatment.

PMID- 8477483
TI  - Sexually transmitted diseases in the age of AIDS.
AB  - Sexually transmitted diseases (STD) are common illnesses in the world. There is
      at least one new sexually transmitted disease consultation for every 100 persons
      a year in industrialised countries. Today the World Health Organisation estimates
      that there are 250 million new cases of STD every year world-wide, and over 20
      distinct pathogens are currently recognised. While the overall incidence of STD
      have remained high in industrialised countries, the rates of increase of many
      bacterial STD such as syphilis and gonorrhoea were beginning to stabilise; but
      currently there is again a trend for these bacterial STD to rise in urban
      populations.

PMID- 8477484
TI  - Viral hepatitis complicating pregnancy--a five year hospital based retrospective
      study.
AB  - Limited data are available on viral hepatitis (VH) complicating pregnancy from
      Sri Lanka. We retrospectively studied all pregnant and non-pregnant women of
      child bearing age, who were admitted with VH to the Teaching Hospital Peradeniya
      between January 1987 and December 1991. During this period, there were 187 cases
      of icteric VH among non-pregnant women of child bearing age, but only 10 cases
      among pregnant women (hospital incidence of 0.35 cases of VH per 1000 pregnancy
      related admissions). Two of the 10 (case fatality 20%) pregnant women died of
      causes related to VH compared with only 3 of the 187 (1.6%) non-pregnant women (p
      < 0.001), giving a relative risk of death due to VH in pregnant women of 12.5
      (95% confidence limits 1.8-85.6). The perinatal case fatality rate due to VH was
      20%. VH complicating pregnancy does not appear to be a common cause of hospital
      admission, but pregnancy makes death due to VH more likely. VH complicating
      pregnancy also results in a high perinatal mortality.

PMID- 8477485
TI  - Knowledge about diabetes and metabolic control in diabetic patients.
AB  - It is widely accepted that patient education is an essential adjunct to the care
      of diabetic patients. A randomised controlled clinical trial in patient education
      was conducted at a diabetic and general medical clinic in Sri Jayawardenepura
      General Hospital. Two groups of diabetic patients matched for age, gender and
      duration of diabetes were allocated randomly to conventional care at general
      medical clinics or to a diabetes clinic where specific educational objectives
      were defined and patients trained to achieve these objectives. The doctors
      treating these patients were not 'blinded' to treatment groups. Diabetes
      knowledge was assessed using a diabetes knowledge scale and metabolic control
      assessed by mean fasting blood glucose. The patients attending the diabetic
      clinic showed significant improvement in both knowledge scores (67% vs 34%, p <
      0.01) and mean fasting blood glucose 6.38 +/- 0.85 mmol/l vs 9.7 +/- 1.7 mmol/l,
      p < 0.01) at 6 months. We conclude that diabetes education improves patient
      knowledge and diabetes control.

PMID- 8477487
TI  - Does a teaspoonful measure 5 ml?

PMID- 8477486
TI  - Human infection with Dirofilaria (Nochtiella) repens in Sri Lanka.

PMID- 8477488
TI  - Health aspects of an urban elderly population.
AB  - The health status of an urban elderly Sinhala population ordinarily resident in
      their homes was investigated by interview and physical examination. Just over one
      fifth of the subjects had been hospitalised at least once for an episode of
      illness during the previous 12 months. 47.7% of the subjects complained of
      impaired vision, and 12.8% had cataract; 45.0% had less than the minimum number
      of teeth required for proper mastication; 24.8% of the subjects had impaired
      hearing. Medical histories showed that 10.1% of the subjects suffered from
      haemorrhoids; 2.0% were hemiplegic. A random single blood pressure recording
      showed 34.2% of the subjects to have a diastolic blood pressure of 95 mm Hg or
      more. 9.4% of the subjects had glucosuria. With the high morbidity seen among
      this elderly population a case is made for the establishment of geriatric clinics
      in government hospitals, and that care of the elderly be included in the Primary
      Health Care programme of Sri Lanka.

PMID- 8477489
TI  - Actinomycosis of the uterus.
AB  - A 59 year old woman with actinomycosis of the uterus is described. This is the
      first such case to be reported in Sri Lanka.

PMID- 8477490
TI  - Pseudocyst of the auricle.
AB  - Sixteen cases of pseudocyst of the auricle seen in Matara, Sri Lanka over a two
      year period are reported. These were managed with needle aspiration and contour
      pressure dressing for one week with almost 100% success.

PMID- 8477491
TI  - Chloramphenicol resistant typhoid fever.
AB  - We report a patient with typhoid fever caused by a strain of Salmonella typhi
      which was resistant to chloramphenicol. This is the first documentation of
      chloramphenicol resistant Salmonella typhi in Sri Lanka.

PMID- 8477492
TI  - General Hospital Colombo (4): Surgery.

PMID- 8477493
TI  - Changes in malaria vector prevalence in Sri Lanka: the need for local
      surveillance.

PMID- 8477494
TI  - Vitamin A toxicity.

PMID- 8477495
TI  - Screening for Turner syndrome.

PMID- 8477496
TI  - Blastocystis hominis: an old organism with a new significance.

PMID- 8477497
TI  - Spinal muscular atrophy, East and West.

PMID- 8477498
TI  - (2R), (1'R) and (2R), (1'S)-2-amino-3-(1,2-dicarboxyethylthio)propanoic acids
      from Amanita pantherina. Antagonists of N-methyl-D-aspartic acid (NMDA)
      receptors.
AB  - An antagonist of NMDA-sensitive glutamate receptors in rat brain membrane and rat
      spinal motoneurones was isolated from Amanita pantherina and identified as a
      diastereoisomeric mixture of 2-amino-3-(1,2-dicarboxyethylthio)propanoic acids.
      The mixture was separated and the absolute configurations of the components were
      determined as (2R), (1'R) and (2R), (1'S), by analysis of the optical properties.

PMID- 8477499
TI  - Palbinone, a novel terpenoid from Paeonia albiflora; potent inhibitory activity
      on 3 alpha-hydroxysteroid dehydrogenase.
AB  - Palbinone, a novel terpenoid isolated from the roots of Paeonia albiflora, showed
      a strong inhibitory activity on the reduced form of nicotinamide adenine
      dinucleotide phosphate (NADPH)-linked 3 alpha-hydroxysteroid dehydrogenase (3
      alpha-HSD) of rat liver cytosol. The structures of palbinone and a known
      compound, paeonilactone-B isolated from the active fraction of this plant were
      determined by the use of 2D NMR techniques (1H-1H COSY, 1H-13C COSY, 1H-13C long
      range COSY, and HMBC).

PMID- 8477500
TI  - Synthetic study on selenocystine-containing peptides.
AB  - N-9-Fluorenylmethoxycarbonyl-Se-4-methoxybenzylselenocysteine++ + [Fmoc-Sec(MBzl)
      OH] was synthesized from selenocystine and successfully applied to Fmoc-based
      solid-phase peptide synthesis. The stability and the deprotection conditions of
      the Se-MBzl group were examined. The diselenide bond of a peptide was directly
      and effectively established between Sec(MBzl) residues by treatment with iodine
      or the dimethyl sulfoxide-trifluoroacetic acid system. Reduction kinetics of
      diselenide and disulfide in model peptides by reduced glutathione were also
      studied comparatively.

PMID- 8477501
TI  - Agents for the treatment of overactive detrusor. IV. Synthesis and structure
      activity relationships of cyclic analogues of terodiline.
AB  - A series of pyrrolidine derivatives were synthesized and examined for inhibitory
      activity on detrusor contraction in vivo. Among those compounds, 5,5-dimethyl-2
      (2,2-diphenylethyl)-3-isopropylidenepyrrolidine+ ++ hydrochloride (41.HCl), 2
      (2,2-di(4-fluorophenyl)ethylene)-5,5-dimethyl-3-isopropylidenepyrro lidine
      hydrochloride (42.HCl), (+)-5,5-dimethyl-2-(N,N-diphenylaminomethyl)-3
      isopropylidenepy rrolidine hydrochloride (+)-(43a.HCl), (-)-5,5-dimethyl-2-(N,N
      diphenylaminomethyl)-3-isopropylidenepy rrolidine hydrochloride (-)-(43a.HCl),
      and 2-(N,N-di(4-fluorophenyl)aminomethyl)-5,5-dimethyl-3-isopropylidenepy
      rrolidine methanesulfonate (43b.MsOH) showed stronger inhibitory activity on
      detrusor contraction than terodiline.

PMID- 8477502
TI  - Syntheses and inhibitory effects on gastric lesions of trans
      guanidinomethylcyclohexane carboxylic acid arylamides.
AB  - A novel series of trans-guanidinomethylcyclohexanecarboxylic acid (trans-GMCHA)
      arylamides was synthesized. The several trans-GMCHA arylamide derivatives showed
      more potent inhibitory effects on the stress- and HCl-ethanol-induced gastric
      ulcers than cetraxate in rats. In acute toxicity studies in mice, most amides
      showed such severe toxicity that all mice injected with these compounds (50
      mg/kg, i.p.) died. However, mice injected with the trans-GMCHA (2'-,3'- and 4'
      ethoxycarboxy)phenylamide (7, 8 and 9) which bear an alkyloxycarbonyl group at
      benzene ring survived. From these results, trans-GMCHA (2'
      ethoxycarbonyl)phenylamide (7) was selected as a promising anti-ulcer agent.

PMID- 8477503
TI  - Amino acids and peptides. XVII. Synthesis of peptides related to N-terminal
      portion of fibrin alpha-chain and their inhibitory effect on fibrinogen/thrombin
      clotting.
AB  - Various peptides related to N-terminal portion of fibrin alpha-chain were
      synthesized by the solution method and the solid-phase method, and their
      inhibitory effect on fibrinogen/thrombin clotting was examined. Extension of
      peptide chain from N-terminal tripeptide decreased the inhibitory effect. The
      most potent effect was shown by N-terminal decapeptide analog, H-Gly-Pro-Arg-Pro
      Pro-Glu-Arg-His-Gln-Ser-NH2.

PMID- 8477504
TI  - Central cholinergic agents. IV. Synthesis and acetylcholinesterase inhibitory
      activities of omega-[N-ethyl-N-(phenylmethyl)amino]-1-phenyl-1-alkanones and
      their analogues with partial conformational restriction.
AB  - Inhibitors of acetylcholinesterase (AChE) have been designed based on a working
      hypothesis of the enzyme's active site. These compounds were tested for their
      inhibitory activities on AChE and omega-[N-ethyl-N-(phenylmethyl)amino]-1-phenyl
      1-alkanones (3) were found to be potent inhibitors. Various analogues of 3 were
      prepared to study the effect on AChE inhibition of partial restriction of
      conformation. Compounds with potent AChE inhibition were further evaluated in
      terms of central selectivity: the ratio of central action (ameliorating effect on
      scopolamine-induced memory impairment using a T-maze alternation task) to
      peripheral action.

PMID- 8477505
TI  - Preparation of glycyrrhetic acid beta-glycosides having beta (1-->2)-linked
      disaccharides by the use of 2-O-trichloroacetyl-beta-D-pyranosyl chlorides and
      their cytoprotective effects on hepatic injury in vivo.
AB  - Stepwise glycosidation was adopted for the construction of glycyrrhetic acid beta
      glycosides (27-30) having beta (1-->2)-linked disaccharides such as 2-O-beta-D
      glucuronopyranosyl-beta-D-glucopyranose, 2-O-beta-D-glucuronopyranosyl-beta-D
      galactopyranose, 2-O-beta-D-glucopyranosyl-beta-D-glucuronopyranose and 2-O-beta
      D-galactopyranosyl-beta-D-glucuronopyranose. In the first glycosidation, 2-O
      trichloroacetyl-beta-D-payranosyl chlorides (9-11) were utilized as starting
      sugar derivatives to react with methyl glycyrrhetinate (5): Glycosidation of 5
      with 9 and 10 gave beta- and alpha-monoglycosides (12) and (13), and (15) and
      (16), respectively. Treatment of the beta-glycosides 12 and 15 with ammonia
      saturated ether gave products (14) and (17), respectively. The glycosidation of 5
      with 11 followed by treatment with ammonia-saturated ether gave compounds (18)
      and (19), respectively. The second step glycosidations of 14 and 17 with methyl
      2,3,4-tri-O-acetyl-alpha-D-glucuronatopyranosyl bromide (20) gave diglycoside
      derivatives (23) and (24), respectively, and that of 18 with 2,3,4,6-tetra-O
      acetyl-alpha-D-glucopyranosyl bromide (21) and -alpha-D-galactopyranosyl bromide
      (22) gave diglycoside derivatives (25) and (26), respectively. The removal of the
      protecting groups of 23-26 gave diglycosides 27-30, respectively, having a beta-D
      glucuronopyranose (beta-D-glcUA) as one of two sugar components in the molecules.
      The cytoprotective effects of the synthesized glycosides 27-30 on carbon
      tetrachloride (CCl4)-induced hepatotoxicity in vivo were compared with
      diglycosides 31-33 having only neutral sugar components and naturally occurring
      glycyrrhizin (34) having two acidic sugar components (beta-D-glcUA).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8477506
TI  - Direct injection analysis of atenolol enantiomers in plasma using an
      achiral/chiral coupled column HPLC system.
AB  - A novel HPLC system was developed with an achiral/chiral coupled column for the
      direct injection analysis of atenolol (AT) enantiomers in plasma. The system
      consists of a size-exclusion column, an ODS silica column and a newly developed
      beta-cyclodextrin perphenylcarbamate(ph-beta-CD)-bonded silica column connected
      in a series via two switching valves. The neat plasma sample was directly
      injected onto the size-exclusion column, and the deproteinized fraction of AT
      enantiomers was concentrated on the ODS silica column. The enantiomers were then
      transferred and separated mutually on the ph-beta-CD silica column. The
      calibration line for each of the AT enantiomers was linear in the range of plasma
      concentration of 10-200 ng/ml (r > 0.9997) with good reproducibility (CV < 9.7%,
      n = 20). The recoveries from plasma were almost complete (> 97.4%) for both
      enantiomers. One analysis finished within 30 min. The developed system was
      applied to the enantioselective determination of plasma concentration-time curve
      of AT after the oral administration of racemic AT to a healthy volunteer.

PMID- 8477507
TI  - The first specific antibody against cytotoxic polyacetylenic alcohol, panaxynol.
AB  - Antitumor polyacetylenic alcohol, panaxynol, was isolated and purified from a
      powder of the root of Panax ginseng C.A. Meyer. Panaxynol inhibited the growth of
      various kinds of cultured tumor cell lines in a dose-dependent manner. In this
      paper we demonstrated the first specific antibody production against panaxynol.
      Anti-panaxynol antibody was elicited in rabbits by immunization with panaxynol
      hemisuccinate-bovine serum albumin conjugate (panaxynol hemisuccinate-BSA
      conjugate). An enzyme immunoassay (EIA) for the determination of panaxynol was
      established using a double-antibody technique. The EIA was highly specific
      against panaxynol although the antibody showed a minimal cross-reactivity with
      other types of polyacetylenic alcohol, i.e. panaxydol (12.0%) and panaxytriol
      (0.77%). Panaxynol at a concentration as low as 6.4 ng/ml can be detected. Using
      this assay we reconfirmed the rapid consumption of panaxynol by target tumor
      cells in an in vitro-culture system. The anti-panaxynol antibody may be a
      valuable tool for studies of the biological properties of polyacetylenic
      compounds.

PMID- 8477508
TI  - Triterpene glycosides from the bark of Robinia pseudo-acacia L. II.
AB  - From the bark of Robinia pseudo-acacia L., six new triterpene glycosides,
      Robiniosides E--J, were isolated and their structures were elucidated as
      abrisapogenol B 3-O-alpha-L-rhamnopyranosyl(1-->2)-beta-D-galactopyranosyl(1-->2)
      beta-D - glucuronopyranoside (1), abrisapogenol B 3-O-alpha-L-rhamnopyranosyl(1-
      >2)-beta-D- glucopyranosyl(1-->2)-beta-D-glucuronopyranoside (2), 3-O-alpha-L
      rhamnopyranosyl(1-->2)-beta-D-galactopyranosyl(1-->2)-beta-D - glucuronopyranosyl
      abrisapogenol B 22-O-alpha-L-rhamnopyranoside (3), 3-O-alpha-L-rhamnopyranosyl(1-
      >2)-beta-D- glucopyranosyl(1-->2)-beta-D-glucuronopyranosyl abrisapogenol B 22-O
      alpha-L-rhamnopyranoside (4), 3-O-alpha-L- rhamnopyranosyl(1-->2)-beta-D
      galactopyranosyl(1-->2)-beta-D-glucuron opyranosyl abrisapogenol E 30-O-beta-D
      apiofuranosyl(1-->6)-beta-D-glucopyranoside (5) and 3-O-alpha-L-rhamnopyranosyl(1
      ->2)-beta-D-glucopyranosyl(1-->2)-beta-D- glucuronopyranosyl abrisapogenol E 30-O
      beta-D-apiofuranosyl(1-->6)-beta-D-glucopyranoside (6), respectively.

PMID- 8477509
TI  - Two new steroidal saponins from dried fermented residues of leaf-juices of Agave
      sisalana forma Dong No. 1.
AB  - In a previous paper, we reported the isolation and structure determination of
      three new steroidal saponins, dongnosides C (3), D (2) and E (1) from the dried
      fermented residues of leaf-juices of Agave sisalana forma Dong No. 1. In a
      continuing study on this plant, two additional new major steroidal saponins,
      named dongnosides B (4) and A (5), were obtained. Their structures were
      characterized respectively as tigogenin 3-O-alpha-L-rhamonpyranosyl-(1-->4)-beta
      D-glucopyranosyl-(1-->2)- [beta-D- glucopyranosyl-(1-->3)]-beta-D-glucopyranosyl
      (1-->4)-beta-D-galactop yranoside and 3-O-alpha-L-rhamnopyranosyl-(1-->4)-beta-D
      glucopyranosyl-(1-->2)-[beta- D- xylopyranosyl-(1-->3)-beta-D-glucopyranosyl-(1-
      >3)]-beta-D- glucopyranosyl-(1-->4)-beta-D-galactopyranoside on the basis of
      chemical and physicochemical evidence.

PMID- 8477510
TI  - Naturally occurring 5-lipoxygenase inhibitor. II. Structures and syntheses of
      ardisianones A and B, and maesanin, alkenyl-1,4-benzoquinones from the rhizome of
      Ardisia japonica.
AB  - New alkenyl-1,4-benzoquinones, ardisianones A (1) and B (2), and the known
      maesanin (3) as 5-lipoxygenase inhibitors have been isolated from the rhizome of
      Ardisia japonica. Their structures have been elucidated as 2-methoxy-6-[(Z)-10'
      pentadecenyl]-1,4-benzoquinone and 5-hydroxy-2-methoxy-6-[(Z)-8'-tridecenyl]-1,4
      benzoquinone, respectively, on the basis of spectroscopic data and chemical
      degradation. Ardisianone A (1), maesanin (3) and belamcandol A (7) have been
      synthesized starting from belamcandol B (6), readily prepared by Wittig reaction
      between 9-(2-tetrahydropyranyloxy)nonanal and 3,5
      dimethoxybenzyltriphenylphsophonium bromide followed by selective demethylation
      with sodium thioethoxide.

PMID- 8477511
TI  - Comparative studies on the constituents of ophiopogonis tuber and its congeners.
      VIII. Studies on the glycosides of the subterranean part of Ophiopogon japonicus
      Ker-Gawler cv. Nanus.
AB  - Two monoterpene glycosides, tentatively named OJV-I (1) and OJV-II (2), and eight
      steroidal glycosides, tentatively named OJV-III (3), OJV-IV (4), OJV-V (5), OJV
      VI (6), OJV-VII (7), OJV-VIII (8), OJV-IX (9) and OJV-X (10), were isolated from
      the butanol-soluble fraction of the fresh subterranean part of Ophiopogon
      japonicus KER-GAWLER cv. Nanus. Among these compounds, 1, 2, 3, 4, 5, 6 and 7
      were identified as l-borneo1 O-beta-D-glucopyranoside, l-borneo1 O-beta-D
      apiofuranosyl (1-->6)-beta-D-glucopyranoside, ophiopogonin B, glycoside C,
      ophiopogonin D, Ls-10, and ruscogenin 1-O-sulfate, respectively. The structures
      of compounds 8, 9, and 10 were established to be (23S,24S,25S)-23,24
      dihydroxyruscogenin 1-O-[ alpha-L-rhamnopyranosyl(1-->2)] [beta-D-xylopyranosyl(1
      ->3)]-alpha-L-arabinopyranoside 24-O-beta-D-fucopyranoside, (23S,24S,25S)-23,24
      dihydroxyruscogenin I-O-[alpha-L-2,3,4-tri-O-acetylrhamnopyranosyl(1-->2)][beta-D
      xylo pyranosyl(1-->3)]-alpha-L-arabinopyranoside 24-O-beta-D-fucopyranoside, and
      (23S,24S,25S)-23,24-dihydroxyruscogenin 1-O-[alpha-L-2,3,4-tri-O
      acetylrhamnopyranosyl(1-->2)] [beta-D-xylopyranosyl(1-->3)]=alpha-L
      arabinopyranoside 24-O-beta-D-fucopyranoside, respectively.

PMID- 8477512
TI  - Development of a model membrane system using stratum corneum lipids for
      estimation of drug skin permeability.
AB  - Several model membrane systems have been reported to predict the skin
      permeability of drugs, but model membranes using stratum corneum (SC) lipids have
      never been reported. Thus, we developed a model membrane system for drug
      permeation study by fixing liposomes composed of SC lipids (ceramides, palmitic
      acid, cholesterol, and cholesterol-3-sulfate) onto a supporting filter, Biodyne
      B. The permeability of several drugs with different lipophilicities was
      investigated. Permeability increased with drug lipophilicity, estimated from the
      octanol/buffer solubility ratio of the drug. For relatively polar drugs, however,
      the permeability was almost constant, and very close to the value of a K+ ion,
      suggesting the membrane has both lipidic and aqueous pathways. Drug permeability
      through our system was compared with that through guinea pig skin. A good
      correlation (r = 0.880) was observed, although the former was one order of
      magnitude greater than the latter. Our model system will be useful not only for
      practical application, but also for basic studies, such as the elucidation of the
      relationships between SC lipid composition and drug permeability.

PMID- 8477513
TI  - Blood clearance and tissue distribution of various formulations of alpha
      tocopherol injection after intravenous administration.
AB  - The in vivo elimination and tissue distribution (2 h after administration) of
      various types of formulations of alpha-tocopherol as a model drug were examined
      in rats. An organic cosolvents formulation of alpha-tocopherol (alpha
      tocopherol/EtOH/polyethylene glycol 400) was rapidly removed from the blood
      circulation, the ratio of the distributed alpha-tocopherol was 20% in the lungs,
      about 70% in the liver and about 10% in the spleen. The main reason for this was
      considered to be the appearance of droplets more than 10 microns in diameter in
      the blood. Elimination of the micelle formulation using Brij58 from the blood was
      the most rapid, followed by Tween80 and HCO60. This order is thought to be due to
      the difference in the polyoxyethylene group among these surfactants. In liposome
      formulations, liposomes having a diameter of about 80 nm were the most stable in
      the blood circulation, and alpha-tocopherol was distributed in the
      reticuloendothelial system (RES) in the smallest ratio. The uptake of liposomes
      by the spleen and lungs depended on the liposome size. The uptake by the liver
      was in the decreasing order of 28 nm >> 42 nm, 151 nm, 195 nm, 3656 nm > 106 nm >
      75 nm. The 100 nm lipid emulsion was eliminated from the blood more rapidly than
      the 100 nm liposome formulation.

PMID- 8477514
TI  - Microbial hydroxylation of (-)-eburnamonine by Mucor circinelloides and
      Streptomyces violens.
AB  - (6R)-6-Hydroxy-, (6S)-6-hydroxy- and (18S)-18-hydroxyeburnamonines were obtained
      by microbial conversion of (-)-eburnamonine using Mucor circinelloides and
      Streptomyces violens. Their structures were determined by analyses of the mass,
      1H- and 13C-NMR spectra. (-)-Eburnamonine and the three hydroxylated compounds
      showed cerebral protecting effects against potassium cyanide intoxication in
      mice.

PMID- 8477515
TI  - Structure-activity relationship of lipopeptide from outer membrane of Escherichia
      coli and synthesis of highly immunopotenting lipopeptide derivatives with an
      achiral lipo-part.

PMID- 8477516
TI  - Natural course of endothelium-dependent and -independent responses in autogenous
      femoral veins grafted into the arterial circulation of the dog.
AB  - We examined the natural course of endothelium-dependent and -independent
      responses in reversed autogenous vein grafts during regeneration and tissue
      repair processes after vein grafting in dogs. Vein grafts implanted in the canine
      femoral artery were removed, cut into rings, and suspended in organ chambers for
      isometric tension recording at 3 days and 1, 2, 4, and 6 weeks after
      implantation. Endothelial cells were denuded from some rings. Control veins were
      taken from nonsurgically treated femoral veins. Acetylcholine caused endothelium
      dependent relaxations in the control veins, whereas in the vein grafts there was
      no evidence of endothelium-dependent relaxations to acetylcholine 3 days after
      the operation. Acetylcholine caused endothelium-independent contractions
      throughout the study. The endothelium-dependent responses to ADP and calcium
      ionophore A23187 were constantly maintained. Three days after the operation, the
      amplitude of norepinephrine-induced contractions of the vein grafts was impaired,
      and at 1 week the amplitude was recovered, although it was significantly smaller
      than the amplitude of contractions of the control veins at any postoperative
      period. Endothelium-independent relaxations to sodium nitroprusside were
      maintained throughout the study. Thus, there was a selective loss of
      acetylcholine-mediated relaxation in vein grafts in the early postoperative
      stage, a time when the intima is not thickened. These altered responses in vein
      grafts in the early postoperative period may have a role in graft failure.

PMID- 8477517
TI  - Selective contribution of two types of carotid sinus baroreceptors to the control
      of blood pressure.
AB  - This study was performed to determine if selective elimination of afferent input
      from two different types of previously described baroreceptors altered the
      ability of the dog to regulate blood pressure (BP), examining specifically if
      there was differential loss of baroreceptor control of tonic levels of baseline
      pressure versus dynamic changes in pressure. In the first series of experiments
      in this study, anodal block of the carotid sinus nerve was used to selectively
      block afferent input in a sequence from large-diameter A-fiber carotid
      baroreceptors (mostly type I) to smaller A-fiber and nonmyelinated C-fiber
      baroreceptors (mostly type II). In the second series of experiments, anesthetic
      block of the carotid sinus nerve with bupivacaine was used to selectively
      eliminate afferent input in reverse order from anodal block, first blocking input
      from baroreceptors with small afferent fibers and then additionally eliminating
      input from the larger-diameter A-fiber baroreceptors. The effects of selective
      elimination of each baroreceptor type were determined by monitoring baseline BP
      during constant carotid sinus pressure (CSP) perfusion of a vascularly isolated
      carotid sinus (tonic control) and obtaining baroreflex sensitivity (slope) during
      ramp pressure stimulations of the carotid sinus (dynamic control) under various
      blocking conditions. Low levels of anodal block significantly attenuated
      baroreflex sensitivity (-0.84 +/- 0.11 versus -0.63 +/- 0.10 mm Hg BP/mm Hg CSP)
      at levels of block that had no effect on tonic baseline BP (158.41 +/- 9.5 versus
      160.7 +/- 9.5 mm Hg BP). In contrast, low levels of bupivacaine block produced
      significant increases in tonic BP (158.8 +/- 6.4 versus 169.0 +/- 6.5 mm Hg BP),
      whereas there was no effect on dynamic baroreflex sensitivity (-0.85 +/- 0.08
      versus -0.73 +/- 0.08 mm Hg BP/mm Hg CSP). Thus, blocking large A-fiber
      baroreceptors resulted in significant decreases in baroreflex sensitivity without
      changes in baseline levels of BP, indicating primarily an attenuation in dynamic
      baroreflex regulation. Blocking of smaller A-fiber and unmyelinated C-fiber
      baroreceptors resulted in smaller decreases in baroreflex sensitivity and
      significant elevations in baseline BP, indicating a loss of tonic control of
      pressure. These results suggest that the two types of baroreceptors contribute
      differently to the regulation of blood pressure.

PMID- 8477518
TI  - Endothelium-dependent contractions in rabbit pulmonary artery are mediated by
      thromboxane A2.
AB  - This study was designed to characterize the endothelium-dependent contracting
      factor (EDCF) released by arachidonic acid (AA) and methacholine (MeCH) in the
      rabbit pulmonary artery. AA and MeCH contract the rabbit pulmonary artery;
      however, the effects of both are blocked by denuding the vessels and by
      administration of indomethacin (a cyclooxygenase inhibitor), dazoxiben (a
      thromboxane [TX] synthase inhibitor), and SQ29548 (a TXA2/prostaglandin [PG] H2
      receptor antagonist). When segments of rabbit pulmonary artery were incubated
      with [14C]AA and the [14C] metabolites were resolved by reverse-phase high
      performance liquid chromatography (HPLC), radioactive products were observed that
      comigrated with 6-keto-PGF1 alpha and TXB2, the stable metabolites of
      prostacyclin and TXA2. The TXB2 radioactive peak was rechromatographed on normal
      phase HPLC and again migrated with TXB2. Finally, the structures of derivatized
      [14C]6-keto-PGF1 alpha and [14C]TXB2 peaks were confirmed by gas
      chromatography/mass spectrometry. The synthesis of [14C]6-keto-PGF1 alpha and
      [14C]TXB2 was inhibited by removal of the endothelium and by indomethacin.
      Dazoxiben inhibited the synthesis of [14C]TXB2 but not [14C]6-keto-PGF1 alpha.
      Using specific radioimmunoassays, AA and MeCH stimulated 6-keto-PGF1 alpha and
      TXB2 release. Indomethacin blocked the production of both 6-keto-PGF1 alpha and
      TXB2, whereas dazoxiben only blocked TXB2. In a superfusion/bioassay system, AA
      stimulated an endothelium-intact donor vessel to release a labile substance that
      contracted an indomethacin-treated endothelium-denuded recipient vessel. The EDCF
      released by AA had an approximate half-life of 30 seconds. Cultured rabbit
      pulmonary arterial endothelial cells synthesized 6-keto-PGF1 alpha but not TXB2.
      Immunohistochemical studies indicated the presence of cyclooxygenase, but not TX
      synthase, in pulmonary artery endothelial cells. TXA2 appears to be the EDCF
      released by AA and MeCH in rabbit pulmonary artery; however, TXA2 is not produced
      by endothelial cells but may arise from cells that adhere to the luminal
      surfaces, such as platelets or macrophages.

PMID- 8477519
TI  - Cardiac endothelial cells modulate contractility of rat heart in response to
      oxygen tension and coronary flow.
AB  - The aim of this study was to determine if endothelial cells in the heart release
      substances into the coronary perfusion medium that modify the contractility of
      myocardial cells. To assay the effects on the contractility of cardiac muscle of
      fluid that has passed through the coronary vasculature, a new method has been
      developed based on the cascade principle used to study vascular smooth muscle
      function. The coronary venous effluent from an isolated perfused working heart
      was collected periodically, and after reoxygenation it was used as the bathing
      medium for trabeculae isolated from the endocardial surface of another heart. The
      coronary venous effluent changed the contraction of the isolated trabeculae. The
      amplitude and the direction of the change depended on the degree of oxygen
      saturation of the coronary effluent before it was reoxygenated and the rate of
      coronary flow at the time the effluent was collected. The response of the
      trabecula to the coronary effluent was substantially altered by damaging the
      endocardial endothelium with a 1-second exposure to 0.5% Triton X-100 in Krebs'
      solution. It was completely eliminated by damaging endothelial cells in both the
      perfused heart producing the effluent and the trabecula on which the effluent was
      assayed. Therefore, endothelial cells are required for the presence of
      cardioactive substances in the coronary effluent. The production of a labile
      endothelium-derived upregulating (positively inotropic) factor and a more stable
      endothelium-derived downregulating (negatively inotropic) factor has been
      demonstrated and appears to account for all of the changes in myocardial
      contractility produced by the coronary effluent. Neither of the endothelium
      derived substances demonstrated in the isolated perfused heart is nitric oxide or
      endothelin. The concentration of the endothelium-derived upregulating factor is
      sensitive to oxygen tension, whereas the concentration of the endothelium-derived
      downregulating factor is sensitive to the rate of coronary flow but not oxygen
      tension. The coronary effluent appears to contain substances that stimulate
      secretion by the endothelial cells (preendothelial factors) as well as substances
      that have been produced by the endothelial cells (endothelial factors). The
      results indicate that during the passage of perfusion medium through the coronary
      vasculature upregulating and downregulating factors are added to the perfusate in
      relative concentrations that depend at least in part on local tissue PO2 and the
      rate of coronary flow. In the intact heart, this mechanism could operate to
      maintain balance between energy supply and work performed.

PMID- 8477520
TI  - Endocardial versus epicardial differences of intracellular free calcium under
      normal and ischemic conditions in perfused rat hearts.
AB  - Transmural heterogeneity of myocardial metabolism and function are present in the
      left ventricle under normal and ischemic conditions. To determine if endocardial
      versus epicardial differences of [Ca2+]i are also present, perfused rat heart
      studies using indo-1 fluorescence as an index of [Ca2+]i were performed in the
      left ventricular epicardium and endocardium. Hearts were studied during control
      conditions and low-flow ischemia. Results demonstrated the following: 1) At a
      pacing rate of 1.5 Hz, endocardial levels of diastolic and systolic [Ca2+]i (470
      +/- 40 and 1,240 +/- 170 nM) were higher than epicardial levels (290 +/- 30 and
      920 +/- 150 nM). 2) At a more physiological pacing rate of 5 Hz, endocardial
      levels of diastolic and systolic [Ca2+]i (680 +/- 50 and 1,230 +/- 70 nM) were
      also higher than epicardial levels (390 +/- 20 and 950 +/- 60 nM. 3) During low
      flow ischemia, endocardial levels of diastolic [Ca2+]i rose to a greater degree
      (from 680 +/- 50 to 1,050 +/- 70 nM at 10% of control coronary flow) compared
      with epicardial levels (from 390 +/- 20 to 580 +/- 40 nM at 10% of control flow),
      suggesting that the endocardium is more susceptible to low-flow ischemia. 4) The
      amplitude of the [Ca2+]i transient was the same at the endocardium (540 +/- 50
      nM) and epicardium (560 +/- 50 nM) and did not change during low-flow ischemia,
      despite marked contractile dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477521
TI  - Comparison of hirudin and heparin as adjuncts to streptokinase thrombolysis in a
      canine model of coronary thrombosis.
AB  - Recombinant desulfatohirudin (HI), a potent and specific thrombin inhibitor, was
      compared with heparin (HE) as an adjunct to streptokinase thrombolysis. In
      pentobarbital-anesthetized dogs, an occlusive thrombus (whole blood+thrombin) was
      introduced into the left anterior descending coronary artery (LAD) with
      superimposed endothelial damage and distal high-grade stenosis. Intravenous
      infusion of saline (vehicle), HI (0.3 mg/kg followed by 0.3 mg/kg per hour, 1
      mg/kg followed by 1 mg/kg per hour, or 2 mg/kg followed by 2 mg/kg per hour), or
      HE (60 units/kg followed by 40 units/kg per hour or 100 units/kg followed by 60
      units/kg per hour) was initiated 15 minutes before streptokinase (750,000 units
      for 60 minutes) administration. Vessel patency was monitored for 180 minutes
      after streptokinase administration with a volume flow probe on the proximal LAD.
      In dogs treated with no adjunctive agent (saline control), none of the vessels
      were recanalized with streptokinase. Both HI and HE promoted reperfusion,
      inhibited reocclusion, and reduced the residual thrombus mass in a dose-dependent
      fashion. However, at comparable levels of therapeutic anticoagulation (activated
      partial thromboplastin time [APTT] = 1.5-2.0 times baseline) HI exhibited a
      higher incidence of reperfusion (eight of eight dogs [100%] versus one of eight
      dogs [12%]), a shorter time to reperfusion (33 +/- 6 versus 59 minutes), a longer
      duration of initial reperfusion (106 +/- 21 versus 10 minutes), and a smaller
      residual thrombus mass than did HE. Likewise, the slope of the relation between
      the APTT prolongation and the total reperfusion time
      ("anticoagulation/antithrombosis profile") was almost five times higher for the
      combined HI data than for the HE data. Our results indicate that HI is more
      effective than HE in enhancing and sustaining coronary recanalization with
      streptokinase at a HI dose that modestly prolongs coagulation time and does not
      alter bleeding times.

PMID- 8477522
TI  - High density lipoprotein reverses inhibitory effect 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) has any effect on the inhibition of endothelium-dependent
      relaxation by ox-LDL in isolated strips of rabbit thoracic aorta. Both low
      density lipoprotein (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. Although synthetic L-alpha-palmitoyl
      LPC (5 micrograms/ml) completely abolished a relaxation to ACh, the preincubation
      of arterial strips with HDL completely prevented the LPC-induced inhibition.
      Moreover, a relaxation to ACh was almost completely recovered when the strips
      were washed with buffer containing HDL even after LPC-induced inhibition had
      occurred. HDL markedly reduced the incorporation of [1-14C]palmitate-labeled LPC
      ([14C]LPC) into cultured bovine aortic endothelial cells and promoted the release
      of cell-incorporated [14C]LPC into the medium, resulting in a reduction of the
      remaining [14C]LPC in the cells. Agarose electrophoresis after incubation of a
      mixture of ox-LDL labeled with [14C]LPC and unlabeled HDL demonstrated a transfer
      of [14C]LPC from ox-LDL to HDL. These results indicate that HDL reverses the ox
      LDL-induced impairment of endothelium-dependent relaxation by removing LPC from
      ox-LDL and preventing LPC from acting on the endothelium.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8477523
TI  - Effects of chronic mitral regurgitation on diastolic function in isolated
      cardiocytes.
AB  - We have previously shown that chronic mitral regurgitation (MR) increases the
      rate of left ventricular early diastolic filling. These changes in chamber
      diastolic function were felt to be secondary to alterations in left ventricular
      loading conditions. Therefore, cellular diastolic function measured in cardiac
      muscle cells (cardiocytes) isolated from animals with chronic MR (absent
      alterations in loading conditions) was expected to be normal. However, chronic MR
      caused a decrease in sarcomere lengthening rate. The purpose of the current study
      was to define the mechanisms causing this decreased sarcomere lengthening rate in
      chronic MR cardiocytes and to explain the apparent dichotomy between chamber and
      cellular diastolic properties. Accordingly, sarcomere motion was measured using
      laser diffraction techniques in enzymatically isolated cardiocytes from seven
      control dogs and 11 dogs with chronic MR (produced by closed-chest transection of
      the mitral chordae). In the MR cardiocytes, there were abnormalities in cellular
      systolic function (decreased extent and velocity of shortening) and in cellular
      diastolic function (decreased velocity of sarcomere lengthening). Because studies
      in papillary muscles have shown that there is a direct relation between abnormal
      diastolic function (decreased velocity of muscle lengthening) and abnormal
      systolic function (decreased extent of muscle shortening), it was unclear whether
      the changes in cellular relaxation rate observed in chronic MR merely reflected a
      concomitant decrease in the extent of shortening or instead reflected an
      impairment in intrinsic relaxation properties. To make this distinction, the
      relation between relaxation velocity (measured as peak sarcomere lengthening
      rate) and sarcomere shortening extent was examined in MR cardiocytes and compared
      with that in control cardiocytes. There was a direct relation between sarcomere
      relaxation velocity and sarcomere shortening extent in both control and MR
      cardiocytes. Over a wide range of shortening extent, the slopes and y intercepts
      of this relation were similar in control and MR cardiocytes (slope, 27.7 sec-1 in
      control cells versus 28.1 sec-1 in MR cells; y intercept, -1.1 microns/sec in
      control cells versus -1.7 microns/sec in MR cells; p = NS). At any common
      shortening extent, relaxation velocity was the same in control and MR
      cardiocytes. To prove that this relation could detect abnormalities in the
      intrinsic myocardial relaxation process, interventions known to produce primary
      alterations in the intrinsic myocardial relaxation process were examined: the
      effects of hypothermia (30 degrees C) and isoproterenol (10(-6) M) on the
      relaxation velocity-shortening extent relation were studied in normal and MR
      cardiocytes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477524
TI  - In vivo gene transfer and expression in normal uninjured blood vessels using
      replication-deficient recombinant adenovirus vectors.
AB  - Replication-deficient recombinant adenovirus vectors do not require target cell
      replication for transfer and expression of exogenous genes and thus may be useful
      for in vivo gene therapy in the endothelium. To evaluate the feasibility of
      adenovirus-mediated gene transfer in vivo in normal intact blood vessels,
      adenovirus vectors containing the Escherichia coli lacZ gene or a human alpha 1
      antitrypsin (alpha 1AT) cDNA were injected in vivo into the lumen of an occluded
      vessel segment of sheep jugular vein and/or carotid artery. After 15 minutes of
      incubation, circulation was restored; the vessels were harvested 1-28 days later
      and evaluated for gene transfer and expression. Three days after in vivo exposure
      to the lacZ adenovirus vector, the endothelium of jugular veins and carotid
      arteries expressed beta-galactosidase. Exposure of jugular veins and carotid
      arteries in vivo to the alpha 1AT adenovirus vector resulted in the expression of
      alpha 1AT mRNA transcripts detected by Northern analysis and in the synthesis and
      secretion of alpha 1AT detected by ex vivo [35S]methionine labeling. Expression
      with the adenovirus vectors was efficient and easily detectable 1-14 days after
      injection, with maximum expression at 7 days. Expression was no longer evident at
      28 days. Thus, adenovirus vectors are capable of transferring exogenous genes to
      the endothelium of normal arteries and veins with expression for at least 2
      weeks, suggesting that these vectors have the potential for a variety of
      cardiovascular experimental and clinical applications.

PMID- 8477525
TI  - Muscle-specific gene expression. A comparison of cardiac and skeletal muscle
      transcription strategies.

PMID- 8477526
TI  - Troponin I gene expression during human cardiac development and in end-stage
      heart failure.
AB  - Recent reports have demonstrated the presence of two isoforms of troponin I in
      the human fetal heart, namely, cardiac troponin I and slow skeletal muscle
      troponin I. Structural and physiological considerations indicate that these
      isoforms would confer differing contractile properties on the myocardium,
      particularly on the phosphorylation-mediated regulation of contractility by
      adrenergic agonists. We have investigated the developmental expression of these
      isoforms in the human heart from 9 weeks of gestation to 9 months of postnatal
      life, using Western blots revealed with troponin I antibodies to detect troponin
      protein isoforms and Northern blots to detect the corresponding mRNAs. The
      results show the following: 1) Slow skeletal muscle troponin I is the predominant
      isoform throughout fetal life. 2) After birth, the slow skeletal isoform is lost,
      with cardiac troponin I being the only isoform detectable by 9 months of
      postnatal development. 3) The protein isoforms and their corresponding mRNAs
      follow the same pattern of accumulation, suggesting that the transition in
      troponin expression is regulated at the level of gene transcription. The
      developmental transition in troponin I isoform content has implications for
      contractility of the fetal and postnatal myocardium. We further analyzed right
      and left ventricular muscle samples from 17 hearts in end-stage heart failure
      resulting from pulmonary hypertension, ischemic heart disease, or dilated
      cardiomyopathy. Cardiac troponin I mRNA remained abundant in each case, and slow
      skeletal muscle troponin I mRNA was not detectable in any of sample. We conclude
      that alterations in troponin I isoform content do not therefore contribute to the
      altered contractile characteristics of the adult failing ventricle.

PMID- 8477527
TI  - In vivo observation of subendocardial microvessels of the beating porcine heart
      using a needle-probe videomicroscope with a CCD camera.
AB  - We developed a portable needle-probe videomicroscope with a charge-coupled device
      (CCD) camera to visualize the subendocardial microcirculation. In 12 open-chest
      anesthetized pigs, the sheathed needle probe with a doughnut-shaped balloon and a
      microtube for flushing away the intervening blood was introduced into the left
      ventricle through an incision in the left atrial appendage via the mitral valve.
      Images of the subendocardial microcirculation of the beating heart magnified by
      200 or 400 on a 15-in. monitor were obtained. The phasic diameter change in
      subendocardial arterioles during cardiac cycle was from 114 +/- 46 microns (mean
      +/- SD) in end diastole to 84 +/- 26 microns in end systole (p < 0.001, n = 13,
      ratio of change = 24%) and that in venules from 134 +/- 60 microns to 109 +/- 45
      microns (p < 0.001, n = 15, ratio of change = 17%). In contrast, the diameter of
      subepicardial arterioles was almost unchanged (2% decrease, n = 5, p < 0.01), and
      the venular diameter increased by 19% (n = 8, p < 0.001) from end diastole to end
      systole. Partial kinking and/or pinching of vessels was observed in some segments
      of subendocardial arterioles and venules. The percentage of systolic decrease in
      the diameter from diastole in the larger (> 100 microns) subendocardial
      arterioles and venules was greater than smaller (50-100 microns) vessels (both p
      < 0.05). In conclusion, using a newly developed microscope system, we were able
      to observe the subendocardial vessels in diastole and systole.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8477528
TI  - Increased capillary permeability to albumin in diabetic rat myocardium.
AB  - To clarify the mechanism for the well-known increase in microvascular
      permeability that occurs with diabetes mellitus, we investigated capillary
      permeability to albumin in diabetic rat myocardium by electron microscopy using
      albumin-gold (Alb-Au) complexes as a tracer. Diabetes was induced by an
      intravenous injection of streptozotocin. After 24-32 weeks, hearts from diabetic
      rats and age-matched control rats were perfused with Krebs-Henseleit bicarbonate
      buffer containing Alb-Au for 5 or 20 minutes and then fixed and processed for
      electron microscopy. The binding and transport of Alb-Au by capillary endothelium
      was quantitatively evaluated. In control rats, Alb-Au particles were found
      preferentially bound to the luminal plasmalemmal vesicles. In diabetic rats, the
      labeling of luminal vesicles was more extensive and more pronounced after 5
      minutes of perfusion when compared with control vesicles. The plasma membrane
      proper was also heavily labeled in diabetic rats. After 20 minutes, Alb-Au
      particles were transported across the capillary endothelium via plasmalemmal
      vesicles, but they did not penetrate the intercellular junctions in either
      control or diabetic rats. The vesicular transport of Alb-Au across the capillary
      endothelium was significantly increased in the diabetic myocardium when compared
      with control myocardium (percentage of abluminal labeled vesicles, 25.9 +/- 5.5%
      versus 1.3 +/- 0.5%; p < 0.01). The study on food-restricted rats with body
      weights close to those of diabetic rats suggested that caloric deficiency alone
      did not have much effect on capillary permeability. The data indicate that
      capillary permeability to albumin is markedly increased in diabetic myocardium
      because of enhanced vesicular transport. This may play an important role in the
      pathogenesis of diabetic cardiomyopathy.

PMID- 8477529
TI  - Identification of functional PGH2/TxA2 receptors on human endothelial cells.
AB  - Although functional receptors for thromboxane A2 and prostaglandin H2 (TxA2/PGH2)
      have been identified in platelets and vascular smooth muscle cells, receptor
      mediated events in human endothelial cells stimulated by these endoperoxides have
      not been shown. Using cultured endothelial cells harvested from human umbilical
      or saphenous veins, we measured the effect of the TxA2 mimetic U46619 on
      mobilization of cytoplasmic calcium ([Ca2+]i), as well as release of prostacyclin
      and expression of the proto-oncogene c-fos, intracellular events that have been
      linked to [Ca2+]i rise in stimulated endothelial cells. Addition of U46619 to
      confluent fura 2-loaded endothelial cells caused a concentration-dependent rise
      in intracellular [Ca2+]i, with agonist concentrations of 300 nM producing a
      maximal [Ca2+]i rise. This [Ca2+]i rise was a uniform response observed in all
      individual endothelial cells throughout the monolayer, as shown by
      microspectrofluorimetric visualization. Similar effects were seen with a
      structurally dissimilar endoperoxide analogue, I-BOP, and with the naturally
      occurring endoperoxide PGH2. The initial [Ca2+]i rise was not reduced when
      extracellular [Ca2+]i was chelated with EGTA, but a later "plateau" phase was
      eliminated. An antagonist of the receptor for TxA2/PGH2 (SQ29548) strongly
      inhibited [Ca2+]i mobilization. Stimulation of endothelial cells with U46619 also
      transiently increased expression of the proto-oncogene c-fos, as determined by
      RNA hybridization, and induced a fivefold increase in prostacyclin release. Thus,
      endoperoxides can stimulate human venous endothelial cells by means of TxA2/PGH2
      receptors, whose occupancy can activate intracellular events associated with
      functional changes.

PMID- 8477530
TI  - Phosphatidylinositol metabolism in hypertrophic rat heart.
AB  - The accumulation of inositol 1,4,5-trisphosphate (IP3) after hormonal stimulation
      has a physiological role, possibly by alteration of Ca2+ levels in cardiac
      myocyte. However, this accumulation has not been studied under pathophysiological
      conditions. In this report, we examine phosphatidylinositol metabolism during
      cellular response to norepinephrine in pressure-overloaded hypertrophic rat
      heart. After stimulation with norepinephrine, the accumulations of IP3 and
      diacylglyceride significantly increased in isolated myocytes from stroke-prone
      spontaneously hypertensive rat (SHRSP) heart, indicating phosphatidylinositol
      specific phospholipase C activity increased in SHRSP heart cells. Protein kinase
      C activity was also enhanced in SHRSP, with a marked increase in particulate
      activity. We determined the intracellular calcium concentration and found it to
      be higher in SHRSP than in Wistar-Kyoto (WKY) rats at 30-40 weeks of age. Ca2+
      influx was also elevated in SHRSP stimulated by norepinephrine. In SHRSP heart,
      cytosolic Ca2+ concentration may rise quickly in response to some stimuli, such
      as alpha 1-adrenergic stimulation, which is shown to be one of the pathways that
      increases cytosolic Ca2+ levels in hypertrophied rat heart. These data suggest
      that a part of the phosphatidylinositol-turnover pathway, such as the
      phosphatidylinositol 4,5-bisphosphate-IP3-Ca2+ pathway or the diacylglyceride
      protein kinase C pathway, may play an important role in the development of
      hypertrophy in SHRSP heart.

PMID- 8477531
TI  - Mechanosensitive gating of atrial ATP-sensitive potassium channels.
AB  - Cell-attached and inside-out excised-patch recording techniques were used to
      search for mechanosensitive ion channels in neonatal and adult rat atrial
      myocytes. A channel activated by negative pressure applied to the patch, with a
      single-channel conductance of 52 pS in symmetric potassium solutions, was
      frequently observed. This channel has been identified as the atrial ATP-sensitive
      potassium (KATP) channel on the basis of its potassium selectivity, as well as
      its inhibition by ATP or tolbutamide in the inside-out excised patch.
      Mechanosensitive modulation of the KATP channel has not previously been reported.
      In the presence of 1 mM ATP, 10-50 microM pinacidil (a specific KATP channel
      agonist) does not significantly increase basal KATP channel activity; however,
      these concentrations of pinacidil potentiated the mechanosensitive modulation of
      the KATP channel. A hypotonic swelling protocol (a mechanical stimulus) was used
      in an effort to determine whether mechanosensitive modulation of this channel can
      generate significant whole-cell currents. Under perforated-patch whole-cell
      recording conditions, superfusion of atrial myocytes with a 240 mosm/kg solution
      (control solution, 290 mosm/kg) stimulated whole-cell currents with a magnitude
      similar to those activated by 10 microM pinacidil. These results demonstrate that
      the gating of the atrial KATP channel is mechanosensitive and suggest that
      mechanosensitive modulation may be an additional and significant mechanism,
      modulating channel activity under both physiological and pathological conditions.

PMID- 8477532
TI  - Issues confronting medicine.
AB  - Our representatives in Washington are attempting to deceive the American public
      with a giant prevarication. The electorate is being told that more patients can
      obtain better health care at a lower cost. The practicing dermatologist is caught
      between opposing forces that are demanding improved care in the face of dwindling
      reimbursements. Concomitantly, the inexorable forces and constraints of
      escalating office overhead, tort liability, bureaucratic red tape, and managed
      competition hang like a sword of Damocles over the head of the practicing
      dermatologist. The independent practitioner stands alone as the only advocate for
      his patient; however, the physician's plea to maintain the sanctity and dignity
      of the doctor-patient relationship is being sacrificed on the altar of cost
      containment.

PMID- 8477533
TI  - Major issues confronting the practicing dermatologist in the 1990s.
AB  - Protein issues confront the dermatologic practitioner in this last decade of the
      twentieth century, including 1) the role of managed care; 2) the decline of
      direct access to the specialist; 3) malpractice liability and the need for
      reform; 4) declining reimbursements in the face of escalating practice overhead;
      and 5) conflict between the individual's right to care and society's ability to
      subsidize that right. Correcting and improving the American health care system
      demands a return to the emphasis and values that made that system the envy of the
      entire world. We must re-emphasize the sanctity of the doctor-patient
      relationship, halt the incursion upon physician autonomy, and eliminate those
      third party factors such as insurance companies, bureaucrats, and administrators
      that accentuate commerce instead of compassion in medicine. It is hoped that by
      expanding and equalizing the American health care system, it is not made
      unpalatable and unresponsive to every citizen.

PMID- 8477534
TI  - Prioritization of health services. The Oregon Basic Health Services Act and its
      implications for dermatologists and patients with dermatologic disease.
AB  - The Oregon Basic Health Services Act was passed by the Oregon Legislature in
      1989. This act mandates the provision of and payment for health services to
      Medicaid recipients based on a prioritized list of diseases and treatments. As a
      result of this legislation, Oregonians with incomes of 100% or less of the
      federal poverty level are eligible for Medicaid benefits. At present, families
      with incomes not exceeding 67% of the federal poverty level qualify for Medicaid
      in Oregon. The definition of prioritized care, how the prioritization was
      accomplished, and the potential effect of the implementation of this plan for
      dermatology and patients with dermatologic disease is discussed.

PMID- 8477535
TI  - Universal health coverage.
AB  - Although over 12% of our gross national product is spent on health care,
      approximately 14% to 17% of Americans are not covered by any form of health
      insurance. The cost, benefits, and deficiencies of private insurance and
      government programs are discussed in this article. The increasing percentage of
      persons surviving into older age, improved technology, patient demands and
      expectations, administrative costs, medical malpractice and defensive medicine,
      and other factors contribute to the steadily increasing cost of care. Physicians
      must participate in health care reform or passively accept determinations made in
      their absence.

PMID- 8477536
TI  - The national health service and dermatology as a specialty.
AB  - The history and development of health care provision prior to and following the
      introduction of the National Health Service in 1948 is outlined. This article
      covers all aspects of the training of dermatologists and the development of
      dermatologic services currently in the United Kingdom.

PMID- 8477538
TI  - Hospital staff privileges for dermatologists.
AB  - All dermatologists need to work at both the national and the local level to make
      our national dermatologic organizations reflect our surgical skills. At the local
      level, we should seek to become well integrated into the hospital staff and to
      document our competency when we take courses to learn new techniques. As more
      dermatologists are granted hospital privileges and become respected as valuable
      members of their medical community, this will help dignify and legitimize all of
      us on every level.

PMID- 8477537
TI  - Canadian dermatology.
AB  - Canadian dermatology differs from the American system by a predominant referral
      system in most provinces and by universal health care scheme. Canadian
      certification requires 1 year of internal medicine training in addition to 3
      years of clinical training. The Canadian Dermatology Association has formed
      several links with the American Academy of Dermatology and sponsors a similar sun
      awareness campaign.

PMID- 8477539
TI  - Physician advertising.
AB  - Practically nonexistent until the late 1970s, advertising by physicians has
      become commonplace. Although informational and educational advertising may
      contain information that potential patients may find to be useful, laudatory and
      predatory advertising are unethical and may be patently illegal. There is a
      conflict between the obligations of a physician to his patients and the
      intentions of advertising. The role of the Federal Trade Commission and state
      regulations are discussed.

PMID- 8477540
TI  - Ethics in pharmaceutical advertising.
AB  - Pharmaceutical manufacturing is one of the most financially lucrative industries
      in America due, in part, to massive marketing and advertising. The content of
      many symposia and medical journals as well as physician prescribing decisions
      seems to be influenced by the promotional efforts of pharmaceutical companies. In
      an effort to increase sales, the industry now advertises directly to the public.
      The role of the Food and Drug Administration and ethical standards established by
      medical organizations are discussed.

PMID- 8477541
TI  - Contract law: relationship between dermatologists and third-party payers.
AB  - The relationship between third-party payers and dermatologists is generally
      governed by a written contract. That relationship can be more beneficial to the
      dermatologist, and chances of liability may be decreased, both for breach of
      contract and for malpractice, if the dermatologist pays close attention to the
      language in the contract. All contracts are generally negotiable; detrimental
      language in the contract often may be removed or changed. This article presents
      information to help prepare dermatologists to review and negotiate contracts.

PMID- 8477542
TI  - The impact of professional liability on dermatologists.
AB  - Familiarity with and adherence to the above principles may not make you claim- or
      judgment-proof, but they should improve patient care in your office and decrease
      your exposure to medicolegal interventions. Always bear in mind that medical
      practice is not a right conferred upon you by virtue of your medical degree, but
      rather a privilege granted you by state statute and licensure. Inherent in this
      privilege are the following: 1. That you remain familiar with and comply with all
      state and federal laws governing the practice of medicine. 2. That you remain
      current in your continuing medical education, quality assurance, and loss
      prevention. 3. That you possess and exercise that degree of skill and learning
      commonly possessed and exercised by some physicians of your specialty in the same
      or similar communities at the same point in time. 4. That you maintain a valid
      license, DEA registration, and appropriate hospital credentialing.

PMID- 8477543
TI  - Future trends in dermatology.
AB  - If the specialty of dermatology is to enjoy a bright future in medicine,
      excellence in education and basic research, use of technologic advances, and
      advancement of our scientific and clinical knowledge through general and
      subspecialty dermatology must continue. The specialty needs to be unified and
      must learn to function in local, state, and federal governmental appropriations,
      regulations, legislation, and administration. The specialty needs to establish
      dermatologists as primary care physicians for dermatologic medical and surgical
      services. Dermatologists deliver the highest quality of dermatologic care and are
      cost-effective health care providers. The specialty of dermatology has developed
      a strong organizational structure to effectively deal with these six strategic
      components so as to afford a bright future for dermatology. Effective actions by
      the specialty will require increased participation by the constituents and
      continued involvement of the varied dermatology organizations. The future cannot
      be predicted with certainty, but a well-prepared society can continue its past
      success and look forward to a future beyond its highest expectations.

PMID- 8477544
TI  - International Foundation for Dermatology. A challenge to meet the dermatologic
      needs of developing countries.
AB  - The primary goal of the IFD, which serves under the aegis of the International
      Committee of Dermatology (the governing body of the International League of
      Dermatological Societies), is to improve dermatology and dermatologic care in
      rural areas and developing countries. The principal mission of the IFD is to
      create regional dermatology training centers in geographic areas of greatest
      need. The first such center, serving the 12 countries of the African Regional
      Health Community, is located in Moshi, Tanzania. After successfully completing a
      2-year course, the emerging dermatology officers will return to their countries
      of origin to promulgate the information they have learned by teaching others. The
      second RDTC is located in Chimaltenango, Guatemala to serve 10 countries in the
      Caribbean basin by training auxiliary nurses to man health posts in rural areas
      in this region. All dermatologists in the developed world should view their
      responsibility to their profession and to those suffering from dermatologic
      diseases in developing countries as a challenge that can be met if we all labor
      together to ensure a better world for those who currently have minimal or no
      dermatologic care. Remember: Give a man a fish and you feed him for one day;
      teach a man to fish and you feed him for life!

PMID- 8477545
TI  - Treatment of leg ulcers.
AB  - Leg ulcers represent the most common chronic wound in our population. This
      devastating problem often cripples patients, many of whom are in the prime of
      their working years. The resulting morbidity and financial cost are
      extraordinary. Fortunately, with the right approach, the vast majority heal with
      simple ambulatory outpatient therapy. The essential requirements for treating leg
      ulcers include a thorough understanding of lower extremity anatomy, vascular
      hemodynamics, and the management of trophic and inflammatory skin changes.

PMID- 8477546
TI  - Vitiligo. An overview of therapeutic approaches.
AB  - Vitiligo often induces severe cosmetic disfigurement in patients. These patients
      must function in a society that places profound emphasis and social significance
      on appearance. Although physically healthy, many patients are greatly affected
      psychologically by the disease. Hence, concerted efforts should be made to treat
      these individuals. Despite the inherent difficulties in stimulating melanocytes
      to repigment vitiliginous lesions, a variety of medical, surgical, and
      adjunctive/alternative therapies benefit innumerable patients with vitiligo.
      These treatments may be used as monotherapies or combination therapies to achieve
      optimal results.

PMID- 8477547
TI  - Therapeutic applications of photopheresis.
AB  - Photopheresis is a useful therapy for advanced cutaneous T-cell lymphoma,
      particularly for Sezary syndrome. Additional conditions in which clinical studies
      have suggested a therapeutic role for photopheresis include certain autoimmune
      diseases and reversal of rejection of solid organ allografts. Because
      photopheresis is extremely well tolerated and evidence is lacking for a direct
      immunosuppressive effect produced by this therapy, randomized trials should be
      pursued to determine the full spectrum of clinical benefit of this novel
      therapeutic modality.

PMID- 8477548
TI  - A primer of facial chemical peel.
AB  - Facial chemical peel encompasses a plethora of procedures or techniques and so
      may be confusing. This should not blunt one's enthusiasm for what chemexfoliation
      can achieve. With the use of TCA, chemical peel is a safe, effective, elegant,
      and simple method for treating some common problems of photoaged, fair skin
      (Table 7). When a standardized technique is used, it is possible to quantify the
      therapeutic effects and to predict the outcome reliably. Variations of chemical
      peel will be used as clinicians try to achieve better results. If possible,
      variations from standard techniques should be scientifically studied and
      quantified to establish their safety and efficacy. The goal of chemical face
      peeling is not simply to achieve a deep or longer-lasting peel. The highest
      concentrations of TCA and phenol may cause full-thickness facial chemical burns
      and leave long-lasting scars. Therefore, variations on standard techniques
      provide only subjective, difficult-to-measure benefits. Conversely, standardized
      testing on the facial skin of patients is difficult and thus we chose an animal
      model. Clinicians, especially dermatologists, who want to perform chemical peel
      should know the indications. Using the procedures described here and in other
      articles, one can safely and reliably undertake facial chemical peel.

PMID- 8477549
TI  - Dermal filler materials.
AB  - Although soft-tissue augmentation is not a new cosmetic procedure and actually
      has been performed for centuries, the modern era has introduced filling materials
      that are both safe and effective to soften the features. When used appropriately,
      these substances also can produce alleviation of scars and even true augmentation
      of the face. Newer techniques are being developed to access extremely fine lines,
      especially around the eyes. As research continues into newer materials, more
      procedures will become available and be more accessible to physicians and
      patients as the search for the perfect material for soft-tissue augmentation
      continues.

PMID- 8477550
TI  - Neoplastic angioendotheliomatosis: a treatable "vascular dementia" occurring in
      an immunosuppressed transplant patient.
AB  - A 53-year-old right-handed woman presented with headaches and dizziness. She had
      been well for ten years following successful cadaveric renal transplantation and
      was taking prednisolone and azathioprine. Two months later she had more headaches
      with transient dominant hemisphere disturbances and then suffered a completed
      right hemisphere deficit. As this was recovering, she developed an ischemic optic
      neuropathy, Computerized tomography (CT) was then normal although CSF analysis
      showed lymphocytosis and high protein. Steroid trial led to dramatic symptomatic
      and clinical recovery. On tailing off steroids, progressive bilateral hemisphere
      disturbance occurred. She was bedbound, with fever, headache, incontinence and
      disturbed consciousness. New evidence of infarction in watershed territories on
      CT led to temporal lobe biopsy. Cortical arterioles and venules showed
      proliferation of lymphoid cells staining for leucocyte common antigen and B-cell
      markers characteristic of Neoplastic Angioendotheliomatosis (NAE). After
      chemotherapy she regained independence and mobility and CSF protein fell. This is
      the first case of NAE to our knowledge in association with immunosuppression for
      renal transplant and is further evidence that NAE is malignant lymphoma.
      Cerebrovascular disease is common in such patients, the simultaneous events in
      differing territories is typical of NAE. Response to chemotherapeutic agents
      occurred although the typical natural history was unchanged.

PMID- 8477551
TI  - Functional localization in the Onufrowicz nucleus in man.
AB  - Neuropathological examination of a patient who died 45 days after the rectal
      amputation revealed axonal reaction of the motor neurons mainly in the
      dorsomedial portion of the Onufrowicz nucleus. Apparently normal motor neurons
      were found only in the ventrolateral portion. Also found in the present case was
      the localized distribution of chromatolytic neurons in the sacral
      intermediolateral cell column. While the ventral portion of it showed
      chromatolysis, the lateral portion was well preserved. These findings are in
      accordance with those obtained from the animal studies which demonstrated the
      functional localization of the sacral motor neuron pools into the anorectal
      innervation centers and the vesico-urinary centers.

PMID- 8477552
TI  - Frontal arachnoid cyst. A case of bilateral frontal arachnoid cyst without
      clinical signs.
AB  - The purpose of this study is to report a case of a very large arachnoid cyst in a
      patient having spent a very active life and who had never presented any
      neurological or psychiatric symptomatology beside a dementia in the last years of
      her life. The gross examination of the brain revealed the presence of a
      voluminous frontal bilateral cyst, located in the midline and displacing
      laterally the frontal lobes, so they displayed a foliated aspect.
      Microscopically, the examination of the cyst walls confirmed its arachnoid origin
      and the cerebral cortex contained lesions typical for senile dementia. This case
      exemplifies the histological nature and the pathogeny of arachnoid cysts, in
      particular of congenital origin. This also shows that the very early occurrence
      of such a malformation does not prevent the development of functional neuronal
      pathways, owing to the important plasticity of the central nervous system.

PMID- 8477553
TI  - Temporal lobe pathology in amyotrophic lateral sclerosis. Do amyotrophic lateral
      sclerosis and Alzheimer's disease share a common etiological factor?
AB  - An autopsy study was performed on temporal lobe samples from 20 non-demented
      patients with amyotrophic lateral sclerosis (ALS), 17 age-matched non-demented
      controls and 4 Alzheimer's disease (AD) patients. Formalin fixed, paraffin
      embedded sections from the hippocampus with adjacent parahippocampal gyrus and
      from the superior temporal gyrus were stained with conventional and
      immunohistochemical stains. Immunohistochemical staining for the A4 protein was
      enhanced by pretreatment with 0.25% pepsin before 100% formic acid. The incidence
      and severity of AD-like pathological changes were similar in ALS patients and non
      demented controls. In both groups, pathological changes increased with age. This
      study does not support the hypothesis that ALS and AD share an etiopathogenetic
      background.

PMID- 8477554
TI  - Pleomorphic xanthoastrocytoma: report of two cases and brief review of the
      literature.
AB  - Two cases of pleomorphic xanthoastrocytoma (PXA) involving the temporal lobe are
      reported, both occurring in adolescents. This neoplasma is a recently described,
      rare variant of astrocytoma affecting the superficial cerebral cortex and
      meninges of children and young adults. The tumor is considered to arise from the
      subpial astrocytes of the superficial cortex. Electron microscopic examination
      and immunoperoxidase stains for glial fibrillary acidic protein (GFAP) are
      helpful in making a definitive histologic diagnosis. Despite its pleomorphic
      appearance, this type of supratentorial glioma appears to have a much better
      prognosis than other tumors from which it must be distinguished, such as high
      grade gliomas and meningeal sarcomas. In contrast to malignant gliomas, the
      pleomorphic xanthoastrocytoma does not appear to require aggressive postoperative
      radiation therapy or chemotherapy. Therefore, it is important to recognize and
      identify this type of glioma as a distinct entity.

PMID- 8477555
TI  - Lack of presystemic inversion of (R)- to (S)-ibuprofen in humans.
AB  - Presystemic inversion of (R)- to (S)-ibuprofen has been proposed but not directly
      examined in humans. We investigated the bioavailability of the enantiomers of
      ibuprofen in 10 healthy volunteers. Low-dose racemic ibuprofen (400 mg) was
      administered orally and intravenously (60-minute infusion), in random order.
      There were no significant differences between oral and intravenous doses for the
      area under the curve values, terminal rate constants, clearances, metabolite
      formation clearances, and serum protein binding for (R)- and (S)-ibuprofen. The
      bioavailabilities of (R)-ibuprofen and total ibuprofen were 0.92 +/- 0.11 and
      0.95 +/- 0.08, respectively. The fractional inversion of (R)-ibuprofen was
      determined by two methods (stable isotope method and from the stereochemical
      composition of the urinary metabolites) that gave similar estimates of inversion
      for oral dosing (0.56 +/- 0.12 and 0.60 +/- 0.07, respectively) and intravenous
      dosing (0.56 +/- 0.09 and 0.60 +/- 0.06, respectively). We conclude that the
      bioavailability of both enantiomers of ibuprofen is complete and find no evidence
      of significant presystemic inversion.

PMID- 8477557
TI  - Simultaneous analysis of inulin and 15N2-urea kinetics in humans.
AB  - To elucidate the physiologic basis of multicompartmental systems used to model
      drug distribution, we studied inulin and 15N2-urea kinetics after simultaneous
      intravenous injection in five normal subjects. Distribution of both compounds was
      characterized by three-compartment models in which the central compartment
      corresponded to intravascular space. The mean distribution volumes of 0.164 +/-
      0.009 L/kg (+/- SD) for inulin and of 0.670 +/- 0.143 L/kg for urea were similar
      to expected values for extracellular space and total body water, respectively.
      Distribution from intravascular space was kinetically heterogeneous, presumably
      reflecting differences in vascular beds supplied by either fenestrated and
      discontinuous capillaries or capillaries with a continuous basement membrane.
      Intercompartmental clearances of inulin and urea and the ratio of their free
      water diffusion coefficients were used to estimate blood flows and permeability
      coefficient-surface area products for the peripheral compartments. The sum of
      compartmental blood flows averaged 5.39 +/- 0.49 L/min and was similar to dual
      beam Doppler measurements of cardiac output (5.47 +/- 0.40 L/min).

PMID- 8477556
TI  - Inhibition by fluoxetine of cytochrome P450 2D6 activity.
AB  - Potent inhibition of cytochrome P450 2D6 (CYP2D6) in human liver microsomes by
      fluoxetine and its major metabolite norfluoxetine was confirmed (apparent
      inhibition constant values, 0.2 mumol/L). Several other serotonergic agents were
      also found to be competitive inhibitors of this genetically polymorphic enzyme.
      The O-demethylation ratio of dextromethorphan that expressed CYP2D6 activity in
      19 patients receiving fluoxetine fell in the region of the antimode separating
      the O-demethylation ratio values observed in 208 extensive metabolizers from 15
      poor metabolizers of a control group of healthy subjects. Inhibition of CYP2D6
      activity in patients undergoing treatment with fluoxetine or other serotonin
      uptake inhibitors could contribute to toxicity or attenuated response from
      concurrent medications that are substrates of this enzyme. Other in vitro studies
      indicated that CYP2D6 catalyzes the O-demethylation of oxycodone to form
      oxymorphone. This reaction was inhibited by fluoxetine and its normetabolite in
      liver microsomes from both extensive and poor metabolizer individuals, indicating
      that these compounds are not selective inhibitors of CYP2D6 activity.

PMID- 8477558
TI  - Protein binding and ivermectin estimations in patients with onchocerciasis.
AB  - We measured ivermectin in plasma, urine, and saliva of nine patients with
      onchocerciasis. The aim was to establish pharmacokinetic parameters and to assess
      the most facile medium for use in monitoring compliance. Binding of ivermectin to
      plasma proteins in vitro was also investigated. The mean (+/- SEM) plasma values
      for the nine subjects were as follows: weight, 66.3 +/- 2.8 kg; dose, 11.11 +/-
      0.4 mg; half-life, 56.50 +/- 7.01 hours; clearance, 142.5 +/- 22.6 L/kg; volume
      of distribution, 9.91 +/- 2.67 L/kg; area under the plasma concentration-time
      curve, 1545.3 +/- 190.5 ng/ml.hr; time to reach maximum concentration, 4.7 +/-
      0.5 hours; and maximum concentration, 38.2 +/- 5.8 ng/ml. Ivermectin was not
      detected in the urine of any of the nine subjects. Low levels were found in
      saliva. Blood specimens remain the only reliable biologic fluid for assessment of
      compliance after ivermectin oral administration. Ivermectin binds specifically to
      human serum albumin.

PMID- 8477559
TI  - A pharmacokinetic evaluation of the second-generation H1-receptor antagonist
      cetirizine in very young children.
AB  - The pharmacokinetics of the second-generation H1-receptor antagonist cetirizine
      was studied in eight children younger than 4 years of age who were treated with a
      single dose of cetirizine solution (5 mg). These children were hospitalized with
      suspected allergic respiratory problems or recurrent respiratory tract
      infections. Blood samples were collected at 1/2, 1, 1 1/2, 2, 4, 6, 8, 12, and 24
      hours, and a 24-hour urine collection was performed in five of the samples. The
      findings obtained in children were compared with those obtained in 16 healthy
      young adults (mean +/- SD, 24.6 +/- 4.1 years) who received a single 20 mg dose.
      Cetirizine was absorbed more slowly in children (p = 0.006; mean +/- SD, 1.44 +/-
      1.12 hours) than in adults (0.62 +/- 0.22 hours). The plasma elimination half
      life of cetirizine was significantly shorter in children (p < 0.001; 4.91 +/- 0.6
      hours) than in adults (8.6 +/- 2.1 hours), and the clearance rate was
      significantly higher in children (p < 0.001; 1.48 +/- 0.41 ml/min/kg) than in
      adults (0.80 +/- 0.17 ml/min/kg). Urinary excretion of unchanged cetirizine was
      significantly lower in children (p < 0.001; 37.8% +/- 5.2%; n = 5) than in adults
      (57.7% +/- 11.8%). Therefore the metabolism of cetirizine is faster in young
      children than in adults. This effect must be taken into account in future
      pharmacodynamic studies in this age group.

PMID- 8477560
TI  - Dose-related effect of moxisylyte on maximal urethral closing pressure in
      patients with spinal cord injuries.
AB  - The effects of single intravenous doses of 0.25, 0.50, and 0.75 mg/kg moxisylyte
      on maximum urethral closure pressure were evaluated in a placebo-controlled
      double-blind experiment in 20 patients with spinal cord injuries. Pharmacodynamic
      testing was performed until 30 minutes, and blood pressure was assessed until 60
      minutes. Our findings showed a dose-dependent decrease in maximum urethral
      closure pressure. At each individual time point, the three doses differed
      significantly from placebo. Ten minutes after dose administration the maximum
      effect (48% decrease) was obtained with 0.75 mg/kg. A significant difference in
      favor of the highest dose was shown from 15 to 20 minutes after administration.
      According to these findings and because 0.75 mg/kg was as well tolerated as the
      two other doses, such a drop in pressure indicates that the alpha-blocking agent
      moxisylyte may be an effective means of decreasing urethral resistance, with
      obvious implications for the management of urinary obstruction.

PMID- 8477561
TI  - Decreased angiotensin II response but unaltered cardiovascular pressor response
      to infused norepinephrine after sodium restriction and converting enzyme
      inhibition.
AB  - Although studies indicate that converting enzyme inhibitors such as captopril
      influence beta-adrenergic physiology, the data on alpha-adrenergic physiology is
      inconsistent. This study therefore examined the effects of captopril (50 mg/day
      for 5 days) during sodium restriction on the pressor response and on angiotensin
      II and neuropeptide Y levels to infused norepinephrine (0.01 to 0.1
      micrograms/kg/min) in 17 hypertensive and 27 normotensive subjects. Angiotensin
      II increased significantly in response to infused norepinephrine during placebo
      administration (p < 0.001) but not during captopril administration (p = 0.15).
      Neuropeptide Y levels decreased in response to captopril (p = 0.02). Despite
      these changes the pressor response to infused norepinephrine was unchanged with
      captopril. These data support the conclusion that the antihypertensive action of
      captopril is unrelated to alterations in norepinephrine-mediated alpha-adrenergic
      pressor regulation. The finding of a decrease in neuropeptide Y levels may have
      relevance to the therapeutic effects of captopril.

PMID- 8477562
TI  - Quinidine enhances digitalis toxicity at therapeutic serum digoxin levels.
AB  - OBJECTIVE: To determine the effect of the digoxin-quinidine interaction on rate
      of in-hospital digitalis toxicity. METHODS: This was a prospective observational
      study over 9 months, set in two general medical wards. We studied consecutive
      patients (n = 141) who were receiving digoxin. Measurements included digitalis
      toxicity, defined by ECG criteria and resolution after stopping digoxin; all
      additional medications (including antiarrhythmics) continued. The observer was
      "blinded" to serum digoxin level and to concomitant drugs. RESULTS: Digitalis
      toxicity rates were as follows: digoxin alone, 4.9% (5 of 101 patients); with
      amiodarone or verapamil, 5.0% (1 of 20 patients); with quinidine, 50% (10 of 20
      patients) (p < 0.01). No toxicity was seen at digoxin levels < 1.0 ng/ml.
      Toxicity at 1.0 to 2.0 ng/ml was as follows: digoxin alone, 1 of 41 patients;
      with quinidine, 4 of 15 patients (p = 0.014). Toxicity was similar at levels >
      2.0 ng/ml: 4 of 8 patients and 7 of 11 patients, respectively. Independent
      relative risks and 95% confidence intervals (CI) of digitalis toxicity were as
      follows: serum digoxin, 9.1 (95% CI, 2.9 to 13.0); concurrent quinidine, 24.3
      (95% CI, 3.4 to 124). There was a significant (p < 0.01) interaction between
      concurrent quinidine, serum digoxin of 1.0 to 2.0 ng/ml, and digitalis toxicity.
      CONCLUSION: The digoxin-quinidine interaction significantly increases digitalis
      toxicity, even in the therapeutic range of serum digoxin levels.

PMID- 8477563
TI  - Glutathione S-transferase mu polymorphism does not explain variation in
      nitroglycerin responsiveness.
AB  - OBJECTIVE: To determine whether the considerable interindividual variability in
      nitroglycerin-induced venodilation in humans is related to the polymorphic
      expression of the mu class of glutathione S-transferase (GST mu). Recently
      vascular glutathione S-transferase (EC 2.5.1.18) of the mu-class (GST mu), a
      polymorphic group of enzymes present in only about 60% of the population, have
      been identified and shown in vitro to possess high metabolic activity toward
      nitroglycerin. Their clinical relevance is unknown. DESIGN: Dose-response
      relationships to nitroglycerin were constructed in vivo measuring changes in
      compliance of dorsal hand veins in 26 healthy volunteers during local infusion of
      small amounts of nitroglycerin. Polymerase chain reaction was applied to detect
      the deoxyribonucleic acid sequence that codes GST mu in whole blood samples.
      RESULTS: The GST mu isozyme was present in 15 subjects (58%) and deficient in 11
      subjects. Values for mean maximum venodilation (Emax) and dose rates producing
      50% of Emax (ED50) were not significantly different between the groups with or
      without GST mu. The respective values were 98% and 103% dilation for Emax and 9
      and 16 ng/min for ED50. There was no gender difference in the venodilatory
      response to nitroglycerin. CONCLUSIONS: Subjects lacking GST mu can clearly
      respond normally to nitroglycerin, and the large interindividual variability in
      nitroglycerin potency is not related to the expression of this polymorphic
      enzyme. Intersubject variability is therefore more likely to be the result of
      differences in the presence or activity of other vascular enzymes or in steps
      further distal in the venodilatory cascade.

PMID- 8477564
TI  - Analgesic efficacy and potency of two oral controlled-release morphine
      preparations.
AB  - MS Contin tablets and Oramorph SR tablets are two forms of oral controlled
      release morphine sulfate available for the alleviation of pain. Our objective was
      to compare their analgesic effects in a relative potency assay. In this study,
      151 patients undergoing caesarean section or abdominal hysterectomy and reporting
      moderate or severe postoperative pain received a 30 or 90 mg dose of either drug
      in a balanced, randomized, double-blind, parallel-group, single-dose experimental
      design. Patients provided self-ratings of analgesia. Relative potency for pain
      relief were calculated from log dose-effect curves. For total pain relief (rated
      by visual analog scales) over 12 hours, the log dose relative potency estimate
      for MS Contin tablets/Oramorph SR tablets was 1.9 (95% confidence limits, 0.89 to
      11.1); for peak pain relief (visual analog scales) the relative potency estimate
      was 1.7 (95% confidence limits, 0.65 to 48.3). Overall, the 90 mg dose of MS
      Contin was more effective than 30 or 90 mg doses of Oramorph SR and the 30 mg
      dose of MS Contin at hours 6 to 12. Adverse experiences (mainly drowsiness) were
      mostly mild to moderate, with no significant differences in their overall
      incidence or severity between equivalent doses. MS Contin tablets provided
      greater peak, total, and duration of analgesia, without higher incidence of
      adverse experiences.

PMID- 8477565
TI  - Perindopril as monotherapy in hypertension: a multicenter comparison of two
      dosing regimens. The Perindopril Study Group.
AB  - Perindopril erbumine, a new long-acting, non-sulfhydryl-containing angiotensin
      converting enzyme inhibitor, was evaluated in 289 patients with hypertension in a
      16-week, double-blind, placebo-controlled dose-ranging study. After 4 weeks of
      single-blind placebo treatment, patients with supine diastolic arterial pressures
      from 95 to 114 mm Hg were randomized to receive placebo, 4 mg perindopril once
      daily, or 2 mg perindopril twice daily. The daily dose of perindopril was
      increased by 4 mg every 4 weeks to a maximum of 16 mg per day. Mean decreases in
      systolic and diastolic arterial pressure were greater with perindopril than with
      placebo (p < 0.05). The dose-response curve flattened after 8 mg per day, and
      there was no difference in arterial pressure reduction or in the percentage of
      responders between once- and twice-daily administration of perindopril. Adverse
      reactions with perindopril were generally mild and, with the exception of cough,
      were similar with placebo. The findings of this study indicate that perindopril
      is effective, well tolerated, and suitable for once-daily administration for the
      treatment of hypertension.

PMID- 8477566
TI  - Nonsteroidal anti-inflammatory drug use in relation to major upper
      gastrointestinal bleeding.
AB  - In a study in the United States, Sweden, and Hungary, 335 cases of gastric
      bleeding without predisposing factors were compared with 670 control subjects,
      and 239 cases of duodenal bleeding were compared with 489 control subjects. For
      aspirin taken at least every other day during the week before the onset of
      bleeding (regular use), the relative risk of gastric bleeding was 4.4 (95%
      confidence interval [CI], 2.9 to 6.7); for occasional use, it was 3.3 (95% CI,
      2.1 to 5.0). For ibuprofen, the corresponding estimates were 1.0 (95% CI, 0.4 to
      2.6) and 1.1 (95% CI, 0.5 to 2.4). For naproxen, the estimate for regular use was
      4.0 (95% CI, 1.5 to 11). The estimates for any use of piroxicam (crude estimate),
      indomethacin, and diclofenac during the week before onset were 18 (95% CI, 4.1 to
      83), 1.6 (95% CI, 0.4 to 5.9), and 0.9 (95% CI, 0.2 to 4.2), respectively. The
      corresponding relative risks of duodenal bleeding were 7.1 (95% CI, 4.2 to 12)
      and 2.2 (95% CI, 1.3 to 3.7) for the regular and occasional use of aspirin, 2.4
      (95% CI, 0.5 to 11) and 0.8 (95% CI, 0.3 to 2.0) for ibuprofen, 12 (95% CI, 2.8
      to 54) and 9.9 (95% CI, 2.3 to 44) for naproxen, 17 (95% CI, 3.6 to 79) for any
      use of piroxicam (crude estimate), and 1.7 (95% CI, 0.2 to 14) for any use of
      indomethacin. There was a significant trend in the risk of gastric bleeding with
      increasing dose of regular aspirin use (p = 0.002). The relative risk estimates
      for the regular use of 325 mg or less were significantly elevated for both
      gastric and duodenal bleeding at 3.1 and 6.4, respectively.

PMID- 8477567
TI  - Publication bias.

PMID- 8477568
TI  - Industrial publication of controlled clinical trial data.

PMID- 8477569
TI  - Industrial publication of controlled clinical trial data.

PMID- 8477570
TI  - 1993 Clinical Research Meeting. Washington D.C., April 30-May 3, 1993. Abstracts.

PMID- 8477571
TI  - Scientists, societies, and science education.

PMID- 8477572
TI  - Effect of antibiotics on endotoxin release from gram-negative bacteria.
AB  - Antibiotics may inhibit bacterial growth or may kill bacteria by inhibiting cell
      wall synthesis or protein synthesis. The amount of endotoxin released during
      antibiotic action has been found to be clinically important. Nine antibiotics,
      representing seven classes, were studied for the amounts of endotoxin released
      during their action on susceptible strains of Escherichia coli, Klebsiella
      pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa. Staphylococcus
      aureus, which produces no endotoxin, was used as a control organism. Aztreonam
      induced the highest release of endotoxin, whereas other antibiotics such as
      imipenem and the quinolones induced the lowest release of endotoxin. Although the
      quantities of endotoxin released are not easily explained from the established
      mechanisms of antibiotic action, our findings may have implications for therapy
      of the acutely ill, septic patient in whom release of large quantities of
      endotoxin may be catastrophic.

PMID- 8477573
TI  - Multilaboratory evaluation of the in vitro activity of 13 beta-lactam antibiotics
      against 1474 clinical isolates of aerobic and anaerobic bacteria.
AB  - The in vitro activity of 13 beta-lactam antibiotics against 1474 recent clinical
      isolates was evaluated in a multilaboratory study. The most active antibiotic
      tested in this study was imipenem (98.5% of the strains were susceptible),
      followed by ticarcillin-clavulanate (91.4%), cefoperazone (90.0%), ceftazidime
      (87.9%), cefotaxime (87.7%), ceftriaxone (87.0%), ceftizoxime (86.3%), cefotetan
      (78.5%), ampicillin-sulbactam (77.9%), cefoxitin (73.5%), cefuroxime (70.9%),
      cefonicid (64.5%), and cefazolin (57.9%).

PMID- 8477575
TI  - Drug intolerance to high-dose clarithromycin among elderly patients.
AB  - We treated 13 elderly patients with chronic mycobacterial lung disease with
      clarithromycin using 1000 mg b.i.d. as monotherapy. Patients had a mean age of 70
      years, and 12 of 13 had creatinine clearances of 31-71 ml/min. Adverse events
      were seen in 100% of patients, with the most common being bitter taste (92%),
      nausea (92%), vomiting (54%) and central nervous system symptoms (54%). Elevated
      liver enzymes developed in five (38%) of 13 patients at weeks 1-6 of therapy.
      Mean serum levels of clarithromycin plus its 14-OH metabolite were 12.9 +/- 3.6
      micrograms/ml (SD). There were 11 patients (85%) who discontinued the high dose
      within 3 months because of side effects. Serum drug levels of clarithromycin plus
      its 14-OH metabolite consistently exceeded 12 micrograms/ml in six of six
      patients who discontinued drug (10 of 10 values) compared with neither of two
      patients who tolerated the high dose (0 of 6 values). A dose reduction to 500 mg
      b.i.d. was well tolerated (nine of 10 patients). Future trials with
      clarithromycin in this population should use lower doses with attention to body
      mass and renal function to minimize side effects.

PMID- 8477574
TI  - Occurrence of macrolide-lincosamide-streptogramin resistances among
      staphylococcal clinical isolates at a university medical center. Is false
      susceptibility to new macrolides and clindamycin a contemporary clinical and in
      vitro testing problem?
AB  - A total of 2189 staphylococcal strains at the University of Iowa Hospitals and
      Clinics (Iowa City, IA) were initially screened to determine the incidence of
      constitutive (29.8%) and potential inducible macrolide-lincosamide-streptogramin
      (MLS) resistance (11.3%). Staphylococcus haemolyticus and S. epidermidis (62.5%
      and 55.3%) showed the highest incidence of constitutive resistance.
      Staphylococcus hominis had the highest incidence of inducible resistance (40.6%),
      while S. aureus had the lowest rate for both resistance types. The overall ratio
      of constitutive-inducible MLS resistance was 4:1. Among strains initially
      speciated using the Vitek System GPI card, there was only a 69% species
      identification reproducibility, and 78% accuracy versus a reference
      identification method. A random sample of 105 Staphylococcus spp. isolates with
      discordant macrolide (erythromycin resistant) and lincosamide (clindamycin
      susceptible) susceptibility patterns were tested against 16 antimicrobial agents
      by using a reference broth microdilution method. All erythromycin-resistant
      Staphylococcus spp. were also resistant to other 14-member macrolides and
      azithromycin, while all organisms remained susceptible to clindamycin, rifampin,
      vancomycin, and the streptogramin compounds (RP59500 and virginiamycin).
      Resistance to teicoplanin was identified among some oxacillin-resistant S.
      haemolyticus strains. Of 105 isolates, 65 (62%) showed inducible MLS resistance,
      28 (27%) were noninducible, and 12 (11%) were either fully susceptible or
      resistant to the MLS drugs (Vitek System interpretation errors). MLS disk
      induction tests revealed two inducible resistance phenotypes: ML and MLS.
      Staphylococcus aureus showed the highest inducible resistance rate at 95% with an
      MLS-predominant pattern. In contrast, endemic S. haemolyticus isolates did not
      demonstrate inducible resistance that is, efflux-mediated erythromycin
      resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477576
TI  - RP 59500, a new streptogramin highly active against recent isolates of North
      American staphylococci.
AB  - To assess the potential clinical utility of RP 59500, 10 investigators from
      separate locations in the United States and Canada each tested approximately 200
      current isolates of staphylococci (Staphylococcus aureus and coagulase-negative
      staphylococci) by a standard protocol. RP 59500 was highly active (MIC90 < or = 2
      micrograms/ml) against all strains, including those that were resistant to
      oxacillin, ciprofloxacin, erythromycin, and spiramycin.

PMID- 8477577
TI  - The role of the clinical microbiology laboratory and the clinical pharmacy in the
      management of infectious disease (ASM, 1992). Introduction.

PMID- 8477578
TI  - Qualitative susceptibility tests versus quantitative MIC tests.
AB  - Qualitative susceptibility categories show reasonable, but incomplete,
      correlation with therapeutic outcome. Studies using quantitative MIC tests have
      demonstrated that treatment failures within the susceptible category are
      associated with higher minimum inhibitory concentrations (MICs) than with
      therapeutic successes. Other trials have exhibited enhanced response for
      increasing ratios of a pharmacokinetic parameter to MIC (for example, peak level
      to MIC ratio for aminoglycosides). Dose-response studies in animal infection
      models also demonstrate an excellent correlation between the dose of drug
      required for a given response and the infecting organism MIC. These studies
      suggest that the use of quantitative MIC tests may enable more individualization
      of the therapeutic regimen, especially in regards to dose and dosing frequency,
      than provided by qualitative category susceptibility tests. However, there are
      only rare studies that have used MIC results or pharmacokinetic parameters to
      improve efficacy. Furthermore, these studies have not consistently documented
      enhanced clinical efficacy. MICs can also be used to reduce drug dosage and cost
      of antimicrobial therapy for very susceptible organisms. Additional studies are
      clearly needed to define the full potential of the quantitative MIC test result.

PMID- 8477579
TI  - The impact of same-day tests versus traditional overnight testing.
AB  - Within the last decade, major technologic advances have been made in clinical
      microbiology that have resulted in the availability of a wide variety of
      different methods for the rapid reporting of test results. Included among these
      technologies are rapid methods for producing antimicrobial susceptibility reports
      that many regard as the most important information generated by the microbiology
      laboratory. Ideally, the early availability of this important information should
      favorably affect patient care by enabling the more judicious use of alternative
      drug therapies that are equally efficacious yet less toxic and less costly to the
      patient. Clinicians appear to have been reluctant to modify initial empiric
      therapies, however, despite the availability of the rapid antimicrobial
      susceptibility report. This article addresses some of the issues responsible for
      this long-standing problem and discusses and explores various strategies that can
      be implemented for improving the use and for controlling the cost of
      antimicrobial agents within the hospital.

PMID- 8477580
TI  - Selection of antimicrobial agents for routine testing in a clinical microbiology
      laboratory.
AB  - Each clinical microbiology laboratory must establish its own standard battery of
      antimicrobial agents to be tested routinely on clinical isolates of various
      organism groups. Some choices are based upon the intrinsic activities of
      antimicrobial agents for a particular group of organisms, for example, agents
      primarily active against either Gram-positive or Gram-negative bacteria. For
      final selection of limited batteries of agents for routine testing, however, it
      is necessary to use additional criteria based upon physician prescribing patterns
      and the availability of antimicrobial agents in a particular institution. A
      fundamental principle in the selection process should be routine testing and
      reporting of those antimicrobial agents that physicians actually use, that is,
      the institution's formulary agents. Testing of the most appropriate drugs for an
      institution may be complicated by lack of availability of some antimicrobial
      agents among the standard panels offered by automated instrument or commercial
      test system manufacturers. The laboratory should develop its final test batteries
      in consultation with the infectious disease and pharmacy services and the
      pharmacy and therapeutics and infection-control committees of the medical staff.
      These choices should not be made based upon the most convenient selection of
      drugs from the laboratory's perspective or based upon pharmaceutical industry
      promotional efforts.

PMID- 8477581
TI  - Effective reporting of susceptibility test results.
AB  - An overview of effective reporting of susceptibility test results is presented.
      Areas included in effective antimicrobial reporting are selective reporting of
      antimicrobials within drug families and by specific drug-organism combinations,
      automatic computer-delivered susceptibilities to patient-care areas, "flagged"
      results that are unusual and/or could seriously effect patient care, and the use
      of a coherent report format. Also included are areas that may significantly
      enhance antimicrobial result formats such as the reporting of cost information
      with susceptibility results, reporting "predictive sensitivities" based on
      institutional antibiograms, and reporting specific drugs for therapy based on
      gram's stain, and preliminary and final culture information.

PMID- 8477582
TI  - Changes in antimicrobial agent usage resulting from interactions among clinical
      pharmacy, the infectious disease division, and the microbiology laboratory.
AB  - Rapid reporting of culture and susceptibility data is the first of several
      important steps in the successful management of infected patients. As has been
      said many times, rapidly reported data are of little value unless the patient
      directly benefits. Benefit requires better overall communication and an action
      plan linked to timely use of these results. In 1989 the Millard Fillmore Hospital
      Antibiotic Review Committee developed and implemented a prototype approach to
      hospital wide antimicrobial management. The formulary was revised and the drug
      use evaluation process modified to enhance effectiveness and to lower the cost of
      therapy and inventory. Clinical pharmacy antimicrobial agent management
      specialists were then recruited to individualize patient treatments to the
      isolated pathogens in conjunction with the Division of Infectious Diseases. To
      provide the clinical pharmacy specialists with rapid and clinically useful
      information, a real-time computer link was created between the pharmacy
      (antibiotic orders) and the microbiology laboratory (culture results). Customized
      software was implemented to screen all patients automatically for mismatches
      between pathogens and drugs, or to screen for doses inappropriate to minimum
      inhibitory concentration or renal function. Special attention was paid to
      identification of opportunities to target a more appropriate narrow-spectrum
      regimen after culture results became available. Changes in antimicrobial regimen
      or dosage were made by contacting the prescribing physician. Over 90% of the
      recommended changes were made, and virtually all changed regimens had
      satisfactory clinical outcome. Real dollar expenditures for antimicrobial agents
      declined by > $200,000 per year. Prior to the institution of this computerized
      clinical management strategy, antimicrobial purchases were rising yearly at the
      rate of 12%-15%. The combined efforts of clinical pharmacy, microbiology, and
      infectious disease personnel successfully optimized antimicrobial therapy on a
      hospital wide basis. Antimicrobial agent optimization improved patient outcome,
      and the cost savings more than covered the costs of the program personnel and
      software.

PMID- 8477583
TI  - Formulary control of antimicrobial usage. What price freedom?
AB  - Formulary controls are the most common and probably the most effective method for
      controlling abuse of antimicrobial agents in hospitalized patients. Such programs
      may include restriction of both the number of agents available and the way these
      agents may be used. These programs have been demonstrated to control pharmacy
      expenditures. Other potential advantages include reductions in the incidence of
      adverse drug reactions and the antimicrobial resistance among the hospital flora,
      and improvements in the overall quality of prescribing of antimicrobials. There
      are few data to document such benefits, however. Potential disadvantages are also
      poorly documented but include inconvenience for prescribing physicians, increased
      administrative costs, prescribing errors, and increased antimicrobial resistance.
      Antimicrobial control programs will likely remain common, but the availability of
      new information technologies should enable a transition to systems based on
      concurrent assessment of antimicrobial appropriateness with immediate feedback to
      the prescribing physician.

PMID- 8477584
TI  - Alveolar ventilation to perfusion heterogeneity and diffusion impairment in a
      mathematical model of gas exchange.
AB  - This study describes a two-compartment model of pulmonary gas exchange in which
      alveolar ventilation to perfusion (VA/Q) heterogeneity and impairment of
      pulmonary diffusing capacity (D) are simultaneously taken into account. The
      mathematical model uses as input data measurements usually obtained in the lung
      function laboratory. It consists of two compartments and an anatomical shunt.
      Each compartment receives fractions of alveolar ventilation and blood flow. Mass
      balance equations and integration of Fick's law of diffusion are used to compute
      alveolar and blood O2 and CO2 values compatible with input O2 uptake and CO2
      elimination. Two applications are presented. The first is a method to partition
      O2 and CO2 alveolar-arterial gradients into VA/Q and D components. The technique
      is evaluated in data of patients with chronic obstructive pulmonary disease
      (COPD). The second is a theoretical analysis of the effects of blood flow
      variation in alveolar and blood O2 partial pressures. The results show the
      importance of simultaneous consideration of D to estimate VA/Q heterogeneity in
      patients with diffusion impairment. This factor plays an increasing role in gas
      alveolar-arterial gradients as severity of COPD increases. Association of VA/Q
      heterogeneity and D may produce an increase of O2 arterial pressure with
      decreasing QT which would not be observed if only D were considered. We conclude
      that the presented computer model is a useful tool for description and
      interpretation of data from COPD patients and for performing theoretical analysis
      of variables involved in the gas exchange process.

PMID- 8477585
TI  - A flexible, generic model for anatomic shape: application to interactive two
      dimensional medical image segmentation and matching.
AB  - A representation called a radial contour model (RCM) is described for two
      dimensional anatomic shapes. The model, which is a type of a geometric constraint
      network (GCN), is both flexible, in that it can deform to fit a particular
      instance of an anatomic shape, and generic, in that it captures all examples of a
      particular anatomic shape class. The model is implemented in a program, called
      SCANNER (version 0.7), for interactive model-based two-dimensional image
      segmentation and matching. Use of the model allows the segmenter to direct the
      search for edges in the image, and to fill in edges where none are present.
      Evaluations were done using models of 15 cross-sectional shapes appearing on CT
      images from 16 patients. Results from 480 trials show that the model-based
      approach reduces segmentation time by nearly a factor of 3 over manual methods,
      and correctly classifies 72.9% of the contours. The results not only suggest that
      the RCM will be useful for several current medical image segmentation tasks, but
      also support the hypothesis that geometric constraint networks are a viable
      approach to anatomic shape representation.

PMID- 8477586
TI  - Perusing the literature via citation links.
AB  - While MEDLINE searching is recognized as the single most effective means to
      identify relevant items to solve clinical and research problems, the clinician
      should also consider the complementary strategy to search for relevant items
      citing a known key paper. This study reports on the usefulness of citation
      searching based on the analysis of 89 searches. For each topic, the citations
      linked to an average of 24% additional relevant materials. At least one relevant
      item was added to 85% of the searches. The additional effort of scanning another
      printout is minimal since citation searching for 42% of the searches produced
      less than 7 additional items, half of which were judged to be useful. Duplicate
      retrievals were mostly of definite relevance. This alternate strategy appeared to
      be effective in interdisciplinary topics. Furthermore, the online version of the
      citation index is known for short turn-around time in processing, a feature
      important for many rapidly developing specialties.

PMID- 8477587
TI  - Neural network model: application to automatic analysis of human sleep.
AB  - We describe an approach to automatic all-night sleep analysis based on neural
      network models and simulated on a digital computer. First, automatic sleep stage
      scoring was performed using a multilayer feedforward network. Second, supervision
      of the automatic decision was achieved using ambiguity rejection and artifact
      rejection. Then, numerical analysis of sleep was carried out using all-night
      spectral analysis for the background activity of the EEG and sleep pattern
      detectors for the transient activity. Computerized analysis of sleep recordings
      may be considered as an essential tool to describe the sleep process and to
      reflect the dynamical organization of human sleep.

PMID- 8477588
TI  - Artificial neural networks as adjuncts for assessing medical students' problem
      solving performances on computer-based simulations.
AB  - Artificial neural networks were trained by supervised learning to recognize the
      test selection patterns associated with students' successful solutions to seven
      immunology computer-based simulations. New test selection patterns evaluated by
      the trained neural network were correctly classified as successful or
      unsuccessful solutions to the problem > 90% of the time. The examination of the
      neural networks output weights after each test selection revealed a progressive
      and selective increase for the relevant problem suggesting that a successful
      solution is represented by the neural network as the accumulation of relevant
      tests. Unsuccessful problem solutions were classified by the neural network
      software into two patterns of students performance. The first pattern was
      characterized by low neural network output weights for all seven problems
      reflecting extensive searching and lack of recognition of relevant information.
      In the second pattern, the output weights from the neural network were biased
      toward one of the remaining six incorrect problems suggesting that the student
      misrepresented the current problem as an instance of a previous problem. Finally,
      neural network analysis could detect cases where the students switched hypotheses
      during the problem solving exercises.

PMID- 8477589
TI  - Functional characteristics of QT prediction formulas. The concepts of QTmax and
      QT rate sensitivity.
AB  - A community-based population sample of 14,379 North American children and adults
      aged from birth to 75 years with normal ECG was used to investigate functional
      properties of 13 QT prediction formulas over a wide range of heart rates (HR) in
      normal sinus rhythm. QT measurements were made by a computer program from
      simultaneously sampled standard 12-lead or orthogonal XYZ leads and all QT
      measurements were visually verified using a high-resolution display terminal. New
      concepts of QT rate sensitivity (dQT/dHR) and maximum predicted QT after a long
      pause (QTmax) are introduced. Drastically diverging functional behavior is
      documented for different QT prediction formulas regarding QT rate sensitivity and
      QTmax. The simplest formula for predicted QT (QTp) meeting reasonable
      physiological constraints regarding QTmax and functional behavior of QT rate
      sensitivity while producing the best QT prediction accuracy was a function with
      only one independently adjusted parameter (QTmax) of the form: QTp = QTmax/(1 +
      0.01HR), with QTmax = 656 ms. This formula also suggests that QT rate sensitivity
      is inversely proportional to the square of HR and that individual values of QTmax
      can be predicted from ambulatory or exercise ECGs using the formula QTmax = 2 x
      QT100, where QT100 is QT at HR = 100/min.

PMID- 8477590
TI  - The postoperative incidence of small bowel obstruction following standard, open
      appendectomy and cholecystectomy: a six-year retrospective cohort study at Yale
      New Haven Hospital.
AB  - The incidence of postoperative small bowel obstruction (SBO) after standard, open
      appendectomy and cholecystectomy was calculated during a six-year period at a
      university medical center hospital, which is the larger of two local, community
      hospitals. A cohort of 567 patients who underwent either a standard, open
      appendectomy or cholecystectomy from 1 October 1985 through 30 September 1986 was
      assembled. Of these patients, 182 (32.1%) were readmitted to the hospital prior
      to 1 October 1991 and thereby received follow-up. The time-related incidence of
      readmission to the hospital with a specific diagnosis of SBO as estimated by the
      Kaplan-Meier method was tabulated. This analysis revealed the following incidence
      rates of postoperative SBO: 10.7% following appendectomy during 64 months of
      follow-up (n = 41) and 6.4% following cholecystectomy during 67 months (n = 141).
      The Kaplan-Meier product-limit incidence of postoperative SBO was significantly
      different for standard appendectomy versus standard cholecystectomy (Breslow-Cox
      P value < 0.0277). This implies that the anatomical position and/or the
      likelihood of perioperative infection associated with open, abdominal surgery
      plays a significant role in subsequent adhesion formation and development of SBO.
      These data may be compared to laparoscopic techniques in future studies.

PMID- 8477591
TI  - Postoperative compartment syndrome and the lithotomy position: a report of three
      cases and analysis of potential risk factors.
AB  - There exists a definite association between the placement of patients in the
      modified lithotomy position and the development of postoperative compartment
      syndrome. It must be appreciated that this syndrome is potentially life
      threatening and frequently results in long-term sequelae. We report three cases
      which illustrate the problem and analyze the multifactorial etiology of this
      condition and propose a strategy for its prophylaxis. The combination of direct
      pressure on the posterior compartment of the calf, elevation of the legs above
      heart level, a number of intraoperative variables, the preexistence of any lower
      limb arterial insufficiency, and in some cases, the use of intraoperative
      compression boots, may lead to a state of hypoperfusion in the anterior and
      posterior compartment musculature. Upon completion of the operation, removal from
      the lithotomy position, and correction of the etiological factors, a reperfusion
      occurs with the development of a capillary leak with subsequent tissue edema
      causing an increase in compartmental pressure which may result in neurovascular
      compromise. This is the compartment syndrome. Emphasis must be placed on the
      identification of high-risk patients, the prevention or rapid correction of any
      etiological factors, the early diagnosis of the problem, and an aggressive
      approach to its treatment.

PMID- 8477592
TI  - Pregnancy related coronary artery dissection: a case report and collective
      review.
AB  - There have been 31 patients with pregnancy related coronary artery dissection
      reported in the medical literature. We report a case of both right and left
      coronary artery dissection in a postpartum patient. A collective review of the
      clinical course, risk factors, and treatment specific mortality rates of coronary
      artery dissection in near term and postpartum females is discussed. The mean age
      was 33, the mean parity was 2.7, and the mean time span was 20 days postpartum.
      Twenty-two percent had known risk factors for coronary artery disease. Eighty
      four percent involved the left anterior descending artery. Overall mortality was
      66%. Of the patients that were alive on admission, 61% were treated medically (n
      = 11) with a 64% mortality; 39% were treated surgically (n = 7) with a 0%
      mortality. We conclude that pregnancy related coronary artery dissection occurs
      in otherwise healthy women near term or within three months postpartum.
      Multiparity and advanced maternal age may be risk factors. Early diagnosis and
      prompt surgical treatment may improve outcome.

PMID- 8477593
TI  - Practice locally, search globally.
AB  - The National Library of Medicine introduced the Grateful Med software package for
      accessing its databases over six years ago. Many new features have been added to
      the program since its inception in 1986. These major improvements enable health
      professionals to gain a more user friendly access to the biomedical literature of
      the National Library of Medicine than ever before. The software enhancements aid
      the end-user in performing searches that will retrieve material with greater
      specificity and accuracy. Grateful Med provides a time-saving, cost-effective
      means of equal access to the medical literature regardless of the user's physical
      location or lack of access to other resources.

PMID- 8477594
TI  - Social functions of the modern hospital. 1943.

PMID- 8477595
TI  - The anencephalic as organ donor: issues at the beginning and end of life.

PMID- 8477596
TI  - Listening to the patient, primary care, and reform.

PMID- 8477597
TI  - Multiple-organ dysfunction in the surgical patient: pathophysiology, prevention,
      and treatment.

PMID- 8477598
TI  - National American Academy of Dermatology conference on environmental hazards.

PMID- 8477599
TI  - Four flushers: topical agents producing facial flushing simulating the systemic
      variety.

PMID- 8477600
TI  - A dermatologic diary. Portrait of a practice.

PMID- 8477601
TI  - Infantile seborrheic dermatitis: an approach to cradle cap.

PMID- 8477602
TI  - The office visit and the self-help concept in treating the patient with
      psoriasis: a strategy revisited.
AB  - All dermatologists and physicians who care for patients with psoriasis should be
      aware that their patients may have an insufficient understanding of their
      disease. Every effort should be made to help patients fully comprehend their
      condition: to become aware of factors that can improve self-care and
      environmental events that can exacerbate the disorder. Strategies for self-help
      instructions can be modified from the highly structured approach in a university
      setting to the more informal atmosphere of a physician's office using the
      abundant patient educational resources available today. Improving communication
      between patient and physician will benefit the patient, by providing knowledge
      about psoriasis, encouraging the patient to acquire specific skills in dealing
      with the disease, and instilling a sense of responsibility for the patient's
      involvement in self-care.

PMID- 8477603
TI  - Fleas.

PMID- 8477604
TI  - Stethoscope dermatitis: an unusual presentation.
AB  - A medical intern presented with a rash that proved to be an unusual presentation
      of stethoscope dermatitis, a form of nickel contact dermatitis. The stethoscope
      as a cause of occupational side effects is reviewed.

PMID- 8477605
TI  - Calcifying panniculitis and systemic calciphylaxis in an end-stage renal patient.
AB  - A patient with a history of end-stage renal failure who had been receiving
      hemodialysis for approximately six months experienced painful plaques bilaterally
      on the medial aspects of her thighs. A biopsy specimen of the affected
      subcutaneous tissue demonstrated calcification in the subcutaneous tissue. In
      this case of calcifying panniculitis, the conditions for systemic calciphylaxis
      appear to have been present.

PMID- 8477606
TI  - The sign of Leser-Trelat associated with adenocarcinoma of the rectum.
AB  - The authors report a case of the sign of Leser-Trelat occurring in a patient with
      primary adenocarcinoma of the rectum. The patient demonstrated the sign several
      months before the internal malignancy was discovered. Although the majority of
      patients with the sign have an underlying adenocarcinoma of the gastrointestinal
      tract, relatively few cases have been reported with the rectum as the primary
      site. This case demonstrates a classic example of the sign of Leser-Trelat and
      illustrates its importance as a marker of underlying malignancy.

PMID- 8477607
TI  - Successful treatment of pyoderma gangrenosum with topical 5-aminosalicylic acid.
AB  - Pyoderma gangrenosum in a twenty-nine-year-old woman with associated long
      standing Crohn's disease was treated with topical 5-aminosalicylic acid cream.
      Significant improvement in the ulceration occurred despite progressive
      deterioration of the inflammatory bowel disease. The possible mode of action is
      reviewed. The efficacy, together with the lack of side effects, warrants further
      study into the therapeutic role of topical 5-aminosalicylic acid.

PMID- 8477608
TI  - Long-term follow-up of patients with diffuse fasciitis and eosinophilia
      associated with L-tryptophan ingestion.
AB  - We describe the long-term follow-up of two patients who experienced diffuse
      fasciitis and eosinophilia while ingesting L-tryptophan for treatment of
      insomnia. This is one of the first reports in the dermatologic literature of the
      long-term follow-up of eosinophilic fasciitis in association with L-tryptophan
      ingestion. Both patients fit the Centers for Disease Control's criteria for
      eosinophilia-myalgia syndrome. The literature on the eosinophilia-myalgia
      syndrome is reviewed.

PMID- 8477609
TI  - Cutaneous B-cell lymphoma associated with hypogammaglobulinemia.
AB  - A patient with hypogammaglobulinemia is presented with a primary cutaneous B-cell
      lymphoma. Diagnosis requires clinical and histologic criteria as well as
      phenotyping and genotyping. The cause, differential diagnosis, staging criteria,
      and treatment of the cutaneous B-cell lymphoma are reviewed.

PMID- 8477610
TI  - Transfer of bacteria associated with cryotherapy.
AB  - The aim of this study was to determine whether living bacteria can be transmitted
      by cryosurgery with carbon dioxide. Cultures were taken from the outer layer of
      the ice before starting treatment, and again at the end of the working day during
      ten consecutive working days. Each of ten dry ice blocks was sterile prior to
      use. Staphylococcus epidermidis was isolated from six of the latter following
      use. This finding indicates that the dry ice was contaminated during the
      procedure and that bacteria were transmitted from the patient's skin to the dry
      ice and to culture media. The medical implications of this finding require
      serious consideration regarding the risk of infection to both patient and
      clinical personnel from this procedure.

PMID- 8477611
TI  - Acquired lateral telangiectatic nevus: port-wine stain or nevus flammeus.
AB  - Three adult patients (one man and two women) with acquired lateral telangiectatic
      nevus (acquired port-wine stain or acquired nevus flammeus) on the face are
      presented. One patient had no history of preceding trauma. However, in two
      others, chronic sun exposure probably caused actinic damage of the skin with
      telangiectasia. A review of the literature on acquired lateral telangiectatic
      nevus and its causative factors is presented.

PMID- 8477612
TI  - Linear basal cell carcinoma.
AB  - Linear basal cell carcinoma is a rare morphologic variant of basal cell
      carcinoma. We present two cases of linear basal cell carcinoma. Both cases,
      treated by Mohs' micrographic surgery, demonstrated that there was lateral spread
      of the tumor that was not clinically present.

PMID- 8477613
TI  - Fijian penis marbles: an example of artificial penile nodules.
AB  - Artificial penile nodules are inert objects inserted beneath the skin of the
      penis to enhance the pleasure of female sexual partners during intercourse. The
      practice is most common among men from southeast Asia. This report describes a
      Fijian man who had an artificial penile nodule made from a whittled-down plastic
      toothbrush handle. Although some authors believe that the use of artificial
      penile nodules arose after World War II, the practice was discussed in the Kama
      Sutra, the classic Indian treatise on love.

PMID- 8477614
TI  - Sjogren-Larsson syndrome: report of a case in India.
AB  - The case of a six-year-old Indian girl with Sjogren-Larsson syndrome is reported.
      She displayed the classic triad of oligophrenia, ichthyosis, and spastic
      paraparesis. There was a history of parental consanguinity. The features that
      were absent were hypertelorism, pigmentary degeneration of the retina, simian
      creases of the palms, and aminoaciduria.

PMID- 8477615
TI  - Brittle nails: response to daily biotin supplementation.
AB  - A recent study from Switzerland demonstrated a 25 percent increase in nail plate
      thickness in patients with brittle nails who received biotin supplementation.
      Analysis of all visits to a nail consultation practice over a six-month period
      revealed forty-four patients with this condition who had been prescribed the B
      complex vitamin biotin. Of these, thirty-five who took daily supplementation were
      subjectively evaluated. Twenty-two of thirty-five (63 percent) showed clinical
      improvement and thirteen (37 percent) reported no change in their condition. The
      results of this small, retrospective study suggest a positive response to biotin
      in the treatment of brittle nails in some patients.

PMID- 8477616
TI  - Grandparent-headed families: new therapeutic challenges.
AB  - In today's complex society where dissolution of the nuclear family has become
      commonplace, grandparents are playing an increasingly significant role in the
      nurturing of their young grandchildren. The authors studied twelve randomly
      selected grandparent-headed families from the case files of a suburban child
      guidance clinic. Comparisons were made among the cases in terms of a number of
      factors, most significantly, elements of treatment including therapeutic issues,
      modalities and outcomes. The authors stress a multi-modal and intergenerational
      approach to the treatment of these families.

PMID- 8477617
TI  - Transitional objects, pre-sleep rituals, and psychopathology.
AB  - The prevalence among college age adults (N = 184) of transitional objects and pre
      sleep preparation rituals and their relationship to mental health was
      investigated. Two scales concerning use of transitional objects and fear of going
      to sleep, showed statistically significant correlations with self-reports of
      nightmares, loneliness, depression, and previous physical and sexual abuse. Forty
      six students scoring in the highest 15% of the distribution of scores for each
      scale were compared with students in the lowest 15% on the MAACL and SCL-90-R.
      High scoring students showed significantly higher levels of depression, anxiety,
      hostility, and interpersonal sensitivity.

PMID- 8477618
TI  - When emotionally troubled children grow up: adjustment in young adults who
      attended a psycho-educational treatment center.
AB  - This study examined post treatment outcomes of 88 young adults who attended a
      psycho-educational center for moderately to seriously emotionally troubled
      children. Over 60% made positive adjustment to adult life; the remainder were
      marginally functioning. Most subjects did not continue after high school with
      post-secondary education or vocational training nor did they or their parents
      receive individual and family therapy or supports from social services. Academic
      skills and parents' involvement in psycho-therapy were predictors of positive
      adjustment; child abuse was negatively correlated with adjustment.

PMID- 8477619
TI  - Academic achievement of children with emotional disorders treated in a day
      hospital program: an outcome study.
AB  - Reading, spelling, and arithmetic achievement of children treated in a day
      psychiatric hospital was examined over time. The results indicated that the
      majority of children fell in the average and above achievement group and
      progressed evenly over time. Almost none got worse and only a few made large
      gains. Organic impairment ratings appeared to distinguish the three performance
      groups within each subject area.

PMID- 8477620
TI  - Adolescent identity and delinquency in interpersonal context.
AB  - The relationship between delinquent involvement and the perceived importance of a
      variety of others in influencing, creating, and sustaining identity was explored
      in four subsamples (n = 238) of teens of varying levels of official delinquency.
      More delinquent teens were more likely to view conventional peers, delinquent
      peers and lifestyles, or no one at all as influencing their sense of self and
      identity. They were less likely to perceive parents and other adults as
      influential.

PMID- 8477621
TI  - Psychopathology and relationship measures in children with inflammatory bowel
      disease and their parents.
AB  - Children with inflammatory bowel disease and their parents were assessed for DMS
      III diagnoses, maternal attachment, marital relationship, life stresses, illness
      severity and cognitive/affective profile. Eleven of 15 children and 21 of 27
      parents had psychiatric diagnoses. Three children were suicidal. Thirteen of 15
      mothers had insecure attachment. Marital difficulties and medical severity
      correlated with life stress. The higher prevalence of psychiatric disorders than
      epidemiologically and of insecure attachment suggest at-risk relationships.

PMID- 8477622
TI  - Pretend play skills and the child's theory of mind.
AB  - Pretend play has recently been of great interest to researchers studying
      children's understanding of the mind. One reason for this interest is that
      pretense seems to require many of the same skills as mental state understanding,
      and these skills seem to emerge precociously in pretense. Pretend play might be a
      zone of proximal development, an activity in which children operate at a
      cognitive level higher than they operate at in nonpretense situations.
      Alternatively, pretend play might be fool's gold, in that it might appear to be
      more sophisticated than it really is. This paper first discusses what pretend
      play is. It then investigates whether pretend play is an area of advanced
      understanding with reference to 3 skills that are implicated in both pretend play
      and a theory of mind: the ability to represent one object as two things at once,
      the ability to see one object as representing another, and the ability to
      represent mental representations.

PMID- 8477623
TI  - Young children's conceptualization of pretense: action or mental representational
      state?
AB  - A growing body of research indicates that children do not understand mental
      representation until around age 4. However, children engage in pretend play by
      age 2, and pretending seems to require understanding mental representation. This
      apparent contradiction has been reconciled by the claim that in pretense there is
      precocious understanding of mental representation. 4 studies tested this claim by
      presenting children with protagonists who were not mentally representing
      something (i.e., an animal), either because they did not know about the animal or
      simply because they were not thinking about being the animal. However, the
      protagonists were acting in ways that could be consistent with pretending to be
      that animal. Children were then asked whether the protagonists were pretending to
      be that animal, and children tended to answer in the affirmative. The results
      suggest that 4-year-olds do not understand that pretending requires mental
      representation. Children appear to misconstrue pretense as its common external
      manifestations, such as actions, until at least the sixth year.

PMID- 8477624
TI  - Children's understanding of the stream of consciousness.
AB  - Children and adults were tested for their understanding that there is a virtually
      continuous flow of mental content in a waking person, a "stream of consciousness"
      that continues to run even when the person is not examining stimuli perceptually
      or trying to solve a problem. There was a marked increase with age from preschool
      to adulthood in subjects' tendency to say that a person who was just waiting
      quietly was having "some thoughts and ideas" rather than "a mind empty of
      thoughts and ideas." 4-year-olds also tended to say that the mind of a waiting
      person was "not doing anything," whether that person was another individual or
      themselves, and that a person who wanted to could keep his or her "mind
      completely empty of all thoughts and ideas" for 3 min. These results suggest that
      preschoolers' conceptions of people's mental lives may be quite different from
      those of older children and adults.

PMID- 8477625
TI  - Two roads diverged: young children's ability to judge distance.
AB  - In the present studies, we investigated 4- and 5- to 6-year-old's ability to
      compare the distances covered by a direct route to a location and an indirect
      route to the same location. The distances ranged between 16 and 22 feet. The
      routes were visible from a single vantage point, and objects serving as landmarks
      were sometimes located along the routes. We found clear demonstrations of the two
      classic Piagetian distance errors--the direct-indirect error, in which children
      judge that a direct route and an indirect route cover the same distance, and the
      interposed object error, in which children judge that a route is shorter when it
      is segmented by an object located somewhere along the route. The interposed
      object error occurred because children focused on only one segment of the route,
      which was consistent with Piaget's explanation of the error. However, in contrast
      to Piaget, we found that about 40% of 4-year-olds could successfully avoid the
      direct-indirect error, and in addition, when the routes were visually displayed,
      they could also avoid the interposed object error. It is important that they also
      gave correct explanations for why the indirect route was longer, by referring to
      the fact that it was not straight. For these children at least, the interposed
      object error was due to difficulty they had representing routes, rather than to a
      misconception of distance. We suggest that future research should examine whether
      that may also be true for younger children.

PMID- 8477626
TI  - Effective action by infants to contact objects by reaching and leaning.
AB  - The ability of infants aged 8-12 months to coordinate their arm and trunk
      movements to contact an object located in different positions was investigated in
      2 experiments. In the first, 8- and 10-month-old infants reached for near objects
      but both reached and leaned for more distant ones indicating that they perceived
      that forward leaning extends the range of contact beyond that of reaching alone.
      In addition, arm and trunk movements were initiated simultaneously; visual
      information concerning object distance was sufficient to activate an integrated
      reaching-and-leaning response. Object distances were increased and a mechanical
      aid was provided on half the trials in the second experiment with 10- and 12
      month-old infants. For both age groups the degree of leaning was reduced for
      objects that were out of reach without the aid. Only older infants were able to
      use the aid to extend partially their range of contact. Overall the results
      support the conclusions that, by at least 8 months, infants perceive that leaning
      extends their effective reaching space; by 10 months they perceive the limits
      within which reaching together with leaning is likely to be effective; and by 12
      months they begin to perceive how this space may be extended by a mechanical aid.

PMID- 8477627
TI  - Conflict and friendship relations in middle childhood: behavior in a closed-field
      situation.
AB  - Disagreements between school-aged children were examined as a function of
      friendship status. 66 same-sex dyads were selected, including equal numbers of
      "best friends" and nonfriends, who were then observed while playing a board game
      (a closed-field situation). Conflicts occurred more frequently among friends than
      among nonfriends and lasted longer. Friends did not talk more during their
      conflicts than nonfriends, but assertions were used selectively according to
      friendship and sex: With friends, girls used assertions accompanied by rationales
      more frequently than boys whereas boys used assertions without rationales more
      frequently than girls. These sex differences were not evident during conflicts
      between nonfriends. Results are discussed in relation to the social constraints
      intrinsic to closed-field competitive conditions as they apply to friendship
      relations in middle childhood.

PMID- 8477628
TI  - The significance of gender boundaries in preadolescence: contemporary correlates
      and antecedents of boundary violation and maintenance.
AB  - Previous research has established the importance of gender boundaries as a
      normative aspect of development in middle childhood. Here, the nature and
      importance of gender boundaries as an individual differences construct was
      explored. Ratings of gender boundary violation and gender boundary maintenance
      were made of 47 10-11-year-old children participating in a series of summer day
      camps. These ratings were supported by videotape-based behavior codings of gender
      boundary violating behaviors and by live observations of sheer number of
      associations with members of the opposite gender. In addition, considerable
      external validation of these individual differences was obtained. Children low on
      gender boundary violation and (especially) children high on boundary maintenance
      were independently judged by camp counselors to be socially competent. They also
      were found to be higher on a friendship variable, based on observation. Those who
      violated boundaries were especially unpopular with peers, based on a child
      interview. Finally, boundary violation and maintenance were related to attachment
      history and to early measures of parent-child generational boundary distortions.

PMID- 8477629
TI  - Parenting practices and peer group affiliation in adolescence.
AB  - Social scientists have often assumed that parental influence is sharply curtailed
      at adolescence because of the rising counterinfluence of peer groups, over which
      parents have little control. The present study tested a conceptual model that
      challenged this view by arguing that parents retain a notable but indirect
      influence over their teenage child's peer associates. Data from a sample of 3,781
      high school students (ages 15-19) indicated that specific parenting practices
      (monitoring, encouragement of achievement, joint decision making) were
      significantly associated with specific adolescent behaviors (academic
      achievement, drug use, self-reliance), which in turn were significantly related
      to membership in common adolescent crowds (jocks, druggies, etc). Findings
      encourage investigators to assess more carefully parents' role in adolescents'
      peer group affiliations.

PMID- 8477630
TI  - Emotional autonomy redux: revisiting Ryan and Lynch.
AB  - Ryan and Lynch have suggested that emotional autonomy in adolescence, at least as
      indexed by Steinberg and Silverberg's Emotional Autonomy Scale, is associated
      with poor family functioning and might therefore be better conceptualized as
      detachment. In the present study, we contrast adjustment scores among adolescents
      who differ in both emotional autonomy and perceptions of support in their
      relationship with their parents. Several thousand adolescents aged 14 through 18
      completed Steinberg and Silverberg's emotional autonomy measure, a measure
      designed to assess the provision of support in the parent-adolescent
      relationship, and a number of standardized measures of adjustment. Adolescents
      high in emotional autonomy but low in relationship support show problematic
      adjustment profiles, consistent with Ryan and Lynch's interpretation of the
      measure as an index of detachment. Although adolescents high in both emotional
      autonomy and relationship support report more internal distress and behavior
      problems than some adolescents, they score higher on measures of psychosocial
      development and academic competence than their peers. Emotional autonomy in the
      context of a supportive adolescent-parent relationship may carry some
      developmental advantages as well as some deleterious consequences suggested by
      Ryan and Lynch.

PMID- 8477631
TI  - Emotional and cardiovascular responses to adults' angry behavior and to
      challenging tasks in children of hypertensive and normotensive parents.
AB  - Cardiovascular, overt-motor, and verbal-reported responses to interadult
      emotional expressions, including anger, and to challenging task situations were
      examined in a sample of 49 10-14-year-old children of hypertensive (EH) and
      normotensive parents (NT). Sons of EH parents showed greater systolic blood
      pressure reactivity to interadult anger and to the digit span task than sons of
      NT parents. A consistent pattern was not found for girls. Marital distress and
      overt maternal anger expression predicted verbal-reported and overt-motor
      responses to interadult anger. Family history of EH and sex did not predict these
      responses. Implications include (a) heightened systolic blood pressure response
      to stress may be found in sons of EH parents before they are diagnosed to have EH
      disorders, (b) relations between family history of EH and cardiovascular response
      may be sex moderated, and (c) vulnerability to stress may be related to specific
      familial histories and backgrounds.

PMID- 8477632
TI  - Social and emotional competence in children of depressed mothers.
AB  - The relation between maternal unipolar major depression and children's self
      concept, self-control, and peer relationships were studied in a middle-class,
      predominantly white sample of 96 families. Each family included a target child
      between the ages of 5 and 10. Depressed mothers varied on whether or not the
      child's father also had a psychiatric disorder. Well mothers all had spouses with
      no psychiatric disorders. Analyses controlled for marital status, age, and sex of
      child. Children completed measures of self-concept and peer relations skills;
      teachers completed measures of self-control and a rating of popularity with
      peers. Results supported the multiple risk factor model in that fathers'
      psychiatric status and parents' marital status explained much of the variability
      in children's social and emotional competence. Maternal depression alone, in the
      context of a well husband/father, was only related to children having been rated
      by their teachers as less popular. Results are discussed in terms of possible
      mechanisms by which maternal depression may interact with paternal
      psychopathology and divorce in relation to children's social and emotional
      competence. The findings may further indicate that older children are more
      vulnerable to these multiple risk factors than younger children.

PMID- 8477633
TI  - Greater preference among females than males for dyadic interaction in early
      childhood.
AB  - The present study was designed to examine sex differences in children's
      preferences for dyadic and group interaction in early childhood. In Study 1, a
      professional puppeteer interacted with 21 females and 20 males 4 and 5 years of
      age using 1 (dyad) and 3 (group) puppets in a within-subjects design. Enjoyment
      of the 2 conditions was assessed through frequency of smiling and eye contact. In
      addition, sociometric techniques were used to measure the size of children's play
      networks, and observations of naturally occurring dyadic and group interaction
      were conducted. Study 2 was a replication of the puppet play procedure used in
      Study 1 with 38 females and 37 males 3 and 4 years of age. In both studies,
      females were found to enjoy dyadic interaction more than males. In addition, some
      evidence suggests that males may enjoy group interaction more than females.
      Results are discussed in terms of theoretical explanations for sex differences in
      preferences for interaction with differing numbers of peers.

PMID- 8477634
TI  - Private speech of learning disabled and normally achieving children in classroom
      academic and laboratory contexts.
AB  - Learning disabled (LD) children are often targets for cognitive-behavioral
      interventions designed to train them in effective use of a self-directed speech.
      The purpose of this study was to determine if, indeed, these children display
      immature private speech in the naturalistic classroom setting. Comparisons were
      made of the private speech, motor accompaniment to task, and attention of LD and
      normally achieving classmates during academic seatwork. Setting effects were
      examined by comparing classroom data with observations during academic seatwork
      and puzzle solving in the laboratory. Finally, a subgroup of LD children
      symptomatic of attention-deficit hyperactivity disorder (ADHD) was compared with
      pure LD and normally achieving controls to determine if the presumed immature
      private speech is a function of a learning disability or externalizing behavior
      problems. Results indicated that LD children used more task-relevant private
      speech than controls, an effect that was especially pronounced for the LD/ADHD
      subgroup. Use of private speech was setting- and task-specific. Implications for
      intervention and future research methodology are discussed.

PMID- 8477635
TI  - Disorganized infant attachment classification and maternal psychosocial problems
      as predictors of hostile-aggressive behavior in the preschool classroom.
AB  - This study of 62 low-income families examined the relation between maternal and
      infant measures assessed at 18 months infant age and child behavior problems at
      age 5 as rated by preschool teachers. The infancy assessments included measures
      of mother-infant interaction, maternal psychosocial problems, infant cognitive
      development, and infant attachment security, including the
      disorganized/disoriented classification. The strongest single predictor of
      deviant levels of hostile behavior toward peers in the classroom was earlier
      disorganized/disoriented attachment status, with 71% of hostile preschoolers
      classified as disorganized in their attachment relationships in infancy. Maternal
      psychosocial problems independently predicted hostile aggression in preschool and
      combined additively with infant attachment security in prediction. Results are
      discussed in relation to the asymmetry of forward and backward prediction that
      characterized the findings and in relation to the potential significance of
      disorganized attachment behavior as a precursor to later maladaptation.

PMID- 8477636
TI  - Relation of rearing environment to adaptive behavior of Egyptian toddlers.
AB  - 2 questions were explored: (1) Do observed relations found in Western cultures
      between specific psychosocial environmental factors and toddlers adaptive
      behavior resemble the pattern of relations found in a non-Western setting? (2)
      Does the specificity of relations between environment and performance found in
      Western cultures also operate in a non-Western culture? Subjects were 153
      Egyptian toddlers, 18-30 months of age, and their caregivers. Twice a month
      between 18 and 30 months toddlers were observed in naturalistic interactions with
      their caregivers, and measures of caregiver behavior and toddler functioning were
      coded. Replicating previous results from Western cultures, canonical analysis
      indicated that caregiver vocal stimulation was positively related to indices of
      toddler behavioral competence, while nonverbal response to vocalization and
      physical contact stimulation were negatively related. The salience of sib
      caregivers was also noted. Particularly for the age period between 24 and 29
      months, results indicated specificity of environmental action such that measures
      of caregiver vocal stimulation were uniquely related to measures of toddler
      vocalization, while caregiver response to distress was uniquely related to
      toddler emotionality. The present pattern of results suggests at least some
      degree of cross-cultural generalizability of environment-development relations
      and of the specificity model of environmental action.

PMID- 8477637
TI  - Origins of attachment: maternal interactive behavior across the first year.
AB  - This study built on attachment theory and previous research in examining the
      interactional origins of the secure, insecure-resistant, and insecure-avoidant
      patterns of attachment. Maternal sensitive responsivity, rejection, and activity
      were the focus of repeated naturalistic observations when infants were 1, 4, and
      9 months of age; quality of attachment was assessed at 1 year. Mothers of secure
      1-year-olds were observed to be more sensitively responsive at 1 and 4 months and
      less rejecting at 1 and 9 months than mothers of insecure infants. Mothers of
      insecure-avoidant infants were more rejecting at 9 months, whereas mothers of
      insecure-resistant infants were least sensitively responsive and most rejecting
      at 1 month; the insecure groups were also differentiated on the basis of patterns
      of change from 1 to 9 months, with mothers of resistant infants becoming less
      rejecting and mothers of avoidant infants becoming more rejecting relative to
      other mothers.

PMID- 8477638
TI  - Behavioral organization in newborns and its relation to adrenocortical and
      cardiac activity.
AB  - The aim of this study was to assess relations between behavioral organization and
      adrenocortical and cardiac activity in newborns. Twice during the neonatal
      period, the behavioral organization of 42 newborns, in terms of orientation and
      irritability, was assessed by the Neonatal Behavioral Assessment Scale (NBAS),
      and the newborns' cortisol response to the NBAS procedure was determined. In
      addition, cardiac activity was assessed during 1 of the NBAS. Whereas there were
      only inconsistent correlations between newborn irritability and the
      adrenocortical response during NBAS, low orientation was associated with a higher
      increase in cortisol in both of the assessments. In addition, orientation was
      predicted by basal cortisol level. High heart rates were associated with high
      irritability and low regulation of state, and, in addition, negative relations
      were indicated between orientation and heart rate variability. The findings
      support a coping model of biobehavioral relations in newborns.

PMID- 8477639
TI  - Some complications of the therapy of hemorrhagic disorders.
AB  - The principal mode for treating disorders of hemostasis is correction of the
      patient's functional defect by transfusions of appropriate fractions of normal
      plasma or transfusions of platelets. Two major complications of such therapy are
      the transmission of infectious diseases, particularly hepatitis and the acquired
      immune deficiency syndrome (AIDS), and the development of antibodies against
      clotting factors that are deficient in the patient's plasma. Measures that reduce
      the occurrence of infection include careful selection of donors, fractionation of
      plasma with the help of monoclonal antibodies, and treatment of plasma or its
      fractions with heat or with virus-inactivating organic solvents. No technique of
      preparing or administering blood or its components can prevent the emergence of
      antibodies against clotting factors. Desensitization by repeated infusions of
      antigen, for example, antihemophilic factor, however, appears to result in
      remission in some patients.

PMID- 8477640
TI  - Inhibition of luteinizing hormone secretion by fasting and exercise: "stress" or
      specific metabolic signals?

PMID- 8477641
TI  - Suppression of luteinizing hormone secretion during short-term fasting in male
      rhesus monkeys: the role of metabolic versus stress signals.
AB  - One day of fasting leads to a significant suppression of pulsatile LH secretion
      in adult male rhesus monkeys that is evident within the first 4-6 h after a
      missed meal. Restricting food intake may suppress the central drive to the
      reproductive axis via metabolic signals occurring during the transition from a
      fed, energy storing state to a fasted, energy mobilizing state or via signals
      associated with the "psychological stress" imposed by withholding food. To
      distinguish between these two general types of signals, we chose the experimental
      strategy of providing monkeys with a great excess of calories on the day before
      fasting (i.e. overfeeding on the day before fasting) in order to maintain them in
      a metabolically fed state on the following day when they were fasted, without
      preventing the psychological stress associated with fasting. We reasoned that if
      metabolic signals are responsible for causing the fasting-induced suppression of
      LH secretion, overfeeding on the day before fasting would prevent the fasting
      induced suppression of LH secretion. Eight adult male rhesus monkeys with
      indwelling venous catheters were studied on three occasions: on a day of normal
      feeding (receiving approximately 30 pellets of monkey chow at 1100 h on the day
      of the study), on a day of fasting after a day of normal feeding, and on a day of
      fasting after a day of overfeeding (receiving one meal of 100 pellets on the day
      before the study). Pulsatile LH secretion on a day of fasting after a day of
      normal feeding (0.4 +/- 0.2 pulses/6 h, measured from 1200-1800 h) was
      significantly suppressed, P < 0.05, compared to a day of normal feeding (1.8 +/-
      0.3 pulses/6 h). In contrast, on a day of fasting after a day of overfeeding
      there was no significant difference in LH secretion measured from 1200-1800 h
      (1.5 +/- 0.3 pulses/6 h) compared to a day of normal feeding. Overfeeding the day
      before fasting prevented the normal fasting-induced suppression of plasma T3
      concentrations and delayed the normal fasting-induced decline in plasma insulin
      concentrations. Overfeeding did not prevent the display of agitated behavior that
      we have previously documented in monkeys when they are fasted. These results
      support the hypothesis that the signal(s) which suppresses normal LH secretion
      after brief periods of fasting is related to the metabolic status of the body
      during the transition from a fed to a fasted state, rather than a function of the
      psychological state imposed by withholding food.

PMID- 8477642
TI  - Reversal of fasting-induced suppression of luteinizing hormone (LH) secretion in
      male rhesus monkeys by intragastric nutrient infusion: evidence for rapid
      stimulation of LH by nutritional signals.
AB  - Short periods of fasting (1-2 days) significantly suppress the frequency of
      pulsatile LH secretion in adult male rhesus monkeys. Resumption of food intake
      (i.e. refeeding) after fasting rapidly restores pulsatile LH secretion. We
      hypothesized that the resumption of LH secretion after refeeding results from the
      metabolic consequences of food intake rather than from relief of the
      psychological stress associated with fasting. To differentiate between these two
      possible types of signals, we attempted to provide fasting monkeys with the
      nutritional signals of a refeed meal without relieving the psychological stress
      associated with fasting. To do this, we provided monkeys with a refeed meal via
      indwelling gastric cannulae while continuing to deny them access to monkey chow.
      Nine adult male rhesus monkeys with indwelling gastric and venous catheters were
      fasted for 1 day, and on the following day they received a liquid nutrient
      infusion (equal in caloric content and macronutrient composition to a normal
      meal) at the normal feeding time (1100 h) via the gastric cannulae. Blood samples
      were collected from 0600-2400 h at 20-min intervals. Nutrient infusions caused a
      restoration of pulsatile LH secretion that was not different from the restoration
      caused by refeeding a normal meal of Purina monkey chow. In contrast, LH
      secretion remained suppressed on a second day of fasting. Additionally, monkeys
      receiving nutrient infusions displayed behavioral agitation similar to fasting
      monkeys, while monkeys refed monkey chow showed very little agitation. These
      findings support the hypothesis that nutritional/metabolic signals, rather than
      the relief of psychological stress, lead to the resumption of pulsatile LH
      secretion after refeeding.

PMID- 8477643
TI  - Low doses of endothelin-1 inhibit atrial natriuretic peptide secretion.
AB  - To clarify the interaction between endothelin-1 (ET-1) and atrial natriuretic
      peptide (ANP), the effects of ET-1 on ANP secretion were investigated in isolated
      perfused rat hearts and in conscious unrestrained rats. Perfusion with 10(-9) M
      ET-1 stimulated ANP secretion from the isolated perfused rat heart. However, 10(
      10) M ET-1 significantly decreased ANP secretion for the initial 15 min of the
      perfusion period. The perfusion with 10(-11) M ET-1, which is near the plasma
      level of ET-1 (2 x 10(-12) M), inhibited ANP secretion throughout the perfusion
      period. The perfusion of 10(-12) M ET-1 slightly decreased ANP secretion. After
      the ET-1 perfusion period, ANP secretion increased in proportion to ET-1 dose.
      The inhibitory action of ET-1 on ANP secretion was almost abolished by
      simultaneous perfusion of indomethacin, a cyclooxygenase inhibitor, but not by
      methylene blue, an inhibitor of soluble guanylate cyclase. In conscious
      unrestrained rats the iv infusion of 1 pmol/kg.min ET-1, which doubled the plasma
      ET-1 level, slightly but significantly decreased the plasma ANP level 5 and 10
      min after the initiation of the infusion. The infusion of 10 and 30 pmol/kg.min
      ET-1 increased the plasma ANP level. These results demonstrate that low doses of
      ET-1 exert an inhibitory and short-acting action on ANP secretion from the heart,
      although high doses of ET-1 exert stimulating and long-lasting action, and
      suggest that prostanoids are involved in this inhibitory action.

PMID- 8477644
TI  - Early and late effects of angiotensin-II on Ca2+ fluxes in bovine adrenal zona
      glomerulosa cells.
AB  - Previous studies have yielded conflicting results concerning the effects of
      angiotensin-II (Ang II) on Ca2+ fluxes in adrenal zona glomerulosa (ZG) cells.
      The present study was designed to investigate the kinetics and dose-dependency of
      Ang II-mediated changes in Ca2+ influx and efflux in cultured bovine ZG cells. At
      a high (10 nM) Ang II concentration, cytosolic Ca2+ (Cai) shows a peak-plateau
      response for the first 15 min, with small Cai transients commonly observed with
      longer stimulations. At 50 pM Ang II, more sustained Cai changes were elicited,
      typically consisting of Cai oscillations. The underlying changes in Ca2+ influx
      and efflux were studied. The early modifications of Ca2+ influx after 2 min of
      agonist stimulation were biphasic, with uptake increased by 90% between 1-100 pM
      Ang II and inhibited by 30% at 10 nM Ang II. Furthermore, high (10 nM) Ang II
      doses inhibited extracellular K(+)-stimulated Ca2+ influx. After 30 min of Ang II
      stimulation, the later dose response of Ca2+ influx was of similar magnitude but
      shifted to the left, showing a maximal influx at 10 pM Ang II and a modest
      enhancement at 10 nM. Basal Ca2+ efflux followed a two-compartment exponential
      decay, reflecting rapid Ca2+ displacement from extracellular sites (k1) and
      active Ca2+ transport (k2). A high (10 nM) Ang II concentration induced a
      transient large increase (130%) in k2 during the initial phase of Ang II
      stimulation, which returned to basal values within 10 min. A low (50 pM) Ang II
      concentration induced a small sustained increase (30%) in k2. A 10-nM Ang II
      concentration markedly reduced the exchangeable Ca2+ pool, as Ca2+ mobilized from
      intracellular stores into the cytosol was rapidly extruded, while Ca2+ influx was
      inhibited. A more physiological (50 pM) concentration of Ang II did not
      significantly alter the total exchangeable Ca2+ pool due to modest stimulation of
      both Ca2+ efflux and influx. In summary, the initial transient Cai response to
      high Ang II results from a large Ca2+ mobilization combined with inhibition of
      Ca2+ influx, which does not allow for the refilling of Ca2+ stores. At later
      times, small increases in Ca2+ influx allow for the eventual recovery of
      exchangeable cell Ca2+ and an enhanced elevation in Cai. At low Ang II
      concentrations, stimulation of both Ca2+ influx and efflux are concurrent and
      maintained, allowing for a sustained increase in Cai with little change in
      exchangeable cell Ca2+.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477645
TI  - Intracellular calcium regulates insulin-like growth factor-I messenger
      ribonucleic acid levels.
AB  - Insulin-like growth factor-I (IGF-I) is involved in repair and regeneration in
      tissues in which non-GH-mediated regulation of its production has been shown to
      be important. We have investigated the effects of a second messenger signaling
      pathway, intracellular calcium, on IGF-I mRNA levels in cultured rat dermal
      fibroblasts using a RNase protection assay. Intracellular calcium concentrations
      ([Ca2+]i) were increased using either the calcium ionophore A23187 or
      thapsigargin. The ability of these agents to increase [Ca2+]i was confirmed by
      spectrofluorimetry, using fluo-3 as the Ca2+ indicator. Treatment of cells in
      serum-free medium and 0.25% BSA [Minimum Essential Medium (MEM) + BSA] with 500
      nM A23187 or 1 micron thapsigargin decreased IGF-I mRNA levels in a time
      responsive manner over 4-8 h. A23187 and thapsigargin also decreased IGF-I mRNA
      levels to 36% and 47% of control levels, respectively, in a dose-responsive
      fashion. Basic fibroblast growth factor mRNA levels, which were simultaneously
      determined, were either unchanged or increased in cells treated with thapsigargin
      or A23187. Consistent with the change in IGF-I mRNA levels, immunoreactive IGF-I
      levels in medium conditioned for 48 h by A23187 or thapsigargin decreased to 25%
      and 14%, respectively, of control levels in cells maintained in MEM + BSA. To
      determine the role of protein synthesis in the effects of A23187 and
      thapsigargin, cells were treated with these agents in the presence or absence of
      cycloheximide. Cycloheximide had no effect on the decrease in IGF-I mRNA levels
      mediated by thapsigargin, but significantly attenuated the response to A23187.
      Given these differences in the role of protein synthesis in and the time course
      of the effects of A23187 and thapsigargin on IGF-I mRNA levels, additivity
      experiments were performed. Treatment of cells with the combination of A23187 and
      thapsigargin resulted in IGF-I mRNA levels that were approximately 70% of the
      levels present in cells treated with either agent alone. These data are
      consistent with a small additive effect, but suggest that the majority of the
      effect of A23187 and thapsigargin occurs via the same final pathway.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8477646
TI  - Differentiation of ovarian theca-interstitial cells in vitro: regulation of 17
      alpha-hydroxylase messenger ribonucleic acid expression by luteinizing hormone
      and insulin-like growth factor-I.
AB  - Insulin-like growth factor-I (IGF-I) has been shown to synergistically augment LH
      stimulated androgen biosynthesis in ovarian theca-interstitial cells (TIC).
      Additional evidence suggests that IGF-I may play a role in stimulating TIC
      differentiation during early follicle development. The purpose of the present
      studies was to examine the role of IGF-I in TIC differentiation by determining
      the effects of IGF-I on P450(17 alpha) mRNA expression in TIC differentiating in
      vitro. TIC isolated from the ovaries of hypophysectomized immature rats by
      Percoll gradient centrifugation were cultured with and without LH and IGF-I for
      up to 6 days. At various times, cytoplasmic RNA was extracted from the TIC, and
      P450(17 alpha) mRNA was measured by a specific assay, using reverse transcription
      and the polymerase chain reaction. LH stimulated a dose-related increase in
      P450(17 alpha) mRNA, with an ED50 comparable to that for androsterone
      biosynthesis (33.0 +/- 3.8 ng/ml), but significantly less than the ED50 for cAMP
      accumulation (385 +/- 0.1 ng/ml). IGF-I alone did not stimulate P450(17 alpha)
      mRNA, but in the presence of LH (100 ng/ml) stimulated a dose-related (ED50, 4.1
      +/- 1.6 ng/ml) increase (3-fold) in P450(17 alpha) mRNA. IGF-I did not alter the
      ED50 for LH stimulation of P450(17 alpha) mRNA (36.85 +/- 1.1 ng/ml). Detailed
      time-course studies revealed that IGF-I did not alter the 20-h lag phase before
      LH caused an increase in TIC androsterone biosynthesis; however, IGF-I stimulated
      a more rapid increase in androsterone than LH alone. In the presence of LH alone,
      P450(17 alpha) mRNA levels remained low for approximately 18 h, then increased
      rapidly to maximum levels by 30 h where they were maintained through 48 h.
      Concomitant treatment with LH plus IGF-I did not alter the 18-h lag phase, but
      P450(17 alpha) mRNA levels increased to approximately 2-fold higher levels than
      with LH alone. The results of our studies demonstrate that IGF-I increases the
      expression of P450(17 alpha) mRNA in TIC and support the hypothesis that IGF-I
      may play a role in stimulating thecal differentiation in developing follicles.

PMID- 8477647
TI  - Mechanisms of atrial and brain natriuretic peptide release from rat ventricular
      myocardium: effect of stretching.
AB  - Ventricular hypertrophy is characterized by augmentation of the synthesis and
      storage of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP).
      To evaluate in vitro the cellular mechanisms of immunoreactive ANP (IR-ANP) and
      BNP (IR-BNP) release from ventricular cardiocytes, we measured the secretory
      response to graded passive myocardial stretch in isolated atrialectomized
      perfused hypertrophied hearts of 14- to 18-month-old spontaneously hypertensive
      rats. At this age, the ventricular levels of both IR-ANP and IR-BNP were markedly
      higher in spontaneously hypertensive (182 +/- 27 and 32 +/- 3 pmol/ventricle,
      respectively) than in age-matched normotensive Wistar-Kyoto rats (35 +/- 4 and 12
      +/- 1 pmol/ventricle, respectively; P < 0.001), whereas the differences between
      the strains in atrial levels of these peptides were small. The release of
      natriuretic peptides from ventricles in response to stretch was examined by
      increasing the volume of the intraventricular balloon for 10 min. Stretching of
      the hypertrophied ventricles produced a rapid transient (from 1-5 min) increase
      in both IR-ANP and IR-BNP secretion. As left ventricular pressure rose from 0 to
      26 +/- 1 mm Hg, IR-ANP and IR-BNP release into the perfusion fluid increased 1.8
      +/- 0.4- and 2.5 +/- 0.2-fold, respectively. Infusion of staurosporine, known to
      inhibit protein kinase-C activity in heart cells, blocked the stretch-induced
      increase in IR-ANP release (F = 3.10; P < 0.001, by analysis of variance), but
      had no effect on basal ventricular IR-ANP secretion (F = 0.87; P = NS). An L-type
      calcium channel antagonist, diltiazem, had no significant effect on basal (F =
      1.20; P = NS) or stretch-stimulated (F = 1.47; P = NS) IR-ANP release from
      hypertrophied rat myocardium. Chromatographical analysis revealed that the
      ventricles primarily release the active processed 28- and 45- amino acid ANP- and
      BNP-like peptides, respectively, both before and during stretch. This study
      indicates that stretch stimulates both ANP and BNP secretion from hypertropic
      ventricular myocytes. The results further suggest that protein kinase-C may be
      involved in stretch-induced ventricular ANP release, whereas the influx of
      extracellular calcium may not be necessary.

PMID- 8477648
TI  - Enzyme characteristics of two distinct forms of mouse 3 beta-hydroxysteroid
      dehydrogenase/delta 5-delta 4-isomerase complementary deoxyribonucleic acids
      expressed in COS-1 cells.
AB  - The enzyme 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4-Isomerase (3 beta
      HSD) catalyzes the conversion of delta 5-3 beta-hydroxysteroids to delta 4-3
      ketosteroids, an essential step in the biosynthesis of all biologically active
      steroid hormones. We previously reported the isolation of three distinct mouse
      cDNAs for 3 beta HSD (3 beta HSD I, II, and III) and tissue-specific expression
      of their mRNAs. 3 beta HSD I is expressed only in gonads and adrenal glands, and
      3 beta HSD II and III are expressed in both liver and kidneys. In the current
      study, we present data which demonstrate that transiently expressed 3 beta HSD I
      and 3 beta HSD III proteins can catalyze the conversion of the delta 5-steroids,
      pregnenolone and dehydroepiandrosterone, to their respective delta 4-3
      ketosteroids, progesterone and androstenedione. They also can dehydrogenate the 3
      beta-hydroxy group of the 5 alpha-reduced steroid 5 alpha-androstanediol to yield
      dihydrotestosterone in the presence of the cofactor NAD+. The Km values of the
      expressed 3 beta HSD I (for each of these substrates) were all below 0.2 microM.
      Km values of 3 beta HSD III were greater for all substrates, with the greatest
      increase observed for pregnenolone, which was over 10-fold greater. Both forms of
      expressed protein can catalyze the reduction of dihydrotestosterone to 5 alpha
      androstanediol in the presence of the cofactor NADH, but with considerably higher
      Km values (5.5 microM for form I and 6.8 microM for form III). The observed
      maximum velocity of form I was much higher for all substrates examined. RNase
      protection and immunoblot analysis of expressed 3 beta HSD I and III indicate
      that the difference in maximum velocity reflect differences in the steady state
      levels of mRNA and amounts of protein. In addition, the expressed 3 beta HSD III
      protein analyzed by Western blot has a lower mobility than the 3 beta HSD I
      protein, both similar in mol wt to the 3 beta HSD proteins detected in mouse
      liver and adrenal glands, respectively. These data demonstrate that an isoform of
      3 beta HSD expressed in liver and kidney has the capacity to convert delta 5-3
      beta-hydroxysteroids to delta 4-3-ketosteroids. The data suggest that a
      homologous human 3 beta HSD isoform could play an important role in cases of
      genetic deficiency of the gonadal and adrenal isoform.

PMID- 8477649
TI  - Sites of inhibition of steroidogenesis by activation of protein kinase-C in swine
      ovarian (granulosa) cells.
AB  - We tested the hypothesis that low density lipoprotein (LDL) metabolism and
      cellular concentrations of gene transcripts of cytochrome P450 cholesterol side
      chain cleavage enzyme (P450scc mRNA) are sites of significant protein kinase-C
      (PKC) action in the long term (48-h) inhibitory modulation of steroid hormone
      biosynthesis in ovarian granulosa cells. To this end, we used 12-O
      tetradecanoylphorbol-13-acetate (TPA) as an activator of PKC and a monolayer
      culture system of immature swine granulosa cells responsive to insulin and
      lipoprotein under serum-free conditions. Insulin-regulated LDL metabolism was
      identified as a major site of TPA-mediated inhibition of steroidogenesis in
      granulosa cells. Treatment with TPA (30 ng/ml), but not inactive phorbol base,
      effectively decreased insulin-stimulated [125I]iodo-LDL binding by 75%,
      internalization by 90%, and degradation by 75%, as well as delivery and
      utilization of the [3H]cholesterol moiety of LDL in progesterone biosynthesis by
      intact granulosa cells. Cellular concentrations of P450scc mRNA, as measured by
      Northern blot hybridization with a 32P-labeled 1-kilobase porcine cDNA clone,
      were significantly increased by insulin. This insulin effect was virtually
      abolished by cotreatment with TPA (30 ng/ml). In contrast, accumulation of mRNA
      transcripts of a non-steroidogenic gene, 3-phosphoglyceraldehyde dehydrogenase,
      but not 18S ribosomal RNA, was enhanced by TPA. In summary, major inhibitory
      actions of PKC activation on granulosa cell steroidogenesis are expressed at
      specific loci of LDL metabolism, including LDL receptor number, internalization,
      and degradation, as well as the delivery and utilization of the [3H]cholesterol
      moiety of LDL to intact granulosa cells. Moreover, a PKC activator suppresses the
      intracellular accumulation of insulin-stimulated P450scc mRNA, but not that of
      phosphoglyceraldehyde dehydrogenase or 18S ribosomal RNA. The results obtained in
      this in vitro study suggest that the inhibition by TPA at these different sites
      along the steroidogenic pathway may be similar to that which occurs via hormones
      that work through the PKC system, such as prostaglandin F2 alpha.

PMID- 8477650
TI  - Effect of luteinizing hormone-releasing hormone analogs containing cytotoxic
      radicals on the function of rat pituitary cells: tests in a long term superfusion
      system.
AB  - A novel class of targeted chemotherapeutic agents based on cytotoxic compounds
      linked to LHRH analogs was tested in a long term superfusion system in order to
      determine their effects on different types of rat pituitary cells. The compounds
      investigated included two cytotoxic LHRH agonists, T-98 ([D-Lys6]LHRH coupled to
      glutaryl-2-(hydroxymethyl)anthraquinone (G-HMAQ)) and T-107 ([D-Lys6]LHRH linked
      to doxorubicin (DOX) through glutaric acid spacer), and two cytotoxic LHRH
      antagonists T-121 and T-144, both containing two residues of G-HMAQ. The analogs
      were infused for 24 h at pharmacological (micromolar) concentrations. The
      secretions of LH, GH, and PRL cells after a short (2-h) and a long (20-h)
      recovery period following the treatment were compared to those before the analog
      infusion. All four cytotoxic LHRH analogs selectively decreased the stimulated LH
      response, while basal secretions of LH, GH, and PRL as well as the stimulated
      release of GH and PRL were not influenced in spite of the high doses applied and
      the long duration of exposure. The inhibitory effects of cytotoxic agonists and
      antagonists were significantly greater than those of their parent peptides.
      Equimolar concentrations of cytotoxic compounds alone (DOX or G-HMAQ), however,
      caused functional damage to all types of cells tested. To evaluate the mechanisms
      of the observed inhibitory actions, we compared the amount of LH released in
      response to 1) a specific stimulus to receptors (3 nM LHRH), 2) membrane
      depolarization with 100 MM KCl, not involving the receptor, and 3) the extraction
      of cells with 0.01 N HCl at the end of experiment. Cytotoxic LHRH agonists and
      their carriers caused depletion of LH pools, while cytotoxic LHRH antagonists or
      their parent peptides decreased the available binding sites for LHRH. The
      inhibitory effect of DOX on stimulated secretion of LH, GH, and PRL in our system
      could be due to an action on cell membranes. Our work indicates that in the
      pituitary cell superfusion system, targeted cytotoxic conjugates, based on LHRH
      analogs, selectively affect LH cells, in contrast to unconjugated cytotoxic
      compounds, which also damage GH and PRL cells.

PMID- 8477651
TI  - Glucocorticoid-induced increase in plasma corticosteroid-binding globulin levels
      in fetal sheep is associated with increased biosynthesis and alterations in
      glycosylation.
AB  - In fetal sheep, there is a concomitant prepartum rise in cortisol and
      corticosteroid-binding globulin (CBG) that maintains a low free plasma cortisol
      level and allows for a low negative feedback effect of cortisol on the secretion
      of ACTH from the fetal pituitary. However, the stimulus for the prepartum
      increase in CBG and the mechanism(s) of this effect are not known. It has been
      proposed that glucocorticoids increase CBG concentrations, and therefore, we
      infused fetal sheep with the synthetic glucocorticoid dexamethasone (DEX; 2
      micrograms/min over 15 min every 2 h for 96 h, n = 5) or saline (n = 5). The
      plasma corticosteroid-binding capacity increased from 30.0 +/- 2.4 to 55.6 +/-
      7.7 and 92.6 +/- 11.1 ng/ml at 48 and 96 h, respectively, of DEX infusion. To
      examine possible mechanisms of increasing fetal plasma CBG, we first cloned and
      sequenced a sheep CBG cDNA and purified the protein. This allowed us to deduce
      the primary structure of ovine CBG and to demonstrate that hepatic CBG mRNA
      abundance (single transcript of 1.8 kilobases) rose from 0.9 +/- 0.2 to 3.6 +/-
      1.6 arbitrary units after 96 h of DEX treatment. Fetal DEX treatment produced a
      significant increase (7.1 +/- 1.2% to 13.1 +/- 1.4%) in the Concanavalin-A
      binding forms of CBG that predominate in adult sheep plasma. There was negligible
      transfer of purified [125I]CBG from the ewe to fetal plasma, urine, or amniotic
      fluid. We also injected adult sheep with DEX (10 mg/day for 4 days) and
      demonstrated a significant decrease in plasma corticosteroid-binding capacity by
      24 h, which remained suppressed for the duration of the study. After 96 h of DEX
      treatment, there was also a significant decrease in adult hepatic CBG mRNA
      abundance. We conclude that glucocorticoids increase fetal plasma CBG in part by
      increased hepatic biosynthesis. It may also be accentuated by a change in the
      glycosylation of CBG, but cannot be attributed to transplacental transfer.
      Furthermore, glucocorticoid treatment exerts opposite effects on CBG biosynthesis
      in fetal and adult sheep.

PMID- 8477652
TI  - Human chorionic gonadotropin or human recombinant follicle-stimulating hormone
      (FSH)-induced ovulation and subsequent fertilization and early embryo development
      in hypophysectomized FSH-primed mice.
AB  - Adult hypophysectomized FSH-primed mice were used to study ovulation,
      fertilization, and preimplantation embryo development. Twelve days after
      hypophysectomy, animals were injected sc with oFSH (4 micrograms/day) twice a day
      for 3 days. This resulted in large preovulatory follicles that did not secrete
      estrogen. Concurrent with the last FSH injection, either hCG (5 IU) or human
      recombinant FSH (10 IU) was injected sc to induce ovulation. Animals were mated
      or not and killed 1-4 days later. The ovulation rate was similar for both the hCG
      induced group (FH) and the FSH-induced group (FF), 97% and 90%, respectively.
      About 45% of the FH mice mated successfully with 56% of the eggs fertilized
      compared to only 25% of the FF mice with 45% of the eggs fertilized. However,
      only 5% of ovulated eggs developed to four-cell stages in vivo by day 3 for the
      FH animals and none in the FF group. To determine the reasons for the in vivo
      retarded embryo development, embryos at the one- or two-cell stage were collected
      on day 2 from the FH group. After 96 h of culture, 22% of two-cell embryos were
      converted to blastocysts, and 11% of one-cell eggs divided to the four-cell
      stage. In contrast, 80% of two-cell embryos from normal mice develop into
      blastocysts by 72 h of culture. The ovarian incubation medium and serum were used
      to measure progesterone (P4), androstenedione (A), and estradiol (E2). The
      patterns of serum and in vitro production of steroids were parallel. In FH mice,
      P4 increased immediately on the day after hCG injection (day 1) and decreased
      progressively on days 2 and 3; A and E2 levels increased on day 2, A decreased on
      day 3, and E2 decreased on day 4. When human recombinant FSH was used to induce
      ovulation, there were no significant changes in serum P4 and A; E2 levels were
      about 4 times higher on day 1 than in the FSH-primed control, then dropped to
      baseline levels on days 2 and 3. However, on day 3 in both the FH and FF groups,
      FSH receptors were still present on the granulosa cells of antral follicles, and
      LH/hCG receptors were present on the granulosa cells of large antral follicles
      and newly formed corpora lutea.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477653
TI  - Insulin-like growth factor I regulates c-myc and GAP-43 messenger ribonucleic
      acid expression in SH-SY5Y human neuroblastoma cells.
AB  - In the human neuroblastoma cell line SH-SY5Y, insulin-like growth factors I (IGF
      I) and II (IGF-II) are established mitogens, and IGF-I appears to promote SH-SY5Y
      neuronal differentiation. Studies show that c-myc gene product is a transcription
      factor associated with cell proliferation, and that c-myc messenger RNA levels
      decrease in differentiating SH-SY5Y neurons. Using Northern analysis we show that
      24 h exposure of SH-SY5Y cells to IGF-I (3-10 nM) causes a 3- to 5-fold decrease
      in c-myc expression. The decrease in c-myc expression due to IGF-I is mediated
      via the type I IGF receptor and coincides with an IGF-I-mediated induction of the
      neuronal differentiation markers growth cone associated protein 43 and tissue
      type plasminogen activator. Under these conditions, IGF-I (10 nM) did not
      markedly affect the levels of Max messenger RNA expression. Thus, the
      differentiation promoting activity of IGF-I in SH-SY5Y cells in part due to IGF-I
      dependent regulation of the expression of genes involved in neuronal
      differentiation.

PMID- 8477654
TI  - Nerve growth factor and epidermal growth factor in mouse submandibular glands:
      identical diurnal changes and rates of secretagogue-induced synthesis.
AB  - The granular convoluted tubule cells of the mouse submandibular gland contain
      high concentrations of nerve growth factor (NGF) and epidermal growth factor
      (EGF). Levels of the two growth factors increase in parallel during development
      and after stimulation by thyroid hormone, androgens, and glucocorticoids,
      suggesting that similar controls regulate the production of both proteins. At the
      same time, however, the granular convoluted tubules hypertrophy, with resulting
      increases in glandular size and protein content. In this study, we have monitored
      changes in salivary concentrations of NGF and EGF in the absence of detectable
      changes in submandibular size or protein concentration. Both growth factors
      exhibited identical diurnal changes, peaking between 1200-2000 h. In addition,
      after secretagogue-stimulated release of the proteins into saliva, reaccumulation
      began after 2 h, with normal levels of both molecules attained 6 h posttreatment.
      These data indicate that submandibular NGF and EGF can be controlled by similar
      cellular or molecular mechanisms independent of the regulation of generalized
      growth responses.

PMID- 8477655
TI  - In vivo bioassay for the potency determination of human growth hormone in dwarf
      "little" mice.
AB  - Homozygous 40- to 90-day-old "little" mice (lit/lit), derived from the C57BL/6J
      strain, have been used to set up an in vivo body weight gain bioassay for GH
      whose performance has been compared to the widely used hypophysectomized rat
      assay. A log dose-response curve has been analyzed in order to choose doses in
      the linear range that are suitable for setting up useful, precise, and economical
      2 x 2 factorial assays. A comparison between the response in the two sexes has
      also been carried out, showing no significant difference between male and female
      little mice of this age. Three assays have been carried out in these animals for
      the potency determination of a local human GH (hGH) reference preparation in
      terms of First International Standard of GH (human) for bioassay (WHO 80/505),
      comparing them to a classical assay in hypophysectomized rats performed with the
      same preparations. The calculated potency values were in good agreement, while
      the statistical parameters indicated a comparable assay precision, even in a
      practical and rapid 4-day assay. We suggest the substitution of hypophysectomized
      rats with little mice for this in vivo test, still required for potency and
      bioidentity determination of clinical preparations of recombinant hGH. This
      avoids the highly invasive, costly, and time-consuming surgery, providing a
      faster, more flexible, and economical assay method, while still directly
      measuring parameters of in vivo linear growth in an animal model closely related
      to isolated hGH deficiency type I.

PMID- 8477656
TI  - Differential effects of thyroid hormones on growth and thyrotropic hormones in
      rat fetuses near term.
AB  - We have studied the effects of thyroid hormone deficiency and excess on GH and
      TSH economy in the rat fetus near term. Pregnant rats were either left untreated
      (C group) or treated with methimazole to block thyroid function and infused with
      placebo, T4, T3, or both, until 21 days of gestation. Two experiments were
      performed: the doses (per 100 g body wt/day) of T4 ranging from 2.4-21.6
      micrograms, those of T3 from 1.5-13.5 micrograms, with groups on 2.4 micrograms
      T4 + 1.5 micrograms T3. Fetal plasma T4 levels varied between 6-160% of C values
      and T3 values between 52-770%. Both plasma and pituitary GH decreased in
      hypothyroid fetuses from methimazole dams, and their plasma TSH was elevated.
      When T4 and/or T3 were infused, plasma and pituitary GH increased as a function
      of fetal plasma T4 and T3, reaching normal values when plasma T3 levels became
      normal, then increasing further. The effects on GH economy were related to the
      plasma T3 level, with no appreciable difference if T3 had been infused or derived
      from T4. In contrast, the elevated plasma TSH of the hypothyroid fetus decreased
      toward normal values when fetal plasma levels of T4, and of T3 derived from T4,
      became normal, but was not affected by normal fetal plasma T3 when T3 was
      infused. In the absence of T4, T3 decreased plasma TSH only when infused in doses
      that increased fetal plasma T3 3-fold above C values or more. Thus, both GH and
      TSH economy are under thyroid hormone control in rat fetuses near term.
      Similarities and differences with respect to regulation in adult rats cannot,
      however, be attributed exclusively to differences in fetal somatotrophs and
      thyrotrophs, because of the possibility that control is exerted at regulatory
      sites which are unique to the fetus.

PMID- 8477658
TI  - Insulin-like growth factor-II messenger ribonucleic acid expression in fetal
      tissues of the sheep during late gestation: effects of cortisol.
AB  - Using RNase protection analysis, insulin-like growth factor-II (IGF-II) mRNA
      levels were measured in various tissues from fetal sheep during late gestation
      (term, 146 +/- 2 days) and after experimental manipulation of fetal plasma
      cortisol levels. No gestational trend in IGF-II mRNA levels was observed in the
      fetal lung, kidney, or skeletal muscle. However, in the fetal liver, there was a
      marked decline in IGF-II mRNA abundance immediately before term, which closely
      paralleled the normal prepartum surge in fetal plasma cortisol. This decrease in
      hepatic IGF-II mRNA levels toward term was prevented when the cortisol surge was
      abolished by fetal adrenalectomy and was stimulated prematurely in fetuses
      younger than 130 days by exogenous infusion of cortisol. Hepatic and renal IGF-II
      mRNA abundances were also reduced when fetal cortisol levels were raised
      endogenously by maternal fasting in late gestation. Muscle IGF-II mRNA levels
      were reduced by fetal cortisol infusion, but not by maternal fasting, and were
      higher in adrenalectomized than in intact fetuses in late gestation. No change in
      IGF-II mRNA levels were observed in the fetal lung in response to altering the
      fetal cortisol level either exogenously or endogenously. When the data from all
      fetuses were combined regardless of treatment or gestational age, there was a
      significant inverse correlation between the plasma cortisol level in utero and
      IGF-II mRNA abundance in the fetal liver (P < 0.001), but not in any of the other
      fetal tissues studied. These findings show that cortisol suppresses IGF-II gene
      expression in the liver of the sheep fetus and indicate that the developmental
      change in hepatic IGF status toward term may be due to the prepartum cortisol
      surge.

PMID- 8477657
TI  - Bioactivity of human growth hormone in serum: validation of an in vitro bioassay.
AB  - GH, in clinical practice, is determined by RIA, but RIA estimates may not
      accurately reflect serum GH bioactivity. The available measures of GH bioactivity
      lack either sensitivity, specificity, or a physiologically relevant end point.
      The objective of this research was to develop a physiologically relevant GH
      bioassay which would not only measure the bioactivity of purified GH
      preparations, but would also have sufficient sensitivity to measure GH
      bioactivity in human serum. The method consisted of incubating murine 3T3-F442A
      adipocytes in serum-free medium containing BSA, 14C-glucose, and increasing
      concentrations of GH or test materials for 24 h, followed by measurement of
      conversion of glucose to lipid. Interference by nonspecific serum factors was
      reduced by the addition of 10 micrograms/liter insulin, 25 nM dexamethasone, and
      37 nM estradiol to the medium. In the presence of 10 micrograms/liter insulin, 50
      micrograms/liter insulin-like growth factor-1 did not alter the ability of GH to
      suppress lipid accumulation. Epinephrine and glucagon could suppress lipid
      accumulation but only at concentrations greatly in excess of the physiological
      range in serum. Twenty two thousand dalton hGH produced dose-dependent
      suppression of lipid accumulation which was linear between 0.625 and 10
      micrograms/liter (r = 0.926; P = 0.0001) with a half-maximal response of 3.0 +/-
      0.2 micrograms/liter (n = six experiments). The intra- and interassay
      coefficients of variation were 7% and 19%, respectively. The assay was specific
      for GH since addition of human PRL produced suppression of lipid accumulation
      only at concentrations where contamination of the preparation by GH became a
      significant factor. ACTH also suppressed lipid accumulation but only at doses of
      1000 micrograms/liter or greater. Human placental lactogen and hLH, hFSH, and
      hTSH did not cross-react with GH in this assay. Addition of human serum did not
      alter the slope of ED50 of the GH dose-response curve. Pools of serum from
      prepubertal and pubertal boys and girls, subjects treated with arginine or
      insulin, a diabetic girl, and a boy with gigantism who had a serum GH content of
      80 micrograms/liter by RIA and 40 micrograms/liter by bioassay, produced dose
      response curves parallel to that of the GH standard curve. Serum from patients
      with hypopituitarism did not produce significant suppression of lipid
      accumulation in any assay. Recovery of 5 micrograms/liter GH added to human serum
      was 94%. Twenty thousand dalton GH also suppressed lipid accumulation in this
      assay, but was 2-fold less potent than 22,000 dalton GH.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8477659
TI  - Development of a specific and sensitive two-site enzyme-linked immunosorbent
      assay for measurement of inhibin-A in serum.
AB  - A polyclonal chicken antiserum against purified 32-kilodalton (kDa) recombinant
      inhibin-A (rh-InhA) and two monoclonal antibodies (mAb) against either rh-InhA
      (11B5) or 28-kDa recombinant activin-A (rh-ActA; 9A9) were used to develop three
      sensitive InhA enzyme-linked immunosorbent assays (ELISAs). The sensitivity of an
      ELISA using affinity-purified chicken anti-rh-InhA (Ck) for both coat and capture
      (Ck/Ck) averaged 78 +/- 3 pg/ml, while the mAb/Ck ELISAs (11B5/Ck or 9A9/Ck)
      averaged 100 +/- 6 pg/ml in a 10% serum matrix, with intra-and interassay
      coefficients of variation of 2-5% and 8-10%, respectively, for all assays. The
      ELISA formats did not cross-react with purified rh-ActA or recombinant human
      transforming growth factor-beta 1 or detect any immunoreactive proteins in medium
      conditioned by cell lines expressing rh-ActA or recombinant human transforming
      growth factor-beta 1. The Ck/Ck ELISA detected significant amounts of
      immunoreactivity in medium from cells expressing the free alpha-subunit of
      inhibin and recombinant inhibin-B (rh-InhB). In contrast, the mAb/Ck ELISAs
      showed no cross-reactivity to medium conditioned by these two cell lines. All
      three ELISA formats detected rh-InhA added to either human or rat serum in vitro
      or serum from rats injected with rhInhA. The Ck/Ck and 9A9/Ck ELISAs successfully
      quantitated inhibin in sera from patients undergoing ovulation induction and in
      rats (with or without sc administration of pregnant female serum gonadotropin).
      The 11B5/Ck ELISA appeared to be specific for the 32-kDa form of inhibin, while
      the 9A9/Ck ELISA was useful in quantitating inhibin-A in biological fluids, with
      little cross-reactivity to free alpha-chain or inhibin-B.

PMID- 8477660
TI  - Two molecular forms of gonadotropin-releasing hormone from the brain of the frog,
      Rana ribibunda: purification, characterization, and distribution.
AB  - The molecular forms of GnRH in amphibia have not been characterized structurally.
      An antiserum to mammalian GnRH that shows appreciable cross-reactivity with
      chicken GnRH-I ([Gln8]GnRH), chicken GnRH-II ([His5,Trp7,Tyr8]GnRH), and salmon
      GnRH ([Trp7, Leu8]GnRH) was used in a RIA to detect GnRH-related peptides in an
      extract of the brain of the European green frog, Rana ridibunda. Two peptides
      were purified to apparent homogeneity, and determination of their primary
      structures showed that they are identical to mammalian GnRH and chicken GnRH-II.
      Salmon GnRH and lamprey GnRH-I ([Tyr3,Leu5,Glu6,Trp7,Lys8]GnRH) were not
      identified in this species of frog. Immunocytochemical analysis using specific
      antisera has identified regions of the frog diencephalon and telencephalon in
      which chicken GnRH-II and mammalian GnRH are localized to different populations
      of neurons. This differential distribution suggests distinct physiological roles
      for the two forms of GnRH in amphibia.

PMID- 8477661
TI  - The type I iodothyronine 5'-deiodinase messenger ribonucleic acid is localized to
      the S3 segment of the rat kidney proximal tubule.
AB  - A complementary DNA clone encoding the type I iodothyronine 5'-deiodinase (5'DI),
      which converts T4 to T3, has been isolated recently. The 5'DI messenger RNA
      (mRNA) is most abundant in kidney and liver. To gain insight into the function of
      5'DI in the kidney, Northern blot analysis was used to localize the expression of
      this mRNA. Our results show that 5'DI mRNA was expressed in the cortex and outer
      medulla, but not inner medulla and papilla, indicating that there are regional
      differences in its expression. Using in situ hybridization, we demonstrate that
      the 5'DI hybridization signal is localized predominantly over tubules in the
      outer stripe of the outer medulla and in medullary rays, suggesting localization
      to proximal tubules. To identify which tubular cells express 5'DI mRNA, we
      compared the profile of 5'DI message from in situ hybridization with the
      immunostaining of adjacent sections with proximal tubular S1, S2, and S3 segment
      specific antibodies. Most of the 5'DI antisense complementary RNA hybridized to
      the same proximal tubular cells with which the S3-specific antibody, anti-ecto
      ATPase, reacted. Cells staining with an S1 or S2 segment antibody showed little,
      if any, 5'DI mRNA. We conclude that the expression of 5'DI mRNA is restricted to
      the tubular cells of the proximal S3 segment. The S3 segment is also known to
      express high levels of proteins required for glutathione synthesis consistent
      with the requirement for a reduced thiol cofactor for iodothyronine deiodination
      by the 5'DI pathway.

PMID- 8477662
TI  - Spontaneous cytosolic calcium pulses in Xenopus melanotrophs are due to calcium
      influx during phasic increases in the calcium permeability of the cell membrane.
AB  - We recently discovered that melanotrophs of Xenopus laevis exhibit spontaneous
      pulse-like rises in cytosolic free calcium ([Ca2+]i) and that this cytosolic Ca
      pulsing is inhibited by the secreto-inhibitory transmitters dopamine, gamma
      aminobutyric acid, and neuropeptide-Y and stimulated by the secretagogues CRF and
      TRH. Here we provide evidence for the factors responsible for the individual
      cytosolic Ca pulse and the repetitive behavior. Isolated melanotrophs of Xenopus
      were loaded with fura-2, and fluorescence was recorded from perifused single
      cells to measure [Ca2+]i and assess the patency of divalent cation channels by Mn
      quenching of fluorescence. Cytosolic Ca pulsing was arrested by omission of Ca
      and by the Ca channel blockers Ni and Co, but was unaffected by tetrodotoxin. Mn
      (0.3 mM) caused phasic quenching, each "quench" being synchronous with the rising
      phase of a cytosolic Ca pulse. Quenching was blocked by Ni, but was unaffected by
      tetrodotoxin. When introduced during the course of an individual Ca pulse, Ni
      aborted the pulse and [Ca2+]i collapsed. Extracellular K+ (10 mM) or K channel
      block with tetraethylammonium stimulated Ca pulsing. Threshold concentrations of
      Ni slowed Ca pulsing without reducing the amplitude of the individual pulses. The
      overshoots in quenching and Ca pulsing observed after exposure to Ni, dopamine,
      or baclofen are interpreted as off responses. It is concluded that each cytosolic
      Ca pulse is attributable, probably quantitatively, to Ca influx during a
      spontaneous increase in Ca permeability independent of Na-mediated action
      potentials, and that the pacemaker for the repetitive phenomenon is voltage
      sensitive and may involve Ca currents active around basal membrane potential.

PMID- 8477663
TI  - In vitro evidence for atrial natriuretic factor-(5-28) production by macrophages
      of adult rat thymi.
AB  - Although recent evidence suggests the presence of the 15-kilodalton (K) mol wt
      (Mr) precursor of atrial natriuretic factor (ANF) and pro-ANF mRNA in the thymus
      of human and rat neonates, the cellular origin of the peptides in the tissues
      remains to be elucidated. We report here that in adult male rats, the 15K M(r)
      presumptive precursor for ANF and a smaller 3K M(r), N-terminal truncated
      congener of the peptide, ANF-(5-28), are localized in a small population of
      thymic macrophages. The production of ANF in the thymus was further confirmed by
      demonstrating the presence of a single band of pro-ANF mRNA signal of
      approximately 0.8 kilobases from the tissue extract, corresponding to that in the
      heart. To examine the distribution of pro-ANF mRNA at a cellular level,
      colorimetric in situ hybridization with digoxigenin-labeled 30-mer
      oligonucleotides complementary to the first 10-amino acid sequence of ANF-(1-28)
      was employed. Positive staining was found in thymic cells localized mainly in
      subcapsular areas, with diffuse staining of positive cells in both the cortex and
      medulla mainly concentrated around the cortico-medullary junction of the tissue.
      The identity of the ANF-positive cells was further investigated using a double
      staining technique to costain immunoreactive (ir) ANF and the macrophage markers
      ED1 and S22 or the T-cell marker OX-19 in both thymic sections and in monolayer
      cultures of thymic cells. In the latter, approximately 17% of the adherent cells
      stained positive for irANF after 48 h in culture. Of these cells, more than 95%
      also stained positive for the macrophage marker ED1, whereas approximately 36% of
      the ED1-positive cells were colocalized with irANF. In contrast, no irANF
      positive cells were colocalised with the pan-T-cell marker OX-19. In tissue
      sections, irANF was found in cells distributed predominantly around the cortico
      medullary junctions and subcapsular areas, with diffuse staining of the cells in
      the medullary and cortical regions. Sephadex G-50 gel chromatographic profiles of
      thymic extracts revealed a major peak of immunoreactivity consistent with 15K
      M(r) and a smaller peak that coeluted with rat ANF-(1-28) of 3K M(r). HPLC
      analysis of the 3K M(r) species showed a single peak of immunoreactivity, which
      eluted with a retention time identical to that of synthetic rat ANF-(5
      28).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477664
TI  - Characterization of a morphine-modulating peptide, FLFQPQRFamide, in the rat
      hypophysis: biochemical and immunocytochemical studies.
AB  - The octapeptide FLFQPQRFamide (F8Fa) is a FMRFamide-like peptide with a certain
      number of antiopiate properties. Previous studies have shown that both F8Fa
      specific receptors and F8Fa-like material are present in the rat central nervous
      system. In this study, RIA revealed that the rat neurohypophysis also contains
      F8Fa immunoreactive (IR) material (230 +/- 49 pg/neural lobe). HPLC profiles
      revealed several forms of F8Fa IR. Neurohypophysis extracts can also inhibit the
      binding of F8Fa to rat spinal cord preparations, which suggests that this F8Fa
      like material has a biological activity. Immunocytochemical observations, at the
      light and electron microscopic levels, confirmed the presence throughout the
      neural lobe of F8Fa IR, in axonal fibers and terminals similar to those
      containing the more classical neurohypophysial hormones. Immunogold staining
      showed that F8Fa IR was restricted to neurosecretory granules in certain axonal
      and terminal profiles. Double staining of the same ultrathin sections, using our
      anti-F8Fa antiserum and vasopressin or its neurophysin specific antibodies,
      revealed that F8Fa IR was colocalized with vasopressin. F8Fa IR was not visible
      in ocytocinergic fibers or terminals. A striking depletion of F8Fa IR (80%) was
      observed in rats which were given 2% saline to drink for 6 days. Similarly, an ip
      injection of an hypertonic saline solution was shortly followed by a 20% drop of
      F8Fa IR. In vitro F8Fa IR release from isolated neurohypophysis was evoked under
      a 56 mM KCl depolarization. These results suggest that F8Fa IR may act as a
      paracrine/endocrine mediator released from the rat neurohypophysis.

PMID- 8477665
TI  - Glucoregulatory hormones in the immobilization stress-induced increase of plasma
      glucose in fasted and fed rats.
AB  - We investigated 1) the effect of immobilization stress on glucose metabolism in
      rats after sham operation (SHAM), adrenomedullectomy (ADMX), and adrenalectomy
      (ADX); and 2) the effect of glucoregulatory hormone infusion on plasma glucose
      using untreated normal fasted and fed rats under unanesthetized conditions. In
      immobilization stress, the plasma glucose concentration increased only in the
      SHAM group during fasting, while under fed conditions, all three groups showed
      significant increases (SHAM > ADMX > ADX). Plasma glucagon and norepinephrine
      significantly increased in all groups; plasma epinephrine increased only in the
      SHAM group, and plasma corticosterone increased in SHAM and ADMX groups under
      both conditions. The hepatic glycogen content in all fed groups significantly
      decreased after immobilization stress, while a very low content before stress and
      an undetectable level after stress were observed in all fasted groups. Only
      epinephrine infusion increased plasma glucose during fasting, while epinephrine
      and glucagon infusion increased it under fed conditions. Corticosterone infusion
      did not change it under either condition. These results suggest that in the
      fasted condition, only epinephrine plays an essential role, while under fed
      conditions, glucagon and corticosterone as well as epinephrine also act as
      synergistic factors in stress-induced hyperglycemia.

PMID- 8477666
TI  - Increased follistatin (activin-binding protein) gene expression in rat anterior
      pituitary tissue after ovariectomy may be mediated by pituitary activin.
AB  - For lack of evidence to the contrary, it is now believed that the FSH-suppressing
      actions of follistatin are due to its ability to bind endogenous pituitary
      activin. Recent data have demonstrated a role for pituitary activin-B in
      mediating FSH hypersecretion after ovariectomy (OVX) and during the secondary FSH
      surge on estrus. Therefore, given that follistatin is produced within anterior
      pituitary tissue, and considering the potentially important function of
      follistatin to modulate activin bioactivity, we sought to gain insights into the
      regulation of follistatin gene expression in the anterior pituitary gland of
      adult female rats. At the termination of all in vivo investigations, rats were
      killed, trunk blood was collected for determination of serum LH and FSH levels by
      RIA, and pituitary tissue was collected, pooled (two or three glands per pool),
      and processed for determination of follistatin messenger RNA (mRNA) levels by a
      solution-hybridization RNase protection assay. In the first experiment, pituitary
      follistatin mRNA levels were significantly (P < 0.01) increased 3 weeks after
      OVX. Treatment of long-term ovariectomized rats with a Nal-Glu LHRH antagonist
      restored serum LH levels to precastration levels and suppressed serum FSH
      concentrations by 70%, but follistatin message levels were not altered. In
      contrast, treatment of castrated rats with recombinant human follistatin-288
      selectively suppressed serum FSH levels (50%) and completely abolished OVX
      induced increases in follistatin mRNA levels. Subsequent experiments revealed
      that OVX-induced increases in follistatin gene expression could be observed in
      pituitary tissue grafted underneath the kidney capsule of hypophysectomized rats.
      Furthermore, follistatin mRNA levels were significantly (P < 0.05) higher in
      pituitary glands taken from estrous rats during the secondary FSH surge (0200 h)
      than in glands obtained from rats on proestrous morning when serum FSH levels
      were basal. Because increased steady state follistatin mRNA levels in the latter
      two instances were associated with selective FSH hypersecretion, and such
      hypersecretion was previously shown to be dependent to a significant degree on
      pituitary activin, we next tested the hypothesis that increased pituitary
      follistatin gene expression is mediated by activin. Using cultures of dispersed
      pituitary cells, addition of recombinant human activin-A for 72 h increased
      follistatin mRNA levels 3-fold while enhancing only FSH secretion. Collectively,
      the present results demonstrate a coupling of follistatin gene expression in the
      anterior pituitary gland with changes in pituitary FSH secretion under conditions
      where LH secretion is unaltered. Viewed in the context of previous work, the data
      also suggest that changes in follistatin mRNA levels may be linked to activin
      signaling.

PMID- 8477667
TI  - Identification of a Leydig tumor cell protein that is phosphorylated in response
      to stimulation with choriogonadotropin or epidermal growth factor.
AB  - Although hCG and mouse epidermal growth factor (mEGF) activate different
      signaling systems in a clonal strain of murine Leydig tumor cells (designated MA
      10), both compounds ultimately elicit several common effects, such as increased
      steroidogenesis, decreased transcription of the LH/CG receptor gene, and
      attenuation of adenylyl cyclase. Based on this information, it was hypothesized
      that hCG and mEGF may induce phosphorylation of a common protein or set of
      proteins. Studies were performed to identify such a protein if it exists. MA-10
      cells were metabolically labeled with [32P]orthophosphate, and phosphorylation
      patterns were examined and quantitated using two-dimensional gel electrophoresis.
      A 21-kilodalton protein whose phosphorylation state increased after hCG and mEGF
      stimulation was identified. Three isoforms of this protein were visible after hCG
      stimulation, with approximate pI values of 5.9, 6.0, and 6.1, while only two
      isoforms were visible after mEGF stimulation, with approximate pI values of 6.0
      and 6.1. This protein is phosphorylated on serine residues in response to either
      hCG or mEGF. Since this protein may play a role in eliciting the common actions
      of hCG and mEGF, its time course of phosphorylation and concentration
      responsiveness to hCG and mEGF were also characterized.

PMID- 8477668
TI  - Levels of messenger ribonucleic acid for cytochrome P450 17 alpha-hydroxylase and
      P450 aromatase in preovulatory bovine follicles decrease after the luteinizing
      hormone surge.
AB  - During the transition from the follicular to the luteal phase, follicular steroid
      secretion shifts from predominantly 17 beta-estradiol and androgen production
      before the LH surge to decreased androgen and estrogen and increased progesterone
      production after the LH surge. Our objective was to determine if changes in 17
      beta-estradiol and androgen production by the preovulatory follicle are effected
      via changes in mRNA levels for the steroidogenic enzymes cytochrome P450 17 alpha
      hydroxylase/C17, C20-lyase (P450-17 alpha) and cytochrome P450 aromatase
      (P450arom). Heifers were injected with prostaglandin F2 alpha (PGF2 alpha) during
      the luteal phase to initiate luteolysis and a follicular phase. Preovulatory
      follicles were obtained at two times before the LH surge, in the early follicular
      phase (24 h after PGF2 alpha injection) and in the midfollicular phase (48 h
      after PGF2 alpha), and at one time in the late follicular phase, after the LH
      surge but before ovulation (20 h after the onset of estrus, about 20 h after the
      LH surge). Granulosa cells and theca interna were isolated from preovulatory
      follicles obtained during the early follicular phase and cultured with or without
      ovine LH (100 ng/ml; n = 4 follicles isolated 24 h after PGF2 alpha). Total RNA
      extracted from granulosa cells and theca interna, either immediately after cell
      isolation during the early (n = 5), mid (n = 4)-, or late follicular phase (n =
      5) or after 24 or 72 h of culture, was subjected to Northern analysis for P450-17
      alpha and P450arom mRNA. Autoradiographs were scanned densitometrically, and
      values were adjusted for loading and transfer efficiency. P450-17 alpha mRNA was
      highly abundant in theca interna before the LH surge, but decreased by 96% after
      the LH surge (P < 0.001). In contrast, P450-17 alpha mRNA in the granulosa cell
      fraction was very low at all three times of follicle isolation and most likely
      was due to a slight contamination of the granulosa cell preparation with theca
      interna. P450arom mRNA was abundant in granulosa cells isolated in the early and
      midfollicular phase, but decreased by 94% after the LH surge (P < 0.001). In
      contrast, P450arom mRNA was undetectable in theca interna. Levels of
      androstenedione and 17 beta-estradiol in follicular fluid were high during the
      early and midfollicular phase and decreased dramatically after the LH surge (P <
      0.05 and P < 0.001, respectively). P450-17 alpha and P450arom mRNA were
      undetectable after 24 h of culture in the presence or absence of LH and
      thereafter.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477669
TI  - Tumor necrosis factor mediates the effects of endotoxin on cholesterol and
      triglyceride metabolism in mice.
AB  - The host response to infection is frequently accompanied by changes in
      cholesterol and triglyceride (TG) metabolism. To determine the role of cytokines
      in mediating these changes, we studied the effects of endotoxin (LPS), tumor
      necrosis factor-alpha (TNF) and interleukin-1 beta (IL-1) on cholesterol and TG
      metabolism in C57Bl/6 (LPS-sensitive) mice and in C3H/HeJ (LPS-resistant) mice
      whose macrophages do not produce TNF and IL-1 in response to LPS. Sixteen hours
      after administration, LPS (1 micrograms/mouse) produced a 41% increase in serum
      cholesterol and a 62% increase in serum TG levels in C57Bl/6 mice whereas a 100
      fold higher dose of LPS did not have a significant effect in C3H/HeJ mice. LPS (1
      microgram/mouse) also produced a 8.6-fold increase in hepatic cholesterol
      synthesis and a 2.7-fold increase in hepatic fatty acid synthesis in C57Bl/6 mice
      but had no effect in C3H/HeJ mice. This suggests that macrophage produced
      cytokines such as TNF and IL-1 may be involved in mediating these effects of LPS.
      Additionally, LPS also increased the activity of hydroxy-3-methylglutaryl
      coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol
      synthesis. As seen with LPS, TNF and IL-1 also increased serum cholesterol and TG
      levels in C57Bl/6 mice. Moreover, TNF and IL-1 produced a 2.3- and 2.1-fold
      increase in hepatic HMG-CoA reductase activity, respectively. Finally,
      pretreatment of mice with anti-TNF antibodies, but not with an IL-1 receptor
      antagonist, blocked the effect of LPS on serum cholesterol and TG levels, hepatic
      cholesterol and fatty acid synthesis, and hepatic HMG-CoA reductase activity.
      These results suggest that whereas both TNF and IL-1 mimic the effects of LPS on
      cholesterol and TG metabolism, TNF may be the in vivo mediator of these late
      effects of LPS in mice.

PMID- 8477670
TI  - Purification and characterization of a 3,5,3'-L-triiodothyronine-specific binding
      protein from bullfrog tadpole plasma: a homolog of mammalian transthyretin.
AB  - We analyzed the nature of the thyroid hormone-binding proteins in bullfrog plasma
      using N-bromoacetyl-[125I]T3 as an affinity labeling probe. Polyacrylamide gel
      electrophoresis under nondenaturing conditions of the bullfrog N-bromoacetyl
      [125I]T3-labeled plasma proteins revealed two proteins with specific binding to
      T3. A labeled protein that migrated faster than albumin (T-T3BP) was detected
      only in plasma obtained from tadpoles at stages earlier than, but not at the end
      of, metamorphic climax. Another protein that migrated more slowly than albumin
      appeared in the plasma at the late climax stage and was present in the adult
      stage. To study the function of T-T3BP during metamorphosis, it was purified from
      tadpole plasma to the single protein. The molecular mass of this protein was
      estimated to be 56 kilodaltons by gel filtration, but only 16 kilodaltons by
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis, which indicates that
      the molecule comprised four identical subunits. The amino acid composition of T
      T3BP and the amino acid sequence of its N-terminal portion were highly homologous
      with those of mammalian transthyretins. These molecular features indicate that T
      T3BP is a homolog of mammalian transthyretins. However, in contrast to mammalian
      transthyretins, the affinity of bullfrog transthyretin for T3 was 360 times
      higher than that for T4. Scatchard analysis revealed that T-T3BP possessed a
      single class of T3-binding site, with a Kd of 0.67 nM at 0 C. These results
      suggest that bullfrog transthyretin may play an important role in transporting T3
      in the blood during metamorphosis.

PMID- 8477671
TI  - Novel expression of human chorionic gonadotropin/luteinizing hormone receptor
      gene in brain.
AB  - LH from anterior pituitary and hCG from placenta bind to a common receptor in
      gonadal and nongonadal reproductive tissues. There have been numerous examples
      suggesting that the brain may also contain hCG/LH receptors, yet there has been
      no evidence for their existence so far. We now demonstrate by reverse
      transcription-nested polymerase chain reaction and northern blotting that the rat
      brain contains hCG/LH receptor mRNA. A major receptor transcript of 2.6 kilobases
      and minor transcripts of 1.8 and 4.4 kilobases were found. Western
      immunoblotting, ligand blotting, and covalent receptor cross-linking studies have
      shown that rat brain also contains an 80-kilodalton receptor protein that can
      bind hCG and hLH, but not hFSH. Rat testis used as a positive control showed a
      higher abundance of multiple transcripts and an 80-kilodalton receptor protein
      that can bind [125I]hCG. Rat liver used as a negative control did not contain any
      receptor transcripts or protein. In situ hybridization, dot blotting,
      immunocytochemistry, and topical autoradiography have revealed that hCG/LH
      receptors are present in rat hippocampus; dentate gyrus; hypothalamus;
      cerebellum; choroid plexus; ependymal cells of third, fourth, and lateral
      ventricles; cortex; brainstem; bovine hypothalamus; and human area postrema.
      These novel findings could potentially explain numerous previous observations and
      suggest new possibilities concerning the regulation of brain functions by hCG and
      LH.

PMID- 8477672
TI  - Effects of prolonged cycle ergometer exercise on maximal muscle power and oxygen
      uptake in humans.
AB  - The mechanical power (Wtot, W.kg-1) developed during ten revolutions of all-out
      periods of cycle ergometer exercise (4-9 s) was measured every 5-6 min in six
      subjects from rest or from a baseline of constant aerobic exercise [50%-80% of
      maximal oxygen uptake (VO2max)] of 20-40 min duration. The oxygen uptake [VO2
      (W.kg-1, 1 ml O2 = 20.9 J)] and venous blood lactate concentration ([la]b, mM)
      were also measured every 15 s and 2 min, respectively. During the first all-out
      period, Wtot decreased linearly with the intensity of the priming exercise (Wtot
      = 11.9-0.25.VO2). After the first all-out period (t greater than 5-6 min), and if
      the exercise intensity was less than 60% VO2max, Wtot, VO2 and [la]b remained
      constant until the end of the exercise. For exercise intensities greater than 60%
      VO2max, VO2 and [la]b showed continuous upward drifts and Wtot continued
      decreasing. Under these conditions, the rate of decrease of Wtot was linearly
      related to the rate of increase of VO2 [(dWtot/dt) (W.kg-1 x s-1) = 5.0 x 10(-5) 
      0.20.(VO2/dt) (W.kg-1 x s-1)] and this was linearly related to the rate of
      increase of [la]b [(dVO2/dt) (W.kg-1 x s-1) = 2.3 x 10(-4) + 5.9 x 10(
      5).(d[la]b/dt) (mM.s-1)].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477673
TI  - Contribution of differentiated ratings of perceived exertion to overall exertion
      in women while swimming.
AB  - The purpose of this study was to identify, using multiple regression analysis,
      the contribution of differentiated ratings of perceived exertion to overall
      exertion (RPEO) in women while swimming. Ten female subjects swam at submaximal
      and maximal intensities and the variables measured included oxygen uptake (VO2),
      heart rate (fc), ventilation (VE), breathing frequency, tidal volume, blood
      lactate concentration ([la-]b), RPEO, and four differentiated RPE. These four
      differentiated RPE were cardiac frequency rating (RPEC), respiratory frequency
      rating (RPER), arm rating (RPE(arm)), and leg rating (RPE(leg)). These variables
      used the following equation based on VO2 - R = a + c.(S-b)n, where R was the
      response to increasing exercise intensity (S) and a, b, and c were constants. The
      exponents (n) of fc, VE and [la-]b were approximately 1.0, 2.0 and 3.3,
      respectively. The estimated exponents of RPEO, RPEC, RPER, RPE(arm) and RPE(leg)
      were approximately 2.4, 2.3, 2.2, 2.5 and 2.5, respectively. There was a highly
      significant relationship between the four differentiated RPE and their associated
      physiological responses. The results of this study showed that these
      interrelationships were clearly delineated. As the percentage maximal oxygen
      uptake (% VO2max) increased, the major contributing factor to RPEO changed. The
      RPEC was found to be the main contributing factor from 20% to 45% VO2max, but
      ceased to contribute beyond 50% VO2max. Above 45% VO2max, RPE(arm) was the major
      influence, and RPER was the secondary influence from 66% to 96% VO2max. The
      RPE(leg) was the secondary contributing factor only from 27% to 35% VO2max. It
      was concluded that differentiated RPE contribution was dependent upon the
      intensity of exercise in women while swimming.

PMID- 8477674
TI  - Autonomic nervous control of heart rate during blood-flow restricted exercise in
      man.
AB  - Power spectra of instantaneous heart rate (fc) allows the estimation of the
      contribution of sympathetic and parasympathetic control of fc during steady-state
      conditions. The present study was designed to examine autonomic control of fc as
      influenced by normal dynamic leg exercise and by ischemic leg exercise. Eight
      subjects performed supine cycle ergometry at 30% of their control peak work rate,
      with and without blood-flow restriction. Blood-flow restriction was induced by
      exposing the exercising legs to a supra-atmospheric pressure of 6.7 kPa (leg
      positive pressure; LPP). The exercise responses of arterial pressure and fc
      increased (P < 0.05) by LPP exposure. The exaggerated pressor response may be
      attributed to a chemoreflex drive originating in the ischemic muscles. Exposure
      to LPP during exercise also produced a significant decrease in
      parasympathetically mediated high frequency (HF; 0.15-1.00 Hz) fluctuation of fc,
      as indicated by a decrease (P < 0.05) in percent HF power compared to the control
      exercise level. During LPP exercise, the sympathetically mediated very low
      frequency (VLF; 0-0.05 Hz) fluctuation of fc increased, as indicated by an
      increase (P < 0.05) in percent VLF power above control exercise levels. Both LPP
      and control exercise conditions decreased (P < 0.05) power in all frequency
      ranges of interest compared to their respective resting conditions. The results
      suggest that the increase in fc associated with normal dynamic exercise was
      mediated predominantly by parasympathetic withdrawal, whereas the exaggerated fc
      response during ischemic exercise resulted from a combination of cardiac
      sympathetic drive and parasympathetic withdrawal.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8477675
TI  - Body position affects the power spectrum of heart rate variability during dynamic
      exercise.
AB  - The power spectrum analysis of R-R interval variability (RRV) has been estimated
      by means of an autoregressive method in six men in supine (S) and sitting (C)
      postures at rest and during steady-state cycle exercise at about 14%, 28%, 45%,
      67% of the maximal oxygen consumption (% VO2max). The total power of RRV
      decreased exponentially as a function of exercise intensity in a similar way in
      both postures. Three components were recognized in the power spectra: firstly, a
      high frequency peak (HF), an expression of respiratory arrhythmia, the central
      frequency (fcentral) of which increased in both S and C from a resting value of
      about 0.26 Hz to 0.42 Hz at 67% VO2max; secondly, a low frequency peak (LF)
      related to arterial pressure control, the fcentral of which remained constant at
      0.1 Hz in C, whereas in S above 28% VO2max decreased to 0.07 Hz; and thirdly, a
      very low frequency component (VLF; less than 0.05 Hz, no fcentral). The power of
      the three components (as a percentage of the total power) depended on the body
      posture and the metabolic demand. HF% at rest was 30.3 (SEM 6.6) % in S and 5.0
      (SEM 0.8) % in C. During exercise HF% decreased by about 30% in S and increased
      to 19.7 (SEM 5.5) % at 28% VO2max in C. LF% was lower in S than in C at rest
      [31.6 (SEM 5.7) % vs 44.9 (SEM 6.4) %; P < 0.05], remaining constant up to 28%
      VO2max.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477676
TI  - Differences in activation patterns in elbow flexor muscles during isometric,
      concentric and eccentric contractions.
AB  - To investigate the relative activation of the synergistic muscles during three
      different types of muscle contraction, the electromyograms (EMG) of two elbow
      flexor muscles, the biceps brachii (BB) and the brachioradialis (BR), have been
      compared. To accomplish this eight healthy human subjects performed the following
      elbow flexions against the same load--concentric, eccentric and isometric
      contractions. The isometric contractions were performed at three elbow angles:
      10, 45 and 90 degrees (0 degree equal to full extension). The EMG were recorded
      by bipolar surface electrodes, and the relative activation between the two
      muscles was evaluated as the quotient of mean EMG activities (BR/BB). For the
      isotonic elbow flexions, BR/BB were calculated at three angle divisions: 0-30
      degrees, 30-60 degrees and 60-90 degrees. Results indicated that the relative
      activation of the BR during the concentric contractions was higher than that of
      the eccentric contraction, particularly at the extended elbow angles, i.e. the
      BR/BB of the concentric contractions for the elbow joint angles ranging from 0-30
      degrees and 30-60 degrees were significantly greater (P < 0.05) than those of the
      eccentric contractions. During the isometric and eccentric contractions, the
      BR/BB at the flexed joint angles tended to be greater than those at the extended
      angles. In contrast, there were no angle-dependent BR/BB variations during the
      concentric elbow flexions. Further, changing patterns in the EMG power spectra
      due to the type of contraction were different between BB and BR. These results
      indicated that the activation pattern in the two elbow flexor muscles varied with
      the muscle contraction pattern.

PMID- 8477677
TI  - The effect of ski training at altitude and racing on pituitary, adrenal and
      testicular function in men.
AB  - The effect of similar prolonged exercise on hormonal changes was studied at sea
      level and at moderate altitude. Four cross-country skiers participated in a 30-km
      race and five biathlonists in a 20-km race at sea level in Finland and during
      altitude training and racing at 1650 m in Les Saisies, France. Venous blood
      samples were taken at both altitudes before the race between 0800 and 0900 hours
      and 25-35 min after the race. Resting blood samples were also taken before and
      after the altitude training and the period of racing. Serum testosterone
      concentration was higher before the race at altitude than at sea level (19%, P <
      0.02), and 30 min after the race growth hormone (GH) concentration was higher at
      sea level than at moderate altitude (P < 0.002). There were not significant
      differences in serum luteinising hormone between the altitudes. Serum cortisol
      concentration was higher after the altitude training and the period of racing
      than before (P < 0.02) but no difference was observed in testosterone. We
      concluded, that since the profiles of the anabolic-catabolic hormone
      concentrations measured are indicators of the performance level of athletes, our
      data indicated that to follow them during altitude training could be beneficial
      in optimizing training programme for individual athletes. We also concluded, that
      the lower GH concentration after racing at moderate altitude may have been a
      consequence of decreased racing speed and/or increased physical performance.

PMID- 8477678
TI  - Repeated normoxic hyperbaric exposures induce haemodynamic and myocardial changes
      in rats.
AB  - The effect of repeated exposure to ambient pressures of 5 bar (500 kPa), in
      atmospheres comprising normal partial pressures of oxygen [0.2 bar (20 kPa)] and
      nitrogen [0.8 bar (80 kPa)] and 4 bar (400 kPa) helium, on cardiac function and
      morphology was assessed in conscious rats. Ten test rats underwent chamber dives
      daily for 40 consecutive days, and ten control rats were exposed in the same
      chamber for an equal period of time, but in air at 1 bar (100 kPa). Cardiac
      output (Qc) and myocardial blood flow (Qmyocardial) were determined by the
      microsphere method. After 40 days, the body mass was 7% greater in the control
      than in the test rats (P < 0.05), although they were given exactly the same
      amount of standard food. The test rats had a significantly higher (7% absolute,
      12% ventricular mass to body mass, P < 0.05) heart mass (left ventricular
      myocardium, including the ventricular septum) than the control rats. The
      percentage tissue dry mass of the right and left ventricles was equal in the two
      groups. Microscopic examination revealed a number of small focal necroses in the
      left ventricle of the test rats but none in the control rats. The left
      ventricular pressure (LVP) and the maximum velocity of LVP increase
      (contractility) and decrease were significantly increased (25%-96%, P < 0.001) in
      the pre-exposed compared to the control rats at 1 bar (100 kPa). The systolic
      arterial pressure, heart rate and respiratory frequency were similar in the two
      groups at 1 bar (100 kPa).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477679
TI  - Elbow flexion strength curves in untrained men and women and male bodybuilders.
AB  - The influence of elbow joint angle on voluntary isometric elbow flexion strength
      was assessed in 15 young women (F), 18 young men (M) and 11 male bodybuilders
      (BB). Measurements were made at elbow joint angles of 1.31, 1.57, 1.83, 2.09,
      2.36, 2.62 and 2.88 rad (3.14 rad = 180 degrees = full extension). The peak
      voluntary strength [mean (SE), N.m] in M [69.5 (4.3)] and BB [93.3 (4.8)]
      occurred at 2.09 rad (120 degrees), but occurred at 1.57 rad (90 degrees) in F
      [35.4 (2.4)]. Peak torque at 1.31 rad was 20% and 25% lower than at 2.09 rad in M
      and BB, respectively, but did not differ between these two angles in F. The
      larger elbow flexor muscle and fibre size in M and BB may have been responsible
      for their impaired torque production at joint angles corresponding to the
      shortest muscle lengths.

PMID- 8477680
TI  - Elbow flexor evoked twitch contractile properties in untrained men and women and
      male bodybuilders.
AB  - The influence of elbow joint angle on elbow flexor isometric evoked twitch
      contractile properties was assessed in 15 young women (F), 18 young men (M) and
      11 male bodybuilders (BB). Measurements were made at elbow joint angles of 1.31,
      1.57, 1.83, 2.09, 2.36, 2.62 and 2.88 rad (3.14 rad = 180 degrees = full
      extension). The largest peak twitch torque values [mean (SE) N.m] in F [3.77
      (0.20)], M [10.38 (0.68)] and BB [11.38 (1.05)] occurred at 2.88 rad. Peak torque
      was progressively smaller at smaller joint angles, but the decline from 2.88 to
      1.31 rad was greater in M (68%) and BB (76%) than F (59%). Thus, the magnitude of
      intergroup differences in peak twitch torque (PT) was joint angle dependent.
      Twitch time to peak torque (TPT) was influenced in a complex way by joint angle
      in the three groups; BB had the lowest values at small joint angles but the
      highest values at the largest angles. Half-relaxation time (HRT) generally
      increased from the smallest to largest joint angles in a pattern that did not
      differ significantly among the three groups. Maximum rates of twitch torque
      development and relaxation showed the same pattern of results as PT, indicating
      that these time-related measures were more sensitive to joint angle effects on PT
      than on TPT or HRT. The results of this study indicate that careful consideration
      should be given to the selection of joint angles in the measurement of evoked
      twitch contractile properties for the purpose of making group comparisons or
      investigating the effects of interventions such as training.

PMID- 8477681
TI  - Vibration aftereffects on vasoconstrictor response to cold in the normal finger.
AB  - The acute effects of unilateral 30 min exposure to hand-arm vibration on the
      vasoconstrictor response to cold in a finger from both hands were investigated in
      12 healthy men (age 18-38 years) who had never worked with vibrating tools. One
      hand was exposed to accelerations of 4.0 and 16.0 m.s-2 on 2 different days. The
      vasoconstrictor response to cold (R%) was expressed as the relative decrease in
      finger systolic blood pressure, measured using cuff and strain gauge techniques,
      when the finger was cooled from 30 to 10 degrees C. The R% of both third fingers
      were measured simultaneously before unilateral vibration exposure and 15, 60 and
      120 min after the end of each exposure. The R% of both fingers were not affected
      by the low acceleration vibration (P > 0.10). Exposure to the high acceleration
      vibration was followed by an unchanged R% of the exposed finger but an increased
      R% of the non-exposed finger after 15 min (P < 0.05); there was an equal increase
      of 30%-40% in R% of both fingers after 60 min (P < 0.05). The R% of both fingers
      had returned to normal after 120 min (P > 0.10). The results would indicate that
      short-term exposure to vibration induces a transitory hyperreactive central
      vasoconstrictor drive to the central sympathetic nervous system or circulating
      agents, which initially was locally counteracted by an induced hyporeactive
      vasoconstrictor function of local vasomotor mechanisms of the vibration exposed
      digital arteries. The hyperreactive vasoconstrictor effect demonstrated may
      contribute to the development of vibration-induced white finger if cumulative
      exposure time were to be considerably increased.

PMID- 8477682
TI  - Respiratory changes and structure of sleep in young high-altitude dwellers in the
      Andes of Peru.
AB  - Sleep organisation in eight young [mean (SD); 20.9 (2.6) years] Peruvian high
      altitude residents was studied in a laboratory in Cerro de Pasco at 4300 m.
      Electroencephalograms, electromyograms, electro-oculograms, electrocardiograms,
      respiratory movements and arterial oxygen saturation were recorded on an 8
      channel Medilog recorder and analysed later in England. Haematocrits ranged from
      48% to 64% [57.9 (5.6)%]. The amount of slow wave rapid eye movement (REM) sleep
      was similar to that reported in young lowlanders sleeping at sea level but very
      different to the disturbed sleep in visitors sleeping at high altitude. All the
      Peruvians showed episodes of periodic breathing and respiratory apnoeas [29 (15)
      night-1] resulting in marked arterial oxygen desaturation [81 (4.5)%; changes of
      6 (2.5)%]. These events occurred either during stage 2 or REM sleep and were more
      frequent in those with lower haematocrits. The amount of wakefulness during the
      night was 2-3 times greater than would be expected in an age-matched lowland
      population at sea level. The awakenings were strongly associated with apnoeas (P
      < 0.02) but were negatively correlated with haematocrit, although this was only
      significant for seven of the subjects (P < 0.05).

PMID- 8477683
TI  - Gender differences in strength and muscle fiber characteristics.
AB  - Strength and muscle characteristics were examined in biceps brachii and vastus
      lateralis of eight men and eight women. Measurements included motor unit number,
      size and activation and voluntary strength of the elbow flexors and knee
      extensors. Fiber areas and type were determined from needle biopsies and muscle
      areas by computerized tomographical scanning. The women were approximately 52%
      and 66% as strong as the men in the upper and lower body respectively. The men
      were also stronger relative to lean body mass. A significant correlation was
      found between strength and muscle cross-sectional area (CSA; P < or = 0.05). The
      women had 45, 41, 30 and 25% smaller muscle CSAs for the biceps brachii, total
      elbow flexors, vastus lateralis and total knee extensors respectively. The men
      had significantly larger type I fiber areas (4597 vs 3483 microns2) and mean
      fiber areas (6632 vs 3963 microns2) than the women in biceps brachii and
      significantly larger type II fiber areas (7700 vs 4040 microns2) and mean fiber
      areas (7070 vs 4290 microns2) in vastus lateralis. No significant gender
      difference was found in the strength to CSA ratio for elbow flexion or knee
      extension, in biceps fiber number (180,620 in men vs 156,872 in women), muscle
      area to fiber area ratio in the vastus lateralis 451,468 vs 465,007) or any motor
      unit characteristics. Data suggest that the greater strength of the men was due
      primarily to larger fibers. The greater gender difference in upper body strength
      can probably be attributed to the fact that women tend to have a lower proportion
      of their lean tissue distributed in the upper body.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8477684
TI  - Strength training alters contractile properties of the triceps brachii in men
      aged 65-78 years.
AB  - Voluntary and electrically evoked contractile properties were studied in the
      triceps brachii following a 24-week dynamic strength training program in ten men
      aged 65-78 years. Eight men of a similar age were control subjects. A resistance
      overload program was undertaken three times per week with subjects performing
      four sets of six to eight repetitions at 80% of their one repetition on maximum
      (1RM). Maximum voluntary contraction (MVC) and contractile properties were
      measured at 0, 12, and 24 weeks in the exercise group and at 0 and 24 weeks in
      the controls. The 1RM was used to assess dynamic strength at 0 and 24 weeks in
      the exercise group. Contractile measures consisted of supramaximal isometric
      twitch and post-activation twitch parameters. Muscle size was estimated from
      anthropometric measurements. Compared with the control group, the exercise group
      MVC increased by about 20% and time to peak tension was slowed by about 11%. Also
      in the exercise group the peak rate of torque development of the potentiated
      twitch was reduced by about 10%. Twitch potentiation was substantial in both
      groups (about 140%) and unaffected by training. The 1 RM increased by about 30%,
      and there was a non-significant positive change of 8.6% in the muscle plus bone
      cross-sectional area in the exercise group. The results show that the force
      generating capacity of the triceps brachii in these men can be significantly
      improved for up to 24 weeks using concentric overload training. Furthermore, the
      finding of slowed twitch properties and no change in peak twitch amplitude
      substantiate and extend the limited data currently available on intrinsic
      contractile changes in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477685
TI  - Maximal heart rates and plasma lactate concentrations observed in middle-aged men
      and women during a maximal cycle ergometer test.
AB  - The purpose of this study was to investigate criteria for maximal effort in
      middle-aged men and women undertaking a maximal exercise test until they were
      exhausted if no measurements of oxygen uptake are made. A large group of 2164 men
      and 975 women, all active in sports and aged between 40 and 65 years, volunteered
      for a medical examination including a progressive exercise test to exhaustion on
      a cycle ergometer. In the 3rd min of recovery a venous blood sample was taken to
      determine the plasma lactate concentration ([la-]p,3 min). Lactate concentration
      and maximal heart rate (fc,max) were lower in the women than in the men (P <
      0.001). Multiple regression analyses were performed to assess the contribution of
      sex to [la-]p,3 min, independent of age and fc,max. It was found that [la-]p,3
      min was about 2.5 mmol.l-1 lower in women than in men of the same age and fc,max.
      In our population 88% of the men and 85% of the women met a combination of the
      following fc,max and [la-]p,3 min criteria: fc,max equal to or greater than 220
      minus age beats.min-1 and/or [la-]p,3 min equal to or greater than 8 mmol.l-1 in
      the men and fc,max equal to or greater than 220 minus age beats.min-1 and/or [la
      ]p,3 min equal to or greater than 5.5 mmol.l-1 in the women.

PMID- 8477686
TI  - Effect of one- and two-leg training on arm and two-leg maximum aerobic power.
AB  - The purpose of this study was to examine the effect of one- and two-leg training
      on arm and two-leg maximum aerobic power. Seven subjects cycle-trained both legs
      simultaneously for 30 min.day-1, 4 days.week-1 for 4 weeks. Nine subjects cycle
      trained each leg 15 min.day-1, 4 days.week-1 for 4 weeks. Both groups trained at
      a heart rate equal to that measured at 75% of their two-leg maximum aerobic
      power. Thus, during each training session the groups performed 30 min of work at
      the same heart rate intensity. Five subjects served as a non-training control
      group. Arm and leg maximum oxygen uptake tests were conducted before and after
      training. Only two-leg training induced significant gains in arm aerobic power (P
      < 0.0003), whereas both modes of training resulted in significant increases in
      two-leg aerobic power (P < 0.0008). The data demonstrate that improvements in arm
      aerobic power were dependent on the quantity of leg muscle mass involved in the
      training, whereas gains in two-leg aerobic power occurred regardless of whether
      the legs were trained separately or simultaneously.

PMID- 8477687
TI  - Ascidian entactin/nidogen. Implication of evolution by shuffling two kinds of
      cysteine-rich motifs.
AB  - Entactin/nidogen, a major component of the basement membrane, has a domain
      structure comprising three globular domains, and thread-like and rod-like domains
      connecting them. It contains six epidermal-growth-factor-(EGF)-like motifs and
      one thyroglobulin-like motif. In the present study, ascidian entactin/nidogen has
      been identified by a monoclonal antibody technique. We prepared anti-(ascidian
      entactin/nidogen)IgG, named anti-AsEnt1, then cloned the cDNA of ascidian
      entactin/nidogen using anti-AsEnt1 as a probe, and determined its entire
      sequence. Mainly because the deduced amino acid sequence exhibited high
      similarity to mouse entactin and human nidogen, and because the antigen localized
      in basement membrane of ascidian body-wall muscle, we have concluded that the
      antigen anti-AsEnt1 corresponds to the ascidian entactin/nidogen homologue. The
      deduced amino acid sequence of ascidian entactin/nidogen clearly showed that the
      ascidian homologue also has a domain structure. However, the ascidian homologue
      lacked the thread-like domain, and the rod-like domain differed from that of
      mouse entactin in composition, consisting of two kinds of cysteine-rich motifs,
      that is, the EGF-like motif and the thyroglobulin-like motif. These results
      suggest that entactin/nidogen have evolved by modifying the domains, especially
      by shuffling the two kinds of cysteine-rich motifs.

PMID- 8477688
TI  - Characterization of the promoter region of the rat hepatocyte-growth
      factor/scatter-factor gene.
AB  - Hepatocyte growth factor/scatter factor (HGF/SF) is a potent mitogen for
      hepatocytes in primary culture. In response to liver damage, the levels of HGF/SF
      mRNA change in various tissues. In this study, we isolated a genomic DNA fragment
      containing the promoter region of the rat HGF/SF gene and analyzed transcription
      initiation sites and their utilization in response to acute liver injury. Rat
      HGF/SF-mRNA synthesis starts from at least three sites in the liver, spleen and
      kidney. One of these sites is preferentially utilized in the liver and spleen in
      response to acute liver injury. In the 5' flanking region, several cytokine
      related sequence elements that might be involved in the regulation of HGF/SF-gene
      expression are located near the transcription-initiation sites. The effects of
      cytokines related to these sequence elements on the production of HGF/SF mRNA
      were examined using a cell culture system. Transforming growth factor-beta 1 (TGF
      beta 1) inhibits the production of HGF/SF mRNA by Shay granulocytic sarcoma
      derived cells. The TGF-beta 1-inhibitory element, one of the sequence elements
      present in the promoter sequence, may mediate the inhibition of HGF/SF-gene
      expression by TGF-beta 1.

PMID- 8477689
TI  - Cloning and structural analysis of alpha-latroinsectotoxin cDNA. Abundance of
      ankyrin-like repeats.
AB  - alpha-Latroinsectotoxin (alpha-LIT), purified from venom glands of the black
      widow spider Latrodectus mactans tredecimguttatus, is a presynaptic neurotoxin
      selective only for insects. A cDNA encoding the putative alpha-LIT precursor was
      isolated from a spider venom gland cDNA library. The cDNA contains a 4236-base
      pair open reading frame corresponding to a 157826-Da protein composed of 1411
      amino acids. The mature alpha-LIT, with molecular mass approximately 130 kDa, is
      probably derived from double processing in the N-terminal and C-terminal regions
      of the primary translation product. The structure region, extending over residues
      464-1176, is composed almost entirely of ankyrin-like repeats which represent a
      motif also found in the alpha-latrotoxin (alpha-LTX), which has selective action
      on vertebrates. Total alignment of the alpha-LIT and alpha-LTX amino acid
      sequences reveals an overall similarity of 34.1%. Strong sequence divergence is
      observed in analogous cysteine-rich regions situated within the ankyrin-repeat
      domains of both alpha-LIT and alpha-LTX.

PMID- 8477690
TI  - 8-Dimethylamino-1-methyladenine, a novel potent antagonist of the 1-methyladenine
      receptor in starfish oocytes.
AB  - Starfish oocytes are naturally arrested in the late G2 phase of the first meiotic
      division. The follicle-cell-derived hormone, 1-methyladenine, is responsible for
      highly synchroneous induction of oocyte maturation. A series of systematically
      modified 1-methyladenine analogues was used to map the essential molecular
      interactions between 1-methyladenine and its stereospecific receptors, which are
      localized on the oocyte plasma membrane. The earlier hypothesis about
      structure/activity relationships has been confirmed. Quantum-chemical
      calculations indicated additional dipole-dipole interactions and presumably a
      charge-transfer interaction, with the nucleobase as pi-electron donor. Among the
      49 compounds tested, a series of novel inhibitors of 1-methyladenine-induced
      maturation was found. With the synthesis of 8-dimethylamino-1-methyladenine
      (concentration for 50% inhibition 1 microM), a very potent antagonist of the
      natural hormone was obtained which may become an important tool for investigating
      the mechanism of 1-methyladenine-induced maturation of the starfish oocytes, an
      important model for cell-cycle-control studies. The results are discussed in the
      context of preexisting biological data. In conclusion, we propose a modified
      model of the molecular interactions between 1-methyladenine and its receptor.

PMID- 8477691
TI  - Homonuclear and heteronuclear NMR studies of oxidized Desulfovibrio vulgaris
      flavodoxin. Sequential assignments and identification of secondary structure
      elements.
AB  - Recombinant Desulfovibrio vulgaris flavodoxin (molecular mass 16.3 kDa) was
      produced in Escherichia coli. The oxidized protein has been investigated with a
      combination of homonuclear and heteronuclear two-dimensional and heteronuclear
      three-dimensional NMR spectroscopy. Sequence-specific assignment of all backbone
      and most of the side chain 1H and 15N resonances has been obtained. The secondary
      structure has been inferred from the pattern of sequential, medium-, and long
      range NOEs, together with information about slowly exchanging amide hydrogens and
      HN-H alpha spin-spin coupling constants. In solution, flavodoxin consists of a
      five-stranded parallel beta-sheet and four alpha-helices. Residues 3-9, 32-36, 52
      58, 87-96, and 123-128 are involved in the beta-sheet whereas the a-helical
      regions comprise residues 13-28, 69-76, 104-114, and 134-148. Several proton
      resonances of the bound flavin mononucleotide cofactor have been assigned. NOE
      contacts between the prosthetic group and the apoprotein have been detected.

PMID- 8477692
TI  - Chymotryptic cleavage of lipoprotein lipase. Identification of cleavage sites and
      functional studies of the truncated molecule.
AB  - Treatment of bovine lipoprotein lipase (LPL) with chymotrypsin results in
      cleavage between residues Phe390-Ser391 and between Trp392-Ser393, indicating
      that this region is exposed in the native conformation of LPL. Two main fragments
      are generated, one large including the amino-terminus (chymotrypsin-truncated LPL
      = c-LPL) and one small, carboxy-terminal fragment. The small fragment is not
      stable, but is further degraded by the protease. Isolated c-LPL has full
      catalytic activity against tributyryl glycerol (tributyrin) and p-nitrophenyl
      butyrate, while the activity against emulsions of long-chain triacylglycerols and
      against liposomes is reduced and the activity against milk fat globules and
      chylomicrons is lost. Several properties of c-LPL were investigated. It was found
      that c-LPL interacts with apolipoprotein CII (apo CII) as efficiently as intact
      LPL. The truncated enzyme bound to liposomes and to emulsions of long-chain
      triacylglycerols as well as the intact enzyme did. In contrast, c-LPL did not
      bind to milk fat globules or to chylomicrons. The activity of c-LPL was more
      sensitive to inhibition by other lipid-binding proteins, e.g. apolipoprotein CIII
      (apo CIII), than was the intact enzyme. The affinity for heparin was as high with
      c-LPL as with intact LPL. Like intact LPL, c-LPL is dimeric in its active form,
      as evidenced by sucrose density gradient centrifugation. It is concluded that the
      reduced catalytic and lipid-binding properties of c-LPL compared with intact LPL
      are related to the properties of the substrate interface. It is speculated that
      the carboxy-terminal part of LPL contains a secondary lipid-binding site, which
      is important for activity against chylomicrons and related substrates.

PMID- 8477693
TI  - A Candida albicans homolog of CDC25 is functional in Saccharomyces cerevisiae.
AB  - We have cloned, by functional complementation of the cdc25-2 mutation of
      Saccharomyces cerevisiae, a homolog of CDC25 from the pathogenic yeast Candida
      albicans. The new gene, named CSC25 codes for a 1333-amino-acid protein. The full
      length gene, as well as a truncated form coding for 795 amino acids, suppresses
      the thermosensitive phenotype of cdc25ts mutants. Biochemical analysis has shown
      that Csc25 activates the Ras/adenylyl cyclase pathway in S. cerevisiae at a rate
      two to three times faster than Cdc25, under the same conditions. The C-terminal
      domain of Csc25 is highly similar to the C-terminal domain of Cdc25, to almost
      the same extent as the C-terminus of the endogenous Cdc25 homolog Sdc25. We show
      that polyclonal anti-Cdc25 antibodies interact with Csc25 expressed in S.
      cerevisiae. In addition to the full length protein (approximately 150 kDa), we
      have found a approximately 50-kDa polypeptide which seems to include the C
      terminus of the CSC25 gene product.

PMID- 8477694
TI  - IUPAC-IUB Joint Commission on Biochemical Nomenclature (JCBN). Nomenclature and
      symbolism for amino acids and peptides. Corrections to recommendations 1983.

PMID- 8477695
TI  - Involvement of the 20S proteasome in the degradation of ornithine decarboxylase.
AB  - Eukaryotic cells have been shown to contain two high-molecular-mass proteases of
      700 kDa and 1400 kDa (20S and 26S proteases, respectively). It has been suggested
      that the 20S protease, also known as proteasome, may constitute the catalytic
      core of the 26S protease. While the role of the free 20S protease in
      intracellular protein degradation is unclear, the 26S protease is implicated in
      the degradation of ubiquinated proteins. We have recently demonstrated, that
      ornithine decarboxylase (ODC), one of the most labile proteins in mammalian
      cells, is degraded via an ATP-dependent but ubiquitin-independent proteolytic
      pathway. Here we extend these observations by demonstrating that in reticulocyte
      lysate ODC degradation is inhibited by antibodies raised against the C9 subunit
      of rat proteasome. Partial fractionation of the lysate demonstrated preferential
      degradation of ODC in the fraction of the lysate proteins that are precipitated
      by 38% ammonium sulfate. Since it was demonstrated that the 26S protease
      precipitates at this concentration of ammonium sulfate while the 20S proteasome
      remains soluble, our results suggest that the 26S protease is the one degrading
      ODC.

PMID- 8477696
TI  - Purification and characterization of cytochrome P450RR1 from Rhodococcus
      rhodochrous.
AB  - A soluble cytochrome P450 whose synthesis is induced by and that binds 2
      ethoxyphenol was purified to apparent homogeneity from Rhodococcus rhodochrous
      strain 116. The enzyme had a subunit molecular mass of 44.5 kDa as determined by
      SDS/PAGE and a pI of 5.2. The electronic absorption spectrum indicates that the
      native cytochrome in the absence of substrate is predominantly in the low-spin
      state (13% high-spin state in 50 mM Mops, pH 7.0 25 degrees C). 2-Methoxyphenol
      binds to the cytochrome with a macroscopic dissociation constant of 0.53 +/- 0.03
      microM (50 mM Mops, pH 7.0, 25 degrees C) and induces a 99.7% transition of the
      heme iron to the pentacoordinate high-spin form. Using a reconstituted in-vitro
      activity assay, it was demonstrated that P450RR1 catalyzed the O-dealkylation of
      2-ethoxyphenol and 2-methoxyphenol to produce catechol. The cytochrome binds
      other ortho-substituted phenols, including 2-ethoxyphenol, 2-methylphenol (o
      cresol) and 2-chlorophenol. The affinity of P450RR1 for these compounds is lower
      than that of 2-methoxyphenol and they are less effective than 2-methoxyphenol at
      inducing a transition in the heme iron to the high-spin state. Para-substituted
      and meta-substituted ether phenols did not induce a spin transition.

PMID- 8477697
TI  - Human-liver cytochromes P-450 expressed in yeast as tools for reactive-metabolite
      formation studies. Oxidative activation of tienilic acid by cytochromes P-450 2C9
      and 2C10.
AB  - Human liver cytochromes P-450 (P450) 2C9 and 2C10 expressed in yeast reproduce
      all the metabolic features of the oxidation of tienilic acid (2-aryloxo
      thiophene) and its isomer (3-aroylthiophene) by human liver microsomes.
      Microsomes of yeast expressing either P450 2C9 or P450 2C10 catalyze (a) the 5
      hydroxylation of tienilic acid by NADPH and O2 (Km = 6 microM, Vmax = 2.5
      turnover/min), (b) the activation of tienilic acid and its isomer into
      electrophilic metabolites which covalently bind to proteins, and (c) the
      formation of a mercaptoethanol adduct which results from the trapping of the
      tienilic acid isomer sulfoxide by this thiol. Microsomes of yeast expressing
      human liver P450 3A4, 1A1 and 1A2 are unable to catalyze these reactions. There
      is a striking similarity between the quantitative characteristics of the
      oxidation of tienilic acid (and its isomer) by yeast-expressed P450 2C9 (or 2C10)
      and by human liver microsomes: (a) analogous Km values (around 10 microM) for
      tienilic acid 5-hydroxylation, (b) a strong inhibition of tienilic acid oxidation
      by human sera containing anti-(liver kidney microsomes type 2) (anti-LKM2)
      antibodies, and (c) almost identical relative ratios of tienilic acid metabolic
      activation/5-hydroxylation and of tienilic acid activation/the activation of its
      isomer with both systems. Rates of oxidation of tienilic acid (and its isomer) by
      yeast microsomes are 6-8 fold higher than those found in human liver microsomes,
      which would be in agreement with the previously reported amount of P450 2C9 in
      human liver. These results not only suggest the important role of P450 2C9 in the
      oxidative metabolism of tienilic acid in human liver, but also indicate that the
      5-hydroxylation reaction could be a useful marker for P450 2C9 activity and
      underline the interest of human liver P450s expressed in yeast as tools for
      studying the formation of reactive metabolites.

PMID- 8477698
TI  - Molecular cloning, developmental pattern and tissue expression of 3-hydroxy-3
      methylglutaryl coenzyme A reductase of the cockroach Blattella germanica.
AB  - In insects, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA) synthesizes
      mevalonate for the production of nonsterol isoprenoids, which are essential for
      growth and differentiation. To understand the regulation and developmental role
      of HMG-CoA reductase, we have cloned a full-length HMG-CoA reductase cDNA from
      the cockroach Blattella germanica. This cDNA clone was isolated using as a probe
      a partial cDNA of B. germanica HMG-CoA reductase, amplified using the polymerase
      chain reaction. The composite 3433-bp cDNA sequence contains an open reading
      frame encoding a polypeptide of 856 amino acids (Mr, 93165). The C-terminal
      region is more similar to hamster HMG-CoA reductase than is the Drosophila
      melanogaster enzyme (79% and 69% conserved residues, respectively), and the
      potential transmembrane domains at the N-terminal region are structurally
      conservative with both enzymes. The C-terminal region of the B. germanica protein
      has been expressed as a fusion protein in Escherichia coli and exhibits HMG-CoA
      reductase activity. Analysis of B. germanica HMG-CoA reductase mRNA levels,
      reveals a 3.6-kb transcript, that is overexpressed in 4-day-old embryos. Northern
      blot analysis of RNA samples from different adult female tissues shows high HMG
      CoA reductase mRNA levels in the ovary and lower levels in brain and muscle.

PMID- 8477699
TI  - Oxygenation of lipoproteins by mammalian lipoxygenases.
AB  - Oxidative modification converts low-density lipoprotein (LDL) into its
      atherogenic form and appears to be a necessary precondition for LDL uptake by
      macrophages during foam cell formation. Cellular lipoxygenases have been
      implicated in this process. We studied the interaction of purified mammalian
      lipoxygenases with human LDL in vitro and found that the arachidonate 15
      lipoxygenases of rabbit and man are capable of oxygenating lipoproteins as
      indicated by oxygen uptake and by the formation of thiobarbituric-acid-reactive
      substances. Furthermore, oxygenated polyenoic fatty acids, such as 13
      hydro(pero)xy-9Z,11E-octadecadienoic acid and 15-hydro(pero)xy-5,8,11,13(Z,Z,Z,E)
      eicosatetraenoic acid were detected in the lipid compartment of various
      lipoproteins classes after lipoxygenase treatment. More than 90% of the
      oxygenated polyenoic fatty acids were found in the ester-lipid fraction,
      particularly in the cholesterol esters, whereas only small amounts of free
      hydro(pero)xy polyenoic fatty acids were detected. Lipoxygenase-catalyzed
      oxygenation of LDL is not restricted to the lipid compartment but also leads to a
      cooxidative modification of the apoproteins as indicated by changes in the
      electrophoretic mobility and by the formation of carbonyl derivatives of amino
      acid side chains. The possible biological significance of lipoxygenase-induced
      oxidative modification of lipoproteins in the pathogenesis of atherosclerosis is
      discussed.

PMID- 8477700
TI  - Intracellular retention and degradation of human mutant variant of a alpha 1
      antitrypsin in stably transfected Chinese hamster ovary cell lines.
AB  - Normal (PiM) and mutant (PiZ) variants of human alpha 1-antitrypsin (alpha 1-AT)
      cDNA, cloned into the pTnd eucaryotic expression vector, were used to derive
      recombinant Chinese hamster ovary cell lines permanently expressing the
      corresponding proteins. Secretion, accumulation and glycosylation of PiM and PiZ
      alpha 1-AT proteins were studied in the presence of various transport-impairing
      drugs. Pulse-chase, followed by immunoprecipitation as well as immunofluorescence
      experiments showed that the PiZ alpha 1-AT undergoes continuous degradation that
      was prevented by Brefeldin A but not by incubation of cells at 16 degrees C.
      Moreover, monensin partially impaired the glycosylation of both PiM and PiZ alpha
      1-AT but not their secretion nor the degradation of PiZ alpha 1-AT. Those results
      suggest that PiZ alpha 1-AT degradation occurs in the cis-Golgi network, a
      compartment located between the endoplasmic reticulum and the Golgi stack. The
      process did not apparently involve lysosomes since it was insensitive to
      chloroquine. In addition, inhibition of PiM and PiZ alpha 1-AT glycosylation and
      secretion by tunicamycin did not result in the accumulation of the protein, but
      instead in its rapid lag-free degradation. Treatment of cells with the A23187
      ionophore, for a short (60 min) but not a long (24 h) period, improved the
      secretion of PiZ alpha 1-AT in a similar way as it affects retention of naturally
      endoplasmic-reticulum-resident proteins, suggesting that the small proportion of
      PiZ alpha 1-AT which is not degraded or secreted, but accumulates in the
      endoplasmic reticulum, is back transported as a partially glycosylated species
      from the post endoplasmic reticulum compartment in which degradation takes place.

PMID- 8477701
TI  - Purification and characterization of an extremely thermostable beta-glucosidase
      from the hyperthermophilic archaeon Pyrococcus furiosus.
AB  - Cell-free extracts of cellobiose-grown cells of the hyperthermophile Pyrococcus
      furiosus contain very high activities (19.8 U/mg) of a beta-glucosidase. The
      cytoplasmic enzyme was purified 22-fold to apparent homogeneity, indicating that
      the enzyme comprises nearly 5% of the total cell protein. The native beta
      glucosidase has a molecular mass of 230 +/- 20 kDa, composed of 58 +/- 2-kDa
      subunits. The enzyme has a pI of 4.40. Thiol groups are not essential for
      activity, nor is the enzyme dependent on divalent cations or a high ionic
      strength. The enzyme shows optimum activity at pH 5.0 and 102-105 degrees C. From
      Lineweaver-Burk plots, Vmax values of 470 U/mg and 700 U/mg were found for
      cellobiose (Km = 20 mM) and p-nitrophenyl-beta-D-glucopyranoside (Km = 0.15 mM),
      respectively. The purified enzyme also exhibits high beta-galactosidase activity
      and beta-xylosidase activity, but shows no activity towards alpha-linked
      disaccharides or beta-linked polymers, like cellulose. The purified beta
      glucosidase shows a remarkable thermostability with a half life of 85 h at 100
      degrees C and 13 h at 110 degrees C.

PMID- 8477702
TI  - Isozyme developments in mammalian class-I alcohol dehydrogenase. cDNA cloning,
      functional correlations, and lack of evidence for genetic isozymes in rabbit.
AB  - Isozyme patterns differ widely among the classical type (class I) of mammalian
      alcohol dehydrogenases. For the rabbit enzyme, the possibility of isozymes has
      been reported but structural evidence is lacking. This system was now studied at
      both the mRNA/cDNA and protein levels. Ten cDNA clones, coding for class-I
      alcohol dehydrogenase, were isolated from a rabbit liver cDNA library using a
      human DNA fragment as probe. The cDNA spanned 1296 bp, including the entire
      coding region. All clones coded for the same polypeptide and Northern blots
      identified a single mRNA corresponding to about 1.5 kb. Comparison of two protein
      forms (CC and BC) by HPLC peptide fingerprinting and structural analysis revealed
      peptide segments identical in amino acid sequence. Consequently, direct protein
      analyses and Northern blots show the presence of only one primary translation
      product. The data suggest that lagomorphic alcohol dehydrogenase, like the rodent
      enzyme, is not as isozyme rich as it may appear superficially, and that secondary
      modifications contribute substantially to mammalian alcohol dehydrogenase
      multiplicity. The active center of the rabbit enzyme suggests similarities to the
      horse S, human gamma, and rat enzyme structures, compatible with a steroid
      dehydrogenase activity shown experimentally. Typical class-I properties were
      established by direct analysis and confirmed by structural properties (Km for
      cyclohexanol 0.8-1.1 mM, for ethanol 1.6-1.9 mM). The isozyme versus species
      differences mark the variability of class-I alcohol dehydrogenase versus class
      III and suggest a parallelism between rapid mutational differences and frequent
      duplicatory events.

PMID- 8477703
TI  - 1H-NMR spectroscopy of beta B2-crystallin from bovine eye lens. Conformation of
      the N- and C-terminal extensions.
AB  - 1H-NMR spectroscopic studies of a 46-kDa homodimer, beta B2-crystallin, from
      bovine eye lens are presented. beta B2-crystallin has terminal extensions
      extending from globular N- and C-terminal domains that are well resolved in the
      NMR spectra, whereas, in the main, resonances from the bulk of the protein are
      not observed. Using two-dimensional NMR methods on beta B2-crystallin, its
      synthesised terminal extensions and a proteolysed sample of beta B2-crystallin
      with a portion of its C-terminus removed, it was possible to assign resonances to
      most of the amino acids in the terminal extensions. One-dimensional experiments
      at various pH values provided H-2 chemical shifts for the three terminal
      extension histidines from which their pKa values were measured. It is concluded
      that the terminal extensions appear to be of little ordered conformation, are
      accessible to solvent and flex freely from the main body of the protein. The
      results of the NMR spectroscopic studies of beta B2-crystallin are in excellent
      agreement with those for the X-ray crystal structure [Bax, B., Lapatto, R.,
      Nalini, V., Driessen, H., Lindley, P. F., Mahadevan, D., Blundell, T. L. &
      Slingsby, C. (1990) Nature 347, 776-780]. No change in the spectrum of beta B2
      crystallin was observed in the presence of calcium, suggesting that the termini
      are not involved in calcium binding.

PMID- 8477704
TI  - 1H-NMR spectroscopy of bovine lens beta-crystallin. The role of the beta B2
      crystallin C-terminal extension in aggregation.
AB  - 1H-NMR spectroscopic studies of bovine eye lens beta-crystallin aggregates
      (dimer, trimer and octomer) are presented. The NMR spectra for all three beta
      crystallin aggregates are dominated by resonances from the beta B2 subunit,
      particularly from the N- and C-terminal extensions of this subunit. Resonances
      from other beta subunits, which all have terminal extensions, are, in general,
      absent from spectra of the beta-crystallin aggregates. Therefore, the beta B2
      subunit and, in particular its terminal extensions, has enhanced flexibility
      compared to the other beta-crystallin subunits. Furthermore, resonances arising
      from the C-terminal extension of beta B2-crystallin are not present in the
      spectrum of the octomer, which is consistent with the C-terminal extension
      binding in this aggregate and hence being involved in large aggregate formation.
      A possible interaction between the C-terminal extension of beta B2 and the
      hydrophobic beta B1 subunit, which is only found in the octomer, is discussed. At
      higher temperatures (45 degrees C) in the octomer, partial exposure of the C
      terminal extension of beta B2 occurs indicating that the octomer may be starting
      to break up into smaller aggregates.

PMID- 8477705
TI  - Overproduction, purification and characterization of the bacterioferritin of
      Escherichia coli and a C-terminally extended variant.
AB  - The bacterioferritin (BFR) of Escherichia coli is an iron-sequestering
      haemoprotein composed of 24 identical polypeptide chains forming an approximately
      spherical protein shell with a central iron-storage cavity. BFR and BFR-lambda, a
      variant with a 14-residue C-terminal extension, have been amplified (120-fold and
      50-fold, respectively), purified by a new procedure and characterized. The
      overproduced BFR exhibited properties similar to those of natural BFR, but the
      iron content (25-75 non-haem Fe atoms/molecule) was 13-39-fold lower. Two major
      assembly states of BFR were detected, a 24-subunit protein (tetracosamer) and a
      novel haem-containing subunit dimer. BFR-lambda subunits assembled into
      tetracosamers having the same external-surface properties as BFR, presumably
      because their C-terminal extensions project into and occupy about 60% of the
      central cavity. As a result, BFR-lambda failed totake up iron under conditions
      that allowed incorporation into BFR in vitro. The haem content of BFR-lambda (1-2
      haems/tetracosamer) was lower than that of BFR (3.5-10.5 haems/tetracosamer) and
      this, together with a difference in the visible spectra of the two haemoproteins,
      suggested that the C-terminal extensions in BFR-lambda perturb the haem-binding
      pockets. A subunit dimer form of BFR-lambda was not detected. A combination of
      Mossbauer spectroscopy and electron diffraction showed that the BFR loaded with
      iron in vitro has a ferrihydrite-like iron core, whereas the in-vivo loaded
      protein has an amorphous core.

PMID- 8477706
TI  - Induction of protein phosphorylation, protein synthesis, immediate-early-gene
      expression and cellular proliferation by intracellular pH modulation.
      Implications for the role of hydrogen ions in signal transduction.
AB  - In Syrian hamster embryo cells, intracellular acidification (but not
      alkalization) results in proliferation, immediate-early-gene expression and
      tyrosine phosphorylation. In addition, both intracellular acidification and
      alkalization result in serine/threonine phosphorylation and de novo protein
      synthesis of specific proteins. Calcium is not mobilized in response to either
      intracellular alkalization or acidification. Neither intracellular acidification
      nor alkalization altered the serum proliferative signal while intracellular
      alkalization (but not acidification) reduced the epidermal-growth-factor-induced
      proliferative signal, tyrosine phosphorylation and immediate-early-gene
      expression. Finally, intracellular acidification (but not alkalization) could
      induce immediate-early-gene expression in cells growing in the presence of serum,
      indicating that the pH signalling pathway is not down modulated by the serum
      signalling pathway. These results, while indirect, indicate that hydrogen ions
      may play an important role in mitogen-signal transduction in Syrian hamster
      embryo cells.

PMID- 8477707
TI  - Stimulation of HIT-T15 insulinoma cells by glyceraldehyde does not require its
      metabolism.
AB  - The addition of the triose D-glyceraldehyde (5-20 mM) to HIT-T15 hamster
      insulinoma cells caused a rapid, marked depolarisation of the plasma membrane
      accompanied by a pronounced intracellular acidification, an increase in the
      cytosolic free calcium concentration [Ca2+]i and enhanced secretion of insulin. D
      glyceraldehyde did not reduce the rate of efflux of 86Rb+ from loaded perifused
      cells. All of the above effects of D-glyceraldehyde were also observed in
      response to L-glyceraldehyde. The changes in membrane potential and intracellular
      pH (pHi) caused by D-glyceraldehyde were unaffected by the glycolytic inhibitor
      iodoacetate, by K(+)-channel blockers (tolbutamide and tetraethylammonium), or by
      inhibitors of the transport of lactate (alpha-fluorocinnamate), alanine
      (methylaminoisobutyrate) or glucose (phloretin, phlorrizin). The glyceraldehyde
      induced depolarisation and acidification were also observed in the absence of
      extracellular Ca2+ or Na+. The increase in [Ca2+]i evoked by D-glyceraldehyde was
      reversed by removal of Ca2+ from the medium. The formation of lactate by HIT-T15
      cells was not significantly increased by addition of 10 mM D-glyceraldehyde or L
      glyceraldehyde. In contrast, 10 mM glucose caused an approximately fourfold rise
      in lactate production. The oxidation of D-glyceraldehyde by HIT-T15 cells was
      also extremely modest compared to glucose oxidation by these cells. These results
      suggest that the stimulation of HIT-T15 cells by either D-glyceraldehyde of L
      glyceraldehyde does not require metabolism of the triose within the cell and may
      not involve closure of nucleotide-sensitive K+ channels. We propose that the
      electrogenic transport of glyceraldehyde across the plasma membrane, possibly via
      H+ cotransport, might lead to depolarisation and hence to Ca2+ entry into the
      cell.

PMID- 8477708
TI  - Molecular cloning of a cDNA showing alternative splicing of the 5'-untranslated
      sequence of mRNA for human aromatase P-450.
AB  - A new type of full-length cDNA clone encoding human aromatase P-450 was isolated
      from a human placental cDNA library. The clone, designated as pES-4, has a 3130
      bp insert. The nucleotide sequences of the translated region and the 3'
      untranslated region of the insert of pES-4 are exactly identical with those of
      the cDNA clone characterized previously. However, the sequence of the 5'
      untranslated region of the insert has characteristic feature, i.e. an extra
      sequence of 109 bp is present at a junction between exon 1 and exon 2 on the
      processed human aromatase mRNA. Analysis of the genomic clones containing the
      region between exon 1 and exon 2 of the human aromatase P-450 gene reveals that
      the 109-bp genomic segment, encoding the same sequence as the extra sequence
      observed in pES-4, is located approximately 10-kbp downstream of exon 1 and that
      the nucleotide sequences of the 5'-flanking and the 3'-flanking regions of the
      segment conform to the GT-AG rule for RNA splicing. By means of reverse
      transcription and polymerase chain reaction, relative amounts of the pES-4-type
      mRNA are estimated to be approximately 4.8% and 2.3% of the processed aromatase P
      450 mRNA in human placenta and human BeWo choriocarcinoma cells, respectively.
      These results indicate that the segment of 109 bp between exon 1 and exon 2 is a
      new exon hitherto unidentified and that heterogeneity observed in the 5'
      untranslated sequence of human aromatase P-450 mRNA is, at least in part, caused
      by alternative splicing of this new exon.

PMID- 8477709
TI  - Structures of sialylated oligosaccharides of human erythropoietin expressed in
      recombinant BHK-21 cells.
AB  - The native structures of the Asn-linked oligosaccharides and the O-glycans at
      Ser126 of human erythropoietin expressed from recombinant BHK cells have been
      elucidated. Enzymatically released N-glycans were studied by methylation
      analyses, fast-atom-bombardment mass spectrometry as well as one- and two
      dimensional 1H-NMR spectrometry at 600 MHz. Many (82.7%) were found to be
      tetraantennary N-acetyllactosamine-type (22.8% with one, 3.6% with two and 0.4%
      with three N-acetyllactosamine repeats) being tetrasialylated (41%),
      trisialylated (29.6%) and disialylated (12.2%). A few (9.7%; 4.1% 2,4-branched,
      5.6%, 2,6-branched) of the chains were triantennary (5.4% trisialyl, 4.3%
      disialyl) and 4.6% were of the disialyl diantennary type. Almost all of the
      innermost GlcNAc residues were alpha 1-6 fucosylated and NeuAc was exclusively
      alpha 2-3 linked to Gal beta 1-4GlcNAc-R; 60% of the protein was found to be O
      glycosylated at Ser126; structures were monosialylated (70%) or disialylated
      (30%) forms of the Gal beta 1-3GalNAc core type. Glycosylation patterns at
      individual Asn-Xaa-Thr/Ser sites were determined by analytical high-pH anion
      exchange chromatography with pulsed amperometric detection. Only tetraantennary
      chains with 0-3 N-acetyllactosamine repeats were detected at Asn38 and Asn83,
      while almost all of the di- and triantennary oligosaccharides were attached to
      Asn24. Batch analysis of different preparations of recombinant erythropoietin
      revealed the high reproducibility of the production procedure. Structures
      containing terminal GalNAc-GlcNAc were detected in small amounts in a few
      batches.

PMID- 8477710
TI  - Two-dimensional NMR assignment of hyperfine-shifted resonances of very fast
      relaxing metal binding sites of proteins by NOE spectroscopy. The case of Cu, Co
      superoxide dismutase.
AB  - The isotropically shifted NMR resonances of bovine Cu, Co superoxide dismutase,
      arising from the imidazole protons of the metal binding site of the native Cu, Zn
      enzyme when Zn(II) is replaced by Co(II), were investigated by two-dimensional
      NMR. NOE spectra have been measured at different mixing times in order to obtain
      a good set of interproton dipolar connectivities. A number of NOEs were obtained
      for very fast relaxing resonances close to the paramagnetic copper ion and new
      isotropically shifted resonances were detected in the proximity of the
      diamagnetic region. The recently obtained original X-ray coordinates of the Cu,
      Co enzyme were used in order to give the appropriate values to the interproton
      distances of the imidazole rings of the copper-coordinated histidines. The data
      allowed an unequivocal and definitive assignment of the isotropically shifted
      resonances to be done, with respect to previous results obtained using the
      coordinates of the Cu, Zn enzyme and monodimensional NMR techniques, which
      contain a potential source of artifacts in the selective excitation required
      prior to acquisition of spectra.

PMID- 8477711
TI  - Expression of the rat growth-hormone gene is under the influence of a cell-type
      specific silencer element.
AB  - We have previously shown that a cell-type-specific negative-regulatory element,
      or silencer, acts to specifically restrict rat-growth-hormone(rGH)-promoter
      activity to pituitary cells. Here we report a detailed characterization of this
      element. The activity of the silencer is dependent on its position relative to
      the promoter. The negative regulatory effect can be diminished by cotransfection
      with a high-copy-number, silencer-containing competitor plasmid, suggesting that
      the function of the element is mediated by specific binding of a trans-acting
      negative-regulatory factor. The minimal region required for silencer function is
      contained between positions -309 and -266 relative to the start of the rGH mRNA.
      The specific interaction of a nuclear protein from non-pituitary cells with this
      rGH DNA segment was shown by DNaseI as well as dimethylsulfate methylation
      interference footprinting. A detailed examination of the DNA-binding site for
      that protein clearly suggest that it belongs to the NF1 family of transcription
      factors.

PMID- 8477712
TI  - Overproduction, solubilization, purification and DNA-binding properties of AmpR
      from Citrobacter freundii.
AB  - AmpR belongs to the LysR family of prokaryotic DNA-binding transcriptional
      regulators and controls induction of the enterobacterial ampC beta-lactamase
      gene. The ampR gene of Citrobacter freundii was deregulated by employing the
      polymerase chain reaction to introduce an efficient ribosome-binding sequence and
      suitable restriction enzyme sites for cloning into a chemically inducible tac
      promoter expression vector. When induced in Escherichia coli, the modified ampR
      gene rapidly overproduced the AmpR protein as an insoluble aggregate. The AmpR
      protein could be solubilized with 1.32 M guanidine/HCl and remained soluble when
      dialyzed against 0.5 M NaCl. The solubility properties of AmpR were exploited to
      selectively precipitate and resolubilize the protein in a nearly homogenous
      state. AmpR was then purified by a single gel-filtration chromatography step
      which demonstrated that AmpR exists in solution as a monodisperse homodimeric
      protein. Several milligrams of purified AmpR could be obtained routinely from a 1
      1 culture of induced bacteria. A DNA-binding assay buffer containing 300 mM
      potassium glutamate and 30% glycerol was found to stabilize AmpR and used to
      demonstrate sequence-specific DNA-binding. Additionally, purified AmpR binds a
      half-operator DNA with an inverted-repeat sequence which competes with binding by
      the wild-type operator. These findings are discussed in terms of the helix-turn
      helix DNA-binding motif, whereby AmpR is proposed to interact with its wild-type
      operator as a dimer of dimers.

PMID- 8477713
TI  - The interactions of retinoids with retinol-binding protein. A resonance Raman
      spectroscopic study.
AB  - We have measured the pre-resonance Raman spectrum of retinal, retinoic acid and
      retinol in dilute CCl4 solutions and when bound to the bovine-serum retinol
      binding protein. The comparison reveals that the binding interaction does not
      involve any specific interactions of the head group and/or the polyene chain with
      a particular protein residue. The data indicate hydrogen bonding of bound
      retinal's head-group oxygen to water, as well as some torsional angle change of
      its polyene chain upon binding.

PMID- 8477714
TI  - Purification and characterization of extracellular, acidic chitinase isoenzymes
      from elicitor-stimulated parsley cells.
AB  - Treatment of cultured parsley cells (Petroselinum crispum) with fungal elicitor
      caused large increases in the activities of chitinase and 1,3-beta-glucanase.
      Chitinase activity accumulated predominantly in the culture medium, whereas 1,3
      beta-glucanase activity was located almost exclusively intracellularly.
      Extracellular chitinase activity was resolved into six different isoenzymes, all
      of which were purified and characterized. All six isoforms were acidic proteins
      (pI 3.8-5.3), with molecular mass 30-38 kDa. Four were exochitinases and two were
      endochitinases. The most abundant isoform also showed lysozyme activity. Three of
      the exochitinases were glycoproteins and two of these were reactive with an
      antiserum specific for xylose in complex glycosidic structures. The exochitinases
      constituted relatively small proportions of the total chitinase activity and may
      serve a different function in cellular metabolism compared to the more abundant
      endochitinases.

PMID- 8477715
TI  - Influence of conjugation of doxorubicin to transferrin on the iron uptake by K562
      cells via receptor-mediated endocytosis.
AB  - The influence of conjugation of doxorubicin to holotransferrin on the receptor
      mediated endocytosis of and on the iron uptake from transferrin was studied using
      K562 cells. 125I-labelled transferrin and doxorubicin-transferrin conjugates were
      used in the binding, dissociation, and ligand-exchange experiments at 0 degree C,
      and 59Fe,125I-labelled (double-labelled) ligands were used in the endocytosis,
      iron uptake, and recycling experiments at 37 degrees C. The binding affinity of
      conjugates was about half of that of transferrin. Binding of 125I-labelled
      ligands was blocked by both unlabelled ligands to the same degree, however, it
      was not blocked at all by an 8000-fold excess of doxorubicin. After saturation
      bindings, slightly more 125I-labelled conjugates dissociated from the surface of
      cells than transferrin. Exchange of 125I-labelled ligands for unlabelled ligands
      resulted in different EC50 values (defined as the concentration of unlabelled
      ligand at which half as much radioligand is exchanged for unlabelled ligand as
      would be exchanged at infinitely high concentration of unlabelled ligand under
      similar assay conditions). While transferrin exchanged transferrin with an EC50
      value close to the binding affinity, conjugates exchanged conjugates with much
      lower efficiency. The heterolog exchange experiments yielded EC50 values
      inbetween the two extrema. For studying iron uptake, K562 cells were loaded with
      the double-labelled ligands either at 37 degrees C (endosome-loading only) or at
      0 degree C (surface-loading only). Results obtained for the endocytosis of, the
      iron uptake from, and the recycling of double-labelled ligands indicate that (a)
      the rate of iron uptake is smaller from conjugates than from transferrin, (b)
      there are at least two parallel recycling processes for both ligand.receptor
      complexes, and (c) each time constant characterizing the different steps of iron
      uptake via receptor-mediated endocytosis is smaller for conjugates than for
      transferrin (or, the half times characterizing the different steps are higher for
      conjugates than for transferrin). Endocytosis and iron uptake were unaffected by
      free doxorubicin (12.5 microM) or colchicine (1 mM). Benzyl alcohol (30 mM)
      slowed down the rate of both endocytosis and iron uptake, while dithiothreitol (5
      mM) decreased the rate of iron uptake and increased the rate of endocytosis. N
      Ethylmaleimide (1 mM) completely stopped both endocytosis and iron uptake. The
      results suggest that the binding of conjugates to the surface of cells is
      governed by the binding of the transferrin part of conjugates to the transferrin
      receptor. However, conjugation of doxorubicin to transferrin seems to influence
      all properties of transferrin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8477716
TI  - Structural determination of the capsular polysaccharide produced by Klebsiella
      pneumoniae serotype K40. NMR studies of the oligosaccharide obtained upon
      depolymerisation of the polysaccharide with a bacteriophage-associated
      endoglycanase.
AB  - The Klebsiella pneumoniae K40 capsular polysaccharide has been isolated and
      investigated by use of methylation analysis, specific degradations and NMR
      spectroscopy. The polysaccharide was depolymerised by a bacteriophage-associated
      endogalactosidase, and the resulting oligosaccharide was characterised by one
      dimensional and two-dimensional NMR spectroscopy and direct chemical ionisation
      MS. The repeating unit of the K40 capsular polysaccharide was shown to be a
      linear hexasaccharide with the composition-->3)- alpha-L-Rhap-(1-->2)-alpha-L
      Rhap-(1-->4)-alpha-D-GlcpA++ +-(1-->2-)- alpha-D-Manp-(1-->2)-alpha-D-Manp-(1-
      >3)-alpha-D-Galp-(1--> (Rha, rhamnose).

PMID- 8477717
TI  - Association with B-cell-antigen receptor with protein-tyrosine kinase p72syk and
      activation by engagement of membrane IgM.
AB  - We have demonstrated that a 72-kDa non-receptor-type protein-tyrosine kinase
      (p72syk) was co-immunoprecipitated with membrane IgM in digitonin lysates of
      porcine tonsillar cells and was rapidly activated following the engagement of
      membrane IgM. This activation was occurred within 5 s, even in the presence of
      EGTA and 5,5'-dimethyl-bis-(O-aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid as
      extracellular and intracellular Ca(2+)-chelating agents, respectively, as well as
      in the presence of the protein-kinase-C inhibitor, H-7. Additionally, genistein,
      a potent protein-tyrosine kinase inhibitor, was capable of reducing both IgM
      stimulated Ca2+ mobilization and p72syk activation in a dose-dependent manner.
      These results indicate that p72syk is physically associated with the B-cell
      antigen receptor, participating in antigen-mediated signal transduction in both a
      Ca(2+)-independent and protein-kinase-C-independent manners.

PMID- 8477718
TI  - Cell-specific expression of human beta-galactoside alpha 2,6-sialyltransferase
      transcripts differing in the 5' untranslated region.
AB  - In humans, two cDNAs have been isolated encoding beta-galactoside alpha 2,6
      sialyltransferase, differing only in part of the 5' untranslated region. Primer
      extension data show that the two cDNAs are near full-length clones. RNase
      protection analysis of different cell types showed that the transcript
      corresponding to the alpha 2,6-sialyltransferase cDNA isolated from a B-cell
      library resided only in mature B cells. In contrast, the transcript corresponding
      to the alpha 2,6-sialyltransferase cDNA isolated from a placenta library was
      found in all cells tested. Our results also indicate the existence of a third
      alpha 2,6-sialyltransferase transcript in the hepatoma cell line HepG2. Mature B
      cells were found to express high amounts of alpha 2,6-sialyltransferase mRNA,
      compared to other cell types tested, as shown by Northern blot analysis. Moreover
      there was an increased expression of beta-galactoside alpha 2,6-sialyltransferase
      mRNA in activated B cells compared to resting B cells. In vitro transcription and
      translation of the cDNAs resulted in a protein of 45 kDa, but the transcripts
      were translated with different efficiency, suggesting a role for the 5'
      untranslated region in regulation of translation. We have also made an alpha 2,6
      sialyltransferase construct lacking the specific 5' regions of the two cDNAs. A
      transcript generated from this construct was translated more efficiently in vitro
      than the two alpha 2,6-sialyltransferase cDNAs.

PMID- 8477719
TI  - Exchange reactions catalyzed by group-transferring enzymes oppose the
      quantitation and the unravelling of the identify of the pentose pathway.
AB  - 1. The distributions and rates of transfer of carbon isotopes from a selection of
      specifically labelled ketosugar-phosphate substrates by exchange reactions
      catalyzed by the pentose and photosynthetic carbon-reduction-pathway group
      transferring enzymes transketolase, transaldolase and aldolase have been measured
      using 13C-NMR spectroscopy. 2. The rates of these exchange reactions were 5, 4
      and 1.5 mumol min-1 mg-1 for transketolase exchange, transaldolase exchange and
      aldolase exchange, respectively. 3. A comparison of the exchange capacities
      contributed by the activities of these enzymes in three in vitro liver
      preparations with the maximum non-oxidative pentose pathway flux rates of the
      preparations shows that transketolase and aldolase exchanges exceeded flux by 9
      19 times in liver cytosol and acetone powder enzyme preparations and by 5 times
      in hepatocytes. Transaldolase was less effective in the comparison of exchange
      versus flux rates: transaldolase exchange exceeded flux by 1.6 and 5 in catalysis
      by liver cytosol and acetone powder preparations, respectively, but was only 0.6
      times the flux in hepatocytes. 4. Values of group enzyme exchange and pathway
      flux rates in the above three preparations are important because of the feature
      role of liver and of these particular preparations in the establishment,
      elucidation and measurement of a proposed reaction scheme for the fat-cell-type
      pentose pathway in biochemistry. 5. It is the claim of this paper that the excess
      of exchange rate activity (particularly transketolase exchange) over pathway flux
      will overturn attempts to unravel, using isotopically labelled sugar substrates,
      the identity, reaction sequence and quantitative contribution of the pentose
      pathway to glucose metabolism. 6. The transketolase exchange reactions relative
      to the pentose pathway flux rates in normal, regenerating and foetal liver,
      Morris hepatomas, mammary carcinoma, melanoma, colonic epithelium, spinach
      chloroplasts and epididymal fat tissue show that transketolase exchange may
      exceed flux in these tissues by factors ranging over 5-600 times. 7. The
      confusion of pentose pathway theory by the effects of transketolase exchange
      action is illustrated by the 13C-NMR spectrum of the hexose 6-phosphate products
      of ribose 5-phosphate dissimilation, formed after 30 min of liver enzyme action,
      and shows 13C-labelling in carbons 1 and 3 of glucose 6-phosphate with ratios
      which range over 2.1-6.4 rather than the mandatory value of 2 which is imposed by
      the theoretical mechanism of the pathway.

PMID- 8477720
TI  - Comparative proteolysis of sorbitol and alcohol dehydrogenases.
AB  - Mammalian alcohol and sorbitol dehydrogenases, with distantly related subunits
      but different substrates, quaternary structures and zinc contents, were evaluated
      by comparison of their sensitivities to proteases. Sorbitol dehydrogenase is more
      sensitive to proteolysis than alcohol dehydrogenase, but both enzymes show
      limited cleavage with Lys-specific and Glu-specific proteases. With the former,
      the major cleavage in both proteins involves Lys-Lys-Pro segments, at positions
      247-248 in alcohol dehydrogenase, surface-positioned after the most distal beta
      strand in the coenzyme-binding domain, and at 61-62 in sorbitol dehydrogenase, at
      another surface in the catalytic domain. Further cleavages affect these two and a
      third surface. A non-surface cleavage was obtained with the Glu-specific protease
      and sorbitol dehydrogenase, after insufficient protease inhibition before
      analysis by SDS/PAGE. It probably reflects non-native conditions, and the fact
      that this protease is active in strong SDS, necessitating pre-analytical use of a
      specific inhibitor. Differences in cleavage patterns between the two proteins do
      not involve areas corresponding to the dimer interactions in alcohol
      dehydrogenase. Hence, these areas are likely to be the same in sorbitol
      dehydrogenase. However, major differences involve regions that flank the surface
      which has a 20-residue loop segment in alcohol dehydrogenase that is missing in
      sorbitol dehydrogenase. This segment, previously highlighted from comparisons, is
      therefore also emphasized by experimental results with proteolysis. The surface
      exposed by the missing segment is likely to correlate with the separate
      quaternary structures and to indicate possible sites for the additional subunit
      interactions in the sorbitol dehydrogenase tetramer versus the alcohol
      dehydrogenase dimer.

PMID- 8477721
TI  - Amino acid residues involved in the catalytic site of human erythrocyte
      bisphosphoglycerate mutase. Functional consequences of substitutions of His10,
      His187 and Arg89.
AB  - Human bisphosphoglycerate mutase (GriP2 mutase) is a trifunctional enzyme which
      synthesizes and degrades GriP2 in red cells. Among the amino acid residues
      involved in its active site there are two conserved histidine residues, His10
      which is phosphorylated during the catalytic process and His187 for which only
      speculative data have been made about the potential role during the reactions.
      Another amino acid residue, Arg89, had not been described as part of this active
      site but we have recently shown that a natural mutant Arg89-->Cys was highly
      thermolabile and showed severe perturbations of its enzymatic properties. To
      understand better the exact role of these residues, replacements of His10 by Gly
      (H10G) or Asp (H10D), His187 by Asn (H187N), Tyr (H187Y) or Asp (H187D) and Arg89
      by Cys (R89C), Ser (R89S), Gly (R89G) or Lys (R89K) were performed by site
      directed mutagenesis. The results obtained in this report show that replacement
      of the His10 residue completely abolished the enzymatic activities. Concerning
      the His187 residue, our results afford arguments that it plays an essential role
      in the three catalytic activities. Indeed all these activities are abolished in
      the two H187Y and H187D variants, whereas they are detectable though strongly
      diminished, for the H187N variant. In addition mutations at His187 could be
      distinguishable from those at His10 since the former resulted in a thermolabile
      enzyme, whereas no significant change in heat stability was observed for the
      latter. It is noteworthy that the H187N variant is protected against thermal
      instability by glycerate 2,3-bisphosphate (GriP2). Concerning the Arg89 mutants,
      R89C, R89S and R89G, the three variants showed characteristics identical to those
      found in the natural R89C mutant, i.e. loss of 99% of synthase activity,
      consistent decrease of mutase and 2-phosphoglycolate-stimulated phosphatase
      activities whereas the unstimulated phosphatase activity was normal. Moreover
      these mutants were unstable at 55 degrees C but GriP2 was able to protect them
      against thermal instability. In contrast, the R89K mutant was stable at 55
      degrees C. Its synthase and unstimulated phosphatase activities were normal but
      its mutase and 2-phosphoglycolate-stimulated phosphatase activities were
      decreased. In addition, Km values for monophosphoglycerates were increased (3.2
      fold) in the synthase but normal in mutase activities, whereas Km values for
      GriP2 were normal in mutase and phosphatase activities.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8477722
TI  - Heavy-chain isoforms of non-muscle myosin in human tissues.
AB  - The heavy-chain isoforms of myosin in human non-muscle and smooth muscle tissues
      were analyzed by means of SDS/PAGE and using three distinct newly developed
      monoclonal anti-(human cerebrum myosin) Ig (HBM-1, HBM-3 and HBM-4). Purified
      cerebrum myosin contained three electrophoretic variants of non-muscle myosin
      heavy chain (NM1, NM2 and NM3, with apparent molecular masses of about 200, 198
      and 196 kDa, respectively). Both NM1 and NM2 were recognizable by the brain
      specific antibody HBM-1, while NM3 was recognizable by HBM-3. Each of the
      variants reacted with HBM-4 to a similar extent. Purified cerebellum myosin gave
      three electrophoretic variants of the heavy chain which were indistinguishable
      electrophoretically or immunologically from those of cerebrum myosin. Aortic
      myosin contained four electrophoretic variants, including the two smooth muscle
      myosin heavy chain isoforms and NM2-like and NM3-like heavy chains. Liver,
      platelet and kidney myosins contained a heavy chain very similar to NM3. Kidney
      myosin also contained a small fraction of an NM2-like electrophoretic variant. In
      addition, cerebrum, kidney, liver and platelet myosins appeared to contain minor,
      194-kDa myosin heavy-chain-like polypeptide(s) (NM4). NM1, as well as NM2 and
      NM3, thus appear to be the brain-type and non-brain-type non-muscle myosin heavy
      chain isoforms, respectively, and additional minor heavy-chain isoforms are also
      likely to be present in human tissues.

PMID- 8477723
TI  - Crystallographic studies of azide binding to human carbonic anhydrase II.
AB  - The crystal structures of human carbonic anhydrase II (CAII) at pH 5.7 and 8.0
      have been determined at 0.21-nm resolution in the presence of 20 mM azide, which
      is a noncompetitive inhibitor of the CAII-catalyzed CO2 hydration reaction.
      Although azide often facilitates the crystallization of CAII and its variants,
      this small anion does not cause any significant structural changes in the enzyme
      active site or in the overall protein structure, and zinc coordination remains
      tetrahedral over the pH range 5.7-8.0. Importantly, the binding of azide at pH
      8.0 has implications for the zinc-binding mode of the catalytic product,
      bicarbonate ion. Since azide is a competitive inhibitor of the reverse reaction
      of bicarbonate dehydration, and since the zinc-bound azide nitrogen makes a non
      hydrogen-bonded van der Waals contact with the hydroxyl group of Thr199, it is
      possible that a zinc-bound bicarbonate oxyanion could likewise make a non
      hydrogen-bonded, van der Waals contact with the hydroxyl group of Thr199.
      Therefore, the donation of a hydrogen bond to Thr199 is not absolutely required
      for anion binding to tetracoordinate zinc.

PMID- 8477724
TI  - Arginine 53 is involved in head-group specificity of the active site of porcine
      pancreatic phospholipase A2.
AB  - The X-ray structure of a mutant porcine pancreatic phospholipase A2 inhibitor
      complex [Thunnissen et al. (1990) Nature 347, 689-691] has been determined. This
      structure shows several interactions between the sn-2-acyl chain and the
      phosphate moiety of the inhibitor at sn-3 and the protein. The interactions of
      the remaining part of the polar head group are less clear. Because Arg53 is in
      close proximity to the head group, we tested the importance of charge at position
      53 on enzymatic activity and specificity. Arg53 has been replaced by a glutamine
      and a glutamic acid in mutants R53Q and R53E, respectively. The effects of the
      mutations were tested with both zwitterionic and anionic substrates. With
      monomeric, zwitterionic, (R,S)-1,2-dihexanoyldithiopropyl-3-phosphocholine as
      substrate, the mutants R53Q and R53E display twofold and sevenfold, respectively,
      increased kcat/Km values, composed of increased kcat and decreased Km values.
      Tested on micelles of zwitterionic (R)-1,2-dioctanoylglycero-3-phosphocholine the
      mutants R53Q and R53E are more active than the native enzyme, whereas these
      mutations have an opposite effect on the activity on anionic (R)-1,2
      dioctanoylglycero-3-phosphoglycol. Thus, whereas the native enzyme is 0.3 times
      as active on zwitterionic as on the anionic substrate, these ratios are 1.0
      (R53Q) and 1.7 (R53E) for the mutants. No changes in activity were observed with
      the anionic substrate (R)-1,2-dioctanoylglycero-3-sulfate. Binding studies with
      substrate-derived inhibitors confirmed the increased affinity for zwitterionic
      phospholipids and the reduced affinity for anionic phospholipids. The kinetic and
      binding data indicate the involvement of the charge of residue 53 in head-group
      specificity and suggest a position of residue 53 closer to the choline or glycol
      than to the phosphate.

PMID- 8477725
TI  - Purification of a cytochrome b containing H2:heterodisulfide oxidoreductase
      complex from membranes of Methanosarcina barkeri.
AB  - The reduction of CoM-S-S-HTP, the heterodisulfide of coenzyme M (H-S-CoM) and N-7
      mercaptoheptanoylthreonine phosphate (H-S-HTP), with H2 is an energy-conserving
      step in methanogenic archaea. We report here that in Methanosarcina barkeri this
      reaction is catalyzed by a membrane-bound multienzyme complex, designated
      H2:heterodisulfide oxidoreductase complex, which was purified to apparent
      homogeneity. The preparation was found to be composed of nine polypeptides of
      apparent molecular masses 46 kDa, 39 kDa, 28 kDa, 25 kDa, 23 kDa, 21 kDa, 20 kDa,
      16 kDa, and 15 kDa and to contain 3.2 nmol cytochrome b, 70 to 80 nmol non-heme
      iron and acid-labile sulfur, 5 nmol Ni, and 0.6 nmol FAD per mg protein. The 23
      kDa polypeptide possessed heme-derived peroxidase activity indicating that this
      polypeptide is the cytochrome b. The purified H2:heterodisulfide oxidoreductase
      complex catalyzed the reduction of CoM-S-S-HTP with H2 at a specific activity of
      6 U/mg protein (1 U = 1 mumol.min-1), the reduction of benzylviologen with H2 at
      a specific activity of 66 U/mg protein and the reduction of CoM-S-S-HTP
      benzylviologen with H2 at a specific activity of 66 U/mg protein and the
      reduction of CoM-S-S-HTP HTP with reduced benzylviologen at a specific activity
      of 24 U/mg protein. The complex did not mediate the reduction of coenzyme F420
      with H2 nor the oxidation of reduced coenzyme F420 with CoM-S-S-HTP. The reduced
      cytochrome b in the enzyme complex could be oxidized by CoM-S-S-HTP and re
      reduced by H2. The specific rates of cytochrome oxidation and reduction were too
      high to be resolved under our experimental conditions. The findings suggest that
      the H2:heterodisulfide oxidoreductase complex is composed of a F420-non-reducing
      hydrogenase, a cytochrome b and heterodisulfide reductase and that cytochrome b
      is a redox carrier in the electron transport chain involved in CoM-S-S-HTP
      reduction with H2.

PMID- 8477726
TI  - Purification and properties of N5-methyltetrahydromethanopterin:coenzyme M
      methyltransferase from Methanobacterium thermoautotrophicum.
AB  - N5-Methyltetrahydromethanopterin:coenzyme M meth-yltransferase is an integral
      membrane protein found in methanogenic archaea. It catalyzes an energy-conserving
      step in methane formation from CO2 and from acetate. The enzyme from
      Methanobacterium thermoautotrophicum (strain Marburg) has been purified 30-fold
      to apparent homogeneity. The purified enzyme had an apparent molecular mass of
      670 kDa and was composed of seven different polypeptides of 34 kDa, 28 kDa, 24
      kDa, 23 kDa, 21 kDa, 13 kDa, and 12 kDa. The N-terminal amino acid sequences of
      these polypeptides were determined. The native 670-kDa enzyme was found to
      contain 7.6 mol 5-hydroxybenzimidazolyl cobamide/mol, 37 mol non-heme iron/mol
      and 34 mol acid-labile sulfur/mol. Cobalt analyses after sodium dodecyl
      sulfate/polyacrylamide gel electrophoresis revealed that the corrinoid was bound
      to the 23-kDa polypeptide. The apparent molecular masses of the polypeptides
      given above were determined by sodium dodecyl sulfate/polyacrylamide gel
      electrophoresis without boiling the samples prior to analysis. When the samples
      were boiled, as is usually done, the 23-kDa polypeptide changed its apparent
      molecular mass to 33 kDa and the 21-kDa, 24-kDa, and 28-kDa polypeptides formed
      aggregates. The specific activity (apparent Vmax) of the purified
      methyltransferase preparation was 11.6 mumol.min-1.mg protein-1. The apparent Km
      for N5-methyltetrahydromethanopterin was 260 microM and that for coenzyme M was
      60 microM. The preparation was absolutely dependent on the presence of Ti(III)
      for activity. ATP enhanced the activity 1.5-2-fold.

PMID- 8477727
TI  - Transcriptional control of AAC3 gene encoding mitochondrial ADP/ATP translocator
      in Saccharomyces cerevisiae by oxygen, heme and ROX1 factor.
AB  - The AAC3 gene of Saccharomyces cerevisiae encodes a mitochondrial ADP/ATP
      translocator which is subject to oxygen repression. Evidence is presented here,
      that the repression of AAC3 expression is dependent upon heme and the ROX1
      factor. The promoter region of the AAC3 gene was isolated, sequenced, and
      deletion analysis was performed using lacZ as a reporter gene to determine the
      cis-acting regions responsible for the regulation of AAC3 expression. The results
      of the deletion analysis show that the negative control of the AAC3 gene by
      oxygen and ROX1 factor is mediated by an upstream repression sequence consisting
      of a T-rich segment adjacent to the consensus elements that are present in the 5'
      flanking regions of several other yeast genes. An additional upstream repressor
      site was located within the AAC3 promoter which, however, is not related either
      to oxygen or to ROX1 factor. The data presented here delineate the main cellular
      factors and DNA sequences involved in the regulatory mechanism by which an
      essential function for anaerobic cells growth, ADP/ATP translocation, is ensured.
      In addition, they show that the AAC3 gene belongs to the family of yeast genes
      including TIF51B, COX5b, HEM13 and CYC7 that are negatively regulated by oxygen
      and heme.

PMID- 8477728
TI  - Enzymes of anaerobic metabolism of phenolic compounds. 4-Hydroxybenzoate-CoA
      ligase from a denitrifying Pseudomonas species.
AB  - The initial step of anaerobic 4-hydroxybenzoate and 3-hydroxybenzoate degradation
      was studied in a denitrifying Pseudomonas sp. 4'-Hydroxybenzoate and 3
      hydroxybenzoate are converted into their coenzyme A (CoA) thioesters by two
      different specific coenzyme A ligases. 4-Hydroxybenzoate-CoA ligase (AMP-forming)
      was purified 350-fold. The ligase is active as a monomer of molecular mass 48
      kDa, as determined by gel filtration and SDS/PAGE. At a pH optimum of 8.5, the
      apparent Km values for 4-hydroxybenzoate, ATP, and coenzyme A are 37 microM, 77
      microM, and 125 microM, respectively. The enzyme reacts specifically with 4
      hydroxybenzoate (100%) and 4-aminobenzoate (30%). Other analogues of benzoate,
      notably 3- or 2-hydroxybenzoate, are inactive, and 2,4-dihydroxybenzoate and 2
      hydroxy-4-methylbenzoate act as competitive inhibitors (Ki = 1 microM).
      Polyclonal antibodies were raised and used in immunoblot assays to study the
      regulation of the expression of 4-hydroxybenzoate-CoA ligase. The ligase is
      synthesized when cells are grown anaerobically with 4-hydroxybenzoate, phenol, or
      p-cresol; phenol and p-cresol are degraded via 4-hydroxybenzoate. The enzyme is
      not present in cells grown aerobically with 4-hydroxybenzoate or anaerobically
      with benzoate or 4-hydroxyphenylacetate.

PMID- 8477729
TI  - Enzymes of anaerobic metabolism of phenolic compounds. 4-Hydroxybenzoyl-CoA
      reductase (dehydroxylating) from a denitrifying Pseudomonas species.
AB  - The reductive removal of aromatic hydroxyl functions plays an important role in
      the anaerobic metabolism of many phenolic compounds. We describe a new enzyme
      from a denitrifying Pseudomonas sp., 4-hydroxybenzoyl-CoA reductase
      (dehydroxylating), which reductively dehydroxylates 4-hydroxybenzoyl-CoA to
      benzoyl-CoA. The enzyme plays a role in the anaerobic degradation of phenol, 4
      hydroxybenzoate, p-cresol, 4-hydroxyphenylacetate, and other aromatic compounds
      of which 4-hydroxybenzoyl-CoA is an intermediate. The enzyme is therefore induced
      only under anoxic conditions with these aromatic substrates, but not with
      benzoate or under aerobic conditions. A similar enzyme which reductively
      dehydroxylates 3-hydroxybenzoyl-CoA is induced during anaerobic growth with 3
      hydroxybenzoate. The soluble enzyme 4-hydroxybenzoyl-CoA reductase was purified.
      It has a molecular mass of 260 kDa and consists of three subunits of 75, 35, and
      17 kDa. The subunit composition is likely to be a2b2c2. The enzyme contains 12
      mol iron/mol and 12 mol acid-labile sulfur/mol and exhibits a typical
      ultraviolet/visible spectrum of an iron-sulfur protein. The reaction requires a
      reduced electron donor such as reduced viologen dyes; no other co-catalysts are
      required, the product is benzoyl-CoA and oxidized dye. The reductase is rapidly
      inactivated by oxygen. The inactivation by low concentrations of cyanide or azide
      in a pseudo-first-order time course suggests that it may contain a transition
      metal in an oxidation state which reacts with these ligands. 4-Hydroxybenzoyl-CoA
      reductase represents a type of enzyme which is common in anaerobic aromatic
      metabolism of phenolic compounds. A similar enzyme is demonstrated in
      Rhodopseudomonas palustris anaerobically grown with 4-hydroxybenzoate. The
      biological significance of reductive dehydroxylation of aromatics and a possible
      reaction mechanism similar to the Birch reduction are discussed.

PMID- 8477730
TI  - Troponin-C mutants with increased calcium affinity.
AB  - Binding of two Ca2+ to the regulatory sites I and II of troponin C (TnC) induces
      a conformational transition believed to be responsible for the activation of
      muscle contraction. Based on the known crystal structure (2Ca2+ state), a model
      for the transition to the 4Ca2+ state has been proposed [Herzberg, O., Moult, J.
      & James, M. N. G. (1986) J. Biol. Chem. 261, 2638-2644]. The proposed
      conformational transition predicts that during Ca2+ binding a number of nonpolar
      residues become exposed to the solvent, creating a hydrophobic patch. Such a
      model implies that mutation of the hydrophobic to polar residues should increase
      the Ca2+ affinity at the regulatory sites and reduce the Ca2+ concentration
      necessary for muscle activation. To test this prediction, we have constructed and
      functionally characterized two troponin-C mutants (V45T and M48A mutations).
      Direct calcium-binding measurements in the mutants demonstrate an increase in the
      Ca2+ affinity for two low-affinity sites. Replacement of endogenous troponin C in
      skinned muscle fibers by TnC with mutations V45T or M48A increased the Ca2+
      sensitivity of their tension development. These results show that the model can
      be used to construct mutants that regulate muscle contraction at lower Ca2+
      concentrations. They provide further experimental support for the proposed
      calcium-induced conformational change of troponin C and suggest that the
      predicted transition plays a central role in the activation of the thin filament.

PMID- 8477731
TI  - Amino acid sequence of Coprinus macrorhizus peroxidase and cDNA sequence encoding
      Coprinus cinereus peroxidase. A new family of fungal peroxidases.
AB  - Sequence analysis and cDNA cloning of Coprinus peroxidase (CIP) were undertaken
      to expand the understanding of the relationships of structure, function and
      molecular genetics of the secretory heme peroxidases from fungi and plants. Amino
      acid sequencing of Coprinus macrorhizus peroxidase, and cDNA sequencing of
      Coprinus cinereus peroxidase showed that the mature proteins are identical in
      amino acid sequence, 343 residues in size and preceded by a 20-residue signal
      peptide. Their likely identity to peroxidase from Arthromyces ramosus is
      discussed. CIP has an 8-residue, glycine-rich N-terminal extension blocked with a
      pyroglutamate residue which is absent in other fungal peroxidases. The presence
      of pyroglutamate, formed by cyclization of glutamine, and the finding of a minor
      fraction of a variant form lacking the N-terminal residue, indicate that signal
      peptidase cleavage is followed by further enzymic processing. CIP is 40-45%
      identical in amino-acid sequence to 11 lignin peroxidases from four fungal
      species, and 42-43% identical to the two known Mn-peroxidases. Like these white
      rot fungal peroxidases, CIP has an additional segment of approximately 40
      residues at the C-terminus which is absent in plant peroxidases. Although CIP is
      much more similar to horseradish peroxidase (HRP C) in substrate specificity,
      specific activity and pH optimum than to white-rot fungal peroxidases, the
      sequences of CIP and HRP C showed only 18% identity. Hence, CIP qualifies as the
      first member of a new family of fungal peroxidases. The nine invariant residues
      present in all plant, fungal and bacterial heme peroxidases are also found in
      CIP. The present data support the hypothesis that only one chromosomal CIP gene
      exists. In contrast, a large number of secretory plant and fungal peroxidases are
      expressed from several peroxidase gene clusters. Analyses of three batches of CIP
      protein and of 49 CIP clones revealed the existence of only two highly similar
      alleles indicating less peroxidase polymorphism in C. cinereus strains than
      observed in plants and white-rot fungi.

PMID- 8477732
TI  - Responses of metabolic systems to large changes in enzyme activities and
      effectors. 1. The linear treatment of unbranched chains.
AB  - This first paper in a series investigates the problem of predicting and analysing
      the effects of large changes in enzyme activities or external nutrients/effectors
      on metabolic fluxes. We introduce the concept of a deviation index, D, which
      gives a measure of the relative change in a metabolic variable (e.g. flux) due to
      a large (non-infinitesimal) relative change in a parameter (e.g. enzyme). Using
      simplifying kinetic assumptions we have found, for an unbranched metabolic chain,
      a direct relationship between deviation indices and flux control coefficients.
      This relationship provides a method to estimate flux control coefficients using a
      single large change in enzyme activity. We also provide a method of predicting
      the effects of, for example, DNA manipulation or other techniques for enzyme
      activity/concentration changes on metabolic fluxes. Up-modulations of single
      enzymes rarely produce significant changes in fluxes. We show that combined
      changes of activity of a group of enzymes will produce a more than 'additive'
      response. We provide a method of predicting the effects of these combined
      changes, given either the flux control coefficients of the group of enzymes or
      the effects on the flux of changing the enzymes individually. A similar analysis
      is carried out for large changes in external nutrients or effectors. These
      amplification factors, f, give experimentally accessible estimates of the
      expected changes in metabolic variables. We provide three 'case studies' to
      illustrate our results.

PMID- 8477733
TI  - Responses of metabolic systems to large changes in enzyme activities and
      effectors. 2. The linear treatment of branched pathways and metabolite
      concentrations. Assessment of the general non-linear case.
AB  - We extend the analysis of unbranched chains (preceding paper) to large parameter
      changes in branched systems using linear kinetic assumptions. More complex
      relationships between flux control coefficients and deviation indices are
      established. In particular, the deviation index in such systems depends on more
      than one control coefficient as well as on the magnitude of the enzyme change.
      Non-additivity of the indices is the general rule. Combined changes of groups of
      enzymes, whether co-ordinate or not, have also been formulated. Control
      coefficients can be estimated from a small number of independent large-change
      experiments. Alternatively, the amplification factors can be calculated given the
      knowledge of the control coefficients. A 'case study' using published data is
      presented. The movement of intermediate metabolites as a consequence of large
      parameter changes can be dealt with in a similar manner. Experimental methods for
      showing the admissibility of assuming the simplifying assumptions used are
      summarised. Some simulation studies show possible limits of the application of
      the approach and some aspects of the general, non-linear, case are discussed. It
      is concluded that, although metabolic systems are in principle non-linear, many
      behave, in practice, as quasi-linear systems. The relationships established
      between deviation indices and control coefficients therefore provide a practical
      way of predicting the effects of large-scale changes in parameters for many
      metabolic systems.

PMID- 8477734
TI  - Substrate interactions between trypanothione reductase and N1
      glutathionylspermidine disulphide at 0.28-nm resolution.
AB  - The enzyme trypanothione reductase has been identified as a prime target for the
      rational design of inhibitors which may have clinical use in the treatment of
      tropical diseases caused by the genera Trypanosoma and Leishmania. To aid the
      design or identification of new inhibitors of this enzyme we have elucidated the
      structural detail of a trypanothione reductase complexed with one of the
      naturally occurring substrates, N1-glutathionylspermidine disulphide, by single
      crystal X-ray diffraction methods at 0.28-nm resolution. The model for the
      Crithidia fasciculata enzyme-substrate complex has an R-factor of 14.8% and root
      mean-square deviations of 0.0015 nm and 3.3 degrees on bond lengths and angles
      respectively. Hydrogen bonding and van der Waals interactions between the enzyme
      and substrate are dominated by the amino acid side chains. The substrate binds in
      a rigid active site such that one glutathione moiety is in a V-shape, the other
      in an extended conformation. One spermidine moiety binds closely to a hydrophobic
      patch in the active site formed by a tryptophan and a methionine. Distances
      between the methionine S delta and the terminal N of this spermidine suggest that
      a hydrogen bond may supplement the hydrophobic interactions in this part of the
      active site.

PMID- 8477735
TI  - The structure of the gene encoding chicken ribosomal protein L37a.
AB  - The nucleotide sequence of the gene encoding chicken ribosomal protein L37a was
      determined. The gene was 2626 bp long and distributed in four exons and three
      introns. The transcription initiation site is located at a cytidine residue in a
      tract of 16 pyrimidines flanked by (G + C)-rich regions. Neither canonical TATA
      nor the CAAT box was found in the 5'-flanking region. The region from nucleotides
      -78 to -35 was shown to be important for promoter activity and also to be a
      binding site for nuclear proteins. This region contains two copies of the
      sequence [sequence: see text] that is common to many ribosomal protein genes of
      higher eukaryotes.

PMID- 8477736
TI  - Channelling can affect concentrations of metabolic intermediates at constant net
      flux: artefact or reality?
AB  - We show that if a metabolic intermediate is directly transferred ('channelled')
      from an enzyme that catalyses its production to another that uses it as
      substrate, there is no change in its free concentration compared with a system
      with the same net flux in which there is no direct transfer. Thus the widespread
      idea that channelling provides a mechanism for decreasing metabolite
      concentrations at constant flux is false. Results from computer simulation that
      suggest otherwise [Mendes, P., Kell, D. B. & Westerhoff, H. V. (1992) Eur. J.
      Biochem. 204, 257-266] are artefacts either of variations in flux or of
      alterations in opposite directions of the activities of the relevant enzymes.

PMID- 8477737
TI  - Functional expression and characterization of a Xenopus laevis peptidylglycine
      alpha-amidating monooxygenase, AE-II, in insect-cell culture.
AB  - The alpha-amidating reaction of peptide hormones is a two-step process which is
      catalyzed by peptidylglycine alpha-hydroxylating monooxygenase (PHM) and
      peptidylhydroxyglycine N-C lyase (PHL). There are three types of mRNA for these
      amidating enzymes in Xenopus laevis, namely AE-I, AE-II and AE-III. AE-I encodes
      only PHM and AE-III encodes both PHM and PHL. AE-II seems to encode subtypes of
      both PHM and PHL. While AE-II mRNA is present in high amounts in frog skin, the
      actual enzymes originating from AE-II have not been detected. When we expressed
      AE-II in cultured insect-cells using the baculovirus expression vector system,
      the expressed enzyme was specifically localized to the membrane fraction due to
      its hydrophobic transmembrane domain. Alternatively, when the transmembrane
      domain-deleted AE-II (Met1-Ile731) was expressed, the enzyme was secreted into
      the culture medium; this secreted enzyme was purified to homogeneity by a simple
      two-step procedure. We have verified that the reaction product of the purified
      enzyme was the amidated peptide, indicating that AE-II has the ability to
      catalyze the entire amidating reaction.

PMID- 8477738
TI  - Intron-exon structure, alternative use of promoter and expression of the mouse
      collagen X gene, Col10a-1.
AB  - The entire mouse collagen X gene (Col10a-1) has been isolated. The gene is
      composed of three exons and two introns spanning 7.0 kb of the DNA sequence.
      Exons 2 and 3 together encode 15-bp of 5' untranslated sequence, a 2040-bp open
      reading frame and an 895-nucleotide 3' non-coding region. In the 5' flanking
      region of the gene, two consensus TATA-box sequences were found. Identification
      of the first exon by ribonuclease-protection assays and the determination of the
      5' end of Col10a-1 mRNA transcripts by primer-extension analyses show that the
      more 3' TATA box is probably predominantly used and that there are at least three
      transcription start sites in the exon 1 sequence 3' to this, resulting in 5'
      untranslated regions of 78, 77 and 55 nucleotides. By means of rapid
      amplification of cDNA ends by polymerase chain reaction, an additional mRNA
      species was detected which overlapped the other Col10a-1 transcripts, including
      the 3' TATA box sequence, giving a 5' untranslated sequence of approximately 235
      bases. This latter transcript starts approximately 20 bp 3' to the more 5' TATA
      box. The data suggest alternative use of promoters and transcription starts for
      the Col10a-1 gene. Comparison of the combined nucleotide and deduced amino acid
      sequences of exons 2 and 3 with chicken, bovine and human collagen X genes,
      showed a high degree of similarity indicating conservation of this gene
      throughout evolution. Mouse Col10a-1 mRNA was shown to be approximately 3.0 kb
      and the pepsinized protein, as detected by SDS/PAGE, was approximately 45 kDa.
      The mRNA and protein sizes correlate with that predicted by the open reading
      frame. Reverse-transcription polymerase chain reaction assays indicate that the
      mouse collagen X gene is first expressed at 13.5 days post coitum, temporally
      preceding the onset of endochondral ossification. In agreement with the generally
      accepted association of type-X collagen with endochondral ossification, in situ
      hybridization analyses indicate that Col10a-1 mRNA are restricted to the
      hypertrophic regions of growth cartilage.

PMID- 8477739
TI  - The primary structures and properties of non-stomach lysozymes of sheep and cow,
      and implication for functional divergence of lysozyme.
AB  - Lysozymes were purified from the homogenate of cow and sheep kidneys, and their
      amino-acid sequences as well as some enzymic properties were determined. Like
      most mammalian lysozymes both sheep and cow kidney lysozymes are composed of 130
      amino acids. The sequences of these two lysozymes are the most similar to each
      other (95% identity), the second most similar to the conventional mammalian
      lysozymes like human, rat and rabbit lysozymes (74-85% identity), and much less
      similar to their own stomach lysozymes (65-70% identity). Cow kidney lysozyme is
      also different from cow milk lysozyme (partial sequence), indicating that cow
      contains at least three kinds of chicken type lysozymes, that is kidney, milk and
      stomach lysozymes. The activities of cow and sheep kidney lysozymes were 3% and
      29% against Micrococcus luteus at pH 7.0, ionic strength of 0.1 and 30 degrees C,
      and 57% and 84% against glycol chitin at pH 5.5 and 40 degrees C, which were
      expressed as percentages relative to hen lysozyme. The net charges of cow and
      sheep lysozymes at pH 7 were less positive (+1.5 and +2.5, respectively) than
      human and hen lysozymes (both +8.0) and rather close to the stomach ones (-2 to
      0). The decreased net positive charge observed in cow and sheep kidney lysozymes
      may suggest that the ruminant kidney lysozyme had functioned once as a digestive
      enzyme in the stomach of an ancestral ruminant.

PMID- 8477740
TI  - Identification of novel phosphorylation sites in murine A-type lamins.
AB  - We report the distribution of phosphorylation sites in murine lamins A and C (A
      type lamins) in vitro and in vivo followed by reverse-phase high-performance
      liquid chromatography and microsequencing of peptides spanning the almost
      complete lamin sequence. We show that two distinct protein kinases, cell-division
      cycle-2 kinase (cdc2 kinase) and protein kinase C (PKC), phosphorylate murine A
      type lamins at the non-alpha-helical amino- and carboxy-terminal domains in vitro
      and in vivo. Cdc2 kinase, but not PKC, is capable of inducing depolymerization of
      the nuclear lamina in permeabilized cells. Accordingly, lamins were proposed to
      be direct in vivo substrates of cdc2 kinase and PKC with different effects on the
      lamina dynamics. Analysis of the original A-type lamins revealed phosphorylation
      of residues Ser5 and Ser392. Residue Ser392 was substoichiometrically
      phosphorylated in the substrate and by cdc2 kinase in vitro. PKC phosphorylated
      peptides with its kinase-specific motifs surrounding Ser5, Thr199, Thr416, Thr480
      and Ser625. In vivo, a mitosis-specific phosphorylation at the cdc2-kinase
      specific phosphoacceptor site Ser392 and of the N-terminal peptide was
      identified. An interphase-specific phosphorylation at Ser525 matching the PKC
      consensus sequence and of peptides phosphorylated by unknown kinases was
      determined. The results lead us to propose that different cyclin-dependent kinase
      activities act as lamin kinases in mitosis and in interphase. Other kinases may
      cooperate with cdc2 kinase during reversible disassembly in mitosis and may
      modulate the supramolecular assembly of lamin filaments.

PMID- 8477741
TI  - Orthorhombic crystal structure of the A-DNA octamer d(GTACGTAC). Comparison with
      the tetragonal structure.
AB  - The X-ray crystal structure of the double-helical A-DNA octanucleotide
      d(GTACGTAC) has been solved by molecular replacement and refined to a resolution
      of 0.219 nm. The final R-factor is equal to 16.1% for 1516 observed reflections
      with F > 4 sigma(F). The sequence crystallizes as an A-DNA-type double helix in
      the orthorhombic space group P2(1)2(1)2, with one duplex molecule solvated by 66
      water molecules in the asymmetric unit. Cell parameters are a = 3.860 nm, b =
      5.082 nm, c = 2.174 nm. It is the first time that such a crystal form has been
      observed. This orthorhombic structure has been compared with the tetragonal
      structure of the same oligonucleotide. It adopts a bent structure with an unusual
      packing between symmetry-related molecules.

PMID- 8477742
TI  - Identification of a new family of human epithelial protein kinases containing two
      leucine/isoleucine-zipper domains.
AB  - Using the polymerase chain reaction to study mRNA expressed in human epithelial
      tumor cells, a member of a new family of protein kinases was identified. The
      catalytic domain of this kinase has amino-acid-sequence similarity to both the
      Tyr-specific and the Ser/Thr-specific kinase classes. Clones representing two
      members of this new family have been isolated from a human colonic epithelial
      cDNA library and sequenced. The predicted amino-acid sequences of these clones
      reveal that, in addition to the unusual nature of their kinase catalytic domains,
      they contain two Leu/Ile-zipper motifs and a basic sequence, near their C
      termini. As they possess domains associated with proteins from two distinct
      functional groups, these kinases have been named mixed-lineage kinases (MLK) 1
      and 2. mRNA from MLK1 has been found to be expressed in epithelial tumor cell
      lines of colonic, breast and esophageal origin. The MLK1 gene has been mapped to
      human chromosome 14q24.3-31.

PMID- 8477743
TI  - Fluorescent and biotinylated linear peptides as selective bifunctional ligands
      for the V1a vasopressin receptor.
AB  - We have designed and synthesized a linear peptide analogue of arginine
      vasopressin. This peptide, [1-phenylacetyl, 2-O-methyl-D-tyrosine, 6-arginine, 8
      arginine, 9-lysinamide]vasopressin (PhAcALVP), has a lysinamide residue
      substituted for the more usual glycinamide at position 9. Derivatization of
      PhAcALVP at the N epsilon-lysyl amino group with N-hydroxysuccinimide esters of
      aminomethylcoumarin (Mec) and biotin (Btn) produced the bifunctional ligands
      PhAcAL(Mec)VP and PhAcAL(Btn)VP, respectively. Pharmacological characterization
      of these peptides revealed that all were high-affinity V1a-selective antagonists.
      PhAcAL(Btn)VP can simultaneously bind to both the rat liver V1a receptor and
      avidin conjugates. Using this strategy, we were able to study the distribution of
      V1a receptors on the surface of the rat mammary tumour cell line, WRK-1. Routine
      epifluorescent microscopy and confocal image analysis were used to observe the
      distribution of avidin-Texas-Red associated with receptor-bound PhAcAL(Btn)VP. We
      conclude that PhAcALVP is a useful precursor for the production of hetero
      bifunctional V1a-selective ligands. Both PhAcAL(Mec)VP and PheAcAL(Btn)VP can be
      used selectively to probe the V1a receptor and will be versatile tools for a
      variety of histocytochemical applications, including receptor localization and
      purification.

PMID- 8477744
TI  - Conversion of fructose to glucose in the rabbit small intestine. A reappraisal of
      the direct pathway.
AB  - Gopher et al [Gopher, A., Vaisman, N., Mandel, H. & Lapidot, A. (1990) Proc. Natl
      Acad. Sci. USA 87, 5449-5453] recently reported that about 50% of the glucose
      formed from [U-13C]fructose infused nasogastrically in children contained 13C3
      adjacent to 13C4. Assuming a high isotopic dilution of the triosephosphate pool,
      the authors concluded that about 50% of the fructose converted to glucose in
      liver and intestine bypassed the classical aldolase pathway, utilizing a
      hypothetical direct pathway that would involve the phosphorylation of fructose 1
      phosphate to fructose 1,6-bisphosphate. The present work was undertaken in order
      to establish to what extent the conversion of fructose to glucose in the
      intestine could account for this unexpected isotopic distribution. The technique
      of everted sleeves was used to define the rate of conversion of [U-14C]glucose
      and [U-14C]fructose in the small intestine of 24-h-fasted rabbits. It appeared
      that, at the low concentration of fructose used by Gopher et al., almost as much
      fructose was converted to glucose as remained unmodified in the tissue. Fructose
      uptake was not inhibited by glucose, and the presence of all the necessary
      enzymes in the tissue indicated that the fructose to glucose conversion occurred
      by the aldolase pathway. Remarkably, this conversion operated with an isotopic
      dilution not exceeding 25%, due to the low rate of glucose metabolism and the
      near absence of gluconeogenesis from lactate. It can, therefore, be postulated
      that, in the presence of pure [U13C]fructose, the triosephosphate pool is highly
      enriched in 13C with little dilution by 12C, essentially giving rise to [U
      13C]glucose, as reported by Gopher et al. There is, therefore, no need to
      postulate the participation of a direct pathway.

PMID- 8477745
TI  - Vigilin is a cytoplasmic protein. A study on its expression in primary cells and
      in established cell lines of different species.
AB  - A fusion protein composed of about two vigilin domains and beta-galactosidase was
      used to raise polyclonal antibodies which were affinity-purified and employed for
      immunoblotting and immunohistochemistry. A protein of an apparent molecular mass
      of 155 kDa could be stained in extracts of a variety of cells from different
      species and organs. Immunohistological studies on single cells showed that
      vigilin is accumulated in the cytoplasm. During in vitro maintenance of primary
      cell cultures, as well as of a growth-factor-dependent cell line, vigilin
      expression decreases and ceases in senescent cells. In contrast, vigilin is
      constitutively expressed in all other transformed cell lines of various origin
      studies so far. Vigilin expression can be induced in peripheral blood lymphocytes
      by mitogen stimulation. These observations suggest an involvement of vigilin in
      processes of cell activation. Immunoblot experiments demonstrating the presence
      of vigilin in a broad range of eukaryotes, indicate a high degree of evolutionary
      conservation.

PMID- 8477746
TI  - Crystal structure of apo-neocarzinostatin at 0.15-nm resolution.
AB  - The three-dimensional structure of apo-neocarzinostatin, an antitumour antibiotic
      protein isolated from Streptomyces carzinostaticus, has been determined by X-ray
      diffraction at 0.15-nm resolution and refined to R = 17.2%. The crystal structure
      of neocarzinostatin is similar to that of the related proteins actinoxanthin and
      macromomycin. It is also in good agreement with the solution structure determined
      by NMR spectroscopy. The protein molecule consists of a seven-stranded
      antiparallel beta-sandwich and a smaller lobe formed by two beta-ribbons. A deep
      cleft between the two lobes is a putative chromophore binding site. Side chains
      of Trp39, Leu45, Phe52, Phe78 and the disulphide Cys37-Cys47 aligning the binding
      cleft in neocarzinostatin suggest the importance of hydrophobic interactions in
      stabilizing the chromophore molecule. Comparison of the atomic models of
      neocarzinostatin, actinoxanthin and macromomycin reveals functional residues
      which might determine specificity towards different chromophores.

PMID- 8477747
TI  - Functional domains in the Escherichia coli release factors. Activities of hybrids
      between RF-1 and RF-2.
AB  - Chimeras between Escherichia coli release factors RF-1 and RF-2 have been
      constructed to study the role of the release factors in termination, in
      particular whether each possesses specific domains for recognition of the stop
      codon, and for facilitating peptidyl-tRNA hydrolysis. One hybrid factor showed
      normal codon-recognition activity but was defective in its ability to facilitate
      hydrolysis. Overexpression of this protein was toxic to the cell. Conversely,
      another hybrid factor showed complete loss of codon recognition but retained some
      hydrolysis activity. These two functional activities of the release factors were
      not localised in domains within either the amino-terminal or carboxy-terminal
      halves of the primary sequence as previously predicted. Evidence from the
      activities of the hybrid proteins and from earlier studies suggests that a
      combination of residues from the beginning and middle of the sequence, including
      a region of very high sequence conservation, contribute to the hydrolysis domain,
      whereas residues from both the amino-terminal and carboxy-terminal halves of the
      molecule are important for the codon recognition domain.

PMID- 8477748
TI  - Are there different water requirements in different steps of a catalytic cycle?
      Hydration effects at the E1 and E2 conformers of sarcoplasmic reticulum Ca(2+)
      ATPase studied in organic solvents with low amounts of water.
AB  - The Ca(2+)-ATPase from sarcoplasmic reticulum was transferred in an active form
      to a low-water system composed of toluene, phospholipids, and Triton X-100 (TPT).
      The Ca(2+)-ATPase activity in the TPT system with 4.0% water (by vol. was about
      50% of the activity observed in all-aqueous mixtures. Phosphate formation was
      linear with time up to 20% of ATP hydrolysis and, as expected from an enzyme
      catalysed reaction, activity was linear with protein concentration. No ATPase
      activity was detected in the presence of 3 mM EGTA, indicating that the enzyme
      retained its Ca2+ dependence in the TPT system. A hyperbolic response to ATP
      concentration was observed with a Km of 0.15 mM. There was no detectable ATPase
      activity at water concentrations below 1.5% (by vol.). With 2.0% water, activity
      became detectable and increased as the water content was progressively raised to
      7.0% (by vol.). Higher amounts of water produced unstable emulsions. Enzyme
      phosphorylation by ATP and dephosphorylation took place in the TPT system. The
      velocities of both enzyme phosphorylation and dephosphorylation increased with
      increments in the water content. The enzyme could also be phosphorylated in the
      TPT system by inorganic phosphate. However, in comparison to ATP, phosphorylation
      by phosphate took place with significantly lower amounts of water. It is
      suggested that at low amounts of water, the enzyme is in a relatively rigid
      conformation and, as the water content is increased, the ATPase acquires more
      flexibility and, hence, the capacity to carry out catalysis at higher rates.
      Nevertheless, the release of conformational constraints of the catalytic site of
      the E2 conformer takes place at water concentrations much lower than those needed
      for the expression of catalytic activity by the E1 conformer.

PMID- 8477749
TI  - The action of Trypanosoma cruzi trans-sialidase on glycolipids and glycoproteins.
AB  - Addition of sialic acid residues in the human pathogen Trypanosoma cruzi
      glycoconjugates is mediated by a trans-sialidase and not by a CMP-sialic
      acid:glycoconjugate sialyltransferase. Incubation of trans-sialidase with N
      [galactose-14C]acetyllactosamine and O-linked oligosaccharides, N-linked
      glycopeptides (both obtained from fetuin) or sialyllactose showed that the last
      three compounds were donors of sialic acid residues to the first one. Moreover, N
      and O-linked oligosaccharides in asialofetuin and asialomucin, respectively,
      served as acceptors of sialic acid units. Gangliosides GM3, GD1a and GT1b but not
      GM2, GM1a nor GD1b donated sialic acid units to N-acetyllactos amine when
      incubated with trans-sialidase. This showed that only sialic acid units bound to
      terminal galactosyl residues were transferred. GM1a was converted to GD1a, and
      GD1b to GT1b when incubated with the appropriate donor. The fact that asialo-GM1a
      was converted to a ganglioside migrating as GD1a on thin-layer chromatography
      suggested that sialic acid units may be transferred to internal galactosyl
      residues, although once linked to those residues they can not be further
      transferred to other glycoconjugates. Sialic acid residues linked alpha 2,3- but
      not alpha 2,6- or alpha 2,8- were transferred by the trans-sialidase. Methyl beta
      galactoside but not methyl alpha-galactoside served as acceptor of sialic acid
      units, thus suggesting that terminal alpha-linked galactosyl units in T. cruzi
      and mammalian glycoproteins are not sialylated by the enzyme. As the trans
      sialidase employed in these experiments has been shown to be located on the
      external surface of the parasite and to be shed to the medium, the relatively
      broad specificity shown by the enzyme with respect to protein- and lipid-linked
      oligosaccharides strongly suggests that infection by T. cruzi might alter the
      sialic acid distribution in glycoproteins and glycolipids of the mammalian host.

PMID- 8477750
TI  - CaBP2 is a rat homolog of ERp72 with proteindisulfide isomerase activity.
AB  - Ca-binding protein 2 (CaBP2) has been described previously as an intracisternal
      calcium-binding microsomal glycoprotein. We report now the primary sequence of
      this protein as deduced from the corresponding cDNA. The protein possesses a C
      terminal -KEEL retention sequence and three repeats of the thioredoxin-like
      motive -EFYAPNCGHCK-, and represents the rat homolog of ERp72. In contrast to
      earlier reports on ERp72, CaBP2 possesses significant proteindisulfide isomerase
      activity. Furthermore, in contrast to ERp72, CaBP2 is a glycoporotein containing
      O-linked glycans. The amount of CaBP2 in H-35 Reuber hepatoma cells increases in
      parallel with that of immunoglobin heavy-chain-binding protein under conditions
      which lead to impaired glycosylation, while the amount of calreticulin, another
      KDEL-containing glycoprotein, remains almost unchanged.

PMID- 8477751
TI  - Crude liver membrane fractions and extracellular matrix components as substrata
      regulate differentially the preservation and inducibility of cytochrome P-450
      isoenzymes in cultured rat hepatocytes.
AB  - The influence of cell-substrata interactions on the preservation of basal or in
      vivo-induced microsomal cytochrome P-450 isoenzyme contents in cultured rat
      hepatocytes and on the adaptive responses after exposure to phenobarbital or 3
      methylcholanthrene in vitro, was investigated. Hepatocytes from untreated or
      phenobarbital-treated rats were cultured in serum-free, aprotinin-supplemented
      culture medium in 96-well microtiter plates coated with collagen type I (COL),
      laminin, fibronectin or crude liver membrane fractions/collagen type I (CMF/COL).
      Basal cell functions were characterized by measuring the total protein content
      and lactate dehydrogenase release. The relative contributions of CYP1A1/2,
      CYP2B1/2, CYP2C6, CYP2C11, CYP3A and CYP4A isoenzymes were determined with ELISA
      using monoclonal antibodies raised against purified cytochromes P-450 from rat
      liver microsomes. The characterization of the CMF revealed that contaminations
      with mitochondria, nuclei and lysosomes are relatively low. Among these,
      membranes derived from the endoplasmic reticulum appeared to be the major
      organelle contaminant of the CMF. The matrix components laminin, fibronectin and
      collagen type IV were found in appreciable amounts. Hepatocytes from untreated
      rats, cultured for up to nine days on CMF/COL-coated plates, retained their
      relative cytochrome P-450 contents at 1.5-3-fold higher levels when compared to
      cells cultured on COL, fibronectin or laminin. Similarly, hepatocytes from
      phenobarbital-treated rats preserved the contents of barbiturate-inducible
      CYP2B1/2 and CYP3A proteins best when cultured on CMF/COL. After exposure of
      hepatocytes cultured on CMF/COL to phenobarbital from days 3-6, CYP3A proteins
      were enhanced more than twofold and CYP2B1/2, depending on the exposure level,
      increased 1.3-6-fold. After exposure to 3-methylcholanthrene, a threefold
      increase of CYP1A proteins was found in CMF/COL and laminin cultures. These
      results indicate that CMF/COL, as a substratum in rat hepatocyte cultures,
      regulates gene expression of cytochromes P-450 isoenzymes for up to 9 days and
      provides a matrix which enables the cells to respond qualitatively similar to the
      response observed in different zones of the liver. This activity cannot be
      replaced by single-matrix components.

PMID- 8477752
TI  - High-mobility-group (HMG) proteins and histone H1 subtypes expression in normal
      and tumor tissues of mouse.
AB  - Exhaustive extraction of mouse tissues with perchloric acid has been used
      together with reverse-phase HPLC and electrophoresis to quantify the amounts of
      chromosomal proteins HMG17, HMG14 and HMGI, relative to histone H1. Normal lung
      and thymus contain approximately 3% HMG17/HMG14 but only approximately 2% HMGI.
      In tumor tissues (Lewis lung carcinoma and lymphoma NQ35), the amount of
      HMG17/HMG14 is not greatly altered but HMGI levels rise considerably, reaching
      10% in Lewis lung carcinoma. HMGI synthesis does not replace HMG17/HMG14
      proteins, suggesting that HMGI proteins contribute to the structure of chromatin
      regions in a manner distinct from those of HMG17/HMG14. Ion-spray mass
      spectrometry has been used to determine the molecular masses of H1 subtypes from
      the same four mouse tissues. In addition to the six known species H1 zero, H1a,
      H1b, H1c, H1d and H1e, a newly defined subtype of mass 21,756 Da from Lewis lung
      carcinoma, named H1L was identified. Several phosphorylated H1 subtypes have also
      been defined by mass spectrometry. The combined use of reverse-phase HPLC and
      electrophoresis permitted quantification of these seven histone H1 subtypes in
      the four mouse tissues. Increased phosphorylation of H1 subtypes in tumors
      parallels the phosphorylation of HMGI proteins which are present in great
      amounts, showing that both are involved as post-translational-modified forms in
      the structure of the chromatin of neoplastic systems.

PMID- 8477753
TI  - Natural cycloheximide resistance in yeast. The role of ribosomal protein L41.
AB  - The yeast Kluyveromyces lactis is resistant to high concentrations (1 mg/ml) of
      the antibiotic cycloheximide. Using in vitro translation studies it was confirmed
      that this extreme resistance is a property of ribosomes. The resistance
      determinant from K. lactis was cloned into Saccharomyces cerevisiae. Nucleotide
      sequence analysis of the determinant demonstrated that resistance was conferred
      by the K. lactis ribosomal protein L41. K. lactis was shown to contain only one
      copy of the gene that encodes this protein and the gene was located to chromosome
      III. In contrast, S. cerevisiae was found to contain multiple copies of the gene
      for the corresponding ribosomal protein L41 which mapped to two of the three
      chromosomes V, XIV and VIII. Since the cycloheximide-resistance gene of K. lactis
      causes essentially complete protection against inhibition by the drug, it is
      likely to be particularly useful as a selective marker in eukaryotic gene
      transfer studies.

PMID- 8477754
TI  - Two different genes from Schwanniomyces occidentalis determine ribosomal
      resistance to cycloheximide.
AB  - Two genes (SCR1 and SCR2) encoding natural cycloheximide resistance in the
      budding yeast Schwanniomyces occidentalis have been cloned by expression in
      Saccharomyces cerevisiae. Both genes determine resistance to the inhibitory
      action of cycloheximide on the ribosome, SCR1 and SCR2 are present as single
      copies in Schwanniomyces occidentalis, where they map on chromosomes II and V,
      respectively. The nucleotide sequence of SCR2 contains an open reading frame of
      321 nucleotides which is interrupted by an intron of 452 nucleotides. It encodes
      a polypeptide of 106 amino acids of molecular mass 12.25 kDa and pI 11.19. The
      deduced amino acid sequence shows a high degree of similarity to the L41 protein
      of the 60S ribosomal subunit from several eukaryotic organisms. The intron and
      the 5' non-coding region of SCR2 possess conserved elements which are typical of
      yeast ribosomal protein genes. A single amino acid change determines the
      resistance or sensitive phenotype to cycloheximide of the 80S ribosome since
      replacement of Gln56 in L41 from Schwanniomyces with Pro, by site-directed
      mutagenesis, confers cycloheximide sensitivity. SCR2 may serve as a practical
      yeast cloning marker if integrated in a multicopy plasmid.

PMID- 8477755
TI  - A 1H-NMR study of the transcription factor 1 from Bacillus subtilis phage SPO1 by
      selective 2H-labeling. Complete assignment and structural analysis of the
      aromatic resonances for a 22-kDa homodimer.
AB  - 1H-NMR experiments have been performed on transcription factor 1 (TF1) encoded by
      Bacillus subtilis phage SPO1. To study this 22-kDa homodimeric DNA-binding
      protein, a selective 2H-labeling strategy has been employed. Complete sequence
      specific assignments of all the resonances from the five aromatic residues were
      determined by a modified standard sequential-assignment procedure. The reduced
      contribution of spin diffusion upon the long-mixing-time nuclear-Overhauser
      enhancement spectroscopy for the selectively 2H-labeled variants, as opposed to
      the fully 1H-containing protein, has allowed for the identification of the spin
      systems and of the long-range dipolar contacts between Phe28 and Phe47 protons in
      the protein core and between Phe61 and Phe97 protons. The latter suggests an
      interaction between the proposed beta-ribbon DNA-binding arm and the carboxy
      terminus of the paired monomer. A previously proposed TF1 structural model
      [Geiduschek, E. P., Schneider, G. J. & Sayre, M. H. (1990) J. Struct. Biol. 104,
      84-90)] has been modified using constrained-energy-minimization calculations
      incorporating the experimentally determined set of aromatic-to-aromatic contacts.
      This new model has been analyzed with regard to the relative mobility and the
      relative solvent accessibility of the aromatic residues which have been measured
      by the nonselective T1 relaxation times of the aromatic resonances for the fully
      1H-containing protein and the relaxation time enhancements upon selective 2H
      labeling, respectively.

PMID- 8477756
TI  - LymnaDFamides, a new family of neuropeptides from the pond snail, Lymnaea
      stagnalis. Clue to cholecystokinin immunoreactivity in invertebrates?
AB  - Five tridecapeptides have been identified from the central nervous system of the
      pond snail, Lymnaea stagnalis. The sequences are Pro-Xaa-Asp-Arg-Ile-Ser-Yaa-Ser
      Ala-Phe-Ser-Asp-Phe. NH2, where Xaa is either Tyr or Phe and Yaa either Asn, Ser
      or Gly. The peptides are named lymnaDFamides to acknowledge identity with the C
      terminal dipeptide of the mammalian neuropeptides, cholecystokinin (CCK) and
      gastrin. They were detected by an antiserum that recognizes the biologically
      active C-termini of cholecystokinin and gastrin. LymnaDFamide-1 (Xaa = Tyr and
      Yaa = Asn) had no effect on trout gallbladder, which responds equally to CCK and
      gastrin. We propose that the lymnaDFamides belong to an Asp-Phe-amide
      superfamily, which includes CCK and gastrin, and suggest that the widespread
      CCK/gastrin immunoreactivity in invertebrates is due to peptides belonging to
      such a superfamily.

PMID- 8477757
TI  - Genetic control of population structure in heterogeneous strains of methicillin
      resistant Staphylococcus aureus.
AB  - Cultures of heterogeneous strains of methicillin resistant Staphylococcus aureus
      are composed of several subpopulations of cells that differ in their level of
      antibiotic resistance and frequencies. Experimental evidence is presented
      indicating that the number of these subpopulations, their resistance level and
      the frequency with which they are represented in a culture are strain-specific
      and reproducible with a surprising degree of precision from one culture to
      another. This implies a genetic control of population structure in these
      bacteria.

PMID- 8477758
TI  - Importance of beta-lactamase induction.
AB  - Induction of an enzyme is a temporary phenomenon in which the rate of enzyme
      synthesis is greatly increased in response to the presence of an inducer in the
      environment. Induction of beta-lactamase synthesis is important for the
      resistance of staphylococci to penicillins since the drug both induces synthesis
      of the enzyme and is hydrolysed by it. Similarly, some compounds both strongly
      induce and are hydrolysed by the chromosomally-determined beta-lactamases of gram
      negative bacilli (e.g. amoxicillin and cefoxitin for Enterobacter cloacae). Other
      compounds (e.g. piperacillin and cefotaxime) although labile are poor inducers,
      so that in the case of these drugs the phenomenon of induction is not important
      but the presence of the enzyme is, since resistant mutants with genetically
      derepressed synthesis of the enzyme can emerge. Induction can also be important
      when a strong inducer is present with a poor inducer and antagonises the activity
      of the latter.

PMID- 8477759
TI  - Relevance of antibiotic susceptibility testing for clinical practice.

PMID- 8477760
TI  - Anatomical barriers for antimicrobial agents.
AB  - It is often suggested that there are substantial anatomic barriers to the passage
      of antibiotics from the circulation into tissues and fluids of the body. In fact,
      most capillary beds are fenestrated and allow the passage of antimicrobial agents
      into tissue fluids fairly readily. At equilibrium, the mean concentrations of
      free (unbound) antibiotic in plasma and tissue fluids over the dosing interval
      are equal. However, the time to achieve equilibrium may range from minutes to
      days, depending on the ratio of surface area to volume of the tissue fluid
      compartment. There are several sites in the body in which nonfenestrated
      capillary beds pose appreciable barriers to the diffusion of antibiotics, namely
      the central nervous system, the eye and the prostate gland. Only lipid-soluble
      drugs traverse these capillaries readily. If the nonporosity of the capillaries
      were the only barrier to drug diffusion in these sites, the mean concentrations
      would eventually be equal to those in the plasma. However, in the central nervous
      system and the retina of the eye, transport pumps for organic anions combine with
      the effect of nonporous capillaries to produce concentrations which, even at
      equilibrium, are lower than those in the plasma. Bulk flow may also play a role
      in lowering drug concentrations in the cerebrospinal fluid. In the prostate
      gland, pH partition may cause mean concentrations in the prostatic secretions to
      differ from those in the plasma at equilibrium.

PMID- 8477762
TI  - Fungal and bacterial infections in the immunocompromised host.
AB  - As the number of immunocompromised patients increases due to the spread of the
      AIDS epidemic and the successes being achieved with transplantation, cancer
      chemotherapy and immunosuppressive therapy, increased attention is being turned
      to the prevention and treatment of the infections that afflict these individuals.
      The risk of infection in these patients is determined by the interaction between
      the epidemiologic exposures that the patient experiences and the net state of
      immunosuppression (the greater the exposure, the greater the chances of infection
      even in an immunologically competent individual; the greater the net state of
      immunosuppression, the greater the chances of infection even with minimal
      exposures). The bacterial and fungal infections that affect these patients are
      reviewed and strategies of antimicrobial management defined, recognizing that
      there are three modes of use of antimicrobial agents in these patients:
      therapeutic administration to treat clinical infection, and prophylactic and pre
      emptive administration to prevent or abort clinical infection. These last two are
      of particular importance in this patient population because the prime aim of the
      infectious disease clinician in dealing with these problems is the prevention of
      clinical disease.

PMID- 8477761
TI  - Diseases and drug-related interventions affecting host defence.
AB  - Recognition of an impaired immune system has implications for the diagnosis,
      treatment and outcome of infections. Not only the type of immunological
      dysfunction but also the degree of the dysfunction is important. A review is
      presented of the systemic diseases and immunosuppressive agents which may result
      in defects in host defence and associated infections. Especially in transplant
      patients and patients with HIV infection, knowledge of the stage of the host
      defense defect is important for the success of prophylactic regimens and for the
      clinical approach in the event of infection.

PMID- 8477764
TI  - Relevance of animal models for clinical treatment.
AB  - The use of animal models has become an integral part of the evaluation of drugs
      for antimicrobial chemotherapy. Animal models can be used to define the
      penetration of antimicrobial agents at foci of infections, the time course of in
      vivo antimicrobial therapy, dose-response relationships, and the influence of
      therapy on the pathophysiologic consequences of infection. Animal models have
      been useful in the delineation of many of the basic principles currently used in
      clinical practice and in the selection of new agents and new therapeutic
      approaches for clinical trials in humans. In spite of the many positive aspects
      of animal models, several problems, such as altered pharmacokinetics in animals,
      can preclude direct application of results to clinical practice. Studies in
      animal models cannot replace the need for human clinical trials.

PMID- 8477763
TI  - The value of new antimicrobial agents.
AB  - New antimicrobial agents require careful assessment to determine whether they
      possess the appropriate properties for clinical use. Many new compounds of value
      in the prophylaxis and therapy of infections have been included in the current
      armamentarium. Close monitoring to identify possible adverse effects of new
      agents is essential. Alternative uses of older agents also expands therapeutic
      opportunities in the combat against infectious diseases. Inappropriate use of
      antimicrobial agents contributes to the worldwide problem of increasing bacterial
      resistance. The dramatic spread of such bacterial strains is partially
      responsible for the rising costs of infectious diseases. A rational and strict
      antibiotic policy is thus of great importance for the optimal use of these
      agents.

PMID- 8477765
TI  - Abnormal pharmacokinetics: the need for monitoring.
AB  - Optimal use of a drug depends on rational dosing and subsequent therapeutic drug
      monitoring for effectiveness and toxicity. Drug monitoring is not relevant for
      all drugs, but is indicated in the case of drugs which have a narrow therapeutic
      range or show a large inter-individual variation. If the response is not
      satisfactory or toxic side effects are observed, the regimen has to be adjusted
      or another drug used. Methods have been developed to establish rational dosing
      schedules for the individual patient. In previous methods, the patient's specific
      data such as age, length, weight and serum creatinine are integrated with
      population pharmacokinetic parameters for a drug. This approach is subject to an
      appreciable margin of error, particularly in patients whose physiology is far
      from normal. Therapeutic drug monitoring via blood level determination makes it
      possible to evaluate the patient's individual pharmacokinetic parameters on which
      a rational dosage regimen can be based.

PMID- 8477766
TI  - Pharmacodynamics of antimicrobial agents as a basis for determining dosage
      regimens.
AB  - Pharmacodynamic parameters, such as the rate of bactericidal activity with
      increasing drug concentrations, post-antibiotic effect, sub-MIC effects, post
      antibiotic leukocyte enhancement and first-exposure effect, more accurately
      describe the time course of antimicrobial activity than the MIC and MBC.
      Aminoglycosides and quinolones exhibit concentration-dependent killing and induce
      prolonged post-antibiotic effects. The amount of drug rather than the dosing
      frequency determines the efficacy of these drugs. However, high peak levels can
      reduce the emergence of resistance, and once-daily dosing of aminoglycosides can
      also reduce nephrotoxicity and ototoxicity. On the other hand, beta-lactam
      antibiotics show time-dependent killing and produce prolonged post-antibiotic
      effects only with staphylococci. The frequency of drug administration is an
      important determinant of outcome for these drugs, as the duration of time serum
      levels exceed the MIC is the major determinant of efficacy.

PMID- 8477767
TI  - Liposomes as carriers of antimicrobial agents or immunomodulatory agents in the
      treatment of infections.
AB  - Targeting of antimicrobial agents by means of liposomes is under investigation
      and may be of importance in the treatment of infections that prove refractory to
      conventional forms of antimicrobial treatment. The ability to achieve a
      significantly longer residence time of liposomes in plasma and limited uptake of
      liposomes by the mononuclear phagocyte system opens up new areas of investigation
      and potential therapeutic application. By manipulating the liposomal composition,
      rates of uptake and intracellular degradation can be influenced and thereby the
      rates at which liposome-encapsulated agents are released and become available to
      exert their therapeutic action. With respect to the targeting of macrophage
      modulators at the mononuclear phagocyte system by means of liposomes for maximal
      stimulation of the nonspecific antimicrobial resistance, experimental evidence is
      now available of the potential usefulness of liposomes as carriers of these
      agents. This approach may also be of importance for the potentiation of treatment
      of severe infections.

PMID- 8477768
TI  - Role of glucocorticosteroids in the treatment of infectious diseases.
AB  - The role of glucocorticosteroids in the management of infectious diseases in man
      remains controversial, although experimental data obtained both in in vitro
      systems and in experimental infections in animals provide evidence of a
      beneficial effect of such treatment. Their use in the treatment of Pneumocystis
      carinii pneumoniae and severe typhoid fever seems indicated. A beneficial effect
      on the treatment of bacterial meningitis needs to be confirmed. Sufficient data
      are now available that argue against steroid treatment in septic shock. However,
      new treatment modalities such as monoclonal antibodies against endotoxin and
      inflammatory mediators are currently being developed to modulate infectious
      inflammation. This could also bring a renaissance of the role of
      glucocorticosteroids in the treatment of infectious diseases.

PMID- 8477770
TI  - Epidemiological and clinical aspects of carcinoma in situ of the testis.
AB  - Despite the high cure rate in men with testicular cancer, efforts should be made
      to diagnose the disease at the preinvasive stage. The disease, which affects
      young males, is potentially lethal. Furthermore, testicular neoplasia diagnosed
      at the stage of CIS can be cured without the negative impact on the life-quality
      of the survivors, as chemotherapy and other systemic treatment can be avoided.
      The treatment of choice is orchidectomy if the neoplasia is unilateral, or
      localized irradiation in bilateral cases. Testicular biopsy performed after
      puberty is at present the only reliable diagnostic method. Screening for CIS in
      the contralateral testis should be offered to men with unilateral testicular
      cancer. Patients with assumed extragonadal germ cell tumour and intersex
      individuals are also recommended to have a biopsy for CIS. Biopsies should also
      be considered in adults with maldescended testes and in selected cases of
      infertility. In the future the techniques of detecting of CIS cells in semen may
      become refined. In such circumstances, the general male population may be
      targeted for screening and more cases of testicular cancer could then be
      prevented.

PMID- 8477769
TI  - Interleukin-1 as a possible agent for treatment of infection.
AB  - Treatment of experimental animals with bacterial products, such as cell wall
      components of gram-negative bacteria, leads to enhanced resistance to a variety
      of microorganisms. Since interleukin-1 and other pro-inflammatory cytokines are
      induced by such bacterial products, it has been investigated whether these
      cytokines are also capable of enforcing host resistance. It has been possible to
      demonstrate that a low dose of interleukin-1 protects mice against death from
      either gram-negative or gram-positive bacteria, Candida albicans and Plasmodium
      berghei. The protection against lethal bacterial and fungal infection can be
      produced in both normal and neutropenic animals. Despite extensive
      investigations, the mechanism of protection is not understood. A possible
      mechanism, which is currently being investigated, is that interleukin-1
      interferes with the deleterious action of the pro-inflammatory cytokines during
      the lethal phase of the infection.

PMID- 8477771
TI  - Risk factors for carcinoma in situ of the contralateral testis in patients with
      testicular cancer. An interim report.
AB  - In a study aimed at evaluating risk factors for carcinoma in situ (CIS) in the
      contralateral testis of selected patients with testicular cancer, information
      from 89 patients who have had contralateral testicular biopsies is available. The
      biopsies were performed because of the coexistence of the previously established
      risk factors - atrophy of the remaining testis, or a history of maldescent. CIS
      was diagnosed in 13% of patients, the prevalence being the same for both open and
      needle biopsies. Compared to its overall prevalence in the contralateral testis
      in testicular cancer an increased risk of CIS has been found in clinically
      atrophic testes but has not been found for maldescent. Patients found to have CIS
      were younger than those in whom it was not detected.

PMID- 8477772
TI  - Should the contralateral testis be biopsied? Round table discussion.
AB  - Testicular tumours are bilateral in 5.2% of cases although the incidence of
      bilaterality is affected by the mode of treatment of the primary tumour. A biopsy
      of the contralateral testis of testicular tumour patients will reveal carcinoma
      in situ in 5.5% of cases. In Denmark, most testicular tumour patients have a
      contralateral biopsy at the time of the primary orchidectomy, but in many
      countries general urologists and surgeons are not always aware of the advantages
      of simultaneous contralateral biopsy. Some specialist centres perform a
      contralateral biopsy as a secondary procedure once the patient has been referred.
      It has not been the policy in USA to take a contralateral biopsy at the initial
      orchidectomy, nor to offer a biopsy to patients after referral to a specialist
      centre. As a result of the discussions at this conference, urologists in USA will
      now be encouraged to take a contralateral biopsy at the time of initial surgery.
      If this is not performed, patients should be offered a biopsy after a full
      discussion of the advantages and possible side effects of the procedure so that
      informed consent can be given.

PMID- 8477773
TI  - Effects of chemotherapy and radiotherapy on spermatogenesis.
AB  - Radiation and chemotherapy reduce sperm count and cause infertility in males. In
      the mouse, rat, and human, the differentiating spermatogonia are the most
      sensitive to killing by cytotoxic agents, resulting in short-term azoospermia.
      Stem spermatogonia are also killed by some agents. In the mouse, sperm production
      gradually recovers from surviving stem cells without a lag period. In the rat,
      however, surviving stem cells may remain as A spermatogonia for long times
      without initiating differentiation. In humans, there may be a long period of
      azoospermia; the time at which recovery or sperm production is initiated appears
      to be related to the degree of stem cell killing. Knowledge of the mechanisms
      regulating spermatogonial proliferation and differentiation could lead to ways to
      minimize the duration of azoospermia following treatment.

PMID- 8477774
TI  - Protection against cytotoxic-induced testis damage--experimental approaches.
AB  - In animal models the possibility has been explored that pharmacological
      inhibition of cell division in the spermatogenic epithelium during cytotoxic
      treatment for cancer would preserve fertility. Recent animal models are reviewed.
      In the rat, gonadotrophin releasing hormone (GnRH) analogues or a combination of
      a progestogen and an androgen will protect spermatogenesis from the cytotoxic and
      mutagenic effects of procarbazine and radiation. Cyclophosphamide toxicity is not
      alleviated by GnRH treatment. In the mouse, a GnRH analogue was ineffective
      against cisplatin testicular toxicity. Complete suppression of the spermatogenic
      process does not seem to be important for a successful outcome. These experiments
      serve to illustrate the inconsistency between different laboratories. However, it
      is argued that once the correct pharmacological approach and the mechanisms have
      been established in animal models, only then will it be possible to predict the
      efficacy of these adjuvant treatments to preserve fertility in men being treated
      for cancer.

PMID- 8477775
TI  - The role of LHRH-analogues in protecting gonadal functions during chemotherapy
      and irradiation.
AB  - Therapeutic success has focused attention on late effects in patients with
      testicular cancer, Hodgkin's disease, non-Hodgkin's lymphoma, and acute
      leukaemia. Since most patients with testicular cancer are young, the impact of
      cytotoxic chemotherapy on fertility and hormone deficiency has become
      particularly important. It has been shown that pulsatile secretion of luteinizing
      hormone releasing hormone (LHRH) is a prerequisite for normal gonadal function.
      In contrast, non-pulsatile, chronic treatment with supraphysiological doses of
      LHRH-analogues (LHRHA) results in suppression of the pituitary-gonadal axis. It
      has been suggested that inhibition of spermatogenesis during exposure to
      cytotoxic drugs might reduce gonadal toxicity. The protective effects of LHRHA
      during chemotherapy or irradiation has been examined in 11 preclinical studies.
      In only 6 out of 11 models could protection be demonstrated. Four clinical trials
      have been performed using LHRHA as a gonadal protector. In none of these trials
      could LHRHA significantly influence severity and duration of germ cell
      impairment. New approaches are needed to minimize or even prevent gonadal
      toxicity during chemotherapy or irradiation, such as reduction of courses,
      alternative schedules, or new drugs.

PMID- 8477776
TI  - A preliminary report: postoperative fertility assessment in nerve-sparing RPLND
      patients.
AB  - Nerve-sparing RPLND is a procedure suited to patients with clinical stage I
      nonseminoma. Additionally, nerve-sparing techniques are applicable to patients
      with higher stage disease. Although ejaculation is reliably preserved with nerve
      sparing techniques, the question of these patients' fertility has remained.
      Fertility was assessed in these patients by two techniques: laboratory analysis
      of semen and a post-RPLND questionnaire. Semen analyses and DNA histograms
      suggested fertility in > 70%; in addition, 43 of 53 (81%) patients who have tried
      to father children post RPLND have been successful. Nerve-sparing RPLND appears
      to be able to preserve fertility potential in these patients.

PMID- 8477778
TI  - The possible role of sex hormones in the development of testicular cancer.
AB  - The peak incidence of testicular cancer in young men suggests that gestational
      development and events during early infancy and puberty are important in the
      pathogenesis of the disease. There are two potentially significant events: the
      transformation of fetal germ cells into carcinoma-in-situ cells (CIS) and later
      conversion of CIS cells into fully invasive cancer. Several hypotheses suggest an
      endocrinological background to testicular neoplasia. Based on epidemiological and
      experimental evidence, the possible role of oestrogens, androgens and
      gonadotrophins is discussed in this review. The role of Sertoli cells and the
      importance of interplay between endocrine and paracrine factors is also stressed.

PMID- 8477777
TI  - Semen quality after treatment for testicular cancer.
AB  - During the last 14 years repeated sperm cell analyses and serum hormone analysis
      were done regularly in patients with testicular cancer before and after
      treatment. The summarized results are hereby reported. The sperm cell count was
      highly impaired in 60-70% of testicular cancer patients evaluated 1-4 weeks after
      unilateral orchidectomy before further treatment. However, improvement of the
      exocrine gonadal function was regularly observed during the following 2-3 years,
      provided there were normal or only slightly elevated pre-treatment FSH levels.
      Standard irradiation and cytotoxic treatment (abdominal radiotherapy 30-40 Gy; <
      or = 4 cycles of cisplatin-based chemotherapy) delayed this recovery by about one
      year. Higher doses of chemotherapy or combined irradiation/chemotherapy reduced
      the chances of rapid improvement of the exocrine gonadal function. Unilateral
      retroperitoneal lymph node dissection resulted in a slight reduction of the post
      treatment ejaculatory volume, even in patients with preserved antegrade
      ejaculation.

PMID- 8477779
TI  - The biology of primordial germ cells.
AB  - Primordial germ cells are the founder cells of the gametes. They arise at the
      earliest stages of development, and migrate to the genital ridges, where they
      join the somatic cells of the future gonad. The factors that determine their
      formation and migration are largely unknown. Primary culture of PGCs isolated at
      different times during their migration has allowed the analysis of some aspects
      of the control of their behaviour. The effects of culture medium conditioned by
      genital ridges suggested that both proliferation and migration of PGCs may be
      controlled in part by diffusible factors. Several purified growth factors are now
      known which affect PGC numbers in culture. These include positive and negative
      regulators of proliferation, survival factors, and chemotropic factors. During
      migration, PGCS must change their affinities for surrounding cells, and some
      aspects of this can be analysed in culture. For example, PGCs isolated at
      different stages in their migration show different capacities to adhere to
      fibronectin.

PMID- 8477780
TI  - Heparin binding growth factors and the control of teratoma cell proliferation.
AB  - The role of basic fibroblast growth factor (bFGF) in the control of teratoma cell
      proliferation was examined. It was found that bFGF stimulates proliferation at
      low concentrations but induces cell migration at higher doses. These effects
      could be efficiently counteracted by addition of protamine sulphate. Moreover the
      bFGF gene is actively transcribed in primary human testicular embryonal
      carcinomas but was not expressed in any other embryonic tumour examined. The
      biological implications of these findings will be discussed.

PMID- 8477781
TI  - Cultured cell lines from human teratomas: windows into tumour growth and
      differentiation and early human development.
AB  - Cultured cell lines from human teratomas provide models to study molecules which
      might regulate tumour growth or normal embryonic development. Here, we describe
      efforts to delineate the role of transcription factors, extracellular matrix, and
      growth factors in controlling growth and differentiation of human embryonal
      carcinoma and yolk sac tumour.

PMID- 8477782
TI  - 20/20 Analysis: taking a close look at the margins.
AB  - This article presents "20/20 Analysis" as an experimental, output-oriented,
      noncategorical alternative to traditional approaches to identification of
      students for special education. 20/20 Analysis identifies students showing least
      (below 20th percentile) and most (above 80th percentile) progress toward
      important objectives of education in a school. The situation of each student in
      low 20% and high 20% groups is then examined as a basis for broad
      (noncategorical) approaches to improvement of learning opportunities. Case
      studies of two schools are present. Policy implications are considered briefly.

PMID- 8477783
TI  - Teaching preschool children with disabilities to respond to the lures of
      strangers.
AB  - An investigation was conducted to determine the effectiveness of a constant-time
      delay procedure used in combination with multiple exemplars of strangers, lures,
      and sites to teach a generalized response to the lures of strangers to four
      preschool children with disabilities. Although the correct response was quickly
      acquired in the training site, the response failed to generalize to the probe
      sites until training was conducted in vivo. Instruction in vivo resulted in
      acquisition, maintenance, and generalization of the response to strangers' lures.
      Generalization occurred across probes with novel exemplars of lures, strangers,
      and sites.

PMID- 8477784
TI  - Two approaches to reading instruction with children with disabilities: does
      program design make a difference?
AB  - This study examined the effects on reading achievement of variation in program
      design and tested the hypothesis this Distar Reading Mastery's (Engelmann &
      Bruner, 1988b) demonstrated effects with disadvantaged children in Project Follow
      Through can be generalized to children with disabilities. We compared the effects
      of two synthetic phonics reading programs, Direct Instruction (DI) Reading
      Mastery I and II and Addison Wesley's Meet the Superkids and The Superkids' Club,
      (Rowland, 1982a, 1982b) for 81 children in transitional kindergarten special
      education classes. No significant achievement differences were evident for the
      instructional program either at the end of the treatment year, or on follow-up
      testing 1 year later. However, among children who made advanced progress, the DI
      group showed larger reading gains.

PMID- 8477785
TI  - History strategy instruction: problem-solution-effect analysis, timeline, and
      vocabulary instruction.
AB  - This multiple baseline study investigated the effectiveness of history strategy
      instruction emphasizing the linkage of knowledge in teaching junior high students
      with behavior disorders. The intervention included 24 students and 3 teachers
      across three classes for 3-6 weeks. The strategy included a scripted curriculum
      involving brisk student-teacher interchanges; student note taking and
      constructing of timelines and vocabulary definitions; and reciprocal questioning,
      using a carefully selected history textbook. Results indicate that the history
      strategy was effective; students in each class showed immediate and educationally
      significant improvement compared with baseline instruction that employed
      traditional history instruction.

PMID- 8477786
TI  - Transition from school to adulthood: case studies of adults with learning
      disabilities who dropped out of school.
AB  - In-depth, structured interviews were conducted over a 2-year period with four
      young adults previously identified as having learning disabilities during their
      school years. All four had dropped out of high school; but overall, they reported
      that their early withdrawal was an important and affirming choice in their
      transition from youth to young adulthood. Themes emerging as noteworthy include
      their lack of involvement in formal vocational assessment, their own
      individualized education programs, and adult services. The personal stories and
      experiences cast doubt on the prevailing opinion that school dropouts are
      "losers" and "failures." In contrast, their stories reveal a serious shortfall in
      their secondary special education programming and in the overall transition
      planning process.

PMID- 8477787
TI  - Who becomes an "at-risk" student? The predictive value of a Kindergarten
      Screening Battery.
AB  - This study was undertaken to determine whether a preschool screening instrument
      could predict whether kindergarten students would later be retained, referred to
      special education, or placed in special education. The results of Early
      Prevention of School Failure (EPSF) screening on 161 kindergarten students were
      examined. Students who had been retained, referred to special education, or
      placed in special education demonstrated significantly lower EPSF pretest scores
      except in the gross motor modality. All EPSF modalities were statistically
      significant predictors of students' status; however, other factors such as family
      support network, preschool experiences, and motivational factors must be
      considered in evaluating whether a student is "at risk" of later school failure.

PMID- 8477788
TI  - "I've counted Jon": transformational experiences of teachers educating students
      with disabilities.
AB  - The purpose of this study was to describe the experiences of general education
      teachers who have had a student with severe disabilities in their class.
      Interviews of 19 general education teachers, kindergarten through Grade 9, as
      well as questionnaires completed by 18 teachers, were analyzed using categorical
      coding procedures to identify themes related to the teachers' experiences.
      Results showed that despite teachers' initial negative reactions to the placement
      of a child with severe disabilities in their classrooms, 17 teachers described
      transforming experiences of a more positive nature and related many benefits to
      the students with disabilities, their classmates, and the teachers themselves.
      Respondents also characterized what support services they found helpful and not
      helpful.

PMID- 8477789
TI  - Decreased expression of the platelet-derived growth factor beta-receptor in
      fibroblasts from a patient with Werner's syndrome.
AB  - The study of Werner's syndrome, a premature ageing syndrome, may provide insight
      into the processes of natural ageing. We investigated the reason for the reduced
      growth potential of fibroblasts in Werner's syndrome which is considered to be
      similar to that of fibroblasts in normal senescence. The responses to different
      isoforms of platelet-derived growth factor (PDGF) of fibroblasts from a patient
      with Werner's syndrome (W-cells) and from a normal subject (control cells) were
      assessed by [3H]thymidine incorporation assay, a 125I-PDGF-AB binding experiment,
      and Northern blot analysis with a PDGF beta-receptor specific cDNA probe. PDGF
      stimulated increase in [3H]thymidine incorporation in W-cells was much lower than
      that in control cells, especially with PDGF-AB and -BB as mitogens. The specific
      binding of 125I-PDGF-AB to W-cells was correspondingly lower than that to control
      cells. Furthermore, Northern blot analysis demonstrated a decreased basal level,
      and lack of PDGF-AB-induced up-regulation of the PDGF beta-receptor transcript in
      W-cells. Decreased expression of the PDGF beta-receptor due to decrease in its
      synthesis may be a causative factor of the decreased mitogenic response of W
      cells to PDGF.

PMID- 8477790
TI  - Effect of glucagon immunoneutralization on the increase in urea synthesis after
      hysterectomy in rats.
AB  - To study the effect of glucagon immunoneutralization on postoperative changes of
      urea synthesis, hysterectomized rats were given one injection of a specific high
      titre antibody against pancreatic glucagon 24 h before operation raising the
      plasma glucagon binding capacity to values 10-20 times higher than the plasma
      glucagon concentration in control animals. Earlier studies have shown that the
      spontaneous rate of urea-N synthesis (UNSR) doubles 3 h after operation, and that
      the Vmax of the process, the capacity of urea-N synthesis (CUNS) is 50% higher
      than normal values 24 h after operation. Therefore, the effect of glucagon on
      UNSR and CUNS were investigated 3 and 24 h postoperatively, respectively. Control
      animals were given non immune rabbit serum. Glucagon immunoneutralization partly
      normalized the early increase in UNSR 3 h postoperatively (control: 4.7 +/- 0.3,
      hysterectomy+serum: 6.7 +/- 0.4, hysterectomy+Gluc-Ab: 5.5 +/- 0.4 mumol (min.100
      g BW)-1), but had no effect on the increase of CUNS 24 h postoperatively
      (control: 7.9 +/- 0.3, hysterectomy+serum: 9.5 +/- 0.3, hysterectomy+Gluc-Ab: 9.8
      +/- 0.5 mumol (min.100 g BW)-1). This shows that glucagon is important for the
      early postoperative increase in the efficacy of urea synthesis, whereas the late
      increase in capacity seems not to depend on hyperglucagonemia.

PMID- 8477791
TI  - Increased rates of cortisol production and urinary free cortisol excretion in
      elderly women 2 weeks after proximal femur fracture.
AB  - Cortisol production rate and urinary free cortisol excretion have been measured
      in healthy elderly women and elderly women about two weeks after upper femur
      fracture. Plasma cortisol was determined mid-morning, at the start of urine
      collection. All three variables were higher in the injured patients than in the
      control subjects. Urinary free cortisol excretion showed the greatest rise and
      was correlated with cortisol production rate in the patients. In the control
      subjects there was no correlation and nearly all the points fell below the
      regression line for the injured patients, indicating that urinary free cortisol
      excretion rose in relation to cortisol production rate after injury. Measurement
      of creatinine clearance showed that this was not due to an increased glomerular
      filtration rate, and a possible explanation is decreased metabolic clearance of
      cortisol. Plasma cortisol was not significantly correlated with either cortisol
      production rate or urinary free cortisol excretion.

PMID- 8477792
TI  - Binding of cyclosporine by erythrocytes: influence on cell shape and
      deformability.
AB  - Cyclosporine is a widely used immunosuppressive drug with a high affinity for
      erythrocytes. It was hypothesized that the hydrophobic agent would interact with
      the erythrocyte membrane, which could cause a shape change and alter cell
      deformability. Administration of 300 mg cyclosporine in vivo and incubation of
      erythrocytes with concentrations up to 100 mg l-1 in vitro at room temperature
      showed that cyclosporine is found in the cytoplasm, but not in the membrane of
      erythrocytes and that cell shape or deformability were not affected. Incubation
      of erythrocytes with the highest cyclosporine concentration (100 mg l-1) at 37
      degrees C lead to a time-dependent, slight stomatocytic shape transformation,
      indicating that the drug is intercalated preferentially into the inner
      hemileaflet of the membrane under these conditions. Cyclosporine metabolites had
      no effect on the cell shape. The shape of erythrocyte ghosts was neither affected
      by cyclosporine nor by its metabolites. It is concluded that cyclosporine is
      bound in the erythrocyte cytoplasm and does not affect the cell membrane and cell
      deformability at therapeutic concentrations. These results may contribute to a
      better understanding of the interactions of cyclosporine with cells.

PMID- 8477793
TI  - Cerebral trauma and alcohol abuse.
AB  - We report results of clinical examinations, computed tomography, quantitative
      electroencephalography (QEEG), and cerebral blood flow measurements performed on
      a series of 56 consecutive brain injury patients including 15 alcohol abusers and
      41 non-alcoholic subjects. Greater volumes of intracranial haemorrhage were noted
      in the alcoholics for a similar severity of injury and local brain atrophy became
      more pronounced in them during a follow-up of 1 year. After this time, the third
      ventricle width, distance between frontal horns, the sum of lateral ventricle
      dimensions and cortical sulci were all markedly larger in the alcoholics. The
      QEEG results also indicated a weaker improvement in the alcoholics. The cerebral
      blood flow at the site of the injury was initially slow in the alcoholics when
      compared to the contralateral region of the other hemisphere, although these
      differences disappeared during the follow-up. Permanent occupational disability
      was also found to be associated with pretraumatic alcohol abuse. The findings
      indicate that ethanol abuse is not only commonly associated with cerebral trauma
      but is also a risk factor for a more severe brain damage following the injury.

PMID- 8477794
TI  - Alternative splicing of human G6PD messenger RNA in K562 cells but not in
      cultured erythroblasts.
AB  - The biochemical properties of glucose-6-phosphate dehydrogenase (G6PD) vary in
      different tissues, and different protein isoforms of the enzyme have been
      described. Alternative splicing of G6PD intron VII has been detected in
      transformed lymphoblasts, granulocytes and spermatocytes; the function of this
      mRNA species is still unknown. We developed a PCR for detecting alternatively
      spliced G6PD mRNA in K562 and in erythroblasts at different stage of maturation
      obtained from human peripheral BFU-E in order to evaluate a possible
      physiological role during erythroid maturation. Trace events of alternative
      splicing of G6PD intron VII sequences were observed in K562 cells but not in BFU
      E-derived erythroid precursors; we consider this phenomenon a non-functional
      activity in the cells analysed.

PMID- 8477795
TI  - Effect of ageing on postprandial conjugated and unconjugated serum bile acid
      levels in healthy subjects.
AB  - Colorectal cancer is a disease of elderly subjects. A decreased ileal absorption
      of bile acids in elderly subjects may lead to an increased exposure of the
      colonic mucosa to secondary bile acids. This may contribute to an enhanced risk
      of colorectal cancer. In this study fasting and postprandial conjugated and
      unconjugated serum levels of cholic, chenodeoxycholic, and deoxycholic acid in 12
      elderly and 12 younger subjects were investigated. Intestinal transit time,
      gallbladder emptying and jejunal bacterial flora were also studied in both age
      groups. Fasting levels of conjugated and unconjugated serum bile acids were
      similar in both age groups. Postprandial levels of all individual conjugated bile
      acids increased to a significantly higher extent in the younger subjects.
      Postprandial unconjugated serum bile acid levels did not differ significantly
      between both age groups, although unconjugated deoxycholic levels tended to
      increase to higher levels in the elderly. Results of jejunal bacterial counts,
      gallbladder emptying and intestinal transit time were similar in both groups.
      These data suggest that conjugated bile acids are reabsorbed less effectively in
      elderly subjects.

PMID- 8477796
TI  - Molecular cloning of porcine T cell receptor alpha, beta, gamma and delta chains
      using polymerase chain reaction fragments of the constant regions.
AB  - Fragments of the constant regions of porcine alpha, beta, delta and two types of
      gamma T cell receptor (TcR) chains were obtained by reverse transcription and
      polymerase chain reaction (PCR). Screening of a porcine peripheral T cell cDNA
      library with these PCR fragments led to the isolation of porcine TcR alpha, beta,
      gamma and delta chain clones. Sequence analysis of these clones and the
      respective PCR fragments demonstrated the existence of one alpha, one beta, three
      gamma and one delta chain isotype. Comparisons of the deduced amino acid
      sequences of the constant region with other species revealed a significant
      homology. For two of the three identified porcine gamma chain insertions of 38
      and 40 amino acids were found within the hinge region. In addition, our sequence
      data demonstrate a high variability in the cytoplasmic C gamma domain among the
      three porcine TcR gamma isotypes as well as between species, which might be of
      structural and/or functional significance. Comparison with biochemical data
      indicate the existence of four porcine TcR gamma isotypes.

PMID- 8477797
TI  - The fate of human peripheral blood lymphocytes after transplantation into SCID
      mice.
AB  - Human peripheral blood lymphocytes (hu-PBL) can be adoptively transferred by
      intraperitoneal injection into mice with severe combined immunodeficiency (SCID).
      The transplanted lymphocytes can produce immunoglobulin (Ig), respond to
      antigens, and survive for months in this chimeric model (hu-PBL SCID). However,
      whether the lymphocytes actually repopulate and reconstitute lymphoid structures
      and organs has been subject of some debate. To address this question and to
      characterize the hu-PBL SCID model better, we employed a novel technique for the
      identification of human cells in xenogeneic mice. We used fluorescence in situ
      hybridization (FISH) with a biotinylated DNA probe to all human centromeres. We
      demonstrated that FISH could be used to detect human cells when they accounted
      for less than 1% of human/mouse cell mixtures; it could also be employed for the
      identification and localization of individual human cells in tissue sections. By
      using FISH, we studied 31 SCID mice injected with 1.5 x 10(7)-4 x 10(7) hu-PBL
      via intravenous (i.v.) or intraperitoneal (i.p.) routes. In the 6 i.v.-injected
      mice, we found that the human cells were removed from the circulation into the
      lung within 1 h. In 22 of 25 i.p.-injected animals, 90-3716 micrograms/ml of
      human IgG was found in the sera at 3 to 13 weeks after transplantation (a.t.).
      Human cells colonized the peritoneal cavity and persisted for up to 13 weeks a.t.
      and, in the 12 mice studied, accounted for 4% to 57% of the cells in the
      peritoneal fluid. However, only rare, isolated human cells were found in the
      spleen, blood, bone marrow, lung or Peyer's patches. In 7 of 19 mice that
      received hu-PBL i.p. from Epstein-Barr virus-seropositive donors, we found masses
      of human cells usually beneath the peritoneal lining but sometimes infiltrating
      normal tissue. We conclude that FISH offers a simple means for accurate
      identification of human cells in the xenogeneic mouse. Although there is
      colonization of the peritoneal cavity in most mice, and development of lymphoid
      masses in some, there is no reconstitution of lymphoid structures and only
      minimal engraftment of lymphoid organs by human cells in conventionally-prepared
      hu-PBL SCID constructs.

PMID- 8477798
TI  - Early appearance and activation of natural killer cells in tumor-infiltrating
      lymphoid cells during tumor development.
AB  - We investigated NK cell infiltration into tumor developing lesions at early stage
      of tumor development after intraperitoneal inoculation of 3LL lung carcinoma into
      syngeneic C57BL/6 mice. Natural killer (NK) cells, which were detected by anti-NK
      1.1 monoclonal antibody (mAb), remarkably increased in number in tumor-developing
      lesions (peritoneal cavity) as early as day 3 after inoculation of 3LL. The tumor
      infiltrating NK cells from 3LL-inoculated mice produced a high level of
      interferon-gamma by co-culture with 3LL and showed enhanced cytotoxic activities
      against both NK-sensitive (YAC-1) and NK-resistant (3LL and P815) tumors.
      Furthermore, mice depleted of NK cells by injection of anti-NK 1.1 mAb or anti
      asialo GM1 antibody showed shorter survival times after intraperitoneal
      inoculation of 3LL when compared with control mice. These results suggest that NK
      cells infiltrate the tumor-developing lesion at an early stage and may
      participate in the early protection against tumors through production of a high
      amount of interferon-gamma and enhanced cytotoxicity at tumor-bearing sites.

PMID- 8477799
TI  - Interleukin-4 and interleukin-10 inhibit nitric oxide-dependent macrophage
      killing of Candida albicans.
AB  - Mouse peritoneal and splenic macrophages treated with interferon-gamma (IFN
      gamma) and infected with the yeast Candida albicans expressed high fungicidal
      activity in vitro that correlated with increased nitrite concentrations in
      culture supernatants. Both effects were reduced by an inhibitor of nitric oxide
      (NO) synthesis which, in vivo, impaired the animals' ability to mount a footpad
      reaction and clear the fungus from infected organs. Because T helper type-2 (Th2)
      cytokines in candidiasis are known to limit the expression of protective Th1
      functions, we tested the effect of interleukin (IL)-4 and IL-10 on candidacidal
      activity and NO production of IFN-gamma-activated macrophages. Fungal killing and
      NO secretion were inhibited, in a dose-dependent manner, by the two cytokines
      either separately or in combination. Impaired candidacidal activity was also
      demonstrable in the presence of monoiodoacetic acid, an inhibitor of
      phagocytosis. These data demonstrate that NO is involved in macrophage killing of
      C. albicans and support the notion that regulation of Th1 effector function by IL
      4 and IL-10 might involve modulation of NO synthesis.

PMID- 8477800
TI  - Regulation of CD69 expression on human natural killer cells: differential
      involvement of protein kinase C and protein tyrosine kinases.
AB  - Human peripheral blood natural killer (NK) cells (CD56+, CD16+, CD3 epsilon-
      lymphocytes) express CD69 after their stimulation by interleukin-2 (IL-2) or
      interferon-alpha (IFN-alpha). This activation antigen represents a triggering
      surface molecule in NK cell clones as its stimulation triggers the cytolytic
      machinery of these cells. However, the mechanisms regulating the expression of
      CD69 in NK cells are unknown despite the functional relevance of CD69 in NK cell
      activation. Thus, we have analyzed the role of protein kinase C (PKC) and protein
      tyrosine kinases (PTK) in the expression of CD69 on purified NK cells activated
      by IL-2, IFN-alpha, anti Fc gamma RIII (CD16) monoclonal antibodies or by K562
      target cells. We found that CD69 is induced on NK cells not only by IL-2 and IFN
      alpha but also by activation of the CD16 pathway, the interaction with NK target
      cells and the direct activation of PKC by phorbol 12-myristate 13-acetate (PMA),
      indicating that CD69 induction is associated to different NK activation pathways.
      The treatment with the PKC inhibitor staurosporine abolished the induction of
      CD69 induced by PMA or K562. However, it did not significantly affect CD69
      induction by IL-2, IFN-alpha or CD16 cross-linking. This demonstrates that
      whereas PKC can play a central role in the regulation of CD69 expression in some
      instances (response to K562 cells or PMA), it does not participate in others
      (response to IL-2, IFN-alpha or anti CD16 monoclonal antibodies). On the other
      hand genistein, a competitive inhibitor of PTK enzymes, blocked the expression of
      CD69 induced by activation of NK cells via IL-2 or IFN-alpha receptors, CD16 and
      K562 receptor(s), indicating that stimulation of PTK is a common step in the
      signal transduction events leading to the induction of CD69 antigens after the
      activation of NK cells via these receptors.

PMID- 8477801
TI  - Linkage disequilibrium between TAP2 variants and HLA class II alleles; no primary
      association between TAP2 variants and insulin-dependent diabetes mellitus.
AB  - The TAP1 and TAP2 genes, located in the HLA class II region, encode subunits of a
      peptide transporter. Both genes display limited genetic variability; four
      different nucleotide substitutions have been found in the TAP2 gene. Here studies
      on linkage disequilibrium between TAP2 variants and HLA class II alleles are
      reported, in an attempt to evaluate whether TAP2 variants are associated with
      insulin-dependent diabetes mellitus (IDDM). As reported previously, a significant
      decrease of homozygosity for TAP2 alleles encoding alanine at residue 665 (665
      Ala) and glutamine at 687 (687 Gln) paralleled by an increase in homozygosity for
      TAP2 alleles encoding threonine at residue 665 (665 Thr) and a stop codon at 687
      (687 Stop), was found in both Finnish and Norwegian IDDM patients compared to
      random controls. However, a strong linkage disequilibrium between these TAP2
      polymorphisms and given HLA-DR and -DQ genes was observed among healthy controls.
      The frequent 665 Thr and 687 Stop variants were in linkage disequilibrium both
      with the DR4-DQ8 and the DR3-DQ2 haplotypes, haplotypes which are strongly
      associated with IDDM. In contrast, the DR1-DQ5 and DR13-DQ6 (e.g. DQB1*0603)
      haplotypes, which are decreased among IDDM patients, were associated with the 665
      Ala and 687 Gln variants. Thus, when DR- and DQ-matched patients and controls
      were compared, associations of the investigated TAP2 variants and IDDM were no
      longer detectable. These data, therefore, indicate that the associations
      previously found between certain TAP2 variants and IDDM are secondary to a
      primary association between this disease and particular DQ alpha beta
      heterodimers.

PMID- 8477802
TI  - Serum soluble interleukin-6 receptor in MRL/lpr mice is elevated with age and
      mediates the interleukin-6 signal.
AB  - The characteristics of soluble interleukin-6 receptor (sIL-6R) in murine sera
      were examined. To investigate a relationship between serum sIL-6R level and
      autoimmune diseases, quantitative analysis of serum sIL-6R in MRL/lpr mice was
      performed by an enzyme-linked immunosorbent assay. The serum sIL-6R level in
      MRL/lpr mice of both sexes was below the detection limit (< 1.0 ng/ml) at 8 weeks
      of age, but it increased in accordance with age and reached 42 +/- 9.3 ng/ml in
      female and 31 +/- 13 ng/ml in male mice at 30 weeks of age. In MRL/+ mice,
      although an age-associated increase in serum sIL-6R level was observed, it was
      much less extensive than that in MRL/lpr mice. Elevated serum sIL-6R level at the
      age of 30 weeks was observed in female and male (NZB x NZW)F1 mice (32 +/- 10
      ng/ml and 17 +/- 5.0 ng/ml, respectively), and male BXSB/Mpj Yaa mice (42 +/- 18
      ng/ml), suggesting that elevated serum sIL-6R in aged mice is one of the
      characteristics of autoimmune-prone mice. Quantitative analysis of serum IL-6 in
      MRL/lpr revealed that the serum sIL-6R level correlated well with the serum IL-6
      level. We also showed that sIL-6R in the sera from MRL/lpr mice could mediate the
      IL-6 functions through the IL-6 signal-transducing receptor component gp130,
      suggesting that elevated production of sIL-6R may partly contribute to
      development of autoimmune disease in MRL/lpr mice.

PMID- 8477803
TI  - The structure of the mu/pseudo light chain complex on human pre-B cells is
      consistent with a function in signal transduction.
AB  - Prior to immunoglobulin (Ig) light (L) chain rearrangement, pre-B cells can
      express mu heavy (H) chains at the cell surface in association with pseudo (psi)
      L chains. This complex may be essential for B cell development. We have
      investigated the composition of the mu/psi L chain complex of a human pre-B cell
      line, in view of its potential role in transmembrane signal transduction. The
      mu/lambda receptor of a mature B cell line was analyzed in comparison. The mu/psi
      L chain complex is associated with disulfide-linked molecules that are homologous
      or identical to the mb-1 and B29 proteins, known to be integral components of
      membrane Ig receptors on mature B cells. Both receptors contain tyrosine (Tyr)
      kinase activity. In the mu/lambda receptor, the lyn and lck Tyr kinases could
      clearly be identified. The mb-1 and B29 proteins in both mu/lambda and mu/psi L
      chain receptors are substrates for in vitro phosphorylation on Tyr, but also on
      serine (Ser) and threonine (Thr) residues. The undefined mu-associated Ser/Thr
      kinase also phosphorylates the src-related kinases in the mu/lambda receptor and
      a 43-kDa mu-associated protein that is present in both complexes. The 43-kDa
      protein may be an integral part of both receptor types, or a transiently
      associated molecule instrumental in the signaling process. We conclude that the
      mu/psi L receptor on human pre-B cells fulfills the presently known criteria to
      function as a signal transduction unit.

PMID- 8477804
TI  - Structural motifs involved in human IgG antibody effector functions.
AB  - A humanized IgG antibody to CAMPATH-1 antigen (CDw52) is known to be lympholytic
      both in vitro and in vivo. So as to improve therapeutic potency through protein
      engineering strategies, we wish to define the structural motifs underlying some
      of the documented differences in function between human (h) IgG1 and IgG4 forms
      of the antibody. By the creation of heavy chain domain-switch and intra-domain
      recombinant antibodies we have established an important role for the carboxy
      terminal half of the CH2 domain in determining differential behaviour in antibody
      dependent cytotoxicity (ADCC) and in complement lysis. If this same region were
      necessary for the effector mechanisms that operate in vivo, then it might be
      possible to improve antibody effector functions by construction of novel
      antibodies that possess within the one molecule multiple copies of the crucial
      hinge-CH2 associated structures. Although our previous work suggested that the
      hIgG4 CAMPATH-1 antibody was ineffective at ADCC, we found this to be so only in
      some individuals. In others, IgG4, and indeed all the IgG subclasses were able to
      mediate ADCC. Overall, though, hIgG1 remains the best choice isotype for lytic
      therapy in vivo.

PMID- 8477805
TI  - Activation of uterine intraepithelial gamma delta T cell receptor-positive
      lymphocytes during pregnancy.
AB  - Intraepithelial lymphocytes (IEL) of the uterus of non-pregnant sheep were
      analyzed by single- and two-color flow cytometry. Very few lymphocytes carrying
      classical B and T cell markers (CD5, surface immunoglobulin) were detected in the
      uterine epithelial cell suspensions and all IEL expressed the CD8 surface marker
      although with varying intensities. Three distinct subpopulations were identified
      including a major (46-56%) population of CD8+CD45R- gamma delta T cell receptor
      (TcR)-negative cells and approximately equal numbers of CD8+CD45R+ gamma delta
      TcR- and CD8+CD45R+ gamma delta TcR+ lymphocytes. The same three subpopulations
      were also present in the interplacentomal areas of the uterus of ewes at a late
      stage of pregnancy but there was a dramatic increase (60-70%) in the gamma delta
      TcR+ subpopulation. In addition, a pronounced increase in both size and
      granularity was observed in the IEL population of pregnant uteri and this was
      attributed to the gamma delta TcR+ cells. Light and electron microscopic
      examination of these gamma delta TcR+ IEL revealed an increase in metabolic
      activity and the formation of exceptionally large cytoplasmic granules and
      confirmed their restricted localization within the uterine epithelium close to
      the trophoblast. These results represent for the first time, a clear example of
      the activation of gamma delta TcR+ cells which is not associated with an ongoing
      disease process or infection. gamma delta TcR+ cells have recently been observed
      in the epithelium of the murine reproductive tract and were characterized by
      their unique homogeneous receptor structure. The present results indicate that
      these cells may play an important physiological role during pregnancy.

PMID- 8477806
TI  - Real-time measurement of antigenic peptide binding to empty and preloaded single
      chain major histocompatibility complex class I molecules.
AB  - Cytotoxic T lymphocytes (CTL) recognize peptides in association with major
      histocompatibility complex (MHC) class I proteins, but how peptides bind to class
      I is not well understood. We used a fluorescence technique to measure antigenic
      peptide binding to a soluble, single-chain Kd (SC-Kd) molecule in which the Kd
      heavy chain was connected by a 15-residue link to beta 2-microglobulin. Peptides
      were covalently labeled at their N terminus with dansyl, and binding of
      dansylated Kd-restricted peptides to SC-Kd resulted in significant fluorescence
      enhancement, which could be inhibited by unmodified Kd-restricted peptides. Real
      time binding of a dansylated peptide could be followed by monitoring the
      fluorescence at 530 nm. The dansylated Plasmodium berghei circumsporozoite (PbCS)
      263-260 peptide bound to "empty" SC-Kd with an association rate constant of 1140
      M-1s-1, and the subsequent spontaneous dissociation of the SC-Kd-peptide complex
      was slow. The dissociation increased dramatically after addition of excess
      unlabeled PbCS 253-260 peptide, but with a slower association constant for
      unlabeled peptide, 77 M-1s-1. Thus, the Kd-peptide complex on the surface of
      antigen-presenting cells should be stable, but high concentrations of peptides in
      the endoplasmic reticulum (ER) lumen would allow for peptide exchange on Kd
      before export to the surface. The apparent activation energy for PbCS 253-260
      peptide binding to SC-Kd was 6.78 +/- 0.64 kcal/mole, similar to values
      previously reported for antigen-antibody interactions.

PMID- 8477807
TI  - Interleukin-9 stimulates in vitro growth of mouse thymic lymphomas.
AB  - The ability of interleukin (IL)-9 to stimulate the in vitro proliferation of
      freshly collected mouse thymic lymphoma cells was tested on a panel of 45 tumors,
      induced by N-methyl-N-nitrosourea (MNU) or by X-ray irradiation. IL-9
      significantly stimulated the proliferation of 26 of these tumors. Out of 11 other
      factors tested, only IL-2, IL-4 and IL-7 showed similar activities. In addition
      to the responses to IL-9 alone, a potent synergy was often observed between IL-9
      and IL-2 for MNU-induced tumors. Synergies between IL-9 and IL-7 or IL-9 and IL-4
      were also observed but less frequently. The growth-promoting activity of IL-9 and
      the synergistic activities of IL-2 and IL-9 for thymic lymphoma cells were
      confirmed with cell lines established from the fresh tumors.

PMID- 8477808
TI  - Chicken major histocompatibility complex class II B genes: analysis of
      interallelic and interlocus sequence variance.
AB  - Five different chicken B-LB genes were cloned and sequenced. The comparison of
      these sequences shows that they can be classified as members of two different
      families, the B-LBII family (containing the B-LBI and B-LBII genes) and the B
      LBIII family (containing the B-LBIII, B-LBIV, and B-LBV genes). The extent of
      polymorphism within each of these families was assessed by in vitro amplification
      of DNA fragments encompassing exon 2 in several haplotypes. The nucleotide
      sequences were determined, and pairwise relationships were evaluated. In the
      course of this work, a sixth gene termed B-LBVI was identified, defining a third
      family (B-LBVI family). Polymorphism of the B-LBIII or B-LBVI families is far
      less extensive than that of the B-LBII family. In this latter, the distribution
      of conserved and polymorphic residues is similar to what has been described in
      mammals. These families seem to have been generated by gene duplication events
      giving rise to several isotypes, as observed in mammals. However, phylogenetic
      analyses indicate that these families are not homologous to their mammalian
      counterparts. Evaluation of the level of transcription of these different genes
      showed that genes from the B-LBII family are predominantly transcribed over those
      of the other families.

PMID- 8477809
TI  - Characterization of the human T cell receptor alpha-chain repertoire and
      demonstration of a genetic influence on V alpha usage.
AB  - Despite considerable knowledge of the determinants and profile of the T cell
      receptor (TCR) beta-chain repertoire, very little is known about the repertoire
      of the V alpha and J alpha segments of the TCR in man or mouse. We have used the
      anchored polymerase chain reaction (PCR) to analyze the human TCR alpha-chain
      repertoire at the mRNA level in peripheral blood lymphocytes. We find marked
      differences in the usage of individual V alpha segments. The V alpha repertoire
      is determined both by differences in the use of individual V alpha gene segments
      at the time of gene rearrangement and by genetic influences on the selection of
      the expressed V alpha repertoire, presumably during thymic maturation. Analysis
      of the J alpha repertoire shows non-random usage of individual J alpha segments
      but no obvious relationship to chromosomal position. We also report three new V
      alpha segments, three new J alpha segments and possible allelic variation in V
      alpha gene segments. Two unusual TCR alpha transcripts are described which add
      new information on the nature of TCR alpha transcript assembly.

PMID- 8477810
TI  - Essential role of tumor necrosis factor-alpha in the differentiation of human
      tonsil in vivo induced B cells capable of spontaneous and high-rate
      immunoglobulin secretion.
AB  - Human tonsils contain B cells capable of spontaneous and high-rate immunoglobulin
      (Ig) secretion in vitro. These cells are in vivo induced mature B cells, and, as
      such, they provide and adequate model for studying tonsil B cell differentiation.
      The present report analyzes the effect of a variety of factors on purified tonsil
      B cells capable of spontaneous IgG secretion in fetal calf serum (FCS)-containing
      and serum-free supplemented cultures. Tumor necrosis factor-(TNF) alpha was found
      to be important for these B cells to reach the high-rate IgG-secreting stage, as
      is indicated by the following findings: (a) none of the factors used modified
      tonsil B cell IgG secretion in FCS-containing cultures; (b) TNF-alpha (5-20
      ng/ml), but not other cytokines or factors including interleukin (IL)-6, was
      capable of restoring missing IgG production in serum-free supplemented cultures
      of tonsil B cells; and (c) IgG secretion in FCS-containing cultures was inhibited
      by the addition of blocking anti-TNF-alpha antibodies, but not anti-IL-6
      antibodies, and this inhibition could be specifically reversed by exogenous TNF
      alpha. TNF-alpha was actively produced by tonsil B cells (range 120-750 pg/ml) in
      the presence, but not in the absence, of FCS. The TNF-alpha inductive effect
      occurred during the first 12 h of culture and did not require DNA synthesis.
      These results indicate that the early and endogenous generation of TNF-alpha
      seems to be essential for tonsil in vivo induced B cells to differentiate into
      the high-rate Ig-secreting stage.

PMID- 8477811
TI  - An intermolecular mechanism of T cell help for the production of antibodies to
      the bacterial pathogen, Chlamydia trachomatis.
AB  - Antibodies that neutralize infectivity are directed at the antigenically variant
      major outer membrane protein (MOMP) of Chlamydia trachomatis. A vaccine for
      chlamydia will need to include T cell determinants that elicit T helper (Th)
      cells which provide help to MOMP-specific B cells. A limited number of
      determinants on MOMP are able to elicit Th cells and sequence diversity in the
      MOMP molecule may alter T cell recognition of these determinants. We investigated
      whether two sequence invariant proteins of C. trachomatis that are both abundant
      and immunogenic could elicit T cell help for the production of antibody to MOMP.
      We found that outer membrane protein 2 (OMP2) but not outer membrane protein 3
      (OMP3) was able to prime BALB/c mice for an anamnestic anti-MOMP response
      following boost with the intact organism. This demonstration of an intermolecular
      mechanism of T cell help in a bacterial system has important implications for the
      development of a chlamydial vaccine as well as the design of vaccines for other
      antigenically variant non-viral pathogens.

PMID- 8477812
TI  - Lymphocytes bearing the gamma delta T cell receptor in acute Brucella melitensis
      infection.
AB  - A phenotypical analysis carried out by indirect immunofluorescence and two-color
      cytofluorometry showed that the number of lymphocytes bearing the gamma delta T
      cell receptor (TcR) heterodimer was dramatically increased in the blood of six
      children with Brucella melitensis infection. Most in vivo expanded gamma delta T
      cells reacted with a monoclonal antibody which identifies V delta 2 gene products
      and a significant proportion expressed CD25 and HLA-DR activation antigens. In
      addition, whereas only a few gamma delta T lymphocytes were CD8+, nearly all were
      CD4-. Highly enriched populations of both alpha beta and gamma delta T cells were
      obtained by negative immunoselection from three subjects with brucellosis sampled
      during convalescence. Despite the different form of their TcR, the proliferation
      of these two major T cell subsets in response to a mitogenic anti-CD3 monoclonal
      reagent (OKT3) was optimal. In contrast, alpha beta, but not gamma delta, T
      lymphocytes proliferated vigorously in response to the antigenic stimulus
      elicited by heat-killed Brucella. Further studies are, therefore, needed to
      determine whether the selective expansion of the gamma delta T cell subpopulation
      observed during the clinical course of the infection is driven by antigenic
      determinant(s) borne by the pathogen in vivo or is due to host-derived stimuli,
      such as autologous heat-shock proteins expressed on the surface of the infected
      cells.

PMID- 8477813
TI  - The level of N-region diversity in T cell receptors is not pre-ordained in the
      stem cell.
AB  - The alpha beta T cell repertoires of adults and neonates are distinctly
      different. For example, T cell receptors (TcR) from adult animals have
      substantial N-nucleotide addition at their V-D-J junctions while those from
      neonatal animals do not. This dichotomy reflects a rather abrupt change in
      expression of the terminal deoxynucleotidyl transferase (TdT) gene in thymocytes
      on day 4 after birth. We have asked whether this change is due to the
      differentiation of successive waves of stem cells harboring different potentials
      for TdT expression, a scenario like the one proposed to explain developmental
      regulation of gamma delta T cell repertoires. Reconstitution of adult severe
      combined immunodeficiency mice with either fetal liver or adult bone marrow
      precursors gave rise to T cells with substantial N-region diversity in their TcR,
      even at the earliest points of reconstitution. It is most likely, then, that the
      abrupt change in TdT gene expression in day 4 thymocytes is due to an
      environmentally induced switch-on.

PMID- 8477814
TI  - Clonal deletion as direct consequence of an in vivo T cell response to bacterial
      superantigen.
AB  - To date clonal deletion of peripheral mature T cells is restricted to in vivo
      model systems characterized by prolonged exposure of mice to antigens and clonal
      T cell expansion preceding clonal deletion. Here we describe that upon challenge
      of mice with the superantigen staphylococcal enterotoxin B two immediate events
      become imposed on ligand-reactive V beta 8+ T cells in lymph node cells draining
      the local site of injection. First, and within hours V beta selective clonal
      deletion is initiated via an apoptotic process. Second, the remaining V beta 8+ T
      cells first develop a profound state of ligand-specific unresponsiveness and
      subsequently initiate clonal in vivo growth. It is suggested that the dichotomy
      of events observed reflects a direct consequence of T cell receptor occupancy in
      the context of inappropriate signalling.

PMID- 8477815
TI  - Quantitative analysis of molecules which distinguish functional compartments
      within germinal centers.
AB  - Five zones in the secondary follicles of human tonsils are described, which are
      distinguished by the phenotype of their constituent cells. Moving from the apex
      to the base of the follicle the zones are termed: follicular mantle, outer zone,
      apical light zone, basal light zone and dark zone. The dark zone contains
      proliferating, CD77high, centroblasts and thin, widely spaced processes of
      follicular dendritic cells (FDC). The apical and basal light zones on the other
      hand contain a dense network of FDC which express CD21 and CD54 strongly. The FDC
      of the apical light zone differ from those of the basal light zone by their high
      expression of CD23. Centroblasts of the dark zone give rise to non-proliferating
      centrocytes which move apically through the light zone (Eur. J. Immunol. 1991.
      21:2951). The centrocytes of the basal light zone are more pyroninophilic, more
      closely-packed and larger than those in the apical light zone. Consequently, by
      conventional histology the basal light zone appears to be part of the dark zone.
      The nomenclature adopted, however, adheres to the convention that the dark zone
      is filled with proliferating centroblasts. Cells undergoing apoptosis were
      identified both in the dark and light zones, but more than half of these cells
      were located in the basal light zone. This is consistent with the concept that
      the progeny of cells which undergo somatic mutation in their immunoglobulin
      variable region genes in the dark zone migrate to the light zone where they are
      selected on the basis of their capacity to bind to antigen held on FDC. Cells
      receiving an antigen-dependent signal survive while those that do not kill
      themselves by apoptosis. The outer zone does not contain CD23high cells and in
      this way is distinguished from the adjacent follicular mantle and apical light
      zone. It contains small lymphoid cells, blasts and plasmacytoid cells. Many cells
      of the outer zone express CDw75 strongly. The outer zone also extends as a narrow
      band around the dark zone. Possible roles of FDC and T cells of the light zone
      and outer zone in inducing centrocytes to differentiate to memory cells or
      plasmablasts are discussed.

PMID- 8477816
TI  - Protein kinase C inhibitors potentiate angiotensin II-induced phosphoinositide
      hydrolysis and intracellular Ca2+ mobilization in renal mesangial cells.
AB  - Stimulation of mesangial cells with angiotensin II leads to rapid
      phosphoinositide hydrolysis and subsequent mobilization of intracellular Ca2+.
      Previous studies indicated that activation of protein kinase C (PKC) triggers a
      negative-feedback signal, which limits phosphoinositide turnover. By comparing
      the relative susceptibility of PKC isoenzymes to phorbol ester-induced down
      regulation with the down-regulation of the functional cell response, i.e.
      feedback inhibition of inositol trisphosphate production, we inferred that PKC
      alpha and PKC-delta are candidates for regulating phosphoinositide hydrolysis in
      mesangial cells. To test this hypothesis further, we examined the effects of
      inhibitors of PKC, that are reportedly not active on PKC-delta, on angiotensin II
      stimulated phosphoinositide degradation and Ca2+ mobilization. Pretreatment of
      mesangial cells with the PKC inhibitors staurosporine and K252a potently
      augmented inositol trisphosphate and 1,2-diacylglycerol formation as well as Ca2+
      mobilization in response to angiotensin II. These results suggest that PKC-alpha,
      but not PKC-delta, is the most likely candidate mediating feedback inhibition of
      angiotensin II-stimulated phosphoinositide turnover in mesangial cells.

PMID- 8477817
TI  - Endothelin receptors stimulate both phospholipase C and phospholipase D
      activities in different cell lines.
AB  - Endothelin (ET) receptor-binding assays using [125I]ET-1 in C6-glioma cells and
      in Rat-1 and Swiss 3T3 fibroblasts indicated the presence of two binding sites,
      one of which binds agonists at the pM range and the other at the nM range. All
      three cell lines exhibited the same pharmacological profile for agonist binding
      (ET-1 congruent to sarafotoxin-b > ET-3), which suggests that the receptor is of
      the ETA type. Binding of ET-1 to the receptor resulted in activation of two
      phospholipases, phospholipase C (PLC) and phospholipase D (PLD). The activation
      of PLC or PLD by endothelin in the three cell lines was mediated by the high
      affinity binding site (nM range) and was not significantly affected by either
      extracellular or intracellular Ca2+. Measurement of PLD activation by ET-1 and/or
      phorbol 12-myristate 13-acetate (PMA), in the presence and absence of two potent
      inhibitors of protein kinase C (PKC), strongly suggests that activation of PLD by
      ET receptor in C6 glioma cells as well as in Rat-1 and Swiss 3T3 fibroblasts
      involves both PKC-dependent and PKC-independent mechanisms.

PMID- 8477818
TI  - Angiotensin AT1 receptors mediate a positive inotropic effect of angiotensin II
      in guinea pig atria.
AB  - Angiotensin II receptors in adult guinea pig hearts were characterized using
      [125I][Sar1,Ile8]angiotensin II and the non-peptidic receptor antagonists,
      losartan and PD 123319. Autoradiographic experiments and binding experiments
      performed on membrane preparations showed that cardiac tissues mainly expressed
      losartan (Kd = 30 nM)-sensitive AT1 receptors. In contraction experiments,
      angiotensin II produced a positive inotropic effect in both right and left atrial
      preparations. This action was prevented by losartan but not by PD 123319. It is
      concluded that mainly AT1 receptors are expressed in guinea pig atria and that
      these sites are responsible for the positive inotropic effect of angiotensin II.

PMID- 8477819
TI  - Recent advances in the molecular biology of growth-hormone secreting human
      pituitary tumours.
AB  - The application of DNA technology has led to significant progress in our
      understanding of the aetiology of GH-secreting pituitary tumours. X-chromosome
      inactivation and RFLP analysis has revealed that GH-secreting tumours are
      monoclonal in origin and thus arise as a consequence of a somatic mutation within
      a single cell. Using PCR and sequence analysis, such a mutation has been
      identified in 30-40% of tumours. This is the so-called gsp mutation in which the
      gene for the alpha s subunit of the Gs protein is converted to an oncogene the
      expression of which results in constitutive adenyl cyclase activity and thus
      excessive cAMP production. In our own studies, we demonstrate that it is unlikely
      that a defect within the promoter region of the GH gene will prove to be a cause
      of excessive GH secretion in acromegaly. In contrast, we have shown that the GH
      gene is hypomethylated in tumour derived DNA and this may account, at least in
      part, for abnormal GH gene expression.

PMID- 8477820
TI  - Molecular biology of insulin resistance.
AB  - Insulin resistance is an essential feature of a great variety of clinical
      disorders, like diabetes mellitus, obesity, essential hypertension, and is
      primarily due to a defect in hormone action at the cellular level. In the past
      decade application of novel research techniques including recombinant DNA
      technology have paved the way to understand the mechanisms of insulin action and
      its alterations at the molecular level. The first step in insulin action is the
      activation of the insulin receptor. The insulin receptor is a tetrameric protein
      consisting of two extracellular alpha- and two transmembrane beta-subunits.
      Binding of insulin to the alpha-subunit causes autophosphorylation of the
      intracellular beta-subunit region on tyrosine residues thereby activating the
      receptor. How the hormonal signal is subsequently transduced within the cell is
      still quiet unclear. The activated insulin receptor appears to couple to
      cytosolic receptor substrates which can affect different signaling cascades
      eliciting the pleiotropic hormone response on cell metabolism and growth. Most
      proteins involved in the signal transduction pathway of insulin are not known
      yet, but each of them might play a role in the various forms of insulin
      resistance. Taking the insulin receptor as an exemplary protein involved in
      insulin action we review molecular mechanisms regulating insulin receptor
      activity, gene expression, and the role of natural occurring insulin receptor
      gene mutations in patients with insulin resistant diabetes mellitus. It is
      outlined how the combination of both clinical medicine and molecular biology not
      only helps to understand insulin action and the pathogenesis of insulin
      resistance, but also leads to new avenues in the differential diagnosis, therapy,
      and possibly prevention of this heterogenous but most frequent metabolic and
      endocrine disorder.

PMID- 8477821
TI  - Familial glucocorticoid resistance: an overview.

PMID- 8477822
TI  - Transcriptional control of pancreatic islet hormones gene expression.
AB  - Initiation of transcription requires transcription factors that recognize
      specific DNA sequences present in promoters and enhancers of the respective
      genes. Cell-specific expression of the pancreatic islet hormone genes is
      conferred by a cell-specific combination of transcription factors. The DNA
      binding sites and cDNAs of some of them have been characterized. An islet
      specific enhancer-binding protein of the rat glucagon gene recognizes also cis
      acting elements of the rat insulin I and rat somatostatin genes. Thus identical
      or related factors may be involved in the expression of these pancreatic genes,
      reflecting that the different islet cell types arise from a common progenitor
      cell. The characterization of islet-specific transcription factors may lead to
      regulatory genes whose products specify islet cell phenotypes during development.
      Basal transcriptional activity of islet hormone genes can be enhanced by
      metabolic, humoral or nerve signals via various second messenger systems. Cyclic
      AMP acts through distinct response elements. The islet cells are electrically
      excitable and known secretagogues increase electrical activity and elevate
      cytosolic calcium concentration. Depolarization-induced activation of voltage
      dependent calcium channels stimulates rat glucagon gene transcription suggesting
      that calcium is an intracellular signal for pancreatic islet hormone gene
      transcription.

PMID- 8477823
TI  - Genetic screening for multiple endocrine neoplasia type 2.

PMID- 8477824
TI  - Perspectives in gene therapy with recombinant adenoviruses.

PMID- 8477825
TI  - Synaptic density of axotomized hypoglossal motorneurons following pharmacological
      blockade of the microglial cell proliferation.
AB  - The purpose of the present study was to examine the possible role of reactive
      microglia in the removal of presynaptic terminals following motor axon injury.
      Quantitative electron microscopy was used to examine synaptic numbers and total
      relative synaptic coverage on hypoglossal neuronal perikarya following
      hypoglossal nerve transection in the rat with or without pharmacological blockade
      of the axotomy-induced microglial cell proliferation. In a previous study we have
      shown that the axotomy-induced microglial cell proliferation is selectively
      inhibited by continuous infusion of cytosine-arabinoside (ARA-C) into the
      ventricular system of the adult rat brain. Adopting this procedure in the present
      study resulted in an almost complete elimination of reactive microglia. There was
      a statistically significant decrease in the number of synapses and the relative
      synaptic coverage in untreated as well as ARA-C-treated animals 4 and 7 days
      after nerve transection. Immunocytochemical labeling of terminals in the
      hypoglossal nucleus using antibodies to synaptophysin showed a reduction in
      immunoreactivity around hypoglossal nerve cell bodies ipsilateral to nerve
      transection in both groups of animals. These results indicate that reactive
      microglia are not responsible for detachment of presynaptic terminals following
      motor axon injury.

PMID- 8477826
TI  - The role of the septohippocampal pathway in the regulation of hippocampal field
      activity and behavior: analysis by the intraseptal microinfusion of carbachol,
      atropine, and procaine.
AB  - The role of the septohippocampal pathway in the regulation of hippocampal field
      activity and behavior was assessed using the technique of intraseptal
      microinfusion of carbachol, atropine, and procaine. The effects of these
      manipulations were assessed by comparing them with the effects of intraseptal
      saline control infusions on spontaneously occurring motor behaviors and their
      correlated hippocampal field activities. In control conditions hippocampal theta
      field activity, with up to 40% of the total power concentrated in a 1-Hz band
      around the peak frequency, was recorded only during type 1 voluntary motor
      behaviors. Hippocampal large-amplitude irregular activity was recorded during
      type 2 automatic motor behaviors and during immobility. Microinfusion of
      carbachol into the MS/vDBB (medial septum/vertical limb of the diagonal band of
      Broca) resulted in continuous theta field activity regardless of what type of
      motor behavior the animal performed or whether it was immobile. However, under
      these conditions the performance of a voluntary movement consistently resulted in
      an upward shift of theta frequency, demonstrating that the frequency of carbachol
      elicited type 2 theta can be modulated by the behavioral activation of type 1
      theta. The subsequent infusion of atropine abolished the carbachol-elicited
      theta, while that occurring during type 1 voluntary movement was preserved. In
      contrast to the selective blockade of carbachol-elicited theta by atropine,
      procaine suppression of the MS/vDBB abolished both spontaneous movement-related
      (type 1) theta and carbachol-elicited (type 2) theta. During the postprocaine
      period theta frequency recovered rapidly in contrast to theta amplitude (power).
      This result applied to the recovery of both the coactivated type 1 and type 2
      theta occurring during spontaneous movement and the carbachol-elicited type 2
      theta alone. The behavioral results were discussed within the context of Bland's
      (Prog. Neurobiol. 26, 1-54, 1986) sensorimotor model which posits that
      hippocampal theta activity recorded during voluntary movement represents the
      coactivation of a cholinergically mediated sensory processing component and a
      feedback (possibly serotonergic) motor component.

PMID- 8477827
TI  - The effects of chronic administration of captopril on the mouse subfornical organ
      and area postrema.
AB  - We have studied by morphometric procedures the chronic effect of captopril on the
      subfornical organ (SFO) and area postrema (AP) of the adult mouse. Oral
      administration of captopril does not produce any change in the size of individual
      nuclei of the ependymocytes and neurons in both centers. However, there are other
      quantitative effects of captopril on the global volume of the SFO and on the
      neuropil and vascular elements of both the SFO and AP which present a significant
      increase. It is suggested that this increase is due to metabolic processes at the
      level of both circumventricular organs.

PMID- 8477828
TI  - Regenerating axons are not required to induce the formation of a Schwann cell
      cable in a silicone chamber.
AB  - After suture of proximal and distal nerve stumps into the ends of a silicone
      chamber, a tissue cable forms inside the chamber through which axons regenerate.
      Schwann cells are a critical cellular component of the cable because in their
      absence axons fail to regenerate into the cable. In this study, we sought to
      determine whether axons were needed to induce the formation of a Schwann cell
      containing cable. Transected stumps of sciatic nerves of adult rats were sutured
      into the ends of silicone chambers prefilled with phosphate-buffered saline or
      dialyzed plasma, leaving a 10-mm interstump gap. In order to eliminate any axonal
      influence in the chamber, the proximal sciatic nerve was further transected,
      ligated, and reflected, leaving a 4-mm piece of denervated nerve in the proximal
      chamber. A tissue cable formed at 4 weeks only in those chambers prefilled with
      dialyzed plasma. Light and electron microscopy revealed a central core of Schwann
      cells and fibroblasts within the cable that were collectively surrounded by a
      circumferential layer of fibroblasts and collagen. Blood vessels were randomly
      located throughout the cable. The Schwann cells extended numerous processes that
      were confined within a basal lamina-like membrane. Many of these processes
      contained microtubules and resembled unmyelinated axons. The ultrastructure of
      the processes, however, differed from that of axons in that some of the processes
      were in direct contact with the basal lamina of the Schwann cells and not
      surrounded by any other cell extensions. However, since these processes neither
      stained with silver nor disappeared after transection of the nerves entering or
      leaving the chamber, we conclude that they are not axons but in fact Schwann cell
      processes. In other animals bearing 4-week cables, the reflected nerve stump was
      reattached to the nerve piece in the proximal end of the chamber. Four weeks
      later, all the cables and varying lengths of the distal nerve trunks were filled
      with numerous myelinated and unmyelinated axons. The Schwann cell cable that
      forms within a dialyzed plasma prefilled chamber presents a useful system for
      basic research concerning the molecular mechanisms of Schwann cell or Schwann
      cell-axonal interactions and for applied research involving the clinical repair
      of human peripheral nerve injuries. Since a cable formed by our surgical method
      supports axonal regeneration, it has the potential to eliminate the need for a
      nerve graft to repair a gap in a nerve that requires delayed surgical
      intervention.

PMID- 8477829
TI  - Differential regenerative growth of CNS axons into tibial and peroneal nerve
      grafts in the thalamus of adult rats.
AB  - Segments of peripheral nerve were autografted into the thalamus of adult rats.
      The peroneal nerve was used in one group, the tibial nerve (which has
      approximately twice the cross-sectional area of the peroneal nerve) in a second
      group, and two lengths of peroneal nerve side by side in a third group. Between 1
      and 4 months later HRP was applied to the distal end of each graft to label
      neurons which had regenerated their axons into the graft. Serial coronal sections
      of each brain were reacted to reveal retrogradely transported HRP, and the
      positions of all labeled neurons were recorded in camera lucida drawings. In all
      three groups a few labeled neurons resembling thalamocortical projection cells
      were found in the dorsal thalamus close to the graft tip (mean number, 29 in the
      single peroneal group; 22 in the tibial group; and 14 in the double-peroneal
      group). However, neurons in the thalamic reticular nucleus (TRN) regenerated much
      more successfully into the larger nerve grafts; many more retrogradely labeled
      cells were found in animals with tibial or double-peroneal nerve grafts (mean
      number, 1.1 in the single-peroneal group; 272 in the tibial group; and 163 in the
      double-peroneal group). These neurons were concentrated in the sector of TRN
      known to project to the part of the dorsal thalamus containing the graft tip. The
      largest numbers of labeled neurons were found when the graft tip encroached upon
      the TRN. These results suggest that both graft size and graft position are
      critical determinants of the extent of axonal regeneration from the TRN. Larger
      grafts may be more copiously invaded by regenerating axons because such grafts
      damage larger numbers of TRN axons when implanted and/or because they stimulate
      regeneration by releasing critical quantities of neurotrophic factors.

PMID- 8477830
TI  - Manganese injection into the rat striatum produces excitotoxic lesions by
      impairing energy metabolism.
AB  - There is compelling evidence that excessive exposure to manganese (Mn) produces
      neurotoxicity, especially in the basal ganglia, resulting in a dystonic
      Parkinsonian disorder. Several experimental or clinical observations suggest that
      Mn neurotoxicity could involve impairment of energy metabolism. We examined the
      neurotoxic effects of Mn following local intrastriatal injection. Three hours
      after the injection of 2 mumol of MnCl2 into rat striatum, ATP levels were
      reduced to 51% of the control side and lactate level were increased by 97%,
      indicating an impairment of oxidative metabolism. Neurochemical analysis of the
      striata 1 week after Mn injection showed changes consistent with a N-methyl-D
      aspartate (NMDA) excitotoxic lesion. Dopamine, gamma-aminobutyric acid, and
      substance P concentrations showed dose-dependent significant decreases, but
      concentrations of somatostatin-like immunoreactivity and neuropeptide Y-like
      immunoreactivity were unchanged. The lesions were blocked by prior removal of the
      cortico-striatal glutamatergic input or by treatment with the noncompetitive NMDA
      antagonist MK-801. These findings indicate that Mn neurotoxicity involves a NMDA
      receptor-mediated process similar to that we have previously found with two
      characterized mitochondrial toxins, aminooxyacetic acid, and 1-methyl-4
      phenylpyridinium. Our results show that Mn may produce neuronal degeneration by
      an indirect excitotoxic process secondary to its ability to impair oxidative
      energy metabolism.

PMID- 8477831
TI  - Choroidal and iris angioarchitecture of the newt: a scanning electron-microscopic
      study of vascular corrosion casts.
AB  - The corrosion cast technique provided for the first time an excellent three
      dimensional visualization of the vascular pattern of the choroid and iris in the
      newt eye. The results show the presence of a single arterial afference to the
      choroidal and iris capillaries: the ophthalmic artery is the origin of both
      ciliary arteries and the long posterior ciliary artery. Slightly behind the
      equatorial circumference of the eyeball the venous drainage consists of a single
      vessel on the dorsal side and two distinct vessels on the ventral one. It
      receives blood from both iris and choroid. The surface of the plastic endocasts
      shows some details of fine luminal structures of the endothelial cells. Shallow
      depressions may be regarded as imprints of endothelial cell nuclei, and they are
      distinctly different for arteries and capillaries. The angioarchitecture of the
      newt eye differs from that of brain in that hairpin-shaped capillary loops are
      not observed at all.

PMID- 8477832
TI  - Sulfhydryl oxidation induces calcium release from fragmented sarcoplasmic
      reticulum even in the presence of glutathione.
AB  - Alcian blue and plumbagin induced transient Ca2+ release from fragmented
      sarcoplasmic reticulum. Dithiothreitol (DTT) and glutathione (GSH) partially
      blocked Ca2+ release induced by these oxidizing compounds. Pretreatment of alcian
      blue and plumbagin with DTT or GSH for more than 1 min was required to abolish
      the ability of the oxidizing compounds to release Ca2+. Mg2+ and ruthenium red
      completely blocked alcian blue-and plumbagin-induced Ca2+ release. These results
      suggest that oxidation of sulfhydryls on Ca2+ release channels induces Ca2+
      release even in the presence of GSH in situ.

PMID- 8477833
TI  - Developmental and ageing changes in aminopeptidase activities in selected tissues
      of the rat.
AB  - Aminopeptidase activities, assayed as arylamidase activities, were investigated
      in selected tissues of 1, 6, 12 and 24-month-old rats. The enzyme activities were
      found to have a heterogeneous distribution and age-related changes were observed.
      The highest levels of soluble arginyl-aminopeptidase activity were detected in
      brain homogenate at all the studied ages, whereas membrane-bound activity
      presented the highest levels in brain and kidney in the four ages tested.
      Aspartyl-aminopeptidase activity was detected mainly in the particulate fraction
      of kidney at all four ages. In 1, 6 and 12-month-old animals, soluble aspartyl
      aminopeptidase activity was also higher in the kidney than in the rest of the
      tissues, whereas in the group of 2-year-old rats, the highest levels were found
      in both kidney and liver. Age-related changes were observed in all the studied
      tissues and for all the assayed enzymatic activities. In general, the maximal
      levels were detected in both the youngest and the oldest animals, and the minimal
      ones in 6 and 12-month-old rats. However, in the adrenals, the soluble and
      membrane-bound arginyl-aminopeptidase activity was higher in 6-month and 2-year
      old rats than in 1-month and 12-month-old rats. These changes may reflect the
      functional status of the susceptible endogenous substrates of aminopeptidases.

PMID- 8477834
TI  - Free intracellular and protein bound amino acids in tissues as affected by a
      mixed beta-adrenergic agonist.
AB  - The administration of metaproterenol induced an increase in gastrocnemius muscle
      weight without change in body growth rate or tissue protein concentrations, while
      epididymal fat was reduced. This effect was accompanied by an enhancement in the
      levels of intracellular amino acids in muscle. By contrast, liver amino acids
      were unaffected by treatment with the mixed beta-adrenergic agonist.

PMID- 8477835
TI  - Tissue-specific modulation of rat glucocorticoid receptor binding activity by
      melatonin.
AB  - The effect of melatonin and 2-Iodo-melatonin on nuclear and cytosolic
      glucocorticoid receptors in the brain, pituitary, thymus and liver has been
      examined. The results indicate that both melatonin and 2-Iodo-melatonin
      administration is associated with marked changes in the density and the affinity
      of cytosolic and nuclear forms of glucocorticoid receptors. These observations
      are discussed in the context of a possible involvement of pineal melatonin in the
      mechanisms regulating the behaviour and metabolism of steroid receptors.

PMID- 8477836
TI  - Role of lipid peroxidation in ferric lactate-enhanced calcium uptake by Ehrlich
      carcinoma cells.
AB  - Comparison of Ca2+ uptake by Ehrlich carcinoma cells in presence of ferric
      lactate or aluminum lactate, and formation of thiobarbituric acid-reactive
      substances, suggests that lipid peroxidation is associated with but not the cause
      of calcium overload that can lead to cell injury and death.

PMID- 8477837
TI  - Retroviral-mediated gene therapy for the treatment of citrullinemia. Transfer and
      expression of argininosuccinate synthetase in human hematopoietic cells.
AB  - Citrullinemia is a recessive genetic disease caused by a deficiency in
      argininosuccinate synthetase (AS). Retroviruses were used to transduce the human
      AS gene into cultured human cells. Using amphotropic viruses with high titer (>
      10(6) cfu/ml), we were able to correct the defect in cultured fibroblasts from
      citrullinemic patients. Retroviral transduction of the human AS gene into human
      bone marrow cells was also studied. Co-cultivation was used to infect the cells
      and up to 80% of progenitor cells were found to be carrying and expressing the AS
      retrovirus after infection. When the infected cells were kept in culture,
      integration and expression of the retrovirus was observed. Retroviral sequences
      were present and expressed in the cultured bone marrow-derived cells for up to 10
      weeks.

PMID- 8477838
TI  - Agglutinins from aquatic insects--tumor cell agglutination activity.
AB  - Agglutinins were identified in whole body extracts of aquatic insects by means of
      murine tumor cell agglutination, using sarcoma 180 ascites, Ehrlich, and MM-46
      cells. Screening revealed agglutinins in 5 of 10 of the larvae tested, and in 2
      of 6 of the water-dwelling adult insects; Gerris paludum insularis and Gyrinus
      japonicus. Only the agglutinin from adult G. paludum also agglutinated human
      erythrocytes. An ascites tumor was converted into a solid form in vivo after
      administration of G. paludum agglutinin. The observation that these aquatic
      insect agglutinins preferentially agglutinate tumor cells has considerable
      implications in terms of anti-tumor effects such as inhibition of cell
      proliferation and metastasis.

PMID- 8477839
TI  - Properties of engineered antifreeze peptides.
AB  - Eight antifreeze-like peptides were produced by cleavage from engineered chimeric
      proteins. One was homologous to an antifreeze peptide of the winter flounder; the
      others differed in length and/or sequence. The homologous peptide and all those
      of equal or greater length were able to inhibit recrystallization. The longer
      peptides were so hydrophobic that their identification required modification of
      the usual protocols for high pressure liquid chromatography. Their elution
      positions were correlated to their hydrophobicities and their lengths. Additional
      naturally occurring antifreezes may be identifiable with this knowledge.

PMID- 8477840
TI  - Control of muscle pyruvate oxidation during late pregnancy.
AB  - Despite significant increases in circulating concentrations of lipid fuels
      (triacylglycerol, non-esterified fatty acids (NEFA) and ketone bodies) in late
      pregnant rats sampled in the fed (absorptive) state, cardiac and skeletal muscle
      active pyruvate dehydrogenase (PDHa) activities remained comparable with those
      observed in fed, age-matched virgin controls. Cardiac PDHa activity was
      suppressed in response to acute (6 h) starvation in late-pregnant (as well as
      virgin) rats: this inactivation was opposed by inhibition of mitochondrial long
      chain FA oxidation. Starvation (6 h) also led to PDH inactivation in skeletal
      muscles of late-pregnant, but not virgin, rats. Starvation for 24 h led to
      further suppression of cardiac PDHa activity and was associated with significant
      increases in PDH kinase activities in both virgin and late-pregnant rats. Late
      pregnancy did not itself influence cardiac PDH kinase activity.

PMID- 8477841
TI  - Inhibition of neutral cholesteryl ester hydrolase by a naturally occurring
      cytosolic protein in macrophages.
AB  - The soluble fraction from a number of macrophage cell lines has been shown to
      contain a protein(s) that inhibits neutral cholesteryl ester hydrolase. The
      inhibition is dependent on the concentration of soluble protein used, and the
      efficiency of the inhibitor can be influenced by the inclusion of oleate and an
      inhibitor of ACAT. It is suggested that the presence of this material indicates
      that the macrophage contains a means of negatively controlling the activity of
      the hydrolytic phase of the cholesterol/cholesteryl ester cycle.

PMID- 8477842
TI  - Amino acid sequence similarities between low molecular weight endo-1,4-beta
      xylanases and family H cellulases revealed by clustering analysis.
AB  - The amino acid sequences of seventeen family G xylanases and the two known family
      H cellulases have been compared by hydrophobic cluster analysis. A weak but
      significant similarity was demonstrated between these two families suggesting
      that these enzymes share the same molecular mechanism and catalytic residues and
      that they have related 3D folds. The major differences were found in the N
      terminal regions.

PMID- 8477843
TI  - Different thyroid hormone-deiodinating enzymes in tilapia (Oreochromis niloticus)
      liver and kidney.
AB  - Enzymes catalyzing the outer ring deiodination (ORD) of iodothyronines are
      important for the regulation of thyroid hormone bioactivity. We have studied ORD
      of thyroxine (T4) and 3,3',5'-triiodothyronine (rT3) in liver and kidney
      microsomes of fish, i.e. tilapia (Oreochromis niloticus). Tilapia kidney contains
      an enzyme which resembles the mammalian selenoenzyme type I iodothyronine
      deiodinase (ID-I) with respect to substrate preference (rT3 > T4) and high
      (approximately microM) Km values, but is much less sensitive to selenocysteine
      (Sec)-targeted inhibitors, including 6-propyl-2-thiouracil (PTU). In contrast,
      tilapia liver contains an enzyme very similar to mammalian type II deiodinase (ID
      II) with respect to substrate preference (T4 > rT3), low (approximately nM) Km
      values, and lack of sensitivity to Sec inhibitors.

PMID- 8477844
TI  - Divergent effects of fluoroaluminates on the peptide chain elongation factors EF
      Tu and EF-G as members of the GTPase superfamily.
AB  - Fluoraluminates are thought to mimic the gamma-phosphate of GTP and thus,
      together with GDP, perturb the functioning of heterotrimeric GTP-binding G
      proteins. Here we show they do inhibit the ribosome-stimulated GTPase activity of
      EF-G from Escherichia coli via the formation of a stable complex with EF-G-GDP
      and ribosomes. In contrast, no perturbed interactions were observed in a similar
      ribosomal complex with EF-Tu. Interestingly, in the absence of ribosomes both EF
      Tu an EF-G remain totally unaffected by fluoraluminates. For members of the
      GTPase superfamily such differential effects have not been described before.

PMID- 8477845
TI  - Identification of a protein from Saccharomyces cerevisiae with E2F-like DNA
      binding and transactivating properties.
AB  - The promoter of the human proto-oncogene MYC has been the first cellular target
      shown to be subject to regulation by the E2F transcription factor. E2F also has
      binding sites in other promoters regulated by cell proliferation and during the
      cell cycle. We have analyzed Saccharomyces cerevisiae for the presence of an E2F
      analogous protein. GAL1-based promoter constructs carrying the E2F binding site
      of the MYC or the adenovirus E2 promoter showed transcriptional activity in yeast
      cells. A DNA-binding factor, designated YE2F, binds specifically to the E2F
      consensus sequence and was partially purified from yeast extracts. YE2F showed
      identical contact points within the MYC binding site as authentic E2F protein
      from mammalian cells. The results suggest that the existence of an E2F-like
      protein in the yeast S. cerevisiae.

PMID- 8477846
TI  - Stabilization of mRNA in an Escherichia coli cell-free translation system.
AB  - It became clear that mRNA can be stabilized in a cell-free translation system of
      Escherichia coli by hybridization with a small DNA fragment at its 3' terminus.
      The stability increased when a small DNA fragment containing a stable hairpin
      structure with a GAAA loop was used. The enhancement of stabilization was brought
      about because the hairpin structure is resistant towards the nucleases contained
      in the translation system. The hairpin structure is effective by stabilizing the
      added DNA fragment itself towards the nucleases.

PMID- 8477847
TI  - Regulation of spermidine/spermine N1-acetyltransferase by intracellular polyamine
      pools. Evidence for a functional role in polyamine homeostasis.
AB  - Through its role in polyamine acetylation and the back-conversion pathway,
      spermidine/spermine N1-acetyltransferase (SSAT) has the potential to control
      intracellular polyamine pools by facilitating their catabolism and/or excretion.
      The possibility that the enzyme is subject to regulation by intracellular
      polyamine pools was investigated in MALME-3 human melanoma cells. Increases in
      intracellular polyamine pools by treatment with 3 microM exogenous spermidine or
      spermine for 48 h caused SSAT activity to increase 111% and 226%, respectively,
      and SSAT-specific mRNA to rise 19% and 66%, respectively. Decreases in polyamine
      pools by treatment with inhibitors of polyamine biosynthesis caused SSAT activity
      to decrease by 46% and mRNA to fall by 89%. Both SSAT activity and mRNA were more
      sensitive to changes in spermine than spermidine. The identification of a
      positive regulatory relationship between SSAT and intracellular polyamine pools
      further implicates this enzyme in a proposed model for polyamine pool
      homeostasis.

PMID- 8477848
TI  - Characterization and regulation of the angiotensin II type-1 receptor (binding
      and mRNA) in human adrenal fasciculata-reticularis cells.
AB  - The classical concept of human adrenal physiology indicates that only glomerulosa
      cells are the target of A-II. Herein, we demonstrated that cultured human adrenal
      fasciculata-reticularis cells were also responsive to this hormone. Indeed, these
      cells contained high affinity (Kd = 0.9-1.1 nM) and low capacity (8,000-13,000
      sites/cell) A-II receptors, and more than 95% of them were of the type-1. These
      AT1 receptors are functional since A-II was able to increase cortisol production
      after 48 h of treatment. These effects were inhibited by losartan, an AT1
      antagonist, but not by CGP42112A, an AT2 antagonist. The expression of the type-1
      A-II receptor mRNA was detected in the whole adrenal in both adult and fetus, and
      in cultured human adrenal fasciculata-reticularis cells. In these cells A-II
      negatively regulated AT1 receptor mRNA, and this effect was also mediated through
      the AT1 receptor subtype.

PMID- 8477849
TI  - Diabetes mellitus is one of the heterogeneous phenotypic features of a
      mitochondrial DNA point mutation within the tRNALeu(UUR) gene.
AB  - A heteroplasmic point mutation (transition A-to-G at nucleotide position 3,243 in
      the mitochondrial tRNALeu(UUR) gene) is found in a family suffering from a
      syndrome with diabetes, deafness and cardiomyopathy as the predominant clinical
      features.

PMID- 8477850
TI  - Insertion of MOM22 into the mitochondrial outer membrane strictly depends on
      surface receptors.
AB  - Targeting of preproteins to mitochondria and their translocation across the outer
      membrane are mediated by the mitochondrial receptor complex. This protein complex
      contains the import receptors MOM19 and MOM72 and the general insertion pore GIP.
      All seven components of the receptor complex are synthesized in the cytosol and
      thus have to be targeted to the mitochondria themselves. Here we investigated the
      import pathway of the precursor of MOM22 into the outer membrane. In contrast to
      other mitochondrial preproteins studied so far, the import of MOM22 absolutely
      depended on the presence of surface receptors. In fact, both receptors MOM19 and
      MOM72 were involved in its import pathway. The targeting of MOM22 to mitochondria
      is thus highly specific and controlled.

PMID- 8477851
TI  - Human neuroblastoma cells produce the NF-kappa B-like HIV-1 transcription
      activator during differentiation.
AB  - Human neuroblastoma GOTO and IMR32 cells differentiate into neural cells on
      treatment with 5-BrdU. Here we report that in association with differentiation
      induced by 5-BrdU, the transcription of HIV-1 was activated in both neuroblastoma
      cell lines. An NF-kappa B-like factor was also found to be produced in
      association with the neural cell differentiation of these cells. These results
      suggest that, during differentiation of neural cells, an NF-kappa B-like factor
      was produced, and that when the neural cells are infected with HIV-1 the
      production of NF-kappa B results in activation of transcription of HIV-1. Thus
      this NF-kappa B-like factor may be involved in the mechanism causing AIDS
      dementia.

PMID- 8477853
TI  - Prostaglandin A2 and delta 12-prostaglandin J2 induce apoptosis in L1210 cells.
AB  - Treatment of L1210 cells with prostaglandin A2 (PGA2) or 9-deoxy-delta 9,12-13,14
      dihydro PGD2 (delta 12-PGJ2) resulted in significant G2/M arrest and subsequent
      DNA fragmentation at concentrations that are cytotoxic to the cells. On agarose
      gel electrophoresis, DNA ladder formation was evident 24 h after the addition of
      delta 12-PGJ2 and remained apparent through 72 h, whereas G2/M accumulation was
      observed 6 h after the treatment. When the morphology of cells was examined by
      electron microscopy, L1210 cells incubated with a cytotoxic dose of PGA2 or delta
      12-PGJ2 for 24 h showed the characteristic morphological features of apoptosis
      such as chromatin condensation, nuclear fragmentation and formation of apoptotic
      body. Cycloheximide blocked the DNA fragmentation and morphological changes
      induced by delta 12-PGJ2. Our results suggest that these cyclopentenone PGs
      caused apoptotic cell death of L1210 cells which is preceded by G2/M accumulation
      and requires de novo protein synthesis.

PMID- 8477852
TI  - Prostaglandin H synthase. Inactivation of the enzyme in the course of catalysis
      is accompanied by fast and dramatic changes in protein structure.
AB  - Prostaglandin H synthase (PGHS) as apo-PGHS, holo-PGHS, and holo-PGHS,
      inactivated in the course of catalysis was studied using chemical modification
      with diethyl pyrocarbonate (DEPC). The exhausted reaction with DEPC corresponded
      to the modification of 7 histidine residues in apo-PGHS and 4 in holo-PGHS. All
      18 histidine residues became accessible for modification with DEPC in the enzyme,
      inactivated in the course of catalysis. The velocities of tryptic cleavage of all
      the three forms into two fragments were fairly different but independent of
      modification. Based on the results we hypothesize fast and dramatic changes in
      the protein structure in the course of the substrate conversion.

PMID- 8477854
TI  - Time-resolved tryptophan fluorescence in photosynthetic reaction centers from
      Rhodobacter sphaeroides.
AB  - Tryptophan fluorescence of reaction centers isolated from Rhodobacter
      sphaeroides, both stationary and time-resolved, was studied. Fluorescence
      kinetics were found to fit best a sum of four discrete exponential components.
      Half of the initial amplitude was due to a component with a lifetime of congruent
      to 60 ps, belonging to Trp residues, capable of efficient transfer of excitation
      energy to bacteriochlorophyll molecules of the reaction center. The three other
      components seem to be emitted by Trp ground-state conformers, unable to
      participate in such a transfer. Under the influence of intense actinic light,
      photooxidizing the reaction centers, the yield of stationary fluorescence
      diminished by congruent to 1.5 times, while the number of the kinetic components
      and their life times remained practically unchanged. Possible implications of the
      observed effects for the primary photosynthesis events are considered.

PMID- 8477855
TI  - The ZNF35 human zinc finger gene encodes a sequence-specific DNA-binding protein.
AB  - We developed a rapid method to determine DNA-binding sites for putative DNA
      binding proteins. This procedure has been successfully used to define a specific
      consensus site for the human ZNF35 zinc finger gene. ZNF35 encodes a 58-kDA
      polypeptide containing 11 consecutive finger motifs located at the amino
      terminus, and an acidic domain located at the carboxy terminus. These features
      suggest that ZNF35 is a site-specific DNA-binding protein involved in the
      regulation of gene expression. We have expressed the ZNF35 protein from E. coli
      and have employed a Southwestern-polymerase chain reaction method using random
      oligonucleotides to identify its high-affinity binding site. The core sequence
      for the ZNF35 protein-binding site is 5'-C/GC/GAAG/TA-3'.

PMID- 8477856
TI  - Domain of E. coli translational initiation factor IF2 homologous to lambda cI
      repressor and displaying DNA binding activity.
AB  - The carboxy-terminal region of translational initiation factor IF2 is a common
      region to the three active forms of the factor (alpha, beta and gamma) but its
      function is still unknown. We report here that this region of IF2 carries at
      least one domain which is homologous to the N-terminal and middle part of the cI
      repressor of lambda phage. The IF2 homologous domain harbors functionally
      important features of the lambda repressor, e.g. the helix-turn-helix motif and
      some of the residues essential for the structure of the hydrophobic core of the
      repressor. This homologous domain of IF2 was fused to the beta-galactosidase
      protein. The hybrid protein, as well as IF2 itself, shows a consistent DNA
      binding activity in nitrocellulose filtration assays but does not display the
      specificity of the cI repressor for the PR operator. The implication of this
      domain in the transcriptional activity of IF2, reported by others, is discussed.

PMID- 8477857
TI  - Participation of cathepsin L on bone resorption.
AB  - The proteinase responsible for bone collagen degradation in osteo-resorption was
      examined. The bone pit formation induced by parathyroid hormone (PTH) was
      markedly suppressed by leupeptin, E-64 and cystatin A, while no inhibition was
      observed by CA-074, a specific inhibitor of cathepsin B. Pig leucocyte cysteine
      proteinase inhibitor (PLCPI), a specific inhibitor of cathepsin L, and
      chymostatin, a selective inhibitor of cathepsin L, completely inhibited the pit
      formation. Cathepsin L activity in osteoclasts was much higher than the other
      cathepsin activities. Serum calcium in rats placed on a low calcium diet was
      decreased by treatment of E-64 or cystatin A, but not by CA-074. These findings
      suggest that cathepsin L is the main proteinase responsible for bone collagen
      degradation.

PMID- 8477858
TI  - Structure and localization of mRNA encoding a pigment dispersing hormone (PDH) in
      the eyestalk of the crayfish Orconectes limosus.
AB  - The pigment-dispersing hormone (PDH) is produced in the eyestalks of Crustacea
      where it induces light-adapting movements of pigment in the compound eye and
      regulates the pigment dispersion in the chromatophores. To study this hormone at
      the mRNA level, we cloned and sequenced cDNA encoding PDH in the crayfish
      Orconectes limosus. The structure of the PDH preprohormone consists of a signal
      peptide, a PDH precursor-related peptide (PPRP) and the highly conserved PDH
      peptide at the carboxy-terminal end. In situ hybridization in combination with
      immunocytochemistry revealed four cell clusters expressing PDH in the optic
      ganglia of the eyestalk. Three clusters stained both with the PDH cRNA probe and
      the PDH antiserum, however, the perikarya in the lamina ganglionaris (LG) only
      stained with the PDH antiserum, suggesting the presence of a PDH-like peptide in
      the LG.

PMID- 8477859
TI  - The catalytic activities of monomeric enzymes show complex pressure dependence.
AB  - High hydrostatic pressures in the biologically relevant range (< or = 1,200 bar)
      are known to cause dissociation of oligomeric enzymes in vitro, whereas protein
      denaturation requires pressures far beyond this range. Pressure-induced
      inactivation phenomena attributable to neither of these effects are shown to
      occur in monomeric enzymes. Three different types of pressure dependence can be
      distinguished: (1) a linear dependence of catalytic rate constants on pressure,
      as predicted by the activated complex theory, observed for lysozyme and
      thermolysin; (2) a biphasic profile consisting of two linear contributions, found
      for trypsin; (3) maximum curves, as observed for both directions of the octopine
      dehydrogenase reaction. The third case may be ascribed to a pressure-induced
      decrease in the partial specific volume of the protein, resulting in reduced
      flexibility of the active site. This mechanism may also apply to the pressure
      induced inactivation of assembly systems stabilized against dissociation in the
      cell.

PMID- 8477860
TI  - Nuclear protein transport is functionally conserved between yeast and higher
      eukaryotes.
AB  - The ability of a yeast nuclear protein to be transported into the nucleus of a
      higher eukaryotic cell was investigated. Mcm1, a transcriptional activator
      protein from Saccharomyces cerevisiae, was microinjected into the cytoplasm of
      Xenopus laevis frog oocytes. Mcm1 was imported into the oocyte nucleus indicating
      that the machinery for nuclear transport is conserved from yeast to higher
      eukaryotes. Furthermore, by comparing the nuclear import of free proteins and
      protein-gold complexes, we found that protein-gold complex formation appears to
      partially and specifically inactivate the nuclear transport activity of Mcm1 and
      that nucleoplasmin is an exceptionally good nuclear import substrate.

PMID- 8477861
TI  - The structure of neutrophil defensin genes.
AB  - Defensins are a family of microbicidal peptides abundant in the granules of
      mammalian neutrophils, in rabbit alveolar macrophages, and in human and murine
      intestinal Paneth cells. We cloned and sequenced the genes of three neutrophil
      specific defensins. Human HNP-1 and HNP-3 are nearly identical and rabbit NP-3a
      is closely related. The four known neutrophil-specific defensin genes are
      strikingly similar in the structure and organization of their three exons and two
      introns, but the three defensin genes expressed in macrophages (MCP-1 and -2) or
      Paneth cells (HD-5) are organized differently: HD-5 had only two exons, and MCP-1
      and -2 have a comparatively short first intron. The diverse genomic organization
      of defensin genes may contribute to their cell-specific expression.

PMID- 8477862
TI  - Inactivation of synovial fluid alpha 1-antitrypsin by exercise of the inflamed
      rheumatoid joint.
AB  - alpha 1-Antitrypsin (alpha 1AT) is known to be oxidised by reactive oxygen
      species both in vitro and in vivo, leading to its inactivation. We report here
      that synovial fluid (SF) alpha 1AT is inactivated during exercise of the knee
      joints of rheumatoid arthritis (RA) patients. Sequential SF sampling from
      exercised RA patients showed a marked decrease in the mean activity of alpha 1AT
      after exercise with no change in the molecular forms of alpha 1AT. No such
      inactivation was found in the control (continuously resting) RA patients. We
      suggest that oxidation may contribute to alpha 1AT inactivation as a consequence
      of 'hypoxic-reperfusion' injury after exercise of the inflamed joint.

PMID- 8477863
TI  - Surgical crown lengthening for function and esthetics.
AB  - Clinical crown lengthening is a useful procedure to provide tooth length for
      proper restoration of a tooth without compromising the periodontium or the
      retentive qualities of the restoration. It is also useful for enhancing maxillary
      anterior esthetics. Crown lengthening may be as simple as a limited removal of
      soft tissue or as complex as orthodontic extrusion followed by flap with osseous
      surgery on a tooth requiring endodontic therapy. Total treatment could thus
      involve endodontic, orthodontic, periodontic, and restorative procedures. Careful
      evaluation, case selection, treatment planning, and surgical treatment following
      the principles outlined in this article can achieve results that meet the
      functional and esthetic challenges of current dental practice.

PMID- 8477864
TI  - Surgical and orthodontic management of impacted teeth.
AB  - This article has accomplished four objectives. First of all, the most commonly
      impacted teeth have been identified. Aside from the third molars, these teeth
      include the maxillary canines, maxillary central incisors, mandibular second
      premolars, and mandibular second molars. Second, the cause of impaction has been
      discussed. In most situations, these unerupted teeth have been diverted or are
      angulated aberrantly during development. Once the root apex has closed, they lose
      their potential to erupt. Third, the various surgical procedures to uncover these
      impacted teeth have been described. Three different techniques (excision,
      apically positioned flap, and closed eruption technique) may be used to uncover
      the impacted tooth. The specific criteria used to select the proper surgical
      technique were stated. Last, the orthodontic mechanics and integration of tooth
      movement and surgical procedures were delineated and illustrated for each of the
      various types of impactions and uncovering techniques.

PMID- 8477865
TI  - Soft-tissue surgery to alleviate orthodontic relapse.
AB  - This article has presented three soft-tissue surgical techniques that have been
      shown to alleviate the relapse of orthodontically treated teeth in three specific
      situations: (1) rotations (and possibly also labiolingual irregularities), (2)
      extraction site closures, and (3) maxillary midline diastemas. The anatomy and
      histophysiology of the periodontium have been discussed briefly as they pertain
      to the rationale for these surgical procedures. None of the techniques discussed,
      if performed as indicated, will be detrimental to the supporting periodontal
      tissues and all can easily become a routine part of the clinician's standard
      retention therapy.

PMID- 8477866
TI  - Free gingival grafts. Current indications and techniques.
AB  - The free gingival graft is a simple, predictable technique for increasing the
      zone of attached gingiva. Dentists interested in performing minor surgical
      procedures should include the free gingival graft in their armamentarium.
      Indications and contraindications have been established, but the decision
      regarding the adequacy of the attached gingiva remains one of clinical judgment.
      The clinician must evaluate several variables, including the width of the
      attached gingiva, the patient's age, recession history, oral hygiene practices,
      teeth involved, and dental records. In the opinion of the authors, the free
      gingival graft usually should not be used in areas of inadequate attached gingiva
      when root coverage is indicated. Other techniques are more predictable and yield
      a more esthetic result.

PMID- 8477867
TI  - The subepithelial connective tissue graft for treatment of gingival recession.
AB  - A technique has been described for areas of single or multiple root coverage,
      especially in the maxilla, for coverage of existing crown margins, and for areas
      requiring a combination of ridge augmentation and root coverage. The success of
      the subepithelial connective tissue graft is attributed to the double blood
      supply at the recipient site from the underlying connective tissue base and the
      overlying recipient flap. The donor site is a closed wound, which produces less
      postoperative discomfort. In addition, an excellent color blend can be achieved.

PMID- 8477868
TI  - Treatment of moderate localized alveolar ridge defects. Preventive and
      reconstructive concepts in therapy.
AB  - A conscious effort should be made at the time of tooth extraction to eliminate or
      lessen the creation of a defect within the residual alveolar ridge. This
      objective can be achieved if teeth are extracted in an atraumatic manner and
      appropriate implant materials are placed into the sockets to prevent the eventual
      collapse of the ridge. Guided tissue regeneration procedures also may be used to
      prevent collapse within the ridge or augment an existing defect. In many
      instances, deformed ridges can be augmented to their former dimensions by the use
      of pouch, interpositional, or onlay graft procedures. Case reports are presented
      to show the effectiveness of these procedures.

PMID- 8477869
TI  - Laser in dentistry. Soft-tissue procedures.
AB  - Dentistry has entered the 1990s, an era of high technology. The dental laser
      offers the dentist not only a window, but a door into this high-tech arena. All
      of the advantages lasers offer, from bloodless procedures to minimal
      postoperative pain and from reduction of operative time to high patient
      acceptance, indicate that lasers are great dental instruments for today and the
      future. As a futuristic idea, the ideal laser for dentistry would be able to work
      well, not only in soft tissue, but in hard tissue. Envision a laser with multiple
      wavelengths in the same unit: one for incision, another for removal of hard
      tissue, and yet still another for making tissue "sticky" for flap placement and
      tissue welding. So often dentists are associated with pain, fear, and the noise
      of the high-speed drill. The laser certainly helps to dispel these stereotypes
      and apprehensions, and to bring dentistry into a new era.

PMID- 8477870
TI  - The central nervous system in potassium homeostasis.
AB  - There is considerable evidence that the central nervous system (CNS) is
      significantly involved in potassium homeostasis: (a) Potassium-specific receptors
      located in the liver or hepatic portal circulation initiate a reflex increase in
      potassium excretion via vagal afferents. This reflex is lost or diminished with
      hypophysectomy. (b) Oscillators, presumably located in the hypothalamus,
      determine a circadian rhythm in the renal excretion of potassium. The efferent
      control factors are unknown. (c) Exogenous hypophysial peptides (vasopressin,
      oxytocin, and alpha-, beta-, and gamma-MSH) stimulate increased potassium (and
      sodium) excretion. (d) Hypophysial gamma-MSH or a related hypophysial peptide
      stimulates an increase in the excretion of potassium (and sodium) following
      uninephrectomy in the rat. This adaptive response involves cerebral, naloxone
      inhibitable opioid receptors. (e) Intra-third-ventricular infusion of hypertonic
      NaCl initiates an increased potassium (and sodium) excretion through undetermined
      humoral mechanisms and is blocked by prior hypophysectomy. (f) In rats depleted
      of potassium by low potassium intake or by production of DOCA hypertension, an
      inhibition of skeletal muscle Na+, K(+)-ATPase ion pump activity is directed by
      hypothalamic centers and involves inhibition by alpha-adrenergic activity of slow
      twitch fibers and inhibition by undetermined humoral factors of fast twitch
      fibers. (g) Potassium receptors, either demonstrated or inferred, initiate reflex
      increases in respiration, heart rate, blood pressure, and peripheral tissue
      potassium uptake as well as a reflex inhibition of skeletal muscle ion pumps. (h)
      Evidence for CNS regulation of potassium intake is equivocal. Major gaps exist in
      this emerging picture of neuroendocrine involvement in potassium homeostasis.

PMID- 8477871
TI  - Differential modulation of mitogenic and metabolic actions of insulin-like growth
      factor I in rat glomerular mesangial cells in high glucose culture.
AB  - In order to explore the possible contribution of insulin-like growth factor I to
      the development of diabetic nephropathy, the effect of glucose on the mitogenic
      and metabolic actions of insulin-like growth factor I in cultured rat glomerular
      mesangial cells was examined. The stimulation of [3H]-thymidine incorporation by
      insulin-like growth factor I in the cells exposed to high concentrations (55
      mmol/l) of glucose (4.6 +/- 1.3 fold stimulation) was significantly suppressed as
      compared with that in the cells cultured in 11 mmol/l glucose (17.5 +/- 0.8
      fold). In contrast, [3H]-amino-isobutylic acid uptake into the mesangial cells
      was significantly enhanced by glucose (2.03 +/- 0.03 nmol.mg protein-1. 15 min-1
      at 55 mmol/l glucose vs 0.59 +/- 0.01 at 11 mmol/l glucose), while 2-deoxyglucose
      uptake remained unchanged. [125I]-insulin-like growth factor I binding was
      slightly but significantly increased in the cells exposed to high concentrations
      of glucose. Thus, glucose may modulate the mitogenic and metabolic actions of
      insulin-like growth factor I differently in cultured mesangial cells probably at
      the post-insulin-like growth factor I receptor level. These results may indicate
      that the differential modulation of the actions of insulin-like growth factor I
      by glucose could result in the increase in amino acid uptake and decrease in the
      cell proliferation in the mesangial cells, possibly leading to enhanced mesangial
      matrix synthesis with a relatively small increase in mesangial cell volume as
      seen in diabetic nephropathy.

PMID- 8477872
TI  - Phlorizin treatment of diabetic rats partially reverses the abnormal expression
      of genes involved in hepatic glucose metabolism.
AB  - Liver insulin resistance and glucagon-stimulated hepatic glucose production are
      characteristics of the diabetic state. To determine the potential role of glucose
      toxicity in these abnormalities, we examined whether phlorizin treatment of
      streptozotocin-diabetic rats resulted in altered expression of genes involved in
      key steps of hepatic glucose metabolism. By inhibiting renal tubular glucose
      reabsorption, phlorizin infusion to diabetic rats induced normoglycaemia, did not
      significantly alter low circulating insulinaemia, but caused a marked decrease in
      hyperglucagonaemia. Glucokinase and L-type pyruvate kinase mRNA levels were
      reduced respectively by 90% and 70% in fed diabetic rats, in close correlation
      with changes in enzyme activities. Eighteen days of phlorizin infusion partially
      restored glucokinase mRNA and activity (40% of control levels), but had no effect
      on L-type pyruvate kinase mRNA and activity. In contrast to the glycolytic
      enzymes, mRNA and activity of the gluconeogenic enzyme, phosphoenolpyruvate
      carboxykinase were increased (10- and 2.2-fold, respectively) in fed diabetic
      rats. Phlorizin administration decreased phosphoenolpyruvate carboxykinase mRNA
      to values not different from those in control rats, while phosphoenolpyruvate
      carboxykinase activity remained 50% higher than that in control rats. The 50%
      rise in liver glucose transporter (GLUT 2) mRNA and protein, produced by
      diabetes, was also corrected by phlorizin treatment. In conclusion, we propose
      that phlorizin treatment of diabetic rats may induce a partial shift of the
      predominating gluconeogenesis, associated with hepatic glucose overproduction,
      into glycolysis, by correction of impaired pre-translational regulatory
      mechanisms. This could be essentially mediated through improved pancreatic alpha
      cell function and subsequent lowering of hyperglucagonaemia. These observations
      suggest that glucagon-stimulated hepatic glucose production may result, in part,
      from glucose toxicity.

PMID- 8477873
TI  - Anti-oxidant treatment prevents the development of peripheral nerve dysfunction
      in streptozotocin-diabetic rats.
AB  - We tested the notion that oxidative stress makes an important contribution to the
      aetiology of diabetic neuropathy. The effect of treatment with a 1% dietary
      supplement of the anti-oxidant butylated hydroxytoluene was studied during 2
      months of streptozotocin-induced diabetes mellitus. In final experiments, sciatic
      motor and saphenous sensory conduction velocities were measured in vivo, and
      resistance to hypoxic conduction failure for sciatic trunk was examined in vitro.
      There were 20% and 12% decreases in motor and sensory conduction velocity,
      respectively after 2 months of diabetes (p < 0.001). There were completely
      prevented by butylated hydroxytoluene treatment (p < 0.001). Resistance to
      hypoxic conduction failure, shown by the time taken for sciatic compound action
      potential amplitude to decline by 80%, was 55% increased by diabetes, and this
      was limited to 31% (p < 0.01) by treatment. There were no significant effects of
      treatment on the 9-10 fold elevation of sciatic nerve sorbitol and fructose
      levels with diabetes, or on the non-significant 22% reduction in myoinositol
      content. Butylated hydroxytoluene treatment also did not affect sciatic nerve
      capillary density. We conclude that oxidative stress makes an important
      contribution to the aetiology of early experimental diabetic neuropathy.
      Amelioration of oxidative stress could potentially be a final common mechanism
      whereby a number of diverse treatments exert a beneficial effect on diabetic
      nerve function.

PMID- 8477874
TI  - Preferential alteration of oxidative relative to total glycolysis in pancreatic
      islets of two rat models of inherited or acquired type 2 (non-insulin-dependent)
      diabetes mellitus.
AB  - In islets from both adult rats injected with streptozotocin during the neonatal
      period and spontaneously diabetic rats obtained by repeated selective breedings
      (GK rats), the ratio between D-[3,4-14C]glucose oxidation and D-[5-3H]glucose
      conversion to 3HOH was 25% lower than in islets from control rats, indicating an
      impaired contribution of oxidative to total glycolysis. No primary defect in the
      Krebs cycle was found in the islets of diabetic rats, as judged from the ratio
      between either D-[2-14C]glucose or D-[6-14C]glucose and D-[3,4-14C]glucose
      oxidation. Therefore, we propose that a preferential alteration of oxidative
      glycolysis in the pancreatic beta cell may contribute to the impairment of
      glucose-induced insulin release not only in a cytotoxic but also in a spontaneous
      model of non-insulin-dependent diabetes mellitus.

PMID- 8477875
TI  - Diabetes mellitus induced inhibition of glucosaminyl N-deacetylase: effect of
      short-term blood glucose control in diabetic rats.
AB  - Inhibition of glucosaminyl N-deacetylase activity, a key enzyme in heparan
      sulphate sulphation, may be involved in the development of late diabetic vascular
      complications. We examined the effect of short- and long-term metabolic control
      on N-deacetylase activity in streptozotocin diabetic H and U rats. Spontaneously
      diabetic BB rats were included in parts of the study. Over a 3-week period blood
      glucose was maintained at predetermined levels (6-10 mmol/l or 10-20 mmol/l) by
      insulin treatment and then during the final 2 days rapidly reversed in half of
      each group. In the U rats, the hepatic N-deacetylase activity significantly
      decreased by 10-15% following short- and long-term poor metabolic control and the
      inhibition was entirely reversed by short-term good control. In the H rats a
      similar, not significant, effect was seen. BB rats in long-term poor control
      showed a 10% reduction in hepatic N-deacetylase activity (p = 0.003). Glomerular
      N-deacetylase activity was reduced in U rats after long-term poor control (p =
      0.004) but not in H and BB rats. There was an overall correlation between urinary
      albumin excretion and glomerular N-deacetylase activity (r = -0.60, p < 0.0001).
      We conclude that diabetes-induced inhibition of hepatic N-deacetylase is not
      restricted to the streptozotocin diabetic model, and that short-term blood
      glucose control is of major importance. Genetic factors and tissue specificity
      influence the vulnerability of the enzyme. Finally, the study suggests an
      association between N-deacetylase activity and urinary albumin excretion.

PMID- 8477876
TI  - Distribution of glycosaminoglycans in the intima of human aortas: changes in
      atherosclerosis and diabetes mellitus.
AB  - Arterial glycosaminoglycans are considered to be important in atherogenesis due
      to their ability to trap lipid inside the vessel wall and to influence cellular
      migration and proliferation. Atherosclerotic lesions have displayed an altered
      glycosaminoglycan content and distribution. Diabetes is a recognized risk factor
      for atherosclerosis, but no information is available on the arterial
      glycosaminoglycans in human diabetes. We examined glycosaminoglycans in normal
      and atherosclerotic intima of non-diabetic and Type 2 (non-insulin-dependent)
      diabetic patients. Intima was stripped from autopsy samples of thoracic aortas;
      normal and plaque areas were separated. Glycosaminoglycans were isolated by
      delipidation, proteolytic digestion, and precipitation and characterized by
      quantitation of total glycosaminoglycan and evaluation of glycosaminoglycan
      distribution by electrophoresis and densitometry. Results indicate a significant
      decrease in total glycosaminoglycan and significant changes in their distribution
      in atherosclerotic plaques: a relative decrease in heparan sulphate, a relative
      increase in dermatan sulphate and thus a decrease in the ratio of heparan
      sulphate to dermatan sulphate. A similar but less marked change in the ratio was
      found in normal intima of diabetic subjects, while in their plaques this change
      was more pronounced. This suggests that changes in arterial glycosaminoglycans
      (especially the ratio of heparan sulphate to dermatan sulphate) precede the
      development of lesions in diabetes and may be important in atherogenesis.

PMID- 8477877
TI  - Islet amyloid polypeptide: demonstration of mRNA in human pancreatic islets by in
      situ hybridization in islets with and without amyloid deposits.
AB  - Islet amyloid polypeptide which is normally coexpressed with insulin in beta
      cells, forms amyloid deposits especially in islets of Type 2 (non-insulin
      dependent) diabetic subjects. Occurrence of islet amyloid is paradoxically
      associated with loss of islet amyloid polypeptide immunoreactivity in beta cells.
      The present study was undertaken to examine whether the islet amyloid polypeptide
      gene is expressed in islets with decreased islet amyloid polypeptide
      immunoreactivity. Pancreatic tissue from 14 patients, 7 with Type 2 diabetes and
      7 non-diabetic, were obtained at autopsy or surgery and studied for islet amyloid
      polypeptide expression by in situ hybridization and for presence of insulin and
      islet amyloid polypeptide by immunohistochemistry. Six of the specimens from the
      diabetic and three of those from the non-diabetic patients had varying degrees of
      islet amyloid polypeptide-derived islet amyloid. Amyloid deposits were associated
      with decreased numbers of beta cells with islet amyloid polypeptide
      immunoreactivity despite an apparent normal frequency of insulin-containing
      cells. This discrepancy might reflect an alteration in islet amyloid polypeptide
      production or processing at a transcriptional or post-transcriptional level. In
      contrast to the varying immunohistochemical patterns, islets of all categories
      showed strong labelling using an islet amyloid polypeptide probe for in situ
      hybridization. It is concluded that islet amyloid polypeptide production is not
      altered at the transcriptional level. The following possibilities remain: (1)
      islet amyloid polypeptide production may be altered at a post-transcriptional
      level or (2) that islet amyloid polypeptide production is normal but the reduced
      immunoreactivity of the cells reflects a reduced storage of IAPP in secretory
      granules.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477879
TI  - Human insulin receptor substrate-1 gene (IRS1): chromosomal localization to 2q35
      q36.1 and identification of a simple tandem repeat DNA polymorphism.
AB  - The protein designated as insulin receptor substrate-1 (IRS-1) is a major
      substrate for the insulin receptor tyrosine kinase. Since post-receptor defects
      in the insulin signalling pathway are a common feature of Type 2 (non-insulin
      dependent) diabetes mellitus, we have cloned the human IRS-1 gene in order to
      study the role of genetic variation in this gene in the pathogenesis of diabetes
      mellitus. As a first step in these studies, we have mapped the IRS-1 gene to
      chromosome 2, bands q35-q36.1 and identified a simple tandem repeat DNA
      polymorphism in this gene that will be useful for genetic studies.

PMID- 8477878
TI  - Cognitive dysfunction in adults with type 1 (insulin-dependent) diabetes mellitus
      of long duration: effects of recurrent hypoglycaemia and other chronic
      complications.
AB  - To examine the long-term effects of recurrent severe hypoglycaemia and other
      biomedical complications on mental efficiency, a battery of cognitive tests was
      administered to 142 Type 1 (insulin-dependent) diabetic adult patients (age 33.5
      +/- 5.6 years; mean +/- SD) and 100 demographically similar non-diabetic control
      subjects. All diabetic subjects had been diagnosed before the age of 17 years.
      Diabetic subjects with one or more complications (distal symmetrical
      polyneuropathy; advanced background or proliferative retinopathy; overt
      nephropathy; one or more episodes of severe hypoglycaemia) performed
      significantly (p < 0.001) more poorly than non-diabetic control subjects on tests
      requiring sustained attention, rapid analysis of visuospatial detail, and hand
      eye co-ordination. Regression analyses indicated that the best biomedical
      predictor of cognitive test performance was a diagnosis of polyneuropathy.
      Although severe recurrent hypoglycaemia was not associated with performance on
      any test, the neuropathy x recurrent hypoglycaemia interaction term was
      significant. These results suggest that in adults with Type 1 diabetes of long
      duration, recurrent hypoglycaemia does not appear to influence cognitive
      performance directly, but may interact with neuropathy to exaggerate or otherwise
      magnify the extent of neurobehavioural dysfunction.

PMID- 8477880
TI  - The contribution of naturally labelled 13C fructose to glucose appearance in
      humans.
AB  - Among monosaccharides, fructose has a small hyperglycaemic effect. In order to
      better explain the mechanisms which cause this metabolic property, we used
      tracers labelled with stable isotopes (deuterated glucose and naturally 13C
      labelled fructose) to quantify the overall glucose appearance, the rate of
      appearance in plasma of the 13C glucose synthesized from fructose, and the
      fructose oxidation in vivo in man during a 6-h period following ingestion of 0.5
      and 1 g.kg-1 fructose. Fructose had a very small effect on overall glucose
      appearance (NS). During the 6 h of the study, it was found that the overall
      glucose appearance was 0.87 +/- 0.06 and 0.89 +/- 0.06 g.kg-1 (NS). The amount of
      glucose synthesized from fructose was 0.27 +/- 0.04 and 0.51 +/- 0.03 g.kg-1 (p <
      0.01) representing 31% and 57% of overall glucose appearance (p < 0.01); the non
      fructose glucose production was 0.60 +/- 0.02 and 0.38 +/- 0.03 g.kg-1 (p < 0.05)
      after the 0.5 and 1 g.kg-1 load, respectively. Fructose oxidation was 0.28 +/-
      0.03 and 0.59 +/- 0.07 g.kg-1 after the 0.5 and 1 g.kg-1 load respectively (p <
      0.01) representing 56% and 59% of the fructose loads (NS). These data show that
      the low hyperglycaemic effect of fructose is explained by its very small effect
      on overall glucose appearance and that fructose has a sparing effect on glucose
      metabolism.

PMID- 8477881
TI  - Both acute and chronic near-normoglycaemia are required to improve insulin
      resistance in type 1 (insulin-dependent) diabetes mellitus.
AB  - To determine the impact of both short- and long-term "near-normoglycaemia" on
      insulin resistance in Type 1 (insulin-dependent) diabetes hepatic glucose
      production (mg.kg-1.min-1) and peripheral glucose utilisation ("M-value", mg.kg
      1.min-1) were estimated during an euglycaemic hyperinsulinaemic clamp (10
      mU.kg.min) in patients with either good (HbA1c < 5.8%, groups A and B) or poor
      (HbA1c > 7.5%, groups C and D) long-term metabolic control (time > 12 months) and
      in healthy subjects (HbA1c: 5.08 +/- 0.20%; n = 8). To this end blood glucose was
      stabilized at 6.7 mmol/l by overnight (t = 12 h) i.v. regular insulin in groups
      (n = 8 each) A (HbA1c: 5.49 +/- 0.46%) and C (HbA1c: 8.83 +/- 1.20%), while
      groups B (HbA1c: 5.55 +/- 0.19%) and D (HbA1c: 8.51 +/- 1.09%) were kept
      overnight on long-acting insulin without feed-back control of blood glucose
      before euglycaemic clamping. Thereby, pre-equilibration of blood glucose at 6.7
      mmol/l was shown to normalize basal hepatic glucose production (A: 2.27 +/- 0.48;
      C 2.50 +/- 0.57 mg.kg-1.min-1) despite different HbA1c values, whereas basal
      hepatic glucose production stayed elevated in groups B (3.09 +/- 0.38 mg.kg-1.min
      1) and D (3.21 +/- 0.58 mg.kg-1.min-1) with poor actual glycaemia (B: 10.9 +/-
      4.6; D: 12.1 +/- 4.6 mmol/l).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477882
TI  - Human pancreatic islet function at the onset of type 1 (insulin-dependent)
      diabetes mellitus.
AB  - Viable human pancreatic islets isolated from a recent-onset Type 1 (insulin
      dependent) diabetic patient were used to perform in vitro studies. Pre-proinsulin
      mRNA and insulin content, as well as insulin response were analysed. Insulin
      response to glucose and forskolin was completely absent in diabetic islets, as
      compared to control islets. Insulin content was reduced to only one-third of
      control values (395.0 +/- 3.5 vs 989.0 +/- 46.3 microU/islet) and 20.7 +/- 3.9%
      of islets from the diabetic pancreas contained insulin-positive cells in
      immunofluorescence studies. Northern blot analysis revealed a severe reduction in
      the content of pre-proinsulin mRNA in diabetic pancreatic tissue. Our results
      indicate that although markedly decreased, beta cells in human pancreatic islets
      at the onset of Type 1 diabetes are still present. Nevertheless, pancreatic islet
      function is disproportionately impaired with a complete absence of an insulin
      response.

PMID- 8477883
TI  - Plasma disappearance of glycated and non-glycated albumin in type 1 (insulin
      dependent) diabetes mellitus: evidence for charge dependent alterations of the
      plasma to lymph pathway.
AB  - The fractional plasma escape rates of glycated and non-glycated albumin have
      earlier been measured in groups of Type 1 (insulin-dependent) diabetic patients
      and control subjects. The escape of non-glycated albumin was similar in control
      subjects and normoalbuminuric patients, but elevated in patients with micro or
      macroalbuminuria. In all groups the escape rate of glycated albumin was lower
      than that of non-glycated albumin. Glycation increases the anionic charge of
      albumin. To assay for charge-dependent alterations of transport a selectivity
      index (non-glycated albumin/glycated albumin transport ratio) was determined from
      the disappearance data. The index was high in control subjects (1.021 +/- 0.0057
      (SEM)). This reflects a mean difference between the two escape rates of 2.1% per
      hour (for comparison the mean of the fractional escape rate of non-glycated
      albumin of the normal control subjects was 4.7% per hour). The index was
      numerically even higher in normoalbuminuric patients (1.031 +/- 0.0047 (SEM)),
      but reached significantly lower levels in patients with microalbuminuria (1.013
      +/- 0.0030 (SEM), p < 0.02). Patients with clinical nephropathy had very low
      levels indicating loss of selectivity (1.002 +/- 0.0068 (SEM), p < 0.001). This
      pattern accords well with measurements of renal clearance selectivity indices,
      suggesting a general, progressive deterioration of anionic perivascular barrier
      components in diabetic microangiopathy. The structural target for these changes
      is likely to be the glycosaminoglycans of the glomerular basal membrane and the
      interstitial matrix.

PMID- 8477884
TI  - A model for the involvement of MHC class II proteins in the development of type 1
      (insulin-dependent) diabetes mellitus in response to bovine serum albumin
      peptides.

PMID- 8477885
TI  - Nicotinamide and insulin sensitivity.

PMID- 8477886
TI  - HIV infection and Norwegian general practitioners: does fear affect knowledge?
AB  - The objective was to study the dimensionality of knowledge among general
      practitioners in Norway about transmission of HIV and what factors influence the
      degree of knowledge. Data were collected by a mailed questionnaire. Independent
      variables were experience of HIV, acquisition of knowledge and confidence in
      information on HIV from the central authorities and perception of own knowledge,
      skills of practice and fear of oneself or one's family contracting the HIV
      infection. Analysis of variance and multiple classification analysis were applied
      to measure the effect of independent variables on knowledge about transmission of
      HIV. The general practitioners in three counties (Oslo, More og Romsdal and
      Troms), constituting one-quarter of the Norwegian general practitioner population
      were selected (n = 578). The response rate was 65%, and the results are assumed
      to be representative of Norwegian general practitioners. Four dimensions of
      knowledge about transmission of HIV were identified by factor analysis. The two
      most important, transmission through 'body fluids' and transmission by 'needle
      sticks', were subsequently converted into sum scores and used as dependent
      variables. Forty-five per cent of the respondents were uncertain about ways in
      which HIV is not transmitted through 'body fluids'. There was an association
      between knowledge about transmission through 'body fluids' and the variables
      county background, confidence in the information about HIV and fear of
      contracting HIV. In the multiple classification analysis these three variables
      explained 11% of the variation in knowledge about transmission through 'body
      fluids'. Only confidence and fear significantly predicted the degree of
      knowledge, and among the 11% who had no confidence in the information received
      the effect of fear on knowledge increased significantly.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8477887
TI  - Service delivery for people with chronic fatigue syndrome: a pilot action
      research study.
AB  - Chronic fatigue syndrome (CFS) is a symptom complex which while mild in some
      cases is severely debilitating in others. Long-term ill health leads to greater
      use of resources but in the case of long-term CFS the anecdotal evidence
      suggested a low compliance with the available options and a high level of both
      patient and general practitioner dissatisfaction. This pilot study sought through
      repeated action research cycles to start to identify culturally and contextually
      sensitive forms of language and models for service delivery suitable for people
      with CFS in a general practice setting. It worked through a number of action
      research cycles, to initiate the identification of conceptual models acceptable
      to both doctors and to patients suffering from CFS, self-management options which
      encouraged the body's ability to heal itself and services and delivery mechanisms
      which met patient needs within health provider options.

PMID- 8477888
TI  - Childhood chickenpox: its impact on child and family.
AB  - Sixty-nine parents took part in nine discussion groups designed to explore the
      effect of childhood chickenpox on the behaviour of the affected child, on family
      routines and on the parents themselves. Although most parents thought of
      chickenpox as a relatively trivial illness, it was found that there was
      considerable disruption to family organization and plans and, often, great strain
      was imposed on a parent, usually the mother. Some families incurred extra
      financial burdens in terms of time taken from work, the purchase of over the
      counter preparations, childminders and special treats for the sick child. It was
      apparent that parents needed more information and reassurance about the nature
      and course of the illness.

PMID- 8477889
TI  - Expectations disease: a model for understanding stress, control and dependent
      behaviour.
AB  - Most issues of emotional health seen in primary care do not fit standard
      psychiatric labelling. An integrative model is described for understanding the
      relationships between stress, control and dependent behaviours with clinical
      utility for primary care. In this model, expectations disease occurs when
      expectations consistently disable rather than enable. This clinical diagnosis is
      characterized by five disorders of control which contribute to recurring episodes
      of loss of control. Disorders of control include, 1) unmet or excessive need for
      control, 2) impaired recognition of controllability, 3) misattribution of
      control, 4) control dissimulation and 5) fear of loss of control. Definitions and
      behavioural consequences for each control disorder are described. Loss of control
      is defined as a cascade of behaviours invoked to avoid or diminish chaotic or
      dissonant thinking through actions one would not deliberately choose (or not
      choose to the same degree) while feeling in control. Examples of loss of control
      include substance abuse, anger (rage or violence), binge behaviours (eating,
      shopping, gambling, sex, overwork), depression, panic and somatization. Loss of
      control paradoxically results in a transient sense of relief or shift of focus
      from the problem stimulus, but inevitably creates further problems over time.
      Expectations disease is determined not by the presence or absence of control
      disorders, but by the degree to which these problems exist--their chronicity,
      intensity and rigidity. For some, this disorder may be acute or intermittent, for
      others chronic; for some, a nuisance, for other, disabling. Short-term
      intervention for patients who present with clear distress, but unclear diagnosis
      is discussed. Advantages and disadvantages of the model are detailed.

PMID- 8477890
TI  - The diagnostic value of rectal examination.
AB  - The rectal examination is a much advocated procedure for assessing abdominal and
      urinary symptoms. A Medline literature search yielded only a few studies, not one
      of them in a general practice setting. The sensitivity of the rectal examination
      to rectal carcinoma and appendicitis is low, while it is high for prostate
      carcinoma. When reviewing the likelihood ratios of normal and abnormal findings
      of rectal examinations it was concluded that it may be a useful procedure in the
      case of abnormal findings in patients presenting rectal problems and in assessing
      men with prostate problems, although it does not seem useful in diagnosing
      appendicitis. However, since the diagnostic values in general practice and in
      referred populations may be different, there is a need for further prospective
      studies in settings of general medical practice.

PMID- 8477891
TI  - Withdrawing long-term diuretic treatment among elderly patients in general
      practice.
AB  - The aim of this study was to elaborate, implement and evaluate a strategy for
      discontinuation of long-term diuretic treatment in elderly patients in general
      practice. Thirty-three patients were enrolled for a supervised step-down and
      withdrawal of diuretics. After withdrawal, the patients were followed up for 6
      months or until diuretic treatment was re-established. Withdrawal was successful
      according to the protocol in 18 cases. Diuretic withdrawal failed and the
      treatment was re-established in 15 cases, four of which were sudden
      cardiovascular events. Most withdrawal failures were identified by routine
      examinations through the follow-up programmes, thus they had few consequences for
      the patients. This demonstrates that careful follow-up is essential after
      diuretic withdrawal. Our findings support the view that a large proportion of
      elderly patients on diuretics may not need such treatment.

PMID- 8477892
TI  - Stuck with the patient--what would my colleague have done? A videorecorded
      consultation experiment with an actor simulating as the same patient for
      different doctors.
AB  - The aim of the experiment, in which four general practitioners met an actress who
      played a patient, was to explore how different doctors approach an identical
      patient problem. According to the patient role the actress had two reasons for
      encounter: (i) tachycardia and (ii) fear of HIV infection, which she had great
      difficulty in telling and presented only by indirect cues. The doctors knew they
      were meeting an actress, but the patient role description was unknown. Most of
      the time in each consultation was spent on tachycardia, the first presented
      symptom. None of the doctors paid real attention to the patient's signals of
      emotional distress and did not discover her fear of being HIV positive.
      Evaluation of the recordings and transcripts revealed some keys to understand why
      the doctors missed essential signals from the patient and felt stuck. It was
      difficult for the doctors to see their own role in blocking communication until
      the patient perspective was fully explored during the process of evaluation.

PMID- 8477893
TI  - Characteristics of registered clinic patients who have not visited their family
      physician for 3 years.
AB  - The objective of this study was to obtain and critically evaluate data on the
      health characteristics and the need for medical assistance in patients aged 40
      years and over, from six urban and rural medical practices in northern Israel,
      who have not consulted their family physician for at least 3 years. A health
      questionnaire was completed by means of telephone calls and personal contacts,
      regarding 139 non-visitors (out of 1847 patients aged 40 and over). The health
      characteristics and prevalence of medical and social problems were compared to
      regular clinic attenders. Questionnaires of 101 non-attenders were completed for
      a response rate of 73% (101/139). The non-attendance rate was 7.5% (139/1847) and
      there was a low rate of morbidity. The majority (81%) were 40-59 years old and
      only 16% had had previous illnesses. Only 10% took medications regularly, most of
      them medical personnel. Twenty-eight of the non-attenders were employees of the
      regional health care system. Most of these individuals coped with chronic
      illnesses by consulting the regional hospital's outpatient clinics. Non-attenders
      could be characterized as less prone to health problems. Most of them seemed
      remarkably fit and were not suffering unduly as a result of their lack of medical
      attention.

PMID- 8477894
TI  - In search of excellence. Expanding the patient-centred clinical method: a three
      stage assessment.
AB  - Excellence in caring for the patient has been pursued in better technology and
      better management structures with multidisciplinary teams. Excellence is
      increasingly sought through taking the whole person seriously and in developing
      better ways of working with relationships. This paper traces the growth of ideas
      and their application in a university department of family medicine, toward a
      holistic and more patient-centred, three-stage clinical method. This three-stage
      assessment helps the patient and the physician to deal holistically with the
      problem. The biological, the psychological and the environmental systems as well
      as their interrelationships are considered as they impact on health and illness.
      This method of arriving at a 'best-fit' understanding of a person's problem, by
      the doctor and the patient together, helps to individualize the assessment and
      management. Excellence is more likely to be found when we care in an
      individualized way within a systems understanding.

PMID- 8477895
TI  - A review of the costs and effectiveness of assessing the elderly in general
      practice.
AB  - The 1990 contract for general practitioners made annual health checks for people
      aged 75 and over compulsory. We review the costs and effects of different
      approaches to the health check, focusing on the method advised in the 1990
      contract. This involves an annual home-based functional assessment by a member of
      the primary health care team, known as a blanket assessment. Our review of
      published randomized controlled trials shows such assessments have few consistent
      benefits. Data on the costs of assessment are usually reported in summary form,
      with little or no information on which costs are included. In studies where
      average costs are given for assessments, because of salary and travel expenses,
      the costs are high. Several promising methods for reducing costs in assessment,
      and a method with potential to improve effectiveness, are currently outside the
      terms of the 1990 contract. These methods are described. Revision of the 1990
      contract should incorporate the flexibility to encourage more cost-effective
      approaches to assessing the elderly such as a two-stage assessment or using
      volunteers. A monitoring group is needed to establish how health checks are being
      implemented. This group could co-ordinate and advise on standardized criteria for
      methods of costing and assessing effectiveness in assessment programmes.

PMID- 8477896
TI  - Self-report depression scales for elderly patients in primary care: a preliminary
      study.
AB  - In a primary care setting, the prevalence of depression in elderly patients was
      studied, and the reliability and validity of the geriatric depression scale (GDS)
      were assessed. In 141 consecutive elderly attenders (64-90) of four general
      practices, we estimated the point prevalence of depression with two self-rating
      depression scales. The results of the two scales were compared. Fourteen patients
      (12%) scored above cut-off on the Zung self-rating depression scale and 14 (12%)
      on the GDS. In 10 patients both scales indicated depression. The psychometric
      quality of both scales was adequate. The results of the investigation established
      prevalences found in other countries. The GDS may be a useful case-finding
      instrument aiding the general practitioner in the identification of depression in
      elderly patients.

PMID- 8477897
TI  - Smoking habits in early pregnancy related to age of smoking debut.
AB  - During 1 year, 187 general practitioners in western Norway recruited 530 daily
      smoking, pregnant women for a smoking cessation study. At the first medical check
      up in pregnancy each woman filled in a questionnaire. Women who had started
      smoking within 15 years of age reported more heavy smoking the last 3 months
      before pregnancy (P < 0.0001) and at the first check-up in pregnancy (P < 0.01)
      than those who had started smoking later. They also reported less reduction in
      smoking habits during earlier pregnancies (P < 0.0001) and more serious tobacco
      addiction judged by starting smoking early in the morning (P < 0.005). However,
      even those who had started smoking before 15 years of age reported a reduction of
      30% in cigarette consumption during the first few weeks of the present pregnancy.
      In addition to increasing the antismoking efforts among pregnant women, health
      education among girls 12-15 years of age to prevent smoking initiation should be
      intensified.

PMID- 8477898
TI  - Counselling patients to make lifestyle changes: the role of physician self
      efficacy, training and beliefs about causes.
AB  - Three factors that might help explain the extent to which physicians counsel
      patients to quit smoking and lose weight were examined: counselling self
      efficacy, training in behaviour change and beliefs about causes of smoking and
      being overweight. More aggressive counselling was defined as counselling more
      patients per month and following up on counselling recommendations.
      Questionnaires were returned by 85 health maintenance organization physicians. As
      predicted, physicians with a stronger sense of counselling self-efficacy, and
      those who had received education in health behaviour change techniques were more
      aggressive counsellors. Motivational strategies were also explored. Physicians'
      beliefs about the causes of smoking and being overweight were related to the use
      of some types of strategies. Implications for increasing physician counselling
      patients to make behaviour changes are discussed.

PMID- 8477899
TI  - The nominal group technique: a research tool for general practice?
AB  - Qualitative methods are increasingly recognized as valuable, yet practitioners
      face difficult decisions in their choice of method and the process of analysis.
      The nominal group technique combines quantitative and qualitative data collection
      in a group setting, and avoids problems of group dynamics associated with other
      group methods such as brainstorming, Delphi and focus groups. Idea generation and
      problem solving are combined in a structured group process, which encourages and
      enhances the participation of group members. The stages involved in conducting a
      nominal group are described, and practical problems of its use in a health care
      setting are discussed with reference to a study of the priorities of care of
      diabetic patients, carers and health professionals. Some potential applications
      of the technique in audit and exploratory research are also outlined.

PMID- 8477900
TI  - Barriers to general practitioners caring for patients with HIV/AIDS.
AB  - This paper describes some of the barriers to caring for people with HIV and AIDS
      by general practitioners. It is based on a review of the literature and on
      interviews with individuals. The first section examines the reasons given by
      interviewees for their involvement in HIV and AIDS care. The next section
      discusses the relationship between primary and secondary care services in the
      care of patients with HIV and AIDS. One of the factors previously underexplored
      seems to be that of who 'owns' the patients. The final section looks at GPs'
      involvement in services for intravenous drug users with HIV and AIDS. It is
      concluded that there are still considerable barriers to GPs' involvement with
      patients with HIV and AIDS, in particular with drug users who have HIV or AIDS.
      It is likely that needs for continuing training in this area are not being met.

PMID- 8477901
TI  - The need for another look at the patient in general practice satisfaction
      surveys.
AB  - Although patient satisfaction research has looked at the aspects of care which
      patients are satisfied with and at which patients are satisfied with their care,
      few studies have looked at which patients are satisfied with which aspects of
      care. A retrospective analysis of data collected from 1599 patients attending 43
      GPs was undertaken to examine the way that different patient characteristics
      influenced responses to a 31 item survey completed at the surgery after a
      consultation. Information on perceived distress [as measured by the Nottingham
      Health Profile (NHP)] was collected from patients prior to the consultation and
      further information about the patient and the consultation was recorded by the
      doctor after the consultation. Levels of satisfaction were high, with only seven
      of 31 items producing more than 5% of negative responses. These seven items
      covered whether the waiting time was too long, whether the doctor was relaxed,
      whether the doctor was in a hurry, whether there was anything else the patient
      would have liked to talk about had there been more time, whether the doctor had
      said or done anything to reduce the patient's worries, whether the doctor gave
      the feeling that the patient's opinions were important and whether there was
      anything about the consultation which disappointed the patient. Age, waiting time
      prior to the consultation, consultation length and positive scores on the six NHP
      dimensions of distress were all significantly associated with responses to one or
      more of these seven items. Patients experiencing pain and those with emotional
      distress were dissatisfied with different aspects of the consultation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8477902
TI  - Selections from current literature: using aspirin for primary or secondary
      prevention.
AB  - It seems evident that low doses (75 mg/day) of aspirin are adequate for attempts
      to prevent thrombotic occlusion of blood vessels. There are no data to suggest
      that different doses should be used based on whether primary or secondary
      prophylaxis is planned. However, even low doses of aspirin are associated with
      relatively small numbers of serious haemorrhagic complications. These
      complications are outweighed by the benefits of therapy in many examples of
      secondary prevention in high-risk groups that have already experienced an event
      or symptoms because of underlying vascular disease. Primary prophylaxis is a more
      controversial area. There is generally less to gain, and more to lose, when
      measures are applied to large numbers of asymptomatic people. Based on the
      available data, the conservative approach for aspirin use will be to reserve
      primary prophylaxis for those people with the highest estimated risk.

PMID- 8477903
TI  - Platelet adhesivity to subendothelium is influenced by polymorphonuclear
      leukocytes: studies with aspirin and salicylate.
AB  - Interactions between blood platelets and polymorphonuclear leukocytes (PMN)
      influence cell reactivity. We have examined the effects of inhibiting platelet
      and PMN cyclooxygenase and lipoxygenase pathways, by treatment with aspirin (ASA)
      and salicylate (SAL) on platelet-vessel wall interaction studied under flow
      conditions by means of an annular chamber perfusion system. We have also measured
      the levels of cyclooxygenase-derived metabolites during perfusion. Perfusates
      were prepared with untreated and ASA- or SAL-treated PMN or platelets. Our
      results demonstrated that blockage of the lipoxygenase pathway in PMN
      significantly increased platelet thrombus formation and favored the production of
      thromboxane B2 (TxB2) during perfusion, whereas inhibition of cyclooxygenase
      pathway in PMN had no effect either on platelet deposition or on TxB2 levels. In
      contrast, blockage of platelet cyclooxygenase, which caused almost total
      inhibition of TxB2, enhanced platelet adhesion and did not modify platelet
      thrombus formation. These results suggest that under dynamic conditions
      cooperative metabolic mechanisms between platelets and PMN directly influence
      platelet interaction with vascular subendothelium.

PMID- 8477904
TI  - Comparative plasma disposition and anticoagulant activities of racemic
      phenprocoumon and its metabolites in rats.
AB  - The anticoagulant phenprocoumon (PH) and its metabolites 6-hydroxy-, 7-hydroxy-
      and 4'hydroxy-phenprocoumon (6-OH-PH, 7-OH-PH and 4'-OH-PH, respectively) were
      separately administered intravenously as racemates to rats in order to measure
      the potential effects of the major metabolites of PH on coagulation. Plasma
      samples were assayed for total concentrations of the administered compounds and
      the corresponding prothrombin times; kinetic parameters and anticoagulant
      activities were estimated using a pharmacodynamic model based on the rate of
      synthesis of clotting factors. The relative potencies were in the order PH > 4'
      OH-PH > 6-OH-PH > 7-OH-PH the latter showing no activity. Patients on PH therapy
      showed lower plasma concentrations of metabolites than of PH; in humans the
      metabolites of PH will not contribute significantly to the overall anticoagulant
      activity of the drug.

PMID- 8477905
TI  - Which coagulation factors interfere with the one-stage prothrombin time?
AB  - Coagulation factors that interfere with the one-stage prothrombin time (PT) were
      investigated. PT responded with identical activities (adequately) against
      coagulation factors VII or X, only half as expected against factor IX, less than
      expected and nonlinearly against factor II. In multiple coagulation factor
      deficiencies PT did not differ from factor VII, which was the most reduced
      coagulation factor in warfarin therapy or liver disease. PT may also be
      influenced by factor VII at high activities.

PMID- 8477906
TI  - Development of a rapid and sensitive chromogenic heparin assay for clinical use.
AB  - A new sensitive chromogenic heparin assay is developed, which is well suited for
      clinical use. For the assay two reaction mixtures are required which can be
      lyophilized and reconstituted on the day of use. These reagents are stable during
      at least 6 h. Only two time-dependent pipetting steps are necessary. Any compound
      that inactivates thrombin, or can potentiate thrombin inactivation by an
      inhibitor, can be measured with this assay, including standard heparin, low
      molecular weight heparins, hirudin, alpha-NAPAP, pentosan polysulphate and
      dermatan sulphate. It is shown that heparin can be measured accurately in whole
      blood and in plasma. By addition of dextran sulphate to one of the reagents a
      platelet factor 4-insensitive assay is developed, so heparin can be measured even
      in blood that is partially activated and thus contains platelet factor 4 which
      neutralizes heparin.

PMID- 8477907
TI  - Fibrinolytic imbalance in essential thrombocythemia: role of platelets.
AB  - Thrombotic and hemorrhagic complications are frequent in patients with essential
      thrombocythemia (ET), a myeloproliferative syndrome with an increased number of
      circulating platelets. Since platelets are a physiological reservoir for the
      plasminogen activator inhibitor (PAI-1) contained in plasma, we evaluated plasma
      and platelet tissue plasminogen activator (tPA) and PAI-1 in 20 ET patients with
      and without thrombotic complications and in 13 control subjects. In ET patients
      with thrombotic complications there was a significantly greater platelet PAI-1
      functional activity than in ET patients without thrombotic complications and in
      the control group (p < 0.05 and p < 0.025, respectively). Moreover, platelet tPA
      activity was significantly low in all ET patients (p < 0.001). This fibrinolytic
      imbalance (increased plasminogen inhibitor and lowered activator) might be a
      critical cofactor in the thrombotic complications in ET patients.

PMID- 8477908
TI  - Prothrombin fragment 1 + 2 and thrombin-antithrombin complex measurements
      indicate continuous and progressive intraoperative thrombin generation in liver
      transplantation.
AB  - Prothrombin fragment 1 + 2 (F1 + 2) and thrombin-antithrombin complex (TAT) have
      been measured in the different surgical phases in 40 patients undergoing 43
      orthotopic liver transplantations (OLT), in order to study thrombin generation
      throughout the surgical procedure. F1 + 2 and TAT progressively rose from
      preoperative values (1.47 +/- 0.92 nmol/l and 22.41 +/- 19.15 ng/ml,
      respectively) to the end of anhepatic phase (5.97 +/- 2.20 nmol/l, 64.24 +/-
      11.30 ng/ml), whereas changes in circulating antithrombin III (ATIII) were
      negligible in this period. Thrombin generation continued to slightly but
      significantly increase immediately after liver graft reperfusion (F1 + 2 6.87 +/-
      1.65 nmol/l, TAT 89.32 +/- 7.54 ng/ml), and ATIII levels decreased from 70.61 +/-
      12.28 to 57.16 +/- 9.57%. Higher preoperative values of F1 + 2 were associated
      with larger requirements of both packed red blood cells and fresh frozen plasma
      (FFP) in the host liver explantation phase, whereas the lowest basal levels of
      ATIII were related to a higher plasma expense in the whole OLT procedure. The
      activation of circulating prothrombin begins early in OLT, and adequate FFP
      infusion is capable of maintaining appropriate circulating thrombin-inhibitory
      activity.

PMID- 8477909
TI  - Endothelium releases more von Willebrand factor and tissue-type plasminogen
      activator upon venous occlusion in patients with liver cirrhosis than in normals.
AB  - Venous occlusion was used in 8 patients with liver cirrhosis and in 10 normals to
      investigate the pathomechanism of long-term elevation of plasma von Willebrand
      factor antigen (vWFAg) in liver cirrhosis. The following parameters were
      determined at baseline, and immediately, 60 min and 24 h after 10 min venous
      occlusion: vWFAg, ristocetin cofactor (RiCoF), in vitro platelet retention
      (Adeplat T), and tissue-type plasminogen activator (t-PA). Every baseline value
      in the liver cirrhosis group was significantly higher than in the controls. In
      both groups the 10-min values were significantly higher than their corresponding
      baseline results. Hence, comparing the two groups, in liver cirrhosis a
      significantly higher release of vWFAg and t-PA could be observed. These findings
      suggest on the one hand that the increased release contributes substantially to
      the sustained elevation of plasma vWF level in liver cirrhosis. On the other
      hand, the results indicate that not only the vascular surface of the diseased
      liver but most probably the total endothelium plays an important role in this
      phenomenon.

PMID- 8477910
TI  - Cardiac surgery with extracorporeal circulation in severe factor VII deficiency.
AB  - We describe here successful open heart surgery with extracorporeal circulation
      and haemodilution in a child with severe congenital factor VII deficiency.
      Substitution therapy was realized with factor VII concentrate (SD proconvertin
      concentrate, Bio-Transfusion). This is the first report case of successful
      cardiac surgery in severe congenital factor VII deficiency.

PMID- 8477911
TI  - An acquired cryoglobulinemia which inhibits fibrin polymerization in a patient
      with IgG kappa myeloma.
AB  - A 58-year-old man with multiple myeloma and paraproteinemia (IgG kappa) acquired
      cryoglobulinemia 2 years after the initial diagnosis of the disease. This
      cryoglobulin interfered specifically with fibrin aggregation. The patient's
      fibrinogen was functionally normal; however, clotting times (thrombin clotting
      time, reptilase clotting time) were prolonged in the untreated plasma and in the
      supernatant after removal of the cryoglobulins. Untreated patient's serum, and
      even more pronounced, the cryoprecipitate inhibited the association of fibrin
      monomers obtained from healthy controls. The inhibitory activity on fibrin
      aggregation diminished upon treatment-induced reduction of plasma protein levels.

PMID- 8477912
TI  - Effects of aspirin on embolization in an arterial model of laser-induced thrombus
      formation.
AB  - This model of arterial thrombosis induced by laser was used to evaluate the
      effect of aspirin (Aspegic) on embolization. A partial occlusion was induced in
      small mesenteric arterioles (diameter 35-40 microns) with an Argon Laser. The
      laser induced the formation of a vessel wall lesion with damage of endothelial
      cells. Thrombus formed within seconds after the laser lesion and grew rapidly.
      Embolization began within the minute following the laser flash. Thrombus
      formation and embolization were repetitive phenomena. The duration of
      embolization was 6.50 +/- 0.84 min in the control group. Then the thrombus became
      stable and partially obstructed the vessel lumen. The administration of aspirin
      at three doses (50, 100, 200 mg/kg) by intramuscular injection, 15 min before the
      laser injury, induced three different phenomena: (1) an increase of the number of
      laser injuries required for the thrombus formation; (2) a dose-dependent decrease
      in the duration of embolization, and (3) a dose-dependent decrease in the number
      of emboli. The highest dose injected induced the strongest reduction in the
      duration of embolization and the number of emboli.

PMID- 8477913
TI  - Toxicity threshold of quinine hydrochloride following low-level repeated dosing
      in healthy volunteers.
AB  - Following a double-blind, four-way crossover design, 32 healthy volunteers (20
      males and 12 females) each consumed lactose placebo, or 80, 120 or 160 mg quinine
      HCl daily for 21 days. Before dosing and at regular intervals during dosing,
      blood and urine samples were collected and analysed for quinine HCl.
      Electrocardiography, heart rate, blood pressure, audiometry, peripheral field,
      funduscopy, colour vision, visual acuity, electronystagmography (ENG) and test
      for optokinetic nystagmus were all evaluated before dosing and at selected times
      during dosing. The results showed that daily consumption of up to 80 mg quinine
      HCl did not significantly alter physiological, ophthalmic or audiometric
      responses. ENG determination showed that 12.5% of volunteers given lactose
      placebo or 80 mg quinine HCl exhibited at least one transitory period of ocular
      motor oscillations. This phenomenon was observed in 18.8% (P < 0.05) of
      volunteers with a daily intake of 120 mg quinine HCl or more. However, there was
      not a significant dose-related correlation between nystagmus and daily intake of
      quinine HCl. Five volunteers consuming lactose placebo displayed an aberrant
      ocular flutter that decreased significantly (P < 0.05) as the daily intake of
      quinine HCl increased. One volunteer showed a change in perception of red/green
      colour vision after taking 160 mg quinine HCl for 21 days. This study
      demonstrated that the no-untoward-effect level of quinine HCl is at least 80
      mg/day.

PMID- 8477914
TI  - Thyroid function and other clinical chemistry parameters in subjects eating
      iodine-enriched eggs.
AB  - Iodine-enriched (IE) eggs are produced by chickens fed a diet containing kelp.
      These eggs, which contain an average of 711 micrograms iodine/egg, have been
      reported to reduce plasma cholesterol in humans and laboratory animals. A
      modified form of these eggs is under consideration for marketing in the United
      States. 104 hyperlipidaemic subjects were placed on a low-fat diet for 12 wk.
      Between wk 4 and 12, approximately half of the subjects were randomized to a
      dietary control group (n = 53) or a group who ingested one IE egg/day in addition
      to this diet (n = 51). Some subjects in both groups continued in the study for an
      additional 4-8 wk. No significant adverse clinical effects were observed or
      reported, with the exception of one subject who reported an allergic-like
      reaction soon after beginning egg ingestion. All clinical chemistry values
      remained within normal limits, and comparisons between the egg group and controls
      were not significant. Three subjects (two in the egg group and one in the control
      group) had elevated thyroid stimulating hormone levels during the experimental
      period. All thyroid function tests remained within normal limits in the remaining
      subjects. Thus, ingestion of one IE egg of the type used in our study appears to
      be relatively safe and devoid of clinically significant, short-term adverse
      effects in healthy individuals.

PMID- 8477915
TI  - Tissue distribution and excretion of 14C-labelled cinnamic aldehyde following
      single and multiple oral administration in male Fischer 344 rats.
AB  - 14C-labelled cinnamic aldehyde (CNMA) was given as a single oral dose, or 24 hr
      after multiple oral administration of non-radioactive CNMA for 7 days at 24-hr
      intervals, to male Fischer 344 rats at dose levels of 5, 50 or 500 mg/kg body
      weight. Residues of radioactive CNMA were measured. After the single dose
      radioactivity was distributed primarily in the gastro-intestinal tract, the
      kidneys and the liver of the rats. The radiolabel was excreted mainly in the
      urine, and at 24 hr 85.1, 84.2 and 81.2% of the administered radiolabel was
      recovered in the urine at the 5, 50 and 500 mg/kg dose levels, respectively.
      Faecal excretion of radiolabel at 24 hr for the 5, 50 and 500 mg/kg doses was
      5.1, 4.0 and 3.2% of the administered dose, respectively. At all dose levels, a
      small amount of the dose was distributed to the fat and was easily measured in
      animals killed 3 days after dosing at the 50 or 500 mg/kg dose levels. Following
      multiple oral administration, similar tissue distribution and excretion patterns
      of radiolabel were found at the three dose levels. After 24 hr the administered
      radiolabel was distributed mainly to the fat, liver and gastro-intestinal tract.
      At 24 hr, recoveries of the radiolabel in the urine were 80.4, 80.6 and 81.9% of
      the dose for the 5, 50 and 500 mg/kg dose levels, respectively. Faecal excretion
      of radiolabel after multiple dosing at 24 hr accounted for 6.3, 6.9 and 4.5% of
      the administered radioactivity at the 5, 50 and 500 mg/kg dose levels,
      respectively. The major metabolic pathway of CNMA for all single and the 5 and 50
      mg/kg multiple dose levels in this species of rat was found to be degradation to
      benzoic acid through beta-oxidation and excretion in the urine mainly as hippuric
      acid, with much smaller amounts of benzoic and cinnamic acids. At the multiple
      dose level of 500 mg/kg, benzoic acid was the major urinary metabolite,
      indicating that in the Fischer 344 male rat at this relatively high oral dose
      level the detoxification of CNMA proceeds differently and an alternative
      metabolic pathway is proposed.

PMID- 8477916
TI  - Lipid content and composition of coffee brews prepared by different methods.
AB  - The lipid content and composition of boiled, filtered, dripped, Turkish and
      espresso coffees prepared from roasted beans of Coffea arabica and Coffea
      robusta, and of coffees prepared from different brands of instant coffee were
      examined. The lipid content varied with the method of preparation. While coffee
      brews filtered through filter paper contained less than 7 mg lipids, those
      prepared by boiling without filtering and espresso coffee reached 60-160 mg
      lipids/150-ml cup. Coffee brew filtered through a metal screener contained 50 mg
      lipids/150-ml cup. Although the lipid content varied, the method of preparation
      of the brew and filtration had no important influence on the lipid composition.
      During paper filtration lipids remained mainly in spent coffee grounds, and the
      brew and filter paper retained only 0.4 and 9.4%, respectively, of the total
      lipids recovered. However, the lipids in the brew, filter paper and spent coffee
      grounds had the same profile, indicating that there was no preferential retention
      of a particular lipid component in filter paper. Triglycerides and diterpene
      alcohol esters were the major lipid classes in coffee brewed from ground coffee
      beans, and ranged from 86.6 to 92.9 and 6.5 to 12.5% of total lipids,
      respectively. For coffee brews made from instant coffee, the levels of these two
      lipid classes were 96.4-98.5 and 1.6-3.6%, respectively. The lipid contents of
      both regular and decaffeinated instant coffees varied slightly from one brand to
      the other, and ranged from 1.8 to 6.6 mg/150-ml cup.

PMID- 8477917
TI  - Haemotoxic effect of phenylurea herbicides in rats: role of haemoglobin-adduct
      formation in splenic toxicity.
AB  - Three substituted phenylurea herbicides were used for the study of the haemotoxic
      effects on rats of chronic exposure to these compounds. Female Sprague-Dawley
      rats were given monuron, diuron or fenuron (250-1000 mg/kg diet) for 14 months.
      The final body weights were similar to those of controls. No treatment-related
      effects on organ weights were observed at autopsy, except for a dose-related
      increase in spleen weights in rats treated with monuron or diuron, but not in
      those treated with fenuron. The proportion of haemoglobin in the form of
      methaemoglobin increased in the dosed group and resulted in a secondary anaemia
      with changes in the morphology of erythrocytes. Haemoglobin adducts of aromatic
      amines released from the herbicides were present at dose-related levels in rats
      treated with monuron or diuron. Compound-related lesions were observed
      histologically in treated rats, with increased pigmentation (haemosiderin) in the
      spleen, reflecting the response to the haemolytic anaemia and methaemoglobinaemia
      induced by the herbicides. Pigment deposition consisting of golden brown granules
      in the cytoplasm of the tubular epithelium in the kidney and in the Kupffer cells
      in the liver were observed only in rats treated with monuron. The haemotoxic
      effects that were observed may indicate that the formation of adducts between
      haemoglobin and the parent aromatic amines released metabolically from these
      herbicides has a role in the splenic toxicity of these compounds.

PMID- 8477918
TI  - Toxicological studies on debitterized Neem oil (Azadirachta indica).
AB  - Azadirachta indica, popularly known as 'Neem' in India, is widely grown all over
      the tropics. The seed contains 45% oil and is a minor oil of considerable
      potential. Neem oil is bitter and inedible. Recently, a method has been developed
      to completely remove the bitter and odoriferous principles and leave a
      bitterless, odourless and colourless oil. The nutritional and chemical evaluation
      of debitterized neem oil (NO) was reported earlier (C. Rukmini, Food Chemistry
      1987, 26, 119). We report here a three-generation study, carried out according to
      WHO/FDA protocol in groups of 15 male and 15 female rats fed a diet containing
      10% NO or groundnut oil (GNO). Reproductive toxicology was monitored for three
      generations. The results obtained in both the matings in all the three
      generations did not show any adverse effects on the reproductive parameters
      studied in rats fed NO and were similar to those observed in rats fed GNO. The
      mean organ weights and the histopathological evaluation of all the organs were
      similar to those of the control (GNO-fed) rats. A mutagenicity test of NO was
      also found to be negative in Ames test as reported earlier (K. Polasa and C.
      Rukmini, Food and Chemical Toxicology 1987, 25, 763). These studies indicate that
      NO devoid of all the bitter and odoriferous principles, may be recommended as
      safe for consumption by humans.

PMID- 8477919
TI  - Sulphur dioxide, acid aerosols and particulates.

PMID- 8477920
TI  - [The psychiatric day clinic--a review of experience to date and our results].
AB  - Psychiatric day hospitals are a relatively young therapeutic facility
      insufficiently known to many psychiatrists. This accounts for the application
      potential of day treatment not being adequately recognised and utilised despite
      its many advantages (efficacy, flexibility, versatility). Treatment at a day
      hospital is not a (more or less) acceptable alternative to hospitalisation but
      has a specific contribution of its own to make in certain situations. Although
      the scientific standard of the literature published on day hospitals is
      relatively good, many questions on theoretical and practical aspects remain
      unanswered. The aim of this paper is to show the opportunities and limitations of
      the psychiatric day hospital with reference to a survey of the existing
      literature and to our own experience.

PMID- 8477921
TI  - [The determination of cerebral speech dominance with the intracarotid amobarbital
      test].
AB  - In neuropsychological diagnostics of lateralisation of cognitive functions, the
      intracarotid amobarbital procedure (IAP) is a well established method for the
      determination of cerebral language dominance. In this review, different
      frameworks of classification of dominance patterns are discussed, ranging from
      the simple left/right/bilateral-dominance framework to a quantitative analysis
      according to a computed lateralisation index. Evidence from IAP studies
      concerning the cerebral organisation of linguistic subfunctions like naming and
      reading are discussed. A critical evaluation of rivalling approaches like
      electrical stimulation mapping or visual hemifield studies suggests that these
      methods mainly yield results complementary to IAP data and hence should not be
      taken as substitutes of that procedure.

PMID- 8477922
TI  - [Disorders of eye movements in schizophrenia--a critical review and future
      perspectives].
AB  - Disorders of smooth pursuit eye movements and saccadic eye movements have been
      reported frequently in schizophrenics. Probably 50% of the schizophrenic probands
      and of their unaffected relatives perform abnormal smooth pursuit movements.
      These deficiencies have been regarded as a possible genetic trait marker for
      schizophrenic vulnerability. Saccadic eye movements have been investigated less
      intesively. The most prominent pathological feature is a lack of precision of
      reflexive saccades in case of schizophrenic probands. Although a large body of
      research has been conducted, the multitude of the results of eye movement
      disorders in schizophrenics and also technical and methodological problems impair
      the significance of these findings. In this review, the most important results
      are critically elaborated and research perspectives are pointed out. A valid
      identification of eye movement abnormalities is necessary.

PMID- 8477923
TI  - [A case of idiopathic hyperaldosteronism diagnosed by adrenal imaging].
AB  - We report a case of idiopathic hyperaldosteronism (IHA) which was differentiated
      from an aldosterone producing adenoma by the adrenal imaging techniques with
      computed tomography (CT) and scintigraphy. In this patient, the high basal
      aldosterone level with the suppressed plasma renin activity typically indicated
      the diagnosis of primary aldosteronism. However, the differentiation from an
      aldosterone producing adenoma by responses of plasma aldosterone levels to
      upright posture, captopril or adrenocorticotropic hormone (ACTH) administration
      was not definitive. Abdominal CT revealed bilateral adrenal swelling. Adrenal
      scintillation scanning with 131I-iodocholesterol showed bilateral uptake even
      after the administration of dexamethasone. Blood sampling from the right adrenal
      vein was unsuccessful. Blood pressure and serum potassium levels remained
      unchanged during dexamethasone administration (2 mg/day) over ten days. After the
      administration of spironolactone and nisoldipine blood pressure and serum
      potassium levels were normalized. Adrenal imaging is considered to be very useful
      for the diagnosis of IHA.

PMID- 8477924
TI  - [Etiology of diabetic microangiopathy].

PMID- 8477925
TI  - [Two cases of huge hepatic hemangioma].
AB  - We have experienced two cases of huge hepatic hemangioma. Case 1 was a 51-year
      old man complaining of abdominal fullness and was shown low density area in the
      right hepatic lobe by abdominal computed tomography. He was treated with
      segmentectomy of the right hepatic lobe. The resected specimen was histologically
      diagnosed as cavernous hemangioma. Case 2 was a 61-year-old man who showed no
      symptom and was shown 10 x 6.5 cm hemangioma by abdominal ultrasonography. He
      have been untreated. For 10 years, 29 cases of huge hepatic hemangioma, including
      our two cases have been reported in Japan. The female to male ratio is 5:1. The
      incidence of huge hepatic hemangioma was frequent in the fifth and sixth decades
      of life. The majority of patients complained of palpable abdominal mass and
      abdominal pain. The dominant site of huge hepatic hemangioma was the anatomical
      right hepatic lobe.

PMID- 8477926
TI  - Safeguarding quality in managed competition.

PMID- 8477927
TI  - Challenges for managed competition from chronic illness.

PMID- 8477928
TI  - Doctors, dollars, and determination: making physician work-force policy.
AB  - Because managed care is likely to feature prominently in a reformed health care
      system, policymakers need to examine the impact managed care will have on medical
      practice, physician supply, and access to primary care providers. Goals for work
      force reform should focus on five areas: (1) training physicians in the
      generalist disciplines of family practice, general internal medicine, and general
      pediatrics; (2) shaping the physician work force to reflect the nation's ethnic
      diversity; (3) distributing physicians in a geographically equitable way; (4)
      maintaining the current physician-to-population ratio rather than letting it
      continue to grow; and (5) establishing supply needs for nurse practitioners,
      primary care physician assistants, and certified nurse midwives.

PMID- 8477929
TI  - An iconoclastic view of health cost containment.
AB  - Calls for medical care cost containment are all around us. Although the evidence
      that costs are too high is strong, the evidence that they are rising too quickly
      is much weaker. The principal cause of increasing costs appears to be the
      increased capabilities of medicine; the scant evidence available suggests that to
      date the public has wanted to pay for most of these capabilities. Effective
      global budgets would address the rising opportunity costs of health care.
      However, they would threaten ongoing innovation and probably would increase
      distortions from pricing errors.

PMID- 8477930
TI  - Reorganizing the financial flows in American health care.
AB  - The essays in this volume concentrate heavily on "managed competition," which is
      merely a particular form of controlling the flow of funds from an insurance pool
      to the providers of health care. By contrast, this essay emphasizes the funneling
      of money into the insurance fund. It is argued inter alia that American business
      has been a quite unreliable partner in the financing of American health care and
      also a major cost driver. A reformed health system should reduce the role of
      business to the mere collection of premiums at the nexus of payroll.

PMID- 8477931
TI  - The need for a national global budget.

PMID- 8477932
TI  - Managed competition: little cost containment without budget limits.

PMID- 8477933
TI  - Can managed competition solve the problems of market failure?

PMID- 8477934
TI  - Potential public expenditures under managed competition.
AB  - This DataWatch estimates the public cost of providing universal coverage under a
      managed competition model. First, a uniform benefit package is specified; next,
      the lowest-cost premium for this coverage is estimated, based on average costs in
      a well-managed health maintenance organization (HMO). Based on these estimates,
      the cost of premium subsidies and tax revenue effects are determined. It is
      estimated that if coverage is extended to currently uninsured persons using these
      estimates and assumptions, spending for these persons will increase 73.9 percent
      over current levels. The authors estimate a net increase of $47.9 billion in 1993
      health spending under a managed competition program with low patient cost
      sharing. This includes savings of $4.5 billion from wider use of managed care and
      $11.2 billion in administrative cost savings.

PMID- 8477935
TI  - The history and principles of managed competition.
AB  - Managed competition in health care is an idea that has evolved over two decades
      of research and refinement. It is defined as a purchasing strategy to obtain
      maximum value for consumers and employers, using rules for competition derived
      from microeconomic principles. A sponsor (either an employer, a governmental
      entity, or a purchasing cooperative), acting on behalf of a large group of
      subscribers, structures and adjusts the market to overcome attempts by insurers
      to avoid price competition. The sponsor establishes rules of equity, selects
      participating plans, manages the enrollment process, creates price-elastic
      demand, and manages risk selection. Managed competition is based on comprehensive
      care organizations that integrate financing and delivery. Prospects for its
      success are based on the success and potential of a number of high-quality, cost
      effective, organized systems of care already in existence, especially prepaid
      group practices. As it is outlined here, managed competition as a means to reform
      the U.S. health care system is compatible with Americans' preferences for
      pluralism, individual choice and responsibility, and universal coverage.

PMID- 8477936
TI  - Managed competition estimates for policy making.

PMID- 8477937
TI  - Potential impact of managed care on national health spending.
AB  - Illustrative estimates suggest that if all acute health care services were
      delivered through staff- or group-model health maintenance organizations (HMOs),
      national health spending might be almost 10 percent lower. If the delivery of all
      such services (except those now provided by staff- or group-model HMOs) were
      subject to utilization review arrangements incorporating precertification and
      concurrent review of inpatient care, spending might be 1 percent lower. The
      estimates assume no changes in the health care system apart from expansion of
      these two forms of managed care to cover all insured persons. They also assume
      that moving to universal managed care would produce a one-time drop in the level
      of national health spending with no subsequent effect on spending growth.

PMID- 8477938
TI  - Physician satisfaction under managed care.
AB  - Data from a survey of young physicians have been analyzed to study the
      relationship between practicing medicine under managed care and the levels of
      perceived professional autonomy, practice satisfaction, and career satisfaction.
      Although practicing under managed care is associated with lower levels of
      perceived autonomy in patient selection and time allocation, it is associated
      with higher levels of perceived autonomy in use of hospital care, tests, and
      procedures. Specialists associated with managed care perceive more autonomy than
      generalists. Analyses of physicians' satisfaction with their practices and
      careers show that practicing under managed care is not uniformly associated with
      lower levels of satisfaction. Overall, managed care does not seem to have had the
      deleterious impact on medical practice that was forecast for it.

PMID- 8477939
TI  - Twenty-four-hour coverage and workers' compensation insurance.
AB  - Workers' compensation insurance provides cash benefits and health care for
      workers who are injured on the job. This DataWatch considers the costs and
      benefits of combining the health insurance component of workers' compensation
      with universal health insurance, creating a twenty-four-hour coverage plan. The
      paper documents a large potential savings from twenty-four-hour coverage:
      Workers' compensation medical charges are about twice as high as those for
      comparable off-work injuries. This disparity seems to result from price
      discrimination and lack of cost controls in workers' compensation. Twenty-four
      hour coverage, however, may be difficult to implement.

PMID- 8477940
TI  - Gaps in employer coverage: lack of supply or lack of demand?
AB  - According to data from the May 1988 Current Population Survey, 18 percent of
      workers are in firms that do not offer health insurance. The question explored
      here is whether the absence of insurance in these firms is related to lack of
      supply (that is, a failure of the firm to offer the benefit because the price it
      faces is too high or the benefit too low) or lack of demand (that is, employees
      in these firms would not purchase the insurance even if it were offered).
      Characteristics hypothesized to affect the supply of insurance by firms (size,
      rate of turnover, and union status) are found to distinguish whether or not firms
      offer insurance. The data show near-universal acceptance of group insurance among
      employees offered the opportunity to participate. Both of these factors suggest a
      failure of supply. However, employees in firms that do not offer insurance are
      young, low-wage earners who work part time. These are also characteristics of
      workers who do not purchase group insurance even when it is offered, suggesting
      that many of the workers who are not offered group insurance would not
      participate in a plan even if the supply failure were corrected. These findings
      have implications for the effectiveness of voluntary strategies to improve
      access, but they also raise concern over the fairness to workers of mandates
      requiring that they purchase coverage.

PMID- 8477941
TI  - Health care financing reform in Russia and Ukraine.

PMID- 8477942
TI  - Who should govern the purchasing cooperative?

PMID- 8477943
TI  - Design of health insurance purchasing cooperatives.

PMID- 8477944
TI  - A payment method for health insurance purchasing cooperatives.

PMID- 8477945
TI  - A bridge to compromise: competition under a budget.
AB  - A new approach to universal health insurance combining managed competition and
      global budgets promises to break the impasse blocking comprehensive health
      reform. The central innovation is the development of regional health insurance
      purchasing cooperatives (HIPCs) as managers and reorganizers of the market and
      platforms for global budgets. Financing would be based on community-rated
      premiums, with obligations to employers capped as a percentage of payroll and to
      individuals as a percentage of family income. Budgets would cap the mandated core
      of spending and set a target for out-of-pocket expenditures.

PMID- 8477946
TI  - Informing and protecting consumers under managed competition.

PMID- 8477947
TI  - Where should the buck stop: federal and state responsibilities in health care
      financing reform.

PMID- 8477948
TI  - Benefit design choices under managed competition.

PMID- 8477949
TI  - Effects of amylin on the release of insulin and glucagon from the perfused rat
      pancreas.
AB  - Amylin is a normal secretory protein of the pancreatic beta-cells as well as a
      major constituent of the islet amyloid deposits in patients with non-insulin
      dependent diabetes mellitus. We studied the effects of amylin on the release of
      insulin and glucagon from the isolated perfused rat pancreas. Rat amylin was
      dissolved in basal perfusates to a final concentration of 100 nM. Amylin did not
      alter glucose-stimulated secretion of insulin but significantly inhibited
      arginine-stimulated secretion of insulin (control: 20.9 +/- 1.4 pmol/min; amylin
      group: 14.8 +/- 1.6 pmol/min, p < 0.05). Amylin did not alter the release of
      glucagon from the perfused rat pancreas in response to 16.7 mM glucose and 10 mM
      arginine. These findings suggest that amylin may modulate the secretion of
      insulin from pancreatic beta-cells.

PMID- 8477950
TI  - Effect of epinephrine on 86Rb efflux, 45Ca outflow and insulin release from
      pancreatic islets perifused in the presence of propranolol.
AB  - Pancreatic islets prelabelled with either 86Rb or 45Ca were perifused in the
      presence of propranolol (0.1 microM) and, when required, exposed to epinephrine
      (0.1 microM). In the absence of D-glucose, epinephrine failed to cause any
      obvious change in either 86Rb or 45Ca outflow. In the presence of 16.7 mM D
      glucose, however, epinephrine lowered both 86Rb and 45Ca outflow, this coinciding
      with suppression of insulin release. Epinephrine also suppressed the increment in
      86Rb outflow evoked by a rise in glucose-concentration from 8.3 to 16.7 mM.
      Epinephrine did not abolish the early fall in 45Ca efflux evoked by the
      administration of D-glucose (16.7 mM) to islets previously deprived of the hexose
      but, within the same experiments, impaired the secondary rise in effluent
      radioactivity. Likewise, epinephrine prevented the increase in 45Ca outflow
      provoked by a rise in hexose concentration from 8.3 to 16.7 mM. These findings
      are compatible with the recent proposal that epinephrine interferes with the
      entry of Ca2+ into the B-cell, as mediated by voltage-sensitive Ca2+ channels,
      but do not rule out a multifactorial coupling between the occupancy of alpha 2
      adrenergic receptors and the eventual inhibition of insulin release.

PMID- 8477951
TI  - The concept of metabolic clearance rate in endocrinology. A case study of growth
      hormone in different lines of meat-type chickens.
AB  - Disappearance of growth hormone from blood (plasma) was studied in young broiler
      chickens in two experiments: a) following single injection of GH (50 micrograms
      or 250 micrograms/kg) to anesthetized chicks; b) injection of GH (50
      micrograms/kg) (under anesthesia) to two lines of broilers selected for either
      rapid growth or feed efficiency. Clearance of GH never followed a single negative
      exponential curve. Characterization of the disappearance by a single metabolic
      clearance rate and half-life time were found to be inaccurate and inappropriate
      on methodological grounds. High doses of hormone might disturb receptor or
      catabolism equilibria and result in aberrant values of MCR which could probably
      be because of the very dynamic nature of the GH clearance system, which appeared
      to be influenced by dose, line (or genetics of the animal) and by some indices of
      clearance. Therefore, physiological significance of such data must be interpreted
      carefully.

PMID- 8477952
TI  - Thyroid hormone restores atrial stretch-induced secretion of atrial natriuretic
      peptide in hypophysectomized rats.
AB  - Acute blood volume expansion caused a rapid and profound release of atrial
      natriuretic peptides (ANP) from cardiac atria. The stimulated release of ANP was
      markedly blunted (more than 50%) in hypophysectomized rats (8 days after
      surgery). Daily subcutaneous injections of thyroxine (30 micrograms/kg) to
      hypophysectomized rats for 7 days, completely restored acute volume expansion
      induced release of ANP. Our data suggest that thyroid hormone is required for ANP
      secretion in response to acute volume expansion.

PMID- 8477953
TI  - Effect of ascorbic acid administration on B and E apoproteins in rats fed a
      cholesterol enriched diet.
AB  - The effect of ascorbic acid on cholesterol metabolism is very well documented; it
      is ascribed to the activation of this vitamin on cholesterol 7 alpha-hydroxylase
      (EC 1.14) that activates the catabolism of cholesterol. In this paper we have
      studied the effect of the administration of ascorbic acid on B and E apoproteins
      of rats fed a diet enriched with 1.5% of cholesterol. The results obtained show
      that ascorbic acid is able to affect cholesterol metabolism by modifying the
      serum levels of apo B in total serum and in lipoprotein classes of density less
      than 1.050 g/ml. Moreover the ascorbic acid treatment reduced the amount of
      cholesterol and triglycerides in all lipoprotein classes examined. No significant
      change of total serum apo E was observed following ascorbic acid administration.

PMID- 8477954
TI  - Mononuclear leukocytes from obese patients with type II diabetes have reduced
      activity of hexokinase, 6-phosphofructokinase and glucose-6-phosphate
      dehydrogenase.
AB  - In the present study we measured the activity of some cytosolic enzymes involved
      in intracellular glucose metabolism in mononuclear leukocytes from 77 obese
      subjects of which 39 were nondiabetic and 38 had newly-diagnosed untreated type
      II diabetes mellitus. 28 subjects (19 nondiabetic and 18 diabetic) had also a
      study of insulin binding to monocytes. 35 subjects (14 nondiabetic, 21 diabetic)
      underwent an insulin tolerance test for the evaluation of in vivo insulin action.
      Mononuclear leukocytes from diabetic obese patients showed significantly lower
      activities of hexokinase (HK), 6-phosphofructokinase (PFK) and glucose-6
      phosphate dehydrogenase (G6PDH), while pyruvate kinase (PK) and 6
      phosphogluconate dehydrogenase (6PGDH) activities were similar in the two groups.
      In the whole population HK and G6PDH activities inversely correlated with fasting
      and 2-h OGTT plasma glucose levels. Neither plasma insulin levels nor maximal
      specific insulin binding to monocytes were significantly correlated with any of
      the enzyme activities measured. Conversely, the parameter of insulin action
      generated by insulin tolerance test significantly correlated with HK, G6PDH and
      6PGDH. These results indicate that in obese subjects the presence of diabetes is
      associated with a reduced activity of some enzymes of glucose metabolism in
      mononuclear leukocytes. This multiple enzymatic defect is correlated with the
      impairment of in vivo insulin action.

PMID- 8477955
TI  - In vivo and in vitro effects of glucocorticoids on glucose transport in human
      polymorphonuclear leukocytes.
AB  - In order to study whether or not exogenous and/or endogenous glucocorticoids
      affect the glucose transport rate in human cells, we examined the transport rate
      of a non-metabolizable hexose analogue, 3-O-methyl-D-glucose, in
      polymorphonuclear leukocytes from patients with hypercortisolism. The mean
      glucose transport rate was prominently decreased in 5 patients with Cushing's
      syndrome compared with 29 healthy controls (5.4 +/- 1.8 vs 10.4 +/- 2.5
      fl/cell.sec, mean +/- SD, p < 0.001) and the transport rate returned to normal
      range after adenoma resection in 2 of them. In 10 patients with nephrotic
      syndrome treated with prednisolone, a significant negative correlation was found
      between transport rates and daily prednisolone doses. When prednisolone of 40
      mg/day was administered to a diabetic patient and the dose was gradually reduced,
      glucose transport rate was transiently decreased during the initial period. In an
      in vitro study, a synthetic glucocorticoid, dexamethasone, directly inhibited
      glucose transport rate in those cells in time- and concentration-dependent
      manners by mainly reducing Vmax. These results suggest that either exogenous or
      endogenous hypercortisolism in humans is associated with a decrease in glucose
      transport rate in polymorphonuclear leukocytes, and that the direct effect of
      glucocorticoids accounts at least in part for the decreased glucose transport
      rates found in those cells.

PMID- 8477957
TI  - Long-term impairment of adrenal function after unilateral adrenalectomy.

PMID- 8477956
TI  - Evidence for increased sensitivity of fuel mobilization to growth hormone during
      short-term fasting in humans.
AB  - Since growth hormone (GH) secretion is increased with fasting, the study was
      designed to assess the effects of short-term fasting on both basal and GH
      stimulated substrate metabolism. Seven normal healthy subjects were studied
      following a 12 h and a 36 h fast ("fasting"), for 2 h in the basal state and for
      a further 4 1/2 h after an i.v. bolus injection of 140 micrograms GH. As expected
      fasting induced decrements in circulating concentrations of insulin and C-peptide
      (p < 0.05) and increments in glucagon concentrations (p < 0.05), together with a
      slight increase in serum GH concentrations (p > 0.05). Furthermore plasma glucose
      values, isotopically determined turnover rate for glucose and forearm uptake of
      glucose were all substantially reduced during fasting (p < 0.05). By contrast
      circulating levels of all measured lipid intermediates (free fatty acids [FFA], 3
      hydroxybutyrate [3-OHB] and glycerol) and the forearm uptake of 3-OHB were
      clearly elevated during the fast (p < 0.05). Serum GH rose to a peak of 17.0 +/-
      2.7 within 10 min of injection in both situations. Blood concentrations of
      hormones and parameters of glucose metabolism remained unaffected. After
      administration of GH circulating levels of lipid intermediates increased markedly
      in both situations, the increase being most pronounced in the fasting state (p <
      0.05). During fasting peak levels of 1775 +/- 150 mumol/l and 1780 +/- 360
      mumol/l of FFA and 3-OHB were observed compared to postabsorptive peaks of 980 +/
      100 and 230 +/- 90 mumol/l respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477958
TI  - Intra-uterine fetal death due to pre-eclampsia which was misdiagnosed to be
      complicating with hepatitis.

PMID- 8477959
TI  - Histological evaluation of the intrahepatic biliary tree in intrahepatic
      cholesterol stones, including immunohistochemical staining against apolipoprotein
      A-1.
AB  - Apolipoprotein A-1 is known to be one of inhibiting factors of cholesterol
      nucleation in bile, and decreased activity of apolipoprotein A-1 is considered to
      predispose cholesterol-supersaturated bile to formation of cholesterol crystals.
      To study the pathogenesis of the intrahepatic formation of cholesterol stones, we
      examined surgically resected liver specimens from six patients with intrahepatic
      cholesterol stones and compared the characteristic histopathological features
      with those of intrahepatic calcium bilirubinate stones, using morphological
      examination and immunohistochemical staining against apolipoprotein A-1.
      Morphologically, in all six patients with cholesterol stones the severity of
      chronic proliferative cholangitis with proliferation of the mucus-producing
      glandular elements in the walls of the large bile duct or periductal tissues was
      less extensive than that seen with calcium bilirubinate stones, and cholesterol
      crystals had formed in the septal and interlobular bile ducts.
      Immunohistochemically, unlike the normal liver and calcium bilirubinate stone
      containing lobes, the hepatocytes and the epithelial lining of the bile ducts and
      peribiliary glands of the cholesterol stone-containing lobes did not react
      completely (some of the epithelial cells reacted only faintly) with
      apolipoprotein A-1 antibody. These findings suggest that an abundance of mucous
      substance and bacterial infection of the biliary tree may not be necessary for
      the formation of cholesterol stones, compared with findings in cases of calcium
      bilirubinate stones. We suggest that cholesterol crystals may be produced in the
      septal and interlobular bile ducts in the microenvironment of cholesterol
      supersaturated bile and decreased activity of apolipoprotein A-1.

PMID- 8477960
TI  - Significance of pre-S region-defective hepatitis B virus that emerged during
      exacerbation of chronic type B hepatitis.
AB  - A defective form of the hepatitis B virus has been found in a patient with
      chronic type B hepatitis. Sequence analysis of the viral DNA after polymerase
      chain reaction amplification revealed a 117-base pair deletion (nucleotides 3129
      53, subtype adr). This deletion includes the initiation codon of the pre-S2
      region and a newly created in-frame stop codon in the pre-S1 region (nucleotide
      3055) located 230 base pairs downstream from the pre-S1 initiation codon. This
      virus coexisted with the wild-type virus during the exacerbation period, as
      evidenced by an elevation of serum transaminase levels. It was not detected in
      the stable period, and the blood chemistry results were normal. We assayed
      antibodies against the mutation-related region by enzyme immunoassay in serial
      serum samples to clarify the mechanism of the emergence of this variant virus.
      Antibodies against the pre-S2 region were negative; however, the antibody
      response against the pre-S1 epitopes coincided with the appearance of the variant
      virus. These findings suggest that an activated T-cell and B-cell response had
      developed against the pre-S1 region during hepatic inflammation in this patient
      and that, consequently, selection occurred for a pre-S antigen-defective mutant
      strain of the virus that might be resistant to such an immune response.

PMID- 8477961
TI  - A study of oral nutritional support with oxandrolone in malnourished patients
      with alcoholic hepatitis: results of a Department of Veterans Affairs cooperative
      study.
AB  - A Veterans Affairs cooperative study involving 273 male patients was performed to
      evaluate efficacy of oxandrolone in combination with an enteral food supplement
      in severe alcoholic hepatitis. All patients had some degree of protein calorie
      malnutrition. On an intention-to-treat basis, only minimal changes in mortality
      were observed. However, in patients with moderate malnutrition mortality on
      active treatment at 1 mo was 9.4% compared with 20.9% in patients receiving
      placebo. This beneficial effect was maintained so that after 6 mo on active
      treatment 79.7% of patients were still alive, compared with 62.7% of placebo
      treated patients (p = 0.037). Improvements in both the severity of the liver
      injury (p = 0.03) and malnutrition (p = 0.05) also occurred. No significant
      improvement was observed with severe malnutrition. To better determine the effect
      on therapeutic efficacy, we compared results with those from a nearly identical
      population (cooperative study 119) treated with oxandrolone but not given the
      food supplement. Patients were stratified according to their caloric intake
      (greater than 2,500 kcal/day was considered adequate to supply energy needs and
      promote anabolism). For patients with moderate malnutrition and adequate caloric
      intake, oxandrolone treatment reduced 6-mo mortality (4% active treatment vs. 28%
      placebo [p = 0.002]). For patients with moderate malnutrition and inadequate
      calorie intake, oxandrolone had no effect on mortality (30% active treatment vs.
      33% placebo). In cases of severe malnutrition, oxandrolone had no effect on
      survival. However, adequate caloric intake was associated with 19% mortality,
      whereas patients with inadequate intake exhibited 51% mortality (p = 0.0001).
      These results indicate that nutritional status should be evaluated in patients
      with alcoholic hepatitis. When malnutrition is present, vigorous nutrition
      therapy should be provided, and in patients with moderate malnutrition
      oxandrolone should be added to the regimen.

PMID- 8477962
TI  - Cholesterol-lowering effect of ursodeoxycholic acid in patients with primary
      biliary cirrhosis.
AB  - We have previously shown in a 2-yr controlled trial that hypercholesterolemia,
      frequent in primary biliary cirrhosis, is lowered by ursodeoxycholic acid (13 to
      15 mg daily). To further investigate this effect, we analyzed the influence of
      long-term ursodeoxycholic acid administration on serum lipids, lipoproteins and
      bile acids. The study involved a subgroup of 33 noncirrhotic patients (17
      received ursodeoxycholic acid and 16 received a placebo) analyzed at inclusion
      and after 2 yr. The total serum cholesterol concentration was markedly reduced in
      the ursodeoxycholic acid-treated patients in comparison with the controls (mean
      +/- S.E.M. = 7.49 +/- 0.42 mmol/L and 7.07 +/- 0.23 mmol/L at entry and 4.44 +/-
      0.40 mmol/L and 6.89 +/- 0.27 mmol/L at 2 yr in the ursodeoxycholic acid and
      placebo groups, respectively; p < 0.02). Quantitatively, this decrease was mainly
      caused by a fall in low-density-lipoprotein cholesterol, but very low density
      lipoprotein cholesterol levels also fell significantly. High-density-lipoprotein
      cholesterol levels remained stable in both groups, but the high-density
      lipoprotein2/high-density-lipoprotein3 cholesterol ratio fell significantly
      during ursodeoxycholic acid treatment. No significant change occurred in total
      triglyceride or total phospholipid levels. In the treated group, the proportion
      of ursodeoxycholic acid increased (up to 60% of total circulating bile acids),
      whereas that of cholic and chenodeoxycholic acids fell significantly. In
      conclusion, the cholesterol-lowering effect of ursodeoxycholic acid could be
      related to an improvement of cholestasis, modifications in cholesterol metabolism
      or both. Changes in endogenous bile acid composition induced by ursodeoxycholic
      acid might be the common denominator of these two mechanisms.

PMID- 8477963
TI  - Compression of the common bile duct due to portal-vein thrombosis in polycythemia
      vera.
AB  - The case of a 56-yr-old patient with polycythemia vera who was initially seen
      with jaundice is reported. Compression of the common bile duct by choledochal
      varices was found to be the cause of the obstructive jaundice. This compression
      was successfully treated with placement of a plastic endoprosthesis across the
      stenosis during endoscopic retrograde cholangiopancreatography. The significance
      of choledochal varices in the evaluation of obstructive jaundice is emphasized.

PMID- 8477964
TI  - Serum bile acids in primary biliary cirrhosis: effect of ursodeoxycholic acid
      therapy.
AB  - Serum bile acid levels and distributions were studied every 6 mo in patients with
      primary biliary cirrhosis who were randomly assigned to receive ursodeoxycholic
      acid (13 to 15 mg/kg/day) (n = 73) or a placebo (n = 73) over a 2-yr period. In
      the ursodeoxycholic acid group, ursodeoxycholic acid was the predominant serum
      bile acid at 6 mo and throughout the 2-yr treatment period. The total
      concentration of endogenous bile acids decreased with a reduction in cholic acid
      (in the ursodeoxycholic acid group and the placebo group, respectively [mean +/-
      S.E.]: 13.0 +/- 2.2 and 12.6 +/- 2.5 mumol/L at entry vs. 3.5 +/- 0.6 and 9.0 +/-
      2.2 mumol/L at 2 yr; p < 0.002), chenodeoxycholic acid (in the ursodeoxycholic
      acid group and the placebo group, respectively: 12.1 +/- 1.7 and 12.7 +/- 2.3
      mumol/L at entry vs. 5.8 +/- 0.8 and 10.7 +/- 2.2 mumol/L at 2 yr; p < 0.02) and
      3 beta-hydroxy-delta 5-cholenoic acid. The concentration of deoxycholic acid did
      not change, whereas that of lithocholic acid increased significantly (in the
      ursodeoxycholic acid group and the placebo group, respectively: 0.63 +/- 0.06 and
      0.81 +/- 0.12 mumol/L at entry vs. 1.26 +/- 0.12 and 0.90 +/- 0.15 mumol/L at 2
      yr; p < 0.001). These changes were independent of the histological stage of the
      disease. Thus during ursodeoxycholic acid administration the liver was exposed to
      a lower level of endogenous bile acids and to an increased concentration of
      ursodeoxycholic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477965
TI  - Diagnostic features and clinical outcome of ischemic-type biliary complications
      after liver transplantation.
AB  - The clinical significance and outcome of nonanastomotic strictures and
      dilatations involving only the biliary tree of the graft with a radiological
      appearance of biliary ischemia is unknown. Therefore we analyzed the grafts of
      128 patients to evaluate the biochemical, radiological and histological features
      that prompted the diagnosis of ischemic-type biliary stricture and the clinical
      outcome of this complication. Ischemic-type biliary strictures were diagnosed in
      25 patients (19%). Initial graft function was similar in all patients, whether or
      not this complication developed. Most ischemic-type biliary strictures occurred
      between 1 and 4 mo after orthotopic liver transplantation. However, the
      appearance of ischemic-type biliary stricture in the month after transplantation
      was predictive for a poor outcome in all six grafts with early onset of ischemic
      type biliary strictures. Eighteen patients (72%) were treated with biliary stents
      and repeated dilatations. Long-term patency was achieved in 88% of these
      patients. Repeat transplantation was performed in six patients (24%); five
      survived. Finally, patients with ischemic-type biliary strictures spent more time
      in the hospital during the first year after orthotopic liver transplantation than
      did patients without the complication (62 +/- 27 days vs. 37 +/- 20 days; p < or
      = 0.001). This was due to repeated hospitalizations and a higher incidence of
      retransplantation. One-year graft survival was lower in patients with ischemic
      type biliary strictures than in patients without ischemic-type biliary strictures
      (69% vs. 88%; p = 0.006). However, 1-yr patient survival was similar in the two
      groups (91% vs. 89%). In conclusion, early appearance of ischemic-type biliary
      stricture features is associated with poor graft prognosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8477966
TI  - Augmented glucose use and pentose cycle activity in hepatic endothelial cells
      after in vivo endotoxemia.
AB  - Glucose use and pentose cycle activity were determined in freshly isolated rat
      hepatic endothelial cells 3 hr after an intravenous injection of Escherichia coli
      lipopolysaccharide (0.1 mg/kg body weight), by use of [1-14C]glucose, [6
      14C]glucose and [2-3H]glucose. Lipopolysaccharide treatment in vivo increased
      glucose use fivefold, whereas glucose oxidation in the pentose cycle was elevated
      from 0.2 to 1.5 nmol/hr/10(7) cells. In vitro incubation of endothelial cells
      from saline- and lipopolysaccharide-treated animals in the presence of phorbol 12
      myristate 13-acetate (10(-6) mol/L) increased pentose cycle activity twofold and
      eightfold, respectively. Phorbol 12-myristate 13-acetate caused only a 40% to 60%
      increase in glycolysis in both groups. Addition of t-butyl hydroperoxide (0.5
      mmol/L), a substrate for glutathione peroxidase, caused a 24-fold and 16-fold
      increase in the glucose flux through the pentose cycle in cells from saline- and
      lipopolysaccharide-treated rats, respectively. Oxidation of glucose through the
      Krebs cycle was also increased several-fold after t-butyl hydroperoxide
      administration. Depletion of cellular glutathione by N-ethylmaleimide (0.1
      mmol/L) inhibited the phorbol 12-myristate 13-acetate-induced or t-butyl
      hydroperoxide-induced increase in the pentose cycle activity with no marked
      effects on glycolysis. Diphenyleneiodonium (0.1 mmol/L), an inhibitor of
      superoxide and nitric oxide synthesis inhibited the phorbol 12-myristate 13
      acetate-induced increased pentose cycle activity with no effects on the t-butyl
      hydroperoxide-induced response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8477967
TI  - Decreased mitochondrial oxidation of fatty acids in pregnant mice: possible
      relevance to development of acute fatty liver of pregnancy.
AB  - Severe impairment of the beta-oxidation of fatty acids, as a consequence of a
      single factor or a combination of different causes, leads to microvesicular
      steatosis of the liver. In an effort to understand the mechanism(s) leading to
      the development of acute fatty liver of pregnancy in some women, we determined
      the effects of pregnancy on the mitochondrial oxidation of fatty acids in mice.
      In vivo, the rate of oxidation of the whole fatty-acid chain length was
      determined by measuring the rate of exhalation of [14C]CO2 after intragastric
      administration of a tracer dose of [U-14C]palmitic acid. [14C]CO2 exhalation was
      not significantly decreased at 14 days of gestation, but it had declined by 40%
      at 18 days of gestation (i.e., 24 to 48 hr before delivery). The rate of first
      beta-oxidation cycle was assessed by measuring the rate of [14C]CO2 exhalation
      after administration of [1-14C]octanoic acid, [1-14C]butyric acid or [1
      14C]palmitic acid. [14C]CO2 exhalation had declined by 60%, 46%, and 24% after
      administration of [1-14C]octanoic acid, [1-14C]butyric acid and [1-14C]palmitic
      acid, respectively, in 18-day-pregnant mice. Total hepatic lipids and
      triglycerides, expressed per gram of liver, remained unchanged in 18-day-pregnant
      mice. In vitro, the rate of mitochondrial beta-oxidation (expressed per milligram
      of protein) had decreased by 47% at 18 days' gestation with [U-14C]palmitic acid
      as substrate and by 33% with [1-14C]octanoic acid but remained unchanged with [1
      14C]palmitic acid. The activity of the tricarboxylic acid cycle, assessed by the
      formation of [14C]CO2 from [1-14C]acetic acid, had decreased by 24%. We conclude
      that the mitochondrial oxidation of fatty acids decreased during late-term
      pregnancy in mice as a consequence of both decreased mitochondrial beta-oxidation
      of medium-chain fatty acids, and decreased activity of the tricarboxylic acid
      cycle. We suggest that this effect, in combination with other factors, may
      contribute to the development of fatty liver of pregnancy in some pregnant women.

PMID- 8477968
TI  - Hepatic stimulator substance protects against acute liver failure induced by
      carbon tetrachloride poisoning in mice.
AB  - Hepatic stimulator substance was extracted from the liver of weanling Sprague
      Dawley rats according to the method of LaBrecque. Quang-Ming mice were injected
      with carbon tetrachloride to induce acute liver failure. Hepatic stimulator
      substance suppressed the elevation of ALT and AST induced by carbon tetrachloride
      in a dose-dependent manner. Hepatic histological changes indicated that hepatic
      stimulator substance reduced the severity of hepatic lesion induced by carbon
      tetrachloride and reversed carbon tetrachloride-induced reduction of hepatic
      mitochondrial succinic dehydrogenase activity. In attempting to elucidate the
      mechanism or mechanisms of this protective effect, we found that hepatic
      stimulator substance significantly restored the carbon tetrachloride-induced
      decrease of hepatocyte plasmalemma and mitochondrial and microsomal membrane
      fluidity. Hepatic stimulator substance also decreased the malondialdehyde content
      of carbon tetrachloride-intoxicated mice; restored the liver-reduced glutathione
      content, which was lowered by carbon tetrachloride intoxication; stimulated liver
      regeneration, as shown by enhanced DNA synthesis; and increased the 3H-thymidine
      incorporation into DNA of hepatocytes. We propose that hepatic stimulator
      substance protects the liver against acute liver failure induced by carbon
      tetrachloride poisoning, probably by an antioxidative effect on hepatocyte
      membrane lipid peroxidation, which was increased by free radicals produced from
      carbon tetrachloride. In addition, hepatic stimulator substance stimulates
      hepatocyte proliferation. These protective mechanisms may act in concert to
      protect against carbon tetrachloride injury.

PMID- 8477969
TI  - Cellular heterogeneity in binding and uptake of low-density lipoprotein in
      primary rat hepatocytes.
AB  - Hepatocellular heterogeneity of biochemical function is well established for many
      aspects of liver metabolism. This study addresses the question of cellular
      heterogeneity in the catabolism of low-density lipoprotein by rat hepatocytes.
      Low-density lipoprotein binding (4 degrees C) and uptake (37 degrees C) by rat
      hepatocytes were studied by use of human low-density lipoprotein labeled with a
      highly fluorescent lipophilic probe, N,N-dipentadecylaminostyrylpyridinium
      iodide, recently developed by us. Single-cell suspensions derived from rat
      hepatocytes in primary culture and from liver perfusion were studied with flow
      cytometry with and an approximation algorithm for data analysis. These studies
      show subpopulations of cells negative and positive for the specific binding and
      uptake of low-density lipoprotein. Dissociation constants for low-density
      lipoprotein binding and uptake were determined for the total population (18
      micrograms/ml, binding; 12 micrograms/ml, uptake) and found to be in good
      agreement with previously reported values. Additionally, the dissociation
      constant for binding for the positive subpopulation was determined and found to
      be 3 micrograms/ml. This lower value is more typical of the values seen in other
      cell types. These findings are strongly suggestive of functional heterogeneity in
      the hepatic catabolism of low-density lipoprotein.

PMID- 8477970
TI  - Decrease in the hepatic clearance of hepatocyte growth factor in carbon
      tetrachloride-intoxicated rats.
AB  - To examine whether a decrease in hepatic uptake, clearance or both of hepatocyte
      growth factor contributes to increased plasma hepatocyte growth factor levels, we
      kinetically analyzed hepatic hepatocyte growth factor handling using rats with
      carbon tetrachloride-induced liver injury in both in vivo and perfused liver
      systems. After the intravenous administration of tracer 125I-hepatocyte growth
      factor, the time profile of trichloroacetic acid-precipitable 125I-hepatocyte
      growth factor was analyzed, and tissue clearance and total body plasma clearance
      were determined. For the tissues examined (liver, kidney, lung, spleen and
      adrenal), liver and adrenal clearance of 125I-hepatocyte growth factor decreased
      significantly. It was found that the hepatic clearance explains the bulk of the
      total body plasma clearance. The hepatic clearance and the total body clearance
      decreased to minimums (approximately 40% of control) 24 hr after carbon
      tetrachloride administration and recovered to near-control values over a 6-day
      period. At 24 hr after carbon tetrachloride administration, a single-pass liver
      perfusion of 125I-hepatocyte growth factor was performed, and its results were
      compared with the control results. After a 15-min perfusion of 125I-hepatocyte
      growth factor, we washed the liver sequentially with heparin and then with acid
      buffer to separately determine the cell-surface-bound and internalized 125I
      hepatocyte growth factor. In carbon tetrachloride-intoxicated rats, both the acid
      washable binding and the internalized 125I-hepatocyte growth factor dropped to
      almost half of the control values, but the decrease in heparin-washable binding
      was minimal. In contrast, when 125I-hepatocyte growth factor was perfused with
      excess unlabeled hepatocyte growth factor (135 pmol/L), mostly saturating the
      cell-surface receptors, the change in cell-surface-bound 125I-hepatocyte growth
      factor and internalized 125I-hepatocyte growth factor in carbon tetrachloride
      intoxicated rats was minimal. This finding, along with our previous finding that
      the cell-surface hepatocyte growth factor receptors are greatly down-regulated in
      carbon tetrachloride-intoxicated rats, suggests that the hepatic clearance of
      hepatocyte growth factor through receptor-mediated endocytosis decreases in
      carbon tetrachloride-intoxicated rats. The decrease in the hepatic clearance of
      hepatocyte growth factor could be one of the causes of the elevated hepatocyte
      growth factor level in the circulating blood in liver diseases.

PMID- 8477971
TI  - Time course of ethanol-induced impairment in fluid-phase endocytosis in isolated
      rat hepatocytes.
AB  - The time-course effects of long-term ethanol administration on fluid-phase
      endocytosis were studied in isolated rat hepatocytes. Rats were pair-fed an
      ethanol-supplemented liquid diet or an isocaloric control diet for 3 days, 1 wk,
      2 wk or 5 wk. Hepatocytes were isolated and incubated at 37 degrees C with
      various concentrations of the fluid-phase marker Lucifer yellow. Net
      internalization of the marker dye was determined. After as little as 1 wk,
      ethanol-fed rats demonstrated marked decreases in the net internalization of dye
      compared with pair-fed controls; these changes persisted throughout 5 wk of
      feeding. Because net internalization is the balance between uptake into the cells
      vs. efflux from the cells, these components were examined individually. Early
      uptake was not significantly decreased by ethanol feeding; however, efflux of
      preloaded Lucifer yellow from cells from the ethanol-fed animals was markedly
      faster than efflux from pair-fed controls. This increased efflux was more
      prominent in the longer preload time (90 min) compared with a shorter preload
      time (15 min), indicating an alteration in dye distribution among various
      intracellular pools. These ethanol-induced changes in fluid-phase endocytosis
      were apparent for 1 wk through 5 wk of feeding and were similar for all Lucifer
      yellow concentrations examined. These results indicate that the decreased net
      internalization of Lucifer yellow through fluid-phase endocytosis is mainly a
      result of an ethanol-induced increase in efflux possibly caused by altered
      intracellular trafficking rather than by reduction in uptake.

PMID- 8477972
TI  - Effect of hypoxia on the hepatic metabolism of lidocaine in the isolated perfused
      pig liver.
AB  - The metabolism of lidocaine to monoethylglycinexylidide has been found useful as
      an indicator of liver function in association with liver transplantation. It has
      been postulated that this is due to the common effect of hypoxic damage on liver
      function and lidocaine metabolism. The effects of hypoxia on the elimination of
      lidocaine and the formation of monoethylglycinexylidide and on indexes of liver
      function were investigated with the isolated perfused pig liver preparation. This
      study was performed at similar hepatic effluent lidocaine concentrations of
      approximately 5 micrograms.ml-1 in normoxic (n = 7) and hypoxic (n = 8) livers of
      similar mass harvested from male Landrace x Large White pigs and perfused at
      standard unit hepatic flow rates. Whole blood lidocaine extraction ratio was 0.63
      +/- 0.02 in normoxic livers (30% O2 at oxygenator inflow). It was significantly
      less (0.23 +/- 0.03) in livers subjected to hypoxia (2% O2 at oxygenator inflow),
      as were hepatic clearance (57.1 +/- 2.1 vs. 20.3 +/- 3.1 ml.min-1.100 gm-1),
      intrinsic clearance (1,706 +/- 182 vs. 284 +/- 53 ml.min-1.100 gm-1) and
      monoethylglycinexylidide formation as indicated by
      monoethylglycinexylidide/lidocaine ratios in the hepatic venous effluent (0.379
      +/- 0.061 vs. 0.073 +/- 0.014) (p < 0.01). Hepatic oxygen consumption, adenine
      nucleotide status and bile flow were significantly impaired by hypoxia. Whereas
      perfusate potassium concentration increased early, AST levels showed delayed
      increases and ALT levels showed no changes. These changes correlated strongly
      with hepatic lidocaine elimination (p < 0.01). We conclude that lidocaine
      metabolism may be an early indicator of severe hepatic hypoxia.

PMID- 8477973
TI  - Immunoelectron microscopy identification of early proliferating cells in rat
      liver tissue during hyperplasia induced by lead nitrate.
AB  - Recent studies have suggested that hepatic stem cells may be involved in at least
      some forms of liver epithelial growth. To obtain further information on this
      controversial hypothesis, we treated rats with lead nitrate to induce liver
      growth and identified the cells undergoing early DNA synthesis by
      bromodeoxyuridine immunohistochemistry, using both light and electron microscopic
      detection methods. Eight hours after an intravenous injection of lead nitrate 100
      mumol/kg, DNA synthesis was detected in a few scattered hepatocytes and in
      nonparenchymal cells in portal connective tissue. At the light microscopic level,
      identification of nonparenchymal cells was limited to bile duct epithelial cells.
      Other cell types were also labeled, but their identity could not be established.
      At the ultrastructural level, however, four types of nonparenchymal cells were
      identified as containing bromodeoxyuridine immunogold particles. These four types
      included bile duct epithelial cells, fibroblasts, macrophages and nondescript
      periductular cells. These periductular cells displayed certain ultrastructural
      features of bile duct cells but did not line a lumen or display microvilli on
      their apical membrane, nor did they reside within the bile duct basement
      membrane. Because proliferation of nonparenchymal cells in portal areas preceded
      that of hepatocytes, it is suggested that the former reaction reflects a direct
      mitogenic effect of lead nitrate and not an adaptive growth response secondary to
      parenchymal enlargement. However, whether DNA synthesis in periductular cells or
      bile duct cells reflects activation of hepatic stem cells cannot be established
      from the present morphological observations. If so, such a progenitor compartment
      must be dormant because it does not seem to play a functional role in this and
      other forms of adult liver epithelial growth.

PMID- 8477974
TI  - Cholesterol cholelithiasis in the prairie dog: role of mucin and nonmucin
      glycoproteins.
AB  - The aims of this study were to examine the effect of exogenous prostaglandin on
      mucin secretion and to determine the role of nonmucin glycoproteins on gallstone
      formation in the prairie dog model of cholesterol cholelithiasis. The
      concentration of total glycoprotein and nonmucin glycoproteins was measured in
      gallbladder bile from four groups of prairie dogs fed a control diet or a diet
      supplemented with 1.2% cholesterol with or without simultaneous subcutaneous
      administration of prostaglandin E1. Cholesterol feeding resulted in an increased
      concentration of concanavalin-A binding-proteins in gallbladder bile associated
      with an increase in pronucleating activity in vitro. Treatment with prostaglandin
      E1 and cholesterol feeding was associated with a significant increase in the
      incidence of cholesterol gallstone formation. Prostaglandin E1 treatment in the
      cholesterol-fed animals increased biliary concentrations of total glycoprotein
      and concanavalin-A-binding glycoproteins. Therefore the increased biliary
      glycoprotein level in cholesterol-fed, prostaglandin E1-treated prairie dogs,
      which reflects higher levels of mucin and nonmucin glycoproteins, appears to be
      an important factor in gallstone formation.

PMID- 8477975
TI  - Effects of thyroxine on the expression of alcohol dehydrogenase in rat liver and
      kidney.
AB  - We studied the effect of thyroxine on alcohol dehydrogenase activity,
      immunoreactive protein levels and messenger RNA levels in the livers of
      thyroidectomized and sham-operated male rats. Effects on kidney alcohol
      dehydrogenase activity were also examined. Sham-operated rats injected with 100
      micrograms thyroxine/kg/day, which induced hyperthyroidism, showed a 30% decrease
      in liver and a 40% decrease in kidney alcohol dehydrogenase activity compared
      with sham-operated rats injected with vehicle. Hypothyroid rats exhibited a 1.5
      fold increase in alcohol dehydrogenase activity in liver and kidney compared with
      thyroidectomized rats injected with a replacement dose of 20 micrograms
      thyroxine/kg/day. We saw a twofold and a 2.5-fold higher level of alcohol
      dehydrogenase activity in liver and kidney, respectively, of hypothyroid rats
      compared with hyperthyroid rats. These effects were not accounted for by
      nutritional differences; daily food intake did not differ between groups.
      Immunoreactive protein levels as seen on Western blots varied in the same
      direction as enzyme activity. Northern-blot analysis showed higher levels of
      liver alcohol dehydrogenase messenger RNA in hypothyroid rats compared with
      euthyroid rats. These studies show that liver alcohol dehydrogenase activity and
      protein levels are modulated by thyroxine at pathophysiologically relevant levels
      and that this effect is not due to changes in food intake; kidney alcohol
      dehydrogenase activity is regulated in parallel. The change in alcohol
      dehydrogenase activity appears to be controlled in part by pretranslational
      mechanisms in hypothyroid animals and by posttranslational mechanisms in
      hyperthyroid animals.

PMID- 8477976
TI  - Administration of prostaglandin E1 analog reduces rat hepatic and Ito cell
      collagen gene expression and collagen accumulation after bile duct ligation
      injury.
AB  - Recent studies suggest that prostaglandin E may have the ability to suppress
      cytokine responsiveness. We examined the effects of prostaglandin E
      administration on several parameters of acute and chronic liver injury induced by
      bile duct ligation. Enisoprost, a prostaglandin E1 analog, was found to suppress
      early hepatic and Ito cell type I collagen gene expression without diminishing
      the induction of the fibrogenic cytokine transforming growth factor-beta. Overall
      liver inflammation and cell proliferation were not altered, suggesting that
      prostaglandin E acts distal to the initial injurious event(s). During later
      phases, drug administration reduced total collagen accumulation and type I
      collagen periductular infiltration associated with early nodule formation.

PMID- 8477977
TI  - New concepts in bilirubin chemistry, transport and metabolism: report of the
      Second International Bilirubin Workshop, April 9-11, 1992, Trieste, Italy.

PMID- 8477978
TI  - Primary cholesterol hepatolithiasis: a disease with a different pathogenesis.

PMID- 8477979
TI  - To ligate or sclerose: beginning of a new era in the management of esophageal
      varices?

PMID- 8477980
TI  - Omeprazole induction of cytochrome P-450IA2: the importance of selecting the
      appropriate human model.

PMID- 8477981
TI  - Bidirectional transport of glutathione in hepatocyte membranes: does glutathione
      efflux stimulate organic anion uptake?

PMID- 8477982
TI  - Use of natural interferon-beta in the treatment of acute hepatitis C.

PMID- 8477983
TI  - The clinical connection. Hospitals work to design information systems that
      physicians will use.

PMID- 8477984
TI  - Physicians using computers show lower resource utilization.

PMID- 8477985
TI  - Pioneering protocols. Hospitals test the computer's use in patient care
      decisions.

PMID- 8477986
TI  - Physician leader rallies support for information network.

PMID- 8477987
TI  - A doctor in the network. Physician links improve access to critical data.

PMID- 8477988
TI  - Military MDs pilot regional clinical system.

PMID- 8477989
TI  - Training physicians. Government to influence specialty mix, distribution.

PMID- 8477990
TI  - Out in front. Managed care helps push clinical guidelines forward.
AB  - Until recently, most managed care provider incentives were productivity-oriented,
      but an increasing number of plans are shifting the focus to quality. For
      hospitals, the question is whose clinical practice guidelines to follow.

PMID- 8477991
TI  - Leadership incentives. Support, education and pay attract medical staff leaders.

PMID- 8477992
TI  - Physicians and the ADA. Hospitals should examine policies and procedures.
AB  - Though they aren't usually considered hospital employees, physicians with staff
      privileges may be covered by the Americans with Disabilities Act. As a result,
      hospitals should examine carefully their procedures regarding physicians in the
      context of the ADA's requirements.

PMID- 8477993
TI  - Outpatient acceleration. 1992 survey traces continued ambulatory care growth.

PMID- 8477995
TI  - Data watch. HMOs continue to experience sporadic growth.

PMID- 8477994
TI  - Physician CEOs: ranks continue to grow.

PMID- 8477996
TI  - Robodoc: study tests robot's use in hip surgery.

PMID- 8477997
TI  - Dutch experts discuss access, bioethical issues.

PMID- 8477998
TI  - Wireless radio system reduces intercom noise.

PMID- 8477999
TI  - Physicians: the rate of change accelerates.

PMID- 8478000
TI  - Tension wanes between hospitals and MDs.

PMID- 8478001
TI  - Strategizing health care for an aging America.

PMID- 8478002
TI  - Development of a sequence-tagged site for the centromere of chromosome 10: its
      use in cytogenetic and physical mapping.
AB  - We sequenced the alphoid centromere probe p alpha 10RP8 (D10Z1), aligned it to
      three published consensus sequences, and developed a sequence-tagged site (STS),
      sJRH-2, based upon oligonucleotide primers having two 3' mismatches with these
      consensus sequences. Polymerase chain reaction (PCR) amplification using genomic
      DNA from a somatic cell hybrid panel representing all human chromosomes
      demonstrated amplification from only those cell lines containing chromosome 10.
      Fluorescence in situ hybridization of the amplified product demonstrated intense
      and specific hybridization of the PCR product to 10p11.1-q11.1. A human genomic
      yeast artificial chromosome (YAC) library was screened using the sJRH-2 PCR
      assay, and five clones were identified. Sequence analysis of one chimeric clone
      (consisting of DNA segments derived from chromosomes 5p and 10cen) confirmed
      specificity of the STS for the centromere of chromosome 10. sJRH-2 provides a
      convenient cytogenetic marker for chromosome 10, which will also be useful for
      physical mapping of the pericentromeric region of chromosome 10, a region that
      harbors the gene(s) for three forms of multiple endocrine neoplasia (types 2A,
      2B, and familial medullary thyroid carcinoma). The GenBank accession number for
      the p alpha 10RP8 sequence is X63622.

PMID- 8478003
TI  - Detection of a cryptic paracentric inversion within band 11p13 in familial
      aniridia by fluorescence in situ hybridization.
AB  - We report the first familial case of dominantly inherited aniridia with a cryptic
      inversion within band 11p13. High-resolution chromosome analysis gave a suspicion
      of a tiny constitutional aberration around band 11p13 and fluorescence in situ
      hybridization using 11p cosmids successfully confirmed that the aniridia patients
      of this family have an inversion within band 11p13. The distal breakpoint of the
      inversion is telomeric to a candidate aniridia gene (AN2) and suggests that more
      genes might be involved in the etiology of aniridia. In situ hybridization is a
      powerful tool to detect cryptic rearrangements in sporadic or familial patients
      with aniridia. This family indicated the importance of careful observation of the
      11p13 region of aniridia patients, even if the aniridia was autosomal dominantly
      inherited.

PMID- 8478004
TI  - Chromosomal localization of four human zinc finger cDNAs.
AB  - cDNA clones encoding zinc finger motifs were isolated by screening human placenta
      and T-cell (Peer) cDNA libraries with zinc finger (ZNF) consensus sequences.
      Unique cDNA clones were mapped in the human genome by rodent-human somatic cell
      hybrid analysis and in some cases in situ chromosomal hybridization. ZNF80 mapped
      to 3p12-3qter, ZNF7 was previously mapped to 8q24 and is here shown by in situ
      hybridization and use of appropriate hybrids to map telomeric to the MYC locus.
      ZNF79 mapped to 9q34 centromeric to the ABL gene and between a constitutional
      chromosomal translocation on the centromeric side and the CML specific ABL
      translocation on the telomeric side. ZNF77 mapped to 19p while ZNF78L1 (pT3)
      mapped to 19q. Chromosome 19 carries many ZNF loci and other genes with zinc
      finger encoding motifs; the pT3 clone additionally detected a locus designated
      ZNF78L2, which mapped to chromosome region 1p, most likely in the region 1p32
      where the MYCL and JUN loci map.

PMID- 8478005
TI  - Human reciprocal translocations: is the unbalanced mode at birth predictable?
AB  - Two methods of prediction for the risk of unbalance at birth were tested on a
      large data base of reciprocal translocation (1376 families): the pachytene
      diagram predictive method (PDP method) and the discriminant method (D method).
      These method succeeded in correctly predicting the segregation mode in 66% of the
      data for the PDP method and in 80% of the data for the D method. The quality of
      chromosome material (in particular R bands) must be taken into account for more
      accurate prediction. Some difficulties still exist in predicting the 3:1 tertiary
      segregation mode, which can frequently be incorrectly classified as the adjacent
      1 mode.

PMID- 8478006
TI  - Steroid 21-hydroxylase (P450c21): a new allele and spread of mutations through
      the pseudogene.
AB  - Lesions in the gene encoding the adrenal enzyme steroid 21-hydroxylase (P450c21)
      result in defective adrenal cortisol synthesis, often accompanied by aldosterone
      deficiency. The symptoms range from severe neonatal disease to inconspicuous
      symptoms in adulthood depending on the nature of the mutations. The 21
      hydroxylase gene is present in close proximity to a highly homologous pseudogene,
      and both genes show variation in copy number between individuals. For complete
      DNA sequence characterization, we have applied selective polymerase chain
      reaction amplification and direct sequencing of all full-length steroid 21
      hydroxylase genes present in individuals. Using healthy individuals with only one
      remaining steroid 21-hydroxylase allele as normal references, a new allele was
      found in two siblings, in whom clinical and laboratory findings demonstrated
      moderate enzyme deficiency. Full-length sequencing of this allele displayed an
      Arg 484 to Pro codon change in exon 10, in the same position as a previously
      identified GG to C mutation found in a patient with severe 21-hydroxylase
      deficiency. Arg 484 is located within a stretch of amino acids that are highly
      conserved between mammalian 21-hydroxylases. The finding of the presently
      reported 21-hydroxylase allele indicates that the GG to C mutation from the
      severely affected patient has arisen by a two-step mechanism, consisting of a G
      to C transversion accompanied by an adjacent G deletion. When sequencing 26
      pseudogenes, both these mutations, which are not present in the pseudogenes
      hitherto reported, were found at low frequency together with a number of other
      polymorphisms. Thus, also rare mutations can spread via the pseudogene and can
      therefore be expected to arise independently in unrelated individuals.

PMID- 8478007
TI  - Nucleotide substitutions at the -6 position in the promoter region of the factor
      IX gene result in different severity of hemophilia B Leyden: consequences for
      genetic counseling.
AB  - Mutations in the promoter region of the factor IX gene result in hemophilia B
      Leyden, which is characterized by considerable improvement in the disease after
      puberty. We have found that distinct nucleotide substitutions at the -6 position
      in the Leyden-specific (LS) region are associated with a different severity of
      hemophilia B. The proband (aged 2) from one family is a severe hemophiliac with
      factor IX activity (F.IXC) and antigen (F.IXAg) levels less than 1.0 U/dl. F.IXC
      and F.IXAg levels in two affected uncles are approximately 30% of normal levels.
      The LS region was targeted for analysis because the phenotypes suggested the
      inheritance of a factor IX Leyden gene. An abnormal TaqI digestion pattern was
      found in amplified DNA from the proband, and sequencing showed a G(-6) to C
      transversion that was linked to the disease in the family. In another family, two
      brothers (aged 8 and 9) suffer from mild hemophilia with F.IXC ranging from 7 to
      10 U/dl and F.IXAg from 3 to 4 U/dl. They are the only documented members of the
      family with a bleeding tendency. Denaturing gradient gel electrophoresis on
      amplified fragments from one of the patient's genomic DNA corresponding to the 8
      exons and flanking sequences of the factor IX gene suggested a defect only in a
      segment from the 5' region. This segment showed an altered TaqI digestion
      pattern, and sequencing demonstrated a G(-6) to A transition that was traced to
      the patient's mother and a grandmother. The different phenotypes associated with
      the G(-6) to A purine nucleotide transition compared with a G(-6) to C
      transversion provide evidence that this area is directly involved in the
      regulation of the human factor IX gene expression in vivo by binding of
      regulatory factors. The ability to predict that the conditions of a hemophilia B
      patient will improve with age has important implications for genetic counseling
      of the family. Therefore, the LS region should always be included when scanning
      the factor IX gene for mutations.

PMID- 8478008
TI  - Partial physical map of human chromosome 21 from fibroblast and lymphocyte DNA.
AB  - A partial physical map of the human chromosome 21 including 26 genes and
      anonymous sequences was established by pulsed-field gel electrophoresis analysis
      of restriction fragments obtained from lymphocyte and fibroblast DNAs. The sizes
      of the restriction fragments obtained by total digestion with eight different
      enzymes were compared in these two tissues. Differences resulting from the
      variations in the methylation state of the restriction sites were frequently
      observed. These differences and partial digestions were used to estimate the
      order and the distances between genes and sequences. Six linkage groups were
      defined: D21S13-D21S16, D21S1-D21S11, D21S65-D21S17, (D21S55,ERG)-ETS2, BCEI
      D21S19-D21S42-D21S113-CBS-CRYA1, and COL6A2-S100B. For six intergenic distances
      the resolution of previous maps was significantly increased.

PMID- 8478009
TI  - The effect of the apolipoprotein E phenotype on plasma lipids is not influenced
      by environmental variability: results of a Dutch twin study.
AB  - We tested the influence of the apolipoprotein E (apoE) polymorphism on the
      intrapair differences in the levels of plasma cholesterol, plasma triglycerides,
      low density lipoprotein-cholesterol, apoB and apoE in monozygotic (MZ) twins, and
      estimated whether or not there was a interaction between the apoE polymorphism
      and environmental factors. In 65 MZ twin pairs, the intrapair differences in the
      measured lipoprotein parameters were similar in the different apoE phenotype
      classes. This indicates that the effect of the apoE polymorphism is not
      influenced by environmental variability between the MZ pair members and
      accordingly identifies the APOE gene as a "level" gene.

PMID- 8478010
TI  - A recombinant Friedreich's ataxia family.

PMID- 8478011
TI  - Chromosomal mapping of the human gene for the tricyclic antidepressant-sensitive
      noradrenaline transporter.
AB  - The neuronal Na(+)- and Cl(-)-dependent transporter for the neurotransmitter
      noradrenaline (NA) is the primary target for the tricyclic antidepressant
      desipramine. The NA-transporter belongs to a new gene family of structurally
      related Na(+)- and Cl(-)-dependent neurotransmitter transporters. In this study,
      the chromosomal localization for the gene encoding the human NA-transporter (h
      NAT) was determined. By hybridization of a panel of somatic cell hybrids and by
      fluorescent in situ hybridization to metaphase chromosomes, the hNAT gene was
      localized on chromosome 16q12.2. In addition, evidence is presented for an intron
      exon structure of the gene.

PMID- 8478012
TI  - Parathyroid hormone gene analysis in autosomal hypoparathyroidism using an
      intragenic tetranucleotide (AAAT)n polymorphism.
AB  - We have identified a polymorphic tetranucleotide consisting of (AAAT)n within the
      first intron of the parathyroid hormone (PTH) gene, and have used this to
      investigate the segregation of the PTH gene and idiopathic hypoparathyroidism in
      7 affected and 21 unaffected members from three families. An association between
      the PTH locus and autosomal dominant idiopathic hypoparathyroidism in one family
      was excluded by observing recombination between the two loci. In the remaining
      two families with autosomal recessive idiopathic hypoparathyroidism, the PTH
      locus was not similarly excluded. We had previously demonstrated a donor splice
      site mutation of the PTH gene in one of these families, and PTH gene
      abnormalities were therefore sought in the second of these families. DNA sequence
      analysis of the three exons, together with 4 exon-intron boundaries and the
      promoter region of the PTH gene revealed no abnormalities, thereby indicating
      molecular pathology at another locus. Thus, our analysis of idiopathic
      hypoparathyroidism reveals genetic heterogeneity for this disorder. In addition,
      our identification of a microsatellite polymorphism of the PTH gene should help
      further segregation studies of this locus in families with parathyroid disorders.

PMID- 8478013
TI  - Identification of the 408 valine to methionine mutation in the low density
      lipoprotein receptor in a German family with familial hypercholesterolemia.
AB  - Familial hypercholesterolemia (FH) is caused by different mutations in the gene
      encoding the low density lipoprotein receptor (LDLR). In Caucasian patients, at
      least three single point mutations have been identified causing FH. The
      asparagine206 to glutamine, and valine408 to methionine mutations were originally
      described in Afrikaners and recently identified in Dutch FH patients. The
      proline664 to leucine mutations was previously identified in an FH homozygote of
      Asian Indian origin and later identified in patients from London. Any of these
      mutations can be identified using direct amplification of genomic DNA by the
      polymerase chain reaction (PCR) and restriction enzyme digestion of PCR products.
      In this study, 100 unrelated German FH patients were screened for these three
      mutations. The valine408 to methionine mutation was identified in one individual
      and subsequently in the hypercholesterolemic child of the proband. Haplotype
      analysis with 7 restriction fragment length polymorphisms (RFLPs) revealed that
      the mutant allele carried the same haplotype as the previously described patients
      in South Africa and the Netherlands. Our finding supports the previous assumption
      of the European origin of the mutation.

PMID- 8478014
TI  - Polymorphism of glucose dehydrogenase (GDH, EC 1.1.1.47): formal and population
      genetic data.
AB  - The polymorphism of glucose dehydrogenase (GDH) is demonstrated by isoelectric
      focusing of leucocyte extracts followed by enzyme staining. Segregation in 52
      families with 145 children is consistent with the formal hypothesis of three
      common alleles, GDH*1, GDH*2 and GDH*3, at an autosomal locus GDH. Allele
      frequencies from 104 unrelated individuals from southwestern Germany were
      calculated as GDH*1 = 0.70, GDH*2 = 0.18 and GDH*3 = 0.12.

PMID- 8478015
TI  - G6PD Mediterranean accounts for the high prevalence of G6PD deficiency in Kurdish
      Jews.
AB  - The Jews of Kurdistan are a small inbred population with a high incidence of beta
      thalassaemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Recently,
      it was reported that the beta-thalassaemia in this population shows an unusual
      mutational diversity; 13 different mutations were identified, of which 4 had not
      previously been observed in any other population. In contrast, we now report that
      the G6PD deficiency, which has the highest known incidence in the world, and
      which affects about 70% of males, is almost entirely attributable to a single
      widespread mutation, G6PD Mediterranean.

PMID- 8478016
TI  - Epidemiological data on Werdnig-Hoffmann disease in Germany (West-Thuringen).
AB  - This study contains the largest body of epidemiological data on Werdnig-Hoffmann
      disease (acute infantile spinal muscular atrophy; ASMA) in West-Thuringen in
      Germany. The incidence of ASMA was calculated to be 1 in 10,202 live births. The
      prevalence was 1 in 595,362 of the general population (as of 31 December 1987).
      The study gives an unexpectedly high incidence rate confirming the suggestion
      that ASMA in Central and Eastern Europe might be more frequent than in Western
      Europe. However, we consider that this high incidence rate in West-Thuringen is a
      result of the almost complete ascertainment made possible because of the well
      organised and centralised health system existing in Thuringen over the last few
      decades.

PMID- 8478017
TI  - Absence of familial defective apolipoprotein B-100 in Israeli patients with
      dominantly inherited hypercholesterolemia and in offspring with parental history
      of myocardial infarction.

PMID- 8478018
TI  - The relationship between meiotic chromosome pairing and chiasma formation.

PMID- 8478019
TI  - Structure and homology of human C1q receptor (collectin receptor).
AB  - In this paper we report partial amino acid sequence for C1q receptor (C1qR). The
      N-terminal amino acid sequence of isolated C1qR and the sequences of peptides
      obtained by V8/trypsin digestion show a high degree of similarity to the cDNA
      derived amino acid sequence of a human protein which was initially reported as a
      component of RoSSA and subsequently as calreticulin. This sequence in turn shows
      homology with Onchocerca volvulus antigen (RAL-1) and B50 murine melanoma
      antigen. A component of approximately 53,000 MW, isolated from human spleen, was
      found to have identical mobility on SDS-PAGE to C1qR and identical N-terminal
      sequence, but a different overall charge. Human antibodies from Sjogren's
      syndrome patients did not recognize C1qR, but showed positive reaction with the
      purified 53,000 MW component from spleen. Rabbit antibodies against denatured
      C1qR, in contrast, recognized both C1qR and the purified 53,000 MW component. The
      53,000 MW spleen component thus has an identical N-terminal sequence to
      calreticulin, and to the reported RoSSA component, and is recognized by
      antibodies in Sjogren's syndrome sera. The data obtained indicate that C1qR and
      the reported calreticulin/RoSSA component are similar but not identical
      molecules, which belong to the same protein superfamily.

PMID- 8478020
TI  - Biochemical characterization of murine Fc gamma RI.
AB  - The biochemical analysis of murine Fc gamma RI has been difficult because this
      receptor is co-expressed with other Fc receptors on the cell surface of myeloid
      cells and all precipitate together with immune complexes. To overcome this
      problem and to study cells which expressed Fc gamma RI and only this Fc receptor,
      stable transfection of Chinese hamster ovary (CHO) cells (Fc gamma RI-) with Fc
      gamma RI cDNA was performed thereby permitting biochemical characterization of Fc
      gamma RI in isolation from other Fc receptors. Studies of Fc gamma RI+CHO cells
      showed the mature Fc gamma RI to be a 70,000 MW single-chain receptor on the cell
      surface. The 70,000 MW molecule was also identified on the Fc gamma RI+ cell
      lines, J774 (a macrophage-like cell line), and 18.81 (a pre-B-cell line). Fc
      gamma RI was shown to be N-linked glycosylated and after deglycosylation to have
      a protein core of 49,000 MW. Fc gamma RI was found to be phosphorylated and after
      PMA stimulation, the level of phosphorylation was increased; serine residues in
      the cytoplasmic tail were identified as the phosphate acceptors. Thus, Fc gamma
      RI can now be definitely characterized as a 70,000 MW phosphoprotein.

PMID- 8478021
TI  - Nucleotide sequence analysis of CDR3 elements of a panel of anti-peptide
      monoclonal antibodies recognizing parathyroid hormone-related protein.
AB  - Nucleotide sequences of heavy (VH) and light (VL) chain variable region
      complementarity determining regions have been determined from in vitro amplified
      mRNA isolated from a panel of monoclonal antibodies (mAb) raised to a synthetic
      34mer peptide representing the N-terminal portion of human parathyroid hormone
      related protein (PTHrP or parathyrin) reported to contain an immunodominant
      epitope. These mAb vary in affinity for the synthetic peptide and native PTHrP
      (Ka between 5.9 x 10(8) and 1.9 x 10(11)l/M). All 10 mAb studied were found were
      found to utilized restricted VH2, V kappa 2, JH4 and J kappa 1 family genes.
      Significant differences in the length and sequence of D elements were found;
      however 9/10 mAb utilize members of the DSP2 family. Significantly, two broad
      ranges of affinity could be determined based on the presence of Asp or Ala at
      residue 101 in JH.

PMID- 8478022
TI  - In vivo lymphokine production in experimental autoimmune uveoretinitis.
AB  - Experimental autoimmune uveoretinitis (EAU) is a well-characterized model of
      immune-mediated intraocular inflammation. The intraocular infiltrate in EAU
      consists predominantly of T lymphocytes. The in vivo production of interleukin-2
      (IL-2), lymphotoxin and IL-4 by these T cells was investigated by in situ
      hybridization using cDNA probes to lymphokine mRNA. Localization of lymphokine
      mRNA was found simultaneous with disease onset in areas of T-cell infiltration.
      Positive signal was seen over cells in the uveal tract, retina and extraocular
      region. Less than 10% of the population of T cells defined immunohistochemically
      had positive localization of mRNA for these lymphokines. The number of positive
      cells was similar for each of the three probes and increased as the disease
      progressed. The findings suggest that these lymphokines are produced in vivo in
      immune-mediated intraocular inflammation and may play a role in the
      immunopathology seen in these conditions.

PMID- 8478023
TI  - Theiler's murine encephalomyelitis virus induces tumour necrosis factor-alpha in
      murine astrocyte cell cultures.
AB  - Cytokines have been postulated to exert an important modulatory and recruiting
      role in demyelination induced by Theiler's murine encephalomyelitis virus (TMEV)
      in SJL/J mice. Using a cytolytic bioassay and ELISA, we have detected and
      quantified a cytokine, tumour necrosis factor-alpha (TNF-alpha), in supernatants
      from astrocyte cultures infected in vitro with TMEV. TNF was detected only after
      TMEV-specific infection of astrocyte cultures (approximately 200-400 U/ml). In
      vitro TNF synthesis appeared in a dose- and time-dependent manner and was
      produced by both SJL/J (a strain susceptible to TMEV-induced demyelination) and
      BALB/c (a resistant strain) astrocytes. The precise nature of TNF activity was
      further assessed by fast protein liquid chromatography (FPLC) and antibody
      neutralization. These results indicate an active role for astrocytes as accessory
      immune cells in our experimental model for multiple sclerosis.

PMID- 8478024
TI  - Mucosal and systemic cellular immune responses induced by Toxoplasma gondii
      antigens in cyst orally infected mice.
AB  - This study was performed to determine the T-cellular immune responses following
      Toxoplasma gondii oral infection and to assess further toxoplasma antigens on
      their ability to stimulate in vitro mucosal and systemic T-cell immunity.
      Parasite-specific cellular immune responses in Peyer's patches (PP), in
      mesenteric lymph nodes (MLN) and in spleen (SPL) were investigated using a
      lymphoblastic transformation test following oral infection of mice with strain
      76K cysts of T. gondii. An early toxoplasma sonicate-induced mucosal T-cell
      proliferation occurred in MLN and PP with a peak responsiveness on day 6 post
      infection (PI) and rapidly reached background levels on day 7 PI in PP and on day
      8 PI in mesenteric lymph nodes. A later splenic cellular blastogenesis was
      observed from day 28 PI and persisted throughout the experiment (day 91). At the
      time of T-cell proliferation, FACS analyses revealed a decrease in the relative
      percentages of CD4+ and CD8+ T cells with a predominance of CD8+ lymphocytes
      which leads to an inversion of the CD4/CD8 ratios. We found that CBA/J is a high
      responder mouse strain in the induction of mesenteric and splenic T-lymphocyte
      blastogenesis compared to the intermediate responder BALB/c and low responder
      C57BL/6. Toxoplasma gondii antigens SAG1 (30,000 MW) and GRA4 (40,000-41,000 MW),
      which are known to induce locally IgA antibodies, are shown to stimulate primed
      mucosal T lymphocytes from CBA/J and BALB/c mice whereas no proliferation was
      demonstrated with C57BL/6 T cells. 229-242 peptide, derived from the deduced
      amino acid sequence of GRA4, only induces detectable proliferation of primed
      CBA/J T lymphocytes. Following oral experimental infection, the in vitro
      mesenteric response to a toxoplasma sonicate is dominated by a Th2-type cytokine
      pattern whereas a predominant Th1 cytokine response is observed in the spleen.
      Finally, in vitro stimulation of mesenteric T cells with the three defined
      toxoplasma antigens resulted in secretion of interleukin-5 (IL-5) and IL-6
      (except for SAG1) and interferon-gamma (IFN-gamma) whereas no detectable IL-2 or
      IL-4 was observed.

PMID- 8478025
TI  - Expression of major histocompatibility complex class II antigens and levels of
      interferon-gamma, tumour necrosis factor, and interleukin-6 in cerebrospinal
      fluid and serum in Toxoplasma gondii-infected SCID and immunocompetent C.B-17
      mice.
AB  - In order to investigate activation of the innate immune system in murine
      toxoplasmosis, T- and B-cell-deficient SCID mice and their co-isogenic
      immunocompetent C.B-17 counterparts were orally infected with a low-virulent
      strain of Toxoplasma gondii (DX strain). SCID mice developed a fatal necrotizing
      toxoplasmosis, whereas CD4+ and CD8+ T cells contributing to inflammatory
      infiltrates conferred resistance to immunocompetent mice. Significant amounts of
      interferon-gamma (IFN-gamma) were detectable in SCID mice. The most likely source
      for this cytokine is activated natural killer (NK) cells. In comparison to
      immunocompetent mice IFN-gamma levels were reduced in cerebrospinal fluid (CSF)
      and serum of SCID mice at days 7 and 14 of disease. Similar amounts of tumour
      necrosis factor (TNF) were detected in both strains of mice. In addition,
      immunohistochemistry showed major histocompatibility complex (MHC) class II
      antigen expression on SCID and C.B-17 microglial cells and macrophages
      demonstrating activation of these cells in both strains. However, the up
      regulation of MHC class II antigen on microglia was less pronounced in SCID mice,
      presumably due to reduced levels of IFN-gamma. Interleukin-6 (IL-6) levels in CSF
      and serum were elevated in both strains and correlated with systemic and
      intracerebral disease activity. In conclusion, our results demonstrate activation
      of macrophages and NK cells as the predominant defence mechanisms of the
      comprised SCID immune system during toxoplasma infection. This implies a major
      role for the innate immune system during early stages of toxoplasmosis although T
      cells are necessary to control the infection efficiently.

PMID- 8478026
TI  - Requirements for the induction of the interleukin-2 receptor complex in a human
      pre-T-cell line.
AB  - Cell line PER-117 is a T-cell receptor negative human T-cell line that can be
      induced to express a functional interleukin-2 receptor (IL-2R). Recombinant
      interleukin-1 (IL-1) as well as certain combinations of inducer substances could
      be shown to stimulate the expression of the p55 (alpha)-chain of the IL-2R in PER
      117 cells. The synergistic increases in IL-2R alpha expression were demonstrated
      at the cell surface as well as at the mRNA level. The results suggested that in
      PER-117 cells IL-1 appears to induce expression of the alpha-chain by pathways
      that are different to activation via protein kinase C (PKC), and that drug
      induced cyclic AMP (cAMP) activation did not substitute for IL-1. We found that
      the regulation of mRNA for IL-2R beta (p75) differed significantly from that seen
      for IL-2R alpha. Moreover, the requirements for IL-2R alpha induction determined
      for this cell line differ from other human cell lines, which may reflect that
      there are distinct requirements for activation depending on the stage of
      differentiation and/or lineage of the cells. The PER-117 cell line provides a
      unique model to examine further the mechanism leading to induction of a
      functional IL-2R at an early stage of human T-cell differentiation.

PMID- 8478027
TI  - High-dose interferon-gamma alters the distribution of B lymphocytes and
      macrophages in rat spleen and lymph nodes.
AB  - Continuous intravenous infusion of rat interferon-gamma (IFN-gamma) for 3 days
      provokes profound alterations of splenic architecture in LEW rats. The marginal
      zone of the white pulp is almost totally depleted of B lymphocytes and the
      follicles are reduced to small remnants. IgM kappa + plasmablasts and plasma
      cells increase substantially in the outer periarteriolar lymphatic sheath (PALS)
      and in the splenic red pulp. In addition, marginal metallophilic and marginal
      zone macrophages are augmented, partially by proliferation. It is discussed
      whether the activation and proliferation of these macrophages prevent
      replenishment of the marginal zone and follicles with recirculating B cells.
      Changes in B lymphocyte and medullary macrophage distribution are also present in
      submandibular and mesenteric lymph nodes.

PMID- 8478028
TI  - Low responsiveness of hepatitis B virus-transgenic mice in antibody response to T
      cell-dependent antigen: defect in antigen-presenting activity of dendritic cells.
AB  - The experiments presented here were performed to evaluate immune responsiveness
      of hepatitis B virus (HBV)-transgenic mice (transgenic mice), as a model of HBV
      carrier state to a T-cell-dependent antigen, keyhole limpet haemocyanin (KLH).
      The transgenic mice which were completely unresponsive to hepatitis B surface
      antigen (HBsAg), responded poorly to KLH. The levels of anti-KLH antibodies (Ab)
      produced in vivo were significantly lower in transgenic mice compared with the
      normal control mice at respective immunizing doses of KLH. In addition, a little
      or no anti-KLH Ab production was detected in culture supernatants of KLH-primed
      transgenic mice spleen cells. KLH-primed T cells from normal and transgenic mice
      induced anti-KLH Ab production from transgenic B cells in the presence of antigen
      presenting spleen adherent cells (SAC) from normal mice, but not those from
      transgenic mice. Depletion of dendritic cells from normal mice-derived SAC
      completely abrogated the anti-KLH Ab response in transgenic spleen cell culture
      and their addition to the culture restored the response. Low efficiency of
      transgenic dendritic cells was demonstrated in sodium periodate (NaIO4)-induced
      non-specific and allogenic antigen-induced T-cell proliferation. Finally,
      cytofluorometric analyses showed a reduced Ia antigen expression on transgenic
      dendritic cells. These results indicate that low responsiveness of transgenic
      mice in specific-antibody response is not due to functional defects in T cells or
      B cells but rather to a defect of antigen-presenting activity of dendritic cells.

PMID- 8478029
TI  - Tumour necrosis factor-alpha augments the expression of Fc IgE receptor (Fc
      epsilon RII/CD23) on human monocytic cell lines and down-regulates interleukin-4
      driven Fc epsilon RII expression on monocytes.
AB  - We investigated the expression of the low affinity Fc IgE receptor (Fc epsilon
      RII/CD23) on the human monocytic cell lines U937, THP-1, Mono-Mac-6, and cultured
      human peripheral blood monocytes under stimulation with human tumour necrosis
      factor-alpha (TNF-alpha) and other cytokines. Fc epsilon RII was demonstrated by
      flow cytometry analysis employing the anti-Fc epsilon RII monoclonal antibody 3
      5. TNF-alpha alone had a weak but significant stimulating effect on the Fc
      epsilon RII expression on the cell lines U937 and THP-1, and very modestly on
      Mono-Mac-6 cells. TNF-alpha strongly synergized with interferon-gamma (IFN-gamma)
      and interleukin-4 (IL-4). IFN-alpha per se was ineffectual, but was able to
      increase the TNF-alpha effect. Furthermore, the action of TNF-alpha was slightly
      augmented by human IL-6. Similar effects were noted with TNF-beta alone or in
      combination with other cytokines. Interestingly, on human monocytes TNF-alpha
      weakly reduced the basal level of Fc epsilon RII, and markedly diminished the IL
      4-induced Fc epsilon RII expression. Our results indicate that several cytokines
      may interact in a cytokine network to modulate Fc epsilon RII expression on
      monocytic cell lines. On human blood monocytes, TNF-alpha, like IFN-gamma or IL
      6, counteracts the IL-4-induced Fc epsilon RII expression. These data suggest
      different regulatory pathways of Fc epsilon RII expression on blood monocytes and
      myelomonocytic cell lines.

PMID- 8478030
TI  - Two distinct types of cellular mechanisms in the development of delayed
      hypersensitivity in mice: requirement of either mast cells or macrophages for
      elicitation of the response.
AB  - Using mast cell-deficient mutant W/Wv mice and their normal counterpart we re
      evaluated the significance of participation of mast cells in allergic
      inflammatory response. W/Wv mice developed immediate hypersensitivity (IH)
      footpad reaction (FPR) to a somewhat lesser degree than the normal mice,
      suggesting that the mast cell might amplify the response. To exert classical
      tuberculin (tbc) delayed-type hypersensitivity (DTH) mast cells were not an
      essential cellular component. Vasoactive amines were essential to develop the
      response, but it did not necessarily originate from mast cells. When mice were
      immunized with methylated human serum albumin (MHSA) emulsified in incomplete
      Freund's adjuvant (IFA), mast cells were required to elicit DTH FPR. This was
      confirmed by the lack of the response in W/Wv mice, and the restoration of FPR by
      local transplantation of mature mast cells into mutant mice. This mast cell
      dependent (MD) DTH was different from tbc DTH as follows: mast cell dependency,
      macrophage dependency as revealed by ferritin sensitivity, kinetics of
      sensitization, effect of host's age and histopathology. Thus we concluded that
      there are two types of DTH in mice; one is macrophage-dependent tbc and the other
      is mast cell-dependent DTH. The correspondence of the DTH to the Jones-Mote (JM)
      DTH is discussed, although the dominance of mast cells in MD DTH lesion was not
      observed.

PMID- 8478031
TI  - Chemotactic desensitization of neutrophils demonstrates interleukin-8 (IL-8)
      dependent and IL-8-independent mechanisms of transmigration through cytokine
      activated endothelium.
AB  - We have recently shown that an exogenous gradient of interleukin-8 (IL-8) induces
      the transendothelial migration of neutrophils. Treatment of endothelium with the
      cytokines IL-1 or tumour necrosis factor (TNF) also causes neutrophil
      transmigration, and recent evidence suggests that this may be due to endogenous
      IL-8 produced by the endothelium. We have used specific chemotactic
      desensitization of neutrophils to investigate the role of IL-8 in transmigration
      through cytokine-activated endothelium. Preincubation of neutrophils with IL-8
      reduced their chemotactic transmigration response to an IL-8 gradient by 81%,
      demonstrating desensitization. Transmigration in response to cytokine-activated
      endothelium was inhibited by 104% after IL-8 preincubation, thus tending to
      support the role of IL-8. However, preincubation with another neutrophil
      chemotactic factor N-formyl-methionyl-leucyl-phenylalanine (FMLP), which did not
      affect the IL-8, response, also inhibited transmigration, by 74%. This suggests
      that FMLP preincubation acts to inhibit a non-IL-8-dependent mechanism of
      transmigration through cytokine-activated endothelium. Chemotactic factor
      pretreatment of neutrophils did not reduce their adhesion to activated
      endothelium, but specifically blocked the transmigration step. We have therefore
      shown that chemotactic transmigration can be subjected to factor-specific
      desensitization, and have used this to provide evidence supporting a role for IL
      8 in transmigration through cytokine-activated endothelium, as well as suggesting
      a further IL-8-independent mechanism. These data also provide a mechanism for the
      observed defect in accumulation of neutrophils at inflammatory sites when
      chemotactic factors are infused intravenously.

PMID- 8478032
TI  - An interspecies idiotope associated with the anti-cholera toxin response detected
      by a monoclonal auto-anti-idiotypic antibody.
AB  - We have produced an auto-anti-idiotypic (auto-anti-id) monoclonal antibody (mAb)
      which reacted with syngenic mouse polyclonal anti-cholera toxin (anti-CT) IgG
      antibody (Ab) and six/eight different anti-CT IgG mAb, but not with normal mouse
      BALB/c IgG. The binding of this auto-anti-id mAb on one anti-CT mAb was
      significantly inhibited by polyclonal anti-CT sera of rats, rabbits and mice.
      Thus the idiotope on anti-CT Ab recognized by this auto-anti-id mAb was public
      and expressed in different species. Because of the absence of competition between
      CT and this auto-anti-id mAb for the binding to the six anti-CT mAb, the anti-id
      mAb was classified as an Ab2 alpha. The efficiency of this auto-anti-id mAb to
      induce anti-CT Ab3 was tested with success in rabbits and rats. Auto-anti-id mAb
      immunized rats were significantly protected against an intraintestinal CT
      challenge.

PMID- 8478033
TI  - Follicle epithelial M cells are a source of interleukin-1 in Peyer's patches.
AB  - The production of interleukin-1 (IL-1) by rabbit Peyer's patch M cells populating
      the follicle-associated epithelium (FAE) was studied. Sorted 5D9+ phagocytic
      epithelial M cells synthesized IL-1 after stimulation with lipopolysaccharide
      (LPS) in vitro, as evidenced by the ability of culture supernatants to induce the
      proliferation of the T-cell line D10.G4.1. Fixed LPS-stimulated M cells were less
      effective at mediating T-cell proliferation than supernatants from LPS-activated
      M cells. The magnitude of T-cell proliferation was M-cell concentration
      dependent, and proportional to the dose of LPS. The M-cell-mediated D10.G4.1 cell
      proliferation was inhibited > 75% with anti-IL-1 alpha, but < 50% with similar
      concentrations of anti-IL-1 beta. The results show that M cells secrete IL-1, and
      suggest the participation of M cells in the delivery of a localized co
      stimulatory signal for T-cell and B-cell proliferation in the microenvironment of
      gut-associated lymphoid tissue (GALT).

PMID- 8478034
TI  - Sensitization of mice to chemical allergens modulates the responsiveness of
      isolated mast cells to IgE-dependent activation.
AB  - It is known that the release of granule-associated inflammatory amines by
      isolated mouse tissue-type mast cells is subject to regulation in vitro by a
      number of cytokines that are produced during the immune response. In this study
      we investigated whether mast cell secretory function might also be subject to
      regulation in vivo during active sensitization. Mice were sensitized with one of
      three chemical allergens (trimellitic anhydride, TMA; 2,4-dinitrochlorobenzene,
      DNCB; or oxazolone) all of which induce contact sensitization and one of which
      (TMA) in addition causes immediate hypersensitivity. Peritoneal mast cells
      isolated from treated mice and sensitized passively with IgE released a greater
      proportion of cellular serotonin (5-HT) on stimulation either by anti-IgE or by
      specific antigen than did cells isolated from vehicle-treated controls. These
      results show that the function of mast cells is susceptible in vivo to regulatory
      influences that result from induction of an immune response.

PMID- 8478035
TI  - Alterations in calcium metabolism in young people at risk for primary
      hypertension. The Dutch Hypertension and Offspring Study.
AB  - Several disturbances in calcium metabolism have been reported in primary
      hypertensive subjects. It is, however, not clear whether these alterations
      predate the development of hypertension or occur as a consequence of high blood
      pressure. We studied indexes of calcium metabolism in three groups of
      normotensive children with different familial predispositions for hypertension,
      based on parental blood pressure levels, with two, one, or no hypertensive
      parents. Plasma intact parathyroid hormone [1-84] was higher in the offspring of
      hypertensive parents compared with offspring of normotensive parents (difference,
      0.58 pmol/L; standard error of the difference [SED], 0.24; p = 0.02). Mean serum
      calcium levels were slightly reduced in the offspring of two hypertensive parents
      (-0.019 mmol/L, SED = 0.013, p = 0.17). Plasma magnesium and phosphate levels
      were lower in the offspring of hypertensive parents (-0.032 mmol/L [SED = 0.016,
      p = 0.05] and -0.045 mmol/L [SED = 0.024, p = 0.05], respectively). Mean 1.25
      dihydroxyvitamin D3 levels were similar among the groups. No differences in
      dietary intake of calcium, phosphate, or fiber were found. Urinary calcium
      excretion per 24 hours and the ratio of 24-hour urinary calcium excretion to
      daily calcium intake were somewhat higher in the offspring of hypertensive
      parents. Renal fractional excretion of calcium was similar in the offspring of
      two hypertensive parents, and renal fractional excretion of phosphate was lower
      in the offspring of two hypertensive parents compared with offspring of two
      normotensive parents (-1.50%, SED = 0.74, p = 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8478036
TI  - Insulin resistance in young salt-sensitive normotensive subjects.
AB  - Insulin resistance has been demonstrated in patients with essential hypertension,
      and insulin-mediated sodium retention is believed to contribute to hypertension
      in these individuals. Recently, a hyperinsulinemic response to an oral glucose
      load has been found in salt-sensitive normotensive subjects, suggesting that
      insulin resistance may be present in these hypertension-prone individuals before
      the development of hypertension. In the present study, we examined the relation
      between insulin sensitivity and blood pressure response to salt intake in young,
      lean normotensive subjects on a high and a low salt diet. Insulin sensitivity was
      estimated by the "insulin suppression test," i.e., by measuring the plasma
      glucose and insulin concentrations achieved during a 180-minute infusion of
      somatostatin, insulin, and glucose in 18 healthy male volunteers (age, 21-28
      years) given a standardized low salt diet (20 mmol/day) for 2 weeks, supplemented
      by either 220 mmol of NaCl per day or placebo in a single-blind randomized order
      for 1 week each. We defined salt sensitivity as a significant decrease in mean
      arterial blood pressure (> 3 mm Hg [p < 0.05]) measured for 60 minutes at 1
      minute intervals on the low salt diet. By this definition, seven of the 18
      subjects were salt sensitive. Although insulin infusion resulted in similar
      plasma insulin levels (approximately 50 milliunits/L) in both groups, concomitant
      glucose infusion resulted in plasma glucose levels that were more than 50% higher
      in the salt-sensitive than in the salt-resistant group (p < 0.005 by two-way
      analysis of variance).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478037
TI  - Interleukin-2 causes endothelium-dependent contractions to arachidonic acid.
AB  - The present experiments were designed to investigate the effect of interleukin-2
      on the response to arachidonic acid in rings with and without endothelium from
      Wistar-Kyoto (WKY) and spontaneously hypertensive rat (SHR) aortas. In control
      rings, arachidonic acid induced contractions of WKY aorta that were not different
      between preparations with and without endothelium. Incubation with interleukin-2
      (10 units/mL) for 6 or 18 hours augmented the response to arachidonic acid in
      rings with, but not in those without, endothelium from WKY rat aortas. In the WKY
      aorta, both the endothelium-dependent and endothelium-independent contractions to
      arachidonic acid observed after incubation with interleukin-2 were abolished by
      indomethacin and ridogrel (a thromboxane-endoperoxide receptor antagonist and a
      thromboxane synthase inhibitor) but were not affected by dazoxiben (a thromboxane
      synthase inhibitor). Interleukin-2 did not augment the vascular reactivity of WKY
      aortic smooth muscle to activation of the thromboxane-endoperoxide receptor with
      U46619. In aortas from SHRs, arachidonic acid evoked endothelium-dependent
      contraction; interleukin-2 did not modify the response to arachidonic acid in
      preparations with and without endothelium. These data demonstrate that 1)
      endothelium-dependent contractions to arachidonic acid are observed in SHR but
      not in WKY rat aortas; 2) interleukin-2 induces endothelium-dependent
      contractions to arachidonic acid in the WKY aorta that are mediated by an
      augmented release of a metabolite of cyclooxygenase, different from thromboxane
      A2 but activating thromboxane-endoperoxide receptors; and 3) interleukin-2 does
      not affect the endothelium-dependent and endothelium-independent response to
      arachidonic acid in the SHR aorta.

PMID- 8478038
TI  - Increased endothelin-1 content in blood vessels of deoxycorticosterone acetate
      salt hypertensive but not in spontaneously hypertensive rats.
AB  - Endothelin-1 (ET-1) is a powerful vasoconstrictor peptide produced in the
      endothelium of blood vessels that may play an important role in the control of
      local blood flow and could be involved in the pathogenesis of hypertension. We
      investigated immunoreactive ET-1 (ir-ET-1) levels in acid extracts from blood
      vessels of deoxycorticosterone acetate (DOCA)-salt and spontaneously hypertensive
      rats. We found that segments of thoracic aorta and the mesenteric vascular bed
      contain significantly more ir-ET-1 (11.84 +/- 0.84 and 17.30 +/- 1.89 fmol,
      respectively) than uninephrectomized control rats (1.78 +/- 0.20 and 9.19 +/-
      0.63 fmol, respectively; p < 0.001). High performance liquid chromatography
      showed that ir-ET-1 of blood vessels of DOCA-salt hypertensive rats eluted in the
      same position as synthetic ET-1. Significantly increased ir-ET-1 was localized by
      immunohistochemistry in endothelial cells of aorta and large and small mesenteric
      arteries of DOCA-salt hypertensive rats. In contrast to the latter, in
      spontaneously hypertensive rats, vascular content of ir-ET-1 was similar to that
      of blood vessels of Wistar-Kyoto control rats, at both 6 and 16 weeks of age.
      High levels of vascular ET-1 may explain the downregulation of vascular
      endothelin receptors previously described in DOCA-salt hypertensive rats.
      Furthermore, this suggests that ET-1 may be involved in the maintenance of high
      blood pressure in mineralocorticoid hypertension.

PMID- 8478039
TI  - Pressor reactivity to norepinephrine and angiotensin in salt-sensitive
      hypertensive patients.
AB  - The mechanisms responsible for increased blood pressure in response to a high
      dietary sodium intake in salt-sensitive patients with essential hypertension are
      only partially understood. The possibility that increased reactivity to pressor
      hormones might contribute to hypertension in these patients has not been
      adequately investigated. We studied 11 salt-sensitive and 15 salt-resistant
      patients with essential hypertension while they were ingesting a diet with 20
      meq/day sodium for 9 days or one with 200 meq/day sodium for 14 days. During the
      last 4 days of each dietary regimen, they received 30 mg/day of slow-release
      nifedipine. Blood pressure response to increasing doses of norepinephrine and
      angiotensin II (Ang II) was studied at the end of each of four phases of the
      study. Salt-sensitive patients exhibited a greater blood pressure response to
      norepinephrine than salt-resistant patients, irrespective of the dietary sodium
      intake and whether we took into account the dose infused or the actual plasma
      levels of norepinephrine achieved during the infusion. The blood pressure
      response to Ang II, on the other hand, was greater in salt-sensitive than salt
      resistant patients during low but not during high sodium intake. The blood levels
      of norepinephrine achieved during the infusion of this hormone were lower in salt
      sensitive than in salt-resistant patients. These studies indicate that an
      increased reactivity to the pressor action of norepinephrine might contribute to
      the maintenance of hypertension in salt-sensitive patients. The increased
      reactivity appears to be specific for norepinephrine. In fact, we observed
      increased reactivity to Ang II during low but not during high sodium
      intake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478040
TI  - Effects of weight reduction on cellular cation metabolism and vascular
      resistance.
AB  - The early stages of weight loss are associated with a reduction in blood
      pressure, and the mechanisms mediating this reduction remain unclear. Platelet
      free calcium levels, [Ca2+]i, have been reported to be elevated in essential
      hypertension and to decrease with pharmacological treatment of the hypertension.
      In the current study, 18 obese subjects had measurements of blood pressure,
      forearm blood flow, forearm vascular resistance, and both basal platelet [Ca2+]i
      and [Ca2+]i responses to vasopressin during 12 weeks on a very low calorie (3,360
      kJ, or 800 kcal) diet. Weight reduction was associated with reduction in mean
      arterial blood pressure at 3-4 weeks. There were associated reductions in forearm
      vascular resistance and platelet [Ca2+]i as well as increases in forearm blood
      flow at 3-4 weeks of the diet. Increased forearm blood flow was correlated with
      weight loss. Vasopressin-induced platelet [Ca2+]i responses increased, which
      correlated with the reduction in mean arterial pressure at 7-8 weeks of weight
      loss. Assuming that platelet [Ca2+]i metabolism reflects vascular smooth muscle
      cell [Ca2+]i metabolism, the data suggest that blood pressure reduction after
      weight loss may be related to reduced vascular smooth muscle cell [Ca2+]i. The
      reason for the increased vasopressin-induced [Ca2+]i after weight reduction is
      unclear.

PMID- 8478041
TI  - Cyclosporine and oxidized lipoproteins affect vascular reactivity. Influence of
      the endothelium.
AB  - Cyclosporine and in particular oxidatively modified low density lipoproteins can
      both exert direct vasoconstricting effects. We hypothesized that coincubation of
      arteries with low density lipoproteins and cyclosporine would enhance their
      respective influence on vascular tone. Therefore, we investigated vascular
      reactivity of isolated intact rabbit renal arteries preincubated with
      cyclosporine in the presence of native and oxidized low density lipoproteins.
      After preincubation of the arteries with cyclosporine (10 micrograms/ml, 90
      minutes), unstimulated vascular tone as well as norepinephrine-induced
      vasoconstrictions remained unchanged compared with controls preincubated with the
      cyclosporine solvent dimethyl sulfoxide. Oxidized low density lipoproteins (100
      micrograms/ml) in the absence of cyclosporine significantly enhanced
      vasoconstrictions to threshold concentrations of norepinephrine (78 +/- 10
      microns at 30 nM). However, after cyclosporine treatment, the oxidized low
      density lipoprotein-induced potentiation of contractile responses to
      norepinephrine was further enhanced (157 +/- 19 versus 71 +/- 11 microns). Native
      low density lipoproteins had no influence on vascular tone. Potentiation of
      norepinephrine-induced vasoconstriction by oxidized low density lipoproteins took
      place in either endothelium-denuded or endothelium-intact arteries, whereas the
      further enhancement of vascular tone after cyclosporine treatment was seen only
      in endothelium-intact segments. Endothelium-dependent dilations to acetylcholine
      were fully preserved after treatment with oxidized low density lipoproteins and
      cyclosporine. Indomethacin, saralasin, and the thromboxane A2 antagonist
      daltroban had no influence, but the Ca2+ antagonist verapamil prevented the
      potentiation of vasoconstrictions by cyclosporine and oxidized low density
      lipoproteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478042
TI  - Normal ultrasonic myocardial reflectivity in hypertensive patients. A tissue
      characterization study.
AB  - Ultrasonic backscatter of myocardial walls is directly related to the
      morphometrically evaluated collagen content in humans. The integrated backscatter
      is also increased in hypertrophic cardiomyopathy, whereas it gives normal values
      in the physiological hypertrophy of elite athletes. We assessed the
      quantitatively evaluated myocardial reflectivity in 46 mild to moderate,
      clinically uncomplicated essential hypertensive patients, with
      echocardiographically assessed normal regional and global left ventricular
      function, and 22 age- and sex-matched normotensive control subjects. With an echo
      prototype implemented in our institute, we performed an on-line radiofrequency
      analysis to obtain quantitative operator-independent measurements of the
      integrated backscatter signal of the ventricular septum and posterior wall. The
      integrated values of the radiofrequency signal of myocardial walls were
      normalized for those of the pericardial interface and expressed as a percent
      (integrated backscatter index). Hypertensive patients and control subjects
      differed in mean blood pressure (119 +/- 11 versus 95 +/- 5 mm Hg, p < 0.001) and
      left ventricular mass index (134 +/- 31 versus 105 +/- 21 g/m2, p < 0.001).
      However, integrated backscatter index overlapped for both the septum (28 +/- 17%
      versus 25 +/- 6%, p = NS) and the posterior wall (13 +/- 7% versus 13 +/- 4%, p =
      NS). In the hypertensive group, there was no detectable correlation between
      septal integrated backscatter index and either septal thickness (r = -0.26, p =
      NS) or mean arterial pressure (r = -0.14, p = NS). Hypertensive patients showed a
      normal pattern of quantitatively assessed ultrasonic backscatter, even in the
      presence of left ventricular hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478043
TI  - Implications of the systolic hypertension in the elderly program. The Systolic
      Hypertension in the Elderly Program Cooperative Research Group.
AB  - Several imperatives drive the need to establish the merit of treating isolated
      systolic hypertension in the elderly. These include its higher prevalence with
      age, the associated excess cardiovascular risks, and the rapid aging of the
      population. The Systolic Hypertension in the Elderly Program demonstrated a
      significant reduction in stroke incidence (fatal and nonfatal) (36%, equivalent
      to preventing 30 strokes per 1,000 participants per 5 years). A 27% reduction in
      coronary heart disease incidence and a 32% reduction in all major cardiovascular
      events were also achieved (equivalent to the prevention of 16 and 55 events per
      1,000 participants per 5 years, respectively). These results were associated with
      a treatment regimen in which the primary agent was low-dose chlorthalidone. The
      benefits accrued to all subgroups identified based on baseline age, race and sex,
      blood pressure, serum cholesterol levels, and electrocardiographic abnormalities.
      The reduction in coronary disease is consistent with predictions based on
      prospective epidemiological studies and is concordant with other recent
      intervention trials. It is a reasonable inference from the Systolic Hypertension
      in the Elderly Program findings that middle-aged as well as older people with
      isolated systolic hypertension, and people with less severe degrees of this
      condition, particularly when other risk factors are present, would benefit from
      such therapy. Another reasonable implication of the trial relates to the matter
      of preferred drug treatment regimens for diastolic hypertension, in middle-aged
      as well as older people.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478044
TI  - Heparin has an inhibitory effect on endothelin-1 synthesis and release by
      endothelial cells.
AB  - We studied the inhibitory effects of heparin on basal and agonist-induced
      endothelin-1 biosynthesis and release from cultured bovine endothelial cells.
      Heparin dose-dependently and similarly inhibited endothelin-1 release, inositol
      trisphosphate production, and intracellular free Ca2+ levels stimulated by
      thrombin. Hirudin fragment had an inhibitory effect on thrombin-induced
      endothelin-1 release, whereas anti-thrombomodulin antibody had no effect. Heparin
      completely blocked phorbol ester-induced endothelin-1 release, whereas it had a
      partial inhibitory effect on endothelin-1 release stimulated by angiotensin and
      vasopressin. Northern blot analysis using complementary DNA for bovine
      preproendothelin-1 as a probe revealed that heparin reduced not only the basal
      but also the stimulated expression of preproendothelin-1 messenger RNA by
      thrombin and phorbol ester. These data suggest that heparin, in addition to its
      antithrombin effect, has an inhibitory effect on the biosynthesis and release of
      endothelin-1, possibly by inhibiting protein kinase C-dependent pathway.

PMID- 8478045
TI  - Sustained hypertension induced by orally administered nitro-L-arginine.
AB  - To study the hemodynamic and metabolic effects of chronic inhibition of
      endothelium-derived nitric oxide, we treated conscious rats with an oral solution
      of N omega-nitro-L-arginine (LNA), an inhibitor of nitric oxide production by
      endothelial cells. After 3 days of treatment with 2.74 mM LNA, rats had higher
      blood pressures (136 +/- 5 versus 113 +/- 3 mm Hg, p < 0.0005) than did the
      control animals. This effect was maintained through 7 days of treatment (142 +/-
      6 versus 109 +/- 4 mm Hg, p < 0.0005) and in three animals for 35 days (167 +/- 7
      mm Hg). The blood pressure rise was dose dependent. The hypertensive effect of
      oral LNA was not enhanced by the administration of 20 mg intraperitoneal LNA and
      was prevented by pretreatment with L-arginine, although L-arginine also caused a
      transient but significant increase in urinary sodium excretion. When LNA
      treatment was discontinued, blood pressure fell gradually, with an effective
      biological half-life of 4.2 days. Metabolic balance studies did not identify
      differences in sodium or potassium balance between treated and control animals.
      Plasma renin activity was lower in LNA-treated animals, and aldosterone
      concentrations tended to be lower. In contrast, atrial natriuretic factor levels
      and serum electrolyte concentrations were unchanged after 7 days of treatment
      with LNA. These data support the premise that endothelium-derived nitric oxide
      plays an important role in basal hemodynamic homeostasis. Oral administration of
      LNA may serve as a model of chronic nitric oxide-deficient hypertension and allow
      for the future study of endothelium dependence in hypertension.

PMID- 8478046
TI  - Mechanism of hypertriglyceridemia in Dahl rats.
AB  - Plasma triglyceride concentrations were shown to be higher in hypertensive (153
      +/- 2 mm Hg) male Dahl salt-sensitive rats than in control Sprague-Dawley rats
      (122 +/- 2 mm Hg). These differences in triglyceride concentrations were seen
      when blood was drawn at 9 AM from unfasted animals (229 +/- 27 versus 111 +/- 8
      mg/dL), at 1 PM after a 4-hour fast (186 +/- 13 versus 88 +/- 4 mg/dL), or at 9
      AM after a 13-hour fast (151 +/- 6 versus 90 +/- 6 mg/dL), all p < 0.001. Total
      triglyceride secretion was also compared in groups of rats by determining the
      increment in plasma triglyceride concentration for 2 hours after blocking
      triglyceride removal from plasma by injecting Triton. Studies performed at 1 PM
      and 9 AM, after the 4- and 13-hour fast, demonstrated that total triglyceride
      secretion was greater (p < 0.05) in Dahl rats only when studied at 1 PM. Direct
      estimates of hepatic triglyceride secretion at 1 PM also demonstrated a
      significant (p < 0.02) increase in secretion rate by perfused livers from Dahl
      rats, due in part to their increased liver size. In addition, removal of
      prelabeled very low density lipoprotein-triglyceride in the intact rat was
      significantly (p < 0.05) decreased in Dahl rats. Lipoprotein lipase activity
      measured in skeletal muscle, heart, and adipose tissue was also significantly
      decreased at 9 AM and 1 PM (after 0 and 4 hours of fasting) in tissue from Dahl
      rats. These data confirm that Dahl rats have higher plasma triglyceride
      concentrations than Sprague-Dawley rats. Since both total and hepatic
      triglyceride secretion were somewhat greater in Dahl rats, in association with a
      decrease in both removal of very low density lipoprotein from plasma and
      decreased muscle and adipose tissue lipoprotein lipase activity, it seems likely
      that hypertriglyceridemia in Dahl rats results from a combination of increased
      triglyceride secretion and decreased triglyceride removal.

PMID- 8478047
TI  - Essential hypertension: a renal disease? A review and update of the evidence.

PMID- 8478049
TI  - Presence of a capsule in Vibrio vulnificus biotype 2 and its relationship to
      virulence for eels.
AB  - Strains of Vibrio vulnificus biotype 2, isolated from internal organs of diseased
      European eels as pure cultures of opaque cells, together with some reference
      strains from Japanese eels, were used in this study. Spontaneous translucent
      phase variants were obtained from the corresponding parent strains and compared
      for a variety of phenotypic traits related to virulence for eels. The rate of
      colony dissociation from opaque to translucent cells was higher (around 10(-2))
      than that observed for translucent to opaque cells (10(-3) to 10(-4)). Electron
      microscopy with ruthenium red revealed the presence of a capsule of variable
      thickness on opaque cells, whereas translucent-type colonies had no observable
      capsular materials. No differences in plasmid profiles were detected between the
      two cell types so that plasmids do not seem to be implicated in the mechanism of
      phase shift of biotype 2 strains. No apparent difference in outer membrane
      protein and lipopolysaccharide patterns could be observed between the cell types.
      Both isogenic morphotypes were able to grow in eel serum and minimal medium
      supplemented with ethylenediamine di(O-hydroxyphenyl-acetic acid) or transferrin.
      Therefore, the presence of capsule was not required for the acquisition of iron
      from iron chelators or for resistance to serum bactericidal action. Both
      morphotypes were highly virulent for elvers, although the 50% lethal dose for
      translucent cells was higher than that for the corresponding opaque cells. The
      latter observation, together with the overall data, suggests that the production
      of capsular materials by biotype 2 of V. vulnificus is not essential for the
      development of vibriosis in eels, at least when cells are injected
      intraperitoneally.

PMID- 8478048
TI  - Pathogenicity of Helicobacter pylori: a perspective.

PMID- 8478050
TI  - Endotoxin-induced tumor necrosis factor alpha synthesis in murine embryo
      fibroblasts.
AB  - Murine embryo fibroblasts (MEF) were found to secrete tumor necrosis factor (TNF)
      in response to stimulation with endotoxin. Endotoxin-induced TNF production by
      MEF was inhibited by cycloheximide. However, reversal of the effect of this
      inhibitor on protein synthesis results in TNF being secreted in amounts
      equivalent to those produced by endotoxin-induced MEF not treated with
      cycloheximide. Actinomycin D treatment of MEF blocked the production of endotoxin
      induced TNF. Maximal production of TNF required MEF gene transcription during the
      first 6 h of incubation with endotoxin. To determine whether endotoxin-induced
      TNF alpha (TNF-alpha) and/or TNF beta were produced by MEF, cDNA was synthesized
      from the total RNA isolated from endotoxin-induced MEF and amplified by the
      polymerase chain reaction in the presence of oligonucleotide primers specific for
      each cytokine. On the basis of the polymerase chain reaction analysis, it was
      determined that TNF-alpha mRNA levels were increased in endotoxin-induced MEF.
      Thus, production of TNF-alpha by fibroblasts in response to the endotoxin
      component of bacterial cell walls is likely to contribute to the expression of
      TNF-mediated effects occurring in fibroblast-rich tissues infected with gram
      negative bacteria.

PMID- 8478051
TI  - Complement resistance of pathogenic Entamoeba histolytica mediated by trypsin
      sensitive surface component(s).
AB  - Pathogenic forms of the protozoan parasite Entamoeba histolytica were reported
      previously to resist the cytolytic effect of the alternative complement pathway
      (AP) only temporarily during exposure to complement. In contrast, nonpathogenic
      forms of E. histolytica had been found to show AP resistance as a stable
      property. We studied the mechanisms of AP resistance of the two forms. Upon
      exposure to AP activity, resistant pathogenic or nonpathogenic forms bound
      significantly less C3 products than complement-sensitive pathogenic amebae,
      indicating that the two resistant forms both inhibited AP amplification. Various
      enzymatic treatments and inhibition of membrane mobility by cytochalasin B and
      glutaraldehyde fixation showed that the mechanisms of AP inhibition differed
      between pathogenic and nonpathogenic forms; in contrast to nonpathogenic forms,
      pathogenic amebae required intact membrane mobility and a trypsin-sensitive
      surface component(s) to inhibit AP activation.

PMID- 8478052
TI  - Single and combined humoral and cell-mediated immunotherapy of Pneumocystis
      carinii pneumonia in immunodeficient scid mice.
AB  - Homozygous mutant scid/scid (severe combined immunodeficiency) mice (referred to
      as scid mice) lack both specific humoral and cell-mediated immune functions and
      are exemplary in vivo models for analysis of host-parasite relationships. In our
      colony, scid mice routinely and predictably develop spontaneous Pneumocystis
      carinii pneumonia (PCP) with high morbidity. Previous studies have identified
      both T cells (specifically, CD4+ cells) and antibody as independent mechanisms of
      effective anti-P. carinii resistance; however, CD4+ T cells also cause an often
      fatal hyperinflammatory reaction. The current study has explored the optimal
      application of these immune components for conferring protection against P.
      carinii. Anti-P. carinii hyperimmune serum was highly effective at reducing the
      number of P. carinii organisms in early, intermediate, and advanced stages of PCP
      and was capable of increasing the mean life expectancy of P. carinii-infected
      scid mice by more than threefold if provided on a continuing basis. When a short
      course of hyperimmune-serum therapy was provided prior to transfer of P. carinii
      sensitized normal lymphocytes, scid mice were rendered permanently free of P.
      carinii without the pathological sequelae of the hyperinflammatory reaction.
      These findings are discussed in the contexts of mechanism and clinical relevance.

PMID- 8478053
TI  - The alkaline protease of Aspergillus fumigatus is not a virulence determinant in
      two murine models of invasive pulmonary aspergillosis.
AB  - Little is known of the pathophysiology of invasive pulmonary aspergillosis (IPA),
      an opportunistic fungal infection usually caused by Aspergillus fumigatus. It has
      been suggested that the ability of the fungus to degrade elastin may aid its
      invasion and growth in lung tissue. We have described previously the construction
      of a strain of A. fumigatus in which the gene encoding an alkaline protease,
      AFAlp, had been disrupted (C.M. Tang, J. Cohen, and D.W. Holden, Mol. Microbiol.
      6:1663-1671, 1992); this mutant is deficient in extracellular proteolytic and
      elastinolytic activity over a broad pH range. In this study, we compared the
      pathogenicity of this and another AFAlp disruptant with their isogenic, elastase
      producing parental strains in two murine models of IPA. In both models, animals
      were inoculated via the respiratory tract. In the first model, the inoculum was
      delivered as airborne conidia and animals developed signs of respiratory distress
      within 2 to 4 days. In the second model, conidia were administered intranasally
      as a suspension and the disease developed over a 2-week period. No difference was
      observed between the wild-type and AFAlp disruptants in terms of mortality, and
      elastin breakdown was detected in lung tissue from animals inoculated with all
      four strains. We conclude that AFAlp is not a virulence determinant in these
      models of IPA.

PMID- 8478054
TI  - Anaerobic growth and cytidine 5'-monophospho-N-acetylneuraminic acid act
      synergistically to induce high-level serum resistance in Neisseria gonorrhoeae.
AB  - In vivo, gonococci encounter a myriad of conditions not present in vitro. At some
      stages of infection and disease, gonococci may grow anaerobically, probably by
      using sodium nitrite as a terminal electron acceptor. Also, gonococci sialylate
      their lipooligosaccharide (LOS) in vivo, by using low concentrations of cytidine
      5'-monophospho-N-acetylneuraminic acid (CMP-NANA) present in host tissue. This
      sialylation is responsible for the acquired resistance of gonococci to both
      normal and immune human serum. Given that gonococci grown in the absence of
      oxygen or in the presence of CMP-NANA probably more closely resemble gonococci
      grown inside a human host, we studied the serum resistance of gonococci
      cultivated under these conditions. In the absence of CMP-NANA, anaerobically
      grown (anaerobic) gonococci were somewhat less sensitive to serum killing than
      were aerobically grown (aerobic) gonococci. However, anaerobic gonococci grown
      with 6 micrograms of CMP-NANA per ml exhibited almost complete serum resistance,
      while aerobic gonococci required 16-fold-higher CMP-NANA concentrations to
      achieve significant serum resistance. Anaerobic gonococci incubated in CMP-NANA
      converted to serum resistance two to three times faster than did similarly
      treated aerobic gonococci and incorporated up to six times as much sialic acid
      into their LOS. Gonococci can express several different LOS molecules. Anaerobic
      gonococci expressed the LOS molecule that acts as an acceptor for sialic acid
      from CMP-NANA in greater quantity than aerobic gonococci did. Finally, Triton X
      100 extracts of anaerobic gonococci contained about four times more
      sialyltransferase activity than did extracts of aerobic gonococci.
      Sialyltransferase activity in these extracts was not inhibited by oxygen or
      enhanced by anaerobiosis. These data indicate that anaerobic conditions lead to
      altered LOS biosynthesis and to induction of sialyltransferase activity in
      gonococci. In vivo, where decreased oxygen levels and relevant concentrations of
      CMP-NANA are found, gonococci could readily become resistant to killing by normal
      and immune human serum.

PMID- 8478055
TI  - Murine T-cell response to native and recombinant protein antigens of Rickettsia
      tsutsugamushi.
AB  - A polyclonal T-cell line with TH1 characteristics was used to assess the murine
      cellular immune response to native and recombinant Rickettsia tsutsugamushi
      antigens. Proliferation of this T-cell line was observed in response to numerous
      native antigen fractions, which indicates that the murine T-helper-cell response
      is directed at multiple scrub typhus antigens with no apparent antigenic
      immunodominance. Subsequent analysis of recombinant R. tsutsugamushi antigens
      made it possible to identify a 47-kDa scrub typhus antigen (Sta47) that was
      stimulatory for the polyclonal T-cell line. Recombinant clones encoding 56-, 58-,
      and 110-kDa antigens (Sta56, Sta58, and Sta110, respectively) were unable to
      induce proliferation of this T-cell line. DNA sequence analysis of the cloned
      rickettsial insert encoding the Sta47 protein revealed the presence of four open
      reading frames potentially encoding proteins of 47, 30, 18, and 13 kDa. Analysis
      of sodium dodecyl sulfate-polyacrylamide gel electrophoresis-separated and eluted
      fractions of lysates from the recombinant HB101(pRTS47B4.3) demonstrated that the
      fractions containing the 47-kDa protein as well as those containing proteins less
      than 18 kDa were stimulatory. Selected synthetic amphipathic peptides derived
      from the Sta47 antigen sequence identified a 20-amino-acid peptide that gave a 10
      fold increase in T-cell proliferation over a control malarial peptide of similar
      length. Recognition of the 47-kDa antigen by a T-cell line with TH1
      characteristics implicates this protein as one of potential importance in
      protection studies and future vaccine development.

PMID- 8478056
TI  - Safety, stability, and efficacy of noncapsulated mutants of Actinobacillus
      pleuropneumoniae for use in live vaccines.
AB  - Clonal, noniridescent mutants of Actinobacillus pleuropneumoniae serotypes 1 and
      5 were isolated following chemical mutagenesis with ethyl methanesulfonate. The
      absence of any detectable capsule was confirmed by inhibition radioimmunoassay.
      There were no differences between the parent and mutant strains in
      lipopolysaccharide or protein electrophoretic profiles or in hemolytic activity.
      There was no detectable reversion to the encapsulated phenotype in vitro after
      passage in mice or pigs or in microporous capsules that were implanted
      subcutaneously in pigs for 6 weeks. The mutants were able to survive for more
      than 1 week in pigs following subcutaneous inoculation, which resulted in a
      strong immune response to whole cells and Apx toxins I and II. Intratracheal
      challenge of pigs with the serotype 5 mutant at a dose 1 log greater than the 50%
      lethal dose for the parent resulted in no clinical disease or lesions except in
      one pig that had slight pneumonia and pleuritis. Twenty-four hours after
      challenge, A. pleuropneumoniae could not be recovered from the respiratory tracts
      of any of the challenged pigs except for the one infected pig; this isolate
      remained noncapsulated. Immunization of pigs with one or both serotypes of
      noncapsulated mutants protected all pigs against clinical disease following
      intratracheal challenge with the virulent homologous or heterologous serotype.
      Nonimmunized control pigs and pigs immunized with a commercial bacterin died or
      had to be euthanized within 24 h of challenge. Thus, live noncapsulated mutants
      of A. pleuropneumoniae may provide safe and cost-effective protection against
      swine pleuropneumonia. These observations support the possibility that
      noncapsulated mutants of other encapsulated, toxin-producing bacteria may also
      prove to be efficacious live-vaccine candidates.

PMID- 8478057
TI  - Induction of macrophage-mediated production of tumor necrosis factor alpha by an
      L-form derived from Staphylococcus aureus.
AB  - We investigated the capability of an L-form derived from Staphylococcus aureus to
      induce tumor necrosis factor alpha (TNF-alpha) production in murine peritoneal
      macrophages. The activity for TNF-alpha induction was found in the membrane
      fraction of the L-form but not in the cytoplasmal fraction purified by the
      sucrose step gradient centrifugation. TNF-alpha mRNA was also detected in
      macrophages stimulated with L-form membranes. L-form induced TNF-alpha production
      in macrophages from both lipopolysaccharide-responsive and -unresponsive mouse
      strains. Regardless of the presence of polymyxin B, the activity of TNF-alpha
      induction of L-form was mostly found in the phenol layer, but not in the aqueous
      layer, both of which were prepared by phenol extraction method. Fractions of L
      form membranes representing molecular masses of approximately between 29 and 36
      kDa were primarily responsible for inducing the production of TNF-alpha
      consistently. Moreover, this stimulatory effect was abolished by digestion with
      Streptomyces griseus protease. In Western blot (immunoblot) analysis with anti
      lipoteichoic acid antibody, two bands (65 and 45 kDa) were observed in the sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis of the phenol layer, whereas
      one band (14 kDa) was observed in either the aqueous layer or lipoteichoic acid
      of S. aureus. These results suggest that the component in the membrane of the L
      form, distinct from cell wall components such as teichoic acid or
      lipopolysaccharide, possesses the capability to stimulate TNF-alpha production by
      macrophages.

PMID- 8478058
TI  - Characterization of the Shigella flexneri ipgD and ipgF genes, which are located
      in the proximal part of the mxi locus.
AB  - The Shigella flexneri invasion process requires the synthesis of the Ipa proteins
      and their secretion by specific factors encoded by the mxi and spa genes, which
      are clustered upstream from the ipa operon. We report here the characterization
      of the ipgD, ipgE, and ipgF genes, which are located in the 5' end of the mxi
      locus. Analysis of IpgF-PhoA fusions endowed with high levels of alkaline
      phosphatase activity confirmed the functionality of a classical signal sequence
      detected in the sequence of IpgF. The ipgD and ipgF genes were each inactivated
      on the large virulence plasmid by insertion of a nonpolar cassette; each of the
      ipgD and ipgF mutants thus constructed showed the same invasive phenotype as the
      wild-type strain and was able to provoke keratoconjunctivitis in guinea pigs. It
      thus appears that two genes located at the ipa-proximal part of the mxi locus are
      not directly involved in invasion. Analysis of concentrated culture supernatants
      of the wild-type and ipgD strains indicated that secretion of one polypeptide,
      whose size was consistent with that predicted for the IpgD protein (60 kDa), was
      abolished in the ipgD mutant.

PMID- 8478059
TI  - Cytocidal effects of Escherichia coli hemolysin on human T lymphocytes.
AB  - Escherichia coli hemolysin is the prototype of a large family of pore-forming
      toxins produced by gram-negative organisms. Besides its known cytotoxic
      activities against granulocytes, monocytes, endothelial cells, and renal
      epithelial cells, we now demonstrate that the toxin potently kills human T
      lymphocytes. Evidence based on different and independent approaches indicates
      that lymphocidal activity is due to formation of transmembrane pores.
      Additionally, cells prestimulated with phytohemagglutinin respond to low doses of
      E. coli hemolysin with DNA fragmentation similar to that observed in cells
      undergoing programmed cell death. Kinetic considerations lead us to conclude that
      DNA degradation may, however, represent an epiphenomenon. Killing of T cells is
      another means through which E. coli hemolysin could directly impair host defense.

PMID- 8478060
TI  - Lipopolysaccharide from Brucella abortus behaves as a T-cell-independent type 1
      carrier in murine antigen-specific antibody responses.
AB  - In order to determine the carrier nature of lipopolysaccharide from Brucella
      abortus (LPS-BA) in evoking humoral responses, normal and immunodeficient mice
      were immunized with trinitrophenyl (TNP)-conjugated LPS-BA (TNP-LPS-BA) and the
      responses were compared with those to known T-dependent and T-independent
      antigens. TNP-LPS-BA, like T-independent type 1 (TI-1) antigens such as TNP-BA
      and TNP-LPS from Escherichia coli (TNP-LPS-EC), generated anti-TNP responses in
      BALB/c, athymic BALB/c nu/nu, and CBA/N mice. In contrast, N-2,4-dinitrophenyl
      beta-alanylglycylglycyl-substituted keyhole limpet hemocyanin, a typical T
      dependent antigen, was not immunogenic in athymic mice, and TNP-Ficoll (T
      independent type 2) was ineffective in eliciting humoral responses in CBA/N mice.
      These results indicate that LPS from B. abortus acts as a TI-1 carrier in
      generating antibody responses. In C3H/HeJ mice, TNP-LPS-BA generated higher-titer
      immunoglobulin G1 (IgG1), IgG2a, and IgG2b anti-TNP antibodies than TNP-LPS-EC.
      Compared with those from BALB/c mice, pure resting B cells isolated from C3H/HeJ
      mice exhibited a 30-fold lower proliferative response to LPS-EC, whereas the LPS
      BA response was reduced to a lesser extent (5-fold). This suggests that the
      disparity observed in antibody titers was due to different abilities of LPS from
      B. abortus and E. coli to stimulate C3H/HeJ B cells. The ability of LPS from B.
      abortus to act as a carrier in generating humoral immune responses indicates that
      LPS-BA can be substituted for whole B. abortus organisms in vaccine development.

PMID- 8478061
TI  - Evidence for absence of the MPB64 gene in some substrains of Mycobacterium bovis
      BCG.
AB  - Substrains of Mycobacterium bovis BCG have been divided in two major groups, high
      producers and low producers of the secreted proteins MPB64 and MPB70. Of these,
      Mycobacterium tuberculosis secretes only the analog MPT64 during growth on Sauton
      medium. It has been confirmed that high-producer and low-producer substrains of
      BCG as well as M. tuberculosis contain the gene for the MPB/MPT70 protein. By
      contrast, polymerase chain reaction and hybridization experiments are reported
      here which indicate that the MPB64 gene is absent in the BCG substrains
      Copenhagen, Pasteur, Glaxo, and Tice, in which previous methods did not permit
      distinction between secretion of small amounts or absence of the protein in
      culture fluids.

PMID- 8478062
TI  - Haemophilus ducreyi adheres to but does not invade cultured human foreskin cells.
AB  - Haemophilus ducreyi is the etiologic agent of the localized genital ulcer disease
      known as chancroid. The pathogenesis of this organism is poorly understood. The
      role of attachment in the disease process has not been evaluated. In this study,
      125I-H. ducreyi was used to quantitatively evaluate the interaction of virulent
      and avirulent H. ducreyi strains with human foreskin cells. Using this in vitro
      model system, we demonstrated that, at 22 and 35 degrees C, the attachment of
      virulent H. ducreyi 35000 to human foreskin cells was significantly more marked
      than that of avirulent H. ducreyi A77. Although H. ducreyi penetrated between
      human foreskin cells, internalization was not a major component. Our competition
      assay data suggest that the attachment mechanism of H. ducreyi may be similar to
      that of Neisseria gonorrhoeae. We speculate that the attachment and microcolony
      formation of virulent H. ducreyi may provide a mechanism for bacterial
      localization and evasion of host defenses.

PMID- 8478063
TI  - Effect of growth conditions on expression and antigenicity of Staphylococcus
      epidermidis RP62A cell envelope proteins.
AB  - Staphylococcus epidermidis RP62A (ATCC 35984) was grown in tryptic soy broth
      (TSB), iron-depleted TSB (TSB-Fe), iron-reconstituted TSB-Fe (TSB+Fe), a
      chemically defined medium, and fetal calf serum (FCS) and on silastic disks in
      chambers that were sutured to the pig peritoneal wall. Bacterial cell wall
      proteins were extracted by digestion with recombinant lysostaphin, separated by
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and detected by silver
      staining. Cell wall proteins from TSB-, chemically defined medium-, or FCS-grown
      cells had a complex profile of greater than 25 protein bands spanning the full
      molecular mass range. By contrast, a digest obtained from in vivo-grown cells had
      only five major proteins of 40 kDa or greater. Proteins of 130 and 106 kDa were
      present in the cell envelopes of TSB-Fe- and in vivo-grown cells but not in those
      grown in TSB or TSB+Fe. A 43-kDa protein expressed by in vitro-grown cells and 52
      and 96-kDa proteins expressed by in vivo-grown cells reacted with antisera from
      pigs with the chamber implants and from catheterized, paracatheter-inoculated
      pigs but not with hyperimmune sera from pigs immunized with TSB-grown cells. The
      data indicate that S. epidermidis, growing under in vivo conditions, expresses
      antigens distinct from those that are grown in vitro.

PMID- 8478064
TI  - Characterization of a heat-modifiable outer membrane protein of Haemophilus
      somnus.
AB  - In immunoblot analysis, a murine monoclonal antibody (MAb), 27-1, which was
      produced to an outer membrane protein (OMP) of Haemophilus somnus, showed that a
      major OMP is heat modifiable, having a molecular mass of 28 kDa when the N
      lauroylsarcosine-insoluble OMP preparation was solubilized at 60 degrees C and a
      mass of 37 kDa when the OMP preparation was solubilized at 100 degrees C. The
      heat-modifiable OMP reacted intensely with convalescent sera obtained from calves
      with experimental H. somnus pneumonia in immunoblot analysis. Immunoelectron
      microscopic and antibody absorption studies revealed that the MAb 27-1 epitope
      was not surface exposed on the intact bacterium. However, a decrease in antibody
      reactivity to the heat-modifiable OMP in immunoblot analysis after absorption of
      convalescent serum with intact bacterial cells of H. somnus suggests that a
      surface-exposed portion of the heat-modifiable OMP is expressed on the intact
      bacterium. MAb 27-1 reacted with 45 of 45 strains of H. somnus tested in
      immunoblot analysis. The apparent molecular mass of the antigen varied among
      strains, and five reactivity patterns demonstrated by MAb 27-1 were observed. MAb
      27-1 also reacted with six species in the family Pasteurellaceae, Escherichia
      coli, and Salmonella dublin, but not with the other eight species of gram
      negative bacteria. The heat-modifiable OMP of H. somnus showed immunological
      cross-reactivity with the OmpA protein of E. coli K-12 and significant N-terminal
      amino acid sequence homology with the OmpA proteins of gram-negative bacteria. We
      conclude that a major, 37-kDa heat-modifiable OMP of H. somnus, which elicits an
      antibody response in H. somnus-infected animals, is a common antigen among H.
      somnus strains tested and is structurally related to the OmpA protein of E. coli.

PMID- 8478065
TI  - Reactivity of the human antiendotoxin immunoglobulin M monoclonal antibody HA-1A
      with lipopolysaccharides from rough and smooth gram-negative organisms.
AB  - Clinical data suggest that the human immunoglobulin M antiendotoxin antibody HA
      1A reduced mortality in patients diagnosed with gram-negative bacteremia and
      bacteremia with shock. Previous studies have demonstrated that HA-1A binds to the
      lipid A domain of lipopolysaccharide (LPS). The present study evaluated the
      ability of HA-1A to interact with LPs isolated from various strains of gram
      negative bacteria by using liquid-phase rate nephelometry and solid-phase
      immunoblotting assays. HA-1A formed immune complexes in solution with LPSs
      isolated from both rough and smooth gram-negative organisms. Western blot
      (immunoblot) analysis of these LPS preparations revealed that HA-1A bound to LPS
      isolated from rough gram-negative organisms and to a rough LPS-like component
      present in smooth LPS. HA-1A also bound to LPS-protein complexes found in certain
      commercial rough LPS preparations. Preincubation of HA-1A with lipid A completely
      blocked subsequent binding of HA-1A to LPS in both liquid- and solid-phase assay
      formats, suggesting that the interaction of HA-1A with LPS is through the lipid A
      domain. Evidence that the binding of HA-1A to LPS was mediated through the
      antigen-combining (Fv) region of the antibody was provided by the finding that a
      murine anti-idiotypic antibody to HA-1A inhibited binding. These findings
      suggested that the broad antiendotoxin reactivity exhibited by HA-1A appeared to
      be due to the ability of HA-1A to bind to the conserved lipid A moiety of LPSs
      derived from both smooth- and rough-phenotype gram-negative bacterial strains.

PMID- 8478066
TI  - Role of flagella in adherence, internalization, and translocation of
      Campylobacter jejuni in nonpolarized and polarized epithelial cell cultures.
AB  - Previous studies of Campylobacter jejuni have suggested that flagellin is an
      adhesin for epithelial cells and that motility is a virulence factor of this
      bacterium. The role of flagella in the interactions of C. jejuni with
      nonpolarized and polarized epithelial cells was examined with flagellar mutants.
      Flagellated, nonmotile (flaA flaB+ Mot-) and nonflagellated, nonmotile (flaA flaB
      Mot-) mutants of C. jejuni were constructed by in vivo homologous recombination
      and gene replacement techniques. Both classes of mutants were found to adhere to
      cells of human epithelial origin (INT 407) equally well; however, on the basis of
      the percentage of the inoculum internalized, internalization of the flaA flaB Mot
      mutants was decreased by factors ranging from approximately 30 to 40 compared
      with the parent. The flaA flaB+ Mot- mutant was internalized by the INT 407 cells
      at levels six- to sevenfold higher than the flaA flaB Mot- mutants. Both classes
      of mutants, unlike the parent, were unable to translocate across polarized Caco-2
      monolayers. These results indicate that flagella are not involved in C. jejuni
      adherence to epithelial cells but that they do play a role in internalization.
      Furthermore, the results suggest that either the motility of C. jejuni or the
      product of flaA is essential for the bacterium to cross polarized epithelial cell
      monolayers.

PMID- 8478067
TI  - Increased C3 production in human monocytes after stimulation with Candida
      albicans is suppressed by granulocyte-macrophage colony-stimulating factor.
AB  - Activation of the complement system is an important part of host resistance
      against fungal infections. When human monocytes, cultured for 2 days or more,
      were treated in vitro with Candida albicans for 24 h, an enhancement of their
      biosynthesis of the complement components C3 and factor B was found. However,
      when C. albicans was administered to freshly isolated monocytes, a consistent
      stimulation of factor B biosynthesis occurred, while the C3 production was
      increased in about 50% of the donors. C. albicans also induced the release of
      granulocyte-macrophage colony-stimulating factor (GM-CSF) from the cultured
      cells, apparently in larger amounts in the donors in whom no stimulation of C3
      production was found. An antibody to GM-CSF administered with the yeast at the
      initiation of the monocyte culture caused an increase in the C3 production.
      Furthermore, when monocytes were treated with recombinant human GM-CSF either at
      the same time as or 4 days prior to the addition of C. albicans, the increase in
      C3 production was suppressed or neutralized, while factor B biosynthesis was
      unaffected. Taken together, these results indicate that monocytes respond to C.
      albicans with an increased production of complement factors. This may be an
      important mechanism both for opsonization of the fungus and for initiation of an
      inflammatory reaction. At an inflammatory site, this complement response may be
      suppressed by locally produced GM-CSF.

PMID- 8478068
TI  - Molecular cloning, nucleotide sequence, and characterization of lppB, encoding an
      antigenic 40-kilodalton lipoprotein of Haemophilus somnus.
AB  - Haemophilus somnus is a facultative intracellular pathogen which causes a wide
      range of diseases in cattle. To identify putative virulence determinants, a
      genomic library of H. somnus in Escherichia coli was screened for Congo red
      binding, a property associated with virulence in pathogenic bacteria, and
      subsequently with bovine hyperimmune sera raised against H. somnus HS25. A Congo
      red-binding clone carrying a 1.8-kb DNA insert was found to encode a strongly
      seroreactive LppB protein with an apparent molecular weight of 40,000. The
      nucleotide sequence of the entire DNA insert was determined. Two open reading
      frames coding for polypeptides with calculated molecular weights of 21,893 and
      30,721 were identified. The larger open reading frame encoded LppB, while the
      smaller reading frame encoded a nonseroreactive protein with a relative molecular
      mass of approximately 18 kDa. The 16 amino-terminal amino acids of the deduced
      LppB polypeptide showed strong sequence homology to the signal peptide of
      secreted bacterial proteins, and the sequence Leu-Ala-Ala-Cys at the putative
      cleavage site corresponds to the consensus cleavage sequence of bacterial
      lipoproteins. Synthesis of the mature LppB lipoprotein in H. somnus was inhibited
      by globomycin, a specific inhibitor of signal peptidase II. LppB was localized to
      the outer membrane of H. somnus.

PMID- 8478069
TI  - Cloning and expression of a high-molecular-mass major antigen of Helicobacter
      pylori: evidence of linkage to cytotoxin production.
AB  - A high-molecular-mass (120- to 128-kDa) Helicobacter pylori antigen has been
      associated with peptic ulcer disease. We created a bank of 40,000 random
      chromosomal fragments of H. pylori 84-183 by using lambda ZapII. Screening of
      this bank in Escherichia coli XL1-Blue with absorbed serum from an H. pylori
      infected person permitted the isolation and purification of a clone with a 3.5-kb
      insert. Subcloning of this insert (pMC3) permitted the expression of a
      recombinant H. pylori protein that had a mass of approximately 96 kDa and that
      was recognized by the human serum. Sera that were obtained from H. pylori
      infected persons and that recognized the native 120- to 128-kDa H. pylori antigen
      recognized the recombinant 96-kDa pMC3 protein to a significantly greater extent
      than did sera that did not recognize the native H. pylori antigen. All 19 H.
      pylori isolates producing the 120- to 128-kDa antigen hybridized with pMC3; none
      of 13 nonproducers did so (P < 0.001). Because all 15 isolates producing the
      vacuolating cytotoxin hybridized with pMC3, we called the gene cagA (cytotoxin
      associated gene). Sequence analysis of pMC3 identified an open reading frame of
      859 amino acids, without a termination codon. Parallel screening of a lambda gt11
      library with human serum revealed positive plaques with identical 0.6-kb inserts
      and sequences matching the sequence of the downstream region of pMC3. To clone
      the full-length gene, we used the 0.6-kb fragment as a probe and isolated a clone
      with a 2.7-kb insert from the lambda ZapII genomic library. Nucleotide sequencing
      of this insert (pYB 2) revealed a 785-bp sequence that overlapped the downstream
      region of pMC3. Translation of the complete nucleotide sequence of cagA revealed
      an open reading frame of 1,181 amino acids yielding a protein of 131,517 daltons.
      There was no significant homology with any previously reported protein sequence.
      These findings indicate the cloning and characterization of a high-molecular-mass
      H. pylori antigen potentially associated with virulence and with cytotoxin
      production.

PMID- 8478070
TI  - Establishment of an antitoxoplasma state by stable expression of mouse
      indoleamine 2,3-dioxygenase.
AB  - Indoleamine 2,3-dioxygenase (IDO), a tryptophan-degrading enzyme, is inducible by
      various interferons (IFNs). IDO-mediated tryptophan degradation, but not the
      formation of IDO-catalyzed tryptophan metabolites, has been suggested as a
      mechanism for the antiparasitic action of IFN-gamma. To determine whether the IFN
      gamma-induced IDO alone is sufficient for establishing the antiparasitic state,
      we constructed a mouse IDO expression plasmid containing a heavy metal-responsive
      metallothionein promoter and obtained a stable transformant (C6) by transfection
      of this plasmid into mouse rectal cancer (CMT-93) cells. In the presence of 100
      microM ZnSO4, C6 cells yielded a high level of IDO; and after a 2-day culture
      period, the enzyme induction resulted in complete depletion of tryptophan from
      the culture medium. Under these conditions, the growth of Toxoplasma gondii in C6
      cells infected with the organisms on day 3 after enzyme induction was completely
      blocked. In the absence of ZnSO4, however, IDO induction was negligible in C6
      cells, and T. gondii continued to grow. Furthermore, in a transformant (CC10)
      carrying an antisense mouse IDO plasmid or in parental CMT-93 cells, IDO was not
      induced at all even in the presence of 100 microM ZnSO4, and T. gondii continued
      to grow in these cells as well. These results taken together indicate that
      complete depletion of tryptophan from the culture by IDO alone is sufficient to
      establish the antitoxoplasma state in mouse cells.

PMID- 8478072
TI  - Coordinate regulation of two opaque-phase-specific genes during white-opaque
      switching in Candida albicans.
AB  - Cells of Candida albicans WO-1 switch spontaneously and frequently between a
      white and an opaque CFU. Recently, an opaque-phase-specific cDNA, PEP1, was
      cloned and was demonstrated to code for a pepsinogen. By using a differential
      hybridization screen, a second opaque-phase-specific cDNA, Op4, has been isolated
      and its corresponding gene has been cloned. Op4 is coordinately regulated with
      PEP1 but resides on a different chromosome. During temperature-induced mass
      conversion from opaque to white, transcription of PEP1 and Op4 is immediately
      inhibited by the increase in temperature, but transcription of both genes can be
      rapidly reestablished by a downshift in temperature prior to phenotypic
      commitment. However, the capacity to rapidly induce both PEP1 and Op4 is lost
      coincidentally with the second semisynchronous round of cell division and
      phenotypic commitment during mass conversion. Op4 shows no significant base or
      amino acid sequence homology with a known gene or protein, respectively. However,
      the deduced Op4 protein exhibits several interesting characteristics, including a
      hydrophobic amino terminus with 26 amino acids, a pI of 10.73 for the last 100
      amino acids, two serine repeats adjacent to alanine repeats, and the potential
      for alpha-helical conformation within the alanine-rich sequences. No genomic
      reorganization was evident in the proximity of Op4 during transcriptional
      activation and deactivation accompanying the white-opaque transition.

PMID- 8478071
TI  - Long-term study of cell-mediated responses to Borrelia burgdorferi in the
      laboratory mouse.
AB  - Borrelia burgdorferi infection of disease-susceptible (C3H) and -resistant (BALB)
      mice resulted in impaired proliferation to both T- and B-cell mitogens up to 30
      days after inoculation. Interleukin-2 and -4 production was also impaired,
      paralleling the T-cell response to concanavalin A. Impaired lymphocyte
      proliferation could not be attributed to diminished numbers of T or B cells and
      was found to depend on the lymphoid organ (spleen or lymph node) examined.
      Prostaglandin production accounted for part of this immune dysfunction. Attempts
      to assess antigen-specific proliferation to B. burgdorferi were inconsistent, and
      delayed-type hypersensitivity responses were not detected. Adoptive transfer of T
      enriched cells from chronically infected donors failed to prevent infection and
      disease development in recipient C3H mice. The current study emphasizes caution
      in the study of B. burgdorferi antigen-specific assays and argues against the
      role of a vigorous T-cell response in Lyme borreliosis in infected laboratory
      mice.

PMID- 8478073
TI  - Characterization of kinetics and target proteins for binding of human complement
      component C3 to the surface-exposed outer membrane of Chlamydia trachomatis
      serovar L2.
AB  - In order to characterize the interaction of human complement with Chlamydia
      trachomatis, flow cytometry was used to quantitate binding of complement
      component C3 to elementary bodies of C. trachomatis serovar L2 preincubated in
      fresh serum in the presence or absence of human polyclonal chlamydial antibody.
      Isolation of each of the complement activation pathways revealed that C3 was
      activated most effectively by the alternative pathway. The degree of binding by
      the classical pathway was proportional to the concentration of antibody, but dual
      pathway-mediated binding was not greater than antibody-independent alternative
      pathway binding. Electrophoresis and immunoblotting of detergent-extracted outer
      membrane protein-C3b complexes indicated that the chlamydial major outer membrane
      protein was the primary cell surface moiety binding C3b in both the presence and
      absence of specific antibody. Hydroxylamine cleavage of outer membrane protein
      C3b complexes provided evidence that the majority of C3b is bound to the major
      outer membrane protein by hydroxyl ester bonds. This result was also unchanged by
      the presence of specific antibody. An unexpected finding was the apparent binding
      of anti-C3 antibody to a 40-kDa protein of the chlamydial outer membrane complex,
      perhaps indicating C3 mimicry on the part of the chlamydial major outer membrane
      protein.

PMID- 8478074
TI  - Effects of in vitro and in vivo growth conditions on expression of type 8
      capsular polysaccharide by Staphylococcus aureus.
AB  - Type 8 capsular polysaccharide (CP8) is widely prevalent among clinical isolates
      of Staphylococcus aureus, but the role that the capsule plays in the pathogenesis
      of staphylococcal infections is unclear. This study was performed to identify
      growth conditions that would optimize the production of CP8 and to determine
      whether enhanced CP8 expression would influence staphylococcal virulence. S.
      aureus Becker grown in a chemically defined broth medium with < 1 microM ferric
      nitrate produced up to eightfold more CP8 per milligram of biomass than did
      bacteria cultivated in the same medium containing 20 microM ferric nitrate. The
      bacteria produced > 350-fold more cell-associated CP8 per milligram of biomass
      when grown on the surface of Columbia agar than when grown in Columbia broth.
      Most of the CP8 produced by broth-grown cells was secreted into the culture
      medium. S. aureus cultivated on the surface of nitrocellulose membranes floating
      on Columbia broth produced levels of CP8 similar to those produced by cells grown
      on Columbia agar. Similarly, bacteria harvested from endocardial vegetations of
      rabbits infected with S. aureus produced high levels of CP8. These results
      indicate that staphylococci grown on surfaces, both in vitro and in vivo, produce
      larger quantities of cell-associated CP8 than those grown in liquid cultures.
      However, no differences were observed in the 50% lethal dose for mice of strain
      Becker grown on solid medium (high levels of capsule expression) or in liquid
      medium (low levels of capsule expression).

PMID- 8478075
TI  - Immune responses to Streptococcus sobrinus surface protein antigen A expressed by
      recombinant Salmonella typhimurium.
AB  - In this study, we used a vaccine strain of Salmonella typhimurium to express
      antigenic determinants of the SpaA antigen of Streptococcus sobrinus, which is
      involved in the caries-forming process. We cloned either a single repeat
      (pYA2901) or three tandem repeats (pYA2905) of the 0.48-kb fragment of the spaA
      gene, which codes for an important component of the SpaA protein, plus a 1.2-kb
      minor antigenic determinant and measured the resulting immune responses to SpaA
      in orally immunized BALB/c mice. The single or triple repeat of the spaA gene
      fragment was inserted into the Asd+ vector pYA292 and was transformed into the S.
      typhimurium delta cya delta crp vaccine strain chi 4072 containing delta asd in
      the chromosome. Female BALB/c mice were then orally immunized with two doses of
      the S. typhimurium containing either of the two SpaA constructs, and the immune
      responses to the expressed SpaA protein were assessed. Significant serum
      immunoglobulin G (IgG) anti-SpaA titers were detected in mice immunized with chi
      4072(pYA2905) but not chi 4072(pYA2901). Salivary anti-SpaA IgA titers were
      minimal and were only detected in mice immunized with S. typhimurium expressing
      the SpaA encoded by pYA2905. Intestinal anti-SpaA IgA titers, however, were
      detected in both groups of mice, particularly in mice immunized with chi
      4072(pYA2905). An oral booster 26 weeks after the initial series of immunizations
      resulted in increased serum IgG titers in both chi 4072(pYA2901)- and chi
      4072(pYA2905)-immunized animals, particularly in the chi 4072(pYA2905)-immunized
      animals. No anamnestic IgA response was detected in the saliva following the
      booster immunization.

PMID- 8478076
TI  - Preparation, characterization, and immunogenicity of meningococcal
      lipooligosaccharide-derived oligosaccharide-protein conjugates.
AB  - A method was developed for coupling carboxylic acid-containing oligosaccharides
      (OS) to proteins. An OS was isolated from Neisseria meningitidis group A strain
      A1 lipooligosaccharide (LOS). This LOS has no human glycolipid-like lacto-N
      neotetraose structure and contains multiple immunotypes, including L8, found in
      group B and C strains. The carboxylic acid at 2-keto-3-deoxyoctulosonic acid of
      the OS was linked through adipic acid dihydrazide to tetanus toxoid. The molar
      ratio of the OS to tetanus toxoid in three conjugates ranged from 11:1 to 19:1.
      The antigenicity of the OS was conserved in these conjugates, as measured by an
      enzyme-linked immunosorbent assay (ELISA) and an inhibition ELISA with polyclonal
      and monoclonal antibodies to A1 LOS. These conjugates induced immunoglobulin G
      antibodies to A1 LOS in mice and rabbits. The immunogenicity of the conjugates in
      rabbits was enhanced by use of monophosphoryl lipid A plus trehalose dimycolate
      as an adjuvant. The resulting rabbit antisera cross-reacted with most of 12
      prototype LOSs and with LOSs from two group B disease strains, 44/76 and BB431,
      in an ELISA and in Western blotting (immunoblotting), which revealed a 3.6-kDa
      reactive band in these LOSs. The rabbit antisera showed bactericidal activity
      against homologous strain A1 and heterologous strains 44/76 and BB431. These
      results indicate that conjugates derived from A1 LOS can induce antibodies
      against many LOS immunotypes from different organism serogroups, including group
      B. OS-protein conjugates derived from meningococcal LOSs may therefore be
      candidate vaccines to prevent meningitis caused by meningococci.

PMID- 8478077
TI  - Immunological activities of a Candida albicans protein which plays an important
      role in the survival of the microorganism in the host.
AB  - A protein with an isoelectric point of 4.3 and a relative molecular mass of 43
      kDa (p43) was purified from the supernatants of the cultures of pathogenic
      Candida albicans but could not be detected in the supernatants of cultures of
      this fungus with pathogenicity previously attenuated after being repeatedly
      subcultured in vitro. Treatment of BALB/c and C57BL/6 mice with p43 resulted in
      (i) marked increases in the numbers of splenic immunoglobulin-secreting plaque
      forming cells (PFC) with peak responses of immunoglobulin M (IgM) PFC preceding
      those of IgG PFC, with an isotype restriction pattern of IgG2a > IgG2b > IgG3 >
      IgG1 > IgM, and (ii) specific immunosuppression of the murine primary immune
      response against sheep erythrocytes. Immunosuppressive and B-cell mitogenic
      properties of p43 were quantitatively associated and inversely correlated with
      susceptibility to C. albicans infection. C57BL/6 mice treated with p43 2 days
      before inoculation with C. albicans were considerably more susceptible to the
      fungal infection than untreated mice. The immunobiological and chemical
      properties of p43 are compared with previously described immunosuppressive and B
      cell mitogenic proteins produced by bacteria and viruses, and strategies for
      immunointervention are discussed.

PMID- 8478078
TI  - Purification of a mycobacterial adhesin for fibronectin.
AB  - Previous studies have demonstrated that mycobacteria attach to fibronectin (FN).
      The attachment of mycobacteria to FN is considered to be biologically important
      in Mycobacterium bovis BCG therapy for superficial bladder cancer, initiation of
      delayed hypersensitivity to mycobacterial antigens, and the phagocytosis of
      mycobacteria by epithelial cells. Therefore, we purified the mycobacterial
      receptor for FN. Culture supernatants from 3-week cultures of Mycobacterium
      vaccae, which contained proteins that bound FN and inhibited the attachment of
      both M. vaccae and BCG to FN, were used as a source of receptor. Lyophilized M.
      vaccae supernatants were reconstituted in 0.02 M bis-Tris (pH 6.0) and applied
      sequentially to an ACA 54 gel filtration column and a DEAE-Sephacel anion
      exchange column. A purified inhibitory protein of 55 kDa (p55) was obtained. The
      purified p55 protein was observed to bind to FN and to inhibit 125I-FN binding to
      viable BCG in a dose-dependent manner. Polyclonal and monoclonal antibodies to
      the protein were generated. The resulting polyclonal antiserum blotted a single
      protein band at 55 kDa in crude M. vaccae supernatants, cross-reacted with a 55
      kDa BCG protein by Western blot (immunoblot), and recognized a 55-kDa band that
      was associated with the BCG cell wall, which is consistent with its function as a
      FN receptor. A monoclonal immunoglobulin M(lambda) was isolated from mice
      immunized with purified M. vaccae p55 protein that was not functional in Western
      blots but inhibited the attachment of viable BCG to FN. These studies demonstrate
      that a protein or antigenically related proteins with M(r)s of 55,000 function as
      FN receptors for at least two distinct mycobacteria.

PMID- 8478079
TI  - Synthetic peptides of human lysosomal cathepsin G with potent antipseudomonal
      activity.
AB  - Enzymatically active and inactive (diisopropylfluorophosphate-treated) cathepsin
      G exerted antibacterial action in vitro against Staphylococcus aureus, whereas
      only enzymatically active cathepsin G displayed bactericidal action against
      Pseudomonas aeruginosa. In order to further test the requirement for protease
      activity for the antipseudomonal action of cathepsin G, synthetic peptides
      spanning the full-length mature protein were prepared and examined for
      antibacterial action. Surprisingly, three structurally distinct peptides that
      correspond to residues 61 to 80, 117 to 136, and 198 to 223 within the full
      length protein were found to exert potent antipseudomonal action (> 4.5 logs of
      killing at 500 micrograms/ml) against P. aeruginosa ATCC 27853 and four mucoid
      clinical isolates. Only the peptide (CG117-136) corresponding to residues 117 to
      136 (117-RPGTLCTVAGWGRVSMRRGT-136) within cathepsin G exerted antibacterial
      action against the gram-positive pathogen S. aureus. The antipseudomonal action
      of CG117-136 was rapid and could be inhibited either by increasing concentrations
      of NaCl or by 0.5 mM MgCl2 plus 0.5 mM CaCl2, and these conditions appeared to
      reduce binding of the peptide to whole bacteria. Variants of peptide CG117-136
      lacking either a hydrophobic N-terminal domain or a positively charged C-terminal
      domain were found to have significantly less antipseudomonal action than CG117
      136. The antibacterial capacity of the all-D-enantiomeric form of peptide CG117
      136 was found to be identical to that of the all-L-peptide, suggesting that the
      mechanism of killing does not require the recognition of a target site possessing
      a chiral center.

PMID- 8478080
TI  - Sequence divergence in two tandemly located pilin genes of Eikenella corrodens.
AB  - Eikenella corrodens normally inhabits the human respiratory and gastrointestinal
      tracts but is frequently the cause of abscesses at various sites. Using the N
      terminal portion of the Moraxella nonliquefaciens pilin gene as a hybridization
      probe, we cloned two tandemly located pilin genes of E. corrodens 31745, ecpC and
      ecpD, and expressed the two pilin genes separately in Escherichia coli. A
      comparison of the predicted amino acid sequences of E. corrodens 31745 EcpC and
      EcpD revealed considerable divergence between the sequences of these two pilins
      and even less similarity to EcpA and EcpB of E. corrodens type strain ATCC 23834.
      EcpC from E. corrodens 31745 displayed high degrees of homology to the pilins of
      Neisseria gonorrhoeae and Pseudomonas aeruginosa. EcpD from E. corrodens 31745
      showed the highest homologies with the pilin of one of the three P. aeruginosa
      classes, whereas EcpA and EcpB of strain ATCC 23834 most closely resemble
      Moraxella bovis pilins. These findings raise interesting questions about
      potential genetic transfer between different bacterial species, as opposed to
      convergent evolution.

PMID- 8478081
TI  - Similar mechanisms of action of defined polysaccharides and lipopolysaccharides:
      characterization of binding and tumor necrosis factor alpha induction.
AB  - Little has been reported about the effects of different polysaccharides on
      cytokine production from human monocytes. In this study, we show that several
      well-defined polysaccharides, including polymers with different sizes of beta 1-4
      linked D-mannuronic acid (poly-M, high-M alginate, and M-blocks) and cellulose
      oxidized in the C-6 position, induced human monocytes to produce tumor necrosis
      factor alpha (TNF-alpha). Poly-M was the most efficient polysaccharide tested
      and, on a weight basis, was approximately as efficient as lipopolysaccharide
      (LPS) from Escherichia coli. TNF-alpha production was shown to depend strongly on
      the molecular weights of poly-M and high-M alginate, with maximal TNF-alpha
      production occurring at molecular weights above 50,000 and 200,000, respectively.
      G-blocks, alpha 1-4-linked L-guluronic acid polymers that did not induce cytokine
      production from monocytes, reduced the cytokine production induced by the beta 1
      4-linked polyuronic acids and LPS. Furthermore, both G-blocks and LPS were found
      to inhibit the binding of poly-M to monocytes, as measured by flow cytometry. In
      addition, we found that the binding of LPS to monocytes was inhibited by G
      blocks, M-blocks, and poly-M. Our results indicate that beta 1-4-linked
      polyuronic acids and LPS may stimulate monocytes to produce TNF-alpha by similar
      mechanisms and may bind to a common receptor.

PMID- 8478082
TI  - Directional actin polymerization associated with spotted fever group Rickettsia
      infection of Vero cells.
AB  - Members of the spotted fever group (SFG) of rickettsiae spread rapidly from cell
      to cell by an unknown mechanism(s). Staining of Rickettsia rickettsii-infected
      Vero cells with rhodamine phalloidin demonstrated unique actin filaments
      associated with one pole of intracellular rickettsiae. F-actin tails greater than
      70 microns in length were seen extending from rickettsiae. Treatment of infected
      cells with chloramphenicol eliminated rickettsia-associated F-actin tails,
      suggesting that de novo protein synthesis of one or more rickettsial proteins is
      required for tail formation. Rickettsiae were coated with F-actin as early as 15
      min postinfection, and tail formation was detected by 30 min. A survey of
      virulent and avirulent species within the SFG rickettsiae demonstrated that all
      formed actin tails. Typhus group rickettsiae, which do not spread directly from
      cell to cell, lacked F-actin tails entirely or exhibited only very short tails.
      Transmission electron microscopy demonstrated fibrillar material in close
      association with R. rickettsii but not Rickettsia prowazekii. Biochemical
      evidence that actin polymerization plays a role in movement was provided by
      showing that transit of R. rickettsii from infected cells into the cell culture
      medium was inhibited by treatment of host cells with cytochalasin D. These data
      suggest that the cell-to-cell transmission of SFG rickettsiae may be aided by
      induction of actin polymerization in a fashion similar to that described for
      Shigella flexneri and Listeria monocytogenes.

PMID- 8478083
TI  - Analysis of Candida albicans adhesion to salivary mucin.
AB  - Clearance of Candida albicans from the oral cavity is thought to be mediated via
      specific receptor-ligand interactions between salivary constituents and the
      fungus. Since surfaces in the oral cavity are normally coated with a saliva
      derived pellicle, specific interactions between salivary constituents and C.
      albicans may also contribute to adhesion of C. albicans to the oral mucosa and
      dental prostheses. Therefore, the purpose of this study was to identify salivary
      constituents to which C. albicans is capable of binding. A solid-phase overlay
      assay was used in which electrophoretically separated rat and human salivary
      constituents bound to membrane filters were incubated with radiolabelled C.
      albicans cells. C. albicans adhered to a single salivary component from each
      host. Correlation of cell-binding activity with specific monoclonal antibody
      (MAb)-binding activity indicated that the constituent bound by C. albicans in
      human saliva was low-molecular-weight mucin (MG2) and that in rat saliva was rat
      submandibular gland (RSMG) mucin. Further studies showed an identical cell
      hybridization signal and MAb colocalization by using RSMG ductal saliva and an
      aqueous RSMG extract in the solid-phase overlay assay. Analysis of cell binding
      to the aqueous extract of RSMG fractionated by anion-exchange chromatography
      demonstrated that C. albicans binding was restricted to an acidic subfraction of
      the RSMG extract, which also bound the RSMG mucin-specific MAb. The Candida
      binding fraction contained predominantly RSMG mucin glycoprotein and also a
      noncovalently associated, chloroform-extractable material. Furthermore, we
      identified two strains of C. albicans which differed severalfold in the ability
      to bind RSMG mucin in the overlay assay. These results suggest that C. albicans
      binds to only a specific subfraction of RSMG mucin and that the two C. albicans
      strains tested differ in the ability to bind RSMG mucin subfractions.

PMID- 8478084
TI  - Evaluation of mixtures of purified Haemophilus influenzae outer membrane proteins
      in protection against challenge with nontypeable H. influenzae in the chinchilla
      otitis media model.
AB  - Nontypeable Haemophilus influenzae (NTHi) is one of the leading causative agents
      of bacterial otitis media, and no vaccine has been shown to be effective against
      it. Three outer membrane lipoproteins of NTHi have been investigated extensively
      and are leading candidates for inclusion in a vaccine against this organism. Hi
      PAL (P6), recombinant PCP (rPCP), and e (P4) proteins are antigenically conserved
      among NTHi strains and elicit bactericidal and protective antibodies. A genetic
      fusion of the rPCP and Hi-PAL proteins has also been reported. Mixtures of these
      proteins were used for active immunization experiments in the chinchilla model of
      otitis media. Chinchillas were immunized either with a mixture of all three
      lipoproteins or with the mixture of rPCP-PAL hybrid plus e protein. When these
      animals were challenged with a NTHi strain injected directly into the middle
      ears, no protection from infection or disease, as measured by otoscopy, was
      observed in either group. However, effusion and inflammation measured by
      tympanometry were significantly reduced in animals immunized with the three
      lipoproteins. Animals that had been immunized with either whole NTHi cells or
      total outer membranes and then challenged with the homologous strain were
      significantly protected from both infection and disease, as determined by
      tympanometry and otoscopy. Unlike other animals antisera, chinchilla antisera
      against the purified proteins had no bactericidal activity against NTHi but did
      fix complement on the cell surface. Thus, the chinchilla immune responses to
      mixtures of these lipoproteins differ from the immune responses observed in other
      animal species. Further evaluation of these proteins for their vaccine potential
      remains to be done.

PMID- 8478085
TI  - An approach to development of specific T-lymphocyte lines by use of preprocessed
      antigens in Plasmodium vinckei vinckei murine malaria.
AB  - The development of parasite-specific T-cell lines represents one approach to the
      potential identification of relevant immunogens in erythrocytic malarial
      infection. However, the use of parasitized-erythrocyte lysates as antigens
      inhibits the proliferation of T cells. To circumvent this problem, we
      preincubated antigen-presenting cells (APCs) from spleens of malaria-naive,
      BALB/c mice with a Plasmodium vinckei vinckei (hereafter referred to as P.
      vinckei)-parasitized erythrocyte lysate. APCs were subsequently irradiated and
      washed prior to being incubated with T lymphocytes from P. vinckei-immune,
      histocompatible mice. After 8 to 10 cycles of antigenic stimulation and rest, two
      T-cell lines were analyzed. Both lines were predominantly CD4+. Proliferation
      assays demonstrated marked lymphocyte blastogenesis to syngeneic but not
      allogeneic APCs that had preprocessed malarial antigen. Antigen incubated
      directly with T cells and nonpulsed APCs in vitro did not result in T-cell
      proliferation. Assays of interleukin-2 (IL-2), IL-4, IL-5, and gamma interferon
      were compatible with one cell line being predominantly TH1 and the other being
      TH2. Thus, APCs that have preprocessed malarial antigen and are free of
      extraneous parasite material induce highly reactive, antigen-specific, major
      histocompatibility complex-restricted T-cell lines that functionally appear
      capable of inducing humoral and/or cell-mediated immunity.

PMID- 8478087
TI  - Bacteria induce release of platelet-activating factor (PAF) from
      polymorphonuclear neutrophil granulocytes: possible role for PAF in pathogenesis
      of experimentally induced bacterial pneumonia.
AB  - The role of platelet-activating factor (PAF) as mediator of the endotoxin shock
      and endotoxin-dependent tissue injury has been examined. The ability of opsonized
      bacteria to stimulate the release of PAF from human polymorphonuclear neutrophil
      granulocytes was evaluated by measuring both the activity and the amount of the
      mediator released in the supernatant of the cell-bacteria reaction in vitro.
      There was no significant difference between gram-positive and gram-negative
      bacteria in the ability to release PAF from neutrophils. However, preincubation
      of the cells with the specific PAF receptor antagonist WEB 2170 decreased release
      of PAF from the cells. Furthermore, a possible protective effect of the PAF
      antagonist was examined during experimentally induced pneumonia with Klebsiella
      pneumoniae in NMRI mice. Oral treatment of mice with WEB 2170, followed by
      infection with the microorganisms, resulted in a considerable increase in the
      animals' survival (53 to 73%) compared with the control group (40%); this
      increase corresponded with a decrease in the CFU per gram of lung tissue. These
      findings indicate an important role of PAF in the pathogenesis of pneumonia in
      mice.

PMID- 8478086
TI  - Protective salivary immunoglobulin A responses against Streptococcus mutans
      infection after intranasal immunization with S. mutans antigen I/II coupled to
      the B subunit of cholera toxin.
AB  - The B subunit of cholera toxin (CTB) has been shown to augment mucosal responses
      to microbial virulence antigens, including those of Streptococcus mutans, which
      is the principal etiologic agent of dental caries. In the present study, the
      surface fibrillar protein antigen of S. mutans, antigen I/II (Ag I/II), was
      chemically coupled to CTB (Ag I/II-CTB), and the conjugate was examined for its
      effectiveness in inducing salivary immune responses protective against S. mutans
      infection. Weanling Fischer rats were given Ag I/II-CTB (50 micrograms) by the
      intranasal route and then orally infected with a virulent strain of S. mutans.
      Gnotobiotic or conventional rats were given two or three additional
      immunizations, respectively, at about 2-week intervals. One week after each
      immunization, individual serum, saliva, and fecal samples were collected and
      stored frozen until assayed for antibody activity to Ag I/II and cholera toxin
      (CT) by an enzyme-linked immunosorbent assay. The rats were sacrificed 1 week
      after the last immunization, when mandibles were also collected from individual
      rats for assessment of S. mutans levels in plaque and caries activity. Rats
      immunized only or both immunized and infected showed a salivary immunoglobulin A
      (IgA) anti-Ag I/II response which reached significantly (P < 0.05) higher levels
      than those seen in nonimmunized, infected controls. A salivary IgA anti-Ag I/II
      response was also seen in rats infected only with S. mutans. Essentially no
      salivary antibody activity to CT was detected. Some serum anti-Ag I/II and anti
      CT responses were seen in immunized animals. Serum IgG anti-Ag I/II responses
      were seen in immunized, infected rats and also in infected-only rats, suggesting
      that the responses were a result of infection with S. mutans. The immunized and
      infected rats had significantly (P < 0.05) lower levels of S. mutans in plaque
      and lower caries activity than nonimmunized, infected rats. These results
      indicated that intranasal immunization of rats with Ag I/II-CTB induced a
      protective salivary immune response which was associated with a reduction in S.
      mutans colonization and S. mutans-induced dental caries.

PMID- 8478088
TI  - Coaggregation of Prevotella intermedia with oral Actinomyces species.
AB  - Five strains of Prevotella intermedia were examined for their ability to
      coaggregate with various gram-positive and gram-negative species of oral
      bacteria. Two of the P. intermedia strains coaggregated with selected Actinomyces
      species, P. intermedia 27 with Actinomyces viscosus T14V and Actinomyces
      naeslundii ATCC 12104, PK606, PK984, and PK947, and P. intermedia 113 with
      Actinomyces odontolyticus WVU 1546 and Actinomyces israelii WVU 838. Exposure of
      both Prevotella strains but not the Actinomyces strains to heat, trypsin, or
      proteinase K abolished most coaggregations. All pairs were disaggregated by the
      addition of sodium dodecyl sulfate, but only those coaggregations involving P.
      intermedia 113 were reversed by the addition of 2.0 M urea. P. intermedia 27 was
      sensitive to periodate oxidation, whereas the partner strains were stable to this
      treatment. Most coaggregations occurred in the presence of saliva; however,
      reactions involving P. intermedia 27 were not as strong as those of buffer
      suspended cells. Treatment of both P. intermedia 113 coaggregations pairs with
      proteinase K and the results obtained from suspensions of these pairs in saliva
      suggest that different surface molecules of this P. intermedia strain may mediate
      each of these coaggregations. These data suggest that all of these coaggregations
      involve either a protein or glycoprotein on the Prevotella strain, which may
      interact with carbohydrates or carbohydrate-containing molecules on the surface
      of the Actinomyces strain.

PMID- 8478089
TI  - Rickettsial stimulation of endothelial platelet-activating factor synthesis.
AB  - Endothelial cells (EC) synthesize platelet-activating factor (PAF) when activated
      by agents such as ATP or thrombin, and PAF production occurs as a consequence of
      endothelial phospholipase A activity. Because interactions between Rickettsia
      prowazekii and a variety of host cells result in the expression of phospholipase
      A activity, we assessed the relative abilities of uninfected and rickettsia
      infected EC to synthesize PAF. Endothelial cells were infected with rickettsiae
      and examined at 24-h intervals for rickettsial multiplication, EC viability, and
      PAF synthesis. By 24 h postinfection, 80% of the EC were infected with an average
      of 10.6 rickettsiae per cell; by 72 h, the rickettsiae were too numerous to count
      and the numbers of viable EC began to decrease. Both rickettsia-infected and sham
      treated EC synthesized PAF when stimulated with either thrombin or ATP, but
      rickettsia-infected EC synthesized about three times as much PAF in response to
      cell activation as did their uninfected counterparts. Additionally, unlike their
      uninfected counterparts, rickettsia-infected EC synthesized significant amounts
      of PAF in the absence of cell activation; rickettsia-infected EC synthesized as
      much PAF in the absence of activation as did uninfected EC in response to ATP. In
      each case, essentially all of the newly synthesized PAF remained with the cell
      pellet. Finally, EC incubated with high numbers of rickettsiae (1,000 rickettsiae
      per EC) for 30 min synthesized more PAF when activated with ATP than did their
      sham-treated activated counterparts.

PMID- 8478090
TI  - Heterogeneity of the purified extracellular aspartyl proteinase from Candida
      albicans: characterization with monoclonal antibodies and N-terminal amino acid
      sequence analysis.
AB  - Three dominant proteins (41, 48, and 49 kDa) were detected by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in purified preparations of
      the extracellular aspartyl proteinase (AP) of Candida albicans. All three
      proteins bound to the specific carboxyl proteinase ligand, pepstatin A, and were
      associated with maximum AP activity. The N-terminal amino acid sequence for the
      48- and 49-kDa proteins matched that reported by others for AP, whereas the
      sequence for the 41-kDa protein was unique and was not homologous to any known
      protein. Time course studies demonstrated the simultaneous presence of all three
      proteins, supporting evidence that the 41- and 48-kDa proteins were not breakdown
      products of AP. Previous studies did not detect carbohydrate in SDS
      polyacrylamide gels of purified AP preparations stained with periodic acid and
      silver, making glycosylation an unlikely explanation for the observed differences
      in the molecular masses of the proteins. Some monoclonal antibodies directed
      against the 49-kDa protein reacted with the 41- and 48-kDa proteins, indicating
      cross-reactive epitopes. Other monoclonal antibodies, however, reacted only with
      the 49-kDa protein. We conclude that three pepstatin A-binding proteins occur in
      purified AP preparations: two have the same amino acid N terminus as that
      reported for AP, whereas the third has a unique sequence. All three proteins
      should be considered when undertaking studies to determine the role of AP in
      candidal pathogenesis or when preparing specific antibodies for antigen capture
      assays.

PMID- 8478091
TI  - A mouse model of Chlamydia pneumoniae strain TWAR pneumonitis.
AB  - Chlamydia pneumoniae is a common cause of acute respiratory infections in humans.
      We evaluated mice as experimental animals for C. pneumoniae. Intranasal
      inoculation of Swiss Webster mice with C. pneumoniae induced a prolonged course
      of lung infection, as demonstrated by reisolation of organisms from lungs (at 42
      days) and persistence of lung pathology (> 60 days). The lung pathology was
      characterized by patchy interstitial pneumonitis with predominantly
      polymorphonuclear leukocyte infiltration in the early and mononuclear cell
      infiltration in the later stages of infection. Inoculated mice developed serum
      immunoglobulin G antibody responses and partial resistance against rechallenge
      inoculation. The other mouse strains tested, Icr, BALB/cAnN, C57BL/6N, C3H/HeN,
      and B6C3F1, were shown to be susceptible to C. pneumoniae. The mouse model should
      be useful for investigating the immunopathogenesis of C. pneumoniae infections.

PMID- 8478092
TI  - Protective immunity induced in Aotus monkeys by a recombinant SERA protein of
      Plasmodium falciparum: adjuvant effects on induction of protective immunity.
AB  - We report the results of vaccination trial 2 of Panamanian Aotus monkeys with a
      recombinant blood-stage antigen, SERA 1, of the malaria parasite Plasmodium
      falciparum. Monkeys were immunized with SERA 1, a 262-amino-acid fragment (amino
      acids 24 to 285) of the 989-amino-acid SERA protein produced by the Honduras 1
      strain of the parasite. Immunization mixtures contained 100 micrograms of
      recombinant SERA 1 protein per dose mixed with one of five different adjuvants.
      The protein mixed with either Freund's adjuvant or MF75.2 adjuvant stimulated
      protective immunity. When other P. falciparum antigens were included in the SERA
      1-Freund's adjuvant mixture, no protective immunity was observed, although high
      anti-SERA 1 antibody titers were produced. Three other adjuvants mixed with SERA
      1 failed to induce a protective immune response. These results, their
      relationship to those reported previously in the first vaccination trial (trial
      1), and their relationships to the quantitative measurement of anti-SERA 1
      antibodies in enzyme-linked immunosorbent assays provided insights into the
      induction of a protective immune response in vaccinated monkeys.

PMID- 8478093
TI  - Protective immunity induced in Aotus monkeys by a recombinant SERA protein of
      Plasmodium falciparum: further studies using SERA 1 and MF75.2 adjuvant.
AB  - We describe the third of three vaccination trials of Panamanian Aotus monkeys
      with a recombinant blood-stage antigen derived from the malaria parasite
      Plasmodium falciparum. Immunization was performed with an N-terminal region of
      the SERA antigen (serine repeat antigen protein), SERA 1, that contains a 262
      amino-acid fragment including amino acids 24 to 285 of the 989-amino-acid SERA
      protein. Vaccinations were carried out with the recombinant protein mixed with
      either Freund's, MF75.2, or MF59.2 adjuvant. A control group that did not receive
      SERA 1 but only MF75.2 adjuvant was included. Monkeys vaccinated with the antigen
      MF59.2 mixture produced low anti-SERA 1 titers and were not protected. Monkeys
      vaccinated with antigen and Freund's adjuvant had, in general, a higher average
      anti-SERA 1 titer (107,278) than did monkeys immunized with SERA 1 and MF75.2
      (40, 143), yet monkeys in both groups were well protected. Monkeys that received
      only MF75.2 developed neither detectable anti-SERA 1 nor anti-P. falciparum
      antibodies prior to or 10 days after parasite challenge, yet were apparently
      protected against infection. Monkeys vaccinated with either SERA 1 and Freund's,
      SERA 1 and MF75.2, or MF75.2 alone and that had been challenged but did not
      develop a countable parasitemia were treated with a curative dose of mefloquine
      100 days after parasite challenge and then rechallenged 40 days later. None of
      the five rechallenged monkeys that had originally received SERA 1 and Freund's
      developed a countable parasitemia. Only one of five rechallenged monkeys that
      originally received SERA 1 and MF75.2 developed a high countable parasitemia,
      while two animals developed a barely countable parasitemia. Four of the
      rechallenged monkeys that had originally received only MF75.2 developed a
      moderate to high countable parasitemia. The results indicate that vaccination
      with SERA 1 and either Freund's or MF75.2 adjuvant provides protection and
      vaccination with MF75.2 alone can provide a temporary protection unrelated to the
      induction of anti-SERA 1 or antimalarial antibodies.

PMID- 8478094
TI  - Immunogenicity of Vibrio vulnificus capsular polysaccharides and polysaccharide
      protein conjugates.
AB  - Opaque colony morphology has been correlated to Vibrio vulnificus virulence.
      However, the number of capsular serotypes expressed by virulent isolates is
      unknown. In an effort to produce anticapsule sera, capsular polysaccharide (CPS)
      from three opaque V. vulnificus strains was purified and characterized. Purified
      CPSs were acidic and contained considerable amounts of hexosamine and trace
      quantities of protein and nucleic acid. CPS purified from strain C7184 was poorly
      immunogenic for rabbits and mice, since repeated injection produced little
      detectable anticapsular antibody. To improve immunogenicity, CPS-protein
      conjugates were prepared from adipic acid hydrazide derivatives of CPS purified
      from each strain and carbodiimide as a coupling reagent. The immunogenicity of
      C7184 CPS was enhanced by conjugation to keyhole limpet hemocyanin, since
      injection into mice elicited production of anticapsular antibodies, the level of
      which was dependent on the dose and time since initial immunization. Injection of
      rabbits with CPS-protein conjugates also produced anticapsular antibodies.
      Staphylococcus aureus cells armed with each of the three anticapsular antibodies
      coagglutinated only the homologous opaque strain, indicating the existence of at
      least three capsular types. Further screening of 32 opaque and translucent V.
      vulnificus isolates revealed only three cross-reacting strains. These results
      suggest the presence of numerous V. vulnificus capsular types.

PMID- 8478096
TI  - Evidence for two cell division cycle (CDC) genes that govern yeast bud emergence
      in the pathogenic fungus Wangiella dermatitidis.
AB  - Strains Mc2 and Mc3 are morphological mutants of the melanized, pathogenic fungus
      Wangiella dermatitidis. These strains possess temperature-sensitive (ts)
      mutations designated mcm2 and mcm3, respectively. At the restrictive temperature
      (37 degrees C), uninucleate yeast cells of strains Mc2 and Mc3 cease budding and
      initiate an isotropic mode of cellular development, which is reflected in the
      formation of a multicellular and multinucleate morphology. Because W.
      dermatitidis either lacks or has an undiscovered sexual cycle, parasexual methods
      of analysis were used to confirm that mcm2 and mcm3 define separate bud emergence
      control genes in the wild-type strain. Spheroplasts of albino auxotrophs derived
      from strains Mc2 and Mc3 were fused and then regenerated on minimal medium. The
      resulting fusion products grew as darkly pigmented, prototrophic colonies. When
      incubated at 37 degrees C, all fusion products exhibited polarized growth
      predominantly as uninucleate, budding yeasts and less frequently as pseudohyphae
      and moniliform hyphae. Subsequent analysis of cultures derived from albino, ts
      segregants, which were induced from fusion products by using methyl benzimidazole
      2-yl-carbamate, revealed three types of cell populations. Two resembled those
      expressed by strain Mc2 or Mc3. The third consisted of a cell population unlike
      the former, suggesting the presence of both ts mutations in all cells. These
      results imply that yeast development in the fusion products resulted from
      intergenic complementation of mcm2 and mcm3, i.e., they are nonallelic. Because
      mcm2 and mcm3 are equivalent to certain cdc lesions in the yeast Saccharomyces
      cerevisiae, we have renamed the analogous genes defined by the mutations in W.
      dermatitidis as CDC1 and CDC2. To our knowledge, these are the first CDC genes
      identified in a dematiaceous fungus.

PMID- 8478095
TI  - Staphylococcal enterotoxin type A internal deletion mutants: serological activity
      and induction of T-cell proliferation.
AB  - Previous findings indicate that the N-terminal region of staphylococcal
      enterotoxin type A (SEA) is required for its ability to induce T-cell
      proliferation. To better localize internal peptides of SEA that are important for
      induction of murine T-cell proliferation, SEA mutants that had internal deletions
      in their N-terminal third were constructed. A series of unique restriction enzyme
      sites were first engineered into sea; only one of these changes resulted in an
      amino acid substitution (the aspartic acid residue at position 60 of mature SEA
      was changed to a glycine [D60G]). Because the D60G substitution had no
      discernible effect on serological or biological activity, the sea allele encoding
      this mutant SEA was used to construct a panel of mutant SEAs lacking residues 3
      to 17, 19 to 23, 24 to 28, 29 to 49, 50 to 55, 56 to 59, 61 to 73, 68 to 74, or
      74 to 85. Recombinant plasmids with the desired mutations were constructed in
      Escherichia coli and transferred to Staphylococcus aureus. Staphylococcal culture
      supernatants containing the mutant SEAs were examined. Western immunoblot
      analysis with polyclonal anti-SEA antiserum revealed that each of the recombinant
      S. aureus strains produced a mutant SEA of the predicted size. All the mutant
      SEAs exhibited increased sensitivity to monkey stomach lavage fluid in vitro,
      which is consistent with these mutants having conformations unlike that of wild
      type SEA or the SEA D60G mutant. In general, deletion of internal peptides had a
      deleterious effect on the ability to induce T-cell proliferation; only SEA
      mutants lacking either residues 3 to 17 or 56 to 59 consistently produced a
      statistically significant increase in the incorporation of [3H]thymidine. In the
      course of this work, two monoclonal antibodies that had different requirements
      for binding to SEA in Western blots were identified. The epitope for one
      monoclonal antibody was contained within residues 108 to 230 of mature SEA.
      Binding of the other monoclonal antibody to SEA appeared to be dependent on the
      conformation of SEA.

PMID- 8478097
TI  - Oral immunization with Toxoplasma gondii antigens in association with cholera
      toxin induces enhanced protective and cell-mediated immunity in C57BL/6 mice.
AB  - Following oral immunization of C57BL/6 mice with a Toxoplasma gondii sonicate
      (TSo) in association with either cholera toxin (CT) or CT B subunit, the T.
      gondii-specific in vitro proliferation of splenic T lymphocytes was determined.
      Cytokines produced by these T cells were then characterized. After oral challenge
      with T. gondii 76K cysts, the percentage of cumulative survival was assessed, as
      was the number of brain cysts in the mice which survived. The TSo-specific
      proliferation of splenic T lymphocytes was greatly enhanced by the use of CT,
      whereas CT B subunit alone did not lead to amplification of splenic T-cell
      proliferation. The use of CT was associated with an increase of interleukin-2 (IL
      2) and gamma interferon synthesis by TSo-stimulated splenic T cells, whereas no
      enhancement of IL-5 and IL-6 production was observed. IL-4 was not detected. A
      significant protection of mice immunized orally with TSo plus CT was observed in
      comparison with those immunized with TSo alone. This protection was associated
      with a large decrease in the number of brain cysts compared with the number found
      in naive mice infected orally with a sublethal dose of T. gondii 76K cysts.
      Further studies, using well-defined T. gondii proteins which are known to induce
      both mucosal and systemic immune responses, are needed to confirm the value of CT
      in the enhancement of protection against oral toxoplasmosis.

PMID- 8478098
TI  - Molecular characterization of a leukotoxin gene from a Pasteurella haemolytica
      like organism, encoding a new member of the RTX toxin family.
AB  - A Pasteurella haemolytica-like organism, a new species of bacterium isolated from
      piglets with diarrhea, secretes a leukotoxin into the culture media. Western blot
      (immunoblot) analysis indicated that this leukotoxin cross-reacted with
      antileukotoxin antibody derived from cattle immunized with P. haemolytica. Five
      overlapping recombinant bacteriophages carrying the gene for this 105-kDa
      polypeptide were identified with a DNA probe containing sequences from the P.
      haemolytica lktCA genes from a P. haemolytica-like organism strain 5943 genomic
      library. Sequence analysis of a region of the cloned DNA revealed two open
      reading frames encoding proteins with predicted masses of 19.4 and 101.6 kDa.
      These genes, which we designate pllktC (P. haemolytica-like organism leukotoxin C
      gene) and pllktA (A gene), respectively, are similar in sequence to the RTX
      (repeat of toxin) toxin family. The structure of the 101.6-kDa protein derived
      from the DNA sequence shows three transmembrane domains in the N-terminal part of
      the protein, 13 glycine-rich repeat domains in the second half of the protein,
      and a hydrophobic C-terminal part. pllktC and pllktA are strongly homologous to
      P. haemolytica lktC and lktA genes. However, this leukotoxin kills both BL-3 and
      pig leukocytes and is not hemolytic.

PMID- 8478099
TI  - Nucleotide sequence analysis of the gtfT gene from Streptococcus sobrinus OMZ176.
AB  - The gtfT gene and its upstream region isolated from the Streptococcus sobrinus
      OMZ176 chromosomal DNA were sequenced. The gtfT gene was preceded by a potential
      Shine-Dalgarno sequence. The gtfT gene product, glucosyltransferase (GTF),
      displays a typical gram-positive bacterial signal peptide sequence and both an
      active site peptide sequence and carboxy-terminal repeats typical of GTFs. The
      signal sequence is similar to those of other known GTF proteins. The putative
      active-site peptide sequence of this enzyme was DGIRVDAVD, which was different by
      one amino acid from the active-site peptide sequence derived from two different
      types of the S. sobrinus GTFs reported previously (G. Mooser, S. A. Hefta, R. J.
      Paxton, J. E. Shively, and T. D. Lee, J. Biol. Chem. 266:8916-8922, 1991). The
      gtfT gene product has three repeated sequences of 51 to 52 amino acids and a
      partial repeat of 18 amino acids. Another open reading frame (ORF) was detected
      in the region immediately upstream of the gtfT gene. The upstream ORF showed
      substantial DNA homology with the gtfS gene isolated from Streptococcus downei
      MFe28. The inferred amino acid sequence of the upstream ORF has four repeating
      units and has extensive homology with the repeated peptides coded by the S.
      downei gtfS gene. These results suggested that the gtfT gene was a typical gtf
      gene isolated from the mutans streptococci and that the two gtf genes were
      located in tandem on the chromosomal DNA of S. sobrinus OMZ176.

PMID- 8478100
TI  - Borrelia burgdorferi infection and immunity in mice deficient in the fifth
      component of complement.
AB  - When immunocompetent mice are inoculated with Borrelia burgdorferi, they develop
      acute arthritis and carditis that undergo spontaneous regression despite the
      persistence of infection. Specific T- and/or B-cell immunity appears to be
      necessary for resolution of disease manifestations. Humoral immune responses to
      B. burgdorferi are also important in prevention of B. burgdorferi infection, in
      that passive transfer of immune sera or protective monoclonal antibodies prevents
      the spirochete from establishing infection. It has previously been suggested that
      complement is necessary for effective antibody-mediated host responses against B.
      burgdorferi. To investigate the role of complement in the pathogenesis and
      prevention of Lyme disease, we compared the responses to B. burgdorferi challenge
      inoculation of mice genetically deficient in the fifth component of complement
      (C5) with those of C5-sufficient mice. All C5-deficient strains tested were
      susceptible to B. burgdorferi infection, and disease manifestations underwent
      regression in a similar time-course to those of complement-sufficient mice.
      Moreover, passive immunization of C5-deficient mice with either immune rabbit
      sera or neutralizing monoclonal antibody protected them from challenge infection.
      These results demonstrate that the expression of Lyme disease is not altered in
      mice deficient in C5 and that C5-mediated complement activation is not necessary
      for antibody-mediated protection from infection.

PMID- 8478101
TI  - Dietary vitamin D affects cell-mediated hypersensitivity but not resistance to
      experimental pulmonary tuberculosis in guinea pigs.
AB  - Outbred, Hartley strain guinea pigs were fed purified diets varying only in their
      levels of vitamin D. The amounts of vitamin D in the diets were adjusted to
      represent 0, 25, 50, 100, or 200% of the recommended level (1,180 IU/kg of body
      weight) for guinea pigs. In some experiments, half of the animals in each diet
      group were vaccinated with Mycobacterium bovis BCG vaccine at the time the diets
      were introduced. Six weeks later, all guinea pigs were infected by the
      respiratory route with a low dose of virulent M. tuberculosis H37Rv. Vitamin D
      deficient animals exhibited marked reductions in levels of the major vitamin D
      metabolite, 25-hydroxyvitamin D3, in plasma. Altered vitamin D intake was
      accompanied by changes in antigen (purified protein derivative)-induced, cell
      mediated immune responses both in vivo (tuberculin hypersensitivity) and in vitro
      (lymphoproliferation). Dermal tuberculin reactivity developed more slowly in
      vitamin D-deficient guinea pigs but eventually achieved normal levels. The
      proliferation of splenocytes cultured with purified protein derivative was
      suppressed by both deficiency and excess of dietary vitamin D. Vitamin D status
      did not affect the abilities of naive guinea pigs to control primary, pulmonary
      tuberculosis, nor did it influence the protective efficacy of BCG vaccination. We
      conclude that changes in dietary vitamin D are associated with alterations in
      some cellular immune functions but may not be an important determinant of disease
      outcome in pulmonary tuberculosis, as has been suggested previously.

PMID- 8478102
TI  - Abrogation of suppression of delayed hypersensitivity induced by Candida albicans
      derived mannan by treatment with monophosphoryl lipid A.
AB  - Monophosphoryl lipid A (MLA), derived either from Salmonella minnesota or
      Salmonella typhimurium, was tested for its ability to alter Candida albicans
      mannan (MAN)-specific suppression. Since we showed previously that naive mice
      injected intravenously (i.v.) with MAN developed suppressor T cells capable of
      down-regulating delayed-type hypersensitivity when transferred to immunized
      recipients, MLA was tested for its ability to influence suppressor activity in
      the donors of suppressor cells. T-lymphocyte-enriched suspensions from donor mice
      treated with MLA, especially that derived from S. typhimurium, 2 or 3 days after
      the injection of MAN lost the ability to suppress delayed-type hypersensitivity
      when transferred to immunized mice. Transferable suppressor activity was reduced
      but not always completely abrogated when donor animals were treated with MLA 1
      day following the administration of MAN. In several experiments, S. minnesota MLA
      also abrogated activity, but it was not effective in other transfer experiments.
      In a different type of experiment, MLA was given to immunized mice which had been
      suppressed directly with MAN. Mice were immunized, either by the introduction of
      C. albicans intragastrically followed by inoculation intradermally (i.d.) or by
      two i.d. inoculations, and MAN-specific suppressor cells were induced in such
      animals by the i.v. injection of MAN 1 day before the first or second i.d.
      inoculation in animals given intragastric plus i.d. inoculations and those given
      two i.d. inoculations, respectively. MLA was administered to such mice prior to
      the i.v. injection of MAN, on the same day, or 1 to 4 days thereafter. S.
      typhimurium MLA, especially when given to mice 2 days following the
      administration of MAN, caused a partial abrogation of suppressor activity.
      Overall, however, MLA, at 5 to 100 micrograms, had variable and minimal effects
      on suppressor activity in immunized mice suppressed by the i.v. administration of
      MAN. In summary, MLA is clearly capable of abrogating MAN-induced suppression
      when given to nonimmunized animals in which MAN-specific suppressor cells had
      been induced, but its efficacy in immunized animals suppressed by the i.v.
      administration of MAN was marginal.

PMID- 8478103
TI  - Influence of some bacterial and host factors on colonization and invasiveness of
      Escherichia coli K1 in neonatal rats.
AB  - Of 209 healthy infants examined, 44 (21.1%) carried Escherichia coli K1 in their
      feces. Of these 44 isolates, 36 (81.8%) were attributed to 10 different known
      clonal groups of E. coli K1 and 4 isolates represented unknown types. The
      influence of mannose-resistant (MR) adhesins, aerobactin production, and
      resistance to serum on colonization and invasiveness of E. coli K1 in orally
      infected inbred LEW baby rats was investigated. Strains expressing MR adhesins
      had significantly higher colonization and invasion rates than non-MR strains did.
      Mixed-infection experiments of LEW rats revealed interactions between different
      types of E. coli K1 strains affecting colonization and invasion rats. P
      fimbriated strains appeared to have a selective advantage for colonization. The
      bacteremic potentials of different E. coli K1 strains could not be associated
      with their resistance to sera from LEW rats free of members of the family
      Enterobacteriaceae. No differences in virulence between fecal E. coli K1 isolates
      and clinical isolates from diseased humans were found. An influence of the major
      histocompatibility complex on host susceptibility to invasive E. coli K1 was
      indicated by comparing the parental LEW rat strain with different congenic LEW
      strains (RT1).

PMID- 8478104
TI  - Sequence and immunological characterization of a serine-rich antigen from
      Mycobacterium leprae.
AB  - Sera from lepromatous leprosy patients were used to screen a Mycobacterium leprae
      lambda gt11 library. Three positive plaques were picked, and lysogens were
      constructed. Immunoblot analysis showed that all of the lysogens expressed an
      apparently identical beta-galactosidase fusion protein which reacted strongly
      with the sera. The 1.7-kbp insert from one clone was subcloned into the lacZ gene
      in pUR290; sequence analysis of the end fused to lacZ revealed an open reading
      frame with no significant homology to previously published sequences. The insert
      was used to screen an M. leprae cosmid library, and five clones were isolated.
      The insert was also found to hybridize to clones expressing the M. leprae antigen
      which had previously been designated class III and 25L. A 1.8-kbp HindIII
      fragment was subcloned from one of the cosmids and sequenced. The sequence
      revealed a 1,227-bp open reading frame, encoding a 408-amino-acid protein with a
      predicted molecular mass of 42,466 Da. The protein contains amino- and carboxy
      terminal hydrophobic domains and a hydrophilic central domain; the amino-terminal
      domain shows some homology to a 51-kDa hypothetical antigen of Mycobacterium
      tuberculosis, while the hydrophilic region contains a high proportion of serine
      residues, and we have therefore designated the protein serine-rich antigen (Sra).
      Some repeated motifs are present in the protein, but their significance is
      unknown. Seventy-eight percent of serum samples from multibacillary leprosy
      patients and 68% of serum samples from paucibacillary leprosy patients recognized
      the fusion protein, showing that this is a major M. leprae antigen. In contrast,
      all serum samples from endemic controls were negative, while 26% of serum samples
      from tuberculosis patients were weakly positive.

PMID- 8478105
TI  - Listeria monocytogenes-induced gamma interferon secretion by intestinal
      intraepithelial gamma/delta T lymphocytes.
AB  - gamma/delta T cells represent a major proportion of intestinal intraepithelial
      lymphocytes (IEL), and it has been suggested that these IEL serve as a first
      immune barrier against microbial invasion and that they do so by destroying
      infected epithelial cells. In the present study, we confirm that both alpha/beta
      and gamma/delta IEL from naive mice express potent cytotoxicity and produce gamma
      interferon (IFN-gamma) after T-cell receptor (TCR) engagement by specific
      monoclonal antibodies (MAb). Intraperitoneal administration of the anti
      gamma/delta TCR MAb GL3 caused downregulation of the gamma/delta TCR in IEL, and
      IEL from gamma/delta TCR-modulated mice failed to express cytotoxic activity and
      to secrete IFN-gamma after gamma/delta TCR engagement. In contrast, alpha/beta
      IEL from such mice were still cytolytic and secreted IFN-gamma. Mice were
      infected orally with virulent Listeria monocytogenes at doses which caused
      bacterial invasion through the intestinal epithelia. Although alpha/beta and
      gamma/delta IEL from these mice expressed high cytolytic activities in antibody
      redirected killer assays, target cells pulsed with listerial antigens were not
      lysed. In contrast, IFN-gamma secretion by IEL from L. monocytogenes-infected
      mice was induced not only by anti-TCR MAb but also by target cells pulsed with
      listerial antigens, whereas irrelevant antigens, including heat shock protein 60,
      did not induce IFN-gamma secretion. Furthermore, the number of IFN-gamma
      secreting IEL, as assessed by the enzyme-linked immunospot technique, was
      increased during listeriosis. gamma/delta TCR modulation by GL3 administration
      abrogated antigen-induced IFN-gamma secretion by IEL from infected mice. These
      findings suggest that L. monocytogenes induced IFN-gamma secretion by gamma/delta
      IEL from mice suffering from intestinal L. monocytogenes infection and invasion.
      Thus, the data provide evidence for a role of IFN-gamma-secreting IEL in local
      resistance against listeriosis and perhaps other food-borne diseases.

PMID- 8478106
TI  - Immune response of the female rat genital tract after oral and local immunization
      with keyhole limpet hemocyanin conjugated to the cholera toxin B subunit.
AB  - The immune response of the female rat genital tract was evaluated with Lewis rats
      given primary and secondary immunizations with keyhole limpet hemocyanin (KLH)
      alone or coupled to the cholera toxin (CT) B subunit (CTB) by the oral or
      intravaginal-uterine route or a combination of routes. CT (2 to 5 micrograms) was
      administered as an adjuvant with the KLH-CTB conjugate. While a significant
      mucosal immunoglobulin A (IgA) response was induced by KLH, there were no
      significant differences among the immunized groups in the levels of IgA
      antibodies in salivary gland, gut, vaginal, and uterine secretions, with the
      exception that rats immunized only orally with the KLH-CTB conjugate lacked a
      detectable vaginal response. Levels of IgA antibodies to CT, however, were
      significantly increased in genital tract secretions of rats immunized locally
      versus orally with the KLH-CTB conjugate. Antibody activity of the IgG isotype
      against both KLH and CT was significantly elevated in genital tract secretions of
      rats immunized with KLH-CTB by the oral or intravaginal-uterine route and given
      genital tract boosters, in comparison with the results for the other groups. IgM
      antibody titers were generally negligible in the different secretions. An enzyme
      linked spot-forming assay revealed IgA and IgG antibody-secreting cells in
      salivary gland and uterine tissues. A highly significant correlation between the
      numbers of antibody-secreting cells and antibody titers existed for uterine IgG
      but not IgA responses to KLH among the different groups of rats. In conclusion, a
      vigorous local immune response was induced after immunization of the female rat
      reproductive tract alone or in combination with peroral challenge with the KLH
      CTB conjugate.

PMID- 8478107
TI  - An aromatic-dependent mutant of the fish pathogen Aeromonas salmonicida is
      attenuated in fish and is effective as a live vaccine against the salmonid
      disease furunculosis.
AB  - Aeromonas salmonicida is the etiological agent of furunculosis in salmonid fish.
      The disease is responsible for severe economic losses in intensively cultured
      salmon and trout. Bacterin vaccines provide inadequate protection against
      infection. We have constructed an aromatic-dependent mutant of A. salmonicida in
      order to investigate the possibility of an effective live-attenuated vaccine. The
      aroA gene of A. salmonicida was cloned in Escherichia coli, and the nucleotide
      sequence was determined. The codon usage pattern of aroA was found to be quite
      distinct from that of the vapA gene coding for the surface array protein layer (A
      layer). The aroA gene was inactivated by inserting a fragment expressing
      kanamycin resistance within the coding sequence. The aroA::Kar mutation was
      introduced into the chromosome of virulent A. salmonicida 644Rb and 640V2 by
      allele replacement by using a suicide plasmid delivery system. The aroA mutation
      did not revert at a detectable frequency (< 10(-11). The mutation resulted in
      attenuation when bacteria were injected intramuscularly into Atlantic salmon
      (Salmo salar L.). Introduction of the wild-type aroA gene into the A. salmonicida
      mutants on a broad-host-range plasmid restored virulence. A. salmonicida mutant
      644Rb aroA::Kar persisted in the kidney of brown trout (Salmo trutta L.) for 12
      days at 10 degrees C. Vaccination of brown trout with 10(7) CFU of A. salmonicida
      644Rb aroA by intraperitoneal injection resulted in a 253-fold increase in the
      50% lethal dose (LD50) compared with unvaccinated controls challenged with a
      virulent clinical isolate 9 weeks later. A second vaccination after 6 weeks
      increased the LD50 by a further 16-fold.

PMID- 8478108
TI  - Immunological and molecular polymorphisms of OspC, an immunodominant major outer
      surface protein of Borrelia burgdorferi.
AB  - The gene of the immunodominant major protein pC of Borrelia burgdorferi was
      previously cloned and sequenced (R. Fuchs, S. Jauris, F. Lottspeich, V. Preac
      Mursic, B. Wilske, and E. Soutschek, Mol. Microbiol. 6:503-509, 1992). pC is
      abundantly expressed on the outer surface of B. burgdorferi, as demonstrated by
      immunoelectron microscopy with monoclonal antibody L22 1F8. Accordingly, pC is
      renamed OspC, by analogy to the outer surface proteins OspA and OspB. Western
      immunoblot analysis of 45 B. burgdorferi isolates with monoclonal antibodies
      revealed that OspC is immunologically heterogeneous. Partial sequence analysis of
      the ospC gene confirmed the protein heterogeneity at the genetic level. We found
      that the degree of identity between the ospC partial sequences of five strains
      representing different OspA serotypes was only 63.3 to 85.4%. Immunological
      heterogeneity was also observed among representatives of the three newly
      designated genospecies of B. burgdorferi sensu lato, B. burgdorferi sensu
      stricto, B. garinii, and group VS461. Heterogeneity was confirmed for B. garinii
      at the genetic level. The ospC gene was also cloned from strains that did not
      express OspC, and antibody-reactive OspC was expressed in Escherichia coli. In
      addition, OspC-expressing variants were obtained from a nonexpressing strain by
      plating single colonies on solid medium. These findings confirm that the ospC
      gene is also present in nonexpressing strains. Because OspC is an immunodominant
      protein for the early immune response in Lyme borreliosis and was effective as a
      vaccine in an animal model, the immunological and molecular polymorphisms of ospC
      and OspC have important implications for the development of diagnostic reagents
      and vaccines.

PMID- 8478109
TI  - The cryptic ospC gene of Borrelia burgdorferi B31 is located on a circular
      plasmid.
AB  - Borrelia burgdorferi B31 cells lacking all linear plasmids or all but the 49-kb
      linear plasmid expressed the otherwise silent gene for the outer membrane protein
      OspC. In the first demonstration of a function for a circular plasmid of Borrelia
      spp., ospC was located on a 27-kb circular plasmid of B31.

PMID- 8478110
TI  - Cell-mediated immunity to Chlamydia pneumoniae measured as lymphocyte blast
      transformation in vitro.
AB  - The purpose of the present study was to analyze Chlamydia pneumoniae-induced,
      antigen-specific, cell-mediated immunity. Peripheral blood mononuclear cells of
      four persons infected with C. pneumoniae Kajaani 6 and 17 healthy volunteers were
      stimulated with antigen composed of whole elementary bodies of C. pneumoniae
      Kajaani 6 (CP-Ag). Definitive antigen-specific lymphoproliferation (LP) responses
      were developed after recent infection. The LP responses of healthy people to CP
      Ag varied considerably. There was no clear correlation between LP responses to CP
      Ag and those to an antigen prepared from Chlamydia trachomatis serotype L2 (r >
      or = 0.50, P < 0.1). A larger study is required to demonstrate whether the LP
      responses to CP-Ag can be used for the diagnosis of C. pneumoniae infection.

PMID- 8478111
TI  - Identification of eae sequences in enteropathogenic Escherichia coli strains from
      rabbits.
AB  - DNA sequences coding for attachment and for verotoxin production were
      investigated in a collection of enteropathogenic Escherichia coli strains from
      rabbits. All of the strains produced diarrhea after experimental infection,
      attached to the brush borders of the intestinal lining, and possessed homology to
      the eae probe, whereas strains isolated from healthy rabbits did not. Sequences
      homologous to the AF/R1 fimbriae of strain RDEC-1 were not found. One strain
      reacted with the probe for the Shiga-like toxin type I gene.

PMID- 8478112
TI  - Regulation of expression of major outer surface proteins in Borrelia burgdorferi.
AB  - We have characterized a Borrelia burgdorferi clone (CA-11 2A) that does not
      synthesize the major outer surface proteins, OspA and OspB. While the osp operon
      is intact and capable of expression, no mRNA transcript is detectable in this
      clone. These results suggest that osp operon expression in the B. burgdorferi
      clone can be regulated at the level of transcription.

PMID- 8478113
TI  - Biochemical and immunological properties of two forms of pertactin, the 69,000
      molecular-weight outer membrane protein of Bordetella pertussis.
AB  - Two apparent isoforms of the virulence-associated 69,000-molecular-weight protein
      pertactin were purified from Bordetella pertussis. Mass spectrometry showed a
      difference of 2,060 Da, which may result from differential C-terminal cleavage of
      a larger precursor. Both forms were protective in a mouse model, eliciting
      bactericidal antibodies and reducing respiratory tract colonization.

PMID- 8478114
TI  - Lipopolysaccharide restores anti-Candida albicans growth inhibition activity of
      polymorphonuclear neutrophils from retrovirus-immunosuppressed mice.
AB  - It has been documented that the immune function of leukocytes may be markedly
      suppressed after infection of mice with the murine retrovirus Friend leukemia
      virus (FLV). Antimicrobial activity of polymorphonuclear neutrophils (PMNs)
      against Candida albicans is impaired after retrovirus infection of mice, and this
      occurs as early as 3 days after infection of genetically susceptible BALB/c mice.
      By 2 weeks after infection, there was essentially very little growth inhibition
      of C. albicans by PMNs from the FLV-infected mice. However, when bacterial
      lipopolysaccharide (LPS), a known activator of macrophages and PMNs, was added to
      PMNs from the FLV-infected mice, anti-C. albicans activity was restored to normal
      levels. This restoration of anti-C. albicans activity of FLV-infected mouse PMNs
      was observed after stimulation with as little as 0.01 micrograms of LPS per ml.
      The data obtained show that the impaired antimicrobial function of PMNs from
      retrovirus-infected mice can be readily restored by a biological response
      modifier such as bacterial LPS.

PMID- 8478115
TI  - Arcobacter (Campylobacter) butzleri-associated diarrheal illness in a nonhuman
      primate population.
AB  - After DNA hybridization identified an isolate from an ill rhesus macaque (Macaca
      mulatta) as Arcobacter (Campylobacter) butzleri, we initiated a study to
      determine whether A. butzleri was associated with diarrheal disease in nonhuman
      primates at the Yerkes Primate Research Center. By using Campy-CVA medium
      incubated at 35 degrees C, 15 A. butzleri isolates were obtained from 14
      macaques; 7 macaques were coinfected with Campylobacter coli and Campylobacter
      jejuni. A. butzleri was not isolated from normal feces, despite the fact that
      feces from 76 macaques were cultured at necropsy. Histologic evaluation of
      colonic specimens from three macaques from which A. butzleri had been isolated
      showed mild to moderately severe chronic, active colitis. Ribotype analysis of
      the 15 A. butzleri isolates revealed nine different strains; these data suggest
      that A. butzleri may be endemic in this primate population and that a point
      source of infection is unlikely. This is the first report of the presence of A.
      butzleri in juvenile and adult macaques with diarrhea, and it may present an
      opportunity to study the pathogenesis of this organism, which appears to be
      associated with persistent diarrhea in humans.

PMID- 8478116
TI  - Isolation, expression, and nucleotide sequencing of the pilin structural gene of
      the Brazilian purpuric fever clone of Haemophilus influenzae biogroup aegyptius.
AB  - In this study we isolated the pilin gene from the Brazilian purpuric fever (BPF)
      clone of Haemophilus influenzae biogroup aegyptius, expressed the gene in
      Escherichia coli, and determined its nucleotide sequence. Comparison of the
      nucleotide sequence of the BPF pilin gene with the sequences of pilin genes from
      strains of H. influenzae sensu stricto demonstrated a high degree of identity.
      Consistent with this observation, hemagglutination inhibition studies performed
      with a series of glycoconjugates indicated that BPF pili and H. influenzae type b
      pili possess the same erythrocyte receptor specificity.

PMID- 8478117
TI  - Reversal of age-associated decline in immune response to Pnu-imune vaccine by
      supplementation with the steroid hormone dehydroepiandrosterone.
AB  - Recently, we reported that murine antibody responses to the 23-valent
      pneumococcal polysaccharide (Pnu-Imune) vaccine declined with age. Here we
      present data to support the concept that age-associated immune defects are not
      only due to intrinsic defects in immune cells but are also due to extrinsic
      factors emanating from the neuroendocrine system. We found that supplementation
      with dehydroepiandrosterone, a steroid hormone known to be reduced in the aged,
      corrects the immune deficiency of aged mice and significantly enhanced their
      splenic immune responses to the Pnu-Imune vaccine.

PMID- 8478118
TI  - Cutaneous leishmaniasis in mast cell-deficient W/Wv mice.
AB  - Genetically mast cell-deficient W/Wv mice infected with Leishmania amazonensis
      showed progressive development of ulcerative skin lesions. However, no
      significant differences between the W/Wv mice and the normal littermates with
      respect to size of the lesions, anti-Leishmania immunoglobulin E antibody, and
      the number of eosinophils accumulated in the lesions were observed.

PMID- 8478119
TI  - Characterization of an aromatic amino acid-dependent Listeria monocytogenes
      mutant: attenuation, persistence, and ability to induce protective immunity in
      mice.
AB  - A transposon insertion mutant of Listeria monocytogenes was shown to be deficient
      in prephenate dehydratase, an enzyme acting late in the pathway for biosynthesis
      of phenylalanine. This mutant had reduced virulence in mice. The mutant and
      parent strains persisted to the same extent in the tissues of infected mice and
      elicited similar degrees of splenomegaly. Mice vaccinated with the mutant were
      protected significantly from subsequent challenge with virulent L. monocytogenes.

PMID- 8478120
TI  - Identification and characterization of serotype 4-specific antigens of Ureaplasma
      urealyticum by use of monoclonal antibodies.
AB  - Monoclonal antibodies against Ureaplasma urealyticum serotype 4 were produced by
      immunizing BALB/c mice with whole-cell antigens of the U. urealyticum serotype 4
      reference strain. Ten monoclonal antibodies differentiated into two groups were
      found: one group included five monoclonal antibodies recognizing a band in
      immunoblotting that had a molecular mass of 81 kDa, and a second group included
      another five monoclonal antibodies recognizing three bands in immunoblotting that
      had molecular masses of 81, 75, and 71 kDa. Fifteen clinical U. urealyticum
      isolates were selected for serotyping with serotype 4-specific monoclonal
      antibodies and polyclonal antisera 1 to 14. The results obtained with polyclonal
      and monoclonal antibodies suggest the existence of heterogeneity of the serotype
      antigens among clinical isolates of U. urealyticum serotype 4.

PMID- 8478121
TI  - Antigenic analysis of the major outer membrane protein of Haemophilus somnus with
      monoclonal antibodies.
AB  - The major outer membrane protein of Haemophilus somnus possesses at least five
      distinct epitopes. Three surface-exposed epitopes on the major outer membrane
      protein include a conserved epitope with potential for development of a vaccine
      and a diagnostic test and two variable epitopes responsible for antigenic
      differences among strains; the remaining two epitopes are well preserved among
      strains but not exposed on the cell surface.

PMID- 8478122
TI  - TH1 and TH2 T-cell subsets are differentially activated by macrophages and B
      cells in murine leishmaniasis.
AB  - The role of antigen-presenting cells in the differential expansion of TH1 and TH2
      T cells in murine leishmaniasis was investigated. In general, macrophages
      preferentially induced gamma interferon and interleukin-2 secretion by syngeneic
      Leishmania-specific T cells, whereas B cells were more efficient in activating
      interleukin 4 production. B cells from susceptible BALB/c mice were better in
      inducing TH2 responses than B cells from resistant C57BL/6 mice, whereas
      macrophages from C57BL/6 mice were superior to BALB/c macrophages in inducing TH1
      responses.

PMID- 8478123
TI  - Chemotaxis of leptospires to hemoglobin in relation to virulence.
AB  - A guinea pig-lethal line of Leptospira interrogans serovar copenhageni strain
      Shibaura, but not an avirulent line of the same strain, moved in larger numbers
      toward hemoglobin than toward distilled water (control) in a U-shaped
      polypropylene tube. L. interrogans serovar lai strains 017 and KH-1, which were
      also guinea pig lethal, showed a similar move to hemoglobin. No such move toward
      hemoglobin was shown by 14 avirulent strains of L. interrogans (with one
      exception) or any of the 8 strains of L. biflexa tested.

PMID- 8478124
TI  - Overtreatment with restorative dentistry: when to intervene?
AB  - Traditional restorative dental treatment has many shortcomings and has not been
      shown to be an effective method for managing caries. In spite of this, many
      dentists continue to be powered by an aggressive restorative approach which may
      result in unnecessary treatment and which must now be seen as inappropriate.
      There is a pressing need for a greater understanding as to the precise criteria
      that dictate the need for both non-invasive (reversible) preventive measures and
      invasive (irreversible) restorative treatment. This paper examines these criteria
      and provides decision trees with respect to the clinical management of carious
      lesions and teeth with existing restorations, showing when, and what type of,
      intervention is required. The assessment and management of fissured tooth
      surfaces receives special attention. It is demonstrated that while many clinical
      situations warrant clinical intervention, often this should be entirely
      preventive and of a non-invasive type.

PMID- 8478125
TI  - Improving oral health through understanding the meaning of health and disease in
      a Chinese culture.
AB  - Advances in modern technology have undoubtedly been of benefit to dentistry in
      its preventive and curative activities for populations worldwide. Studies, mainly
      from Western societies, show nonetheless that utilisation of services or adoption
      of preventive methods are not taken up at satisfactory levels. The focus of this
      paper is on the special problems in a Chinese society where major differences
      exist between the traditional lay health concepts and the modernised professional
      ones. Traditional Chinese health concepts comprise the balance between and
      interaction of 'Yin' and 'Yang', the vital forces in both the universe and in
      man's body, as the basis for maintaining health. To restore a disturbed
      equilibrium of vital forces, which will manifest itself as disease, a range of
      dietary products are available in Hong Kong, for example cooling herb tea to
      reduce fire from the stomach producing gum disease. Seeking dental treatment from
      dentists could be delayed or made 'unnecessary' due to reliance on home remedies.
      This could reduce the effectiveness of any planned health education activities
      and dental services available for improving the oral health status of the
      community according to prevailing Western concepts. An understanding of the
      cultural meaning of dental disease is fundamental to changing beliefs and
      attitudes of people in order to improve the oral health of the community.

PMID- 8478126
TI  - Management of elderly patients in the private practice system.
AB  - The distribution of the world's population has resulted in a significant increase
      in both the number and percentage of older adults in the industrially developed
      countries. The ageing populations in these countries are tending to maintain
      natural teeth longer and so require preventive and restorative dental services as
      they age. The majority of these populations live in the community and are
      functionally independent while a much smaller minority have become frail. An even
      smaller minority are institutionalised, hospitalised or home-bound. The majority
      of those who live in the community can utilise the services of dentists working
      in their own private offices or government clinics provided dentists are
      sensitive to their needs.

PMID- 8478127
TI  - Needs for tooth replacement.
AB  - The prime objective of dental care is maintaining a natural functional dentition
      for life. It is expected that a growing group of adults will keep their dentition
      into old age. Although routine prosthodontic care will still be important in the
      future the treatment strategy for older adults and elderly people with a reduced
      dentition does require a different approach. The traditional approach in
      prosthetic therapy was guided primarily by morphological criteria aimed at
      preservation of complete dental arches, which resulted in emphasis on quantity in
      dental care. Nowadays requirements such as aesthetics and functional comfort are
      considered more important and more easily achieved. In the presented principles
      for treatment planning the importance of a thorough preliminary treatment is
      stressed. Furthermore, needs for tooth replacement are discussed and guidelines
      are given for a preventive prosthodontic treatment approach in severely broken
      down dentitions and edentulous patients.

PMID- 8478128
TI  - The application of the theoretical model WHO/FDI planning system to an
      industrialised country: France.
AB  - The results of the application of the WHO/FDI planning system to a specific
      situation in an industrialised country provide valid arguments in favour of its
      use. It is shown to be an aid to planners when estimating oral health personnel
      requirements and emphasises the necessity of obtaining basic information on the
      oral health status and demand for treatment in industrialised countries. The
      strength of the system lies in the fact that it enables the user to forecast
      requirements, by age cohort and by type of care, while at the same time including
      socio-economic variables which have a major influence in industrialised countries
      with moderate caries levels. This flexibility of use enables the system to be
      adapted, if necessary, or even improved, according to the constraints which may
      result from a specific situation analysis.

PMID- 8478129
TI  - Stomatological treatment of patients with artificial heart valves: coagulation
      control and antibiotic cover.

PMID- 8478130
TI  - Age and culture: influences on oral health behaviour.
AB  - The role of patient age and cultural background in predicting dental service
      utilisation and self-care behaviours is discussed in the context of a person
      environment model of oral health. This model suggests that dental behaviours are
      a function of patient characteristics such as age, gender, culture, perceived
      dental needs and health beliefs, as well as characteristics of the dental
      delivery system such as cost, availability of third party payment systems and the
      accessibility of dentists who are viewed by patients as understanding and
      sympathetic to their needs. Each of these elements of person and environment is
      reviewed, with examples of research that has found associations between them and
      consequent dental behaviours.

PMID- 8478131
TI  - Caries prevention--a continuing need.
AB  - The frequently iterated, optimistic view of the demise of caries is not supported
      by the epidemiologic data. What is in evidence is a changing pattern of caries in
      developed countries. Among the young there is a polarisation in prevalence with
      20 per cent of the children experiencing 70 per cent of the decay. The ageing
      population is at increasing risk because of longer tooth retention and exposure
      of root surfaces. A realistic view would envision control rather than extinction
      of caries with enhancement of current methods of combating tooth decay and more
      effective employment of multiple anticaries strategies.

PMID- 8478132
TI  - Role of Ca-P-F in caries prevention: chemical aspects.
AB  - The fluoride agents used in caries prevention can be divided into two broad
      categories: systemic and topical, although this division is not exempt from
      ambiguities. A review is given of the efficacy of systemic (fluoridated water and
      supplements) and topical agents. The latter include high concentration (12,000
      ppm F) solutions, fluoridated dentifrices and mouthrinses. Emphasis is placed on
      the concept that there is no unique mode of action of the fluoride agents; their
      beneficial effects are related to different mechanisms depending on the agent and
      the mode of usage. Chemical models are advanced to explain the effect of the
      various agents. Of particular interest is the chemistry involved with dentifrices
      containing dicalcium phosphate dihydrate. It is shown that the presence of this
      compound greatly enhances fluoride utilisation in in vitro systems simulating the
      oral environment.

PMID- 8478133
TI  - In vivo studies with a dicalcium phosphate dihydrate/MFP system for caries
      prevention.
AB  - Recent basic studies have shown that increasing supersaturation with respect to
      dicalcium phosphate dihydrate (DCPD), above and beyond the amount present in
      saliva, enhanced the efficacy of fluoride in vitro. Since the combination of
      monofluorophosphate (MFP) with DCPD abrasive is unique for fluoride stability,
      dentifrices containing the combination were evaluated in a variety of in vivo
      tests. MFP with silicon dioxide (silica) abrasive at an equivalent fluoride
      concentration was used for comparison. The influence of slurries of DCPD or
      silicon dioxide on the intraoral plaque pH was measured following sucrose
      challenge in humans. The data indicated that DCPD slurries were more effective
      than silica in preventing plaque pH drop when compared to silica. A toothpaste
      containing MFP and DCPD was significantly more effective than an MFP/silica
      toothpaste. A toothpaste containing radiolabeled DCPD was applied topically in
      rats' teeth during a cariogenic challenge. The results showed that calcium45 was
      incorporated into the enamel with a concomitant reduction in enamel solubility.
      In a rat caries study using MFP/DCPD, matching placebo and MFP/silica, MFP/DCPD
      dentifrice showed a significantly greater reduction in smooth surface caries. Two
      dentifrices were also tested in an in situ human model for fluoride uptake in
      artificial root caries lesions where MFP/DCPD provided a significantly higher
      fluoride uptake than MFP/silica. A second in situ study in humans evaluated the
      same dentifrices. MFP/DCPD increased salivary plaque calcium and fluoride. These
      results of laboratory, animal and in situ studies taken together indicate that
      the MFP/DCPD combination is unique in providing extra supersaturation in saliva
      and plaque with concomitant enhanced anticaries efficacy.

PMID- 8478134
TI  - Clinical studies on MFP/calcium containing abrasive.
AB  - Monofluorophosphate (MFP) is unique in that its calcium salt is relatively
      soluble. Because of this property MFP can be combined with a dicalcium dihydrate
      (dical) abrasive in a dentifrice formulation without loss of efficacy. It has
      been reported that fluoride uptake by artificial lesions in enamel and dentine is
      significantly greater from an MFP formulation containing dical than from an
      equivalent calcium-free formulation. Additionally, it has been shown in an in
      situ remineralisation study that brushing with MFP dical significantly increases
      the levels of fluoride and calcium in plaque, and produces a concomitant increase
      in remineralisation of artificial caries lesions, as compared to brushing with
      MFP silica. All of the foregoing suggests that dical may enhance the benefit of
      MFP in a dentifrice formulation. MFP dentifrices have been tested more
      exhaustively in human clinical trials than any other form of fluoride dentifrice.
      In some trials the test formulation contained dical while in others a non-calcium
      abrasive system was employed. Collectively, studies of F/dical formulations have
      not produced more impressive results than studies of calcium-free MFP agents.
      However, there has never been a direct comparison of the conventional 0.76 per
      cent sodium monofluorophosphate dentifrice in a dicalcium phosphate abrasive
      system with a dentifrice containing a similar level of MFP combined with a non
      calcium containing abrasive. In the closest approximation to such a study, an
      MFP/NaF dentifrice with a dical abrasive was compared to an MFP/NaF dentifrice
      with a silica abrasive system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478135
TI  - Age distribution of histologic types of breast carcinoma.
AB  - The large number of cases in the Surveillance, Epidemiology and End Results
      (SEER) program of the US National Cancer Institute allowed a detailed analysis of
      the age distribution of the histologic types of invasive breast carcinoma.
      Between ages 50 and 85 years in females, the age-specific incidence rate shows
      little change for medullary, inflammatory and apocrine carcinomas; is about
      doubled for Paget's disease and for ductal, lobular, tubular and metaplastic
      carcinomas; and increases to 4 to 8 times the menopausal level for mucinous,
      papillary and signet-ring-cell carcinomas. The peri-menopausal break on the age
      incidence curve is most marked for carcinomas of predominantly lobular origin and
      virtually absent for carcinomas of predominantly ductal origin. In males, the age
      distribution of papillary carcinoma is similar to that of all types combined,
      whereas that of mucinous carcinoma is skewed towards older ages, as in females.

PMID- 8478136
TI  - 12(S)-HETE promotes tumor-cell adhesion by increasing surface expression of alpha
      V beta 3 integrins on endothelial cells.
AB  - The present work was undertaken to investigate the regulatory role of 12(S)-HETE,
      a lipoxygenase metabolite of arachidonic acid, in the surface expression of alpha
      v beta 3 integrin receptors in endothelial cells (rat aortic endothelial cells,
      or RAEC). Several monoclonal and polyclonal antibodies localized alpha v beta 3
      in focal adhesions in both subconfluent and post-confluent RAEC. RAEC alpha v
      beta 3 integrins were further characterized by immunoblotting and
      immunoprecipitation. 12(S)-HETE, but not 12(R)-HETE or other lipoxygenase-derived
      hydroxy fatty acids, induced a dose-dependent increase in alpha v beta 3 surface
      expression in RAEC, which was antagonized by prostacyclin or its analog iloprost
      as well as by 13-HODE, a 15-lipoxygenase product of linoleic acid. 12(S)-HETE
      promoted RAEC adhesion to vitronectin, an effect inhibited by antibodies against
      alpha v beta 3. 12(S)-HETE also promoted tumor-cell (W256 carcinosarcoma)
      adhesion to vitronectin, which was inhibited by various antibodies against alpha
      IIb beta 3 but not by an antibody against alpha v. W256 adhesion to 12(S)-HETE
      treated RAEC demonstrated a significant increase, which was inhibited by anti
      alpha v, -beta 3, or -alpha v beta 3 antibodies and by 13-HODE. Western blotting,
      immunoprecipitation and reverse transcription-polymerase chain reaction indicated
      that W256 carcinosarcoma cells expressed alpha IIb beta 3 integrins but not alpha
      v beta 3. The results suggest that the lipoxygenase metabolites [i.e., 12(S)-HETE
      and 13-HODE] play a significant role in modulating tumor-cell interactions with
      endothelium by enhancing endothelial cell integrin (e.g., alpha v beta 3)
      expression.

PMID- 8478137
TI  - Proliferation, migration and invasion of human glioma cells exposed to antifolate
      drugs.
AB  - The present study describes the effects of 2 folate antagonists, methotrexate
      (MTX) and the lipophilic antifolate trimetrexate (TMX) on 2 permanent human
      glioma cell lines (GaMg and D-54Mg) grown as monolayers and as multicellular
      tumor spheroids. In addition, the effects of drug exposure on tumor cell invasion
      was studied using a three-dimensional organ co-culture system. In monolayer
      cultures, TMX was a more potent inhibitor of cell growth than MTX, especially
      towards the GaMg cell line. The 2 drugs, however, showed similar cytotoxicity as
      assessed by the plating efficiency assay. Reduced ability of directional
      migration of cells on a plastic surface was seen by either antifolate usually at
      concentrations to 10-fold higher than those exerting a cytotoxic effect in the
      plating efficiency assay. TMX was somewhat more potent than MTX as an inhibitor
      of spheroid growth. When tumor spheroids were exposed to MTX or TMX at
      concentrations that caused 65 to 70% inhibition of cell migration, there was a
      latent period of 4 to 5 days before inhibition of spheroid growth ensued.
      Invasion was investigated in a co-culture system, where tumor spheroids were
      confronted with fetal rat brain cell aggregates. Neither drug reduced tumor cell
      invasion, although histological examination revealed toxic effects both in GaMg
      and in D-54Mg spheroids. We conclude that spheroids from human glioma cells were
      less sensitive to the antifolates than monolayers. For both drugs a latency
      period was observed before inhibition of spheroid growth. The spheroids retained
      their ability to invade normal brain tissue when exposed to levels of folate
      antagonists inhibiting spheroid growth.

PMID- 8478138
TI  - Estrone sulfate promotes human breast cancer cell replication and nuclear uptake
      of estradiol in MCF-7 cell cultures.
AB  - Estradiol levels in breast tumors from post-menopausal women are similar to those
      in pre-menopausal women even though plasma estrogens are much lower after the
      menopause. In situ estrogen production by the tumor provides a potential means of
      maintaining high estradiol levels in post-menopausal breast cancer tissue. The
      estrone sulfatase pathway has been proposed as the mediator of in situ estrogen
      production. A number of studies suggest that estrone sulfate may be converted
      into estradiol in breast tumors via the catalytic activity of estrone sulfatase
      and 17 beta-hydroxysteroid dehydrogenase. However, these studies used
      pharmacologic levels of estrogen sulfates and have not shown that physiologic
      levels can support biologic effects. Accordingly, the present study examined the
      dose relationship of estrone sulfate to a variety of biologic endpoints in MCF-7
      breast cancer cells in culture. These cells converted physiologic concentrations
      of estrone sulfate to quantities of free estradiol capable of stimulating cell
      growth. Under these conditions, the nuclear steroids observed were free estrone
      and estradiol. Increase in cell number after 6 days of exposure to steroid
      required 100 nM estrone sulfate. However, S-phase, a more sensitive measure of
      cell proliferation, was stimulated by 0.1 nM estrone sulfate, a clearly
      physiologic concentration. Stimulation of estrogen-dependent protein markers such
      as pS2 and progesterone receptor required much higher concentrations of estrone
      sulfate. These effects were mediated through the estrogen receptor since the pure
      anti-estrogen, ICI 164384, blocked all effects produced by estrone sulfate. While
      it has been suggested that anti-estrogens may partly exert their effects by
      inhibition of sulfatase and 17 beta-hydroxysteroid dehydrogenase, this did not
      occur under our experimental conditions. These data provide evidence of the
      relevance of the estrone sulfatase pathway since biologic effects can be
      demonstrated in response to physiologic concentrations of estrone sulfate.

PMID- 8478139
TI  - TGF-beta induces an inhibitory effect of normal cells directed against
      transformed cells.
AB  - Co-cultivation of normal and transformed fibroblasts in the presence of
      exogenously added transforming growth factor type beta I (TGF-beta I) leads to a
      drastic reduction of colony-forming transformed cells. This inhibitory effect is
      dependent both on the dose of TGF-beta applied and the density of normal cells.
      It does not reflect a direct action of TGF-beta on transformed cells, but is
      rather induced by TGF-beta in normal cells. In the absence of exogenously added
      TGF-beta, normal cells exhibit a basal inhibitory activity, which can be
      abrogated by anti-TGF-beta. TGF-beta-mediated inhibition of transformed cells by
      normal cells may be considered as a novel potent controlling step in
      carcinogenesis.

PMID- 8478140
TI  - Abrogation of tumor-inhibitory MRC-OX8+ (CD8+) effector T-cell generation in rats
      by selective depletion of neutrophils in vivo using a monoclonal antibody.
AB  - These studies were designed to examine the role of neutrophils in transplantation
      immunity to syngeneic rat tumors. We have earlier reported that specific
      transplantation immunity to syngeneic transplanted tumors is abrogated by
      selective depletion of peripheral-blood neutrophils by administration of a
      monoclonal antibody (MAb) (RP-3) at the time of immunization with X-irradiated
      tumor cells. In order to elucidate the mechanisms of this phenomenon, we have now
      examined whether induction of the sensitized spleen cells that inhibit the growth
      of tumor cells is inhibited by RP-3 treatment at the time of in vivo priming with
      tumor-associated antigen (TAA). Neutrophils were required to induce the
      sensitized T cells responsible for tumor inhibition with Winn's assay. In
      addition, CD8+ T cells are proved to be effector cells in an assay system of
      tumor-growth inhibition using a diffusion chamber. Our results indicate that
      neutrophils are required for priming rats with TAA to induce CD8+ effector T
      cells in tumor inhibition.

PMID- 8478141
TI  - N-terminal peptide fragments of lipocortin-1 inhibit A549 cell growth and block
      EGF-induced stimulation of proliferation.
AB  - Lipocortin-1 mediates growth inhibition of glucocorticoids in A549 cells by
      suppressing the release of PGE2 necessary for their proliferation. We now show
      that 2 peptide fragments derived from the N-terminal portion of lipocortin-1
      corresponding to amino-acids 13-25 and 21-33 also inhibited A549 cell growth and
      suppressed release of PGE2, whereas peptides 1-12 and 13-25 (Phe21; in which the
      tyrosine at position 21 was replaced by a phenylalanine residue) were inactive.
      Similarly, peptide 21-33 (Phe21) and a scrambled sequence of 13-25 failed to
      inhibit cell growth. Moreover, the EGF-induced stimulation of cell proliferation
      and PGE2 release in these cells was blocked by peptides 13-25 and 21-33, and also
      by peptides 1-12, 13-25 (Phe21) and 21-33 (Phe21), but not by a scrambled
      sequence of peptide 13-25.

PMID- 8478142
TI  - Spontaneous and induced differentiation of human melanoma cells.
AB  - Malignant melanoma cells can differentiate spontaneously in vivo and in vitro
      into cells with a finite lifespan. Analysis of differentiating cells from primary
      melanomas in culture revealed a flat, fibroblast-like morphology and expression
      of the fibroblast-associated marker leucine aminopeptidase (LAP). Differentiation
      was also observed in a minor sub-population of permanent cell lines derived from
      metastatic lesions. An experimental model of melanoma cell differentiation was
      then developed, using the pyrimidine analog bromodeoxyuridine (BUdR). BUdR
      treated cells had a flat morphology, were contact-inhibited, had up to 20-fold
      increased surface area, expressed LAP, no longer proliferated anchorage
      independently in soft agar, and 3 out of 4 cell lines were non-tumorigenic in
      athymic nude mice. Our results show that models of differentiation of melanoma
      cells can be established that help to define pathways of differentiation.

PMID- 8478143
TI  - Potentiation of DNA-adduct formation and cytotoxicity of platinum-containing
      drugs by low pH.
AB  - The low interstitial pH of tumor tissue is an important modulator of various anti
      tumor modalities. In order to explore the optimal conditions for the potentiating
      action of low pH on the cytotoxic activities of cis- and carboplatin, we have
      investigated the temporal aspects of drug activity and pH modulation in L1210
      murine leukemia cells in comparison with various other drugs. Extra- and intra
      cellular pH of L1210 cells was modulated before, during and after drug exposure
      and survival of L1210 cells was determined. During short exposures, cytotoxicity
      of cisplatin and alkylating drugs was potentiated by conditions of low pH in the
      ranking order of: cisplatin, mitomycin C, melphalan and chlorambucil. Low pH had
      no effect on the cytotoxic activity of carboplatin and cytosine arabinoside and
      it inhibited the action of doxorubicin. During prolonged incubation at low pH,
      potentiation of cisplatin was increased and a more than 3-fold potentiation was
      induced in the case of carboplatin. Part of the latter effect was also manifested
      by 20 hr post-incubation in drug-free medium at low pH after a 4-hr exposure to
      carboplatin. Post-incubation did not increase the stimulating effect of low pH on
      the cytotoxic activity of melphalan and cisplatin. Acidification affected neither
      the uptake nor the extracellular hydrolysis of platinum-containing drugs. Under
      all circumstances, potentiation of platinum-containing drugs was accompanied by
      an increase in platinum-induced DNA modification, as detected by
      immunocytochemistry.

PMID- 8478144
TI  - Calcium intake and 28-year gastro-intestinal cancer mortality in Dutch civil
      servants.
AB  - The association between calcium intake and gastrointestinal cancer mortality was
      investigated in a 28-year follow-up study. Data were obtained from a general
      health examination in 1953-1954 among Dutch civil servants and their spouses,
      aged 40 to 65 years. Information from 2,591 participants was used for this study.
      Risk analyses were performed using logistic regression models with the highest
      quintile of calcium intake as reference. No statistically significant relation
      between calcium intake and gastrointestinal cancer mortality is observed,
      although the risk estimate for women with the lowest calcium intake is
      substantial. Odds ratios (OR) were adjusted for age, energy intake and dietary
      fiber. After inclusion of other potential confounders to the models (body-mass
      index and smoking habits), the results hardly differed. Both men and women who
      died of colorectal cancer had a lower mean calcium intake compared to the rest of
      the population. For women this was statistically significant. Our results suggest
      that a low calcium intake may be related to gastrointestinal cancer mortality
      among women of this study population.

PMID- 8478145
TI  - Cancer in Kampala, Uganda, in 1989-91: changes in incidence in the era of AIDS.
AB  - Re-establishment of the cancer registry in Kyadondo County, Uganda, has allowed
      estimation of incidence rates for the period September 1989 to December 1991. The
      results are compared with earlier data from the same area, and from other African
      cancer registries. The most striking feature is the emergence of Kaposi's sarcoma
      as the leading cancer in males (almost half of all registered cases) and the
      second most frequent (17.9%) in females. This parallels the evolution of the
      epidemic of AIDS. There were also marked increases in the incidence of both
      oesophageal and prostatic carcinoma, while the incidence of cancer of the penis
      and the urinary bladder declined, possibly as a result of improved standards of
      hygiene. In females, the incidence of cancer of the cervix has more than doubled
      since the 1950s, and is now among the highest recorded in the African continent.

PMID- 8478146
TI  - Expression of the neuroglandular antigen and analogues in melanoma. CD9
      expression appears inversely related to metastatic potential of melanoma.
AB  - Immunohistological methods were used to examine the relation between the
      metastatic potential of melanoma and expression of the neuroglandular antigen
      (CD63) and other members of this family of molecules, CD53, CD37, CD9 and the
      target of an anti-proliferative antibody (TAPA-I), as well as MHC-class-I and -II
      antigens. The criteria used to establish metastatic potential were their relation
      to thickness of the primary melanoma, and differences in expression between
      vertical and radial growth phases of primary melanoma and between primary and
      metastatic melanoma. Studies on basal-cell carcinoma (BCC) and squamous-cell
      carcinoma (SCC) were also included as controls for malignant skin cancers with
      low metastatic potential. Expression of CD9 and MHC-class-I antigen was found to
      be inversely related to thickness of the primary tumor, and CD9 was expressed
      predominantly on primary rather than on metastatic tumors. CD9 expression
      correlated with MHC-class-I expression on melanoma, and both were expressed on
      BCCs and SCCs having low metastatic potential, but not on compound nevi. CD63 and
      TAPA-I were expressed on nevi but not on SCC and BCC. Leu 13 is a molecule
      associated with TAPA-I in lymphomas, and was found to be expressed in sections
      from 5 out of 34 primary and 5 out of 21 metastatic melanoma. CD53 and CD37 were
      not detected on melanoma. Our results indicate that several members of the
      neuroglandular antigen are expressed in melanoma and that low expression of CD9
      on primary melanomas might have prognostic significance with respect to the
      potential for metastasis.

PMID- 8478147
TI  - Expression of P-cadherin in gastric carcinomas and its reduction in tumor
      progression.
AB  - The expression of P-cadherin, one of the Ca(2+)-dependent cell-cell adhesion
      molecules, in human gastric carcinomas was examined by Northern blotting, Western
      blotting and immunohistochemistry. P-cadherin mRNA was expressed in all the
      gastric carcinoma tissues examined, whereas no message was detected in non
      neoplastic mucosa. By Western-blot analysis, P-cadherin protein was expressed in
      83% and 29% of the well-differentiated and poorly differentiated gastric
      adenocarcinomas, respectively, the incidence being significantly different.
      Immunohistochemically, P-cadherin immunoreactivity was localized on the cell
      surface or the cell-to-cell borders of well-differentiated adenocarcinomas. P
      cadherin was not detected in Borrmann's type-4 or scirrhous carcinomas where the
      tumor cells proliferate diffusely with productive fibrosis. The level of P
      cadherin expression in stage-2 carcinomas was significantly higher than in stage
      I carcinomas. In the case of patients in stages 2 to 4, however, the level of P
      cadherin expression decreased as the stage progressed, the difference between
      stages 2 and 3 and between stages 3 and 4 being significant. Our findings suggest
      that P-cadherin might play an important role in the development of well
      differentiated gastric adenocarcinomas and the decreased expression of P-cadherin
      might be responsible for the infiltrative growth and progression of gastric
      carcinomas.

PMID- 8478148
TI  - Analysis of T-cell-receptor variable gene segment usage in peripheral-blood
      lymphocytes of advanced cancer patients.
AB  - Advanced cancer patients generally display impaired T-cell immune functions. The
      underlying mechanisms are not well understood. The aim of this study was to
      analyze whether major alterations of TCR variable gene segment usage could be
      detected in the blood of these patients. Seventeen individuals with various
      malignancies were tested using PCR and a panel of V-gene-segment-sub-family
      specific (V alpha 1-w29/V beta 1-w24) oligonucleotide primers. The results
      indicate that these cancer patient lymphocytes expressed most V alpha and V beta
      sub-family specificities, similarly to the lymphocytes of healthy donors (n =
      10). This suggests that immunodepression in advanced cancer patients is not
      related to major deletions in their T-cell repertoires. We also compared the mean
      relative expression of each V-sub-family specificity of patients and healthy
      donors by quantitative densitometric analysis. We found significant differences
      in 4 V beta specificities (and no V alpha). Our analysis identified unique T-cell
      sub-sets putatively involved in the mechanisms leading to immunodepression in
      advanced cancer patients. Alternatively, the observed differences in terms of V
      beta specificity expression may reflect the host response against the tumor.

PMID- 8478149
TI  - Integrin expression in cutaneous malignant melanoma: association of the alpha
      3/beta 1 heterodimer with tumor progression.
AB  - The cell-surface heterodimers of the integrin family of molecules, which mediate
      cell-cell and cell-substratum interactions, are likely to be functionally
      relevant in local and metastatic tumor growth. In the present study we have
      analyzed whether the alpha 3/beta 1 receptor for collagen, laminin and
      fibronectin undergoes changes in expression during tumor progression in cutaneous
      malignant melanoma (CMM). The results of this study have demonstrated that, while
      low levels of VLA3 expression are detectable in benign lesions, in primary
      melanomas the heterodimer undergoes progressive increase in expression which
      correlates with the degree of dermal invasiveness. Metastatic lesions were found
      VLA3 positive in 82% of cases. Furthermore, the heterodimer is homogeneously
      expressed in multiple autologous metastases. The presence of VLA3 correlates with
      detection of at least one of the ligands in 45% of the cases studied. These
      findings provide additional evidence that tumor progression in CMM is associated
      with changes in integrin phenotypes which include the alpha 3/beta 1 heterodimer.

PMID- 8478150
TI  - Breast cancer risk in mothers of multiple births.
AB  - Data from an international case-control study of breast cancer that was conducted
      in the 1960s were used to examine whether multiple births affect the risk of
      breast cancer in the mother. Among 2821 parous breast-cancer patients, 88 had had
      one or more multiple births, whereas among 8882 controls 247 had had one or more
      multiple births; the logistic-regression-adjusted odds ratio (OR) was 1.21, the
      95% confidence interval (CI), 0.94 to 1.55. The OR was significantly elevated
      during the 15-year period following the latest multiple birth (1.76; CI, 1.12 to
      2.75), but declined toward the null afterwards. A late first pregnancy imparted a
      substantially higher breast-cancer risk when it was multiple rather than
      singleton; the OR was 2.34 for a multiple and 1.48 for a singleton first
      pregnancy when the cutoff point was 30 years, and 4.58 and 1.57, respectively,
      when the cutoff point was 35 years. Since multiple pregnancies are characterized
      by higher levels of pregnancy estrogens, the results of this study would be
      compatible with the hypothesis that these hormones may be responsible for the
      transient increase in breast-cancer risk following a term pregnancy and, in
      particular, a multiple term pregnancy. The long-term reduction of breast-cancer
      risk is probably due to a different mechanism, most likely the terminal
      differentiation of susceptible mammary-gland cells.

PMID- 8478151
TI  - Studies on the role of platelet eicosanoid metabolism and integrin alpha IIb beta
      3 in tumor-cell-induced platelet aggregation.
AB  - Platelet eicosanoid metabolism resulting from tumor-cell-induced platelet
      aggregation (TCIPA) was examined in a homologous in vitro system. Rat Walker 256
      carcinosarcoma cells induced the aggregation of rat platelets via a thrombin
      dependent mechanism with concomitant production of eicosanoid metabolites (e.g.,
      12-HETE, TXA2). TCIPA was dependent on the concentration of tumor cells inducing
      aggregation, as well as cyclooxygenase and lipoxygenase products. Cyclooxygenase
      inhibitors, but not lipoxygenase inhibitors, blocked platelet aggregation induced
      in vitro by a low concentration of agonist. At a high agonist concentration,
      neither cyclooxygenase nor lipoxygenase inhibitors alone affected platelet
      aggregation; however, the combined inhibition of both the cyclooxygenase and
      lipoxygenase pathways resulted in subsequent inhibition of platelet aggregation
      regardless of agonist concentration. The extent of platelet TXA2 and 12-HETE
      biosynthesis was likewise dependent on and correlated with agonist concentration.
      The inhibitors used in this study did not significantly inhibit protein kinase C
      activity at the doses tested. Platelet surface glycoprotein alpha IIb beta 3 play
      an important role in platelet aggregation. The effect of platelet cyclooxygenase
      and lipoxygenase inhibition in regulating alpha IIb beta 3 surface expression was
      examined by flow cytometric analysis. Thrombin stimulation of washed rat
      platelets resulted in significantly increased surface expression of platelet
      alpha IIb beta 3 integrin complex. The enhanced surface expression was not
      inhibited by a cyclooxygenase inhibitor (aspirin), a thromboxane synthase
      inhibitor (CGS-14854) or a thromboxane receptor antagonist (SQ 29,548), nor was
      it stimulated by a thromboxane A2 mimic (pinane-thromboxane A2). However, alpha
      IIb beta 3 expression was blocked by lipoxygenase inhibition and
      stereospecifically increased by the platelet lipoxygenase metabolite 12(S)-HETE.
      These results suggest that both the platelet lipoxygenase and cyclooxygenase
      pathways are important for TCIPA but that different mechanisms of action are
      involved.

PMID- 8478152
TI  - We need a guerrilla war on drugs.

PMID- 8478153
TI  - The "rainbow" model: an attempt at a global approach to the drug problem.
AB  - A global, tridimensional, and comprehensive model for the drug problem is
      presented. On a flat matrix with five components (growing, production,
      processing, traffic/distribution, and consumption) and seven dimensions
      (individual, family, restricted group, neighborhood, city/region, national, and
      international), six different perspectives are employed (psychobiological,
      social/political, economics, legal, historical/cultural, and geographical). Each
      psychoactive substance may be analyzed separately.

PMID- 8478154
TI  - Personality and cigarette smoking in Italy, Poland, and the United States.
AB  - This study reports data on over 700 young adults, undergraduate and medical
      students attending the University of Vermont, the University of Rome, and the
      Warsaw Medical Academy. Each subject provided information about cigarette smoking
      history and completed several personality, Type A, and life events inventories.
      Subjects were classified as nonsmoker, ex-smoker, and smoker. Each measure was
      analyzed by ANOVA on this basis, with gender and country as additional main
      effects. Smokers were found to have higher state anxiety, a lower lie score, and
      were more Type A than ex-smokers and nonsmokers, but they tended to report fewer
      life events and of lower value.

PMID- 8478155
TI  - Substance misuse and comorbid psychopathology in a high-risk group: a study of
      siblings of cocaine misusers.
AB  - Vulnerability to drug misuse and psychopathology was explored among 673 siblings
      of 298 opioid-addicted probands. Disorders were evaluated based on family history
      information obtained from the proband. Results indicated that (1) siblings of
      cocaine misusers showed high vulnerability to developing drug misuse, alcoholism,
      and antisocial personality disorder; (2) siblings of probands with specific
      comorbid diagnoses were vulnerable to developing a range of disorders (no
      specificity of aggregation was found); (3) proband major depression was related
      to a broad spectrum of sibling disorders; (4) the presence of a major psychiatric
      disorder was strongly associated with substance misuse among siblings; (5)
      psychopathology appeared to precede drug misuse in terms of age of onset. These
      findings corroborate those previously obtained with siblings of opioid addicts,
      and they are discussed in terms of implications for the classification and
      treatment of substance misuse.

PMID- 8478156
TI  - Psychosocial correlates of drug use among Latino youth leading autonomous lives.
AB  - Drug use and psychosocial profile of young Central American immigrants in
      Washington, D.C., were compared to the National Household Survey of Latinos. The
      immigrants showed: (1) more exposure to alcohol and illicit drugs; (2)
      interrelated marijuana, cocaine, PCP, and hallucinogenic drug use; and (3) a
      positive association between psychosocial competency and ratio of perceived
      supports/threats. Drug involvement intensity was negatively associated with
      psychosocial competence and positively with instrumental drug use, CAGE scores,
      and problems. Crisis scores and drug involvement were related only in the high
      support/threat group. Supportive environments may be more effective than threats
      in preventing drug use.

PMID- 8478157
TI  - Alcohol use, depressive symptoms, and cultural characteristics in two Mexican
      American samples.
AB  - We modeled associations of quantity and frequency of alcohol use with depressive
      symptoms (negative affect, lack of positive affect, somatic disturbance,
      interpersonal problems) in two household surveys of Mexican-Americans (Ns = 1,313
      and 3,577). Multivariate analyses controlled cultural (immigration,
      acculturation) and demographic (age, income, household size, marital status,
      employment status) characteristics, and assessed interactions of these two
      classes of predictors. Alcohol use was inconsistently related to depression. In
      some analyses, cultural characteristics accounted for associations of alcohol use
      with depression. In others, associations of alcohol use with depression depended
      on cultural characteristics. Associations of drinking with depression tended not
      to be robust across samples.

PMID- 8478158
TI  - Personality characteristics of adult children of alcoholics, other adults from
      dysfunctional families, and adults from nondysfunctional families.
AB  - This study used the California Psychological Inventory (CPI) to examine the
      personality characteristics of adult children of alcoholics. The sample was
      noncollege age adults (N = 174). Subjects responding to advertisements were
      grouped into Adult Children of Alcoholics (ACOA) (56%), Adults with Dysfunctional
      Family Histories (ADFH) (21%), or Adults without Identified Dysfunctional Family
      Histories (AIDFH) (23%). Results indicated that the ACOA group was different from
      the AIDFH group on nine of the 28 CPI scales, but there were no significant
      differences between the ACOA and ADFH groups. The validity of clinical
      impressions of ACOAs and the utility of considering ACOAs as a distinct field of
      study are discussed.

PMID- 8478159
TI  - Depression and anxiety among Afro-Caribbean general practice attenders in
      Britain.
AB  - Schizophrenia is diagnosed more frequently among Afro-Caribbeans in Britain than
      among white British controls. Studies among the general population indicate that
      non-psychotic disorders such as anxiety, depression and functional somatic
      symptoms are the commonest expression of psychiatric morbidity. Yet, among Afro
      Caribbean primary care attenders, rates of anxiety and depression appear lower
      than in the general population. This finding is at odds with the reportedly
      higher rates of schizophrenia among this group. The majority of authors favour
      socio-cultural explanations to account for the higher rates of schizophrenia. Yet
      many of the factors that are evoked to account for the greater incidence of
      schizophrenia would be expected to lead to higher rates of non-psychotic
      disorders in primary care settings. Possible explanations for these apparently
      contradictory findings are discussed.

PMID- 8478160
TI  - Comparison of adaptation to the home culture of Japanese children and adolescents
      returned from overseas sojourn.
AB  - A questionnaire based on the MMPI was administered to Japanese children aged
      between 6 and 18 years who had returned from an overseas sojourn of more than one
      year's duration (N = 1941) and a matched control group who had no overseas
      experiences (N = 1354). Overall females had more difficulty with friends, and
      scored higher on both psychological and physical symptoms. The older children had
      more complaints about life in Japan, difficulty with friends and physical and
      psychological problems. The differences between the returnee and control group
      were less in the age range between 7 and 9, but the overseas experience seemed to
      have positive effects between the ages of 10 to 15. The longer the children
      stayed overseas, the more they had complaints about life in Japan and difficulty
      with friends, and less negative attitudes towards overseas life. Children who had
      multiple overseas experiences had more problems such as anxiety, depression and
      mental complaints. Children's developmental stages and the amount of exposure to
      the foreign culture are therefore important determinants of their readjustment.
      The expectations of parents and the home culture to the returnee children,
      gender, and emphasis on academic achievement, must also be taken into account.

PMID- 8478161
TI  - Gender, generational and social support correlates of mental health in Asian
      immigrants.
AB  - A sample of 100 Asian immigrants, mainly from India and Pakistan, were
      interviewed in their native language (Urdu, Punjabi, Hindi or English) concerning
      their psychological adjustment to life in Britain. It was predicted that female
      Indo-Pakistan immigrants would have higher levels of psychological symptomatology
      than male immigrants; and that second generation immigrants would have higher
      levels of psychological symptomatology than the first generation immigrants did
      not have higher levels of psychological symptoms than the first generation
      immigrants. Social support networks of the subjects were not correlated with
      mental health. However for the two generations, there was evidence linking social
      support to mental health. The extent of acculturisation, as measured by
      identificational assimilation, was not correlated with mental health. Results are
      discussed in terms of the burgeoning literature in this field.

PMID- 8478162
TI  - Coping with adversity: testing the origins of resiliency in mental health.
AB  - This paper examines the multi-dimensional nature of resiliency to risk in mental
      health, and tests regression models of differential resiliency, based on two
      hospital-based clinical research projects. The first project involves adult
      children of problem drinkers, individuals who are at greater risk to alcohol
      abuse given their parents' pathology. The second involves schizophrenics
      diagnosed with varying dispositions to depression. The analyses reveal that for
      both adult children of problem drinkers and for schizophrenics, individuals have
      varying degrees of susceptibility to adversity and that these variations are
      based, to a large degree, on psychosocial concerns. Furthermore, the results show
      quite clearly that men and women suffer to varying degrees when exposed to the
      same kinds of adversity, and that the causal origins of resiliency are different
      for men and women.

PMID- 8478163
TI  - Exploring the feasibility of assessing perceived parental rearing styles in
      Spanish children with the EMBU.
AB  - Most of the available data on the dimensional structure underlying the EMBU--an
      originally Swedish measure designed to assess one's recollections concerning
      one's parents' rearing behaviour--has been obtained with adults or adolescents.
      In the present study, using exploratory factor analysis, an attempt was made to
      determine the EMBU factorial structure in a Spanish sample of children aged 7-12
      years (N = 205). Four factors explaining only 24% and 25% of the total variance
      in the ratings of the fathers and those of the mothers, respectively, and being
      invariant across parental sex, were interpreted: Emotional Warmth, Rejection,
      Control Attempts, and Favouring Subject. Results with respect to the internal
      consistency reliability of the corresponding scales were satisfactory, as were
      homogeneity figures pertaining to each set of theoretically-related items. Higher
      order analyses of the first-order dimensions (mothers and fathers jointly)
      revealed three factors explaining 85% of the total variance. Control Attempts,
      Care (Rejection vs. Emotional Warmth), and Favouring Subject. The factorially
      derived (first-order) scales were uncorrelated with sex of the recipient. All
      scales (except Rejection) correlated sizeably, negatively, with age (medium
      effect size) pointing, as outlined, to the need to take into account the relevant
      normative, design and research implications in further investigation. Some
      similarities and differences with findings yielded previously with adults and
      adolescents are briefly pinpointed.

PMID- 8478164
TI  - A comparison of Type A behaviour pattern, hostility and Typus Melancholicus in
      Japanese and American students: effects of defensiveness.
AB  - A comparison of Type A behaviour pattern, hostility and Typus Melancholicus (TM)
      was examined in a sample of 228 Japanese and 121 American college students. It
      was found that: the Japanese students expressed Type A, especially hostility,
      less strongly than American ones; TM was seen to the same degree in both Japanese
      and American students; Type A was related to hostility and TM in both groups of
      students; and compared with American students, the Japanese students displayed
      the defensiveness more frequently, and there appeared to be a strong relationship
      between defensiveness and hostility. These results suggest the possibility that
      hostility, a component element of Type A, is manifested under the influence of
      defensiveness, which is partially related to a variety of different sociocultural
      contexts.

PMID- 8478165
TI  - Suicidal behaviour in people infected with human immunodeficiency virus: a
      literature review.
AB  - Suicidal acts seem to be more frequent in AIDS patients than in the general
      population: nevertheless, the interpretation of these findings remains uncertain,
      because an increased risk of suicide has been found in some groups at risk of HIV
      infection (homosexuals, i.v. drug users) irrespective of the presence of HIV
      infection. The lack of adequate registration of causes of death in mortality
      statistics, the difficulty of identifying AIDS cases, and the lack of appropriate
      reference populations in the majority of register-based studies and post-mortem
      investigations are the main methodological problems in this research area.

PMID- 8478166
TI  - Freud's influence on American political science.
AB  - In an effort to assess which of Sigmund Freud's theories have had an influence on
      political scientists in the United States, the author conducted a survey of the
      American Political Science Association. The results of the survey showed that two
      concepts, the concepts of repression and the unconscious, were deemed most useful
      for political analysis and/or teaching. This paper traces the origins and
      infusion of these two constructs into American political thought.

PMID- 8478167
TI  - A perceptually based method for enhancing pulmonary nodule recognition.
AB  - RATIONALE AND OBJECTIVES: Feedback of chest areas receiving prolonged gaze
      durations significantly increases nodule detection performance. Why feedback
      circling enhances performance when other cueing methods produce equivocal results
      was assessed. METHODS: Chest and noise images with nodule targets were used to
      determine: what type of cue is most effective; whether circling influences the
      way the eye samples the target; whether circling limits processing of distracting
      information outside its boundary. RESULTS: Circling improves performance more
      than cues with less complete boundaries and increases the accuracy and frequency
      with which nodules are fixated. Outside distractors were detected less often with
      than without the circle present. CONCLUSIONS: Circling isolates the abnormal
      region from the rest of the image, making disembedding and integration of nodule
      features more likely and insulates this region from distractors. The facilitative
      effects of circling are generalizable to other images in which low contrast
      targets are embedded in noisy backgrounds.

PMID- 8478168
TI  - Sonographic image degradation after barium enema.
AB  - RATIONALE AND OBJECTIVES: The authors previously showed that barium does not
      interfere with abdominal sonography performed after a biphasic upper
      gastrointestinal tract examination. This study was designed to assess the impact
      of a barium enema (BE) examination on the quality of abdominal sonography
      performed immediately after the barium enema. METHODS: Forty patients scheduled
      for routine barium enemas (22 air contrast and 18 solid column) were
      prospectively examined with abdominal sonography before and after their BEs. The
      resulting 80 sonograms were randomized; three radiologists blindly assessed the
      quality of images of each of six anatomic areas (aorta, pancreas, porta hepatis,
      gallbladder, and the right and left lobes of the liver). RESULTS: There was no
      statistically significant degradation of the images for the right and left lobes
      of the liver and the pancreas. However, the images for the gallbladder, porta
      hepatis, and aorta had a statistically significant (P < .05) degradation of their
      ultrasound quality following barium enema. CONCLUSIONS: Unlike upper
      gastrointestinal tract examination, BE examination does interfere with the
      quality of a subsequent abdominal ultrasonography. Thus, when both studies are
      required, sonography should be performed first.

PMID- 8478169
TI  - Fatty infiltration of the liver. Quantification by 1H localized magnetic
      resonance spectroscopy and comparison with computed tomography.
AB  - RATIONALE AND OBJECTIVES: The authors evaluated the degree of fatty infiltration
      of the liver in subjects with diffuse liver steatosis using image-guided 1H
      localized MR spectroscopy and correlated the magnetic resonance (MR)-determined
      fat fraction with the computed tomography (CT) liver/spleen density ratio and
      histologic evaluation. METHODS: MR measurements were performed at 1.5 T by
      applying a double-spin-echo localization sequence. Twenty-six patients underwent
      MR and CT examinations and ultrasound (US)-guided biopsy. Additionally, three
      healthy volunteers underwent MR examination. Steatosis severity was estimated
      using 1) the ratio between fat and total MR signal areas; 2) the ratio between
      liver and spleen CT number; and 3) histologic score. RESULTS: The linear
      correlation between MR fat/fat-plus-water signal ratio and CT liver/spleen
      density values ratio is statistically significant. Both techniques correlate well
      with histologic score. No significant correlation exists between water or fat T2
      values and the severity of steatosis. CONCLUSIONS: 1H MR spectroscopy allows a
      noninvasive estimate of the hepatic fat content.

PMID- 8478170
TI  - Patient choice and nonionic contrast media.
AB  - RATIONALE AND OBJECTIVES: Because of the greatly increased cost of nonionic, low
      osmolar contrast material, some practitioners reserve its use for patients at
      high risk for an adverse contrast reaction. The authors attempt to evaluate the
      proportion of low-risk outpatients--when offered a choice between the more
      expensive but lower-risk nonionic and the cheaper but higher-risk conventional
      ionic contrast material--that would choose the nonionic media. METHODS: Two
      hundred and fifty consecutive outpatients awaiting contrast-enhanced computed
      tomography were included in this study. Patients at increased risk for a contrast
      reaction were excluded. The remaining 162 patients were informed of the risks and
      told of the availability of nonionic contrast media with its up to six-fold
      decrease in serious complications. They were also informed that if they chose the
      lower-risk nonionic agent, they would likely have to pay the additional $100 to
      $150 in cost. RESULTS: Of the 162 low-risk patients surveyed, 48% selected
      nonionic contrast media, and 63% believed that all patients should be informed of
      the risks of contrast material and of the availability of nonionic contrast.
      CONCLUSIONS: The data support providing patients at low risk for an adverse
      reaction informed consent about the relative risks of ionic and nonionic contrast
      material.

PMID- 8478171
TI  - Effects of ioversol versus iothalamate on endothelin release and radiocontrast
      nephropathy.
AB  - RATIONALE AND OBJECTIVES: Certain radiocontrast agents, including iothalamate,
      iohexol, and ioxaglate, release the renal vasoconstrictor peptide endothelin from
      vascular endothelium in a way that might contribute to radiocontrast nephropathy.
      The effects of the nonionic, low osmolar agent, ioversol, on endothelin release
      and renal function are investigated. METHODS: Effects of ioversol were compared
      with equi-iodine doses of iothalamate when applied to cultured bovine aortic
      endothelial cells or injected into normal rats and rats preconditioned by
      uninephrectomy, salt depletion, and indomethacin (USIC) to develop radiocontrast
      nephropathy. RESULTS: In comparison with iothalamate, ioversol had a greatly
      reduced propensity to stimulate the release of endothelin, from cultured cells
      and when injected into anesthetized rats. Ioversol produced less renal
      vasoconstriction than did iothalamate, in control and in USIC rats, and the
      development of radiocontrast nephropathy, assessed by creatinine clearance and
      morphologic damage to the renal medulla, was largely avoided. CONCLUSIONS: These
      results strengthen the hypothesis that endothelin release induced by
      radiocontrast agents is correlated with their renal toxicity and therefore, may
      play a role in radiocontrast nephropathy.

PMID- 8478172
TI  - Renal tubular effects of diuretics and X-ray contrast media. A comparative study
      of equimolar doses in healthy volunteers.
AB  - RATIONALE AND OBJECTIVES: The isotonic nonionic contrast medium iodixanol has
      been shown to increase urinary enzyme excretion less than the hypertonic contrast
      medium iopentol. The authors investigated whether this could be caused by
      different molar loads using enzyme excretion after diuretic administration as a
      model. METHODS: Matching molar doses of mannitol were given to two groups of 10
      healthy volunteers. Furosemide was administered perorally to a third group of 10
      persons. Urinary enzyme excretion was sequentially measured, and the results were
      compared to our previous findings after contrast-media administration. RESULTS:
      Equimolar doses of mannitol and contrast media (CM) induced similar changes in
      urine volume and free water clearance. Mannitol and furosemide increased the
      urinary excretion of N-acetyl-beta-glucosaminidase (NAG) and alkaline phosphatase
      (ALP) in the period 0 to 4 hours after administration, i.e. during peak diuresis,
      whereas both CM increased ALP significantly more, their effects still evident at
      24 to 48 hours. Iodixanol had no effect on urinary NAG excretion, but iopentol
      increased NAG more than did mannitol. CONCLUSIONS: The early effect of CM on
      urinary enzyme excretion can be related, in part, to the increased diuresis, but
      the late effect apparent at 24 to 48 hours cannot be explained by the osmotic
      load of the CM.

PMID- 8478173
TI  - Comparison of different perfluorocarbons as ultrasound contrast agents.
AB  - RATIONALE AND OBJECTIVES: The sonographic properties of Fluosol 20% (F20), which
      was recently approved for clinical use as an oxygen carrier for coronary
      angioplasty, were compared to those of perflubron emulsion, which is still in
      clinical testing. METHODS: Contrast agents were evaluated in 21 normal rabbits
      divided into three groups of seven rabbits each. All rabbits received 2.7 g/kg of
      perfluorocarbon (PFC). One group received 2.7 ml/kg of an experimental
      formulation of perflubron emulsion AF0102, which contains 1 g of PFC in 1 ml of
      emulsion (P100), the other received 13.5 ml/kg of F20 (1 ml has 0.2 g of PFC),
      and the third received 13.5 ml/kg of P100 diluted to a 20% concentration (P20).
      All rabbits were scanned by a blinded sonographer before, during, and immediately
      after infusion, and then again at 30 minutes and 48 hours. Doppler enhancement,
      echogenicity of inferior vena cava lumen, echogenic enhancement of perfused
      tissues, and reticuloendothelial organs were assessed. RESULTS: P100 and P20 had
      nearly identical sonographic properties at all points. During their vascular
      phase they enhanced Doppler signal, filled the lumen of the IVC and hepatic veins
      with flowing echogenic reflectors, and enhanced perfused tissues. F20 had no
      detectable sonographic effect during its vascular phase. All three emulsions
      enhanced the liver relative to kidney to a similar degree at 48 hours.
      CONCLUSIONS: Because RE enhancement was similar for F20, P100, and P20, and
      because P100 and P20 had similar properties during the vascular phase, the lack
      of vascular effect of F20 could not be due to the different PFCs used in these
      agents, or due to the difference in the dilution or volume. The most likely cause
      for the observed sonographic behavior of F20 and P100 is the difference in
      emulsion formulation.

PMID- 8478174
TI  - Methods for mitigating soft-tissue injury after subcutaneous injection of water
      soluble contrast media.
AB  - RATIONALE AND OBJECTIVES: Water soluble contrast media may cause tissue injury by
      extravasation during intravenous injection during various radiologic
      examinations. The authors attempted to find out what kind of management could
      mitigate tissue injury when extravasation of water soluble contrast media occurs.
      METHODS: Sodium and meglumine ioxithalamate was injected subcutaneously into 240
      hind feet of 120 rats that were divided into six groups according to the methods
      of experimental management. Experimental managements included the following: no
      further management (control), injection of distilled water, injection of normal
      saline, injection of hydrocortisone, hot water application, and cold water
      application. Gross morphologic changes in each group were compared with those in
      the control group. RESULTS: Only the saline injection group showed statistically
      significant decrease of tissue injury compared with the control group.
      CONCLUSIONS: Saline injection lessens the degree of soft-tissue injury at
      contrast media extravasation sites in rats.

PMID- 8478175
TI  - Magnetic resonance imaging after arterial portography with manganese dipyridoxal
      diphosphate.
AB  - RATIONALE AND OBJECTIVES: The authors assess performing hepatic magnetic
      resonance imaging (MRI) after arterial portography with manganese dipyridoxal
      diphosphate (MnD-PDP), a hepatobiliary contrast agent, as an invasive but
      potentially highly sensitive means of focal lesion detection. METHODS: Eight pigs
      underwent superior mesenteric artery catheterization and injection of 10 mumol/kg
      MnDPDP. Magnetic resonance imaging at 1.5 T (SE-140/10) was performed before,
      then at 15 and 30 minutes after injection. Seven or more days later, the same MRI
      protocol was performed after intravenous injection of 10 mumol/kg MnDPDP.
      RESULTS: Fifteen minutes after intra-arterial injection, enhancement of the liver
      predominated (86 +/- 13%), followed by the renal cortex (44 +/- 14%), pancreas
      (26 +/- 9%), and spleen (14 +/- 9%). At 30 minutes, enhancement of renal cortex
      significantly increased (50 +/- 14%). There was no significant difference in
      enhancement of the liver, spleen, pancreas, or renal cortex when we compared
      intra-arterial and intravenous administration. CONCLUSION: After the injection of
      10 mumol/kg MnDPDP into the superior mesenteric artery of pigs there is no
      significant difference in visceral organ enhancement compared to intravenous
      administration. The data suggests that the hepatocyte binding sites may be
      overwhelmed by this dose and/or injection rate of MnDPDP.

PMID- 8478176
TI  - Mission, role, and responsibilities of an academic department of radiology.

PMID- 8478177
TI  - New radiopharmaceuticals for detecting infection.

PMID- 8478178
TI  - Intracranial aneurysms.

PMID- 8478180
TI  - Preparing a grant proposal.

PMID- 8478179
TI  - Use of radiologic studies by nonradiologists in academic publications: should
      radiologists care?

PMID- 8478181
TI  - Preparing a research grant application budget.

PMID- 8478182
TI  - Design of clinical radiologic research.
AB  - The components of clinical research design--the research question, the review of
      prior research, the study design, the study subjects, the study measurements, the
      statistical analysis, and the critical analysis--have been discussed. These
      components relate to the overall philosophy of the research process in the
      following manner. The driving force behind research is the desire to understand a
      universal truth (Fig. 6). The research question is formed to reflect the truth
      sought. Next defined is the specific target population and the phenomena of
      interest with regard to the sought-after truth. The study is then designed with a
      study plan detailing timing and location and an intended sample population chosen
      to reflect the target population. The phenomena of interest are translated into
      measurable intended variables. Care is needed to identify the systematic error
      that can be introduced at this stage; outside opinion can be invaluable. The
      actual study results from the implementation of the study design. The actual
      subjects may differ from the intended sample population due to a low recruitment
      rate or a large dropout rate. The actual measurements may differ from the
      intended variables due to unsuspected confounding variables or random errors.
      Statistical analysis is performed on the study findings to infer truth within the
      study. This truth may be affected by random and systematic errors in implementing
      the study. Truth in the study is then inferred to reflect truth in the universe.
      Systematic and random errors in study design may affect the validity of that
      deduction, but that deduction is the only way we have of understanding universal
      truth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478183
TI  - Grantsmanship.

PMID- 8478184
TI  - Animal research.

PMID- 8478185
TI  - Tracking a grant through the NIH. Or, the radiologist who came in from the cold.

PMID- 8478186
TI  - NIH peer review of grant applications. Definitions, procedures, and suggestions.

PMID- 8478187
TI  - Investigative partnership with industry.

PMID- 8478188
TI  - Research in radiology departments.

PMID- 8478189
TI  - Radiology research. Not an amateur sport, but fun.

PMID- 8478190
TI  - Activities of the Conjoint Committee. Enhancement of diagnostic radiologic
      research and education.
AB  - Even though we have made much progress over the last decade, much still needs to
      be done. I am personally very pleased with the excellent management and authority
      of my coauthor, Joe Frank, in assuming the Acting Directorship of our DRRP. You
      will be hearing more from him in the immediate future about this research
      program, and he will be accessible to all of you, both individually and at our
      national meetings. We must continue to recruit representatives to fill
      responsible positions at the NIH, including Director for the DRRP at the National
      Cancer Institute. Further funding for equipment and personnel within the
      Diagnostic Radiology Research Laboratory also will be necessary. We are
      anticipating that the annual laboratory budget will increase further, but to
      provide additional resources, the Conjoint Committee plans to take an active role
      in encouraging foundations, corporations, and member societies to assist further
      with this effort. Most of the other disciplines within medicine--in fact, many
      individuals in your own medical school within other departments--have spent time
      at the NIH. It is this high-quality experience, in an environment that can
      provide both the research background and the cultivated personal relationships
      and interactions, that will foster a long-term research career. Clearly, the
      complementary role of both the intramural and extramural programs will allow
      diagnostic radiology to achieve excellence and true respect in the total research
      community of the Academy. Many people have been responsible for our success, and
      I have already mentioned a few.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478191
TI  - The grantsmanship workshop 1986-1992 and radiology research funding.

PMID- 8478192
TI  - Assessment of anxiety, depression, and suspiciousness in the home care setting.
AB  - Home care nurses who are not trained as psychiatric nurses can meet the challenge
      of caring for clients with anxiety, depression, or suspiciousness. The home care
      setting provides more opportunity for prolonged periodic nurse-client interaction
      in the client's usual surroundings. Home care nurses have a further advantage
      over acute care nurses in that they tend to have a more developed concept of
      cultural and environmental influence. Assessing psychosocial issues requires
      nontangible tools, the most crucial of which is the ability to listen--to listen
      with ears and heart. Although test instruments may be useful, most assessment
      involves interview and observation. Drawing on these special opportunities and
      skills, the home care nurse can objectively collect and evaluate data to
      determine the presence of anxiety, depression, or suspiciousness in preparation
      for appropriately intervening.

PMID- 8478193
TI  - Psychiatric home care. A framework for assessment and intervention.
AB  - In this article, we will discuss how the theories of crisis intervention, self
      care, and behavior direct our psychiatric home care practice. A brief discussion
      of the theories will be followed by a case example that illustrates their
      application to a psychiatric home care situation.

PMID- 8478194
TI  - Family health assessment.
AB  - A family health assessment tool that focused on the family as the unit of care
      was developed. The tool adapted Gordon's 11 functional health pattern typology
      and categorized data using interview, observation, and measurement methods.

PMID- 8478195
TI  - Strategies for organizational change in home healthcare.
AB  - There has been an unprecedented increase in the use of home healthcare services
      in the past decade. Opportunities for the professional advancement of nurses and
      a decrease of healthcare costs abound with the growth of home healthcare, if home
      health services are managed wisely. A proactive approach to organizational change
      embracing four paradigms of organizational functioning will enable the nurse
      administrator involved in home healthcare to adequately confront the demands of
      the future.

PMID- 8478196
TI  - Learning styles and instructional processes for home healthcare providers.
AB  - The extension of ancillary nursing roles challenges registered nurses to devise
      pertinent and effective teaching and learning strategies in home healthcare
      educational orientation and inservice programs. A powerful method to strengthen
      preferred ways of learning and broaden learning styles to meet changing
      circumstances is described.

PMID- 8478197
TI  - Discharge planning.

PMID- 8478198
TI  - The mind-body connection.

PMID- 8478199
TI  - Home care nursing and psychosocial-emotional needs. How nursing diagnosis helps
      to direct and inform practice.

PMID- 8478200
TI  - Psychiatric evaluation and therapy.

PMID- 8478201
TI  - Polypharmacy: dangers of multiple-drug therapy in patients with immunodeficiency
      virus infection.

PMID- 8478202
TI  - Hospice home health aides.

PMID- 8478203
TI  - Chronic sorrow in multiple sclerosis. A case study.
AB  - Multiple sclerosis, one of the most common chronic disabilities among young
      adults, may potentiate the occurrence of chronic sorrow. Chronic sorrow differs
      from acute grief because it is permanent, periodic, and progressive in nature; it
      may be a normal component of chronic illness and disability. This study describes
      one woman's experience with multiple sclerosis, her chronic sorrow about the
      trajectory of her disability, her progressive loss of bodily function, and the
      stigma of chronic illness. It also reports some of the feelings experienced by
      her husband, the primary caregiver.

PMID- 8478204
TI  - International Hemoglobin Information Center (IHIC) variants list.

PMID- 8478205
TI  - Sex-linkage of the chicken ornithine transcarbamylase gene.
AB  - The chicken ornithine transcarbamylase gene has been mapped to the short arm of
      the Z chromosome, near the centromere. Radioactive in situ hybridization was
      performed using a human cDNA clone, and chromosomes were scored for silver grain
      accumulation. This represents the first documented case of a mammalian X-linked
      gene also being sex-linked in an avian species. The significance of this finding
      in the context of sex chromosome evolution is briefly discussed. Further,
      differential sex-related OTC expression, whereby females (ZW) consistently
      produce higher levels of the enzyme than males (ZZ), must imply a peculiar mode
      of OTC transcription regulation.

PMID- 8478206
TI  - Variable expression of tapetoretinal degeneration in northern Sweden.
AB  - In the county of Vasterbotten in northern Sweden, 20 families with 50 diagnosed
      cases and 53 sporadic cases of tapetoretinal degenerations (TRD), including
      retinitis pigmentosa (RP), were ascertained. The familial and sporadic cases were
      traced genealogically as far back as was possible. Ancestors born before 1890 (n
      = 12,033) were registered on a PC. The analysis of data showed that 7 families
      (20 cases) and 21 sporadic cases could be traced to ancestors in a parish in the
      northern part of the county. The results suggest, in that parish, a gene source
      of an autosomal recessive gene causing TRD, with varying phenotypic expression,
      including variants of RP.

PMID- 8478207
TI  - Ageing before mating and quinacrine ameliorate the expression of abnormal oocyte
      (abo) in homozygous Drosophila melanogaster females.
AB  - Several studies have shown that the characteristically skewed sex ratio among the
      progeny of abo homozygous females, derived from heterozygous stocks and mated to
      attached XY males, can be modified during homozygous stock-keeping. This
      amelioration seems to have a complex mechanistic background, and both loss of the
      blood transposon from chromosome 2, where abo is located, and amplification of a
      specific heterochromatic element (ABO) have been suggested to work in this
      direction. There is also an increased frequency of non-disjunction associated
      with abo, beside the poor recovery of X0 males. Experiments were performed to see
      if there was a coordinated loss of both phenotypic expressions during homozygous
      stock-keeping and if non-disjunction was amenable to modification by quinacrine.
      We found an unexpected spontaneous amelioration of the phenotypic expressions of
      abo despite heterozygous stock-keeping. The spontaneous amelioration of non
      disjunction and male lethality under heterozygous condition was coordinated while
      the process initiated by homozygosity slowly decreased non-disjunction and
      rapidly increased male recovery over generations, which may point to a
      mechanistic difference between the amelioration processes. Quinacrine was found
      to ameliorate the skewed sex ratio but did not affect non-disjunction. In these
      experiments larval and adult treatment, respectively, were employed and the
      respective controls revealed that also ageing before mating significantly
      increased male recovery and reduced non-disjunction. Ageing before mating and
      quinacrine seemed to act additively on male recovery, suggesting independent
      action, while interaction could be suspected between quinacrine and some
      ameliorating factor associated with brood. Some of the results also suggest that
      quinacrine acts indirectly and does not substitute for the abo gene product. Due
      to the action of quinacrine in other biological systems it is speculated that the
      compound compensates for a biochemical aberration in abo/abo females or their
      progeny, showing some relation to phospholipase activity and/or actin
      polymerisation state.

PMID- 8478208
TI  - Sister chromatid exchange in the goat (Capra hircus).
AB  - Lymphocyte cells from 30 Maltese and Syrian derivative goats (13 males and 17
      females) reared in southern Italy underwent sister chromatid exchange (SCE) test.
      For the 902 cells we studied, the SCE-mean values were 6.6 +/- 3.0 per cell for
      both breeds. The SCE-frequency did not follow a Poisson distribution. The
      simultaneous visualization of SCEs and G-bands in the lightly stained chromatid
      allowed the study of SCE-distribution in chromosomes 1 and X. The number of SCEs
      in chromosome 1 was significantly higher (P > 0.001) than expected from relative
      chromosome length. No statistical differences between the numbers of SCEs in the
      active (early-replicating) and inactive (late-replicating) X-chromosomes of
      female cells were found.

PMID- 8478209
TI  - Cytogenetic patterns in 384 northern-Spanish patients with haematological
      disorders.
AB  - During 1988-1991, we have conducted cytogenetic analysis in 384 consecutive
      patients with suspected neoplastic haematological diseases. A total of 404
      samples were evaluated with banding techniques; 66 patients had
      myeloproliferative syndromes (MPS); 64, chronic myeloid leukaemia (CML); 50,
      acute nonlymphocytic leukaemia (ANLL); 40, myelodysplastic syndromes (MDS); 39,
      lymphoproliferative disorders (LPD); 37, acute lymphocytic leukaemia (ALL); 31
      with non-Hodgkin lymphomas; and 57 patients had benign disorders. The frequencies
      and the type of detected chromosomal abnormalities were, in most diagnostic
      groups, within the limits of previous reports. For lymphomas, LPD, and MPS these
      frequencies were lower than expected. 144 cases (44.8%) of the 295 de novo
      diagnosed cases showed structural rearrangements. Breakpoints involved in
      structural rearrangements cluster to 35 bands of the standard 650-banded
      karyotype. We have observed eight cases with new chromosomal rearrangements.

PMID- 8478210
TI  - Zygotene-pachytene substaging and synaptonemal complex karyotyping of boar
      spermatocytes.
AB  - Synaptonemal complex analysis, by electron microscopy of spread spermatocytes
      after phosphotungstic acid staining, made possible description of the chromosomal
      synaptic patterns and the synaptonemal complex karyotype of the pig (Sus scrofa
      domestica). The autosomal synaptic pattern in conjunction with the sex chromosome
      morphology and pairing behaviour can serve as a reference for the meiotic cell
      progression from the zygotene stage to the pachytene. The autosomes started
      terminal synapsis at early zygotene (Z1) and at mid-zygotene (Z2) some of the
      small bivalents were completely paired. The extension of pairing between the X
      and the Y chromosome, and the differentiation of their axes, disclosed seven
      types of sex bivalent (Types 0-VI). The Type 0 sex bivalent occurred in late
      zygotene (Z3), at which the X and Y axes began terminal synapsis by their short
      arms. Each one of the pachytene substages, early, mid-, and late, included two
      sex bivalent types. By early pachytene (P1-P2) the entire Y chromosome was paired
      with the X axis. Subsequently, progressive desynapsis and differentiation of the
      sex chromosome axes defined the mid- (P3-P4) and late pachytene substages (P5
      P6). At mid-pachytene, the unpaired XY segments were associated end-to-end and
      showed differing degrees of complexity (thickening, splitting, despiralization
      and strandedness). These axial complexities were replaced at late pachytene by
      fine excrescences along the sex chromosome axes, which still formed a short SC
      stretch. Additionally, an attempt to construct an SC karyotype for the pig is
      presented. There was general agreement between the autosomal SC karyotype and the
      autosomal somatic karyotype when comparisons were made, considering the relative
      lengths and arm ratios of individual chromosome pairs.

PMID- 8478211
TI  - In situ polymerase chain reaction: toy or tool?

PMID- 8478212
TI  - Robert Feulgen Prize Lecture. Distribution and role of gap junctions in normal
      myocardium and human ischaemic heart disease.
AB  - In the heart, individual cardiac muscle cells are linked by gap junctions. These
      junctions form low resistance pathways along which the electrical impulse flows
      rapidly and repeatedly between all the cells of the myocardium, ensuring their
      synchronous contraction. To obtain probes for mapping the distribution of gap
      junctions in cardiac tissue, polyclonal antisera were raised to three synthetic
      peptides, each matching different cytoplasmically exposed portions of the
      sequence of connexin43, the major gap-junctional protein reported in the heart.
      The specificity of each antiserum for the peptide to which it was raised was
      established by dot blotting. New methods were developed for isolating enriched
      fractions of gap junctions from whole heart and from dissociated adult myocytes,
      in which detergent-treatment and raising the temperature (potentially damaging
      steps in previously described techniques) are avoided. Analysis of these
      fractions by SDS-polyacrylamide gel electrophoresis revealed major bands at 43
      kDa (matching the molecular mass of connexin43) and at 70 kDa. Western blot
      experiments using our antisera indicated that both the 43-kDa and the 70-kDa
      bands represent cardiac gap-junctional proteins. Pre-embedding immunogold
      labelling of isolated gap junctions and post-embedding immunogold labelling of
      Lowicryl-embedded whole tissue demonstrated the specific binding of the
      antibodies to ultrastructurally defined gap junctions. One antiserum (raised to
      residues 131-142) was found to be particularly effective for cytochemical
      labelling. Using this antiserum for immunofluorescence labelling in combination
      with confocal scanning laser microscopy enabled highly sensitive detection and
      three-dimensional mapping of gap junctions through thick slices of cardiac
      tissue. By means of the serial optical sectioning ability of the confocal
      microscope, images of the entire gap junction population of complete en face
      viewed disks were reconstructed. These reconstructions reveal the presence of
      large junctions arranged as a peripheral ring around the disk, with smaller
      junctions in an interior zone: an arrangement that may facilitate efficient
      intercellular transfer of current. By applying our immunolabelling techniques to
      tissue from hearts removed from transplant patients with advanced ischaemic heart
      disease, we have demonstrated that gap junction distribution between myocytes at
      the border zone of healed infarcts is markedly disordered. This abnormality may
      contribute to the genesis of reentrant arrhythmias in ischaemic heart disease.

PMID- 8478213
TI  - The distribution of oestrogen and progesterone receptors in the human endometrial
      basal and functional layer during the normal menstrual cycle. An
      immunocytochemical study.
AB  - The distribution of oestrogen and progesterone receptors in the human endometrial
      basal and functional layer during the normal menstrual cycle was investigated by
      means of an immunocytochemical technique. A cyclic pattern of receptor
      distribution was observed. The highest concentration of hormone receptors was
      observed in the basal layer, in accordance with the idea that this layer is the
      source of endometrial regeneration.

PMID- 8478214
TI  - Zonal expression of the glucokinase gene in rat liver. Dynamics during the daily
      feeding rhythm and starvation-refeeding cycle demonstrated by in situ
      hybridization.
AB  - The abundance and zonal distribution of glucokinase (GK) mRNA were studied in rat
      liver during a normal 12 h day/12 h night rhythm (dark from 1900 to 0700 hours)
      and during refeeding after 60 h of starvation. Zonation of GK gene expression was
      examined by in situ hybridization with a radiolabelled cRNA probe and GK mRNA
      abundance was determined by Northern blot analysis with a digoxigenin-labelled
      cRNA probe. GK mRNA appeared to be almost homogeneously distributed throughout
      the whole daily feeding cycle; yet it was predominantly localized in the
      perivenous and intermediate zone during refeeding after 60 h of starvation.
      During the daily feeding rhythm, the total amount of GK mRNA increased quickly
      with the beginning of the feeding period at 1900 hours reaching a maximum at
      midnight and then decreased continuously to a basal level at noon. Virtually no
      GK mRNA was detected after 60 h of starvation. Refeeding caused a rapid increase
      in GK mRNA to a maximum at 2400 hours followed by a decrease to approximately two
      thirds of the maximum value at 0700 hours. If the homogeneous distribution of GK
      mRNA during the daily feeding rhythm was real rather than apparent because of too
      low a sensitivity of the cRNA probe, the present results suggest that during the
      normal circadian cycle the mainly perivenous distribution of GK enzyme activity
      and protein is regulated preferentially at a translational level. The findings
      clearly show that during refeeding after 60 h of starvation the GK distribution
      is controlled predominantly at a pretranslational level.

PMID- 8478216
TI  - Allopathic medical research echoes earlier findings in osteopathic medicine.

PMID- 8478215
TI  - Manipulation, exercise resolve shoulder dysfunction.

PMID- 8478217
TI  - Immigrants infected with the human immunodeficiency virus (HIV)

PMID- 8478218
TI  - Using convergent combination therapy, researchers stopped the human
      immunodeficiency virus (HIV) from reproducing in test tubes.

PMID- 8478219
TI  - No single test can determine clinical outcome of prostate cancer.

PMID- 8478220
TI  - Flow cytometric determination of ploidy in prostatic adenocarcinoma and its
      relation to clinical outcome.
AB  - Flow cytometry was used to measure the DNA content in paraffin-embedded archival
      specimens of prostatic adenocarcinoma. The specimens were from 49 patients who
      were found to have adenocarcinoma of the prostate at the time of transurethral
      resection of the prostate for bladder outlet obstruction. At initial
      presentation, 34 of these patients had clinically localized disease and 15 had
      metastatic disease. The authors studied the relationship of DNA ploidy to
      clinical stage, histologic grade, disease progression, and duration of survival.
      Their results indicate that regardless of the clinical stage at presentation, the
      mean time to disease progression is longer in a patient with a DNA diploid tumor
      when compared with that in a patient with a DNA aneuploid tumor (18.1 months vs
      6.5 months, respectively). Additionally, mean time of survival was longer in a
      patient with a diploid tumor than in a patient with an aneuploid tumor (31.6
      months vs 9.6 months, respectively).

PMID- 8478221
TI  - Shame and the origin of physician-patient conflict.
AB  - Shame is a powerful negative emotion that motivates much intrapersonal and
      interpersonal conflict. The relationship between patient and physician can turn
      to conflict if the medical environment elicits shame in the patient; conflict
      arises when the patient externalizes the cause and blames the physician for
      negative feelings. Patients who suffer from hyperactive and reactive shame
      responses may require particularly sensitive care. Including the assessment of
      shame reactivity in the medical history can help identify such persons. Measures
      that reduce shame should improve compliance and reduce the incidence of
      malpractice suits.

PMID- 8478222
TI  - Arranging affiliation agreements and outside rotations.
AB  - Affiliation agreements are necessary when a sponsoring institution makes
      arrangements for all or part of the education elements of an internship or
      residency program to be delivered at another hospital. The sponsoring institution
      may be a college of osteopathic medicine or an osteopathic hospital. Some basic
      considerations, which are outlined herein, should be reviewed when the sponsoring
      institution enters such agreements. Some of these considerations are requirements
      of the American Osteopathic Association, while others are necessary to avoid
      later complications. Agreement should be reached on negotiable factors, accepted
      by both institutions, and then referred for legal review by appropriate
      authorities.

PMID- 8478223
TI  - Computed tomography and magnetic resonance imaging of tuberculous meningitis.
AB  - Tuberculous meningitis usually results from hematogenous seeding of the central
      nervous system from a primary pulmonary source of infection. Initially, the
      meningitic process can mimic a flu-like syndrome, followed rapidly by the
      development of profound neurologic deficits. Computed tomography scanning or
      magnetic resonance imaging of the head often demonstrates a characteristic
      pattern of basal cistern involvement with Mycobacterium tuberculosis. The
      incidence of tuberculous meningitis in the more developed countries has increased
      during the past 5 years because of the growing number of cases in patients with
      acquired immunodeficiency syndrome, the spread among the homeless, and the
      expanding immigrant population. The significant morbidity and mortality rates
      associated with tuberculous meningitis--generally considered to be a disease of
      the past--emphasize the need for greater clinical awareness, early diagnosis, and
      prompt treatment.

PMID- 8478224
TI  - Group C streptococcal arthritis.
AB  - Septic arthritis is a common disorder that is rarely caused by group C
      streptococci. This infectious process usually occurs in patients with a
      preexisting rheumatologic condition. Treatment consists of intravenous
      antibiotics, joint aspiration, and physical therapy. Prolonged recovery and
      septic complications are expected. This report describes a case typical of group
      C streptococcal arthritis.

PMID- 8478225
TI  - Another skin manifestation of HIV infection.

PMID- 8478226
TI  - Long-term results of post-operative radiation therapy following mastectomy with
      or without chemotherapy in stage I-III breast cancer.
AB  - PURPOSE: To determine the risk of local-regional failure following post
      mastectomy radiotherapy and the incidence of complications associated with such
      treatment. METHODS AND MATERIALS: We retrospectively analyzed the results in 309
      patients with Stage I-III invasive breast cancer treated with post-mastectomy
      radiation therapy between 1975 and 1985. The median radiotherapy dose was 45 Gy
      in 1.8 to 2.25 Gy fractions. One hundred forty-seven (48%) of the patients
      received adjuvant systemic chemotherapy with 115 (78%) of these receiving a CMF
      based or doxorubicin-containing regimen. The median follow-up time of surviving
      patients was 130 months (range, 28 to 191 months) after mastectomy. RESULTS:
      Seventeen patients (6%) developed a local-regional failure at an interval of 4 to
      87 months after radiotherapy. Moderate or severe complications related to
      radiotherapy and requiring treatment were uncommon. Symptomatic radiation
      pneumonitis occurred in four patients (1.3%), arm edema in 18 (5.8%), and
      brachial plexopathy in 2 (0.6%). CONCLUSION: We conclude that post-operative
      radiotherapy is a safe and effective means of reducing local-regional failure
      following mastectomy. The efficacy of post-mastectomy radiotherapy in improving
      survival should be addressed in new large randomized controlled studies.

PMID- 8478227
TI  - Sequential transurethral surgery, multiple drug chemotherapy and radiation
      therapy for invasive bladder carcinoma: initial report.
AB  - Forty-seven patients with muscle-invasive bladder cancer (T2-T4, Nx, M0) were
      treated by transurethral resection, followed by 3-4 cycles of combination
      chemotherapy (methotrexate 30 mg/m2 on days 1, 14; cis-platinum 100 mg/m2 on day
      2; vinblastine 3 mg/m2 on days 1, 14; repeated every 21 days), and external beam
      irradiation (64-66 Gy to the bladder and 40 Gy to the pelvic lymphatics).
      Complete remission after trans urethral resection and chemotherapy was achieved
      in 24 out of 45 patients (53%). Cystectomy was performed in patients without
      complete response to transurethral resection and chemotherapy. The therapy was
      completed as planned in 45/47 patients. After transurethral resection,
      chemotherapy, and radiation therapy, biopsy proven complete response was achieved
      in 62% (28/45); Stage T2T3 in 67% (23/34), Stage T4 in 45% (5/11) of patients.
      Among 19 patients with positive biopsy findings after transurethral resection and
      chemotherapy, 14 underwent cystectomy. After follow-up of 4-55 months (median 23
      months) 75% (34/45) are alive, 68% (31/45) have had their bladders preserved, and
      53% (24/45) are free of the primary tumor. The actuarial survival of all 45
      patients is 73%. Moderate nausea and vomiting during treatment were common;
      severe leukopenia and mucositis were observed in five patients. Late side effects
      such as miction disorders and diarrhea were predominantly mild. Although the
      observation period has been too short to allow a definitive evaluation of
      treatment results, we feel both from the point of bladder preservation and
      disease-free survival that the presented treatment approach is successful in a
      majority of T2T3 patients, whereas a large tumor size (T4) renders this treatment
      less effective.

PMID- 8478228
TI  - Combined modality program with possible organ preservation for invasive bladder
      carcinoma: results of RTOG protocol 85-12.
AB  - PURPOSE: This Phase II study was designed to test the tolerance and effectiveness
      of concurrent cisplatin-radiotherapy in the treatment of invasive bladder cancer.
      Objectives were to determine toxicity, complete response rate, bladder
      preservation rate, and survival. METHODS AND MATERIALS: Patients with invasive
      bladder cancer, clinical Stages T2-4, NO-2 or NX, MO were treated with pelvic
      radiotherapy 40 Gy in 4 weeks and cisplatin 100 mg/m2 on days 1 and 22. Complete
      responders were given an additional 24 Gy bladder boost plus a third dose of
      cisplatin; patients with residual tumor after 40 Gy were assigned radical
      cystectomy. RESULTS: The complete remission rate following cisplatin and 40 Gy
      for evaluable cases was 31/47 (66%). Acute toxicity was acceptable with only two
      patients not completing induction therapy. Patients with poorly differentiated
      tumors were more likely to achieve complete remission. Of fully evaluable
      patients, 28/42 (67%) achieved complete remission with induction therapy, 11
      remain continuously in remission, and eight have relapsed with bladder as the
      only site of failure. Five of these eight cases relapsed with noninvasive tumor.
      Of the 14 patients who failed to achieve complete remission, only three remain
      disease-free. Median survival is not reached, with 17/42 (19/48) deaths reported.
      Actuarial survival is 64% at 3 years. CONCLUSION: This combined cisplatin
      radiotherapy regimen was moderately well-tolerated and associated with tumor
      clearance in 66% of patients treated. Isolated bladder recurrences with invasive
      carcinoma are infrequent. Better definition of pretreatment selection criteria is
      needed if combined modality treatment is to achieve disease control and organ
      preservation for patients with bladder cancer.

PMID- 8478229
TI  - Preoperative concurrent 5-fluorouracil infusion, mitomycin C and pelvic radiation
      therapy in tethered and fixed rectal carcinoma.
AB  - PURPOSE: This is a Phase I/II study of preoperative concurrent radiation and
      chemotherapy in tethered and fixed rectal carcinoma. This study examined the
      curative resectability, the acute toxicities during chemo-radiation and the
      surgical complications. METHODS AND MATERIALS: Between 1986 and 1990, 46 patients
      were treated with preoperative pelvic radiation (4000 cGy in 20 fractions in 4
      weeks), 5-Fluorouracil infusion (20 mg/m2, days 1-4 and 15-18) and Mitomycin C (8
      mg/m2, day 1). This was followed by surgery 6 to 8 weeks later. 30 patients had
      tethered tumors and 16 patients had fixed tumors. RESULTS: After preoperative
      chemo-radiation, 41 patients (89%) underwent curative resection. Two patients
      (4%) had no residual tumor found (T0N0M0). Seven patients (15%) had nodal
      metastases. Two patients developed grade 3 neutropenia (WBC = 1-2 x 10(9)/L)
      during chemo-radiation. Five patients had delay in perineal wound healing. One
      patient had an anastomotic leak. Four patients developed stomal stenosis which
      required surgical revision. The 2-year actuarial survival was 73%. The 2-year
      local relapse rate was 16%. Patients with fixed carcinoma had a higher incidence
      of local failure (38% vs. 10%) and the difference was statistically significant
      (p = 0.0036). The 2-year distant failure rate was 41%, and the rates were similar
      for both tethered and fixed carcinomas. CONCLUSION: Preoperative pelvic
      radiation, chemotherapy and surgery could achieve a curative resection rate of
      89% in tethered and fixed rectal carcinomas. However, distant metastases remained
      the major cause of failure.

PMID- 8478230
TI  - Results of a randomized phase-III trial to evaluate the efficacy of strontium-89
      adjuvant to local field external beam irradiation in the management of endocrine
      resistant metastatic prostate cancer.
AB  - PURPOSE: A large proportion of the practice of radiotherapy in the management of
      metastatic adenocarcinoma of the prostate is associated with palliation of pain
      from osseous metastases and improving quality of life. Radiation therapy is well
      known to be effective in treating painful sites and may also be effective in
      reducing the propensity for adjuvantly treated disease to become symptomatic.
      Strontium-89 is a systemic radionuclide that has clinical efficacy in the
      palliation of pain from bony metastases. METHODS AND MATERIALS: The study was a
      Phase-III randomized placebo control trial performed in eight Canadian Cancer
      Centers to evaluate the effectiveness of strontium-89 as an adjunct to local
      field radiotherapy. Patients with endocrine refractory metastatic prostate cancer
      received local field radiotherapy and either strontium-89 as a single injection
      of 10.8 mCi or placebo. RESULTS: One hundred twenty-six patients were recruited.
      No significant differences in survival or in relief of pain at the index site
      where noted. Intake of analgesics over time demonstrated a significant reduction
      in the arm treated with strontium-89. Progression of pain as measured by sites of
      new pain or the requirement for radiotherapy showed statistically significant
      differences between the arms in favor of strontium-89. Tumor makers including
      prostate specific antigen, acid phosphatase, and alkaline phosphatase were also
      reduced in patients receiving strontium-89. A Quality-of-Life analysis was
      performed as a multivariate data set and demonstrated an overall superiority of
      strontium-89 with alleviation of pain and improvement in physical activity being
      statistically significant. Toxicity was evaluated and demonstrated increased
      hematological toxicity in the group receiving strontium-89. CONCLUSIONS: It is
      concluded that the addition of strontium-89 is an effective adjuvant therapy to
      local field radiotherapy reducing progression of disease as evidenced by new
      sites of pain and the requirement of further radiotherapy and improving quality
      of-life and need for analgesic support in this group of patients.

PMID- 8478231
TI  - Radiation dose to the lens and cataract formation.
AB  - PURPOSE: To determine the radiation tolerance of the lens of the eye and the
      incidence of radiation-induced lens changes in patients treated by fractionated
      supervoltage radiation therapy for orbital tumors. METHODS: Forty patients
      treated for orbital lymphoma and pseudotumour with tumour doses of 20-40 Gy were
      studied. The lens was partly shielded using lead cylinders in most cases. The
      dose to the germinative zone of the lens was estimated by measurements in a
      tissue equivalent phantom using both film densitometry and thermoluminescent
      dosimetry. Ophthalmological examination was performed at 6 monthly intervals
      after treatment. RESULTS: The lead shield was found to reduce the dose to the
      germinative zone of the lens to between 36-50% of the tumor dose for Cobalt beam
      therapy, and to between 11-18% for 5 MeV x-rays. Consequently, the len doses were
      in the range 4.5-30 Gy in 10-20 fractions. Lens opacities first appeared from
      between 3 and 9 years after irradiation. Impairment of visual acuity ensued in
      74% of the patients who developed lens opacities. The incidence of lens changes
      was strongly dose-related. None was seen after doses of 5 Gy or lower, whereas
      doses of 16.5 Gy or higher were all followed by lens opacities which impaired
      visual acuity. The largest number of patients received a maximum lens dose of 15
      Gy; in this group the actuarial incidence of lens opacities at 8 years was 57%
      with visual impairment in 38%. CONCLUSION: The adult lens can tolerate a total
      dose of 5 Gy during a fractionated course of supervoltage radiation therapy
      without showing any changes. Doses of 16.5 Gy or higher will almost invariably
      lead to visual impairment. The dose which causes a 50% probability of visual
      impairment is approximately 15 Gy.

PMID- 8478232
TI  - Pre-operative combined 5-FU, low dose leucovorin, and sequential radiation
      therapy for unresectable rectal cancer.
AB  - PURPOSE: We performed a Phase I trial to determine the maximum tolerated dose of
      combined pre-operative radiation (5040 cGy) and 2 cycles (bolus daily x 5) of 5
      FU and low dose LV (20 mg/m2), followed by surgery and 10 cycles of post
      operative LV/5-FU in patients with unresectable primary or recurrent rectal
      cancer. METHODS AND MATERIALS: Twelve patients were entered. The initial dose of
      5-FU was 325 mg/m2. 5-FU was to be escalated while the LV remained constant at 20
      mg/m2. Chemotherapy began on day 1 and radiation on day 8. The post-operative
      chemotherapy, was not dose escalated; 5-FU: 425 mg/m2 and LV: 20 mg/m2. The
      median follow-up was 14 months (7-16 months). RESULTS: Following pre-operative
      therapy, the resectability rate with negative margins was 91% and the pathologic
      complete response rate was 9%. For the combined modality segment (preoperative)
      the incidence of any grade 3+ toxicity was diarrhea: 17%, dysuria: 8%, mucositis:
      8%, and erythema: 8%. The median nadir counts were WBC: 3.1, HGB: 8.8, and PLT:
      153,000. The maximum tolerated dose of 5-FU for pre-operative combined LV/5-FU/RT
      was 325 mg/m2 with no escalation possible. Therefore, the recommended dose was
      less than 325 mg/m2. CONCLUSIONS: Since adequate doses of 5-FU to treat systemic
      disease could not be delivered until at least 3 months (cycle 3) following the
      start of therapy, we do not recommend that this 5-FU, low dose LV, and sequential
      radiation therapy regimen be used as presently designed. However, given the 91%
      resectability rate we remain encouraged with this approach.

PMID- 8478233
TI  - Determination of the radiation sensitivity of the stromal cells in the murine
      long-term bone marrow culture by measuring the induction and rejoining of
      interphase chromosome breaks.
AB  - PURPOSE: To determine the radiosensitivity of bone marrow stromal cells, the rate
      of interphase chromosome breakage and rejoining of stromal cells in the murine
      long term bone marrow culture and of human skin fibroblasts were compared.
      METHODS AND MATERIALS: The cells were irradiated with doses up to 6 Gy and repair
      times up to 6 hr were investigated. After induction of premature chromosome
      condensation by fusing the cells with mitotic HeLa cells, the number of
      interphase chromosome fragments was counted. RESULTS: The number of radiation
      induced breaks was found to be not significantly different for both cell types
      with 6.16 +/- 0.26 breaks per Gray for the fibroblasts and 5.96 +/- 0.20 breaks
      per Gray for the stromal cells. A significant difference was observed in the
      repair rate. The fibroblasts rejoined 39.6% of the breaks induced initially
      during the first hour after irradiation and 5.6 +/- 1.84 breaks remained
      unrejoined after 6 hr, while the stromal cells were able to rejoin 63.2% in 1 hr
      and had 2.05 +/- 0.07 breaks unrejoined after 6 hr. CONCLUSION: If the well
      substantiated assumption is made, that the capacity to repair DNA double strand
      breaks or interphase chromosome breaks is correlated with the cellular
      radiosensitivity, this finding indicate, that murine bone marrow stromal cells
      are more radioresistant than human skin fibroblasts.

PMID- 8478234
TI  - The relative biological effectiveness of ytterbium-169 for low dose rate
      irradiation of cultured mammalian cells.
AB  - PURPOSE: An important step in the development of 169Yb as a new brachytherapy
      source is to determine its biological effectiveness relative to other commonly
      used radioisotopes. The purpose of this paper is to determine the relative
      biological effectiveness of 169Yb, with respect to 60Co, for a range of low dose
      rates. METHOD AND MATERIALS: The relative biological effectiveness of photon
      radiation from encapsulated 169Yb was determined by exposing Chinese hamster
      ovary cells, in exponential growth, to graded doses of radiation from either
      169Yb or 60Co. Clonogenic cell survival was determined for continuous low dose
      rates ranging from 6.5 cGy/hr to 52 cGy/hr. RESULTS: The relative biological
      effectiveness of 169Yb, with respect to 60Co, was determined to be 1.2 +/- 0.3
      and did not vary significantly over the dose-rate range from 13 cGy/hr to 50
      cGy/hr. An inverse dose-rate effect was observed, but only for 60Co irradiation
      at 8.9 cGy/hr. Therefore, relative biological effectiveness values could not be
      determined reliably for dose rates less than 13 cGy/hr. CONCLUSIONS: We have
      established that 169Yb is approximately 20% more effective than 60Co in vitro. It
      is hoped that this study will guide the introduction of 169Yb into clinical
      brachytherapy practice.

PMID- 8478235
TI  - Cumulative minutes with T90 greater than Tempindex is predictive of response of
      superficial malignancies to hyperthermia and radiation.
AB  - PURPOSE: To better define thermal parameters related to tumor response in
      superficial malignancies treated with combined hyperthermia and radiation
      therapy. METHODS AND MATERIALS: Patients were randomized to receive one or two
      hyperthermia treatments per week with hyperthermia given during each week of
      irradiation. Hyperthermia was given for 60 min with treatments begun within 1 hr
      following irradiation. Power was increased to patient tolerance or normal tissue
      temperature of 43.0 degrees C. Irradiation was generally given 5 times per week
      with doses prescribed to normal tissue tolerance (generally 24-70 Gy at 1.8-2.5
      Gy per fraction). Multipoint thermometry was used with temperatures obtained
      every 5 min. RESULTS: One hundred eleven individual treatment fields containing 1
      or more tumor nodules were completely evaluable. The complete and overall
      response rates were 46% and 80%, respectively. Forty-one percent of all treatment
      fields (51% of responding lesions) remained controlled at 2 years. Multivariate
      analysis revealed that the cumulative minutes that the temperature achieved by
      90% of the measured tumor sites (T90) was > or = 40.0 degrees C, tumor histology,
      tumor volume, and radiation dose were significantly associated with complete
      tumor response. The complete response rate was not significantly affected by the
      number of hyperthermia treatments given per week. The incidence of clinically
      significant complications was low. CONCLUSIONS: These results support the
      usefulness of the cumulative minute system in describing time-temperature
      relationships. The significance of thermal variables with regard to tumor
      response strongly supports the contention that hyperthermia can be a useful
      adjunct to irradiation for the local control of cancer.

PMID- 8478236
TI  - Beam shaping for microwave waveguide hyperthermia applicators.
AB  - PURPOSE: Hyperthermia treatments commonly use single element microwave waveguide
      applicators. The microwave beam patterns produced by these applicators are often
      non-uniform. As a result, hot spots are formed in the heated tissue and
      therapeutic temperatures are reached in only small areas of the treatment field.
      We have constructed new coupling boluses that improve the heating patterns of
      external microwave applicators. METHODS: The microwave beam transmitted through
      the bolus is modified by microwave absorbing saline/gelatin pads. The pads can be
      designed to result in a uniform heating pattern over a large area or
      alternatively, complex heating patterns can be generated for specific clinical
      applications. An analysis of the effect of bolus design parameters on microwave
      absorption patterns is presented. The heating patterns of the MA-100 and MA-120
      microwave waveguide applicators have been measured in muscle and fat phantom
      materials with both the manufacturer's boluses and the new boluses. RESULTS: In
      the case of the MA-100, the area above the 70% heating level measured in a muscle
      phantom was increased by a factor of 2.3 by an absorbing pad bolus. Similarly,
      the heating area of the MA-120 was increased by a factor of 2.6 by an absorbing
      pad bolus. The boluses were tested in a clinical setting by measuring tissue
      temperature profiles in patients under different bolus arrangements. The area
      over which therapeutic temperature was achieved was increased considerably when
      the absorbing bolus was used. A second bolus was designed for the MA-120 to
      produce a ring heating pattern for the treatment of a breast cancer patient who
      had developed recurrences at the periphery of a skin graft. The heating pattern
      produced in a muscle phantom is compared with tissue temperature profiles
      measured during the hyperthermia treatment of this patient. CONCLUSIONS:
      Microwave absorbing filters using saline pads significantly improve the heating
      patterns of microwave waveguide hyperthermia applicators. This improvement was
      confirmed in clinical application where much greater areas of homogeneous heating
      were observed. The technology was extended to produce complex heating patterns
      for special clinical applications.

PMID- 8478237
TI  - Dynamic field shaping for stereotactic radiosurgery: a modeling study.
AB  - PURPOSE: This work assesses the relative field shaping advantages of dynamic
      field shaping devices for stereotactic radiosurgery using a linear accelerator.
      METHODS AND MATERIALS: We selected 43 intracranial tumors (2.0-4.2 cm maximum
      dimension, 1.5-25.5 cc tumor volume) out of the first 64 intracranial tumors
      treated with radiosurgery at the Joint Center for Radiation Therapy. We modeled
      five field shaping devices, each including a fixed auxiliary circular collimator:
      (a) fixed circular collimator alone; (b) two independent parallel jaws; (c) four
      independent rectangular jaws; (d) four independent rotatable jaws; and (e)
      "ideal" multileaf collimator. We adjusted the model parameters until the minimum
      target isodose was 80% of the dose delivered to isocenter. We defined the
      treatment volume ratio as the target volume divided by the treatment volume
      (volume receiving at least the minimum target dose). We used the treatment volume
      ratio to compare the five models and the actual patient treatments. RESULTS: For
      34 tumors originally treated with one isocenter, the median Treatment Volume
      Ratio was higher for all of the device models except the fixed circular
      collimator compared to the actual patient treatments. For the nine tumors
      originally treated with multiple isocenters, the median Treatment Volume Ratio
      for the actual multiple isocenter treatments was similar to that for two parallel
      jaws, four rectangular jaws and four rotatable jaws. Only the median "ideal"
      collimator treatment volume ratio was higher for these nine tumors. CONCLUSION:
      Simple field shaping devices have approximately 50% of the conformal advantage of
      an "ideal" multileaf collimator. Approximately 50% of typical radiosurgical
      tumors between 2 and 4 cm have field shaping advantages which exceed the
      geometrical uncertainties inherent in linear accelerator radiosurgery treatments.
      The three models, two parallel, four rectangular, or four rotatable independent
      jaws would improve current linear accelerator technology by providing homogeneous
      doses with equivalent field shaping for most tumors originally treated with
      inhomogeneous multiple isocenter plans (6/9 tumors in the current series).

PMID- 8478238
TI  - Follow-up thallium-201 scintigraphy after mantle field radiotherapy for Hodgkin's
      disease.
AB  - PURPOSE: Assessment of the long-term cardiac effects of mediastinal radiotherapy
      for Hodgkin's disease, by Thallium scintigraphy. METHODS AND MATERIALS: 32
      patients (14 males and 18 females) who underwent mantle field radiotherapy for
      Hodgkin's disease were included in this study. Twenty patients received 4
      fractions of 2.5 Gy per week and 12, five fraction of 2 Gy per week, delivered on
      alternate days. All the patients, except three, performed exercise testing
      electrocardiogram and Thallium-201 tomoscintigraphy. The average time interval
      from completion of treatment to the study was 7 years (range 3-13 years). No
      patients had clinical symptoms of cardiac disease. Mean age at the time of the
      study was 35 years (range 23-48 years). RESULTS: Two electrocardiograms revealed
      left bundle branch block and the patients were excluded from the study. Only one
      out of 27 exercise electrocardiograms was abnormal in a patient with mitral valve
      prolapse, who was also excluded from the study. Twenty-six scintigraphies were
      evaluable. Twenty-two (85%) were clearly abnormal with partial or complete
      redistribution on delayed images. The anterior region was affected in 19 of these
      cases (86%). Four explorations were undoubtedly normal. Coronary angiography was
      not performed for ethical reasons in these asymptomatic patients. CONCLUSION:
      Despite possible false positive tests, the high rate of abnormality (85%) in this
      small series is striking. These preliminary data justify larger studies and a
      close long-term follow-up of these patients.

PMID- 8478239
TI  - Malignant glioma--timing of response to radiation therapy.
AB  - PURPOSE: The response of malignant gliomas to radiation was examined
      retrospectively in 71 patients with newly diagnosed supratentorial malignant
      gliomas. Questions asked included frequency, timing and clinical significance of
      response. METHODS AND MATERIALS: After surgery, all were treated with whole brain
      plus boost radiotherapy followed 8 weeks later by chemotherapy. The rate, degree,
      and timing of response to radiation were determined by comparing postoperative,
      end of radiation, and prechemotherapy CT scans on each patient. RESULTS:
      Postoperative residual tumor was evident on 63/71 postoperative scans. Twenty-two
      of 63 tumors (35%) had a partial or complete response to radiation. Twenty (32%)
      had responded by the end of radiation; 17 maximally. Six to 8 weeks later, three
      responding tumors had responded further and two previously stable ones had begun
      to respond. Only three tumors (5%) responded completely. A greater proportion of
      anaplastic gliomas than glioblastomas responded to radiation (52% vs. 26%).
      Protracted or delayed responses were only observed in patients with anaplastic
      glioma. Patients who responded to radiation did not live significantly longer
      than non-responders. However, tumor progression prior to chemotherapy was
      associated with significantly shorter survival. CONCLUSION: This CT scan-based
      analysis demonstrates that malignant gliomas are only moderately radioresponsive
      tumors and also demonstrates that response to radiation, if it is going to occur,
      is usually evident by the end of treatment.

PMID- 8478240
TI  - Autoradiography for iodine-125 seeds.
AB  - To study the interior design of model 6702 and 6711 iodine-125 seeds contact
      autoradiographs were performed using mammography film. Improved resolution was
      obtained using a pin-hole camera with a hole of 0.1 mm x 0.1 mm. With these
      techniques, qualitative determination of the relative activity distribution
      within each seed was possible. The number of the activated resin spheres and the
      positions of the centers of these spheres can be exactly determined. A model
      calculation shows, that variations in the arrangement of the activated spheres
      within a seed have a moderate influence on the dose distribution at source
      distances below 10 mm. Knowing the exact source configuration may be useful when
      comparing dose calculations with measured data for model 6702 125I seeds which
      are currently employed in ophthalmic plaque and implant therapy of other tumors.

PMID- 8478241
TI  - Volumetric analysis of small bowel displacement from radiation portals with the
      use of a pelvic tissue expander.
AB  - PURPOSE: Many techniques and devices have been used in an attempt to minimize
      gastrointestinal morbidity of pelvic irradiation. The value of a temporary
      intrapelvic tissue expander to displace small bowel from pelvic radiotherapy
      fields was analyzed by comparing volumetric treatment parameters of patients with
      and without such a device. METHODS AND MATERIALS: Between 1983 and 1991, 77
      patients with a diagnosis of endometrial (n = 35), colorectal (n = 41), or anal
      carcinoma (n = 1) received adjuvant postoperative radiotherapy after undergoing
      treatment planning simulation with the use of small bowel oral contrast medium.
      Fourteen of these patients underwent surgical placement of a temporary
      intrapelvic tissue expander prior to radiotherapy, and 63 patients did not. Small
      bowel volume within the treatment portals was measured for both initial pelvic
      and conedown fields for all cases, and compared between the two patient groups.
      RESULTS: The volume of small bowel within the initial pelvic fields receiving
      full dose irradiation was significantly less among patients with a tissue
      expander. For patients with a tissue expander, mean volume receiving full dose
      irradiation was 25 cm3 (median 0 cm3, range 0-297 cm3), whereas the corresponding
      volume was 239 cm3 (median 181 cm3, range 0-943 cm3) without a tissue expander (p
      < .0001). A similar reduction of irradiated small bowel volume was noted in the
      conedown fields with the use of a tissue expander (p = .07). Volumes receiving
      less than full dose irradiation were also less within the initial pelvic (p =
      .0001) and conedown (p = .002) fields with a tissue expander. Multivariate
      analysis of patient and treatment-related parameters showed the use of a tissue
      expander to be the only factor correlated with decreased small bowel volume
      within the treatment field (p = .003). Morbidity related to placement and removal
      of the tissue expander was acceptable. Acute radiation-related morbidity was
      significantly less in patients irradiated with a tissue expander in place (p <
      .001). CONCLUSIONS: Placement of an intrapelvic tissue expander was correlated
      with decreased small bowel volume within the radiotherapy treatment field.
      Diminished radiation-induced acute gastrointestinal morbidity was noted with use
      of a tissue expander.

PMID- 8478242
TI  - Cost accounting in radiation oncology: a computer-based model for reimbursement.
AB  - PURPOSE: The skyrocketing cost of medical care in the United States has resulted
      in multiple efforts in cost containment. The present work offers a rational
      computer-based cost accounting approach to determine the actual use of resources
      in providing a specific service in a radiation oncology center. METHODS AND
      MATERIALS: A procedure-level cost accounting system was developed by using
      recorded information on actual time and effort spent by individual staff members
      performing various radiation oncology procedures, and analyzing direct and
      indirect costs related to staffing (labor), facilities and equipment, supplies,
      etc. Expenditures were classified as direct or indirect and fixed or variable. A
      relative value unit was generated to allocate specific cost factors to each
      procedure. RESULTS: Different costs per procedure were identified according to
      complexity. Whereas there was no significant difference in the treatment time
      between low-energy (4 and 6 MV) or high-energy (18 MV) accelerators, there were
      significantly higher costs identified in the operation of a high-energy linear
      accelerator, a reflection of initial equipment investment, quality assurance and
      calibration procedures, maintenance costs, service contract, and replacement
      parts. Utilization of resources was related to the complexity of the procedures
      performed and whether the treatments were delivered to inpatients or outpatients.
      In analyzing time motion for physicians and other staff, it was apparent that a
      greater effort must be made to train the staff to accurately record all times
      involved in a given procedure, and it is strongly recommended that each
      institution perform its own time motion studies to more accurately determine
      operating costs. Sixty-six percent of our facility's global costs were for labor,
      20% for other operating expenses, 10% for space, and 4% for equipment.
      Significant differences were noted in the cost allocation for professional or
      technical functions, as labor, space, and equipment costs are higher in the
      latter. External beam treatment-related procedures accounted for more than 50% of
      all technical and professional revenues, simulation for 8% to 10%, and other
      physics/dosimetry procedures for 11% to 14% of revenues. Some discrepancies were
      identified between the actual cost and level of reimbursement of various
      procedures. Details are described in the manuscript. CONCLUSION: It is imperative
      to develop an equitable reimbursement system for radiation oncology services,
      based on cost accounting and other measures that may enhance productivity and
      reduce the cost per procedure unit, while at the same time preserving the highest
      quality of service provided to patients.

PMID- 8478243
TI  - Radiotoxic model for three-dimensional treatment planning. Part 1: Theoretical
      basis.
AB  - Since recent treatment planning systems calculate volumetric dose distribution,
      an objective evaluation of potential toxicity in the main critical organs may be
      helpful in treatment optimization. Modeling the toxicity of radiotherapy must at
      least account for: (a) specific risks in every critical organ; (b) total dose and
      dose per fraction; (c) partial irradiation of critical organs; (d) heterogeneous
      dose distribution. The Radiation Damage Factor formula is aimed at estimating the
      delayed toxicity of a given treatment plan on every critical organ concerned. The
      formulation uses a double exponential function: RDF = 100 e-Ke-(a+bd)DVc, where:
      D is the total dose, and d the dose per fraction; a and b are coefficients
      representing the radiosensitivity of the critical organ, according to the linear
      quadratic model, with a/b = alpha/beta. K represents the theoretical critical
      unit content of the organ, these critical units being groups of functionally
      related stem cells. The avoidance of a complication depends on the ability of
      surviving critical units to preserve organ function. V is the ratio:irradiated
      volume/total volume of the organ. Exponent c accounts for tissue organization: c
      is equal to or near 1 in "parallel organs" like the liver or the lung, where
      localized hot spots are tolerated; c is lower in "series organs" like the spinal
      cord where hot spots, even in a small portion, are dangerous. Heterogeneous
      irradiation, summarized by dose cumulative-volume histograms, is accounted for by
      calculating step by step the dose D' considered as having an equivalent effect
      when given in the largest irradiated volume ratio. Preliminary calibration of the
      RDF formula is attempted for radiation myelitis and radiation hepatitis.

PMID- 8478244
TI  - Hodgkin's disease with bulky mediastinal involvement.

PMID- 8478245
TI  - Pre-operative chemoradiation for advanced rectal cancer.

PMID- 8478246
TI  - Fatal hemoptysis: complication or failure of treatment.

PMID- 8478247
TI  - Regarding predictive role of TDF values in late rectal recto-sigmoid
      complications in irradiation treatment of cervix cancer.

PMID- 8478248
TI  - A "reappraisal" of the LQ model for the understanding of dose-fractionation in
      radiotherapy.

PMID- 8478249
TI  - Radiation-recall.

PMID- 8478250
TI  - Psychophysiology and social events.

PMID- 8478251
TI  - Psychophysiology and the changing world.

PMID- 8478252
TI  - In commemorating the 10th anniversary of the International Organization of
      Psychophysiology.

PMID- 8478253
TI  - Psychophysiologists and the AIDS epidemic: can we help?

PMID- 8478254
TI  - Terpestacin, a new syncytium formation inhibitor from Arthrinium sp.
AB  - Terpestacin, a new antibiotic which inhibits syncytium formation, was isolated
      from Arthrinium sp. FA1744 (ATCC 74132). The structure of terpestacin was
      elucidated as a bicyclic sesterterpene on the basis of spectroscopic data and
      chemical derivatization.

PMID- 8478255
TI  - 5-N-acetylardeemin, a novel heterocyclic compound which reverses multiple drug
      resistance in tumor cells. I. Taxonomy and fermentation of the producing organism
      and biological activity.
AB  - The ardeemins are a new family of secondary metabolites produced by submerged
      fermentation of a fungus which was isolated from a soil sample collected in
      Brazil. Based on taxonomic studies, the producing culture was identified as
      Aspergillus fischeri var. brasiliensis strain AB 1826M-35. 5-N-Acetylardeemin
      potentiated the cytotoxicity of the anticancer agent vinblastine in multidrug
      resistant human tumor cells.

PMID- 8478256
TI  - 5-N-acetylardeemin, a novel heterocyclic compound which reverses multiple drug
      resistance in tumor cells. II. Isolation and elucidation of the structure of 5-N
      acetylardeemin and two congeners.
AB  - A family of novel compounds has been detected and isolated following an assay for
      the attenuation of multiple drug resistance in tumor cells from the fermentation
      broth and mycelia of a strain of Aspergillus fischeri which we have designated
      var. brasiliensis. The structures of three components were determined employing 1
      D and 2-D homonuclear and heteronuclear NMR spectroscopy and mass spectrometry.
      The structure of 5-N-acetylardeemin was confirmed by single crystal X-ray
      diffraction. These compounds are most closely structurally related to asperlicin
      E1).

PMID- 8478257
TI  - Pradimicins L and FL: new pradimicin congeners from Actinomadura verrucosospora
      subsp. neohibisca.
AB  - Pradimicin L, a new congener of pradimicin A having the D-glucosyl-D-thomosamine
      moiety at the C-5 position, was isolated from Actinomadura verrucosospora subsp.
      neohibisca subsp. nov. The structure of pradimicin L was deduced to be N
      [[(5S,6S)-5-O-[4,6-dideoxy-4-(methylamino)-3-O-(beta-D-glucopyranosyl) - beta-D
      galactopyranosyl]-5,6,8,13-tetrahydro-1,5,6,9,14-pentahydroxy-11- methoxy-3
      methyl-8,13-dioxobenzo[a]naphthacene-2-yl]carbonyl ]-D-alanine by MS and NMR
      spectrometry and degradation studies. Pradimicin FL which has the D-serine moiety
      instead of D-alanine was produced by directed biosynthesis in D-serine
      supplemented medium. Pradimicins L and FL have a broad spectrum of in vitro
      antifungal activity. Pradimicin L was equiactive to pradimicin A and pradimicin
      FL was more active than pradimicin L.

PMID- 8478258
TI  - Pradimicins FS and FB, new pradimicin analogs: directed production, structures
      and biological activities.
AB  - Exogenous addition of D-serine to Actinomadura spinosa AA0851 resulted in
      directed production of pradimicin FS, a new D-serine analog of pradimicin S,
      together with pradimicin FB. Pradimicin FS was produced in higher yields by
      derivation of ferrous sulfate-resistant strains from strain AA0851. Pradimicin
      FB, a minor product, was identified as deglucosylpradimicin FL. Pradimicin FS was
      equivalent to pradimicin S in syncytium formation inhibition activity and in
      vitro and in vivo antifungal activities.

PMID- 8478259
TI  - Biosynthesis of the pradimicin family of antibiotics. I. Generation and selection
      of pradimicin-nonproducing mutants.
AB  - Germinated spores of Actinomadura verrucosospora subsp. neohibisca E-40, a high
      pradimicins producer, were mutagenized by N-methyl-N'-nitro-N-nitrosoguanidine
      and/or UV treatment. Thirty-seven mutants which did not produce pradimicin were
      selected to test for cosynthesis ability, and classified into nine classes. On
      the basis of their cosynthesis ability and bioconversion results, we concluded
      that strain JN-213 (class III) was a true converter and that strains JN-219
      (class IV), JN-47 (class V) and JNU-46 (class VI) were secretors accumulating
      biosynthetic intermediates of pradimicin, and that strains JN-59 (class VII), JN
      58 (class VIII) and JN-207 (class IX) were producers of shunt metabolites of
      pradimicin biosynthesis. TLC and HPLC analyses of the fermentation broths of
      individual strains showed that 8 new compounds were produced along with pradinone
      I, pradimicinone I, 11-O-demethylpradimicinone II and 7-O-methylpradimicinone II.

PMID- 8478260
TI  - Biosynthesis of the pradimicin family of antibiotics. II. Fermentation, isolation
      and structure determination of metabolites associated with the pradimicins
      biosynthesis.
AB  - Ten metabolites produced by 4 mutants derived from Actinomadura verrucosospora
      subsp. neohibisca E-40, a high pradimicins producer, were isolated and their
      structures were determined. Strain JN-219 produced 3 novel analogs of the
      pradimicin A aglycone, i.e. 11-O-demethyl-7-methoxypradinone II and 11-O
      demethylpradinones I and II together with a known aglycone analog, pradinone I,
      while the metabolites from strain JN-47 were determined to be 2 new aglycone
      analogs, 11-O-demethylpradimicinone I and 11-O-demethyl-7-methoxypradimicinone II
      and a known aglycone analog, 11-O-demethylpradimicinone II (11dM-PMN II).
      Products of strain JN-207 were identified as 11-O-demethyl-6-deoxypradinone I and
      11dM-PMN II. Interestingly, a new pradimicin analog, 7-hydroxypradimicin A was
      isolated from strain JN-58 together with a new aglycone analog, pradimicinone II
      and 11dM-PMN II. None of these metabolites showed antifungal activity.

PMID- 8478261
TI  - Biosynthesis of the pradimicin family of antibiotics. III. Biosynthetic pathway
      of both pradimicins and benanomicins.
AB  - The biosynthetic pathway of the pradimicin-benanomicin family of antibiotics was
      investigated by using sinefungin and blocked mutants derived from Actinomadura
      verrucosospora subsp. neohibisca E-40 (a high pradimicin producer) or
      Actinomadura sp. AB1236 (a benanomicin producer). Addition of sinefungin to
      strain E-40, pradimicin A aglycone-producing mutant or strain AB1236 inhibited
      the formation of 11-O-demethyl-7-methoxypradinone II (11dM-7M-PN II), resulting
      in the accumulation of 11-O-demethylpradimicinone II and pradimicinone II. By
      feeding pradimicin A aglycone and its analogs to mutants blocked early in
      pradimicin or benanomicin biosynthesis, the following results were obtained: 11-O
      demethylpradinone II, 11dM-7M-PN II 11-O-demethylpradinone I, 11-O
      demethylpradimicinone I and pradimicinone I were converted to pradimicin A or
      benanomicin A; the remaining 6 aglycone analogs were not incorporated into the
      antibiotics. Pradimicin B, dexylosylpradimicin C and dexylosylbenanomicin A were
      converted to pradimicin A, pradimicin C and benanomicin A, respectively. A
      biosynthetic pathway for the antibiotics is proposed.

PMID- 8478262
TI  - Autoregulation of carbapenem biosynthesis in Erwinia carotovora by analogues of N
      (3-oxohexanoyl)-L-homoserine lactone.
AB  - N-(3-Oxohexanoyl)-L-homoserine lactone (HSL) (I) is the autoregulator controlling
      carbapenem antibiotic biosynthesis in Erwinia carotovora ATCC 39048. The chemical
      synthesis and biological evaluation of analogues of HSL are described. These
      include alterations of chirality, side-chain modifications, ring size and ring
      hetero atom. A number of compounds are reported which are capable of restoring
      the phenotype to a HSL negative mutant but at higher concentrations than HSL. A
      factor, the autoregulator of streptomycin biosynthesis in Streptomyces griseus,
      was not active as an inducer of carbapenem biosynthesis in E. carotovora.

PMID- 8478263
TI  - Studies on the mode of antifungal action of pradimicin antibiotics. II. D
      mannopyranoside-binding site and calcium-binding site.
AB  - Based on the structure-activity relationship data of BMY-28864 and related
      pradimicin derivatives, the calcium salt-forming ability and the D
      mannopyranoside-specific visible absorption maximum shift of BMY-28864 were
      analysed in the ternary complex formation of BMY-28864 with D-mannopyranoside and
      calcium. The free C-18 carboxyl group of BMY-28864 was proved to be the sole site
      for binding to calcium, while no hydroxyl groups of the aglycone were involved in
      calcium salt formation. The stereospecific D-mannopyranoside-recognizing ability
      of BMY-28864 was completely abolished by removal of the C-5 disaccharide moiety,
      and, more particularly, of the C-5 thomosamine moiety. Close relationship of
      these findings with the antifungal action was also supported by the in vitro
      antifungal assay and the potassium leakage induction test.

PMID- 8478264
TI  - Studies on the mode of antifungal action of pradimicin antibiotics. III.
      Spectrophotometric sequence analysis of the ternary complex formation of BMY
      28864 with D-mannopyranoside and calcium.
AB  - Sequence of reactions in the process of ternary complex formation of BMY-28864
      with D-mannopyranoside and calcium was spectrophotometrically determined under
      more strict analytical conditions using metal-free preparations of sugars and the
      pradimicin derivative at a bandpass slit width of 1 nm. In the first phase of
      ternary complex formation, BMY-28864 stereospecifically recognized and bound to D
      mannopyranoside in the absence of calcium, which was revealed by a visible
      absorption maximum shift of ca. 8 nm. Subsequently, the BMY-28864-D
      mannopyranoside conjugate reacted with calcium to yield the ternary complex,
      which was detected by an additional visible absorption maximum shift of ca. 8 nm.
      When the three components were mixed at the same time, both phases simultaneously
      occurred to produce the ternary complex which was accompanied by a visible
      absorption maximum shift of 16 nm in total. Based on this two-phased reaction
      sequence, the mechanism of ternary complex formation of BMY-28864 with D
      mannopyranoside and calcium was reexamined in details. Terminal D-mannopyranoside
      was confirmed to be essential as BMY-28864-specific sugar receptor by in vitro
      analysis and animal cell experiments. While calcium, strontium and cadmium
      behaved similar in the in vitro ternary complex formation, the yeast and animal
      cell experiments showed that only calcium played a dual role as a base in the
      ternary complex formation and as an effector in physiological disturbances
      leading to cell death.

PMID- 8478265
TI  - Implication of cohesive binding of a macrolide antibiotic, rokitamycin, to
      ribosomes from Staphylococcus aureus.
AB  - In a previous paper we reported that rokitamycin (RKM) which killed some types of
      RKM-susceptible staphylococci bound cohesively to ribosomes obtained from such
      bacteria whereas other macrolides such as erythromycin and josamycin, which are
      generally known to be bacteriostatic, bound to these ribosomes only reversibly.
      From this observation, we speculated that such cohesive binding of RKM to certain
      ribosomes probably resulted in cell killing (Endou, K. et al., FEMS Microbiology
      Letters, 72: 93-96, 1990). However, this speculation was based only on
      circumstantial evidence and we did not show directly that reversible binding of
      RKM to ribosomes from other strains would bring about bacteriostasis only. A
      clinically isolated strain. Staphylococcus aureus S704, was found to be
      susceptible to RKM, mycinamicin and tylosin as well as lincosamide and
      streptogramin type B antibiotics but not to other macrolides (erythromycin,
      josamycin, rosamicin, etc.). RKM showed bacteriostatic, but not bactericidal
      activity, on the strain. Determinant(s) responsible for the bacteriostatic
      phenotype was transferred into strain NCTC8325 using bacteriophage 80L2; the
      obtained transductant was referred to as strain 8325MMT7. The drug bound
      reversibly, not cohesively, to the ribosomes from both strains S704 and 8325MMT7,
      confirming our earlier hypothesis that rokitamycin can cause bacteriostasis or
      cell death depending upon whether it binds reversibly or cohesively to the
      ribosomes of a given strain.

PMID- 8478266
TI  - Synthesis and antifungal selectivity of new derivatives of amphotericin B
      modified at the C-13 position.
AB  - The syntheses of the first amphotericin B derivatives to be modified solely at
      the C-13 hemiketal position are described. Selective functionalisation at this
      position is facilitated by use of the allyl ester as a C-16 carboxylate
      protecting group on the amphotericin B nucleus. In in vitro tests all compounds
      showed markedly reduced haemolytic activity against mammalian erythrocytes while
      two of the novel 13-alkoxy derivatives retained good antifungal activity.

PMID- 8478267
TI  - Synthesis and antifungal activities of pradimicin A derivatives modification of
      the alanine moiety.
AB  - Chemical modifications of the carboxyl group in the alanine moiety of pradimicin
      A were performed and in vitro and in vivo antifungal activities of the
      derivatives were examined in comparison with those of pradimicin A. The amide
      derivatives showed activities comparable to pradimicin A, indicating that the
      free carboxyl group can be modified without impairing the antifungal activity.

PMID- 8478268
TI  - Synthesis and antifungal activities of alanine-exchanged analogs of pradimicin A.
AB  - A series of pradimicin analogs were designed and synthesized to investigate the
      effect of the amino acid side chain on the antifungal activity. The alanine
      exchanged analogs (3a approximately 3q) were synthesized from 4'-N-Cbz-pradimic
      acid by coupling with appropriate amino acids or their equivalents followed by
      deblocking. All the D-alpha-amino acid derivatives except D-proline analog, 3k
      retained the antifungal activity.

PMID- 8478269
TI  - Pradimicin Q, a new pradimicin aglycone, with alpha-glucosidase inhibitory
      activity.

PMID- 8478270
TI  - Analysis of the nucleotide sequence of fmrT encoding the self-defense gene of the
      istamycin producer, Streptomyces tenjimariensis ATCC 31602; comparison with the
      squences of kamB of Streptomyces tenebrarius NCIB 11028 and kamC of
      Saccharopolyspora hirsuta CL102.

PMID- 8478271
TI  - Microbial conversion of milbemycins: 28-hydroxylation of milbemycins by Amycolata
      autotrophica.

PMID- 8478272
TI  - Biological activities of novel polyether antifungals, gambieric acids A and B
      from a marine dinoflagellate Gambierdiscus toxicus.

PMID- 8478273
TI  - Anticoccidial activity of salinomycin derivatives.

PMID- 8478274
TI  - New 2''-amino derivatives of arbekacin, potent aminoglycoside antibiotics against
      methicillin-resistant Staphylococcus aureus.

PMID- 8478275
TI  - A synthetic opioid peptide increases plasma growth hormone and prolactin in
      Holstein calves.
AB  - The effect of the synthetic opioid agonist D-Ala2,N-Me-Phe4,Met(O)5-ol enkephalin
      (DAMME) on plasma growth hormone (GH) and prolactin (PRL) concentrations in
      Holstein heifer calves was investigated in this study. The possible site of
      action of DAMME was determined by pretreating calves with an opioid antagonist
      that crosses the blood-brain barrier poorly if at all (N-methyl levallorphan
      methane sulphonate [MLM]) or one that crosses readily (naloxone [NAL]). All
      calves were assigned to one of three treatment groups: 1) pretreatment with
      saline, 2) pretreatment with NAL, or 3) pretreatment with MLM. All groups were
      injected with DAMME 30 min after pretreatments. Plasma PRL increased after
      injection of DAMME in calves pretreated with saline. Prolactin concentrations
      were not different before and after injection of DAMME in calves pretreated with
      either NAL or MLM. Plasma GH increased after injection of DAMME in saline- and
      MLM-pretreated calves but was unchanged in NAL-pretreated calves. These data show
      that peripherally administered DAMME increases plasma GH and PRL in Holstein
      heifer calves and suggest that DAMME mediates GH release through receptors
      located somewhere inside the blood-brain barrier, but it can induce PRL secretion
      at a site located outside the barrier.

PMID- 8478276
TI  - Effects of supplemental protein source on passage of nitrogen to the small
      intestine, nutritional status of pregnant ewes, and wool follicle development of
      progeny.
AB  - Rambouillet wethers, surgically fitted with ruminal and duodenal cannulas, were
      used to determine the influence of substituting soybean meal (SBM) with blood
      meal (BM) in grass hay diets (8.0% CP) on N flow to the small intestine.
      Treatments were arranged in a 3 x 4 Latin square design and included diets (10.6%
      CP) supplemented with SBM; 2/3 SBM:1/3 BM; 1/3 SBM:2/3 BM; or BM. Ruminal NH3 N
      concentration decreased linearly (P = .03) as BM replaced SBM; however, feeding
      BM did not affect (P > .10) the total N, microbial N, or nonammonia N flows to
      the small intestine. A second experiment was conducted to determine the influence
      of substituting SBM with BM on ewe BW and condition score changes, blood
      metabolite profiles, wool growth, and progeny wool follicle development. Thirty
      two pregnant Targhee ewes fed a grass hay diet were allotted randomly to four
      groups (n = 8) and supplemented with either SBM; 2/3 SBM:1/3 BM; 1/3 SBM:2/3 BM;
      or BM. Soybean meal, BM, or their combinations provided 22 g of dietary CP daily.
      Dietary treatments had no influence on ewe BW (P = .40) or body condition score
      (P = .77) changes, and ewes gained 7.6 kg of BW during the 84-d experiment.
      Protein source did not influence (P > .10) serum protein, urea N, creatinine,
      glucose, or nonesterified fatty acid concentrations. Lamb wool follicle density
      per square millimeter and secondary:primary follicle ratios were 22.4 and 10.8,
      respectively, and were not different (P > .10) among dietary treatments. Compared
      with SBM, no advantages were detected for BM supplementation of grass hay diets
      in these studies.

PMID- 8478277
TI  - Modeling gas production kinetics of grass silages incubated with buffered ruminal
      fluid.
AB  - Time course measurements of in vitro gas production of feedstuffs incubated with
      buffered ruminal fluid give information about the rate at which the feed is
      fermented. To compare gas production kinetics from different feeds, a
      mathematical model was needed to describe the data. We investigated several
      existing models (exponential, logistic, Gompertz, Richards, Schnute), fitting
      them to 50 gas production curves obtained with grass silages. None of them gave a
      satisfactory description of the data. A new model was developed (modified
      Gompertz model; mGom) that basically divided gas production into two fractions,
      one arising from rapidly fermentable feed components and the other from slowly
      fermentable feed components. Residual mean squares (RMS) for the mGom model were
      lower (P < .05; n = 50) than the RMS for the other models. A good statistical
      comparison of kinetic gas production data is made possible with the mGom model.

PMID- 8478278
TI  - Effect of protein source and grain type on finishing calf performance and ruminal
      metabolism.
AB  - A finishing trial and a metabolism trial were conducted to evaluate sources of
      supplemental protein in dry-rolled corn (DRC) and dry-rolled grain sorghum (DRGS)
      diets fed to large-framed calves and to determine effects of grain and protein
      source on ruminal metabolism. In Exp. 1, 144 Charolais crossbred steer and heifer
      calves (BW = 269 +/- 3 kg) were used in a randomized complete block design and
      fed (199 d) DRC or DRGS diets supplemented with urea or urea plus a 60:40
      combination (CP basis) of blood meal (BM) and feather meal (FTH). Calves
      supplemented with urea-BM/FTH were more efficient (P < .05) during the first 41 d
      of the trial than were calves supplemented with urea alone. After 41 d, daily
      gain and feed efficiency were not affected (P > .2) by source of protein. The NRC
      metabolizable protein (MP) requirements accurately predicted response to urea
      BM/FTH. In Exp. 2, five ruminally cannulated steers (BW = 721 +/- 20 kg) were
      used in a 5 x 5 Latin square design and fed (on an ad libitum basis) diets
      similar to those used in Exp. 1. An additional treatment of DRC supplemented with
      soybean meal (SBM) was included. Rate (P < .01) and extent of 12-h (P = .14) and
      18-h (P < .05) in situ N disappearance of SBM, BM, FTH, DRC, DRGS, and corn
      silage were greater when diets were supplemented with urea-BM/FTH or SBM.
      Estimates of escape N (percentage of total N) were 52.3, 93.3, 91.7, 65.7, 63.6,
      and 23.2% for SBM, BM, FTH, DRC, DRGS, and corn silage, respectively. Finishing
      calves supplemented with urea were deficient in MP during the early finishing
      period (0 to 41 d) but were adequate in MP from d 42 to slaughter. Supplementing
      urea-BM/FTH improved feed efficiency when MP was limiting but not when MP was
      adequate.

PMID- 8478279
TI  - Teaching principles of behavior and equipment design for handling livestock.
AB  - A course is described in which students are taught principles of livestock
      behavior and how an understanding of behavior can facilitate handling. Some of
      the principles that are covered in the course are livestock senses, flight zone,
      herd behavior during handling, and methods to reduce stress during handling. To
      teach problem solving and original thinking, the students design three different
      types of handling facilities. Design of restraint equipment and humane slaughter
      procedures are also covered. Both existing systems and ideas for future systems
      are discussed. Students are provided with information from both scientific
      studies and practical experience.

PMID- 8478280
TI  - Teaching standard agricultural practices that are known to be painful.
AB  - Animal science faculty teach, demonstrate, and ask students to perform procedures
      that are known to be painful. Potentially painful procedures include castration,
      branding, dehorning, ear notching, teeth clipping, beak trimming, comb and wattle
      removal, and tail docking. In each case, the degree of pain experienced by an
      animal is generally not known. Furthermore, the consequences of animals having to
      endure pain are also not fully understood. A survey was conducted of animal
      science faculty to identify current departmental policies and practices related
      to castration in beef and swine production classes. Departments vary in what they
      require of students. Departments should set a policy to address 1) which (and
      how) potentially painful procedures are taught and 2) how the faculty deal with
      students who refuse to participate in putatively painful procedures. The
      institutional animal care and use committee should approve potentially painful
      teaching procedures after instructor and department have concluded that teaching
      such procedures is essential to a complete educational experience.

PMID- 8478281
TI  - Effect of dietary fat and cholesterol level on tissue cholesterol concentrations
      of growing pigs selected for high or low serum cholesterol.
AB  - Thirty-six female pigs selected for three generations for high or low serum
      cholesterol were chosen to evaluate the effects of a high-fat, high-cholesterol
      diet and a low-fat, low-cholesterol diet provided on an ad libitum basis for 92 d
      beginning at 12 wk of age on the cholesterol content and percentage of fat in
      muscle and organ tissues. The pigs were four-way crosses (Chester White x
      Landrace x Large White x Yorkshire). Samples of cerebrum, heart, ileum, kidney,
      liver, longissimus muscle, semitendinosus muscle, and subcutaneous fat were
      collected from each animal for determination of cholesterol concentration. The
      liver was the only tissue that had a significant difference in cholesterol
      content and in fat percentage between the genetic groups (high serum cholesterol
      and low serum cholesterol) and between the two diets (high-fat, high-cholesterol
      diet and low-fat, low-cholesterol diet). There were no interactions between diet
      and genetic background on cholesterol accretion or on the percentage of fat in
      the tissues.

PMID- 8478282
TI  - Testis function and feedlot performance of bulls actively immunized against
      gonadotropin-releasing hormone: effect of implants containing progesterone and
      estradiol benzoate.
AB  - The effect of implants containing anabolic steroid (Synovex) on testis function,
      feedlot performance, and carcass traits was evaluated in bulls, steers, and bulls
      actively immunized against gonadotropin-releasing hormone (GnRH). Ninety-one
      Hereford or Hereford x Red Angus bull calves were randomly assigned to a 3 x 2
      factorial experiment. The treatments were: 1) unimmunized control (n = 30), 2)
      actively immunized against GnRH (n = 31), or 3) castrate (n = 30). The classes
      were 1) unimplanted (n = 45) or 2) implanted (n = 46) with Synovex. Animals in
      treatment Groups 2 and 3 were either immunized with a GnRH-keyhole limpet
      hemocyanin (KLH) conjugate or castrated at 3.6 +/- .1 mo of age. Animals assigned
      to Class 2 received Synovex-C at the time of initial treatment and Synovex-S at
      weaning and feedlot entry. Animals in treatment Group 2 received a booster
      immunization at feedlot entry. Anti-GnRH titer was evident at weaning and
      remained elevated to slaughter in all (31 of 31) immunized animals. Anti-GnRH
      titer was not evident in steers or unimmunized bulls. Immunization and (or)
      Synovex decreased (P < .05) serum concentrations of testosterone (T) and scrotal
      circumference (SC) at weaning. Similarly, SC, testis weight, and tissue
      concentrations of spermatozoa at slaughter were significantly reduced by
      immunization, Synovex, or the immunization/Synovex combination. Immunization, but
      not Synovex, reduced (P < .05) serum levels of T at slaughter. The masculinity of
      immunized bulls was less (P < .05) than that of control bulls.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8478283
TI  - Estimation of the water requirement for beef production in the United States.
AB  - A static model of developed water use for U.S. cattle production was constructed
      on a spreadsheet. Water use included that consumed directly by various classes of
      animals, water applied for irrigation of crops that are consumed by the cattle,
      water applied to irrigated pasture, and water used to process animals at
      marketing. Government statistics were consulted for numbers of cattle and crop
      production. The most recent statistics available for numbers of cattle and crops
      in individual states were used. On January 1, 1992, a total of 33.8 million beef
      cows and 5.7 million replacement heifers were in U.S. breeding herds, 12 million
      animals were on feed, and approximately 28 million animals were fed annually.
      Thus, the U.S. beef cattle herd produced 6.9 billion kg of boneless beef. Beef
      cattle directly consumed 760 billion L of water per year. Feedlot cattle were fed
      various grain and roughage sources corresponding to the regions in which they
      were fed. Feeds produced in a state were preferentially used by cattle in that
      state with that state's efficiency; any additional feedstuffs required used water
      at the national efficiency. Irrigation of crop feedstuffs for beef cattle
      required 12,991 billion L of water. Irrigated pasture for beef cattle production
      required an additional 11,243 billion L of water. Carcass processing required 79
      billion L of water. The model estimates 3,682 L of developed water per kilogram
      of boneless meat for beef cattle production in the United States. The model was
      most sensitive to the dressing percentage and percentage of boneless yield in
      carcasses of feedlot cattle (62 and 66.7, respectively).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8478284
TI  - Dose-dependent effects of exogenous porcine somatotropin on the yield,
      distribution, and proximate composition of carcass tissues in growing pigs.
AB  - Dose-dependent effects of porcine somatotropin (pST) on mass, distribution, and
      proximate composition of carcass tissues were investigated in 46 growing pigs.
      Barrows, weighing 30 +/- 1 kg, were assigned to five treatment groups to receive
      0, 50, 100, 150, or 200 micrograms of recombinant pST/kg BW per day until pigs
      individually reached the 90-kg slaughter weight. Left carcass sides were
      fabricated into whole-sale cuts that were separated into muscle, adipose tissue,
      bone, and skin. Despite the reduction in dressing percentage, total muscle mass
      of the side was significantly increased by 3.9 to 5.7 kg (28 to 36%) by the
      lowest and highest doses of pST, respectively, whereas adipose tissue mass was
      decreased by 4.4 to 8.6 kg (38 to 74%). Bone mass was increased by 8 to 27% (P <
      .05), and skin mass was increased by 16 to 38% (P < .01) across the dose range.
      Distribution of carcass weight among the wholesale cuts was altered by pST toward
      lower proportions in the belly, jowl, and fat trimmings and greater proportions
      in the four lean cuts. Porcine somatotropin substantially reduced lipid
      concentration in all muscle groups in a dose-dependent manner, resulting in
      increased protein and moisture concentrations (P < .05). Adipose tissue lipid
      concentrations were reduced to an even greater extent at each dose. The
      progressive increase in muscle mass observed with pST doses > 50 micrograms/kg BW
      was less than the associated decrease in adipose tissue mass, indicating that a
      dose range of 50 to 100 micrograms/kg BW per day may be optimum for improving
      carcass value.

PMID- 8478285
TI  - Sequential transformation for multiple traits for estimation of (co)variance
      components with a derivative-free algorithm for restricted maximum likelihood.
AB  - Transformation of multiple-trait records that undergo sequential selection can be
      used with derivative-free algorithms to maximize the restricted likelihood in
      estimation of covariance matrices as with derivative methods. Data transformation
      with appropriate parts of the Choleski decomposition of the current estimate of
      the residual covariance matrix results in mixed-model equations that are easily
      modified from round to round for calculation of the logarithm of the likelihood.
      The residual sum of squares is the same for transformed and untransformed
      analyses. Most importantly, the logarithm of the determinant of the untransformed
      coefficient matrix is an easily determined function of the Choleski decomposition
      of the residual covariance matrix and the determinant of the transformed
      coefficient matrix. Thus, the logarithm of the likelihood for any combination of
      covariance matrices can be determined from the transformed equations. Advantages
      of transformation are 1) the multiple-trait mixed-model equations are easy to set
      up, 2) the least squares part of the equations does not change from round to
      round, 3) right-hand sides change from round to round by constant multipliers,
      and 4) less memory is required. An example showed only a slight advantage of the
      transformation compared with no transformation in terms of solution time for each
      round (1 to 5%).

PMID- 8478286
TI  - Estimates of variances due to direct and maternal effects for growth traits of
      Romanov sheep.
AB  - Records of growth traits of 2,086 Romanov lambs were used to estimate variance
      components for an animal model and genetic correlations between growth traits.
      Traits analyzed were birth weight (BWT), weaning weight (WW), 90-d weight (W90),
      and daily gain for the periods birth to weaning (DG1) and weaning to 90 d (DG2).
      Weaning was at approximately 40 d. Variance components were estimated using
      restricted maximum likelihood with an animal model including fixed effects for
      year x season, sex, rearing type, and litter size and random effects for the
      direct genetic effect of the animal (with relative variance h2), the maternal
      genetic effect (with relative variance m2), the permanent environmental effect
      (with relative variance c2), and random residual effect. Genetic correlations
      were estimated for a model with the same fixed effects and only additive genetic
      effects. Estimates of the variances of random effects, h2, m2, and c2,
      respectively, as a proportion of phenotypic variance were .04, .22, .10 (BWT);
      .34, .25, .0 (WW); .09, .01, .07 (W90); .26, .17, .02 (DG1); and .15, .01, .03
      (DG2). Estimates of genetic correlations were .12 (BWT with WW); .24 (BWT with
      W90); .48 (WW with W90); .69 (DG1 with DG2); -.01 (BWT with DG1); .05 (BWT with
      DG2); .59 (WW with DG1); .47 (WW with DG2); .67 (W90 with DG1); and .98 (W90 with
      DG2). Results suggest that selection should be effective for WW, DG1, and DG2 but
      less effective for BWT and W90. An important maternal effect was observed for
      BWT, WW, and DG1. The estimates of genetic correlations showed no genetic
      antagonisms among the traits.

PMID- 8478287
TI  - Animal model estimation of genetic parameters and response to selection for
      litter size and weight, growth, and backfat in closed seedstock populations of
      large white and Landrace swine.
AB  - Records from 2,495 litters and 14,605 Landrace and Large White pigs from two
      farms, but established from the same base population and run as replicated
      selection lines, were analyzed. Selection within herd was on estimated breeding
      values weighted by economic values. Animal models and REML procedures were used
      to estimate genetic, phenotypic, and environmental parameters for the number of
      pigs born alive (NBA), litter weight at 21 d (LW), average daily gain form
      approximately 30 to 104 kg (ADG), and backfat thickness adjusted to 104 kg (BF).
      Random animal genetic effects (o), permanent (NBA and LW) or litter (ADG and BF)
      environmental effects, maternal genetic effects (m), and the covariance between o
      and m were sequentially added to the model. Estimates of total heritability
      calculated from all data (ht2 = sigma o2 + 1/2 sigma m2 + 3/2 sigma om) ranged
      from .01 to .14 for NBA, from .18 to .22 for LW, from .23 to .34 for ADG, and
      from .40 to .50 for BF. Maternal genetic variance was from 2.4 to 3.8% of
      phenotypic variance in NBA, from 1.2 to 3.6% in LW, from .5 to 1.5% in ADG, and
      from 1.9 to 3.4% in BF. The correlation between o and m was -.07 for NBA, -.25
      for LW, -.34 for ADG, and -.26 for BF. Permanent environmental effects explained
      from 16 to 17% of total phenotypic variation for NBA and from 1.6 to 5.3% for LW.
      Approximately 7% of the variation in ADG and 5% in BF was due to litter
      environmental effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478288
TI  - Comparison of Texel- and Suffolk-sired crossbred lambs for survival, growth, and
      compositional traits.
AB  - Texel sheep were imported from Finland and Denmark for evaluation as a terminal
      sire population relative to the Suffolk breed. The objective was to estimate
      effects of sire breed on fitness, growth, and compositional traits of crossbred
      progeny that were serially slaughtered at 63, 105, 147, and 189 d of age. A total
      of 325 lambs, sired by 19 Texel and 20 Suffolk rams, were born to mature, half
      Finnsheep ewes during a 2-yr period. Carcass traits were recorded on 183 lambs.
      Texel-sired lambs had greater survival to weaning (P = .06) and similar birth and
      weaning weights compared with Suffolk progeny. Lambs by Texel sires grew 11% less
      rapidly from 63 to 189 d of age. Estimated accretion rates of carcass fat at 189
      d of age were 96.1 and 78.5 g/d for Suffolk and Texel progeny, respectively.
      Corresponding values for carcass protein were 17.4 and 16.0 g/d. At fixed ages,
      area of the longissimus muscle did not differ between sire breeds. Texel progeny
      weighed less at 189 d of age, producing lighter, leaner carcasses of shorter
      length (P < .05). Compositional differences were not detected when sire breeds
      were compared at 25 kg of carcass weight. However, Texel progeny had
      significantly greater depth of fat at the 12th rib and weight of kidney-pelvic
      fat. Data indicated that Texel-sired lambs deposited proportionally more
      subcutaneous and less intermuscular fat than did lambs by Suffolk sires. Due to
      the apparent advantage in lamb survival and the observation that Texel progeny
      produce lean carcasses relative to the intermediate growth rate and mature size
      characteristic of the breed, it is concluded that Texel sheep can be used
      effectively as a terminal sire breed.

PMID- 8478289
TI  - Diallel cross of three Moroccan breeds of sheep: I. Lamb growth and carcass
      traits.
AB  - A diallel cross involving three Moroccan breeds of sheep (D'man, Beni Guil, and
      Sardi) was conducted for two successive years at the Gharb Experiment Station in
      Morocco. Significant effects associated with breed of sire and breed of dam for
      live and carcass weights are consistent with differences in mature body size of
      the three breeds involved. Carcasses of lambs by Sardi sires or out of Sardi dams
      were the heaviest and those by D'man sires or out of D'man dams were the
      lightest. Lambs by D'man sires reached the prescribed stage of maturity for
      slaughter at a younger age than did lambs of Beni Guil sires, and lambs out of
      Beni Guil dams were younger at slaughter than lambs out of Sardi dams. Because of
      its genetic potential for high growth rate and carcass weight, the Sardi breed
      could be used in breeding programs to enhance meat production from sheep in
      Morocco. With the large and desirable maternal effects expressed by the Beni Guil
      breed on growth traits and carcass weight per 100 d of age, it could also be used
      in Morocco as a breed of dam.

PMID- 8478290
TI  - Diallel cross of three Moroccan breeds of sheep: II. Reproductive performance and
      productivity of purebred ewes.
AB  - A diallel cross involving three Moroccan breeds of sheep (Sardi, Beni Guil, and
      D'man) was analyzed by least squares procedures. A total of 456 ewes were mated
      to 22 rams and this resulted in 528 lambs born from 412 ewes. D'man ewes had by
      far the highest general performance as measured by total weight of lamb weaned,
      even though the average live weight per lamb was the lowest for the three breeds;
      this resulted from the higher number of lambs weaned per ewe for the D'man. The
      least squares means for litter size at birth per ewe lambing were 2.04, 1.01, and
      1.11 for D'man, Beni Guil, and Sardi ewes, respectively. The comparable figures
      for litter size at weaning were 1.55, .90, and .99, respectively, and the least
      squares means for total weight of lamb weaned were 20.7, 16.9, and 18.2 kg for
      D'man, Beni Guil, and Sardi ewes, respectively. The comparable figures for total
      weight of lamb weaned per 100 kg of ewe weight were 71.1, 44.3, and 41.1 kg/100
      kg for D'man, Beni Guil, and Sardi ewes. Conversely, D'man rams had the poorest
      breeding performances of the rams of the three breeds, and Beni Guil rams had the
      lowest litter mortality. The breed of ram had only small and nonsignificant
      effects on all measures of fertility and ewe productivity. The least squares
      means for number born/ewe lambing were 1.36, 1.35, and 1.44, respectively, for
      D'man, Beni Guil, and Sardi rams; the comparable least squares means for number
      weaned per ewe lambing were 1.10, 1.18, and 1.16, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8478291
TI  - Shipping stress and social status effects on pig performance, plasma cortisol,
      natural killer cell activity, and leukocyte numbers.
AB  - Crossbred pigs were used to evaluate the effects of shipping stress on natural
      killer (NK) cell activity, leukocyte numbers, plasma cortisol, and BW changes. In
      the first study, pigs were bled at a commercial farm and, after shipping,
      resident and shipped pigs were bled again. Plasma cortisol concentrations were
      not different (P > .10) because of large variation in cortisol concentrations.
      Furthermore, NK cytotoxicity was nondetectable among all pigs. A second study
      showed that plasma cortisol concentration rose by approximately 2.6 ng/mL (P =
      .018) for each minute after pigs were aroused. In the third, more controlled
      study, pigs were housed in pens of three pigs each. Video recordings were made
      during the first 24 h pigs were grouped to identify socially dominant,
      intermediate, and submissive pigs. At time zero (before shipping), resident pigs
      and those to be shipped had similar plasma cortisol concentrations. However,
      after the 4-h shipping experience, shipped pigs had elevated (P < .05) plasma
      cortisol compared with resident control pigs. Shipped pigs lost 5.1% of their BW
      (P < .05) compared with resident pigs, which gained .02% of their BW. Body weight
      change during shipping and plasma cortisol were negatively correlated (r = -.34,
      P = .04), indicating pigs that had greater adrenal response to shipping also lost
      more weight during shipping. Shipping reduced (P < .05) NK cytotoxicity among
      pigs of intermediate and submissive social status compared with shipped, dominant
      pigs. At the end of shipping or control treatments, the correlation between NK
      cytotoxicity and plasma cortisol was positive (r = .35, P = .036), indicating
      that pigs with greater cortisol response had greater NK cytotoxicity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8478292
TI  - Acute effects of administration of porcine growth hormone on circulating levels
      of hormones and metabolites in 20-, 40-, and 60-kilogram gilts.
AB  - Three groups of eight gilts weighing 20, 40, or 60 kg were fitted with indwelling
      venous catheters to determine daily integrated circulating levels (DICL, serum
      concentration above baseline x time) of insulin, growth hormone (GH), glucagon,
      glucose, urea, and nonesterified fatty acids (NEFA) in response to acute
      challenge with porcine pituitary GH (pGH). Pigs were fed a common diet containing
      18% CP and 3.5 Mcal of DE/kg between 0800 and 1200 (85% of ad libitum). Blood and
      urine were collected at 2- or 4-h intervals for 4 d. On d 2, 3, and 4, four pigs
      in each group were injected i.m. at 0800 with pGH (.1 mg/kg) and four pigs
      (controls) were injected with buffer. In control pigs DICL of GH was 20.4, 14.1,
      and 10.2 ng pGH.h.mL-1 in 20-, 40-, and 60-kg pigs, respectively. The DICL of GH
      in pGH-treated pigs was 4.2-, 7.0-, and 10.7-fold greater in 20-, 40-, and 60-kg
      pigs, respectively, than in controls. The DICL of insulin in control pigs was
      7.9, 9.7, and 9.4 ng.h.mL-1 and was increased (P < .001) in pGH-treated pigs by
      118, 213, and 276% in 20-, 40-, and 60-kg pigs, respectively. Although serum
      levels of glucose were increased (P < .001) by pGH treatment, the acute elevation
      observed in 60-kg pigs was more consistent relative to 20- and 40-kg pigs. In
      contrast, the acute reduction in blood urea upon pGH injection was more apparent
      in 20-kg gilts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478293
TI  - Muscle histochemical and biochemical properties in relation to meat quality
      during selection for increased lean tissue growth rate in pigs.
AB  - The relationship between the histochemical and biochemical properties of muscle
      and the quality of meat during selection to improving the lean tissue growth rate
      was studied. Pigs (n = 82) from Generations 2 and 4 were randomly sampled in a
      selection experiment in which the genotype x protein interaction was studied.
      Comparisons were made of longissimus muscle (LM) and quadriceps femoris (QF) from
      Generations 2 and 4, and biceps femoris (BF) in the fourth generation from pigs
      fed a low- or high-protein diet. A higher total growth rate, lean tissue growth
      rate, and lean percentage were found in pigs fed the high-protein diet than in
      pigs fed the low-protein diet. Pigs fed the high-protein diet had a higher
      glycolytic capacity in all muscles than pigs fed the low-protein diet. When the
      meat quality traits were compared, pigs fed the high-protein diet had a lower
      intramuscular fat content, higher shear force value, higher protein
      extractability, lower light reflectance, and somewhat higher water-holding
      capacity. With selection, pigs became fatter on both diets. In Generation 4,
      glycolytic and oxidative capacity was somewhat higher in muscle tissue than in
      Generation 2. Muscle metabolic profile and meat quality traits differed among
      muscles (LM, BF, QF) but no pronounced differences were found between
      generations. No marked changes were observed in Type I, IIA, or IIB fibers,
      either between diets or between generations. The Type IIC fibers could only be
      identified in Generation 4.

PMID- 8478294
TI  - Effect of heating rate on palatability and associated properties of pre- and
      postrigor muscle.
AB  - Precooked, uncured meat is not widely available to consumers, partially because
      of associated palatability problems and lack of published information on heat
      uptake under different industrial conditions. The objectives of this study were
      to determine the tenderness, extent of lipid oxidation, and total cooking losses
      in pre- and posterior beef and pork roasts heated at different rates. The muscles
      were cooked in stainless-steel, perforated heating chambers at oven temperatures
      of 150, 200, or 250 degrees C and the temperature rise during and after heating
      was monitored with a digital temperature recorder. Samples were vacuum-packaged,
      frozen at -20 degrees C for 45 d, thawed at 4 degrees C for 24 h, and reheated in
      60 degrees C water for 1 h. Cooking losses, Warner-Bratzler shear force values,
      thiobarbituric acid values, and pH were determined. The results provide heating
      curves for pre- and postrigor beef and pork roasts at three oven temperatures.
      Prerigor samples of both species were less tender than postrigor samples (P <
      .05). Cooking losses were generally low in prerigor samples of both species
      compared with postrigor samples (P < .05). All beef samples had relatively low
      thiobarbituric acid (TBA) values before and after storage, whereas pork samples
      had relatively high TBA values before and after storage. Results indicate that
      prerigor cooked roasts shrink less, are equivalent or better in oxidative
      stability, and are less tender than postrigor cooked roasts under the conditions
      of this experiment.

PMID- 8478295
TI  - Zinc-silicon interactions influencing sperm chromatin integrity and testicular
      cell development in the rat as measured by flow cytometry.
AB  - Flow-cytometric procedures were used to determine effects of dietary Zn and Si
      variations on rat testicular cell development, including integrity of caudal
      epididymal sperm chromatin structure defined as the susceptibility of DNA to
      denaturation in situ. Concentrations of 4 (deficient), 12 (adequate), and 500
      (excessive) mg of Zn/kg of diet were used with Si concentrations of 0 (low), 540
      (medium), and 2,700 (high) mg/kg of diet in a 3 x 3 factorial arrangement. Three
      week-old Sprague-Dawley male rats were fed the experimental diets for 8 wk. Rats
      fed the Zn-deficient/Si-low diet demonstrated significant deviations in the ratio
      of testicular cell types present, including a reduction of S phase and total
      haploid cells. Furthermore, approximately 50% of epididymal sperm had a
      significant decrease in resistance to DNA denaturation in situ. In the Zn
      deficient/Si-medium treatment, the effects of Si on animal and testicular growth,
      distribution of testicular cell types, and sperm chromatin structure integrity
      were quite similar to the effects of the Zn-adequate diets. A toxic effect of Zn
      on sperm chromatin structure integrity observed in the Zn-excess/Si-medium
      treatment seemed to be counteracted by Si in the Zn-excess/Si-high treatment.
      Silicon at medium and high levels seems to affect Zn metabolism through
      potentiation and antagonistic reactions, respectively. Zinc deficiency likely
      disrupts the normal sperm chromatin quaternary structure in which Zn plays a role
      by providing stability and resistance to DNA denaturation in situ.

PMID- 8478296
TI  - Microbially detoxified vomitoxin-contaminated corn for young pigs.
AB  - A performance trial was conducted to evaluate the effect of microbially
      detoxified moldy corn in a corn-soybean meal-based starter diet for young pigs.
      Moldy corn containing 450 ppm of vomitoxin replaced clean corn in a control diet
      to give a diet containing 5 ppm of vomitoxin. The same amount of moldy corn was
      microbially detoxified by incubation with the contents of the large intestine of
      chickens (CLIC) and then incorporated into the control diet to give a
      "detoxified" vomitoxin diet, which contained 2.1 ppm of vomitoxin. A paired diet
      was formulated by incorporating the untreated moldy corn into the control diet to
      give a diet containing the same level of vomitoxin as the "detoxified" vomitoxin
      diet. Clean corn was also treated with CLIC and replaced corn in the control diet
      to give a biologically treated control diet. Each diet was fed to six pigs (three
      gilts and three boars) for 5 d and then all pigs were changed to the control diet
      for a further 5-d feeding period. During the first 5-d feeding period, no
      differences were observed in pigs fed either the control diet or the biologically
      treated control diet. A diet containing 5 ppm of vomitoxin decreased the pigs'
      daily feed consumption, weight gain, and feed efficiency by 25, 57, and 45%,
      respectively, compared with the control diet (P < or = .05). Daily feed intake,
      weight gain, and feed efficiency in pigs fed the "detoxified" vomitoxin diet were
      19, 54, and 37% greater, respectively, than for pigs fed the vomitoxin diet (P <
      or = .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478297
TI  - Ovulatory and endocrine responses after active immunization of gilts against a
      synthetic fragment of bovine inhibin.
AB  - The objective of this study was to determine whether neutralizing endogenous
      inhibin would affect ovulation rate and serum concentrations of FSH, LH,
      estradiol-17 beta, and progesterone in gilts. At wk 0, during their second
      postpubertal estrous cycle, gilts (195 +/- 2.4 d of age) were given a primary
      immunization against the 1-26 gly-tyr NH-terminal amino acid sequence of bovine
      inhibin-alpha conjugated to human alpha globulin (INH; n = 10) or against human
      alpha globulin alone (control; n = 10). The primary immunization mixed with
      Freund's complete adjuvant contained .915 mg of the inhibin peptide. Booster
      immunizations in Freund's incomplete adjuvant contained .3 and .183 mg of the
      inhibin peptide and were given at wk 8 and 12, respectively. Free, unconjugated
      inhibin was given to INH gilts at 16 wk. Blood samples for determination of
      hormones were collected every 4 h beginning on d 15 of the first estrous cycle
      beyond wk 16 (first cycle) and continuing until d 5 of the second estrous cycle
      following wk 16 (second cycle). Ovulation rate was estimated by laparoscopy
      during the second cycle. Antibody titers were estimated by determining the
      percentage of [125I]-INH bound by serum diluted 1:4,000. The antibody titers were
      17 +/- 2, 22 +/- 3, and 9 +/- 1% at wk 9, 17, and 23 for INH gilts, respectively,
      and 0% at all times for control gilts. Duration of three consecutive estrous
      cycles terminating with the first experimental cycle did not differ between
      treatments (INH, 20.7 +/- .3 vs control, 20.4 +/- .3 d).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8478298
TI  - Influence of stage of lactation, exogenous luteinizing hormone-releasing hormone,
      and suckling on estrus, positive feedback of luteinizing hormone, and ovulation
      in sows treated with estrogen.
AB  - The overall objective of this study was to investigate the LH response and
      occurrence of estrus and ovulation in sows treated with estradiol benzoate (EB)
      at mid- (d 14) or late (d 28) lactation. Experiment 1 tested the hypothesis that
      hourly pulses of LHRH given to sows treated with EB would cause a greater
      proportion to exhibit LH surges. Sows (n = 32) at mid- or late lactation were
      given (i.m.) corn oil (CO) or EB (10 micrograms/kg BW) at 0 h and no pulses or
      hourly pulses (100 ng/pulse) of the LHRH agonist des-Gly10,[D-ALA6]-LHRH
      ethylamide (LHRH-A) from 54 to 96 h, the anticipated period of positive feedback
      of LH. Blood samples for determination of estradiol-17 beta (E2) and LH were
      collected every 6 h from -12 to 120 h from sows treated with EB. Estrus was
      checked daily with a mature boar, and ovulation was assessed by measuring
      progesterone in blood 1 wk after estrus induced by EB or 2 wk after weaning at 34
      +/- 1.4 d postpartum. Lactational estrus occurred in 0 of 16 and 15 of 16 sows
      given CO and EB, respectively; however, no sow ovulated in response to EB.
      Concentrations of LH were lower (P < .01) during mid- than during late lactation,
      and LHRH-A pulses had no effect on secretion of LH and E2. The LH concentrations
      during the pretreatment (-12 to 0 h), negative feedback (6 to 54 h), and positive
      feedback (60 to 96 h) periods at mid-lactation (.32 +/- .03, .22 +/- .01, and .54
      +/- .08 ng/mL, respectively) differed (P < .01) from values at late lactation
      (.80 +/- .06, .49 +/- .02, and 1.47 +/- .17, respectively). Preovulatory-like
      surges of LH occurred in one of eight (peak 2.1 ng/mL) and seven of eight (peak
      2.9 +/- 1 ng/mL) sows given EB at mid- and late lactation, respectively.
      Experiment 2 tested the hypothesis that the hypothalamus and pituitary of sows
      weaned 96 h before they were given EB would show a greater responsiveness than
      those weaned and given EB simultaneously. Sows (n = 16) at mid- or late lactation
      were treated with EB (10 micrograms/kg BW; i.m.), and one-half of the sows were
      suckled until the moment of EB treatment, whereas the other half had their
      litters weaned 96 h before treatment with EB.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8478299
TI  - Prolonged postpartum anovulation in mastectomized cows requires tactile
      stimulation by the calf.
AB  - Association of the calf with its dam prolongs the postpartum interval to first
      ovulation in intact and mastectomized cows indicating that tactile stimulus of
      the teat and (or) udder is not necessary. Therefore, we conducted the following
      experiment to determine whether individual calves allowed restricted contact with
      their mastectomized dam would delay the onset of first postpartum ovulation.
      Mastectomized cows (n = 21) were allotted randomly and equally to three groups in
      which cows were 1) allowed unrestricted access to their calves, with unlimited
      tactile, olfactory, visual, and auditory stimuli (calf present); 2) removed
      permanently from their calves 24 h after parturition and provided no further
      association with their calves (calf removed); and 3) remained with their calves
      for 24 h and then the cow-calf pair was restricted to a pen where tactile contact
      of the calf was limited to the head and neck region of its dam (calf restricted).
      Seven udder-intact cows (control) remained with their calves and were allowed to
      nurse ad libitum. Postpartum intervals to ovulation and first estrus for the calf
      restricted cows and calf-removed cows were similar but shorter (P < .05) than
      those for the calf-present and udder-intact groups. We conclude that restricting
      tactile stimuli of the calf to the head and neck area of its dam failed to
      prolong postpartum anovulation in the mastectomized dam and that a cow-calf
      nursing orientation with tactile stimuli to the inguinal area, but not limited to
      the teat and(or) udder, was sufficient to prolong anovulation.

PMID- 8478300
TI  - Clinical efficacy of dirithromycin versus miocamycin in tonsillopharyngitis.
AB  - A single-blind, randomized, parallel-group study was conducted to compare the
      efficacy and safety of dirithromycin with miocamycin in the treatment of
      streptococcal pharyngitis/tonsillitis caused by Group A streptococci. The study
      population consisted of 60 patients: 30 were randomized to receive 500 mg
      dirithromycin od and 30 to receive 600 mg miocamycin bd. All 30 dirithromycin
      treated patients were eligible for efficacy analysis. A favourable clinical
      response was observed in 100% of these patients at the post-therapy visit. In the
      miocamycin-treated group, 28 of 30 (93.3%) patients were eligible for efficacy
      analysis; a favourable clinical response was observed in 100%. Bacteriological
      cure of evaluable dirithromycin- and miocamycin-treated patients was 96.7% and
      92.9%, respectively. No statistically significant post-therapy differences in
      clinical or bacteriological response rates were noted between the two groups.
      Adverse event analysis showed no significant differences between treatment
      groups. There were no serious adverse events during the study. Two miocamycin
      treated patients were prematurely withdrawn from the study due to adverse events
      (diarrhoea). Analysis of clinical laboratory data revealed no statistically
      significant differences between the treatment groups that were considered to be
      drug related. The results of this study suggest that dirithromycin has comparable
      safety and efficacy to miocamycin in the treatment of streptococcal
      pharyngitis/tonsillitis infections caused by Group A streptococci.

PMID- 8478301
TI  - Comparison of macrolide antibiotics.
AB  - Macrolides have been in use since the early 1950s. In recent years new macrolides
      have been developed to try to overcome the problems associated with erythromycin.
      In general they have fairly similar in-vitro activity, although azithromycin has
      superior activity against Haemophilus influenzae and some Gram-negative
      organisms. Clarithromycin shows superior in-vitro activity against Legionella
      spp. and against the type strain of Chlamydia pneumoniae. The pharmacology of
      macrolides produces many interpretive problems, and macrolides show marked
      variation in their pharmacokinetic parameters, tissue affinity and intracellular
      penetration. Newer macrolides such as clarithromycin, roxithromycin,
      dirithromycin and azithromycin only need to be taken once or twice a day, which
      is likely to improve patient compliance. Few objective side-effect studies have
      been performed with the newer macrolides. Clinical efficacy studies are essential
      to elucidate the significance of the complex pharmacology of macrolides.

PMID- 8478302
TI  - The problems of treating atypical pneumonia.
AB  - Atypical pneumonia has been recognized for at least four decades as a clinical
      syndrome characterized by a less severe clinical course than typical bacterial
      pneumonia. It is caused by a variety of different organisms including Mycoplasma
      pneumoniae, chlamydiae, rickettsiae, viruses and Legionella pneumophila. Of the
      chlamydiae, TWAR-strain (Chlamydia pneumonia) is now considered the most
      important pathogen. Its prevalence in community-acquired pneumonia varies
      considerably depending on the cyclical nature of the disease, but also on the
      diagnostic methods applied. The first line therapy in community-acquired
      pneumonia is usually empirical administration of a penicillin or cephalosporin to
      cover the bacterial pathogens which usually cause 'typical' pneumonia, most
      importantly Streptococcus pneumoniae. If, however, atypical pneumonia is
      diagnosed by bacteriological or serological testing, or is suspected clinically
      or on the basis of treatment failure, the treatment of choice would be
      erythromycin 2-4 g or tetracyclines (doxycycline 200 mg) daily for M. pneumoniae
      pneumonia and C. pneumoniae (TWAR-strain) infection. For coxiella pneumonia
      tetracycline is preferred. Psittacosis (ornithosis) has a high mortality and must
      be treated with tetracyclines immediately. Legionella pneumonia is preferably
      treated with erythromycin 2-4 g for at least three weeks; as an alternative,
      tetracyclines or quinolones may be given. Quinolones are less effective in
      mycoplasma and chlamydial infection. The new macrolide antibiotics are promising
      agents in pneumonia due to M. pneumoniae, L. pneumophila and C. pneumoniae.
      Compared to erythromycin they have improved pharmacological properties. They have
      long half-lives allowing once-daily dosing and achieve high tissue and
      intracellular concentrations.

PMID- 8478303
TI  - Clinical efficacy of dirithromycin in pneumonia.
AB  - In a double-blind, double-dummy, multicentre study the efficacy and safety of
      dirithromycin 500 mg/day given orally once daily for 10-14 days were compared
      with those of erythromycin 1000 mg/day given orally four times daily for 10-14
      days in patients with bacterial pneumonia. At 3-5 days post-therapy, 90
      dirithromycin- and 83 erythromycin-treated patients were evaluable; the main
      reason for non-evaluability was failure to isolate the causative organism.
      Symptomatic responses were favourable in 94.5% of dirithromycin- and 100% of
      erythromycin-treated patients at post-therapy. At late post-therapy (2-3 weeks
      after completion of treatment), symptomatic responses were favourable in 98.7% of
      dirithromycin- and 94.8% of erythromycin-treated patients. At post-therapy, 63.3%
      of dirithromycin- and 50.6% of erythromycin-treated patients were unable to be
      evaluated bacteriologically, mainly due to Mycoplasma pneumoniae or Legionella
      pneumophila being assessed serologically. In the remaining evaluable patients
      treated with dirithromycin and erythromycin, bacteriological responses were
      favourable in 91.4% and 87.8%, respectively. At late post-therapy, favourable
      bacteriological responses occurred in 89.7% and 86.8%, respectively, of
      dirithromycin- and erythromycin-treated patients. Abdominal pain was the only
      treatment-emergent event to occur significantly more frequently in dirithromycin
      treated patients.

PMID- 8478304
TI  - Clinical efficacy of dirithromycin in acute exacerbations of chronic bronchitis.
AB  - The efficacy and safety of seven days treatment with oral dirithromycin 500 mg
      given once daily was compared with oral erythromycin 250 mg qid in patients with
      acute bacterial exacerbations of chronic bronchitis. A total of 393 patients
      received dirithromycin and 409 erythromycin. Of 101 dirithromycin-treated
      patients analysed for efficacy, 87 (86%) had favourable clinical responses
      compared with 72/81 (89%) of those treated with erythromycin. Proven or presumed
      pathogen elimination was noted in 85/101 (84%) dirithromycin-treated patients and
      66/81 (82%) erythromycin treated patients. Late post-therapy responses were also
      similar between treatment groups. Favourable clinical responses were noted in 89%
      of patients treated with dirithromycin and 91% of those receiving erythromycin. A
      favourable bacteriological response was noted in 87.5% and 89.6% of the
      dirithromycin- and erythromycin-treated groups, respectively. Adverse events were
      also similar between treatment groups. Gastrointestinal events were the most
      common events in both groups of patients; erythromycin was associated with a
      significantly higher incidence of diarrhoea (P = 0.003). Dirithromycin was
      associated with a higher incidence of lung events (P = 0.043). It is concluded
      that dirithromycin given once a day is comparable in efficacy and safety to four
      times-daily erythromycin in the treatment of acute bacterial exacerbations of
      chronic bronchitis.

PMID- 8478305
TI  - A multicentre study comparing the safety and efficacy of dirithromycin with
      erythromycin in the treatment of bronchitis.
AB  - This European multicentre (110 centres), double-blind, randomized clinical trial
      compared the safety and efficacy of dirithromycin (500 mg orally once daily) and
      erythromycin (250 mg orally qds) in the treatment of either acute bacterial
      bronchitis or acute bacterial exacerbations of chronic bronchitis. From January
      1989 to September 1990, 1222 patients (529 with acute bronchitis and 693 with
      acute exacerbations of chronic bronchitis) were included in the trial. Clinical
      and bacteriological evaluations were performed on 135 evaluable patients with
      acute bronchitis (72 in the dirithromycin group and 63 in the erythromycin group)
      and in 202 patients with acute exacerbations of chronic bronchitis (89 treated
      with dirithromycin and 113 treated with erythromycin). Evaluations were performed
      during treatment (days 3-5), post-therapy (three to five days after therapy
      completion), and late post-therapy (10-14 days following the end of therapy). In
      acute bronchitis, both drugs were effective with clinical success rates of 93.0%
      and 95.2% at post-therapy, and 96.9% and 100% at late post-therapy for
      dirithromycin and erythromycin, respectively. Pathogen eradication rates at post
      therapy were 83.3% for the dirithromycin group and 85.7% for the erythromycin
      group. In acute exacerbations of chronic bronchitis, the drugs were also
      effective with 89.9% and 92.1% cure or improvement at post-therapy and 98.7% and
      95.0% at late post-therapy for dirithromycin and erythromycin, respectively.
      Pathogen eradication rates were 75.3% in both treatment groups. There were no
      statistically significant differences in clinical and bacteriological results
      between treatments in patients with acute bronchitis or acute exacerbations of
      chronic bronchitis. Of the 1222 patients included, no significant differences in
      the number of patients reporting adverse events were observed. There were nine
      early discontinuations due to adverse events in the dirithromycin group and 14 in
      the erythromycin group. Dirithromycin (500 mg once daily for seven days) was as
      effective and as safe as erythromycin (250 mg qid for seven days) in the
      treatment of acute bacterial bronchitis and acute bacterial exacerbations of
      chronic bronchitis.

PMID- 8478306
TI  - Clinical efficacy of dirithromycin versus miocamycin in the treatment of acute
      bronchitis or acute exacerbations of chronic bronchitis.
AB  - A multicentre trial was carried out to compare the efficacy and safety of
      dirithromycin with miocamycin in the treatment of patients with acute bronchitis
      or acute exacerbations of chronic bronchitis. The study was a single-blind,
      randomized, parallel-group study. Dirithromycin was administered orally at a
      dosage of 500 mg once daily and miocamycin was administered orally at a dosage of
      600 mg twice daily; the duration of therapy was five to seven days for both
      drugs. The results, in 161 assessable patients (78 taking dirithromycin; 83
      taking miocamycin), show that dirithromycin and miocamycin have comparable
      efficacy and safety in the treatment of bronchitis caused by susceptible
      bacterial pathogens.

PMID- 8478307
TI  - Dirithromycin in the treatment of skin and skin structure infections.
AB  - The efficacy and safety of dirithromycin were compared with those of erythromycin
      or miocamycin for the treatment of skin and/or skin structure infections in two
      double-blind, double-dummy, randomized, parallel group, multicentre studies
      conducted in North America and in Europe, and one single-blind, randomized,
      parallel group study conducted in Italy. The US and European study patients, in
      which bacterial infection was confirmed by culture, received either dirithromycin
      500 mg once daily or erythromycin base 250 mg four times daily for seven days.
      Patients in the Italian trial were treated with either 500 mg dirithromycin once
      daily or with 600 mg miocamycin twice daily for seven days. A total of 156 of the
      304 US patients treated with dirithromycin and 127 of the 274 patients treated
      with erythromycin qualified for efficacy analysis post-therapy. At the post
      therapy evaluation, 112 (71.8%) dirithromycin-treated patients were cured and 34
      (21.8%) improved compared with 94 (74.0%) and 25 (19.7%) patients treated with
      erythromycin. The pathogen was eliminated or presumably eliminated in 136 (87.2%)
      and 110 (86.6%) dirithromycin- and erythromycin-treated patients, respectively. A
      total of 100 of the 193 dirithromycin-treated patients qualified for efficacy
      analysis, as did 99 of the 198 erythromycin-treated patients in the European
      study at post-therapy. Favourable clinical responses (cure or improvement) at the
      post-therapy visit were recorded in 96 (96.0%) dirithromycin- and 98 (99%)
      erythromycin-treated patients, and pathogens were eliminated or presumed to have
      been eliminated in 87 (87.0%) and 88 (88.9%) patients respectively, in the
      dirithromycin and erythromycin treatment groups. Efficacy analysis was performed
      in 56 of the 70 Italian patients treated with dirithromycin and in 62 of the 71
      patients treated with miocamycin. At post-therapy evaluation, a favourable
      clinical response was observed in 98.2% of the dirithromycin-treated patients
      compared with 95.1% of miocamycin-treated patients, whereas a favourable
      bacteriological response was observed in 52 (92.9%) dirithromycin- and 52 (83.9%)
      miocamycin-treated patients respectively. In all studies no serious treatment
      related events were noted. Events most frequently reported were gastrointestinal
      in nature. Overall in the three studies, no statistically significant differences
      were observed between two treatment groups in the clinical and bacteriological
      outcomes.

PMID- 8478308
TI  - Pharmacokinetics and safety of dirithromycin in the elderly.
AB  - Pharmacokinetic and safety studies were undertaken in elderly (age > or = 65
      years) and non-elderly (age 18-50 years) subjects receiving the normal
      recommended dose of 500 mg/day dirithromycin for ten days. There was a
      considerable variation in the maximum plasma concentration and time when this was
      achieved in each of the subject groups. There was also a trend for values for the
      area under the plasma concentration versus time curve to increase with age, but
      neither of these pharmacokinetic parameters was significantly altered with age.
      The incidence and nature of adverse events were similar in elderly and non
      elderly subjects, and there was no electrocardiographic evidence that
      dirithromycin caused an increased incidence of cardiac disturbances. No changes
      in clinical laboratory values were thought to be due to dirithromycin. It is
      concluded that 500 mg/day dirithromycin may be used to treat elderly patients
      without the need for any dose adjustment.

PMID- 8478309
TI  - Safety profile of dirithromycin.
AB  - Dirithromycin is a recently developed oral antibiotic, and has been shown to be
      effective in the treatment of respiratory tract, skin and soft tissue infections.
      Dirithromycin is administered once daily which may contribute to patient
      compliance. In this paper we review the data from studies conducted in Europe,
      USA, Israel and South Africa over a six-year period to assess the safety and
      efficacy of dirithromycin in the treatment of a variety of acute infectious
      illnesses, and to compare it with structurally related antibiotics (erythromycin
      base, roxithromycin, and miocamycin) given orally. A total of 7437 patients have
      been enrolled from a total of 66 studies and trials, 4263 (57.3%) treated with
      dirithromycin and 3174 (42.7%) treated with a comparator antibiotic. Patients
      received either 500 mg dirithromycin (two tablets once daily), 1000 mg
      erythromycin base (250 mg qid), 300 mg roxithromycin (150 mg bid), or 1200
      miocamycin (600 mg bid); the length of therapy ranged from 7 to 14 days. These
      studies have shown that dirithromycin has a safety profile similar to the
      comparator agents. The most frequently reported adverse events for both
      dirithromycin and comparator treatment groups were gastrointestinal in nature.
      The majority (99%) of adverse events reported from patients treated with
      dirithromycin were considered mild or moderate in severity. Early discontinuation
      of antibiotic therapy was infrequent (3-4%) in both treatment groups, and
      considered to be possibly drug-related in 2-3% of the population. The safety
      profile of dirithromycin in elderly patients was comparable to that recorded in
      the overall patient population. The incidence and nature of abnormal clinical
      laboratory evaluation were similar in dirithromycin and comparator groups.
      Notable alterations in laboratory tests of haematological or hepatic function
      were infrequent and were not associated with clinical manifestations. Routine
      monitoring of standard clinical laboratory tests in patients prescribed
      dirithromycin does not appear to be necessary.

PMID- 8478310
TI  - Dirithromycin disc susceptibility tests: interpretative criteria and quality
      control parameters.
AB  - Dirithromycin and its bioactive metabolite (erythromycylamine) were compared in
      vitro to erythromycin against 450 bacterial isolates. Dirithromycin and
      erythromycylamine did not differ in their in-vitro activity and the two compounds
      were additive when combined in equal proportions. Both compounds were active
      against erythromycin-susceptible bacteria but erythromycin was two to four times
      more potent on a weight-to-weight basis. Interpretive criteria for dirithromycin
      were not based on achievable blood concentrations since tissue concentrations may
      be 20-30 times greater than peak serum levels. Dirithromycin-susceptible strains
      were those with zones > or = 19 mm in diameter (15 micrograms dirithromycin disc)
      or MIC < or = 2.0 mg/L and resistance was defined as a zone < or = 15 mm or MIC >
      or = 8.0 mg/L. Interpretive criteria for testing Haemophilus influenzae on
      Haemophilus Test Medium (HTM) agar were not defined because of the drug's poor
      activity in the test system used. Two multi-laboratory studies were also
      undertaken, one to define quality control limits for disc diffusion tests and the
      other to define broth microdilution MIC control limits for tests with
      dirithromycin.

PMID- 8478311
TI  - In-vitro activity of dirithromycin in comparison with other new and established
      macrolides.
AB  - Improvements with regard to the in-vitro activity of new macrolides are marginal
      and apply mainly to Haemophilus spp., Moraxella catarrhalis and Neisseria
      gonorrhoeae (e.g. azithromycin is two to eight times more active than
      erythromycin) and to non-enterococcal streptococci (e.g. clarithromycin is two to
      four times more active than erythromycin). The increase in activity against
      staphylococci is even less striking, being restricted to a few species and
      limited to clarithromycin (twice as active as erythromycin). The
      Enterobacteriaceae, as well as glucose non-fermenting Gram-negative bacilli,
      remain outside the therapeutic range of the new macrolides, as they were for the
      established compounds. The majority of enterococci and Corynebacterium jeikeium
      are resistant to all macrolides, whereas Corynebacterium diphtheriae is highly
      susceptible. In-vitro susceptibilities both of Campylobacter jejuni/coli and
      Helicobacter pylori indicate only moderate susceptibility to macrolides and the
      azalide. In the case of anaerobic organisms, clarithromycin is the most active
      macrolide against the majority of species. Dirithromycin, clarithromycin,
      roxithromycin and josamycin, and the azalide azithromycin, are similar in their
      antibacterial spectrum to erythromycin. New macrolides differ from established
      compounds largely in their pharmacokinetic behaviour and only minor progress has
      been achieved in improving their antibacterial spectrum.

PMID- 8478312
TI  - Modulation of human polymorphonuclear neutrophil function by macrolides:
      preliminary data concerning dirithromycin.
AB  - Polymorphonuclear neutrophils (PMN) play a prominent role in the host response to
      infectious diseases. One major bactericidal mechanism used by these cells is the
      production of reactive oxygen species during what is referred to as the oxidative
      burst. However, excessive oxidant generation can also be involved in cell and
      tissue damage associated with severe inflammatory reactions. Macrolide
      antibiotics are able to penetrate and concentrate within phagocytes and have been
      successfully used to treat infections due to facultative intracellular pathogens.
      However, intracellular accumulation of macrolides with possible alkalinization of
      cellular compartments may interfere with normal cell function. In-vitro and ex
      vivo data suggest that macrolides affect various phagocytic functions. This paper
      presents an overview of the published data concerning the modulation of
      neutrophil function by macrolides. Preliminary data concerning the in-vitro
      modulation of the neutrophil oxidative burst by dirithromycin and its metabolite,
      erythromycylamine, are also discussed.

PMID- 8478313
TI  - Pharmacokinetics of dirithromycin.
AB  - Dirithromycin is a new member of the macrolide class of antibiotics and has been
      developed for oral administration. Dirithromycin is a 14-membered lactone ring
      macrolide and is the C9-oxazine derivative of erythromycylamine. The human
      pharmacokinetics and clinical pharmacology of dirithromycin have been studied.
      Dirithromycin has unique pharmacokinetics which distinguish it from erythromycin.
      In man, following an oral 500 mg dose of dirithromycin, a mean peak plasma
      concentration (Cmax) of 0.48 mg/L (range 0.1-1.97) was observed at 4 h. The mean
      area under the plasma concentration versus time curve (AUC0-24h) measured 3.37
      mg.h/L (range 0.39-17.16). No plasma accumulation was observed with multiple-dose
      administration. Dirithromycin may be taken without regard to meals, although food
      and H2-receptor antagonists may increase the systemic bioavailability in some
      patients. Based upon drug interaction studies performed with antipyrine and
      theophylline, dirithromycin has shown less potential to interact with other drugs
      metabolized by the cytochrome P450 system that does erythromycin. Plasma
      concentrations and AUCs were low due to rapid movement of the drug from the
      vascular space to the extravascular compartment, as reflected by tissue
      concentrations, which exceeded plasma concentrations 4 h after dosing.
      Dirithromycin achieves relatively high tissue concentrations (approximately 0.8
      5.0 mg/kg) 4-24 h after dosing. The extensive tissue penetration is reflected in
      a large mean apparent volume of distribution of 800 L (range 504-1041).
      Dirithromycin is rapidly converted by non-enzymatic hydrolysis during absorption
      to erythromycylamine, which is microbiologically active. In a 14C-radiolabelled
      study, 60-90% of the administered dose was hydrolysed to erythromycylamine within
      35 min of infusion. After 1.5 h, conversion to erythromycylamine in serum was
      virtually complete. Plasma protein binding was determined to be 15-30% by
      ultracentrifugation. Dirithromycin is characterized by a plasma elimination half
      life of 44 h (range 16-65 h) that permits once-daily administration. Total body
      clearance was 226-1040 mL/min in the 14C-radiolabelled study. The primary route
      of elimination of dirithromycin/erythromycylamine was faecal/hepatic. Following
      intravenous administration, approximately 17-25% of the radioactivity appeared in
      the urine and 62-81% appeared in the stool, indicating predominantly hepatic
      excretion. With oral administration 1.2-2.9% of the radioactivity appeared in the
      urine and 81-97% in the stool. The major part of urinary excretion occurs within
      the first 48 h post-administration; however, urinary excretion of radioactivity
      lasted longer than 240 h. The absolute bioavailability calculated from dose
      corrected urinary excretion data was 10% (6-14%).

PMID- 8478314
TI  - Tissue distribution of dirithromycin: comparison with erythromycin.
AB  - In order to ensure effective in-vivo activity, high antibiotic concentrations
      need to be achieved rapidly at the site of the infection and effective post
      dosage concentrations should be maintained. Dirithromycin, a new macrolide
      antibiotic, is converted in vivo to erythromycylamine, which has antimicrobial
      activity similar to that of the parent compound and a half-life of 20-50 h which
      allows for once-daily dosing. Both dirithromycin and erythromycylamine are
      released slowly from the tissue compartment and the major route of elimination is
      hepatic/faecal: approximately 10% of an oral dose is absorbed and rapidly leaves
      the circulation to localize in tissues. Dirithromycin and erythromycylamine
      achieve lung parenchyma concentrations of 1.58-3.81 mg/kg depending on the number
      of doses administered. Tissue concentrations are significantly higher than
      simultaneous serum concentrations. Studies in both healthy and pathological lung
      tissues have shown that significant antibiotic concentrations remain in the
      tissue 12 and 24 h post-dose. The presence of an inflammatory exudate, especially
      the phagocytic component, probably contributes to the increased local
      concentration of dirithromycin found in pathological tissues. The ability of
      macrolides to concentrate within phagocytes and alveolar macrophages accounts for
      the observed high lung tissue concentrations of dirithromycin. Dirithromycin also
      effectively penetrates bronchial secretions: concentrations of 1.04 mg/L 3 h and
      1.3 +/- 1.5 mg/L 12 h after a single 250 mg dose. Following a single dose of 500
      mg dirithromycin, bronchial mucosa concentrations of > 1.0 mg/kg were detected at
      4-24 h post-dose; after multiple doses, concentrations increased to 1.30 mg/kg at
      12 h post-dose. Single and multiple 500 mg doses resulted in mean nasal mucosa
      concentrations of 0.59 +/- 0.17 and 1.86 +/- 0.54 mg/kg (multiple dose) at 24 and
      12 h, respectively. Administration of single oral doses of 500 mg 12 or 24 h
      before tonsillectomy resulted in 24 h post-dosing tonsillar concentrations of
      0.60 +/- 0.55 mg/kg (56% of the 12 h concentrations) while doses of 1000 mg/day
      for two days, resulted in tonsillar antibiotic concentrations of 1.37 +/- 0.55
      mg/kg which were maintained for 24 h after the last dose. Dirithromycin also
      penetrates prostatic tissue with concentrations of 4.1-6.5 mg/kg achieved 15-17 h
      after the second of two 500 mg doses. In conclusion, dirithromycin exhibits good
      tissue distribution within selected tissues, is rapidly distributed and persists
      in significant concentrations up to 24 h post-dose. These studies suggest that
      dirithromycin has an extremely large volume of distribution.

PMID- 8478315
TI  - Dirithromycin in the treatment of streptococcal pharyngitis.
AB  - A double-blind, double-dummy, randomized, multicentre study compared the safety
      and the efficacy of dirithromycin (two 250 mg tablets, once daily) to
      erythromycin base (four 250 mg tablets, four times daily) for ten days in the
      treatment of proven group A beta-haemolytic (GABHs) streptococcal pharyngitis.
      Five-hundred and fifty-three patients (265 dirithromycin, 288 erythromycin) were
      enrolled in the trial and analysed for efficacy and safety. Clinical and
      bacteriological evaluations were performed pre-therapy, during therapy (days 3
      5), post-therapy (three to five days after completion of treatment), and late
      post-therapy (three to five weeks after treatment). All patients qualified for
      safety analysis. A negative pre-therapy culture was the predominant reason a
      patient did not qualify for analysis of efficacy. At post-therapy, favourable
      clinical responses (cure or improvement) were reported for 94.1% (159/169) of
      dirithromycin and 94.6% (158/167) of erythromycin patients who qualified for
      efficacy analysis. Post-therapy throat cultures were negative for GABH
      streptococci in 79.3% (134/169) of dirithromycin patients and 86.2% (144/167) of
      patients treated with erythromycin (P = 0.314). At late post-therapy 87.6%
      (134/153) of dirithromycin and 88.7% (134/151) of erythromycin patients reported
      a favourable clinical response; pathogens were absent in 69.9% (107/153) of
      dirithromycin and 86.1% (130/151) of erythromycin patients (P = 0.001). The
      adverse event profile of the two drugs was comparable although digestive and
      cutaneous adverse events were reported more frequently in the erythromycin
      treatment group. In this study, more dirithromycin patients had throat cultures
      positive for GABH streptococci at late post-therapy.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8478316
TI  - Clinical efficacy of dirithromycin in pharyngitis and tonsillitis.
AB  - A total of 193 patients with streptococcal pharyngitis/tonsillitis received 500
      mg dirithromycin once daily and 196 patients 250 mg erythromycin four times daily
      for ten days in a double-blind, parallel-group multicentre study. In the
      dirithromycin treatment group, 97 (50.3%) patients completed the study and were
      evaluated for efficacy analysis, and 99/196 (50.5%) erythromycin-treated were
      evaluated for efficacy of treatment. Favourable clinical responses to treatment
      (cure or improvement of symptoms) at the post-therapy visit (three to five days
      after therapy completion) occurred in 89 (91.7%) dirithromycin- and 93 (93.9%)
      erythromycin-treated patients. Bacteriological response was favourable (pathogen
      eliminated in 81 (83.5%) dirithromycin- and 87 (87.9%) erythromycin-treated
      patients. At late post-therapy (three to five weeks after treatment) 82/89
      (92.1%) dirithromycin- and 90/93 (96.8%) erythromycin-treated patients had a
      favourable clinical response. Bacteriological response at late post-therapy was
      favourable in 77 (86.5%) dirithromycin- and 85 (94.4%) erythromycin-treated
      patients. No deaths occurred during or after treatment, and the serious events
      experienced by three dirithromycin- and one erythromycin-treated patients were
      unrelated to treatment. Five patients taking dirithromycin and seven taking
      erythromycin discontinued treatment prematurely, mainly due to gastrointestinal
      disturbances. Adverse events that occurred in 2% or more of patients in each
      treatment group were mainly gastrointestinal (diarrhoea, abdominal pain, nausea
      and vomiting); headache and rash were also reported. No significant differences
      in clinical laboratory data were detected that were considered to be drug
      related.

PMID- 8478317
TI  - Protein-protein communication within the transcription apparatus.

PMID- 8478318
TI  - Cloning and nucleotide sequence of the Bacillus subtilis ansR gene, which encodes
      a repressor of the ans operon coding for L-asparaginase and L-aspartase.
AB  - Previous work has shown that expression of the Bacillus subtilis ans operon which
      codes for L-asparaginase and L-aspartase, is both increased and made insensitive
      to repression by NH4+ by the aspH1 mutation. In current work, the gene in which
      the aspH1 mutation resides has been identified and sequenced; this gene, termed
      ansR, is immediately upstream of, but transcribed in the opposite direction from,
      the ans operon. The promoter region of ansR contains -10 and -35 sequences
      similar to those recognized by RNA polymerase containing the major vegetative
      cell sigma factor sigma A, and ansR appears to be monocistronic. The ansR gene
      codes for a 116-residue protein, but the aspH1 mutant allele has an additional
      guanine residue at codon 55, resulting in generation of a truncated polypeptide
      of only 58 residues. Insertional inactivation of ansR resulted in a phenotype
      identical to that of the aspH1 mutant. The predicted amino acid sequence of the
      ansR gene product (AnsR) was homologous to that of the repressor of B. subtilis
      prophage PBSX, and a helix-turn-helix motif, characteristic of many DNA-binding
      proteins, was present in the AnsR amino-terminal region. These results suggest
      that ansR codes for a repressor of the ans operon.

PMID- 8478319
TI  - Cloning and characterization of the Escherichia coli K-12 rfa-2 (rfaC) gene, a
      gene required for lipopolysaccharide inner core synthesis.
AB  - A genetically defined mutation, designated rfa-2, results in altered
      lipopolysaccharide (LPS) biosynthesis. rfa-2 mutants produce a core-defective LPS
      that contains lipid A and a single sugar moiety, 2-keto-3-deoxyoctulosonic acid,
      in the LPS core region. Such LPS core-defective or deep-rough (R) mutant
      structures were previously designated chemotype Re. Phenotypically, rfa-2 mutants
      exhibit increased permeability to a number of hydrophilic and hydrophobic agents.
      By restriction analyses and complementation studies, we clearly defined the rfa-2
      gene on a 1,056-bp AluI-DraI fragment. The rfa-2 gene and the flanking rfa locus
      regions were completely sequenced. Additionally, the location of the rfa-2 gene
      on the physical map of the Escherichia coli chromosome was determined. The rfa-2
      gene encodes a 36,000-dalton polypeptide in an in vivo expression system. N
      terminal analysis of the purified rfa-2 gene product confirmed the first 24 amino
      acid residues as deduced from the nucleotide sequence of the rfa-2 gene coding
      region. By interspecies complementation, a Salmonella typhimurium rfaC mutant
      (LPS chemotype Re) is transformed with the E. coli rfa-2+ gene, and the
      transformant is characterized by wild-type sensitivity to novobiocin (i.e.,
      uninhibited growth at 600 micrograms of novobiocin per ml) and restoration of the
      ability to synthesize wild-type LPS structures. On the basis of the identity and
      significant similarity of the rfa-2 gene sequence and its product to the recently
      defined (D. M. Sirisena, K. A. Brozek, P. R. MacLachlan, K. E. Sanderson, and C.
      R. H. Raetz, J. Biol. Chem. 267:18874-18884, 1992), the S. typhimurium rfaC gene
      sequence and its product (heptosyltransferase 1), the E. coli K-12 rfa-2 locus
      will be designated rfaC.

PMID- 8478320
TI  - Identification of a novel operon in Lactococcus lactis encoding three enzymes for
      lactic acid synthesis: phosphofructokinase, pyruvate kinase, and lactate
      dehydrogenase.
AB  - The discovery of a novel multicistronic operon that encodes phosphofructokinase,
      pyruvate kinase, and lactate dehydrogenase in the lactic acid bacterium
      Lactococcus lactis is reported. The three genes in the operon, designated pfk,
      pyk, and ldh, contain 340, 502, and 325 codons, respectively. The intergenic
      distances are 87 bp between pfk and pyk and 117 bp between pyk and ldh. Plasmids
      containing pfk and pyk conferred phosphofructokinase and pyruvate kinase
      activity, respectively, on their host. The identity of ldh was established
      previously by the same approach (R. M. Llanos, A. J. Hillier, and B. E. Davidson,
      J. Bacteriol. 174:6956-6964, 1992). Each of the genes is preceded by a potential
      ribosome binding site. The operon is expressed in a 4.1-kb transcript. The 5' end
      of the transcript was determined to be a G nucleotide positioned 81 bp upstream
      from the pfk start codon. The pattern of codon usage within the operon is highly
      biased, with 11 unused amino acid codons. This degree of bias suggests that the
      operon is highly expressed. The three proteins encoded on the operon are key
      enzymes in the Embden-Meyerhoff pathway, the central pathway of energy production
      and lactic acid synthesis in L. lactis. For this reason, we have called the
      operon the las (lactic acid synthesis) operon.

PMID- 8478321
TI  - Deletion analysis of the avermectin biosynthetic genes of Streptomyces
      avermitilis by gene cluster displacement.
AB  - Streptomyces avermitilis produces a group of glycosylated, methylated macrocyclic
      lactones, the avermectins, which have potent anthelmintic activity. A homologous
      recombination strategy termed gene cluster displacement was used to construct
      Neor deletion strains with defined endpoints and to clone the corresponding
      complementary DNA encoding functions for avermectin biosynthesis (avr). Thirty
      five unique deletions of 0.5 to > 100 kb over a continuous 150-kb region were
      introduced into S. avermitilis. Analysis of the avermectin phenotypes of the
      deletion-containing strains defined the extent and ends of the 95-kb avr gene
      cluster, identified a regulatory region, and mapped several avr functions. A 60
      kb region in the central portion determines the synthesis of the macrolide ring.
      A 13-kb region at one end of the cluster is responsible for synthesis and
      attachment of oleandrose disaccharide. A 10-kb region at the other end has
      functions for positive regulation and C-5 O methylation. Physical analysis of the
      deletions and of in vivo-cloned fragments refined a 130-kb physical map of the
      avr gene cluster region.

PMID- 8478322
TI  - Escherichia coli shows two types of behavioral responses to osmotic upshift.
AB  - Behavioral responses to osmotic upshift were characterized by temporal assays of
      free-swimming cells of Escherichia coli. Small osmotic upshifts (200 to 300 mosM)
      elicited tumble responses which were chemotaxis dependent, while large osmotic
      upshifts (400 to 500 mosM) elicited stopping followed by pseudotumbling which was
      chemotaxis independent.

PMID- 8478323
TI  - Proteolytic processing of the protease which initiates degradation of small, acid
      soluble proteins during germination of Bacillus subtilis spores.
AB  - Degradation of small, acid-soluble spore proteins during germination of Bacillus
      subtilis spores is initiated by a sequence-specific protease called GPR. Western
      blot (immunoblot) analysis of either Bacillus megaterium or B. subtilis GPR
      expressed in B. subtilis showed that GPR is synthesized at about the third hour
      of sporulation in a precursor form and is processed to an approximately 2- to 5
      kDa-smaller species 2 to 3 h later, at or slightly before the time of
      accumulation of dipicolinic acid by the forespore. This was found with both
      normal levels of expression of B. subtilis and B. megaterium GPR in B. subtilis,
      as well as when either protein was overexpressed up to 100-fold. The sporulation
      specific processing of GPR was blocked in all spoIII, -IV, and -V mutants tested
      (none of which accumulated dipicolinic acid), but not in a spoVI mutant which
      accumulated dipicolinic acid. The amino-terminal sequences of the B. megaterium
      and B. subtilis GPR initially synthesized in sporulation were identical to those
      predicted from the coding genes' sequences. However, the processed form generated
      in sporulation lacked 15 (B. megaterium) or 16 (B. subtilis) amino-terminal
      residues. The amino acid sequence surrounding this proteolytic cleavage site was
      very homologous to the consensus sequence recognized and cleaved by GPR in its
      small, acid-soluble spore protein substrates. This observation, plus the
      efficient processing of overproduced GPR during sporulation, suggests that the
      GPR precursor may autoproteolyze itself during sporulation. During spore
      germination, the GPR from either species expressed in B. subtilis was further
      processed by removal of one additional amino-terminal amino acid (leucine),
      generating the mature protease which acts during spore germination.

PMID- 8478324
TI  - Characterization of the Lactococcus lactis nisin A operon genes nisP, encoding a
      subtilisin-like serine protease involved in precursor processing, and nisR,
      encoding a regulatory protein involved in nisin biosynthesis.
AB  - Biosynthesis of the lantibiotic peptide nisin by Lactococcus lactis NIZO R5
      relies on the presence of the conjugative transposon Tn5276 in the chromosome. A
      12-kb DNA fragment of Tn5276 including the nisA gene and about 10 kb of
      downstream DNA was cloned in L. lactis, resulting in the production of an
      extracellular nisin precursor peptide. This peptide reacted with antibodies
      against either nisin A or the synthetic leader peptide, suggesting that it
      consisted of a fully modified nisin with the nisin leader sequence still attached
      to it. This structure was confirmed by N-terminal sequencing and 1H-nuclear
      magnetic resonance analysis of the purified peptide. Deletion studies showed that
      the nisR gene is essential for the production of this intermediate. The deduced
      amino acid sequence of the nisR gene product indicated that the protein belongs
      to the family of two-component regulators. The deduced amino acid sequence of
      NisP, the putative product of the gene upstream of nisR, showed an N-terminal
      signal sequence, a catalytic domain with a high degree of similarity to those of
      subtilisin-like serine proteases, and a putative C-terminal membrane anchor. Cell
      extracts of Escherichia coli overexpressing nisP were able to cleave the nisin
      precursor peptide, producing active, mature nisin. A similar activation was
      obtained with whole cells but not with membrane-free extracts of L. lactis
      strains carrying Tn5276 in which the nisA gene had been inactivated. The results
      indicate that the penultimate step in nisin biosynthesis is secretion of
      precursor nisin without cleavage of the leader peptide, whereas the last step is
      the cleavage of the leader peptide sequence from the fully maturated nisin
      peptide.

PMID- 8478325
TI  - Coordinate regulation of siderophore and exotoxin A production: molecular cloning
      and sequencing of the Pseudomonas aeruginosa fur gene.
AB  - A 5.9-kb DNA fragment was cloned from Pseudomonas aeruginosa PA103 by its ability
      to functionally complement a fur mutation in Escherichia coli. A fur null mutant
      E. coli strain that contains multiple copies of the 5.9-kb DNA fragment produces
      a 15-kDa protein which cross-reacts with a polyclonal anti-E. coli Fur serum.
      Sequencing of a subclone of the 5.9-kb DNA fragment identified an open reading
      frame predicted to encode a protein 53% identical to E. coli Fur and 49%
      identical to Vibrio cholerae Fur and Yersinia pestis Fur. While there is
      extensive homology among these Fur proteins, Fur from P. aeruginosa differs
      markedly at its carboxy terminus from all of the other Fur proteins. It has been
      proposed that this region is a metal-binding domain in E. coli Fur. A positive
      selection procedure involving the isolation of manganese-resistant mutants was
      used to isolate mutants of strain PA103 that produce altered Fur proteins. These
      manganese-resistant Fur mutants constitutively produce siderophores and exotoxin
      A when grown in concentrations of iron that normally repress their production. A
      multicopy plasmid carrying the P. aeruginosa fur gene restores manganese
      susceptibility and wild-type regulation of exotoxin A and siderophore production
      in these Fur mutants.

PMID- 8478326
TI  - The frequency and accuracy of replication past a thymine-thymine cyclobutane
      dimer are very different in Saccharomyces cerevisiae and Escherichia coli.
AB  - We have compared the mutagenic properties of a T-T cyclobutane dimer in baker's
      yeast, Saccharomyces cerevisiae, with those in Escherichia coli by transforming
      each of these species with the same single-stranded shuttle vector carrying
      either the cis-syn or the trans-syn isomer of this UV photoproduct at a unique
      site. The mutagenic properties investigated were the frequency of replicational
      bypass of the photoproduct, the error rate of bypass, and the mutation spectrum.
      In SOS-induced E. coli, the cis-syn dimer was bypassed in approximately 16% of
      the vector molecules, and 7.6% of the bypass products had targeted mutations. In
      S. cerevisiae, however, bypass occurred in about 80% of these molecules, and the
      bypass was at least 19-fold more accurate (approximately 0.4% targeted
      mutations). Each of these yeast mutations was a single unique event, and none
      were like those in E. coli, suggesting that in fact the difference in error rate
      is much greater. Bypass of the trans-syn dimer occurred in about 17% of the
      vector molecules in both species, but with this isomer the error rate was higher
      in S. cerevisiae (21 to 36% targeted mutations) than in E. coli (13%). However,
      the spectra of mutations induced by the latter photoproduct were virtually
      identical in the two organisms. We conclude that bypass and error frequencies are
      determined both by the structure of the photoproduct-containing template and by
      the particular replication proteins concerned but that the types of mutations
      induced depend predominantly on the structure of the template. Unlike E. coli,
      bypass in S. cerevisiae did not require UV-induced functions.

PMID- 8478327
TI  - The Escherichia coli heat shock gene htpY: mutational analysis, cloning,
      sequencing, and transcriptional regulation.
AB  - We have identified a new heat shock gene, designated htpY, located 700 bp
      upstream of the dnaK dnaJ operon. We cloned it and showed that it is transcribed
      clockwise vis-a-vis the Escherichia coli genetic map, in the same direction as
      the dnaK dnaJ operon. The htpY gene encodes a 21,193-Da polypeptide. Promoter
      mapping experiments and Northern (RNA) analysis showed that the htpY gene belongs
      to the classical heat shock gene family, because the transcription from its major
      promoter is under the positive control of the rpoH gene product (sigma 32) and
      resembles canonical E sigma 32-transcribed consensus promoter sequences. This
      conclusion has been strengthened by the construction and analysis of a phtpY-lacZ
      promoter fusion. Despite the fact that htpY null bacteria are viable, the
      expression of various E sigma 32 heat shock promoters is significantly decreased,
      suggesting that HtpY plays an important role in the regulation of the heat shock
      response. Consistent with this interpretation, overproduction of the HtpY protein
      results in a generalized increase of the heat shock response in E. coli.

PMID- 8478328
TI  - Molecular cloning and characterization of the Candida albicans enolase gene.
AB  - A DNA clone containing the putative Candida albicans enolase gene (ENO1) was
      isolated from a genomic DNA library. The sequenced insert contained a continuous
      open reading frame of 1,320 bp. The predicted 440-amino-acid protein is 78 and
      76% identical, respectively, to Saccharomyces cerevisiae enolase proteins 1 and
      2. Only one enolase gene could be detected in C. albicans genomic DNA by Southern
      analysis with a homologous probe. Northern (RNA) analysis detected a single,
      abundant C. albicans ENO1 transcript of approximately 1,600 nucleotides. When
      cells were grown on glucose, levels of ENO1 mRNA were markedly increased by
      comparison with ENO1 mRNA levels in cells grown on ethanol, a gluconeogenic
      carbon source. In contrast to this glucose-mediated transcriptional induction,
      the carbon source had no dramatic effect on the levels of enolase protein or
      enzyme activity in the C. albicans strains tested. These results suggest that
      posttranscriptional mechanisms are responsible for modulating expression of the
      C. albicans enolase gene.

PMID- 8478329
TI  - Characterization of a Flavobacterium glutathione S-transferase gene involved
      reductive dechlorination.
AB  - The gene pcpC, encoding tetrachloro-p-hydroquinone (TeCH) reductive dehalogenase,
      was cloned from Flavobacterium sp. strain ATCC 39723 and sequenced. The gene was
      identified by hybridization with a degenerate oligonucleotide designed from the N
      terminal sequence of the purified protein. An open reading frame of 747
      nucleotides was found, which predicts a translational product of 248 amino acids
      having a molecular weight of 28,263, which agrees favorably with the sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis-determined molecular weight of
      30,000 reported for the purified protein. The predicted translational product of
      pcpC matched the N-terminal sequence of the purified protein exactly. From the
      nucleotide sequence, the protein appears to have a processed formylmethionyl. An
      Escherichia coli pcpC overexpression clone was shown to produce
      dichlorohydroquinone and trichlorohydroquinone from TeCH. Protein data base
      searches grouped the predicted translational sequence of pcpC with two previously
      reported plant glutathione S-transferases but less significantly with any of the
      mammalian glutathione S-transferases or the glutathione-utilizing, hydrolytic
      dechlorinating enzyme from Methylobacterium sp. strain DM4.

PMID- 8478330
TI  - Detection of an A-factor-responsive protein that binds to the upstream activation
      sequence of strR, a regulatory gene for streptomycin biosynthesis in Streptomyces
      griseus.
AB  - DNA-binding assays using mobility shift polyacrylamide gel electrophoresis
      revealed the presence of a protein that specifically bound to a restriction
      fragment -288 to -191 bp upstream from the transcriptional start point of strR, a
      regulatory gene for streptomycin biosynthesis in Streptomyces griseus. The
      binding site corresponded to an upstream activation sequence predicted from the
      results of in vivo promoter assays. The binding was greatly enhanced by 5 mM
      Mg2+. This binding was detected with the protein source only from the wild-type
      strain and not from an A-factor-deficient mutant strain. The exogenous
      supplementation of A-factor to the A-factor-deficient mutant strain caused the
      appearance of the protein in the DNA-binding assay. A synthetic nucleotide 52 bp
      in length (region from -293 to -242), which was synthesized on the basis of data
      obtained from both retardation assays with dissected DNA fragments and in vivo
      promoter assays, was retarded by the A-factor-dependent protein. In addition to
      this A-factor-dependent protein, at least three proteins with different
      recognition site affinities capable of binding to the upstream region of the strR
      promoter were detected. The binding of one of these proteins to both sides of the
      upstream activation sequence bound by the A-factor-dependent protein was
      completely abolished in the presence of ATP and Mg2+ in the incubation mixture.
      The region bound by these proteins showed anomalous electrophoretic mobility,
      like that of a bent DNA molecule, which is probably caused by the presence of
      many blocks consisting of A and T. The region bound by these proteins was found
      to be transcribed in the orientation opposite to that of strR.

PMID- 8478331
TI  - Symbiotic nitrogen fixation by a nifA deletion mutant of Rhizobium meliloti: the
      role of an unusual ntrC allele.
AB  - In the N2-fixing alfalfa symbiont Rhizobium meliloti, the three sigma 54 (NTRA)
      dependent positively acting regulatory proteins NIFA, NTRC, and DCTD are required
      for activation of promoters involved in N2 fixation (pnifHDKE and pfixABCX),
      nitrogen assimilation (pglnII), and C4-dicarboxylate transport (pdctA),
      respectively. Here, we describe an allele of ntrC which results in the
      constitutive activation of the above NTRC-, NIFA-, and DCTD-regulated promoters.
      The expression and activation of wild-type NTRC occur in response to nitrogen
      availability, whereas in cells carrying the ntrC283 allele, the NTRC283 protein
      appears constitutively active and is constitutively expressed. The ntrC283 allele
      was shown to carry a single mutation resulting in the replacement of an Asp by a
      Tyr residue in the helix-turn-helix motif of ntrC283. Introduction of the ntrC283
      allele into a nifA deletion mutant restores the N2-fixation ability to 70 to 80%
      of the wild-type level. Thus, the nifA gene is dispensable for symbiotic N2
      fixation.

PMID- 8478332
TI  - Negative regulation of sigma 54-dependent dctA expression by the transcriptional
      activator DctD.
AB  - In Rhizobium meliloti, the presence of the C4-dicarboxylate transport protein
      DctA is required for symbiotic N2 fixation in alfalfa root nodules. Expression of
      dctA is inducible and is mediated by a sensor and activator gene pair encoded by
      dctB and dctD. In the presence of C4-dicarboxylates, the DCTB sensor protein is
      believed to phosphorylate and activate DCTD, which in turn activates
      transcription at the sigma 54-dependent dctA promoter. Here, we present evidence
      that in addition to activating dctA transcription, DCTD can also repress
      expression of dctA. By employing an ntrC allele, ntrC283, whose product appears
      to activate dctA transcription independently of DCTD, we found that while ntrC283
      leads to constitutive dctA expression in the absence of dctB and dctD, in a dctB+
      dctD+ ntrC283 background high-level expression of dctA occurred in succinate but
      not in glucose-grown cells. This result suggested that in uninduced cells,
      inactive DCTD binds to the dctA promoter and prevents its activation by NTRC283.
      Consistent with the latter interpretation was the observation that overexpression
      of DCTD from a plasmid promoter prevents dctA expression and results in a Dct-
      phenotype. Moreover the Dct- phenotype resulting from the overexpression of dctD
      was dominant to ntrC283. Results from studies of the ability of ntrC283 to
      suppress the Dct- phenotype of dctB alleles, together with the finding that the
      Fix- phenotype of a particular dctB allele was dctD dependent, suggest that in
      particular dctB alleles, sufficient dctD transcription occurs such that the
      resulting inactive DCTD prevents activation of dctA transcription by NtrC283 or
      alternate symbiotic regulators. The latter suggestion is supported by the
      observation that in symbiosis, R. meliloti strains in which DCTD was
      overexpressed formed nodules which failed to fix nitrogen.

PMID- 8478334
TI  - Alpha-keto acids are novel siderophores in the genera Proteus, Providencia, and
      Morganella and are produced by amino acid deaminases.
AB  - Growth promotion and iron transport studies revealed that certain alpha-keto
      acids generated by amino acid deaminases, by enterobacteria of the Proteus
      Providencia-Morganella group (of the tribe Proteeae), show significant
      siderophore activity. Their iron-binding properties were confirmed by the chrome
      azurol S assay and UV spectra. These compounds form ligand-to-metal charge
      transfer bands in the range of 400 to 500 nm. Additional absorption bands of the
      enolized ligands at 500 to 700 nm are responsible for color formation.
      Siderophore activity was most pronounced with alpha-keto acids possessing an
      aromatic or heteroaromatic side chain, like phenylpyruvic acid and indolylpyruvic
      acid, resulting from deamination of phenylalanine and tryptophan, respectively.
      In addition, alpha-keto acids possessing longer nonpolar side chains, like alpha
      ketoisocaproic acid or alpha-ketoisovaleric acid and even alpha-ketoadipic acid,
      also showed siderophore activity which was absent or negligible with smaller
      alpha-keto acids or those possessing polar functional groups, like pyruvic acid,
      alpha-ketobutyric acid, or alpha-ketoglutaric acid. The fact that deaminase
      negative enterobacteria, like Escherichia coli and Salmonella spp., could not
      utilize alpha-keto acids supports the view that specific iron-carboxylate
      transport systems have evolved in members of the tribe Proteeae and are designed
      to recognize ferric complexes of both alpha-hydroxy acids and alpha-keto acids,
      of which the latter can easily be generated by L-amino acid deaminases in an
      amino acid-rich medium. Exogenous siderophores, like ferric hydroxamates
      (ferrichromes) and ferric polycarboxylates (rhizoferrin and citrate), were also
      utilized by members of the tribe Proteeae.

PMID- 8478333
TI  - Bacterioopsin, haloopsin, and sensory opsin I of the halobacterial isolate
      Halobacterium sp. strain SG1: three new members of a growing family.
AB  - The genes coding for bacterioopsin, haloopsin, and sensory opsin I of a
      halobacterial isolate from the Red Sea called Halobacterium sp. strain SG1 have
      been cloned and sequenced. The deduced protein sequences were aligned to the
      previously known halobacterial retinal proteins. The addition of these new
      sequences lowered the number of conserved residues to only 23 amino acids, or 8%
      of the alignment. Data base searches with two highly conserved peptides as well
      as with an alignment profile yielded no significant similarity to any other
      protein, so the halobacterial retinal proteins should be regarded as a distinct
      protein family. The protein alignment was used to make predictions about the
      structure of the retinal proteins as well as about the amino acids in contact
      with retinal proteins. These results were in excellent agreement with the
      structural model of bacteriorhodopsin of Halobacterium halobium as well as with
      mutant studies, indicating that (i) structure predictions based on the sequences
      of a membrane protein family can be quite accurate; (ii) halorhodopsin and
      sensory rhodopsin I have tertiary structures similar to that of
      bacteriorhodopsin; (iii) conserved amino acids do not take part in reactions
      specific for one group of proteins, e.g., proton translocation for
      bacteriorhodopsins, but have a crucial role in determining the conformation and
      reactions of the chromophore; and (iv) the general mode of action (light-induced
      chromophore and protein movements) is the same for all halobacterial retinal
      proteins, ion pumps as well as sensors.

PMID- 8478335
TI  - Low-molecular-weight thiols in streptomycetes and their potential role as
      antioxidants.
AB  - The intracellular low-molecular-weight thiols present in five gram-positive
      Streptomyces species and one Flavobacterium species were analyzed by high
      performance liquid chromatography after fluorescence labeling with
      monobromobimane. Bacteria were chosen to include penicillin and cephalosporin
      beta-lactam producers and nonproducers. No significant amount of glutathione was
      found in any of the streptomycetes. Major intracellular thiols in all strains
      examined were cysteine, coenzyme A, sulfide, thiosulfate, and an unknown thiol
      designated U17. Those streptomycetes that make beta-lactam antibiotics also
      produce significant amounts of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine
      (ACV), a key intermediate in their biosynthesis. In Streptomyces clavuligerus, a
      potent producer of beta-lactams, the level of ACV was low during the early phase
      of growth and increased rapidly toward the end of exponential growth, paralleling
      that of antibiotic production. These and other observations indicate that ACV
      does not function as a protective thiol in streptomycetes. U17 may have this role
      since it was the major thiol in all streptomycetes and appeared to occur at
      levels about 10-fold higher than those of the other thiols measured, including
      ACV. Purification and amino acid analysis of U17 indicated that it contains
      cysteine and an unusual amine that is not one of the common amino acids. This
      thiol is identical to an unknown thiol found previously in Micrococcus roseus and
      Streptomyces griseus. A high level of ergothioneine was found in Streptomyces
      lactamdurans, and several unidentified thiols were detected in this and other
      streptomycetes.

PMID- 8478336
TI  - A cluster of three genes (dapA, orf2, and dapB) of Brevibacterium lactofermentum
      encodes dihydrodipicolinate synthase, dihydrodipicolinate reductase, and a third
      polypeptide of unknown function.
AB  - The dapA and dapB genes, encoding, respectively, dihydrodipicolinate synthase and
      dihydrodipicolinate reductase, the two first enzymes of the lysine branch of the
      aspartic amino acid family, were cloned from the DNA of the amino acid-producing
      bacterium Brevibacterium lactofermentum. The two genes were clustered in a 3.5-kb
      Sau3AI-BamHI fragment but were separated by an open reading frame of 750
      nucleotides. The protein encoded by this open reading frame had little similarity
      to any protein in the data banks, and its function remains unknown. The three
      genes were translated in Escherichia coli, giving the corresponding polypeptides.

PMID- 8478337
TI  - Identification of a phosphoenolpyruvate:fructose phosphotransferase system
      (fructose-1-phosphate forming) in Listeria monocytogenes.
AB  - Listeria monocytogenes is a gram-positive bacterium whose carbohydrate metabolic
      pathways are poorly understood. We provide evidence for an inducible
      phosphoenolpyruvate (PEP):fructose phosphotransferase system (PTS) in this
      pathogen. The system consists of enzyme I, HPr, and a fructose-specific enzyme II
      complex which generates fructose-1-phosphate as the cytoplasmic product of the
      PTS-catalyzed vectorial phosphorylation reaction. Fructose-1-phosphate kinase
      then converts the product of the PTS reaction to fructose-1,6-bisphosphate. HPr
      was shown to be phosphorylated by [32P]PEP and enzyme I as well as by [32P]ATP
      and a fructose-1,6-bisphosphate-activated HPr kinase like those found in other
      gram-positive bacteria. Enzyme I, HPr, and the enzyme II complex of the Listeria
      PTS exhibit enzymatic cross-reactivity with PTS enzyme constituents from Bacillus
      subtilis and Staphylococcus aureus.

PMID- 8478338
TI  - Large-scale recrystallization of the S-layer of Bacillus coagulans E38-66 at the
      air/water interface and on lipid films.
AB  - S-layer protein isolated from Bacillus coagulans E38-66 could be recrystallized
      into large-scale coherent monolayers at an air/water interface and on
      phospholipid films spread on a Langmuir-Blodgett trough. Because of the asymmetry
      in the physiochemical surface properties of the S-layer protein, the subunits
      were associated with their more hydrophobic outer face with the air/water
      interface and oriented with their negatively charged inner face to the
      zwitterionic head groups of the dipalmitoylphosphatidylcholine and
      dipalmitoylphosphatidylethanolamine (DPPE) monolayer films. The dynamic crystal
      growth at both types of interfaces was first initiated at several distant
      nucleation points. The individual monocrystalline areas grew isotropically in all
      directions until the front edge of neighboring crystals was met. The
      recrystallized S-layer protein and the S-layer-DPPE layer could be chemically
      cross-linked from the subphase with glutaraldehyde.

PMID- 8478339
TI  - The cortical peptidoglycan from spores of Bacillus megaterium and Bacillus
      subtilis is not highly cross-linked.
AB  - Determination by amino acid analyses of the percentage of diaminopimelic acid in
      the spore cortex of Bacillus megaterium and Bacillus subtilis which is involved
      in interpeptide cross-links gave values of 31 to 37%. This finding supports the
      idea that the cortex volume could undergo significant changes in response to
      changes in pH or ionic strength and could thus play an active role in reducing
      the water content of the spore protoplast during sporulation.

PMID- 8478340
TI  - Altered muropeptide composition in Staphylococcus aureus strains with an
      inactivated femA locus.
AB  - Tn551 inactivation of femA, a factor involved in methicillin resistance of
      Staphylococcus aureus, caused the production of peptidoglycan in which the
      fraction of monoglycyl- and serine-containing muropeptides was increased at the
      expense of pentaglycyl muropeptides. femA mutants have a specific block in the
      biosynthesis of pentaglycine cross bridges after the addition of the first
      glycine residue.

PMID- 8478341
TI  - Cell division and transcription of ftsZ.
AB  - For normal cell division, the ftsZ gene must be transcribed from a number of
      promoters that are located within the proximal upstream genes (ddlB, ftsQ, and
      ftsA). We show that the main promoters have identical responses to changes in
      growth rate, i.e., under all conditions, the frequency of transcription per
      septum formed is approximately constant and independent of cell size or growth
      rate per se. We also show that transcription from these promoters is independent
      of stationary-phase transcription factor sigma s.

PMID- 8478342
TI  - ESB Research Award 1992. The mechanism of bone remodeling and resorption around
      press-fitted THA stems.
AB  - A major problem threatening the long-term integrity of total hip replacement is
      the loss of proximal bone often found around noncemented stems in the long term.
      It is generally accepted that 'stress shielding' is the cause for this problem:
      after implantation of the prosthesis the surrounding bone is partially
      'shielding' from load carrying and starts to resorb. One of the proposed answers
      to this problem is the application of press-fitted stems. These smooth-surfaced
      implants are thought to provoke higher proximal bone loading, and, hence, less
      stress shielding than bonded implants, because they are wedged into the femur
      every time when loaded. However, in a two-year experiment in dogs, similar
      amounts of resorption of the proximal cortex were found around press-fitted and
      bonded implants. The question arises how similar resorption patterns can develop
      under completely different stress conditions, and whether this phenomenon can be
      explained by adaptive bone remodeling theories based on Wolff's law. In the
      present study an answer was sought for this question. An advanced iterative
      computer simulation model was used to analyze the remodeling process in the
      animal experiment. Three-dimensional finite element models were constructed from
      the animal experimental configuration, in which smooth, press-fitted stems were
      applied unilaterally in the canine. The FE model was integrated with iterative
      remodeling procedures, validated in earlier studies. In the model an appropriate
      non-linear representation of the loose bone-implant interface was realized, also
      capable of simulating the proximal interface gap that was found around the
      uncoated implants. The simulation models predicted similar amounts of proximal
      bone loss and distal bone densification as found in the animal model. Hence, the
      cortical bone loss could indeed be predicted by the strain-adaptive bone
      remodeling theory. By unraveling the simulation process, the question stated
      above could be answered. Densification of the distal bone bed during the initial
      remodeling process was found to cause reduced axial stem displacement (elastic
      subsidence), decreasing the wedging effect of the stem and, hence, decreasing the
      loading of the proximal bone, resulting in proximal bone loss. Hence, whereas in
      the case of bonded stems the proximal resorption process develops monotonously to
      a new equilibrium, the process around smooth, press-fitted stems develops
      nonmonotonously. This is due primarily to the unbonded interface conditions and
      the development of a proximal fibrous membrane. The remodeling process then
      gradually causes the stem to be jammed in the distal diaphyses (proximal 'stress
      bypass').

PMID- 8478343
TI  - Errors in the estimation of arterial wall shear rates that result from curve
      fitting of velocity profiles.
AB  - An analysis was performed to determine the error that results from the estimation
      of the wall shear rates based on linear and quadratic curve-fittings of the
      measured velocity profiles. For steady, fully developed flow in a straight
      vessel, the error for the linear method is linearly related to the distance
      between the probe and the wall, dr1, and the error for the quadratic method is
      zero. With pulsatile flow, especially a physiological pulsatile flow in a large
      artery, the thickness of the velocity boundary layer, delta is small, and the
      error in the estimation of wall shear based on curve fitting is much higher than
      that with steady flow. In addition, there is a phase lag between the actual shear
      rate and the measured one. In oscillatory flow, the error increases with the
      distance ratio dr1/delta and, for a quadratic method, also with the distance
      ratio dr2/dr1, where dr2 is the distance of the second probe from the wall. The
      quadratic method has a distinct advantage in accuracy over the linear method when
      dr1/delta << 1, i.e. when the first velocity point is well within the boundary
      layer. The use of this analysis in arterial flow involves many simplifications,
      including Newtonian fluid, rigid walls, and the linear summation of the harmonic
      components, and can provide more qualitative than quantitative guidance.

PMID- 8478344
TI  - Do bone ingrowth processes produce a globally optimized structure?
AB  - A topology optimization program was applied to test the hypothesis that bone
      adaptation to porous coated implants produces a structure which minimizes the
      global strain energy density. The program was used to predict the optimal
      material layout around a porous coated tibial component with multiple cones
      [Goldstein et al., Trans. 37th ORS, p. 92 (1991)]. The sensitivity of the
      predicted adaptation to analysis assumptions was assessed and the predicted bone
      ingrowth and apposition were compared with the experimental findings of Goldstein
      et al. The results showed that apposition occurred consistently at the cone tips
      regardless of analysis assumptions. The specific topology of apposition at the
      cone tips was most sensitive to the assumed loading conditions. A comparison with
      the experimental results for 11 subdivisions showed that the general predicted
      location of material agreed with the experimental results (R2 > or = 0.59).
      However, the program predicted a consolidated bone greater than 1000 microns in
      thickness at the cone tips, which differed from the porous bone structure found
      experimentally. This discrepancy was reflected in a refined comparison over 31
      subdivisions which did not produce a significant correlation (R2 < or = 0.3). The
      program also predicted little ingrowth (< 6-7%), indicating that ingrowth past
      the first bead layer contributed little to the overall bone-implant interface
      layer stiffness. Based on these results, we conclude, within limitations of a two
      dimensional analysis, that bone adaptation to porous coated implants does not
      produce a structure solely optimized to minimize the global strain energy
      density. We hypothesize that the final bone structure reflects the need to meet
      both mechanical and nutritional demands.

PMID- 8478345
TI  - Nonstationary properties of postural sway.
AB  - Postural sway during quite stance is usually assumed to be a stationary
      stochastic process. We tested this assumption by investigating the time
      invariance of the average value and variance of the postural sway of three
      subjects. The sway was measured with a force plate under three conditions:
      subject standing on two feet with eyes open; subject standing on two feet with
      eyes closed; and subject standing on one foot with eyes open. Data were collected
      in 1 min runs. More than 50 min of data were collected for each subject under
      each test condition. The data were averaged across all runs for each subject and
      condition. Trends were found to be present in the data. In addition, there were
      initial transient increases in the second-order moments about the trends. The
      transient changes in first- and second-order moments usually disappeared during
      the first 20 s. In light of these findings, we can reject the hypothesis that
      postural sway is a stationary process. The results imply that the usual methods
      to parameterize postural sway have to be either changed or reinterpreted.

PMID- 8478346
TI  - Geometric properties and the predicted mechanical behavior of adult human
      clavicles.
AB  - An image processing system was used to examine histomorphometric properties of 15
      adult male and female human clavicles. Variations in porosity, cross-sectional
      area, anatomic and principal moments of inertia were assessed at 2.5-5.0%
      increments along the length of the clavicles. The clavicle's biomechanical
      behavior (axial, flexural, and torsional rigidities and the critical force for
      buckling) was modeled from these data using beam theory. Over threefold
      variations in porosity and moments of inertia were found along the length of the
      s-shaped clavicle--the greatest porosity and moments of inertia were located in
      the variably shaped sternal and acromial thirds of the bone in contrast to the
      denser and smaller, more circulatory shaped central third of the bone. Clavicle
      orientation, as indicated by the direction of greatest resistance to bending
      (maximum principal moment of inertia), was found to rotate from a primarily
      cranio-caudal orientation at the sternum to a primarily anterior-posterior
      orientation at the acromion. Based on cross-sectional geometry, section moduli,
      and estimates of flexural and torsional rigidity, the clavicle was found to be
      weakest in the central third of its length. These data concur with the fracture
      location most commonly reported clinically. Analysis of Euler buckling predicted
      a minimum critical force for buckling during axial loading of approximately two
      to three body weights for an average adult. Thus, buckling, or a combination of
      axial loading and bending or torsional loading, must be considered as possible
      failure mechanisms for this commonly injured bone.

PMID- 8478347
TI  - Experimental measurement of ligament force, facet force, and segment motion in
      the human lumbar spine.
AB  - Facet forces, longitudinal ligament loads, and vertebral body motion were
      experimentally measured in five fresh human lumbar spine segments, L1-L2. Strain
      gages on the bone surface were used to quantify facet loads. Buckle transducers
      were used to measure anterior and posterior longitudinal ligament loads. The
      three-dimensional motion of the motion segment was measured with an instrumented
      spatial linkage. The facets were found to carry no load in flexion, large loads
      during extension (205 N at a 10 Nm moment and a 190 N axial load), torsion (65 N
      at a 10 Nm moment and a 150 N axial load), and lateral bending (78 N at a 3 Nm
      moment and a 160 N axial load). The facet contact site on the inferior articular
      process of L1 was found to move inferiorly to a position of tip impingement near
      the lamina as extension moments increased. Impingement occurred in the range of 4
      6 Nm extension. The posterior and anterior longitudinal ligaments were
      predominantly loaded in flexion and extension, respectively. No ligament loads
      occurred in lateral bending and torsion. A 1 cm strip of the anterior
      longitudinal ligament carried loads up to 130 N at the largest extension moment
      of 11.4 Nm. The posterior longitudinal ligament had a 60 N load at the largest
      flexion moment of 7.1 Nm. There was no pre-load in the ligament detectable with
      the buckle transducers (> 4 N). The facets and ligaments began carrying load
      immediately with applied load, without a lax region. The experimental technique
      developed and used provides a good tool for obtaining simultaneous facet joint
      loads, ligament loads, and vertebral body motion without altering the motion
      segment.

PMID- 8478348
TI  - On the viscoelastic properties of the anteromedial bundle of the anterior
      cruciate ligament.
AB  - The nonlinear viscoelastic properties of the anteromedial (AM) bundle of porcine
      anterior cruciate ligament (ACL) were characterized by using a new analytical
      approach based on the quasi-linear viscoelastic theory. Stress relaxation and
      cyclic tensile tests were performed. Using the solution derived from this
      approach, we curve-fitted data from the stress relaxation test to determine the
      viscoelastic coefficients for the ligament bundles. The coefficients were
      verified by comparison of the predicted and the experimental results from the
      cyclic tensile test. The ACL AM bundle exhibited significant stress relaxation
      with time; a reduction of more than 50% of the peak value occurred during the 2-h
      experiment. Also, the reduced relaxation function for the ACL AM bundle was not a
      linear function of logarithmic time, as is commonly assumed for many soft
      tissues. The new approach, which takes into account the finite strain rate of the
      ramp function used in the stress relaxation test, provides an accurate
      description of this nonlinear stress relaxation behavior.

PMID- 8478349
TI  - Compressive fatigue behavior of bovine trabecular bone.
AB  - We studied the fatigue behavior of bovine trabecular bone specimens under stress
      control using a sinusoidal uniaxial compressive load profile with a frequency of
      2 Hz. The stress range was determined from the corresponding initial global
      platen-to-platen strain range, where the maximum initial strain was between 0.8
      and 2.1% and the minimum strain was 0.6%. The local strain distribution was
      measured on the same type of specimen by affixing glass spheres and photographing
      them in the unloaded and loaded positions using multiple exposures. The number of
      cycles to failure (defined as a 5% decrease in secant modulus) was strongly
      correlated with the initial global maximum strain (r2 = 0.78) and ranged from 20
      cycles at 2.1% strain to 400,000 cycles at 0.8% strain. All of the fatigue
      specimens showed a region of transverse failure approximately 1 mm from the end
      of the specimen. Microscopic examination of the failure zones revealed two
      failure modes: a straight transverse brittle-like fracture through the
      trabeculae, most often found in trabeculae transverse to the loading direction,
      and buckling-like failure, common in oblique trabeculae, involving bending and
      splitting. The local strain increased towards the ends of the specimens to a
      value 2-4 times that in the middle. Modulus degradation with the number of cycles
      was distinctively different for high-cycle and low-cycle fatigue, suggesting the
      possibility that both creep and damage accumulation contribute to fatigue failure
      of trabecular bone.

PMID- 8478350
TI  - Relationship between ankle muscle and joint kinetics during the stance phase of
      locomotion in the cat.
AB  - The purpose of this study was to examine the relationship between internal force
      production in selected skeletal muscles and the externally calculated joint
      moment during overground locomotion in the adult cat. Hindlimb segments were
      modelled as a linked system of rigid bodies and a generalized muscle moment
      (GMM), the sum over all active and passive tissues acting about the joint, was
      calculated using principles of inverse dynamics. Moments produced by individual
      muscles were calculated using tendon transducers implanted in freely moving cats
      and muscle moment arm information. Results indicated that the externally measured
      variables of peak ground reaction force and joint position were equally important
      to the determination of peak ankle GMM. Examination of peak moments revealed that
      increases in peak ankle GMM were met by increases in medial (MG) and lateral (LG)
      gastrocnemius output. Peak soleus (SOL) moments did not change significantly as a
      function of peak ankle GMM. The role of the plantaris (PLT) was less clear, with
      peak moments increasing significantly as a function of peak ankle GMM in one cat.
      All four ankle extensors were important to the attainment of peak ankle GMM early
      in stance. Subsequently, SOL and PLT contributed substantially to the ankle GMM
      throughout stance, LG moments declined to near zero, soon after peak ankle GMM;
      and MG moments demonstrated a substantial but more gradual decline. The relative
      contributions of these individual muscles to the ankle GMM were supported by
      their respective architecture, uniarticular versus multiarticular function, and
      physiological profiles.

PMID- 8478351
TI  - Effects of hip center location on the moment-generating capacity of the muscles.
AB  - We have developed a three-dimensional biomechanical model of the human lower
      extremity to study how the location of the hip center affects the moment
      generating capacity of four muscle groups: the hip abductors, adductors, flexors,
      and extensors. The model computes the maximum isometric force and the resulting
      joint moments that each of 25 muscle-tendon complexes develops at any body
      position. Abduction, adduction, flexion, and extension moments calculated with
      the model correspond closely with isometric joint moments measured during maximum
      voluntary contractions. We used the model to determine (1) the hip center
      locations that maximize and minimize the moment-generating capacity of each
      muscle group and (2) the effects of superior-inferior, anterior-posterior, and
      medial-lateral displacement of the hip center on the moment arms, maximum
      isometric muscle forces, and maximum isometric moments generated by each muscle
      group. We found that superior-inferior displacement of the hip center has the
      greatest effect on the force- and moment-generating capacity of the muscles. A 2
      cm superior displacement decreases abduction force (44%), moment arm (12%), and
      moment (49%), while a 2 cm inferior displacement increases abduction force (20%),
      moment arm (7%) and moment (26%). Similarly, a 2 cm superior displacement
      decreases flexion force (27%), moment arm (6%), and moment (22%), while inferior
      displacement increases all three variables. Anterior-posterior displacement
      alters the moment-generating capacity of the flexors and extensors considerably,
      primarily due to moment arm changes. Medial-lateral displacement has a large
      effect on the moment-generating capacity of the adductors only. A 2 cm medial
      displacement decreases adduction moment arm (20%), force (26%) and moment (40%).
      These results demonstrate that the force- and moment-generating capacities of the
      muscles are sensitive to the location of the hip center.

PMID- 8478352
TI  - Slow deformation of intervertebral discs.
AB  - Intervertebral discs exhibit pronounced time-dependent deformations when
      subjected to load variations. These deformations are caused by fluid flow to and
      from the disc and by viscoelastic deformation of annulus fibres. The fluid flow
      is caused by differences between mechanical and osmotic pressure. A mechanical
      model of lumbar disc functions allows one to calculate both the extent of fluid
      flow and its implications for disc height as well as the role played by
      viscoelastic deformation of annulus fibres. From such calculations changes in
      body height are estimated. Experimental results already documented in the
      literature offer bases for the determination of the parameters involved. Body
      height variations are studied, both those related to normal diurnal rhythmicity
      and those related to somewhat exceptional circumstances. The normal diurnal fluid
      flow is found to be about +/- 40% of the disc fluid content late in the evening.
      Viscoelastic deformation of annulus fibres contributes approximately one quarter
      of the height change obtained after several hours normal activity, but dominates
      during the first hour.

PMID- 8478353
TI  - The relationship between EMG activity and extensor moment generation in the
      erector spinae muscles during bending and lifting activities.
AB  - The relationship between EMG activity and extensor moment generation in the
      erector spinae muscles was investigated under isometric and concentric
      conditions. The full-wave rectified and averaged EMG signal was recorded from
      skin-surface electrodes located over the belly of the erector spinae at the
      levels of T10 and L3, and compared with measurements of extensor moment. The
      effects of muscle length and contraction velocity were studied by measuring the
      overall curvature (theta) and rate of change of curvature (d theta/dt) of the
      lumbar spine in the sagittal plane, using the '3-Space Isotrak' system. Isometric
      contractions were investigated with the subjects pulling up on a load cell
      attached to the floor. Hand height was varied to produce different amounts of
      lumbar flexion, as indicated by changes in lumbar curvature. The extensor moment
      was found to be linearly related to EMG activity, and the 'gradient' and
      'intercept' of the relationship were themselves dependent upon the lumbar
      curvature at the time of testing. Concentric contractions were investigated with
      the subjects extending from a seated toe-touching position, at various speeds,
      while the torque exerted on the arm of a Cybex dynamometer was continuously
      measured. Under these conditions the EMG signal (E) was higher than the isometric
      signal (E0) associated with the same torque. E and E0 were related as follows: E0
      = E/(1 + A d theta/dt), where A = 0.0014 exp (0.045P) and P = percentage lumbar
      flexion. This equation was used to correct the EMG data for the effect of
      contraction velocity. The corrected data were then used, in conjunction with the
      results of the isometric calibrations, to calculate the extensor moment generated
      by the erector spinae muscles during bending and lifting activities. The extensor
      moment can itself be used to calculate the compressive force acting on the lumbar
      spine.

PMID- 8478354
TI  - Mechanical and textural properties of pelvic trabecular bone.
AB  - So far, virtually nothing is known about the mechanical properties of pelvic
      trabecular bone. In this study, several techniques have been used to establish
      some insight in these properties. Dual-energy quantitative computer tomography
      (DEQCT) was used to look at the distribution of bone densities throughout the
      pelvic bone and nondestructive mechanical testing was used to obtain Young's
      moduli and Poisson's ratios in three orthogonal directions for cubic specimens of
      pelvic trabecular bone. The same specimens were then used for stereological
      measurements to obtain volume fractions and the spatial orientations of the mean
      intercept lengths. The combined data on the mechanical tests and the
      stereological measurements made it possible to calculate Young's moduli and
      Poisson's ratios for the specimens' principal material axes. DEQCT showed that
      bone densities within a pelvic bone are significantly higher in the superior part
      of the acetabulum, extending to the sacroiliac joint area and, secondly, in the
      area of the pubic symphysis. Volume fractions found for the specimens did not
      exceed 20%. This may be considered rather low when compared to values reported in
      the literature for trabecular bone of femoral or tibial origin, but the values do
      lie in the same range as vertebral trabecular bone. With the volume fraction as
      its primary predictor, values of Young's moduli were also low. For most specimens
      these values were not higher than 100 MPa, with an occasional peak of 250 MPa.
      Looking at the ratio of the highest and lowest Young's modulus or at the
      components of the fabric tensor, it can be concluded that pelvic trabecular bone
      is not highly anisotropic. On an average, Poisson's ratio was found to be closer
      to 0.2 rather than 0.3, which is in accordance with other studies on Poisson's
      ratio of trabecular bone.

PMID- 8478355
TI  - Trunk muscle geometry and centroid location when twisting.
AB  - The trunk muscles of the lumbar region were studied using magnetic resonance
      imaging (MRI) in five male volunteers placed in neutral and in two twisted
      postures. Using a CAD digitizing system, the positions of trunk muscle centroids
      and the cross-sectional areas of these muscles were measured from the transverse
      scans at 1 cm intervals from L2 to S1. Muscle lines of action were created by
      connecting the muscle centroids from the successive sections. Changes in cross
      sectional areas and displacements of centroids in a three-dimensional coordinate
      system and the local two-dimensional coordinate system were estimated at each
      disc level. In the three-dimensional coordinate system, all muscle centroids were
      displaced when twisting. Thus, the locations and orientations of all muscle lines
      of action changed. In the local two-dimensional coordinate system, only the
      muscle centroids of four abdominal muscles were displaced. Most of these
      displacements occurred in the first 25 degrees of twisting. Higher up in the
      lumbar spine, the displacement was greater. The changes in moment arms were
      sometimes as great as twofold. Only the abdominal oblique muscles (AOM) changed
      their cross-sectional area significantly; the area of the right AOM ipsilateral
      to the side of twisting increased, while that of the left AOM was decreased.

PMID- 8478357
TI  - Mechanical responses of the periodontal ligament in the transverse section of the
      rat mandibular incisor at various velocities of loading in vitro.
AB  - Stress-strain curves of the periodontal ligament (PDL) were obtained at various
      velocities of extrusive loading of 1, 10, 10(2), 10(3) and 10(4) mm/24 h in
      vitro. Significant increases of the maximum shear stress, tangent modulus and
      failure strain energy density were found with increases in the velocity of
      loading. The maximum shear strain increased from a velocity of 1 to 10 mm/24 h
      but decreased from 10 to 10(4) mm/24 h. It was shown histologically that the free
      surface of the PDL adhering to the cementum after mechanical testing was rough
      and irregular at higher velocities and rather smooth at lower velocities. These
      results showed that the mechanical properties and mode of failure of the rat
      incisor PDL were greatly dependent on the strain rate. It is possible that the
      PDL of the continuously erupting rat incisor has mechanical characteristics
      favourable for resisting weakly to slow and small eruptive forces but strongly to
      the fast and large occlusal forces as suggested previously [Chiba and Komatsu,
      The Biological Mechanisms of Tooth Eruption and Root Resorption (1988)].

PMID- 8478356
TI  - Estimation of muscle forces about the wrist joint during isometric tasks using an
      EMG coefficient method.
AB  - A technique for estimating isometric muscle forces based on EMGs and anatomical
      parameters is presented. In the present study, we record EMGs from five muscles
      acting at the wrist, during a series of isometric contractions in flexion,
      extension, ulnar deviation and radial deviation. The method then uses these EMG
      signals and the necessary anatomical data to estimate individual muscle forces.
      For one subject, complete anatomical parameters were estimated by MRI
      reconstruction of muscle moment arms and lines of muscle action. In all subjects,
      the errors associated with variability in the EMG signals were reduced through
      the use of signal processing techniques and intensive subject training. These EMG
      based force estimates were then validated by evaluations at torque directions in
      which no mechanical redundancy existed. The stability of the solution space was
      examined using Monte Carlo simulations. The results of our study show that
      individual muscle forces at the wrist can be estimated with considerable
      accuracy, without assuming any control strategy (as is done with optimization
      theories). However, due to the limited mechanical redundancy of the wrist, it is
      uncertain whether the method can be used to estimate muscle forces in more highly
      redundant systems.

PMID- 8478358
TI  - Determination of loading parameters in the canine hip in vivo.
AB  - The loading parameters in the canine hip were determined from multiple studies,
      involving the collection of kinematic and force plate data in vivo joint reaction
      force from an instrumented hip replacement prosthesis, and in vivo femoral
      cortical bone strain gauge data in different dogs. In the middle of the stance
      phase of gait the canine femur was flexed 110 degrees with respect to the pelvis
      and formed a 20 degree angle relative to the floor. At this point in the gait
      cycle, a line passing from the superior to the inferior aspect of the pubic
      symphysis was parallel to the floor. The joint reaction force measurements showed
      that the net force vector during midstance was directed inferiorly, posteriorly,
      and laterally, with a peak magnitude of up to 1.65 times the body weight. A
      torsional moment of 1.6 N m is exerted about the femoral shaft. In vivo strain
      data showed that during gait peak compressive strains of -300 to -502 microstrain
      were produced on the medial aspect of the femoral cortex and peak tensile strains
      of +250 to +458 midstrain were produced on the femoral cortex. At the midstance
      phase of gait, principal cortical bone strains were rotated up to 29 degrees
      relative to the long axis of the femur, suggesting torsional loads on the femur.
      These data in combination provide valuable insights on the loading parameters of
      the canine hip which can be used in future applications of the canine as a model
      for evaluating mechanically based phenomena such as bone ingrowth and remodeling
      or hip prostheses.

PMID- 8478359
TI  - The biphasic poroviscoelastic behavior of articular cartilage: role of the
      surface zone in governing the compressive behavior.
AB  - Surface fibrillation of articular cartilage is an early sign of degenerative
      changes in the development of osteoarthritis. To assess the influence of the
      surface zone on the viscoelastic properties of cartilage under compressive
      loading, we prepared osteochondral plugs from skeletally mature steers, with and
      without the surface zone of articular cartilage, for study in the confined
      compression creep experiment. The relative contributions of two viscoelastic
      mechanisms, i.e. a flow-independent mechanism [Hayes and Bodine, J. Biomechanics
      11, 407-419 (1978)], and a flow-dependent mechanism [Mow et al. J. biomech. Engng
      102, 73-84 (1980)], to the compressive creep response of these two types of
      specimens were determined using the biphasic poroviscoelastic theory proposed by
      Mak. [J. Biomechanics 20, 703-714 (1986)]. From the experimental results and the
      biphasic poroviscoelastic theory, we found that frictional drag associated with
      interstitial fluid flow and fluid pressurization are the dominant mechanisms of
      load support in the intact specimens, i.e. the flow-dependent mechanisms alone
      were sufficient to describe normal articular cartilage compressive creep
      behavior. For specimens with the surface removed, we found an increased creep
      rate which was derived from an increased tissue permeability, as well as
      significant changes in the flow-independent parameters of the viscoelastic solid
      matrix. permeability, as well as significant changes in the flow-independent
      parameters of the viscoelastic solid matrix. From these tissue properties and the
      biphasic poroviscoelastic theory, we determined that the flow-dependent
      mechanisms of load support, i.e. frictional drag and fluid pressurization, were
      greatly diminished in cartilage without the articular surface. Calculations based
      upon these material parameters show that for specimens with the surface zone
      removed, the cartilage solid matrix became more highly loaded during the early
      stages of creep. This suggests that an important function of the articular
      surface is to provide for a low fluid permeability, and thereby serve to restrict
      fluid exudation and increase interstitial fluid pressurization. Thus, it is
      likely that with increasing severity of damage to the articular surface, load
      support in cartilage under compression shifts from the flow-dependent modes of
      fluid drag and pressurization to increased solid matrix stress. This suggests
      that it is important to maintain the integrity of the articular surface in
      preserving normal compressive behavior of the tissue and normal load carriage in
      the joint.

PMID- 8478360
TI  - Decomposition of superimposed ground reaction forces into left and right force
      profiles.
AB  - The process of collecting ground reaction force data by mounting a forceplate
      beneath a treadmill belt has the advantage that numerous walking trials can be
      analyzed without the problem of subjects 'targeting' their footsteps. However, a
      potential problem is that the measured forces represent a summation of bilateral
      force profiles during the double support phase of walking. To address this issue,
      an algorithm is described for decomposing superimposed ground reaction force data
      into individual left and right profiles. It is based on an examination of the
      side-to-side oscillations of the measured center of pressure (CoP). Whenever the
      measured CoP exceeds a certain threshold, it is assumed that the person is being
      supported by a single limb, and the measured GRF data reflect the forces under
      that limb. Conversely, when the measured CoP indicates that both feet are on the
      treadmill, it is assumed that the location of the individual CoP under each foot
      is given by wL2 and wR2. These quantities reflect the greatest excursion of the
      measured CoP towards the left and right sides of the forceplate, respectively.
      With this assumption, individual GRF profiles can be calculated by means of
      solving two simultaneous equations--one describing the equilibrium of forces in
      the vertical direction, and one describing the equilibrium of moments about an
      antero-posterior axis of the forceplate. The algorithm describing this procedure
      is simple enough to be implemented on a spreadsheet and yields estimates for
      average force, impulse, peak force and stance time that are typically within 3%
      of the true values.

PMID- 8478361
TI  - Theoretical analysis of the experimental artifact in trabecular bone compressive
      modulus.
AB  - A theoretical analysis was performed to characterize potential experimental
      artifacts in conventional compression testing of trabecular bone, where strains
      are based on the relative displacements of the two loading platens. We assumed
      that the total experimental artifact for modulus was the sum of a damage and
      friction artifact and derived equations to describe these artifacts. The two
      unknown constants in these equations were found using a combination of data
      derived from linear finite element analyses and in vitro uniaxial compression
      tests. Subsequent finite element analyses allowed estimation of the artifacts for
      a wide range of specimens (cube, 1:4-3:1 aspect ratio cylinders). If friction is
      completely eliminated at the specimen-platen interface, the Young's modulus of a
      5 mm sized (1:1 aspect ratio dimension) specimen which has a damage artifact due
      to machining may be underestimated by at least 45% regardless of specimen
      geometry; otherwise, the platens modulus may vary from less than 30 to over 175%
      of the Young's modulus, depending upon the specimen geometry and Poisson's ratio
      of the bone. Increasing the specimen size reduces the artifact only slightly.
      Since Poisson's ratio can be large for trabecular bone and is rarely known a
      priori, the precision of the conventional compression test will, therefore, be
      poor unless friction is completely eliminated at the specimen-platen interface.
      However, without friction at the interface, the platens modulus will always
      underestimate Young's modulus, thereby reducing the accuracy of this test. There
      was also evidence that the strength may be affected by these artifacts.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8478362
TI  - Measurement of angular displacements using Hall effect transducers.
AB  - Hall effect transducers were studied as an alternative to limited-wear precision
      potentiometers and optical encoders in measuring angular displacements. Various
      design parameters are identified, and the optimum Hall effect transducer
      configuration is presented. Using this configuration, it was possible to measure
      an angular rotation of 140 degrees with a standard deviation of 0.5 degrees.
      Within the +/- 35 degrees mid-range of the total 140 degrees, the standard
      deviation improved to 0.1 degrees.

PMID- 8478363
TI  - Calculating the probability that microcracks initiate resorption spaces.
AB  - This paper explores the assumptions and limitations of the probability
      calculation that led to the conclusion by Burr et al. (1985) that microcracks
      initiate new remodeling events. It also corrects several minor errors in the
      calculation in the original manuscript. The results show that the probability
      that cracks and resorption spaces are associated depends heavily on a factor, F,
      that accounts for the possibility that some osteons that contain both a crack and
      a resorption space share a cement line with an adjacent osteon to which the crack
      more properly 'belongs.' F in turn depends on (1) the measurement criteria for
      cracks and resorption spaces, (2) the osteon population density in the bone, and
      (3) the mechanism by which cracks initiate remodeling. The theoretical maximum
      number of osteons that can contain both a crack and a resorption space (nmax)
      increases as the number of resorption spaces (r), the number of cracks (c), and F
      increase, but decreases as the osteon population density (d) increases. A larger
      nmax makes a direct association between cracks and resorption spaces more
      difficult to demonstrate experimentally.

PMID- 8478364
TI  - A numerical-experimental method for a mechanical characterization of biological
      materials.
AB  - For the determination of material parameters, it is a common practice to extract
      specimens with well-defined geometries. The design of the samples and the choice
      of the applied load are meant to lead to a homogeneous stress and strain
      distribution in a part of the sample. When applied to biological materials, this
      raises a number of problems: homogeneous strains cannot be obtained because the
      materials have inhomogeneous properties, and the manufacturing of samples is hard
      or sometimes impossible. In this technical note a different approach is
      presented, based on the use of a digital image technique for the measurement of
      nonhomogeneous strain distributions, finite element modeling and the use of a
      minimum-variance estimator. The method is tested by means of experiments on an
      orthotropic elastic membrane of a woven and calendered textile. Five parameters
      are identified using the experimental data of one single experiment.

PMID- 8478365
TI  - Analysis of birth intervals in India's Uttar Pradesh and Kerala States.
AB  - Life tables of birth intervals and median birth intervals in two Indian states,
      Uttar Pradesh and Kerala, were computed for several subgroups of the study
      population. Multivariate hazards modelling technique was used to examine the net
      effect of each of the variables studied. The results show a substantial effect of
      socioeconomic variables in child-spacing after controlling for the major
      intermediate variables.

PMID- 8478366
TI  - Emerging patterns of child-spacing in Canada.
AB  - This study used data from the 1984 Family History Survey conducted by Statistics
      Canada to examine recent trends and patterns of child-spacing among currently
      married women. Life table and proportional hazards estimates show that Canadian
      women, particularly those in younger age groups with higher education and longer
      work experience, start having children late, but have subsequent children rather
      quickly. This suggests that such women tend to complete childbearing within a
      compressed time period.

PMID- 8478367
TI  - Estimates of adult mortality in Burundi.
AB  - Adult mortality in Burundi during the 1970s and 1980s is estimated using data
      from the 1987 Demographic and Health Survey (DHS). Estimates from traditional
      indirect methods are compared with those from the inter-survey method using data
      on the number of years since the respondent's parent died. Life expectancy at
      birth was estimated as 48.55 years for males and 51.23 years for females.

PMID- 8478368
TI  - Breast-feeding and child health in the United States.
AB  - This paper evaluates the influence of breast-feeding on infectious and allergic
      diseases in infants and children through an analysis of data from a large
      national sample of US children. It controls for a large number of maternal and
      child health, demographic, and socioeconomic variables which have been shown to
      affect feeding patterns, and it includes several aspects of the feeding pattern
      in addition to breast-feeding. The results suggest that breast-feeding provides
      some protection against pneumonia and otitis media in the United States while
      early introduction of formula may have a separate and negative effect.

PMID- 8478369
TI  - Breast-feeding, water and sanitation, and childhood malnutrition in the
      Philippines.
AB  - This study examines effects and interactions of socioeconomic status, access to
      water supply and sanitation, and breast-feeding practices in relation to child
      growth in two provincial cities in the Philippines. Multivariate analysis
      identified food expenditure per head, education of the household head and gender
      of the child as significant predictors of nutritional status. The duration of
      partial and full breast-feeding was negatively (though non-significantly)
      associated with growth. Sanitation facilities and breast-feeding are, however,
      important determinants during the first year of life. Among children over 1 year
      of age, socioeconomic variables and gender are the most important predictors.
      Breast-feeding is shown to provide more important health benefits for children in
      lower income households. The need for further studies on the causes of gender
      differences in nutritional status was apparent.

PMID- 8478370
TI  - Gender of children and contraceptive use.
AB  - In 1984, half of married/cohabiting Canadian women aged 18-49 years were using
      contraception, with sterilisation being the most prevalent method. This study,
      using data from the 1984 Canadian Fertility Survey of 5315 women aged 18-49
      years, found that there was a preference for sons. Women with two sons are more
      likely to use contraception than those who have had two daughters; the gender of
      children may have a weak effect on contraceptive behaviour of Canadian couples at
      higher parities. Sociocultural factors (e.g. education, religion, religiosity)
      were also found to influence contraceptive behaviour.

PMID- 8478371
TI  - Factors responsible for childhood mortality variation in rural Ethiopia.
AB  - This paper uses the 1981 National Rural Demographic Survey to document childhood
      mortality variations in rural areas of Ethiopia. Four significant findings are
      highlighted. (1) Health status of parents is identified as an important
      determinant of childhood mortality. (2) Religion, region of residence and
      ethnicity interact in their effects on childhood mortality and the effect of
      ethnicity varies in different regions for the same religion; in some areas
      ethnicity may serve as a proxy for economic and cultural differences. (3)
      Childhood mortality is inversely related to literacy status of parents, which may
      also reflect socioeconomic status. (4) The data show a clear difference in
      childhood mortality between the famine-prone areas and the rest.

PMID- 8478372
TI  - Diffusion of a particular 4.1(-) hereditary elliptocytosis allele in the French
      Northern Alps.
AB  - Heterozygous 4.1(-) hereditary elliptocytosis results from the absence of one
      haploid set of protein 4.1, a major component of the red cell skeleton. Two
      successive epidemiological investigations revealed fifteen probands in the French
      Northern Alps. The frequency of this disease seems to be very high in four small
      villages isolated in the Aravis mountains. The genealogical study shows that
      eleven probands share common ancestors who lived eight or ten generations ago in
      these villages. Thus there was probably a founder effect from one pair of
      ancestors, strengthened by endogamy. In contrast, four probands originate from
      another area and are not genealogically related. Recent results in molecular
      genetics support the present data.

PMID- 8478373
TI  - Evaluation of natural family planning programmes in Liberia and Zambia.
AB  - Studies to evaluate use-effectiveness and cost-effectiveness of natural family
      planning (NFP) were conducted in Liberia and Zambia. The Liberian programme
      provided uni-purpose NFP services to 1055 clients mainly in rural areas; the
      Zambian programme provided NFP services integrated with MCH to 2709 clients
      predominantly in urban areas. The one-year life table continuation and unplanned
      pregnancy rates were 78.9 and 4.3 per 100 woman-years in Liberia, compared to
      71.2 and 8.9 in Zambia. However, high rates of loss to follow-up mandate caution
      in interpretation of these results, especially in Zambia. More women progressed
      to autonomous NFP use in Liberia (58%) than in Zambia (35.3%). However, programme
      costs per couple-year protection were lower in Zambia (US$25.7) than in Liberia
      (US$47.1). Costs per couple-year protection were higher during learning than
      autonomy, and declined over time. These studies suggest that NFP programmes can
      achieve acceptable use- and cost-effectiveness in Africa.

PMID- 8478374
TI  - Family background, cognitive abilities, and personality as predictors of
      education and occupational attainment across two generations.
AB  - This study reports on the relative influences of parental attainment and
      cognitive ability and subjects' own cognitive ability, personality, and social
      attitudes on the educational and occupational attainments and incomes of 183
      Generation 3 subjects of Caucasian ancestry and 186 of Japanese ancestry
      originally tested in 1972-76 in the Hawaii Family Study of Cognition (HFSC) and
      re-tested in 1987-88. In contrast to earlier reports of sex differences in the
      influence of Generation 2 attainment and on Generation 3 attainment when these
      offspring were younger, family background had a trivial influence and own
      cognitive ability had a substantial influence on educational attainment for both
      racial/ethnic groups and both sexes. For income, however, own cognitive ability
      was only a significant predictor for male subjects. Within-family correlational
      analyses also supported this sex difference in influences on attainment.

PMID- 8478375
TI  - Open reduction and internal fixation of displaced intra-articular fractures of
      the glenoid fossa.
AB  - Ten displaced intra-articular fractures of the glenoid fossa were treated with
      open reduction and internal fixation between 1980 and 1987. Nine patients were
      available for evaluation at an average of four years (range, two to ten years)
      after the operation. Eight patients had mild or no symptoms and little or no
      restriction of the motion of the shoulder. There were no infections or malunions.
      The only complication was heterotopic ossification in one patient. Radiographic
      evaluation showed no evidence of traumatic osteoarthrosis in any patient. Open
      reduction and internal fixation is a useful and safe technique for the treatment
      of selected, displaced fractures of the glenoid fossa, and it can restore
      excellent function of the shoulder.

PMID- 8478376
TI  - Prosthetic replacement of the shoulder for the treatment of defects in the
      rotator cuff and the surface of the glenohumeral joint.
AB  - We operatively treated, between 1978 and 1987, twenty-one shoulders in nineteen
      patients, fifty-four to eighty-four years old, who had disabling pain
      attributable to a massive tear of the rotator cuff, accompanied by loss of the
      surface of the glenohumeral joint. These patients were not candidates for total
      shoulder replacement because of the massive deficiency in the cuff and the fixed
      upward displacement of the humeral head. A prerequisite for hemiarthroplasty was
      a functionally intact coracoacromial arch to provide superior secondary stability
      for the prosthesis. One important aspect of the operative technique was the
      selection of a sufficiently small prosthesis so that excessive tightness of the
      posterior aspect of the capsule could be avoided. Eighteen shoulders in sixteen
      patients were available for follow-up, which ranged from twenty-five to 122
      months. Pain decreased from marked or disabling in fourteen shoulders
      preoperatively to none or slight in ten and to pain only after unusual activity
      in four. Active forward elevation improved from an average of 66 degrees
      preoperatively to an average of 109 degrees postoperatively. One patient, who had
      had an excellent result, fell and sustained an acromial fracture, so the
      functional result changed to poor. Three patients had persistent, substantial
      pain in the shoulder that led to a revision. Neither infection nor prosthetic
      loosening developed in any shoulder.

PMID- 8478377
TI  - Instability of the shoulder after arthroplasty.
AB  - A replacement arthroplasty was performed in 236 shoulders at The Hospital for
      Special Surgery from 1984 through 1989. Ten patients (eight women and two men)
      from that group were identified as having instability of the shoulder at the time
      of follow-up, and the results for these patients were reviewed retrospectively.
      The ages of the patients ranged from fifty-six to seventy-nine years. The
      instability was anterior in seven of the patients and posterior in three. The
      anterior instability was caused by a rupture of the repaired subscapularis
      tendon. The operative treatment of the anterior instability consisted of
      mobilization and repair of the tendon, but three of the seven patients continued
      to have instability. A static stabilizer, consisting of an allograft of Achilles
      tendon, was inserted in these three patients, and the result was a success. The
      etiology of the posterior instability (three patients) was multifactorial.
      Treatment consisted of correction of any soft-tissue imbalance and revision of
      the prosthetic components as necessary. All ten patients were followed clinically
      and radiographically for at least two years. All of the patients had some loss of
      motion of the shoulder as compared with the motion before the dislocation. There
      were no neurovascular complications, problems related to the allografts, or any
      other complications. We concluded that proper balancing of the soft tissues and
      positioning of the prosthetic components are essential to a successful
      arthroplasty of the shoulder. The postoperative rehabilitation should include a
      physical therapy program in which the range of motion of the arm that was
      achieved in the operating room is not exceeded.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478378
TI  - Capitellocondylar total elbow replacement in rheumatoid arthritis. Long-term
      results.
AB  - We evaluated the long-term results of 202 capitellocondylar total elbow
      replacements that had been performed, from July 1974 through June 1987, in 172
      patients. The duration of follow-up averaged sixty-nine months (range, twenty
      four to 178 months). At the most recent follow-up examination, use of a 100-point
      rating score demonstrated an improvement from an average preoperative score of 26
      points (range, 2 to 50 points) to an average postoperative score of 91 points
      (range, 45 to 100 points). The most improvement occurred in the categories of
      relief of pain, functional status, and range of motion in all planes except
      extension. The improvements in these categories and in the roentgenographic
      appearance that were seen in the early postoperative period did not deteriorate
      with time. The average preoperative arc of motion at the elbow ranged from -37
      degrees of extension to 118 degrees of flexion. The average postoperative arc of
      motion at the elbow ranged from -30 degrees of extension to 135 degrees of
      flexion. Supination improved from 45 degrees preoperatively to 64 degrees
      postoperatively; pronation improved from 56 degrees preoperatively to 72 degrees
      postoperatively. The roentgenograms showed a radiolucent line adjacent to eight
      humeral and nineteen ulnar components; most of the lines were incomplete and one
      millimeter wide or less. Revision of the prosthesis was necessary in three elbows
      (1.5 per cent) because of loosening without infection, and in three additional
      elbows because of dislocation of the prosthesis. Complications included deep
      infection in three elbows (1.5 per cent); problems related to the wound in
      fifteen (7 per cent); permanent, partial sensory ulnar-nerve palsy in five (2.5
      per cent); permanent, partial motor ulnar-nerve palsy in one (0.5 per cent); and
      dislocation in seven (3.5 per cent).

PMID- 8478379
TI  - The function of the quadriceps muscle after a fracture of the femur in patients
      who are less than seventeen years old.
AB  - Thirty-three patients who had been managed for an isolated, closed fracture of
      the femoral shaft when they were less than seventeen years old were examined at
      an average of thirty-three months (range, eighteen to fifty-six months) after the
      injury. Thirteen patients (39 per cent) had a persistent deficit in the strength
      of the quadriceps of the fractured limb, as identified on testing with a Cybex-II
      isokinetic dynamometer. Six patients (18 per cent) had a deficit according to the
      one-leg-hop for distance test, fourteen (42 per cent) had an average loss of ten
      millimeters in the circumference of the thigh, and sixteen (48 per cent) had an
      average loss of 10 degrees of flexion of the knee. The etiological factors that
      were thought to possibly be responsible for the weakness of the quadriceps were
      evaluated. The amount of maximum displacement of the fracture, as seen on the
      initial radiographs, was the only factor that was significant for the prediction
      of weakness of the quadriceps (p = 0.006) at both test speeds of the Cybex
      dynamometer and in all statistical analyses. Despite the persistent weakness of
      the quadriceps, none of the patients had a clinical problem at the latest follow
      up examination. A subclinical deficit in the strength of the quadriceps may be
      related to damage sustained by the muscle at the time of the fracture. On the
      basis of the results of this study, we do not recommend a change from the
      traditional methods of treatment, which involve early application of a spica cast
      or use of traction followed by application of a spica cast.

PMID- 8478380
TI  - Scoliosis in children after thoracotomy for aortic coarctation.
AB  - A follow-up study was performed to assess the prevalence of scoliosis in 160
      patients in whom aortic coarctation had been treated operatively through a left
      posterolateral incision in the fourth intercostal space. Scoliosis had not been
      seen in any patient before the thoracotomy, but a scoliosis of 10 degrees or more
      was observed in thirty-five patients (22 per cent) at the follow-up examination,
      which was performed an average of seven years after the thoracotomy. The
      scoliosis was a thoracic curve and was directed to the left in twenty-six of the
      thirty-five patients. Most of the curves were mild (between 10 and 20 degrees)
      and hardly progressed during the follow-up period. The high-risk period for the
      onset of scoliosis began about three years after the operation. The prevalence of
      scoliosis did not correlate significantly with the age or sex of the patients.

PMID- 8478381
TI  - The use of one compared with two distal screws in the treatment of femoral shaft
      fractures with interlocking intramedullary nailing. A clinical and biomechanical
      analysis.
AB  - The torsional and compressive biomechanical characteristics of a system for
      intramedullary fixation with a slotted locking nail and either one or two distal
      locking screws were evaluated in sixteen femora obtained from eight cadavera. No
      significant difference was found in the torsional rigidity or axial load to
      failure when one as opposed to two distal screws had been used. We also managed
      twenty-seven patients who had a fracture of the femoral shaft with interlocking
      fixation, using only a single distal screw for distal fixation. The average
      duration of follow-up was nine months (range, three to twenty-five months). The
      average time to radiographic healing was three months (range, two to six and one
      half months). There were no non-unions or failures of the implant. Clinically
      unimportant migration of the distal screw occurred in five patients. We concluded
      that one distal screw provides adequate distal fixation of fractures of the
      femoral shaft treated with interlocking intramedullary nailing.

PMID- 8478382
TI  - Cell origin and differentiation in the repair of full-thickness defects of
      articular cartilage.
AB  - The origin and differentiation of cells in the repair of three-millimeter
      diameter, cylindrical, full-thickness drilled defects of articular cartilage were
      studied histologically in New Zealand White rabbits. The animals were allowed to
      move freely after the operation. Three hundred and sixty-four individual defects
      from 122 animals were examined as long as forty-eight weeks postoperatively. In
      the first few days, fibrinous arcades were established across the defect, from
      surface edge to surface edge, and this served to orient mesenchymal cell ingrowth
      along the long axes. The first evidence of synthesis of a cartilage extracellular
      matrix, as defined by safranin-O staining, appeared at ten days. At two weeks,
      cartilage was present immediately beneath the surface of collagenous tissue that
      was rich in flattened fibrocartilaginous cells in virtually all specimens. At
      three weeks, the sites of almost all of the defects had a well demarcated layer
      of cartilage containing chondrocytes. An essentially complete repopulation of the
      defects occurred at six, eight, ten, and twelve weeks, with progressive
      differentiation of cells to chondroblasts, chondrocytes, and osteoblasts and
      synthesis of cartilage and bone matrices in their appropriate locations. At
      twenty-four weeks, both the tidemark and the compact lamellar subchondral bone
      plate had been re-established. The cancellous woven bone that had formed
      initially in the depths of the defect was replaced by lamellar, coarse cancellous
      bone. Autoradiography after labeling with 3H-thymidine and 3H-cytidine
      demonstrated that chondrocytes from the residual adjacent articular cartilage did
      not participate in the repopulation of the defect. The repair was mediated wholly
      by the proliferation and differentiation of mesenchymal cells of the marrow.
      Intra-articular injections of 3H-thymidine seven days after the operation clearly
      labeled this mesenchymal cell pool. The label, initially taken up by
      undifferentiated mesenchymal cells, progressively appeared in fibroblasts,
      osteoblasts, articular chondroblasts, and chondrocytes, indicating their origin
      from the primitive mesenchymal cells of the marrow. Early traces of degeneration
      of the cartilage matrix were seen in many defects at twelve to twenty weeks, with
      the prevalence and intensity of the degeneration increasing at twenty-four,
      thirty-six, and forty-eight weeks. Polarized light microscopy demonstrated
      failure of the newly synthesized repair matrix to become adherent to, and
      integrated with, the cartilage immediately adjacent to the drill-hole, even when
      light microscopy had shown apparent continuity of the tissue. In many instances,
      a clear gap was seen between repair and residual cartilage.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8478383
TI  - Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted
      without cement.
AB  - A prospective study was done of the intermediate-term clinical and radiographic
      results of 121 total hip arthroplasties in which a Harris-Galante porous titanium
      fiber-coated prosthesis was inserted without cement in 110 patients. The average
      age at the time of the operation was forty-nine years (range, twenty to seventy
      years). The average duration of follow-up was sixty-seven months (range, fifty
      five to seventy-nine months). The average preoperative Harris hip score was 55
      points, and the average postoperative score was 93 points. One acetabular
      component was revised due to recurrent dislocation. Eleven femoral implants were
      unstable, and of these, four were revised. Cortical erosion was present around
      the distal part of the femoral stem in nine patients (8 per cent) who had stable
      implants, and one of these femoral implants was revised because the erosion was
      extensive. Survivorship analysis at five years revealed a 97 per cent chance of
      survival (95 per cent confidence limit, 0.937 to 1.0) of the Harris-Galante
      femoral-stem implant inserted without cement.

PMID- 8478384
TI  - Hip and knee replacement in osteogenesis imperfecta.
AB  - Five total hip and three total knee arthroplasties were performed, from 1969 to
      1990, in six patients who had osteogenesis imperfecta. The patients who had a hip
      arthroplasty were followed for a mean of seven years, and those who had a knee
      arthroplasty, for a mean of ten years. Postoperatively, all had relief of pain
      and were able to walk; one patient used a walker and two used a cane. The only
      postoperative complication was an intrapelvic protrusion of the acetabular
      component six years after a bipolar hip replacement.

PMID- 8478385
TI  - Pulmonary function during and after total hip replacement. Findings in patients
      who have insertion of a femoral component with and without cement.
AB  - Eleven patients who had a femoral component inserted with cement and twenty-three
      who had a femoral component inserted without cement were studied prospectively
      for changes in the pulmonary shunt associated with total hip replacement. The
      levels of oxygen in the arterial blood and the platelet counts were measured
      preoperatively and each morning for three days after the arthroplasty. Levels of
      oxygen in the arterial blood were determined intraoperatively, once before and
      once after the femoral component was inserted. Intraoperative shunt values
      increased 28 per cent when a femoral component was inserted with cement (p <
      0.05), but they did not change when cement was not used. The average
      postoperative shunt values were higher than the average preoperative shunt values
      for both groups of patients, but only the values on the second postoperative day
      after a procedure with cement were significantly higher (p < 0.05). The ability
      of the patient to tolerate an increase in pulmonary shunt should be assessed when
      the femoral component is to be cemented during total hip replacement.

PMID- 8478386
TI  - Pyomyositis in patients who have the human immunodeficiency virus. Case report
      and review of the literature.

PMID- 8478387
TI  - Anterior dislocation of the distal end of the ulna after use of a compression
      plate for the treatment of a Galeazzi fracture. A case report.

PMID- 8478388
TI  - A unique multifocal osteoblastoma-like tumor of the bones of a single lower
      extremity. Report of a case.

PMID- 8478389
TI  - Sciatica caused by a neurilemoma of the intrapelvic portion of the sciatic nerve.
      A case report.

PMID- 8478390
TI  - Cytogenetic and molecular cytogenetic techniques in orthopaedic surgery.

PMID- 8478391
TI  - Biopsy of bone and soft-tissue lesions.

PMID- 8478392
TI  - Diagnostic strategy for bone and soft-tissue tumors.
AB  - The diagnostic strategy to be used for a bone tumor depends on the ability of the
      clinician to make an accurate differential diagnosis on the basis of clinical
      information and plain radiographs. The clinician must be able to classify the
      patient as having a non-progressive or a progressive primary benign bone tumor, a
      primary malignant bone tumor, or a metastatic bone tumor. Only after assignment
      to one of these four categories can an effective diagnostic strategy ensue. If
      the clinical and radiographic information favors a diagnosis of malignant or
      aggressive benign bone tumor, the clinician should refer the patient to an
      experienced orthopaedic oncologist without performing additional diagnostic tests
      or a biopsy. If a soft-tissue mass is five centimeters in diameter or larger on
      physical examination, and especially if it is deep to the fascia, the patient
      should also be referred to an orthopaedic oncologist, without additional
      evaluation or biopsy, because of the relatively high probability that the mass is
      malignant.

PMID- 8478393
TI  - Early and late loosening of the acetabular cup after low friction arthroplasty.

PMID- 8478394
TI  - Early and late loosening of the acetabular cup after low-friction arthroplasty.

PMID- 8478395
TI  - Nitric oxide measured by a porphyrinic microsensor in rat brain after transient
      middle cerebral artery occlusion.
AB  - We measured, in vivo, the local concentration of nitric oxide (NO) in cerebral
      tissue, during and after transient middle cerebral artery occlusion in the rat (n
      = 8). Baseline concentration of NO was < 10(-8) M; upon initiation of ischemia,
      NO concentration increased to approximately 10(-6) M and then declined.
      Reperfusion likewise stimulated an increase in NO concentration to above baseline
      level. Administration of N-nitro-L-arginine methyl ester (n = 4), an inhibitor of
      nitric oxide synthase, before onset of ischemia, maintained NO at basal levels.
      Our data indicate that large increases in NO occur at onset of ischemia, which
      may affect tissue response to an ischemic insult.

PMID- 8478396
TI  - Basic FGF, NGF, and IGFs protect hippocampal and cortical neurons against iron
      induced degeneration.
AB  - Iron is believed to contribute to the process of cell damage and death resulting
      from ischemic and traumatic insults by catalyzing the oxidation of protein and
      lipids. Exposure of cultured rat hippocampal neurons to iron (FeSO4) caused a
      dose-dependent reduction in neuronal survival, which was potentiated by
      ascorbate. Damage to neurons was associated with a significant level of oxygen
      radical in the culture medium. The iron chelator desferal prevented both the
      neuronal degeneration caused by FeSO4 and the production of oxygen radical,
      demonstrating that ionic iron was responsible for the cell damage. Iron
      neurotoxicity was associated with an elevation of [Ca2+]i and was attenuated by
      NMDA receptor antagonists. Since recent findings demonstrated neuroprotective
      effects of growth factors in cell culture and in vivo models of ischemia, we
      examined the effects of growth factors on iron-induced damage. Basic fibroblast
      growth factor (bFGF), nerve growth factor (NGF), and insulin-like growth factors
      (IGF-I and IGF-II) each protected neurons against iron-induced damage. Both rat
      hippocampal and human cortical neurons were protected by these growth factors.
      Taken together, the data suggest that the neuroprotective effects of growth
      factors against excitotoxic/ischemic insults may result, in part, from a
      prevention or attenuation of oxidative damage.

PMID- 8478397
TI  - Temperature modulation of cerebral depolarization during focal cerebral ischemia
      in rats: correlation with ischemic injury.
AB  - The role of cerebral depolarizations in focal cerebral ischemia is unknown. We
      therefore measured the direct current (DC) electrical activity in the cortex of
      Wistar rats subjected to transient occlusion of the middle cerebral artery (MCA).
      Focal ischemia was induced for 90 min by insertion of an intraluminal filament to
      occlude the MCA. To modulate cell damage, we subjected the rats to hypothermic
      (30 degrees C, n = 4), normothermic (37 degrees C, n = 4), and hyperthermic (40
      degrees C, n = 6) ischemia. Controlled temperatures were also maintained during 1
      h of reperfusion. Continuous cortical DC potential changes were measured using
      two active Ag-AgCl electrodes placed in the cortical lesion. Animals were killed
      1 week after ischemia. The brains were sectioned and stained with hematoxylin and
      eosin, for evaluation of neuronal damage, and calculation of infarct volume. All
      animals exhibited an initial depolarization within 30 min of ischemia, followed
      by a single depolarization event in hypothermic animals, and multiple periodic
      depolarization events in both normothermic and hyperthermic animals. Hyperthermic
      animals exhibited significantly more (p < 0.05) DC potential deflections (n =
      6.17 +/- 0.67) than normothermic animals (n = 2.75 +/- 0.96). The ischemic
      infarct volume (% of hemisphere) was significantly different for the various
      groups; hypothermic animals exhibited no measurable infarct volume, while the
      ischemic infarct volume was 10.2 +/- 12.3% in normothermic animals and 36.5 +/-
      3.4% in hyperthermic animals (p < 0.05). A significant correlation was detected
      between the volume of infarct and number of depolarization events (r = 0.90, p <
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478398
TI  - Thermal sensitivity of hypoxic responses in neocortical brain slices.
AB  - Electrophysiological responses to transient hypoxia were studied in neocortical
      brain slices from adult gerbils. Evoked responses and direct current (DC)
      potentials were recorded in layer III of the parietal cortex under normoxic and
      hypoxic conditions. The excitatory synaptic component of the evoked waveform was
      identified by its sensitivity to calcium and 6,7-dinitroquinoxaline-2,3-dione
      (DNQX). Under normoxic conditions, hypothermia reduced excitatory synaptic
      responses in a temperature-dependent manner. Under hypoxic conditions,
      hypothermia prolonged the delays to synaptic loss and hypoxic depolarization in a
      temperature-dependent manner. Synaptic recovery following a fixed period under
      hypoxic depolarization was greatly enhanced when hypoxia was administered at
      reduced temperature. The findings demonstrate that evoked responses are reduced
      under hypothermic conditions, but that these responses are sustained for a longer
      period of time during hypoxia. The data suggest that hypothermia protects against
      hypoxic damage to excitatory synaptic mechanisms in the neocortex both by
      prolonging the delay to hypoxic depolarization, and by extending the period of
      hypoxic depolarization that can be tolerated.

PMID- 8478399
TI  - Alterations in protein kinase C activity and membrane lipid metabolism in
      cerebral vasospasm after subarachnoid hemorrhage.
AB  - Changes in protein kinase C (PKC) activity, membrane lipid metabolism, and the
      extent of 20-kDa myosin light chain (MLC) phosphorylation in spastic cerebral
      basilar arteries were examined by using the beagle "two-hemorrhage" model of
      subarachnoid hemorrhage. In spastic arteries at days 4 and 7, cytosolic PKC
      activity showed a decrease of 40-45% with no significant changes in membrane PKC
      activity as compared with nonspastic control arteries. Cytosolic PKC activity of
      the day 14 arteries returned toward the normal control level with the remission
      of vasospasm. Western blot analysis of the PKC isoforms revealed that the amounts
      of PKC alpha and PKC epsilon but not PKC zeta were decreased in spastic arteries.
      As compared with nonspastic arteries, spastic arteries showed higher rates of
      incorporation of [3H]choline into phosphatidylcholine (PC) and [14C]ethanolamine
      into phosphatidylethanolamine (PE), but not of [3H]myoinositol into
      phosphoinositides, suggesting the stimulated turn-over of PC and PE. The extent
      of 20-kDa MLC phosphorylation was not increased in the spastic arteries at days 4
      or 7 as compared with that in the nonspastic control arteries. These results
      demonstrate that PKC activity and related membrane lipid metabolism are altered
      in spastic basilar arteries after subarachnoid hemorrhage.

PMID- 8478400
TI  - PET study of changes in local brain hemodynamics and oxygen metabolism after
      unilateral middle cerebral artery occlusion in baboons.
AB  - Local cerebral hemodynamics and oxygen metabolism were measured by positron
      emission tomography (PET) with the oxygen-15 (15O) steady-state method in
      baboons, immediately before (T0), 1 (T1), and 3-4 (T2) h after permanent middle
      cerebral artery occlusion (MCAO). At T1, there was a marked fall in both cerebral
      blood flow (CBF) and the CBF/cerebral blood volume (CBV) ratio in the occluded
      territory; these changes were sustained at T2, indicating stable reduction in
      cerebral perfusion pressure and lack of spontaneous reperfusion within this time
      range. Compared with preocclusion conditions, the oxygen extraction fraction
      (OEF) in the occluded territory was elevated at both T1 and T2, indicative of a
      persistent oligemia/ischemia for up to 3 h after MCAO. At T2, however, this OEF
      increase had lessened, concomitantly with a decline in cerebral metabolic rate of
      oxygen (CMRO2). This impairment of oxidative metabolism occurred earlier in the
      deep, compared with the cortical, MCA territories; in the latter, the CMRO2 was
      essentially preserved at T1 and only moderately reduced at T2, possibly
      suggesting prolonged viability. Finally, no significant changes in CBF or CMRO2
      were observed in the contralateral MCA territory in this time range after MCAO.
      Despite methodological limitations (mainly partial volume effects related to PET
      imaging, which may have resulted in an underestimation of true changes and an
      overlooking of heterogeneous changes) our study demonstrates the feasibility of
      the combined PET-MCAO paradigm in baboons; this experimental approach should be
      valuable in investigating the pathophysiology and therapy of acute stroke.

PMID- 8478401
TI  - Analysis of individual positron emission tomography activation maps by detection
      of high signal-to-noise-ratio pixel clusters.
AB  - We present a new method for the analysis of individual brain positron emission
      tomography (PET) activation maps that looks for activated areas of a certain size
      rather than pixels with maximum values. High signal-to-noise-ratio pixel clusters
      (HSC) are identified and their sizes are statistically tested with respect to a
      Monte-Carlo-derived distribution of cluster sizes in pure noise images. From
      multiple HSC size tests, a strategy is proposed for control of the overall type I
      error. The sensitivity and specificity of this method have been assessed using
      realistic Monte Carlo simulations of brain activation maps. When compared with
      the gamma 2 statistic of the local maxima distribution, the proposed method
      showed enhanced sensitivity, particularly for signals of low magnitude and/or
      large size. Its potential for the individual analysis of PET activation studies
      is presented in two sets of subjects who underwent two cognitive protocols.
      Although it can be viewed as an alternative to the classical stereotactic
      averaging approach, this new method is intended to be a first step toward the
      analysis of single-subject PET activation studies.

PMID- 8478402
TI  - Early detection of Alzheimer's disease: a statistical approach using positron
      emission tomographic data.
AB  - Correlational analysis of regional cerebral glucose metabolism (rCMRglc) obtained
      by high-resolution positron emission tomography (PET) has demonstrated reduced
      neocortical rCMRglc interactions in mildly/moderately demented patients with
      probable Alzheimer's disease (AD). Thus, identification of individual differences
      in patterns of rCMRglc interactions may be important for the early detection of
      AD, particularly among individuals at greater risk for developing AD (e.g., those
      with a family history of AD). Recently, a statistical procedure, using multiple
      regression and discriminant analysis, was developed to assess individual
      differences in patterns of rCMRglc interdependencies. We applied this new
      statistical procedure to resting rCMRglc PET data from mildly/moderately demented
      patients with probable AD and age/sex-matched controls. The aims of the study
      were to identify a discriminant function that would (a) distinguish patients from
      controls and (b) identify an AD pattern in an individual at risk for AD with
      isolated memory impairment whose initial PET scan showed minor abnormalities, but
      whose second scan showed parietal hypometabolism, coincident with further
      cognitive decline. Two discriminant functions, reflecting interactions involving
      regions most involved in reduced correlations in probable AD, correctly
      classified 87% of the patients and controls, and successfully identified the
      first scan of the at-risk individual as AD (probability > 0.70). The results
      suggest that this statistical approach may be useful for the early detection of
      AD.

PMID- 8478403
TI  - Reliability of regional cerebral blood flow activation to cognitive tasks in
      elderly normal subjects.
AB  - The assessment of cerebral blood flow (CBF) using noninvasive 133Xe techniques
      provides an indirect measurement of cortical metabolic activity. The utility of
      this method in longitudinal clinical studies depends on the stability and
      reproducibility of resting and activated flow measures. We evaluated CBF in a
      sample of 16 elderly normal subjects (aged 54-73 years) at rest and during task
      performance in two sessions separated by an average of 9 weeks. Resting global
      CBF was lower in the second session, a finding consistent with the known effects
      of habituation previously reported. Regionally specific activated CBF did not
      change with repeated measurements. The results provide evidence that the 133Xe
      technique is reliable and of potential utility in evaluating the effect of the
      natural course of brain disease, as well as the effects of therapeutic
      interventions on brain activity.

PMID- 8478404
TI  - Modeling analysis of [11C]flumazenil kinetics studied by PET: application to a
      critical study of the equilibrium approaches.
AB  - The multi-injection modeling approach was used for the in vivo quantitation of
      benzodiazepine receptors in baboon brain using positron emission tomography (PET)
      and [11C]flumazenil (RO 15-1788) as a specific ligand. The model included three
      compartments (plasma, free, and bound ligand) and five parameters (including the
      benzodiazepine receptor concentration). The plasma concentration after correction
      for the metabolites was used as the input function. The experimental protocol
      consisted of four injections of labeled and/or unlabeled ligand. This protocol
      allows the evaluation, from a single experiment, of the five model parameters in
      various regions of interest. For example, in the temporal cortex, the
      concentration of receptor sites available for binding (B'max) and the equilibrium
      dissociation constant (Kd) were estimated to be 70 +/- 15 pmol/ml and 15.8 +/-
      2.2 nM, respectively. The validity of the equilibrium approach, which is the most
      often used quantitation method, has been studied from simulated data calculated
      using these model parameters. The equilibrium approaches consist of reproducing
      in PET studies the experimental conditions that permit the use of the usual in
      vitro methods such as Scatchard analysis. These approaches are often open to
      criticism because of the difficulty of defining the notion of equilibrium in in
      vivo studies. However, it appears that the basic relation of Scatchard analysis
      is valid over a broader range of conditions than those normally used, such as the
      requirement of a constant bound/free ratio. Simulations showed that the values of
      the receptor concentration (B'max) and the equilibrium dissociation constant (Kd)
      found using Scatchard analysis are always underestimated. These simulations also
      suggest an explanation concerning the dependency of B'max and Kd on the time
      point employed for the Scatchard analysis, a phenomenon found by several authors.
      To conclude, we propose new protocols that allow the estimation of the B'max and
      Kd parameters using a Scatchard analysis but based on a protocol including only
      one or two injections. These protocols being entirely noninvasive, it thus
      becomes possible to investigate possible changes in receptor density and/or
      affinity in patients.

PMID- 8478405
TI  - Defective brain energy metabolism shown by in vivo 31P MR spectroscopy in 28
      patients with mitochondrial cytopathies.
AB  - We studied brain energy metabolism by phosphorus magnetic resonance spectroscopy
      (31P MRS) in 28 patients with mitochondrial cytopathies, and 20 normal control
      subjects. Fourteen patients had myopathy alone, six had only mild brain symptoms,
      and eight showed different degrees of brain involvement. Brain 31P MRS showed a
      low phosphocreatine content in all patients, accompanied by a high inorganic
      phosphate in 14 of 28 patients. The average value of the Pi concentration in the
      patient group was significantly (p = 0.009) different from the control group. The
      cytosolic pH was normal. From these data were derived a high concentration of ADP
      (calculated from the creatine kinase equilibrium), a high percent value of V/Vmax
      for ATP biosynthesis, and a low phosphorylation potential, all features showing a
      derangement of brain energy metabolism, in all patients with mitochondrial
      cytopathies. 31P MRS proved to be sensitive enough to disclose a deficit of
      mitochondrial functionality not only in the affected patients, but also in those
      without clinically evident brain symptoms.

PMID- 8478406
TI  - Hypoxia increases velocity of blood flow through parenchymal microvascular
      systems in rat brain.
AB  - The postulation that hypoxia increases local cerebral blood flow (lCBF) mainly by
      perfusing more capillaries (the capillary recruitment hypothesis) was tested in
      awake adult male Sprague-Dawley rats exposed to 10% O2 and control rats. The
      [14C]iodoantipyrine technique was used to measure lCBF. Local cerebral blood
      volume was determined by measuring plasma and red cell distribution spaces within
      the brain parenchyma with 125I-labeled serum albumin (RISA) and 55Fe-labeled red
      cells (RBC), respectively. Tissue radioactivity in 44 brain areas was estimated
      by quantitative autoradiography. Hypoxia raised lCBF by 25-90% in all brain
      areas. In about one-quarter of the brain areas, the rise in blood flow was
      associated with a small increase in microvascular plasma and blood volumes. This
      change in blood volume, which could be the result of perfusing more parenchymal
      microvessels and/or increasing parenchymal microvessel diameter, is not
      sufficient to account for the observed rise in lCBF. In the remaining areas the
      RISA, RBC, and blood spaces were either unchanged or only marginally increased by
      hypoxia. For this hypoxic perturbation, the major mechanism of raising blood flow
      appears to be increased velocity of microvessel perfusion and not perfusion of
      more capillaries. These findings provide only limited support for the capillary
      recruitment hypothesis.

PMID- 8478407
TI  - The velocities of red cell and plasma flows through parenchymal microvessels of
      rat brain are decreased by pentobarbital.
AB  - Local cerebral blood flow is lowered in many brain areas of the rat by high-dose
      pentobarbital (50 mg/kg). In the present study, the mechanism of this flow change
      was examined by measuring the distribution of radiolabeled red blood cells (RBCs)
      and albumin (RISA) in small parenchymal microvessels and calculating the
      microvascular distribution spaces and mean transit times of RBCs, RISA, and
      blood. In most brain areas, pentobarbital slightly decreased the RISA space,
      modestly increased the RBC space, and did not alter the blood space. The mean
      transit times of RBCs, RISA, and blood through the perfused microvessels were
      considerably greater in treated rats than in controls. These findings indicate
      that the mechanism by which high-dose pentobarbital diminishes local cerebral
      blood flow in rat brain is, in the main, a lowered linear velocity of plasma and
      RBC flow through small parenchymal microvessels and not decreased percentage of
      perfused capillaries (capillary retirement). This response is probably driven
      mainly by lowered local metabolism and may well entail a slight increase in the
      number of small microvessels that are perfused by RBCs.

PMID- 8478408
TI  - Electrical and mechanical changes during anoxic contractions of the isolated
      canine basilar artery.
AB  - Isometric tension and membrane potential were measured to determine the
      electrophysiological events occurring during anoxia in the isolated canine
      basilar artery. Anoxia induced transient contractions which were inhibited by the
      Ca(2+)-channel inhibitor, diltiazem, and were abolished in Ca(2+)-free solution.
      Anoxic contractions were accompanied by membrane depolarizations, which were
      resistant to diltiazem. When matched contractions were obtained with anoxia and
      high K+, the level of membrane depolarization was smaller during anoxic
      contractions. These results support the importance of voltage-dependent Ca2+
      influx in the generation of anoxic contractions in the canine basilar artery.
      However, membrane depolarization does not fully account for these anoxic
      contractions.

PMID- 8478409
TI  - Human visual cortical function during photic stimulation monitoring by means of
      near-infrared spectroscopy.
AB  - Near-infrared spectroscopy (NIRS) was used to monitor human visual cortical
      function during and after photic stimulation (PS) in five adult volunteers.
      Cerebral blood volume (CBV) increased on the occipital surface during PS, but
      NIRS parameters did not change on the frontal surface. The increase in CBV was
      caused by a rapid increase in oxyhemoglobin with but a small increase in
      deoxyhemoglobin, suggesting cerebral vascular dilatation with decreased oxygen
      consumption. After PS stopped, CBV promptly decreased and then slightly increased
      again. Cytochrome aa3 did not show any change during and after PS. These
      phenomena reappeared following repeated PS in all five subjects. These results
      may represent the first step in the development of NIRS imaging.

PMID- 8478410
TI  - Effect of propentofylline on regional cerebral glucose metabolism in acute
      ischemic stroke.
AB  - In a randomized double-blind placebo-controlled study in 30 patients with acute
      ischemic stroke, the effect of the adenosine uptake blocker propentofylline on
      regional brain glucose metabolism (rCMRglu) was investigated using repeated
      positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-D-glucose (FDG).
      Treatment was initiated within 48 h after onset of symptoms. The clinical course
      was followed for 3 months. In the propentofylline group, after 14 days rCMRglu
      was increased in the infarct by 37.3% and was practically unchanged in other
      brain regions, whereas in the control group glucose metabolism had decreased in
      all regions (1.4-13.4%). These differences were significant between the two
      groups [Analysis of variance (ANOVA) p = 0.005]. Although there was a trend
      toward greater clinical improvement in the propentofylline-treated patients, this
      did not reach statistical significance. The results correspond to experimental
      data showing that propentofylline improves energy metabolism in cerebral
      ischemia. A clinical trial is needed to determine whether this new therapeutic
      principle can be successfully used in acute human stroke.

PMID- 8478411
TI  - Local cerebral blood flow in rats with congenital hydrocephalus.
AB  - Local cerebral blood flow (LCBF) has been measured by [14C]iodoantipyrine
      quantitative autoradiography in H-Tx rats with inherited congenital hydrocephalus
      at 10, 21, and 30 days after birth. LCBF at 10 days was uniformly low in all ten
      brain regions studied and not significantly different between hydrocephalic and
      age-matched control rats. By 21 days LCBF had increased significantly in control
      rats. LCBF was significantly lower (< 69%) in the hydrocephalics in all cortical
      regions and in the inferior colliculus LCBF at both 21 and 30 days. The
      cerebellar cortex, pons, and caudate were not significantly affected. At 30 days
      LCBF ranged from 55 to 115 ml 100 g-1 min-1 for hydrocephalics and from 100 to
      183 ml 100 g-1 min-1 for controls.

PMID- 8478412
TI  - Blockade of nitric oxide synthesis in rats strongly attenuates the CBF response
      to extracellular acidosis.
AB  - We tested the hypothesis that the CBF response to extracellular acidosis is
      mediated by nitric oxide (NO). A closed cranial window, superfused with
      artificial CSF (aCSF), was implanted over the parietal cortex in anesthetized and
      ventilated Wistar rats. Regional cerebral blood flow (rCBF) was measured
      continuously with laser-Doppler flowmetry (LDF). The reaction of rCBF to
      hypercapnia (PaCO2 from 30.5 +/- 1.8 to 61.3 +/- 5.8 mm Hg by adding CO2 to the
      inspiratory gas) was 2.9 +/- 1.4%/mm Hg, and the reaction of rCBF to H+
      (superfusion of acidic aCSF, pH 7.07 +/- 0.05) was 101.7 +/- 24.7%/pH unit. The
      regional NO synthase (NOS) activity was blocked by superfusing aCSF containing
      10(-3) M N omega-nitro-L-arginine (L-NA, n = 10). After 30 min of L-NA
      superfusion, rCBF was reduced to 80.1 +/- 6.5% of baseline, and the rCBF
      responses to hypercapnia (PaCO2 from 30.9 +/- 2.9 to 58.8 +/- 7.7 mm Hg) and
      extracellular acidosis (aCSF pH 7.08 +/- 0.06) were reduced to 0.8 +/- 1.1%/mm Hg
      and 10.1 +/- 23.0%/pH unit, respectively (both p < 0.001). This effect was
      stereospecific since aCSF containing 10(-3) M N omega-nitro-D-arginine affected
      neither baseline rCBF nor the response to H+ (n = 5). The NOS blockade did not
      affect the vasodilatation by the NO donor sodium nitroprusside (n = 5, 114.3 +/-
      25.1% before vs. 130.2 +/- 24.7% after NOS blockade). The results confirm the
      involvement of NO in the CBF reaction to hypercapnia and demonstrate for the
      first time that NOS blockade also strongly attenuates the H+ response of the
      cerebral vasculature.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478413
TI  - Cumulative author, subject, compound and special issue indexes. Volumes 551-600
      (1991-1992).

PMID- 8478414
TI  - A region of the mouse genome homologous to human chromosome 1q21 affects facial
      clefting.
AB  - We sought to determine whether mouse chromosomal regions homologous to human
      chromosomal regions implicated in the etiology of facial clefting would be
      related to the incidence of spontaneous cleft palate (CP) or cleft lip with or
      without cleft palate [CL(P)], Dilantin-induced CL(P), hydrocortisone-induced CP,
      and/or 6-aminonicotinamide-induced CP. We found that a region on mouse chromosome
      3, homologous to human chromosome 1q21, significantly increased the incidence of
      sporadic CL(P) when the allele from the A/J inbred strain was present. None of
      the other chromosomal regions or conditions studied had significant associations
      with this susceptibility to facial clefting, although there was a suggestion that
      the B allele of the same region was associated with hydrocortisone-induced CP.
      Thus, the region on human chromosome 1q21 should be further studied for a role in
      the etiology of human CL(P).

PMID- 8478415
TI  - Changes in human palatine bone location and tongue position during prenatal
      palatal closure.
AB  - Closure of the palatal shelves during normal prenatal palate formation is
      commonly supposed to be the result of a complex interaction between tissue growth
      processes and functional factors such as mandibular and tongue movements. The
      purpose of the present study was to analyze tongue and palatine bone positions
      during palatal shelf closure. The material consisted of 40 normal human fetuses
      (CRL 26-57 mm). The series covers the developmental stages in which palatal shelf
      closure takes place. The spatial relation between the tip of the tongue and the
      lips was examined by visual inspection, and radiographic/cephalometric methods
      were used for analyzing palatine bone positions. On axial radiographs of the
      upper jaws, the angle in the horizontal plane between the vertical plates of the
      palatine bones was measured. The study revealed that the vertical plates of the
      palatine bones rotate on their vertical axes during palatal closure, the mean
      interpalatine angle changing from 23.7 degrees (SD 2.0 degrees) to 13.3 degrees
      (SD 3.2 degrees), P < 0.001. The rotation of the palatine bones occurred while
      the cranial base was still unossified. Moreover, the tip of the tongue became
      visible between the lips immediately after palate closure. In the present study
      the rotational changes observed in skeletal tissue provided information about
      soft tissue changes during palatal closure. These normal developmental aspects
      are discussed in relation to skeletal deviations in congenital cleft palate
      malformations.

PMID- 8478416
TI  - The development and morphology of the incisive fissure and the transverse
      palatine suture in the human fetal palate.
AB  - The incisive fissure and the transverse palatine suture are well known anatomical
      structures in the human palate. The purpose of the present study was to describe
      the development and the morphology of the incisive fissure and the transverse
      palatine suture. Another purpose was to compare the nature of both structures
      with the aim of elucidating their possible function in the developing facial
      skeleton. Descriptions of the initial formation, development, and maturation of
      the incisive fissure and the transverse palatine suture, in combination with a
      comparison between the suture systems, were not found in the literature. Human
      fetal material, consisting of a total number of 96 specimens with gestational
      ages ranging from 9 to 24 weeks, was analyzed macroscopically (radiologically and
      after devisceration) and microscopically (histologically). The bony maturation of
      specimens was recorded by relating to the stages of maxillary ossification (MAX),
      an index for skeletal maturity of the palate. The study revealed pronounced
      macroscopic and microscopic differences between the incisive fissure and the
      transverse palatine suture. The transverse palatine suture appears to be a site
      for anteroposterior growth of the palate. The incisive fissure has a different
      macroscopic and microscopic appearance and presumably has a function more closely
      related to the development of the dentition and the anterior part of the maxilla.

PMID- 8478417
TI  - Growth-related changes in familial resemblance of maxillofacial morphology.
AB  - We investigated changes in resemblance between Japanese parents and their growing
      children with regard to maxillofacial morphology. Lateral roentgenographic
      cephalograms taken from 963 children (336 male and 627 female) over 6 years of
      age and their parents were used as samples. Based on the age of the children,
      there were six groups--I: 6-7 years of age; II: 8-9; III: 10-11; IV: 12-13; V: 14
      15; and VI: over 16. Parent-offspring heritabilities (h2) were computed for 35
      variables representing maxillofacial and dentoalveolar traits, and group
      comparisons were also made. The following results were obtained: (1) there were
      more significant heritabilities for maxillofacial variables than those for
      dentoalveolar ones; (2) in general, additive genetic effects were more prominent
      in controlling maxillofacial and dentoalveolar structure of on-growing children,
      with increasing age.

PMID- 8478418
TI  - Finite element method analysis of craniofacial morphology in unilateral cleft lip
      and palate prior to palatoplasty.
AB  - The craniofacial morphology in unilateral cleft lip and palate (UCLP) prior to
      palatoplasty was analyzed with the finite element method (FEM). The study
      examined cross-sectional data sets of affected and control males aged 4.5 to 6.0
      years from Czechoslovakia. The facial skeleton and cranial base were discretized
      into 26 two-dimensional, triangular finite elements. Cranial base morphology is
      altered in UCLP. The extensive nature of most craniofacial deformities means that
      almost any registration is likely to be distorted. The fundamental advantage of
      the FEM is that biological descriptions are not dependent upon the selected
      reference plane. The FEM localizes changes in form to discrete anatomical
      regions. Significant shape and size differences characterize UCLP prior to
      palatoplasty. Dramatic deformations associated with cheiloplasty are localized to
      the lips and maxillary alveolar process. Nasal deformation reflects loss of
      structural support for the nose.

PMID- 8478419
TI  - Facial growth and development in unilateral complete cleft lip and palate from
      palate surgery up to adulthood.
AB  - Mixed longitudinal and cross-sectional roentgen-cephalometric data were used for
      studies of the growth and development of the face in unilateral complete cleft
      lip and palate from the time of primary palatoplasty up to adulthood. The results
      were compared with the data obtained in controls at the age of 5 years and in
      adults. The vertical growth of the upper and lower face exceeded its sagittal
      growth. The lower face showed a higher growth rate in both directions than did
      the upper face. The depth of the maxilla showed the lowest growth rate. The
      height of the upper lip increased very little as well. The most important
      deviation in facial development consisted of the deficient growth of maxillary
      depth and the prolongation of the lower face. Both these deviations develop
      predominantly after palate surgery and the former resulted in a gradual retrusion
      of the maxilla, a flattening of the face, and impairment of sagittal jaw
      relations. The reduction of upper face height, the posterior position of the
      maxilla, and the shortening of the mandible (both of the body and ramus)
      represented, on the contrary, early changes. The a persisting posterior rotation
      of the mandible, changes in the shape of the mandible, and vertical disproportion
      of the face increased with age, the steep slope of the mandibular body remaining
      at the level ascertained in early childhood. An improvement in the occlusion of
      incisors was obtained prior to the age of 12 years, but it regressed during the
      period of puberty. The prominence of the upper lip gradually decreased and the
      lip was short.

PMID- 8478420
TI  - Effects of 5-fluorouracil on collagen synthesis during quail secondary palate
      development.
AB  - A study was undertaken to examine the involvement of collagen synthesis during
      palate development in quail where mammalian-type shelf reorientation is absent.
      Teratological observation showed that 100 micrograms 5-fluorouracil (FU) on day 4
      of incubation increased the gap between the palatal shelves. Light microscopic
      observation indicated that the quail palatal shelves develop as horizontal ridges
      on day 5 and approximate on day 8 of incubation but never fuse. FU treatment
      affected the approximation of palatal shelves. In separate experiments, both the
      control and FU-treated quail embryonic palates, which were dissected between days
      5 and 10 of incubation, were incubated in a growth medium supplemented with 14C
      proline. The rate of collagen synthesis, total protein, hydroxyproline (HYP)
      levels, and collagen isotype were determined. The result showed that in control
      palates the rate of collagen synthesis increased fivefold between days 6 and 8 of
      incubation but dropped thereafter. In FU-exposed palates, the rate of collagen
      synthesis was lower than that in controls. It increased threefold between days 7
      and 8 of incubation. High performance liquid chromatographic measurement of HYP
      levels indicated that, in comparison to controls, HYP accumulation in FU-treated
      palates was reduced by 50% on day 6 and 75% on day 8 of incubation. Total protein
      content in FU-treated palate were also 50-70% lower than those in their control
      counterparts between days 5 and 10 of incubation. Gel electrophoresis showed that
      only type I collagen was synthesized in the developing palate of both the control
      and FU-treated quail embryo. An analysis of results of the present study, along
      with the data from literature on mammals, corroborate the proposition that an
      increased collagen synthesis may contribute to the acquisition of volume of
      vertebrate's secondary palatal shelf for its continuing morphogenesis.

PMID- 8478421
TI  - Effects of amrinone on shortening velocity and force development in skinned
      skeletal muscle fibres.
AB  - The effects of amrinone were studied on single skinned fibres isolated from rat
      hindlimb muscles. In each fibre a force-velocity relation was determined during
      maximal calcium activation (pCa = 4.45) in control conditions and in the presence
      of amrinone. The MgATP concentration was 3.93 mM, close to the physiological
      value. After the experiment the fibre was classified as fast or slow on the basis
      of its reactivity with anti-myosin monoclonal antibodies. In fast fibres amrinone
      (3 mM) potentiated isometric tension (Po) by 13.8 +/- 2.9% (n = 13), reduced
      maximum shortening velocity (Vmax) by 32.6 +/- 3.2% and the curvature of the
      force-velocity relation (a/Po) was increased by 98.9 +/- 46.0%. All these effects
      were less pronounced in slow fibres, where Vmax was reduced only by 11.4 +/- 3.6
      (n = 16). The effects of amrinone (0.3-6 mM) on the ATPase activity of myofibrils
      and myosin prepared from fast (tibialis anterior) and slow (soleus) rat skeletal
      muscles were studied. Amrinone was found to depress Ca-Mg dependent ATPase
      activity of myofibrillar preparations of the tibialis anterior (up to 16.6 +/-
      2%) and, to a lesser extent, of the soleus (up to 7.2 +/- 1.2%). On the contrary,
      Ca-stimulated myosin ATPase activity was significantly increased by amrinone in
      myosin preparations from the tibialis anterior. Experiments were carried out to
      test whether amrinone (3 mM) might affect the sensitivity of the contractile
      system to MgATP concentration ([MgATP]). The results obtained showed that (1) the
      [MgATP] value at which isometric tension reached its maximum was shifted by
      amrinone from 0.1 mM to 0.3 mM, (2) the slope of the negative relation between
      [MgATP] and a/Po was made more steep by amrinone, and (3) the Km of the
      hyperbolic relation between [MgATP] and Vmax was increased from 0.39 to 1.71 mM
      by amrinone, thus indicating a reduced affinity of myosin for MgATP. These
      results are in accordance with the hypothesis that amrinone exerts a direct
      effect on the contractile mechanism.

PMID- 8478422
TI  - Migration of lacZ positive cells from the tibialis anterior to the extensor
      digitorum longus muscle of the X-linked muscular dystrophic (mdx) mouse.
AB  - C2 mouse myogenic cells carrying the lacZ gene coding for beta-galactosidase
      (beta-gal) were injected into the tibialis anterior muscle of dystrophin
      deficient mdx mice. Introduced cells were shown to have been incorporated into
      fibres of the injected muscle by virtue of the colocalization of beta-gal and
      dystrophin within them. Synthetic Nuclepore membrane inserted between the
      injected tibialis anterior and adjacent extensor digitorum longus muscle
      permitted the visualization of cells migrating between the two muscles through
      the pores of the membrane. Although the exact nature of the cells passing through
      the Nuclepore could not be determined by this method, they were thought to
      include implanted myogenic cells. Evidence for this was gained by the presence of
      beta-gal/dystrophin positive fibres within the extensor digitorum longus.
      Incorporation of cells into the adjacent extensor digitorum longus was greater in
      animals where this muscle had been autografted by the cutting and resuturing of
      the distal tendon. Autografted extensor digitorum longi differed from those which
      had not been subject to this procedure, by undergoing extensive fibre
      degeneration followed by regeneration, and further by the stripping of their
      surrounding epimysial covering. Implanted cells substantially participated in
      extensor digitorum longus fibre formation in these mice, up to 31% of their
      fibres 3 weeks after implantation coexpressing both the introduced lacZ gene
      product and the dystrophin gene product, the latter not normally expressed within
      the fibres of this myopathic recipient.

PMID- 8478423
TI  - Lack of dystrophin but normal calcium homeostasis in smooth muscle from
      dystrophic mdx mice.
AB  - The free cytosolic Ca2+ concentration ([Ca2+]i) in the dystrophin-lacking smooth
      muscle from mdx mice was studied to gain new insights into the relation between
      dystrophin and cytoplasmic Ca2+ homeostasis, which was reported to be impaired in
      the mdx skeletal muscle. We observed that [Ca2+]i, as measured with the
      fluorescent Ca2+ indicator fura-2, was not elevated in resting smooth muscle of
      the vas deferens from mdx mice, in comparison with control C57 mice. Changes of
      the external Ca2+ concentration evoked similar changes of [Ca2+]i in mdx and
      control vas deferens. During contraction, cytosolic Ca2+ transients were
      identical, both in amplitude and in kinetics, whether or not dystrophin was
      present. Stretches evoked similar Ca2+ increases in muscles from both strains.
      Intracellular Ca2+ homeostasis appears to be unimpaired in mdx smooth muscle.
      Thus, the lack of dystrophin per se does not automatically induce a perturbation
      of Ca metabolism in muscle cells.

PMID- 8478424
TI  - Tension transients in skeletal muscle fibres of the frog at varied tonicity of
      the extracellular medium.
AB  - Length steps (complete in 0.2 ms; amplitude < 2% of the fibre length) were
      applied during the tetanus plateau of intact frog muscle fibres (1.7-3.2 degrees
      C). The effects of varied tonicity on the early changes in tension in response to
      the length steps were studied. The solutions were made hypotonic by reduction of
      the NaCl concentration from 115.5 mM to 92.4 mM and hypertonic by addition of 98
      mmol sucrose per litre of the normal Ringer fluid. In all solutions tested, the
      length step first caused tension to change simultaneously with the step reaching
      an extreme value T1. After completion of the length change, tension recovered
      quickly to an intermediate level T2 and, after a period with slowing or reversal
      of the recovery, it returned slowly to the steady-state value. The maximum
      isometric tension was significantly reduced by increases in tonicity. In
      contrast, there were only small effects of varied tonicity on the peak tension
      change in response to a length step (the stiffness) and on the amplitude of the
      fast force recovery (T2-T1) after releases. The slope of the T2-curve (a plotting
      of T2 versus amplitude of the length step) was reduced for releases and increased
      for stretches when tonicity was raised. Furthermore, the T2-curve intersected the
      length axis for smaller releases at high tonicity levels. The reduced isometric
      tension to stiffness ratio at raised tonicity could be interpreted as a reduced
      average force per crossbridge. Simulations using the crossbridge model of Huxley
      and Simmons (1971) showed that the lack of change of the recovery amplitude (T2
      T1) after releases and the changes in the T2-slope are in accordance with this
      interpretation. The shift of the T2 length intercept is consistent with the idea
      that the distance traversed by the crossbridges during the power-stroke is
      reduced by raised tonicity.

PMID- 8478425
TI  - In vitro production of enzymatically active myosin heavy chain.
AB  - In order to initiate studies on the structural and functional relationships of
      the myosin heavy chain, we constructed a full-length complementary DNA encoding
      the isoform that is found in the fast white muscle of the embryonic chicken. The
      complementary DNA contained 108 basepairs of its 3'-untranslated region and was
      preceded by a leader sequence derived from the alfalfa mosaic virus. Similarly, a
      complementary DNA encoding 963 amino acids which encompass the subfragment-1 of
      myosin and part of the subfragment-2 was also constructed. Each was inserted into
      the expression vector pMT2 and transiently transfected into COS-1 cells. Both
      constructs directed the expression of the respective proteins, each of which was
      immunogenic. The full-length and subfragment-1 proteins interacted with actin and
      demonstrated high levels of a K(+)-activated, EDTA-resistant ATPase activity,
      which is characteristic of myosin.

PMID- 8478426
TI  - Functional effects of LC1-reassociation with cardiac papain Mg.S1.
AB  - The effect of LC1 on cardiac myosin structure and activity was investigated using
      as a model S1 prepared by papain digestion in the presence of Mg2+. The resulting
      S1 contained LC2 but a part of the N-terminal region of LC1 was cleaved.
      Sequencing the N-terminal part of the band migrating below LC1 on SDS gels
      revealed it to consist of alternating alanyl and prolyl residues thus
      establishing LC1 as the origin of this band. However, Western blots did not
      reveal any LC1 while radioimmunoassays indicated it to be present at the 5% level
      suggesting the anti-LC1 antibody used in these experiments did not recognize the
      C-terminal portion of LC1 still attached to Mg.S1. Mixing a 10-15 M excess of
      isolated light chains with Mg.S1 in the presence of 10 mM ATP, 12 mM MgCl2, 4.7 M
      NH4Cl allowed LC1 to recombine with LC1-deficient Mg.S1. Equilibrium
      ultracentrifugation analysis revealed a highly heterogeneous LC1-deficient S1
      which upon recombination with intact LC1 became monodisperse as indicated by the
      superimposition of molecular weight averages all across the centrifuge cell. LC1
      deficient Mg.S1 had a Vm of 0.4 s-1, Ka of 30 microM and a Kbind of 28 microM. In
      the presence of intact LC1, Vm rose to 0.8 s-1 while Ka and Kbind were reduced to
      7.5 and 12 microM, respectively. The fourfold decrease in Ka strongly indicated
      an increased affinity for actin by Mg.S1 in the presence of uncleaved LC1. Also,
      Ca(2+)-regulation of dog heart myofibrils was suppressed when Ca(2+)-activated
      MgATPase assays, as a function of Ca2+, were performed in the presence of anti
      LC1 antibodies. These observations suggest the presence of intact, uncleaved LC1
      in S1 is required for the stability of S1 heavy chains and proper Ca(2+)
      regulation.

PMID- 8478427
TI  - Regional differences in organization of the extracellular matrix and cytoskeleton
      at the equator of chicken intrafusal muscle fibres.
AB  - Equatorial regions of chicken intrafusal fibres were examined with a panel of
      monoclonal antibodies against intracellular proteins and components of
      extracellular matrix to identify structural associations at points of contact
      between sensory terminals and intrafusal fibres, and at points which lacked them.
      One aspect of this study was to establish whether the known morphological
      differences between myosensory and neuromuscular junctions also extended to the
      molecular level. As viewed in cross-sections, myosensory junctions at the equator
      are restricted to approximately one-half of the intrafusal fibre circumference, a
      region referred to as the sensory sector. The diametrically opposite region which
      lacks sensory terminals is referred to as the non-sensory sector. The basal
      lamina over the sensory sector was positive for chondroitin sulphate, while that
      part which covered the non-sensory sector was negative. Staining for collagen
      type IV was very faint at the sensory sector and stronger at the non-sensory
      sector, but immunoreactivity for heparan sulphate proteoglycan and laminin was
      moderate to strong in all parts of the basal lamina. Within intrafusal fibres,
      filamin and alpha-actinin were largely limited to the sensory sector. The major
      feature of the non-sensory sector was a sharply delineated, narrow intrafibre
      crescent of vinculin, and colocalized with it, a crescent of talin. The
      plasmalemma of intrafusal fibres at the non-sensory sector reacted positively for
      the beta 1 subunit of the integrin family of receptors. Immunolocalization of
      these receptors was not observed to any significant extent in the sensory sector.
      Towards the end of the equator and the initial portion of the juxtaequator,
      chondroitin sulphate, vinculin and the other proteins came gradually to be
      distributed equally all the way round the intrafusal fibres. This changeover in
      distribution of connective tissue proteins and structural intracellular proteins
      parallels the decreasing number of contacts made by sensory terminals.

PMID- 8478428
TI  - Changes in morphological and functional characteristics of male rat EDL muscle
      during growth.
AB  - Morphological and functional changes as well as changes in fibre-type composition
      were investigated in the left extensor digitorum longus (EDL) muscles of male
      Wistar rats of approximately 40, 60, 120 and 700 days old. A number of
      morphological changes occurred in the EDL muscle during growth. While from 40 to
      120 days muscle mass and cross-sectional area (CSA) increased by 247 and 192%,
      changes in muscle and fibre lengths were much smaller (44 and 17%, respectively).
      Besides morphological changes tetanic force was also found to increase
      (approximately 307%) up to 120 days. Because this increase in force was greater
      than the increase in CSA, specific force increased by approximately 29% between
      40 and 60 days. Thereafter, specific force stayed rather constant. From 40 until
      60 days changes were also found in the force-frequency and force-velocity curve,
      which indicate a slowing of the muscles (until 60 days). Changes in fibre-type
      composition of the EDL muscle were found to occur later during growth between 60
      and 120 days. In this period an increase in the relative total area of Type IIBd
      fibres and a decrease in the relative total area of Type IIBm fibres
      (corresponding to the Type 2X and IIB fibres, respectively), were found; this was
      apparently due to a conversion of many Type IIBm into Type IIBd fibres and not to
      a difference in cross-sectional growth between these fibres.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8478429
TI  - Electron microscopic images suggest both ends of caldesmon interact with actin
      filaments.
AB  - An improved rotary shadowing technique enabled us to visualize chicken gizzard
      caldesmon (CaD) and its complexes with one or two covalently linked calmodulin
      (CaM) molecules by electron microscopy. Using a monoclonal antibody against an
      epitope in the N-terminal region of CaD (anti-N), we can now identify the end of
      the molecule that is involved in binding to another protein molecule. Thus in the
      1:1 complex of CaD and CaM, the CaM molecule was almost always associated with
      the C-terminus of CaD, indicating preferential CaM-binding to the C-terminal
      region. We have also studied binding of CaD to filamentous actin (F-actin), using
      an EM technique that avoids spraying or freeze drying and thereby preserves the
      structure of F-actin. Only one end of CaD appeared to bind to F-actin, leaving
      the rest of the molecule projecting away from the filament. While the majority of
      anti-N bound at the free end of CaD, some antibody molecules were found on F
      actin. These findings suggest that either end of CaD can bind to F-actin.
      Experiments using a monoclonal antibody against the C-terminus of CaD (anti-C)
      supported this idea. When the native thin filaments that contain endogenous CaD
      were incubated with anti-N, almost all the bound antibodies were found on the
      filaments, indicating that the N-terminal regions of CaD interact with actin, and
      that the binding affinity of the N-terminal region of CaD for actin is higher in
      vivo than that in vitro, either because the properties of CaD have been altered
      during purification, or because of the presence of some other component(s)
      associated with the native filaments.

PMID- 8478430
TI  - Force-calcium relations in skinned twitch and slow-tonic frog muscle fibres have
      similar sarcomere length dependencies.
AB  - The sarcomere length (SL) dependence of the calcium sensitivity of force was
      measured in skinned single twitch and slow-tonic muscle fibres from frog and
      toad. Twitch and slow-tonic fibres were characterized by location, appearance,
      physiological response to calcium and by protein band patterns from sodium
      dodecyl-sulphate polyacrylamide gel electrophoresis (SDS-PAGE). Force-calcium
      relations were determined for each fibre type at two sarcomere lengths, 2.4 and
      3.1 microns. Bathing solution ionic strength (IS) was 200 mM and solution pH was
      7.0, 6.0 or 5.5; experiments were also done at IS = 120 mM and pH 7.0. At all pHs
      and ionic strengths tested, slow-tonic fibres exhibited a slower time course of
      force development and were more sensitive to calcium than were twitch fibres.
      Lowering IS increased calcium sensitivity and lowering pH decreased calcium
      sensitivity in both fibre types. Increasing SL increased the calcium sensitivity
      of force in both twitch and slow-tonic fibres at pH 7.0 and at both 200 and 120
      mM IS. Lowering pH caused a decrease in the length dependence of calcium
      sensitivity of both fibre types; at pH 5.5 the calcium sensitivity of force in
      slow-tonic fibres exhibited a slight decrease with increasing SL.

PMID- 8478431
TI  - Ca-EGTA affects the relationship between [Ca2+] and tension in alpha-toxin
      permeabilized rat anococcygeus smooth muscle.
AB  - The relationship between calcium concentration ([Ca2+]) and force in smooth
      muscle can be studied by permeabilizing the sarcolemma and bathing the
      preparation in a mock intracellular solution. Normally [Ca2+] is set in these
      solutions using the Ca2+ chelator EGTA in the concentration range of 4-10 mM.
      This study shows that lowering total EGTA concentration ([EGTA]t) below 10 mM
      depresses Ca(2+)-activated force generated in 0.1 microM Ca2+. The observed
      threshold for the effect of EGTAt is 0.2 mM, and the effect is maximal at
      approximately 10 mM. BAPTA, another Ca2+ chelator, also produces this effect.
      Tension production in smooth muscle is controlled by acto-myosin interaction.
      This in turn is mediated by the relative activities of myosin light chain kinase
      (MLCK) and phosphatase (MLCP). Inhibiting MLCP with Microcystin LR (10 microM),
      an increase [EGTAt] from 0.2 mM to 10 mM still enhanced force. This suggests that
      EGTA promotes phosphorylation of myosin by the activation of MLCK and not by
      inhibition of MLCP.

PMID- 8478434
TI  - Construction of a bite plane with light-cured resin.

PMID- 8478432
TI  - A non-flight muscle isoform of Drosophila tropomyosin rescues an indirect flight
      muscle tropomyosin mutant.
AB  - The tropomyosin I(TmI) gene of Drosophila melanogaster encodes two isoforms of
      tropomyosin. The Ifm-TmI isoform is expressed only in indirect flight and jump
      muscles; the Scm-TmI isoform is found in other muscles of the larva and adult.
      The level of Ifm-TmI is severely reduced in the flightless mutant Ifm(3)3, which
      also is unable to jump. To explore the functional significance of tropomyosin
      isoform diversity in Drosophila, we have used P element-mediated transformation
      to express Scm-TmI in the indirect flight and jump muscles of Ifm(3)3 flies.
      Transformants gained the ability to jump and fly. The mechanical properties of
      isolated indirect flight muscle myofibres, and the ultrastructure of indirect
      flight and jump muscles from the transformants were comparable to wildtype. Thus,
      the Scm-TmI isoform can successfully substitute for Ifm-TmI in the indirect
      flight and jump muscles of the Ifm(3)3 strain.

PMID- 8478435
TI  - Modified lingual lever arm technique.

PMID- 8478433
TI  - Developmental transitions in the myosin patterns of two fast muscles.
AB  - Transitions in myosin patterns were examined in situ by immunofluorescence in two
      fast muscles of the developing chicken, the pectoralis and the posterior
      latissimus dorsi. Myosin isoforms were localized using stage-specific monoclonal
      antibodies against the heavy chain of pectoralis myosin. Two antibodies (12C5 and
      10H10) recognize adult and late embryonic myosin. They reacted weakly with both
      the pectoralis and posterior latissimus dorsi at 10 days in ovo, but intensely at
      18 days in ovo. Both muscles were completely unreactive with an adult-specific
      antibody (5C3), indicating that the staining with 12C5 and 10H10 at 18 days in
      ovo reflects embryonic myosin. Thus two different embryonic isoforms are
      expressed sequentially in each muscle. Both 12C5 and 10H10 reacted weakly again
      with these muscles after hatching. The reappearance of a strong positive response
      to both antibodies, at 28 days in the pectoralis and after 60 days in the
      posterior latissimus dorsi, correlated well with the first appearance of a
      response to the adult-specific antibody, 5C3, signalling the beginning of the
      adult pattern. Both muscles reacted strongly with an antibody (5B4) specific for
      'neonatal' myosin between 18 days in ovo and 60 days after hatching. In the
      pectoralis, embryonic was replaced by neonatal myosin in most fibres by 14 days
      after hatching; by 28 days, both adult and neonatal myosin were expressed in most
      fibres; and in the adult, neonatal myosin was replaced entirely by the adult
      isoform. In contrast, many fibres in the posterior latissimus dorsi still
      expressed both embryonic and neonatal myosins up to at least 60 days post-hatch,
      and the remaining fibres expressed the neonatal isoform; the neonatal isoform was
      present in some fibres even in the adult posterior latissimus dorsi. We have
      therefore demonstrated in situ four different heavy chain isoforms in two
      different fast muscles. 'Early embryonic', 'late embryonic', 'neonatal' and
      eventually 'adult' isoforms are expressed in each muscle and more than one
      isoform often coexists in the same fibre.

PMID- 8478436
TI  - Direct bonding with reduced acid etchant concentrations.

PMID- 8478437
TI  - Ten tips for improving your case acceptance ratio.

PMID- 8478438
TI  - Essix retainers: fabrication and supervision for permanent retention.

PMID- 8478439
TI  - Periodontal plastic surgery and orthodontics.

PMID- 8478440
TI  - Endovaginal Doppler flow measurements of the ovarian artery in patients with a
      normal menstrual cycle and with polycystic ovary syndrome during in vitro
      fertilization.
AB  - Women with a normal menstrual cycle (n = 21, controls), polycystic ovary syndrome
      (n = 10) and hypogonadotropic amenorrhea (n = 3) were stimulated with clomiphen
      citrate (4th day to 8th day of the cycle) and with human menopausal gonadotropin
      (8th day to 11th day). The vascular impedance of the ovary carrying the dominant
      follicles was monitored by endovaginal pulsed Doppler flow measurement.
      Simultaneously, serum levels of LH, E2 and 17-OHP were assayed. Contrary to
      controls, women with polycystic ovary syndrome or hypogonadotropic amenorrhea
      showed decreased hormone levels and no lowering of the vascular impedance. In
      controls, the lower pulsatility index is caused by neovascularization around the
      dominant follicle and by E2-induced vasodilatation in the ovarian artery.

PMID- 8478441
TI  - Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is
      it a normal phenomenon and what are the causes?
AB  - A prospective ultrasound study of the renal morphology of 51 neonates with no
      clinical signs of renal impairment showed transient medullary hyperechogenicity
      of varying intensity in 37%. These findings were made in the first few postnatal
      days, were not accompanied by any other echographic changes, and disappeared
      again within the first week of life. They were encountered twice as often in full
      term as in premature babies. In parallel with this phenomenon, the concentration
      of Tamm-Horsfall protein, calcium, and uric acid, and the osmolality were
      determined in the daily urine of 44 of these neonates. The analyses did not
      provide any definite clues as to the etiology of the ultrasound findings. It is
      therefore suggested that the term "Tamm-Horsfall nephropathy or proteinuria"
      should no longer be used for such sonographic phenomena in the neonatal kidney,
      but rather, they should be regarded as normal. Furthermore, the term "tubular
      stasis nephropathy" should be reserved for cases with clinically demonstrable
      impairment of renal function.

PMID- 8478442
TI  - The assessment of normal early pregnancy by transvaginal color Doppler
      ultrasonography.
AB  - Transvaginal color Doppler was performed in 198 volunteer pregnant women whose
      menstrual age ranged from the fifth to the twelfth week. In all patients an
      attempt was made to obtain signals from both uterine arteries,
      peritrophoblastic/retroplacental vessels, umbilical arteries, fetal aorta,
      intracranial vessels, and corpus luteum flow. With the combination of color and
      pulsed Doppler transvaginal sonography, detection of vascular structures was
      greatly facilitated and the amount of time for examination significantly reduced.
      Flow velocity waveforms were measured and results were analyzed by calculation of
      the Resistance Index. During the early stage of pregnancy, we were able to locate
      both uterine arteries in all cases and continuous diastolic shift signal was
      found. Flow in the peritrophoblastic/retroplacental area was observed with an
      overall success rate of 94%. Blood flow in the umbilical artery and fetal aorta
      was visualized by color Doppler starting from the seventh week. Intracranial
      blood flow could be visualized starting from the tenth week in some cases.
      Diastolic flow in these vessels was detectable starting from the twelfth week.
      Corpus luteum flow was found in 148 cases (75%) and the Resistance Index
      decreased as pregnancy progressed.

PMID- 8478443
TI  - Intrascrotal adenomatoid tumors and their ultrasound findings.
AB  - Adenomatoid tumors are regarded as uncommon neoplasms of the paratesticular
      tissues, probably of mesothelial origin, and the majority of cases reported have
      involved the epididymis. Ultrasonography is the method of choice for imaging
      scrotal pathology, but there are very few data on ultrasound findings in cases of
      adenomatoid tumors. We report our experience and ultrasound findings regarding 8
      intrascrotal adenomatoid tumors--3 cases of a testicular tunica albuginea tumor
      and 5 cases of epididymal origin. Ultrasonography is recommended as the
      preoperative imaging method for excluding the possibility of a cystic lesion and
      for determining the location of the tumor. Local excision is regarded as the
      treatment of choice. The clinical course of all these tumors was benign, without
      recurrences.

PMID- 8478444
TI  - Intracystic papilloma in male breast: ultrasonography and pneumocystography
      diagnosis.

PMID- 8478445
TI  - Atypical renal hamartomas: ultrasonography, computed tomography, and angiographic
      findings.

PMID- 8478446
TI  - Aspiration of acute calcerous trochanteric bursitis using ultrasound guidance.

PMID- 8478447
TI  - Clinical findings and endosonographic appearance of endometriosis in the anal
      sphincter.

PMID- 8478448
TI  - Sonographic diagnosis of an inflamed urachal cyst.

PMID- 8478449
TI  - Ultrasound-directed diagnosis and treatment of pelvic hematoma after therapeutic
      abortion.

PMID- 8478450
TI  - Recurrent transient gallbladder wall thickening associated with interleukin-2
      chemotherapy.

PMID- 8478451
TI  - First trimester transvaginal sonographic diagnosis of Dandy-Walker malformation.

PMID- 8478452
TI  - Left heart obstructive disease with ventricular hypoplasia: changes in the
      echocardiographic appearance during pregnancy.

PMID- 8478453
TI  - Ultrasound appearance of gas bubbles in hepatic veins after orthotopic liver
      transplantation: a phenomenon with consequences?

PMID- 8478454
TI  - Image-directed Doppler ultrasonography: a novel technique for the diagnosis of
      colorectal liver metastases.
AB  - Image-directed Doppler ultrasonography has been used to measure changes in
      hepatic arterial and portal venous blood flows in 22 controls and 88 patients
      with colorectal cancer. Doppler Perfusion Index, (DPI, ratio of hepatic arterial
      to total liver blood flow) and Doppler Flow Ratio (DFR, ratio of hepatic arterial
      to portal venous blood flow) of controls and patients with overt liver metastases
      were clearly separated (p < 0.0001). There was a significant reduction in the
      Hepatic Arterial Resistive Index (HARI) of patients with overt liver metastases
      (p < 0.0001). Percentage Hepatic Replacement (PHR) by metastases, measured using
      a computed tomography scanner, did not correlate with DFR or DPI. The results
      suggest that the measurement of hepatic perfusion changes using image-directed
      Doppler ultrasonography may be of value in the detection of small liver
      metastases.

PMID- 8478455
TI  - Sonourethrography in the evaluation of anterior urethral strictures: correlation
      with radiographic urethrography.
AB  - A total of 30 patients with suspected urethral strictures underwent sonographic
      and roentgenographic urethrograms. Two patients showed a normal anterior urethra
      in the sonourethrogram; 29 strictures were diagnosed in the remaining 28
      patients, 1 patient showing strictures at two different sites. Sonourethrography
      was an accurate predictor of stricture length, retrograde urethrography
      underestimating the stricture length in most of the cases. Periurethral
      structures, including the urethral wall, corpus spongiosum, corpora cavernosa,
      bulb, and external urinary sphincter, were seen clearly with sonourethrography.
      Periurethral fibrosis was seen in 16 patients and graded as mild (n = 5),
      moderate (n = 2) or severe (n = 9), depending on the depth of involvement of the
      corpus spongiosum. Sonourethrography was unsatisfactory in the evaluation of
      membranous strictures, failing to visualize the proximal limit of the stricture.

PMID- 8478456
TI  - Myoma vs. contraction in pregnancy: differentiation with color Doppler imaging.
AB  - During pregnancy, leiomyomas may cause complications such as spontaneous
      abortion, premature labor, and obstruction of labor. The conventional real-time
      ultrasound examination usually detects myomas adequately, but, in some cases, a
      local thickening of the uterine wall persists throughout the examination,
      interfering with the differentiation between myoma and contraction. In such
      cases, repeat scanning approximately 30 minutes later differentiates
      contractions, which usually resolve, from myomas. We examined 10 patients with B
      mode and color Doppler ultrasonography. In the 5 patients with myoma, we observed
      splaying of the vessels around the mass, whereas in the 5 patients with
      contraction, there was no vessel displacement in the area of the local myometrial
      thickening. The use of color Doppler and observation of these findings may
      obviate a prolonged ultrasound examination in questionable cases.

PMID- 8478457
TI  - Ultrasonic signs of pneumothorax: preliminary work.
AB  - Ultrasonography is considered to have limited application in respiratory diseases
      because air reflects sound waves. Twenty-four patients with radiologically
      confirmed pneumothorax and 100 healthy subjects underwent sonography. In all
      normal subjects, the hyperechoic pulmonary interface showed respiratory motions
      termed the "gliding sign" with some comet-tail artifacts. Sonographic signs were
      shown in all pneumothoraces: disappearance of the gliding sign and no comet
      tails. The extent of collapse cannot be evaluated, but it is possible to
      determine its area in partial pneumothorax (N = 5). The follow-up (N = 8) showed
      the reappearance of the gliding sign. Ultrasonography may be helpful in
      diagnosing pneumothorax in certain cases.

PMID- 8478458
TI  - Ultrasonography and biliary extracorporeal shock-wave lithotripsy.
AB  - The results of shock-wave treatment of gallbladder stones depend to a very high
      degree on the quality and expertise of ultrasonography applied before, during,
      and after shock-wave disintegration of the stones. Ultrasonography is decisive in
      evaluating the inclusion criteria; it is the method of choice for directing the
      shockwave energy at the stones and monitoring the disintegration process. It is
      the only diagnostic modality to really demonstrate the gallbladder being free
      from stones.

PMID- 8478460
TI  - Tuberculosis of the lower genitourinary tract: ultrasonography as an aid to
      diagnosis and treatment.

PMID- 8478459
TI  - The effect of drainage of fetal chylothorax on cardiac and blood vessel
      hemodynamics.

PMID- 8478461
TI  - Ultrasonic diagnosis of acute uncomplicated appendicitis located in the
      subhepatic space.

PMID- 8478462
TI  - Megaureter associated with severe renal dysplasia.

PMID- 8478463
TI  - Prenatal diagnosis of congenital pyloric atresia.

PMID- 8478464
TI  - Periportal and retroperitoneal sarcoidosis.

PMID- 8478465
TI  - Retroperitoneal sarcoidosis.

PMID- 8478466
TI  - Gossypiboma: diagnosis with ultrasonography.

PMID- 8478467
TI  - Intraoperative transrectal ultrasonography in the management of ejaculatory duct
      obstruction caused by midline prostatic cyst.

PMID- 8478468
TI  - What's new in cutaneous laser surgery.

PMID- 8478469
TI  - Pulsed dye laser treatment of vascular lesions in children.
AB  - BACKGROUND: The flashlamp-pumped pulsed dye laser (577,585 nm) with 300 to 450
      microseconds pulsewidths has been demonstrated to effectively and safely treat
      port-wine stains, telangiectases, and superficial hemangiomas in children.
      OBJECTIVE: The objective of this manuscript is to review the indications of the
      pulsed dye laser in the treatment of vascular lesions in children. CONCLUSION:
      Pulsed dye laser treatment of port-wine stains can remove or lighten the lesions
      with multiple treatment sessions. Spider telangiectases respond with complete
      resolution, usually within one to two treatment sessions. Superficial hemangiomas
      respond quite easily and effectively with the pulsed dye laser, while a more
      variable response is noted in deeper hemangiomas, early proliferative lesions,
      and ulcerated hemangiomas. This procedure is safe with a low incidence of
      scarring and pigmentary alteration.

PMID- 8478470
TI  - Clinical usefulness of the Hexascan. Treatment of cutaneous vascular and
      melanocytic disorders.
AB  - BACKGROUND: The Hexascan is an automated scanning laser handpiece originally
      developed to treat port-wine stains. It can be adapted to operate with most
      continuous wave laser systems delivering a variety of visible wavelengths.
      OBJECTIVE: To review the use of Hexascan with 585-nm yellow dye laser light for
      cutaneous vascular disorders and 514-nm green argon light for benign cutaneous
      melanocytic disorders. METHODS: The current clinical results, treatment
      parameters, indications, limitations, and complications of these procedures are
      discussed in a review format. In addition, a new clinical study of benign
      lentigines treated with green laser light is presented. RESULTS: Most benign
      lentigines showed considerable lightening or complete disappearance after one or
      two treatments. Other melanocytic disorders may also respond. Deep dermal lesions
      such as Nevus of Ota may be totally unresponsive. Both vascular malformations
      such as port-wine stains and hemangiomas are also treatable. CONCLUSION: The
      Hexascan device attached to a continuous wave tunable dye laser can successfully
      treat a wide variety of cutaneous vascular and melanocytic disorders in both
      infants and adults.

PMID- 8478472
TI  - Clinical use of the Q-switched ruby and the Q-switched Nd:YAG (1064 nm and 532
      nm) lasers for treatment of tattoos.
AB  - BACKGROUND: The desire to remove tattoos has probably been around as long as
      their existence. Recent technological advances in lasers have finally made it
      possible to remove tattoos without leaving an equally undesirable scar.
      OBJECTIVE: The purpose of this article is to review the use of the Q-switched
      ruby (694 nm) and the Q-switched Nd:YAG (532 and 1064 nm) lasers for effective
      removal of tattoo ink, with cosmetically appealing results. RESULTS: The Q
      switched ruby laser (694 nm) effectively removes blue-black and green ink, may
      treat other colors less efficiently, and is frequently associated with transient
      pigmentary changes, including rare depigmentation. The Q-switched Nd:YAG laser at
      1064 nm quickly removes black ink, as well as other colors less efficiently;
      pigmentary changes are much less frequent, correlating with its lower absorption
      by melanin. The 532-nm wavelength treats red ink effectively, but also leads to
      temporary hypopigmentation. Transient textural changes may be noted at all three
      wavelengths discussed, but scarring is rare. CONCLUSIONS: Q-switched lasers can
      remove tattoos without residual scarring. Efficacy of ink removal is dependent on
      the wavelength used for the targeted pigment.

PMID- 8478471
TI  - Clinical efficacy of the pulsed dye laser in the treatment of vascular lesions.
AB  - BACKGROUND: Increasing the selectivity of laser-induced damage is an ongoing goal
      for the laser treatment of cutaneous lesions. The flashlamp-pumped pulsed dye
      laser has significantly participated and advanced this pursuit. This is
      especially true in its use for the treatment of cutaneous vascular lesions.
      OBJECTIVE: A review of the development and current use of this laser for the
      treatment of cutaneous vascular lesions will be presented. METHODS: The laser has
      been designed to limit laser energy absorption and damage to hemoglobin and the
      blood vessel. This has been done by setting the wavelength at 577 to 585 nm and
      the pulse duration at 360 to 450 microseconds. RESULTS: The therapeutic results
      have been beneficial for almost all types of superficial small vessel vascular
      lesions regardless of lesional anatomic site or patient age. These lesions
      include port-wine stains, telangiectasia, capillary hemangioma, and other
      angiomata and vascular ectasia. Deeper cutaneous vascular processes and lower
      extremity telangiectases have proven to be less responsive to therapy. The
      increased vascular selectivity has allowed for a dramatic decrease in adverse
      effects when compared to previously used laser systems. CONCLUSION: Based on many
      thousands of treatment sessions and follow-up evaluation, the pulsed dye laser
      appears to have the greatest margin of safety in the treatment of cutaneous
      vascular lesions, especially for the pediatric population.

PMID- 8478473
TI  - Laser treatment of benign pigmented epidermal lesions using a 300 nsecond pulse
      and 510 nm wavelength.
AB  - Sixty-five patients having a total of 492 lesions were treated with the Candela
      pigmented lesion dye laser (510 nm, 300 ns). Lesions treated included cafe-au
      lait macules, lentigines, seborrheic keratoses, and postinflammatory
      hyperpigmentation. Fluences varied from 2.0 J/cm2 to 3.5 J/cm2, but averaged 2.25
      J/cm2. Response was good to excellent after one treatment with 40-50% completely
      clearing and an additional 33% clearing by 75% or more. Repeated treatments were
      capable of clearing residual lesions. Histologic examination revealed
      vacuolization of melanin-containing cells and suprabasilar vesicles. The only
      adverse sequelae were transient hypopigmentation and hyperpigmentation, which
      resolved in 4 to 6 months.

PMID- 8478474
TI  - Treatment of port-wine stains for the 1990s.
AB  - BACKGROUND: A dramatic improvement in the treatment of patients with port-wine
      stains has occurred over the past 20 years owing to the availability of a variety
      of different laser systems. The argon laser was the first system to offer an
      advantage over the older surgical techniques that had previously been used to
      manage these patients. However, many new lasers have since been developed that
      further improved the treatment results while simultaneously reducing the risks,
      even when treating children. OBJECTIVE: To present the current status of laser
      surgery for port-wine stains and describe how the many newer systems are being
      used to more effectively manage these patients. METHODS: A thorough review of the
      medical literature was conducted on the use of new lasers, delivery systems, and
      treatment techniques for the management of port-wine stains. RESULTS: The biggest
      advance in laser treatment of port-wine stains resulted from the development of
      systems that are capable of delivering yellow light. The improved precision
      provided by these lasers serves to minimize epidermal injury, limit nonspecific
      thermal damage, and permit treatment of newborns and young children without a
      significant risk of scarring. CONCLUSION: Major benefits in the treatment of port
      wine stains have resulted from the recent development of many new laser systems
      and laser accessories that provide a more precise response with less potential
      for complications than had been previously attainable with older technologies.

PMID- 8478475
TI  - Clinical usefulness of the argon laser for the 1990s.
AB  - The argon laser remains an excellent, important laser in the 1990s. Its major
      role in dermatology is for the treatment of mature nodular port-wine stains,
      telangiectasia, small vascular lesions, and superficial pigmented lesions.
      Technique modifications and appropriate patient selection have been developed to
      maximize favorable response.

PMID- 8478476
TI  - Use of the carbon dioxide laser in dermatologic surgery. A clinically relevant
      update for 1993.
AB  - BACKGROUND: The effective and safe use of the carbon dioxide (CO2) laser in the
      1990s has been facilitated by technologic advances and widespread clinical use
      producing a better understanding of laser-tissue interactions, refinements in
      technique, and modifications of the list of indications. Safety guidelines have
      evolved from identification of complications. OBJECTIVE: To discuss the basic
      principles and applications of CO2 laser surgery. METHODS: Types of CO2 lasers
      and their applications are discussed. CONCLUSION: Today, use of the carbon
      dioxide laser simplifies many procedures, is reasonably safe, is effective for
      its intended usages, and is the preferred treatment of several cutaneous
      disorders.

PMID- 8478477
TI  - The copper vapor laser for treatment of cutaneous vascular and pigmented lesions.
AB  - BACKGROUND: Clinical experience has shown that a variety of skin lesions are
      treatable with rapidly pulsed yellow and green light of the copper vapor laser.
      OBJECTIVE: To review the development, use, complications, and efficacy of the
      copper vapor laser when utilized for cutaneous lesions. METHODS: Articles were
      identified through a MEDLINE search, review of these articles' bibliographies,
      and advice from expert physicians who have used the copper vapor laser. RESULTS:
      A variety of vascular and pigmented cutaneous lesions are effectively treated
      with the copper vapor laser. A distinct advantage for hypertrophic or
      cobblestoned port-wine stains and most types of facial telangiectasia is seen
      when this laser's results are compared with the results of other available laser
      systems. Complications, including scarring, are rarely observed. CONCLUSION: The
      copper vapor laser is a useful addition to the family of lasers that are used for
      cutaneous conditions.

PMID- 8478478
TI  - Benign pigmented lesions of the skin. Treatment with the Q-switched ruby laser.
AB  - BACKGROUND: The Q-switched ruby laser is a 694 nanometer (red light) pulsed (20
      40 nsecond) laser that has been shown to be effective in the treatment of
      cutaneous pigmented lesions. OBJECTIVE: This article will review my experience in
      the use of the Q-switched ruby laser to treat a wide gamut of epidermal and
      dermal pigmented lesions. RESULTS: The Q-switched ruby laser is highly effective
      in treating epidermal pigmented lesions and can be efficacious in the treatment
      of some dermal pigmented lesions. CONCLUSION: The Q-switched ruby laser is an
      effective addition to the cutaneous laser armamentarium.

PMID- 8478479
TI  - 510-nm pigmented lesion dye laser. Its characteristics and clinical uses.
AB  - BACKGROUND: Benign pigmented lesions are of a cosmetic concern to many
      individuals. Numerous treatments exist, including several types of lasers. The
      Candela 510 nm pigmented lesion dye laser has recently been added to this
      armamentarium. It is designed specifically for the treatment of superficial
      pigmented lesions while significantly decreasing the risk of scarring and
      prolonged hypopigmentation. OBJECTIVES: To describe the characteristics of the
      Candela pigmented lesion dye laser and report on the therapeutic outcome of
      patients treated for actinic lentigines, cafe-au-lait macules, melasma and red
      tattoos by one of the authors (RCG). METHODS: The Candela 510 nm pigmented lesion
      dye laser was used to treat solar lentigines, cafe-au-lait macules, melasma and
      red tattoo. RESULTS: Excellent outcomes resulted on facial and hand lentigines
      (89% and 88% of patients had greater than 75% clearing, respectively), but often
      required more than one treatment. Lentigines located on the upper extremities and
      trunk improved less dramatically. Immediate greying occurred universally.
      Bruising was often noted. Treatment failures have been observed especially in
      treating lentigines located on the lower extremities. Cafe-au-lait macules
      responded inconsistently, with facial lesions giving the best results. Melasma
      responded poorly, often with hyperpigmentation. Three red tattoos cleared.
      Treatment failure may be related to inaccurate clinical assessment of pigment
      depth or regrowth of the lesion. Several cases are presented to demonstrate
      clinical and histologic effects of the laser. CONCLUSION: The Candela 510-nm
      pigmented lesion dye laser is an effective treatment for superficial pigmented
      lesions. Its associated morbidity is minimal.

PMID- 8478480
TI  - Mini- and micrografts exclusively versus standard grafts mixed with mini- and
      micrografts.

PMID- 8478481
TI  - Electrodessication at the DIP for myxoid cyst and skin flaps in proximity to the
      interphalangeal joints.

PMID- 8478482
TI  - Autologous fat transplantation: evaluation and interpretation of results.

PMID- 8478483
TI  - Secondary syphilis mimicking borderline (BL) leprosy.
AB  - A young woman with syphilids resembling borderline lepromatous (BL) leprosy is
      being described. This is yet another addition to its already well-documented
      manifestations. The high prevalence of leprosy and syphilis augments the
      epidemiological significance of the case.

PMID- 8478484
TI  - Generalized eruptive histiocytoma: report of a pediatric case.
AB  - A one-year-old boy was seen with brownish, flat papules on his face, neck and
      upper arms. The lesions were symmetric, discrete, slightly raised, firm to the
      touch, and asymptomatic papular eruptions. Histological and immunohistochemical
      investigation revealed monomorphous infiltration of S-100 negative, lysozyme
      negative, and alpha 1-antitrypsin negative, but alpha 1-antichymotrypsin positive
      and vimentin positive histiocytic cells with small numbers of lymphocytic cells.
      The histiocytic cells did not show any foamy changes in the cytoplasm. No giant
      cells were found. The lesions increased in number during the first few years and
      then spontaneously regressed by the sixth year of age, leaving partial brownish
      pigmentation.

PMID- 8478485
TI  - Linear lichen planus mimicking creeping eruption.
AB  - A 42-year-old woman was referred to our hospital with a linear eruption on her
      right flank of two months duration. Because she had eaten loach-fish a month
      before she noticed the eruption, a creeping eruption due to Gnathostoma spp. was
      initially suspected, but the histological findings of the biopsy specimens showed
      typical features of lichen planus. Linear lichen planus is discussed based on the
      cases accumulated in the literature regarding the distribution of Blaschko lines.

PMID- 8478486
TI  - Introduction of a fluorescence-microscopic technique for the detection of eggs,
      egg shells, and mites in scabies.
AB  - A technique using the fluorescence microscope can prove helpful in the laboratory
      diagnosis of scabies. Specimens from fifteen patients with scabies were used in
      this study. All of the specimens were embedded with glycerine instead of
      potassium hydroxide (KOH) solution. The specimens were examined at 0 min, 30 min,
      1 hr, 6 hrs, 24 hrs, and one week after mounting under light and fluorescence
      microscopes. Specimens embedded with non-fluorescent glycerine were not clear
      immediately after mounting but became so after about 1 hr. Eggs and egg shells
      were easily counted in the specimens under the fluorescence microscope but were
      very hard to identify under the light microscope. Mites were absent in half of
      the specimens; only eggs and egg shells were present in those specimens found by
      the fluorescence microscope. The above findings suggest that the detection of egg
      shells by the use of fluorescence microscope may be helpful for the diagnosis of
      scabies, in particular with mite negative specimens. Slides prepared with non
      fluorescent glycerine were more stable and could be preserved for a long time.
      However, this method is time-consuming and requires expensive equipment.

PMID- 8478487
TI  - Deposits of fibronectin in sclerotic fibromas of the skin.

PMID- 8478488
TI  - Immunotherapy of melanoma: current status and prospects for the future.
AB  - As one of the most immunogenic human malignancies, melanoma has served as a
      prototype for the development of immunotherapy against human cancer in a number
      of treatment modalities over the past two decades. These studies have included
      augmentation of host immunity with lymphokines and other biological response
      modifiers, lymphokine-activated killer cells, and cytotoxic T-cells; active
      immunotherapy using purified antigens, tumor cell vaccines, and anti-id
      antibodies; and passive immunotherapy with monoclonal antibodies. The results of
      these investigations are discussed as well as the prospect for future treatments
      of melanoma incorporating immunotherapeutic techniques. A report on a recent
      trial of gene therapy of human melanoma performed by Dr. Steven Rosenberg is also
      presented.

PMID- 8478489
TI  - Effects of ultraviolet-B and PUVA on ornithine decarboxylase activity, DNA
      synthesis, and protein kinase C activity in mouse skin.
AB  - Ultraviolet-B and PUVA share several biological events with phorbol ester tumor
      promoters. The effects of ultraviolet-B irradiation and topical PUVA treatment on
      ornithine decarboxylase activity, DNA synthesis, and protein kinase C activity,
      which are known to be induced or activated by phorbol ester tumor promoter, were
      investigated in hairless mouse skin. Ornithine decarboxylase activity was
      remarkably enhanced by ultraviolet-B and PUVA. Although PUVA did not affect DNA
      synthesis significantly, ultraviolet-B stimulated epidermal DNA synthesis
      approximately 5-fold over control values at 48 h. However, unexpectedly, neither
      cytosolic nor membrane-bound protein kinase C activity showed any change during
      the 2 h after either treatment. These results suggest that the protein kinase C
      system is not involved in the initial signal transduction system of ultraviolet-B
      or PUVA, unlike the case with phorbol ester tumor promoter.

PMID- 8478490
TI  - A case of pretibial dystrophic epidermolysis bullosa: decreased expression of the
      non-helical domain of type VII collagen molecule.
AB  - A 27-year-old man with an ataxic gait due to infantile cerebral paralysis
      exhibited recurrent blistering caused by mechanical stimuli on the pretibial area
      of both legs from the age of 20. His parents were not consanguineous, and he had
      no relatives who suffered from blistering. The histology showed a subepidermal
      bulla due to dermolytic epidermal-dermal separation. The anchoring fibrils were
      sparse and rudimentary in the predilection area. An LH 7:2 monoclonal antibody
      against the non-helical domain of the type VII collagen molecule stained the
      basement membrane zone of the patient's skin at a weaker intensity than the
      staining of normal human skin, but at a distinctively stronger intensity than the
      staining of skin from a patient with recessive dystrophic epidermolysis bullosa.
      Immunoelectron microscopy revealed that LH 7:2-immunoreactants were distributed
      irregularly within the lamina densa and sparsely in the sublamina densa region.
      The patient was diagnosed with pretibial dystrophic epidermolysis bullosa.

PMID- 8478491
TI  - Secretion of IL-2, IL-4, and IFN-gamma for dust mite antigens in a patient with
      atopic dermatitis.
AB  - In a 21-year-old female with severe atopic dermatitis, the secretion of
      interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-gamma) by
      her peripheral blood mononuclear cells (PBMC) was measured after incubation
      with/without antigens extracted from Dermatophagoides pteronyssinus (Dp), to
      which the patient had developed a positive patch-test reaction. Incubation with
      Dp antigen produced marked secretion of IL-2 and IFN-gamma, but not IL-4. This
      may suggest that Dp-specific T lymphocytes present in the circulating blood cells
      are capable of producing IL-2 and IFN-gamma, which may be relevant to the delayed
      type allergic reaction occurring in the skin lesion.

PMID- 8478492
TI  - A study of the efficacy of antimicrobial detergents for hand washing: using the
      full-hand touch plates method.
AB  - We studied the effects of four kinds of antimicrobial detergents, 4%
      chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone-iodine
      (PVI), 0.3% triclosan (TRI), and one non-medicated detergent (NMD) using the full
      hand touch plates method. Before and after 3 minutes of hand scrubbing with a
      brush, bacterial colonies on the hand surface and subungual bacteria were
      counted. CHG, CBC, and PVI were excellent antimicrobial detergents against hand
      surface bacteria, but most of the subungual bacteria remained. The subungual
      space was the most difficult region from which to eradicate bacteria. TRI was
      much less effective than hand soap against hand surface bacteria.

PMID- 8478493
TI  - Concomitant occurrence of circulating IgA anti-intercellular and anti-basement
      membrane zone antibodies in autoimmune blistering diseases: immunofluorescence
      and immunoblot studies.
AB  - Recently, cases with circulating IgA anti-intercellular antibodies have been
      described. The objective of this study was to present immunofluorescence and
      immunoblot findings in three cases of bullous diseases with concomitant
      circulating IgA anti-intercellular and anti-basement membrane zone antibodies.
      Direct immunofluorescence, indirect immunofluorescence on intact and 1M NaCl
      split skin, immunoblotting of epidermal extracts from dispase- and EDTA-separated
      (two different procedures) human skin, and immunoblotting of the bovine desmosome
      preparation were performed. All three cases had IgA anti-intercellular and anti
      basement membrane zone antibodies. However, immunoblot results were divergent.
      Case 1 had antibodies against the 150 kD pemphigus foliaceus antigen (IgG), the
      170 kD protein (IgG and IgA), and the 97 kD antigen (IgG and IgA). Case 2 had IgG
      antibodies reactive with the 230 kD and the 170 kD bullous pemphigoid antigens,
      while case 3 had IgA antibodies against the 97 kD antigen only. The results of
      immunofluorescence and immunoblot studies in our patients widen the spectrum of
      laboratory features in blistering skin diseases mediated, at least in part, by
      antibodies of the IgA class.

PMID- 8478494
TI  - Giant-cell (temporal) arteritis following a bypass operation for cerebral
      infarction.
AB  - A 61-year-old man was referred to us with linear and indurated erythemas and
      severe tenderness on the scalp, neck, tongue, and scrotum which had gradually
      spread over the previous six months. He had a history of an intracranial bypass
      operation for cerebral infarction. Histologic and ultrastructural examinations
      revealed giant-cell arteries in the skin as well as inflammatory cells
      infiltrating into nerves. Carotid angiograms indicated stenosis of cranial
      arteries. It is suggested that the bypass operation may be related to the
      occurrence of the giant-cell arteritis and that the inflammatory cell infiltrate
      into nerves may have caused the severe tenderness of this disease.

PMID- 8478495
TI  - Epidermolysis bullosa acquisita (EBA) with nonclassical distribution of
      eruptions.
AB  - The skin lesions in epidermolysis bullosa acquisita (EBA), a mechanobullous
      disease, often show acral distribution. Recently, we experienced a case of EBA in
      which most of the skin lesions were located on the trunk. We reviewed the
      distribution of the skin eruptions in 58 reported cases of EBA. Although the
      extensor surfaces of the extremities are the most common site, there were some
      cases with non-acral distribution. These "nonclassical" cases should also be
      considered in the clinical diagnosis of EBA and other bullous diseases.

PMID- 8478496
TI  - Sexually transmitted diseases in a HIV infected patient.
AB  - We report a case of HIV infection with herpes simplex, syphilis, and condyloma
      acuminatum in a 66-year-old heterosexual man. The patient was an asymptomatic
      carrier (group II) of HIV infection. Herpes simplex on his penis was controlled
      by aciclovir. Secondary syphilis was treated with penicillin G, after which skin
      lesions disappeared. These four diseases were all sexually transmitted diseases
      (STD). One should consider the possible existence of other STD in similar cases.

PMID- 8478497
TI  - Childhood lichen planus (LP).
AB  - In adults, lichen planus (LP) is relatively more common than in children. Among
      222 cases of LP, there were 25 (11.2%) children in our study. The majority of the
      cases were females in the age group of 8-14; the youngest child was 3 years old.
      Papular and linear types of LP were common in children. There was no familial
      history of LP in any of the cases. The patients with classic LP lesions responded
      well to dapsone therapy. This study supports the suggestion of Ramsay and Hurley
      that childhood LP is more common in the tropics.

PMID- 8478498
TI  - Incidental epidermolytic hyperkeratosis in progressive systemic sclerosis.
AB  - Incidental epidermolytic hyperkeratosis (EH) has been reported in a variety of
      lesions. We describe here incidental EH in a patient with progressive systemic
      sclerosis (PSS). We reviewed 108 skin biopsies from our cases of PSS and
      localized scleroderma, but this finding was seen only in the present case. Focal
      acantholytic dyskeratosis is analogous to EH, but we believe that this case is
      most consonant with EH. Since there has been no other report of EH in PSS, this
      association may be coincidental.

PMID- 8478499
TI  - Prominent telangiectasia associated with marked bleeding in CREST syndrome.
AB  - A 64-year-old woman with CREST syndrome developed prominent telangiectases
      mimicking hereditary hemorrhagic telangiectasia (HHT) of Osler-Rendu-Weber. We
      have been following her since she first came to us with discrete telangiectatic
      mats and Raynaud's phenomenon 11 years ago. Telangiectatic lesions have been seen
      on her larynx and esophagus in addition to commonly affected sites. She has
      experienced spontaneous epistaxis and marked bleeding from the lesions on her
      lips, oral mucous membrane, and soles. This case illuminates new aspects of
      telangiectasia in CREST syndrome.

PMID- 8478500
TI  - Eosinophilic panniculitis.
AB  - A 39-year-old obese female patient with borderline diabetes mellitus who
      developed multiple, tender, and hard nodules on the lower abdominal wall is
      described. The histological features were characterized by mixed panniculitis,
      showing massive eosinophilic infiltration and fibrosis in the septae and many
      foam cells in the parenchymal area of subcutaneous tissues. The eruption
      regressed gradually during the course of diet therapy for diabetes mellitus and
      obesity. Although the etiology is diverse and nonspecific, eosinophilic
      panniculitis seems to be a unique histopathological reaction pattern
      characterized by massive eosinophilic infiltration into subcutaneous tissues.

PMID- 8478501
TI  - Subclinical syringoma coexisting with nevocellular nevus on the vulva.

PMID- 8478502
TI  - Comparison of full-dose versus half-dose pharmacotherapy in the maintenance
      treatment of recurrent depression.
AB  - Recent evidence points to the prophylactic efficacy of maintaining recurrent
      unipolar patients on the same dose of antidepressant medication that was used to
      treat the acute episode (Frank et al., 1990; Kupfer et al., 1992). Therefore, the
      question of whether such patients should be tapered to a lower maintenance dose
      after successful resolution of an acute episode is clearly important. In this
      report we describe a small randomized clinical trial in which patients were
      assigned to either full-dose or half-dose maintenance treatment for a period of 3
      years. Survival analysis suggests that superior prophylaxis can be achieved with
      a full-dose as compared to a half-dose maintenance treatment strategy (p < 0.07).
      Mean survival time for the full-dose subjects was 135.17 (SE 19.75) weeks as
      compared to 74.94 (SE 19.78) weeks (median of 43.1 weeks) for the half-dose
      subjects. We conclude that for patients who have suffered several recurrences,
      full-dose maintenance treatment is the more effective prophylactic strategy.

PMID- 8478503
TI  - Organic manic syndrome: causative factors, phenomenology and immediate outcome.
AB  - A prospective study on organic manic syndromes led to identification of 30 cases
      over a period of 11 months, constituting 1.75% of all admissions and 4.67% of all
      patients with mania. They were compared with 60 sex- and age-matched bipolar
      controls. The mean age of onset of illness was not significantly different in the
      two groups. Family history of affective disorder was more often negative in
      organic manics. The overall mania rating score was similar in the two groups, but
      after 3 months organic manics improved less. Compared to the bipolar group,
      organic manics were more often irritable, made threats, had delusions, and showed
      cognitive dysfunctions. The implications of these findings on definition of the
      organic manic syndrome are discussed.

PMID- 8478504
TI  - Inter-rater reliability of a refined index of melancholia: the CORE system.
AB  - We report an inter-rater reliability study of the modified 18-item, sign-based
      CORE index of melancholia, undertaken on 205 ratings of 35 patients by five
      clinical research psychiatrists. Inter-rater agreement about the presence or
      absence of individual items was slight to moderate when examined by the kappa
      coefficient, but moderate to high when examined by the intraclass correlation
      statistic. For total CORE scores, perhaps the most important application of the
      index of melancholia, high levels of intraclass correlation coefficients (ranging
      0.79 to 0.90 across the varying rater dyads) were established. When a single cut
      off score (of 7/8) was used to allocate patients to either a 'melancholic' or
      'non-melancholic' class, only moderate agreement was established between raters
      in such 'class' assignments--a limitation which can be redressed by imposing a
      'probable/possible melancholia' band of scores.

PMID- 8478505
TI  - Depressed patients' parental representations: stability across changes in
      depressed mood and specificity across diagnoses.
AB  - Parental representations of a Dutch sample of psychiatric patients with diagnoses
      of dysthymia and unipolar depression were compared with those of a matched sample
      of non-depressed patients and a matched sample of healthy controls. No
      differences in recalled parental rearing styles were found between depressives
      with a diagnosis of dysthymia and those with a diagnosis of unipolar depression.
      Depressive did not differ from the mixed (but non-depressed) sample of
      psychiatric patients, whereas both the depressed and the mixed group of patients
      reported more adverse parenting than the healthy controls. Analysis of repeated
      measurements of parental representations showed that memories of parental
      behavior were highly stable across clinically significant changes in depressed
      mood, so that it seems unlikely that patients' relatively negative recollections
      of their parents' behavior were due to mood state dependent recall. Results are
      discussed within the framework of depression theories and with regard to the
      validity and utility of self-report instruments for parental rearing styles.

PMID- 8478506
TI  - Low genetic effect and age-specific family effect for symptoms of anxiety and
      depression in nuclear families, halfsibs and twins.
AB  - Questionnaire information on symptoms of anxiety/depression was obtained from
      61,286 persons, most of whom could be grouped in families as spouses, parents,
      offspring, siblings, halfsibs and twins. The correlations between mental health
      in relatives, varying somewhat by sex, were: 0.27 for 18,768 pairs of spouses,
      0.12 to 0.17 for 30,888 pairs of parents and offspring, 0.11 to 0.18 for 13,134
      pairs of siblings, 0.27 to 0.35 for 57 pairs of MS twins, -0.06 to 0.10 for 60
      pairs of DZ twins, 0.30 for 88 pairs of halfsibs reared together, and 0.16 for 40
      pairs of halfsibs reared apart. The heritability was estimated to be between 0
      and 0.20. There was a significant effect of environmental transmission from
      mother, but not from father, to offspring. The effect of environmental factors
      shared by sisters was substantial, the corresponding effect was lower in
      brothers, and zero in siblings of opposite sex. The correlations decreased with
      increasing age differences between relatives, implying effects of age-specific
      genes or environmental factors in the family.

PMID- 8478508
TI  - Challenges of the 1990's.

PMID- 8478507
TI  - Sleep disorders and anxiety as symptom profiles of sympathoadrenal system
      hyperactivity in major depression.
AB  - Recently, it has been reported that major depression is accompanied by an
      increased sympathoadrenal system (SAS) activity. In order to study the
      psychopathological correlates of SAS activity in depression, the authors measured
      the 24 h urinary excretion of catecholamines (CA), i.e., noradrenaline (NE),
      adrenaline (E), dopamine (DA) and the NE/E metabolite 3-methoxy-4
      hydroxyphenylglycol (MHPG) in 80 unipolar depressed subjects. The excretion of
      these indices of SAS activity have been studied in relation to the depressive
      items of the Structured Clinical Interview for DSM-III (SCID) and the Hamilton
      Depression Rating Scale (HDRS). There were significant positive correlations
      between the SCID item sleep disorders and the HDRS item middle insomnia, on the
      one hand, and NE, E and DA excretion, on the other. The MHPG excretion in 24 h
      urine was significantly and negatively related to somatic anxiety and
      hypochondriasis. It is suggested that these intertwined relationships between
      increased CA turnover, sleep discontinuity and anxiety may reflect the occurrence
      of a hyperarousal state in some major depressives that may be regarded as a
      coping response to various putative noxious stimuli.

PMID- 8478509
TI  - Economics of dentistry: practitioner income and employee wages.

PMID- 8478510
TI  - Update on scholarship among dental faculty.
AB  - A study was conducted to gather data from dental deans regarding the publication
      rates of faculty in dental schools. An analysis of the findings suggests that
      when compared with a previous study the rate of publication has increased. For
      tenure awardees, the number of publications has increased when the findings of
      the current study are compared with the original study. At all academic ranks,
      the publication rate has increased. The increase is more pronounced at the ranks
      of associate and full professor. The effect on the publication rate is the same
      for those schools with small numbers of advanced education programs when compared
      with schools that have larger numbers of advanced programs. The changing nature
      of dental education has resulted in an increased emphasis on scholarly activity
      involving a shift away from teaching and toward scholarship. This shift is
      evident in faculty publication rates when the findings of the two studies
      conducted by the authors are compared. In the future, it may be expected that
      dental faculty may be required to contribute to the professional literature at a
      rate equivalent to or greater than is required at the present time.

PMID- 8478511
TI  - Where we stand with AIDS.

PMID- 8478512
TI  - After the analysis: analyst as both old and new object.
AB  - In the course of followup study of satisfactorily analyzed former patients, there
      are observed two sets of phenomena: (1) recurrence of the analytic transference
      neurosis, and (2) rapid recovery from this transference neurosis. These phenomena
      are telescoped repetitions of the analysis and reflect the ongoing mental
      representation of the analyst as a displacement from the objects of the past,
      organized into the transference neurosis. The spontaneous and rapid recovery from
      the transference neurosis in followup study repeats the "cure" of the analysis
      and the new ongoing representation of the analyst as a nonconflicted object. This
      new image of the analyst is based on both the resolution of the transference
      neurosis and new displacements from positive experiences with significant figures
      from the past.

PMID- 8478513
TI  - The eclectic analyst, or the many roads to insight and change.
AB  - Common wisdom has it that psychoanalysis is composed of a number of discrete
      bodies of theoretical and technical thought, or "schools." I argue that
      psychoanalytic schools are not as different from one another as they are commonly
      supposed to be, particularly in matters of technique. In their daily practice,
      most analysts do not adhere strictly to the precepts of a specific school, even
      though they profess to be adherents of that school. Instead, they read widely and
      adopt those technical procedures and principles that fit their own personality
      and prove most efficacious with their patients, regardless of the school from
      which those ideas come. In short, they are eclectic. I present a case to
      illustrate this eclecticism in my own practice, discuss the widespread nature of
      such eclecticism among the professions in general, and briefly discuss the
      significance of eclecticism for psychoanalysis itself.

PMID- 8478514
TI  - Shall drawing become part of free association?: Proposal for a modification in
      psychoanalytic technique.
AB  - Three psychoanalytic case vignettes are presented where drawing is used
      beneficially as part of the free-associative process. The history of the
      psychoanalytic use of drawing is briefly reviewed, together with a new technical
      proposal regarding the role of drawing in free association. Justification for
      testing this modification leads to a consideration of methodological issues and
      the nature of free association. Possible advantages of this modification,
      including enhanced clinical understanding through integration of pictorial and
      verbal modes, and greater potential for access to the period of life where
      experience is more visually dominated, are considered and also discussed in
      relation to dual hemispheric mental organization.

PMID- 8478515
TI  - On reminiscences.
AB  - Recently, psychoanalysts have focused on narrative truth and hermeneutics with
      diminished attention to the role of remembering in symptom formation and
      treatment. This shift has tended to remove us from prior status as a motivational
      and cognitive science with potential for causal inferences. At the same time,
      psychiatry and cognitive science have moved toward a vigorous study of
      reminiscences and their role in pathology. Arguments for a revival of Freud's
      position on the central role of memory are cited. A case example is offered to
      show that Freud and his psychoanalytic progeny have never taken a simplistic view
      of archeological truth, but were among the original group to bring to light the
      distorting effect of mind on remembering, and actually led the way for other
      scientific approaches.

PMID- 8478516
TI  - Paranoia: a part of most analyses.
AB  - Paranoid defenses appear during most analyses, sometimes with great intensity,
      but often subtly, and require specific analytic attention. Preoedipal conflicts,
      inner fears around passivity, narcissistic injury and rage, and subsequent
      masochistic and projective defenses lie at the core of these patients' pathology.
      In addition, specific cognitive, object-relational, and affective distortions
      reflecting multiple developmental levels emerge during analysis. A case vignette
      is provided to demonstrate the analysis of a neurotic patient without borderline
      features who showed prominent paranoid formation.

PMID- 8478517
TI  - Useful aspects of acting out: repetition, enactment, and actualization.
AB  - In his seminal paper on acting out, Freud (1914) wrote: "We render the compulsion
      [to repeat] harmless, and indeed useful, by giving it the right to assert itself
      in a definite field. We admit it into the transference as a playground in which
      it is allowed to expand in almost complete freedom and in which it is expected to
      display to us everything in the way of pathogenic instincts that is hidden in the
      patient's mind" (p. 154). This paper reexamines the ambiguous concept of acting
      out as both a resistance to and a useful component of the analytic process.
      Current concepts of repetition in the transference, enactment, and actualization
      avoid the pejorative connotation of acting out and, therefore, allow for a more
      neutral, analytic attitude toward these inevitable and vital components of the
      analytic process.

PMID- 8478518
TI  - Therapeutic process and developmental process in the restructuring of object and
      self constancy.
AB  - This paper holds that the analytic relationship embodies both therapeutic process
      and developmental process, that these processes are best viewed as different and
      separate, and that they function in a complementary way in the revision of
      pathologically impaired and underdeveloped psychic structure. The focus of the
      paper is on the developmental formation and clinical restructuring of object and
      self constancy. The illustrative case material is excerpted from the case of a
      man who returned for additional treatment five years after the completion of an
      apparently successful analysis of his neurotic conflicts.

PMID- 8478519
TI  - Can analysts agree? The problems of consensus and the psychoanalytic mannequin:
      I. A proposed solution.
AB  - Psychoanalysis, plagued by lack of demonstrable consensus on clinical
      formulations, is as much endangered by overinflated agreement from stereotypical
      dynamic formulas: tests of psychoanalytic hypotheses derived from any such
      formulations may therefore rest on questionable foundations. The problems that
      give rise to artifactual overagreement or failure to reach agreement are here
      traced in earlier empirical psychoanalytic research. Review reveals that although
      new and inventive empirical strategies (applied in the last two decades) achieve
      adequate success in the area of agreement, they demonstrate little headway in
      ruling out that stereotypy may underlie such consensus. The present investigation
      offers a solution for testing agreement in complex clinical psychoanalytic
      propositions, in a way that sets up a "test of the mannequin": that is, whether
      stereotypical assumptions about the patient's dynamics are overridden (revised)
      by the specific character of a given patient's narrative. The mannequin concept
      introduces a new and epistemically crucial consideration in the making of
      psychodynamic formulations and is relevant to both empirically controlled and
      clinical contexts of observation and formulation. No psychoanalytic paradigm,
      whether classically ego-psychological, self-psychological, control-mastery, or
      object-relational, escapes this problem.

PMID- 8478520
TI  - Can analysts agree? The problems of consensus and the psychoanalytic mannequin:
      II. Empirical tests.
AB  - The present investigation reports on the execution of an empirical strategy for
      testing agreement in complex clinical psychoanalytic propositions, and for
      testing whether stereotypical assumptions are overridden (revised) by the
      specific character of the patient's narrative. The findings reveal that, in
      general, for the several domains of psychoanalytic formulation, psychoanalyst
      judges reach superior levels of ordinal agreement, and modest to good levels for
      agreement on magnitude. Moreover, formulations based on verbatim psychoanalytic
      sessions pass the "test of the mannequin" in most domains, i.e., surpass
      stereotypical psychoanalytic assumptions about the patient's dynamics. The
      mannequin concept, here operationalized, introduces a new and epistemically
      crucial consideration for the making of psychodynamic formulations. Other novel
      contributions of these studies include the development of operationalized
      measures of (reconstructive) historical linkage, and the introduction of
      magnitudinal agreement in this empirical area.

PMID- 8478521
TI  - What is sublimated in sublimation?
AB  - Sublimation has always been an elusive idea in psychoanalytic thought. This is
      because psychoanalysis is most systematic as a clinical psychology, while
      sublimation signifies an obverse of neurosogenesis. Nevertheless, the idea of
      sublimation remains a concern of psychoanalysis inasmuch as sublimation entails a
      version of socialization and cultural experience that answers to various
      principles of psychoanalytic theory. For reasons developed here, the creation and
      experience of art figure prominently in reflections on sublimation. Clinical
      material from the analyses of several artists is presented to demonstrate how
      neurosis takes a toll of sublimation and how sublimation takes a toll of the
      analytic process. Sublimatory experiences are then reconstructed from the devices
      of art. Two achievements of sublimation are especially noted: reduction of the
      ordinary instrumental functions of affects, and heightened consciousness of
      endopsychic processes.

PMID- 8478522
TI  - Comments on erroneous interpretations of Freud's seduction theory.
AB  - The seduction theory, as formulated by Freud in 1896, has been erroneously
      understood by many to be a statement about the frequency of sexual abuse of
      children, but in reality it postulates a specific etiology of adult
      psychopathology. Freud stated two conditions that would falsify the theory. When
      he discovered their existence, he was forced, very much against his preference,
      to abandon the theory. Later, this sequence was denied and Freud's change of
      theory was referred to opprobrious subjective traits, assertions made without
      documentation except by Masson. He maintained that he had come across a document
      from the pen of Ruth Mack Brunswick the alleged content of which implied grave
      deficits in Freud's scholarship. When it became possible to examine the original
      document, it was found that it does not contain anything corresponding to what
      Masson reported. The discrepancies between his account and Mack Brunswick's draft
      are presented. In the document, Mack Brunswick set forth some of the observations
      she had made when treating the Wolf Man in the years subsequent to the patient's
      first analysis, which she had reported in 1928. Her enlargement of the role of
      seduction in the etiology of the Wolf Man's psychopathology is discussed.

PMID- 8478523
TI  - A transitional phase in our understanding of the psychoanalytic process: a new
      look at Ferenczi and Rank.
AB  - In The Development of Psychoanalysis, Ferenczi and Rank (1922) demonstrate an
      important transitional phase in the conceptualization of the psychoanalytic
      process. It is not the archaic language of libidinal flow that separates their
      work from modern psychoanalysis, but their insistence on the ideal of the
      analysts's objective authority, despite the implicitly more current interpersonal
      and structural understandings embedded in their sound principles of character
      analysis. Freud's early theory presumed the possibility that an analyst could be
      an objective observer of forces entirely within the patient. Today's theories
      must account for newer intrapsychic, interpersonal, and intersubjective realities
      -the analyst's subjective experience as well as his observing functions. In the
      decade preceding the monograph, implicit developmental, structural, and object
      relational understandings began to emerge. A concurrent dramatic but
      unacknowledged change in the meaning of the terms "psychic reality" and
      "intrapsychic" also occurred. The controversies surrounding the monograph
      predicted many lines of development and dialectics for future theoretical
      discourse. The subjects of countertransference and empathy, almost entirely
      absent in the monograph, became major fields of study, and focal points for
      divergent schools in the new struggle to define the necessary roles of the
      analyst's interaction and subjective experience.

PMID- 8478524
TI  - Preoperative prophylactic antibiotics: brief historical note.

PMID- 8478525
TI  - Nosocomial invasive aspergillosis in lymphoma patients treated with bone marrow
      or peripheral stem cell transplants.
AB  - OBJECTIVES: To determine the prevalence of aspergillosis in lymphoma patients
      housed in a protective environment while undergoing a bone marrow transplant or
      peripheral stem cell transplant and its relation to lymphoma type, type of
      transplant, period of neutropenia, method of diagnosis, species of Aspergillus,
      and the use of empiric amphotericin B. DESIGN: Clinical, autopsy, and
      microbiology records were reviewed retrospectively to determine the presence or
      absence of invasive aspergillosis. All positive specimens underwent further
      review to determine parameters outlined above. SETTING: The review took place at
      the University of Nebraska Medical Center with lymphoma patients housed in the
      oncology/hematology special care unit, which consists of 30 single-patient rooms
      under positive pressure with high-efficiency particulate air filtration.
      PATIENTS: 417 lymphoma patients admitted to the oncology/hematology special care
      unit who underwent 427 courses of high-dose chemotherapy with or without total
      body irradiation followed by a stem cell rescue. RESULTS: Twenty-two cases (5.2%)
      of nosocomial invasive aspergillosis (14 caused by Aspergillus flavus, 2 by
      Aspergillus terreus, 2 by Aspergillus fumigatus, and 4 by characteristic
      histology) were diagnosed. The prevalence of disease according to transplant was
      8.7% for allogeneic bone marrow transplant (2/23 treatments), 5.6% for autologous
      peripheral stem cell transplant (9/161), and 4.5% for autologous bone marrow
      transplant (11/243). Fifteen patients were presumptively diagnosed prior to death
      (68.2%) most commonly by histologic examination of skin biopsies. All 22 patients
      received amphotericin B therapy, 17 prior to aspergillosis diagnosis, and 7
      (31.8%) survived. No patient with disseminated disease survived. CONCLUSIONS:
      Even when housing lymphoma patients undergoing myeloablative therapy in a
      protective environment containing high-efficiency particulate air filtration,
      there was a risk of developing aspergillosis. These data also showed that
      antemortem diagnosis with aggressive amphotericin B therapy was most effective in
      the management of infected lymphoma patients when engraftment occurred and the
      disease did not become disseminated.

PMID- 8478526
TI  - Installing needle disposal boxes closer to the bedside reduces needle-recapping
      rates in hospital units.
AB  - OBJECTIVE: To compare the proportion of recapped needles, an injury surrogate
      measure, in disposal boxes on two different types of hospital units, both before
      and after an intervention. DESIGN: Prospective nonrandomized intervention trial.
      SETTING: A major public teaching hospital. PARTICIPANTS: Specific hospital units.
      We selected two types of hospital units for study: the first type of hospital
      unit (medical-surgical ward) had existing mounted in-bathroom needle disposal
      boxes, and the second type of hospital unit (intensive care unit) had unmounted
      needle disposal boxes in the room but not necessarily near the patient's bedside.
      INTERVENTION: The installation, in the medical-surgical wards only, of mounted
      needle disposal boxes on the wall near the patient's bed. The box location in the
      intensive care units remained the same. In both types of unit, a new mailbox-slot
      disposal box (SAGE) also was substituted for the previous round-top container.
      RESULTS: The baseline proportion of recapped needles in the first medical
      surgical unit was 32.6% (+/- 3.8%) and in the second medical-surgical unit it was
      27.4% (+/- 4.0%) in the bathroom needle disposal boxes, which was similar to the
      observed proportion (34.7 +/- 6.4%) in the intensive care unit boxes. Following
      the intervention, the proportion of recapped needles was significantly reduced in
      the disposal containers adjacent to the bedside in medical-surgical units, to 27%
      (a difference of 2.9 standard errors of the baseline distribution) in the first
      unit and 18.2% (a difference of 4.6 standard errors) in the second. In the
      intensive care unit, where boxes were not moved but new mailbox-types were simply
      substituted, no significant change was noted (36.6%, a difference of 0.59
      standard errors). A statistically significant reduction was observed in the
      proportion of needles recapped in both wards combined following the intervention
      (30.2% to 26.2%, a difference of 2.9 standard errors). CONCLUSION: Environmental
      changes alone are an effective means of altering the risk to healthcare workers
      from sharp instruments. The use of needle-box counts provides a sensitive and
      stable instrument to measure injury surrogates and, indirectly, behavioral change
      in hospital workers.

PMID- 8478527
TI  - Physical and chemical composition of hospital waste.
AB  - For selecting the most efficient treatment method of hospital waste, the
      composition analysis is generally considered to be the fundamental information.
      Currently, there are few studies regarding the characteristics of hospital waste.
      This study evaluated the physical and elemental composition of the hospital waste
      at the National Taiwan University Hospital (NTUH). The results should help us
      design an incinerator for the treatment of infectious waste, plastic syringes,
      pathological waste, and kitchen waste. During the study period, the estimated
      daily waste generation rate at NTUH was 4,600 kg/day, which consisted of 4,100
      kg/day noninfectious refuse, 340 kg/day infectious waste, 70 kg/day kitchen
      waste, 50 kg/day pathological waste, and 40 kg/day plastic syringes. The NTUH
      waste consisted of 99.02% combustible wastes and 0.97% noncombustible wastes by
      mass. The combustible wastes constituted paper (16.17%), textiles (9.77%),
      cardboard, wood, and leaves (1.12%), food waste (21.51%), and plastics (50.45%).
      The noncombustible waste included 0.40% metal and 0.57% glass. Furthermore, the
      analysis indicated that the wastes contained 38% moisture, 4% ashes, and 58%
      solid with an average heat value of 3,400 kcal/kg. From the elemental analysis,
      the dominant elements were found to be carbon (34%) and oxygen (15%).

PMID- 8478528
TI  - A fire on the AIDS ward.

PMID- 8478529
TI  - An innovative option to comply with 1992 OSHA guidelines.

PMID- 8478530
TI  - Malaria: protection of the international traveler.
AB  - Thorough counseling with emphasis on the importance of mosquito bite avoidance,
      as well as on compliance with prophylactic antimalarial regimens, remains an
      important task for the physician preparing a patient for international travel.
      Chloroquine continues to be the drug of choice for prophylaxis in areas not
      reporting chloroquine resistance. Otherwise, mefloquine is the first-line agent.
      Under special circumstances, alternatives to mefloquine can be employed and
      include doxycycline or proguanil plus chloroquine.

PMID- 8478531
TI  - Statistics for hospital epidemiology.

PMID- 8478532
TI  - Epidemiology of nosocomial ventilator-associated pneumonia.

PMID- 8478533
TI  - Hospital may lose federal funding for discriminating against HIV-positive
      healthcare worker.

PMID- 8478534
TI  - New TB control recommendations call for four-drug regime and HIV testing of TB
      patients.

PMID- 8478535
TI  - NIOSH to expand research on workplace transmission of infectious diseases.

PMID- 8478536
TI  - Nonclinical epidemiologists concerned about quality in healthcare.

PMID- 8478537
TI  - Cooperation needed to control TB.

PMID- 8478538
TI  - Responsibilities of infection control practitioners.

PMID- 8478539
TI  - Nosocomial infections surveillance.

PMID- 8478540
TI  - Selective surveillance for nosocomial infections in a Brazilian hospital.
AB  - OBJECTIVE: To devise a system for surveying the frequency of nosocomial
      infections in a tertiary care hospital in a developing country. DESIGN:
      Prospective selective surveillance by nurses of the charts of patients at high
      risk for nosocomial infections, as identified by a form completed by resident
      physicians. The sensitivity, specificity, and predictive value of this method of
      selective surveillance were compared with those for total prospective chart
      review by two infectious disease specialists. SETTING: A university hospital in
      northeastern Brazil. PATIENTS: All patients hospitalized for more than 72 hours
      with an identified risk factor for nosocomial infection. RESULTS: The ratio of
      nosocomial infections to 100 discharges was 13.4 and the incidence density was
      11.2/1,000 patient days. The surveillance method demonstrated a sensitivity of
      74% and a specificity of 99.7%. Positive predictive value was 93%, negative
      predictive value was 99%, and overall accuracy was 98%. CONCLUSIONS: This method
      of selective surveillance for nosocomial infections based on risk factors
      identified by physicians demonstrated excellent predictive value and overall
      accuracy and may be of use to other hospitals that lack a nursing care plan book
      such as the Kardex. The relative frequency of nosocomial infections significantly
      exceeded the rates reported from hospitals in developed countries.

PMID- 8478542
TI  - Validation of surgical wound surveillance.
AB  - OBJECTIVE: To determine the sensitivity and specificity of standard infection
      control surveillance techniques for the identification of surgical wound
      infections. DESIGN: Surveillance data collected by three infection control
      practitioners (ICPs) was compared to surveillance data collected simultaneously
      by a gold standard observer. SETTING: University-affiliated, tertiary care
      hospital. METHODS: Using standard infection control surveillance techniques
      (chart review and discussions with patients' nurses and physicians), ICPs
      collected surveillance data on patients on the General Surgery and Trauma Surgery
      Services on days 4 and 7 after surgery and then weekly for 30 days or until
      patients were discharged from the hospital. Simultaneously, a hospital
      epidemiologist collected surveillance data and examined each patient's wound
      daily. RESULTS: Nine hundred twenty-five surgical patients including 537 trauma
      cases and 388 elective general surgery cases were followed postoperatively. The
      ICPs identified 67 surgical wound infections, and the hospital epidemiologist
      identified 80 surgical wound infections for a sensitivity of 83.8% with a 95%
      confidence interval (CI95) of 75.7% to 91.9%. Specificity was 99.8% with a CI95
      of 99% to 100%. The sensitivity was the same for trauma surgery and general
      surgery, but incisional wound infections were more difficult to identify than
      deep wound infections. During a second validation period, sensitivity was 92.3%
      with a CI95 of 62% to 100%. CONCLUSIONS: Standard infection control surveillance
      techniques have the same sensitivity for detection of surgical wound infections
      as they do for identification of other nosocomial infections. Accurate data on
      surgical wound infections can be collected without direct examination of surgical
      wounds.

PMID- 8478541
TI  - Klebsiella pneumoniae infection on a rehabilitation unit: comparison of
      epidemiologic typing methods.
AB  - OBJECTIVE: To identify factors associated with an increased occurrence of
      Klebsiella pneumoniae isolation in urine cultures and infected wounds on a
      rehabilitation unit and to compare typing methods for K pneumoniae isolates.
      DESIGN: Retrospective review of laboratory reports and patient records with case
      control study. Analysis of K pneumoniae isolates using capsular serotyping,
      enzyme electrophoretic typing, ribotyping, and DNA typing. SETTING: 48-bed
      rehabilitation unit in an 1,100-bed tertiary care teaching hospital in Winnipeg,
      Manitoba. RESULTS: In 1988, 20 (19%) of 106 patients admitted to the
      rehabilitation unit had K pneumoniae isolated from urine or wound, and in 1989 31
      (28%) of 111 patients had Klebsiella isolated. Review of ward practices revealed
      appropriate written policies but evidence of failure in execution leading to
      multiple opportunities for transmission among patients. Substantial environmental
      contamination was not identified, although a common urine graduate may have
      contributed to some transmission. Individuals with K pneumoniae isolated had a
      significantly longer duration of stay. Many of these were spinal cord-injured
      patients and were maintained on intermittent catheterization. One outbreak strain
      was identified in epidemiologic typing. Other strains were generally identified
      in individuals with non-nosocomial acquisition of infection. Comparison of
      epidemiologic typing methods suggests ribotyping may be the optimal method for
      typing K pneumoniae strains. CONCLUSIONS: K pneumoniae was acquired frequently by
      spinal cord-injured patients with extended admissions, re-emphasizing the
      importance of both patients and staff following appropriate infection control
      practices on rehabilitation wards. Ribotyping was the optimal method for typing K
      pneumoniae isolates.

PMID- 8478543
TI  - Comparison of patient telephone survey with traditional surveillance and monthly
      physician questionnaires in monitoring surgical wound infections.
AB  - OBJECTIVE: To evaluate the utility of patient telephone surveys in further
      improving the detection of surgical wound infections (SWIs) postdischarge in the
      setting of ongoing traditional surveillance system and monthly physician surveys.
      DESIGN: Prospective surveillance study of randomly selected patients undergoing
      surgery in inpatient or outpatient settings. SETTING: Tertiary care suburban
      hospital. RESULTS: Five hundred one patients were randomly selected for telephone
      contact, of whom 189 (38%) were successfully contacted after three attempts.
      Eighteen (9.5%) patients reported one or more signs or symptoms of possible SWI.
      However, none of these patients required antibiotic therapy, was hospitalized
      with an SWI, or reported by his or her physician (based on the monthly
      questionnaire) to have had an SWI. Total time spent contacting patients was 47
      hours and 48 minutes, or 15 minutes per each successful telephone contact.
      CONCLUSIONS: Patient telephone surveys as conducted in this study were
      inefficient and failed to substantially improve the rate of detection of SWIs
      over traditional surveillance system and monthly physician questionnaires.

PMID- 8478544
TI  - Urinary tract infections in long-term care facilities.

PMID- 8478545
TI  - A needleless intravenous system: an effective risk management strategy.

PMID- 8478546
TI  - Tuberculosis in the healthcare setting in the 1990s: from Bird Island to the
      Bronx.

PMID- 8478547
TI  - AHA issues revised AIDS/HIV recommendations.

PMID- 8478548
TI  - Court orders AIDS patient to pay exposed healthcare worker.

PMID- 8478550
TI  - Guidelines available for managing TB and HIV in the workplace.

PMID- 8478549
TI  - Glaxo, Inc., releases video on preventing occupational HIV infection in
      healthcare workers.

PMID- 8478551
TI  - New York begins 24-hour hotline for AIDS clinical drug trial information.

PMID- 8478552
TI  - New CDC recommendations call for voluntary testing of hospital patients.

PMID- 8478553
TI  - Impaired mobility: Guillain-Barre syndrome.
AB  - Guillain-Barre syndrome (GBS) is a complicated degenerative disorder which can be
      chronic or acute in nature. Its etiology is unclear although it has been
      associated with both cell- and humoral-mediated autoimmune mechanisms.
      Pathophysiologic effects of the disease include inflammation, demyelination of
      peripheral nerves, loss of granular bodies and degeneration of the basement
      membrane of the Schwann cell. This results in ascending paralysis and loss of
      cranial nerve function. Manifestations may be acute or chronic, and temporary or
      permanent, depending upon the degree of neuronal destruction. Due to the
      pervasive nature of GBS, nursing care is a challenge. Assessment of motor,
      respiratory and cardiac function is of key importance. Total care of the patient
      focuses on risks related to impaired mobility and ineffective airway clearance.
      Psychosocial care and patient education are also integral components of care.

PMID- 8478554
TI  - Multiple sclerosis: health-promoting behaviors of spousal caregivers.
AB  - This pilot study examined the relationship between health-promoting behaviors of
      spousal caregivers of individuals with multiple sclerosis (MS) and dependency
      needs of the afflicted spouses. The study sample included 20 subjects who were
      residing with their spouses and served as primary caregivers. The data were
      collected through a semistructured interview of caregiving spouses. The health
      promoting lifestyle profile (HPLP) was used to measure health-promoting behavior.
      The Index of ADL was employed to measure independence in activities of daily
      living (ADL). Descriptive statistics were calculated for demographic, ADL and
      health-promoting variables. Pearson product-moment correlations were employed to
      assess the relationship between the care recipient dependency needs and the
      health-promoting behavior of the caregiving spouse. Findings revealed a
      significant inverse relationship between level of recipient dependency and health
      promoting behavior of the caregiver (r = -.394, p < .04). Further examination of
      health behaviors revealed that caregiving wives reported higher total frequency
      of health-promoting behaviors than did their husband counterparts. Additional
      analyses revealed subjects scored highest on the self-actualization dimension and
      lowest on the exercise dimension of the HPLP scale.

PMID- 8478555
TI  - Responsible dissemination of scholarly work.

PMID- 8478556
TI  - Development of printed teaching materials for neuroscience patients.
AB  - Neuroscience nurses are challenged by the current climate of cost containment and
      the nursing shortage to continue to provide quality patient education. One
      strategy for meeting this challenge is to follow the process outlined in this
      overview for the development and use of printed materials.

PMID- 8478557
TI  - The changing health care system: neuroscience nursing practice in the 1990s.
AB  - Radical changes in the health care system, including the paradigm shift from an
      acute to chronic illness model, and advances in managing major neuroscience
      patient populations are redefining neuroscience nursing practice in the 1990s.
      For example, advances in management mean that many more neurotrauma patients and
      patients with cerebrovascular disorders survive. Once stabilized, illness may
      become chronic and require long-term management. There are also promising
      developments in managing major neurological diseases. The decade of the 90s will
      require more collaboration, new practice models and a greater focus on
      rehabilitation. Research and education must support practice in reshaping
      neuroscience nursing.

PMID- 8478558
TI  - Needs of family members of critically ill patients with and without acute brain
      injury.
AB  - A comparative descriptive study was implemented to identify and compare the
      personal needs of family members of critically ill patients with and without
      acute brain injury. The study was, in part, a replication of Mathis's study which
      used Molter's Critical Care Family Needs Inventory (CCFNI) to identify
      differences in the degree of importance of the perceived personal needs between
      family members of critically ill patients with and without acute brain injury.
      Fourteen relatives of critically ill patients completed and mailed a
      questionnaire adapted from the CCFNI. Results indicated a difference in the
      degree of importance of the perceived personal needs between the family members
      of critically ill patients without acute brain injury and family members of
      critically ill patients with acute brain injury at the 0.001 level of
      significance (Chi square = 17.70, critical value = 16.27, df = 3). Similarities
      in the rank ordering of the need statements were found between the two groups in
      this study and in comparison to the groups in Mathis's study. Family members
      indicated that most needs were met (78.5%) and nurses and doctors were identified
      as meeting the majority of these needs (> 80%). Ongoing research is necessary to
      determine what the needs of the relatives are in order to most effectively use
      the energies of health care professionals in providing patient care.

PMID- 8478559
TI  - Head-injured adults: recommendations for endotracheal suctioning.
AB  - Endotracheal suctioning (ETS) is a conventional nursing intervention used to
      decrease pulmonary complications in the critically ill patient. ETS provides a
      particular dilemma for the head-injured patient because it increases intracranial
      pressure and may put the patient at increased risk for intracranial hypertension
      and cerebral ischemia. Research in endotracheal suctioning targets understanding
      the ETS response in the severely head-injured patient. This article reviews the
      major research focused on suctioning the head-injured patient. The guidelines for
      practice based on this research include preoxygenating patients prior to
      suctioning, limiting suction duration to 10 seconds, limiting suction passes to 1
      2 per procedure, using hyperventilation with caution, not rotating the head,
      keeping negative suction pressure under 120 mm Hg, and not using suction
      catheters with outer to inner diameter ratios greater than .50.

PMID- 8478560
TI  - Hyponatremia after aneurysmal subarachnoid hemorrhage.
AB  - Hyponatremia frequently complicates the clinical course for patients with
      aneurysmal subarachnoid hemorrhage (SAH). Although commonly attributed to the
      syndrome of inappropriate antidiuretic hormone (SIADH), emerging evidence
      suggests a range of pathological conditions may produce the abnormality.
      Effective management requires an approach to data collection which avoids
      suppositions about etiology, as incorrect assumptions may result in selection of
      interventions leading to further clinical deterioration. Adherence to
      comprehensive monitoring and management protocols ensures rapid detection and
      efficient management of this common problem after SAH.

PMID- 8478561
TI  - [Effects of oxygenation and/or SOD on addition to St. Thomas' Hospital
      cardioplegic solution].
AB  - The effects of oxygenation (95% O2 + 5% CO2) and/or SOD (400 mg/l) on addition to
      St. Thomas' Hospital cardioplegic solution were examined by hemodynamic,
      cytochemical and biophysical assessments in the isolated working rat heart
      subjected to hypothermic ischemic arrest (22 degrees C in temperature, 180 min in
      ischemic time) with multidose cardioplegic infusion. According to the feature of
      used cardioplegic solution, thirty-two rats were divided into four groups (8
      animals per group): That is, Group I; O2 (+) SOD (+), Group II; O2 (-) SOD (+),
      Group III; O2 (+) SOD (-), Group IV (control); O2 (-), SOD (-). Aortic flow (AF)
      recovery, expressed as a percent of pre-arrest AF, was 76.7 +/- 11.7% in Group I,
      66.9 +/- 7.1% in Group II, 73.9 +/- 11.6% in Group III and 57.7 +/- 12.9% in
      Group IV (mean +/- SD). Differences in recovery between Group I vs III and Group
      III vs IV approached statistically significance (respectively, p < 0.01, p <
      0.05). The birefringence ratio (ATP value/air value) of the biopsy specimen was
      2.49 +/- 0.53 in Group I, 1.96 +/- 0.44 in Group II, 2.04 +/- 0.29 in Group III
      and 1.65 +/- 0.39 in Group IV (mean +/- SD). Difference between Group I and Group
      IV indicated statistically significance (p < 0.05). The birefringence ratio (X)
      had good correlation with the AF recovery ratio (Y): Y = 29.7 + 19.1X (R = 0.74).
      No statistical difference was seen from cytochemical assessment (myosin ATPase
      stain) in four groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478562
TI  - [A new skeletal muscle powered ventricle (SMPV) designed to work under
      physiologic preload].
AB  - To maximize pumping function the SMPV has been highly preloaded (over 30 mmHg);
      but the effects of pump size and configuration on the required preload have never
      been determined. A new double barrel dual chamber single layered (DCSL) SMPV
      having two SL small pumps in parallel was compared with a single chamber double
      layered small pump (SCDL). Stroke volume (SV) and stroke work (SW) were
      determined in acutely constructed SMPV using mongrel dog untrained latissimus
      dorsi: 10 DCSL and 12 SCDL. Under physiologic afterload (120 mmHg) and preload
      (15 mmHg), the DCSL displayed a significantly (p < 0.05) larger SV (9.9 +/- 1.2
      ml) and SW (0.84 +/- 0.15 x 10(6) ergs) than the SCDL pumps (SV = 6.9 +/- 0.6 ml,
      and SW = 0.55 +/- 0.07 x 10(6) ergs). The DCSL pumps, requiring less muscle mass
      for its construction, indicated better performance under physiologic pre and
      afterload conditions than SCDL pumps.

PMID- 8478563
TI  - [Surgical results in diabetics undergoing coronary artery bypass grafting].
AB  - Diabetes mellitus is a well-known risk factor in the patients undergoing coronary
      artery bypass grafting (CABG) and with increasing frequency diabetic patients are
      referred for CABG. From the fact that the arteriosclerosis is more diffuse and
      advanced in patients with diabetes, the presence of the diabetic state might be
      expected to be at risk for CABG. We retrospectively evaluated the surgical
      results in 91 patients with diabetes mellitus operated on from January, 1985, to
      June, 1991, compared with a control group of 339 patients during the same period.
      Compared with nondiabetic patients, diabetic patients had more extensive coronary
      artery disease and, therefore, received the more number of grafts per patient.
      However, no difference was noted in the incidence of operative mortality,
      morbidity and postoperative complication. The incidence of postoperative
      sternotomy infection was slightly higher, if not statistically significant, in
      the diabetic patients. Our study demonstrates that patients with diabetes
      mellitus can be operated on relatively safely.

PMID- 8478564
TI  - [A basic study on bradycardiac dysrhythmias following atrial surgery].
AB  - Various dysrhythmias often developing atrial surgery can be lethal, although the
      precise mechanism remains unknown. An experimental study was conducted to
      elucidate the influence of internodal tract injury and sinoatrial node (SAN)
      artery blockade on bradycardiac arrhythmias, using 40 adult mongrel dogs. Changes
      in rhythm, SAN tissue flow rate, SAN function and His bundle electrocardiogram
      were evaluated in those with complete division of the internodal tract (INT)
      and/or artery blockade under cardiopulmonary bypass. The results were as follows:
      1) Junctional rhythm (JR) or ectopic atrial rhythm (ER) occurred in 87.5% of
      those subjected to anterior INT (AINT) division+SAN artery blockade, whereas such
      arrhythmias developed in none of those with division of any single INT alone, and
      appeared in only 18% of those with SAN artery blockade alone; 2) The SAN tissue
      flow rate was reduced to 29 +/- 17% of the control level by AINT division+SAN
      artery blockade, while it was reduced to only 91 +/- 16%, 84 +/- 12% and 90 +/-
      18% by division of AINT, MINT and PINT, respectively, and 55 +/- 16% by SAN
      artery blockade (The former was significantly lower than the latter two (p <
      0.01)); 3) None of those with the SAN tissue flow rate of less than 10 Laser
      Doppler Flowmeter unit (LDF unit) by laser Doppler flowmeter output were capable
      of maintaining sinus rhythm (SR) with its minimum requirement that was assumed to
      be more than 10 LDF unit; 4) Immediately before shifting to JR, corrected sinus
      recovery time (CSRT) was elongated, indicating a hypofunction of the SAN; 5) The
      A-H interval was more significantly prolonged by AINT division than by either of
      the other two divisions (p < 0.01). Division of the AINT brought about
      prolongation of the A-H interval, and AINT division+SAN artery blockade caused a
      marked SAN hypofunction. It was inferred that preservation of both the AINT and
      the SAN artery should be of vital importance in preventing surgical bradycardiac
      arrhythmias.

PMID- 8478565
TI  - [Extravascular lung water in patients after cardiac surgery].
AB  - Extravascular lung water (EVLW) measured by a double indicator dilution method
      using thermal-dye indicator was evaluated in 204 patients after cardiac surgery
      during last 7 years. The measurement of EVLW was done at 2, 4, 8, 24 and 48 hours
      after extracorporeal circulation (ECC), EVLW showed no significant change except
      transient decrease at 4 hours after ECC, average of that was 7.62 +/- 3.58 ml/kg,
      EVLW of group I (MVR) and group III (AVR + MVR) were significantly higher than
      those of group II (AVR), group IV (noncyanotic congenital heart disease) and
      group V (A-C bypass). EVLW of 7 patients with postoperative pulmonary edema was
      14.47 +/- 4.44 ml/kg, and that was significantly higher than those of others
      (7.54 +/- 3.06 ml/kg). EVLW of the patients using bubble oxygenator (8.60 +/-
      3.90 ml/kg) was significantly higher than those of membrane oxygenator (7.15 +/-
      3.40 ml/kg). Postoperative EVLW correlated with mean pulmonary artery pressure
      (mPAP), mean left atrial pressure (LAP) and microvascular hydrostatic pressure
      (PMV), and showed inverse correlation with cardiac index (CI). But there was no
      correlation of EVLW with duration of ECC. In the preoperative parameter, EVLW
      correlated with age, mPAP, mean pulmonary wedge pressure (mPAWP), PMV, serum BUN
      and serum creatinine, and showed inverse correlation with CI, %VC, FEV%, PSP test
      and creatinine clearance. We concluded that the patients with mitral valve
      disease who have high mPAP and LAP, respiratory and renal dysfunction and old
      aged preoperatively showed upward trend of EVLW. In perioperative management,
      care must be taken in such patients and membrane oxygenator was thought useful
      for prevention of pulmonary edema.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478566
TI  - [Evaluation of the right ventricular function in postoperative esophageal cancer
      patients].
AB  - We evaluated the right ventricular function in pre- and post-operative esophageal
      cancer patients who had no complications after surgery by measurement of
      cardiopulmonary hemodynamics, right ventricular ejection fraction (RVEF) and
      right ventricular end-diastolic volume index (RVEDVI) using Swan-Ganz catheter
      and the thermodilution technique. The measurement of RVEF, RVEDVI and other
      cardiopulmonary hemodynamics were performed from the preoperative day to the 3rd
      postoperative day. The values of RVEF were stable about 40% from preoperative day
      to 3rd. RVEDVI was varied at 93.6 +/- 26.3 ml/m2 (preoperative day), 83.6 +/-
      15.0 ml/m2 (after surgery), 70.2 +/- 10.6 mg/m2 (morning of the 1st POD), 95.6 +/
      19.4 ml/m2 (evening of the 1st POD), 103.2 +/- 17.9 m/lm2 (morning of the 2nd
      POD), 1108.3 +/- 14.2 ml/m2 (evening of the 2nd POD) and 112.4 +/- 31.0 ml/m2
      (morning of the 3rd POD). The values of RVEDVI on the morning of the 1st POD were
      statistically lower than those at other times (p < 0.05). The values of RVEDVI
      were not correlated with mean pulmonary arterial pressure and pulmonary
      arteriolar resistance which were the afterload of the right ventricle. These data
      suggest that the right ventricular function of the patients who underwent
      esophagectomy with no complication does not change and that the changes of RVEDVI
      are influenced by the preload of the right ventricle.

PMID- 8478567
TI  - [Exercise test to predict postoperative complications in patients with impairment
      of pulmonary function].
AB  - We studied the prediction of postoperative complications in patients whose
      predicted postoperative FEV1.0% and/or %VC were below fifty. Preoperative
      exercise tests were performed in 88 cases mainly old patients of age or with
      impaired pulmonary function; 57 were lobectomies, 10 were bilobectomies and 21
      were pneumonectomies. Predicted postoperative FEV1.0% and/or %VC were below fifty
      in 29 cases consisting of 12 lobectomies, one bilobectomy and 16 pneumonectomies.
      Among these 29 patients, thirteen suffered postoperative complications (A group)
      and sixteen did not (B group). All five cases of operative death (death within 30
      days after operation) were included in the A group. The prediction of
      postoperative complications in cases of which pred. postope, FEV1.0% and %VC were
      fifty or over (C group) was also studied. The results were as follows; (1) The
      percentage of complications among A and B groups was higher than that among C
      group but no statistical difference could be found. (2) In the A group, the
      number of pred. postope. FEV1.0% and/or %VC had little correlation to
      complications. (3) Statistical differences between A and B group were found in
      submax VO2 (p < 0.05), VO2/VE at AT (p < 0.001) and VCO2/VE at submaximal
      exercise (p < 0.001). (4) Cardiac output ratio of maximal exercise to rest had
      marked correlation to complications (p < 0.001) in C group but had no correlation
      in the A and B groups. (5) The three items of A and B groups, submax VO2 < 500
      ml/min/m2, VO2/VE at AT < 40 ml/l and submax VCO2/VE < 25 ml/l, showed high
      correlation to operative death (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478568
TI  - [Surgical repair in hearts with univentricular atrioventricular connection and
      subaortic stenosis].
AB  - Between 1986 and 1990, fourteen patients with univentricular atrioventricular
      connection and subaortic stenosis underwent surgical treatment. The patients
      consisted of 7 cases of double inlet left ventricle, 4 with double inlet right
      ventricle, 3 with tricuspid atresia. The palliative operation was performed in 6
      infants ranging in age from 17 days to 6 months. Four patients with mild
      subaortic stenosis underwent pulmonary artery banding, in two patients this was
      combined with repair of coarctation of the aorta. Two patients with severe
      subaortic stenosis underwent the Norwood operation. There were no operative
      deaths. One of two patients who underwent the Fontan operation 2 years after the
      Norwood operation died later. The definitive operation was performed in 8
      children ranging in age from 4 to 11 years. Five of these 8 patients had previous
      pulmonary artery banding. Five children with double inlet left ventricle
      underwent septation combined with enlargement of bulboventricular foramen.
      Postoperatively all remained in sinus rhythm and had no pressure gradient between
      Aorta and left ventricle. A Fontan operation combined with a Damus operation was
      performed in 2 children, 1 of double inlet right ventricle and 1 of tricuspid
      atresia. In both cases, postoperative angiogram showed no pulmonary incompetence.
      One patient underwent enlargement of bulboventricular foramen after a Fontan
      operation. All survived later. Young infants and neonates with severe subaortic
      stenosis can survive by the Norwood operation. Infants with mild subaortic
      stenosis, although can survive by pulmonary artery banding, should be closely
      followed for the development of subaortic stenosis. For relief of subaortic
      stenosis, enlargement of bulboventricular foramen may be effective in
      septation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478569
TI  - [Surgical treatment with aortic valve homograft harvested from heart transplant
      recipients or donors].
AB  - From March 1988 to November 1991, 24 patients underwent aortic valve replacement
      or aortic root replacement with an aortic homograft harvested from a heart
      transplant recipient or donor that was not suitable for heart transplantation.
      Those patients were followed from 2 to 34 months (mean 12.6 months). The mean age
      was 44 years (range 19 to 77 years). The main lesion was aortic stenosis in 8
      patients, aortic regurgitation in eight, mixed lesion in eight, annulo-aortic
      ectasia in two, active prosthetic valve endocarditis in two, and recurrent LVOTO
      in one. Cardiac status before operation was NYHA class II in one patient, III in
      nineteen, IV in four. Aortic valve replacement was performed in 17 patients, and
      aortic root replacement in seven. There was no early or late death. No structural
      deterioration was found. Surgical technical error resulted in moderate aortic
      regurgitation in one patient and mild paravalvular leak in another patient
      immediately after operation. All patients except one were not given
      anticoagulants postoperatively, but the entire group was free from
      thromboembolism. All patients returned to NYHA class I. Most homografts in this
      series were cryopreserved without antibiotic sterilization immediately after
      harvest, but homograft valve endocarditis did not occur. The results in this
      series suggested that homografts from heart transplant recipients or donors were
      encouraging, but more long-term follow-up was required to be determined whether
      homografts from heart transplant recipients without antibiotic sterilization were
      superior to homografts prepared in ordinary manner.

PMID- 8478570
TI  - [Immunocytochemical investigations of occluded saphenous vein grafts].
AB  - Occluded saphenous vein aorto-coronary bypass grafts were investigated using two
      types of monoclonal antibodies, specific to either the muscle actin (HHF 35) or
      the macrophage (HAM 56). The early post operative occlusions of saphenous vein
      grafts were associated with the deposition of mural thrombi with little intimal
      proliferation. The late occlusions of saphenous vein grafts were associated with
      intimal fibrous proliferation without mural thrombus formation. Proliferated
      smooth muscle cells were a major constituent of intimal fibrous proliferation in
      both early and late occluded grafts. Macrophages were not detected in both
      groups. The proliferation of smooth muscle cells in the intima may play a role in
      the development of late occlusion, rather than the organizational process of
      accumulated mural thrombi.

PMID- 8478571
TI  - [Clinical application of recombinant human SOD for the protection of ischemia
      reperfusion injury during open heart surgery].
AB  - We have applied recombinant human superoxide dismutase (RH-SOD) to prevent
      ischemia reperfusion injury in the patients who received open heart surgery.
      Twenty-four patients were divided into 2 groups; group A had no treatment as
      control and group B received bolus injection of RH-SOD (35,000 IU/kg) into
      cardiopulmonary bypass 5 minutes before reperfusion. Arterial and coronary sinus
      blood was collected to measure chemiluminescence (ChL) value, SOD activity,
      lactate and pyruvate level, and several parameters of myocardial oxygen
      metabolism after reperfusion. Arterio-venous difference of ChL value showed the
      tendency of less ChL generation of the heart in group B compared with those in
      group A. But no other parameters showed significant difference between the two
      groups. Our data suggested that this way of the administration of RH-SOD failed
      to improve the myocardial protection during open heart surgery. Further
      investigation, such as dose response study, might be required to determine
      whether RH-SOD possess beneficial effects or not in the clinical setting.

PMID- 8478572
TI  - [Flow characteristics and responses to vasoactive drugs in canine gastroepiploic
      artery].
AB  - We studied flow characteristics and response to norepinephrine, Chlorpromazine
      and gastrin in 22 canine gastroepiploic artery (GEA) recirculation model. The GEA
      flow was obtained by a drip for a minute, opening the end of pedicle GEA.
      Furthermore, aortic flow and celiac arterial flow were measured by magnetic flow
      probe. The administration of chlorpromazine, vagostigumine, and gastrin induced a
      increase in both celiac arterial flow and pedicle GEA graft flow. Especially, the
      administration of gastrin induced significant increase in GEA flow and celiac
      arterial flow. Furthermore, adding norepinephrine step-wisely, the GEA flow
      increased remarkably, in spite of decrease of celiac arterial flow. This response
      was caused from difference in vascular resistance among celiac arterial branches.
      Therefore, the pedicle GEA graft has homogenous response as same as intact GEA
      that perfuses stomach, because its flow was affected by adrenergic and
      parasympathetic agent, alpha-blocker and gastric hormone.

PMID- 8478573
TI  - [Cardioprotective effect of cromakalim, a K+ channel opener, on isolated globally
      ischemic and reperfused rat hearts].
AB  - Examination was made of cardioprotective effect related to the ATP-sensitive K+
      (KATP) channel on isolated globally ischemic reperfused rat hearts using
      cromakalim, a putative ATP-sensitive K+ channel opener. The hearts were subjected
      to 20 min Langendorff perfusion with Krebs Henseleit Bicarbonate Buffer (KHBB)
      (70 cmH2O, 37 degrees C), followed by 30 min ischemia at 36 degrees C, and 30 min
      reperfusion with KHBB, with (cromakalim group) or without (control group)
      pretreatment by 10 microM cromakalim added to KHBB for 5 min prior to ischemia.
      Before ischemia, no significant change in heart rate (HR), left ventricular
      developed pressure (LVDP) or coronary flow (CF) by 10 microM cromakalim could be
      detected. The two groups were the same in CF during reperfusion, but recovery of
      HR and LVDP significantly improved in the cromakalim group. Creatine kinase (CK)
      leakage in the cromakalim group was significantly less than in the control group
      during reperfusion. Cromakalim is thus shown to reduce the myocardial injury
      during ischemia and reperfusion. Intracellular Ca2+ content of the cromakalim
      group appeared lower than that of the control group at 30 min of reperfusion. At
      5-30 min of reperfusion, in the cromakalim group, intracellular Ca2+ storage was
      prevented, leading to a good recovery of cardiac function, while in the control
      group, intracellular Ca2+ increased and recovery of cardiac function was poor.
      After pretreatment with 10 microM cromakalim, intracellular K+ content of the
      cromakalim group was significantly lower than in the control group before
      ischemia. At 5 min of reperfusion, intracellular K+ content of the cromakalim
      group was slightly less than that of the control group.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8478574
TI  - [Autotransplantation as optimal technique for recurrent malignant myxoma of left
      ventricle].
AB  - Application of autotransplantation for left ventricular recurrent malignant tumor
      which was considered to be originating from the posterior leaflet of mitral valve
      was presented. A patient was 29 year-old-female and underwent the resection of
      tumor. The tumor was resected en bloc with the mitral valve, and its histology
      was myxoma. But she was required reoperation two times because of the recurrence
      of the tumor unfortunately. The tumor was ultimately diagnosed as the
      myxofibrosarcoma with chondroid differentiation. At the time of the third
      surgery, the heart transplantation was thought to be only treatment for
      radicality. While sounding American counterparts on the possibility of the heart
      transplantation, her condition took a sudden turn for the worse. An
      autotransplantation technique was applied for the resection of the tumor
      emergently. As a result, it was impossible to completely resect the tumor because
      of severe invasion to the left ventricle, and the patient died suddenly on the
      75th day after the operation due to fetal arrhythmia. Through this case, heart
      transplantation should be considered for such a case, but autotransplantation
      technique allowed to be a life-prolonging in this case. We believe that this
      technique which will be obtained the excellent operative field could be used for
      repair of complex cardiac anomalies and rupture of left ventricle and so on.

PMID- 8478575
TI  - [A case of an intra-pericardial bronchogenic cyst requiring an emergency
      operation].
AB  - The patient was a 36-year-old male, who complained of anterior chest pain and
      dyspnea. A chest X-ray showed a cardiac enlargement and widened tracheal carina.
      A cardiac echography showed an intra-pericardial simple cyst which was fixed and
      did not move with cardiac motion. CT showed a cyst, measuring to 10 cm between
      the left atrium and vertebra. An angiography revealed that the left atrium and
      right main pulmonary artery were compressed in the anterior direction. Because
      his symptoms deteriorated suddenly, an emergency operation was performed. The
      intrapericardium was explored through the right postero-lateral thoracotomy, and
      the cyst was resected. A microscopic examination revealed that the cystic wall
      was lined with ciliated columnar epithelium and contained cartilage and bronchial
      gland. Review of the literatures indicated that the most of the intra-pericardial
      bronchogenic cysts were revealed as cardiac enlargement by chest X-ray film, and
      that the cyst compressing the atrium or main pulmonary artery should be resected
      without delay, because of a risk of sudden death or cardiac failure.

PMID- 8478576
TI  - [A case of solitary plasmacytoma that originated in a rib].
AB  - A 52-year-old woman was admitted to our hospital with the chief complaint of left
      anterior chest pain. A chest X-ray showed a tumor shadow in the left 4th rib. No
      abnormalities were detected in peripheral blood and aspirated bone marrow
      samples. The tumor was surgically resected with the involved bone, the
      intercostal muscle and the parietal pleura. The resected specimen contained a 3 x
      6 x 3 cm lesion, and histological investigation of the tumor revealed a
      plasmacytoma of the rib. It relapsed as a multiple myeloma within two months
      after surgery. Chemotherapy was administered and the bone lesions were observed
      to disappear. We believe that the best way to treat solitary plasmacytoma is to
      first resect the solitary tumor, and then to add cobalt irradiation and
      chemotherapy after surgery.

PMID- 8478577
TI  - [A case of thymic cyst & thymolipoma with ocular myasthenia gravis].
AB  - A 65-year-old woman with ocular myasthenia gravis (MG) and thymic tumor underwent
      expanded thymectomy. Histologically the tumor was thymic cyst and thymolipoma. To
      our knowledge, there has been no case reported in medical literatures, which is
      thymic cyst & thymolipoma with ocular MG. This case suggests some effect of
      steroid therapy.

PMID- 8478578
TI  - [A case of isolated congenital left ventricular diverticulum].
AB  - Isolated congenital diverticulum of the left ventricle is a rare malformation. A
      2-year-old boy was admitted to our hospital for evaluation of heart murmur. The
      echocardiogram and MRI showed an extra cavity communicating with the left
      ventricle. The diagnosis was made by LV angiography. He was diagnosed as having
      congenital isolated diverticulum of the left ventricle without other cardiac
      anomalies. He received resection of the diverticulum under cardiopulmonary
      bypass. Histological examination showed a fibrous diverticulum. Postoperative
      clinical course was uneventful. We can expect good prognosis after resection of
      the congenital diverticulum of the left ventricle, if necessary under
      cardiopulmonary bypass.

PMID- 8478579
TI  - [A case report of coronary sinus atrial septal defect].
AB  - We experienced an uncommon case of coronary sinus atrial septal defect, which was
      not associated with a left superior vena cava (LSVC). A 29-year-old woman, who
      experienced fatigue during moderate exercises, was found to have the atrial
      septal defect located in the lower part of the septum by echocardiography
      preoperatively. On operation, the coronary sinus ASD was diagnosed. The ostium of
      coronary sinus was located in the left atrium. This type is classified as
      partially unroofed coronary sinus without LSVC. Our case, in the absence of the
      LSVC, was repaired by simple closure of the coronary sinus ASD, so the coronary
      veins drained into the left atrium. Postoperative course was uneventful.

PMID- 8478580
TI  - [Report of a case of the anomalous origin of the right coronary artery from the
      pulmonary artery with atrial fibrillation and bradycardia].
AB  - A 62-year-old man who was referred to implantation of pacemaker on account of
      severe bradycardia revealed anomalous origin of the right coronary artery from
      the pulmonary artery on aortography. The aortic root cineangiogram demonstrated
      single left coronary artery arising from the aorta with retrograde filling of the
      right coronary artery (RCA) which drained into the main pulmonary artery. Chest X
      ray revealed marked cardiomegaly and treadmill exercise test shows positive at
      stage 2 of the Bruce protocol. Operation was performed under cardiopulmonary
      bypass. Although we tried to transplant the RCA to the aorta, the arterial wall
      was very fragile and could't bear arterial pressure. Therefore the RCA was
      ligated at its origin and disconnected from the pulmonary artery. Post operative
      course was uncomplicated and the patient was discharged without any symptoms.

PMID- 8478581
TI  - [A case report of successfully corrected 26 days old infant of tetralogy of
      Fallot with absent pulmonary valve].
AB  - A female infant weighing 2.4 kg had respiratory distress at birth. She became
      dyspneic and hypercapnic and required intubation with assisted ventilation 11
      days after birth. Because cardiac failure and respiratory failure did not
      improve, she underwent total correction at 26 days old, which consisted of VSD
      closure, right ventricular outflow tract reconstruction with valved porcine
      pericardial roll (VPR) and plication of both pulmonary arteries. She was weaned
      from the ventilator 11 days after operation and discharged at 12 weeks of age.
      One year later, reoperation was successfully performed for the replacement of the
      stenotic VPR with a transannular patch.

PMID- 8478582
TI  - [Extirpation of intra-atrial tumor thrombus of renal cell carcinoma by means of
      extracorporeal circulation--report of a case].
AB  - We report a case of renal cell carcinoma with a tumor thrombus extending into the
      right atrium, which was successfully removed with the use of extracorporeal
      circulation. A 68-year-old male presented with a one month history of abdominal
      distension. CT-scanning, selective renal angiography, vena cavography and
      echocardiography revealed a left renal tumor with a tumor thrombus extending into
      the right atrium through the inferior vena cava. Left nephrectomy and removal of
      the intra-atrial tumor thrombus were performed using extracorporeal circulation.
      Preoperative laboratory results showed elevation of the total bilirubin (17.0
      mg/dl) due to congestion of the liver which was caused by obstruction of hepatic
      vein with the tumor thrombus. Postoperatively, the total bilirubin gradually
      decreased to 11.9 mg/dl on the third day, but increased to 22.2 mg/dl on the 9th
      day. So plasma exchange was performed on the 10th, 11th and 12th days, and the
      total bilirubin decreased to the normal range. The patient was discharged on the
      50th day. For renal cell carcinoma with a tumor thrombus extending into the right
      atrium, effectiveness of operation using extracorporeal circulation and
      subsequent prognosis are discussed.

PMID- 8478583
TI  - [Two cases of intrapulmonary teratoma].
AB  - We encountered two unusual cases of intrapulmonary teratoma, one in a 31-year-old
      female and the other in a 15-year-old female. The chief complaint of both
      patients was fever, and in both a consolidation was detected in the left upper
      lobe using routine radiography. We performed left upper lobectomy for the former
      patient and segmentectomy of the left lingual segment for the latter. Neither
      tumor communicated with the mediastinum. Histological examination revealed a
      pulmonary teratoma containing no thymic tissue in both. Intrapulmonary teratoma
      has been reported to be extremely rare, and only 27 cases including these two
      have been reported in the literature.

PMID- 8478584
TI  - [A case of myocardial revascularization in a patient after renal
      transplantation].
AB  - A 46-year-old woman after renal transplantation 10 years ago underwent CABG using
      the right internal thoracic artery to LAD, the left internal thoracic artery to
      Circumflex and the right gastroepiploic artery to RCA, with the diagnosis of
      unstable angina (triple vessels disease) after failed PTCA. The postoperative
      course has been uneventful. To our knowledge, this is the first case who
      underwent GABG after renal transplantation in Japan.

PMID- 8478585
TI  - [A combined operation of aortic valve replacement and bullectomy for aortic valve
      stenosis and giant bulla].
AB  - A 61-year-old male with aortic valve stenosis and giant bulla, whose respiratory
      function was very poor, successfully underwent a combined operation of aortic
      valve replacement and bullectomy. Firstly aortic valve replacement was performed
      under cardio-pulmonary bypass, and after coming off bypass, giant bulla was
      resected via median sternotomy. Postoperative respiratory function was improved
      remarkably (VC: per-op 1.89 l, post-op 2.53 l, FEV1.0: pre-op 0.74 l, post-op
      1.13 l) and also his clinical symptom improved from Hugh-Jones IV. to I.
      postoperatively.

PMID- 8478586
TI  - [A case of acute postinfarction mitral regurgitation and cardiogenic shock caused
      by a total rupture of the papillary muscle].
AB  - We report a case of mitral regurgitation caused by a total rupture of the
      posterior papillary muscle that had occurred after acute myocardial infarction. A
      72-year-old woman was transferred to our hospital for cardiogenic shock.
      Echocardiogram revealed massive mitral regurgitation and prolapse of posterior
      mitral leaflet presumably due to a rupture of a papillary muscle. Cardiac
      catheterization demonstrated a total occlusion in the segment 2 of the right
      coronary artery. She had developed progressively increasing heart failure even
      though the patient had received a successful PTCA for a total occlusion of the
      right coronary artery. She underwent an emergency mitral valve replacement with
      preservation of the posterior leaflet using a SJM prosthetic valve.
      Intraoperative findings were confirmative of total rupture of the posterior
      papillary muscle. A postoperative course was uneventful. This case is the seventh
      case which has been reported as the successful operation of a total rupture of
      the papillary muscle in Japan.

PMID- 8478587
TI  - [Emergency operation for complete papillary muscle rupture after myocardial
      infarction--a case report of 81-year-old patient].
AB  - Mitral regurgitation due to complete rupture of the papillary muscles after
      myocardial infarction has a very poor prognosis, even if diagnosed and operated
      on at an early phase. Recently, we performed an emergency operation for mitral
      regurgitation due to complete papillary muscle rupture after myocardial
      infarction in an 81-year-old patient. This is probably the oldest case in Japan.
      Operation revealed complete rupture of the posterior papillary muscle, and valve
      replacement with a Carpentier-Edwards bioprosthesis was performed.

PMID- 8478588
TI  - [A case report--successful surgical treatment of prosthetic aortic valve
      detachment with enlargement of sinuses of Valsalva caused by the recurrence of
      aortitis].
AB  - A successful operation on a 49-year-old female with aortitis syndrome associated
      with prosthetic aortic valve detachment was reported. Aortic valve replacement
      using SJM 25A had been performed for aortic regurgitation caused by aortitis.
      Though her C-reactive protein (CRP) was kept between (+/-) and (2+) with
      prednisolone administered, general fatigue suddenly appeared 4 years after the
      first operation. The blood sedimentation rate was 65 mm/30 min and CRP was (4+),
      and the echocardiography showed abnormal movement of the prosthetic valve with
      perivalvular leakage on admission. Aortography showed the valve detachment and
      abnormal movement due to enlargement of sinuses of Valsalva, one of which was
      transformed as a diverticulum and projected into Left ventricular cavity with
      moderate leakage. After the inflammation was well controlled, she was operated
      upon. Dilatation of sinuses, perforation of intima around the prosthetic valve
      were recognized as left ventricular-aortic discontinuity, but ascending aorta was
      not enlarged. So the prosthetic valve was suspended below coronary ostia with
      transmural mattress sutures from right atrium. Postoperative course was
      uneventful. The postoperative aortography revealed only trivial perivalvular
      leakage without abnormal movement of the valve. This was a rare case of the valve
      detachment in the aortitis patient.

PMID- 8478589
TI  - Histidine-rich glycoprotein: an abundant plasma protein in search of a function.

PMID- 8478590
TI  - Pathogenetic mechanisms in cystic fibrosis lung disease: a paradigm for
      inflammatory airways disease.

PMID- 8478591
TI  - Academic medicine: the social consciousness of the profession.

PMID- 8478592
TI  - The genetics of the Gilles de la Tourette syndrome: a review.
AB  - The Gilles de la Tourette syndrome (GTS) is a hereditary, neuropsychiatric
      neurobehavioral disorder with childhood onset that is characterized by motor and
      vocal tics that may vary from relatively mild to very severe. The exact
      pathogenesis is still unknown. Following anecdotal reports of familial
      occurrence, systematic family studies have been carried out since 1980 to
      establish the mode of inheritance and ultimately to map and clone the
      susceptibility gene(s). Currently, as a result of combined North American,
      English, and Dutch studies, the most accepted genetic model is an autosomal
      dominant pattern of inheritance with incomplete penetrance and a variable
      expression. The objective of linkage studies is to "link" a particular DNA
      sequence (with known chromosomal localization) with the disease in all affected
      family members. Essential for these gene mapping studies is a clear and rigorous
      definition of the phenotype. Such studies are vastly more difficult if the
      disease phenotype is ambiguous, proper subject assignment being clouded by
      incomplete penetrance, cases mild enough to escape detection, or genetically
      unrelated but highly associated traits. Indeed, because of just these features,
      the initial optimism about the "well-defined and easy-to-objectivate" phenotype
      of GTS has gradually been tempered. The tics vary in frequency and severity, are
      frequently suppressed during examination, or might go unnoticed when associated
      behavioral symptoms like disturbed impulse control, obsessive-compulsive disorder
      and attention deficit disorder with hyperkinesia (among others) dominate the
      clinical picture. Whether these associated behavioral symptoms are a part of the
      phenotype remains to be established.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478593
TI  - Familial association of high levels of histidine-rich glycoprotein and
      plasminogen activator inhibitor-1 with venous thromboembolism.
AB  - High levels of histidine-rich glycoprotein (HRGP) and plasminogen activator
      inhibitor-1 (PAI-1) have been claimed to contribute to the hypofibrinolytic state
      observed in patients with venous thrombosis. These abnormalities were detected,
      respectively, in eight and 10 members of a family from which four of seven
      members with both abnormalities had venous thromboembolism. Binding of tissue
      plasminogen activator (t-PA) by PAI-1 may induce hypofibrinolysis. To determine
      whether plasminogen binding by HRGP may influence plasminogen activation, we
      studied the fibrinolytic activity of members of this family cohort with a system
      that detects modifications in plasmin generation by proteins interfering with the
      binding of plasminogen to fibrin. Plasminogen activation was performed by adding
      plasma to fibrin surfaces to which t-PA had been previously bound in the presence
      of 40 mg/ml bovine serum albumin and 20 mumol/L of the lysine analog trans-4
      (aminomethyl)-cyclohexane carboxylic acid to prevent nonspecific binding and
      thereby the inhibitory effect of elevated PAI-1 levels. The generation of plasmin
      as a function of time was detected (1) by photometric analysis with a chromogenic
      substrate highly selective for plasmin and (2) by measuring the binding and
      activation of plasminogen at the fibrin surface with radiolabeled plasminogen.
      The amount of plasmin generated by plasma from patients having high levels of
      HRGP (160% to 280%) was similar to that of a control group having normal levels
      of HRGP (100% +/- 22%). Similar results were obtained with a plasma artificially
      depleted in HRGP and supplemented with various amounts of this protein. No
      correlation between HRGP level and t-PA-mediated plasminogen activation was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478594
TI  - Effect of chronic potassium depletion on muscle bioenergetics in rats.
AB  - To test the hypothesis of muscle bioenergetic impairment in potassium depletion,
      chronic potassium-depleted rats and pair-fed control rats were studied with
      phosphorus 31 nuclear magnetic resonance measurements of leg muscle intracellular
      pH, phosphocreatine, inorganic phosphate, and adenosine triphosphate at rest and
      during maximal nontetanic stimulation, 48 hours after a swimming test. The
      potassium-depleted rats exhibited a significant hypokalemia, a metabolic
      extracellular alkalosis, and an intracellular acidosis. Their physical endurance
      was markedly reduced, and they displayed higher plasma creatine kinase levels
      than the control group. However, the phosphocreatine/inorganic phosphate ratio,
      which is a measure of the energy reserve of the cell, was similar in both groups
      at rest and during electrical stimulation and subsequent recovery. Resting muscle
      glycogen and relative intracellular acidification during stimulation did not
      differ in the two groups, arguing against an impairment of anaerobic metabolism
      in potassium depletion. These results indicate that the energy availability of
      muscle cell is unchanged during potassium deficiency.

PMID- 8478595
TI  - Staphylococcus aureus binding to cardiac endothelial cells is partly mediated by
      a 130 kilodalton glycoprotein.
AB  - Binding of Staphylococcus aureus to vascular endothelial cells may be an
      initiating event in the pathogenesis of endovascular infection, particularly
      infective endocarditis. In this study a competition assay between labeled and
      unlabeled bacteria was used to identify potential S. aureus-binding determinants
      on the surface of cultured porcine aortic valve endothelial cells. Concanavalin A
      inhibited 30% to 40% of the specific binding of S. aureus to membrane-associated
      components. Concanavalin A affinity chromatography of radiolabeled cell-surface
      proteins, followed by isolation of S. aureus-binding proteins, identified a
      130,000-molecular-weight cell surface protein that may function as an endothelial
      cell S. aureus receptor. These data suggest that specific binding of S. aureus to
      cardiac valve endothelial cells is mediated in part by a 130 kd mannose
      containing glycoprotein.

PMID- 8478596
TI  - Biochemical and immunochemical localization of GTP-binding proteins in the rat
      ileal enterocyte.
AB  - This study characterizes the distribution of various guanosine triphosphate
      binding proteins (G proteins) in rat intestinal epithelial membranes. Enriched
      basolateral membranes were prepared from isolated enterocytes through
      differential density centrifugation; apical membranes were prepared with a
      chaotropic agent. Enrichment and purity of the membrane fractions were assessed
      by various biochemical markers. G proteins were identified by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis after adenosine diphosphate
      ribosylation in the presence of pertussis or cholera toxins. Western blotting was
      performed with the use of highly specific antibodies against the following
      subunits: alpha Gs, alpha G1(1 or 2), alpha G 1(3), alpha Go, alpha Gz, and beta
      subunits. Adenosine diphosphate ribosylation catalyzed by cholera toxins revealed
      two major substrates of molecular weights 47 and 43 kd in only the crude and
      basolateral fractions. The reaction catalyzed by pertussis toxin revealed a 41 kd
      substrate in the crude and basolateral fractions and a 40 kd substrate in the
      apical fraction. Immunoblotting confirmed the presence of alpha Gs, alpha G1(1 or
      2), and alpha G1(3) but failed to identify alpha Go or alpha Gz subunits in the
      basolateral fraction; none of these subunits were identified in the apical
      fraction. Beta subunits were identified in both apical and basolateral fractions.
      These findings suggest selective sorting of the G proteins to regional domains in
      the plasma membrane of intestinal epithelial cells. The presence of previously
      unidentified G proteins is also suggested.

PMID- 8478597
TI  - Lactic acid changes during and after hypothermic cardiopulmonary bypass in
      infants.
AB  - Infants undergoing open-heart surgery with hypothermic cardiopulmonary bypass
      experience markedly elevated lactate and glucose levels. Reports in infants less
      than 10 kg show the elevated lactate to be progressive during the operative
      period. The pathogenesis of the hyperglycemia is not clear but may be caused by
      excess glucose administration, inadequate insulin response, or glucose regulatory
      hormone levels of glucagon, cortisol, and growth hormone. The purpose of this
      study is to confirm these findings and to investigate their pathogenesis. Serial
      blood samples were taken preoperatively, intraoperatively, and postoperatively
      during hypothermic cardiopulmonary bypass in nine infants of less than 10 kg.
      Samples were analyzed for levels of lactate, glucose, and regulatory hormones
      insulin, growth hormone, glucagon, and cortisol. Our study did not show a
      progressive accumulation of lactate. The elevated lactate level appears to come
      from the pump prime solution. The hyperglycemia is also from the pump prime
      solution, and there do not appear to be elevated levels of regulatory hormones
      intraoperatively. Insulin response during hypothermia is blunted; however, on
      rewarming the patient in the immediate postoperative period, a brisk insulin
      response is seen. The changes in levels of lactate and glucose and the regulatory
      hormones return to baseline at 24 hours with no further significant changes in
      the next 48 hours.

PMID- 8478598
TI  - Comparative study of the adhesion of sickle cells and malarial-parasitized red
      cells to cultured endothelium.
AB  - Increased adhesion of red cells to vascular endothelium has been implicated in
      the pathogenesis of falciparum malaria and sickle cell disease. We have carried
      out a comparative study of the adhesiveness of normal (AA), sickle trait (AS),
      and homozygous sickle (SS) red cells, with and without parasitization by
      Plasmodium falciparum, with an in vitro flow system. Adhesion of nonparasitized
      red cells to cultured human umbilical vein endothelial cells (either
      glutaraldehyde fixed or untreated) was strongly dependent on the wall shear
      stress. Many AA and SS cells adhered at low stress (0.02 Pa), but far fewer did
      so when the stress was increased to a physiologic level (0.1 Pa). Compared with
      AA cells, SS adhered in greater number (about threefold) and required greater
      stress (about two-fold) for their subsequent removal. In contrast, the efficiency
      of adhesion of AA cells parasitized by Plasmodium falciparum was essentially
      constant up to 0.1 Pa, where it was about 1000 times greater than the efficiency
      for nonparasitized cells. The stress required to remove parasitized cells was
      about 6 times that for controls. When parasites were grown in SS cells, fewer
      cells adhered than when parasites were grown in AA cells. However, the adhesion
      of malarial-parasitised AS cells was only slightly less than that of parasitized
      AA cells, so that modulation of adhesion is unlikely to underlie the protective
      effect of sickle gene in malaria. Adhesion of red cells to endothelium may
      promote blockage of microvessels, and the interaction of parasitized cells
      appears strong enough to directly cause ischemic complications in falciparum
      malaria.

PMID- 8478599
TI  - Relevance of findings may be limited to rat model.

PMID- 8478600
TI  - Glycogen loss in rat muscles during locomotion on different inclines.
AB  - Running downhill causes structural damage in deep slow-twitch extensor muscles of
      the limbs. Both mechanical and metabolic hypotheses have been proposed to explain
      the damage. The purpose of this study was to use measurements of glycogen loss in
      the muscles and metabolic rates of rats running on the level and up and down 16
      degrees inclines at 26 m min-1 to try to distinguish between these hypotheses.
      Glycogen loss in the soleus and medial head to the triceps brachii muscles during
      running on the three inclines was proportional to whole-animal oxygen
      consumption, indicating that there were no unusual metabolic demands on these
      muscles during the downhill exercise. The minimum area of these muscles showing
      glycogen loss was smaller during downhill than during uphill running. Average
      forces in the muscles are similar during locomotion on different inclines at the
      same speed, suggesting that stresses in the active motor units were greater
      during downhill running. Thus, the results are more consistent with a mechanical
      than with a metabolic etiology for the muscle injury resulting from downhill
      running.

PMID- 8478601
TI  - Contractile properties of the striated adductor muscle in the bay scallop
      Argopecten irradians at several temperatures.
AB  - The isometric and isotonic contractile properties of the cross-striated adductor
      muscle of the bay scallop (Argopecten irradians) were measured in vitro at 10, 15
      and 20 degrees C. The length at which twitch force was maximal as a function of
      the closed length in situ (L0/Lcl) averaged 1.38 +/- 0.01 (mean +/- S.E.M.) at 10
      degrees C. This length is very close to the typical length at maximum gape during
      natural swimming at this temperature. Passive force was very low over the range
      of lengths measured here; at L0, passive force averaged approximately 0.08 N cm
      2, or only 0.5% of the corresponding peak twitch force. The mean peak isometric
      twitch force (Ptw,max) at 10 degrees C was 21.43 +/- 0.68 N cm-2 (S.E.M.), and
      the ratio of peak twitch force to tetanic force (Ptw,max/P0) averaged 0.89 +/-
      0.01. Temperature did not affect either twitch force (Ptw), once fatigue was
      taken into account, or Ptw,max/P0. In contrast, the time-related properties of
      twitch contractions (latent period, tL; time to peak tension, tPtw; and time from
      peak tension to half-relaxation, t50%R) were positively modified by temperature
      at all temperatures measured (Q10 > 1.8). All three properties were more
      temperature-sensitive over the range 10-15 degrees C than over the range 15-20
      degrees C. The force-velocity relationships of the striated adductor muscle were
      fitted to the hyperbolic-linear (HYP-LIN) equation. The force-velocity curves of
      the striated adductor muscle of the scallop were strongly influenced by
      temperature. Maximal velocity at zero force (Vmax), and therefore maximal power
      output, increased significantly with temperature. The Q10 over the temperature
      range 10-15 degrees C (1.42) was significantly lower than that over the range 15
      20 degrees C (2.41). The shape of the force-velocity relationship, assessed
      through comparisons of the power ratio (Wmax/VmaxP0), was not influenced by
      temperature.

PMID- 8478602
TI  - Acetate, butyrate and proline uptake in the caecum and colon of prairie voles
      (Microtus ochrogaster).
AB  - We have measured unidirectional uptake (not transmural flux) of acetate, butyrate
      and proline by everted sleeves of intact tissue from the jejunum, caecum,
      proximal colon and distal colon of prairie voles (Microtus ochrogaster). There
      was active (i.e. Na(+)-dependent) transport of L-proline in the jejunum, but we
      found no evidence for it in any region of the hindgut (i.e. the caecum, proximal
      colon and distal colon). Uptake of acetate was carrier-mediated in all three
      regions of the hindgut, but the Jmax and apparent Km (< or = 1.5 mmol l-1) were
      low, and uptake was primarily passive over the concentration range 10-50 mmol l
      1, which spanned measured acetate levels in the caecum and proximal colon. At 100
      mmol l-1, acetate uptake (nmol min-1 cm-2) was higher (P < 0.001) in distal colon
      (359 +/- 33) than in the proximal colon (225 +/- 17) and caecum (150 +/- 5) (mean
      +/- S.E., N = 8). Uptakes summed over the length of each region were also higher
      (P < 0.001) in the distal colon at 100 mmol l-1, but not at low concentrations
      (0.1 mmol l-1). Uptakes normalized to diffusion coefficients were higher for
      butyrate than acetate and were lowest for L-glucose (which is absorbed passively
      via an aqueous pathway) in all regions, indicating that uptake of the short-chain
      fatty acids involves solubilization in the lipid bilayer of the apical membrane.
      The short-chain fatty acids absorbed from the hindgut of the vole were equivalent
      to 22% of standard metabolic rate or 15% of resting (but fed) metabolic rate.

PMID- 8478603
TI  - Lateral line stimuli can override vision to determine sunfish strike trajectory.

PMID- 8478604
TI  - Development of connections by axons growing through injured spinal cord of
      neonatal opossum in culture.
AB  - The ability of neurites to grow through a lesion and form synaptic connections
      has been analyzed in a developing mammalian spinal cord in vitro. After isolation
      of the entire central nervous system (CNS) of the newly born South American
      opossum (Monodelphis domestica) the spinal cord was crushed. Outgrowth through
      and beyond the lesion was observed in living preparations for 2-5 days by
      staining axons with carbocyanine dyes. The structure of the acute crush and the
      growing neurites was examined by light and electron microscopy in tissue fixed
      immediately after the crush had been made. All axons had been severed and the
      site was filled with debris and amorphous vesicular structures. By 3 days after
      injury, numerous labelled neurites had grown into the lesion; by 4 days, many had
      extended several millimetres beyond it. At this time normal axonal profiles were
      apparent in electron micrographs of the crush site. Although fewer axons grew
      across the lesion than had been severed by the crush, the amplitudes of compound
      action potential volleys conducted across the crush in injured preparations were
      comparable with those recorded from uninjured spinal cords. Physiological
      experiments made with raised concentrations of extracellular magnesium in the
      culture fluid indicated that growing axons had formed synaptic connections. Thus,
      delayed major peaks of the response were abolished while the small component
      corresponding to through conduction remained unaffected by magnesium. These
      experiments demonstrate the development of synaptic interactions by the growing
      neurites and confirm the far greater powers of repair in neonatal mammals
      compared to adults. They set the stage for comparing molecular mechanisms
      involved in development and regeneration of the mammalian CNS.

PMID- 8478605
TI  - Suppression of cell motility and metastasis by transfection with human motility
      related protein (MRP-1/CD9) DNA.
AB  - Previously we showed that motility-related protein (MRP-1) is an antigen
      recognized by monoclonal antibody (mAb) M31-15 inhibiting cell motility and that
      the sequence of MRP-1 coincides with that of CD9. In the present study, plasmid
      was constructed in which human MRP-1/CD9 cDNA is expressed under the control of
      the Abelson murine leukemia virus promoter sequence. The expression plasmid for
      MRP-1/CD9 was introduced into Chinese hamster ovary cells, human lung
      adenocarcinoma cell line MAC10 (MRP-1 positive), and human myeloma cell line
      ARH77 (MRP-1 negative). All of the MRP-1/CD9 (over)expressing clones obtained
      from these transfected cells showed suppressed cell motility (penetration and
      phagokinetic track assays) depending on the degree of expression of MRP-1/CD9.
      Overexpression of MRP-1/CD9 by MAC10 cells resulted in the suppression of cell
      motility (maximally 73%) associated with considerable inhibition of the cell
      growth (maximally 48%). However, the inhibition of the growth of MAC10 cells by
      mAb M31-15 was < 17% at an antibody concentration of 1-5 micrograms/ml, which
      inhibits cell motility by > 90%. These results suggest that MRP-1/CD9 directly
      regulates cell motility and may also affect cell growth. Effects on metastasis by
      the expression of MRP-1 CD9 were investigated with mouse melanoma BL6 cells
      BALB/c nu/nu mouse system. Metastatic potential of all transformants expressing
      MRP-1/CD9 was lower than that of parent BL6 cells.

PMID- 8478606
TI  - Glucocorticoid-mediated control of the activation and clonal deletion of
      peripheral T cells in vivo.
AB  - Poly- and oligoclonal T cell stimuli like anti-CD3 epsilon monoclonal antibody or
      Staphylococcus aureus enterotoxin B (SEB), injected at doses that per se are not
      lethal, provoke acute death within less than 24 h, provided that endogenous
      glucocorticoids (GC) are depleted by adrenalectomy or by injection of saturating
      amounts of the GC receptor antagonist RU-38486 (mifepristone). Pharmacological
      doses of the GC agonist dexamethasone (DEX) alter the in vivo response of splenic
      V beta 8+ T cells to SEB, thus impeding the expansion of such cells and causing
      their rapid (3 d) clonal deletion. In contrast, coadministration of RU-38486
      counteracts a SEB-induced early (12 h) reduction of V beta 8+CD4+ and V beta
      8+CD8+ spleen cells. In vivo T cell stimulation by injection of bacterial
      superantigen induces a rapid (peak at 90-120 min) increase in corticosterone
      serum levels, suggesting that endogenous GC might control early T cell
      activation. Accordingly, kinetic studies revealed that RU-38486 has to be
      administered within 2 h after superantigen administration to exert its lethal
      effect. Similarly, exogenous GC must be injected during this critical phase (2 h)
      to rescue animals from acute death induced by coinjection of SEB and D
      galactosamine (GalN). Adrenalectomy, injection of RU-38486 and priming with GalN
      per se provoke the programmed death of peripheral CD4+ and CD8+ T cells. Thus,
      three manipulations that sensitize mice for the lethal effect of T cell
      stimulation also exert a proapoptotic effect on peripheral T cells. In synthesis,
      endogenous and exogenous GC regulate T cell responses and determine the
      propensity of peripheral T cells to undergo apoptosis.

PMID- 8478607
TI  - Differential T cell receptor photoaffinity labeling among H-2Kd restricted
      cytotoxic T lymphocyte clones specific for a photoreactive peptide derivative.
      Labeling of the alpha-chain correlates with J alpha segment usage.
AB  - Using a direct binding assay based on photoaffinity labeling, we studied the
      interaction of T cell receptor (TCR) with a Kd-bound photoreactive peptide
      derivative on living cells. The Kd-restricted Plasmodium berghei circumsporozoite
      (PbCS) peptide 253-260 (YIPSAEKI) was reacted NH2-terminally with biotin and at
      the TCR contact residue Lys259 with photoreactive iodo, 4-azido salicylic acid
      (IASA) to make biotin-YIPSAEK(IASA)I. Cytotoxic T lymphocyte (CTL) clones derived
      from mice immunized with this derivative recognized this conjugate, but not a
      related one lacking the IASA group nor the parental PbCS peptide. The clones were
      Kd restricted. Recognition experiments with variant conjugates, lacking
      substituents from IASA, revealed a diverse fine specificity pattern and indicated
      that this group interacted directly with the TCR. The TCR of four clones could be
      photoaffinity labeled by biotin-YIPSAEK(125IASA)I. This labeling was dependent on
      the conjugates binding to the Kd molecule and was selective for the TCR alpha (2
      clones) or beta chain (1 clone), or was common for both chains (1 clone). TCR
      sequence analysis showed a preferential usage of J alpha TA28 containing alpha
      chains that were paired with V beta 1 expressing beta chains. The TCR that were
      photoaffinity labeled at the alpha chain expressed these J alpha and V beta
      segments. The tryptophan encoded by the J alpha TA28 segment is rarely found in
      other J alpha segments. Moreover, we show that the IASA group interacts
      preferentially with tryptophan in aqueous solution. We thus propose that for
      these CTL clones, labeling of the alpha chain occurs via the J alpha-encoded
      tryptophan residue.

PMID- 8478608
TI  - Malaria circumsporozoite protein binds to heparan sulfate proteoglycans
      associated with the surface membrane of hepatocytes.
AB  - During feeding by infected mosquitoes, malaria sporozoites are injected into the
      host's bloodstream and enter hepatocytes within minutes. The remarkable target
      cell specificity of this parasite may be explained by the presence of receptors
      for the region II-plus of the circumsporozoite protein (CS) on the basolateral
      domain of the plasma membrane of hepatocytes. We have now identified these
      receptors as heparan sulfate proteoglycans (HSPG). The binding of CS to the
      receptors is abolished by heparitinase treatment, indicating that the recognition
      of region II-plus is via the glycosaminoglycan chains. We have purified and
      partially characterized the CS-binding HSPGs from HepG2 cells. They have a
      molecular weight of 400,000-700,000, are tightly associated with the plasma
      membrane, and are released from the cell surface by very mild trypsinization, a
      property which the CS receptors share with the syndecan family of proteoglycans.

PMID- 8478609
TI  - Antigen acquisition by dendritic cells: intestinal dendritic cells acquire
      antigen administered orally and can prime naive T cells in vivo.
AB  - In the rat, mesenteric lymphadenectomy allows collection of dendritic cells (DC)
      derived from the small intestine after cannulation of the thoracic duct. We
      prepared rats this way and administered antigens by oral feeding or
      intraintestinal injection. DC enriched from the thoracic duct lymph collected
      over the first 24 h from these animals are able to stimulate sensitized T cells
      in vitro and to prime popliteal lymph node CD4+ T cells after footpad injection,
      while B and T cells from the same thoracic duct lymph are inert in priming. 500
      or less DC pulsed in vitro with antigen can prime T cells in vivo, whereas 100
      times more B cells or macrophages pulsed in vitro are quite inert. 1 mg of
      ovalbumin administered orally is sufficient to load DC for in vivo priming of T
      cells. Antigen could not be detected directly in DC but was present in
      macrophages in the lamina propria. Direct presentation of antigen by DC to T
      cells was demonstrated by injecting F1 recipients with parental DC and showing
      restriction of T cell sensitization to the major histocompatibility complex of
      the injected DC. Antigen-bearing DC do not induce a detectable primary antibody
      response but a small secondary antibody response can be detected after a boosting
      injection. These results show that acquisition of antigens by DC in the intestine
      is very similar to what occurs in vitro or in other tissues, suggesting that
      there may be no special difference in antigen handling at mucosal surfaces. One
      implication of these results is that hypotheses designed to explain oral
      tolerance must take into account the presence of immunostimulatory, antigen
      bearing DC in animals that have received oral antigens.

PMID- 8478610
TI  - Regulatory role of OX22high T cells in mercury-induced autoimmunity in the brown
      Norway rat.
AB  - The monoclonal antibody OX22 defines a functional split within CD4+ T cells in
      the rat, with OX22high cells mainly producing interleukin 2 (IL-2) and interferon
      gamma and responsible for delayed-type hypersensitivity responses, and OX22low
      cells mainly producing IL-4 and -5 and responsible for providing B cell help.
      There are reciprocal interactions between OX22high and OX22low cells, and it has
      been suggested that the OX22low subset has a role in the prevention of
      autoimmunity. We have used OX22 in vivo to define the role of these subsets in
      mercuric chloride-induced autoimmunity in the Brown Norway rat. In this model,
      there is polyclonal B cell activation and animals develop widespread tissue
      injury. Treatment of thymectomized animals with OX22 led to a profound reduction
      in the number of OX22high T cells in the peripheral blood. OX22-treated animals
      consistently developed more severe tissue injury than controls given an
      irrelevant antibody of the same isotype. Control animals pretreated with broad
      spectrum antimicrobial drugs showed milder tissue injury, but this protective
      effect of antimicrobials was lost in OX22-treated animals. Transfer of naive T
      cells to OX22-treated animals provided protection, but if T cells were depleted
      in vitro of OX22high cells before transfer, this effect was lost. These data
      provide evidence for a protective immunoregulatory role for OX22high T cells in
      mercuric chloride-induced autoimmunity.

PMID- 8478611
TI  - Restricted kappa chain expression in early ontogeny: biased utilization of V
      kappa exons and preferential V kappa-J kappa recombinations.
AB  - To determine the extent of kappa chain diversity in the preimmune repertoire
      early in development, kappa cDNA libraries were analyzed from 15-d old fetal
      omentum, 18-d-old fetal liver, and 3-wk old bone marrow. An anchored polymerase
      chain reaction approach was used to avoid bias for particular V kappa families.
      From the sequence analysis of 27 bone marrow clones, 10 different families and 20
      unique V kappa genes were identified. In contrast, the V kappa expression in the
      fetus is highly restricted and clearly differs from the broader distribution see
      in 3-wk-old bone marrow. Although several V kappa families were represented in
      the fetal library including V kappa 9, V kappa 10, V kappa 4,5, V kappa 8, and V
      kappa 1, one or two members of individual families were observed repeatedly. The
      fetal liver and omentum libraries were found to be largely overlapping. Given the
      V kappa families/exons identified in the fetal sequences, the mechanism of kappa
      rearrangements in the early repertoire appears to occur predominantly by
      inversion. Importantly, the fetal repertoire was further restricted by dominant V
      kappa-J kappa combinations such as V kappa 4,5-J kappa 5, V kappa 9-J kappa 4,
      and V kappa 10-J kappa 1. Since in some cases independent rearrangements could be
      established, the results indicate a bias for particular V kappa-J kappa joins.
      The results also suggest that clonal expansion/selection in the fetal repertoire
      takes place after light chain rearrangement as opposed to at the pre-B cell level
      in the bone marrow. The restriction observed in kappa light chain expression
      together with known restrictions in gene usage and junctional diversity at the
      heavy chain level indicate a remarkably conserved fetal repertoire.

PMID- 8478612
TI  - Nucleosome: a major immunogen for pathogenic autoantibody-inducing T cells of
      lupus.
AB  - Only a fraction (12%) of 268 "autoreactive" T cell clones derived from lupus
      prone mice can selectively induce the production of pathogenic anti-DNA
      autoantibodies in vitro and accelerate the development of lupus nephritis when
      transferred in vivo. The CDR3 loops of T cell receptor beta chains expressed by
      these pathogenic T helper (Th) clones contain a recurrent motif of anionic
      residues suggesting that they are selected by autoantigens with cationic
      residues. Herein, we found that approximately 50% of these pathogenic Th clones
      were specific for nucleosomal antigens, but none of them responded to cationic
      idiopeptides shared by variable regions of pathogenic anti-DNA autoantibodies.
      Nucleosomes did not stimulate the T cells as a nonspecific mitogen or
      superantigen. Only the pathogenic Th cells of lupus responded to nucleosomal
      antigens that were processed and presented via the major histocompatibility class
      II pathway. Although the presentation of purified mononucleosomes to the Th
      clones could be blocked by inhibitors of endosomal proteases, neither of the two
      components of the nucleosomes--free DNA or histones by themselves--could
      stimulate the Th clones. Thus critical peptide epitopes for the Th cells were
      probably protected during uptake and processing of the nucleosome particle as a
      whole. The nucleosome-specific Th clones preferentially augmented the production
      of IgG autoantibodies to histone-DNA complex in vitro. In vivo, nucleosome
      specific, CD4+ T cells were not detectable in normal mice, but they were found in
      the spleens of lupus-prone mice as early as 1 mo of age, long before other
      autoimmune manifestations. Immunization of young, preautoimmune lupus mice with
      nucleosomes augmented the production of autoantibodies and markedly accelerated
      the development of severe glomerulonephritis. Previously, crude preparations
      containing nucleosomes were shown by others to have polyclonal mitogenic activity
      for B cells from normal as well as lupus mice. Identification here of pure
      mononucleosome as a lupus-specific immunogen for the Th cells that selectively
      help the pathogenic anti-DNA autoantibody producing B cells of lupus could lead
      to the design of specific therapy against this pathogenic autoimmune response.

PMID- 8478613
TI  - Extinction of the tumor necrosis factor locus, and of genes encoding the
      lipopolysaccharide signaling pathway.
AB  - The tumor necrosis factor (TNF-alpha or TNF) gene is activated by both
      lipopolysaccharide (LPS) and cycloheximide in RAW 264.7 macrophages, whereas
      neither stimulus activates the gene in 3T3 fibroblasts. Moreover, the pattern of
      CG methylation within the TNF gene is readily distinguishable in DNA derived from
      cells of these two types. These findings would suggest that the TNF gene has been
      rendered inaccessible to transcription in the 3T3 cell environment. When RAW
      264.7 cells are fused with 3T3 cells, an immortal pentaploid hybrid results. In
      the hybrid cell, all three TNF genes contributed by the RAW 264.7 cell parent
      become highly methylated according to the pattern observed in the 3T3 cell
      parent. Permanently transfected chloramphenicol acetyl transferase (CAT) reporter
      constructs, bearing 2.2 kb of upstream sequence (including the entire TNF
      promoter and 5'-untranslated region [UTR]) as well as 1.0 kb of downstream
      sequence (including the entire TNF 3'-UTR and termination sequence), are
      accessible in both RAW 264.7 cells and 3T3 cells, but are silenced in transition
      from the RAW 264.7 cell to the hybrid cell environment. Moreover, the endotoxin
      signaling pathway is abrogated, as assessed by transient transfection of hybrid
      cells with LPS-responsive CAT reporter constructs. It would therefore appear that
      the fusion of 3T3 cells and RAW 264.7 cells activates a system that silences the
      TNF gene, as well as the LPS signaling pathway. This system may operate to
      determine TNF gene accessibility and LPS responsiveness in the course of cell
      differentiation. The DNA sequences targeted within the TNF gene are included in
      the CAT reporter construct; therefore, the silencing element has been
      circumscribed to a region of DNA 3.2 kb in length.

PMID- 8478614
TI  - Enhancement of experimental metastasis by tumor necrosis factor.
AB  - The influence of endogenous and exogenous tumor necrosis factor (TNF) on
      metastasis was investigated in an experimental fibrosarcoma metastasis model. A
      single intraperitoneal injection of recombinant human (rh) TNF or recombinant
      mouse (rm) TNF into mice 5 h before intravenous inoculation of methylcholanthrene
      induced fibrosarcoma cells (CFS1) induced a significant enhancement of the number
      of metastases in the lung. Dose responses of rmTNF and rhTNF demonstrated a
      stronger metastasis-augmenting effect by rmTNF compared with rhTNF. This effect
      was time dependent, as administration of rmTNF 5 h before or 1 h but not 24 h
      after tumor cell inoculation caused an increase of tumor cell colony formation on
      the lung surface, suggesting an influence of TNF on the vascular adhesion and
      diapedesis of tumor cells. Since tumor-bearing mice showed an enhanced ability to
      produce TNF after endotoxin injection compared to control mice, tumor-bearing
      mice were treated with anti-mTNF antibodies. Neutralization of endogenous tumor
      induced TNF led to a significant decrease of the number of pulmonary metastases.
      Histological analysis of micrometastases in the lung on day 5 by silver staining
      of proteins associated with nucleolar organizer regions revealed more metastatic
      foci and augmented proliferative activity of the tumor cells after rmTNF
      pretreatment of mice. However, no direct effect of rmTNF on the proliferation
      rate of tumor cells was seen in vitro. These findings suggest that low doses of
      endogenous TNF or administered TNF during cytokine therapy might enhance the
      metastatic potential of circulating tumor cells.

PMID- 8478615
TI  - Selective immunosuppression by administration of major histocompatibility complex
      class II-binding peptides. II. Preventive inhibition of primary and secondary in
      vivo antibody responses.
AB  - The self-mouse lysozyme peptide corresponding to residues 46-62 (ML46-62) binds
      to the major histocompatibility complex (MHC) class II molecules I-A(k) and it
      selectively inhibits, when coinjected with antigen, priming of I-A(k)-restricted,
      antigen-specific T cells. We demonstrate that administration of ML46-62 also
      inhibits in vivo antibody responses induced by I-A(k)-restricted T helper cells.
      ML46-62 is able to prevent the primary anti-hen egg white lysozyme (HEL) antibody
      response induced by the entire HEL molecule in B10.A(4R) mice, expressing only I
      A(k) molecules, but not in mice of H-2d haplotype. ML46-62 also strongly
      decreases, in B10.A(4R) mice, the antibody response to ribonuclease A, a protein
      antigen unrelated to the MHC blocker, indicating that MHC blockade is the
      mechanism leading to inhibition of antibody response. This is further supported
      by the concomitant decrease, in vivo, of complex formation between immunodominant
      HEL peptides and I-A(k) molecules, preventing I-A(k)-restricted T cell induction.
      Administration of ML46-62 after antigen priming does not affect ongoing antibody
      responses, as expected from MHC blockade. A single injection of ML46-62 at the
      time of protein antigen priming precludes not only the primary, but also the
      secondary antibody response to a subsequent challenge with soluble protein, even
      when the challenge is performed several months after priming. Coinjection of
      antigen and MHC antagonist inhibits production of all antibody isotypes equally
      well, suggesting that MHC class II blockade affects both Th1- and Th2-type T
      helper cells. Therefore, these results indicate that administration of MHC class
      II-binding peptides can efficiently and selectively prevent the induction of T
      cell-dependent primary and secondary in vivo antibody responses by blocking
      antigen presentation to class II-restricted T helper cells.

PMID- 8478616
TI  - Positive selection of CD8+ T cells induced by major histocompatibility complex
      binding peptides in fetal thymic organ culture.
AB  - We have used an in vitro system to study the effects of major histocompatibility
      complex class I binding peptides on thymic development. Fetal thymus lobes from
      mice deficient in the class I light chain (beta 2 microglobulin or beta 2 M-/-)
      were cultured for 10 d in vitro, during which time T cell precursors develop into
      mature T cells. In these organ cultures, as in the adult or neonatal beta 2 M-/-
      thymus, CD8+ mature T cells did not develop, demonstrating that the mature T
      cells seen during early murine thymic development are the result of the positive
      selection process. To these cultures we added various class I binding peptides
      with or without a source of exogenous beta 2M. CD8+ T cells developed to various
      degrees only in the presence of beta 2M and peptides. Using peptide mixtures of
      differing complexity, we showed that the efficiency of this process is dependent
      more on peptide complexity than on peptide concentration. These data argue for a
      specific role for peptides in the process of positive selection. Furthermore,
      this culture system should be useful in identifying peptides that can promote
      positive selection of cells expressing a specific T cell receptor (TCR) in TCR
      transgenic mice.

PMID- 8478617
TI  - Physical and functional association of p56lck with Fc gamma RIIIA (CD16) in
      natural killer cells.
AB  - The transmembrane receptor for immunoglobulin G immune complexes on natural
      killer (NK) cells and macrophages, Fc gamma RIIIA (CD16), mediates cellular
      activation through a tyrosine kinase-dependent pathway. We show that Fc gamma
      RIII crosslinking results in activation of the src-related kinase p56lck in NK
      cells and demonstrate a physical association of p56lck with Fc gamma RIIIA in
      immunoprecipitates from NK cells obtained using anti-Fc gamma RIII antibodies or
      immune complexes. Our studies show that the zeta chain, the signal transducing
      subunit of Fc gamma RIIIA and of T cell receptor, associates with p56lck and, in
      NK cells, is a substrate for this kinase. Such direct association of p56lck with
      the zeta subunit as confirmed by demonstrating the interaction in heterologous
      cells transfected with cDNA expressing p56lck and zeta. Our findings demonstrate
      both functional and physical association of p56lck with Fc gamma RIIIA, through
      direct interaction of the kinase with the zeta and/or the gamma signal transducer
      subunits of the receptor. These data suggest a possible mechanism by which
      activation via Fc gamma RIIIA occurs.

PMID- 8478618
TI  - Bacterial superantigens mediate T cell deletions in the mouse severe combined
      immunodeficiency-human liver/thymus model.
AB  - The ability to analyze T cell receptor (TCR) thymic repertoire shaping in humans
      by self and foreign ligands is hampered by the lack of suitable models. We
      recently documented that the mouse severe combined immunodeficiency (SCID)-human
      fetal liver/thymus model recapitulates the TCR V beta gene repertoire of human
      thymocytes. Here, we show that an exogenous superantigen, staphylococcal
      enterotoxin B, administered to such mice induces clonal deletions in both CD4+8-
      and CD8+4- cells involving the same human V beta clones that are selected in
      vitro by this toxin. This model, therefore, may allow comprehensive studies into
      the effects of microbial and other agents on human T cell thymic selection
      processes in a biologically relevant setting.

PMID- 8478619
TI  - Oligoclonal expansion of major histocompatibility complex class I-restricted
      cytolytic T lymphocytes during a primary immune response in vivo: direct
      monitoring by flow cytometry and polymerase chain reaction.
AB  - Previous T cell receptor (TCR) sequence analysis of a panel of 23 H-2Kd
      restricted cytotoxic T lymphocyte (CTL) clones recognizing the decapeptide HLA
      CW3 170-179 revealed a striking conservation of TCR structure, in that all clones
      examined used V beta 10 and J alpha pHDS58 segments. We show here that the
      primary response in vivo after intraperitoneal injection of DBA/2 mice with HLA
      CW3 expressing transfectants of syngeneic P815 (H-2d) tumor cells is
      characterized by a dramatic expansion of CD8+ V beta 10+ CTL in the peritoneal
      cavity and draining (mesenteric) lymph node, as well as in peripheral blood.
      Additional analysis of TCR on HLA-CW3 immune populations by flow cytometry and
      polymerase chain reaction further indicates that the vast majority of responding
      CD8+ cells express restricted V alpha domains, a dominant J alpha segment
      (pHDS58), and a conserved CDR3 length for both alpha and beta chains. This novel
      system provides a unique opportunity to directly monitor an oligoclonal primary
      antigen specific immune response in vivo at the single cell level independently
      of functional assays.

PMID- 8478620
TI  - Prevention of autoimmune diabetes in non-obese diabetic mice by treatment with a
      class II major histocompatibility complex-blocking peptide.
AB  - The role of antigen presentation as a possible mechanism underlying major
      histocompatibility complex (MHC) association of autoimmune disease has been
      studied in non-obese diabetic (NOD) mice. By screening for inhibition of antigen
      presentation to NOD T cell hybridoma, we have selected a synthetic peptide,
      yTYTVHAAHAYTYt (small letters denote D amino acids), that efficiently blocks
      antigen presentation by the NOD class II MHC molecule A alpha g7A beta g7 (Ag7)
      in vitro. The inhibition is MHC selective, in that it does not affect antigen
      presentation by the E(d) and E(k) molecules, and has only a marginal effect on
      presentation by the A(d) molecule. This peptide also inhibits the priming for Ag7
      restricted T cell responses in vivo, and prevents the spontaneous development of
      diabetes in female NOD mice, when administered chronically from 3 wk of age on.
      Chronic treatment with a control peptide, KMKMVHAAHAKMKM, that fails to bind to
      Ag7 has no effect on the disease. These data indicate that antigen presentation
      by the Ag7 molecule plays a pivotal role in the induction of autoimmune diabetes.
      Furthermore, the results demonstrate that interference with antigen presentation
      by a class II molecule can prevent the onset of spontaneous autoimmune disease
      associated with the same molecule.

PMID- 8478621
TI  - Enhanced susceptibility of blood monocytes from patients with pulmonary
      tuberculosis to productive infection with human immunodeficiency virus type 1.
AB  - Blood monocytes from patients with active pulmonary tuberculosis and age-matched
      healthy purified protein derivative-reactive donors were infected with human
      immunodeficiency virus type 1 (HIV-1)JR-FL in vitro to assess their
      susceptibility to productive infection by HIV-1. HIV-1 p24 levels (enzyme-linked
      immunosorbent assay) in supernatants of infected cells from patients with
      tuberculosis, albeit variable, were significantly higher at days 10-20 of
      culture; the maximum levels of p24 antigen were greater in supernatants of HIV-1
      infected monocytes from patients than maximum levels for controls (p < 0.05). The
      maximum increment in p24 levels for patients also exceeded that for controls (p <
      0.05). Entry of HIV-1 and/or initiation of reverse transcription, measured by
      polymerase chain reaction using HIV-1 R/U5 primer pairs, was variable and low in
      infected monocytes from both patients and controls, and did not correlate with
      HIV-1 p24 levels. The frequency of infected cells as assessed by endpoint
      dilution viral cultures was similar for both groups. Therefore, blood monocytes
      from patients with active tuberculosis can develop a highly productive infection
      with HIV-1 that does not appear to be due to enhanced HIV entry or higher
      frequency of infected cells. The enhanced susceptibility may result directly from
      activation of monocytes by exposure to Mycobacterium tuberculosis and its
      products in situ.

PMID- 8478622
TI  - Clonal anergy blocks in vivo growth of mature T cells and can be reversed in the
      absence of antigen.
AB  - Experiments in various models have indicated that immunological tolerance can
      result from the physical elimination (deletion) of reactive lymphocytes as well
      as from anergy. We have previously reported that mature CD4-CD8+ T cells when
      confronted with their antigen can proliferate extensively but are finally
      eliminated or become intrinsically anergic such that remaining cells are
      refractory to stimulation by any T cell receptor ligands, even in the presence of
      exogenous interleukin 2. Here we show that in vivo the anergy can be reversed in
      the absence of antigen, such that the cells are then able to proliferate
      extensively in vivo to a new challenge with the antigen in question.

PMID- 8478623
TI  - Synthesis of porphinatoirons having an alkyl amphiphilic chain and their O2
      binding properties in lipid bilayers.
AB  - Synthesis and characterization of two amphiphilic tetraphenylporphinatoiron
      complexes having a glycerophosphocholine or an alkyl phosphoserine group are
      described. These porphinatoiron(II) complexes with 1-dodecyl-2-methyl-imidazole
      (L2MIm) were efficiently embedded in the bilayer of a phospholipid vesicle due to
      their high compatibility with lipids, similar to the heme substituted with four
      alkyl amphiphilic chains (lipid-heme). Oxygen transporting ability of the
      phospholipid vesicles embedded with hemes were similar to that of hemoglobin (Hb)
      in red blood cells.

PMID- 8478624
TI  - Temperature dependent coordination effects in base-off adenosyl and
      methylcobalamin by X-ray edge spectroscopy.
AB  - Examination of the role of base-off cobalamin species (where the 5,6
      dimethylbenzimidazole ligand coordinated to cobalt is detached by protonation of
      the imidazole nitrogen) in differentiation between homolytic and heterolytic
      cobalt-carbon bond cleavage mechanisms is a primary step in better understanding
      B12-dependent enzyme catalysis. X-ray absorption edge spectroscopy provides the
      first direct structural evidence of five-coordination in base-off adenosyl- and
      base-off methylcobalamin complexes at room temperature. Integration of 1s-3d pre
      edge transitions of the base-off species reveals the dependence of coordination
      number on temperature. Gradual increases in 1s-3d transition intensities, as the
      temperature is increased from 180 K to 298 K, reflect a change in the
      coordination number from six (where a water molecule is presumed to occupy the
      coordination site vacated by the 5,6-dimethylbenzimidazole ligand) to primarily
      five-coordinate. Base-off configurations that strengthen the Co-C bond may be
      both decreasing the tendency for homolytic cleavage while increasing the tendency
      for hetrolytic Co(I) B12 formation.

PMID- 8478625
TI  - The binding of a complex cobalt ruthenium polyamine by deoxyribonucleic acid and
      a lipopolysaccharide: a model for a novel class of drugs.
AB  - In this paper we discuss the following: 1. Synthesis of
      [Co(H3CsarNHCH2pyRu(NH3)5)] (PF6)5, (CoRu). 2. Interaction of CoRu with calf
      thymus DNA and with lipopolysaccharide from Escherichia coli C (LPS) has been
      estimated using the absorption of the complex at 242 and 420 nm. 3. DNA and LPS
      increase the rate of fall of absorption at 420 nm due to autooxidation of the
      complex. 4. The fall in absorption of CoRu(II) at 420 nm can be used to give an
      approximate measure of binding to DNA and to LPS. 5. Both macromolecules are
      aggregated by CoRu at high concentrations and the cation and macromolecule
      complex can be removed by low speed centrifugation. 6. The DNA-CoRu complex can
      also be removed by high speed centrifugation when the cation concentration is too
      low to cause aggregation (20 microM CoRu/155 microM DNA-P). Absorption of
      redissolved complex at 420 nm is restored by reduction with ascorbic acid. 7. At
      saturation the ratio of mole CoRu bound/mole DNA-P is 0.16.

PMID- 8478626
TI  - Heterotopic ossification following primary total knee arthroplasty.
AB  - Heterotopic ossification is a rare complication following primary total knee
      arthroplasty and may be symptomatic if massive enough. The authors
      retrospectively reviewed 158 primary total knee arthroplasties from 1985 to 1989
      and found 6 cases (3.8%) of heterotopic ossification. Patients were graded before
      and after surgery according to the Hospital for Special Surgery total knee
      arthroplasty score and their histories were reviewed for the presence of
      recognized risk factors for heterotopic ossification and whether a manipulation
      under anesthesia was performed. This report describes the incidence of,
      appearance of, and clinical risk factors for heterotopic ossification following
      primary total knee arthroplasty in this series. A radiographic grading system is
      proposed.

PMID- 8478627
TI  - A new radiographic method for detection of tibial component migration in total
      knee arthroplasty.
AB  - In a prospective study the accuracy of a new radiographic method, Matched
      Indicators for Radiographic Assessment (MIRA), used to assess tibial component
      migration in total knee arthroplasty was evaluated. Radiopaque markers were
      placed in the tibial component and the tibial metaphysis in a standardized way so
      that four vertical distances could be measured on standard radiographs.
      Subsidence during the first postoperative year was measured both with this new
      method and with roentgen stereophotogrammetric analysis in 27 Freeman-Samuelson
      total knee arthroplasties. The error of measurement of MIRA was determined using
      the known error of roentgen stereophotogrammetric analysis. The new method was
      found to be promising with an accuracy of 1 mm, and the correlation between MIRA
      and roentgen stereophotogrammetric analysis was high when subsidence exceeded
      this value. Therefore, subsidence of clinical importance should be detected with
      MIRA. The method is simple and well suited for routine follow-up examination of
      large patient materials.

PMID- 8478628
TI  - Reinfusion of whole blood after revision surgery for infected total hip and knee
      arthroplasties.
AB  - Because of its proven effectiveness in reducing the need for banked blood
      transfusions following total joint arthroplasty, the indications for
      postoperative blood retrieval were expanded to include seven cases of infected
      total knee or hip arthroplasties where a one-stage exchange procedure was
      performed. Each joint had been aspirated after surgery and had positive cultures
      but no gross pus at the time of revision surgery. Each of the operations included
      debridement with reimplantation of a cementless prosthesis under cover of
      intravenous antibiotics for 48 hours followed by oral treatment until discharge.
      Antibiotic-soaked morselized bone graft was used in all patients to restore
      deficient nonstructural bone. Wound drainage blood was retrieved and reinfused
      during the first 8 hours after surgery, averaging 958 cc. Banked blood usage
      averaged 2.4 U (88% homologous) with an average blood loss of 1,974 cc. One
      patient experienced shaking chills during a second reinfusion of 600 cc of blood
      without stoppage of the transfusion. Wound hematoma occurred in one patient but
      did not require surgical evacuation. No patient developed evidence of septicemia.

PMID- 8478629
TI  - Biomechanical analysis of a distally interlocked press-fit femoral total hip
      prosthesis.
AB  - This study was undertaken to compare the stability of a distally interlocked
      femoral prosthesis to a standard press-fit implant (Cementless Spotorno, Protek
      Co., Toronto, Canada). Five human femora were studied with each acting as its own
      control. All were tested in the locked mode followed by unlocked testing modes.
      The MTS 858 Biomaterials Testing System was used to test the implanted femoral
      stems under both pure torsional and pure axial loading. Distal interlocking
      increased the torsional stability by 320% (locked 4.05 Nm/degree; unlocked 1.25
      Nm/degree) (P < .01) and the axial stability by 230% (locked 1,236.26 N/mm;
      unlocked 527.44 N/mm) (P < .01). the use of temporary distal interlock in cases
      where the initial stability of a press-fit implant is suboptimal should allow for
      improved biological fixation by minimizing micromotion at the stem-bone
      interface.

PMID- 8478630
TI  - Factors affecting deep vein thrombosis rate following total knee arthroplasty
      under epidural anesthesia.
AB  - A retrospective review was performed of 448 consecutive patients undergoing
      primary, unilateral, bicondylar, and cemented total knee arthroplasty under
      epidural anesthesia by three surgeons to determine factors contributing to deep
      vein thrombosis rate. All had venography on the fourth or fifth postoperative day
      and received aspirin and elastic stockings as their only thromboprophylaxis. The
      overall deep vein thrombosis rate was 41% (2% had proximal clots). The rate of
      deep vein thrombosis was not related to obesity, history of heart disease,
      hypertension, prior malignancy, smoking, diagnosis of osteoarthritis, duration of
      surgery, type of local anesthetic used, or the use of postoperative epidural
      analgesia. The rate of deep vein thrombosis varied significantly between
      surgeons: one surgeon had an overall deep vein thrombosis rate of 58% (proximal
      thrombi, 4%) whereas the other two surgeons had a deep vein thrombosis rate of
      35% (proximal clot thrombi, 1%). A number of possible mechanisms to explain the
      variation in deep vein thrombosis rates between surgeons are provided.

PMID- 8478631
TI  - Femoral head autograft and contralateral total hip arthroplasty.
AB  - Femoral head autograft from a primary total hip arthroplasty side was used to
      supplement deficient bone stock on the contralateral revision side. Five patients
      (10 operations) were treated; all had excellent clinical results and full
      incorporation of the graft. The methods of treatment was found to be suitable in
      selected patients.

PMID- 8478632
TI  - Does the irrigation bag become infected in total hip arthroplasty?

PMID- 8478633
TI  - Mechanical evaluation of cadaver retrieval specimens of cementless bone-ingrown
      total hip arthroplasty femoral components.
AB  - Early retrieval prior to gross failure of implants can provide valuable
      information for critical issues in total joint arthroplasty. To evaluate fixation
      of the femoral component in total hip arthroplasty, two femoral specimens--one
      Mallory-Head (Biomet, Warsaw, IN) specimen and one AML (DePuy, Warsaw, IN)
      specimen--were retrieved after 2-8 years of successful use in active patients.
      Radiographs were made and evaluated for trabecular apposition to the porous
      coated areas of the stem, then torsional and axial load tests were performed for
      each specimen to determine micromotion and displacement at the bone-implant
      interface. Both implants had radiographic signs of bone ingrowth. No permanent
      rotational displacement was found in either specimen during torsional load
      testing, but rotational and axial micromotion were found in both. These findings
      indicate excellent fixation of implant to bone, and no slippage at the bone
      implant interface. The Mallory-Head implant had much greater elastic displacement
      than the AML, and histological examination showed cancellous bone ingrowth into
      the porous-coated portion of the Mallory-Head stem. The AML implant, which
      withstood much higher torsional loads, was found upon histological evaluation to
      have dense cortical-cancellous bone ingrowth. Strength of attachment of the metal
      implant to bone was good in both specimens, and neither had slippage at this
      interface. Differences in mechanical behavior can be attributed to the type of
      bone supporting the implant. The Mallory-Head implant had a severely worn
      titanium femoral head, so the joint was full of particulate metal
      debris.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478634
TI  - Autopsy studies of the bone-cement interface in well-fixed cemented total hip
      arthroplasties.
AB  - Although knowledge of the clinical status of the implant is important, only
      instrumented mechanical testing of retrieved specimens provides quantitative
      assessment of implant fixation. This measurement allows placement of the implant
      along a continuum of loosening and is the foundation for the interpretation of
      subsequent findings. Analysis of implants that have been proven to be well fixed
      by instrumented testing reveals significant differences in the initial events in
      the loosening of femoral and acetabular components. Although radiolucencies were
      observed around all of these well-fixed femoral and acetabular components, the
      histology (and therefore the etiology) of the radiolucency is different and
      variable on the two sides of the articulation. The majority of femoral
      radiolucencies appear to be due to age and stress-related remodeling while
      particulate-induced bone resorption plays an important role in acetabular
      radiolucencies. A finding common to both sides of the articulation in these
      stable components, however, was intimate contact of bone with cement without any
      interposed soft tissue even after 17.5 years of service. Primary incompatibility
      and/or failure of the cement was not identified as a factor in initiating either
      femoral or acetabular component loosening. These studies document the long-term
      compatibility of bone with cement in bulk form. Improvements in cemented femoral
      component fixation should focus on stem design and cementing technique. Long-term
      acetabular component fixation can be improved by reduction or elimination of
      polyethylene wear and optimization of the bone-implant interface.

PMID- 8478635
TI  - Bone ingrowth into a porous-coated total shoulder component retrieved postmortem.
AB  - An uncemented porous-coated humeral component, which functioned in vivo for over
      2 1/2 years, was retrieved postmortem and examined histologically. Radiographs of
      the specimen revealed close approximation to the endosteal cortex medially and
      laterally. Apposition was limited or absent anteriorly and posteriorly. The
      overall extent of bone ingrowth was approximately 11% of the available pore
      volume with over 95% of ingrowth occurring in the medial and lateral quadrants.
      Bone ingrowth was limited anteriorly and posteriorly to regions in which spot
      welds were identified radiographically. There were no loose beads or coating
      failure observed.

PMID- 8478636
TI  - A quantitative study of bone and soft tissues in cementless porous-coated
      acetabular components retrieved at autopsy.
AB  - The authors examined 11 cementless acetabular components of one design retrieved
      at autopsy and made observations concerning tissue ingrowth and local tissue
      reaction, radiographic-histologic correlation, and the distribution of
      particulate wear debris. The cups were hemispherical in design with a
      commercially pure titanium fiber-metal porous coating. All of the prostheses were
      implanted with screws. The implants were in place for an average of 41 months
      (range, 5 weeks to 75 months). Ten of the cups had bone ingrowth, with the
      average volume fraction being 12.1 +/- 8.2%. There were no differences in the
      amount of bone ingrowth when the component was partitioned into nine anatomic
      regions. However, there was more bone adjacent to screw holes through which
      screws were inserted compared with empty screw holes. As the number of
      radiolucent zones increased on the clinical radiographs less bone ingrowth was
      observed histologically. The amount of metal debris in holes with screws and
      holes without screws was similar. In the longest term cases, polyethylene debris
      was noted within empty screw holes, but no granulomatous reactions or osteolytic
      processes were observed.

PMID- 8478637
TI  - Choline acetyltransferase and calcitonin gene-related peptide immunoreactivity in
      motoneurons after different types of nerve injury.
AB  - This study examined changes in choline acetyltransferase and calcitonin gene
      related peptide immunoreactivity in hypoglossal motoneurons of rats at 1, 3, 7,
      20 and 50 days after three types of nerve injury: crush, transection and
      resection. Peripheral reinnervation was assayed by retrograde labelling of the
      motoneurons after injections of the exogenous protein, horseradish peroxidase,
      into the tongue. Maximal reduction in choline acetyltransferase immunostaining
      occurred at seven days after nerve damage and the amount of the decrease was
      related to the nature of the injury. The recovery of choline acetyltransferase to
      normal levels was related to the timing of reinnervation after nerve crush, but
      not after transection or resection injuries. In contrast to these findings, a
      rapid increase in calcitonin gene-related peptide immunoreactivity preceded the
      decrease in choline acetyltransferase levels. A striking increase in calcitonin
      gene-related peptide immunoreactivity was observed at one day postoperative and
      was maximal at three days postoperatively for all injuries. Later changes in
      calcitonin gene-related peptide levels were dependent on the type injury.
      Increased calcitonin gene-related peptide staining persisted to 20 days after
      nerve crush. After nerve transection or resection, calcitonin gene-related
      peptide immunoreactivity decreased to basal levels at seven days postoperatively.
      This declination was followed by a second rise in calcitonin gene-related peptide
      immunolabeling at 20 days for nerve transection or 50 days after resection.
      Nearly complete reinnervation was established by 20 days after nerve crush. At 50
      days after transection, less than half the number of normally-labelled neurons
      contained horseradish peroxidase. At this time only 1% of those whose axons had
      been resected were labelled. These observations suggest that different mechanisms
      regulate the responses of choline acetyltransferase and calcitonin gene-related
      peptide to nerve injury. The present results indicate that choline
      acetyltransferase levels in motoneurons can not be used to predict either the
      likelihood of or the timing of reinnervation after nerve transection or
      resection. However, our results strengthen the premise that an increased of
      calcitonin gene-related peptide immunoreactivity serves as a reliable index for
      predicting nerve regeneration/reinnervation after cranial nerve injury.

PMID- 8478638
TI  - Co-localization of the beta-subtype of protein kinase C and phosphorylation
      dependent immunoreactivity of neurofilaments in intact, decentralized and
      axotomized rat peripheral neurons.
AB  - The localizations of protein kinase C-beta-immunoreactivity and phosphorylation
      dependent immunoreactivity of neurofilaments were compared in rat dorsal root,
      hypogastric, and superior cervical ganglia. In all the ganglia studied, protein
      kinase C-beta and phosphorylation-dependent immunoreactivity of neurofilaments
      were co-localized in nerve fibres, and no fibres with only protein kinase C-beta
      immunoreactivity or phosphorylation-dependent immunoreactivity of neurofilaments
      were observed. Most intense perikaryal protein kinase c-beta and phosphorylation
      dependent neurofilament-staining were seen in large dorsal root ganglion neurons,
      whereas in the superior cervical ganglion only very faint protein-kinase C-beta
      and no phosphorylation-dependent staining was seen in the neuronal cell bodies.
      Both decentralization and axotomy of the superior cervical ganglion induced an
      accumulation of protein-kinase C-beta-immunoreactivity and phosphorylation
      dependent immunoreactivity of neurofilaments in the majority of neuronal
      perikarya. The accumulation was first observed at 1-2 days postoperation and it
      persisted up to 6-10 days postoperation. In strongly labelled decentralized
      neuronal perikarya, precipitation of immunoreactivity was seen near the cell and
      nuclear membranes, whereas in axotomized neurons, immunoreactivity was often
      concentrated as a unipolar clump in the cytoplasm. The results show that protein
      kinase C-beta-immunoreactivity and phosphorylation-dependent immunoreactivity of
      neurofilaments are colocalized in intact rat peripheral ganglia and that both
      accumulate transiently in cell bodies of the superior cervical ganglion after
      decentralization and axotomy.

PMID- 8478639
TI  - The influence of fibronectin and laminin during Schwann cell migration and
      peripheral nerve regeneration through silicon chambers.
AB  - The ability of extracellular proteins to influence the regenerative process was
      examined in Sprague-Dawley rats. Silicon chambers, filled with sterile saline
      solutions of cytochrome-c, fibronectin, laminin, a combination of fibronectin and
      laminin, or nerve growth factor were surgically implanted between the severed
      ends of sciatic nerves to form gaps of 18 mm. Four months later, the various
      groups were examined to determine the success of regeneration. The incidence of
      cable formation that bridged the gap was similar in all groups. The group of
      animals that had implants containing the combination of fibronectin/laminin had
      increased numbers of myelinated axons in the regenerated segment within the
      chamber and in the distal sciatic tributary nerves. Horseradish peroxidase
      labelling demonstrated that increased numbers of sensory and motor neurons in the
      fibronectin/laminin group had regenerated axons across the gap into the distal
      tributaries of the sciatic nerve. The effect of the various agents on non
      neuronal cells was measured by immunohistochemical staining with S-100 antibodies
      to determine the effects on Schwann cell migration. Silicon chambers, filled with
      sterile saline solutions of fibronectin, laminin, fibronectin/laminin, nerve
      growth factor, or cytochrome-c, were surgically implanted to form 5 mm gaps
      between severed sciatic nerve ends. Ten days later, Schwann cell migration into
      the bridging cables was examined in each group. Analysis revealed a greater
      influx of Schwann cells migrating into the regenerating segments in the
      fibronectin, the laminin, and the combination fibronectin/laminin groups compared
      to the control group (cytochrome-c).

PMID- 8478640
TI  - He-Ne laser irradiation affects proliferation of cultured rat Schwann cells in a
      dose-dependent manner.
AB  - Schwann cell proliferation is considered an essential part of Wallerian
      degeneration after nerve damage. Laminin, an important component of the
      extracellular matrix and produced by Schwann cells, provides a preferred
      substrate for outgrowing axons. To study whether low energy (He-Ne) laser
      irradiation may exert a positive effect on nerve regeneration through an effect
      on Schwann cells, its effect was evaluated in vivo. Schwann cells were isolated
      from sciatic nerves of 4-5-day-old Wistar rates and cultured on 96-multiwell
      plates. The cells were irradiated by a He-Ne laser beam (632.8 nm, 5.98 mW) that
      was optically expanded to a beam width of 4 mm. During irradiation the plate was
      kept in an air-tight box equilibrated with humidified air containing 5% CO2 and
      kept at 37 degrees C. At three consecutive days, starting either at day 5 or day
      8, cells were irradiated each day for 0.5, 1, 2, 5 or 10 min. Both cell number
      and laminin production were determined for each irradiation condition (n = 5)
      within one experiment. Schwann cells that were irradiated from day 8 on were
      hardly affected by laser irradiation. However, the proliferation of cells that
      were irradiated starting on day 5 was significantly increased after 1, 2, and 5
      min of daily irradiation, compared to non-irradiated control cultures. The
      laminin production per cell of these Schwann cells was not significantly altered.
      From these results we conclude that He-Ne laser irradiation can modulate
      proliferation of rat Schwann cells in vitro in a dose-dependent manner.

PMID- 8478641
TI  - Periterminal synaptic organization of primary afferents in laminae I and IIo of
      the rat spinal cord, as shown after anterograde HRP labelling.
AB  - The fine structure and periterminal synaptology of the primary afferent
      terminations in laminae I and IIo are examined in the rat, following anterograde
      labelling with horseradish peroxidase applied to the right C5-dorsal root.
      Labelled varicosities observed along the terminal arbors in parasagittal thick
      sections were relocated in ultrathin sections by electron microscopy. The
      labelled terminal profiles generated by the three primary afferent plexuses which
      can be identified by light microscopy in laminae I-IIo had similar fine
      structural features, except that axo-axonal contacts, although rare, were more
      frequent in the medial network plexus. Primary boutons were packed with agranular
      spherical vesicles and some large granular vesicles, and were mostly presynaptic
      to profiles of dendritic trunks of marginal cells. Unlabelled axonal profiles,
      either light with some flattened vesicles, or dense with round vesicles, were
      also presynaptic at symmetrical or asymmetrical contacts, respectively, to those
      dendritic profiles. It is suggested that such knobs of intrinsic origin are
      responsible for postsynaptic modulation of the primary noxious input. Although
      the 20 microns wide lamina IIo belongs cytoarchitectonically to lamina II and can
      be distinguished from lamina I by a decreased amount of myelinated fibres and
      large dendritic profiles, the periterminal synaptology was here found to be the
      same as in lamina I.

PMID- 8478642
TI  - Spinule formulation in the fish retina: is there an involvement of actin and
      tubulin? An electronmicroscopic immunogold study.
AB  - During light-adaptation dendrites of teleost horizontal cells form finger-like
      processes, called 'spinules', which are characterized by synaptic membrane
      densities. To investigate the involvement of cytoskeletal elements in the
      formation and retraction of spinules, effects of the microtubule and actin
      inhibitors colchicine and cytochalasin D were examined by injection into the
      vitreous. Both substances inhibited the light-induced spinule formation. The
      ultrastructural immunolocalization of tubulin revealed labelling of dendrites
      only in their proximal parts. The distal parts of dendrites which invaginate into
      cone pedicles were free of label. Treatment with anti-actin revealed
      immunoreactivity along the entire length of dendrites up to the dendritic
      terminals. The spinules, however, showed no labelling. This finding does not
      support the hypothesis that spinules are protruded by actin polymerization. After
      cytochalasin D treatment the density of label in the dendritic terminals was
      enhanced by a factor of three, which suggests an accumulation of actin. Thus,
      spinule inhibition by cytochalasin D is probably caused by distortion of a
      functional actin network in the dendritic terminals.

PMID- 8478643
TI  - Basement membranes during development of human nerve: Schwann cells and
      perineurial cells display marked changes in their expression profiles for laminin
      subunits and beta 1 and beta 4 integrins.
AB  - The formation of the connective tissue compartments of human sciatic and tibial
      nerves was studied with special reference to the maturation of the basement
      membranes during foetal development (11-35 weeks of gestation). All Schwann cells
      were surrounded by continuous basement membranes as early as at week 11, while
      the perineurial cells became covered by basement membranes gradually between
      weeks 17 and 35, as estimated by electron microscopy. The first laminin subunits
      detectable within the nerve were the B1, B2 and M chains. These laminin subunits
      were present in Schwann cell basement membrane zone at week 11, and in the
      perineurium at week 17 and later. Laminin A and S chains were first detected at
      26 weeks in the perineurium, and at a later stage (35 weeks) on Schwann cells. In
      mature nerves, all these five laminin chains could be demonstrated in both
      Schwann cell and perineurial cell basement membrane zones, although A, S and B2
      chains predominated in the perineurium, and M, B1 and B2 were the predominant
      chains in Schwann cell basement membranes. Beta 1 and beta 4 integrins were
      expressed by all Schwann cells in samples from the youngest foetuses (11-17
      weeks). At 22-35 weeks, however, only a subpopulation of Schwann cells stained
      positively for beta 1 and beta 4 integrins. Perineurial cells expressed beta 1
      integrins at all ages studied. Staining for beta 4 integrin in perineurium became
      detectable and intensified concomitant with the formation of structural basement
      membranes. The results demonstrate that Schwann cells and perineurial cells
      change their laminin and integrin expression profiles during the maturation of
      peripheral nerve.

PMID- 8478644
TI  - Cycloheximide mimics effects of oestradiol that are linked to synaptic plasticity
      of hypothalamic neurons.
AB  - The synaptic connectivity of the rat arcuate nucleus, a hypothalamic area rich in
      oestradiol receptors, is rapidly affected by physiological modifications of
      hormonal levels. A rise of oestradiol in plasma elicits a coordinated neuronal
      glial response that begins with a rapid fall in the number of small (< 10 nm)
      intramembrane particles and a rapid increase in the number of large (> 10 nm)
      intramembrane particles in neuronal membranes, followed by a modification in the
      branching of astrocytic processes and finally results in decreased number of axo
      somatic synapses and increased glial wrapping of the neuronal somas. In the
      course of a series of studies aimed to test possible non-genomic effects of
      oestradiol on neuronal membranes we analyzed the effect of the systemic
      administration of the protein synthesis inhibitor cycloheximide on the
      ultrastructure of arcuate neurons and granule cells of the cerebellar cortex, an
      area of the brain with low levels of estrogen receptors. Cycloheximide resulted
      in a significant inhibition of protein synthesis in hypothalmus and cerebellum of
      ovariectomized rats. Under these circumstances, the number of small intramembrane
      particles was reduced in hypothalamic and cerebellar neuronal membranes while the
      number of large intramembrane particles showed a decrease in cerebellar membranes
      and a transient increase in arcuate neuronal somas. Furthermore, cycloheximide
      resulted in an increased glial wrapping of arcuate neuronal somas but not of
      cerebellar granule cells. The ensheathing of arcuate neurons by glial was
      associated with a 41% decrease in the number of axo-somatic synapses. These
      results indicate that the protein synthesis inhibitor cycloheximide may elicit
      the integrated neuronal-glial response that is associated with the hormonally
      induced remodelling of synaptic contacts on arcuate neurons.

PMID- 8478645
TI  - Reciprocal axo-axonal synapses between the common inhibitor and excitor
      motoneurons in crustacean limb muscles.
AB  - Nerve terminals of the common inhibitor motoneuron in a crab (Eriphia spiniforns)
      limb closer muscle and in a crayfish (Procambarus clarkii) limb accessory flexor
      muscle make neuromuscular synapses with the muscle membrane (postsynaptic
      inhibition) as well as axo-axonal synapses with the terminals of the excitatory
      axon (presynaptic inhibition). That transmission is from the inhibitor to the
      excitor terminals at these axo-axonal synapses is indicated by the occurrence on
      the inhibitor membrane of presynaptic dense bars denoting sites of transmitter
      release. Axo-axonal synapses with the opposite polarity, in which transmission is
      from an excitatory onto an inhibitory terminal, were occasionally seen either
      adjacent to or separate from the inhibitory axo-axonal synapse. Nerve terminals
      of the specific inhibitor in the crayfish opener muscle were seen to make
      numerous axo-axonal output synapses upon excitatory nerve terminals but excitor
      nerve terminals were not seen to make output synapses onto inhibitor terminals.
      Thus reciprocal axo-axonal synapses appear to be a feature of the common
      inhibitor but not of the specific inhibitor. The excitor-to-inhibitor component
      of these reciprocal synapses may serve to limit transmitter output in the common
      inhibitor axon by activating glutamateB receptors which facilitate efflux of K+
      and hyperpolarization of the membrane.

PMID- 8478646
TI  - Ultrastructure and permeability of the Schwann cell layer surrounding the giant
      axon of the squid.
AB  - The ultrastructure of the Schwann cell layer surrounding the giant axon of the
      squid Alloteuthis subulata is described, and the permeability of extracellular
      compartments assessed by exposure to electron-dense tracers. Morphometric
      analysis is used to deduce the number, size and shape of the Schwann cells, and
      the routes for ion flux across the Schwann cell layer. Axons (mean diameter 233
      microns) were surrounded by a 1-2 microns thick layer of Schwann cells which were
      approximately 1 micron thick, approximately 70 microns long and approximately 23
      microns wide. There were around 62,000 Schwann cells per cm2 axon surface. The
      outer (abaxonal) surface of the Schwann cells was invaginated, with evidence for
      a covering of fine Schwann cells processes; the inner (adaxonal) surface of the
      Schwann cells was less folded. The percentage area occupied by mesaxonal cleft
      openings to the axon and to the basal lamina was 0.02% and 1.09% respectively. A
      system of tubules, the glial tubular system, occupied 3.9% of the Schwann cell
      volume, and opened to both axonal and basal lamina surfaces, with more elaborate
      lattice-like clusters towards the basal side of the cell. Tubule openings
      accounted for 0.26% of the surface area facing the axon and 0.37% of the area
      facing the basal lamina (where there was greater clustering of openings). The
      electron dense tracers horseradish peroxidase, ionic lanthanum and tannic acid
      filled mesaxon clefts, glial tubular system and periaxonal space. If ion flux
      occurred via the mesaxonal clefts, a theoretical series resistance (Rsth) of > 20
      omega cm2, would be predicted, whereas if it occurred via the tubular system, the
      figure would be < 2 omega cm2, closer to physiological estimates. The results
      presented show that the glial tubular system is likely to be the major route for
      ion flux into and across the Schwann cell layer, and for clearance of K+ from the
      periaxonal space during periods of axonal stimulation. The implications for K+
      homeostasis in the axonal microenvironment are discussed.

PMID- 8478647
TI  - Reactive astrocytes in the kainic acid-damage hippocampus have the phenotypic
      features of type-2 astrocytes.
AB  - Kainic acid treatment, a model of temporal lobe epilepsy, induces Ammon's horn
      sclerosis characterized by degeneration of CA3 pyramidal neurons and reactive
      gliosis. We now report that in kainic acid treated rats, reactive astrocytes in
      the hippocampus are A2B5 immunopositive and express GAP-43 immunoreactivity. A2B5
      is a cell surface ganglioside selectively expressed in the glial O-2A lineage
      (oligodendrocytes and type-2 astrocytes in vitro). Since A2B5-positive cells were
      also GFAP immunoreactive, our observation suggest that hippocampal-reactive
      astrocytes in the epileptic process are type-2 astrocytes. GAP-43 is a membrane
      associated phosphoprotein involved in neurite outgrowth. In vitro analysis showed
      that the glial O-2A lineage may express this phosphoprotein. In this study, we
      found that GAP-43 was coexpressed in astrocytes with A2B5 suggesting that in vivo
      as in vitro type-2 astrocytes express GAP-43.

PMID- 8478648
TI  - The usefulness of the preoperative electrocardiogram.

PMID- 8478649
TI  - Anesthesia systems. Part II: Operating principles of fundamental components.
AB  - This second article in a 2-part series on the operation of principal components
      within Narkomed anesthesia systems describes the function and compensation
      mechanisms of the Drager 19.n vaporizer, the operating principles of the
      anesthesia ventilator-electronic, the structure and mechanics of the pressure
      limit control, and the 3 basic monitoring systems built into the anesthesia
      system. Part II of this series builds on the data published in part I (J Clin
      Monit 1992;8:295-307).

PMID- 8478650
TI  - Artifact detection and removal during auditory evoked potential monitoring.
AB  - Various artifacts can distort or obscure evoked potential waveforms. The
      algorithms presented in this paper scan the output electroencephalographic signal
      for artifacts during evoked potential recordings. If possible, the artifact is
      removed; if not possible, that sweep is excluded from the averaging process
      required to raise the evoked response above the background
      electroencephalographic activity. An artifact is detected if 1 or more amplitude
      or frequency parameters exceed a threshold. These thresholds have been determined
      after constructing histograms of the parameters concerned using a number of
      control evoked potential recordings containing no visually recognizable
      artifacts. The distributions of the parameters shown by these histograms give
      information about their normal range. The method improves the quality of the
      waveform in many cases, but its effectiveness strongly depends on the
      characteristics of the artifacts concerned.

PMID- 8478651
TI  - The esophageal temperature gradient in anesthetized children.
AB  - OBJECTIVE: Our objective was to study the effect of the temperature of the
      anesthetic gas mixture (AGM) on esophageal temperature measurements made in
      children whose tracheas had been intubated for anesthesia. We also sought to
      establish the optimal site for the temperature sensor in the esophagus and to
      find a way to accurately place the sensor. METHODS: Special esophageal
      temperature probes with thermistors located at 1-cm intervals were used for data
      collection on a multiplex system. Esophageal temperature measurements were made
      every 15 minutes for a period of 120 minutes in anesthetized children receiving
      heated (n = 30) and unheated (n = 30) anesthetic gases. RESULTS: The temperature
      of the AGM (p < 0.001), the site of measurement (p < 0.001), and the interaction
      between AGM temperature and site of measurement (p < 0.007) all had a significant
      effect on esophageal temperature measurements. This effect was greatest at a
      point 3 cm distal to the level of the tip of the endotracheal tube when AGMs were
      not heated. CONCLUSION: We conclude that best results are obtained when care is
      taken to place the thermistor in the lower quarter of the esophagus. (We provide
      a simple formula for calculating this placement in pediatric patients of varying
      ages.) Placing the probe by acoustic criteria cannot consistently be relied on to
      provide good thermometry.

PMID- 8478652
TI  - Absence of a capnogram after positive end-expiratory pressure.
AB  - OBJECTIVE: The objective of this study was to evaluate the effect of positive end
      expiratory pressure (PEEP) on capnography. DESIGN: The study design was
      experimental and open, and it was performed in the Anesthesiology Experimental
      Research Laboratory. METHODS: Six dogs (9.8 +/- 0.8 kg) were anesthetized and
      intubated. The animals' lungs were ventilated with a tidal volume of 137 +/- 34
      ml and a respiratory frequency of 34 +/- 10 breaths/min to produce a PaCO2 of 35
      to 45 mm Hg. Application of 20 cm H2O of PEEP was initiated for 1 minute, then
      repeated twice after 10-minute stabilization periods. Arterial pH and gas
      tensions were measured, and capnogram, airway gas flow, and airway pressure were
      recorded continuously. Airway gas flow was electronically integrated to calculate
      tidal volume. RESULTS: Mean values before application of PEEP were as follows:
      pHa, 7.37 +/- 0.04 mm Hg; PaCO2, 37.1 +/- 3.2 mm Hg; PaO2, 93.4 +/- 1.6 mm Hg;
      and PETCO2, 32.0 +/- 3.5 mm Hg. Compliance of the ventilator circuit was 3.3
      ml/cm H2O. Mean deflation lung-thorax compliance was 41.5 +/- 10.3 ml/cm H2O.
      After application of PEEP, no capnogram was reported for 1 to 6 breaths, an
      average of 2.7 +/- 1.8 breaths. CONCLUSION: These results demonstrated that
      absence of gas flow immediately after the application of PEEP may transiently
      abolish a capnogram when the lung volume increases.

PMID- 8478653
TI  - The effect of dyshemoglobins on pulse oximetry: Part I, Theoretical approach and
      Part II, Experimental results using an in vitro test system.
AB  - Pulse oximeters are known to be inaccurate in the presence of elevated
      concentrations of carboxyhemoglobin and methemoglobin. This paper attempts to
      alleviate some of the confusion that exists between fractional and functional
      saturation, and to clarify the comparison of each with SpO2. A series of
      theoretical relationships between pulse oximeter reading (SpO2) and actual oxygen
      saturation (both fractional and functional) is derived using simple absorption
      theory. The theoretical relationships are checked using an experimental in vitro
      test system. This consists of a blood circuit containing a model finger, capable
      of simulating the pulsatile transmission signals through a real finger.
      Theoretical predictions and experimental results are compared and are found to
      agree well in the presence of carboxyhemoglobin, but less well with
      methemoglobin. Possible reasons are discussed.

PMID- 8478654
TI  - Urinary bladder temperature monitoring in extensively burned patients.

PMID- 8478655
TI  - Curable neoplasms and the ethics of clinical trials.

PMID- 8478656
TI  - Prognostic factors in medulloblastoma, including DNA ploidy.
AB  - PURPOSE: DNA ploidy status, completeness of surgical resection, use of
      chemotherapy, adequacy of radiation therapy, metastatic stage, sex, and age at
      diagnosis were evaluated as predictors of relapse in 58 patients with cerebellar
      medulloblastoma. METHODS: Flow cytometry (FCM) and/or image analysis (IA) were
      used to characterize tumor DNA ploidy. Twelve tumors (21%) were found to be
      aneuploid, 11 (19%) tetraploid, and 35 (60%) diploid. RESULTS: The most
      significant predictors of relapse in univariate analyses were the adequacy of
      radiation (> or = 50 Gy) (P = .02), metastatic staging (P = .05), completeness of
      resection (P = .085), and DNA ploidy status (diploid/tetraploid v aneuploid; P =
      .11). When the 52 patients who received > or = 50 Gy were included in a
      multivariate Cox model analysis, those with diploid/tetraploid tumors had fewer
      recurrences than those with aneuploid tumors (relative risk, 0.33; 95% confidence
      interval, 0.12 to 0.89; P = .03). Patients with complete resections (P = .07), or
      with stage M0 disease (P = .06) had fewer recurrences than other patients, but
      these factors were not independent predictors of outcome. DNA ploidy status was
      correlated with age; 10 of the 12 aneuploid tumors were found in children ages 3
      to 10 years. Age, sex, and the use of chemotherapy were not prognostically
      significant in these analyses. CONCLUSION: The adequacy of radiation dose and DNA
      ploidy were the most important prognostic factors in this series. Contrary to
      previous reports, when corrected for adequacy of treatment, DNA aneuploidy was
      associated with a poor outcome. By multivariate analyses, DNA ploidy was an
      independent variable, even when controlling for extent of surgical resection and
      metastatic stage.

PMID- 8478657
TI  - Escalating dose of continuous infusion combination chemotherapy for refractory
      neuroblastoma.
AB  - PURPOSE: This trial was undertaken to determine if a continuous infusion format
      with increased dose-intensity had antitumor activity with tolerable toxicity in
      patients with advanced neuroblastoma. PATIENTS AND METHODS: Forty heavily
      pretreated patients with refractory or progressive neuroblastoma received
      continuous infusion doxorubicin, cisplatin, and etoposide along with bolus
      ifosfamide in a dose-escalation format. A total of 79 courses of chemotherapy
      were administered at five different dose levels. RESULTS: Fifteen of 35
      assessable patients (43%) achieved either a partial response (PR) or complete
      response (CR), including five patients with a CR, three with a very good PR
      (VGPR), and seven with a PR. Hematologic toxicity was severe, but reversible, and
      other toxicities, although significant, were tolerable and much less than that
      accepted in a bone marrow transplantation (BMT) setting. CONCLUSION: This
      investigation illustrates that response is possible even in an extremely poor
      prognosis group of patients, and it suggests that such a regimen may be effective
      if given before disease progression occurs.

PMID- 8478658
TI  - Combined continuous infusion etoposide with high-dose cyclophosphamide for
      refractory neuroblastoma: a phase II study from the Societe Francaise d'Oncologie
      Pediatrique.
AB  - PURPOSE: Patients older than 1 year with stage IV neuroblastoma who fail to
      achieve complete remission (CRem) have a particularly poor long-term prognosis.
      In an attempt to improve the outcome of these refractory patients, we tested a
      new drug combination. PATIENTS AND METHODS: Twenty-nine children with advanced
      neuroblastoma (27 stage IV and two stage III) were entered onto this phase II
      study. All were refractory to conventional chemotherapy and had measurable
      disease at the time of the trial. The regimen was a combination of high-dose
      cyclophosphamide (2 g/m2/d) on days 2, 3, and 4, and etoposide (VP16; 50 mg/m2/d)
      by continuous intravenous (IV) infusion on days 1 to 5. A pharmacokinetic study
      of VP16 was conducted in eight patients to determine whether the goal of
      persistent plasma levels between 1 and 5 micrograms/mL was achieved. RESULTS:
      Patients received a median of two courses, for a total of 58 courses. The median
      interval between each course was 32 days. In the 28 assessable patients, the
      overall response rate was 43%, with one CRem and 11 partial remissions (PRems).
      No life-threatening complication was observed in these heavily pretreated
      patients. The median duration of neutropenia (< 5 x 10(9)/L) was 14 days, and
      that of thrombocytopenia (< 50 x 10(9)/L) was 11 days. The overall incidence of
      sepsis was 27%. Gastrointestinal toxicity was frequent, but mild. Electrolyte
      disturbance with antidiuretic hormone (ADH)-like syndrome occurred in eight
      courses, but resolved rapidly. Grade > or = 2 hemorrhagic cystitis was observed
      in three courses. No cardiac toxicity was observed. There were no treatment
      related deaths. Pharmacokinetic analysis showed that mean steady-state plasma
      levels (Css) of VP16 were greater than 1 microgram/mL during all the courses.
      CONCLUSION: This new drug combination appears to be effective in advanced
      neuroblastoma. Its toxicity remains manageable, with no life-threatening
      complications. Further evaluation in patients with less-advanced disease is
      warranted.

PMID- 8478659
TI  - Role of computed tomography in the staging of primary melanoma.
AB  - PURPOSE: To evaluate the role of body computed tomography (CT) for the staging of
      patients with early melanoma. PATIENTS AND METHODS: A total of 151 new patients
      with American Joint Committee (AJC) clinical stage I, II, and III melanoma who
      received a CT scan of at least the chest and abdomen are the subject of this
      study. CT scans considered suspicious for metastases were reviewed again by one
      of the investigators (A.McB.C.). RESULTS: Of 151 patients, 63 had AJC clinical
      stage I, 61 stage II, and 23 stage III disease. In addition, one patient each had
      primary melanoma of the anal canal, esophagus, or vulva. Twenty-nine (19%) of 151
      patients had a CT scan that was considered suspicious for metastases. The most
      common radiologic findings were single hepatic, and single or multiple pulmonary
      nodules. Of these 29 patients with suspicious scans, 24 subsequently proved to
      have benign processes by biopsy or follow-up studies, three had second primary
      tumors (well-differentiated lymphocytic lymphoma, Hodgkin's disease, and renal
      cell carcinoma), and only two were found to have metastatic melanoma. Of these
      two patients, one had regional nodal disease (unsuspected on physical
      examination) and one had distant nodal metastases. CONCLUSION: Body CT is not a
      useful imaging study in the detection of occult metastases in patients with
      primary melanoma. Although body CT commonly shows suspicious radiologic
      abnormalities in patients with early melanoma, these abnormalities most likely
      represent benign processes or a second primary tumor, rather than metastatic
      melanoma. The value of body CT in patients who present with nodal metastases
      needs further study.

PMID- 8478660
TI  - Long-term follow-up of patients with low-grade malignant lymphomas treated with
      doxorubicin-based chemotherapy or chemoimmunotherapy.
AB  - PURPOSE: We reviewed survival data of patients with low-grade lymphoma entered on
      Southwest Oncology Group (SWOG) lymphoma trials in 1972 to 1983 to determine the
      utility of doxorubicin-containing therapy (cyclophosphamide, doxorubicin,
      vincristine, and prednisone [CHOP]) in such patients. PATIENTS AND METHODS: We
      identified all patients with low-grade lymphoma, no prior therapy, and stage III
      or IV disease who were treated with full-dose CHOP induction therapy on any arm
      of SWOG studies 7204, 7426, or 7713. Survival data for this group of patients
      were correlated with pretreatment prognostic factors, including histology,
      patient age, sex, symptom status, performance status, bone marrow or extranodal
      involvement, and the number of disease sites. The effect of maintenance treatment
      was also assessed. RESULTS: Four hundred fifteen patients met criteria for
      inclusion in the study group. With median follow-up periods of 12.8 years
      (maximum, 19.8 years), the median survival duration was 6.9 years. Survival was
      significantly shorter in patients with follicular mixed or small lymphocytic
      histology, age greater than 40 years, male sex, B-symptom status, and SWOG
      performance status greater than 1. Multivariate regression analysis showed
      histology, age, and sex to be independent predictors of survival. There was no
      definite survival plateau of cured patients in any subgroup, although the
      survival curve for follicular mixed histology patients showed long-term survival
      of approximately 25%. Maintenance therapy did not prolong survival. CONCLUSION:
      Doxorubicin-containing treatment did not prolong the overall median survival of
      low-grade lymphoma patients compared with results with less-aggressive programs.

PMID- 8478661
TI  - Randomized phase II trial of high-dose interleukin-2 either alone or in
      combination with interferon alfa-2b in advanced renal cell carcinoma.
AB  - PURPOSE: To determine better the activity of high-dose interleukin-2 (IL-2)
      either alone or in combination with interferon alfa-2b (IFN; Schering-Plough,
      Kenilworth, NJ) in patients with metastatic renal cell carcinoma, the IL-2
      Working Group initiated a randomized phase II trial. PATIENTS AND METHODS:
      Patients were randomly assigned to receive treatment with either IL-2 (Chiron
      Corp, Emeryville, CA) 1.33 mg/m2 (approximately 600,000 IU/kg) alone or IL-2 0.8
      mg/m2 and IFN 3 x 10(6) U/m2 administered by bolus intravenous injection every 8
      hours, days 1 to 5 and 15 to 19 (maximum, 28 doses). All patients had an Eastern
      Cooperative Oncology Group (ECOG) performance status of 0 or 1 and normal organ
      function. After 28 patients were entered onto each arm, the IL-2/IFN arm was
      closed because of a failure to meet predetermined efficacy criteria. An
      additional 43 patients (total, 71) were assigned to receive IL-2 alone. RESULTS:
      Toxicities were similar for both study arms. Hypotension requiring pressors was
      the most frequent dose-limiting toxicity. Only 11 of 99 patients experienced
      severe toxicity; there were no irreversible side effects or treatment-related
      deaths. Responses were seen in three of 28 patients (11%) on IL-2/IFN (three
      partial responses [PRs] lasting 14, 7, and 7 months) and 12 of 71 patients (17%)
      on IL-2 alone (four complete responses [CRs] and eight PRs). Six of the partial
      responders on IL-2 and two on IL-2/IFN experienced greater than 90% reduction in
      tumor mass. Ten of the 12 responders to IL-2 have ongoing responses of 12+ to 26+
      months in duration. CONCLUSION: We conclude that both IL-2 and IL-2/IFN therapy
      have activity in metastatic renal cell carcinoma. In particular, therapy with
      high-dose IL-2 alone produces meaningful and durable responses with manageable
      and reversible toxicity. This study supports the contention that high-dose IL-2
      represents the treatment of choice in selected patients with advanced renal cell
      carcinoma.

PMID- 8478662
TI  - Granulocytic sarcoma is associated with the 8;21 translocation in acute myeloid
      leukemia.
AB  - PURPOSE: Since the only three cases of granulocytic sarcoma among patients with
      acute myeloid leukemia (AML) seen at our institution during the last 12 years
      were each associated with the 8;21 translocation [t(8;21)], we sought to
      determine if this association is specific and more frequent than previously
      recognized. PATIENTS AND METHODS: We report three patients with AML and t(8;21)
      who developed granulocytic sarcomas, and review the world literature. RESULTS:
      Between 1980 and 1992, 53 cases of AML French-American-British (FAB) M2 were
      identified at our institution. Eight (15%) patients had t(8;21). Three of these
      eight patients (38%) developed granulocytic sarcoma. All three of our patients
      received conventional intensive antileukemic chemotherapy yet had short relapse
      free survival durations. Several series of patients with t(8;21) report that
      granulocytic sarcomas occur in approximately 18% of this population, which is
      four times the expected incidence in AML. Thirty-seven cases have been previously
      reported. Although karyotype analyses were not reported in many cases of
      granulocytic sarcoma in the literature, the vast majority of abnormal karyotypes
      in patients with AML involved t(8;21). Recent work with a cell line derived from
      a patient with t(8;21) indicates that such cells are unusually adherent to
      culture bottles and are aggregable CONCLUSION: Our data suggest that this
      association is more common than generally recognized and may be specific.
      Patients with t(8;21) should be observed closely for signs and symptoms of
      granulocytic sarcoma. These patients may have a less favorable prognosis than
      other patients with t(8;21). Cooperative oncology groups should retrospectively
      identify patients with AML and t(8;21) who had a poor outcome to determine if
      they had a disproportionate incidence of granulocytic sarcoma. If so, aggressive
      therapy such as bone marrow transplantation may be warranted early in the
      therapeutic strategy.

PMID- 8478663
TI  - Yttrium 90-labeled antiferritin followed by high-dose chemotherapy and autologous
      bone marrow transplantation for poor-prognosis Hodgkin's disease.
AB  - PURPOSE: This study was undertaken to examine the feasibility of combining
      radiolabeled antibody therapy with high-dose chemotherapy followed by autologous
      bone marrow transplantation in patients with poor-prognosis Hodgkin's disease.
      PATIENTS AND METHODS: Patients were entered onto this protocol if they had
      chemotherapy-resistant disease, bulky disease, or extensive prior therapy.
      Patients received yttrium-labeled antiferritin on day -13, -12, or -11, followed
      by high-dose cyclophosphamide, carmustine, and etoposide (CBV) on days -6 to -3,
      and then bone marrow infusion on day 0. RESULTS: Twelve patients received both
      radiolabeled antibody and high-dose chemotherapy followed by autologous
      transplantation. Two additional patients started the study, but were unable to
      complete all therapy. Four of 12 patients experienced early transplant-related
      mortality. Four patients are alive more than 2 years following transplantation
      and three are free from disease progression at 24+, 25+, and 28+ months following
      transplantation. The progression-free survival rate at 1 year is estimated to be
      21%. Considering the poor prognostic characteristics of these patients, toxicity
      on this protocol was not necessarily greater than that observed with high-dose
      chemotherapy alone. CONCLUSION: This report demonstrates the feasibility of
      combining radiolabeled antibody therapy with high-dose chemotherapy and
      autologous bone marrow transplantation.

PMID- 8478664
TI  - High-dose etoposide and melphalan, and autologous bone marrow transplantation for
      patients with advanced Hodgkin's disease: importance of disease status at
      transplant.
AB  - PURPOSE: To evaluate an intensive therapy regimen of high-dose etoposide and
      melphalan and autologous bone marrow transplantation (ABMT) in advanced Hodgkin's
      disease; and to determine possible prognostic factors that predict for long-term
      disease-free survival (DFS). PATIENTS AND METHODS: Seventy-three patients with
      advanced Hodgkin's disease who had failed to achieve remission with front-line
      chemotherapy (n = 16) or who had relapsed (n = 57) were treated with high-dose
      etoposide 60 mg/kg and melphalan 160 mg/m2 and ABMT. Previous therapy included
      mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) alternating
      with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), or hybrid
      MOPP/ABV. All patients received pretransplant cytoreduction with conventional
      dose salvage chemotherapy and 40 also received pretransplant extended-field
      radiation to areas of bulky nodal disease (> 5 cm). RESULTS: Response to high
      dose etoposide and melphalan was determined at 3 months post-ABMT. The complete
      response (CR) rate was 75% (95% confidence interval [CI], 64% to 84%), including
      35 of 50 patients with measurable disease before ABMT (70%; 95% CI, 60% to 86%).
      There were three early deaths (septicemia) and four late deaths (three
      interstitial pneumonitis, one intracerebral hemorrhage). Actuarial DFS is 38.6%
      at 4 years. Multivariate regression analysis showed that disease status at the
      time of ABMT (no evidence of disease [NED], nonbulky residual disease [NBRD], or
      bulky disease) was the most important factor determining DFS: 68% of those
      transplanted with NED versus 26% for patients with NBRD and 0% for bulky disease
      (P = .0002, log-rank test). Relapse in a previous radiation field was the only
      other significant prognostic factor. CONCLUSION: Etoposide and melphalan is an
      effective and well-tolerated intensive therapy regimen in advanced Hodgkin's
      disease. Patients in complete remission after conventional-dose salvage therapy
      transplanted with this regimen enjoy superior long-term DFS.

PMID- 8478665
TI  - Combined modality treatment with primary CHOP chemotherapy followed by
      locoregional irradiation in stage I or II histologically aggressive non-Hodgkin's
      lymphomas.
AB  - PURPOSE: A single-center, prospective, nonrandomized trial was conducted to
      evaluate therapeutic results of a short-term program of chemotherapy followed by
      locoregional radiotherapy in stage I or II intermediate/aggressive non-Hodgkin's
      lymphoma (NHL). PATIENTS AND METHODS: From 1985 to 1990, 183 consecutive patients
      with a diagnosis of NHL (Working Formulation [WF] E through J excluding Burkitt's
      type), Ann Arbor stage I or II, and no more than three sites of disease
      involvement were treated with four cycles of cyclophosphamide, doxorubicin,
      vincristine, and prednisone (CHOP) chemotherapy (six cycles in partial
      responders). Radiation therapy to initial sites of disease involvement (40 to 44
      Gy) and to proximal uninvolved nodal region (36 Gy) was delivered shortly after
      completion of the chemotherapy program. RESULTS: The complete remission (CR) rate
      was 98% at the end of combined therapy. Diagnostic excision of all measurable
      disease was performed in 33% of patients. In the remaining patients, 87% achieved
      CR with chemotherapy and 11% with radiation therapy, while three patients failed
      to achieve CR. After a median follow-up of 51 months, 26 patients have relapsed
      and 25 have died. The 5-year relapse-free and total survival rates were 83%.
      Aside from age older than 60 years, no other factor such as histology, stage,
      extranodal disease, bulky lymphoma, or abnormal lactic dehydrogenase (LDH) could
      predict for treatment outcome. There was a trend toward higher relapse rate for
      patients achieving CR at the time of radiation therapy (31%) as opposed to
      patients achieving CR with chemotherapy (15%) or with initial surgery (10%).
      Treatment was well tolerated and no deaths due to acute toxicity were observed.
      CONCLUSION: For patients who present with limited-stage, aggressive NHL, a short
      course of CHOP chemotherapy followed by locoregional irradiation is safe, highly
      effective, and curative for most. Therefore, at the present time this approach
      can be regarded as standard therapy for these patients.

PMID- 8478666
TI  - Antibody localization in human renal cell carcinoma: a phase I study of
      monoclonal antibody G250.
AB  - PURPOSE: To define the imaging and biodistribution characteristics of iodine 131
      labeled monoclonal antibody (mAb) G250 (131I-mAbG250), which recognizes a cell
      surface antigen expressed by human renal cell carcinoma (RCC). PATIENTS AND
      METHODS: G250 is a cell-surface antigen recognized by mAbG250 expressed by RCC
      but not detected in normal kidney. Clear-cell RCC, the most frequent form of RCC,
      shows homogeneous expression of G250, whereas non-clear-cell RCC and cancers
      derived from other organs generally do not express G250. Expression in normal
      tissues is highly restricted and limited to large bile ducts and gastric
      epithelium. 131I-mAbG250 was administered intravenously (IV) to 16 patients with
      RCC 7 to 8 days before surgery at five dose levels, with at least three patients
      entered at each dose level. RESULTS: Clear tumor images were observed in 12
      patients with G250-positive tumors and in one of three patients with G250
      negative tumors. Imaged lesions in the peritoneal cavity were confirmed at
      surgery. The smallest lesion visualized was 8 mm in diameter. The specificity of
      131I-mAbG250 localization to tumor tissue was established by radioactivity
      measurements, autoradiography, and immunohistochemistry of biopsied tissues, and
      technetium 99-human serum albumin blood-flow studies. The fraction of the
      injected 131I-mAbG250 dose per gram tumor (%ID/g tumor) localized in G250
      positive tumors showed a broad range, but reached levels as high as 0.02% to
      0.12%. CONCLUSION: 131I-mAbG250 localized specifically to G250 antigen-positive
      RCC and seems to have considerable potential as an imaging agent in RCC patients.
      131I-mAbG250 uptake in the tumors, relative as well as absolute, are among the
      highest reported for tumor biopsies obtained 8 days after IV mAb administration.
      Based on the specific localization and high accumulation, mAb G250 may have
      therapeutic potential.

PMID- 8478667
TI  - Phase I and plasma pharmacokinetic study of infusional fluorouracil combined with
      recombinant interferon alfa-2b in patients with advanced cancer.
AB  - PURPOSE: Enhanced fluorouracil (FUra) cytotoxicity caused by recombinant
      interferon alfa-2b (rIFN-a) has been reported, but the mechanism, optimal dose,
      and schedule remain unknown. Therefore, a phase I and pharmacokinetic study of
      FUra with escalating doses of rIFN-a was initiated. PATIENTS AND METHODS: FUra
      (750 mg/m2/d) was given by continuous intravenous (IV) infusion for 5 days. rIFN
      a (0.1 to 15 x 10(6) U/m2/d) was given subcutaneously (SC) daily for 5 days
      concurrent with FUra. Courses were repeated every 14 to 21 days. Forty-four
      patients were enrolled; 39 received at least two courses. During the first course
      of therapy, FUra levels before and after administration of rIFN-a were
      quantitated in 26 patients by high-pressure liquid chromatography. RESULTS: The
      maximum-tolerated dose of rIFN-a was 10 x 10(6) U/m2/d. Stomatitis was dose
      limiting. Three partial and five minor responses occurred. Interpatient
      pharmacokinetics showed that rIFN-a did not alter steady-state plasma
      concentration (Css; range, 0.77 +/- 0.35 mumol/L to 1.85 +/- 0.48 mumol/L),
      elimination half-life (t1/2; mean, 9.7 +/- 4.3 minutes), area under the
      concentration-versus-time curve (AUC; range, 93 to 224 mumol/L x hours), total
      body clearance (CI; range, 1,172 to 3,236 mL/min), or volume of distribution
      (range, 11.9 to 49.2 L) of FUra. Intrapatient data evaluation revealed a dose
      independent effect of rIFN-a. The mean FUra Css after rIFN-a administration (1.31
      mumol/L) was greater than that before rIFN-a administration (1.02 mumol/L, P <
      .0001). FUra Cl after rIFN-a administration was reduced by 20% to 35% compared
      with use of FUra alone (P < .0001). Patients with a greater than 20% decrease in
      FUra Cl had a fourfold greater incidence of diarrhea. CONCLUSION: rIFN-a reduces
      FUra Cl and, consequently, increases FUra-associated toxicity. Phase II studies
      of FUra and rIFN-a seem to be warranted.

PMID- 8478668
TI  - Phase III evaluation of four doses of megestrol acetate as therapy for patients
      with cancer anorexia and/or cachexia.
AB  - PURPOSE: Several placebo-controlled randomized clinical trials have demonstrated
      that megestrol acetate can result in appetite stimulation and nonfluid weight
      gain in patients with cancer anorexia/cachexia. The present trial was designed to
      compare megestrol acetate doses ranging from 160 to 1,280 mg/d. METHODS: This
      trial randomized 342 assessable patients with cancer anorexia/cachexia to receive
      oral megestrol acetate at doses of 160, 480, 800, or 1,280 mg/d. Patients were
      evaluated monthly by history, examination, patient-completed questionnaires, and
      serum albumin levels. RESULTS: The data demonstrate that there is a positive dose
      response effect for megestrol acetate on appetite stimulation (P < or = .02). In
      concert, there was a trend for more nonfluid weight gain with higher drug doses.
      Megestrol acetate was well tolerated in this group of patients with advanced
      malignant disease. CONCLUSION: The positive dose-response effect that we observed
      for megestrol acetate on appetite stimulation supports both our prestudy
      hypothesis and other available literature. Nonetheless, based primarily on the
      cost and inconvenience associated with the use of higher doses of this drug, it
      is reasonable to use 160 mg/d for the initial treatment of cancer
      anorexia/cachexia in routine clinical practice.

PMID- 8478669
TI  - Postchemotherapy rheumatism.
AB  - PURPOSE: This report describes a previously unreported clinical phenomenon that
      occurs in some patients after completion of combination chemotherapy. METHODS AND
      RESULTS: Eight case reports are presented. Affected patients developed a syndrome
      of myalgias/arthralgias within several months of completing
      cyclophosphamide/fluorouracil (5FU)-containing adjuvant combination chemotherapy
      for breast cancer. These symptoms did not appear to be related to cancer
      recurrence or any common rheumatologic disorder. The syndrome generally resolved
      over several months. CONCLUSION: Postchemotherapy rheumatism is a syndrome of
      myalgias/arthralgias that usually develops 1 to 3 months after completion of
      adjuvant chemotherapy. Recognition of this syndrome can limit the need for
      extensive work-ups to exclude recurrent breast cancer or inflammatory
      rheumatologic diseases.

PMID- 8478670
TI  - The efficacy and cost-effectiveness of adjuvant therapy of early breast cancer in
      premenopausal women.
AB  - PURPOSE AND METHODS: We used decision analysis to model the natural history of
      breast cancer in hypothetical cohorts of 45-year-old women receiving tamoxifen,
      chemotherapy, or combined therapy. We used recurrence and efficacy data from the
      Early Breast Cancer Trialists' Collaborative Group (EBCTCG), utility values from
      focus groups, and costs from clinic charges and Medicare data. RESULTS: Tamoxifen
      alone provides minimal benefit in estrogen receptor-negative (ER-; 0.2 to 0.4
      months) and modest benefit in receptor-positive (ER+; 3.5 to 5.2 months) cancer.
      Chemotherapy adds substantial benefit independent of receptor status (4.9 to 10.7
      quality-adjusted months). In ER+ cancer, combined therapy adds an additional
      benefit (1.2 to 2.1 months) compared with chemotherapy alone. The incremental
      costs (United States dollars) necessary to add an additional year of life to the
      average woman ranged from $4,300 to $11,400 for tamoxifen alone for ER+ cancer,
      $4,900 to $11,400 for chemotherapy alone, and $14,800 to $33,100 for combined
      therapy. CONCLUSION: In premenopausal early-stage breast cancer, chemotherapy
      adds substantial clinical benefit at a modest cost. Tamoxifen alone adds
      meaningful benefit only in ER+ cancer. Combined therapy is effective for all
      women, but is most beneficial and only cost-effective in ER+ women. If secondary
      effects of tamoxifen in reduction of cardiovascular and osteoporosis mortality
      are confirmed, then combined treatment may be optimal for all premenopausal
      women.

PMID- 8478671
TI  - Should the elderly receive chemotherapy for node-negative breast cancer? A cost
      effectiveness analysis examining total and active life-expectancy outcomes.
AB  - PURPOSE: This study determines the survival benefit and cost-effectiveness of
      adjuvant chemotherapy in elderly women with breast cancer. In addition, the
      analysis measures the impact of substituting active life expectancy for survival
      in the clinical decision. PATIENTS AND METHODS: Two cohorts of women with
      estrogen receptor (ER)-negative, stage I breast cancer from age 60 to 80 years
      were monitored using a Markov process. One group received standard chemotherapy
      following primary therapy, and the other had no postoperative treatment. Data
      were derived from recently published clinical trials and a major meta-analysis.
      Outcome included the average survival, active life-expectancy, and incremental
      cost/quality-adjusted life-year (cost/QALY). RESULTS: Adjuvant chemotherapy
      prolongs survival in older women, but to a lesser extent compared with younger
      women. The average gain in quality-adjusted months was 1.8 months in a 75-year
      old cohort at a cost/QALY of $4,400. These small benefits were not substantially
      altered when univariate changes were made in toxicity, recurrence risk, or
      effectiveness of chemotherapy. When active life expectancy replaced survival as
      an end point, the benefit for 75-year-old women decreased to 2 weeks at a cost of
      more than $96,000/QALY. CONCLUSION: There is a small survival benefit for
      adjuvant chemotherapy in elderly patients. The cost of this benefit is high, but
      within the range of commonly reimbursed procedures until a point between 75 and
      80 years old. The use of active life expectancy as the primary outcome reduces
      the benefit and adds to the cost. If physicians and policymakers agree that
      active life expectancy is a relevant outcome, withholding chemotherapy for
      patients > or = 70 years old is a reasonable approach.

PMID- 8478672
TI  - Characteristics of women at risk for psychosocial distress in the year after
      breast cancer.
AB  - PURPOSE: To provide a detailed description of rehabilitation problems of women,
      considered to be low risk and at risk for psychosocial morbidity, diagnosed with
      stage I and II breast cancer 1 month and 1 year after primary treatment. PATIENTS
      AND METHODS: A sample of 227 newly diagnosed breast cancer patients were
      systematically interviewed by a clinical social worker and classified for risk of
      psychosocial distress in the year after diagnosis. They completed a battery of
      standardized instruments to assess quality of life (QL), rehabilitation needs,
      and psychologic distress. The primary QL instrument, the Cancer Rehabilitation
      Evaluation System (CARES), provides a detailed listing of rehabilitation needs.
      Descriptive CARES data are presented with comparisons between the two groups.
      RESULTS: The at-risk women had significantly more problems with greater severity
      than the low-risk women in all areas (physical, psychosocial, medical
      interaction, sexual, and marital). While both groups showed improvement over the
      year following diagnosis, the at-risk group had significantly more problems 1
      year later. Many physical problems subside, but problems at the local surgical
      site, psychologic distress, communication with marital partners, and negative
      body image are more persistent in the at-risk group 1 year later, while half of
      both groups continue to have sexual dysfunction. CONCLUSION: The detailed listing
      of problems provided by the CARES may be helpful to clinicians in their
      interactions with patients. The need for preventive and early intervention for
      the at-risk patients is underscored.

PMID- 8478673
TI  - Using the tolerable-dose diagram in the design of phase I combination
      chemotherapy trials.
AB  - PURPOSE: Choosing maximum-tolerated doses (MTDs) of agents to be administered in
      combination is more complicated than choosing the MTD for a single agent. This is
      because there are many combinations of doses that will be tolerated. We offer
      guidance in targeting specific MTD combinations, and suggest trial designs to
      achieve these targets. METHODS: A graphical method based on a simple, previously
      described mathematical model is used to guide the phase I trial design. The
      method involves constructing a tolerable-dose diagram, which displays the
      toxicities that are expected to occur at various dose combinations. The data
      required for the method are the single-agent toxicity profiles of the agents.
      Designs for combinations of taxol with fluorouracil, carboplatin, doxorubicin,
      cyclophosphamide, and cisplatin are used to demonstrate the methods. RESULTS: For
      all of the drugs considered here, leukopenia is dose-limiting or nearly dose
      limiting. Consequently, no major improvement in total dose-intensity is
      achievable by combining these drugs. If leukopenia can be eliminated or
      substantially reduced by use of chemoprotective agents, then a
      cyclophosphamide/taxol combination appears promising from a dose-intensity point
      of view. For other combinations, the doses must be reduced from single-agent MTD
      levels. In the absence of biologic information such as concentrations needed for
      optimal modulation, it is suggested that single-agent MTDs be reduced
      approximately proportionately for each drug in the combination. CONCLUSION:
      Tolerable-dose diagrams are useful for planning phase I trials of combinations of
      agents. They can suggest which combinations are promising from a dose-intensity
      perspective, as well as dose-escalation schemes for combinations to be pursued
      for dose-intensity or other considerations.

PMID- 8478674
TI  - Intermediate lymphocytic lymphoma: clinical and pathologic features of a recently
      characterized subtype of non-Hodgkin's lymphoma.
AB  - PURPOSE: We present a comprehensive review of clinical, pathologic, molecular,
      and prognostic features and therapy of intermediate lymphocytic (mantle cell)
      lymphoma (ILL/MCL), a recently characterized subtype that represents 2% to 8% of
      non-Hodgkin's lymphomas (NHLs), but which has not been included in most
      classification schemes, including the International Working Formulation. DESIGN:
      The English-language literature encompassing the above aspects, published between
      1977 and 1992, is critically reviewed. RESULTS AND CONCLUSION: ILL/MCL is a
      disease of proliferating B lymphocytes that is characterized by generalized
      lymphadenopathy and frequent, often extensive, involvement of the spleen, bone
      marrow, and gastrointestinal tract. The malignant cells usually express the
      markers CD5 and IgM with or without IgD, but not CD10, on the cell surface, and
      grow in one of two dominant histologic patterns: mantle zone and diffuse. The
      characteristic cytogenetic abnormality is a t(11;14)(q13;q32) translocation,
      which juxtaposes the bcl-1 locus on chromosome 11 with the immunoglobulin (Ig)
      heavy-chain locus on chromosome 14, and appears to result in dysregulated
      expression of the gene encoding cyclin D1. Median survival is in the range of 2
      to 5 years. While responses to chemotherapy may be seen in up to half the
      patients, relapses are the rule, and longterm survival is uncommon. The optimal
      treatment remains undefined, although therapy may be deferred until there are
      symptoms or complications, at which time judicious administration of alkylating
      agents and glucocorticoids may result in effective palliation.

PMID- 8478675
TI  - Follow-up report on the outcome of patients relapsing after autologous marrow
      transplantation for malignant lymphoma.

PMID- 8478676
TI  - Effects of posterior association cortex lesions on brain potentials preceding
      self-initiated movements.
AB  - To assess the role of subregions of the posterior association cortex in movement
      control, we recorded movement-related potentials (MRPs) in patients who had
      lesions centered in the temporal-parietal junction (T-PCx; damaged areas 22,
      caudal 39, 40, and 42; n = 7), superior parietal cortex (ParCx; damaged areas 5,
      7, rostral 39, and 40; n = 5), and posterior association cortex lesions involving
      both the temporal-parietal junction and the superior parietal structures (PosCx;
      damaged areas 7, 22, 39, 40, 41, and 42; n = 5) and in 14 age-matched normal
      controls. MRPs were recorded in a self-paced button-press task in which subjects
      performed a switch closure with the right, left, or both hands (experiment I,
      experiment II, and experiment III, respectively) under counter-balanced
      experimental conditions. Data epochs beginning 1400 msec prior to and extending
      to 600 msec after each motor response were recorded from scalp sites over the
      precentral, central, and parietal regions. Normal controls and patients with T
      PCx lesions generated comparable vertex maximal, symmetrical readiness potentials
      (onset 1000 msec), contralaterally enhanced NS' values (onset 500 msec), and MP
      values (onset 100 msec) preceding voluntary self-paced movements. Extensive
      lesions involving the posterior association cortex reduced MRP amplitudes.
      Patients with selective ParCx lesions also had marked reduction of MRPs under all
      experimental conditions. The MRP findings coupled with clinical and behavioral
      data on patients with parietal-cortex lesions indicate that the superior parietal
      regions are part of a neural system necessary for movement preparation.

PMID- 8478677
TI  - Stress-induced inhibition of protein synthesis initiation: modulation of
      initiation factor 2 and guanine nucleotide exchange factor activities following
      transient cerebral ischemia in the rat.
AB  - Neuronal protein synthesis is severely depressed following stress such as heat
      shock, hypoxia, and hypoglycemia. Following reversible cerebral ischemia, protein
      synthesis is transiently inhibited in ischemia-resistant areas, but persistently
      depressed in vulnerable brain regions. Eukaryotic initiation factor 2 (eIF-2)
      activity, that is, the formation of the ternary complex eIF-2.GTP.initiator 35S
      Met-tRNA, a rate-limiting step in the initiation of cellular protein synthesis,
      was studied in the rat brain during and following 15 min of transient global
      cerebral ischemia. At 30 min and 1 hr of reperfusion, a general decrease of eIF-2
      activity by approximately 50% was seen in the postmitochondrial supernatant
      (PMS). In the relatively resistant neocortex and CA3 region of the hippocampus,
      the eIF-2 activity returns to control levels at 6 hr of reperfusion, but remains
      depressed in the vulnerable striatum and the CA1 region. Similarly, the activity
      of the guanine nucleotide exchange factor (GEF), which catalyzes the exchange of
      GTP for GDP bound to eIF-2, a crucial step for the continued formation of the
      ternary complex, is transiently reduced in neocortex but persistently depressed
      in striatum. The postischemic decrease in eIF-2 activity is further attenuated by
      agarose-bound alkaline phosphatase, and mixing experiments revealed that a
      vanadate-sensitive phosphatase may be responsible for the depression. Addition of
      partially purified GEF to PMS from postischemic neocortex restored eIF-2 activity
      to control levels. We conclude that ischemia alters the balance between
      phosphorylation and dephosphorylation reactions, leading to an inhibition of GEF
      and a depression of ternary complex formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478678
TI  - The contributions of protein kinase A and protein kinase C to the actions of 5-HT
      on the L-type Ca2+ current of the sensory neurons in Aplysia.
AB  - In the sensory neurons of Aplysia, 5-HT acts through cAMP to reduce current flow
      through two classes of K+ channels, the S-K + channel and a transient K+ channel
      (Ikv). In addition, 5-HT increases a voltage-dependent, nifedipine-sensitive Ca2+
      current. In this article we show that, while the effect on the S-K+ channel is
      mediated exclusively by cAMP, the effect on the Ca2+ current can be mimicked by
      phorbol 12,13-dibutyrate (PDBu) as well as by intracellular injection of cAMP. We
      then use specific blockers of protein kinase C (PKC) and the cAMP-dependent
      protein kinase A (PKA) to examine the roles of PKC and PKA in mediating the
      effect of 5-HT on the nifedipine-sensitive Ca2+ current. We find that H-7, a
      kinase inhibitor that appears to inhibit PKC more effectively than PKA in intact
      Aplysia neurons, reverses the increase in the Ca2+ current produced by PDBu.
      Moreover, H-7 partially blocks the effect of 5-HT on the Ca2+ current without
      affecting the decrease in the S-K+ current. A more specific PKC inhibitor (the 19
      31 pseudosubstrate of PKC) also partially blocks the increase in the Ca2+ current
      produced by 5-HT, suggesting that this increase is mediated by PKC. Rp-cAMPS, a
      specific blocker of PKA, did not block the increase in the Ca2+ current produced
      by 5-HT, suggesting that the effect of 5-HT on this current may be mediated to
      only a small extent by PKA. The effect of 5-HT on the S-K+ current and the Ca2+
      current can also be separated on basis of the time course of their appearance.
      The fact that the decrease in the S-K+ current precedes the increase in Ca2+
      current suggests that there may be a temporal difference in the activation of the
      two kinase systems.

PMID- 8478679
TI  - A higher control center of locomotor behavior in the Drosophila brain.
AB  - In order to elucidate the behavioral significance of the central complex (CC), we
      have examined walking in 15 Drosophila mutant strains belonging to eight
      independent X-linked genes that affect the structure of the CC. Compared to four
      different wild-type strains, all are impaired either in a general or in a
      paradigm-dependent manner. Behavioral deficits concern walking activity, walking
      speed, or "straightness of walking" as measured in an object fixation task, in
      fast phototaxis, and in negative geotaxis. Behavioral deficits of three strains
      with mutations in different genes were studied in detail using mosaic analysis
      and high-speed cinematography. In all cases the focus for declining walking
      activity is located in the brain and is fully correlated with the respective
      defect of the CC. A high correlation between the degree of the behavioral
      impairment and the severity of the structural defect in two strains further adds
      to the evidence. Declining walking activity is not an unspecific side effect of
      structural brain defects, as steady walking is observed in structural mutants of
      the visual system and mushroom bodies. In mutant flies no-bridgeKS49 (nob), step
      size as a function of the stepping period is reduced. The focus of the resulting
      reduced average and maximum walking speeds resides in the brain and, again, the
      behavioral impairment fully correlates with the structural defects of the CC.
      While no indication is found for a role of the CC in setting up the basic
      stepping rhythm in straight walking (a respective phenotype in mutant central
      complexKS181 flies resides in the ventral ganglion), a role in turning and
      start/stop maneuvers is suggested by aberrations in the stepping pattern of nob
      flies during such episodes.

PMID- 8478680
TI  - The jamming avoidance response in Eigenmannia is controlled by two separate motor
      pathways.
AB  - The gymnotiform fish Eigenmannia generates weakly electric signals for
      electrolocation and communication. The signals are produced by electric organ
      discharges (EODs) that are driven by a medullary pacemaker nucleus. To avoid
      jamming by neighboring conspecifics with similar frequencies, a fish raises its
      own EOD frequency if the neighbor's frequency is lower, and it lowers its EOD
      frequency if the neighbor's frequency is higher (Watanabe and Takeda, 1963). Both
      the raising and lowering of EOD frequency of this jamming avoidance response
      (JAR; Bullock et al., 1972) are thought to be controlled by feature-extracting
      neurons in the diencephalic prepacemaker nucleus (PPn-G) that discriminate the
      sign of the frequency difference between the jamming signal and the fish's EOD
      (Kawasaki et al., 1988a; Rose et al., 1988; for review, see Heiligenberg, 1991).
      These prepacemaker neurons are excited in response to lower jamming frequencies,
      thereby raising the frequency, and inhibited by higher jamming frequencies,
      producing a discharge deceleration. The results of experiments presented here,
      however, suggest a mechanism for the motor control of the JAR that is different
      from the one described previously (see, e.g., Heiligenberg, 1991). Two
      prepacemaker nuclei, one PPn-G and one sublemniscal prepacemaker nucleus (SPPn)
      (Keller et al., 1991 a,b), which provide the only known inputs to the pacemaker,
      were lesioned selectively. This article explores the effects of these lesions on
      the JAR. Pharmacological experiments were used to elucidate the transmitter types
      involved. The results suggest that the JAR is controlled by two separate motor
      pathways. One controls frequency rises and originates in the dorsal substructure
      of the nucleus electrosensorius (Keller, 1988). It sends excitatory connections
      to the diencephalic prepacemaker and finally to the pacemaker nucleus, where AMPA
      type receptors mediate the synaptic transmission. The second pathway controls
      frequency decreases and originates in the ventral substructure of the nucleus
      electrosensorius. It provides GABAergic input to the SPPn. The SPPn is tonically
      active and also controls the EOD frequency even in the absence of jamming
      signals. Its projection to the pacemaker nucleus is mediated by NMDA-type
      receptors. The results of this study suggest that there is no single population
      of final, feature-extracting elements or "recognition units" that controls JAR
      related shifts of the pacemaker frequency. Instead, the motor control of the JAR
      consists of an interaction of two independent pathways according to a "push-pull"
      principle.

PMID- 8478681
TI  - Gangliosides rescue neuronal cells from death after trophic factor deprivation.
AB  - Serum-free cultures of PC 12 cells have been used as a model system for studying
      neuronal death occurring after neurotrophic factor deprivation. In this system,
      NGF rescues cells from death and prevents apoptotic DNA fragmentation. We report
      here that GM1 also promotes long-term survival of naive and NGF-pretreated PC 12
      cells in serum-free medium and prevents internucleosomal cleavage of PC 12 cell
      DNA. In contrast to NGF, GM1 does not promote neurite outgrowth or somatic
      hypertrophy. The survival effects of GM1 are concentration dependent, with
      maximal activity at 30-50 microM. Optimal promotion of survival is obtained with
      multiple additions of GM1. Asialo-GM1 and sialic acid do not mimic these actions,
      indicating a requirement for the intact GM1 molecule. Prevention of serum-free PC
      12 cell death is also obtained with di-, tri-, and tetrasialogangliosides. The
      ganglioside effects on survival and DNA fragmentation appear to be independent of
      macromolecular synthesis. GM1 is also effective under conditions in which
      cellular protein kinase C activity is downregulated by preexposure to high
      concentration of 12-O-tetradecanoylphorbol-13-acetate. Furthermore, GM1 promotes
      long-term survival of cultured rat sympathetic neurons after withdrawal of NGF.
      These findings complement prior observations that gangliosides protect cerebellar
      granule neurons from neurotoxicity caused by exposure to excitatory amino acids
      and extend the actions of gangliosides to rescue of neuronal cells deprived of
      neurotrophic factor support.

PMID- 8478682
TI  - Expression of glutamate receptor genes in the mammalian retina: the localization
      of GluR1 through GluR7 mRNAs.
AB  - Seven distinct cDNAs encoding functional subunits of the AMPA/kainate-type
      glutamate receptors have been recently cloned. This in situ hybridization study
      was done to determine which subunits are expressed in the retina and, where
      possible, which neurons express them. Hybridization of 35S-UTP-labeled cRNA
      probes with transverse sections revealed that mRNAs for all seven receptor
      subunits (GluR1-GluR7) are expressed in both cat and rat retinas. GluR1 and GluR2
      produced labeling over the entire inner nuclear layer (INL) and ganglion cell
      layer (GCL). GluR3-GluR7 have more limited distributions, indicative of
      expression by only a subset of neurons. All of the subunits are expressed by the
      cells at the inner edge of the INL, where amacrine cells reside, yet the layers
      with the horizontal, bipolar, and ganglion cells contain different subsets of
      subunits. These findings suggest that these glutamate receptor subunits are
      employed at many of the retinal synapses, including the photoreceptor input to
      the outer plexiform layer and the bipolar cell's contacts with the processes at
      the INL. It is also possible that some glial cells in the INL express some of the
      subunits. Since different combinations of GluR1-GluR3 have been shown to play an
      important role in the calcium permeability in response to glutamate, we
      investigated whether single cells coexpressed those subunits. By hybridizing
      adjacent semithin (1 micron) sections of the cat retina with probes for GluR1
      GluR3, it was possible to observe coexpression of all three subunits, or of pairs
      of these subunits, in cells within the INL and GCL.

PMID- 8478683
TI  - An audio-vocal interface in echolocating horseshoe bats.
AB  - The control of vocalization depends significantly on auditory feedback in any
      species of mammals. Echolocating horseshoe bats, however, provide an excellent
      model system to study audio-vocal (AV) interactions. These bats can precisely
      control the frequency of their echolocation calls by monitoring the
      characteristics of the returning echo; they compensate for flight-induced Doppler
      shifts in the echo frequency by lowering the frequency of the subsequent
      vocalization cells (Schnitzler, 1968; Schuller et al., 1974, 1975). It was the
      aim of this study to investigate the neuronal mechanisms underlying this Doppler
      shift compensation (DSC) behavior. For that purpose, the neuronal activity of
      single units was studied during spontaneous vocalizations of the bats and
      compared with responses to auditory stimuli such as playback vocalizations and
      artificially generated acoustic stimuli. The natural echolocation situation was
      simulated by triggering an acoustic stimulus to the bat's own vocalization and by
      varying the time delay of this artificial "echo" relative to the vocalization
      onset. Single-unit activity was observed before, during, and/or after the bat's
      vocalization as well as in response to auditory stimuli. However, the activity
      patterns associated with vocalization differed from those triggered by auditory
      stimuli even when the auditory stimuli were acoustically identical to the bat's
      vocalization. These neurons were called AV neurons. Their distribution was
      restricted to an area in the paralemniscal tegmentum of the midbrain. When the
      natural echolocation situation was stimulated, the responses of AV neurons
      depended on the time delay between the onset of vocalization and the beginning of
      the simulated echo. This delay sensitivity disappeared completely when the act of
      vocalization was replaced by an auditory stimulus that mimicked acoustic self
      stimulation during the emission of an echolocation call. The activity of
      paralemniscal neurons was correlated with all parameters of echolocation calls
      and echoes that are relevant in context with DSC. These results suggest a model
      for the regulation of vocalization frequencies by inhibitory auditory feedback.

PMID- 8478684
TI  - Development of local circuits in human visual cortex.
AB  - How we see the world largely depends on the organization of neuronal circuits in
      visual cortex. Physiological recordings in mammals indicate that circuits develop
      over a period that extends well into early postnatal ages (LeVay et al., 1980;
      Albus and Wolf, 1984). Our understanding of how these circuits are assembled
      during development is still fragmentary (Katz and Callaway, 1992). Here we
      describe the development of local connections within visual cortex, using the
      fluorescent dye 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine
      perchlorate to trace axonal projections in post-mortem human brains. Vertical
      (intracolumnar) connections between layers 2/3 and 5, which link neurons
      representing the same point in the visual field, develop prenatally at 26-29
      weeks gestation. In contrast, horizontal (intercolumnar) connections between
      different points in the visual field develop later. They first emerge prenatally
      at approximately 37 weeks gestation within layers 4B and 5. After birth (> 40
      weeks gestation) the fiber density increases rapidly, showing a uniform plexus of
      connections at 7 weeks postnatal. The more adult-like patchiness of the
      projection, however, emerges after 8 weeks postnatal. Long-range horizontal
      connections within layer 2/3 develop after the connections within layers 4B, 5,
      and 6. These connections emerge after 16 weeks postnatal, long after cytochrome
      oxidase blobs have developed, and reach mature from sometime before 15 months of
      age. Unlike the patchy horizontal projections within layers 4B and 5, which seem
      to develop through a process of collateral elimination, long-range projections
      within layer 2/3 are patchy from the outset and seem to develop with greater
      topographical precision. The finding that intracolumnar connections develop
      before intercolumnar projections suggests that circuits that process local
      features of a visual scene develop before circuits necessary to integrate these
      features into a continuous and coherent neural representation of an image. In
      addition, the sequential development of horizontal connections within layer 4B
      before those within layer 2/3 suggests that circuits that may be related to the
      processing channel for visual motion develop in advance of those that may be more
      intimately related to the processing of form, color, and precise stereoscopic
      depth.

PMID- 8478685
TI  - Pharmacology of the effects of bradykinin, serotonin, and histamine on the
      release of calcitonin gene-related peptide from C-fiber terminals in the rat
      trachea.
AB  - The effects of inflammatory substances, bradykinin (BK), 5-HT, and histamine
      (HIS), on the release of calcitonin gene-related peptide (CGRP) from the
      peripheral terminals of sensory afferents in the rat trachea were examined ex
      vivo. With intralumenal perfusion, the isolated rat trachea displays low but
      measurable secretion of CGRP (32 +/- 4.6 fmol/10 min fraction). The addition of
      BK (10(-6) to 10(-4) M) to the superfusate resulted in an immediate,
      concentration-dependent increase in the level of CGRP (5-30-fold increase above
      baseline) in the perfusates, and this effect showed a concentration-dependent
      tachyphylaxis. [Des-Arg10]-kallidin, a B1 receptor agonist, at concentrations of
      up to 10(-4) M did not induce any significant increase in CGRP outflow from the
      rat trachea. HIS at 10(-4) M caused a modest but progressive augmentation in the
      release of CGRP. 5-HT at 10(-4) M had no effect upon the resting efflux of CGRP,
      but at a concentration of 10(-6) M significantly enhanced the release of CGRP
      evoked by capsaicin (10(-6) M). Similar conditioning studies carried out with HIS
      and BK showed no augmentation. BK-evoked CGRP efflux was significantly inhibited
      by [D-Arg0, Hyp3, Thi5,8, D-Phe7]-BK (B2 antagonist) and indomethacin. While [Des
      Arg9, Leu8]-BK (B1 antagonist) also caused a reduction of BK-induced release, its
      effect did not reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8478686
TI  - Effects of met-enkephalin on GABAergic spontaneous miniature IPSPs in organotypic
      slice cultures of the rat hippocampus.
AB  - The action of met-enkephalin on GABAergic spontaneous miniature IPSPs (smIPSPs)
      was investigated in CA1 neurons from hippocampal slice cultures. In the presence
      of excitatory amino acid blockers (2,3-dihydroxy-6-nitro-7-sulphamoyl
      benzo(F)quinoxaline, DL-2-amino-5-phosphonovaleric acid) and TTX, a continuous
      high-frequency bombardment of smIPSPs was recorded. The smIPSPs were blocked by
      the GABAA antagonist bicuculline. The occurrence of the smIPSPs was random and
      their amplitude distribution was skewed toward larger smIPSPs. Met-enkephalin (10
      20 microM) reversibly reduced the frequency and changed the amplitude
      distribution of the smIPSPs. The proportion of "large" smIPSPs was reduced, but a
      loss of "small" smIPSPs also contributed to the reduction in smIPSP frequency.
      The selective mu-receptor agonist DAGO mimicked the effect of met-enkephalin and
      naloxone blocked the effect of DAGO. Hyperpolarization of the neuronal membranes,
      produced by reducing the extracellular K+ concentration, did not reduce the
      frequency of the smIPSPs, nor did it block the effect of DAGO. Reduction of the
      extracellular concentration of Ca2+ combined with an increase in extracellular
      Mg2+ or the addition of Cd2+ did not reduce the smIPSP frequency, nor did it
      block the effect of DAGO. These results suggest that CA1 pyramidal cells of
      hippocampal organotypic cultures are tonically inhibited by spontaneous release
      of GABA, through a release mechanism that is independent of propagated sodium
      action potentials. Met-enkephalin and DAGO reduce the tonic inhibition by
      reducing the frequency of the smIPSPs, through a direct action on the presynaptic
      GABAergic terminals. The effect was probably not mediated by hyperpolarization of
      the presynaptic membrane or by modulation of presynaptic Ca2+ currents.

PMID- 8478687
TI  - Alpha-bungarotoxin binding to hippocampal interneurons: immunocytochemical
      characterization and effects on growth factor expression.
AB  - The nicotinic cholinergic antagonist alpha-bungarotoxin (alpha-BT) binds
      throughout the rat hippocampal formation. The binding is displaceable by d
      tubocurarine. The most heavily labeled cells are GABA-containing interneurons in
      the dentate and in Ammon's horn. These neurons have several different
      morphologies and contain several neuropeptides. alpha-BT-labeled interneurons in
      the dentate are small cells between the granular and molecular layers that often
      contain neuropeptide Y. alpha-BT-labeled interneurons in CA1 are medium-sized
      interneurons, occasionally found in stratum pyramidale, but more often found in
      stratum radiatum and stratum lacunosum moleculare. These neurons often contain
      cholecystokinin. The largest alpha-BT-labeled interneurons are found in CA3, in
      both stratum radiatum and stratum lucidum. These neurons are multipolar and
      frequently are autofluorescent. They often contain somatostatin or
      cholecystokinin. These large interneurons have been found to receive medial
      septal innervation and may also have projections that provide inhibitory feedback
      directly to the medial septal nucleus. The cholinergic innervation of the
      hippocampus from the medial septal nucleus is under the trophic regulation of NGF
      and brain-derived neurotrophic factor, even in adult life. Expression of mRNA for
      both these factors is increased in CA3 and the dentate after intraventricular
      administration of alpha-BT, but not after administration of the muscarinic
      antagonist atropine. alpha-BT-sensitive cholinergic receptors on inhibitory
      interneurons may be critical to medial septal regulation of the hippocampal
      activity, including the habituation of response to sensory input.

PMID- 8478688
TI  - Glutathione S-transferase isoenzymes in rat brain neurons and glia.
AB  - The glutathione S-transferases (GSTs) constitute a family of cytosolic isoenzymes
      and a structurally unrelated microsomal enzyme that is involved in the
      detoxication of electrophilic xenobiotics. These enzymes also participate in the
      intracellular binding and transport of a broad range of lipophilic compounds
      including bilirubin, and hormones such as the glucocorticoids and thyroid
      hormones. The present investigation demonstrates that GSTs are present in neurons
      of the brainstem, forebrain, and cerebellum. An isoenzyme-specific distribution
      of GSTs was found in cytoplasm, nuclei, and nucleoli. The regional and cellular
      distribution of cytosolic GSTs in the brain was studied by immunohistochemistry,
      spectrophotometric enzyme assay, and reverse-phase HPLC. Polyclonal antibody
      against microsomal GST was strongly reactive with Purkinje cells throughout the
      cerebellar cortex, and with neurons in the brainstem and hippocampus. Nuclei of
      Purkinje cells and of neurons in the brainstem, hippocampus, and cerebral cortex
      were immunopositive for alpha-class GST 1-1 (YaYa), whereas alpha-class GST 2-2
      (YcYc) antibody was consistently immunoreactive with the nucleolus, but not with
      the nucleus or soma. All alpha-class GST antibodies studied were reactive, to
      various degrees, with astrocytes and choroid plexus; however, ependymal cells of
      the subventricular zones were immunonegative. alpha-class GST 8-8 (YkYk)
      immunoreactivity was specifically localized to endothelial cells and/or
      astrocytic end feet associated with blood vessels. Reverse-phase HPLC indicated
      that there were also substantial regional differences in the pattern of alpha-,
      mu-, and pi-class GST subunit expression. For example, the thalamus/hypothalamus
      had the highest GST activity and greatest concentration of total GST protein and
      mu-class GST subunit 6 (Yb3), whereas the brainstem had the greatest
      concentration of pi-class GST subunit (Yp). This regional variation in GST
      expression may be reflective of regional differences in cell populations. In
      cerebellar cortex, the concentration of mu-class GST subunit 4 (Yb2) was greatest
      in the flocculus and lowest in the vermis. This is of clinical interest because
      the pattern of expression of mu-class GST subunit 4 (Yb2) in the cerebellum
      coincides with the known regional susceptibility of this structure to
      degeneration after exposure to toxic or metabolic insults. The vermis is most
      susceptible to these insults, whereas the lateral lobes and flocculus are most
      resistant.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8478689
TI  - Neurogenesis in adult canary telencephalon is independent of gonadal hormone
      levels.
AB  - Neurons generated in adulthood are found throughout the canary telencephalon. We
      are interested in the factors that control the rate of proliferation of stem
      cells that give rise to these new neurons. The rate of incorporation of newly
      generated neurons into vocal-control regions varies seasonally. This difference
      could reflect a higher rate of neurogenesis, a lower rate of cell death, or an
      altered migration. We examined the incidence of thymidine-labeled cells in the
      telencephalic ventricular zone of adult canaries as a function of variations in
      gonadal hormone levels. Adult female canaries maintained on a short-day
      photoperiod were anesthetized and gonadectomized. Four separate groups of birds
      received systemic exposure to either testosterone, estradiol, a combination of an
      anti-androgen and an inhibitor of estrogen synthesis, or nothing. All birds were
      also implanted with an osmotic minipump that released 3H-thymidine for 3 d and
      were killed 4 or 7 d following the onset of treatment. Analysis of autoradiograms
      revealed no differences between groups in the incidence of labeling within the
      ventricular zone either at the level of the anterior commissure or directly
      adjacent to the vocal-control nucleus HVC (higher vocal center). These results
      suggest that sex steroids do not regulate the rate of cell division in the
      ventricular zone. Seasonal differences in the incorporation of labeled cells into
      HVC may therefore be due to regulation of neurogenesis by photoperiodic factors
      other than gonadal steroids or to some other cellular mechanism, such as
      differential migration or survival of neurons.

PMID- 8478690
TI  - GABA shapes sensitivity to interaural intensity disparities in the mustache bat's
      inferior colliculus: implications for encoding sound location.
AB  - This study examined how GABAergic inhibition affected binaural properties of
      neurons in the mustache bat's inferior colliculus. Evaluations were made by
      documenting changes in acoustically evoked inhibition that occurred when
      GABAergic inputs were reversibly blocked by iontophoretic application of the
      GABAA antagonist bicuculline. We studied neurons sensitive to interaural
      intensity disparities (IIDs), since these are the principal cues animals use to
      localize high-frequency sounds. Neurons sensitive to these cues receive
      excitation from one ear and inhibition from the other ear, and are called EI
      neurons. Recordings focused on the EI region in the hypertrophied 60 kHz
      isofrequency contour, where the sensitivities of the EI cells to IIDs are
      systematically ordered, thereby creating a map of IID sensitivity. EI neurons
      were classified on the basis of their IID functions, of which there were two
      principal types. Seventy percent of the cells had conventional IID functions
      where the firing rate evoked by a fixed intensity at the contralateral
      (excitatory) ear remained constant with low intensities at the ipsilateral
      (inhibitory) ear and then declined progressively as the intensity at the
      ipsilateral ear increased. We refer to cells that had this type of IID function
      simply as EI neurons. The IID functions in the remaining 30% of the cells showed
      binaural facilitation and were classified as EI/f neurons. In these cells,
      increasing sound intensity at the ipsilateral (inhibitory) ear when the intensity
      at the contralateral (excitatory) ear was fixed, initially caused the firing rate
      to increase by at least 25% above the rate evoked by the sound at the
      contralateral ear alone. Additional intensity increases at the ipsilateral ear
      then resulted in a marked decline in response rate. We examined the effects of
      bicuculline on three binaural properties: (1) the degree of inhibition evoked by
      the ipsilateral ear (the maximum inhibition), (2) the IID at which the unit's
      discharge rate declined by 50% (the 50% point), and (3) binaural facilitation.
      There are three main findings. First, bicuculline substantially reduced or
      eliminated the inhibition evoked by the ipsilateral ear in about 40% of the
      cells. In the other 60% of the cells, bicuculline had little or no effect on the
      magnitude of the ipsilaterally evoked inhibition. The second finding is that in
      more than half of the cells in which there was little or no reduction in the
      magnitude of the ipsilaterally evoked inhibition, bicuculline changed the IID at
      which the ipsilaterally evoked inhibition caused the discharge rate to decline by
      50%.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8478691
TI  - Number, distribution, and morphology of retinal ganglion cells with axons
      regenerated into peripheral nerve graft in adult cats.
AB  - The optic nerve of adult cats was transected and an autologous peripheral nerve
      was transplanted to the stump. Two months later retinal ganglion cells (RGCs)
      that had regenerated their axons were retrogradely labeled with fluorescent dye
      injected into the graft. The more than 4000 labeled cells, which were 3.0-4.3% of
      total ganglion cell number in the intact retina, were distributed in a high
      density area elongating horizontally, in a pattern similar to that observed in
      the intact retina. The dendritic morphology of RGCs with regenerated axons was
      examined after intracellular injections of HRP or Lucifer yellow in vitro. The
      morphology of alpha- and gamma-cells appeared comparable to normal, whereas the
      dendrites of some beta-cells seemed to degenerate. Some "unclassified" cells
      could not be identified as alpha-, beta-, or gamma-cells. The main dendrites of
      most unclassified cells were thin and less ramified than alpha- and beta-cells.
      Some unclassified cells had a vacant area in their dendritic fields, suggesting
      degenerative change in dendrites. The distal dendrites of some unclassified and
      gamma-cells had many fine processes that probably regrew during axonal
      regeneration. The proportion of alpha-, beta-, and other cells including gamma-
      and unclassified cells in the regenerating cell population was evaluated by
      examining all of the Lucifer yellow-injected cells in local patches. The average
      proportion of alpha-cells was 23.9%, about six times higher than in intact
      retinas. The average proportion of beta-cells was 50.3%, slightly higher than in
      intact retinas. The remaining cells (25.7%) could not be categorized as alpha or
      beta; this proportion is about half that found in intact retinas. These findings
      suggest that alpha-cells have the highest capacity to regenerate their axons into
      nerve grafts, rather than all types equally regenerating their axons.

PMID- 8478692
TI  - Functional uncoupling of inhibitory interneurons plays an important role in short
      term sensitization of Aplysia gill and siphon withdrawal reflex.
AB  - Attempts to explain learning-associated potentiation of synaptic transmission in
      model systems such as withdrawal reflexes in the mollusk Aplysia or the
      hippocampus of vertebrates have focused on the mechanisms by which transmitter
      release is increased in the principal elements of the circuit. Increased
      transmission in neuronal networks such as the gill and siphon withdrawal reflex
      (GSWR) of Aplysia may, however, also be caused by a decrease of transmitter
      release by inhibitory interneurons. The importance and function of cholinergic
      inhibitory transmission in the GSWR network were investigated. Central
      application of the nicotinic cholinergic antagonist d-tubocurarine (d-TC)
      considerably potentiated gill contractions, evoked either by nerve stimulation or
      by tactile stimulation of the siphon. Compound EPSPs evoked in motoneurons upon
      siphon nerve stimulation were also significantly prolonged following application
      of d-TC, but were unaffected by hexamethonium, a blocker of excitatory ACh
      receptors in Aplysia. Recordings from excitatory interneurons showed that they
      received excitation followed by powerful inhibitory input upon stimulation of the
      siphon nerve. Application of d-TC completely blocked this rapid inhibition, thus
      prolonging the compound EPSPs evoked in the interneurons. These effects were
      obtained at a concentration of d-TC (100 microM) that almost totally blocked fast
      inhibitory cholinergic transmission, but was without effect on monosynaptic
      connections between sensory neurons and motoneurons of the reflex. Facilitation
      of (1) compound EPSCs in motoneurons and (2) evoked excitatory interneuronal
      firing was reduced in preparations already disinhibited by pretreatment with d
      TC. Facilitation of sensory-motor synapses, however, was not reduced in the
      presence of d-TC, indicating that facilitatory interneurons are still activated
      under cholinergic blockade. These data show that transmission through the GSWR
      neuronal network is gated by a feedback inhibitory mechanism. They also suggest
      that a reduction of cholinergic inhibition onto excitatory interneurons may be a
      mechanism through which transmission within the GSWR network is increased during
      various forms of learning, such as sensitization. These data place new emphasis
      on the important role of inhibitory interneurons in determining the plastic
      properties of neuronal networks, in both invertebrates and vertebrates.

PMID- 8478693
TI  - Nerve growth factor-induced hyperalgesia in the neonatal and adult rat.
AB  - Recently, we have shown that the interaction between NGF and sensory neurons in
      early postnatal periods is restricted to nociceptive afferents (Ritter et al.,
      1991; Lewin et al., 1992a; Ritter and Mendell, 1992). Here we show that
      administration of excess NGF to neonatal or mature animals can lead to a profound
      behavioral hyperalgesia. Neonatal NGF treatment (postnatal day 0-14) resulted in
      a profound mechanical hyperalgesia that persisted until the animals had reached
      maturity (6 weeks of age). This hyperalgesia could be explained by an NGF
      mediated sensitization of A delta nociceptive afferents to mechanical stimuli.
      This peripheral sensitization wore off with a time course similar to that of the
      behavior hyperalgesia. Treatment of animals from the second postnatal week until
      5 weeks of age (juveniles) led to a very similar behavioral hyperalgesia;
      however, there was no corresponding sensitization of A delta nociceptors to
      mechanical stimuli. Finally, one group of adult animals (5 weeks old) was treated
      daily with single injections of NGF for between 1 and 4 d. Within 24 hr after the
      first NGF injection these animals developed a mechanical hyperalgesia of the same
      magnitude seen after neonatal and juvenile NGF treatments. No sensitization of A
      delta nociceptive afferents was observed in these animals. In addition to the
      mechanical hyperalgesia, the animals also developed a heat hyperalgesia after one
      injection of NGF. The heat hyperalgesia was apparent within 15 min after the
      injection; however, signs of mechanical hyperalgesia were not seen until 6 hr
      after the injection. In conclusion, it appears that the NGF-induced mechanical
      hyperalgesia is brought about by different mechanisms in neonatal and adult rats.
      Furthermore, in adult animals the NGF-induced mechanical and heat hyperalgesia
      also appear to be attributable to two different mechanisms. The mechanical
      hyperalgesia may be due to central changes (see Lewin et al., 1992b), whereas the
      heat hyperalgesia is likely to result at least in part from the sensitization of
      peripheral receptors to heat.

PMID- 8478694
TI  - Sites of microtubule stabilization for the axon.
AB  - We have sought to determine the principal site(s) in the neuron where axonal
      microtubules (MTs) are stabilized. To accomplish this, we compared the proximal
      and distal regions of the axon and the axon shaft with regard to their content of
      newly stabilized MT polymer, using the following criteria. Stable polymer was
      identified by its resistance to nocodazole, and newly stabilized polymer was
      distinguished from older stable polymer by the staining of the former but not the
      latter for tyrosinated alpha-tubulin. Our results indicate that roughly 36.4%,
      5.4%, and 2.4% of the total MT mass in the proximal and distal regions of the
      axon and the axon shaft is newly stabilized, respectively. Thus, while MT
      stabilization occurs throughout the axon, the proximal region is by far the most
      active with regard to this process.

PMID- 8478695
TI  - An invertebrate calcium-binding protein of the calbindin subfamily: protein
      structure, genomic organization, and expression pattern of the calbindin-32 gene
      of Drosophila.
AB  - Antisera against vertebrate calcium-binding proteins cross-react with Drosophila
      nervous and muscle tissue. We have used an antiserum against carp parvalbumin to
      isolate from a Drosophila head cDNA library immunopositive expression clones.
      Tissue in situ hybridization identified a clone that labeled specific neurons and
      muscles similar to the parvalbumin-like immunohistochemical staining pattern.
      Five independent cDNAs derive from an mRNA whose open reading frame codes for a
      310 amino acid polypeptide. Sequence analysis identifies six EF-hand calcium
      binding domains and reveals 42% and 37% homology to chicken calretinin and
      calbindin D-28k, respectively. Since the positions of 9 out of 10 introns within
      the ORF are conserved from the Drosophila gene to both vertebrate genes, we
      conclude that we have identified the first invertebrate member of the calbindin
      sub-family of calcium-binding protein genes of the EF-hand homolog family. The
      calbindin-32 gene (cbn) maps to 53E on the second chromosome. It is expressed
      through most of ontogenesis with a selective distribution in the nervous system
      and in a few small adult thoracic muscles. The cloning of a Drosophila homolog to
      vertebrate neuronal Ca(2+)-binding proteins opens new routes to study the so far
      largely elusive function of these brain molecules.

PMID- 8478696
TI  - Short-term changes in the numerical density of synapses in the intermediate and
      medial hyperstriatum ventrale following one-trial passive avoidance training in
      the chick.
AB  - Previous ultrastructural studies using stereological counting techniques, based
      on assumptions regarding shape, size, and orientation of synapses, have suggested
      synaptic remodeling occurred at least 24 hr after one-trial passive avoidance
      training in day-old chicks. The present study estimates the mean synaptic density
      (Nv syn) in a region of the chick forebrain known to be involved in memory
      formation, the intermediate and medial hyperstriatum ventrale (IMHV), 1 and 24 hr
      following one-trial passive avoidance training. A stereological technique, the
      "disector," that makes no assumptions about size, shape, and orientation of
      synapses was used in the synaptic analyses. The density of axospinous synapses
      increased by approximately 77% at 1 hr posttraining in the right IMHV of chicks
      (M-trained) that learned to avoid a bitter-tasting bead, compared to those (W
      trained controls) that peck a water-coated bead. A measure of the postsynaptic
      density size, the mean projected height of synapses (H), was 57% smaller 1 hr
      posttraining in the right IMHV of M-trained chicks. These differences were not
      found at 24 hr posttraining. We suggest that structural modification of synapses
      may be a key part of the processes involved in short-term memory formation.

PMID- 8478697
TI  - G(olf) and Gs in rat basal ganglia: possible involvement of G(olf) in the
      coupling of dopamine D1 receptor with adenylyl cyclase.
AB  - Using specific antibodies and cDNA probes, we have investigated, in rat basal
      ganglia, the distribution and the regulation of the expression of the alpha
      subunits of Gs and G(olf), two GTP-binding proteins (G-proteins) that stimulate
      adenylyl cyclase. We confirmed that G(olf) alpha is highly expressed in caudate
      putamen, nucleus accumbens, and olfactory tubercle, whereas Gs alpha is less
      abundant in these areas than in the other brain regions. Intrastriatal injections
      of quinolinic acid decreased dramatically the levels of G(olf) alpha protein in
      the striatum and the substantia nigra, and those of G(olf) alpha mRNA in the
      striatum. Retrograde lesions of striatonigral neurons with volkensin reduced
      markedly the levels of D1 dopamine (DA) binding sites, as well as those of G(olf)
      alpha protein and mRNA in the striatum, without altering D2 binding sites. In
      contrast, both types of lesions increased the levels of Gs alpha protein in the
      striatum and substantia nigra. Immunocytochemistry showed the presence of G(olf)
      alpha protein in striatal medium-sized neurons and in several other neuronal
      populations. These results demonstrate that striatonigral neurons contain high
      levels of G(olf) alpha and little, if any, Gs alpha, suggesting that the coupling
      of D1 receptor to adenylyl cyclase is provided by G(olf) alpha. The levels of
      G(olf) alpha were five- to sixfold higher in the striatum than in the substantia
      nigra, indicating a preferential localization of G(olf) alpha in the
      somatodendritic region of striatonigral neurons and providing a basis for the low
      efficiency of D1 receptor coupling in the substantia nigra. Six weeks after 6
      hydroxydopamine lesions of DA neurons, an increase in G(olf) alpha (+53%) and Gs
      alpha (+64%) proteins was observed in the striatum. This increase in G(olf) alpha
      levels may account for the DA-activated adenylyl cyclase supersensitivity,
      without change in D1 receptors density, that follows destruction of DA neurons.
      Fine regulation of the levels of G(olf) alpha in physiological or pathological
      situations may be a critical parameter for the efficiency of DA
      neurotransmission.

PMID- 8478698
TI  - Attenuation of hippocampal long-term potentiation by ethanol: a patch-clamp
      analysis of glutamatergic and GABAergic mechanisms.
AB  - Long-term potentiation of synpatic transmission (LTP) of the perforant path-
      dentate gyrus synapse is induced by 5 Hz, theta-like stimulation patterns. Such
      stimuli induce plasticity that is most likely driven by a decrease in synaptic
      inhibition (disinhibition) mediated by GABAB autoreceptors. In the present study,
      we demonstrate that LTP induced in this manner is completely antagonized by
      ethanol. In order to determine the site of ethanol inhibition of LTP induced by
      theta-like stimulation, we combined slice patch recordings with pharmacologic
      isolation of the individual glutamatergic and GABAergic synaptic currents. The
      present experiments revealed that ethanol inhibited NMDA receptor-mediated
      synaptic currents without potentiation of GABAA currents or attenuation of GABAB
      mediated fading of GABAA synaptic currents. These observations with ethanol
      contrasted with the actions of the water-soluble benzodiazepine midazolam, which
      strongly potentiated GABAA synaptic currents, reversed the effect of GABAB
      mediated fading of GABAA synaptic currents, and therefore blocked the resulting
      NMDA synaptic currents. These data indicate that the effects of ethanol on long
      term changes in synaptic strength in the rat hippocampal formation are due
      primarily to an action at the NMDA receptor-channel complex.

PMID- 8478699
TI  - Mallinckrodt Fellowship. Using anti-sense to predict chemotherapy resistance of
      tumors.

PMID- 8478700
TI  - Pioneer Award. Engineer and chemist honored for four decades of nuclear
      pioneering.

PMID- 8478701
TI  - Abersold Award. Nuclear chemistry's 'two Alans' share basic science award.

PMID- 8478702
TI  - Concordance of nutritive myocardial perfusion reserve and flow velocity reserve
      in conductance vessels in patients with chest pain with angiographically normal
      coronary arteries.
AB  - We have previously shown that myocardial perfusion can be quantified by positron
      emission tomography (PET) with 15O-labeled water (H2(15)O), as experimentally
      validated with radiolabeled microspheres in animal hearts. The purpose of our
      study was to determine whether myocardial nutritive perfusion reserve assessed
      with PET in human subjects was parallel to flow velocity reserve assessed in
      conductance vessels measured with intracoronary Doppler probes. We studied nine
      patients with chest pain and angiographically normal coronary arteries with
      intracoronary Doppler flow velocity assessments before and after administration
      of 16 micrograms of intracoronary adenosine. We also assessed myocardial
      nutritive perfusion with PET and H2(15)O before and after intravenous
      administration of dipyridamole (0.56 mg/kg). Perfusion reserve (the ratio of
      absolute values of myocardial perfusion after dipyridamole administration to
      perfusion at rest) estimated with PET (3.5 +/- 0.9 s.d.) correlated closely with
      flow velocity reserve (the ratio of hyperemic intracoronary flow velocity to flow
      velocity at rest) (3.5 +/- 1.2, r = 0.80, p < 0.01). Absolute values of perfusion
      assessed tomographically averaged 1.22 +/- 0.19 ml/g/min in patients at rest and
      4.16 +/- 0.93 after dipyridamole administration. Our data indicate that
      noninvasive assessment of myocardial perfusion with PET provides results that
      parallel intracoronary Doppler flow velocity measurements. Because PET delineates
      nutritive perfusion throughout the heart in absolute terms, its use may
      facilitate detection of impaired coronary arterial function and enhance
      delineation of the efficacy of potentially therapeutic interventions in patients
      with chest pain and angiographically normal coronary arteries.

PMID- 8478703
TI  - Regional cerebral blood flow improves with treatment in chronic cocaine polydrug
      users.
AB  - Brain perfusion is abnormal in chronic cocaine users. To determine whether these
      perfusion abnormalities are reversible following treatment, we studied 10 cocaine
      dependent polydrug users with 99mTc-HMPAO SPECT 2 to 3 days after admission to an
      inpatient treatment facility and at 7 to 8 days and 17 to 29 days after
      abstinence from drugs. The patients also received buprenorphine, an opioid mixed
      agonist-antagonist, beginning 10 days after admission and continuing to the end
      of the study. Imaging began 10-15 min after injection of 99mTc-HMPAO (20 mCi)
      using an annular gamma camera system. MRI was performed during hospitalization
      using a 1.5 Tesla system. SPECT and MRI were merged and five axial SPECT slices
      centered at the level of the basal ganglia were selected for analysis. Activity
      ratios were derived for cortical regions relative to cerebellar activity and were
      corrected for linearity with respect to regional cerebral blood flow. The
      cortical regions were classified as abnormal (activity ratio < 0.6), borderline
      (0.6-0.72) and normal (> 0.72) based on the results of the first SPECT study. In
      abnormal zones, regional cerebral blood flow (rCBF) increased 11.0% +/- 9.0% at 7
      to 8 days and 23.8% +/- 9.4% at 17 to 29 days after initiation of treatment. The
      increase in rCBF was 4.8% +/- 7.1% (7 to 8 days) and 11.1% +/- 8.0% (17 to 29
      days) in borderline cortex and decreased 2.9% +/- 6.3% (7 to 8 days) and
      increased only 2.7% +/- 13.4% (17 to 29 days) in normal cortex. The increase in
      rCBF did not vary significantly by location. The perfusion defects observed in
      chronic cocaine polydrug users are partially reversible with short-term
      abstinence and buprenorphine treatment.

PMID- 8478704
TI  - Role of quantitative planar thallium-201 imaging for determining viability in
      patients with acute myocardial infarction and a totally occluded infarct-related
      artery.
AB  - We studied 57 patients with a recent infarction and an occluded infarct-related
      artery to test the hypothesis that the amount of 201Tl on delayed planar images
      correlates with the extent of viable myocardium after acute myocardial
      infarction. There was a significant (p < 0.001) correlation between mean 201Tl
      activity in the infarct zone and regional wall motion score in that zone both at
      baseline (r = -0.60, n = 57) and 1 mo after attempted angioplasty (r = -0.67, n =
      48), with better function being associated with greater 201Tl uptake in the
      delayed images. There was no correlation between the number of segments showing
      redistribution and the wall motion score. We conclude that in patients with
      recent myocardial infarction and an occluded infarct-related artery, the average
      201Tl activity within the infarct zone on delayed planar imaging correlates well
      with the extent of viable myocardium in that zone. The presence or absence of
      redistribution does not influence these results.

PMID- 8478705
TI  - Immediate thallium-201 reinjection following stress imaging: a time-saving
      approach for detection of myocardial viability.
AB  - Thallium-201 reinjection following 3-4-hr redistribution imaging improves the
      detection of viable myocardium but considerably prolongs the total investigation
      time. We compared the results of immediate 201Tl reinjection with 3-hr
      redistribution imaging in 120 consecutive patients who were evaluated for
      myocardial ischemia. Thallium-201 was reinjected immediately following the
      postexercise study. The images were acquired 1 hr later and reacquired at 3 hr
      redistribution. A total of 960 segments per imaging series were evaluated, of
      which 320 (33%) segments showed perfusion defects on the post-exercise images. On
      the 1-hr images, 220 (69%) segments demonstrated enhanced thallium uptake, 97
      (30%) segments did not change and 3 (1%) segments showed reverse redistribution.
      Of the 100 (97 + 3) persistent defects, only 12 (4%) segments showed fill-in of
      201Tl on 3 hr redistribution images. A total of 49 (15%) segments showed reverse
      redistribution. Defects on postexercise images were seen in 95 patients (79%) of
      whom 9 (10%) showed no change on immediate reinjection images. In only 1 (1%)
      patient was the diagnosis changed from myocardial necrosis to myocardial ischemia
      after analysis of the 3-hr redistribution images. These data indicate that
      immediate postexercise reinjection of 201Tl followed by 1-hr image acquisition
      may be superior to 3-hr redistribution imaging in identifying viable myocardium
      in patients evaluated for myocardial ischemia. This protocol eliminates the need
      for an additional series of 3-4-hr redistribution images and offers the
      advantages of reduced total imaging time, improved convenience for the patient
      and increased patient throughput.

PMID- 8478706
TI  - Thallium reinjection imaging: the search for an optimal protocol.

PMID- 8478707
TI  - Comparison of technetium-99m-ECD to Xenon-133 SPECT in normal controls and in
      patients with mild to moderate regional cerebral blood flow abnormalities.
AB  - Technetium-99m-1,1-ethyl cysteinate dimer (ECD) has been proposed as a "chemical
      microsphere" for SPECT measurement of regional cerebral blood flow (rCBF).
      However, its distribution has not yet been compared in humans to an established
      rCBF measure. Therefore, we compared the uptake and distribution of ECD with rCBF
      measured by 133Xe SPECT in subjects with mild to moderate flow abnormalities and
      in normal volunteers. Blood and urine chemistries and vital signs were unchanged
      from pre-ECD values up to seven days postinjection. Profile plots demonstrated
      pattern agreement between rCBF ratios (133Xe) and ECD count density ratios. A
      significant correlation of rCBF ratios to ECD count density ratios was observed
      (r = 0.77), with a slope of 0.64 and intercept of 0.36. To explore whether or not
      the relationship between rCBF and ECD was dependent on absolute flow, ECD region
      of interest data were expressed in units of ml/min/100 g by equating global CBF
      (133Xe) and ECD global count density. A closer correlation (r = 0.88) was found
      for these data than for the count ratio data. The slope was closer to one (m =
      0.83) and the intercept was closer to zero (b = 8.2). Also, a significant
      correlation was observed between ECD-derived rCBF and 133Xe rCBF in the lesion
      area (r = 0.92) for patients with well-demarcated rCBF lesions. The slope (0.80)
      suggested a slight underestimation of lesion flow by ECD. Finally, ECD clearance
      from cortical gray matter ROIs derived from high-resolution scans from 1 to 4 hr
      postinjection was slow (2.4%/hr). In summary, ECD is a safe and effective marker
      of regional cerebral perfusion. The distribution of ECD is linearly related to
      rCBF measured by 133Xe SPECT, although our data suggest a mild underestimation of
      flow at the high end of the normal range.

PMID- 8478708
TI  - Normalized clearance-to-uptake slope ratio: a method to minimize false-positive
      diuretic renograms.
AB  - The success of diuretic renography in the evaluation of children with renal
      outflow tract obstruction has been hampered by a high incidence of false-positive
      and indeterminate results. The main causes of interpretative errors are
      collecting system dilatation and impaired renal function. In this prospective
      study, we introduce a parameter with the potential to overcome these two
      problems: the normalized slope ratio (SRn). This ratio is calculated from the
      division of the maximum renal clearance slope by the maximum renal uptake slope,
      both normalized to peak renal activity. Fifty-one children (94 renal units) were
      evaluated. Traditional parameters such as diuretic half-time and percentage of
      retention at 30 min showed specificities of 77% and 85%, respectively. However,
      the normalized clearance slope increased specificity to 94% and SRn further
      improved it to 98%. The SRn takes into account the renal uptake curve, whose
      slope is dependent on glomerular function, and thus may correct for renal
      dysfunction. It also differentiates obstructed from patent kidneys even in cases
      with significant collecting system dilatation. As shown by regression analysis,
      it is independent of collecting system size. We recommend the routine use of this
      parameter to reduce false-positive and indeterminate results of diuretic
      renograms.

PMID- 8478709
TI  - Radiation dose to positron emission tomography technologists during quantitative
      versus qualitative studies.
AB  - Positron emission tomography technologists were monitored with thermoluminescent
      dosimeters (TLDs) during qualitative and quantitative studies. Doses to
      technologists during specific tasks were also measured. The technologists
      received at least twice as much radiation during the quantitative as the
      qualitative studies. The average dose per study for qualitative studies was 0.017
      mSv (1.7 mrem) shallow and 0.014 mSv (1.4 mrem) deep. The average dose per study
      for the quantitative studies was 0.05 mSv (5 mrem) shallow and 0.04 mSv (4 mrem)
      deep. The average dose per study was based on the TLD dose accumulated over
      studies conducted over four 2-mo and one 1-mo intervals. The dose incurred by the
      technologists each time they drew a radioactive dose was 0.002 mSv (0.2 mrem)
      shallow and 0.001 mSv (0.1 mrem) deep. The doses received during injection were
      0.014 mSv (1.4 mrem) shallow and 0.007 mSv (0.7 mrem) deep. Doses received during
      blood sampling were 0.016 mSv (1.6 mrem) shallow and 0.014 mSv (1.4 mrem) deep.
      During quantitative studies, the technologist received a much greater dose than
      during its qualitative counterpart due to the blood sampling process and
      increased time in the room with the radioactive patient.

PMID- 8478710
TI  - In vitro assessment of 2-fluoro-2-deoxy-D-glucose, L-methionine and thymidine as
      agents to monitor the early response of a human adenocarcinoma cell line to
      radiotherapy.
AB  - The tumor cell uptake of three tracers that can be labeled with isotopes suitable
      for PET imaging--FDG, L-methionine and thymidine--were examined in vitro in a
      human ovarian carcinoma cell line (HTB77IP3) at varying times following 30 Gy
      60Co irradiation and were compared to a nonirradiated control group. FDG,
      methionine and thymidine uptake per tissue culture well all increased following
      irradiation when compared to basal values, although to a much lower extent than
      the increases in uptake seen in a nonirradiated group. This increase in tracer
      uptake occurred despite a 6.25-fold decline in viable cell numbers. When examined
      per cell, FDG uptake per cell increased 9.77-fold, methionine 7.82-fold and
      thymidine 9.48-fold over basal levels from Day 0 to Day 12 following irradiation.
      Part of these increases may be due to giant cell formation and/or radiation
      repair processes that require energy, protein and DNA substrates. While the in
      vitro system differs from in vivo systems due to the absence of a blood supply in
      vitro, a lack of infiltrating leukocytes and other factors, our data suggest that
      early assessment of human adenocarcinoma response to radiotherapy by PET with
      these tracers may be complicated by this normal increase in tracer uptake
      postirradiation. Clearly, in this human cancer cell line, early radiation-induced
      cell death is not associated with an early decline in tumor cell uptake of FDG,
      methionine or thymidine.

PMID- 8478711
TI  - High accumulation of 2-deoxy-2-fluorine-18-fluoro-D-galactose by well
      differentiated hepatomas of mice and rats.
AB  - The potential application of 2-deoxy-2-[18F]fluoro-D-galactose for the detection
      and evaluation of hepatomas with PET was examined in mouse and rat liver tumor
      models. Biodistribution studies showed that uptake of this marker was high in
      well-differentiated, spontaneous hepatoma of C3H mice at almost 92% of the normal
      liver level. The uptake by well-differentiated Morris rat hepatoma (5123D) was
      relatively high and second to that of the C3H hepatoma. On the other hand, uptake
      values for poorly differentiated mouse hepatoma (MH129P), rat hepatomas (AH109A,
      AH272), mouse melanoma (B-16) and mammary carcinoma (FM3A) were very low and only
      14%-18% of that in the normal liver. The results suggest that while well
      differentiated hepatomas maintain a high galactose metabolic activity, poorly
      differentiated hepatomas or other tumors lose this to a large extent.
      Consequently, this radiopharmaceutical can be used with PET for biochemical
      characterization of hepatomas and the differential diagnosis between hepatomas
      and other cancers.

PMID- 8478712
TI  - Changes in local cerebral glucose utilization in the awake rat during acute and
      chronic administration of ethanol.
AB  - Local cerebral glucose utilization (LCGU) was measured in 51 structures of the
      rat brain after acute and/or chronic oral administration of ethanol using the
      quantitative autoradiographic 2-deoxyglucose method. In the acute experiments,
      ethanol (3.2 g/kg) was administered via a gastric tube 110 min before the 2-deoxy
      D-[1-14C]glucose. The chronic pretreatment was performed using increasing
      concentrations of ethanol in the drinking water for a period of 20-24 days. The
      most striking effects on LCGU were seen in the inferior colliculus. Acute and
      acute plus chronic treatment with ethanol significantly decreased LCGU by 33% and
      37%, respectively, whereas chronic treatment significantly increased LCGU by 25%.
      In general, acute administration of ethanol decreased LCGU in 16 brain
      structures, particularly of the auditory system. Chronic treatment, besides its
      effect on the inferior colliculus, only decreased LCGU in the internal capsule.
      Chronic plus acute administration of ethanol decreased LCGU significantly in 22
      structures. It is concluded that an acute oral administration of ethanol has
      distinct and mainly depressive effects on the functional activity of several
      brain areas. Chronic administration is less effective.

PMID- 8478713
TI  - From the cradle to the grave: alcohol and its effects upon the brain.

PMID- 8478714
TI  - False-positive lymph nodes by radioimmunoguided surgery: report of a patient and
      analysis of the problem.
AB  - Preoperative administration of radiolabeled monoclonal antibody allows
      radioimmunoguided surgery with hand-held intraoperative detection devices. From a
      theoretical perspective, this technology may offer more knowledgable patient
      management and more complete resection of intra-abdominal cancer. False-positive
      examinations may seriously jeopardize the widespread application of this
      apparatus. Our experience with a patient with false-positive lymph nodes
      following administration of 125I-labeled B72.3 monoclonal antibody is reported.
      After careful histopathological analysis of five nodes thought to be false
      positive for cystadenocarcinoma, one lymph node was found to have a minute nidus
      of cancer. The cause of false-positive radioimmunoguided tests and their
      implications for the clinical use of this tool is discussed. We interpreted our
      data to suggest that tumor antigen-monoclonal antibody complexes processed in
      reactive lymph nodes, anatomically draining the malignant tissue, may cause false
      positive tests.

PMID- 8478715
TI  - Bronchogenic carcinoma mimicking metastatic thyroid carcinoma.
AB  - We present a case of a false-positive 131I scan in the follow-up of a patient
      with papillary thyroid carcinoma, which developed 24 yr after radiation therapy
      for Hodgkin's disease. In the primary evaluation of a neck mass, histology was
      typical for a papillary thyroid carcinoma and thyroglobulin staining was
      positive. After total thyroidectomy, 131I uptake was seen in the hilum and right
      lung. The initial interpretation of these foci as metastatic disease was not
      supported by the progressive clinical course despite radioiodine treatment.
      Hence, repeated bronchial brushings and cytology of the pleural effusion were
      obtained. These specimens were negative in thyroglobulin staining and positive
      for synoptophysin, a marker for small-cell bronchial carcinoma. Thereby a small
      to medium cell undifferentiated bronchial carcinoma was demonstrated, which
      apparently was actively taking up iodine. In conclusion, an atypical clinical
      course of a suspected metastatic thyroid carcinoma should lead to a reevaluation
      of the initial diagnosis to prevent an inappropriate therapeutic regimen.

PMID- 8478716
TI  - Indium-111-labeled leukocyte scintigraphy in a case of cutaneous sarcoidosis.
AB  - A 54-yr-old woman with cutaneous nodules showed accumulation of 67Ga- and 111In
      labeled leukocytes in skin nodules, bilateral pulmonary hilar lymph nodes and the
      right upper mediastinum. Biopsy of the skin nodule proved epithelioid cell
      granuloma with moderate lymphocyte infiltration peripherally consistent with
      sarcoidosis. Sarcoidosis is a potential pitfall in labeled leukocyte imaging,
      which is performed for detecting a febrile focus.

PMID- 8478717
TI  - Indium-111-leukocyte imaging in Gaucher's disease.
AB  - A 29-yr-old man with Gaucher's disease and fever of unknown origin underwent
      111In-labeled mixed autologous leukocyte scintigraphy. Although no focus of
      infection was identified, the resulting images were most unusual and were
      characterized by massive hepatomegaly, lack of central marrow activity and
      extensive lymph node uptake of labeled leukocytes. All of these findings could be
      explained on the basis of the patient's underlying disease. Hepatomegaly and
      absent central marrow activity correlated with extensive infiltration of these
      organs by Gaucher cells, while the lymph node findings were attributed to the
      presence of extramedullary hematopoiesis.

PMID- 8478718
TI  - Radiation dose estimates for the carbon-14-labeled urea breath test.
AB  - The use of the 14C-urea breath test for diagnosis of Helicobacter pylori
      infection in gastric mucosa has gained widespread acceptance and utilization. In
      order to obtain regulatory approval for this procedure, new dose estimates were
      required. Previous radiation dose equivalent estimates for males only were based
      upon data published in 1975 for bicarbonate metabolism. Since that time,
      calculational techniques for dose estimation have been significantly improved and
      the organ masses of Reference Man updated. We have calculated dose estimates for
      males and females who test positive (HP+) and negative (HP-) for gastric H.
      pylori infection. Our results indicate that the urinary bladder wall receives the
      highest absorbed dose in all four of the above subject populations (HP- males =
      0.14 mGy/MBq; HP- females = 0.19 mGy/MBq; HP+ males = 0.10 mGy/MBq; HP+ females =
      0.14 mGy/MBq). Gonadal absorbed doses were similar to those previously estimated
      (testes < 0.065 mGy/MBq and ovaries < 0.084 mGy/MBq, respectively).

PMID- 8478719
TI  - Estimation of left ventricular mass and infarct size from nitrogen-13-ammonia PET
      images based on pathological examination of explanted human hearts.
AB  - The purpose of this study was to develop a technique to quantify left ventricular
      mass and infarct size in chronic ischemic heart disease from PET images based on
      correlation with pathological examination of explanted human hearts. Fourteen
      hearts from patients with cardiomyopathy who had 13N-ammonia scans prior to
      orthoptic heart transplantation were studied. Accurate estimation of the relative
      infarct size was possible in patients with a well-delineated, nearly transmural
      infarct (r = 0.93, y = 1.1x - 0.7, n = 11). Both absolute and relative infarct
      mass measurements on PET images correlated well with pathological measurements.
      We identified a population of patients with patchy interstitial or subendocardial
      scarring with globally reduced perfusion, for which the infarct size could not be
      estimated using the criteria derived for the patients with well-delineated
      infarcts.

PMID- 8478720
TI  - How can positron emission tomography help evaluate patients before and after
      heart transplantation?

PMID- 8478721
TI  - Functional mapping of flow and back-diffusion rate of N-isopropyl-p
      iodoamphetamine in human brain.
AB  - Iodine-123-labeled N-isopropyl-p-iodoamphetamine (IMP) has been reported to be an
      excellent tracer for mapping cerebral blood flow with single-photon emission
      computed tomography (SPECT). Clinical interpretation of these SPECT images,
      however, requires further understanding of the kinetics of IMP in the human
      brain. In order to evaluate the kinetic behavior of IMP in normal and diseased
      areas, we measured flow and back-diffusion rates with serial dynamic SPECT scans
      following an intravenous bolus injection of IMP using a multi-detector SPECT
      scanner. Arterial input function was determined by octanol extracted
      radioactivity of serial arterial blood samples. Average values for influx rate
      (K1) and back-diffusion rate (k2) were 0.43 ml/g/min and 0.014 min-1 in the
      normal cerebral cortex, 0.43 and 0.013 in the basal ganglia, 0.28 and 0.012 in
      the white matter and 0.48 and 0.016 in the cerebellar hemisphere. The partition
      coefficient (K1/k2 ratio) was 32.4 ml/g in the cerebral cortex, 35.3 in the basal
      ganglia, 24.7 in the white matter and 30.4 in the cerebellum. The K1-to-k2 ratio
      in the infarcted and ischemic regions as well as in the tumor was smaller than
      that of the normal cortex. Accurate measurement of local cerebral blood flow
      (LCBF) based on the microsphere model was possible only on the early SPECT
      images, but a relative pattern of LCBF can be assessed with SPECT images obtained
      within 1 hr after injection except for tumors.

PMID- 8478722
TI  - Validation of renal output efficiency as an objective quantitative parameter in
      the evaluation of upper urinary tract obstruction.
AB  - This is a preliminary study of the parameter, renal output efficiency (ROE), for
      the quantitation of furosemide (frusemide) response in diuresis renography. This
      is calculated by a technique independent of variations in uptake rate by the
      kidneys. Eleven healthy volunteers and 34 patients suspected of upper urinary
      obstruction were subjected to gamma camera studies using 99mTc-MAG3 and a
      standard protocol. Furosemide was given at 18 min after the study was started.
      The ROE was calculated in each kidney and the results were correlated with final
      diagnosis. The range of ROE in healthy individuals varied between 82% and 98%
      (mean = 91.6%); while obstructed kidneys showed significantly reduced values (p <
      0.001) ranging between 30% and 76% (mean = 56%). In the diagnosis of urinary
      obstruction, the ROE has a sensitivity of 91%, specificity of 94% and accuracy of
      94%. ROE complements conventional diuresis renography and provides better
      diagnostic yield in patients with impaired renal function.

PMID- 8478723
TI  - Scintigraphic evaluation of liver masses: cavernous hepatic hemangioma.
AB  - Hepatic cavernous hemangioma must be included in the differential diagnosis of
      any hepatic solid mass. It is the second most common neoplasm of the liver,
      following intrahepatic metastases. With the exception of giant or symptomatic
      HCH, it does not require specific intervention. The ability to diagnose HCH
      radiologically (Table 2) has significant clinical importance. When confronted
      with clinical data and a preliminary radiologic study suggestive of HCH, serial
      planar blood-pool scintigraphy (with SPECT if the lesion is < 3-4 cm) should
      probably be the initial diagnostic examination. In comparison to MRI, it is
      safer, less expensive and easier for some patients to tolerate. For small, deep
      seated lesions or those adjacent to the heart or large vessels, MRI is the
      preferred test. Dynamic CT is probably most useful in patients with normal renal
      function in whom optimal imaging of the extrahepatic abdomen is desired. If the
      etiology of an incidental hepatic mass suspected to be an HCH is still not
      evident after these studies, angiography or biopsy are the remaining options. As
      described, angiography is sensitive and relatively specific for HCH. Although
      percutaneous biopsy may be associated with increased risk of bleeding, fine
      needle biopsy has been shown to be safe for hemangiomas. However, fine-needle
      biopsy is more useful for confirming a suspected malignancy than for actually
      diagnosing hemangioma.

PMID- 8478724
TI  - Gallium-67 scintigraphy in tuberculous and nontuberculous infectious spondylitis.
AB  - Vertebral osteomyelitis is a difficult condition to diagnose clinically. A
      retrospective review of 21 cases of infectious spondylitis (6 tuberculous, 15
      nontuberculous) confirmed the utility of 67Ga scintigraphy in imaging this
      process. Gallium-67 scans were positive at all sites of disease in this patient
      population. They anticipated the presence of spondylar infection in 23% of
      regions where radiographic abnormalities were originally lacking, while
      confirming a current and ongoing septic process at the other sites where
      vertebral destruction was already present on x-ray. Gallium-67 studies, as
      compared to the 99mTc-MDP bone scans, also provided important information as to
      the extent of disease by documenting the presence of eight paraspinal abscesses
      and the location of remote extraspinal foci of infection both in soft tissues and
      in bone. The relative merits of all radiologic imaging procedures are discussed.
      A diagnostic algorithm is also suggested.

PMID- 8478725
TI  - Tough choices: who is to make the call?

PMID- 8478726
TI  - Parametric images for quantitative measurements of regional myocardial blood flow
      in humans: a step in the right direction.
AB  - Choi et al. describe a useful method for producing parametric images of
      myocardial blood flow from dynamic PET 13N-ammonia images of the myocardium. The
      method is important because it provides a convenient vehicle for quickly
      displaying anatomically oriented information about absolute values of myocardial
      blood flow in humans. Absolute values of myocardial blood flow will enhance our
      ability to assess relative coronary flow reserve and will make it possible to
      noninvasively and routinely measure absolute coronary flow reserve. In addition,
      absolute measurements of myocardial blood flow will be useful in addressing
      important clinical problems, such as myocardial viability, stunning and
      hibernation. We look forward to the time when technical advances make it possible
      to obtain accurate parametric images not only of transmural but also endocardial
      epicardial distribution of blood flow.

PMID- 8478727
TI  - Lesion detection in neuroblastoma with iodine-131-MIBG.

PMID- 8478728
TI  - Functional imaging of peripheral vascular disease.

PMID- 8478729
TI  - Fluorodeoxyglucose, myocardial perfusion and myocardial cell death.

PMID- 8478730
TI  - Detection of cardiovascular infections with radiolabeled leukocytes.

PMID- 8478731
TI  - A 'city that reads' ... or breeds?

PMID- 8478732
TI  - Do fetal heart rates predict gender?

PMID- 8478733
TI  - Neonatal kidnapping.

PMID- 8478734
TI  - Oocyte donation and in vitro fertilization: the nurse's role with ethical and
      legal issues.
AB  - Oocyte donation has made pregnancy a realistic option for women who want to
      become pregnant yet are unable to produce viable, healthy eggs. This article
      reviews oocyte donation technology, discusses ways that donor programs can deal
      effectively with the legal and ethical issues involved, and describes the role of
      the in vitro fertilization nurse.

PMID- 8478735
TI  - The biophysical profile: antepartal assessment of fetal well-being.
AB  - The assessment of fetal well-being is a primary consideration for perinatal
      nurses. The biophysical profile is a clinical evaluation of the status of the
      fetus based on assessment of multiple discrete variables. This article describes
      current biophysical profile scoring systems, the physiologic basis of the fetal
      variables, and factors that may affect the variables. It also discusses issues
      related to future applications and refinement of the biophysical profile, as well
      as nursing implications of the technology.

PMID- 8478736
TI  - Prevention of HIV infection in women.
AB  - The number of HIV-infected women in the United States has continued to rise.
      Although risk-reducing behaviors such as condom use, partner selection, partner
      reduction, and safe sex practices have been identified, women continue to engage
      in high-risk activities. Nurses need to offer testing for HIV infection to all
      women. Education programs directed at the transmission and prevention of HIV
      infection also are needed. This article describes nursing strategies designed to
      incorporate primary, secondary, and tertiary prevention of HIV infection in
      women.

PMID- 8478738
TI  - Nipple feeding for preterm infants with bronchopulmonary dysplasia.
AB  - OBJECTIVE: To examine the influence of an infant's physical condition on nipple
      feeding practices and the contribution of the infant's age at complete nipple
      feeding to dietary intake and somatic growth outcomes. DESIGN: A retrospective,
      correlational study. SETTING: Two Level III nurseries. PARTICIPANTS: Records of
      55 preterm infants with bronchopulmonary dysplasia. MAIN OUTCOME MEASURES: The
      infant's intake of kcal/kg on Day 1 of complete nipple feeding and the weight
      gain per day between complete nipple feeding and discharge. RESULTS: Gestational
      age and days on mechanical ventilation, continuous positive airway pressure, or
      supplementary oxygen influenced age at start and at completion of nipple feeding
      (p < .05). The infant's weight when nipple feeding was introduced was the primary
      determinant of age at introduction of nipple feeding (B = .50, p < .001). The
      physical condition variables did not influence the transition time from
      introduction of nipple feeding to complete nipple feeding. Neither the physical
      condition variables nor the feeding practice variables contributed to caloric
      intake. Weight gain between the time of complete nipple feeding and hospital
      discharge was less for infants who were on supplementary oxygen longer and who
      were older when completely nipple fed (p < .01).

PMID- 8478737
TI  - Obstetric infection control in a developing country.
AB  - In Ghana, infection has been identified as a major cause of birth-related
      mortality. Results of a 2-month observation of infection control practices among
      Ghanaian obstetric nurses and midwives indicated that most personnel did not
      practice basic rules of asepsis. Problems included frequent breaks in technique,
      inadequate sterilization and disinfection, and repeated exposure to large amounts
      of blood and vaginal secretions. Supplies were limited and, even when available,
      not always used appropriately. The situation in developing countries is different
      from that in the United States. Therefore, an observational needs assessment is
      essential to plan relevant and practical measures for change.

PMID- 8478739
TI  - Changes in attitudes toward cesarean birth.
AB  - OBJECTIVE: To compare the findings of three studies of women's responses to
      planned and unplanned cesarean birth. DESIGN: Descriptive. SETTING: Private
      obstetric practices, childbirth education classes, and hospital postpartum units.
      PARTICIPANTS: Study 1: 24 women who had cesarean deliveries between 1973 and
      1980; Study 2: 15 women who delivered in 1981-82; Study 3: 173 women who
      delivered in 1989-90. MAIN OUTCOME MEASURE: Qualitative data were obtained by an
      investigator-developed open-ended questionnaire that was mailed to participants
      after cesarean delivery. RESULTS: The findings from the three studies indicate
      that the dominant responses to cesarean birth are happiness and excitement about
      the newborn, accompanied by disappointment about having to have a cesarean
      delivery. The women in Study 1 expressed the highest proportion of ineffective
      responses and the lowest proportion of adaptive responses (p = .003), whereas the
      women in Studies 2 and 3 expressed approximately equal percentages of adaptive
      and ineffective responses. Women who had unplanned cesarean deliveries had a
      lower percentage of adaptive responses and a higher percentage of ineffective
      responses than those who had planned cesarean deliveries (p < .05). Women who had
      regional anesthesia had more adaptive responses than those who had general
      anesthesia (p = .0217). CONCLUSION: The findings suggest that women who deliver
      by cesarean section require continued attention and sensitive care that takes
      into account their special needs for information, for the presence of their
      partners throughout the birth experience, and for sustained contact with their
      newborn.

PMID- 8478741
TI  - Propagation of photon-density waves in strongly scattering media containing an
      absorbing semi-infinite plane bounded by a straight edge.
AB  - Light propagation in strongly scattering media can be described by the diffusion
      approximation to the Boltzmann transport equation. We have derived analytical
      expressions based on the diffusion approximation that describe the photon density
      in a uniform, infinite, strongly scattering medium that contains a sinusoidally
      intensity-modulated point source of light. These expressions predict that the
      photon density will propagate outward from the light source as a spherical wave
      of constant phase velocity with an amplitude that attenuates with distance r from
      the source as exp(-alpha r)/r. The properties of the photon-density wave are
      given in terms of the spectral properties of the scattering medium. We have used
      the Green's function obtained from the diffusion approximation to the Boltzmann
      transport equation with a sinusoidally modulated point source to derive analytic
      expressions describing the diffraction and the reflection of photon-density waves
      from an absorbing and/or reflecting semi-infinite plane bounded by a straight
      edge immersed in a strongly scattering medium. The analytic expressions given are
      in agreement with the results of frequency-domain experiments performed in skim
      milk media and with Monte Carlo simulations. These studies provide a basis for
      the understanding of photon diffusion in strongly scattering media in the
      presence of absorbing and reflecting objects and allow for a determination of the
      conditions for obtaining maximum resolution and penetration for applications to
      optical tomography.

PMID- 8478740
TI  - Pelvic inflammatory disease: risk factors and microbial etiologies.
AB  - OBJECTIVE: To review the risk factors and microbial etiologies of pelvic
      inflammatory disease (PID). DATA SOURCES: Include 77 current and historical
      references on PID, PID risk factors, and sexually transmitted diseases. STUDY
      SELECTION: 34 studies that address specific research questions. DATA EXTRACTION:
      Data were used from studies whose methodologies are discussed. DATA SYNTHESIS:
      This review identifies research problems regarding the definition, diagnosis, and
      identification of microbial profiles and risk factors of PID. CONCLUSIONS: More
      reliable diagnostic criteria for the varied clinical presentations of this
      polymicrobial infection are needed. PID is a disease with multiple, interrelated
      risks. Education is an important nursing intervention.

PMID- 8478742
TI  - Ideal observer for discrimination of the global direction of dynamic random-dot
      stimuli.
AB  - Random-dot cinematograms in which each dot's successive movements are randomly
      drawn from a Gaussian distribution of directions can produce a percept of global
      coherent motion in a single direction. Discrimination of global direction was
      measured for various exposure durations, stimulus areas, and dot densities and
      bandwidths of the distribution of directions. Increasing the duration produced a
      greater improvement in performance than did increasing either the area or the
      density. Performance decreased as the distribution bandwidth increased. An ideal
      observer model was developed, and the absolute efficiency for human direction
      discrimination was evaluated. Efficiencies were highest at large distribution
      bandwidths, with average efficiencies reaching 35%. A local-global noise model of
      direction discrimination, based on the ideal-observer model, containing a spatial
      and temporal integration limit as well as internal noise, was found to fit the
      human data well. The utility of ideal-observer analyses for psychophysical tasks
      and the interpretation of efficiencies is discussed.

PMID- 8478743
TI  - Measurements of chromatic and achromatic afterimages.
AB  - Several types of measurement were made of the negative afterimages formed by
      viewing chromatic and achromatic sine-wave conditioning gratings that were
      stabilized on the retina. We varied the spatial frequency, contrast, and duration
      of the conditioning stimulus and the interval between its offset and the
      afterimage measurement. Different methods of measuring afterimage contrast were
      also compared. We conclude that (1) an isoluminant chromatic stimulus creates an
      isoluminant chromatic afterimage; (2) afterimage contrast is linearly related to
      conditioning contrast; (3) chromatic and achromatic afterimages have similar low
      pass spatial-frequency characteristics; (4) both types of afterimage build up and
      decay exponentially, with a (1/e) time constant of 4-8 s; (5) most important,
      both chromatic and achromatic afterimages raise the threshold for a chromatic
      flashed grating, but neither affects the threshold for an achromatic flashed
      grating; (6) we can explain these results by postulating that negative
      afterimages are subserved only by the sustained, or parvocellular, pathways.

PMID- 8478744
TI  - Detection mechanisms in L-, M-, and S-cone contrast space.
AB  - Detection thresholds were obtained for a 2 degrees Gaussian-blurred spot flashed
      for 200 ms on an 8.9 degrees white adapting field of 1070 trolands. The spot's
      contrast was represented in an L-, M-, and S-cone contrast space. Detection
      thresholds were obtained for many vectors close to specific but theoretically
      important planes within this space. A three-dimensional surface was fitted to the
      data generated by the probability summation of three mechanisms, each a weighted
      sum of cone contrasts. The fit revealed a red-green chromatic mechanism driven by
      delta L/L--delta M/M with no S-cone input that was 1 order of magnitude more
      sensitive than the two other mechanisms. The latter consisted of a luminance
      mechanism with little S-cone input and a blue-yellow chromatic mechanism with the
      S cone opposed to L and M cones.

PMID- 8478745
TI  - Mapping cone photopigment optical density.
AB  - The distribution of cone photopigment across the retina affects the amount of
      light captured by cones at each retinal location. Cone photopigment optical
      density is measured in two ways, with reflectometry and/or with color matching.
      Color matching measures a higher optical density than does reflectometry. Control
      experiments confirm that large-field color matches measure photopigment optical
      density toward their outer edge. There is qualitative agreement as to
      photopigment distribution from both techniques near the fovea. Beyond 1 deg,
      color matching indicates little decrease in photopigment with increasing
      eccentricity, whereas retinal densitometry shows a steep decline in photopigment.
      The decrease in perifoveal optical density measured with reflectometry is
      attributed to the decrease in cone coverage from fovea to perifovea as rods and
      interphotoreceptor spaces increase. Differences among subjects in photopigment
      distribution near the fovea, measured with both techniques, reflect differences
      in the specialization of the foveal center for cone length and/or photopigment
      concentration per cone, which are factors influencing results from both
      techniques.

PMID- 8478746
TI  - Modulation transfer of the human eye as a function of retinal eccentricity.
AB  - We measured the monochromatic image quality of the eye across a wide visual field
      (120 degrees), with natural pupil (4 mm) and accommodation (3 diopters). The
      method is based on the acquisition and the posterior processing of double-pass
      aerial images of a point source imaged on the retina, which was kept at a fixed
      distance from the eye at all retinal eccentricities. The two-dimensional
      modulation transfer functions (MTF's) computed from the aerial images show that
      astigmatism is the dominant monochromatic aberration in both the fovea and the
      periphery and is also the major cause of variability among individuals. We found
      a slower decline in optical quality with eccentricity than had been found by
      previous measurements. Our foveal results are in close agreement with those of
      Campbell and Gubisch [J. Physiol. (London) 186, 558-578 (1966)], but off-axis
      optical quality is much better than found previously by Jennings and Charman [Am.
      J. Optom. Physiol. Opt. 55, 582-590 (1978); Vision Res. 21, 445-454 (1981)]. The
      optical system of the eye seems to follow a wide-angle lens design: the optical
      quality in the center (fovea) is not particularly good (it is far from the
      diffraction limit at this pupil size), but the modulation transfer function
      remains roughly constant for a wide visual field.

PMID- 8478747
TI  - Experimental determination of the chromatic difference of magnification of the
      human eye and the location of the anterior nodal point.
AB  - Theory predicts that retinal image size will vary with wavelength. However, this
      chromatic difference of magnification (CDM) is likely to be very small (< 1%
      between 400 and 700 nm) under natural viewing conditions. There has been only one
      attempt to measure CDM experimentally, and the results were inconsistent with
      optical theory. Using a technique described by Ogle [Research in Binocular
      Vision, Hafner, New York (1964)], which is sensitive to even small interocular
      differences in retinal image size, we measured the apparent tilts in the
      frontoparallel plane induced by interocular differences in wavelength. We
      obtained the ocular CDM by determining the afocal lens magnification necessary to
      cancel the apparent frontoparallel plane tilt caused by interocular differences
      in wavelength. We show that (1) the ocular CDM can be considerably less than
      theoretical model predictions, (2) the relationship among delta Rx (wavelength
      dependent refractive error), CDM, and pupil position is consistent with our
      theoretical model, (3) CDM increases considerably when an artificial pupil in
      front of the eye is used, (4) the location of the anterior nodal point of the eye
      may be inferred from the data, and (5) unlike in the case for delta Rx, large
      intersubjective differences may exist for CDM. The results suggest caution in the
      use of artificial pupils experimentally with polychromatic stimuli because of
      amplification of CDM and concomitant losses of image contrast.

PMID- 8478749
TI  - Theory of wavelength discrimination in tritanopia.
AB  - Many theories of color discrimination predict a discontinuity in the wavelength
      discrimination function of a tritanope at the point in the spectrum at which the
      rate of change of the visual signal constrained to an equiluminant plane passes
      through zero (near 460 nm). The predicted discontinuity follows from the use of a
      first-order approximation for which the reciprocal of the slope of the response
      function that generates the visual signal is proportional to the discrimination
      limen. In view of the good discrimination shown by such observers elsewhere in
      the spectrum, however, such a singularity is impossible. I show that the
      inclusion of the higher-order terms produces a finite value in the 460-nm region
      that falls in the range of values from the literature that have been obtained
      experimentally.

PMID- 8478748
TI  - Color matching at high illuminances: photopigment optical density and pupil
      entry.
AB  - Changes in the effective optical density of the cones are sufficient to explain
      changes in color matches with retinal illuminance and pupil entry. We performed
      three experiments. In the first experiment, six observers made color matches
      under both bleached and unbleached conditions to a series of six standard
      wavelengths. The effects of bleaching could be modeled by a decrease in optical
      density of the L and M cone photopigments. Slight spectral shifts in the peak
      wavelengths of the photopigments were required for different observers. In the
      second experiment we varied retinal illuminance of the color-matching field from
      2.4 to 5.4 log Td for a series of long-wavelength primaries. The shape of the
      color match versus the intensity function was unchanged by the wavelength
      composition of the matching field. In the third experiment we measured the change
      in color match with retinal illuminance for different pupil entry positions. At
      low luminances there was a marked dependence of the color match on pupil entry
      positions. At high illuminance there was only a small dependence. The half-bleach
      illuminance values varied as expected from the Stiles-Crawford I effect. We
      conclude that for wavelengths > 540 nm, changes in color matches with bleaching
      and pupil entry can be explained by changes in the effective optical density of
      the cones.

PMID- 8478750
TI  - Treatment of a severe drug-induced gingival hyperplasia on a medically
      compromised patient--a case report.

PMID- 8478751
TI  - Dental hypersensitivity: recent advances in diagnosis and treatment.
AB  - Dentinal hypersensitivity affects eating, brushing, drinking, and breathing
      habits. Each dentist must know its manifestations and management. Hypersensitive
      teeth are not temporary annoyances. Dental patients want and expect solutions to
      the hypersensitivity problem. The latest diagnostic and treatment skills, along
      with new products and reimbursement procedures, can be offered as part of your
      practice-building agenda.

PMID- 8478753
TI  - Nutrition education for the oral and maxillofacial surgeon.

PMID- 8478752
TI  - Hospital dental program serves severely apprehensive and medically-compromised
      patients.

PMID- 8478754
TI  - Mandibular reconstruction.

PMID- 8478755
TI  - Ophthalmic complications associated with orthognathic surgery.
AB  - Ophthalmic complications are rare following maxillary osteotomies. Potential
      complications include a decrease in visual acuity, extraocular muscle
      dysfunction, neuroparalytic keratitis, and nasolacrimal problems involving both
      an increase or a decrease in tearing. Ophthalmic injuries appear to be primarily
      mediated through indirect injuries to neurovascular structures occurring from
      traction, compression, or contrecoup injuries from forces transmitted during the
      pterygomaxillary dysjunction using an osteotome or from fractures extending to
      the base of the skull or orbit associated with the pterygomaxillary dysjunction
      or the maxillary downfracture. A review of the literature of previous ophthalmic
      complications as well as eight new cases are reported. The possible etiologic
      basis for these injuries is discussed in detail as well as treatment
      possibilities when appropriate.

PMID- 8478756
TI  - The role of physical therapy in recovery after temporomandibular joint surgery.
AB  - The purpose of this study was to investigate the effect of aggressive physical
      therapy on the rehabilitation of patients who have had temporomandibular joint
      (TMJ) surgery. The control group consisted of 26 postsurgical patients who had no
      physical therapy, and the treatment group consisted of 24 postsurgical patients
      who were treated with aggressive therapy for 8 weeks. Patients in both groups had
      range of motion measurements taken at 1 and 8 weeks. The ratio of patients in the
      treatment group who achieved normal range of motion was compared with the ratio
      of patients in the control group who achieved it. The results showed a
      significantly greater range of opening in experimental than in control subjects
      at 8 weeks but not for lateral excursions. These results suggest that aggressive
      physical therapy is an important adjunct to postsurgical care for patients with
      TMJ.

PMID- 8478757
TI  - Effects of extensive oral surgery and hemorrhage on coagulation and fibrinolysis.
AB  - The changes in coagulation and fibrinolytic activity in 22 patients with oral
      cancer undergoing extensive surgical procedures were studied. The patients were
      divided into two groups: group I patients suffered blood loss of less than 2,000
      mL and group II patients had blood loss of more than 2,000 mL. The platelet count
      decreased significantly during surgery, at the end of surgery and on the 1st
      postoperative day in both groups. Fibrinogen was decreased during and at the end
      of surgery in both groups, but increased significantly on the 3rd postoperative
      day and reached about two times the preoperative levels on the 7th postoperative
      day. Fibrin degradation products increased significantly after surgery and
      reached the maximum value on the 1st postoperative day in both groups. Plasmin
      inhibitor complex and plasminogen increased significantly on the 3rd and 7th
      postoperative days. There was no clear evidence regarding the influence of blood
      loss on coagulation and fibrinolytic factors except for platelets. It was
      concluded that coagulation and fibrinolysis are enhanced between the 3rd and 7th
      postoperative days.

PMID- 8478758
TI  - Nasal tip modification using four distinct methods.
AB  - Oral and maxillofacial surgeons are combining orthognathic surgery with
      rhinoplasty. In many instances, alteration of the tip is the key to attaining an
      esthetically pleasing nasal shape. This article addresses four separate
      procedures for tip modification. Tip support and a variety of surgical nuances,
      highlighting the open technique, are discussed.

PMID- 8478759
TI  - Comparison of rectal midazolam and diazepam for premedication in pediatric dental
      patients.
AB  - Rectally administered midazolam (0.35 mg/kg) and diazepam (0.70 mg/kg) were
      compared with each other and with placebo for preanesthetic medication in
      children undergoing dental extractions. All rectal medications were very well
      accepted, but mask acceptance, improvement in anxiety, and sedation were best in
      the midazolam group. Improvement in anxiety and sedation were significantly
      better in the two drug groups than in those patients who had received placebo.
      Thirty minutes after rectal administration of midazolam, patients showed a
      decrease in both systolic and diastolic blood pressure and heart rate. Although
      these decreases differed significantly from the premedication values, they were
      probably of little clinical importance. Only minor adverse effects were observed
      in this study. Overall rectally administered midazolam appeared to be somewhat
      more efficacious than diazepam.

PMID- 8478760
TI  - Long-term viability of the temporalis muscle/fascia flap used for
      temporomandibular joint reconstruction.
AB  - Temporalis muscle/fascia axial flaps (TFs) were used in 115 temporomandibular
      joints (TMJs) in 81 patients to correct ankylosis (n = 25 joints), traumatic
      defects (n = 8), congenital anomalies (n = 4), defects resulting from tumor
      resection (n = 2), degenerative joint disease (n = 52), autoimmune arthritides (n
      = 21), and lateral capsule flaccidity (n = 3). The follow-up period ranged from 6
      months to 5.5 years. Seven patients (8.6% of the group; 10 TMJs) were reevaluated
      for recurrent symptoms (pain and decreased motion), with a mean of 1.7 years
      (range = 1 to 3 years) postoperatively. Four of these patients (seven TMJs) had
      magnetic resonance imaging (MRI) as part of their diagnostic workup and four
      patients (five TMJs) required a second operative procedure. This study reports
      the results of the MRI, intraoperative, and histologic evaluations of the TFs in
      these seven patients. The MRIs showed vascularized tissue between the condyle and
      roof of the glenoid fossa in all seven joints examined. The signal was consistent
      with muscle and/or fat as opposed to scar tissue. All flaps examined at the time
      of surgery (arthroscopy, n = 1; arthrotomy, n = 4) were in place and had the
      gross appearance of normal muscle. Histologic examination of biopsies of four
      flaps indicated the presence of viable muscle with normal-appearing nuclei. The
      results of this study indicate that the TF does survive when it is carefully
      dissected and inferiorly based to preserve blood supply.

PMID- 8478761
TI  - Principles of management of complex craniofacial trauma.
AB  - Successful treatment of patients with complex craniofacial injuries is heavily
      dependent on the surgeon's appreciation of the associated nonfacial injuries,
      precise clinical and diagnostic imaging examinations to establish a three
      dimensional configuration of the fractured segments, and the application of well
      established principles of facial fracture repair. Factors that influence improved
      treatment outcome are 1) early definitive treatment, 2) anatomic and functional
      repair of naso-orbito-ethmoidal injuries, 3) wide exposure of fracture segments,
      and 4) anatomic repositioning and stable fixation of fracture segments in all
      planes of space.

PMID- 8478762
TI  - Sequencing treatment for naso-orbito-ethmoid fractures.
AB  - This article presents a strategy for treating naso-orbito-ethmoid fractures.
      Eight steps for the management of such injuries are presented: surgical exposure,
      identification of the medial canthal tendon/tendon-bearing bone fragment,
      reduction/reconstruction of medial orbital rim, reconstruction of the medial
      orbital wall, transnasal canthopexy, reduction of septal fractures, nasal dorsum
      reconstruction/augmentation, and soft tissue adaptation. Following these steps
      can make treatment outcomes more predictable.

PMID- 8478763
TI  - Expanding the specialty: a survey of oral and maxillofacial surgery residencies
      in the United States.
AB  - This article reports the results of a survey of oral and maxillofacial surgery
      (OMS) residency program directors regarding teaching of expanded scope surgical
      procedures during the academic year 1990 to 1991. Data is provided for the nation
      as a whole, as well as grouped by geographic regions and type of residency
      program. Significant differences were found for some procedures based on both
      geographic region and program type. The majority of program directors responding
      to this survey disagreed with the trend toward expanding the scope of OMS into
      cosmetic procedures. Directors of integrated dual degree programs believed that
      the trend toward expanding the scope of OMS was positive; 2:1 over directors of
      MD optional or traditional OMS programs.

PMID- 8478764
TI  - Paresthesia of the mandibular division, trigeminal nerve.

PMID- 8478765
TI  - Parotid gland metastases from orbital tumors: report of two cases.

PMID- 8478766
TI  - The role of labial salivary gland biopsy in the diagnosis of Sjogren's syndrome:
      report of three cases.

PMID- 8478767
TI  - Necrosis of the lip in giant cell arteritis: report of a case.

PMID- 8478768
TI  - Adult T-cell leukemia with initial presentation as sinonasal lymphoma: report of
      two cases.

PMID- 8478769
TI  - Thyroid metastasis to the oral soft tissues: case report of a diagnostic dilemma.

PMID- 8478770
TI  - Management of an ingested iatrogenic foreign body: report of a case.

PMID- 8478771
TI  - Recurrent oral bleeding in Maffucci's syndrome: report of a case.

PMID- 8478772
TI  - Primary meningioma of the infratemporal fossa: a clinicopathologic and
      immunohistochemical study.

PMID- 8478773
TI  - Angioneurotic edema mimicking Ludwig's angina: a case report.

PMID- 8478774
TI  - Titanium screw failure: a case report.

PMID- 8478775
TI  - Split-thickness skin graft harvesting from an intraoral flap: a new technique.

PMID- 8478776
TI  - The proper orientation of oral and maxillofacial surgery training.

PMID- 8478777
TI  - A swat at the SWOT.

PMID- 8478778
TI  - A retrospective look at tip location and complications of peripherally inserted
      central catheter lines.
AB  - In 1982, Southern Regional Medical Center in Riverdale, Ga, instituted a program
      for selected intravenous nurses to insert and manage peripherally inserted
      central catheters (PICCs). At present, approximately 125 to 150 PICCs are
      inserted annually by eight experienced IV nurses. In this retrospective study,
      the authors review medical record data on PICC insertions that occurred between
      January 1987 and December 1991. The optimal tip location is defined as the
      superior vena cava (SVC) and an anterior-posterior one-view chest x-ray is
      performed to confirm tip location. This study focuses on the initial location of
      the PICC and actions taken to correct the initial tip placement if not in the
      SVC. Medical records were reviewed for complications including mechanical
      phlebitis, infections, ruptured catheters, clotted catheters, or vein thromboses.
      The frequency of these complications, their prevention, and management are
      discussed.

PMID- 8478779
TI  - How to evaluate study methodology in published clinical research.
AB  - When reading a clinical research article, the clinician must judge if the
      reported findings and conclusions are valid before applying them to patient care.
      This concern is legitimate given the wide range of study validity in the clinical
      literature. In this article, the authors present many validity markers that
      signify the quality of the information reported from a study, such as authorship,
      bias, confounding, statistics, randomization, controls, blinding, and the logical
      framework of scientific investigations.

PMID- 8478780
TI  - "Allergic-type reaction" to a Landmark catheter.

PMID- 8478781
TI  - Re: "Implantable ports" by Dawn Camp-Sorrell.

PMID- 8478782
TI  - An overview of ondansetron for chemotherapy-induced nausea and emesis.
AB  - Nausea and vomiting are major complications associated with the administration of
      cytotoxic drugs. Ondansetron (Zofran, Glaxo, Inc., Research Triangle Park, NC), a
      5-hydroxy tryptamine (5-HT3) serotonin antagonist, has shown efficacy in managing
      chemotherapy-induced nausea and vomiting without extrapyramidal side effects. The
      author provides an overview of recent studies and manufacturer's administration
      recommendations, as well as guidelines for nursing care and patient teaching.

PMID- 8478783
TI  - The peripherally inserted central catheter: a retrospective look at three years
      of insertions.
AB  - The advent of intravenous therapies administered in the home setting has created
      a demand for the peripherally inserted central catheter (PICC). A variety of
      PICCs is now on the market, offering choices of insertion methods as well as size
      and length. This article represents a retrospective look at 858 PICCs inserted
      over a 3-year period, using three insertion methods: 1) the Seldinger technique,
      2) the peel-away sheath, and 3) the break-away needle. A brief history of PICCs
      along with problems encountered, an account of PICCs in immune-suppressed
      patients, and principles of catheter management are presented.

PMID- 8478784
TI  - Epithelial cell-fibroblast interactions: modulation of extracellular matrix
      proteins in cultured oral cells.
AB  - A model system involving co-cultures of human gingival or periodontal ligament
      fibroblasts with mouse epithelial root sheath cells or human gingival epithelial
      cells was used to study epithelial cell-fibroblast interactions. Double-labeled
      immunofluorescence and microfluorometry were used to investigate the expression
      of extracellular matrix molecules of collagen type I (collagen I), type III
      (collagen III) and fibronectin in fibroblasts. When fibroblasts from either
      source were cultured alone, the fluorescence for collagen I and fibronectin
      ranged from strongly positive to almost negative. Collagen III staining was
      relatively weak compared with that of collagen I. After 2-3 days of co-culture,
      gingival fibroblasts and ligament fibroblasts adjacent to the mouse sheath cells
      exhibited enhanced intracellular fluorescence for collagen I and fibronectin.
      Very little change was observed for collagen III. Gingival fibroblasts cultured
      with gingival epithelial cells showed increased fluorescence for collagen I but
      decreased fluorescence for fibronectin. In contrast, the fluorescence intensity
      for both collagen I and fibronectin in ligament fibroblasts were reduced after 3
      days of co-culture with gingival epithelial cells. Ultrastructural changes in
      fibroblasts co-cultured with mouse root sheath cells included increased Golgi
      cisternae and vesicles and an increased abundance of rough endoplasmic reticulum,
      polyribosomes, secretory vesicles and pinocytotic vesicles. Thus, the expression
      of extracellular matrix proteins and the metabolic activity of fibroblasts can be
      modulated by oral epithelial cells.

PMID- 8478785
TI  - Concentrations of thiocyanate, hypothiocyanite, 'free' and 'total' lysozyme,
      lactoferrin and secretory IgA in resting and stimulated whole saliva of children
      aged 12-14 years and the relationship with plaque accumulation and gingivitis.
AB  - Resting and stimulated whole saliva was collected from 94 children aged 12-14
      years and analyzed for thiocyanate, hypothiocyanite, 'free' and 'total' lysozyme,
      lactoferrin and secretory IgA. Clinical assessments of the amounts of plaque and
      gingival inflammation were made, and plaque was collected for determination of
      dry weight. An inverse relationship was observed between salivary thiocyanate
      concentrations in both resting and stimulated saliva and the amounts of plaque
      and gingival inflammation in these subjects (p < 0.05). Lactoferrin concentration
      in stimulated saliva was directly related to the amounts of plaque and gingivitis
      (p < 0.05). 'Total' lysozyme concentration in stimulated saliva was directly
      related to the amount of plaque (p < 0.05), and the 'free' lysozyme concentration
      in the same saliva was directly related to the amount of gingivitis (p < 0.05).
      The direct relationship observed between clinical measurements and both lysozyme
      and lactoferrin concentrations in saliva may have been due to contributions from
      gingival crevicular fluid. Cluster analysis identified three groups of subjects
      with different profiles in resting whole saliva, and in particular with different
      levels of secretory IgA. A statistically significant difference was observed in
      the quantity of plaque collected from subjects in two of these groups (p < 0.05).
      These results from cluster analysis using resting whole saliva from children
      confirmed the findings of a previous study with young adults.

PMID- 8478786
TI  - Kinetics of CD11b expression on neutrophils isolated from subjects with healthy
      gingivae and patients with advanced periodontitis.
AB  - The adhesion molecule, CD11b/CD18, plays a role in host defense against bacterial
      infections owing to its involvement in cell migration and phagocytosis. We
      examined the kinetics of CD11b expression on neutrophils isolated from peripheral
      blood (PB-PMNs) and gingival crevicular fluid (CF-PMNs) in subjects with healthy
      gingivae and in patients with advanced periodontitis in order to assess if CF
      PMNs respond differently in regard to CD11b expression from PB-PMNs isolated from
      healthy or periodontitis subjects. CF-PMNs or formylmethionylleucylphenylalanine
      (fMLP)-stimulated PB-PMNs were incubated in buffer with or without divalent
      cations for 60, 90, or 110 minutes. Plasma membrane (surface) CD11b as measured
      by flow cytometry was found to be reduced with time when cells (PB-PMNs or CF
      PMNs) from either controls or patients were treated with calcium- and magnesium
      free buffer. However, when CF-PMNs were treated with buffer containing Ca++/Mg++,
      surface CD11b expression increased on cells from both controls and patients. The
      reduction in CD11b expression on PB-PMNs is significantly greater than that
      measured on CF-PMNs over time. Therefore, CF-PMNs respond differently from PB
      PMNs which have been artificially stimulated with fMLP in regard to kinetics of
      CD11b expression on the plasma membrane.

PMID- 8478787
TI  - Change detection on longitudinal data in periodontal research.
AB  - Longitudinal data of attachment level (AL) or the alveolar bone level are often
      used to assess the progression of periodontal disease. This paper tries to
      identify the most efficient method to detect the changes of AL in a general
      periodontal research environment; that is, a sequential decision based on
      multiple sites. Several existing methods suggested in the periodontal research
      literature such as the tolerance, running median, cusum, and regression methods
      as well as change-point detection methods in the statistical literature are
      examined. It is found that the regression method is most convenient among the
      several methods that are equally effective in change detection. Formulae, tables
      and their usage are discussed in detail.

PMID- 8478788
TI  - Partial characterization of proteoglycans synthesized by human gingival
      epithelial cells in culture.
AB  - Proteoglycans (PGs) were extracted from the [35S]-sulfate labelled medium and
      cell layer of proliferating human gingival epithelial cells and analyzed by ion
      exchange and molecular sieve chromatography, and by SDS-PAGE. The majority of the
      incorporated radioactivity secreted into the medium eluted from a DEAE Sephacel
      ion exchange column as a single peak at 0.44 M NaCl with a small shoulder at 0.52
      M NaCl. This material, when chromatographed on Sepharose CL-6B contained two
      species--a quantitatively major peak at K(av) = 0.30 (M(r) congruent to 235,000
      on SDS-PAGE) and a quantitatively minor peak at K(av) = 0.39. The major peak was
      sensitive to alkaline borohydride, shifting to K(av) = 0.45, and nitrous acid
      degradation, indicating the presence of heparan sulfate PG with glycosaminoglycan
      chains with M(r) congruent to 26,000. The minor peak is chondroitin/dermatan
      sulfate PG with glycosaminoglycan chains of M(r) = 22,200 as indicated by
      sensitivity to alkaline borohydride (shifting to K(av) = 0.48) and chondroitin
      ABC lyase digestion. The [35S]-sulfate labelled material from the cell layer
      eluted in a broad peak between 0-0.50 M NaCl from DEAE Sephacel. Chromatography
      of this material on Sepharose CL-6B revealed the presence of three peaks at K(av)
      = 0.20, 0.31, and 0.75. The largest peak (K(av) = 0.20 and M(r) congruent to
      245,000 on SDS-PAGE) shifted elution position to K(av) = 0.50 after alkaline
      borohydride treatment and was completely sensitive to nitrous acid degradation.
      These results indicate that this peak contains heparan sulfate PG with
      glycosaminoglycan chains of M(r) congruent to 20,000. Two peaks containing [35S]
      sulfate labelled glycosaminoglycan chains were detected by chromatography of the
      cell layer extract over Sepharose CL-6B with K(av)S = 0.42 (M(r) congruent to
      30,500) and 0.75 (M(r) congruent to 5300). The larger peak was predominantly
      chondroitin/dermatan glycosaminoglycan as indicated by susceptibility to
      chondroitin ABC lyase while the chains at K(av) = 0.75 were predominantly heparan
      sulfate with 83% susceptibility to nitrous acid. These results indicate that
      cultured human gingival epithelial cells synthesize and secrete principally
      heparan sulfate PGs with small amounts of chondroitin/dermatan sulfate PGs. This
      work will serve as a basis for future studies designed to examine those factors
      involved in regulation of PG synthesis by these cells.

PMID- 8478789
TI  - Interactions of chlorhexidine with salivary films adsorbed at solid/liquid and
      air/liquid interfaces.
AB  - Chlorhexidine is a cationic compound which has been shown to bind to salivary
      proteins and enamel through electrostatic interactions. The aims of this study
      were to investigate the interaction of chlorhexidine molecules with salivary
      films adsorbed on solid surfaces with varying physico-chemical characteristics
      and to investigate the effect of different concentrations of chlorhexidine on the
      surface tension of saliva. The interactions between 0.2% chlorhexidine
      digluconate with films adsorbed from whole saliva were monitored by a Rudolph
      Thin-film ellipsometer equipped with a He-Ne laser (632.8 nm). The films were
      adsorbed on hydrophilic silica surfaces which were plasma cleaned or on
      methylated hydrophobic surfaces. Experiments of chlorhexidine adsorption on bare
      surfaces were also performed. The surface tension of mixtures of whole saliva
      with various concentrations of (0.1%, 0.2%, 1%) chlorhexidine was monitored with
      a tensiometer. The results show that chlorhexidine adsorbs on both types of
      studied substrates. Addition of the substance followed by rinsing caused a
      partial desorption of the adsorbed pellicles. Furthermore, at all studied
      concentrations chlorhexidine reduced the interfacial tension. There are
      indications that the amphiphilic characteristics of the molecule play an
      important role in the retention of the substance in the oral cavity.

PMID- 8478790
TI  - Microbial degradation of aquatic biomass by Trichoderma viride 992 and
      Aspergillus wentii 669 with reference to the physical structure.
AB  - There was a considerable change in the structural parameters of both the
      lignocellulosic substrates. This change was confirmed by infrared (IR)
      spectroscopy and X-ray diffraction data, which revealed the presence of phenolic
      groups in the peaks range 1310-1410 and 1200 cm-1 with large crystalline
      substrates. These were found to be reduced after treatment with alkali. Enzyme/s
      activity were found to be increased after pretreatment of hydrolysed substrates.
      The structural modifications in both the substrates were further evidenced by the
      results obtained after enzymatic hydrolysis of alkali-treated substrates.

PMID- 8478791
TI  - The effect of light and glucose concentration on the content of S- and R-glucans
      in the mycelium of Aspergillus giganteus mut. alba.
AB  - The amounts of S- and R-glucans in the mycelium of Aspergillus giganteus mut.
      alba depend on light within the range of selected light intensities: 0 W.m-2; 3
      W.m-2; 10.6 W.m-2 at 20% glucose concentration in the nutrient medium. This
      species synthesizes the highest amount of S-glucans at the light intensity 10.6
      W.m-2, and that of R-glucans--at the intensity 3 W.m-2.

PMID- 8478792
TI  - A genetic study of apramycin-resistant mutants of Escherichia coli.
AB  - The apramycin-resistant mutants of E. coli were isolated spontaneously.
      Mutations, aprA and aprB, conferring resistance to apramycin were located at 72
      min on the E. coli genetic map where most of ribosomal genes were mapped. One of
      the mutants, carrying the aprB mutation, has an altered translational fidelity
      expressed as severe restriction of amber suppressor activity in vivo. The
      chromosome location and altered translational fidelity indicate that the
      apramycin-resistant phenotype could be a consequence of an alteration of the
      ribosomal structure.

PMID- 8478793
TI  - Steroid metabolism with intestinal microorganisms.
AB  - As a result of the metabolic activities of numerous anaerobic microorganisms with
      sterols, bile acids and steroid hormones as substrates in connection with the
      enterohepatic circulation of these compounds, the intestine may be considered as
      an "endocrine" active site or organ. The review summarizes transformations of
      steroids by anaerobic intestinal bacteria, the physiological and supposed
      pathophysiological meaning thereof. The aim is to recommend further investigation
      in this field with respect to both the elucidation of the reactions and
      biological responses.

PMID- 8478794
TI  - Panmetatarsal head resection. A viable alternative to the transmetatarsal
      amputation.
AB  - While the transmetatarsal amputation has resulted in the salvage of numerous
      diabetic limbs, it remains an ablative procedure with both short- and long-term
      complications. The authors reviewed their experience with the panmetatarsal head
      resection as an alternative to the transmetatarsal amputation. A retrospective
      review was performed of all patients having undergone this procedure between May
      1986 and November 1991. Thirty-seven procedures were performed; of these, 34 were
      evaluated. The average follow-up period was 20.9 months. Thirty-two feet showed
      primary healing while one showed delayed healing. One patient had local
      recurrence of the original ulceration. Primary healing was 94% while overall
      success was 97%. No patient required amputation of any kind. The authors conclude
      that the panmetatarsal head resection is a viable alternative to the
      transmetatarsal amputation in properly selected patients because it avoids many
      of the structural and biomechanical pitfalls of the transmetatarsal amputation.

PMID- 8478795
TI  - Postgraduate podiatric medical education.

PMID- 8478796
TI  - Morton's neuroma.

PMID- 8478797
TI  - Transmetatarsal amputation for infection or gangrene in patients with diabetes
      mellitus. 1949.

PMID- 8478798
TI  - A historical look at the transmetatarsal amputation and its changing indications.
AB  - In March 1949, McKittrick described the use of the transmetatarsal amputation for
      the diabetic foot, along with specific indications. Infection, ischemia, and
      neuropathic ulcerations of the toes and forefoot were all treated with this
      procedure. In the past 30 years, however, advances in the management of these
      problems have led to a decrease in the number of transmetatarsal amputations
      performed at the New England Deaconess Hospital. With these advances, the current
      approach to the transmetatarsal amputation has changed, leading to significant
      modifications in the basic indications for this procedure.

PMID- 8478799
TI  - A biomechanical model for the transmetatarsal amputation.
AB  - The transmetatarsal amputation has been performed for over 40 years as a limb
      salvage procedure, in diabetic patients with nonhealing ulcerations or
      nonreconstructible ischemia. It is generally believed that the transmetatarsal
      amputation provides a better walking extremity than a more proximal amputation
      and is more energy efficient. A review of the literature reveals little regarding
      the biomechanics of the "short foot." The authors will review the functions of
      the myofascial structures in both the normal foot and the transmetatarsal
      amputation and discuss the influence of mechanics on transmetatarsal amputation
      lesions.

PMID- 8478800
TI  - Salvaging the ischemic transmetatarsal amputation through distal arterial
      reconstruction.
AB  - From 1982 to 1991, 17 patients underwent a lower extremity arterial bypass to
      salvage an ischemic transmetatarsal amputation at the New England Deaconess
      Hospital. Eleven patients were male, and 16 had diabetes for an average of 29
      years. The mean age was 71 years. Twelve patients presented with an ischemic
      ulcer, one had rest pain, and four underwent bypass for failure to heal a
      transmetatarsal amputation. Twelve patients presented with findings of secondary
      infection. All 17 patients underwent successful lower extremity bypass procedures
      to a variety of outflow vessels. Thirteen bypasses were to infrapopliteal
      arteries, including four to the dorsalis pedis artery. There were no
      perioperative deaths and all patients were discharged with patent grafts and
      healing limbs. Actuarial graft patency of the 14 vein grafts was 90% at 2 years.
      Actuarial limb salvage for the entire group was 93% at 2 years. Thirteen of the
      14 patients who maintained patent grafts and healed their transmetatarsal
      amputations were ambulatory at their last known follow-up examination. Ischemic
      complications of previously created transmetatarsal amputations are uncommon.
      However, limb salvage attempts by lower extremity arterial bypass have a high
      likelihood of success. Major amputation in these patients should not be done
      without having first undergone a comprehensive vascular evaluation.

PMID- 8478801
TI  - Surgical revision of the problematic transmetatarsal amputation.
AB  - Recurrent ulcerations may develop following transmetatarsal amputation in
      patients with diabetes mellitus. In many cases, these ulcerations require
      surgical intervention to achieve healing, especially in situations where
      conservative care has not been effective. These procedures range from the local
      resection of bone to skin grafting and flap techniques to successfully heal the
      wound. The ultimate goal of any surgical intervention is to prevent a more
      proximal amputation.

PMID- 8478802
TI  - Tendo Achillis procedures for chronic ulcerations in diabetic patients with
      transmetatarsal amputations.
AB  - Recurrent ulceration following transmetatarsal amputation commonly results from
      hypertrophic bone formation or equinus deformity. In the current study, 31
      diabetic patients underwent 33 Achilles tendon procedures for recurrent
      ulcerations at the distal stump of their transmetatarsal amputation. Primary
      healing was achieved in 21 procedures (64%) and secondary healing in 9 procedures
      (27%) for an overall healing rate of 91%. Two procedures failed to resolve the
      original ulceration (6%). The average follow-up examination was 27 months. The
      authors conclude that Achilles tendon procedures are an effective means of
      managing ulcerations in transmetatarsal amputation feet exhibiting an equinus
      deformity.

PMID- 8478803
TI  - Standard of care: legal implications in the postanesthesia care unit.
AB  - PACU staff provide specialized nursing care to diverse patient populations in an
      environment of constant activity, high volume, rapid turnover, and intense
      pressure. Nursing practice in the PACU requires quick, effective responses when
      emergencies occur. The PACU nurse is held to the same standard of care as any
      reasonably prudent nurse in similar life-threatening situations. It is essential
      that the PACU nurse know the standards of care, the basic elements of negligence,
      and the legal implications of practice. Ultimately, the responsibility for each
      nurse's practice lies in his or her knowledge and understanding of professional
      standards. These standards form the foundation of PACU nursing care.

PMID- 8478804
TI  - Intermediate-term intravenous therapy: a pilot study.
AB  - Midline catheters provide an effective alternative for intermediate-term
      intravenous therapy. During a pilot study, 27 midline catheters were inserted in
      patients who met specific criteria. The insertion success rate was 64%, and the
      infection rate was 7%. One mechanical phlebitis occurred, but it was resolved by
      the application of warm, moist heat. One chemical phlebitis occurred during
      antibiotic therapy. The average dwell time was 8.7 days, and the longest dwell
      time was 49 days. Patients reported the catheters to be very comfortable and did
      not experience limitations in mobility.

PMID- 8478805
TI  - Precious moments of caring.

PMID- 8478806
TI  - Infection control monitoring in the ambulatory surgery unit.
AB  - This article shares a plan for infection control monitoring in an ambulatory
      surgery unit. Simple, efficient, and effective, the plan meets the unique needs
      of nurses working in a high-volume unit with rapid turnover of patients where
      virtually no contact occurs nor is information received about patients after the
      first 24 hours. The success of the plan depends on the surgeons assuming
      responsibility for identifying and reporting their patients' postoperative
      infections. We have found that surgeons will respond if provided with a simple
      reporting system that requires minimal completion time.

PMID- 8478807
TI  - Patients who develop postanesthesia shaking increase body temperature at the same
      rate as those who do not develop shaking.
AB  - Postanesthesia shaking is a common complication occurring after general
      anesthesia. Although the cause is unknown, some nurses believe that shaking is
      useful and beneficial for patients because it increases body temperature and that
      shaking stops when patients are no longer hypothermic. The primary purpose of
      this study was to examine changes in body temperature among patients who
      developed and who did not develop shaking. Secondary purposes were to examine
      changes in body temperature among patients who received or who did not receive
      intravenous narcotic-analgesic medication treatment to stop shaking and among
      those who either stopped shaking or who continued to shake until spontaneous
      cessation occurred minutes to hours later. The convenience sample consisted of 36
      shaking patients and 56 nonshaking patients who were extubated, were over 18
      years of age, had an intact intravenous line, and received isoflurane anesthesia.
      Shaking was established when patients reached and sustained grade 2 or 3 shaking
      on a 0-to-3 visual scale for 3 minutes (no shaking to forceful shaking). Shaking
      was determined as having stopped when patients achieved grade 2 on a 0-to-2
      visual scale (continues shaking to stopped shaking). Axillary temperature was
      measured on PACU admission and again after 60 minutes. The six hypotheses were
      supported. Patients who developed shaking (mean = .67 degrees C [1.2 degrees F])
      changed body temperature at the same rate as those who did not develop shaking
      (mean = .72 degrees C [1.3 degrees F]). Administration of intravenous narcotic
      analgesic medication to stop shaking did not alter the rate of body temperature
      change in patients who received or who did not receive treatment for shaking and
      those who did or who did not stop shaking. Findings suggest that postanesthesia
      shaking does not increase body temperature. This finding does not support the
      long-held belief that shaking is useful and beneficial for patients because it
      increases body temperature. Findings also indicated that the administration of
      intravenous narcotic-analgesic medications to stop shaking does not alter the
      rate of body temperature change. Suggestions for further research focus on
      systematically examining nursing interventions currently implemented to stop
      shaking. Research findings will provide evidence that either supports or fails to
      support the implementation of therapeutic interventions that effectively stop
      shaking within 5 minutes.

PMID- 8478808
TI  - Practical points in the care of the patient post-cleft lip and palate repair.
AB  - It is the purpose of this article to discuss care of the patient post-cleft lip
      and palate repair. The incidence and epidemiology of clefting is presented.
      Surgical goals and procedures are discussed, and special attention is given to
      PACU priorities.

PMID- 8478810
TI  - The essence of leadership: facing the challenge of being the new manager.
AB  - To meet the challenge of today's work environment, the leader of a professional,
      technically skilled, and highly diverse work "group must be an enabler of people,
      a facilitator of groups, as well as know how to be an effective group member"
      (Blanchard et al, The One Minute Manager Builds High Performance Teams, New York,
      NY, William Morrow, 1990). To accomplish this the leader must participate as a
      member of the work group as well as identify areas of needed management support
      and direction. Creating the climate that allows professional work teams to
      develop and mature is both challenging and rewarding. Fully mature, high
      performance teams require minimal direction from the leader. At this stage
      empowerment is reached: the leader lets go so that the team can get going.

PMID- 8478809
TI  - Introduction to instrument development: scaling methods.
AB  - Deciding which instrument scale technique to choose is an important step in
      instrument development. Measurement theory dictates rules regarding level of
      measurement and approaches to decrease the error component of true scores.
      Measurement rules are applied to types of scaling, including methods to quantify
      demographic data, opinion rating scales, summated rating scales, semantic
      differential scales, and methods to quantify laboratory data. Consideration to
      scaling should be made before planning data analysis so that research questions
      or hypotheses can be answered using the appropriate statistical method.

PMID- 8478811
TI  - Healthy neighbors: exploring the health care systems of the United States and
      Canada.
AB  - Millions of Americans are without insurance or access to health care. The health
      care industry, politicians, government, concerned groups, and individuals are
      struggling with proposals for a system that will ensure basic care for all our
      citizens. The Canadian system is often suggested as a model for the United
      States. Allen recently visited Canada and spoke with residents in Nova Scotia and
      Newfoundland about their health care. Kardos has done extensive research on
      various systems designed to provide universal access to health care. In the
      following article the authors offer information, make comparisons, and pose
      questions for readers.

PMID- 8478812
TI  - Beyond blame: modeling achievement.

PMID- 8478813
TI  - Central auditory neurophysiology of a sound-producing fish: the mesencephalon of
      Pollimyrus isidori (Mormyridae).
AB  - This paper describes the auditory neurophysiology of the mesencephalon of P.
      isidori, a sound-producing mormyrid fish. Mormyrids have a specialized pressure
      sensitive auditory periphery, and anatomical studies indicate that acoustic
      information is relayed to the mesencephalic nucleus MD. Fish were stimulated with
      tone bursts and clicks, and responses of MD neurons were recorded
      extracellularly. Auditory neurons had best frequencies (BF) and best
      sensitivities (BS) that fell within the range of frequencies and levels of the
      natural communication sounds of these fish. BSs were in the range of 0 to -35 dB
      (re. 1.0 dyne/cm2). Many of the neurons were tuned (Q10 dB: 2-6), and had BFs in
      the range of 100-300 Hz where the animal's sounds have their peak energy. A range
      of different physiological cell types were encountered, including phasic,
      sustained, and complex neurons. Some of the sustained neurons showed strong phase
      locking to tones. Many neurons exhibited non-monotonic rate-level functions.
      Frequencies flanking the BF often caused a reduction in spontaneous activity
      suggesting inhibition. Many neurons showed excellent representation of click
      trains, and some showed a temporal representation of inter-click-intervals with
      errors less than 1 ms.

PMID- 8478814
TI  - Cerebral neurons underlying prey capture movements in the pteropod mollusc,
      Clione limacina. II. Afterdischarges.
AB  - The pteropod mollusc Clione limacina is a highly specialized carnivore which
      feeds on shelled pteropods and uses, for their capture, three pairs of oral
      appendages, called buccal cones. Contact with the prey induces rapid eversion of
      buccal cones, which then become tentacle-like and grasp the shell of the prey. In
      the previous paper, a large group of electrically coupled, normally silent cells
      (A motoneurons) has been described in the cerebral ganglia of Clione. Activation
      of A neurons induces opening of oral skin folds and extrusion of the buccal
      cones. The present study continues the analysis of the electrical properties of A
      motoneurons. Brief intracellular stimulation of an A neuron can produce prolonged
      firing (afterdischarge), lasting up to 40 s, in the entire population of A
      neurons. After-discharge activity is based on an afterdepolarization evoked by an
      initial strong burst of A neuron spikes. The data suggest that this
      afterdepolarization represents excitatory synaptic input from unidentified
      neurons which in turn receive excitatory inputs from A neurons, thus organizing
      positive feedback. The main functional role of this positive feedback is the
      spread and synchronization of spike activity among all A neurons in the
      population. In addition, it serves to transform a brief excitatory input to A
      neurons into their prolonged and stable firing, which is required during certain
      phases of feeding behavior in Clione.

PMID- 8478815
TI  - Modulation of swimming behavior in the medicinal leech. I. Effects of serotonin
      on the electrical properties of swim-gating cell 204.
AB  - The effects of serotonin on the electrical properties of swim-gating neurons
      (cell 204) were examined in leech (Hirudo medicinalis) nerve cords. Exposure to
      serotonin decreased the threshold current required to elicit swim episodes by
      prolonged depolarization of an individual cell 204 in isolated nerve cords. This
      effect was correlated with a more rapid depolarization and an increased impulse
      frequency of cell 204 in the first second of stimulation. In normal leech saline,
      brief depolarizing current pulses (1 s) injected into cell 204 failed to elicit
      swim episodes. Following exposure to serotonin, however, identical pulses
      consistently evoked swim episodes. Thus, serotonin appears to transform cell 204
      from a gating to a trigger cell. Serotonin had little effect on the steady-state
      current-voltage relation of cell 204. However, serotonin altered the membrane
      potential trajectories in response to injected current pulses and increased the
      amplitude of rebound responses occurring at the offset of current pulses. These
      changes suggest that serotonin modulates one or more voltage dependent
      conductances in cell 204, resulting in a more rapid depolarization and greater
      firing rate in response to injected currents. Thus, modulation of intrinsic ionic
      conductances in cell 204 may account in part for the increased probability of
      swimming behavior induced by serotonin in intact leeches.

PMID- 8478816
TI  - Gilles de la Tourette syndrome: a neuropsychiatric disorder.
AB  - Gilles de la Tourette Syndrome is a neuropsychiatric disorder which manifests
      with neurological psychological and psychiatric symptoms. Understanding of this
      complex disorder has grown rapidly in the past 25 years. This paper reviews the
      current knowledge of biological and psychological factors which interact to
      produce a variable yet clearly recognisable syndrome. New directions for research
      are explored. Current literature suggests that despite many gains, much remains
      to be learned about this disorder.

PMID- 8478817
TI  - Association between physical and psychological morbidity in the Whitehall II
      Study.
AB  - Mechanisms for the association between psychiatric disorder measured by the
      General Health Questionnaire and subjective and objective indices of physical
      illness are examined among 6900 male and 3414 female civil servants aged between
      35 and 55 yr from the cross-sectional results of the Whitehall II Study. It was
      hypothesized that the association between physical illness and psychiatric
      disorder might be because psychiatric disorder was either secondary to the pain
      and disability of physical illness, or related to the somatic presentation of
      psychiatric disorder, or to common causes of both physical and psychiatric
      illness. Overall health status, and self-reported physical symptoms were strongly
      associated with psychiatric disorder. Angina in men and severe chest pain in men
      and women were significantly associated with psychiatric disorder, but
      electrocardiographic abnormalities were not. Established risk factors for
      physical illness: alcohol intake in women and men and smoking habit in men were
      related to psychiatric disorder. Fibrinogen was related to self reported physical
      symptoms but not psychiatric disorder. The association between psychiatric
      disorder and self-reported physical symptoms is most likely explained by
      somatisation and plaintive set. However, psychiatric disorder is likely to be
      secondary to the pain and disability of conditions such as angina.

PMID- 8478818
TI  - Osteoporosis and normal weight bulimia nervosa--which patients are at risk?
AB  - This study assesses the degree of bone mineral loss in women with active DSM IIIR
      bulimia nervosa. The subjects in this study were 20 GP-referred female patients
      of normal weight who met criteria for bulimia nervosa and 16 healthy age, sex and
      weight matched controls. Dual energy X-ray densitometry of lumbar L1-L4 vertebrae
      was performed on all subjects. The patients with bulimia nervosa had a
      significantly lower mean lumbar bone mineral density (0.964 g/cm2) than the
      control group (1.043 g/cm2, p < 0.01). Within the patient group only subjects
      with a past history of anorexia nervosa had a significantly lower mean bone
      mineral density (BMD) than the controls. Small sample sizes limit the power of
      the study, however significant correlations were found between duration of
      amenorrhoea, low BMI and lumbar BMD. Bulimic patients do suffer from
      osteoporosis. Risk factors for this may be; a past history of anorexia nervosa,
      prolonged secondary amenorrhoea, and a persistently low body mass index.

PMID- 8478820
TI  - Evidence against multiple premenstrual syndromes: results of a multivariate
      profile analysis of premenstrual symptomatology.
AB  - The topic of a single vs multiple premenstrual syndromes has generated much
      discussion. In this study, multivariate profile analysis was used to determine
      whether or not physical and affective symptoms associated with the premenstrual
      syndrome (PMS) could be explained as the manifestation of one underlying
      pathophysiologic process. The premenstrual symptom profiles of 820 undergraduate
      students and 485 graduate students were evaluated. It was not possible to reject
      the null hypothesis of parallel profiles in most comparisons, suggesting that
      variability in the severity of premenstrual symptoms may be the result of
      individual differences in the expression of one underlying pathophysiologic
      process.

PMID- 8478819
TI  - Relationship of cardiovascular reactivity and anger expression to serum lipid
      concentrations in healthy young men.
AB  - The relationship between behaviorally evoked cardiovascular reactivity, preferred
      mode of anger expression, and serum lipid concentrations was examined in 63
      healthy, young adult males. Subjects derived from three studies, each evaluating
      cardiovascular response to laboratory stressors. All participants completed the
      Spielberger Anger Expression Scale and provided fasting blood samples for lipid
      determinations. A significant negative correlation, calculated by meta-analytic
      procedures, was noted between a baseline-free measure of heart rate reactivity
      and high density lipoprotein-cholesterol (HDL-C) concentrations (r = -0.26, p =
      0.05). However, the previously reported relationship between cardiovascular
      reactivity and elevated total serum cholesterol (TSC) was not found.
      Additionally, men scoring high on a self-report measure of the tendency to
      express anger outwardly had significantly higher HDL-C concentrations than men
      scoring low on this measure (r = 0.30, p = 0.02); when subjects were stratified
      by level of cardiovascular reactivity, this relationship was apparent only among
      those showing the greatest magnitude of heart rate and blood pressure responses
      to acute mental stress.

PMID- 8478821
TI  - Improvement of respiratory function in chronic asthmatic patients with autogenic
      therapy.
AB  - Stress, unpleasant emotions and autonomic imbalance may play a main role in
      precipitating asthmatic attacks. In this study two homogeneous groups of
      asthmatic patients (N = 24) are treated over an eight-month period. The
      experimental group was treated with autogenic therapy and the control group with
      supportive group psychotherapy. Respiratory function parameters measured were
      Forced Vital Capacity (FVC), Forced Expiratory Volume in the first sec (FEV1),
      Forced Expiratory Flow between 25% and 75% of the FVC (FEF25-75%), and
      Mesoexpiratory Flow (MEF50%). The group under Autogenic Therapy obtained a
      relevant clinical improvement (> 15% of pretreatment values) in respiratory
      function. No significant changes were observed in the control group. These
      results suggest that autogenic therapy could be an effective adjunctive treatment
      in bronchial asthma.

PMID- 8478822
TI  - Psychosocial status in pre-adolescent children with beta-thalassaemia.
AB  - Psychiatric disorders and social profile were investigated in 57 children with
      beta-thalassaemia and 57 control subjects. Although there was no significant
      difference in the number of individuals with psychiatric disorders between the
      two groups, the number of psychiatric disorders observed in the group of patients
      was significantly greater than in the control subjects (p < 0.01). Oppositional
      defiant disorder (ODD) was diagnosed in 23% of the thalassaemics and in 5% of the
      control subjects (p < 0.01). The frequency of ODD in male patients (38%) was
      significantly greater than in female (7%) (p < 0.01). Thalassaemic patients
      demonstrated a significantly greater frequency of disturbed behavior with
      relatives and friends than the control subjects (p = 0.0005). This behavior was
      related to ODD. Also, thalassaemic patients with ODD showed a significantly
      higher serum ferritin level than thalassaemics without ODD (p < 0.005). This was
      attributed to non-compliance to treatment. No association of ODD with another
      haematological parameter was found. ODD is the major psychiatric disorder
      appearing in thalassaemic pre-adolescent children warranting psychiatric
      intervention.

PMID- 8478823
TI  - Discordance between symptom and physiological criteria for the hyperventilation
      syndrome.
AB  - Hyperventilation is assumed to produce a set of somatic and psychological
      symptoms, the so-called Hyperventilation Syndrome (HVS). Recognition of symptoms
      during the hyperventilation provocation test (HVPT) is the most widely used
      criterion for diagnosing HVS, but additional physiological and symptom criteria
      have been proposed. The concordance of various diagnostic criteria for HVS is
      investigated in the present study. Forty-eight psychiatric patients with panic
      disorder and 90 somatic patients with symptoms suspective of HVS performed a
      HVPT. There was a strong interrelationship between the various symptom criteria
      as well as the physiological criteria. However, almost no association between
      symptom and physiological HVS criteria were found. Symptom recognition was
      significantly related to trait anxiety, agoraphobia and depression. These data do
      not only question the validity of the HVPT, but also of the concept of HVS. The
      results are more consistent with a cognitive approach to anxiety in which the
      HVPT is seen as an aspecific stressor during which more anxious patients
      anticipate an anxiety attack.

PMID- 8478824
TI  - Associations between mood and specific health composites during U.S. Navy Persian
      Gulf operations.
AB  - Previously conducted field studies using shipboard U.S. Navy personnel during at
      sea operations in the Persian Gulf have shown that crew members experience mood
      changes and degradations in general physical health. The objectives of this study
      were to: (a) examine the relationship between mood and health complaints among
      personnel deployed in the Persian Gulf; and (b) extend previous research using
      specific health composites rather than a general measure of health. Mood was
      assessed for 104 shipboard volunteers using the Profile of Mood States
      Tension/Anxiety and Fatigue subscales. Health symptoms were measures using the
      Environmental Symptoms Questionnaire. Results of multiple regression analyses
      showed that each of 11 distinct health composites was significantly associated
      with one or both mood variables. Further, the two mood factors were
      differentially associated with 9 of the 11 health composites. This study
      underscores the usefulness of employing multiple specific health measures rather
      than global measures.

PMID- 8478825
TI  - Pain thresholds during standardized psychological stress in relation to perceived
      psychosocial work situation. Stockholm Music I Study Group.
AB  - The hypothesis that perceived psychosocial work situation is associated with pain
      threshold was tested on a sample of 103 men and women aged 19-65 yr in Stockholm.
      Half of the studied sample was a random sample of men (N = 26) and women (N =
      31), while the remaining subjects were medical secretaries (women, N = 28) and
      furniture movers (N = 31). Pain thresholds were measured by means of an algometer
      before, during and after a standardized colour word test. The measurements were
      made on six different points in the neck and shoulder region. Before
      psychological stress in the laboratory, perceived psychological demands were
      significantly associated with pain threshold--the higher the demands the higher
      the pain threshold. During stress those who reported low decision latitude and
      high degree of sleep disturbance were shown to have a low pain threshold. The
      findings are consistent with the hypothesis that subjects with high demand levels
      have an elevated pain threshold when they are not under excessive psychological
      stress. During psychological stress, on the other hand, those with low decision
      latitude are more pain sensitive than others, and this is aggravated in those who
      also report a high degree of sleep disturbance.

PMID- 8478826
TI  - Leg lengthening.
AB  - The combined experience of the Royal Hospital for Sick Children, Glasgow and the
      Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry in lengthening 52
      lower limb segments with the Orthofix device is reviewed. Forty-eight segments
      were lengthened by callotasis, 24 in patients with achondroplasia. Attempted
      lengthening with chondrodiatasis was performed in 4 patients with leg length
      discrepancy. With callotasis, planned lengthening was achieved in 43/48 (90%) of
      segments. There was a small number of significant complications. Angulation or
      buckling of the new bone was the commonest major complication, and was seen in
      10% of segments. Pin tract infection was the predominant minor complication.
      Premature union was noted commonly in the femurs of achondroplastics, but could
      usually be overcome with manipulation under anaesthesia. We confirm that
      callotasis achieves its objectives with fewer complications and operations than
      the commonly used Wagner method which it should supersede. By contrast, we had
      major complications in all cases with chondrodiatasis and have abandoned this
      method.

PMID- 8478827
TI  - Bilateral knee replacements: simultaneous or staged?
AB  - Approximately one-third of primary knee replacements are performed on patients
      with bilateral symptomatic disease. This retrospective study compared the
      complication rate, functional outcome and cost implications of performing
      bilateral total knee replacements under a single anaesthetic or as staged
      procedures with a control group of unilateral cases. There was no significant
      difference in the complications or outcome. There was a significant reduction in
      the mean hospital admission time of 7 days per knee replacement (P < 0.001,
      Student's t test) by performing bilateral knee replacements for osteoarthritis
      under the same anaesthetic. However, a survey of practising knee surgeons in
      three health regions in the United Kingdom shows that only 24% would regularly
      perform bilateral knee replacements under one anaesthetic.

PMID- 8478828
TI  - A clinicopathological study of idiopathic CTEV.
AB  - Clubfeet were assessed preoperatively, intra-operatively, postoperatively and
      histologically. There appeared to be a variety of distinct pathobiological
      groups. A type I/type II fibre area ratio of equal to or greater than 0.9 may be
      of prognostic value.

PMID- 8478829
TI  - What do orthopaedic surgeons tell patients?
AB  - Surgical patients have the right to clear communication regarding diagnosis,
      treatment and prognosis including risks and likelihood of success. In order to
      ascertain the level of consensus which exists among orthopaedic surgeons about
      what patients should be told, a short questionnaire comprising a fictitious case
      history of a candidate for total hip replacement and a list of sample statements
      was mailed to all orthopaedic surgeons in Northern Ireland; 86% replied. Surgeons
      were in general agreement about what the patient should and should not be told
      prior to operation. This approach may be adapted for other procedures.

PMID- 8478830
TI  - Elbow dislocation with intra-articular entrapment of the lateral epicondyle.

PMID- 8478831
TI  - Reducing skin exposure to methylmethacrylate: a description of technique.

PMID- 8478832
TI  - Modified AO bone clamp used as a distractor.

PMID- 8478833
TI  - An alternative soft tissue protector for intramedullary nailing.

PMID- 8478834
TI  - HRT and the surgeon. Guidelines from the Royal College of Surgeons of Edinburgh
      (November 1992).

PMID- 8478835
TI  - Thyroid surgery without drainage: 15 years of clinical experience.
AB  - Drainage in thyroid surgery has been a routine but empirical practice with no
      scientific evidence to support its benefit. The largest series to date of non
      drainage in thyroid surgery is presented, comprising 260 patients over a 15-year
      period. No case selection for non-drainage was employed. Two hundred and fifty
      nine cases were not drained and included toxic goitres, and bilateral and redo
      procedures. There was one thyroid storm and two cases of subcutaneous fluid
      collection, treated by needle aspiration. No cases of recurrent laryngeal nerve
      injury, airway obstruction or death were recorded. This study strongly
      demonstrates the safety of non-drainage in routine thyroid surgery.

PMID- 8478836
TI  - Combined predeposit and salvage autotransfusion in elective aortic aneurysm
      repair.
AB  - In this study assessing the safety and value of the routine use of
      autotransfusion in elective aortic aneurysm surgery, the first 16 patients
      (control group) received homologous transfusion only, while the subsequent 38
      patients (autotransfusion group) received a combination of predeposit and salvage
      autotransfusion (Solcotrans device). Between 1 and 3 units of blood were
      venesected preoperatively, and a median of 0.80 (0.20-2.75) litres of unwashed
      shed blood was salvaged and re-infused (48% of the measured blood loss). A median
      of 4 units of banked blood was required in the control group compared with 2
      units in the autotransfused group, an average saving of 2 units per patient (P <
      0.001). Banked blood was avoided completely in 37% of patients in the
      autotransfusion group. There were no haematological or biochemical complications.
      Predeposit and salvage autotransfusion is simple and safe, and reduces banked
      blood requirement in aortic aneurysm surgery.

PMID- 8478837
TI  - Experience with breast cancer in Zimbabwe.
AB  - Eighty-four patients were treated for carcinoma of the breast at Mpilo Central
      Hospital, Bulawayo, between July 1987 and December 1990. The age at diagnosis
      appears to be bimodal with an early peak between 35 years and 40 years and a
      later peak between 60 years and 65 years. As expected, these patients were of
      high parity (median 5) and 96% of them breast fed for an average of 16 months. It
      would appear that late presentation with advanced systemic disease accounts for
      the dismal prognosis. Eighty-four per cent of the patients presented with late
      disease with only 16% presenting with early disease. Of the 25 patients who were
      followed to death the median survival was 12 weeks. For various logistic reasons
      long-term follow-up has not been possible for the rest of the patients. The
      expense involved in travelling long distances appears to be the main problem. To
      improve the outcome of breast cancer in our community we we need to embark on an
      active education campaign to increase public awareness of the significance of
      breast symptomatology. However, the incidence of carcinoma of the breast in this
      part of the world remains very low when compared with experience in Western
      countries.

PMID- 8478838
TI  - Cholecystectomy: a study of patient satisfaction.
AB  - A prospective study of 77 patients undergoing open cholecystectomy was undertaken
      to establish the degree of satisfaction experienced by these patients. Specific
      symptoms were recorded preoperatively and at one year postoperatively. Two
      patients died from unrelated diseases during the year of follow-up and were
      excluded from the analysis. All symptoms inquired about reduced in frequency
      postoperatively, the best cures being achieved for jaundice, upper abdominal
      colic, fatty food intolerance and back/shoulder pain. A third of patients
      developed at least one new symptom during the year of follow-up. Seventy-seven
      per cent graded themselves either completely or well satisfied. It was not
      possible to predict from preoperative symptoms those who would be dissatisfied or
      those who would develop a new symptom. This study refutes recent suggestions that
      up to 50% of patients are dissatisfied with cholecystectomy and provides data
      which may be used to counsel patients preoperatively.

PMID- 8478839
TI  - Omentoplasty versus introflexion for hydatid liver cysts.
AB  - Forty-three patients with unilocular hydatid cyst of the liver were divided into
      three groups. Omentoplasty (n = 15) was performed in group 1, introflexion (n =
      18) in group 2 and a combination of both (n = 10) in group 3. Patients with
      omentoplasty developed fewer complications and had a significantly shorter
      hospitalization than those with introflexion. The results indicate that
      omentoplasty is superior both to introflexion and to introflexion plus
      omentoplasty for the management of hydatid liver cysts.

PMID- 8478840
TI  - Open biliary surgery and the use of routine inpatient audit.
AB  - 'Morbidity profiles' offer a practicable and effective method of assessing
      overall surgical performance. In this study they have been used to document the
      results of elective and emergency open biliary surgery carried out on 246
      consecutive patients over a 2-year period. The results demonstrate that such
      surgery for the treatment of cholelithiasis and its complications is extremely
      safe. There was one postoperative death (0.4%) and an in-hospital major morbidity
      rate of 4.6%. Minor morbidity was common, especially in the elderly and following
      emergency surgery. The data presented here will be of particular interest to the
      increasing number of surgeons advocating laparoscopic biliary surgery.

PMID- 8478841
TI  - Effect of bowel cleansing and colonoscopy on serum CEA levels.
AB  - A group of patients being investigated for various forms of colonic pathology
      showed an apparent rise in serum carcinoembryonic antigen (CEA) level following
      bowel cleansing at the time of colonoscopy, as compared with the 'resting' level.
      The rise was particularly marked in a small group of patients with colonic polyps
      or previous colonic resection for carcinoma, suggesting a need for careful timing
      in the taking of blood samples. The findings may also have diagnostic importance
      in identification of patients at higher risk of malignant disease of the colon.

PMID- 8478842
TI  - Avoidable complications of arthroscopic surgery.
AB  - The incidence of complications from arthroscopic surgery is low. Between 1978 and
      1991, 8500 arthroscopies were performed by the two senior authors (J.N. and
      D.R.A.D.). Several significant complications were recorded, and these are
      presented to show how they occurred, and how our practice of arthroscopy was
      subsequently modified. There were four cases of clinically detectable deep vein
      thrombosis of which three were associated with pulmonary embolus, three cases of
      haemarthrosis, two deep infections, three compartment syndromes with one case of
      impending compartment syndrome, six cases of instrument failure and one case of
      persistent synovial fistula.

PMID- 8478843
TI  - Removal of metal implants after fracture surgery--indications and complications.
AB  - In a study of 297 internal fixation operations for fractures or joint injuries
      performed during 1982, a second operation for implant removal was undertaken in
      42% of cases. Significant complications occurred following the second procedure
      in 19%. Implants which were retained did not give rise to appreciable problems.
      It is suggested that implants should only be removed when there are clear
      clinical indications for doing so.

PMID- 8478844
TI  - Platonic outcomes.

PMID- 8478845
TI  - Hyperimmune fatigue syndromes: diseases of the stress response?

PMID- 8478846
TI  - The contribution of human c-fos DNA to cultured synovial cells: a transfection
      study.
AB  - To clarify the role of c-fos DNA in the activation of human synovial cells, the
      pH8 expression vector containing human c-fos DNA under the control of murine
      leukemia virus long terminal repeat was transfected into cultured synovial cells.
      After G418 selection, the control transfectant clones transfected with pH8 vector
      not containing c-fos DNA insertion changed their original fibroblastic shape into
      dendritic cells. They stopped growing at this stage. However, the c-fos DNA
      transfectant clones continued to grow actively beyond this stage, and regained
      the fibroblastic appearance. Furthermore, c-fos DNA transfectants adhered to and
      grew on hyaluronidase treated cartilage surfaces more extensively than control
      transfectants after 6 days in culture. These findings suggest that c-fos DNA
      supports active growth of human synovial cells by facilitating transition of
      synovial dendritic cells into fibroblastic cells.

PMID- 8478847
TI  - A comparison of the sensitivity to change of several health status instruments in
      rheumatoid arthritis.
AB  - We carried out a study to compare the sensitivity to change of disease specific
      compared with more generic health status instruments in relation to rheumatoid
      arthritis (RA). A sample of 102 patients was recruited and assessed by means of 4
      health status instruments and standard rheumatological measures on 3 occasions
      separated by 3 monthly intervals. Sensitivity to change for mobility, activities
      of daily living, household, pain, emotions and social dimensions were calculated.
      For some dimensions disease specific health status instruments performed less
      well. However overall there was no evidence of consistent differences between the
      2 approaches. We conclude that generic instruments have a role in the assessment
      of RA.

PMID- 8478848
TI  - Influence of disease duration, continued followup and further antiphospholipid
      testing on the frequency and classification category of antiphospholipid syndrome
      in a cohort of patients with systemic lupus erythematosus.
AB  - In an earlier study of a cohort of 667 patients with systemic lupus erythematosus
      (SLE) followed for 7.5 months with mean antiphospholipid (aPL) testing 2.5 times,
      we found a 10% prevalence of definite antiphospholipid syndrome (APS) (2 clinical
      manifestations and high aPL levels). To determine if more followup and aPL
      testing increased such prevalence we restudied the cohort after a mean followup
      of 3.1 years and a mean aPL testing of 5.6 times and found a 15% prevalence of
      definite APS. Another 21% of patients with SLE had probable APS with either high
      titers of aPL but only one clinical manifestation or low titers with 2 clinical
      manifestations. The prevalence of high titer positivity of aPL (IgG and/or IgM
      isotype) reached 41%. One aPL related feature that increased significantly was
      livedo reticularis possibly from increased awareness. Factors that influenced
      significantly the mobility upwards in APS category were more pregnancies and
      further aPL testing. Conversely, immunosuppressive treatment decreased higher aPL
      levels. The large number of patients with long disease duration in our cohort
      showed that the maximum prevalence of definite APS is reached after 15-18 years
      and is 23%. This might be the highest prevalence of definite APS within SLE.

PMID- 8478849
TI  - Complement component C4A and C4B levels in systemic lupus erythematosus:
      quantitation in relation to C4 null status and disease activity.
AB  - Immunoassays using C4 monoclonal antibodies were developed to quantitate C4A, C4B
      and total C4 in the serum of healthy controls and patients with systemic lupus
      erythematosus (SLE). Mean C4A or C4B levels were reduced when a single C4A*Q0 or
      C4B*Q0 gene was present; however, total C4 levels showed considerable overlap
      with and did not differ significantly from the non-C4 null groups in either
      patients or controls. Black patients with SLE without active disease, as well as
      black controls, had higher levels of C4B and consequently total C4 than whites.
      Ten patients with SLE studied serially showed that C4A and C4B levels changed
      proportionally during changes in disease activity. Thus, it may be more important
      to consider race and disease activity rather than C4 null gene status when
      assessing C4 levels in patients with lupus.

PMID- 8478850
TI  - Arthritis in hemochromatosis.
AB  - We reviewed the clinical and radiographic features of arthropathy in 25 subjects
      with hemochromatosis, 16 probands and 9 discovered homozygous relatives. Clinical
      arthritis was present in 15/16 probands and 1/9 discovered homozygotes (p <
      0.005). Radiologic evidence of arthropathy was seen additionally in 2
      asymptomatic discovered homozygotes. The metacarpophalangeal joints and wrists
      were most commonly involved; severe hip disease occurred in 6. Patients with
      clinical or radiologic arthropathy were older than patients without. Arthropathy
      occurred in all 4 female probands, but in none of the 3 female discovered
      homozygotes. Chondrocalcinosis was seen in 9 subjects but was usually
      asymptomatic. The arthritis of hemochromatosis may be difficult to differentiate
      from several other joint diseases, especially calcium pyrophosphate dihydrate
      deposition disease.

PMID- 8478851
TI  - Suprascapular nerve block for persistent rotator cuff lesions.
AB  - The suprascapular nerve supplies sensory nerves to the posterosuperior aspect of
      the shoulder, including major portions of the rotator cuff. Suprascapular nerve
      block using steroid/bupivacaine is temporarily effective in reducing pain in
      rotator cuff tendinitis and tears, improving movement range in tendinitis and is
      possible in an outpatient setting with little or no complication risk.

PMID- 8478852
TI  - A double-blind trial of the clinical effects of pulsed electromagnetic fields in
      osteoarthritis.
AB  - OBJECTIVE: Further evaluation of pulsed electromagnetic fields (PEMF), which have
      been observed to produce numerous biological effects, and have been used to treat
      delayed union fractures for over a decade. METHODS: In a pilot, double-blind
      randomized trial, 27 patients with osteoarthritis (OA), primarily of the knee,
      were treated with PEMF. Treatment consisted of 18 half-hour periods of exposure
      over about 1 month in a specially designed noncontact, air-coil device.
      Observations were made on 6 clinical variables at baseline, midpoint of therapy,
      end of treatment and one month later; 25 patients completed treatment. RESULTS:
      An average improvement of 23-61% occurred in the clinical variables observed with
      active treatment, while 2 to 18% improvement was observed in these variables in
      placebo treated control patients. No toxicity was observed. CONCLUSION: The
      decreased pain and improved functional performance of treated patients suggests
      that this configuration of PEMF has potential as an effective method of improving
      symptoms in patients with OA. This method warrants further clinical
      investigation.

PMID- 8478853
TI  - The risk of osteoarthritis with running and aging: a 5-year longitudinal study.
AB  - Our purpose was to determine the 5-year longitudinal effects of running and aging
      on the development of radiographic and clinical osteoarthritis (OA) of the knees,
      hands and lumbar spine. Thirty-five running subjects and 38 controls, with a mean
      age of 63 years, were matched for age (+/- 2 years), years of education, and
      occupation; 33 matched pairs were constructed. All subjects underwent
      rheumatologic examination, completed questionnaires, and had radiographs taken of
      the hands, lateral lumbar spine, and knees in 1984 and in 1989. Five year
      radiographic results for both the runner and control groups showed OA progression
      for the knees, hands, and lumbar spine. In 1989, 10 (13%) of the 73 subjects fit
      American College of Rheumatology (ACR) criteria for clinical OA of the hand, and
      9 subjects (12%) fit ACR criteria for OA of the knee. In summary, running did not
      accelerate the development of radiographic or clinical OA of the knees, but with
      aging, 13% of all subjects developed OA of the hands and 12% of all subjects
      developed OA of the knees.

PMID- 8478854
TI  - Fibromyalgia and quality of life: a comparative analysis.
AB  - The quality of life of women with fibromyalgia was explored and compared to the
      quality of life of women with rheumatoid arthritis, osteoarthritis, permanent
      ostomies, chronic obstructive pulmonary disease, insulin dependent diabetes, and
      healthy controls. The women with fibromyalgia consistently scored among the
      lowest in all domains measured. These results suggest that fibromyalgia may
      adversely affect quality of life to an extent not previously recognized.

PMID- 8478855
TI  - Risk factors for physical disability in an aging cohort: the NHANES I
      Epidemiologic Followup Study.
AB  - Successful improvement in health in our increasingly aged population will depend
      in substantial part on reduction of age specific disability levels. In turn, the
      epidemiologic model suggests that this requires identification of risk factors,
      development of intervention models, and testing of these models. We attempted to
      identify risk factors for physical disability among 4,428 50-77-year-olds using
      baseline data collected in the first National Health and Nutrition Examination
      Survey (NHANES I) (1971-1975) linked to disability data collected 10 years later
      in the NHANES I Epidemiologic Followup Study. Results of forward stepwise linear
      regression analysis showed that the major characteristics contributing to greater
      disability (explaining at least 1% of the variability in scores) were older age
      at baseline, less nonrecreational activity, arthritis history, less education,
      female sex, and greater body mass index at age 40. Other factors associated with
      greater disability included a history of asthma, cardiovascular disease, abnormal
      urine test, less recreational activity, higher sedimentation rate, rheumatic
      fever history, lower caloric intake, positive musculoskeletal findings, histories
      of polio and allergies, lower family income, elevated blood pressure, lower serum
      albumin, history of tuberculosis, glucose in the urine, and histories of hip or
      spine fracture, chronic pulmonary disease, and kidney disease.

PMID- 8478856
TI  - Treatment of systemic lupus erythematosus by prolonged administration of high
      dose intravenous immunoglobulin: report of 2 cases.
AB  - Two patients with life threatening manifestations of systemic lupus erythematosus
      (SLE), unresponsive to corticosteroid and immunosuppressive therapy, were treated
      with high dose intravenous immunoglobulin (IVIG). Following IVIG therapy, lupus
      pneumonitis and encephalitis in the first patient, and lupus nephritis in the
      second patient, resolved. Continuous treatment with IVIG, every 4 weeks for up to
      20 months induced a prolonged clinical and laboratory remission. Treatment with
      cytotoxic agents was stopped, and the dosage of corticosteroids lowered.
      Exacerbation of lupus nephritis occurred in the second patient after 10 months of
      IVIG therapy. We suggest that prolonged use of high dose IVIG may be a useful
      therapy for acute exacerbations of SLE and for inducing prolonged remissions.

PMID- 8478857
TI  - First case of pneumatosis cystoides intestinalis in adult dermatomyositis.
AB  - We describe the first case of pneumatosis cystoides intestinalis in
      dermatomyositis (DM) of an adult. Our patient had been in remission of her DM for
      years when pneumatosis cystoides intestinalis occurred. Discovery of it was
      concomitant with that of interstitial lung disease. The overall course of
      pneumatosis cystoides intestinalis was benign. We discuss the mechanism of bowel
      and lung involvement and hypothesize that vasculitis could be the underlying
      process.

PMID- 8478858
TI  - Respiratory failure in Wegener's granulomatosis: response to pulse intravenous
      methylprednisolone and cyclophosphamide.
AB  - We describe a patient with respiratory failure due to Wegener's granulomatosis
      (WG) who obtained a dramatic and sustained response to pulse intravenous
      methylprednisolone and cyclophosphamide. Discussion includes a review of the
      literature with respect to the relative merits of daily oral cyclophosphamide
      versus pulse intravenous cyclophosphamide in WG and other vasculitides. While the
      combination of daily oral steroids and daily oral cyclophosphamide dramatically
      improves the outcome of WG, this therapy is not without serious side effects.
      Pulse therapy may be equally as effective and may lessen the frequency of serious
      side effects.

PMID- 8478859
TI  - Bronchocentric granulomatosis, acute renal failure, and high titer antineutrophil
      cytoplasmic antibodies: possible variants of Wegener's granulomatosis.
AB  - We describe 2 patients with clinical syndromes suggestive of Wegener's
      granulomatosis: elevated titers of cytoplasmic antineutrophil cytoplasmic
      antibodies (cANCA), bronchocentric granulomatosis, and acute renal failure. A
      renal biopsy in one case showed crescentic glomerulonephritis and in the other
      case showed interstitial nephritis. These cases may reflect bronchocentric
      granulomatosis among a spectrum of diseases associated with cANCA. Use of cANCA
      may identify those patients with bronchocentric granulomatosis who require
      immunosuppressive therapy.

PMID- 8478860
TI  - Uncommon origin for the iliopsoas sign.
AB  - The term "iliopsoas sign" has different meanings in the medical literature. Among
      musculoskeletal disorders, iliopsoas bursitis is probably the most common cause
      of this clinical sign. Here we report an unexpected vascular pathology in a young
      man. The only clinical manifestation on examination was an iliopsoas sign.

PMID- 8478861
TI  - Osteomalacia in a patient with anorexia nervosa.
AB  - A 32-year-old patient with anorexia nervosa since adolescence was admitted
      because of diffuse bone pain, increasing during the 2 preceding winters. She had
      a special aversion to dairy products and all forms of dietary fat. Low normal
      serum calcium and very low calciuria were noted, with a highly elevated bone
      fraction of alkaline phosphatase, and severe hypovitaminosis D and B12. Apart
      from a recent spontaneous fracture of the clavicle, Looser lines and
      pseudofractures were noted in a finger, fibula and malleolus. In particular,
      magnetic resonance imaging of the knee showed additional evidence of a
      pseudofracture in the femur, and medullary changes were found. Evidence for
      secondary hyperparathyroidism was described. Apart from the well known occurrence
      of osteoporosis, our case shows that osteomalacia may exceptionally occur in
      anorexia nervosa.

PMID- 8478862
TI  - Pyomyositis and septic arthritis from Fusobacterium nucleatum in a
      nonimmunocompromised adult.
AB  - We describe a case of pyomyositis of the quadriceps associated with septic
      arthritis of the knee that developed after Fusobacterium nucleatum septicemia in
      a healthy man. The primary foci was presumed to be the oral cavity. Pyomyositis
      from Fusobacterium nucleatum is uncommon, and to our knowledge its association
      with septic arthritis has not been described.

PMID- 8478863
TI  - Pyomyositis: early detection and treatment.
AB  - We describe a patient with Crohn's disease and pyomyositis due to Streptococcus
      anginosus ("milleri"). Early recognition of pyomyositis during its presuppurative
      phase allowed for prompt antibiotic treatment and rapid resolution of the muscle
      infection without surgical drainage.

PMID- 8478864
TI  - OMERACT conference on outcome measures in rheumatoid arthritis clinical trials:
      introduction.

PMID- 8478865
TI  - Choosing a core set of disease activity measures for rheumatoid arthritis
      clinical trials.
AB  - Rheumatoid arthritis (RA) clinical trials often include at least 10 measures of
      disease activity (e.g., tender and swollen joint counts, erythrocyte
      sedimentation rate, patient pain, grip strength, etc.), and each trial contains
      different measures. Using dissimilar disease activity (outcome) measures to
      assess therapies makes it impossible to judge therapies against a common
      standard. Furthermore, multiple statistical testing is performed, and outcome
      measures are often used which are insensitive to change. Ultimately, to compare
      different RA therapies, the same outcomes should be measured in all trials. In
      the first stage of an effort to develop a core set of outcome measures to be used
      in all RA trials, we present an approach to the selection of the measures. This
      approach is based on a critical evaluation of whether commonly used outcome
      measures have construct, face, content, criterion, and discriminant validity. In
      addition, our approach includes testing whether these measures are redundant.
      Also, selected evidence on the validity of currently used outcome measures is
      reviewed.

PMID- 8478866
TI  - Sensitivity to change of rheumatoid arthritis clinical trial outcome measures.
AB  - OBJECTIVES: To present the properties of an efficiency measure that may be used
      to make statistical comparisons of sensitivities of trial outcome measures. To
      use this measure to examine the relative sensitivities of several common
      rheumatoid arthritis (RA) trial outcome measures in 2 different trial settings.
      METHODS: Efficiency is expressed as the mean change divided by the standard
      deviation of change. Variability and correlations of efficiencies for typical RA
      trial outcomes are described. RESULTS: From among a variety of joint assessments
      and other clinical measures, pain and global measures, and health status and
      laboratory measures, the joint tenderness and pain measures were the most
      sensitive, both in a trial of nonsteroidal antiinflammatory drugs (NSAID) and in
      a set of second-line drug trials. Measures with rather different sensitivities in
      the 2 types of trials were erythrocyte sedimentation rate (low sensitivity in the
      NSAID trial) and physician and patient global measures (higher sensitivity in the
      NSAID trial). CONCLUSION: The use of statistical information on efficiency
      estimates allows for a variety of comparisons of measures and may inform the
      selection of outcome measures for clinical trials.

PMID- 8478867
TI  - European preferences in assessing rheumatoid arthritis.

PMID- 8478868
TI  - Outcome measures in rheumatoid arthritis clinical trials: assessing improvement.

PMID- 8478869
TI  - The hierarchy of outcome assessment.

PMID- 8478870
TI  - A method for achieving consensus on rheumatoid arthritis outcome measures: the
      OMERACT conference process.
AB  - We describe the process used during the international Conference on Outcome
      Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The objectives of the
      conference were (1) to broaden consensus on the minimum number of outcome
      measures to be included in all RA clinical trials in rheumatoid arthritis (RA);
      (2) to achieve consensus on criteria for (a) minimum clinically important
      improvement in patients with RA and (b) minimum important differences between
      treatment groups in RA clinical trials; and (3) to decide whether aggregate
      outcome measures (indices) are useful in the assessment of patients and trials. A
      combination of plenary sessions and structured nominal groups were employed
      during the conference. Simulated patient profiles and clinical trial profiles
      were used to generate discussion. The objective of the nominal group exercises
      was to capture each participant's judgments of the relative importance of each
      outcome measure and the degree of change required to indicate clinical
      improvement. Considerable discussion ensued on the content of the core set of
      outcome measures. An electronic interactive voting machine was used to obtain
      participants' views on a core set of outcome measures and methodological issues.
      To permit further discussion of outcome measures, the group explored the use of
      aggregate outcome measures (indices) in patient care and trials only in a
      preliminary way. A final plenary session dealt with patient perceptions of
      minimum important differences, a new classification of antirheumatic drugs, and a
      repeat of part of the preconference questionnaire. Concluding statements and
      future plans were developed at the conclusion of the meeting.

PMID- 8478871
TI  - OMERACT conference questionnaire results. OMERACT Committee.
AB  - Just prior to the OMERACT conference, participants completed a questionnaire that
      solicited explicit opinions on the issues discussed at the conference. The
      response rate was 77%. To determine the minimum level of important difference in
      a clinical trial comparing 2 active drugs, participants were asked to think of
      each of 6 separate measures in turn as designated primary outcome measure. In
      this situation, to decide that an important difference between the 2 groups was
      present, participants required a median of 20% difference in painful joints,
      swollen joints, and in disability, 30% in pain and patient global assessment, and
      40% in physician global assessment. On each measure, between 3 to 12% of
      participants felt they could not decide on an important difference in that
      situation. Similar questions were asked for the minimum important improvement in
      a patient; required levels of improvement were similar but slightly higher than
      the responses given for trials, and more participants felt they could not decide.
      Correspondents indicated that acute phase reactants are also very important for
      assessing minimum levels of important difference and improvement in trials and
      patients. A large majority was in favor of applying an index of aggregated
      outcome measures if sensible and valid: 72% in patients, and 93% in trials.

PMID- 8478872
TI  - Developing consensus on preliminary core efficacy endpoints for rheumatoid
      arthritis clinical trials. OMERACT Committee.

PMID- 8478873
TI  - Minimum important difference between patients with rheumatoid arthritis: the
      patient's perspective.
AB  - OBJECTIVE: To determine the point at which differences in clinical assessment
      scores on physical ability, pain and overall condition are sufficiently large to
      correspond to a subjective perception of a meaningful difference from the
      perspective of the patient. METHODS: Forty patients with a diagnosis of
      rheumatoid arthritis participated in an evening of clinical assessment and one-on
      one conversations with each other regarding their arthritic condition. The
      assessments included tender and swollen joint counts, clinician and patient
      global assessments, participant assessment of pain and the Health Assessment
      Questionnaire (HAQ) on physical ability. After each conversation, participants
      rated themselves relative to their conversational partner on physical ability,
      pain and overall condition. These subjective comparative ratings were compared to
      the differences of the individual clinical assessments. RESULTS: In total there
      were 120 conversations. Generally participants judged themselves as less disabled
      than others. They rated themselves as "somewhat better" than their conversation
      partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9%
      better global assessment. In contrast, they rated themselves as "somewhat worse"
      when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse
      global assessment. CONCLUSIONS: Patients view clinically important differences in
      an asymmetric manner. These results can provide guidance in interpreting results
      and planning clinical trials.

PMID- 8478874
TI  - Criteria for clinically important changes in outcomes: development, scoring and
      evaluation of rheumatoid arthritis patient and trial profiles. OMERACT Committee.
AB  - OBJECTIVE: To further the development of criteria for clinically important
      changes in outcomes seen in rheumatoid arthritis (RA) patients and trials.
      METHODS: Small group discussions and voting on specially designed profiles based
      on a 6 factor 2 level factorial design for changes seen in patients and trials.
      The purpose was to bring out the implicit opinions of participants on these
      issues, to complement the explicit opinions expressed in the OMERACT
      questionnaire. This took place at a conference of rheumatologists,
      methodologists, biostatisticians, regulatory, pharmaceutical and biotechnology
      industry personnel with an interest in therapies for patients with RA. Data from
      patients with RA and randomized clinical trials of second line drugs in patients
      with RA formed the basis to create 64 patient profiles and 64 trial profiles. The
      profiles contained information on changes in 6 measures: swollen joint count,
      tender joint count, pain, patient global assessment, physician global assessment
      and physical disability. The profiles were prepared on 4" x 5" cards and
      presented to the participants in packages of 64 in random order, in 2 different
      group sessions. Participants were assigned to 8 groups that contained a mix of
      all types of participants, with a majority of clinicians in each group. In the
      patient profile session, individual participants scored whether the profile
      represented important improvement. In the trial profile session, participants did
      likewise for important difference between the drugs. After structured discussion
      the group then voted: consensus was defined as agreement by at least 70% of the
      group. We decided that an important improvement or difference was present in the
      profiles on which at least 6 of the 8 groups had achieved consensus. The changes
      in the profiles showing important improvement or difference can be used to
      suggest minimum criteria for each of the 6 measures. RESULTS: The lower quartile
      of the change present in the patient profiles with important improvement varied
      from 17% (swollen joints) to 49% (disability); the median of these quartiles was
      36%. The lower quartile of the differences present in the trial profiles with
      important differences varied from 13% (tender joints) to 26% (physician global);
      the median of these quartiles was 18%. CONCLUSIONS: This approach has provided a
      beginning for less arbitrary definition of criteria for important change in
      patients and trials. It might be suggested that for patients, an improvement of
      at least 36% should be clinically important, while an active drug needs to be at
      least 18% better than placebo to be clinically important.

PMID- 8478875
TI  - Pooled outcome measures in arthritis: the pros and cons.
AB  - This article considers the implications of reporting multiple measures of
      efficacy in studies of patients with rheumatoid arthritis (RA). A possible
      solution to the problems that result is the use of a pooled index which combines
      the individual outcome measures. The potential advantages and disadvantages of
      pooled indexes are discussed in the context of clinical trials in RA.

PMID- 8478876
TI  - The validity of pooled outcome measures (indices) in rheumatoid arthritis
      clinical trials.
AB  - No consensus exists on the appropriate (set of) endpoints to be reported in
      rheumatoid arthritis clinical trials. The traditional endpoints are not
      comprehensive, show overlap, and are insensitive to change. A single, pooled
      outcome measure or index may be an alternative. However, such an index must be
      valid and acceptable. An overview of the existing indices suggests several
      options are available. To date, practical experience with these indices in trials
      is limited.

PMID- 8478877
TI  - Interpretation and power of a pooled index.
AB  - OBJECTIVE: To describe, illustrate, provide statistical rationale and give
      clinical examples of the concept of a pooled index. METHODS: No explicit design.
      Randomized control trials of patients diagnosed with rheumatoid arthritis from
      Rheumatic disease clinics, tertiary care hospitals and communities are used as
      examples to illustrate the pooled index technique. Interventions in rheumatic
      disease unit inpatient and outpatient care, occupational therapy and
      physiotherapy provided by Arthritis Society Therapists in the community were
      compared. Variables included active joint count, morning stiffness in min, mean
      of right and left grip strength in mm Hg, erythrocyte sedimentation rate in mm/h,
      a functional change score, and a pooled index. RESULTS: The pooled index in each
      study detected a clinically important effect while individual measures were
      generally not able to declare the effect statistically significant. CONCLUSIONS:
      The pooled index is a more powerful clinical outcome than any individual measure
      provided it is computed from at least 2 relevant clinical outcome measures that
      have low correlation with each other.

PMID- 8478878
TI  - Development of a disease activity score based on judgment in clinical practice by
      rheumatologists.
AB  - In a prospective study of up to 3 years' duration of 113 patients with early
      rheumatoid arthritis a disease activity score (DAS) was developed based on the
      clinical judgment of 6 rheumatologists. The patients were divided in groups with
      high and low disease activity according to explicit rules. By various statistical
      methods, including discriminant analysis and multiple regression analysis, a DAS
      could be defined. This DAS is a continuous measure consisting of the variables
      Ritchie articular index, number of swollen joints, erythrocyte sedimentation rate
      and general health measured on a visual analog scale.

PMID- 8478879
TI  - A simple index to assess disease activity in rheumatoid arthritis.
AB  - Changes in clinical and laboratory measures of disease activity were studied
      prospectively in 12 European centers. Altogether 282 rheumatoid patients were
      evaluated during 6 months of therapy with slow-acting drugs. Patients' global
      assessment was taken to indicate overall response. The number of swollen joints
      and number of tender joints correlated highly with this. The erythrocyte
      sedimentation rate (ESR) correlated less well but was more uniform across
      centers. Grip strength, C-reactive protein and hemoglobin performed poorly
      between centers. There were cultural and linguistic difficulties using the Health
      Assessment Questionnaire in a European setting. Physician's global assessments
      were similar to the patient's global assessments and provided redundant
      information. The best measures are: the number of swollen joints, the number of
      tender joints, the ESR, and the patient's global assessment. It may also help to
      measure articular pain.

PMID- 8478880
TI  - New classification of antirheumatic drugs. The evolution of a concept.

PMID- 8478881
TI  - OMERACT and the clinical evaluation of new therapeutic agents: a bird's eye view.
      OMERACT Committee.

PMID- 8478882
TI  - Treatment of pernicious anemia associated with systemic lupus erythematosus.

PMID- 8478883
TI  - Repetitive use of pulse therapy.

PMID- 8478884
TI  - Human T lymphotropic virus I, myelopathy, polymyositis and synovitis.

PMID- 8478885
TI  - Successful treatment of pulmonary hypertension associated with systemic lupus
      erythematosus with prostaglandin I2 and prostaglandin E1.

PMID- 8478886
TI  - Fibrous myopathy induced by propoxyphene injections.

PMID- 8478887
TI  - Erosive arthritis with dermatomyositis without elevated anti-Jo-1 antibodies and
      not associated with pain.

PMID- 8478888
TI  - Oral methotrexate in the treatment of Felty's syndrome.

PMID- 8478889
TI  - Remission in palindromic rheumatism during pregnancy.

PMID- 8478890
TI  - Thyroid disorder in patients with mixed connective tissue disease.

PMID- 8478891
TI  - Accidents in industry.

PMID- 8478892
TI  - A pilot study of diet and gallstone formation in young Saudi women.
AB  - The diet of 100 younger than 40 years Saudi females; 50 cases with gallstones and
      50 control mean age and SD 30.2 (6.1) and 29.7 (6.4) years respectively, was
      studied by taking a qualitative dietary history. There was no significant
      difference between the dietary intake of the 2 groups with regard to cholesterol
      rich food and animal fat-rich foods, high fibre foods and the consumption of fast
      food. However, dates, 'kabsah', 'modabi' and cheese were consumed significantly
      more by cases (P-value < .001, < .046, < .001 and < .004 respectively) and
      vegetable oil was used more by controls for cooking purposes (P-value < .05).

PMID- 8478893
TI  - High perinatal and neonatal mortality in rural India.
AB  - A prospective study conducted in rural India on pregnant women showed poor
      utilization of primary health services and very poor maternal care receptivity
      especially in terms of antenatal care. A very high perinatal mortality rate of
      81.3/1000 live births and a neonatal mortality rate of 63.7/1000 live births was
      observed in the present study. Out of 204 live births, 72.05% of newborn
      developed complications within 6 weeks of the delivery. Most of the complications
      were of a minor nature and could be attributed to poor environmental conditions,
      lack of personal hygiene and ignorance. The study highlights the need for
      training of grass root level workers for the improvement of perinatal and
      neonatal care in rural India.

PMID- 8478894
TI  - Socio-cultural and economic factors affecting food consumption patterns in the
      Arab countries.
AB  - Several factors have been found to determine the dietary habits of the people in
      the Arab world. Food consumption pattern has dramatically changed in some Arab
      countries as a result of sudden increase in income from oil revenue. It is
      believed that food subsidy policy has adversely affected the food habits in the
      Gulf states by encouraging the intake of fat, sugar, rice, wheat flour and meat.
      Socio-cultural factors such as religion, beliefs, food preferences, gender
      discrimination, education and women's employment all have a noticeable influence
      on food consumption patterns in this region. Mass media, especially televised
      food advertisements, play an important role in modifying the dietary habits. The
      migration movement, particularly that which was carried out during the 70s has a
      great impact on the food practices in many Arab countries. Comprehensive studies
      on social, cultural and economic factors associated with food consumption
      patterns in the Arab region are highly recommended.

PMID- 8478895
TI  - Nutritional and non-nutritional factors for 'healthy' longevity.
AB  - The far-reaching effects of the ageing of populations is being increasingly
      appreciated. Lengthening longevity, associated with decreasing family size,
      evokes rising charges, socioeconomically, and on health services. Information on
      these and other parameters is presented for developed and developing populations.
      Examples are given, with lessons to be learned, of long-living segments of
      populations, past and present. The roles of diet, physical activity, and smoking
      and alcohol consumption also of attitudes, are discussed. It is concluded that if
      the middle-aged and elderly could be persuaded to follow long-term practices
      associated with good public health, then morbidity could be compressed, and
      disability-free years extended. However, this goal could only be achieved with a
      high level of motivation.

PMID- 8478896
TI  - The research challenge for the Professions Allied to Medicine.
AB  - The transfer of health care schools into Higher Education, coupled with the
      universal development of degree programmes has resulted in the need to develop
      research strategies for the Professions Allied to Medicine (PAMs). While
      considerable reliance has to be placed on the University sector to lead and
      encourage research activity, it is essential to recognise the need to maintain
      and develop links with clinical colleagues and to promote the growth of
      interdisciplinary research. A variety of areas which could allow early fruition
      of collaborative work between the professions are proposed.

PMID- 8478897
TI  - Nurses ... bridging the gap: Australian aboriginals and primary health care.
AB  - This paper outlines a clinical learning experience designed to provide nursing
      students with experience in working with the Australian Aboriginal people. It
      also provided an opportunity for the concepts of primary health care from the
      rural perspective to be observed and experienced. Walgett is 433 miles or 694
      kilometers from Sydney and situated in the north west of the state of New South
      Wales (NSW). Australia, being a large continent of some 7,682,300 square
      kilometers or 2,966,153 square miles, is divided into 7 states, of which New
      South Wales is the most populated (National Geographic Atlas of the World, 1981).

PMID- 8478898
TI  - Cigarette smoking and health: a radical view.

PMID- 8478899
TI  - The NHS: past, present and future.

PMID- 8478900
TI  - Mechanistic interpretation of the genotoxicity of nitrofurans (antibacterial
      agents) using quantitative structure-activity relationships and comparative
      molecular field analysis.
AB  - Quantitative structure-activity relationship (QSAR) and comparative molecular
      field analysis (CoMFA) have been applied to elucidate the mechanisms of
      genotoxicity (SOSIP) of nitrofuran derivatives on Escherichia coli PQ37. The
      following equation was developed: log SOSIP = -33.1qc2 + 1.00 log P - 1.50Isat -
      1.19MR - 0.76I5,6 - 3.76; n = 40, r = 0.900, s = 0.475. The QSAR model clearly
      reveals three important factors, namely, electronic (qc2), hydrophobic (log P)
      and steric (MR, Isat, I5,6) contributing toward the genotoxic activity of this
      class of compounds. qc2, the charge on the c2 atom attached to the NO2 group,
      supports a furan ring opening mechanism in explaining the genotoxicity. The
      finding of the coefficient of 1 with log P conforms to our previous findings with
      several different classes of mutagens acting on different systems. CoMFA analysis
      clearly demonstrates its potential in unraveling the steric features of the
      molecules through contour maps. The CoMFA cross-validated model also supports the
      importance of the electronic factor. It could not reveal any hydrophobic
      influence because the interaction energies of the CH3 and H2O probes are
      collinear. QSAR (classical) and CoMFA, if used judiciously, may complement each
      other and enhance the applicability of SAR in drug design.

PMID- 8478901
TI  - Interaction of calcium channel antagonists with calcium: structural studies on
      verapamil and its Ca2+ complex.
AB  - The conformation of the calcium channel antagonist verapamil has been determined
      in acetonitrile, in the absence and presence of Ca2+, using two-dimensional 1H
      NMR and molecular modeling techniques. Interproton connectivities in the drug
      molecule were identified from the observed NOESY cross peaks and interproton
      distances were estimated from the magnitudes of the volume integrals of the cross
      peaks. The molecular modeling program utilized the Monte Carlo simulation to
      generate a random ensemble of conformers complying with the NOESY-derived
      distance constraints. The energies of these conformers were subsequently
      computed. The minimum-energy structure of the free drug obtained in this manner
      exhibited some significant differences from the structure of verapamil determined
      by X-ray crystallography. In particular, the torsional angles in the middle
      region of the molecule containing the aliphatic "backbone" were such that the two
      aromatic rings at either end of the drug molecules were moved farther apart from
      each other in solution than in the crystal structure. The nearly perpendicular
      orientation of the aromatic rings seen in the crystal was, however, maintained in
      the solution structure as well. The addition of Ca2+ to a solution of verapamil
      in acetonitrile caused marked changes in the difference absorbance of the drug in
      the 200-300-nm region and in many of its 1H-NMR resonances. The changes were most
      significant up to a mole ratio of about 0.5 Ca2+:drug. Analysis of the binding
      data at 25 degrees C showed the presence of both 2:1 and 1:1 drug:Ca2+ complexes
      in equilibrium, the former "sandwich" complex being dominant at the lower cation
      concentrations with an estimated dissociation constant of about 300 microM. All
      of the NOESY cross peaks of the free drug remained on addition of 0.5 mol ratio
      of Ca2+ to verapamil in deuterated acetonitrile and only two new connectivities
      were observed. Using the interproton distances calculated from these NOESY data,
      molecular modeling of the 2:1 drug:Ca2+ complex was carried out to yield the
      minimum-energy conformer. In this conformer, Ca2+ was coordinated to two methoxy
      oxygens from each of the two drug molecules. The implications of the verapamil
      Ca2+ interaction are discussed in terms of available experimental data on the
      binding of verapamil to the dihydropyridine-sensitive channel and in terms of a
      hypothesis on the formation of a drug-Ca(2+)-receptor complex in the lipid
      bilayer environment.

PMID- 8478902
TI  - Nucleosides. 5. Synthesis of guanine and formycin B derivatives as potential
      inhibitors of purine nucleoside phosphorylase.
AB  - In an effort to develop potent human purine nucleoside phosphorylase (PNP)
      inhibitors as immunosuppressive and chemotherapeutic agents, several 8
      aminoguanine derivatives were synthesized and evaluated as potential PNP
      inhibitors. These studies were designed to investigate the hydrophobic effect of
      a substituent on the N-9 of the purine heterocycle and/or the C-5' positions.
      Compounds such as 8-aminoguanosine, guanosine, formycin B, and 8-aminoacyclovir
      containing a p-(fluorosulfonyl)benzoyl moiety were synthesized. The affinity of
      these compounds to erythrocytic PNP was determined and none of these compounds
      showed a better affinity than those of the parent compounds. However, we found
      that the effect of hydrophobicity at the N-9 and the C-5' positions might play an
      important role in binding to the active site of PNP. Thus, 8-amino-5'-deoxy-5'
      (phenylthio)guanosine (19) was found to be the best inhibitor in this series of
      compounds with a Ki = 0.45 microM.

PMID- 8478903
TI  - Dicarboxylate diamide dimercaptide (N2S2) technetium-99m complexes: synthesis and
      biological evaluation as potential renal radiopharmaceuticals.
AB  - Novel diamide dimercaptide (N2S2) ligands 4, 5, and 8 have been synthesized and
      evaluated as potential renal radiopharmaceuticals. The target compounds were
      prepared in modest overall yields of 22%, 19%, and 20%, respectively, using
      readily available starting materials. Following in situ deprotection, 99mTc
      complexes of high radiochemical purity were obtained in excellent yield and were
      found to be stable for up to 6 h. The 99Tc complex of ligand 8 was isolated as
      the AsPh4 salt. The X-ray crystallographic data for [99TcO(8)]AsPh4 (space group
      P2(1)/n: Z = 4, a = 9.342(3) A; b = 18.594(5) A; c = 18.417(7) A; beta, deg =
      90.61(3); V, A3 = 3199.1(20)) show that the Tc is bound to both thiolate sulfur
      atoms and to two deprotonated amide nitrogen atoms. The coordination geometry
      about the Tc is square-pyramidal with an -yl oxygen atom in the apical position.
      The Tc-N bond distances (2.002(12) and 1.984(12) A), the Tc-S bond distances
      (2.300(5) and 2.286(5) A), and the Tc-O bond distance (1.667(11) A) are in good
      agreement with bond lengths reported for similar complexes. The carboxylate
      groups are not bonded to the Tc atom in the solid state, nor in CDCl3 solution,
      as evidenced by X-ray crystal data and solution NMR data, respectively. In the
      solid state, [99TcO(8)]AsPh4 is monoanionic, therefore, at physiological pH,
      [99mTcO(8)] is presumably trianionic. Biodistribution studies performed in rats
      with the 99mTc complexes revealed slow blood clearance and high muscle uptake for
      these agents. Modest hepatobiliary excretion was observed, and low quantities of
      the complexes were found in the heart, lungs, and spleen after 1 h. The urinary
      excretion of the 99mTc complexes of ligands 4, 5, and 8 was found to be slow when
      compared to the excretion of [131I]OIH in rats (22%, 22%, and 32% vs 85-86%,
      respectively). Protein binding of 99mTc complexes of ligands 4, 5, and 8 in both
      rat and monkey plasma was found to be similar to MAG3. While the synthetic
      schemes reported here supply facile routes to novel N2S2 ligands, biodistribution
      studies of the 99mTc complexes performed on rats revealed slow renal excretion
      rates, accompanied by slow blood clearance and high uptake in muscle tissue.
      Preliminary planar imaging studies in monkeys also revealed slow renal excretion
      for these agents. The 99mTc complexes evaluated here are poor candidates as renal
      radiopharmaceuticals.

PMID- 8478904
TI  - Intracellular delivery of bioactive AZT nucleotides by aryl phosphate derivatives
      of AZT.
AB  - Novel aryl phosphate derivatives of the anti-HIV nucleoside analogue AZT have
      been prepared by phosphorochloridate chemistry. These materials were designed to
      act as membrane-soluble prodrugs of the bioactive free nucleotides. In vitro
      evaluation revealed the compounds to have a pronounced, selective anti-HIV
      activity in CEM cells; the magnitude of the biological effect varied considerably
      depending on the nature of the phosphate blocking group. Moreover, several of the
      compounds retain marked antiviral activity in TK- (thymidine kinase-deficient)
      mutant CEM cells in which AZT was virtually inactive. These data strongly support
      the hypothesis that the AZT phosphate derivatives exert their biological effects
      via intracellular release of AZT nucleotide forms and suggest that the potential
      of nucleoside drugs in antiviral chemotherapy may be enhanced by suitable
      nucleotide delivery strategies.

PMID- 8478905
TI  - Inhibition studies of some serine and thiol proteinases by new leupeptin
      analogues.
AB  - Fifteen tripeptide analogues of leupeptin containing either a C-terminal
      argininal or lysinal were synthesized. The synthetic analogues were tested, using
      spectrophotometric assay techniques, as inhibitors of trypsin, kallikrein,
      thrombin, plasmin, and cathepsin B. The lysinal analogues were fairly selective
      as inhibitors of cathepsin B activity. Acetyl-L-leucyl-L-valyl-L-lysinal (21)
      showed a stronger inhibition of cathepsin B (IC50 = 4 nanomolar) than leupeptin.
      Acetyl-L-phenylalanyl-L-valyl-L-argininal (2i) was found to be a good inhibitor
      of cathepsin B (IC50 = 0.039 microM), thrombin (IC50 = 1.8 microM), and plasmin
      (IC50 = 2.2 microM).

PMID- 8478906
TI  - Design of 5-(3,5-di-tert-butyl-4-hydroxyphenyl)-1,3,4-thiadiazoles, -1,3,4
      oxadiazoles, and -1,2,4-triazoles as orally-active, nonulcerogenic
      antiinflammatory agents.
AB  - To discover dual inhibitors of 5-lipoxygenase (LO) and cyclooxygenase (CO) with
      improved pharmacokinetic properties, we have designed and synthesized series of
      1,2,4-triazole, 1,3,4-oxadiazole, and 1,3,4-thiadiazole di-tert-butylphenol
      derivatives which exhibit a wide range of log P (2.3 to > 4) and pKa (5.5-12)
      values. From this work 5-[3,5-bis(1,1-dimethylethyl)-4-hydroxyphenyl]-1,3,4
      thiadiazole-2(3H)- thione, choline salt (12a, CI-986) was found to be a potent
      inhibitor of 5-LO (IC50 = 2.8 microM) and CO (IC50 = 0.8 microM), orally active
      in rat models of inflammation and nonulcerogenic.

PMID- 8478907
TI  - N-(1-methyl-5-indolyl)-N'-(3-pyridyl)urea hydrochloride: the first selective 5
      HT1C receptor antagonist.

PMID- 8478908
TI  - Inhibitors of the protease from human immunodeficiency virus: synthesis, enzyme
      inhibition, and antiviral activity of a series of compounds containing the
      dihydroxyethylene transition-state isostere.
AB  - A number of potential HIV protease inhibitory peptides that contain the
      dihydroxyethylene isostere were prepared and evaluated for their enzyme binding
      affinity and antiviral activity in cell cultures. From the template of a
      previously reported active peptide A, modifications at the N- and C-terminal
      groups were assessed for potential maintenance of good inhibitory activity of the
      resulting peptides. Among the active peptides found, peptide XVIII exhibited
      potent enzyme inhibitory activity. Interestingly, the previously reported,
      effective 1(S)-amino-2(R)-hydroxyindan C-terminal group for the preparation of
      very active HIV protease inhibitory peptides could not be applied to the template
      of peptide XVIII. Molecular modeling of peptide XVIII was studied using the X-ray
      crystal structure of peptide A as a starting point in order to study the likely
      conformation of peptide XVIII in the active-site cleft. Relative binding
      conformations of peptide A and XVIII were obtained, although the reason for poor
      binding affinity for a number of congeneric peptides in this report was not
      straightforwardly apparent. More importantly, however, peptide XVIII was found to
      exhibit more effective antiviral activity in the HIV-1/PBMC assay than the
      reference peptide A which was previously reported to be approximately equal in
      efficacy to the reverse transcriptase inhibitor AZT in this assay.

PMID- 8478909
TI  - Binding-site modeling of the muscarinic m1 receptor: a combination of homology
      based and indirect approaches.
AB  - A model of the muscarinic m1 receptor has been constructed on the basis of the
      putative three-dimensional structural similarity between bacteriorhodopsin and G
      protein coupled receptors. The homology-based m1 receptor model takes into
      account hydrophobicity and conserved amino acids and information from site
      directed mutagenesis studies and from hydropathy plots. The resulting model was
      used in conjunction with an indirect model which describes a proposed active
      agonist conformation of acetylcholine and a number of related compounds. A
      receptor-excluded volume was constructed by superimposing these muscarinic
      agonists and calculating their combined van der Waals volume. The resulting m1
      receptor excluded volume was used to define the agonist binding site, which
      consists of nine amino acids and which binds agonists primarily through
      interaction with Asp105 (ionic interaction). Thr192 and Asn382 (hydrogen bonds).
      The model is flexible since the conformation of the nine amino acids may change
      in response to the agonist structure. The combination of indirect and homology
      based approaches is particularly attractive since it utilizes more experimental
      data than a purely homology-based model and since a binding-site model might be
      more realistic and general in terms of applicability than indirect models.
      Docking of the ligands was performed by optimizing attractive interactions and
      minimizing repulsive interactions. In addition to the agonists used to define the
      binding site, structurally different agonists are also accommodated by the
      binding-site model. Furthermore, the m1 receptor binding-site model is able to
      reproduce experimentally determined stereoselectivities.

PMID- 8478910
TI  - Nonsymmetrical bipiperidyls as inhibitors of vesicular acetylcholine storage.
AB  - Introduction of a nitrogen atom into the cyclohexane ring of 2-(4
      phenylpiperidinyl)cyclohexanol (vesamicol, AH5183) yielded two positional
      isomers, 5-azavesamicol (5, prezamicol) and 4-azavesamicol (6, trozamicol). As
      inhibitors of vesicular acetylcholine transport, 5 and 6 were found to be 147 and
      85 times less potent than vesamicol. N-Benzoylation of 5 (to yield 9a) increased
      the potency 3-fold. In contrast, 10a, a compound derived from N-benzoylation of
      6, was 50 times more potent than the latter and almost equipotent with vesamicol,
      thereby suggesting a preference for the 4-azavesamicol series. Although (-)
      vesamicol is more potent than its dextrorotary isomer, (+)-10a was found to be 3
      times more potent than (-)-10a, suggesting a reversal of the sign of rotation in
      the azavesamicol series. Reduction of 9a and 10a (to yield the corresponding N
      benzyl derivatives 11a and 12a) increased potency 20- and 2-fold, respectively,
      indicating a preference for a basic nitrogen. The reaction of 5 or 6 with
      substituted benzyl halides yielded several potent inhibitors of vesicular
      acetylcholine transport, including N-(p-fluorobenzyl)trozamicol, 12d, which is
      twice as potent as vesamicol. Thus the introduction of a nitrogen atom into the
      cyclohexane ring of vesamicol provides opportunities for developing a new class
      of anticholinergic agents.

PMID- 8478911
TI  - Design and modeling of new platelet-activating factor antagonists. 1. Synthesis
      and biological activity of 1,4-bis(3',4',5'-trimethoxybenzoyl)-2-[[(substituted
      carbonyl and carbamoyl)oxy]methyl]piperazines.
AB  - To further investigate our hypothesis on the structure of the platelet-activating
      factor (PAF) receptor, 35 compounds derived from 1,4-bis(3',4',5'
      trimethoxybenzoyl)piperazine were synthesized and their in vitro antagonistic
      effect was measured. Substitution of the compounds in position 2, by ester or
      carbamate groups, giving increased steric hindrance and hydrophobicity, increased
      the platelet aggregation inhibitory activity from 2 microM (without substitution,
      compound 2) to 0.07 microM (compound 1h) and gave a maximum displacement of
      [3H]PAF from platelet membrane of 0.05 microM (compound 1k). It appears that the
      PAF antagonistic effect is only weakly enantiospecific, as observed in many cases
      including antagonists structurally related or not to PAF. 3D electrostatic
      potential maps (calculated at -10 kcal/mol) of such compounds revealed a double
      "Cache-oreilles" (ear-muffs) system. One of these systems has been previously
      described (distance between atoms generating negative wells, 11-14 A). The second
      shorter "Cache-oreilles" (6-7 A) system appears to be required for increased PAF
      antagonistic activity. This short distance between groups generating the negative
      wells is present in the gingkolides, a series of naturally occurring PAF
      antagonists. The present study indicates that the structure of the PAF receptor
      may be more complicated than our initial hypothesis and may be a tetrapolarized
      structure, with alternants of electropositive and hydrophobic areas. This
      modified hypothesis is in agreement with recent publications concerning PAF
      antagonists bearing a cationic moiety.

PMID- 8478912
TI  - Intercellular junctions and the application of microscopical techniques: the
      cardiac gap junction as a case model.
AB  - Intercellular junctions are fundamental to the interactions between cells. By
      means of these junctions, the activities of the individual cells that make up
      tissues are co-ordinated, enabling each tissue system to function as an
      integrated whole. In this review, the work of the authors on one specific type of
      junction--the cardiac gap junction--is presented as a case model to illustrate
      how the application of a range of microscopical methods, as part of a
      multidisciplinary approach, can help extend our understanding of cell junctions
      and their functions. In the heart, gap junctions form the low-resistance pathways
      for rapid impulse conduction and propagation, enabling synchronous stimulation of
      myocyte contraction. Gap junctions also form pathways for direct intercellular
      communication, a function of particular importance for morphogenetic signalling
      during development. The work discussed demonstrates some of the applications of
      techniques in electron microscopy, immunocytochemistry and confocal scanning
      laser microscopy to the understanding of the structural basis of the function of
      gap junctions in the normal adult heart, the developing heart and the diseased
      heart. Freeze-fracture electron microscopy of heart tissue prepared by rapid
      freezing techniques, in which excision-related structural damage to the cells is
      minimized or avoided, makes it possible to deduce the structure of the
      functioning gap junction in vivo. Gap junctions in hearts that are beating
      normally in the living animal until the very instant of freezing consist of
      connexons (transmembrane channels) organized in a quasi-crystalline arrangement,
      not a 'random' arrangement as proposed in the original hypothesis on the
      structural correlates of gap junction function. Alterations in connexon
      arrangement occur in response to ischaemia and hypoxia, though the relationship
      of these to gap-junctional permeability is indirect. To obtain probes for mapping
      the distribution of gap junctions in cardiac tissue, polyclonal antisera to
      synthetic peptides matching portions of the sequence of connexin43, the major gap
      junctional protein reported in the heart, were raised. The specificity of the
      antisera was confirmed by dot blotting, Western blotting and by immunogold
      labelling of isolated gap junctions. One antiserum (that raised to residues 131
      142) was found to be particularly effective as a cytochemical probe. An
      immunofluorescence labelling procedure for use with confocal scanning laser
      microscopy was developed to enable the three-dimensional precision mapping of gap
      junctions through thick slices of cardiac tissue.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8478913
TI  - Three-dimensional distribution of damaged cells in cryopreserved pancreatic
      islets as determined by laser scanning confocal microscopy.
AB  - The technique of serial optical sectioning by confocal microscopy, in conjunction
      with off-line digital image analysis, was used to quantify the radial
      distribution of damaged cells in rat pancreatic islets following
      cryopreservation. The process consists of imaging frozen-thawed islets of
      Langerhans using laser scanning confocal microscopy (LSCM). The three-dimensional
      (3-D) distribution and analysis of the two populations of viable and damaged
      cells was visualized via acridine orange/propidium iodide (AO/PI) fluorescent
      staining. In preparation for cryopreservation, isolated and cultured rat
      pancreatic islets were brought to a 2 M concentration of dimethyl sulphoxide
      (DMSO) by serial addition at decreasing temperatures. Ice was nucleated in the
      islet suspension at -10 degrees C, and individual specimens were frozen to -70
      degrees C at cooling rates of 1, 3, 10 and 30 degrees C/min in a programmable
      bulk freezer and subsequently stored in liquid nitrogen. After rapid thawing and
      serial dilution to remove DMSO, individual islets were prepared with AO/PI stains
      for imaging on the LSCM. Serial sections of the islets, 2-7 microns in thickness,
      were obtained and processed to obtain high-contrast images. Analysis algorithms
      consisted of template masking, grey-level thresholding, median filtering and 3-D
      blob colouring. The radial distribution of damaged cells in the islets was
      determined by isolating the cell and computing its distance from the centroid of
      the 3-D islet volume. An increase in the number of blobs corresponding to single
      and/or aggregates of damaged cells was observed progressively with distance from
      the centre towards the periphery of the islet. This pattern of freeze-induced
      killing of cells within the islet was found to occur consistently in the numerous
      individual specimens processed.

PMID- 8478914
TI  - Modelling of three-dimensional fluorescence images of muscle fibres: an
      application of the three-dimensional optical transfer function.
AB  - Striated muscle fibres can be modelled by a simple geometry, which has allowed
      three-dimensional (3-D) images in conventional and confocal microscopes to be
      calculated. This model is useful for comparing different imaging methods and
      represents a simple example of an application of the 3-D optical transfer
      function (OTF) for the system. The rejection of out-of-focus blur is
      demonstrated, and the effects of fibre thickness and confocal pinhole size on
      image contrast are investigated. The effects of using a simple filter for image
      enhancement are studied, elucidating the characteristics of the OTF.

PMID- 8478915
TI  - Iterative, constrained 3-D image reconstruction of transmitted light bright-field
      micrographs based on maximum likelihood estimation.
AB  - We present several image reconstruction algorithms for generating three
      dimensional (3-D) renderings of bright-field micrographs that are founded on
      maximum likelihood estimation (MLE) theory. The basic principle of the algorithms
      is in estimating the values of the optical densities of the specimen. A computer
      simulation and initial experimental testing of a steepest ascent version of the
      algorithm is presented. The computer simulation demonstrates that the MLE
      algorithm has an advantage over previously used inverse filtering techniques in
      that it partially restores the zeroed Fourier components in the well-known
      missing-cone region. We present 3-D reconstructions from real biological data to
      show the potential of the algorithm in practical applications.

PMID- 8478916
TI  - Complement-stabilized D-loop. RecA-catalyzed stable pairing of linear DNA
      molecules at internal sites.
AB  - The RecA protein (RecA) of Escherichia coli has the ability to pair a single
      stranded DNA to a homologous sequence in a duplex DNA without requiring
      denaturation of the duplex. This ability has stimulated interest in the use of
      RecA for targeting probes to genomic DNA. However, because pairing generally
      requires that the double-stranded DNA either have a homologous end or be
      negatively supercoiled, the application of RecA to targeting has been very
      limited. Here, we show that if the sequence complementary to the probe is also
      included in the reaction, RecA can pair the two single strands to sites distant
      from any ends on linear DNA. The resulting structure, termed a complement
      stabilized D-loop (csD-loop), is cleavable by restriction endonucleases and, upon
      removal of RecA, remains stable to temperatures up to the tm of the double
      stranded probe. These results indicate that the csD-loop probably consists of two
      side-by-side Watson-Crick duplexes, much like a replication bubble. This novel
      reaction of RecA may be useful in gene mapping and isolation, as well as in
      sequence-specific cleavage of genomic DNA, and might have functions in vivo.

PMID- 8478917
TI  - Sequence-dependent DNA structure. The role of base stacking interactions.
AB  - The sequence-dependent structure of DNA is analysed on the basis of the
      energetics of the base stacking (pi-pi) interactions. The conformational
      preferences of the ten possible base-pair steps in double-helical DNA have been
      calculated and compared with experimental data from X-ray fibre diffraction, X
      ray crystal structures and gel-running experiments. The calculations account for
      many features of sequence-dependent DNA structure, including polymorphism in DNA,
      the lack of polymorphism in RNA, the structure of Z-DNA, bistability in
      pyrimidine-purine (YR) steps, the origin of propeller twist and buckle and the
      role of TATA sequences at the sites of origin of replication. The computational
      model used specifically allows for the charge distribution associated with the
      out-of-plane pi-electron density of the bases. The results obtained are
      rationalized on the basis of the shapes and charge distributions of the bases.
      Calladine's cross-strand steric clashes at pyrimidine-purine (YR) and CX/XG steps
      are reproduced. In AX/XT steps, same-strand steric clashes occur between the
      thymine methyl group and the 5'-neighbouring sugar. They are the cause of the
      large negative propeller twist observed in A.T base-pairs. Steric clashes between
      the thymine methyl group and the 5'-neighbouring base block A-DNA conformations
      in AX/XT steps. Electrostatic interactions between partial atomic charges are
      most important for C.G base-pairs which are highly polarized. They lead to strong
      preferences for positive slide and negative slide conformations in CG and GC
      steps, respectively. This combination can be accommodated in poly(CG) by left
      handed Z-DNA. Many of the more subtle sequence-dependent effects are caused by
      electrostatic interactions between the partial atomic charges on one base-pair
      and the out-of-plane pi-electron density on another. The effect is most important
      in CX-XG steps and leads to bistability. In general, electrostatic interactions
      cause non-zero slide. This is opposed by the hydrophobic effect which favours the
      zero slide B-type conformation. Thus, B-DNA is observed at high water content in
      fibres and electrostatic interactions force high or low slide A or C-DNA
      conformations at low water content. If two juxtaposed steps have very different
      conformational preferences, this incompatibility can lead to unusual structures
      such as Z-DNA or strain such as in TATA sequences.

PMID- 8478918
TI  - Molecular basis for methoxyamine-initiated mutagenesis: 1H nuclear magnetic
      resonance studies of oligonucleotide duplexes containing base-modified cytosine
      residues.
AB  - Methoxyamine, N4-methoxycytidine and its 2'-deoxyribo analogue are transition
      mutagens. The mechanism by which the latter acts after incorporation into or
      generation within DNA has been ascribed to the ability of the base analogue to
      pair effectively with both adenine and guanine. To obtain a detailed
      understanding of these interactions, the solution structures of the self
      complementary octanucleotide d(CGGATCCG) and its analogues d(CGGATTCG),
      d(CGGATMCG) and d(CGGATPCG) (designated 8mer-GC, -GT, -GM and -GP, respectively)
      were investigated by 1H nuclear magnetic resonance spectroscopy; M is N4
      methoxycytosine (mo4C) and P is an analogue, the bicyclic dihydropyrimido[4,5
      c][1,2] oxazin-7-one. A variable temperature study showed the order of stability
      as 8mer GC > GP > GT > GM. Nuclear Overhauser spectroscopy permitted the
      assignment of the base, anomeric and H2'/H2" protons in these 8mers. All had
      spectra consistent with regular B-DNA duplex structures. Imino proton spectra
      showed that the 8mers GC, GP and GM involved Watson-Crick base-pairing but that
      the G.P and to a greater extent G.M base-pairs were in slow exchange on the
      nuclear magnetic resonance time-scale with the wobble configuration. Indeed, the
      G.M pair showed an additional exchange process interpreted in terms of the
      presence of syn and anti conformers of the methoxy group in the wobble pair. This
      accounts for the destabilization of M compared with the P-containing duplex. The
      observations are compared with those made earlier on the corresponding AT, AP and
      AM octamers. It is evident that M and P can form stable base-pairs with both A
      and G with essentially Watson-Crick geometry. This confirms the earlier, although
      unsubstantiated explanation for the transition mutational propenstty of
      methoxyamine which, in turn, was based on the fact that methoxycytosine bases
      have tautomeric constants (KT) much nearer to unity than the normal bases. The
      same general explanation for hydroxylamine and hydrazine-induced mutations is
      correspondingly rendered more certain.

PMID- 8478919
TI  - Crystallization and stoichiometry of binding of a complex between a rat
      intestinal Fc receptor and Fc.
AB  - Fc receptors expressed in the gut of newborn rodents bind to maternal
      immunoglobulin in milk at pH 6.5, and transport it to the bloodstream of the
      neonate, where it dissociates at pH 7.4. The rat intestinal Fc receptor (FcRn)
      consists of a heavy chain, with significant sequence similarity to the heavy
      chain of class I MHC molecules, complexed to the class I light chain, beta 2
      microglobulin. Although FcRn is predicted to contain a groove analogous to that
      which serves as the MHC peptide-binding site, the immunoglobulin ligand of FcRn
      is a macromolecule instead of a peptide. We have expressed and crystallized a
      secreted form of FcRn, and here report the crystallization of a complex between
      FcRn and its Fc ligand. Isolated FcRn-Fc complexes crystallize in space group
      I222 or I2(1)2(1)2(1) with unit cell dimensions a = 125 A, b = 152 A and c = 216
      A. The crystals diffract to 5.5 A resolution with anisotropic diffraction to 3.5
      A. Data collection from cryopreserved crystals may allow the resolution limit to
      be extended, since the major reason for the poor resolution appears to be
      radiation decay. Even a low-resolution view of how FcRn binds Fc would be of
      interest to see if the binding site corresponds to the functional part of an MHC
      molecule. Since the structure of Fc is known, and a structure determination of
      FcRn is underway, it may be possible to locate the Fc binding site on FcRn at low
      resolution. As an initial characterization of the FcRn-Fc mode of interaction,
      and to facilitate the structure determination, we have determined the
      stoichiometry of binding of FcRn to Fc. We show that two FcRn molecules bind per
      Fc, as determined by analysis of gels of washed crystals, a column binding assay,
      and isothermal titration calorimetry.

PMID- 8478920
TI  - Isolation, crystallization and preliminary diffraction analyses of human
      pancreatic alpha-amylase.
AB  - Human pancreatic alpha-amylase has been isolated using a glycogen affinity
      precipitation procedure and crystallized in a form suitable for high resolution
      three-dimensional X-ray crystallographic analyses. Crystals are of the
      orthorhombic space group P2(1)2(1)2(1), with unit cell dimensions of a = 53.04 A,
      b = 74.80 A and c = 137.34 A, and contain only one protein molecule per
      asymmetric unit. Diffraction data have been collected and found to extend to 1.6
      A resolution. These studies form the basis for elucidating the full atomic
      structure of human pancreatic alpha-amylase and thereby providing insight into
      the catalytic mechanism of this enzyme.

PMID- 8478921
TI  - Crystallization and preliminary X-ray diffraction studies of a NADH oxidase from
      Thermus thermophilus HB8.
AB  - The thermophile NADH oxidase from Thermus thermophilus, cloned and expressed in
      Escherichia coli, has been purified to homogeneity and crystallized. Three
      different crystal forms were found to be suitable for X-ray diffraction analysis.
      Crystals of the tetragonal form, grown in the presence of 25% polyethylene glycol
      4000 and 0.25 M-NaCl at pH 6.6, were chosen for further analysis. These crystals
      belong to the space group P4(1)(3)2(1)2 with refined lattice constants of a =
      94.8 A and c = 49.0 A, indicating a cell content of one monomer per asymmetric
      unit of the crystal. The crystals diffract to a resolution of 2.2 A.

PMID- 8478922
TI  - Crystallization of Bacillus subtilis tryptophanyl-tRNA synthetase.
AB  - Tryptophanyl-tRNA synthetase from Bacillus subtilis was overexpressed in
      Escherichia coli and was purified using column chromatography on DEAE-Sephacel
      and hydroxyapatite columns. Single crystals of the synthetase were grown by vapor
      diffusion at 4 degrees C from pH 5.5 solutions of polyethylene glycol 8000
      containing magnesium ATP and L-tryptophan. The crystals diffracted to about 4.0 A
      resolution at -150 degrees C and appeared to belong to the orthorhombic space
      group P2(1)2(1)2 with unit cell dimensions: a = 143.6 A, b = 111.6 A, c = 50.6 A
      with one dimer in the asymmetric unit.

PMID- 8478923
TI  - Crystallization of a deletion mutant of the R-subunit of cAMP dependent protein
      kinase.
AB  - A single deletion (delta 1 to 91) mutant of the regulatory subunit of the cAMP
      dependent protein kinase was crystallized. The crystals are hexagonal P6(1)22
      (P6(5)22) with a = b = 88.7 A and c = 179.9 A. The crystals diffract to 3 A
      resolution. There is one molecule per asymmetric unit.

PMID- 8478924
TI  - Diffraction grade crystals of Escherichia coli serine hydroxymethyltransferase.
AB  - Diffraction grade crystals of serine hydroxymethyltransferase were obtained after
      extensive screening of source of enzyme, purification procedures, ligand binding
      and crystallization conditions. Serine hydroxymethyltransferase purified from
      Escherichia coli crystallizes in two forms that are suitable for crystal
      structure determination.

PMID- 8478925
TI  - Crystallization of DsbA, an Escherichia coli protein required for disulphide bond
      formation in vivo.
AB  - DsbA is a 21 kDa protein that facilitates disulphide bond formation and is
      required for the correct folding and stability of a number of exported proteins
      in Escherichia coli. Crystals of oxidized DsbA have been obtained from
      polyethylene glycol 8000 (20 to 25%), 0.1 M-cacodylate buffer (pH 6.5) and 1% 2
      methyl-2,4-pentanediol. Oxidation of the protein is critical for reproducibly
      obtaining high quality crystals. The resulting crystals diffract to 2 A and
      belong to the monoclinic space group C2 with cell dimensions a = 117.5 A, b =
      65.0 A, c76.3 A, beta = 126.3 degrees with two molecules in the asymmetric unit.

PMID- 8478926
TI  - Identification of a cis-acting sequence within the Pm promoter of the TOL plasmid
      which confers XylS-mediated responsiveness to substituted benzoates.
AB  - The DNA sequences within the Pm promoter/operator region of the meta operon of
      the TOL plasmid of Pseudomonas putida, which confer XylS-mediated responsiveness
      to substituted benzoates, have been identified through deletion analysis and
      mutagenesis of the region. Integrity and proper phasing of two homologous tandem
      sequences 5'-TGCAAPuAAPu-PyGGNTA-3', separated by six base-pairs and overlapping
      with the -35 region of the Pm promoter, was essential for m-toluate activation of
      a Pm-lacZ fusion in xylS+ strains. The spacing between equivalent bases in each
      of the half-sites is 21 base-pairs, i.e. two turns of DNA helix. The activity of
      Pm varieties containing identical half-sites suggested that the XylS-responsive
      element is arranged as a direct repeat, the distal sequence being the one which
      provided the most stringent regulation when duplicated. The role of the repeats
      as the target for XylS binding to Pm is discussed.

PMID- 8478927
TI  - Expression of bacteriophage T4 gene 25 is regulated via RNA secondary structure
      in the translational initiation region.
AB  - Analysis of the nucleotide sequence in the 5' flanking region of bacteriophage T4
      gene 25 revealed three potential Shine and Dalgarno sequences, SD1, SD2 and SD3,
      with a spacing of 8, 17 and 27 nucleotides from the initiation codon of this
      gene, respectively. Results of our experiments in the bacteriophage T7 expression
      system clearly demonstrate that the SD3 sequence is required for efficient
      expression of gene 25. We propose the existence of a stem-loop structure that
      includes SD1 and SD2 sequences and brings the SD3 sequence to a favourable
      spacing with the initiation codon of gene 25. Since the predicted secondary
      structure in the translational initiation region of gene 25 is relatively
      unstable and the SD3 sequence, GAGG, is more typical than the SD1 sequence, GAG,
      we suggest that this structure could control the level of gene expression.

PMID- 8478928
TI  - Re-refinement of the X-ray crystal structure of bovine lens leucine
      aminopeptidase complexed with bestatin.
AB  - Bestatin, (2S,3R)-3-amino-2-hydroxy-4-phenylbutanoyl-L-leucine, has been
      incorrectly modelled in the previously reported structure of the complex between
      bovine lens leucine aminopeptidase (blLAP) and bestatin. In the previously
      reported structure, the C2 of bestatin was modelled and refined in the R
      configuration instead of the correct S configuration. The structure of the blLAP
      bestatin complex has been re-refined after remodelling bestatin in its correct
      stereochemistry.

PMID- 8478929
TI  - Functional expression of the uncomplexed serum retinol-binding protein in
      Escherichia coli. Ligand binding and reversible unfolding characteristics.
AB  - The serum retinol-binding protein solubilizes the lipophilic vitamin A alcohol
      and plays an important physiological role in the transport of this compound. The
      monomeric single-domain protein, the three-dimensional structure of which is
      known, constitutes a well-characterized member of the lipocalin family of
      proteins. We report here the functional expression of the apo-protein in
      Escherichia coli by secretion to the periplasm. The recombinant protein, purified
      in a single step by metal chelate affinity chromatography, exhibits the same
      ligand binding characteristics as described for the natural protein. Guanidinium
      chloride-induced unfolding and refolding experiments suggest that the recombinant
      retinol-binding protein adopts a stable conformation despite being expressed and
      purified in the absence of the large hydrophobic ligand. The expression system
      described here should also be useful for the recombinant production of other
      lipocalin proteins, thus permitting the elucidation of the structure-function
      relationships of ligand binding by protein engineering.

PMID- 8478930
TI  - Double strand packing in hemoglobin S fibers.
AB  - The sickling variant of human hemoglobin, Hb S (beta 6 Glu-->Val), assembles into
      14-strand helical fibers composed of seven pairs of double strands. The
      organization of the helical double strands closely resembles the parallel, half
      staggered, linear strand pairs of the crystals of Hb S characterized by Wishner
      et al. In the crystals, the molecules are arranged such that each possesses a
      beta 6 Val in contact with a molecule on the opposite strand. In the fibers, the
      overall hexagonal packing of strands leads to 22 classes of potential contacts
      between the seven double strands, but the presence of 2-fold helical symmetry
      reduces these contacts to 11 distinct classes. An analysis of the intermolecular
      contacts reported by Watowich et al., based on the data of Carragher et al.,
      indicated a loosely packed structure for which only four of the 11 potential
      classes of contacts between double strands are significant (residues within 5 A).
      We have recently analyzed the packing based on the results of Dykes et al. and
      Rodgers et al., and compared the findings with the structure derived from the
      data of Carragher et al. We find serious differences between the two data sets
      concerning the packing of double strands. The Dykes-Rodgers data indicate a more
      closely packed structure in which nine of the 11 potential classes of contacts
      are within 5 A. Considerations on the stability of certain contacts derived from
      incomplete fibers, as well as studies of Hb molecules composed of beta S chains
      and mutant alpha chains, suggest that the structural model with closer packing of
      the double strands provides a better correlation with the other experimental
      results.

PMID- 8478931
TI  - Undiscriminating codon reading with adenosine in the wobble position.
AB  - To investigate the reading properties of adenosine in the wobble position we have
      used site-directed mutagenesis of the Escherichia coli glycine tRNA1(CCC) gene to
      substitute the nucleotide A in the wobble position of the corresponding tRNA. The
      effect of this change on the ability of the tRNA to discriminate between the
      nucleotides in the third position of the glycine codons has been investigated. We
      have compared the ability of the mutant glycine tRNA1(UCC) and glycine tRNA1(ACC)
      as well as the mycoplasma glycine tRNA(UCC) to read the glycine codons. The
      results showed that glycine tRNA1(ACC) unlike glycine tRNA1(UCC) did not fully
      discriminate between the glycine codons. These experiments were carried out using
      a new in vitro protein synthesizing system that allows us to monitor the reading
      of all four glycine codons. In the present paper we give a detailed description
      of this new in vitro system.

PMID- 8478932
TI  - Conformation and thermodynamics of DNA "necks". Models for three-arm branch
      formation in a duplex.
AB  - The properties of three-arm DNA junctions differ from those of four-arm junctions
      in several respects. Most apparently, bases flanking the branch are reactive to
      single strand specific agents in three-arm junctions but not four-arm junctions.
      To determine the basis for this, we have designed and synthesized a series of
      complexes in which a short duplex, a neck, progressively extends from a parent 16
      mer DNA duplex. These structure allow us to investigate how a three-arm branch
      forms, and how its properties change as the neck extends. Comparison of the
      properties of a nicked duplex with those of the neck structures using native gel
      electrophoresis with reporter arms attached reveals progressively greater
      geometrical perturbation of the complexes as the number of base-pairs in the neck
      increases. Footprinting by single-strand specific reagents indicates that the
      reactivity to single-strand reagents near the branch occurs when only a single
      pair is possible. The branch in each neck interacts tightly with ethidium, as
      does a nick in the same duplex. The thermodynamics of neck formation have been
      evaluated by calorimetry and from the concentration dependence of absorbance
      temperature profiles. Each neck complex is destabilized with respect to duplex
      DNA or a nicked duplex, and has a lower enthalpy of formation despite the
      increased number of base-pairs present. A model is proposed to account for these
      properties in which the bases in the pair adjacent to the duplex interact
      directly with the duplex, via transient insertion.

PMID- 8478933
TI  - Effects of co-factor and deoxycytidine substituted oligonucleotides upon sequence
      specific interactions between MspI DNA methyltransferase and DNA.
AB  - MspI methyltransferase (M.MspI) catalyses the transfer of a methyl group from S
      adenosyl-L-methionine to the C-5 position of the outer deoxycytidine base in the
      DNA sequence 5'-CCGG-3'. Recombinant M.MspI when expressed and purified as a
      translational fusion with glutathione-S-transferase, shows all of the properties
      of the wild-type enzyme. We report the kinetic analysis of M.MspI binding to DNA,
      which suggests a two-stage methylation process, whose initial DNA binding rate is
      governed by the presence of a positively charged sulphonium centre on the
      cofactor. Results are also presented that indicate that M.MspI binds
      preferentially to hemi-methylated DNA and that full methylation of either
      deoxycytidine on both strands significantly impairs sequence-specific protein-DNA
      interactions. Furthermore, the importance of the 4-amino group of the inner
      deoxycytidine for sequence-specific protein-DNA interactions is demonstrated by
      substituting deoxycytidine with 2-pyrimidinone-1-beta-D-2-deoxyriboside. In
      addition, we detail the intrinsic structural elements of a cofactor, required to
      enhance the binding of M.MspI to its recognition sequence, by using S-adenosyl-L
      methionine and a range of derivatives.

PMID- 8478934
TI  - Structure of the sequences adjacent to the centromeric alphoid satellite DNA
      array on the human Y chromosome.
AB  - Eighteen yeast artificial chromosome (YAC) clones containing alphoid satellite
      DNA and adjacent sequences from the human Y chromosome have been identified from
      three different YAC libraries. Restriction site mapping of the genomic alphoid
      arrays and the YACs has allowed seven of the alphoid clones to be positioned on
      the arrays. Three clones extend into flanking sequences. At one edge the alphoid
      DNA is highly diverged and is flanked by a small block of the 48 base-pair
      satellite, dispersed moderately repeated sequences and a separate short alphoid
      array. More distal sequences are Y-specific. At the other edge there is much less
      divergence and the alphoid DNA is flanked by an Alu sequence and the five base
      pair satellite.

PMID- 8478935
TI  - Structure of the maltodextrin-uptake locus of Streptococcus pneumoniae.
      Correlation to the Escherichia coli maltose regulon.
AB  - The mechanism of induction of the maltose/maltodextrin regulon of the Gram
      positive bacterium Streptococcus pneumoniae seems to be different to the
      positively controlled maltose regulons of the enteric bacteria Escherichia coli,
      Klebsiella pneumoniae and Salmonella typhimurium. In this work, we report on the
      structure of the S. pneumoniae genes involved in maltodextrin uptake malX, malC
      and malD. Comparisons of the amino acid sequences encoded by these genes indicate
      that they are homologous to the E. coli MalE periplasmic maltose binding protein
      and the two maltose permeases MalG and MalF. The analysis of transcription start
      points indicates that malXCD could be transcribed from a single consensus
      promoter sequence. Northern analysis of the mRNA molecules pertaining to this
      region reveals that the transcript encompassing all these three genes is
      apparently cleaved at a large putative mRNA secondary structure, yielding two
      mRNA molecules. The smaller of these molecules would include only the malX gene
      while a larger fragment spans through malC and malD. The processing of mRNA has
      not been reported in the Gram-negative maltose regulons, and may suggest either a
      less evolved or a divergent system for the control of gene expression of this
      regulon in S. pneumoniae.

PMID- 8478936
TI  - Molecular profile of an antibody response to HIV-1 as probed by combinatorial
      libraries.
AB  - A large number (33) of human Fab fragments reacting with HIV-1 surface
      glycoprotein gp120 have been generated by selection from a combinatorial IgG1
      kappa library displayed on the surface of phage. The library was prepared from a
      long term asymptomatic HIV-seropositive donor. Analysis of the sequences from
      these Fabs shows the heavy chains can be placed in groups, many of which contain
      intraclonal variants, almost certainly corresponding to chains used in vivo.
      Further variants can be accessed via chain shuffling experiments in which a given
      light chain is recombined with a library of heavy chains. Heavy chain
      promiscuity, i.e. the ability of heavy chains to pair with different light chains
      with retention of antigen binding, is dependent on the particular heavy chain
      considered and probably excludes the identification of in vivo light chain
      partners. The antibodies examined here are primarily to the CD4 binding site on
      gp120 and broadly reflect the serum profile of the donor. The antibodies show
      evidence of extensive somatic modification indicative of an antigen-driven
      response. The heavy chain CDR3 regions of the antibodies show a remarkably
      conserved extended length. A number also show strong sequence conservation in
      CDR3 against a background of considerable diversity in the rest of the VH gene
      supporting a central role for this region in antigen recognition.

PMID- 8478937
TI  - Reconstitution of short-spaced chromatin from the histone octamer and either HMG
      14,17 or histone H1.
AB  - Two new chromatin-assembly reactions are described. The first involves the
      addition of phosphorylated HMG-14,17 to the histone octamer plus DNA in high
      concentrations of salt and yields a repeating particle size or spacing of about
      165 base-pairs. The second involves the addition of histone H1 to the acetylated
      histone octamer plus poly(glutamate) in low concentrations of salt, followed by
      the addition of DNA; and it yields a spacing of about 170 base-pairs. Plots of
      band size versus band number in gels, often used to determine nucleosome repeat
      length, yield slopes of 138 base-pairs for the histone octamer alone, or 155 base
      pairs with HMG-14,17 or 160 base-pairs with histone H1, and intercepts of 10,25
      and 20 base-pairs, respectively, in the three cases. Attempts were made to
      combine the spacing activities of HMG-14,17 and histone H1 within a single
      assembly reaction, to provide an even longer spacing of about 190 base-pairs (as
      observed in cell extracts to which H1 has been added), but our present methods
      did not allow this. The two assembly reactions described here will be of use for
      structural studies of chromatin having defined length and sequence, and
      potentially of practical use for the regular, ordered condensation of very long
      DNA.

PMID- 8478938
TI  - Separation and characterization of homo and hetero-oligomers of the intermediate
      filament proteins desmin and vimentin.
AB  - Affinity chromatography on single-stranded (ss)DNA-cellulose in conjunction with
      gel permeation chromatography in the presence of urea was employed to separate
      the intermediate filament (IF) protein complement of catalytically oxidized BHK
      21 cell Triton cytoskeletons into disulfide-cross-linked homo- and heterodimers
      of desmin and vimentin and uncross-linked homodimers. The same separation was
      performed on a desmin-vimentin mixture under autoxidizing conditions in 6 M-urea
      to obtain the respective cross-linked collision complexes of both proteins. In 5
      M-urea, the oxidation products were identified as dimers that were physically
      indistinguishable from uncross-linked homodimers, suggesting that they were in
      the form of partially denatured face-to face pairs. Heterodimers derived from
      intact IFs were identical to those derived from collision complexes. In the
      presence of 2-mercaptoethanol, heterodimers were unstable and transformed
      spontaneously into homodimers. After removal of urea, all cross-linked dimers
      were totally unable to polymerize into filaments; however, in the presence of 2
      mercaptoethanol they showed a normal assembly competence. This inability of
      oxidized homo- and heterodimers to polymerize, together with the relatively low
      yield of cross-linked dimers obtained from cytoskeletons, is probably due to the
      introduction of steric strain into the dimers by disulfide bond formation.
      Substantial amounts of cross-linked heterodimers could also be isolated from IFs
      reconstituted from mixtures of desmin and vimentin in their homodimeric or
      tetrameric forms. Taken together, these results suggest that the cross-linked
      dimers isolated from cytoskeletons arise from a reaction between subfilament
      strands of IFs rather than from disulfide bond formation within pre-existing
      dimers and that the heterotypic IFs of BHK-21 cells are largely formed from
      homodimers and tetramers, respectively, rather than from heterodimers. The
      differential capacity of desmin and vimentin to interact with ssDNA has also been
      exploited to distinguish between homotypic and heterotypic protofilaments, the
      latter consisting of one homodimer of each protein species. This distinction
      could be made on the basis of characteristic differences in the sedimentation
      behavior of the respective protein-DNA complexes.

PMID- 8478939
TI  - Endonuclease VII of phage T4 triggers mismatch correction in vitro.
AB  - The reactivity of endonuclease VII (gp49 of phage T4) with DNA-loops of eight,
      four, or one nucleotide, or any of 12 possible base mismatches was tested in
      vitro. Endonuclease VII introduces double-strand breaks by nick and counter-nick
      within six nucleotides 3' from the mispairings. High relative cleavage
      efficiencies at mismatches in heteroduplexes correlate with their decreased
      thermal stability and vice versa. A delay between nick and counter-nick was
      sufficient to allow T4 DNA-polymerase and T4 DNA-ligase to correct a C/C-mismatch
      in vitro, thereby saving the DNA from double-strand breakage. Very short repair
      tracks of three to four nucleotides mapped between the mismatch and one of the
      formerly induced nicks, which were subsequently sealed by DNA ligase.

PMID- 8478940
TI  - Interactions between morpholinyl anthracyclines and DNA. The crystal structure of
      a morpholino doxorubicin bound to d(CGTACG).
AB  - Anthracycline antibiotics daunomycin and adriamycin are among the most widely
      used in cancer chemotherapy and DNA is believed to be the primary target of their
      biological action. The crystal structure of a morpholino derivative of adriamycin
      bound to the DNA hexamer d(CGTACG) has been determined at 1.5 A resolution. The
      complex crystallizes in space group P1 with unit cell dimensions a = 18.01 A, b =
      18.83 A, c = 27.65 A, alpha = 92.6 degrees, beta = 100.5 degrees, gamma = 94.9
      degrees and there are two drug molecules bound per duplex. Morpholino derivatives
      differ greatly from their parent compounds in their biological and
      pharmacological properties. Structural comparison of this complex with the series
      of previously reported anthracycline-DNA complexes offers an opportunity for
      studying relationships between structure and function. The anthracycline
      chromophore intercalates at the CpG step and DNA distortions from a B-type
      conformation are similar to those observed in the other DNA-anthracycline
      complexes. Interactions between drug and DNA show no differences at the
      intercalation site, while in the minor groove they are significantly affected by
      the presence of the bulky morpholinyl moiety on the anthracycline amino sugar.
      The binding site involves four base-pairs and the absence of a positive charge on
      the amino sugar appears to influence the hydration pattern on both grooves. The
      two halves of the duplex are symmetrically related by a non-crystallographic 2
      fold axis but they are not equivalent. In one half, one magnesium cluster bridges
      both drug and DNA, further stabilizing the complex.

PMID- 8478941
TI  - Refined structure of Escherichia coli heat-labile enterotoxin, a close relative
      of cholera toxin.
AB  - Heat-labile enterotoxin (LT) from Escherichia coli is a bacterial protein toxin
      with an AB5 multimer structure, in which the B pentamer has a membrane binding
      function and the A subunit is needed for enzymatic activity. The LT crystal
      structure has been solved using a combination of multiple isomorphous
      replacement, fivefold averaging and molecular dynamics refinement. Phase
      combination using all these sources of phase information was of crucial
      importance for the chain tracing. The structure has now been refined to 1.95 A
      resolution, resulting in a model containing 6035 protein atoms and 293 solvent
      molecules with a crystallographic R-factor of 18.2% and good stereochemistry. The
      B subunits are arranged as a highly stable pentamer with a donut shape. Each
      subunit takes part in approximately 30 inter-subunit hydrogen bonds and six salt
      bridges with its two neighbors, whilst burying a large surface area. The A
      subunit has higher temperature factors and less well-defined secondary structure
      than the B subunits. It interacts with the B pentamer mainly via the C-terminal
      A2 fragment, which runs through the highly charged central pore of the B
      subunits. The pore contains at least 66 water molecules, which fill the space
      left by the A2 fragment. A detailed analysis of the contacts between A and B
      subunits showed that most specific contacts occur at the entrance of the central
      pore of the B pentamer, while the contacts within the pore are mainly hydrophobic
      and water mediated, with the exception of two salt bridges. Only a few contacts
      exist between the A1 fragment and the B pentamer, showing that the A2 fragment
      functions as a "linker" of the A and B parts of the protein. Interacting with the
      A subunit by the B subunits does not cause large deviations from a common B
      subunit structure, and the 5-fold symmetry is well maintained. A potential NAD(+)
      binding site is located in an elongated crevice at the interface of two small
      sheets in the A1 fragment. At the back of this crevice the functionally important
      Arg7 makes a hydrogen bond connecting two strands, which seems to be conserved
      across the ADP-ribosylating toxin family. The putative catalytic residue
      (A1:Glu112) is located nearby, close to a very hydrophobic region, which packs
      two loops together. This hydrophobic region may be important for catalysis and
      membrane translocation.

PMID- 8478942
TI  - Relocating a negative charge in the binding pocket of trypsin.
AB  - The functional and structural consequences of altering the position of the
      negatively charged aspartate residue at the base of the specificity pocket of
      trypsin have been examined by site-directed mutagenesis, kinetic characterization
      and crystallographic analysis. Anionic rat trypsin D189G/G226D exhibits a high
      level of catalytic activity on activated amide substrates, but its relative
      preference for lysine versus arginine as the P1 site residue is shifted by 30 to
      40-fold in favor of lysine. The crystal structure of this variant has been
      determined in complexes with BPTI (bovine pancreatic trypsin inhibitor), APPI
      (amyloid beta-protein precursor inhibitor domain) and benzamidine inhibitors, at
      resolutions of 2.1 A, 2.5 A and 2.2 A, respectively. Asp226 bridges the base of
      the specificity pocket with its negative charge partially buried by interactions
      made with Ser190 and Tyr228. An equal reduction in the affinity of the variant
      enzyme for Arg and Lys substrates is attributable to a decreased electrostatic
      interaction of each ligand with the relocated aspartate residue. Comparison of
      structural and functional parameters with those of wild-type trypsin suggests
      that direct hydrogen-bonding electrostatic contacts in the S1 site do not
      significantly improve the free energy of substrate binding relative to indirect
      water-mediated interactions. The conformation adopted by Asp226, as well as by
      other adjacent side-chain and backbone groups, depends upon the ligand bound in
      the primary specificity pocket. This structural flexibility may be of critical
      importance to the retention of catalytic activity by the variant enzyme.

PMID- 8478943
TI  - Structures of the lectin IV of Griffonia simplicifolia and its complex with the
      Lewis b human blood group determinant at 2.0 A resolution.
AB  - The structures of the fourth lectin isolated from Griffonia simplicifolia (GS4)
      and its complex with the methyl-glycoside of the Lewis b human blood group
      determinant (Le(b)-OMe) are reported at high resolution. The native GS4 crystal
      is isomorphous with the complexed GS4 crystal. The space group is P4(2)2(1)2 with
      unit cell dimensions a = 78.9 A, c = 89.1 A with one subunit of the lectin (bound
      to 1 Le(b)-OMe in the complex) in the crystallographic asymmetric unit. The
      native GS4 structure was solved by the molecular replacement technique and least
      squares refined (PROLSQ and X-PLOR). The orientation of the Le(b)-OMe
      tetrasaccharide in the complex was established from a 2.8 A difference map with
      coefficients (Fcomplex--Fnative) and calculated phase angles from the native
      model. Both the final native and complex GS4 models consist of 1904 protein non
      hydrogen atoms, one sulfate ion, one Ca ion, one Mn ion and three covalently
      bound sugar residues N-linked to Asn18. In addition, the complex model has 47
      Le(b)-OMe non-hydrogen atoms. The two structures have 135 water molecules in
      common in addition to eight and nine unique water molecules in the native and
      complex structures, respectively. The root-mean-square deviations from ideal bond
      distances and angles are 0.016 A, 3.2 degrees and 0.016 A, 3.0 degrees, for the
      native and complexed GS4, respectively. The R index for all unique data from 8 to
      2.0 A is 0.187 for the native (19,204 reflections) and 0.181 for the complex
      (19,212 reflections). The tertiary structure of each subunit is similar to that
      of other leguminous lectins but the quaternary structure of the molecular dimer
      is different from that of any other lectin reported to date. The co-ordination
      about the Ca ion is pentagonal bipyramidal (with 1 long Ca(2+)-oxygen bond) and
      the co-ordination about the Mn ion is octahedral. Two conserved residues (Asp149
      and Ser155) appear to be important because they are hydrogen-bonded to each other
      and to groups that co-ordinate the Mn ion. There are three cis-peptides in the
      polypeptide chain; two involve non-proline residues, one of which is homologous
      with other leguminous lectins and the other is unique to GS4. The two non-proline
      cis-peptides are located in the carbohydrate-binding site and are important for
      the specificity of the lectin. The molecular recognition of Le(b)-OMe by GS4
      involves both polar and extensive non-polar interactions.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8478944
TI  - Characterization of the zinc-induced structural transition to *H-DNA at a
      d(GA.CT)22 sequence.
AB  - Zinc induces transition of a d(GA.CT)22 sequence to a novel DNA conformation,
      called *H-DNA. In this paper, the structural characteristics of this altered DNA
      conformation are determined. Formation of *H-DNA is induced at zinc
      concentrations higher than 70 microM (Zn/P = 2) and it is favoured by negative
      supercoiling and low ionic strength. Two different structural conformations of
      the d(GA.CT)22 sequence are observed upon increasing the zinc concentration. At
      low zinc concentration (Zn/P < 15), half of the purine strand falls back upon
      itself giving rise to the formation of an RRY intramolecular triplex (H*
      triplex). At higher zinc concentration, the complete pyrimidine strand is single
      stranded and an RR hairpin is formed (*H-hairpin). Protection towards
      dimethylsulphate modification suggests that zinc binds to the N-7 group of
      guanine residues in the *H-hairpin with a higher affinity than in B-DNA. The
      dissociation constant of the *H-zinc complex is estimated to be in the range of
      10(-3) M to 10(-4) M.

PMID- 8478945
TI  - X-ray structures and mechanistic implications of three functional derivatives of
      ascorbate oxidase from zucchini. Reduced, peroxide and azide forms.
AB  - The X-ray structures of three functional derivatives of ascorbate oxidase (EC
      1.10.3.3) from Zucchini have been determined and are compared to the "native"
      oxidized form. The fully reduced form of ascorbate oxidase has been refined to a
      crystallographic R-factor of 19.6% for all reflections between 8.0 A and 2.2 A
      resolution. The geometry at the type-1 copper (CU1) is unchanged compared to the
      oxidized form, but the oxygen ligand bridging the copper ions CU2 and CU3
      (spectroscopic type-3 copper pair) is released and the copper ions move apart
      yielding a trigonal planar co-ordination with their ligating histidine residues.
      The co-ordination at the copper ion CU4 (spectroscopic type-2 copper) is not
      affected. The copper-copper distances increase from an average 3.7 A in the
      native form to 5.1 A for CU2-CU3, 4.4 A for CU2-CU4 and 4.1 A for CU3-CU4. The
      peroxide derivative of ascorbate oxidase has been refined to a crystallographic R
      factor of 16.0% for all reflections between 8.0 A and 2.59 A resolution. The
      geometry at the type-1 copper site is not changed compared to the oxidized form.
      The oxygen ligand bridging copper atoms CU2 and CU3 is lost, too. The peroxide
      binds terminally to the copper ion CU2 as hydroperoxide. Copper ion CU2 is
      fourfold co-ordinated to the NE2 atoms of the three histidine residues and to the
      oxygen atom of the terminally bound peroxide molecule in a distorted tetrahedral
      geometry. Copper ion CU3 is threefold co-ordinated as in the reduced form and co
      ordination around copper atom CU4 is unaltered. The copper-copper distances
      increase to 4.8 A for CU2-CU3 and 4.5 A for CU2-CU4. The distance CU3-CU4 remains
      3.7 A. Treatment with peroxide causes a partial depletion of copper ion CU2. The
      refinement for the azide derivative of ascorbate oxidase converged at a
      crystallographic R-factor of 17.8% for all reflections between 8.0 A and 2.32 A.
      There are no significant structural changes at the type-1 copper site. The oxygen
      ligand bridging copper ions CU2 and CU3 is again released. Two azide molecules
      bind terminally to copper ion CU2. Copper ion CU2 is fivefold co-ordinated to the
      NE2 atoms of the three histidine residues and to both terminally bound azide
      molecules in a trigonal-bipyramidal manner. Copper-copper distances increase to
      5.1 A for CU2-CU3 and 4.6 A for CU2-CU4. The distance CU3-CU4 is decreased to 3.6
      A.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8478946
TI  - The Slezak workshop on antiarrhythmic drugs and self ventricular defibrillation.
      A satellite to the XIV European meeting of the International Society for Heart
      Research. Tel-Aviv, 6-7 May, 1993. Abstracts.

PMID- 8478947
TI  - International Society for Heart Research. XIV European Section Meeting.
      Jerusalem, Israel, May 9-13, 1993. Abstracts.

PMID- 8478948
TI  - Supratentorial malignant gliomas: risk patterns and therapy.

PMID- 8478949
TI  - Do hormones link alcohol with breast cancer?

PMID- 8478950
TI  - Collins takes helm of NIH genome project.

PMID- 8478952
TI  - Spain's cancer researchers ready for next step.

PMID- 8478951
TI  - Sphingolipids implicated in programmed cell death.

PMID- 8478953
TI  - Registries keep track in Spain.

PMID- 8478954
TI  - Study suggests mechanism for alcohol-breast cancer link.

PMID- 8478955
TI  - States aim laws at off-label reimbursement.

PMID- 8478956
TI  - Recursive partitioning analysis of prognostic factors in three Radiation Therapy
      Oncology Group malignant glioma trials.
AB  - BACKGROUND: Despite notable technical advances in therapy for malignant gliomas
      during the past decade, improved patient survival has not been clearly
      documented, suggesting that pretreatment prognostic factors influence outcome
      more than minor modifications in therapy. Age, performance status, and tumor
      histopathology have been identified as the pretreatment variables most predictive
      of survival outcome. However, an analysis of the association of survival with
      both pretreatment characteristics and treatment-related variables is necessary to
      assure reliable evaluation of new approaches for treatment of malignant glioma.
      PURPOSE: This study of malignant glioma patients used a non-parametric
      statistical technique to examine the associations of both pretreatment patient
      and tumor characteristics and treatment-related variables with survival duration.
      This technique was used to identify subgroups with survival rates sufficiently
      different to create improvements in the design and stratification of clinical
      trials. METHODS: We used a recursive partitioning technique to analyze survival
      in 1578 patients entered in three Radiation Therapy Oncology Group malignant
      glioma trials from 1974 to 1989 that used several radiation therapy (RT) regimens
      with and without chemotherapy or a radiation sensitizer. This approach creates a
      regression tree according to prognostic variables that classifies patients into
      homogeneous subsets by survival. Twenty-six pretreatment characteristics and six
      treatment-related variables were analyzed. RESULTS: The years). Patients younger
      than 50 years old were categorized by histology (astrocytomas with anaplastic or
      atypical foci [AAF] versus glioblastoma multiforme [GBM]) and subsequently by
      normal or abnormal mental status for AAF patients and by performance status for
      those with GBM. For patients aged 50 years or older, performance status was the
      most important variable, with normal or abnormal mental status creating the only
      significant split in the poorer performance status group. Treatment-related
      variables produced a subgroup showing significant differences only for better
      performance status GBM patients over age 50 (by extent of surgery and RT dose).
      Median survival times were 4.7-58.6 months for the 12 subgroups resulting from
      this analysis, which ranged in size from 32 to 256 patients. CONCLUSIONS: This
      approach permits examination of the interaction between prognostic variables not
      possible with other forms of multivariate analysis. IMPLICATIONS: The recursive
      partitioning technique can be employed to refine the stratification and design of
      malignant glioma trials.

PMID- 8478957
TI  - Role of antioxidant enzymes in the induction of increased experimental metastasis
      by hydroxyurea.
AB  - BACKGROUND: Treatment of tumor cells with hydroxyurea and other DNA-damaging
      agents has been shown to increase the experimental metastatic potential of these
      cells. PURPOSE: We sought to elucidate some of the biochemical and genetic
      changes that promote tumor cell metastasis in hydroxyurea-treated cells. We
      hypothesized that drug treatment induces resistance to oxidative damage and that
      elimination of this resistance reverses the drug-induced experimental metastatic
      capabilities of tumor cells. METHODS: We examined the effect of hydroxyurea
      treatment on B16 melanoma cells with respect to experimental metastatic
      potential, resistance to hydrogen peroxide (H2O2), glutathione peroxidase
      activity and messenger RNA (mRNA) level, glutathione reductase activity,
      glutathione levels, glutathione-S-transferase activity, and catalase activity and
      mRNA level. RESULTS: Hydroxyurea-treated cells were transiently more metastatic
      following intravenous injection in syngeneic mice and transiently more resistant
      than untreated cells to exogenous H2O2. Hydroxyurea-induced experimental
      metastases and H2O2 resistance were eliminated by depletion of intracellular
      glutathione with buthionine sulfoximine. Glutathione peroxidase activity and mRNA
      level, glutathione reductase activity, and reduced glutathione levels were all
      transiently increased in hydroxyurea-treated cells, whereas the increase in
      glutathione-S-transferase activity was sustained. Catalase activity was modestly
      increased with no increase in its mRNA levels. CONCLUSIONS: In B16 melanoma
      cells, experimental metastasis induced by hydroxyurea appears to depend on a
      process that requires glutathione. Hydroxyurea treatment also induces resistance
      to exogenous H2O2, which may be due to induction of glutathione and antioxidant
      enzyme activity. IMPLICATIONS: The role of antioxidants in B16 melanoma cells
      offers new insights into the metastatic process and the cellular response to
      chemotherapy.

PMID- 8478958
TI  - Effects of alcohol consumption on plasma and urinary hormone concentrations in
      premenopausal women.
AB  - BACKGROUND: Most epidemiologic studies of the relationship between alcohol
      consumption and breast cancer risk over the past decade have shown that persons
      who consume a moderate amount of alcohol are at 40%-100% greater risk of breast
      cancer than those who do not consume alcohol. Dose-response effects have been
      observed, but no causal relationship has been established. PURPOSE: This study
      examines the hypothesis that alcohol consumption affects levels of reproductive
      hormones. METHODS: A controlled-diet study lasting for six consecutive menstrual
      cycles was conducted. Participants were randomly assigned to two groups, and a
      crossover design was used. During the last three menstrual cycles, alcohol
      consumption of the two groups was reversed. Thirty-four premenopausal women, aged
      21-40 years, with a history of regular menstrual cycles, consumed 30 g of ethanol
      (equivalent to approximately two average drinks) per day for three menstrual
      cycles and no alcohol for the other three. All food and alcohol consumed were
      provided by the study. Caloric intake was monitored to ensure that each woman
      would maintain body weight at approximately the baseline level. Hormone assays
      were performed on pooled plasma or 24-hour urine specimens collected during the
      follicular (days 5-7), peri-ovulatory (days 12-15), and mid-luteal (days 21-23)
      phases of the third menstrual cycle for subjects on each diet. RESULTS: Alcohol
      consumption was associated with statistically significant increases in levels of
      several hormones. Plasma dehydroepiandrosterone sulfate levels were 7.0% higher
      in the follicular phase (P = .05). In the peri-ovulatory phase, there were
      increases of 21.2% (P = .01) in plasma estrone levels, 27.5% (P = .01) in plasma
      estradiol levels, and 31.9% (P = .009) in urinary estradiol levels. In the luteal
      phase, urinary estrone levels rose 15.2% (P = .05), estradiol levels increased
      21.6% (P = .02), and estriol levels rose 29.1% (P = .03). No changes were found
      in the percent of bioavailable estradiol, defined by the sum of percent free
      estradiol and percent albumin-bound estradiol. However, increased total estradiol
      levels in the peri-ovulatory phase suggest elevated absolute amounts of
      bioavailable estradiol. CONCLUSION: This study has shown increases in total
      estrogen levels and amount of bioavailable estrogens in association with alcohol
      consumption in premenopausal women. IMPLICATION: This possible explanatory
      mechanism for a positive association between alcohol consumption and breast
      cancer risk merits further investigation.

PMID- 8478959
TI  - Randomized phase I chemoprevention dose-seeking study of alpha
      difluoromethylornithine.
AB  - BACKGROUND: alpha-Difluoromethylornithine (DFMO) is an irreversible inhibitor of
      ornithine decarboxylase (ODC), the key enzyme in mammalian polyamine
      biosynthesis. Levels of ODC are closely related to tumor promotion, and
      inhibition of ODC is associated with suppression of tumor development in
      laboratory animals. DFMO has shown a dose-response effect in tumor inhibition in
      mice. PURPOSE: A randomized phase I study of DFMO was conducted to determine the
      lowest daily oral dose that can achieve at least 50% inhibition of ODC activity
      induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in human skin, with minimal
      clinical toxicity (grade 1 or lower; Eastern Cooperative Oncology Group [ECOG]).
      METHODS: Cancer patients entered in steps 1 and 2 of the study had been treated
      and had no clinical evidence of cancer. In step 1, 13 patients received 0.125,
      0.25, 0.5, or 0.75 g/m2 DFMO four times a day. In step 2, 13 patients received
      0.125 or 0.25 g/m2 four times a day or 0.5 or 1.0 g/m2 every day. The 26 patients
      treated in steps 1 and 2 (range, < 1-6 months) had colon, prostate, or bladder
      cancer. In step 3, six cancer-free subjects at risk for colorectal cancer
      received 0.5 g/m2 every day for 5-12 months. To evaluate the effectiveness of
      DFMO in reducing TPA-induced ODC activity, we calculated the percent change from
      pretreatment ODC levels in skin biopsy specimens and the percentage of subjects
      with at least a 50% reduction in ODC levels. RESULTS: In step 1 of the study,
      treatment-limiting audiotoxicity was observed at the three highest doses. Because
      the only dose with no major toxic effects in step 2 was 0.5 g/m2 every day, that
      dose was administered in step 3, with no major toxic effects. Seven subjects
      treated with 0.5 g/m2 every day had pretreatment ODC levels in the normal range;
      five averaged a reduction in ODC activity of at least 50%. DFMO had linear
      pharmacokinetics over the entire dose range. When 0.5 g/m2 was given every day,
      the peak plasma concentration was 47.1 +/- 5.1 microM at 3-4 hours (monthly mean
      +/- SE, 14.5 +/- 5.2 microM); half-life was 3.5 hours; and area under the curve
      for plasma concentration x time for a single dose of DFMO was 311 +/- 39 microM x
      hour. CONCLUSIONS: These data support phase II chemoprevention studies with DFMO
      given at a dose of 0.5 g/m2 every day. IMPLICATIONS: Studies investigating
      prevention of cancers with DFMO are under consideration.

PMID- 8478960
TI  - Social support and cancer screening among older black Americans.
AB  - BACKGROUND: Age-adjusted cancer mortality is 27% higher for Black Americans than
      for the general U.S. population, which may result from inappropriate use of
      cancer detection tests. Social support has been shown to affect adjustment to
      breast cancer and survival, but it has not been studied as a predictor of use of
      preventive health care services in the older population. Our hypothesis is that
      larger social networks are associated with greater utilization of cancer
      screening tests in the older population. PURPOSE: The objective of this study was
      to examine the relationship between social support and use of cancer-screening
      tests among older Black Americans. METHODS: Data for this study were obtained
      from a 1986 baseline survey evaluation of a community intervention program to
      increase cancer awareness and a 1991 end-point survey of use of cancer detection
      tests. Our study sample consisted of 617 Black Americans aged 55 years or older
      who lived in San Francisco (Calif.), the control community, and in Oakland
      (Calif.), the target community for intervention. The survey included measures of
      1) social network characteristics, as determined by a modified version of Berkman
      and Syme's Social Network Index; 2) demographic characteristics; and 3) use of
      six cancer-screening tests--mammography, occult blood stool examination, cervical
      smear, clinical breast examination, digital rectal examination, and
      sigmoidoscopy. RESULTS: Multiple logistic regression analysis of the Social
      Network Index results indicated statistically significant positive associations
      of social support with the use of mammography and occult blood stool examination
      but not with the other cancer-screening tests. There were statistically
      significant associations between having HMO (Health Maintenance Organization)
      insurance and increased use of mammography and occult blood stool examination,
      compared with having Medi-Cal or other insurance. The interval between the
      surveys had a statistically significant positive association with use of
      mammography. These significant associations were not explained by differences in
      the other variables, which included health status, age, gender, education, type
      of health insurance, interval between the surveys, and a regular source of care.
      CONCLUSIONS: Social support seems to be associated with increased use of
      mammography and occult blood stool examinations among older Black Americans.
      IMPLICATIONS: Interventions designed to increase utilization of social networks
      may be an effective way to increase use of cancer screening, which may ultimately
      lead to reduced mortality from cancer.

PMID- 8478961
TI  - Oral cavity cancer in non-users of tobacco.

PMID- 8478962
TI  - Re: Environmental tobacco smoke and lung cancer risk in nonsmoking women.

PMID- 8478964
TI  - Sexual orientation, gender orientation.

PMID- 8478963
TI  - Re: Environmental tobacco smoke and lung cancer risk in nonsmoking women.

PMID- 8478965
TI  - The gift of health: yours to enjoy, yours to destroy.

PMID- 8478966
TI  - President Clinton's managed competition proposal.
AB  - In the search for fairness of access to health care, value for the money spent,
      and high quality of patient care, the United States has vacillated between
      advocacy of government regulations (the 1970s) and of market-driven, pro
      competitive (1980s) approaches. The possible enactment of President Clinton's
      health reform plan with a managed-care strategy (1990s) calls for paying
      physicians and other providers in a manner that often induces them to minimize
      the provision of services to patients per episode of illness. This article
      discusses the impact of such legislation on patients, physicians, and other
      providers. It then argues that the President's managed competition approach,
      which micromanages health-care services, will fail except by concurrently
      implementing his proposed National Health Board's global budgetary concept. The
      major reason is that health reform for the 36.6 million uninsured Americans, who
      are mostly the working poor and their dependents, is only practical and
      affordable if stringent policies are adopted that reorganize available health
      care resources and simultaneously implement cost-containment constraints.

PMID- 8478967
TI  - Plasma glucose and insulin responses to oral glucose loading in nonobese Nigerian
      subjects with essential hypertension.
AB  - In assessing the relationship between insulin levels and blood pressure, we
      analyzed glucose and insulin data after standard 75 g oral glucose tolerance
      tests in 16 nonobese male Nigerian subjects with essential hypertension and
      compared their results with those obtained from 16 age- and sex-matched healthy
      normotensive subjects. The fasting plasma glucose and insulin as well as 2-hour
      postload insulin values were similar in both groups. The hypertensive subjects
      had significantly greater 2-hour glucose levels, larger incremental areas under
      the glucose/time curves, and smaller ratios of incremental insulin to incremental
      glucose areas (P < .05). These parameters suggest some impairment of glucose
      tolerance in the hypertensive subjects related to an inadequate insulin response
      to the oral glucose load. Model analysis of the glucose and insulin data
      confirmed these observations in that the estimated rate of glucose uptake into
      peripheral tissues (M value) was lower in the hypertensive subjects (P = .02).
      There was no correlation at any time point between insulin values and blood
      pressure in either group of subjects. These results suggest that essential
      hypertension in Nigerian diabetic subjects is associated with a reduced insulin
      response to glucose loading, which is at variance with reports in whites, and
      deserve further investigation.

PMID- 8478968
TI  - Altered coagulability: an aid to selective breast biopsy.
AB  - Difficulty in discriminating nonadvanced breast cancer from benign breast disease
      results in many cancer negative biopsies. Development of a test to better
      differentiate between these two entities to reduce the number of cancer negative
      biopsies was the purpose of this blind study. The clue that prompted the
      development of this test resides in the state of hypercoagulability in cancer.
      Hypercoagulability can be measured by assessing tissue factor-mediated altered
      coagulability. The amount of tissue factor release is contingent on prior
      activation of the monocyte (the only blood cell that generates tissue factor) in
      vivo.

PMID- 8478969
TI  - Barriers to medical care for white, black, and Hispanic American children.
AB  - As demonstrated by efforts to expand Medicaid coverage for poor and needy
      children, removing barriers to medical care continues to be an important social
      policy goal. Data from the 1987 National Medical Expenditure Survey, a multistage
      probability sample of 15,000 US households, was used to examine some of the
      barriers that black and Hispanic children encounter in obtaining access to
      medical care. Results from the 1987 study indicate that black and Hispanic
      children were more likely than white children to be poor, uninsured members of
      single-parent households, and to have to wait longer to see a medical provider.
      Yet differences in waiting time at the usual source of care remained after
      controlling for insurance. In 1987, 18.6% of uninsured white children were
      without a usual source of care compared with 28.4% and 25.2% of uninsured black
      and Hispanic children, respectively. Furthermore, 17.6% of uninsured white
      children made at least one routine visit to a physician during 1987, while only
      11.4% and 10.6% of the uninsured black and Hispanic children, respectively, saw a
      physician for a regular checkup.

PMID- 8478970
TI  - The association between serum albumin and HDL and total cholesterol.
AB  - Relatively low serum albumin is a predictor of increased mortality and coronary
      heart disease incidence. To shed light on the likelihood of confounding this
      association by high-density lipoprotein (HDL) cholesterol or other risk factors,
      data from the National Center for Health Statistics were examined. Serum albumin
      concentration was significantly correlated with HDL cholesterol concentration
      only in white men aged 25 to 34 and 35 to 44 years. Serum albumin was positively
      correlated with serum total cholesterol. Several other cardiovascular risk
      factors were correlated with serum albumin in whites and blacks. Further studies
      are needed.

PMID- 8478971
TI  - Short-term declines in CD4 levels associated with cocaine use in HIV-1
      seropositive, minority injecting drug users.
AB  - This study evaluates the association of cocaine use with short-term change in CD4
      counts among human immunodeficiency virus type 1 (HIV-1) seropositive, minority
      injecting drug users prior to the introduction of zidovudine (AZT). Ninety-eight
      HIV-1 seropositive subjects were recruited from six inner-city, methadone
      maintenance clinics. A baseline assessment included a short questionnaire
      regarding drug behavior and quantitation of CD4 cell counts. These measures were
      repeated on all subjects 3 to 4 months later. Thirty-eight subjects reported
      using cocaine between baseline and 4-month follow-up evaluations. Males and
      African Americans were more likely to be cocaine users (P < .01). Cocaine users
      were more likely to engage in heroin and needle use (P < .001). Cocaine users
      experienced a significant decline in CD4 cells compared with nonusers (P = .013);
      no marked difference in CD4 decline was noted between heroin users and nonusers
      (P = .19). Multivariate analysis showed that a decline in CD4 counts was 2.82
      times more likely to occur in cocaine users than in cocaine nonusers (90% two
      sided confidence interval of 1.08, 7.37). These findings support the hypothesis
      of a possible link between cocaine use and short-term CD4 decline in HIV-1
      seropositive injecting drug users.

PMID- 8478972
TI  - The role of nonoperative management of the injured spleen.
AB  - The role of selective nonoperative management of blunt splenic injuries in adults
      has been the focus of considerable controversy over the last decade. This article
      reviews the markedly contrasting experiences of proponents and opponents of this
      approach. When strict selection criteria are applied (ie, hemodynamic stability,
      opportunity for close observation, and radiographic confirmation of severity of
      injury), nonoperative management of blunt splenic injuries can be expected to be
      successful in more than 80% of cases where it is applied. However, these same
      criteria would select only about one-quarter of adults with blunt splenic
      injuries for nonoperative management, and mandate early surgery in the remaining
      three fourths. There is a limited role for nonoperative management of adults with
      blunt splenic injuries. The greatest contribution to increasing splenic salvage,
      however, can be expected to come from improved techniques in operative splenic
      repair.

PMID- 8478973
TI  - The effects of lithium therapy on leukocytes: a 1-year follow-up study.
AB  - Lithium carbonate is a well-established drug for the treatment of manic
      depressive illness. Leukocytosis is also a common finding in patients given
      lithium salts, but a few studies have addressed the possibility of persistent
      leukocyte elevation during long-term lithium therapy. We observed leukocyte
      counts in 10 manic-depressive patients over a 1-year period after establishing
      prelithium leukocyte baselines. During the first few weeks, all patients showed
      significant increases, which persisted throughout the course of treatment.
      However, there was no significant correlation between plasma lithium levels and
      leukocytosis. Additionally, there was a significant correlation between lithium
      dose and leukocytosis. Although leukocytosis is not always a consistent finding
      in patients on long-term lithium therapy, the persistence of white blood cell
      elevation in our patient population suggests that lithium might be useful in the
      long-term management of certain leukopenic conditions using lower-than
      conventional doses.

PMID- 8478974
TI  - Passive marijuana usage and water intoxication.
AB  - This article reports a case of a 3-month-old male presenting with hyponatremic
      seizure and hypothermia. The presence of marijuana in the infant's urine was
      remarkable. An etiologic role for the drug is questioned. A review of the
      literature is provided and the hypothesis of child neglect in the genesis of
      water intoxication is explored.

PMID- 8478975
TI  - Atypical desmoid tumor of the abdomen: a case report.
AB  - Desmoids are rare lesions that are histologically benign but locally aggressive.
      These lesions should be considered in patients who present with abdominal masses,
      particularly if there is a prior history of familial polyposis. This case report
      describes a patient with an abdominal desmoid that demonstrated atypical features
      on computed tomography and correlative magnetic resonance images.

PMID- 8478976
TI  - Hughenna L. Gauntlett, MD, FACS: a profile in courage.

PMID- 8478977
TI  - Mercuric chloride affects protein secretion in rat primary hepatocyte cultures: a
      biochemical ultrastructural, and gold immunocytochemical study.
AB  - The toxicity of mercury on hepatocytes was studied at the ultrastructural,
      biochemical, and immunocytochemical levels. Albumin metabolism was examined
      because it is a representative liver-specific function. A novel cytochemical
      method using the protein A-gold technique for the in situ localization of albumin
      in hepatocyte cultures was applied. Primary rat hepatocyte cultures were exposed
      to increasing HgCl2 concentrations. Cytotoxicity was assessed by measuring the
      release of lactic dehydrogenase from the cells. At the highest exposure
      concentration tested (50 microM), Hg was found to be significantly cytotoxic in
      contrast to what occurred at 5.0 and 0.5 microM. The level of albumin secreted,
      as measured by ELISA, was decreased by approximately 38% at 5.0 microM HgCl2 and
      was found not to be different from that of controls at lower concentrations. The
      ultrastructural analysis showed that hepatocytes treated with 5.0 microM HgCl2
      undergo drastic morphological changes such as a decreased number of ribosomes
      associated with the rough endoplasmic reticulum, and the disappearance of the
      latter organelle, proliferation of the smooth endoplasmic reticulum, and
      dilatation of both the Golgi apparatus and the biliary canaliculus-like
      structures. Immunocytochemical detection of albumin-immunoreactive sites using
      protein A-gold labeling further revealed that these were less abundant in
      hepatocytes treated with 5.0 microM HgCl2 (-64%) as compared to control
      preparations. These results suggest that one of the effects of mercury on
      hepatocytes is to affect liver-specific functions such as albumin production,
      possibly through interference with ribosomal function. This study also
      demonstrates for the first time the applicability of the high-resolution protein
      A-gold technique for toxicological investigations on hepatocytes in vitro.

PMID- 8478978
TI  - Absorption of polycyclic aromatic hydrocarbons through human skin: differences
      between anatomical sites and individuals.
AB  - In order to determine differences in absorption of polycyclic aromatic
      hydrocarbons (PAH) between anatomical sites and individuals, coal-tar ointment
      was applied to skin of volunteers at various sites. The surface disappearance of
      PAH and the excretion of urinary 1-OH-pyrene after skin application of coal-tar
      ointment were used as parameters for dermal PAH absorption. The surface
      disappearance was determined by the measurement of the fluorescence of PAH on
      skin. Surface disappearance measurements show low but significant differences in
      dermal PAH absorption between anatomical sites: shoulder > forehead, forearm,
      groin, > ankle, hand (palmar site). The average PAH absorption rate constant at
      different skin sites ranges from 0.036/h to 0.135/h (overall mean: 0.066/h). This
      indicates that after 6 h of exposure, 20-56% of a low dermal dose of PAH (e.g.,
      about 1.0 ng pyrene/cm2) will be absorbed. The interindividual differences in PAH
      absorption are small (7%) in comparison with differences between anatomical sites
      (69%). Results based on the urinary excretion of 1-OH-pyrene are less clear. The
      site of application of the coal-tar ointment (dose: 2.5 mg/cm2 during 6 h) has no
      significant effect on the excreted amount of 1-OH-pyrene in urine. It is
      estimated that after coal-tar ointment application on skin, 0.3-1.4% of the
      pyrene dose (about 2 micrograms pyrene/cm2) becomes systemically available. For
      the accurate estimation of PAH uptake through skin of workers, it seems relevant
      to distinguish different body regions, not only because of the regional variation
      in percutaneous PAH absorption, but also because of the high dispersal of PAH
      contamination on skin of workers.

PMID- 8478979
TI  - Effect of pyridine on the hepatic and pulmonary metabolism of 2-butanol in rat
      and rabbit.
AB  - Pyridine has been shown to be an effective inducer of the ethanol-inducible
      cytochrome P-450IIE1 in both liver and lung. The oxidation of 2-butanol by rat
      liver is inducible by chronic ethanol consumption. The purpose of this study was
      to determine the effect of pyridine on the hepatic and pulmonary metabolism of
      butanol. Comparisons were made between rat and rabbit. Acute pyridine treatment
      (200 mg/kg, ip) increased hepatic metabolism of 2-butanol in the rat twofold and
      in the rabbit threefold. The effect of pyridine on hepatic butanol oxidase is
      similar to the effect reported by other investigators for ethanol administered in
      the drinking water for 3 wk. Control rabbit pulmonary butanol oxidase activity
      was 10-fold higher than that in the rat. Pyridine decreased pulmonary butanol
      oxidase activity in the rabbit. The effect was demonstrated both in vitro and in
      the isolated perfused rabbit lung. Pyridine had no effect on pulmonary butanol
      oxidase activity in the rat.

PMID- 8478980
TI  - Recovery potential of hepatocytes from inhibition of albumin secretion by
      cadmium.
AB  - The aim of this study was to examine albumin production, a typical liver-specific
      function, in hepatocytes treated with Cd and to examine the reversibility of the
      perturbations induced by the toxic metal. Cultures of freshly isolated rat
      hepatocytes were exposed to increasing amounts of Cd in modified Leibowitz L-15
      medium for 20 h; the cells were then allowed to recover by further incubation in
      Cd-free medium for an additional period of 20 h. The levels of albumin secreted
      into the extracellular medium were determined by enzyme-linked immunosorbent
      assay and were found to be reduced by Cd in a concentration-dependent fashion
      over the first 20 h. Inhibition was seen at Cd concentrations that did not cause
      any loss of cellular viability (up to 0.5 microM Cd), as judged from the release
      of lactate dehydrogenase by the cells. After replacement of the exposure medium
      by Cd-free medium, the same pattern of diminished albumin secretion was obtained,
      revealing the persistence of the cytotoxic effects when recovery conditions were
      applied. Moreover, hepatocytes exposed to 0.5 microM Cd for 20 h and processed
      for visualization of albumin immunoreactive sites using protein A-gold and
      electron microscopy exhibited very low albumin-specific labeling as compared to
      the controls (0.6 +/- 0.05 vs. 20.0 +/- 2.6 gold particles/micron2).
      Intracellular glutathione levels were not significantly changed by Cd either
      after the initial exposure or after the incubation that followed in control
      medium. The accumulation of Cd by the cells, as measured by graphite furnace
      atomic absorption spectrophotometry, was concentration dependent. It remained
      stable after medium change, indicating that Cd efflux was negligible upon
      reestablishment of normal conditions. The present data show that the
      perturbations in albumin metabolism caused by Cd are not readily alleviated after
      the cells are returned to Cd-free medium, suggesting a limited short-term
      recovery potential against cytotoxic damage. The data also demonstrate that
      hepatocyte-specific functions can be used as sensitive indicators for the
      detection of cellular disturbances by hepatotoxins.

PMID- 8478981
TI  - Toxicological effects of ziram, thiram, and dithane M-45 assessed by sperm shape
      abnormalities in mice.
AB  - The three commonly used dithiocarbamate fungicides ziram, thiram, and dithane M
      45 were investigated for their mutagenic and carcinogenic potency using sperm
      shape abnormalities in mice. The fungicides were administered intraperitoneally
      in single and cumulative doses. All three of the fungicides tested were found to
      induce significant increase in the frequency of abnormal sperm at all the doses,
      and a linear dose effect was observed.

PMID- 8478982
TI  - Effects on thyroid hormone metabolism and depletion of lung vitamin A in rats by
      airborne particulate matter.
AB  - Thyroxine (T4) and vitamin A are important regulators of normal epithelial
      differentiation and proliferation and might act in the promotion phase of
      carcinogenesis. Thyroid hormone and vitamin A metabolism are linked by a common
      plasma carrier protein, transthyretin (TTR). Polychlorinated biphenyls (PCBs) and
      related organochlorine compounds deplete vitamin A and thyroxine by interaction
      with TTR and alteration of their metabolism in hepatic and other organs. In the
      present report an outdoor airborne particulate matter (APM) extract was tested
      for both interaction with thyroid hormone and vitamin A metabolism, in order to
      address the question of whether APM has the potency to deplete vitamin A and
      thyroid hormones. Furthermore, studies were performed to characterize compounds
      present in APM that interact with TTR. A third aim was to compare the interaction
      of APM extracts with TTR and thyroxine-binding globulin (TBG), the major carrier
      protein for thyroxine in humans. Results showed that a single treatment of rats
      with an outdoor APM extract depleted plasma thyroxine and triiodothyronine levels
      and increased plasma retinol levels gradually over the time period studied, while
      liver retinol, lung retinol, and retinyl palmitate levels were depleted by 30
      50%. As outdoor APM was able to inhibit T4-TTR binding in vitro, this suggests
      that the reduction in thyroxine levels in vivo is caused by the same phenomenon.
      Experiments showed that the neutral fraction of the APM extract accounted for
      most of the inhibitory activity on T4-TTR binding. Polycyclic aromatic
      hydrocarbons and nitrated derivatives are not likely to be responsible for the
      activity of the neutral fraction, because several representatives of these
      compounds showed no or very little interaction with TTR. Pentachlorophenol, a
      compound with known inhibitory activity on T4-TTR binding, was detected in the
      organic acid fraction of both a cigarette smoke sample and an outdoor APM sample.
      Finally, it was shown that several indoor and outdoor APM extracts only interact
      with TTR, but not with TBG. As APM has the potency to deplete lung vitamin A in
      vivo and vitamin A might have a protective effect in the process of lung
      carcinogenesis, APM might increase the susceptibility for the development of lung
      cancer.

PMID- 8478983
TI  - Airway inflammatory effect of hydrogen peroxide in guinea pigs.
AB  - Reactive oxygens are now considered to be important substances in promoting
      inflammatory process. Recently, airway inflammation has attracted attention
      closely linked to bronchial asthma. The present study was undertaken to examine
      whether hydrogen peroxide, one of the reactive oxygens, could produce airway
      inflammation. Airway inflammation was assessed by airway vascular permeability in
      terms of pontamine sky blue (PSB) exudation. Airway resistance was measured with
      a modified Konzett-Rossler method and was expressed as a change in ventilation
      overflow. Inhalation of hydrogen peroxide (0.01-1.0 M) markedly caused a PSB
      exudation in a concentration-dependent manner in all of the trachea, main
      bronchus, and lungs. The hydrogen peroxide-induced PSB exudation effect was
      attenuated was attenuated by pretreatment with catalase, although heat
      inactivated catalase had no inhibitory effect. Deferoxamine, which inhibits
      conversion of hydrogen peroxide into hydroxyl radical, decreased the PSB
      exudation induced by hydrogen peroxide. On the other hand, inhalation of hydrogen
      peroxide (1.0 M) caused a significant and biphasic increase in ventilation
      overflow. This airway constriction was suppressed by pretreatment with inhaled
      catalase, but not by inhaled deferoxamine. These results indicate that hydrogen
      peroxide causes an intense airway inflammation; this inflammatory effect may be
      mediated not only by hydrogen peroxide itself but also by hydroxyl radical.
      Hydrogen peroxide and hydroxyl radical may thus play an important role in
      bronchial asthma and bronchitis through inducing airway inflammation.

PMID- 8478984
TI  - Interferon-gamma inhibits DNA synthesis and insulin-like growth factor-II
      expression in human neuroblastoma cells.
AB  - Interferon-gamma (IFN-gamma) is known to be an antiproliferative, differentiating
      agent in many cell types, including neuroblastoma. In this study, we determined
      the effects of IFN-gamma on cellular growth and expression of insulin-like growth
      factor II (IGF-II) and IGF receptors in the human neuroblastoma cell line SH
      SY5Y. Incubation of SH-SY5Y cells in IFN-gamma (20-100 U/ml) induced the
      formation of long neuritic processes. IFN-gamma treatment also induced decreases
      in [3H]TdR incorporation, as well as serum-dependent changes in cell number.
      Treatment with IFN-gamma reduced cell number 33% in the presence of serum but had
      no effect on cell number in the absence of serum. IGF-II mRNA content was 60%
      inhibited by IFN-gamma, and was not serum dependent. The concentration of
      immunoreactive IGF-II in SH-SY5Y conditioned medium was also reduced in the
      presence of IFN-gamma, to less than half of control levels. In contrast, type I
      IGF receptor mRNA content was increased more than three-fold after treatment with
      IFN-gamma and serum. Co-incubation in IFN-gamma (20-100 U/ml) and IGF-II (3-10
      nM) prevented the inhibitory effects of IFN-gamma on [3H]TdR incorporation in
      serum-free media. Our results suggest that IFN-gamma may inhibit DNA synthesis
      and cell growth by interfering with an IGF-II/type I IGF receptor autocrine
      growth or survival mechanism.

PMID- 8478985
TI  - Basic fibroblast growth factor expression is required for clonogenic growth of
      human glioma cells.
AB  - Basic fibroblast growth factor (bFGF) is a heparin-binding protein, expressing
      potent mitogenic and angiogenic properties. Elevated levels of bFGF have been
      identified in human gliomas and glioma cell lines, suggesting that bFGF
      expression is involved in the aberrant growth patterns associated with these
      tumors. In the present study, the influence of bFGF on additional parameters of
      glioma cell malignancy was evaluated utilizing three distinct methods to suppress
      bFGF expression or activity including antisense oligonucleotide primers, a
      neutralizing monoclonal antibody or an inhibitor of the agonist action of bFGF:
      (1) The addition of 30 microM bFGF-specific antisense oligonucleotide primer to
      the human glioma cell line SNB-19 resulted in a 55% inhibition in colony
      formation in soft agar. This effect was dose-dependent and specific, as sense
      strand primer was ineffective in suppressing growth. In addition to exhibiting
      fewer colonies, antisense treatment significantly altered colony morphology. (2)
      SNB-19 cell growth in culture was suppressed in the presence of a neutralizing
      bFGF-specific monoclonal antibody. (3) Inositolhexakisphosphate, a newly
      identified antagonist of FGF binding and activity, suppressed SNB-19 cell growth
      in soft agar culture. These results demonstrate that bFGF may regulate glioma
      growth and progression independent of its role in tumor angiogenesis and that
      bFGF release or secretion may be required for these actions.

PMID- 8478986
TI  - Neuropeptide Y-producing neurons of the arcuate nucleus regenerate axons after
      surgical deafferentation of the mediobasal hypothalamus.
AB  - Dorsolateral and ventomedial surgical deafferentiation of the hypothalamus were
      used to study the capacity of different types of neuropeptide Y-containing axons
      afferent to the dorsal hypothalamus to regenerate through surgical lesions. The
      kinetics of the postlesional responses of transected neuropeptide Y-axons was
      studied on 30-40 microns thick vibratome sections, either (i) by light or
      electron microscopy after peroxidase immunostaining for neuropeptide Y or (ii) by
      confocal microscopy after double fluorescence immunostaining for neuropeptide Y
      and for glial fibrillary acidic protein. The dorsolateral cut was found to sever
      2 main pathways containing neuropeptide Y axons located, respectively, below the
      bed nucleus of the stria terminalis and in the perifornical region. In both
      regions transected fibers were found to abut onto the surgical lesion, but even
      45 days after the lesion, they were very rarely observed to penetrate into the
      astroglial scar forming along the lesion. The ventromedial cut was found to sever
      numerous neuropeptide axons that originate in the underlying arcuate nucleus.
      Seven to 15 days after the lesion neuropeptide Y fibers located below this type
      of cut presented a dramatic increase in both their numerical density and their
      immunostaining intensity. With increasing post-surgery times, an increased number
      of neuropeptide Y fibers was observed to penetrate and to cross the lesional scar
      formed by densely packed astrocytic processes. Electron microscope observations
      further demonstrated that 45 days after the lesion, numerous neuropeptide Y
      immunoreactive axonal profiles were included in the scar matrix, which appeared
      to be mainly composed of closely interdigitating astrocytic processes containing
      dense bundles of filaments. These data indicate that, in contrast to other
      neuropeptide Y neurons innervating the dorsal hypothalamus, neuropeptide Y
      neurons of the arcuate nucleus regenerate axons through the astroglial scar
      produced by a surgical lesion placed in the ventromedial hypothalamus.

PMID- 8478987
TI  - Reactive astrocytes involved in the formation of lesional scars differ in the
      mediobasal hypothalamus and in other forebrain regions.
AB  - The fine organization of lesional scars was studied in adult rats at the level of
      2 types of surgical cuts aimed at deafferentating the dorsal hypothalamus from
      its neuropeptide-Y innervation. These included: (i) lesions located dorsolateral
      to the dorsal hypothalamus, which were shown to form a permanent obstacle to the
      regeneration of transected neuropeptide-Y-fibers, and (ii) lesions located in the
      ventromedial hypothalamus, where transected neuropeptide-Y-fibers were shown to
      penetrate and eventually cross the lesional area. Double labeling
      immunocytochemistry and conventional electron microscopy were used to identify
      various molecules produced by reactive astrocytes and to visualize their
      ultrastructural organization within the scars, respectively. In the different
      portions of the dorsolateral scars, the large majority of reactive astrocytes was
      characterized by a strong immunoreactivity to glial fibrillary acidic protein,
      vimentin, and embryonic (polysialylated) NCAM. Intense laminin-immunoreactivity
      was also observed over large patches included in the scar. Electron microscope
      observations further indicated that the matrix of the scar was mainly composed of
      tightly packed astrocytic perikarya and processes connected by extended gap
      junctions. All around the extracellular and perivascular spaces, these astrocyte
      profiles were bordered by a thick basal lamina. Only scarce axonal profiles were
      detected in the core of the scar, most of which exhibited degenerative features.
      In the ventromedial hypothalamic scars, reactive astrocytes were found to exhibit
      intense immunoreactivity to both glial fibrillary acidic protein and vimentin. On
      the other hand, only slight immunostaining to embryonic NCAM and laminin were
      associated with this type of lesional scar. At the ultrastructural level, the
      main differences with the dorsolateral scars concerned (i) the gap junctions,
      which were less frequent and involved shorter portions of adjacent membranes;
      (ii) the basal lamina, which was essentially localized to the perivascular
      spaces; and (iii) the axonal profiles, which were frequently observed throughout
      the scar matrix. These data indicate that reactive astrocytes that formed the
      glial scar differ in the mediobasal hypothalamus and in other forebrain regions.
      This provides strong support for the hypothesis that the regeneration of
      neuropeptide-Y axons through a mediobasal hypothalamic surgical cut depends
      mainly on the particular organization of the astroglial scar.

PMID- 8478988
TI  - Interleukin-4 and -5 as modulators of nerve growth factor synthesis/secretion in
      astrocytes.
AB  - To examine the regulation of nerve growth factor (NGF) gene expression with
      respect to neural trauma, we examined the effects of T cell-derived lymphokines
      on NGF synthesis/secretion in cultured mouse astrocytes. Interleukin (IL)-4 and
      IL-5 significantly increased the amount of NGF secreted by astrocytes, whereas IL
      2, IL-3, and IL-6 had no significant effect. IL-4 and IL-5 produced marked
      increases in NGF mRNA levels in astrocytes as demonstrated by the reverse
      transcription-polymerase chain reaction (RT-PCR) method. The effect of IL-4 and
      IL-5 was greater in quiescent astrocytes than in growing cells. Neither increase
      in thymidine incorporation nor any morphological change was observed during the
      treatment with IL-4 and IL-5. The stimulatory effect of IL-4 and IL-5 on NGF
      synthesis was completely inhibited by the addition of anti-IL-4 monoclonal
      antibody and anti-IL-5 monoclonal antibody, respectively. The results indicate
      that IL-4 and IL-5 specifically trigger a cascade of events to regulate NGF
      synthesis in astrocytes, independent of cell growth.

PMID- 8478989
TI  - Blockage of nicotinic acetylcholine receptors by 5-hydroxytryptamine.
AB  - The action of 5-hydroxytryptamine (5HT) on nicotinic acetylcholine receptor
      (nAChR) channels was investigated in mouse myotubes, human cloned TE671/RD cells,
      and Xenopus laevis oocytes. The decay of the ACh-activated whole-cell currents
      was reversibly accelerated in the presence of 5HT (10(-5) to 10(-3) M), in a dose
      dependent manner. 5HT also reduced the size and accelerated the decay of currents
      elicited by ACh in Xenopus oocytes injected with mRNA extracted from C2 myotubes
      or Torpedo electroplaques, or oocytes injected with cloned mouse muscle AChR
      subunit mRNAs. The effect of 5HT was promptly reversed after washout, or by
      depolarizing the oocyte beyond -10 mV. In patch-clamp recordings from myotubes,
      bath-application of 5HT did not exert an indirect influence on the ACh-activated
      channels within the patch membrane. In contrast, when the patch membrane was
      exposed to 5HT (10(-6) M), ACh unit responses appeared as bursts of short pulses.
      It is concluded that the regulation of ACh responses by 5HT results from a fast
      noncompetitive blocking action of nAChR-channels. These results show that ligand
      gated channels, activated by their specific neurotransmitter, may be regulated by
      a different neurotransmitter through a direct action on the receptor molecule.

PMID- 8478990
TI  - Rat cerebral cortical neurons in primary culture release a mitogen specific for
      early (GD3+/04-) oligodendroglial progenitors.
AB  - The development of cells of the oligodendroglial lineage, from immature
      progenitor to myelinating cells, occurs largely in a neuronal environment, yet
      little is known about specific interactions between these 2 cell types. We have
      tested the effects of medium conditioned by cultures of rat cerebral cortical
      neurons (CCM), cerebellar granule interneurons (GCM), and a dorsal root ganglion
      derived cell line (NDCM) on cells of the oligodendroglial lineage in culture.
      Different stages of the lineage were defined using the cell surface antigens GD3,
      04, and GalC. CCM and NDCM were mitogenic for the early GD3+/04- oligodendroglial
      progenitor, whereas GCM was mitogenic for the later GD3+/04+ stage. Neutralising
      antibodies to PDGF and bFGF were able to eliminate the mitogenic activity of NDCM
      and GCM, respectively, but did not abolish the mitogenic effect of CCM. We have
      demonstrated that neurons in primary culture from distinct CNS regions exert
      different influences on cells of the oligodendroglial lineage, and specifically
      that cortical neurons release an unknown mitogen for GD3+/04- oligodendroglial
      progenitors.

PMID- 8478991
TI  - The acute haemodynamic effects of captopril in dogs with heart failure.
AB  - The acute effects of three doses of captopril (12.5, 25, and 50 mg [approximately
      0.5, 1.0, and 2.0 mg/kg]) on several haemodynamic variables and plasma
      aldosterone concentration were investigated in four dogs with experimentally
      produced heart failure (rapid ventricular pacing) and one dog with dilated
      cardiomyopathy. Haemodynamic variables were measured with a Swan-Ganz
      thermodilution catheter and an indwelling carotid artery catheter at baseline and
      1, 2, and 4 h after drug administration. A statistically significant (P < 0.05)
      decrease in peripheral vascular resistance was observed 1 and 2 h following the
      12.5 mg dose. A significant and large enough decrease in peripheral vascular
      resistance to produce a significant decrease in mean systemic arterial blood
      pressure was observed 1 and 2 h after administering 25 and 50 mg of captopril. A
      mild but significant increase in cardiac output was observed 1 h after each dose.
      The drug effect on systemic arterial blood pressure lasted less than 4 h. No
      statistically significant changes were observed for the group in pulmonary
      capillary wedge pressure, right atrial blood pressure, or plasma aldosterone
      concentration at any time. We conclude that the acute haemodynamic benefits
      provided by captopril administration were mild and due primarily to arteriolar
      dilation. Doses of approximately 1-2 mg/kg produced slightly greater arteriolar
      dilation than an approximate dose of 0.5 mg/kg. The drug effect was short-lived,
      lasting less than 4 h.

PMID- 8478992
TI  - Theophylline kinetics in dog neonates.

PMID- 8478993
TI  - Compared N-demethylation of veterinary drugs by microsomes from normal and fluke
      infected sheep livers.

PMID- 8478994
TI  - Pharmacokinetics of sulphadiazine and trimethoprim in carp (Cyprinus carpio L.)
      acclimated at two different temperatures.

PMID- 8478995
TI  - Effect of intra-ovarian 6-hydroxydopamine on progesterone secretion in sheep.

PMID- 8478996
TI  - Lack of arrhythmogenicity of aminophylline in dogs.
AB  - This study was designed to determine if doses of aminophylline up to 10 mg/kg
      given i.v. would produce ventricular arrhythmias in seven healthy dogs
      anaesthetized with fentanyl-droperidol-pentobarbital. Arrhythmias were sought by
      inspection of ECGs before and after attempts at provoking them with 5
      micrograms/kg boluses of epinephrine given i.v., or by programmed electrical
      stimulation. After cumulative doses of 10 mg aminophylline/kg body weight,
      producing an estimated plasma concentration of greater than 30 micrograms/ml, no
      ventricular ectopia other than escape depolarizations were observed. We were
      unable to document an arrhythmogenic effect of aminophylline when given rapidly
      by the i.v. route. It is possible that the anaesthetic regimen reduced the
      arrhythmogenic property of aminophylline, or that arrhythmias might be produced
      in either obese or ill dogs; but it is unlikely that chronic administration of
      aminophylline would be more arrhythmogenic.

PMID- 8478997
TI  - Pharmacokinetic disposition of intravenous and oral pentoxifylline in horses.
AB  - The pharmacokinetics of pentoxifylline (P) and its alcohol metabolite I (MI) were
      determined after administration of intravenous pentoxifylline, sustained release
      pentoxifylline tablets (Trental), and crushed pentoxifylline tablets in corn
      syrup, to five healthy adult horses. Pharmacokinetics were evaluated in a model
      independent manner. After intravenous administration, pentoxifylline was rapidly
      eliminated (mean residence time 1.09 +/- 0.67 h), had a large steady-state volume
      of distribution (2.81 +/- 1.16 l/kg), and high clearance (3.06 +/- 1.05 l/kg/h).
      Oral absorption of pentoxifylline from both dose forms varied considerably
      between individuals. Times to peak concentration ranged from 1-10 h for either
      dose form. There was no difference in relative bioavailability (F') between whole
      (0.98 +/- 0.30) and crushed Trental tablets. Ratios between areas under the curve
      (AUC) for pentoxifylline and MI were different following administration of oral
      versus intravenous doses. This finding suggests that route of administration may
      affect the metabolic profile of pentoxifylline. Given the extreme differences in
      absorption characteristics between individuals in this study, recommendations are
      not made as to appropriate dose, dose interval, or dose form for administration
      of pentoxifylline to horses.

PMID- 8478998
TI  - Nicarbazin stimulates intestinal transport of L-leucine in rabbit.
AB  - Nicarbazin is an anticoccidial drug used mainly in birds, but also in rabbits.
      Besides the anticoccidial activity, nicarbazin has shown several other effects
      such as inhibition of growth and feed efficiency in poultries, and stimulation of
      sugar intestinal absorption in rabbits. The present work has been performed in
      order to check whether nicarbazin also affects L-leucine intestinal absorption.
      The results obtained show that nicarbazin decreases L-leucine accumulation in the
      jejunal tissue, and increases mucosal to serosal transepithelial fluxes of this
      amino acid in a dose-dependent way, without modifying its diffusion across the
      intestinal epithelium. The drug stimulates the amino acid uptake in brush-border
      and basolateral membrane vesicles, thus suggesting that nicarbazin increases the
      absorption of L-leucine mediated by carriers.

PMID- 8478999
TI  - Gastrointestinal distribution of albendazole metabolites following netobimin
      administration to cattle: relationship with plasma disposition kinetics.
AB  - The gastrointestinal (GI) distribution and plasma disposition kinetics of
      albendazole (ABZ) metabolites after oral administration of netobimin (NTB) to
      cattle were studied. Eight Holstein steers (150-180 kg) were surgically fitted
      with permanent cannulae in the rumen, abomasum and ileum. After post-surgical
      recovery, the animals were treated orally with a suspension of netobimin
      zwitterion (400 mg/ml) at 20 mg/kg. Jugular blood and ruminal, abomasal and ileal
      fluid samples were taken serially over a 96 h period and analysed by HPLC for NTB
      and its metabolites, including ABZ, ABZ sulphoxide (ABZSO), ABZ sulphone (ABZSO2)
      and amino-albendazole sulphone (NH2ABZSO2). NTB parent drug was only found in the
      GI tract and for only 12-18 h post-treatment. ABZSO and ABZSO2 were the main
      metabolites found in plasma, being present for 30-36 h. These metabolites were
      exchanged between plasma and different GI fluids and were greatly concentrated in
      the abomasum. This phenomenon may account for the presence of ABZ, ABZSO and
      ABZSO2 in the GI tract for 72 h post-treatment despite the fact that ABZ was not
      detected in plasma and ABZSO and ABZSO2 were detected for only 30-36 h in plasma.
      The presence of ABZ and ABZSO in the abomasum and intestine for this extended
      period of time is probably relevant for anthelmintic efficacy against GI
      parasites. The NH2 ABZSO2 metabolite was detected in plasma, abomasum and ileum
      and its disposition kinetics were characterized for the first time.

PMID- 8479000
TI  - Effects of dietary variations on plasma concentrations of oral flukicides in
      sheep.
AB  - Groups of parasite-free lambs which were either housed and fed hay and
      concentrates or were grazing on pasture were dosed with the oral flukicides
      rafoxanide and triclabendazole and subsequent plasma concentrations monitored.
      Peak plasma concentrations and areas under curves (AUC) of both chemicals were
      significantly reduced in the grazing compared with the housed lambs. In order to
      investigate the observation similar groups of lambs were dosed orally with
      chromium EDTA and faecal throughput estimated. It was observed that the rate of
      throughput was greater in the grazing lambs, leading to the conclusion that the
      differences in plasma concentrations of the flukicides was caused by a reduction
      in their absorption in the grazing lambs. The implications on flukicide efficacy
      and dose rates are discussed.

PMID- 8479001
TI  - Hormonal regulation of oxidative drug metabolism in the dwarf goat. The effect of
      sex and hormonal treatment on plasma disposition and metabolite formation of
      sulphadimidine.
AB  - Sulphadimidine (20 mg/kg i.v.) plasma elimination and metabolite formation were
      studied in intact male, castrated male, and female dwarf goats. Plasma
      pharmacokinetics and urinary metabolite patterns were first studied in untreated
      animals. Afterward, females and castrated were treated with a combination of
      testosterone-propionate (1 mg/kg) and 17 beta-oestradiol-benzoate (0.02 mg/kg)
      once every 3 days, for a period of 4 weeks. In untreated animals, males showed a
      considerably lower plasma clearance than females or castrates. This was
      accompanied by lower partial clearances for the production of two hydroxylated
      sulphadimidine metabolites. After hormonal treatment of females and castrates,
      sulphadimidine plasma clearance was significantly reduced, to values
      corresponding with those observed in control males. Furthermore, hydroxylation
      was significantly inhibited after treatment. The results indicate that
      sulphadimidine hydroxylation in the goat is performed by enzymes of the
      cytochrome P450 complex which are strongly influenced by gonadal hormones.
      Androgens seem to play a central role in this respect.

PMID- 8479002
TI  - Pharmacokinetics and applications of ampicillin sodium as an intravenous infusion
      in the horse.
AB  - A regime for administration of ampicillin sodium by continuous intravenous
      infusions to horses was designed. The aim was to achieve plasma ampicillin
      concentrations between 5 and 10 micrograms/ml over a 4-h period. A 2 mg/kg
      bodyweight loading dose of ampicillin sodium was administered intravenously at
      the beginning of the infusion in order to achieve steady-state plasma
      concentrations rapidly. The infusion system subsequently administered ampicillin
      at a rate of approximately 19.2 micrograms/min/kg bodyweight. The plasma
      concentrations obtained over the infusion period correlated very well with
      predicted calculations based on pharmacokinetic parameters. A mean +/- SEM steady
      state plasma concentration (Cpss) of 5.94 +/- 0.33 was obtained and ampicillin
      was shown to have an apparent steady-state volume of distribution (Vdss) of
      175.43 +/- 13.63 ml/kg. When the pump was disconnected the concentrations
      declined over the following 4 h in an exponential way with an elimination half
      life (t1/2 beta) of 0.62 h. In addition, three different infusion dose rates
      (13.78, 19.34 and 24.48 micrograms/min/kg) were administered to a single animal
      showing that a good correlation (correlation coefficient > 0.99) existed between
      the dose administered the steady-state plasma concentrations and the
      corresponding areas under the plasma concentration versus time curve.

PMID- 8479003
TI  - Plasma ronidazole concentrations in sheep after intravenous, oral, intraruminal
      and intraabomasal administration.
AB  - Plasma ronidazole concentrations were examined after intravenous (i.v.) and oral
      administration of ronidazole in sheep (n = 6) at a dosage of 5 mg/kg body weight.
      In three sheep a ruminal and an abomasal fistula were inserted. The ronidazole
      determinations were performed by an HPLC method. Oral bioavailability in the
      fistulated sheep was only 5.5 +/- 1.8% (mean +/- SE). Somewhat lower values (4.6
      +/- 1.4%) were obtained when the drug was administered through the ruminal
      fistula in the rumen. After administration of the same dose directly in the
      abomasum through the intraabomasal fistula, bioavailability was increased to 86.0
      +/- 8.9%. In the non-fistulated sheep, oral biodisponibility was 2.6 +/- 0.5%.
      After water was restricted for 48 h before the oral ronidazole administration to
      these sheep, bioavailability was slightly increased (6.0 +/- 3.1%). When
      desmopressin acetate was injected i.v. before the oral ronidazole administration,
      bioavailability was 10.6 +/- 6.5%. When glypressin, another vasopressin analogue,
      was used, oral bioavailability was not influenced: 2.4 +/- 1.3%. Ronidazole was
      also incubated with ruminal contents and the ronidazole concentration decreased
      with a first order rate constant of 0.122 +/- 0.050 min-1 (mean +/- SE). These
      results suggest that oral administration of ronidazole to sheep is of little
      therapeutic use, because most is metabolised by the ruminal micro-organisms
      before it can reach the circulation. A second conclusion we can make is that it
      is very difficult, if not impossible, at least with the methods used, to
      influence gastro-intestinal motility in sheep to get a reproducible closure of
      the oesophageal groove.

PMID- 8479004
TI  - Lidocaine decay and hepatic extraction in the pig.
AB  - Plasma lidocaine decay after injection was studied in five anaesthetized pigs and
      fitted to a two compartment open model. Derived pharmacokinetic parameters were
      employed to rapidly achieve plateau concentrations within 60 min of starting a
      two stage infusion of lidocaine hydrochloride. Hepatic extraction and clearance
      of lidocaine at steady state were determined in 10 pigs by transhepatic sampling
      and measurement of hepatic arterial and portal venous blood flow using
      perivascular ultrasonic flow probes placed at laparotomy. These data were
      compared with similar studies performed in man as well as the sheep, dog, monkey
      and cat. The lidocaine extraction ratio of 0.60 in the pig was found to be
      similar to that determined by others in man.

PMID- 8479005
TI  - Pharmacodynamics, pharmacokinetics and faecal persistence of morantel in cattle
      and goats.
AB  - Morantel could not be detected (< 0.05 microgram/ml) in the plasma of cattle or
      goats following the oral administration of morantel tartrate at a dose rate of 10
      mg/kg bodyweight. No morantel was detected in the milk of lactating goats except
      in one animal where a concentration of 0.092 microgram/ml was detected at 8 h
      after drug administration. Morantel was highly effective against Cooperia
      oncophora infections in calves treated 6, 9 or 18 days after infection; however,
      was highly effective against Ostertagia ostertagi only when treated 18 days after
      infection. Morantel did not affect the fecundity of adult O. ostertagi surviving
      treatment 18 days after infection which had similar average numbers of eggs in
      their uteri (range 13.4 +/- 0.73-16.8 +/- 0.98) as did parasites from control
      animals (range 12.0 +/- 0.70-13.6 +/- 0.66). Morantel could be detected at a
      concentration of 96 +/- 4.5 micrograms/g (dry weight) in the faeces of a calf 24
      h after treatment with 10 mg/kg bodyweight of morantel tartrate. The
      concentration of morantel in replicate samples of this faeces exposed to natural
      atmosphere, but not to soil or soil organisms, declined slowly over the following
      322 days. At day 322 after the start of the experiment 8.8 micrograms/g of
      morantel could be measured in the remaining faecal material. Throughout the
      faecal degradation study the concentration of morantel in the crusts of the
      replicate sample pats was lower than the concentration in the core samples.

PMID- 8479007
TI  - Special issue: impotence and infertility.

PMID- 8479008
TI  - Venous impotence: pathophysiology, diagnosis and treatment.

PMID- 8479006
TI  - Urinary excretion of metals during treatment with D-penicillamine and 2
      mercaptopropionylglycine in normal and cystinuric dogs.
AB  - Urinary excretion of metals during treatment with 2-mercaptopropionylglycine (2
      MPG) was studied in 11 normal and 20 cystinuric male dogs. The results were
      compared with those obtained during D-penicillamine treatment. Twenty-four-h
      urine and morning samples of urine were taken for determination of 13 metals
      before and during treatment. After single intravenous and oral D-penicillamine
      treatment of the normal dogs, significant increases were found in the 24-h
      urinary excretion of Ca, Cu and Zn. Oral intake of D-penicillamine increased the
      excretion of Co, Cr, Fe and Mg as well. No effect on renal metal excretion was
      observed after single intravenous and up to 2 months of daily oral treatment with
      2-MPG. In 14 cystinuric dogs no effect was found after single intravenous and
      oral administrations of 2-MPG. However, after oral treatment of six cystinuric
      dogs with 2-MPG for 2-4 months, significantly increased excretions of Ca and Mg
      were found. Fourteen of the cystinuric dogs were also investigated after 2-6
      years of continuous 2-MPG treatment, and after this period no significant
      elevation in the urinary excretion of metals was found. The present study shows
      that in contrast to D-penicillamine, 2-MPG does not increase the urinary
      excretion of metals to any appreciable extent. Observed increases in the
      excretion of Ca and Mg seemed to be a temporary effect only.

PMID- 8479009
TI  - Diagnosis and treatment of psychogenic erectile dysfunction in a urological
      setting: outcomes of 18 consecutive patients.
AB  - The diagnostic criteria and treatment outcomes of 18 consecutive patients with
      psychogenic erectile dysfunction were examined. Average patient age was 38 years,
      and all patients had either awakening penile or masturbatory rigidity. Each
      patient was studied with home monitoring (ART-1000) on 2 consecutive nights. The
      average number of maximum erectile episodes, the event during which the maximum
      rigidity was maintained for at least 5 minutes, was 1.6. The maximum sleep
      erectile episodes averaged 11.2 minutes during which penile rigidity averaged 572
      gm. The main predictor for remission of erectile dysfunction in this study was
      whether the dysfunction was primary or secondary. Of 14 patients with secondary
      psychogenic erectile dysfunction, that is history of being able to achieve and
      maintain penile rigidity sufficient for at least 5 minutes of vaginal
      intercourse, 10 (71%) experienced remission. Three patients noticed spontaneous
      remission during the initial evaluation and another 3 experienced remission
      within 3 months of completion of the evaluation and reassurance that they had
      normal erectile capacity. Two patients had remission while considering penile
      vascular surgery and in 2 normal erectile function returned during injection
      therapy. Only 2 of 3 patients referred for sex therapy actually received it
      (Freudian theory), and neither noticed improvement in erectile function. One
      patient received yohimbine without benefit. None of the patients elected
      treatment with the vacuum constriction device. All 4 patients with primary
      psychogenic erectile dysfunction, that is never able to achieve and/or maintain
      penile rigidity sufficient to achieve vaginal intercourse, failed to respond to
      physician reassurance and time. Of 2 patients who received sex therapy (1
      Freudian and 1 behavioral) without improvement in erectile function 1 has entered
      the pharmacological erection program and has achieved vaginal penetration, and
      the other is considering the pharmacological erection program. The remaining 2
      patients have deferred all therapy. Based on this experience, we currently
      reassure patients with secondary psychogenic erectile dysfunction that they have
      erectile capacity for sustained vaginal intercourse and schedule a followup visit
      in 3 months. Additional individualized therapy (pharmacological erection program,
      vacuum constriction device, sensate focus/psychodynamic specific therapy or
      penile prosthesis) is offered as needed and requested. Patients with primary
      psychogenic erectile dysfunction are initially offered the pharmacological
      erection program or the vacuum constriction device and sex sensate
      focus/psychodynamic specific therapy. The penile prosthesis is considered for
      treatment failures.

PMID- 8479010
TI  - Evaluation of penile deep arteries in psychogenic impotence by means of duplex
      ultrasonography.
AB  - Echo Doppler flowmetric investigation in patients with erectile insufficiency
      represents an effective method for hemodynamic evaluation of the penis. The
      detection of referential standard parameters is helpful to understand the
      pathogenesis of the disease, since patients with erectile insufficiency due to
      psychogenic factors cannot be distinguished from normal subjects by means of
      current diagnostic techniques. Echo Doppler flowmetry applied to rigorously
      selected subjects with psychogenic impotence allowed for detection of hemodynamic
      parameters in the penis after corpora cavernosa stimulation with 10 micrograms.
      prostaglandin E1. Flowmetric investigation was performed only on the deep
      cavernous artery, since it is well known that the penile dorsal artery does not
      undergo hemodynamic alterations after stimulation with drugs. A statistically
      meaningful difference existed between the systolic flow in the psychogenic
      impotence subjects (group 1) and the controls (group 2, p < 0.0001). In the same
      manner, the diastolic flows (right and left cavernous arteries, p < 0.0002 and p
      < 0.0001, respectively) and diameter increase rates of the investigated arteries
      following stimulation were also different. According to these results, echo
      Doppler flowmetry could represent the only instrumental method able to detect
      patients with psychogenic impotence.

PMID- 8479011
TI  - Comparison of RigiScan and formal nocturnal penile tumescence testing in the
      evaluation of erectile rigidity.
AB  - Evaluation of male erectile function ideally should include measurement of axial
      rigidity expressed as grams force required to produce penile buckling. An axial
      rigidity more than 550 gm. is generally considered adequate for vaginal
      penetration. Unfortunately, this test cannot be done frequently and may disrupt
      sleep. An alternative method of determining rigidity is to use the RigiScan,*
      which makes repetitive measurements of radial rigidity at the base and tip of the
      penis expressed as per cent of normal maximum. Previous studies have demonstrated
      a positive correlation between axial and radial rigidity measurements but they
      have not been compared in patients with a wide range of erectile function. We
      performed a prospective study in a consecutive series of patients presenting with
      impotence comparing axial rigidity measured with a tonometer and radial rigidity
      measured by RigiScan. Erectile rigidity also was evaluated by a trained, blinded
      observer. Overall, RigiScan base and tip radial rigidity correlated well with
      axial rigidity (p < 0.002) and observer ratings (p < 0.003); axial rigidity
      similarly correlated well with observer ratings (p < 0.0001). However, when
      RigiScan base and tip radial rigidity exceeded 60% of maximum, there was a poor
      correlation with axial rigidity and observer ratings (p > 0.1). In this range,
      the RigiScan failed to discriminate axial rigidities between 450 and 900 gm.
      buckling force; however, axial rigidity in this same range again correlated well
      with observer ratings (p < 0.0001). Since an axial rigidity of more than 550 gm.
      is considered adequate for vaginal penetration, the RigiScan may not be able to
      detect mild abnormalities in erectile function. Further study is in progress to
      evaluate the significance of these findings but presently a RigiScan measurement
      of radial rigidity in excess of 60% of maximum should be interpreted cautiously
      and not necessarily regarded as normal. In this range further measurements of
      axial rigidity or observer ratings of rigidity may be necessary to establish the
      diagnosis.

PMID- 8479012
TI  - Predictive value of real-time RigiScan monitoring for the etiology of organogenic
      impotence.
AB  - We performed routine diagnostic evaluations in 160 consecutive patients from our
      impotence clinic. After the diagnostic studies were completed, the results of
      RigiScan* monitoring during visual sexual stimulation before and after
      intracavernous injection of vasoactive drugs were compared to the results of
      standardized pharmacological testing, single potential analysis of cavernous
      electrical activity and pharmacocavernosometry. The results suggest RigiScan
      monitoring to be a highly accurate method to evaluate and document objectively
      the erectile response after intracavernous injection of vasoactive drugs.
      Although pathological monitoring after intracavernous injection is significantly
      associated with pathological findings in the specific evaluation, the predictive
      value of RigiScan monitoring for specific organogenic etiologies is not
      satisfactory, since normal monitoring showed no convincing correlation to single
      potential analysis of cavernous electrical activity or cavernosometry.

PMID- 8479013
TI  - Posttraumatic impotence: magnetic resonance imaging and duplex ultrasound in
      diagnosis and management.
AB  - In 15 patients, impotent as a result of prostatomembranous urethral disruption
      consequent to pelvic crush injuries, magnetic resonance imaging (MRI) and duplex
      ultrasound were used to establish anatomical and pathophysiological criteria for
      accurate diagnosis and appropriate management. All patients were initially
      treated by suprapubic cystostomy diversion for at least 3 months, after which
      urethral reconstruction was performed. All men were potent before the pelvic
      trauma, with loss of sexual function immediately thereafter. Preoperative MRI
      demonstrated prostatic displacement in 13 cases (86.7%) and cavernous injury in
      12 (80%). Duplex ultrasound revealed the cause of erectile failure as
      vasculogenic in 12 patients (80%) and neurogenic in 3 (20%). Treatment of
      impotence was deferred for at least 18 months after injury. Of the neurogenic
      group 2 patients were started on intracavernous injection therapy and 1 refused
      treatment. Of the vasculogenic group 3 patients underwent successful
      revascularization, 2 are on injection therapy and 1 had a penile prosthesis
      inserted. The detailed anatomical information obtainable with pelvic MRI and the
      functional data provided by duplex ultrasonography enabled us to identify the
      individual organic components of posttraumatic impotence and to select effective
      cause-specific therapy.

PMID- 8479014
TI  - Evaluation of vasculogenic impotence by monitoring of cavernous oxygen tension.
AB  - Color coded duplex sonography, regarded as the gold standard in penile vascular
      evaluation, does not yield data on cavernous oxygenation itself. In addition to
      using color coded duplex sonography to measure peak flow velocity in cavernous
      arteries after injection of 20 micrograms. prostaglandin E1 in 34 unselected
      patients with impotence, we monitored cavernous oxygen tension with oxygen
      sensitive Eppendorf needle electrode. During flaccidity the mean cavernous oxygen
      tension of 38 mm. Hg increased to 61 mm. Hg after injection of prostaglandin E1.
      Peak flow shown with color coded duplex sonography and maximal oxygen tension
      correlated well in 24 men (71%). However, in 10 men (29%) normal peak flow did
      not result in a cavernous oxygen tension of greater than 65 mm. Hg, so this might
      have been isolated cavernous perfusion defects. In contrast, there was no case of
      impaired arterial inflow and high oxygen tension. Monitoring of cavernous oxygen
      tension allows for characterization of patients with cavernous perfusion
      deficiency. This new and simple diagnostic method might help to improve diagnosis
      and followup after penile vascular surgery. However, more data on patients and
      controls will be required to define normal ranges.

PMID- 8479016
TI  - Impotence evaluation.

PMID- 8479015
TI  - Prostaglandin E1 and the nitric oxide donor linsidomine for erectile failure: a
      diagnostic comparative study of 40 patients.
AB  - A total of 40 patients (average age 55.9 years, range 23 to 78 years) with
      erectile failure was enrolled in a study to compare 1 mg. of the nitric oxide
      donor linsidomine to 20 micrograms prostaglandin E1 administered for diagnostic
      purposes. Prostaglandin E1 was considered comparable to linsidomine by 10% of the
      patients, slightly superior by 15%, moderately superior by 20% and much superior
      by 55%. No patient rated linsidomine superior to prostaglandin E1. Objective
      evaluation of erectile response to linsidomine versus prostaglandin E1 by the
      investigator revealed no response in 7.5% versus 0% of the cases, tumescence in
      57.5% versus 17.5%, semirigid erection in 22.5% versus 17.5% and full erection in
      12.5% versus 65%, respectively. Duplex sonography after linsidomine and
      prostaglandin E1 with evaluation of peak flow velocities (centimeters per second)
      showed that the increase in peak flow velocity after linsidomine was at least a
      third less than the increase after prostaglandin E1. The appearance after
      linsidomine often resembled arterial insufficiency, whereas after prostaglandin
      E1 there was no evidence of arterial insufficiency. The erectile and hemodynamic
      response to the nitric oxide donor linsidomine was modest compared to that of
      prostaglandin E1. Therefore, linsidomine is not a genuine alternative to
      prostaglandin E1 for the diagnosis and treatment of male impotence.

PMID- 8479017
TI  - The negative pressure device for erectile disorders: when does it fail?
AB  - Of 74 men with erectile dysfunction who used a vacuum device at home only 20 were
      satisfied with the erections achieved. The device was offered only to men who had
      not been helped by sexual counseling, self-injection therapy or venous surgery,
      and to 8 patients who had had problems with a penile implant. Fibrosis reduces
      the chances of success with the vacuum device, and only 2 of 14 such patients
      used it successfully. In all 9 patients with psychogenic impotence the device
      failed. Although 9 men did achieve erections with the device, they disliked it so
      much that they did not begin regular use. Our disappointing overall result was
      probably due to negative patient selection.

PMID- 8479019
TI  - Followup results of a combination of calcitonin gene-related peptide and
      prostaglandin E1 in the treatment of erectile dysfunction.
AB  - Recent human and animal studies have shown a possible role for calcitonin gene
      related peptide in penile erection and a therapeutic benefit in combination with
      prostaglandin E1 for autoinjection therapy. The ethical committee approved
      calcitonin gene-related peptide-prostaglandin E1 combination for cases of
      nonresponse or cavernous fibrosis to papaverine-phentolamine. Since June 1990, 65
      patients (59 nonresponders and 6 with fibrosis) were injected with 5 micrograms.
      calcitonin gene-related peptide plus 10 micrograms. prostaglandin E1. Of the 59
      nonresponders to papaverine-phentolamine 31 and of the 6 patients with fibrosis 5
      had full erectile response. Of these 36 patients 2 experienced pain during the
      pharmacologically induced erection. A total of 39 patients who had had at least
      20 autoinjections of calcitonin gene-related peptide plus prostaglandin E1 was
      available for minimum followup. There were no side effects, such as pain (the 2
      patients with pain mentioned previously were not included in the autoinjection
      therapy group), systemic side effects or (increased) fibrosis. Our results show
      that a combination of calcitonin gene-related peptide and prostaglandin E1 may be
      beneficial to the treatment of impotence in carefully selected patients.

PMID- 8479018
TI  - Intracavernous pharmacotherapy for impotence: selection of appropriate agent and
      dose.
AB  - We performed a retrospective analysis of 101 impotent patients using
      intracavernous self-injections as primary therapy for vasculogenic impotence. A
      total of 70 patients used an average of 5.58 micrograms prostaglandin E1 (95%
      confidence interval 4.83 to 6.34 micrograms) as a single agent, and 31 injected
      0.40 ml. (95% confidence interval 0.342 to 0.457 ml.) of a combination of
      papaverine (12 mg./ml.), phentolamine (1 mg./ml.) and prostaglandin E1 (9
      micrograms/ml.). We describe the procedure to establish the dosage for home use
      and discuss the implications of the low dosages relative to previous reports.

PMID- 8479020
TI  - Long-term results of penile vein ligation for impotence from venous leakage.
AB  - Between 1986 and 1991, 46 men with organic impotence documented by dynamic
      pharmacocavernosometry and cavernosography to have venous leakage underwent
      penile vein ligation. Despite initial improvement in erections allowing normal
      intercourse in 34 men (74%) within the first 6 months, long-term (more than 12
      months) evaluation revealed sustained potency without adjunctive therapy in only
      11 (24%). Of the remaining 35 men 6 (13%) progressed to a penile prosthesis, 8
      (17%) required intracavernous vasoactive injection therapy and 21 (46%) have not
      sought further therapy despite continued impotence. Of the 14 patients who had
      isolated distal leakage 6 (43%) had sustained erectile function while only 5 of
      the 32 patients (16%) with proximal leakage maintained potency. Associated
      complications included penile shortening in 20 (43%) and penile hypoesthesia in 9
      men (20%). Therefore, we conclude that the long-term success of penile vein
      ligation is poor, with only 24% of the patients able to have normal intercourse
      more than 1 year later, although those patients with distal penile shaft leakage
      appear to have a greater chance of success than those with more proximal leakage.

PMID- 8479021
TI  - The Hydroflex penile prosthesis: a test case for the introduction of new
      urological technology.
AB  - The AMS Hydroflex* penile prosthesis was introduced for commercial distribution
      in 1985 but 5 years later this device was no longer available on the United
      States market. In an attempt to understand why this device, which initially
      enjoyed substantial popularity, was abruptly withdrawn from the market, patients
      who underwent implantation at the University of Wisconsin were interviewed and a
      critical analysis of the Food and Drug Administration approval process of medical
      devices was performed. An AMS Hydroflex penile prosthesis was implanted in 17
      patients (mean age 57.7 years, range 27 to 84 years). The followup period ranged
      from 37 to 73 months with a mean of 58 months, and 3 patients died within that
      time. Of the remaining patients 10 (71%) were satisfied with the device in the
      first months after implantation but only 6 (43%) were satisfied at the time of
      followup, 9 (64%) were more satisfied with sexual relationships after receiving
      the prosthesis and 7 (50%) found the prosthesis simple to operate. Mechanical
      failure was noticed by 11 patients (79%), of whom 5 (45%) underwent further
      surgery. Classification of medical devices started with the enactment of the
      Medical Device Amendment to the Federal Food, Drug and Cosmetic Act, May 28,
      1976. All medical devices that were in commercial distribution at that time were
      classified in 3 regulatory control categories depending upon the degree of
      regulation necessary to assure safety and effectiveness of each device. Before
      May 28, 1976 no approved application was necessary for marketing medical devices,
      and the Food and Drug Administration has variable amounts of information about
      safety and effectiveness of the different devices marketed prior to that date.
      Since May 1976 approved applications have been mandated for new or significantly
      changed devices. The specific process by which the Hydroflex prosthesis, as well
      as other medical devices, is approved is critically reviewed.

PMID- 8479022
TI  - Analysis of microsurgical penile revascularization results by etiology of
      impotence.
AB  - We reviewed the results of microsurgical penile revascularization, with or
      without a combined procedure to correct cavernosal venous leakage, in 50
      consecutive patients with vasculogenic impotence. All patients underwent an
      extensive preoperative evaluation, including dynamic infusion cavernosography and
      cavernosometry, and selective penile arteriography. Overall 48% (24 patients) had
      an excellent postoperative result, 40% (20 patients) were improved and 12% (6
      patients) failed, with a median followup of 24 months (range 19 to 56).
      Furthermore, these results appear durable with no significant difference in
      length of followup between groups irrespective of surgical outcome (p > 0.05).
      Analysis of surgical outcomes by preoperative etiology of impotence (pure
      arterial versus arterial combined with corporeal venous dysfunction) revealed a
      statistically significant advantage of an excellent surgical outcome in patients
      with pure arterial impotence compared to those with mixed etiology with results
      of 67% and 42%, respectively (p < 0.01). There was no significant difference in
      outcome when patients were analyzed with respect to age or duration of impotence
      (p > 0.05). We conclude that in patients with arteriogenic impotence
      identification of concomitant corporeal veno-occlusive dysfunction diagnosed by
      preoperative dynamic infusion cavernosography and cavernosometry may be helpful,
      not only in planning a more physiological surgical procedure but also in
      predicting long-term postoperative success.

PMID- 8479023
TI  - Impotence therapy.

PMID- 8479024
TI  - Development of Peyronie's disease with the use of a vacuum constriction device.
AB  - Vacuum constriction devices are generally considered to be a safe, effective,
      noninvasive means of producing erections in impotent men. However, long-term
      study of the effect of subatmospheric pressure on penile structures and
      vasculature has not been performed. We report the development of Peyronie's
      disease in a patient after 4 years of complication-free vacuum constriction
      device use.

PMID- 8479025
TI  - Pulmonary migration of coils inserted for treatment of erectile dysfunction
      caused by venous leakage.
AB  - Embolization of penile veins by coils and/or detachable balloons has been
      reported as a possible effective form of treatment of venogenic erectile
      dysfunction. The major appeal for this avenue of therapy in these patients is the
      reported low morbidity and negligible rate of complications compared to an open
      operation. We describe a case of asymptomatic pulmonary migration of a coil
      placed for venous leakage in a patient in whom the procedure was conducted
      through the femoral vein rather than the deep dorsal vein. We conclude that
      patients undergoing coil embolization for venous leakage should be appraised of
      the potential for coil migration.

PMID- 8479026
TI  - Results of combined Nesbit penile plication with plaque incision and placement of
      Dacron patch in patients with severe Peyronie's disease.
AB  - We treated 9 men with severe curvature of the penis secondary to Peyronie's
      disease with penile plication and a previously unreported technique of incision
      of the Peyronie plaque and placement of Dacron patch. All men were potent before
      penile straightening. At a mean followup of 17.5 months all men achieved good to
      excellent correction of the deformity and they have remained potent. One patient
      initially complained of numbness of the glans penis and decreased penile rigidity
      distal to the Dacron patch but potency returned and the numbness resolved.

PMID- 8479027
TI  - Peyronie's plaque: surgical treatment with the carbon dioxide laser and a deep
      dorsal vein patch graft.
AB  - We describe a procedure for ablation of Peyronie's plaque using the carbon
      dioxide laser, which allows one to remove all palpable evidence of plaque while
      at the same time avoiding the creation of a large defect in the tunica albuginea
      requiring coverage with a large graft. The plaque is removed by making either a
      longitudinal or transverse incision in the plaque with a focused carbon dioxide
      laser beam from a hand held probe, and evaporating the plaque substance from the
      undersurface by tangentially directing the laser beam. It is possible to remove
      large dystrophic calcifications from within the plaque and to augment the repair
      in the area of greatest curvature using the deep dorsal vein as a patch graft. In
      cases of narrow plaques relaxation incisions and venous patch grafting alone are
      usually sufficient to correct the deformity. Our experience with 12 patients is
      summarized and 2 cases are reported in detail to illustrate the versatility of
      the procedure.

PMID- 8479028
TI  - Peyronie's disease.

PMID- 8479029
TI  - The effects of cancer and cancer therapy on male reproductive function.

PMID- 8479030
TI  - Antigens in capacitated spermatozoa eliciting autoimmune responses.
AB  - We studied the possible qualitative antigenic differences between native and
      capacitated spermatozoa pertaining to immunological infertility. Western blot
      analysis was used to test serum and seminal plasma immunoglobulin G (IgG) from 18
      infertile couples with sperm antibodies, and 14 fertile men and 9 fertile women
      without significant sperm antibodies against native and capacitated spermatozoa
      from fertile and infertile men. More fertile and infertile subjects had serum and
      seminal plasma IgG binding to antigens with molecular weights of 34/36, 46, 68,
      97, 105, 115, 120, 130, 150 and 190 kDa. in capacitated versus native spermatozoa
      of all men. Of the other hand, immune reactivity to antigens with molecular
      weight 22/24, 30, 32, 50, 80, 88/92 and 180 kDa. found in native autoimmune
      spermatozoa was strongest in infertile couples with sperm antibodies. This
      reactivity significantly increased against capacitated autoimmune spermatozoa.
      Native spermatozoa from few fertile men had these antigens but they appeared
      after capacitation. It seems that certain antigens normally appearing or enhanced
      after capacitation are already present in native spermatozoa from infertile men,
      probably due to an inherent aberration or premature capacitation. This might
      account for the observed enhanced immune responses in infertile couples to sperm
      antigens from infertile husbands.

PMID- 8479031
TI  - The correlation between round cells and white blood cells in the semen.
AB  - It is generally recognized that white blood cells in semen are detrimental to
      sperm function and fertility. Traditionally, pyospermia has been suspected if
      greater than 10 round cells per high power field or more than 1 million round
      cells per ml. were identified in the semen. Since immature germ cells and white
      blood cells appear as round cells under wet mount light microscopy, the
      relationship between increased numbers of round cells in semen and true
      pyospermia was examined. Semen analyses were performed on specimens from 627
      infertility patients. The numbers of round cells per high power field and the
      number of round cells per ml. of semen were recorded. Specimens from 57 patients
      (9%) persistently demonstrated greater than 10 round cells per high power field
      or more than 1 million round cells per ml. and they were subjected to
      immunohistochemical staining against white blood cell surface antigens. Greater
      than 1 million white blood cells per ml. were identified in only 20 patients
      (35%) and only 8 samples demonstrated more than 3 million white blood cells per
      ml. Of the patients with greater than 1 million white blood cells per ml. 65% had
      motilities of less than 60% compared to 49% of the patients with less than this
      amount of pyospermia. This difference was not statistically significant. Round
      cells counted on a per milliliter basis correlated better with results of
      immunohistochemical staining than did round cells counted on a per high power
      field basis. These data demonstrate that the majority of patients with excess
      round cells in the semen do not have pyospermia and, therefore, empiric
      antibiotic therapy without further testing will likely be unproductive.

PMID- 8479032
TI  - Transrectal ultrasound in the evaluation of men with low volume azoospermia.
AB  - The evaluation of the subfertile man has changed with the advent of noninvasive
      imaging techniques. We used high resolution transrectal ultrasound early in the
      evaluation of 25 men 24 to 35 years old with probable ductal obstruction
      represented by azoospermia or severe oligospermia (less than 1 million sperm per
      cc) and low volume ejaculate. Of these patients 13 were found to have a post
      testicular obstructive cause including ejaculatory duct obstruction (5),
      voluminous seminal vesicle dilatation with obstruction (3), seminal vesicle
      aplasia (2), nonpalpable vas (2) or epididymal obstruction (1). The other 12 men
      had either a varicocele (8) or testicular failure (4). Except for vasal or
      epididymal pathology, the other causes of post-testicular azoospermia presented
      with an ejaculate volume consistently less than 1.0 cc. All 10 patients with low
      volume and an abnormal ultrasound had normal follicle stimulating hormone levels
      and testicular biopsy findings. Sonography not only was helpful in establishing
      the diagnosis but also in determining the distal extent of the obstruction.
      Transrectal ultrasound is an important noninvasive diagnostic tool that minimizes
      the need for more invasive studies in the evaluation of azoospermia, particularly
      when associated with low ejaculate volume.

PMID- 8479033
TI  - The value of quantitative testicular biopsy and deoxyribonucleic acid flow
      cytometry in predicting sperm recovery from electrostimulated ejaculates.
AB  - Spermatogenic abnormalities have been reported in the majority of men following
      spinal cord injury, and they contribute to the multifactorial etiology of
      reproductive dysfunction. Thus far, few have studied the seminiferous epithelium
      in this group of patients by objective criteria. While quantitative micrometry
      and flow cytometric analysis are accurate and reproducible methods of
      quantitating spermatogenesis, the latter is simpler and permits needle aspiration
      for tissue recovery. The objective of this study is to determine the value of
      quantitative micrometry and flow cytometric analysis as methods of predicting
      total sperm yield in electrostimulated ejaculates. Incisional testicular biopsy
      was performed in 12 anejaculatory men, and the tissue specimens were divided for
      analysis by quantitative micrometry and flow cytometric analysis. Quantitative
      micrometry consisted of determining the mean tubular wall thickness, mean tubular
      concentration of the Sertoli cells and mature spermatids in a minimum of 10 round
      seminiferous tubules per patient. Specimens were prepared for flow cytometric
      analysis and the deoxyribonucleic acid histogram was analyzed to determine the
      percentage of cells in each ploidy compartment. Of the quantitative micrometry
      parameters analyzed a significant correlation resulted between the total sperm
      yield per electroejaculate and the mean tubular concentration of late spermatids
      (p = 0.001) as well as with the mean tubular ratio of late spermatids to Sertoli
      cells (p = 0.003). The tubular concentration of spermatids resulted in a
      sensitivity and specificity of 100% and 75%, respectively, to predict adequate
      sperm yield in semen. Likewise, the mean tubular ratio of spermatids to Sertoli
      cells resulted in a sensitivity and specificity of 75% and 87.5%, respectively,
      in its ability to predict normal sperm yield in the recovered ejaculate.
      Deoxyribonucleic acid flow cytometry analysis showed a normal haploid compartment
      in all 6 specimens studied, and each was associated with high numbers of sperm in
      recovered semen. Quantitative histometric parameters correlate significantly with
      the total sperm yield obtained in electrostimulated ejaculates and may have a
      role in the selection of candidates for treatment in reproductive rehabilitation
      programs.

PMID- 8479034
TI  - Evaluation and treatment of infertility in spinal cord injured men through rectal
      probe electroejaculation.
AB  - A total of 18 men older than 19 years with spinal cord injury was evaluated for
      fertility potential with testing of semen obtained by rectal probe
      electroejaculation. After fertility testing, including sperm penetration assay,
      semen cryopreservation and sperm antibody status, 6 of the 18 men proceeded with
      their partners to use rectal probe electroejaculation in efforts to conceive.
      Sperm was obtained in 16 of 18 cases. Average ejaculate total sperm count (306
      million) was good but motility (22%) was poor. Adequate sperm retrieval after
      processing yielded a normal sperm penetration assay in 4 of 16 cases (25%) in
      which sperm were obtained. Favorable semen cryopreservation (greater than 33% of
      pre-freeze motility noted after thaw) was present in 5 of 16 cases (31%). Live
      births were achieved in 2 of 6 couples attempting conception. Despite the
      typically poor sperm motility noted in electroejaculates, rectal probe
      electroejaculation can result in pregnancies from couples involving spinal cord
      injured men. The sperm penetration assay data indicate that pregnancy should be
      achievable in at least 25% of spinal cord injured couples. Achieving these
      conceptions requires a team approach involving a urologist/andrologist,
      gynecologist/reproductive endocrinologist and a sperm-processing laboratory.

PMID- 8479035
TI  - Infertility diagnosis.

PMID- 8479036
TI  - Should the testicular artery be preserved at varicocelectomy?
AB  - A surgical method of varicocelectomy, in which the internal spermatic veins
      together with the testicular artery are ligated as a whole in the retroperitoneal
      space, has been proposed as a simple and reliable procedure. We evaluated the
      effects of ligating the testicular artery at varicocelectomy on fertility. A
      total of 34 subfertile patients with a left varicocele was randomized into an
      artery-preserved or artery-ligated group at open varicocelectomy and the change
      in semen quality was prospectively studied. The artery-preserved group showed
      improvements in sperm density and total sperm count, while the artery-ligated
      group showed improvements in sperm density, total sperm count and sperm motility.
      The results indicated identical improvement in semen quality in both groups of
      patients. Testicular volume, measured by a punched-out orchidometer, did not
      change in any of the patients in the ligated group, except for 1 with a grade 3
      varicocele, although this decrease could not be detected by sonography. The
      effects of artery-preserving and artery-ligating varicocelectomy on postoperative
      pregnancy rates were investigated by examining 116 patients retrospectively. The
      pregnancy rates of 37.8% and 23.8% in the artery-preserved and artery-ligated
      groups, respectively, were not significantly different. Despite the theoretical
      advantage of artery preservation, our study did not show any significant
      difference between artery-preserving varicocelectomy and the artery-ligating
      operation when improvements in semen quality and postoperative pregnancy rate
      were evaluated.

PMID- 8479037
TI  - Varicocele vein ligation in 565 patients under local anesthesia: a long-term
      review of technique, results and complications in light of proposed management by
      laparoscopy.
AB  - Several recent reports have suggested that laparoscopic internal spermatic vein
      ligation provides a simpler, less debilitating and more cost efficient method of
      varicocele ligation than conventional surgical techniques. We analyzed the
      results of open varicocele ligation using local anesthesia in 565 patients for 10
      years. All surgery was performed in the outpatient setting using 0.5% lidocaine.
      In most patients 50 to 200 mcg. fentanyl or 3 to 7 mg. midazolam were used for
      intravenous sedation. The average operating time, including the administration of
      anesthesia, was 39 minutes for unilateral and 71 minutes for bilateral
      procedures. All patients returned to light duty work in 24 to 48 hours and full
      strenuous physical activity within 1 week. The only complications encountered
      were 2 wound hematomas (0.3%), 4 minor wound separations (0.7%) and 41 hydroceles
      (7.3%). Semen improvement and pregnancy rates were similar to those reported in
      prior series. This study demonstrates that varicocele vein ligation can be done
      rapidly, efficiently and safely using local anesthesia with time of recovery and
      return to work comparable to those reported for laparoscopic techniques.

PMID- 8479038
TI  - Microsurgical epididymovasostomy: predictors of success.
AB  - The results of microsurgical epididymovasostomy for congenital and acquired
      vasoepididymal obstruction were retrospectively reviewed in 22 patients in an
      attempt to determine what preoperative or intraoperative factors might predict
      surgical success. The overall success rate, defined as sperm on postoperative
      semen analysis, was 48%. The presence of sperm on an intraoperative touch
      preparation from the epididymis was significantly correlated with response (chi
      square 3.24, p < 0.10) and no patient without sperm on touch preparation had
      sperm on subsequent semen analyses. Testicular biopsy positive for
      spermatogenesis and presence of motile sperm on intraoperative touch preparation
      were not statistically significant predictors of response. These results suggest
      that presence or absence of sperm on intraoperative touch preparation is the only
      significant prognosticator of successful microsurgical epididymovasostomy.

PMID- 8479039
TI  - Microsurgical aspiration of sperm from the epididymis: a mobile program.
AB  - We report data from 25 microsurgical aspirations of the epididymis on 22 men.
      There were 14 men with congenital absence of the vas, 6 with failed
      vasoepididymostomy, 1 with adult cystic fibrosis and 1 with a childhood hernia
      repair. The specimens were used for assisted reproductive technologies, including
      in vitro fertilization and tubal embryo transfer. The protocol for aspiration,
      ovulation induction and sperm processing evolved during the course of these
      studies, and the patients were classified into 2 groups on the basis of
      methodology. Seventeen procedures were performed for the in-house in vitro
      fertilization team but 8 other procedures were done for nearby in vitro
      fertilization centers, and the final prepared sperm samples were transported as
      part of our mobile program. Group 1 patients underwent standard aspiration
      techniques, standard ovulation induction and sperm processing by wash and swim
      up. Among this group there were no fertilizations or pregnancies with 8 in-house
      and 2 transported specimens. Group 2 patients had leuprolide suppression before
      ovulation induction, direct intratubular aspiration and a complex sperm
      preparation, including pentoxifylline stimulation, mini-Percoll filtration and
      incubation with human follicular fluid. Among this group there were 2
      fertilizations and 1 pregnancy with 9 in-house cases, and 3 fertilizations and 2
      pregnancies with 6 transported specimens. These results suggest that a mobile
      program for microsurgical aspirations of sperm from the epididymis and in vitro
      fertilization or tubal embryo transfer is feasible within the framework of a
      strict protocol.

PMID- 8479040
TI  - Surgical therapy of male infertility.

PMID- 8479041
TI  - Long-term care for older Americans: the institutionalization of senescence.

PMID- 8479042
TI  - Demographers ponder the aging of the aged and await unprecedented looming elder
      boom.

PMID- 8479043
TI  - Bang more of a whimper, health economist avers.

PMID- 8479044
TI  - Older people now more able-bodied than before.

PMID- 8479045
TI  - Long-term care training, research expanding.

PMID- 8479046
TI  - Nursing home research focus on outcomes may mean playing catch-up with
      regulation.

PMID- 8479047
TI  - Cross-national comparisons of long-term care become a gold mine for rigorous
      investigators.

PMID- 8479048
TI  - In or out of nursing homes, elder care's costly.

PMID- 8479049
TI  - Adult day care centers vital, many more needed.

PMID- 8479050
TI  - Must older Americans save up to spend down?

PMID- 8479051
TI  - Insurance--private and public--a payment puzzle.

PMID- 8479052
TI  - After long delay, federal regulations for enforcing nursing home standards may be
      issued this year.

PMID- 8479053
TI  - Base closings alter military long-term care.

PMID- 8479055
TI  - From the Centers for Disease Control and Prevention. Rates of cesarean delivery-
      United States, 1991.

PMID- 8479054
TI  - From the Centers for Disease Control and Prevention. FDA approval of use of a new
      Haemophilus b conjugate vaccine and a combined diphtheria-tetanus-pertussis and
      Haemophilus b conjugate vaccine for infants and children.

PMID- 8479056
TI  - Information technology and patient care: who, when and why.

PMID- 8479057
TI  - Information technology and patient care: who, when, and why?

PMID- 8479058
TI  - Asking about domestic violence: SAFE questions.

PMID- 8479059
TI  - Alternatives for health care workers with latex glove allergies.

PMID- 8479060
TI  - Treatment of attention-deficit hyperactivity disorder.

PMID- 8479061
TI  - Treatment of attention-deficit hyperactivity disorder.

PMID- 8479062
TI  - Effect of magnesium on postoperative dysrhythmias.

PMID- 8479063
TI  - Detection and significance of myocardial ischemia in stable patients after
      recovery from an acute coronary event. Multicenter Myocardial Ischemia Research
      Group.
AB  - OBJECTIVE: To determine the clinical significance of silent and symptomatic
      myocardial ischemia detected by noninvasive testing in stable postcoronary
      patients. DESIGN: Cohort study with a mean 23-month follow-up. SETTING:
      Ambulatory outpatients after recent hospitalization for an acute coronary event.
      PATIENTS: Nine hundred thirty-six patients (76% male; mean age, 58 years) who
      were clinically stable 1 to 6 months after hospitalization for acute myocardial
      infarction or unstable angina. INTERVENTIONS: Noninvasive testing involved rest,
      ambulatory, and exercise electrocardiograms and stress thallium-201 scintigraphy.
      MAIN OUTCOME MEASURES: Cox regression analysis was used to evaluate the risk
      (hazard ratio) of first recurrent primary events (cardiac death, nonfatal
      infarction, or unstable angina) or restricted events (cardiac death or nonfatal
      infarction) associated with ischemic noninvasive test results. RESULTS: ST
      segment depression on the rest electrocardiogram was the only noninvasive test
      variable that identified a significantly increased risk (P = .05) for first
      recurrent primary events (hazard ratio; 95% confidence limits): rest
      electrocardiogram ST depression (1.5; 1.00, 2.25); ambulatory electrocardiogram
      ST depression (0.86; 0.49, 1.51); exercise electrocardiogram ST depression (1.13;
      0.82, 1.56); and stress thallium-201 reversible defects (1.3; 0.96, 1.74). Test
      results were similar for first recurrent restricted events, and in patients with
      and without angina. Significantly increased risk (P < .05) was noted when
      exercise-induced ST depression occurred in patients who also had reduced exercise
      duration (hazard ratio, 3.4) or when reversible thallium-201 defects occurred in
      patients who also had increased lung uptake (hazard ratio, 2.8). Each high-risk
      subset made up less than 3% of the population and contained less than 6% of
      patients with first primary events. CONCLUSION: Detection of silent or
      symptomatic myocardial ischemia by non-invasive testing in stable patients 1 to 6
      months after an acute coronary event is not useful in identifying patients at
      increased risk for subsequent coronary events.

PMID- 8479064
TI  - Population-based norms for the Mini-Mental State Examination by age and
      educational level.
AB  - OBJECTIVE: To report the distribution of Mini-Mental State Examination (MMSE)
      scores by age and educational level. DESIGN: National Institute of Mental Health
      Epidemiologic Catchment Area Program surveys conducted between 1980 and 1984.
      SETTING: Community populations in New Haven, Conn; Baltimore, Md; St Louis, Mo;
      Durham, NC; and Los Angeles, Calif. PARTICIPANTS: A total of 18,056 adult
      participants selected by probability sampling within census tracts and
      households. MAIN OUTCOME MEASURES: Summary scores for the MMSE are given in the
      form of mean, median, and percentile distributions specific for age and
      educational level. RESULTS: The MMSE scores were related to both age and
      educational level. There was an inverse relationship between MMSE scores and age,
      ranging from a median of 29 for those 18 to 24 years of age, to 25 for
      individuals 80 years of age and older. The median MMSE score was 29 for
      individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of
      schooling, and 22 for those with 0 to 4 years of schooling. CONCLUSIONS:
      Cognitive performance as measured by the MMSE varies within the population by age
      and education. The cause of this variation has yet to be determined. Mini-Mental
      State Examination scores should be used to identify current cognitive
      difficulties and not to make formal diagnoses. The results presented should prove
      to be useful to clinicians who wish to compare an individual patient's MMSE
      scores with a population reference group and to researchers making plans for new
      studies in which cognitive status is a variable of interest.

PMID- 8479065
TI  - Effect of gender on long-term outcome of angina pectoris and myocardial
      infarction/sudden unexpected death.
AB  - OBJECTIVE: To determine the effects of female gender on long-term survival and
      subsequent coronary heart disease events in a population developing first
      clinical manifestations of coronary artery disease. DESIGN: Follow-up of all
      Rochester, Minn, residents first diagnosed with either angina pectoris or
      myocardial infarction/sudden unexpected death between January 1, 1960, and
      December 31, 1979. MAIN OUTCOME MEASURES: Patients with angina pectoris were
      followed up through 1982 for survival and time to initial myocardial
      infarction/cardiac death. Patients with myocardial infarction were followed up
      through 1982 for survival and time to recurrent myocardial infarction/cardiac
      death. RESULTS: Angina pectoris was the initial diagnosis for 529 women and 504
      men. Myocardial infarction or sudden unexpected death was the initial diagnosis
      for 611 women and 997 men. The average age of patients diagnosed with angina
      pectoris was 67.0 years (SE, 0.5 years) for women and 60.0 years (SE, 0.5 years)
      for men. The average age of patients diagnosed with myocardial infarction/sudden
      unexpected death was 71.9 years (SE, 0.5 years) for women and 62.0 years (SE, 0.4
      years) for men. Women presenting with angina pectoris survived significantly
      longer and had a lower incidence of subsequent myocardial infarction/cardiac
      death compared with men of similar age (P < .01). When rates of myocardial
      infarction and sudden unexpected death were combined to assess all cardiac
      endpoints with objective criteria ("hard" endpoints), women presenting with
      myocardial infarction/sudden unexpected death had survival rates and risk of
      subsequent myocardial infarction/coronary death that were similar to men of the
      same age. When survival following myocardial infarction was analyzed separately,
      survival also did not vary by gender. CONCLUSION: In this population, women with
      angina pectoris as an initial diagnosis, but not those with myocardial infarction
      or sudden unexpected death, have longer survival and lower risk of subsequent
      myocardial infarction/cardiac death than do men with the same presentation and of
      a similar age.

PMID- 8479067
TI  - Disposal of low-level radioactive waste. Problems and implications for
      physicians.

PMID- 8479066
TI  - The appropriateness of hysterectomy. A comparison of care in seven health plans.
      Health Maintenance Organization Quality of Care Consortium.
AB  - OBJECTIVE: To develop and test a method for comparing the appropriateness of
      hysterectomy use in different health plans. DESIGN: Retrospective cohort study.
      SETTING: Seven managed care organizations. PATIENTS: Random sample of all
      nonemergency, non-oncological hysterectomies performed in the seven managed care
      organizations over a 1-year period. Patients who were not continuously enrolled
      in a plan for 2 years prior to their hysterectomy were excluded. MAIN OUTCOME
      MEASURES: Proportion of women undergoing hysterectomy in each plan for
      inappropriate clinical reasons according to ratings derived from a panel of
      managed care physicians. RESULTS: Overall, about 16% of women underwent
      hysterectomy for reasons judged to be clinically inappropriate. Only one plan had
      significantly more hysterectomies rated inappropriate compared with the group
      mean (27%, unadjusted). Adjusting for age and race did not affect the rankings of
      the plans and had little effect on the numeric results. CONCLUSION: The rates of
      inappropriate use of hysterectomies are similar to those for other procedures and
      vary to a small degree among health plans. This information may be useful to
      purchasers when they consider which health plans to offer their employees.

PMID- 8479068
TI  - Pulmonary artery catheterization. Can there be an integrated strategy for
      guideline development and research promotion?
AB  - OBJECTIVES: To review the evidence regarding indications for pulmonary artery
      catheterization (PAC) in critically ill patients, and to propose a guideline
      generating process that would encourage randomized controlled trials of PAC. DATA
      SOURCES: Computerized and manual search for randomized trials involving PAC as an
      integral part of the protocol, published as of October 1992. Manual search for
      guidelines endorsed by specialty societies and/or proposed by expert panels
      following an explicit group process. DATA SYNTHESIS: Four trials suggest benefit
      from PAC for pre- or perioperative management of high-risk surgical patients. Two
      others indicate that PAC for low-risk aortic aneurysm surgery confers no
      advantages. Use of PAC to guide therapy aimed at improved mixed venous oxygen
      saturation was beneficial compared with usual care with PAC in two small trials
      among patients with septic shock and severe trauma. Other PAC indications are
      either untested or inadequately tested by small trials. Large trials are needed,
      but trials to date have been impeded by clinicians' uncertainty about PAC and
      unwillingness to randomize critically ill patients. No published guidelines for
      PAC have used a formal group process and/or a hierarchical review of evidence to
      demarcate proven from unproven indications. CONCLUSIONS: We propose a research
      promoting expert panel on indications for PAC. Aided by a critical literature
      review, experts would rate case scenarios on the need for routine PAC with or
      without a specified intervention strategy. Future trials should test indications
      where there is either consensus about the uncertainty of need for PAC, or
      interpanelist disagreement owing to inconclusive evidence. This process could
      facilitate practice guideline development, utilization management, and large
      trials of PAC and related interventions.

PMID- 8479069
TI  - Breast cancer. What the Department of Defense should do with its $210 million.

PMID- 8479070
TI  - Postinfarction risk stratification. Is preventive war winnable?

PMID- 8479071
TI  - Mini-Mental State Examination. Norms, normals, and numbers.

PMID- 8479073
TI  - A piece of my mind. Babu.

PMID- 8479072
TI  - Changing the system. Implications for physicians.

PMID- 8479074
TI  - [Complications and management of hematopoietic malignancy therapy].
AB  - Infection and refractoriness to platelet transfusion, as complications in
      hematopoietic malignancy therapy, were investigated. The Hanshin Study Group of
      Hematopoietic Disorders and Infection treated with 3,346 cases of bacterial
      infection (7.8% sepsis, 71% sepsis suspected, 13.7% respiratory infection) during
      the past 13 years. A total of 688 strains were detected as causative organisms,
      59.2% being gram-negative bacilli and 40.3% gram-positive bacteria. Comparison of
      the detection rates obtained 10 years ago and those obtained in the last three
      years showed a decrease from 73.8% to 46.8% for gram-negative bacilli and an
      increase from 25.1% to 53.2% for gram-positive bacteria. Twenty-eight antibiotics
      administered singly and nine combinations of two drugs administered concomitantly
      were assessed. Efficacy rates were 43.9% to 67.2% for single-drug administration
      and 35.2% to 64.2% for concomitant administration. Notably, some combinations
      were less effective than single-drug administration. Of 153 cases of fungal
      infection seen in the last three years, 80% were caused by the genus Candida. Two
      antifungal drugs were used, with efficacy rates ranging from 45.5% to 70.0%. In
      150 patients undergoing frequent transfusion, anti-HLA alloantibody was measured.
      The positive rate was 32.9%. In 76 subjects receiving leukocyte-depleted platelet
      transfusion using a polyester filter, a decreased alloantibody positive rate of
      17.1% was obtained.

PMID- 8479075
TI  - [Recent advances in molecular cytogenetics of leukemia].
AB  - Recent advances in molecular cytogenetics of leukemia is reported with special
      reference to the pathogenesis, diagnosis, prognosis, and potential gene therapy.
      Regarding leukemogenesis, we found that neocarzinostatin induced a variety of
      deletions and reciprocal translocations. Among these random chromosome
      abnormalities, two reciprocal translocations which were specific for certain
      leukemias could be observed; t(11;14)(q13;q32) and t(7;11)(p15p13). This fact
      suggests that a translocation carrying oncogene rearrangement may be of potential
      relevance to the leukemogenesis. The success in making a subgroup (FAB
      classification) identified a number of subtype-specific translocations in
      leukemias. It has been suggested that an initiation or progression-associated
      event is mediated through a gross chromosomal change. The molecular
      characterization of chromosomal rearrangement leads to the identification of
      genes involved in leukemia. Our recent works in molecular cytogenetics of chronic
      myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL), FAB-M3 and -M4
      were shown in this article. Since rearrangement of relevant genes were cloned,
      PCR made it feasible to detect minimal residual disease at 10(-6) level after
      intensive treatment or bone marrow transplantation for CML, Ph-positive ALL, M3
      and approximately half of childhood leukemia. Recently developed fluorescent in
      situ hybridization (FISH) using specific probes can visualize certain chromosomes
      or chromosomal segments. Ph translocation, for instance, is now demonstrated as
      three spot-signals in interphase nuclei using YAC (yeast artificial chromosome)
      BCR clone. Lastly, the use of antisense oligonucleotides for the BCR-ABL
      junctions should result in the inhibition of growth of CML clone. The strategy
      using antisense molecules may be very powerful tool in the gene-targeting therapy
      for human neoplasms.

PMID- 8479076
TI  - [Ferrokinetics and bone marrow scanning in patients with myelodysplastic
      syndrome, hypoplastic myelodysplastic syndrome and aplastic anemia].
AB  - Ferrokinetic measurement were performed in a total of 48 patients with
      myelodysplastic syndrome (MDS), 13 with hypoplastic MDS and 25 with aplastic
      anemia (AA). Forty seven % of patients with hypoplastic MDS progressed to acute
      leukemia, however none of the patients with AA progressed to acute leukemia.
      Sixty-nine% of the patients with MDS showed increased erythron transferrin uptake
      (ETU) caused by ineffective erythropoiesis. On the other hand, 85% of the
      patients with hypoplastic MDS and all patients with AA showed decreased ETU
      caused by reduced erythropoiesis. Positive correlation was observed between ETU
      and the erythroid precursor cells in the bone marrow. Bone marrow scintigraphy
      utilizing 99mTc-sulphur colloid showed peripheral expansion of active marrow in
      MDS patients and islands-like distribution in hypoplastic MDS and AA patients.
      Ferrokinetics and bone marrow scintigraphy demonstrated the difference between
      typical MDS and hypoplastic MDS. Hypoplastic MDS appears to be a distinct
      clinicopathologic entity.

PMID- 8479077
TI  - [Clinical implications of chromosome analysis in myelodysplastic syndrome].
AB  - We attempted to identify the cytogenetic significance in predicting the prognosis
      of patients with myelodysplastic syndrome (MDS). From the results, we established
      scoring system (Bournemouth scoring+cytogenetic scoring: 3 for > or = 3
      chromosomal abnormalities; 1 for -7/7q-, +8, 2 abnormalities); patients with
      score of > or = 5 had significant worse prognosis than that with score 0-2.
      Moreover, RARS with complex abnormalities consists of specific subtype showing a
      high leukemic rate with a high mortality rate. MDS with hypocellular marrow
      showed prognosis similar to those with typical MDS, while those with minimal
      dysplasia had prognosis similar to those with aplastic anemia. Patients with MDS
      were categorized into 3 subtypes, i.e., early disease-evolution, late disease
      evolution, and no disease-evolution group. About 50% of patients with complex
      abnormalities showed early disease-evolution, while the remaining died before
      disease-evolution. In patients showing late disease-evolution, no cytogenetic
      factor are informative to predict the timing of disease-evolution, except
      percentage of marrow blasts at the diagnosis.

PMID- 8479078
TI  - [Treatment of myelodysplastic syndromes with cytokines].
AB  - To evaluate the effects of colony-stimulating factors (CSFs) on pathological
      cells from myelodysplastic syndromes (MDS), CD34-positive cell fractions (mainly
      blast cells) from nineteen MDS patients and four normal volunteers were
      successfully enriched by the use of immunomagnetic beads, and their
      responsiveness to CSFs was examined in short-term liquid suspension cultures.
      Considerable parts of blast cells from MDS patients remained immature as compared
      with the favorable maturation of normal blast cells, especially in high-risk MDS
      group that included two prominent cases with a remarkable blast cell growth
      without maturation induction by CSFs. Short-term clinical administrations of G
      CSF often brought about hematological improvements on MDS patients. Other
      cytokines are also reported to be of use on some patients. However, a few cases
      progressed to overt leukemia in relation to G-CSF treatment. Much care should be
      taken with in vivo application of CSFs to high-risk MDS patients, although there
      may be no effective clue to foresee the risk of leukemic transformation yet.

PMID- 8479079
TI  - [Bone marrow transplantation for refractory anemia].
AB  - Each nineteen patients with severe aplastic anemia (SAA) and myelodysplastic
      syndrome (MDS) have been treated by allogeneic bone marrow transplantation (BMT)
      at Hyogo College of Medicine between 1980 and 1991. Rejection was one of the
      major problems for SAA patients. Conditioning regimen including irradiation
      reduced the rejection rate, but secondary cancers may develop as the dose of
      irradiation increased. It is practically important to determine the indication of
      BMT for MDS-refractory anemia (RA). We considered the indication of BMT for those
      who have abnormal karyotypes and/or life threatening complications. Five out of
      nine patients with MDS-RA are surviving after BMT. Four out of ten cases with MDS
      RAEB-T and overt leukemia are alive. BMT should be recommended for patients with
      MDS who satisfy the above conditions, if suitable donors are available. However,
      it remains to be determined whether the patients with RAEB or MDS overt leukemia
      should be treated with chemotherapy prior to the preconditioning for BMT.

PMID- 8479080
TI  - [Levels of serum lactate dehydrogenase and its isozymes with relation to clinical
      features of pneumocystis carinii pneumonia in acquired immunodeficiency syndrome
      patients].
AB  - The clinical courses of 9 patients with acquired immunodeficiency syndrome (AIDS)
      complicated by pneumocystis carinii pneumonia (PCP) were followed to investigate
      the clinical significance of the measurement of various parameters such as serum
      lactate dehydrogenase (LDH). The mean duration of symptoms before diagnosis was
      20 days, and the median duration of therapy was 29.5 days. Serum LDH activity
      increased in 8 of 9 cases. The isozyme pattern in all cases was characterized by
      high LDH3 values from the early stage. However, inflammatory markers did not
      increase in most cases. There were good correlations between the levels of LDH,
      clinical course, and PaO2.

PMID- 8479081
TI  - [Leukemic B-cell colony formation in patients with B-cell prolymphocytic
      leukemia].
AB  - We performed in vitro B cell colony assay after coculture with phytohemagglutinin
      P (PHA-P) and some cytokines (IL-2, IL-4, IL-6 and PHA-MTCM) in B leukemic cells
      from B-PLL and B-CLL patients. The number of colonies generated with PHA and PHA
      MTCM was significantly smaller in patients with B-PLL than B-CLL. The surface
      markers of colony cells from a PLL patient were similar to those of circulating
      leukemic cells of the patient. IL-2, IL-4 and IL-6 did not enhance PHA-induced B
      cell colony formation in B-PLL. The expression of CD23 and CD25 antigens of the
      PLL cells was not enhanced after coculture with PHA for 72 hours in contrast to
      the enhancement of these antigens in B-CLL. B-PLL cells might be less responsive
      to PHA than B-CLL cells.

PMID- 8479082
TI  - [Treatment of adult acute lymphoblastic leukemia with DCVP-l-asp protocol].
AB  - From 1985 to 1991, 20 patients with adult acute lymphoblastic leukemia (ALL) were
      treated with the DCVP-l-asp protocol, which consists of daunorubicin, cytosine
      arabinoside, vincristine, prednisolone, and I-asparaginase. of these 17 patients
      (85%) achieved complete remission. A Kaplan-Meier analysis predicted that 30% of
      the patients in remission would remain disease-free at 5 years. Four patients
      relapsed between 1 and 2.5 years from the start of treatment. The median survival
      time for the four patients with an abnormal karyotype was 15 months. No meningeal
      relapses occurred in patients treated with regular CNS prophylaxis.
      Myelosuppression was severe, but was well tolerated with supportive therapy, and
      there were no treatment-related deaths. We conclude that DCVP-l-asp is a feasible
      and effective protocol for adult ALLs including elderly patients. However, new
      treatment modalities, such as bone marrow transplantation, should be explored in
      patients with unfavorable prognostic factors.

PMID- 8479083
TI  - [Clinical significance of micromegakaryocytes in de novo AML].
AB  - Bone marrow specimens obtained from 54 patients with de novo AML and 7 patients
      with AML evolving from MDS were retrospectively examined for the presence of
      micromegakaryocytes defined as cells of less than 30 microns in diameter with one
      or two nuclei. At least 25 megakaryocytes were counted in each patient.
      Micromegakaryocytes were found in 17 cases (31%), M1:1/11, M2:5/18, M3:0/4,
      M4:5/12, M5:1/4, M6:4/4, M7:1/1. The median age of the patients was higher in de
      novo AML with micromegakaryocytes (57 years) than in de novo AML without
      micromegakaryocytes (41 years) (p = 0.014). Chromosomal analysis revealed that
      deletion of 5 or 5q-, 7 or 7q- was recognized only in the group of de novo AML
      with micromegakaryocytes and that t(15;17), t(8:21) and inv (16) were not
      recognized in this group. Micromegakaryocytes were identified in each bone marrow
      specimen obtained from 9 of 10 patients with de novo AML with trilineage
      myelodysplasia. The complete remission rate was significantly lower in de novo
      AML with micromegakaryocytes (33%) than in de novo AML without
      micromegakaryocytes (86%) (p = 0.001). The duration of survival of the patients
      with de novo AML with micromegakaryocytes was shown to be shorter than that of
      the patients with de novo AML without micromegakaryocytes (p = 0.017).
      Micromegakaryocytes were recognized in all of 7 patients with AML evolving from
      MDS. The presence of micromegakaryocytes in bone marrow of the patients with AML
      indicates a subset of AML with poor prognosis that may be closely associated with
      myelodysplastic syndrome.

PMID- 8479084
TI  - [Primary malignant lymphoma of the breast characterized by pleural, pericardiac,
      and central nervous system invasion and leukemic conversion].
AB  - A 46-year old married woman was admitted with a tumor in the left breast. Needle
      biopsy revealed non-Hodgkin's lymphoma. After preoperative irradiation, a
      standard curative mastectomy was performed. She had been in complete remission
      for 12 months, but she was readmitted because of dyspnea and pretibial edema. An
      echocardiogram and X-ray films of the chest revealed pericardial and bilateral
      pleural effusion. Cytological examination of both aspirated effusion showed many
      lymphoma cells compatible with the primary lesion. After the disappearance of
      effusion following 3 courses of VEPA-M regimen, left hemiparesis and left facial
      nerve palsy suddenly appeared. The number of the cells in the spinal fluid was
      1496/microliters and most cells were lymphoma cells. A MRI scan of the brain
      showed high intensity lesions in the left thalamus and the white matter of the
      left temporal lobe on T2-weighted images. Two months after the onset of cerebral
      involvement, leukemic conversion occurred. Cell surface marker and immunoglobulin
      gene analyses indicated that these cells were of B cell origin. In spite of
      multidrug chemotherapy she died in 24 months after the onset of the disease.

PMID- 8479085
TI  - [Successful treatment with combination chemotherapy of BHAC-AMP in a case of
      acute myelofibrosis developed from myelodysplastic syndrome with multiple
      chromosomal aberrations].
AB  - A 62 year old male patient was previously admitted to another hospital in
      February 1989 because of palpitation. Peripheral blood examination revealed
      pancytopenia. Although the number of nucleated cells in the bone marrow aspirate
      was in the normal range. It contained 2.2% of blastic cells and dysplastic cells.
      He was diagnosed to be myelodysplastic syndrome with refractory anemia. He
      subsequently received repeated blood transfusions and other symptomatic
      treatments as an outpatient until 1990. When he was admitted to our hospital
      because of severe pancytopenia. The numbers of WBC, RBC, and platelets were
      2,000/microliters, 134 x 10(4)/microliters, 2.9 x 10(4)/microliters respectively.
      Bone marrow aspiration resulted in dry tap, and biopsy at the iliac bone showed
      remarkable fibrosis with marked decrease of normal hematopoietic cells.
      Chromosome analysis revealed multiple aberrations such as 47XY, +8, 13q-, 14p+,
      48XY, +8, +9, 13q+. The patient was treated with BHAC-AMP combination
      chemotherapy. After 3 cycles of the therapy, pancytopenia was improved and
      chromosomal aberration disappeared. This case was considered to be an acute
      myelofibrosis developed from myelodysplastic syndrome and worth to reporting with
      a review of literature, because drastic combination chemotherapy was extremely
      effective.

PMID- 8479086
TI  - [Acute megakaryoblastic leukemia associated with Sweet's syndrome, including
      review of the literature].
AB  - A case of Sweet syndrome (SS) associated with acute megakaryoblastic leukemia
      (AMKL) is reported. A 66-year-old male was admitted to Ashikaga Red Cross
      Hospital because of skin eruption and sore throat. His eruption was tender and
      erythema-like nature. He developed a spiking fever after admission. CBC revealed
      pancytopenia, and a bone marrow specimen showed increased megakaryoblasts and
      fibrosis. These blasts were shown to be CD41-positive by flow cytometric
      analysis. A diagnosis of AMKL was then made. Skin biopsy revealed infiltration of
      neutrophils without vasculitis, compatible with SS. Oral administration of
      prednisolone was begun which improved his skin lesions considerably. He was then
      treated with low dose Ara-C, which was however ineffective. The blasts increased
      in the peripheral blood and he died on the 72nd hospital day. There are 37
      reported cases of SS associated with acute nonlymphocytic leukemia, and this is
      the first case report of SS associated with AMKL.

PMID- 8479087
TI  - [Ph1 positive myeloblastic crisis followed by Ph1 negative, bcr rearrangement
      positive T lymphoid crisis in a CML case].
AB  - A 26 year old Japanese male who had a history of leukocytosis in 1985 and
      received chemotherapy because of myeloblastic crisis of chronic myelogenous
      leukemia (CML) from May 1986, was admitted in November 1987. He had
      lymphadenopathy, lymphoid tumor of paranasal sinus and pleural effusion with
      marked lymphoid cells infiltration. On admission, laboratory data of peripheral
      blood and bone marrow revealed remission; lymphoid cells of pleural effusion were
      positive for CD3, CD4 and CD8. Second induction chemotherapy was performed
      successfully. After a few months, however, myeloblastic crisis recurred.
      Intensive chemotherapy ended in failure and he died of renal and heart failure.
      Chromosome analysis showed Ph1 and additional abnormalities at myeloblastic
      crisis and normal at T lymphoid crisis, but the same rearrangement of breakpoint
      cluster region existed in both crisis cells. Therefore we supposed that more than
      two-step pathogenesis is involved in the development of Ph1 positive or Ph1
      negative CML clone of this patient.

PMID- 8479088
TI  - [Primary Waldenstrom's macroglobulinemia associated with pure red cell aplasia in
      which Ts/c lymphocytes inhibiting erythroid precursors were detected].
AB  - Waldenstrom's macroglobulinemia (WMG) is a malignancy of B lymphocytes
      manifesting heavy accumulation of monoclonal IgM in the plasma. In about 80%
      cases of WMG, Normocytic normochronic anemia (NNA) is complicated. A case of WMG
      complicated with pure red cell aplasia (PRCA) and the results of in vitro CFU-E
      colony assay of bone marrow mononuclear cells (BMMNC) cultured with the patient's
      serum and/or peripheral lymphocytes were described. A 59-year-old male was
      admitted with serum total protein Level of 9.7g/dl and 48.2% of gamma globulin.
      The diagnosis of WMG was made by monoclonal IgM in immunoelectrophoresis. Severe
      NNA was initially demonstrated on admission and gradually deteriorated further.
      Both reticulocytes in peripheral blood and erythroid precursors in bone marrow
      were markedly decreased. Erythropoietin showed high values in plasma.
      Complication by PRCA was considered to be present in vitro study of a CFU-E
      colony formation of BMMNC from a normal volunteer showed significant suppression
      on addition of the patient's peripheral lymphocytes and adverse enhancement by
      adding the patient's serum. This inhibition of CFU-E colony formation was most
      prominent by the addition of suppressor/cytotoxic T lymphocytes (Ts/c) and was
      dose dependent. This result showed the existence of inhibitory Ts/c against
      proliferation of allogeneic erythroid precursors.

PMID- 8479089
TI  - [Red cell fragmentation syndrome after bone marrow transplantation presumed to be
      caused by cyclosporin A].
AB  - Red cell fragmentation syndrome (RCFS) appeared in a 19-year-old female with
      acute lymphocytic leukemia 30 days after receiving allogenic bone marrow
      transplantation (BMT) with a conditioning regimen of a high-dose of cytosine
      arabinoside, cyclophosphamide and total body irradiation. Thirty days after BMT,
      severe anemia, reticulocytosis and red cell fragmentation were recognized. As
      RCFS due to cyclosporin A was suspected, CsA therapy was immediately stopped and
      methotrexate was substituted for CsA. After the discontinuation of CsA, rapid
      resolution of the hemolysis was observed. When we resumed treatment with CsA,
      similar hemolysis developed and disappeared again after discontinuation of CsA.
      Though we considered that RCFS occurred due to CsA, the participation of GVHD and
      cytomegalovirus might be undeniable.

PMID- 8479090
TI  - [Interferon-alpha therapy in the myeloproliferative variants of hypereosinophilic
      syndrome].
AB  - Two cases of hypereosinophilic syndrome (HES) that seemed to be
      myeloproliferative disorders were treated with interferon-alpha (IFN-alpha). Case
      1 was a 45-year-old man with HES who was unresponsive to prednisolone. Because
      Flaum's hematologic grading score was 8 points, he was diagnosed as a
      myeloproliferative variant of HES. Although his condition was well controlled by
      hydroxyurea (HU), cardio-pulmonary insufficiency with refractory eosinophilia
      developed after 4 years. Instead of HU, IFN-alpha dramatically decreased
      eosinophil counts, and the clinical situation has stabilized since. Case 2 was a
      30-year-old man with HES whose grading score was 9 points. IFN-alpha therapy was
      started when an accelerated phase of neutrophil dominant with chromosomal
      abnormality (8 trisomy) occurred. However, he died because of no response to IFN
      alpha and other chemotherapy. In both cases, studies of eosinophil colony
      formation revealed no excess of eosinophil colony-stimulating factor from their
      lymphocytes. Flaum's hematologic grading score was useful for the diagnosis of
      myeloproliferative variants of HES. IFN-alpha successfully induced hematologic
      remission in one case, and this therapy may be beneficial for these patients as a
      first line agent.

PMID- 8479091
TI  - [Myocardial hemorrhage due to high-dose cyclophosphamide treatment in a case of
      non-Hodgkin's lymphoma].
AB  - 43-year-old male with non-Hodgkin's lymphoma which was resistant to standard
      treatment received high-dose chemotherapy followed by autologous stem cell
      transplantation. He had a past history of nephrectomy due to renal cell
      carcinoma. He had received adriamycin at a total dose of 280mg/m2, but had no
      episode of heart disease. His chest radiograph, electrocardiogram and serum
      creatinine were within normal ranges at the start of high-dose chemotherapy. He
      was given 120 mg/kg of cyclophosphamide (CPM) over two days. Serum creatinine
      levels elevated two days before transplantation, and he felt discomfort of the
      chest followed by severe arrhythmia. He died of heart failure one day after the
      transplantation. Postmortem examination revealed diffuse myocardial hemorrhage
      with degeneration and necrosis of the heart muscle. CPM is one of the useful
      antitumor alkylating agents for the treatment of malignant neoplasms. Although
      conventional doses of CPM can be used without adverse cardiac effects, high-dose
      CPM has been reported to induce cardiotoxicity in a few cases. Patients often
      develop fatal acute heart failure. For the safe use of high-dose CPM, we must
      consider about the dosing schedule, early detection of adverse cardiac effects,
      and patient risk factors.

PMID- 8479092
TI  - [Diagnosis of pheochromocytoma using 131I-MIBG scintigraphy].
AB  - 131I-MIBG scintigraphy was performed on 18 patients with pheochromocytoma and 25
      patients with essential hypertension. In comparison of grade of 131I-MIBG
      accumulation in various organs the heart accumulation of pheochromocytoma group
      was significantly lower than that of essential hypertension group. And between
      the positive and false negative accumulation group of pheochromocytoma reverse
      relationship was observed between the heart and tumor. The results of 131I-MIBG
      scintigraphy for pheochromocytoma included 78% sensitivity, 100% specificity, and
      90% accuracy. False negative accumulation of tumors were shown at 6 lesions in 4
      cases. On the bases of CT and operative findings, false negative accumulation was
      observed not only in very small tumors, but also in large cystic tumors with a
      small amount of tumor tissue or totally hemorrhagic necrosis within the tumor.

PMID- 8479093
TI  - [Scintigraphic appearance in stress 201Tl myocardial SPECT of midportion lesion
      in left anterior descending artery].
AB  - Scintigraphic appearance of left anterior descending artery (LAD) lesion in
      stress 201Tl myocardial SPECT was studied in 43 patients (pts) with midportion
      lesion in LAD confirmed by coronary angiography. Right margin of ischemic region
      in the basal short axial image was -36 +/- 17 degrees and left margin was -128 +/
      75 degrees. In 28 pts of 43 pts left margin lied beyond -120 degrees. From the
      results it was concluded that in most cases basal inferior wall was perfused by
      septal branches from LAD. In 6 pts with midportion lesion situated proximal to
      the first diagonal branch and in 12 pts with midportion lesion situated proximal
      to the second diagonal branch ischemic region in the apical portion was noted at
      both septum and anterolateral wall. Critical short axial image, in which right
      margin of ischemic region shifted from plus to minus area, was the 3.2nd short
      axial image in the former group and the 5.2nd in the latter group (p < 0.01). In
      10 pts with midportion lesion situated distal to the large first diagonal branch,
      ischemic region was noted in septal wall and not in anterolateral wall. It was
      concluded that right margin of ischemic region in the basal coronal image was the
      most useful sign for predicting midportion lesion and left margin for dominance
      between LAD and right coronary artery and that apical anterolateral ischemia was
      sign for LAD lesion involving diagonal branch. Critical short axial image was
      useful for determining whether the lesion was situated proximal or distal to the
      first diagonal branch and whether the lesion was situated proximal to the second
      diagonal branch.

PMID- 8479094
TI  - [Evaluation of the clinical usefulness of a new myocardial imaging agent, 99mTc
      Tetrofosmin (PPN1011)--a report of multicenter phase III clinical trials].
AB  - The clinical usefulness of a new myocardial perfusion imaging agent, 99mTc-1,2
      bis[bis(2-ethoxyethyl)phosphino]ethane (99mTc-Tetrofosmin, (PPN1011) was
      evaluated in 355 patients with various heart diseases. Both 1 and 2 day protocols
      resulted in images that were significantly clearer than those of 201Tl. The
      absence of significant drug related adverse reaction supported the safety of the
      agent for clinical use. Regional abnormalities detected by CAG agreed with 99mTc
      Tetrofosmin SPECT findings in 74% and with 201Tl SPECT in 78% of this study.
      Eighty-four percent of an abnormalities were detected with 99mTc-Tetrofosmin
      SPECT, as compared with those detected with 201Tl SPECT (88.4%). The complete
      concordance ratio between 99mTc-Tetrofosmin and 201Tl images in segmental
      analysis was 87-89% at rest and stress. Since 99mTc-Tetrofosmin SPECT was judged
      clinically useful in 93.2% (331/355) of the patients studied, it is concluded
      that 99mTc-Tetrofosmin is a promising agent for myocardial perfusion imaging. The
      simple labeling procedure without heating and cooling is suitable for emergency
      administration. Reconditioning of myocardial perfusion could be evaluated with
      99mTc-Tetrofosmin injection before and after interventional therapy. These are
      additional features of the agent for clinical use.

PMID- 8479095
TI  - [Influence of cerebellopontine angle tumor on cerebellar circulation--possibility
      of remote effect to the cerebellum].
AB  - Nine cases (4 men and 5 women, ranging in age from 39 to 73 years with a mean age
      of 51 years) of cerebello-pontine angle tumors were evaluated by cerebral blood
      flow scintigraphy on the basis of clinico-functional anatomy. In the 4 of 5 cases
      in which the middle cerebellar peduncle was compressed by the mass, definite
      hypoperfusion was revealed in the ipsilateral cerebellar hemisphere. On the other
      hand, in the 3 of 4 cases without compression of the middle cerebellar peduncle,
      no asymmetric perfusion was seen in either the right or left cerebellar
      hemisphere. There were neither supratentorial lesions nor signs of increased
      intracranial pressure in any of the 9 cases. On the vertebral angiograms of the 4
      cases with compression of the middle cerebellar peduncle, non-opacification of
      the ipsilateral anterior inferior cerebellar artery occurred in only one case.
      There were no definite signs of reduction of cerebellar blood flow in the other 3
      cases. The middle cerebellar peduncle is one of the largest bundles of
      centripetal fibers in the cerebellar hemispheres. Secondary neuronal fibers of
      the corticopontocerebellar pathway are the most prominent among these fibers. The
      mass lesion in the cerebellopontine cistern has a tendency to compress the middle
      cerebellar peduncle and may deactivate the corticopontocerebellar pathway even if
      it is small.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479096
TI  - [Semi-quantitative evaluation of cerebral blood flow with modified bull's eye
      display using 123I-IMP SPECT].
AB  - We developed Modified Bull's Eye (MBE) display to demonstrate 123I-IMP SPECT
      images on a single map. To compare the difference of some SPECT images, we
      changed the ratio of the occipitofrontal diameter to the temporal diameter of
      oblique SPECT images and transformed the oblique images to round-shaped images.
      After circumferential profile analysis (CPA) was performed on the round-shaped
      oblique images, the data were mapped into a polar representation (MBE display).
      The severity score, as the index of severity of the perfusion defect, was
      calculated in the same way as the myocardial SPECT. We selected five slices from
      the round-shaped SPECT images and divided each slice into 12 areas. The severity
      of the perfusion defect was scored (0-3 points) visually, and the total score was
      defined as the "severity points". We compared the severity score with the
      severity points for 29 patients and six normal male volunteers. The correlation
      coefficient of the severity score and the severity points was 0.86 (p < 0.001).
      The MBE display makes it easy to evaluate SPECT images because it is represented
      on a single map, and it takes no more time to construct than the myocardial
      bull's eye display. It should be useful display.

PMID- 8479097
TI  - [The administered activity of radionuclides in nuclear medicine--rational
      reduction of medical radiation exposure].
AB  - A survey of 104 hospitals was conducted to determine the administered activity of
      radionuclides. Eighty-five hospitals responded, and reported a total of 119,614
      examinations in one year. The examinations included: bone scintigraphy, 26.4%;
      Thallium-201 (201Tl) myocardial scintigraphy, 15.5%; Gallium-67 (67Ga)
      scintigraphy, 13.3%; N-isopropyl-p-[123I]iodoamphetamine (IMP) brain perfusion
      scintigraphy, 7.0%. The administered activity was corrected by body weight only
      for children at more than 80% of the responding hospitals. The number of
      hospitals that reported over-administration of radionuclide varied according to
      the type of scintigraphy performed: bone, 76%; inflammatory (67Ga), 93%;
      myocardial (201Tl), 89.2%; brain (IMP), 8.5%. The administered activity of IMP
      was closer to the upper limits specified in the Recommendations on
      Standardization of Radionuclide Imaging by the Japan Radioisotope Association
      (1987), because IMP is very expensive and is supplied as single vials. The
      highest average effective dose was for myocardial scintigraphy, the second
      highest for inflammatory scintigraphy, and the third-highest for bone
      scintigraphy. In 201Tl and 67Ga scintigraphy, the entire contents of the vial may
      be administered two days before the expiration date, because the ratio of (true
      patient administered activity) to (declared patient administered activity) is
      similar to the ratio of (radioactivity on the day of supply) to (radioactivity on
      the day of expiration). The factors that influence administered activity are
      throughput, price of the radionuclide, and whether the radionuclide is sold as a
      single vial. In order to decrease the effective dose, it is necessary to
      establish a close cooperation between medical personnel, the makers of
      radiopharmaceuticals, and manufacturers of gammacameras.

PMID- 8479098
TI  - [A case of frontal lobe syndrome followed by serial 123I-IMP SPECT].
AB  - Single photon emission computed tomography (SPECT) studies with N-isopropyl-p
      [123I]iodoamphetamine (IMP) were performed in a 58-year-old man with frontal lobe
      syndrome. He had abulia and personality changes suggesting frontal lobe
      impairment. Six follow-up SPECT studies were conducted during 18 months from the
      onset. On the first scan, no abnormal pattern of regional cerebral blood flow
      (rCBF) was found. On the second scan, a mild reduction of rCBF was observed in
      bilateral frontal lobes. Through the third to sixth scans, a progressed reduction
      of rCBF in bilateral frontal lobes was confirmed by a semi-quantitative regions
      of-interest analysis. Contrarily, abulia was improved, and personality change was
      not progressed during that period. Magnetic resonance imaging on admission
      revealed only a small subdural hematoma and high intensity areas in the right
      frontal lobe, which were resolved at the time of the sixth SPECT scan. It is
      suggested that rCBF studies by SPECT is not necessary concordant with psychiatric
      symptoms, and has possible limitations in pathophysiological evaluation for
      psychiatric disorders.

PMID- 8479099
TI  - [Clearance of 99mTc-Tetrofosmin from the myocardium and the adjacent organs].
AB  - We studied clearance of a new myocardial perfusion imaging agent, 99mTc
      Tetrofosmin, from the myocardium and the adjacent organs in nine patients. 99mTc
      Tetrofosmin was injected intravenously at stress and at rest, and SPECT images
      were obtained 25 min and 120 min later. Anterior view images were also obtained
      10 min and 150 min after the injection to compare the myocardial clearance with
      those from the liver and lung. Clearance from the liver was faster than those
      from the myocardium and lung. Washout rate calculated with SPECT was higher for
      the inferior wall than for the anterior wall and lateral wall (p < 0.05 at rest,
      N.S. at stress). The value was higher at stress in any region than at rest (the
      anterior wall and lateral wall, p < 0.01; the septum, p < 0.05; the inferior
      wall, N.S.). Washout rate for the anterior wall was 3.4 +/- 14.0% at rest and
      18.0 +/- 10.6% at stress. The rate for the lateral wall was 2.7 +/- 22.5% at rest
      and 15.8 +/- 7.9% at stress. It was suggested that rapid hepatic clearance and
      high myocardial washout at stress may be important in determining the period
      between the injection of 99mTc-Tetrofosmin and the data acquisition for SPECT
      imaging.

PMID- 8479100
TI  - [Basic study of CA549, a new tumor marker for breast cancer, and evaluation of
      its clinical usefulness].
AB  - We performed basic and clinical studies of IRMA kits for serum CA549 antigen and
      examined the immunological correlation between CA549 and CA15-3 antigens.
      Satisfactory results were obtained in the basic studies of CA549 assays, such as
      the reproducibility and the dilution test. Many patients with breast cancer had
      elevated serum CA549 concentrations and significant correlation was observed
      between serum CA549 and CA15-3 values. Anti-CA549 antibody completely inhibited
      the binding of 125I-labeled anti-CA15-3 antibody to its antigens. These results
      suggest that CA549 and CA15-3 antigens have similar immunological
      characteristics.

PMID- 8479101
TI  - [Usefulness of electrocardiogram gated 99mTc-methoxy isobutyl isonitrile (MIBI)
      single photon emission computed tomography for detection of wall motion
      abnormality of left ventricle].
AB  - We evaluated whether the newly developed perfusion imaging agent "99mTc-methoxy
      isobutyl isonitrile (MIBI)" has a possibility to detect wall motion abnormality
      of left ventricle. Electrocardiogram (ECG) gated single photon emission computed
      tomography (SPECT) was performed in 6 patients with myocardial infarction
      (anterior: 3 and inferior: 3). Apical and basal short axis images were selected
      from each patient and circumferential analysis was performed on end-diastolic
      (ED) and end-systolic (ES) images respectively. Count in end-diastole (EDC) and
      count in end-systole (ESC) were obtained, then % (ESC-EDC) and (ESC-EDC)/EDC were
      calculated. Wall motion of left ventricle was evaluated by either ultrasonic
      cardiogram or left ventriculography. Left ventricle was divided into anterior,
      septal, posterior and lateral areas and then each area was divided into apical
      and basal segments (finally the heart was divided into 8 segments). Of 48
      segments, 33 segments showed normal wall motion and 15 segments showed abnormal
      wall motion: hypokinesis, akinesis and dyskinesis. % (ESC-EDC) was 74.39 +/-
      16.85% in segment of normal wall motion and 33.27 +/- 23.56% in segment of
      abnormal wall motion (p < 0.001). (ESC-EDC)/EDC was 48.67 +/- 13.35% in segment
      of normal wall motion and 23.33 +/- 18.83% in segment of abnormal wall motion (p
      < 0.001). From these data, lower limit of % (ESC-EDC) and (ESC-EDC)/EDC in normal
      wall motion was defined as 40 and 22 respectively: mean -2SD of normal wall
      motion. Sensitivity of diagnosis of abnormal wall motion was 73% in % (ESC-EDC)
      and 60% in (ESC-EDC)/EDC (n.s.). Specificity was 94% and 97% (n.s.).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8479102
TI  - [The recent studies of myocardial blood flow and metabolism by using positron
      emission computed tomography].
AB  - Since the application of positron emission computed tomography (PET) for
      myocardium, the evaluation of myocardial blood flow, glucose metabolism, fatty
      acid metabolism, oxygen consumption and etc. has been performed. Especially, it
      has been regarded very important clinically to evaluate myocardial viability from
      the mismatch of myocardial glucose metabolism and blood flow. Many early
      myocardial PET studies were qualitative, while recently noninvasive quantitation
      method without arterial blood sampling has become possible in quantitating
      myocardial glucose metabolism or myocardial blood flow reserve. We quantitated
      regional myocardial glucose utilization rates (rMGU) in 114 cases during fasting,
      oral glucose loading, or insulin clamp to study the relation between rMGU and
      plasma insulin value or FFA value, the normal rMGU value during each condition
      and the difference of rMGU among each part of myocardium. And as to the question
      in which condition of FDG study was appropriate to evaluate myocardial viability,
      we introduced the opinion of Schelbert for oral glucose loading or insulin
      injection method and presented our opinion for fasting or mild insulin clamp.

PMID- 8479103
TI  - Metabolic response to burn injury: nutritional implications.
AB  - The response to critical illness involves alterations in all aspects of metabolic
      control, favoring catabolism of stored energy substrates and protein. Glucose
      production is accelerated, due principally to a chronic elevation in glucagon.
      Whereas glucose is available at increased rates, the muscle tissue is less
      responsive than normal to the stimulatory effect of insulin on glucose uptake.
      Stored triglyceride is also catabolized at a high rate, predominantly due to
      enhanced adrenergic activity. This causes the release of free fatty acids at a
      rate well in excess of their requirement for oxidation, leading to a high rate of
      reesterification and triglyceride transport in plasma. Protein metabolism is
      characterized by accelerated catabolism that is not balanced by a corresponding
      increase in synthesis. Whereas the mechanism for this response is not known,
      peripheral insulin resistance does not appear to be responsible.

PMID- 8479104
TI  - Problems in assessing the response to therapy on bone metastases in breast
      cancer: analysis of post-recurrence prognostic factors.
AB  - The problems of assessment of response to therapy and the factors contributing to
      the post-recurrence survival period were clinically investigated using 72
      patients mostly with evaluable bone metastases. When the various factors involved
      in the post-recurrence survival period were investigated by Cox multivariate
      analysis, the results were significant for number of metastatic lymph nodes at
      initial surgery (p < 0.05) and disease-free period (p < 0.01), while the
      therapeutic effect on bone metastases made only a marginal contribution (p =
      0.06). Imaging of bone metastases required a long time until effects could be
      assessed, 4 months (1-20 months) for Partial Response (PR) cases and 10 months (2
      60 months) for Progressive Disease (PD) cases, with a median of 8 months, but
      even so, assessment of effect based on imaging techniques did not necessarily
      correlate with the clinical course. No background factors or therapeutic
      modalities typical for responders were noted. These findings require a
      comprehensive assessment of therapeutic utility for bone metastases by
      considering (a) the improvement of clinical symptoms (b) the decrease in tumor
      markers, and (c) the absence of new lesions.

PMID- 8479105
TI  - Changes of pial vessel diameter and CO2 reactivity during insulin-induced
      hypoglycemia and in the recovery period following glucose administration.
AB  - The present study examined the changes of cerebrovascular CO2 reactivity during
      insulin-induced hypoglycemia and in the recovery period following glucose
      administration in cats. The diameters of pial vessels were continuously measured
      using the vidicon camera system. Hypoglycemia was induced by intraperitoneal
      injection of Actrapid insulin (100 IU/kg). Cerebrovascular CO2 reactivity was
      estimated by the changes of pial vessel diameters during 3 min inhalation of 5%
      CO2 in air at each stage of glucose level. CO2 reactivity was impaired in the
      hypoglycemic stage and this impairment was further enhanced in the early recovery
      stage. In the late recovery stage, CO2 reactivity was restored particularly in
      the small arteries which were less innervated by autonomic nerves. These results
      suggest that the sympathetic activity plays an important role in the impairment
      of cerebrovascular CO2 reactivity during hypoglycemia.

PMID- 8479106
TI  - A system for three-dimensional shape measurement and its application in microtia
      ear reconstruction.
AB  - Microtia is one form of ear anomalies representing the defect of a partial or
      total loss of external ear. This paper describes new method of total auricular
      reconstruction which combines the use of tissue expander and the non-contact, 3
      dimensional (3-D) shape measurement system. The anterolateral and posterior
      surface of the both sides of the ear of the patients were measured with the 3-D
      shape measurement system. The data from normal side was mirror-imaged
      electronically and transferred to the computer-controlled milling machine to
      create the life-sized, mirror-image wax model. These models were sterilized and
      used as a template or an aid during assembling procedure of the autologous
      cartilage framework in order to reproduce the 3-D configuration of the wax model.
      Seven cases were treated with this method and 5 cases (72%) were graded as
      excellent (superior to that result obtainable from conventional methodology), one
      each (14%) was good (better result) and fair (the same level). There are no poor
      evaluations. In two cases, the exposure of the expander, one of the major
      complications, developed. Although additional surgery was needed, excellent and
      fair result was obtained in these cases. It was concluded that the method
      presented here was evaluated as an overall good method and its application should
      be further extended.

PMID- 8479107
TI  - Lymphangioma of the jejunal mesentery in an adult: a case report and a review of
      the Japanese literature.
AB  - A rare case of lymphangioma of the jejunal mesentery in a 34-year-old woman is
      presented. She was diagnosed as having an ovarian cyst preoperatively, but
      laparotomy revealed a cystic tumor of the mesentery that was histologically
      diagnosed as lymphangioma. Thus far, 44 cases of adult mesenteric lymphangioma
      have been reported in Japan. In nine cases, accurate diagnosis of mesenteric
      cysts was obtained preoperatively. In 31 cases, complete excision with or without
      bowel resection was done, whereas two cases were partially resected and one case
      was drained.

PMID- 8479108
TI  - Immunoelectron microscopic study on IgA, secretory component and complement
      component C3 in the liver of children undergoing total parenteral nutrition
      through neonatal period.
AB  - To study the mechanism of the intrahepatic cholestasis observed during total
      parenteral nutrition (TPN) in neonates, we examined the localization of IgA,
      secretory component (SC) and complement component C3 (C3) in the liver in 4
      patients by light and electron microscopic immunohistochemistry. In the patients
      who received TPN for 1 month, IgA- and SC-positive cholestasis was limited to
      bile canaliculi, but the integrity of both the canalicular wall and intercellular
      tight junction was maintained. These findings suggest that obstruction in the
      biliary tract develops at the canalis of Hering, causing reflux of IgA and SC
      into the bile canaliculi. When the duration of TPN extended beyond 6 months, the
      cholestasis in bile canaliculi progressed further, and degeneration of
      hepatocytes became more marked. Bile retained in hepatocytes occasionally
      contained IgA and SC. IgA- and SC-positive cholestasis also developed in the
      interlobular bile ducts, where no cholestasis had been observed 1 month after the
      beginning of TPN. SC production and SC-mediated transport of IgA, which are
      important functions of bile duct epithelial cells in the local immune mechanism,
      were impaired in association with the injury of those cells. C3 was localized not
      only in the hepatocellular organelles where C3 is normally observed, but also in
      the lumen of dilated bile canaliculi, suggesting that C3 is released from
      hepatocytes into bile in neonates receiving TPN and that C3 may be involved in
      some local immune mechanism of biliary system.

PMID- 8479109
TI  - [Identification of Mycobacterium avium-intracellulare complex in Tohoku district
      of Japan by using DNA probes].
AB  - Attempts were made to identify Mycobacterium avium and Mycobacterium
      intracellulare in the M. avium-intracellulare complex (MAC) isolated in the
      Tohoku district of Japan by using DNA probes (Gen-Probe; Rapid Diagnostic System)
      which are specific for M. avium, M. intracellulare and M. tuberculosis complex,
      respectively. In the Tohoku district, the ratio of M. avium isolates (80%)
      exceeded that of M. intracellulare isolates. It was thus shown that, in the
      Tohoku district where no data concerning the ratio of M. avium to M.
      intracellulare isolates had been available, the ratio of M. avium by far exceeded
      that of M. intracellulare.

PMID- 8479110
TI  - [Investigation of self-discharged patients of pulmonary tuberculosis].
AB  - This study investigates 27 cases in which the patients left hospital care without
      permission for personal reasons. These patients were classified as "self
      discharged patients". Each of the patients had been diagnosed as having pulmonary
      tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital
      during the period from January 1988 to July 1991. Disease was in an advanced
      stage in each of the patients when admitted: all sputum examinations were
      positive and chest roentgenograms revealed cavities in 26 patients. In addition
      to pulmonary tuberculosis, the patients were also diagnosed has having a variety
      of other medical complications such as diabetes mellitus, gastric ulcers and
      liver disease. Many of them were unemployed or were day labors. Reasons
      attributed to patients self-discharge from the hospital included repetition of
      alcohol drinking and unauthorized outings. At the time patients chose to leave
      hospitalization 11 cases checked positive for sputum examinations, and 16 cases
      never returned to complete therapy. Many of them were rated as high risk patients
      for pulmonary tuberculosis because they had no immediate family, did not own a
      residence or have regular employment thus economic and psychological conditions
      were very low. There is a high possibility that these individuals will suffer
      pulmonary tuberculosis relapse and become infectious bacteria carriers. It is
      important that such patients be hospitalized long enough to receive adequate
      treatment to prevent then from becoming infectious carriers and spreading
      disease.

PMID- 8479111
TI  - [Drug resistance of M. tuberculosis and comparison of drug sensitivity test in
      Nepal].
AB  - In Nepal, drug sensitivity test for M. tuberculosis has been carrying out at the
      clinic of German-Nepal Tuberculosis Project (GENETUP) since 1986 and at National
      Tuberculosis Centre (NTC) since 1991. The studies of primary drug resistance and
      acquired drug resistance were performed at NTC. On the other hand, results of
      drug sensitivity test at GENETUP and NTC were compared and analyzed. In total,
      160 M. tuberculosis strains which were isolated from new smear positive patients
      were studied for the primary drug resistance. One of 160 strains, 21 (13.1%)
      strains were resistant to one or more drugs. Resistance rate to one drug, two
      drugs and three drugs were 9.4%, 3.1% and 0.6% respectively. Resistance to four
      drugs and five drugs were not found. Prevalence of resistance of each drug were
      INH 8.1%, SM 5.0%, RFP 2.5%, EB 0.6% and Tb1 1.3% respectively. In total, 125
      strains which were isolated from previously treated patients were studied for the
      acquired drug resistance. Out of 125 strains, 103 (82.4%) strains had resistance
      to one or more drugs. Resistance rate to one drug, two drugs, three drugs, four
      drugs and five drugs were 13.6%, 28.0%, 31.2%, 4.0% and 5.6% respectively.
      Resistance rate of each drug were INH 56.8%, SM 38.4%, RFP 71.2%, EB 16.8% and
      Tb1 24.0% respectively. Since media, criteria of resistance and definition of
      resistance for drug sensitivity test are different between GENETUP and NTC, it is
      difficult to compare the results. However, it is necessary to understand the
      differences well and get good agreement with both sides.

PMID- 8479112
TI  - [Behaviour of gamma delta TCR+ T cells during the course of nontuberculous
      mycobacterial infections and proliferative response of host lymphocytes to 65kD
      heat shock protein].
AB  - In order to know the possibility that gamma delta TCR+ T cells induced by
      Mycobacterium avium complex (MAC) infections participate in the expression of
      host resistance and in the occurrence of Behcet disease, we examined the
      behaviour of them in MAC-infected host mice. In both BALB/c (Bcgs; MAC
      susceptible) and CBA/JN (Bcgr; MAC-resistant) strain mice, a transient but
      appreciable increase in the number of gamma delta TCR+ T cells in the host
      peritoneal lymphocytes was noted around week 1 to 2 after M. intracellulare
      infection via ip. route. The degree of induction of gamma delta TCR+ T cells was
      somewhat higher in CBA/JN mice than in BALB/c mice. Therefore, gamma delta TCR+ T
      cells are partly responsible for the expression of host resistance against the
      MAC in the early phase of infection. However, the subsequent decrease in the
      level of gamma delta TCR+ T cells was observed by week 5. Thus, in the case of
      chronic state of MAC infection, the size of gamma delta TCR+ T cell-pool seems to
      be in normal level. This suggests that per cell activity of gamma delta TCR+ T
      cells rather than mobilizing number of them is important factor in the mechanisms
      for occurrence of allergic diseases including Behcet disease. Although, the early
      increase in gamma delta TCR+ T cells of peritoneal cells was also observed during
      the course of M. fortuitum infection, the degree of induction of gamma delta TCR+
      T cells in A/J mice (M. fortuitum-susceptible) was in similar level as that in
      BALB/c mice (M. fortuitum-resistant).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479113
TI  - Parathyroid gland function in chronic renal failure.
AB  - The concept that the PTH-calcium curve is representative of parathyroid function
      has been discussed. Comparisons of parathyroid function have been made between
      normal humans and hemodialysis patients and also between hemodialysis patients
      with different forms of renal osteodystrophy. From these comparisons, it is
      apparent that the magnitude of HPT is much greater in patients with renal failure
      than in normal humans, and as represented by the ratio of basal to maximal PTH,
      the parathyroid gland appears to be stimulated at basal serum calcium levels in
      hemodialysis patients. Similarly, based on an analysis of the PTH-calcium curve,
      we were able to determine that several differences in parathyroid function were
      present in hemodialysis patients with different forms of renal osteodystrophy. As
      compared to hemodialysis patients with LTAABD and aplastic bone disease, patients
      with osteitis fibrosa have a greater magnitude of hyperparathyroidism, a greater
      sensitivity of the parathyroid cell (slope), a higher set point of calcium, and
      greater PTH stimulation at basal serum calcium (ratio of basal to maximal PTH).
      Calcitriol treatment of hemodialysis patients with osteitis fibrosa resulted in a
      significant decrease in PTH throughout the PTH-calcium curve and also reduced the
      sensitivity (slope) of the PTH-calcium curve. The concept of hysteresis has been
      discussed as well as the role that the ambient basal serum calcium concentration
      may have on the determination of the PTH-calcium curve. Finally, the effect that
      successful renal transplantation has on HPT has been examined. In conclusion, we
      believe that the PTH-calcium curve provides a reliable assessment of parathyroid
      function, and as such, has considerable application for the study of parathyroid
      disorders in the clinical setting.

PMID- 8479114
TI  - Expression of insulin-like growth factor-1 in uremic rats: growth hormone
      resistance and nutritional intake.
AB  - This study was designed to test the hypothesis that induction of insulin-like
      growth factor-1 (IGF-1) is reduced in the uremic rat liver, which would help to
      explain the purported growth hormone resistance noted in uremia. IGF-1 mRNA, in
      the steady state and after acute induction by two doses of 100 micrograms/100 g
      body wt recombinant human growth hormone (rhGH), was quantitated by solution
      hybridization in total liver RNA, extracted by the guanidine thiocyanate/cesium
      chloride gradient method. Eighteen Sprague-Dawley rats weighing 100 to 102 g were
      randomly divided into three groups: sham-operated control rats (control group);
      5/6 nephrectomized rats (uremic group); and sham-operated controls with dietary
      intake matching that of the uremic rats (pair-fed group). The results showed that
      the steady state liver IGF-1 mRNA was 1.7 arbitrary densitometry units (ADU) in
      the uremic animals, and was lower than the value of 3.2 ADU in the control
      animals (P < 0.05). After the acute administration of rhGH, the liver IGF-1 mRNA
      of control, uremic and pair-fed groups showed mean increases of 154% (P < 0.05),
      124% (not significant, NS) and 117% (NS), respectively. The lack of IGF-1
      induction in the uremic group supported the concept of growth hormone resistance
      in uremia. In addition, a similar lack of induction was observed in the pair-fed
      group, whose food intake was 65% that of the control animals. This indicated that
      the lack of IGF-1 induction was at least partially due to the reduced food
      intake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479115
TI  - IGF-II/Man-6-P receptors in rat kidney: apical localization in proximal tubule
      cells.
AB  - The present study was performed to determine the localization of insulin-like
      growth factor II (IGF-II) binding in the rat nephron and, furthermore, to
      determine directly the distribution of the IGF-II/Man-6-P receptor in the
      proximal tubule. The IGF-II/Man-6-P receptor was visualized by immunohisto- and
      cytochemical techniques, and the binding of IGF-II was shown by light and
      electron microscope autoradiography applying 125I-IGF-II directly on
      cryosections. The tubular uptake of IGF-II was studied by autoradiography after
      in vivo injection of 125I-IGF-II. The light microscope immunolabeling was
      confined to a relatively narrow band in the apical part of the proximal tubule
      cells just below the brush border, and was strongest in the first portion of the
      proximal tubule, segment 1 (S1), with decreasing intensity in segment 2 (S2) and
      weaker in segment 3 (S3). Several cytoplasmic bodies were labeled but no label
      was observed in the basolateral part of the cells. We did not detect any labeling
      of glomeruli or other segments of the nephron. Electron microscope
      immunocytochemistry in the proximal tubule revealed a strong labeling in apical
      endocytic invaginations, small endocytic vacuoles, and large endocytic vacuoles,
      weaker in lysosomes and dense apical tubules. Light microscope autoradiography
      after incubation of cryosections with labeled IGF-II demonstrated an intense
      labeling just beneath the brush border, especially in S1 of the proximal tubule,
      and, in addition, the corresponding electron microscope autoradiography revealed
      an intense labeling over large endocytic vacuoles and lysosomes. These results
      were confirmed and extended by competitive binding experiments and quantitative
      immunocytochemistry. After i.v. injection of 125I-IGF-II autoradiographic grains
      were almost exclusively observed in the electronmicroscope over endocytic
      vacuoles and lysosomes in the S1 of the proximal tubule. The present study shows
      that the IGF-II/Man-6-P receptor is located in components of the vacuolar system
      in the apical cytoplasm of rat renal proximal convoluted tubule cells, mainly in
      S1. This localization was seen to be consistent using various immunolabeling and
      autoradiographic techniques in vivo and in vitro.

PMID- 8479116
TI  - Calcium antagonists and converting enzyme inhibitors reduce renal injury by
      different mechanisms.
AB  - Both glomerular hypertension and hypertrophy have been associated with the
      development of glomerular injury in models of hypertension and reduced renal
      mass. The purpose of this study was to examine the effects of antihypertensive
      therapy on these parameters in the remnant kidney model of progressive glomerular
      sclerosis. Rats underwent 5/6 nephrectomy and were randomly assigned to receive
      either no therapy, the calcium entry blocker (CEB), nifedipine, or the
      angiotensin converting enzyme inhibitor (CEI), enalapril. Administration of
      either drug was associated with a reduction in systemic blood pressure and in the
      severity of glomerular injury assessed eight weeks after renal ablation.
      Micropuncture studies four weeks after ablation revealed that systemic and
      glomerular capillary pressure were high in untreated remnant kidney rats and
      reduced by enalapril. Administration of nifedipine was associated with a decline
      in systemic pressure, however, plasma renin levels increased, causing efferent
      arteriolar vasoconstriction and persistence of glomerular hypertension.
      Morphometric analysis showed that kidney weight, glomerular volume and glomerular
      capillary radius were lower in nifedipine treated rats than in the other two
      groups, indicating that the CEB, but not enalapril, inhibited the hypertrophic
      response to ablation of renal mass. Therefore, both CEIs and CEBs reduce
      glomerular injury in rats with remnant kidneys but they may act by different
      mechanisms. CEI reduce glomerular capillary pressure while CEBs inhibit
      compensatory kidney growth.

PMID- 8479117
TI  - Distribution of erythropoietin producing cells in rat kidneys during hypoxic
      hypoxia.
AB  - We have used in situ hybridization to determine the localization and distribution
      of cells expressing the erythropoietin (EPO) gene in kidneys of rats exposed to
      reduced oxygen tensions to characterize the control of renal EPO formation during
      hypoxic hypoxia. Animals were subjected to severe hypoxia (7.5% O2) for 4, 8 and
      32 hours to assess changes related to the duration of hypoxic exposure, and
      additionally to 9% and 11.5% O2 for eight hours to define changes related to the
      degree of hypoxia. The number of cells containing EPO mRNA were counted on tissue
      sections and compared to tissue concentrations of EPO mRNA and to the serum
      hormone concentrations. In situ hybridization revealed expression of the EPO gene
      exclusively in peritubular cells that were predominantly located in the cortical
      labyrinth under all conditions tested. After four hours of severe hypoxia (7.5%
      O2) approximately 170-fold more cells were found to contain EPO mRNA than under
      normoxic conditions. The number of EPO producing cells did not change
      significantly between four and eight hours exposure to 7.5% O2, but the amount of
      EPO mRNA per kidney increased approximately threefold. Further continuation of
      hypoxia resulted in down-regulation of renal EPO mRNA levels, which was mainly
      due to a reduction in the number of cells containing EPO mRNA. Comparison of
      graded degrees of hypoxia applied for eight hours showed an inverse exponential
      relationship between oxygen tension and the number of EPO producing cells. This
      recruitment of cells expressing the EPO gene occurred along a gradient extending
      from the corticomedullary border to the subcapsular tissue.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8479118
TI  - Lack of albuminuria in the early heterologous phase of anti-GBM nephritis in
      beige mice.
AB  - Passive anti-glomerular basement membrane (GBM) nephritis in the mouse is
      accompanied by acute massive albuminuria in the early heterologous phase. As we
      have previously shown, this albuminuria does not occur in the beige mutant of the
      C57BL/6J strain which is deficient for the leukocytic neutral proteinases
      elastase and cathepsin G. To address the question whether an intrinsic defect in
      the polymorphonuclear granulocyte (PMN) or local factors in the beige kidney are
      responsible for the lack of albuminuria in the beige mouse strain, we conducted
      reciprocal bone marrow transplantations (BMT) in beige and congenic control mice.
      Injection of anti-GBM antibody resulted in only slight albuminuria (89 +/- 47
      micrograms/18 hours; N = 6) in normal (that is, non-irradiated, non
      reconstituted) beige mice. By contrast, in beige mice, reconstituted with bone
      marrow (BM) from control mice, acute albuminuria developed (3032 +/- 1408
      micrograms/18 hours; N = 8), to a degree comparable to that in non-irradiated
      control mice (4411 +/- 3405 micrograms/18 hours; N = 6, P < 0.01). Albuminuria in
      control mice, reconstituted with beige BM, was in the range of the normal beige
      mice (112 +/- 55 micrograms/18 hours; N = 9). Reconstitution with syngeneic bone
      marrow demonstrated that BMT by itself did not influence the level of
      albuminuria. All mice showed similar morphological lesions, with comparable
      influx of PMN in the glomeruli two hours after antibody injection. Elastase
      activities of PMN extracts in BMT groups were not different from those in donor
      mice. We conclude that the absence of albuminuria in beige mice is caused by an
      intrinsic defect in leukocytic neutral proteinase activity.

PMID- 8479119
TI  - Ca2+ oscillations in the rabbit renal cortical collecting system induced by Na+
      free solutions.
AB  - The presence of a Na(+)-Ca2+ exchange system has been previously demonstrated at
      the basolateral side of the cortical collecting system. The role of such an
      exchanger in maintaining low intracellular [Ca2+] ([Ca2+]i) in this nephron
      segment is now investigated. Cells from the connecting tubule and cortical
      collecting duct of rabbit kidneys were isolated by immunodissection with mAb R2G9
      and subsequently cultured on glass coverslips. [Ca2+]i was measured in single
      cells using quantitative fluorescence microscopy. Surprisingly, isoosmotic
      substitution of extracellular Na+ ([Na+]o) for N-methylglucamine generated
      [Ca2+]i oscillations in individual cells instead of an anticipated sustained
      increase in [Ca2+]i. The amplitude of these oscillations ranged between 150 to
      600 nM (average 308 +/- 19 nM) and occurred at a frequency of 0.63 +/- 0.03 min
      1, with a duration of 44 +/- 2 seconds per spike. Oscillations were only observed
      in response to [Na+]o less than 5 mM and lasted until Na+o was re-introduced. The
      compound U73122 (10 microM), a new phospholipase C inhibitor, inhibited [Ca2+]i
      oscillations, which strongly suggests that IP3 generation initiates [Ca2+]i
      oscillations. [Ca2+]i oscillations were independent of extracellular Ca2+ and
      could not be inhibited by lanthanum ions, indicative for an intracellular source
      for the generation of Ca2+ spikes. Addition of thapsigargin, a specific inhibitor
      of endoplasmic reticulum Ca(2+)-ATPase activity, induced a considerable
      intracellular Ca2+ release, after which [Ca2+]i oscillations could no longer be
      provoked. Caffeine (20 mM) reversibly inhibited the Ca2+ oscillations, which
      implies that Ca(2+)-induced Ca2+ release is involved in generating these
      oscillations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479120
TI  - Vasopressin receptor-mediated endocytosis in cells transfected with V1-type
      vasopressin receptors.
AB  - We examined the process of receptor-mediated endocytosis in A-9 lung fibroblast
      and chinese hamster ovary (CHO) cells transfected with the recently cloned
      vasopressin V1a receptor (51). We used a fluorescent labeled vasopressin analog
      (rhodamine-mercaptopropionic acid lysine vasopressin) and radiolabeled
      vasopressin to examine this process in the two transfected cell lines. Both A-9
      and CHO cells internalize vasopressin in a manner consistent with receptor
      mediated endocytosis. A-9 cells internalize vasopressin more rapidly than CHO
      cells. The process is inhibited by vasopressin and by specific vasopressin V1
      receptor antagonists but not by specific V2 receptor antagonists. Hypertonic
      sucrose inhibits endocytosis in both cell types suggesting a role of clathrin
      coated pits in the endocytosis of receptor in these cells. These cells are
      excellent models in which to examine the effect of receptor mutations on
      vasopressin receptor-mediated endocytosis.

PMID- 8479121
TI  - Nonenzymatic glycation of mesangial matrix and prolonged exposure of mesangial
      matrix to elevated glucose reduces collagen synthesis and proteoglycan charge.
AB  - Expansion of the mesangial matrix in diabetes occurs after prolonged exposure to
      the diabetic milieu. To mimic the long-term hyperglycemia of diabetes mellitus we
      developed tissue culture systems that might approximate the chronic state. This
      was accomplished in two ways: (1) by growing mesangial cells on extracellular
      matrix glycated and crosslinked in vitro and (2) by continuously growing cells on
      their own matrix on filters in elevated glucose medium (500 mg/dl) for up to
      eight weeks without passage. Synthesis of collagen and proteoglycans was
      evaluated in cells grown under these conditions. In both these situations, 3H
      proline incorporation into collagenase sensitive protein and 35S incorporation
      into sulfated proteins were reduced compared to control cultures. Despite
      reduction in 35S incorporation into proteoglycans in the high glucose cultures,
      total glycosaminoglycan content was unchanged. However, proteoglycans generated
      by mesangial cells grown in elevated glucose media were of a lower negative
      charge than controls. In mesangial cells continuously grown on filters, the
      levels of messenger RNA for collagen types I and IV, biglycan and TGF-beta were
      not different in cells grown at elevated or standard glucose concentrations for
      two and four weeks. We conclude that crosslinking of mesangial matrix or
      continuous culture of cells for prolonged periods of time in high glucose medium,
      which may also crosslink matrix, suppresses collagen synthesis and reduces the
      negative charges on matrix proteoglycans without altering mRNA levels.

PMID- 8479122
TI  - Bilateral ureteral obstruction alters levels of the G-protein subunits G alpha s
      and G alpha q/11.
AB  - To evaluate the effects of bilateral ureteral obstruction (BUO) on the levels of
      G-protein subunits in glomeruli, we examined the types and amounts of G-protein
      subunits in glomerular membranes from sham-operated control (SOC) rats and rats
      with BUO of 24 hours duration utilizing bacterial toxin-catalyzed ADP
      ribosylation and specific antibodies. ADP-ribosylation catalyzed by cholera or
      pertussis toxin demonstrated the presence of Gs and Gi proteins in glomerular
      membranes. Immunoblots further revealed the existence of two types of G alpha s
      (45 and 52 kDa), as well as G alpha i2 (40 kDa), G alpha i3 (41 kDa), G alpha
      q/11 (42 kDa) and G beta (35 to 36 kDa) in glomerular membranes. The predominant
      subspecies of G alpha s was the 52 kDa protein. Detectable amounts of G alpha o
      were not found in glomerular membranes. Moreover, G-protein subunits were not
      detected in cytosolic extracts of glomeruli. Both forms of G alpha s and G alpha
      q/11 were significantly reduced in glomerular membranes from rats with BUO when
      compared to SOC rats. No significant difference in total G alpha i, G alpha i2
      and G alpha i3 and G beta content was observed between the two groups of rats. In
      vivo pretreatment of rats with simultaneous administration of the angiotensin
      converting enzyme inhibitor, enalaprilat, and the thromboxane synthase inhibitor,
      OKY-046, maintained the amount of G alpha s and G alpha q/11 in rats with BUO at
      the levels seen in SOC rats. The two drugs did not affect the amounts of G
      protein subunits in glomerular membranes of SOC rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8479123
TI  - Gianturco self-expanding stent in the treatment of stenosis in dialysis access
      grafts.
AB  - This study evaluated the effectiveness of the Gianturco endovascular stent in
      preserving graft patency following percutaneous transvenous angioplasty (PTVA) of
      stenotic lesions occurring at the graft-vein anastomosis in hemodialysis patients
      with polytetrafluoroethylene grafts. Fifty-eight patients having 50% or greater
      stenosis were randomly divided into a treatment group (N = 28) and a concurrent
      control group (N = 30) following PTVA. In the treatment group, a stent was placed
      following dilatation. Graft thrombosis, the need for surgical revision, or the
      need for a repeat PTVA were used as end point events. The period of time from the
      PTVA/stent procedure to the end point event was referred to as the duration of
      efficacy (DE). By life table analysis, the DE for the treatment group was 100% at
      30 days, 91% at 60 days, 85% at 90 days, 72% at 180 days, and 17% at 360 days.
      Comparison of the characteristics and results obtained in the treatment group and
      that of the concurrent control group revealed no significant difference in any
      parameter prior to treatment, in the response to PTVA, or in the DE of the
      procedure performed. It was concluded that the stent offered no advantage in the
      treatment of the graft-vein anastomosis stenotic lesion affecting PTFE dialysis
      access grafts.

PMID- 8479124
TI  - Soluble CD23 as an effector of immune dysregulation in chronic uremia and
      dialysis.
AB  - Patients with chronic renal failure often present an immunodeficiency state
      paradoxically exacerbated by hemodialysis and associated with signs of T cell
      activation. The presence of circulating monokines suggests that monocytes are
      also activated. Whether or not this includes B cells is controversial, despite
      frequently abnormal antibody responses. We thus investigated whether the soluble
      low-affinity receptor for IgE (Fc epsilon RII/CD23), recently identified as a
      marker of B cell and monocyte activation and possibly involved in T cell
      activation, was modulated by chronic renal failure and hemodialysis. Relative to
      values in healthy individuals (N = 31), plasma concentrations of soluble CD23
      were significantly elevated in non-dialyzed chronically uremic patients (N = 44),
      more elevated in patients on peritoneal dialysis (N = 24), and most elevated in
      those on regular hemodialysis (N = 132), stabilizing after about six months.
      Soluble CD23 levels were unmodified by the first dialysis session but rose
      markedly during regular dialysis with cellulose or polysulfone membranes, but not
      with polyacrilonitrile AN-69 membranes. Soluble CD23 levels correlated with
      levels of IgG, and those of tumor necrosis factor alpha and interleukin-6,
      suggesting that increased sCD23 levels reflect activation of B cells and
      monocytes, respectively. These findings reinforce the view of soluble CD23 as a
      multi-functional receptor/cytokine, and provide evidence that it might contribute
      to the immune dysregulation associated with chronic renal failure and exacerbated
      by hemodialysis.

PMID- 8479125
TI  - 31P NMR spectroscopy investigation of muscle metabolism in hemodialysis patients.
AB  - Calf muscle metabolism of six patients with end-stage chronic renal failure
      undergoing maintenance hemodialysis and of six control subjects was studied using
      31P nuclear magnetic resonance spectroscopy at 4.7 Tesla. Spectra were obtained
      at rest, during exercise and recovery. At rest, the inorganic phosphate, ATP and
      phosphocreatine concentrations, and the intracellular pH were similar in both
      groups of subjects. In the patients, the maximum workload achieved at the end of
      exercise led to a 84% and 46% depletion of phosphocreatine and ATP, respectively;
      under this condition, the intracellular pH fell to 6.50 +/- 0.09. In control
      subjects, a maximum workload caused no change in ATP concentration at the end of
      exercise, but a phosphocreatine depletion and an intracellular pH fall similar to
      those observed in the patients. Although the rate of phosphocreatine depletion
      during exercise was not different in the two groups of subjects, the decrease in
      intracellular pH was more rapid in the patients than in control subjects. At the
      end of maximum exercise, the rates of recovery of both phosphocreatine and
      intracellular pH were significantly reduced in the muscle of hemodialysis
      patients when compared to normal subjects. These results suggest that, in the
      calf muscle of hemodialysis patients, energy production via oxidative metabolism
      is impaired and compensated for by an increase in anaerobic glycolysis.

PMID- 8479126
TI  - Serial measurements of GFR in infants using the continuous iothalamate infusion
      technique. Southwest Pediatric Nephrology Study Group (SPNSG).
AB  - We undertook a preliminary study to determine if a clinical trial was feasible
      that would compare the effect of a low protein vs a control formula on GFR and
      growth in infants with congenital renal insufficiency (CIo < 55 ml/min/1.73 m2).
      In this report from the Infant Diet Protein Study, we describe validation of a
      method using the plasma clearance of iothalamate (CIo) as an estimate of
      glomerular filtration rate (GFR) and results of the preliminary study relating to
      renal function. The plasma CIo method was validated as an accurate estimate of
      GFR by showing it to be the same as the plasma clearance of inulin (CIn). In the
      preliminary study infants who qualified for the study were randomly assigned to a
      low protein or control formula and were followed from 8 to 18 months of age. CIo
      was measured at 8, 14 and 18 months of age in 21 of the infants and at 8 and 18
      months of age in all twenty four infants that entered the study. Average absolute
      GFR in the 24 infants increased in the 10 month period from 5.3 +/- 2.7 to 7.6 +/
      4.5 ml/min. The percent increase in GFR was no different in infants whose GFR at
      8 months of age was severely reduced from those whose GFR was only moderately
      reduced. When adjusted for age and body size, GFR did not change. Change in mean
      CIo or serum creatinine (SCr) from 8 to 18 months of age between the infants in
      each diet groups was not different. We conclude that a clinical trial enrolling
      more infants and extending the study period is necessary to evaluate dietary
      protein effect.

PMID- 8479127
TI  - Aluminum kinetics using bicarbonate dialysate with the sorbent system.
AB  - In the REDY system a sorbent cartridge is used to regenerate the spent
      hemodialysate so that only six liters of dialysate are required for a treatment.
      The manufacturer claims that the cartridge can be used to remove aluminum from
      the dialysate and that it does not add aluminum to the dialysate. This claim for
      acetate dialysate is supported by the literature, but there are few data
      available relative to bicarbonate dialysate. The present study evaluates the use
      of bicarbonate dialysate and the REDY system in regard to aluminum kinetics both
      in vitro and in vivo. In vitro, the sorbent cartridge removed aluminum from
      dialysate prepared from water containing as much as 470 micrograms/liter of
      aluminum, giving a dialysate containing less than 10 micrograms/liter. The first
      500 ml of effluent contained 13 micrograms/liter of aluminum but after filtration
      decreased to below 10 micrograms/liter. Thus, it is unnecessary, as recommended,
      to discard the first effluent since this unfilterable aluminum will not pass
      through a dialysis membrane. In vivo, in a crossover study comparing the REDY
      with single pass, there were no significant differences between the pre- and post
      plasma aluminum concentrations, and the dialysate aluminum remained below 4
      micrograms/liter during the dialysis. In a second in vivo study the effect of
      dialysate from tap water on plasma aluminum using the predialysis purification
      procedure was evaluated. There was no differences between the pre- and post
      plasma aluminum concentration. The aluminum levels were comparable to those of
      the crossover study. The dialysate remained below 4 micrograms/liter during the
      dialysis.

PMID- 8479128
TI  - Adsorption of complement factor D by polyacrylonitrile dialysis membranes.
AB  - Factor D, an essential enzyme of the alternative pathway (AP) of complement,
      accumulates in end-stage renal failure (ESRF). Polyacrylonitrile (PAN) membrane
      activates complement poorly and has been shown to adsorb C3a, the main
      anaphylatoxin released during complement activation. In the present work we
      investigated whether factor D might be adsorbed on PAN. In vitro there was a loss
      of hemolytic factor D when normal human serum (NHS) was incubated with PAN
      dialysis fibers, whereas no loss was observed with cuprophan (Cu) fibers. There
      was a dose and time dependent binding of purified radiolabeled factor D to PAN
      but not to Cu. The hemolytic function of factor D released from PAN by 2 M NaCl
      was normal. By contrast, factor D was inactive while adsorbed to PAN fibers. When
      50 ml of NHS or 100 ml of whole blood were passed through a new hollow fiber PAN
      dialyzer 95% of factor D was adsorbed. The eluate from a PAN filter which had
      been used for dialysis in a patient with ESRF contained 38.4 mg of hemolytic
      factor D, representing 34% of the proteins eluted. By immunoblotting, antigenic
      factor D from the PAN eluate was identical to purified human factor D. In six
      patients there was a 81.4% decrease in hemolytic factor D in blood after dialysis
      with PAN, contrasting with a 9.6% decrease in those dialyzed with cellulose
      acetate. No factor D was found in the dialysis fluid of PAN dialyzers, indicating
      that PAN removed factor D mainly by adsorption. In conclusion, PAN has a
      significant capacity to adsorb factor D, a reaction that might contribute to the
      diminished capacity of PAN membrane to activate the AP of complement. Whether the
      efficient removal of large amounts of factor D might be beneficial in uremic
      patients remains to be defined.

PMID- 8479129
TI  - A multivitamin infusion prevents lipid peroxidation and improves transplantation
      performance.
AB  - The objective of this study was to test the hypothesis that ischemia reperfusion
      damage in kidney transplantation is associated with lipid peroxidation and that
      inhibition of lipid peroxidation by antioxidants improves the function of the
      transplanted kidney. Lipid peroxidation was assessed by measuring the plasma
      malonaldehyde content (as thiobarbituric acid reaction product) with high
      performance liquid chromatography. Kidney function was assessed by plasma
      creatinine and creatinine clearance. Thirty patients of an ongoing series were
      randomly selected into two groups, with 14 controls and 16 patients in the
      antioxidant therapy group. Therapy consisted of two ampoules of Omnibionta (which
      contains vitamins C, E, A and B complex) diluted in 500 ml physiological sodium
      chloride, which was infused intravenously prior to reperfusion onset. No
      significant differences existed for the age of the patients in the control (43.00
      +/- 9.86 years) and the therapy group (41.56 +/- 14.14 years) nor in the kidney
      preservation time, which was 24.12 +/- 8.73 and 18.43 +/- 9.97 hours in the
      control and therapy group, respectively. The controls showed a transient increase
      of plasma lipid peroxides as measured by malonaldehyde with a peak one hour after
      onset of reperfusion. Compared to the baseline value of 0.74 +/- 0.26 (mean +/-
      SD) the one hour malonaldehyde value increased to 1.46 +/- 0.22 nmol/ml (P <
      0.001). In the therapy group the plasma malonaldehyde level did not increase, but
      slightly decreased by about 20% compared to the baseline value. The difference of
      plasma malonaldehyde between the two groups one hour after reperfusion onset was
      highly significant (P > 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479130
TI  - Apolipoproteins and lipoprotein receptors in glomeruli in human kidney diseases.
AB  - This study offers morphological evidence of the involvement of lipid
      abnormalities in human glomerular injury. Renal biopsy tissues from patients with
      several types of glomerular diseases were immunocytochemically examined using
      antibodies to apolipoproteins (apo) A-I, B-100, and E, and antibodies to low
      density lipoprotein (LDL) receptors and scavenger receptors. Immunofluorescent
      staining showed the predominant deposition of apo B and apo E in the mesangial
      area in mesangial proliferative types of glomerulonephritis; the distribution and
      staining intensity of these apolipoproteins correlated with the grade of
      mesangial proliferation and proteinuria, but were independent of plasma lipid
      levels. Immunoelectron microscopy revealed that apo B and apo E were distributed
      in droplets within glomerular epithelial and mesangial cells or in a granular
      pattern in the expanded mesangial matrix. Apo A-I was mainly localized in the
      visceral epithelial cells of normal human kidneys. Staining for apo A-I was
      increased in the glomerular epithelial cells of nephritic kidneys, compared to
      the pattern in normal human kidneys, and was decreased in the sclerosed areas of
      glomeruli. An immunogold technique revealed the expression of LDL receptors on
      the surface membranes of glomerular mesangial and epithelial cells. Dual
      immunofluorescent staining showed that apo B and LDL receptors were occasionally
      co-localized in nephritic glomeruli. Scavenger receptor was detected on the
      plasma membranes of mesangial and visceral epithelial cells. The glomerular
      expression of scavenger receptor was increased in glomeruli with marked mesangial
      proliferation. In addition, the expression of this receptor was intense in
      monocytes/macrophages occasionally infiltrating the glomeruli. Our present
      findings indicate that in human nephritic kidneys, glomerular epithelial and
      mesangial cells express both LDL receptors and scavenger receptors. The
      accumulation of apolipoproteins, whether receptor-mediated or mediated by other
      mechanisms, can occur independently of plasma lipid levels, and may be associated
      with mesangial expansion and proteinuria.

PMID- 8479131
TI  - A crossover comparison of progression of chronic renal failure: ketoacids versus
      amino acids.
AB  - Rates of progression of chronic renal failure were compared in patients receiving
      alternately an amino acid supplement (AA) and a ketoacid supplement (KA) to a
      very low protein (0.3 g/kg), low phosphorus (7 to 9 mg/kg) diet. The first
      supplement was randomly chosen. Bias due to carryover effects was minimized by
      delaying the regression analysis until one month after starting or changing
      supplements. In order to minimize possible bias caused by initiating the two
      supplements at differing levels of severity, a multiple crossover design was used
      (ABA, BAB, ABAB, or BABA) with at least four GFR's in each treatment period
      (except for three GFR's in one instance). Sixteen patients completed the
      protocol; five dropped out. Average starting GFR's were nearly identical for the
      two supplements (15.4 and 15.9 ml/min). For each patient, mean progression on KA
      was compared with mean progression on AA. Thirteen out of 16 patients progressed
      more slowly on KA than AA. On the average, progression on KA was significantly
      slower (95% confidence limits = -0.36 to 0.09 ml/min/month) than on AA (-0.91 to 
      0.41 ml/min/month; P = 0.024). There was no significant difference in estimated
      protein intake, phosphate excretion, or mean arterial pressure between KA and AA
      periods. Serum triglyceride concentration was significantly lower on KA (P =
      0.0026). 17-hydroxycorticosteroid excretion was also lower (P = 0.031). We
      conclude that KA slow progression, relative to AA, independently of protein or
      phosphorus intake, in patients on this regimen.

PMID- 8479132
TI  - [Secondary retinal detachment].

PMID- 8479133
TI  - [Retinopathy of prematurity and retinal detachment].
AB  - The authors examined 60 children (91 eyes), aged 5 months to 17 years, with
      retinal detachment in the ROP course; 19 eyes were selected for the surgery, 5
      eyes with the active ROP phase and 14 myopic eyes with the vitreo-retinal changes
      resulting from ROP. The segmental or encircling scleral buckling was performed in
      19 eyes, in 4 eyes the vitrectomy and the endo-tamponade was used. In 12 eyes
      (63%) the retinal attachment was achieved, in 2 eyes in the active phase (40%)
      and 10 eyes (71.3%) with regressed ROP.

PMID- 8479134
TI  - [Clinical course and treatment of angiomatosis of the retina].
AB  - Basing on 11 cases of angiomatosis retinae, diagnosed and treated in the last 30
      years in the Ophthalmological Clinic in Halle, the authors discussed the problems
      concerning this rare disease. Their observations confirmed the opinion that
      photocoagulation is the method of choice in the treatment of angiomatosis retinae
      and that it is successful in small, less than 2 disc diameter angiomas. The
      further possible therapeutical methods are cryocoagulation, radioactive-isotopes
      and vitrectomy. As the treatment should be repeated and the long-lasting follow
      up is necessary, the efficient cooperation with the patients is very important.

PMID- 8479135
TI  - [Treatment of secondary retinal detachment in von Hippel-Lindau disease].
AB  - In the last 16 years, 8 patients (9 eyes) with secondary retinal detachment in
      von Hippel-Lindau disease were treated. The methods of treatment depended on the
      size and number of vascular tumours and on the extent and type of retinal
      detachment. The retina was successfully reattached in 4 eyes. In 4 eyes with the
      total retinal detachment, our treatment was uneffective. One patient is treated
      till now. The best results were observed when the tumours were small and single
      and the retinal detachment extended to less than 1 quadrant of the fundus of the
      eye. The successful therapy is conditioned by the complete destruction of the
      tumour. The treatment of the large retinal detachment, in spite of using
      different methods, is very often difficult and unsuccessful.

PMID- 8479136
TI  - [500 operations of retinal detachment. Early and long-term evaluation].
AB  - The early and long-term postoperative results of 453 patients (510 eyes) with
      retinal detachment, treated with several buckling procedures, have been analysed.
      The follow-up, ranging from 2 to 9 years, revealed that the better anatomical and
      functional results were observed in the group of 325 eyes, in which the complete
      subretinal fluid drainage had been performed during the surgery, compared with
      185 non-drained eyes.

PMID- 8479137
TI  - [Intraocular tamponade with SF6 gas in the treatment of selected cases of retinal
      detachment].
AB  - The aim of this paper is to present the results of the endotamponade with SF6 gas
      in the treatment of 19 patients with retinal detachment. The cases selected for
      the surgery were characterised by the retinal tear situated in the upper part of
      the fundus of the eye or in the posterior pole with no symptoms of PVR phase C
      and D and vitreo-retinal traction. The indications for endotamponade, the causes
      of failures and the complications connected with this kind of surgery were
      discussed.

PMID- 8479138
TI  - [Blood-retinal barrier and visual field in retinitis pigmentosa].
AB  - The aim of the research was to determine, with new-generation fluorometer
      (Fluorotron Master), the factor of fluorescein leakage into the vitreous and to
      reveal, with the static perimeter (Humphrey's), the quantitative parameter of the
      visual field in retinal pigmentary dystrophy. The factor of fluorescein leakage
      into the vitreous was almost ten times higher in retinal pigmentary dystrophy and
      it indicated the damage of blood-retina barrier. The correlation between the
      factor of fluorescein leakage into the vitreous and the degree of visual field
      defect has not been found.

PMID- 8479139
TI  - [Retinoschisis vs. retinal detachment--diagnosis and treatment].
AB  - In the years 1985-1990, 987 patients with retinal detachment were treated in the
      Ophthalmological Clinic of Medical Academy in Poznan. In 25 patients, from the
      above group, the coexistence of retinoschisis was observed. The clinical picture
      of retinal detachment and retinoschisis was the basis for explaining the
      pathogenesis of two different phenomena: "retinoschisis versus retinal
      detachment" and "retinal detachment versus retinoschisis". The surgical treatment
      applied to 25 eyes resulted in 88% retinal attachment.

PMID- 8479140
TI  - [Clinical examinations on pathogenesis and treatment of serous macular detachment
      associated with congenital optic pit].
AB  - The author reports two clinical tests performed in 6 patients for explaining the
      pathogenesis of serous macular detachment associated with congenital optic pit.
      The results of these tests indicate, that the detachment is caused by the fluid
      of vitreal origin. The treatment of this disease with the laser coagulation is
      also reported.

PMID- 8479141
TI  - [Serous macular detachment caused by congenital optic pit].
AB  - The observations concerning the treatment of 5 patients suffering from the serous
      macular detachment caused by the optic pit are presented. In all 5 cases, the
      laser photocoagulation along the temporal margin of disc was applied. The retinal
      attachment was obtained in 2 eyes.

PMID- 8479142
TI  - [Use of transconjunctival cryoapplication in chronic pars planitis with
      involvement of peripheral retina and choroid].
AB  - The transconjunctival cryoapplication was performed in 8 patients (13 eyes) with
      the recurrent pars planitis and the simultaneous involvement of peripheral retina
      and choroid. Before the surgery, the peripheral fundus of the eye was examined
      with the Goldmann three-mirror lens and afterwards, the cryoapplication of
      lesions was performed. The topical treatment, dexamethasone and indomethacin
      drops, followed the surgery only. In all cases the inflammation disappeared but
      the macular edema and vitreal exudation regressed slowly. The considerable
      improvement of visual acuity was achieved in 8 eyes (61%). So far, the results of
      the observations are satisfactory and they entitle the authors to carry on the
      application of the treatment mentioned above.

PMID- 8479143
TI  - [Simultaneous bilateral retinal detachment as a delayed consequence of
      retinopathy of prematurity].
AB  - The case of prematurely born woman, aged 22, with bilateral retinal dialysis and
      detachment in high myopic eyes is presented. The minor head-trauma preceded the
      onset of the detachment. The segmental scleral buckling procedures were performed
      in both eyes. The attachment of the retina and some improvement of visual acuity
      were achieved.

PMID- 8479144
TI  - [History of the department of Ophthalmology in Krakow from 1851-1991].

PMID- 8479145
TI  - Oxidized lipoproteins and leukocyte-endothelial interactions: growing evidence
      for multiple mechanisms.

PMID- 8479146
TI  - Neuroexcitation, excitotoxicity and human neurological disease.

PMID- 8479147
TI  - Capillary endothelium. Target site of renal radiation injury.
AB  - BACKGROUND: Therapeutic abdominal irradiation may be accompanied by late
      occurring progressive renal disease associated with glomerular mesangial
      sclerosis and tubular degeneration. Pathogenesis of this lesion is disputed.
      EXPERIMENTAL DESIGN: Kidneys of mature pigs were irradiated with a single dose of
      9.8 Gy 60Co gamma-rays; serial individual kidney glomerular filtration rate and
      renal biopsies were obtained at 3-4-week intervals with death 24 weeks after
      irradiation. RESULTS: Irradiated pigs displayed a progressive reduction in
      glomerular filtration rate with minimal values observed 12 weeks postirradiation.
      Morphologic changes in irradiated glomeruli were characterized by leukocytic
      attachment to capillary endothelial cells 3-6 weeks after irradiation followed by
      activation and swelling of endothelial cells and occasional microthrombi
      formation. Similar changes were noted focally in peritubular capillaries with
      accompanying tubular degeneration and atrophy. In glomeruli these endothelial
      cell changes were followed by increased capillary permeability and fluid,
      erythrocyte, platelet, and leukocytic exudation into the subendothelial/mesangial
      space resulting in compression of glomerular capillary lumina. By 12 weeks
      postirradiation mesangial cells showed evidence of activation and proliferation
      accompanied by progressive mesangial expansion and sclerosis with continued
      reduction of glomerular filtration rate. CONCLUSIONS: It is concluded that
      endothelial cell injury represents the primary site of radiation damage in the
      kidney and that the progressive glomerular mesangial sclerosis and reduced renal
      function of radiation nephropathy may be associated with exposure of capillary
      elements to various vasoactive and growth promoting factors that stimulate
      mesangial contraction and proliferation resulting in reduced glomerular
      filtration area and glomerular filtration rate.

PMID- 8479148
TI  - Increase production of fibronectin by glomerular cultures from rats with
      nephrotoxic nephritis. Macrophages induce fibronectin production in cultured
      mesangial cells.
AB  - BACKGROUND: The participation of monocytes-macrophages and their products in the
      pathogenesis of several types of glomerulonephritis has become increasingly
      evident. One of the most important aspects is the potential stimulation of
      monocyte-macrophages of the extracellular matrix. Therefore, production of
      fibronectin (FN) by glomeruli of rats with nephrotoxic nephritis was studied. In
      addition, the effect of macrophage-conditioned medium and interleukin-1 on FN
      production by cultured mesangial cell (MC) was tested. EXPERIMENTAL DESIGN:
      Nephrotoxic nephritis was induced in rats by injection of nephrotoxic serum and
      glomeruli obtained at different periods of time from nephritic and normal animals
      were cultured. FN in glomerular supernatants was determined by enzyme-linked
      immunosorbent assay and newly synthesized FN by incorporation of [35S]
      methionine. Macrophage-conditioned medium was obtained from cultures of
      peritoneal resident macrophages and elicited macrophages by different stimuli. MC
      were cultured with or without macrophage supernatant or interleukin-1 and FN
      content from MC supernatants was determined by enzyme-linked immunosorbent assay.
      RESULTS: These data show increase amounts of FN in nephritic cultures when
      compared with saline controls (time of nephritis; day 4: 3.9-, day 8: 4.35-, and
      day 18: 2.68-fold increase in FN) and experiments of newly synthesized FN by
      incorporation of [35S]-methionine had similar results. Macrophage-conditioned
      medium had FN stimulatory effect on cultured MC but interleukin-1 did not.
      CONCLUSIONS: These data suggest: (a) that there is an increased newly synthesized
      FN production in glomeruli from rats with nephrotoxic nephritis, (b) that
      macrophage produce a FN-stimulatory factor(s) for MC, and (c) that this
      stimulatory factor probably is not interleukin-1.

PMID- 8479149
TI  - Decreased synthesis and delayed processing of sulfated glycoproteins by cells
      from human polycystic kidneys.
AB  - BACKGROUND: In polycystic kidney disease, there is progressive distention of
      tubules and remodeling of an altered extracellular matrix. Recent findings
      indicate a defect(s) in the synthesis, post-translational modification, cellular
      transport, and extracellular matrix incorporation of proteoglycans in PKD that
      may have a fundamental role in its pathogenesis. EXPERIMENTAL DESIGN: Pulse-chase
      techniques and quantitative autoradiography were used to investigate in vitro the
      de novo synthesis and the kinetics of intracellular transport and extracellular
      matrix assembly of sulfated glycoproteins by epithelial cells from normal human
      kidneys (NK) and from cysts of autosomal dominant polycystic kidneys (ADPKD). NK
      and ADPKD cell monolayers were pulsed with [35S]sulfate for 150 min and chased
      for four intervals between 15 and 120 min. RESULTS: In ADPKD versus NK cells
      there was a significant reduction in the de novo synthesis of sulfated
      glycoproteins and, during the chase, a marked prolongation of the disappearance
      time for cellular sulfated glycoproteins. Transport kinetics revealed a
      substantial delay in processing and release of these macromolecules by the Golgi
      apparatus in ADPKD cells. During the chase, kinetics for the cellular transport
      of sulfated glycoproteins by secretory vesicles and their assembly into
      extracellular matrix were comparable in ADPKD and NK cells. However, the
      percentage of total sulfated glycoproteins incorporated into the matrix of ADPKD
      versus NK cell monolayers was notably diminished. CONCLUSIONS: The findings
      indicate that in ADPKD versus NK cell monolayers, synthesis of sulfated
      glycoproteins is impaired, processing of sulfated glycoproteins by the Golgi
      apparatus is prolonged, and assembly of these macromolecules into the
      extracellular matrix is reduced. These alterations may have a fundamental role in
      the pathogenesis of autosomal dominant polycystic kidney disease.

PMID- 8479150
TI  - Differences in expression of lupus nephritis in New Zealand mixed H-2z homozygous
      inbred strains of mice derived from New Zealand black and New Zealand white mice.
      Origins and initial characterization.
AB  - BACKGROUND: F1 hybrids of New Zealand Black (NZB) and New Zealand White (NZW)
      mice develop autoimmune glomerulonephritis resembling human lupus nephritis.
      Susceptibility to this complex autoimmune syndrome in humans and mice has been
      linked to genes mapping in or near the major histocompatibility complex that
      govern immune responses and levels of certain complement components. Previous
      studies showed that both parental strains contribute major histocompatibility
      complex-linked genes that are important for disease of the F1 hybrid.
      EXPERIMENTAL DESIGN: New inbred strains of New Zealand Mixed (NZM) mice were
      derived by selective inbreeding of progeny of a cross between NZB and NZW mice.
      Twelve of the 27 new NZM strains were selected for analysis. Mice were observed
      for up to 10 months of age to document the occurrence of nephritis and strain
      specific differences in disease expression. H-2, Hc, and coat color loci were
      determined for each strain to establish homozygosity of NZB and NZW polymorphic
      markers. Strains were screened for the presence of anti-dsDNA autoantibodies.
      RESULTS: In some NZM strains early onset of lupus nephritis in females resembled
      the (NZB x NZW)F1 model, whereas in other strains early disease also occurred in
      males. Age at death and severity of nephritis vary among the lines; a few strains
      remain relatively free of glomerular lesions. Histocompatibility (H-2) typing
      showed that all strains are homozygous for the NZW haplotype (Ku, Au, Sz, Dz).
      Coat color analysis for four loci on chromosomes 2, 4, and 7 was consistent with
      specific reassortments and recombinations to explain the grey, tan, and white
      mice with red/pink eyes and the presence or absence of the fifth component of
      serum complement (C5) (Hc, chromosome 2). Anti-dsDNA autoantibodies were found in
      all but one of the NZM strains reported here. CONCLUSIONS: The NZM strains of
      mice are a unique set of inbred strains that have inherited various genomic
      segments of the two parental strains that lead to phenotypic differences in
      disease expression. These results indicate that the previously proposed strict
      requirement for H-2 heterozygosity for the development of nephritis in the (NZB x
      NZW)F1 hybrid mice may not be valid. It is assumed that both the Lpn-1 locus of
      NZB and the Lpn-2 locus of NZW and a sufficient number of other disease
      associated genes of both ancestral strains have been recombined in these new
      strains to produce the various patterns of renal disease.

PMID- 8479151
TI  - Ammonium chloride alters renal tubular cell growth and protein turnover.
AB  - BACKGROUND: Since renal hypertrophy occurs in conditions associated with
      increased renal ammonia genesis it has been suggested that ammonia may stimulate
      renal growth. Indeed, quiescent cultured tubular epithelial cells exposed to
      NH4Cl undergo hypertrophy. However, ammonia inhibits liver regeneration in vivo
      and proliferation of cultured fibroblasts. This study was designed to evaluate
      the effect of ammonia (NH3/NH4+) as a regulator of kidney cell hypertrophy and
      also kidney cell proliferation. EXPERIMENTAL DESIGN: Cultured opossum kidney
      cells and primary rabbit proximal tubular epithelial cells were grown with or
      without (controls) NH4Cl present. RESULTS: After 3 days exposure to 5-20 mM
      NH4Cl, there was a dose-dependent depression of cell replication that ranged
      between 8 and 63% compared with controls (p < 0.017). In contrast, cell volume
      and protein content were significantly greater in the NH4Cl-treated cells. At 20
      mM NH4Cl the protein content of treated cells exceeded that of controls by as
      much of 75%. This difference in protein content could, in part, be related to the
      disparity in cell density. However, experiments performed with cells at similar
      density revealed that NH4Cl also has a direct effect on cell protein content that
      increased by 25%; this appeared to be a consequence of depressed protein
      breakdown and was not due to altered protein synthesis. Experiments with rabbit
      kidney cells revealed that inhibition of replication was associated with a
      decrease in DNA [3H]thymidine incorporation. Cell cycle analysis revealed a fall
      in the proportion of cells in the S + G2 + M phase compared with controls (22
      versus 30%, respectively; p < 0.01). NH4Cl also inhibited the burst of
      replication that followed chemically induced hypoxic injury of quiescent opossum
      kidney cells. CONCLUSIONS: We conclude that in addition to inducing hypertrophy,
      NH4Cl can inhibit tubular cell proliferation. Thus, while heightened
      ammoniagenesis in vivo may favor hypertrophy, this in vitro study raises the
      question whether an elevated intrarenal ammonia content might be harmful when
      cell replication is required. Acute tubular necrosis is a condition in which
      elevated ammonia levels and a requirement for cell replication coexist and could
      serve as an important model to study this question.

PMID- 8479152
TI  - Anomalous structure of urinary chondroitin sulfate from cancer patients. A
      potential new marker for diagnosis of neoplasias.
AB  - BACKGROUND: Chondroitin sulfate is significantly increased in tumors (10 to 100
      times) when compared to the amounts present in normal adjacent tissues. To
      investigate if the changes in concentration of chondroitin sulfate could be
      reflected in the urine of cancer patients we have analyzed the chondroitin
      sulfate excreted by 44 patients with different types of tumors, 50 normal
      individuals and 15 patients with unrelated diseases. EXPERIMENTAL DESIGN: The
      identification and structural analyses of the sulfated glycosaminoglycans were
      made by electrophoresis and degradation with specific enzymes (chondroitinases AC
      and ABC), identification/quantitation of their disaccharide products by
      chromatography (paper and HPLC) and chemical determinations. RESULTS: The
      disaccharide products formed from chondroitin sulfate of the 44 cancer patients
      by action of chondroitinase ABC show a substantial relative increase of non
      sulfated disaccharide (32.1% +/- 15.2) with a relative decrease of 6-sulfated
      disaccharide (28.9% +/- 11.5) and 4-sulfated disaccharide (39.0% +/- 13.5) when
      compared to the chondroitin sulfate of normal subjects (9.1% +/- 2.2, 40.6% +/-
      4.5 and 50.2% +/- 4.5, respectively) or from patients with unrelated diseases.
      There is a direct correlation between the non sulfated disaccharide content and
      the stage of malignancy of the cancer patients. A significant change of the ratio
      of chondroitin sulfate and heparan sulfate and a decrease in the electrophoretic
      migration of chondroitin sulfate were also observed in cancer patients.
      CONCLUSIONS: All the cancer patients analyzed so far have shown the structural
      anomaly of the urinary chondroitin sulfate and this may be useful in the
      diagnosis and follow up of cancer therapy.

PMID- 8479153
TI  - Spontaneous evolution of cytoplasmic lectin binding and nuclear size and
      deoxyribonucleic acid content in human colorectal cancers grafted onto nude mice.
AB  - BACKGROUND: The development of certain biologic characteristics in human
      colorectal tumor xenografted onto nude mice are described with respect to their
      precocious passages, i.e., passaging below 10 onto athymic mice. EXPERIMENTAL
      DESIGN: The biologic characteristic monitoring involved the determination of
      modifications occurring in cytoplasmic lectin binding and spontaneous development
      in nuclear size and DNA content. The lectin immunohistochemistry included the
      characterization of staining modifications in the glandular parts of the
      colorectal xenografts of wheat germ, Dolichos biflorus, peanut, Solanum tuberosum
      and Ulex europaeus I agglutinins. The nuclear modifications were monitored by
      means of the digital cell image analyses of Feulge-stained nuclei. RESULTS: The
      results show that although the xenografted human colorectal lines may be
      relatively stable according to their macroscopic growth over serial passaging,
      certain of their microscopic characteristics develop markedly. Three lectins,
      i.e., wheat germ agglutinin, Solanum tuberosum, and Ulex europaeus I, showed a
      glandular binding which remained relatively stable over serial passaging, whereas
      the peanut binding exhibited some variations and the DBA binding progressively
      disappeared. These cytoplasmic modifications occurring over time were less
      pronounced than those that occurred with respect to nuclear measurements, i.e.,
      size and DNA content. CONCLUSIONS: Nuclear DNA content heterogeneity as revealed
      by DNA histogram typing rather than by DNA index assessments increased markedly
      in the colorectal xenografts over their serial passaging on nude mice.

PMID- 8479154
TI  - Expression of HSP 70, immediate-early response and heme oxygenase genes in
      ischemic-reperfused rat liver.
AB  - BACKGROUND: Reperfusion of the liver after non-necrogenic ischemia induces the
      expression of the HSP gene and the synthesis of the hsp 70 protein, the best
      known among stress (heat-shock) proteins. EXPERIMENTAL DESIGN: We have studied
      the time course of the induction and the effects of cycloheximide treatment on
      the expression of c-fos, c-jun and the heat-shock gene HSP 70 in ischemic
      reperfused livers; extracts of these livers have also been examined for the
      binding to a synthetic oligonucleotide containing the heat-shock consensus
      sequence (HSE) in order to reveal the possible presence of an active heat-shock
      factor (HSF) in ischemic-reperfused tissue. RESULTS: Expression of HSP 70 gene
      appears only after a certain threshold of cell damage, is preceded by induction
      of c-fos and c-jun but does not depend on ongoing protein synthesis. The binding
      of HSF to HSE seems to start during the late period of ischemia, although the
      subsequent reperfusion increases the effect. The level of heme-oxygenase mRNA, an
      indicator of oxidative stress, increases in the liver after reperfusion but the
      oxidative stress caused by CoCl2 treatment does not induce the expression of HSP
      70 gene under the conditions of the present experiments. CONCLUSIONS: We suggest
      that, similar to heat-shock, protein malfolding occurring during ischemia may
      trigger the HSP 70 gene induction, which is then amplified by the subsequent
      reperfusion stress. A model of chemically induced oxidative stress seems to be
      unable to induce the HSP 70 gene expression with the same characteristics of heat
      shock or ischemia-reperfusion.

PMID- 8479155
TI  - Protein kinase C activity and messenger RNA modulation by estrogen in normal and
      neoplastic rat pituitary tissue.
AB  - BACKGROUND: Estrogens stimulate pituitary cell growth by prolactin cell
      hyperplasia in normal rat pituitaries while inhibiting growth of transplantable
      rat pituitary tumors in vivo and in vitro. The mechanisms by which estrogens
      stimulate proliferation of normal and hyperplastic pituitary tissues while
      inhibiting growth of established transplantable tumors is unknown. Protein kinase
      C (PKC) is involved in proliferation and differentiation of many cells including
      those of the anterior pituitary gland. PKC has a major role in regulating
      pituitary hormone synthesis and secretion. Analysis of PKC activity in normal,
      hyperplastic and transplantable pituitary tumors may provide insight into the
      mechanism of estrogen action on tumor growth and differentiation in pituitary
      tissues. EXPERIMENTAL DESIGN: Normal female rats and female rats with
      transplantable pituitary tumors were treated with estradiol 17 beta (E2) in vivo
      and subsequently analyzed for PKC activity. Rats with GH3 pituitary tumors were
      treated with E2 in vivo and a GH3 pituitary cell line maintained in vitro were
      also analyzed for PKC activity after estrogen treatment. The calcium-dependent
      and calcium-independent PKC isozymes were analyzed by in situ and Northern
      hybridization in normal and neoplastic pituitary tissue using specific
      oligonucleotide probes to characterize the subtypes of PKCs present in pituitary
      tissues. The calcium-dependent PKCs were also analyzed by immunohistochemistry
      using specific antibodies to PKC alpha, beta and gamma. RESULTS: Estrogen
      treatment increased total PKC activity significantly in normal pituitaries, but
      did not change total PKC activity in transplantable MtT/F4 and MtT/W15 tumors or
      in GH3 cells in vivo or in vitro. The mRNAs for PKC alpha and beta were detected
      in normal and neoplastic pituitary tissues and were increased after estrogen
      treatment in normal pituitary and MtT/F4 tumors, but not in MtT/W15 tumors. The
      calcium-independent PKC delta, epsilon and zeta were also detected in normal
      pituitary and in transplantable pituitary tumors and in GH3 cells by Northern
      hydridization and the levels of these PKCs were also regulated by estrogens.
      CONCLUSIONS: Estrogen modulates PKC levels in pituitary cells with an increase in
      total PKC activity in hyperplastic pituitaries but not in transplantable
      pituitary tumors. Estrogen also regulates the mRNA levels of the calcium
      dependent and calcium-independent PKC isozymes.

PMID- 8479156
TI  - Light- and electron microscopical studies of interstitial cells of Cajal and
      muscle cells at the submucosal border of human colon.
AB  - BACKGROUND: It has been suggested that interstitial cells of Cajal (ICC) at the
      submucosal border of the colonic circular muscle are pacemaker cells. We studied
      smooth muscle cells and ICC at the submucosal surface of the circular muscle
      layer of the normal human colon. EXPERIMENTAL DESIGN: Resected, unaffected
      specimens from human colon were studied by light microscopy and transmission
      electron microscopy. RESULTS: Throughout the colon, the inner fourth of each
      circular-muscle lamella was covered with a layer of 2 to 15 muscle cells (ICMC)
      with a smaller diameter, more perinuclear organelles, and a greater glycogen
      content than the outer circular muscle cells. ICMC were interconnected by
      adherens junctions and close appositions. Small bundles of ICMC were present in
      the submucosa. ICC were identified in all regions of the colon (ascendens,
      transversum, and sigmoideum) at the submucosal border, in deeper parts of the
      submucosa in close contact with smooth muscle bundles as well as in the circular
      muscle and main septa. ICC had a continuous basal lamina, caveolae, dense bands,
      thin and intermediate filaments, dense bodies and a well-developed smooth
      endoplasmic reticulum. Mitochondria and granular endoplasmic reticulum were very
      abundant. Lipid droplets and glycogen granules were frequent. Thick (myosin)
      filaments were absent. Close contacts to nerves and gap junctions to other ICC or
      smooth muscle cells were exceptional. Fibroblast-like cells in the submucosa were
      rich in granular endoplasmic reticulum and intermediate filaments. They had few
      dense bands and caveolae. Mitochondria, smooth cisternae and glycogen granules
      were sparse, cytoplasmic dense bodies and a continuous basal lamina were lacking.
      Fibroblast-like cells were associated closely with collagen bundles and they had
      no close contacts with nerves, ICC or muscle cells. CONCLUSIONS: Throughout the
      normal human colon, submucosal ICC and ICMC are identified and distinguished from
      other cell types present. Their organization and cytology differ from that of
      other animal species. The ultrastructure of ICC and ICMC is compatible with
      important regulatory functions on the circular muscle in the entire human colon.

PMID- 8479157
TI  - Control of health care costs.

PMID- 8479158
TI  - Co-occurrence of substance use and loneliness as a risk factor for adolescent
      hopelessness.
AB  - This research among a sample of 1,915 Mississippi adolescents investigated
      whether lonely adolescents who use illicit substances were at increased risk of
      hopelessness. Relative risk of scoring within the severe hopelessness range was
      6.9 for non-substance users who were lonely and 4.2 for substance users who were
      not lonely. Yet, relative risk for severe hopelessness in substance-using lonely
      adolescents was 25.2. Lonely, substance-using adolescents were 25 times more
      likely to be severely hopeless than the reference group composed of non-substance
      using, not-lonely adolescents. Lonely adolescents who get drunk also were 15.9
      times more likely to be severely hopeless than the reference group. Because
      hopelessness often is an indicator of suicidal behavior, these results may have
      important implications for school health adolescent suicide prevention efforts.

PMID- 8479159
TI  - Applying community organization to developing health promotion programs in the
      school community.

PMID- 8479160
TI  - The school nurse's role in attention deficit hyperactivity disorder.

PMID- 8479161
TI  - Selected behaviors that increase risk for HIV infection, other sexually
      transmitted diseases, and unintended pregnancy among high school students--United
      States, 1991.

PMID- 8479162
TI  - Teacher offers a child's perspective of weapon use.

PMID- 8479163
TI  - Peer coaching: building collegial support for using innovative health programs.
AB  - To ensure students achieve intended benefits from effective health programs, it
      is necessary to maximize program implementation and maintenance. Peer coaching
      provides a post-inservice staff development approach for health educators to
      strengthen teacher use of new health programs during implementation trials. While
      peer coaching positively influences teacher behavior and student outcomes,
      previous coaching programs have been limited in scope, have not been
      theoretically derived or adequately evaluated, and have not been systematically
      applied to health programs. This paper addresses teacher needs during trials,
      reviews peer coaching program features, and proposes a model to guide future
      planning, evaluation, and research. In this model, critical components of the
      coaching program include classroom assessments, coaching team cluster meetings,
      and administrative support. Strategies based on Social Learning Theory and
      Diffusion Theory are incorporated into the peer coaching program to influence
      teacher perceptions of their work roles, capability to implement a program, and
      commitment to the new instructional program. Interrelations among components are
      discussed and directions for future research and practice are suggested.

PMID- 8479164
TI  - Death themes in literature for children ages 3-8.
AB  - Children's literature provides an appropriate tool for addressing concepts of
      death education. This study examined how death is presented in literature for
      children ages three-eight. A review of literature and Holsti's formula for
      intercoder reliability were used to develop a data collection instrument.
      Children's books with death themes were identified, and a content analysis
      recording frequencies for 39 items was performed on 65 books available for the
      study. A profile of the typical children's book with death themes was developed.
      The profile is discussed in terms of positive and negative presentations of death
      and being developmentally appropriate for young children. Based on results from
      the study, death themes are presented in a positive, realistic way that promote
      healthy development. Because of its positive presentations, children's literature
      is recommended as a teaching tool for death education.

PMID- 8479165
TI  - Correlates of condom use and number of sexual partners among high school
      adolescents.
AB  - Factors associated with condom use and number of sexual partners were examined in
      a statewide sample of public high school students in grades 9-12 (N = 3,893).
      Data were collected in spring 1990 using the 70-item, self-report Youth Risk
      Behavior Survey, developed and piloted by the Centers for Disease Control.
      Composite scores were constructed to measure aggression, physical recklessness,
      alcohol use, illegal drug use, cigarette use, lack of exercise, and academic self
      image. Since simple polychotomous logistic regression models revealed a
      significant race by gender interaction, multivariate models were run separately
      for each race-gender group. Odds ratios and 95% confidence intervals were
      calculated from polychotomous logistic regression of lifetime sexual activity and
      condom use with their potential correlates. Risky sexual behavior appears to be
      correlated with a complex of other behaviors that place students at risk. A
      pattern of declining condom use with increasing number of partners was evident,
      especially for White students.

PMID- 8479166
TI  - Predicting cigarette smoking among adolescents using cross-sectional and
      longitudinal approaches.
AB  - The ability to identify groups of children at risk of initiating a smoking habit
      may prove useful in developing effective smoking prevention programs. This report
      includes data collected over a three-year period, and attempts to predict
      adolescents' smoking behavior using both cross-sectional and longitudinal
      analyses. In addition, predictor variables reflecting both interpersonal and
      intrapersonal domains were included. Results indicated the highest rates of
      accurate classification into smoking categories were achieved with cross
      sectional analyses. In addition, interpersonal variables emerged as most
      important in all analyses. Implications for smoking prevention programming are
      discussed.

PMID- 8479167
TI  - Scintigraphic evaluation of bacterial translocation during hemorrhagic shock.
AB  - We investigated the use of gamma scintigraphy to evaluate the temporal and
      spatial patterns of translocation of radiolabeled Escherichia coli from the
      porcine jejunum during and following hemorrhagic shock. Thirteen healthy mixed
      breed pigs (22-43 kg) were randomly allocated to two groups. Pigs were
      anesthetized with sodium pentobarital (30 mg/kg) and mechanically ventilated
      (100% O2). Each pig was instrumented for mean arterial pressure (MAP) and
      superior mesenteric artery (SMA) blood flow determination. A 25-cm loop of
      vascularly intact distal jejunum was isolated, and 10 mCi (10(11) cfu) of
      radiolabeled E. coli (99mTcO4-) was placed within the bowel segment. Consecutive
      5-min scintigrams of the entire abdomen and thorax were collected for 6 hr. Pigs
      in the shock group (n = 7) were hemorrhaged such that MAP was maintained at 50-60
      mm Hg for 5 hr. Pigs in the sham group (n = 6) were maintained without hemorrhage
      for 6 hr. The total radioactive counts in the translocation regions of the
      scintigram were plotted against time, and the slope of the regression lines was
      compared between groups. In the shock group, SMA blood flow decreased
      significantly (P < 0.05) during the hypotensive period but returned above
      baseline during reperfusion. The mean (+/- SD) slopes for translocation
      regression lines were 9.3 +/- 11.4 counts/min and 36.3 +/- 33.7 counts/min in the
      sham and shock groups, respectively (P < 0.05). Translocation was
      scintigraphically evident 50-100 min following induction of hemorrhage and did
      not require reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479168
TI  - Phorbol dibutyrate and ionomycin improve murine effector cell cytotoxicity.
AB  - Simultaneous protein kinase C stimulation with phorbol 12,13-dibutyrate (PDBU)
      and calcium mobilization with ionomycin (Io) trigger cellular events leading to
      expression of proliferation-associated genes in human lymphocytes. The effect of
      a 16-hr exposure to PDBU and Io on the growth and cytotoxic activity of murine
      splenocytes and tumor-infiltrating lymphocytes (TIL) cocultured with interleukin
      2 (IL-2) was studied. PDBU + Io increased the number of cytotoxic effector cells
      that could be generated in lymphokine-activated killer cells (LAK) cultures (40
      fold) and to a lesser extent in TIL (10-fold). DNA synthesis of TIL increased
      significantly when exposed to PDBU + Io. Also, TIL stimulated with PDBU + Io
      demonstrated in vitro tumor-specific lytic activity significantly greater than
      that of control TIL (500 lytic units vs 50). The cell-surface phenotype of TIL
      treated with PDBU + Io was identical to that of control TIL (> 95% CD-3+, CD-4-,
      CD-8+). Results of adoptive immunotherapy using splenocytes stimulated by PDBU +
      Io and cultured in IL-2 were identical to those achieved when standard LAK
      cultures were used. However, treatment using TIL stimulated by PDBU + Io led to a
      significant reduction in the number of pulmonary nodules compared to standard
      TIL. In addition, PDBU + Io-stimulated TIL maintained significant in vivo
      activity without the need for systemic IL-2 administration. Pharmacologic
      manipulation of cytotoxic precursor cells is a useful strategy for improving the
      generation of murine cytotoxic effector cells. By using PDBU + Io, cytotoxic
      lymphocytes could be generated with improved in vitro and in vivo activity.

PMID- 8479169
TI  - Pancreaticogastrostomy: preferred reconstruction for Whipple resection.
AB  - Anastomotic leak is the main complication after Whipple procedures. We reviewed
      retrospectively our experience with pancreatic cancer patients treated with
      Whipple resection and reconstruction with a pancreaticogastrostomy (PG) or a
      pancreaticojejunostomy (PJ). Ten patients operated between 1966 and 1990 composed
      the PJ group. Eight patients operated recently made up the PG group. Data on age,
      length of stay (LOS), survival, and complications (early and late) were noted
      from patient's charts. Patients in the PJ group had an average age of 58.3 years,
      a mean LOS of 60.3 days (median, 48 days), and a mean survival of 14.5 months. PG
      group patients had a mean age of 64.5 years, an average LOS of 14.3 days (median,
      14 days), and an average survival of 10+ months. None of these differences were
      significant. Major complications in the PJ group included 2 leaks, 2 cases of
      pancreatic insufficiency, and 2 deaths related to the anastomotic leaks. Eleven
      other major complications occurred. The PG group patients did not have any leaks.
      One developed pancreatic insufficiency. Complications in the PG group were much
      less serious than those in PJ group. The longest hospital stay in the PG group
      was 20 days (range, 2-20) and 144 days (range, 11-144) in the PJ group. We
      conclude that PG is superior to PJ because of the decreased incidence of
      anastomotic leaks and the less serious nature of the complications associated
      with PG.

PMID- 8479170
TI  - Increased circulating cholecystokinin in obstruction-induced acute pancreatitis.
      II. Pancreatic duct obstruction with and without bile duct obstruction.
AB  - Pancreatic exocrine stimulation by cholecystokinin (CCK) has been implicated in
      the pathogenesis of experimental acute pancreatitis. Bile exclusion from the gut
      stimulates duodenal CCK release and exacerbates obstruction-induced acute
      pancreatitis. Pancreatic and bile duct obstruction increases circulating CCK
      concentration. We hypothesized that acute pancreatitis induced by pancreatic and
      bile duct obstruction would be ameliorated when bile was returned to the
      duodenum. As many small pancreatic ducts drain into the bile duct in rats,
      preservation of bile flow required the use of a bile shunt. We studied acute
      pancreatitis and the time course of circulating CCK increase in three groups of
      rats after: (1) sham operation (dissection, no obstruction), (2) bile and
      pancreatic duct obstruction, and (3) bile and pancreatic duct obstruction with
      bile shunt. The rats were killed at 3-, 6-, and 18-hr intervals after operation.
      Their blood was collected for measurement of CCK, amylase, and bilirubin
      concentrations. The pancreata were excised, weighed, and processed for
      histological examination. The shunting of bile back to the duodenum ameliorated
      the acute pancreatitis along with a simultaneous limitation of the rise in CCK
      concentration. This suggests that bile duct obstruction, another form of bile
      exclusion, exacerbates pancreatic duct obstruction-induced acute pancreatitis.
      The elevation in CCK concentration showed an early peak indicating that the
      potential role of CCK in the pathogenesis of obstruction-induced acute
      pancreatitis is predominantly in the early phase of its development.

PMID- 8479171
TI  - Colonoscopy for intermittent rectal bleeding: impact on patient management.
AB  - Rectal bleeding is a frequent presenting symptom of a number of benign anorectal
      disorders. However, it may also be a warning sign of more significant
      gastrointestinal pathology. For this reason, full colonic evaluation has been
      recommended in patients with intermittent bright red rectal bleeding. The purpose
      of this study is to evaluate the utility of colonoscopy in this setting. Data
      were prospectively collected on 125 colonoscopies performed on the surgical
      service at the Cleveland Wade Park Veterans Administration Medical Center during
      a two year period. During this period 33 patients underwent colonoscopy for the
      evaluation of intermittent bright red rectal bleeding. Fourteen patients had
      abnormal rectal exams, including hemorrhoids in 9, mass lesions in 3, prolapse in
      1, and fistula in ano in 1. Colonoscopy was normal in only 7 (21%) of the 33
      patients examined. Findings in the remaining 26 included 31 polyps in 14
      patients, cancer in 3, AVM in 1, diverticula in 9, hemorrhoids in 4, and other
      benign lesions in 5. Positive findings on rectal examination had no relationship
      to findings at endoscopy, with abnormal findings in 52% of patients with normal
      rectal exams and in 27% of patients with abnormal rectal exams (P = 0.187, NS).
      Findings at colonoscopy resulted in a change in management in 16 (48%) of
      patients examined. In patients with intermittent rectal bleeding, the entire
      colon should be evaluated regardless of findings on rectal examination, as a
      significant number of patients will have concomitant findings. Colonoscopy is an
      excellent method for colonic evaluation in this setting.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8479172
TI  - Tumor necrosis factor mediates disseminated intravascular inflammation (DII) in
      the genesis of multiple organ edema.
AB  - Multiple system organ failure (MSOF), resulting from a diffuse overwhelming
      inflammatory response, is frequently the cause of death in patients suffering
      either severe injury or infection. Previous studies have demonstrated increased
      circulating levels of tumor necrosis factor with both severe injury and
      infection. In addition, the intravenous administration of tumor necrosis factor
      (TNF) has been shown to induce systemic responses similar to those seen in
      patients with MSOF. The data from in vitro studies suggest that TNF-mediated
      events at the level of the microcirculation may be primary in the genesis of
      multiple system organ edema and dysfunction. We hypothesized that the intravenous
      administration of TNF would acutely induce alterations in the microcirculation
      that were associated with the development of multiple organ edema and
      cardiorespiratory impairment. The cremaster microcirculation model was used to
      quantitate changes in microvascular indices. We directly observed increased
      numbers of firmly adherent leukocytes to the microvascular endothelium and
      quantitated decreased leukocyte rolling along the surface of the endothelium as
      leukocytes became firmly adherent following TNF injection. This TNF-mediated
      leukocyte-endothelial adherence was also associated with the development of
      microvascular protein leakage. TNF also acutely induced arteriolar vasodilation
      and increased microvascular blood flow. These changes in microvascular parameters
      were associated with the synchronous development of TNF-mediated multiple organ
      edema and cardiorespiratory impairment. These data support the hypothesis that
      TNF acutely mediates disseminated intravascular inflammation resulting in
      multiple organ edema and subsequent hemodynamic instability.

PMID- 8479173
TI  - Impaired response to alloantigens in murine biliary obstruction.
AB  - Male Lewis strain rats underwent bile duct ligation and division (BDL), selective
      hepatic duct ligation (SHL), simple ligation and recanalization (RCN), or sham
      celiotomy (SC). Unoperated rats served as normal controls (NC). At intervals of
      1, 2, and 3 weeks postoperatively, the popliteal lymph node assay was used to
      study host versus graft (HVG) response. LBN-F1 splenocytes (5 x 10(6)) were
      injected into the hind foot pads, and the contralateral foot pad was injected
      with medium as a control. The popliteal lymph nodes were removed and weighed 7
      days later. In the BDL group, HVG response was significantly impaired at 1 (BDL,
      12.9 +/- 5.1 mg; SC, 21.6 +/- 2.6; NC, 22.4 +/- 9.4; P < 0.005, BDL vs SC or NC),
      2 (BDL, 12.6 +/- 5.6; SC, 19.1 +/- 3.0; NC, 15.8 +/- 5.8; P < 0.001, BDL vs SC),
      and 3 weeks (BDL, 8.9 +/- 3.9; SC, 21.7 +/- 6.3; NC, 16.7 +/- 3.8; P < 0.001, BDL
      vs SC or NC). SHL did not cause hyperbilirubinemia or impair the HVG response at
      2 weeks (SHL, 17.2 +/- 4.5; NC, 16.7 +/- 7.4). The serum bilirubin was normal 2
      and 3 weeks after RCN, and the HVG response was normal in both groups; however,
      the HVG response was somewhat lower at 2 weeks (RCN, 12.1 +/- 2.1) than at 3
      weeks (RCN, 18.2 +/- 4.4; P < 0.01, RCN 2 weeks vs RCN 3 weeks). BDL causes
      significant impairment in the murine response to alloantigens as measured by the
      popliteal lymph node assay.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479174
TI  - Arterial hemorrhage complicating pancreatic pseudocysts: role of angiography.
AB  - Major arterial hemorrhage associated with pancreatic pseudocysts represents a
      formidable complication with high mortality rates. This study was undertaken to
      analyze presentation and outcome and to assess the role of angiography in
      diagnosis and management of this complication. A retrospective review of 180
      patients referred for surgical management of pancreatic pseudocysts from 1964 to
      1991 identified 13 patients (7.2%) with arterial hemorrhage. Eight patients
      presented with intracystic hemorrhage, 4 with upper gastrointestinal bleeding,
      and 1 with intra-abdominal bleeding. Six patients had gastroduodenal artery
      bleeding, 4 splenic, and 1 each left gastric, right colic, and left
      gastroepiploic. The site of bleeding was identified with selective visceral
      angiography in 9 patients; evidence of pseudocyst bleeding was seen in 5 of 7
      patients who had contrast-enhanced computerized tomography (CT) scans.
      Angiographic embolization for control of hemorrhage was used in 6 patients and
      operative control in 7. Over the past decade, bleeding has been controlled with
      angiographic embolization in all patients except 1 with massive bleeding due to
      splenic artery erosion. Average blood loss was less in patients treated with
      angiographic embolization (6.8 vs 17.5 units, packed red cells, P < .05, Wilcoxon
      rank sum test). The sole mortality was a patient with cirrhosis treated in 1969.
      Clinical presentation of pseudocyst bleeding is variable; the underlying cause is
      usually related to chronic pancreatitis due to alcohol abuse. The dynamic
      contrast-enhanced CT scan is valuable in demonstrating evidence of pseudocyst
      bleeding. Accurate diagnosis with dynamic CT scan and angiography and control of
      bleeding with angiographic embolization has improved the outcome in patients with
      this complication.

PMID- 8479175
TI  - Comparison of techniques for harvesting enterocytes for transplantation.
AB  - Selective enterocyte transplantation is a potential alternative to small
      intestinal transplantation for treatment of the short bowel syndrome. Our aim was
      to compare chelation and enzymatic methods of isolating enterocytes with respect
      to initial cell yield and characteristics and in vitro growth. Enterocytes were
      harvested from adjacent ileal segments in 35 rabbits using chelation with EDTA
      and warm trypsinization. Determinations were made of initial viability by trypan
      blue exclusion, cell yield, and proportion of intact crypts. Cells (5 x 10(6))
      were seeded in growth media into culture vessels. Cell attachment was estimated
      by measuring cells liberated by Dispase at 24 hr. In vitro growth was assessed at
      14 and 28 days. Although total cell yield (15.0 +/- 9.9 vs 12.5 +/- 8.3 x 10(6)
      cells/cm) and intact crypts were similar, the trypsin technique resulted in cells
      with higher initial viability (86 +/- 7 vs 71 +/- 18%, P < 0.05). Cell attachment
      (7 +/- 8 vs 8 +/- 4%) and enterocyte disaccharidase activity were similar using
      both techniques. While the number of epithelial cell growth foci was not
      significantly different at 14 days, there was significantly greater surface
      coverage on both plain (44 +/- 20% vs 1 +/- 0%, P < 0.05) and Matrigel-coated (80
      +/- 14 vs 16 +/- 25%, P < .05) vessels at 28 days with trypsin-isolated cells.
      Trypsinization resulted in a cell population which had a higher percentage of
      viable cells but a similar proportion of intact crypts and differentiated cells
      compared to those resulting from the chelation technique. Trypsin-liberated cells
      had greater capacity for in vitro growth particularly on Matrigel-coated
      surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479176
TI  - Limb-threatening ischemia complicated by perigenicular infection.
AB  - When graft infection or infection of the medial leg or popliteal fossa precludes
      a standard approach to revascularization of the ischemic leg, the literature
      suggests amputation may be the most prudent course because of excessive
      perioperative mortality and morbidity of attempts to reestablish axial flow. The
      purpose of this study is to define the outcome of revascularization when limb
      threatening ischemia is complicated by perigenicular infection. Of 1020
      infrainguinal reconstructions performed since 1984, nine (0.9%) presented with
      limb-threatening ischemia and graft or wound infections involving the popliteal
      fossa (6) or medial thigh or calf wounds (3) which precluded standard
      revascularization in the five women and four men. Risk factors for infection
      included diabetes mellitus (5/9), wound hematoma at initial operation (2/9), and
      intravenous drug abuse (1/9); Staphylococcus aureus was the predominant organism
      in all infected wounds and two popliteal fossa infections. The other deep
      infections grew group D streptococci, Enterococcus, and Salmonella. Extra
      anatomic reconstruction was performed from the femoral (7) and iliac vessels (2)
      extending to the below-knee popliteal (2), the anterior tibial (4) and the
      peroneal (3) arteries using vein (5), and PTFE (4) in a lateral tunnel which
      avoiding the plane of the infection. Postoperative complications included MI (1),
      early graft thrombosis (2), and osteomyelitis of the femur (1); there were no
      deaths. With a mean follow-up of 19 months (3-57 months), primary graft patency
      was 66% and secondary patency was 78%, resulting in salvage of 66% of extremities
      at risk. These data demonstrate the safety and efficacy of extra-anatomic
      reconstruction for maintaining axial flow when limb-threatening ischemia is
      complicated by perigenicular infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479177
TI  - The effect of protein binding on the adherence of staphylococci to prosthetic
      vascular grafts.
AB  - Staphylococcus epidermidis is the major bacterium causing prosthetic vascular
      graft infections and the ability of some S. epidermidis strains to produce slime
      is associated with pathogenicity. This study investigated the effect of protein
      binding of staphylococci as a possible mechanism affecting bacterial adherence to
      vascular graft materials. Slime- and non-slime-producing S. epidermidis strains
      and an encapsulated Staphylococcus aureus were incubated with Dacron or expanded
      polytetrafluoroethylene (PTFE). The slime-producing RP-62A strain had
      significantly greater adherence to all materials than the other bacteria tested
      and coincubation with serum did not affect its adherence. The adherence of all
      bacteria was greater to Dacron than to PTFE. Serum increased the adherence of S.
      aureus to PTFE (P < 0.05) but did not significantly alter the bacterial adherence
      to other materials. This suggests that protein binding does not affect the
      adherence of S. epidermidis to prosthetic vascular grafts.

PMID- 8479178
TI  - The regulation of mitochondrial fatty acid oxidation and hepatic gene expression
      by catecholamine.
AB  - We hypothesized that dopamine or dobutamine may alter hepatic mitochondrial fatty
      acid oxidation secondary to an effect on hepatic gene expression. We investigated
      the effect of dopamine or dobutamine on hepatic fat oxidation and gene
      transcription by studying the enzyme carnitine palmitoyltransferase (CPT), the
      rate-limiting step in hepatic mitochondrial long-chain fat oxidation. We
      incubated either H4IIE rat hepatoma cells or rat hepatocytes in primary cell
      culture with either dopamine (1, 0.1, 0.01 microgram/ml), dobutamine (1, 0.1,
      0.01 microgram/ml), or vehicle control for 1, 2, 3, or 4 hr. We investigated the
      effect on (1) CPT mRNA (Northern or dot blotting) and the possible regulatory
      mechanism by incubating dopamine (0.1 microgram/ml) or dobutamine (0.1
      microgram/ml) with propranolol or phentolamine, (2) CPT translation (CPT
      [35S]methionine incorporation), and (3) hepatic mitochondrial fatty acid
      oxidation ([1-14C]-palmitate oxidation to acid-soluble products). We conclude
      that (1) dopamine or dobutamine increases both hepatic CPT mRNA and CPT protein
      translation, (2) the effect on CPT mRNA is mediated by the beta-receptor, (3) the
      increase in hepatic mitochondrial fat oxidation induced by dopamine or dobutamine
      may be, in part, secondary to increased CPT transcription and translation, and
      (4) the significant difference in hepatic fat oxidation induced by dopamine as
      compared with that by dobutamine is secondary to factors other than
      transcriptional or translational mechanisms. We speculate that dopamine treatment
      in the critically ill may increase hepatic mitochondrial fatty acid oxidation and
      ketogenesis and that this increase in beta-oxidation may be, in part, secondary
      to increased CPT gene expression.

PMID- 8479179
TI  - POEMS syndrome in association with Sweet's syndrome--a new variant?

PMID- 8479180
TI  - An evaluation of residents' recognition of depressive symptoms in obstetrical
      patients.

PMID- 8479181
TI  - The impact of OBRA '90 on the pharmacist-patient-physician relationship.

PMID- 8479182
TI  - Scalping injuries: report of a historical case.

PMID- 8479183
TI  - Hepatomegaly and weight loss.

PMID- 8479184
TI  - Gross hematuria and easy bruising in a young man.

PMID- 8479185
TI  - High blood pressure: new efforts in primary prevention and disease management.

PMID- 8479186
TI  - Outpatient risk--inpatient injury.

PMID- 8479187
TI  - Reassuring patients about infection control. TMA Communications and Public
      Service Committee.

PMID- 8479188
TI  - Controlling costs after a workers' comp injury.

PMID- 8479189
TI  - OSHA stuff and nonsense.

PMID- 8479190
TI  - Breast cancer and the menstrual cycle.

PMID- 8479191
TI  - Significance of in vitro attachment of human colon cancers to extracellular
      matrix proteins in experimental and clinical liver metastases.
AB  - The attachment of 7 human colon cancer lines transplantable into nude mice, and
      primary tumors and liver metastases from 30 patients with colon cancer to 4
      extracellular matrix proteins (EMPs)--Matrigel, laminin, fibronectin, and type IV
      collagen--was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H
      (MTT) assay. Cancer cells from the 4 established tumor lines which produced
      experimental liver metastases in vivo showed significantly greater attachment to
      each EMP than those from the other 3 tumor lines which did not. Although there
      were no significant differences between attachment to EMPs of cancer cells from
      15 clinical primary tumors with liver metastases and those without, attachment to
      each EMP of cells derived from liver metastases was significantly greater than
      that of the cells from the corresponding primary tumors in 8 cases for which
      liver metastases and primary tumors were examined simultaneously. Attachment to
      EMPs, which could be determined simply and rapidly using the MTT assay, is thus
      considered a significant factor in experimental and clinical liver metastases of
      human colon cancers.

PMID- 8479192
TI  - Wound bleeding after head and neck surgery.
AB  - Using our head and neck service database, we reviewed 3,200 surgical procedures
      performed at our institution over a 7-year period. We identified 54 patients
      whose surgery was complicated postoperatively by wound bleeding. The procedure
      most often complicated by wound bleeding was parotidectomy, 1.7% (14 of 510
      patients), followed by thyroidectomy, 1.6% (8 of 504 patients), neck dissection
      combined with other procedures, 1.3% (12 of 885 patients), and neck dissection
      alone, 1.1% (6 of 534 patients). Bleeding developed in flap donor sites in 2 of
      227 patients and followed miscellaneous procedures in 12 others. Thirty-one
      patients were treated by reexploration in the operating room, 13 had limited
      exploration on the ward and 10 were observed with no intervention. There was no
      difference in wound healing between the three treatment groups. However, mean
      hospital stay was shortest for patients who had wound exploration in the
      operating room, 6.2 days, for exploration on the ward, 10.8 days, and 18.9 for
      those that were observed. Drains had no effect on wound healing or mean hospital
      stay.

PMID- 8479193
TI  - A phase I/II study of intraoperative radiotherapy in advanced unresectable or
      recurrent carcinoma of the rectum: a Radiation Therapy Oncology Group (RTOG)
      study.
AB  - The Radiation Therapy Oncology Group (RTOG) initiated a phase I/II study of
      intraoperative radiotherapy (IORT) in advanced or recurrent rectal cancer to
      assess therapeutic efficacy, toxicity, and establish quality control guidelines
      prior to beginning a phase III trial. From October 1985 through December 1989, 87
      patients with histologically proven adenocarcinoma of the rectum or rectosigmoid
      with recurrent/persistent disease after surgery or those primarily inoperable
      were entered by 14 institutions. Of 86 evaluable patients, 42 patients received
      IORT either alone (n = 15) or in combination with external beam (n = 27). Local
      control was dependent on the amount of residual disease prior to IORT, with 2
      year actuarial local control of 77% if no gross residual disease remained vs. 10%
      with gross residual disease (P = 0.001). For the recurrent/residual group (n =
      33), this observation was also significant with a 2-year actuarial local control
      rate of 64% if no gross residual remained vs. 10% with gross residual disease (P
      = 0.004). Local control translated into an improved survival for all patients and
      the recurrent/residual group with 2-year actuarial survival of 88% and 89% if no
      gross residual disease remained vs. 48% and 45% with gross residual disease,
      respectively (P = .0005, 0.006). Six patients (14.6%) experienced four grade 3
      and three grade 4 complications as a possible result of IORT during follow-up
      with a 2-year actuarial risk of major complications of 16%. We conclude that IORT
      is feasible within a cooperative group and can be performed with acceptable
      complication rates. A phase III trial to demonstrate a therapeutic advantage for
      IORT over external beam alone is currently in progress.

PMID- 8479194
TI  - The influence of surgical margins on advanced cancer treated with intraoperative
      radiation therapy (IORT) and surgical resection.
AB  - Intraoperative radiation therapy (IORT) has been used successfully in the
      treatment of malignancies, alone and as an adjunct to surgical resection. This
      study examined a single institution's experience with combined IORT and surgical
      resection in the treatment of advanced cancer. The records of 41 consecutive
      patients undergoing intraoperative radiation therapy (IORT) at the Fox Chase
      Cancer Center, from July 1987 through March 1990, were retrospectively reviewed.
      All patients had locally advanced disease, of whom 73% had failed previous
      multimodality therapy and 44% had undergone prior radiation therapy (XRT). The 2
      year actuarial survival for the entire cohort was 72%. Disease-free survival was
      47% at 1 year and 5% at 2 years. The only important prognostic factor predicting
      outcome was status of the surgical margin. Positive surgical margins decreased
      the 2-year actuarial survival from 100% to 59%, and increased the local failure
      rate from 21% to 52%. Margin status had no effect on the later development of
      metastatic disease. Higher IORT doses, field sizes > 7 cm, and multiple IORT
      fields were used for larger tumors and larger amounts of residual disease. These
      parameters alone did not correlate with improved local control. This analysis
      suggests the usefulness of aggressive surgical resection with IORT in extending
      survival for locally advanced or recurrent cancer. Negative margin status is the
      best predictor of a favorable outcome and should be used to select patients who
      may benefit from IORT. The use of radiation sensitizing agents should be explored
      in patients with positive margins, since in-field failure continues to be the
      major pattern of failure. IORT in conjunction with aggressive surgical resection
      should continue to be studied in prospective randomized clinical trials.

PMID- 8479195
TI  - Immunohistologic analysis of the extracellular matrix components of the fibrous
      stroma of human colon cancer.
AB  - In order to elucidate the gross composition of fibrous stroma and to better
      understand the obstructive nature of advanced human colonic cancers the
      extracellular matrix components of its stroma were analyzed immunohistologically,
      emphasizing the process of fibrosis and possible tissue constriction. Collagenous
      material, identified by Masson's trichrome stain, was distributed mainly in the
      invasive area, where type I and III collagens and chondroitin 4-sulfate stained
      intensely in the periacinar area, and further, fibronectin stained. Conversely,
      in the invasive area away from tumor acini type III collagen stained weakly and
      fibronectin not at all. Type V collagen and myofibroblasts stained in the
      periacinar area and did not stain in the invasive area away from tumor acini, the
      findings of myofibroblasts being prominent in cases with obstructive type
      carcinomas. In conclusion, the invasive area, especially the periacinar area,
      displayed signs of active ongoing fibrosis and tissue contraction, which may be
      responsible for the genesis of obstructing type colonic carcinomas.

PMID- 8479196
TI  - Breast Cancer Detection Demonstration Project data can determine whether the
      prognosis of breast cancer is affected by the time of surgery during the
      menstrual cycle.
AB  - The purpose of this study was to determine the feasibility of using Breast Cancer
      Detection Demonstration Project (BCDDP) data to ascertain whether the prognosis
      of breast cancer in premenopausal women is affected when surgery is performed
      relative to the different phases of the menstrual cycle. In the Louisville BCDDP
      only 40 cases were available for study, but even with this small number, the data
      indicate that survivorship was superior when the surgery was performed between
      days 7-20 of the menstrual cycle (P < 0.06). One thousand eighty-seven
      premenopausal women underwent surgery for breast cancer during the first 5 years
      of the national BCDDP, beginning in 1972. This large number of cases, plus the
      long period of follow-up should provide sufficient statistical power for us to
      evaluate if there is any relationship between the day of the menstrual cycle, the
      day surgery was performed, and prognosis. This feasibility study indicates that
      these women should be followed up and the appropriate statistical studies should
      be done.

PMID- 8479197
TI  - Photo detection of carcinoma of the colon in a rat model: a pilot study.
AB  - Photodynamic sensitizers are light-absorbing chemicals that cause photoreactions
      in biologic systems when exposed to light of the proper wave-length.
      Dihematoporphyrin ethers (DHE) are the active porphyrin derivatives most commonly
      used as a photosensitizer (Photofrin, QLT). DHE accumulates in tumor tissue and
      also fluoresces when light activated. A more reliable and less costly screening
      method for early detection and treatment of colon cancer is needed. The present
      study was designed to induce adenocarcinoma of the colon in rats with 1,2
      dimethylhydrazine (DMH) and attempt to identify tumors early in their evolution
      by DHE fluorescence. Forty rats were injected with 20 mg/kg of DMH at weekly
      intervals until sacrifice. Photofrin (3 mg/kg) was injected through the tail vein
      in each prior to sacrifice. Eight colonic specimens contained invasive
      adenocarcinoma, seven of which fluoresced when exposed to a Woods lamp. Carcinoma
      in situ was identified in two specimens by fluorescence, and one fluorescent
      specimen contained dysplasia.

PMID- 8479198
TI  - Selected benefits of thoracotomy and chemotherapy for sarcoma metastatic to the
      lung.
AB  - To determine the benefit of aggressive surgical therapy, we studied 77
      consecutive patients presenting to our sarcoma registry with pulmonary
      metastases. Detailed follow-up was available on all patients; the median follow
      up of the 13 long-term survivors was 72 months from the date of diagnosis of the
      primary tumor. Survival of these 77 patients with metastatic disease was
      independent of the size, location, and histology of the primary tumor. Once
      metastases developed, survival of patients with pulmonary metastases was not
      influenced by the extent of surgical resection of the primary tumor or by the use
      of radiation therapy. Pulmonary metastases were initially treated with
      thoracotomy and metastasectomy in 34 patients. The median survival after
      thoracotomy was 26 months. Seven patients were alive more than 4 years after
      their diagnosis. Pulmonary metastases were treated with chemotherapy alone in 43
      patients. Although the survival was shorter (median survival 14 months) in
      patients treated with chemotherapy, an objective response to chemotherapy was
      obtained in 13 (30%) patients. Four of these patients were alive 4 years after
      their diagnosis. These data demonstrate that both thoracotomy and chemotherapy
      are associated with long-term survival of patients with sarcoma metastatic to the
      lung.

PMID- 8479199
TI  - Resection margin in patients with gastric cancer associated with esophageal
      invasion: clinicopathological study.
AB  - We investigated the correlations between resection margin involvement by
      carcinoma and a number of clinicopathological features in patients with gastric
      cancer and esophageal invasion. From January 1968 to December 1988, 1,040
      patients with carcinoma of the stomach underwent gastric resection. Thirty-nine
      patients had tumor infiltration of the esophagus on histological examination of
      the resected specimens. The patients were divided into two groups on microscopic
      examination: those in whom the resection margin was less than 5 mm wide, and
      those in whom it exceeded 5 mm microscopically. There were 6 and 33 patients in
      the narrow and wide margin groups, respectively. There were statistically
      significant differences in tumor size, depth of cancer invasion, and macroscopic
      appearance between the two groups. The risk of resection margin involvement was
      high in tumors with the following features: large Borrmann type 4 tumor
      (macroscopic appearance and size) and infiltrative carcinoma (depth of invasion).

PMID- 8479200
TI  - Limb-sparing treatment with surgery and intraoperative radiotherapy (IORT) for a
      second local recurrence of myxoid liposarcoma in the popliteal region, after
      previous surgery and high-dose radiation.
AB  - A 46-year-old man with a second local recurrence of a myxoid liposarcoma in the
      fossa poplitea, after surgery and high-dose external beam radiotherapy, was
      successfully treated by a limb-sparing procedure combining marginal excision,
      intraoperative radiotherapy and reconstructive surgery. After a 48-month follow
      up, there was no evidence of disease, and the function of the leg and knee was
      normal.

PMID- 8479201
TI  - Inventory of plants used in traditional medicine in Somalia. IV. Plants of the
      families Passifloraceae-Zygophyllaceae.
AB  - Thirty-seven plants are listed, which are used by traditional healers in the
      central and southern parts of Somalia. For each species are listed: the botanical
      name with synonyms, collection number, vernacular name, medicinal use,
      preparation of remedy and dosage. Results of a literature survey are also
      reported including medicinal use, substances isolated and pharmacological
      effects. Three plants which should have been included in Part I of the series
      have been added and some corrections to that paper have been made. With these
      additions the series comprises 180 different plant species, distributed in 59
      plant families.

PMID- 8479202
TI  - Plants used in Guatemala for the treatment of gastrointestinal disorders. 3.
      Confirmation of activity against enterobacteria of 16 plants.
AB  - Ethnobotanical surveys and literature review identified 408 plants used in
      Guatemala for the treatment of gastrointestinal disorders. The screening of 84
      showed that 34 inhibit one or more enterobacteria; 16 of these were selected for
      further investigation. Extracts were obtained with three solvents of different
      polarity (n-hexane, acetone and alcohol) and the in vitro activity was
      demonstrated against enteropathogenic Escherichia coli, Salmonella enteritidis
      and Shigella flexneri. The activity of nine ethanolic extracts against
      enterobacteria, particularly Acalypha guatemalensis, Diphysa robinioides, Lippia
      dulcis, Psidium guajava and Spondias purpurea was confirmed. The plants with
      antibacterial activity are discussed.

PMID- 8479203
TI  - Mutagenic and antimutagenic activities of Uncaria tomentosa and its extracts.
AB  - Mutagenic and antimutagenic activities of extracts and chromatographic fractions
      of Uncaria tomentosa bark are reported. The plant extracts and fractions show no
      mutagenic effect in different strains of Salmonella typhimurium with and without
      metabolic activation. However, the plant extracts and fractions show a protective
      antimutagenic effect in vitro against photomutagenesis induced by 8-methoxy
      psoralen (8-MOP) plus UVA in S. typhimurium TA 102. A decoction of U. tomentosa
      ingested daily for 15 days by a smoker decreased the mutagenicity induced in S.
      typhimurium TA98 and TA100 by the subject's urine.

PMID- 8479204
TI  - Toxic effects of crude root extract of Plumbago rosea (Rakta chitraka) on mice
      and rats.
AB  - The ethanolic root extract of Plumbago rosea (Plumbaginaceae) was studied for
      acute toxicity in mice and subacute toxicity in rats. The 24 h LD50 values of the
      extract in mice were 239.88 mg and 1148.15 mg/kg b.wt. for intraperitoneal and
      oral routes, respectively. Oral administration of doses above 1250 mg/kg produced
      severe diarrhea. In subacute toxicity studies no mortality was observed when 50
      mg/kg of the extract was injected i.p. daily for 30 days; however, there was no
      weight gain in the treated rats. Significant reduction in the weights of liver,
      kidney, thymus and testes was observed in the male rats, while the spleen weight
      showed a significant increase from control. The females showed a significant loss
      in thymus weight and a gain in the weight of the uterus, but the liver and spleen
      did not show any weight change from the control. There was a significant increase
      in total WBC and neutrophil counts as well as in the levels of serum alkaline
      phosphatase and alanine transaminase (ALT) in both sexes. Similarly, the liver
      alkaline phosphatase level was significantly higher than control, but a
      significant reduction was observed in the DNA, RNA and total proteins. Thus, a
      higher drug dose (total dose of 15 g/kg b.wt.) was tolerated in fractionated
      administration, but it had a growth inhibitory effect in both sexes. The males
      appear to be more susceptible than females when individual organs are considered.

PMID- 8479205
TI  - Pulmonary complications of orthotopic liver transplantation.
AB  - We retrospectively reviewed the pulmonary complications and associated morbidity
      and mortality of 44 consecutive patients who underwent 52 orthotopic liver
      transplantations (OLTs) at the Mayo Clinic during 1987. All survivors
      participated in follow-up for 1 year after OLT. Of the five deaths in the study
      group, three were associated with pulmonary infections. On postoperative chest
      roentgenograms, 24 cases of pulmonary infiltrates were noted; 12 were caused by
      infections. Ten opportunistic pulmonary infections developed in nine patients:
      four cytomegalovirus, three Pneumocystis carinii pneumonia, and one each of
      Cryptococcus, Aspergillus, and Candida. All except one of the opportunistic
      infections were diagnosed after the sixth postoperative week. Fiberoptic
      bronchoscopy was helpful for diagnosing opportunistic pulmonary infections in six
      patients. One Aspergillus pulmonary infection was diagnosed by transthoracic
      needle aspiration. Bacterial pneumonia occurred in five patients. Preoperative
      pulmonary function tests, performed in 40 patients, revealed a restrictive
      ventilatory defect in 28% and impaired gas transfer in 52%. Pleural effusion was
      present in 18% of patients preoperatively and in 77% during the first week after
      OLT. Preoperative severity of liver disease and results of arterial blood gas
      determinations, pulmonary function tests, and chest roentgenography were not
      associated with postoperative mortality and pulmonary infections. Infectious and
      noninfectious pulmonary complications are common in liver transplant recipients.
      Attempts to decrease the frequency and severity of pulmonary complications by
      early diagnosis and effective treatment may diminish the morbidity and mortality
      associated with OLT.

PMID- 8479206
TI  - Medical mythology: Hygeia.

PMID- 8479207
TI  - Posttraumatic cervical dystonia.
AB  - Posttraumatic cervical dystonia has been described as a distinct syndrome with
      some similarities to idiopathic nontraumatic cervical dystonia (torticollis). We
      describe five patients in whom cervical dystonia developed immediately after
      relatively mild trauma to the neck. Four of the five patients had persistent
      contractions of all cervical muscles including the trapezius muscles, which
      almost completely prevented motion of the neck and resulted in muscle
      hypertrophy. The condition persisted unabated in all patients for the entire
      period of follow-up (duration, 1 1/2 to 3 years). Pharmaceutical interventions,
      which had been used previously for idiopathic nontraumatic cervical dystonia,
      failed to benefit these patients. Two patients who received injections of
      botulinum toxin had no more than mild benefit. Selective denervation was
      inapplicable because of the widespread involvement of all cervical muscles in all
      but one patient. Physical therapy was essentially ineffective. Because of the
      unusual features and possible medicolegal setting, clinicians may tend to
      diagnose this condition as a psychogenic disorder or litigation-oriented
      behavior. The clinical picture, however, is consistent with an organic dystonia
      that may render the patient functionally and occupationally disabled.

PMID- 8479209
TI  - Likelihood of malignant disease for various categories of mammographically
      detected, nonpalpable breast lesions.
AB  - To determine the likelihood of malignant disease for mammographically detected,
      nonpalpable breast lesions, we defined 11 morphologic categories and
      retrospectively reviewed the mammograms in 859 cases in which biopsy was
      performed after a wire localization procedure at our institution during 1989 and
      1990. Within each category, the total number of lesions and the percentage of
      cases with a surgical pathologic diagnosis of malignant involvement were as
      follows: benign calcification, 25 (0% malignant); indeterminate calcification,
      200 (22%); malignant calcification, 39 (92%); smooth mass, 84 (1%); irregular
      mass, 337 (40%); architectural distortion, 45 (47%); asymmetric breast tissue, 37
      (3%, or 1 case of asymmetrically prominent ducts); smooth mass with
      calcification, 3 (0%); irregular mass with calcification, 68 (66%); architectural
      distortion with calcification, 14 (57%); and asymmetric breast tissue with
      calcification, 7 (29%). The overall rate of malignant involvement for the 859
      cases was 34%. If follow-up examinations rather than biopsies had been done for
      the lesions categorized as benign calcification, smooth mass, smooth mass with
      calcification, and asymmetric breast tissue (excluding asymmetrically prominent
      ducts), the overall positive predictive value would have increased from 34 to
      41%, and 148 biopsies would have been deferred (17% of all biopsies). If
      morphologic criteria are applied to the evaluation of mammographically detected,
      nonpalpable lesions, the rate of malignant disease at biopsy may reach 40%. This
      rate correlates with that in recent large series.

PMID- 8479208
TI  - Long-term follow-up of young patients with chronic hereditary or idiopathic
      pancreatitis.
AB  - We conducted a retrospective study of patients younger than 20 years of age who
      had a diagnosis of chronic pancreatitis and underwent assessment at the Mayo
      Clinic between 1960 and 1990. Those with a known etiologic factor for the
      pancreatitis (such as a virus, trauma, alcohol, or hyperlipidemia) were excluded
      from the study. We compared the clinical course of the 42 patients who had
      hereditary pancreatitis (HP)--defined as at least two family members affected by
      the condition--with that of the 28 patients who had idiopathic pancreatitis (IP).
      The mean age at initial assessment was 7 years for those with HP and 12 years for
      those with IP. All patients in both groups had abdominal pain. Vomiting was more
      frequent in patients with HP than in those with IP; otherwise the initial
      symptoms were similar in both groups. Patients with HP, however, had more
      complications, including pseudocysts (seven patients), steatorrhea (four),
      ascites (three), portal hypertension (two), and diabetes (one), than did patients
      with IP (one each had diabetes, steatorrhea, and a pseudocyst). Complications or
      pain necessitated surgical intervention in 23 of 42 patients with HP versus 4 of
      28 patients with IP. Overall in comparison with IP, HP seems to be a more severe
      variant of chronic pancreatitis, inasmuch as it is associated with more frequent
      complications and need for surgical intervention.

PMID- 8479210
TI  - Falling off the pedestal: what is happening to the traditional doctor-patient
      relationship?

PMID- 8479212
TI  - Pulmonary manifestations of extrathoracic malignant lesions.
AB  - Two of the most common thoracic manifestations of extrapulmonary malignant tumors
      are thoracic metastatic lesions and pulmonary thromboembolism. Recognition of the
      broad array of patterns of pulmonary metastatic involvement is essential for
      optimal management of oncology patients. In addition to the "typical" pattern of
      multiple bilateral nodules, patients may have solitary nodules, reticulonodular
      infiltrates, hilar and mediastinal adenopathy, endobronchial obstruction, pleural
      disease, or even normal roentgenographic findings. An awareness of the
      association between cancer and pulmonary thromboembolism is also valuable. The
      mechanisms potentially responsible for the thrombotic events associated with
      malignant disease are discussed, and diagnostic issues are reviewed.

PMID- 8479211
TI  - Aneurysm of an aberrant right subclavian artery: case report and review of the
      literature.
AB  - In this article, we describe a case of a surgically treated aneurysm of an
      aberrant right subclavian artery. The historical literature to date is
      summarized, as are the key concepts relative to the anatomy, embryology,
      diagnosis, and treatment of this uncommonly occurring entity. Although the topic
      might be expected to be of concern to only a few specialists, all physicians
      should be aware that a patient with an enlarging aneurysm of an aberrant
      subclavian artery may experience dyspnea, dysphagia, or sudden collapse from
      rupture as the initial manifestations. An asymptomatic patient may have a
      mediastinal mass detected by roentgenography. The diagnosis may be confirmed with
      computed tomography or magnetic resonance imaging. As with most aneurysms,
      surgical treatment is recommended, and the benefit-to-risk analysis depends on
      individual case factors.

PMID- 8479213
TI  - Insufficiency-type stress fracture.

PMID- 8479215
TI  - Perioperative indications for red blood cell transfusion--has the pendulum swung
      too far?

PMID- 8479214
TI  - Palsies of the trochlear nerve: diagnosis and localization--recent concepts.
AB  - In this review, the anatomy of the trochlear nerve, the diagnosis of palsies of
      the trochlear nerve, and the localization of lesions of the trochlear nerve are
      discussed. Paresis of the superior oblique muscle is often not evident on duction
      testing; therefore, subjective diplopia testing with use of a Maddox rod is often
      necessary. The torsional component of the deviation may be evaluated by double
      Maddox rod testing. Palsies of the trochlear nerve must be distinguished from
      other causes of vertical diplopia, such as oculomotor palsy, skew deviation,
      myasthenia gravis, and Graves' ophthalmopathy. Trauma is the most common cause of
      isolated, unilateral or bilateral, acquired palsies of the trochlear nerve when a
      cause can be determined. The localization of lesions of the trochlear nerve to
      the nucleus or fascicles (or both), subarachnoid space, cavernous sinus and
      superior orbital fissure, or orbit depends on the associated damage to
      neighboring neurologic structures. Myokymia of the superior oblique muscle is
      usually idiopathic and benign but may rarely be an isolated manifestation of
      tectal disease.

PMID- 8479216
TI  - [Thyroid ophthalmopathy: clinical and tomographic study].
AB  - BACKGROUND: To evaluate exophthalmos by Hertel exophthalmometer (HE) compared to
      computed tomography (CT), and extraocular muscle width on CT and its relation
      with the clinical course in patients with thyroidal ophthalmopathy. METHODS: On
      reviewed 118 orbits from 59 patients (50 women, mean age 40.6 y., range 12-84)
      who suffered a thyroidal ophthalmopathy (Graves' disease, n = 57; Hashimoto's
      thyroiditis, n = 2). Muscle width was evaluated using coronal and mid-axial scans
      in all cases. Medial rectus (MR) width was analysed by Hallin and Feldon
      technique. RESULTS: Exophthalmos by HE was 22.5 +/- 2.5 and 23.2 +/- 3.2 mm
      (right-RE/left eye-LE), and CT 20.8 +/- 3.2 and 20.9 +/- 2.9 mm (p < 0.00001, r =
      0.72 and 0.65, respectively). MR width on mid-axial scan was 4.1 +/- 1.6 and 4.2
      +/- 1.5 mm (RE/LE). On coronal scans, MR was the muscle more often enlarged
      followed by superior, inferior and lateral rectus. CONCLUSIONS: Exophthalmos
      measured by HE was greater than by CT-measured one, but with a good correlation.
      Muscle were not equally affected, being MR the most frequently enlarged. MR-width
      was not related to duration and severity of disease.

PMID- 8479217
TI  - [Effect of a highly hypocaloric diet on the control of morbid obesity in the
      short and the long term].
AB  - BACKGROUND: The ponderal evolution and biochemical parameters during the in
      patient administration of a highly hypocaloric and high protein diet (VLCD) were
      evaluated. The efficacy at medium term of this treatment was determined and the
      possible determining factors of the ponderal evolution were analysed. METHODS: A
      VLCD was administered to 20 women with morbid obesity during 21 days. The
      modifications of the biochemical parameters were determined during admission. The
      ponderal evolution was studied during hospitalization and during 9 months of out
      patient follow up. The prognostic factors of ponderal evolution analyzed were:
      age, attempts to lose weight, familiar history of obesity, maximum weight
      attained, weight and index of body mass (IBM) at study initiation and admission,
      loss of weight during admission and the number of out patient controls. RESULTS:
      During hospitalization, a mean loss of 7.0-1.9 kg, a significant decrease in
      glycemia, cholesterol, triglycerides, lymphocytes and blood pressure were
      observed. It was found that ponderal loss at 3 and 6 months may be predicted by
      IBM upon initiation of the study. At 9 months weight was lower than at initiation
      of hospitalization but not than at discharge (p < 0.001). Weight upon initiation
      of the study and the maximum reached explain the weight at 9 months in 82.5% of
      the cases. CONCLUSIONS: Highly hypocaloric and high protein diets lead to a
      significant weight loss which is maintained at medium term and an improvement in
      the factors of cardiovascular risk are observed. Of the factors evaluated, only
      the grade of obesity significantly influences ponderal evolution.

PMID- 8479218
TI  - [Immunotherapy of leukemia].

PMID- 8479219
TI  - [Spain and research in applied biology in the European community: present and
      future].

PMID- 8479220
TI  - [Epidemiology of abdominal aorta aneurysms].

PMID- 8479221
TI  - [Mild renal insufficiency in a 70-year-old male with bladder carcinoma].

PMID- 8479222
TI  - [Molecular epidemiology].

PMID- 8479223
TI  - [Mycobacterium gordonae isolation in samples from bronchial aspirates and its
      practical implications].

PMID- 8479224
TI  - [Evaluation of a style of classes and seminars].

PMID- 8479225
TI  - [Visceral leishmaniasis associated with disseminated intravascular coagulation.
      Report of 2 cases].

PMID- 8479226
TI  - [Pre- and post-vaccination markers in health personnel].

PMID- 8479227
TI  - [Retrospective evaluation of the effectiveness of the BCG vaccination program in
      neonates in Barcelona].

PMID- 8479228
TI  - [Breast cancer, tamoxifen, and uterus].

PMID- 8479229
TI  - [Brigantium study. Cardiovascular risk factors in childhood and adolescence in a
      rural area of Galicia].
AB  - BACKGROUND: The aim of this study was to determine the levels of certain factors
      of cardiovascular risk in children and adolescents in rural areas of Gallicia.
      METHODS: One thousand eight children between the ages of 6 and 15 years selected
      from three primary schools were studied. Weight, height, blood pressure, serum
      levels of cholesterol and self admitted consumption of tobacco were determined in
      each participant. RESULTS: The patterns of body mass, blood pressure and total
      cholesterol selected to age and sex are very similar to those observed in a great
      deal of the Spanish and foreign studies. However, the absolute values do not
      necessarily coincide. The children studied were more obese than those reported in
      other studies carried out in the rest of Spain with similar values of systolic
      blood pressure and lower cholesterol levels. The levels of cholesterol in this
      study were within the range observed in other Western countries, lower than those
      found in other parts of Spain but much higher than the ideal quantities
      recommended by the WHO. Blood pressure was similar to that of a recent meta
      analysis of Spanish studies but much higher than that observed in the Second
      American Task Force Study. With regard to the use of tobacco, this population
      demonstrated lower prevalences to those of other Spanish populations. From the
      age of 14 the consumption of cigarettes greatly increases, especially in boys.
      CONCLUSIONS: Obesity and blood pressure appear to be a more important potential
      problem than cholesterol among the cardiovascular risk factors considered in the
      children studied in comparison with populations of a similar age. If prevention
      plans on the use of tobacco are foreseen in Spain, they should be made before the
      age of 14 when an important number of children already smoke or have tried
      cigarettes.

PMID- 8479230
TI  - [Clinical effectiveness and tolerance of acarbose in the treatment of insulin
      dependent diabetic patients (type I)].
AB  - BACKGROUND: Acarbose is a reversible inhibitor of the intestinal alpha
      glucosidases, the oral administration of which delays or diminishes the
      postprandial increase of glucose and insulin. METHODS: A multicentric double
      blind clinical trial (11 centers), controlled versus placebo, crossed and
      randomized, was carried out with 137 insulin-dependent diabetic type I patients
      treated with diet and insulin. During the first 3 months of the trial the
      patients received placebo or acarbose randomly. Following one month of wash out
      with placebo the patients received the inverse medication for 3 more months.
      During the first month of each phase the patients were given 50 mg three times
      per day of acarbose or placebo and the two following moths received 100 mg x
      3/day. RESULTS: Upon comparison of the two treatments significant statistical
      differences were found in HbA1 (p = 0.0005) and in postprandial glycemia (p =
      0.007). There were differences, although not statistically significant, in the
      amounts of triglycerides, cholesterol and fasting glycemia. One hundred and two
      patients referred adverse events, most being gastrointestinal (flatulence,
      meteorism). CONCLUSIONS: Acarbose may be useful in the treatment of insulin
      dependent diabetic type I patients treated with insulin and diet since it reduces
      the levels significantly of HbA1 and postprandial glucose.

PMID- 8479231
TI  - [Multicenter study of HTLV-I and HTLV-II infection in Spain. Spanish Group for
      the Study of HTLV-II/II Infection].
AB  - BACKGROUND: Human T-lymphotropic viruses type I (HTLV-I) and type II (HTLV-II)
      infections have been related to lymphoproliferative disorders and subacute
      neurological diseases. Screening blood donors for specific HTLV-I/II antibody has
      been implemented in Japan, United States, and recently in France. Should be it
      recommended in Spain? METHODS: Antibodies to HTLV-I/II were investigated in sera
      from 7,884 individuals living in Spain. They were classified in four major
      groups: 1) subjects at high-risk for retrovirus infection, as drug addicts,
      homosexuals, and polytransfused individuals (n = 4,740), 2) patients suffering
      HTLV-like symptoms (n = 760), 3) immigrants from or travellers to endemic areas
      (n = 1,427), and 4) blood donors (n = 957). RESULTS: Eighteen (0.22%) subjects
      were HTLV-I positive and 11 (0.12%) were classified as HTLV-II reactive. Five
      (71.5%) of 7 immigrants or travelers to endemic areas reacting against HTLV were
      typed as HTLV-I. Six (60%) of 10 drug addicts HTLV-reactive were typed as HTLV-II
      carriers. CONCLUSIONS: Both HTLV-I and HTLV-II infections are present in Spain,
      although in a low rate and mostly restricted to drug addicts (HTLV-II), and
      people coming from endemic regions (HTLV-I). All tested blood donors were
      negative. In this view, HTLV-I/II screening in Spanish blood banks seems to be
      non urgent, although alternative strategies should be considered.

PMID- 8479232
TI  - [Tobacco and adolescents: better safe than sorry].

PMID- 8479233
TI  - [The illness perceived by the patient and the clinical method. A thought from the
      general medicine point of view].

PMID- 8479235
TI  - [Drug-induced fever].

PMID- 8479234
TI  - [Tobacco and adolescents: influence of the personal environment].
AB  - BACKGROUND: The initiation of the smoking habit is related both with personal and
      environmental characteristics. Several authors have described the association of
      the smoking habit of parents, older siblings, and friends with the use of tobacco
      by teens. METHODS: This study is based on a cross-sectional survey to 6th and 7th
      grade students in Barcelona (Spain). RESULTS: This study confirms there is a
      growing proportion of smokers among teens when their parents, siblings and friend
      smoke. Children whose parents have quit smoking behave as the sons of parents who
      have never smoked, and smoke much less than the children of current smokers. When
      parents do not smoke, having siblings and friends who smoke increases the
      frequency of smoking from 0.2 to 3.4%, a 17-fold increase. CONCLUSIONS: Current
      smoking and future smoking intention are related with the number of smokers in
      the teen environment. These results support preventive programs in schools that
      include activities to resist external pressures to smoke. It also suggests that
      helping young adult smokers quit contributes not only to their own health, but
      also prevents the initiation of smoking among teens in their environment.

PMID- 8479236
TI  - [Campylobacter jejuni bacteremia in patients infected with HIV].

PMID- 8479237
TI  - [Subcutaneous venous reservoirs].

PMID- 8479238
TI  - [Hypoglycemic coma and advanced grade atrioventricular block with episodes of
      torsades de pointes].

PMID- 8479239
TI  - [Changes in the thyroid hormone profile following the prophylactic administration
      of mefloquine].

PMID- 8479240
TI  - [One year's experience with "home hospitalization" in the rural area].

PMID- 8479241
TI  - [Preventive interruption of the administration of HA-1A monoclonal antibody
      against endotoxin].

PMID- 8479242
TI  - Generation of early afterdepolarization in mouse ventricular fibers at long cycle
      length.
AB  - Early afterdepolarization (EAD) was studied in ventricular fibers of mouse heart.
      EAD could be occasionally induced under long cycle length of superfusion with
      Tyrode's solution (containing 3.0 or 5.0 mM KCl) at long cycle length. Three
      types of EAD were found: a second plateau with a prominence, a single triggered
      burst and a train of triggered bursts. Take-off potential of the first triggered
      burst or of the prominence varied from -40 to -60 mV. The triggered bursts in the
      third type often stopped at -35 to -45 mV level forming a very long second
      plateau before it completely repolarized. Changing abruptly from a long cycle
      length to a short one lead to a transient EAD induction. It is suggested that EAD
      in ventricular fiber in mouse heart shared the characteristics of that in atrial
      fibers, although it was very difficult to induce and was not very reproducible.

PMID- 8479243
TI  - The electrophysiological effects of alcoholized rhubarb solution in feline heart
      in vivo.
AB  - The effects of Chinese medicine, alcoholized rhubarb, on cardiac
      electrophysiology and contractile force were studied by using monophasic action
      potential (MAP) techniques with an improved pressure-electrical transducer
      epicardial electrode and/or an endocardial pressure-contact electrode catheter in
      27 feline hearts in vivo. The results of the experiments were as follows: 1)
      Alcoholized rhubarb solution (1.5 g/kg) caused a greater increase in the MAP
      amplitude (from 18.8 +/- 0.62 mV to 26.7 +/- 3.87 mV, p < 0.01), in the MAP
      maximum rate of rise of phase 0 (from 1.7 +/- 0.13 V/sec to 2.6 +/- 0.43, p <
      0.01), and in the MAP duration at 50% and 90% repolarization (from 194.3 +/-
      14.00 msec to 216.3 +/- 6.30 msec and from 238.8 +/- 21.41 msec to 280.5 +/-
      14.68 msec, respectively, p < 0.01), and a decrease in the heart rate (from 130.8
      +/- 12.10 bpm to 110.8 +/- 10.35 bpm, p < 0.01) in the epicardial monophasic
      action potentials after rhubarb solution administration for 1 min. 2) The
      ventricular contractile force of the feline heart in vivo was also significantly
      increased (11.1 +/- 0.52 g to 14.0 +/- 1.41 g, p < 0.01) by rhubarb solution. 3)
      A dose-dependent relation of alcoholized rhubarb solution was found and indicated
      that lower doses (1.0-1.5 g/kg) had an excitatory effect, while a higher dose
      (2.0 g/kg) had inhibitory or toxic effects on the intact feline heart. The
      present study provides evidence that Chinese rhubarb solution has
      electrophysiological effects on the feline heart in vivo.

PMID- 8479244
TI  - A study on the development of nociceptive responses in pre- and postweanling
      rats: the tail electric stimulation test as a suitable methodology.
AB  - The development of nociceptive responses to the tail electric stimulation test
      was investigated. Male Wistar albino rats were used for studies on adult and pre-
      and postweanling rats of 20 and 25 days of age, respectively. The thresholds for
      the motor response (tail withdrawal), vocalization during stimulus and
      vocalization afterdischarge were assessed. These responses are considered to be
      integrated at spinal, medulla oblongata and diencephalon-rhinencephalon levels,
      respectively. Adult animals showed significantly higher thresholds for the three
      responses when compared to the neonates, while 25-day old rats showed
      significantly higher thresholds for the vocalization afterdischarge than the 20
      day old pups. Although the effect of age cannot be ruled out, these latter
      results might indicate that the weaning process is critical in the development of
      the mechanisms related to the emotional/affective component of pain. The results
      also indicate the suitability of the nociceptive test employed for these kinds of
      studies.

PMID- 8479245
TI  - Selective inhibition of endothelium-dependent relaxation by sympathectomy in
      rabbit carotid artery rings in vitro.
AB  - The influence of cervical and periarterial sympathectomy on endothelium-dependent
      relaxation of the rabbit common carotid artery was studied in vitro.
      Noradrenaline, serotonin, acetylcholine and papaverine concentration-response
      curves of sympathectomized and control rabbit common carotid artery rings were
      recorded and analyzed and effects of endothelium removal were investigated.
      Endothelium-dependent relaxation was selectively and significantly inhibited in 3
      weeks postsympathectomy arterial preparations. Alterations in acetylcholine
      receptors of endothelial cells, decrease in endothelium-derived relaxing factor
      synthesis, or desensitization of medial muscular cells to endothelium-derived
      relaxing factor are hypothetical causes of this phenomenon.

PMID- 8479247
TI  - Telemetry.

PMID- 8479246
TI  - The single-pass perfused rabbit ear as a model for studying percutaneous
      absorption of clonazepam. II. Influence of hydrogel-borne propylene glycol and
      skin pretreatment with lauryl alcohol.
AB  - Enhancers of the percutaneous diffusion of clonazepam in the isolated single-pass
      perfused rabbit ear were evaluated and included propylene glycol (PG),
      polyethylene glycols (PEGs) of different molecular weight, as well as skin
      pretreatment with lauryl alcohol (LA). PG caused a concentration-dependent
      increase in the diffusion of clonazepam, due partly to the increased solubility
      of the active principle in the hydrogel. PEGs of molecular weight up to 3,000
      Daltons added to the PG hydrogel showed a simple additive effect on percutaneous
      diffusion enhancement induced by PG. Transdermal delivery of clonazepam also
      increased as a function of exposure time following pretreatment with LA.

PMID- 8479248
TI  - A foreshortened method of measuring liquid gastric emptying in normal volunteers.
AB  - The purpose of this study was to compare the cumulative fraction absorbed-time
      profile method of paracetamol with the shorter proportional area under the curve
      method of paracetamol by pretreating normal volunteers with cisapride, codeine
      and metoclopramide with and without neostigmine. Both methods are sensitive and
      comparable in defining early phase liquid gastric emptying, with the proportional
      area under the curve method having the advantage of providing the relevant
      information with a two-hour study period.

PMID- 8479249
TI  - Alternatives to assess rate of absorption.

PMID- 8479250
TI  - BN-50739: a PAF antagonist and limitation of myocardial infarct size.
AB  - Anesthetized rats were subjected to coronary artery ligation (CAL) for 72 h and
      infarct size was measured macroscopically using TTC staining. Systolic blood
      pressure and ECG were monitored. BN-50739 (5 mg/kg i.p.) decreased the myocardial
      infarct size in rats. It prevented the loss of R wave, an electrophysiological
      measure of ischemic injury in this model. In addition, BN-50739 markedly reduced
      serum malondialdehyde levels elevated as a consequence of CAL. It is speculated
      that being a PAF antagonist, BN-50739 decreased lipid peroxidation, perhaps by
      inhibiting migration of PMN cells to the site of ischemic injury through the
      limited collateral flow available in rat myocardium, and consequently may have
      reduced the generation of oxygen reactive species. This may be responsible for
      its beneficial effect in limiting infarct size.

PMID- 8479251
TI  - [Annus horribilis for MFR. The junior program is a lottery involving millions].

PMID- 8479252
TI  - [Bad arguments for the grades!].

PMID- 8479253
TI  - [How to deal with drunk drivers].

PMID- 8479254
TI  - [The tobacco legislation must be more stringent].

PMID- 8479255
TI  - [The debate on equality is important].

PMID- 8479256
TI  - [Variation ECG. New thinking on diagnostics in electrophysiology].

PMID- 8479257
TI  - [Nitric oxide--more than a vasodilator].
AB  - Endothelium-dependent vasodilation is mediated by nitric oxide (NO), which is
      synthesised from the amino acid arginine. The enzymes involved are present in
      several cell types, and NO has important regulatory functions in many of the
      organ systems of the body. NO seems to be of importance in the regulation of
      blood pressure, neuronal activity in the peripheral and central nervous systems,
      in ventilation perfusion-matching in the lungs, and in immune defense. Although
      the clinical use of nitroglycerin is more than a century old its mechanism of
      action, the liberation of NO, has only recently been elucidated. Endogenous
      nitric oxide synthesis inhibitors have been identified, and both these and NO
      itself are being examined in clinical trials.

PMID- 8479258
TI  - [Public information about ionizing radiation is unsatisfactory].

PMID- 8479259
TI  - [Neglected research of anorexia and bulimia].

PMID- 8479260
TI  - [The greatest progress in enteral nutrition. Percutaneous endoscopic gastrostomy
      is used more and more].

PMID- 8479261
TI  - [Nutrition via gastrostomy. Low frequency of complications with PEG].

PMID- 8479262
TI  - [Myocarditis after Borrelia infection? Case reports].

PMID- 8479264
TI  - [Need for thrombocytes among hematologic patients. Medical and economic aspects].

PMID- 8479263
TI  - [Screenings methods for microalbuminuria. Measuring rods are sufficiently exact].

PMID- 8479265
TI  - [The Swedish hostage in Bagdad in 1990. Early stress reactions and psychological
      support].

PMID- 8479266
TI  - [Positive effects of the guarantee of care. Markedly reduced waiting lists for
      treatment].

PMID- 8479267
TI  - [Prontosil. A German coloring agent which became the current sulfa].

PMID- 8479268
TI  - [How to grade a good physician?].

PMID- 8479269
TI  - [Surplus of physicians--parallels with the 30's].

PMID- 8479270
TI  - [Open care environment--nothing granted for pediatric surgeons only!].

PMID- 8479271
TI  - [Reconsideration of and professorship in psychoanalysis are needed].

PMID- 8479272
TI  - [Cardiopulmonary resuscitation. New discoveries and recommendations].

PMID- 8479273
TI  - [A longitudinal study of schoolchildren. Rehabilitate early in
      backache/headache].

PMID- 8479274
TI  - [Mental stress and heart disease. Is there a connection?].

PMID- 8479275
TI  - [Diethylstilbestrol. Tragic late effect after prenatal exposure].

PMID- 8479276
TI  - [Rubber allergy. An increasing problem with special risk for children with
      myelocele].

PMID- 8479277
TI  - [HIV-positive Africans spread the infection. Many of them ignore the rules of
      protection against the infection].

PMID- 8479278
TI  - Distribution of GAP-43 (B50/F1) mRNA in the adult rat brain by in situ
      hybridization using an alkaline phosphatase labeled probe.
AB  - GAP-43 (B-50,F1, pp46) is a calmodulin binding protein which is specific to the
      nervous system and also a substrate for the protein kinase C. Furthermore an
      enrichment of this protein in the growth cone and developmental brain indicate
      that this protein is related to nerve development, regeneration, and outgrowth.
      While its level dramatically decreases after the completion of synaptogenesis,
      the protein is still to some extent continuously expressed in certain regions of
      the mature brain. In order to clarify GAP-43 localization in mature normal rats,
      we investigated the distribution of GAP-43 mRNA in the rat central nervous system
      by using a non-radioisotopic in situ hybridization histochemistry. This method
      demonstrated GAP-43 mRNA expressing cells with high resolution. GAP-43 mRNA was
      more abundant in the forebrain than in the lower brainstem. Intense hybridization
      signal was observed in the mitral cells of olfactory bulb, cerebral cortex, CA3
      region of hippocampus, diagonal band, substantia nigra, raphe nuclei, locus
      coeruleus, and dorsal motor nucleus of vagus. Weak to moderate hybridization
      signals were also widely expressed in thalamus, hypothalamus, and midbrain.
      Moreover, most noradrenergic, adrenergic, serotonergic, histaminergic, and caudal
      part of dopaminergic cells exhibited an intense GAP-43 mRNA signal. Thus, GAP-43
      mRNA is abundantly expressed under normal conditions in the brain and may play an
      important physiological role particularly in the forebrain and in monoaminergic
      neurons supporting the findings that GAP-43 could be implicated in plasticity and
      monoamine release.

PMID- 8479279
TI  - A comparison of microtubule assembly in brain extracts from young and old rats.
AB  - Microtubule assembly was examined in the high-speed supernatant from homogenates
      of young (2-4 months old) and old (more than 24 months old) rat brains and
      significant age-related differences in microtubule assembly were found in the
      absence of exogenous GTP. In extracts from young brains, the increase in
      absorbance at 350 nm, which reflects the assembly reaction, was characterized by
      three phases (lag, elongation, and steady state) superimposed on a slow
      continuous increase due to non-specific aggregation. However, assembly in
      extracts from old brains, was very sluggish, in some cases barely more rapid than
      the non-specific aggregation reaction. Two to three times as much protein was
      assembled into cold-labile microtubules in extracts from young brains than from
      old brains. When 1 mM GTP was included in the assembly solutions the patterns of
      assembly in extracts from young and old brains became similar, with about the
      same amount of protein assembled into cold-labile microtubules. The assembly of
      tubulin purified from rat brains showed no differences between young and old.
      Results showed that extracts from old brains contained a higher GTPase activity
      than extracts from young brains. The sluggish assembly in extracts from old
      brains could be due to a deficiency in GTP or an inefficient regeneration of GTP.

PMID- 8479280
TI  - Neural regulation of phenylethanolamine N-methyltransferase in vivo:
      transcriptional and translational changes.
AB  - The hypothesis that neural regulation of rat adrenal medullary phenylethanolamine
      N-methyltransferase (PNMT, EC 2.1.1.28) occurs through transcriptional control is
      examined by following temporal changes in PNMT mRNA expression using paradigms of
      acute and chronic reserpine treatment. Concommitant changes in PNMT activity and
      protein were also measured to determine if reserpine induced changes depend
      solely on gene activation. Further, changes in adrenal corticosterone were
      measured to examine whether mRNA and enzyme responses might be mediated via
      reserpine induced changes in ACTH, and hence, corticosterone. Steady-state levels
      of PNMT mRNA peaked at approximately 8-fold normal by 6 h after a single
      reserpine injection (10 mg/kg i.p.), and then declined to control values. With
      continued treatment, a second, slower rise occurred after three alternate day
      injections (approximately 3-fold basal levels). Enzyme activity and protein rose
      simultaneously but were attenuated in magnitude and time course by comparison to
      message. With both acute and chronic treatment, activity increased 2.0-fold,
      peaking at 12 h after a single dose of reserpine and again after four doses of
      the drug. Protein, as measured by immunotitration, was elevated 1.2-and 1.4-fold,
      respectively. Adrenal corticosterone rose approximately 8-fold at 6 h, declined
      slightly at 12 h, rose again, and remained elevated thereafter. Comparison of the
      time courses for the various indices demonstrated that the early parallel bursts
      in PNMT mRNA and corticosterone are consistent with an increase in
      transcriptional activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479281
TI  - Effect of growth factors and cytokines on expression of amyloid beta protein
      precursor mRNAs in cultured neural cells.
AB  - We analyzed the effect of several growth factors and cytokines on the expression
      of amyloid beta protein precursor (APP) mRNAs in cultured mouse neuronal and
      glial cells. In neuronal cultures from embryonic day-15 brain. Northern blotting
      revealed that APP mRNAs increased by 1.3- to 2.6-fold when treated with nerve
      growth factor, basic fibroblast growth factor, interleukin 1, interleukin 2,
      interleukin 3, interleukin 6 or granulocyte-macrophage colony-stimulating factor
      but not with tumor necrosis factor alpha. An S1 nuclease protection assay
      revealed that the enhanced APP mRNA in neuronal cultures was exclusively APP695
      mRNA. On the other hand, astrocyte-enriched cultures prepared from postnatal day
      2 brain did not show any significant alteration among these factors. We conclude
      that certain growth factors and cytokines could enhance APP 695 mRNA expression
      in neurons in vitro.

PMID- 8479282
TI  - Cholinergic regulation of rat preproenkephalin RNA in the adrenal medulla.
AB  - Expression of the rat preproenkephalin (ppENK) gene involves transsynaptic
      cholinergic mechanisms. We evaluated the effects of cholinergic agonist
      treatments in vivo on the expression of adrenomedullary ppENK RNA. Cholinergic
      treatment with nicotinic + muscarinic receptor agonists resulted in a synergistic
      100-fold rise in steady-state ppENK messenger RNA levels, but only a 30- to 35
      fold rise in initiation of steady-state ppENK RNA transcripts. The levels of
      initiated ppENK steady-state RNA peaked at two days, whereas mature (1.45 kb)
      ppENK mRNA levels continued to rise, peaking at four days. This suggested that
      other transcriptional (attenuation or alternative splicing) or post
      transcriptional (RNA stabilization) regulatory mechanisms must be operative. As
      multiple ppENK RNA start sites exist, we examined how usage of multiple sites was
      altered by cholinergic treatments. The predominant start site changed from E2 in
      the basal state, to E4 after primary cholinergic stimulation, to E3 after re
      treatment. This represents novel example of differential usage of multiple RNA
      initiation start sites in vivo. Differences in initiated and mature transcripts
      are consistent with at least four mechanisms involved in control of cholinergic
      induced ppENK RNA expression: (i) simply new initiation of RNA transcripts, (ii)
      differential usage of the multiple RNA start sites, (iii) stabilization of mRNA
      transcripts, and (iv) attenuation and/or alternative RNA splicing of RNA
      transcripts.

PMID- 8479283
TI  - Colocalization of muscarinic acetylcholine receptors and protein kinase C gamma
      in rat parietal cortex.
AB  - The present investigation analyzes the cellular distribution of muscarinic
      acetylcholine receptors (mAChRs) and the gamma isoform of protein kinase C (PKC)
      in the rat parietal cortex employing the monoclonal antibodies M35 and 36G9,
      respectively. Muscarinic cholinoceptive neurons were most present in layers 2, 3
      and 5, whereas most PKC gamma-positive cells were found in layers 2, 5 and 6.
      Under normal, non-stimulated conditions, approximately 58% of all muscarinic
      cholinoceptive neurons were immunoreactive for PKC gamma. Conversely, nearly all
      PKC gamma-positive neurons were M35-immunoreactive. Although both pyramidal and
      nonpyramidal neurons express the two types of protein, the pyramidal cell type
      represents the vast majority. Of all cortical neurons, the large (15-25 microns
      in diameter) muscarinic cholinoceptive pyramidal neurons in layer 5 express the
      gamma isoform of PKC most abundantly and most frequently. Approximately 96% of
      these cells are immunoreactive for PKC gamma. Stimulation of mAChRs by the
      cholinergic agonist carbachol resulted in a pronounced increase in the intensity
      of 36G9 immunoreactivity, which may suggest that the mAChRs are functionally
      linked to the colocalized PKC gamma. No change was found in the number of 36G9
      immunoreactive neurons. In contrast, the number of immunocytochemically
      detectable muscarinic cholinoceptive neurons increased by approximately 38% after
      carbachol stimulation. The high degree of codistribution in cortical neurons of
      both transduction proteins suggests a considerable cholinergic impact upon the
      regulation of PKC gamma, a candidate key enzyme in cortical learning and memory
      mechanisms.

PMID- 8479284
TI  - Increases in sulphated glycoprotein-2 mRNA levels in the rat brain after
      transient forebrain ischemia or partial mesodiencephalic hemitransection.
AB  - Sulphated glycoprotein-2, thought to be involved in programmed cell death in
      peripheral organs, has been detected at increased levels in brain degenerative
      states. In this paper we have investigated the regional and cellular expression
      of this protein during development of brain lesion. With this aim sulphated
      glycoprotein-2 mRNA levels were studied in models of ischemic (transient
      forebrain ischemia) or mechanical (partial mesodiencephalic hemitransection)
      brain injuries using in situ hybridization histochemistry. Marked increases in
      sulphated glycoprotein-2 mRNA were observed in lesioned brains in both models. In
      addition, we report a shift in the regional distribution of positive cells in
      both lesion models 1-7 days post-lesion. After transient forebrain ischemia,
      sulphated glycoprotein-2 mRNA increases were always localized in selectively
      vulnerable regions (caudate-putamen, hippocampal formation), showing a temporal
      change in the pattern of intraregional distribution from less to more lesioned
      parts. In the case of mechanical lesion at 1 day, increased labelling had a
      widespread distribution on the lesioned side and was also observed on the intact
      side near the midline. In contrast, at 7 days increased labelling was restricted
      to regions directly lesioned (either areas whose input and/or output connections
      were severed by the transection or areas which were directly affected by the
      mechanical lesion). Analysis at the cellular level revealed that at both time
      intervals and in both lesion models most cell bodies overlain by dense clusters
      of specific grains were non-neuronal cells. The distribution patterns and their
      change over time suggest that at least some of these cells are inflammatory and
      phagocytic cells. The majority of degenerating neuronal cells after ischemia did
      not show increased levels of sulphated glycoprotein-2 mRNA. However, seven days
      after hemitransection and at all time intervals after transient ischemia, some
      cells clearly identifiable as neurons exhibited increased sulphated glycoprotein
      2 mRNA levels.

PMID- 8479285
TI  - Memory processing and apamin induce immediate early gene expression in mouse
      brain.
AB  - The present study analyses the effects of learning on the spatial pattern and the
      time-course of changes of immediate early gene messenger RNA's (c-fos and c-jun)
      in mouse brain produced by training in an appetitive bar-pressing task.
      Activation of c-fos and c-jun after training is strictly located in the
      hippocampal formation and is learning-dependent. Levels of both proto-oncogene
      mRNAs in the trained group were 4 to 5 times higher than in the sham-conditioned
      group. Injections of apamin, a bee venom neurotoxin that selectively blocks a
      class of Ca(2+)-activated K+ channels and improves learning and memory retention,
      produced as compared to untrained animals a 3- to 5-fold increase of expression
      of c-fos and c-jun with the same pattern as that observed in the trained animals.
      Post-training injection of 0.2 mg/kg apamin enhanced 1.4-fold the expression of
      both immediate early genes in CA1, CA3 and dentate gyrus as compared to trained
      saline-injected mice. All these results suggest that apamin-induced increase of
      immediate early gene expression might be related to the apamin-induced
      facilitation of learning.

PMID- 8479286
TI  - Non convulsive spike-wave discharges do not induce Fos in cerebro-cortical
      neurons.
AB  - Immunohistochemical localisation of Fos was used as a marker of neuronal activity
      to demonstrate neurons active during non-convulsive spike-wave epilepsy. Fos
      positive neurons in cortex and several subcortical areas were counted. In
      undisturbed animals. Fos counts were not related to spike-wave in any region.
      With the electroencephalographic (EEG) recording procedure. Fos induction
      occurred in all regions, even after habituation. However, in central cortex,
      counts were found to be inversely related to spike-wave duration. This suggests
      that neuronal activity is not increased during spike-wave and that the central
      cortex in these animals is less responsive to arousal than in non-epileptic
      animals.

PMID- 8479287
TI  - Dopamine transporter mRNA expression is intense in rat midbrain neurons and
      modest outside midbrain.
AB  - Dopamine transporter mRNA expression in individual neurons from the substantia
      nigra pars compacta. 'All' area, arcuate nucleus of the hypothalamus, retina, and
      olfactory bulb was assessed by in situ hybridization. High levels of expression
      were noted over individual neurons in midbrain nuclei; much lower expression was
      found in cells of the inner nuclear layer of the retina, glomerular cell layer of
      the olfactory bulb, and medial aspect of the arcuate nucleus of the hypothalamus.
      The low levels of expression in the latter nuclei are consistent with the paucity
      of effects of cocaine in visual and olfactory systems, failure to detect
      photoaffinity-labelled transporter protein in hypothalamus or olfactory bulb, and
      observations that little or no damage is found in dopaminergic neurons outside
      the basal midbrain in idiopathic Parkinsonism.

PMID- 8479288
TI  - Different posttranscriptional controls for the human neurofilament light and
      heavy genes in transgenic mice.
AB  - To investigate the mechanisms regulating neurofilament gene expression, we
      generated transgenic mice with high copy number of the intact human neurofilament
      light (NF-L) and heavy (NF-H) genes. Overexpression in transgenic mice of NF-L
      mRNA from 3- to 5-fold in different regions of the central nervous system (CNS)
      resulted only in a mild increase of 10-50% in the levels of NF-L proteins. The
      failure to enhance NF-L protein content was not due to interspecies differences
      in posttranscriptional NF-L regulation. For instance, based on specific
      immunodetection, it is estimated that human NF-L proteins composed 80% of total
      NF-L content in the spinal cord of transgenics. In contrast to the situation with
      NF-L, the CNS of transgenic mice bearing multiple copies of the human NF-H gene
      showed comparable increases in the levels of NF-H mRNA and proteins. These
      results suggest that the NF-L and NF-H genes are subject to different
      posttranscriptional regulation in the CNS. In vivo labeling of newly synthesized
      proteins by injection of [35S]methionine in the spinal cords of normal and
      transgenic mice provided evidence that the posttranscriptional regulation of NF-L
      expression in the CNS must occur, at least in part, at the level of translation.

PMID- 8479289
TI  - Reduction of calbindin-28k mRNA levels in Alzheimer as compared to Huntington
      hippocampus.
AB  - Disturbances in calcium homeostasis have been observed to be associated with
      Alzheimer's and other neurodegenerative diseases. Increased total calcium levels
      and decreased levels of calcium binding proteins have been found in Alzheimer
      brain tissue. However, the mechanism behind these disturbances remain unknown. In
      situ hybridization with tritiated antisense RNA probes for the calcium binding
      proteins, calbindin-28k and calmodulin, was used to examine the expression of
      genes coding for these proteins in Alzheimer and Huntington brain tissues matched
      for age, agonal process and autopsy interval. mRNA levels for calbindin-28k were
      reduced by 35% in CA1 and CA2 regions of Alzheimer hippocampus, as compared to
      Huntington control. In contrast, calmodulin expression was unchanged in CA1 but
      reduced by 30% in CA2. mRNA expression of calbindin-28k and calmodulin in
      Alzheimer temporal cortex did not differ from control. There were no significant
      differences in calcium binding protein message levels in cerebellar Purkinje
      cells between Alzheimer and Huntington control. There was no correlation between
      calcium binding protein message levels and brain weight, autopsy interval,
      patient age or the extent of neurofibrillary degeneration. Instead, decreased
      calbindin-28k expression in Alzheimer-affected hippocampus was due to an increase
      in the percentage of neurons expressing lower message levels for these proteins.

PMID- 8479290
TI  - Regulation of growth-associated protein 43 (GAP-43) messenger RNA associated with
      plastic change in the adult rat barrel receptor complex.
AB  - Plastic change occurs in the adult rat barrel receptor complex following
      peripheral deafferentation by removal of facial vibrissae (vibrissectomy) and can
      be prevented by prior depletion of brain norepinephrine. Growth-associated
      protein (GAP-43, B50, F1, pp46), a marker for synaptic reorganization, increases
      in the barrel cortex of adult rats following both peripheral and central
      deafferentation. Here we followed changes in GAP-43 mRNA expression in the barrel
      receptor system following vibrissectomy. Adult rats had unilateral total
      vibrissectomy with sparing of the central (C3) vibrissa. By in situ
      hybridization, GAP-43 mRNA first increased at 24h (9%, P < 0.05) in the
      ipsilateral trigeminal complex. Levels remained elevated (up to 25% of the
      unlesioned side) over the next 6 days, decreased to 88% at 7 days and returned to
      control levels at 14 days. Contralateral barrel cortex levels of GAP-43 mRNA
      increased by 14% at 4-5 days remained elevated through 7 days and returned to
      control levels by 14 days. Increased GAP-43 mRNA levels 6 days after
      vibrissectomy were reproduced by complete transection of the infraorbital nerve
      and were blocked by depletion of brain norepinephrine. No change occurred in
      ventrobasal thalamus GAP-43 mRNA at any time. Dot blot and Northern blot
      hybridizations of GAP-43 mRNA after vibrissectomy showed a 43% increase in the
      ipsilateral trigeminal complex and a 16% increase in the contralateral barrel
      cortex at 3 days and an 84% increase in ipsilateral trigeminal and 50% increase
      in contralateral barrel cortex GAP-43 mRNA at 6 days, respectively. Thus,
      deafferentation-induced plasticity in the barrel pathway depends upon
      norepinephrine and is associated with increase in both GAP-43 mRNA and protein
      suggesting that this may involve a structural change.

PMID- 8479291
TI  - Multiple mRNA species of choline acetyltransferase from rat spinal cord.
AB  - A cDNA library directed by a specific primer was constructed from the rat spinal
      cord and screened with 32P-labeled rat choline acetyltransferase cDNA which was
      recently isolated in this laboratory. Sequence analysis of 29 clones indicated
      that there are four types of cDNA (R1-, R2-, N1- and M-types). The nucleotide
      sequences in these cDNAs were identical in the coding region and the first 38 bp
      of the 5'-noncoding region, but differed in the 5'-noncoding region upstream of 
      38 bp. The R1-type was identical to the cDNA previously cloned from the rat
      spinal cord. The M and N1-type cDNAs both had sequences homologous to that of the
      cDNA previously obtained from the mouse spinal cord. Polymerase chain reaction
      analysis confirmed the presence of these 4 types of mRNA and found another type
      (N2-type) of transcript. The numbers of cDNA clones isolated and the relative
      amounts of polymerase chain reaction products for each type of mRNA suggested
      that the most abundant transcript was M-type. Sequencing of the genomic clone
      containing the 5'-region of choline acetyltransferase mRNA revealed that these
      five types of mRNA species were transcribed from three different promoter regions
      and produced by differential splicing of the 5'-noncoding exons.

PMID- 8479292
TI  - The expression of tropomyosin genes in pure cultures of rat neurons, astrocytes
      and oligodendrocytes is highly cell-type specific and strongly regulated during
      development.
AB  - Transcripts from the alpha-, beta- and delta-tropomyosin genes were studied
      during development of pure cultures of rat neurons, astrocytes and
      oligodendrocytes. The three cell types contained five alpha-tropomyosin
      messengers, produced using both alternative promoters and splicing; one was
      specific for mature neurons. The beta-tropomyosin gene is expressed only in
      astrocytes and the delta-tropomyosin gene in all three cell types, especially in
      immature cells. Most of the tropomyosin isoforms are highly cell-specific. Their
      developmental regulation involves either differential expression of genes, in
      neurons and oligodendrocytes, and/or changes in alternative splicing, in
      astrocytes, delta-Tropomyosin (TM-4) may be important during the growth of
      neuronal and glial cell processes, while specialized isoforms such as the neuron
      specific alpha-tropomyosin TMBr-3 may be involved in the function or plasticity
      of the mature cells.

PMID- 8479294
TI  - Muscle fatigue. June 1979.

PMID- 8479293
TI  - The complete amino acid sequence for brain beta spectrin (beta fodrin):
      relationship to globin sequences.
AB  - The amino acid sequence of mouse brain beta spectrin (beta fodrin), deduced from
      the nucleotide sequence of complementary DNA clones, reveals that this non
      erythroid beta spectrin comprises 2363 residues, with a molecular weight of
      274,449 Da. Brain beta spectrin contains three structural domains and we suggest
      the position of several functional domains including f-actin, synapsin I, ankyrin
      and spectrin self association sites. Analysis of deduced amino acid sequences
      indicated striking homology and similar structural characteristics of brain beta
      spectrin repeats beta 11 and beta 12 to globins. In vitro analysis has
      demonstrated that heme is capable of specific attachment to brain spectrin,
      suggesting possible new functions in electron transfer, oxygen binding, nitric
      oxide binding or heme scavenging.

PMID- 8479295
TI  - Introduction: exercise capacities and adaptations of people with chronic
      disabilities--current research, future directions, and widespread applicability.
AB  - This symposium addresses the unique physiological problems, current research,
      future needs, and widespread applicability for research involving people
      experiencing five major chronic disabilities within the United States:
      quadriplegia, paraplegia, mental retardation, multiple sclerosis, and
      poliomyelitis. Each author represents ACSM members who, by their distinguished
      research efforts, exemplify scientists who have demonstrated their dedication to
      the specific needs of these populations. The papers will give a brief description
      of the pathophysiology of the disability and the resultant effects upon the
      group's acute response to exercise and their physiological adaptations to
      exercise programs. Each paper will include reports on the state of current
      research and what benefits to that group could be expected if a major research
      breakthrough occurred. Additionally, the papers will indicate the major research
      questions currently confronting each population and a brief statement about the
      strategy needed to resolve these questions. If applicable, the authors will
      address how such a model (of the specific disability/disease) could be used to
      better understand the able-bodied response to exercise. The purpose of this
      symposium, therefore, was not only to better understand the effects of exercise
      on persons having chronic disabilities, but from a physiological point of view,
      to use what we know about the response of people with chronic disabilities to
      better understand the able-bodied response.

PMID- 8479296
TI  - Exercise capacity of individuals with paraplegia.
AB  - Spinal cord injury below the first thoracic vertebra defines the condition of
      paraplegia, with common medical sequelae including impaired motor function, bone
      and muscle atrophy, poor myocardial function, and a general decline of physical
      fitness. Recently, there has been renewed interest in the role of exercise for
      improving the physical fitness, health, and rehabilitation potential of
      individuals rendered wheelchair dependent following spinal cord injury. This
      brief review examines the pathophysiology of paraplegia, outlines useful
      strategies for cardiorespiratory fitness assessment, discusses the current levels
      of cardiorespiratory fitness in individuals with paraplegia, and highlights a few
      unique responses to acute exercise in this population.

PMID- 8479297
TI  - Exercise responses and quadriplegia.
AB  - The purpose of this paper is to review the exercise physiology literature on
      spinal cord injured individuals with quadriplegia performing voluntary arm
      exercise and/or electrically stimulated leg exercise. The effects of level of
      injury, active muscle mass, and sympathetic dysfunction on acute physiologic
      adjustments during exercise testing and chronic training adaptations are
      discussed. Several topics for future research are suggested, including methods to
      achieve higher aerobic/cardiovascular fitness, reduce secondary
      cardiovascular/pulmonary disabilities and related health care costs, and promote
      health, wellness, and an active lifestyle.

PMID- 8479298
TI  - Physical fitness and exercise training of individuals with mental retardation.
AB  - Recent social policies have focused on reentering persons with mental retardation
      (MR) into the work force and the mainstream of society. However, as individuals
      with MR age, their rate of institutionalization greatly outweighs that of the
      general population as well as children with MR. Health care organizations have
      expressed serious concern about the impact of an aging population with
      disabilities, particularly the cost associated with institutionalization.
      Considering that cardiovascular disorders are more common in population with than
      without MR, and that physical fitness has been directly related to work
      productivity among individuals with MR, physical fitness and exercise training
      have important implications for this population. Yet, available data suggest that
      individuals with MR have low levels of physical fitness, a higher incidence of
      obesity, and may respond differently to exercise training than persons without
      MR. This paper reviews current knowledge of physical fitness status, impact of
      exercise testing and training, and identifies differences between populations
      with and without MR, with special emphasis on trends associated with aging. This
      review is limited to three physical fitness components: obesity, cardiovascular
      fitness, and muscular strength and endurance, as these components have been shown
      to impact health and well-being, and are related to work performance of persons
      with MR. Suggestions for future research are also provided.

PMID- 8479299
TI  - Exercise and multiple sclerosis.
AB  - Multiple sclerosis (MS) is a neurological disease characterized by a variety of
      potentially debilitating symptoms. The manner in which the disease affects each
      individual is unique; however, many individuals with MS have a normal life
      expectancy and remain ambulatory throughout their lives. Very little research has
      focused on understanding how MS affects basic physiologic responses during
      exercise. Four general topics have been addressed: autonomic control of heart
      rate (HR) and arterial blood pressure (BP), cardiorespiratory fitness, skeletal
      muscle function, and symptom instability under thermal stress. Abnormalities in
      cardiovascular reflexes have been observed in some MS individuals during
      quiescent testing; however, HR and BP responses during exercise have not
      confirmed such findings. Deficits in cardio-respiratory fitness appear to be
      present in moderately impaired individuals, which are not always present in
      minimally impaired persons. Similarly, abnormalities in skeletal muscle function
      have been reported in some individuals with MS, while absent in others. Training
      appears to improve both cardiorespiratory fitness and skeletal muscle function.
      Findings appear to be indirectly influenced by the level of physical impairment
      of the experimental sample. This factor needs to be considered in sample
      selection, as well as in analyzing and reporting data. Elicitation of symptoms in
      response to thermal stressors has been documented by several investigators using
      unreliable techniques to measure core temperature. The use of more valid methods
      during rest and exercise have not confirmed the relationship between symptoms and
      core temperature changes. It may be that thermal sensitivity, although typically
      reported by most MS individuals, is a symptom that is very unique to each
      individual and sample selection may have indirectly contaminated results in past
      research. Considerations for future research are discussed.

PMID- 8479300
TI  - Poliomyelitis and the post-polio syndrome: exercise capacities and adaptation-
      current research, future directions, and widespread applicability.
AB  - Poliomyelitis is an acute viral disease that attacks the brain and the ventral
      horn of the spinal cord. Damage to the lower motor neurons usually results in
      atrophy and weakness of muscle groups, perhaps paralysis and possibly deformity.
      A second type, bulbar poliomyelitis, infects the medulla oblongata and may result
      in dysfunction of the swallowing mechanism along with respiratory and circulatory
      distress. Minor forms of poliomyelitis result in fever, sore throat, headache,
      and upper body stiffness, but leave no significant atrophy or paralysis. The
      purpose of this paper is to review post-polio syndrome (PPS) as well as the
      effect of exercise on the symptoms and morphologic adaptations to PPS and where
      future research efforts should be directed. The most common features of PPS for
      over 350,000 afflicted survivors include general fatigue, weakness, and
      joint/muscle pain. The primary reasons for these symptoms include 1) destruction
      of the anterior horn cells by the polio virus, leaving fewer motor neurons to
      induce muscle contraction; 2) unaffected motor unit enlargement by reinnervation
      through terminal sprouting; and 3) defective transmission at the neuromuscular
      junction secondary to failure of terminal axonal sprout. Acute responses to
      resistive exercise suggest significant muscle strength decrements in the knee
      extensors compared with similar aged people without polio. However, limited
      training investigation indicates significant strength increases for the knee
      extensors following at least 6 wk of training. Acute aerobic responses also
      differ significantly from those observed in aged-matched control subjects.
      Chronic aerobic responses to limited training studies suggest significant
      elevations in maximal oxygen uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479301
TI  - Effects of Ca(2+)-channel drugs on K(+)-induced respiration in skeletal muscles.
AB  - When skeletal muscles are exposed to elevations in extracellular K+, they
      experience a significant and long-lasting increase in O2 uptake. The basis for
      this response is unknown but may be related to an influx in extracellular Ca2+
      ions during sarcolemmal depolarization. The purpose of this study was to
      determine if altering Ca2+ entry, either by removal of Ca2+ from the bathing
      fluid or by exposing muscles to selective Ca(2+)-channel agonists or antagonists,
      would affect K(+)-induced respiration. Isolated frog sartorii muscles were
      incubated in normal Ringer's solution (R) or a modified Ringer's containing 10 or
      18 mM KCl. O2 uptake increased 83.7% in R+10 mM KCl and 502.2% in R+18 mM KCl.
      Incubation in Ca(2+)-free R+18 mM KCl containing Ni2+ in place of Ca2+ depressed
      the metabolic response to elevated K+. O2 uptake increased 234.5% in R+18 mM KCl
      containing Ni2+ and 80.6% in R+18 mM KCl containing Mg2+. Similarly, addition of
      the Ca(2+)-channel antagonists (gallopamil (D600) and diltiazem (DILT)) to R+18
      mM KCl also depressed the respiratory response to elevated K+. O2 uptake
      increased 224.2% and 133.1% in R+18 mM KCL containing D600 and DILT,
      respectively. Conversely, addition of the Ca(2+)-channel agonists (Bay K 8644
      (BAY) or palmitoyl carnitine (PC)) to R+10 mM KCl enhanced the metabolic response
      to elevated K+. O2 uptake increased 278% and 438.9% in R+10 mM KCl containing BAY
      and PC, respectively. These results indicate that the stimulatory effects of
      elevated extracellular K+ on skeletal muscle respiration are at least partially
      dependent on the availability of extracellular Ca2+ and its subsequent entry
      during membrane depolarization.

PMID- 8479302
TI  - 31P-MRS of quadriceps reveals quantitative differences between sprinters and long
      distance runners.
AB  - Phosphorus-31 nuclear magnetic resonance spectroscopy (31P-MRS) has been used to
      characterize the spectral pattern of quadriceps muscle at rest for sedentaries (N
      = 10), sprinters (N = 12), and long-distance runners (N = 10). Intracellular pH
      (pHi), phosphocreatine (PCr), inorganic phosphate (Pi), phosphodiesters (PDE),
      adenosine triphosphate (ATP) and total phosphate (Pt), defined as the sum of the
      areas of PCr, PDE, Pi, and 3 times the beta-ATP resonances, were obtained from
      all spectra. The pHi and ATP/Pt ratio were the same in the three groups of people
      studied. The PCr/Pi and PCr/Pt ratios were significantly lower and the Pi/Pt
      ratio was significantly higher for long-distance runners than for sprinters and
      sedentaries, while the PDE/Pt ratio was significantly lower for sprinters than
      for sedentaries and long-distance runners. Furthermore, the PCr concentration for
      sprinters and sedentaries was significantly higher and the Pi was significantly
      lower than for long-distance runners. The results obtained in this study can be
      explained by the accepted differences in fiber type composition between sprint
      and endurance athletes. We suggest that 31P-MRS at rest could be used to monitor
      noninvasively the individual adaptive response to training in the metabolic
      characteristics of the athlete muscle fiber.

PMID- 8479303
TI  - Effect of continuous infusion of an anabolic steroid on murine skeletal muscle.
AB  - The purpose of this study was to investigate whether continuous infusion of an
      anabolic steroid, stanozolol, would alter skeletal muscle size and performance in
      sedentary male mice. The study was performed as a preliminary to an investigation
      on the effect of anabolic steroids on skeletal muscle regeneration in the mdx
      mouse, an animal model used for the study of Duchenne muscular dystrophy.
      Skeletal muscle structure and contractile behavior, and heart, liver, kidney, and
      testis wet weights were assessed after 3 or 6 wk of continuous exposure to one of
      two concentrations of stanozolol. Continuous release pellets containing either a
      high (1.5 mg) or low (0.5 mg) concentration of stanozolol were implanted into 8
      wk-old C57BL/6J male mice. Control mice were implanted with pellets containing
      the drug vehicle. Stanozolol infusion had no significant effect on the
      contractile strength or mass of either fast-twitch extensor digitorum longus or
      slow-twitch soleus muscle. The resistance to fatigue of both muscles, assessed in
      vitro, was unaffected by stanozolol; however, postfatigue recovery of soleus
      twitch and tetanic tension after 3 wk of treatment was significantly (P < 0.05)
      increased in high-dose mice compared with control and low-dose mice. Androgen
      sensitive muscles, bulbocavernosus and levator ani, were significantly (P < 0.05)
      increased in wet weight after 3 wk of stanozolol treatment, but were not
      significantly different from control muscles after 6 wk, suggesting that
      continuous infusion produced a tolerance to the drug. Similarly, heart wet weight
      was significantly (P < 0.05) increased in stanozolol-treated mice compared with
      control after 3 wk, but not after 6 wk. Testis wet weight was significantly (P <
      0.05) decreased in low-dose mice compared with control mice at 3 wk, but not at 6
      wk. Plasma testosterone concentration was not significantly different between any
      of the groups after 3 or 6 wk of treatment. This study suggests that in the
      absence of other factors (e.g., high-intensity exercise or other degenerative
      changes in muscle fibers), continuous infusion of an anabolic steroid produces no
      significant effect on the growth, contractile strength, or endurance of hindlimb
      skeletal muscles.

PMID- 8479304
TI  - Is insulin-like growth factor gene expression modulated during cardiac
      hypertrophy?
AB  - The goal of this study was to examine the relationship between work-induced
      cardiac hypertrophy and insulin-like growth factor-I and -II (IGF-I and -II) mRNA
      expression in adult female Sprague-Dawley rats. Increased cardiac work was
      induced by coarctation, which involved placing a constricting silk ligature
      around the abdominal aorta to increase peripheral resistance. Cardiac hypertrophy
      was determined by measuring in vivo left ventricular protein synthesis rates.
      There was a rapid increase in left ventricular weight (LV) [both absolute and
      relative to body weight (mg tissue.100 g-1 body weight)] following the
      coarctation surgery. By the third day following coarctation, LV weight was
      increased approximately 20% and reached 24% by the 10th day as compared with
      controls. Protein synthesis rates increased dramatically, reached a peak level at
      3 d (133%.d-1) compared with 29% Ks.d-1 in the sham operated group and then began
      to slowly decrease toward control rates. The fractional synthesis rates of total
      protein in the LV were unchanged 1 d post-surgery. IGF-I mRNA content in the LV
      decreased to approximately 38% below the control content at day 1. However, by 3
      d post-surgery IGF-I mRNA content increased to 30-50% above controls, were 31%
      above control by day 7, and remained elevated thereafter. On the other hand, IGF
      II mRNA content remained constant throughout the 10 d post-surgery. Work
      necessitated increase in cardiac protein mass may be mediated, in part, by a
      local autocrine/paracrine production of IGF-I.

PMID- 8479305
TI  - Alterations in inspiratory and leg muscle force and recovery pattern after a
      marathon.
AB  - We measured lung mechanics and metabolic parameters, first in a series of 15
      marathon (M) and 12 half-marathon (H) runners, before and 2.5 h after the race,
      in order to assess the running effect on respiratory muscles. Maximal static
      inspiratory (Pi) and expiratory (Pe) pressures, maximal voluntary ventilation
      (MVV), blood lactate (LAC), arterialized blood gases (ABG), plasma glucose (GLU),
      and, with a visual analog scale, subjective tiredness were assessed. Pi decreased
      in M and H without change in Pe, MVV, or lung mechanics; it was still abnormal
      2.5 h after the race and did not correlate with LAC, ABG, training parameters,
      running times, or subjective tiredness. A second study of six other M compared
      Pi, Pe, adductor pollicis longus (Ppol), and triceps surae (Ptri) forces, aiming
      to: 1) assess the reproducibility of the prolonged Pi decrease without Pe change,
      2) prove that such a decrease corresponded to a real reduction in inspiratory
      muscle force and was not due to a poor collaboration of the subjects, 3)
      correlate Pi decrease with the force loss of a potentially tired leg muscle: the
      triceps surae. We observed a significant and similar decrease in Pi and Ptri, but
      no change in Ppol and Pe. Moreover, the high correlation between Pi and Ptri
      diminutions suggested a similar recovery pattern for inspiratory and leg muscles.
      In conclusion, the prolonged decrease in Pi after such races is compatible with
      inspiratory muscle fatigue, which, as well as its recovery, is similar to leg
      muscle tiredness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479306
TI  - Interrelationships between mechanical power, energy transfers, and walking and
      running economy.
AB  - The interrelationships between aerobic demand, kinematic and kinetic-based
      estimates of mechanical power output and energy transfer, and total body angular
      impulse (summation of net joint moments integrated with respect to time over a
      stride) were quantified for walking at 1.69 m.s-1 and running at 3.35 m.s-1 to
      assess the ability of these various biomechanical expressions to explain interin
      dividual differences in walking and running economy. Fourteen healthy men
      participated in the walking study and 16 recreational male runners were subjects
      for the running analysis. Each subject performed treadmill locomotion for
      determination of aerobic demand and overground locomotion from which
      biomechanical measures were quantified. It was expected that mechanical power and
      angular impulse expressions would correlate positively with aerobic demand while
      energy transfer expressions would correlate negatively. Correlations between
      aerobic demand and power estimates primarily were positive, but explained no more
      than 32% of the variability in walking or running VO2 (center of mass model: 0.22
      < r < 0.57; segment-based model: -0.02 < r < 0.20; kinetic model: -0.07 < r <
      0.22). Total body angular impulse also correlated positively with aerobic demand
      (0.32 < r < 0.42). Energy transfer expressions from the various analytical models
      showed no consistent relationship with aerobic demand, either in terms of
      magnitude or direction (-0.26 < r < 0.48). It was concluded that mechanical
      power, energy transfer, and angular impulse expressions frequently used in
      analyses of gait explain only a small proportion of normal interindividual
      variability in the aerobic demand at a given speed of walking or running.

PMID- 8479307
TI  - State anxiety and ambulatory blood pressure following resistance exercise in
      females.
AB  - The purpose of this investigation was to examine state anxiety and blood pressure
      responses during ambulatory recovery from resistance exercise. Fourteen females
      completed three separate bouts of resistance exercise in which the sets (N = 3),
      repetitions (N = 10), exercise type (knee extension, knee flexion, arm pull down,
      chest press, shoulder press, and abdominal curl), and time (30 min) were held
      constant, but the intensity was manipulated to equal 40%, 60%, and 80% of the 10
      repetition maximum for each exercise. Immediately before as well as 1, 15, 30,
      45, 60, 75, 90, 105, and 120 min following the cessation of exercise blood
      pressure and heart rate were assessed. State anxiety assessments were initiated
      immediately following blood pressure measurements. The subjects were ambulatory
      during the post-exercise period, and information about body posture during the
      cardiovascular assessments was obtained. MANOVAs, ANOVAs, and Tukey tests
      revealed that post-exercise state anxiety levels were reduced compared with pre
      exercise values from 90 to 120 min following exercise. Systolic blood pressure
      was elevated at 1 and 15 min following the 80% intensity condition, and at 1 min
      following the 60% intensity condition. It is concluded that during ambulatory
      recovery from resistance exercise: 1) reductions in state anxiety are realized;
      and 2) systolic blood pressure, in contrast to what has been shown to occur
      following aerobic exercise, is not reduced.

PMID- 8479308
TI  - Magnetic resonance imaging determination of left ventricular mass: junior Olympic
      weightlifters.
AB  - The relationship between left ventricular mass (LVM) and peak VO2 in junior elite
      Olympic-style weightlifters and sedentary subjects was investigated. Ten male
      weightlifters (mean +/- SE, age = 17.5 +/- 0.4 yr, wt = 72.9 +/- 3.3 kg) and 15
      sedentary males (age = 18.8 +/- 0.4 yr, wt = 69.6 +/- 2.0 kg) served as subjects.
      Peak VO2 was measured using a continuous, incrementally loaded bicycle ergometry
      protocol. LVM was measured using magnetic resonance imaging techniques. Absolute
      peak VO2 was not significantly different (P > or = 0.05) between the
      weightlifters and the control subjects (3.5 +/- 0.1 vs 3.3 +/- 0.11.min-1).
      Absolute LVM (g) was significantly (P < or = 0.05) correlated to absolute peak
      VO2 (1.min-1) in the weightlifters (r = 0.723), but not in the control subjects.
      No other correlations between LVM in absolute or normalized by body weight, body
      surface area, or fat free mass terms, and absolute peak or normalized by body
      weight peak VO2 were significant. The weightlifters absolute LVM was
      significantly greater (P < or = 0.05) than that of the controls (208.1 +/- 10.0
      vs 179.7 +/- 8.4 g). LVM normalized by body weight and body surface area but not
      by fat free mass, was significantly greater (P < or = 0.05) in the weightlifters
      than the control subjects. These data indicate that LVM in junior elite
      weightlifters is greater than that of control subjects and absolute LVM is
      related to absolute peak VO2 in weightlifters but not control subjects.

PMID- 8479309
TI  - Prediction of percent body fat in adult males using dual energy x-ray
      absorptiometry, skinfolds, and hydrostatic weighing.
AB  - The purpose of this study was to compare the prediction of percent body fat
      (%FAT) by dual energy x-ray absorptiometry (DXA), skinfolds (SF), and hydrostatic
      weighing (HW) in adult males. Subjects were 35 adult male Caucasians (mean +/-
      SD; age: 39.1 +/- 14.0 yr, height: 180.6 +/- 5.3 cm, weight: 81.0 +/- 11.1 kg).
      %FAT, determined by HW with residual volume determined via O2 dilution, served as
      the criterion. DXA %FAT was determined by the Norland XR-26 (XR-26) bone
      densitometer and by the SF equations of Jackson and Pollock (JP) (1978), and
      Lohman (LOH) (1981). Criterion referenced validation included analyzing mean (+/-
      SD) %FAT values using a one-way ANOVA for significance, comparison of mean
      differences (MD), correlations (r), standard error of estimates (SEE), and total
      errors (TE). Significant differences were found between means of each method. The
      r (0.91) and SEE (3.0 %FAT) for DXA compare favorably with the established SF
      methods of JP and LOH for predicting %FAT; however, DXA demonstrated the largest
      MD (3.9 %FAT) and TE (5.2 %FAT). Regression analysis yields HW = 0.79* DXA +
      0.56. The results do not support earlier research that found no significant
      difference between HW and DXA %FAT in males. The study suggests the density of
      the fat-free body (DFFB) is not constant, and that the variation in bone mineral
      content affects the DFFB, which contributes to the differences between DXA and HW
      %FAT. We recommend further research to identify inconsistencies between
      manufacturers of DXA equipment in prediction of %FAT in males.

PMID- 8479310
TI  - Accuracy of RPE from graded exercise to establish exercise training intensity.

PMID- 8479311
TI  - Effect of pre-existing health conditions on the results of reconstructive
      microvascular surgery.
AB  - The effect of different pre-existing health conditions on the results of
      reconstructive microvascular surgery are reviewed. These conditions include: age,
      vital organ failure, diabetes, arterial and venous diseases, medications,
      smoking, wound healing disorders, epidermolysis bullosa, hematological diseases,
      multiple injury patients, pregnancy, and neuropsychiatric disease.

PMID- 8479312
TI  - Operative complications and the management of intraoperative flow failure.
AB  - Free flap flow failure can be either that of an artery and/or vein(s). One
      approach is to ascertain precisely which vessel(s) is compromised, then figure
      out whether the problem is on the patient's side or the flap side or at the
      anastomosis itself. A well perfused patient can minimize a patient-side problem.
      An anastomotic problem can be revised with or without adding a graft. There is
      potential to avoid further anastomotic problems with the use of some form of
      anticoagulant. Problems on the flap side, if limited, can be dealt with by
      resection or repair. Anticoagulants may be of value. Occasionally, another free
      flap is needed.

PMID- 8479313
TI  - Monitoring techniques for the detection of flow failure in the postoperative
      period.
AB  - Free tissue transfer is now a commonly used reconstructive tool. Vascular
      compromise is still a common complication and salvage rates of compromised flaps
      have been in the region of 50%. Numerous monitoring techniques have been tried
      but there is yet no single technique which has enjoyed universal acceptance. This
      paper reviews the available techniques and indicates where current trends are
      leading.

PMID- 8479314
TI  - Ischemia reperfusion injury: a review.
AB  - Ischemia reperfusion injury is reviewed in the context of the evolution of flap
      research over the past decade. A description of the clinical relevance of this
      field is presented and the possible etiologies are reviewed. The pathophysiology
      of this injury is then explored in some detail. Both skin and myocutaneous flaps,
      in a variety of animal models, are discussed. Research performed in vitro, as
      well as in other organ systems similarly affected by ischemia and reperfusion, is
      also examined. Particular attention is placed on the function of several newly
      described inflammatory mediators where it appears relevant to future research and
      treatment in the field of reconstructive microsurgery.

PMID- 8479315
TI  - Pharmacologic intervention in ischemia-induced reperfusion injury in the skeletal
      muscle.
AB  - This article provides a concise review on the potential causes of ischemia
      induced reperfusion (I/R) injury and pharmacologic intervention in the skeletal
      muscle. Special emphasis is placed on the recent observation of the acute
      ischemic preconditioning phenomenon for prevention of I/R injury in skeletal
      muscle. Finally, the mechanism of ischemic preconditioning and its clinical
      applications for augmentation of skeletal muscle tolerance to prolonged ischemic
      insult are discussed.

PMID- 8479316
TI  - The medical leech: an old treatment revisited.
AB  - The treatment modality of choice for venous insufficiency after free tissue
      transfer or replantation remains surgical repair. When this is not technically
      possible, the use of medical leeches is a useful adjunct to treatment. This paper
      reviews the history of the use of leeches in medicine, the anatomy and physiology
      of Hirudo medicinalis, the techniques of leech therapy, and the complications and
      contraindications.

PMID- 8479317
TI  - Complications in head and neck microsurgery.
AB  - Microvascular surgery plays a vital role in head and neck reconstruction. This
      paper deals with the complications arising from this form of surgery. They can be
      classified as general complications, anastomotic problems, and specific problems
      related to particular donor and recipient sites.

PMID- 8479318
TI  - Complications and unsatisfactory results in the microsurgical reconstruction of
      lower extremities.
AB  - Complications and unsatisfactory results in the microsurgical reconstruction of
      lower extremities were reviewed in a chronological sequence. Perioperative
      complications were grouped into the following categories: improper patient or
      donor tissue selection, unsatisfactory choice of recipient site vessels,
      inadequate exposure of recipient site vessels, improper "insetting" of the free
      tissue transfer, extralumenal obstruction, and miscellaneous adverse factors.
      Vascular changes in the limb as a result of free tissue transfer are discussed.
      Discussion of late postoperative problems includes the long-term results of soft
      tissue and skeletal reconstruction.

PMID- 8479319
TI  - Experimental microsurgical vein grafts: quantitative temporal analysis of
      progressive media fibroplasia.
AB  - The sequential histopathologic changes in microvenous grafts placed in a
      microarterial system were studied. In 48 Sprague Dawley rats, a 1 cm segment of
      epigastric vein was interposed into a defect created in the femoral artery.
      Grafts were explored at 1, 2, 4, and 12 weeks. After an initial smooth muscle
      hyperplasia, a progressive fibroplasia of the media was observed. Only small
      focal areas of intimal hyperplasia were seen. The width of the media was measured
      with an eyepiece micrometer. A statistically significant (P < 0.01) increase in
      width from 17 microns at 1 week to 462 microns at 12 weeks was noted. Although
      this process has been described before, this is the first quantitative
      assessment.

PMID- 8479320
TI  - Colon transplantation: a new microvascular technique.
AB  - This paper describes a new transplantation technique, using the colon instead of
      the small bowel for intestinal transplantation. With microsurgical techniques,
      allogeneic colon transplantation was carried out in rats in a heterotopic
      fashion. The vascular pedicle containing the aortic cuff and the portal vein was
      anastomosed to the aorta and the inferior vena cava of the host, respectively.
      The technique has proven reliable and reproducible, and our preliminary results
      suggest that the colon produces a milder rejection response than transplantation
      of the small bowel.

PMID- 8479321
TI  - En bloc kidney and whole pancreaticoduodenal transplantation with bladder
      drainage in the rat: microsurgical technique and outcome.
AB  - A microsurgical technique for en bloc kidney and whole pancreaticoduodenal
      transplantation with bladder drainage employing triple vascular anastomoses
      without the need for a vascular cuff is described. Nineteen combined isografts
      were performed using this technique in inbred male Lewis (RT1:I) rats with
      streptozotocin-induced diabetes. Six recipients died within 1 month from early
      complications (two from uremia, two from pancreatitis, one from bleeding, one
      from peritonitis); the other 13 survived more than 1 month after transplantation
      with both the pancreas and kidney grafts functioning. Four of the 13 rats died
      after 1 month (one from uremia secondary to an obstructed ureter, one from
      unexplained uremia, one from peritonitis after a biopsy, and one of unknown
      causes). The pancreas isografts of two animals were excised at 1 and 3 months to
      confirm dependence on the graft; both animals became hyperglycemic after graft
      pancreatectomy and had immediate declines of urine amylase activity to normal.
      One animal was sacrificed at 3 months to determine the insulin content of its
      native and transplanted pancreas; insulin was very low in the former and normal
      in the latter. The remaining rats survived with both grafts functioning for at
      least 6 months (normoglycemic, high urinary amylase levels, normal or near-normal
      plasma creatinine concentrations), before being sacrificed within the context of
      other experiments and for histological observations. Both the kidney and pancreas
      isografts were well preserved microscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479322
TI  - Replantation of a multiple digit and circular palm amputation: a case report.
AB  - A case of successful replantation of multiple digits and circular palm amputation
      caused by an industrial punch force is reported. The two-level amputation was
      reconstructed by first replanting the severed fingers to the palmar segment and
      then connecting the palm segment to the hand stump. An arterial crisis was
      treated with urokinase, and postoperative functional recovery is described.

PMID- 8479323
TI  - Connective tissue disease and autoantibodies in the kindreds of 63 patients with
      systemic sclerosis. The United Kingdom Systemic Sclerosis Study Group.
AB  - Systemic sclerosis (SSc) tends to occur in a sporadic fashion and familial
      occurrence of the disease is unusual. Nevertheless, reports of related connective
      tissue diseases (CTD), autoantibodies, or both in family members together with
      associations of certain HLA class II phenotypes with SSc suggest that genetic
      factors might play a part in susceptibility to the disease. Because of the
      relative rarity of SSc only a small number of family pedigrees have been studied
      previously. This report represents the largest study to date, to our knowledge,
      of family members of patients with scleroderma, and provides the opportunity to
      investigate the relative importance of genetic and environmental factors
      operating in the disease. The family pedigrees of 63 patients with systemic
      sclerosis were examined with respect to clinical, serologic, and immunogenetic
      features. Multiple cases of SSc were seen only in 1 family, in which the disease
      affected a father and daughter. Disease expression in these 2 individuals was
      very similar both clinically and serologically; relatives with other connective
      tissue diseases were found in 9 families, and nonspecific features of CTD such as
      Raynaud phenomenon, and arthralgia or arthritis, occurred commonly, especially in
      female relatives. Antinuclear antibodies (ANA) were also detected more frequently
      in relatives than in controls. However, antibodies previously demonstrated to
      have a high degree of specificity for SSc were confined to patients with this
      disease. Probands had an increase in the frequency of HLA-DR3, DR5, and C4AQO.
      Patients with diffuse scleroderma had an increased frequency of HLA-DR3, while
      those with the limited form of the disease had an increased frequency of HLA
      DR5.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479324
TI  - Systemic lupus erythematosus: clinical and immunologic patterns of disease
      expression in a cohort of 1,000 patients. The European Working Party on Systemic
      Lupus Erythematosus.
AB  - In the present study we have analyzed the prevalence and characteristics of the
      most relevant clinical and immunologic features in 1,000 patients with SLE.
      Several differences in the expression of the disease have been observed in
      relation to the patients' age at onset, sex, and autoantibody serology. The
      childhood-onset patients more often had malar rashes (55% vs 39%) and nephropathy
      (28% vs 15%) as presenting manifestations. During the evolution of the disease,
      these patients had an increased prevalence only of malar rash (79% vs 56%) and a
      lower prevalence of rheumatoid factor (6% vs 19%). The older-onset patients (age
      50 or older) less often showed malar rash (21% vs 42%), arthritis (52% vs 71%),
      and nephropathy (3% vs 17%) as the first symptom. During the evolution of their
      disease, these patients had a decreased prevalence of malar rash (33% vs 60%),
      photosensitivity (29% vs 47%), arthritis (73% vs 85%), nephropathy (22% vs 41%),
      thrombosis (4% vs 15%), and anti-La antibodies (6% vs 20%), but an increased
      prevalence of sicca syndrome (33% vs 15%). Males more often had serositis (28% vs
      16%) as a first symptom, but they presented with a lower prevalence of arthritis
      (74% vs 85%) during the evolution of the disease. The presence of ANA, a high
      titer of anti-dsDNA, rheumatoid factor, anti-ENA, and antiphospholipid antibodies
      also distinguished additional homogeneous SLE subsets of clinical significance.

PMID- 8479325
TI  - Herpetic infection, with especial reference to involvement of the nervous system.
      1929.

PMID- 8479326
TI  - The spectrum of non-Candida fungal infections following bone marrow
      transplantation.
AB  - We evaluated a consecutive series of patients who underwent bone marrow
      transplantation (BMT) at a single institution between 1974 and 1989 for the
      occurrence of a non-Candida fungal infection in the first 180 days after BMT. Of
      the 1186 patients, 129 (11%) patients developed a total of 138 significant non
      Candida fungal infections in this period. Eight patients had multiple distinct
      infections. The most common isolate was Aspergillus spp. (n = 97), followed by
      Fusarium (n = 10), and Alternaria (n = 6). The 4 clinical subtypes of infections
      were minor skin or soft-tissue infections (n = 7), infections of a single organ
      or site (n = 61), disseminated fungal infection (n = 58), and isolated fungemia
      (n = 12). The respiratory tract was involved in 95% of single organ or site
      infections, and 84% of disseminated infections. Outcome was poor, with only 18%
      of patients surviving. The cause of death was directly related to the non-Candida
      fungal infection in 66% of patients who died. Mortality rates were significantly
      higher in patients with either single-organ or site infections (41%) or
      disseminated infections (83%). The cause-specific mortality rate was greatest
      following infections with Aspergillus, Chrysosporium, Fusarium, Mucor, or
      Scopulariopsis, in which there was a high potential for invasive disease and
      disseminated infection. In contrast, the cause-specific mortality rate was lowest
      in infections which were either isolated fungemia or were localized and amenable
      to surgical debridement, most often seen with those infections caused by
      Acremonium, Alternaria, Penicillium, and Saccharomyces. The spectrum of clinical
      infections caused by these uncommon non-Candida fungal isolates both in our
      series and in the literature is reviewed. These unusual opportunistic fungal
      isolates are now gaining recognition in immunosuppressed patients such as the BMT
      population, and have a significant impact on patient outcome. Effective therapy
      of non-Candida fungal infections remains difficult. Early aggressive surgical
      debridement appears to be important in control of localized invasive infections.
      Prolonged therapy with amphotericin B is the standard of care, although the role
      of the newer antifungal agents is not yet well-defined. Ancillary roles may also
      be provided by granulocyte transfusions and the colony-stimulating factors.

PMID- 8479327
TI  - Infective endocarditis at a large community teaching hospital, 1980-1990. A
      review of 210 episodes.
AB  - We studied 210 episodes of infective endocarditis in 204 patients. The prevalence
      of this disease in our series ranged from 0.32 to 1.30 (mean, 0.75) episodes per
      1000 admissions per year. There were 115 male and 89 female patients, whose ages
      ranged from newborn to 91 years (median, 60-70). One-hundred-and-forty-eight
      episodes involved host valves and another 33 episodes occurred in intravenous
      drug users. There were 2 episodes of early and 27 episodes of late prosthetic
      valve endocarditis. Staphylococcus aureus accounted for 99 episodes (47.1%),
      alpha-hemolytic streptococci for 29 episodes (13.8%), enterococci for 11 episodes
      (5.2%), culture-negative endocarditis for 11 episodes (5.2%), and other organisms
      for 60 episodes (28.6%). Severe back pain was the chief complaint in 15 patients.
      2-D echocardiography was performed in 164 episodes, results in 67 (40.9%) of
      which were positive. Valve surgery was performed in 29 episodes (23 host valves
      and 6 prosthetic valves). The overall mortality was 21.4%. Autopsy was performed
      in 22 of the 45 patients who died (48.9%). The mortality rate increased with age,
      (10.1% and 31.5% for patients < 60 years old and 60 years or older, respectively
      (p < 0.001).

PMID- 8479328
TI  - Prevalence of obesity in adults with mental retardation: implications for health
      promotion and disease prevention.
AB  - The purpose of this study was to determine the incidence of obesity among 364
      adults (mean age, 36.8 years) with mental retardation living in four residential
      settings. Skinfold measurements were used to measure adiposity. Results indicated
      that rates of obesity were significantly higher among females, subjects with
      severe mental retardation had the lowest overall rates of obesity, and the
      institutional group had the lowest incidence of obesity. These findings indicate
      a need for more investigation into the caloric intake and energy expenditure of
      adults with mental retardation, specifically focusing on level of retardation and
      living arrangement.

PMID- 8479329
TI  - Use of blacklight as visual stimulation for people with profound mental
      retardation and multiple handicaps.
AB  - Nineteen people with profound mental retardation and multiple handicaps who lived
      in a large ICF/MR facility were given visual stimulation in a blacklight
      environment. A comparison was made between conditions of blacklight and normal
      light for tracking and reaching. The students performed reliably higher under
      conditions of blacklight. In the blacklight environment, which removed
      distracting stimuli and exaggerated critical features, students were able to
      respond better to visual cues.

PMID- 8479330
TI  - Education of children with mental retardation in the Arab countries.
AB  - An overview of current issues in the education of children with mental
      retardation in Arab countries was presented and salient features of available
      programs were described. Major problems facing Arab practitioners working with
      this population were also discussed. The conclusion was made that despite serious
      challenges, special education programs for children with mental retardation in
      Arab countries are gradually evolving, making the outlook for these children more
      promising.

PMID- 8479331
TI  - On the importance of helping families: policy implications from a national study.
AB  - This study is a companion to our 4-year study (Birenbaum, Guyot, & Cohen, 1990)
      on financing health care for individuals with autism or severe mental
      retardation. We reported on nonmedical expenditures and opportunity costs
      pertaining to maintaining a child or young adult with serious developmental
      disabilities in the home or in residential care and discussed policy implications
      for assisting their families. We proposed that (a) personal care and family
      support should be included in health care requirements, (b) family-centered care
      should be promoted, (c) appropriate programs and care should be provided for
      young adults no longer in school, (d) financing and organizing of family supports
      and subsidies should be administratively simple, (e) Medicaid should be expanded
      to increase use of home- and community-based services, and (f) financial support
      should be provided to families.

PMID- 8479332
TI  - Comparison of families of children with mental retardation and families of
      children without mental retardation.

PMID- 8479333
TI  - On the medicalization of family caregiving.

PMID- 8479334
TI  - In the best interests of the family: some comments on Birenbaum and Cohen's
      recommendations.

PMID- 8479335
TI  - Injuries in young people with developmental disabilities: comparative
      investigation from the 1988 National Health Interview Survey.
AB  - Injury rates among community-based young people with developmental disabilities
      were compared to controls and to young people with chronic illness and their
      controls, using data from the 1988 National Health Interview Study. Children with
      disabilities had higher injury rates than did controls, but children with chronic
      illness did not. Preschoolers with chronic illness tended to have lower rates of
      injury. Analyses were also conducted by sex. These injury patterns may be due to
      both impaired function resulting from disability and overprotection with
      decreased exposure to risk.

PMID- 8479336
TI  - The era of optimism, 1850-1870: a preliminary reappraisal.
AB  - Hervey B. Wilbur founded the Barre School, the first private residential school
      in the United States, in 1848. Samuel G. Howe began the Massachusetts School for
      Idiotic and Feeble Minded Youth, the first residential public school in the
      United States, in 1850. Correspondence of the period indicates educational
      results were less than expected and that strains of pessimism surfaced quite
      early. By the late 1850s, both Howe and Wilbur raised the possibility of
      custodial care. The primary source material suggests that the disillusionment
      with the residential facility as a vehicle for reform and habilitation reflected
      the decreased faith in moral education and remediation of problems associated
      with insanity, criminal behavior, and the poverty in the pre-Civil War period.

PMID- 8479337
TI  - Behavioral problems and medication utilization.
AB  - Although psychotropic medications are commonly used with older adults who have
      mental retardation, patterns of medication use for this group are not easily
      determined. Our objective was to explore relations between prescribed
      psychoactive treatments and rated behavioral difficulties. Adults with moderate
      mental retardation living in congregate and group care settings were rated by
      care providers using a standard behavior rating instrument. Older adults
      demonstrated a tendency toward higher medication utilization. Results indicated
      higher drug utilization in the larger setting despite the fact that behavior
      problems and cognitive level was matched across all settings. Medication
      utilization appears to be related to multiple factors, not only the behavioral or
      cognitive characteristics of adults with mental retardation.

PMID- 8479338
TI  - Percolation phenomenon: the effect of capillary network rarefaction.
AB  - The relationship between microvascular network resistance and functional
      capillary density was investigated by computer simulation. A model of
      spinotrapezius muscle microcirculatory network was constructed from measured data
      of vessel length and diameter. Progressive rarefaction was simulated by random
      stepwise removal of capillaries from the network. The flow distribution in the
      network was calculated after each step of capillary removal. Network resistance
      increased little when decreases in functional capillary density were less than
      30%. Furthermore, capillary flow did not decrease and its variance across the
      network was unchanged despite the gradual flow redistribution. However, with
      further decreases in capillary density, network resistance increased in a double
      exponential fashion. The resistance approached infinity at a critical value of
      functional capillary density termed the percolation threshold. The value of this
      parameter varied between 56 and 62% and it was lower when capillaries with the
      lowest flow were preferentially removed.

PMID- 8479339
TI  - Comparative evaluation of laser Doppler flux metering, bulbar conjunctival
      angioscopy, and nail fold capillaroscopy in sickle cell disease.
AB  - Eleven adult patients with stable sickle cell disease (SCD) were investigated
      twice at a 15-day interval by nail fold capillaroscopy (NFC), bulbar conjunctival
      angioscopy (BCA), and laser Doppler flux metering (LDF). NFC and BCA are
      essentially descriptive. NFC revealed, in some patients, network patterns similar
      to those observed in vasculitis. BCA provides a reproducible method for the
      visual assessment of the microcirculation. When using a rating scale with five
      criteria it identified abnormalities related to both altered red blood cells and
      vascular morphology but failed to discriminate between patients. LDF, in
      contrast, is quantifiable and showed reproducible characteristic reactive
      alterations of vasomotion in response to ischemia after 3 min of occlusion. The
      SCD patients had a delayed response, best measured by the recovery half time,
      which was four to five times longer than that of normal subjects. In addition,
      the cold provocative test was always abnormal, as evidenced by a significant drop
      in the contralateral flux, and was often poorly tolerated. The observed trends
      suggest that BCA and LDF should be performed in a large cohort of patients, both
      in the steady state and during vasoocclusive crises. These methods seem to be
      useful complementary noninvasive procedures to cellular and clinical evaluation
      monitoring for therapeutic trials.

PMID- 8479340
TI  - A simplified method for culture of endothelial cells and analysis of adhesion of
      blood cells under conditions of flow.
AB  - We have developed a simplified technique for culturing human umbilical vein
      endothelial cells under shear flow conditions, using prefabricated glass
      microcapillary tubes ("microslides") with a well-defined rectangular cross
      section and good optical quality. These microslides have been incorporated into a
      controlled flow system for quantitative video-microscopic analysis of the
      adhesion of blood cells to endothelial cells. Microslides were pretreated with 3
      aminopropyltriethoxy-silane, or gelatin, and then loaded with a suspension of
      endothelial cells. After the cells had settled and attached to the substrate, the
      microslides were inserted into a flow-based culture system. Medium was drawn
      through them at intervals or continuously until confluency was reached
      (approximately 24 hr). Cells were cultured at wall shear stresses over a range
      0.06 to 2.2 Pa. For adhesion assays, the endothelialized microslides were
      attached to microscope slides, and suspensions of blood cells were drawn through
      at desired wall shear stresses (0.02-0.5 Pa). Adhesion of malarial-infected red
      blood cells and of neutrophilic granulocytes was quantitated by direct
      microscopic observation. The adhesive behavior of both cell types closely
      resembled that previously described by ourselves and others using flow chambers
      incorporating endothelial-coated glass coverslips. The use of microslides
      represents a significant simplification of methodology for endothelial cell
      growth and adhesion studies under flow conditions.

PMID- 8479341
TI  - Quantitative analysis of the Landis method.
AB  - Landis developed the single capillary micro-occlusion method for the
      determination of the capillary filtration coefficient, Lp. More recently, several
      modified versions of Landis's original procedure have been introduced in an
      attempt to measure Lp with greater ease and accuracy. Each of the techniques
      assumes that the capillary is a uniformly cylindrical indistensible tube. Since
      recently obtained experimental data have demonstrated that the capillary is
      compliant, a distributed mathematical model of the capillary was developed to
      reveal the extent to which capillary distensibility influences the measurement of
      Lp at different sites along the capillary. After assigning physiologic values to
      this modeled capillary, including Lp and the capillary wall's modulus of
      elasticity, Landis's method and two of its modified versions were performed on
      the modeled capillary, with each yielding values for Lp at 10 different locations
      along the capillary. Comparison of these 10 computed Lp values with the
      corresponding Lp values defined in the modeled capillary demonstrates that
      capillary distensibility can introduce significant error into the measurement of
      Lp.

PMID- 8479342
TI  - Reproducibility of the finger cooling test.
AB  - A finger cooling test is used to objectify Raynaud's phenomenon and to assess its
      severity. For this purpose, finger skin temperature (FST) and laser Doppler flux
      (LDF) are measured on the fingertips before and during cooling of the hand (16
      degrees water bath for 5 min) and a subsequent recovery period (20 min). To study
      reproducibility, this test was performed twice within 3 months in 34 healthy
      subjects and in 56 Raynaud patients. Three test parameters were used in the
      analysis: the baseline value, the value after 12 min of recovery, and the mean
      level during recovery. We determined the limits of agreement (mean differences
      between the first and the second test +/- 2SD) and the coefficients of variation.
      No systematic differences between the first and the second test were found.
      Outside temperature did not influence FST or LDF. FST was shown to have a better
      reproducibility than LDF. For the baseline value in the total group the
      coefficient of variation was 3.3% for FST and, rather high, 21.6% for LDF. The
      limits of agreement for the baseline value in the total group were -4.8 to 4.2
      degrees for FST and -25.2 to 22.2 arbitrary units for LDF. In conclusion, the
      applied cooling test has limited value in individual cases, but can be useful
      when comparing large groups in pathophysiologic or therapeutic studies.

PMID- 8479343
TI  - Influence of selenium on the microvasculature of the retina.
AB  - The impact of small differences in selenium exposure during the first year of
      life was investigated in male Wistar rats. Forty-five rats were evaluated in two
      experiments. Rats were provided diets that contained sucrose as the sole
      carbohydrate to induce an elevation in blood triglycerides, cholesterol, glucose,
      and insulin. In each experiment one-half the rats received 0.1 mg Se/kg and the
      other half 0.2 mg Se/kg diet. Both levels of selenium supported normal activity
      of the marker for selenium sufficiency erythrocyte glutathione peroxidase. In
      experiment 1 rats were maintained in galvanized cages and in experiment 2 they
      were housed in stainless steel cages. In both experiments rats provided 0.2 mg
      Se/kg diet had fewer acellular degenerating capillaries and a higher ratio of
      pericyte to endothelial cells in the capillary wall than those fed 0.1 mg/kg as
      well as fewer vessels over the optic disc head. In the second experiment, the
      height of the central choroid was also greater in rats exposed to the higher
      level of selenium suggesting that the element protected the capillaries in this
      region from degeneration. In contrast to vascular tissue, the retinal parenchymal
      tissue was unaffected by the level of selenium exposure. These results are
      consistent with the hypothesis that the microvasculature has a unique requirement
      for selenium.

PMID- 8479344
TI  - Enhanced arteriolar vasomotion in rats with chronic salt-induced hypertension.
AB  - The aims of this study were (1) to determine if the establishment of hypertension
      in the Dahl salt-sensitive (DS) rat is accompanied by alterations in arteriolar
      vasomotion and (2) to explore the influence of endogenous nitric oxide on
      vasomotion in normotensive and hypertensive DS rats. Rhythmic diameter changes of
      arcading arterioles were studied in the superfused spinotrapezius muscle of DS
      fed high (4%) or low (0.45%) salt diets for 6 weeks. Mean arterial pressure for
      DS on high salt (166 +/- 7 mm Hg) was significantly greater than that for DS on
      low salt (131 +/- 9 mm Hg). There was no difference between hypertensive and
      normotensive DS in time-averaged arteriolar diameter, vasomotion frequency, or
      vasomotion cycle length. However, average vasomotion amplitude was 93% greater in
      hypertensive DS than in normotensive DS. Inhibition of nitric oxide synthesis
      with NG-Nitro-L-arginine methyl ester did not alter vasomotion in hypertensive
      DS, but increased vasomotion amplitude in normotensive DS to a level not
      different from that in hypertensive DS. L-Arginine had no effect on vasomotion in
      either group. Therefore, cyclic variations in arcade arteriole diameter are
      normally limited by basal nitric oxide, and the enhancement of these variations
      in animals with salt-induced hypertension may be attributable to the loss of this
      nitric oxide influence. The increased vasomotion amplitude and unchanged average
      diameter in hypertensive DS suggests a reduced hydraulic resistance within this
      particular segment of the arteriolar network.

PMID- 8479345
TI  - A computer controlled system for multiple site microcirculatory measurements.
AB  - A system has been developed for intravital microscopy studies that records
      optical signals at different tissue sites together with X-Y coordinates within an
      area of up to 100 cm2. Z axis coordinates can also be recorded. The system
      utilizes a computer and a motor-driven microscope stage to rapidly and
      repetitively move between selected sites. The system can also be used to map
      topological features and geometry. The application of the system to study spatial
      heterogeneity of changes in tissue metabolism with time and to map vascular
      network architecture is described.

PMID- 8479346
TI  - Preventing childhood allergy.

PMID- 8479348
TI  - Who are the elderly?

PMID- 8479347
TI  - Arthritis: the hidden disability.

PMID- 8479349
TI  - Effectiveness of low-dose intradermal hepatitis B vaccination. Five years'
      experience of primary vaccination.
AB  - OBJECTIVE: To determine whether intradermal hepatitis B vaccination is an
      effective procedure. DESIGN: A study of antibody responses to hepatitis B vaccine
      in 753 medical students. SETTING: Routine vaccination of medical students with
      intradermal doses of hepatitis B vaccines of various origins. OUTCOME MEASURES:
      Rates of seroconversion and geometric mean levels of antibody achieved. RESULTS:
      Seroconversion rates, indicated by antibody to hepatitis B surface antigen (anti
      HBs) levels of 10 mIU/mL or more, varied between 82% and 94.7% with different
      preparations of the vaccine. With a four-dose intradermal schedule over two
      successive cohorts, Engerix-B (SmithKline Beecham) gave better responses, in this
      context, than H-B-Vax II (Merck Sharp & Dohme). Any reactions to the vaccination
      were mild and local. CONCLUSION: The intradermal route is a practical method of
      vaccination against hepatitis B in healthy young adults when the cost of the
      vaccine is an inhibiting factor.

PMID- 8479351
TI  - Rubella vaccination and congenital rubella syndrome in Western Australia.
AB  - OBJECTIVE: To review the incidence of congenital rubella syndrome (CRS) and the
      acceptance of schoolgirl rubella vaccination in Western Australia (WA), and to
      determine whether any groups in the community are at increased risk of having a
      child affected by CRS. DESIGN: Review of records of the WA Birth Defects Registry
      for cases of CRS; survey of obstetricians for terminations of pregnancy for
      maternal rubella infection; survey of schoolgirls eligible for the 1991 annual
      rubella vaccination campaign; review of Perth Immunisation Clinic and rural
      community and child health records; review of the rubella immune status of women
      tested antenatally. MAIN OUTCOME MEASURES: The incidence rate of CRS per 10,000
      live births in WA 1980-1990; the incidence of rubella-associated terminations of
      pregnancy during 1990 and 1991; trends in rubella vaccine acceptance among WA
      schoolgirls between 1971 and 1991; and the proportion of women attending
      antenatal clinics who showed satisfactory immunity against rubella, stratified by
      country of birth. RESULTS: The incidence rate of CRS in WA remains below 2 cases
      per 10,000 live births. Approximately 86% of Perth schoolgirls have been
      vaccinated against rubella. Rubella vaccine acceptance fell in some country areas
      during the late 1980s, but is now returning to acceptable levels. Women born in
      Asia are at greater risk of having a baby affected by CRS than women born in
      Australia. Babies with CRS may be born to women who have previously been
      vaccinated against rubella. CONCLUSIONS: The incidence of CRS has fallen
      dramatically since the introduction of the schoolgirl vaccination program, but
      there is still a need for mechanisms to identify and vaccinate non-immune women.

PMID- 8479350
TI  - Booster doses of hepatitis B vaccine: responses to low-dose inoculations.
AB  - OBJECTIVE: To examine the anamnestic response to hepatitis B vaccine in
      previously vaccinated subjects. DESIGN: Subjects who had received a course of
      hepatitis B vaccine at least two years previously had a sample of blood taken
      before and seven days after a low-dose booster of hepatitis B vaccine. SETTING
      AND PARTICIPANTS: A pilot group of laboratory scientists in the Microbiological
      Diagnostic Unit; fifth year medical students, University of Melbourne; and a
      group of ambulance officers from the Geelong Ambulance Depot (Victoria). All
      participants volunteered after having been informed of the study. OUTCOME
      MEASURES: Serum levels of antibody to hepatitis B surface antigen (HBsAg) were
      measured before and after the booster dose of vaccine and, when available, in
      serum taken a month after the end of the primary course of vaccine, and the
      changes in antibody level were studied. RESULTS: Although some individuals with a
      restricted antibody response were identified, most showed a quick response. There
      was limited evidence that this rise peaked early and began to fall within weeks.
      CONCLUSIONS: In many subjects, levels of antibody to HBsAg peak early after
      booster doses of vaccine but the rapid anamnestic response to small amounts of
      antigen make it probable that effective protection from symptomatic illness may
      be long lasting, when there has been a satisfactory primary response. This
      provides an argument for testing for adequate seroconversion after vaccination.

PMID- 8479352
TI  - The disabled elderly living in the community: care received from family and
      formal services.
AB  - OBJECTIVES: Based on a community sample, to assess the reasons disabled elderly
      people need care, the type of formal services they receive, the characteristics
      of their carers and the degree of psychological morbidity in these carers. DESIGN
      AND SETTING: A community survey of people aged 70 or more years living in
      Canberra or Queanbeyan. Survey participants were asked to nominate informants,
      who were interviewed about the subjects' state of health. The informants provided
      information on need for care, services received and the role of carers.
      Informants also reported on their own health, including symptoms of anxiety and
      depression. RESULTS: Elderly people needed care because of physical disability
      more often than behavioural disability. Those with physical disability received
      more formal services and more help from health professionals than those with
      behavioural disability. Contact with general practitioners was high for both
      disabled and non-disabled subjects. Carers of the physically disabled had raised
      levels of anxiety and symptoms of depression, and poorer self-rated health, but
      carers of the behaviourally disabled did not. Wives, daughters and husbands made
      up the biggest categories of carers and around two-thirds of carers were women.
      CONCLUSION: Family carers play an important role in maintaining disabled elderly
      people in the community and this role is often stressful. Formal services have to
      be aimed as much at the needs of the carers as at the disabled people themselves.

PMID- 8479353
TI  - Relevance of pharmacokinetics and pharmacodynamics.
AB  - Appropriate and rational use of drugs in the elderly is a matter of growing
      medical and social concern. The elderly as a group are particularly prone to
      adverse drug reactions. Such reactions have often been due to inappropriate drug
      prescribing, based on incomplete recognition and knowledge of changes in drug
      handling with age and pathological states associated with ageing. Recognition of
      such changes with modification of prescribing practice may lead to benefits by
      minimising the incidence of adverse drug reactions. This article discusses the
      current knowledge of age-related changes in drug absorption, distribution,
      clearance and sensitivity and some implications of these changes for clinical
      therapeutics in the elderly.

PMID- 8479354
TI  - Domestic violence and the general practitioner.
AB  - Domestic violence is a common social problem that raises many difficult questions
      and management issues for both the patient and the doctor. Domestic violence is
      an abuse of power within the relationship. Physical assault is common and
      serious, but psychological abuse is more damaging. Perpetrators of domestic
      violence do not usually perceive that they have a problem and no change in their
      behaviour is possible unless they want to change. For general practitioners the
      first step in dealing with domestic violence is detection, and that means
      acknowledging that it can exist in any patient. General practitioners have three
      choices in their management of victims of domestic violence: they can do nothing,
      they can be sympathetic only or they can be an agent of change. Effective
      management of domestic violence involves raising the victim's self-esteem so that
      she is able to alter her situation herself.

PMID- 8479355
TI  - Central nervous system tuberculosis in Australia: a report of 22 cases.
AB  - OBJECTIVE: To review the clinical features, treatment and outcome of patients
      with central nervous system (CNS) tuberculosis. DESIGN AND SETTING: A
      retrospective analysis of the case records of patients diagnosed as having CNS
      tuberculosis in a large Australian teaching hospital. PATIENTS: Twenty-two
      patients with CNS tuberculosis were identified between 1978 and 1989. Six
      patients (age range, 17-78 years) were Australian-born whites, seven patients
      (age range, 21-68 years) were overseas settlers in Australia and nine patients
      (age range, 14-56 years) were New Caledonians. The diagnoses included tuberculous
      meningitis, intracranial tuberculomas and intracranial tuberculous abscesses.
      These were confirmed by microbiology and/or histopathology in 16 patients and
      were presumptive in the remaining six. RESULTS: All patients were treated with
      antituberculous drugs and 14 received corticosteroids as well. Fourteen patients
      made a full recovery and two had mild residual neurological disability. Four
      patients died and two were left with severe residual disability. The neurological
      state of seven patients (all non-whites) deteriorated paradoxically after they
      started taking the antituberculous drugs. CONCLUSIONS: The diagnosis of CNS
      tuberculosis may be difficult to make, so therapy based on a presumptive
      diagnosis will often be needed because of the poor outcome if treatment is
      delayed. Computed tomographic scanning helps the initial diagnosis and
      demonstrates the processes underlying paradoxical deterioration, which may occur
      in the face of adequate antituberculous treatment. Corticosteroids are effective
      in treating this uncommon complication.

PMID- 8479357
TI  - Planning bedside teaching--3. Briefing before seeing the patient.

PMID- 8479356
TI  - Psychotropics, thiazide diuretics and hip fractures in the elderly.
AB  - OBJECTIVE: To determine whether psychotropic medications increase, and thiazide
      diuretics decrease, the risk of hip fractures in elderly Australians. DESIGN:
      Population-based case-control study. SUBJECTS AND SETTING: The population aged 65
      years and over living in a defined area in western Sydney, Australia, during 1990
      1991. Cases (n = 209) were recruited from hospitals and controls (n = 207) were
      selected by an area probability sampling method, with additional sampling from
      nursing homes. Response rates were 96% for cases and 84% for controls. MEASURES:
      Data were collected directly from subjects by questionnaire; a proxy respondent
      was required for 27% of subjects. In addition to medication use, information was
      also collected on potential confounders: alcohol consumption, body mass index,
      cognitive status, dairy product consumption, health status, physical activity,
      smoking history and type of residence. RESULTS: The use of temazepam, a short
      acting benzodiazepine, was associated with an increase in the risk of hip
      fracture--odds ratio, adjusted for age, gender and residence is 3.78; 95%
      confidence interval (CI), 1.60-8.92. After adjusting for multiple potential
      confounders by logistic regression, the odds ratio for temazepam use was 3.52.
      There was a non-significant (P > 0.05) increase in hip fracture risk associated
      with the use of antidepressants and antipsychotics. Thiazide diuretics were not
      associated with a risk of hip fracture--the multivariate-adjusted odds ratio was
      0.98 (95% CI, 0.49-1.99). CONCLUSIONS: Temazepam may increase the risk of hip
      fracture in elderly people. The effect of thiazide diuretics on fracture risk
      should be assessed in a large randomised trial.

PMID- 8479359
TI  - The clinician and therapeutic drug monitoring in the 1990s.

PMID- 8479358
TI  - Screening for carriers of genetic disease: points to consider.

PMID- 8479360
TI  - Quality of life in cancer care.

PMID- 8479361
TI  - Head injuries from road accidents--a diminishing problem?

PMID- 8479362
TI  - Algal toxins and bellyaches beyond the Barcoo.

PMID- 8479363
TI  - Rubella vaccination.

PMID- 8479364
TI  - The effectiveness of rubella vaccine.

PMID- 8479365
TI  - Electrocution.

PMID- 8479366
TI  - Scombroid poisoning.

PMID- 8479367
TI  - Atrial fibrillation.

PMID- 8479368
TI  - Hormone replacement therapy and breast cancer.

PMID- 8479369
TI  - Hysterectomy.

PMID- 8479370
TI  - The cost of cost-of-illness studies.

PMID- 8479371
TI  - Ovarian carcinoma: a continuing challenge.

PMID- 8479372
TI  - Problems assessing aboriginal infant mortality.

PMID- 8479373
TI  - The potential for elderly donors to increase renal transplantation rates in
      Australia.
AB  - OBJECTIVE: To estimate the potential increase in renal donation rates if elderly
      donors (those over 60 years of age) were considered. DESIGN: Patients dying from
      acute brain damage resulting from stroke were identified using the Royal
      Melbourne Hospital (RMH) Stroke Service Register. Their records were
      retrospectively analysed to assess their eligibility as potential renal donors.
      SETTING: One hundred and ninety-eight patients dying from acute brain damage
      caused by stroke at a large metropolitan teaching hospital (RMH), from May 1987
      to December 1990 inclusive. PATIENT ASSESSMENT: Patients were considered
      "eligible", "ineligible" or "possibly eligible" (requiring further assessment) as
      donors according to existing strict criteria (see methods) but irrespective of
      age. RESULTS: Of 198 stroke patients dying of brain damage, 92 satisfied the
      criteria of eligibility for renal donation; 51 of these were over 60 years old,
      yet only one became a renal donor. CONCLUSION: There is good evidence that
      elderly donors are acceptable for renal transplantation, yet they are not being
      referred. The consideration of elderly stroke victims as renal donors could have
      a dramatic effect on decreasing transplant waiting lists, increasing recipient
      patient well-being, and reducing hospital costs.

PMID- 8479374
TI  - Cholestatic hepatitis associated with flucloxacillin.
AB  - OBJECTIVE: To estimate the frequency of cholestatic hepatitis of uncertain origin
      occurring among persons who had recently received flucloxacillin, a drug which
      has recently been reported as causing cholestatic hepatitis, and to compare this
      frequency with that related to oxytetracycline, a drug which has seldom been
      reported as causing this disorder. DESIGN: A retrospective cohort study using
      data automatically recorded on general practitioners' office computers. SETTING:
      Some 600 general practices in the United Kingdom. SUBJECTS: 132,087 people who
      received flucloxacillin and 145,844 people who received oxytetracycline. MAIN
      OUTCOME MEASURE: Clinically documented cholestatic hepatitis of uncertain origin
      diagnosed 1-45 days after a prescription for flucloxacillin, 46-90 days after a
      prescription for flucloxacillin and, for comparison, 1-45 days after a
      prescription for oxytetracycline. RESULTS: There were 10 cases of cholestatic
      hepatitis of uncertain origin diagnosed within 45 days of receiving
      flucloxacillin that were either characteristic of or consistent with a syndrome
      recently described as being associated with this drug; there was one such case 46
      90 days after a prescription for flucloxacillin; there were three such cases 1-45
      days after a prescription for oxytetracycline. CONCLUSION: Flucloxacillin is a
      likely cause of cholestatic hepatitis. The risk is estimated to be in the range
      of 7.6 per 100,000 users (95% confidence interval, 3.6-13.9).

PMID- 8479375
TI  - Erythromycin-associated cholestatic hepatitis.
AB  - OBJECTIVE: To estimate the risk of cholestatic hepatitis of uncertain origin in
      patients who had recently received erythromycin, a drug which is known to cause
      this disorder. DESIGN: A retrospective cohort study using data automatically
      recorded on general practitioners' office computers. SETTING: Some 600 general
      practices in the United Kingdom. SUBJECTS: 366,064 people who received
      erythromycin. MAIN OUTCOME MEASURE: Clinically documented cholestatic hepatitis
      of uncertain origin diagnosed 1-45 days after a prescription for erythromycin.
      RESULTS: There were 13 cases of cholestatic hepatitis of uncertain origin
      diagnosed within 45 days of receiving erythromycin which were either
      characteristic of or consistent with a syndrome previously described as being
      associated with this drug. CONCLUSION: The risk of cholestatic jaundice
      associated with erythromycin is estimated to be in the range of 3.6 per 100,000
      users (95% confidence interval, 1.9-6.1).

PMID- 8479376
TI  - Serological evidence of the three chlamydial species in an aboriginal community
      in the Northern Territory.
AB  - OBJECTIVE: To determine the pattern of seropositivity to the three species of
      Chlamydia in women and children from a single community. DESIGN: Testing of blood
      samples obtained during a prospective study of mothers and infants. For each
      individual, the sample giving the highest titre of antichlamydial antibody was
      included in the analysis. SETTING: The only health centre for a small rural
      community in the Top End of the Northern Territory. This served all 1200 or so
      residents, almost 95% of whom were Aboriginal. PARTICIPANTS: Sixty-one pregnant
      Aboriginal women at routine antenatal clinic visits, and 114 of their children
      aged between one and six years at the time of sampling. MAIN OUTCOME MEASURE:
      Specific IgG or IgM antibody to any of the three species of Chlamydia at titres >
      or = 32, as determined by micro-immunofluorescence. RESULTS: IgG antibody to one
      or more chlamydial species was found in 83.6% of mothers and 42.1% of their
      children. IgM antibody was found in five mothers and four children, in each case
      against only one chlamydial species. IgG antibody to C. trachomatis was found in
      55.7% of mothers and 28.9% of children, to C. pneumoniae in 59.0% of mothers and
      19.3% of children, and to C. psittaci in 29.5% of mothers and 17.5% of children.
      Log linear modelling gave positive correlations between seropositivity for C.
      trachomatis and C. pneumoniae (chi 2 = 9, P < 0.01), and for C. trachomatis and
      C. psittaci (chi 2 = 15, P < 0.001). Cross-reactivity was more evident in
      children than in mothers. CONCLUSIONS: This is the first Australian report
      providing serological evidence of exposure to the three chlamydial species in one
      community. The seropositivity patterns suggest complex interactions when all
      species are present.

PMID- 8479377
TI  - Admission rates for hip fracture in Australia in the last decade. The New South
      Wales scene in a world perspective.
AB  - OBJECTIVES: To study the changes in admission rates for hip fracture in New South
      Wales in the last decade; and to compare the age-adjusted rates with those from
      Europe, America and Asia. METHODS: Hospital discharge data for the years 1981,
      1986 and 1989-1990 for New South Wales were used. The number of patients
      discharged with hip fracture (International Classification of Diseases code 820)
      as one of the diagnoses was calculated. Age-specific rates were calculated using
      the census population for 1981, 1986 and 1991. These rates were then directly
      standardised to the 1985 United States population and then presented with
      similarly adjusted rates from countries in Europe, America and Asia. RESULTS: For
      New South Wales men, the incidence rates of hip fracture (directly standardised
      to the 1985 United States population) for 1981, 1986 and 1989-1990 were 148 per
      100,000, 181 per 100,000 and 182 per 100,000 respectively. In women, the rates
      for these three years were 437 per 100,000, 537 per 100,000 and 500 per 100,000
      respectively. The age-adjusted rates for both men and women were high and were
      comparable to the rates in the United States and New Zealand. CONCLUSIONS: The
      incidence of hip fracture in NSW in the last decade was very high by world
      standards. The prevention of hip fracture is essential as the Australian
      population ages.

PMID- 8479378
TI  - Planning bedside teaching--6. Reflection on the clinical experience.

PMID- 8479379
TI  - Medicine in tropical Australia.
AB  - In the unique environment of Australia's tropical north there are endemic
      diseases inherited from Gondwana, others introduced from the north and from
      Europe, and a wide range of particularly venomous animals. There is continuing
      disparity in morbidity and mortality between Aboriginal people and other
      Australians in tropical areas and elsewhere. This is being addressed by the
      National Aboriginal Health Strategy, which emphasises social, environmental and
      economic issues, as well as control and coordination of services by Aboriginal
      and Torres Strait Islander communities. While the re-introduction of malaria
      remains a potential threat, together with other infections, current diseases in
      tropical Australia are being better elucidated; melioidosis is now recognised as
      the commonest cause of fatal [corrected] community-acquired pneumonia in the Top
      End of the Northern Territory, and a new focus of scrub typhus has been found.
      Sexually transmitted diseases are an urgent issue, especially for Aboriginal
      communities, given the potential impact of the human immunodeficiency virus.

PMID- 8479380
TI  - Molecular biology in ocular disorders.

PMID- 8479381
TI  - Qualitative research in medical practice.

PMID- 8479382
TI  - Focus groups: a useful research method in general practice.

PMID- 8479383
TI  - Protracted form of encephalitis with good outcome.
AB  - OBJECTIVE: To present four patients seen over a five-year period who developed
      severe protracted encephalitic illnesses but whose outcomes were favourable.
      CLINICAL FEATURES: Of the four patients, aged 18, 22, 34 and 19, three presented
      with acute psychosis, and all had a prolonged clinical course requiring intensive
      care management. One patient had residual generalised seizures and the other
      three recovered fully. No infective or toxic agent could be identified but viral
      encephalitis was considered most likely. OUTCOME: Despite the protracted courses,
      the outcomes were favourable. This is in contrast to the generally poor outcomes
      in encephalitis caused by established infective agents such as herpes simplex
      type 1. CONCLUSIONS: When the aetiology and hence the natural history of the
      encephalitis is unknown, long-term intensive support is appropriate.

PMID- 8479384
TI  - Endocarditis caused by Brucella melitensis.
AB  - OBJECTIVE: To describe the management of an uncommon but serious infection in
      Australia. CLINICAL FEATURES: A 25-year-old woman developed endocarditis after
      residence in Turkey and consumption of goat dairy products. Brucella melitensis
      was isolated from blood cultures. INTERVENTION AND OUTCOME: The valve remained
      infected after prolonged intravenous administration of trimethoprim
      sulfamethoxazole, gentamicin and rifampicin. Uncontrolled sepsis and worsening
      haemodynamic function necessitated valve replacement. To date the patient remains
      well while taking trimethoprim-sulfamethoxazole and rifampicin. CONCLUSION:
      Endocarditis due to Brucella spp. is uncommon in Australia. This infection is
      difficult to cure with antimicrobial therapy alone and early surgical
      intervention is advisable.

PMID- 8479385
TI  - Pulmonary arteriovenous malformation. Progressive enlargement with replacement of
      the entire right middle lobe in a patient with concomitant mitral stenosis.
AB  - OBJECTIVE: To present a case of pulmonary arteriovenous malformation (AVM) that
      showed progressive enlargement in a patient with concomitant rheumatic mitral
      stenosis. CLINICAL FEATURES: A 73-year-old woman first presented eight years ago
      because of an uncomplicated acute myocardial infarction. She was noted to have
      rheumatic mitral stenosis. Six years later, she developed symptomatic sick sinus
      syndrome for which a permanent pacemaker was implanted. Chest x-ray revealed new
      development of an opacity in the middle zone of the right lung. Two years later,
      she was admitted to hospital because of progressive dyspnoea. Chest x-ray showed
      further increase in size of the right middle zone opacity. OUTCOME: She died of
      cardiopulmonary failure on the 18th day in hospital. Autopsy revealed a pulmonary
      AVM, replacing the entire right middle lobe. CONCLUSION: The elevated pulmonary
      vascular resistance caused by mitral stenosis may have increased the preferential
      flow of blood through the AVM, leading to its rapid enlargement. Patients with
      concomitant pulmonary AVM and mitral stenosis need to be recognised, as close
      follow-up and early treatment may be desirable.

PMID- 8479386
TI  - Vaccination against influenza infection. Thoracic Society of Australia and New
      Zealand.

PMID- 8479387
TI  - Human fetal tissue for medical research.

PMID- 8479388
TI  - Recurrent episodes of confusion, headache and visual disturbance in a young
      woman.

PMID- 8479389
TI  - Kids play the safe way.

PMID- 8479390
TI  - Pregnancy from subzonally microinjected epididymal spermatozoa.

PMID- 8479391
TI  - Compensable psychiatric illness.

PMID- 8479392
TI  - Fatal Stevens-Johnson syndrome associated with a new non-steroidal anti
      inflammatory agent, tiaprofenic acid.

PMID- 8479393
TI  - Disarming the box-jellyfish.

PMID- 8479394
TI  - Awareness of the National Asthma Campaign.

PMID- 8479395
TI  - Child homicide--the extreme of child abuse.

PMID- 8479396
TI  - Child homicide--the extreme of child abuse.

PMID- 8479397
TI  - New directions for acute stoke therapy.

PMID- 8479399
TI  - Gap between approved indications and use of older drugs.

PMID- 8479398
TI  - Decisions in clinical management.

PMID- 8479400
TI  - Vigabatrin in the Sturge Weber syndrome.

PMID- 8479401
TI  - The history of studying the interactions of medical, surgical, and psychiatric
      conditions and their treatments.

PMID- 8479402
TI  - Organic and psychological sequelae of traumatic brain injury: the
      postconcussional syndrome in clinical practice.

PMID- 8479403
TI  - Psychiatric disorders complicating treatment of patients with pulmonary disease.
AB  - Treatment of pulmonary disease can be significantly complicated by the presence
      of psychiatric disorders. It is therefore essential to evaluate and understand
      the interaction of the pulmonary and psychiatric disorders in order to optimize
      patient care and management.

PMID- 8479404
TI  - Presentations and management of depression in medical-surgical patients.
AB  - Depression in medical-surgical patients has great impact on their well-being and
      medical condition. Although depression is like cancer, it is like a treatable
      cancer. If it is recognized and treated, the positive results can be dramatic and
      rewarding.

PMID- 8479405
TI  - Recognition and management of delirium in medical-surgical patients.

PMID- 8479406
TI  - Emotional aspects of sleep disorders: the case of obstructive sleep apnea
      syndrome.

PMID- 8479407
TI  - Biopsychosocial aspects of AIDS.

PMID- 8479408
TI  - Management of the psychiatric aspects of chronic noncancer pain.

PMID- 8479409
TI  - Depression syndromes in patients with Alzheimer's disease, Parkinson disease, and
      cerebral vascular accidents.

PMID- 8479410
TI  - Evaluation and care of the dementia patient.
AB  - Dementia is the result of a variety of factors that produce cognitive decline.
      While no cure exists for the majority of cases, treatment is available, and
      optimism for the future is reasonable.

PMID- 8479411
TI  - Specific psychotherapy approaches to medical-surgical patients.

PMID- 8479412
TI  - Management of psychiatric disorders in epileptic patients.

PMID- 8479413
TI  - Rates of cesarean delivery--United States, 1991.
AB  - Cesarean deliveries have accounted for nearly 1 million of the approximately 4
      million annual deliveries in the United States since 1986 (Table 1). The cesarean
      rate in the United States is the third highest among 21 reporting countries,
      exceeded only by Brazil and Puerto Rico (1). This report presents data on
      cesarean deliveries from CDC's National Hospital Discharge Survey (NHDS) for 1991
      and compares these data with previous years.

PMID- 8479414
TI  - Malaria among U.S. Embassy personnel--Kampala, Uganda, 1992.
AB  - The treatment and prevention of malaria in Africa has become a challenging and
      complex problem because of increasing drug resistance. Although the risk of
      acquiring malaria for U.S. citizens and their dependents stationed overseas
      generally has been low, this risk varies substantially and unpredictably. During
      May 1992, the Office of Medical Services, Department of State (OMS/DOS), and CDC
      were notified of an increased number of malaria cases among official U.S.
      personnel stationed in Kampala, Uganda. A review of the health records from the
      Embassy Health Unit (EHU) in Kampala indicated that 27 cases of malaria were
      diagnosed in official personnel from March through June 1992 compared with two
      cases during the same period in 1991. EHU, OMS/DOS, and CDC conducted an
      investigation to confirm all reported malaria cases and identify potential risk
      factors for malaria among U.S. Embassy personnel. This report summarizes the
      results of the investigation.

PMID- 8479415
TI  - FDA approval of use of a new Haemophilus b conjugate vaccine and a combined
      diphtheria-tetanus-pertussis and Haemophilus b conjugate vaccine for infants and
      children.

PMID- 8479416
TI  - Fatalities attributed to entering manure waste pits--Minnesota, 1992.
AB  - In August 1992, four farm workers in Minnesota died in two separate incidents
      after entering manure waste pits: two were poisoned by hydrogen sulfide gas, and
      two were asphyxiated. The Minnesota Fatality Assessment and Control Evaluation
      (FACE) program was notified of the incidents by the state Occupational Safety and
      Health Administration and the Minnesota Farming Health Project, respectively.
      This report summarizes the investigations of these two incidents by the Minnesota
      FACE program and CDC's National Institute for Occupational Safety and Health
      (NIOSH) FACE personnel.

PMID- 8479417
TI  - Update: investigations of persons treated by HIV-infected health-care workers-
      United States.
AB  - Previous reports have described transmission of human immunodeficiency virus
      (HIV) to five persons (patients A, B, C, E, and G) during receipt of care from an
      HIV-infected dentist in Florida and other investigations of patients who were
      treated by HIV-infected health-care workers (HCWs). This report updates these
      investigations and presents evidence that a sixth patient (patient I) became
      infected with HIV while receiving care at the Florida dental practice, the only
      practice in which HIV transmission from an infected HCW to patients has been
      documented.

PMID- 8479418
TI  - Fetal alcohol syndrome--United States, 1979-1992.
AB  - Fetal alcohol syndrome (FAS) is characterized by a variety of physical and
      behavioral traits that result from maternal alcohol consumption during pregnancy.
      Features of FAS include prenatal or postnatal growth deficiency, abnormal facial
      features, and central nervous system deficits. CDC's Birth Defects Monitoring
      Program (BDMP)--a national program to monitor congenital malformations--has
      collected data on the incidence of FAS among newborn infants since 1979. This
      report presents a rate for FAS in the United States using BDMP data from 1979
      through 1992.

PMID- 8479419
TI  - A specific host factor binds at a cis-acting transcriptionally silent locus
      required for stability control of yeast plasmid pSR1.
AB  - A cis-acting locus, Z, of plasmid pSR1 functions in stable maintenance of the
      plasmid in the native host, Zygosaccharomyces rouxii. The Z locus was shown to be
      located in a 482 bp sequence in the 5' upstream region of an open reading frame,
      P, by subcloning various DNA fragments in a plasmid replicating via the ARS1
      sequence of the Saccharomyces cerevisiae chromosome. Northern analysis revealed
      that the Z region is not transcribed in either the native host Z. rouxii or the
      heterologous host S. cerevisiae. The Z region is protected from micrococcal
      nuclease attack in Z. rouxii but not in S. cerevisiae, its protection depending
      on the product of the S gene encoded by pSR1. Gel retardation assays suggested
      that a factor present in nuclear extracts of Z. rouxii cells, irrespective of the
      presence or absence of a resident pSR1 plasmid, binds to a 111 bp RsaI-SacII
      sequence in the Z region. These findings suggest that a host protein binds to the
      Z locus and that the S product interacts with this DNA-protein complex and
      stabilizes pSR1.

PMID- 8479420
TI  - Signal transduction and sporulation in Bacillus subtilis: autophosphorylation of
      Spo0A, a sporulation initiation gene product.
AB  - Spo0A is a positive/negative transcriptional regulator that plays a very
      important role in sporulation initiation in Bacillus subtilis. The N-terminal
      amino acid sequence of Spo0A is homologous to that of regulator proteins of the
      two-component regulatory systems involved in signal transduction in bacteria.
      Phosphorylation of SpooA through a phosphorelay has been reported recently. In
      this study, we found that Spo0A is autophosphorylated in the presence of ATP and
      that an autophosphorylation-deficient Spo0A mutant is completely defective in
      initiating sporulation. These results suggest that Spo0A autophosphorylation is
      an essential event in the signal transduction process that controls sporulation
      in B. subtilis.

PMID- 8479421
TI  - Analysis of the Rhizobium meliloti exoH/exoK/exoL fragment: ExoK shows homology
      to excreted endo-beta-1,3-1,4-glucanases and ExoH resembles membrane proteins.
AB  - Nucleotide sequencing of a 4.15 kb DNA fragment from megaplasmid 2 of Rhizobium
      meliloti 2011 revealed the location of the genes exoH, exoK and exoL. The
      putative proteins encoded by these genes have molecular weights of 41, 30, and 44
      kDa, respectively. The hydrophobicity profile of the ExoH amino acid sequence
      resembles that of transmembrane proteins. The predicted exoL gene product does
      not contain hydrophobic regions, indicating a cytoplasmic localization. The exoK
      gene product is characterized by a putative signal peptide and exhibits
      significant homology to endo-beta-1,3-1,4-glucanases of bacilli and Clostridium
      thermocellum. R. meliloti exoK mutants induced pink nodules and synthesized a
      reduced amount of exopolysaccharide (EPS). Colonies of this mutant showed a delay
      in the appearance of the Calcofluor white fluorescence. In addition, the
      formation of the characteristic halo was strongly delayed. R. meliloti exoL and
      exoH mutants induced pseudonodules. The exoH, but not the exoL mutant,
      synthesized an EPS that could be precipitated by cetyl pyridinium chloride (CPC)
      and also by ethanol. Plasmid integration mutagenesis revealed promoter regions
      preceding exoH, exoK and exoL.

PMID- 8479422
TI  - Differential expression of the psbA genes in the cyanobacterium Synechocystis
      6803.
AB  - The 5' region and transcription initiation sites of the psbA-2 and psbA-3 genes
      of Synechocystis 6803 were determined. The otherwise highly homologous genes were
      shown to diverge significantly in the 5' noncoding regions. The transcription
      start site for the psbA-2 gene was mapped to position -49 upstream of the coding
      region and for the psbA-3 gene to position -88, i.e. 38 bp upstream of the psbA-2
      transcription start point. Both genes exhibit promoter elements, which conform in
      sequence and position to Escherichia coli consensus motifs. The two genes share
      identical -35 sequences but differ in their -10 sequences. Primer extension
      analysis demonstrated that the psbA-2 and psbA-3 genes are differentially
      expressed, with > 90% of the total psbA transcripts being produced by the psbA-2
      gene and the rest by the psbA-3 gene. Inactivation of the psbA-2 gene resulted in
      an eightfold up-regulation of the psbA-3 gene. The strikingly higher stability of
      the psbA transcripts in darkness compared to light, and the accumulation of a
      specific decay intermediate under dark conditions was reported previously. We
      show here that this dark-stability applies to both the psbA-2 and psbA-3
      transcripts. The psbA-3 transcript did not appear to produce the processed
      intermediate, arguing for the involvement of the 5' non-coding region as a
      determinant in psbA transcript degradation.

PMID- 8479423
TI  - Isolation of temperature-sensitive aminoacyl-tRNA synthetase mutants from an
      Escherichia coli strain harboring the pemK plasmid.
AB  - The pem locus, which is responsible for the stable maintenance of the low copy
      number plasmid R100, contains the pemK gene, whose product has been shown to be a
      growth inhibitor. Here, we attempted to isolate mutants which became tolerant to
      transient induction of the PemK protein. We obtained 20 mutants (here called pkt
      for PemK tolerance), of which 9 were temperature sensitive for growth. We
      analyzed the nine mutants genetically and found that they could be classified
      into three complementation groups, pktA, pktB and pktC, which corresponded to
      three genes, ileS, gltX and asnS, encoding isoleucyl-, glutamyl- and asparaginyl
      tRNA synthetases, respectively. Since these amino-acyl-tRNA synthetase mutants
      did not produce the PemK protein upon induction at the restrictive temperature,
      these mutants could be isolated because they behaved as if they were tolerant to
      the PemK protein. The procedure is therefore useful for isolating temperature
      sensitive mutants of aminoacyl-tRNA synthetases.

PMID- 8479424
TI  - The plant hormone abscisic acid mediates the drought-induced expression but not
      the seed-specific expression of rd22, a gene responsive to dehydration stress in
      Arabidopsis thaliana.
AB  - Nine cDNA clones, corresponding to genes that are responsive to dehydration
      (named RD), have been isolated from Arabidopsis thaliana. The sequence of a
      putative protein encoded by one of the RD cDNA clones, RD22, exhibits
      considerable homology to an unidentified seed protein (USP) of Vicia faba.
      Northern analysis showed that RD22 mRNA is induced by salt stress as well as by
      water deficit but not by cold or heat stress. RD22 mRNA appeared after the
      application of abscisic acid (ABA), an indication that transcription of RD22 mRNA
      is induced by endogenous ABA, the production of which is triggered by drought and
      salt stress. The induction of RD22 mRNA by ABA was inhibited by cycloheximide.
      Thus, it appears that protein synthesis is required for the induction of this
      mRNA by ABA. By contrast, protein synthesis was not required for the ABA
      responsive induction RD29 mRNA, which corresponds to another dehydration
      responsive gene of A. thaliana. These results suggest that there are at least two
      mechanisms for the induction of dehydration-responsive genes by ABA. RD22 mRNA
      was also expressed during the early and middle stages of seed development,
      showing a pattern of expression similar to that of USP. The seed-specific
      expression of RD22 seems not to be regulated by ABA. Structural analysis of the
      RD22 genomic clone revealed that the structural gene (designated rd22) contains
      three introns, and only a single copy of the gene is present in the A. thaliana
      genome, while the gene for USP from V. faba is actually a family of genes with 10
      to 20 members.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479425
TI  - Two classes of isocitrate lyase genes are expressed during late embryogeny and
      postgermination in Brassica napus L.
AB  - We have analyzed the structure of genes encoding the glyoxylate cycle enzyme
      isocitrate lyase from Brassica napus L. and their expression during embryogeny
      and postgermination. Restriction mapping, nucleotide sequence, and DNA gel blot
      hybridization analyses of cDNA and genomic clones indicated that there are
      approximately six isocitrate lyase genes in the B. napus genome that can be
      divided into at least two subfamilies based upon their divergence in 5' and 3'
      untranslated regions. We showed previously that isocitrate lyase mRNA accumulates
      during late embryogeny and postgermination. Here, we present results which
      indicate that several isocitrate lyase genes are expressed at both stages of
      development. First, gene-specific probes were used to show that mRNAs encoded by
      representatives of both gene subfamilies accumulated in both late maturation
      stage embryos and in seedlings of B. napus. Second, a single B. napus isocitrate
      lyase gene, together with 3.5 kb and 1.4 kb of 5' and 3' flanking regions,
      respectively, was expressed in both embryos and seedlings of transgenic tobacco
      plants. The results indicated that accumulation of isocitrate lyase in late
      embryogeny and postgermination does not result from the alternate expression of
      distinct members of the gene family.

PMID- 8479426
TI  - At least four regulatory genes control sulphur metabolite repression in
      Aspergillus nidulans.
AB  - Mutations in four genes: sconA (formerly suA25meth, mapA25), sconB (formerly
      mapB1), sconC and sconD, the last two identified in this work, relieve a group of
      sulphur amino acid biosynthetic enzymes from methionine-mediated sulphur
      metabolite repression. Exogenous methionine has no effect on sulphate
      assimilation in the mutant strains, whereas in the wild type it causes almost
      complete elimination of sulphate incorporation. In both mutant and wild-type
      strains methionine is efficiently taken up and metabolized to S
      adenosylmethionine, homocysteine and other compounds, scon mutants also show
      elevated levels of folate-metabolizing enzymes which results from the large pool
      of homocysteine found in these strains. The folate enzymes appear to be inducible
      by homocysteine and repressible by methionine (or S-adenosylmethionine).

PMID- 8479427
TI  - Nonsense suppression in thymine-requiring strains of Escherichia coli is a
      consequence of altered folate metabolism.
AB  - Thymine-requiring strains of Escherichia coli suppress nonsense and frameshift
      mutants of T4 phage. We proposed that these mutants make errors during
      translation because of an imbalance in folate metabolism. A thymine-requiring
      strain grown under suppressing conditions has elevated levels of reduced folates.
      We tested the effect of either mutational blocks or the inhibition of various
      steps in folate biosynthesis on suppression. Conditions which prevent the
      accumulation of 5-methyl tetrahydrofolate inhibit suppression, suggesting that
      elevated levels of this folate are required for suppression. Furthermore,
      conditions that result in an accumulation in dihydrofolate inhibit suppression.

PMID- 8479428
TI  - Mutants of Ustilago maydis defective in production of one of two polypeptides of
      KP6 toxin from the preprotoxin.
AB  - Double-stranded RNA viruses of Ustilago maydis encode secreted killer toxins to
      which other cells of the same species and closely related species are sensitive.
      KP6 toxin consists of two polypeptides, alpha and beta, produced from a single
      precursor preprotoxin. In this work, we cloned complementary DNA for the toxin
      encoding segment of two of the KP6 nonkiller mutants NK3 and NK13 that secrete
      the beta and alpha polypeptides, respectively. Both sequence analysis of the cDNA
      clones and in vitro translation of the toxin-encoding double-stranded RNAs showed
      that both mutants can produce full-length preprotoxins. Cys51 in alpha is
      converted to Arg in NK3 and Thr25 and Lys42 in beta are changed to Pro and Arg,
      respectively, in NK13. Although alpha and beta are encoded in a single
      prepropolypeptide, only the beta polypeptide is secreted by NK3 and only the
      alpha polypeptide is secreted by NK13. This differential expression of peptides
      from one precursor is a unique phenomenon. Neither of the nonsecreted
      polypeptides accumulated in the cytosol. The possible effects of these mutations
      on preprotoxin folding and their consequences for toxin secretion are discussed.

PMID- 8479429
TI  - The cell cycle genes cdc22+ and suc22+ of the fission yeast Schizosaccharomyces
      pombe encode the large and small subunits of ribonucleotide reductase.
AB  - The cdc22+ gene of Schizosaccharomyces pombe is required early in the cell cycle,
      and its transcript varies in concentration in step with the cell cycle, with a
      peak level at the G1-S boundary. The sequences of the cdc22+ gene and of a
      multicopy suppressor of cdc22ts mutations, suc22+, have been determined. The
      cdc22+ open reading frame, which is interrupted in the genome by a single intron
      very close to its 5' end, encodes a protein of 811 amino acids, which has an
      amino acid sequence highly similar to that of the large subunit of ribonucleotide
      reductase from several species. The suc22+ gene contains an uninterrupted open
      reading frame of 391 amino acids, very similar to the sequence of the small
      subunit of ribonucleotide reductase. Disruption of either gene is lethal.
      Upstream of the cdc22+ coding region are seven short sequence elements similar to
      the recognition sequence for MluI, which are involved in regulating periodic
      transcription of the gene. Inhibition of DNA synthesis by hydroxyurea results in
      a several-fold increase in the level of the cdc22+ transcript. In contrast,
      hydroxyurea does not induce the 1.5 kb transcript of suc22+, but results in the
      induction of a 1.9 kb mRNA which hybridises to suc22+ DNA.

PMID- 8479430
TI  - A technique for targeted mutagenesis of the EF-Tu chromosomal gene by M13
      mediated gene replacement.
AB  - A generally applicable system for targeted mutagenesis of a chromosomal sequence
      is described. The Escherichia coli tufA gene was mutated using a recombinant
      M13mp9 phage vector carrying a tuf gene. Integration via crossing over with the
      chromosomal tufA target gene produced an M13 lysogen. These lysogens were
      screened for resistance to kirromycin. The M13 phage carrying tufA mutations were
      efficiently retrieved by a genetic procedure. Genetic mapping was performed with
      the M13 vectors. The same recombinant M13 phage was used for mutagenesis, lysogen
      formation, gene replacement, retrieval, mapping and sequencing of kirromycin
      mutants. Three different mutations yielding resistance to kirromycin were found:
      two of these have previously been found and characterised, while the third
      mutation, Gly316-->Asp, is a new mutant. We also report the identification of a
      fourth kirromycin-resistant mutant, Gln124-->Lys.

PMID- 8479431
TI  - A study of integrative transformation in Schizosaccharomyces pombe.
AB  - Using the one-step gene disruption technique, we studied the effect of various
      parameters on the disruption frequency (percentage of homologous integrants) and
      transformation efficiency (number of transformants per microgram of input DNA) of
      integrative transformation in Schizosaccharomyces pombe. We used suc1 as the
      target gene for disruption and ura4 as the selectable marker. Our results are as
      follows. 1) Use of the strong adh1 promoter to drive the expression of ura4 did
      not affect the disruption frequency but modestly increased the transformation
      efficiency. 2) The transformation method had a profound effect, with the lithium
      acetate method yielding both a 10-fold higher disruption frequency compared to
      the protoplast method and a 5- to 10-fold higher transformation efficiency. 3)
      The presence of increasing amounts of non-homologous sequences at the ends of the
      transforming DNA decreased the disruption frequency by up to 5-fold but had no
      effect on the transformation efficiency. We also describe the use of the sup3-5
      allele in an ade6-704 genetic background to discriminate between the products of
      homologous versus non-homologous integration, thereby promoting the
      identification of rare homologous integrants.

PMID- 8479432
TI  - Resistance in tomato to Xanthomonas campestris pv vesicatoria is determined by
      alleles of the pepper-specific avirulence gene avrBs3.
AB  - Bacterial spot disease of tomato and pepper caused by Xanthomonas campestris pv
      vesicatoria is prevented by resistance genes in the plant that match genes for
      avirulence in the bacterium. Based on DNA homology to the avirulence gene avrBs3,
      which induces the resistance response on pepper, we have isolated another
      avirulence gene from X. c. vesicatoria, designated avrBs3-2. This gene differs in
      specificity from avrBs3 in inducing the hypersensitive response on tomato but not
      on pepper. Sequence analysis of the avrBs3-2 gene revealed a high degree of
      conservation: the 3480 bp open reading frame contains an internal region of 17.5
      nearly identical 102 bp repeat units that differ in their order from those
      present in the avrBs3 gene. The coding region is 97% identical to avrBs3 and
      expresses constitutively a 122 kDa protein, thus representing a natural allele of
      this gene. The previously isolated 1.7 kb avrBsP gene from X. c. vesicatoria is
      100% identical to the corresponding avrBs3-2 sequence, indicating that these
      genes might be identical. Interestingly, derivatives of avrBs3-2 lacking the C
      terminal region and part of the repetitive region are still able to confer
      incompatibility in tomato. The avrBs3-2 gene is compared with the sequence of
      avrBs3 derivatives generated by deletion of repeat units that also have
      avirulence activity on tomato. Both genes, avrBs3 and avrBs3-2, are flanked by a
      62 bp long inverted repeat, which prompts speculations about the origin of the
      members of the avrBs3 gene family.

PMID- 8479433
TI  - Cloning and analysis of the mating type genes from Cochliobolus heterostrophus.
AB  - Cochliobolus heterostrophus, a heterothallic Ascomycete, has a single mating type
      locus with two alternate forms called MAT-1 and MAT-2. MAT-1 was cloned by
      complementing a MAT-2 strain using a cosmid library from a MAT-1 strain and
      screening for a homothallic transformant. The cosmid recovered from this
      transformant was able to re-transform a MAT-2 strain to homothallism and MAT
      identity was proven by restriction fragment length polymorphism and conventional
      genetic mapping. All homothallic transformants could mate with either MAT-1 or
      MAT-2 strains, although the number of ascospores produced by self matings or
      crosses to MAT-2 strains was low. Progeny of selfed homothallic transformants
      were themselves homothallic. MAT-2 was cloned by probing a cosmid library from a
      MAT-2 strain with a fragment of insert DNA from a MAT-1 cosmid. A 1.5 kb subclone
      of either MAT-containing cosmid was sufficient to confer mating function in
      transformants. Examination of the DNA sequence of these subclones revealed that
      MAT-1 and MAT-2 contain 1297 bp and 1171 bp, respectively, of completely
      dissimilar DNA flanked by DNA common to both mating types. Putative introns were
      found (one in each MAT gene) which, when spliced out, would yield open reading
      frames (ORFs) that occupied approximately 90% of the dissimilar DNA sequences.
      Translation of the MAT-1 ORF revealed similarity to the Neurospora crassa MATA,
      Podospora anserina mat-, and Saccharomyces cerevisiae MAT alpha 1 proteins;
      translation of the MAT-2 ORF revealed similarity to the N. crassa MATa, P.
      anserina mat+, and Schizosaccharomyces pombe mat-Mc proteins. These gene products
      are all proven or proposed DNA binding proteins. Those with similarity to MAT-2
      are members of the high mobility group.

PMID- 8479434
TI  - The Nicotiana tabacum genome encodes two cytoplasmic thioredoxin genes which are
      differently expressed.
AB  - A Nicotiana tabacum thioredoxin h gene (EMBL Accession No. Z11803) encoding a new
      thioredoxin (called h2) was isolated using thioredoxin h1 cDNA (X58527), and
      represents the first thioredoxin h gene isolated from a higher plant. It encodes
      a polypeptide of 118 amino acids with the conserved thioredoxin active site Trp
      Cys-Gly-Pro-Cys. This gene comprises two introns which have lengths of 1071 and
      147 bp respectively, and three exons which encode peptides of 29, 41 and 48 amino
      acids, respectively. This thioredoxin h shows 66% identity with the amino acid
      sequence of thioredoxin h1 (X58527) and only around 35% with the choroplastic
      thioredoxins. The two thioredoxins, h1 and h2, do not have any signal peptides
      and are most probably cytoplasmic. Using the 3' regions of the mRNAs, two probes
      specific for thioredoxins h1 and h2 have been prepared. Southern blot analysis
      shows that thioredoxin sequences are present in only two genomic EcoRI fragments:
      a 3.3 kb fragment encodes h1 and a 4.5 kb fragment encodes h2. Analysis of the
      ancestors of the allotetraploid N. tabacum shows that thioredoxin h2 is present
      in N. sylvestris and N. tomentosiformis but that thioredoxin h1 is absent from
      both putative ancestors. Thus, the thioredoxin h1 gene has probably been recently
      introduced in to N. tabacum as a gene of agronomic importance, or linked to such
      genes. Northern blot analysis shows that both genes are expressed in N. tabacum,
      mostly in organs or tissues that contain growing cells.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8479435
TI  - Genetic and physical mapping of barley telomeres.
AB  - Barley (Hordeum vulgare L.) telomeres were investigated by means of pulsed field
      gel electrophoresis (PFGE) and in situ hybridization. In situ hybridization
      showed that a tandemly repeated satellite sequence has a subtelomeric location,
      and is present at thirteen of the fourteen chromosome ends. PFGE revealed that
      this satellite sequence is physically close to the telomeric repeat. Pulsed field
      gel electrophoresis was then used for segregation analysis and linkage mapping of
      several telomeric and satellite loci in a segregating doubled-haploid population.
      The telomeric repeat displayed a hypervariable segregation pattern with new
      alleles occurring in the progeny. Eight satellite and telomeric sites were mapped
      on an restriction fragment length polymorphism (RFLP)-map of barley, defining the
      ends of chromosome arms 1L, 2S, 3L, 4S, 4L, 5S and 6. One satellite locus mapped
      to an interstitial site on the long arm of chromosome 3. The physical location of
      this locus was confirmed by in situ hybridization to wheat/barley addition line
      3.

PMID- 8479436
TI  - The A mating-type genes of the mushroom Coprinus cinereus are not differentially
      transcribed in monokaryons and dikaryons.
AB  - The A mating type factor of Coprinus cinereus regulates part of a developmental
      sequence that leads to the conversion of the asexual monokaryon into the fertile
      dikaryon. The A42 factor is a complex of seven genes, at least four of which are
      involved in determining the specificity of mating interactions. In this report we
      show that the A42 genes are constitutively expressed in both monokaryons and
      dikaryons. This has important implications with respect to intracellular
      recognition of a compatible mating, which requires an interaction between
      proteins already present within the cells of the mating partners, and for the
      subsequent maintenance of dikaryotic growth.

PMID- 8479437
TI  - The Drosophila Tumorous-lethal hematopoietic oncogene is a dominant mutation in
      the hopscotch locus.
AB  - The Drosophila Tumorous-lethal (Tum-l) mutation acts as an activated oncogene,
      causing hematopoietic neoplasms, overproliferation, and premature
      differentiation. Tum-l is a dominant mutation in the hopscotch (hop) locus, which
      is required for cell division and for proper embryonic segmentation. The Tum-l
      temperature-sensitive period for melanotic tumor formation includes most of
      larval and pupal development.

PMID- 8479438
TI  - Amplification and loss of repeat units of the human minisatellite MS1 integrated
      in chromosome III of a haploid yeast strain.
AB  - Minisatellites comprise arrays of tandemly repeated short DNA sequences which
      show extensive variation in repeat unit number. The mechanisms that underlie this
      length variation are not understood. In order to study processes influencing
      length changes of minisatellites, we integrated the human minisatellite MS1 into
      a haploid strain of the yeast Saccharomyces cerevisiae. Frequent spontaneous
      generation of MS1 alleles with new lengths were observed in this yeast strain.
      Hence it is concluded that recombination between members of a pair of homologous
      chromosomes is not a prerequisite for the generation of length changes in MS1 in
      yeast.

PMID- 8479439
TI  - Electrophoretic karyotypes of the elm tree pathogen Ophiostoma ulmi (sensu lato).
AB  - Pulsed field gel electrophoresis using OFAGE, TAFE, and CHEF systems has been
      used to more fully characterize karyotypic variation within the two closely
      related fungal species of Ophiostoma ulmi sensu lato. Twelve wild-type and
      laboratory strains, representing the less aggressive species O. ulmi and both of
      the biotypes of the more aggressive species O. novo-ulmi were studied and their
      karyotypes determined. Depending on the strain, a minimum of four to a minimum of
      eight chromosomal DNA bands were present that fall into three distinct size
      classes, with one exception. Strain CESS16K (O. novo-ulmi, North American
      aggressive subgroup) contains a unique chromosomal DNA band which comigrated near
      a Saccharomyces cerevisiae chromosome of 0.95 Mb. This unique band was the
      smallest O. ulmi s. l. chromosomal DNA observed. Seven of the twelve strains
      shared a common chromosomal DNA banding pattern, whereas each of the other five
      had a unique karyotype. There was no correlation between chromosome profile and
      species, as some O. novo-ulmi and O. ulmi strains shared common electrophoretic
      karyotypes.

PMID- 8479440
TI  - Individualization and estimation of relatedness in crocodilians by DNA
      fingerprinting with a Bkm-derived probe.
AB  - Individual-specific DNA fingerprints of crocodilians were obtained by the use of
      Bkm-2(8) probe. Pedigree analyses of Crocodylus palustris, C. porosus and Caiman
      crocodilus revealed that the multiple bands (22-23 bands with Aludigest) thus
      obtained were inherited stably in a Mendelian fashion. Unique fingerprints
      permitted us to identify individuals, assign parentage, and reconstruct the DNA
      profile of a missing parent. Average band sharing between unrelated crocodiles
      was found to be 0.37. Band sharing between animals of known pedigrees increased
      predictably with relatedness and provided a basis for distinguishing relatives
      from non-relatives. Similar results obtained in other species/genera, using the
      same probe, suggest that this approach may be applicable to all species of
      crocodilians, and could facilitate genetic studies of wild and captive
      populations.

PMID- 8479441
TI  - Effect of tandem repeated AUG codons on translation efficiency of eukaryotic mRNA
      carrying a short leader sequence.
AB  - The effect on translation of multiple copies of the initiation codon AUG at the
      initiation site in a eukaryotic mRNA carrying a short leader sequence was tested
      in translation experiments in vitro. DNA, corresponding to a chimeric mRNA
      sequence consisting of the 5' leader region of brome mosaic virus (BMV) RNA4 and
      the goat pre-alpha-lactalbumin mRNA sequence, was prepared and transcribed in
      vitro using SP6 RNA polymerase. Site-directed mutagenesis was carried out to
      change the sequence around the initiation codon AUG. In a wheat germ translation
      system, the yield of protein obtained using the mRNA with a duplication of the
      AUG codons at the initiation site was 1.6 times that achieved when only one AUG
      was present. The rate of formation of the 80S initiation complex was measured by
      the ribosome binding assay using cycloheximide. A good correlation was observed
      between the ability to form the complex and translation efficiency.

PMID- 8479442
TI  - Pseudomonas aeruginosa promoters which contain a conserved GG-N10-GC motif but
      appear to be RpoN-independent.
AB  - The proC gene of Pseudomonas aeruginosa encodes the constitutive delta 1
      pyrroline 5-carboxylate reductase (the third enzyme of proline biosynthesis) and
      ranks among the numerous Pseudomonas genes which are poorly transcribed in
      Escherichia coli. The promoters of the proC gene were located by deletion
      mapping. The 5' ends of the proC transcripts originating from one promoter were
      determined by primer extension. This promoter has a GG-N10-GC motif with a 16 bp
      spacing between the GC doublet and the transcription start site. Such spacing is
      unusually long for sigma 54-dependent promoters. In rpoN mutants of P. aeruginosa
      and P. putida a proC'--'lacZ fusion was expressed at wild-type levels, suggesting
      that sigma 54 RNA polymerase is not involved in proC transcription. The
      expression of another P. aeruginosa gene, anr (for anaerobic regulation of
      nitrate respiration and anaerobic arginine degradation), also appeared to be
      independent of RpoN in Pseudomonas and occurred at a very low level in E. coli.
      The proC and anr promoters have sequence similarities in addition to the
      conserved GG--N10--GC motif and may also be related to some alg (alginate)
      promoters of P. aeruginosa. We propose that the proC and anr promoters are
      activated by proteins, including perhaps an alternative sigma factor, which are
      present in Pseudomonas but absent from E. coli.

PMID- 8479443
TI  - Molecular characterization of conventional and new repeat-induced mutants of nit
      3, the structural gene that encodes nitrate reductase in Neurospora crassa.
AB  - Nitrate reductase of Neurospora crassa is a dimeric protein composed of two
      identical subunits, each possessing three separate domains, with flavin, heme,
      and molybdenum-containing cofactors. A number of mutants of nit-3, the structural
      gene that encodes Neurospora nitrate reductase, have been characterized at the
      molecular level. Amber nonsense mutants of nit-3 were found to possess a
      truncated protein detected by a specific antibody, whereas Ssu-1-suppressed
      nonsense mutants showed restoration of the wild-type, full-length nitrate
      reductase monomer. The mutants show constitutive expression of the truncated
      nitrate reductase protein; however normal control, which requires nitrate
      induction, was restored in the suppressed mutant strains. Three conventional nit
      3 mutants were isolated by the polymerase chain reaction and sequenced; two of
      these mutants were due to the deletion of a single base in the coding region for
      the flavin domain, the third mutant was a nonsense mutation within the amino
      terminal molybdenum-containing domain. Homologous recombination was shown to
      occur when a deleted nit-3 gene was introduced by transformation into a host
      strain with a single point mutation in the resident nit-3 gene. New, severely
      damaged, null nit-3 mutants were created by repeat-induced point mutation and
      demonstrated to be useful as host strains for transformation experiments.

PMID- 8479444
TI  - A homologous gene-reporter system for the basidiomycete Schizophyllum commune
      based on internally deleted homologous genes.
AB  - Problems encountered in our attempts to achieve expression of heterologous genes,
      driven by ascomycetous regulatory sequences, in homobasidiomycetes led us to
      develop a gene-reporter system based on the expression of homologous genes in
      Schizophyllum commune. Internal deletions were made in the coding sequences of
      the regulated Sc4 gene and the constitutively expressed GPD gene. After
      introduction of these constructs into S. commune it was found that the expected
      truncated transcripts were produced. The internally deleted Sc4 gene, containing
      1140bp of upstream and 200 bp of downstream sequences, was only expressed in
      dikaryons at the time of fruiting (as was the resident Sc4 gene) but not at all
      in monokaryons, indicating that the construct contained all regulatory sequences
      necessary and sufficient to confer control by the mating-type genes and
      expression during fruiting. The internally deleted GPD gene, containing 1300 bp
      of upstream and 150 bp of downstream sequences, was expressed both in monokaryons
      and dikaryons at levels similar to those of the resident GPD gene, indicating
      that all sequences necessary for proper expression were present. This reporter
      gene system may be applicable to the analysis of cis-regulatory sequences of
      these genes. Furthermore, heterologous genes may be inserted into the well
      expressed GPD deletion construct to obtain expression of such genes in S. commune
      and possibly in other homobasidiomycetes.

PMID- 8479445
TI  - Characterization and localization of an ATP-diphosphohydrolase on the external
      surface of the tegument of Schistosoma mansoni.
AB  - An ATP-diphosphohydrolase (EC 3.6.1.5) was identified in the tegumental fraction
      isolated from Schistosoma mansoni worms. Both ATP and ADP were hydrolyzed to AMP
      at similar rates by the enzyme. Other nucleotides were also degraded by the
      tegument enzyme, revealing a broad substrate specificity. Electrophoretic
      separation of tegumental proteins under non-denaturing conditions followed by
      addition of ATP or ADP as substrate revealed a single band of activity with
      similar mobility. In addition, similar heat-inactivation profiles were obtained
      for ATPase or ADPase activities, indicating that a single enzyme is responsible
      for degrading both nucleotides. The enzyme was not inhibited by vanadate,
      levamisole, tetramisole, ouabain or sodium azide. The ADPase activity was not
      affected by adenosine (5')-pentaphospho-(5')-adenosine (Ap5A) or by an excess of
      glucose and hexokinase used as an ATP-trapping system, thus excluding the
      presence of any significant adenylate kinase activity. The ATP-diphosphohydrolase
      displayed micromolar affinities for both Mg2+ and Ca2+, and the calcium-activated
      enzyme was inhibited by millimolar Mg2+. In intact live worms a calcium phosphate
      precipitate was formed on the outer tegumental surface upon incubation of the
      worms with either ATP or ADP, indicating the ectolocalization of this enzyme. In
      addition, ultrastructural histochemical localization of the enzyme was obtained.
      A distinct deposition of lead phosphate granules on the outer surface of the
      tegument was observed by electron microscopy, in the presence of either ATP or
      ADP as substrate. It is suggested that the ATP-diphosphohydrolase could regulate
      the concentration of purine nucleotides around the parasites and hence enable
      them to escape the host hemostasis by preventing ADP-induced platelet activation.

PMID- 8479446
TI  - A developmentally regulated gene of Echinococcus granulosus codes for a 15.5
      kilodalton polypeptide related to fatty acid binding proteins.
AB  - A stage-specific expressed gene has been isolated from a cDNA expression library
      of Echinococcus granulosus protoscolices. The isolated clone contains the
      complete coding sequence. The corresponding protein (EgDf1) has a molecular
      weight of 15.5 kDa and is expressed at the tegumental level in the protoscolices,
      being undetectable in the germinal layer of the metacestode. This protein shares
      an important homology with a family of low-molecular weight proteins involved in
      the binding of hydrophobic ligands. This family includes a protein of Schistosoma
      mansoni (Sm 14) that has immunoprotective activity in rodents. Histochemical and
      metabolic data already reported for E. granulosus suggest that EgDf1 could be a
      molecular marker for early events in the process of protoscolex differentiation.

PMID- 8479447
TI  - Role of acidic compartments in Trypanosoma brucei, with special reference to low
      density lipoprotein processing.
AB  - In the bloodstream form of Trypanosoma brucei, specific receptors mediate the
      endocytosis of host low-density lipoprotein particles. We have explored the fate
      of ligand and receptor with a biochemical approach, using inhibitors of the
      endocytotic apparatus. The weak base chloroquine rapidly accumulates in
      trypanosomes, its uptake is prevented by the proton ionophore monensin, and it
      induces the swelling of intracellular vacuoles, indicating that their content is
      acidic. Cell-associated LDL is rapidly degraded into intermediately sized
      fragments and TCA-soluble material that can be recovered in cell extracts and
      extracellular medium. Chloroquine, leupeptin and E64, but not PMSF, efficiently
      prevent LDL proteolysis, suggesting that degradation occurs in those acidic
      compartment(s) and is mediated by thiol-protease(s). Both monensin and
      chloroquine decrease the number of LDL receptors exposed at the cell surface, a
      phenomenon amplified in the presence of LDL. This provides indirect evidence that
      internalised LDL receptors are recycled at a rate which is slowed down by
      receptor occupancy and by agents that impair acidification of the endocytic
      organelles. Finally, chloroquine decreases by half the growth rate of procyclic
      trypanosomes in vitro at 5 micrograms ml-1. At 40 mg kg-1 per day, it also slows
      down the increase in parasitaemia and prolongs the survival time of infected mice
      by up to 2 days.

PMID- 8479448
TI  - Selective import of nuclear-encoded tRNAs into mitochondria of the protozoan
      Leishmania tarentolae.
AB  - The trypanosomatid mitochondrial genome does not encode tRNA genes at all and
      experimental evidence obtained with Leishmania tarentolae shows that tRNAs in
      mitochondria represent a selected set of imported nuclear-encoded tRNAs. In this
      paper we present the data showing that tRNAs derived from the clustered genomic
      tRNA genes are invariably imported into mitochondria, while tRNA from the
      solitary gene is not. By sequencing a cosmid DNA clone of L. tarentolae genomic
      DNA, we have identified a 1.5-kb subclone encoding a duplicate set of the closely
      linked tRNA(Tyr) (GTA) and tRNA(Thr) (AGT) genes. Northern analysis shows that
      these tRNAs are imported into mitochondria. In contrast, when the tRNA gene
      [tRNA(Gln) (CUG)] located alone in a 40-kb DNA fragment was examined, the
      corresponding tRNA was not detected in the mitochondrion. This "loner" tRNA gene
      is highly unusual since the 3'-flanking putative RNA polymerase III transcription
      termination signal sequence is characterized by a long string of 8 Ts followed by
      an A and a stretch of 7 Cs, while all other trypanosomatid tRNA genes whose tRNA
      transcripts are imported are terminated by a possible transcription termination
      signal of only 4-6 Ts. Whether the correlation found between the gene
      organization and tRNA-import characteristics is of general significance needs to
      be investigated further. A simple computer analysis presented in this paper rules
      out the possibility that tRNAs found in the trypanosomatid mitochondrion are the
      products of the U-addition type 'RNA editing' of maxicircle DNA.

PMID- 8479449
TI  - A gene encoding a 69-kilodalton major surface protein of Giardia intestinalis
      trophozoites.
AB  - A gene encoding a 68.5-kDa trophozoite surface protein (TSP11) of the Australian
      Giardia intestinalis (syn. G. lamblia) isolate, Ad-1, has been cloned from a
      genomic expression library screened with an antiserum specific for 3 major
      surface antigens. Sequence analysis of two overlapping genomic fragments
      identified a single open reading frame that contained no introns and predicted a
      cysteine-rich, 667-residue polypeptide with features common to other trophozoite
      surface proteins. These include the presence of 27 copies of the 4-amino acid Cys
      X-X-Cys motif, an N-terminal signal sequence and a highly conserved, hydrophobic
      C-terminal segment. Transcripts from the tsp11 gene were detected as a single
      band on Northern blots using total RNA extracted from Ad-1 trophozoites. Primer
      extension analysis indicated that the mRNA has a 5' untranslated region of only 5
      nt, similar to the very short (1-6 nt) leader sequences reported for other
      Giardia mRNAs. A large portion of the promoter distal segment of tsp11 has
      homology with tsa417, a gene encoding a 72.5-kDa trophozoite surface antigen of
      the Afghanistan-derived G. intestinalis isolate, WB [13].

PMID- 8479450
TI  - Design of Onchocerca DNA probes based upon analysis of a repeated sequence
      family.
AB  - Repeated DNA sequences have been instrumental in the development of DNA probes
      for many different parasites. Isolation of such DNA probes has generally been
      accomplished by differential screening of genomic libraries with total genomic
      DNA preparations. In the current work, a rational design strategy is presented
      for the development of oligonucleotide probes based upon repeated sequence
      families. A repeated sequence family present in the genome of Onchocerca
      parasites, designated O-150, has been amplified from various samples of genomic
      DNA using PCR. DNA sequence analysis of the resulting PCR products demonstrated
      that the sequences may be arranged into clusters within which the individual
      sequences are identical or nearly identical. Differences among the cluster
      consensus sequences have been exploited to explain the specificities of
      previously isolated O-150 based probes and to develop two new oligonucleotide
      probes. One of these probes hybridizes specifically to Onchocerca volvulus O-150
      PCR products, while the second hybridizes specifically to O-150 PCR products from
      the closely related bovine parasite O. ochengi. These oligonucleotide probes have
      been used to characterize Onchocerca infective larvae isolated from wild caught
      infected flies in West Africa. Because repeated sequence families are a common
      feature of most genomes, including those of parasites, this method should be
      applicable to the rational design of oligonucleotide probes for other parasitic
      infections.

PMID- 8479451
TI  - Characterization of a surface metalloprotease from Herpetomonas samuelpessoai and
      comparison with Leishmania major promastigote surface protease.
AB  - The monogenetic kinetoplastid protozoan parasite Herpetomonas samuelpessoai
      expresses a surface-exposed metalloprotease. Comparable to the Leishmania
      promastigote surface protease, or PSP, the protease of Herpetomonas is active at
      the surface of fixed and live organisms, and both enzymes display an identical
      cleavage specificity toward a nonapeptide substrate. The protease was enriched
      440 times by partition into Triton X-114 followed by 2 steps of anion exchange
      chromatography. The 56-kDa enzyme is inhibited by the metal chelator 1,10
      phenanthroline and is susceptible to cleavage by glycosyl-phosphatidylinositol
      phospholipase C (GPI-PLC). The conservation of an identical surface protease
      activity in these monogenetic and digenetic trypanosomatids suggests that the
      enzyme has a physiological function in the promastigote (insect) stage of these
      parasites.

PMID- 8479452
TI  - Identification of the four human malaria parasite species in field samples by the
      polymerase chain reaction and detection of a high prevalence of mixed infections.
AB  - Genus- and species-specific sequences are present within the small subunit
      ribosomal RNA genes of the four human malaria parasites. Oligonucleotide primer
      pairs specific to each species were designed for specific amplification by the
      Polymerase Chain Reaction (PCR), to detect each malaria species. DNA equivalent
      to 5 microliters of blood was sufficient for the detection of each of the
      species. Blood samples obtained from 196 patients attending a malaria clinic in
      Trad province (Thailand) were analyzed. Detection and identification of the
      parasites, solely by electrophoretic analysis of the PCR products, has proven to
      be more sensitive and accurate than by routine diagnostic microscopy. A high
      proportion of mixed species infections were brought to light by the PCR assay.
      Implications for medical treatment and epidemiological studies are discussed.

PMID- 8479453
TI  - Purification and partial characterization of an acid proteinase from Dirofilaria
      immitis.
AB  - An acid proteinase of Dirofilaria immitis worms was purified 437-fold by gel
      filtration on Sephadex G-75 followed by pepstatin-agarose gel affinity
      chromatography. The enzyme with a molecular weight of 42,000 and specific
      activity of 384 units (mg protein)-1 was homogeneous as judged by both affinity
      chromatography and SDS-polyacrylamide gel electrophoresis. However,
      polyacrylamide disc electrophoresis at pH 8.9 revealed that the enzyme is
      composed of 5 multiforms, all carrying proteinase activity. Optimum pH of the
      enzyme was in the range of pH 2.8-3.4, and its isoelectric point ranged between
      5.8 and 6.4. The purified proteinase showed a potent activity against hemoglobin
      and myoglobin releasing acid soluble peptides, but not free amino acids. Complete
      inhibition of the proteolytic activity by pepstatin in the order of 10(-7) M
      strongly suggests that the enzyme belongs to the carboxyl-proteinase family.

PMID- 8479454
TI  - Molecular cloning of an echinococcal microtrichal antigen immunoreactive in
      Echinococcus multilocularis disease.
AB  - A cDNA expression library of the larval stage of the cestode worm Echinococcus
      multilocularis has been established in the phage lambda ZAPII system. By
      immunoscreening with pooled sera from patients with alveolar echinococcosis an
      immunoreactive clone, termed pEM13, was isolated. EM13 was expressed using the
      expression vector pGEX-3X, resulting in the synthesis of a glutathione S
      transferase fusion protein. 82% of the sera from 28 patients suffering from E.
      multilocularis disease had antibodies against EM13, whereas none of the 55 sera
      obtained from Echinococcus granulosus-infected patients and none of the 15 sera
      from patients with other helminthic infections reacted with recombinant EM13. By
      use of a polyclonal rabbit anti-EM13 hyperimmune serum native EM13 protein could
      be detected only in the protoscolices of E. multilocularis, but not in E.
      granulosus larvae or hydatid fluid. Immunoelectron microscopy suggested that EM13
      is located in the microtriches on the surface of the larvae. In contrast, EM13
      mRNA could be detected by Northern blot analysis in both E. multilocularis and E.
      granulosus larval RNA preparations. Nucleotide and amino acid sequence analysis
      of a cDNA clone coding for the corresponding antigen of E. granulosus larvae,
      termed EG13, revealed a 21-bp insertion, a 51-bp deletion and additional 22
      nucleotide exchanges resulting in a 96.3% identity at the nucleotide sequence
      level and a 96.6% identity at the amino acid sequence level to the coding region
      of the cDNA pEM13. Cross-reactivity of the polyclonal anti-EM13 serum with the
      recombinant EG13 indicates a posttranscriptional regulation mechanism, resulting
      in an EG13 negative phenotype in E. granulosus.

PMID- 8479455
TI  - Characterization of a benzyl-phenoxy-ethanamine binding protein in Trypanosoma
      equiperdum and the possible relation between binding affinity and trypanocidal
      activity.
AB  - A new family of benzyl-phenoxy-ethanamine derivatives has been assayed for
      trypanocidal activity. Using tritiated morpholino-benzyl-phenoxy-ethanamine as a
      probe, it is shown that this ligand is able to bind specifically to a protein
      contained in extracts of Trypanosoma equiperdum. The binding is saturable and of
      high affinity (KD = 4 nM: Bmax = 200 fmol (mg protein)-1). The in vitro
      activities of the investigated compounds against this parasite correlate with
      their affinities to the putative binding site. Moreover, using an azido
      functionalized morpholino-benzyl-phenoxyethanamine as photoprobe a major M(r) =
      40,000 protein was specifically revealed by sodium dodecyl sulphate
      polyacrylamide gel electrophoresis. This molecular weight corresponds with the
      previously observed value determined for the antioestrogen binding site protein
      of rat liver which has been shown to specifically bind antioestrogens of the
      triphenylethylene family and phenoxyethanamine derivatives.

PMID- 8479456
TI  - Chitinolytic activities in Heligmosomoides polygyrus and their role in egg
      hatching.
AB  - The occurrence of chitin in the eggshell of Heligmosomoides polygyrus has been
      determined by histochemical and biochemical techniques. Approximately 5% of the
      egg dry weight was chitin. Staining with Calcofluor white showed the chitin in
      the eggshell to be more accessible to the stain after hatching or rupturing of
      the eggshell. Chitinolytic activity has been detected using fluorescent
      substrates in extracts of adult males (at low levels), females and eggs. Enzyme
      activity in situ, within the developing larvae, was visualised with the same
      substrates. It was localized in discrete granules about 1 micron in diameter
      which occurred as groups in areas of about 5 microns in diameter, in the
      posterior third of the larvae. The chitinolytic activity in the eggs increased
      with the age of the egg and was released into the medium when the eggs hatched.
      The chitinase activities were very sensitive to inhibition by allosamidin, a
      specific chitinase inhibitor, with an IC50 for the crude egg extract of 2.2 nM.
      However, treatment of eggs with 250 microM allosamidin resulted in a slowing but
      not cessation of egg hatching.

PMID- 8479457
TI  - Characterization of the mRNA encoding a proline-rich 37-kilodalton glycoprotein
      from the excretory-secretory products of Trichostrongylus colubriformis.
AB  - A glycoprotein, with apparent molecular weight in SDS-polyacrylamide gels of 37
      kDa, has been isolated from the excretory-secretory (ES) products of the adult
      stage of Trichostrongylus colubriformis, a parasitic nematode. This protein is
      the major ES product recognized in immunoblots by lymph from a naturally infected
      sheep. A synthetic oligonucleotide, based on peptide sequence data from a digest
      of the purified protein was used to successfully screen a cDNA library. A cDNA
      clone was isolated which encoded a presumptive protein precursor of 220 amino
      acids that contained a 63 amino acid region of which more than 35% of the
      residues were proline, three peptide sequences determined from the natural
      component, and three potential N-glycosylation sites, consistent with the protein
      being isolated from the lectin-bound fraction of the adult ES products. The
      presumptive, processed, amino terminus encoded by the cDNA clone was preceded by
      a signal-like, hydrophobic-rich region of 16 amino acids.

PMID- 8479458
TI  - Cloning and characterization of a vacuolar ATPase A subunit homologue from
      Plasmodium falciparum.
AB  - The distribution of the antimalarial drug chloroquine is determined to a
      significant extent by a transvacuolar pH gradient in Plasmodium falciparum. A
      proton pump similar to the vacuolar ATPase found in many cell types has been
      suggested to maintain a pH gradient across the membranes of acidic compartments
      in the parasite. In order to understand and define the components involved in the
      mechanism of acidification of parasite vesicles, we have cloned and characterized
      a gene, designated VAP-A, encoding a P. falciparum homologue of the catalytic A
      subunit of the vacuolar ATPase. The VAP-A gene encodes a polypeptide of 611 amino
      acids which shows between 56 to 61% amino acid identity over its entire length
      with the sequences of vacuolar ATPase A subunits from several species. The VAP-A
      gene exists as a single copy gene on P. falciparum chromosome 13 and gives rise
      to a transcript of 3.7 kb. Antibodies raised against a VAP-A gene segment
      expressed in Escherichia coli react specifically with a 67-kDa polypeptide,
      consistent with the size predicted from the sequence and with the size of the
      corresponding polypeptide in other organisms. The 67-kDa protein is present
      throughout the asexual erythrocytic cycle and is expressed at similar levels in 5
      P. falciparum isolates of differing chloroquine sensitivity. Sequence analysis of
      the coding region of the VAP-A gene from 2 chloroquine-sensitive and 3
      chloroquine-resistant isolates has shown no changes that are linked to
      chloroquine resistance. Therefore, a proposed chloroquine resistance-linked
      vacuolar acidification defect does not involve mutations in the VAP-A gene in the
      isolates we have studied.

PMID- 8479459
TI  - Cloning and characterization of differentially expressed genes from in vitro
      grown 'amastigotes' of Leishmania donovani.
AB  - Leishmanial parasites routinely undergo cyclic differentiation from promastigotes
      to amastigotes during their life cycle. This process involves both morphological
      and macromolecular changes. To study such changes, we used a axenic culture
      system which permits the continuous generation and cycling of Leishmania donovani
      from promastigotes to 'amastigotes' in vitro. cDNA libraries were constructed
      from poly(A)+ RNA isolated from both the pro- and amastigote forms. Using
      differential cDNA hybridization techniques, 3 unique cDNAs clones (P17, A41 and
      A45) were isolated from the amastigote library. To assess whether these clones
      were differentially expressed by the pro-or 'amastigotes' forms, they were
      hybridized to RNA isolated from each of these parasite forms in Northern and slot
      blots. Results of these analyses showed that 'amastigotes' had approx. 2-fold
      higher levels of the A41 and A45 RNAs compared to the promastigotes. Conversely,
      promastigotes showed approx. 2-fold higher levels of the P17 RNA than
      'amastigotes'. Nucleotide sequence analysis and comparison with those in Gene
      bank, revealed that the 3 cDNAs represent unique leishmanial genes. Comparison of
      the deduced amino acid sequences revealed that P17 open reading frame (ORF) had
      significant similarity with a soybean ribosomal protein S11; A41 ORF with a
      Bacillus subtilis spore germination gene (gerC) and A45 ORF with yeast stress
      inducible protein (STI1). It is of interest to note that, of the 3 cDNAs
      identified, the A45-encoded protein was recognized by sera from patients with
      clinically active visceral leishmaniasis and was encoded by a single copy gene.

PMID- 8479460
TI  - Cloning and expression of the gene for Plasmodium falciparum transmission
      blocking target antigen, Pfs230.

PMID- 8479461
TI  - Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study
      Group.
AB  - BACKGROUND: The results of case-control studies and anecdotal reports suggest
      that pancreatitis may be a risk factor for pancreatic cancer, but there have been
      no studies of sufficient size and power to assess the magnitude of the relation
      between these two diseases. METHODS AND RESULTS: We undertook a multicenter
      historical cohort study of 2015 subjects with chronic pancreatitis who were
      recruited from clinical centers in six countries. A total of 56 cancers were
      identified among these patients during a mean (+/-SD) follow-up of 7.4 +/- 6.2
      years. The expected number of cases of cancer calculated from country-specific
      incidence data and adjusted for age and sex was 2.13, yielding a standardized
      incidence ratio (the ratio of observed to expected cases) of 26.3 (95 percent
      confidence interval, 19.9 to 34.2). For subjects with a minimum of two or five
      years of follow-up, the respective standardized incidence ratios were 16.5 (95
      percent confidence interval, 11.1 to 23.7) and 14.4 (95 percent confidence
      interval, 8.5 to 22.8). The cumulative risk of pancreatic cancer in subjects who
      were followed for at least 2 years increased steadily, and 10 and 20 years after
      the diagnosis of pancreatitis, it was 1.8 percent (95 percent confidence
      interval, 1.0 to 2.6 percent) and 4.0 percent (95 percent confidence interval,
      2.0 to 5.9 percent), respectively. CONCLUSIONS: The risk of pancreatic cancer is
      significantly elevated in subjects with chronic pancreatitis and appears to be
      independent of sex, country, and type of pancreatitis.

PMID- 8479462
TI  - Topical tretinoin (retinoic acid) therapy for hyperpigmented lesions caused by
      inflammation of the skin in black patients.
AB  - BACKGROUND AND METHODS: Irregular disfiguring skin hyperpigmentation due to
      inflammation may develop in black persons. We investigated the treatment of this
      hyperpigmentation with topical tretinoin (0.1 percent retinoic acid cream). Fifty
      four subjects completed a 40-week randomized, double-blind, vehicle-controlled
      study. Twenty-four subjects applied tretinoin daily to the face, arms, or both
      areas, and 30 subjects applied vehicle cream. At base line and after 40 weeks of
      treatment, each subject's post-inflammatory hyperpigmented lesions and normal
      skin were assessed by clinical and colorimetric evaluations and by analysis of
      biopsy specimens. RESULTS: The facial post-inflammatory hyperpigmented lesions of
      the tretinoin-treated subjects were significantly lighter after the 40 weeks of
      therapy than those of the vehicle-treated subjects (P < 0.001); overall
      improvement was first noted after four weeks of tretinoin treatment. At the end
      of treatment, colorimetry demonstrated a 40 percent lightening of the lesions
      toward normal skin color in the tretinoin-treated lesions, as compared with an 18
      percent lightening in vehicle-treated lesions (P = 0.05). The epidermal melanin
      content in the lesions decreased by 23 percent with tretinoin and by 3 percent
      with vehicle (P = 0.24). Normal skin was minimally lightened by tretinoin as
      compared with vehicle, according to both clinical evaluation (0.1 vs. -0.1 unit
      change on an 8-point scale; P = 0.055) and colorimetry (P < 0.001). Retinoid
      dermatitis developed in 12 of the 24 tretinoin-treated subjects who completed the
      study (50 percent) and in 1 tretinoin-treated subject who withdrew from the
      study, but diminished as the study progressed. CONCLUSIONS: Topical application
      of tretinoin significantly lightens post-inflammatory hyperpigmentation and, to a
      clinically minimal but statistically significant degree, lightens normal skin in
      black persons.

PMID- 8479463
TI  - Vitamin E consumption and the risk of coronary disease in women.
AB  - BACKGROUND: Interest in the antioxidant vitamin E as a possible protective
      nutrient against coronary disease has intensified with the recognition that
      oxidized low-density lipoprotein may be involved in atherogenesis. METHODS: In
      1980, 87,245 female nurses 34 to 59 years of age who were free of diagnosed
      cardiovascular disease and cancer completed dietary questionnaires that assessed
      their consumption of a wide range of nutrients, including vitamin E. During
      follow-up of up to eight years (679,485 person-years) that was 97 percent
      complete, we documented 552 cases of major coronary disease (437 nonfatal
      myocardial infarctions and 115 deaths due to coronary disease). RESULTS: As
      compared with women in the lowest fifth of the cohort with respect to vitamin E
      intake, those in the top fifth had a relative risk of major coronary disease of
      0.66 (95 percent confidence interval, 0.50 to 0.87) after adjustment for age and
      smoking. Further adjustment for a variety of other coronary risk factors and
      nutrients, including other antioxidants, had little effect on the results. Most
      of the variability in intake and reduction in risk was attributable to vitamin E
      consumed as supplements. Women who took vitamin E supplements for short periods
      had little apparent benefit, but those who took them for more than two years had
      a relative risk of major coronary disease of 0.59 (95 percent confidence
      interval, 0.38 to 0.91) after adjustment for age, smoking status, risk factors
      for coronary disease, and use of other antioxidant nutrients (including multi
      vitamins). CONCLUSIONS: Although these prospective data do not prove a cause-and
      effect relation, they suggest that among middle-aged women the use of vitamin E
      supplements is associated with a reduced risk of coronary heart disease.
      Randomized trials of vitamin E in the primary and secondary prevention of
      coronary disease are being conducted; public policy recommendations about the
      widespread use of vitamin E should await the results of these trials.

PMID- 8479464
TI  - Vitamin E consumption and the risk of coronary heart disease in men.
AB  - BACKGROUND: The oxidative modification of low-density lipoproteins increases
      their incorporation into the arterial intima, an essential step in atherogenesis.
      Although dietary antioxidants, such as vitamin C, carotene, and vitamin E, have
      been hypothesized to prevent coronary heart disease, prospective epidemiologic
      data are sparse. METHODS: In 1986, 39,910 U.S. male health professionals 40 to 75
      years of age who were free of diagnosed coronary heart disease, diabetes, and
      hypercholesterolemia completed detailed dietary questionnaires that assessed
      their usual intake of vitamin C, carotene, and vitamin E in addition to other
      nutrients. During four years of follow-up, we documented 667 cases of coronary
      disease. RESULTS: After controlling for age and several coronary risk factors, we
      observed a lower risk of coronary disease among men with higher intakes of
      vitamin E (P for trend = 0.003). For men consuming more than 60 IU per day of
      vitamin E, the multivariate relative risk was 0.64 (95 percent confidence
      interval, 0.49 to 0.83) as compared with those consuming less than 7.5 IU per
      day. As compared with men who did not take vitamin E supplements, men who took at
      least 100 IU per day for at least two years had a multivariate relative risk of
      coronary disease of 0.63 (95 percent confidence interval, 0.47 to 0.84). Carotene
      intake was not associated with a lower risk of coronary disease among those who
      had never smoked, but it was inversely associated with the risk among current
      smokers (relative risk, 0.30; 95 percent confidence interval, 0.11 to 0.82) and
      former smokers (relative risk, 0.60; 95 percent confidence interval, 0.38 to
      0.94). In contrast, a high intake of vitamin C was not associated with a lower
      risk of coronary disease. CONCLUSIONS: These data do not prove a causal relation,
      but they provide evidence of an association between a high intake of vitamin E
      and a lower risk of coronary heart disease in men. Public policy recommendations
      with regard to the use of vitamin E supplements should await the results of
      additional studies.

PMID- 8479465
TI  - Brief report: shock and multiple-organ dysfunction after self-administration of
      Salmonella endotoxin.

PMID- 8479467
TI  - Pathogenetic mechanisms of septic shock.

PMID- 8479466
TI  - Recent advances in pulmonary medicine (2)

PMID- 8479468
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 20-1993. A 23-year-old woman with a rapidly enlarging intraoral
      mass after a tooth extraction.

PMID- 8479469
TI  - Chronic pancreatitis and pancreatic cancer.

PMID- 8479470
TI  - Tretinoin (retinoic acid) revisited.

PMID- 8479471
TI  - The American Health Security Act. A single-payer proposal.

PMID- 8479472
TI  - Actual versus self-reported intake and exercise in obesity.

PMID- 8479473
TI  - Actual versus self-reported intake and exercise in obesity.

PMID- 8479474
TI  - Actual versus self-reported intake and exercise in obesity.

PMID- 8479475
TI  - Actual versus self-reported intake and exercise in obesity.

PMID- 8479476
TI  - Massive obesity simulating lymphedema.

PMID- 8479477
TI  - Pancreatic and islet transplantation for diabetes.

PMID- 8479478
TI  - Pancreatic and islet transplantation for diabetes.

PMID- 8479479
TI  - Predictors of acute graft-versus-host disease in bone marrow transplantation
      between HLA-identical siblings.

PMID- 8479480
TI  - High-dose erythropoietin for unstable hemoglobin Burke in a patient receiving
      hemodialysis.

PMID- 8479481
TI  - Clinical problem-solving: sounds in the attic.

PMID- 8479483
TI  - Clinical problem-solving: sounds in the attic.

PMID- 8479482
TI  - Clinical problem-solving: sounds in the attic.

PMID- 8479485
TI  - HMOs and physicians without board certification.

PMID- 8479484
TI  - State-by-state pharmaceutical formulations?

PMID- 8479486
TI  - Abdominal pain after taking ursodiol.

PMID- 8479487
TI  - Early termination of pregnancy with mifepristone (RU 486) and the orally active
      prostaglandin misoprostol.
AB  - BACKGROUND AND METHODS: The combination of mifepristone (RU 486) and a
      prostaglandin analogue given either intramuscularly or intravaginally is
      effective in terminating early pregnancy, but the prostaglandin component of the
      regimen is cumbersome to administer and has side effects. We conducted two
      studies to determine the efficacy of 600 mg of mifepristone followed by a small
      dose of misoprostol, an orally active prostaglandin E1 analogue, for the same
      purpose. In the first study, 505 women who had had amenorrhea for less than 50
      days received 400 micrograms of misoprostol 48 hours after receiving
      mifepristone, if the pregnancy was not terminated within that period. In the
      second study, 390 women initially received the same treatment, but if the
      pregnancy was not terminated within four hours after the administration of
      misoprostol, they were offered an additional 200-micrograms dose of misoprostol.
      RESULTS: In study 1, the rate of success (termination of pregnancy and complete
      expulsion of the conceptus) was 96.9 percent (95 percent confidence interval,
      94.1 to 97.7 percent)--similar to the success rate of approximately 95 percent
      for mifepristone followed by the intramuscular or intravaginal administration of
      prostaglandin. Abortion occurred in 2.9 percent of the women within 48 hours
      after the administration of mifepristone, in 60.9 percent within 4 hours after
      the administration of misoprostol, and in 33.2 percent thereafter. The failures
      included ongoing pregnancies in four women (0.8 percent) and incomplete abortions
      in nine (1.8 percent); two other women (0.4 percent) required vacuum aspiration
      for prolonged uterine bleeding. In study 2, pregnancy was terminated in 5.5
      percent of the women before the administration of misoprostol and within four
      hours after the first dose of misoprostol in 69.1 percent. Among the 71 women who
      received a second dose of misoprostol, 67 had complete abortions, 2 had partial
      retention of the conceptus, 1 had synechia with ongoing pregnancy, and 1 had an
      ectopic pregnancy. One ongoing pregnancy, which was terminated by vacuum
      aspiration, was recorded among the 27 women who declined to take the second dose
      of misoprostol. The overall rate of success of the regimen with the optional
      second dose of misoprostol was 98.7 percent (95 percent confidence interval, 96.8
      to 99.5 percent). No woman had any serious adverse event. CONCLUSIONS: The
      combination of mifepristone and misoprostol is effective for the termination of
      early pregnancy in terms of success, tolerance, safety, and practicality.

PMID- 8479488
TI  - Dapsone-pyrimethamine compared with aerosolized pentamidine as primary
      prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV
      infection. The PRIO Study Group.
AB  - BACKGROUND: Pneumocystis carinii pneumonia and toxoplasmic encephalitis are
      frequent life-threatening opportunistic infections in patients with human
      immunodeficiency virus (HIV) infection. Primary prophylaxis against P. carinii
      pneumonia is now common, but there are few data on regimens for primary
      prophylaxis against toxoplasmosis. METHODS: We conducted a randomized trial that
      compared two prophylactic regimens: dapsone (50 mg per day) plus pyrimethamine
      (50 mg per week) was compared with aerosolized pentamidine (300 mg per month).
      The patients had symptomatic HIV infection, no history of P. carinii pneumonia or
      symptomatic toxoplasmosis, and CD4+ counts below 200 per cubic millimeter (0.2 x
      10(9) per liter). RESULTS: In an intention-to-treat analysis, after a median
      follow-up of 539 days P. carinii pneumonia developed in 10 patients in each
      group, whereas toxoplasmosis developed in 32 of 176 patients in the pentamidine
      group and 19 of 173 patients in the dapsone-pyrimethamine group. Those assigned
      to pentamidine had a risk of P. carinii pneumonia that was similar to the risk in
      those assigned to dapsone-pyrimethamine (adjusted relative risk, 1.13; 95 percent
      confidence interval, 0.44 to 2.92; P = 0.79), but a higher risk of toxoplasmosis
      (adjusted relative risk, 1.81; 95 percent confidence interval, 1.12 to 2.94; P =
      0.02). Among the 262 patients with serologic evidence of past exposure to
      Toxoplasma gondii, the relative risk of symptomatic toxoplasmosis was 2.37 times
      higher in those assigned to pentamidine (95 percent confidence interval, 1.3 to
      4.4; P = 0.006). More patients discontinued dapsone-pyrimethamine than
      pentamidine because of toxicity (42 vs. 3; P < 0.001). Survival was similar in
      the two groups. CONCLUSIONS: For primary prevention of P. carinii pneumonia,
      dapsone-pyrimethamine is as effective, though not as well tolerated, as
      aerosolized pentamidine. Dapsone-pyrimethamine also prevents first episodes of
      toxoplasmosis.

PMID- 8479489
TI  - Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat
      Pneumocystis carinii pneumonia in patients with AIDS.
AB  - BACKGROUND: Both trimethoprim-sulfamethoxazole and pentamidine are effective as
      treatments for Pneumocystis carinii pneumonia, but adverse effects frequently
      limit their use. Atovaquone (566C80) is a new hydroxynaphthoquinone with activity
      against P. carinii. METHODS: We conducted a double-blind, multicenter study in
      patients with the acquired immunodeficiency syndrome and mild or moderately
      severe P. carinii pneumonia. They were randomly assigned to 21 days of orally
      administered treatment three times daily with either atovaquone (750 mg) or
      trimethoprim (320 mg) plus sulfamethoxazole (1600 mg). RESULTS: Of the 322
      patients with histologically confirmed P. carinii pneumonia, 160 received
      atovaquone and 162 received trimethoprim-sulfamethoxazole. Of those who could be
      evaluated for therapeutic efficacy, 28 of 138 patients given atovaquone (20
      percent) and 10 of 146 patients given trimethoprim-sulfamethoxazole (7 percent)
      did not respond (P = 0.002). Treatment-limiting adverse effects required a change
      of therapy in 11 patients in the atovaquone group (7 percent) and 33 patients in
      the trimethoprim-sulfamethoxazole group (20 percent) (P = 0.001). Therapy
      involving only the initial drug was successful and free of adverse effects in 62
      percent of those assigned to atovaquone and 64 percent of those assigned to
      trimethoprim-sulfamethoxazole. Within four weeks of the completion of treatment,
      there were 11 deaths in the atovaquone group (4 due to P. carinii pneumonia) and
      1 death in the trimethoprim-sulfamethoxazole group (P = 0.003). Diarrhea at entry
      was associated with lower plasma drug concentrations (P = 0.009), therapeutic
      failure (P < 0.001), and death (P < 0.001) in the atovaquone group but not in the
      trimethoprim-sulfamethoxazole group. CONCLUSIONS: For the treatment of P. carinii
      pneumonia, atovaquone is less effective than trimethoprim-sulfamethoxazole, but
      it has fewer treatment-limiting adverse effects.

PMID- 8479490
TI  - Brief report: a molecular defect in the vasopressin V2-receptor gene causing
      nephrogenic diabetes insipidus.

PMID- 8479491
TI  - Brief report: a mutation in the vasopressin V2-receptor gene in a kindred with X
      linked nephrogenic diabetes insipidus.

PMID- 8479492
TI  - Hormonal contraception.

PMID- 8479493
TI  - Case records of the Massachusetts General Hospital. Weekly Clinicopathological
      Exercises. Case 21-1993. A 71-year-old man with a rash and severe sensorimotor
      neuropathy.

PMID- 8479494
TI  - Mifepristone (RU 486) in the United States. What does the future hold?

PMID- 8479495
TI  - Molecular insights into diabetes insipidus.

PMID- 8479496
TI  - Treatment of Gaucher's disease.

PMID- 8479497
TI  - Treatment of Gaucher's disease.

PMID- 8479498
TI  - Treatment of Gaucher's disease.

PMID- 8479499
TI  - Treatment of Gaucher's disease.

PMID- 8479500
TI  - Treatment of Gaucher's disease.

PMID- 8479501
TI  - Treatment of Gaucher's disease.

PMID- 8479502
TI  - Polymorphism of the glycogen synthase gene and non-insulin-dependent diabetes
      mellitus.

PMID- 8479503
TI  - Polymorphism of the glycogen synthase gene and non-insulin-dependent diabetes
      mellitus.

PMID- 8479504
TI  - Prevention and treatment of Pneumocystis pneumonia.

PMID- 8479505
TI  - More things that go bang in the night.

PMID- 8479507
TI  - Facial palsy in Lyme disease.

PMID- 8479506
TI  - Error in chemotherapy dosages.

PMID- 8479508
TI  - Compulsory payment for unwanted treatment.

PMID- 8479509
TI  - Syncope after eating.

PMID- 8479510
TI  - Physician-assisted suicide--Michigan's temporary solution.

PMID- 8479511
TI  - Canadian study fuels move to limit rise in drug prices.

PMID- 8479512
TI  - 15 drug companies to share data on AIDS therapies.

PMID- 8479513
TI  - Population control.

PMID- 8479514
TI  - Cancer. A death in the life of p53.

PMID- 8479515
TI  - Structural biology. Picture an enzyme at work.

PMID- 8479516
TI  - Universal tree of life.

PMID- 8479517
TI  - Universal tree of life.

PMID- 8479518
TI  - The pathogenesis of atherosclerosis: a perspective for the 1990s.
AB  - Atherosclerosis, the principal cause of heart attack, stroke and gangrene of the
      extremities, is responsible for 50% of all mortality in the USA, Europe and
      Japan. The lesions result from an excessive, inflammatory-fibroproliferative
      response to various forms of insult to the endothelium and smooth muscle of the
      artery wall. A large number of growth factors, cytokines and vasoregulatory
      molecules participate in this process. Our ability to control the expression of
      genes encoding these molecules and to target specific cell types provides
      opportunities to develop new diagnostic and therapeutic agents to induce the
      regression of the lesions and, possibly, to prevent their formation.

PMID- 8479519
TI  - Interfacial activation of the lipase-procolipase complex by mixed micelles
      revealed by X-ray crystallography.
AB  - The three-dimensional structure of the lipase-procolipase complex, co
      crystallized with mixed micelles of phosphatidylcholine and bile salt, has been
      determined at 3 A resolution by X-ray crystallography. The lid, a surface helix
      covering the catalytic triad of lipase, adopts a totally different conformation
      which allows phospholipid to bind to the enzyme's active site. The open lid is an
      essential component of the active site and interacts with procolipase. Together
      they form the lipid-water interface binding site. This reorganization of the lid
      structure provokes a second drastic conformational change in an active site loop,
      which in its turn creates the oxyanion hole (induced fit).

PMID- 8479520
TI  - Kinship affects morphogenesis in cannibalistic salamanders.
AB  - Inclusive fitness theory predicts that organisms can often increase their fitness
      by helping relatives. Indeed, many animals modify their behaviour towards kin in
      a fashion consistent with theory. Morphogenesis may also be sensitive to kinship
      environment, especially in species that facultatively produce distinct morphs
      that differ in their ability to harm relatives, such as those that produce
      alternative cannibalistic and non-cannibalistic phenotypes. We tested this
      hypothesis by examining whether consanguinity affected the probability that
      structurally distinctive cannibal morphs would develop in larval Arizona tiger
      salamanders (Ambystoma tigrinum nebulosum). We report here that when tiger
      salamander larvae are reared in mixed-brood groups they are significantly more
      likely to develop the cannibal morphology and at an earlier age than siblings
      reared in pure-sibship groups. In general, morphogenesis may be responsive to
      kinship in any species that facultatively develops structures that can be used
      against conspecifics as weaponry.

PMID- 8479521
TI  - A metalloproteinase inhibitor domain in Alzheimer amyloid protein precursor.
AB  - Extracellular deposition of amyloid beta-protein (beta-AP), or A4 protein (M(r)
      4,000), is associated with Alzheimer's disease and with Down's syndrome (trisomy
      for chromosome 21). The large membrane-bound precursor protein (APP) of beta-AP
      is normally cleaved within the beta-AP region by a putative proteinase (APP
      secretase) to release its extracellular portion; beta-AP is produced by an
      alternative proteolytic processing. Here we demonstrate that APP contains a
      proteinase inhibitor domain for the matrix metalloproteinase gelatinase A, which
      is located in the C-terminal glycosylated region of the secretory forms of APP.
      In addition, we show that the gelatinase has an APP secretase-like activity,
      which hydrolyses the Lys16-Leu17 bond in the beta-AP sequence. Our results
      indicate that the proteinase inhibitor domain of APP and gelatinase A may be
      involved in the formation of beta-AP.

PMID- 8479522
TI  - p53 is required for radiation-induced apoptosis in mouse thymocytes.
AB  - The p53 tumour suppressor gene is the most widely mutated gene in human
      tumorigenesis. p53 encodes a transcriptional activator whose targets may include
      genes that regulate genomic stability, the cellular response to DNA damage, and
      cell-cycle progression. Introduction of wild-type p53 into cell lines that have
      lost endogenous p53 function can cause growth arrest or induce a process of cell
      death known as apoptosis. During normal development, self-reactive thymocytes
      undergo negative selection by apoptosis, which can also be induced in immature
      thymocytes by other stimuli, including exposure to glucocorticoids and ionizing
      radiation. Although normal negative selection involves signalling through the T
      cell receptor, the induction of apoptosis by other stimuli is poorly understood.
      We have investigated the requirement for p53 during apoptosis in mouse
      thymocytes. We report here that immature thymocytes lacking p53 die normally when
      exposed to compounds that may mimic T-cell receptor engagement and to
      glucocorticoids but are resistant to the lethal effects of ionizing radiation.
      These results demonstrate that p53 is required for radiation-induced cell death
      in the thymus but is not necessary for all forms of apoptosis.

PMID- 8479523
TI  - Thymocyte apoptosis induced by p53-dependent and independent pathways.
AB  - Death by apoptosis is characteristic of cells undergoing deletion during
      embryonic development, T- and B-cell maturation and endocrine-induced atrophy.
      Apoptosis can be initiated by various agents and may be a result of expression of
      the oncosuppressor gene p53 (refs 6-8). Here we study the dependence of apoptosis
      on p53 expression in cells from the thymus cortex. Short-term thymocyte cultures
      were prepared from mice constitutively heterozygous or homozygous for a deletion
      in the p53 gene introduced into the germ line after gene targeting. Wild-type
      thymocytes readily undergo apoptosis after treatment with ionizing radiation, the
      glucocorticoid methylprednisolone, or etoposide (an inhibitor of topoisomerase
      II), or after Ca(2+)-dependent activation by phorbol ester and a calcium
      ionophore. In contrast, homozygous null p53 thymocytes are resistant to induction
      of apoptosis by radiation or etoposide, but retain normal sensitivity to
      glucocorticoid and calcium. The time-dependent apoptosis that occurs in untreated
      cultures is unaffected by p53 status. Cells heterozygous for p53 deletion are
      partially resistant to radiation and etoposide. Our results show that p53 exerts
      a significant and dose-dependent effect in the initiation of apoptosis, but only
      when it is induced by agents that cause DNA-strand breakage.

PMID- 8479524
TI  - Solution structure of the POU-specific DNA-binding domain of Oct-1.
AB  - The transcription factor Oct-1 belongs to a family containing a POU DNA-binding
      domain. This bipartite domain is composed of a POU-specific domain (POUs) and a
      POU-homeodomain (POUhd) connected by a flexible linker. The left half of the
      optimal POU binding site, the octamer ATGCAAAT, is recognized by POUs and the
      right half by POUhd. We have determined the solution structure of POUs by nuclear
      magnetic resonance. It consists of four alpha-helices connected by short loops.
      Helices I and IV are in a parallel coiled-coil arrangement. The folding topology
      appears to be similar to that of the bacteriophage lambda-repressor and 434
      repressor. For the well defined parts of the protein (residues 1-71), the average
      root-mean square deviation for the backbone atoms is 0.9 A. Based on the observed
      selective exchange broadening in the (15N,1H)-HMQC (heteronuclear multiple
      quantum coherence) spectrum of the POUs-DNA complex we conclude that DNA-binding
      is mediated by helix III. We propose a model for the POU-DNA complex in which
      both recognition helices from the two subdomains have adjacent positions in the
      major groove.

PMID- 8479525
TI  - Oncoprotein MDM2 conceals the activation domain of tumour suppressor p53.
AB  - The tumour-suppressor gene p53 is inactivated in most human malignancies either
      by missense mutations or by binding to oncogenic proteins. In human soft tissue
      sarcomas, inactivation apparently results from MDM2 gene amplification. MDM2 is
      an oncogene product that may function by binding to p53 and inhibiting its
      ability to activate transcription. Here we show that, when expressed in
      Saccharomyces cerevisiae, human MDM2 inhibits human p53's ability to stimulate
      transcription by binding to a region that nearly coincides with the p53 acidic
      activation domain. The isolated p53 activation domain fused to another DNA
      binding protein is also inactivated by MDM2, confirming that MDM2 can inhibit p53
      function by concealing the activation domain of p53 from the cellular
      transcription machinery.

PMID- 8479526
TI  - Yeast DNA repair and recombination proteins Rad1 and Rad10 constitute a single
      stranded-DNA endonuclease.
AB  - Damage-specific recognition and incision of DNA during nucleotide excision repair
      in yeast and mammalian cells requires multiple gene products. Amino-acid sequence
      homology between several yeast and mammalian genes suggests that the mechanism of
      nucleotide excision repair is conserved in eukaryotes, but very little is known
      about its biochemistry. In the yeast Saccharomyces cerevisiae at least 6 genes
      are needed for this process, including RAD1 and RAD10 (ref. 1). Mutations in the
      two genes inactivate nucleotide excision repair and result in a reduced
      efficiency of mitotic recombinational events between repeated sequences. The
      Rad10 protein has a stable and specific interaction with Rad1 protein and also
      binds to single-stranded DNA and promotes annealing of homologous single-stranded
      DNA. The amino-acid sequence of the yeast Rad10 protein is homologous with that
      of the human excision repair gene ERCC1 (ref. 3). Here we demonstrate that a
      complex of purified Rad1 and Rad10 proteins specifically degrades single-stranded
      DNA by an endonucleolytic mechanism. This endonuclease activity is presumably
      required to remove non-homologous regions of single-stranded DNA during mitotic
      recombination between repeated sequences as previously suggested, and may also be
      responsible for the specific incision of damaged DNA during nucleotide excision
      repair.

PMID- 8479527
TI  - Problems in Italy.

PMID- 8479528
TI  - A revived opportunity for fetal research.

PMID- 8479529
TI  - The dark side of molecular biology.

PMID- 8479530
TI  - Signal transduction. How receptors turn Ras on.

PMID- 8479531
TI  - Structural biology. Max in a complex affair.

PMID- 8479532
TI  - Cerebellar flocculus hypothesis.

PMID- 8479533
TI  - Study proves Iraq used nerve gas.

PMID- 8479534
TI  - Recognition by Max of its cognate DNA through a dimeric b/HLH/Z domain.
AB  - The three-dimensional structure of the basic/helix-loop-helix/leucine zipper
      domain of the transcription factor Max complexed with DNA has been determined by
      X-ray crystallography at 2.9 A resolution. Max binds as a dimer to its
      recognition sequence CACGTG by direct contacts between the alpha-helical basic
      region and the major groove. This symmetric homodimer, a new protein fold, is a
      parallel, left-handed, four-helix bundle, with each monomer containing two alpha
      helical segments separated by a loop. The two alpha-helical segments are composed
      of the basic region plus helix 1 and helix 2 plus the leucine repeat,
      respectively. As in GCN4, the leucine repeat forms a parallel coiled coil.

PMID- 8479535
TI  - Glowing report may not avert closure of Dutch primate centre.

PMID- 8479536
TI  - Association of Sos Ras exchange protein with Grb2 is implicated in tyrosine
      kinase signal transduction and transformation.
AB  - The proteins Grb2-Sem-5, Shc and Sos have been implicated in the signalling
      pathway from tyrosine kinase receptors to Ras. Grb2-Sem-5 binds directly to
      murine Sos1, a Ras exchange factor, through two SH3 domains. Sos is also
      associated with ligand-activated tyrosine kinase receptors which bind Grb2-Sem-5,
      and with the Grb2-Sem-5 binding protein, Shc. Ectopic expression of Drosophila
      Sos stimulates morphological transformation of rodent fibroblasts. These data
      define a pathway by which tyrosine kinases act through Ras to control cell growth
      and differentiation.

PMID- 8479537
TI  - Stolen report alleging discrimination and favouritism in NIH office raises
      furore.

PMID- 8479538
TI  - Transgenic N. glauca plants expressing bacterial virulence gene virF are
      converted into hosts for nopaline strains of A. tumefaciens.
AB  - Tumours are induced by Agrobacterium tumefaciens on a variety of plants. The
      virulence determinants of A. tumefaciens reside on a large tumour-inducing (Ti)
      plasmid. This plasmid carries two regions essential for tumour induction, namely
      the T region and the Vir region. During infection the T region is transferred to
      the plant cell, where it becomes stably integrated in one of the host chromosomes
      as T-DNA. Expression of T-DNA leads to the production of the plant hormones auxin
      and cytokinin, as well as to the synthesis of specific amino-acid derivatives
      termed opines. Agrobacterium strains are classified according to the types of
      opines produced by the tumours they induce. The Vir region contains genes that
      are expressed in the bacterium and are required for T-DNA transfer to plant
      cells, and several other genes that affect the efficiency of transfer and the
      host range. Vir regions from different Ti plasmids may vary slightly in the genes
      they contain: for instance, the virF gene, which is present in the Vir-region of
      octopine Ti plasmids, is absent from nopaline Ti plasmids. Mutation of the virF
      gene leads to a weakened virulence of octopine strains on tomato and Nicotiana
      glauca (shrub tobacco). Nopaline strains are strongly attenuated in N. glauca
      compared with octopine strains because of the absence of the virF virulence gene
      from the Ti plasmid in nopaline strains. The virF gene product may be transferred
      to and be active in plant cells. Here we isolate transgenic N. glauca plants in
      which the virF coding sequence is expressed using the cauliflower mosaic virus
      35S promoter. The presence of the VirF protein converts the non-host N. glauca
      into a host for tumour formation by A. tumefaciens nopaline strains and octopine
      virF mutants. Our results indicate that certain virulence gene products such as
      the VirF protein may be transferred to plant cells during tumour induction, where
      they function as mediators of T-DNA transfer.

PMID- 8479539
TI  - Spatial calcium buffering in saccular hair cells.
AB  - The potential importance of intracellular calcium-binding proteins in rapid and
      highly localized Ca2+ signalling is poorly understood. During fast synaptic
      transmission, which occurs at specialized active zones where Ca2+ diffuses only a
      few tens of nanometers from channels to neurotransmitter release sites, a
      cytoplasmic Ca2+ buffer would have to be extremely fast or present in millimolar
      concentrations to intercept a significant fraction of the calcium ions en route
      to their targets. Therefore, Ca2+ buffers have been presumed to be unimportant in
      fast exocytosis and another fast calcium-mediated process, electrical resonance
      in hair cells. Here I present evidence to the contrary by showing that hair cells
      in the frog sacculus contain millimolar concentrations of a mobile cytoplasmic
      calcium buffer that captures Ca2+ within a few microseconds after it enters
      through presynaptic Ca2+ channels and carries it away from the point of entry.
      This spatial buffering reduces the presynaptic free Ca2+ by up to 60 per cent and
      probably restricts the region in which the internal calcium ion concentration
      exceeds 1 microM to within < 250 nm of each synaptic site. The buffer can thus
      influence both electrical resonance and synaptic transmission. Calbindin-D28K or
      a related protein may serve as the mobile calcium buffer, an action similar to
      its function in transporting Ca2+ across intestinal epithelial cells.

PMID- 8479540
TI  - The SH2 and SH3 domains of mammalian Grb2 couple the EGF receptor to the Ras
      activator mSos1.
AB  - Many tyrosine kinases, including the receptors for hormones such as epidermal
      growth factor (EGF), nerve growth factor and insulin, transmit intracellular
      signals through Ras proteins. Ligand binding to such receptors stimulates Ras
      guanine-nucleotide-exchange activity and increases the level of GTP-bound Ras,
      suggesting that these tyrosine kinases may activate a guanine-nucleotide
      releasing protein (GNRP). In Caenorhabditis elegans and Drosophila, genetic
      studies have shown that Ras activation by tyrosine kinases requires the protein
      Sem-5/drk, which contains a single Src-homology (SH) 2 domain and two flanking
      SH3 domains. Sem-5 is homologous to the mammalian protein Grb2, which binds the
      autophosphorylated EGF receptor and other phosphotyrosine-containing proteins
      such as Shc through its SH2 domain. Here we show that in rodent fibroblasts, the
      SH3 domains of Grb2 are bound to the proline-rich carboxy-terminal tail of mSos1,
      a protein homologous to Drosophila Sos. Sos is required for Ras signalling and
      contains a central domain related to known Ras-GNRPs. EGF stimulation induces
      binding of the Grb2-mSos1 complex to the autophosphorylated EGF receptor, and
      mSos1 phosphorylation. Grb2 therefore appears to link tyrosine kinases to a Ras
      GNRP in mammalian cells.

PMID- 8479542
TI  - Germany revamps system to fund medical research.

PMID- 8479541
TI  - Guanine-nucleotide-releasing factor hSos1 binds to Grb2 and links receptor
      tyrosine kinases to Ras signalling.
AB  - Many of the actions of receptor tyrosine kinases are mediated by the protein Ras,
      including the activation of various downstream serine/threonine kinases and the
      stimulation of growth and differentiation. The human protein Grb2 binds to ligand
      activated growth factor receptors and downstream effector proteins through its
      Src-homology (SH) domains SH2 and SH3, respectively, and like its homologue from
      Caenorhabditis elegans, Sem-5, apparently forms part of a highly conserved
      pathway by which these receptors can control Ras activity. Here we show that the
      SH3 domains of Grb2 bind to the carboxy-terminal part of hSos1, the human
      homologue of the Drosophila guanine-nucleotide-releasing factor for Ras, which is
      essential for control of Ras activity by epidermal growth factor receptor and
      sevenless. Moreover, a synthetic 10-amino-acid peptide containing the sequence
      PPVPPR specifically blocks the interaction. These results indicate that the
      Grb2/hSos1 complex couples activated EGF receptor to Ras signalling.

PMID- 8479543
TI  - Montagnier to assess French AIDS effort.

PMID- 8479544
TI  - 5-HT3 receptor ligands lack modulatory influence on acetylcholine release in rat
      entorhinal cortex.
AB  - The objective of this study was to explore the role of 5-HT3 receptors in
      modulating potassium (K+)-evoked release of [3H]-acetylcholine ([3H]-ACh) from
      superfused slices of rat entorhinal cortex previously loaded with [3H]-choline.
      Rat entorhinal cortices were cross-chopped into 300 microns slices, superfused
      with oxygenated Krebs buffer containing 2.5 mmol/l Ca2+ and stimulated with two
      consecutive exposures of 20 mmol/l K+ for 4 min (S1 and S2, respectively).
      Compounds were added 20 min before S2 stimulation and remained in the superfusion
      buffer for the duration of the experiment. The S2/S1 ratio was then calculated.
      Stimulated release of [3H]-ACh was dependent on extracellular Ca2+ and K+
      concentration. In Sprague Dawley rats, 2-methyl-5-HT (10(-9)-10(-6) mol/l), in
      the presence of 1 mumol/l ritanserin or 1 mumol/l ondansetron, had no influence
      on K(+)-evoked release of [3H]-ACh. In slices prepared from Hooded Lister rats, 2
      mumol/l 5-HT but not 2-Me-5-HT significantly (P < 0.05) inhibited K(+)-evoked
      [3H]-ACh release only 17% in the presence of 1 mumol/l ritanserin. However, 2
      mumol/l 2-Me-5-HT plus 1 nmol/l ondansetron had no effect. High performance
      liquid chromatography coupled to electrochemical detection (HPLC-ECD) was used to
      monitor endogenous release of ACh in the above conditions to confirm data from
      the radiolabelled experiments. No significant inhibition or increase in K(+)
      evoked ACh release was observed with either 5-HT3 receptor agonists or
      antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479545
TI  - Autoradiographic mapping of 5-HT1 receptors in the guinea-pig brain with
      particular reference to the 5-HT1D receptor sites.
AB  - The anatomical distribution of 5-HT1 receptors in the guinea-pig brain was
      studied by means of in vitro quantitative autoradiography using [3H]-5-HT as
      ligand. The relative presence of the subtypes of the 5-HT1 binding site was
      investigated by adding selective concentrations of 8-OH-DPAT, (-)21,009,
      mesulergine and 5-CT. In addition, differentiation of 5-HT1D receptors was
      achieved by incubation of the tissues with [3H]-5-HT in the presence of 100
      nmol/l 8-OH-DPAT together with 100 nmol/l mesulergine. Areas presenting high
      densities of 5-HT1A receptors included the neocortex (internal layers),
      hippocampal formation (dentate gyrus, CA1 field), septum and raphe nuclei, while
      5-HT1C sites accounted for most of the [3H]-5-HT binding to the choroid plexus.
      Non 5-HT1A-non 5-HT1C sites (mainly 5-HT1D and, also probably, 5-HT1E receptors)
      were clearly predominant in the guinea-pig brain. These sites were mainly present
      in the neocortex (external layers), basal ganglia, hypothalamus and midbrain
      (substantia nigra, superior colliculus). As previously described, sites with the
      properties of 5-HT1B receptors could not be clearly identified in the guinea-pig
      brain. The present results, in addition to providing a detailed map of the 5-HT1
      receptors in the guinea-pig brain, indicate that the guinea-pig is a useful
      laboratory animal for the study of 5-HT1D receptors.

PMID- 8479546
TI  - Anorectic effect and brain concentrations of D-fenfluramine in the marmoset:
      relationship to the in vivo and in vitro effects on serotonergic mechanisms.
AB  - The present study investigated the anorectic activity of d-fenfluramine (d-F) and
      the relationship with brain levels of unchanged drug and its metabolite d
      norfenfluramine (d-NF) in marmosets, relating them to neurochemical effects on
      the serotoninergic system. d-F and d-NF were equally active in reducing food
      intake (ED50 about 3 mg/kg, p.o.). However, the brain concentrations of the
      metabolite required to reduce food intake after synthetic d-NF were more than
      twice those after d-F, indicating that d-NF contributes to but does not
      completely explain the anorectic effect of d-F. At this dose d-F did not
      appreciably modify the serotonin (5-HT) and 5-hydroxyindoleacetic (5-HIAA)
      contents of the brain regions examined, except for a slight enhancement of 5-HIAA
      in hippocampus. In vitro in brain cortical synaptosomes d-F inhibited [3H]5-HT
      uptake more potently than d-NF, as in other species. d-F and d-NF showed similar
      potency in stimulating [3H]5-HT release, in a Ca++ dependent manner. The tritium
      released by d-F and d-NF appeared to be mainly unmetabolized [3H]5-HT. Like in
      other species the marmoset too has saturable and specific [3H]d-F binding sites,
      for which d-NF has lower affinity. d-F and d-NF have low affinities for 5-HT
      receptor subtypes, except that d-NF has appreciable affinity for 5-HT1C and 5
      HT1D receptors. Unlike in rodents but similarly to primates in the striatum the
      pharmacology of 5-HT receptors seems to correspond to the 5-HT1D
      subtype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479548
TI  - German Society of Pharmacology and Toxicology, 34th spring meeting. Mainz, 16-18
      March 1993. Abstracts.

PMID- 8479549
TI  - Implementing a mandatory drug screening program: pros and cons for the dialysis
      unit.

PMID- 8479550
TI  - States tighten grip on limiting physician self-referral, but exceptions for
      referring to renal care facilities are seen.

PMID- 8479547
TI  - A target K+ channel for the LP-805-induced hyperpolarization in smooth muscle
      cells of the rabbit portal vein.
AB  - The resting membrane potential of smooth muscle cells of the rabbit portal vein
      was -51.2 mV. LP-805 (8-tert-butyl-6,7-dihydropyrrolo[3,2-e] 5-methylpyrazolo
      [1,5-a] pyrimidine-3-carbonitrile) hyperpolarized the membrane to -62.3 mV (10
      microM) and inhibited the burst spike discharges as measured using the
      microelectrode method. In dispersed smooth muscle cells, LP-805 (10 microM)
      generated an outward-current with a maximum amplitude of 68 pA at a holding
      potential of -40 mV in experiments using the voltage-clamp procedure. The
      reversal potential of the outward current evoked by LP-805 was -82 mV and this
      value was close to the equilibrium potential for K+ (-80 mV) in the present ionic
      conditions, suggesting that LP-805 activated the K+ channel. Generation of both
      the hyperpolarization and the outward current by LP-805 was inhibited by
      glibenclamide (> or = 1 microM). Using the cell-attached and cell-free patch
      clamp (in the presence of GDP) procedures, the maxi-K+ channel current (150 pS)
      could be recorded in the absence of LP-805; application of LP-805 additionally
      opened a small conductance K+ channel current (15 pS) without change in the
      activity of the maxi-K+ channel. The maxi-K+ channel was sensitive to
      charybdotoxin (0.1 microM) and to intracellular Ca2+ ([Ca2+]i) concentration. The
      15 pS channel was insensitive to [Ca2+]i and charybdotoxin, but sensitive to
      intracellular ATP concentration. Glibenclamide (> 1 microM) inhibited the 15 pS
      K+ channel activated by LP-805.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479551
TI  - Putting data to work.

PMID- 8479552
TI  - Clinton hopes managed competition will slow runaway health care train.

PMID- 8479553
TI  - Plenty of questions still remain on Clinton's approach to health care reform.

PMID- 8479555
TI  - Special travel agencies/summer camps for dialysis and transplant patients.

PMID- 8479554
TI  - Transplant recipients share expression of music, photography, painting, and
      writing.

PMID- 8479556
TI  - Ethics and economics: a tug-of-war for the renal care team?

PMID- 8479557
TI  - Ethics and economics: a tug-of-war for the renal care team?

PMID- 8479559
TI  - True reform not likely until '95, but it's coming.

PMID- 8479558
TI  - TB--will history repeat itself?

PMID- 8479560
TI  - FOB, FOH, but in 1993, who is a FOM? (Friend of Bill, friend of Hillary, friend
      of medicine).

PMID- 8479562
TI  - Defining the important ingredients of a quality laboratory.

PMID- 8479561
TI  - With education, intervention by family physicians can prevent kidney disease.

PMID- 8479563
TI  - Looking back: 14 years as a renal social worker.

PMID- 8479564
TI  - [Dehydration in geriatrics: dry stuff?].

PMID- 8479565
TI  - [Report by the Health Council on dialysis and kidney transplantation].
AB  - The Health Council of the Netherlands has summarised the developments regarding
      dialysis and renal transplantation over the period 1985-1990, and estimated the
      numbers of patients and transplantations for 1995. Currently 21% of the patients
      are treated with peritoneal dialysis. In 1991 53% of patients undergoing
      haemodialysis in a specialised centre were dialysed only twice weekly. The figure
      for the patients being dialysed thrice weekly may rise to 75% in 1995. The number
      of renal transplantations may rise from 28/million inhabitants in 1991 to
      35/million in 1995, which is the figure in the surrounding countries. In that
      case, the prospective number of dialysis patients in 1995 is 3600; if there is no
      increase in the number of transplantations, it will be 3790. At this moment 1400
      patients are waiting for transplantation; the mean waiting time is > 3 years.

PMID- 8479566
TI  - [Dehydration in geriatric patients; pathophysiology, diagnosis, therapy and
      prevention].

PMID- 8479567
TI  - [Islet amyloid polypeptide or amylin; breakthrough in the diagnosis and
      prevention of type II diabetes mellitus?].

PMID- 8479568
TI  - [Do foods specially intended for diabetics have any health benefit?].

PMID- 8479569
TI  - [Shockwave lithotripsy in the pancreas; the first 16 patients treated in
      Rotterdam-Dijkzigt].
AB  - Sixteen patients, 7 women and 9 men, with a mean age of 42 years and with
      recurrent attacks of abdominal pain as a result of chronic calcifying
      pancreatitis, were treated with extracorporeal shock wave lithotripsy (ESWL),
      after endoscopical removal of one or more stones from the main pancreatic duct
      had proved impossible. In all patients fragmentation by ESWL of the stone
      situated farthest distally was attempted, after which the remaining calculi and
      fragments could be voided spontaneously or could be flushed via a drain placed
      endoscopically in the main pancreatic duct. In 12 patients (75%) fragmentation of
      stones was achieved, 11 of them had a dramatic relief of pain immediately after
      ESWL. In 7 patients (44%) stone clearance was achieved; at follow-up (1-38 months
      after ESWL) none of these had complaints. Of the 5 patients with stone
      fragmentation without stone clearance, 2 were operated on because of recurrent
      symptoms. The only complication seen after ESWL, was an exacerbation of
      pancreatitis in 1 patient, which could be treated conservatively. If pancreatic
      stones cannot be removed endoscopically, ESWL appears to be an attractive
      alternative to an operation. It is important to achieve stone clearance.

PMID- 8479570
TI  - [Results of 4 years of gallstone lithotripsy].
AB  - OBJECTIVE: Determination of the efficacy of extracorporeal shock wave lithotripsy
      (ESWL) of gallbladder stones and adjuvant treatment with oral bile acids.
      SETTING: Department of Surgery, University Hospital Dijkzigt, Rotterdam, the
      Netherlands. DESIGN: Descriptive clinical research. PATIENTS AND METHODS: In 4
      years, 133 patients (34 males and 99 females, mean age 49 years (range 24-81))
      underwent 299 ESWL sessions, on an outpatient basis except for the first 16. All
      patients received adjuvant oral bile acid therapy (7-8 mg/kg body weight urso-
      and chenodeoxycholic acid, starting one day after ESWL). The number of ESWL
      sessions was 2.5 (mean; range: 1-7) with 2817 shock waves (75-4000), a session
      duration of 62 min (35-210). 73.7% of the patients (n = 98) required intravenous
      analgesic sedation. RESULTS: At a mean follow-up of 13.8 months (1-45), 27.6% of
      the patients were free of stones. At 1 year after the first ESWL session, 51.0%
      of the patients with a solitary stone and 8.3% of the patients with 2-10 stones
      were free of stones (p < 0.0001). Of the 43 patients who had become free of
      stones 6 developed recurrent stones (14.0%). Fifty-seven patients (42.9%)
      suffered from colic, 9 (6.8%) from obstruction of the common bile duct, including
      4 who developed pancreatitis. Two patients had transient haematuria and one acute
      cholecystitis; 15 (11.3%) suffered from an oral bile acid-related diarrhoea,
      which could easily be resolved by lowering the dose of chenodeoxycholic acid. 30
      patients (22.6%) underwent cholecystectomy. CONCLUSIONS: Our results reconfirm
      that ESWL is safe and moderately effective in selected patients. Nowadays most
      patients choose laparoscopic cholecystectomy, which implies that ESWL will be
      confined to patients with an increased operative risk and to those who refuse
      surgery. ESWL should be limited to patients with solitary stones.

PMID- 8479571
TI  - [Dutch psychiatry and the 'Citation Index'].
AB  - All regular articles in Archives of General Psychiatry, American Journal of
      Psychiatry, British Journal of Psychiatry and Psychological Medicine from 1988
      through 1992 were counted and classified according to the country of the first
      author. 445 articles (II% of the total number) originated in other countries than
      the U.S.A., Canada, the United Kingdom and the Commonwealth countries Australia
      and New Zealand. The Netherlands had the biggest share (48 articles). After
      correction for population figure the Netherlands were third, after Ireland and
      Israel. The basis for research in Dutch psychiatry, however, is probably rather
      narrow, as only few institutes contributed.

PMID- 8479572
TI  - [How can reinfection by Gardnerella vaginalis be prevented?].

PMID- 8479573
TI  - [Surgical correction of urinary incontinence and (or) prolapse symptoms].

PMID- 8479574
TI  - [The treatment of erection disorders].

PMID- 8479575
TI  - [Aberrant origin of the left coronary artery from the pulmonary artery as cause
      of ventricular fibrillation in a young woman].

PMID- 8479576
TI  - [Thin is not always fashionable].

PMID- 8479577
TI  - Women at risk of family violence.
AB  - Presented here are the basic, core picture and pathognomonic features of spouse
      (or partner) violence, stripped of obscuring traditional, often male-dominated
      misinformation. Spouse abuse, like other forms of intentional injury or violence,
      should no longer be considered tolerable or "normal." It represents a form of
      psychopathology, corrupting the family emotional setting, provoking human anguish
      and even death. It often perpetuates itself into the next generation. Assault or
      murder by an abusive male or lover must be recognized as an all too common,
      preventable, public health issue. Health care and legal professionals, as well as
      the public at large, must be informed to recognize the features of this tragic
      family drama. State laws and welfare agencies have started to accommodate this
      problem, directing victims to appropriate counseling, support and protection.
      Reluctant or passive police, attorneys and judges may present considerable
      frustration to those trying to assist these families.

PMID- 8479578
TI  - Price comparison between Nebraska rural and urban hospitals for delivery of
      health services.

PMID- 8479579
TI  - Toxic strep syndrome.

PMID- 8479580
TI  - Intrapartum analgesia.

PMID- 8479581
TI  - Sentimental women need not apply. From the president.

PMID- 8479582
TI  - Nurses are the ones who are really caring for our patients.

PMID- 8479583
TI  - ANA position statement on registered nurse utilization of unlicensed assistive
      personnel.

PMID- 8479584
TI  - Long-term care for young and old must be part of health care reform, says ANA.

PMID- 8479585
TI  - [Associative networks, formal thought disorders and schizophrenia. On the
      experimental psychopathology of speech-dependent thought processes].
AB  - Association psychology research in psychiatry dates back to Kraepelin,
      Aschaffenburg and C.G. Jung. Findings of the 1950s and 60s in this field suggest
      that semantic memory is organized in the form of a network. New results of
      experimental psychiatric studies indicate that schizophrenic symptoms, in
      particular formal thought disorders, are in part the result of an unfocussed
      activation or disinhibition of such associational network structures: The
      phenomenon of semantic priming is more pronounced in schizophrenic patients than
      in normals. Moreover, the phenomenon of indirect semantic priming on short
      stimulus onset asynchrony can be seen only in schizophrenic patients. The study
      of spontaneous speech further suggests the activation of structures responsible
      for the storage and processing of meaning. Increase in semantic priming, similar
      to that observed in schizophrenia, can further be observed in normal subjects on
      awakening from REM sleep. The findings are discussed in the framework of recent
      findings on the neurobiological causes of schizophrenia. They can be related
      structurally to an involvement of the frontal lobe, and functionally to
      disturbances of dopaminergic transmission. Methods such as the investigation of
      priming effects in lexical decision tasks, as well as concepts from the domain of
      cognitive neuroscience such as neural networks and the spreading activation model
      of lexical access, can help to bridge the gap between phenomenological
      psychopathology and neurobiology.

PMID- 8479586
TI  - [Validation of diagnoses according to psychiatric diagnostic manuals in follow-up
      studies, exemplified by affective and schizophrenic diseases].
AB  - The new international classification schedules ICD-10 and DSM-III-R were
      developed by committees of experts. These schedules need to be validated. One
      strategy is to conduct prospective long-term follow-up studies recruiting
      patients with a broad variety of syndromes diagnosed initially by previous and
      more recent classification schedules. Studies following this strategy are
      discussed and a new two-year follow-up study is presented. Several modifying
      psychosocial and treatment factors and methodological problems impose limitations
      on the interpretation of those studies with regard to the validity of applied
      classification schedules. Alternative validation strategies are discussed.

PMID- 8479587
TI  - [Multiple personality disorder: old concepts presented as new].
AB  - The rapid increase in numbers of MPD patients in the Anglo-American literature
      requires discussion of the diagnostic concept. The classification of MPD as
      Dissociative Disorders by DSM-III-R and ICD-10 follows the traditional
      conceptualization of hysteria and hypnosis. In the view of the majority of modern
      authors child abuse appears as a new etiological issue. This theme highly
      sensitive is critically discussed against the background of older
      psychopathological concepts of forgetting. A careful analysis of personality
      traits and motivation in the individual case help to avoid overuse of the new
      diagnostic label.

PMID- 8479588
TI  - [Prognosis of puerperal psychoses: follow-up and outcome after an average of 26
      years].
AB  - 61 women, who became ill for the first time in their life within 6 weeks after
      childbirth were investigated after a mean of 25.6 years (minimum 12, maximum 41
      years), using various standardised instruments of evaluation. A total of 39
      Patient (63.9%) had had a recurrence of illness, the average number of further
      episodes being 4.8. 31 of the women had had additional pregnancies and
      deliveries, and 8 of these (25.8%) had suffered another postpartum psychosis.
      23.5% of the patients who had reached or passed the climacteric became ill again
      in close connection with that time (first time after the postpartum psychosis or
      first time after a relapse-free interval of more than 12 years). 72.1% of the
      patients were symptom-free at the time of follow-up, only 17 (27.9%) showed
      persisting alterations (13.1% "adynamic-deficient syndrome", 9.8% "slight
      asthenic insufficiency syndrome", 4.9% "chronic subdepressive syndrome").
      Considering also the findings according to the Global Assessment Scale (GAS) and
      Disability Assessment Schedule (WHO/DAS) the long-term outcome was found to be
      favourable in the majority of cases, with regard to the frequency and intensity
      of disability and persisting alterations.

PMID- 8479589
TI  - [Effect of therapy variables on suicide of released psychiatric clinic patients.
      Results of a controlled study].
AB  - We studied therapeutic factors influencing the risk of suicide during outpatient
      treatment. A total of 64 former psychiatric inpatients who had committed suicide
      within one year after their discharge were compared with the same number of
      control patients fulfilling the following matching criteria: sex, age, RDC
      diagnosis, year of discharge and length of observation period. There were no
      significant differences between the two groups in psycho-social or clinical pre
      discharge variables including previous suicidal behavior, but the suicide
      subjects became more frequently suicidal during the post-discharge outpatient
      treatment. The formal conditions of the treatment were comparable in both groups.
      However, the control patients were treated by therapists with substantially
      longer professional experience and they also more frequently received
      psychopharmacological agents including lithium.

PMID- 8479590
TI  - [Empirical findings on the personality structure of borderline patients].
AB  - In the present study the question of personality structure in borderline patients
      is studied empirically. The "Diagnostic Interview for Borderlines" of Gunderson
      and Kolb is used to classify the patients. In an inpatient sample of borderline
      patients (n = 26) the clinical diagnoses of personality structure according to
      psychoanalytic criteria are investigated and compared to those of an inpatient
      sample of patients with neurotic disorders (n = 24). According to the results
      most of the borderline patients (88%) had received a diagnosis of a schizoid
      personality structure according to psychoanalytic criteria, in contrast to the
      neurotic patients. The results are compared to those of studies using descriptive
      psychiatric criteria.

PMID- 8479591
TI  - [Are visual and auditory perception modified in psychopathological assessment of
      expressive markers of psychiatric patients?].
AB  - The assessment of nonverbal expression (e.g. facial action, speech, body
      movements, etc.) are an important aspect of the diagnostic and prognostic process
      in psychiatric patients. By means of observer rating scales' expression is
      usually assessed on different observation levels. It appears that visual and
      auditory perception of expression interfere with one other. In the present study
      it was demonstrated, that ratings of certain attributes of expression was
      significantly more inconsistent in schizophrenic than in depressed patients,
      provided information was simultaneously displayed to both visual and auditory
      channels of perception. A "disintegration" of the components of expression in
      schizophrenics may explain why raters get differings impressions of the patient's
      overall expression. Moreover, the description of expressive behaviors seems to be
      influenced by diagnostic stereotypes. The development of a more objective method
      of assessment would therefore be promising.

PMID- 8479592
TI  - [A case of "delusional growth". On the origin and nosologic classification of
      somatic dysmorphic disorder].

PMID- 8479593
TI  - [Are phase II or phase II antidepressive drug studies still feasible considering
      currently required inclusion and exclusion criteria?].
AB  - The present policy of pharmaceutical companies to aim at perfectionistic, and
      therefore inflexible protocols for clinical drug-trials renders patient
      recruitment increasingly difficult or even impossible, and may result in an
      increasing number of non-completed studies. It appears that many of today's
      inclusion and exclusion criteria are not sufficiently assessed in terms of their
      scientific basis and clinical usefulness. Sense and nonsense of these criteria
      are discussed. The tendency to adhere to streamlined protocols to certify the
      needs of drug regulators will severely impair the feasibility and validity of
      antidepressant drug trials in psychiatric in-patients.

PMID- 8479594
TI  - [Successful hyposensitization treatment of a patient with schizoaffective
      psychosis and carbamazepine allergy].
AB  - For the prevention of relapse in a 25 year old man with schizoaffective
      psychosis, lithium was prescribed but had to be discontinued because the patient
      developed psoriasis. Carbamazepine was started but had to be discontinued as the
      patient developed a generalized substance-induced skin rush. A six-week
      desensitization procedure with increased oral doses, starting with 1 mg per day,
      allowed relapse prevention with carbamazepine on a usual dosage. To our
      knowledge, this is the first report of a successful desensitization of a
      psychiatric patient with carbamazepine allergy.

PMID- 8479595
TI  - [Wilhelm Griesinger and the Stuttgart community hospital--experiences with
      community care. Comments on the contribution by W. Rossler. Wilhelm Griesinger
      and community care].

PMID- 8479597
TI  - Regulation of malate dehydrogenases from neonatal, adolescent, and mature rat
      brain.
AB  - Since the malate-aspartate shuttle in brain has been shown to be closely linked
      to brain energy metabolism and neurotransmitter synthesis, the activity of MDH,
      one of the enzymes of the malate-aspartate shuttle, was studied in cortical non
      synaptic mitochondria (mMDH) and cytosol (cMDH) in 1-4 day, 18-20 day and 7-8
      week old rats. The mean mMDH activity (nmol/min/mg protein) was 10,517 +/- 734
      (mean +/- SEM), 8,882 +/- 241 and 10,323 +/- 561 and cMDH activity was 2,453 +/-
      99, 4,673 +/- 152 and 6,821 +/- 205 in 1-4 day, 18-20 day and 7-8 week old rats,
      respectively. While cMDH activity increased with age (p < 0.0001), mMDH activity
      showed no change. This study also determined if endogenous compounds, previously
      shown to alter malate metabolism, affected MDH activities. Lactate inhibited only
      cMDH activity, by a competitive mechanism. Oxaloacetate inhibited mMDH by partial
      non-competitive inhibition and cMDH by competitive inhibition. Alpha
      ketoglutarate competitively inhibited both enzymes; however, the inhibition of
      mMDH activity was more pronounced than that of cMDH activity. Citrate inhibited
      mMDH via an uncompetitive mechanism and cMDH via a noncompetitive mechanism. The
      mechanisms of inhibition of mMDH and cMDH by each of the effectors were the same
      over the three ages. The results suggest mMDH and cMDH activities show a
      dissimilar developmental pattern and may be regulated differently by endogenous
      effectors. The greater sensitivity of mMDH, compared to cMDH, to certain
      effectors may be related to the dual role of mMDH in the tricarboxylic acid cycle
      and the malate-aspartate shuttle.

PMID- 8479596
TI  - Is ammonia a pathogenetic factor in Alzheimer's disease?
AB  - An attempt was made to review experimental evidence in favor of the idea that
      ammonia plays a role in dementia of the Alzheimer type (DAT). Hyperammonemia
      causes biochemical and cellular dysfunctions in the brain, which can be found in
      brains of DAT patients. The most conspicuous among these findings are
      astrocytosis, impairment of glucose utilization, and a decreased rate of energy
      metabolism, and the impairment of neurotransmission, with a net increase in
      excitability and glutamate release. The derangement of lysosomal processing of
      proteins is another potential site of ammonia action. This aspect is especially
      important in view of the growing evidence for the role of the endosomal-lysosomal
      system in the formation of amyloidogenic fragments from beta-amyloid precursor
      protein. Ammonia is not considered a primary factor of the disease. However,
      since hyperammonemia and release of ammonia from the brains of DAT patients is
      well supported by published observations, ammonia should be taken into account as
      a factor that contributes to manifestations and the progression of DAT. If
      elevated ammonia concentrations turn out to be indeed as important in DAT, as is
      suggested in this review, rational therapeutic avenues can be envisaged that lead
      to the amelioration of symptoms and progression of the disease.

PMID- 8479598
TI  - Abundant Gs alpha mRNA in basket cells of the dentate gyrus in adult rat
      hippocampus.
AB  - In situ hybridization histochemistry (ISHH) has been used to study the
      differential distribution and relative abundance of mRNAs encoding a stimulatory
      alpha subunit of the G-protein (Gs alpha) and glutamic acid decarboxylase (GAD)
      in the dorsal hippocampus in adult rat brain. The present quantitative study
      shows that GABAergic neurons containing high levels of GAD mRNA, express
      considerably more Gs alpha message than excitatory principal neurons, the granule
      cells of the dentate gyrus and the pyramidal cells of CA1 subfield. A
      subpopulation of basket cells of the dentate gyrus exhibited a uniquely high
      level of Gs alpha mRNA, in addition to GAD. These findings may indicate a
      specific functional role for Gs alpha in these GABAergic neurons in the
      hippocampus.

PMID- 8479599
TI  - Nuclear benzodiazepine binding: possible interaction with thyroid hormone
      receptors.
AB  - The biochemical and pharmacological properties of nuclear [3H]flunitrazepam in
      brain tissues were studied. Nuclear [3H]flunitrazepam binding is saturable for
      both central and peripheral binding sites. Inosine and hypoxanthine displace
      nuclear [3H]flunitrazepam binding with greater potency than the membrane
      [3H]flunitrazepam binding. Triiodothyronine (T3) increases the maximum number of
      binding sites (Bmax) of nuclear [3H]flunitrazepam binding in vitro while
      thyroxine (T4) does not have any effect. Diazepam reduces the affinity of nuclear
      125I-T3 binding in vitro, while the Bmax is not affected significantly. Mild
      digestion of chromatin, using micrococcal nuclease, reveals that a major portion
      of nuclear [3H]flunitrazepam binding sites are located on chromatin. These data
      suggest a functional role for nuclear benzodiazepine binding and a possible
      modulatory effect of benzodiazepines on T3 binding with its nuclear receptors.

PMID- 8479600
TI  - Naphthalenesulfonamide derivatives ML9 and W7 inhibit catecholamine secretion in
      intact and permeabilized chromaffin cells.
AB  - The role of protein phosphorylation in catecholamine secretion from bovine
      adrenomedullary chromaffin cells was studied using different protein kinase
      inhibitors. Naphthalenesulfonamide derivatives as ML9 and ML7, more specific for
      the myosin light chain kinase, and the calmodulin antagonist W7 inhibited
      catecholamine secretion 20 and 40% respectively in digitonin-permeabilized
      chromaffin cells. ML9 also decreased calcium evoked protein phosphorylation of
      different proteins including tyrosine hydroxylase in permeabilized cells. These
      naphthalenesulfonamide derivatives showed also an effect in intact cells, ML9 and
      W7 produced 50% inhibition in catecholamine secretion and 45Ca2+ uptake, however
      H8 had no effect. The partial [3H]nitrendipine binding displacement of these
      drugs to adrenomedullary membranes suggests that these sulfonamide derivatives
      could interact directly with L-type calcium channels in intact cells. The results
      obtained in permeabilized cells suggest a possible role of protein
      phosphorylation in the regulation of catecholamine secretion in chromaffin cells.

PMID- 8479601
TI  - The effects of L-dopa on the activity of methionine adenosyltransferase:
      relevance to L-dopa therapy and tolerance.
AB  - L-dopa, the major treatment for Parkinson's disease (PD), depletes S-adenosyl-L
      methionine (SAM). Since SAM causes PD-like symptoms in rodents, the decreased
      efficacy of chronic L-dopa administered to PD patients may result from a rebound
      increase in SAM via methionine adenosyl transferase (MAT), which produces SAM
      from methionine and ATP. This was tested by administering intraperitoneally
      saline, or L-dopa to mice and assaying for brain MAT activity. As compared to
      controls, L-dopa (100 mg/kg) treatments of 1 and 2 times per day for 4 days did
      not significantly increase MAT activity. However, treatments of 3 times per day
      for 4 and 8 days did significantly increase the activity of MAT by 21.38% and
      28.37%, respectively. These results show that short interval, chronic L-dopa
      treatments significantly increases MAT activity, which increases the production
      of SAM. SAM may physiologically antagonize the effects of L-dopa and
      biochemically decrease the concentrations of L-dopa and dopamine. Thus, an
      increase in MAT may be related to the decreased efficacy of chronic L-dopa
      therapy in PD.

PMID- 8479602
TI  - Rat brain microsome fluidity as modified by prenatal ethanol administration.
AB  - The fluorescence anisotropy (r) of diphenylhexatriene (DPH) and of trimethylamino
      diphenylhexatriene (TMA-DPH) as a function of temperature (10 degrees to 54
      degrees C) was measured in brain microsomes of newborn rats prenatally exposed to
      ethanol. In this temperature range, the relationship between r and T was linear.
      The addition of ethanol in vitro to microsomal suspensions influenced the slope
      of the line of r versus T only when DPH was used as a probe and with high
      concentrations of the alcohol (> or = 0.3 M). The administration of ethanol (18%
      of total energy intake) in vivo to pregnant dams affected the slope of the lines
      of r versus T of the microsomes of pups, either using DPH or TMA-DPH as probes.
      The slope was also affected in brain microsomes obtained from dams, yet, only
      with TMA-DPH and in the opposite sense than in pups. We conclude that the effect
      of prenatal exposure to ethanol depended on metabolic alterations induced by the
      alcohol and not on its detergent properties for the following reasons: (a) The
      effects in vitro and in vivo were different and (b) in vitro effects could be
      obtained only with high concentrations (> or = 0.3 M), whereas in vivo effects
      were produced by small doses of ethanol. Besides, the effects of the
      administration of the alcohol in vivo were different in adult and intrauterine
      life.

PMID- 8479603
TI  - Actions of a monoclonal antibody Tor 23 on rat brain presynaptic cholinergic
      processes.
AB  - Tor 23 is a monoclonal antibody, generated against cholinergic terminals of the
      Torpedo californica, that has been found to bind to the extracellular surface of
      cholinergic neurons in a variety of tissues. This study shows that Tor 23
      inhibits: 1) high affinity [3H]hemicholinium-3 binding to detergent-solubilized
      membranes prepared from rat neocortices; 2) high affinity [3H]choline uptake in
      rat neocortical and striatal P2 preparations; and 3) [3H]acetylcholine synthesis
      in isolated nerve terminals. Tor 23 does not appear to affect low affinity
      [3H]choline uptake or [3H]acetylcholine release. These results are consistent
      with the hypothesis that Tor 23 may bind to nerve terminal high affinity choline
      transporters in the rat brain.

PMID- 8479604
TI  - Neurotoxicity of 2,4-dichlorophenoxyacetic butyl ester in chick embryos.
AB  - Fertilized hens' eggs were externally treated, before starting incubation, with a
      single dose of 2,4-Dichlorophenoxyacetic butyl ester (2,4-D b.e., 3.1 mg/egg).
      Chicks at different developmental stages were examined, extending from 10 day
      embryos to one day after hatching. Previously, we demonstrated that 2,4-D b.e.
      produces hypomyelination in chicks born from treated eggs. In search of the
      causes of this hypomyelination, "myelin markers" such as sulphatides,
      cerebrosides and 2'3'-cyclic nucleotide 3'-phosphohydrolase (CNPase) activity, as
      well as protein and nucleic acid contents were determined in the embryonic
      brains. We have shown in the present study that the chemical alterations occurred
      even before the period of active myelination, since myelin appears in chicken
      brain stem and cerebrum approximately after 17 days of incubation, and most of
      the chemical parameters studied are diminished before that time. The DNA content
      in brain of treated group is increased from the 14th embryonic day (with a
      transient diminution at 12th day) to the first hatching day, when compared to the
      control, suggesting a proliferation of glial cells, possibly oligodendrocytes.

PMID- 8479605
TI  - Colocalization of progestin receptors with serotonin in raphe neurons of macaque.
AB  - Progesterone stimulates prolactin secretion in estrogen-primed women and monkeys.
      We hypothesize that this effect is neurally mediated since pituitary lactotropes
      do not contain progestin receptors (PR). In rodents, progesterone enhances
      hypothalamic serotonin (5HT) content, and both progesterone and 5HT stimulate
      prolactin and LH secretion. However, it was not known whether progesterone acts
      directly on 5HT neurons or through other neurons. Using a double
      immunocytochemical procedure, we show that 5HT neurons in macaque contain PR and
      thus are a progestin target system. Midbrain tissue blocks were obtained from two
      female monkeys and immersion-fixed prior to freezing and sectioning. PR was
      detected with a monoclonal antibody against human PR (B39) bridged to horseradish
      peroxidase and developed in diaminobenzidine. PR immunoreactivity appeared as a
      brown reaction product which localized in the nuclei of individual neurons. 5HT
      was detected with an antiserum generated against a conjugate of 5HT and BSA
      bridged to alkaline phosphatase. 5HT immunoreactivity appeared as a blue reaction
      product in the cytoplasm and axons of the pontine raphe nucleus. Neurons
      containing both nuclear reaction product for PR and cytoplasmic reaction product
      for 5HT were observed in both the dorsal and ventral aspects of the midbrain
      raphe nucleus as well as the raphe magnus. In summary, progesterone can have a
      direct action on 5HT neuronal function and thereby influence those endocrine and
      affective systems under serotonergic control.

PMID- 8479606
TI  - Chronic ethanol increases proopiomelanocortin gene expression in the rat
      hypothalamus.
AB  - The effect of chronic ethanol exposure on proopiomelanocortin (POMC) mRNA
      accumulation, beta-endorphin (beta-EP) levels as well as incorporation of [3H]
      phenylalanine into beta-EP-related peptides was investigated in the rat
      hypothalamus. Animals were treated with an ethanol-containing liquid diet for 15
      days. Both sucrose pair-fed and ad libitum-fed control groups were included. The
      levels of immunoreactive beta-EP, as well as the relative proportions of
      nonacetyl and acetyl forms of beta-EP in the hypothalami of the ethanol-treated
      rats were not significantly different from those in the sucrose and lab chow fed
      control rats. Northern blot analysis of total hypothalamic RNA indicated that
      ethanol-treated rats had higher POMC mRNA levels than sucrose pair-fed and
      control rats. Quantitation of the in vitro incorporation of [3H]-phenylalanine
      into POMC, beta-lipotropin and beta-EP by the hypothalamus, using
      immunoprecipitation and polyacrylamide disc-gel electrophoresis with sodium
      dodecyl sulfate, revealed that the increased hypothalamic POMC mRNA content was
      associated with increased incorporation of [3H]-phenylalanine into POMC by the
      hypothalami of the ethanol-treated rats. It is concluded that chronic ethanol can
      alter the expression of the POMC gene in the hypothalamus.

PMID- 8479607
TI  - Effects of naloxone on estrogen-induced changes in hypothalamic gonadotropin
      releasing hormone pulse generator activity in the rhesus monkey.
AB  - In the ovariectomized rhesus monkey, estradiol (E2) markedly reduces the
      frequency of the GnRH pulse generator as monitored by LH pulse frequency and the
      concurrent changes in hypothalamic electrical activity, an action mimicked by
      morphine. In addition, the duration of the increments in multiunit electrical
      activity (MUA volleys) that precede each LH pulse is decreased by estrogen
      administration, an action also shared by morphine. The role of endogenous opioids
      in these actions of E2 was investigated in 8 ovariectomized animals restrained in
      primate chairs. They were fitted with indwelling cardiac catheters and with
      bilateral arrays of recording electrodes chronically implanted in the mediobasal
      hypothalamus. Physiological serum E2 levels achieved by subcutaneous implantation
      of E2-containing Silastic capsules increased MUA volley interval from 50.8 +/-
      (SEM) 1.6 min in the control period to 81.1 +/- 6.2 min following E2. Mean MUA
      volley duration decreased from 21.9 +/- 1.0 to 13.0 +/- 0.7 min. The placement of
      empty Silastic capsules had no effect on MUA volley duration or interval.
      Naloxone administration (2.5 mg bolus followed by a 1 mg/h infusion lasting 4-8
      h) completely (n = 4) or partially (n = 2) blocked the effects of E2 on MUA
      volley interval in 6 of the 8 monkeys, and was without effect in the remainder.
      In contrast, however, naloxone had little or no effect on the action of E2 on MUA
      volley duration, (13.0 +/- 0.7 vs. 14.0 +/- 0.9 min). These findings suggest that
      the inhibitory action of E2 on GnRH pulse generator frequency, like that of all
      other gonadal steroids studied to date, may be mediated by endogenous
      opioids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479608
TI  - Enhancing effect of intracerebrally infused beta-endorphin antiserum on the
      secretion of cortisol in foot-shocked sheep.
AB  - It was found in our earlier experiments that infusion of beta-endorphin (beta
      End) into the 3rd brain ventricle in sheep elicited a differential effect on the
      secretion of cortisol under physiological and stress conditions. Under
      physiological conditions it elevated the level of cortisol in the peripheral
      blood, while in stressed animals it suppressed it. To obtain further support for
      the suppressive action of beta-End on cortisol secretion under stress conditions
      a beta-End antiserum was infused into the 3rd ventricle of the brain in stressed
      and nonstressed sheep and the concentration of plasma cortisol was measured.
      Stress was induced by mild electric foot shock. Infusion of the beta-End
      antiserum during stimulation enhanced the plasma cortisol values, when compared
      with those obtained during the infusion of rabbit hyperimmune serum containing
      anti-guinea pig gamma-globulins or saline. Moreover, during the infusion of beta
      End anti-serum some aggravation of stress symptoms expressed by the increase of
      restlessness and higher frequency of defecations and urinations was observed.
      Additional experiments carried out to study the effect of beta-End on prolactin
      (PRL) secretion showed that this opioid induced a very high secretion of PRL in
      stressed animals. On the basis of these data and the known suppressive action of
      PRL on the corticosterone response to stress in the rat, we suggest that the
      suppressive action of beta-End on cortisol secretion in stressed sheep could be
      caused by the action of PRL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479609
TI  - Neuropeptide Y regulation of LHRH release in the median eminence:
      immunocytochemical and physiological evidence in hens.
AB  - It has been suggested that hypothalamic median eminence (ME) might be a control
      site for luteinizing hormone-releasing hormone (LHRH) release. Thus, stimulatory
      and/or inhibitory inputs acting at this site might be involved in regulating LHRH
      release from the ME and, therefore, luteinizing hormone (LH) release from the
      anterior pituitary. Since a role for neuropeptide Y (NPY) on LH release has been
      suggested, we have hypothesized that NPY might act in the ME to control
      preovulatory LHRH release in hens. To examine this possibility we have
      determined: (a) the immunocytochemical distribution of LHRH and NPY in the ME of
      the hen, (b) the basal and NPY-stimulated release of LHRH in vitro from the ME of
      hens undergoing a natural or a premature preovulatory surge of LH, and (c) the
      tissue content of LHRH and NPY in microdissected MEs, at various times before and
      during a natural or a premature preovulatory surge of LH. A potential role for
      NPY on LHRH release in the ME is suggested for the following reasons. (a) There
      are opportunities for synaptic interactions between NPY and LHRH-containing axons
      at this site. LHRH-containing cell bodies localized in the anterior
      hypothalamus/medial preoptic area project to the ME. NPY-containing perikarya,
      concentrated in the ventromedial aspect of the arcuate nucleus, might contact
      LHRH processes going to the ME and/or might themselves send axons to the ME, (b)
      Addition of NPY to the incubation media increases LHRH release from
      microdissected ME tissue of hens killed at the time of the natural preovulatory
      surge of LH, but not in hens killed 7 h before the occurrence of this surge.
      However, the stimulatory effect of NPY on LHRH release can be induced at this
      latter time when a premature LH surge is elicited. While the natural preovulatory
      surge of LH occurs 4 h before the second ovulation in a sequence (C2 ovulation),
      administration of progesterone (P4) 10-14 h before the expected natural C2
      ovulation advances the natural LH surge by 7-8 h. Thus, NPY might act as a
      physiological stimulus of LHRH release at the ME during the preovulatory surge of
      LH. This is suggested since in vitro basal LHRH release from denervated ME tissue
      does not change before and during the natural or the premature LH surge.
      Therefore, preovulatory release of LHRH in vivo might be under a continuous drive
      from stimulatory inputs to the LHRH neuron and NPY might be one of these
      stimulating factors.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8479610
TI  - Effects of rat prolactin on gonadotropin-releasing hormone secretion by the
      explanted male rat hypothalamus.
AB  - Chronic hyperprolactinemia in the rat is associated with suppression of plasma
      gonadotropin concentrations. The reduction of gonadotropins is considered to be
      due to either an inhibitory effect of prolactin (PRL) on pituitary gonadotropin
      secretion and/or suppression of hypothalamic gonadotropin-releasing hormone
      (GnRH) release. In contrast to the in vivo effects of PRL on hypothalamic GnRH
      release, it has recently been reported that endogenous hypothalamic PRL exerts a
      tonic stimulatory effect on GnRH release in vitro. The present study was
      undertaken to further evaluate the role of PRL on GnRH release. To accomplish
      this, we set up a static hypothalamic organ culture system which enabled us to
      evaluate immunoreactive GnRH (iGnRH) release by individually incubated
      longitudinally halved hypothalami. PRL at the concentrations of 100 and 1,000 nM
      (2,300 and 23,000 ng/ml) inhibited iGnRH release. This suppressive effect of PRL
      was apparently specific since growth hormone, a PRL-related molecule, did not
      have any significant effect on iGnRH release at the concentration of 1,000 nM
      (21,500 ng/ml) and a PRL antiserum completely suppressed the inhibitory effect of
      exogenously added PRL. On the other hand, this antiserum had no effect on basal
      iGnRH release suggesting that hypothalamic PRL does not regulate GnRH release.
      Based on the observation that PRL exerts a sexually dimorphic effect on plasma
      gonadotropin levels, we also evaluated the effects of testosterone (T),
      dihydrotestosterone (DHT), 17 beta-estradiol (E2), and progesterone (P) on PRL
      inhibited iGnRH release in vitro. T, DHT and E2 did not have any detectable
      effect on PRL-suppressed iGnRH release whereas P, at the concentration of 0.1 nM
      (0.03 ng/ml), completely abolished the effect of PRL.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8479611
TI  - Intracellular recordings from neurons of the arcuate nucleus in superfused
      explants of rat hypothalamus.
AB  - The membrane properties of arcuate nucleus (ARN) neurons and their connections
      with extranuclear regions were examined in vitro, using intracellular recordings
      obtained in superfused explants of rat hypothalamus. Current-clamp analysis
      revealed that the electroresponsive properties of a large proportion of ARN
      neurons are influenced by the expression of various forms of low threshold
      rectification. When the initial membrane potential of a neuron was maintained
      negative to -70 mV, depolarizing current injection could precipitate an immediate
      bursting response, due to the activation of a low-threshold spike, or delay
      firing as a result of transient outward rectification. These properties represent
      a means by which changes in membrane potential may modulate the responsiveness of
      ARN neurons to synaptic input. Indeed, electrical stimulation revealed that in
      addition to efferent projections to the supraoptic nucleus, medial preoptic area,
      or neurointermediate pituitary, subgroups of ARN neurons may receive a
      reciprocal, or collateral innervation from each of these areas. This functional
      diversity of intrinsic and synaptic mechanisms provides ARN neurons with a high
      capacity for the complex local processing of afferent information.

PMID- 8479612
TI  - Characterization of cysteamine induction of the 22K prolactin variant in the rat
      pituitary.
AB  - Glandular kallikrein (GK) is an estrogen-induced and dopamine-repressed
      lactotroph protease postulated to play a role in the processing of prolactin
      (PRL) to novel hormonal forms. Recent studies have shown that GK can process PRL
      in vitro from a 25K form to a 22K form in the presence of thiols--which appear to
      transform PRL into conformations (folding states) that are GK substrates. We and
      others have reported 22K PRL variants in the rat pituitary which can be increased
      by the administration of cysteamine (CSH), a biological thiol known to alter PRL
      conformation in vitro and in vivo. The present study further characterized CSH
      induction of the 22K PRL variant. Estrogen-primed rats were used in dose-response
      and time-course studies with CSH. CSH effects on 22K PRL levels were studied by
      Western blot analysis of reduced pituitary extracts (disulfides reduced with
      dithiothreitol before electrophoresis). Changes in PRL conformation were studied
      by Western blot analysis of nonreduced samples (thiols and disulfides trapped
      with iodoacetamide). CSH increased 22K PRL in a dose-dependent manner that was
      well correlated with the dose-response curve for changes in PRL conformation. CSH
      at 300 mg/kg produced 10- to 15-fold increases in pituitary levels of 22K PRL. In
      the time course study, 22K PRL levels peaked within 2 h, plateaued between 2 and
      16 h, and approached control levels by 24 h after CSH dosing. CSH-elicited
      changes in PRL conformation peaked within 1 h, plateaued between 2 and 8 h, and
      reached control levels within 16 h of CSH dosing.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8479613
TI  - Epidermal growth factor stimulates thyrotropin secretion in the rat.
AB  - The present work studied the effects of epidermal growth factor (EGF) on the
      release of thyrotropin (TSH) and prolactin (PRL) from perifused pituitary glands
      of 200-gram male Wistar rats. Each pituitary gland, cut into halves, was placed
      in a chamber of a perifusion system connected to a peristaltic pump which
      conveyed the perifusion medium (Medium 199, pH 7.3, Gibco, USA) from a reservoir
      to a chamber at a flow rate of 100 microliters/min. Each tightly closed chamber
      contained one pituitary gland and 600 microliters medium and it was placed in a
      water bath at 37 degrees C throughout the experiment. One milliliter samples of
      effluent were collected every 10 min for 60 min to obtain baseline values of TSH
      and PRL. Thereafter, TSH-releasing hormone (TRH) 10(-8) M or EGF (10(-11), 10(
      10), 10(-9) or 10(-8) M) were added to individual chambers and the 10-min
      sampling of effluent continued for 60 min. EGF 10(-11) M elicited no TSH
      response, but 10(-10) and 10(-9) M doses induced significant increases in TSH
      secretion (p < 0.01) with a peak at 10 min after addition of EGF. In another
      experiment, EGF 10(-8) M or TRH 10(-8) M significantly elevated TSH secretion (p
      < 0.01). However, TRH, but not EGF, stimulated PRL secretion (p < 0.01). In the
      in vivo studies, the intravenous administration of EGF 10(-5) M or TRH 10(-5) M
      both induced significant elevation of TSH release at 10 min after the injection
      (p < 0.02 for EGF and p < 0.01 for TRH).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479614
TI  - Colocalization of corticotropin-releasing factor and vasopressin in the
      paraventricular nucleus of the human hypothalamus.
AB  - The anatomical relationship between corticotropin-releasing factor (CRF)
      containing cells and arginine vasopressin (AVP)-containing cells in the human
      hypothalamus was investigated by immunocytochemistry. In the paraventricular
      nucleus of the hypothalamus (PVH), CRF-like immunoreactivity (CRF-LI) was present
      exclusively in parvocellular cells, while AVP-like immunoreactivity (AVP-LI) was
      present in both parvocellular and magnocellular cells. No CRF-immunoreactive
      neurons were observed in the supraoptic nucleus. All CRF-immunoreactive
      parvocellular cells in the PVH were also AVP immunoreactive. We confirmed the
      presence of AVP in the CRF-immunoreactive cells by using two kinds of anti-AVP
      antisera, one of which recognized the side chain of AVP while the other
      recognized the ring structure of AVP. Colocalization of CRF-LI and AVP-LI was
      observed not only in the same perikarya but also in the same nerve fibers of
      parvocellular cells. The present results raise the possibility that AVP and CRF
      may be secreted together into the human portal circulation.

PMID- 8479615
TI  - Central administration of bombesin blocks the estrogen-induced afternoon
      prolactin surge.
AB  - The effect of central administration of bombesin (BB), a neuropeptide originally
      isolated from the skin of frogs, on the estrogen-induced afternoon prolactin
      (PRL) surge was studied. Two doses of BB, 0.15 and 0.75 micrograms/rat, were
      injected into the lateral cerebroventricle of estrogen-primed ovariectomized rats
      at 12.00 h through preimplanted cannulae. Serial blood samples were obtained
      through preimplanted intra-atrial catheters during the whole afternoon hours. The
      small dose of BB delayed the afternoon PRL surge for an hour, but did not prevent
      it from occurring. The large dose of BB, however, blocked the surge completely.
      When the same effective dose of BB was co-administered with a BB antagonist,
      [Leu13-psi(CH2NH) Leu14]-BB (L psi L-BB), it no longer inhibited the PRL surge.
      The afternoon PRL surge was also reinstated in BB-treated rats by giving a single
      injection of sulpiride (1 microgram/rat, i.v.), a dopamine antagonist, at 14.00 h
      in the same afternoon. These results suggest that BB, by acting through specific
      BB receptors, can inhibit the PRL surge possibly through activating the
      dopaminergic systems.

PMID- 8479616
TI  - Effects of intracerebroventricular and intrahypothalamic cocaine administration
      on adrenocortical secretion.
AB  - Cocaine (COC) has been described as exerting potent stimulatory effects on the
      hypothalamo-pituitary-adrenocortical (HPA) axis. In the present study, we
      investigated the acute and chronic effects of intracerebroventricular and
      intrahypothalamic injections of COC in rats. Twenty minutes following
      intracerebroventricular injection of COC (1-100 micrograms), dose-dependent
      increases in plasma corticosterone (CS) were observed, although the highest dose
      tested (100 micrograms) evoked a significantly smaller response than that
      following 50 micrograms. Prior stressing of the animals resulted in elevated
      plasma CS levels (315 +/- 16 ng/ml) and significantly decreased plasma CS
      concentrations following 50 micrograms COC (87.8 +/- 3.2%). Injections above the
      hypothalamic paraventricular nucleus (PVN), the site of corticotropin-releasing
      factor-secreting neurons which regulate HPA activity, required relatively higher
      doses of COC in order to elicit increases in plasma CS; injections of 0.5
      microgram had no effect, 1 microgram resulted in an increase to 168 +/- 68 ng/ml
      (p < 0.005), and 2.5 micrograms produced an increase to 146 +/- 29 ng/ml (p <
      0.025). Post-PVN injections of COC, behind the posterior margin of the PVN in the
      vicinity of the ventral noradrenergic ascending bundle, also required a high dose
      (2.5 micrograms) in order to elicit a plasma CS response (208 +/- 19 ng/ml; p <
      0.005), with no significant response seen following 0.5 microgram COC. No effects
      of specific neurotoxic lesions of the catecholaminergic or serotonergic
      innervation of the hypothalamus were observed upon adrenocortical responses to
      COC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479617
TI  - Influence of in vivo reproductive endocrine state on growth hormone-releasing
      factor stimulated adenylate cyclase activity in anterior pituitary fragments.
AB  - The growth hormone releasing factor (GRF) stimulated adenylate cyclase activity
      was evaluated in membrane fractions of anterior pituitary glands from male and
      female rats and in gonadectomized rats following in vivo gonadal steroid
      treatments. The baseline adenylate cyclase activity was lower in random estrous
      cycle female rats as compared with males. When estrous cycle phases were
      evaluated, diestrus 1 females had a lower basal activity as compared with males,
      while proestrus females were similar to males. The maximal stimulation of
      adenylate cyclase activity by GRF (i.e. Vmax) was lower in random estrous cycle
      female rats than in males. This lower Vmax, relative to males, was more
      pronounced in diestrus 1 than in proestrus females. There was little difference
      in the ED50 for GRF-stimulated adenylate cyclase activity among these groups. The
      adenylate cyclase activity was altered 1 week after gonadectomy or 1 week after
      gonadectomy plus simultaneous in vivo gonadal steroid treatment. The expression
      of data as a function of whole tissue (content) or as a function of protein
      (concentration) influenced magnitude and direction of these treatment effects.
      This may reflect the proliferation of nonsomatotroph cell populations and altered
      protein synthetic activity following reproductive endocrine manipulations. When
      expressed as a whole tissue content, the baseline adenylate cyclase activity was
      unchanged after gonadectomy when compared to same-sex, gonadal-intact cohorts.
      However, an increase in the Vmax for GRF-stimulated adenylate cyclase activity
      was found in gonadectomized rats relative to sham-operated, gonadal-intact
      cohorts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479618
TI  - Endocrine features of glucocorticoid endangerment in hippocampal astrocytes.
AB  - Metabolic insults, such as ischemia or hypoglycemia, typically cause severe
      neuronal injury in the hippocampus and this cell vulnerability can be exacerbated
      by glucocorticoid (GC) exposure. This endangerment can also be demonstrated in
      vitro in both neurons and astrocytes. Direct GC effects on cell physiology thus
      appear to play a role, but the actual mechanism remains unclear. In order to
      clarify whether GCs act as damaging agents via a 'classical' steroid route, we
      examined the temporal features and steroid-specificity of this synergy in
      hippocampal astrocyte cultures derived from E18 fetal rats. A 24-hour
      pretreatment with corticosterone (CORT), the principal GC in the rat, enhanced
      both hypoxic and hypoglycemic cell damage, as measured by lactate dehydrogenase
      assay. This damaging effect was abolished when CORT exposure was reduced to 8 or
      4 h prior to the hypoglycemic or hypoxic treatment, respectively. A 24-hour
      exposure to several nonGC steroids also failed to enhance hypoxic cell damage.
      The damaging effect of CORT was attenuated if steroid exposure occurred during
      the hypoglycemic insult and was absent in both hypoxic and hypoglycemic paradigms
      if CORT exposure was limited to the recovery period. These results suggest that
      GCs aggravate metabolic astrocyte injury via classical hormonal effects that are
      steroid-specific, receptor-mediated, and emerge slowly after prolonged steroid
      exposure.

PMID- 8479619
TI  - Apoptosis in the anterior pituitary gland of the rat: studies with estrogen and
      bromocriptine.
AB  - Apoptosis was investigated by electron and light microscopy in the anterior
      pituitary gland of the male Fischer rat in which hyperplasia of prolactin
      secreting cells had been induced by estrogen implanted subcutaneously for 6
      weeks. Counts by light microscopy of apoptotic cells and cells containing
      phagocytosed apoptotic bodies increased during a period of 44 h after estrogen
      withdrawal. Necrosis was present but was not prominent. Administration of
      bromocriptine after estrogen withdrawal increased apoptotic counts to nearly
      double those in the absence of bromocriptine. Bromocriptine caused some increase
      in necrosis. Apoptosis occurred in prolactin-secreting cells identified by
      immunostaining and in other cells. Phagocytosed apoptotic bodies were seen in
      folliculo-stellate and not in other cells. It is concluded that apoptosis occurs
      in the anterior pituitary gland and is induced by bromocriptine. Phagocytosis of
      apoptotic bodies is a function of the folliculo-stellate cells.

PMID- 8479620
TI  - On vocal cord dysfunction.

PMID- 8479621
TI  - More poisonous snakes.

PMID- 8479623
TI  - Geneva Convention.

PMID- 8479622
TI  - Emergency transport.

PMID- 8479624
TI  - 1992 Federal Nursing Service Award recipient. An introduction to monoclonal
      antibody concepts for the oncology nurse.
AB  - Over the past 16 years, there has been an explosion of knowledge in the field of
      monoclonal antibody technology. There is an enormous potential for the use of
      monoclonal antibodies in the diagnosis and treatment of malignancies, and many
      clinical trials are under way. This paper serves as an introduction to monoclonal
      antibody concepts for the oncology nurse. Antibody/antigen principles, production
      of monoclonal antibodies, common side effects of use, and nursing implications
      are discussed. Results of a recent clinical trial and a patient case study are
      used to illustrate the application of radiolabeled monoclonal antibodies as a
      cancer diagnostic technique.

PMID- 8479625
TI  - 1992 Mary J. Nielubowicz Award recipient. Nursing organizational restructure:
      choosing to change.
AB  - Major organizational change frequently results in fear, anxiety, and resistance.
      Change is often initiated in response to a perceived threat. However, intentional
      changes to historical patterns of nursing care delivery are now more prevalent,
      in the absence of crisis, as leaders anticipate new challenges and fulfill
      today's nurses' need for high-level professional satisfaction. This essay
      describes factors which inspired nursing organizational restructure at a naval
      hospital. The specific modifications made and strategies for managing them are
      reviewed in the context of using planned change principles and risk-taking
      behavior to achieve organizational growth.

PMID- 8479626
TI  - 1992 New York-Tidewater chapters History of Military Medicine Essay Award
      recipient. James Claude Kimbrough: the father of modern U.S. Army urology.

PMID- 8479627
TI  - Wartime military service and utilization of VA health care services.
AB  - This study sought to examine predisposing, enabling, and illness characteristics
      associated with use of Department of Veterans Affairs (VA) health care services.
      In view of VA's unique mission to care for war veterans, special attention was
      given to features of wartime military service as predisposing factors for VA
      health care use. Data from a 1987 national survey of veterans were used to
      compare VA users and non-users. Logistic regression analysis was used to identify
      specific variables independently associated with VA health service use. Among
      current VA health service users, 55% served in combat and 71% in a war zone.
      Multivariate analysis showed that high illness level, service-connected
      disability status, and lack of health insurance are the strongest predictors of
      VA service use. Significant associations were also found between military service
      during a wartime era, in a war zone, and in combat, and VA health service
      utilization. Although no differences were noted in VA health service use between
      veterans of different wartime eras, it was notable that among Korean War-era
      veterans alone, war zone and combat exposure were not associated with increased
      VA health service use, perhaps reflecting the more limited public attention that
      has been paid to veterans of that war. Veterans with war-related military
      experience show a distinct affinity for VA services.

PMID- 8479628
TI  - The military health care provider in litigation: an overview.
AB  - Nowhere is the importance of readiness more critical than in the context of the
      health care provider preparing for an appearance in court. Accordingly, it is
      necessary to maintain a general working knowledge of both the general principles
      associated with the rendering of health care services in the military and the
      basic tactics that lawyers may employ toward health care providers during
      litigation.

PMID- 8479629
TI  - Electromagnetic pulse (EMP), Part I: Effects on field medical equipment.
AB  - The electromagnetic pulse (EMP) from a high-altitude nuclear detonation has the
      potential to cover an area as large as the continental United States with
      damaging levels of EMP radiation. In this study, two of seven items of medical
      equipment were damaged by an EMP simulator. Computer circuit analysis of 17
      different items showed that 11 of the 17 items would be damaged by current surges
      on the power cords, while two would be damaged by current surges on external
      leads. This research showed that a field commander can expect approximately 65%
      of his electronic medical equipment to be damaged by a single nuclear detonation
      as far as 2,200 km away.

PMID- 8479630
TI  - The future of post-residency fellowship education.
AB  - Post-residency fellowship education has traditionally been a transitionary phase
      toward a possible career involving medical research and teaching. The increasing
      sophistication required for performing medical research, the emphasis on
      molecular medicine, significant overcrowding in specialty disciplines, high
      student indebtedness, declining availability of government research grant
      funding, and the rise or academic-corporate joint ventures facilitating
      technology transfer to the private sector are causing changes in the traditional
      approach to and content of fellowship programs. In light of the overall recent
      economic downturn with the consequent contraction in research budgeting, fewer
      fellows will probably be trained in the near future. Alternatives in fellowship
      programming and support are explored.

PMID- 8479631
TI  - A multifocal comparison of health status and physical readiness test results of
      Navy personnel.
AB  - Many health risk factors are behaviorally related and therefore subject to
      modification. This study compared health risk appraisal (HRA) age, chronological
      age, identified risk factors, physiological measures, and demographic variables
      with Physical Readiness Test results of 100 active duty Navy personnel.
      Cholesterol levels were 200 mg/dl or greater in 42% of the subjects, with 32%
      having total:high-density lipoprotein cholesterol ratios of 5.0 or above.
      Additionally, HRA ages were significantly higher than chronological ages (p < or
      = .05). This study presents methods for (1) identifying needs for health teaching
      and/or counseling, and (2) increasing individual awareness of health risk factors
      and the effects of lifestyle on health risk.

PMID- 8479632
TI  - Handcuff neuropathy among U.S. prisoners of war from Operation Desert Storm.
AB  - Handcuff neuropathy was the most common neurologic problem acquired by U.S.
      prisoners of war during Operation Desert Storm. Neurologic deficits were
      exclusively sensory in all those affected and began to resolve shortly after
      their release from captivity. Some individuals expressed concern that these
      injuries could be career-threatening. One of those repeatedly restrained felt
      that he had discovered measures that could be undertaken to lessen the likelihood
      of developing neuropathy.

PMID- 8479633
TI  - A survey of Army medical department reserve personnel mobilized in support of
      Operation Desert Storm.
AB  - Surveys from 3,930 Army medical reservists mobilized in support of the Health
      Services Command mission during Operation Desert Shield/Storm were collected as
      units were demobilized from April to June, 1991. A survey questionnaire addressed
      questions related to factors associated with mobilization and intentions to
      remain in or leave reserve service after demobilization. Results were grouped
      according to rank, years of service, occupational specialty, and reserve
      category. Survey items used 6-point Likert scales to rate 38 items. Stepwise
      multiple regression models were developed to predict criterion items.

PMID- 8479634
TI  - The amateur Radio Emergency Service (ARES) and the National Disaster Medical
      System (NDMS).
AB  - The rescue, treatment, and evacuation of thousands of patients from a natural
      disaster or armed conflict that is coordinated by the National Disaster Medical
      System must be performed in accordance to health care standards recognized in
      this country. Without an effective communication system, morbidity and mortality
      will needlessly rise. A medical communication protocol that addresses this
      problem is proposed.

PMID- 8479635
TI  - Accuracy of self-reported health histories: a study.
AB  - Many military health care providers (including most dental providers) depend on
      self-reported health questionnaires for critical information about their
      patients' medical history. These questionnaires demand high standards of patient
      self-awareness and integrity, and their importance justifies checking their
      accuracy. The authors checked the accuracy of 155 self-reported health histories
      by comparing them with histories documented in medical records. Although we found
      some discrepancies, over 95% of our sample showed reasonable agreement between
      self-reported medical histories and documented medical histories.

PMID- 8479636
TI  - A comparison of the visual field restrictions with the M17 series protective mask
      and the MCU-2/P chemical-biological mask.
AB  - The U.S. Air Force and U.S. Navy recently adopted the MCU-2/P Chemical-Biological
      Mask to replace the M17 series of protective masks. Visual field plots were
      generated on a patient wearing each of these respirators. Although both resulted
      in a decrease of the visual fields, the magnitude of restrictions was far less
      with the MCU-2/P Chemical-Biological Mask.

PMID- 8479637
TI  - Scrub typhus in Korea: importance of early clinical diagnosis in this newly
      recognized endemic area.
AB  - Scrub typhus became a well recognized infectious disease threat to military
      operations in the Pacific Theater during World War II. Early diagnosis and
      treatment with tetracycline or chloramphenicol dramatically reduces the mortality
      and morbidity of this disease. Korea is a newly recognized scrub typhus endemic
      country. We report our experience with 189 scrub typhus patients seen at a
      civilian outpatient clinic in Chinhae, Republic of Korea, from 1985 through 1990,
      and verify the accuracy of clinical diagnosis by serologic tests.

PMID- 8479638
TI  - CHAMPUS recapture in the treatment of ear infections.
AB  - Ear infections, commonly referred to as otitis media, are one of the most
      commonly occurring problems of childhood. The "hit and miss" treatment of this
      disorder can result in parental frustration and early referral for surgical
      treatment. The application of managed care principles require that a standard
      approach to care be employed for the treatment of this condition. It should be
      high-quality, low-cost, and accessible to the patient population. The use of
      group appointments for common medical problems was first recommended by the
      military-commissioned PRISM III report of the early 1980s. It was felt that this
      technique could increase access and improve quality of care. A modification of
      this concept was tested that allowed the advantages of group parent teaching and
      medical history intake while preserving the individualized approach to care for a
      larger number of patients. This method was found to increase the productivity of
      the clinic by over 100%, while reducing the referral of patients outside the AF
      clinic to less than 1%.

PMID- 8479639
TI  - The military gynecologist in low-intensity conflict environment.
AB  - U.S. military medical personnel have been assigned to Honduras since August 1983.
      While reserve components have 2-week assignments and Air Force medics receive 3
      month assignments, U.S. Army medical personnel are assigned for 6-month tours.
      Duties include rendering medical care and air evacuation capability to all U.S.
      Forces in the Central American area of operations, conducting medical civic
      action programs termed MEDRETES, and assisting the host government in developing
      and conducting a health care system for indigent rural Hondurans. Gynecological
      care to women soldiers assigned to this low-intensity conflict environment and
      gynecological surgery capability for indigent Hondurans has been one important
      aspect of the military medical presence.

PMID- 8479640
TI  - Post-extubation non-cardiogenic pulmonary edema.
AB  - Non-cardiogenic pulmonary edema (NCPE) is a rare entity manifested by pulmonary
      edema with normal pulmonary arterial pressures. NCPE has been described in
      children and recently reported in adults. Onset is rapid and late recognition or
      inappropriate treatment may lead to a fatal outcome. Most adult cases have been
      attributed to laryngospasm and generation of a large negative intrathoracic
      pressure causing transcapillary filtration. The majority of reported adult cases
      were at risk for Upper Airway Obstruction (UAO). This report describes three
      young, active duty men who developed this entity following routine uncomplicated
      surgical procedures. Intubations were uncomplicated and fluid management
      appropriate. No patient had risk factors for UAO. Early extubation with
      respiratory attempts against a closed glottis may be etiology for this
      complication.

PMID- 8479641
TI  - Computed tomography-guided needle localization of suspicious breast lesions.
AB  - Non-palpable breast lesions, suspicious for carcinoma, are usually localized
      prior to biopsy using standard mammographic techniques. We report two patients in
      whom computed tomography was used to localize suspicious non-palpable breast
      lesions that could not be readily localized using standard mammographic
      techniques.

PMID- 8479642
TI  - Recurrent coumadin-induced soft tissue necrosis resulting in mastectomy.
AB  - A 58-year-old woman developed Coumadin-induced necrosis of the left breast,
      resulting in a mastectomy. This patient had experienced an earlier episode of
      coumadin-induced necrosis that resolved spontaneously. The etiology of this rare
      complication is unknown. The literature has suggested that patients can be
      restarted on Coumadin without difficulty. This case and others in the literature
      suggest that this may not be true. Patients requiring long-term anticoagulation
      should be considered for other treatment modalities if they develop Coumadin
      induced skin necrosis.

PMID- 8479643
TI  - [Hematomas of the abdominal rectus muscle].
AB  - The authors report their experience in relation to a series of 12 cases of
      hematoma of the rectus abdominis (ER) observed over the course of 13 years at the
      2nd Division of General Surgery at Vicenza Hospital: 7 were spontaneous, 2 post
      traumatic, 1 occurred during anti-coagulant treatment, 1 in a patient with
      altered coagulation levels due to liver cirrhosis, and 1 was post-operative.
      Clinical symptoms were sub-acute in 8 cases and were characterised by abdominal
      pain in all cases, the appearance of an abdominal mass in 4 cases and by
      ecchymosis in 3 cases. Symptoms were acute in 4 cases with signs of impaired
      general conditions and anemia. Echography made a decisive contribution to the
      diagnosis in this pathology and, based on the author's experience, when it was
      used it prevented the use of surgery. Computerised axial tomography, although it
      contributed a few precise findings to the diagnosis of ER, was rarely useful.
      Eight patients were operated: 2 due to collapse and anemia, 4 due to failure to
      identify the disease, 1 due to persistence of the parietal mass, and 1 due to
      infection of the hematoma. In the 4 cases which were not operated, the course of
      the disease was more favourable. The sole death was an elderly cardiopathic
      patient due to postoperative complications following general surgery. The most
      suitable therapeutic approach, in those cases where an accurate diagnosis of ER
      has been made, is to refrain from any form of treatment and to monitor symptoms
      until they resolve, which will occur spontaneously after 20-30 days.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8479644
TI  - [Multiple synchronous colorectal carcinomas].
AB  - The authors studied 118 patients with colon cancer (65 males and 53 female)
      admitted and operated at the Surgical Department of the Casalpusterlengo Hospital
      (Milan, Italy); over a period of 5 years (1986-1990). All patients were submitted
      to a pre-op. work-up with Barium enema, colonoscopy, abdominal ultrasound exam,
      and PAP-test and mammogram for females patients. We found 7 cases (5.9%) of
      multiple synchronous colon cancer (in 4 patients 2 cancers and in 3 patients 3
      cancers). We also found extracolonic malignancy in the same patients (1
      synchronous and 2 metachronous). New criteria are proposed to distinguish
      multiple colon cancers from multifocal colon cancers. It may be concluded that
      every patient with colo-rectal cancer requires a complete pre-op. examination of
      the colon and some tests to rule out other extracolonic malignancy.

PMID- 8479645
TI  - [Morbidity and mortality after elective Billroth II gastric resection in duodenal
      ulcer. Authors' experience].
AB  - A retrospective study was carried out those patients who underwent elective
      Billroth II gastric resection for pyloric or duodenal ulcer at the Surgical
      Division of the Scientific Institute of Gastroenterology of Castellana Grotte
      between 1974 and 1989. The aim of the study was to asses the incidence of
      postoperative morbidity and mortality. A total of 526 patients were included in
      the study (mean age 49 years +/- 12 years; 451 males (86%) and 75 females (14%).
      Morbidity was 20.7% and mortality 1.5%. These findings are in line with those
      reported in the literature and confirm that gastric resection for duodenal ulcer,
      even when performed electively, has a far from negligible morbidity and mortality
      rate. It is well known that, in comparison to more conservative operations such
      as vagotomy, gastric resection for peptic ulcer presents a high rate of
      postoperative morbidity and mortality, but a lower incidence of ulcerous
      recidivation. Unless there are valid preoperative criteria on which to base the
      choice of one or other techniques, the surgeon will usually choose the method
      with which the is most familiar. until studies have been carried out to identify
      the risk factors leading to postoperative morbidity and mortality, the authors
      suggest that gastric resection is reserved for those patients presenting a low
      operative risk.

PMID- 8479646
TI  - [Trends in the incidence of acute appendicitis in Italy during the past 30
      years].
AB  - The incidence and mortality rate of acute appendicitis for the years 1955 and
      1987 were calculated on the basis of data used by ISTAT. In 1955 the incidence
      was 5.7 per 1000 whereas in 1987 this had fallen to 3.7 per 1000. In both years
      examined there was a prevalence of females (in 1987 females accounted for 4.3 per
      1000 in comparison to 3 per 1000 recorded for for males). In 1987 the lowest
      incidence was recorded in the over 60 years olds, whereas the highest incidence
      was in males between 1 and 14 years old (7.57 per 1000) and females between 15
      and 24 years old (12.17 per 1000). Mortality diminished from 0.42% in 1955 to
      0.05% in 1987. The highest rate of mortality was recorded in those patients over
      60 years old (1.5%).

PMID- 8479647
TI  - [Intra-operative irrigation during colonic resection and anastomosis in colonic
      obstruction].
AB  - The faecal loading associated with colonic obstruction is a fundamental deterrent
      to constructing a primary distal colonic anastomosis. The authors describe their
      preliminary experience of intraoperative colonic irrigation in the management of
      left sided large bowel emergencies. Five patients were operated using this
      technique (4 cancer obstruction and one sigma volvulus). They show good results
      performing primary anastomosis after emergency distal resection combined with
      complete colonic cleansing.

PMID- 8479648
TI  - [Symmetry, ptosis and a new infra-mammary border in the reconstruction of the
      breast with a tissue expander].
AB  - The aim of this procedure is to obtain a permanent prosthesis (after mastectomy
      and the insertion of a tissue expander) that is similar to the contralateral
      breast in volume, morphology and inframammary border. The technique involves
      aspiration of the tissue expander fluid until the desired volume is obtained and
      the measurement of the fluid which indicates the volume of the prosthesis to be
      inserted. Given the satisfactory results obtained, the intention is to continue
      adopting this procedure.

PMID- 8479649
TI  - [Heterologous lyophilized collagen in the secondary healing of pilonidal
      fistulae].
AB  - The authors evaluate heterologous lyophilized collagen efficacy and tolerability
      in second intention healing of pilonidal sinus fistulae. This therapeutical
      approach seems to be characterized by a lower relapse incidence. The use of
      heterologous lyophilized collagen relevantly reduces the prolonged healing time
      required by such method.

PMID- 8479650
TI  - [Hypocobaltemia in chronic obstructive arteriopathy. Physiopathologic and
      therapeutic importance].
AB  - The role of some so-called primary and secondary (or oligo-elements) elements in
      the physiopathology of the cardiocirculatory system has been well known from a
      number of years and they have been regularly included in the treatment protocols.
      Some, including K, Ca, Mg and Zn, are extremely well known and widely used in
      clinical practice. Recently, however, a growing number of studies have focused on
      the biological importance of other oligo-elements in the pathogenetic mechanisms
      of atherogenesis and its clinical manifestations. This study aimed to verify the
      exact role of free cobalt in the physiopathology of the chronic obstructive
      arterial diseases (COAD). A total of 80 patients affected by 2nd stage COAD were
      examined and the levels of some oligo-elements, including Co, were assayed.
      Constantly low levels were found (85% of cases) in relation to other oligo
      elements studied (Cu, Zn, Mg, Ca). This findings is particularly interesting
      since it confirms the biochemical hypothesis of atherosclerosis according to
      which parietal damage plays a central role in the pathogenetic mechanism. Some
      enzymatic deficiencies, which lead to changes in membrane stability at the level
      of the endothelial cells, are closely related to the presence of tissutal and
      humoral peroxidation products. These peroxides (lipid peroxides), which are
      formed following the interaction of fatty acids with oxygen free radicals, have
      been identified by a number of studies as being responsible for endothelial
      damage. Several authors have shown that lipid peroxidation is involved in the
      atherogenic process through several mechanisms entailing monocytic activity and
      reduced prostacyclin (PG2) synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479651
TI  - [ Tissue and blood CEA levels in stomach cancer].
AB  - The assays of serum CEA is a useful prognostic marker in patients with stomach
      cancer. In this study pre-operative serum CEA and tissue CEA in tumour or biopsy
      were assayed in a group of patients with gastric carcinoma in order to assess
      their prognostic roles. Based on an analysis of the results the authors affirm
      that high serum CEA levels in patients with advanced stages of stomach cancer
      indicate a fatal prognosis, and likewise the finding of tissue CEA in loco
      regional lymph nodes at the same concentration as that in the primary tumour is
      also the sign of a severe prognosis.

PMID- 8479653
TI  - [Abdominal desmoid tumor].
AB  - Two cases of desmoid tumor of the abdominal wall are reported, together with some
      considerations and a review of the literature; desmoid tumor is an unusual
      neoplasm which affects women in prevalence. This is an histologically benign
      neoplasm with no metastatic capacity; however it is highly invasive in the site
      where it arose, so its treatment can become very difficult. The treatment is by
      surgical excision that must be as wide as possible, in order to obviate the great
      incidence of recurrence. The role of radiotherapy, hormone and chemotherapy has
      not been completely assessed so far.

PMID- 8479652
TI  - [Primary malignant melanoma of the esophagus. Report of 3 cases and review of the
      literature].
AB  - Primary malignant melanoma of the esophagus is an extremely rare tumour with a
      fatal prognosis. Only 122 cases have been reported to date in the literature, of
      which 105 are undoubtedly primary. This study presents three new cases which were
      surgically treated: two cases underwent subtotal esophageal resection and
      intrathoracic esophagogastroplasty, and one case underwent total esophageal
      resection and cervical esophagogastroplasty. The histogenesis, role of
      immunochemical markers and the therapeutic problems related to malignant
      esophageal melanoma are discussed in the light of a new review of the literature.

PMID- 8479654
TI  - [Surgical treatment of aneurysms of the popliteal artery].
AB  - The authors report their experience of two cases of popliteal artery aneurysm.
      Both patients were treated with aneurysm resection and inverse saphenous vein
      bypass. Early surgical intervention is the only effective therapeutic tool to
      avoid serious complications of this pathology.

PMID- 8479656
TI  - [Role of surgery for non-Hodgkin lymphoma of the gastrointestinal tract].
AB  - From January 1974 to December 1990, 619 patients were submitted to surgical
      treatment for gastrointestinal carcinoma: 10 cases (1.61%) of non-Hodgkin's
      lymphomas were observed (4 of the stomach, 3 of the small intestine, 1 of the
      colon, 2 of the rectum). There were 5 men and 5 women, mean age 57.1 years (range
      34-80). In 6 patients the diagnosis was performed with radiological
      investigations, in 4 with ultrasonography too. Endoscopy biopsy was unfit for
      diagnosis in the gastric localizations, while it was positive in both rectal
      localizations. Seven patients were operated and no postoperative morbidity or
      mortality was observed. The role of surgery is discussed, diagnosis for staging
      and therapy alone or associated with chemotherapy and/or radiotherapy.

PMID- 8479655
TI  - [Therapeutic approach in ventral hernia].
AB  - Laparoceles are diseases of the abdominal wall and their repair does not usually
      involve technical problems which are difficult to resolve. The use of classic
      surgical methods, such as direct suture and plastic surgery, enables the parietal
      defect to be easily repaired in most case. However, cases do occur in which the
      surgeon is faced with considerable technical and tactical difficulties largely
      due to anatomopathological causes: the "loss of the right of domicile" of
      herniated viscera and the loss of musculo-aponeurotic substance. In the former
      case it is necessary to prepare the peritoneal cavity using pneumoperitoneum. In
      the event of the extensive destruction of the muscular component, or when the
      parietal breech is located next to bone or cartilagenous structures, it is
      essential to use a prosthesis. The paper goes on to describe the indications for
      the use of various techniques and their respective methods of use under different
      anatomo-clinical conditions.

PMID- 8479657
TI  - [Doppler color echography in the diagnosis of impotence].
AB  - This study reports the experience achieved with duplex and color Doppler
      ultrasonography in 120 impotent patients. The following morphodynamic parameters
      of the cavernosal arteries were studies before and after intracorporal injection
      of a mixture of vasoactive drugs: arterial diameter, wall pulsatility, morphology
      of the spectral waveform, peak systolic velocity, end diastolic velocity and flow
      volume. The veno-occlusive mechanism of the corpora cavernosa was studied
      directly by determination of flow along the deep dorsal vein of the penis and
      indirectly by serial evaluation of the diastolic flow of the cavernous arteries.

PMID- 8479658
TI  - Hypertension and its treatment in a New Zealand multicultural workforce.
AB  - AIMS: To investigate ethnic variations in blood pressure levels and the
      likelihood of hypertension being treated in a multicultural New Zealand
      workforce. METHODS: An employed population of 5651 staff aged 40 to 64 years at
      worksites in Auckland and Tokoroa, who recorded their current prescribed
      medication, were measured for blood pressure, weight and height. Body mass index
      (BMI) was calculated. RESULTS: Mean blood pressure levels were higher in men than
      women, and increased with age and BMI. Compared with Europeans, mean systolic and
      diastolic blood pressures were higher in Maori (by 5 to 6 mmHg), Pacific
      Islanders (by 4 to 6 mmHg) and Asians (by 1 to 5 mmHg) after controlling for age
      and blood pressure treatment. This increase in Maori and Pacific Islanders,
      compared with Europeans, was approximately halved after also controlling for BMI,
      but still remained statistically significant (p < 0.05). In contrast, ethnic
      differences in BMI did not explain any of the blood pressure increase in Asians.
      In analyses restricted to hypertensive participants, the likelihood of
      hypertension being treated was higher in women than men (odds ratio (OR) = 3.42;
      95% CI 2.13, 5.47), and lower in Maori (OR 0.33; 95% CI 0.19, 0.58), Pacific
      Islanders (OR 0.27; 95% CI 0.16, 0.47) and Asians (OR 0.29; 95% CI 0.10, 0.86)
      than Europeans. CONCLUSION: These results suggest that the likelihood of
      hypertension being treated is related to sex and ethnic group; and that other
      unknown factors, in addition to increased BMI levels, explain the higher blood
      pressure levels in Polynesians compared to Europeans.

PMID- 8479659
TI  - The patient with haematuria.

PMID- 8479660
TI  - Planned early discharge from New Zealand maternity hospitals.
AB  - AIMS: The purpose of the Plunket National Child Health Study was to establish a
      database on health indicators of New Zealand children and families. This paper
      examines the issue of early discharge in New Zealand maternity hospitals.
      METHODS: As part of the study, 4286 parents were interviewed when the child was
      around six weeks post partum regarding their planned choice for length of post
      natal hospital stay and their actual length of stay. RESULTS: Most New Zealand
      mothers choose to stay in hospital for 4-7 days following childbirth. Those
      mothers choosing early discharge (within 48 hours of delivery), tended to be
      multiparous, nonEuropean, less educated and of lower socioeconomic status.
      CONCLUSIONS: The characteristics of those choosing early discharge demonstrate
      the vulnerability of this group and also have implications for the provision of
      health care services which are discussed.

PMID- 8479661
TI  - Cervical cancer: changing trends in the Wellington region.
AB  - AIM: To identify changes in patient and tumour characteristics of women with
      carcinoma of the cervix treated through the Wellington Regional oncology unit
      between 1975-89. METHODS: The medical records of the patients treated between
      1985-9 were reviewed. The age and stage of disease was noted in each case and
      results compared with the previous two 5-year cohorts. RESULTS: Over the 15 year
      period there was no obvious reduction in the incidence of cervical cancer. There
      was a significant trend towards women presenting with earlier stage disease. In
      the 1985-9 cohort, patients less than 40 years old were significantly more likely
      to present with earlier stage disease, and there was no detectable difference
      between the incidence of cervical cancer in Maori and nonMaori. CONCLUSIONS: The
      results indicate that cervical screening has not yet made an impact on the
      incidence of cervical cancer in the greater Wellington region, and possible
      reasons for this are discussed.

PMID- 8479662
TI  - Diabetes detection on the surgical wards in an area with a high prevalence of
      diabetes.
AB  - AIM: To describe the prevalence of diabetes and audit the processes used for
      diabetes detection on the surgical wards at Middlemore Hospital. METHODS: By the
      retrospective viewing of the notes of all admissions over a 12 month period.
      Comparison was made with routinely collected hospital discharge data. RESULTS:
      Notes from 10,893 of 11,004 (99.0%) admissions were viewed. 550 (5.0%) admissions
      involved a diabetic patient but diabetic patients were more likely to be
      readmitted (27.6% vs 13.5% diabetes vs no diabetes, chi 2 = 61.2, df = 1, p <
      0.001). Only 18.2% of diabetic admissions and 24.5% of diabetic patients were
      identified as such on hospital discharge data. No screening for diabetes was
      undertaken in 34.2% of younger and 8.7% of older admissions and 7.5% of patients
      had either glycosuria or a glucose > or = 8.0 mmol/L but received no follow up.
      Only 17 new cases of diabetes were detected. Although no ethnic group difference
      in screening or identification of diabetes was found, in those aged > or = 60
      years, 31% of Maori and 26% of Pacific Islands inpatients had diagnosed diabetes
      (vs 7.9% European). A similar excess of diabetes in Maori (18%) and Pacific
      Islands (16%) patients was found in those aged 40-59 years (Europeans 6%).
      CONCLUSION: In areas with a high proportion of Maori and Pacific Islands people,
      diabetes is an important medical condition to be considered in all surgical
      inpatients. Screening tests for diabetes need to be more closely followed up,
      perhaps by informing the general practitioner of the inpatient glucose.

PMID- 8479663
TI  - Lifestyle advice to pregnant patients.

PMID- 8479664
TI  - Wernicke's encephalopathy presenting with blindness.

PMID- 8479665
TI  - Cost benefit of pharmacy audit and nonrestrictive antibiotic policy.

PMID- 8479666
TI  - Antiarrhythmic drugs.

PMID- 8479667
TI  - Health messages on alcohol advertising: a positive or a counterproductive
      measure?

PMID- 8479668
TI  - Childhood asthma.

PMID- 8479669
TI  - Costing the HIV/AIDS epidemic.

PMID- 8479670
TI  - Use of ondansetron (Zofran)

PMID- 8479671
TI  - Safety of intravenous dipyridamole thallium myocardial perfusion imaging:
      experience in 435 patients.
AB  - Dipyridamole stress 201Tl scintigraphy is widely used in the investigation of
      myocardial ischaemia. We report our experience of adverse effects observed during
      this diagnostic procedure. A prospective study was undertaken of 435 consecutive
      patients (mean age 59 years; 273 males) referred to two nuclear medicine
      departments for assessment of myocardial perfusion was undertaken. Patients were
      monitored prior to and following the infusion of dipyridamole. All symptomatic,
      haemodynamic and electrocardiographic changes were documented. No deaths occurred
      in this series. Adverse events were observed in 174 (40%) patients. Of these,
      three patients experienced 'major' adverse events (0.6%) requiring
      hospitalization (myocardial infarction = 1; chest pain = 1; simple partial
      seizure = 1). 'Moderate' adverse events occurred in 39 (8.9%) patients and
      required intravenous aminophylline to reverse effects (ST segment abnormalities =
      26; nausea = 7 headache = 3; chest pain = 2; bronchospasm = 1; protracted
      vomiting = 1; diarrhoea = 1). 'Minor' adverse events were experienced by 132
      (30.3%) patients and did not require aminophylline. Sixty per cent of our
      patients experienced no ill effects from dipyridamole given as an exercise
      substitute in conjunction with 201Tl imaging. The rest had symptoms which were
      mostly mild, although a few patients found the experience unpleasant. Only one
      patient experienced a life-threatening episode.

PMID- 8479672
TI  - Regional distribution of 123I-(ortho-iodophenyl)-pentadecanoic acid and 99Tcm
      MIBI in relation to wall motion after thrombolysis for acute myocardial
      infarction.
AB  - To characterize the myocardium after thrombolytic therapy for infarction single
      photon emission computed tomographic (SPECT) studies with 123I-(ortho-iodophenyl)
      pentadecanoic acid (oPPA) and 99Tcm-methoxyisobutyl isonitrile (MIBI) were
      obtained at rest in nine patients within a fortnight after the acute event. A
      decreased oPPA activity compared to MIBI was observed in 15/45 segments (7/9
      patients). The segments with discordant oPPA/MIBI activities showed less severe
      wall motion abnormalities than the segments with concordant decreased oPPA and
      MIBI activities (P = 0.004). A significant association was found between
      discordant oPPA/MIBI activities and the early evolution of wall motion following
      thrombolysis: discordant oPPA/MIBI activities were present in nine of the 11
      segments (82%) with improved wall motion, while the wall motion of the seven
      segments with similar decreased oPPA and MIBI activities was unchanged or had
      deteriorated (P = 0.018). It is concluded that metabolic abnormalities often
      persist longer than perfusion and wall motion abnormalities soon after
      thrombolysis, and that 123I-oPPA in combination with 99Tcm-MIBI is useful to
      demonstrate myocardial areas which have been salvaged by thrombolysis.

PMID- 8479674
TI  - The design and construction of a central radiopharmacy.
AB  - Following an inspection by the Medicines Control Agency (MCA) of the existing
      radiopharmacy, it was necessary to design and build a new facility at the Western
      Infirmary to supply radiopharmaceuticals for patient use throughout the West of
      Scotland. This is one of the largest radiopharmacies in Europe, supplying some
      40,000 patient doses per year prepared using both closed and open procedures. The
      design parameters and construction details of the new facility are presented.

PMID- 8479673
TI  - Markers of left ventricular dysfunction induced by exercise, dipyridamole or
      combined stress on ECG-gated myocardial perfusion scans.
AB  - An index of left ventricular contraction can be extracted from the cavitary time
      activity curve of electrocardiographic (ECG)-gated myocardial perfusion scans. To
      assess the induction of stress-induced myocardial depression, we compared
      contraction indexes derived from immediate poststress and delayed 201Tl images
      with indexes of ventricular dilation and lung uptake in the prediction of severe
      coronary artery disease (defined as two or more 90% stenoses). Stress procedures
      were performed in 93 patients with symptom-limited supine bicycle exercise alone,
      and in 227 with intravenous dipyridamole, combined where possible with exercise.
      The immediate and delayed contraction indexes reflected left ventricular
      dysfunction on ventriculography (P < 0.0001), but additionally the immediate
      index was reduced (P < 0.0001) in severe coronary disease. Stress-induced
      hypokinesis was seen frequently after each of the test modes. The relationship
      with angiographic findings was better defined for indexes of contraction than for
      lung uptake or ventricular dilation (P < 0.01). The prediction of severe coronary
      disease was optimized by combining the poststress contraction index and lung
      uptake. These data support the use of ECG-gated myocardial scans in evaluating
      the functional consequences of stress/imaging procedures.

PMID- 8479675
TI  - Use of fine needle aspiration cytology in the management of the solitary cold
      thyroid nodule.
AB  - The aim of this study was to evaluate the use of fine needle aspiration cytology
      (FNA) in the management of the solitary cold thyroid nodule and set up a thyroid
      cytology service in a district general hospital. One hundred and eight patients
      underwent FNA and then went on to have thyroid lobectomy. The results of cytology
      were compared with histology. The percentage of cancers was 8% and of benign
      lesions 92%. The overall accuracy of FNA was 86%. There were no false positive
      results and one false negative result. If one includes a suspicious cytology as
      positive then six of seven cancers were diagnosed by FNA. Also, 49 benign colloid
      nodules were accurately diagnosed by FNA and could have avoided surgery (55% of
      the Series). We conclude that fine needle aspiration cytology is a useful adjunct
      to the management of the solitary cold thyroid nodule and should be used with
      other clinical information to decide the best form of treatment for the patient.

PMID- 8479677
TI  - Democrats introduce OSHA reform bill.

PMID- 8479676
TI  - Scintigraphy and sonography in reflux nephropathy: a comparison.
AB  - The evaluation of reflux nephropathy (RNP) is a major task in the following up of
      children with vesicoureteral reflux (VUR). Adequate monitoring of RNP development
      depends on the frequent use of sonographical and scintigraphical examinations. In
      order to evaluate the accuracy of sonography in monitoring RNP 63 patients
      suffering from VUR (mean age: 8.8 years, range: newborn to 18 years, male:female
      = 19:44) were examined prospectively. We calculated renal size sonographically
      and compared our data to static and dynamic renographic findings. Our results
      showed a good correlation between relative DMSA uptake and sonographically
      estimated relative renal size (r = 0.95, P < 0.001), whereas not unexpectedly the
      correlation between relative kidney function and sonographically estimated renal
      size was poor (r = 0.83, P < 0.01). We therefore believe, that in monitoring
      children with VUR, sonography can offer accurate information on questions about
      renal size and renal parenchymal structure as well as pelvic distention. With
      very small kidneys as well as with kidneys showing severe dilatation and above
      all for evaluating renal function, scintigraphy proved to be the better method.

PMID- 8479678
TI  - Notes from Washington.

PMID- 8479679
TI  - Lead construction standard readied.

PMID- 8479680
TI  - Mine safety experts aim for 'zero fatalities'.

PMID- 8479681
TI  - Coal dust and black lung.

PMID- 8479682
TI  - Healthcare claims and cost analysis can reap huge dividends for employers.

PMID- 8479683
TI  - ASHRAE's Indoor Air Quality procedure generates the dilution ventilation rate.

PMID- 8479684
TI  - Case incentive plan gives safe workers 'friendly competition,' encouragement.

PMID- 8479685
TI  - Unheeded advice?

PMID- 8479686
TI  - Blueprint for health surveillance.

PMID- 8479687
TI  - Analytical focus reduces anxiety over CTD claims.

PMID- 8479688
TI  - Detecting 'fakes'.

PMID- 8479689
TI  - Correct PPE helps alleviate persistent back injuries, compensation expenses.

PMID- 8479690
TI  - Skin exposures can develop into dermatitis.

PMID- 8479691
TI  - Emphasize handwashing benefits.

PMID- 8479693
TI  - AOHC's Atlanta conference sets up debates on healthcare, safety issues.

PMID- 8479692
TI  - Who's protected? Legal, ethical issues in employing the immunosuppressed.
AB  - There does exist a growing population of immunosuppressed people who are entering
      or re-entering the workforce, and their impact will be felt in the future. They
      present unique needs that should be addressed clearly, but the waters remain
      muddy. How do all remain protected and at what cost? The government has
      established mandates for hiring and accommodating the disabled, but how does the
      small employer survive the financial consequences? What happens when the 16-year
      old bone-marrow transplant recipient cuts her hand on metal shelving at the
      hardware store where she works? Who is liable for the medical costs if the
      individual contracts an infection, or worse, tetanus? Is the individual's
      transplant considered a pre-existing condition? Will the employer's worker's
      compensation package cover the expense? Worse yet, what happens if this
      individual should die of complications from the injury? Who is responsible? Would
      the outcome be different if the employer knew the individual was
      immunosuppressed? Does the pre-existing condition influence the medical insurance
      coverage or costs? Can a truly safe environment be provided? At what cost to
      whom?

PMID- 8479694
TI  - Fibrinous iritis and IOLs.

PMID- 8479695
TI  - "Sterile" endophthalmitis after sutureless cataract extraction.

PMID- 8479696
TI  - Ultraviolet radiation damage to the corneal endothelium?

PMID- 8479697
TI  - Different providers and differing error rates in health care outcomes: cataract
      co-management at what price?

PMID- 8479698
TI  - Postoperative Propionibacterium endophthalmitis. Treatment strategies and long
      term results.
AB  - PURPOSE: Postoperative Propionibacterium endophthalmitis is a condition
      characterized by exacerbations and remissions that has often been accompanied by
      recurrence after treatment. The purpose of this study is to evaluate the efficacy
      of initial therapies in preventing recurrent endophthalmitis and to assess the
      safety of intraocular lens (IOL) exchange performed during treatment of active
      endophthalmitis. METHODS: The records of 22 patients with culture-proven
      Propionibacterium endophthalmitis treated at one facility were retrospectively
      reviewed. RESULTS: Two patients presented acutely, were treated with intraocular
      antibiotic injection alone, and experienced no recurrent inflammation. Twenty
      patients presented with chronic, delayed-onset pseudophakic endophthalmitis.
      Eight of these were treated initially with intraocular antibiotic injection
      alone, and recurrent endophthalmitis developed in seven. Twelve patients with
      chronic endophthalmitis were initially managed surgically with either pars plana
      vitrectomy or IOL exchange. Four of the 12 experienced recurrent endophthalmitis.
      Patients undergoing capsulectomy as part of initial management experienced the
      lowest rate of recurrent endophthalmitis. Eight patients eventually underwent
      total capsulectomy and IOL explantation, seven of whom had IOL exchange. None of
      these eight patients had recurrent endophthalmitis. In seven of the eight,
      persistent bacterial colonization of the lens capsular remnants was demonstrated.
      CONCLUSIONS: These data suggest that recurrent Propionibacterium endophthalmitis
      is due to persistence of viable organisms sequestered within lens capsular
      remnants, and that initial therapy directed toward surgical removal of these
      sequestered organisms results in a reduced frequency of recurrent
      endophthalmitis. Intraocular lens exchange with complete capsular removal during
      active endophthalmitis was not associated with recurrent or persistent
      endophthalmitis.

PMID- 8479699
TI  - Vitreous cultures in suspected endophthalmitis. Biopsy or vitrectomy?
AB  - BACKGROUND: Isolation of bacteria from vitreous biopsy often guides therapy in
      suspected endophthalmitis. Therapeutic vitrectomy provides an additional source
      of culture material. The authors compared the ability of these two techniques to
      isolate organisms from patients with acute endophthalmitis. METHODS: In a large
      ophthalmic microbiology laboratory during a 4-year period, the authors analyzed
      206 microbial culture results from patients with suspected endophthalmitis.
      RESULTS: Two hundred six cases were evaluated. While cultures of vitreous biopsy
      specimens obtained using a needle and syringe were positive in 91 (53.8%) of 169
      patients, culturing the contents of the vitrectomy cassettes produced positive
      cultures in 29 (74.8%) of 39 patients. Both techniques were performed on 23
      patients. Vitreous biopsy allowed isolation of the causative organism in 43% of
      these patients, whereas vitrectomy was 76% successful. Both comparisons were
      significant at the P < 0.01 level. No positive vitreous biopsy cultures had
      associated negative vitrectomy cultures. CONCLUSION: Culturing the contents of
      the vitrectomy cassette significantly increases the likelihood of obtaining a
      positive culture compared with merely culturing a vitreous biopsy.

PMID- 8479700
TI  - Capnocytophaga endophthalmitis.
AB  - PURPOSE: This article presents three patients with endophthalmitis associated
      with infection with Capnocytophaga species. METHODS: The medical records of three
      patients with culture-positive Capnocytophaga endophthalmitis were reviewed. A
      panel of isolates of Capnocytophaga were then tested for sensitivity to third
      generation cephalosporins. RESULTS: Endophthalmitis with Capnocytophaga species
      developed in three patients. Infection in the setting of sepsis developed in one
      patient. Two other patients, one with a penetrating injury and another with
      keratitis in association with a corneal graft, developed mixed infection with
      Capnocytophaga being the predominant infecting organism by culture. Two patients
      recovered vision with clearance of the infection. The third patient underwent
      enucleation. Capnocytophaga was found to be sensitive to several of the third
      generation cephalosporins. To the best of the authors' knowledge, these are the
      first reported cases of endophthalmitis with Capnocytophaga species. CONCLUSION:
      Capnocytophaga species, previously shown to cause necrotizing keratitis, is a
      potential cause of endophthalmitis, either as a single organism or as part of a
      mixed infection.

PMID- 8479701
TI  - Suprachoroidal hemorrhage. Clinical features and results of secondary surgical
      management.
AB  - PURPOSE: The purposes of this study are to identify clinical features in eyes
      with suprachoroidal hemorrhage which portend a poor visual prognosis and to
      determine visual outcome in these eyes after secondary surgical management of
      suprachoroidal hemorrhage. METHODS: This was a retrospective study of 106
      patients with suprachoroidal hemorrhages occurring in association with trauma
      (35), cataract surgery (30), glaucoma surgery (17), penetrating keratoplasty (6),
      corneal perforation (5), secondary lens implantation (3), pars plana vitrectomy
      (3), and other causes (7). RESULTS: Five (10%) of 49 eyes with a suprachoroidal
      hemorrhage and an initial retinal detachment had a visual outcome of 20/200 or
      better compared with 21 (43%) of 49 eyes without a retinal detachment. The
      presence or absence or a retinal detachment could not be determined in eight
      patients and all eight of these patients had a poor visual outcome. Sixteen (20%)
      of 82 eyes with a 360 degrees suprachoroidal hemorrhage had a visual outcome of
      20/200 or better compared with 10 (47%) of 21 for those with suprachoroidal
      hemorrhage limited to one or two quadrants. The extent of the hemorrhage could
      not be determined in three eyes. Overall, 34% (14/41) of the patients with
      suprachoroidal hemorrhage who had a secondary surgical procedure achieved a
      visual outcome of 20/200 or better. Forty-three percent (6/14) who had a
      suprachoroidal hemorrhage during or after cataract surgery and who were treated
      with secondary surgical management achieved a visual outcome of 20/200 or
      greater. CONCLUSION: Clinical features associated with a poorer visual outcome
      included initial or indeterminate retinal detachment and 360 degrees
      suprachoroidal hemorrhage. Limited suprachoroidal hemorrhage without initial
      retinal detachment usually has a good visual prognosis and does not usually
      require secondary surgical intervention. However, if the former complication is
      present, secondary surgical intervention should be considered.

PMID- 8479702
TI  - Cryotherapy during surgery for giant retinal tears and intravitreal dispersion of
      viable retinal pigment epithelial cells.
AB  - BACKGROUND: Retinal pigment epithelial (RPE) cells are a major component of
      contractile cellular membranes in proliferative vitreoretinopathy (PVR).
      Displacement of viable RPE cells into the vitreous cavity is necessary for
      membrane formation. This study examines the effect of cryotherapy during surgery
      for giant retinal tears on the dispersion of viable cells into the vitreous
      cavity. METHODS: A total of seven eyes undergoing vitrectomy and retinal
      reattachment surgery were studied. Vitreous fluid from three eyes was aspirated
      immediately after cryotherapy; fluid from four eyes was aspirated after scleral
      indentation with the cryoprobe, but without cryotherapy. Colonies of pigmented
      cells routinely grew in flasks inoculated with fluid from eyes treated with
      cryotherapy. In contrast, flasks inoculated with fluid from eyes not treated with
      cryotherapy contained significantly fewer viable cells. CONCLUSION: Cryotherapy
      performed during retinal reattachment surgery in eyes with giant retinal tears is
      likely to enhance intravitreal dispersion of viable RPE cells. The findings in
      this study suggest that possible harmful effects of cryotherapy should be
      evaluated further and that alternative methods of creating a chorioretinal
      adhesion should be considered in cases with an especially high risk of PVR.

PMID- 8479703
TI  - Retinal vascular changes in congenital hypertrophy of the retinal pigment
      epithelium.
AB  - BACKGROUND: Congenital hypertrophy of the retinal pigment epithelium (CHRPE) is a
      well-defined clinical entity with usually well-delineated, pigmented oval or
      round lesion with smooth or scalloped margins. Occasional retinal vascular
      changes have been reported previously. PURPOSE AND METHOD: To assess the
      prevalence of these changes, the authors performed a retrospective analysis of 12
      patients with CHRPE, for whom fluorescein angiography allowed visualization of
      the entire lesion and of the retinal vascular capillary bed. RESULTS: Retinal
      vascular changes were found in 11 (91%) of these 12 patients. The changes
      consisted of capillary rarefaction in all 11 patients, with areas of capillary
      nonperfusion exceeding 1 disc diameter (DD) in three patients (25%), micro
      aneurysmal capillary dilatations in three (25%), and chorioretinal anastomosis in
      one. CONCLUSION: These results suggest that the above changes could constitute
      clinical and angiographic characteristics of CHRPE and allow easy corroboration
      of its diagnosis, thus avoiding the need for further clinical investigations.

PMID- 8479704
TI  - Effect of transposition surgery on rectus muscle paths by magnetic resonance
      imaging.
AB  - PURPOSE: To evaluate effects of transposition on extraocular rectus muscle paths
      in middle and deep orbit. METHODS: The effect of various transposition procedures
      was assessed in five patients, using surface coil magnetic resonance imaging
      (MRI), performed with controlled gaze before and after surgery. Path changes were
      compared with those expected under conventional concepts of functional orbital
      anatomy, quantified by biomechanical modeling. RESULTS: Vertical rectus
      transpositions of 6 to 10 mm produced changes in muscle paths of 3 mm or less,
      assessed posterior to the equator of the globe. Lateral rectus transpositions as
      large as 10 mm resulted in almost no movement of muscle bellies. Conventional
      modeling predicted much larger changes. CONCLUSION: The authors observed less
      movement of rectus muscle bellies relative to orbital walls than would be
      expected under the traditional assumption that transposed muscles follow the
      shortest path from origin to insertion. This implies that middle and deep orbital
      tissues (connective tissues and compartmentalized orbital fat) constrain the
      paths of rectus muscle bellies, preventing them from sliding freely to follow
      their transposed insertions. The authors propose that these tissues function as
      "pulleys" elastically coupled to the orbital wall, and that they are important
      determinants of extraocular muscle function.

PMID- 8479705
TI  - The Teller acuity card procedure. Three testers in a clinical setting.
AB  - PURPOSE: The Teller acuity card procedure provides a quantitative measure of
      grating acuity in infants and young children and has been used in clinical and
      laboratory settings. The purpose of this study is to address the influence of the
      individual testers in a clinical setting. The authors report a comparison of
      acuity results obtained by three well-trained, experienced testers in a busy
      hospital-based clinical practice. METHODS: Three different testers (A, B, C)
      performed 971 consecutive acuity assessments using the Teller acuity card
      procedure on 570 patients. The testers used similar techniques and adaptations,
      depending on clinical need. Diagnostic categories include nystagmus, aphakia,
      strabismus, glaucoma, retinopathy of prematurity (ROP), ptosis, optic nerve
      abnormalities, etc. Patients ranged in age from 2 weeks to 17 years (mean +/-
      standard deviation, 23 +/- 20 months). RESULTS: When each patient was represented
      only once, A tested 144 patients; B, 251; and C, 175. The geometric mean right
      eye acuity scores of A were 3.00 cycles/degree (cy/deg) (0.34 octaves, standard
      error [SE]; n = 134); B, 4.05 cy/deg (0.20 octave, SE; n = 225); and C, 3.71
      cy/deg (0.30 octave, SE; n = 163). An analysis of covariance showed a significant
      difference in the mean log scores across testers (P = 0.02 adjusted for both age
      and diagnosis). Age was a strong predictor of acuity (P = 0.0001), and the
      interactions between tester and age and tester and diagnosis were not
      significant. The geometric mean left eye acuity scores for A were 2.86 cy/deg
      (0.33 octave, SE; n = 132); B, 3.46 cy/deg (0.23 octave, SE; n = 218); and C,
      3.32 cy/deg (0.30 octave, SE; n = 160). The differences for left eyes among
      testers were not significant (P = 0.37 adjusted for age and diagnosis).
      CONCLUSIONS: These results suggest that the tester may influence the acuity
      results measured by the Teller acuity card procedure in a clinical setting.
      Evaluation of interobserver reliability in clinical subjects should be a high
      priority of further work using the Teller acuity card procedure.

PMID- 8479706
TI  - Distance stereoacuity. Assessing control in intermittent exotropia.
AB  - BACKGROUND: A patient's ability to control an intermittent exotropic deviation is
      usually assessed by subjective means such as observation of control in the
      office, questioning the patient and/or family about control at home, and reports
      of monocular eye closure in bright light. An objective method of assessing
      control has not been developed. PURPOSE: The purposes of this study are to
      determine if distance stereoacuity was different in patients with intermittent
      exotropia than in normal subjects and to determine if distance stereoacuity could
      be used as a objective means of assessing control in intermittent exotropia.
      METHODS: The authors evaluated near and distance stereoacuity in 44 patients with
      intermittent exotropia and 50 normal subjects. Patients with intermittent
      exotropia also were assessed for office control, home control, and monocular eye
      closure in bright light. Additionally, six patients who underwent successful
      surgery were reevaluated postoperatively. CONCLUSION: Normal subjects and
      patients with intermittent exotropia had good near stereoacuity. Patients with
      intermittent exotropia demonstrated significantly worse distance stereoacuity
      than the population of normal subjects (P < 0.001). Five of six patients with
      poor distance stereoacuity preoperatively had dramatic improvement in distance
      stereoacuity postoperatively. Diminished distance stereoacuity seems to be an
      objective measure of poor control of the exotropic deviation. This test may
      provide important objective criteria for deciding when to perform surgery in
      patients with intermittent exotropia.

PMID- 8479707
TI  - Extraocular muscle involvement in sarcoidosis.
AB  - BACKGROUND: Sarcoidosis is a granulomatous inflammatory disease that may have a
      variety of ocular and orbital manifestations. The most common ocular
      manifestation is uveitis, and the most common orbital manifestation is
      dacryoadenitis. Extraocular muscle involvement in sarcoidosis has rarely been
      reported. The authors report a case of sarcoidosis involving the extraocular
      muscles of a 15-year-old boy with bilateral, painful, external ophthalmoplegia
      and enlargement of all extraocular muscles on computed tomography (CT) scan.
      RESULTS: Lateral rectus muscle biopsy and transbronchial lung biopsy showed
      noncaseating granulomas characteristic of sarcoidosis. Cultures and serologic
      studies excluded fungal and mycobacterial diseases. Treatment with oral
      corticosteroids improved symptoms and signs. CONCLUSIONS: The authors report the
      first case of sarcoidosis in a patient with symptomatic extraocular muscle
      involvement, and only the third case in which extraocular muscle involvement has
      been shown histologically.

PMID- 8479708
TI  - Retrobulbar anesthesia risk. Do sharp needles really perforate the eye more
      easily than blunt needles?
AB  - PURPOSE: Conventional wisdom in ophthalmology is that the force required to
      perforate an eye during retrobulbar injection is noticeably greater with a
      specially designed blunt needle than with a standard hypodermic needle. A search
      of the literature showed no measurements of scleral perforation pressure with
      specific needle tips. The authors investigated this concept. METHODS: A
      computerized search for eye perforations of the surgical records over a 5-year
      period at Wilford Hall United States Air Force Medical Center was conducted. A
      double-masked trial by experienced ophthalmologists, using preserved eye bank
      eyes and several commercially available needles, subjectively assessed the force
      required to perforate the globe. The authors designed and built a portable
      transducer system to objectively measure the perforation pressure of human globes
      with the needles. Measurements were done with preserved and unpreserved human
      cadaver eyes. RESULTS: No globe penetrations or perforations were found in this
      consecutive series of over 4000 retrobulbar anesthesia procedures. A subjective
      difference between the hypodermic and blunt needles was detected. Objective
      measurements showed a significant difference between the hypodermic and blunt
      needles, and between types of blunt needles. The difference was present with both
      eye bank eyes and fresh cadaver eyes. CONCLUSIONS: Blunt-tipped needles do
      require greater force to penetrate the eye. The noncutting edge, blunt-tipped
      needles have higher scleral perforation pressures than those with cutting edges.

PMID- 8479709
TI  - The effect of simulated cataract on the glaucomatous visual field.
AB  - PURPOSE: The current study is designed to determine the effect of light
      scattering (simulated cataract) on glaucomatous visual fields. METHODS: Twelve
      patients with relative scotomas caused by glaucoma underwent the 30-2 threshold
      test with the Humphrey Visual Field Analyzer twice: once with and once without
      having a light-diffusing piece of ground glass in front of the eye, which, in
      previous experiments, has been shown to decrease perimetric threshold by 4.4
      decibels (dB) in normal eyes. As controls, 12 patients underwent the same
      examination with and without a piece of clear glass in front of the eye. In each
      pair of fields, five points were analyzed within the relative scotoma and
      compared with five points in a normal area of the opposite hemifield. RESULTS:
      The diffusing ground glass produced a mean decrease of perimetric threshold of
      5.7 dB (standard deviation [SD] = 3.3 dB) within the area of relative scotoma
      compared with 6.1 dB (SD = 2.4 dB) within the normal area and 4.4 dB (SD = 2.25
      dB) at the fovea. The differences between means were not statistically
      significant. In addition, the diffusing glass did not affect the corrected
      pattern SD (CPSD) index (6.5 dB with the diffuser and 6.5 dB without).
      CONCLUSION: Light scattering depresses the glaucomatous visual field diffusely.
      Relative glaucomatous scotomas and normal areas are depressed equally, expressed
      as change in decibel of sensitivity. Therefore, in following patients with
      cataracts and glaucoma, depression of threshold sensitivity in glaucomatous areas
      out of proportion to normal areas should not be attributed to the light
      scattering effect of the cataract, but rather to possible worsening of
      glaucomatous damage.

PMID- 8479710
TI  - Priority of test locations for automated perimetry in glaucoma.
AB  - PURPOSE: Static threshold automated perimetry is a demanding test which can be
      tiring for some patients. The authors investigate how to optimize early stages of
      the test which can shorten examination time and improve performance. The
      effectiveness of measuring every point twice to improve diagnostic precision
      (proportion of eyes correctly diagnosed as normal or glaucomatous) also was
      evaluated. METHODS: The authors evaluated the relative contributions of
      individual test locations to the sensitivity and specificity of static threshold
      perimetry. One hundred visual fields (Octopus Program G1) of 100 patients with
      open-angle glaucoma and early glaucomatous defects were used to rank the most
      frequently defective test locations. This sequence was modified so that highly
      correlated points were not ranked together. The sensitivities and specificities
      of the defined sequence of test presentations were then measured in a separate
      database of 70 normal controls and 70 patients with early glaucomatous visual
      field defects. RESULTS: Sensitivity and specificity were, respectively, 80% and
      80% after 12 locations, 89% and 89% after 26 locations, and 97% and 99% after all
      59 test locations. The information obtained with the first phase alone
      approximates that of both phases. CONCLUSION: Staging of locations tested with
      automated perimetry in glaucoma may be a valuable method to reduce examination
      time, minimize fatigue effects, and optimize diagnostic information. Retesting
      every point does not improve diagnostic precision.

PMID- 8479711
TI  - Clinical features and linkage analysis of a family with autosomal dominant
      juvenile glaucoma.
AB  - BACKGROUND: Juvenile glaucoma is an uncommon form of open-angle glaucoma that is
      usually recognized during childhood or early adulthood and which often has a
      strong family history. METHODS: The authors clinically characterized a large
      multigeneration family with autosomal-dominant, juvenile-onset, open-angle
      glaucoma. Linkage analysis with short tandem repeat polymorphisms was used to
      evaluate the Rieger's syndrome locus as the site of the disease-causing mutation.
      RESULTS: Forty members of a family with a five-generation history of open-angle
      glaucoma were examined. Clinical data were available from an additional five
      individuals, three of whom were decreased. Older family members provided limited
      information about the visual history of five other deceased individuals in the
      first three generations. Fifty-nine people were at 50% risk of harboring the
      disease-causing mutation; and of these, 30 were affected with glaucoma by
      examination or by family history. All affected patients had an affected parent.
      The average age at diagnosis was 18 years (range, 8-30 years). Affected family
      members tended to be myopic but lacked other ocular or systemic abnormalities.
      The intraocular pressures (IOPs) of affected individuals were commonly more than
      50 mmHg when they were first examined. Gonioscopy showed the angles to be open,
      with no abnormal pigmentation, iris processes, or embryonic tissue. Topical
      medications were initially effective in controlling IOP, but surgery was usually
      required for long-term pressure control. The Rieger's syndrome locus on
      chromosome 4q25 was excluded as the site of the disease-causing mutation.
      CONCLUSION: Juvenile open-angle glaucoma can occur as an autosomal dominant trait
      with high penetrance. Genetic linkage analysis of the family reported here has
      the potential to identify the chromosomal location of a glaucoma-causing gene.
      This gene is genetically distinct from the chromosome 4 locus that was recently
      associated with Rieger's syndrome.

PMID- 8479712
TI  - Results of therapeutic penetrating keratoplasty.
AB  - PURPOSE: To determine the anatomic and visual results of therapeutic penetrating
      keratoplasty (PK) and its role in the management of corneal disease. METHODS: The
      authors reviewed the records of all of their patients who had undergone
      therapeutic PK over the past 9 years and evaluated each for the following
      criteria: cure of disease, graft clarity, and visual acuity. Patients were
      divided into seven categories: (1 and 2) bacterial and fungal keratitis, (3 and
      4) herpetic keratitis, with and without inflammation, (5) acanthamoebic
      keratitis, (6) perforations due to keratoconjunctivitis sicca, and (7) other
      causes of perforation. RESULTS: In microbial keratitis, therapeutic PK eradicated
      the disease in all cases. Seventy-three percent of grafts for bacterial keratitis
      and 60% for fungal keratitis remained clear. A higher percentage of clarity was
      achieved when grafts were 9.0 mm or less. Seven patients with secondary
      endophthalmitis were cured with a surgical approach including therapeutic PK. In
      herpetic keratitis with active inflammation, only 36% of grafts remained clear,
      and inflammation recurred in 36%. All perforations due to post-herpetic
      persistent epithelial defects in "quiet" eyes were grafted successfully. In
      patients with severe keratoconjunctivitis sicca, eyes were anatomically
      stabilized in 83%, but all grafts failed because of complications from ocular
      surface disease. CONCLUSIONS: Therapeutic PK is valuable in the management of
      microbial keratitis that does not respond to antimicrobial therapy. Results are
      poorer for patients with herpetic keratitis, although selected patients respond
      to therapeutic PK when other methods of management have failed. Patients with
      perforations due to keratoconjunctivitis sicca have a uniformly poor prognosis
      for graft clarity.

PMID- 8479713
TI  - A prototype erodible mask delivery system for the excimer laser.
AB  - PURPOSE: The authors developed an erodible mask delivery system for the argon
      fluoride 193-nm excimer laser, which offers the possibility of correcting
      hyperopia and astigmatism as well as myopia. METHOD: Masks were made of
      polymethylmethacrylate on a quartz window, with intended corrections for myopia
      and hyperopia of 2.5 and 5 diopters (D). Ablations using the mask and control
      ablations using an expanding diaphragm were performed in 30 eyes of 15 pigmented
      rabbits with an Excimed UV200 laser (Summit Technology, Inc, Waltham, MA). The
      rabbits were followed for 134 days with regular biomicroscopy and retinoscopic
      examination by two observers. RESULTS: Ablations with the mask to correct myopia
      were successful and produced stable corrections, although the higher-power mask
      produced undercorrections. Hyperopic masks produced paradoxic myopic corrections,
      possibly due to the lack of a transition zone at the edge of the mask. Corneas
      ablated with the mask had less sub-epithelial haze than those ablated with the
      diaphragm at all examinations. Results of histopathologic examination showed
      epithelial hyperplasia over the ablation zone in all eyes. Dichlorotriazinyl
      aminofluorescein collagen staining showed subepithelial new collagen in all eyes,
      but there was no relation between the depth of ablation at any point on the
      cornea and the amount of new collagen deposited there. CONCLUSIONS: Myopic
      ablations are feasible with the erodible mask, although additional calibration is
      needed. Hyperopic ablations were unsuccessful with the current design. Corneas
      ablated with the mask may be clearer than corneas ablated with the diaphragm,
      possibly due to a smoother ablated surface. Regression of effect after laser
      ablation in the rabbit model is likely due more to epithelial hyperplasia than to
      stromal remodeling.

PMID- 8479714
TI  - Visual prognosis in giant cell arteritis.
AB  - PURPOSE: The visual prognosis in giant cell arteritis (GCA) was evaluated over a
      5-year period. METHODS: The authors reviewed the records of all patients with a
      diagnosis of GCA established at the Mayo Clinic over a 5-year period regarding
      visual status. Follow-up data for these patients were obtained 5 years later.
      RESULTS: Of the 245 patients studied, 34 (14%) permanently lost vision because of
      GCA. In 32 of these patients, the visual deficit developed before glucocorticoid
      therapy for GCA was begun; in the 2 other patients, the visual loss occurred
      after the diagnosis was made and therapy was started. Visual loss progressed in
      three patients after initiation of oral glucocorticoids, and in five other
      patients vision improved. After 5 years, the probability of loss of vision
      developing after initiating oral glucocorticoid treatment was determined to be 1%
      (Kaplan-Meier technique), and the probability of additional loss was 13% in
      patients with GCA who had a visual deficit at the time therapy was begun.
      CONCLUSION: The development or progression of visual loss was rare after the
      initiation of glucocorticoid therapy.

PMID- 8479715
TI  - A new ultrasonographic method to detect disease activity and predict response to
      immunosuppressive treatment in Graves ophthalmopathy.
AB  - PURPOSE: To determine whether the internal reflectivity of the eye muscles on A
      mode ultrasonography serves as indicator for disease activity in Graves
      ophthalmopathy, thereby predicting response to immunosuppressive treatment.
      METHODS: Eye muscle reflectivity, expressed as percentage of the initial scleral
      spike, was measured in the superior, medial, and lateral recti, and normal values
      were determined in 23 healthy controls. These were compared with values in 16
      consecutive patients with untreated, moderately severe Graves ophthalmopathy. The
      accuracy of the measurement was assessed by calculating the intra- and
      interobserver coefficient of repeatability. Baseline eye muscle reflectivity in
      the 16 patients was correlated to the therapeutic outcome 24 weeks after start of
      immunosuppressive therapy. The response to treatment served as indicator for
      pretreatment disease activity. RESULTS: Eye muscle reflectivity could be measured
      reliably, with an intraobserver coefficient of repeatability of 8.2% in controls
      and 10.2% in patients. Patients had lower reflectivity than controls (54.6 +/-
      17.4% versus 70.7 +/- 6.6%; P < 0.001). Reflectivity in eye muscles with the
      lowest echogenicity was lower in responders than in nonresponders (25.8 +/- 8.4%
      versus 40.6 +/- 13.6%; P = 0.02). From the individual data, a cut-off value of
      40% was derived, which appeared as an accurate predictor of outcome (positive
      predictive value 73%; 95% confidence interval 39%-94%). CONCLUSIONS: Measuring
      eye muscle reflectivity in Graves ophthalmopathy appears to be a reliable new
      method to determine disease activity, with a promising accuracy in predicting
      therapeutic outcome of immunosuppressive treatment.

PMID- 8479716
TI  - Orbital infarction syndrome.
AB  - BACKGROUND: The authors define orbital infarction as ischemia of all intraorbital
      and intraocular structures. It is a rare disorder due to the rich anastomotic
      vascularization of the orbit. PATIENTS: The authors report three patients with
      orbital infarction with similar clinical presentations: acute blindness, orbital
      pain, total ophthalmoplegia, and anterior and posterior segment ischemia.
      RESULTS: Etiologies of orbital infraction syndrome include occlusion of the
      common carotid artery (case 1), giant-cell arteritis (case 2), and mucormycosis
      (case 3). CONCLUSION: Three cases discussed in this article illustrate that
      orbital infarction is a disorder that can occur secondary to different mechanisms
      such as (1) acute perfusion failure (e.g., common carotid artery occlusion
      [possibly combined with anomalous orbital anastomotic channels]), 2) systemic
      vasculitis (e.g., giant-cell arteritis), and (3) orbital cellulitis with
      vasculitis (mucormycosis). The blindness and retinal and optic nerve damage were
      permanent, whereas the other signs of orbital ischemia (ophthalmoplegia and
      anterior segment ischemia) resolved. Therefore, diagnosis of orbital infarction
      can best be made during the acute phase.

PMID- 8479717
TI  - Scleral melt after cryotherapy for conjunctival melanoma.
AB  - BACKGROUND: The authors report a patient with a cryotherapy-induced scleral melt
      after combined excision and cryotherapy of a conjunctival melanoma arising within
      primary acquired melanosis with atypia. FINDINGS: In a 65-year-old white man, a
      severe scleral melt developed within 1 month of complete excision of a
      superficial conjunctival melanoma combined with double-freeze-thaw nitrous oxide
      cryotherapy to the scleral bed and surrounding conjunctival margins. Ultrasound
      biomicroscopy showed the degree of scleral thinning. CONCLUSIONS: Although many
      complications associated with cryotherapy have been described in the literature,
      there are no reports of a scleral melt. Scleral melt is a potential complication
      of cryotherapy that can occur despite taking precautions and should be monitored
      in the first few weeks after cryotherapy to the scleral bed of excised
      conjunctival tumors.

PMID- 8479718
TI  - The rationale for precise management of distal radius fractures.
AB  - Fractures of the distal radius continue to be one of the most common skeletal
      injuries treated by orthopedic or trauma surgeons. These injuries account for one
      sixth of all fractures seen and treated in emergency rooms. The rapid expansion
      of knowledge regarding the functional anatomy of the hand and wrist, the
      recognition by treating physicians of the ever increasing functional demands of
      senior citizens, and improved methodologies of achieving and maintaining anatomic
      restoration of these fractures have generated a renewed interest in addressing
      these fractures in a more precise manner.

PMID- 8479719
TI  - Fractures of the distal radius. A modern treatment-based classification.
AB  - The classification of fractures is necessary to make a proper assessment of the
      injury and to recommend appropriate treatment. This article presents a treatment
      based classification that assists in directing treatment. It is straight forward
      and easy to remember, yet has the potential for expansion to more detailed
      subclassifications as desired. Specific treatment planning can result from
      reference to this classification.

PMID- 8479720
TI  - Imaging techniques for distal radius fractures and related injuries.
AB  - In patients with distal radius fractures, routine roentgenographic examination in
      at least two or three planes should be performed first and is usually sufficient
      for correct diagnosis and adequate treatment. A careful examination of the soft
      tissues of the forearm and wrist on conventional roentgenograms may be key for
      correct diagnoses. Routine roentgenographic examination of the wrist, preferable
      in four views, should be performed in every patient with a distal radius fracture
      acutely as well as at follow-up. The technique is easy to perform, universally
      available, and inexpensive. Advanced imaging techniques such as radionuclide bone
      imaging, CT, or MR imaging should not be first choice modalities in patients with
      distal radius fractures and should be used only when conventional roentgenograms
      are inconclusive. Scintigraphy can be helpful for diagnosing occult fractures,
      for documenting fracture healing and ligamentous or cartilaginous post-traumatic
      disorders, as well as for diagnosis and follow-up of reflex sympathetic
      dystrophy. A disadvantage of scintigraphy is its poor specificity. Indications
      for CT include the confirmation of occult fractures suspected on the basis of the
      findings of physical examination and focally hot bone scintigrams when plain
      films are normal or inconclusive. In comparison with conventional radiography, CT
      is superior for the preoperative evaluation of complex comminuted distal radius
      fractures, depicting the distal radial articular surface and size and position of
      fracture fragments, as well as for the assessment of fracture healing.
      Additionally, CT is the imaging technique of choice for the correct diagnosis of
      subluxations of the distal radioulnar joint. Magnetic resonance imaging is an
      important diagnostic technique for the evaluation of suspected injuries of soft
      tissues related to distal radius fractures, such as to the flexor and extensor
      tendons or the median nerve, and for the early diagnosis of necrosis of the
      scaphoid or lunate. Other indications include identification of triangular
      fibrocartilage complex perforations, ruptures of carpal ligaments, and
      demonstration of contents of the carpal tunnel.

PMID- 8479721
TI  - Extra-articular fractures of the distal radius.
AB  - Extra-articular distal radius fractures frequently are undertreated. Results
      correlate directly with restoration of anatomy. Immobilization in plaster is an
      inferior method of preserving radial length and palmar tilt. Failure to maintain
      reduction with plaster can be predicted by the initial injury, if reduction is
      lost, closed reduction of the redisplaced fracture should be accompanied by
      external fixation.

PMID- 8479722
TI  - Distal radius fractures: patterns of articular fragmentation.
AB  - Distal radius articular fractures principally result from the die-punch mechanism
      of injury that leads to consistent patterns of articular disruption with readily
      identifiable radiographic signs of instability and reducibility. In the vast
      majority of articular fractures, prompt recognition of these key radiographic
      features serves as a sound basis for optimal management. Whereas the type I
      stable injury can be managed by short-term immobilization, the most frequently
      encountered type II unstable die-punch fracture requires stabilization provided
      by external fixation, frequently coupled with percutaneous internal fixation, to
      maintain an accurate reduction. Restoration of articular congruity in an
      irreducible type IIB dorsal die-punch fracture, in contrast, can only be
      accomplished by open treatment, usually comprising a limited exposure for
      reduction and internal fixation of the radiocarpal articular surface,
      supplementary external fixation, and adjunctive iliac bone grafting. The
      irreducible type IIB articular fracture with volar displacement is most suitable
      for stabilization by plate and screw fixation; however, in patients with
      excessive comminution, Kirshner wires provide a satisfactory alternative method
      of fixation. The type III spike fragment is secured with either small screws or
      wires in conjunction with closed or limited open articular restitution and
      appropriate nerve and tendon surgery. The irreducible type IV fracture
      demonstrating wide separation of articular components always requires extensive
      open treatment for restoration of articular congruity as well as repair of
      associated skeletal and soft tissue injuries. In the type V explosion injury,
      provisional stabilization employing, external fixation provides a sturdy
      framework for critical revascularization or resurfacing procedures and serves to
      maintain radial alignment before definitive articular reconstruction. In more
      severe injuries, early detection and repair of frequent periarticular injuries
      are essential for a favorable recovery. In those fractures requiring open
      reduction with internal fixation, supplementary external fixation and iliac bone
      grafting have proved to be increasingly beneficial adjuvants to management. In
      all cases, preservation of articular congruity with precise restoration of key
      medial fragments is the principal prerequisite for a successful outcome.

PMID- 8479723
TI  - External fixation of distal radius fractures. Indications and technical
      principles.
AB  - External fixation of unstable intra-articular fractures of the distal radius has
      become an effective tool in the management of these difficult injuries. Careful
      assessment of the fracture pattern, appropriate patient selection, meticulous
      surgical technique, the appropriate choice of fixation device and pins,
      recognition of the need for augmentation with limited internal fixation or bone
      grafting, and aggressive postoperative rehabilitation provide the foundation for
      successful management of these fractures while minimizing complications. The
      surgeon must remember that the pin-bone interface is the link between the patient
      and the fixator. He or she must ensure a stable environment for this interface by
      providing a clean, tight purchase of the pin in bone with minimal damage to the
      bone and its surrounding soft tissues at the time of operation. Postoperatively,
      the surgeon must convey to the patient the importance of maintaining a healthy
      environment for this pin-bone interface. An appropriately chosen external
      fixation device can be expected to provide overall stability while maintaining
      length as well as angular and rotational alignment. However, it cannot be
      expected to provide precise small fragment control and restoration of articular
      congruity. This must be achieved by precise reduction and limited internal
      fixation using Kirschner wires while prevention of late collapse is afforded by
      subarticular bone grafting of the metaphyseal defect. Adherence to these
      principles should provide a satisfactory outcome with a significant reduction in
      the rate of complications when external fixation is used for the management of
      complex fractures of the distal radius.

PMID- 8479724
TI  - External fixation. Technical advances based upon multiplanar ligamentotaxis.
AB  - The principle of ligamentotaxis obtained by longitudinal traction is useful in
      restoring skeletal length to distal radial fractures. Using external skeletal
      fixation to translate the hand in radial-ulnar and dorsal-palmar directions,
      ligamentotaxis in two additional planes aligns and tilts the distal radial
      fragment and its articular surface. Following restoration of palmar tilt by
      palmar translation, wrist position can be adjusted into neutral or extension to
      help avoid finger stiffness and carpal tunnel syndrome without compromising
      fracture reduction.

PMID- 8479725
TI  - Unstable articular fractures of the distal radius. Comparative techniques of
      ligamentotaxis.
AB  - Ligamentotaxis employing either pins and plaster or external fixators, frequently
      in conjunction with supplemental Kirschner wire internal fixation, has proved to
      be a reliable means of maintaining an accurate reduction of unstable articular
      fractures of the distal radius. Critical preoperative evaluation and surgical
      restoration of articular congruity along with attention to key technical details
      have resulted in a reproducible successful recovery. In our experience, the
      advantages of the pins and plaster technique are its relatively simple
      methodology, its comparatively low cost, and its high level of patient
      acceptance. The distinctive advantages of the external fixator are its superior
      mechanical efficiency, its capacity for fracture adjustment during the healing
      period, and the fact that it ensures unimpeded access to wounds. Nonetheless,
      regardless of the specific method chosen, this study clearly supports the
      contention that precision in patient selection and pin placement are the
      prerequisites for successful ligamentotaxis in the management of distal radius
      fractures.

PMID- 8479726
TI  - The history and evolution of percutaneous pinning of displaced distal radius
      fractures.
AB  - This article discusses the history and evolution of percutaneous pinning of
      displaced distal radial articular fractures. Six distinct methods are examined
      from an historical viewpoint, focusing on problems associated with each
      technique. The evolution of the Kapandji technique to include arum nuts and the
      Rayhack technique to include an alignment jig and pin guide with locking set
      screws is presented also.

PMID- 8479727
TI  - Intrafocal (Kapandji) pinning of unstable fractures of the distal radius.
AB  - Intrafocal pinning of distal radius fractures was described first by Kapandji in
      1976. The technique has been used widely in Europe but remains relatively unknown
      in the United States. It is indicated in unstable distal radius fractures without
      significant intra-articular displacement. This article provides a review of the
      European experience, a description of the surgical technique, and an analysis of
      our own clinical series. Intrafocal pinning works best in patients less than 65
      years of age, for the fracture patterns described previously. It provides the
      surgeon with a simple and effective, minimally invasive method of improving
      alignment and stability of unstable fractures.

PMID- 8479728
TI  - Indications and techniques of open reduction. Internal fixation of distal radius
      fractures.
AB  - Complex distal radius fractures present in a variety of patterns that differ by
      the area and degree of involvement of the articular and metaphyseal fracture
      components. No single method of treatment is appropriate for all fractures. This
      article discusses the types of fractures that either require or are best handled
      by formal open reduction and internal or external fixation.

PMID- 8479729
TI  - Concomitant skeletal and soft tissue injuries.
AB  - The diagnosis and treatment of those injuries most commonly seen in conjunction
      with distal radius fractures are reviewed in this article. Concomitant tendon,
      arterial, and nerve injuries often are associated with a high-energy mechanism of
      trauma. These injuries may complicate an already difficult fracture care plan,
      especially if the diagnosis of these injuries is delayed. Late tendon rupture and
      intercarpal injuries are discussed also.

PMID- 8479730
TI  - Distal forearm fractures in children. Complications and surgical indications.
AB  - Appropriate indications for operative management of pediatric distal forearm
      fractures include: 1. Compartment syndrome for fasciotomy. 2. Open fractures for
      irrigation and debridement. 3. Soft tissue/nerve entrapment. 4. Displaced intra
      articular physeal fractures. 5. Displaced or angulated fractures when the patient
      is close to skeletal maturity. 6. Correction of physeal arrest with malalignment
      or malrotation. 7. Gross displacement with cosmetic deformity.

PMID- 8479731
TI  - Reconstructive procedures for malunion and traumatic arthritis.
AB  - Despite the fact that surgical management of fractures of the distal radius has
      become more aggressive, leading to substantial improvement of anatomic results,
      malunion and post-traumatic arthritis remain the two most common complications
      following conservative treatment. Techniques, operations, and salvage procedures
      are discussed in this article.

PMID- 8479732
TI  - Management and rehabilitation of distal radius fractures.
AB  - Distal radius fractures require precise medical treatment, therapeutic
      intervention during fracture immobilization, and specialized rehabilitation
      thereafter to ensure an optimal functional result. With an understanding of the
      mechanics of distal radius fractures, surgical intervention, and bone healing,
      the therapist can modify the therapy program according to the patient's
      individual needs. The therapeutic process is begun in the crucial stage of bone
      healing during fracture immobilization. By addressing edema reduction and early
      range of motion of the uninvolved joints, most problems can be avoided before
      cast or fixator removal. Rehabilitation following the immobilization period
      should focus on regaining wrist movements provided that earlier problems have
      been addressed properly. During the rehabilitative process, the therapist can
      incorporate scar management, modalities, joint mobilization, active and passive
      range of motion, splinting, and strengthening to maximize the patient's
      functional result.

PMID- 8479733
TI  - [Laparoscopic cholecystectomy].
AB  - Traditional cholecystectomy has been the standard surgical treatment of the
      gallstone disease for more than 100 years. The technical development led to a new
      surgical procedure and its rapid acceptance. This is laparoscopic
      cholecystectomy. Its application is becoming widespread in therapy too. But most
      of the surgeons are lack of technical experiences in this field. Currently it
      restricts the indications those are anyway the same of standard cholecystectomy.
      Besides its many advantages, laparoscopic cholecystectomy has its own
      disadvantages and being an invasive procedure, there are possibilities of
      complications. The latest can be reduced by the adequate choice of patients, the
      careful learning of the operative technic and by turning to open surgery
      (conversion) when it is necessary. Its morbidity is nearly equal to complications
      of standard cholecystectomy, but mortality rate is lower (0.05-0.2%). Our
      morbidity of performed 300 laparoscopic cholecystectomies was 6.4%. We had no
      death. The hospitalization became as short as 4 days. Our early clinical results
      (90%) are the same of traditional cholecystectomy. Laparoscopic cholecystectomy
      as a new surgical procedure involves the efficiency of the standard
      cholecystectomy and the noninvasive endoscopic technic. Laparoscopic
      cholecystectomy performed by well trained surgeons is a safe surgical procedure,
      its early results are excellent and makes the choice of surgical treatment, used
      in bile surgery richer.

PMID- 8479734
TI  - [Amanita phalloides poisoning in a 15-year case load of a pediatric intensive
      care unit].
AB  - The clinical course of eight patients with Amanita phalloides poisoning is
      reviewed. Early diagnosis was based on the history, characteristic clinical
      features and non-specific laboratory data. A complex supportive therapy with
      gastric lavage, bowel irrigation, correction of volume and electrolyte
      abnormalities, and penicillin-G (Penicillin, Biogal), silibinin (Legalon SIL,
      Madaus), thioctacid (Thioctacid, Asta), corticosteroid (Di-Adreson-F aquosum,
      Organon) administration was commenced in every cases before identification of the
      mushroom. Haemoperfusion was performed in six cases, and in one patient
      plasmapheresis was applied as well. Seven children recovered completely.
      Unfortunately, a girl of 12 years died. According to the authors' experience, the
      use of non-invasive and invasive methods of the non-specific detoxication is
      proposed in case of severe Amanita phalloides poisoning.

PMID- 8479735
TI  - [Zinc excretion in osteoporotic women].
AB  - Urinary zinc excretion was detected in 24 normal and 25 age matched osteoporotic
      women. The osteoporotic group was classified in two groups on the basis of bone
      mineral density (BMD) measurements. Urinary zinc excretion was 327 micrograms/g
      creat. in healthy subjects and 488 micrograms/g creat. in the "common porotic
      group". In the "trabecular porotic group" (decreased BMC with DEXA at the lumbar
      spine alone or together with the femoral neck, but with normal radius BMD) it was
      455 micrograms/g creatinine while in the "cortical porotic group" (decreased BMD
      with SPA at the radius midshaft and/or all the sites measured) the zinc excretion
      was even higher, 588 micrograms/g creat. The difference between the normal and
      porotic groups was statistically significant, while within the porotic groups it
      was not, however the tendency was remarkable. A close significant correlation
      exists between BMC of radius and urinary zinc excretion. In the osteoporotic
      group the urinary calcium excretion was significantly higher, than in normal
      group (220.2 vs 145.2 mg/g creat, p < 0.01). The correlation between the urinary
      zinc and calcium excretion was not significantly statistically. Elevated urinary
      zinc excretion is characteristic in both types of involutional osteoporosis in
      women and therefore seems to be a potential new simple marker of bone resorption.

PMID- 8479736
TI  - [Ovarian carcinoma antigen (CA 125) and ovarian cancer (clinical follow-up and
      prognostic studies)].
AB  - Serum concentrations of ovarian carcinoma antigen (CA 125) were determined by
      Abbot CA 125-EIA Monoclonal kit from 66 patients with malignant ovarian tumor.
      The preoperative serum levels of CA 125 were elevated (> 35.0 IU/ml) in 93%
      (27/29). After the laparotomy and before the irradiation or chemotherapy in 36%
      (24/36) of patients had elevated levels. No significant correlation was seen
      between elevated levels and histology, tumor grade and clinical stage. However,
      the rate of positive cases were significantly higher in advanced stages than in
      the 1st stage (p < 0.05). No significant correlation was found between the
      preoperative levels of CA 125 and the clinical course. The postoperative elevated
      levels indicated bad prognosis. Good conformity was found between CA 125 levels
      and the therapy response. Serological follow up revealed a correlation with the
      clinical course of ovarian carcinoma in 84% (44/52). In patients with tumor
      progression the CA 125 levels increased before clinical signs of progression with
      median lead time of 97 days. The second look laparotomy proved, that residual
      tumor larger than 2 cm of diameter cause elevated levels. Smaller tumors remained
      marker negatives. CA 125 determination before operation, during and after therapy
      provide a useful tool in detecting progression and persistence of ovarian
      carcinoma.

PMID- 8479737
TI  - Overexpression of cyclin D1 in mouse skin carcinogenesis.
AB  - Recent studies have provided evidence suggesting that disruption of cyclin
      function may play a critical role in tumorigenesis. Cyclin D1, a putative G1
      cyclin previously isolated in human parathyroid adenomas (designated PRAD1) and
      mouse macrophages (designated Cyl1), has been implicated in various neoplasias
      including breast and squamous cell carcinomas (SCC). The role of cyclin altered
      regulation in the different stages of tumor progression has not been studied in a
      well defined animal model system. In the study presented here, Cyl1 was mapped to
      the distal end of mouse chromosome 7 and found to be dramatically overexpressed
      in skin SCC. In premalignant stages of tumor development, early papillomas showed
      basal Cyl1 transcript levels, whereas over-expression was observed in most
      advanced papillomas. These findings suggest that altered expression of cyclin D1
      plays a critical role in mouse skin carcinogenesis and may be related to the
      acquisition of autonomous growth by papillomas. Further studies on the role of
      cyclin D1 in the mouse model system should prove valuable for understanding the
      multistep basis of tumor progression.

PMID- 8479738
TI  - Amino acid substitutions modulate the effect of Jun on transformation,
      transcriptional activation and DNA replication.
AB  - The retroviral oncogene v-jun and its cellular counterpart code for proteins that
      function as major components of the transcription factor complex AP-1. Jun
      proteins bind to the AP-1 consensus sequence as homodimers or heterodimers with
      members of the Fos protein family. This report compares the ability of viral and
      cellular Jun proteins (v-Jun and c-Jun) to activate transcription and to
      stimulate DNA synthesis. The effect of amino acid substitutions on cellular
      transformation is also described. In F9 cells c-Jun is a more effective
      transactivator than v-Jun, which carries two amino acid substitutions in the
      carboxy-terminal region that together down-regulate transactivation. The delta
      deletion, present in the amino-terminal region of v-Jun, does not affect
      transactivation in F9 cells; however, it does modulate the stimulation of DNA
      synthesis. When delta is deleted, the amino acid substitutions are without
      consequence on DNA synthesis. In the presence of delta the amino acid
      substitutions down-regulate DNA synthesis. Deletion of the Jun transactivation
      domain, which is required for cellular transformation, abolishes both
      transactivation and stimulation of DNA synthesis. We conclude that
      transformation, transactivation and stimulation of DNA synthesis all depend on
      the presence of the transactivation domain. The three functions are, however, not
      tightly correlated, and further work is needed to define the role of the
      biochemical activities of Jun in oncogenesis.

PMID- 8479739
TI  - Mutation of a phosphorylation site in the DNA-binding domain is required for
      redox-independent transactivation of AP1-dependent genes by v-Jun.
AB  - The ability of the nuclear oncoprotein Jun to activate transcription is
      controlled both by level of DNA binding and by the activity of its
      transactivation domain. Control of DNA binding is achieved by two mechanisms:
      phosphorylation and redox regulation. Mutation of Ser-226 inhibits
      phosphorylation of the DNA binding, resulting in enhanced DNA-binding and
      transactivation activity of Jun. In contrast, mutation of Cys-252, which is the
      target for repression of DNA-binding activity under oxidative conditions, results
      in a strong decrease of Jun-specific activation of transcription. However,
      transactivation by c-Jun-Cys-252 is fully restored upon mutation of Ser-226. Both
      mutations are also found in the oncogenic counterpart of c-Jun, v-Jun, and are
      the only differences between these proteins in the DNA-binding domain, suggesting
      that v-Jun escapes down-modulation of DNA binding by both mechanisms. However,
      inhibition of phosphorylation of Ser-226 is absolutely required for the ability
      of v-Jun to activate transcription of AP-1-dependent genes in a redox-independent
      manner.

PMID- 8479740
TI  - Chimeric c-Jun containing an heterologous homodimerization domain transforms
      primary chick embryo fibroblasts.
AB  - To investigate a possible role for c-Jun homodimers in c-Jun-mediated
      transformation, we designed two chimeric c-Jun derivatives, called c-Juneb1 and c
      Jungcn4. In these chimeric derivatives the natural dimerization domain of c-Jun
      was replaced by the heterologous homodimerization domain of the Epstein-Barr
      virus EB1 or the yeast GCN4 transcription factor. Chick embryo fibroblasts
      chronically infected with retroviruses expressing c-Jun, c-Juneb1 or c-Jungcn4
      are transformed. Infection with each construction results in sustained growth in
      low serum and development of colonies from single cells in agar with similar
      efficiencies. In contrast to c-Jun, c-Juneb1 and c-Jungcn4 confer additional
      phenotypic alterations related to in vitro transformation including a condensed
      cell morphology and ability to develop highly invasive, fast growing colonies in
      agar. These data suggest that c-Jun homodimers can transform chick embryo
      fibroblasts and activate cellular functions which influence cell morphology and
      invasive potential in agar. These findings are consistent with the notion that
      cellular transformation by c-jun is mediated by c-Jun homodimers.

PMID- 8479741
TI  - Structural determinants outside of the leucine zipper influence the interactions
      of CREB and ATF-2: interaction of CREB with ATF-2 blocks E1a-ATF-2 complex
      formation.
AB  - Dimerization of leucine zipper-containing proteins has been associated
      characteristically with the formation of a coiled-coil structure between two
      compatible leucine zipper motifs. In the present study we demonstrate the
      association of the leucine zipper of cAMP response element-binding protein (CREB)
      with a zinc finger motif of ATF-2. The association of the CREB leucine zipper
      with the ATF-2 zinc finger is stabilized if the ATF-2 leucine zipper is intact,
      implying that the preferred interactive structure of ATF-2 juxtaposes the amino
      terminal zinc finger motif of this protein with the carboxy-terminal leucine
      zipper of this same protein. Furthermore, we demonstrate that the association of
      the CREB leucine zipper with the ATF-2 zinc finger in vitro blocks the
      association of the adenoviral E1a protein with ATF-2. Similarly, overexpression
      of full-length CREB, or a truncated version of this protein corresponding to the
      carboxy-terminal 74 amino acids that make up the DNA-binding and dimerization
      domains, can block the ATF-2-mediated transcriptional stimulation by E1a in vivo.
      Mutation of the ATF-2 zinc finger motif stimulates DNA binding of this protein,
      and abolishes interactions with E1a and CREB proteins. These results demonstrate
      that the structural conformation of ATF-2 is critical for DNA binding and protein
      protein interactions and, further, that leucine zippers can mediate protein
      protein interactions with structural motifs other than leucine zippers.

PMID- 8479742
TI  - Wild-type but not mutant p53 can repress transcription initiation in vitro by
      interfering with the binding of basal transcription factors to the TATA motif.
AB  - It has previously been shown that excess wild type (wt) p53 can repress the
      transcriptional activity of a variety of promoters in intact cells. To determine
      whether this transcriptional repression represented a direct effect of p53, wt
      and mutant p53 were prepared from E. coli-produced p53 and from insect cells
      infected with a recombinant baculovirus. When added into an in vitro
      transcription system, wt p53, but not mutant p53 reduced markedly transcription
      from the c-myc promoter, as well as from an array of other promoters, with the
      exception of an MHC class I gene promoter. The presence of wt p53 seemed to
      affect specifically the formation of the transcription preinitiation complex
      because preformed initiation complexes were completely refractory to wt p53, as
      was also the process of transcript elongation. Wild-type but not mutant p53
      interfered with the stable binding of TBP and TFIIA to the TATA motif, although
      both wt and mutant p53 could associate in vitro with purified TBP. We propose
      that upon binding to TBP, wt but not mutant p53 specifically blocks the ability
      of TBP to engage in interactions required for efficient transcriptional
      initiation. This may account, at least in part, for the ability of excess wt p53
      to inhibit cell proliferation and to interfere with neoplastic processes.

PMID- 8479743
TI  - A novel germline p53 splicing mutation in a pediatric patient with a second
      malignant neoplasm.
AB  - A novel germline p53 splicing mutation was identified in a pediatric patient with
      two metachronous primary cancers that are constituent tumors of the Li-Fraumeni
      syndrome. Genomic DNA from the second tumor showed the same mutation and loss of
      heterozygosity at the p53 locus. The mutant mRNA and protein were present in the
      tumor tissue. In contrast, in the normal tissues bearing the germline mutation in
      the heterozygous state, predominantly normal mRNA was expressed and the mutant
      p53 protein was not detectable. The functional silence and relative lack of
      mutant p53 mRNA expression in the normal tissues of this patient may be caused by
      decreased stability or decreased production. If this proves a more general
      pattern of expression of mutant p53 in individuals with germline mutations, these
      findings may explain the paucity of tumors in individuals affected with the Li
      Fraumeni syndrome.

PMID- 8479744
TI  - Defining the critical gene expression changes associated with expression and
      suppression of the tumorigenic and metastatic phenotype in Ha-ras-transformed
      cloned rat embryo fibroblast cells.
AB  - Carcinogenesis requires a complex series of genetic changes often involving
      multiple oncogenes and the inactivation of multiple tumor-suppressor genes. We
      presently examined the effect of the Krev-1 tumor-suppressor gene on the
      tumorigenic and metastatic potential of Ha-ras-transformed cloned rat embryo
      fibroblast (CREF) cells. Ha-ras-transformed CREF cells are morphologically
      transformed and anchorage independent; produce reduced levels of nm23-H1 (a
      putative metastasis-suppressor gene product) and TIMP-1 (tissue inhibitor of
      metalloproteinase 1) transcripts and mRNA compared with CREF cells; produce
      increased levels of cripto, 94-kDa gelatinase/type IV collagenase (94-kDa GEL),
      osteopontin (OPN) and transin/stromelysin transcripts and mRNA compared with CREF
      cells; and are tumorigenic and metastatic in both nude mice and syngeneic rats.
      Ha-ras-transformed CREF cells coexpressing the Krev-1 gene display a reversion in
      cellular phenotype and gene expression to that of untransformed CREF cells.
      However, Ha-ras/Krev-1-coexpressing CREF cells retain, albeit with extended
      latency periods, both tumorigenic and metastatic potential that is not related
      directly to the final level of Ha-ras or Krev-1 mRNA or the Ha-ras p21
      transforming protein. Development of metastatic potential is, however, directly
      correlated with a reduction in nm23-H1 and TIMP-1 transcription and mRNA levels
      and an enhanced expression of cripto, 94-kDa GEL, osteopontin and transin. In
      contrast, expression of additional tumor-suppressor genes, such as the RB gene
      and p53, or genes associated with tumorigenesis in other model systems, such as
      major excreted glycoprotein (MEP), 72-kDa gelatinase/type IV collagenase (72-kDa
      GEL), fibronectin (FIB), tenascin and intracellular adhesion molecule 1 (ICAM-1)
      is not altered in a consistent manner during in vitro transformation suppression
      or escape from tumorigenic and metastatic suppression. These results indicate
      that Krev-1 suppression of the Ha-ras-transformed/oncogenic phenotype is
      associated with a distinct program of gene expression changes manifested by
      altered rates of transcription and steady-state mRNA levels of specific oncogenic
      suppressing and oncogenic-inducing genes. These data support a model of Ha-ras
      induced metastasis in CREF cells that involves a direct modulation in the
      expression/suppression of specific combinations of oncogenic-suppressor genes and
      metastasis-promoting genes that are regulated coordinately in the process of
      tumor progression.

PMID- 8479745
TI  - Autocrine transformation of hemopoietic cells resulting from cytokine message
      stabilization after intracisternal A particle transposition.
AB  - Cell lines that no longer require exogenous interleukin 3 (IL-3) for growth were
      isolated from an IL-3-dependent cell line that possesses characteristics of early
      lymphoid cells. Unlike the parental cells (FL5.12), these autocrine transformed
      lines (FL-IL3-R) constitutively secreted IL-3, were rearranged at the IL-3 locus
      and formed tumors upon injection into syngeneic mice. The rearrangement and IL-3
      expression resulted from the transposition of an intracisternal A particle (IAP)
      provirus into the 3' untranslated region of the IL-3 gene. This region contained
      ATTTA sequence motifs that have been associated with cytokine and oncogene mRNA
      instability. IL-3 transcripts from the autocrine transformed cell lines had a
      longer half-life than similar transcripts isolated from either phorbol ester
      stimulated T cells or the WEHI-3B myelomonocytic cell line. IAP proviral
      transposition did not alter the transcription rate of the IL-3 gene in FL-IL3-R
      cells. Therefore, IAP proviral transposition can activate IL-3 gene expression by
      prolonging mRNA stability, and this mechanism can contribute to the autocrine
      transformation of the hemopoietic cells.

PMID- 8479746
TI  - ABL oncogenes directly stimulate two distinct target cells in bone marrow from 5
      fluorouracil-treated mice.
AB  - Mice reconstituted with BCR/ABL-infected 5-fluorouracil-treated bone marrow are
      considered a model system for human chronic myelogenous leukemia, a malignancy
      that arises in hematopoietic stem cells. These animals develop multiple types of
      hematopoietic tumors, which could arise either from undifferentiated cells that
      mature during tumor development or from progenitors committed to different
      lineages. To examine the BCR/ABL-sensitive target cells present in the marrow of
      mice treated with 5-fluorouracil, we used a single-step in vitro assay. These
      experiments revealed that both the P210 and P185 BCR/ABL proteins and the related
      v-abl protein induce lymphoid and myeloid colonies, colony types that mimic two
      of the prominent types of tumors found in the reconstitution model. The lymphoid
      colonies were similar to lymphoid colonies found following infection of normal
      bone marrow with respect to differentiation state and tumorigenicity. The cells
      in the myeloid colonies were differentiated and non-tumorigenic. Fluorescence
      activated cell sorting revealed that most of the lymphoid and myeloid colonies
      arose from distinct precursors and that the lymphoid colonies arose from B
      lineage-committed cells. These data suggest that most of the lymphomas observed
      in the reconstitution model arise from committed progenitors that are distinct
      from those involved in the myeloid disease.

PMID- 8479747
TI  - The physiology of bcl-2 expression in murine B lymphocytes.
AB  - Quantitation of bcl-2 gene expression in B-lineage lymphocytes from normal adult
      mice allows the identification of four cell populations, characterized by
      successive three- to fivefold increases in average mRNA levels: bone marrow pre-B
      cells, bone marrow B cells, splenic B cells and long-lived splenic B cells. Thus,
      in line with previous experiments using overexpression systems, a correlation
      between longevity and levels of bcl-2 mRNA exists also in the physiology of B
      lineage cells. The data are compatible with a quantitative regulation of
      expression, possibly determined at selective differentiation steps. No difference
      in bcl-2 expression was detected by comparing splenic IgD+ with IgD- B cells,
      while distinctly low levels of bcl-2 mRNA were scored in peritoneal CD5+ and CD5-
      B cells. These observations indicate that the reported persistence of peritoneal
      B cells may be controlled by mechanisms other than bcl-2 gene expression.

PMID- 8479748
TI  - Transfected wild-type and mutant max regulate cell growth and differentiation of
      murine erythroleukemia cells.
AB  - Max protein forms specific DNA-binding dimeric complexes with itself and with
      proteins of the c-myc gene family. A large volume of data has accumulated on the
      role of the c-myc proto-oncogene in cell proliferation, differentiation and
      tumorigenesis. To elucidate the role of max in regulating c-myc functions and the
      effect of both proteins on cell proliferation and differentiation, we transfected
      murine erythroleukemia (MEL) cells with a full-length wild-type (wt) human max
      gene and a mutant containing a double point mutation in the basic region (bm),
      which abolishes specific DNA binding. All clones expressing wt-max grow slowly,
      and the process of inducer-mediated differentiation is delayed. Furthermore,
      cells transfected with the mutated max exhibit growth retardation, accumulation
      in the G0/G1 phase of the cell cycle and spontaneous differentiation. Our
      findings are consistent with a model in which a large excess of wt-Max in the
      cells enhances the formation of Max-Max growth-suppressor complexes, while
      elevated bm-Max deprives the cell of growth-promoting Myc-Max heterodimers in a
      dominant-negative manner, presumably by inactivating endogenous Myc and Max.

PMID- 8479749
TI  - Constitutional mutation in exon 8 of the p53 gene in a patient with multiple
      primary tumours: molecular and immunohistochemical findings.
AB  - We report a constitutional mutation of codon 273 in exon 8 of the p53 gene. The
      affected individual has developed multiple independent benign and malignant
      tumours (tricholemmoma of the scalp, multiple trichoepitheliomata of the face,
      osteosarcoma of the ovary, bilateral breast cancer, malignant fibrous
      histiocytoma of the thigh and endometrial adenocarcinoma) and belongs to a family
      with some, but not all, features of the Li-Fraumeni syndrome. The mutation, found
      in both blood lymphocyte and tumour specimens, is a cytosine to thymine
      transition at codon 273, resulting in an amino acid change from arginine to
      cysteine. The mother and sister of the index case both died of tumours at an
      early age. We have demonstrated that formalin-preserved material from these
      tumours contains the same C-->T mutation at codon 273, indicating that this
      mutation has probably been transmitted through the germline. All tumours from the
      index case, both benign and malignant, showed immunohistochemical positivity with
      four antibodies to the p53 protein. Positive staining was also seen in scattered
      nuclei of morphologically normal epidermal keratinocytes and pilosebaceous cells,
      but not in lymphocytes or other morphologically normal cells from the index case.
      However, a similar staining pattern in apparently normal tissue was also observed
      in 13/48 sections from other individuals with various skin conditions
      (melanocytic naevi, psoriasis and normal skin adjacent to malignant melanoma and
      fibrous histiocytomas), suggesting that this pattern of p53 staining may not be
      unique to individuals with constitutional p53 mutations.

PMID- 8479750
TI  - Tumorigenic activity of rho genes from Aplysia californica.
AB  - rho genes have been found in both lower and higher eucaryotes. They code for
      proteins of 21 kDa, highly conserved in evolution, which belong to the
      superfamily of ras GTPases. Among the members of this superfamily there are
      proteins with a regulatory function, such as ras, and proteins involved in
      vesicular trafficking, such as the family of rab proteins. We have investigated
      the putative role of rho proteins from Aplysia californica as transforming
      GTPases utilizing the wild-type and a Val-14 mutant, equivalent to the oncogenic
      Val-12 mutation of ras genes found in animal and human tumors. Over-expression of
      either rho gene was sufficient to confer anchorage- and serum-independent growth.
      Moreover, when introduced into nude mice, selected clones generated from either
      gene were able to induce tumors, although those carrying the mutated version were
      more efficient. Pathological analysis indicated that generated tumors
      corresponded to well-differentiated fibrosarcomas with distinct and intersecting
      bundles and spindle cells. By contrast, ras-induced tumors were poorly
      differentiated fibrosarcomas. Thus, our results indicate that under appropriate
      conditions rho genes function as oncogenes and may have a role in the regulation
      of proliferation in fibroblast cells.

PMID- 8479751
TI  - Lack of c-jun expression in a transformed cell line isolated by glucocorticoid
      promotion of ras-transfected rat embryo fibroblasts.
AB  - Rat embryo fibroblasts (REFs) are inefficiently transformed by the T24-ras
      oncogene. A contributing factor to cellular resistance to transformation is the
      limited tolerance to p21-ras oncoprotein expression. Here we present data
      suggesting that long-term glucocorticoid treatment of ras oncogene-transfected
      REFs results in increased tolerance to p21-ras oncoproteins, leading to
      expression of the transformed phenotype. Stably transformed cell lines that
      expressed high levels of H-ras and could be maintained in the absence of hormone
      were isolated. In three out of four lines studied, the AP-1-dependent collagenase
      gene was expressed at a low level. In one of these lines, low collagenase
      expression was paralleled by lack of c-jun mRNA. Immunochemical analysis revealed
      that progression to hormone independence was not paralleled by mutations in the
      p53 gene. We propose that a decreased expression of AP-1-driven genes may result
      in increased tolerance to p21-ras oncoprotein.

PMID- 8479752
TI  - Expression cDNA cloning of a serine kinase transforming gene.
AB  - By ectopic expression of cDNAs derived from a Ewing sarcoma cell line in NIH3T3
      cells, we isolated a transforming gene (est). Sequence analysis revealed homology
      to the cot oncogene, which encodes a novel serine kinase. Whereas the cot product
      was truncated at its carboxy-terminal end as a result of gene rearrangement
      during transfection, est encodes the normal cot product. Thus, this gene can be
      activated as an oncogene by overexpression as well as by gene rearrangement.
      NIH3T3 cells transfected with est formed progressively growing colonies in soft
      agar and were tumorigenic in nude mice. The 3.2-kb est transcript was expressed
      at low level in both human fibroblasts and epithelial cells. Addition of the
      tumor promoter, okadaic acid (OA), or cytokine, interleukin 1 (IL-1), but not
      serum or platelet-derived growth factor (PDGF), induced increased expression of
      the est transcript. Using fluorescence in situ hybridization, we localized the
      est gene to the short arm of human chromosome 10 at band p11.2.

PMID- 8479753
TI  - The ezrin-like family of tyrosine kinase substrates: receptor-specific pattern of
      tyrosine phosphorylation and relationship to malignant transformation.
AB  - A method for the isolation of tyrosine kinases substrates was developed. The
      method takes advantage of immuno-affinity purification of an entire set of
      proteins phosphorylated by tyrosine kinases, followed by generation of antisera
      against the purified protein pool and immunological screening of bacterial
      expression libraries with these antisera. By applying this methodology to the
      study of the phosphorylation events triggered by activation of the epidermal
      growth factor receptors, we have isolated several cDNAs encoding novel putative
      tyrosine kinase substrates. One of these cDNAs encodes radixin, a protein
      belonging to the band 4.1 family of proteins and highly related to ezrin and
      moesin. We demonstrated that, despite a high degree of relatedness, these three
      proteins exhibit a distinct receptor-specific pattern of phosphorylation, raising
      the possibility that they might mediate receptor-specific cellular changes. In
      addition the generation of antibodies specific for either radixin, ezrin or
      moesin allowed us to show that a previously described tumor transplantation
      antigen is indeed ezrin, thus implicating this protein in the determination of
      the biological phenotype of certain tumors.

PMID- 8479754
TI  - Two potentially oncogenic cyclins, cyclin A and cyclin D1, share common
      properties of subunit configuration, tyrosine phosphorylation and physical
      association with the Rb protein.
AB  - Originally identified as a 'mitotic cyclin', cyclin A exhibits properties of
      growth factor sensitivity, susceptibility to viral subversion and association
      with a tumor-suppressor protein, properties which are indicative of an S-phase
      promoting factor (SPF) as well as a candidate proto-oncogene. Other recent
      studies have identified human cyclin D1 (PRAD1) as a putative G1 cyclin and
      candidate proto-oncogene. However, the specific enzymatic activities and, hence,
      the precise biochemical mechanisms through which cyclins function to govern cell
      cycle progression remain unresolved. In the present study we have investigated
      the coordinate interactions between these two potentially oncogenic cyclins,
      cyclin-dependent protein kinase subunits (cdks) and the Rb tumor-suppressor
      protein. The distribution of cyclin D isoforms was modulated by serum factors in
      primary fetal rat lung epithelial cells. Moreover, cyclin D1 was found to be
      phosphorylated on tyrosine residues in vivo and, like cyclin A, was readily
      phosphorylated by pp60c-src in vitro. In synchronized human osteosarcoma cells,
      cyclin D1 is induced in early G1 and becomes associated with p9Ckshs1, a Cdk
      binding subunit. Immunoprecipitation experiments with human osteosarcoma cells
      and Ewing's sarcoma cells demonstrated that cyclin D1 is associated with both
      p34cdc2 and p33cdk2, and that cyclin D1 immune complexes exhibit appreciable
      histone H1 kinase activity. Immobilized, recombinant cyclins A and D1 were found
      to associate with cellular proteins in complexes that contain the p105Rb protein.
      This study identifies several common aspects of cyclin biochemistry, including
      tyrosine phosphorylation and the potential to interact directly or indirectly
      with the Rb protein, that may ultimately relate membrane-mediated signaling
      events to the regulation of gene expression.

PMID- 8479755
TI  - Analysis of multigene families by DNA fingerprinting of conserved domains:
      directed cloning of tissue-specific protein tyrosine phosphatases.
AB  - Little is known about the number of mouse protein tyrosine phosphatases (PTPs)
      and their developmental and tissue-specific expression patterns. A new procedure
      based on fingerprinting of amplified catalytic domains detects expression of at
      least 20 different mouse PTPs during development. The majority of these PTPs show
      developmentally regulated expression patterns; some display a unique tissue
      specificity. Diagnostic fragments detected in the fingerprint analysis are used
      here as specific probes to directly clone two previously unknown ubiquitously
      expressed PTPs and PTP1C, a protein tyrosine phosphatase highly expressed in
      thymus RNA. The fingerprinting procedure is also applicable to the analysis of
      protein tyrosine kinases and may also be used to study the expression pattern of
      other multigene families.

PMID- 8479756
TI  - Deletion mapping in colorectal cancer of a putative tumour suppressor gene in
      8p22-p21.3.
AB  - Although previous studies of acquired loss of heterozygosity (LOH) in colorectal
      tumours have suggested that a tumour suppressor gene may lie within the short arm
      of chromosome 8, its precise localisation remains to be determined. To obtain a
      more accurate positional map 120 colorectal cancers were examined with eight
      chromosome 8 polymorphic markers comprising both restriction fragment length
      polymorphisms and microsatellite polymorphisms based on (CA)n repeats. 91 cases
      were informative and LOH was detected in 47 (51%). The markers most commonly
      sited within the lost region mapped to the lipoprotein lipase gene (LPL) at
      chromosome 8p22. From study of tumours showing break-points within 8p, a common
      region of deletion was established extending centromerically from LPL to the
      ankyrin 1 gene (ANK1) which is mapped to 8p21.1-11.2. This overlaps with common
      deleted regions observed in other studies of colorectal tumours (8p23.1-p21.3)
      and bladder tumours (8p21-q11.2). Taken together, the results in colorectal
      cancer delineate a region in 8p22-p21.3 where the putative tumour suppressor gene
      must lie. The chromosome 8p deletions appear to be independent of those involving
      5q and 17p in the same tumours. No relationship was found between the presence of
      8p deletion and site or stage of the tumour, or the sex or age of the patient at
      diagnosis.

PMID- 8479757
TI  - Stabilised p53 facilitates aneuploid clonal divergence in colorectal cancer.
AB  - Mutations in the p53 tumour suppressor gene are amongst the most frequent genetic
      abnormalities acquired in tumours. Recent studies in vitro suggest that mutant
      p53 destabilises the genome and facilitates development of aneuploidy. Here, in a
      study of 83 colorectal carcinomas, we demonstrate that alterations in p53
      (detected by immunocytochemical stabilisation) precede and apparently facilitate
      divergence of aneuploid sub-clones. Aneuploidy in these tumours (but not those
      with normal p53) is predominantly in the subtetraploid range, suggesting that
      endoreduplication is important in its origin. This association with a specific
      phase of carcinoma progression is not shared by other commonly acquired genetic
      abnormalities in these tumours. These observations highlight the critical role of
      p53 in the regulation of abnormal chromosome replication and afford an
      explanation for the association between p53 abnormalities, aneuploidy and
      biological aggression in cancer.

PMID- 8479758
TI  - The medical profession: reality and reform.

PMID- 8479759
TI  - Market economics and biomedical ethics.
AB  - Though biomedical ethics has only recently been recognized as a major new medical
      field, the connection between the practice of medical professionals and the
      ethics of medical practice dates back to the beginning of Western medicine. More
      recently, ethics has become more and more involved with economics.

PMID- 8479760
TI  - Assessing the need for bioethics networks.
AB  - Because the ethical choices of medicine become more and more complex each year,
      the Pennsylvania Medical Society Commission on Bioethics in 1992 sponsored a
      survey to assess the need for a statewide ethics network. This article discusses
      the results of that survey.

PMID- 8479762
TI  - Student trustee discusses tuition, choices, and reform.

PMID- 8479761
TI  - Physicians speak out on system reform concerns.
AB  - Physicians this past winter took an aggressive role testifying at hearings on a
      health care reform plan proposed late last year by the governor's Economic
      Development Partnership (EDP). The State Society offered substantial support to
      those physicians and closely monitored each event. This second in a series of
      articles highlights Society members' comments about reform and includes excerpted
      testimonies submitted to the EDP by three concerned physicians.

PMID- 8479763
TI  - Helping the medically indigent and underserved. Part II--Physician's Voluntary
      Fee Discount Program and Society-AMA Cooperative Physician Placement Service.

PMID- 8479765
TI  - New methodology challenges PRO.

PMID- 8479764
TI  - The intimate plague: child abuse becomes epidemic. Interview by Juli C. McGreevy.

PMID- 8479766
TI  - Relief offered in underserved areas. The Health Care Group.

PMID- 8479767
TI  - American ethics: a world perspective.

PMID- 8479768
TI  - Crossed eyes.

PMID- 8479769
TI  - [Hepatitis B vaccination of neonates].

PMID- 8479770
TI  - [Guidelines for completing a medical certificate for obtaining a higher rate of
      family assistance in atopic dermatitis].
AB  - This paper gives guidelines for medical doctors in which cases of atopic
      dermatitis an attestation--according to austrian law--can be given to get an
      elevated family subvention. Following points have to be taken into consideration:
      correct diagnosis of atopic dermatitis, severity of disease (more than 10% of
      body surface), duration of disease (more than 6 months), correct treatment with
      acknowledged methods, necessity of diet and psychotherapy, combination with other
      atopic diseases. In the rule only in infancy and for preschool aged children the
      attestation can be given.

PMID- 8479771
TI  - [Vitamin K administration to neonates].

PMID- 8479772
TI  - [Diphtheria in an infant].
AB  - A seven week old infant developed pharyngeal diphtheria. The child quickly
      deteriorated with severe dyspnea and bradycardia. These symptoms made
      endotracheal intubation necessary. The pharynx and the larynx were covered with
      pseudomembranes. At the fourth day of hospital stay antitoxin has been
      administrated. At first the condition of the child became much better. Then
      progredient paralysis of the diaphragm occurred and led again to intubation. The
      neurologic complications resolved completely. Diphtheria--above all in an infant-
      is a rare disease. Our report shows, that it has to be kept in mind to react
      adequately if necessary. The source of the infection seemed to be visitors from
      India or Russia. Therefore Diphtheria generally has to be regarded as an
      "imported disease".

PMID- 8479773
TI  - Successful extracorporeal lithotripsy of gallbladder stones in a 12 year-old
      girl.
AB  - An otherwise healthy 12-year-old girl presented with radiolucent gallstones and
      colicky pain. After extracorporeal shock wave lithotripsy and oral bile acid
      treatment she is free of stones and biliary symptoms since 18 months. The
      treatment options for gallstone disease in this age group are discussed.

PMID- 8479774
TI  - [Acute reversible liver necrosis after valproate therapy (immunologic
      hypersensitivity)].
AB  - We describe a case of a 9-year-old boy with the severe acute liver injury caused
      by idiosyncrasy after the administration of valproate. The liver biopsy performed
      during the first days after the onset of the disease revealed the necrosis of
      more than 50% of hepatocytes but the injury was almost fully reversible which was
      well demonstrated by the second biopsy five months later. After five years an
      evidence for the immunologic idiosyncrasy caused by valproate was still present,
      which was demonstrated in vitro by blastic transformation of lymphocytes from the
      patient. The boy is quite healthy and epilepsy is under control of suximide. The
      family was informed that the boy could be treated with valproate never more.

PMID- 8479775
TI  - Ventilator dependence and high tetraplegia.

PMID- 8479776
TI  - Tetraplegics and the justice of resource allocation.

PMID- 8479778
TI  - Experience with ventilator dependent patients.

PMID- 8479777
TI  - The French organisation of mechanical ventilation at home for neuromuscular
      diseases.
AB  - In this paper there is an outline of the organisation and the results of
      domiciliary ventilation for patients with neuromuscular diseases where there are
      serious respiratory problems, in relation to special facilities that have been
      made available in France. The clinical and economic benefits are stated, in
      particular concerning the situation in the greater Paris area.

PMID- 8479779
TI  - Southport experience with domiciliary ventilation.
AB  - Experience of the Southport Spinal Injuries Centre in reestablishing ventilator
      dependent patients back in their own homes has confirmed the view that such level
      of disability need not prevent people from returning to the community and start
      living again. Convincing the carers in the community and abolishing the
      traditional boundaries between hospital and community appear to be the
      fundamental prerequisites. Increased use of advanced assistive technology will
      enable these disabled people to have more acceptable control of their lives.

PMID- 8479780
TI  - The Swedish experience in the organisation of domiciliary ventilation for
      patients with a high spinal cord injury.

PMID- 8479781
TI  - Implications of focal spinal cord lesions following trauma: evaluation with
      magnetic resonance imaging.
AB  - In a series of 15 patients who underwent early and follow up magnetic resonance
      imaging following spinal cord injury, those with focal spinal cord abnormalities
      such as cord contusion or haematoma had worse neurological outcomes, and most
      developed spinal cord cysts, showing as well-defined areas of CSF intensity
      within the cord on T1 weighted images. Patients with cord oedema initially, had
      better outcomes, with the development of residual areas of myelomalacia. These
      observations suggest that patients with focal initial spinal cord abnormalities
      may have an increased risk of developing posttraumatic spinal cord cysts, which
      may be associated with the development of delayed neurological deterioration.

PMID- 8479782
TI  - The development of a spinal injuries unit in Armenia.
AB  - A severe earthquake in December 1988 in Armenia, resulted in a large number of
      spinal cord injuries. A rehabilitation facility was urgently established in
      Yerevan by the Red Cross with volunteers from various countries outside the then
      Soviet Union. A programme of training of Armenian doctors, nurses and therapists
      was established, and a new purpose built spinal unit planned. The new unit was
      opened in August 1992 and should serve as a model for similar units throughout
      the Commonwealth of Independent States.

PMID- 8479783
TI  - Arterial oxygen saturation over time and sleep studies in quadriplegic patients.
AB  - This study evaluated arterial oxygen saturation (SaO2) over time in a randomly
      selected group of quadriplegic patients to assess whether clinical history
      prospectively correlated with profiles of oxygen saturation. In 16 stable male
      quadriplegic patients (C4-T5), we used pulse oximetry to measure SaO2 over a 24
      hour period. Measured values of SaO2 were formatted into a cumulative frequency
      distribution of SaO2 over time. The cumulative SaO2 values from the quadriplegic
      patients were compared to SaO2 values in a control group of 12 age-matched
      healthy male subjects. Ten quadriplegic patients had SaO2 profiles comparable to
      the range observed in healthy subjects. Six quadriplegic patients had SaO2
      profiles outside of the normative range. These 6 exhibited cyclic desaturations
      (> 4%) during periods of behaviorally-defined sleep, suggestive of sleep
      disordered breathing. During wakefulness, however, their values of SaO2 were
      within the normative range. With respect to level of injury, age, time after
      injury, or medication use, there was no difference between the six 'hypoxic'
      quadriplegic patients and the 10 'normoxic' quadriplegic patients. Five of the 6
      hypoxic patients had a positive medical history of snoring and increased daytime
      sleepiness, as compared to 6 of 10 normoxic patients who gave a similar history.
      We also performed polysomnographic studies in a subgroup of 7 quadriplegic
      patients. In this subgroup, sleep-disordered breathing was observed in 3 patients
      (AHI of 54/53/12 per hour, respectively). We conclude that in quadriplegic
      patients, in whom there is a low clinical suspicion for sleep-disordered
      breathing, there can occur significant decreases in SaO2 over time.

PMID- 8479784
TI  - The dynamics of magnetic resonance findings in patients with a spinal haematoma.
AB  - In 6 patients with an incomplete transverse section, magnetic resonance (MR)
      imaging revealed a spinal haematoma. The MR signal intensity changed with the
      interval between the haemorrhage and the MR investigation. Signal intensities of
      T1- and T2-weighted images exhibited specific changes with time after the
      haemorrhage, allowing for a retrospective assessment of the time of onset of the
      haemorrhage.

PMID- 8479785
TI  - Pyrexia in hospitalised spinal cord injury patients.
AB  - To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the
      Hospital for Medicine of the Locomotor System (HMLS/SARAH), a review study was
      undertaken. For a period of 3 months, all new episodes of fever were recorded.
      During the study 221.3 patients/month were observed. The age ranged from 14 to 60
      years and time of lesion from 1 to 6,264 days: 85 patients were paraplegia or
      paraparetic, and 44 tetraplegic or tetraparetic. At the beginning of the study
      10.8% of the patients had fever. During follow up, we observed a rate of 33.9 new
      incidences per 100 patients/month. In 77.3% only one cause was identified, and in
      8% no cause could be defined. The commonest causes were urinary tract infection
      (UTI) (44.3%), and soft tissue infections (11.4%). Frequent causes of fever in
      the acute stage other than UTI were complications related to the initial trauma
      and thromboembolic disease (p < 0.05). These results demonstrate the high
      incidence of fever in patients with SCI, in addition to providing a useful
      approach for diagnosis and management.

PMID- 8479786
TI  - Neurological outcome from conservative or surgical treatment of cervical spinal
      cord injured patients.
AB  - This is an analysis of the results of treatment of 1761 patients with traumatic
      injury of cervical spinal cord, admitted to hospital within the first hours or
      days after injury. Analysis of the results of conservative treatment in 798
      patients and of surgical treatment in 963 patients has shown that the results are
      to a large extent dependent on the method of treatment and when specialist
      treatment was started.

PMID- 8479787
TI  - Adhesive capsulitis of the shoulder.
AB  - Adhesive capsulitis of the shoulder is a relatively common problem that can cause
      significant functional morbidity in a wide variety of patient populations.
      Numerous treatment methods have been advocated and are reviewed and summarized in
      this article. Although several advances have been made in determining the
      etiology of this disorder, it remains poorly understood and without any
      definitive treatment algorithm.

PMID- 8479788
TI  - Developments in diagnosis of the painful total hip replacement.
AB  - There has been significant improvement in the interpretation of diagnostic tests
      for the evaluation of the cemented and uncemented symptomatic total hip
      replacement. Lucent lines around cemented implants have often been found to
      represent remodeling rather than loosening. Lysis without looseness has been
      described as a cause of hip pain in both cemented and uncemented hip
      replacements. Therefore, there are a number of recent developments in diagnosis
      that must be considered when evaluating the symptomatic cemented or cementless
      total hip replacement. Some of these developments are reviewed in this paper.
      Other developments and contemporary algorithms for treatment incorporating these
      recent data will be presented in next month's issue.

PMID- 8479789
TI  - The saphenous nerve: an external method for identifying its exit from the
      adductor canal.
AB  - The saphenous nerve is the largest and longest branch of the femoral nerve. At
      its proximal origin, it travels with the femoral artery. The nerve passes lateral
      to medial in the adductor canal to emerge subcutaneously and supply the medial
      side of the knee. This investigation analyzes the course of the nerve in 24 lower
      extremities (12 right, 12 left) and offers a standardized measuring system for
      externally pinpointing the nerve's exit from the canal. This study may benefit
      physicians who treat patients with knee pain of obscure etiology. It probably
      will have direct application to saphenous nerve injection by physicians as part
      of a pain-management program.

PMID- 8479790
TI  - Limited femoral endoprosthesis for avascular necrosis of the femoral head.
AB  - The options for treatment of the young patient with late-stage avascular necrosis
      of the femoral head are limited. The authors performed a conservative type of
      femoral hemiarthroplasty on a select group of patients. They chose for the series
      only patients with Ficat stage III and IV avascular necrosis, particularly those
      who had an intact acetabulum and femoral-head involvement only. Of 19 procedures
      followed for an average of 36 months, there were 84% good and excellent results.
      The authors feel that this operative procedure may have a role in the treatment
      of this specific group of young patients.

PMID- 8479791
TI  - Percutaneous screw fixation of intercondylar fracture of the distal humerus.
AB  - A greenstick intercondylar fracture of the distal humerus occurred in a 13-year
      old boy. The articular surface of the trochlea was diastased nearly 5 mm. The
      fracture was reduced and fixed percutaneously using a 4.5-mm cannulated screw
      from a lateral approach.

PMID- 8479792
TI  - Subcapital femoral neck fracture following open reduction and internal fixation
      of an intertrochanteric hip fracture using a sliding screw and side plate.
AB  - This case report illustrates a subcapital femoral neck fracture following
      application of a compression screw and side plate to treat an intertrochanteric
      hip fracture. This is an uncommon complication in the management of
      intertrochanteric hip fractures. The authors describe steps in this surgical
      technique that minimize the possibility of this complication.

PMID- 8479793
TI  - Measuring intramedullary nails.
AB  - Determining the length of nail needed for intramedullary nailing can sometimes be
      difficult. This article describes a simple procedure for taking this important
      measurement.

PMID- 8479794
TI  - A 35-year-old-man with pain in the metatarsophalangeal joints. Soft-tissue
      chondroma.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to the orthopaedic surgeon. Initial history,
      physical findings, and roentgenographic examinations are found on the first two
      pages. The final clinical and roentgenographic differential diagnoses are
      presented on the following pages.

PMID- 8479795
TI  - The novel hydroxynaphthoquinone 566C80 inhibits the development of liver stages
      of Plasmodium berghei cultured in vitro.
AB  - The causal prophylactic activity of the novel hydroxynaphthoquinone, 566C80, was
      assessed against the exo-erythrocytic (EE) stages of Plasmodium berghei cultured
      in the human hepatoma cell line, HepG2. 566C80 was found to be highly active as
      an inhibitor of EE development and was more active than the established causal
      prophylactic pyrimethamine. A 566C80 concentration of 1.85 x 10(-9) M, added 3 h
      after sporozoite invasion, reduced the numbers of EE forms visible at 48 h by 50
      degrees o, while the equivalent concentration of pyrimethamine was 1.95 x 10(-8)
      M.

PMID- 8479796
TI  - Common and rare trout parasites in a small landscape system.
AB  - Brown trout (Salmo trutta) from four lakes within an area of approximately 40 km2
      were found to harbour nine helminth species. Crepidostomum metoecus could be
      classified as core species, while Crepidostomum farionis had an intermediate
      position. All the others could be classified as satellite species. Salmon (Salmo
      salar) fingerlings were grown to smolts in an earthpond over the summer. The
      fingerlings became infected with Crepidostomum spp. which may indicate a superior
      colonization ability in the core species. The results support the 'rescue effect
      hypothesis' rather than the 'carrying capacity hypothesis'.

PMID- 8479797
TI  - In vitro excystation of Cryptosporidium parvum.
AB  - Protocols for in vitro excystation of oocysts of Cryptosporidium parvum,
      including different chemical pre-incubation steps, were compared to examine some
      of the biochemical triggers involved in excystation and to define an in vitro
      excystation protocol of a reproducibly high efficiency. Pre-incubation steps
      which increased the permeability of the oocysts were found to enhance excystation
      dynamics and pre-treatment of oocysts with saliva was found to decrease the
      permeability and reduce excystation. Although excystation was maximal after
      incubation for 4 h, sporozoites tended to lyse over this period, and maximum
      sporozoite recovery occurred after 30 min. The results obtained are discussed in
      relation to excystation protocols adopted by different research groups and a
      number of recommendations are given for in vitro excystation of C. parvum
      oocysts.

PMID- 8479798
TI  - Aerobic resistance of Trichomonas vaginalis to metronidazole induced in vitro.
AB  - Aerobic resistance of Trichomonas vaginalis to metronidazole was induced in vitro
      by anaerobic cultivation of drug-susceptible trichomonads with low concentrations
      of the drug (2-3 micrograms/ml) for 50 days. Minimal lethal concentrations (MLC)
      for metronidazole of the resistant derivatives were high in aerobic
      susceptibility assays (MLC = 216-261.5 micrograms/ml) but low in anaerobic assays
      (MLC = 4.2-6.3 micrograms/ml), surpassing MLC values of their parent strain
      approximately 50-fold and 3-fold under aerobiosis and anaerobiosis, respectively.
      Sensitivity to metronidazole under anaerobic conditions and activity of the
      hydrogenosomal enzyme pyruvate: ferredoxin oxidoreductase indicated that the
      resistance was of the aerobic type. Dependence of the resistance manifestation on
      O2 was further confirmed by susceptibility assays in vitro performed in defined
      gas mixtures of different oxygen content (1-20%). Five percent concentration of
      O2 proved to be the threshold required for resistance demonstration and the MLC
      values further increased with increasing O2 concentrations. The in vitro-induced
      resistance was also demonstrated in vivo by subcutaneous mouse assay. The dose of
      metronidazole needed to cure 50% of infected mice (DC50) was 223 mg/kg x 3 for
      resistant derivative MR-3a but 6.6 mg/kg x 3 only for its drug-susceptible parent
      strain. The metronidazole-resistant strains developed in this study correspond by
      their properties to drug-resistant T. vaginalis strains isolated from patients
      refractory to treatment, and promise to be a useful tool in the study of 5
      nitroimidazole aerobic resistance.

PMID- 8479799
TI  - Population dynamics of Sphaerospora dicentrarchi Sitja-Bobadilla et Alvarez
      Pellitero, 1992 and S. testicularis Sitja-Bobadilla et Alvarez-Pellitero, 1990
      (Myxosporea: Bivalvulida) infections in wild and cultured Mediterranean sea bass
      (Dicentrarchus labrax L.).
AB  - The population dynamics of Sphaerospora dicentrarchi and S. testicularis,
      myxosporean parasites of sea bass (Dicentrarchus labrax), was studied in
      different groups of cultured and wild fish. S. dicentrarchi prevalence was higher
      for wild fish (100%) than for cultured ones (70.5%). Infection levels increased
      with host age and there were no significant sex differences in cultured fish.
      Among parasitized organs, the gall bladder and intestine registered the highest
      infection levels in wild and cultured fish. A progressive increase in infection
      levels of S. testicularis was observed in cultured males during the spawning
      season in four consecutive periods. The evolution of the percentage of the
      different parasitic stages is pointed out. The infection seems to be related to
      water temperature and gonadal maturation.

PMID- 8479800
TI  - The recruitment of mast cells, exclusively of the mucosal phenotype, into
      granulomatous lesions caused by the pentastomid parasite Porocephalus crotali:
      recruitment is irrespective of site.
AB  - Adults of the porocephalid pentastomid Porocephalus crotali infect the lung of
      rattlesnake definitive hosts and larvae develop in rat intermediate hosts. In the
      latter, nymphs encyst within a variety of tissue sites (commonly abdominal fat
      bodies and lungs) and each becomes the focus of an eosinophilic granuloma. From
      an early stage in infections, granulomas become increasingly infiltrated by mast
      cells which, using conventional histology and paired immunofluorescence against
      mast cell proteases, appear to be exclusively of the mucosal phenotype. Mucosal
      mast cells are concentrated along the dorsal region of the parasite and in a plug
      of tissue containing degenerating cuticles within independent granulomas, which
      is located between its head and tail. ELISAs against the rat mast cell proteases
      I and II (RMCP I and II), extracted from abdominal fat, lung, spleen, liver and
      kidney granulomas at various intervals post-infection, reveal a substantially
      elevated concentration of RMCP II in all lesions. In fat, concentrations increase
      up to about 100 days post-infection, at which time moulting ceases and
      inflammatory responses subside. RMCP II was scarcely detectable in matched
      control tissues. Unlike infections with certain nematode parasites, where enteric
      mucosal mast cells secrete RMCP II systemically, concentrations of RMCP II in the
      serum of infected rats were significantly reduced when compared with age-matched
      uninfected controls. These results confirm that P. crotali can selectively
      recruit mucosal mast cells to a variety of tissue sites, most of which are non
      mucosal. Possible mechanisms are discussed.

PMID- 8479801
TI  - Purification and properties of phosphoenolpyruvate carboxylase from Molinema
      dessetae (Nematoda: Filarioidea).
AB  - The presence of phosphoenolpyruvate (PEP) carboxylase (EC 4.1.1.31), an enzyme at
      the branchpoint of glycolysis and the Krebs cycle was detected in the Filaria
      Molinema dessetae. This enzyme has not previously been identified in Helminths,
      which have so far been found to only possess a phosphoenolpyruvate carboxykinase
      (EC 4.1.1.32). This enzyme had a level of activity comparable to that of pyruvate
      kinase, and was relatively less active than enzymes such as malate dehydrogenase
      or lactate dehydrogenase. We propose here a method of purification of M. dessetae
      PEP-carboxylase. When purified to electrophoretic homogeneity, the enzyme had a
      molecular weight of 64 kDa. Kinetic studies indicated that the carboxylation
      reaction had an optimal pH of 5.8. The enzyme was inhibited by cations such as
      Fe2+, Zn2+, Cd2+, Cu2+ but required the presence of Mg2+ or Mn2+. The enzyme was
      thermostable. The apparent Km value of 2.38 mmol for phosphoenolpyruvate for the
      carboxylation reaction was higher than previously reported values. The Km value
      for KHCO3 was found to be 1.6 mmol. PEP-carboxylase did not catalyse the reverse
      reaction.

PMID- 8479802
TI  - Vaccination of merino lambs against haemonchosis with membrane-associated
      proteins from the adult parasite.
AB  - Groups of South African, farm-reared merino lambs about 4 months old were
      vaccinated with extracts of adult Haemonchus contortus enriched with H11, an
      integral membrane protein from the parasite's intestinal microvilli, or with
      proteins soluble in Tween 20. The lambs were challenged with 5000 infective 3rd
      stage larvae. Compared to the adjuvant-injected controls, lambs vaccinated with
      350 micrograms/kg liveweight of the H11-enriched extract showed an 89% reduction
      in parasite egg production and an 88% reduction in total worm burden at post
      mortem 35 days post-challenge. The H11-enriched extract contained some protein
      also present in the Tween 20 extract. Lambs vaccinated with 600 micrograms/kg of
      protein soluble in Tween 20 showed a 40% reduction in faecal egg counts and 51%
      reduction in total worm numbers 35 days post-challenge. Animals injected with 20
      micrograms/kg of a sub-fraction containing H11 obtained from the H11 extract,
      showed a 71% reduction in egg output and total worm numbers.

PMID- 8479803
TI  - Pharmacological profile of the 5-hydroxytryptamine receptor of Fasciola hepatica
      body wall muscle.
AB  - 5-HT is a candidate for the excitatory transmitter at the neuromuscular junction
      in trematodes including Fasciola hepatica. This study has determined the response
      of a muscle strip preparation from Fasciola hepatica to 5-HT and a range of
      agonists that distinguish between the vertebrate receptor 5-HT subtypes. 5-HT
      increased the resting tone and the rhythmic activity of the muscle strip. Of the
      19 compounds tested, only 10 had an effect similar to 5-HT and all but 2 of these
      were tryptamine compounds. 5-HT was more potent than tryptamine whilst 4-OH
      tryptamine had no effect, suggesting that the response is mediated by a 5-HT
      rather than a tryptamine receptor. 5-Fluorotryptamine and 5
      carboxyamidotryptamine were the most potent agonists. 8-OH-DPAT also mimicked the
      effect of 5-HT, though less potently. Assuming that these agents elicit their
      response through a common receptor, this suggests the presence of a 5-HT receptor
      with similar properties in terms of agonist recognition as the vertebrate 5-HT1
      class of receptor involved in controlling Fasciola muscle motility.

PMID- 8479804
TI  - Effects of qinghaosu (artemisinin) and its derivatives on experimental cutaneous
      leishmaniasis.
AB  - We have investigated the effect of qinghaosu (QHS, artemisinin) and its
      derivatives on Leishmania major replication in vitro and on the disease
      development in mice infected with L. major. Artemisinin is effective against
      promastigotes in vitro, with an ED50 (50% effective dose) at 7.5 x 10(-7) M. Both
      artemisinin and artemether are leishmanicidal for amastigotes in infected murine
      macrophages in vitro, with ED50 at 3 x 10(-5) M and 3 x 10(-6) M respectively.
      These compounds have no effect on the viability of macrophages or on the
      phytohaemaglutinin-induced proliferation of normal spleen cells, even at 10(-4)
      M. BALB/c mice infected in the footpad with L. major developed significantly
      smaller lesions and parasite loads when treated with the compounds. Intra-lesion
      injection of the compounds was the most effective route. The intramuscular and
      oral routes were also effective; however, intravenous injection with artesunate
      was not effective.

PMID- 8479805
TI  - Assessment of monoclonal antibodies to Echinococcus granulosus antigen 5 and
      antigen B for detection of human hydatid circulating antigens.
AB  - Four monoclonal antibodies (MAb) to Echinococcus granulosus Antigen 5 (Ag5) and
      Antigen B (AgB) were assessed in an enzyme-linked immunosorbent assay (ELISA) for
      detection of circulating antigens (CAg) in sera of human patients with E.
      granulosus infection. Around 5.5-8% of 200 sera from 42 surgically proven hydatid
      patients contained detectable CAg by individual MAb. The combined detection rate
      for CAg, using four MAb, was 19% (38/200). Although hydatid CAg was detected by
      MAb in at least one serum sample from 21 of 42 patients, some patients remained
      negative in the assay regardless of the time when serum samples were taken (pre-
      or post-operatively), or of the continuing presence of hydatid cysts, their
      location or fertility. In addition, it was observed that the binding capacity of
      MAb for sheep hydatid cyst fluid antigen (SHCF) was somewhat reduced in the
      presence of normal human serum. The CAg detection assay would only be useful for
      assessment of hydatid infection status in patients with detectable CAg in serum
      samples.

PMID- 8479806
TI  - Immunocytochemical evidence for the presence of substance P-like peptide in
      Diphyllobothrium dendriticum.
AB  - Substance P immunoreactivity (SP-IR) was detected in the nervous system of the
      gull-tapeworm Diphyllobothrium dendriticum. The distribution of the SP-IR neurons
      in the plerocercoid differs from that of other peptidergic and aminergic neurons
      in the worm. As well as occurring in the ganglionic commissure and along the two
      main nerve cords, SP-IR neurons are located laterally to the main nerve cords but
      not dorsally or ventrally. The SP-IR neurons have projections extending to the
      surface. Bipolar SP-IR neurons with processes to the surface also occur in the
      tip of the scolex. A sensory function for the SP-IR neurons is suggested.

PMID- 8479807
TI  - Maximum local helminth parasite community richness in British freshwater fish: a
      test of the colonization time hypothesis.
AB  - The investigation of Price & Clancy (1983), which demonstrated a significant
      positive correlation between total helminth species number per host species and
      geographical range of freshwater fish host species in Britain, was re-examined
      using a different measure of parasite species richness. Re-calculation of the
      correlations between the two parameters after controlling for the effect of the
      composition of the list of fish by excluding, on biological and distributional
      grounds, 2 species of agnathans and 7 species of introduced teleosts, and for the
      effect of sampling effort by using helminth richness in the richest component
      community of each fish species rather than check-list data, reveals no
      significant relationship between helminth species richness and host range.
      Habitat and an omnivorous host diet now appear more significant determinants of
      helminth richness than the accumulation of parasites by predation. The findings
      provide little support for the interpretation of the relationship between
      helminth species richness and host range in terms of island biogeographic theory,
      but do support an alternative explanation in terms of the colonization time
      hypothesis, i.e. that helminth species richness is related to the time since the
      fish host arrived in Britain.

PMID- 8479808
TI  - Gene therapy: possibilities and promise.

PMID- 8479809
TI  - Plasma fibrinogen and its correlates in children from a biracial community: the
      Bogalusa Heart Study.
AB  - Fibrinogen levels were measured in 5- to 17-y-old children (n = 3047; 40% black
      and 49% female), from a well-defined biracial community. No significant race and
      sex differences in fibrinogen levels were observed, but levels increased (p <
      0.001) with age or sexual maturation in black females. Adjusted for age,
      fibrinogen concentrations were positively correlated with ponderal index
      (weight/height3) (0.09-0.22, p < 0.01), triceps skinfold thickness (0.10-0.23, p
      < 0.05), and subscapular skinfold thickness (0.13-0.24, p < 0.01) in all race-sex
      groups. Weak correlations were found between fibrinogen level and blood pressure
      and lipoprotein components for some of the race-sex groups, but these become
      nonsignificant or minimal after adjustment for ponderal index and skinfolds. A
      positive correlation (0.12-0.16, p < 0.01) was found between fibrinogen and white
      blood cell count for Caucasians, which still held after adjustment for ponderal
      index and skinfolds. In a stepwise regression, ponderal index, white blood cell
      count, and HDL cholesterol showed an independent association with fibrinogen.

PMID- 8479810
TI  - Antenatal cocaine exposure produces accelerated surfactant maturation without
      stimulation of antioxidant enzyme development in the late gestation rat.
AB  - Antenatal cocaine administration is associated with increases in catecholamines
      and glucocorticoids and results in fetal hypoxemia, with the speculated potential
      for increased free radical formation in the fetus. Because of this, we
      hypothesized that antenatal cocaine exposure would produce not only accelerated
      pulmonary surfactant maturation, but also stimulation of antioxidant enzyme (AOE)
      system maturation and the ability to mount a protective AOE response to hyperoxia
      as well. Seventy-two, 48, and 24 h before delivery at either 20, 21, or 22 d of
      gestation, pregnant rats received twice daily s.c. injections of cocaine
      hydrochloride (40 mg/kg) or saline. Off-spring demonstrated growth retardation
      with significant reduction in body weight at all 3 gestational d studied that
      persisted to the 5th postnatal d. Serum corticosterone and total catecholamines
      were elevated from 50 to 200% in cocaine-exposed adult rats and pups. Advanced
      surfactant development in cocaine-exposed fetal offspring was apparent at d 21 of
      gestation, with significant increases in lung disaturated phosphatidylcholine
      content in cocaine (3.94 +/- 0.67 mg/g lung) versus control (3.25 +/- 0.64)
      offspring (p < 0.01). No increases in AOE maturation were found in cocaine
      exposed fetuses at all 3 gestational d studied, whereas a significant decrease
      was demonstrated in glutathione peroxidase activity at d 20 and 22 of gestation
      in cocaine-exposed fetuses. In addition, cocaine newborns manifested a protective
      AOE response to hyperoxia of a magnitude similar to that of control
      newborns.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479811
TI  - Mitigation of pulmonary oxygen toxicity in rats by intratracheal instillation of
      polyethylene glycol-conjugated antioxidant enzymes.
AB  - Hyperoxic lung injury may be mitigated by increasing alveolar epithelial
      antioxidant activity. We examined whether intratracheal instillation of
      superoxide dismutase (SOD) and catalase, conjugated to polyethylene glycol (PEG)
      to permit cellular access, reduces hyperoxic lung injury. Adult rats, pretreated
      intratracheally with 1,500 U PEG-SOD and 10,000 U PEG-catalase or with
      inactivated PEG-SOD/catalase, 1% PEG, or saline (treated controls), were exposed
      to hyperoxia (fraction of inspired oxygen > 0.95) for 48 h and compared with
      untreated air controls. Alveolar wash protein values in the treated control
      groups were significantly higher than in the PEG-SOD/catalase and air control
      groups, which had comparable values. Lung homogenate and alveolar type II cell
      SOD and catalase activities were higher after PEG-SOD/catalase treatment and
      lower after the control treatments when compared with untreated air controls.
      Lung homogenate dipalmitoyl phosphatidylcholine decreased and alveolar wash
      dipalmitoyl phosphatidylcholine increased after hyperoxia, but these changes were
      less after PEG-SOD/catalase treatment. Rats pretreated intratracheally with PEG
      SOD/catalase survived significantly longer in hyperoxia than saline controls.
      These data indicate the potential of intratracheal antioxidant treatment to
      reduce pulmonary oxygen toxicity.

PMID- 8479812
TI  - Prevention of postasphyxial increase in lipid peroxides and retinal function
      deterioration in the newborn pig by inhibition of cyclooxygenase activity and
      free radical generation.
AB  - Free radicals have been implicated in the development of injury to the immature
      retina. Asphyxia increases free radicals as well as prostaglandins (PG) in neural
      tissues. We assessed whether in the retina the cyclooxygenase pathway contributes
      to free radical formation after oxidative insults such as asphyxia, which in turn
      disrupts retinal function. Newborn pigs were treated with either saline,
      ibuprofen (194 mumol/kg i.v.), or allopurinol (1 mmol/kg i.v.), and retinal
      malondialdehyde (MDA), hydroperoxides, PGE2 and PGF2 alpha levels, and the
      amplitudes and implicit times of the a- and b-waves of the full-field
      electroretinogram were measured before and 1 h after a 5-min period of asphyxia.
      In saline-treated animals, asphyxia caused a marked increase (p < 0.01) in MDA,
      hydroperoxides, PGE2, and PGF2 alpha concentrations in the retina. This was
      associated with a significant decrease (p < 0.01) in the b-wave amplitude
      measured under scotopic and photopic conditions and an increase in the b-wave
      implicit times. Ibuprofen and another cyclooxygenase inhibitor, indomethacin (28
      mumol/kg i.v.), decreased PGE2 and PGF2 alpha levels and prevented the increase
      in MDA and hydroperoxides after asphyxia. Allopurinol maintained low
      concentrations of MDA and hydroperoxides after asphyxia. Both ibuprofen and
      allopurinol prevented the postasphyxial changes in the b-wave amplitude and
      diminished the delay in implicit time observed after asphyxia in saline-treated
      pigs. Our findings suggest that in the retina after asphyxia free radicals appear
      to originate primarily from the cyclooxygenase pathway and contribute to the
      deterioration in retinal electrophysiologic function of the newborn animal.
      Cyclooxygenase inhibitors, like free radical scavengers, may protect retinal
      function from deteriorating after oxidative stresses.

PMID- 8479813
TI  - Hyperoxia and alkalosis produce pulmonary vasodilation independent of endothelium
      derived nitric oxide in newborn lambs.
AB  - Supplemental oxygen and alkalosis are the most effective treatments used to lower
      pulmonary arterial pressure in children with pulmonary hypertensive disorders.
      However, their mechanisms of action are unknown. Endothelium-derived nitric oxide
      (EDNO) is an important mediator of pulmonary vascular tone and produces potent
      pulmonary vasodilation during pulmonary hypertension. In vitro evidence suggests
      that EDNO may mediate the vasodilating effects of oxygen. To investigate whether
      EDNO synthesis mediates the pulmonary vasodilation produced by hyperoxia
      [normocarbic ventilation with 100% oxygen, arterial oxygen tension > 450 torr (60
      kPa)] or alkalosis (hyperventilation with 21% oxygen, pH > 7.55) in vivo, eight
      intact newborn lambs were studied during similar degrees of pulmonary
      hypertension induced either by the infusion of U46619 (a thromboxane A2 mimic) or
      N omega-nitro-L-arginine (an inhibitor of EDNO synthesis). The lambs were
      sedated, paralyzed, and mechanically ventilated. Meclofenamic acid was infused to
      inhibit prostaglandin synthesis. During pulmonary hypertension induced by U46619,
      pulmonary arterial pressure and pulmonary vascular resistance were significantly
      decreased by acetylcholine (an EDNO-dependent vasodilator) (23.1 +/- 3.4% and
      43.3 +/- 14.5%, respectively), hyperoxia (26.8 +/- 7.8% and 32.9 +/- 10.6%), and
      alkalosis (32.1 +/- 10.3% and 36.1 +/- 17.0%) (p < 0.05). During pulmonary
      hypertension induced by N omega-nitro-L-arginine, the decreases in pulmonary
      arterial pressure and pulmonary vascular resistance produced by acetylcholine
      (9.6 +/- 6.4% and 23.9 +/- 14.1%, respectively) were significantly attenuated (p
      < 0.05), but the decreases produced by hyperoxia or alkalosis were unchanged.
      Therefore, hyperoxia and alkalosis can produce pulmonary vasodilation independent
      of EDNO synthesis in the intact newborn lamb.

PMID- 8479814
TI  - Biologic effects of parenteral bisulfite on human vascular tissue.
AB  - Antioxidant properties of bisulfite are used to stabilize parenteral amino acid
      solutions. After reports of adverse reactions to dietary sulfites, we evaluated
      whether the infusion of bisulfite had biologic effects on human vascular tissue.
      Because an endothelial oxidative injury can affect mediators of vasoreactivity,
      vascular pressure and prostaglandin production were studied in an intact human
      vein model infused with clinically relevant amino acid solutions differing only
      by their metabisulfite content (0 versus 300 mg/L). The amino acid solution
      containing bisulfite presented higher venous pressure (p < 0.01) and
      prostaglandin production (6-keto-prostaglandin F1 alpha, p < 0.01; and
      prostaglandin E2, p < 0.05). A hydroxyl radical-generating system added to the
      solutions did not modify the pressure readings, but it resulted in an overall
      decrease in prostacyclin production (p < 0.05). Despite this known inhibitory
      effect on oxidative challenge on prostaglandin I2 production, prostaglandins
      remained higher in the presence of bisulfite. The results suggest that the effect
      of bisulfite takes place before prostaglandin H2 synthesis in the eicosanoid
      cascade, whereas the oxidative challenge affects specifically the synthesis of
      prostaglandin I2, after prostaglandin H2, indicating that there is no interaction
      between bisulfite and the hydroxyl generating system. Bisulfite has local
      vascular effects on endothelial mediators, separate from its antioxidant
      properties.

PMID- 8479815
TI  - Regulation of fetal lamb ductus arteriosus smooth muscle cell migration by
      indomethacin and dexamethasone.
AB  - Postnatal closure of the ductus arteriosus (DA) requires the development, during
      late gestation, of "intimal cushions." These structures, which partially occlude
      the vessel lumen, are characterized by smooth muscle cell (SMC) migration into an
      expanded subendothelium. DA SMC migration is dependent upon increased fibronectin
      (FN) production. We hypothesized that indomethacin (INDO) or dexamethasone, which
      could influence FN production, may affect SMC migration and DA intimal cushion
      formation. SMC harvested from the DA and aorta of 100-d fetal lambs were seeded
      onto three-dimensional collagen gels. Migration into the gels was quantitatively
      assessed by phase-contrast microscopy. INDO retarded DA SMC migration (p < 0.05),
      but it had no effect on aorta SMC migration. Synthesis of FN was measured after
      [35S]-methionine radiolabeling of cells, gelatin sepharose extraction of
      conditioned media, and resolution by SDS-PAGE. Despite the decrease in migration,
      INDO did not affect FN synthesis in DA SMC, whereas dexamethasone, a stabilizer
      of FN mRNA that increased DA FN synthesis by 44%, had no further effect on SMC
      migration. We then investigated whether INDO might be influencing SMC migration
      by decreasing collagenase production or altering cell shape through changes in F
      actin polymerization. Collagenase activity, assessed by zymography using collagen
      types I and IV, was similar in control and treated DA and aorta cells. Image
      analysis of the actin cytoskeleton after rhodamine-phalloidin staining of DA SMC,
      however, revealed significant shortening of INDO-treated DA SMC relative to
      control, consistent with the observed reduction in migration.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8479816
TI  - Mechanically increased right ventricular afterload alters left ventricular
      configuration, not contractility, in neonatal lambs.
AB  - Left ventricular dysfunction has been observed in human infants with pulmonary
      hypertension. The purpose of this study was to establish whether mechanically
      increased right ventricular afterload alters left ventricular performance by
      altering its contractility, configuration, or both. Six neonatal 3- to 7-d-old
      lambs were acutely instrumented with micromanometer-tipped catheters and two
      pairs of ultrasonic crystals to measure left ventricular pressure and anterior
      posterior and septal-free wall dimensions. The product of these two dimensions,
      denoted left ventricular area, was used as an index of left ventricular volume.
      Two levels of mechanically increased right ventricular afterload were induced
      with a closed pericardium under three levels of left ventricular preload produced
      by whole-blood transfusions. Four brief increases in left ventricular afterload
      were induced by constricting the aorta under each right ventricular afterload and
      preload condition. Using multiple linear regression, we found that the slope of
      the end-systolic pressure-area relationship, an index of contractility, was
      unchanged [0.90 +/- 0.11 mm Hg/mm2 (SEM)], and stroke area (65.8 +/- 7 mm2) and
      cardiac output (the product of stroke area and heart rate) (13,400 +/- 1,660
      mm2/min) were maintained. However, the area intercept of the pressure-area line
      at zero pressure (499 +/- 13 mm2) shifted significantly to the left in the
      presence of both levels of increased right ventricular afterload (by -39.2 +/- 13
      and -76.2 +/- 15 mm2, respectively). Mechanically increased right ventricular
      afterload alters left ventricular configuration and causes a shift in the
      operating volume (area) range of the ventricle with no change in contractility in
      3- to 7-d-old lambs.

PMID- 8479817
TI  - Pancuronium does not alter the hemodynamic status of piglets after normoxia or
      hypoxia.
AB  - Pancuronium is a neuromuscular blocking agent commonly used to eliminate
      agitation in sick newborn infants requiring mechanical ventilation. Experimental
      data supporting this method of intervention are controversial, and hemodynamic
      studies in newborn infants report conflicting results. This study was designed to
      determine the hemodynamic effects of pancuronium administered under conditions of
      normoxia, hypoxia, and preexposure to hypoxia in neonatal piglets with normal
      lungs. After baseline hemodynamic and blood gas measurements were obtained,
      pancuronium was administered in two i.v. bolus injections of 0.1 mg/kg. Tidal
      volume and minute ventilation were maintained constant during the experimental
      procedure by adjusting ventilator settings. Twenty min after pancuronium, no
      changes from baseline values were found in arterial blood gases, heart rate,
      cardiac output, mean arterial pressure, systemic vascular resistance, pulmonary
      artery pressure, pulmonary vascular resistance, central venous pressure, or
      pulmonary capillary wedge pressure in any of the three conditions studied. In
      conclusion, pancuronium administered during normoxia, hypoxia, or after
      preexposure to hypoxia while controlled ventilation is maintained does not alter
      systemic or pulmonary hemodynamic status of the newborn piglet.

PMID- 8479818
TI  - Three different strains of heat-killed group B beta-hemolytic streptococcus cause
      different pulmonary and systemic hemodynamic responses in conscious neonatal
      lambs.
AB  - Although group B beta-hemolytic streptococcus (GBS) causes pathologic hemodynamic
      alterations in both human neonates and neonatal animal models of sepsis, little
      is known about strain-dependent differences in hemodynamic responses to GBS. This
      study compared pulmonary and systemic hemodynamic dose-response profiles in
      conscious neonatal lambs with three different strains of heat-killed GBS
      originally isolated from infected human neonates (group 1: serotype Ib, early
      onset sepsis; group 2: serotype Ib, necrotizing enterocolitis; and group 3:
      serotype III, meningitis). Regression models of hemodynamic responses were
      characterized after lambs were injected with heat-killed GBS (dose range 0.1-6.0
      x 10(9) colony-forming units, i.v.). All three GBS strains caused dose-dependent
      increases in mean pulmonary arterial pressure and pulmonary and systemic vascular
      resistances and decreases in cardiac output and heart rate. The GBS strain used
      in group 1 caused a greater effect on mean pulmonary arterial pressure and
      systemic vascular resistance than those used in groups 2 and 3 and was the only
      strain to cause an increase in mean systemic arterial pressure. The GBS strains
      used in groups 1 and 2 had a greater effect on pulmonary vascular resistance than
      that used in group 3. No group differences were observed in cardiac output and
      heart rate responses, which were, however, influenced by age, gender, and
      duration of postoperative recovery of the lambs. No attenuation or augmentation
      of hemodynamic effect was observed after sequential doses of 10(9) colony-forming
      units of GBS given in a single day. This study demonstrates strain-dependent
      quantitative differences in pulmonary vascular response and qualitative
      differences in systemic vascular response to heat-killed GBS.

PMID- 8479819
TI  - Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 plasma levels
      in neonatal sepsis.
AB  - Tumor necrosis factor-alpha, IL-1 beta, and IL-6 are thought to be involved in
      the pathogenesis of sepsis with gram-negative bacteria. We studied these
      cytokines during neonatal sepsis with mainly gram-positive bacteria. Ten newborns
      with clinical sepsis and 22 healthy controls were enrolled in the study. TNF
      alpha plasma levels proved to be increased in the newborns with sepsis up to 560
      +/- 234 pg/mL (ng/L) versus 36 +/- 4 pg/mL (ng/L) in the control group (p <
      0.005), whereas IL-6 plasma levels in newborns with sepsis were 79.700 +/- 37.500
      pg/mL (ng/L) versus 55 +/- 28 pg/mL (ng/L) in the control group (p < 0.01). The
      IL-1 beta plasma levels were only slightly elevated in the group newborns with
      sepsis [up to 18 +/- 5 pg/mL (ng/L) versus 7 +/- 1 pg/mL (ng/L) in the control
      group (p < 0.01)]. After the start of therapy with antibiotics, both TNF alpha
      and IL-6 plasma levels decreased concomitantly with the improvement of the
      clinical situation within 2 d. These data confirm the abundant presence of TNF
      alpha and IL-6 during neonatal sepsis, whereas IL-1 beta appeared to be present
      in small amounts only. Nevertheless, the IL-1 beta but not the TNF alpha plasma
      level appeared to correlate inversely with the decrease in diastolic tension as
      standardized according to birth weight (R = 0.66, p = 0.04). TNF alpha, IL-1
      beta, and IL-6 were not correlated with any febrile response in the group with
      sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479820
TI  - Combination macrophage-colony stimulating factor and interferon-gamma
      administration ameliorates the osteopetrotic condition in microphthalmic (mi/mi)
      mice.
AB  - Malignant osteopetrosis is a fatal congenital bone disorder characterized by
      defective osteoclastic function. Death frequently occurs within the first decade
      of life. The precise molecular defect(s) that causes osteopetrosis is not known.
      The possibility that osteoclasts, like macrophages, are controlled by
      interactions with cytokines suggests that these agents may provide a means of
      increasing osteoclastic function. Macrophage-colony stimulating factor (M-CSF), a
      cytokine known to enhance macrophage and osteoclast generation, and recombinant
      human interferon-gamma (rIFN), a cytokine known to stimulate superoxide
      generation by white cells, were administered to microphthalmic (mi/mi) mice in an
      attempt to improve the osteopetrotic condition. Each cytokine was administered
      separately and in combination to neonatal mi/mi mice for 7 consecutive d. Bone
      turnover, osteoclast numbers, superoxide generation by white cells, and
      hematocrit were assessed. rIFN, M-CSF, and a combination of the cytokines
      stimulates oxygen-derived free radical production by white cells and increased
      bone resorption. rIFN resulted in a reduction in the number of osteoclasts. This
      reduction in number was ameliorated by M-CSF. M-CSF alone and in combination with
      rIFN resulted in improved hematopoietic function, increased weight gain, and
      increased physical activity of the affected mutants.

PMID- 8479821
TI  - Different regulation of clonal growth by transforming growth factor-beta 1 in
      human fetal articular and costal chondrocytes.
AB  - The variable affection of rib and limb growth in human skeletal dysplasias
      suggests the presence of site-specific regulatory mechanisms for chondrocyte
      proliferation. We therefore studied the clonal growth of normal human costal and
      articular chondrocytes from the same four fetuses (15 to 30 wk of gestation) in a
      semisolid medium (0.8% methylcellulose) with a basal supplementation of 5% heat
      inactivated FCS. IGF-I[0.3-12.5 ng/mL (0.04-1.6 nmol/L)], IGF-II [0.3-12.5 ng/mL
      (0.04-1.7 nmol/L)], and hGH [0.5-25 ng/mL (0.02-1.1 nmol/L)] stimulated clonal
      growth of articular and costal chondrocytes without site-specific difference. In
      contrast, a significant difference was found for transforming growth factor-beta
      1, which proved to be a potent growth factor for fetal articular chondrocytes but
      did not stimulate or only minimally stimulated fetal costal chondrocytes [p <
      0.05 for 0.3 ng/mL (0.01 nmol/L) TGF-beta 1 and p < 0.01 for 1.25 ng/mL (0.05
      nmol/L) TGF-beta 1 using paired t test]. Preincubation with an IGF-I receptor
      antibody (alpha IR-3) completely prevented the proliferative effect of IGF-I, IGF
      II, and hGH, indicating that hGH acts via autocrine or paracrine induction of
      IGF. The antibody partly reduced TGF-beta 1 action on articular chondrocytes [p <
      0.05 for 0.3 ng/mL (0.01 nmol/L) TGF-beta 1, NS for 1.25 ng/mL (0.05 nmol/L) TGF
      beta 1 using paired t test]. These results indicate that TGF-beta 1 is involved
      in the regulation of human fetal growth and has a different effect in ribs and
      limbs.

PMID- 8479822
TI  - Effects of ischemia and reperfusion on intrinsic vascular regulation in the
      postnatal intestinal circulation.
AB  - The purpose of these experiments was to determine the effect of 1 h of total
      ischemia followed by 2 h of reperfusion on intrinsic vascular regulation within
      intestine from 3- and 35-d-old swine. Intrinsic vascular regulation was defined
      as the ability of in vitro segments of small intestine to bring about adjustments
      of blood flow and the arteriovenous O2 content difference across the intestinal
      segment of sufficient magnitude to preserve tissue O2 uptake in response to a 35%
      reduction in arterial perfusion pressure. This response was elicited before
      (control conditions) and after ischemia-reperfusion (post-I/R). In older
      subjects, the efficacy of blood flow regulation was attenuated post-I/R, insofar
      as blood flow fell in response to pressure reduction. However, this group
      demonstrated a rise in arteriovenous content difference after pressure reduction
      under control and post-I/R conditions that were of sufficient magnitude to
      preserve tissue O2 uptake. In younger subjects, blood flow regulation was absent
      under control conditions and post-I/R. The arteriovenous O2 content difference
      increased in response to pressure reduction under control conditions but failed
      to do so post-I/R; consequently, tissue oxygenation decreased in response to
      arterial pressure reduction post-I/R in 3-d-old intestine. We conclude that
      ischemia-reperfusion affects intrinsic vascular regulation in postnatal intestine
      and that this effect is age-dependent. Intestine from older subjects maintains
      the intrinsic capacity to preserve tissue oxygenation in response to a
      hypotensive challenge despite the insult of ischemia-reperfusion, whereas
      intestine from younger subjects does not maintain this capacity.

PMID- 8479823
TI  - Allopurinol administered after inducing hypoxia-ischemia reduces brain injury in
      7-day-old rats.
AB  - We determined that treatment of immature rats with allopurinol at 15 min after
      cerebral hypoxia-ischemia reduces brain damage. Seven-d postnatal rats were
      subjected to right common carotid artery ligation followed by 2.25 h of hypoxia
      (8% O2). At 15 min of recovery in room air, the rat pups received either
      allopurinol (135 mg/kg s.c.) or saline. Some of the rats (n = 65) were killed at
      42 h of recovery for measurement of cerebral hemispheric water content. Other
      animals (n = 63) were killed at 30 d for morphologic assessment of the severity
      of damage. In separate rats, we measured the levels of allopurinol and its
      metabolites in serum and in the brain around the time of peak serum levels. We
      also determined the effect of allopurinol on rat pup body temperature.
      Allopurinol reduced the increase in right hemisphere water content and markedly
      reduced atrophy. No cavitary lesions were seen in the 31 allopurinol-treated
      rats, whereas 15 of 32 saline-treated rats had cavitary cerebral lesions.
      Histologic examination confirmed that the allopurinol-treated rats had less brain
      injury. Serum allopurinol and oxypurinol peaked between 0.5 and 1 h after
      allopurinol injection. Their peak serum concentrations at 0.75 h postinjection
      combined was between 360 and 510 microM. Allopurinol did not lower rectal
      temperature more than 0.04 degrees C. In conclusion, high-dose allopurinol
      administered at 15 min of recovery from cerebral hypoxia-ischemia markedly
      reduces both acute brain edema and long-term cerebral injury in immature rats.

PMID- 8479824
TI  - Deficiency of the adenine nucleotide translocator in muscle of a patient with
      myopathy and lactic acidosis: a new mitochondrial defect.
AB  - In a patient with a mitochondrial myopathy, presenting with lactic acidosis, 31P
      nuclear magnetic resonance spectroscopy in resting muscle showed half the
      creatine phosphate level of controls. The creatine phosphate resynthesis rate
      after aerobic exercise was only 18% of that in controls. However, the activities
      of complexes I to V catalyzing oxidative phosphorylation and the pyruvate and the
      2-oxoglutarate dehydrogenase complexes showed a 2- to 20-fold increase. In line
      with this, the uncoupled mitochondrial respiration rate was significantly higher
      than in controls. In contrast, the respiration of the mitochondria from the
      patient was less stimulated by ADP than that of control mitochondria. This
      finding could point to a defect in complex V, the enzyme directly involved in ATP
      synthesis. The activity of complex V, measured as the mitochondrial ATPase
      activity, and its concentration, as judged from Western blots using antisera
      against the F1 part of complex V, were, however, also greatly increased in the
      patient. Alternatively, the transport system, importing ADP into and exporting
      ATP out of the mitochondrial matrix, the ADP/ATP or adenine nucleotide
      translocator, could be affected. Immunostaining of Western blots revealed a 4
      fold decrease in the concentration of the adenine nucleotide translocator in the
      patient. Because oxidative phosphorylation was not disturbed in fibroblasts and
      lymphocytes, we conclude that this patient suffers from a muscle-specific
      deficiency of his mitochondrial adenine nucleotide translocator, a defect unknown
      so far.

PMID- 8479825
TI  - Preservation of permeability barrier ontogenesis in the intrauterine growth
      retarded fetal rat.
AB  - The epidermal permeability barrier is provided by intercellular lipids forming
      multiple membrane bilayers in the stratum corneum. In the fetal rat, the barrier
      to transepidermal water loss forms during the 20th d of gestation and is
      accompanied by 1) increasing stratum corneum thickness; 2) increasing stratum
      corneum lipid content, particularly nonpolar ceramide and cholesterol content;
      and 3) the formation of lamellar unit structures throughout the stratum corneum
      interstices. In this report, we demonstrate that among pups of 20 d gestational
      age increasing barrier competence is correlated with increasing fetal weight. It
      has been previously demonstrated that fetal rats subjected to intrauterine growth
      retardation (IUGR) exhibit a thinner stratum corneum and decreased content of
      differentiation-specific epidermal structural proteins. To determine whether IUGR
      fetal rats also exhibit immaturity of barrier function and the barrier membrane
      system, maternal rats underwent unilateral uterine vessel ligation on d 17 or 18
      of gestation and IUGR and control littermates were harvested on d 20, 21, or 22
      of gestation for determination of transepidermal water loss. Despite significant
      somatic growth retardation and a thinner stratum corneum, barrier function in
      IUGR fetal rats did not significantly differ from that in control littermates at
      any gestational age. In both IUGR and control fetal rat epidermis at 21 d
      gestational age, lipids were deposited in a membrane pattern as visualized by
      nile red fluorescence microscopy and formed lamellar unit membrane structures
      throughout the stratum corneum intercellular domains as observed by electron
      microscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8479826
TI  - Erythrocyte docosahexaenoic acid correlates with the visual response of healthy,
      term infants.
AB  - Recent studies have reported that formula-fed preterm infants score lower on
      visual and developmental tests relative to breast-fed preterm infants. This
      phenomenon has been associated with the presence of docosahexaenoic acid (DHA),
      an omega-3 fatty acid, in breast milk and its absence from infant formula. To
      investigate the possibility that DHA status of healthy, term infants is also
      related to neuronal function of the visual pathway, we studied the erythrocyte
      fatty acid profiles of 16 infants at 22.3 +/- 3.9 wk of age and related these to
      maturity of the visual pathway as assessed by visual-evoked potentials. Healthy,
      term infants fed breast milk had better visual-evoked potential acuity (p < 0.05)
      and higher DHA levels (p < 0.001) than infants who received infant formula as
      their major energy source. There was a positive correlation between erythrocyte
      DHA and visual-evoked potential acuity (p < 0.01). The data are preliminary and
      the long-term effects as yet unknown. However, our results suggest that there is
      an urgent need to evaluate the dietary fatty acid supply of formula-fed term
      infants.

PMID- 8479827
TI  - Lawson Wilkins Pediatric Endocrine Society and European Society for Paediatric
      Endocrinology. Fourth Joint Meeting. June 3-7, 1993, San Francisco, California.
      Abstracts.

PMID- 8479828
TI  - Ethnocultural variations in the prevalence and impact of childhood chronic
      conditions.

PMID- 8479830
TI  - Multiculturalism, chronic illness, and disability.
AB  - To gain at least an initial understanding of the underlying beliefs and attitudes
      in a cross-cultural situation, we believe that the three key points discussed in
      this paper should prove a significant point of departure: 1. Traditional beliefs
      about the cause of chronic illness or disability will play a significant role in
      determining family and community attitudes toward individuals with a disability
      and will influence when, how, and why medical input is sought. 2. The expectation
      of survival on the part of parents and community will have an effect on the
      amount of time, energy, and cooperation shown by family and community for the
      individual who has an impairment. 3. The expectations by family and community for
      the social role(s) and individual with a chronic illness or disability will hold
      will affect a broad range of issues, including education, social integration, and
      independence. Furthermore, although chronic illness and disability are often
      considered as issues distinct from the full range of problems encountered in
      society for immigrant and minority groups, in fact, these issues could not be
      more closely tied. The frequently discussed concerns within the ethnic and
      minority community about the role of the family, integration and acculturation,
      social articulation with the greater American society, stress, cross-cultural
      misunderstanding, and outright prejudice can all compound the problems
      encountered for the chronically ill or disabled individual in a multicultural
      society.

PMID- 8479829
TI  - Health insurance differentials among minority children with chronic conditions
      and the role of federal agencies and private foundations in improving financial
      access.

PMID- 8479831
TI  - Culture, ethnicity, and bicultural competence: implications for children with
      chronic illness and disability.

PMID- 8479832
TI  - Culture, ethnicity, and the family: critical factors in childhood chronic
      illnesses and disabilities.

PMID- 8479834
TI  - German Physiology Society, 72nd meeting. Munchen, 9-12 March 1993. Abstracts.

PMID- 8479833
TI  - Race and ethnicity: issues for adolescents with chronic illnesses and
      disabilities. An annotated bibliography.

PMID- 8479835
TI  - Address of President Clara D. Noyes. Twentieth annual convention of the NLNE,
      1914, St. Louis, Missouri.

PMID- 8479836
TI  - Address of President Clara D. Noyes. Proceedings of the twenty-first annual
      convention of the NLNE, 1915, San Francisco, California.

PMID- 8479837
TI  - Address of President Clara D. Noyes. Proceedings of the twenty-second annual
      convention of the NLNE, 1916, New Orleans, Louisiana.

PMID- 8479838
TI  - Address of President Sara E. Parsons. Proceedings of the twenty-third annual
      convention of the NLNE, 1917, Philadelphia, Pennsylvania.

PMID- 8479839
TI  - Address of President S. Lillian Clayton. Proceedings of the twenty-fourth annual
      convention of the NLNE, 1918, Cleveland, Ohio.

PMID- 8479840
TI  - Address of President S. Lillian Clayton. Proceedings of the twenty-fifth annual
      convention of the NLNE, 1919, Chicago, Illinois.

PMID- 8479841
TI  - Address of President S. Lillian Clayton. Proceedings of the twenty-sixth annual
      convention of the NLNE, 1920, Atlanta, Georgia.

PMID- 8479842
TI  - Address of President Anna C. Jamme. Proceedings of the twenty-seventh annual
      convention of the NLNE, 1921, Kansas City, Missouri.

PMID- 8479843
TI  - Address of President Anna C. Jamme. Proceedings of the twenty-eighth annual
      convention of the NLNE, 1922, Seattle, Washington.

PMID- 8479844
TI  - Address of President Linda Richards. Second annual convention of the
      Superintendents' Society, 1895, Boston, Massachusetts.

PMID- 8479845
TI  - Address of President Laura Logan. Proceedings of the twenty-ninth annual
      convention of the NLNE, 1923, Swamscott, Massachusetts.

PMID- 8479846
TI  - Address of President Laura Logan. Proceedings of the Thirtieth annual convention
      of the NLNE, 1924, Detroit, Michigan.

PMID- 8479847
TI  - Address of President Laura Logan. Proceedings of the thirty-first annual
      convention of the NLNE, 1925, Minneapolis, Minnesota.

PMID- 8479848
TI  - Address of President Carrie M. Hall. Proceedings of the thirty-second annual
      convention of the NLNE, 1926, Atlantic City, New Jersey.

PMID- 8479849
TI  - Address of President Carrie M. Hall. Proceedings of the thirty-third annual
      convention of the NLNE, 1927, San Francisco, California.

PMID- 8479850
TI  - Address of Mary E. P. Davis. Third annual convention of the Superintendents'
      Society, 1896, Philadelphia, Pennsylvania.

PMID- 8479851
TI  - Address of President Carrie M. Hall. Proceedings of the thirty-fourth annual
      convention of the NLNE, 1928, Louisville, Kentucky.

PMID- 8479852
TI  - Toward economic stability, 1929-1944.

PMID- 8479853
TI  - Address of President Elizabeth C. Burgess. Proceedings of the thirty-fifth annual
      convention of the NLNE, 1929, Atlantic City, New Jersey.

PMID- 8479854
TI  - Address of President Elizabeth C. Burgess. Proceedings of the thirty-sixth annual
      convention of the NLNE, 1930, Milwaukee, Wisconsin.Developing potential leaders.

PMID- 8479855
TI  - Address of President Elizabeth C. Burgess. Proceedings of the thirty-seventh
      annual convention of the NLNE, 1931, Atlanta, Georgia. The effect on nursing
      education of American traditions and ideals.

PMID- 8479856
TI  - Address of President M. Adelaide Nutting. Fourth annual convention of the
      Superintendents' Society, 1897, Baltimore, Maryland.

PMID- 8479857
TI  - Address of President Elizabeth C. Burgess. Proceedings of the thirty-eighth
      annual convention of the NLNE, 1932, San Antonio, Texas. What are nurses going to
      do about it?

PMID- 8479858
TI  - Address of President Effie J. Taylor. Proceedings of the thirty-ninth annual
      convention of the NLNE, 1933, Chicago, Illinois. Yesterday--today--tomorrow.

PMID- 8479859
TI  - Address of President Effie J. Taylor. Proceedings of the fortieth annual
      convention of the NLNE, 1934, Washington, D.C. Of what is the nature of nursing?

PMID- 8479860
TI  - Address of President Effie J. Taylor. Proceeding of the forty-first annual
      convention of the NLNE, 1935, New York, New York. Twenty-five years in nursing
      education.

PMID- 8479861
TI  - Address of President Effie J. Taylor. Proceedings of the forty-second annual
      convention of the NLNE, 1936, Los Angeles, California.

PMID- 8479862
TI  - Toward social reform, 1894-1913.

PMID- 8479863
TI  - Address of President Nellie X. Hawkinson. Proceedings of the forty-third annual
      convention of the NLNE, 1937, Boston, Massachusetts.A task and a vision is joy
      unspeakable.

PMID- 8479864
TI  - Address of President Nellie X. Hawkinson. Proceedings of the forty-fourth annual
      convention of the NLNE, 1938, Kansas City, Missouri. The outlook in nursing
      education.

PMID- 8479865
TI  - Address of President Nellie X. Hawkinson. Proceedings of the forty-fifth annual
      convention of the NLNE, 1939, New Orleans, Louisiana.

PMID- 8479866
TI  - Address of President Nellie X. Hawkinson. Proceedings of the forty-sixth annual
      convention of the NLNE, 1940, Philadelphia, Pennsylvania.

PMID- 8479867
TI  - Address of President Stella Goostray. Proceedings of the forty-seventh annual
      convention of the NLNE, 1941, Detroit, Michigan.

PMID- 8479868
TI  - Address of President Stella Goostray. Proceedings of the forty-eighth annual
      convention of the NLNE, 1942, Chicago, Illinois.

PMID- 8479869
TI  - Address of President Mary Agnes Snively. Fifth annual convention of the
      Superintendents' Society, 1898, Toronto, Canada.

PMID- 8479870
TI  - Address of President Stella Goostray. Proceedings of the forty-ninth annual
      convention of the NLNE, 1943, Chicago, Illinois.

PMID- 8479871
TI  - Address of President Stella Goostray. Fiftieth annual report of the NLNE, 1944,
      Buffalo, New York. The time is now.

PMID- 8479872
TI  - Toward professional maturity, 1945-1952.

PMID- 8479873
TI  - Address of President Ruth Sleeper. Fifty-first annual report of the NLNE, 1945,
      New York, New York.

PMID- 8479874
TI  - Address of President Ruth Sleeper. Proceedings of the fiftieth convention of the
      NLNE, 1946, Atlantic City, New Jersey.

PMID- 8479875
TI  - Address of President Ruth Sleeper. Proceedings of the fifty-first convention of
      the NLNE, 1947, Seattle, Washington. One world--one objective for nursing
      education.

PMID- 8479876
TI  - Address of President Ruth Sleeper. Proceedings of the fifty-second convention of
      the NLNE, 1948, Chicago, Illinois. A year of sowing.

PMID- 8479877
TI  - Address of President Agnes Gelinas. Proceedings of the fifty-third convention of
      the NLNE, 1949, Cleveland, Ohio. The pressures, problems,and programs of nursing
      education.

PMID- 8479878
TI  - Address of President Agnes Gelinas. Proceedings of the fifty-fourth convention of
      the NLNE, 1950, San Francisco, California. Unified nursing organizations.

PMID- 8479879
TI  - Address of President Agnes Gelinas. Proceedings of the fifty-fifth convention of
      the NLNE, 1951, Boston, Massachusetts. Increasing the teacher supply in schools
      of nursing.

PMID- 8479880
TI  - Address of President Agnes Gelinas. Proceedings of the fifty-sixth convention of
      the NLNE, 1952, Atlantic City, New Jersey. Needed: bettereducational programs in
      nursing.

PMID- 8479881
TI  - Address of President Lystra E. Gretter. Ninth annual convention of the
      Superintendents' Society, 1902, Detroit, Michigan.

PMID- 8479882
TI  - Toward the future, 1953-.

PMID- 8479883
TI  - Address of President Ida Giles. Tenth annual convention of the Superintendents'
      Society, 1903, Pittsburgh, Pennsylvania.

PMID- 8479884
TI  - Address of President Georgia M. Nevins. Eleventh annual convention of the
      Superintendents' Society, 1905, Washington, D.C.

PMID- 8479885
TI  - Address of President Annie W. Goodrich. Twelfth annual convention of the
      Superintendents' Society, 1906, New York, New York.

PMID- 8479886
TI  - Address of President Maude Banfield. Thirteenth annual convention of the
      Superintendents' Society, 1907, Philadelphia, Pennsylvania.

PMID- 8479887
TI  - Address of President Mary Hamer Greenwood. Fourteenth convention of the
      Superintendents' Society, 1908, Cincinnati, Ohio.

PMID- 8479888
TI  - Address of President Isabel Hampton Robb. Fifteenth annual convention of the
      Superintendents' Society, 1909, St. Paul, Minnesota.

PMID- 8479889
TI  - Address of President Mary Adelaide Nutting. Sixteenth annual convention of the
      Superintendents' Society, 1910, New York, New York.

PMID- 8479890
TI  - Address of President Mary M. Riddle. Seventeenth annual convention of the
      Superintendents' Society, 1911, Boston, Massachusetts.

PMID- 8479891
TI  - Address of President Mary C. Wheeler. Eighteenth annual convention of the
      Superintendents' Society, 1912, Chicago, Illinois.

PMID- 8479892
TI  - Toward international involvement, 1914-1928.

PMID- 8479893
TI  - [Initial trauma care].

PMID- 8479894
TI  - [New AIDS vaccine tested in 8 countries].

PMID- 8479895
TI  - [Prostate cancer in Scandinavia. Variations in practice and attitude to radical
      treatment].
AB  - Some controversy persists as to the optimal assessment and treatment of prostate
      cancer, a lack of consensus reflected in differences in clinical practice. Our
      survey among departments of urology and general surgery in the Nordic countries
      showed Danish physicians to be the most conservative, while the most active
      intervention strategies were found in Finland.

PMID- 8479896
TI  - [When is Scandinavia getting specialized trauma care? Report from a leading
      trauma center in the USA].
AB  - The specialized care provided at the trauma centre in Baltimore, Maryland, in the
      USA is described. By means of a sophisticated communications system, prehospital
      and hospital care are coordinated with a view to providing optimal care to people
      with various types of injuries. It is suggested how the American experience might
      be applied to conditions in the Nordic countries in order to improve the quality
      of trauma care.

PMID- 8479897
TI  - [Recording of heart arrest according to the Utstein model].

PMID- 8479898
TI  - [Health effects in Sweden of the Chernobyl accident].
AB  - An international committee (2) which has studied the health and environmental
      effects of the Chernobyl accident within the borders of the former Soviet Union
      does not expect that any increase in cancer frequency among adults can be
      demonstrated epidemiologically. However, the possibility of an observable
      increase in the incidence of thyroid cancer and increase in juvenile leukemia
      could not be excluded. The statistics in Sweden is more accurate, though the
      radiation doses were significantly lower. It would appear to be unlikely that any
      changes in cancer incidence (even among children), in mental development in
      children, in malformations or genetic changes ascribable to the Chernobyl
      accident will ever be demonstrated in Sweden.

PMID- 8479899
TI  - [Integration of the patient's viewpoint in quality assessment--a new method].
AB  - Attempts at evaluating the health services are characterised by the multiplicity
      of methods used to assess diagnosis, treatment and care--e.g., compliance
      investigations, consensus and audit methods, and methods that include evaluation
      by patients. By means of triangulation methods both medical and consumer
      perspectives can be included in the evaluation.

PMID- 8479901
TI  - Editing of a tRNA anticodon in marsupial mitochondria changes its codon
      recognition.
AB  - RNA editing has been described for organellar genes of protozoa and plants as
      well as in three cases for nuclear transcripts of mammals. The mitochondrial tRNA
      for aspartic acid is encoded in the mitochondrial genome of marsupials with the
      anticodon GCC. However, cDNA from the gene product revealed that the second
      nucleotide of the anticodon of the tRNA is posttranscriptionally changed to be
      recognized as an uridine residue. This restores the coding property of the tRNA.
      Direct sequencing as well as clones of the amplified cDNA indicated that about
      50% of the cellular pool of pre-tRNA molecules for aspartic acid is edited. Thus,
      RNA editing occurs in mammalian mitochondria and can affect the anticodons of
      tRNAs.

PMID- 8479900
TI  - Compilation of E. coli mRNA promoter sequences.
AB  - An updated compilation of 300 E. coli mRNA promoter sequences is presented. For
      each sequence the most recent relevant paper was checked, to verify the location
      of the transcriptional start position as identified experimentally. We comment on
      the reliability of the sequence databanks and analyze the conservation of known
      promoter features in the current compilation. This database is available by E
      mail.

PMID- 8479902
TI  - cDNA cloning and transcriptional properties of a novel GC box-binding protein,
      BTEB2.
AB  - We have cloned a cDNA for a novel GC box-binding protein designated BTEB2 from a
      human placenta cDNA library using rat BTEB cDNA (Imataka et al. (1992). EMBO J.
      11,3663-3671. as a hybridization probe. BTEB2 consists of 219 amino acids and
      contains three contiguous zinc finger motifs at its C-terminus. The zinc finger
      domains showed 59% and 64% sequence similarity to those of Sp1 and BTEB,
      respectively. Adjacent to the N-terminal of the zinc finger motifs, a short
      sequence rich in basic amino acids is conserved between BTEB2 and Sp1.
      Furthermore, This basic sequence concurs with the N-terminal half of the
      consensus sequence for basic domains of the proteins containing both helix-loop
      helix and leucine zipper motifs. The other region of BTEB2 is notably rich in
      proline, serine, threonine, and alanine residues. BTEB2 expressed in Escherichia
      coli showed DNA-binding activity whose specificity was closely similar to that of
      Sp1. Cotransfection experiments using Hepa-1 cells (a mouse hepatoma cell line)
      with a BTEB2 expression plasmid and GC box-containing reporter plasmids revealed
      that BTEB2 apparently activated the expression of the CAT activity. Moreover,
      when BTEB2 was fused to GAL4 DNA-binding domain, the chimeric protein could
      enhance the transcription through promoters containing GAL4-binding sites.
      Analysis of the BTEB2 mRNA by RNA blot analysis demonstrated that the mRNA was
      expressed specifically in testis and placenta with different sizes, 20S and 28S,
      respectively, among various organs examined.

PMID- 8479903
TI  - Activity of U-snRNA genes with modified placement of promoter elements in
      transfected protoplasts and stably transformed tobacco.
AB  - In higher plants the promoter elements of pol II- and pol III-transcribed U-snRNA
      genes are identical, comprising a -30 TATA box and an upstream sequence element,
      USE. The USE and TATA are centred approximately four and three helical DNA turns
      apart in pol II and pol III genes, respectively, and it is this difference in the
      element spacing that determines the RNA polymerase specificity of the gene. In
      this study we have analyzed the effect of spacing mutations on activity of
      Arabidopsis U2 and U6 genes in transfected protoplasts of Nicotiana
      plumbaginifolia and in stably transformed tobacco. In the pol III-transcribed U6
      gene the insertions and deletions of either odd or even numbers of half helical
      turns completely inactivate transcription in transfected protoplasts, consistent
      with the high conservation of the element spacing found in all plant U-snRNA
      genes. Surprisingly, while insertions of 50 base pairs (bp) or more into the
      spacer of the pol II-specific U2 gene inactivate transcription, a deletion of 5
      bp or insertions of as much as 20 bp decrease transcription by only 40 to 70%.
      This relaxed requirement for the conserved element spacing is only seen in
      transfected protoplasts since the same mutant U2 genes are not transcribed in
      stably transformed tobacco when transcription takes place from the chromosome.
      The results provide some clues about possible factor interactions at the
      promoters of plant U-snRNA genes and also offer an example of major differences
      in transcription between transiently and stably transformed cells.

PMID- 8479904
TI  - Purification of mouse MEP-1, a nuclear protein which binds to the metal
      regulatory elements of genes encoding metallothionein.
AB  - Metal regulatory elements (MREs) shared by metallothionein (MT) gene promoters
      are essential for metal induction of MT genes. MEP-1, a nuclear protein which
      binds to these elements has been purified from heavy metal-resistant mouse L
      cells using footprinting, Southwestern and UV cross-linking techniques to assay
      its binding activity. The purification scheme, starting from crude nuclear
      extracts, involved a combination of heparin-Sepharose and MRE-DNA affinity
      chromatography. The purified protein preparation showed a single polypeptide band
      of 108 kDa on polyacrylamide gel electrophoresis, and 2D-gel analyses revealed
      the presence of a protein species migrating as a single population of
      approximately 110 kDa. MEP-1 does not appear to be glycosylated since it eluted
      with the flow-through on a Wheat Germ Sepharose column. It was retained by a zinc
      Chelating Sepharose column suggesting that amino acid residues (i.e., cysteine,
      histidine) which have an affinity for zinc ions are exposed on the protein
      surface. Binding studies with the purified protein indicated that it binds
      specifically to MRE sequences and that the binding can be abolished by a point
      mutation in the MRE core consensus sequence or by the addition of the chelating
      agent 1,10-phenanthroline. Binding activity can be restored by the addition of
      zinc ions to the chelated protein. These results suggest that MEP-1 is one of the
      major proteins interacting with MRE sequences.

PMID- 8479905
TI  - The biochemical defects of prp4-1 and prp6-1 yeast splicing mutants reveal that
      the PRP6 protein is required for the accumulation of the [U4/U6.U5] tri-snRNP.
AB  - We have raised specific antibodies against the PRP6 protein and shown that the
      U4, U5 and U6 snRNAs are co-precipitated with this protein. Using splicing
      extracts prepared from in vivo heat-inactivated cells, we have characterized the
      prp4-1 and prp6-1 biochemical defects. In inactivated prp4-1 cell extracts, the
      U6 snRNA content as well as the U6, U4/U6 snRNPs and the [U4/U6.U5] tri-snRNP
      particles amounts are severely reduced. In inactivated prp6-1 cell extracts, the
      PRP6 mutant protein is barely detectable. Glycerol gradient analyses indicate
      that, in these extracts, the [U4/U6.U5] tri-snRNPs are present in very low
      amounts, but U4/U6 snRNP particles are normally represented. These results
      establish that the PRP6 protein is required for the accumulation of the
      [U4/U6.U5] tri-snRNP. We found no evidence for the presence of the PRP6 protein
      in the U4/U6 particle.

PMID- 8479906
TI  - A novel method for site specific introduction of single model oxidative DNA
      lesions into oligodeoxyribonucleotides.
AB  - Calf thymus terminal deoxynucleotidyl transferase was used to incorporate several
      products of oxidative base damage onto the 3' end of oligodeoxyribonucleotides.
      Under the defined conditions described in this report, single residues of
      dihydrothymine, beta-ureidoisobutyric acid, thymine glycol, urea, 7-hydro-8
      oxoadenine, 7-hydro-8-oxoguanine, 5-hydroxycytosine and 5-hydroxyuracil were
      incorporated into oligodeoxyribonucleotides of different lengths. The reaction is
      both efficient and cost effective. The 3' termini of the reaction products were
      suitable substrates for ligation by phage T4 DNA ligase, facilitating greatly the
      construction of oligodeoxyribonucleotides containing unique and site specific
      oxidative DNA lesions.

PMID- 8479907
TI  - Variable effects of the conserved RNA hairpin element upon 3' end processing of
      histone pre-mRNA in vitro.
AB  - We have studied the requirements for efficient histone-specific RNA 3' processing
      in nuclear extract from mammalian tissue culture cells. Processing is strongly
      impaired by mutations in the pre-mRNA spacer element that reduce the base-pairing
      potential with U7 RNA. Moreover, by exchanging the hairpin and spacer elements of
      two differently processed H4 genes, we find that this difference is exclusively
      due to the spacer element. Finally, processing is inhibited by the addition of
      competitor RNAs, if these contain a wild-type spacer sequence, but not if their
      spacer element is mutated. Conversely, the importance of the hairpin for histone
      RNA 3' processing is highly variable: A hairpin mutant of the H4-12 gene is
      processed with almost wild-type efficiency in extract from K21 mouse mastocytoma
      cells but is strongly affected in HeLa cell extract, whereas an identical hairpin
      mutant of the H4-1 gene is affected in both extracts. The hairpin defect of H4-12
      specific RNA in HeLa cells can be overcome by a compensatory mutation that
      increases the base complementarity to U7 snRNA. Very similar results were also
      obtained in RNA competition experiments: processing of H4-12-specific RNA can be
      competed by RNA carrying a wild-type hairpin element in extract from HeLa, but
      not K21 cells, whereas processing of H4-1-specific RNA can be competed in both
      extracts. With two additional histone genes we obtained results that were in one
      case intermediate and in the other similar to those obtained with H4-1. These
      results suggest that hairpin binding factor(s) can cooperatively support the
      ability of U7 snRNPs to form an active processing complex, but is(are) not
      directly involved in the processing mechanism.

PMID- 8479908
TI  - A chicken RAD51 homologue is expressed at high levels in lymphoid and
      reproductive organs.
AB  - Comparisons of the amino acid sequences of three yeast RecA-like proteins, Rad51
      and DMC1 from S.cerevisiae and Rad51 from S.pombe, revealed several highly
      conserved regions. Degenerated oligonucleotides encoding two of these regions
      were used for the polymerase chain reaction to clone a chicken RecA-like gene.
      The encoded protein shares 68% and 49% identical amino acids with the Rad51 and
      DMC1 proteins. The strong sequence conservation between the yeast and chicken
      genes indicates that RecA homologues are conserved throughout evolution from
      prokaryotes to higher eukaryotes. High expression of the chicken Rad51 gene was
      found within the organs of lymphoid and germ cell development suggesting its
      involvement in lymphoid and meiotic recombination.

PMID- 8479909
TI  - Different TRE-related elements are distinguished by sets of DNA-binding proteins
      with overlapping sequence specificity.
AB  - Several promoter elements with sequence similarity to the prototype TPA
      responsive element (TRE) were compared by mobility-shift analyses. Activities
      within whole cell extracts were identified that bind to the TRE-like elements in
      the collagenase, the somatostatin, and the c-jun promoters. The corresponding
      factors appeared to differ in their degree of selectivity for these TRE-like
      sequences. One protein species bound equally well to all TREs. In addition, a
      subset of specific activities recognised only the somatostatin and the c-jun
      derived element and one DNA-protein complex had exclusive specificity for the TRE
      present in the c-jun promoter. By antibody 'supershift' assays some of the
      protein components of the specific complexes were identified as CREB- and ATF
      related products. Based on these data we postulate that bZip protein dimers
      differ in their ability to tolerate variations from the canonical TRE sequence.
      We propose that TRE-like promoter elements are distinguished by this ability to
      bind to different subsets of a family of related transcription factors.

PMID- 8479910
TI  - An insulinoma nuclear factor binding to GGGCCC motifs in human insulin gene.
AB  - Cell specific expression of the insulin gene is achieved through transcriptional
      mechanisms operating on 5' flanking DNA elements. In the enhancer of rat I
      insulin gene, two elements, the Nir and Far boxes, located at positions -104 and 
      233 respectively and containing the same octameric motif are essential for B cell
      specific transcription activity. Homologous sequences are present in the human
      insulin gene. While studying the binding of nuclear proteins from insulinoma
      cells to the -258/+241 region of the human insulin gene, we observed a previously
      undetected protein binding site in the intron I region between nucleotides +160
      and +175. The binding activity was present in insulin producing cells such as RIN
      and HIT insulinoma cells but not in fibroblasts or insulin negative fibroblast x
      RIN hybrid cells. DNAse I footprinting and gel retardation/methylation
      interference experiments allowed us to define the core binding site of the intron
      binding factor as a GGGCCC hexamer. This factor is also capable to bind to a
      related sequence, contiguous to the Far-like element in rat and human insulin
      genes. The binding of the GGGCCC binding factor in this critical region of the
      insulin gene enhancer may participate in the regulation of insulin gene
      expression.

PMID- 8479911
TI  - Cell-specific expression of helix-loop-helix transcription factors encoded by the
      E2A gene.
AB  - The E2A gene encodes transcription factors of the helix-loop-helix family that
      are implicated in cell-specific gene expression as part of dimeric complexes that
      interact with E box enhancer elements. It has previously been shown that
      transcripts of the E2A gene can be detected in a wide range of cell types. We
      have now examined expression of the mouse E2A gene at the protein level using
      polyclonal antisera directed against distinct portions of the E2A protein to
      probe blots of cellular extracts. A 73 kDa protein was identified by this
      analysis: this protein is highly enriched in cell lines of B lymphoid origin as
      compared to pancreatic beta-cells and fibroblast cells. The detection of this
      protein selectively in extracts of lymphoid cells correlates with the presence of
      the E box-binding activity LEF1/BCF1 in these cells; this binding activity was
      previously shown to be efficiently recognized by antiserum directed against E2A
      gene products. Transfection of cells with full length E2A cDNA leads to
      appearance of protein co-migrating with the 73 kDa protein on SDS gel
      electrophoresis and co-migrating with LEF1/BCF1 on mobility shift analysis. Our
      results are consistent with the view that the DNA-binding activity LEF1/BCF1 is a
      homodimer of E2A proteins; the selective appearance of this putative cell
      specific transcription factor in B lymphoid cells seems to be attributable, at
      least in part, to the elevated E2A protein concentrations in these cells.

PMID- 8479912
TI  - Protection of human endothelial cells from oxidant injury by adenovirus-mediated
      transfer of the human catalase cDNA.
AB  - In a variety of disorders, endothelial cells are exposed to high levels of
      oxidants, generated within the cells and/or consequent to local inflammation. In
      the context of the sensitivity of endothelial cells to oxidant stress,
      particularly related to H2O2, we have designed a replication deficient
      recombinant adenovirus containing the human catalase cDNA (AdCL) to transfer the
      catalase cDNA to the endothelial cells, in order to augment intracellular anti
      H2O2 protection. Human umbilical vein endothelial cells that were not infected or
      infected with control adenovirus maintained low levels of catalase mRNA.
      Endothelial cells infected with AdCL expressed AdCL-driven exogenous catalase
      mRNA, as early as 24 hr and at least for 7 days. Catalase protein levels were
      increased significantly over controls in cells infected with AdCL, as were
      catalase activity levels, with catalase activity correlated closely with levels
      of catalase protein. Importantly, when the endothelial cells were exposed to 500
      microM H2O2, all the AdCL infected endothelial cells survived, compared to only
      37% of the control cells. Thus, a recombinant adenovirus containing the human
      catalase cDNA is able to infect human endothelial cells in vitro and express high
      levels of functional intracellular catalase, protecting the cells against H2O2
      mediated oxidant stress. These observations support the feasibility of the
      transfer of catalase cDNA to human endothelium to protect against oxidant injury.

PMID- 8479913
TI  - Activation and repression of Drosophila alcohol dehydrogenase distal
      transcription by two steroid hormone receptor superfamily members binding to a
      common response element.
AB  - Developmental activation of the Drosophila alcohol dehydrogenase (Adh) distal
      promoter is controlled by the Adh adult enhancer (AAE). Within this 150 bp,
      complex enhancer is a small (12 bp) positive cis-acting element that is required
      for high levels of distal transcription in adult flies and ADH-expressing tissue
      culture cells. We previously reported that the steroid receptor superfamily
      member FTZ-F1 binds to this site. We have identified a second steroid receptor
      superfamily member, DHR39, which also binds to this site. DHR39 is expressed
      throughout development in transcripts of several sizes. In situ hybridization to
      embryos has shown that DHR39 RNA is found primarily in the central nervous
      system, and not in embryonic tissues that express ADH. FTZ-F1 RNA, however, shows
      temporal-specific patterns similar to those of the distal promoter. FTZ-F1 and
      DHR39 have identical amino acids in the 'P-box' of the DNA binding domain,
      suggesting that they have identical DNA recognition characteristics. By
      electrophoretic mobility shift analysis we show that a DHR39 fusion protein binds
      specifically to two FTZ-F1 binding sites. By over expressing the full length
      DHR39 protein in a transient co-transfection assay we have shown that it
      represses distal Adh expression in a dosage- and binding site-dependent manner.
      Over expression of an alternative DHR39 open reading frame that lacks part of the
      putative ligand binding domain does not alter Adh expression. In contrast, over
      expression of FTZ-F1 specifically activates distal Adh expression.

PMID- 8479915
TI  - The preprotachykinin A promoter interacts with a sequence specific single
      stranded DNA binding protein.
AB  - An element within the Preprotachykinin A (PPT) promoter is highly homologous to
      an element from the rat type II Na channel promoter. This Na Channel element has
      been previously proposed to be common to a number of neuronal genes. We
      demonstrate that the PPT element binds a sequence specific DNA binding protein.
      The protein binds to only one strand of the PPT element and has little or no
      specificity for the double stranded DNA species. Gel retardation analysis
      indicates that the protein is found in both rat neuronal tissue and adult dorsal
      root ganglia neurons in culture but not in established tissue culture cell lines.
      Using the PPT element linked to magnetic beads we have been able to demonstrate
      the enrichment of a protein with a molecular weight of 40k with that of the
      binding activity. A mechanism for protein binding to the DNA is proposed based on
      the fact that the region binding the protein is the loop of a larger stem-loop
      structure in the DNA.

PMID- 8479914
TI  - Estrogen-inducible and liver-specific expression of the chicken Very Low Density
      Apolipoprotein II gene locus in transgenic mice.
AB  - We have examined the chicken Very Low Density Apolipoprotein II (apoVLDL II) gene
      locus in transgenic mice. A DNA fragment composed of the transcribed region, 16
      kb of 5' flanking and 400 bp of 3' flanking sequences contained all the
      information sufficient for estrogen-inducible, liver-specific expression of the
      apoVLDL II gene. The far-upstream region contains a Negative Regulating Element
      coinciding with a DNaseI-hypersensitive site at -11 kb. In transgenic mice, the
      NRE at -11 kb is used for downregulating the expression to a lower maximum level.
      The NRE might be used for modulating apoVLDL II gene expression, and may be
      involved in the rapid shut-down of the expression after hormone removal.

PMID- 8479916
TI  - Isolation and characterization of cDNA clones encoding the Drosophila homolog of
      the HMG-box SSRP family that recognizes specific DNA structures.
AB  - Recently an HMG-box protein denoted SSRP1, for structure-specific recognition
      protein 1, has been discovered which binds to specific DNA structural elements
      such as the bent, unwound conformations that occur upon the formation of
      intrastrand crosslinks by the anticancer drug cisplatin. The SSRP family includes
      the mouse protein T160, which recognizes recombination signal sequences. In order
      to delineate functional domains more clearly, a homolog of SSRP1 was cloned from
      Drosophila melanogaster. This homolog maps to polytene region 60A (1-4) and
      shares 54% identity with human SSRP1. Comparison of the predicted amino acid
      sequences among SSRP family members reveals 48% identity, with structural
      conservation in the carboxy terminus of the HMG box as well as domains of highly
      charged residues. Interestingly, however, the most highly conserved regions of
      the protein are in the less well understood amino terminus, strongly suggesting
      that this portion of the protein is critical for its function.

PMID- 8479917
TI  - Two cDNAs from the plant Arabidopsis thaliana that partially restore
      recombination proficiency and DNA-damage resistance to E. coli mutants lacking
      recombination-intermediate-resolution activities.
AB  - Escherichia coli ruvC recG mutants lack RuvC endonuclease, which resolves crossed
      strand joint molecules (Holliday junctions) formed during homologous
      recombination into recombinant products, and an activity (RecG) thought to
      partially replace RuvC. They are therefore highly deficient in homologous
      recombination, and sensitive to UV light and chemical DNA-damaging agents,
      presumably because of inability to tolerate unrepaired DNA damage by
      recombinational mechanisms (Lloyd, R.G. (1991) J. Bacteriol. 173:5414-5418). We
      transformed these mutants with plasmids expressing cDNAs from the plant
      Arabidopsis thaliana. Selection for bacteria with increased resistance to
      methylmethanesulfonate yielded two cDNAs, designated DRT111 and DRT112 (DNA
      damage-repair/toleration). Expression of these plant cDNAs, especially DRT111,
      restored conjugal recombination proficiencies in ruvC and ruvC recG mutants to
      nearly wild-type levels. Both plant cDNAs significantly increased resistance of
      both mutants to UV light and several chemical DNA-damaging agents, but did not
      fully correct the mutant phenotypes. Drt111 activity, but not Drt112, also
      increased, to nearly wild-type levels, resistance of recG single mutants to UV
      plus mitomycin C. The predicted Drt111 and Drt112 polypeptides, 383 and 167 amino
      acids respectively, show no similarity with one another or with prokaryotic
      Holliday resolvases. Both appear chloroplast targeted; Drt112 is highly
      homologous to Arabidopsis plastocyanin. DRT111 and DRT112 probes hybridize only
      to DNA from closely related plants.

PMID- 8479918
TI  - Computer-assisted prediction, classification, and delimitation of protein binding
      sites in nucleic acids.
AB  - We present a method to determine the location and extent of protein binding
      regions in nucleic acids by computer-assisted analysis of sequence data. The
      program ConsIndex establishes a library of consensus descriptions based on
      sequence sets containing known regulatory elements. These defined consensus
      descriptions are used by the program ConsInspector to predict binding sites in
      new sequences. We show the programs to correctly determine the significant
      regions involved in transcriptional control of seven sequence elements. The
      internal profile of relative variability of individual nucleotide positions
      within these regions paralleled experimental profiles of biological significance.
      Consensus descriptions are determined by employing an anchored alignment scheme,
      the results of which are then evaluated by a novel method which is superior to
      cluster algorithms. The alignment procedure is able to include several closely
      related sequences without biasing the consensus description. Moreover, the
      algorithm detects additional elements on the basis of a moderate distance
      correlation and is capable of discriminating between real binding sites and false
      positive matches. The software is well suited to cope with the frequent
      phenomenon of optional elements present in a subset of functionally similar
      sequences, while taking maximal advantage of the existing sequence data base.
      Since it requires only a minimum of seven sequences for a single element, it is
      applicable to a wide range of binding sites.

PMID- 8479919
TI  - Cloning and sequence of the human RecA-like gene cDNA.

PMID- 8479920
TI  - Nucleotide sequence and secondary structure of the chloroplast group I intron
      Cr.psbA-2: novel features of this self-splicing ribozyme.

PMID- 8479921
TI  - Sequence of the dengue virus type 2 (strain PR-159) NS1 gene and comparison with
      its vaccine derivative.

PMID- 8479922
TI  - Sox 15, a novel member of the murine Sox family of HMG box transcription factors.

PMID- 8479923
TI  - Complete small ribosomal subunit RNA sequence of the chiton Acanthopleura
      japonica (Lischke, 1873) (Mollusca, Polyplacophora).

PMID- 8479924
TI  - Human ribosomal protein S20 cDNA sequence.

PMID- 8479925
TI  - Sequence of a cDNA encoding human ribosomal protein L26 and of a cDNA probably
      encoding human ribosomal protein L6.

PMID- 8479926
TI  - Cloning and analysis of cDNA for rat histone H1(0).

PMID- 8479927
TI  - Molecular cloning and DNA sequence of a Dictyostelium cDNA encoding a Ran/TC4
      related GTP binding protein belonging to the ras superfamily.

PMID- 8479928
TI  - DNA sequence of the putA gene from Salmonella typhimurium: a bifunctional
      membrane-associated dehydrogenase that binds DNA.

PMID- 8479929
TI  - E. coli host strains significantly affect the quality of small scale plasmid DNA
      preparations used for sequencing.

PMID- 8479930
TI  - A simple and rapid amplification procedure for cDNA cloned in dephosphorylated
      plasmid.

PMID- 8479931
TI  - Ultrasonic ligation for rapid high-efficiency subcloning in plasmid vectors.

PMID- 8479932
TI  - Quantitative analysis of anti-CEA antibody accumulation in human colorectal
      carcinomas.
AB  - In order to obtain quantitative data on intratumoral antibody accumulation we
      analyzed resected colorectal adenocarcinomas of 25 patients who had undergone
      immunoscintigraphy 4-14 days earlier. All had been injected with 0.5-1.0 mg
      intact anti-CEA antibody (BW 431/26) labelled with 70-80 MBq131I. Correlation of
      tissue radioactivity concentrations with tumor characteristics revealed
      significantly higher values in necrotic compared to viable as well as in CEA
      positive compared to CEA-negative viable tumor tissue indicating action of both
      specific and unspecific uptake mechanisms. In contrast, diagnostic results of
      immunoscintigraphy were influenced by tumor size only. 11 of 12 false-negative
      findings were obtained in tumors < 4 cm in diameter. Since ex-vivo scintigraphy
      of resected specimens correctly visualized all but one of these lesions, it is
      concluded that technical limitations of scintigraphy are the main cause of
      negative results of radioimmunoimaging with 131I-labelled antibodies.

PMID- 8479933
TI  - [The value of bone scintigraphy in thigh pain following cementless hip
      prosthesis].
AB  - Persisting postoperative pain of the thigh is a common problem of cementless hip
      endoprostheses occurring in about 15-20% of the patients. We performed a
      comparative study including patients with (n = 40) and without (n = 45) pain of
      the thigh. 85 cementless porous-coated anatomic (PCA) hip endoprostheses in 74
      patients were examined. All patients underwent clinical examination including a
      standardized questionnaire, x-ray, and 3-phase bone scintigraphy. Slight or
      moderate 99mTc-MDP uptake in the area of the greater and lesser trochanter as
      well as at the tip was a common finding in PCA prostheses in patients without
      pain and was not a sign of loosening of the hip. Radiologically, there was no
      difference between patients with and without pain. However, persisting pain of
      the thigh in patients with PCA prosthesis corresponded with an increased uptake
      at the tip and the medial and lateral femur, not being a sign of loosening even
      in this group. The special biomechanical conditions of cementless prostheses
      causing inhomogeneous intraosseous stress distribution are supposed to be the
      reason for that.

PMID- 8479934
TI  - [Prophylactic inhalation of amphotericin B in invasive aspergillosis: a
      distribution study].
AB  - Invasive pulmonary aspergillosis (IPA) during periods of immunosuppression or
      prolonged neutropenia is a serious condition with high mortality. Prophylaxis is
      unsatisfactory because of the low effectiveness of systemic administration of
      amphotericin B (AMB) and because of its side effects. Prophylactic inhalation of
      AMB by means of a nebulizing system may be able to reduce the incidence of IPA.
      Therefore, we studied the distribution of nebulized 99mTc-labeled AMB and
      estimated its particle size. AMB is homogeneously distributed in the lung and
      partly deposited in the terminal respiratory unit; it remains there with a half
      life of at least 14 h. Therefore, prophylaxis of IPA with AMB nebulized as
      described can be recommended.

PMID- 8479935
TI  - 201Tl reinjection predicts improvement of left ventricular function following
      revascularization.
AB  - The aim of this study was to evaluate the correlation between improved Tl uptake
      in reinjection imaging with improvements in regional wall motion and global
      ejection fraction following PTCA or aorto-coronary bypass surgery. 19 patients
      with CHD were investigated and divided into two groups according to their
      thallium uptake in the reinjection studies. Group I showed additional uptake on
      reinjection imaging compared to the redistribution image, whereas group II showed
      no additional uptake. Both groups had a similar number and distribution of
      affected vessels and location of the leading stenosis. Stress, redistribution and
      reinjection images were obtained prior to revascularization and evaluated
      semiquantitatively from a bulls eye scheme. There was a postoperative increase in
      regional wall motion in group 1 from 5.3 to 8.8% whereas group II did not show a
      relevant change (6.3 vs 6.0%). The ejection fraction increased II from 55.0 to
      66.7% in group I and dit not increase in group II (59.8 vs 58.7%). The overall
      predictive value of the reinjection image for improvement in wall motion (> 10%)
      was 91% and for the redistribution image 58%. Increased uptake in reinjection
      imaging predicts improved ventricular function following revascularization and
      indeed indicates viable myocardium with reversible functional impairment.

PMID- 8479936
TI  - [The importance of the radioiodine test for the calculation of the therapeutic
      dose in benign thyroid diseases].
AB  - The aim of this study was to determine the significance of the radioiodine uptake
      test for predicting the kinetics of therapeutic 131I doses in the treatment of
      benign thyroid disorders. We studied retrospectively the histories of 518
      consecutive patients treated with 131I for hyperthyroidism or autonomous thyroid
      goiter, with respect to uptake and effective half-life of tracer and therapeutic
      doses. The mean half-life and uptake of the therapeutic doses were significantly
      smaller than that of the tracer dose. A comparison of different methods of
      calculation showed that the radioiodine uptake test is indispensible for dose
      calculation in radioiodine treatment but a single measurement after 24 or 48 h is
      sufficiently accurate because, on average, the therapeutic dose was achieved as
      planned and with the smallest scatter. Average half-lives specific to the disease
      to be treated may be used in the calculations.

PMID- 8479937
TI  - [Long term biokinetics of 169Yb following injection as citrate,
      hydroxyethylethylenediaminetetraacetate and nitrilotriacetate].
AB  - 169Yb complexes with known biokinetics in tumour-bearing mice up to 48 h p.i.
      were injected into healthy mice to study the radionuclide biodistribution in
      various organs and tissues for 672 h after injection, in order to obtain reliable
      biokinetic data in an animal model, not affected by tumour-growth, as a basis for
      the calculation of biological half-life and dose distribution. The results
      demonstrated the existence of at least two components with different biological
      half-lives in the organs and tissues investigated. The effective half-lives of
      these components decreased with increasing stability of the complexes
      administered. The effective half-life of the fast component was a few hours and
      that of the slow one between about 200 and 800 h.

PMID- 8479938
TI  - A new prognosis-oriented classification of chronic glomerulonephritis.

PMID- 8479939
TI  - [Does a short-term hemodialysis treatment influence function of the pituitary
      testicular axis in patients with chronic renal failure?].
AB  - Abnormal function of the pituitary-gonadal axis is a well documented endocrine
      abnormality in chronic renal failure (CRF). The purpose of the work was to assess
      the influence of the short-term haemodialysis treatment on LH, FSH and
      testosterone secretion. In 17 men dialyzed up to 50 months and 10 non-dialyzed
      male patients with advanced CRF the test of stimulation with LHRH was done.
      Results obtained in patients were compared with those assessed in healthy
      subjects. Significantly higher concentration of LH and FSH and lower
      concentration of testosterone in serum under basal conditions were found in
      patients as compared to controls. Basal concentrations of LH, FSH and
      testosterone in dialyzed patients and in non dialyzed men were similar. The area
      under the curve of LH, FSH and testosterone in both groups of patients was
      similar. These results suggest that in men dialyzed shorter than 50 months
      haemodialysis treatment does not change significantly the function of the
      pituitary-testicular axis as compared to men with advanced CRF.

PMID- 8479940
TI  - [Effect of aminophylline on respiratory function in patients with chronic renal
      failure treated by peritoneal dialysis].
AB  - In 8 patients with chronic renal failure aminophylline influence was studied on
      respiratory function. No changes were seen in lung volumes after 30 minutes of
      intravenous aminophylline infusion. After 2 weeks of intraperitoneal infusion of
      aminophylline, maximal ventilation, vital capacity, forced vital capacity and
      inspiratory residual volume rose significantly. Residual volume and the ratio
      residual volume/total lung capacity, decreased. This changes may indicate an
      improved contractility of the respiratory muscles. A rise in the concentration of
      oxypurines after peritoneal dialysis and a significant improvement in the
      arterial oxygen tension indicate that aminophylline influences the respiratory
      function by bronchodilatation and by contractility improvement of the respiratory
      muscles.

PMID- 8479941
TI  - [Effect of long term prazosin treatment on secretion of insulin, glucagon,
      gastrin, and pancreatic polypeptide in patients with essential hypertension].
AB  - Secretion of insulin, glucagon, gastrin and pancreatic polypeptide (PP) at basal
      and test meal stimulation conditions were investigated in 17 patients with
      essential hypertension (EH) before and after 12 months of treatment with prazosin
      and in 10 healthy subjects. Before prazosin therapy, patients with EH differ from
      healthy subject higher insulin and gastrin but lower PP secretion after test meal
      stimulation. 12 month therapy with prazosin enhanced insulin and suppressed
      gastrin secretion stimulated by test meal in comparison to the pretreatment
      values. Prazosin therapy did not influence significantly glucagon and PP
      secretion. Our results suggest, that long term prazosin treatment markedly
      influenced insulin and gastrin secretion in patients with EH.

PMID- 8479942
TI  - [Factors influencing survival in patients with coronary disease. I.
      Characteristics of examined patients and survival curves].
AB  - The group of 683 patients with the significant narrowing (> 70%) of at least one
      coronary vessel diagnosed by coronarography performed between 1976-1988 in the
      Institute of Cardiology in Warsaw was followed during one to seven years. The
      number of patients with a poor left ventricular function was high in the group
      treated surgically and non surgically. Ejection fraction < 50% was found in 27%
      and 43% respectively, LVEDP > 12 mmHg (66% and 69%), EDVI > 100 ml/m2 (58% and
      70%). Survival curves were calculated in the two different subsets of patients
      treated surgically and non surgically. Despite some favorite trend toward a
      better outcome for patients treated surgically the differences were not
      statistically significant for a whole group. However we showed a significantly
      higher probability of survival in the subgroup of the three vessel disease
      treated surgically compared to other treatment. There were no significant
      differences in survival in patients with one, two, or three vessel disease
      treated surgically (survival probability of 0.82; 0.78; 0.84 respectively after 7
      years). In patients treated non surgically the growing number of diseased vessels
      worsened the prognosis (survival probability of 0.84; 0.78; 056 respectively). In
      our observation the differences for better outcome in patients with poor left
      ventricular function treated surgically did not reach a statistical significance.

PMID- 8479943
TI  - [Influence of diabetes on the clinical course and hospital mortality of patients
      with recent myocardial infarction].
AB  - In group of 1026 patients with recent myocardial infarction (from program
      "Streptokinase in acute myocardial infarction"--patients below 70 years old, up
      to 12 hours from the onset of the symptoms) we analyzed the influence of diabetes
      on clinical course and hospital mortality. In this group were 77 patients with
      noninsulin-dependent diabetes (NIDDM), and 21 patients were insulin-dependent
      diabetes (IDDM). The risk factors of coronary heart disease and myocardial
      infarction in the past were significantly more often in patients with diabetes
      than in subjects without diabetes. In hospital mortality was significantly higher
      (p < 0.05) in group of patients with diabetes (17.3%) than in group without
      diabetes (9.5%). Reinfarction in the hospital period occurred significantly more
      often in diabetes group (p < 0.01). Congestive heart failure was observed in 50%
      patients with diabetes and in 32.3% cases without diabetes (p < 0.01), the left
      ventricle aneurysm occurred accordingly 9.8% i 5.2% (N.S.). Early ventricular
      fibrillation and atrio-ventricular blocks occurred with the same frequency in the
      both groups. We analyzed also the influence of thrombolytic therapy on clinical
      course in patients with diabetes proving the benefit of this treatment.

PMID- 8479944
TI  - [Factors influencing survival in patients with coronary heart disease. II.
      Multivariate logistic function analysis].
AB  - A group of 683 patients with the significant narrowing (> 70%) of at least one
      coronary vessel diagnosed by coronarography performed between 1976-1988 in the
      Institute of Cardiology in Warsaw was followed during one to seven years. Two
      hundred ninety of them were treated surgically, 393 non surgically. A
      multivariate logistic function (MLF) analysis of 10 variables is presented
      obtained from anamnesis and hemodynamic data and their significance upon survival
      after 2, 4 and 6 years. In the group treated non surgically the number of
      narrowed vessels was a factor independently significant after 2, 4 and 6 years.
      After 4 and 6 years the ejection fraction and the left ventricle end diastolic
      volume index were also significant. In the group treated surgically none of those
      were significant after 2 years. After 4 and 6 years anamnesis of arterial
      hypertonia was significant after 6 years also left ventricle end diastolic volume
      index. Coefficients calculated from multivariate logistic function analysis allow
      the calculation of probability of survival for an individual patient.

PMID- 8479945
TI  - [A difficult diagnostic case of malignant hypertension].
AB  - A case of a 62-year old male with malignant hypertension was described. The
      clinical picture was dominated by the presence of cachexia, polyuria and
      polyneuropathy. Laboratory examinations revealed highly elevated sedimentation
      rate, hyponatremia and hypokalemia. Secondary hypertension as well as other
      diseases with similar clinical symptoms were excluded basing in diagnostic
      procedures. The authors discuss pathophysiological mechanisms on the base of
      abnormally elevated activity of the renin-angiotensin-aldosterone system. Unusual
      body weight loss (approximately 20 kgs), polyneuropathy and irreversible lesion
      of renal tubules without renal function impairment are emphasized.

PMID- 8479946
TI  - [Pulsed dose intravenous steroid treatment in the therapy of acute lupus
      nephritis with renal failure].
AB  - The effectiveness of pulse-dose intravenous steroid treatment was studied in
      acute phase of lupus nephritis with renal failure rapidly progressive despite
      conventional therapy. On 5-6 consecutive days 1g of prednisolone or
      methylprednisolone was given intravenously to 33 patients with a mean initial
      serum creatinine 5.9 +/- 4.1 mg/dl (521.6 +/- 362.4 mumol/l); then the patients
      were placed on conventional therapy. Immediate remission (group I), lasting at
      least 6 months, was achieved in 23 patients (69.7%), with a significant decrease
      of serum creatinine from 4.5 +/- 3.2 mg/dl (397.8 +/- 282.9 mumol/l) to 1.3 +/-
      0.7 mg/dl (114.9 +/- 61.9 mumol/l) (p < 0.001) within 3 months. In 19 patients
      the remission lasted more than a year; till now the longest one is 13 years. In
      10 patients (group II), the therapy brought no improvement and they went quickly
      into terminal renal failure. In this group the initial serum creatinine was 8.9
      +/- 3.6 mg/dl (786.8 +/- 318.2 mumol/l), which was much higher than in the I
      group. All those patients were admitted to chronic dialysis programme; however, 5
      of them died during the first 3 months of the treatment. The most frequent
      complications of the therapy were infections; all but one (a generalized zoster
      being a cause of death) caused no therapeutic difficulties. Pulse-dose
      intravenous steroid treatment makes achieving rapid clinical remission possible
      even in cases of advanced renal failure due to acute phase of lupus nephritis,
      refractory to conventional therapy.

PMID- 8479947
TI  - [Mesangium].

PMID- 8479948
TI  - Comparison of probiotics maintained by in vivo passage through laying hens and
      broilers.
AB  - Cecal colonization by salmonellae may be greatly reduced by inoculating chickens
      with normal cecal microflora, a phenomenon known as competitive exclusion.
      Unfortunately, it has not been possible to reliably store active cecal microflora
      over long time periods, and it is difficult to obtain consistent experimental
      results with different batches of microflora. In order to overcome these
      problems, the present authors have maintained active cecal flora through a 2-yr
      period by in vivo passage through both broiler chicks and layers that were fed a
      diet containing 5% lactose. Competitive exclusion cultures maintained in laying
      hens worked as well as cultures from broilers. Cecal microflora from either
      source excluded both nonlactose-fermenting and lactose-fermenting Salmonella
      strains. Colonization by both types of Salmonella was reduced even when the
      competitive exclusion organisms were given as late as 3 days after oral challenge
      inoculation with Salmonella typhimurium.

PMID- 8479949
TI  - Effect of dietary lactose on cecal morphology, pH, organic acids, and Salmonella
      enteritidis organ invasion in Leghorn chicks.
AB  - The effect of 14 or 19 days of 10% dietary lactose administration on Salmonella
      enteritidis (SE) colonization and histological, morphometric, and organic acid
      changes of the ceca were investigated. At Day 13 or 18, chicks were challenged
      with 10(8) cfu of SE. Chicks were killed and cultured 24 h later. A reduction in
      the total number of positive SE organ invasions was observed following 14 days (P
      < .001) or 19 days (P < .005) of treatment in chicks fed with lactose.
      Histological examination revealed a marked reduction in lamina propria thickness
      of ceca, as well as subjective epithelial cell proliferation from chicks
      following either 14 or 19 days of lactose administration. Using morphometric
      analysis, a reduction in the mean lamina propria thickness in chickens fed with
      lactose during 14 or 19 days was observed as compared with controls (P < .05).
      Yet, an increase (P < .05) in the mean epithelial cell length in both lactose
      treated groups was observed as compared with controls. Lactose decreased luminal
      pH (P < .05) and increased the concentration of acetic, propionic, butyric, and
      lactic acid (P < .05). These data indicate that lactose-induced resistance to SE
      organ invasion is associated not only with an increase in organic acid
      concentration but also with measurable morphological changes of the cecal mucosa.

PMID- 8479950
TI  - An evaluation of fructooligosaccharide in diets for broiler chickens and effects
      on salmonellae contamination of carcasses.
AB  - Two similar trials were conducted to evaluate the effects of dietary inclusion of
      fructooligosaccharide (FOS) on live performance and carcass characteristics of
      broilers and on incidence and level of salmonellae on prechill broiler carcasses.
      The FOS was fed at two levels (0 and .375%) in a complete factorial arrangement
      with two levels (0 and 55 mg/kg) of bacitracin methylene disalicylate (BMD) in
      nutritionally complete diets. Broilers were grown to 49 days of age, and samples
      were processed to determine dressing percentage, abdominal fat content, and most
      probable number salmonellae on prechill carcasses. The addition of FOS to
      nutritionally complete broiler diets at .375% had little consistent effect on
      growth rate, feed utilization, mortality, carcass dressing percentage, abdominal
      fat content, or incidence or severity of salmonellae contamination of processed
      broiler carcasses. There appeared to be an antagonism between FOS and BMD on both
      live performance and salmonellae contamination of processed broiler carcasses.

PMID- 8479951
TI  - The effects of shuttle programs upon the growth of broilers and the development
      of immunity to eimeria species.
AB  - A floor-pen trial was conducted to investigate the effects of different shuttle
      programs upon the growth of broilers to 8 wk of age. Nicarbazin, halofuginone,
      and robenidine, when included in the starter feed for 3 wk, were effective in
      preventing lesions due to Eimeria. The effects of medication upon performance
      were apparent, medicated groups gaining more weight by 6 wk and having a lower
      feed conversion at 6, 7, and 8 wk than the unmedicated controls. There were no
      significant differences in body weight at 6, 7, or 8 wk or feed conversion at 6
      or 7 wk among the medicated groups, whether medication was withdrawn for 7 or 14
      days. A decrease in the number of small and medium oocysts in the litter was
      observed as the trial progressed. Few large oocysts (Eimeria maxima) were seen in
      the medicated groups. Numbers of oocysts did not increase following withdrawal of
      medication. Birds from all medicated groups were challenged at 6 wk with oocysts
      of Eimeria acervulina, Eimeria maxima, or Eimeria tenella. Weight gains were
      similar to that of the unchallenged controls, indicating that they had acquired
      immunity to these species of Eimeria.

PMID- 8479952
TI  - Effect of oligosaccharide additions on nitrogen-corrected true metabolizable
      energy of soy protein concentrate.
AB  - In order to determine TMEn response to individual saccharide moieties, five
      different sugar additions were made to a soy protein concentrate control that
      contained low levels of oligosaccharides. The sugar additions to the control were
      made to approximate the amounts of raffinose, stachyose, and sucrose found in
      soybean meal (SBM). All samples were precision-fed to adult Leghorn roosters to
      determine TMEn values. The control had a dry matter gross energy (GE) of 4,873
      kcal/kg, CP of 73.1%, and TMEn value of 3,757 kcal/kg. Raffinose and stachyose
      significantly reduced TMEn values for the control. Sucrose did not exhibit this
      effect. In a second experiment, different levels of stachyose and raffinose were
      added separately to the control to develop a TMEn dose response curve for these
      alpha-galactosides of SBM. The TMEn of soy protein concentrate was found to be
      significantly decreased by stachyose and raffinose inclusion and to be dose
      dependent.

PMID- 8479953
TI  - Thyroid hormone and growth hormone regulation of broiler adipocyte lipolysis.
AB  - Broiler adipocytes in culture were utilized 1) to determine acute and chronic
      effects of triiodothyronine (T3) and growth hormone (GH) on lipolysis; and 2) to
      determine whether T3 and GH act synergistically to increase lipolysis. Short-term
      effects of T3 and GH on lipolysis were determined by measuring glycerol release
      from adipocytes incubated for 1 h with T3 or GH and glucagon (GLU). To
      investigate long-term effects, adipocytes were cultured for 24 h with T3, GH, or
      a combination of T3 and GH before removal of hormones by washing and assessment
      of lipolysis. Basal and GLU-stimulated lipolysis were not altered by short-term
      (1 h) incubation of adipocytes with T3 or GH. Pretreatment of adipocytes with T3
      for 24 h increased (P < .05) basal lipolysis and lipolysis in the presence of low
      (.3 to 1.5 ng/mL) doses of GLU. Preincubation of adipocytes with GH for 24 h
      decreased (P < .05) glycerol release in response to maximal stimulatory doses (3
      to 10 ng/mL) of GLU and increased (P < .05) glycerol release in response to .3 ng
      GLU/mL. Long-term pretreatment of adipocytes with a combination of T3 and GH
      produced a similar increase in lipolysis with .3 ng GLU/mL as pretreatment with
      either T3 or GH alone. Thus, T3 and GH did not act synergistically to increase
      lipolysis from broiler adipocytes.

PMID- 8479954
TI  - Influence of large doses of ascorbic acid on performance, plasma calcium, bone
      characteristics, and eggshell quality in broilers and Leghorn hens.
AB  - Four experiments were conducted using broilers (Experiments 1 and 2) or White
      Leghorn hens (Experiments 3 and 4) to determine the effects of large doses of
      dietary ascorbic acid on performance, plasma concentration of total and ionic
      calcium, bone characteristics, and eggshell quality. A total of 564 male broilers
      were fed diets containing ascorbic acid (ranging from 0 to 3,000 ppm) from 3 to 7
      wk of age. Weight gain and feed conversion were measured, and blood plasma was
      analyzed for total and ionic calcium. Leg bones (femur, tibia, and metatarsus)
      were analyzed for bone mineral content, density, and breaking strength. In
      Experiments 3 and 4, a total of 484 Leghorn hens were fed diets containing
      ascorbic acid (ranging from 0 to 3,000 ppm) for 4 wk. Egg weight and specific
      gravity were determined, and plasma and tibiae were analyzed as in Experiments 1
      and 2. Results of the broiler experiment (Experiment 2) indicated that plasma
      ionic calcium was significantly increased (P < .05) in ascorbic-acid-treated
      birds. Among leg bones examined, femur strength was improved by 16% in birds fed
      2,000 ppm of ascorbic acid (Experiment 2). Other bone characteristics were not
      affected. In the layer experiments (Experiments 3 and 4), egg weight increased up
      to 5% and egg specific gravity was improved in hens fed 2,000 or 3,000 ppm of
      ascorbic acid, which also had increased calcium in the blood. Results suggest
      that large doses of ascorbic acid in the diet influence calcium metabolism,
      affecting bone and eggshell mineralization in chickens.

PMID- 8479955
TI  - Effects of sex, heat stress, body weight, and genetic strain on the dietary
      lysine requirement of broiler chicks.
AB  - Experiments were carried out to investigate the effects of sex, heat stress (37
      C), body weight (heavy and light within strain), and strain of chicks on the
      dietary lysine requirement of chicks during 8 to 22 days posthatching. A lysine
      deficient basal diet (.64% total lysine, 23% CP, 3,200 kcal ME(n)/kg) containing
      corn, feather meal, and soybean meal was supplemented with graded levels of L
      lysine.HCl to produce growth response curves. The lysine-deficient diet contained
      .52% true digestible lysine as determined with a precision-fed cecectomized adult
      cockerel assay (Experiment 1). Hubbard x Hubbard chicks were used in Experiment 2
      and New Hampshire x Columbian crossbred chicks were used in Experiments 3 and 4.
      Experiment 2 compared lysine requirements of male and female chicks. Weight gains
      between sexes were similar when diets were deficient in lysine, but males grew
      faster than females when lysine-adequate diets were fed. Male chicks required a
      higher level of dietary lysine than females for both maximal weight gain and feed
      efficiency. Also, regardless of sex, the lysine requirement (percentage of diet)
      for maximal feed efficiency was higher than that for maximal weight gain. In
      Experiment 3, heat stress reduced weight gain and feed intake of both males and
      females by about 22%, and it increased the lysine requirement of female but not
      male chicks. In Experiment 4, light and heavy chicks were selected from male and
      female populations. Heavy and light chicks exhibited the same dietary lysine
      requirement for maximal growth. However, the lysine requirement for maximal feed
      efficiency was higher for heavy birds than for light birds.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8479956
TI  - Follicle-stimulating hormone-enhanced fibronectin production by chicken granulosa
      cells is influenced by follicular development.
AB  - Experiments were conducted in vitro to examine the effect of ovine follicle
      stimulating hormone (FSH) on various fractions of fibronectin (deposited,
      secreted in medium, and cell-associated) resulting from culture (12 or 24 h) of
      chicken granulosa cells isolated from the largest (F1) and third largest (F3)
      preovulatory follicles as well as from a pool of immature small yellow follicles
      (SYF). Fibronectin in each fraction was quantified with a specific ELISA. The
      amount of fibronectin deposited in culture wells containing unstimulated cells
      increased with time and was greatest in wells containing F1 cells. Follicle
      stimulating hormone increased the quantity of fibronectin deposited within 12 h
      by F3 and SYF cells, but not by F1 cells. The magnitude of FSH-enhanced
      fibronectin deposition was greatest in cells derived from immature SYF.
      Fibronectin secreted in the medium by unstimulated cells also increased with the
      stage of follicular maturation. Follicle-stimulating hormone increased the amount
      of fibronectin secreted in the medium by F3 and SYF cells. The quantity of
      fibronectin associated with cells was increased by FSH in all cell types. Total
      (deposited plus medium plus cell-associated) fibronectin production was elevated
      in a dose- and time-dependent manner when FSH was added to F3 and SYF granulosa
      cells, but the gonadotropin was without effect in F1 cells. The magnitude of FSH
      stimulation (fold increase) of total fibronectin production was calculated as a
      multiple of the unstimulated (control) value for each cell type. The relative
      change in total fibronectin production resulting from addition of FSH (after 24 h
      incubation) was .02- to .24-fold in F1 cells as compared with .33- to .92-fold in
      F3 cells and 2.75- to 4.38-fold in SYF cells. These results indicate that FSH
      stimulates fibronectin production by chicken granulosa cells, and this
      stimulatory effect decreases as the follicle matures.

PMID- 8479957
TI  - Stimulus control of copulatory behavior in male Japanese quail.
AB  - The copulatory behavior of sexually experienced male Japanese quail was tested
      using taxidermic models with varying proportions of natural and artificial
      features. Completely artificial models exerted little control over copulatory
      behavior, and whole natural body models reliably elicited copulatory behavior. In
      single model presentation tests, a model containing a natural head and neck with
      an artificial body was as effective in eliciting copulatory behavior as a whole
      body model, but a model containing a natural body with an artificial head and
      neck was largely ineffective. In choice tests, however, males clearly preferred a
      whole model over a natural head and neck model, and a natural body model over a
      completely artificial model. These data indicate male Japanese quail do attend to
      features of body plumage. Furthermore, test procedures can influence conclusions
      about effective controlling stimuli.

PMID- 8479958
TI  - Evidence that estrogen binding sites are present in bone cells and mediate
      medullary bone formation in Japanese quail.
AB  - Studies were carried out in Japanese quail to characterize the binding of
      estrogen to bone cells and to determine whether induction of medullary bone by
      estrogen is mediated by estrogen receptors. First, attempts were made to identify
      specific, high affinity nuclear binding sites for estrogen with a nuclear
      exchange assay in oviduct and femora from laying female quail and in liver,
      kidney, and femora from adult male quail treated with estradiol valerate (2 mg
      per bird). High-affinity nuclear estrogen binding sites were detected in each of
      the tissues except femora. Second, estrogen binding sites in femora from male
      quail were localized by radioautography after treatment with 100 microCi of [3H]
      17 beta-estradiol ([3H]-E). Estrogen binding sites were present at 1 and 3 h
      after administration of [3H]-E, and binding of the radiolabeled hormone was
      prevented by the simultaneous administration of an excess of radioinert estrogen.
      Third, estradiol valerate (.4 mg) was given as a bolus to adult male Japanese
      quail. Five days later, the quail had hypercalcemia due to accumulation of
      phosvitin in serum, had an extensive network of medullary bone at the femur
      midshaft, and had reduced cortical bone area. The nonsteroidal, anti-estrogen
      tamoxifen (2 mg/day) prevented estrogen-induced hypercalcemia, medullary bone
      formation, and reduction of cortical bone area. Fourth, the estrogen target cells
      in femora from adult male quail that were induced to differentiate to osteoblasts
      by estrogen treatment were located by [3H]-proline radioautography as early as 12
      h following administration of the hormone. These results are interpreted as
      evidence that induction of medullary bone is a process mediated by estrogen
      receptor.

PMID- 8479959
TI  - Evaluation of cross-contamination on automatic viscera removal equipment.
AB  - Contamination of poultry carcasses by fecal or ingested material is a major
      problem in the processing of poultry products. It was determined that the
      automatic equipment used to process uncontaminated carcasses could be used to
      clean and reprocess contaminated carcasses and significantly reduce the manual
      labor required to reprocess these carcasses. The potential for cross
      contamination of the automatic viscera removal equipment was tested by
      microbiological evaluation, and it was determined that cross-contamination by
      this equipment was not a problem.

PMID- 8479960
TI  - Research note: differential chemotaxis of Physarum polycephalum to Salmonella
      gallinarum and Salmonella pullorum.
AB  - The chemotactic and chemotropic responses of the plasmodial stage of the slime
      mold Physarum polycephalum were used to distinguish Salmonella gallinarum and
      Salmonella pullorum from 10 Salmonella serovars that are commonly isolated from
      domestic poultry. Utilizing an in vitro plasmodium agar plate assay method, P.
      polycephalum was attracted to S. gallinarum and S. pullorum, but the organism was
      repelled by Salmonella derby, Salmonella dublin, Salmonella enteritidis,
      Salmonella heidelberg, Salmonella minnesota, Salmonella montevideo, Salmonella
      newington, Salmonella newport, Salmonella reading, and Salmonella typhimurium.

PMID- 8479961
TI  - [Medicinal plants of the New World--500 years of discovery in the Americas].

PMID- 8479962
TI  - [Biological frost prevention in fish, frogs, flies and pines].

PMID- 8479963
TI  - [Potassium agonists: mechanisms of action and therapeutic expectations].

PMID- 8479964
TI  - [Preservation today].

PMID- 8479965
TI  - A comparative study of facial growth following lip and palate repair performed in
      sequence and simultaneously: an experimental study in beagles.
AB  - This study was designed to assess the effects of the commonly accepted sequence
      of cleft lip and palate repair on subsequent maxillofacial growth and to compare
      these effects with those resulting from simultaneous lip and palate repair. Using
      62 eight-week-old normal beagles, we tested the hypothesis that sequential repair
      (lip first, palate second) of surgically induced lip and palate defects is less
      detrimental to maxillofacial growth than simultaneous repair of both surgically
      created defects. Animals were assigned to one of four groups: two control groups
      (unoperated and unrepaired) and two experimental groups. Defects simulating cleft
      of the lip, alveolus, and palate were surgically created in the unrepaired
      controls and in the experimental animals. In one experimental group, the lip and
      palate defects were repaired immediately and simultaneously. In the other
      experimental group--simulating current clinical practice--the lip defect was
      repaired first at the time that it was created, while closure of the palatal
      defect was delayed 4 weeks. After the animals were killed at 36 weeks of age, 11
      maxillary variables were measured directly from cleaned skulls and analyzed by
      using univariate and multivariate techniques. Animals that had lip and palate
      defects closed in sequence had less severe maxillofacial aberrations than animals
      with simultaneously closed defects. Sequential closure of the defects also had
      identifiable effects on maxillofacial form. The growth aberrations observed among
      animals with sequential closure, however, are primarily attributable to surgical
      creation of the defects and not to the surgical repair. Delaying palate repair is
      less traumatic to the subsequent growth of the maxillary complex than
      simultaneous repair of lip and palate defects.

PMID- 8479966
TI  - Periocular reconstruction: a systematic approach.
AB  - The records and photographs of 90 patients who underwent reconstructive
      procedures on the eyelids, canthi, and periocular tissues between 1982 and 1988
      were reviewed retrospectively. The defects created by either fresh tissue
      histologically controlled resection or primary excision were analyzed according
      to location, size, and degree of resection and visual status. Histologic types
      included nodular, morphea, and fibrosing basal cell carcinomas; well to poorly
      differentiated squamous cell carcinoma; and melanoma in situ. The adequacy of
      both ocular protection and tissue preservation was assessed between 1 and 6 years
      postoperatively. Anatomic as well as functional reconstructions were performed
      with a complication rate of 12 percent. There were two tumor recurrences
      requiring extensive craniofacial extirpation and reconstruction. A systematic
      method of classifying periocular defects was developed in order to analyze
      various reconstructive options as well as the type and frequency of complications
      encountered. This classification system is applicable to primary benign and
      malignant lesions as well as defects. Analysis of patients who underwent
      periocular reconstruction in the context of this classification system reveals
      that larger defects and those involving the medial canthus are more prone to
      complications. Recurrent complications in the medial and lateral canthal region
      underscore the necessity of routinely utilizing ancillary procedures such as
      lacrimal intubation and canthopexy. Recommendations for periocular reconstruction
      are suggested based on this classification system.

PMID- 8479967
TI  - The fate of intraoral free muscle flaps: is skin necessary?
AB  - Intraoral free musculocutaneous flaps can be bulky and inflexible for
      reconstruction of mucosal and soft-tissue defects to the head and neck. Free
      muscle flaps alone can be much less bulky and restore better contour than
      musculocutaneous flaps. When using free muscle flaps, however, it was felt that a
      skin graft was needed for proper epithelialization without significant
      contracture. Nine patients, average age 59 years (range 42 to 71 years), six
      males and three females, underwent extirpation of head and neck tumors and
      reconstruction with free muscle flaps only. Mucosal defects from 4 x 4 to 12 x 10
      cm (four floor of mouth, five hard palate) were filled. Reconstruction was done
      with seven free rectus abdominis muscle flaps and two internal oblique/iliac bone
      flaps. All flaps survived with no significant complications. There was one minor
      abdominal wound separation. All patients who were able to swallow started oral
      feedings by 2 weeks postoperatively. Total epithelialization of even the large
      defects was completed by 8 weeks. Histologic assessment revealed an early fibrin
      layer over the muscle at 1 week with eventual epithelialization that was
      indistinguishable microscopically from normal surrounding mucosa. There was some
      contracture in all the flaps, but this was not clinically significant, even in
      the large defects. Intraoral free muscle flaps offer a safe and reliable
      reconstructive method that has led to a good functional result.

PMID- 8479968
TI  - Familial medial telangiectatic nevus: variant of nevus flammeus--port-wine stain.
AB  - Six families in which a few members, in three generations, were affected with
      medial telangiectatic nevus (salmon patch, stork bite, angel's kiss) on the
      forehead, glabella, upper eyelids, upper lip, nose, and nuchal and occipital
      areas are presented. This is a mild variant of lateral telangiectatic nevus
      (nevus flammeus, port-wine stain) that disappears in about 50 percent of patients
      during the first years of life. In one family, lateral telangiectatic nevus
      (nevus flammeus, port-wine stain) and superficial (strawberry) hemangioma
      coexisted with medial telangiectatic nevus. This paper discusses the familial
      incidence of medial telangiectatic nevus and a new modality of treatment.
      Moreover, the paper presents a classification of vascular malformations and
      proposes a new terminology.

PMID- 8479969
TI  - Botulinum A toxin for treatment of aberrant facial nerve regeneration.
AB  - Twelve patients with involuntary synkinetic eyelid closure were given 40
      injections of botulinum A toxin. Temporary improvement in involuntary eyelid
      closure was observed in all 12 patients. Eleven of the 12 patients desired
      repeated injections. Dose requirements for this indication were compared with
      doses used in 697 injections in 112 patients with essential blepharospasm and
      Meige syndrome. Additionally, dose comparisons were made with 269 injections in
      71 patients with hemifacial spasm. Dose requirements needed to treat aberrant
      regeneration of the facial nerve were substantially less than needed to treat
      blepharospasm and Meige syndrome. The dose requirement was similar to that in
      hemifacial spasm treatment. The reason for the differences probably relates to
      existing muscular denervation associated with hemifacial spasm and aberrant
      facial nerve regeneration.

PMID- 8479970
TI  - Reduction mammaplasty and correction of ptosis: a personal technique.
AB  - New upper pedicle reduction mammaplasty and mastopexy techniques are presented.
      The surgical steps are described point by point. An analysis is made of the
      results obtained in 25 patients who underwent surgery between November of 1987
      and November of 1988 and were examined in December of 1990 with a mean follow-up
      of 31.5 months. An assessment was made of the postoperative ptosis, which was
      minimal in 76 percent of patients. The overall assessment of breasts was
      satisfactory (good mammary morphology and a correct position of the nipple-areola
      complex). Nipple-areola complex sensitivity was unchanged in 80 percent of
      patients. Good-quality inframammary scars were observed in 92 percent of
      patients, with scar length never exceeding 4 cm. The overall complication rate
      was 32 percent, but only 12 percent were major complications. The technique
      presented is excellent when the quantity of glandular tissue to be removed is
      less than 400 gm, and it is not therefore recommended for gigantomasties.

PMID- 8479971
TI  - An in vivo study of the effect of various breast implant filler materials on
      mammography.
AB  - Silicone breast implants have the potential to interfere with mammography through
      a variety of different mechanisms. One important factor is the radiopacity of the
      implant. A comparison was made of the effect of six different implant filler
      materials on visualization of known breast lesions in a living subject. The
      materials studied were normal saline, a triglyceride solution, silicone gel, a
      solution of 50% polyvinylpyrrolidone (PVP) in saline, a solution of 10% PVP in
      saline, and a solution of 2.5% PVP in glycerine. The ease with which known breast
      lesions could be identified through different materials varied dramatically. The
      poorest visualization was through the silicone gel-filled implant. The best
      visualization was through the prosthesis containing a triglyceride solution.
      Physical density, atomic number, and electron density are the factors which
      determine the radiopacity of materials used to fabricate breast implants.
      Radiopacity, in turn, affects the ease with which breast lesions can be imaged in
      vivo. The radiologic characteristics of filler materials will be an important
      consideration in the design of future breast implants.

PMID- 8479972
TI  - The relative radiolucencies of breast implant filler materials.
AB  - Breast implants in current use utilize silicone gel for filler material. One
      substantial drawback of silicone gel is its radiodensity, resulting in the
      obscuration of breast tissue on mammography. The relative radiolucencies of
      silicone gel, saline, breast tissue equivalent, triglycerides (peanut oil), and
      polyvinylpyrrolidone (Bio-Oncotic gel) were determined by using standard
      mammographic equipment. Visibility through these materials was compared by using
      a standard breast phantom as background. The x-ray dosage necessary to create
      each mammographic image was measured. Peanut oil provided the clearest image of
      the phantom artifacts, required the least radiation exposure, and was
      approximately four times more radiolucent than the saline or Bio-Oncotic gel and
      about 45 times more radiolucent than silicone gel. As improved implant filler
      materials are being sought, triglycerides maintain superior radiographic
      properties.

PMID- 8479973
TI  - Capsular tissue: a new local flap.
AB  - Capsular tissue, the interface that forms between an implanted device and the
      body's own soft tissues, has recently been shown to develop its own unique blood
      supply. This capsular tissue with its extensive vascular plexus has not been
      described previously as an isolated flap. The purpose of our study was to
      determine whether an isolated flap of capsular tissue would survive as a local
      pedicle flap and provide enough inherent vascularity to support a skin graft.
      Isolated expanded and nonexpanded capsular flaps were compared by using 20
      expanders (10 expanded and 10 nonexpanded) in two mixed-breed female pigs.
      Expanded and nonexpanded capsular flaps were elevated 8 weeks following expander
      placement. These flaps were raised on their capsular bases alone, and skin grafts
      were placed onto the capsular surfaces. All the expanded capsular flaps and their
      skin grafts had 100 percent survival. Skin grafts on the nonexpanded flaps
      survived an average of 28 percent, with graft survival corresponding to flap
      survival. This study confirms that flaps of isolated expanded capsular tissue
      survive and provide enough inherent vascularity to support a split-thickness skin
      graft.

PMID- 8479975
TI  - Endogenous versus toxin-induced diabetes in rats: a mechanical comparison of two
      skin wound-healing models.
AB  - This study was designed to compare skin wound healing in three groups of Wistar
      rats: normal, genetically diabetic, and streptozotocin-induced diabetic. All
      diabetic animals received daily insulin. Full-thickness midline dorsal skin
      wounds were analyzed biomechanically for strength, toughness, and elasticity
      (Young's modulus) at 1 and 3 weeks after wounding. Wounds from normal controls
      were the strongest, toughest, and least compliant. Genetically diabetic rat
      wounds were the weakest and had the lowest elastic modulus. Wounds from the
      streptozotocin-induced rats were intermediate for all parameters measured (ANOVA,
      p = 0.001). Toxin-induced diabetes is less detrimental to skin wound healing than
      diabetes of endogenous origin. Whether this is due to basic differences in the
      models or to differences in duration of diabetes is unknown.

PMID- 8479974
TI  - Ventral/incisional abdominal herniorrhaphy by fascial partition/release.
AB  - Ventral/incisional abdominal hernias following celiotomies continue to be a
      vexing problem for both patients and general and plastic and reconstructive
      surgeons, since no universally applicable preventive or reconstructive techniques
      have evolved. With reference to reconstruction, for example, primary repair is
      associated with a high incidence of recurrence; utilization of synthetic mesh is
      susceptible to extrusion, infection, and intestinal fistulization; and employment
      of truncal or extremity, free or rotational, myofascial flaps is associated with
      the morbidity of the procedure per se. By contrast, the use of fascial
      partition/release of the components of the abdominal wall employing bilateral
      parasagittal relaxing incisions in the obliquus externus abdominis and/or
      transversus abdominis fascia facilitates coaptation of the linea alba and
      obviates the aforementioned morbidity. This technique was utilized electively in
      seven adult patients with large defects of the anterior abdominal wall. In
      addition, for two patients, synthetic nonabsorbable mesh was applied superficial
      to the midline fascial closure. During a mean follow-up interval of 18 months
      (range 6 to 36 months), each patient healed per primum without evidence of
      eventration or herniation. The theoretic and pragmatic advantages of this
      technique are discussed. The use of fascial partition/release for reconstruction
      of abdominal wall defects should be part of the armamentarium of all
      herniotomists.

PMID- 8479976
TI  - Microbiology and healing of the occluded skin-graft donor site.
AB  - Delayed healing of skin-graft donor sites may be costly and life-threatening,
      especially in patients with large body surface area burns. A donor site dressing
      should maximize the ability of the wound to heal without increasing the risk of
      local infection, systemic infection, or both. Specifically, the possibility of a
      secondary infection may either slow the healing process or ultimately convert the
      donor site into a full-thickness skin loss. A number of materials ranging from
      gauze to biologicals have been investigated for use as donor site dressings. The
      use of hydrocolloids for donor sites has been widely studied and has shown
      improved healing rates over the rates reported for conventional dressings. Our
      recent study using hydrocolloids confirmed earlier research that showed fewer
      infections and more rapid donor site healing.

PMID- 8479977
TI  - Prefabricated flaps using tissue expanders: an experimental study in rats.
AB  - The aim of this study was to determine if muscle vascularized pedicle flaps (MVP
      flaps) elevated in expanded tissue on the rat would survive to the same or
      greater area than flaps elevated in nonexpanded tissue. The animals were divided
      into three groups: group I (n = 10), with a tissue expander; group II (n = 10),
      with a tissue expander but not expanded; and group III (n = 10), with a thin
      silicone sheet (Biobrane). The mean surviving area of group I (96.6 +/- 3.6
      percent) was statistically higher than that of group II (73.2 +/- 24.7 percent)
      (p < 0.05) and group III (59.5 +/- 25.1 percent) (p < 0.005). These experiments
      demonstrate that there is a larger area of flap survival in expanded muscle
      vascularized pedicle flaps than that found in nonexpanded flaps in rats. The
      mechanism of increased vascularity associated with tissue expansion is still
      unclear, but microangiography of flaps showed increased vascularity of the
      pedicle itself, especially in group I.

PMID- 8479978
TI  - Morphologic analysis of the microcirculation during reperfusion of ischemic
      skeletal muscle and the effect of hyperbaric oxygen.
AB  - The morphologic events in the microcirculation that lead to reperfusion injury of
      ischemic skeletal muscle remain incompletely understood. The purpose of this
      experiment was to evaluate leukocyte endothelial adherence characteristics and
      dynamic changes in microvessel caliber during reperfusion of an in vivo skeletal
      muscle ischemia preparation. In addition, the effect of hyperbaric oxygen
      treatment on these microcirculatory changes also was studied. An intravital
      microscopy preparation of a transilluminated gracilis muscle in 27 rats was used
      to observe a total of 101 arterioles and 63 venules (13 to 73 microns diameter).
      Baseline hemodynamics were videotaped for 30 minutes following muscle isolation.
      The animals were divided into six groups: (1) sham, no ischemia, (2) 4 hours of
      global ischemia only, (3) no ischemia plus hyperbaric oxygen (one 2.5 ATA/1 hour
      of treatment with 100% oxygen), (4) 4 hours of ischemia plus hyperbaric oxygen
      during ischemia, (5) 4 hours of ischemia plus hyperbaric oxygen immediately on
      reperfusion, and (6) 4 hours of ischemia plus hyperbaric oxygen 1 hour after
      reperfusion. Changes in arteriolar and venular diameters at specific times during
      3 hours of reperfusion were recorded, and the number of adherent and slow-rolling
      leukocytes in 100-microns venular segments were counted and compared with
      baseline measurements. The proximity of arterioles to venules was classified as
      adjacent (< 15 microns) or distant (> 15 microns). No significant changes in
      leukocyte endothelial adherence or arteriolar diameter were noted in group 1 sham
      or group 3 nonischemic hyperbaric oxygen-treated rats when compared with baseline
      measurements. A significant increase in adherent leukocytes was observed in group
      2 ischemic venules (+14.9 +/- 2.5) within 5 minutes of reperfusion, which was
      maintained for 3 hours. Reperfusion measurements of arteriolar diameter in group
      2 ischemic muscle preparations demonstrated an initial vasodilation that was
      followed at 1 hour by a progressive and severe vasoconstriction (-46.9 +/- 11.3
      percent at 3 hours) in arterioles adjacent to venules that was not seen in
      distant arterioles. The increase in adherent leukocytes seen in group 2 ischemic
      venules was significantly reduced by hyperbaric oxygen treatment given during
      ischemia (group 4) or up to 1 hour during reperfusion (groups 5 and 6). In
      addition, the progressive ischemic arteriolar vasoconstriction was inhibited in
      all groups (4, 5, and 6) treated with hyperbaric oxygen.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8479980
TI  - Comparison of the contact neodymium:YAG and carbon dioxide lasers for skin
      deepithelialization.
AB  - The application of laserbrasion by the carbon dioxide (CO2) laser for skin
      deepithelialization previously has been proven efficacious in numerous clinical
      experiences. This study in adult Sprague-Dawley rats was designed to compare
      those known effects of the CO2 laser with the contact neodymium:yttrium-aluminum
      garnet (Nd:YAG) laser for skin deepithelialization, since tactile feedback from
      the handpiece of the latter is a theoretical advantage. This proved that although
      the contact Nd:YAG laser does have the capability to achieve skin
      deepithelialization, when compared with more conventional methods, it is
      laboriously inefficient and therefore at present impractical.

PMID- 8479979
TI  - Laser-assisted microvascular anastomosis of human adult and placental arteries
      with expanded polytetrafluoroethylene microconduit.
AB  - Laser-assisted microvascular anastomoses can be performed more quickly than
      sutured anastomoses, yet manifest similar patency rates and tensile strength.
      This study was undertaken to determine if in vitro laser-assisted microvascular
      anastomoses could be created between human adult arteries (anterior tibial
      arteries), human placental arteries, and expanded polytetrafluoroethylene
      microconduits. A CO2 laser was applied in single or continuous bursts with a
      matrix of variables encompassing power P = 80 to 160 mW, spot size SS = 150 to
      500 microns, and exposure time EXP = 1.0-second continuous exposure (n = 2 each
      composite setting). The endpoints measured to assess the ability to laser-weld
      vessels were morphologic appearance by scanning electron microscopy and bursting
      strength. Scanning electron microscopy revealed apparent fusion of human
      placental arteries and human adult arteries to expanded polytetrafluoroethylene
      microconduits at settings of P = 130 mW, SS = 300 microns, and EXP = 1.0 second,
      though bursting pressure at all settings was less than 10 mmHg. Laser-assisted
      microvascular anastomoses of human placental artery to human placental artery and
      human adult artery to human adult artery were successful at this setting, though
      bursting pressures of anastomoses incorporating placental vessels were
      significantly weaker than those created with adult tissue. The relative weakness
      of laser-assisted microvascular anastomoses incorporating placental arteries
      might be explained by qualitative or quantitative differences in vessel wall
      collagen, as seen in fetal tissue, and deserves further characterization.

PMID- 8479981
TI  - Extended wrap-around flap for reconstruction of the finger with recurrent
      arteriovenous malformation.
AB  - Treatment of arteriovenous malformations of the finger is difficult because
      complete resection of malformations by ligation or en bloc resecting methods is
      impossible. We used an extended wrap-around flap consisting of a combined wrap
      around flap and a dorsalis pedis flap to reconstruct the soft-tissue defects
      following complete resection of a recurrent malformation in the index finger.
      This method has two advantages: no postoperative recurrence of the malformation
      is expected, and the affected finger can be preserved. However, it is indicated
      only for malformations with no invasion to the bone and localized in one finger.

PMID- 8479982
TI  - The form-ative years.

PMID- 8479984
TI  - Double fillet of foot free flaps for emergency leg and hand coverage with
      ultimate great toe to thumb transfer.
AB  - A 42-year-old woman presented with avulsion amputation of her right leg 14 cm
      below the knee joint and a hemihand amputation of the opposite hand. Two free
      flaps, taken from the amputated foot, were used to cover the injured extremities.
      The sole fillet flap was used to preserve length and cover the injured leg, while
      the dorsal fillet flap covered the injured hand and provided ectopic storage for
      the great toe. The great toe was later transferred on a pedicle for thumb
      reconstruction. Spare parts surgery is now a well-accepted technique. This case
      demonstrates maximum utilization of amputated parts for functional and aesthetic
      reconstruction.

PMID- 8479983
TI  - Salvage replantation of two fingers from a nonreplantable midpalm.
AB  - To achieve better functional results following mutilating multidigital trauma,
      every effort should be made to maximize the ultimate function of the hand, and
      the plan of replantation should be guided accordingly. All usable parts should be
      salvaged from the amputated nonreplantable areas. A patient is reported in whom
      two fingers taken from the nonreplantable midpalm were used to reconstruct the
      thumb and ring fingers, ultimately improving the overall quality of the patient's
      life.

PMID- 8479985
TI  - Magnetic resonance imaging of the nose with surface coils: a new technique to
      evaluate functional and aesthetic problems.
AB  - Determining the preoperative functional and aesthetic anatomy has been of
      critical importance to surgeons planning nasal procedures. Beyond skilled
      clinical examination, few objective studies exist to aid the surgeon. Magnetic
      resonance imaging (MRI) represents a potentially excellent method for precise
      anatomic imaging of the nose. Unlike computed tomography (CT) and conventional x
      rays, MRI involves no radiation. Similar to CT, however, MRI can provide computer
      enhanced three-dimensional and quantitative airway data. Full-head MRI has proven
      sensitivity in evaluation of tumors of the brain and sinuses and is the imaging
      modality of choice for many soft-tissue tumors. Due to the relatively high cost
      of conventional full-head MRI scanning ($600 to $1200 per scan), MRI of the nose
      utilizing full head scanning technique has been limited. The recent development
      of small field of view surface coils has enabled higher-resolution nasal scans at
      a fraction of the scanner time and cost ($200 to $500) of conventional MRI scans.
      We have developed a protocol utilizing a small field of view coil which results
      in reproducible high-resolution nasal scans requiring less than 6 minutes of
      scanner time. This protocol has been used in both the diagnosis and follow-up of
      patients with traumatic and congenital nasal and septal deformities. Image
      resolution obtained using the protocol is significantly better than with
      conventional coils. This technique is excellent for both diagnosing and
      documenting nasal anatomy and pathology.

PMID- 8479986
TI  - Central tongue reduction for macroglossia.
AB  - Unhappy with our postoperative results from standard tongue reduction methods, we
      have developed a central tongue reduction technique. This technique allows for
      alteration of the tongue base as well as tongue height and width while minimizing
      postoperative scarring. Although the technique and its associated surgical
      complications are in some ways comparable with the standard tongue reduction
      methods, our postoperative polysomnographic and tongue functioning results are
      improved. It is noteworthy that none of our patients had worse speech
      postoperatively and that our one Down syndrome patient had improved speech. Our
      indication for central tongue reduction is macroglossia of any sort in
      appropriate patients.

PMID- 8479987
TI  - A lip guard to protect repaired unilateral cleft lip in adults.

PMID- 8479988
TI  - Circumferential wiring for fractures (Le Fort types) of the maxilla.

PMID- 8479989
TI  - Facial artery musculomucosal flap.

PMID- 8479990
TI  - Ideal approach to management of chronic nonhealing ulcer of the foot: basic
      principle of surgery revisited.

PMID- 8479991
TI  - Enterocutaneous fistulas treated successfully by a turnover flap from surrounding
      tissue reinforced by musculocutaneous flaps and other local flaps.

PMID- 8479992
TI  - The art of plastic surgery.

PMID- 8479993
TI  - Periareolar mammaplasty technique with silicone supporting sheeting.

PMID- 8479995
TI  - Computed tomography for diagnosis of deep venous thrombosis in burn patients.

PMID- 8479994
TI  - Proper terminology for status of breast implants.

PMID- 8479997
TI  - Local flap template versus the fan principle for skin flaps.

PMID- 8479996
TI  - Acute management of the burned patient.

PMID- 8479998
TI  - The monobloc frontofacial advancement: do the pluses outweigh the minuses?
AB  - The results of 32 patients who underwent transcranial monobloc frontofacial
      advancement by the senior author (Wolfe) are examined. Fifteen of the patients
      were Crouzon's and 17 were Apert's, 14 of whom also underwent simultaneous facial
      bipartition. The ages ranged from 7 months to 14 years. Although a transcranial
      facial advancement carries with it substantial risks, with careful consideration
      of airway control, the anterior cranial base dura, and the retrofrontal dead
      space, the procedure is recommended for carefully selected patients. The
      indications and contraindications for the procedure in various age groups are
      given.

PMID- 8479999
TI  - Complications with facial advancement: a comparison between the Le Fort III and
      monobloc advancements.
AB  - Certain procedures for facial advancement may carry greater risk than others.
      While many believe that separating the cranial base by monobloc advancement leads
      to a higher complication rate, no comparative series between the Le Fort III and
      monobloc advancements has ever been reported. We reviewed our series of these
      different techniques. Over a 15-year period, 29 patients underwent 30 surgical
      procedures, with either a midfacial or frontofacial advancement. The average age
      of patients at the time of surgery was 12 years, with a range from 3 to 26 years.
      There were 20 Le Fort III and 10 monobloc advancements. Follow-up averaged 4
      years, with a range from 10 weeks to 13 years. There were no deaths in this
      series. The infectious complications differed significantly between the two
      groups, with all major infections occurring in the monobloc group. The
      noninfectious complications (2 major and 20 minor) were proportionately
      distributed between the Le Fort III and monobloc groups. Aesthetic results of the
      midface, judged by the percentage of revisions necessary, were found to be the
      same between the two procedures. Aesthetic results were noted to correlate
      strongly with age at the time of surgery, with the older patients being judged as
      having a better aesthetic result and most of the younger patients requiring a
      repeat of the facial advancement. We conclude that while we were unable to
      determine any definitive aesthetic advantage of one procedure over the other in
      our series, there was a significantly higher infection rate with the monobloc
      advancement. On the basis of these results, we recommend a staging of the
      forehead and midfacial advancements.

PMID- 8480000
TI  - Median facial dysplasia in unilateral and bilateral cleft lip and palate: a
      subgroup of median cerebrofacial malformations.
AB  - The median facial dysplasia group of patients is a unique, distinct, definable
      group characterized by mid-line facial deficiencies in the presence of a
      unilateral or bilateral cleft lip with or without cleft palate and without
      clinically detectable anomalies of the brain. This group of patients comprised 2
      percent of new cleft lip and palate patients. The midline facial deficiencies in
      median facial dysplasia are characterized by a poorly defined Cupid's bow,
      absence of the labial frenulum and anterior nasal spine, deficient columella, and
      poorly developed septal cartilage and premaxilla. One of the central incisors may
      be absent or rudimentary. There are no definable gross abnormalities of the
      brain. The results of intelligence tests of median facial dysplasia patients have
      a normal distribution and are not significantly different from those of a
      noncleft normal population. Unoperated and operated median facial dysplasia
      patients all have typical midfacial growth disturbances below the norm for their
      ages. The classification of median facial dysplasia patients as well as other
      median cerebrofacial anomalies, the embryologic basis of these deformities, and
      the clinical results of their treatment are helpful in understanding some of the
      problems related to the treatment of the cleft lip and palate patient. Median
      facial dysplasia patients demonstrate an inherent potential for poor midfacial
      growth. Deficiencies of soft tissue such as a lack of the Cupid's bow make it
      difficult to reconstruct the lip and nose satisfactorily.

PMID- 8480001
TI  - Rigid and non-rigid kinetic depth effect with rotating discrete helices.
AB  - To examine the conditions in which human observers fail to recover the rigid
      structure of a three-dimensional object in motion we used simulations of discrete
      helices with various pitches undergoing either pure rotation in depth (rigid
      stimuli) or rotation plus stretching (non-rigid stimuli). Subjects had either to
      rate stimuli on a rigidity scale (Experiments 1 and 2) or to judge the amount of
      rotation of the helices (Experiments 3 and 4). We found that perceived rigidity
      depended on the pitch of the helix rather than on objective non-rigidity.
      Furthermore, we found that helices with a large pitch/radius ratio were perceived
      as highly non-rigid and that their rotation was underestimated. Experiment 5
      showed that the detection of a pair of dots rigidly related (located on the
      helix) against a background of randomly moving dots is easier at small phases in
      which the change of orientation across frames is also small. We suggest that this
      is because at small phases the grouping of dots in virtual lines does occur and
      that this may be an important factor in the perceived nonrigidity of the helices.

PMID- 8480002
TI  - Context-produced increase in visibility.
AB  - It has not been clearly shown that context (e.g., three lines of a square)
      increases the visibility of a feature (e.g., the fourth line of the same square).
      To investigate this possibility, four sets of context+feature, context, feature,
      and BLANK (empty field) stimuli were used. For three out of the four sets, the
      context+feature stimulus was less likely to be falsely identified as the context
      and BLANK stimuli (i.e., the stimuli without the feature) than was the feature
      stimulus. For the same three sets, discriminating between the context+feature and
      context stimuli produced fewer false identifications (FIs) than discriminating
      between the feature and BLANK stimuli. THE CONCLUSION: the context components of
      context+feature stimuli increased the visibility of the feature components of the
      same stimuli.

PMID- 8480003
TI  - Aging and temporal discrimination of brief auditory intervals.
AB  - In a duration-discrimination experiment, young adults (mean age = 25.1), middle
      aged adults (mean age = 45.5), and older adults (mean age = 64.6) were presented
      with two very brief auditorily marked intervals per trial, and their task was to
      decide which of the two was longer in duration. An adaptive psychophysical
      procedure was used to determine difference thresholds in relation to a constant
      standard interval of 50 ms. It was found that duration-discrimination performance
      was unaffected by age; all three age groups yielded a difference threshold of
      approximately 17 ms. It was concluded that the ability to discriminate durations
      of very brief auditory intervals appears to be based on an underlying timing
      mechanism that does not slow down with advancing adult age.

PMID- 8480004
TI  - A psychophysiological analysis of response-channel activation and outcome states
      in Eriksen's noise-compatibility task.
AB  - Eleven subjects were tested with a modified version of Eriksen's noise
      compatibility task. Four noise conditions were realized--neutral, compatible,
      fully incompatible, and partially incompatible context. Target and flanking
      stimuli had an intrinsic association to either the left- or the right-hand side.
      As a response subjects pulled, with either their left or their right hand, an
      ordinary bicycle handbrake from a preload position towards a stop. The EMG from
      the forearm muscles and the movement trajectory were recorded continuously.
      Trials were categorized according to the outcome states, i.e., whether a full
      movement or only a rudimentary EMG activation had occurred in the correct and in
      the incorrect response channels, respectively, and whether the correct-channel
      activation was leading or lagging. Incompatible noise delayed information
      transfer and increased the likelihood of errors, while compatible noise had an
      opposite effect, i.e., it facilitated transfer and reduced the likelihood of
      errors. The effect of noise on transfer times was the same for all outcome
      states. Moreover, in all cases, noise had an effect on transfer times only up to
      the point of EMG onset, while it left movement-execution times unaffected. These
      findings are seen as contradictory to a strong continuous flow conception
      according to which any response-related change in the input channel is
      continuously and immediately transferred to the response-execution device. At
      least the final stage of movement control seems to be autonomous and not subject
      to input control, except for the case that a movement already initiated has to be
      aborted completely.

PMID- 8480005
TI  - The effects of sleep deprivation and incentives on human performance.
AB  - This study explores whether KR (knowledge of results) and reward compensate for
      the negative joint effects of sleep deprivation and signal degradation in a
      choice-reaction task. The negative effect of signal degradation on performance
      was aggravated by sleep loss and time-on-task, whereas KR improved performance,
      especially when signals were degraded. Reward changed the effects of time-on-task
      owing to lack of sleep. Performance was also improved by a brief task
      interruption after 30 minutes' work, with 5 more minutes to go. These results can
      be interpreted in terms of the performance model of Sanders (1983), which links
      energetic mechanisms to stages of information processing. A lack of energetic
      supply from the arousal mechanism to perceptual processing, induced by signal
      degradation, sleep deprivation, and time-on-task, was effectively counteracted by
      KR:KR enables the mobilization of effort to compensate for this lack of arousal.
      The relation between reward and KR is not yet clear. The interruption effect
      suggests that the influence of time-on-task is not due to loss of arousal, but
      causes a reallocation of resources by effort.

PMID- 8480006
TI  - Is the brain an effective Turing machine or a finite-state machine?
AB  - A theorem presented by Hornik, Stinchcombe, and White (1989) suggested the
      possibility that connectionist networks could be effectively Turing machines.
      Levelt (1990) argued that the theorem of Hornik et al. only implies that networks
      are finite-state machines and are therefore not capable of generating the very
      unlimited productivity of symbol systems. Yet it can be argued that all real
      machines, including the brain, are finite-state machines. If so, no real machine
      actually possesses the very unlimited productivity of symbol systems. So any
      model of actual behaviour should capture the limitations on productivity inherent
      in the situation. Thus connectionist networks can be valuable models in
      psychology, precisely because they are finite-state machines.

PMID- 8480007
TI  - Children with disabilities and the Children Act: who will assess their needs?
AB  - The Children Act focuses attention on meeting the assessed needs of children with
      disabilities. General practitioners (GPs) and Community Child Health (CCH)
      doctors in one health district were asked by postal questionnaire who it was who
      currently assessed such needs and who would do so in the future. The involvement
      of GPs (15) varied from none (1) to regular reassessment (3). Nearly all (14)
      treated acute illnesses but educational assessments were assigned to CCH doctors.
      Community doctors (9) had a clearer idea of their role including regular
      reassessment (9), education assessment (9) and interagency liaison (3). Both
      groups complained of poor communication with each other and with hospital
      services. To fulfil the requirements of the Children Act, community child health
      services, family health services authorities and district health authorities will
      have to specify how and by whom children with disabilities are identified and
      assessed. Arrangements will vary according to local service development. These
      arrangements, and the resulting liaison with other agencies, should be specified
      in National Health Service contracts, thus improving communication and
      cooperation.

PMID- 8480008
TI  - A survey of community child health audit.
AB  - Community child health medical audit is established in most districts surveyed. A
      minority have integrated audit with hospital paediatric units. Very few districts
      use an external auditor. Subject audit is preferred to individual performance
      audit and school health services were the most common services subjected to
      medical audit. The need for integrated audit and audit forms suitable for use in
      the community services is discussed.

PMID- 8480010
TI  - Investigation of smoking habits among 14-17-year-old boarding school pupils:
      factors which influence smoking status.
AB  - A questionnaire-based investigation was performed to elucidate factors with
      possible influence on smoking status in 557 14-17-year-old boarding school
      pupils. A representative sample of boarding school pupils in Denmark
      participated. Before entering boarding school an increased risk of being a smoker
      was present if a majority of one's schoolmates were smokers (odds ratio 5.9; P <
      0.0001); if parents were not living together (odds ratio 2.1; P < 0.005); if
      older brother or sister was a smoker (odds ratio 3.1; P < 0.0001); and if both
      parents smoked (odds ratio 1.9; P < 0.01). After changing to boarding school
      there was an increased risk of starting to smoke if a majority of the schoolmates
      were smokers (odds ratio 4.6; P < 0.0001). Believing that smoking causes damage
      to the smokers' own health decreased the risk (odds ratio 2.9; P < 0.01). More
      efficient smoking prevention programmes should be created by aiming particularly
      at the special problems encountered in certain age groups, and possibly through a
      better understanding of the influence that psycho-social factors may have on
      youngsters' risk of becoming smokers.

PMID- 8480009
TI  - The school leaver medical: an evaluation.
AB  - The school records of 492 pupils attending routine school leaver medicals were
      examined retrospectively. Excluding known problems and problems detected by
      school nurse screening, only 11 new problems were detected which needed treatment
      (although a further 18 pupils were investigated to exclude potentially serious
      problems). Selective examination of school leavers by a school doctor with
      routine screening by a school nurse would appear to be a more efficient use of
      time than routine medicals.

PMID- 8480011
TI  - Preventing unintended teenage pregnancies.
AB  - A review of the literature on unplanned and teenage pregnancies was undertaken
      for four District Health Authorities. This work was carried out within a national
      context of increasing conception rates for teenage women aged 16 and under and in
      the knowledge that pregnant teenagers and their children tend to have poor life
      chances. The Health of the Nation White Paper has now focused attention on this
      by the inclusion of a target to reduce pregnancies to under 16-year-old women by
      half. To achieve this, health authorities need some understanding of the types of
      services which might be effective. Whilst there is limited evaluative work on the
      effectiveness of services for young people in this country, international
      comparisons suggest that some methods for reducing unintended teenage pregnancies
      may be more effective than others. The specific service issues identified are the
      need for advice and support pre-conceptually, during pregnancy and after
      abortion/birth; the need for easier access to contraception; the need for
      improved information on risky behaviour--particularly relating to pregnancy,
      sexually transmitted diseases, HIV/AIDS and substance abuse, and the need for
      improved medical and social care for pregnant teenage women. The most effective
      approaches for preventing unintended teenage pregnancy would appear to be the
      development of comprehensive advisory and family planning services, including sex
      education and the commitment by central and local government to tackle the
      adverse socio-economic factors which are associated with teenage pregnancy.

PMID- 8480012
TI  - The UPA score and teenage pregnancy.
AB  - Teenage motherhood is often said to be the result of deficient contraceptive and
      abortion services. Using data from the Public Health Common Data Set (PH CDS) we
      demonstrate two important effects in a Regional Health Authority: higher rates of
      conception are related to a live birth rather than an abortion pregnancy outcome;
      District Health Authorities (DHAs) with high underprivileged area scores (UPA)
      are more likely to have high rates of conception in the teenage years than those
      districts with low scores.

PMID- 8480013
TI  - Routine weighing of infants.

PMID- 8480014
TI  - The Tomlinson Report.

PMID- 8480015
TI  - Public health aspects of the war in Yugoslavia.

PMID- 8480016
TI  - Measles epidemics in Kerman City, Iran.
AB  - In early 1990 an outbreak of measles occurred in Kerman City (population
      257,284), Iran. Overall 745 cases were identified, four of whom died (case
      fatality ratio was 5.4 per thousand). Illness was limited, primarily, to children
      below 15 years of age: 166 (22.3%) cases were in children under five years, 573
      (77%) in those aged between five and 14 years and six (0.8%) were above 15 years
      of age. The age of the cases ranged from 5 months to 35 years. The age-specific
      attack rates were 3.9, 1.8, 7.3 and 2.8 per 1,000 for children under 1, 1-4, 5-9
      and 10-14 years of age respectively. Overall 14 (1.9%) children with measles were
      hospitalized for severe complications which consisted mainly of pneumonia, otitis
      and gastroenteritis. Based on 745 cases with available immunization records,
      vaccine efficacy was calculated at 88% indicating a slight problem with the cold
      chain or vaccine. The outbreak was primarily related to low immunization coverage
      during the last 10 years and indicates the need to improve vaccine coverage with
      the AIK-C existing vaccine. It also highlights the urgent need for an effective
      single-dose measles vaccine (Edmondson-Zagreb) for children below nine months of
      age.

PMID- 8480017
TI  - Falls among elderly nursing home residents.
AB  - The purpose of this study was to measure the rate of falls and to identify the
      causes, consequences and opportunities for preventing falls among 796 permanent
      residents of a nursing home. Altogether 377 falls were reported among 207
      residents during the study period. The most important association discovered was
      that between impaired visual acuity and falls. In addition, 49% of the fallers
      suffered from severe and 19% from mild dementia. In the group of demented
      subjects it was impossible to assess visual acuity in 30% of the fallers as the
      subjects were unable to fixate at request. This finding may be one explanation
      for the increased incidence of falls in demented subjects. We conclude that the
      high number of subjects suffering from dementia among institutionalized elderly
      limits the possibility of training in prevention. The main emphasis in prevention
      of falls in institutions should be in proper design of the environment, including
      the visual environment.

PMID- 8480018
TI  - Is there consensus on the placement of older adults?
AB  - In implementing Caring for People, local authorities and health authorities must
      decide the most appropriate source of provision of long-stay residential care for
      older adults. A review of the planning and funding arrangements introduced by
      Caring for People was conducted, referenced by professional opinion, to find how
      far a consensus on the above could be achieved.

PMID- 8480019
TI  - [Postmortem high-resolution computed tomography of the lung. Radiologic
      morphologic correlations].
AB  - To establish precise correlations between high-resolution computed tomography
      (CT) and normal pulmonary anatomy and pulmonary pathology, 49 lungs affected by
      different diseases were analysed. Post-mortem high-resolution CT scans were
      compared with the corresponding macroscopic and microscopic pathological
      findings. For scanning, lungs were inflated and fixed, which avoided any decrease
      in the structural resolution of pulmonary parenchyma and allowed a
      topographically exact correlation between CT appearances and morphological
      changes. After demonstration of the structural details relevant for CT in normal
      pulmonary parenchyma, an attempt is made to establish the morphological basis of
      the following CT phenomena: thickening of interlobular septae, increase in
      pulmonary translucency, consolidation of the non-nodular alveolar and of the
      nodular type, and changes in the pleural region. Although CT findings in
      pulmonary lesions are mainly non-specific, knowledge of the corresponding
      morphological basis is helpful in diagnostic evaluation.

PMID- 8480020
TI  - [Functional HR-CT of the lung. Experimental studies of the pulmonary vascular and
      airway reactions].
AB  - We describe the use of high-resolution computed tomography (HRCT) for assessment
      of the function of pulmonary vessels and airways. With its excellent spatial
      resolution, HRCT is able to demonstrate pulmonary structures as small as 300
      microns and can be used to monitor changes following various stimuli. HRCT also
      provides information about structures smaller than 300 microns through
      measurement of parenchymal background density. To date, sequential, spiral and
      ultrafast HRCT techniques have been used in a variety of challenges to gather
      information about the anatomical correlates of traditional physiological
      measurements, thus making anatomical-physiological correlation possible. HRCT of
      bronchial reactivity can demonstrate the location and time course of aerosol
      induced bronchoconstriction and may show changes not apparent on spirometry. HRCT
      of the pulmonary vascular system visualizes adaptations of vessels during hypoxia
      and intravascular volume loading and elucidates cardiorespiratory interactions.
      Experimental studies provide a basis for potential clinical applications of this
      method.

PMID- 8480021
TI  - [Computed tomography in noninfectious interstitial lung diseases].
AB  - Computed tomography is a well-established imaging technique for the assessment of
      non-infectious interstitial pulmonary disease. Compared with the conventional
      chest radiograph it is characterized by a higher degree of sensitivity and
      specificity, particularly when a high-resolution technique is implemented.
      Because of its superior correlation with the morphological characteristics in
      specific diseases, it plays an important role if the histological diagnosis is
      doubtful and also in patients with clinical features suggestive of pulmonary
      disease in the presence of a normal chest film. This article describes the
      limitations of the conventional chest radiograph and the advantages of pulmonary
      computed tomography. Typical CT findings in different interstitial diseases are
      illustrated, and their value is discussed in comparison with the plain
      radiograph.

PMID- 8480022
TI  - [High-resolution computed tomography of the lung in young patients with cystic
      fibrosis].
AB  - In a prospective study we proved the value of high-resolution computed tomography
      (HRCT) and the CT scoring system developed by Stiglbauer et al. on 47 young
      patients suffering from cystic fibrosis (CF) (median age: 10.1 years). The most
      frequent pulmonary finding was bronchial wall thickening (BWT) in 43 patients
      (94.6%), followed by bronchiectasis (BE) in 36 patients (79.2%). A less frequent
      finding was ill-defined patchy consolidation (39.6%). We found an almost even
      distribution of BWT and BE in the upper and lower lobes of the lung. These two
      findings were scored according to their severity and extent. The maximum possible
      score for BWT and BE was 72 in a single patient. For both the overall score was
      19.9 +/- 11.1. A statistically significant correlation of the CT scoring system
      with the lung function tests FEV1/FVC (P = 0.03) and MEF50 (P = 0.02) was found.
      The results of HRCT and the CT scoring system were shown to be valuable methods
      in the assessment of pulmonary changes, in young patients suffering from CF.

PMID- 8480023
TI  - [High-resolution computed tomography (HR-CT) of the lung following lung
      transplantation].
AB  - We report our high-resolution computed tomography (HRCT) and conventional CT
      findings after lung transplantation in 20 patients. Sixty-four examinations were
      performed 7-511 days after transplantation. The radiological observations were
      then correlated with the clinical results. The pathological findings in the early
      postoperative phase were pleural effusion, edema, and pulmonary consolidation.
      The HRCT findings associated with acute rejection were nonspecific. Dilation and
      thickening of the walls of the peripheral bronchi is a common, but non-specific
      feature in bronchiolitis obliterans. The manifestations of posttransplant
      lymphoproliferative disorder are discussed in two patients.

PMID- 8480024
TI  - [Magnetic resonance tomographic findings in cardiac tumors].
AB  - After ultrasound, magnetic resonance imaging (MRI) is the second noninvasive
      powerful method of examining the heart. The findings in 9 patients with cardiac
      tumors are reported, who were examined by means of MRI: There was little variance
      in the MRI signal behavior (with only one exception), although the tumor
      population examined was very heterogeneous. The MRI techniques used (T1-weighted
      spin echo, steady-state gradient echo) seem to allow no better tumor
      specification than ultrasound. Wince multiplanar reconstruction is possible with
      MRI, tumor size, localization, and the borders of the cardiac neoplasms can be
      depicted. The cine technique provides dynamic information. In addition, this
      method allows reliable discrimination between the flow effects and true space
      occupying lesions.

PMID- 8480025
TI  - [A malignant bone tumor?].

PMID- 8480026
TI  - Regulation of serotonin synthesis.

PMID- 8480027
TI  - Short-term control of GABA synthesis in brain.

PMID- 8480028
TI  - Short-term control of the synthesis of acetylcholine.

PMID- 8480029
TI  - [Chronic idiopathic periostosis].

PMID- 8480030
TI  - Isolated unilateral clavicular hypoplasia. A case report.

PMID- 8480031
TI  - [A rare case of congenital fusion between the scaphoid and capitatum].

PMID- 8480032
TI  - [Muscular hydatidosis. The echographic, computed tomographic and magnetic
      resonance aspects. Apropos a case].

PMID- 8480033
TI  - [Cerebral ischemic lesions following tuberculous meningitis. A case report].

PMID- 8480034
TI  - [Recklinghausen's neurofibromatosis. A report of a case characterized by
      extensive thoracic and abdominal locations].

PMID- 8480036
TI  - [A case of suspected pulmonary alveolar microlithiasis].

PMID- 8480035
TI  - [Magnetic resonance in the diagnosis of lesions of the carpal triangular
      fibrocartilage. The experience with 49 patients with chronic pain at the wrist].
AB  - In order to evaluate the diagnostic capabilities of MR Imaging in defining
      triangular fibrocartilage (TFC) lesions, 49 selected patients--21 with rheumatoid
      arthritis, 13 with traumatic injury and 15 with wrist fracture--presenting
      chronic wrist pain were examined with MR Imaging. The wrists of 12 healthy
      subjects were also studied as a control group. MR examinations were performed by
      means of a superconductive 1.0 T unit (Magnetom-Siemens); SE and GE T1- and T2
      weighted pulse sequences were employed to acquire images of the wrists on the
      coronal, axial and, if necessary, sagittal planes. The results showed peripheral
      TFC tears in 10 cases, central TFC lesions in 12 cases and TFC lesions with
      collateral insertion involvement in 9 cases. In 4 patients focal thickening of
      TFC without disruption was observed. The correct diagnosis was made in all the 19
      surgically verified cases. Our experience confirms the clinical value of MR
      Imaging in the evaluation of TFC lesions in patients with chronic ulnar pain
      syndrome.

PMID- 8480037
TI  - [Rhodococcus equi pulmonitis in HIV+. A review of the literature and a case
      report].

PMID- 8480038
TI  - [A pseudoaneurysm of the right phrenic artery treated by preoperative
      percutaneous embolization].

PMID- 8480039
TI  - [The echographic diagnosis of portal venous gas. 3 cases].

PMID- 8480040
TI  - [A rare case of a voluminous aneurysm of the hepatic artery. A computed
      tomographic, echo-Doppler and arteriographic study].

PMID- 8480041
TI  - [The magnetic resonance aspects of cystic lymphangiomatosis. Apropos a case].

PMID- 8480042
TI  - [A volumetric increase in the submandibular glands due to an organic iodate
      contrast medium. A case report].

PMID- 8480043
TI  - [Desmoid tumor of the anterior abdominal wall. A case report].

PMID- 8480044
TI  - [The disease of beta 2-amyloid deposition in the differential diagnosis of juxta
      articular subchondral geode lesions].
AB  - Beta-2 amyloidosis deposition is a new type of amyloidosis recently observed in
      long-term hemodialysis patients. One of the major osteoarticular complications of
      this disease is the appearance of subchondral bone cysts. In this paper the
      radiologic features of such radiolucencies are described and the criteria are
      outlined of the differential diagnosis from the geodes found in other
      arthropathies or para-physiologic conditions. The importance of the status of the
      joint space is stressed: on the basis of its patterns, arthropathies may be
      grouped as follows: inhomogeneous space narrowing in degenerative arthritis;
      homogeneous space narrowing in inflammatory arthritis; normal or nearly normal
      joint space if there is no/not-prevalent involvement of articular cartilage.

PMID- 8480045
TI  - [Osteoporosis and the thalassemia "trait"].
AB  - The authors evaluated the prevalence of the thalassemia trait in a general
      population affected with femoral neck fractures. Our research was aimed at
      assessing whether hemoglobinopathy might affect osteoporosis, which is
      responsible for femoral fractures. Two hundred and thirty-eight patients admitted
      to St. Anna Hospital, Ferrara, for proximal femoral fractures, were
      retrospectively studied. The patients were 68 males and 170 females, aged 58 to
      83 years (mean age: 70.4 years). The thalassemia trait was seen in 11.76% of
      cases, versus in 7-8% of the general population. The high prevalence of
      heterozygous beta-thalassemic subjects probably means that the beta-thalassemia
      condition is a further "variable" which is responsible for the more frequent
      occurrence of fractures of the proximal femur and is certainly related to an
      osteopenic condition much more severe than usual.

PMID- 8480046
TI  - [Hemophilic arthropathy: echography and radiology].
AB  - Our experience is reported with the combined use of radiology and US in the study
      of 210 joints of hemophilic patients. The study was carried out considering that
      in hemophilia the classification of the grades of disease generally relies upon X
      ray findings which, although reliable in the advanced stages of the disease,
      appear inadequate in the early stages. In fact, synovial hypertrophy, cartilage
      erosions and initial subchondral cysts are most often missed on X-ray films. In
      the examined cases, US was employed to evaluate: 1) the degree of synovial
      hypertrophy, 2) the status of the explorable cartilage, 3) the presence of
      effusions and 4) the status of bone linings--whenever erosions, even of minimal
      extent, were suspected, X-rays were always performed and the results employed as
      the reference standard. The examined joints did not exhibit the same grade of
      involvement: the knee, elbow and ankle had advanced arthropathy in 85% of cases,
      corresponding to > or = 7 according to Pettersson score. On the contrary, the
      shoulder and hip were found to be equally involved either by initial (Pettersson
      score: 0-6) or by advanced arthropathy (Pettersson score: > or = 7). Moreover, in
      nearly 10% of the cases, hemarthrosis was found which showed no correlation with
      the grade of joint involvement. Our results indicate that: 1) US appears very
      useful in the early stages of the disease when the X-ray picture is negative or
      poorly significant. The demonstration of early alterations is useful mainly in
      those cases in whom synoviectomy is considered (for prevention); the latter is
      useful only if performed before cartilage erosion appear; 2) US appears equally
      useful in hemarthrosis cases, especially in those of limited extent in which the
      clinical therapeutic management may be difficult; 3) US appears unnecessary in
      the cases of advanced arthropathy in which X-rays serve as the reference
      standard.

PMID- 8480047
TI  - [Magnetic resonance angiography in the study of neoplastic cerebral pathology].
AB  - To date, magnetic resonance angiography (MRA) has been used in neuroradiology
      mainly to study vascular malformations and atherosclerotic changes of the carotid
      bifurcation. Our study was aimed at investigating the role of MRA with the time
      of-flight technique in the study of intracranial neoplasms; a superconductive 1.5
      T magnet was used, and FLASH and FISP 2D and 3D pulse sequences were acquired
      before and after Gd-DTPA administration. Fifty-five MRA examinations were
      performed. Our series consists in 32 meningiomas, 14 glial tumors, 3 hypophysis
      adenomas, 2 metastases, 1 NF2, 2 craniopharyngiomas, 1 lymphoma and 1
      rhinopharyngeal carcinoma with intracranial involvement. In 27 patients MRA
      results were compared with DSA findings. The results showed high agreement
      relative to indirect angiographic patterns (dislocations, encasement, dural
      sinuses involvement) and poor accuracy in the demonstration of tumor
      vascularization (inflow and outflow, vascular neoformation).

PMID- 8480048
TI  - [Inflammation of the anterior chest wall: its assessment by magnetic resonance].
AB  - Magnetic resonance (MR) is the imaging method used to assess primary and
      secondary inflammatory lesions of the chest wall. Five patients with inflammatory
      lesions of the anterior chest wall were submitted to MR examinations in order to
      define the role of this method in both identification and assessment of the
      extent of tissue involvement. In all the examined patients MR Imaging accurately
      showed the involved muscle groups and the presence/absence of mediastinitis. MR
      Imaging easily detected sternal and clavicular osteomyelitis; in one patient only
      MR failed to detect osteomyelitis of the first rib. The accurate assessment of
      soft tissue infections enabled us to select the most suitable surgical therapy to
      reduce esthetic damage. Two cases were restudied after chest wall reconstruction
      by means of rotated pectoral flaps. In the 2 patients in whom the differential
      diagnosis between inflammatory lesion and recurrent tumor could not be made by
      means of MR Imaging, CT-guided needle biopsy was performed.

PMID- 8480049
TI  - [Nodular lesions simulated on an anthropomorphic thoracic phantom. A comparison
      between analog and digital images of the thorax].
AB  - Aim of this work is to evaluate the diagnostic accuracy of different modalities
      of digital radiology, compared with conventional radiology, in the detection of
      lung nodules. Forty images of an anthropomorphic chest phantom, on which
      simulated nodules had been previously set, were analyzed by 6 radiologists with 4
      different viewing modalities: a) conventional radiography; b) photostimulable
      plates digital radiography; c) photostimulable plates digital image on dedicated
      monitor; d) conventional radiography digitized with Film Laser Digitizer and
      viewed on Display Workstation. For each image the radiologists had to transfer on
      a sketch the site of the detected nodules giving an opinion on their
      detectability (uncertain-presumable-probable-certain presence) with a 1 to 4
      score. The statistical analysis of the results was made using modified ROC
      curves. No statistically significant difference was found between the areas under
      a) and c) ROC curves (p = 0.262). A statistically significant difference resulted
      between the areas under a) and d) ROC curves (p < 0.05) and, particularly,
      between the a) and b) areas (p < 0.001), in favor of a).

PMID- 8480050
TI  - [A comparison between traditional mammography and digital with storage
      phosphors].
AB  - Conventional and digital mammographic images obtained with storage phosphors were
      compared. The digital images were acquired with high-resolution 3rd-generation
      (HR III) screens and specifically adapted algorithms. The experience was made
      both on a phantom and in vivo. The phantom study was carried out by comparing
      conventional with digital radiographs acquired with: a) same kV (28) and same
      mAs; b) same kV (24) and same mAs; c) 28 kV with 30% mAs reduction, in digital
      images only. The results obtained upon counting the amount of recognizable
      details per image demonstrated slight loss of information in digital radiographs
      only when mAs was reduced by 30%. Two hundred patients were studied; they were
      divided into four groups according to the type of breast (medium inherent
      contrast or solid breast) and to exposure factors. After conventional
      mammography, an additional digital radiograph was performed using one of the
      three techniques previously employed on the phantom. Separately, 10
      ductogalactographies and 10 magnification radiographs of microcalcifications were
      compared; the same exposure factors were used in these images too. The
      radiographs were viewed by three expert mammographic radiologists; contrast
      quality and spatial resolution were investigated and a score was given to each
      image on a 3-grade scale (insufficient, sufficient, good). The comparison of the
      mean values obtained showed higher contrast and better enhancement of nodular
      lesions on digital images, on which, however, the depiction of
      microcalcifications was worse than on conventional radiographs, especially with
      lower radiation doses, even though the number of detected microcalcifications was
      the same.

PMID- 8480051
TI  - [The evaluation of a digital system for the automatic analysis of the density of
      abdominal radiograms].
AB  - This paper reports the results of the evaluation of an automatic system developed
      to analyze radiographic densities. This system, called RADEN, has been
      implemented at the Institute for Information Processing of the Italian National
      Research Council in Pisa. Forty-three pairs of abdominal X-ray films were
      obtained before and after the administration of ionic iodate contrast medium
      (i.i.c.m.) during urographic examinations. The 86 X-ray films were acquired and
      digitized using a computer-controlled optoelectronic device with a sampling step
      ranging 125 microns to 250 microns. The resulting images were arrays of 512 x 512
      pixels, each one quantified on a byte (256 gray levels). The computing system
      included a high-performance personal computer equipped with a video RAM board
      having built-in facilities for image processing and with an optical disk to
      archive the images. Automatic and semi-automatic procedures were developed to
      segment, recognize and classify the images and to characterize three homogeneous
      regions--i.e., bone, water and air. The output data were compared with the area
      values of the air densities computed directly on the X-ray films by a
      radiologist. Furthermore, both data sets were compared with the scores given in a
      blind study by four observers. The subsequent statistic analysis showed the
      increase in air density areas after i.i.c.m. administration and the applicability
      of the implemented system to the automatic examination of abdominal radiographic
      densities. The results encourage to believe that the proposed approach could be
      employed as a first step for the development of quite a more complex system
      oriented to X-ray image understanding and to assisted diagnosis.

PMID- 8480052
TI  - Spondylo-metaphyseal dysplasia corner fracture type (a cautionary tale).
AB  - Spondylo-metaphyseal dysplasia Sutcliffe type is a rare disease characterised by
      oval vertebral bodies, coxa vara and metaphyseal irregularities. It was named
      spondylo-metaphyseal dysplasia corner fracture type by Langer et al. as corner
      fractures are a constant feature later in life. We report 3 further cases of
      spondylo-metaphyseal dysplasia Sutcliffe type; one without coxa vara and 2 bone
      dysplasias with distinctive radiographic features--different from spondylo
      metaphyseal dysplasia Sutcliffe type, for diagnosis. Both of the latter showed
      corner fractures. Corner fractures are a characteristic but not diagnostic
      feature of spondylo-metaphyseal dysplasia Sutcliffe type.

PMID- 8480053
TI  - [The pancreas in diabetes mellitus. The echographic aspects].
AB  - Forty patients with diabetes mellitus (25 with insulin-dependent and 15 with non
      insulin dependent diabetes) were studied by means of US in order to evaluate
      possible volumetric alterations in the pancreas and their eventual progression
      over time. Thirty healthy subjects were also studied as a control group. The
      following variables were recorded: thickness of the head, body and tail of the
      pancreas and area of its head. The patients were also divided into 5 groups
      according to the age of diabetes (< 1, > 1, > 7, > 14, > 21 years). The results
      showed 25 IDDM patients to exhibit significant reduction in these variables
      relative to controls (p < = 0.01), especially in the body (average reduction 
      40%) and tail (average reduction -20%) of the pancreas. NIDDM patients exhibited
      non-significant reductions in pancreatic size. The study of the 5 groups of IDDM
      patients, divided according to the duration of diabetes, revealed all pancreatic
      variables to reduce more than in controls within a year since diagnosis, to
      exhibit relative increase during the next 7 years and finally to reduce again in
      the following years. These results show that anatomic damage to the pancreas
      occurs within the first year of diabetes. Moreover, IDDM was seen to alter the
      normal proportions among the single anatomic structures forming the pancreas,
      especially relative to two anatomic ratios--i.e., head/body and tail/body
      pancreatic thickness. The relative values in IDDM patients were markedly higher
      than those in controls (p < 0.001). The patients were again divided into 5 groups
      according to the age of diabetes: the values of the above ratios in the course of
      diabetes greatly differed from those observed in controls--i.e., they increased
      within the first year of diabetes, were steady during the next 7 years, and
      returned to normal values after 21 years of diabetes, which meant the return to
      the normal anatomic ratios among the three parts of the pancreas.

PMID- 8480054
TI  - [The echographic and computed tomographic diagnosis of polysplenia].
AB  - Polysplenia syndrome is a malformation with impaired visceral lateralization; it
      consists in the incomplete development of the spleen which is replaced by two or
      more splenules (1-3 cm phi). This malformation is often associated with other
      anomalies and is more frequently seen in situs inversus and situs ambiguus. On
      the basis of their findings in 3 cases, the authors describe the main US and
      radiographic patterns of polysplenia syndrome, that is: polysplenia syndrome
      associated with situs solitus (several splenules where the spleen should be,
      without other anomalies); polysplenia syndrome associated with situs ambiguus
      (splenules in the right hypochondrium with such anomalies as "umbrella-like"
      liver and the absence of the hepatic segment of the inferior vena cava and
      enlargement of both azygos and hemiazygos veins); polysplenia syndrome associated
      with situs viscerum inversus (right-sided splenules, with transposition of
      abdominal and thoracic organs). The splenules exhibit the same echogenicity as
      the liver; when situs viscerum ambiguus is present. US patterns of splenuli are
      equivocal and may mimic liver metastases. On the contrary, CT allows better
      demonstration of both the anomaly and the associated malformations.

PMID- 8480055
TI  - [Echography applied in dermatologic diseases. A comparative preliminary study of
      the use of high-frequency transducers].
AB  - Ultrasonography (US) was first used in dermatology in 1979. During the last few
      years, US has evolved thanks to technological progress and its use has been on
      the increase, in dermatology, to study both localized and diffuse skin diseases.
      In this paper, the authors review and compare the results obtained with a 20 MHz
      transducer with those obtained with 7.5 MHz and 10 MHz transducers in the study
      of skin alterations. Three parameters were considered: lesion identification,
      spatial evaluation and US structure. Fifty-eight cases of localized and 48 of
      diffuse skin diseases were examined. The localized forms were benign in nature in
      18 patients (3 nevi, 2 seborrheic keratoses, 3 ulcus cruris cases, 6 sebaceous
      and 2 liquid cysts). The other 40 patients had malignant neoplastic lesions (16
      epitheliomas, 13 primitive melanomas, 1 metastatic melanoma, 8 lymphomas and 2
      Kaposi's sarcomas). The 48 cases of diffuse conditions included 27 systemic
      sclerosis, 18 psoriasis and 3 lichen planus cases. The comparative analysis of
      the results obtained using the different types of transducers in the study of
      localized dermatoses showed no differences in lesion identification and in the
      depiction of their US features. On the other hand, the 20 MHz transducer was much
      more accurate than the others as regards the spatial evaluation of the lesions
      measurable in millimeters, whereas it poorly demonstrated the lesions > 1.5 cm.
      However, only the 20 MHz transducer could demonstrate the US features of diffuse
      conditions.

PMID- 8480056
TI  - [Computed tomography in the follow-up of patients nephrectomized for
      adenocarcinoma].
AB  - A retrospective study was carried out of 159 CT examinations acquired in 64
      patients who underwent unilateral nephrectomy for renal-cell carcinoma (34 in the
      left-hand side and 30 in the right-hand side). Thirty-nine patients were examined
      twice in the three years following nephrectomy; 25 were examined three or more
      times over a 5-year period after nephrectomy. Acute or chronic inflammatory
      disease was demonstrated in 6 patients (4 abscesses were detected by means of
      clinico-radiologic signs and 2 by means of cytology after CT-guided needle
      biopsy). Twenty patients had local recurrences 2-7 cm phi: in 17 of them the
      diagnosis was confirmed by CT-guided percutaneous FNAB; 15 patients had liver
      metastases, in 3 of them associated with local recurrences; 26 patients were free
      of both local recurrences and distant metastases. The authors analyze the value
      of CT in the definition of post-nephrectomy anatomic alterations, in the early
      detection and staging of local recurrences, and in the differentiation between
      postoperative fibrosis and complications. Moreover, the value is stressed of CT
      guided FNAB of suspicious lesions. Our study suggests the value of a methodical
      CT follow-up of asymptomatic post-nephrectomy patients. CT immediately after
      surgery is also recommended to serve as a baseline reference for subsequent
      examinations. In our series, CT was accurate in the early detection of both local
      recurrences and distant solitary metastases.

PMID- 8480057
TI  - [The stationary grid in mammography: its clinical evaluation].

PMID- 8480058
TI  - [Smoking addiction treatment, with nicotine chewing gum, in primary care. Double
      blind study].
AB  - BASIS: Study of the efficacy of nicotine chewing gum in the treatment of smoking
      addiction in primary health care. METHODS: Three interventions groups are
      compared. Active group (37): treated with group psychotherapy and nicotine
      chewing gum; Placebo group (38): Treated exactly as first group, but with placebo
      chewing gum, and Outpatient Group (31): Individual psychotherapy in an outpatient
      basis, with nicotine chewing gum. RESULTS: Comparison of results, one year after
      intervention, between active group (35.1% success) and placebo group (13.2%
      success) showed the existence of statistically significant differences (p <
      0.03). Outpatient group yielded 25.8% success rate, without finding any
      statistically significant differences in comparison with the active group.
      CONCLUSIONS: Nicotine chewing gum can be an effective support in the treatment of
      smoking addiction, in primary health care, in certain smokers, assuming that this
      treatment is accompanied with individual or group psychotherapy follow up, which
      reinforces the behavior and prevents relapses.

PMID- 8480059
TI  - [Diabetes mellitus in the elderly: a study on its clinical presentation, C
      peptide reserve, and immunogenetic markers of insulin dependence].
AB  - In order to evaluate clinical presentation and to determinate classification
      criteria of type 1 diabetes in the elderly, we carried out a study in 258
      diabetic patients more than 60 years old of which 100 used insulin by failure to
      oral hypoglycemic agents (OHA). The prevalence of ischemic cardiovascular disease
      was 36%, peripheral vascular disease 34% and stroke 30%. Non-proliferative
      retinopathy 47%, nephropathy 16% and peripheral neuropathy 37%. Cardiovascular
      risk factors as obesity (36%), hypertension (33%) and hypercholesterolemia (12%)
      were evaluated. The average duration of diabetes was 20 years. Post-glucagon C
      Peptide, HLA-DR antigens and islet cell antibodies (ICA), were measured in 75
      older diabetic patients on treatment of which 24 used insulin, 11 diet and 40
      OHA. Older patients on treatment with insulin had longer duration of disease,
      less obesity, low level basal of C-Peptide and a low response to post glucagon C
      Peptide (0.94 +/- 0.5 pmol/ml) compared with patients on diet (1.8 +/- 0.9
      pmol/ml) and OHA (1.8 +/- 0.8 pmol/ml). Older diabetics on insulin therapy had a
      greater frequency of HLA-DR3 (42%) and HLA-DR4 (21%) than other older diabetics.
      The ICA was negative in most patients. This study shows the high prevalence of
      macrovascular and microvascular disease in elderly patients with diabetes
      mellitus and that the most reliable parameter in classifying type 1 (insulin
      dependent) diabetes is the measurement of basal and post-glucagon C-Peptide. HLA
      DR specific markers can be used with this parameter because their expression is
      partly shared. This approach appears useful in the older diabetic patients to
      help classify diabetes and its management.

PMID- 8480060
TI  - [Respiratory function tests. Differences between smokers and non-smokers. Effects
      of withdrawal].
AB  - The purpose of this study is to determine the characteristics of spirometric
      performance in a group of smokers and to carry out a prospective study of the
      changes in ventilatory lung function after smoking withdrawal. The ventilatory
      lung function was studied in 90 smokers and 30 non-smokers. Afterwards the
      smokers were included in smoking withdrawal program. One year later, the
      ventilatory function tests were repeated in those individuals who were able to
      stop smoking. Respiratory function tests were likewise repeated in 10 subjects
      chosen randomly among those who were not able to stop smoking. The initial study
      of the ventilatory lung function showed that smokers had significantly lower
      values of FVC (p < 0.001), FEV1 (p < 0.001), FEVC1/FVC (p < 0.001), FEF25-75 (p <
      0.01 and PEF (p < 0.01) compared to non-smokers. Likewise smokers also had a
      statistically significant higher prevalence rate of obstructive pulmonary disease
      (p < 0.001). Ventilatory function studies performed one year after smoking
      withdrawal on those who were able to stop smoking showed a significant
      improvement of respiratory function parameters compared to studies done one year
      before. There was also a significant decrease in the prevalence and severity of
      obstructive pulmonary disease. No differences were observed in the ventilatory
      function tests performed on the ten subjects who did not stop smoking. From these
      data we suggest that tobacco consumption produces obstruction of the airways that
      can be reverted, at least in part, after smoking withdrawal.

PMID- 8480061
TI  - [Spontaneous tendinous rupture in systemic lupus erythematosus. Presentation of 2
      cases].
AB  - Spontaneous tendinous breakage is a rare complication in patients with systemic
      erythematous lupus. Bilateral tendinous breakage is an exceptional phenomena. Two
      cases of bilateral spontaneous breakage are discussed, one achillea, the other
      patellar, its frequency is compared in the scientific literature with the one
      found in the patients at our center. Magnetic Resonance usefulness is underlined
      to confirm the diagnosis of tendinous breakage.

PMID- 8480062
TI  - [Secondary arterial hypertension in type I neurofibromatosis (NF-1). Findings in
      6 patients].
AB  - With the aim to analyze the association of Type I Neurofibromatosis with
      secondary arterial hypertension, a retrospective study has been performed on 36
      patients, diagnosed of pheochromocytoma (n = 12) and/or renal artery stenosis (n
      = 25), finding in 6 of them diagnostic criteria of Type I neurofibromatosis, of
      these 4 showed pheochromocytoma, 1 renal artery stenosis and 1 pheochromocytoma
      plus renal artery stenosis. CAT and angiography were the best diagnostic imaging
      methods to confirm clinic and biological suspicion of adrenal tumor of renal
      artery stenosis. It is recommended the systematized study of patients with NF-1
      together with their relatives who phenotypically show some illness stigma, or
      with arterial hypertension resistant to conventional treatment.

PMID- 8480063
TI  - [Auditory evoked potentials and magnetic resonance in the diagnosis and follow-up
      of central pontine myelinolysis].
AB  - We report the case of a woman who developed central pontine myelinolysis in spite
      of gradual correction of hyponatremia. The good clinical evolution as well as the
      influence of rapid correction of serum sodium concentration in the unfolding of
      this rare condition are discussed. Several diagnostic procedures, mainly auditory
      evoked responses and magnetic resonance imaging are also analysed. We remark the
      particular interest of the auditory-evoked responses in the attestation of an
      eventual remyelination.

PMID- 8480064
TI  - [Specifications on the lecithin/sphingomyelin ratio (L/S). Updated review].
AB  - We review the lecithin/sphingomyelin ratio (L/E) studying the amniotic fluid to
      value the fetal lung maturity. We compare him with others biological parameters.
      We consider the modifications arising across pregnancy and in different diseases
      as well as the factors influencing its results.

PMID- 8480065
TI  - [Rectovaginal fistula as presentation form of Crohn disease].

PMID- 8480066
TI  - [Favorable course of cerebral toxoplasmosis treated with doxycycline and
      pyrimethamine].

PMID- 8480067
TI  - [Primary duodenal adenocarcinoma. Report of a new case].

PMID- 8480068
TI  - [Clinical resolution of a suspected thyroid nodule].

PMID- 8480069
TI  - [Parkinsonism induced by metoclopramide].

PMID- 8480070
TI  - [Mononucleosis syndrome in a patient with varicella].

PMID- 8480071
TI  - [Sweet's syndrome as presentation form of hairy cell leukemia].

PMID- 8480072
TI  - [Native valve endocarditis caused by Staphylococcus epidermidis].

PMID- 8480073
TI  - [Herpes zoster involving multiple cranial nerves].

PMID- 8480074
TI  - Developmental retardation of the Japanese quail embryo under the influence of
      dexamethasone.
AB  - Cultured Japanese quail embryos were treated with various doses of dexamethasone
      on day 2 and in part also on day 5. The treatment lead to a significant delay of
      development. This was demonstrated by means of developmental (growth rate,
      developmental stage), histological and metabolic (excreted uric acid, protein
      synthesis) parameters. The effect was intensified when the agent was administered
      into the subembryonic liquid instead of the albumen. This is due to the fact that
      a higher dilution is expected when the agent is deposited into the albumen. In
      conclusion Japanese quail embryos respond to exogenous glucocorticoids, at a very
      early stage of development and at a comparatively low concentration with a
      depression of development.

PMID- 8480075
TI  - Cellular sensitivity to native type IV collagen in primary biliary cirrhosis.
AB  - We examined 60 patients with various chronic liver diseases for cellular
      sensitivity to native human type I and IV collagens using an in vitro leucocyte
      migration inhibition test. Mononuclear cells from 7 (33%) of 21 patients with
      chronic active hepatitis, 14 (52%) of 27 patients with liver cirrhosis and 11
      (92%) of 12 patients with primary biliary cirrhosis exhibited cellular
      sensitivity to type IV collagen, although cells from almost all patients
      responded to type I collagen. None except one for type I collagen of 25 normal
      controls showed positive response to both collagens. In chronic active hepatitis
      and liver cirrhosis, cellular sensitivity to type IV collagen was significantly
      lower than to type I collagen (p < 0.01). Patients with primary biliary cirrhosis
      showed significantly higher cellular sensitivity to type IV collagen when
      compared to patients with other chronic liver diseases (p < 0.01). Cellular
      sensitivity to type IV collagen was significantly correlated with serum levels of
      the 7S domain of type IV collagen in all 85 subjects (r = +0.462, p < 0.001).
      These findings suggest that cellular sensitivity to type IV collagen as well as
      to type I collagen exists in chronic liver disease, especially in primary biliary
      cirrhosis, and may reflect the accelerated metabolism of the perisinusoidal and
      peribiliary basement membranes.

PMID- 8480076
TI  - Antiproliferative and antimetastatic effects of gossypol on Dunning prostate cell
      bearing Copenhagen rats.
AB  - Gossypol, a polyphenolic aldehyde naturally present in cottonseed, has long been
      recognized as a male contraceptive and recently as a potential anticancer agent.
      Our study used a rodent model to evaluate gossypol's potential for the treatment
      of human prostatic carcinoma. Two-month-old Copenhagen male rats received
      subcutaneous implants of a subpassage of MAT-LyLu prostatic cancer line, a highly
      metastatic, androgen-independent Dunning prostate tumor subline that specifically
      metastasizes to lymph nodes and lungs of recipients. After 2 weeks of gossypol
      treatment (0 or 12.5 mg/kg B.W./day S.C.) initiated immediately after
      transplantation, the rats were sacrificed and evaluated for prostate tumor growth
      and metastasis. Testosterone and gossypol levels in tumor tissue and various
      reproductive organs and serum potassium level were measured by radioimmunoassay
      (RIA), high pressure liquid chromatography (HPLC) and atomic emission
      spectroscopy (AES), respectively. Gossypol-treated rats exhibited weight
      reductions in developed MAT-LyLu prostate tumor mass and prostate of 24% (p <
      0.05) and 31% (p < 0.05), respectively; whereas testicular and epididymal weights
      were not significantly affected. Few metastases (20%) were observed in either
      lymph nodes or lungs of gossypol-treated recipients. The control rats, however,
      had a much higher rate of lung (60%) and lymph node metastasis (40%). Testicular
      testosterone levels, as measured by RIA, were significantly lower in gossypol
      treated rats than in controls (p < 0.05), but serum testosterone levels were not
      different. Extractable gossypol content in the prostate tumor, as measured by
      HPLC, reached 19.67 ng/gm and was 1.28 times higher than in liver, 1.98 times
      higher than in testes, but was 3.3% of that in prostate. Moreover, serum had the
      highest gossypol content (10.7 micrograms/ml). Serum potassium levels, as
      measured by AES, were significantly higher in gossypol-treated individuals than
      controls (p < 0.05). Our results indicate for the first time that gossypol has
      antiproliferative and antimetastatic effects on MAT-LyLu prostate cancer cells
      and can be explored as a potential therapeutic agent for androgen-independent
      human prostatic carcinoma.

PMID- 8480077
TI  - Theophylline increases pyridoxal kinase activity independently from vitamin B6
      nutritional status.
AB  - Asthmatics treated with theophylline, a potent inhibitor of pyridoxal kinase and
      therefore a vitamin B6 antagonist, demonstrated a significant correlation (r =
      0.71; p < 0.001) between drug plasma levels and erythrocyte pyridoxal kinase
      activities. A cross-over, placebo controlled study was completed on 15 healthy
      volunteers to investigate the mechanism by which theophylline induces pyridoxal
      kinase activity. The subjects were supplemented with vitamin B6 or placebo for
      two weeks before theophylline therapy was started. Vitamin B6 supplementation
      resulted in a four-fold increase in circulating pyridoxal 5'-phosphate levels,
      while placebo had no effect. When theophylline therapy was commenced, erythrocyte
      pyridoxal kinase activities increased significantly (p < 0.001) irrespective of
      whether vitamin B6 or placebo was supplemented. It is concluded that a depressed
      vitamin B6 status is not responsible for higher erythrocyte pyridoxal kinase
      activities encountered during theophylline therapy, but that the drug is directly
      responsible for elevated enzyme levels.

PMID- 8480078
TI  - Effects of felbamate and other anticonvulsant drugs in two models of status
      epilepticus in the rat.
AB  - Felbamate was compared with several antiepileptic drugs for protective effects in
      two rat models of status epilepticus. Felbamate was ten times more potent against
      pilocarpine-induced seizures in lithium-treated rats than in lithium-free
      animals. Diazepam, valproate and phenobarbital were effective in both the high
      dose pilocarpine and lithium-pilocarpine models. On the other hand, phenytoin was
      ineffective in both models, whereas carbamazepine displayed protective effects
      only in the lithium-pilocarpine model.

PMID- 8480079
TI  - In vitro metabolism of cyanohydroxybutene: formation of a glutathione-S
      transferase catalyzed product.
AB  - The pancreatotoxin cyanohydroxybutene (CHB) causes a significant and prolonged
      elevation in glutathione (GSH) in liver and pancreas (Wallig and Jeffery, 1990).
      Here we report that urinary thiols also increase. This suggests that CHB may
      react with GSH, either directly or following phase I oxidation, to form an
      adduct, which is further metabolized to the corresponding mercapturic acid for
      urinary excretion. Metabolism of CHB by hepatic mixed function oxidase and
      cytosolic alcohol dehydrogenase enzymes was evaluated by monitoring microsomal
      NADPH consumption and alcohol dehydrogenase-dependent NADH generation,
      respectively. There was no apparent increase in the rate of microsomal NADPH
      consumption or alcohol dehydrogenase-dependent NADH generation in the presence of
      CHB. To evaluate in vitro formation of a glutathione-S-transferase (GST)
      catalyzed adduct, [3H-glycyl]-GSH and [14C-cyano]-CHB were incubated at 37
      degrees C for 1 h, with or without GST. Dinitrophenol derivatization and high
      performance liquid chromatographic (HPLC) analysis (Farris & Reed, 1987) revealed
      no double-labeled peaks, suggesting that no stable conjugate was formed. However
      a tritiated product, not present in control samples, and with an identical
      retention time to cysteinyl-glycine (cys-gly) was formed. In addition, the
      product has a fast atom bombardment mass-spectrum consistent with cys-gly. These
      results suggest that while CHB may not undergo phase I oxidation, in the presence
      of CHB, GSH may break down to form cys-gly. A mechanism for CHB-dependent
      breakdown of GSH to cys-gly is proposed, and the pharmacological implications of
      this finding are discussed.

PMID- 8480080
TI  - Antiinflammatory activity of aminoketone derivatives of 2,4-disubstituted
      thiazoles.
AB  - A group of nine aminoketones, 2,4-disubstituted thiazole derivatives were tested
      in vivo in order to evaluate their biological activity. Antiinflammatory activity
      was studied by means of the carrageenin-induced mouse paw edema. Writhing induced
      by acetic acid in rats used to evaluate the analgesic activity. The results are
      discussed from the view of structure activity relationship.

PMID- 8480081
TI  - Antipyrine concentrations in liver and blood monitored by microdialysis of
      unrestrained conscious rats.
AB  - A newly developed microdialysis probe for measurement of drugs in unrestrained,
      conscious animals was used for quantitation of antipyrine in liver and blood of
      rats. Microdialysis probe were implanted in the liver and right jugular vein of
      rats; antipyrine was then administered at a dose of 50 mg/kg i.p. The
      concentration of antipyrine was determined in the fluid from the two probes and
      compared with measurement made on blood drawn from the left jugular vein. The
      elimination half lives in serum, blood dialysate and hepatic dialysate were 2.24
      +/- 0.09, 2.06 +/- 0.31 and 2.10 +/- 0.32 hrs, respectively; there were not
      significantly different statistically. The concentration of Na+, K+ and Cl- in
      the hepatic dialysate was stable at least for up to 12 hrs in anesthetized rats.
      In unrestrained, conscious animals these electrolytes were stable in hepatic
      dialysate for at least 48 hrs. Therefore, the microprobe should be useful for
      analysis of drugs in extra cellular fluids of rats liver for up to 48 hrs. These
      studies suggest that this microdialysis technique by employing the newly
      developed probe will be useful in many studies on pharmacokinetics and drug
      metabolism in the organ.

PMID- 8480082
TI  - Evaluation of 5-hydroxytryptamine concentration in portal vein measured by
      microdialysis.
AB  - Free 5-hydroxytryptamine (5-HT) concentration in the portal vein was monitored in
      anesthetized rats using microdialysis. The 5-hydroxytryptamine metabolite 5
      hydroxyindoleacetic acid (5-HIAA) was also measured. Concentration of 5-HT in the
      portal vein decreased gradually after insertion of a microdialysis probe but
      fluctuated markedly throughout the entire perfusion, whereas 5-HIAA values did
      not fluctuated in the same manner. An electron microscopic study of the probe
      membrane after dialysis showed platelet adhesion and aggregation on part of the
      membrane. In contrast, 5-HT concentration measured by puncture and direct blood
      sampling of the portal vein did not fluctuate in the same way as that determined
      by microdialysis. These results suggest that measurement of free 5-HT
      concentration in the blood by microdialysis might be inaccurate due to
      contamination of 5-HT from adhesion and aggregation of platelets on the probe
      membrane.

PMID- 8480083
TI  - Effect of various dietary constituents on gastrointestinal absorption of aluminum
      from drinking water and diet.
AB  - The influence of some frequent dietary constituents on gastrointestinal
      absorption of aluminum from drinking water and diet was investigated in mice.
      Eight groups of male mice received lactic (57.6 mg/kg/day), tartaric (96
      mg/kg/day), gluconic (125.4 mg/kg/day), malic (85.8 mg/kg/day), succinic (75.6
      mg/kg/day), ascorbic (112.6 mg/kg/day), citric (124 mg/kg/day), and oxalic (80.6
      mg/kg/day) acids in the drinking water for one month. At the end of this period,
      animals were killed and aluminum concentrations in liver, spleen, kidney, brain,
      and bone were determined. All the dietary constituents significantly increased
      the aluminum levels in bone, whereas brain aluminum concentrations were also
      raised by the intake of lactic, gluconic, malic, citric, and oxalic acids. The
      levels of aluminum found in spleen were significantly increased by gluconic and
      ascorbic acids, whereas gluconic and oxalic acids also raised the concentrations
      of aluminum found in kidneys. Because of the wide presence and consumption of the
      above dietary constituents, in order to prevent aluminum accumulation and
      toxicity we suggest a drastic limitation of human exposure to aluminum.

PMID- 8480084
TI  - Second branchial arch anomalies induced by fluconazole, a bis-triazole antifungal
      agent, in cultured mouse embryos.
AB  - The teratogenic potential of the novel bis-triazole antifungal agent fluconazole
      (F) was investigated on mouse embryos during early organogenesis using the whole
      embryo culture system. Early somite stage embryos (4-5 somites) were continuously
      cultured for 48 hours in rat serum added with 0, 25, 50 or 75 micrograms/ml of F.
      Doses of 50 and 75 micrograms/ml of F significantly (p < 0.001) impaired
      morphogenesis, resulting in a 83.3% and 91.6% of embryos showing second branchial
      arch anomalies, respectively. These findings demonstrate that F induces second
      branchial arch anomalies in cultured mouse conceptuses. Furthermore, these
      results may suggest an useful model for the study of arches-derived
      malformations.

PMID- 8480085
TI  - Differentiation of acute promyelocytic leukemia cell induced by 1,25
      dihydroxyvitamin D3 and pentoxifylline (Trental).
AB  - Human promyelocytic leukemia cell line HL-60 in tissue culture was treated with
      various concentrations of 1,25-dihydroxyvitamin D3, (D3) pentoxifylline (Px) or
      in combinations. Differentiation to normal granulocytes or monocytes was
      evaluated by nitroblue tetrazolium (NBT) reducing capacity and morphologic
      criteria. (D3) produced monocytic differentiation, but sub-differentiation
      inducing doses of (Px) had no effect. In previous studies we found higher doses
      of (Px) to produce granulocytic differentiation in vitro and in vivo.

PMID- 8480086
TI  - Role of the immune system in recovery from infection.
AB  - Infection is regarded as an imbalance between microbial pathogenicity factors and
      the host defense system. The virulence mechanisms include adhesion, chemotaxis,
      invasion, resistance and production of toxins. In addition, local and/or systemic
      immune functions in patients undergoing infections are altered. Nonspecific as
      well as specific cellular and humoral defense mechanisms are affected. The
      interaction of defined microbial pathogenicity factors with immune effector cells
      results in the activation of a variety of inflammatory mediators; they are a
      prerequisite for protective immunity but also induce local or systemic damage in
      the host when they occur in excessive amounts and when their metabolism is
      inadequately controlled. The analysis of the pathophysiological events during
      infection in patients by taking advantage of modern molecular and cell-biological
      methods may contribute to the development of novel therapeutic strategies.

PMID- 8480087
TI  - Clinical requirements in the treatment of today's respiratory tract infections.
AB  - Respiratory tract infections (RTIs) are among the most frequent infections in man
      and lower tract infections account substantially for the overall mortality in
      hospitals. Regarding the etiology of pneumonias, one has to consider different
      pathogenic mechanisms, age of the patients, underlying diseases, concomitant
      medications, symptomatologies, seasonal influences, and clinical conditions, e.g.
      intensive care environment and mechanical ventilation. To optimize the rational
      management of respiratory infections, identification of the etiologic agent would
      be desirable. The decision of how to treat is often based on epidemiologic,
      clinical, and radiological assessments. Epidemiologic studies have shown a
      pronounced difference in the etiologic spectrum between community- and hospital
      acquired RTIs. In community-acquired pneumonias, pneumococci, Haemophilus
      influenzae, Legionella, Mycoplasma and viruses predominate, whereas in
      nosocomially acquired pneumonias, Enterobacteriaceae, e.g. Klebsiella, Proteus,
      Enterobacter as well as Pseudomonas and staphylococci comprise the most frequent
      isolates. Empirical therapy has to cover all possible etiologic pathogens which
      most likely cause the infection. In addition, an adequate kinetic profile, e.g.
      once or twice daily dosing, sufficient pulmonary tissue or fluid penetration, and
      acceptable tolerance and costs are prerequisites for optimal therapy. Drugs of
      choice for the treatment of community-acquired pneumonia are
      aminobenzylpenicillins or macrolides. Oral cephalosporins exhibit excellent
      activity against many bacterial pathogens of typical community-acquired
      pneumonia, and are active against beta-lactamase-producing H. influenzae.

PMID- 8480088
TI  - Relevance of antibiotic tissue penetration in treating respiratory tract
      infections.
AB  - The majority of bacterial respiratory tract infections are caused by
      streptococci, Haemophilus spp. and Moraxella catarrhalis. These pathogens are
      located extracellularly. In logical consequence, the bactericidal action of the
      antimicrobial is required in these loci. To define the reasonable dosing regimen
      for effective eradication without creating unnecessary toxic potential we need to
      know (1) the distribution principles and kinetics, and (2) the correct
      correlation between concentration profiles in extracellular fluid (ECF) and
      blood. According to the permeability of the vascular capillaries unbound drug
      concentrations in plasma and ECF are in a dynamic equilibrium. Thus, for the beta
      lactam antibiotics therapeutic efficacy is predictable by maintaining the free
      drug concentration above the bacterial minimum inhibitory concentration. Tissue
      homogenate data can only be useful if correctly interpreted by correcting for the
      partitioning between the tissue components.

PMID- 8480089
TI  - Antibiotic treatment of pediatric community-acquired lower respiratory tract
      infections: challenges and possible solutions.
AB  - Bacterial pneumonia presents a real challenge in childhood, since its morbidity
      is impressive, its diagnosis is elusive and the treatment options are not always
      clear. Despite these difficulties, appropriate management based on an individual
      approach, good clinical skills and available antibiotics provides a rapid cure to
      most cases. The problems in diagnosis and treatment as well as the therapeutic
      approach to childhood bacterial pneumonia are discussed.

PMID- 8480090
TI  - Literature survey on clinical efficacy and tolerability on cefetamet pivoxil: an
      analysis of 3,128 cases.
AB  - The oral third-generation cephalosporin cefetamet pivoxil has a broad spectrum of
      antibacterial activity and favorable pharmacokinetic properties which makes it
      particularly suitable for the treatment of upper and lower respiratory tract
      infections as well as of infections of the urinary tract. The clinical trial
      results of cefetamet pivoxil have been reviewed from the literature in 4,112
      patients out of whom 3,128 patients were treated with cefetamet pivoxil. The
      standard doses of cefetamet pivoxil, 500 mg twice daily in adults and 10 mg/kg
      twice daily in children, were at least as effective and in many cases clinically
      superior to most currently recommended antibiotics for the treatment of
      complicated urinary tract infections including pyelonephritis. High efficacy has
      also been demonstrated in patients with pneumonia, in acute exacerbation of
      chronic bronchitis and infections of the ear, nose and throat. Clinical trial
      results have shown that a 7-day treatment period with cefetamet pivoxil is as
      effective as a 10-day course of phenoxymethylpenicillin in the treatment of
      pharyngotonsillitis due to group A beta-hemolytic streptococci. Cefetamet pivoxil
      was well tolerated: 226 patients (7.2%) out of 3,128 had adverse events which
      were mainly gastrointestinal, i.e. diarrhea, nausea and vomiting. An additional
      53 (1.7%) patients had laboratory changes which were of no clinical relevance.
      Premature treatment withdrawals were reported in 13 (0.5%) out of 2,612 adults
      and in 11 (2.1%) out of 516 children. All adverse events subsided rapidly after
      treatment. Many current antibiotic treatment regimens require the administration
      of three daily doses. However, twice daily standard doses of cefetamet pivoxil of
      500 mg in adults or 10 mg/kg in children provide unbound plasma concentrations of
      cefetamet which generally exceed the MIC90 for susceptible organisms between
      doses and are clinically effective, well tolerated and should result in good
      compliance.

PMID- 8480091
TI  - [Clinical features and pathogenesis of Yusho (PCB poisoning)].
AB  - The occurrence and progress of Yusho (PCB mass poisoning) is briefly described.
      Various investigative studies on Yusho are also briefly reviewed. Yusho occurred
      in the northern district of Kyushu Island in 1968. A specific product of rice oil
      used for food was accidentally contaminated with PCB during its manufacturing
      process and consequently, the customers who ate it showed severe intoxication
      symptoms. Major clinical symptoms of Yusho were acneiform eruptions and
      circumscribed pigmentation. These skin and mucous membrane eruptions, because of
      their appearance, caused severe mental suffering for the patients. The government
      authorized patients amounted to 1,860. These symptoms have gradually declined
      with the passing of years and presently the principal clinical problems are only
      various subjective complaints. At first, it was naturally thought that the
      causative agent of Yusho was PCB (Kanechlor 400) itself. However, it was found
      later that the causative rice oil contained PCDF (polychlorodibenzofuran) and PCQ
      (polychloroquaterphenyl) which were proved to be formed during the heating
      process used in the deodorization of the oil. PCDFs show, in animal studies, a
      high toxicity and therefore its role for the pathogenesis of Yusho is seriously
      evaluated in spite of its rather small contaminating amount. On the other hand,
      PCQs are recognized as the specific marker of Yusho, since almost no PCQ is a
      general environmental pollution substance.

PMID- 8480092
TI  - [Neurotoxicity of methyl bromide--neuropathologic evaluation--preliminary study].
AB  - Methyl bromide exposure produces disorders of the central and peripheral nervous
      system. In the literature, there are many neuropathologic studies on the nervous
      system, especially on the central nervous system, of experimental animals
      intoxicated with methyl bromide presented. However, in our opinion, a variety of
      lesions of the nervous system described in the human methyl bromide intoxication
      have not been well reproduced in the experimental animals. In this study, male
      Wistar rats were subjected to a 6-hour exposure a day to methyl bromide at a
      concentration of 500 or 290 ppm 3 days a week for 3 to 8 weeks. The systematic
      neuropathologic studies of their central and peripheral nervous systems were
      carried out to reproduce the nervous system lesions in the human methyl bromide
      intoxication hitherto not produced in the experimental animals. Among the rats
      exposed to methyl bromide at a concentration of 500 ppm for 10 to 18 days, the
      axonal degeneration of myelinated fibers at the cervical level of the fasciculus
      gracilis, which probably corresponds to the degeneration of the spinal posterior
      column in humans, and the necrosis of the caudate-putamen and atrophy of neurons
      and pallor of the neuropile in caudate-putamen, thalamus and cingulate cortex,
      which probably correspond to the degenerative findings of the cerebrum in humans,
      were found. The rats exposed to methyl bromide at a concentration of 290 ppm for
      8 weeks (24 days) did not show any noticeable abnormalities
      histologically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480093
TI  - [Comparison of the casual serum triglyceride levels at health check-up with the
      values during fasting].
AB  - Since higher levels of serum triglycerides were frequently found during the UOEH
      physical check-up for employees and students in 1989, we analysed subjects with
      higher triglyceride levels and discussed ways of handling them. Blood sampling to
      determine serum lipids was done between 13:00-15:00. Of the total (males 1257,
      females 1267), 272 had higher serum triglyceride levels (over 200 mg/dl) (males
      246, females 26) (1st TG). One hundred and twenty-one of the group with higher TG
      levels in the 1st examination were reevaluated by blood sampling the morning
      after overnight fasting (2nd TG). There was a significant positive
      correlationship between the TG levels from the 1st examination and those from the
      2nd examination (r = 0.62, n = 121, P < 0.0001). The predictive value calculated
      from the equation between the TG in the first and second measurements was 341.7
      mg/dl. There was a 14.9% rate of false negatives in subjects under 341.7 mg/dl on
      the first TG measurement. However, there were only 6.3% false negatives in the
      subjects under 250 mg/dl on the first TG measurement. Age, body mass index and
      serum cholesterol level were significantly higher in the group with the higher TG
      level on reevaluation (more than 160 mg/dl) than those in the group with the
      lower TG level on reevaluation (less than 160 mg/dl). We concluded from these
      results that the casual serum TG levels above 250 mg/dl might be a suitable cut
      off level in physical check-ups.

PMID- 8480094
TI  - [Problems in Papanicolaou classification].
AB  - There are several reasons why Papanicolaou classification should not be used for
      the interpretation of cytologic findings. First, many different classification
      criteria are sometimes used for a single pathologic condition. Second,
      inflammatory change or hormonal evaluation are not included in the system. Third,
      the classification is not compatible for the evaluation of endometrial lesions or
      chorionic diseases. Fourth, mismanagement of the patient is sometimes encountered
      when this classification is only used. Instead of Papanicolaou classification,
      descriptive diagnosis should be used for cytologic interpretation.

PMID- 8480096
TI  - Developing links to higher education institutions.

PMID- 8480095
TI  - The ENB framework and higher award.

PMID- 8480097
TI  - An initiative within higher education.

PMID- 8480098
TI  - International difficulties.

PMID- 8480099
TI  - Leading questions.

PMID- 8480100
TI  - Placing APL on the agenda.

PMID- 8480101
TI  - Locality-based teaching.

PMID- 8480103
TI  - Coping with disability.

PMID- 8480102
TI  - Nurses under stress.

PMID- 8480104
TI  - Nursing's nature and boundaries.

PMID- 8480106
TI  - Classroom observation research.

PMID- 8480105
TI  - Managing educational change.

PMID- 8480107
TI  - Degrees of change.

PMID- 8480108
TI  - [Why a "7th Romance Meeting of Immunology and Allergy"?].

PMID- 8480109
TI  - [Global approach to the asthmatic patient].

PMID- 8480110
TI  - [Indications for intravenous immunoglobulins].

PMID- 8480111
TI  - [Targets for immuno-allergic reactions].

PMID- 8480112
TI  - [New markers of vasculitis: antineutrophil antibodies].

PMID- 8480113
TI  - [Antihistaminics: dangerous medications?].

PMID- 8480114
TI  - New vaccines for the world: needs and prospects.

PMID- 8480115
TI  - [Alcohol and arterial hypertension].

PMID- 8480116
TI  - [Duration of rehabilitation and fate of patients with cerebral infarction].
AB  - We studied 61 patients with a first stroke, admitted in our rehabilitation
      center. Functional evolution is usually good, 84% of patients are able to return
      at home, after a mean of 4.6 months of rehabilitation. Age, sex, severity of the
      initial deficit, shoulder-hand syndrome, etiology and localisation of stroke are
      the factors which determine the functional recovery and duration of
      hospitalisation.

PMID- 8480117
TI  - [Growth and hormones: from fetus to adult].

PMID- 8480118
TI  - [From hypercalcemia to the discovery of a new hormone: PTHrP].

PMID- 8480119
TI  - [Headache and acute respiratory distress in a young woman].

PMID- 8480120
TI  - [Treatment of hospital and medical waste in the Canton of Vaud: why, by whom and
      how?].

PMID- 8480121
TI  - [Consensus: cum sensu?].

PMID- 8480122
TI  - [Faradization according to Duchenne de Boulogne (1855)].

PMID- 8480123
TI  - [Concerning Heraieff's article ob obesity in the Revue medicale de la Suisse
      Romande (No.11, Vol.112, November 1992)].

PMID- 8480124
TI  - Hospital won't limit duties of HIV+ pharmacist.

PMID- 8480125
TI  - Public perceptions about AIDS are at odds with facts.

PMID- 8480126
TI  - To flush or not to flush with heparin.

PMID- 8480127
TI  - Fractures are never simple.

PMID- 8480128
TI  - Now I stand up for my patients.

PMID- 8480129
TI  - OTC interactions. Asthma medications.

PMID- 8480130
TI  - A nurse's guide to implanted ports.

PMID- 8480131
TI  - Patient teaching for x-ray and other diagnostics. Transesophageal echocardiogram.

PMID- 8480133
TI  - Fat substitutes--a closer look.

PMID- 8480132
TI  - Assessing pediatric rashes.

PMID- 8480134
TI  - Sorbitol isn't always a sweet deal.

PMID- 8480135
TI  - Statistics don't always tell the whole story.

PMID- 8480136
TI  - When a merger involves opposing religious doctrines.

PMID- 8480137
TI  - Less isn't more if you can't read it.

PMID- 8480138
TI  - Association of HLA class I and class II antigens with rheumatic fever in a
      Turkish population.
AB  - The distribution of class I and class II HLA antigens of 100 Turkish patients
      with rheumatic fever, 77 of whom had cardiac involvement, was examined. We
      compared the results with a control group of identical origin. The frequency of
      HLA A10 and HLA B35 antigens were found significantly higher in patients with
      rheumatic fever (p < 0.05, p < 0.01, respectively). The frequency of HLA A10 and
      HLA DRw11 in patients with cardiac involvement were significantly higher than in
      those without cardiac involvement (p < 0.05, p < 0.01, respectively). On the
      other hand, HLA Cw2 antigen frequency was found significantly higher in patients
      without cardiac involvement than in those with rheumatic heart disease (p <
      0.05). We support the concept that rheumatic fever is an immunological reaction
      to group A, beta hemolytic streptococci in individuals who have genetic
      predisposition.

PMID- 8480139
TI  - Evaluation of criteria contributions for the classification of systemic lupus
      erythematosus.
AB  - The American Rheumatism Association (ACR) preliminary and revised criteria for
      classification of systemic lupus erythematosus (SLE) were evaluated for
      sensitivity and specificity in a population of 100 patients with SLE and 100
      patients with other rheumatic diseases. Bayes' theorem was applied for evaluation
      of ARA criteria for the classification of SLE and a scoring system was developed
      which allows simple determination of the probability of SLE. The evaluation
      revealed considerable differences in values of the ARA criteria. The serologic
      tests and discoid lupus appeared to be the most distinctive criteria, while
      Raynaud's phenomenon, oral and nasal ulcers and arthritis were of little value.
      Comparison of SLE and control patients presenting the same number of criteria
      revealed that patients with SLE exhibit more distinctive criteria. This finding
      emphasizes the need for a quantitative evaluation of classification criteria.

PMID- 8480140
TI  - More evidence of distinctive features of mixed connective tissue disease.
AB  - A comparison of clinical, immunological and HLA-D region antigen features was
      made between 22 patients with mixed connective tissue disease (MCTD) and 118
      patients with systemic lupus erythematosus (SLE), scleroderma or primary
      Sjogren's syndrome. The MCTD patients had hypergammaglobulinemia more often than
      did those with SLE and scleroderma, but had less skin ulceration, serositis,
      nephritis, central nervous system disease and hypocomplementemia than the SLE
      patients. The frequencies of HLA-DR4 and its Dw4 subtype were significantly
      increased in MCTD as compared with both the other patient groups and healthy
      controls. Anti-RNP antibodies and the clinical characteristics together seem to
      illustrate a disease syndrome which is clinically and genetically distinct and
      fits with the prevailing concept of MCTD.

PMID- 8480141
TI  - Clinical features in patients with chronic muscle pain--with special reference to
      fibromyalgia.
AB  - Clinical characteristics were studied in patients with chronic muscle pain,
      divided into three groups according to the characteristics of their pain;
      "fibromyalgia" (n = 23), "widespread muscle pain" (n = 21), and "regional muscle
      pain" (n = 28). Typical fibromyalgia features were also seen in the other groups
      of patients, but not to the same extent. In particular, sleep disturbance,
      subjective swelling, cold and exercise intolerance and low self-reported physical
      performance were significantly related to fibromyalgia. The major components of
      fibromyalgia were not wholly different compared with other European and North
      American studies, except for sleep disturbance and subjective swelling, which was
      somewhat more pronounced in this study. The most used medications in fibromyalgia
      patients at referral were analgesics, anxiolytic drugs and female sex hormones.
      Medication in fibromyalgia was not excessive and seemed appropriate compared to
      the other patient groups. Effects of various biases and classification criteria
      on the results of fibromyalgia studies are discussed. The characteristic features
      of fibromyalgia, its stability when diagnosed and the promotion of research and
      patient management justify the current classification of fibromyalgia at this
      stage.

PMID- 8480142
TI  - Proresid therapy in rheumatoid arthritis. A comparison with injectable gold using
      life-table analysis.
AB  - Proresid, mainly consisting of podophyllotoxin derivatives and two glycosides
      thereof, has been used as a disease-modifying antirheumatic drug in Sweden since
      the late 1960s. A life-table analysis of Proresid treatment averaging 41 months
      (range 4-144) in 79 rheumatoid arthritis patients showed a termination rate of
      40, 56, 75 and 85% after 1/2, 1, 2 and 4 years, respectively. Dominant reasons
      for discontinuing therapy were inefficacy (37%) and gastrointestinal symptoms
      (35%). The risk of discontinuation of therapy due to inefficacy was constant over
      time, while the risk due to other causes, including side effects, gradually
      decreased. A comparison with injectable gold therapy showed, after adjusting for
      confounding factors, that the total termination incidence was higher (p < 0.05)
      in the Proresid-treated patients. A comparison with the regional cancer register
      of 334 patients exposed to Proresid for a mean time of 2.2 years showed no
      increased cancer risk after a mean observation time of 6.1 years.

PMID- 8480143
TI  - Cyclosporin treatment in rheumatoid arthritis is associated with an increased
      serum activity of beta-glucuronidase.
AB  - The serum activity of beta-glucuronidase (beta-gluc) has been presumed to
      indicate the disease activity in rheumatoid arthritis (RA). In 10 patients with
      RA the serum beta-gluc was repeatedly determined after the initiation of a
      treatment with cyclosporin for one year. A significant increase of beta-gluc was
      found after 8, 12 and 16 weeks compared to the values before treatment, while the
      concentration of the soluble interleukin 2-receptor decreased. The data reveal,
      that beta-gluc is not a useful indicator of the disease activity during
      cyclosporin treatment.

PMID- 8480144
TI  - The course of erythropoietin in patients with rheumatoid arthritis with normal
      and low blood-hemoglobin. A longitudinal study.
AB  - A consistent elevated level of erythropoietin was found in eight patients with
      R.A., who continuously for 10 years had a low hemoglobin (< 8 mmol/l) compared
      with nine patients with R.A., who had a normal hemoglobin (> or = 8 mmol/l) (p =
      0.017). A significant inverse correlation between erythropoietin and hemoglobin
      (r = -0.61) was found in the low-hemoglobin group, but not in the normal
      hemoglobin group. Erythropoietin was not found to be correlated to clinical
      variables.

PMID- 8480145
TI  - Pulmonary pseudolymphoma presented with a mass lesion in a patient with primary
      Sjogren's syndrome: beneficial effect of intermittent intravenous
      cyclophosphamide.
AB  - A 61-year-old woman with primary Sjogren's syndrome (SS) presented with fever,
      dry cough, dyspnea on exertion, and a mass lesion with reticular shadowing at
      both bases on her chest X-ray. Pulmonary pseudolymphoma was diagnosed by
      transbronchial lung biopsy which revealed infiltration of T cell-like slightly
      atypical lymphoid cells. After three infusions of cyclophosphamide (750 mg every
      4 weeks) combined with prednisolone, the pulmonary mass lesion was diminished and
      her symptoms improved. Evaluation of the 12 reported cases of pulmonary
      pseudolymphoma with SS that presented with mass lesions showed an increase in IgM
      level, frequent pulmonary fibrosis, precedence of SS, and better prognosis with
      immunosuppressants in those patients.

PMID- 8480146
TI  - Adult idiopathic polymyositis without elevation of creatine kinase. Case report
      and review of the literature.
AB  - A patient fulfilling diagnostic criteria for definite polymyositis, but with
      normal levels of creatine kinase (CK) is reported. Review of the literature
      reveals significant variations regarding the frequencies of normal CK reported
      among cases with myositis. The discrepancies may be partly explained by inclusion
      of both probable and possible polymyositis, administration of steroid therapy
      prior to estimations of CK, and possible differences in CK levels between
      polymyositis and dermatomyositis. The patient reported did not suffer from
      neither lung disease nor concomitant malignancy. Thus, the alleged association
      between low levels of CK and poor prognosis in myositis could not be supported by
      the present case report.

PMID- 8480147
TI  - [The DHS (dynamic hip screw) buttress plate in the management of unstable
      proximal femoral fractures].
AB  - The DHS-implant system is a technically simple and widely used operative
      treatment modality for pertrochanteric fractures of the femur. In unstable 4-part
      fractures rotation of the head and neck fragment around the lag screw and
      significant impaction might lead to lateralisation of the greater trochanter and
      therefore to marked shortening. To prevent these effects we treated 17 patients
      with 4-part fractures with a prototype of a modular trochanteric DHS buttress
      plate. With this additional implant lateralisation of the greater trochanter
      could be prevented in all cases. This also leads to a limitation of telescoping,
      with less shortening even with immediate full weight bearing.

PMID- 8480148
TI  - [Laparoscopic cholecystectomy in a teaching center. Apropos of 208
      interventions].
AB  - Laparoscopic cholecystectomy is a relatively recent acquisition and still remains
      limited to a few surgeons. We started an education program for surgeons used to
      open biliary surgery. Between September 1990 and December 1991, 208 patients have
      been operated on day 14 operators flanked by 2 teachers. Technique was
      standardized and all patients were examined preoperatively for absence of stones
      in bile ducts using i.v. cholangiography and tomography. Only 6 patients (< 3%)
      needed to be converted to laparotomy. Morbidity was less than 6% and due to minor
      complications. Only one patient needed reoperation because of incisional hernia.
      Mortality was nil. Mean postoperative hospitalization time was less than 3 days.
      We conclude that laparoscopic activity in a teaching center allows acquisition of
      a new technique modality while remaining safe for patients.

PMID- 8480149
TI  - [Multiple tumors of colon and rectum].
AB  - The possible occurrence of multiple synchronous or metachronous malignant lesions
      in patients with carcinoma of the colon and rectum is a well known event. In this
      population-based study in the Geneva area from 1970 to 1986, the frequency of
      synchronous colorectal carcinomas was 1.1% and that of metachronous carcinomas
      1%. The relative risk of metachronous colorectal carcinoma is higher than in the
      general population (colon after rectum 1.2, colon after colon 1.7 and rectum
      after rectum 1.4). A high association of adenomatous polyps with multiple
      colorectal carcinoma was observed. The 5-year actuarial survival in case of
      curative resection was 87% for metachronous carcinomas, 35% for single carcinomas
      and 33% for synchronous carcinomas. We conclude that complete preoperative
      colonoscopy, whenever possible, should be performed to screen patients with
      synchronous carcinomas. Finally, a lifelong follow-up of the residual colon or
      rectum should be planned to detect metachronous lesions.

PMID- 8480150
TI  - [Multiple organ removal from the viewpoint of the non-transplanting hospital.
      Cost, yield, problems].
AB  - Our algorithm is an example of the way in which multiple organ donation can be
      organized in a hospital which does not perform transplants. We describe problems
      which arise during evaluation of the donor and pending explanation. In conclusion
      we call for better coordination and support from transplantation centres.

PMID- 8480151
TI  - [The significance of computerized tomography in the conservative treatment of
      liver injuries].
AB  - Increasing experience with early radiological evaluation by ultrasound (US) and
      computed tomography (CT) of patients with abdominal trauma is leading to more
      frequent use of conservative treatment in patients with severe liver injuries. In
      a retrospective study with predominant use of peritoneal lavage only 3 out of 100
      patients with liver injuries were treated non-surgically. In a consecutive
      prospectively evaluated series of 75 patients with early use of US and CT, 30
      patients in stable circulatory conditions were treated non-surgically. With
      increasing experience a higher percentage of patients, even with severe liver
      injuries, could be treated non-operatively. 17 patients with minor injuries
      (grade I and II, modified according to Moore) and 13 patients with severe
      injuries (grade III and IV) could be treated non-surgically. 2 patients with
      grade IV injury developed an arterial/portal-venous fistula and an arterial
      aneurysm which necessitated radiological embolizations. All conservatively
      treated patients have been followed up for a mean period of 18 months without
      complications. Although a precise anatomical classification of the liver injury
      degree seems difficult, the predictive value of computed tomography for non
      surgical treatment was good. Use of i.v.-contrast is mandatory. We conclude that
      in experienced hands computed tomography allows precise evaluation of liver
      injuries for adequate treatment, provided careful follow-up (intensive care unit,
      CT, angiography) ensues to avoid complications.

PMID- 8480152
TI  - [Unstable spinal injuries in cranio-cerebral injuries].
AB  - Estimates of the incidence of injury to the cervical spine among patients
      suffering blunt trauma to the head vary widely. In an attempt to quantify the
      risk, the records of 593 consecutive patients with blunt craniocerebral injuries
      admitted to our trauma center in 1991 were reviewed. The overall incidence of
      cervical spine injuries was 5.8% and for unstable cervical spine injuries 2.9%.
      In the management of head trauma with associated cervical spine injuries
      realignment and immobilization of the spine and surgery of the head were carried
      out as first step, followed by decompression and stabilization of the affected
      segment in the same session. In patients with altered consciousness there is
      always loss of cooperation and early spinal stabilization for optimal treatment
      in the intensive care unit and in the wake-up-phase is important.

PMID- 8480153
TI  - [Initial results with the unreamed AO tibial nail].
AB  - It is generally accepted that intramedullary nailing in combination with reaming
      should be avoided in treating open fractures. However, the use of an unreamed,
      solid nail combined with interlocking also allows stabilization of open and
      complex fractures. 20 tibia fractures (65% open, 45% complex fractures) have been
      treated by the AO unreamed tibial nail (UTN), 12 (5 of them open fractures) by
      direct nailing and 8 after initial stabilization by an external fixator. In our
      series no intraoperative complications, no soft-tissue healing problems and no
      infections occurred. Thus, treatment of both open and comminuted fractures by UTN
      appears to be safe and generally needs no secondary stabilization.

PMID- 8480154
TI  - [Preoperative arthroscopy in fresh complicated internal knee lesions].
AB  - In a prospective study, 197 preoperative arthroscopies were carried out on 194
      patients with fresh severe internal lesions of the knee. The injuries are
      analyzed, with reference in particular to diagnosis and treatment of additional
      meniscus lesions. Advantages and disadvantages of the procedure are discussed.

PMID- 8480155
TI  - [Incidence of ileus following rectum resection in rectal carcinoma with or
      without radiotherapy].
AB  - Between 1984 and 1989 240 patients underwent radical abdominal resection of a
      rectal carcinoma. Out of 201 patients surviving 12 months or more
      postoperatively, two groups are surveyed. The first group presents patients
      undergoing adjunctive radiation therapy (n = 47), while the second group did not
      undergo postoperative radiation therapy (n = 134). Mean follow-up time
      postoperatively is 39 months. Within the irradiation group, the incidence of
      ileus was found to be 23% (11/47), and in the non-irradiated group 8% (11/134).
      Subsequent reoperations in order to clear intestinal obstruction were performed
      on 4% (5/134) of non-irradiated patients and on 21% (10/47) of the irradiated
      group. Considering the increased risk of postoperative ileus after rectal
      resection for rectal carcinoma, serious reflection should be given to assessing
      the appropriateness of adjunctive radiation therapy.

PMID- 8480156
TI  - [Digestive system carcinoid tumor and synchronous malignant tumors].
AB  - 270 digestive carcinoid tumors have been diagnosed at the Pathology Institute of
      Lausanne between 1971 and 1990; of these 21 were associated with other,
      synchronous, tumors: 7 of the carcinoids were from the appendix (33%), 8 from the
      small bowel (38%), 4 were from the colorectum (25%), one from the duodenum (4.5%)
      and finally one from the stomach (4.5%). Two thirds (14) were associated with
      adenocarcinomas of the colon, the rest with 2 gastric tumors, 1 tumor of the
      appendix, 1 of the gallbladder, 1 of the small gut, 1 of the duodenum and 1 of
      the peritoneum. The mean age of the patients was 70 years, which correlates with
      the large proportion of carcinomas of the colon. The males (16) clearly
      outnumbered the females (5) for no obvious reason. 80% of the carcinoids were
      discovered during the treatment of the associated tumor. Survival was directly
      related to the stage and aggressivity of the malignant tumor. The carcinoid
      itself hardly changed the prognosis, except for one case of liver failure due to
      metastases from carcinoid of the stomach associated with an adenocarcinoma. The
      histologic features of the carcinoid tumors were unexceptional. Different
      hypotheses to explain the associations are formulated.

PMID- 8480157
TI  - [Hemodynamic effects of the implantation of an intracaval oxygenator].
AB  - Treatment of severe respiratory failure by extracorporeal membrane oxygenation
      (ECMO) is complex. However, there is now an intravascular gas exchanger (IVOX)
      available that provides extrapulmonary gas transfer without requiring an
      extracorporeal blood path. The present study was performed to determine the
      hemodynamic effects resulting from the intracaval placement of the intravascular
      device. A bovine model (n = 6; body-weight = 72 +/- 5 kg) was selected for
      temporary lung support with the intravascular device. The latter was placed in
      the caval axis under fluoroscopic control after full instrumentation of the
      animal for hemodynamic measurements including a pulmonary artery catheter for
      determination of cardiac output by thermodilution and continuous readout of mixed
      venous oxygen saturation. All measurements were taken after a stabilization
      period of 15 min. The heart rate moved from 65 +/- 8 before to 72 +/- 10 after
      implantation and 68 +/- 9 after onset of intravascular gas exchange (NS). Right
      atrial pressure was 13 +/- 3 mm Hg before, 12 +/- 3 mm Hg after implantation and
      10 +/- 3 mm Hg after onset (NS) whereas femoral venous pressure moved from 14 +/-
      3 mm Hg to 17 +/- 4 mm Hg (p < 0.05) and remained at 17 +/- 4 mm Hg after onset.
      Cardiac output was 5.3 +/- 0.7 l/min before, 5.4 +/- 0.7 l/min after implantation
      and 5.3 +/- 1.1 l/min after onset (NS) while mixed venous oxygen saturation
      dropped from 60 +/- 7% to 54 +/- 11% and moved to 57 +/- 11 after onset of the
      device (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480158
TI  - [Islet of Langerhans transplantation in humans].
AB  - Islet of Langerhans transplantation is an alternative to whole pancreas
      transplantation for type I diabetic patients, in whom exogenous insulin therapy
      has not prevented the occurrence of systemic complications. Thanks to a new
      isolation technique of human islets, 45 patients have been transplanted worldwide
      since 1988, of whom only 7 have become totally insulin-independent. Rejection and
      quality of the islet preparations are problems which remain to be solved.
      Autotransplantation of islets has been proposed in patients undergoing a
      pancreatectomy for benign disease. The present report concerns two of our
      patients who had a pancreatectomy with islet autotransplantation. Both patients
      are insulin-independent 3 and 11 months postoperatively, with satisfactory
      metabolic tests. Islet autotransplantation can be proposed when pancreatectomy
      for non-malignant disease is performed. This method may prevent the development
      of insulin-dependent diabetes, known to be particularly labile. Because of the
      sophisticated technical procedures required, human islet isolation is at present
      only performed in a small number of medical centers and still is in the field of
      medical experimentation.

PMID- 8480159
TI  - [Platelet aggregation inhibitor and brain infarct: quo vadis?].

PMID- 8480160
TI  - [Whiplash injury--a confusing concept].
AB  - The functional anatomy of the cervical spine, the biomechanics of lesions due to
      rear end collisions, the human behaviour of victims of these collisions and the
      influence of insurance, legislation, court decisions and the modalities and
      duration of treatment are discussed in a survey of the literature on lesions of
      the cervical spine due to rear end collisions. The problems posed by changed
      court rulings on lesions of the cervical spine due to rear end collisions are
      mentioned, as well as the danger of producing a "whiplash" compensation epidemic.
      It appears that immediate treatment of the lesion avoiding manipulation, long
      immobilization and delay in decisions on compensation may reduce the frequency,
      intensity and duration of symptoms. The symptoms usually remit after settlement
      of compensation and seldom give rise to substantial disability. The prevention of
      lesions of the cervical spine and head due to rear end collisions will only be
      possible if car safety engineers succeed in preventing rear end collisions and/or
      in ending hyperextension by appropriate devices. The head supports in use today
      are not sufficient to prevent hyperextension of the cervical spine.

PMID- 8480161
TI  - [Is extracorporeal cholelithotripsy still justified as treatment in
      cholelithiasis?].
AB  - This prospective study evaluates the results of extracorporeal shock-wave
      piezoelectric lithotripsy in 52 patients, 41 with radiolucent and 11 with
      calcified shell gallstones. The fragmentation rate was above 90% and the
      complication rate 31%, with pain or intolerance to the adjuvant dissolution
      therapy in particular. At the end of the treatment, 7 cholecystectomies were
      carried out among the 31 patients in whom lithotripsy failed. After 18 months,
      the success rate was 23% and only 12 patients remained stone free. Nowadays,
      thanks to the new laparoscopic therapy, extracorporeal shock-wave lithotripsy is
      no longer judged appropriate, particularly in view of its poor cost-effectiveness
      and high recurrence ratio.

PMID- 8480162
TI  - [Extracorporeal shockwave lithotripsy of the gallbladder: importance of selection
      criteria].
AB  - In recent years, a number of alternatives to surgery for gallstones have been
      developed. Among them, extracorporeal shock-wave lithotripsy (ESWL) was
      promising, being non-invasive and risk-free. Nevertheless, its results vary
      according to the size, number and composition of the stones and according to the
      bile acids treatment used for fragment dissolution. To better evaluate the
      importance of these factors, we have widened the selection criteria currently
      used (1 to 3 non-calcified stones with a diameter below 30 mm) by including
      patients with large stones (up to 40 mm in diameter), multiple stones (up to 10
      stones) and calcified stones. We also compared, for efficacy of fragment
      dissolution after ESWL, treatment by ursodeoxycholic acid alone as opposed to a
      mixture with chenodeoxycholic acid. Our results were (1) significant lessening of
      the fragmentation rate and of the number of gallbladders free of stones 1 year
      after ESWL when selection criteria are widened; (2) a mixture of ursodeoxycholic
      and chenodeoxycholic acids may favour fragment dissolution after ESWL compared to
      treatment by ursodeoxycholic acid alone.

PMID- 8480163
TI  - [Diffuse idiopathic skeletal hyperostosis (DISH) and pseudo-coxarthritis
      following long-term etretinate therapy].
AB  - A 51-year old patient with congenital basal cell naevus syndrome was treated with
      etretinate (50-100 mg/daily) over a period of 5 years (cumulative dose 110 g).
      Clinically he developed a stiff back with pronounced disability of both hips.
      Radiologically, axial involvement of the spine with severe diffuse idiopathic
      skeletal hyperostosis especially of the lumbar spine, and ossifications of both
      hips were documented. Rheumatological implications of long-term therapy with
      etretinate are discussed.

PMID- 8480164
TI  - [Neurological side effects following vaccination of early-summer
      meningoencephalitis. Case report and experiences of the Swiss Center for Adverse
      Drug Effects].
AB  - Two weeks after vaccination against tick-born encephalitis (TBE) a 69-year-old
      patient developed subacute myelo-polyradiculitis. The neurological symptoms
      subsided after a few weeks. Alerted by this observation, we scanned the database
      of the Swiss Drug Monitoring Center (SANZ) for similar case reports. Of twenty
      spontaneous reports 11 concerned neurological side effects closely related to TBE
      vaccination. We conclude that TBE vaccination is associated with substantial
      neurological side effects and should, therefore, remain restricted to individuals
      at high risk for TBE.

PMID- 8480165
TI  - [Concerning: "Long-term course in differentiated thyroid carcinoma" by H. Rosler,
      A. Birrer, D. Luscher and J. Kinser (Schweiz. med. Wschr. 1992; 122: 1843-1857)].

PMID- 8480166
TI  - The economics of life and death.
AB  - Mortality data can be used to analyze economic performance. Such information can
      illuminate critical aspects of the economic organization of society.

PMID- 8480167
TI  - Moderation in science budgeting.

PMID- 8480168
TI  - Database contamination.

PMID- 8480169
TI  - Database contamination.

PMID- 8480170
TI  - Sequencing the human genome.

PMID- 8480171
TI  - Congress may hang up on AIDS hotline.

PMID- 8480172
TI  - Sex surveys come out of the closet.

PMID- 8480173
TI  - Genetic 'master switch' for left-right symmetry found.

PMID- 8480174
TI  - Cytokines and estrogen in bone: anti-osteoporotic effects.

PMID- 8480175
TI  - Imaging of features on surfaces by condensation figures.
AB  - Condensation of a vapor to a liquid on a cold surface that is not wet completely
      by this liquid leads to the formation of an array of droplets. If the surface is
      heterogeneous in its physical properties (especially its interfacial free
      energy), the patterns of these arrays reflect this heterogeneity. The
      distribution of droplets of water (condensation figures or CFs) observed by
      optical microscopy on a surface can be correlated with the molecular structure of
      that surface. The substrates used to investigate the formation and morphology of
      the CFs were patterned, self-assembled monolayers of different alkanethiolates on
      gold and of alkyl siloxanes on glass. Analysis of CFs is a valuable
      nondestructive technique for characterizing heterogeneities in surfaces.

PMID- 8480176
TI  - Social structure of pilot whales revealed by analytical DNA profiling.
AB  - Long-finned pilot whales swim in large, extremely cohesive social groups known as
      pods. Molecular typing revealed that pod members form a single extended family.
      Mature males neither disperse from nor mate within their natal pods, a situation
      unusual for mammals. Such behavior could be explained in terms of inclusive
      fitness benefits gained by adult males helping the large number of female
      relatives with which they swim.

PMID- 8480177
TI  - Where plants make oxygen: a structural model for the photosynthetic oxygen
      evolving manganese cluster.
AB  - In the photosynthetic evolution of oxygen, water oxidation occurs at a catalytic
      site that includes four manganese atoms together with the essential cofactors,
      the calcium and chlorine ions. A structural model and a determination of the
      manganese oxidation states based on x-ray absorption spectroscopy are presented.
      The salient features, in both higher plants and cyanobacteria, are a pair of di
      mu-oxo bridged manganese binuclear clusters linked by a mono-mu-oxo bridge, one
      proximal calcium atom, and one halide. In dark-adapted samples, manganese occurs
      in oxidation states (III) and (IV). Data from oriented membranes display distinct
      dichroism, precluding highly symmetrical structures for the manganese complex.

PMID- 8480178
TI  - Reversal of left-right asymmetry: a situs inversus mutation.
AB  - A recessive mutation was identified in a family of transgenic mice that resulted
      in a reversal of left-right polarity (situs inversus) in 100 percent of the
      homozygous transgenic mice tested. Sequences that flanked the transgenic
      integration site were cloned and mapped to mouse chromosome 4, between the Tsha
      and Hxb loci. During early embryonic development, the direction of
      postimplantation turning, one of the earliest manifestations of left-right
      asymmetry, was reversed in homozygous transgenic embryos. This insertional
      mutation identifies a gene that controls embryonic turning and visceral left
      right polarity.

PMID- 8480179
TI  - Intermediate filament formation by a yeast protein essential for organelle
      inheritance.
AB  - Intermediate filaments are abundant cytoskeletal components whose specific
      cellular functions are poorly understood. The Saccharomyces cerevisiae protein
      MDM1 displays structure and solubility properties that are similar to those of
      intermediate filament proteins of animal cells. Yeast cells that have a mutant
      form of MDM1 exhibit temperature-sensitive growth and defective transfer of
      nuclei and mitochondria to daughter cells during incubation at the nonpermissive
      temperature of 37 degrees C. The purified, wild-type MDM1 protein readily forms
      10-nanometer-wide filaments at either 4 degrees C or 37 degrees C. In contrast,
      the purified, mutant protein forms filaments at 4 degrees C but fails to form
      such structures at 37 degrees C. These results suggest that intermediate filament
      proteins are universal components of eukaryotic cells.

PMID- 8480180
TI  - Retinoic acid stimulates regeneration of mammalian auditory hair cells.
AB  - Sensorineural hearing loss resulting from the loss of auditory hair cells is
      thought to be irreversible in mammals. This study provides evidence that retinoic
      acid can stimulate the regeneration in vitro of mammalian auditory hair cells in
      ototoxic-poisoned organ of Corti explants in the rat. In contrast, treatment with
      retinoic acid does not stimulate the formation of extra hair cells in control
      cultures of Corti's organ. Retinoic acid-stimulated hair cell regeneration can be
      blocked by cytosine arabinoside, which suggests that a period of mitosis is
      required for the regeneration of auditory hair cells in this system. These
      results provide hope for a recovery of hearing function in mammals after auditory
      hair cell damage.

PMID- 8480181
TI  - Linkage on chromosome 3 of autoimmune diabetes and defective Fc receptor for IgG
      in NOD mice.
AB  - A congenic, non-obese diabetic (NOD) mouse strain that contains a segment of
      chromosome 3 from the diabetes-resistant mouse strain B6.PL-Thy-1a was less
      susceptible to diabetes than NOD mice. A fully penetrant immunological defect
      also mapped to this segment, which encodes the high-affinity Fc receptor for
      immunoglobulin G (IgG), Fc gamma RI. The NOD Fcgr1 allele, which results in a
      deletion of the cytoplasmic tail, caused a 73 percent reduction in the turnover
      of cell surface receptor-antibody complexes. The development of congenic strains
      and the characterization of Mendelian traits that are specific to the disease
      phenotype demonstrate the feasibility of dissecting the pathophysiology of
      complex, non-Mendelian diseases.

PMID- 8480182
TI  - Immuno-PCR with a commercially available avidin system.

PMID- 8480183
TI  - Lung cancer. Part 1. Introduction.

PMID- 8480184
TI  - The biology of lung cancer.

PMID- 8480185
TI  - Chemoprevention of lung cancer.

PMID- 8480186
TI  - Imaging in lung cancer.

PMID- 8480187
TI  - Human erythrocyte membrane protein band 4.2 (pallidin).

PMID- 8480188
TI  - Molecular genetics of the glycophorin A gene cluster.

PMID- 8480189
TI  - Glycophorin C and related glycoproteins: structure, function, and regulation.

PMID- 8480190
TI  - Ankyrins: structure and function in normal cells and hereditary spherocytes.

PMID- 8480191
TI  - The challenges of inhibitor patient care.

PMID- 8480192
TI  - Use of porcine factor VIII for surgical procedures in hemophilia A patients with
      inhibitors.
AB  - We have described the use of polyelectrolyte fractionated porcine factor VIII
      (HYATE:C, Porton Speywood Ltd, Wrexham, UK) to provide hemostasis in 45 patients
      with hemophilia A complicated by inhibitor antibodies. The cases were collected
      from hemophilia care providers in seven nations and represent some of the
      experience with porcine factor VIII generated over the past 12 years. A wide
      variety of procedures was performed with varying degrees of associated hemostatic
      challenge in a difficult treatment group. The patients were representative of the
      hemophilia population in general and ranged in age from 1 to 67 years. The
      results of our survey should encourage clinicians to consider use of porcine
      factor VIII to provide hemostatic coverage in hemophilia patients with inhibitors
      who require surgical procedures. Hemostatic coverage was satisfactory in the vast
      majority of episodes; there have been only a small number of easily controlled,
      well-tolerated adverse reactions, which were usually self-limited in nature. No
      life-threatening reactions to porcine factor VIII were seen during coverage for
      surgical procedures in our survey, although serious reactions can occur as noted
      above. This is remarkable, since surgical patients usually are treated with
      higher doses of porcine factor VIII for greater periods of time than most other
      hemophilic patients treated for hemarthroses or soft-tissue bleeding, for
      example. Thrombocytopenia in association with porcine factor VIII therapy has
      been a major concern since the first crude preparations were used in the 1950s.
      Modern series, however, note the incidence of thrombocytopenia in only a minority
      of patients treated with the current polyelectrolyte fractionated preparations of
      porcine factor VIII. In our series, thrombocytopenia with platelet counts of less
      than 150 x 10(9)/L occurred in 11 of 54 treatment episodes (20%). The mechanism
      for thrombocytopenia demonstrated in a previous study involves porcine von
      Willebrand factor, which may copurify with porcine factor VIII and cause platelet
      aggregation and/or clearance from the circulation. The phenomenon of
      thrombocytopenia appears to be related to the administration of high doses of
      porcine factor VIII in some cases; however, in other patients, it may develop
      inconsistently at modest doses. It may be that there are idiosyncratic
      differences between patients that determine the dose of porcine factor VIII
      likely to cause thrombocytopenia. As yet, there is no way to predict which
      patient will develop thrombocytopenia while being treated with porcine factor
      VIII.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8480193
TI  - The treatment of acquired factor VIII inhibitors: worldwide experience with
      porcine factor VIII concentrate. International Acquired Hemophilia Study Group.

PMID- 8480194
TI  - Immunosuppression of factor VIII inhibitors in nonhemophilic patients.

PMID- 8480195
TI  - Diagnosis of factor VIII versus nonspecific inhibitors.

PMID- 8480196
TI  - Continuous infusion of porcine factor VIII for the treatment of patients with
      factor VIII inhibitors.

PMID- 8480197
TI  - Prediction and management of adverse events associated with the use of factor IX
      complex concentrates.
AB  - Among the adverse events that have been associated with the use of F IX CC in
      inhibitor patients, the likelihood of transmission of blood-borne pathogens is
      now greatly reduced. However, one must be aware of the possibility of thrombotic
      complications and acute myocardial infarction when using large, repetitive doses
      of F IX CC. A greater awareness of such potentially life-threatening
      complications, and avoidance of frequent, repetitive large doses, should decrease
      the risk. F IX CC are not always effective in achieving or maintaining hemostasis
      in hemophiliacs with inhibitors. Thus, in subjects who are responding
      suboptimally, in those in need of surgical intervention, or in those who have
      large intramuscular hemorrhages and/or will require a prolonged period of
      treatment, alternative therapeutic approaches should be considered.

PMID- 8480198
TI  - World registry on factor VIII inhibitor patients: why?

PMID- 8480199
TI  - Radiographic features that enable assessment of first metatarsal rotation: the
      role of pronation in hallux valgus.
AB  - This study describes a method of detecting first metatarsal pronation on the
      basis of the movement of the inferior tuberosity of the base of 20 cadaveric
      first metatarsals at 0 degrees, 10 degrees, 20 degrees and 30 degrees pronation.
      On pronation, the inferior tuberosity of the base of the first metatarsal moved
      lateral to the mid-line axis. At 10 degrees, the tuberosity pointed to the
      junction of the inner third and outer two-thirds of a line between the midpoint
      and lateral tubercle of the base. At 20 degrees, it pointed to the junction of
      the inner two-thirds and outer third of that line. At 30 degrees, it pointed to
      the outer margin of the lateral third. Using these features, the amount of first
      metatarsal pronation in 100 consecutive weight-bearing views of feet was recorded
      and plotted against the corresponding intermetatarsal angles in those feet. Four
      of 43 patients with an intermetatarsal angle of less than 9 degrees had pronation
      greater than 10 degrees, 48 of 57 patients with an intermetatarsal angle greater
      than 9 degrees had pronation greater than 10 degrees (P < 0.001). As
      intermetatarsal angles increase, the amount of first metatarsal pronation
      increases (r = 0.69). Pronation and varus deviation of the first metatarsal are
      linked; both alter the tendon balance maintaining proximal phalanx alignment and
      lead to the development of hallux valgus.

PMID- 8480200
TI  - Eosinophilic granuloma: MRI manifestations.
AB  - The appearance on magnetic resonance imaging (MRI) of 16 cases of pathologically
      proven eosinophilic granuloma were reviewed retrospectively and correlated with
      the radiographic appearance of the lesion. The most common MR appearance (ten
      cases) was a focal lesion, surrounded by an extensive, ill-defined bone marrow
      and soft tissue reaction with low signal intensity on T1-weighted images and high
      signal intensity on T2-weighted images, considered to represent bone marrow and
      soft tissue edema (the flare phenomenon). The MRI manifestations of eosinophilic
      granuloma, especially during the early stages, are nonspecific, and may stimulate
      an aggressive lesion such as osteomyelitis or Ewings sarcoma, or other benign
      bone tumors such as osteoid osteoma or chondroblastoma.

PMID- 8480201
TI  - MR imaging of eosinophilic granuloma: report of 11 cases.
AB  - The findings in 11 patients with histologically proven eosinophilic granuloma
      (EG) examined by magnetic resonance imaging (MRI) are described. In contrast with
      the variable appearance of EG on conventional radiography and computed tomography
      (CT), relatively constant features--intermediate to high signal intensity on T1
      weighting, high signal intensity on T2-weighting, marked enhancement--were found
      on MRI. MRI was superior to other imaging methods in demonstrating bone marrow
      involvement and any accompanying soft tissue mass or inflammation. Intermediate
      to high signal intensity on T1-weighting and marked contrast enhancement could
      not be "explained" by histological findings. Prediction of the evolutionary phase
      of EG by MRI remains questionable because of the phase I (proliferative)
      histology of all 11 lesions.

PMID- 8480202
TI  - Factors affecting the thickness of the cervical prevertebral soft tissues.
AB  - Lateral cervical spine films of 227 patients examined over 2 years were analyzed
      to determine the thickness of the soft tissues anterior to C2 through C4. These
      measurements were correlated with patient age, sex, weight, shoulder width, neck
      width, and calculated radiographic magnification. We found that only patient
      weight and age had any statistically significant effect on the soft tissue
      thickness. A stepwise regression model produced a simple equation for predicting
      the mean value of the soft tissue thickness (specifically at C3) using the
      patient's age and weight: C3 width = 3.7 mm-0.02 x age (years) + 0.01 x weight
      (pounds). Using this formula we determined that weight and age account for 28% of
      the observed variability in the soft tissue measurements at C3. These
      relationships were similar at C2 and C4. Interestingly, patient sex and
      radiographic magnification had no detectable effect on the measured widths.

PMID- 8480203
TI  - Giant cell tumor in children and adolescents.
AB  - The radiological appearance of giant cell tumors (GCT) in the developing skeleton
      was retrospectively assessed in 49 (10.6%) of the 462 patients with GCTs seen in
      consultation by the Netherlands Committee on Bone Tumors. There were 31 female
      and 18 male patients, all below 19 years of age. Thirty-four tumors were located
      in short and long tubular bones, two in the tarsus, while the others were in the
      pelvis, vertebral spine, and a rib. Involvement of the epiphysis in tubular bones
      was closely related to the age of the patient: the average age of the 3 patients
      with a lesion in the metaphysis was 11 years, that in the 6 patients with
      metadiaphyseal lesions 13 years, average age in the 10 patients with
      epimetaphyseal lesions 17 years, and it was also 17 years in the 17 patients with
      epimetadiaphyseal lesions. In tubular bones with the epiphyseal growth plates
      still open, the epiphysis was never involved, with the exception of two
      epimetadiaphyseal lesions in which closure of the growth plate was difficult to
      establish. Assessing GCT characteristics in this study population demonstrated
      that epiphyseal involvement increased with age and showed; to some extent, a
      predominance of female patients.

PMID- 8480204
TI  - Radiographic assessment of sagittal knee instability in weight bearing. A study
      on anterior cruciate-deficient knees.
AB  - In 16 patients with chronic, symptomatic anterior cruciate ligament-deficient
      knees, sagittal displacement was studied in the standing position using
      fluoroscopic control and a simple device to support the knee. In slight weight
      bearing all knees but one had normal femorotibial alignment in the lateral view.
      During full weight bearing sagittal displacements between 2 mm and 17 mm were
      recorded in 14 patients. The largest displacements were obtained at different
      angles of inclination of the leg and flexion of the knee joint and were
      independent of the point of support of the knee joint. The reproducibility of
      this new standing technique was within 2 mm. A high correlation with previous
      methods of radiographic measurements of sagittal laxity was found. By the use of
      the normal relationship between the tibial eminence and the femoral condyles it
      is possible to record and measure sagittal displacements on a single lateral
      radiograph of the standing knee joint.

PMID- 8480205
TI  - Coexistence of calcific tendinitis and rotator cuff tear: an arthrographic study.
AB  - A prospective evaluation of the coexistence of calcific tendinitis and tear of
      the rotator cuff demonstrated by arthrography was made in patients presenting
      with shoulder pain. Patients were X-rayed using conventional views and
      impingement views. Eighty-one patients (mean age 61.2 years) with calcific
      tendinitis underwent arthrography. Arthrography showed 22 partial or complete
      tears of the rotator cuff. A small rather than a large amount of calcification
      was more likely to be associated with a rotator cuff tear (p = 0.005). The
      coexistence of calcific tendinitis with rotator cuff tear is not uncommon,
      especially in older age groups.

PMID- 8480206
TI  - Fractures of the occipital condyles: report of four cases and review of the
      literature.
AB  - Fractures of the occipital condyle are rare; 32 cases have been reported in the
      literature. Here, the authors describe four additional cases of occipital
      condylar fracture. Anderson's classification is used: type I fracture:
      comminution of the condyle without significant displacement; type II: basilar
      fracture extending into the condyle; type III: condylar avulsion. The possible
      mechanisms are identified. Computed tomography proved essential in diagnosing
      these fractures; coronal reconstructions together with axial scans are
      particularly helpful. Three-dimensional reconstruction did not prove essential in
      diagnosing these fractures.

PMID- 8480207
TI  - Slipped capital femoral epiphysis: ultrasonographic findings.
AB  - Slipped capital femoral epiphysis (SCFE) is an uncommon skeletal disorder of
      adolescence often overlooked because of its nonspecific clinical presentation.
      Anteroposterior radiography may fail to demonstrate a minimal slip even when
      clinical examination raises suspicion of the disease. On the other hand, prompt
      diagnosis is essential to obtain better therapeutic results. In our patient
      population joint effusion, which often accompanies SCFE, was readily recognized
      and quantified by ultrasonography (US). US also permitted recognition of the
      initial SCFE and assessment of the degree of slip by measuring the height of the
      physeal step. As to metaphyseal remodeling, plain radiography seems to be more
      informative than US; however, US has a role in the follow-up of SCFE because of
      the risk of slippage in the contralateral hip. This work suggests that US is
      useful as a primary imaging tool in the evaluation of subjects with limp or hip
      or knee pain to rule out SCFE.

PMID- 8480208
TI  - Predisposing factors in obstetrical fractures.
AB  - To compare various obstetrical methods with different types of obstetrical
      fractures, 29 neonates with fractures were evaluated retrospectively. Plain films
      of skull, limbs and chest were obtained. Transfontanellar ultrasonography was
      performed in one case and a computed tomographic scan of the skull in two. We
      reviewed 12 fractures of long bones, 7 fractures of the skull, and 10 fractures
      of the clavicle. Ten fractures occurred during caesarean sections and 11 in
      vaginal delivery requiring medical assistance. Depressed skull fractures were
      associated with manoeuvres and the use of forceps during delivery. Fractures of
      the long bones were associated with caesarean section, breech delivery with
      assistance and low birth weight. All fractures were treated conservatively except
      for skull fractures with depression of more than 2 cm. Early consolidation
      occurred in all fractures of long bones. The long-term follow-up of all fractures
      but one revealed no persisting disability. The belief that obstetrical fractures
      occur primarily in large babies or after breech delivery is not supported by this
      study.

PMID- 8480209
TI  - Case report 765. Von Gierke's disease.

PMID- 8480210
TI  - Case report 777. Osteolytic Paget's disease of the fifth lumbar vertebra.

PMID- 8480211
TI  - Case report 778. Melorheostosis presenting as two soft-tissue masses with osseous
      changes limited to the axial skeleton.

PMID- 8480212
TI  - Case report 779. Carbonate apatite calcification of ligamentum flavum.

PMID- 8480213
TI  - Case report 780. Fracture of talar beaks in tarsal coalition.

PMID- 8480214
TI  - Case report 782. Predominantly osteolytic Paget's disease of the calcaneus.

PMID- 8480215
TI  - Case report 783. Intraosseous ganglion of scapula.

PMID- 8480216
TI  - Health consequences of employment and unemployment: longitudinal evidence for
      young men and women.
AB  - This study examines the impact of employment and unemployment on psychological
      health and well-being, as measured by the General Health Questionnaire (GHQ).
      Using longitudinal data, it traces health changes over time for a variety of
      groups and through a variety of labour market experiences: during sustained
      employment and unemployment, in the transition from school to employment and
      unemployment, and as people move between employment and unemployment and between
      satisfying and unsatisfying jobs. The results show that employed people report
      significantly lower levels of health disorder than students and the unemployed.
      These differences are largely unaffected by demographic attributes, living
      arrangements, socioeconomic status or immediate labour market experiences, and
      can be attributed to employment status itself rather than predisposing health
      differences. However, the health consequences of employment and unemployment are
      directly contingent upon quality of work. As a result, the highest levels of
      health risk are found amongst dissatisfied workers and the lowest levels amongst
      satisfied workers. In between these two extremes lie employed people neither
      satisfied nor dissatisfied with their jobs, unemployed people irrespective of
      duration, and students. These results indicate that what happens in the workplace
      has even more impact on a person's health than success or failure in finding a
      job and keeping it.

PMID- 8480217
TI  - The structure and properties of the sense of coherence scale.
AB  - Previous work of the author presents a salutogenic theoretical model designed to
      explain maintenance or improvement of location on a health ease/dis-ease
      continuum. The model's core construct, the Sense of Coherence (SOC), was
      consciously formulated in terms which are thought to be applicable
      crossculturally. The SOC scale which operationalizes the construct is a 29-item
      semantic differential questionnaire, its design guided by Guttman's facet theory.
      A 13-item version of the scale has also been used. The purpose of the present
      paper is to present the extant evidence from studies conducted in 20 countries
      for the feasibility, reliability and validity of the scale, as well as normative
      data. In 26 studies using SOC-29 the Cronbach alpha measure of internal
      consistency has ranged from 0.82 to 0.95. The alphas of 16 studies using SOC-13
      range from 0.74 to 0.91. The relatively few test-retest correlations show
      considerable stability, e.g. 0.54 over a 2-year period among retirees. The
      systematic procedure used in scale construction and examination of the final
      product by many colleagues points to a high level of content, face and consensual
      validity. The few data sets available point to a high level of construct
      validity. Criterion validity is examined by presenting correlational data between
      the SOC and measures in four domains: a global orientation to oneself and one's
      environment (19 r's); stressors (11 r's); health, illness and wellbeing (32 r's);
      attitudes and behavior (5 r's). The great majority of correlations are
      statistically significant. All available published normative data on SOC-29 and
      SOC-13 are presented, data which bear upon validity using the known groups
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480218
TI  - Increasing reliance on user fees as a response to public health financing crises:
      a case study of El Salvador.
AB  - Since the early 1980s, the Ministries of Health of most Developing Countries have
      been plagued by significant and persistent resource shortages. One response of
      many Third World countries to this health financing crisis has been to turn to
      user fees. This article presents a case study of the evolution of public health
      care system fees in El Salvador in the decade of the 1980s. Since 1980 falling
      levels of real funding of the Ministry of Health of El Salvador have resulted in
      falling supplies of drugs, materials and equipment throughout the public health
      system, and have contributed to declining utilization levels of public health
      facilities. Local public health providers and their community health boards
      (patronatos) have responded to this crisis by creatively institutionalizing
      decentralized, revolving accounts based on 'voluntary' user fees for ambulatory
      care, collected and retained at individual facilities. This article describes the
      legal foundations, organization, functioning, incentive structures, financial
      performance, and the institutional development of El Salvador's local user fee
      systems.

PMID- 8480219
TI  - Suicide and unemployment in Australia 1907-1990.
AB  - Ever since Durkheim postulated a relationship between economic change and suicide
      there has been evidence of a general association between aggregate data on
      unemployment and the frequency of suicide. Quantitatively, however, the
      association has been variable and it is clear that due to differing cultural,
      social and individual determinants of suicide, the relationship is complex.
      Methodological difficulties abound with interpretation of aggregate data.
      Australian records for most of the present century are suitable for examining
      secular trends in suicide and unemployment by age group and gender to gain an
      indication of the extent to which both parameters may be causally related. An
      aggregate/ecological study was designed to incorporate quantitative and
      qualitative strategies. Annual age-adjusted male and female suicide rates and
      annual unemployment rates were derived for the period 1907-1990. Female suicide
      rates were generally stable throughout the period, whereas those for males
      demonstrated sharp fluctuations with the peaks coinciding with times of high
      unemployment. The association between suicide and unemployment for 15-24 year old
      males was comparatively high for the recent period, 1966-1990. The increasingly
      youthful contribution to male suicide was demonstrated by a rise in the loss of
      life years during 1973-1984. Despite the inability of any investigation based on
      aggregate data to establish an unequivocable causal relationship, no evidence was
      detected to suggest that relatively high population levels of unemployment were
      not related to the occurrence of suicide.

PMID- 8480220
TI  - Patient control over dying: responses of health care professionals.
AB  - Decisions concerning how, when and where patients should die have traditionally
      been the exclusive domain of health care professionals. More recently, patients
      and their families are demanding increasing control over these decisions. This
      paper reports on the responses of 20 physicians and 20 nurses in a major teaching
      hospital regarding the desire of patients to exert more control over the
      circumstances of their dying. The findings, based on in-depth, semi-structured
      interviews, suggest that while health care professionals are generally in favour
      of the principle of patient control over dying, they have reservations about
      accommodating patients' wishes in actual clinical situations. Key factors that
      underly their ambivalence on this point are: (1) specific patient circumstances,
      such as age, severity of illness and mental competence; (2) moral and legal
      concerns; and (3) the type of intervention requested by patient. The results
      indicate that patient control over dying represents a challenge to the clinical
      judgement of health care professionals; that it runs counter to their perception
      of their role as healers and supporters; that it raises crucial concerns about
      their personal ethics and legal liability and that it poses a challenge to their
      professional autonomy and power. It is likely that health care practitioners will
      increasingly be pressured to concede their autonomy and enter into a partnership
      with patients in the decision-making process.

PMID- 8480221
TI  - The attitudes of patients and physicians towards placebo treatment--a comparative
      study.
AB  - Placebo treatment in clinical practice can be given either in order to comply
      with the wishes of the patient, or with the purpose of doing good and not causing
      harm. In the former instance, the procedure may be in accordance with the
      interests of the patient, yet be in conflict with the interests of the medical
      profession. In the latter instance, the procedure presupposes that in most cases
      the patient has not been informed of the nature of the treatment; this type of
      procedure may jeopardize a trusting patient-doctor relationship. Therefore, it is
      of interest to investigate both the extent to which patients and physicians feel
      they can accept placebo treatment and a paternalistic attitude, and in which
      particular situations. In order to shed some light on this matter, we compiled a
      questionnaire built around three case histories which problematize placebo
      treatment and paternalistic acts. The questionnaire was distributed to 100
      patients and 100 physicians. 83 patients and 94 physicians responded. The results
      show that patients and physicians do not automatically follow specific group
      interests. Physicians are more inclined to respect the patient's option to refuse
      medical treatment than the patients are inclined to respect a physician's
      professional autonomy. Patients appear more to be paternalistic in their
      judgements than physicians, but one cannot rule out the possibility that the
      answers of the physicians reflect the fact that placebo treatment represent a
      socially undesirable behaviour. We conclude that theoretical and normative
      analyses of the perspective of the actors ought to be supplemented by empirical
      research.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480222
TI  - Primary health workers in north east Brazil.
AB  - One approach to providing primary health care in developing countries is to
      implement programs which rely on minimally trained primary health workers (PHWs).
      Originally, such programs were primarily designed for rural areas with intact
      social structures--where a community--based PHW could easily establish a link
      between the community and the conventional health services (delivery programs).
      However, faced with increasing migration of the rural population to urban centers
      in developing countries, the present need for elementary health care in urban
      slums raises the question of whether PHWs can also provide health assistance to
      the population there. This paper deals with the issue of whether PHWs in North
      East Brazil can improve health care delivery and the health situation of the poor
      population in rural and urban areas. The investigations covered both PHWs and the
      population. Questionnaire-guided interviews and participant observation were used
      as research tools. The conclusion is drawn that the PHW-program there has
      succeeded, if the PHWs have increased the coverage of the health service delivery
      and also the level of health-related knowledge, attitudes and practices (KAP) in
      the population--although with significant differences between rural and urban
      areas (higher coverage and higher KAP in rural areas). The quality of training
      and supervision and the characteristics of the area and local framework were also
      found to influence the quality of the work (performance) of the PHWs.

PMID- 8480223
TI  - Social science and the study of pain since Zborowski: a need for a new agenda.
AB  - In 1969, anthropologist Mark Zborowski published People in Pain, in which he
      showed that pain is responded to by behaviors and attitudes learned by pain
      sufferers within the cultures in which they are socialized. Research for this
      work was accomplished at a time when a number of social scientists were deeply
      involved in inquiry about the relationship between the individual psyche and
      society, and were, therefore, interested in subjective experiences of
      individuals. For reasons discussed in this article, social researchers shifted
      their focus, in the late 1960s and throughout the 1970s, from the study of
      subjective experience to research pertaining to more objectively verifiable
      phenomena. Consequently, because pain is not easily measurable, relatively few
      studies illuminating the human experience of pain were performed by social
      scientists since Zborowski completed his work. This article provides an overview
      of the small but pertinent research that has been conducted since the late 1960s,
      and challenges social scientists to develop a new agenda for the study of pain
      experiences. This research may be especially timely now, when there seems to be
      renewed interest among social scientists to study subjective experiences.

PMID- 8480224
TI  - Witchcraft-explained childhood tragedies in Tlaxcala, and their medical sequelae.
AB  - This paper describes results of a study in Tlaxcala, Mexico, involving the sudden
      death of infants and children that culturally are explained as resulting from the
      attack of blood-sucking witches. The attacks of the supernaturals are relatively
      common occurrences and an elaborate ideology has evolved to explain them. Such an
      ideology serves to explain what constitutes a major trauma of loss and
      supernatural assault. Data on a total of 47 cases were collected prospectively.
      The illness experiences of the parents following these traumas were recorded and
      their nature and consequences analyzed. The results of the study provide a 'folk
      medical' epidemiology of sudden infant death, a well identified cultural
      ecological stressor. Ideas from cultural, psychological and medical anthropology
      as well as general medicine and psychiatry are used in the interpretation of the
      results.

PMID- 8480225
TI  - Socioeconomic, environmental, demographic and behavioral factors associated with
      occurrence of diarrhea in young children in the Republic of Congo.
AB  - This study is the result of a cross-sectional survey undertaken in five regions
      of the Republic of Congo. A sample of 612 women having children under 3 years of
      age was interviewed to determine the socioeconomic, environmental, demographic
      and behavioral factors associated with the occurrence of diarrhea in young
      children. Logistic regression analysis was used to determine which variables
      predict the occurrence of diarrhea in a multivariable context. Most of the
      statistically significant variables were those suggesting behaviorally mediated
      modes of transmission. These include: type of weaning food fed to the child,
      maternal age, sex of the child, maternal sickness and method of refuse disposal.
      Male children had a more than two-fold odds of experiencing recent diarrhea than
      did female children among those greater than 1 year of age. Although
      breastfeeding status was not statistically significantly associated with
      diarrheal disease, children under 1 year of age who were already weaned had a
      greater odds of disease than those who were still breasted. Due to the pattern of
      extended breastfeeding in this population, this relationship was difficult to
      assess. Urban residence also was highly associated with diarrheal disease
      occurrence. Urban residence is likely to reflect a host of socioeconomic,
      environmental and behavioral factors. These findings underscore the potential
      impact of educational interventions on the occurrence of diarrheal disease among
      young children.

PMID- 8480226
TI  - Prevalence of smoking in physicians and medical students, and the generation
      effect in The Netherlands.
AB  - This study investigates smoking habits and attitudes towards smoking in general
      practitioners, consultants at a university hospital, medical students and
      students of health policy and management (H.P.M.). An anonymous, self
      administered postal survey was used. Thirty-eight percent of the general
      practitioners, 27% of the consultants, 18% of the medical students and 31% of the
      H.P.M. students are current smokers. The prevalence of smoking was found to be
      higher in the male general practitioners and the male H.P.M. students than in the
      general male population. The prevalence of smoking was lower in female physicians
      and students than in their male counterparts and also lower than in the general
      female population. Medical students are not inclined to start smoking: a strong
      generation effect can be observed. This will reinforce the current downward trend
      in the prevalence of smoking in Dutch physicians. The doctors were found to have
      a suboptimal level of knowledge about methods of smoking cessation and about the
      association between smoking and health disorders. Most Dutch physicians,
      especially those who smoke, fail to perceive their role as an example to the
      general population concerning smoking behaviour. Medical students were found to
      have even less recognition of their future exemplary role.

PMID- 8480227
TI  - What do students find attractive about the practice of medicine? A pattern of
      stability over time.
AB  - There is little consensus about the stability or instability of medical students
      career preferences during their time in college. These two studies found little
      change in their perception of the attractiveness of aspects of medical work which
      may be related to their final career choice. In the first study three successive
      cohorts of students in a London medical school completed questionnaires about the
      attractiveness of various medical job-attributes. Each cohort was tested twice
      such that the pattern of testing covered the entire course. Only data from
      students who were present at both test sessions were used for the longitudinal
      study. Comparisons with students in other London schools indicated that the study
      groups were representative of all London medical students. The second study was
      cross-sectional comparing final year data from 1983 and 1991 at three London
      medical schools. The first study results suggest that students enter medical
      school with values and opinions about their work which remain, on the whole,
      unchanged until they leave. There were significant decreases in the
      attractiveness of four attributes, but none became significantly more attractive.
      The second study revealed little change, five attributes were significantly less
      attractive 8 years later. In both studies most of the changes related to
      organisational rather than patient-related attributes. This may reflect greater
      realism about doctors' work. Comparison of final years students' data with
      published data from the mid-seventies confirms the overall stability of these
      values. It is suggested that specialists could use this information to highlight
      the desirable aspects of their work and so 'sell' their discipline to students
      and newly qualified doctors.

PMID- 8480228
TI  - Methodology of dietary investigation.

PMID- 8480229
TI  - W.H.R. Rivers and the anthropology of psychiatry.

PMID- 8480230
TI  - The impact of war on children's health in Mozambique.
AB  - Since 1982, South African destabilization of Mozambique has caused children's
      health to deteriorate. Destabilization has functioned through support of a
      surrogate movement and economic pressure. Attacks on economic and civilian
      targets have included the health services, leading to closure of 48% of the
      primary health care network. The war has caused displacement of over 3,000,000
      persons and an estimated 494,000 excess childhood deaths between 1981 and 1988.
      An estimated 200,000 children have been separated from their families or
      orphaned; many children have also witnessed atrocities and suffered violence. A
      deepening economic crisis has been followed by an economic structural adjustment
      programme. Responses to the war include changes in vaccination strategy and
      programmes to reunite families and heal psychological trauma.

PMID- 8480231
TI  - Obstacles to medical audit: British doctors speak.
AB  - Currently, British doctors are being encouraged by government, managers and their
      professional associations to undertake medical audit. How easy a task will it be
      to introduce audit? In an attempt to find out, doctors working in general,
      geriatric and accident and emergency medicine in four district general hospitals
      were interviewed. Twenty-eight consultants and 34 junior doctors participated.
      Generally speaking, doctors accepted the need for audit. In this paper we have
      focussed deliberately on their worries, since it is these which are of most
      importance in developing better methods of implementation. The 19 obstacles to
      audit that respondents identified can be grouped into four categories:
      perceptions of the need for and the role of audit; practical considerations; the
      effects of audit; and anxieties about the use of audit. In general, criticisms
      were levelled at the way audit was being implemented rather than at the
      principles of the approach. While some obstacles could be overcome by simple,
      practical measures, others will require a change in doctors' knowledge, beliefs
      and attitudes. The difficulty of achieving such changes should not be
      underestimated.

PMID- 8480232
TI  - The body: from an immateriality to another.
AB  - A first level of immateriality of the human body is very classic for
      anthropologists: it concerns the different conceptions of soul, of a supernatural
      component of the human being. It refers also to different kinds of continuity and
      exchange between the human body and society. The other immateriality appears as
      an answer to the biological reductionism of the body. As we can see in biomedical
      conception of the body, as well as in different totalitarian utopias, biological
      reductionism tends to reduce the whole person to its biological body. Consciously
      or unconsciously, people cannot accept it. Contemporary ways of healing reflect
      this contradiction: people accept biological knowledge but they do not accept a
      purely biological conception of their own body. They conceive that there is an
      immaterial part in the human body; however it is not supernatural but a part of
      nature. In this way this 'not divine immateriality' can be conciliated with some
      kind of scientific approach. The refusal to enclose the person in the biological
      body appears as a constant through human societies. At the medical level, this
      refusal is always present in the ill person's image of his body and of his
      illness. At a more general level, this refusal is probably necessary in order to
      keep human freedom as well as human specificity.

PMID- 8480233
TI  - Child health and the social environment of white and black children.
AB  - Both poverty and other factors associated with race are related to child health.
      However, the mechanisms of these relationships have not been adequately
      specified. The purpose of this study was to explore the relationship of the
      social environment to child health status in black and white children and
      further, to explore whether the patterns of the effects of social class were
      different by race. This study provides further evidence that the social
      environment is strongly associated with child health status. Several risk factors
      are similar for both white and black children: mothers who view their own health
      as fair or poor are much more likely to rate their children in poor health. The
      presence of childhood chronic medical conditions is independently associated with
      poor health status regardless of race. However, the relative importance of
      several social risks for poor health status differs between white and black
      children. Specifically, while low family income is a consistent risk factor for
      poor health among white children, low income alone is not a risk factor for black
      children. Among black children, other social risks that are associated with
      poverty, such as low maternal education and a mother's perception of her own
      health as poor, increased the risk of poorer health in the child.

PMID- 8480234
TI  - Societal and ecological determinants of urban health: a case study of pre
      reproductive mortality in 19th century Gibraltar.
AB  - A historical based enquiry of colonial Gibraltar at the turn of the 19th century
      was conducted in order to assess what factors gave rise to residential variation
      of pre-reproductive mortality. Gibraltar's unusual configuration of a port city,
      garrison town, and commercial centre at the tip of the Iberian peninsula offers a
      unique opportunity to examine the interplay of ecology, demographic and socio
      economic factors on childhood mortality. Communal living under the patio system
      and the sharing of essential resources were characteristic features of life on
      the Rock. Using the residential district as the focus of enquiry, stepwise
      regression results for the period 1879-81, designated as a period of 'low
      ecological stress', indicated that the number of gallons of potable water per
      person captured a significant amount of variability in mortality. During the year
      1878, a serious shortfall in rainfall was associated with lower life expectancy,
      a change in the seasonal pattern of mortality, and elevated rates of death
      attributable to the diarrhea complex. Under this period of 'high ecological
      stress', the percentage of servants in the household, a proxy for wealth/status,
      proved to be the single most important factor accounting for 46.6% of the
      variation in the death rate under 15. Analysis of mortality at the patio level
      revealed that residents of buildings of two household units had lower mortality
      than residents living in smaller or larger dwellings, particularly in the period
      of high ecological stress. The complex pattern of mortality at the district and
      patio level is explained in terms of the development of residential preferences
      and decentralized nature of vital resources, such as the water support system and
      food supply.

PMID- 8480235
TI  - Anti-permissive attitudes to lifestyles associated with AIDS.
AB  - AIDS is in the tradition of diseases which have given moral interpretations. One
      way in which this moralistic perspective may express itself is by members of the
      public holding high risk groups responsible for their (AIDS related) lifestyles
      and their considering AIDS to be a self-inflicted disease. A unique data source
      of 7000 verbatim comments recorded in the course of 25,000 structured Computer
      Assisted Telephone Interviews on Lifestyle and Health which contain a substantial
      component on AIDS--knowledge, attitudes, beliefs and sexual behaviour, was used
      to document negative attitudes to 'AIDS related lifestyles'. These comments
      revealed that despite evidence of concern about drug use, many respondents
      consider AIDS to be irrelevant to the majority of the population. There is some
      evidence that AIDS has contributed to reinforcing negative attitudes towards
      homosexuality and drug use, especially among older respondents. Extreme punitive
      attitudes towards high risk groups were expressed by a small minority
      (predominantly males).

PMID- 8480236
TI  - Health related response to natural disasters: the case of the Bangladesh cyclone
      of 1991.
AB  - This paper evaluates the health related response to large natural disasters using
      the example of the recent Bangladesh cyclone of 1991. After providing a
      description of the extent of the health response, it focuses on three major
      issues: (i) assessment of needs (ii) coordination of major groups involved in
      health relief and rehabilitation efforts and (iii) appropriateness and
      effectiveness of the health response in terms of definable outcome criteria. The
      conclusions are that in the case of the Bangladesh cyclone: (a) the assessment of
      needs was more reactive rather than anticipatory and was not based on any
      systematic data gathering from the field; (b) in contrast to previous disaster
      situations there was excellent coordination of the major groups involved in the
      aid process (the government, the armed forces and non-governmental organizations)
      and (c) given the caveat of inadequate baseline information, it appears that the
      health response was prompt and effective in preventing any increase in mortality
      from diarrheal diseases and measles. The reasons for the deficiencies and
      successes of the health response are analysed and finally a list of detailed
      recommendations to facilitate future disaster/cyclone management and response is
      provided.

PMID- 8480237
TI  - Towards understanding treatment preferences of hospital physicians.
AB  - Seventy-two physicians working in a university hospital in The Netherlands were
      interviewed to clarify their decision-making process when choosing drugs of
      preference. Each physician was questioned about the treatment choices for either
      one or two general case descriptions. The physicians considered only a limited
      set of different treatment options, on an average 1.7-5.0. Further, the
      physicians expressed their expectancies as regards various treatment
      alternatives, and the value or weight they attached to the principle aspects of a
      treatment. An analytical decision model was used as a reference to gain insight
      into the extent to which the physicians make decisions based on their own
      subjective expectancies and values. This model assumes that physicians follow a
      maximizing strategy by choosing the treatment they personally assess as optimal.
      It was found that a model including only biomedical expectancies and values
      predicted the preferred treatment correctly in no more than 53% of the cases.
      Sometimes, biomedical aspects were disregarded that should have been relevant
      according to the physicians themselves. Adding aspects of the social environment
      and experiences improved the prediction of the model substantially; 3 out of 4
      treatment preferences could be understood by following an analytical maximizing
      strategy including biomedical aspects and social aspects and experiences. In the
      remaining cases, the physicians were not able to describe their decision in terms
      of this maximizing strategy, which points at the use of alternative decision
      strategies. One alternative decision strategy mentioned by the physicians was a
      'follow-the-routine' decision rule.

PMID- 8480238
TI  - Maternal education and child feeding practices in rural Bangladesh.
AB  - This study in rural lowland Bangladesh used spot and event observations from 185
      children aged 4-27 months in order to examine whether child feeding practices
      differed with mother's education and with household education. Each child and
      his/her caretakers were observed for a mean of 20 hr over 6 months from February
      to July 1986. Only 25% of mothers and 51% of fathers had had any formal
      education. Exploratory partial correlations and stepwise multiple regression
      analyses revealed significant behavioral differences with both maternal and
      household measures of education while controlling for wealth. Caretakers in
      families with education were found to feed the children more frequently, with
      fresher food, and in cleaner, more protected places. They did not allow their
      children to eat food intended for someone else as often, and were more observant
      when their children's food dropped during the feeding. These caretakers also used
      more cups and bottles for feedings, breastfed their children less frequently, and
      their mothers terminated the breastfeedings more often. These behaviors suggested
      a shift from less attentive feeding practices and less frequent feedings to more
      frequent feedings in which the caretaker took more control of the child's feeding
      sessions. They also suggest a commitment to more labor-intensive child care.
      These associations between education and child feeding practices are mechanisms
      through which maternal education may improve child health and growth. They
      suggest the need for promoting more formal and nonformal education.

PMID- 8480239
TI  - Child feeding practices in a rural area of Zimbabwe.
AB  - This paper reports preliminary results from a study of child feeding practices in
      a rural area of Zimbabwe. Although Zimbabwe has relatively low infant mortality
      rates, it still has high child malnutrition rates. Several factors, including sex
      roles and relations between the sexes, access to resources, food costs and
      availability, time and energy costs of food production and preparation, and
      illness beliefs and practices, especially those concerning diarrhea and
      malnutrition, are examined as possible determinants of feeding practices and
      nutritional and health status. Results are compared to reports made by the World
      Bank and the Zimbabwe national nutrition survey. Whereas the World Bank report
      suggests a problem of late introduction of breastmilk supplements or solids, we
      found the opposite tendency of early introduction (by 3 months) of supplements.
      We suggest that mothers' pragmatic attitudes, interacting with certain social,
      cultural, and economic variables, are important factors influencing their child
      feeding decisions, especially resisting the use of commercial infant formula, at
      least in this rural area, and promoting prolonged breastfeeding.

PMID- 8480240
TI  - HIV transmission through social and geographic networks in Uganda.
AB  - Long distance drivers and prostitutes at trading centres and towns have been
      targeted as groups that engage in risky sexual behaviours that promote HIV
      transmission. While towns and stops along highways have been linked to HIV
      transmission, the role of small urban and rural centres have been overlooked.
      There is need to study socio-geographical mating networks because situations not
      deemed to be risky may be an important aspect of HIV transmission.

PMID- 8480241
TI  - Interfacing anthropology and epidemiology: the Bedouin Arab Infant Feeding Study.
AB  - This paper encapsulates a 10 year effort of multi-disciplinary research on the
      relationship between infant feeding, growth, and morbidity among the Negev
      Bedouin Arabs of Israel as they underwent a transition from semi-nomadism to
      urban settlement. The research team was multi-disciplinary including a
      nutritional epidemiologist and an anthropologist who both came to the study with
      previous experience in interdisciplinary work. The specific study objectives were
      (1) a description of infant feeding practices among Negev Bedouin Arab women at
      various stages of settlement, (2) an examination of the trend in these infant
      feeding practices, (3) a comparison of the extent to which different infant
      feeding practices are related to infant morbidity and growth after adjustment for
      exposure to social change and other covariates. The data collection took place in
      1981-83 and the analysis from 1984-88. In this paper, two areas of the study are
      discussed in depth: the duration of exclusive breast feeding during the practice
      of the traditional postpartum 40 day rest period, and the development of a
      culture-specific scale of socioeconomic status. Through these examples, we
      highlight the use of ethnographic data and the merging of epidemiology and
      anthropology from hypothesis generation through data collection, data analysis
      and interpretation.

PMID- 8480242
TI  - Prostitution and the military: planning AIDS intervention in Belize.
AB  - First world militaries based in 'third world' countries offer an appropriate
      context for developing AIDS intervention models that are keyed to large-scale
      population movements and regional differences in HIV infection. In this work, the
      ethnographic concept of 'social interface' replaces the epidemiological concept
      of 'risk group' to allow for a more dynamic analysis of the particular forms of
      interactions between groups that may be linked to the sexual transmission of HIV.
      The social interface between military and sex workers in Belize displays two
      distinct forms of organization: (1) 'recognized prostitution' in health-regulated
      brothels, and (2) 'quasi-prostitution' in non-health regulated public sites such
      as bars and hotels. These two forms are also distinguished by the ethnicity,
      national origin, and professional identity of sex workers. Based on survey-form
      participant-observation in Belize and cross-cultural data on condom use, the
      social identity of sex workers emerges as a factor crucial to understanding how
      public health information is incorporated by heterosexuals who put themselves at
      risk for HIV in different social contexts. The scope of analysis shifts between
      the personal and transnational; discussion of the possibilities for inter
      governmental negotiations regarding AIDS policy issues is included.

PMID- 8480243
TI  - Role conflict: cause of burnout or energizer?
AB  - A year-long study of public child welfare administrators examined the effects of
      role conflict on their attitudes and performance. Popular belief and some of the
      literature have suggested that burnout is inevitable for those confronted with
      role conflict. Other literature has proposed that it may instead be energizing to
      individuals and lead to greater personal and organizational effectiveness. This
      qualitative study found that individuals in the study had developed specific,
      effective skills for responding to role conflict. Although there was a public
      presentation of self that indicated they were under stress and in "impossible"
      situations, there was in fact an energizing effect resulting from the ongoing
      challenge of dealing with conflict.

PMID- 8480244
TI  - Facilitating support groups for professionals working with people with AIDS.
AB  - Social workers, nurses, and other health care professionals who work with people
      with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome
      (AIDS) are experiencing burnout from the excessive demands on their energy,
      strength, and resources. Support groups, with their focus on awareness, shared
      experiences, supportive and helping relationships, and the emotional consequences
      of working with people with AIDS, help health care professionals manage stress
      and enhance their capacity and effectiveness to work with these clients. In
      addition, support groups help participants feel less isolated and share feelings
      regarding such difficult issues as death, anger, helplessness, and loss. The use
      of this type of group work is identified, including its administration, effective
      intervention techniques, and issues of health care professionals who work with
      the HIV/AIDS epidemic. Problems related to group membership and dropout rates are
      explored as unresolved issues.

PMID- 8480245
TI  - Effects of social support and undermining on African American workers'
      perceptions of coworker and supervisor relationships and psychological well
      being.
AB  - Although social undermining is a commonly experienced stressor in human services
      workplaces, it has received little study in contemporary models of social work
      stress and burnout. Furthermore, African Americans currently make up nearly 25
      percent of self-identified social workers in the United States, yet most
      literature on personnel relationships in human services does not reference this
      group. Data collected from a national sample of 288 African American members of
      the National Association of Social Workers were used to investigate the impact of
      undermining among coworker and supervisor-supervisee relationships. Multiple
      regression analyses revealed substantial increases in irritability, depression,
      anxiety, and depersonalization among social workers when social undermining was
      included in a set of predictor variables (age, gender, and social support). The
      presence of social support, however, did not diminish the impact of undermining.
      The authors discuss several practice and training implications of these findings.

PMID- 8480246
TI  - Classification and correlates of ethical dilemmas in hospital social work.
AB  - The authors used categories based on the NASW Code of Ethics to code hospital
      social workers' descriptions of ethical dilemmas according to the specific
      principles in conflict. They also developed codes to identify discharge
      destination and medical care issues involved in the ethical dilemma. Most ethical
      dilemmas were found to involve conflicts between client self-determination and
      client best interest. Ethical dilemmas were more likely when patient mental
      status was impaired and when decision making was problematic. Ethical dilemmas
      were related to delayed discharge, in-hospital mortality, and less-than-adequate
      postdischarge care. The study enhances understanding of ethical dilemmas and
      advances a methodology for studying their occurrence and consequences.

PMID- 8480247
TI  - Record keeping: directions for the 1990s.
AB  - In studies conducted in the late 1980s, managers and direct service workers
      agreed that their biggest record-keeping problems were caused by lack of time.
      This article describes how 114 agencies in 20 states tried to resolve this
      problem Agencies were more successful when they simplified recording and
      allocated new resources to the task. This article outlines the techniques these
      agencies used and contrasts those that were more successful with those that had
      mixed or poor results. The findings suggest directions for record keeping in
      social services agencies in the 1990s, when agencies will face critical choices
      about how to use limited resources.

PMID- 8480248
TI  - Suicide prevention: a classroom presentation to adolescents.
AB  - The increase in attention given to adolescent suicide has led to a proliferation
      of suicide prevention programs in schools throughout the United States. Concern
      is mounting over the benefits of these programs. The author, with the same
      concern about his own suicide prevention program, subjects his program to a
      statistical analysis of effectiveness. Results show that a disturbingly high
      proportion of adolescents had undesirable attitudes about suicide in the baseline
      period. The program appears to have caused a significant shift from undesirable
      to desirable attitudinal responses in six of eight targeted areas. In addition,
      the results seem to dispel a commonly held belief that associating mental illness
      with suicide will diminish self-disclosure.

PMID- 8480249
TI  - Misdiagnosing assessment.

PMID- 8480250
TI  - [The right to health among all individuals and social groups is an exigency of
      man and a responsibility of the state and of society].

PMID- 8480251
TI  - [The Free Trade Agreement and environmental health in Mexico].
AB  - This work offers an overview of the state of the art and future state of
      environmental health in our country from a viewpoint of the impact of the
      commercial opening established in the Free Trade Agreement among Mexico, the USA,
      and Canada. In the first section of this work, we analyze the expected economic
      changes resulting from the implementation of the FTA and foretells the way in
      which those changes will influence the present environmental and epidemiologic
      profiles of this country in the medium and long term. The main changes predicted
      by the analysis are, in the epidemiologic context, the acceleration of the
      transference of occupational, consumption, environmental and population risks,
      characteristic of industrialized countries, to the country's polarized
      epidemiologic profile; and, in the environmental context, a transition consisting
      of a broadening and composition of the spectrum of pollutants, including and
      important lagging of bacteriologic control. The second section offers an analysis
      of the predicted response capacity facing the new environmental risk dynamics in
      the country, encompassing regulation, normativeness and enforcement of
      environmental and consumer protection, as well as obstacles found in health
      services to the implementation of surveillance, detection and treatment of health
      damages caused by environmental factors. The analysis of the organized social
      response to these problems discloses a relative flexibility of the normativeness
      and enforcement functions in comparison with our northern neighbors, a paramount
      factor for the possible transference of environmental risks, as well as the
      informational and research deficiency about environmental issues, basic elements
      for sustaining environmental health in the country, aiming at speeding up the
      development and transference of technologies for prevention, detection and
      management of environmental risks in the country, drawing upon the
      systematization of our experience and that of our neighbors. This speeding
      process ought to match, in the medium term, the velocity of risk transference
      produced by the commercial opening. In this way, the commercial integration of
      North America will become a favorable context for the development of the
      environmental health infrastructure of the country.

PMID- 8480252
TI  - [Mortality in young adults: international comparisons].
AB  - In searching for an epidemiological indicator which might reflect the impact of
      the widespread use of various drugs among California youth in the late 1960s, the
      customary sources of health statistics were found to be unsatisfactory due to the
      lack of consensus on diagnosis of drug related problems. Examination of mortality
      of young adults (persons aged 15-24, YAM) showed marked and paradoxical rises
      when drug use was rising. Males and Blacks had higher rates than females and
      Whites; motor vehicle accidents were the largest single overall cause. But the
      rise, both in California and the US was proportionally greater among women and
      motor vehicle accidents did not contribute to the rise. Examination of rates
      during mid-1970s for various countries showed that for countries with per capita
      income less than about $3,000 per year, YAM due to diseases was very closely
      correlated with per capita income. Above that external cause, YAM and
      particularly that due to motor vehicle accidents, increased with per capita
      income. The increase was steeper in some countries than in others. The difference
      in these two groups of countries was correlated with fraction of national income
      spent on education and with ethnic homogeneity. In the US fluctuations in YAM
      paralleled admissions for heroin use. As part of the Epidemiological Revolution,
      young adult mortality complements infant mortality, since it is closely related
      to social health, employment opportunities and appropriateness of education.
      Further, it is important for the potential development of a country, region, or
      community. This report examines YAM data for mid-1980s from selected countries
      and notes major changes during the past decade, most countries having shown
      striking decreases. In some countries high rates of suicide, homicide and death
      due to civil disorders provide an incentive for further improvement. In other
      countries, the high rates for death attributed to motor vehicle crashes compels
      attention. Involvement of young persons themselves in plans for improvement of
      their opportunities seems an essential strategy, for which the educational
      strategies suggested by Freire seem to be appropriate.

PMID- 8480253
TI  - [Women and violence: an everyday fact].
AB  - In comparison with other countries, Mexico lacks information on the issue of
      violence against women, especially regarding the incidence and prevalence of
      battering and emotional abuse. The aim of this study was to determine the
      frequency and distribution of violence against women among both rural and urban
      populations in the state of Jalisco, Mexico. A cross-sectional study was
      conducted among two groups randomly selected; 1,163 rural women (RW) and 427
      urban women (UW). Variables included: frequency of violence of family members
      against women and vice versa, socioeconomic variables and reason for violence.
      The results were: a) 44.2 per cent and 56.7 per cent rural and urban female
      population, respectively, suffered some form of violence; b) the principal
      aggressor was the husband in more than 60 per cent of the cases in both rural and
      urban areas. Significant statistical difference (p < 0.05) were found between
      rural and urban groups in relation to low education, middle-age and family size
      over 7 members.

PMID- 8480254
TI  - [Patterns of medical prescriptions for individuals with diabetes mellitus type 2
      at the primary care level].
AB  - A cross-sectional study was conducted to investigate the prescription patterns of
      general practitioners for non-insulin dependent diabetes mellitus patients in
      Guadalajara, Mexico. Two hundred and forty medical prescriptions were evaluated.
      These were indicated by 16 primary care physicians. Results showed that
      physicians prescribed pharmacologic agents in 93 per cent of the cases, dietary
      control in 73 per cent, and physical exercise in 48 per cent. A combination
      therapy of these three measures was employed in 40 per cent of the patients, but
      the combination regimen of diet and exercise was given only to 3 per cent of the
      patients. Data showed significant differences in prescribing patterns according
      to gender of physicians; male physicians prescribed the three measures by more
      than 10 per cent; On the contrary, female physicians prescribed the drug as the
      only therapy 27 per cent of the time. The proportion of prescribing diet and
      exercise measures increased with more years of professional experience. These
      observations support the findings that prescription patterns by primary care
      physicians do not meet the criteria currently recommended by international
      committees for diabetes therapy. We discuss some implications for the metabolic
      control of the disease and the quality of medical care.

PMID- 8480255
TI  - [A self-care group in diabetes mellitus type 2].
AB  - The present work presents the experience of a diabetes self-care group in San
      Antonio Tecomitl, Milpa Alta, D.F., Mexico. Diabetes is a serious disease posing
      a public health problem in our country, since it affects a great number of
      productive age persons, causing, if uncontrolled, deleterious effects on their
      life quality and expectancy because of vascular and neural complications. We
      carried out an intervention in six female patients diagnosed as having diabetes
      mellitus type II, with different stages of the disease; all of them were
      residents of Milpa Alta municipality, with an average age of 63.6 years. They
      were receiving different doses of oral hypoglycemic agents. The group of patients
      met once a week for two-hour sessions in which they received: a) information
      about diabetes mellitus, b) self-care training and c) profound relaxation
      techniques. In each session we evaluated glycemia, body weight and blood pressure
      in each patient. Results from the intervention showed no correlation between body
      weight and blood pressure, though there was a significant variation in glycemia
      levels after the intervention.

PMID- 8480256
TI  - [The use of personal computers and health damage in the workers of a daily
      newspaper].
AB  - We present the results of a research work carried out in 1989 in newspaper
      workers in Mexico City. This research was supported by the worker's Union. The
      main objective was to identify health occupational problems related with the use
      of personal computers (PC). The results of this work intended to be used for
      promoting preventive measurements to be included in the worker's contract. We
      found some evidences of an association between the use of PC visual fatigue and
      muscle pain as well as of an association between myopia and astigmatism, although
      it was not possible to demonstrate their relationship with PC. However, the
      chronic evolution of visual fatigue can induce refraction problems. In relation
      to the presence of stress and its subjective symptoms, we confirmed that the
      existence of psychological and physiological symptoms were greater in workers
      that use PC. It was also observed that these subjective symptoms have a very
      close relationship with the work contents more than with the use of the PC
      itself.

PMID- 8480257
TI  - [The privatization of public services. The case of health services in Costa
      Rica].
AB  - This article analyzes the role of the State and public enterprises in the
      development of nations, from a particular standing point, and inquires into the
      privatization issue, reviewing both its concept and the possible mechanisms for
      its implementation. Also, emphasis is made on the selling of public enterprises
      as one of the several ways to privatize. Within this context, some measures for
      the reorganization of the Costa Rican National Health System are proposed. These
      measures uphold fundamental values of social justice. This article is based on a
      theoretical-conceptual framework from an innovative experience in health services
      management in Costa Rica, in which a self-managing cooperative society (a
      nonprofit enterprise) manages, by contract with national health care public
      institutions, an urban local health care system.

PMID- 8480258
TI  - [The validation of qualitative nutritional indicators: the Guttman Scale vs the
      customary diet].
AB  - The purpose of this study was to assess the validity and feasibility of using the
      Guttman Scale as an indicator of usual dietary intake. Validation was done by
      comparing the results of dietary intake of a population obtained by using the
      Guttman Scale with a well-known method for evaluating dietary intake: the dietary
      history (one week). The study was done in seven communities in the state of
      Puebla, Mexico. Results from this study showed a weak correlation between the
      Guttman Scale with socioeconomic status and nutritional status. However, the
      results obtained with the dietary history method had a significant relationship
      with socioeconomic status and nutritional status. The conclusions are that the
      Guttman Scale has limitations when it is used as an alternative to the dietary
      history method for evaluating the total caloric intake, though it can be useful
      to determine dietary patterns of the individual.

PMID- 8480259
TI  - [An evaluation of the new program of Master of Sciences in Environmental Health].
AB  - Our country is presently undergoing a historical, environmental and economic
      transition, along with an intense industrial expansion. As the rapid
      industrialization has not run parallel with the strengthening of environmental
      sanitary infrastructure, metropolitan cities have grown anarchically, turning
      over excessive amounts of air, water and soil pollutants. The harmonic
      combination of development, environment and health requires the supervision of
      trained human resources. The scarcity of such resources is a major restriction to
      overcome. In response to the lack of human resources devoted to environmental
      issues, the School of Public Health of Mexico established the Specialty of
      Environmental Health. In coordination with experts and decision makers from the
      health services, this specialty was reorganized in a Master of Science Degree in
      Environmental Health. Several institutions participated in this program actively,
      either with financial support or with human resources. The major obstacle to the
      continuity of the Program has been the lack of institutional financial support
      for students to devote fully to the programs. Nevertheless this Master's Degree
      is expected to undergo intense development in coming years. In the future, this
      program will have to reduce its epidemiologic focus and adopt a more general one.
      Efforts will be directed toward a wider national and international projection.

PMID- 8480260
TI  - [Bioethics and environmental health].
AB  - Institutions such as World Health Organization and United Nations have considered
      the necessity to establish programs to control and preserve our environment. From
      the beginning, industrial development has polluted the air, water and soil, in
      some cases irreversibly affecting the ecosystems. Rampant use of natural
      resources and inattention to preventive measures have promoted environmental
      pollution, along with its hereditary effects, producing brain damage,
      intoxications, cancer, and respiratory and cardiovascular conditions, among other
      problems. It is necessary to put aside self-serving materialism and individualism
      and become aware of this problem. It is necessary to implement environmental
      policies, foster bioethical responsibility in environmental health research,
      conduct epidemiologic, biomedical and toxicologic environmental health research
      works if we are to have a worthy life and an optimal environment.

PMID- 8480261
TI  - [Historical and practical treatise on vaccines. 1803].

PMID- 8480262
TI  - Intraoperative cholangiography for laparoscopic cholecystectomy.
AB  - Intraoperative cholangiography in the course of laparoscopic cholecystectomy is
      not only valuable to detect common bile duct stones, but also to delineate the
      anatomy of the biliary ducts, facilitate the dissection, avoid injuries to the
      biliary tract and identify other abnormalities, such as fistulas, cysts and
      tumors of the biliary system. Most surgeons use a variation of the transcystic
      injection of contrast. We describe herein a technique of cholangiography through
      the gallbladder, performed before starting any dissection in the cystic duct
      area, which has resulted in a rate of 92 percent of adequate cholangiograms and
      has proved to be easier, by far, and safer than the transcystic technique. A
      comparison was made between 405 instances of open cholecystectomies and 200
      laparoscopic cholecystectomies with transcystic cholangiograms and 105
      laparoscopic cholecystectomies with cholangiograms done through the gallbladder.
      All instances were done for symptomatic chronic or acute calculous cholecystitis.
      Satisfactory cholangiograms were obtained in 95 percent of open cholecystectomies
      and in only 68 percent of transcystic laparoscopic attempts. Complications and
      false-positive findings were seen in transcystic laparoscopic procedures in five
      and six instances, respectively. Cholangiography performed through the
      gallbladder was 100 percent successful among 73 patients with chronic
      cholecystitis and in 66 percent of 32 patients with acute calculous
      cholecystitis. For optimal visualization of the bile ducts, it is essential to
      exert pressure on the gallbladder after the injection of contrast to advance the
      contrast through the cystic duct. This is greatly facilitated by the use of a
      double-balloon catheter to avoid leak at the site of the gallbladder puncture.

PMID- 8480263
TI  - Increasing antibiotic dose decreases polymicrobial infection after hemorrhagic
      shock.
AB  - Hemorrhagic shock has been shown to increase the susceptibility to infection
      despite the administration of conventionally accepted doses of antimicrobial
      drugs. The efficacy of increasing antibiotic dose in a model of mixed gram
      negative infection, both with and without hemorrhagic shock, was examined. Shock
      was induced by bleeding rats to a mean arterial pressure of 45 millimeters of
      mercury for 45 minutes followed by resuscitation with shed blood and saline
      solution. One hour after shock or sham, the rats were inoculated with 1 x 10(8)
      Escherichia coli plus 1 x 10(9) Bacteroides fragilis in a fecal suspension
      subcutaneously. Rats were given either no antibiotic (CONTROL) or cefoxitin at 30
      milligrams per kilogram (STANDARD) or 200 milligrams per kilogram (HIGH)
      intraperitoneally, 30 minutes before and at six and 12 hours after inoculation.
      Tissue cefoxitin concentrations were measured 30 minutes before and at six and 12
      hours after inoculation. Tissue cefoxitin concentrations were measured 30 minutes
      after the initial dose. STANDARD reduced abscess diameter by 58 percent compared
      with CONTROL in rats that were not shocked, but only by 26 percent after shock (p
      < 0.05 shock versus sham). HIGH further decreased abscess diameter and weight (4
      +/- 1 millimeter and 22 +/- 22 milligrams) after shock compared with STANDARD (9
      +/- 1 millimeter and 230 +/- 90 milligrams; both p < 0.05). Peak tissue cefoxitin
      levels were greater than 19 times the minimal inhibitory concentration for each
      bacteria for HIGH compared with eight times for STANDARD. These data demonstrate
      that an increased dose of cefoxitin was superior to a conventional dose in
      controlling a mixed gram-negative infection after shock and suggest that altering
      traditional antibiotic use may decrease the incidence of infection after shock
      and hemorrhage.

PMID- 8480264
TI  - Ketorolac and patient controlled analgesia in the treatment of postoperative
      pain.
AB  - Ketorolac tromethamine (Toradol [Syntex, Palo Alto]), a new commercially
      available nonsteroidal antiinflammatory drug (NSAID), has appropriate solubility
      and minimal tissue irritation, making it suitable for intramuscular injection.
      Previously, NSAID have only been available for oral use in the United States for
      the treatment of pain. Ketorolac, the most potent NSAID known, relieves pain
      through inhibition of arachidonic acid synthesis at the cyclooxygenase level and
      has no central opioid effects. The results of previous studies using parenteral
      ketorolac in combination with patient administered narcotics have shown a 40
      percent reduction in narcotic requirements. However, ketorolac is presently only
      approved for intramuscular injection and oral use in the United States. In a
      prospective, randomized study, we compared intramuscular ketorolac in combination
      with patient controlled intravenous narcotic analgesia (morphine) (PCA-M) to PCA
      M alone for the control of pain after extensive colonic resections. The
      combination of intramuscular ketorolac and PCA-M provided equal pain relief with
      no increased side effects when compared with narcotics alone. However, narcotic
      requirements of the patients were decreased by an average of 45 percent.
      Ketorolac and narcotics in combination provide effective postoperative pain
      relief and significantly decrease narcotic requirements. This combination may be
      particularly beneficial in the subpopulation of patients especially prone to
      narcotic related complications.

PMID- 8480265
TI  - Hysteroscopic metroplasty with resectoscope or microscissors for the correction
      of septate uterus.
AB  - During 1990, we performed hysteroscopic incision of uterine septum in 23 women
      with repeated abortion. The patients were allocated randomly to metroplasty with
      resectoscope (12 patients in group 1) or microscissors (11 patients in group 2)
      to compare surgical feasibility and anatomic results with these instruments. The
      uterine cavity was distended by instillation of sorbitol and mannitol solution
      under manometric control. Two patients in group 1 and three in group 2 had a
      complete septum. In group 1, the mean operating time, plus or minus standard
      deviation (S.D.), was 22 +/- 6 minutes compared with 17 +/- 5 minutes in group 2
      (p = 0.06). The mean amount of distension medium used, plus or minus S.D., was
      890 +/- 153 milliliters in group 1 versus 671 +/- 170 milliliters in group 2 (p =
      0.003). One woman in group 1 with complete uterine septum had a uterine
      perforation that was managed conservatively. Postoperative morbidity for the
      entire series was negligible. At follow-up ultrasonography and hysteroscopy
      performed two months postoperatively, a residual fundal notch > or = 1 centimeter
      deep was detected and corrected in four patients in group 1 and two in group 2.
      Our findings indicate that, in terms of operating time and efficacy, the
      resectoscope and microscissors are equally valid instruments to correct a septate
      uterus, with a feasibility rate of 100 percent.

PMID- 8480266
TI  - Evidence of venous stasis after abdominal insufflation for laparoscopic
      cholecystectomy.
AB  - Intraoperative venous stasis may increase the risk for perioperative deep vein
      thrombosis and pulmonary embolism. To determine if abdominal insufflation during
      laparoscopic cholecystectomy causes venous stasis, eight patients undergoing this
      procedure had their left common femoral veins examined by a duplex scanner before
      and after abdominal insufflation; the veins then were examined again before and
      after deflation. The right femoral veins were catheterized to measure femoral
      venous pressures. Abdominal insufflation to 14 millimeters of mercury pressure
      increased femoral venous pressures (10.2 +/- 4.1 millimeters of mercury to 18.2
      +/- 5.1 millimeters of mercury; p < 0.001) and slowed peak blood velocities (24.9
      +/- 8.5 centimeters per second to 18.5 +/- 4.5 centimeters per second; p < 0.05)
      without changing the cross-sectional areas (1.1 +/- 0.4 centimeter squared to 1.2
      +/- 1.5 centimeter squared; p = NS) of the common femoral veins. Insufflation
      also reduced or eliminated pulsatility in the common femoral veins in 75 percent
      of the patients, indicating that insufflation was causing partial proximal venous
      obstruction. After 80 +/- 21 minutes of surgery, these changes remained
      significant. Deflation of the abdomen restored normal venous pulsatility in all
      patients, reduced femoral venous pressures (18.5 +/- 5.2 millimeters of mercury
      to 12.2 +/- 9.8 millimeters of mercury; p < 0.001), increased the peak blood
      velocities (14.2 +/- 6.8 centimeters per second to 28.1 +/- 16 centimeters per
      second; p < 0.05) and decreased the cross-sectional areas (1.4 +/- 0.6
      centimeters squared to 0.9 +/- 0.4 centimeters squared; p < 0.05) of the common
      femoral veins, indicating venous decompression had occurred. The results suggest
      abdominal insufflation causes venous stasis during laparoscopic
      cholecystectomies. Measures shown to reduce intraoperative venous stasis, such as
      pneumatic compressive stockings, may benefit patients undergoing these
      procedures.

PMID- 8480267
TI  - Laparoscopic treatment of adnexal torsion.
AB  - Adnexal torsion remains an infrequent and difficult to diagnose gynecologic
      emergency. Until recently, laparoscopic diagnosis was followed by laparotomy.
      Now, with proper laparoscopic technique, it is possible to untwist the adnexa or
      to remove it with excellent results. We report herein our cumulative four year
      experience with laparoscopic detorsion or removal of the adnexa in 41 patients.
      Ten patients were simultaneously pregnant, seven having the ovarian
      hyperstimulation syndrome, six with paraovarian cysts and 18 with idiopathic
      torsion. All of the women had an uneventful recovery, with 14 of 19 patients who
      claimed desire for pregnancy becoming pregnant within one year after the
      procedure, emphasizing its advantages and safety.

PMID- 8480268
TI  - The use of oximetry in determining intestinal blood flow.
AB  - The intraoperative evaluation of intestinal ischemia and viability is often
      subjective and unreliable. The results of recent reports of pulse and surface
      oximetry have suggested that these techniques may be useful in assessing
      intestinal blood flow. In the current study, we evaluated and compared the
      ability of intestinal tissue oxygen saturation (as measured by pulse oximetry)
      and intestinal surface oxygen tension (as measured by surface oximetry) to
      determine the actual intestinal tissue blood flow (as measured with a
      radiolabeled microsphere technique). In five dogs, tissue oxygen saturation,
      surface oxygen tension and blood flow of the proximal and distal parts of the
      small intestine were measured under basal conditions. A clamp placed around the
      root of the superior mesenteric artery was then tightened to decrease the blood
      flow through this artery (as measured by an ultrasonic flow probe) by 50 percent
      and then by 75 percent, repeating all measurements after each reduction. The two
      consecutive reductions in superior mesenteric artery blood flow resulted in an
      average 54 and 76 percent reduction in tissue blood flow, respectively. As a
      result of these reductions in tissue blood flow, the average intestinal tissue
      oxygen saturation (percentage), as determined by pulse oximetry, decreased
      significantly from a basal value of 93 +/- 1 to 83 +/- 1 (p < 0.05) and then to
      76 +/- 1 (p < 0.05) with the two progressive blood flow reductions. Intestinal
      surface oxygen tension decreased more steeply, from a basal value of 97 +/- 1 to
      80 +/- 6 (p < 0.05) and then to 64 +/- 7 millimeters of mercury (p < 0.05) with
      the same two reductions in tissue blood flow. Both techniques were capable of
      estimating tissue blood flow, but pulse oximetry was quicker and simpler to use.
      We conclude that the pulse oximeter has the potential to be of value in the
      intraoperative assessment of intestinal blood flow.

PMID- 8480269
TI  - Burn induced cardiac dysfunction is reduced by pentoxifylline.
AB  - Thermal injury impairs cardiac contractility and slows isovolumic relaxation;
      these myocardial defects persist despite adequate fluid resuscitation. Results of
      previous studies suggest that myocardial dysfunction occurring after thermal
      injury results from the byproducts of activated neutrophils and other
      inflammatory mediators. Pentoxifylline (PTX) (Hoechst-Roussel Pharmaceuticals)
      has been shown to modulate many of the deleterious effects mediated by the
      neutrophil. In the current study, isolated coronary perfused hearts of rats were
      used to determine if PTX improved cardiac dysfunction after burn injury.
      Parameters measured included left ventricular pressure (LVP), maximal rate of LVP
      rise (+dP/dt max) and fall (-dP/dt max). Full thickness scald burns averaging 40
      percent of total body surface area (burn groups, n = 22) or zero percent for sham
      burns (n = 10) were produced using a template device. Ten rats with burns were
      not fluid resuscitated and served as untreated burns. An additional 12 burned
      rats received PTX intraperitoneally (50 milligrams per kilogram) 30 minutes, six
      hours and 20 hours after thermal insult. The results of ex vivo studies confirmed
      significant burn mediated cardiac dysfunction as indicated by a decrease in LVP
      (55 +/- 4 millimeters of mercury, p < 0.001), +/- dP/dt max (1,063 +/- 119
      millimeters of mercury per second; 874 +/- 82 millimeters of mercury per second,
      p < 0.001) and a downward shift of LV function curves from those obtained for
      sham-burn hearts. However, hearts from burned rats treated with PTX had
      significantly higher LVP (76 +/- 3 millimeters of mercury, p < 0.001) and +/-
      dP/dt max (1,790 +/- 54 millimeters of mercury per second; 1,334 +/- 50
      millimeters of mercury per second, p < 0.001) compared with hearts from untreated
      burned rats and generated LV function curves comparable with those calculated for
      sham-burned rats. The current data indicate that PTX attenuates postburn cardiac
      dysfunction and suggest a potential role for the adjunctive use of PTX after
      thermal injury.

PMID- 8480270
TI  - Surgical treatment or gastric drainage only for intestinal obstruction in
      patients with carcinoma of the ovary or peritoneal carcinomatosis of other
      origin.
AB  - The records of 38 patients with advanced carcinoma of the ovary and 21 patients
      with peritoneal carcinomatosis of other origin who were treated for relief of
      intestinal obstruction were retrospectively analyzed. An explorative laparotomy
      was performed upon 40 instances, whereas in 25 instances, a large bore draining
      tube gastrostomy was done primarily. Retrospectively, the 40 explorative
      laparotomies were performed in two separate groups of patients. The first group
      consisted of 15 patients without palpable masses or ascites and five patients
      with intestinal obstruction as the first sign of ovarian disease. Another group
      of 20 patients presented with clinically manifest ascites or palpable masses, or
      both. The patients in group 1 survived for a median time of 154 days (range of 29
      to 1,086 days) without recurrent intervention for obstruction. The patients in
      group 2 died after a median time of 36 days (three to 151 days). The explorative
      laparotomy was successful in only one patient in group 2. A third group of 25
      patients was deemed inoperable and primarily received a tube gastrostomy. Twenty
      three patients presented with ascites or palpable masses, or both. They died
      after a median time of 33 days (eight to 163 days). Surgical therapy for relief
      of intestinal obstruction should only be considered in patients who do not
      present with manifest ascites or palpable masses and in patients with carcinoma
      of the ovary for whom effective chemotherapy is available. Percutaneous
      gastrostomy should be the method of choice for other patients.

PMID- 8480271
TI  - The failure of conventional methods to promote spontaneous transpyloric feeding
      tube passage and the safety of intragastric feeding in the critically ill
      ventilated patient.
AB  - Nasoenteral tube feedings are often recommended in critically ill patients when
      gastrointestinal tract function is intact. Conventional methods of placement
      include turning the patient on the right side and the use of drugs that stimulate
      peristalsis to promote transpyloric passage. A prospective study was initially
      performed to assess the success of conventional methods used to promote
      transpyloric feeding tube placement in patients requiring assisted ventilation
      admitted to the Surgical Intensive Care Unit (SICU) (Part I of the study). In 68
      critically ill ventilated patients, placement of nasoduodenal feeding tubes was
      attempted. Successful transpyloric placement was achieved in only ten patients.
      There was no correlation between age, gender, admitting diagnosis, time of tube
      placement and successful placement. The second part of the study was initiated to
      assess the safety of nasogastric feeding in critically ill ventilated patients.
      Forty-two patients admitted to the SICU were considered candidates for
      gastrointestinal tract feeding and were fed through the gastric route. Twenty
      five patients reached enteral feeding goal rate within 72 hours, while 34
      patients achieved goal rate by five days. Eight patients required total
      parenteral nutrition to meet nutritional needs because of an inability to achieve
      adequate nutritional support enterally. There were 11 complications noted in ten
      patients, including one episode of aspiration pneumonia. The presence of
      complications was not related to age, gender, admitting diagnosis, infusion
      method or type of formula used. Duodenal intubation using conventional methods in
      critically ill ventilated patients is unsuccessful in most patients. Nasogastric
      feeding in this group of patients can be safely administered in selected
      instances.

PMID- 8480272
TI  - A randomized multicenter clinical trial of antibiotic prophylaxis of septic
      complications in acute necrotizing pancreatitis with imipenem.
AB  - Recent evidence of pancreatic penetration of several antibiotics active against
      the usual flora found in pancreatic sepsis, at therapeutic minimal inhibitory
      concentration, prompted the authors to perform a randomized, multicenter,
      clinical trial on imipenem prophylaxis in acute pancreatitis. Seventy-four
      patients with computed tomographic (CT) scans demonstrating necrotizing
      pancreatitis within 72 hours of onset were randomly assigned to two groups
      receiving no antibiotic treatment or 0.5 gram of prophylactic imipenem
      administered intravenously every eight hours for two weeks. Pancreatic sepsis was
      always detected by means of cultures (percutaneous CT or ultrasound-guided needle
      aspiration and intraoperative samples). The incidence of pancreatic sepsis was
      much less in treated patients (12.2 versus 30.3 percent, p < 0.01). Therefore,
      the authors recommend prophylactic use of imipenem in patients with acute
      necrotizing pancreatitis.

PMID- 8480273
TI  - A new approach to the treatment of nonsteroidal anti-inflammatory drugs induced
      gastric bleeding by free radical scavengers.
AB  - The effect of the free radical scavengers allopurinol (50 milligrams) and
      dimethyl sulfoxide (DMSO) (500 milligrams), taken orally four times a day, on the
      clinical outcome of hematemesis resulting from nonsteroidal anti-inflammatory
      drugs (NSAID) induced erosive gastritis was examined in a prospective randomized
      double-blinded controlled trial. In 180 fully evaluable patients with
      osteoarthritis or rheumatoid arthritis, administration of allopurinol (n = 63) or
      DMSO (n = 58) enabled significantly (p < 0.01) larger numbers of patients to
      remain hemodynamically stable with no rebleed relative to those in the control
      group (n = 59). The results of endoscopic examination 48 hours after admission
      demonstrated that gastric erosions were still present in significantly more
      patients in the control group (p < 0.01; n = 20; 50 percent) than in the
      allopurinol (n = 5; 9 percent) or DMSO (n = 4; 7 percent) groups. The radical
      scavengers also reduced the number of patients requiring blood transfusion
      because of a rebleed or continued bleeding and emergency operation relative to
      control values. It is, thus, construed that oxygen derived free radicals mediate
      the mechanism of NSAID induced erosive gastritis. Scavenging these radicals
      impairs the gastritis, stimulates healing and protects against the complications
      of its hemorrhagic episodes.

PMID- 8480274
TI  - Use of percutaneous stitches in laparoscopic mesh hernioplasty.
AB  - Sutures placed percutaneously have considerably facilitated the accurate
      intraperitoneal laparoscopic placement of synthetic mesh in the groin. The mesh
      effectively covers the abdominal wall defect, preventing further herniations in
      the area.

PMID- 8480275
TI  - End in end anastomosis to the diseased aorta.

PMID- 8480276
TI  - The usefulness of Avitene for the control of oozing in laparoscopic
      cholecystectomy.
AB  - An efficient method for the laparoscopic application of Avitene is presented
      herein. During laparoscopic operation, we cannot staunch bleeding points
      directly. Given such circumstances, the spray application of Avitene is a very
      effective method of hemostasis that should make laparoscopic operations even
      safer.

PMID- 8480277
TI  - The technique of giant prosthetic reinforcement of the visceral sac performed
      through an anterior groin incision.
AB  - The technique of giant prosthetic reinforcement of the visceral sac performed
      through an anterior groin incision is described. The procedure, which is usually
      performed through an abdominal incision, is indicated for all hernias of the
      groin that are at high risk for recurrence after classical repair and that are
      encountered unexpectedly during routine primary hernioplasty.

PMID- 8480278
TI  - The Whipples and their legacies in medicine.
AB  - George Whipple and Allen Whipple lived as contemporaries, but were not related.
      Their careers have many similarities. Both had the best available education and
      training. Both achieved distinction as administrator, educator and researcher.
      George Whipple founded the medical school at University of Rochester and was its
      first Dean for 32 years. Allen Whipple established a modern department of surgery
      at Columbia University and held the chair in surgery for 25 years. Both Whipples
      were published extensively and did extensive work on the gastrointestinal system.
      George Whipple's elucidation of the effect of liver on hemoglobin formation won
      for him a Nobel Prize. The work of Allen Whipple on the pancreas earned him the
      title of father of modern pancreatic surgical treatment. He also revitalized the
      surgical management of portal hypertension. Both Whipples were remembered with
      eponyms--George Whipple for his report on a small intestinal disease and Allen
      Whipple for his triad and operation. Both achieved international reputations and
      represented the finest embodiments of American medicine.

PMID- 8480279
TI  - Surgical treatment for tubal pregnancies.
AB  - From these data, it seems highly likely that conservation of the involved tube
      does not substantially increase the risk of a future ectopic pregnancy, although
      it does slightly increase the chance of a subsequent intrauterine pregnancy. This
      advantage of conservative therapy is also demonstrable in patients with a repeat
      tubal pregnancy. Pregnancy rates after conservative operation still compare
      favorably with those after in vitro fertilization. There seems to be a slightly
      increased risk of persistent trophoblastic activity after laparoscopic
      conservative therapy compared with conservative surgical treatment by laparotomy,
      but prospective randomized data are lacking. The psychosocial and economic
      benefits of laparoscopic treatment are well established.

PMID- 8480280
TI  - Electrophysiological characterization of rat striatal neurons in vitro following
      a unilateral lesion of dopamine cells.
AB  - The effects of a unilateral 6 to 19-week lesion of dopamine cells on the
      excitability of rat striatal neurons were investigated in vitro using the
      intracellularly recorded membrane properties of neurons obtained ipsilateral and
      contralateral to 6-hydroxydopamine (6-OHDA) injection sites. Neurons ipsilateral
      to the lesion site and in striatal tissue depleted of dopamine exhibited resting
      membrane potentials and membrane resistances similar to those recorded in
      contralateral striatal neurons. Denervation appeared to have no appreciable
      effect on the proportion of neurons exhibiting various patterns of neuronal
      spiking (repetitive, bursting, or single spike) evoked by depolarizing current
      pulses. Current-voltage determinations revealed nominal rectification in the
      majority of neurons and marked nonlinearity consistent with inward rectification
      at potentials hyperpolarized and depolarized to rest in a large proportion of the
      remaining neurons. Neurons ipsilateral to 6-OHDA lesion sites exhibited these
      relationships in the same proportion as contralateral control cells. However,
      ipsilateral neurons with nominal rectification exhibited an average rate constant
      for the early onset of small hyperpolarizing membrane transients which was
      significantly smaller than that of controls. This finding suggests that intrinsic
      membrane parameters regulating the excitability of certain striatal neurons may
      be under the influence of dopamine or other factors closely associated with
      nigrostriatal nerve terminals.

PMID- 8480282
TI  - [Development and changes in cardiology].

PMID- 8480281
TI  - Striatal binding of the PET ligand 11C-raclopride is altered by drugs that modify
      synaptic dopamine levels.
AB  - Bilateral decreases in striatal 11C-raclopride binding were observed in adult
      female baboons with high resolution PET following administration of drugs that
      act centrally on dopaminergic neurons. At baseline and following administration
      of d-amphetamine (a dopamine-releasing drug), GBR-12909 (a potent dopamine
      reuptake inhibitor), or tetrabenazine (a biogenic amine depleting drug) PET scans
      of 11C-raclopride binding were obtained in a CTI 931 positron tomograph. In all
      studies, the ratio of the distribution volumes for the striatum to the cerebellum
      for 11C-raclopride binding decreased significantly by an average of 16.2% for d
      amphetamine, 22.1% for GBR-12909, and 28.3% for tetrabenazine while there were no
      significant changes observed in the cerebellum or in the rate of systemic
      metabolism of the radiotracer. These decreases exceed the test/retest variability
      of striatal 11C-raclopride binding measured in the same animals under identical
      experimental conditions (Dewey et al., 1992b). Together these studies demonstrate
      that PET measurements of striatal 11C-raclopride binding can be used to
      indirectly and non-invasively monitor changes in synaptic dopamine concentrations
      that result from a variety of neurophysiologic mechanisms.

PMID- 8480283
TI  - [What contributes to the occurrence of sexually transmitted diseases?].

PMID- 8480284
TI  - [Prevalence of Chlamydia trachomatis in women applying for abortion in Oslo 1985
      91].
AB  - The prevalence of Chlamydia trachomatis was investigated in a retrospective study
      of 17,215 women who requested termination of pregnancy at Ulleval and Aker
      hospitals in Oslo during the years 1985-89 and 1991. The overall prevalence of C
      trachomatis decreased from 11.3% (267/2,354) in 1985 to 3.8% (112/2,958) in 1991.
      The reduction was considerable from 1985 to 1989 but only slight at the end of
      the period. The prevalence was higher in younger women during the whole period.
      In women < 25 years old the prevalence decreased from 16.7% in 1985 to 6.3% in
      1991, and in women > or = 25 years old from 5.9% in 1985 to 1.8% in 1991.

PMID- 8480285
TI  - [Follow-up after treatment of genital chlamydia infection].
AB  - We surveyed routine practice among a random sample of 302 Norwegian general
      practitioners. 49% perform a test of cure in all the patients whom they treat for
      genital infection caused by Chlamydia trachomatis. 22% of the practitioners test
      "most" patients, 19% test "some" patients while 10% of the general practitioners
      test none of the patients after treatment for genital chlamydial infection.
      Female practitioners perform more tests of cure than male practitioners do. Most
      tests are performed 1-4 weeks after completion of treatment. Although test of
      cure has been a controversial topic, we believe it to be a useful measure against
      the epidemic of genital chlamydial infections. The purposes of the test are to
      establish whether or not the treatment has been effective and ensure that the
      patient has not been reinfected by a partner who did not receive treatment. The
      test of cure must be performed later than two weeks after completion of
      treatment, in order to avoid false positive tests as a result of residual
      chlamydial antigen in the genitalia.

PMID- 8480286
TI  - [Endocrine treatment of prostatic cancer. A renaissance for parenteral estrogen].
AB  - The standard treatment for advanced cases of cancer of the prostate is
      castration. Oestrogens, administered per os may have serious side effects, in
      particular thrombosis and cardiovascular complications. If the oestrogens are
      administered parenterally, changes in liver function can be avoided and risk of
      side effects markedly reduced. 38 patients have been treated at Huddinge Hospital
      in Stockholm, and 14 patients at Aker Hospital in Oslo, with polyoestradiol
      phosphate (Estradurin) 240 mg injected intramuscularly every 4th week (initial
      dose 320 mg). We can sum up our own experience as follows: Plasma testosterone is
      reduced to castration level after 2-3 weeks. Liver function, evaluated by the
      sexual hormone binding globulin level in plasma, remains unchanged. Morbidity and
      mortality from cancer are the same as may be achieved by surgical orchidectomy.
      The only side effect of significance is gynaecomastia. Follow-up of the patients
      does not indicate any increased risk of thrombosis or cardiovascular disease. The
      treatment is fairly cheap compared with other alternative methods of endocrine
      treatment.

PMID- 8480287
TI  - [Emergency admissions to a department of internal medicine. Are departments of
      internal medicine used optimally, and how would observation units affect the
      management of the department?].
AB  - 279 consecutive emergency admissions to our Department of Internal Medicine were
      reviewed. Admission was appropriate for 58%. These patients consumed 88% of the
      "ward-days" during the period studied. Of the remaining patients, 22% could have
      been treated adequately in an observation unit, 10% need not have been
      hospitalized, and 10% should have been admitted to a different department. All
      stays in hospital lasting more than 50 days were due to lack of a place in a
      nursing home. If no patient had to wait more than 50 days, this would release 23%
      of the total "ward-day" capacity. The pressure on Departments of Internal
      Medicine could be reduced substantially by establishing observation units, and
      reducing the waiting time for a place in a nursing home.

PMID- 8480288
TI  - [The practical benefits of ambulatory continuous ECG recording].
AB  - The diagnostic yield from ambulatory continuous ECG recording (Holter ECG) has
      been evaluated retrospectively in 200 consecutive patients referred from an urban
      population of 250,000 for arrhythmia diagnosis or evaluation. About half of the
      patients were in hospital, the other half were ambulatory. In 20/200 (10%) the
      examination was obviously useful: indication for therapy was documented or
      arrhythmia and symptoms did not coincide. 53/200 (26.5%) possibly benefited, with
      qualitative or quantitative observations of clinical interest, and 127 (63.5%)
      probably did not benefit (no previously unknown findings of importance). Of the
      85 patients referred for syncope, six obviously benefited and ten possibly
      benefited from the examination.

PMID- 8480289
TI  - [Botulinum toxin. A new therapeutic alternative in spastic dysphonia (laryngeal
      abductor dystonia)].
AB  - Laryngeal dystonia is a condition characterized by involuntary spasms of the
      laryngeal muscles. In most patients this involves the adductor laryngeal muscles
      (adductor laryngeal dystonia). Treatment with a variety of therapies, including
      speech therapy and pharmacotherapy, have led to minimal improvement. Injections
      of botulinum-toxin (Botox) bilaterally into the vocalis muscles is a new
      treatment for adductor laryngeal dystonia. Since May 1991 we have treated 23
      patients with adductor laryngeal dystonia with botulinum-toxin. In 74% of the
      patients the voice improved within 24-72 hours, and effect lasted for 2-14 months
      (average four months). Most of the patients got a breathy voice and a mild
      sensation of dysphagia during the first week after the injection.

PMID- 8480290
TI  - ["Microscopic colitis" and collagenous colitis. Unusual explanation of diarrhea
      of unknown origin].
AB  - The article describes two female patients with severe diarrhoea. Both patients
      were suspected of having an organic diarrhoea syndrome and underwent extensive
      investigations. No specific diagnoses such as inflammatory bowel disease,
      pancreatic cholera, malabsorption and surreptitous ingestion of laxatives could
      be established. Histologic examination of biopsy specimens from apparently normal
      colon revealed microscopic changes characteristic of "microscopic colitis" in one
      of the patients, and of collagenous colitis in the other. The authors discuss
      similarities between these two microscopic abnormalities in colonic mucosa and
      their close association with chronic watery diarrhoea.

PMID- 8480291
TI  - [Fatty tissue necrosis and oil granuloma after subcutaneous injections of vitamin
      B12].
AB  - A patient is described who developed fatty tissue necrosis and oil granuloma in
      her thigh after repeated subcutaneous injection of vitamin B12. The injections
      were taken in a badly documented attempt to prevent migraine. The preparation
      used was vitamin B12 combined with a mineral oil to give slow release resorption.
      We describe the histopathological mechanism for reaction of fatty tissue to
      mineral oil injections. The 40 ml cavity of fat necrosis had to be drained out
      several times and over a long period of time before our patient was without
      symptoms.

PMID- 8480292
TI  - [Epilepsy and physical activity].
AB  - Physicians should encourage epileptic patients to participate in sporting
      activities to enhance their physical fitness, self-esteem and social integration.
      Since about 5% of the population with epilepsy run the risk of suffering seizures
      induced by exercise, advice on such activity should be given individually. The
      physician should have good insight into the patient's medical history and should
      be interested in, and know about the different kinds of sport. The risk of
      injuries connected to seizure must be weighed against the physical, psychological
      and social problems which may result from exclusion from sports.

PMID- 8480293
TI  - [Infectious diseases and physical activity].
AB  - Moderate physical activity has a beneficial effect on health. On the other hand,
      physical and psychological stress may have a suppressive effect on the immune
      system, implying that intense physical activity may possibly enhance the
      appearance of infectious diseases. There are no studies showing any effect on the
      immune system, nor on the frequency of infections, from physical training of low
      to moderate intensity. However, in several cases, high intensity training has
      been shown to produce chronic overtraining, which may impair general health. It
      is suggested that the extreme physical exertion of elite athletic training may
      suppress the immune system and thus lead to enhanced susceptibility to infectious
      diseases. Furthermore physical activity during the incubation period of several
      serious infectious diseases seems to be especially disadvantageous for the course
      of the disease.

PMID- 8480294
TI  - [Apolipoprotein E phenotyping--useful in the study of hyperlipoproteinemia type
      III].
AB  - Apolipoprotein E (apo E) is a protein constituent of several plasma lipoproteins.
      Its major physiological role is to mediate the interaction of these lipoproteins
      and receptors. Three common apo E alleles and six phenotypes are known. The
      phenotype E2/E2 is associated with type III hyperlipoproteinemia. As a
      consequence of the increasing clinical interest in apo E phenotypes, especially
      in relation to the diagnosis of type III hyperlipoproteinemia, we have
      established a method for apo E phenotyping. Allele frequencies from a population
      of 211 healthy individuals are presented. The results show that, like as in
      Finland and Sweden the e4 allele is more frequent than in non-Nordic countries.

PMID- 8480295
TI  - [Closed functional treatment of fractures of the ulnar shaft].
AB  - Various treatments of isolated fractures of the ulnar shaft have been attempted.
      The rates of non-union have varied widely, and impaired movement of the elbow and
      wrist is common at the end of the treatment. We present a series of eight
      patients who were treated initially with an above-elbow plaster, followed by a
      brace on the lower arm. All fractures healed with good functional results.

PMID- 8480296
TI  - [Chlamydia pneumoniae--pathogenesis and perspectives].
AB  - Chlamydia pneumoniae, a Gram-negative bacterium, formerly named TWAR but
      identified as a distinct species since 1988, is now considered to be the most
      common agent of chlamydial infection in Scandinavia. C pneumoniae has a different
      tissue trophism from that of Chlamydia trachomatis, since C pneumoniae may infect
      bronchi and lungs, macrophages, monocytes, and endothelial cells. C pneumoniae,
      like other chlamydiae, has a slow, intracellular life cycle. An absence of
      reaction from the host cells, combined with scant tissual reaction owing to the
      low endotoxic activity of chlamydial lipopolysaccharide, may help to explain the
      usually discreet clinical picture. Atherosclerosis and coronary heart disease may
      follow chronic lung infection, and acute pneumonic episodes can trigger
      myocardial infarct. Asymptomatic infection with C pneumoniae is widespread.
      Intriguing diagnostic questions are the possible existence of a non-pathogenic
      carrier state, and the conceivable sensitization of the host with respect to a
      heterotypic, secondary chlamydial infection by, for example, C trachomatis,
      giving rise to an aggravated clinical picture. Early antibiotics are indicated to
      avoid the development of chronic disease.

PMID- 8480297
TI  - [Complaints about primary care physicians].
AB  - The most serious complaints against general practitioners are investigated and
      dealt with by the Directorate of Health. A systematic review of 100 cases of
      complaint from 1983 up to 21 May 1992 showed that 57 of them concerned an urgent
      need of medical assistance and deputizing service. One-quarter of the complaints
      concerned telephone consultations. Incorrect diagnosis was the most frequent
      reason for the complaint. More than half of the cases referred to acute somatic
      diseases and accidents. The results will be used jointly by the Directorate of
      Health and the Norwegian Medical Association to improve practice.

PMID- 8480299
TI  - [Ethics and mathematics in clinical trials].

PMID- 8480298
TI  - [Cancer anxiety in Somna--created by the newspaper Dagsrevyen?].

PMID- 8480300
TI  - [Medical education--ready to fall down?].

PMID- 8480301
TI  - [After the debate on death].

PMID- 8480302
TI  - The role of acupuncture in analgesia.

PMID- 8480303
TI  - Practical management of dental hard tissue disorders in the dog.

PMID- 8480304
TI  - Perineal herniorrhaphy in the dog.

PMID- 8480305
TI  - Diagnosis and surgical modalities of megacolon in the cat.

PMID- 8480306
TI  - Surgical treatment of perianal fistulas in dogs, evaluation of 33 patients.

PMID- 8480307
TI  - Effect of slow release antibiotics on pin-tract infection.

PMID- 8480308
TI  - Arthritis--its classification, pathogenesis and clinical relevance.

PMID- 8480309
TI  - Understanding and controlling inherited diseases in dogs and cats.

PMID- 8480310
TI  - Polymorphic DNA markers for molecular diagnosis of inherited diseases in dogs.

PMID- 8480311
TI  - Adverse reactions to food [allergies].

PMID- 8480312
TI  - Liposome-enhanced tumour therapy in canine mammary gland tumours.

PMID- 8480313
TI  - Canine growth hormone regulation: new insights.

PMID- 8480314
TI  - Clinical aspects and surgical procedures in trichiasis.

PMID- 8480315
TI  - Tumours of the lid margin, corneal ulcers and perforations.

PMID- 8480316
TI  - Diseases and basic surgery of the nictitating membrane.

PMID- 8480317
TI  - Diagnostic ultrasound in companion animals.

PMID- 8480318
TI  - Contrast radiography of the gastrointestinal tract: barium or air?

PMID- 8480319
TI  - Neoplasias and pseudoneoplasias.

PMID- 8480320
TI  - Congenital and genetic skin disease.

PMID- 8480321
TI  - Behaviour problems in cats.

PMID- 8480322
TI  - Recent advances in psychopharmacology.

PMID- 8480324
TI  - Anthropomorphism, spoiling, and environmental factors.

PMID- 8480323
TI  - Nonsteroidal anti-inflammatory drugs (NSAIDS) in companion animal medicine.

PMID- 8480325
TI  - Chemotherapy in reptiles.

PMID- 8480326
TI  - Hereditary Kooiker dog ataxia.

PMID- 8480327
TI  - Activity of mouse liver glutathione S-transferases toward trans,trans
      muconaldehyde and trans-4-hydroxy-2-nonenal.
AB  - This study investigated the catalytic activities of hepatic glutathione S
      transferase (GST) isoenzymes isolated from CD-1 mice toward two activated
      alkenals of toxicological relevance: trans,trans-muconaldehyde (MA), a putative
      myelotoxic metabolite of benzene, and trans-4-hydroxy-2-nonenal (HNE), a highly
      reactive lipid peroxidation product. The activity toward 1-chloro-2,4
      dinitrobenzene (CDNB) was also determined. Four isoenzymes with pI values of 9.8,
      8.7, 6.4, and 5.7 were each isolated from male and female mice. The isoenzymes
      with pI values of 8.7 and 6.4 are pi and mu class GSTs, respectively, whereas the
      pI 9.8 and 5.7 GSTs are both alpha class isoenzymes. CDNB activity was greatest
      in the pi (pI 8.7) isoenzyme of both sexes. In addition, the CDNB activity of the
      pi (pI 8.7) isoenzyme from males was markedly greater than the corresponding GST
      from female mouse liver. In contrast to CDNB, both MA and HNE were better
      substrates for the acidic alpha (pI 5.7) and mu (pI 6.4) GSTs, whereas minimal
      activity toward either alkenal was detected in the pi (pI 8.7) and alpha (pI 9.8)
      isoenzymes. Maximum activity toward MA and HNE was exhibited by the alpha (pI
      5.7) isoenzyme of both sexes. The level of HNE activity observed with the alpha
      (pI 5.7) isoenzyme was five- to sixfold greater than that reported previously for
      any mouse GST isoenzyme. Moreover, the specific activities of the female alpha
      (pI 5.7) isoenzyme toward both HNE and MA were markedly greater than those of the
      corresponding isoenzyme from males. A similar gender-specific difference was
      noted in the activity of the mu (pI 6.4) isoenzyme toward HNE, but not toward MA.
      These results show that both MA and HNE are substrates for the alpha (pI 5.7) and
      mu (pI 6.4) GSTs of murine liver, with maximum activity toward both activated
      alkenals exhibited by the alpha (pI 5.7) isozyme. In addition, evidence is
      presented that demonstrates a female-dominant sex difference in the activity of
      the alpha (pI 5.7) isoenzyme toward MA and HNE, which contrasts sharply with the
      male-dominant activity of pi class GSTs toward CDNB. These results are consistent
      with the hypothesis that alpha and mu class GSTs are critical detoxication
      enzymes in female mouse liver, whereas pi-class GST isozymes predominate in the
      liver of male mice.

PMID- 8480328
TI  - The role of oxidative metabolism in hexachlorobenzene-induced porphyria and
      thyroid hormone homeostasis: a comparison with pentachlorobenzene in a 13-week
      feeding study.
AB  - Hexachlorobenzene (HCB) induces a broad spectrum of effects including
      disturbances in the heme synthesis (porphyria) and in thyroid hormone
      homeostasis. For most of its effects, biotransformation of the parent compound
      seems to be a prerequisite. The present study was designed to assess the
      relevance of the oxidative metabolites in HCB-induced toxicity, with special
      attention to the role of the reactive tetrachlorobenzoquinone (TCBQ). To this
      end, toxicity and biotransformation of HCB were compared with those of
      pentachlorobenzene (PCB), since this chemical is oxidized to the same products as
      HCB, i.e., pentachlorophenol (PCP) and TCBQ. Female Wistar rats received diets
      containing different dose levels of HCB or PCB for 13 weeks, with or without
      cotreatment with triacetyloleandomycin (TAO), a selective inhibitor of cytochrome
      P450IIIA1/2. Rats treated with HCB (high dose) had significantly elevated levels
      of urinary porphyrins from the 4th week on and had a significant hepatic
      accumulation of porphyrins at the end of the study. Both urinary porphyrin
      excretion and hepatic porphyrin accumulation were greatly inhibited in rats
      receiving cotreatment with HCB and TAO. However, the inhibition of HCB-induced
      porphyria by TAO cannot be explained by a diminished formation of the highly
      reactive TCBQ, since rats treated with a high dose of PCB, which had a several
      fold higher urinary excretion of PCP and TCHQ compared to a high dose of HCB, did
      not develop porphyria. Instead, the present study points to the involvement of a
      putative reactive intermediate in the primary oxidative step in HCB-induced
      porphyria, since based on paired observations of individual rats, the degree of
      porphyria was correlated to a high degree with excretion of PCP, whereas
      correlation of porphyria with early excretion of TCHQ was much weaker. This
      finding fits well with the fact that the mechanisms of oxidation of HCB to PCP
      and PCB to PCP are different. Both HCB and PCB were oxidized to PCP and
      tetrachlorohydroquinone (TCHQ), the reduced analog of TCBQ. Cytochrome
      P450IIIA1/2 appears to be involved in the conversion of HCB and PCB, since
      cotreatment of TAO resulted in a strongly diminished urinary excretion of PCP and
      TCHQ. Treatment with HCB as well as PCB results in disturbances of retinoid and
      thyroid hormone homeostasis. These effects, which have also been reported after
      exposure to polychlorinated biphenyls, originate from interference of
      hydroxylated metabolites (notably PCP) with the plasma thyroxine transport
      protein, transthyretine, and since this metabolite is formed from both HCB and
      PCB, this results in the same toxicity for both compounds.

PMID- 8480329
TI  - Investigation of a mechanism for Leydig cell tumorigenesis by linuron in rats.
AB  - In a previously conducted 2-year study, a concentration-dependent increase in
      Leydig cell adenomas was observed in Crl:CD BR(CD) rats fed diets containing the
      herbicide linuron. Linuron has been shown to be negative in a battery of six
      tests for genotoxicity; therefore, a nongenotoxic mechanism of tumorgenesis was
      investigated. Linuron is structurally related to the nonsteroidal antiandrogen,
      flutamide. Flutamide has also been shown to produce Leydig cell tumors within 1
      year, presumably due to sustained hypersecretion of luteinizing hormone (LH)
      which occurs following disruption of the hypothalamic-pituitary-testicular (HPT)
      axis. To investigate whether linuron possesses antiandrogenic activity, sexually
      immature and mature CD rats were administered either 200 mg/kg linuron or 10
      mg/kg flutamide (positive control) for 2 weeks. Accessory sex organs were weighed
      and serum hormone levels were measured to assess androgen status and alterations
      in the HPT axis. Serum from a multigeneration reproduction study with linuron was
      also analyzed for serum hormone levels. In addition, competitive receptor binding
      studies were conducted to evaluate the ability of linuron to bind to the androgen
      receptor. Linuron decreased accessory sex organ weights in sexually immature and
      mature linuron-treated rats. Increased serum estradiol and LH levels were
      observed in sexually mature linuron-treated rats. Serum estradiol and LH levels
      were also elevated in P1 and F1 male rats from the multigeneration reproduction
      study. These accessory sex organ and hormonal changes are consistent with those
      seen with the antiandrogen flutamide, the only exception being serum
      testosterone, which was elevated following exposure to flutamide but not to
      linuron. The inability of linuron to increase testosterone levels may reflect the
      lower potency of linuron as an antiandrogen compared with that of flutamide,
      which is a potent antiandrogen. Additionally, linuron competed with
      [3H]testosterone for binding to the androgen receptor. The IC50 data for
      competition to the androgen receptor suggest that linuron is approximately 3.5
      times less potent than flutamide. These data are consistent with the effects seen
      with flutamide and demonstrate that linuron is a less potent antiandrogen than
      flutamide. Collectively, these data support the hypothesis that linuron produces
      Leydig cell tumors via an antiandrogenic mechanism where sustained hypersecretion
      of LH appears to be responsible for the development of Leydig cell hyperplasia
      and adenomas.

PMID- 8480330
TI  - Maturational changes in dermal absorption of 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD) in Fischer 344 rats.
AB  - An earlier study indicated that percutaneous absorption of a 40-nmol dose of TCDD
      decreased with aging in rats, suggesting that the potential for systemic exposure
      following dermal contact would be decreased in older age groups. In this study,
      maturational changes in potential for systemic exposure to TCDD following dermal
      application of a low dose (200 pmol) of this chemical were examined in male
      Fischer 344 rats. Absorption, tissue distribution, and elimination of TCDD,
      measured as TCDD-derived radioactivity, were examined 72 hr after dermal
      application of 200 pmol [3H]TCDD (111 pmol/cm2 applied over 1.8 cm2) to the
      interscapular region of 3-, 5-, 8-, 10-, and 36-week-old rats. The dose was
      applied in 60 microliters acetone and the application site was covered with a
      perforated metal cap; animals were held in individual metabolism cages. Dermal
      absorption was greatest in 3-week-old rats (approximately 129 pmol; approximately
      64% of the administered dose), decreasing to approximately 80 pmol (approximately
      40%) in 5-, 8-, and 10-week-old rats and to 45 pmol (approximately 22%) in 36
      week-old rats. In each age group, 70 to 80% of the radioactivity remaining at the
      application site 72 hr after dosing could be removed with acetone swabs. Major
      tissue depots of radioactivity were liver and fat; skin and muscle were minor
      depots. Changes in distribution of absorbed TCDD-derived radioactivity reflected
      changes in body mass of these depots; however, tissue concentration also varied.
      Whole body dissection was performed on rats to determine body mass of tissue
      depots. Adipose tissue content (Y) increased linearly with body weight (X), Y =
      0.03X + 2.1 (r2 = 0.95). Elimination of absorbed TCDD-derived radioactivity was
      incomplete in all age groups with larger residues being recovered in the carcass.
      Results indicate that TCDD is absorbed to a greater degree through skin of very
      young animals and that a significant decrease in potential for systemic exposure
      may occur during maturation and again during aging.

PMID- 8480331
TI  - In vitro analysis of the accumulation and toxicity of inorganic mercury in
      segments of the proximal tubule isolated from the rabbit kidney.
AB  - Cellular accumulation and toxicity of inorganic mercury were studied in
      suspensions (1 mg protein/ml buffer) of proximal tubular segments isolated from
      the kidneys of rabbits. Mercuric chloride containing trace amounts of
      radiolabeled inorganic mercury (203Hg2+) was added to the buffer to produce a
      concentration of inorganic mercury ranging from 0.1 to 10 microM. Significant
      release of lactate dehydrogenase (LDH) and significant decreases in oxygen
      consumption (QO2), which were used as indices of cellular injury, were detected
      only when the tubules were in the presence of 10 microM inorganic mercury. At
      this concentration of inorganic mercury, cellular release of LDH increased and
      QO2 decreased significantly between the 1st and 4th hr of exposure, by which time
      most of the proximal tubular cells were necrotic. Maximal cellular content of
      inorganic mercury was attained within the first 5 min of exposure, during which
      time nearly 70% of the inorganic mercury in the bath was removed. Accumulation of
      mercury was more gradual when the tubules were exposed to 0.1 microM inorganic
      mercury. Addition of 40 microM glutathione, cysteine, or bovine serum albumin to
      the bath provided the segments of the proximal tubule with complete protection
      from the toxic effects of 10 microM inorganic mercury. The rate of uptake of
      inorganic mercury was also significantly decreased. By the end of 4 hr of
      exposure only about 30% of the content of mercury in the bath was abstracted.
      These findings indicate that isolated segments of proximal tubules take up
      inorganic mercury very rapidly and subsequently become intoxicated. They also
      show that when compounds containing free sulfhydryl groups are in the presence of
      inorganic mercury in the bath, the rate of uptake of inorganic mercury is
      significantly decreased and the tubules are provided protection from the toxic
      effects of the inorganic mercury.

PMID- 8480332
TI  - Potentiation and antagonism of 2,3,7,8-tetrachlorodibenzo-p-dioxin effects in a
      complex environmental mixture.
AB  - There is increasing need to understand the toxicity of complex environmental
      mixtures. The organic phase of a leachate (OPL) from the Love Canal chemical dump
      site is a complex mixture that contains over 100 organic compounds, including
      0.74 ppm 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Mice congenic at the Ah
      locus were used to evaluate several toxic effects of the OPL, including immune
      function and hepatic enzyme induction. OPL toxicity was compared with that of
      pure TCDD in both C57BL/6J Ahb/b and congenic C57BL/6 Ahd/d (B6.D2) mice. Mice
      were given single oral doses of up to 2 g OPL/kg or 100 micrograms TCDD/kg,
      immunized, and evaluated after 7 days. The TCDD equivalent of the OPL was
      determined to be 3.9 and 5.0 ppm in C57BL/6J and B6.D2 mice, respectively. This
      is six times the TCDD content. The Ah phenotype-dependent response ratio was
      calculated by dividing the dose required to cause an effect in the B6.D2 strain
      by the dose causing the same effect in the C57BL/6J strain. Ratios based on both
      ED50s and the lowest observed adverse effect levels were used to determine
      whether each adverse effect was Ah phenotype-dependent, the extent to which TCDD
      contributed to the effect, whether there were interactive effects between the AhR
      ligands and nonligands and if they were additive, antagonistic, or synergistic,
      and whether the response was predictable based on the known chemical composition
      of the mixture. It was concluded that the non-TCDD component potentiated TCDD
      immune suppression, and possibly thymic atrophy, through AhR mechanisms. In
      contrast, this analysis indicated that the non-TCDD component of the OPL
      antagonized the ability of the TCDD component to induce hepatic AHH activity
      whereas OPL hepatomegaly was caused primarily by the non-TCDD component of the
      OPL. This study demonstrates that the toxicity of mixtures containing TCDD may
      not be accurately predicted based on the TCDD content alone and that this
      approach could be useful in the toxicologic assessment and management of
      environmental contamination.

PMID- 8480333
TI  - Acute inflammatory response to sheep red blood cell challenge in mice treated
      with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD): phenotypic and functional
      analysis of peritoneal exudate cells.
AB  - TCDD is a widespread environmental contaminant of concern to human health because
      of its well-recognized immunotoxicity in laboratory animals. Suppression of the
      murine antibody response to xenogeneic erythrocytes has been shown to be one of
      the most sensitive assays for TCDD immunotoxicity. However, the cellular
      mechanisms underlying the suppressed immune function have not been fully
      elucidated. In the present studies, peritoneal macrophage recruitment,
      activation, and antigen-presenting function in response to sheep red blood cell
      (SRBC) injection were compared in C57Bl/6 mice treated with a single oral dose of
      0 or 5 micrograms TCDD/kg. In vehicle-treated mice, SRBC injection induced a
      typical inflammatory response in the peritoneal cavity. Within 6 hr, the number
      of neutrophils increased and remained elevated until 40 hr. Macrophage numbers
      increased at 24 hr and remained elevated through 72 hr. In TCDD-treated mice, a
      hyperinflammatory response to SRBC was observed. The total number of peritoneal
      exudate cells was significantly greater at 16, 24, and 40 hr after SRBC challenge
      when compared to that of vehicle-treated mice. The increased number of peritoneal
      cells reflected significant increases in both neutrophils and macrophages. Mac-1+
      peritoneal cells were examined by two-color flow cytometric analysis on Days 0-3
      after SRBC injection for expression of the activation markers F4/80 and I-A. The
      intensity of F4/80 fluorescence significantly decreased 24-72 hr following SRBC
      challenge, while fluorescence associated with I-A significantly increased at 72
      hr. These changes are consistent with macrophage activation. TCDD did not
      significantly alter F4/80 expression on Mac-1+ cells, whereas I-A expression was
      increased earlier on cells from TCDD-treated mice. However, TCDD treatment did
      not alter the antigen presentation function of peritoneal cells, assessed by
      their ability to induce the proliferation of SRBC-primed T cells in vitro. The
      antigen-presenting function of adherent spleen cells was also not altered by TCDD
      exposure. To test the hypothesis that an excess number of phagocytes in TCDD
      treated mice were clearing the antigen more efficiently, leading to a smaller
      (e.g., suppressed) antibody response, we attempted to overcome TCDD suppression
      by increasing the amount of SRBC antigen used for challenge. However, the
      magnitude of the anti-SRBC response in TCDD-treated mice was not significantly
      altered by increasing the antigen challenge dose, suggesting that enhanced
      clearance of antigen by macrophage is not a mechanism for TCDD-induced
      suppression of the anti-SRBC response.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8480334
TI  - In vivo metabolism of chloroform in B6C3F1 mice determined by the method of gas
      uptake: the effects of body temperature on tissue partition coefficients and
      metabolism.
AB  - Mice exposed to various chemicals have been shown to respond by decreasing their
      core body temperature. To examine what effect such a response might have on the
      determination of in vivo metabolism, core body temperatures of B6C3F1 mice were
      recorded with temperature telemetry devices during exposure to chloroform (CHCl3)
      in a closed, recirculating chamber (100 to 5500 ppm). Significant decreases in
      body temperature occurred in all mice exposed to greater than 100 ppm CHCl3, with
      the greatest decrease of 14 degrees C occurring at 5500 ppm. A starting CHCl3
      concentration of 4000 ppm had no effect on the 7-ethoxycoumarin O-deethylase
      (ECOD) activity or P450 levels determined at the end of a 5-hr gas uptake
      exposure. A physiologically based pharmacokinetic (PB-PK) model was developed to
      describe the effects of decreased body temperature on the analysis of metabolic
      data. In vitro ECOD activity as a measure of in vivo P450 metabolism was
      determined for temperatures ranging from 24 to 40 degrees C. In vitro enzyme
      activity decreased linearly from a maximum at 37 degrees C to one-third of this
      activity at 24 degrees C. A linear equation describing this enzymatic activity
      temperature correlation was incorporated into the PB-PK model structure to
      describe decreases in metabolic activity resulting from decreases in core body
      temperature. In vitro blood/air and tissue/air partition coefficients were
      determined for CHCl3 at temperatures ranging from 24 to 40 degrees C. All
      blood/air and tissue/air partitions increased with decreasing temperature, while
      the tissue/blood partition coefficients calculated from the tissue/air and
      blood/air partitions decreased with decreasing temperature. Adding these
      temperature corrections to the model greatly improved the overall fit of the gas
      uptake curves at all concentrations. Incorporation of a first-order metabolic
      rate constant was also required to provide an adequate representation of the data
      at high concentrations. The analysis of gas uptake data by the use of a PB-PK
      computer model is a very powerful technique for determining in vivo metabolism of
      many volatile compounds, but the incorporation of significant deviations from a
      generally used model structure (i.e., Ramsey-Andersen model) to account for
      shortcomings of the model's ability to adequately analyze a gas uptake data set
      should be based on data collection when possible.

PMID- 8480335
TI  - Ovariectomy enhances cadmium-induced nephrotoxicity and hepatotoxicity in rats.
AB  - The toxicity of cadmium (Cd) chloride was studied in ovariectomized (OX) female
      rats and non-OX female rats after intravenous administration of the compound at
      doses of 2.0 and 3.0 mg/kg for 14 days. Mild hypochromic microcytic anemia
      developed in all rats treated with Cd, but growth retardation in the OX rats was
      more prominent than that in the non-OX rats. There was an increase of AST and ALT
      and a decrease of total cholesterol and the A/G ratio in both OX and non-OX rats
      treated with Cd. The hepatic and renal Cd concentrations increased in a dose
      dependent manner, and the concentrations in both organs on Day 14 were comparable
      in the 3.0 mg/kg OX group (liver, 270.0 +/- 39.6 micrograms/g; kidney, 121.3 +/-
      10.1 micrograms/g) and non-OX group (liver, 277.0 +/- 29.9 micrograms/g; kidney,
      100.8 +/- 1.3 micrograms/g). Hepatocyte necrosis developed only in OX rats
      treated with Cd, and the nephrotoxicity of Cd was also notably enhanced by
      ovariectomy, since Cd nephropathy affected the proximal convoluted epithelium
      more severely and more frequently in OX rats than in non-OX rats. BrdU-labeled
      cells in the renal cortex were increased by approximately 2.7-fold in OX rat (7.4
      cells/mm2) over those in the renal cortex in non-OX rat (2.7 cells/mm2). In
      conclusion, the present study demonstrated that ovariectomy enhanced Cd-induced
      nephrotoxicity and hepatotoxicity in rats.

PMID- 8480336
TI  - The involvement of Kupffer cells in carbon tetrachloride toxicity.
AB  - Carbon tetrachloride (CCl4) is a classical pericentral hepatotoxicant; however,
      precise details of its mechanism of action remain unknown. One possibility is
      that Kupffer cells participant in this mechanism since CCl4 elevates calcium, and
      the release of toxic eicosanoids and cytokines by Kupffer cells is calcium
      dependent. Therefore, these studies were designed to evaluate the role of Kupffer
      cells in CCl4 toxicity in the rat in vivo. Kupffer cells were destroyed
      selectively with gadolinium chloride treatment (10 mg/kg GdCl3 iv) 1 day prior to
      administration of CCl4 (4 g/kg ig). Twenty-four hours after CCl4 treatment, rats
      were anesthetized, blood samples were drawn for aspartate aminotransferase (AST)
      determination, which is indicative of parenchymal cell damage, and trypan blue
      was infused into the liver to stain the nuclei of dead hepatocytes. AST levels
      were in the normal range and trypan blue staining was negligible in livers from
      vehicle- or GdCl3-treated rats. As expected, CCl4 treatment alone elevated AST
      levels to values over 4000 U/liter and caused massive cell death (60-90 trypan
      blue-positive cells/pericentral field). In dramatic contrast, the elevation in
      AST and cell death due to CCl4 were almost completely prevented by GdCl3
      treatment. In attempts to understand this phenomenon, metabolic and
      detoxification pathways were assessed. CCl4 is metabolized via cytochrome P450
      II.E.1; however, GdCl3 treatment did not alter this pathway as assessed from p
      nitrocatechol formation from the selective substrate, p-nitrophenol. GdCl3
      treatment also had no effect on hepatic glutathione levels. On the other hand,
      GdCl3 treatment significantly reduced infiltration of neutrophils resulting from
      exposure to CCl4. These data clearly support the hypothesis that Kupffer cells
      participate in the mechanism of toxicity of CCl4 in vivo, possibly by release of
      chemoattractants for neutrophils.

PMID- 8480337
TI  - Characterization of vitamin A potentiation of carbon tetrachloride-induced liver
      injury.
AB  - Pretreatment of rats with large doses of vitamin A (VA, retinol) has been shown
      to potentiate carbon tetrachloride hepatotoxicity. The relationship between VA
      dose or pretreatment duration with VA and the extent of potentiation of CCl4
      hepatotoxicity is unknown. Therefore, VA was administered to male SD rats (180
      200 g) by oral gavage in daily doses of 100,000, 150,000, 200,000, or 250,000
      IU/kg for 3 weeks. In another experiment, rats were given VA in a daily dose of
      250,000 IU/kg for 1 day, 1, 2, 3, or 5 weeks. At 24 hr after the last VA dose,
      CCl4 (0.15 ml/kg, ip) was administered. Hepatotoxicity was assessed by increases
      in plasma alanine aminotransferase activity and by histological evaluation of the
      liver. Additionally, the correlation between the hepatic concentration of retinol
      and retinyl palmitate after VA treatment and the extent of potentiation of CCl4
      induced liver injury was studied. In the initial 3-week dose-response study, as
      the daily dose of VA increased so did the degree of potentiation of CCl4
      hepatotoxicity. All treatment durations with VA (250,000 IU/kg per day), except 1
      day, resulted in equivalent potentiation of CCl4 hepatotoxicity. VA treatment did
      not result in elevated hepatic concentration of retinol. However, VA treatment
      did increase the concentration of retinyl palmitate in the liver (except for the
      1-day treatment). No linear correlation could be seen between the hepatic
      concentration of retinyl palmitate and the extent of VA potentiation of CCl4
      hepatotoxicity. VA treatment also potentiated to hepatotoxicity of minimally
      hepatotoxic doses of acetaminophen, allyl alcohol, and endotoxin. Because these
      chemicals produce hepatic injury by diverse mechanisms it is concluded that VA
      potentiates hepatic injury by altering a process involved in the progression of
      cell injury.

PMID- 8480338
TI  - Vitamin A potentiation of carbon tetrachloride hepatotoxicity: enhanced lipid
      peroxidation without enhanced biotransformation.
AB  - To better understand the mechanism by which vitamin A (VA, retinol) potentiates
      the hepatotoxicity of carbon tetrachloride, its effect on metabolism and covalent
      binding of CCl4 as well as its effect on lipid peroxidation was determined.
      14CCl4 (0.15 ml/kg, 21.4 microCi/mmol) was administered to male SD rats that had
      been treated with vitamin A (250,000 IU/kg/day for 1 week) or vehicle. Vitamin A
      pretreatment did not increase the 24-hr biotransformation of 14CCl4 to 14CO2, to
      exhaled volatile organics, or to metabolites excreted in the urine or feces.
      Furthermore, there was no dramatic effect of vitamin A pretreatment on the
      covalent binding of 14CCl4 equivalents to hepatic lipids and proteins at early
      time points (1/2-4 hr) after administration of 14CCl4. The microsomal
      concentration of cytochrome P450 was unchanged by vitamin A treatment. There was
      a dramatic increase (6-8x) in the amount of ethane exhaled in those rats treated
      with vitamin A and then administered CCl4 compared to that of those administered
      CCl4 without pretreatment. The enhanced lipid peroxidation as evidenced by the
      increased exhalation of ethane was not the result of vitamin A-induced decreases
      in hepatic glutathione or vitamin E. These data indicate that the potentiation of
      CCl4 hepatotoxicity by vitamin A pretreatment is associated with an enhancement
      of lipid peroxidation that is independent of changes in CCl4 biotransformation or
      the hepatic concentration of two important hepatoprotective agents.

PMID- 8480339
TI  - Vitamin A potentiation of carbon tetrachloride hepatotoxicity: role of liver
      macrophages and active oxygen species.
AB  - Pretreatment of rats with large doses of vitamin A (VA) potentiates the
      hepatotoxicity of CCl4. Because our previous studies indicate that VA treatment
      does not enhance CCl4 metabolism but does enhance CCl4-induced lipid peroxidation
      and activates liver Kupffer cells to release increased amounts of oxygen-centered
      free radicals, the current studies were designed to determine if VA treatment
      potentiates CCl4-induced liver injury through increased release of reactive
      oxygen species. Plasma clearance of colloidal carbon, an index of Kupffer cell
      phagocytic activity, was enhanced two- to threefold in rats treated for 7 days
      with VA (retinol, 250,000 IU/kg per day). Accordingly, VA treatment alone caused
      Kupffer cell activation. To determine if these activated Kupffer cells could
      potentiate hepatic injury through release of reactive oxygen species upon CCl4
      challenge, polyethylene glycol coupled-superoxide dismutase (PEG-SOD, 10,000
      IU/kg) or -catalase (PEG-CAT, 40,000 IU/kg) was given iv 2 hr after CCl4 (0.15
      ml/kg, ip) to control or VA-pretreated rats to quench any released reactive
      oxygen. PEG-SOD and PEG-CAT effectively blocked VA potentiation of CCl4 liver
      injury as assessed at 24 hr by change in plasma ALT. Methylpalmitate (MP, 2
      g/kg), an inhibitor of Kupffer cell phagocytosis and related oxygen burst, also
      blocked the potentiation of liver injury when given iv 24 hr before CCl4 to VA
      pretreated rats. At the doses used, PEG-SOD or PEG-CAT did not influence CCl4
      toxicity in control rats (at 0.15 or 2 ml CCl4/kg). Importantly, SOD, CAT, and MP
      blocked the enhanced lipid peroxidation induced by CCl4 in VA-pretreated rats.
      From these findings we conclude that the potentiation of CCl4 liver injury by VA
      pretreatment is mediated, at least in part, by active oxygen species released
      from Kupffer cells and possibly other macrophages that are activated by VA.
      Supporting this conclusion is the failure of VA pretreatment to increase the
      release of LDH from suspension of hepatocytes incubated with CCl4.

PMID- 8480340
TI  - Differential ovotoxicity of 4-vinylcyclohexene and its analog, 4
      phenylcyclohexene.
AB  - Vinylcyclohexene (VCH) is an industrial byproduct that is known to cause the
      destruction of ovarian follicles in mice. Its analog, 4-phenylcyclohexene (4PC),
      is a volatile product from latex-backed carpeting. These studies were undertaken
      to assess the structure-activity relationships of these compounds and the
      potential for 4PC to cause ovotoxicity. Female B6C3F1 mice were dosed with VCH (6
      mmol/kg/day, ip) or 4PC (3 or 6 mmol/kg/day, ip) daily for 30 days. Treatment
      with VCH caused dramatic reductions in small and growing follicles as compared to
      those of vehicle controls. No treatment-related ovarian lesions were associated
      with 4PC administration. Plasma FSH concentrations were unaltered by treatment
      with either compound. These results indicate that in mice, the substitution of
      the phenyl for the vinyl group in the 4 position eliminates the ovotoxicity
      caused by this class of compounds. Presumably, the ability of the vinyl group to
      form an epoxide (or dihydrodiol) and/or its smaller size accounts for this
      difference in ovarian toxicity.

PMID- 8480341
TI  - Ozone inhalation stimulates expression of a neutrophil chemotactic protein,
      macrophage inflammatory protein 2.
AB  - Short-term exposure of humans and animals to ozone results in increased lung
      neutrophils; however, the mechanisms underlying this response are not completely
      understood. We examined the potential involvement of the neutrophil chemotactic
      factor, macrophage inflammatory protein 2 (MIP-2), in ozone-induced inflammation.
      Exposure-response relationships for ozone and MIP-2 expression were characterized
      by exposing C57B1/6 mice to 0.1-2 ppm ozone for 3 hr and determining lung levels
      of MIP-2 mRNA 6 hr after exposure. Temporal relationships between ozone and MIP-2
      were determined by exposing mice (2 ppm ozone x 3 hr) and characterizing MIP-2
      mRNA expression 0, 2, 6, and 24 hr after exposure. Neutrophils in lung lavage
      fluid were determined in both exposure-response and time course studies. Ozone
      concentrations > or = 1.0 ppm increased MIP-2 mRNA and this increase corresponded
      with recruitment of neutrophils. MIP-2 mRNA was increased immediately after ozone
      exposure and decreased to control levels by 24 hr. To examine the role of direct
      oxidant effects in ozone-induced MIP-2 expression, alveolar macrophages were
      exposed in vitro for 4 hr to 10(-10)-10(-5) M hydrogen peroxide and MIP-2
      expression was characterized. MIP-2 mRNA levels in lung macrophages were
      increased by > or = 10(-9) M hydrogen peroxide. In summary, our findings suggest
      the chemotactic protein MIP-2 may be responsible, at least in part, for ozone
      induced increases in lung neutrophils and indicate that direct exposure of
      alveolar macrophages to an oxidant is sufficient to induce MIP-2 expression.

PMID- 8480342
TI  - Thymectomy as treatment of autoimmune diseases other than myasthenia gravis.
AB  - This paper reviews the different series of thymectomies performed in patients
      with autoimmune diseases other than myasthenia gravis. It is possible that
      thymectomy can decrease the activity of T-helper lymphocytes or, alternatively,
      it may enhance the activity of T-suppressor lymphocytes, whose function is
      depressed in autoimmune diseases. Thymectomy was performed empirically for
      systemic lupus erythematosus and rheumatoid arthritis. The therapeutic benefits
      were questionable. Conflicting results were reported for thymectomy against
      autoimmune hemolytic anemia. Several trials were conducted to assess the
      therapeutic value of thymectomy in multiple sclerosis. Benefits were achieved
      only in relapsing-remitting but not in chronic-progressive multiple sclerosis.
      The effect of thymectomy in autoimmune diseases associated with myasthenia gravis
      were also reported. The authors conclude that thymectomy as treatment for
      autoimmune diseases other than myasthenia gravis is not elective therapeutic
      choice and it is acceptable only in selected cases.

PMID- 8480343
TI  - Effect of ambient temperature on immune functions of athymic nude mice.
AB  - We performed cytoflourometric analysis of the expression of various T and B
      surface markers on lymphocytes isolated from bone marrow, spleen and lymph nodes
      of nu/nu and +/+ mice kept at 22 or 28 degrees C for various time intervals. In
      bone marrow of nu/nu mice the cold exposure decreased the expression of sIg and
      CD4 molecules and increased expression of MHC class II antigens. In the spleen,
      the numbers of MHC class II and sIg expressing lymphocytes continually decreased
      with the length of cold exposure. At the same time, the number of CD4+ cells
      increased. The most pronounced changes in lymph nodes were observed in the
      expression of CD5 antigen. The values obtained from euthymic mice kept at cold
      temperature were always comparable to those found in mice kept at 28 degrees C.
      Exposure to lowered temperature caused in nu/nu mice also significant changes in
      appearance of subpopulations of cells differing in size and in density of
      antigens. The changes did not affect the antibody response to a thymus
      independent antigen.

PMID- 8480344
TI  - Phenotype and adhesion characteristics of rat thymic macrophages cultivated in
      serum-free medium.
AB  - Rat thymic macrophages (TMF) were cultivated in serum-free medium (Biorich 2)
      using an explant technique. This medium favored the growth of macrophages and
      inhibited the proliferation of other non-lymphoid cells. Macrophage
      characteristics of cultivated cells were confirmed by their morphology, NSE
      activity and positivity (approx. 95%) with ED1 and Mar 1 mAbs (pan-macrophage
      markers in the rat). The majority of non-adherent cells (NAC) released in culture
      medium during the proliferation of TMF also possessed macrophage characteristics.
      Both adherent TMF and NAC were heterogeneous cells expressing cortical/CMZ
      phenotype (ED2+, R-MC 41+, R-MC 42+) and CMZ/medullary phenotype (R-MC 43+, R-MC
      44+). NAC population contained higher proportion of cells expressing class II MHC
      molecules, IL-2R and 1F119 antigen compared to adherent TMF. The TMF phenotype
      changed during cultivation and upon stimulation with inflammatory cytokines (IL
      1, IFN-gamma, TNF-alpha). TMF formed rosettes with syngeneic or allogeneic
      thymocytes both at 37 and 4 degrees C. The percentages of rosettes was dependent
      on the incubation time and TMF/thymocyte ratio. A higher percentage of immature
      thymocytes (CD4-CD8- or CD4+CD8+) bound to TMF compared to mature, cortisone
      resistant thymocytes. The involvement of TMF membrane molecules in TMF/thymocyte
      adhesion was tested by preincubation of TMF with specific mAbs. It was found that
      Mar 1 mAb was partially inhibitory, OX-42 (anti CD11b) was slightly stimulatory,
      whereas other mAbs had no significant effect.

PMID- 8480345
TI  - Transfusion science and practice in developing countries: "...a high frequency of
      empty shelves....".

PMID- 8480346
TI  - Artificial preservatives for platelets.

PMID- 8480347
TI  - Posttransfusion survival of stored red cells and membrane-associated complement
      inhibitors.

PMID- 8480349
TI  - Storage of platelets in additive solutions: the effect of citrate and acetate in
      in vitro studies.
AB  - The in vitro effects of storage of platelets prepared from 6 pooled buffy coat
      units and stored in a platelet storage medium consisting of CPD and plasma and
      different platelet additive solutions were evaluated. The total count of
      platelets per pooled unit included in the present investigation (n = 20) was 335
      +/- 35 x 10(9) (mean +/- SD). Measurements of pH, pO2, pCO2, glucose, lactate,
      ATP, total adenine nucleotide content, and extracellular adenylate kinase
      activity were performed in a three-part study. The observations were 1) During
      storage in saline and citrate (10 mmol/L of citrate), the consumption of glucose
      and the production of lactate were significantly increased over the values with
      storage in saline, which were used as a reference. The values for pH at Day 6
      were significantly lower. 2) The effects of different concentrations (10, 20, and
      30 mmol/L) of acetate in saline were studied. With the exception of significantly
      higher pH values in saline and acetate, no significant differences were seen in
      the effects with saline and those with saline and acetate. 3) The combined effect
      of citrate and acetate was evaluated. The consumption of glucose and the
      production of lactate, the values for pO2, and extracellular adenylate kinase
      activity were significantly lower with saline and citrate and acetate than with
      saline and citrate. Significantly higher values for pH were found at Day
      5.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480348
TI  - Lack of clinical significance of "enzyme-only" red cell alloantibodies.
AB  - In a retrospective study on samples from 10,000 recently transfused patients, 35
      samples were found to contain an antibody that reacted with ficin-treated red
      cells but was not demonstrable by low-ionic-strength saline solution and indirect
      antiglobulin test (LISS-IAT). In those 35 patients, the specificity of the
      antibody was such that each patient would have been transfused with antigen
      negative blood had the antibody reacted in LISS-IAT. Tests on red cells from the
      units already transfused showed that 19 patients had among them received, by
      chance, 32 antigen-positive and 74 antigen-negative units. The remaining 16
      patients had among them received 57 units that were, again by chance, all antigen
      negative. One patient given antigen-positive blood suffered a delayed transfusion
      reaction; in two others the antibodies became LISS-IAT active after transfusion.
      However, similar changes to the LISS-IAT-active state were seen with two
      antibodies of patients given only antigen-negative blood. Also found in the
      10,000 patients were 28 clinically insignificant antibodies, 77 sera in which the
      antibody was too weak to identify, and 216 autoantibodies that reacted only with
      ficin-treated red cells. These data support a belief, generally held in the
      United States but not necessarily elsewhere, that the use of protease-treated red
      cells for routine pretransfusion tests creates far more work than the accrued
      benefits justify.

PMID- 8480350
TI  - Roles of acetate and phosphate in the successful storage of platelet concentrates
      prepared with an acetate-containing additive solution.
AB  - The development of a synthetic medium for platelet storage is an important goal
      in transfusion medicine. Its use would make large volumes of plasma available for
      fractionation and might improve the quality of platelets after storage. Several
      investigators have described successful storage in media containing acetate. The
      previous work of the authors showed that platelet concentrates (PCs) can be
      stored successfully for 5 days at 22 degrees C by using an additive solution
      (Seto sol) to replace 80 to 95 percent of the plasma usually employed as a
      suspending medium. Seto sol contains 23 mM (23 mmol/L) sodium acetate and 25 mM
      (25 mmol/L) sodium phosphate. The roles of acetate and phosphate in achieving
      successful platelet storage were studied in the work reported here. The
      concentration of acetate decreased linearly for 7 days at 0.61 +/- 0.11 mumol per
      day per 10(9) platelets in parallel with the disappearance of 1-14C or 2-14C
      acetate. There was no disappearance of tritiated acetate from PCs or of 1-14C
      acetate from platelet-free mixtures of plasma and Seto sol, which suggests that
      the disappearance of 14C acetate from PCs reflected oxidation to CO2, which could
      leave PCs through the walls of the plastic container. Since O2 consumption was
      1.47 mumol per day per 10(9) platelets, and the oxidation of a molecule of
      acetate requires 2 molecules of oxygen, acetate oxidation accounted for
      approximately 85 percent of oxygen consumption by platelets. The pH of PCs stored
      in Seto sol was nearly constant for 7 days, whereas, without acetate, it fell to
      6.4 +/- 0.1 on Day 5.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480351
TI  - Storage of single-donor platelet concentrates: metabolic and functional changes.
AB  - During the last decade, the trend toward intensifying chemotherapeutic regimens
      in patients with hematologic malignancies rapidly increased the demand for single
      donor platelet concentrates (PCs). The logistics of such supply, however,
      necessitated the storage of these blood components prior to transfusion. Today,
      most blood centers use di(2-ethylhexyl)phthalate-free blood bags, which are
      assumed to allow a storage period of up to 5 days. This report describes
      biochemical and functional changes of stored single-donor PCs, which may
      influence the expected quality of PCs. The acid-base status is characterized by
      an initial respiratory alkalosis compensated by a metabolic acidosis. Changes in
      extracellular electrolyte, lactate dehydrogenase, glucose, lactate, elastase, and
      complement levels, as well as in the release of alpha granule content and the
      initial activation of plasma coagulation, are demonstrated. These changes result
      in a functional impairment of stored PCs as reflected by thromboxane and
      serotonin release reaction and by aggregation and in vitro bleeding time studies.
      In contrast, in vivo recovery and survival rates have been reported to be
      unaffected. Whether the good recovery and survival rates are caused by a
      rejuvenescence of stored PCs in vivo or are due to injured circulating platelets
      has not yet been proven.

PMID- 8480352
TI  - Refrigerated storage of lyophilized and rehydrated, lyophilized human red cells.
AB  - Human red cells (RBCs) were collected in CPDA-1 and then freeze-dried in
      lyoprotective solution. The lyophilized RBCs were then stored at -20 degrees C
      for 7 days. At the end of the storage period, the lyophilized RBCs were
      rehydrated and washed in dextrose saline. The washed, reconstituted, lyophilized
      RBCs were resuspended in final wash solutions of ADSOL, CPDA-1, or a special
      additive solution containing glucose, citrate, phosphate, adenine, and mannitol,
      and then they were stored at 4 degrees C for an additional 7 days. The main
      purpose of this study was to determine whether human RBCs can be lyophilized in
      such a manner that normal metabolic, rheologic, and cellular properties are
      maintained during rehydration and subsequent storage in standard blood bank
      preservative solutions. Our results show that reconstituted, lyophilized RBCs
      maintained levels of ATP, 2,3 DPG, lactate, and cellular properties that are
      equal to or better than those in control nonlyophilized RBCs stored for a
      comparable period in CPDA-1. Reconstituted, lyophilized RBCs stored at 4 degrees
      C after rehydration also show better maintenance of ATP, 2,3 DPG, and lactate
      than do control RBCs stored in the same preservative solutions for comparable
      periods.

PMID- 8480353
TI  - Blood donation and patterns of use in southeastern Nigeria.
AB  - A retrospective study of donor blood availability and patterns of use from 1984
      through 1988 was conducted in a 400-bed university teaching hospital in Nigeria
      by extraction of data from the master registers for blood donors and recipients.
      Blood transfusion requests, number of persons who underwent phlebotomy, number of
      crossmatches performed, and blood use increased each year during the period of
      study. Average wastage rate and crossmatch-to-transfusion ratio were 3.5 percent
      and 1.61, respectively. Replacement blood donation constituted 98 percent of
      available donor blood. Obstetrics and gynecology and surgery patients used 70.4
      percent of the donor blood. The donor blood units were used as whole blood (81%)
      because of a lack of infrastructure such as a refrigerated centrifuge. Less than
      5 percent of the donors were females. It is concluded that the levels of
      voluntary blood donation and general blood supply are unacceptably low. The need
      for a functional National Blood Transfusion Service is highlighted.

PMID- 8480354
TI  - Blood donation behavior of Hispanics in the lower Rio Grande Valley.
AB  - This study was designed to determine the blood donation behavior and attitudes of
      Hispanic residents of the Lower Rio Grande Valley for the purpose of developing
      promotional and educational approaches to enhance levels of donor participation.
      Personal interviews of 545 respondents were conducted in English and Spanish
      using quota sampling and standard intercept techniques at lower- and middle
      income supermarkets in five cities during a payday weekend. A number of research
      hypotheses were established to test for demographic, behavioral, and attitudinal
      differences that were observed in donors and nondonors using chi-square analysis
      and multiple discriminant analysis. After analyzing the difference between
      Hispanics and non-Hispanics for blood donation rates, all non-Hispanics were
      eliminated from analysis, and the remaining 419 Hispanics were evaluated on the
      basis of their donor behavior. Donation among Hispanics was most likely to be by
      better-educated, English-speaking, higher-job-status individuals who had
      participated in a blood donation drive. Donors tend to have parent(s) who were
      donors, and they were also more likely to carry an organ donor card. Donors were
      found to vary in their behaviors as well as their attitudes and beliefs.
      Perceptions of a lack of safety in donating, the risk of contracting acquired
      immune deficiency syndrome, and the financial motivation of donors were most
      pronounced among Hispanics, which indicated a need for improved education on
      these issues.

PMID- 8480355
TI  - Safety and efficacy of preoperative donation of blood for autologous use by
      patients with end-stage heart or lung disease who are awaiting organ
      transplantation.
AB  - Many patients are, perhaps inappropriately, denied the benefits of autologous
      blood transfusion, because they are thought to be too ill to donate blood safely.
      The safety and efficacy of autologous blood donation by selected patients with
      end-stage heart or lung disease who are awaiting organ transplantation were
      studied to determine if even these critically ill patients could be suitable
      candidates for autologous blood donation. Seventy-two adults awaiting heart or
      lung transplantation were evaluated for autologous blood donation in a hospital
      based blood collection facility. Phlebotomy was performed if the patient met the
      required medical eligibility protocol, and if he or she consented to participate.
      Units of blood were separated into packed red cells and plasma and stored in a
      frozen state. Of 48 heart transplant candidates, 31 (65%) were each able to
      donate 1 to 8 units of blood. The median number of exposures to allogeneic
      components was 1 for patients who donated and 7 for nondonors (p = 0.0141). Among
      patients who donated, 54 percent required allogeneic components, as compared to
      88 percent of nondonors (p = 0.0968). Of 24 lung transplant candidates, 15 (63%)
      made 1 to 6 donations each. The median number of exposures to allogeneic
      components was 0 for donors and 2 for nondonors (p = 0.1871), but only 45 percent
      of donors required allogeneic components, as compared to 100 percent of nondonors
      (p = 0.0418). No serious complications during or following phlebotomy were
      observed. It is concluded that autologous blood donation by patients with end
      stage heart or lung disease may be safe.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480356
TI  - Transfusion therapy: improved patient care and resource utilization.
AB  - Improving the quality of medical care while reducing costs is one of the major
      challenges facing the health care system in the United States. At a 1020-bed,
      tertiary-care, teaching hospital, the Transfusion Committee modified transfusion
      practice by establishing new transfusion guidelines based upon national standards
      rather than local practices and by implementing educational and monitoring
      systems. Over a 3-year period, the number of transfusions decreased, the types of
      transfused components changed, and the waste due to unused components decreased.
      From the baseline of Fiscal Year (FY) 1989 (89), the number of exposures to
      components from allogeneic blood donors for the patient population decreased by
      11,015 in FY 90, 14,067 in FY 91, and 16,990 in FY 92, thereby decreasing the
      risk of transfusion-transmitted disease, transfusion reaction, and
      alloimmunization. As compared to costs in FY 89, the altered transfusion
      practices resulted in cost savings of $376,269 in FY 90, $566,375 in FY 91, and
      $684,704 in FY 92. Over the 3-year period, exposures to components from
      allogeneic blood donors for the patient population were reduced by 42,072, and
      the total cost savings was $1,627,348. The methodology and results should be
      reproducible at other hospitals.

PMID- 8480357
TI  - Rh phenotypes of Chinese blood donors in Hong Kong, with special reference to
      weak D antigens.
AB  - Among Hong Kong Chinese blood donors, 99.71 percent were found to be D+. Of
      these, 55.02 percent were of the phenotype CCDee. The Du phenotype was found to
      be present in 0.016 percent. Among the 0.27 percent who were apparently D-, 0.079
      percent were of the Del phenotype, while the remaining 0.19 percent were "true D
      ," as defined by a nonreactive eluate obtained by an adsorption and elution
      procedure using anti-D. The ccdee phenotype constitutes 56.77 percent of the
      "apparent D-" and 80.24 percent of the true D-. Data show that anti-D rarely
      occurs in Hong Kong Chinese, and it is postulated that this could be due to the
      presence of a very weak form of the D antigen among many of those who appear to
      be D-.

PMID- 8480359
TI  - Correction of the corrected count increment units.

PMID- 8480358
TI  - Selection of white cell-reduced blood components for transfusions during early
      infancy.

PMID- 8480360
TI  - Platelets collected with a two-stage automated blood cell separator.

PMID- 8480362
TI  - Soluble proteins: size, shape and function.
AB  - Why are proteins so big? Why do cells build oligomeric proteins? A visual survey
      of the protein structures available in the Protein Data Bank sheds new light on
      these questions.

PMID- 8480361
TI  - The metabolic role of leucovorin.
AB  - Interest in determining if leucovorin, known chemically as 5-formyltetra
      hydrofolate, plays a role in one-carbon metabolism is reemerging. While
      investigations in the 1940s suggested it was an important donor of one-carbon
      units in folate-mediated biosynthetic reactions, studies between the 1950s and
      1980s disproved this hypothesis and dismissed its presence in biological systems
      as artifactual. Recently, new data has focused attention on the possible
      biological function of this compound that is widely used in cancer chemotherapy.

PMID- 8480363
TI  - Amino acid titration curves--misshapen or mislabeled?
AB  - Titration curves are frequently used to illustrate the change in charge of amino
      acids with pH, and as such are a fundamental part of most biochemistry courses.
      We have noticed that the graphs of titration curves appearing in many
      biochemistry textbooks are drawn incorrectly near the origin of the titration.
      This article demonstrates that this curve is misshapen, or, alternatively, that
      the axis of the graph is incorrectly labelled.

PMID- 8480364
TI  - Protein conformation monitored by energy-selective optical spectroscopy.
AB  - Fluctuations in the polypeptide chain lead to disorder in proteins and to a
      distribution in the parameters that regulate their functions. Using low
      temperature (to reduce the fluctuations) and narrow-band lasers (to select one
      substate among the many forms), high-resolution absorption and fluorescence
      spectra for chromophores in proteins can be obtained. These spectra reveal
      information on the kind and extent of disorder in proteins and allow for the
      determination of the vibrational energies of both ground and excited state
      molecules, true inhomogeneous spectral width, and kinetic studies of individual
      protein substates.

PMID- 8480365
TI  - Hydrophobicity curvature and membrane fusion.

PMID- 8480366
TI  - Sequence homologies between four cytoskeleton-associated proteins.

PMID- 8480367
TI  - A template for the protein kinase family.
AB  - The crystal structure of the catalytic subunit of cAMP-dependent protein kinase,
      complexed with ATP and a 20-residue inhibitor peptide, is reviewed and correlated
      with chemical and genetic data. The striking convergence of the structure with
      the biochemistry and genetics provides for the first time a molecular basis for
      understanding how this enzyme functions, as well as an explanation for the highly
      conserved residues that are scattered throughout the molecule. Because these
      residues probably serve a common role in all eukaryotic protein kinases, this
      first protein kinase structure serves as a general template for the entire family
      of enzymes.

PMID- 8480368
TI  - Multiple functions of nucleosomes and regulatory factors in transcription.
AB  - The in vivo packaging of DNA with histone proteins to form chromatin makes its
      transcription a difficult process. Biochemical and genetic studies are beginning
      to reveal mechanistic details of how transcriptional regulatory factors confront
      at least two hurdles created by nucleosomes, the primary structural unit of
      chromatin. Regulatory factors must gain access to their respective binding sites
      and activate the formation of transcription complexes at core promoter elements.
      Distinct regulatory factors may be specialized to perform these functions.

PMID- 8480369
TI  - RCC1 in the cell cycle: the regulator of chromosome condensation takes on new
      roles.
AB  - In the eukaryotic cell cycle, nuclear DNA replication (S phase) and mitosis (M
      phase) are linked such that replication must be complete before mitosis can
      begin. In order for this coupling to work, there must be some system for
      detecting unreplicated DNA and transducing an inhibitory signal to prevent the
      activation of mitotic factors. The DNA-bound protein RCC1 is involved in this
      regulatory process since mitosis initiates before DNA synthesis is finished in
      the absence of RCC1. This has led to the proposal that RCC1 is a signalling
      molecule, detecting unreplicated DNA and producing the inhibitory signal.
      However, mutants in RCC1 show defects beyond their inability to regulate the cell
      cycle, suggesting other roles for the RCC1 protein in the nucleus and thus
      hitherto unexplored relationships between cell cycle control and other cellular
      processes.

PMID- 8480370
TI  - Noradrenergic mechanisms in Parkinson's disease.

PMID- 8480371
TI  - Ca(2+)-inhibited adenylyl cyclase in cardiac tissue.

PMID- 8480372
TI  - Modulation of platelet function by free radicals and free-radical scavengers.
AB  - Platelets have the capacity to generate oxygen-derived free radicals and are
      often present at inflammatory foci with other free-radical-generating cells such
      as white blood cells. Free radicals can modify platelet adhesion and aggregation
      directly or through effects on the vascular endothelium, which generates
      prostacyclin and nitric oxide. To defend against the overproduction of free
      radicals the body manufactures endogenous scavengers, which can be of enzymic or
      non-enzymic origin. Daniela Salvemini and Regina Botting describe how free
      radical scavengers may be used therapeutically to regulate the platelet
      reactivity involved in many pathological phenomena.

PMID- 8480373
TI  - Molecular characterization of the dopamine transporter.
AB  - Neurotransmission, which represents chemical signalling between neurons, usually
      takes place at highly differentiated anatomical structures called synapses. To
      fulfill both the time and space confinements required for optimal
      neurotransmission, highly specialized proteins, known as transporters or uptake
      sites, occur and operate at the presynaptic plasma membrane. Using the energy
      provided by the Na+ gradient generated by the Na+/K(+)-transporting ATPase, these
      transporters reuptake the neurotransmitters soon after their release, thereby
      regulating their effective concentrations at the synaptic cleft and the
      availability of neurotransmitters for a time-dependent activation of both pre-
      and postsynaptic receptors. The key role these proteins play in normal
      neurotransmission is further emphasized when the physiological and social
      consequences of drugs that interfere with the function of these transporters,
      such as the psychostimulants (e.g. amphetamine and cocaine) or the widely
      prescribed antidepressant drugs, are considered. In this review, Bruno Giros and
      Marc Caron elaborate on the potential consequences of the recent molecular
      cloning of the dopamine and related transporters and summarize some of the
      interesting properties that are emerging from this growing family of Na(+)- and
      Cl(-)-dependent transporters.

PMID- 8480374
TI  - Neuronal ATP receptors and their mechanism of action.
AB  - ATP stores and supplies energy in neurons, but it also acts as a transmitter
      molecule. ATP activates a class of membrane receptors termed P2 purinoceptors.
      Based on the potencies of structural analogues of ATP, P2 purinoceptors in non
      neuronal tissues were classified by classic pharmacological methods into two
      subtypes, P2x and P2y. Peter Illes and Wolfgang Norenberg report that
      electrophysiological investigations indicate the presence of P2y-like
      purinoceptors on neurons. They describe two alternative ionic transduction
      mechanisms that may be activated by this receptor family.

PMID- 8480375
TI  - Endothelins--from receptors to medicine.
AB  - Since the discovery of endothelins, peptides with exceptional vasoconstrictor
      potency that were originally suggested to act by causing the opening of Ca2+
      channels, it has emerged that these agents are important in intercellular
      communication in many tissues. They exert their effects through G protein-coupled
      receptors, of which two classes have been cloned. Robert Miller, John Pelton and
      John Huggins review the progress made towards a molecular understanding of ligand
      recognition by endothelin receptors. Receptor-selective agonists and antagonists
      have emerged from attempts to understand the three-dimensional structure of the
      endothelin pharmacophore, from structure-activity studies and from rapid
      screening programmes. From the nature of the secretion and action of endothelins,
      it would seem that these peptides are involved in long-term changes rather than
      in acute responses to stimuli, and that they are likely to be important in a
      number of pathological states. Evidence suggests that receptor antagonists with
      appropriate affinity and selectivity may be useful in the treatment of conditions
      as diverse as hypertension, ulcerogenesis and ciclosporin toxicity.

PMID- 8480376
TI  - Current perspectives on anabolic-androgenic steroid abuse.
AB  - For the past 40 years anabolic-androgenic steroids have been used by a wide
      variety of athletes with the hope of improving their training, endurance and
      performance. Proponents of their use claim that the drugs increase muscle
      strength and mass, endurance, decrease recovery time between workouts and improve
      physique. Critics claim that these beneficial effects are due primarily to
      expectancy and other factors associated with training; many doctors also claim
      that their use is actually quite dangerous. Regardless of their efficacy, the use
      and abuse of anabolic-androgenic steroids has escalated such that in 1990 the US
      Congress enacted the Anabolic Steroids Control Act requiring that anabolic
      steroids be added to Schedule III of the Controlled Substances Act. This action
      placed compounds such as testosterone cipionate and nandrolone decanoate in the
      company of various opioid drugs, amphetamines and barbiturates. As chair of the
      American Society for Pharmacology and Experimental Therapeutics' Committee on
      Substance Abuse, Scott Lukas advocates continued research on the effectiveness,
      toxicity and natural history of anabolic-androgenic steroid abuse.

PMID- 8480377
TI  - Nonchiral, homochiral and composite chiral drugs.
AB  - Chirality and the implicit stereoselectivity in pharmacodynamics and
      pharmacokinetics, in particular of racemic therapeutics, are interesting from
      both scientific and applied points of view. There is much literature on the
      subject, including a series of papers on chirality in TiPS in 1986 (Vol. 7, pp.
      20-23, 60-64, 112-116, 155-158, 200-205 and 281-285). The choice between single
      stereoisomers (homochiral drugs) and composite chiral drugs (mixtures of
      stereoisomers) depends upon therapeutic advantages (such as a reduction in
      xenobiotic load), possible adverse side-effects and development costs. There is a
      need for critical evaluation of existing and new composite chiral drugs, while
      the potential of nonchiral drugs is hardly discussed in the literature. This
      review by E. J. Ariens considers current information on composite, homo- and
      nonchiral drugs, with particular regard to drug development.

PMID- 8480378
TI  - [Chronic pelvic pain].

PMID- 8480379
TI  - [Long-term prognosis for women with chronic pelvic pain without laparoscopically
      demonstrable cause].
AB  - With the object of assessing the long-term prognosis and the frequencies of
      recurrence and remission in women chronic low abdominal pain without
      laparoscopically visible cause, questionnaire were sent in 1985 and 1991 to 55
      women who had been submitted to laparoscopy in 1982-1984 for this reason. These
      women had been told that there was no demonstrable explanation of the pain
      experienced and were then discharged. 65% and 55% respectively had experienced
      and unfavourable course with considerable and continued symptoms. Only 22% stated
      in both investigations that they had experienced a favourable course and that
      they were, by and large, free from pain. 36% changed from an unfavourable to a
      favourable course or the reverse. The assessment made by the women was confirmed
      by a series of subordinate questions and this demonstrated a marked difference
      between the favourable and unfavourable courses of the condition. It is concluded
      that laparoscopy with exclusion of significant pathology is not, in itself,
      satisfactory as treatment of this patient group and that no improvement occurs in
      the course of time. The condition varies greatly with many recurrences and
      remissions and, for this reason, uncontrolled reports of the therapeutic effects
      are of no significance. When compared with the literature, it is suggested that
      this patient group should be referred early in the course of the condition to a
      therapist with specialist psychological/sexological insight and/or to a
      physiotherapist with interest in this patient group.

PMID- 8480380
TI  - [Ultrasound Doppler examination of the carotid artery].
AB  - Ultrasound-Doppler examination of the carotid artery is employed to an increasing
      extent in investigation of patients with cerebrovascular disease. The diagnostic
      criteria and results achieved with the various forms: continuous wave Doppler,
      duplex scanning and colour-Doppler, are described. In the two latter methods, the
      accuracy is high in the diagnosis of occlusions, quantitating of all degrees of
      stenosis and also in identification of normal vessels. On comparison with
      arteriography, the accuracy is stated to be typically 85-95%. The reproducibility
      of the method is high and equivalent to the results obtained by assessment of the
      same arteriography by two independent radiologists. The sources of error are
      discussed and it is concluded that ultrasound-Doppler examination of the carotid
      artery should replace arteriography in the primary investigation of patients with
      cerebrovascular disease.

PMID- 8480381
TI  - [The immune system and physical training].
AB  - The effects on the immune system of sudden physical exercise and degree of
      training are reviewed. During moderate as well as strenuous physical exercise
      natural killer (NK) cells especially, but also T and B cells are released into
      the blood. A few hours after moderate physical exercise the immune system is back
      to the pre-exercise state, but following strenuous exercise the lymphocyte
      concentration and the NK and B cell functions are suppressed. The immune
      suppression following strenuous exercise is at least partly due to release of
      prostaglandins from an elevated number of monocytes in the circulation. The
      importance of stress hormones for mediating the immune modulation is discussed.
      Examination of trained persons at rest show that these have elevated NK cell
      activity when compared to matched controls. There are sporadic reports in the
      literature, showing that persons who train moderately have fewer infections,
      while persons who train very hard have increased risk of upper respiratory
      diseases. These findings are in accordance with the observed immune modulation on
      moderate versus strenuous exercise. The effects of physical training in relation
      to acute and chronic diseases are evaluated.

PMID- 8480382
TI  - [Respiratory monitoring during sleep].
AB  - A review of respiratory disorders of sleep with the possible related clinical
      alterations are described. Techniques and methods used in non-invasive
      respiratory monitoring during sleep are presented. Diagnostic events and
      therapeutic approaches are discussed related to special patient groups: the
      obstructive sleep apnoea syndrome, asthma, chronic obstructive pulmonary disease
      and neuromuscular diseases.

PMID- 8480383
TI  - [The course of bronchial asthma in adults. Factors of importance for the annual
      decline of lung function].
AB  - The purpose of this study was to describe the relation of various factors of
      potential importance to the rate of decline in lung function in adults with
      intrinsic and extrinsic asthma. Of 180 asthmatic patients, 143 (79%) participated
      in a 10 year follow up examination; 94 patients had intrinsic asthma and 49
      extrinsic asthma. Patients with intrinsic asthma had an annual decline in FEV1 of
      50 ml, whereas those with extrinsic asthma had a decline of 23 ml; the rate of
      decline of lung function increased with increasing age in both groups. There was
      no relation between rate of decline in lung function and number of cigarettes
      smoked. An inverse relation between initial FEV1 and decline in FEV1 was found
      for the patients with extrinsic asthma but not for the patients with intrinsic
      asthma. A high degree of airway variability--that is, reversibility in FEV1--at
      the time of enrollment was found to be associated with a steeper decline in lung
      function in patients with intrinsic asthma, whereas increasing degrees of
      obstruction (decreasing FEV1/VC ratio at enrollment) and need for treatment with
      corticosteroids were associated with a more pronounced decline in FEV1 in
      patients with extrinsic asthma. The rate of decline in lung function is greater
      in patients with intrinsic asthma than in patients with extrinsic asthma; the
      prognosis for intrinsic and extrinsic asthma is to some extent influenced by
      different factors, which suggests that the pathogenetic mechanisms underlying
      intrinsic and extrinsic asthma may differ.

PMID- 8480384
TI  - [Nosocomial pneumonia in an intensive care unit].

PMID- 8480385
TI  - [Causes of visual impairment among Scandinavian children].

PMID- 8480386
TI  - [Earlier experiences with duplex scanning of femoropopliteal and crural vein
      bypass].
AB  - Identification and correction of graft stenoses in femoropopliteal and -crural
      vein bypasses can prevent reconstruction failure. Sixty six consecutive vein
      bypasses entered a postoperative surveillance protocol, which implied clinical
      assessment, measurement of ankle blood pressure and duplex-scanning every three
      months. In 15 cases the duplex-scanning indicated graft stenoses. Seven were
      revised, five of which remain patent after a median follow-up of three months.
      Eight stenoses were observed without intervention. Five of these uncorrected
      stenoses (63%) thrombosed and the function of the bypass could not be
      reestablished. Of the 34 bypasses with normal duplex-scans only 2 (6%) thrombosed
      (p < 0.01 compared to observed but not revised stenosis). Neither clinical
      evaluation or ankle blood pressure measurement could reliably predict graft
      failure. This study indicates that duplex-scanning effectively identifies grafts
      at risk and can be expected to improve long-term patency of infrainguinal vein
      bypasses.

PMID- 8480387
TI  - [Treatment of anal incontinence with an implanted artificial anal sphincter].

PMID- 8480388
TI  - [Contact tracing in HIV infection].
AB  - The results of contact tracing in two male and one female HIV antibody positive
      index cases are described. Altogether 19 sexual partners were reported, of whom
      13 were traced. In one case previously unknown HIV infection was diagnosed.
      Contact tracing for HIV infection in Denmark depends solely upon the cooperation
      of the index case and upon the willingness of notified partners to appear for
      counselling and testing. The efficacy of partner notification for HIV infection
      in Denmark based on the current strategy should be further evaluated.

PMID- 8480389
TI  - [Intrathoracic perforation of stomach ulcer in a massive hiatal hernia].
AB  - A case of intrathoracic perforation of a chronic gastric ulcer in a hiatus hernia
      is presented. A 67-year-old woman had suffered from interscapular pain and
      epigastric discomfort following large meals for four years. During the week
      before admission, the epigastric and interscapular pain increased, reaching a
      crescendo in the 24 hours before the patient's arrival in the emergency room.
      Chest and abdominal x-ray showed free gas and a large hiatus hernia with an
      intrathoracic stomach. At laparotomy, the stomach was gently returned to the
      abdominal cavity, and a perforated chronic gastric ulcer was found on the greater
      curvature. The ulcer was excised, and the diaphragmatic crura were approximated.
      Apart from wound dehiscence, the postoperative course was uneventful.

PMID- 8480390
TI  - [Fibrinogen substitution in systemic defibrination because of thrombolysis in
      acute myocardial infarction].

PMID- 8480391
TI  - [Incidence of schizophrenia].

PMID- 8480392
TI  - [Liver in systemic lupus erythematosus].

PMID- 8480393
TI  - [American turnaround in the cholesterol policy].

PMID- 8480394
TI  - [Cholesterol screening--fraud or fact?].

PMID- 8480395
TI  - [Neuroblastoma: epidemiology and spontaneous remission. Significance for
      evaluation of screening studies].

PMID- 8480396
TI  - [Pravastatin--(Pravachol)--a new inhibitor of cholesterol synthesis].

PMID- 8480397
TI  - Report of the RCVS working party on veterinary undergraduate education.

PMID- 8480398
TI  - Local secretory IgA in dogs with low systemic IgA levels.
AB  - Low plasma IgA concentrations are commonly found in clinically normal dogs. In
      order to ascertain the relative importance of local and systemic IgA
      concentrations as factors determining the absence of clinical signs, IgA
      concentrations in plasma and tears were assayed in clinically normal dogs with a
      deficiency of IgA (10.33 +/- 0.63 mg/dl). The IgA levels in tears (25.28 +/- 1.91
      mg/dl) did not differ significantly from those of control dogs or from previously
      published data for dogs. Thus, low systemic levels did not imply a significant
      reduction in local IgA levels. The absence of clinical signs in dogs with low
      plasma IgA concentrations may therefore be explained by the presence of normal
      secretory levels and an effective immune response against local pathogens.

PMID- 8480399
TI  - Reduced rumination in bovine spongiform encephalopathy and scrapie.

PMID- 8480400
TI  - Delayed ragwort poisoning associated with lactation stress in cows.

PMID- 8480401
TI  - First report of kidney enlargement disease in UK goldfish.

PMID- 8480402
TI  - Meat hygiene service.

PMID- 8480403
TI  - Cyclosporin eye drops.

PMID- 8480404
TI  - Detection of bacterial antigens in milk.

PMID- 8480405
TI  - Poultry meat inspection.

PMID- 8480406
TI  - Bilateral optic disc colobomas and microphthalmos in a thoroughbred horse.
AB  - A thoroughbred colt had bilateral but unequal microphthalmos together with
      microcornea, abnormalities of the iris and lens and posterior segment colobomas.
      The case is compared with other reports of microphthalmos and coloboma in horses.

PMID- 8480407
TI  - Radiography as an aid in the diagnosis of traumatic reticuloperitonitis in
      cattle.
AB  - Radiographs of the reticulum, the medical records and the surgical and post
      mortem findings for 151 cattle were evaluated, and the radiographic findings in
      animals which had no pathological changes in the cranioventral abdomen were
      compared with those in animals with traumatic reticuloperitonitis. Features that
      were found to be reliable in the diagnosis of the condition included atypically
      positioned foreign bodies, abnormal gas shadows in the region of the reticulum,
      and depressions in the cranioventral margin of the reticulum. In addition to the
      reticulum, the remainder of the cranioventral abdomen was also assessed
      radiographically. An accumulation of gas or a gas-fluid interface outside the
      gastrointestinal tract, and intra-abdominal masses were typical findings in
      cattle with traumatic reticuloperitonitis. Various parameters were used to
      determine the reliability of radiography of the reticulum in the diagnosis of the
      condition; its prevalence was 50 per cent, the sensitivity of the radiographic
      diagnosis was 76 per cent, the specificity was 93 per cent, the accuracy was 85
      per cent, the positive predictive value was 92 per cent and the negative
      predictive value was 80 per cent.

PMID- 8480408
TI  - Incidence of hydrometra in dairy goats.
AB  - Hydrometra or pseudopregnancy is characterised by the accumulation of aseptic
      fluid within the uterus and a persistent corpus luteum. In goats the diagnosis
      can be easily made by ultrasound. The incidence of hydrometra was investigated in
      three herds of dairy goats, in two of them during one oestrous season and in the
      other over three years. The incidence varied between 3.0 per cent and 20.8 per
      cent with a mean incidence of 9.0 per cent. The incidence in older goats was
      significantly higher than in yearlings, and the chance of a hydrometra increased
      with the age of the goats. The finding, during one year, that a pseudopregnancy
      occurred more often after an induced ovulation, was not repeated in another year.

PMID- 8480409
TI  - Urine retention and abdominal straining in a ewe with a pyometra and a retained
      corpus luteum.

PMID- 8480410
TI  - Possible association of metritis with periparturient subcutaneous oedema in dairy
      cows.

PMID- 8480411
TI  - Prescribing for racehorses.

PMID- 8480412
TI  - Sarcoptic mange.

PMID- 8480413
TI  - Identification of a putative cellular receptor for HTLV-I by a monoclonal
      antibody, Mab 34-23.
AB  - The ability of HTLV-I to infect cells is presumed to be dependent, in some part,
      on the attachment of the virus to a target cell via a specific cell surface
      receptor which is, as yet, unknown. Here we present evidence that a monoclonal
      antibody, Mab 34-23, inhibits the binding of HTLV-I to IL-2 and
      phytohemagglutinin-activated peripheral blood mononuclear cells and also inhibits
      virus entry into these cells. Analysis of a variety of target cells, including a
      human:mouse somatic hybrid which contains only human chromosome 17q, indicates
      that the binding of Mab 34-23 correlates with HTLV-I adsorption and entry. SDS
      PAGE and Western blot analysis show that Mab 34-23 binds to four major proteins
      of MW 31, 45, 55, and 70 kDa and this binding can be inhibited by HTLV-I and not
      HIV proteins. HTLV-I virions bind to proteins of similar molecular weight and
      virus-binding to these proteins can be inhibited by preincubation with Mab 34-23.
      These data suggest that Mab 34-23 may identify a specific cell surface
      receptor(s) for HTLV-I.

PMID- 8480414
TI  - The parvovirus H-1 NS2 protein affects viral gene expression through sequences in
      the 3' untranslated region.
AB  - We reported previously that an NS2 null mutant of parvovirus H-1 (H-1SA) was
      capable of lytic growth in human and hamster cells, but not in rat cells (Li and
      Rhode, 1991). The host-range phenotype of H-1SA was also manifested in newborn
      rats and was associated with a reduction of viral protein synthesis to about 10%
      of wild-type virus and an absence of virions in cultured rat fibroblasts.
      However, the H-1SA mRNAs for NS1 and capsid proteins, R1 and R3, accumulated to
      wild-type levels and translated well with a cell free rabbit reticulocyte lysate.
      These results indicate that NS2 plays an important role in the regulation of
      viral protein synthesis in rat cells in vivo and in vitro, but NS2 is largely
      dispensable in other types of cells, such as human and hamster cells. To analyze
      whether the 5' and 3' untranslated regions (UTR) of viral RNA are involved in the
      regulation by NS2, the viral VP2 gene was replaced by a reporter gene, firefly
      luciferase, in a plasmid clone of viral sequences and the protein synthesis under
      the control of P38 was evaluated by luciferase assay. Cells were transfected with
      luciferase expressing plasmids and subsequently infected with wild-type H-1 or H
      1SA. We were able to mimic the defect in expression that we observed in cultured
      cells and animals with virus infection. Luciferase activity in H- 1SA-infected
      rat cells was about 10-fold lower than that in H-1-infected rat cells, but only 2
      fold lower or less in H-1SA-infected human cells and hamster cells compared to
      wild-type H-1. These results are consistent with our previous data that NS2 has a
      host-range phenotype in the natural host of H-1, the rat. Deletion of 5' UTR
      sequences from P38 transcripts reduced the overall P38-luc expression but
      expression was NS2 independent, whereas deletion of the terminal 3' UTR sequences
      of viral RNA reduced NS2-dependent expression in rat cells. These results suggest
      that the regulation of viral protein synthesis by NS2 depends on RNA sequences in
      the 3' UTR.

PMID- 8480415
TI  - The short tail-fiber of bacteriophage T4: molecular structure and a mechanism for
      its conformational transition.
AB  - Electron microscopy, image processing and computational sequence analysis were
      used to investigate the structure of the short tail-fiber of bacteriophage T4.
      This molecule, an oligomer of gp12, is an adhesin that binds the virion
      irreversibly to the bacterial surface. Short tail-fibers were isolated from
      mutant-infected cells in which gp12 is synthesized and assembled correctly, but
      not incorporated into virions. Visualized in negative stain, these filamentous
      molecules are approximately 38 nm in total length, with an arrowhead-shaped head
      (approximately 10 nm long by 6 nm wide), a 24-nm shaft of uniform width
      (approximately 3.8 nm), and a small, seemingly flexible, tail. The primary
      sequence contains a domain consisting of tandem quasi-repeats, each about 40
      residues long, extending from approximately residue 50 to residue 320. Molecular
      mass analyses by scanning transmission electron microscopy confirm that the
      molecule is a trimer. The masses of the head, shaft, and tail domains are
      consistent with (trimers of) the carboxy-terminus, the repeat region, and the
      amino-terminus, respectively. When short tail-fibers are visualized extending
      from baseplates, their heads are distal, i.e., detached, implying that it is the
      tail that remains in contact with the baseplate. Analysis of the molecules'
      curvature properties detects three hinge-sites: these suggest how the short tail
      fiber may be initially accommodated in a compact conformation in the "hexagon"
      state of the baseplate, from which it converts to the extended conformation when
      the baseplate switches into its "star" state.

PMID- 8480416
TI  - A multicomponent cis-activator of transcription of the E1b gene of adenovirus
      type 5.
AB  - We report that transcription of the adenovirus type 5 E1b gene is activated
      substantially in cis by sequences located between positions -362 and -49 with
      respect to the RNA start site. DNA fragments consisting of the -362 to -49
      sequences, or subsets thereof, were inserted into a reporter plasmid containing a
      minimal E1b promoter (positions -48 to +14) joined to the Escherichia coli cat
      gene. In the presence of cotransfected E1a and E1b genes in trans, CAT enzyme
      synthesis in transfected KB cells was stimulated about 20-fold by sequences from 
      362 to -49 (XY) in cis and to a lesser extent by sequences from either -362 to 
      128 (X) or -127 to -49 (Y). Adenoviruses were isolated lacking the X, Y, or XY
      sequences and KB cells were infected with one of the mutants, as well as wild
      type virus to provide E1a and E1b in trans. Deletion of both X and Y resulted in
      a 20-fold reduction in early E1b RNA and a 12-fold reduction in late RNA.
      Deletion of X or Y alone produced up to 5-fold reductions in early or late E1b
      RNA accumulation. In vitro DNA-protein interactions in the Y sequence were
      revealed by modification of the procedure used for previous detection of X region
      footprints. These data indicate that X and Y sequences, which include E1a protein
      coding and 3' untranslated DNA, also participate in DNA-protein interactions
      necessary for high levels of E1b promoter activity. The presence of such
      overlapping genetic elements raises the interesting possibility that functional
      E1a and E1b mRNAs must be synthesized from separate templates.

PMID- 8480417
TI  - Infectious hepatitis B virus variant defective in pre-S2 protein expression in a
      chronic carrier.
AB  - All human hepatitis B viruses characterized so far express three envelope
      proteins, pre-S1, pre-S2, and HBs, which are believed to function as binding
      proteins for the cellular receptor, as targets for immune-mediated virus
      elimination, and in virion morphogenesis and secretion. Here we report the
      characterization of infectious HBV variant genomes that are unable to express a
      pre-S2 protein and which were derived from serum of a highly viremic chronic
      carrier. Direct sequencing of the amplified pre-S region and sequencing of 50
      cloned amplified pre-S DNA fragments revealed that in all molecules, in addition
      to numerous nucleotide changes, there were deletions of the pre-S2 translation
      initiation codon and three codons 54 nucleotides downstream thereof. No pre-S2
      protein and altered pre-S1 proteins were found in the serum of the patient.
      Cloned infectious HBV DNA genomes having the pre-S region substituted by the
      variant pre-S region were replication competent in cultured hepatoblastoma cells.
      Morphologically normal virions were efficiently secreted and were infectious for
      primary human hepatocyte cultures. These data demonstrate that HBV devoid of pre
      S2 protein can occur in vivo as a dominant or exclusive virus population and that
      expression of the pre-S2 protein is not essential for HBV replication, virion
      morphogenesis, secretion, or in vitro infectivity.

PMID- 8480418
TI  - Early and late gene expression in UT-7 cells infected with B19 parvovirus.
AB  - UT-7, a human megakaryocytoblastoid cell line, can be persistently infected with
      B19 parvovirus. We performed detailed serial analysis of parvovirus DNA
      replication and RNA transcription of synchronized cells. RNA transcription
      appeared as an early event following infection, with viral RNA detected about 6
      hr after infection. In contrast, dimer-replicative intermediate forms of
      parvovirus DNA did not appear until more than 16 hr after infection. Northern
      analysis of specific transcripts showed an earlier appearance of nonstructural
      protein RNA (6 hr) compared to capsid protein RNA (24 hr). The addition of an
      inhibitor of protein synthesis to block synthesis of nonstructural protein
      abolished capsid protein RNA transcription as well as DNA replication. Primer
      extension analysis confirmed the initiation of all transcription from the single
      P6 promoter. RNA transcription precedes DNA replication of B19 parvovirus in
      these cells, and RNA processing may have a major role in regulating gene
      expression.

PMID- 8480419
TI  - Isolation, characterization, and mapping of temperature-sensitive mutations in
      the genes essential for lysogenic and lytic growth of the mycobacteriophage L1.
AB  - Forty temperature-sensitive mutations affecting lytic growth and eight affecting
      both establishment and maintenance of lysogeny of the temperate mycobacteriophage
      L1 have been isolated. All of the latter mutations form one complementation group
      and map within a very short region around the 15% coordinate of the L1 genome;
      these affect a single gene, cl, coding for the L1 repressor. The former 40
      mutations form 28 complementation groups, identifying 28 different genes, G1-G28,
      essential for the lytic growth of L1. These genes have been mapped using the Gts
      mutations. Of the 28 Gts mutants, 14 are defective in host lysis at 42 degrees
      but not at 32 degrees while the other 14 can lyse the host at both temperatures.
      Among the former 14 Gts mutants, 6 are also defective in L1 DNA synthesis at 42
      degrees, and they map in two different clusters, 4 around 65% and 2 around 84% of
      the L1 genome.

PMID- 8480420
TI  - Selection and partial characterization of dengue 2 virus mutants that induce
      fusion at elevated pH.
AB  - Two types of dengue (DEN) 2 virus mutants were selected either by repeated
      exposure to acidic pH (acid mutant, AM), or by the addition of ammonium chloride
      to Aedes albopictus C6/36 cells prior to and during viral infection (fusion
      mutant, FM). Both mutants grew more slowly than the parent strain and induced
      smaller plaques in Vero cells. The 50% fusion from within index for both mutants
      occurred at least 0.65 pH units higher than with the wild-type DEN virus. A
      single amino acid substitution (Asn-153 to Asp) was found in the envelope (E)
      glycoprotein of the AM virus. Three amino acid substitutions were detected on the
      E-glycoprotein of the FM virus: Ile-6 to Met, Asn-134 to Ser, and Asn-153 to Tyr.
      No mutations were found in the precursor to the membrane protein, prM. The DEN
      virus E-glycoprotein has two potential glycosylation sites: Asn-67 and Asn-153.
      The loss of the potential glycosylation site at Asn-153 or the change in the
      chemical characteristics resultant from the amino acid substitutions in both
      mutants implicates these regions of the E-glycoprotein in virus-mediated membrane
      fusion.

PMID- 8480421
TI  - Temperature-sensitive mutants in the vaccinia virus A18R gene increase double
      stranded RNA synthesis as a result of aberrant viral transcription.
AB  - Mutations in the vaccinia gene A18R cause activation of the cellular
      ribonucleolytic 2-5A pathway. To determine the mechanism of 2-5A pathway
      activation, mutant infections were analyzed for synthesis of double-stranded RNA
      and for transcription of individual virus genes. At late times postinfection,
      A18R mutant-infected cells contained an increased amount of complementary RNA and
      a higher steady state level of RNA from regions of the genome transcribed
      normally only early in the infection. The phenotype of A18R ts mutants is
      indistinguishable from that of wild-type infections done in the presence of
      isatin-beta-thiosemicarbazone (IBT). Actinomycin D is a potent inhibitor of
      activation of the 2-5A pathway in IBT-treated wt infections. Based on these
      observations, we conclude that the phenotype induced by A18R mutants or by IBT
      treatment of wt infections is caused by a loss of control of late viral
      transcription.

PMID- 8480422
TI  - The complete nucleotide sequence of a pre-core mutant of hepatitis B virus
      implicated in fulminant hepatitis and its biological characterization in
      chimpanzees.
AB  - Hepatitis B virus (HBV) with an in-frame stop codon within the pre-core region of
      the virus genome caused fulminant hepatitis in two individuals. Serum from a
      chronically infected patient who was the source of the virus was inoculated into
      three chimpanzees at dilutions of 10(-1), 10(-3), and 10(-7). All three
      chimpanzees developed acute hepatitis B with relatively high peak values of liver
      enzymes in their serum. The complete nucleotide sequence of virus DNA recovered
      from the chimpanzee serum by enzymatic amplification was identical with that from
      the human serum. By comparing the sequence of this strain (HT) with that of 32
      published HBV genomes, changes in nucleotides and predicted amino acids that were
      rarely or never found in other HBV isolates were identified. Thirteen such
      nucleotides were found within the cis-acting regulatory elements, of which 6 were
      within the enhancer II-core promoter region. Twenty-four rare or unique changes
      in amino acids were found in open reading frames, of which 15 occurred in the
      region that spanned the 3' half of the X gene, through the pre-core/core gene, to
      the 5' end of the polymerase gene. Thus, an HBV pre-core stop mutant implicated
      in fulminant hepatitis is highly infectious, induces severe hepatitis in
      chimpanzees, and possesses significant genetic variation from reported HBV
      isolates.

PMID- 8480423
TI  - Characterization of two African swine fever virus 220-kDa proteins: a precursor
      of the major structural protein p150 and an oligomer of phosphoprotein p32.
AB  - Two kinds of unrelated African swine fever virus proteins of 220 kDa have been
      identified by means of two-dimensional gel electrophoresis and
      immunoprecipitation analysis. One species, named pp220 and identified as the
      precursor of the major structural protein p150, was found to be a moderately
      acidic protein (pl near 7) expressed after the replication of the viral DNA. The
      second species, a cluster of 220-kDa proteins with slightly different isoelectric
      points (pl ranging from 5 to 6), was found to be a homooligomeric complex formed
      by an early 32-kDa protein. This component was identified as the viral
      phosphoprotein p32, the most immunogenic early protein of African swine fever
      virus. A detailed characterization of its oligomeric structure is reported.

PMID- 8480424
TI  - RNA binding of recombinant nucleocapsid proteins of hantaviruses.
AB  - Genes encoding the nucleocapsid (N) proteins of two hantaviruses, Hantaan virus
      strain 76-118 (HTN) and Puumala virus strain CG 18-20 (PUU), were expressed in
      Escherichia coli as histidine-tagged proteins. They were purified by metal
      chelate affinity chromatography under native or denaturing conditions to near
      homogeneity. The soluble form of HTN N protein was associated with RNA of E.
      coli. Renatured N proteins were shown to bind in vitro transcribed RNA
      representing the hantaviral small genomic (S) RNA segment. RNA binding was shown
      by affinity to filter-immobilized N proteins and by gel mobility shift assays.
      Competition experiments using tRNA, poly(U) and poly(A)+ U indicated that binding
      of RNA by the N protein is nonspecific. However, direct binding of ds-RNA
      resulted in efficient formation of large complexes suggesting that double
      stranded nucleic acids are bound preferentially. Carboxyterminal fragments of HTN
      and PUU N proteins containing about 100 amino acids of the carboxy termini
      retained full binding capacity indicating that RNA binding occurs via a
      carboxyterminal domain.

PMID- 8480425
TI  - HIV-1 Nef protein inhibits the recruitment of AP-1 DNA-binding activity in human
      T-cells.
AB  - The human immunodeficiency virus type 1 long terminal repeat, HIV-1-LTR, contains
      binding sites for several cellular transcription factors which contribute to HIV
      1 gene expression. Our previous studies on the function of the HIV-1-encoded Nef
      protein suggested that Nef may be an inhibitor HIV-1 transcription. To determine
      whether Nef affects the binding of cellular factors implicated in HIV-1
      regulation, 32P-labeled oligonucleotides corresponding to the binding sites were
      incubated with nuclear extracts prepared from Nef-expressing T-cell lines that
      were not stimulated or were stimulated with T-cell mitogens. We found that Nef
      inhibited the recruitment of AP-1 DNA-binding activity in mitogen-stimulated
      human T-cells. Additionally, Nef expressing cells were transiently transfected
      with a plasmid in which HIV-1 AP-1 DNA recognition sequences were cloned
      downstream of the chloramphenicol acetyltransferase (CAT) gene. Mitogen-mediated
      transcriptional activation of the CAT gene in this construct was inhibited in Nef
      expressing cells but not in control cells. These studies suggest that, by
      inhibiting AP-1 activation, Nef may play a role in regulating HIV-1 gene
      expression in infected T-cells.

PMID- 8480426
TI  - Mapping of the human immunodeficiency virus type 2 envelope glycoprotein CD4
      binding region and fusion domain with truncated proteins expressed by recombinant
      vaccinia viruses.
AB  - Human immunodeficiency virus type 2 (HIV-2) is more closely related to certain
      simian immunodeficiency viruses than to HIV-1. The HIV-1 and HIV-2 envelope (env)
      glycoproteins share only approximately 40% amino acid (aa) sequence homology.
      Additionally, HIV-1 and HIV-2 seem to differ in pathogenicity and in host range.
      In order to identify the functional domains of the HIV-2 env glycoprotein, e.g.,
      the CD4 binding region, the membrane anchor, and the fusion site, and to compare
      them to equivalent sites of HIV-1, a set of recombinant vaccinia viruses (VV) was
      constructed expressing N-terminal overlapping env proteins of 863 (full-length
      gp160), 708, 534 (full-length gp120), 438, 332, 198, and 488 aa (internal
      deletion of aa 333-707). Upon infection, only env proteins comprising the amino
      terminal half of the transmembrane protein were expressed on the cell surface.
      Such VV constructs also induced syncytia in CD4-positive cells. The syncytia were
      smaller when the cytoplasmic domain of the transmembrane protein was removed. The
      CD4 binding site of HIV-2 was located between the carboxy terminus of gp120 (aa
      512) and aa 438. Thus the amino-terminal half of the transmembrane protein of HIV
      2 is sufficient for cell surface localization of the env protein and syncytia
      induction. These properties are shared with the HIV-1 env protein and demonstrate
      a functional conservation among HIV-1 and HIV-2 despite their genetic and
      phenotypic heterogeneity.

PMID- 8480427
TI  - Selection and characterization of a neuraminidase-minus mutant of influenza virus
      and its rescue by cloned neuraminidase genes.
AB  - A neuraminidase (NA)-deficient mutant, designated NWS-Mvi, of the reassortant
      influenza virus A/NWS/33HA-A/tern/Australia/G70c/75NA (H1N9), was selected by
      passaging virus in MDCK cells in a medium containing neuraminidase from the
      bacterium Micromonospora viridifaciens and polyclonal antiserum against the
      influenza NA. Growth of the resulting mutant virus is dependent on the addition
      of neuraminidase to the medium. Western blot analysis showed that the
      neuraminidase protein was absent from the mutant virus particles, and Northern
      hybridization showed that RNA segment 6, which contains the coding information
      for the NA, had undergone massive deletion. Viral protein synthesis in cells
      infected with the mutant virus was not dependent on the addition of
      neuraminidase. In the absence of a functional NA, the NWS-Mvi mutant virus can
      infect MDCK cells with normal cytopathic effects. This neuraminidase-minus
      influenza virus serves as an excellent source of parent virus for reverse
      genetics experiments involving genes that encode a functional neuraminidase.

PMID- 8480428
TI  - RNase protection analyses show high genetic diversity among field isolates of
      satellite tobacco mosaic virus.
AB  - Fifteen field isolates of satellite tobacco mosaic virus (STMV) were collected
      from wild Nicotiana glauca plants within a 20-km2 area in southern California.
      Analyses of the entire length of the satellite genomic RNA of each isolate by
      RNase protection assays showed that there were 10 different genotypes within the
      15 isolates, including some with regions of extreme divergence from the STMV type
      strain. This indicates a very high level of genetic diversity between natural
      STMV populations. Isolates from adjacent plants (within 3 m) were not always
      identical, but were more similar than those from more distant locations. Mapping
      of the genomic sites of heterogeneity revealed that in all cases the 3' half of
      the genome, which comprises the untranslated region, was more conserved than were
      the 5' coding regions.

PMID- 8480429
TI  - Structure and expression in baculovirus of the Mokola virus glycoprotein: an
      efficient recombinant vaccine.
AB  - The sequence of the glycoprotein gene of the Mokola virus, the more divergent
      element of the Lyssavirus genus, has been determined and the predicted protein
      structure compared to its counterpart in rabies vaccine strains. A global
      similarity of 54.3% was observed. The divergence affects particularly the rabies
      antigenic sites involved in the B-cell response. This provides a molecular basis
      for the absence of cross-protection between Mokola and rabies viruses and argues
      for the necessity of a specific anti-Mokola vaccine. Toward this goal, a cDNA
      copy of the glycoprotein gene was cloned into the baculovirus and expressed in
      Spodoptora frugiperda cells. A recombinant protein was produced in substantial
      amounts at the surface of the insect cells. Although less strongly glycosylated
      than the native viral glycoprotein produced in BHK-21 cells, the recombinant
      protein is antigenically and immunologically similar, it is recognized by
      specific monoclonal antibodies, and protects mice against an intracerebral
      challenge with Mokola virus. It therefore constitutes the first experimental
      genetically engineered vaccine against a rabies-related virus, and fulfills the
      international standard for protection.

PMID- 8480430
TI  - Double-stranded strong-stop DNA and the second template switch in human
      immunodeficiency virus (HIV) DNA synthesis.
AB  - Synthesis of unintegrated retroviral DNA via reverse transcription is thought to
      involve two separate template switches. Minus-strand strong-stop DNA, a major
      product of in vitro reactions using detergent-treated virions, is synthesized
      prior to the first template switch. Plus-strand strong-stop DNA, which is found
      base-paired to near full-length minus-strand DNA in infected cells, is believed
      to be synthesized before the second template switch. Using a synchronized, one
      step HIV infection model, we report here the detection in acutely infected cells
      of a novel double-stranded strong-stop HIV DNA with a discrete length of
      approximately 650 base pairs, commencing at or near the left hand end of the
      right-hand U3 region of the HIV long terminal repeat. The plus-strand of this
      double-stranded strong-stop DNA possesses the primer binding site sequence and
      appears to be synthesized prior to the completion of the synthesis of its
      complementary minus-strand. In contrast, the minus-strand of the double-stranded
      strong-stop DNA lacks the primer binding site sequence after RNaseH digestion. We
      propose that a transient free plus-strand strong-stop DNA is released from its
      template by displacement synthesis and subsequently used as template for the
      synthesis of its complementary minus-strand. The proposed transient free plus
      strand strong-stop DNA may also mediate the second template switch.

PMID- 8480431
TI  - [Unexpected and undesirable treatment results].
AB  - The most frequent causes of unexpected and undesired results of treatment are due
      to insufficient information of the patient, furthermore, apart from technical
      deficiencies, to insufficient attention and experience of the physician, and to
      erroneous evaluation of the situation, especially with measuring out a dose of
      treatment-"medicus curat". On the other hand "natura sanat" comprises spontaneous
      healing. It's reactions of adaptation to functional stress are just partially
      known and, therefore, cannot be controlled safely. With insufficient
      incorporation of the cybernetic systems of the tissues into our planning of
      operations counter-reactions have to be expected, resulting in unphysiological,
      "unsound" operative procedures. They are characterised by relative frequent
      recurrences. The chances to reduce unexpected and undesired results in the
      "curative" and "sanative" sector are outlined. The personal experience remains
      most important.

PMID- 8480432
TI  - [Distribution pattern of subchondral mineralization in the glenoid cavity in
      normal subjects, athletes and patients].
AB  - To get information on the stresses acting on the shoulder joint, the distribution
      of subchondral mineralisation was examined by means of CT-Osteo-absorptiometry in
      the glenoid cavity in healthy people, athletes and patients. In young persons two
      density maxima are found ventrally and dorsally older persons, however, show a
      centrally located maximum which suggests a different joint mechanics in different
      ages depending on the decreasing physiological incongruence. In gymnasts the
      overall mineralisation is significantly higher, maxima are found centrally or
      shifted dorsally. In patients with recurrent dislocation of the shoulder or
      instability the zone of highest density is shifted to the edges of the glenoid
      cavity indicating that the prevailing position of the resultant force is
      excentric. By means of CT-Osteo-absorptiometry these individual patterns of
      mineralisation can be displayed in the living and can give information on the
      individual mechanical situation ("loading history") of a joint.

PMID- 8480433
TI  - [Computer-assisted analysis of the kinematics of the upper ankle joint].
AB  - Usually the upper ankle joint is described as a typical hinge though it had been
      often remarked that the axis of rotation moves considerably with regard to the
      angular adjustment between the tibia and the trochlea tali. In the present study
      the relation between the movements in the upper ankle joint and the geometry of
      the lateral ligaments was analysed. The contours and elected landmarks of 6
      dissected ankle joints were measured using a digitizer which allowed the
      computerized scanning of motion x-rays. In addition the proximal and distal
      insertion planes of the lateral ligaments were registered. Mathematical
      procedures were applied on the experimental data to predict the kinematic
      principles. The model of an hinged joint could not reproduce the motion curve
      which was actually found. Using the model of a link chain with four pivots, which
      was determined by the course of the talofibular and the calcaneofibular ligament,
      a good correlation with the experimental results was evident. This model implies
      a rotary and gliding component in the movement of the tibia against the trochlea
      tali. Beside the correspondence with the data of the present study the model
      allows an easy explanation of many other well known morphologic phenomena of the
      upper ankle joint for which a stringent interpretation was not yet available.

PMID- 8480434
TI  - [Shoulder arthrodesis. Possible causes of functionally poor results].
AB  - Due to severe articular destruction of the glenohumeral joint with corresponding
      soft tissue changes arthrodesis has been performed in 24 patients since 1973.
      After an average period of 5.4 years (2-15) years, 22 patients were reviewed.
      Primary bone consolidation was achieved in all cases. During the observation
      period in 7 cases one of the following additional operations had to be performed
      on the involved shoulder: subcapital osteotomy due to excessive abduction (2
      cases), resection of the acromio-clavicular joint due to painful osteoarthritis
      (2 cases), partial resection of an ugly acromion projecting laterally (1 case),
      removal of the fixation plate protruding proximally (4 cases). 18 patients
      experienced a marked improvement after arthrodesis. No improvement in 2 cases and
      a deterioration in 2 cases were the result of a not optimal positioning of the
      arthrodesis. A position of 20 of abduction, 20 to 30 of flexion and 45 of
      internal rotation proved to be functionally the most beneficial. Patients will be
      only painless if the optimal position of the arthrodesis was achieved. Excessive
      abduction and flexion was generally experienced as unpleasant. Deviation in the
      rotational position leads to functional restriction. The remaining function after
      arthrodesis is often overrated.

PMID- 8480435
TI  - [Synovial giant cell tumor or nodular circumscribed form of pigmented
      villonodular synovitis?].
AB  - In two case reports we demonstrate symptoms, clinical findings and treatment of
      patients with a benign synovial giant cell tumor of the knee and ankle joint.
      This tumor impresses like a localized pigmented villonodular synovitis but
      compared to this benign synovial giant cell tumors are rare in synovial joints
      and more often localized at the synovial tendon sheaths of fingers. Symptoms and
      clinical findings often mimic meniscal lesions. One of the most important finding
      is a hemorrhagic joint effusion without previous trauma. There are no typical
      findings in diagnostic imaging procedures and it seems that the most important
      fact is that the clinician is aware of this type of synovial tumor. Early
      resection of the tumor within wide margins is the treatment of choice.
      Postoperative radiotherapy is not to recommend.

PMID- 8480436
TI  - [Diagnosis and clinical aspects of Yersinia arthritis].
AB  - Clinical and serological criteria of Yersinia arthritis are presented by a review
      of the literature and case studies. Characteristic findings are preceding
      abdominal symptoms followed by oligoarthritis of the lower extremities. 80% of
      patients are HLA-B 27 positive, rheumatoid factors are negative. Detection of
      Yersinia in stool cultures is a rare proof. The most important serological
      indicator is IgA for identification of Yersinia antibodies. Yersinia arthritis
      will resolve without sequelae under symptomatic and antibiotic (chemotherapeutic)
      medication within 6 months.

PMID- 8480437
TI  - [Are pathohistological studies helpful in the clinical differential diagnosis of
      chronic arthritis?].
AB  - We have evaluated the diagnostic and therapeutic consequences of
      histopathological examinations of knee synovium from 216 patients with chronic
      arthropathies. We were able to differentiate between non-rheumatic etiologies,
      such as tuberculous arthritis, villonodular synovitis, crystal arthropathies and
      chondromatosis. This resulted in the establishment of a diagnosis and often a
      guide to therapy as well. It is rarely possible however to conclusively
      differentiate among the different inflammatory rheumatic diseases or osteo
      arthroses by the histopathology of the joint lesions seen.

PMID- 8480438
TI  - [Suppression of macrophage subpopulations in post-traumatic osteomyelitis].
AB  - Similar to other chronic inflammatory diseases such as rheumatoid arthritis the
      distribution of macrophage subtypes seems to be disturbed in post-traumatic
      osteomyelitis. This atypical distribution is clearly locally restricted in
      osteomyelitis. 27E10-positive macrophages found only during the acute phase of
      inflammation were reduced in 39%, the 25F9-positive subtype, predominating in the
      late stage of inflammation, was missing in 33%. The antiinflammatory macrophage
      RM3/1 was decreased in 40% of the osteomyelitis biopsies. Local suppression of
      macrophage subsets has to be discussed as one of the reasons for the persistence
      of chronic inflammatory processes in osteomyelitis.

PMID- 8480439
TI  - [Fibrous dysplasia versus osteofibrous dysplasia. Morphological, differential
      diagnostic and clinical aspects. Experiences from the Westfalen bone tumor
      registry].
AB  - Histologically, this lesion, which was first described by Campanacci, is
      characterized by an osteofibrous stroma replacing normal bone, showing trabeculae
      which, unlike in FD, are surrounded by a regular rim of prominent cubic
      osteoblasts, mature lamellar bone and zonal segmentation with newly formed
      trabeculae mostly in the cortical region. Radiologic features are eccentric,
      usually diaphyseally localized osteolytic lesions of the tibia with ground glass
      appearance. Differential diagnosis includes FD and adamantinoma. Just like OFD,
      the latter occurs almost exclusively in the tibia, its potential malignancy
      calling for a more radical therapeutical procedure. Being such a rare lesion,
      there are no clear guidelines regarding formal pathogenesis and therapy of
      adamantinoma in combination with osteofibrous stromal reaction. The mean age of
      the eleven patients with OFD was nine years, which is considerably lower than
      that of patients with FD (30 years). The lesions were found exclusively in the
      tibia. Surgical therapy is often followed by a recurrence of the tumor (in two
      cases in the present material), so it should be avoided, where possible. Thus,
      surgery should only be performed if complications are imminent, such as marked
      bone deformation or pseudoarthrosis. Unlike in FD, once bone maturation is
      completed, surgical treatment of OFD is not normally followed by recurrent
      disease. Thus, the prognosis of OFD with restricted surgical therapy is more
      favourable than that of FD, which frequently shows extensive skeletal involvement
      and recurrent disease even after many years. The more aggressive course of OFD
      reported by other authors must therefore be explained by too early surgical
      intervention, i.e. during bone maturation.

PMID- 8480440
TI  - [Cost analysis of a bone bank].
AB  - The costs of a bone-bank working in accordance with the guidelines of the german
      federal chamber of physicians are described. Establishing a bone-bank storing
      deep-frozen bone is not very expensive. The main costs are due to laboratory
      costs for excluding HIV, hepatitis, syphilis and bacterial contamination of bone
      grafts. In our experience with 206 bone grafts about 20% of them are to be
      discharged because of positive laboratory tests. The costs of each bone graft are
      DM 327. A second HIV-Test of the donor 3 months after explantation of a bone
      graft will cause rising of costs up to 47%. About 20-30% of bone graft donors
      will probably not carry out this test. In this case discharging of the bone graft
      is necessary.

PMID- 8480441
TI  - [Damage assessment of a stainless steel lock pin].
AB  - Metallurgical investigation methods were used to determine the cause of failure
      in a broken and explanted lock pin. Material analysis revealed that the implant
      material consists of a stainless steel. The fractographic investigation indicated
      a fatigue fracture with its typical characteristics. Macroscopic damage of the
      outer surface of the implant caused the fatigue fracture in the bone fracture
      region. Once the lock pin had failed, further crack propagation of the fatigue
      fracture was largely dependent on stress intensity and/or overloading of the
      implant in the bone fracture region as well as on the number of stress cycles.
      The following items should be observed by the physician applying implant
      materials: 1. A material showing only very small surface scratches in the order
      of magnitude of thousands of millimeters should not be implanted at all, because
      even the smallest surface roughness may cause fractures of the material. 2.
      Implant materials from low-cost manufacturers should never be applied. Such
      materials often show construction faults (in the present case an unnecessary weld
      in the upper part of the lock pin) or the material itself is not well conditioned
      (in the present case an insufficient annealing treatment).

PMID- 8480442
TI  - [Undesirable treatment results from the viewpoint of an expert witness on medical
      liability problems--an analysis of 142 cases].
AB  - Causes of proven medical misconduct were analyzed on the basis of 142 expert
      testimonies prepared for an advisory committee on medical liability. The
      principal causes of misconduct identified were: 1. an incorrect indication for
      surgery; 2. Unsatisfactory surgical technique; 3. Inadequate preoperative patient
      enlightenment. In many of the cases in which an incorrect indication for therapy
      or a technical error could not be proved, the patients or their lawyers attempted
      to assert their claims by declaring that they had been insufficiently informed.
      The majority of the claims for recourse concerned: a) problems associated with
      implantation of total hip replacements; b) sequelae of revisional osteotomies of
      the lower extremity; c) infiltration therapy with a topical anesthetic; d)
      sequelae of lumbar disc surgery. These four therapeutic categories accounted for
      almost two-thirds of all proven errors of therapy and in informing patients. A
      total of 16.26% of the claims were resolved in the plaintiff's favor. Several
      examples are presented to illustrate the problem of incorrect indication and
      unsatisfactory surgical technique as a cause of proven therapeutic error.

PMID- 8480443
TI  - [Determination of the elasticity of the femoral cortex of Adam's arc in patients
      with osteoarthritis].
AB  - In this study, the compressive strength, the compressive force as well as
      cortical thickness of prismatic specimens from Adam's arc of the femur were
      determined in patients with osteoarthrosis. Correlations were evaluated between
      the cortical bone parameters, which depend on age and sex. Supported by
      histomorphometric data of cancellous bone, the great variability of mechanical
      properties revealed the variable osteological status prior to implantation of hip
      endoprostheses. Its eventual consequences for alloarthroplastic surgery had been
      discussed.

PMID- 8480444
TI  - [Fracture incidence in 803 women with postmenopausal osteoporosis under drug
      treatment].
AB  - In a survey of cases of confirmed postmenopausal osteoporosis, 803 women were
      asked to complete a questionnaire on radiologically confirmed fractures sustained
      prior to and during drug therapy. Under monotherapy (fluoride or calcium, n = 92)
      the number of peripheral and central fractures was 54% and 49% lower,
      respectively. The corresponding figures with two substances (fluoride and
      calcium, n = 226) were 58% and 60%, with three substances (fluoride, calcium and
      estrogens or Vitamin D, n = 223) 83% and 72%, and with four substances (n = 254)
      85% and 75%.

PMID- 8480445
TI  - [Bone/cement interface reactions following several years of implantation and
      consequences for its fixation].
AB  - Retrieved femora with fixed cemented hip arthroplasties were sectioned
      horizontally. Bone sections were prepared of the whole cross-sectional area to
      study the bone/cement-interface (bci) histologically and morphometrically. The
      interface between bone and cement mainly consists of a thin (< 25 microns)
      connective tissue layer. Demineralized zones were in parts found, this tendency
      seems to slightly increase in time. The bone newly formed at the bci is
      structured like thick trabecular bone or like dense cortical bone. A strong
      fixation seems possible even if a thin connective tissue layer exists, and a
      complete adaptation of the implant to the bone is not necessary, as the bone
      adapts as well.

PMID- 8480446
TI  - [Sterilization and the mentally handicapped: who decides?].
AB  - At the moment sterilization of mentally handicapped persons is carried out in a
      medical and a legal vacuum in Belgium as well as abroad. To give an adequate
      answer to the problem of sterilization of mentally handicapped adolescents in
      medical practice, Dr. J. Denekens undertook an extensive literature review and an
      empirical investigation comprising case-studies of 52 adolescents, their parents
      and family doctors. The adolescents, between the ages of 16 and 21, were selected
      at random from students attending schools for mentally handicapped persons in the
      province of Antwerp during the school year 1989-1990. This study and
      investigation resulted in the formulation of medical and ethical criteria to
      assist decision makers confronted with a request for sterilization from or on the
      behalf of a mentally handicapped person who may be unable to decide this issue
      alone. These criteria have been ordered in a useful and practical algorithm that
      enables a motivated, logical and ethically responsible decision to be taken. A
      proposal of procedure for such a sterilization request has been elaborated. The
      medical-ethical criteria, the algorithm and the procedure proposal come out right
      in time as the European Parliament is discussing a motion that deals with the
      legal part of the subject.

PMID- 8480447
TI  - [Peroxisomal beta-oxidation].
AB  - In animal cells peroxisomes as well as mitochondria are capable of degrading
      lipids via beta-oxidation. Nevertheless, there are important differences between
      the two systems. 1) The peroxisomal and mitochondrial beta-oxidation enzymes are
      different proteins. 2) Peroxisomal beta-oxidation does not degrade fatty acids
      completely but acts as a chain-shortening system, catalyzing only a limited
      number of beta-oxidation cycles. 3) Peroxisomal beta-oxidation is not coupled to
      oxidative phosphorylation and is thus less efficient than mitochondrial beta
      oxidation as far as energy conservation is concerned. 4) Peroxisomal beta
      oxidation is not regulated by malonyl-CoA and--as a consequence--by feeding as
      opposed to starvation. Peroxisomes are responsible for the beta-oxidation of very
      long chain (> C20) fatty acids, dicarboxylic fatty acids, 2-methyl-branched fatty
      acids, prostaglandins, leukotrienes, and the carboxyl side chains of certain
      xenobiotics and of the bile acid intermediates di- and trihydroxycoprostanic
      acids. Mitochondria oxidize mainly long (C16-C20) chain fatty acids, which-
      because of their abundance--constitute a major source of metabolic fuel. The
      first step in peroxisomal beta-oxidation is catalyzed by two acyl-CoA oxidases in
      extrahepatic tissues and by three acyl-CoA oxidases in liver, each enzyme having
      its own substrate specificity. Palmitoyl-CoA oxidase and pristanoyl-CoA oxidase
      are found in liver and extrahepatic tissues. The former enzyme oxidizes the CoA
      esters of straight chain fatty acids, dicarboxylic fatty acids and
      prostaglandins; the latter enzyme oxidizes the CoA esters of branched fatty acids
      but also shows some activity towards straight chain and dicarboxylic fatty acids.
      Hepatic peroxisomes contain a third acyl-CoA oxidase, trihydroxycoprostanoyl-CoAA
      oxidase, which oxidizes the CoA esters of the bile acid intermediates di- an
      trihydroxycoprostanic acids. Treatment of rodents with a number of structurally
      diverse compounds called peroxisome proliferators, results in the proliferation
      of peroxisomes, especially in liver, and in the induction of the hepatic
      peroxisomal beta-oxidation enzymes except pristanoyl-CoA oxidase and
      trihydroxycoprostanoyl-CoA oxidase. There exist several inborn errors, in which
      peroxisomal beta-oxidation is deficient. These diseases are characterized by
      severe neurological symptoms. The biochemical findings in these diseases confirm
      the function of peroxisomal beta-oxidation as described above.

PMID- 8480448
TI  - [The central role of the thymus in the education of T cells to neuroendocrine
      principles].
AB  - The thymus, the lymphoid organ responsible for the induction of central T cell
      self-tolerance, is the site of expression of peptides belonging to the
      neurohypophysial peptide family. The classical model of neurosecretion
      established by the Scharrers for the hypothalamo-neurohypophysial axis however
      cannot be applied to characterize the secretory pathways of neurohypophysial
      related peptides in the thymic epithelial component. The novel model of cell-to
      cell cryptocrine signalling has recently been proposed by J.W. Funder to describe
      the molecular relationships between fixed epithelial cells and migratory
      differentiating cells. In the thymus, the cryptocrine signalling is further
      closely associated to the presentation of the "self" molecular structure by major
      histocompatibility complex-derived proteins to developing T cells. On the basis
      of our observations, the model of the thymic repertoire of neuroendocrine "self"
      antigens transposes to the molecular peptide level the dual physiological role of
      the thymus in T cell negative and positive selection. Moreover, this model should
      also contribute to a better understanding of the molecular mechanisms underlying
      the central T cell tolerance of "self" neuroendocrine functions.

PMID- 8480449
TI  - Pharmacological influences on cardiopulmonary arrest-related brain damage in the
      rat.
AB  - The aim of the present work was to evaluate the protective properties of the
      calcium-entry blocker nimodipine against brain damage induced by cardiopulmonary
      arrest in a rat model. We studied first the effect of nimodipine administered in
      a blind and randomized fashion and started 5 min after the restoration of
      spontaneous circulation. Our experiments showed no improvement of survival, and
      nimodipine did not improve the neurological outcome in the animals surviving
      after 7 days. We even observed a trend toward a decreased survival rate when
      higher doses of nimodipine were used. In order to evaluate whether the lack of
      protective effect of nimodipine might have been due to the fact that it was given
      too late, we administered nimodipine in the second series of experiments at the
      earliest feasible postischemic moment, i.e. at the start of the resuscitation
      attempts. However, this study also failed to show an improved outcome in
      nimodipine-treated animals; there was even a significantly decreased
      resuscitation rate. In order to exclude that a cerebroprotective effect was
      antagonized by deleterious effects of nimodipine on the cardiovascular system,
      which may be especially vulnerable after resuscitation, we also studied
      nimodipine in the 4-vessel occlusion model in the rat. Indeed, in contrast to the
      cardiopulmonary arrest model, cardiovascular depression does not occur in this
      model. In these experiments, we started the administration of nimodipine before
      the induction of global brain ischemia, used 2 different dosage regimens and
      provided prolonged drug administration after restoration of cerebral blood flow
      in order to create optimal circumstances for a cerebroprotective effect to be
      detected. These experiments, however, also failed to show any cerebroprotective
      effect of nimodipine. In this 4-vessel occlusion model, we also evaluated, as a
      control drug, 1,3-butanediol, an alternate substrate for brain metabolism during
      ischemia that has been shown to offer cerebral protection in this animal model.
      Our results could, however, not confirm this beneficial effect. We conclude that
      in the rat there is no cerebroprotective effect of the calcium-entry blocker
      nimodipine on global brain ischemia as present during cardiopulmonary arrest. On
      the contrary, we even observed adverse effects, especially when high doses are
      used and/or when the drug is given during resuscitation attempts.

PMID- 8480450
TI  - Progress in the management of ovarian cancer at the First Department of
      Obstetrics and Gynecology, University of Vienna, since 1955.

PMID- 8480451
TI  - [Embryotomy. A historical review].
AB  - Destructive operations are the oldest type of bloody operation in obstetrics and
      possibly in the (written) history of Medicine. The name "embryotomy" is already
      mentioned in the hippocratic literature. The indication and technique of this
      "two-tempi" operation (embryotomy or reduction of the fetus and embryulcia or
      extraction of the reduced foetus) were thoroughly mentioned, described and coded
      for the first time by Soranos of Ephesos. Soranos was also the first to mention
      clearly by their names the instruments used. Only the Arabic physicians,
      especially Albucasim, transmitted to us the first image of their collection of
      instruments. The author elucidates the many--medical and ethical--aspects
      relating to embryotomy, which has been practised till after W.W.II.

PMID- 8480452
TI  - Production and some properties of fibrinolytic enzymes from Fusarium oxysporum
      N.R.C.1.
AB  - A mixture of yeast extract and peptone in the culture medium was the most
      favourable for the production of active fibrinolytic enzyme by Fusarium oxysporum
      N.R.C.1. Potassium dihydrogen phosphate had stimulating effect, while glucose,
      sucrose, lactose, ribose and soluble starch had adverse effect on enzyme
      productivity. The optimum of the fibrinolytic enzyme activity was at pH 7.0.

PMID- 8480453
TI  - Purification and properties of two fibrinolytic enzymes from Fusarium oxysporum
      N.R.C.1.
AB  - The crude fibrinolytic enzyme preparation from Fusarium oxysporum N.R.C.1 was
      purified into two enzymes by ammonium sulphate precipitation followed by
      chromatography on Sephadex G-100 and DEAE-cellulose. Both fibrinolytic enzymes
      were more active on human than on bovine fibrin. The activity of the "major"
      enzyme component on human fibrin was 72-fold that of the "minor" enzyme
      component. Both enzymes had the same temperature (37 degrees C) and pH (6.98)
      optima. The "minor" enzyme component was more stable than the "major" one against
      heat and pH treatments. Both enzymes were significantly activated with Co2+ and
      inhibited with EDTA.

PMID- 8480454
TI  - Fusarium poae and Fusarium sporotrichioides in cereal grains of the Slovak
      Republic.
AB  - The occurrence of Fusarium poae and F. sporotrichioides was examined in 37,172
      cereal grains of 229 samples from the Slovak Republic. In an area where strains
      of Fusarium parasitized. 40% of grains on average, owing to unfavourable weather,
      5 strains of F. poae were isolated (0.5% out of 1,015 strains of Fusarium). In an
      area where the situation was less unfavourable, Fusarium spp. contaminated on
      average 4.1% of grains, F. poae were present in 6.1% out of 82 strains of
      Fusarium. When cereal ripened and harvested under climatically favourable
      conditions. Fusarium spp. were isolated, on average, out of 3.0% of grains, but
      the strains of F. poae made an essential part of the mycoflora (25.5% out of 985
      isolated Fusarium strains). In three samples there were ascertained 5%, 15% and
      19.5% of grains contaminated by strains of F. poae, F. sporotrichioides was
      isolated only 5 times.

PMID- 8480455
TI  - Mycoflora and mycotoxin of hazelnut (Corylus avellana L.) and walnut (Juglans
      regia L.) seeds in Egypt.
AB  - Fifty-one species and 3 varieties appertaining to 20 genera were collected from
      20 samples of each of hazelnut and walnut seeds on glucose- and 40% (W/V) sucrose
      Czapek's agar at 25 degrees C and 45 degrees C with the most common mesophiles
      were Aspergillus flavus, A. fumigatus, A. niger, Cladosporium cladosporioides, C.
      herbarum, Penicillium chrysogenum, P. citrinum and P. oxalicum. Fusarium
      (represented by F. equiseti, F. moniliforme and F. oxysporum) was recovered from
      walnut seeds in moderate frequency (on glucose-Czapek's agar). Eurotium (E.
      amstelodami, E. chevalieri, E. repens and E. rubrum) was completely absent on
      glucose agar, but it was isolated in high frequency from the two types of seeds
      on 40% sucrose-Czapek's agar. Aspergillus fumigatus and Rhizomucor pusillus were
      the most common thermophilic fungi in hazelnut and walnut seeds on glucose agar
      at 45 degrees C. Humicola grisea var. themoidae and Thermoascus aurantiacus were
      encountered rarely from walnuts. The nuts samples were assayed for natural
      occurrence of aflatoxins B1, B2, G1 and G2, citrinin, ochratoxin A, patulin,
      sterigmatocystin, zearalenone, T-2 toxin and diacetoxyscirpenol by thin layer
      chromatography analysis. Aflatoxin was detected in 90% of hazelnut samples (25
      175 micrograms/kg) and 75% of walnut samples (15-25 micrograms/kg). Zearalenone
      was detected in one sample of walnut (125 micrograms/kg). This is the first
      report for the presence of zearalenone in walnut. The other mycotoxins were not
      detected.

PMID- 8480456
TI  - [The localization of toxin in the cells of Pasteurella multocida].
AB  - The application of the degradation procedure for Gram-negative bacteria according
      to Bewick and Lo to Pasteurella multocida indicates that the obvious localization
      of the toxin is in the periplasm. The stability of the outer membrane and of the
      substances adhering to it is essential for the release of the toxin. The
      production of the toxin clearly depend on the media used.

PMID- 8480457
TI  - [The toxin-producing ability of salmonella from bovine test material].
AB  - Cell-free supernatants of 40 Salmonella strains of different serovars were tested
      for the existence of enterotoxic substances in the rabbit skin permeability
      factor test, rabbit ileal loop test, tissue culture assays (CHO K1, RTG-2), and
      baby mouse test. There were differences in the test results between the strains
      even within the same serovar. Correlation coefficients between the results of
      different toxin tests were low. It is therefore improbable that the "enterotoxic
      activity" of Salmonella is caused by only one toxic substance. The activities
      revealed in the different test systems could not be related to virulence or the
      epizootiological behaviour of the strains. The in vitro occurrence of the
      virulence factor "enterotoxin production" is lower for Salmonella than for E.
      coli and V. cholerae.

PMID- 8480458
TI  - Clinical chemical diagnosis of diseases assisted by logistic regression
      illustrated by diagnosis of canine primary and secondary hepatobiliary diseases.
AB  - OBJECTIVE: The purpose of the present study was to demonstrate the use of
      logistic regression models in the prediction of diseases using the prediction of
      canine primary and secondary hepatobiliary diseases as an example. Briefly, in a
      logistic regression model independent variables (i.e. the analytical results) are
      combined in a linear equation that is used to estimate the logarithm of the odds
      (logit) of an event (i.e. having primary or secondary hepatobiliary disease).
      From the estimated logit given by the logistic regression model, a conditional
      probability of the event (i.e. having primary or secondary hepatobiliary disease)
      can be calculated. STUDY DESIGN: Twenty-six dogs with verified primary and
      secondary hepatobiliary diseases and 19 dogs, initially suspected to have
      hepatobiliary diseases, but with apparently other diseases, were included in the
      study. The following clinical chemical parameters were measured: alanine
      aminotransferase (ALAT), aspartate aminotransferase (ASAT), alkaline phosphatase
      (AP), bilirubin(Total) (TB), urea, glucose, retention of bromosulphthalein (BSP),
      fasting and postprandial total serum bile acid concentration (FSBA and PSBA).
      Logistic regression analysis, using the CATMOD procedure in SAS, was used to
      select which of the measured parameters should be included in the model, and to
      derive a logistic regression model using the selected parameters. To observe more
      closely the potential of the logistic regression model, the model was also used
      to classify a test group consisting of 13 dogs (6 dogs with hepatobiliary
      diseases and 7 dogs with other diseases). RESULTS: By logistic regression
      analysis, ASAT and PSBA were selected to be included in the final model, and the
      final logistic regression model was Y = -3.194 + 0.044.PSBA + 3.251.ASAT. The
      logistic regression model classified correctly 38 (84%) of 45 dogs in the present
      study. Specifically, 21 (81%) of 26 dogs with verified primary or secondary
      hepatobiliary diseases and 17 (90%) of 19 dogs with various other diseases were
      correctly classified by the logistic regression model. When the model was used on
      the test group, 5 (83%) of 6 dogs with hepatobiliary diseases and 7 dogs (100%)
      of 7 dogs with other diseases were correctly classified. CONCLUSIONS: Even though
      the logistic regression model derived in the present study only serves as an
      example, thus reducing the practical usefulness of the derived logistic
      regression model, the present study indicates a great potential of logistic
      models for the diagnosis of diseases.

PMID- 8480459
TI  - Determination of the fructosamine concentration in bovine serum samples.
AB  - The study reports on a spectrophotometric assay for the determination of serum
      fructosamine concentration. The assay was evaluated for use in bovine serum
      samples by assessment of the precision, accuracy and detectability. A reference
      interval for the bovine serum fructosamine concentration was also established.
      Further, the effect of acute changes in blood glucose on serum fructosamine
      concentration as well as the diurnal variations of the serum fructosamine
      concentration were investigated. The main conclusions can be summarized as
      follows: Determination of bovine serum fructosamines may be achieved by a precise
      and accurate assay with a detection limit well below the serum fructosamine
      concentration normally found in bovine sera. As a reference interval for the
      bovine serum fructosamine concentration 213.4 mumol/l to 265.0 mumol/l may be
      used. Serum fructosamine concentration is not affected by acute changes in blood
      glucose, and it displays no significant diurnal variation in cows.

PMID- 8480460
TI  - Periparturient concentrations of insulin glucagon and ketone bodies in dairy cows
      fed two different levels of nutrition and varying concentrate/roughage ratios.
AB  - High producing multiparous dairy cows were fed either diets differing in energy
      content or diets with identical energy and protein content but differing in
      roughage content at the end of the dry period and beginning of lactation. Basal
      insulin and ketone bodies were analysed every week from 3 weeks before to 7 weeks
      after calving. Pancreatic glucagon was estimated 3 weeks before, 1-3 days after,
      and 3 weeks after calving. Before calving the feeding regimen had a very strong
      influence on the basal insulin level. High amounts of concentrate increased basal
      insulin levels until one week before calving and caused an interruption in the
      physiological decreasing course. After calving the insulin levels were low in all
      groups of cows. Before calving there were small variations in the glucagon
      levels, and no influence of feeding was observed. After calving there was a
      strong increase, especially in the cows fed the highest amounts of concentrate.
      Feeding high amounts of concentrate resulted in varying and in many cases
      increased levels of ketone bodies in plasma. Hyperketonemic cows had lower
      insulin and higher glucagon levels than normal cows. The influence of non
      structural carbohydrates in the feed on pancreatic hormones is a cause of
      ketogenesis is discussed.

PMID- 8480461
TI  - [Effect of the storage temperature and time and the test sample materials on the
      LDH isoenzyme activity and protein fractions in horse blood].
AB  - The LDH-isoenzyme activities and the concentration of protein fractions did not
      differ among heparinized plasma and serum samples of horses. In heparinized
      plasma samples stored at 20-22 degrees C and -18 degrees C the LDH-isoenzyme
      activities and the content of the protein fractions remained constant within
      seven days. In contrast in heparinized blood samples the total LDH activity
      increased markedly after seven days of storage. This increase was shared by all
      LDH-isoenzymes but to different extents. While the share of LDH1, LDH2 and LDH3
      decreased, the proportions of LDH4 and LDH5 increased. The concentration of the
      protein fractions in heparinized blood samples was not affected by storage at 20
      22 degrees C for seven days.

PMID- 8480463
TI  - Dicephalus, Arnold-Chiari malformation and spina bifida in a Japanese black calf.
AB  - A case of dicephalus, Arnold-Chiari malformation (ACM) and spina bifida was
      reported in a Japanese Black calf. Both brains and crania showed the same
      abnormalities as those of the monocephalic cases with ACM and were mirror-images
      of each other. The common findings were elongation of the brain, caudal
      displacement and hypoplasia of the cerebellum, dorso-ventral compression of the
      skull, platybasia, and enlargement of the foramen magnum. The craniolacunia was
      also found in our case.

PMID- 8480462
TI  - [Laryngeal hemiplegia in warmblood horses--a study of stallions, mares and their
      offspring].
AB  - Laryngoscopic examination during sedation was performed on 24 stallions and on
      their offspring (240 foals and 474 adult horses). Additionally the dams (n = 308)
      of 35 foals and 216 horses were examined. With the bilateral comparison of the
      arytaenoid movements the function of the abductory and adductory laryngeal
      muscles were evaluated and the left abductory dysfunction (idiopathic laryngeal
      hemiplegia, ILH) was divided into six degrees. The incidence and degree of ILH
      depended on age and the occurrence of the same dysfunction in the parents. Foals
      suffered in significantly lower number (24.7 per cent) than adult horses (49.7
      per cent). The progeny of unaffected parents suffered significantly less from ILH
      (8.9 per cent of the foals, 39.6 per cent of the adult offspring) than did
      comparable progeny of affected parents (41 per cent of the foals, 60.9 per cent
      of the adult offspring). There was no correlation between the occurrence of ILH
      and sex. 120 horses were examined laryngoscopically and during work to get an
      information about the correlation between a visible ILH and the appearance of a
      typical inspiratory noise. 54.3 per cent of the horses with ILH had a typical
      inspiratory noise. 80.9 per cent of the horse with a typical inspiratory noise
      showed ILH.

PMID- 8480464
TI  - Normal electro- and vectorcardiographic data in the growing Friesian calf using a
      semi-orthogonal lead system.
AB  - This study derives normal values for electro- and vectorcardiographic parameters,
      as generated by the Holmes semi-orthogonal lead system, in healthy growing
      calves. Sixty-four electrocardiograms were recorded from healthy Friesian calves
      aged from one week to one year. Waveform and duration were analysed and compared
      in the X-, Y- and Z-leads. The modal P, QRS and T tridimensional vectors were
      graphically constructed and their magnitude and orientation were calculated. The
      duration of waves and intervals were similar to data previously reported in the
      bovine species. Differences from data reported in other species were attributed
      to heart rate. The duration of waves and QT and ST intervals significantly
      lengthened with the decrease in heart rate which occurred during growth. PR
      interval significantly lengthened with physical maturation, and this change was
      independent of the decrease in heart rate. The magnitude and the orientation of
      the spatial modal vectors were approximately similar to the few data previously
      reported in cattle and in other ungulates and were not affected by somatic
      growth.

PMID- 8480465
TI  - Omega-3 fatty acid incorporation in fat and muscle tissues of growing pigs, fed
      supplements of fish oil.
AB  - Fifteen pigs from two litters of Norwegian Landrace were divided into three
      groups of five animals. The pigs were fed individually the same basic diet for 64
      days, one group serving as control, the two other groups receiving daily
      supplements of 5 and 20 g fish oil, respectively. Biopsies were taken from
      subcutaneous fat and muscle tissues on day 0, 3, 8, 16 and 32. Samples were also
      collected from animals slaughtered on days 64 and 78. In fat tissue from pigs
      given a daily dose of 20 g fish oil containing 30% eicosapentaenoic acid (EPA)
      and docosahexaenoic acid (DHA) as triglycerides, the concentrations of EPA and
      DHA were significantly increased above the levels in the control animals over the
      32 days period. Unexpectedly, there was also a significant increase in
      docosapentaenoic acid (DPA), in spite of the very low level of this fatty acid in
      the fish oil. In fat tissue from pigs given 5 g fish oil the contents of EPA and
      DPA were significantly increased. Also in muscle tissue from pigs given a daily
      dose of 20 g fish oil, the concentration of EPA, DPA and DHA were significantly
      elevated above the level of the control group over the 32 days period. In muscle
      tissue from pigs given 5 g fish oil only the contents of EPA were significantly
      increased. There was a positive correlation between the dose of fish oil and the
      concentrations of omega-3 polyunsaturated fatty acids in both fat and muscle
      tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480466
TI  - Is there a place for urinary growth hormone measurement?
AB  - The evaluation of growth hormone (GH) secretion is an important problem in
      pediatric endocrine practice. The diagnosis of GH insufficiency is based on the
      finding of a "blunted" GH response to GH provocative tests or on the
      demonstration of a decreased endogenous secretion. From a practical point of
      view, these methods are uncomfortable, expensive and time consuming. Recently,
      very sensitive specific assays to measure human GH in urine have been developed.
      We present a discussion of available data on these tests in order to estimate
      their role in the evaluation of a short or slowly growing child. The present
      available assays allow measuring very low levels of GH in a small sample of
      untreated urine. The main limitations of urinary GH measurement are the
      intrasubject variability, wide normal range, overlapping results in several GH
      secretory states and lack of information on GH pulsatility. However, most of
      these limitations also apply to other tests of GH secretion. The advantage of
      urinary GH tests is that they provide, in an easy procedure, information on serum
      GH concentration. There is good correlation between urinary and serum GH
      concentration and several findings suggest that urinary GH excretion reflects
      changes in plasma GH levels during the period of urine collection. Therefore, the
      usefulness of urinary GH measurement is that of a simpler and cheaper screening
      method for assessing integrated serum GH concentration in clinical practice.

PMID- 8480467
TI  - Subclinical hypothyroidism and hyperlipoproteinaemia: indiscriminate L-thyroxine
      treatment not justified.
AB  - It is still under discussion whether subclinical hypothyroidism is a biochemical
      syndrome or a disease associated with an increased risk for development of
      vascular diseases due to lipid elevation. Therefore, we investigated lipid values
      in 40 patients with subclinical hypothyroidism, which is defined in terms of
      normal (N = 26) or slightly increased (N = 14) basal TSH values and/or an
      exaggerated TSH response (N = 34) to TRH (> 25 mU/l). Patients with increased
      lipid values were treated with L-thyroxine and reanalysed three months later.
      Mean levels of total cholesterol. LDL- and HDL-cholesterol and triglycerides in
      patients with subclinical hypothyroidism were comparable with those in normal
      subjects. Individual analysis, however, revealed hyperlipoproteinaemia (HL) in
      22.5% of the patients investigated (HL type IIa in seven, type IV in two
      patients). Thyroid function was the same in affected patients as in those with
      normal lipid values, whereas higher age was significantly more often associated
      with this syndrome (p < 0.01). Treatment with L-thyroxine resulted in a
      significant decrease in total and LDL-cholesterol (p < 0.05), although a
      normalization of their lipid values could be obtained only in half of the
      patients. None of the subjects with hyperlipoproteinaemia had a history or
      clinical signs of actual vascular disease. Although the incidence of
      hyperlipoproteinaemia in our study group of patients with mild subclinical
      hypothyroidism (22.5%) is comparable to that of the normal population (21.5%), it
      is more severe in the former group (LDL-cholesterol in patients 5.26 +/- 0.58 vs
      4.8 +/- 0.56 mmol/l in controls; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480468
TI  - Pancreas and gut hormone responses to oral glucose and intravenous glucagon in
      cystic fibrosis patients with normal, impaired, and diabetic glucose tolerance.
AB  - Pancreatic and gut hormone responses to oral glucose, and insulin sensitivity
      were studied in cystic fibrosis patients with normal (N = 14), impaired (N = 4),
      and diabetic (N = 12) glucose tolerance, and in 10 control subjects, and beta
      cell responses to oral glucose and intravenous glucagon were compared. Compared
      to control subjects, initial insulin and C-peptide responses to oral glucose were
      lower in all patient groups, and decreased with decreasing glucose tolerance.
      Insulin sensitivity in patients with impaired and diabetic glucose tolerance was
      lower than in control subjects. The 6 min post-glucagon C-peptide concentration
      was positively correlated with the initial insulin response to oral glucose.
      Fasting levels of pancreatic polypeptide, pancreatic glucagon, total glucagon,
      glucagon-like peptide-1 7-36 amide, and gastric inhibitory polypeptide were
      normal in all patient groups. Following oral glucose, pancreatic polypeptide
      responses were absent in all patients, suppressibility of pancreatic glucagon
      secretion was increasingly impaired with decreasing glucose tolerance, and gut
      hormone levels were normal. In conclusion, at cystic fibrosis (a) insulin
      secretion is impaired even when glucose tolerance and insulin sensitivity are
      within the normal range, (b) the glucagon test gives valid estimates of residual
      beta cell function, (c) pancreatic polypeptide response to oral glucose is
      absent, (d) glucagon suppressibility decreases with decreasing glucose tolerance,
      and (e) the enteroinsular axis is intact.

PMID- 8480469
TI  - Stimulation of mitogenesis in human thyroid epithelial cells by endothelin.
AB  - We investigated whether a potent vasoconstrictor, endothelin, stimulated the
      proliferation of human thyroid epithelial cells (thyrocytes). [3H]-thymidine
      incorporation into normal thyrocytes and thyrocytes from patients with Graves'
      disease was significantly increased at 10(-9) mol/l endothelin, reaching a
      plateau at 10(-8) mol/l. The proliferative responses of the thyrocytes obtained
      from patients with Graves' disease were similar to those of normal thyrocytes.
      Furthermore, the cell number of thyrocytes stimulated by endothelin was increased
      as compared with that of unstimulated thyrocytes. Neither indomethacin nor
      heparin affected this endothelin-stimulated thyrocyte proliferation. When
      thyrocytes were cultured with both endothelin and recombinant interleukin 1 beta,
      there was an additive effect on thyrocyte proliferation. The Ca2+ entry blocker,
      verapamil, inhibited both the proliferative responses of thyrocytes to endothelin
      and the additive effect of endothelin and recombinant interleukin 1 beta on
      thyrocyte proliferation. These results suggest that endothelin functions as a
      growth-promoting factor for human thyrocytes, presumably through intracellular
      calcium influx.

PMID- 8480470
TI  - Impaired pancreatic polypeptide response to a meal in type 1 diabetic patients:
      vagal neuropathy or islet cell dysfunction?
AB  - The pancreatic polypeptide (PP) response to a mixed meal was investigated in
      seven insulin-dependent diabetics without measurable signs of diabetic autonomic
      neuropathy, and in seven healthy subjects. Since acute changes in metabolic
      regulation might influence the meal-induced PP response, the insulin-dependent
      diabetic patients were studied during normo- and hyperglycemic experimental
      conditions at blood glucose levels of 5 and 15 mmol/l, respectively. The PP
      response was identical on the two occasions, the response being significantly
      smaller than in the healthy subjects. Thus, PP response is independent of short
      term changes in metabolic control. Since the response was attenuated in the
      insulin-dependent diabetic patients, who had no otherwise measurable signs of
      neuropathy, the PP response to a meal could be a sensitive indicator of
      dysfunction of the reflex arc controlling PP secretion in insulin-dependent
      diabetic patients. Alternatively, the reduction in PP secretion in these patients
      reflects dysfunction of the PP secreting cells of the pancreas. Iv injection of
      cholecystokinin-8 elicited a small but significant increase in PP concentrations,
      while iv secretin did not increase PP concentrations at all in healthy subjects.
      These stimuli are therefore less suitable in the assessment of vagal neuropathy.

PMID- 8480471
TI  - Human early placental trophoblasts produce an epidermal growth factor-like
      substance in synergy with thyroid hormone.
AB  - Previous studies have shown that human trophoblast is the site of epidermal
      growth factor (EGF) localization, reception and action and that thyroid hormone
      exerts similar effects on trophoblasts endocrine function as observed with EGF.
      Thus, the present study was designed to examine local production of an EGF-like
      substance in synergy with thyroid hormone by early placenta. Explants of normal
      early (7-8 weeks) placentas were cultured in a serum-free condition in the
      presence or absence of L-triiodothyronine (T3), with or without cycloheximide for
      4 days. The conditioned media were dialyzed, lyophilized, acidified and
      chromatographed over a Sephadex G-75 column equilibrated with 1 mol/l acetic
      acid. EGF was measured by a specific RIA for human EGF. Fractionation of the
      serum-free conditioned media resulted in the elution of immunoreactive EGF with
      an apparent molecular weight of 9,000 which is larger than [125I] human EGF. The
      addition of T3 (10(-8) mol/l) resulted in increased secretion of immunoreactive
      EGF by placental explants. By contrast, the addition of cycloheximide (5 x 10(-5)
      mol/l) dramatically reduced the secretion of immunoreactive EGF. The similarity
      of the immunoreactive EGF material to authentic human EGF was supported by
      parallel displacement in human EGF-RIA. These results suggest that human early
      placental trophoblast is capable of producing an EGF-like substance and that
      thyroid hormone enhances the local production of the EGF-like substance. This
      suggests that an autocrine/paracrine control system, wherein EGF serves as the
      signal in regulating placental growth and function in synergy with thyroid
      hormone, exists in human early placenta.

PMID- 8480472
TI  - Mortality in patients treated for hyperthyroidism with iodine-131.
AB  - Causes of death were studied in 10,552 Swedish hyperthyroid patients treated with
      131I diagnosed between 1950 and 1975. The patients were followed for an average
      of 15 years (range 0-35 years) and were matched with the Swedish Cause of Death
      Register. A total of 5,400 deaths were observed and the overall standardized
      mortality ratio was 1.47 (95% confidence interval (CI) 1.43-1.51). The
      standardized mortality ratio for females was 1.50 (95% CI 1.46-1.55) compared to
      1.31 (95% CI 1.23-1.39) in males. The most common cause of death (61%) was from
      cardiovascular diseases (standardized mortality ratio 1.65; 95% CI 1.59-1.71).
      Significantly elevated risks were also seen for tumours, diseases of the
      endocrine system, respiratory system, gastro-intestinal system, and congenital
      malformations. In all causes of death, except tumours and trauma, decreasing
      standardized mortality ratios over time were seen. Patients followed for more
      than 10 years had significantly elevated risks for tumours, diseases of the
      endocrine, respiratory, and cardiovascular systems. Patients given higher 131I
      activity and younger patients had higher standardized mortality ratios than those
      given lower activity and older patients. The hyperthyroidism per se, rather than
      the 131I treatment, appeared to be the major explanation for the elevated
      mortality.

PMID- 8480473
TI  - Significance of steroidogenic enzymes in the pathogenesis of adrenal tumour.
AB  - We examined both activities and amounts of steroidogenic cytochrome P-450s at the
      posttranslational protein level and steroid contents in the adrenocortical
      adenoma from patients with primary aldosteronism and Cushing's syndrome.
      Aldosterone synthase cytochrome P-450 (human P-450aldo) was detected in the
      tumour portion of aldosterone-producing adenoma, but not in the normal control
      adrenals, at the protein level. Neither the activities nor the amounts of other P
      450s in the tumour portion of aldosterone-producing adenoma were significantly
      different from those in the non-tumour portion in the adenoma and the normal
      control adrenals. The aldosterone content was significantly elevated, while the
      androstenedione content was significantly decreased in the tumour portion of the
      adenoma compared with that in the normal control adrenals. In Cushing's syndrome,
      both the activities and amounts of P-450(17 alpha) and P-450c21 were
      significantly elevated in the tumour portion compared with the non-tumour portion
      of the adenoma and the normal control adrenals, while those of P-450scc and P
      450(11 beta) in the tumour portion were not significantly different from the
      normal control adrenals. The cortisol content was significantly elevated, while
      the amounts of aldosterone and 18-hydroxydeoxycorticosterone in the tumour
      portion of the adenoma were significantly decreased compared with those in the
      normal control adrenals. These results demonstrate that overexpression of P
      450aldo in aldosterone-producing adenoma, and those of P-450(17 alpha) and P
      450c21 in cortisol-producing adenoma may play some role in the pathogenesis of
      primary aldosteronism and Cushing's syndrome, respectively.

PMID- 8480474
TI  - Heterogeneity of neuropeptide Y immunoreactivity in patients with
      pheochromocytoma: influence on the diagnostic power of measuring plasma NPY using
      antisera with different specificities.
AB  - The nature of NPY-like immunoreactivity (NPY-LI) was investigated in plasma and
      tumour tissue of 17 pheochromocytoma patients by HPLC, gel filtration and
      isoelectric focusing using two radioimmunoassays (RIAs) directed against the C-
      and N-terminals of NPY respectively. The two RIAs gave similar results in
      pheochromocytomas: 86% of cases had higher NPY-LI concentrations than those found
      in normal adrenal glands and NPY-LI behaved like authentic human NPY during gel
      filtration and HPLC. Assessed by isoelectric focusing, NPY was found to be
      amidated in seven of nine tumours. Contrary to the findings obtained in tumours,
      the results of the two RIAs in plasma samples were not always concordant:
      compared to controls, elevated concentrations of NPY-LI were found in 86% of
      cases of pheochromocytomas using the C-terminally directed RIA and in 76% of
      cases using the N-terminally directed RIA. The results of HPLC and gel filtration
      of NPY-LI in plasma suggested that circulating C- and N-terminal NPY fragments
      account for the discrepancy between the results of the two RIAs. In conclusion,
      most pheochromocytomas contain large amounts of NPY-LI that behaved like
      authentic NPY by chromatographic analysis. On the contrary, circulating NPY-LI in
      some pheochromocytoma patients is heterogeneous with cleaved products which
      influence differently the power of the C- and N-terminally directed RIAs for the
      diagnosis of pheochromocytoma.

PMID- 8480475
TI  - Influence of short-term dexfenfluramine therapy on glucose and lipid metabolism
      in obese non-diabetic patients.
AB  - In a short-term (eight days) double-blind crossover study involving 10 obese
      patients, the effects of dexfenfluramine on glucose and lipid metabolism were
      examined. The protocol comprised whole body in vivo measurements
      (hyperinsulinemic euglycemic clamp in combination with indirect calorimetry) and
      in vitro studies of isolated adipocytes (lipolysis and glucose transport). All
      study participants were weight stable during the study period (103.1 +/- 3.2,
      placebo vs 103.3 +/- 3.1 kg, dexfenfluramine, NS). The following parameters were
      significantly reduced after dexfenfluramine treatment: fasting levels of plasma
      glucose (6.2 +/- 0.2 vs 5.7 +/- 0.2 mmol/l, p < 0.01), serum insulin (168.0 +/-
      14.5 vs 138.9 +/- 7.9 pmol/l, p < 0.05), serum C-peptide (0.68 +/- 0.03 vs 0.58
      +/- 0.02 nmol/l, p < 0.05) and total serum cholesterol (6.07 +/- 0.41 vs 5.48 +/-
      0.38 mmol/l, p < 0.01). In the basal state glucose oxidation rate was
      significantly reduced by 36% (p < 0.001), whereas non-oxidative glucose disposal
      was significantly increased by 41% (p < 0.01), following dexfenfluramine
      treatment. Insulin-stimulated (2 mU.kg-1 x min-1) glucose disposal rate tended to
      be increased (18%, p = 0.10) after dexfenfluramine. In conclusion,
      dexfenfluramine possesses beneficial regulatory effects on glucose and lipid
      metabolism in non-diabetic obese patients, independently of weight loss.

PMID- 8480476
TI  - Effects of tibolone on serum concentrations of lipoprotein(a) in postmenopausal
      women.
AB  - OBJECTIVE: To evaluate the effects of tibolone (Org OD14), a synthetic steroid
      used for the relief of postmenopausal symptoms, on serum concentrations of
      lipoprotein(a) (Lp(a)), an independent risk marker for coronary heart disease.
      DESIGN: Subset of women participating in a non-randomized prospective trial of
      tibolone therapy. Twenty-seven women requesting relief of menopausal symptoms
      were treated with tibolone 2.5 mg/day for six months; 27 women who did not
      request treatment acted as controls. RESULTS: Tibolone induced a substantial fall
      (p < 0.001) in serum Lp(a) levels (median change -48%, range -100% to +3%).
      CONCLUSIONS: In terms of cardiovascular risk, the ability of tibolone to lower
      serum concentrations of Lp(a) may be advantageous in view of the unwanted
      reduction in high density lipoprotein concentrations which has previously been
      demonstrated in users of this steroid.

PMID- 8480477
TI  - The effect of single doses of inhaled beclomethasone dipropionate on the
      circadian rhythm in serum osteocalcin in normals.
AB  - A single dose of 2.5 mg prednisone leads to a significant transient decrease in
      serum osteocalcin, which is only demonstrated by frequent serum sampling. The aim
      of the present study was to evaluate whether a single dose of inhaled
      beclomethasone dipropionate causes transient changes in serum osteocalcin,
      indicating a systemic effect on bone cells. In a double-blind, placebo
      controlled, cross-over design we evaluated the effects of single doses of 250
      micrograms and 1000 micrograms beclomethasone on the circadian rhythm in serum
      osteocalcin. Fifteen normal subjects aged 23-38 years were studied twice with an
      interval of one week with hourly blood sampling from 16.30 until 17.00 the
      following day; 1000 micrograms beclomethasone, but not 250 micrograms, suppressed
      serum cortisol by 14.4 +/- 6.7% (p = 0.03). Neither of the beclomethasone doses
      significantly altered the time pattern of serum osteocalcin. We conclude that a
      single inhaled dose of beclomethasone in the therapeutical range does not acutely
      influence osteoblastic activity as judged from serial measurements of serum
      osteocalcin.

PMID- 8480478
TI  - In vivo acute testicular testosterone response to injection of luteinizing
      hormone in the rat fetus.
AB  - The acute in vivo testosterone response to LH stimulation and its change during
      late fetal life were determined in the rat. In 18.5-day-old fetuses, testicular
      testosterone content was increased in a dose- and time-dependent manner after
      fetal subcutaneous LH injection. The maximum response was small: the testicular
      content and plasma concentration were increased by 200% and 250% over basal
      values respectively, while they were increased 1100% and 1200% in adult rats.
      Similarly, comparable low responses were obtained after subcutaneously injecting
      the fetuses with human chorionic gonadotropin (hCG) and after injecting LH into
      the vitelline vein. Between days 18.5 and 21.5 of fetal life, the testosterone
      levels in the testis and plasma of uninjected or PBS-injected fetuses decreased
      and were comparable in both groups. In maximally LH-stimulated fetuses, the
      testicular content did not change with age, and plasma concentration was lower on
      day 21.5 than on day 18.5. Since the number of Leydig cells increases 1.5 to 2
      fold between days 18.5 and 21.5, these results show an age-related decrease in
      basal and maximally LH-stimulated in vivo testosterone secretions per Leydig cell
      during late fetal life.

PMID- 8480479
TI  - Biological and immunological properties of the international standard for FSH
      83/575: isoelectrofocusing profile and comparison with other FSH preparations.
AB  - The new international standard for FSH, IS 83/575, has been analyzed, after
      isoelectric focusing separation, by Sertoli cell in vitro bioassay, radioligand
      receptor assay and two highly specific immunometric assays. Its molecular
      composition was then compared with the isoelectric focusing profiles obtained
      from the fractionation of the reference preparation 2nd IRP 78/549 and from pools
      of human male and female pituitary extracts and male and female sera. The results
      showed that > 80% of immunoreactive and bioactive FSH in the IS 83/575 has a pI
      value < 4, while such very acidic material was represented much less in the other
      FSH preparations tested. All the immunoreactive material contained in the IS
      83/575 was shown to be capable of receptor binding and bioactivity in vitro. A
      generally good correspondence between IEF profiles obtained by bioassay and by
      immunofluorimetric assay was evident in the case of IS 83/575, 2nd IRP 78/549 and
      pituitary extracts, although the profiles recorded by immunofluorimetric assay
      were rather smooth and more isoforms were detected by bioassay. A striking
      discrepancy between immunoreactive FSH and bioactive FSH was observed after
      isoelectric focusing fractionation of the serum pools, in which some bioactive
      material was not detected by immunofluorimetric assay and some of the
      immunoreactive FSH peaks were devoid of bioactivity, indicating that serum
      contains inhibitors of FSH action and that immunometric assays based on
      monoclonal antibodies may miss some bioactive FSH isoforms.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8480480
TI  - Low-dose recombinant alfa-2a-interferon: a feasible maintenance therapy in acute
      myeloid leukaemia in the older patient.
AB  - Eleven patients with acute myeloid leukaemia (AML) in first complete remission
      (CR) were treated with alfa-2a-interferon (for short 'interferon') maintenance
      therapy, at a dose of 3 MU twice to thrice weekly subcutaneously. Adjustments
      were made to maintain neutrophil counts > 1 x 10(9)/l and platelet counts > 100 x
      10(9)/l. A transient fall in haemoglobin, neutrophil and platelet counts was
      noted in all 9 evaluable patients. Median time to nadir was 7 weeks. Initial
      dosage reductions were necessary in 5 patients, 3 of whom were later able to
      tolerate the starting dose. No episodes of infection or bleeding were documented
      during therapy and no red cell or platelet transfusions were necessary. At the
      time of writing (median follow-up of 31 weeks), 7 patients continue in CR, 6 of
      whom remain on interferon. One patient discontinued interferon on developing
      sicca syndrome. Other than in this patient, side effects were minor. Mean dose
      administered was 6.7 MU/patient/week. We conclude that low-dose IFN maintenance
      therapy is well tolerated in older patients with AML in first CR.

PMID- 8480481
TI  - Changes in plasma levels of prothrombin fragment F 1 + 2 in cases of disseminated
      intravascular coagulation.
AB  - Plasma levels of prothrombin fragment F 1 + 2 (PTF) and thrombin-antithrombin III
      complex (TAT) were assayed in 86 cases of disseminated intravascular coagulation
      (DIC). A significant elevation of both parameters was observed in most cases of
      DIC, which suggested that the in vivo generation of thrombin is highly
      accelerated by the cleavage of the prothrombin molecule by factor Xa. On the
      contrary, no significant elevation of plasma levels of PTF was observed in cases
      of DIC with severe hepatic failure or fulminant hepatitis in spite of significant
      elevation of TAT. Plasma levels of PTF were directly proportional to those of TAT
      in 86 cases of DIC as a whole (r = 0.682, p < 0.001). The measurement of both
      parameters was considered to be useful to estimate the hemostatic activation in
      DIC.

PMID- 8480482
TI  - Expression of fibronectin and adhesion to fibronectin in myeloma cell lines.
AB  - Fibronectin (FN) expression in six myeloma, two mature B-cell lines, and four T
      cell lines was analyzed. All myeloma cell lines expressed FN at various levels,
      while mature B- and T-cell lines apparently had less FN. Moreover, an
      extramedullary plasmacytoma-derived myeloma cell line, KHM7, was found to secrete
      FN into the culture medium. Fibronectin receptors, VLA4 or VLA5, were expressed
      at various levels on all myeloma cell lines. An adhesion assay revealed three of
      six myeloma cell lines bound to FN. However, there was no correlation between
      binding to FN and FN receptor expression, indicating a complicated FN binding
      pathway. The mechanism and pathological significance of FN expression and FN
      binding in myeloma cells are discussed.

PMID- 8480483
TI  - Recurrent transient bone marrow hypoplasia associated with pregnancy.
AB  - A 24-year-old female was admitted for evaluation of thrombocytopenia during her
      second pregnancy. During the second trimester of her first pregnancy, the patient
      developed aplastic anemia which resolved completely following termination of
      pregnancy. Three and a half years later she was admitted in the third trimester
      of pregnancy suffering from severe thrombocytopenia and hypoplastic bone marrow
      which improved after a normal delivery. To the best of our knowledge this is the
      first description of recurrent bone marrow hypoplasia associated with pregnancy.

PMID- 8480484
TI  - Atypical hereditary ovalocytosis associated with defective dyserythropoietic
      anemia.
AB  - The cases of a child and his mother affected by chronic anemia with atypical
      elliptocytosis are reported. When adolescent the mother underwent splenectomy,
      with an incomplete response. Anemia was characterized by a morphological picture
      of ovalocytosis associated with a significant percentage of spherocytes in the
      peripheral blood of the child and spiculated red cells in that of the
      splenectomized mother. Bone marrow aspirates of the child showed a striking
      erythropoietic hyperplasia with marked decrease of mature cells and
      dyserythropoietic features. Reticulocyte count was rather low. Ferrokinetics
      showed ineffective erythropoiesis. Biochemical studies on red blood cell membrane
      cytoskeleton showed that beta-spectrin, alpha-spectrin and protein 4.1, which are
      usually altered in hereditary elliptocytosis (HE), were normal in our cases. This
      report confirms the hypothesis of Torlontano who postulated the existence of a
      distinct atypical form of HE associated with ineffective and dysplastic
      erythropoiesis.

PMID- 8480485
TI  - Severe osteoporosis and multiple vertebral collapses in a child during treatment
      for B-ALL.
AB  - The incidence of bone lesions at diagnosis of childhood acute lymphoblastic
      leukemia (ALL) is relatively high. However, no cases of severe osteoporosis with
      multiple vertebral collapses secondary to treatment in children with ALL have
      been reported. We report the case of a 9-year-old-boy with B-ALL, with no bone
      lesions at the diagnosis that, following the 4th block of aggressive chemotherapy
      (protocol B-ALL BFM 86), presented severe back pain and functional impairment
      with diffuse osteoporosis and vertebral collapses. He was treated with
      calcitonin, vitamin D, calcium, physical therapy and orthopedic corset.
      Osteoporosis progressed slowly during the following 2 months of chemotherapy and
      the boy developed dorsal kyphosis. After discontinuing antiblastic treatment
      progressive clinical improvement was observed, with complete resolution of
      kyphosis in about 6 months. An almost complete bone recovery was seen on X-ray
      survey at 26-months follow-up.

PMID- 8480486
TI  - Myelodysplastic syndrome with thrombocytosis in a patient with Klinefelter's
      syndrome.
AB  - We report herein a patient with Klinefelter's syndrome associated with refractory
      anemia with excess of blasts in transformation, a subtype of myelodysplastic
      syndrome (MDS). The MDS developed with karyotypic abnormality involving
      t(4;7)(q21;q11), and was characteristic of marked thrombocytosis and marrow
      infiltration by many atypical megakaryocytes. The patient also had diabetes
      mellitus and a disturbed immune system. To our knowledge, this is the fifth
      reported case of MDS in patients with Klinefelter's syndrome in the literature.

PMID- 8480488
TI  - In vivo evidence of all-trans retinoic acid inducing maturation in acute
      promyelocytic leukaemia.
AB  - All-trans retinoic acid therapy induces maturation in acute promyelocytic
      leukaemia. We document in vivo evidence of differentiation by all-trans retinoic
      acid in a case of acute promyelocytic leukaemia which was characterized by
      cytoplasmic vacuolations.

PMID- 8480487
TI  - B-type large-cell primary splenic lymphoma with massive involvement of the red
      pulp.
AB  - A B-type large-cell primary splenic lymphoma with massive red-pulp involvement
      was diagnosed in a 64-year-old woman presenting with malaise, fever, anemia,
      atypical lymphoid cells in peripheral blood, and splenomegaly. This case differs
      from most splenic lymphomas both macroscopically and microscopically. At
      macroscopic examination, the spleen was homogeneously red without tumoral nodules
      or masses. Microscopically, the cords of the red pulp were extensively invaded by
      tumor cells maintaining patient sinuses. The white pulp was reduced by expansion
      of the red pulp. To our knowledge only few additional cases of splenic lymphoma
      with similar features have been previously described. The differential diagnosis
      of this unusual form of lymphoma with other lymphoproliferative disorders is
      briefly discussed.

PMID- 8480489
TI  - A rapid method for the detection of alpha I/65 hereditary elliptocytosis.

PMID- 8480490
TI  - Proteins C and S in two different vaso-occlusive disorders.

PMID- 8480491
TI  - Treatment of acute idiopathic thrombocytopenic purpura with high-dose
      methylprednisolone and immunoglobulin.
AB  - In childhood idiopathic thrombocytopenic purpura (ITP), both intravenous high
      dose steroids and immunoglobulin treatments have been demonstrated to raise
      platelet counts reliably and in most cases within 72 h, when used as separate
      therapeutic modalities. However, until now, the preferred emergency management of
      life-threatening complications in children with ITP has been immediate
      splenectomy. Since steroids and immunoglobulin create a partial splenic
      dysfunction, through different mechanisms, we investigated whether combined
      treatment with both drugs could produce a rapid platelet count increase
      comparable to that of splenectomy. Eleven patients, ages 4 months to 6 years,
      with a diagnosis of acute ITP were entered into this pilot study. Treatment
      consisted of intravenous high-dose methylprednisolone (20 mg/kg in 30 min)
      followed by intravenous gamma globulin (Gamimune-N, 1 g/kg over 5 h). The
      combined therapy resulted in rapid increments in the platelet counts of all
      patients within the 24-hour period. At 12-h, in particular, 9/11 patients had
      platelet counts of 30 x 10(9)l or more. We conclude that this combined therapy
      provides a prompt rise in platelet counts to a safe and hemostatic level and may
      offer a viable alternative for emergency splenectomy and its associated
      morbidity/mortality in many cases of childhood ITP.

PMID- 8480492
TI  - Lung permeability and other pathophysiological lung problems in shock.

PMID- 8480493
TI  - Kidney function in shock.

PMID- 8480494
TI  - Manipulation of the immunoinflammatory reaction in clinical sepsis.
AB  - For many years patients with sepsis and septic shock have been treated with
      antibiotics, fluids, surgery (if indicated) and, in the more severe cases,
      inotropic and ventilatory support. During recent years there has been an
      intensive development of new treatments based on increased knowledge of the
      pathophysiology. This presentation will focus on treatments modulating the
      immunoinflammatory response, which are either available in clinical practice
      today or which will be available in the near future. It is concluded that optimal
      therapy depends on the stage of the septic disease as well as the gram stain of
      the causative bacteria.

PMID- 8480495
TI  - Volume substitution in shock.
AB  - Shock treatment seems optimal when a "balanced" fluid and volume regimen,
      including both crystalloid (Ringer's acetate) and about 3% colloid, is used.
      Dextran is the colloid of choice due to its beneficial effects on plasma volume,
      hemorheology, and microvascular blood flow. Dextrans exert, in addition,
      inhibiting effects on the shock- and trauma-induced activation of the cascade
      system, whereby the risk of complications in the form of multiple organ failure
      is reduced. Infusion of red blood cells, plasma or thrombocytes should be based
      on a proper assessment of each individual patient's actual need of oxygen
      transporters and coagulation factors.

PMID- 8480496
TI  - Oxygen transport in severe sepsis.

PMID- 8480497
TI  - The pathophysiology of shock.
AB  - Trauma often includes considerable losses of blood and plasma that may lead to
      hypovolemia and shock. The initial response of the body to trauma and hemorrhage
      is characterized by a neuroendocrine-mediated general defence reaction for the
      maintenance of circulatory homeostasis and substrate availability for vital organ
      function. Endogenous fluid is mobilized from intracellular and interstitial
      sources into the vascular compartment. This transcapillary refill is achieved by
      activation of glucose osmotic and neurogenic adaptive vascular mechanisms. The
      metabolic consequences of insufficient tissue perfusion are anaerobic glycolysis
      with increased production of lactate and hydrogen ions, acidosis, impaired
      mitochondrial energy production, disturbed ionic homeostasis across cell
      membranes, and reduced functional capacity of tissue cells. The shock- and trauma
      induced alterations in tissue perfusion and metabolism vary, depending on the
      autoregulatory capacity of an organ, its basal metabolic requirements, its high
      energy phosphagen reserves, and its ongoing functional activity. Metabolic
      alterations impairing organ function occur early in the kidney and the liver and
      late in the heart and the brain. The ischemic tolerance of the skeletal muscle
      cell is considerable but vast amounts of lactic acid are produced, which at
      reperfusion will reach central blood and disturb vital organ function. Tissue
      factors released from mechanically traumatized or hypoxic cells will activate
      cascade systems and may induce alterations in remote organs, i.e. result in the
      development of multiorgan failure.

PMID- 8480498
TI  - Optimization of oxygen transport to the tissues.

PMID- 8480499
TI  - Cascade system activation in shock.
AB  - Trauma and sepsis activate different cascade systems. Activation of the
      coagulation and clotting systems, of the kinin-kallikrein system and of the
      complement system are important etiological mechanisms behind development of the
      adult respiratory distress syndrome (ARDS) and multisystem organ failure (MOF)
      after extensive trauma or severe septic situations. Activation of complement with
      the release of anaphylatoxins and terminal complement complexes is associated
      with increased mortality and development of ARDS and MOF after major surgery and
      in situations of septic shock. The anaphylatoxins have potent vascular properties
      and they activate leukocytes. Their effects on the leukocytes lead to the release
      of free oxygen radicals, different lysosomal enzymes and cytokines, leukotrienes
      and histamine. All these inflammatory mediators may, if released in extensive
      amounts, induce microvascular injury and interstitial edema. If this process
      takes place in the lung, ARDS may develop and if other organs, i.e the liver and
      the kidneys, are involved, MOF may be the result.

PMID- 8480500
TI  - Physiological aspects of vascular endothelial cell interactions in hypertension
      and atherosclerosis.
AB  - Hypertension causes a number of alterations of the coronary circulation which may
      influence the outcome of anaesthesia and surgery. These include changes in the
      architecture of the coronary vasculature, and impairments in coronary reserve and
      autoregulatory ability of the coronary microvasculature during decreases in
      perfusion pressure. Chronic hypertension may also alter endothelial regulation of
      vascular control. Many of the vasodilators used to treat hypertension may have
      unique effects on the coronary circulation which may become modified by chronic
      hypertension and cardiac hypertrophy. In this review, each of these areas are
      considered together with some unique aspects of endothelial/vascular smooth
      muscle interactions as they relate to acute and chronic hypertension, and to the
      pharmacological agents used in the treatment of hypertension.

PMID- 8480501
TI  - Therapies for perioperative hypertension: pharmacodynamic considerations.
AB  - Cardiac output (CO) and peripheral resistance (PR), the two major determinants of
      systemic arterial blood pressure (BP), are regulated principally by the
      adrenergic (ADR) and renin-angiotensin-aldosterone (RAA) systems.
      Antihypertensive medications ultimately decrease CO, PR, or both, by acting at
      various sites in the ADR and RAA pathways or affecting cardiovascular functions
      directly. Beta-ADR-receptor blockers decrease heart rate (HR) and stroke volume
      (SV) by preventing the cardiostimulating effects of catecholamines and inhibiting
      renin release. Alpha-ADR-receptor blockers prevent the vasoconstricting effects
      of catecholamines and reduce PR (afterload). Angiotensin-converting enzyme
      inhibitors (ACEI) block the formation of angiotensin, a potent peripheral
      vasoconstrictor and aldosterone releaser. Hence, ACEI cause a decrease in both PR
      and CO, the latter by preventing salt and water retention by aldosterone, thereby
      reducing plasma volume and venous return. Direct vasorelaxation and, thus, a fall
      in PR can be achieved by vasodilators. These include drugs (e.g. calcium
      antagonists) that prevent the entry of calcium ions into vascular smooth muscle
      cells, and others (e.g. nitrovasodilators) that boost the intracellular levels of
      vasodilating second messengers (e.g. cyclic GMP). Antihypertensives from
      different classes are often combined to improve the ratio between therapeutic and
      adverse effects.

PMID- 8480502
TI  - The ideal agent for perioperative hypertension and potential cytoprotective
      effects.
AB  - Perioperative hypertension is primarily due to increased systemic vascular
      resistance (SVR). Therefore, the major therapeutic approaches are directed at
      reducing vasoconstriction, using drugs that increase cyclic nucleotides or block
      calcium entry into vascular smooth muscle. Nitroprusside and other nitric oxide
      derived vasodilators affect both the resistance vessels and the vascular
      capacitance bed. Antihypertensive drugs that affect venous return can have
      unpredictable effects on blood pressure and calculated SVR. The new intravenous
      dihydropyridine calcium antagonists have arterial vasodilating actions and are
      especially promising as new therapeutic approaches for perioperative
      hypertension. Following coronary bypass-grafting, patients have undergone direct
      mechanical manipulation of their native grafts, coronary arteries, and internal
      mammary artery, creating a potential risk for coronary or internal mammary spasm.
      Calcium antagonists may be an important therapy for perioperative hypertension in
      such patients. Experimental models have demonstrated that calcium antagonists can
      attenuate the production of inflammatory mediators and thereby reduce cellular
      damage following reperfusion. These potential anti-inflammatory drugs may prove
      to offer additional benefits in the therapy of perioperative hypertension. The
      potential anti-inflammatory and cytoprotective effects of calcium antagonists may
      make them the ideal agents for the treatment of acute perioperative hypertension.

PMID- 8480503
TI  - Isradipine: a profile in essential hypertension.
AB  - Isradipine is a new dihydropyridine-derived calcium antagonist. It possesses
      marked vascular selectivity, resulting in a powerful vasodilating action,
      whereas, in practical terms, it is devoid of cardiac effects. The usefulness of
      isradipine in the treatment of arterial hypertension is well documented, both
      when used as single-drug treatment and in combination with other agents,
      particularly, beta-blockers. Isradipine is well tolerated and does not negatively
      affect quality of life or capacity for physical exercise. It does not cause
      metabolic disturbances and, apart from the typical dihydropyridine-type vascular
      side-effects, specifically, flushing and ankle oedema, there are no specific
      adverse effects. Even ankle oedema is apparently relatively rare with this
      compound. Studies in animal models show that isradipine has a potent anti
      atherosclerotic effect, and a brain tissue-preserving effect after experimental
      stroke, in doses that are relevant for antihypertensive treatment. If such
      results can be confirmed in humans, they will undoubtedly be of great clinical
      importance.

PMID- 8480504
TI  - Haemodynamics and tissue specificity with isradipine.
AB  - The significant effects of isradipine in producing arterial vasodilation and mild
      negative chronotropic effects without significant negative inotropic effects
      suggests that this agent should provide excellent antihypertensive efficacy in
      the treatment of perioperative hypertension. Isradipine may prove to be a safe
      antihypertensive treatment in patients with impaired ventricular function
      (cardiac failure), impaired myocardial perfusion (ischaemia), and in cases of
      selected conduction abnormalities or arrhythmias. The demonstration that its
      effects are limited to vascular resistance rather than vascular capacitance is an
      important distinguishing feature of isradipine compared with other
      antihypertensive agents. Finally, the potential application of this
      dihydropyridine calcium antagonist for cytoprotection and its effects on
      atherosclerosis remain exciting therapeutic prospects.

PMID- 8480505
TI  - Isradipine and the coronary circulation.
AB  - Isradipine has been shown to be an effective vasodilator in different vascular
      beds. Experimental evidence suggests that isradipine is a potent coronary
      vasodilator, and this is supported by clinical studies in both cardiology and
      cardiac surgery. Furthermore, in these studies, coronary vasodilation was not
      accompanied by evidence of any significant effect on cardiac contractility or
      conduction. It can be concluded that the cardiac effects of isradipine will
      ultimately prove to be beneficial in patients undergoing myocardial
      revascularization.

PMID- 8480506
TI  - A randomized comparative study of the electrophysiological and
      electrocardiographic effects of isradipine vs verapamil.
AB  - Isradipine is a new dihydropyridine calcium antagonist reported to have minimal
      effects on cardiac electrophysiology. Of 19 patients with normal cardiac
      electrophysiological profiles, 11 received isradipine intravenously at doses of
      0.0010, 0.0020, 0.0040 and 0.0080 mg.kg-1 (0.0150 mg.kg-1 total dose), and eight
      received verapamil intravenously at 0.0125, 0.0250, 0.0500 and 0.1000 mg.kg-1
      (0.1875 mg.kg-1 total dose). One patient experienced hypotension several minutes
      after receiving the third isradipine dose. With isradipine, systolic blood
      pressure (BP) decreased from 154 +/- 24 to 151 +/- 22, 143 +/- 25, 133 +/- 19 and
      124 +/- 17 mmHg, respectively. Diastolic BP decreased from 83 +/- 10 (baseline)
      to 80 +/- 12, 76 +/- 10, 74 +/- 7 and 68 +/- 9 mmHg, respectively. With
      verapamil, systolic BP changed from 132 +/- 20 (baseline) to 135 +/- 29, 132 +/-
      24, 130 +/- 25 and 115 +/- 17 mmHg, respectively, and diastolic BP changed from
      80 +/- 14 to 84 +/- 14, 81 +/- 9, 78 +/- 6 and 73 +/- 5 mmHg, respectively.
      Isradipine had no significant effect on the PR, QRS, QT and QTc intervals, nor
      were there changes in the atrial-His (AH) and His-ventricle (HV) intervals,
      atrioventricular nodal effective refractory period. Wenckebach cycle length or
      sinus node recovery time. Similarly, verapamil at the doses studied did not
      significantly affect PR, QRS, QT, QTc, AH or HV intervals. However, with
      verapamil, the Wenckebach cycle length changed significantly from 394 +/- 82
      (baseline) to 448 +/- 93 ms. Despite the significant fall in BP with isradipine,
      heart rate did not change significantly. These results support the
      electrophysiological neutrality of isradipine on the cardiac conduction system.

PMID- 8480507
TI  - Comparative study of isradipine and sodium nitroprusside in the control of
      hypertension in patients following coronary artery-bypass surgery.
AB  - Essential hypertension is a common occurrence after coronary artery bypass-graft
      surgery. CABG and may lead to postoperative complications. In an open randomized
      study, either isradipine or sodium nitroprusside was given by infusion to 27
      postoperative CABG patients who had a mean arterial pressure (MAP) greater than
      100 mmHg. Both agents were able to achieve reductions in MAP to 80-90 mmHg
      quickly and safely, although the effects of isradipine at the dosage used were
      apparent sooner and gave smoother control than with sodium nitroprusside. There
      were two non-responders with the latter agent. Systemic vascular resistance fell
      and cardiac output increased in patients in both treatment groups. Also, an
      increase in heart rate was observed with both agents, although this increase was
      smaller with isradipine. In conclusion, isradipine appears to be a useful agent
      in the treatment of hypertension following CABG surgery and may have some
      advantages over sodium nitroprusside.

PMID- 8480508
TI  - Incidence and aetiology of perioperative hypertension.
AB  - The reported incidence of perioperative hypertension associated with coronary
      artery bypass-graft (CABG) surgery ranges from 30-80%, which may reflect the
      various definitions of the condition as well as differences in the patients'
      preoperative states. Systolic, diastolic and mean arterial blood pressures are
      variously used to define perioperative hypertension, but absolute values range
      from a target systolic blood pressure of below 170 mmHg in some studies to below
      110 mmHg in others. Patients' preoperative states have been extensively studied
      to determine potential risk factors. The majority of these studies indicate that
      perioperative hypertension is predictive of perioperative cardiac morbidity, but
      others do not confirm this finding, rendering the issue unresolved. The
      consequences of perioperative hypertensive episodes include bleeding from
      vascular suture lines, cerebrovascular haemorrhage or subendocardial ischaemia,
      and are associated with a mortality rate that may approach 50%. Increases in
      peripheral vascular resistance (PVR), caused by elevated levels of circulating
      catecholamines, appear to be the primary aetiology. Antihypertensive agents which
      correct or prevent the increase in PVR would appear to be the most appropriate
      therapy. However, no single agent appears to be ideal for all hypertensive
      episodes, suggesting multiple potential aetiologies.

PMID- 8480509
TI  - Gliofibromas (including malignant forms), and gliosarcomas: a comparative study
      and review of the literature.
AB  - The presence of connective tissue elements in gliomas necessitates in every case
      a thorough analysis of the character and derivation of such elements to allow the
      formulation of an appropriate diagnosis. Four cases are presented in this paper.
      In cases 1 and 2 (anaplastic astrocytomas in two children, 9 and 4 years old,
      respectively) all the neoplastic elements were astrocytes and their ability to
      produce or indirectly promote the production of reticulin and collagen fibers
      accounted for the presence of such elements in close association with the tumor
      cells. The term "gliofibroma" has been coined for such tumors, but "desmoplastic
      astrocytoma", (low grade or anaplastic) or in highly malignant cases
      "desmoplastic glioblastoma", as the case may be, also seem to be appropriate
      terms for such neoplasms. In contrast, cases 3 and 4 represented composite tumors
      in adults (66 and 58 years old, respectively) and the neoplasms of these patients
      consisted of glioblastoma and sarcoma, the latter component demonstrably being of
      vascular origin. This is the type of tumor usually referred to as gliosarcoma or
      "Feigin tumor". Although some apparent similarities between the two groups may
      exist at times, the histogenesis of the latter group's sarcomatous or sarcoma
      like portions is different from that of the first group and, therefore, warrants
      separate diagnostic terms and placement in brain tumor classification.

PMID- 8480510
TI  - Colocalization of cholinesterases with beta amyloid protein in aged and
      Alzheimer's brains.
AB  - The colocalization of beta amyloid protein with the enzymes acetyl- and
      butyrylcholinesterase was assessed using immunocytochemistry for beta amyloid
      protein and a sensitive histochemical technique for cholinesterases. In non
      demented aged and Alzheimer's disease brains, double-stained sections for
      cholinesterases and thioflavin-S showed that all thioflavin-S-positive plaques
      were also positive for cholinesterases, indicating the presence of these enzymes
      in all plaques with beta-pleated amyloid protein. When amyloid angiopathy was
      present, cholinesterases were also observed in amyloid-laden vessels walls.
      Comparison of series of adjacent sections alternatively stained for
      acetylcholinesterase, beta amyloid protein and butyrylcholinesterase, as well as
      by double histo-immunocytochemical staining, showed either cholinesterase in a
      proportion of the preamyloid diffuse plaques. These data indicate that
      cholinesterases are associated with the amyloid protein from very early stages,
      when the beta-pleated structure is being formed. Novel functions attributed to
      acetyl- and butyrylcholinesterase, such us their proteolytic activity either by
      themselves or in association with heparan sulfate proteoglycans, may play a role
      in the aggregation or the consolidation processes taking place at the early
      stages of diffuse plaque formation.

PMID- 8480511
TI  - The possible role of lysosomal enzymes in the pathogenesis of hypertensive
      cerebral lesions in spontaneously hypertensive rats.
AB  - In an attempt to clarify the role of lysosomal enzymes in the developmental
      mechanisms of cerebral lesions under chronic hypertensive conditions, we
      biochemically investigated the activities of acid phosphatase (AcPase), N-acetyl
      beta-glucosaminidase (NAGase) and cathepsin B (CathB) in the cerebral cortex and
      subcortical white matter in stroke-prone spontaneously hypertensive rats
      (SHRSPs). We also investigated enzyme-histochemically the activities of AcPase
      and NAGase, and immunohistochemically the distribution of CathB. The activities
      of all enzymes tended to increase with advancing age. The enzyme activities in
      the aged SHRSPs were in general higher than those in normotensive rats, the
      differences being significant at 24 weeks of age. Histochemical investigation
      showed that SHRSPs had an increased number of cells with positive reaction to
      these enzymes in the edematous cortex with and without vascular changes, and
      degenerated subcortical white matter. These cells with positive reaction were
      made up of reactively increased astrocytes and microglia. Neurons in the
      edematous area also showed slightly intensified enzyme activities. The present
      studies suggest that chronic hypertension or chronic edema due to hypertension
      causes increased activities of lysosomal enzymes in the cerebral cortex and
      subcortical white matter and, thus, that activated lysosomal enzymes may take
      part in the developmental mechanisms of cystic formation as well as the diffuse
      degeneration of the white matter.

PMID- 8480512
TI  - Fatal infantile encephalopathy with olivopontocerebellar hypoplasia and
      micrencephaly. Report of three siblings.
AB  - We report three siblings born with severe neonatal encephalopathy, manifested
      clinically by microcephaly, myoclonus, and muscular hypertonus. Karyotypic
      analyses and all biochemical investigations were unrevealing. All three patients
      died during infancy. Postmortem examination of the brain in one child disclosed
      severe neuronal loss in the inferior olives and the pontine nuclei. There was
      also severe hypoplasia of the cerebellum and micrencephaly. There was diffuse
      gliosis of the white matter in all areas of the brain. We believe this may
      represent a previously undescribed form of familial infantile encephalopathy with
      olivopontocerebellar hypoplasia.

PMID- 8480513
TI  - Columnar arrangement of beta-amyloid protein deposits in the cerebral cortex of
      patients with Alzheimer's disease.
AB  - The spatial pattern of beta-amyloid protein (BAP) deposits in Alzheimer's disease
      cerebral cortex was investigated. In cortical areas where the accumulation of BAP
      was relatively sparse, the deposits tended to accumulate vertically in a columnar
      arrangement. Typically, these aggregates consisted of both consolidated and
      diffuse deposits approximately 200 to 600 microns in width. Blood vessels running
      perpendicularly to the pial surface were sometimes observed penetrating the
      center of these columns, but this was not a consistent finding. These BAP
      extracellular aggregates might be related to the columnar organization of the
      cerebral cortex.

PMID- 8480514
TI  - Experimental emetine myopathy: enzyme histochemical, electron microscopic, and
      immunomorphological studies.
AB  - Ipecac, containing emetine hydrochloride, is used by patients with anorexia
      nervosa to induce vomiting. Its chronic usage may result in a myopathy and a
      cardiomyopathy, the former marked by cytoplasmic bodies. We studied
      myopathological changes after daily injections of female Wistar rats with emetine
      hydrochloride intraperitoneally for periods of 4, 5, 9, and 10 weeks. The
      extensor digitorum longus muscle and the soleus muscle showed core-like lesions,
      streaming of the z-discs, nemaline bodies, cytoplasmic bodies, and spheroid
      cytoplasmic bodies. Immunomorphological studies revealed increased amounts of
      desmin. During a period of repair, i.e., 2, 4, and 6 weeks after termination of
      emetine application, these myopathological alterations faded while proliferation
      of the T-tubular system, i.e., honeycomb structures, was more often prevalent.
      Pathological features completely disappeared between 6 and 12 weeks of recovery.

PMID- 8480515
TI  - Ultrastructural neuropathology of chronic wasting disease in captive mule deer.
AB  - Chronic wasting disease (CWD), a progressive and uniformly fatal neurological
      disorder, is characterized neuropathologically by intraneuronal vacuolation,
      spongiform change of the neuropil and astrocytic hyperplasia and hypertrophy.
      Ultrastructural neuropathological findings consist of (1) extensive vacuolation
      in neuronal processes, within myelin sheaths, formed by splitting at the major
      dense lines or within axons; (2) dystrophic neurites (dendrites, axonal
      preterminals and myelinated axons containing degenerating mitochondria and
      pleomorphic, electron-dense inclusion bodies); (3) prominent astrocytic gliosis;
      (4) amyloid plaques; and (5) giant neuronal autophagic vacuoles. Other findings
      include activated macrophages and occasional spheroidal structures containing
      densely packed fibrillar material of unknown origin, abundant structures
      suggestive of degenerating microtubules entrapped in filamentous masses, vacuoles
      and myelin figures. Similar findings have been previously observed in scrapie
      infected hamsters and Creutzfeldt-Jakob disease (CJD)-infected mice, bovine
      spongiform encephalopathy, and CJD indicating that CWD in captive mule deer
      belongs to the subacute spongiform encephalopathies (transmissible brain
      amyloidoses).

PMID- 8480516
TI  - An early cytoplasmic change before Lewy body maturation: an ultrastructural study
      of the substantia nigra from an autopsy case of juvenile parkinsonism.
AB  - Neurons containing a central pale area which may possibly represent an early
      cytoplasmic change before Lewy body maturation were observed in the substantia
      nigra from a rare autopsy case of juvenile parkinsonism. Ultrastructurally, such
      neurons exhibited cytoplasmic swelling along with disappearance of the rough
      endoplasmic reticulum from the central part of the perikaryon. The pale central
      cytoplasm was replaced by numerous-cored vesicles, mitochondria, ribosome-like
      granules and a few Lewy body filaments. The relation of this central pale area to
      the pale body is discussed.

PMID- 8480518
TI  - [Treatment of obstructive processes of prostatic origin with the Fabian
      prosthesis].
AB  - The present report is a contribution of our experience on the use of Fabian's
      prothesis. All patients had a urethral obstructive process which resulted from a
      hyperplastic or carcinomatous prostatic disease for which open- or endoscopic
      surgery was totally contraindicated due to the patients' general status as a
      result of major cardiorespiratory disorders. A literature review and an
      evaluation of both indications and contraindications for using such prothesis was
      made.

PMID- 8480517
TI  - Cortical tubers demonstrate reduced immunoreactivity for synapsin I.
AB  - To evaluate the effects of tuberous sclerosis (TS) on cortical synaptic
      organization, we analyzed synaptic densities within cortical tubers from the
      brains of two TS patients using a polyclonal antibody directed against synapsin
      I, a synaptic terminal-specific protein. The synaptic densities of the tubers and
      adjacent histologically normal cortex were obtained by determining optical
      densities using an IBAS (Zeiss) image analysis system. The tubers showed
      abnormally low levels of synapsin I compared with the normal cortex. The data
      suggest that cortical tubers do not contain a normal complement of synapses. This
      may reflect focal underdevelopment of normal cortical-cortical connections.
      Altered afferent cortical projections may also contribute to synaptic loss in
      cortical tubers.

PMID- 8480519
TI  - [Blue nevus of the prostate].
AB  - The presence of melanin in the prostatic gland's stroma is a histopathological
      finding of extreme rarity. It receives the name of blue nevus as a result of its
      similitude to the skin's blue nevus. The paper describes the finding of melanin
      stores in the fibromuscular stroma of a patient's prostate and reviews the
      theories on its source.

PMID- 8480521
TI  - [Acute colonic pseudo-obstruction (Ogilvie syndrome) after nephrectomy for renal
      carcinoma: persistence after decompressive colonoscopy and spontaneous
      remission].
AB  - A 65-year-old male patient presented acute dilatation in the ascendant colon on
      the third post-operative day following nephrectomy due to renal adenocarcinoma.
      No changes in colonic diameter were seen after decompressive colonoscopy and,
      while the patient was asymptomatic, conservative therapy was instituted and the
      picture was resolved in just a few days. The case is used to review the issue of
      acute colonic pseudo-obstruction and its relationship to urological operations.

PMID- 8480520
TI  - [Cyst of the seminal vesicle. Importance of transrectal echography in this type
      of malformations].
AB  - Presentation of one case of seminal vesicle cyst with no associated anomalies.
      Review of diagnostic procedures useful in this type of disease, illustrating the
      relevance of transrectal ultrasound scanning due to its high specificity and low
      morbidity. Comments on the therapeutical options for this entity.

PMID- 8480523
TI  - [Acquired cystic renal disease, bilateral spontaneous renal hemorrhage, and
      functional renal transplantation. Review of the literature and report of a case].
AB  - Presentation of one case of bilateral, retroperitoneal, intracystic and
      spontaneous renal haematoma in a patient with acquired renal cystic disease
      (ARCD) and renal transplantation with functioning graft. A literature review is
      made with regard to the association of ARCD and spontaneous renal haematoma in
      dialysed patients; also an analysis of the etiopathogenic factors, as well as
      diagnostic and therapeutical approaches to the above association. No reference
      has been found in the literature of concomitant ARCD, bilateral spontaneous renal
      haemorrhage and renal transplantation with functioning graft.

PMID- 8480522
TI  - [Urothelial carcinoma after treatment with cyclophosphamide. Review of the
      literature and presentation of our caseload].
AB  - Cyclophosphamide has been used since 1958 in the treatment of various malignant
      tumours and certain systemic diseases, toxicity to the urothelium, frequently
      causing haemorrhagic cystitis and less often urothelial carcinomas, being one of
      its most notorious side effects--some 60 urothelial carcinoma cases have been
      published following therapy with cyclophosphamide since 1971. The present paper
      is a contribution of two new cases and its raises the need of paying special
      attention to urinary manifestations as well as narrowing the cooperation between
      the physicians which prescribe cyclophosphamide and the urologist, in order to
      make an appropriate follow-up and management of the patient.

PMID- 8480524
TI  - [Gastrocystoplasty for renal insufficiency in adults].
AB  - Vesical substitution or augmentation with various segments from the gut is a
      frequent occurrence in urology. In the presence of normal renal function there
      are few or no metabolic disorders. In the presence of renal failure the most
      suitable gut segment is the stomach due to its characteristics of Cl- and
      ammonium excretion, smaller mucus formation, acid pH provided to the urine and
      because it allows easy ureteral regrafting. This article contributes one case of
      gastrocystoplastia in a patient with trigonal bladder and chronic renal failure,
      presenting reno-vesical TB.

PMID- 8480525
TI  - [Congenital prepubic sinus: blind epispadial duplication of the urethra].
AB  - Presentation of one case of congenital epispadial urethral duplication in a 1
      year old child. The malformation consisted on one normal urethra and the other
      one a prepubic epispadial accessory urethra, with the proximal end finishing
      blind into the anterior side of the bladder. The mictional cystography performed
      showed normal bladder and urethra, while the retrograde urethrography through the
      dorsal sinus showed a 3 cm long tract with no communication to the urethra or the
      bladder. Treatment consisted in total exeresis of the accessory urethra by way of
      suprapubic approach, with no symphysiotomy. Up to the present date, the patient
      remains asymptomatic.

PMID- 8480526
TI  - [Urologic surgery without hospitalization].
AB  - The improvement of surgical utensils, the development of endoscopic techniques,
      the simplification of many surgical procedures and the increasing substitution of
      classic surgery with treatments using the physical effects originated from
      innovative devices, together with the evolution of anaesthetic techniques, make
      possible for urological operations to be now simpler and less aggressive. All of
      what, whenever both the hospital and the social environment so allow it, can let
      us in many cases dispense with hospitalizations which, up to now, were considered
      essential or, at any rate, significantly reduce the patient's stay in hospital.

PMID- 8480527
TI  - [Medical and surgical aspects of renal lithiasis].
AB  - Over the last ten years a true revolution has developed in the resolution of
      renal and excretory tract calculi. Modern technology has made available to
      urologists a wide variety of procedures to be used for the fragmentation and
      removal of calculi, providing few complications, and more satisfaction and speed.
      The results have surprised urologists, patients and the entire community, up to
      the point where all interest in the etiological diagnosis and medical management
      of the lithiatic condition has been lost. Treatment, however, can only be
      considered complete when formation of new calculi is stopped; and progress to
      achieve this objective has also been relevant. The purpose of this paper is to
      explain the reasons for which surgical and medical management should not be
      competitive but complementary. Surgical procedures are directed to existing
      calculus, whereas medical measures focus on prophylaxis.

PMID- 8480528
TI  - [Current controversies on the treatment of urinary lithiasis].
AB  - With the discovery during the 1960s of an access to the renal sinus and intra
      operative radiological monitoring, the lithiasis surgery reached its summit of
      technical perfection. A comparative study on the various therapeutical options is
      presented: NLP, URN, ESWL and open surgery, as the single or combined treatment
      in complex renal lithiasis. Also, intrasinusal and transparenquimatous accesses
      to the intrarenal tract are compared, evaluating the morbidity, surgical time and
      economical interpretation of both techniques. Establishment of each treatments'
      indications and contraindications as well as likely short- and long-term adverse
      effects of the new technologies.

PMID- 8480529
TI  - Report of the 14th meeting of the British Inflammation Research Association.
      Topic: cellular and molecular aspects of inflammatory bowel disease.

PMID- 8480530
TI  - Muramyldipeptide and granulocyte-macrophage colony-stimulating factor enhance
      interferon-gamma-induced nitric oxide production by rat alveolar macrophages.
AB  - Rat alveolar macrophages incubated with recombinant rat interferon-gamma produce
      L-arginine-dependent nitric oxide, which is rapidly decomposed into nitrite: this
      production by interferon-gamma was markedly enhanced by granulocyte-macrophage
      colony-stimulating factor and muramyldipeptide, but not by other cytokines. The
      enhancement was dependent on the presence of L-arginine in the incubation medium.
      It was based on a simple synergism between interferon-gamma and muramyldipeptide
      and a priming effect of granulocyte-macrophage colony-stimulating factor for
      interferon-gamma-induced nitrite production. These data suggest that cytokine
      networks are important in the induction of nitric oxide in rat alveolar
      macrophages.

PMID- 8480531
TI  - Pharmacologic manipulation of a four day murine delayed type hypersensitivity
      model.
AB  - A murine delayed-type hypersensitivity (DTH) model was developed as a tool for
      drug discovery. Time course studies indicated that hind paw swelling was maximal
      at four days post-sensitization with picryl chloride. A pharmacological survey
      involving daily administration of drugs revealed that as a class, the
      glucocorticoids (e.g. dexamethasone and corticosterone) were the most potent
      inhibitors of the DTH response. The immunosuppressants, methotrexate,
      cyclosporine A, cyclophosphamide, and azathioprine, were all able to suppress the
      DTH response, with methotrexate being the most potent suppressor of paw swelling.
      Likewise, non-steroidal anti-inflammatory agents (e.g. indomethacin, piroxicam,
      diclofenac, and naproxen) all suppressed the DTH response, with indomethacin and
      piroxicam being the most potent suppressors. A series of central nervous system
      affecting drugs, including serotonin agonists [e.g.
      trifluromethylphenylpiperazine (tfMPP), 1-(3-chlorophenyl)piperazine (mCPP),
      quipazine, and 8-hydroxy-DPAT hydrobromide (8-OH DPAT)], and serotonin
      antagonists (e.g. cyproheptadiene, ketanserin, and mianserin) were examined in
      the 4 day DTH model. Except for 8-OH DPAT, all of the serotonin agonists were
      able to suppress the DTH response, with mCPP being the most potent suppressor. In
      contrast, none of the tested serotonin antagonists had any effect on the DTH
      response. The histamine antagonists (e.g. cimetidine and chlorphineramine) were
      largely ineffective in suppressing the DTH response. These data provide a
      pharmacological profile for a series of immunomodulator, non-steroidal anti
      inflammatory, and central nervous system active compounds in a classic
      immunologic model.

PMID- 8480532
TI  - In vitro effects of hyaluronan on prostaglandin E2 induction by interleukin-1 in
      rabbit articular chondrocytes.
AB  - Effects of hyaluronan (HA) on the prostaglandin E2 (PGE2) production induced by
      recombinant human interleukin-1 beta (rhIL-1 beta) in rabbit articular
      chondrocytes were studied in vitro. The rhIL-1 beta-induced PGE2 production was
      dose-dependently inhibited by HA. HA with the highest molecular weight (M(r) =
      2.0 x 10(6)) exhibited an inhibitory effect that was statistically more
      significant than the same polymer of lower molecular weights (M(r) = 1.0 x 10(6),
      0.5 x 10(6)). This effect was observed in both young and adult rabbit articular
      chondrocytes. Since PGE2 has been implicated as a mediator of inflammatory joint
      diseases, our observations suggest that HA may elicit an anti-inflammatory effect
      by inhibiting PGE2 production.

PMID- 8480533
TI  - The use of angiostatic steroids to inhibit cartilage destruction in an in vivo
      model of granuloma-mediated cartilage degradation.
AB  - Angiogenesis is an important component of the development of chronic inflammatory
      diseases such as rheumatoid arthritis. It is known that clinically used anti
      rheumatic drugs exert, in part, effects on the angiogenic response. Little work,
      however, has investigated the potential of experimental angiostatic therapies in
      chronic inflammatory disease models. The effect of one such angiostatic
      treatment, cortisone combined with heparin, was tested in an in vivo model of
      granuloma-mediated cartilage degradation. Angiostatic treatment significantly
      retarded the growth of granulomatous tissue, mononuclear cell influx into the
      granuloma, and the degradation of juxtaposed cartilage. This correlated with a
      decrease in the vascularity of the granulomatous tissue. Modulation of this
      component of pathogenesis of "angiogenesis-dependent disease" may be useful as a
      new therapeutic approach.

PMID- 8480534
TI  - Therapeutic potential of protein kinase C inhibitors.
AB  - The serine/threonine protein kinase, protein kinase C (PKC) is a family of
      closely related isoforms which are physiologically activated by diacylglycerol
      generated by the binding of a variety of agonists to their cellular receptors.
      Free fatty acids may also play a role in activating PKC. The enzyme apparently
      mediates a wide range of signal transduction processes in cells and, therefore,
      inhibitors directed selectively against PKC may have wide-ranging therapeutic
      potential. This review highlights the evidence that inappropriate activation of
      PKC occurs in a number of disease states. Such evidence, however, is often
      seriously flawed because it relies on the use of phorbol esters, which are potent
      and direct PKC activators but may not mimic the physiological triggering of the
      enzyme in cells, or on the use of non-selective protein kinase inhibitors such as
      H7 and staurosporine. A new generation of bis-indolylmaleimides, derived from the
      lead provided by staurosporine, shows a high degree of selectivity for PKC over
      closely related protein kinases and such agents may provide more appropriate
      tools to investigate the role of PKC in cellular processes.

PMID- 8480535
TI  - Airway inflammation induced by xanthine/xanthine oxidase in guinea pigs.
AB  - Airway inflammation is suggested to play an important role in bronchial asthma.
      However, there is poor documentation about the effects of reactive oxygens on
      airway tissues in aspect of airway inflammation. Presently, we investigated
      whether aerosolized xanthine (X)/xanthine oxidase (XOD) induces airway
      inflammation in anesthetized guinea pigs. Inhalation of X for 5 min followed by
      inhalation of XOD for 5 min was performed with an ultrasonic nebulizer in
      anesthetized animals. Airway inflammation was assessed by airway vascular
      permeability using Pontamine sky blue. Inhalation of X/XOD produced a marked
      Pontamine sky blue exudation in the trachea, main bronchus and lungs. The X/XOD
      induced increase in Pontamine sky-blue exudation was attenuated by pretreatment
      with inhaled catalase, but not by superoxide dismutase. Additionally, in the
      bronchus and lungs, the increase in Pontamine sky-blue exudation was
      significantly suppressed by deferoxamine. The above results indicate that
      hydrogen peroxide and hydroxyl radical converted from superoxide anion cause an
      intense airway inflammation.

PMID- 8480536
TI  - Identification of tissue kallikrein messenger RNA in human neutrophils.
AB  - Expression of tissue kallikrein in human neutrophils has been suggested by
      previous studies using enzymatic and immunochemical techniques. Secretion of this
      potent biological factor by neutrophils would be of marked significance in the
      inflammatory process. The present study utilized the polymerase chain reaction
      following reverse transcriptase generation of total neutrophils cDNA to
      demonstrate the presence of tissue kallikrein mRNA in the human neutrophils. In
      addition, use of sequence-specific primers demonstrated the presence of mRNA for
      the hGK-1 gene, but not for the hPK gene product or the gene for prostate
      specific antigen. These results confirm that tissue kallikrein is present in
      neutrophils and may be secreted as part of the inflammatory process.

PMID- 8480537
TI  - Release of polyamines in cultures of rat parotid and liver cells.
AB  - Rat parotid gland and liver cells were cultured for 6 and 24 h. The cells as well
      as their growth medium were analyzed on their content of the polyamines
      putrescine, spermidine and spermine. In control medium the content of polyamines
      was very low but already after 6 h substantial amounts of all three polyamines
      under study had been released into the medium from parotid as well as from liver
      cells. The release was much more pronounced from parotid compared to liver cells.
      Putrescine was accumulated in parotid cells as well as in the medium indicating
      that a new synthesis of this amine occurred in these cells.

PMID- 8480538
TI  - Rat paw edema and leukocyte immigration induced by plant lectins.
AB  - Lectins from Dioclea grandiflora (DG) and Canavalia brasiliensis (CB) were
      compared with Concanavalin A (ConA) for their ability to induce paw edema and
      peritoneal cell immigration in rats. ConA caused a slight edema with a peak at 1
      h after injection, while DG or CB induced a pronounced and long-lasting edema
      that reached a maximum at about 6 h. Different antiinflammatory drugs partially
      inhibited the edema. alpha-D-glucose (GLU) partially blocked the edema caused by
      ConA and markedly inhibited that due to CB, but had no effect on the edema
      induced by DG. alpha-Methyl mannoside (alpha-MM) blocked the edema caused by DG
      and ConA, but did not affect that caused by CB. At doses much lower than those
      used to induce paw edema, the lectins promoted an intense accumulation of
      neutrophil and mononuclear cells in the rat peritoneal cavity. CB and DG were
      more potent than ConA, which also presented a different profile of cell
      immigration. GLU significantly inhibited leukocyte accumulation caused by all
      lectins. alpha-MM impaired ConA- and DG-induced cell immigration, but only
      partially inhibited CB. Thus, despite their physicochemical similarities with
      ConA, DG and CB have more powerful pro-inflammatory effects. This difference
      seems to be related to their sugar-binding properties. However, while ConA- and
      DG-induced effects were inhibited more by alpha-MM than by GLU, CB-induced
      effects were inhibited more by glucose.

PMID- 8480539
TI  - Dihydrolipoic acid protects pancreatic islet cells from inflammatory attack.
AB  - In vitro models of pancreatic islet cell inflammation are the lysis of isolated
      islet cells by activated macrophages or by oxygen radicals released by the
      endothelial enzyme xanthine oxidase. Dihydrolipoic acid protected islet cells in
      both systems by different modes of action. Macrophage cytotoxicity towards islet
      cells, which is nitric-oxide-mediated, was suppressed by 2 h of preincubation of
      macrophages with lipoic acid. Similarly, 2 h of preincubation sufficed to protect
      islet cells against enzymatically produced oxygen radicals. Dihydrolipoic acid
      was found by chemiluminescence assay to scavenge directly such radicals. In
      macrophages dihydrolipoic acid suppressed the production of nitrite as a measure
      of nitric oxide release. These results suggest that dihydrolipoic acid is an anti
      inflammatory agent which at the same time interferes with nitric oxide release
      from inflammatory macrophages and protects target cells from oxygen radical
      attack.

PMID- 8480540
TI  - Effect of BW B70C, a novel inhibitor of arachidonic acid 5-lipoxygenase, on
      allergen-induced bronchoconstriction and late-phase lung eosinophil accumulation
      in sensitised guinea-pigs.
AB  - The actions of BW B70C, an orally available, biologically persistent and
      selective inhibitor of arachidonic acid 5-lipoxygenase, have been examined in two
      systems of anaphylaxis in actively sensitised guinea-pigs in vivo. In
      anaesthetised, artificially ventilated animals pretreated with mepyramine and
      indomethacin to leave only the "peptidoleukotriene-dependent" component
      (leukotrienes C4, D4 and E4) of the anaphylactic response, direct inhalation of
      nebulised allergen resulted in a slowly developing bronchoconstriction which was
      prevented in a dose-dependent manner by BW B70C (2-50 mg/kg p.o.) administered 1
      or 6 h before challenge. In conscious animals fasted overnight and then
      pretreated with mepyramine to prevent death due to acute bronchial anaphylaxis,
      exposure to nebulised allergen produced slight respiratory symptoms. When blood
      and lung samples were analysed 4-48 h after allergen provocation a sustained
      leukocytosis and pulmonary eosinophil accumulation were observed. In contrast, in
      food-replete conscious animals, the early respiratory symptoms were still
      observed upon allergen inhalation, but no significant blood leukocytosis or
      accumulation of eosinophils in the lungs occurred subsequently. The eosinophil
      influx induced by allergen in fasted animals was assessed both by histological
      examination and determination of tissue peroxidase content, two measures which
      demonstrated reasonable agreement. Administration of a single dose of BW B70C (10
      mg/kg p.o.) 1 h prior to allergen challenge did not affect the subsequent
      eosinophil infiltration 24 h later, but 20 mg/kg given in divided doses (-1 and
      +12 h) produced 67% inhibition of cell accumulation. A single dose of 50 mg/kg (
      1 h) had a similar effect (78% inhibition). The potent glucocorticosteroid
      betamethasone was used as a reference compound, and 4 mg/kg given as a divided
      dose (-1 and +7) fully inhibited lung inflammation assessed 24 h after
      provocation with allergen. BW B70C inhibited both acute and allergic
      bronchoconstriction and late-phase eosinophil accumulation subsequent to allergen
      inhalation in guinea-pigs. In view of the apparent requirement for sustained
      plasma levels of BW B70C in order to prevent late-phase eosinophil recruitment to
      the lung after a single challenge with allergen, it is unclear whether inhibition
      of 5-lipoxygenase underlies the observed anti-eosinophil accumulation effects of
      the compound, but the anti-bronchoconstrictor effects are consistent with the
      known inhibitory activity of BW B70C against 5-lipoxygenase.

PMID- 8480541
TI  - Macrolide antibiotics as antiinflammatory agents: roxithromycin in an unexpected
      role.
AB  - The antiinflammatory activity of a new 14-membered macrolide antibiotic,
      roxithromycin, was evaluated in various rat models including carrageenan- and
      poly-L-arginine-induced hind-paw oedema, croton oil inflamed ear assay and
      polyester sponge granuloma. When administered orally to animals, roxithromycin
      displayed an atypical profile in the assays utilized, including: (1) marked
      antioedema activity similar to that of indomethacin in poly-L-arginine assay, (2)
      significant inhibition of lambda-carrageenan hind-paw oedema and croton-oil
      induced inflammation in the ear, although indomethacin was more effective, and
      (3) failure to reduce the development of granuloma induced by implanted polyester
      sponges, while indomethacin significantly reduced the chronic inflammatory
      reaction. Based on these results, it is concluded that roxithromycin is active in
      reducing the acute inflammatory reaction in rat models through mechanisms
      different from conventional nonsteroidal antiinflammatory agents such as
      indomethacin. Therefore, roxithromycin may have a favorable impact on skin
      inflammatory reactions accompanying microbial infections.

PMID- 8480543
TI  - Update on childhood asthma.

PMID- 8480542
TI  - The retinoic acid analog CBS-211A potentiates the 1 alpha,25-dihydroxyvitamin D3
      induced differentiation of U937 cells.
AB  - We report the effect of CBS-211A, a synthetic retinoid analog, designed for
      topical eye administration, on the growth and differentiation of myelomonocytic
      cells. This compound was assayed alone or in combination with 1 alpha,25
      dihydroxyvitamin D3 (1 alpha,25(OH)2D3), since we previously evidenced a
      synergism of retinoic acid (RA) and 1 alpha,25(OH)2D3 in the induction of U937
      cell differentiation. Unlike RA, CBS-211A neither affected the growth of
      myelomonocytic cells nor differentiated them. Nevertheless, when it was
      associated with 1 alpha,25(OH)2D3, CBS-211A strongly potentiated the 1
      alpha,25(OH)2D3-induced inhibition of U937 cell proliferation and caused a
      dramatic increase in their differentiation toward monocytes/macrophages. The co
      inducing effect of CBS-211A was restricted to U937 cells. Our data suggest that
      CBS-211A may have therapeutic implications in the treatment of certain kinds of
      myelomonocytic leukemia. CBS-211A also provides an interesting tool to understand
      the mechanisms involved in the differentiation of myelomonocytic cells.

PMID- 8480544
TI  - Changing pattern of asthmatic symptoms during childhood--different diseases?

PMID- 8480545
TI  - Airway inflammation, bronchial reactivity and asthma.
AB  - Asthma is a common disease of children the basis of which is a state of chronic
      immunological inflammation which causes bronchial hyperreactivity and renders the
      patient liable to develop widespread airways obstruction in response to a variety
      of stimuli. In many instances it is likely that the immunological inflammation
      results from ongoing antigenic stimuli with the release of chemical mediators
      responsible for short term bronchospasm and cytokines responsible for the ongoing
      inflammatory process. Other insults can apparently result in very similar
      immunological events in asthmatics, particularly viral infections and a similar
      process can be initiated in children without asthma, including those with chronic
      bacterial infections of the lungs. There are differences in the bronchial
      hyperreactivity of asthma and other diseases which suggest that in the asthmatic
      the mast cell is either different structurally or functionally and this renders
      the patient susceptible to exercise induced asthma in addition to the bronchial
      hyperreactivity to chemical mediators common to a number of diseases with
      hyperreactivity. There is good evidence of direct genetic control of atopy and
      the large majority of children with asthma are atopic but there is no direct
      genetic link between atopy and asthma and twin studies strongly suggest the
      existence of a 'permissive' asthma gene which will allow the disease to develop
      if there is an appropriate external trigger. The only drugs which have been shown
      to significantly reduce bronchial reactivity are the corticosteroids with a
      lesser effect noted for sodium cromoglycate and nedocromil. Inhaled
      corticosteroids can reverse the immunologic inflammatory process and reduce
      bronchial reactivity, sometimes to normal levels, but on stopping treatment the
      patient reverts back to the asthmatic state. At the present time it appears that
      controlled longterm inhaled corticosteroid therapy is the most rational treatment
      for significant perennial childhood asthma.

PMID- 8480546
TI  - A specific feedback by anti-IgE autoantibodies on the cytokine network in
      allergy.
AB  - During recent years we have shown that anti-IgE antibodies can have different
      biological functions. Depending on their epitope specificity they can be
      anaphylactogenic or not, they interfere with IgE binding to its receptor or not,
      and they enhance or inhibit IgE synthesis. Therefore we propose a theoretical
      model implying that anti-IgE autoantibodies are specific feed back molecules that
      neutralize IgE induced by the cytokine network. In the normal individual this
      system would be beneficial, where as the atopic individual, due to differences in
      its B cell repertoire, will produce the wrong type of anti-IgE antibody. The
      wrong type of anti-IgE antibody may even aggravate the disease as some of these
      autoantibodies may induce IgE synthesis or trigger effector cells that in turn
      generate a Th2 like cytokine pattern.

PMID- 8480547
TI  - Immuno-allergologic aspects of childhood asthma.
AB  - Asthma has a major impact on the health of children. Airway inflammation and
      bronchial hyperresponsiveness of variable severity have presently come to be
      considered underlying the pathogenesis and pathophysiology of the condition.
      Atopy in infancy seems to predict the severity of bronchial hyperresponsiveness
      in later childhood. Genetic predisposition, allergen exposure and contributory
      factors combine to set the clinical picture. Early sensitization to ingested or
      inhaled allergens accelerates development of allergic asthma. In children, the
      activity of inflammation can be assessed by estimation of indirect markers.

PMID- 8480548
TI  - Mechanisms of airways inflammation which may be amenable to prophylaxis.
AB  - The presence of mucosal inflammation in the lower airways of atopic asthmatics
      and to a milder degree of atopic nonasthmatics suffering from rhinitis points to
      atopy and allergen exposure as risk factors for lower airways disease. The study
      of mechanisms which regulate the degree of inflammation should enable the
      understanding of why some individuals suffer from rhinitis alone whereas others
      go on to develop bronchial disease. This information should enable the
      development of prophylactic strategies to prevent atopy from expressing itself in
      the lower airways.

PMID- 8480549
TI  - The risks and benefits of inhaled antiinflammatory therapy in children.

PMID- 8480550
TI  - The use of inhaled steroids in young children.
AB  - There are apparently irreversible inflammatory changes in the airways of young
      adults with chronic asthma so a strong case can be made for starting anti
      inflammatory treatment early. Corticosteroids have potent and diverse anti
      inflammatory activity. High efficacy is established in school age children.
      Trials in pre-school children and infants have given more mixed results perhaps
      because of problems with administration. No clinically important systemic effects
      have been observed in children taking conventional doses of inhaled steroids.

PMID- 8480551
TI  - Comparison of different inhalation schedules to control childhood asthma.
AB  - In a double-blind, placebo-controlled study control of asthma was assessed by
      diary symptom cards, peak-flow measurements and lung function within 3 treatment
      groups over a 6 months period. 36 children (25 boys, 11 girls 5.5 to 13.2 years
      of age) with exogen allergic, perennial asthma inhaled either beclomethasone
      dipropionate (BDP) with salbutamol (S) or disodium cromoglycate (DNCG) with S or
      a placebo preparation with S from metered dose inhalers (MDI) through a large
      spaced auxiliary device (Volumatic). At entry, after 2 and 4 months lung function
      tests were performed evaluating changes in the degree of pulmonary
      hyperinflation, bronchial obstruction, and bronchial hyperreactivity (BHR). Daily
      PF measurements showing wide variations (up to 10-12%) were insensitive to
      indicate any significant changes. In contrast evaluation of symptom diaries
      presented dramatic improvement during the first 3 months of the study. In
      addition, the DNCG group showed significant improvement of BHR (p = 0.02).
      Moreover, the majority of patients on regular therapy with salbutamol and placebo
      showed an increase of airway resistance. It is concluded that even in mild
      childhood asthma, for optimal control a combination of a beta 2-stimulant as
      bronchodilator and DNCG or BDP as protector should be applied.

PMID- 8480552
TI  - Psychosomatic symptoms in asthmatic children and adolescents.
AB  - In order to identify different patterns of association between physical and
      psychical symptoms in childhood asthma 102 children have been investigated.
      Somatic investigations included clinical examination, whole-body plethysmography,
      total IgE and RAST of specific allergens such as pollens, mites and animals.
      Psychosocial assessment comprised a semi-structured interview and questionnaires
      (Achenbach, CBCL and Olson, FACES II). There were typical psychosocial patterns
      in function of aetiopathogenetic groups. The infection-induced asthma was
      accompanied by high anxiety and here the most school problems were found.
      Children with seasonal asthma were psychologically healthy whereas those with
      perennial asthma showed important psycho-vegetative difficulties secondary to
      chronic somatic disease. Atypical asthma was found to be most often associated
      with real psychiatric symptoms. We concluded that psychosocial findings are
      heterogeneous and should be interpreted in relation to somatic manifestations.

PMID- 8480554
TI  - Assessment of functional abnormalities in infants and children with lung disease.
AB  - Lung function testing in infants and children has to cover a wide palette of
      various investigational procedures and the fact that babies can predominantly
      only be tested asleep and young children may not cooperate accurately must be
      taken into account. There is still a life-span between 2 and 5 years in which
      lung function testing is impossible. Different techniques for infants lung
      function testing (spirometry, squeeze-jacket method, forced oscillation
      technique, occlusion technique, whole-body infant-plethysmography, multibreath
      nitrogen washout (MBNW), interruption technique), which helps already in early
      childhood to evaluate objectively clinical findings in infants after infant
      respiratory distress syndrome (iRDS) with/or without hyaline membrane disease
      (HMD), developing or not developing broncho-pulmonary dysplasia (BPD), wheezy
      bronchitis or cystic fibrosis (CF) are available. Lung function techniques in
      children include spirometry, whole-body plethysmography, multibreath nitrogen
      washout (MBNW), interruption technique, bronchial challenge tests, exercise
      testing.

PMID- 8480553
TI  - Consequences of unbalanced protease in the lung: protease involvement in
      destruction and local defense mechanisms of the lung.
AB  - Complex mechanisms regulate sequestration, retention and migration of neutrophils
      in the lung. Neutrophils can migrate into the lung without producing significant
      damage under some circumstances, whereas at other times great structural
      alteration occurs. A potential explanation lies in the phenomenon of priming, a
      state of altered responsivity of neutrophils. A wide variety of molecules are
      able to induce this higher degree of responsiveness including PAF, TNF, GM-CSF,
      and IL-1. Enhanced cellular responses include secretion, adhesion and synthetic
      function. Unprimed neutrophils can migrate through lung tissues, secreting but
      little of their contents, in the context of "normal" inflammatory response. On
      the other hand neutrophils primed before the emigration phase, injury to the
      tissue they are migrating through would be likely by virtue of releasing toxic
      mediators. One of these mediators is neutrophil elastase, a potent protease. It
      is the purpose of this review to highlight the duality function of neutrophils as
      (i) one of the bodies highly effective host defense weapons and (ii) mediator of
      destruction and host defense impairment in the lung by releasing mediators such
      as neutrophil elastase.

PMID- 8480555
TI  - A new method for assessing flow-volume measurements by means of a simple isoflow
      electronic pocket device (IfloPen).
AB  - The IfloPen is a new device for measuring isoflows featuring specific information
      about the effort-independent part of the flow-volume curve. Whereas the recording
      of the latter normally requires expensive equipment, the IfloPen is a handy,
      portable and simple device. In addition, the isoflow technique requires minimal
      cooperation. Significant correlations have been found between the isoflow-points
      measured with the IfloPen and PF, MEF50, MEF25 and FEV1 (p < 0.001). The IfloPen
      showed better correlations with spirometric lung function data than with the Peak
      flow-Meter. Even experimentally induced bronchial obstruction during a bronchial
      challenge with carbachol can be measured functionally by the IfloPen, showing
      similar changes as obtained by the FEV1 and the MEF50 (p < 0.001). From a
      practical point of view, the IfloPen features a new device to measure more
      accurately bronchial obstruction (no overestimation, physiological breathing
      maneuver, good practicability). It can therefore be used in medical practice and
      is a suitable device for home monitoring.

PMID- 8480556
TI  - The interrupter technique--a renaissance of a non-invasive approach for lung
      function testing in infants and children.
AB  - The analysis of the postocclusional rapid oscillatory mouth pressure transients
      pao(t) after expiratory flow interruption during 100 ms features additional
      information to the conventional interrupter technique. The analysis focuses on
      the sudden oscillatory rise in pressure after flow interruption and the following
      damped oscillation. By calculating the first derivative of pao(t) ( = change in
      pressure), the frequency omega 0 and damping characteristic d of the pressure
      swings reflecting the inertive and elastic properties of the thoracopulmonary
      system can be computed. The interrelationship between omega 0 respectively d and
      different sizes of lung volume respectively characteristics of airway mechanics
      (airway resistance (Raw) and/or maximal expiratory flow at 50% vital capacity
      (MEF50)) was evaluated in 5 healthy adult subjects (28-37 y) and 10 healthy
      children (7-14 y). The measured frequency was statistically significantly related
      to lung volume (p < 0.05) and varied between 66 Hz in healthy adults and 91 Hz in
      children. The damping factor d increased with increasing airway resistance (n.s.)
      and decreasing MEF50 (p < 0.005). These findings add further arguments to the
      conjecture previously intimated that development of the viscoelastic properties
      of the lung are defined by characteristics of airway mechanics in close
      relationship to lung growth. In consequence, alterations in mechanical properties
      observed in diseased lungs have functionally closely be evaluated in relation to
      actual lung volumes (pulmonary hyperinflation, restrictive lung disease).

PMID- 8480557
TI  - The lung clearance index (LCI) as an estimate of ventilation inequalities in
      patients with cystic fibrosis.
AB  - Assessment of respiratory function is indispensable for provision and control of
      respiratory care in infants and children with lung disease. Based on
      plethysmographic measurements and the multibreath nitrogen washout (MBNW)
      distinction of patients with cystic fibrosis (CF) into different functional
      groups revealed that the mixed type (TGV > 130 % pred. and Raw > 130 % pred.) has
      to be considered as worst: highest degree of trapped gases (TG) and ventilation
      inequalities and consequently most impeded gas exchange. Best predictor in
      patients with abnormal gas exchange are the degree of bronchial obstruction (Raw)
      and the amount (TG). Vital capacity (VC) as overall estimate of lung function is
      best predicted by TG, FEV1 and MEF50. The major merit of the MBNW technique is
      the possibility to have the amount of TG estimated. Based on the present the
      calculation of the LCI adds no further information of sufficient clinical
      importance, remaining the question open, whether the assessment of the so called
      "moment ratios" from the entire washout curve would feature a better estimate of
      disturbed lung physiology.

PMID- 8480558
TI  - Prevalence of childhood asthma: facts, tendencies and interpretations.
AB  - Questionnaire surveys are an appropriate instrument to assess epidemiologic data
      on respiratory ill health, to analyse influences of environmental factors on
      respiratory morbidity and to evaluate treatment strategies. To investigate the
      prevalence rates of asthma and symptoms suggestive of asthma we performed
      population surveys in Swiss school children. Special attention is drawn to
      particular aspects such as atypical symptoms, underdiagnosis and undertreatment
      of asthma.

PMID- 8480559
TI  - Family-centered birthing: a niche for family physicians.

PMID- 8480560
TI  - Integrating mental health into family practice.

PMID- 8480561
TI  - Erythema nodosum and Hansen's disease.

PMID- 8480562
TI  - Aminoglycosides for infections in the elderly.

PMID- 8480563
TI  - Nonulcer dyspepsia: current approaches to diagnosis and management.
AB  - Many patients with dyspepsia do not have peptic ulceration or other organic
      disease that explains their symptoms. The etiology of nonulcer dyspepsia is not
      established, and its treatment remains empiric. A careful clinical evaluation can
      usually rule out other disorders, such as gastroesophageal reflux disease and
      irritable bowel syndrome, and can identify patients who require immediate
      investigation and those who can safely receive empiric therapy with antacids or a
      histamine H2-receptor antagonist. If diagnostic investigation is indicated,
      endoscopy is the procedure of choice. The physician can then classify patients
      with documented nonulcer dyspepsia on the basis of symptoms, which may guide
      therapy. Many patients with nonulcer dyspepsia respond to reassurance,
      explanation, dietary modifications and avoidance of precipitating factors.

PMID- 8480564
TI  - Management of cataract in adults. Agency for Health Care Policy and Research.

PMID- 8480565
TI  - Pyogenic hepatic abscess.
AB  - Pyogenic hepatic abscess is a rare condition associated with severe sequelae. The
      diagnosis may be obvious in patients with fever and leukocytosis who are clearly
      predisposed to this infectious complication. In patients without known risk
      factors, diagnosis and treatment are often delayed, usually until numerous health
      care resources have been consulted. The evaluation of occult hepatic abscess may
      be improved by a history directed at identifying predisposing conditions, by an
      appropriate physical examination and by the use of computed tomographic scanning.
      The standard treatment for pyogenic hepatic abscess is percutaneous or open
      drainage, accompanied by broad-spectrum antibiotic therapy.

PMID- 8480566
TI  - Common dermatoses in the elderly.
AB  - Common dermatoses in the elderly include xerosis, pruritus, contact dermatitis,
      acne rosacea, stasis dermatitis, bullous pemphigoid and herpes zoster. Physicians
      must be able to recognize these pathologic changes superimposed on the intrinsic
      and extrinsic effects of aging. Diagnosis is dependent on clinical appearance and
      supportive laboratory studies. Management is based on correct diagnosis.

PMID- 8480567
TI  - Cluster headache.
AB  - Cluster headache is a rare condition that predominantly affects older men. The
      diagnosis is based on the history and clinical characteristics, which are
      distinctive. The headache is always unilateral, excruciating and, most uniquely,
      occurs in timed attacks, called "clusters." The etiology is unknown, but
      disturbances in the hippocampal areas controlling circadian rhythm may contribute
      to cluster headache. Various treatments to relieve individual attacks and to
      shorten active cluster periods have been used, including systemic
      corticosteroids, lithium, ergotamine and calcium channel blockers. Patient
      education and individualized treatment are important elements of the management
      plan.

PMID- 8480568
TI  - The rational management of labor.
AB  - Some practices and procedures that are common during the management of childbirth
      lack proof of efficacy, and some have adverse effects. The practice of
      withholding food and liquids and using intravenous fluids during labor may pose
      risks such as fluid overload, and maternal and fetal hyperglycemia. Enemas should
      be reserved for women with painful constipation. Evidence does not support the
      value of shaving the perineal area. Nonpharmacologic measures to control pain
      during labor are safe and moderately effective. Pharmacologic methods of
      analgesia and anesthesia provide good pain relief but pose significant risks.
      Continuous electronic fetal monitoring should be considered a diagnostic
      procedure, not a screening procedure. Amniotomy may shorten labor but can result
      in abnormally high uterine forces, infection, umbilical cord prolapse and fetal
      laceration. Position changes and alternative birth positions promote greater
      comfort and efficiency during labor. Finally, episiotomy has not been shown to
      reduce severe lacerations or prevent pelvic relaxation, and use of this procedure
      should be limited.

PMID- 8480569
TI  - AMA issues diagnostic and treatment guidelines on child sexual abuse.

PMID- 8480570
TI  - Ultrasound guide wire-directed stent deployment.
AB  - A new mechanically rotated 20 MHz intravascular ultrasound guide wire (0.032
      inch) with a transducer core was placed through the central lumen of a peripheral
      arterial balloon-expandable stent. Using an anesthetized canine model, 11 stents
      were then deployed into the iliac or femoral arteries. Eight stents were
      successfully deployed with proper position and full stent expansion documented by
      ultrasound imaging. Four of the stents were overlapping and the double row of
      stent struts at the region of overlap was easily seen. Three stents were
      unsuccessfully deployed because of undersizing, as clearly documented by
      ultrasound imaging showing stent strut recoil. As a result, the procedure was
      modified by performing ultrasound measurements of arterial dimensions before
      stent selection. There were no complications attributed to the ultrasound guide
      wire. This study demonstrates an effective combination of diagnostic and
      therapeutic devices that may allow more precise placement of intravascular
      stents.

PMID- 8480571
TI  - Serial angiographic observations after successful directional coronary
      atherectomy.
AB  - This study focuses on the early and late angiographic evolution observed in 82
      patients with coronary artery disease who were successfully treated by
      directional coronary atherectomy (DCA) without adjunctive balloon angioplasty.
      Qualitative inspections and quantitative measurements were obtained from a
      selected angled-view projection in the following conditions: (1) before
      treatment; (2) immediately after treatment; (3) the day after atherectomy; (4) 1
      month after; and (5) 6 months after. The appearance of the treated segment 24
      hours after the procedure did not differ in 79 patients from that observed
      immediately after DCA; silent total occlusion occurred in two patients, and one
      had an aneurysm at the site of resection (all three patients were excluded from
      the analysis). At the 1-month study restenosis developed in 3 (3.6%) patients;
      the remaining 76 had identical appearances, with no evidence of renarrowing of
      the lumen. However, from 1 to 6 months after the procedure restenosis developed
      in 35 of the remaining 76 (46%) patients, and 41 patients were free of restenosis
      and symptoms. These findings, which show that early elastic recoil does not occur
      after successful DCA, are different from the changes observed after balloon
      angioplasty. At the 1-month observation restenosis is an infrequent but possible
      phenomenon (3.8%). From this point the healing of the arterial wall leads to no
      or mild renarrowing (late success); an exaggerated proliferative response
      produces restenosis.

PMID- 8480572
TI  - Preprocedural anticoagulation does not reduce angioplasty heparin requirements.
AB  - To determine whether continuous preprocedural heparin influences the need for
      anticoagulation during percutaneous transluminal coronary angioplasty (PTCA), we
      compared heparin requirements in patients therapeutically anticoagulated after
      continuous heparinization for > or = 12 hours with patients not pretreated with
      heparin (controls). A Hemochron device was used to monitor the activated clotting
      time (ACT) values during the procedure. An ACT > or = 300 seconds was used as a
      measure of optimal anticoagulation. Patients pretreated with heparin had
      significantly higher preprocedural ACT measurements (163 +/- 31.5 vs 126 +/- 13
      seconds, p < 0.001) and partial thromboplastin time (PTT) measurements (46 +/- 15
      vs 25 +/- 3 seconds, p < 0.001) than controls. While the amount of heparin needed
      to achieve an initial ACT > 300 seconds was slightly greater in control patients
      (10,682 +/- 1,852 vs 9,269 +/- 2,993 units, p < 0.001), the total heparin
      required to maintain an ACT > 300 seconds throughout the procedure was similar
      between the two groups (11,551 +/- 3,181 units vs 12,136 +/- 2,575 units, p =
      NS). Thus preprocedural anticoagulation does not significantly reduce total
      heparin requirements, and these patients should receive the same initial heparin
      regimen as patients not pretreated with intravenous heparin.

PMID- 8480573
TI  - Aggravation of left ventricular dilatation and reduction of survival by a calcium
      channel blocker in rats with chronic myocardial infarction.
AB  - The mechanism of adverse effects of calcium channel blockade on cardiac
      performance and survival in patients with cardiac dysfunction after myocardial
      infarction is controversial. To test whether left ventricular dilatation and
      remodeling, as predictors of long-term survival and cardiac performance, are
      important, rats with healed infarcts received a vasodilating calcium channel
      blocker (anipamil) or placebo. After 8 weeks the mortality rate (total population
      n = 111) was 35% with calcium channel blockade and 4% with placebo in rats with
      infarction (p < 0.001). In survivors with large infarctions (44% +/- 12% of left
      ventricle, n = 9), calcium channel blockade did not aggravate left ventricular
      dysfunction and decreased chamber stiffness, but increased left ventricular
      volume (1.55 +/- 0.13 ml/kg, p = 0.03 vs placebo: 1.16 +/- 0.11 ml/kg; n = 11)
      (passive pressure-volume relationship) at persistently elevated volume/mass
      ratio. Thus this study shows for the first time that aggravation of left
      ventricular dilatation and remodeling is one important mechanism by which calcium
      channel blockade may reduce survival in the presence of ventricular dysfunction
      after myocardial infarction.

PMID- 8480574
TI  - Tedisamil (KC 8857) is a new specific bradycardic drug: does it also influence
      myocardial contractility? Analysis by the conductance (volume) technique in
      coronary artery disease.
AB  - To determine whether inotropism influences the bradycardic action of tedisamil,
      hemodynamic assessment was performed in 13 patients with ischemic coronary artery
      disease including analysis of end-systolic pressure-volume relationships after an
      infusion of tedisamil, 0.3 mg/kg, at rest, and during paced tachycardia stress.
      Slope Emax fell by 14% at rest (13 patients) and by 10% during tachycardia (6/13
      patients), whereas loops of end-systolic pressure-volume relationships moved
      rightward; all parameter changes indicated a lack of significant inotropism loss
      with tedisamil (p > 0.05). Although the mean heart rate decreased from 77.5 to
      64.7 beats/min and QTc duration increased by 14% (p < 0.05), filling pressure and
      dp/dtmin remained unchanged and vascular resistance increased by 30%. Parameters
      of left ventricular pump function (ejection fraction, stroke volume, left
      ventricular efficiency) decreased slightly (between 3% and 13%), whereas left
      ventricular volumes increased (end-diastolic volume by 6%, end-systolic volume by
      23%). The respective parameter changes during tachycardia were comparable in
      tendency, and angina could no longer be induced during postdrug pacing stress. We
      concluded that the bradycardic effects of tedisamil are selectively generated
      without impairing either ventricular pump function or contractility in a
      clinically relevant fashion, whereas the postdrug anginal threshold appears
      elevated. Thus tedisamil can be used safely in ischemic coronary artery disease.

PMID- 8480575
TI  - Prevalence and functional significance of transient ST-segment depression during
      daily life activity: comparisons of ambulatory ECG with stress redistribution
      thallium 201 single-photon emission computed tomographic imaging.
AB  - To assess the prevalence and functional significance of ischemic ambulatory ECG
      responses, we prospectively performed ambulatory ECG monitoring in 244 patients
      (mean age 61 +/- 10 years) referred for stress redistribution thallium 201
      myocardial perfusion scintigraphy. The prevalence of ST-segment depression during
      ambulatory ECG was 33% among patients with a positive exercise ECG, but
      prevalence varied in selected patient subgroups. Among three groups with coronary
      artery disease (CAD), the group with ambulatory ECG ischemia (group 1) had a
      greater frequency of ischemic thallium responses (p = 0.07), a greater median
      number of reversible thallium defects (p < 0.05), and a greater summed thallium
      "reversibility" score (p < 0.05) than did the group with a positive exercise ECG
      but negative ambulatory ECG response (group 2) or that with negative exercise and
      ambulatory ECG responses (group 3). Exercise ST depression in group 1 versus
      group 2 was significantly greater (p = 0.002), occurred at a lower heart rate
      threshold (p = 0.002), and lasted longer after exercise (p = 0.001). Notably, one
      third of group 1 patients also manifested evidence of transient ischemic dilation
      of the left ventricle after exercise (p < 0.01 vs groups 2 and 3), a sign of
      severe ischemia. However, although functionally less "sick" than group 1
      patients, 66% of group 2 patients and 50% of group 3 patients still had an
      ischemic thallium response, which was sometimes severe. Thus transient ischemia
      during ambulatory ECG monitoring identifies a functionally sicker cohort of
      patients with CAD and occurs in approximately one third of CAD patients with
      positive results of exercise tests. A negative ambulatory ECG response, however,
      does not exclude functionally significant disease among CAD patients. These
      results imply that caution should be applied in the interpretation of a negative
      ambulatory ECG response for the purpose of patient risk stratification.

PMID- 8480576
TI  - Dobutamine stress echocardiography: prevalence of a nonischemic response in a low
      risk population.
AB  - The problems of population referral bias in the calculation of specificity in
      diagnostic testing for coronary artery disease have been previously described.
      Previous studies investigating the sensitivity and specificity of dobutamine
      stress echocardiography (DSE) have been subject to pretest and posttest referral
      biases, largely as a result of the requirement for coronary arteriography. This
      study determines the normalcy rate for DSE by examining a population at
      statistically low risk for coronary artery disease. The probability of
      significant coronary artery disease was determined for 828 consecutive patients
      referred for DSE at the University of Michigan, and groups were identified with <
      10% and < 5% probability of disease. Four of 72 patients (5.6%) with a normal
      baseline echocardiogram and a probability of coronary artery disease of < 10%,
      and three of 38 (7.9%) with a probability of < 5% were found to have an abnormal
      DSE, yielding normalcy rates of 94.4% and 92.1%, respectively. The area of
      abnormality involved the posterior circulation in three of four patients (75%).
      This study demonstrates that DSE has a normalcy rate of 92% to 94% and is an
      accurate test for excluding the presence of significant coronary artery disease.

PMID- 8480577
TI  - Catheter ablation with radiofrequency current of ventricular tachycardia
      originating from the right ventricle.
AB  - Catheter ablation of ventricular tachycardia (VT) with radiofrequency current
      would be safer than the conventional ablation with direct current shocks. Seven
      patients who had eight morphologically distinct symptomatic monomorphic VTs
      underwent catheter ablation with radiofrequency current. The mean age +/- SD was
      52 +/- 16 years, and the mean cycle length of the clinical VT was 298 +/- 36
      milliseconds. Sustained VT was induced by programmed stimulation with or without
      isoproterenol in four patients and developed during the infusion of isoproterenol
      alone in two patients. Of these, four VTs were entrained with rapid pacing. The
      ablation was attempted at the site of earliest activation through the distal
      electrode and the external patch electrode on the back during VT in seven
      episodes in six patients. In the other patient it was applied during sinus
      rhythm. Energy was 40 to 50 W in the first case and 30 to 40 W in the others, and
      was given for 30 seconds. All VTs were terminated within 6 seconds, 3.6 +/- 0.8
      seconds after the application of the radiofrequency current. Additional current
      was given to one to four predetermined sites by mapping. The mean number of
      applications was 4.0 +/- 1.3 sites. Except in the first patient, VT was
      eliminated successfully and VT was not induced by programmed stimulation, by the
      administration of isoproterenol, or by treadmill exercise testing. VT did not
      recur during the follow-up period of 6.8 +/- 1.1 months.

PMID- 8480578
TI  - Increasing catheter ablation lesion size by simultaneous application of
      radiofrequency current to two adjacent sites.
AB  - Treatment of ventricular tachycardia by radiofrequency current application can be
      difficult, partly because of the larger size of the reentry circuit in relation
      to the lesion generated. Larger lesions than those currently achieved with single
      radiofrequency applications are desirable. This study evaluated simultaneous
      radiofrequency application to two adjacent electrodes to determine the effects of
      inter-electrode distance and configuration (bipolar serial vs parallel) on lesion
      size and tissue temperature. Two 6F electrodes were placed, with the tips facing
      each other, on bovine myocardium in a saline bath at 37 degrees C. Radiofrequency
      current was applied to a single electrode, or simultaneously to two electrodes
      connected either in series or in parallel. Tissue temperature, power, and lesion
      size were measured. Lesions produced by simultaneous radiofrequency delivery to
      both electrodes were more than twice the size of those produced by a single
      electrode alone (> 100 mm3 vs 33.2 mm3, p < 0.01). Temperatures between
      electrodes were greater than those temperatures at the same distances from a
      single electrode (p < 0.001). The size of the lesions increased as inter
      electrode distance decreased below 3.5 mm (p < 0.030) because of the increasing
      depth of the lesion between the electrodes. Two electrodes placed in a bipolar as
      opposed to a parallel configuration were most efficient, as this configuration
      produced greater lesion sizes for a given level of power delivery (p < 0.0001).
      The bipolar lesion size decreased by > 50% if one electrode was not in contact
      with the tissue (p < 0.0004).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480579
TI  - Effects of diltiazem on concealed atrioventricular nodal conduction in relation
      to ventricular response during atrial fibrillation in anesthetized dogs.
AB  - By means of a new quantitative index for concealed conduction, we evaluated the
      effects of diltiazem on atrioventricular (AV) node concealment and correlated
      this index with the variability of the ventricular response during atrial
      fibrillation in 16 anesthetized mongrel dogs. After determination of the atrial
      effective refractory period (ERP), AV nodal ERP (AVNERP), concealment zone, and
      concealment index (AVNERP of blocked atrial extrasystole/AVNERP of conducted
      atrial extrasystole), the R-R intervals during atrial fibrillation induced by
      electrical stimulation were measured. Both low (0.1 mg/kg) and medium (0.2 to 0.4
      mg/kg) doses of diltiazem prolonged the AVNERP and increased the mean R-R
      interval during atrial fibrillation. Only medium doses of diltiazem increased the
      degree of concealed conduction in the AV node and accentuated the variability of
      R-R intervals. There was a good positive correlation between the variability of
      the ventricular response during atrial fibrillation and the concealment index. In
      conclusion, medium doses of diltiazem are more effective in reducing heart rate
      during atrial fibrillation than a low dose. However, medium doses also increase
      the degree of concealed conduction in the AV node and enhance the irregularity of
      the ventricular response during atrial fibrillation. Measurement of the
      concealment index is useful for quantitating the degree of concealed conduction
      in the AV node, which is actually an important determinant of the ventricular
      response during atrial fibrillation.

PMID- 8480580
TI  - Longitudinal study in 18 cases of fetal supraventricular tachycardia: Doppler
      echocardiographic findings and pathophysiologic implications.
AB  - A longitudinal study was performed in nine nonhydropic and nine hydropic fetuses
      with supraventricular tachycardia (SVT). First, because of a lack of reference
      methods in utero, the validity of spatial (length and area) and temporal
      parameters for semiquantitative grading of atrioventricular (AV) valve
      regurgitation by color Doppler flow mapping and M-Q mode imaging was evaluated by
      a longitudinal intraindividual study before and after drug-induced cardioversion
      to sinus rhythm and by correlation with the severity of hydrops and the time
      required for complete remission of hydrops. Second, with the demonstration of AV
      valve incompetence and changes in venous blood flow velocity wave forms, new data
      were collected concerning chronic SVT in the fetus. AV valve incompetence
      occurred in eight fetuses: during SVT only in three severely hydropic fetuses,
      during sinus rhythm in one nonhydropic fetus, and in seven hydropic fetuses
      including those previously mentioned, where AV incompetence outlasted
      tachycardia. The length and area of the regurgitant jet as imaged by color
      Doppler flow mapping and the temporal duration of regurgitation in relation to
      the systolic phase as measured by M-Q mode continuously diminished
      intraindividually but with great interindividual differences in the time span
      required for complete remission, which ranged from 5 to 42 days. Pulsed-wave
      Doppler studies of blood flow in the inferior vena cava and left hepatic vein
      demonstrated normal biphasic forward flow with a systolic and a diastolic surge
      during sinus rhythm in all fetuses and in two instances also during SVT of 190
      and 195 beats/min, respectively. In all cases a pulsatile reversal of blood flow
      with systolic forward flow and diastolic reverse flow was observed during
      tachycardia greater than 220 beats/min. Thus the presence of functional AV valve
      incompetence as a result of annular enlargement seems to be a sign of SVT-induced
      "cardiomyopathy" during fetal life. AV valve incompetence during SVT was always
      associated with extremely severe hydrops and seemed to indicate the most severe
      degree of ventricular dysfunction, which could influence the selection of
      antiarrhythmic drugs. After termination of SVT, severe AV valve insufficiencies
      also occurred in other cases of hydrops, probably because of the markedly
      increased diastolic filling distending the already enlarged annular ring. The
      observed great interindividual differences in time required for disappearance of
      AV valve incompetence and hydrops could be explained by a different state of
      progression of tachycardia-induced "cardiomyopathy" at the time of drug-induced
      cardioversion.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8480581
TI  - Hemodynamic determinants of exercise capacity in chronic atrial fibrillation.
AB  - To evaluate the response of patients with chronic atrial fibrillation (AF) to
      exercise, 79 male patients (mean age 64 +/- 1 years) with AF underwent resting
      two-dimensional and M-mode echocardiography and symptom-limited treadmill testing
      with ventilatory gas exchange analysis. Patients were classified by underlying
      disease into five subgroups: no underlying disease (LONE: n = 17), hypertension
      (HT: n = 11), ischemic heart disease (n = 13), cardiomyopathy or history of
      congestive heart failure (CHF: n = 26), and valvular disease (n = 12). A higher
      maximal heart rate than expected for age was observed (175 vs 157 beats/min),
      which was most notable in the LONE and HT subgroups. Maximal oxygen uptake (VO2
      max) was lower than expected for age in all groups. Patients with CHF had a lower
      resting ejection fraction than all other patients (p < 0.001), a lower VO2 max,
      and a lower maximal heart rate than LONE and HT patients (p < 0.001). Stepwise
      regression analysis demonstrated that echocardiographic measurements at rest were
      poor predictors of VO2 max and VO2 at the ventilatory threshold. Among clinical,
      morphologic, and exercise variables, maximal systolic blood pressure accounted
      for the greatest variance in exercise capacity, but it explained only 35%. In
      patients with AF the higher than predicted maximal heart rates may be a
      compensatory mechanism for maintaining exercise capacity after the loss of normal
      atrial function. However, even in the absence of underlying disease, it does not
      appear to compensate fully for a compromised exercise capacity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480582
TI  - Increased risk of progressive hemodynamic deterioration in advanced heart failure
      patients requiring permanent pacemakers.
AB  - To determine the influence of long-term permanent pacing systems on survival in
      patients with severe left ventricular dysfunction, data from 557 consecutive
      patients hospitalized with advanced heart failure for cardiac transplant
      evaluation and discharged on medical therapy were reviewed. Permanent pacemakers
      were identified in 42 (8%) patients. One-year actuarial risk of death from heart
      failure or urgent transplantation in paced patients was higher (49%) than that of
      a control group, matched for the severity of heart failure (15%, p = 0.003).
      Sudden death did not differ between paced patients and controls.

PMID- 8480583
TI  - On-line estimation of stroke volume by means of echocardiographic automated
      border detection in the canine left ventricle.
AB  - Echocardiographic automated border detection (ABD) is a new on-line technique
      that can determine the interface between blood and myocardial tissue and
      calculate left ventricular (LV) cavity area in real time. The objective of this
      study was to determine whether ABD measurements of the LV cavity area could be
      used to estimate LV stroke volume at basal conditions and during large changes in
      LV stroke volume induced by inferior vena caval occlusions in an open-chest
      canine model. Seven dogs had LV stroke volume measured by electromagnetic flow
      from the ascending aorta with epicardial recordings of ABD echocardiographic area
      at the midventricular short-axis level. Simultaneous beats of stroke volume were
      recorded along with ABD echo area during baseline apnea and during IVC
      occlusions. Neither ABD echo stroke area nor stroke volume varied significantly
      during apnea baseline. Changes in stroke area were closely correlated with
      changes in stroke volume for 540 matched beats from 24 IVC occlusions: R = 0.93,
      standard error of the estimate = 5%, y = 0.92x + 0.4 (p < 0.001).
      Echocardiographic ABD appears to be a promising new on-line method of determining
      rapid alterations in LV stroke volume; it also has potential applications to
      multiple investigational and clinical settings.

PMID- 8480584
TI  - 31P MR spectroscopy in hypertrophic cardiomyopathy: comparison with Tl-201
      myocardial perfusion imaging.
AB  - Abnormal phosphate metabolism of the myocardium was evaluated in patients with
      hypertrophic cardiomyopathy (HCM) using 31P magnetic resonance (MR) spectroscopy.
      The results were compared with those from left ventricular function and thallium
      201 (Tl-201) perfusion scintigraphy. Six normal volunteers and 19 patients with
      HCM were studied with a 1.5 T MR system. The spectra were localized to the
      myocardium using volume selection with the depth-resolved surface coil
      spectroscopy (DRESS) technique. Peak areas of 2,3-diphosphoglycerate (DPG),
      phosphodiesters (PDE), phosphocreatine (PCr), and beta-ATP were determined by
      fitting Gaussian functions to the phased spectra. The peak areas were corrected
      for contamination of blood adenosine triphosphate (ATP) and PDE. The corrected
      PCr/beta-ATP ratio in patients (1.07 +/- 0.10, mean +/- SE) was significantly
      lower compared with that in normal volunteers (1.71 +/- 0.13, p < .01). The
      PCr/beta-ATP ratio showed an abnormal decrease (< mean -2 SD of the controls) in
      11 (58%) of 19 patients. The averaged PCr/beta-ATP ratio in 15 patients with
      normal left ventricular ejection fraction (LVEF) was 1.14 +/- 0.10, significantly
      lower than in healthy subjects. By contrast, the corrected PDE/PCr ratio in HCM
      did not differ significantly compared with that in healthy subjects (0.46 +/-
      0.09 vs 0.36 +/- 0.09). The PDE/PCr ratio was abnormally elevated (> mean + 2 SD
      of the controls) in only four (21%) of the patients. On Tl-201 myocardial single
      photon emission computed tomography (SPECT) imaging, the perfusion of the left
      ventricular wall looked normal in 6 and abnormal in 5 of 11 HCM
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480585
TI  - Coronary vasodilating action of dobutamine in patients with idiopathic dilated
      cardiomyopathy.
AB  - To assess the coronary hemodynamic effects of dobutamine in patients with
      idiopathic dilated cardiomyopathy, dobutamine was infused at the incremental
      infusion rates of 25, 50, 100, and 200 micrograms/min into the left main coronary
      artery of nine patients undergoing cardiac catheterization. In response to
      dobutamine infusion, systemic hemodynamic effects were dose related. At the
      highest infusion rate cardiac index and left ventricular peak positive rate of
      rise in ventricular pressure increased from 2.33 +/- 0.54 to 2.97 +/- 0.65
      L/min/m (p = 0.001) and from 690 +/- 177 to 1157 +/- 275 mm Hg/sec (p = 0.001),
      respectively. Left ventricular end-diastolic pressure decreased from 17 +/- 8 to
      8 +/- 7 mm Hg (p = 0.001) and a trend toward decrease in left ventricular wall
      stress was observed (from 166 +/- 75 to 148 +/- 66 gm/cm2, not significant).
      Heart rate and mean arterial pressure remained unchanged. The coronary
      hemodynamic response to dobutamine infusion was also dose related. At the highest
      infusion rate coronary sinus blood flow increased from 133 +/- 35 to 179 +/- 47
      ml/min (p < 0.01) and was associated with an increase in coronary oxygen blood
      content from 4.5 +/- 0.6 to 7.8 +/- 1.7 ml per 100 ml (p < 0.01) whereas
      myocardial oxygen consumption remained unchanged. During dobutamine infusion
      norepinephrine decreased in the femoral artery and in the coronary sinus from
      1.03 +/- 0.34 to 0.641 +/- 0.179 ng/ml (p < 0.05) and from 1.76 +/- 0.98 to 1.38
      +/- 0.65 ng/ml (p < 0.05), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480586
TI  - Variation in left ventricular regional wall stress with cine magnetic resonance
      imaging: normal subjects versus dilated cardiomyopathy.
AB  - We measured the variation of end-systolic wall stress and its relation to
      regional ejection fraction in short-axis planes through the left ventricle in
      normal subjects and in patients with dilated cardiomyopathy (DCM) by cine
      magnetic resonance imaging. There was a gradual increase in end-systolic wall
      stress but a gradual decrease in ejection fraction from apex to base in normal
      subjects (14 +/- 6 to 52 +/- 15 kdyne/cm2, 78% +/- 12% to 62% +/- 8%) and in
      patients with DCM (49 +/- 28 to 130 +/- 30 kdyne/cm2, 40 +/- 18 to 23% +/- 9%).
      The end-systolic wall stress in patients with DCM was higher than in normal
      subjects at every level (p < 0.01). We conclude that there is a variation in end
      systolic wall stress in both normal subjects and patients with DCM with regional
      ejection fraction inversely related to regional end-systolic wall stress.

PMID- 8480587
TI  - Subepicardial myocardial lesions.
AB  - Subepicardial myocardial lesions are rarely seen at necropsy, and a description
      of them and their causes has not been reported. Over the last 13 years we have
      studied 22 patients with subepicardial myocardial lesions. They ranged in age
      from 14 to 73 years (mean 47), and 20 were men. The lesions were associated with
      atherosclerotic coronary artery disease in six patients, sarcoidosis in five,
      idiopathic dilated cardiomyopathy in four, lymphocytic myocarditis in two, and
      hypoplastic right and left circumflex coronary arteries in one. In four patients
      the cause was unclear. In the patients with atherosclerotic coronary artery
      disease, the subepicardial myocardial lesions were small, few in number, and
      located in the left ventricular posterior wall. In patients with sarcoidosis or
      myocarditis, the subepicardial lesions were extensive and commonly associated
      with transmural left and right ventricular lesions. The right ventricular half of
      the ventricular septum also was frequently affected. In the remaining nine
      patients, the subepicardial lesions were small and unassociated with transmural
      left ventricular lesions. Thus subepicardial myocardial lesions occur in a
      variety of cardiac diseases.

PMID- 8480588
TI  - A new model for infective endocarditis of the mitral valve in rabbits.
AB  - To produce an experimental model of infective endocarditis without inserting
      catheters into the heart, we injected a bacterial suspension into rabbits in
      which mitral complex lesions had been induced by electrical stimulation of the
      cervical vagus. Typical infective vegetations grew on the surface of the mitral
      valves 1 week later. The formation of vegetations was related to the timing of
      the inoculation. Streptococcus viridans injected just after vagal stimulation
      produced vegetations in 10 of 17 animals (58.8%), but the same bacteria injected
      14 days after vagal stimulation did so in only 2 of 11 animals (18.2%). The
      incidence of infective endocarditis was significantly higher after early
      inoculation compared with delayed inoculation (p < 0.01). The susceptibility to
      infection depended on the species of bacteria injected. Both S. viridans and
      Pseudomonas pseudoalkaligenes injected just after vagal stimulation produced
      vegetations in 10 of 17 (58.8%) and 6 of 13 (46.2%) animals, respectively, but
      Staphylococcus epidermidis injected just after vagal stimulation did not produce
      vegetations in any of the 10 animals. S. viridans injected into nine normal
      animals never produced vegetations. These findings indicate that infective
      endocarditis develops after intravenous injection of bacterial suspensions alone
      in rabbits with mitral complex lesions.

PMID- 8480589
TI  - The safety of transesophageal echocardiography in the elderly.
AB  - The safety of transesophageal echocardiography (TEE) in elderly patients (aged >
      or = 70 years) and young patients (aged < or = 50 years) was compared in a
      retrospective study of 283 examinations in each group. A greater percentage of
      studies was performed in an intensive care unit in the elderly group (22%) as
      compared with the younger group (13%, p < 0.02). In studies performed in an
      intensive care unit, 39% (24/61) of patients in the elderly group and 45% (17/38)
      in the young group were on ventilators. Transient systemic hypotension
      complicating TEE was 3.5 times more frequent in the elderly (5%) as compared with
      the young group (1.4%, p < 0.02). Life-threatening complications associated with
      TEE were rare (< 0.01%) and included third-degree atrioventricular block in one
      patient and profound vasovagal reaction in one patient in the elderly group and
      myocardial ischemia in one patient in the young group. Being elderly and on a
      ventilator were independent predictors of the development of systemic hypotension
      during TEE. Overall, TEE is a low-risk procedure but is associated with a 3.5
      times greater risk of systemic hypotension in elderly patients as compared with
      younger subjects. The benefit and risk should be assessed in all patients before
      TEE, particularly in the elderly.

PMID- 8480590
TI  - Biplane transesophageal echo-Doppler studies of atrial septal defects:
      quantitative evaluation and monitoring for transcatheter closure.
AB  - Forty-four patients with atrial septal defects, aged 7 months to 18 years (median
      8.9), underwent biplane transesophageal (TEE) and transthoracic (TTE)
      echocardiography. The size of the defect and the shunt flow volume were measured
      by TEE and compared with the actual size at surgery (N = 14) or the shunt volume
      measured by the Fick method (N = 34), respectively. In all cases the location and
      morphology of the defect were clearly demonstrated by TEE; on the other hand, two
      patients with sinus venosus-type and multiple-type defects, respectively, and one
      with a small ostium primum defect did not have a complete diagnosis by TTE. The
      defect size determined by TEE correlated well with the surgical measurement.
      Similarly a significant correlation was demonstrated between the shunt volume
      measured by TEE and that obtained by the Fick method. In three patients
      transcatheter closure of the atrial septal defect by means of a clamshell device
      was accomplished successfully with TEE monitoring. We conclude that biplane TEE
      provides a better appreciation of cardiac anatomy and hemodynamic evaluation than
      TTE in this setting, and TEE is essential for monitoring during transcatheter
      closure.

PMID- 8480591
TI  - Left-to-right shunt through patent foramen ovale in adult patients with left
      sided cardiac lesions: a transesophageal echocardiographic study.
AB  - To define the prevalence rate of left-to-right interatrial shunt through patent
      foramen ovale in adults with symptomatic left-sided cardiac lesions, 56 patients
      were examined with transthoracic and transesophageal echocardiography and cardiac
      catheterization. By transesophageal echocardiography, 15 patients (group A) were
      found to have left-to-right interatrial shunt through patent foramen ovale,
      constituting a prevalence rate of 27%. In group A, transthoracic echocardiography
      detected the interatrial shunt in two patients, and catheterization detected it
      in only one. The remaining 41 patients (group B) had no shunt demonstrated by
      either echocardiographic or catheterization examinations. In another 44 patients
      (group C) with no significant left-sided cardiac lesions, no interatrial shunt
      could be found by transesophageal echocardiography even though some of them had a
      patent foramen ovale. All patients with such shunt had left atrial size > 34 mm
      (45.1 +/- 6.0 mm), left atrial pressure > 13 mm Hg (23.4 +/- 7.6 mm Hg), and
      pressure gradient between left and right atria > 10 mm Hg (19.3 +/- 5.2 mm Hg).
      These findings support the concept that in the presence of a patent foramen ovale
      any left-sided cardiac lesion increasing left atrial size and pressure may induce
      left-to-right interatrial shunt through this channel and that the prevalence rate
      is much higher than generally acknowledged.

PMID- 8480592
TI  - Effect of percutaneous balloon valvuloplasty on pulmonary hypertension in mitral
      stenosis.
AB  - Percutaneous mitral balloon valvuloplasty (PMBV) has been useful in decreasing
      mitral valve obstruction in mitral stenosis; however, the long-term effects of
      valvuloplasty on pulmonary artery pressure have not been extensively studied.
      Thirty-three patients underwent PMBV in our institution between January 1988 and
      December 1991. There were significant reductions in peak (19 +/- 1 to 12 +/- 1 mm
      Hg) and mean (10 +/- 0.7 to 6 +/- 0.4 mm Hg) mitral valve gradients estimated by
      Doppler techniques immediately after PMBV. The mitral valve area, as assessed by
      the pressure half-time method, increased from 1.06 +/- 0.05 to 1.98 +/- 0.08 cm2
      (p < 0.001) after the procedure and remained significantly greater (1.68 +/- 0.11
      cm2) at 17 +/- 2 months. Right ventricular systolic pressure (RVSP) was estimated
      in patients with tricuspid regurgitation (TR) using the modified Bernoulli
      equation. There was a good correlation between Doppler and catheterization for
      RVSP (r = 0.83 pre valvuloplasty; r = 0.87 post valvuloplasty). Right ventricular
      systolic pressure by Doppler was 56 +/- 4 mm Hg before valvuloplasty and 48 +/- 4
      mm Hg immediately afterwards (p < 0.001). Nine patients had TR on follow-up
      Doppler studies with an estimated RVSP of 53 +/- 9 mm Hg (p = NS compared with
      pre- and post-valvuloplasty values). Six of these nine patients had moderate or
      severe mitral regurgitation (MR), compared with one patient without TR at follow
      up (p < 0.05). There appears to be a good correlation between the RVSP determined
      by Doppler and measured at catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480593
TI  - The clinical spectrum of patients with aneurysms of the ascending aorta.
AB  - Aneurysms of the ascending aorta are often unsuspected, yet they can quickly lead
      to death from aortic rupture or dissection. To examine the clinical spectrum of
      patients with aneurysms of the ascending aorta, we searched the University of
      California, San Francisco (USCF) Echocardiography Data Base for all patients with
      aneurysms of the ascending aorta (> or = 5.0 cm in diameter) seen over a 7-year
      period. The echocardiograms and clinical courses of these patients were then
      reviewed. We identified 15 patients with aneurysms of the ascending aorta: five
      had aneurysms > 7.0 cm in diameter, three had aneurysms 6.0 to 6.9 cm, and seven
      had aneurysms 5.0 to 5.9 cm in diameter. Among the five patients < 50 years of
      age, four had Marfan's syndrome, and among the 10 patients > or = 50 years of
      age, eight had evidence of atherosclerotic vascular disease. At presentation, 13
      patients had nonspecific symptoms, and two were asymptomatic. Echocardiography
      demonstrated that 12 patients had at least mild aortic insufficiency and that
      five had aortic dissections. One of the seven patients who underwent surgical
      resection died of an intraoperative cardiac arrest, and two of the eight patients
      treated medically died within 1 week of presentation. We conclude that the
      clinical spectrum of patients with aneurysms of the ascending aorta is wide.
      Because these aneurysms are often unsuspected, physicians should have a low
      threshold for imaging the ascending aorta in patients with Marfan's syndrome or
      atherosclerotic vascular disease, particularly when aortic insufficiency is
      present.

PMID- 8480594
TI  - Definition and measurement of restenosis after successful coronary angioplasty:
      implications for clinical trials.
AB  - Angiographic restenosis represents the most established measure of long-term
      outcome in most prospective clinical trials of coronary angioplasty (PTCA). The
      accuracy of assessing this endpoint is of utmost importance. The purpose of this
      article is to propose guidelines for the use of coronary angiography in this
      setting. First, the cineangiograms must be of high technical quality and
      performed in a high proportion of consecutive patients in follow-up under
      controlled study conditions that are reproducible. Second, computer-assisted
      quantitative coronary angiographic analysis is essential to minimize
      interobserver and intraobserver variability in stenosis measurement between
      successive studies. The following recommendations are presented for quantitative
      coronary angiographic analysis. Because biplane orthogonal views cannot always be
      performed both at baseline and at follow-up, stenosis measurement in the single
      plane, most severe view often constitutes the most consistent and practical
      approach. The edge-detection method is still much more reproducible and accurate
      than densitometry and should be the preferred method of analysis. Measurement of
      reference diameter by the interpolated method is more objective than measurement
      by the user-defined approach and should be used whenever possible. Finally,
      measurements of absolute minimum diameter and percent diameter stenosis are both
      important in the assessment of outcome in clinical trials. Absolute minimum
      diameters are independent of variations in reference diameter, and the extent of
      reduction in minimum diameter between the immediate postangioplasty and follow-up
      angiograms, when expressed in dichotomous or continuous fashion, accurately
      defines the extent of vessel wall hyperplasia as an endpoint. On the other hand,
      vessel size corresponds in general to the size of myocardium subserved, and
      absolute changes do not take into account this physiologic fact. Therefore
      defining restenosis in terms of significant reduction in percent diameter
      stenosis is also a useful approach because of its clinical relevance. Thus
      clinical restenosis requires that a successfully dilated segment (< 50% diameter
      stenosis) show a > or = 50% diameter stenosis at follow-up angiography with, in
      addition, a meaningful degree of change, that is, exceeding 2 SDs of observer
      variability in quantitative measurements which, in our experience, translates
      into > or = 15% difference between early postangioplasty and follow-up
      angiography measurements.

PMID- 8480595
TI  - Causes of congenital heart diseases: old and new modes, mechanisms, and models.

PMID- 8480596
TI  - Ebstein's anomaly: a long-term study of survival.
AB  - This study examines data regarding the survival of patients with Ebstein's
      malformation. Of 61 patients studied at the University of Minnesota, 31 are
      currently alive, with the average survival being 15 years. Several factors
      adversely affected survival: NYHA functional classification, hemoglobin level,
      right atrial pressure, symptoms during the neonatal period, and cardiac surgery.
      Data from a multi-institutional study collected during the past decade adds
      information regarding survival. Of 18,281 patients in the study, 71 (0.4%) had
      Ebstein's malformation. Sixteen of these were among 7235 infants, and of these
      seven died during the first year of life. In contrast, among 55 patients over the
      age of 1 year, four died, each after cardiac surgery. The data help our
      understanding of the course of patients with Ebstein's malformation and decisions
      regarding surgical treatment.

PMID- 8480597
TI  - Reversal of perfusion defect on resting thallium-201 emission computed tomography
      in stunned myocardium and coronary spasm.

PMID- 8480598
TI  - Internal mammary-to-coronary artery communication in a patient with occluded
      right coronary artery.

PMID- 8480599
TI  - Efficacy and safety of amiodarone in infants.

PMID- 8480600
TI  - Acceleration of atrioventricular conduction during corticosteroid therapy.

PMID- 8480601
TI  - Double atrial responses to a single ventricular premature impulse resulting from
      simultaneous ventriculoatrial conductions through the normal pathway and a slow
      paraseptal accessory pathway.

PMID- 8480602
TI  - Torsade de pointes induced by astemizole in a patient with prolongation of the QT
      interval.

PMID- 8480603
TI  - Atrial fibrillation after intravenous administration of gasoline.

PMID- 8480604
TI  - Left ventricular hypertrophy in normotensive cocaine users.

PMID- 8480605
TI  - Atypical presentation of papillary fibroelastoma mimicking multiple vegetations
      in suspected subacute bacterial endocarditis.

PMID- 8480606
TI  - Disappearance of a large intraaortic mass in a patient with prior systemic
      embolization.

PMID- 8480607
TI  - Complementary value of transthoracic and transesophageal echocardiography in
      detecting a mycotic aortic aneurysm ruptured into the right atrium.

PMID- 8480608
TI  - Myxoma of the mitral valve detected by transesophageal echocardiography.

PMID- 8480609
TI  - Single ventricle with severe pulmonary hypertension: natural survival into the
      third decade of life.

PMID- 8480610
TI  - Dilation of the ductus arteriosus by oral prostaglandin E1 derivative in cyanotic
      congenital heart diseases.

PMID- 8480611
TI  - Prospective study of bacteremia during transesophageal echocardiography.

PMID- 8480612
TI  - Rapid resolution of symptomatic acute pericarditis with ketorolac tromethamine: a
      parenteral nonsteroidal antiinflammatory agent.

PMID- 8480613
TI  - Impaired ventricular repolarization associated with disturbed left ventricular
      sympathetic function and diastolic filling in diabetes.

PMID- 8480614
TI  - Assessment of a coronary artery fistula to the pulmonary artery by
      transesophageal echocardiography.

PMID- 8480615
TI  - TEE in the diagnosis of intravenous leiomyomatosis extending into the right
      atrium.

PMID- 8480616
TI  - Early descriptions of aortic valve stenosis.

PMID- 8480617
TI  - Early descriptions of aortic regurgitation.

PMID- 8480618
TI  - Introduction: is hypertension a metabolic disease?

PMID- 8480619
TI  - Antihypertensive therapy to maximally reduce coronary risk.
AB  - Antihypertensive therapy as it is currently prescribed has not provided the
      degree of protection against coronary disease that was predicted by epidemiologic
      evidence. At least five steps can be taken to maximally reduce coronary risk: (1)
      more frequent, out-of-the-office monitoring of blood pressure, particularly
      during the early morning hours; (2) diligent search for other coexisting coronary
      risk factors; (3) vigorous use of various life-style modifications; (4) greater
      selectivity in the choice of antihypertensive agents, using those that may
      provide additional benefits for other coronary risk factors and other coexisting
      conditions; and (5) avoidance of coronary hypoperfusion by too great a reduction
      of blood pressure.

PMID- 8480620
TI  - Decreased peripheral blood flow in the pathogenesis of the metabolic syndrome
      comprising hypertension, hyperlipidemia, and hyperinsulinemia.
AB  - Major cardiovascular risk factors, such as hypertension, hyperlipidemia, and
      diabetes, often cluster in the same individuals. It has been claimed that
      obesity, hyperinsulinemia, insulin resistance, and a deranged intracellular
      handling of ions have pathogenetic importance in the development of this
      metabolic syndrome. However, a decrease in peripheral blood flow is another
      factor found in all the different facets of this syndrome. An increased
      peripheral resistance and a rarefaction of skeletal vessels are often seen in
      hypertensive subjects. Also, the insulin resistance so commonly seen in
      hypertension may be a consequence of a decreased blood flow because insulin
      resistance is associated with a decreased capillarization in skeletal muscle.
      Furthermore, the activity of skeletal muscle lipoprotein lipase, the key enzyme
      involved in the removal of triglycerides from the circulation, is known to be
      related to skeletal muscle vascularization. Because enhanced sympathetic activity
      has been associated with vascular hypertrophy and rarefaction of vascularization,
      overactivity in this part of the autonomic nervous system may lead to structural
      changes that will decrease the blood flow in peripheral tissues and thereby
      induce the metabolic syndrome of cardiovascular risk factors, particularly in
      individuals who, for genetic reasons, have decreased capillarization at the
      onset.

PMID- 8480621
TI  - Pathogenesis and treatment of hypertension associated with diabetes mellitus.
AB  - The pathogenesis of hypertension associated with diabetes mellitus (DM) involves
      an interplay of hereditary and acquired mechanisms. A familial trait for
      essential hypertension appears to be a risk factor for the development of both
      hypertension and nephropathy in type I DM and coexists commonly with impaired
      insulin sensitivity, relative hyperinsulinemia, and dyslipidemia, which can
      already be detected before the appearance of hypertension, obesity, or upper
      abdominal redistribution of body fat. The latter finding helps explain the
      frequent development of hypertension as well as dyslipidemia and/or type II DM in
      given individuals. Obesity is an important factor promoting these complications.
      Type I or II DM but not uncomplicated essential hypertension is
      characteristically accompanied by excess body Na+. This abnormality complements a
      tendency toward vascular hyperreactivity and a presumably morphologic and
      functional vasculopathy, thereby promoting the pathogenesis of hypertension in
      diabetic patients. For the treatment of hypertension in diabetic patients,
      nonpharmacologic measures are indispensable. If drugs are needed, angiotensin
      converting enzyme (ACE) inhibitors and some but not all calcium antagonists are
      the preferred agents. Monotherapy or a combination of these drug types allows
      effective blood pressure control in most diabetic patients without further
      metabolic impairment; ACE inhibitors even tend to improve glucose control.
      Ketanserin may be a potential alternative, and if a diuretic is also needed, the
      metabolically neutral indapamide is a reasonable choice. If these agents do not
      allow satisfactory blood pressure highly selective beta 1-blockers or alpha 1
      blockers may be introduced as a second choice. In diabetic patients with
      nephropathy, effective antihypertensive therapy can reduce proteinuria and slow
      the progression of the nephropathy; ACE inhibitors may improve diabetic
      proteinuria even at unchanged systemic blood pressure levels. Unless diuretics
      are needed for reasons other than hypertension, the treatment of diabetic
      patients with thiazides or loop diuretics in conventional dosage should probably
      be avoided until clarification of their influence on prognosis. Nevertheless,
      whether and to what extent other agents and nonpharmacologic measures can modify
      the prognosis in diabetic patients is also unclear, and the approach to
      antihypertensive therapy is therefore still largely empiric.

PMID- 8480622
TI  - Hypertension in diabetic nephropathy: prevention and treatment.
AB  - Hypertension is the major determinant of morbidity and mortality in diabetic
      patients. In type I diabetes hypertension develops in parallel with the evolution
      of nephropathy, whereas in type II diabetes hypertension precedes the onset of
      manifest diabetes mellitus by years or decades. Nephropathy is equally common in
      types I and II diabetes. Strong genetic determinants for nephropathy have been
      recognized, but it is unclear whether a genetic predisposition to hypertension
      and elevated sodium-lithium countertransport are involved. In epidemiologic
      studies hypertension is related to the risk and rate of evolution of diabetic
      nephropathy, retinopathy, and cardiovascular complications. The relationship
      appears to be causal, because antihypertensive treatment attenuates the rate of
      loss of glomerular filtration. In this respect angiotensin-converting enzyme
      inhibitors appear to be superior (renal protective action). Calcium channel
      blockers have been promising in experimental studies, but clinical information is
      currently incomplete.

PMID- 8480623
TI  - Reduction of left ventricular hypertrophy: how beneficial?
AB  - Left ventricular hypertrophy (LVH) can no longer be considered a compensatory
      adaptation of the heart serving to normalize the increased wall stress in
      hypertension. Recent studies have indicated that LVH is a powerful pressure
      independent risk factor for cardiovascular morbidity and mortality. The
      pathophysiologic sequelae of LVH are reduced ventricular filling and
      contractility, ventricular dysrhythmias, and diminished coronary reserve or
      myocardial ischemia. Left ventricular hypertrophy can be reduced by
      antihypertensive therapy, although not all drugs are equipotent in this regard.
      Recent studies have shown that such a reduction also improves the
      pathophysiologic sequelae of LVH, that is, ventricular filling, coronary reserve,
      and ventricular dysrhythmias, and maintains left ventricular pump function.
      Although the reversal of these pathophysiologic findings is encouraging, it
      remains unknown whether a reduction of LVH will ultimately reduce the excessive
      risk of sudden death, acute myocardial infarction, and congestive heart failure
      that has been associated with this disorder independent of arterial pressure.

PMID- 8480624
TI  - Pharmacologic profile of trandolapril, a new angiotensin-converting enzyme
      inhibitor.
AB  - Trandolapril is a newly developed angiotensin-converting enzyme (ACE) inhibitor
      that is rapidly hydrolyzed mainly in the liver to its biologically active
      metabolite trandolaprilat. The time to reach peak plasma concentrations of
      trandolaprilat is about 6 hours; the effective plasma half-life of accumulation
      at steady state is 24 hours. The active metabolite trandolaprilat has very high
      lipophilicity in comparison with other ACE inhibitors, which should contribute to
      an improved tissue penetration of the substance. The very high affinity of
      trandolaprilat to the ACE and the corresponding low dissociation rate are
      probably the two main reasons for the prolonged duration of action. The high
      potency of trandolaprilat in ACE inhibition is reflected by its low IC50
      (concentration needed to inhibit 50% of the enzyme activity). With repeated once
      daily administration of trandolapril, plasma ACE activity was reduced in a dose
      dependent fashion, but increasing the dose beyond 2 mg did not further reduce
      angiotensin II levels, apparently because of the compensatory increase in plasma
      renin levels. Therefore trandolapril in a dose of 2 mg once a day reduces blood
      pressure consistently throughout the 24 hour-period after intake. Because of its
      particularly long half-life, trandolapril, probably more than any other drug of
      its class, can be considered a true, once-a-day antihypertensive drug.

PMID- 8480625
TI  - Influence of the nonsulfhydryl angiotensin-converting enzyme inhibitor
      trandolapril on lipid and carbohydrate metabolism related to exercise capacity in
      healthy subjects.

PMID- 8480626
TI  - Cardiac effects of trandolapril in hypertension.
AB  - Baseline echocardiography was performed on 25 patients with essential
      hypertension and a supine diastolic blood pressure of 95 to 114 mm Hg while
      receiving placebo. Once-daily trandolapril was then titrated from 1 to 4 mg.
      After 3 months of therapy, supine diastolic blood pressure decreased by 7.5% (p <
      0.0001). Left ventricular hypertrophy regressed as evidenced by a 23.2% (p <
      0.0001) decrease in left ventricular mass index at 3 months and a 12.4% (p <
      0.05) reduction of relative wall thickness at 6 months. Although afterload
      decreased by 12.4% (p < 0.05) at 3 months, left ventricular systolic function
      remained unchanged, whereas left ventricular contractility, which was assessed
      from the load-independent relationship of end-systolic wall stress to velocity of
      circumferential fiber shortening, improved. Left ventricular diastolic function
      (E/A ratio) improved in 15 of 25 patients with low baseline values from 0.96 +/-
      0.14 to 1.18 +/- 0.25 (mean +/- SD, p < 0.0002) at 3 months. We conclude that
      trandolapril effectively reduces left ventricular hypertrophy and improves
      diastolic function in patients with hypertension while systolic function is
      preserved.

PMID- 8480627
TI  - Clinical experiences with trandolapril.
AB  - In this article the clinical experiences with the new non-sulfhydryl angiotensin
      converting enzyme inhibitor trandolapril are reviewed. The drug lowers blood
      pressure effectively in patients with mild-to-severe hypertension including
      elderly and obese patients. Distinguishing features of the compound are its long
      plasma half-life and high degree of lipophilicity.

PMID- 8480628
TI  - Development and optimization of a supercritical fluid extraction method for the
      analysis of aflatoxin B1 in grain dust.
AB  - A new method for the extraction of aflatoxins from small quantities of airborne
      dust, using supercritical carbon dioxide, is described. The efficacy of this
      method is compared with a previously used liquid extraction procedure, using
      naturally contaminated grain dust samples. Supercritical fluid extraction (SFE)
      provides faster, more sensitive, and more selective extraction, compared with the
      liquid extraction method. The optimized SFE conditions for 0.1-1.2 g of dust in a
      2.5 mL extraction chamber are: 2000 psi, 40 degrees C, 15 mL of liquid CO2,
      static extraction for 15 min, and 250 microL of acetonitrile added to sample in
      the extraction chamber. A detection limit of 1 ng aflatoxin B1 per sample is
      obtained using off-line HPLC analysis with UV detection. Lower detection limits
      are obtained using on-line SFE and HPLC analysis with fluorescence detection.

PMID- 8480629
TI  - A model for correcting Workplace Protection Factors for lung deposition and other
      effects.
AB  - The Workplace Protection Factor (WPF) is a measure of the protection provided by
      an industrial respirator against a challenge agent. It is traditionally defined
      as the ratio of the ambient contaminant concentration (Co) in a worker's
      breathing zone to the in-facepiece contaminant concentration (Ci) that occurs
      during inhalation, and is determined by simultaneous concentration measurements
      during the time the respirator is worn. There are several sources of particulate
      loss that result in the overestimation of the true WPF. A model is presented to
      "estimate" these losses so that an adjusted or "unbiased" WPF can be calculated.
      This model requires three measurements: Co, Ci, and the ambient aerodynamic mass
      frequency particle size distribution (PSD). Both Co and Ci are expressed in units
      of "mass per unit volume." There are four steps to the calculation of the
      unbiased WPF. First, the in-facepiece PSD is estimated using the ambient PSD and
      a particle leak penetration curve. Second, the fraction of the in-facepiece PSD
      that will deposit in the lung is estimated using the in-facepiece PSD and a
      "reference worker" total lung deposition curve. Third, the fraction of the in
      facepiece PSD that will deposit at the inlet of the sampling probe during both
      inhalation and exhalation is estimated using the in-facepiece PSD, the exhaled in
      facepiece PSD, and published inlet deposition data. Last, the adjusted in
      facepiece concentration is calculated using the estimates from steps two and
      three. The adjusted WPF, WPFa, is then calculated as the ratio of the measured
      ambient contaminant concentration and the adjusted in-facepiece concentration.

PMID- 8480630
TI  - Exposure of sprayers and plant handlers to mevinphos in Finnish greenhouses.
AB  - The exposure of sprayers and plant handlers to mevinphos, a toxic organophosphate
      insecticide, was evaluated in eight flower-growing greenhouses. The purpose was
      to assess an appropriate re-entry interval for mevinphos after its application in
      greenhouses. Inhalational and dermal exposure was measured during two days after
      application by measuring mevinphos in the greenhouse air and on the foliage.
      Workers' dermal exposure was measured with patch and handwash samples. The method
      of application considerably affected the levels of mevinphos in greenhouse air
      and on the foliage. The occupational exposure was measured with patch and
      handwash samples. The method of application considerably affected the levels of
      mevinphos in greenhouse air and on the foliage. The occupational exposure limit
      for mevinphos in Finland (100 micrograms/m3) was exceeded during the use of
      nonthermal foggers. Usually, however, the concentration of mevinphos in the
      breathing zone of the workers was below 10 micrograms/m3 9-12 hr after
      application. Mevinphos disappeared rapidly from greenhouse air and from the
      foliage after application, with a half-life of 9.2 hr. These data provide
      evidence that the main route of exposure to mevinphos is dermal, a conclusion
      supported by the excellent correlation between dermal exposure and the amount of
      mevinphos on the foliage. The calculated re-entry interval for mevinphos was
      approximately 4.5 hr. However, that interval is likely to be too short in
      practice because the risk of dermal exposure is considerable for more than 10 hr
      after the application of mevinphos.

PMID- 8480631
TI  - Electric and magnetic fields: what do we know?

PMID- 8480632
TI  - Exposure assessment for power frequency electric and magnetic fields.
AB  - Over the past decade considerable data have been collected on electric and
      magnetic fields in occupational environments. These data have taken the form of
      area measurements, source characterizations, and personal exposure measurements.
      Occupational EMF levels are highly variable in space and time. Exposures
      associated with these fields exhibit similar large variations during a day,
      between days, and between individuals within a group. The distribution of
      exposure measures is skewed over several decades with only a few values occurring
      at the maximum field levels. The skewness of exposure measures implies that large
      sample sizes may be required for assessments and that multiple statistical
      descriptors are preferred to describe individual and group exposures. Except for
      the relatively few occupational settings where high voltage sources are
      prevalent, electric fields encountered in the workplace are probably similar to
      residential exposures. Consequently, high electric field exposures are
      essentially limited to utility environments and occupations. Within the electric
      utility industry, it is definitely possible to identify occupations with high
      electric field exposures relative to those of office workers or other groups. The
      highly exposed utility occupations are linemen, substation operators, and utility
      electricians. The distribution of electric field exposures in the utility worker
      population is very skewed even within a given occupation. As with electric
      fields, magnetic fields in the workplace appear to be comparable with residential
      levels, unless a clearly defined high-current source is present. Since high
      current sources are more prevalent than high-voltage sources, environments with
      relatively high magnetic field exposures encompass a more diverse set of
      occupations than do those with high electric fields. Within the electric utility
      industry, it is possible to identify occupational environments with high magnetic
      field exposure relative to the office environment. Utility job categories with
      the highest exposures are generation facility workers, substation operators,
      utility linemen, and utility electricians. There are also higher exposures among
      traditional "electrical worker" job categories. Outside the electrical utility
      industry, potential sources of high occupational magnetic field exposures at ELF
      are induction furnaces, welding machines, electrical transportation systems, and
      electrical distribution vaults. However, the use of low power electrical
      equipment such as small motors in close proximity to workers and possibly for
      long periods of time could also lead to high exposure situations. Handheld survey
      instruments are available to perform area measurements of electric and magnetic
      fields at power frequencies but not aat all frequencies within the ELF range.
      Sophisticated personal computer-based instruments are available to characterize
      areas and sources across the entire frequency range.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8480633
TI  - A review of in vitro studies: low-frequency electromagnetic fields.
AB  - In vitro studies of effects of low-frequency (LF) electromagnetic (EM) fields
      have revealed a variety of sensitive cell-physiologic end-points. Effects have
      been reported on (1) DNA, RNA, and protein synthesis; (2) cell proliferation; (3)
      cation fluxes and binding; (4) immune responses; and (5) membrane signal
      transduction (i.e., hormones, enzymes, and neuro-transmitters). Typically such
      effects occurred as a result of short-term exposure of cells to EM at frequencies
      of 100 Hz or less and at low field intensities. The dependency on frequency or
      modulation, as well as the apparent weak cellular interaction of these LF EM
      fields, lacks theoretic explanation. It has not been determined whether effects
      are induced by electric or magnetic fields. Confounding interpretation of the
      results are phenomena such as (1) transient or time-delayed responses; (2)
      modulation- and intensity-specific effects, referred to as modulation or
      intensity "windows;" and (3) general lack of dose- (or dose-rate) response data
      or EM field thresholds. Consequently, although it is well-established that LF EM
      fields affect biological systems in vitro, use of these data to assess human
      health effects is limited. This paper reviews selected published reports of LF EM
      fields on in vitro systems. Where possible, relevance of the findings to
      occupational exposures will be assessed, principally by considering the
      consistency of in vitro and in vivo EM exposure effects and comparison of EM
      field intensities that affect in vitro systems with occupational EM exposure
      intensities. Finally, suggestions will be made for the direction of future in
      vitro research of direct pertinence to potential occupational exposure problems.

PMID- 8480634
TI  - Biological effects of extremely low-frequency electromagnetic fields: in vivo
      studies.
AB  - This paper discusses the biological effects of exposure to extremely low
      frequency electromagnetic fields observed in animal studies. Three areas of
      investigation are reported: (1) studies on the nervous system, including behavior
      and neuroendocrine function; (2) experiments on cancer development in animals;
      and (3) measurements of currents and electric fields induced in animal models by
      exposure to external magnetic fields. An attempt is made to evaluate experimental
      results and interpret them with respect to potential health implications.

PMID- 8480635
TI  - Overview of epidemiologic research on electric and magnetic fields and cancer.
AB  - This overview of epidemiologic research addresses the potential role of 60 Hertz
      electric and magnetic fields (EMF) in the etiology of cancer. The key findings
      are summarized with notation of the methodological challenges with which
      investigators must content. Although exposure is ubiquitous, long-term average
      EMF is influenced primarily by the background levels in homes, use of selected
      electric appliances such as electric blankets, and workplace exposures to
      energized equipment. Studies of residential exposure have focused on childhood
      cancer, starting with the report of an excess of wire configurations associated
      with elevated magnetic fields near the homes of children who developed cancer
      compared to healthy children. Several subsequent studies have tended to confirm
      that association, although the evidence falls short of demonstrating a causal
      association between magnetic fields and cancer. Exposures from electric
      appliances have been less extensively pursued, with some suggestions of an
      association with childhood cancer. A more extensive literature has evaluated the
      association between workplace exposure to EMF, based on job titles of "electrical
      workers" and cancer. Across many different study designs and settings, certain
      groups of electrical workers show elevated occurrence of leukemia and brain
      cancer. The consistency of findings is notable, but the key question is whether
      the association with job title is due to EMF or some other agent in the
      workplace. Future research would benefit from specification of testable
      challenges to a causal association between EMF exposure in the home or workplace
      and cancer, along with continued efforts to improve our understanding and
      measurement of EMF exposure.

PMID- 8480636
TI  - Electric and magnetic field management.
AB  - The emergence of new electrical technologies has produced an extremely complex
      electric and magnetic field environment in which we must live and work. Although
      there presently exist no universally accepted human exposure guidelines, current
      biological research may someday produce such limits. It is in anticipation of
      these exposure limits that electric and magnetic field management techniques are
      being investigated. At low frequencies, two categories of field management exist:
      cancellation and shielding. The particular class of control used will depend on
      several functions of the field and its source, and will be determined finally on
      a case-by-case basis. In general, it is found that magnetic fields are much more
      complicated to manage than electric fields. The discussion of this paper serves
      as a primer in the area of low frequency electric and magnetic fields and the
      control thereof.

PMID- 8480637
TI  - Prediction of late arrhythmic events after acute myocardial infarction from
      combined use of noninvasive prognostic variables and inducibility of sustained
      monomorphic ventricular tachycardia.
AB  - A combined use of noninvasive techniques and electrophysiologic study in the
      prediction of arrhythmic events was prospectively evaluated in 303 surviving
      patients of acute myocardial infarction (AMI). The most powerful combination of
      noninvasive prognostic variables in identifying patients suitable for invasive
      strategies was also assessed. Patients who had > or = 2 variables among left
      ventricular ejection fraction < 0.4, ventricular late potentials and repetitive
      ventricular premature complexes (VPCs) were considered eligible for programmed
      ventricular stimulation. After 15 +/- 7 months of follow-up, 19 patients (6%) had
      an arrhythmic event. Left ventricular dyskinesia (p < 0.00001) and ejection
      fraction < 0.4 (p < 0.000001), late potentials (p < 0.001), filtered QRS duration
      > or = 106 ms (p < 0.00001), VPCs/hour > 6 (p < 0.05), paired VPCs (p < 0.01), >
      or = 2 runs of unsustained ventricular tachycardia (VT) per monitoring (p <
      0.001), heart rate variability index < or = 29 (p < 0.00001) and mean RR interval
      < or = 750 ms (p < 0.01) were found to be significant univariate predictors of
      events. At multivariate analysis, only low left ventricular ejection fraction,
      prolonged filtered QRS duration, reduced heart rate variability index and
      detection of > or = 2 runs of unsustained VT per monitoring had an independent
      relation to late arrhythmic events. Of 67 eligible patients, 47 (70%) consented
      to undergo programmed stimulation. A positive electrophysiologic study was found
      to be the strongest independent predictor of events among patients preselected by
      noninvasive techniques. With a good sensitivity (81%), a combined use of
      noninvasive tests and electrophysiologic study selected a group of post-AMI
      patients at sufficiently high risk (event rate 65%) to be considered candidates
      for interventional therapy. The combination of > or = 2 variables among left
      ventricular ejection fraction < 0.4, filtered QRS duration > or = 106 ms and > or
      = 2 runs of unsustained VT was superior to the other ones in identifying high
      risk subjects (positive and negative predictive values for arrhythmic events of
      44 and 99%, respectively). On the basis of the data, this scheme appears to be
      the most appropriate for selecting patients suitable for electrophysiologic
      testing and invasive strategies after AMI.

PMID- 8480638
TI  - Prognostic significance of early ischemia after acute myocardial infarction in
      low-risk patients. IRES (Ischemia Residua) Study Group.
AB  - Early postinfarction angina is generally believed to imply an unfavorable
      prognosis. However, most of the published information devices from data collected
      in the prethrombolytic era, with widely differing populations and definitions of
      early angina, and very little data pertinent to low-risk patients are available.
      This collaborative study prospectively assessed the incidence of early recurrent
      ischemia after thrombolysis, as well as its prognostic significance, in 453
      consecutive patients aged < or = 70 years with an uncomplicated course in the
      first 24 hours of a first myocardial infarction participating in the second
      Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI
      2) trial. Early recurrent ischemia (spontaneous, transient ST depression or
      elevation of > 1 mm and/or T-wave inversion), assessed in the coronary care unit
      with continuous clinical and electrocardiographic monitoring, was documented in
      35 of 453 patients (8%) and was unrelated to sex, age, electrocardiographic
      location, Q-wave or non-Q-wave infarction, thrombolytic agent and time to its
      administration. In-hospital cardiac events (7 deaths, 19 nonfatal reinfarctions
      and 8 urgent revascularizations) occurred in 15 of 35 patients (43%) with versus
      19 of 418 without (4.5%) recurrent ischemia (p < 0.001). At the 6-month follow-up
      of 352 medically treated patients who did not have in-hospital events, the
      incidence of death, reinfarction and recurrent angina was comparable between
      patients with (2 of 18, 11%) and without (62 of 334, 19%) early ischemia (p =
      NS). With use of stepwise multivariate analysis, early ischemia was the only
      significant predictor of in-hospital cardiac events (p < 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480639
TI  - Five- to ten-year outcome after multivessel percutaneous transluminal coronary
      angioplasty.
AB  - The early and late outcome of patients who underwent multivessel percutaneous
      transluminal coronary angioplasty (PTCA) in a 1-stage procedure are described,
      and the predictors for clinical event and new revascularization procedure are
      identified. Of 1,937 patients treated by PTCA between 1981 and 1986, 203 (10.4%)
      had multivessel PTCA in a 1-step procedure. A follow-up extending to 71 +/- 23
      months was obtained in 195 patients (96%). Primary success was achieved in 91% of
      494 attempted sites, and complete revascularization in 65% of 203 patients. There
      were no in-hospital deaths. Acute complications occurred in 13 patients (6.4%),
      including non-Q-wave (n = 8) and Q-wave (n = 5) infarction, and urgent coronary
      artery bypass surgery (n = 3). Before PTCA, 126 patients (62%) were in class III
      or IV of the Canadian Cardiovascular Society classification; at follow-up, 84%
      were angina-free or in class I. Death occurred in 14 patients and nonfatal
      myocardial infarction in 18. Angiographic restenosis was diagnosed in 37.2% of
      dilated lesions in 96 patients (60% of 159 restudied). A repeat revascularization
      procedure for restenosis or progression of disease, or both, was needed in 92
      symptomatic patients (47%). The survival rate at 7 years without the need for
      surgery or PTCA was 53%, and cardiac survival without myocardial infarction was
      85.5%. The only independent predictor of cardiac death was ejection fraction (p <
      0.001). The rate of restenosis per patient was primarily determined by the number
      of segments dilated, whereas progression of disease was related to the number of
      nonsignificant coronary artery stenoses (< 50%) at baseline (p < 0.02).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480640
TI  - Recent changes in the management and outcome of acute closure after percutaneous
      transluminal coronary angioplasty.
AB  - The major cause of morbidity and mortality associated with percutaneous
      transluminal coronary angioplasty (PTCA) is acute closure. This study compared
      the clinical outcome of 2 groups of patients who experienced acute closure during
      PTCA. One group was treated during a period when intracoronary stents, laser
      balloons and perfusion balloons were available for treatment of acute closure
      (group II). These results were compared with the clinical outcome a group of
      similar patients who were treated for acute closure during a period that
      immediately preceded the availability of these devices (group I). One hundred
      sixty-six patients had acute closure in group I, whereas 156 patients experienced
      acute closure in group II. Baseline clinical characteristics were similar for
      both groups. There was no difference in ejection fraction, number of vessels
      diseased, degree of stenosis or number of vessels attempted between the 2 groups.
      Patients in group II had more balloon inflations and longer balloon inflation
      times when compared with patients in group I. Of the 156 patients in group II,
      47% were treated with either an intracoronary stent, laser balloon or perfusion
      balloon. Group II patients had fewer Q-wave myocardial infarctions (9.1 vs 20.3%,
      p = 0.005). In addition, peak creatine phosphokinase levels (826 +/- 1,515 vs 517
      +/- 1,050, p < 0.01) and mean residual stenosis (40.7 +/- 33.2 vs 58.0 +/- 34.4%,
      p < 0.0001) were also lower in group II patients. There was also less coronary
      artery bypass grafting during the same admission (38.6 vs 29.5%, p = 0.02) in
      group II patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480641
TI  - Effects of aspirin DL-lysine on thrombin generation in unstable angina pectoris.
AB  - To evaluate the effects of aspirin on thrombin generation in patients with
      unstable angina, plasma levels of thrombin-antithrombin III complex (TAT) as a
      new marker of thrombin generation and of 11-dehydro-thromboxane B2 (11-dehydro
      TXB2) as an indicator of platelet activation were measured in 18 patients with
      unstable angina, including 8 patients with prolonged rest angina (> 15 minutes).
      Aspirin DL-lysine (900 mg) was administered intravenously to 9 of the 18 patients
      (aspirin group); the other 9 were not given aspirin during the first 24 hours of
      hospitalization (non-aspirin group). Clinical characteristics, angiographic
      features and medications other than aspirin were similar between the 2 groups.
      Levels of plasma TAT and 11-dehydro-TXB2 were significantly higher (p < 0.05) in
      patients with prolonged rest angina than in those without the condition (n = 10).
      In 5 patients with prolonged rest angina who received aspirin, plasma TAT levels
      (ng/ml) were significantly decreased (4.52 +/- 1.18 at baseline, 2.50 +/- 0.65 at
      1 hour and 2.16 +/- 0.42 at 24 hours after aspirin administration, p < 0.01) with
      a significant decrease in plasma 11-dehydro-TXB2 levels. However, the reduction
      in TAT after aspirin administration was slight in patients without prolonged rest
      angina (n = 4). In contrast, levels of plasma TAT and 11-dehydro-TXB2 in the non
      aspirin group remained unchanged during the study period. These results suggest
      that aspirin rapidly reduces thrombin generation through inhibition of platelet
      activity in patients with unstable angina with prolonged rest angina.

PMID- 8480642
TI  - Clinical significance of morphologic classification of coronary arterial
      segmental stenosis due to Kawasaki disease.
AB  - Coronary arteriograms obtained in 1,392 patients from a cohort of 4,562 with
      Kawasaki disease showed 395 to have coronary arterial lesions. The specific
      lesions, known as segmental stenoses, were observed in 62 patients, involving 68
      coronary arterial branches. The lesions involved the right coronary artery in 56
      cases (14.2% of the group with arterial lesions) and the left coronary artery in
      the other 12 (3% of the overall group with arterial lesions). Three morphologic
      variations were observed. Braid-like lesions accounted for 15 lesions, involving
      the right coronary artery and occurring < 2 years after the onset of Kawasaki
      disease. Bridging vessels were observed in 40 of 68 arterial lesions, 30 of which
      involved the right coronary artery. Of these bridging vessels, 86% were present
      within 4 years of onset of the disease. Pericoronary communications were observed
      in the remaining 13 of 68 lesions, 11 involving the right coronary artery and
      appearing at variable intervals, but usually significantly later than the other
      lesions. Myocardial ischemia was found at the first study in 60% of braid-like
      lesions, but in only 29% of the lesions at follow-up studies. Of bridging vessels
      or pericoronary communications, 95 and 77%, respectively, were found to have
      produced ischemia in the initial study, which persisted in 78 and 77%,
      respectively. There are 3 different mechanisms involved in the formation of
      segmental stenosis, with different prognoses for the clinical course of
      myocardial ischemia.

PMID- 8480643
TI  - Radiofrequency ablation in multiple accessory pathways and the physiologic
      implications.
AB  - The presence of multiple accessory pathways was noted in 24 of 210 consecutive
      patients (12 males and 12 females aged 15 to 77 years [mean +/- SD 43 +/- 16])
      with the Wolff-Parkinson-White syndrome who underwent electrophysiologic study
      and radiofrequency ablation. Six had 3 and 18 had 2 accessory pathways. There
      were 25 manifest and 29 concealed accessory pathways. The location of the
      accessory pathways was in the left free wall in 22, the right free wall in 17,
      the left posterior portion of the ventricular septum in 8, the right posterior
      portion of the ventricular septum in 6, and the midseptum in 1. The success rate
      of accessory pathway ablation and the fluoroscopic time in these 24 patients with
      multiple accessory pathways were 89% and 78 +/- 66 minutes, respectively, whereas
      they were 98% (p < 0.01) and 36 +/- 37 minutes (p = 0.01) in the 186 patients
      with a single accessory pathway. The mean applications, the power level of the
      radiofrequency current and the application duration in these 24 patients were 21
      +/- 22, 30 +/- 3 W, and 27 +/- 10 seconds, respectively. In the 186 patients with
      a single accessory pathway, they were 9 +/- 12 applications (p = 0.02), 30 +/- 4
      W (p = NS) and 26 +/- 9 seconds (p = NS), respectively. Seventeen of the 24
      patients had a follow-up electrophysiologic study 89 +/- 40 days after ablation,
      and 2 (12%) had resumption of a right and left accessory pathway
      conduction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480644
TI  - Factors determining late success after mitral balloon valvulotomy.
AB  - Mitral balloon valvulotomy (MBV) has proved to be an effective method in the
      treatment of patients with mitral stenosis. Although several factors determining
      an optimal immediate result have been described, there is little information
      regarding long-term follow-up, as well as factors influencing late success after
      MBV. This study analyzes 350 patients (mean age 46 +/- 12 years) treated by MBV
      who were clinically followed up between 6 months and 6 years. At least 1 echo
      Doppler follow-up study was obtained in 298 patients 28 +/- 14 months after MBV;
      hemodynamic reevaluations were performed in 66 patients after 23 +/- months. Late
      success was considered if the patient was in functional class I to II and free of
      major events (death, restenosis and valve surgery). Restenosis was defined as a
      50% loss of initial gain with regard to valve area by echocardiography, which was
      confirmed hemodynamically. After a mean follow-up of 38 +/- 15 months, 296
      patients (84%) remained in functional class I to II, without surgery or the need
      for an increase in medical treatment. The 5-year Kaplan-Meier survival rate was
      94 +/- 1%, whereas restenosis, valve surgery and major event-free probability
      were 90 +/- 3%, 91 +/- 2% and 85 +/- 2%, respectively. Multivariate study (Cox
      regression model) identified the presence of sinus rhythm (p < 0.001) and the
      absence of calcium at fluoroscopy (p < 0.003) as the only independent factors of
      late success.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480645
TI  - Clinicopathologic features of active infective endocarditis isolated to the
      native mitral valve.
AB  - Although a number of clinicopathologic studies in patients with active infective
      endocarditis (IE) have been reported, none have focused on patients studied at
      necropsy with active IE isolated to the mitral valve. We studied at necropsy 63
      patients (aged 12 to 88 years [mean 50], 44 males [70%]) with active IE limited
      to the native mitral valve: 21 (33%) had preexisting mitral valve disease
      (rheumatic in 8, prolapse in 3, hypertrophic cardiomyopathy in 1, and mitral
      annular calcium in 9), and the other 42 patients (67%) had previously normal
      mitral valves. Of the latter 42 patients, 22 (52%) had recognized predisposing
      factors to IE: opiate addiction in 14, habitual alcoholism in 6 and/or chronic
      hemodialysis in 4. Staphylococcus aureus or epidermidis was the responsible
      organism in 32 patients (51%), and the active IE was associated with an infection
      elsewhere in the body in 31 patients (50%). The active IE caused rupture of
      mitral chordae tendineae in 11 patients (18%), perforation of the anterior mitral
      leaflet in 7 patients (11%), and mitral ring abscess in 10 patients (16%).
      Grossly visible systemic emboli were found in 44 patients (70%) and 33 (52%) had
      infarcts in 1 or more body organs. Thus, active IE isolated to the mitral valve
      in necropsied patients appears to be more common in males than females (2 to 1);
      the infection more commonly than not involves a preexisting anatomically normal
      valve rather than a preexisting abnormal one (2 to 1); the vegetations often do
      not cause or worsen valvular dysfunction; a predisposing factor is commonly
      present (2 of 3 patients), and the IE commonly is part of a generalized or
      systemic infection (1 of 2 patients).

PMID- 8480646
TI  - Retrobronchial vertical vein in totally anomalous pulmonary venous connection to
      the innominate vein and its specific occurrence in right isomerism.
AB  - Recently, a case of right isomerism with totally anomalous pulmonary venous
      connection (TAPVC) to the innominate vein through a vertical vein that ascended
      in the mediastinum posterior to the left-sided main bronchus was encountered.
      This retrobronchial vertical vein that has not been described previously in
      patients with TAPVC to the innominate vein prompted the performance of a
      retrospective analysis of 44 cases with TAPVC to the innominate vein in which
      angiography had been performed. The 44 cases consisted of 36 patients with situs
      solitus, 7 with right isomerism, and 1 with left isomerism. The spatial relation
      of the vertical vein to the adjacent pulmonary artery and main bronchus could be
      defined in 41 cases. The vertical vein was retrobronchial in 4 of 5 cases with
      right isomerism in which the location of the vertical vein could be defined with
      certainty. No case with situs solitus or left isomerism was associated with a
      retrobronchial vertical vein. In all 4 patients with a retrobronchial vertical
      vein, angiographic evidence of obstruction of pulmonary venous drainage was
      present, and was due to an extrinsic bronchial compression in 2 and to an
      intrinsic narrowing of the vertical vein in 2.

PMID- 8480647
TI  - Relation of elevated plasma endothelin in congenital heart disease to increased
      pulmonary blood flow.
AB  - Endothelin-1 (ET), a potent vasoconstrictor peptide, has been found to be
      elevated in children with pulmonary hypertension associated with congenital heart
      defects. To evaluate the effect of pulmonary blood flow on ET concentrations, 5
      ml blood samples were obtained peripherally at cardiac catheterization from 35
      patients, ages 0.13 to 17 years (median 2). Plasma was extracted and ET measured
      by radioimmunoassay. Patients were classified into 2 groups based on the presence
      (group A) or absence (group B) of increased pulmonary blood flow defined as a
      Qp/Qs > or = 1.5. When the 13 patients (37%) in group A were compared with the 22
      patients (63%) in group B there were no significant differences in age, cardiac
      index, or pulmonary and systemic resistances. ET concentrations were
      significantly higher in group A patients (median 3.25, range 0 to 16.5 vs median
      0, range 0 to 6.35 pg/ml; p < or = 0.05). Pulmonary blood flow and pulmonary
      artery pressure were also higher in group A patients (p < or = 0.01). When
      patients within group A were subdivided into those with and without pulmonary
      hypertension, no difference was present in their ET concentrations (mean/SD:
      4.4/4.3 vs 4.0/6.4 pg/ml, p = NS). Thus, ET is elevated in patients with
      congenital heart disease associated with left-to-right shunts and it appears that
      this increase is related to increased pulmonary blood flow independent of
      pulmonary artery pressure.

PMID- 8480648
TI  - Detection of atherosclerotic lesions in the aorta by transesophageal
      echocardiography.
AB  - Transesophageal echocardiographic studies were prospectively performed in 152
      consecutive patients older than age 40 years referred to the echocardiography
      laboratory to assess the prevalence of atherosclerosis in the thoracic aorta and
      relate this to a history of systemic embolization. Forty-four patients (29%) had
      at least 1 atherosclerotic lesion in the thoracic aorta. This was associated with
      a higher prevalence of coronary artery disease (78% of all patients with coronary
      artery disease), carotid artery disease (88% of all patients with carotid artery
      disease) and peripheral vascular disease (all symptomatic patients). Forty-two of
      all patients (28%) had systemic emboli, 20 (48%) of whom had at least 1
      atheromatous lesion in the thoracic aorta. Conversely, only 24 of 110 patients
      (22%) without previous systemic emboli had atheromatous lesions (p < 0.001). It
      is concluded that atherosclerotic lesions in the thoracic aorta can readily be
      identified with transesophageal echocardiography. The detection of
      atherosclerotic plaques of the aorta represents a marker of diffuse
      atherosclerotic disease, often associated with carotid, coronary and peripheral
      vascular disease and with the occurrence of systemic emboli. Transesophageal
      echocardiography may be used serially to investigate whether dietary or
      pharmacologic maneuvers, or both, can shrink established atherosclerotic plaques
      in the thoracic aorta.

PMID- 8480649
TI  - Comparison of activated partial thromboplastin time to activated clotting time
      for adequacy of heparin anticoagulation just before percutaneous transluminal
      coronary angioplasty.

PMID- 8480650
TI  - Comparison of major complication rates with new atherectomy devices for
      percutaneous coronary intervention in women versus men.

PMID- 8480651
TI  - Direct holmium laser-assisted balloon angioplasty in acute myocardial infarction.

PMID- 8480652
TI  - Six-month quantitative angiographic follow-up of < 50% diameter stenoses dilated
      during multilesion percutaneous transluminal coronary angioplasty.

PMID- 8480653
TI  - Frequency of unfavorable cardiac events documented by routine telemetry
      monitoring after uncomplicated percutaneous transluminal coronary angioplasty.

PMID- 8480654
TI  - Interleukin-6 (IL-6) as a mediator of stunned myocardium.

PMID- 8480655
TI  - Prevalence of reciprocating tachycardia in patients aged < 50 years with apparent
      lone atrial fibrillation.

PMID- 8480656
TI  - Rapid bedside temporary pacing by the right supraclavicular subclavian vein
      approach.

PMID- 8480657
TI  - Long-term survival in the Munich Mild Heart Failure Trial (MHFT).

PMID- 8480658
TI  - Variability of mitral valve area by Gorlin formula after replacement by a caged
      ball prosthesis.

PMID- 8480659
TI  - Discrepancies between Doppler and catheter gradients across bileaflet aortic
      valve prostheses.

PMID- 8480660
TI  - Percutaneous balloon mitral valvotomy in patients with history of embolism.

PMID- 8480661
TI  - Frequency of acquired coronary-cameral fistula after ventricular septal myectomy
      in hypertrophic cardiomyopathy.

PMID- 8480662
TI  - Determinants for outcome of balloon valvuloplasty for severe pulmonary stenosis
      in neonates and infants up to six months of age.

PMID- 8480663
TI  - The 12-lead electrocardiogram of "healthy" ambulatory subjects with positive Lyme
      immunoserology.

PMID- 8480664
TI  - Relation between mitral annular calcium and complex intraaortic debris.

PMID- 8480665
TI  - Electrocardiographic changes during long-term follow-up of pediatric heart
      transplant recipients.

PMID- 8480666
TI  - Ego-state therapy: an overview.
AB  - Ego-state therapy is a psychodynamic approach in which techniques of group and
      family therapy are employed to resolve conflicts between the various "ego states"
      that constitute a "family of self" within a single individual. Although covert
      ego states do not normally become overt except in true multiple personality, they
      are hypnotically activated and made accessible for contact and communication with
      the therapist. Any of the behavioral, cognitive, analytic, or humanistic
      techniques may then be employed in a kind of internal diplomacy. Some 20 years
      experience with this approach has demonstrated that complex psychodynamic
      problems can often be resolved in a relatively short time compared to more
      traditional analytic therapies.

PMID- 8480667
TI  - The use of ego-state therapy in the treatment of posttraumatic stress disorder.
AB  - Ego-state therapy has been cited in the literature as a promising tool for the
      treatment of patients who suffer from the effects of past trauma experiences. In
      this paper, I review various methods to activate ego states and to uncover
      traumatic experiences and their related internal conflicts in sexually abused
      patients with posttraumatic symptoms. I also discuss ego-state-therapy techniques
      that promote the integration and resolution of trauma. Three clinical case
      examples illustrate the use of ego-state therapy with posttraumatic patients. I
      suggest ways in which ego-state-therapy methods can be useful with some of the
      symptomatology specific to this population. The effectiveness of ego-state
      therapy is also explored in dealing with certain features of posttraumatic
      conditions that can complicate treatment, including dissociation and
      fragmentation, cognitive and perceptual distortion, and rigidification of
      personality and behavior.

PMID- 8480668
TI  - From strength to strength: "inner strength" with immature ego states.
AB  - The ego-strengthening literature concentrates on the use of hypnotic techniques
      with the entire or total personality. Ego-state therapy conceptualizes the ego as
      a system of subpersonalities or ego states that have shifting energies. At any
      particular time the ego state with the most energy is dominant or executive. Any
      technique that can be used with an individual patient can also be used with an
      identified ego state. The "inner-strength" hypnotic technique has been used for
      ego strengthening and mobilization of inner resources. In this paper the "inner
      strength" technique is used with ego states that have been identified as
      responsible for specific symptoms. We will discuss indications for the
      appropriate use of this technique in ego-state therapy and the mechanisms of its
      role in the resolution of symptoms in the cases presented.

PMID- 8480669
TI  - Ego-state therapy for self-injurious behavior.
AB  - The authors describe the use of ego-state therapy for the treatment of self
      injurious behavior (SIB). We propose that for some patients, SIB results from
      conflict among dissociated ego states. We review the historical and theoretical
      basis for this position and delineate a specific treatment technique. Our
      strategy consists of identifying an ego state in which SIB occurs, activating the
      patient's ego strengths using inner-adviser techniques and facilitating the
      integration of these resources within the ego state responsible for the behavior.
      We have used this strategy with favorable results for patients with dissociative
      symptoms, primarily those suffering from borderline personality disorder,
      posttraumatic stress disorder, or dissociative disorders.

PMID- 8480670
TI  - Therapeutic writing as a form of ego-state therapy.
AB  - In this paper I describe a special form of ego-state therapy that integrates
      writing letters to one's self as an internal therapeutic communication among
      various ego states previously not fully aware of each other or engaged in
      destructive power struggles. Expressing one's thoughts, feelings, and urges in
      writing transforms primary process activities of the self into secondary
      processes that are more mature and adaptive to healthy functioning in day-to-day
      living. This method also reinforces the idea of patient empowerment in the form
      of self-healing and utilizing internal resources in the process of recovery.

PMID- 8480671
TI  - Accessing the relevant areas of maladaptive personality functioning.
AB  - Personality functions in different dimensions: perceptual, cognitive, and
      affective (emotional). It can be manifested in different areas--overt
      (conscious), covert (unconscious), or in some relative degree of each.
      Personality segments can operate independently of one another, as in multiple
      personalities or with varying degrees of mutual dependence and
      intercommunication, as in normal "ego states." Therapeutic interventions will be
      more efficient if focused within the problem dimension, area, or segment. The
      essence of Alexander and French's "corrective emotional experience" was a
      restructuring of the patient through release and interpretation within the
      "emotional" sphere. When their concept is extended to other dimensions of
      personality functions, such as behavioral, perceptual, and cognitive, it allows
      interventions to be more specifically focused in the regions that are most
      relevant. In this paper we present specific techniques using this extended
      concept. Rapid and significant change followed in the patient so treated.

PMID- 8480672
TI  - Research directions in nutrition: view from the NICHD.

PMID- 8480673
TI  - Accuracy of measurements of body composition by dual-energy x-ray absorptiometry
      in vivo.
AB  - The accuracy of body-composition measurements in vivo by dual-energy x-ray
      absorptiometry (DEXA) was assessed in seven pigs (weight: 35-95 kg) by
      measurement by DEXA in vivo and chemical analysis after postmortem
      homogenization. The regression lines between these measurements were not
      significantly different from the line of identity (P > 0.05), the r values were >
      0.97, and the corresponding SEEs were 2.9%, 1.9 kg, and 2.7 kg for percent fat,
      fat tissue mass, and lean body mass, respectively. Changes in fat and lean tissue
      mass (simulated by placing 8.8 kg porcine lard on the trunk of six women) were
      accurately measured by DEXA. The measured total-body bone mineral (TBBM) was
      significantly affected by the lard (P < 0.05). In conclusion, DEXA is an accurate
      method for measurement of soft-tissue body composition. TBBM measurements in
      longitudinal studies may, however, be difficult to interpret if considerable
      change in soft-tissue composition has occurred.

PMID- 8480674
TI  - Advantage of knee height over height as an index of stature in expression of body
      composition in adults.
AB  - It is not clear how body composition should best be compared between subjects,
      but it is accepted that simply comparing total mass or percentage fat-free mass
      (FFM) or fat mass (FM) is not adequate. Indexing body composition to stature
      seems more appropriate, but the decline in height with age or osteoporosis could
      confound comparisons of body composition across age or disease groups. Using
      bioimpedance data from 600 adults in the Framingham Offspring Study, we examined
      the ability of height and knee height indexes to correctly describe the loss of
      FFM seen with increasing age between 28 and 75 y. Indexing body composition to
      height obscured the loss of FFM with age (r = -0.065, P < 0.26 for men; r = 
      0.050, P < 0.394 for women), whereas indexing body composition to knee height
      preserved the correct information (r = -0.154, P < 0.007 for men; r = -0.161, P <
      0.006 for women). These data suggest that knee height is a reliable surrogate for
      stature and should be used to adjust body composition measurements when
      bioimpedance is used to estimate body composition.

PMID- 8480675
TI  - Resting energy expenditure in human immunodeficiency virus-infected patients:
      comparison between patients with and without secondary infections.
AB  - Resting energy expenditure (REE) was measured in 165 malnourished patients with
      human immunodeficiency virus infection and compared with that of 31 control
      subjects. Of these patients, 129 had no symptoms of secondary infections (NI),
      whereas 36 had evolving secondary infection (I) despite a body temperature < 38
      degrees C. Mean REE was 11% higher in the NI group than in the control group (P <
      0.05); it was 34% higher in the I group than in the control group (P < 0.001) and
      21% higher than in the NI group (P < 0.01). In all cases the best predictive
      variable for REE was the fat-free mass (FFM) (r = 0.77, P < 0.001 in NI; r =
      0.70, P < 0.001 in I; r = 0.78 in the control group. The REE-FFM ratio was 152.5
      +/- 1.2 and 207 +/- 5.4 kJ.kg-1.d-1 in the NI and I groups, respectively. A high
      energy expenditure may be a harbinger of secondary infection in acquired
      immunodeficiency syndrome and may participate in accelerated weight loss.

PMID- 8480676
TI  - Seasonality of energy expenditure during pregnancy and lactation for rural Nepali
      women.
AB  - Total energy expenditure (TEE) was estimated for 19 nonpregnant, nonlactating
      (NPNL) and 24 pregnant (P) or lactating (L) women from 3601 h of minute-by-minute
      observation and 168 measurements of the energy cost of activities. NPNL women
      significantly increased subsistence activity and TEE from 9.9 MJ [1.89 x basal
      metabolic rate (BMR)] in the winter to 10.5 MJ (2.01 x BMR) in the monsoon
      season. There were differences between NPNL,P, and L women in the winter, but not
      in the spring or monsoon season when all individuals sustained very heavy
      physical activity. High TEE values resulted from spending very long hours in
      tasks that, although appearing physically demanding to the casual observer, were
      characterized by light or moderate energy cost. The study highlights the
      importance of seasonal constraints on women's work, which prevent P and L women
      from significantly curtailing physical activity during the monsoon season, and
      which effectively limit the scope of behavioral mechanisms for saving energy and
      reducing TEE.

PMID- 8480677
TI  - Adipose tissue fatty acids as biomarkers of dietary exposure in Danish men and
      women.
AB  - Adipose tissue fatty acids, it has been proposed, reflect dietary intake. Using
      data from a validation study preceding a prospective study on diet, cancer, and
      health in Denmark, we were able to compare fatty acid profiles in adipose tissue
      biopsies from 86 individuals (23 men and 63 women) aged 40-64 y and dietary
      intake of fatty acids (as percentage of total fat) assessed by two 7-d weighed
      diet records or by a semi-quantitative food frequency questionnaire. Correlation
      coefficients (Pearson r) between fatty acid concentrations in adipose tissue
      biopsies (as percentage of total peak area) and dietary intake of fatty acid
      (percentage of total fat), determined from the diet records for men and women,
      respectively, were as follows: polyunsaturated fatty acids r = 0.74 and r = 0.46;
      n - 3 fatty acids of marine origin: eicosapentaenoic acid r = 0.15 and r = 0.61,
      and docosahexaenoic acid r = 0.47 and r = 0.57. Correlation coefficients obtained
      by using the food frequency questionnaire were slightly lower for most fatty
      acids.

PMID- 8480678
TI  - Individual effects of dietary saturated fatty acids and fish oil on plasma lipids
      and lipoproteins in normal men.
AB  - Fish ingestion is associated with lower mortality from coronary heart disease
      (CHD). However, in some Western populations whose diets are rich in saturated
      fatty acids (SFAs), CHD mortality is consistently high despite high fish
      consumption. To study this paradox, we fed six healthy men diets with two amounts
      of SFA (5% and 19% of energy) that also differed in total fat (25% and 39% of
      energy). Each fat amount was given with and without n-3 fatty acids (FAs) (2% of
      energy) for 3 wk. On both the low and high SFA diets the presence of n-3 FAs
      significantly lowered plasma total cholesterol, very-low-density-lipoprotein
      cholesterol, (high-density-lipoprotein cholesterol (HDL-C), total triglyceride,
      and very-low-density-lipoprotein triglyceride. Compared with the high SFA diet,
      the low SFA diet decreased total cholesterol, low-density-lipoprotein
      cholesterol, and HDL-C. No interaction of SFA and n-3 FA was found. These results
      indicate that dietary SFAs and n-3 FAs have independent mechanisms of actions on
      the plasma lipids and lipoproteins. Optimal plasma lipids were produced by the
      diet low in SFA and high in n-3 FA.

PMID- 8480679
TI  - Marked increase in plasma high-density-lipoprotein cholesterol after prolonged
      fasting during Ramadan.
AB  - We evaluated the effect of the Ramadan fasting on plasma lipids and lipoproteins
      in normal individuals. Twenty-four healthy subjects were studied before the end
      of the Ramadan month (Ram) and for 1 mo thereafter. Plasma total cholesterol
      (TC), triglycerides, low-density-lipoprotein cholesterol (LDL-C), and very-low
      density-lipoprotein cholesterol (VLDL-C) did not change. High-density-lipoprotein
      cholesterol (HDL-C) was 30% higher (P < 0.005) at the end of Ram; apolipoprotein
      A-I also increased (P < 0.0001). Both the ratios of TC to HDL-C and LDL-C to HDL
      C (P < 0.001) decreased at Ram. There was a striking nonpharmacologic improvement
      in plasma HDL-C and ratios of TC to HDL-C and LDL-C to HDL-C, which were most
      probably induced by eating one large evening meal a day. Further studies to
      determine the mechanism of this observation are underway.

PMID- 8480680
TI  - Rapid incorporation of fish or olive oil fatty acids into rat hepatic sinusoidal
      cell phospholipids after continuous enteral feeding during endotoxemia.
AB  - Therapeutic modalities that downregulate macrophage and endothelial production of
      eicosanoid mediators by displacing membrane arachidonic acid (20:4 omega 6) may
      benefit patients at increased risk of septic complications. The objective of this
      study in rats was to assess the incorporation of fish or olive oil fatty acids
      into hepatic Kupffer and endothelial (K&E) cell phospholipids after 4 d of
      continuous enteral feeding during endotoxemia. Either endotoxin (ETX) (0.5-1 mg
      1.day-1) or vehicle was infused intravenously during the last 72 h. Dietary fish
      and olive oil fatty acids were rapidly incorporated into both K&E and plasma
      phospholipids irrespective of ETX cotreatment. Rats infused with the fish oil
      enriched diet had a significantly lower relative percent of both K&E linoleic
      acid (18:2 omega 6) and 20:4 omega 6, whereas rats infused with the olive oil
      enriched diet only had a lower relative percent of 18:2 omega 6 compared with
      control rats receiving corn oil. Provision of specific dietary lipids by
      continuous enteral infusion may prove efficacious for the rapid modulation of
      hepatic sinusoidal cell membrane fatty acids under either normal or endotoxemic
      conditions.

PMID- 8480681
TI  - Pharmacologic doses of vitamin E improve insulin action in healthy subjects and
      non-insulin-dependent diabetic patients.
AB  - Ten control (healthy) subjects and 15 non-insulin-dependent diabetics underwent
      an oral glucose-tolerance test and a euglycemic hyperinsulinemic glucose clamp
      before and after vitamin E supplementation (900 mg/d for 4 mo). In control
      subjects (placebo-treated vs vitamin E-supplemented subjects, respectively)
      vitamin E reduced the area under the curve for glucose (344 +/- 21 vs 287 +/- 13
      mmol.L-1 x min-1; P < 0.05) and increased total body glucose disposal (39.0 +/-
      0.3 vs 47.6 +/- 0.4 mumol.kg lean body mass-1 x min-1; P < 0.05) and non
      oxidative glucose metabolism (23.4 +/- 0.2 vs 30.8 +/- 0.3 mumol.kg lean body
      mass-1 x min-1; P < 0.05). In diabetics (placebo-treated vs vitamin E
      supplemented subjects, respectively) vitamin E supplementation reduced glucose
      area under the curve (614 +/- 129 vs 544 +/- 98 mmol.L-1 x min-1; P < 0.03) and
      increased glucose disappearance (19.4 +/- 0.4 vs 26.4 +/- 0.7 mumol.kg lean body
      mass-1.min-1; P < 0.03), total glucose disposal (19.0 +/- 0.7 vs 28.1 +/- 0.4
      mumol.kg lean body mass-1 x min-1; P < 0.02), and nonoxidative glucose metabolism
      (8.5 +/- 0.3 vs 13.9 +/- 0.3 mumol.kg lean body mass-1 x min-1; P < 0.02).
      Therefore we conclude that administration of pharmacologic doses of vitamin E is
      a useful tool to reduce oxidative stress and improve insulin action.

PMID- 8480682
TI  - Positive association between serum zinc and apolipoprotein A-II concentrations in
      middle-aged males who regularly consume alcohol.
AB  - The relationship of serum zinc with serum concentrations of lipids and
      apolipoproteins was investigated in 464 male clerical workers aged 35-59 y.
      Subjects were divided into three groups, by drinking habits. Serum triglycerides,
      apolipoprotein (apo) A-I, and apo A-II in occasional (2-5 times/wk) and regular
      (> or = 6 times/wk) drinkers were higher than in non- or seldom (< 1 time/wk)
      drinkers, whereas serum zinc, total cholesterol (TC), and apo B were not
      different among groups. Significantly higher high-density-lipoprotein cholesterol
      (HDL-C) and HDL-C% (HDL-C/TC%) were observed in regular drinkers. Correlation
      analysis revealed that the serum zinc concentration was positively correlated
      with apo A-II only in the regular drinkers, and the relationship was significant
      even after body mass index, smoking habits, and frequency of physical exercise
      were adjusted for. The results suggest that the individual response of the apo A
      II concentration to alcohol is associated with zinc nutritional status in
      regularly drinking middle-aged men.

PMID- 8480683
TI  - Toenail selenium as an indicator of selenium intake among middle-aged men in an
      area with low soil selenium.
AB  - Toenail selenium concentration has been proposed as a long-term (6-12 mo)
      indicator of human selenium status. This study investigated the association
      between toenail selenium concentration and selenium intake and other dietary
      factors among 166 urban men aged 55-69 y. The dietary information was collected
      by food records covering a 6-mo period. Toenail clippings were collected by mail
      9-10 mo after food recording. The mean selenium intake from food was 42.5
      micrograms/d and the dietary intake was equal to that of users and nonusers of
      selenium supplements. The mean toenail selenium concentration was 0.47 mg/kg. The
      mean selenium intake from supplements was 29.7 micrograms/d among supplement
      users. In the analysis of covariance the best predictors of toenail selenium
      concentration were selenium intake from supplements and food, and among
      supplement users dietary beta-carotene also.

PMID- 8480684
TI  - Low red blood cell glutathione reductase and pyridoxine phosphate oxidase
      activities not related to dietary riboflavin: selection by malaria?
AB  - This study was designed to confirm that low dietary riboflavin does not
      contribute to the flavin-deficient red blood cells commonly found in subjects in
      Ferrara Province, northern Italy. In this area it is primarily an inherited
      characteristic believed to have been selected for by malaria, which was endemic
      from the 12th century. In parallel with assessment of daily riboflavin intake
      (DRI), flavin adenine dinucleotide-dependent glutathione reductase (EGR) and
      flavin mononucleotide-dependent pyridoxine phosphate oxidase (PPO) were measured
      in beta-thalassemic heterozygotes, their normal relatives, and normal spouses
      (representative of the normal population). In all of these groups there is a high
      incidence of deficiency of these flavin enzymes. We found that the majority had
      an adequate riboflavin intake and there was no significant correlation of EGR and
      PPO activities with DRI. Thus, interpretation of low EGR activity is discussed
      with reference to studies of EGR done to detect nutritional riboflavin deficiency
      in countries where there is malnutrition and endemic malaria.

PMID- 8480685
TI  - The effect of zinc supplementation on parasitic reinfestation of Guatemalan
      schoolchildren.
AB  - One hundred thirty children (65-95 mo old) from a low-socioeconomic neighborhood
      of Guatemala City participated in a randomized, double-blind, controlled trial of
      zinc supplementation. One group received 10 mg Zn/d (n = 65) and the other group
      received a placebo (n = 65); 90 +/- 9.2 doses were given over 120-150 d. Stools
      were examined for prevalence and intensity of helminths and prevalence of
      protozoa at the beginning and end of the study. The initial prevalence was 42%
      for helminths and 18% for protozoa, with no differences between groups.
      Mebendazole was administered to all children, and protozoal infections were
      treated specifically at the beginning of the study. The reinfection rates were
      17% (11 of 65) for helminths and 12.3% (8 of 65) for protozoa in the zinc group
      and 15% (10 of 65) and 10.7% (7 of 65), respectively, in the placebo group (P >
      0.05). Analysis by specific parasites revealed no treatment effect. We conclude
      that neither plasma or hair zinc status nor oral zinc supplementation had an
      effect on parasite status in children.

PMID- 8480686
TI  - Effect of chemotherapy on the energy and protein metabolism of children near the
      end of treatment for acute lymphoblastic leukemia.
AB  - Eight children in the final 3 mo of chemotherapy for acute lymphoblastic leukemia
      were studied while on oral 6-mercaptopurine (6MP) maintenance therapy and then
      again 4-9 mo after chemotherapy had been completed. Six of the eight were also
      studied a second time while on 6MP in the 24-h period after receiving intravenous
      methotrexate (MTX). 6MP reduced protein oxidation after a test meal and reduced
      fasting urinary urea excretion by enhancing the reutilization of endogenous amino
      acids for protein synthesis. MTX had no detectable effects on protein metabolism
      but reduced overnight carbohydrate utilization by enhancing fat utilization. A
      similar enhancement of fat utilization was evident after a test meal. The two
      drugs in combination resulted in effects on protein and energy metabolism that
      were the sum of the individual effects plus an increase in the rate of whole-body
      protein turnover and synthesis.

PMID- 8480687
TI  - Resting energy expenditure before and after treatment for Pseudomonas aeruginosa
      infection in patients with cystic fibrosis.
AB  - To investigate whether metabolic rates change after antipseudomonal treatment,
      resting energy expenditure (REE) was measured in 29 patients with cystic fibrosis
      (CF) aged 5-27 y before and after a 2-wk course of intravenous antibiotics for
      the treatment of chronic Pseudomonas aeruginosa infection. Before therapy, mean
      (+/- SD) REE was increased to 119.0 +/- 11.4% of the predicted normal value
      (REE%). Seventeen of the 29 patients were classified as having increased baseline
      REE% (> 115% of predicted, group I), whereas 12 patients had resting energy
      expenditures within the normal range (group N). After antipseudomonal therapy,
      mean REE% decreased significantly by 6.2% of predicted. This decline was
      negatively correlated with the baseline REE% (r = 0.70, P < 0.001). It was most
      pronounced (-11.3%) in group I whereas patients of group N showed no major
      changes. These results suggest that antipseudomonal therapy can reduce increased
      energy requirements of moderately ill CF patients with chronic Pseudomonas
      aeruginosa infection.

PMID- 8480688
TI  - Zinc distribution in blood components, inflammatory status, and clinical indexes
      of disease activity during zinc supplementation in inflammatory rheumatic
      diseases.
AB  - The effects of zinc supplementation on zinc status and on clinical and biological
      indicators of inflammation were investigated in 18 patients with chronic
      inflammatory rheumatic diseases and in 9 healthy control subjects. Patients with
      mild and recent onset disease were assigned to a 60-d trial to receive either 45
      mg Zn (as gluconate)/d or a placebo, while control subjects received the zinc
      supplement. Baseline mean plasma zinc of the patients was low whereas mononuclear
      cell zinc content was elevated, suggesting a redistribution of the element
      related to the inflammatory process rather than to a zinc-deficient state. Zinc
      supplementation increased plasma zinc to a similar extent in patients and in
      control subjects, which suggested no impairment of zinc intestinal absorption as
      a result of the inflammatory process. On the contrary, erythrocyte and leukocyte
      zinc concentrations were not modified in the two groups examined. No beneficial
      effect of zinc treatment could be demonstrated on either clinical or inflammation
      indexes.

PMID- 8480689
TI  - Pathogenesis of the fatty liver in protein-energy malnutrition.

PMID- 8480690
TI  - Zinc metabolism in pregnancy.

PMID- 8480691
TI  - Serum lipids and arterial blood pressure in relation to waist-to-hip ratio in
      young males.

PMID- 8480692
TI  - Nutrition of Alaskan Natives.

PMID- 8480693
TI  - Crime and punishment.

PMID- 8480694
TI  - Angle classification.

PMID- 8480695
TI  - Facial keys to orthodontic diagnosis and treatment planning. Part I.
AB  - The purpose of this article is twofold (1) to present an organized, comprehensive
      clinical facial analysis and (2) to discuss the soft tissue changes associated
      with orthodontic and surgical treatments of malocclusion. Facial examination
      leads to avoidance of potential orthodontic and surgical facial balance decline
      and enhances diagnosis, treatment planning, treatment, and quality of results.
      Patients are examined in natural head position, centric relation, and relaxed lip
      posture. Nineteen key facial traits are analyzed. By examining the patient in
      this format, reliable facial-skeletal traits can be recorded that enhance all
      aspects of care. Orthodontics and surgery used to correct the bite alter facial
      traits; alteration should reverse negative traits and maintain positive traits.
      This cannot be achieved without a complete understanding of the face before
      treatment. Tooth movement (orthodontic or surgical) used to correct the bite can
      negatively impact facial esthetics, especially if pretreatment esthetics are not
      defined before treatment. Treating the bite based on model analysis or on osseous
      cephalometric standards without examination of the face is not adequate. Three
      questions are asked regarding the 19 facial traits before treatment: (1) What is
      the quality of the existing facial traits? (2) How will orthodontic tooth
      movement to correct the bite affect the existing traits (positively or
      negatively)? (3) How will surgical bone movement to correct the bite affect the
      existing traits (positively or negatively)? This article is for orthodontists,
      and yet, much surgical information is included. This is intentional. We only
      treat what we are educated to see. The more we see, the better the treatment we
      render our patients.

PMID- 8480696
TI  - Periodontal tissue response to orthodontic movement of teeth with infrabony
      pockets.
AB  - The aim of this study was to evaluate the effect of orthodontic tooth movement on
      the level of the connective tissue attachment in sites with infrabony pockets.
      The experiment was carried out in four beagle dogs. The second and fourth
      premolars were extracted. After healing, angular bony defects were prepared at
      the mesial aspect of the third premolars. The exposed root surface was scaled and
      planed, and a notch was prepared at the bottom of the defect. Plaque-collecting
      cotton floss ligatures were placed around the neck of the teeth and maintained in
      situ for 3 weeks, followed by an additional 2 months of plaque accumulation
      before the orthodontic tooth movement was initiated. In each dog, one premolar
      was moved away from the angular bony defect and one premolar into and through the
      angular bony defect. The maxillary third premolars served as control teeth and
      were not subjected to orthodontic tooth movement. After orthodontic treatment (5
      to 6 months), the teeth were stabilized for a period of 2 months before biopsy
      sampling. Clinical, radiographic, and histologic evaluations revealed that it was
      possible to establish and maintain an infrabony pocket with a subcrestal, plaque
      induced inflammatory lesion during the entire course of the study. While the
      control teeth had maintained their attachment levels, all but one of the
      orthodontically moved teeth showed additional loss of attachment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480697
TI  - Serum and alveolar bone phosphatase changes reflect bone turnover during
      orthodontic tooth movement.
AB  - Acid and alkaline phosphatase changes have been demonstrated histochemically and
      biochemically during the early stages of an orthodontic tooth movement cycle.
      However, quantitative data on neither alveolar bone nor serum phosphatase changes
      over an entire tooth movement cycle have been reported. This study examined acid,
      tartrate-resistant acid (TRAP), and alkaline phosphatase changes in serum and
      alveolar bone during an orthodontic tooth movement cycle in 288 adult male
      Sprague-Dawley strain rats. The effect of differing initial force magnitudes on
      phosphatase changes was also examined. Data were obtained from four groups: sham
      control and three treatment groups (20, 40, and 60 gm activations). Each group (n
      = 72) was subdivided equally into six sacrifice subgroups (1,3,5,7,10, and 14
      days). Treated animals received a precisely loaded orthodontic tipping force to
      the maxillary molars. Phosphatase measures were obtained by colorimetric assays.
      Analysis of variance (ANOVA) procedures were performed to examine for differences
      within groups across time and among groups at each time point. Data from treated
      animals were combined, adjusted for control values, and examined across time to
      permit comparisons with previously described histomorphometric changes. Analysis
      of variance indicated no differences occurred in the control group across time.
      Significant differences in serum values occurred across time within the force
      groups (p < 0.01), and among force and control groups at various times in both
      sera and bone (p < 0.05). In the pooled treatment data, a peak in serum acid
      phosphatase occurred at day 1 and in bone at day 3 (the later mirroring
      histomorphometric findings) (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480698
TI  - Craniofacial morphometry by photographic evaluations.
AB  - Frontal and lateral oriented profile photographs of 108 healthy young adults (57
      men and 51 women) were taken, and a standardized protocol was used to
      quantitatively describe the depicted craniofacial soft tissue structure, the
      relationships among facial structures, and head posture relative to the ground.
      Pictures were taken in two body positions, standing and sitting. The male faces
      were, on average, wider and longer than the female faces, in both frontal and
      lateral views, with greater differences in the mouth and chin regions. Both sexes
      were generally symmetrical. Persons who were asymmetric compensated for their
      appearance by changing head posture relative to the ground, so that in the
      frontal plane, the interpupillary axis and the occlusal plane were parallel to
      the ground. Measurements can be employed in computer graphic reconstructions used
      in orthognathic, maxillofacial, and plastic surgery. In the standing position,
      the Frankfurt plane was directed upward and forward, with a mean angle of 13
      degrees relative to the ground. In seated subjects, it was more nearly horizontal
      (5 degrees in the men, 8 degrees in the women). This result confirms the need for
      a careful reevaluation of standard cephalometric and photographic protocols.

PMID- 8480699
TI  - Pulpal response to orthognathic surgery: a long-term radiographic study.
AB  - The purpose of this study was to determine if the ischemia associated with
      orthognathic surgery causes long-term pathologic changes in the pulp similar to
      those documented after traumatic injuries. A total of 93 patients, 21.9 to 63.9
      years of age (mean 38.5 years, SD 9.4), consented to participate in a follow-up
      study ranging from 4.7 to 15.3 years (mean 8.9 years, SD 2.9) after surgery.
      LeFort I osteotomy was performed on 42 patients and bilateral sagittal split
      osteotomies on 76 patients. Full-mouth series of periapical radiographs taken at
      the time of follow-up were compared with pretreatment and posttreatment panoramic
      radiographs. The development of pulp canal obliteration was observed more often
      in the maxillae of patients treated with LeFort I osteotomy than in those without
      (p < 0.001). No difference was seen in the frequency of maxillae with teeth
      developing radiographic signs of pulp necrosis between patients treated with and
      without LeFort I osteotomy. However, a higher proportion of the teeth were
      affected among the patients treated with osteotomy (p < 0.01). The presence of a
      restoration or caries was a risk factor for the development of necrosis (p <
      0.01). Bilateral sagittal split osteotomies had no apparent effect on long-term
      pathologic pulpal changes. No internal resorption was seen. Only very few teeth
      were extracted during the follow-up period.

PMID- 8480700
TI  - Recording and measuring malocclusion: a review of the literature.
AB  - The methods of recording and measuring malocclusion can be broadly divided into
      two types: qualitative and quantitative. Among the qualitative methods of
      recording malocclusion, Angle's method of classifying malocclusion with or
      without modifications is probably the most widely used. The "WHO/FDI Basic Method
      for Recording of Malocclusion" was published in 1979 to establish an assessment
      format to determine the prevalence of malocclusion and to estimate treatment
      needs of a population. Among the many occlusion indices developed by various
      research workers, the occlusal index developed by Summers appeared to have the
      least amount of bias, is best correlated with clinical standards and has the
      highest validity during time. More recently, methods have also been developed to
      enable assessment of treatment need according to grade index scales. However,
      experience in using these methods is still very limited.

PMID- 8480701
TI  - The influence of growth hormone (rhGH) therapy on tooth formation in idiopathic
      short statured children.
AB  - The purpose of this preliminary study was to evaluate tooth formation in children
      with idiopathic short stature, before and during treatment with recombinant
      growth hormone (rhGH). Twenty-nine short-statured children ages 6 to 13 years
      were assigned into two treatment groups, an "experimental" group (n = 18), which
      received rhGH, and a "control" group (n = 11), which was observed for 1 year
      before commencing rhGH treatment. Clinical and radiographic records were obtained
      at the initial, year 1, and year 2 visits. Tooth formation and stature were
      assessed by calculating Z-scores, appropriate for the age and gender of each
      child. Delta-Z scores, which measure the change in Z-score over time, were also
      calculated between annual visits. Height was measured and recorded every 3
      months, and Z-score statural norms for age and gender were derived from the 1977
      National Center for Health Services national probability sampling. Tooth
      formation standards were derived from Moorrees et al. A matched control sample
      for tooth development was derived from untreated children. Tooth formation was
      initially delayed although the degree of reduction in stature exceeded the
      initial degree of delay in tooth formation. During this 2-year study, rhGH
      therapy had a significant influence on acceleration or gain in stature, but did
      not have a significant influence on tooth formation.

PMID- 8480702
TI  - Patient empowerment: the young patient.
AB  - The responsibilities that doctors have for their patients often transcend the
      obvious. When orthodontists begin treatment relationships with young people, they
      should understand that preadolescent and adolescent patients are very
      impressionable and educable. This creates the possibility for extraordinary
      positive experiences during the period of therapy that may be unexpected by the
      doctor, the professional office staff, the patient, and the patients' families.
      In the present day climate created by OSHA and barrier techniques, recognition of
      our potential role is more important than ever. Children will be exposed over an
      extended time interval to the work of well-trained orthodontists and orthodontic
      staff. Role modeling and mentoring may occur that could benefit these patients
      throughout their entire life. New responsibilities that can create a sense of
      accomplishment and build self-confidence are introduced and accepted. The genesis
      of this article was the result of a conversation that developed between Mrs.
      Burnes and me after she had commented about the positive influence that her
      children's orthodontic therapy had on their general character development. Noting
      her area of professional expertise, and combining that with my general interest
      in the subject of personal character development, we decided to commit our
      thoughts to paper. Our goal was to identify some of the mutually satisfying
      interactions that can occur between the orthodontist, staff, patient, and parent.

PMID- 8480703
TI  - Palatal measurements of prematurely born, very low birth weight infants:
      comparison of three methods.
AB  - To enable investigation of palatal changes in infants who are prematurely born,
      it is necessary to first establish a reliable method of measurement of these tiny
      edentulous palates. This study compared the Olivetti-Inspector machine, Vernier
      calipers, and stereophotogrammetry for this purpose. Measurements were taken of
      12 palatal casts of four infants at prescribed time intervals during the neonatal
      period. In each of the three methods, measurements were recorded as variables
      generated in the X and Z axes of the Cartesian scale in relation to three
      specified points along the Y axis. The results revealed that all methods were
      comparable, but the Vernier calipers differed significantly from the other two
      methods in height measurements, (p < 0.001). It was also found that both the
      Olivetti-Inspector machine and the Vernier calipers consistently underestimated
      the width, compared with Olivetti-Inspector machine, (p < 0.05).
      Stereophotogrammetry was found to be the most consistent method of measuring the
      configuration of preterm infant palates.

PMID- 8480704
TI  - A mesially impacted mandibular second molar. Treatment considerations and
      outcome: a case report.
AB  - The uprighting of an impacted mandibular second molar presents special problems
      that may require auxiliary appliances and the implementation of "therapeutic
      diagnosis." In this case, the presence of an ectopically positioned third molar
      required modification of the original treatment plan.

PMID- 8480705
TI  - Pneumoparotitis with orthodontic treatment.
AB  - Self-induced pneumoparotitis has not been commonly associated with orthodontic
      treatment nor dental treatment in general. However, the patient described
      previously and the other reported cases demonstrate the distinct possibility that
      accommodation to appliance irritation by "puffing out" the cheeks could result in
      parotid swelling. Pneumoparotitis should definitely be considered in the
      evaluation of patients with parotid swelling, particularly in cases of
      unexplained swelling with rapid onset.

PMID- 8480706
TI  - Mock Boards and motivation: the keys to certification by the American Board of
      Orthodontics.

PMID- 8480707
TI  - Concern for orthodontic education.

PMID- 8480708
TI  - Comments on the frontal sinus and mandibular growth prediction.

PMID- 8480709
TI  - Facial keys to orthodontic diagnosis and treatment planning--Part II.

PMID- 8480710
TI  - Normalization of incisor position after adenoidectomy.
AB  - Changes in incisor inclination and position in both jaws of children during the
      first 5 years after adenoidectomy were studied. The main change is a significant
      increased labial inclination of the incisors for the adenoidectomy groups. All
      variables that measure the labiolingual position of the mandibular incisors
      confirm a significant labial incisor positioning for both sexes. Stepwise
      regression analysis shows that 41% to 44% of the incisor proclination after
      adenoidectomy is accounted for by two regressors--sex (female) and increase in
      the sagittal size of the nasopharynx. The study supports the hypothesis that a
      changed mode of breathing after adenoidectomy is associated with significant
      labial positioning of the incisor teeth.

PMID- 8480711
TI  - Moments with the edgewise appliance: incisor torque control.
AB  - Traditional edgewise orthodontic mechanics are significantly limited in their
      ability to provide incisor torque control because of the limitations of bracket
      to-bracket mechanics and the poorly defined reciprocal actions inherently
      produced. Attempts to address this issue clinically have been largely empirical.
      The science of mechanics dictates that all incisor torque control mechanisms must
      act through one of two basic principles: the moment of a couple or the moment of
      a force. The torquing arch is a modification of the traditional edgewise system
      and employs the moment of a couple to achieve incisor torque control and precise
      definition of reciprocal effects. The torquing arch force system includes a large
      moment to rotate incisors in a crown facial/root lingual direction, and
      concurrent equilibrium forces to extrude incisors and intrude molars.
      Alternatively, the base arch uses the moment of a force to also rotate incisors
      in a crown facial/root lingual direction. The base arch, however, includes a
      large moment to rotate molars in a crown distal/root mesial direction, and
      concurrent equilibrium forces to intrude incisors and extrude molars. Depending
      on how they are employed, torquing arches and base arches may also rotate molars
      in a faciolingual direction, enhance or diminish posterior anchorage, and
      increase or conserve arch perimeter. Contemporary quality orthodontic care
      requires an awareness and control of all of the forces created by orthodontic
      appliances.

PMID- 8480712
TI  - Morphologic and functional implications of the surgical-orthodontic management of
      mandibular prognathism: a comprehensive review.
AB  - The aim of this review is to present the various morphologic and functional
      implications of the surgical-orthodontic management of mandibular prognathism,
      thus providing a more complete determination of the efficacy of this modality of
      treatment. Major conclusions that can be drawn from the bibliography indicate
      that: (1) After treatment considerable improvement takes place on the soft tissue
      and dentoskeletal profile, occlusal tooth contacts, and temporomandibular joint
      function and and pain; (2) Surgical management of mandibular prognathism can be
      associated with decreased maximum interincisal opening; (3) Although immediately
      after surgery there is a tendency for the condyles to be distracted downward and
      anteriorly from their preoperative position, in long-term postsurgery the
      condyles, on the average, regain their initial position; (4) Compensatory
      alterations in the pharyngeal, suprahyoid, and infrahyoid muscular regions take
      place postoperatively; (5) Skeletal changes after mandibular setback to correct
      mandibular prognathism occur frequently, but their magnitude and patterns exhibit
      variation and are not necessarily detrimental; and (6) Fulfillment of
      expectations toward surgical-orthodontic management of mandibular prognathism was
      reported to be frequent.

PMID- 8480713
TI  - The evaluation of dual cement resins in orthodontic bonding.
AB  - Dual-cement resins are composite resins that are both light activated and
      chemically cured. They can be cured completely with a visible light source or by
      the catalyst and base reaction of the material. With the control of setting time,
      dual cements appear to offer clinicians advantages in orthodontic bonding. The
      purposes of the present research are to compare various dual cements in regard to
      orthodontic bonding and to evaluate them in relation to currently used chemically
      cured and light-cured composite resins for bonding stainless steel mesh-backed
      orthodontic brackets. Seven currently available orthodontic bonding systems
      (three light cured and four chemically cured) and three dual cements were
      evaluated. Each of the 10 groups contained 15 noncarious mandibular incisors.
      Mandibular incisor brackets were bonded to the teeth in accordance with the
      manufacturer's recommendation. After bonding, the teeth were stored for 5 days in
      water at 37 degrees C. An Instron machine (Instron Corp., Canton, Mass.) was used
      to test samples. All samples were compared with Concise orthodontic bonding
      composite (3M, St. Paul, Minn.). The results of this investigation show that it
      is possible to bond solid, mesh-backed metal orthodontic brackets to teeth with a
      dual cement. The shear bond strengths of the dual cements, as tested in the
      laboratory, should be adequate to withstand normal orthodontic forces. Increased
      control of the setting time of the dual cements will allow the clinician more
      time to correctly position brackets and to remove excess resin before curing. In
      addition, the clinician can be assured of complete polymerization with the
      chemical properties of the dual cement resins.

PMID- 8480714
TI  - Effects of orthodontics on the facial profile: a comparison of changes during
      nonextraction and four premolar extraction treatment.
AB  - Cephalometric radiographs were used to examine soft tissue profiles of 198
      orthodontic patients treated with full fixed appliances without extraction of any
      permanent teeth. Records were selected at random from five sources: cases treated
      by a Tweed Foundation instructor using the Tweed technique, patients treated with
      the Begg appliance, patients treated in one of two different practices with
      pretorqued, preangulated edgewise appliances, and patients treated in two stages
      with a functional appliance followed by full fixed edgewise appliances. The
      criteria for selection of cases and the methods of data collection were designed
      to allow comparisons with data collected by Drobocky and Smith on patients
      treated with extraction of four first premolars. Although the mean value of soft
      tissue changes were smaller in the nonextraction patients, the variability of
      these changes were generally as great as in the four premolar extraction cases.
      In addition, the percentage of undesirable facial changes was similar in the
      extraction and nonextraction samples. The results provide additional evidence
      that it is simplistic and incorrect to blame undesirable facial esthetics after
      orthodontic treatment on the extraction of premolars.

PMID- 8480715
TI  - Class II elastics and extractions and temporomandibular disorders: a longitudinal
      prospective study.

PMID- 8480716
TI  - A comparison of the rate of space closure using a nickel-titanium spring and an
      elastic module: a clinical study.
AB  - A study of the efficiency of space closure after premolar extraction was
      undertaken, comparing a nickel-titanium closed coil spring and an elastic
      retraction module by using sliding mechanics along an 0.019 x 0.025-inch
      stainless steel arch wire in 0.022 x 0.028-inch preadjusted stainless steel
      brackets. The rate of space closure in 17 subjects was analyzed from study models
      and was found to be significantly greater and more consistent with the nickel
      titanium closed coil springs than with the elastic modules, in both arches. There
      were no clinically observable differences in the tooth positions between the
      respective techniques.

PMID- 8480717
TI  - Three-stage activator treatment of a severe skeletal Class II, open bite
      malocclusion.
AB  - Activator therapy for a severe Class II, Division 1 malocclusion with open bite
      malocclusion is described. The treatment was performed in three stages: one,
      "early-early," at the age of 5 to 6 years; one "early," between 9 and 11 years;
      this was followed by 2 years of retention with a maxillary retainer. The patient
      continued to be observed further over a 3-year period. The final records show a
      normal, stable occlusion, and good facial balance.

PMID- 8480718
TI  - ABO certification: a worthy goal.

PMID- 8480719
TI  - Principles of the merge letter.

PMID- 8480720
TI  - The management of financial assets yield considerations.

PMID- 8480721
TI  - Cyclosporine and other immunosuppressive agents: current and future role in the
      treatment of inflammatory bowel disease.

PMID- 8480722
TI  - Endoscopic surveillance of Barrett's esophagus: another viewpoint.

PMID- 8480723
TI  - Current treatment modalities for symptomatic gallstones.
AB  - Gallstone disease is an important clinical problem: approximately 10% of all
      adults in the western population have gallstones. Most gallstones, however,
      remain asymptomatic, and from various disciplines there is consensus that only
      symptomatic gallstones require therapy. Since the first gallbladder extirpation
      in 1882, cholecystectomy has been considered the gold standard. Nowadays, this
      operation is performed laparoscopically in most hospitals. Despite relatively low
      morbidity and mortality rates, a number of alternative therapies have been
      developed in the past few years. These alternative treatment modalities are
      especially indicated in high risk patients and in patients rejecting surgery. In
      this review article, the currently available treatment modalities are discussed.

PMID- 8480724
TI  - Cyclosporine enemas for treatment-resistant, mildly to moderately active, left
      sided ulcerative colitis.
AB  - Ten patients with treatment-resistant left-sided ulcerative colitis were treated
      in an open protocol with 350 mg cyclosporine enemas nightly for 4 wk. A 12-point
      clinical disease activity index (DAI) score was calculated at baseline and after
      4 wk. Whole blood and colonic tissue cyclosporine concentrations were determined
      by HPLC at the end of the study. Five of 10 patients responded to treatment,
      defined as a decrease in the clinical DAI score > or = 3 points. Responders
      retained the enemas longer than nonresponders (7.5 +/- 1.3 vs. 3.3 +/- 2.2 h, p =
      0.01), and there was a positive correlation between decrease in the clinical DAI
      score and enema retention time (r = 0.64, p = 0.05). The mean colonic tissue
      cyclosporine concentration was not significantly higher in responders than in
      nonresponders (2884 +/- 1635 vs. 2359 +/- 576 ng/g, p = 0.52), and the
      correlation between decrease in the clinical DAI score index and colonic tissue
      cyclosporine was weak (r = 0.39, p = 0.26). Cyclosporine was undetectable in
      whole blood samples from all patients, and there were no apparent side effects
      with treatment. In conclusion, 50% of patients with treatment-resistant left
      sided ulcerative colitis significantly improved during therapy with cyclosporine
      enemas for 4 wk. Patients with longer enema retention times were more likely to
      respond. A controlled trial is underway to investigate these findings further.

PMID- 8480725
TI  - Rapid closure of Crohn's disease fistulas with continuous intravenous cyclosporin
      A.
AB  - Fistulas complicating Crohn's disease often are refractory to medical management.
      Immunosuppressive therapy is sometimes effective but requires several months
      before efficacy can be determined. We treated five patients with Crohn's disease
      complicated by chronic draining fistulas unresponsive to previous surgery,
      steroids, antibiotics, total parenteral nutrition, 6-mercaptopurine, or
      azathioprine with continuous infusion cyclosporin A (CyA). The five patients had
      a total of 12 fistulas (five enterovaginal, three perianal, three
      enterocutaneous, one enterovesical). CyA was administered initially at 4
      mg/kg/day for 6-10 days, after which oral dosing was begun at 8 mg/kg/day and
      adjusted to maintain trough serum levels of 100-200 ng/ml. All fistulas responded
      to CyA infusion with decreased drainage and with improvement in both perifistular
      inflammation and patient comfort. Complete resolution of drainage was seen in 10
      of the 12 fistulas. Initial response was seen after a mean of 3.6 days (range, 2
      5 days) with complete cessation of drainage in the 10 fistulas after a mean of
      7.9 days (range, 3-28 days). Therapy was continued for a mean of 6.2 months
      (range, 1.5-18 months). Relapse was seen in two perianal fistulas (3 wk and 7
      months) and in two enterovaginal fistulas (1 and 2 months). Two of these
      recurrences corresponded to lowered serum levels of CyA. An enterocutaneous
      fistula also recurred after 2.5 months, associated with a distal stricture that
      required resection. Side effects were minor except for a mycotic aneurysm in one
      patient which occurred after 7 months of treatment. Intravenous CyA may prove to
      be a useful agent in the initial management of refractory Crohn's disease
      fistulas, although relapse as serum levels are lowered and infectious
      complications are limiting factors for long-term use as a single agent.

PMID- 8480726
TI  - The effect of ethanol on the pancreatic duct sphincter of Oddi.
AB  - Alcohol ingestion causes pancreatitis to develop in some people, but the
      mechanism(s) by which alcohol causes pancreatitis are unclear. The effect of
      alcohol on the pancreatic duct sphincter of Oddi (PD-SO) may play a significant
      role. To better understand the effects of alcohol on the PD-SO, we studied 24
      alcoholic subject's PD-SO before and after 80 g of alcohol was instilled into
      their stomachs. Seventeen of the subjects had a prior history of pancreatitis.
      The mean maximal alcohol level achieved by 30 min after the instillation was 98.1
      +/- 47.9 mg/dl. The only prealcohol differences between the pancreatitis group
      and the nonpancreatitis group were higher mean basal PD-SO pressures and higher
      mean phasic contraction amplitudes (8.7 and 20.2 mm Hg higher, respectively) in
      the pancreatitis group. The acute change in the subjects' blood alcohol levels
      produced similar changes in both groups. A non-statistically significant fall in
      the mean basal PD-SO pressure of 2.7 mm Hg was observed. The phasic contraction
      mean amplitude decreased by 24.1 mm Hg (p < 0.001) and the mean duration
      decreased by 0.6 s (p = 0.0064). The frequency of phasic contractions did not
      change after ingestion of alcohol. There was a significant fall in the percentage
      of antegrade phasic contractions (-15.8%, p = 0.016), which was compensated for
      by nearly equal increases in the percentage of retrograde and simultaneous
      contractions. We conclude that acute alcohol ingestion in subjects with a history
      of chronic alcohol consumption changes the PD-SO motor activity in a way that
      could predipose to duodenopancreatic reflux. Thus, reflux of bile, activated
      enzymes, or other substances into the pancreatic duct might occur more readily
      and predispose one to pancreatitis after alcohol ingestion.

PMID- 8480727
TI  - Comparison of simultaneous esophageal pH monitoring and scintigraphy in infants
      with gastroesophageal reflux.
AB  - Twenty-nine infants under 1 yr of age were studied by simultaneous esophageal pH
      monitoring and scintigraphy for evaluation of gastroesophageal reflux (GER).
      Scintigraphy and pH monitoring were performed for 120 min after infants ingested
      their usual volume of formula. The number of reflux episodes during six 20-min
      intervals, as determined by both tests, were recorded. Esophageal pH monitoring
      was continued for 18-24 h. Sixteen of 29 patients exhibited GER by pH monitoring
      during the 2-h study. Gastroesophageal reflux occurred in seven of 29 during the
      first hour and 13 of 29 during the second hour. The mean time of first reflux
      episode detected by pH monitoring following the feeding was 82.4 +/- 49.3 min. In
      comparison, 28 of 29 patients had GER by scintigraphy during the 2 h. All 28
      exhibited GER during the first hour, whereas only 22 of 29 patients exhibited GER
      during the second hour. The mean time of first episode of reflux by scintigraphy
      was 3.1 +/- 2.7 min. Forty-five percent of all reflux episodes detected by
      scintigraphy occurred during the first 20 min and 80% were detected during the
      first hour. In contrast, only 17% of reflux episodes were seen by pH monitoring
      during the first 20 min and 35% during the first hour; 65% of reflux episodes
      detected by pH monitoring were during the second hour. There was no correlation
      between the total number of reflux episodes detected by scintigraphy and 2-h
      esophageal pH monitoring during the 2-h study period (r = 0.326; p > 0.1).
      Overall, to detect reflux, scintigraphy was a more sensitive method than
      esophageal pH monitoring under the conditions of this study. Scintigraphy
      selectively detected reflux during the first 60 min post-prandially whereas pH
      monitoring was more likely to detect reflux beyond the first postprandial hour.
      These observations help to explain the lack of correlation between the two tests.

PMID- 8480728
TI  - Effect of age and bolus variables on the coordination of the glottis and upper
      esophageal sphincter during swallowing.
AB  - We studied 1) the effect of age and bolus variables on a) the coordination of
      deglutitive vocal cord adduction and upper esophageal sphincter (UES) relaxation
      and b) the duration of deglutitive vocal cord adduction; 2) the effect of the
      presence of a manometric catheter across the UES on the deglutitive glottal
      function; and 3) the temporal relationship between deglutitive vocal cord closure
      and swallow-induced apnea. We studied 10 young (23 +/- 2 yr) and 10 healthy
      elderly (73 +/- 2 yr) volunteers by concurrent videoendoscopy, UES manometry,
      respirography, and submental surface electromyography. In both groups the onset
      of vocal cord adduction preceded the onset of UES relaxation, deglutitive apnea,
      and submental electromyogram swallowing signal. In both groups, bolus volume and
      temperature did not have any significant effect on the duration of deglutitive
      vocal cord adduction. In both young and elderly volunteers, water swallows,
      compared with dry swallows, significantly shortened the interval between the
      onset of deglutitive vocal cord adduction and the onset of UES relaxation. In
      conclusion, coordination between deglutitive glottal and UES function, as well as
      the duration of deglutitive vocal cord adduction, is preserved in the elderly.
      Bolus volume and temperature do not have a modulatory effect on the duration of
      vocal cord closure, but water swallow shortens the interval between the onset of
      glottal closure and UES relaxation. This shortened interval may contribute to the
      safety of the airway during swallowing of liquid volumes.

PMID- 8480729
TI  - Magnetic resonance imaging and localized in vivo proton spectroscopy in patients
      with fulminant hepatic failure.
AB  - Magnetic resonance imaging (MRI) and in vivo proton spectroscopic changes in the
      brain in three patients with fulminant hepatic failure are described. MRI showed
      cerebral atrophy in two and changes somewhat similar to what have been described
      in chronic hepatic encephalopathy. MR spectroscopy showed low myoinositol with
      high glutamine in grade IV coma, which returned to normal as patient showed
      clinical recovery. We conclude that these techniques will be useful in
      understanding the complex pathophysiology of fulminant hepatic failure.

PMID- 8480730
TI  - Does co-prescription of sucralfate with ranitidine therapy enhance the healing of
      gastric ulcers?
AB  - It has been suggested that the co-administration of ranitidine and sucralfate may
      enhance peptic ulcer healing more than administration of either drug alone. This
      study compared the frequency of healing of gastric ulcers treated with either
      ranitidine 300 mg nocte plus sucralfate 1 g tds or with ranitidine 300 mg nocte
      plus placebo. Patients (n = 259) were treated initially for 4 wk, and this period
      was extended to 8 wk for those patients whose ulcers had not healed. Ulcer
      healing and patient symptom data were assessed at 4 and 8 wk, whereas patients
      recorded the presence of ulcer pain on a daily basis. Ulcer healing rates were
      63% and 66% at 4 wk, and were 93% and 91% at 8 wk, in the ranitidine-plus
      sucralfate group and the ranitidine-plus-placebo group, respectively. Both
      treatments were equally effective in relieving symptoms. Thus, combination
      therapy with sucralfate provided no additional benefit over treatment with
      ranitidine alone.

PMID- 8480731
TI  - Esophageal manometry in children with esophagitis.
AB  - Esophageal motility was studied in 31 patients with mild to moderate esophagitis
      and in 48 patients without esophagitis to determine the effect of esophageal
      inflammation on lower esophageal sphincter pressure, and the amplitude, duration,
      and velocity of esophageal contractions. There were no significant differences in
      any of these parameters associated with esophageal inflammation. We conclude that
      mild to moderate esophagitis does not cause serious esophageal dysfunction in
      children.

PMID- 8480732
TI  - NSAID-induced gastric ulceration is dose related by weight: an endoscopic study
      with flurbiprofen.
AB  - Numerous studies have shown that higher doses of nonsteroidal anti-inflammatory
      drugs (NSAIDs) are associated with increased levels of mucosal injury and
      ulceration in both normal volunteers and patients. The present dose-ranging study
      was designed to determine whether escalating doses of a commonly prescribed
      NSAID, flurbiprofen, when expressed as mg/kg dosages, were associated with
      increased mucosal injury and ulceration. Subjects received either the recommended
      dose of 300 mg/day of flurbiprofen (N = 10), or the higher than recommended doses
      of 400 mg/day (N = 20) and 500 mg/day (N = 10), for a period of 7 days.
      Endoscopic examination was performed on day 0 and day 7, and the stomach was
      evaluated on day 7 for mucosal injury on a 0-4 scale, and for the presence or
      absence of ulcer. One gastric ulcer was seen in each of the 300- and 400-mg
      groups. However, in the 500 mg/day group, four gastric ulcers were seen (40%) (p
      = 0.04). Three of the six subjects developing gastric ulcer were of a fairly low
      body weight (two women, one man), and when the data were analyzed on a mg/kg
      basis, all six ulcers occurred in 19 of the 40 subjects receiving > 5.95 mg/kg,
      whereas no gastric ulcers were seen in the 21 subjects receiving dosages below
      that level (p < 0.01). These data suggest that, at least for this agent, a
      threshold level may exist above which gastric ulcers are much more likely to
      occur. This may in part explain why elderly debilitated, low-body-weight female
      patients are more prone to NSAID-related gastric ulcer.

PMID- 8480733
TI  - Helicobacter pylori prevalence in acquired immunodeficiency syndrome.
AB  - Helicobacter pylori is consistently reported with high prevalence in HIV-negative
      patients with chronic gastritis and active ulcer disease. This study is an
      evaluation of the prevalence of H. pylori in AIDS patients, and the association
      with chronic gastritis, erosions, and ulcer disease. Seventy-three AIDS patients
      referred for the evaluation of gastrointestinal symptoms underwent upper
      endoscopy and antral gastric biopsy. Histologic gastritis was diagnosed and
      degree of activity graded on hematoxylin-eosin stain. H. pylori organisms were
      identified by acridine orange stain. A single pathologist evaluated the biopsy
      specimens. H. pylori was found in 15% (11 of 73) of AIDS patients. Histologic
      chronic active gastritis was evident in 94.5% (69 of 73) of the study group. H.
      pylori was identified in 15.9% (11 of 69) of biopsy specimens with histologic
      chronic active gastritis. The organism was more common in biopsy specimens with a
      higher grade of activity in the chronic gastritis. Endoscopic erosions or ulcers
      were noted in 11 patients (seven gastric, four duodenal). H. pylori was present
      in 18% (2 of 11) of AIDS patients with erosions or ulcers. The prevalence of H.
      pylori in AIDS patients with histologic chronic active gastritis is much lower
      than the prevalence previously reported for HIV-negative patients with similar
      pathology. The low prevalence observed does not implicate H. pylori as the causal
      agent in most chronic active gastritis in the AIDS population. Impaired acid
      secretion may reduce colonization of gastric mucosa and explain the low rate of
      H. pylori observed.

PMID- 8480734
TI  - Effect of long-term treatment with ursodiol on clinical and biochemical features
      and biliary bile acid metabolism in patients with primary biliary cirrhosis.
AB  - The effect of ursodiol on the clinical and biochemical features, serum, urinary,
      and biliary bile acids was investigated over a 2-yr treatment period in 14
      patients with primary biliary cirrhosis (stages II-IV). Pruritus and fatigue
      improved, and alkaline phosphatase and liver transferases declined significantly
      in all patients during therapy. In four patients, less inflammation was noted by
      liver biopsy after 2 yr, but histology of disease did not change. Serum and
      urinary bile acids were increased several-fold before treatment, with cholic acid
      predominating. Ursodiol accounted for 30% of biliary bile acids after
      administration (gallstone subjects approximately 50%), and was conjugated with
      glycine and taurine in a ratio of 7.3:1. However, in the endogenous bile acids,
      the ratio increased from 1.2:1 to only 2.1:1. About 6% unconjugated bile acids
      were secreted into the bile (healthy controls < 1%). Thus, in patients with
      primary biliary cirrhosis, a larger fraction of free bile acids and a higher
      proportion of taurine-conjugated bile acids are secreted into the bile, compared
      with healthy controls. Ursodiol improves symptoms and histology with lower
      biliary enrichment with this bile acid.

PMID- 8480735
TI  - The role of neopterin in assessing disease activity in Crohn's disease:
      classification and regression trees.
AB  - Neopterin, a product of human monocytes/macrophages stimulated by gamma
      interferon, was previously found to be correlated with clinical activity of
      Crohn's disease. The present investigation attempted to identify more precisely
      the role of neopterin for assessment of clinical activity in a multivariate
      setting. A broad panel of clinical and laboratory variables was obtained on 76
      patients. Neopterin was determined in urine by high performance liquid
      chromatography. Using a 4-point clinical activity score as dependent variable,
      multivariate linear discriminant analyses were performed in order to identify
      subsets of statistically independent laboratory activity indices. Neopterin was
      shown to be an independent indicator for clinical activity. The significant
      variables were then tested together with the eight constituent variables of the
      Crohn's Disease Activity Index. The resulting model, which consisted of the three
      laboratory variables--erythrocyte sedimentation rate, serum protein and
      neopterin, together with pain score--was further subjected to two multivariate
      techniques for comparison: polychotomous logistic regression analysis and the
      technique of classification and regression trees. By all methods, neopterin was
      included into the multivariate models, confirming that its determination aids in
      the assessment of clinical activity in Crohn's disease.

PMID- 8480736
TI  - Endogenous sex hormones and cholesterol gallstones: a case-control study in an
      echographic survey of gallstones.
AB  - In a population survey of gallstones, the serum levels of hormones of the
      pituitary-gonadal axis and the sex hormone-binding globulin (SHBG) were compared
      in subjects with cholesterol gallstones and in a control group. In 84 subjects
      who entered the survey, echographic gallstones that had been identified at the
      survey, turned out to be radiolucent or mixed (predominantly of cholesterol) at
      subsequent x-ray. The controls were without gallstones at echography, matched to
      the cases for potential confounders of the association sex hormones
      cholelithiasis. Testosterone (T) 17-beta-estradiol (E2), 17-OH progesterone (P),
      and SHBG were dosed by radioimmunoassay; follicle-stimulating hormone (FSH),
      luteinizing hormone (LH), and prolactin (Prl) by dissociation-enhanced lanthanide
      fluoro immunoassay (DELFIA). Men with gallstones had lower LH than controls (n =
      34, median difference = -0.62 mU/ml, 95% confidence interval (CI) -1.20 to -0.26
      mU/ml, paired sign test, p = 0.003). Premenopausal women in the luteal phase of
      the menstrual cycle with gallstones had higher E2 than controls (n = 7, median
      difference: +117, pg/ml, 95% CI: +10 to +218 pg/ml, p = 0.008). Postmenopausal
      women had lower LH than controls (n = 35, median difference = -4.57 mU/ml, 95% CI
      -9.5 to -1.0 mU/ml, p = 0.04). No other hormones showed statistically significant
      differences between cases and controls, in either males or females. The findings
      of this exploratory study in subjects with radiolucent and mixed gallstones
      suggest that men and postmenopausal women have lower LH, and premenopausal women
      in the luteal phase of the cycle have higher E2, than controls.

PMID- 8480737
TI  - The relationship of plasma polyunsaturated fatty acid deficiency with survival in
      advanced liver cirrhosis: multivariate analysis.
AB  - Total plasma fatty acids were measured in 101 cirrhotic inpatients (64 men, 37
      women, aged 64.3 +/- 1.2 (SEM) yr; range, 34-80) who were subsequently followed
      for survival for a mean of 14.8 +/- 1.0 months. Data on plasma fatty acids have
      been published elsewhere. Individual values of these variables were categorized
      in a binary fashion using the 5th or the 95th percentiles of a group of 44 well
      nourished healthy controls (24 men, 20 women, aged 51.3 +/- 2.1 yr; range, 32-76)
      as the cutoff limit. Forty-nine patients died during follow-up (2-yr cumulative
      probability of survival, 52%). Deficiency of palmitate, dihomo-tau-linolenate,
      and arachidonate (values below the 5th percentile) were univariately associated
      with death (long-rank test). However, after a multivariate analysis (Cox's
      proportional hazards regression), only the existence of plasma arachidonate
      deficiency was included in the final model (beta, 0.62; relative risk, 1.86; 95%
      CI, 1.06-3.25; p < 0.05). We conclude that arachidonic acid deficiency
      significantly increases the mortality risk in patients with advanced liver
      cirrhosis.

PMID- 8480738
TI  - Intrahepatic portosystemic venous shunt: diagnosis by color Doppler imaging.
AB  - Intrahepatic portosystemic venous shunt is a rare clinical entity; only 33 such
      cases have been reported. It may be congenital, or secondary to portal
      hypertension. Five patients with this disorder are presented, each of whom was
      diagnosed by color Doppler imaging, including waveform spectral analysis. One
      patient with clinical evidence of cirrhosis and portal hypertension had episodes
      of hepatic encephalopathy and elevated blood levels of ammonia. This patient had
      a large tubular shunt between the posterior branch of the portal vein and the
      inferior vena cava. Shunts of this type are considered to be collateral pathways
      which develop in the hepatic parenchyma as a result of portal hypertension. The
      other four patients had no evidence of liver disease, and all four evidenced an
      aneurysmal portohepatic venous shunt within the liver parenchyma. Shunts of this
      type are considered congenital. The diagnosis of intrahepatic portosystemic
      venous shunts was established by color Doppler imaging, which demonstrated a
      direct communication of color flow signals between the portal vein and hepatic
      vein, in addition to the characterization of the Doppler spectrum at each
      sampling point from a continuous waveform signal (portal vein) to a turbulent
      signal (aneurysmal cavity), and finally, to a biphasic waveform signal (hepatic
      vein). As demonstrated by the five patients, color Doppler imaging is useful in
      the diagnosis of an intrahepatic portosystemic hepatic venous shunt, and the
      measurement of shunt ratio may be useful in the follow-up and determining the
      therapeutic option.

PMID- 8480739
TI  - Results of a multicenter trial using a mechanical lithotripter for the treatment
      of large bile duct stones.
AB  - A prospective, uncontrolled trial of the use of a prototype mechanical
      lithotripter was performed in 116 patients at nine centers. Standard endoscopic
      approaches had failed to remove all stones, primarily because of large size (80%
      of patients). For 92% of patients, common bile duct stones were successfully
      captured and fragmented following the use of this lithotripter. The frequency of
      pancreatitis and hemorrhage was no greater than with standard endoscopic
      retrograde sphincterotomy, and complications unique to lithotripter use were not
      noted. For endoscopists skilled in therapeutic duodenoscopy, this modality should
      be considered in management of common bile duct stones refractory to standard
      techniques.

PMID- 8480740
TI  - Biochemical and clinical effects of aspartame in patients with chronic, stable
      alcoholic liver disease.
AB  - Aspartame is an artificial sweetener completely metabolized in the gut and
      absorbed as aspartate, phenylalanine, and methanol. Phenylalanine is thought to
      mediate or exacerbate hepatic encephalopathy, and an impaired liver may not be
      able to cope with the ammoniagenic properties of the amino acid constituents, or
      adequately metabolize methanol. Thus, we compared the clinical and biochemical
      effects of a single ingestion of aspartame (15 mg/kg) to skim milk (phenylalanine
      content equimolar to aspartame) and placebo in patients with chronic, alcoholic
      liver disease in a randomized, crossover study. Aspartame produced an elevation
      of plasma phenylalanine significantly greater than milk and placebo (Cmax 14.55
      +/- 7.38, 10.95 +/- 4.95, 8.84 +/- 4.55 mumol/dl, respectively; p < 0.01).
      However, quantified encephalopathic changes were observed only with milk (p <
      0.05). Plasma aspartate, methanol, formate, and ammonia levels remained unchanged
      after all treatments. The lack of clinical derangements in encephalopathic
      indices, methanol accumulation, or biochemical changes in liver status suggests
      that a single large dose of aspartame (representing 5 times the average daily
      intake of adults) may be used safely by patients with chronic, stable liver
      disease.

PMID- 8480741
TI  - Abdominal tuberculosis: still a potentially lethal disease.
AB  - The findings in a 4-yr survey of 82 patients with abdominal tuberculosis are
      described and compared with those encountered in previous surveys. Fourteen cases
      of intestinal, 11 of mesenteric-lymphnodal, and 57 of peritoneal tuberculosis
      were identified. The disease occurred essentially in patients living under
      worsening socioeconomic conditions, and 51 of them had associated pulmonary
      tuberculosis. Symptoms and clinical findings were again nonspecific, but newer
      imaging, endoscopic, and other invasive procedures were helpful in establishing a
      definite diagnosis. In addition, adenosine deaminase determination showed great
      promise as a noninvasive diagnostic procedure in patients with tuberculous
      ascites. The six hospital deaths in the series highlight the hazard of
      potentially lethal delays in early diagnosis and treatment, even in centers with
      a high awareness of the disease.

PMID- 8480742
TI  - Plasma acetate levels in a group of obese diabetic, obese normoglycemic, and
      control subjects and their relationships with other blood parameters.
AB  - Acetate is a short-chain fatty acid derived from colonic fermentation of
      carbohydrate and dietary fiber, and from endogenous glucose and fatty acid
      metabolism in the liver. An impaired acetate metabolism has been reported in
      diabetic subjects. The aim of the study was to evaluate plasma acetate levels in
      a group of obese diabetic subjects, compared with obese normoglycemic subjects
      and normal control subjects. Eleven noninsulin-dependent diabetic patients taking
      oral antidiabetic drugs, eight obese normoglycemic subjects, and seven control
      subjects were studied. Liver, kidney, and gut functions were normal in all
      subjects. Blood acetate, glucose, insulin, and C-peptide were evaluated in all
      subjects. Acetate levels were significantly higher in the diabetic subjects than
      in obese normoglycemic and normal subjects. Significant correlations between
      HbA1c, glucose, and acetate levels, but not between acetate and C-peptide or
      insulin, were also observed.

PMID- 8480743
TI  - Acute pancreatitis presenting with visual disturbance.
AB  - Retinopathy is a rarely recognized complication of acute pancreatitis. We review
      the literature on this condition and report a case in which the manifestations of
      retinopathy dominated the clinical picture, initially diverting attention away
      from the presence of pancreatic disease.

PMID- 8480744
TI  - Fluoxetine treatment of depression caused by interferon-alpha.
AB  - Interferon-alpha is the only approved and effective treatment for hepatitis C.
      Psychiatric side effects are common and have frequently required a decrease in
      dose or discontinuation of therapy. We here report a case of interferon-alpha
      induced depression in a 40-yr-old man with hepatitis C successfully treated with
      the antidepressant fluoxetine, which allowed completion of interferon treatment.

PMID- 8480745
TI  - AIDS-related hepatic Kaposi's sarcoma: massive bleeding following liver biopsy.

PMID- 8480746
TI  - Efficacy of the somatostatin analog octreotide in the treatment of two patients
      with refractory diabetic diarrhea.
AB  - Two patients with severe refractory diabetes-related diarrhea are described. One
      patient had steatorrhea. Both responded to octreotide during a mean follow-up
      period of 7 months. The pathophysiology of diabetic diarrhea and the potential
      mechanism of action of octreotide are discussed. The only adverse side effect
      reported was hypoglycemia in one of the patients, which required a reduction of
      the insulin dose. Octreotide is a safe and effective agent for the treatment of
      refractory diabetic diarrhea.

PMID- 8480747
TI  - Failure of piezoelectric lithotripsy of a gallstone impacted in the gallbladder
      neck.
AB  - Failure of extracorporeal shockwave lithotripsy is most frequently related to
      total stone mass, the size of individual stones, or unrecognized stone
      calcification which interferes with the dissolution effects of orally
      administered bile salts. We report a case of piezoelectric extracorporeal
      shockwave lithotripsy failure in a young woman with a 2-cm stone impacted in the
      neck of the gallbladder. Despite adequate positioning of the shockwave focal
      point on two separate occasions, no fragmentation was achieved. The stone was
      subsequently retrieved after the woman underwent laparoscopic cholecystectomy.
      When treated ex vivo, the stone rapidly fragmented. We hypothesize that the
      impacted stone, lacking a uniform liquid interface, failed to fragment because of
      the inability of cavitational forces to achieve a surface effect.

PMID- 8480748
TI  - Normal serum alkaline phosphatase: an unusual finding in early suppurative
      biliary obstruction.

PMID- 8480749
TI  - Acute liver failure due to non-Hodgkin's lymphoma.
AB  - Acute hepatic failure secondary to involvement of the liver by hematologic
      malignancies is a very uncommon condition, and usually has a fatal prognosis. We
      describe the case of a woman who developed acute hepatic failure due to
      infiltration by a non-Hodgkin's lymphoma 18 yr after the initial diagnosis of a
      nodular-type lymphocytic lymphoma, while she was apparently in remission. Early
      diagnosis was achieved through liver biopsy; therefore, rapid administration of
      chemotherapy allowed her complete recovery. Hepatic biopsy may provide a
      diagnosis in patients in whom the etiology of liver failure is unknown, thus
      establishing the possible need for specific treatment.

PMID- 8480750
TI  - Upper gastrointestinal hemorrhage preceding development of Bouveret's syndrome.
AB  - Gastric outlet obstruction by a gallstone is a very uncommon clinical entity; it
      was first reported by Bouveret in 1896. In the patient presented, we were able to
      show the development of formation of the bilioenteric fistula with massive
      arterial bleeding from the eroded cystic artery until duodenal occlusion. The
      process was endoscopically and radiologically observed and documented. Although
      the diagnosis was made immediately, the patient had to undergo surgery because
      the gallstone proved to be too large to be extracted endoscopically.

PMID- 8480751
TI  - The irritable bowel syndrome: in your dreams?

PMID- 8480752
TI  - Esophageal carcinoma and achalasia: another call for screening?

PMID- 8480753
TI  - Posttransplant biliary complications: management menagerie.

PMID- 8480754
TI  - Heatstroke and its manifestations.

PMID- 8480755
TI  - Change in the histologic type of gastric carcinoma.

PMID- 8480756
TI  - Ischemic hepatitis.

PMID- 8480757
TI  - Re: Chronic non-B, non-C hepatitis: report from Pakistan.

PMID- 8480758
TI  - Colonoscopy to the cecum: how often do we get there? Experience in a community
      hospital.

PMID- 8480759
TI  - Colonic obstruction due to anospasm from a thrombosed hemorrhoid mimicking
      colonic pseudoobstruction in a frail and elderly patient.

PMID- 8480760
TI  - Presedation intravenous hydrocortisone to reduce diazepam-induced phlebitis.

PMID- 8480761
TI  - Pulmonary fat emboli associated with acute fatty liver of pregnancy.

PMID- 8480762
TI  - Successful Helicobacter pylori eradication: a systemic effect of antibiotics?

PMID- 8480763
TI  - Rectus sheath abscess in Crohn's disease.

PMID- 8480764
TI  - Gastric ulcer penetrating to the liver: endoscopic diagnosis.

PMID- 8480765
TI  - The effect of vibro-acoustic stimulation on fetal behavioral state organization.
AB  - During the third trimester of pregnancy there is a gradual development of fetal
      behavioral states. These states are distinct and discontinuous modes of neural
      activity; they reflect a certain degree of maturity and/or integrity of the fetal
      brain and are homologous with those seen in newborn infants. Abnormal state
      development has been found in growth retarded fetuses and in fetuses of women
      with type-1 diabetes. Behavioral state organization is not easily influenced by
      external factors and most stimuli fail to induce a state change when the fetus is
      in quiet sleep (state 1F). However, fetuses do react to vibro-acoustic
      stimulation (VAS) with an electronic artificial larynx. This stimulus induces
      excessive fetal movements, prolonged tachycardia, disorganization of behavioral
      states, and state transitions normally not seen in healthy fetuses. The
      backgrounds for these excessive and unusual reactions are largely unknown. For
      the time being, it seems better not to use this device in clinical practice. In
      this review paper, data on the development of behavioral states and on fetal
      reactions to VAS are discussed.

PMID- 8480766
TI  - Work in pregnancy.
AB  - Pregnant women in the western world are increasing their part in paid employment.
      This can be added to their work in the home which, with their leisure and
      athletic activities, might add up to a considerable load; the possible effects
      this exertion could have on the woman and her unborn child has been realized only
      in the last twenty years and many attempts have been made to quantify it. The
      patterns of work in the home, in employment, and at sporting activity are
      assessed. There are two distinct areas of possible influence on the fetus: the
      work with its physical effort might affect respiratory and metabolic acid-base
      balance and specific teratogens related to activity at work may be encountered
      and act at nodal points during fetal growth at specific times, causing congenital
      abnormalities of organs. Potential hazards under chemical, physical, and
      biological headings are considered, while both the psychological and physical
      effect of energy expenditure are discussed. Possible measures of outcome are
      assessed and three recently published studies from the U.S. and U.K. are examined
      to show the difficulties of making valid measurements about the effect of work on
      the pregnancy, as well as that of pregnancy on the work. It is probable that
      ordinary work done by a fit young woman has no serious effect on herself or a
      healthy fetus. Research will continue, for it may be that with an impaired
      afferent nutrition and oxygen supply to the fetus, certain specific increases in
      degrees of work could have an exaggerated effect.

PMID- 8480767
TI  - The biomechanics of vibration and low back pain.
AB  - This work is a review of the mechanical factors related to low back pain
      production in a vibration environment. The sitting posture is an extreme
      orientation for the lumbar intervertebral disc that 1) increases its internal
      pressure, 2) increases its anteroposterior shear flexibility, while: 3)
      decreasing its resistance to buckling instability and 4) stressing the posterior
      region of the disc. Vibration is an additional mechanical stressor. Several
      studies suggest that the following preventive measures be taken to reduce the
      risk of low back pain due to driving: 1) minimize the vibration reaching the
      driver, 2) avoid lifting or bending immediately following driving, and 3) walk
      around for a few minutes following driving.

PMID- 8480768
TI  - Selected health risks caused by long-term, whole-body vibration.
AB  - The problem of a "vibration disease" caused by low-frequency whole-body vibration
      (wbv) is critically discussed. Disorders of the nervous, circulatory, and
      digestive systems are interpreted not to be predominantly wbv-specific, but to be
      related to the totality of working conditions. Long-term wbv exposure can
      probably contribute to the pathogenesis of disorders of female reproductive
      organs (menstrual disturbances, anomalies of position) and disturbances of
      pregnancy (abortions, stillbirths). Animal experiments suggest harmful effects on
      the fetus. WBV has a minor synergistic effect on the development of noise-induced
      hearing loss. Degenerative changes of the spine are more prevalent among wbv
      exposed workers. Model calculations demonstrate an increased spinal load in
      pregnant women exposed to wbv or self-induced vibration, and illustrate a
      possibility for the comparison of data on stress, strain, and strength. The
      analysis of individual exposure-effect relationships is suggested as a future
      approach for evaluating potential occupation-related diseases.

PMID- 8480769
TI  - Asbestos fiber type in malignant mesothelioma: an analytical scanning electron
      microscopic study of 94 cases.
AB  - Although the association between asbestos exposure and malignant mesothelioma is
      indisputable, controversy continues regarding the relative contribution of the
      various types of asbestos fibers to the development of mesothelioma. We examined
      the types of asbestos fibers recovered from lung parenchyma in more than 90 cases
      of malignant mesothelioma from the United States, using an analytical scanning
      electron microscope. Almost half of the patients were former asbestos insulators
      or shipyard workers. The fibers were recovered from lung tissues obtained at
      autopsy or surgical resection by means of a sodium hypochlorite digestion
      procedure. Amosite asbestos was identified in 81% of the cases and accounted for
      58% of all fibers 5 microns or greater in length.
      Tremolite/actinolite/anthophyllite were identified in 55% of the cases and
      accounted for 10% of all fiber types. Chrysotile was identified in 21% of the
      cases and accounted for 3% of fibers exceeding 5 microns in length. Crocidolite
      was found in 16% of the cases and accounted for 3% of fibers exceeding 5 microns
      in length. Nonasbestos mineral fibers (commonly found in the lungs of the general
      population) were observed in 71% of the cases and accounted for 25% of all fibers
      5 microns or greater in length. The findings in this study are at odds with the
      assertion that crocidolite asbestos is responsible for most mesotheliomas in the
      United States.

PMID- 8480770
TI  - Mortality of professional chemists in England and Wales, 1965-1989.
AB  - Several studies on the mortality of chemists have revealed a lower overall
      mortality but an excess of deaths from certain diseases, in particular, cancers.
      This study determined the causes of mortality of 4,012 chemists among 14,884
      members of The Royal Society of Chemistry who were followed for a period of 25
      years. The results demonstrated consistency with other studies. There was an
      overall low mortality rate, with fewer deaths than expected from cancers, but an
      excess mortality from lymphatic and hematopoietic cancers, in particular
      leukemias. There was an excess of deaths from certain gastrointestinal cancers.
      There was reduced mortality from respiratory diseases, including lung cancers,
      and from cardiovascular disease. New findings reported in this study are
      increased mortality from cancers of the duodenum and kidney, certain skin
      cancers, mental disorders, and diseases of the nervous system.

PMID- 8480771
TI  - Validity of exposure in one job as a surrogate for exposure in a cohort study.
AB  - Frequently, information pertaining to only one job is available or used to
      evaluate risk estimates of disease in occupational epidemiologic research. The
      amount of misclassification that such a practice could create has not, however,
      been examined. We used data from a mortality study of workers employed in 10
      formaldehyde-producing or -using plants to address how closely several parameters
      of exposure based on the first, longest, or last job held in a company compared
      with those based on the worker's entire employment history at the plant. The best
      predictor for cumulative formaldehyde exposure at the plant was the longest job
      at that plant, with a correlation coefficient (r) of 0.70. The correlation with
      average exposure over the worker's employment was 0.77 for the first job and 0.74
      for the longest and last jobs. Peak exposures and highest exposure levels
      experienced in the plant were more closely related to the first job (r = 0.72 and
      r = 0.74). The highest correlation with any of the measures was never with the
      last job. Variation between plants for each of these comparisons, however, was
      wide. These findings indicate that the use of a single job as a surrogate for
      exposure received at a particular worksite can result in different degrees of
      misclassification for different exposure measures. Even though the correlations
      were generally high, the associated misclassification of exposure could lead to a
      substantial underestimation of the relative risks in some situations. In this
      report two hypothetical examples show what effect the misclassification rates
      could have on estimates of disease risks.

PMID- 8480772
TI  - Methodology in industrial health studies: Social Security disability data and the
      medical care system.
AB  - This paper is directed at the exploration and development of the Social Security
      data, in the ascertainment and evaluation of industrial health effects. The focus
      of the study is on disability data, as a national uniform means to identify
      illnesses and disease that occurred prior to death, that were not recorded on the
      death certificates. A cohort of employees of an industrial company was processed
      through the Social Security System to simultaneously identify the disability and
      death claims that were filed. The total number of white males that filed
      disability claims was 1,333 and for white females 278. The total number of claims
      filed for the white males was 1,734 and for white females 382. Comparisons were
      made of all causes of disability with all causes of death for white males and
      white females. A remarkably high percentage of causes of disability were not
      recorded or available by death certificate for ICD categories of diseases and
      specific cancer sites. The study also demonstrated that disability data
      contribute significantly to the confirmation of the diagnosis for the cancer
      sites. The development of the methodology linking Social Security data on
      disability, medical care, and mortality with industrial medical and environmental
      exposure data in epidemiological studies is discussed.

PMID- 8480773
TI  - Upjohn pharmacist reimbursement programs halted by FDA.

PMID- 8480774
TI  - Heparin lock flush solution versus 0.9% sodium chloride injection for maintaining
      patency.

PMID- 8480775
TI  - Providing pharmaceutical services through a pharmacy management company.

PMID- 8480776
TI  - Asking for more help.

PMID- 8480777
TI  - Importance of following instructions when compounding.

PMID- 8480778
TI  - Results of a brown-bag day.

PMID- 8480779
TI  - Follow-up to coverage of nurse practitioner prescribing bill in California.

PMID- 8480781
TI  - Insurance that isn't.

PMID- 8480780
TI  - Marketing practices and health care costs.

PMID- 8480782
TI  - Implementation of a hospital policy for health care workers exposed to hepatitis
      or the human immunodeficiency virus.
AB  - Implementation of a hospital policy for health care workers exposed to the human
      immunodeficiency virus (HIV) or hepatitis is discussed, using a model program
      established by San Francisco General Hospital (SFGH). Occupational Safety and
      Health Administration (OSHA) guidelines on blood-borne pathogens require a
      comprehensive program for management of occupationally exposed workers at all
      health care institutions. To meet the need of immediate assessment, SFGH has
      established a 24-hour hotline staffed by several clinicians. These clinicians
      provide risk assessment at the time of the call, and the 24-hour pharmacy
      service, using an anonymous system to protect the worker, can have zidovudine
      prophylaxis available within five minutes for workers potentially exposed to HIV.
      Hepatitis prophylaxis focuses on hepatitis B immunization and administration of
      hepatitis B immune globulin to workers who have been exposed. Ongoing medical
      management involves monitoring the adverse effects of zidovudine, ensuring that
      workers receive any workers' compensation benefits to which they are entitled,
      providing pretest and posttest counseling for exposed workers and their
      significant others and families, and supplying appropriate documentation.
      Confidentiality is essential for worker participation in the program. The costs
      of such a program are not insignificant but must be borne by the institution if
      it is to take care of its health care workers. Institutional policies and
      procedures must address all the components of postexposure management, as well as
      the issues related to HIV- and hepatitis B-infected health care workers.
      Sufficient staffing and funding, confidentiality, and prevention are the keys to
      a successful program.

PMID- 8480783
TI  - Health center-supplier team approach to solving i.v. equipment problems.
AB  - A team approach to problem solving in which a health care center and a supplier
      worked together to improve product quality is described and a detailed example is
      provided. When the health care center began using a new supplier for i.v.
      solutions and equipment, the supplier's incomplete product line and recurrent
      functional problems with products led to dissatisfaction of staff members. The
      supplier suggested that the health care center and supplier form a quality action
      team. The team addressed eight product concerns by using a total quality
      management process. For each concern, the team defined the problem and formulated
      a problem statement, collected data and determined the contributing factors to
      the problem, developed an action plan for solving the problem, and executed the
      plan and monitored its impact. After the first meeting, the team met monthly to
      monitor progress and discuss new ways they could work together to improve product
      quality and reduce costs. The implementation of the action plans allowed the
      health care center to realize cost savings and increased staff members'
      satisfaction with the supplier's products. A quality action team, composed of
      representatives from a health care center and one of its suppliers, used a total
      quality management process to solve problems to the satisfaction of both sets of
      participants.

PMID- 8480784
TI  - Pharmacy-managed, weight-based heparin protocol.
AB  - A revised protocol for heparin therapy, in which dosing was based on the
      patient's weight and the pharmacy staff assumed responsibility for management of
      the treatment protocol, was evaluated. A fixed-dose protocol for heparin therapy,
      in which an initial loading dose and infusion rate were specified by physicians
      and partial thromboplastin times (PTTs) were determined every 12 hours, was
      revised to determine dosing based on patient weight and diagnosis and to include
      more levels of dose adjustment and additional laboratory tests. Data on
      demographic characteristics of patients, heparin therapy, laboratory monitoring,
      conversion to warfarin therapy, and protocol management were collected for the
      patients receiving heparin under the revised protocol. Results were compared with
      those obtained for the old, fixed-dose protocol, which was managed by nursing
      staff. The revised protocol showed improvements in heparin therapy according to
      commonly accepted treatment criteria, including dosages, time to achieve a PTT
      associated with therapeutic anticoagulation, and the time a patient was in the
      target PTT range. The new protocol was also significantly more effective in
      avoiding low as well as high PTT ratios. The laboratory monitoring mandated by
      the revised protocol enhanced the monitoring of heparin therapy, and pharmacy
      management improved the accuracy and documentation of heparin therapy. Under the
      revised protocol, anticoagulation goals were attained more rapidly, and dosing
      changes were more likely to be correct and appropriately documented.

PMID- 8480785
TI  - Stability of midazolam hydrochloride in parenteral nutrient solutions.
AB  - The compatibility and stability of midazolam hydrochloride in three parenteral
      nutrient (PN) solutions and the stability of 15 amino acids in the presence of
      midazolam hydrochloride were studied. Six combinations of three PN solutions with
      amino acid concentrations of 1.5%, 2.5%, and 5% and two midazolam concentrations
      (0.1 and 0.5 mg/mL) were prepared in triplicate and stored at room temperature
      under normal fluorescent lighting. Duplicate samples were visually inspected for
      color change, precipitation, or gas formation and tested for pH. The samples were
      evaluated for midazolam and amino acid content by high-performance liquid
      chromatography at zero, one, three, and five hours. Midazolam and amino acid
      concentrations did not change significantly during the study. There was no
      evidence of color change, precipitation, or gas formation with any midazolam-PN
      solution combination when the combinations were examined visually and under a
      microscope, and no substantial changes in pH occurred. Midazolam 0.1 and 0.5
      mg/mL (as the hydrochloride salt) was stable in the three PN solutions studied;
      in addition, the amino acids present in the 1.5%, 2.5%, and 5% amino acid PN
      solutions were stable when combined with midazolam at concentrations of 0.1 and
      0.5 mg/mL.

PMID- 8480786
TI  - Evaluating and selecting an information system, Part 2.
AB  - Final steps in the evaluation and selection of a computerized information system
      for the pharmacy department are described. Once the computerization committees
      have been established, the needs assessment has been conducted, and vendors have
      responded to the request for proposal, the vendors and their products are
      subjected to quantitative and qualitative evaluations. The quantitative
      evaluation involves factors that can be counted, weighted, or tabulated and
      involves little professional judgment. Vendors can be quantitatively evaluated on
      the basis of the utility and features of the proposal, the fields to which the
      product applies, financial strength, product maturity, number of installations,
      regional presence, user group, software releases and upgrades, personnel,
      technology, and system costs. The qualitative evaluation requires judgment and
      intuition and is best performed by pharmacists. Vendors can be qualitatively
      evaluated on the basis of references, site visits, personnel, demonstrations and
      presentations, history and plans, user group, product literature, implementation
      plans, technology, and personalities. The steering committee makes the final
      selection of a system, and a contract is written that safeguards the hospital's
      interests. The contract should include performance criteria, promises made orally
      by salespersons, protection against software and other defects, a phased-in
      payment schedule, and language covering hardware, support and maintenance,
      default, and liability. Resources should be budgeted for implementation and
      stress testing after the contract is signed. Costly errors in selecting a
      pharmacy information system can be avoided by thoroughly evaluating vendors and
      writing a contract that protects the hospital.

PMID- 8480787
TI  - Pharmacy students' experience with identifying and solving drug-related problems
      during clinical clerkship.

PMID- 8480788
TI  - Preliminary study of autonomy as a factor influencing medication-taking by
      elderly patients.

PMID- 8480789
TI  - Refractometric testing of alfentanil hydrochloride, fentanyl citrate, sufentanil
      citrate, and midazolam hydrochloride.

PMID- 8480790
TI  - ASHP guidelines on preventing medication errors in hospitals.

PMID- 8480791
TI  - Medication error versus medication misadventure--what's in a name?

PMID- 8480792
TI  - Initial responses to recommendations of the Blue Ribbon Committee on Generic
      Medicines.

PMID- 8480793
TI  - Generic and alternative brand-name pharmaceutical equivalents: select with
      caution.

PMID- 8480794
TI  - Michael's sign.

PMID- 8480795
TI  - Where credit is due.

PMID- 8480796
TI  - Authenticity remembered.

PMID- 8480797
TI  - Immunization strategy worked.

PMID- 8480798
TI  - The delivery dilemma: a question of competency.

PMID- 8480799
TI  - My life as a symptom.

PMID- 8480800
TI  - Diabetic hypoglycemia: how to keep the threat at bay.

PMID- 8480801
TI  - Where did the jobs go?

PMID- 8480802
TI  - IV vesicants: how to avoid extravasation.

PMID- 8480803
TI  - Moral support for 'Grandparents Who Care'.

PMID- 8480804
TI  - New relief for esophageal varices.

PMID- 8480805
TI  - Carpal-tunnel syndrome.

PMID- 8480806
TI  - Four against infection.

PMID- 8480807
TI  - Sleuthing on tribal turf.

PMID- 8480808
TI  - What is transesophageal echocardiography?

PMID- 8480809
TI  - Selecting a QA glucose meter.

PMID- 8480810
TI  - 1993 directory of nursing organizations.

PMID- 8480811
TI  - Neural correlates of mental phenomena.

PMID- 8480812
TI  - Caring for the AIDS victim: what can we learn?

PMID- 8480813
TI  - In memoriam George Tarjan, M.D. 1912-1991.

PMID- 8480814
TI  - Psychosocial impact of HIV-related caregiving on health providers: a review and
      recommendations for the role of psychiatry.
AB  - OBJECTIVE: The author considers current knowledge about the stresses of HIV
      related care and assesses available evidence for the presence of major
      occupational, physical, and psychiatric morbidity in health care providers
      involved in intensive HIV-related caregiving. METHOD: The review is based on
      anecdotal reports of AIDS-care-related psychosocial distress and the literature
      concerning caregivers' attitudes toward people with HIV illness and HIV-related
      caregiving, the psychosocial impact of HIV work, and stress related to the
      ethical and philosophical challenges facing HIV caregivers. RESULTS: Few of the
      current publications concerning HIV caregiver stress come from the psychiatric
      literature. Psychiatry appears to lack a strong clinical, educational, research,
      or policy presence regarding psychosocial stress in HIV care providers. The
      numerous studies in the nursing, medical, public health, and health education
      literature do not include any controlled investigations documenting the incidence
      and prevalence of physical, psychological, occupational, or interpersonal
      symptoms or disorders in health care professionals who devote a substantial
      amount of their clinical activities to patients with HIV illness. CONCLUSIONS:
      Major HIV-related stress in conjunction with other psychiatric morbidity, such as
      mood disorders, anxiety disorders, substance abuse, and relationship and
      occupational problems, seems likely in susceptible caregivers. Decisions about
      the structure and form of delivery of HIV-related care and programs for
      caregivers must be based on more carefully controlled psychiatric observations of
      occupational, physical, psychological, and social adaptation to HIV-related work.
      The author suggests several areas in which psychiatric clinicians, educators,
      researchers, and policy experts can make major contributions.

PMID- 8480815
TI  - Neural correlates of self-induced dysphoria.
AB  - OBJECTIVE: The authors explored the question of whether acute, transient changes
      in mood are reflected in activation of discrete neuronal systems in the human
      brain. METHOD: Using positron emission tomography, they measured the regional
      cerebral blood flow (CBF) of seven psychiatrically healthy subjects under two
      conditions. During the control condition the subjects were resting with their
      eyes closed. During the active condition, with their eyes still closed, they were
      asked to imagine or recall a situation that would make them feel very sad. They
      were explicitly asked to experience sadness and to avoid any feelings of anger or
      anxiety. RESULTS: There were significant differences in regional CBF measured
      during the control condition and during the active condition, particularly in the
      inferior and orbitofrontal cortices. Women showed bilateral inferior and
      orbitofrontal activation, but men displayed predominantly left-sided activation
      in these areas. CONCLUSIONS: The authors conclude that the inferior and
      orbitofrontal cortices play an important role in normal emotional cognitive
      processes.

PMID- 8480816
TI  - The enduring psychosocial consequences of mania and depression.
AB  - OBJECTIVE: The authors sought to determine the scope, severity, and persistence
      of psychosocial impairment arising from bipolar and unipolar affective disorder.
      METHOD: Patients with bipolar (N = 148) or unipolar (N = 240) major affective
      disorder were assessed as they sought treatment and again after a 5-year follow
      up. Concurrently, parents, siblings, and adult children underwent similar
      assessments and were followed for 6 years. To quantify the impact of affective
      disorder, probands were individually matched to relatives who had no lifetime
      history of affective disorder. Sixty-nine relatives who were depressed at intake
      constituted a separate, nonclinical study group and were also matched to
      relatives who were well. RESULTS: Both unipolar and bipolar patients began follow
      up with deficits in annual income. Relative to comparison subjects, affective
      disorder groups were significantly more likely to report declines in job status
      and income at the end of follow-up and significantly less likely to report
      improvements. Similarly, both bipolar and unipolar patients showed significant
      deficits in nearly all other areas of psychosocial functioning measured at follow
      up. Except for relationships with spouses, deficits did not differ significantly
      by polarity. Surprisingly, probands with recovery sustained throughout the final
      2 years of follow-up also showed severe and widespread impairment. Relatives with
      major depression exhibited substantial deficits on follow-up, but job status and
      income were not significantly affected. CONCLUSIONS: The psychosocial impairment
      associated with mania and major depression extends to essentially all areas of
      functioning and persists for years, even among individuals who experience
      sustained resolution of clinical symptoms.

PMID- 8480817
TI  - Does age make a difference in the effects of physical health and social support
      on the outcome of a major depressive episode?
AB  - OBJECTIVE: The authors examined the effects of physical health and social support
      on 6-month outcome of a major depressive episode in 67 patients who were less
      than 60 years old and 46 patients who were 60 years old or older. They
      hypothesized that despite their higher rate of troublesome health problems, older
      patients would have fewer depressive symptoms at follow-up than would younger
      patients. METHOD: The Center for Epidemiologic Studies Depression Scale (CES-D
      Scale) and a modified version of the National Institute of Mental Health
      Diagnostic Interview Schedule were used to gather data from inpatients and
      outpatients treated at Duke University Medical Center during a face-to-face
      interview at baseline and over the telephone at 6-month follow-up. At baseline,
      all patients met DSM-III-R criteria for a major depressive episode. Data analyses
      included bivariate and multivariate procedures. RESULTS: At baseline, the mean
      CES-D Scale scores of the two age groups were similar. As expected, the mean
      illness index score of the older patients was significantly higher and their mean
      impaired subjective social support score was slightly lower than those of the
      younger patients. At 6-month follow-up, the mean CES-D Scale score of the younger
      patients was above the depressive threshold, but the mean CES-D Scale score of
      the older patients was below the depressive threshold. The illness index and
      impaired subjective support measures were significant predictors of depressive
      symptoms at 6 months for the younger patients but not for the older patients.
      CONCLUSIONS: The authors conclude that older depressed patients have a more
      favorable prognosis than younger depressed patients. Predictors of outcome vary
      by age.

PMID- 8480818
TI  - Somatization and the recognition of depression and anxiety in primary care.
AB  - OBJECTIVE: The authors examined the effect of patients' style of clinical
      presentation on primary care physicians' recognition of depression and anxiety.
      METHOD: The subjects were 685 patients attending family medicine clinics on self
      initiated visits. They completed structured interviews assessing presenting
      complaints, self-report measures of symptoms and hypochondriacal worry, the
      Diagnostic Interview Schedule (DIS), and the Center for Epidemiologic Studies
      Depression Scale (CES-D). Physician recognition was determined by notation of any
      psychiatric condition in the medical chart over the ensuing 12 months. RESULTS:
      The authors identified three progressively more persistent forms of somatic
      presentations, labeled "initial," "facultative," and "true" somatization. Of 215
      patients with CES-D scores of 16 or higher, 80% made somatized presentations; of
      75 patients with DIS-diagnosed major depression or anxiety disorder, 76% made
      somatic presentations. Among patients with DIS major depression or anxiety
      disorder, somatization reduced physician recognition from 77%, for psychosocial
      presenters, to 22%, for true somatizers. The same pattern was found for patients
      with high CES-D scores. In logistic regression models education, seriousness of
      concurrent medical illness, hypochondriacal worry, and number of lifetime
      medically unexplained symptoms each increased the likelihood of recognition,
      while somatized presentations decreased the rate of recognition. CONCLUSIONS:
      While physician recognition of psychiatric distress in primary care varied widely
      with different criteria for recognition, the same pattern of reduction of
      recognition with increasing level of somatization was found for all criteria. In
      contrast, hypochondriacal worry and medically unexplained somatic symptoms
      increased the rate of recognition.

PMID- 8480819
TI  - Development of aphasia, apraxia, and agnosia and decline in Alzheimer's disease.
AB  - OBJECTIVE: The purpose of this study was to compare the stage and the subtype
      models of disease progression in Alzheimer's disease. The authors address the
      issue of whether the overall rate of clinical decline is different in Alzheimer's
      disease patients with and without early development of aphasia, apraxia, or
      agnosia. METHOD: The study was a case series study. Two separate cohorts of
      Alzheimer's disease patients were used, one from an ongoing single center study
      at Stanford University (N = 57) and the other from a multicenter project across
      the state of California (N = 70). Patients were assessed every 6 months in the
      Stanford study and yearly in the state study. All patients were assessed at least
      three times. The outcome measure was the average rate of decline on the Mini
      Mental State examination. RESULTS: The average rates of decline on the Mini
      Mental State were computed for each subject. Subjects were then divided among
      groups according to whether and when they exhibited aphasia, agnosia, or apraxia.
      The effects of the presence of aphasia, agnosia, or apraxia were assessed by
      comparing the average rates of decline on the Mini-Mental State. CONCLUSIONS:
      Alzheimer's disease patients who developed aphasia or apraxia declined more
      rapidly than those patients who did not develop either sign. These results were
      not attributable to differences in Mini-Mental State scores at entry into the
      study. The results suggest the presence of subtypes of Alzheimer's disease in
      which accelerated decline is associated with the early appearance of certain
      neurological signs.

PMID- 8480820
TI  - Denial of memory deficit in Alzheimer's disease.
AB  - OBJECTIVE: Patients with probable Alzheimer's disease often deny or underestimate
      the severity of their memory impairment. The authors examined the relationships
      between denial and severity of cognitive impairment and between denial and the
      presence of depressed mood and sad affect in 128 patients with probable
      Alzheimer's disease. METHOD: Denial of memory deficit was evaluated by structured
      interview. Cognition was evaluated with a quantitative examination that assessed
      performance on 16 subtests. Depression was rated by using a scale that included
      patients' self-ratings as well as caregivers' and examiners' assessments of the
      patient's mood and affect. Pearson correlation coefficients were used to quantify
      the relationship between denial and demographic, cognitive, and depression
      variables. Stepwise multiple regression analysis was used to further examine the
      relationship between denial and individual cognitive subset scores. RESULTS:
      Denial did not correlate with age at onset of Alzheimer's disease, duration of
      illness, or educational background. It did correlate with gender: women exhibited
      greater denial than men. A significant correlation was found between denial and
      overall severity of cognitive deficit and particularly with impairment in object
      naming. A negative correlation was found between denial and depression.
      CONCLUSIONS: The association between denial and cognitive impairment may suggest
      that denial of probable Alzheimer's disease results from disruption of cognitive
      abilities needed for awareness of illness. The negative association between
      denial and depression may suggest that depression in Alzheimer's disease is in
      part reactive in nature.

PMID- 8480821
TI  - Comorbidity in psychosis at first hospitalization.
AB  - OBJECTIVE: The authors sought to determine the prevalence and effects of medical
      and psychiatric comorbidity on initial outcome in a group of patients
      experiencing a first episode of psychosis. METHOD: Patients with a first episode
      of psychosis who were consecutively admitted to a hospital (N = 102) were
      examined for the presence of psychiatric and medical disorders. Patients were
      given psychiatric diagnoses with the use of the Structured Clinical Interview for
      DSM-III-R and were rated weekly on symptom rating scales. Outcome variables at
      discharge were final symptom rating scale scores, length of hospitalization, and
      recovery on the basis of operationalized criteria. RESULTS: Comorbid diagnoses
      were present in 52.0% (N = 53) of the patients, and 37.7% (N = 20) had multiple
      comorbid diagnoses. The most common comorbid diagnosis was substance abuse.
      Patients with affected psychoses were significantly more likely than those with
      nonaffective psychoses to have a comorbid substance abuse diagnosis. Patients
      with psychiatric comorbidity had poorer initial outcomes, while those with
      medical comorbidity had fewer symptoms at discharge. CONCLUSIONS: Comorbidity is
      common and may be a useful predictor of the outcome of a first episode of
      psychosis.

PMID- 8480822
TI  - Unrecognized cocaine use among schizophrenic patients.
AB  - OBJECTIVE: Unrecognized stimulant use could lead to the misdiagnosis of
      schizophrenia or the misunderstanding of its course and prognosis. This study was
      conducted to determine the prevalence of unrecognized stimulant use among
      patients with a clinical diagnosis of schizophrenia. METHOD: The subjects were
      108 schizophrenic patients admitted consecutively to a Veterans Affairs
      psychiatric hospital. Admitting psychiatrists supplemented routine clinical
      evaluations with a semistructured interview regarding recent and lifetime use of
      alcohol, cocaine, amphetamine, marijuana, and opiates. A urine specimen was
      assayed for the four illicit drugs. RESULTS: Of the 103 patients who provided a
      urine specimen, 37 (36%) used cocaine during the 6 months before admission,
      including 31 who used the drug in the week before admission. Because of the poor
      reliability of negative self-reports of recent cocaine use, clinicians failed to
      recognize cocaine use in one-third of the patients with a urine toxicology
      positive for cocaine metabolites. Two other groups of patients were identified;
      schizophrenic patients without substance abuse (including alcohol) and
      schizophrenic patients with substance abuse other than stimulants. Both substance
      abusing groups were younger than the nonabusing group, but the three groups had
      similarly high rates of recent psychotic symptoms, homelessness, and
      unemployment. CONCLUSIONS: Among schizophrenic patients who require
      hospitalization, clinicians should not rely solely on self-reported stimulant
      use. Recognition of stimulant use could be improved through routine urine
      toxicologies for all psychotic patients. The authors suggest that recognition of
      stimulant use among schizophrenic patients may identify a population with a
      better prognosis for schizophrenia and different treatment needs.

PMID- 8480823
TI  - Achieving cocaine abstinence with a behavioral approach.
AB  - OBJECTIVE: The authors compared the efficacy of a multicomponent behavioral
      treatment and drug abuse counseling for cocaine-dependent individuals. METHOD:
      The 38 patients were enrolled in outpatient treatment and were randomly assigned
      to the two treatments. Counseling in the behavioral treatment was based on the
      community reinforcement approach, while the drug abuse counseling was based on
      the disease model of dependence and recovery. Patients in the behavioral, but not
      the drug counseling, treatment also received incentives contingent on submitting
      cocaine-free urine specimens. RESULTS: Of the 19 patients who received behavioral
      treatment, 58% completed 24 weeks of treatment, versus 11% of the patients who
      received counseling. In the behavioral treatment group 68% and 42% of the
      patients achieved at least 8 and 16 weeks of documented continuous cocaine
      abstinence, respectively, versus 11% and 5% in the drug abuse counseling group.
      CONCLUSIONS: This multicomponent behavioral treatment appears to be an effective
      intervention for retaining outpatients in treatment and establishing cocaine
      abstinence.

PMID- 8480824
TI  - Pharmacotherapy of bulimia nervosa with fluoxetine: assessment of clinically
      significant attitudinal change.
AB  - OBJECTIVE: The authors used an individual change model to examine the clinically
      significant effect of pharmacotherapy with fluoxetine on the attitudes and
      beliefs characteristic of bulimia nervosa. METHOD: Three hundred eighty-two women
      meeting DSM-III-R criteria for bulimia nervosa participated in a multicenter,
      double-blind, randomized clinical trial of placebo, 20 mg of fluoxetine, and 60
      mg of fluoxetine for 8 weeks. Behavioral change was assessed with self-monitored
      measures of binge eating and purging, and psychological change was measured with
      the self-rating Eating Disorder Inventory and the Hamilton Rating Scale for
      Depression. A specific statistical method was used to determine clinically
      significant change in psychological measures. RESULTS: On the majority of
      psychological measures, more of the subjects receiving active drug than those
      receiving placebo showed clinically significant change. Behavioral improvement
      was significantly associated with the likelihood of demonstrating clinically
      significant psychological change. The observed effect of pharmacotherapy on
      attitudinal change was not related to the presence of depression at baseline.
      These results compare favorably with other interventions for bulimia nervosa.
      CONCLUSIONS: Measures of change in treatment studies should reflect clinical as
      well as statistical significance. In the short-term, treatment of bulimia nervosa
      with fluoxetine appears to produce clinically significant attitudinal and
      behavioral changes.

PMID- 8480825
TI  - Severity of psychiatric symptoms after HIV testing.
AB  - OBJECTIVE: The authors were interested in the psychiatric effects of serological
      testing for HIV and what information feasibly available at intake might predict
      more severe psychiatric symptoms 1 year later. METHOD: HIV testing in a private
      office setting was offered to adults at perceived risk for HIV infection but
      without AIDS. At entry, then 6 and 12 months later, subjects were counseled by
      psychiatric nurses and assessed by the Hamilton Rating Scale for Depression, Beck
      Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Brief
      Symptom Inventory. RESULTS: Mean scores on all measures of psychiatric symptoms
      were lower at follow-up among both 106 HIV-positive and 222 HIV-negative adults.
      One year after HIV testing, 121 (37%) of the 328 subjects had scores associated
      with psychopathology. These elevated scores were not predicted by serostatus but
      by initial psychopathological scores (N = 150), annual income less than +15,000
      (N = 114), being female (N = 46), and history of injection drug use (N = 32) and
      heterosexual risk factors (N = 60) as compared to males having sex with males (N
      = 236). CONCLUSIONS: Before the development of more severe physical symptoms, on
      average, knowledge of HIV infection does not increase psychiatric morbidity;
      however, regardless of serostatus, a notable percentage of at-risk adults have
      sustained high levels of psychiatric symptoms. Counseling during the HIV testing
      process provides an opportunity to identify these individuals for closer study
      and indicated psychiatric treatment.

PMID- 8480826
TI  - Clinical course of alcoholism in 636 male inpatients.
AB  - OBJECTIVE: This study was undertaken to determine the relative order of
      appearance of symptoms in alcohol dependence. METHOD: The age at which 21 alcohol
      related major life events first occurred was investigated in 636 male alcohol
      dependent inpatients through a standardized, structured personal interview with
      each subject and at least one resource person. RESULTS: A general pattern of
      first occurrence of these events was observed. Heavy drinking escalated further
      when the subjects were in their late 20s, followed by evidence of interference
      with functioning in multiple life areas in the early 30s, a subsequent perception
      of loss of control, and then an intensification of social and job-related
      problems, along with evidence of deterioration in body systems, in the mid- to
      late 30s. Similar patterns of problems emerged when the alcoholic subjects were
      divided into subgroups based on onset of alcohol dependence before or after age
      30, presence or absence of a family history of alcoholism, and presence or
      absence of additional psychiatric disorders. CONCLUSIONS: These data indicate
      that there is a typical progression of events related to alcohol dependence. This
      information can be useful for clinicians in their work with patients and for
      teachers and researchers as well.

PMID- 8480827
TI  - Psychiatric disorders in adult children of alcoholics: data from the
      Epidemiologic Catchment Area project.
AB  - OBJECTIVE: The authors examined differences in the prevalence of psychiatric
      disorders in individuals who did or did not have alcoholic parents. METHOD: They
      used data from the National Institute of Mental Health Epidemiologic Catchment
      Area project, specifically from the Piedmont of North Carolina. Prevalence of
      psychiatric disorders was estimated in 408 ECA participants who reported problem
      drinking in their mother, their father, or both and in 1,477 age- and sex-matched
      subjects who did not report having alcoholic parents. RESULTS: The adult children
      of alcoholics showed significantly higher current (6-month) prevalence rates of
      simple phobia and agoraphobia and lifetime rates of dysthymia, generalized
      anxiety disorder, panic disorder, simple phobia, and agoraphobia. Adult children
      of alcoholics also had significantly more antisocial symptoms. Male children of
      alcoholics had higher rates of alcohol and drug abuse and reported more
      antisocial symptoms than did female children of alcoholics. Male children of
      alcoholics had a significantly higher rate of lifetime diagnoses of alcohol and
      drug abuse than men who were not children of alcoholics. More female children of
      alcoholics had generalized anxiety disorder than women who were not children of
      alcoholics. Both male and female children of alcoholics had significantly more
      antisocial symptoms than their matched comparison subjects. Sons of alcoholic
      fathers had a higher rate of substance abuse and more antisocial symptoms than
      did daughters of alcoholic fathers. Daughters of alcoholic fathers had a higher
      rate of generalized anxiety disorder. CONCLUSIONS: These data on adult children
      of alcoholics in a large community sample add to a literature based mainly on
      descriptive material or studies of smaller samples.

PMID- 8480828
TI  - Missed psychiatric appointments: who returns and who stays away.
AB  - OBJECTIVE: This study investigated reasons for missed psychiatric appointments,
      rescheduling of appointments, adverse outcomes, and the association of specific
      diagnoses and treatments with missed appointments. METHOD: A prospective survey
      covering all individual outpatient visits to seven mental health clinic
      psychiatrists was conducted during a 3-month period in 1991. Of the 1,620
      scheduled visits, 142 (8.8%) were missed, representing 130 separate patients. For
      each missed appointment, the psychiatrist involved completed a questionnaire on
      the type of visit, the patient's DSM-III-R diagnosis, the reason for missing the
      appointment, the date of patient recontact, and adverse outcome, if any. RESULTS:
      Of the 142 missed appointments, 71.1% were rescheduled spontaneously by the
      patients; of these, most (73.3%) were rescheduled within 2 weeks. The remaining
      missed appointments represented various outcomes, including dropping out of
      treatment. The most common stated reason for missing an appointment was patient
      error, such as forgetting, oversleeping, or getting the date wrong. Patients with
      PTSD and/or substance abuse were significantly more likely than others to miss
      appointments, and those with major depression were somewhat less likely to do so.
      CONCLUSIONS: Most patients quickly reschedule missed appointments, and those in
      more intensive treatments miss fewer appointments. Missed appointments for
      initial evaluation are not rescheduled most often. Patients in ongoing treatment
      who do not return may have histories of noncompliance with treatment. The high
      rate of rescheduling suggests that follow-up of patients who miss appointments
      should be a clinical decision rather than a routine policy.

PMID- 8480829
TI  - Ketoconazole administration in hypercortisolemic depression.
AB  - Ketoconazole, an antiglucocorticoid drug, was administered to 10
      hypercortisolemic depressed patients for up to 6 weeks. Three patients dropped
      out because of side effects or intercurrent illness. The remaining seven had
      significant ketoconazole-associated decreases in serum cortisol levels and in
      depression ratings. Antiglucocorticoid agents may be useful probes for
      investigating the sequelae of hypercortisolemia in patients with major
      depression.

PMID- 8480831
TI  - A comparison of treated and untreated simple phobia.
AB  - The authors compared 25 treated and 58 untreated subjects with simple phobia
      uncomplicated by other lifetime anxiety disorders. The treated individuals
      reported more phobias involving dogs and cats, elevators, and transportation;
      most had multiple phobias; and many experienced panic attacks in the context of
      their phobias. The untreated individuals typically reported only one phobia,
      which was often related to blood-injury and was seldom complicated by panic
      symptoms.

PMID- 8480830
TI  - CSF transthyretin in patients with depression.
AB  - Some depressed patients may suffer from restricted central hypothyroidism, which
      could occur if levels of the thyroid hormone transport protein transthyretin were
      low. CSF transthyretin was measured in eight inpatients with refractory major
      depression and nine neurological patients. The depressed patients had
      significantly lower transthyretin levels than the comparison subjects, suggesting
      that central hypothyroidism, with normal peripheral thyroid concentrations, could
      occur in some depressed patients.

PMID- 8480832
TI  - Double-blind study of adjuvant buspirone for fluoxetine-treated patients with
      obsessive-compulsive disorder.
AB  - In a double-blind, crossover study, 13 fluoxetine-treated patients with obsessive
      compulsive disorder were given adjuvant buspirone and placebo for 4 weeks each.
      There were no significant differences between buspirone and placebo in obsessive
      compulsive, depressive, or anxiety symptoms.

PMID- 8480833
TI  - Buprenorphine versus heroin dependence: comparison of toxicologic and
      psychopathologic characteristics.
AB  - Sociodemographic, toxicologic, and psychopathologic characteristics of 22
      buprenorphine addicts and 45 heroin addicts admitted for inpatient detoxification
      were compared. Although the buprenorphine addicts were older, clinically
      significant differences were not apparent. The availability of buprenorphine may
      be the main reason for its abuse.

PMID- 8480834
TI  - Self-induced water intoxication treated with group psychotherapy.
AB  - The authors conducted a controlled, prospective 4-month study of 10 male
      inpatients with chronic schizophrenia and polydipsia. The five men who were
      treated with group psychotherapy drank significantly less fluid than the five men
      not given this therapy. The effect of group psychotherapy quickly dissipated in
      the follow-up period, indicating the need for ongoing treatment.

PMID- 8480835
TI  - Development of obsessive-compulsive symptoms during clozapine treatment.

PMID- 8480836
TI  - Interaction between fluoxetine and neuroleptics.

PMID- 8480837
TI  - Detectable levels of fluoxetine metabolites after discontinuation: an unexpected
      serotonin syndrome.

PMID- 8480838
TI  - Precipitation of dystonia by m-CPP in a schizophrenic patient treated with
      haloperidol.

PMID- 8480839
TI  - HLA and panic disorder.

PMID- 8480840
TI  - Ultrashort noninvasive opiate detoxification.

PMID- 8480842
TI  - Treatment with drugs and drug testing.

PMID- 8480841
TI  - Allegations of abuse in psychotic patients.

PMID- 8480843
TI  - Multiple personality disorder in Europe.

PMID- 8480844
TI  - Panic as a posttraumatic stressor.

PMID- 8480845
TI  - Panic as a posttraumatic stressor.

PMID- 8480846
TI  - CPM in polydipsic psychiatric patients.

PMID- 8480847
TI  - Serotonin and Parkinson's disease.

PMID- 8480848
TI  - Buspirone, anxiety, and sleep.

PMID- 8480849
TI  - Differences in late- and early-onset schizophrenia.

PMID- 8480850
TI  - Psychotherapy and borderline personality disorder.

PMID- 8480851
TI  - Women in academic psychiatry and research.

PMID- 8480852
TI  - AIDS policy: position statement on confidentiality, disclosure, and protection of
      others. Commission on AIDS.

PMID- 8480853
TI  - AIDS policy: guidelines for inpatient psychiatric units. Commission on AIDS.

PMID- 8480854
TI  - Hemoglobin catabolism and host-parasite heme balance in chloroquine-sensitive and
      chloroquine-resistant Plasmodium berghei infections.
AB  - Catabolism of host hemoglobin by the malaria parasite liberates required amino
      acid precursors, but is also releases large amounts of potentially toxic heme
      that accumulates in parasite food vacuoles during intra-erythrocytic development.
      The schizonticidal drug chloroquine binds to free heme with high affinity and is
      concentrated in parasite food vacuoles. To better understand the disposition of
      heme within the host-parasite complex, we studied the balance of hemoglobin and
      heme in Plasmodium berghei-infected reticulocytes in the rat and compared this
      process in chloroquine-sensitive (CS) and chloroquine-resistant (CR) parasites.
      We found that CS P. berghei parasites have 1.5-fold more heme than CR parasites
      isolated from rats, and that CS P. berghei-infected reticulocytes accumulate more
      chloroquine than CR P. berghei-infected reticulocytes. Despite these differences
      in parasite heme content, the decrease in host cell hemoglobin content and the
      rate of free amino acid generation within the host-parasite complex is similar in
      CS and CR P. berghei-infected rat reticulocytes. The heme content of the infected
      reticulocyte-parasite complex decreases with increasing parasitemia but to a
      lesser extent than expected for the decrease in hemoglobin. Furthermore, the
      decrease in host-parasite heme is accelerated in the CR P. berghei infection
      compared with the CS P. berghei infection. Therefore, hemoglobin catabolism by
      malaria parasites is associated with the overall loss of heme from the host
      parasite complex and with variable deposition of heme within parasites.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480855
TI  - Oxidative stress and Trichomonas vaginalis: the effect of hydrogen peroxide in
      vitro.
AB  - The oxidative stress response induced in Trichomonas vaginalis by exposure to
      various concentrations of hydrogen peroxide (H2O2) was traced by metabolic
      labeling and monitored by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis and fluorography of trichloroacetic acid-precipitated proteins.
      Concentrations of H2O2 > 450 microM decreased incorporation of radiolabel into
      protein and altered protein synthesis resulted in a banding pattern similar to
      the heat shock protein profile. The proteins produced by oxidative stress
      included molecules with average molecular masses of 145-165, 92-84, 66, 43-46,
      and 35-36 kD. Oxidative stress induced changes in T. vaginalis protein synthesis
      slowly. Full conversion to oxidative stress response occurred within 150-180 min
      after stress initiation. The oxidative stress responses of three strains freshly
      initiated from stabilates were compared with the responses of the same strains
      cultured in vitro for extended periods (culture adapted). Both freshly initiated
      and culture adapted T. vaginalis of the three strains synthesized the 92-84- and
      66-kD heat shock proteins but differed in the synthesis of the 74-75-, 43-, and
      35-36-kD molecules. Culture adaptation did not modify the oxidative stress
      response of the three strains tested.

PMID- 8480856
TI  - Induction of adhesiveness in human endothelial cells by Plasmodium falciparum
      infected erythrocytes.
AB  - Cytoadhesion of infected erythrocytes to endothelium plays an important role in
      the pathogenesis of Plasmodium falciparum malaria. In vitro assays of
      cytoadhesion have helped to identify putative host ligands, namely
      thrombospondin, platelet glycoprotein IV (CD36), and intercellular adhesion
      molecule-1 (CD54) as possible mediators of cytoadhesion. However, the presence of
      these ligands on some host cells to which infected erythrocytes do not adhere
      raises the possibility that other molecules or factors may be involved. In the
      present study, we investigated the effects of prolonged incubation of endothelial
      cells (EC) with infected erythrocytes on adhesiveness of EC. We also studied the
      effects of tumor necrosis factor (TNF), interleukin-1 (IL-1), and phorbol
      myristate acetate (PMA). We found that when EC were incubated in contact with
      ring-infected erythrocytes for 24 hr during which the rings developed into
      trophozoites, adhesiveness was enhanced up to 250%. Incubation of EC with IL-1 or
      TNF for 12 hr increased adhesiveness by 50% at minimum doses of 5 U/ml and 50
      U/ml, respectively, while PMA decreased adhesiveness in a consistent and dose
      dependent manner. These results show that host EC adhesive ligands for infected
      erythrocytes can be induced, most notably by direct contact between the EC and
      infected erythrocytes containing developing parasites. The cultured human EC used
      in this study lacked surface CD36 detectable by immunofluorescence assay,
      suggesting that CD36 is not required for endothelial adhesiveness.

PMID- 8480857
TI  - Biology and pathology of Schistosoma mansoni and Schistosoma japonicum infections
      in several strains of nude mice.
AB  - Schistosoma mansoni and S. japonicum infections in nude mice (nu/nu) were
      compared with infections in nu/+ heterozygotes or intact mice. Seven to 12 weeks
      after exposure to S. mansoni, the responses of Swiss NCR, C3H, BALB/c and C57B1/6
      nude mice did not differ substantially. Nude mice of all these strains showed
      minute granulomas around eggs in the liver and minimal hepatic fibrosis.
      Microvesicular and necrotizing changes in hepatocytes were similar in all mouse
      strains, and S. mansoni infections were frequently lethal to nude, but not to
      intact mice between the seventh and ninth weeks of infection. Nude mice that
      survived the ninth week of infection generally lived until the 12th week. The
      number of eggs per mature worm pair in the tissues of S. mansoni-infected nude
      mice was similar to the number in intact mice, but nude mice passed fewer eggs in
      the feces. Nude mice that received serum from infected intact mice excreted eggs
      in the stool in numbers equivalent to intact mice, but continued to form minute
      granulomas around S. mansoni eggs. Reconstitution with fetal thymus or with
      splenocytes from normal or S. mansoni-infected mice partially or completely
      restored hepatic granuloma size, granuloma eosinophils, hepatic fibrosis, and
      excretion of eggs in the feces. In contrast to S. mansoni infection, S. japonicum
      infections in nude mice did not cause necrosis of hepatocytes or excessive
      mortality, and S. japonicum eggs were passed in the feces in numbers equivalent
      to those passed by infected intact mice.

PMID- 8480858
TI  - Differential sequestration of parasitized erythrocytes in the cerebrum and
      cerebellum in human cerebral malaria.
AB  - Sequestration of parasitized red blood cells (PRBC) in the microvessels results
      in impairment of microcirculation with organ dysfunction in complicated human
      Plasmodium falciparum malaria. In cerebral malaria patients, the percentage of
      small blood vessels with PRBC sequestration is higher in the brain than in other
      organs. The clinical severity of cerebral malaria depends on the level of PRBC
      sequestration in the brain. In our study, postmortem samples from cerebrum and
      cerebellum of 16 patients who died of P. falciparum malaria were examined and
      compared using light microscopy. In the cerebellum, the percentage of
      microvessels with PRBC sequestration was higher than that in the cerebrum. The
      difference in sequestration rates between cerebrum and cerebellum is
      statistically significant (P < 0.05). There is a higher degree of vascularity in
      the cerebellum (7 vessels/mm2) than in the cerebrum (5 vessels/mm2), and the
      difference is also statistically significant (P < 0.025). Perivascular
      hemorrhages also occur more frequently in the cerebellum than in the cerebrum.
      The results of this study, which show that differential sequestration of PRBC
      occurs in the microvessels of the cerebrum and cerebellum, explain the varied
      neurologic manifestations that result from cerebral and cerebellar dysfunction in
      human cerebral malaria. This study also reveals the necessity of postmortem
      histologic examination of the cerebellum in every suspected case of cerebral
      malaria.

PMID- 8480859
TI  - Development of in vitro parameters of cell-mediated immunity in the course of
      human cutaneous leishmaniasis infection.
AB  - The goal of the present study was to determine whether a correlation between the
      clinical stage of cutaneous leishmaniasis lesions and in vitro parameters of cell
      mediated immunity could be established. For this purpose, we measured lymphocyte
      proliferation, using a total lymphocyte proliferation (TLP) blood assay, and
      leishmanicidal effector activity using peripheral blood mononuclear cells (PBMC)
      in a three-day assay. The parameters of leishmanicidal activity measured included
      percent infected monocytes and number of amastigotes per 100 infected monocytes
      24 and 72 hr after infection. Three groups of people were studied: a group of
      patients in the course of the disease, a group of immune individuals, and
      unexposed controls. The results of the study suggested that the ability of PBMC
      to kill parasites increased in patients as the lesions cured, and was highest in
      immune individuals. In contrast, the TLP response once positive, did not increase
      after cure. In approximately 30% of the patients who were retested on several
      occasions during the course of the disease, a positive response reversed to
      negative both in the TLP and the effector assays while the lesions were still
      active. In approximately 50% of these cases, the response eventually became
      positive again. The data presented show that effector activity and proliferation
      correlate with immunity, and suggest that marked heterogeneity characterizes the
      immune response in the course of active disease.

PMID- 8480860
TI  - Enhancement of resistance to Cryptosporidium parvum by pooled bovine colostrum
      during murine retroviral infection.
AB  - The therapeutic efficacy of pooled bovine colostrum for the control of
      cryptosporidiosis was investigated during murine acquired immunodeficiency
      syndrome in female C57Bl/6 mice. Mice were infected with LP-BM5 murine leukemia
      retrovirus for four months and then inoculated with Cryptosporidium parvum
      oocysts. Persistent cryptosporidiosis was established in all retrovirus
      immunosuppressed mice, while control mice were refractory to infection. Parasite
      colonization of intestinal villi was significantly (P < 0.05) reduced in
      immunosuppressed animals that received dietary supplemental pooled bovine
      colostrum compared with to those that did not receive colostrum treatment.
      Similarly, shedding of oocysts in the feces of immunosuppressed animals that
      received dietary pooled bovine colostrum was significantly (P < 0.05) reduced
      compared with those that did not at 26 days post-parasite challenge. Since the
      nonimmune bovine colostrum contained no anti-Cryptosporidium antibodies, this
      suggests that passively transferred antibodies alone are unlikely to have
      provided the improved resistance shown in this study.

PMID- 8480861
TI  - Leishmania donovani parasites in the nasal secretions, tonsillopharyngeal mucosa,
      and urine centrifugates of visceral leishmaniasis patients in Kenya.
AB  - In the early 1930s, investigators of visceral leishmaniasis stated that Leishman
      Donovan bodies are found in body fluids of kala-azar patients, for example, in
      urine, feces, semen, and nasal and pharyngeal secretions. Based on this finding,
      we investigated the diagnostic potential of nasal secretions, tonsillopharyngeal
      mucosal swabs, and urine centrifugates inoculated into Schneider's Drosophila
      Medium (containing antibiotics and antifungal agents) as well as with Giemsa
      stained smears. Consequently, 64 randomly selected patients with visceral
      leishmaniasis from Kenya (59 who were splenic culture or Giemsa stain positive
      and five who were culture negative but Giemsa stain positive) were tested by
      three noninvasive methods. These tests were all performed before the patients
      were treated with Pentostam. Cultures of nasal and tonsillopharyngeal swabs and
      urine centrifugates produced 28 positive samples representing 24 patients
      (37.5%). Moreover, a set of 25 Giemsa-stained slide smears made from the nasal
      and tonsillopharyngeal mucosa of 25 patients with visceral leishmaniasis who had
      not tested positive in cultures produced nine positives. Therefore, the overall
      total of patients who tested positive by all of the above methods was 33 or
      51.6%. The cryopreserved Leishmania isolates were characterized by cellulose
      acetate electrophoresis using 20 enzyme systems. The isoenzyme profiles produced
      by the parasites were represented in five different L. donovani s.l. zymodemes.
      Representatives of these isolates were also characterized by DNA Southern
      blotting analysis, which corroborated the isoenzyme results.

PMID- 8480862
TI  - Immunodiagnosis of human dirofilariasis in Puerto Rico.
AB  - A seroepidemiologic study was carried out in humans inhabiting southeastern
      Puerto Rico, the area on this island with highest prevalence of canine heartworm,
      to detect the presence of antibodies to Dirofilaria immitis. Three hundred serum
      samples were analyzed by enzyme-linked immunosorbent assay (ELISA) using somatic
      antigens of the adult worm. Serum samples from eight patients were positive for
      anti-dirofilarial IgG. These patients had a mean age of 54 years. Although the
      study population had a female: male of 2.5:1, six out of the eight positive sera
      were from males. The minimum prevalence of human dirofilariasis was
      conservatively estimated to be 2.66%. After Western blot analysis of positive
      sera, four polypeptide markers with M(r) values of 15, 33, 42, and 69 kD were
      selected as potential immunologic markers for this human infection. Three of them
      (15, 33, and 69 kD) were specifically reactive only with ELISA-positive sera. The
      42-kD polypeptide reacted strongly with ELISA-positive sera, although it reacted
      weakly with some of the ELISA-negative controls. The 15-, 33-, and 69-kD
      polypeptides were recognized by positive sera in several combinations, but only
      those sera with the highest ELISA optical density values reacted with all three
      polypeptides.

PMID- 8480863
TI  - A case of intestinal capillariasis in the Republic of Korea.
AB  - In 1991, we observed a Korean man infected by Capillaria philippinensis who had
      no history of traveling in known endemic areas. He had year-long diarrhea with
      severe loss of body weight. He enjoyed hunting and fishing and eating raw meat of
      game animals and fish. An open full-thickness biopsy of the ileum showed flat
      mucosal surface and sections of the round worm, and fecal examination revealed
      numerous elliptical helminth eggs. The worms and eggs were consistent with
      features of C. philippinensis. He was treated with albendazole and was cured.
      This is the first known case of intestinal capillariasis in the Republic of
      Korea.

PMID- 8480864
TI  - Child growth, nutritional status, and schistosomiasis japonica in Jiangxi,
      People's Republic of China.
AB  - The association between schistosomiasis japonica and nutritional status and child
      growth was studied cross-sectionally in 239 males and females (age range 4-19.9
      years) residing in Jishan Island in Po Yang Lake in an endemic region of Jiangxi,
      China. The presence of Schistosoma japonicum eggs in Kato stool smears and the
      intensity of schistosomiasis as assessed by quantitative egg count were
      determined, as were the presence of hookworm, Ascaris, and Trichuris eggs.
      Anthropometric measures included stature, weight, weight-for-height, upper arm
      muscle area, and the sum of triceps and subscapular skinfold thickness. The
      association between schistosomiasis and nutritional status and growth was
      analyzed with multivariable models adjusted for the influence of age, age2, and
      polyparasitism. The prevalence of schistosomiasis was approximately 70% in both
      males and females. Current schistosomiasis and its intensity were significantly
      related to reduced stature, weight, weight-for-height, and the sum of skinfolds
      (all P < 0.01) in females across the entire age-span. The greatest age-specific
      differences were during adolescence in females: 4 cm in height and 5 kg in
      weight. In males, intensity of schistosomiasis was related (P < 0.03) only to the
      sum of skinfolds. The cross-sectional associations between anthropometric
      reductions and schistosomiasis japonica in childhood and adolescence indicate a
      strong independent effect of infection on malnutrition and growth in this
      population from a highly endemic region of China.

PMID- 8480865
TI  - Etiology of hypoferremia in a recently sedentary Kalahari village.
AB  - To determine the etiology of hypoferremia in recently sedentary hunter-gatherers,
      a community located in the Kalahari Desert of Botswana was studied. Iron profiles
      of 106 Basarwa (Bushmen, San) volunteers were examined. Hematocrits were measured
      in the field. The remaining blood was processed for transportation to a research
      medical laboratory for further studies. Subnormal serum iron values were present,
      depending on the subpopulation, in 50-52% of the volunteers. Transferrin
      saturation was subnormal in 35-49% of those tested. The absence of subnormal
      serum ferritin levels indicates that dietary iron deficiency is not the cause of
      the hypoferremia. Instead, serum ferritin was greater than 50 micrograms/l (a
      level indicative of anemia of chronic disease/inflammation) in 92% of the
      hypoferremic adult Basarwa. We suggest that by depriving microbes of needed iron,
      the frequency of the anemia of infections and chronic disease in this population
      might be a response to, and defense against, a chronically high pathogen load in
      a community that has not yet incorporated sanitation practices appropriate for
      sedentary aggregations.

PMID- 8480866
TI  - Comparison of human trichinellosis caused by Trichinella spiralis and by
      Trichinella britovi.
AB  - The first documented report of an outbreak of human trichinellosis caused by
      Trichinella spiralis in Italy is described. Two family groups were involved. The
      source was wild boar meat products. The principal clinical features were fever
      (60%), myalgia (50%), and diarrhea (40%). The most useful laboratory indicators
      were eosinophilia (100%), elevated levels of creatine phosphokinase (CPK) (90%)
      and other muscle enzymes, parasite-specific IgG titers (100%), and anti-newborn
      larvae antibodies (30%). The levels of these responses correlated with the number
      of infective muscle larvae ingested, which was influenced by the length of time
      the ingested meat was cured. The clinical and biological features observed during
      human infection with T. spiralis appear to have been different from those
      reported during two outbreaks due to T. britovi, which occurred in southern
      Italy. The main distinctions between the two types of infections were a longer
      duration of parasite-specific IgG, increased CPK levels, and a more severe
      intestinal symptomatology in T. spiralis-infected patients than in those infected
      with T. britovi.

PMID- 8480867
TI  - Transmission of Crimean-Congo hemorrhagic fever virus in two species of Hyalomma
      ticks from infected adults to cofeeding immature forms.
AB  - Crimean-Congo hemorrhagic fever (CCHF) virus was transmitted from infected adult
      Hyalomma ticks to uninfected larval and nymphal Hyalomma ticks while cofeeding on
      a guinea pig host that did not have a detectable viremia. When tested after
      feeding with infected adults, three (0.8%) of 370 H. truncatum larvae contained
      detectable CCHF virus (mean virus titer 10(1.6) plaque-forming units [PFU]/tick).
      The virus was transmitted transstadially from infected larvae and was detected in
      15 (1.2%) of 1,253 nymphs and 12 (0.1%) of 2,049 adults. Virus was recovered from
      18 (1.9%) of 931 H. impeltatum nymphs, which originated from larvae that cofed
      with infected adults. After H. impeltatum nymphs cofed with infected adults, CCHF
      virus was detected in 21 (4.3%) of 449 (mean virus titer 10(1.7) PFU/tick) fed
      nymphs, but none of 886 adults tested after molt. Results of this study indicate
      that a small proportion of either larvae or nymphs may acquire CCHF infection
      while cofeeding on a host without a detectable viremia.

PMID- 8480868
TI  - Treatment of subperiodic Brugia malayi infection with a single dose of
      ivermectin.
AB  - A clinical trial on the efficacy of a single oral dose of ivermectin at 20, 50,
      100, and 200 micrograms/kg was carried out in 40 subjects with subperiodic Brugia
      malayi microfilaremia. There was no significant difference in the clearance of
      microfilaremia in the four treatment groups, and the lowest geometric mean
      microfilarial count (GMC) achieved in the 40 subjects was 8.8/ml or 8.3% of the
      initial count (106.1/ml), at two weeks post-treatment. The GMC started to
      increase at one month post-treatment and by six months was 22.2% of the initial
      GMC. Only 27.5%, 23.1%, 15.0%, and 18.9% of subjects were amicrofilaremic at two,
      four, 12, and 24 weeks post-treatment, respectively. Mild fever in 35% of the
      subjects was the primary side reaction and was more common in those with
      microfilarial counts > or = 500/ml (85.7%) than in those with counts < 500/ml
      (32%). The clearance of B. malayi microfilaremia by ivermectin was less rapid
      than that reported for Wuchereria bancrofti. The smaller number of side reactions
      encountered in the present study compared with those reported for bancroftian
      filariasis is probably related to the lower microfilarial density in the present
      subjects. Since ivermectin at a single oral dose of 20-200 micrograms/kg can
      reduce the GMC to less than 10% at two weeks and maintain it below 25% of the
      initial level even at six months post-treatment, it is recommended that the drug
      be seriously evaluated for use in the control of brugian filariasis.

PMID- 8480869
TI  - Proceedings of the NIH Consensus Development Conference on Gallstones and
      Laparoscopic Cholecystectomy. Bethesda, Maryland, September 14-16, 1992.

PMID- 8480870
TI  - National Institutes of Health Consensus Development Conference Statement on
      Gallstones and Laparoscopic Cholecystectomy.

PMID- 8480871
TI  - Natural history of asymptomatic and symptomatic gallstones.
AB  - Review of the sparse literature on the prognosis of asymptomatic and mildly
      symptomatic gallstones reveals a diversity of methods, definitions, and groups of
      patients studied, which makes it difficult to draw conclusions. It appears that
      serious symptoms and complications develop in about 1% to 2% of patients with
      asymptomatic gallstones annually, with fewer complications developing in later
      years than in years soon after gallstones are discovered. In patients with stones
      with mild symptoms, rates of the development of complications are perhaps a
      little higher, about 1% to 3% per year. In patients who are initially mildly
      symptomatic, cholecystectomy for severe symptoms probably is undertaken in 6% to
      8% per year in the early years, decreasing with longer follow-up. Other than
      symptoms, no factors related to prognosis have been established. Acute
      cholecystitis is the most common severe complication of gallstones. Based on
      follow-up studies, obstructive jaundice, cholangitis, pancreatitis, and cancer of
      the gallbladder are infrequent complications. Risk of subsequent colon cancer
      should not ordinarily be a factor when cholecystectomy is considered. Analyses of
      cost-effectiveness have not demonstrated substantial differences in life
      expectancy between patients with asymptomatic gallstones who undergo immediate
      open cholecystectomy compared with watchful waiting.

PMID- 8480872
TI  - Clinical manifestations and impact of gallstone disease.
AB  - The main symptom of gallstone disease is biliary pain. Biliary pain is not
      necessarily colicky or postprandial, and it most frequently occurs at night
      during the same clock-time. The relief of biliary pain by cholecystectomy would
      support the idea that the gallbladder or the stones caused pain. Long-term follow
      up studies after cholecystectomy are infrequent, however. Our studies show that
      biliary pain is relieved in 99% of patients after 4 years of follow-up. The
      nonspecific symptoms associated with gallstones (i.e., dyspepsia, bloating,
      belching, etc.) remained in 12% of these patients. We have also shown that the
      gallbladder itself, without stones, can cause pain and that this biliary pain is
      relieved in 77% of patients by cholecystectomy. The impact of gallstones on the
      patient depends on the quality of cholecystectomy as classically measured by
      morbidity and mortality. However, quality must also be monitored by comparing the
      long-term relief of biliary pain and the cost. Quality cannot be monitored
      through inaccurate national databases or multicenter trials. Rather, the
      continuous quality improvement (CQI) technique of larger centralized health care
      systems may be the most accurate monitoring system. This technique coordinates
      the entire health care system by assuming that any process can improve its
      quality, no matter how good it may already be. Our CQI laparoscopic
      cholecystectomy database has yielded preliminary perspectives on accurate data
      collection and improving costs. After a thorough examination, 5% of the database
      contained cases not done laparoscopically (coding errors), whereas it missed 21%
      of true laparoscopic cholecystectomy cases (staff errors). Only with the
      accuratized database were we able to provide insight into cost-savings
      procedures.

PMID- 8480873
TI  - Pathogenesis of gallstones.
AB  - Gallstones form as a result of many disorders. Unphysiologic supersaturation,
      generally from hypersecretion of cholesterol, is essential for the formation of
      cholesterol gallstones. The other common abnormalities of the hepatobiliary
      system in gallstone patients are accelerated nucleation, gallbladder
      hypomotility, and the accumulation of mucin gel. An attempt is made here to
      relate hypersecretion of cholesterol and biliary supersaturation to the molecular
      basis of the associated phenomena. Supersaturation of bile with calcium hydrogen
      bilirubinate, the acid calcium salt of unconjugated bilirubin, is essential for
      pigment gallstone formation, but its magnitude remains undefined in model
      systems. Nucleation and the precipitation of calcium hydrogen bilirubinate with
      the polymerization of the pigment in the gallbladder, together with the
      deposition of the inorganic salts, calcium carbonate and phosphate, result in
      black pigment gallstone formation. On the basis of ex vivo muscle studies,
      gallbladder hypomotility is unlikely in patients with black pigment stones but is
      invariably present in patients with cholesterol stones. Pigment supersaturation
      in the gallbladder is the result of hepatic hypersecretion of bilirubin
      conjugates in hemolytic disorders and possibly enterohepatic cycling of
      unconjugated bilirubin in nonhemolytic states. Less common is bile salt
      hyposecretion from impaired synthesis in constitutional disorders and cirrhosis,
      and uncompensated interruption of the enterohepatic circulation in ileal
      dysfunction syndromes. Bile salt deficiency causes incomplete solubilization of
      unconjugated bilirubin and impaired binding of calcium ions. Stasis and anaerobic
      bacterial infection are responsible for brown pigment stones, which usually form
      in the bile ducts. In addition to the precipitation of calcium hydrogen
      bilirubinate that remains unpolymerized, there is also the deposition of the
      calcium salts of saturated fatty acids and free bile acids, both of which are the
      result of bacterial enzymatic hydrolysis of biliary lipids.

PMID- 8480874
TI  - Overview of therapeutic modalities for the treatment of gallstone diseases.
AB  - The management of gallstone diseases has been revolutionized in less than 2 years
      by the advent of laparoscopic cholecystectomy (LC). However, the rapid adoption
      of LC has occurred without comparative randomized trials with other available
      therapies. Thus, the evaluation of LC versus other therapies can only be based on
      case series. The criteria used for this evaluation are clinical effectiveness,
      cost-effectiveness, and the patient's level of acceptance and satisfaction with
      the procedure. The techniques of both LC and open cholecystectomy (OC) have the
      advantage over other approaches, such as extracorporeal shock-wave lithotripsy or
      bile acid therapy, of eliminating not only the gallstones but also the
      gallbladder, thereby preventing recurrence of the disease. Additionally, medical
      therapies are effective in only a subgroup of patients. Since the complications
      of surgery are more frequent and more severe in older patients and, due to life
      expectancy, the risk of recurrence is lower in this population, cost
      effectiveness analyses have shown that medical therapies may be preferable in
      older patients in the subgroup eligible for the respective medical therapies.
      Compared with OC, LC results in a reduction in hospital stay and time to return
      to work, in lower cost, and in higher patient satisfaction with the procedure.
      However, a major concern with the laparoscopic approach has been an increase in
      the incidence of bile duct injury, particularly during the learning phase of the
      procedure. Clearly, this problem must be solved. The development of training
      courses in laparoscopy and the adoption of rigorous criteria for ductal
      identification are critical in preventing such injuries. Bile duct injury can
      probably be reduced at least to the level of OC (about 1 in 1,000). Acute
      cholecystitis may also be treated by LC, but the safety and timing of surgery
      should be conclusively evaluated. Patients with gallbladder stones and
      choledocholithiasis are usually treated by endoscopic sphincterotomy either
      before or soon after laparoscopic surgery. Laparoscopic techniques of common bile
      duct exploration that will obviate the need for endoscopic sphincterotomy are in
      the developmental stages. When such a technique is available, comparative trials
      with endoscopic sphincterotomy will be necessary to assess the best approach.

PMID- 8480875
TI  - Oral and contact dissolution of gallstones.
AB  - The appropriate selection of patients for treatment with oral ursodeoxycholic
      acid (UDCA)--a drug that has virtually no side effects--results in about 50% of
      patients experiencing safe dissolution of gallstones within 2 years. Eligible
      patients have small (less than 20 mm in diameter) radiolucent gallstones in a
      gallbladder visualized by oral cholecystography (OCG); ideal candidates are thin
      women who have gallstones that are less than 15 mm in diameter, floating when
      observed by OCG, or of low density on computed tomographic (CT) scanning. Contact
      dissolution with methyl tert-butyl ether (MTBE) is rapid, effective more often
      than UDCA, and safe but requires the expertise of an interventional radiologist.
      Any size and number of cholesterol gallstones that are not CT-dense will be
      dissolved by MTBE, leaving at most only insoluble debris that is clinically
      innocuous. Although gallstones recur after dissolution by UDCA or MTBE in 50% of
      patients within 5 years, recurrent gallstones are usually asymptomatic and/or can
      probably be dissolved. We conclude that oral or contact dissolution provides an
      alternative treatment to cholecystectomy for about 30% of patients with
      symptomatic gallstones.

PMID- 8480876
TI  - Gallstone lithotripsy.
AB  - Extracorporeal shock-wave lithotripsy (ESWL) has been applied to patients with
      gallstones since the mid-1980s. Lithotriptors differ by their means of shock-wave
      generation, the mechanisms by which they are coupled to the patient, and their
      imaging systems. Entry in most treatment protocols is limited to symptomatic
      patients with one to three radiolucent stones having a diameter of 30 mm or less
      and a functioning gallbladder according to oral cholecystography. Treatments are
      given on an out-patient basis using intravenous analgesia and include adjuvant
      bile acid therapy. Deaths have not been reported, and the incidence of serious
      complications, related to the presence of fragments in the biliary system, is
      low. The studies show that ESWL is a safe and effective treatment for patients
      with a single gallstone less than or equal to 20 mm in diameter, but the efficacy
      for larger single stones and multiple stones is poor. To date, the Food and Drug
      Administration has not approved lithotriptors for the treatment of gallstones in
      the United States.

PMID- 8480877
TI  - Open cholecystectomy.
AB  - The experience with "open" biliary tract surgery is documented in this report in
      an effort to provide a basis for comparison with the more recent experience with
      laparoscopic cholecystectomy. During the years 1932 through 1984, 14,232 patients
      were surgically treated for nonmalignant biliary tract disease at The New York
      Hospital-Cornell Medical Center. Among these patients, the mortality rate was
      1.7% (237 postoperative deaths). Cholecystectomy was performed in 10,749
      patients, and the mortality rate was 0.6% (60 postoperative deaths). Of this
      group of patients, chronic cholecystitis was present in 8,910 patients, and the
      mortality rate was 0.4% (38 postoperative deaths). Acute cholecystitis was
      present in 1,839 patients, and the mortality rate was 1.2% (22 postoperative
      deaths). Choledochotomy as a component of the primary biliary tract operation was
      performed in 2,226 patients (15.6%), and there were 89 postoperative deaths (4%).
      In the last 6 years of this study (1978 through 1984), 1,693 patients underwent
      cholecystectomy alone, and the mortality rate was 0.2% (3 postoperative deaths).

PMID- 8480878
TI  - Mini-lap cholecystectomy.
AB  - With the introduction of laparoscopic cholecystectomy, the surgical community
      witnessed a revolution in basic ideology. Gone are the days when surgeons spoke
      of wounds healing "from side to side, and not top to bottom." The surgical
      community has become aware of the concept of minimally invasive surgery. Despite
      this recent advance, surgeons have long realized that the surgical wound does
      contribute to morbidity and mortality. The mini-lap cholecystectomy, described as
      early as 1982, is an indication that surgeons are making an attempt to reduce
      this morbidity. Mini-lap cholecystectomy is now being suggested as an alternative
      to laparoscopic cholecystectomy--a technique that boasts many of the same
      benefits without the problems inherent in laparoscopic surgery. The author has
      reviewed the literature for mini-lap cholecystectomy, laparoscopic
      cholecystectomy, and conventional cholecystectomy. Using this "historical"
      database, he then compares the three techniques to determine whether mini-lap
      cholecystectomy is a viable alternative.

PMID- 8480879
TI  - Laparoscopic cholecystectomy: the European experience.
AB  - Laparoscopic cholecystectomy, initially performed in France in 1987, has rapidly
      spread to other European countries, the United States, and elsewhere. Of the
      techniques that have evolved, the "French" technique, in which the surgeon stands
      between the patient's legs, and the "American" technique, in which the surgeon
      stands on the patient's left side, are the most commonly used. In the former
      technique, the liver is retracted via the mid-clavicular cannula and the
      infundibulum of the gallbladder via the anterior axillary port. In the latter
      technique, the liver is retracted by axial traction on the gallbladder through
      the anterior axillary cannula and the infundibulum through the mid-clavicular
      cannula. This position may increase the risk of bile duct injury. The technique
      selected for operative cholangiography should be adapted to the problem at hand.
      Cystic duct cholangiography shows ductal calculi more reliably due to better
      filling of the common bile duct; direct puncture of the gallbladder is safer when
      the biliary anatomy is unclear. A number of European studies confirm the safety
      of laparoscopic cholecystectomy. Mortality rates vary between 0% and 0.1%, and
      duct injury rates range between 0.2% and 0.6%. Conversion, which is done in 3% to
      8% of cases, may be necessary in the case of uncontrollable hemorrhage, bile duct
      injury unsuitable for laparoscopic repair, or if the gallbladder is densely
      scarred (scleroatrophic). It can also be done for safety reasons, when the
      anatomy is unclear. Complications include bile collections due to accessory duct
      or cystic duct stump leaks or less commonly to common duct injury. The average
      postoperative stay is longer in Europe (3.2 days) than in the United States. A
      decision tree is presented for the management of common bile duct stones. In
      general, preoperatively identified ductal stones are removed by endoscopic
      sphincterotomy, which is then followed by laparoscopic cholecystectomy to remove
      the source of the calculi. The techniques of laparoscopic choledochotomy and
      transcystic exploration for the removal of stones in the common bile duct are
      only beginning to be used, but they may well prove to be the most popular
      procedures. Results with these procedures will need to be evaluated against those
      obtained with endoscopic sphincterotomy.

PMID- 8480880
TI  - U.S. experience with laparoscopic cholecystectomy.
AB  - Thirteen published series concerning laparoscopic cholecystectomy performed in
      the United States were reviewed. The review was based on reports that included at
      least 100 patients. Three of the series are surveys of surgery chairpersons and
      multiple hospitals. The other 10 series are based on the experience of the
      investigators. The operation was performed by trained and qualified surgeons,
      usually in females with early gallbladder and gallstone disease. The patient
      profiles were similar, and the outcomes were favorable. The incidence of
      complications and deaths was very low, but the rate of injury to the common bile
      duct was slightly higher in laparoscopic cholecystectomy than in open
      cholecystectomy. Intraoperative cholangiography can be performed selectively. The
      major benefits to the patient are a short hospital stay, early return to
      activity, and a reduced hospital bill.

PMID- 8480881
TI  - Laparoscopic versus open cholecystectomy: the Canadian experience. The McGill
      Gallstone Treatment Group.
AB  - Numerous uncontrolled trials have suggested that laparoscopic cholecystectomy
      (LC) is a major improvement over open cholecystectomy (OC). In an effort to
      objectively document the benefits of LC, two Canadian studies are reviewed. The
      first is a matched time series based on prospective data from a single surgeon's
      practice in which patients are closely matched for baseline characteristics. The
      groups consist of 121 patients from each of 3 time periods: 1989, prior to the
      introduction of LC; 1990, when LC was being introduced; and 1991, when LC had
      become the preferred method of cholecystectomy. The second study is a randomized
      trial, in which LC is compared with mini-cholecystectomy. In both studies, the
      superior efficacy of LC is demonstrated with respect to the duration of
      hospitalization and the duration of postoperative convalescence. The incidence of
      complications as well as their severity is also less in LC patients. Although
      quality of life improves after any type of cholecystectomy, LC patients improve
      faster and seem to accept the operation better. These studies support the
      widespread dispersion of LC in Canada, although comparative efficacy with
      nonsurgical alternatives has not been addressed.

PMID- 8480882
TI  - Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single
      center.
AB  - In this retrospective study, we compared the results of 1,283 open
      cholecystectomies (OCs) performed at our medical center during the pre
      laparoscopic era with 1,107 laparoscopic cholecystectomies (LCs) performed from
      1990 to 1992. There was no difference in the percentage of cases of acute and
      chronic cholecystitis in each time period (16.8% in each), nor were there
      differences in the patient characteristics for each group. The percentage of
      patients undergoing intraoperative cholangiography was similar for patients with
      chronic cholecystitis for each period, although the incidence of abnormal
      cholangiograms was lower in the laparoscopic era (5.8% versus 15.2%, p < 0.001).
      There was one bile duct injury in the OC group and three in the LC group
      (although one of these occurred after conversion ot an open procedure), but this
      difference was not statistically significant. However, there was a higher
      mortality rate in the patients with acute cholecystitis treated with OC (2.3%
      versus 0%, p = 0.03) and an increase in the overall complications in the patients
      with chronic cholecystitis in the OC group (7.5% versus 3.1%, p < 0.001) compared
      with the LC group. The increase in overall complications appeared to be primarily
      related to the increased rate of wound-related complications (3.6% versus 0%, p <
      0.001) in the patients with chronic cholecystitis in the OC group. LC appears to
      be a safe procedure with a low incidence of complications including bile duct
      injury when performed by adequately trained surgeons.

PMID- 8480883
TI  - Cost-effectiveness of laparoscopic cholecystectomy versus open cholecystectomy.
AB  - To assess the cost-effectiveness of laparoscopic cholecystectomy versus open
      cholecystectomy from the payer's perspective, we estimated the probabilities of
      potential outcomes of each procedure, associated quality-of-life effects, and
      related direct medical charges and incorporated these estimates into a
      computerized simulation model. The model projects that laparoscopic
      cholecystectomy will be more effective than open surgery in terms of total
      mortality and quality-adjusted survival, for both sexes and all ages. Projected 5
      year cumulative charges are lower for laparoscopic cholecystectomy than for open
      cholecystectomy ($5,354 versus $5,525 for 45-year-old women; $6,036 versus $6,830
      for 45-year-old men), and the differences increase substantially with increasing
      age. We concluded that laparoscopic cholecystectomy is likely to be less costly
      and more effective than open cholecystectomy for most patients, as long as it
      does not routinely require preoperative cholangiography and is not associated
      with increased professional fees or increased risks of retained stones or bile
      duct injury.

PMID- 8480884
TI  - The laparoscopic buck stops here!

PMID- 8480885
TI  - Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy.
AB  - Few laparoscopic surgeons currently explore the bile duct at cholecystectomy,
      which has focused attention on the role of preoperative endoscopic retrograde
      cholangiopancreatography (ERCP) in the diagnosis and treatment of duct stones.
      Indications for ERCP depend on the likelihood of duct pathology; clinical,
      biochemical, and radiologic predictive factors are well established. Expert
      endoscopists use ERCP sparingly, only in patients known or very likely to have
      duct stones, believing that the duct can be cleared after laparoscopic
      cholecystectomy (LC) when necessary in almost every case. Paradoxically, when the
      level of local ERCP expertise is modest, ERCP may be attempted before LC more
      often, thus leaving the option of open exploration if ERCP fails. ERCP is highly
      efficient in the management of patients with symptoms after LC in order to
      exclude, diagnose, and treat complications such as retained stones, cystic duct
      leaks, and strictures. Concern about performing sphincterotomy in young patients
      (especially those with normal-sized ducts) because of unknown long-term effects
      is leading some endoscopists to remove small stones through the intact papilla.
      Selected patients with gallbladder and duct stones may be best treated by
      endoscopic duct clearance alone, without cholecystectomy (unless or until
      symptoms develop). Overall, ERCP techniques are currently used in about 10% of
      patients before or after LC. Each surgical/endoscopic team should develop an
      algorithm to maximize the effectiveness of the combined approach and to minimize
      problems.

PMID- 8480886
TI  - Lithotripsy in the treatment of biliary stones.
AB  - Noninvasive or minimally invasive techniques for the treatment of biliary stones
      have been significantly advanced in the past two decades. The least invasive,
      extracorporeal shock-wave lithotripsy, continues to be used successfully, not
      only at its earliest reported site of use in Munich, Germany, but also in
      numerous other centers in the world. Lithotriptors that utilize a spark gap
      electrode or other sources of energy to generate sound waves and imaging by
      radiographic and ultrasonographic targeting of stones have proved to be effective
      in fragmenting biliary stones (90% to 95%) that are too large or otherwise
      inaccessible to removal by endoscopic papillotomy. Stone clearance (53% to 90%)
      may require successive treatments and the removal of debris by transendoscopic or
      surgical means. The mortality is low (0.5%), and the post-treatment course is
      relatively uncomplicated in an elderly, high-risk group of patients.

PMID- 8480887
TI  - Role of open choledochotomy in the treatment of choledocholithiasis.
AB  - In recent years, several less invasive procedures have challenged the preeminence
      of open choledochotomy in the management of patients with choledocholithiasis.
      Alternatives now include endoscopic sphincterotomy, extracorporeal shock-wave
      lithotripsy, percutaneous transhepatic stone extraction, and laparoscopic common
      duct exploration. In deciding whether an alternative is appropriate for an
      individual patient, factors to consider include the following: (1) the presence
      or absence of the gallbladder; (2) the severity of the presenting symptoms; (3)
      the results of open choledochotomy; and (4) local endoscopic, radiologic, and
      laparoscopic expertise. Review of available data suggests that endoscopic
      sphincteroplasty is appropriate for older patients without a gallbladder and for
      those with severe toxic cholangitis. However, endoscopic sphincterotomy has not
      been proven to be worthwhile before open surgery. Open choledochotomy has been
      reported to have a mortality rate of less than 2%, leaving fewer than 5% of
      patients with retained stones. Since the introduction of laparoscopic
      cholecystectomy, treatment algorithms for patients with common duct stones have
      seldom included open choledochotomy. However, future prospective, randomized
      trials of the management of patients with choledocholithiasis should include open
      choledochotomy as the gold standard.

PMID- 8480888
TI  - Laparoscopic approach to common duct pathology.
AB  - The author reviews his experience with the laparoscopic management of common duct
      pathology and compares it with the experience of others as reported in the
      literature. Routine intraoperative cholangiography is advocated. A variety of
      methods of managing common duct stones laparoscopically is presented. These
      include balloon-catheter manipulation, fluoroscopically guided basket extraction,
      and choledochoscopic evaluation and removal of stones. The accumulated experience
      indicates that more than 90% of common duct stones can be removed
      laparoscopically via the cystic duct. This approach significantly reduces the
      need for either preoperative or postoperative endoscopic retrograde
      cholangiopancreatography. Although laparoscopic choledochotomy has been employed
      in a number of cases and can be performed with a high degree of safety and
      efficacy, it is needed only infrequently. This form of management results in
      decreased dependence upon T-tubes, thereby reducing postoperative morbidity and
      the length of hospitalization. A rational protocol for the management of common
      duct pathology is presented.

PMID- 8480889
TI  - Exposure, dissection, and laser versus electrosurgery in laparoscopic
      cholecystectomy.
AB  - The technical complications of laparoscopic cholecystectomy occur while creating
      the pneumoperitoneum, placing trocars, obtaining exposure, and performing the
      initial dissection of the cystic duct and artery. The errors most feared are
      intestinal injury, vascular injury, and common bile duct injury. Bile duct injury
      usually results from the misinterpretation of the extrahepatic biliary anatomy.
      Confusion is most likely if the gallbladder infundibulum is pushed superiorly and
      medially, pulling the common bile duct out from behind the duodenum and into line
      with the cystic duct and gallbladder. Other dissection errors resulting in bile
      duct injury include the failure to begin dissection on the gallbladder, routine
      dissection of the cystic duct all the way to the common bile duct, failure to
      identify anomalies of the cystic and hepatic ducts, failure to open all folds of
      the gallbladder infundibulum, and entrapment of a narrow common bile duct by a
      cystic duct clip "slid" too far proximally. Proper dissection strategy includes
      posterolateral traction on the gallbladder infundibulum and initiation of
      dissection at the most medial point where the gallbladder is clearly seen.
      Pedunculation of the gallbladder will reveal most ductal anomalies but should be
      supplemented with routine digital fluoroscopic cholangiography. The controversy
      over optimal sources for thermal dissection of the gallbladder has largely been
      resolved. Electrosurgical dissection is a more rapid, hemostatic, and economical
      dissection.

PMID- 8480890
TI  - Gallbladder and gallstone removal, open versus closed laparoscopy, and
      pneumoperitoneum.
AB  - Surgeons need to be aware of the various options available to remove enlarged
      gallbladders or gallstones lost during laparoscopic cholecystectomy. Every
      attempt should be made to recover stones that have escaped from a ruptured
      gallbladder during laparoscopic cholecystectomy, short of converting to
      laparotomy. Initial access to the peritoneal cavity can be safely accomplished
      using either a closed or an open technique. Ideally, surgeons should become
      facile with both procedures. Carbon dioxide (CO2) gas has emerged as the most
      practical agent for pneumoperitoneum during laparoscopic cholecystectomy.
      Surgeons should be knowledgeable about the physiologic and pathologic effects of
      CO2 gas.

PMID- 8480891
TI  - Routine versus selective intraoperative cholangiography.
AB  - Since its introduction 60 years ago, intraoperative cholangiography (IOC) has
      reduced the incidence of unnecessary common bile duct (CBD) explorations from 66%
      to less than 5%. However, the use of routine IOC during cholecystectomy remains
      controversial. Routine IOC during laparoscopic cholecystectomy reduces the
      incidence, level, and severity of bile duct injuries. Performing routine IOC with
      CBD exploration eliminates the need for postoperative endoscopic retrograde
      cholangiopancreatography or endoscopic sphincterotomy in the 1.4% to 3.5% of
      postoperative patients with abdominal pain or retained stones, thereby also
      eliminating the need for reoperation after failed endoscopic sphincterotomy. The
      financial cost of routine IOC is equal to or less than the cost of treating the
      severe bile duct injuries that are prevented as well as the cost of the work-up
      and treatment of patients with retained stones who have not had IOC. A policy of
      routine IOC sets operative priorities and improves the surgical skills that are
      necessary for laparoscopic transcystic duct CBD exploration.

PMID- 8480892
TI  - Laparoscopic management of acute cholecystitis.
AB  - The role of laparoscopic surgery in patients presenting with acute cholecystitis
      remains controversial. From September 1989 through August 1992, a total of 720
      patients underwent cholecystectomy. Ninety-six were unplanned admissions with a
      clinical diagnosis of acute cholecystitis. Laparoscopic surgery was attempted in
      83 patients. Thirteen individuals were not offered laparoscopy because of the
      surgeon's inexperience. Twenty-two (27%) patients required the laparoscopic
      procedure converted to an open laparotomy. The mean postoperative hospital stay
      for patients undergoing laparoscopic cholecystectomy was 3.3 days versus 6.8 days
      for the laparotomy group. There was no mortality and no bile duct or major
      vascular injuries in either group. The overall operative morbidity rate was
      16.9%. Laparoscopic cholecystectomy appears to be a safe and beneficial option in
      selected patients with acute cholecystitis. A low threshold for conversion to
      laparotomy appeared to be an important factor in maintaining a low incidence of
      operative complications. Several modifications to the technique of laparoscopic
      cholecystectomy have evolved over the 3-year study period and are described.

PMID- 8480893
TI  - Surgery for gallstone pancreatitis.
AB  - Operative intervention during an attack of biliary pancreatitis is an effective
      way to treat the associated biliary tract disease and prevent the development of
      future attacks. Laparoscopic cholecystectomy has now emerged as the procedure of
      choice to treat cholelithiasis, but the treatment of associated
      choledocholithiasis is not yet defined. There are currently two possible
      approaches to these patients: First, early endoscopic retrograde
      cholangiopancreatography (ERCP) to determine if stones are present within the
      bile duct and, if so, early endoscopic sphincterotomy. If this approach is
      followed, then laparoscopic cholecystectomy should be performed as soon as the
      acute symptoms have subsided. On the other hand, if ERCP is not performed early
      and there are no obvious signs of biliary obstruction, laparoscopic
      cholecystectomy should probably be performed just before the patient is
      discharged. By waiting 5 to 6 days after the onset of the attack, the chances of
      finding associated choledocholithiasis are minimized. At the time of laparoscopic
      cholecystectomy, a cholangiogram must be obtained. If choledocholithiasis is
      found, the common bile duct may be explored via laparoscopic techniques, the
      operation may be converted to an open procedure, or the patient may be scheduled
      for endoscopic sphincterotomy for the next day.

PMID- 8480894
TI  - Role of endoscopy in gallstone pancreatitis.
AB  - Early identification of those patients presenting with acute pancreatitis due to
      gallstone disease is important since emergency intervention may prevent the
      development of local and systemic complications. Urgent biliary surgery carries
      unacceptably high morbidity and mortality rates, but endoscopic retrograde
      cholangiopancreatography in experienced centers appears to be safe and is the
      optimal method for the diagnosis of bile duct stones. Two randomized controlled
      prospective trials have shown an advantage for endoscopic sphincterotomy and bile
      duct clearance compared with supportive therapy when performed within 24 to 72
      hours of admission in those patients whose symptoms are considered severe
      according to prognostic scoring systems.

PMID- 8480895
TI  - Effect of nonbiliary problems on laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy may be performed safely in most patients with
      symptomatic cholelithiasis. There are few absolute contraindications to
      laparoscopic cholecystectomy. Many relative contraindications exist, which relate
      to the surgeon's experience and the ability of the operating team to manage
      potential complications. Preoperative evaluation should assess the potential
      nonbiliary problems that affect the performance of laparoscopic cholecystectomy,
      including severe cardiopulmonary disease, coagulopathy, cirrhosis, and pregnancy.
      Since most therapeutic laparoscopic procedures are currently performed with a
      carbon dioxide (CO2) pneumoperitoneum, the physiologic effects of the elevated
      abdominal pressure and absorbed CO2 must be understood by the surgeon. Specific
      nonbiliary problems addressed in this review are cardiopulmonary disease,
      hypercortisolism, cirrhosis and portal hypertension, morbid obesity, previous
      abdominal surgery, and pregnancy.

PMID- 8480896
TI  - Complications of laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy is a safe and effective treatment of cholelithiasis
      in experienced hands. Mortality is rare. The Southern Surgeons Club data and
      several other recent large series indicate that major complications occur in less
      than 3% of patients. The most significant common complication is injury to the
      bile duct, for which the greatest risk factor is inexperience. Major biliary
      injury usually requires reoperations. Roux-en-Y hepaticojejunostomies, often
      multiple, are usually necessary for repair. The popularity of this technique
      continues, and further efforts should be focused on elimination of the learning
      curve for major biliary injury. If injuries do occur, they should be recognized
      early, and patients should be referred to centers experienced in their treatment.

PMID- 8480897
TI  - Complications after laparoscopic cholecystectomy.
AB  - After becoming alarmed about seven unusual and severe complications reported by
      New York State hospitals after laparoscopic cholecystectomy, the Department of
      Health of New York State tabulated all reported adverse incidents. After
      observing unusual injuries to the great vessels of the abdomen and an increase in
      major bile duct injury during laparoscopic cholecystectomy, the Department of
      Health prepared a memorandum to New York State hospitals advising closer
      attention to education, credentialing, proctoring, and outcome after these
      operations. The frequency of cholecystectomy has increased sharply, by 21%, since
      the advent of laparoscopic cholecystectomy. The serious injury rate may be
      approximately 15 times that observed after an open cholecystectomy. Recognizing
      the theoretic advantages of the procedure, the Department of Health reminded
      hospital Boards of Trustees of their obligation to establish mechanisms for
      credentialing and privileging surgeons and surgical teams so that the risks do
      not exceed those expected of the open procedure and to detect and correct
      deviations from this standard.

PMID- 8480898
TI  - Registry of laparoscopic cholecystectomy and new and evolving laparoscopic
      techniques.
AB  - To collect information on the rapid application of laparoscopic surgery, the
      National Laparoscopic Surgery Registry surveyed more than 4,000 of the 16,000
      currently practicing laparoscopic surgeons. Preliminary analysis of the data has
      revealed that most of the respondents had been trained in general surgery, but a
      small percentage were certified only in surgical subspecialties. Surgeons
      acquiring skills in laparoscopic surgery had various levels of experience ranging
      from less than 1 year to more than 38 years in surgical practice. Nearly 90% of
      the respondents attended a laparoscopic cholecystectomy course with hands-on
      training. In those courses, an average of 16 hours was devoted to animal
      laboratories for acquisition of skills. Additional training in the form of a
      preceptorship is being undertaken by an increasing number of surgeons. The future
      of minimally invasive surgery is being supported by rapid advances in technology.
      New video systems capable of displaying three-dimensional images and miniaturized
      fiberoptic scopes are now available. Computer enhanced three-dimensional
      ultrasound images provide the surgeon with the ability to examine the content and
      consistency of tissues in addition to their appearance. Advances in mechanical
      retraction may eliminate the need for carbon dioxide insufflation of the abdomen.
      Tissue repair using tissue glues or laser-mediated processes may reduce the need
      for endocavitary suturing. These advances in technology and techniques may reduce
      the morbidity and mortality of these surgical procedures and, ultimately, improve
      the standard of care for surgical patients.

PMID- 8480899
TI  - [The role of clonidine in anesthesia].
AB  - For decades the adrenergic alpha2 agonist clonidine has been considered to be one
      of the classical, centrally acting antihypertensive agents. In addition to its
      antihypertensive and sympathicolytic effects, in recent studies clonidine has
      been demonstrated to be an effective sedative and analgesic and to reduce the
      amount of anaesthetic agents required. Therefore, a reconsideration of possible
      new indications for clonidine in clinical anaesthesiology seems to be justified.
      This paper presents the pharmacological basis for treatment with clonidine and
      reviews the extensive literature on its clinical indications in anaesthesia.
      Clonidine apparently produces its sedative and anaesthetic-sparing effects by
      stimulation of centrally located alpha2 adrenoceptors. Analgesia seems to be
      mediated mainly by activation of alpha2 adrenoceptors in the dorsal horn of the
      spinal cord. Considering its clinical indications, clonidine is often used as a
      supplement in the treatment of alcohol withdrawal syndromes. Future indications
      for clonidine may be the treatment of postoperative shivering and chronic pain
      management. Administration of clonidine in combination with a local anaesthetic
      prolongs analgesia and motor blockade. Its use in premedication and postoperative
      pain management may be limited by its principal effects of hypotension and
      bradycardia. In future, cardiovascular side effects may be minimized if all the
      subtypes of alpha2 adrenoceptors, their distribution within the central nervous
      system, and their specific action are clearly defined. This could result in a
      detailed therapeutic index of more selective and potent alpha2 agonists.

PMID- 8480900
TI  - [Topographic-quantitative EEG-analysis of the paradoxical arousal reaction. EEG
      changes during urologic surgery using isoflurane/ N2O anesthesia].
AB  - Increases in slow-wave (delta) activity in the EEG may reflect increased depth of
      anaesthesia provided that hypoxia, haemodynamic instability and drug overdose
      have been excluded. In contrast, similar intraoperative EEG responses have been
      described as paradoxical arousal reactions. The aim of this study was to assess
      the effects of surgical stimulation on spatial EEG changes during anaesthesia
      with 0.6% isoflurane/66% nitrous oxide. METHODS. The present study investigated
      changes in EEG power and frequencies in 20 patients (mean age 36 +/- 8 years; ASA
      I or II) scheduled for elective urological surgery during steady-state
      anaesthesia with 0.6% isoflurane and 66% nitrous oxide. The following variables
      were measured: heart rate (HR), mean arterial blood pressure (MAP), end-tidal
      isoflurane (PetISO) and carbon dioxide concentrations (PetCO2), arterial oxygen
      saturation (SaO2%) and body temperature (degree C). Patients were randomly
      assigned to one of two groups: group 1 (n = 10; without surgery) and group 2 (n =
      10; with surgical procedure). The EEG was recorded over 20 min. The first 5 min
      were taken as baseline. In group 2 surgical stimulation (skin incision with
      subsequent surgical preparation) was started 1-2 min after recording of baseline
      values. Topographical distribution of EEG output was recorded from 17 electrodes
      (international 10-20 system), digitized and stored on disk (CATEEM) after
      establishment of steady-state anaesthesia (PetISO: 0.6%; PetCO2: 35-37 mmHg).
      Data are given as medium (microV2/Hz) and relative changes (%) +/- SD with
      respect to baseline. Statistical significance was tested for F4 versus C4 for the
      delta- and alpha-1-frequency bands using Wilcoxon's test (P < 0.05). RESULTS. In
      group 1 (without surgical stimulation) all parameters did not change over time.
      EEG slowing with an increase in power (> 100%) was noted in 8 patients of group 2
      (n = 10; during surgical stimulation). By visual inspection of the original EEG
      tracings paradoxical arousal patterns were seen in these patients. In group 2,
      delta output changed from 69.6 microV2/Hz (baseline) to 147.4 microV2/Hz at
      frontal leads (F4) 5-6 min after the start of surgery. Only minimal changes were
      observed for theta activity. At the same time, in most cases fast wave activity
      (alpha 1, alpha 2, beta 1 and beta 2) was decreased by more than 50% at identical
      cortical areas. Increases in MAP were noted continuously after start of surgery
      up to a maximum of 19.8% from baseline, which became significant at the 16-min
      level. Heart rate did not change over time. DISCUSSION. Our data demonstrate that
      EEG slowing may be induced by surgical stimulation during steady-state
      anaesthesia with 0.6% isoflurane/66% nitrous oxide in oxygen. These findings are
      consistent with previous reports indicating the occurrence of slow wave patterns
      following sensory stimulation in comatose patients. Since these events occur
      predominantly at frontal areas they may not be detected with single-channel
      parietal recordings. Our data suggest that topographical EEG monitoring may
      useful for assessing painful events during surgery. Using EEG monoparameters like
      spectral edge frequency or median the occurrence of paradoxical arousal reactions
      may be falsely interpreted as an increased depth of anaesthesia.

PMID- 8480901
TI  - [Propofol, isoflurane and neuroleptanesthesia. Ophthalmic surgery in geriatric
      patients].
AB  - Ophthalmic surgeons require anaesthesia to ensure that the patient is completely
      relaxed for microsurgical operations and that the intraocular pressure is
      reduced. These conditions must be maintained throughout the operation. In
      addition to these requirements, the anaesthetist mostly deals with elderly
      patients with multiple diseases. Although earlier studies have shown which
      general or local anaesthesia is preferred for which patients and operations,
      studies on which general anaesthesia technique is ideal to fulfil these
      requirements are still lacking. The aim of this study was to show which technique
      causes the least stress for a geriatric patient undergoing an ophthalmic
      operation, propofol/fentanyl anaesthesia, isoflurane anaesthesia or
      neuroleptanaesthesia. PATIENTS AND METHODS. Sixty patients aged 60 years and
      above were included in this study. After being randomly allocated to either
      propofol/fentanyl (continuous propofol infusion), isoflurane or
      neuroleptanaesthesia, they underwent ophthalmic surgery. Intraoperative
      complications (cardiocirculatory changes) and surgical conditions were recorded.
      After the operation, patient vigilance and post-operative pain reactions (nominal
      pain score) were assessed over 8 h by means of simple reaction tests and the Juhl
      index. Within the first 2 h after surgery, cardiocirculatory changes were also
      documented and arterial blood gases measured. RESULTS. The treatment groups did
      not differ with respect to general biometric data, preoperative risk or
      operations carried out. Intraoperative cardiocirculatory changes and the
      resulting therapy (positive inotropic drugs, volume replacement fluids) were
      similar in all groups. The surgical conditions were equally good in all groups.
      Apart from a lower rate pressure product in the first 60 min after
      propofol/fentanyl anaesthesia, there were no postoperative differences in
      cardiocirculatory parameters or blood gases. After isoflurane anaesthesia the
      time until the patients were able to give their names and perform the finger-nose
      test properly was longer than that after neurolept-anaesthesia or propofol
      anaesthesia. After propofol anaesthesia the patients could perform simple tests
      earlier and were more alert over the whole monitoring period than after
      isoflurane or neuroleptanaesthesia. On the other hand, the patients in the
      neuroleptanaesthesia group had fewer pain complaints than those in the two groups
      compared. DISCUSSION. None of the anaesthesia techniques used in this study
      showed an intraoperative advantage. This is not surprising since all
      anaesthetics, with the exception of ketamine, reduce intraocular pressure. The
      prerequisite, however, is careful monitoring of anaesthesia in elderly patients
      in order to avoid cardiocirculatory changes, mild hyperventilation and coughing
      and pressing at the end of the operation. Until this point in time no change in
      the depth of anaesthesia is allowed. Therefore, it seems on the whole that there
      are benefits from propofol-fentanyl anaesthesia because of the fact that in
      comparison with the rather techniques, elderly patients become alert again
      faster. However, sufficient postoperative pain therapy is necessary to free the
      patients of pain to the same degree as with neuroleptanaesthesia. In most cases
      peripherally acting analgesic substances with no interference with vigilance are
      sufficient.

PMID- 8480902
TI  - [Halothane absorption by dry soda lime].
AB  - Humidified soda lime is commonly used to eliminate carbon dioxide from the
      circulatory system. Little is known about adverse reactions to accidentally dried
      soda lime. Therefore, a case of unexpected absorption of halothane by dry soda
      lime is reported. These observations were confirmed by a simulation with
      relevance to anaesthetic practice. CASE REPORT. A 46-year-old ASA class I patient
      was scheduled for elective surgery. After induction of general anaesthesia with
      500 mg thiopentone, followed by 100 mg suxamethonium, the trachea was intubated.
      The patient was ventilated with nitrous oxide in oxygen and 1.5 vol% of halothane
      for several minutes in the induction room. After being connected to a new
      circulatory system in the operating theatre, the patient was ventilated but, in
      addition inspiratory and expiratory anaesthetic gas concentrations were measured.
      Despite a vaporizer position of 1.5 vol% the inspiratory concentration of
      halothane was below 0.2 vol%. Disconnecting the tube, the typical odour of
      halothane was missing in the inspiratory line of the circulatory system, but was
      present in the fresh gas tube. Furthermore, the lower part of the soda lime
      canister was surprisingly hot. After removing both the absorbers, the inspiratory
      halothane concentration immediately normalized. The absorbers were replaced by
      canisters filled with fresh soda lime, and the anaesthesia was terminated without
      further complications. An absorption of halothane by dried soda lime was
      suspected. METHODS OF SIMULATION. In the first simulation four circulatory
      systems with two soda lime canisters each were perfused with 21 of oxygen for 48
      h. In the second simulation four soda lime canisters placed in one circulatory
      system were perfused with 1 l for 120 h. For measurement of halothane absorption
      each canister was placed in a circulatory system. The canister was perfused with
      a fresh gas flow of 2 l of oxygen and a vaporizer position up to 1.3 vol% of
      halothane. By the time an equilibrium was reached, i.e., in- and outflow
      concentrations of halothane were equal for a 3-min period, further halothane
      vaporization was stopped. In a 30-s interval the soda lime temperature and the
      gas concentration entering and leaving the soda lime canister were registered.
      Subsequently, the humidity of the soda lime was determined. RESULTS. In the first
      simulation 6 of the 8 canisters showed a humidity of soda lime of 15.5% of 19%,
      with halothane being absorbed in one case. Normally, the equilibrium between in-
      and outflow gas concentration was reached after 3.5-4 min. In the remaining two
      canisters the humidity was 14% and 9%. Only a small amount of halothane vapour
      was absorbed. The halothane concentrations were in equilibrium after 10 to 13
      min. The probes from the second simulation revealed a humidity of soda lime of 2%
      to 8.7%. Below a humidity of 4% the concentration of halothane leaving the
      canister was greatly reduced. It took 63 min to reach a steady state in the 2%
      humidity probe and the temperature rose to 43.1 degrees C. CONCLUSIONS.
      Accidental perfusion of the circulatory system with dry oxygen can cause a
      reduction in the humidity of soda lime. Dried soda lime delays the increase of
      halothane concentration in the inspiratory limb. The absorption of halothane is
      accompanied by an increase in the temperature of the soda lime. Therefore, in
      every situation lacking a sufficient anaesthetic level during inhalation
      anaesthesia, absorption of the vaporized anaesthetic must be excluded. Only dried
      soda lime can absorb halothane.

PMID- 8480903
TI  - [The effect of age on the spread of spinal anesthesia using isobaric 2%
      mepivacaine].
AB  - In the elderly, anaesthesia and surgery are associated with higher perioperative
      mortality and morbidity as compared to younger patients. There is some evidence
      that spinal anaesthesia may improve the postoperative state of elderly patients.
      A prospective study was performed to elucidate the effects of age on the
      characteristics of spinal anaesthesia with isobaric 2% mepivacaine. METHODS.
      Forty-six patients aged between 17 and 39 years and 48 elderly patients aged
      between 76 and 87 years having operations on the lower extremities or lower
      abdomen were investigated. All patients received 4.5 ml plain mepivacaine 2% (90
      mg) as a subarachnoid injection in the L3-4 interspace in the sitting position.
      The patients were turned supine immediately after the injection. Time of onset,
      extent and duration of analgesia, motor block, and cardiovascular responses were
      assessed. The segmental level of sensory loss was tested using the pin-prick
      method. RESULTS. It was found that the time to maximal motor blockade was
      significantly decreased in the older age group compared to the younger group (7.9
      vs 11.5 min). In the older group, the time to maximum spread was significantly
      shorter (11.4 vs 13.6 min). A significantly higher sensory block was obtained in
      the older group (T8 vs T10). The mean duration of analgesia or motor blockade did
      not differ significantly (200.7 vs 192.8 min). There were no unacceptably high
      degrees of spinal blockade. In the older group there was a tendency to a greater
      decrease in systolic arterial pressure as compared to preanaesthetic values
      (23.7% vs 16.3%) and greater falls in diastolic blood pressure were observed in
      the older group (22.1% vs 14.4%). A greater volume of lactated Ringer's solution
      was necessary in the older group (14.8 vs 10.3 ml/kg). Postspinal headache was
      encountered in 3 patients in the younger group and 2 in the older group.
      DISCUSSION. It is concluded that there was a tendency for greater spread of
      spinal analgesia with isobaric 2% mepivacaine in the elderly. The clinical
      significance of this finding is limited. In elderly patients hypotension is more
      common than in younger patients, but might not be related solely to age or extent
      of the neural blockade.

PMID- 8480904
TI  - [Analysis of the therapy of chronic pain. A comparison of previous therapy and
      specialized pain therapy].
AB  - In Germany patients with chronic pain are often undertreated. It is necessary to
      establish more specialized institutions for pain therapy. As pain therapy is time
      consuming and labor intensive the costs must be justified by quality and
      efficiency. METHODS. We analyzed the new patients who came to our pain clinic in
      1990 and compared the previous nonspecialist pain-related treatment with our pain
      therapy. For each patient we recorded the duration of pain therapy in the past,
      the number of physicians involved in the treatment, the number and duration of
      hospital stays and the number of operations carried out to relieve pain. For our
      pain therapy we recorded the number of treatments on an outpatient basis, the
      number of patients who were hospitalized and the number of hospital days. The
      outcome of our pain therapy was determined on a visual analogue scale (VAS). Pain
      relief of more than 50% was defined as adequate pain therapy. RESULTS. In 1990 we
      treated 379 new patients in our pain clinic. The largest group (140, 37%) had
      pain of the muscle or skeletal system. A further 75 patients (18%) had
      neuropathic pain, 66 (17%) suffered from cancer pain, several types of headache
      were found in 57 patients (15%), 19 patients (5%) had phantom limb pain, 11 (3%)
      suffered from reflex sympathetic dystrophy, and we diagnosed psychogenic pain in
      11 patients (3%). On average the patients had been treated for their pain over a
      period of 10 years by eight different physicians. Patients suffering from
      migraine had the longest duration of preliminary therapy (19.2 years), while
      patients with cancer pain were pretreated for 2, 3 years in the period before.
      80% (n = 302) of all patients were hospitalized at least once. A total of 20,959
      hospital treatment days was registered. At least one operation was performed in
      34% of the patients (n = 130) to relieve the pain. For all patients the pain
      relief afforded by the preliminary therapy was insufficient. In our pain therapy
      the patients had on average 6.5 outpatient appointments. We hospitalized 45
      patients (12%), for a mean of 11 days. During the observation period 74% of the
      patients (n = 280) obtained pain relief of more than 50% in comparison with the
      start of treatment. CONCLUSION. The findings of our retrospective study
      demonstrate that specialized pain therapy is evidently effective. If such therapy
      is instituted early enough, chronic pain can be prevented. Shorter duration of
      disease, fewer stays in hospitals and less absence from work could reduce the
      economic costs of chronic pain. It is necessary to make specialised pain therapy
      a regular component of clinical practice; this means redoubling our efforts
      concerning education and experimental and clinical studies. The efficiency of
      pain therapy must be documented in order to improve the care of patients with
      chronic pain.

PMID- 8480905
TI  - [Inhaled nitric monoxide. Application and continuous measurement of
      concentration].
AB  - Inhaled nitric oxide (NO) is a selective pulmonary vasodilator that may be useful
      in the treatment of patients with severe pulmonary hypertension. We describe a
      delivery system of inhaled NO that allows safe application and continuous
      measurement of the inspired NO concentration during mechanical ventilation. From
      a gas cylinder containing NO in N2 (600 ppm NO), an adjustable amount of gas is
      introduced into the inspiratory side of the tubing system via a pressure
      reduction valve, a magnetic valve, and a special injection nozzle. The NO
      concentration is diluted to the desired value by the tidal volume. The magnetic
      valve is connected to the ventilator and opens at the beginning of each
      inspiration and closes after a predetermined time. The gas volume is proportional
      to the pressure at the magnetic valve and the opening time. To monitor the
      inspiratory NO concentration, a specimen of gas is taken from an angle-connector
      and passed over an electrochemical sensor. The second nozzle of the sensor is
      connected to a water seal, which is adjusted to the positive end-expiratory
      pressure level of the ventilator to insure that the gas flow over the sensor is
      limited to inspiration.

PMID- 8480906
TI  - [Myxedema coma as a rare postoperative complication].
AB  - Myxedema coma is characterized by severe lack of thyroid hormones,
      unconsciousness and serious restriction of vital functions. The mortality rate
      still ranges between 50 and 80%. In patients with inapparent hypothyroidism
      myxedema coma occasionally follows surgery, anesthesia or severe infection. A
      case of myxedema coma following surgery is reported. CASE REPORT. A 46-year-old
      woman was anesthesized for hip replacement. The intraoperative cardiovascular
      situation was characterized by hypotension and tachycardia. On the first
      postoperative day, unexpectedly a cardiac arrest occurred. Resuscitation with
      high doses of epinephrine was successful. There was no evidence of myocardial
      infarction, hypoxia and pulmonary embolism as causative factors for cardiac
      arrest. A pulmonary artery catheter was inserted and showed low cardiac output.
      Catecholamines and intravascular fluids were administered without hemodynamic
      improvement. In the next 5 days pneumonia was followed by ARDS and acute renal
      failure. After successful treatment of these complications the patient remained
      in deep coma. An intracerebral disease could be excluded by computerized
      tomography. Evaluation showed low thyroid hormones (T3; T4) and elevated TSH. The
      diagnosis of a myxedema coma was assumed. After failure of oral therapy with L
      thyroxine (0.025-0.05 mg/day) for 10 days, intravenous therapy with 0.5 mg L
      thyroxine was performed. Thirty-six hours later the patient regained
      consciousness, without cardiac complications. The patient progressed uneventfully
      under oral therapy with 0.1 mg L-thyroxine and was discharged from the hospital 6
      weeks later. DISCUSSION. Pathophysiology and symptomatology of a case of
      postoperative myxedema coma are described (Tables 1-4). In this patient, the
      following symptoms occurred: low thyroid hormones (T3; T4), elevated TSH, deep
      coma, decreased ventilatory response to CO2, diminished myocardial contractility
      under catecholamine stimulation, impaired renal water excretion. After failure of
      oral substitution of L-thyroxine, intravenous therapy had to be performed in
      spite of the high risk of further cardiac complications in this patient. This led
      to complete recovery with normal neuropsychological and cardiopulmonary
      parameters. CONCLUSION. Myxedema coma is a rare complication in postoperative
      care, but in cases of inexplicable unconsciousness thyroid failure should be
      excluded. If myxedema coma is evident, intravenous therapy with L-thyroxine
      should be performed under the conditions of extended monitoring.

PMID- 8480907
TI  - [Comments on the paper by K.A. Lehman and K.H. Krauskopf. Intraoperative
      consciousness during balanced anesthesia].

PMID- 8480908
TI  - [Forensic aspects of blood transfusions].

PMID- 8480909
TI  - Organic-phase biosensors for monitoring phenol and hydrogen peroxide in
      pharmaceutical antibacterial products.
AB  - Organic-phase biosensors open new opportunities for assays of challenging
      pharmaceutical products. Such opportunities are illustrated for the rapid
      determination of phenol and peroxide antiseptics in different anti-infective
      formulations. The tyrosinase and peroxidase enzyme electrodes offer reliable
      quantification of these antibacterial agents following sample dissolution in the
      organic solvent. The dynamic properties of these enzyme electrodes are exploited
      for rapid and reproducible flow-injection assays of the pharmaceutical products
      (relative standard deviation = 1.6-1.9%). Such developments should facilitate
      rapid quality control testing in the pharmaceutical industry and should be
      applicable to other therapeutic agents and products. Applicability to cosmetic
      products containing hydrogen peroxide is also demonstrated.

PMID- 8480910
TI  - Agarose gel electrophoresis system for the separation of antibiotics used in
      animal agriculture.
AB  - A novel electrophoresis system using agarose gel has been developed for the
      separation and as an aid in the classification of antibiotics. This system
      utilizes Nunc cell factory disposable tissue culture dishes, which serve as
      bioassay dish and cooling chamber for agarose gel, in a custom designed
      electrophoresis unit. Tris(hydroxymethyl) methylamine-succinate buffer at pH 6.0
      and 8.0 are employed as the electrolyte for electrophoresis. Bioautography was
      used as the indicator of mobility. Any agar diffusion assay can be modified to
      use this system. A suggested name for this system is Nunc cell factory agarose
      gel electrophoresis (NUAGE). Selected antibiotics, representative of the
      aminoglycoside, beta-lactam, macrolide, moenocinol, peptide, polyene, polyether,
      quinone and tetracycline classes, were separated with this system.

PMID- 8480911
TI  - Echocardiographic Doppler evaluation of left ventricular diastolic function in
      athletes' hypertrophied hearts.
AB  - It is well known that one of the most evident effects of prolonged and intense
      physical training is an increase of left ventricular mass. This increase could
      have a great influence on the diastolic properties of the heart, which can now be
      accurately evaluated by use of pulsed- and continuous-wave of Doppler
      echocardiography. The aim of this study was to evaluate the diastolic function of
      a group of superendurance athletes (professional bicyclists, exercising more than
      forty hours a week). Sixteen athletes (A), aged between twenty and thirty-one
      years, during the period of maximal training, and 16 age-matched controls (C)
      were studied. All subjects were evaluated at rest with mono-dimensional, two
      dimensional, and Doppler echocardiography. Diastolic (DD) and systolic (SD)
      diameter, posterior wall (PW), and interventricular septum (IVS) thickness were
      also measured. The left ventricular mass (LVM) was calculated. Diastolic function
      was evaluated by calculating isovolumetric relaxation time (IVR) with continuous
      wave Doppler, and deceleration time (DT), rapid filling flow peak (Ep), and
      atrial filling peak (Ap) were evaluated with pulsed Doppler echocardiography. The
      LVM (A: 354 +/- 47 g vs C: 170.6 +/- 33.4, p < 0.05), DD (A: 57.7 +/- 3.9 mm vs
      C: 50.5 +/- 2.7, p < 0.01), PW thickness (A: 11.9 +/- 0.7 mm vs C: 8.4 +/- 0.6, p
      < 0.05), and IVS thickness (A: 12.3 +/- 1 mm vs C: 8.2 +/- 0.9, p < 0.05) were
      significantly greater in the athletes than in the controls.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8480912
TI  - Comparison of treadmill walking and stair climbing over a range of exercise
      intensities in peripheral vascular occlusive disease.
AB  - Although claudication pain and hemodynamic responses to exercise are related to
      the degree of arterial narrowing in the lower extremities, the nature of these
      responses to different exercise tasks and intensities is less clear. Thus, the
      purpose of this study was to compare claudication and hemodynamic responses to
      graded walking, level walking, and stair climbing over a range of exercise
      intensities. Ten patients with peripheral vascular occlusive disease performed
      five tests within each of the three exercise tasks. Similar values of oxygen
      consumption were obtained among exercise tasks at each intensity (p = ns). Time
      to onset of claudication pain and to maximal pain were similar among exercise
      tasks (p = ns), and both demonstrated a curvilinear decrease as intensity
      increased (p < 0.05). Foot transcutaneous oxygen tension, ankle systolic blood
      pressure, and ankle/brachial systolic pressure index were also similar among the
      three exercise tasks (p = ns); however, each decreased linearly as exercise
      intensity increased (p < 0.05). Thus, in peripheral vascular occlusive disease,
      the imbalance between oxygen delivery to the exercising lower extremity
      musculature and the local metabolic demand is similar during different weight
      bearing activities. Second, even though the peripheral circulation is
      progressively impaired with increased exercise intensity, anaerobic metabolism in
      the ischemic lower extremity musculature may prevent a continual decline in
      claudication times. The clinical implication is that a more thorough assessment
      of the functional limitations imposed by claudication pain is not obtained by
      using different types of weight-bearing exercise tests as opposed to using on ly
      one type.

PMID- 8480913
TI  - Risk factors for varicose disease before and during pregnancy.
AB  - Risk factors for varicose disease before and during pregnancy have been analyzed
      by use of data from a survey on venous disease in pregnancy conducted in 611
      women (mean age thirty years, range fifteen to forty-seven) who consecutively
      delivered at the Obstetric-Gynecologic Clinic "L. Mangiagalli" of Milan between
      January and April, 1989. In total, 137 women (22%) reported varicose disease
      before the index pregnancy. The relative risk (RR) of varicose disease before the
      index pregnancy increased with age, being, as compared with women aged twenty
      nine years or less, 1.6 in those aged thirty to thirty-four and 4.1 in those aged
      thirty-five years or more (chi 2(1) trend 25.28, p < 0.001). Compared with
      nulliparae, women reporting a full-term pregnancy before the index pregnancy had
      an RR of venous disease of 1.2, and the risk increased to 3.8 in women reporting
      two or more births (chi 2(1) trend 25.28, p < 0.001). A family history of
      varicose disease was associated with an RR of venous disease of 6.2 (95%
      confidence interval, CI, from 4.1 to 9.6). No relationship emerged between
      varicose disease and overweight. Of the 474 women who did not report venous
      disease before the index pregnancy, 132 (28%) developed venous disease during the
      index pregnancy. The risk of developing venous disease in pregnancy increased
      with age, being, as compared with women aged twenty-four years or less, 4.0 in
      those aged thirty-five years or more, and the trend in risk was statistically
      significant (chi 2(1) trend 16.25, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480914
TI  - Types of basilar artery syndrome: clinicoradiologic correlation.
AB  - Twenty-two patients with ischemic stroke, as a single event, in the territory of
      basilar artery (BA) are reported. On the basis of the findings from computerized
      tomography (CT) and clinico-radiologic features, the authors propose that this
      heterogeneous entity--the basilar artery (BA) syndrome--can be divided into five
      subtypes. Type 1 (complete type), characterized by infarctions in the whole
      territory of BA, is incompatible with life; type 2, with extensive brain stem
      infarct, may result in a locked-in state; and type 3, with infarctions in part of
      the BA territory (incomplete form or "partial syndrome") may have a more variable
      clinical outcome. However, type 4, with a top of the BA syndrome, and type 5,
      with negative CT BA syndrome (angiographically verified), are often more benign.
      Although initial CT scanning may infrequently be unrevealing, serial and follow
      up CT scannings have proven their usefulness in the majority of cases as a
      noninvasive tool, in contrast to cerebral angiography, for predicting the short
      term prognosis of BA syndrome.

PMID- 8480915
TI  - Transesophageal echocardiography for detecting intracardiac thrombi in embolic
      stroke.
AB  - The authors studied 56 patients with cardioembolic stroke to search for
      intracardiac thrombi by use of transesophageal and transthoracic
      echocardiography. Forty consecutive patients were examined within four weeks of
      stroke onset and the remaining 16 in the chronic stage. They also performed
      ultrafast computed tomography in 9 of them. Underlying heart disease was present
      in all subjects. Anticoagulant therapy had already been started in 29 at the time
      of examinations. Using their own criteria for echocardiography, they diagnosed
      intracardiac thrombus in 7 cases and valvular vegetation in 1. Six thrombi were
      located in the left atrial appendage, 4 of which were smaller than 10 mm in
      diameter. These small thrombi were not found by either transthoracic
      echocardiography or computed tomography. Transesophageal echocardiography appears
      to be superior to the other two methods, especially for detecting small
      intracardiac thrombi in the left atrial appendage.

PMID- 8480916
TI  - Plasma, serum and whole-blood viscosity variations with age, sex, and smoking
      habits.
AB  - To study the influence of age, sex, and smoking habits on rheology, the authors
      measured plasma (PV), serum (SV), native (NBV), and corrected (CBV) blood
      viscosity with a computerized rotational viscometer in 152 blood donors (86 men
      and 66 women) and in 20 healthy persons (4 men and 16 women) attending smoke
      aversion treatment. None of the viscosity measures or erythrocyte sedimentation
      rate changed significantly with age, whereas hematocrit (HC) and fibrinogen
      concentration (FC) both increased with ageing (p < 0.05 and p < 0.001,
      respectively). Higher (p < 0.001) values of NBV and HC were found in men than in
      women, whereas higher values were found in women than in men for FC (p < 0.01)
      and ESR (p < 0.001). In blood donors, moderate smoking (mean twelve
      cigarettes/day) significantly influenced only ESR, which was higher (p < 0.001)
      in smokers than in nonsmokers. In heavy smokers (mean twenty-one cigarettes/day),
      however, higher (p < 0.001) PV, SV, and NBV were found, as well as higher (p <
      0.01) FC and HC as compared with nonsmoking blood donors.

PMID- 8480917
TI  - Behcet's disease in the etiology of Budd-Chiari disease.
AB  - Hepatic venous outflow obstruction (Budd-Chiari syndrome-BCS) was diagnosed in 30
      patients during the period from March, 1987, to May, 1991, in Hacettepe
      University Hospital, Turkey. Patients with Behcet's disease constituted the major
      group (12/30) in the etiologic distribution. Although the vascular manifestations
      of Behcet's disease, including venous and arterial occlusions, varices, and
      aneurysms, are well known, the hepatic vein involvement has been reported in only
      22 cases in the literature so far. The authors present 30 cases of BCS, of whom
      patients with Behcet's disease comprise the largest group (40%). The angiographic
      findings are not specific to Behcet's disease. It is noted, however, that
      inferior vena cava involvement is more common in these patients (83.3%) than it
      is in the rest of the group (61.1%). It is suggested that Behcet's disease should
      be included among the diagnostic possibilities in a case of BCS, particularly in
      the countries in which it is prevalent.

PMID- 8480918
TI  - Primary muscular hydatid cyst causing arterial insufficiency: case report and
      literature review.
AB  - Hydatid disease, though known to occur in most organs and areas of the body, is
      extremely rare in skeletal muscle. In this article the authors present a case of
      a primary muscular hydatid cyst, originating from the adductor muscle group,
      causing obstruction of the femoral artery and vein.

PMID- 8480919
TI  - Renovascular hypertension caused by lymph node metastasis in a patient with
      uterine cervical cancer: case report.
AB  - Renovascular hypertension was found in a fifty-four-year-old woman who had been
      diagnosed as having uterine cervical cancer, stage Ib, six months before
      admission. Renal arteriography showed a stenosis of the right renal artery with a
      significant increase in renal vein renin level from the ipsilateral kidney.
      Abdominal computed tomographic scanning showed enlarged lymph nodes in the para
      aortic region at the level of the right renal artery, which suggested metastasis
      of the carcinoma. Metastatic lymph node swellings probably caused compression of
      the right renal artery.

PMID- 8480920
TI  - A case report of siblings with hypertrophic cardiomyopathy that progressed to
      dilated cardiomyopathy--case reports.
AB  - The authors encountered 2 brothers with hypertrophic cardiomyopathy (HCM), both
      of whom were later found to have progressed to dilated cardiomyopathy (DCM). Case
      No. 1 (younger brother): A diagnosis of HCM without left ventricular (LV)
      dilatation was made at age two by cardiac catheterization and echocardiogram.
      However, he had been well until age thirteen when dyspnea developed.
      Echocardiograms showed LV wall thickening (septum 20 mm, and posterior 18 mm) and
      LV dilatation (left ventricular diastolic diameter [LVDd] 60 mm) accompanied by
      LV dysfunction (ejection fraction [EF] 18%). At autopsy, the heart weighed 875 g
      and showed LV dilatation with thickened walls. Case No. 2 (elder brother): At age
      twelve, he was found to have an increased heart size on x-ray when his family was
      evaluated owing to his brother's condition. Cardiac catheterization and
      echocardiogram showed HCM without LV dilatation. He remained asymptomatic until
      age twenty when dyspnea developed, at which echocardiography showed a dilated LV.
      The authors speculate that the HCM with progression to DCM is an atypical type of
      familial HCM and that progression to DCM is genetically determined.

PMID- 8480921
TI  - Giant congenital left ventricular aneurysm in an adult--a case report.
AB  - Congenital cardiac aneurysms are extremely rare. The echocardiographic features
      of this condition have never been described. The authors report a case of giant
      congenital left ventricular aneurysm wherein the diagnosis was made by
      echocardiography and confirmed at cardiac catheterization. The aneurysm was
      surgically removed. The histologic examination showed that the aneurysmal wall
      was only 1.5 to 2 mm thick but contained all the layers of the heart.

PMID- 8480922
TI  - Coronary artery ectasia--a case report and literature review.
AB  - A case report of coronary artery ectasia is presented. A middle-aged man was
      admitted with sudden onset of respiratory arrest which is a rather rare
      occurrence. Relevant articles are reviewed, and discussion mainly concerns the
      etiologic and pathophysiologic point of view.

PMID- 8480923
TI  - Indium 111-labeled platelets accumulation over abdominal aortic graft with
      chronic disseminated intravascular coagulation--a case history.
AB  - The authors describe a seventy-six-year-old man with aortic graft, which became
      the focus of chronic disseminated intravascular coagulation (DIC). The patient
      had abdominal aortic aneurysm (AAA) and the size had increased up to 38 mm in
      diameter. The AAA was excised and replaced by Dacron graft. Ten months later, the
      DIC became chronic with renal dysfunction. Indium 111-labeled platelets
      scintigraphy showed increased accumulation of radioactivity over the graft. In
      the treatment of chronic DIC, low-dose subcutaneous heparin injection (5,000
      10,000/day) was effective, and he was discharged. In this case there was also
      suspicion of lung cancer and recurrent aortic aneurysm, which were a more
      reasonable cause of chronic DIC. This case suggests that an aortic graft
      prosthesis may be a cause of localized chronic DIC and that indium 111-labeled
      platelets scintigraphy is useful for the detection of localized chronic DIC.
      Moreover, subcutaneous heparin administration may be effective for chronic DIC in
      patients with an abdominal aortic graft prosthesis.

PMID- 8480924
TI  - From Peachtree Street and back.

PMID- 8480925
TI  - Laparoscopic inguinal herniorrhaphy in a swine model. Third place winner of the
      Conrad Jobst Award in the Gold Medal paper competition.
AB  - A simplified method of laparoscopic inguinal herniorrhaphy using prosthetic
      materials was evaluated in a swine hernia model. The goals of this study were to
      determine 1) effectiveness of repair in a rapidly growing animal, 2)
      effectiveness and extent of adhesion formation of different prosthetic materials,
      3) the effect of repair on testicular growth, and 4) histologic effects on the
      hernia site and surrounding structures. In a prospective randomized study, 30
      juvenile male swine (average, 23 kg) with 35 congenital indirect inguinal hernias
      underwent laparoscopic herniorrhaphy using one of three prosthetic materials:
      Group 1 (polytetrafluoroethylene/Gore-Tex), N = 10; Group 2 (polypropylene
      mesh/Marlex), N = 10; Group 3 (polypropylene mesh/Prolene), N = 10. A
      standardized laparoscopic herniorrhaphy technique consisting of stapling
      prosthetic material over the hernia defect without peritoneal dissection was
      employed. During the 3-month postoperative period, animals were sequentially
      examined for normal growth and development, normal testicular development, and
      signs of hernia recurrence. Clinically apparent complications related to
      herniorrhaphy occurred in five animals (17%) during the observation period (one
      with repair failure, one with testicular torsion, two with repair failure and
      bowel obstruction, and one with intestinal obstruction secondary to adhesions).
      All three animals with bowel obstruction died. At 90 days after surgery all
      remaining animals (N = 27) were euthanized (Group 1 = 9, Group 2 = 8, Group 3 =
      10). Average weight was 84 kg. Necropsy findings included no additional hernia
      recurrences, and one mesh erosion into the urinary bladder.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8480926
TI  - Elective procedure for peptic ulcer: a disappearing operation.
AB  - We retrospectively reviewed all the operative procedures performed for benign
      peptic ulcer disease in a regional hospital during the past 6 years. The
      indications were hemorrhage, perforation, obstruction, chronicity, and
      gastrocolic. No operation for chronicity has been performed since 1986. Only in
      perforation was there a statistical difference between male and female. Two
      hundred forty-six patients were admitted for bleeding, 108 were given
      transfusions and 38 required operative intervention for control of bleeding. The
      average units of blood given to patients with bleeding, who underwent operative
      intervention and recovered, was 7.2. The 6 deaths in this group were in patients
      who received 15.7 units of blood. Of these, none survived. Twenty patients with
      perforated ulcers were successfully treated with gastric resection with vagotomy.
      One patient with a perforated ulcer had primary suture repair, another had
      vagotomy and pylorplasty. Both required gastric resection because of obstruction
      and reperforation, respectively. Gastric resection with truncal vagotomy
      successfully corrected obstruction in 18 patients and chronicity in 9 patients,
      without mortality. Death from hemorrhage is directly related to delay in
      operative intervention. With the availability of effective medication for control
      of gastric acidity, the need for selective vagotomy or elective operative
      procedure for ulcers is fast disappearing.

PMID- 8480927
TI  - Safety, efficacy, cost, and morbidity of laparoscopic versus open
      cholecystectomy: a prospective analysis of 228 consecutive patients.
AB  - Laparoscopic cholecystectomy has become the procedure of choice in most hospitals
      for the resolution of surgically treatable gallbladder disease. Few reports
      address the results of laparoscopic cholecystectomy in comparison to open
      cholecystectomy during the same time interval within the same institution. One
      hundred ninety-six laparoscopic cholecystectomies were performed from April 1990
      through February 1991. Initial patient selection was restricted to elective
      procedures for chronic cholecystitis with expanded indications as experience was
      gained. Of the 196 cases, 11 required conversion to open cholecystectomy, leaving
      185 laparoscopic cholecystectomies for comparison. During the same period, 82
      open cholecystectomies were performed. Thirty-nine of these were complicated
      cases and would not have been considered for laparoscopic cholecystectomy early
      in the study, leaving 43 routine open cholecystectomies for comparative purposes.
      In the laparoscopic group, 1.1 per cent of the patients had major operative
      complications as opposed to the open group, which had none. There were no common
      bile duct injuries in either group. To provide a true cost-benefit analysis, a
      group of patients was identified that would qualify for elective, same-day
      admission for either an open or laparoscopic procedure. Laparoscopic
      cholecystectomy (LC) was performed on 70 patients, and open cholecystectomy (OC)
      was performed on 26 patients. A comparison of data from these groups showed no
      significant difference in age or sex. Hospitalization costs averaged $5,390 for
      the LC group versus $5,392 for the OC group. Postoperative hospital stay averaged
      1.3 days for the LC group versus 3.7 days for the OC group (P < 0.0001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480928
TI  - Impact of a major hurricane on surgical services in a university hospital.
AB  - Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This
      report analyzes the impact this storm had upon surgical care at a university
      medical center. Although disaster planning began on September 17, hurricane
      damage by high winds and an 8.7-foot tidal surge led to loss of emergency power
      and water. Consequently, system failures occurred in air conditioning, vacuum
      suction, steam and ethylene oxide sterilization, plumbing, central paging,
      lighting, and refrigeration. The following surgical support services were
      affected. In the blood bank, lack of refrigeration meant no platelet packs for 2
      days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding
      ruined patient files, resulting in lost information. In the intensive care unit,
      loss of electricity meant no monitors and hand ventilation was used for 4 hours.
      In the operating room, lack of temperature and humidity control (steam, water,
      and suction supply) halted elective surgery until October 2. Ground and air
      transportation were limited by unsafe landing sites, impassable roads, and
      personnel exhaustion. Surgical planning for a major hurricane should include: 1)
      a fail-safe source of electrical power, 2) evacuation of as many critically ill
      patients as possible before the storm, 3) cancellation of all elective surgery,
      and 4) augmented ancillary service staffing with some, although limited,
      physician support.

PMID- 8480929
TI  - Injury severity dictates individualized antibiotic therapy in penetrating
      abdominal trauma.
AB  - Antibiotics play a crucial role in reducing the risk of postoperative infection
      in patients suffering penetrating abdominal trauma. The infection rate for
      patients with these injuries ranges from 7% to 16%. Single agents with broad
      spectrum activity have proven efficacy, but dosage and duration are still
      controversial. A prospective, double-blinded study was performed on 102 patients
      randomized to receive one of three antibiotics for a total of 12 hours: cefoxitin
      (3 doses, 31 patients); ceftizoxime (2 doses, 36 patients); or mezlocillin (3
      doses, 35 patients). Two distinct groups at risk for postoperative infection were
      evident depending on the severity of injury: Group A were those with no colon
      injury or a colon injury that could be repaired, no evidence of shock, or fewer
      than 3 organs injured; Group B were those requiring a colostomy, evidence of
      shock on presentation, or three or more organs injured. All comparisons of the
      patient populations receiving the different antibiotics showed the two groups to
      be equivalent. The mean penetrating abdominal trauma index for Group A was 8.8
      and 28.2 for Group B. The overall infection rate for Group A was 10.3% and 42.3%
      for Group B. There was a significant increase in infection rate for all
      antibiotics except ceftizoxime in Group B compared with group A. The penetrating
      abdominal trauma index was significantly higher in all patients who developed
      infection for all antibiotics. In addition, if the surgical wound was closed
      primarily, patients with colon injuries developed wound infections 71% of the
      time, and those with small-bowel injuries did so 30% of the time.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480930
TI  - Management of epiphrenic esophageal diverticula. A fifteen-year experience.
AB  - Epiphrenic esophageal diverticula represent an unusual cause of dysphagia, pain,
      and weight loss. Although commonly associated with motility disorders, distal
      esophageal diverticula also have been associated with reflux strictures or other
      lesions. To determine the most appropriate diagnostic evaluation and operative
      approach, we reviewed the recent 15-year experience with epiphrenic esophageal
      diverticula at our institution. Over the study period, 18 patients were diagnosed
      with pulsion epiphrenic diverticula. Nine patients (50%) with symptomatic
      diverticula were referred for surgical management. All referred patients were
      evaluated with preoperative manometry, endoscopy, and contrast esophagography.
      Diverticulectomy was performed via posterolateral thoracotomy in all patients,
      combined with myotomy in the 6 patients (67%) with abnormal manometric results
      and in 2 patients with normal manometric results. The third patient with normal
      manometric results underwent simple diverticulectomy. There was no operative
      mortality. One complication, a small esophageal leak, was managed successfully by
      early reoperation. All patients were free of dysphagia at discharge. Follow-up
      was obtained for 17 patients (94%) ranging from 3 months to 12 years. Good to
      excellent results (measured by relief of symptoms, weight gain, and absence of
      clinical recurrence) were seen in all 9 surgical patients; 6 of 9 nonsurgical
      patients remained or became symptomatic. This experience demonstrates the
      efficacy of surgical management of symptomatic epiphrenic esophageal diverticula.
      Diverticulectomy combined with selective myotomy permits excellent operative
      results and resolution of associated symptoms.

PMID- 8480931
TI  - Definitive treatment of colon injuries: a prospective study.
AB  - The results of a prospective protocol for penetrating injuries of the colon in
      252 patients are presented. The protocol emphasized definitive management of the
      injury by repair, resection and anastomosis or exteriorized repair. Colostomy was
      reserved for left colon injuries requiring resection or for delayed treatment.
      Two hundred nineteen patients (86.9%) had definitive treatment by repair (N =
      159), resection and anastomosis (N = 26), or exteriorized repair. This was
      successful in 205 patients (93.6%). Three patients had anastomotic leak after
      repair or ileocolostomy. Eight of the 34 patients with exteriorized repair had
      suture-line breakdown and 26 (76.5%) patients avoided a colostomy. Injury
      severity indices (anatomic: Abdominal Trauma Index and Flint grading of colon
      injury) were higher in the exteriorized repair than in the repair group.
      Postoperative abdominal abscesses occurred in 43 patients (17.1%). A multiple
      regression analysis identified the Abdominal Trauma Index (P < 0.0001) and the
      presence of colostomy (P < 0.0004) as significant independent factors in
      association with this complication. Mortality from sepsis was 2.4 per cent (6
      patients) and in only one patient was the death directly related to colon injury
      management. We conclude that the majority of colon injuries can be managed by
      repair or resection with anastomosis. End colostomy is unavoidable in Flint 3
      injuries of the left colon. In other situations, ileocolic or colocolic
      anastomoses appear to be safe in hemodynamically stable patients. Loop colostomy
      has a role in delayed treatment, but can be replaced by an exteriorized repair in
      Grade 2 colon injuries that do not require resection.

PMID- 8480932
TI  - Systemic and mesenteric vascular effects of platelet-activating factor and
      cocaine. In vivo effects on a neonatal swine model.
AB  - Mesenteric hypoperfusion may be responsible for alterations in gut mucosa leading
      to necrotizing enterocolitis. Platelet-activating factor (PAF) and cocaine have
      been implicated in the etiology of necrotizing enterocolitis. We have
      demonstrated direct toxic effects of these compounds in vitro, but the in vivo
      mechanism of bowel damage is unknown. Newborn piglets (3.0 +/- 0.3 kg) had
      physiologic parameters (electrocardiogram, blood pressure, pulse, and central
      venous pressure) continuously monitored as well as Doppler probe recordings of
      superior mesenteric artery flow (Qsma). Aortic flow with calculation of cardiac
      index, and systemic and mesenteric vascular resistances (SVR and MVR) were also
      determined. Group 1 (N = 8) received PAF (0.5 microgram/kg). Groups 2 (N = 8) and
      3 (N = 8) received high (17 mg/kg) and low (9 mg/kg) doses of cocaine,
      respectively. Each subject served as its own control. Histology demonstrated
      edema or early mucosal hemorrhage in all groups. PAF caused a third-degree
      atrioventricular block of short duration and a prolonged decrease of the cardiac
      index, but only a brief elevation of SVR and MVR. The cocaine groups had a
      sustained increase of SVR and MVR associated with a decrease of cardiac index.
      The decrease of Qsma paralleled the changes of MVR in each subject. These data
      show that both PAF and cocaine induce mesenteric ischemia. The effect of PAF is
      of short duration and mainly related to its cardiotoxic effects resulting in low
      Qsma. Cocaine causes an increase in MVR with prolonged depression of mesenteric
      flow.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480933
TI  - Natural history and clinical evaluation of the lumpectomy scar.
AB  - After lumpectomy with axillary dissection and radiation therapy, there are
      numerous changes that occur to the breast that, if unrecognized as routine, post
      treatment changes, can lead to inappropriate intervention by the physician. The
      purpose of this study is to evaluate the time required to achieve stable post
      treatment mammographic and physical findings. One hundred twenty-three patients
      age 56.6 years with a mean tumor size of 15.9 +/- 8.2 mm were observed every 6
      months with a mean change in scar size of 16.7 +/- 10.6 mm. A scar never
      developed in 27 per cent and completely resolved or decreased in 90 per cent.
      Calcifications developed in 16 per cent of the patients; 40 per cent in the scar,
      60 per cent outside the scar. Recurrence developed in 2 per cent of the patients
      at a mean time of 53 months and was believed to be favorably influenced by
      cytologic evaluation of the resection margins at the time of tumor excision.
      Stabilization or resolution of the post-treatment changes occurred within 24 to
      36 months. The conclusion is for careful surgical and radiologic follow-up with
      examinations, fine-needle aspirations, and meticulous mammograms guiding the need
      for biopsy.

PMID- 8480934
TI  - Sepsis and infection in the intensive care unit: are they related?
AB  - Sepsis is a clinical syndrome characterized by fever, leukocytosis or leukopenia,
      tachycardia, increased cardiac index, reduced systemic vascular resistance, and
      hypercatabolism. It is generally believed to be a response to invasive
      infections, although an infectious source cannot always be identified in patients
      with sepsis. Over an 18-month period 287 patients were admitted for more than 48
      hours to a noncardiac adult surgical intensive care unit. Data were collected
      concurrently and recorded in a computer database. Seventy-three patients (25%)
      developed sepsis, and 50 (68% of those with sepsis) had bacteremia, with a mean
      of 1.5 organisms and 3.5 positive blood cultures per patient. Only 22 of 50
      patients with bacteremia had a potential infectious source, and there was a
      concordance of cultures from the putative source and the blood stream in only 10
      patients. Forty-one patients with sepsis (56%) had no apparent infectious source,
      but 28 of these (68%) had bacteremia, often with multiple organisms. Forty of the
      73 patients with sepsis died in the hospital. Mortality in sepsis could not be
      predicted by the presence of an infectious source (P > 0.35) and was not related
      to bacteremia (P > 0.75). Mortality was strongly associated with the development
      of multiple organ failure (P < 0.0001). Sepsis is a generic response to a number
      of physiologic insults and does not require infection for expression. This
      inflammatory response may have survival value by increasing oxygen delivery to
      sites of injury, but uncontrolled inflammation may cause dysfunction in several
      vital organ systems. The associated immunosuppression results in bacterial
      colonization of sites from which bacteria ordinarily are excluded.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8480935
TI  - Decreased red blood cell deformability and impaired oxygen utilization during
      human sepsis.
AB  - Sepsis is characterized by decreased microcirculatory flow and increased
      peripheral shunting. Previous studies have shown red blood cell deformability
      (RCD) is decreased during sepsis. The purpose of this study was to evaluate the
      effect of changes in RCD on hemodynamics and oxygen utilization during sepsis.
      RCD, arteriovenous oxygen difference (DA-VO2), mixed venous oxygen saturation
      (MVO2), intrapulmonary shunt (QS/QT), cardiac index, and systemic vascular
      resistance were measured in 10 trauma patients, all of whom had or developed
      clinical sepsis. Data are expressed as mean +/- SD. Patients with normal RCD (>
      0.75) were compared with those with low RCD (< 0.75). Patients with low RCD had a
      significantly higher incidence of sepsis (100% vs. 20%, P < 0.05, Student's t
      test or Fisher's Exact Test), lower DA-VO2 (2.4 +/- 0.9 vs. 4.8 +/- 1.5 P < 0.05,
      Student's t test or Fisher's Exact Test), and higher MVO2 (79 +/- 8 vs. 65 +/- 11
      P < 0.05, Student's t test) or Fisher's Exact Test) than those patients with
      normal RCD. There was a direct correlation between RCD and DA-VO2 (r = 0.852, P <
      0.001). MVO2 correlated inversely with changes in RCD (r = 0.813, P < 0.001). No
      significant correlation existed between RCD and cardiac index or systemic
      vascular resistance. Patients with low RCD demonstrated impaired oxygen
      utilization; changes in RCD correlated closely with changes in DA-VO2 and MVO2.
      These data suggest that decreased RCD may have an etiologic role in the impaired
      oxygen utilization that occurs during sepsis.

PMID- 8480936
TI  - Role of the leukocyte in endotoxin-induced alterations of the red cell membrane.
      Second place winner of the Conrad Jobst Award in the Gold Medal paper
      competition.
AB  - Sepsis and endotoxemia are known to be associated with alterations in the red
      cell membrane that result in diminished flexibility. This decreased flexibility
      may be responsible, in part, for the microcirculatory abnormalities accompanying
      sepsis. The etiology of these sepsis-associated changes remains unclear. This
      study evaluates the role of the white blood cell in these abnormalities.
      Specimens were obtained from 44 volunteers and divided into two treatment groups.
      Group I specimens were incubated with Escherichia coli endotoxin (2
      micrograms/ml) followed by removal of the white blood cells. The white blood
      cells were removed from group II specimens before endotoxin incubation. Paired,
      saline-incubated samples served as controls. After incubation, washed
      erythrocytes were evaluated for deformability and membrane viscosity.
      Deformability was assessed by filtration through 4.7-microns membranes. Red cell
      deformability was expressed as filtration rate (volume of cells per second per
      square centimeter). Membrane viscosity was assessed by fluorescent spectroscopy
      of cells into which the membrane probe 1(4-(trimethylamino)-phenyl)-6-phenyl
      1,3,5-hexatriene had been incorporated. Results were expressed as anisotropy.
      Endotoxin resulted in a significant increase in erythrocyte membrane viscosity
      (experimental, 0.296 +/- 0.002 vs. control, 0.284 +/- 0.002, P < 0.001). This was
      reflected by a significant decrease in cellular deformability (experimental,
      142.55 +/- 6.55 vs. control, 157.86 +/- 8.63, P < 0.01). However, these
      alterations are not a direct effect of endotoxin, but require the presence and
      participation of the white blood cell and/or its mediators (experimental, 0.301
      +/- 0.002 vs. control, 0.300 +/- 0.001, P = NS).

PMID- 8480937
TI  - [Food allergy: nutritional value and allergenic properties of hypoallergenic
      formulas].

PMID- 8480938
TI  - [Use of the thermometer among mothers of young children].
AB  - Due to the importance of fever and its correct measurement, we try to describe in
      our study the use of the thermometer by a sample of mothers of young children
      chosen at random in a low-middle class neighborhood. We surveyed them at home and
      checked their use of the thermometer. We found a frequent and correct usage of
      the thermometer. We identify the mother's educational level as one indicator of
      some of the mistakes in their use of the thermometer. We propose specific points
      to teach every mother when she goes to the pediatrician in order to provide
      adequate use of the thermometer in children with fever.

PMID- 8480939
TI  - [Percutaneous balloon valvotomy in neonatal obstructive cardiopathy. I: critical
      pulmonary valvular stenosis].
AB  - Percutaneous pulmonary balloon valvotomy using one balloon or more in sequential
      approach was attempted in 9 no selected neonates with critical pulmonary valve
      stenosis between March 1985 and October 1990 (mean age 10 + 8.6 days). The
      procedure was successful in seven of them (78%) in whom with a 1.22 + 0.2
      balloon/annulus ratio the right ventricular systolic pressure decreased from 96
      to 45 mmHg (p < 0.001), the transvalvular gradient from 65 to 23 mmHg (p <
      0.001); and the systemic oxygen saturation increased from 69 to 86% (p < 0.001).
      In one patient the valve was not crossed. Two patients underwent surgery because
      unsuccessful balloon valvotomy result in the immediate and mid term period:
      hypoplastic right ventricle in one, and inferior vena cava thrombosis that
      prevent a second dilation in the other respectively. The mid term follow up
      showed a 62% (5/8) of successful result. Although the complex methodology and
      complications are not uncommon, the balloon pulmonary valvotomy is a safely and
      effective therapy for neonates with critical pulmonary stenosis.

PMID- 8480940
TI  - [Isolation of Ureaplasma urealyticum in respiratory samples from two patients
      with bronchiolitis].
AB  - We report the cases of two patients, 5 and 4 months of age, without clinically
      important antecedents, that were hospitalized with a bronchiolitis syndrome. In
      the respiratory samples (nasopharynx aspirates) of both patients we isolated
      Ureaplasma urealyticum in pure culture and with a quantitative count > 10(3)
      cfu/ml. Vaginal cultures of mothers were negative. The patients were treated with
      fluid therapy and salbutamol, and after the respiratory cultures were reported
      positive, with erythromycin for 7 days. Because of the age of the patients (not
      in the neonatal period) and the type of respiratory syndrome (bronchiolitis), it
      is very difficult to evaluate the real clinical significance of these isolations.
      We review the respiratory pathology caused by U. urealyticum during the neonatal
      period and we recommend the need for a multicenter study about the clinical
      significance of this microorganism in children under one year of age.

PMID- 8480941
TI  - [Fibrin adhesive: a new therapeutic alternative in the treatment of cystic
      lymphangioma].
AB  - We present three cases of cystic lymphangioma of the neck, treated with a new
      therapeutic method which consists of an injection of fibrin adhesive into the
      lesion following aspiration of the liquid contents of the lymphangioma. Two of
      the cases had been treated surgically and were faced with the recurrence of the
      tumor, the aforesaid treatment was applied. In the third case, it was the only
      therapy applied. We believe that the results obtained were excellent in all three
      cases.

PMID- 8480942
TI  - [A study from Navarra. Hyperlipidemias. Avarage scores and percentiles for lipids
      and lipoproteins in a population of children and adolescents. Correlation with
      anthropometric parameters].
AB  - As part of an epidemiological study on cardiovascular risk factors among children
      and adolescents in Navarra, the following parameters: total cholesterol, HDL
      cholesterol, LDL-cholesterol, triglycerides and C/HDL and LDL/HDL risk quotients
      were determined in 5,829 children. These children, of both sexes and between the
      ages of 4 and 17 years, were selected at random from the school population in our
      community. Average values and percentiles of these parameters were obtained for
      each group according to age and sex as a previous step to define the health
      condition or "lipid risk" in our population. When determining the correlation of
      these biochemical parameters with the anthropometrical parameters of BP, age,
      weight, height, Quetelet Index, body mass surface, skinfold thickness and the
      percentage of subcutaneous fat (after the necessary logarithmic transformations,
      adjusted to each age and sex group by Z-scores) we find that none of the
      correlation coefficients are significant. The triglycerides and the HDL
      cholesterol have a low, but significant. The triglycerides and the HDL
      cholesterol have a low, but significantly, correlation with the other lipid
      parameters. The lipid risk quotient (C/HDL, LDL/HDL) shows a higher correlation
      with LDL-cholesterol than with total cholesterol.

PMID- 8480943
TI  - [A study from Navarra. Hyperlipidemia V. What is the best definition of
      hyperlipemia in childhood and adolescence?].
AB  - As part of an epidemiological study on cardiovascular risk factors among children
      and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829
      children of both sexes, between 4-17 years of age, and selected at random from
      the school population in our community. In this article, we analyze the different
      definitions for lipid risk during childhood, whether based on percentile values,
      according to age and sex of the child, of cholesterol, LDL/cholesterol, or risk
      quotients (C/HDL, LDL/HDL), or even on the absolute values of all of these
      parameters. An appropriate definition for hyperlipemia during childhood, once we
      know the average variations in the levels of lipids and lipoproteins according to
      age and sex, as well as the variations of the lipid risk prevalence according to
      its definition, would be: 1. Previous screening according to cholesterol serum
      levels: Values higher than the 70th percentile for each group according to age
      and sex: or higher than 185 mg/dl for children age 4 to 12 and 170 mg/dl for
      children age 13 to 17. 2. To calculate the LDL/HDL quotient among those selected
      children included in the definition of hyperlipemia when the quotient is higher
      than the 85th percentile for the patients age and sex, or it is higher than 2.2.

PMID- 8480944
TI  - [Prognosis of perinatal asphyxia in full-term neonates].
AB  - We have performed a prospective study in 65 asphyxiated term newborns to evaluate
      the prognostic value of three different methods: 1) Neurological examination, 2)
      Electroencephalographic tracings (EEGs) and 3) Transfontanellar sonography,
      carried out periodically from birth until discharged from the neonatal unit. The
      neurological status of surviving infants was assessed at one year of age. We
      found a statistically significant (p < 0.0001) association between the
      neurological examination, electroencephalographic tracings and transfontanellar
      sonography during the neonatal period and the neurological development. The
      prognostic value, as a function of sensibility, specificity and predictive value
      of the three methods was very high. No differences were found among them,
      although the EEGs and neurological examinations showed the highest predictive
      values.

PMID- 8480945
TI  - [Increased serum levels of soluble IL-2 receptor in food intolerance: possible
      mechanism of delayed immunity in milk intolerance].
AB  - The levels of soluble interleukin-2 receptor (sIL-2R) were measured in 35 serum
      samples from children with food intolerance; 19 had an IgE-mediated sensitization
      and were considered as atopic patients, skin tests and RAST were negative in the
      remaining 16 children and they were diagnosed as having cow milk intolerance
      (CMI) Forty-three coeliac patients were included as a positive control group and
      18 normal children as the negative control group. The atopic group showed normal
      values of sIL-2R (1,183 +/- 468 u/ml); however, it was increased in children with
      CMI (1,453 +/- 469 u/ml, p < 0.05). The sIL-2R mean value was highest in patients
      with gastrointestinal symptoms (1,458 +/- 461 u/ml, p: 0.03) and the presence of
      atopic dermatitis was not relevant. The sIL-2R was also elevated in 8 children
      with igE-mediated sensitization against cow's milk (1,477 +/- 328 u/ml, p <
      0.05). These results suggest that a delayed cellular mechanism occurred in CMI,
      similar to that present in coeliac disease, although it was less severe. In
      addition, there is an overlap of humoral and cellular immunological mechanisms in
      the IgE-mediated sensitization to cow's milk, but we did not find this
      coincidence in the allergy to remaining foods. From a pathogenic point of view,
      to separate CMI from IgE-mediated allergies to milk does not seem to be
      sufficiently justified at the present time. It is possible that the atopy against
      cow milk proteins in children has a different immunological mechanism than the
      atopy to other foods, which would explain its better prognosis.

PMID- 8480946
TI  - [The role of calcium ions and temperature on the effect of exogenous
      semisynthetic surfactants (experimental study)].
AB  - With the final aim of preventing neonatal respiratory distress syndrome (RDS),
      the present study was carried out on premature rabbits (28 days of gestation)
      that showed a moderate level of RDS. These animals were treated intratracheally
      with 25 microliters of semisynthetic surfactant, composed of natural adult rabbit
      surfactant/DPC/DPPG (1/0.6/0.6 mol P) in two types of carriers, saline solution
      (Sf) and a calcium solution (5 mM of Cl2Ca), which were also used as controls.
      This was maintained throughout the experimental period at 37 degrees C or 60
      degrees C, while checking the effect of temperature on their behavior. The final
      results in the P/V curves showed a significant increase in the maximum distention
      in the cases treated with semisynthetic surfactant at 60 degrees C with calcium
      vehicle (60.96 ml/kg) and with saline solution as the vehicle (58.51 ml/kg) with
      respect to the control without treatment (44.08 ml/kg) (p < 0.05). In the
      morphometric quantification of the lungs fixed to 10 cm H2O, the highest
      distention (VV) is reached by the semisynthetic surfactant in calcium solution
      (Mez.Ca) at 37 degrees C (56.30%) and 60 degrees C (56.31%), followed by the
      semisynthetic surfactant in saline solution at 37 degrees C (55.17%). The maximum
      compliance expressed the highest distention (with or without emphysema) and the
      morphometric distention together with the compliance at 10 cm H2O showed the
      residual trapping and/or anticollapsing effect. The temperature and the type of
      vehicle used for the semisynthetic mixture did not significantly influence the
      lung distention.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480947
TI  - [Glutaric aciduria type I].
AB  - We report three patients with glutaric aciduria type I. The biochemical diagnosis
      of two cases was revealed by determination of free glutaric acid in urine, by
      using the CG/EM method. In the third patient, however, these levels were only
      slightly increased and the diagnosis was attained by the determination of total
      glutaric acid and glutaryl-carnitine. Serum carnitine levels were decreased in
      two cases. Clinical symptoms of this type of organic acidemia are highlighted by
      an acute or subacute presentation with signs of dysfunction of the neostriatum,
      simulating a cerebral paralysis with extrapyramidal signs. Homozygous patients
      have been reported with the same biochemical and enzymatic activity findings, but
      these patients were neurologically asymptomatic throughout life. Other features
      suggestive of the disease are macrocephaly associated with a widening of the
      subarachnoid spaces. Riboflavin and carnitine administration to these patients
      seems to prevent new bouts of neurological dysfunction.

PMID- 8480948
TI  - [Dystonia as a principal manifestation of Leigh syndrome in an infant].

PMID- 8480949
TI  - [Virilizing adrenal carcinoma: exeresis and successful treatment with op'DDD].

PMID- 8480950
TI  - [Endotracheal and endobronchial tuberculosis. Variability of its clinical
      manifestation, diagnostic and therapeutic importance of flexible endoscopy].

PMID- 8480951
TI  - [Aspergillus infection of the vascular prosthesis in a child with aortic
      coarctation. Evolution and therapy].

PMID- 8480952
TI  - [Epidemiology of bites in a child day-care center].

PMID- 8480953
TI  - [Benign myoclonus in infancy].

PMID- 8480954
TI  - [Transient hyperphosphatasemia in childhood: 2 new cases at an unusual age].

PMID- 8480955
TI  - [Apropos of a case of multiple deprivations: difficulty of evaluation and
      psychosocial intervention in childhood].

PMID- 8480956
TI  - Management of hypertension after ambulatory blood pressure monitoring.
AB  - OBJECTIVE: To study the test-ordering behavior of practicing physicians regarding
      ambulatory monitoring of blood pressure and to assess changes in patient
      management after this study. DESIGN: Cross-sectional assessment of physicians'
      practice habits regarding the ordering of ambulatory blood pressure monitoring
      and a longitudinal study of patient management after monitoring. SETTING:
      Physicians' offices in central Connecticut. PARTICIPANTS: Two hundred thirty
      seven consecutive patients referred by 65 community- and hospital-based
      physicians. MEASUREMENTS: Indications for ambulatory blood pressure monitoring,
      changes in diagnosis and therapy, and office blood pressures before and after the
      ambulatory blood pressure study. RESULTS: The main indications for ordering the
      test included borderline hypertension (27% of studies ordered), assessment of
      blood pressure control during drug therapy (25%), evaluation for "white coat" or
      "office" hypertension (22%), and drug-resistant hypertension (16%). After the
      ambulatory blood pressure study, only 13% of the patients had further testing
      (for example, echocardiography); the diagnosis was changed in 41% of the
      patients, and antihypertensive therapy was changed in 46%. In 122 patients for
      whom data were complete, office blood pressure measured by the referring
      physician decreased from 161/96 +/- 22/12 mm Hg before the ambulatory blood
      pressure study to 151/86 +/- 27/12 mm Hg 3 months after the study (P = 0.004 for
      systolic blood pressure and P < 0.001 for diastolic blood pressure). One to 2
      years after the study, office blood pressure was 149/86 +/- 24/12 mm Hg (P > 0.2
      compared with 3 months after the study). Seventy-two percent of the patients had
      a lower office blood pressure within 3 months of the ambulatory blood pressure
      study. CONCLUSIONS: Practicing physicians use ambulatory blood pressure
      recordings for appropriate indications, and data from the monitoring studies
      affected the management of patients with hypertension.

PMID- 8480957
TI  - The effectiveness of ovarian cancer screening. A decision analysis model.
AB  - OBJECTIVE: To estimate the effectiveness of ovarian cancer screening with CA 125
      and transvaginal sonography. DESIGN: Decision analysis was used to examine the no
      screen compared with the screen strategy. SETTING: Estimates of cancer incidence,
      survival, and life expectancy were derived from population-based data and
      clinical series. SUBJECTS: A cohort of 40-year-old women of all races and
      residing in the United States. INTERVENTIONS: A one-time screening intervention.
      The criterion standard for diagnosis of ovarian cancer was evaluation with
      exploratory laparotomy. MAIN OUTCOME MEASURE: Average years of life expectancy
      gained by women in the screened group. RESULTS: Screening for ovarian cancer with
      a combination of CA 125 and transvaginal sonography increases the average life
      expectancy in the population by less than 1 day. CONCLUSIONS: Given the limited
      effect on overall life expectancy, it is unlikely that mass screening for ovarian
      cancer with CA 125 and transvaginal sonography would be an effective health
      policy.

PMID- 8480958
TI  - Clinical manifestations of trichomoniasis in men.
AB  - OBJECTIVE: To determine the prevalence and clinical manifestations of
      trichomoniasis among sexually active men. DESIGN: Survey of two groups of men
      attending a sexually transmitted disease clinic. Subjects had a comprehensive
      sexual history and clinical examination plus cultures for Trichomonas vaginalis,
      Neisseria gonorrhoeae, and Chlamydia trachomatis. PARTICIPANTS: The study
      included 147 sexual partners of women with trichomoniasis and 300 subjects
      selected randomly from heterosexual men coming to the same clinic for evaluation
      of new problems. MAIN OUTCOME MEASURES: Isolation of T. vaginalis was compared
      with urogenital signs and symptoms. RESULTS: The prevalence of T. vaginalis was
      33 of 147 (22% [95% CI, 16% to 29%]) among sexual contacts of women with
      trichomoniasis and 17 of 300 (6% [CI, 3% to 9%]) among heterosexual men attending
      the same clinic. Men with trichomoniasis alone were more likely to complain of
      urethral discharge (P < 0.01), to have discharge on examination (P < 0.03), and
      to have inflammatory cells in their urethral secretions (P < 0.01) than were men
      who did not have T. vaginalis, N. gonorrhoeae, or C. trachomatis. Trichomonas
      vaginalis remained associated with nongonococcal nonchlamydial urethritis
      (adjusted odds ratio 3.8; CI, 1.1 to 11.2) after adjustment for race, age, number
      of sex partners in the previous 6 months, exposure to a partner with
      trichomoniasis, and history of trichomoniasis, urethritis, or gonorrhea.
      CONCLUSIONS: Trichomoniasis was common among men at risk for sexually transmitted
      diseases and was associated with symptoms and signs of urethritis.

PMID- 8480959
TI  - Efficacy and tolerability of lovastatin in 3390 women with moderate
      hypercholesterolemia.
AB  - OBJECTIVE: To evaluate the efficacy and safety of lovastatin in women with
      moderate hypercholesterolemia. DESIGN: The Expanded Clinical Evaluation of
      Lovastatin (EXCEL) Study, a multicenter, double-blind, diet- and placebo
      controlled trial, in which participants were randomly assigned to receive placebo
      or lovastatin at doses of 20 or 40 mg once daily, or 20 or 40 mg twice daily for
      48 weeks. SETTING: Ambulatory patients recruited by 362 participating centers
      throughout the United States. PATIENTS: Women (n = 3390) from the total cohort of
      8245 volunteers. MEASUREMENTS: Plasma total, low-density lipoprotein (LDL), and
      high-density lipoprotein (HDL) cholesterol, and triglycerides; and laboratory and
      clinical evidence of adverse events monitored periodically throughout the study.
      RESULTS: Among women, lovastatin (20 to 80 mg/d) produced sustained (12- to 48
      week), dose-related changes (P < 0.001): decreases in LDL cholesterol (24% to
      40%) and triglycerides (9% to 18%), and increases in HDL cholesterol (6.7% to
      8.6%). Depending on the dose, from 82% to 95% of lovastatin-treated women
      achieved the National Cholesterol Education Program goal of LDL cholesterol
      levels less than 4.14 mmol/L (160 mg/dL), and 40% to 87% achieved the goal of
      3.36 mmol/L (130 mg/dL). Successive transaminase elevations greater than three
      times the upper limit of normal occurred in 0.1% of women and were dose dependent
      above the 20-mg dose. Myopathy, defined as muscle symptoms with creatine kinase
      elevations greater than 10 times the upper limit of normal, was rare and
      associated with the highest recommended daily dose of lovastatin (80 mg).
      Estrogen-replacement therapy appeared to have no effect on either the efficacy or
      safety profile of lovastatin. CONCLUSION: Lovastatin is highly effective and
      generally well tolerated as therapy for primary hypercholesterolemia in women.

PMID- 8480960
TI  - Pleural effusions in hospitalized patients with AIDS.
AB  - OBJECTIVE: To determine the incidence, cause, and characteristics of pleural
      effusions in hospitalized patients with the acquired immunodeficiency syndrome
      (AIDS). DESIGN: Retrospective. PARTICIPANTS: A total of 222 patients with AIDS
      hospitalized between January 1986 and January 1992 at the Medical University of
      South Carolina hospitals. RESULTS: Pleural effusions occurred in 59 patients for
      an overall incidence of 27%. The mean age of the patients was 35 +/- 2 years (SE)
      and the male to female ratio was 5:1. The cause was infectious in 39 (66%)
      patients, noninfectious in 18 (31%), and unknown in 2 (3%). Pleural effusions
      were caused by bacterial pneumonia in 18 (31%) patients, Pneumocystis carinii
      pneumonia in 9 (15%), Mycobacterium tuberculosis in 5 (8%), septic embolism in 2
      (3%), Nocardia asteroides in 2 (3%), cryptococcus neoformans in 2 (3%), and
      Mycobacterium arium intracellulare in 1 (2%). Among noninfectious causes (n =
      18), hypoalbuminemia was the cause in 11 patients (19%), cardiac failure in 3
      (5%), and atelectasis, Kaposi sarcoma, uremic pleurisy, and adult respiratory
      distress syndrome in 1 (2%) each. Patients with AIDS who had pleural effusions
      had significantly lower serum albumin levels and had lower CD4 counts than did
      those without pleural effusions (P < 0.001). CONCLUSIONS: Pleural effusions are
      common in hospitalized patients with AIDS. Bacterial pneumonia is the most common
      cause for pleural effusion in AIDS. Large effusions are associated with Kaposi
      sarcoma and tuberculosis. Hypoalbuminemia is a common cause of noninfectious
      pleural effusions.

PMID- 8480961
TI  - Clinical course after liver transplantation in patients with sarcoidosis.

PMID- 8480962
TI  - Nodular lymphangitis: a distinctive but often unrecognized syndrome.
AB  - PURPOSE: To describe nodular lymphangitis by reviewing the clinical and
      epidemiologic features of this disease with an emphasis on distinguishing
      specific etiologic agents. DATA SOURCES: English-language articles were
      identified through a MEDLINE search (1966 to September 1992) using
      sporotrichosis, lymphangitis, and sporotrichoid as key words; additional
      references were selected from the bibliographies of identified articles. In
      addition, three new patients with nodular lymphangitis are described. STUDY
      SELECTION: One hundred fifty articles were reviewed to determine details of the
      etiologic agents and clinical signs and symptoms of patients with nodular
      lymphangitis. DATA SYNTHESIS: Nodular lymphangitis develops most commonly after
      cutaneous inoculation with Sporothrix schenckii, Nocardia brasiliensis,
      Mycobacterium marinum, Leishmania braziliensis, and Francisella tularensis. The
      setting in which infection is acquired is useful in differentiating among the
      various organisms causing infection. Sporotrichosis and leishmaniasis can have
      longer incubation periods than do the other common causes of nodular
      lymphangitis. A painful ulcer at the site of the initial lesion suggests
      tularemia; frankly purulent drainage often accompanies infections with
      Francisella and Nocardia species. Ulcerated or suppurating lymphangitic nodules
      occur commonly with Nocardia infections. Patients with nodular lymphangitis who
      fail to respond to empiric treatment for sporotrichosis should be evaluated for
      other organisms with appropriate biopsies and cultures. CONCLUSIONS: Nodular
      lymphangitis has distinctive clinical signs and symptoms, most commonly due to
      infection with a limited number of organisms. A detailed history, accompanied by
      information obtained from skin biopsy specimens using appropriate stains and
      cultures, should allow specific, effective therapy for most of these infections.

PMID- 8480963
TI  - Automated ambulatory blood pressure devices and self-measured blood pressure
      monitoring devices: their role in the diagnosis and management of hypertension.
      American College of Physicians.

PMID- 8480965
TI  - A way out.

PMID- 8480964
TI  - Characteristics of primary care office systems as predictors of mammography
      utilization.
AB  - OBJECTIVE: To evaluate the association between primary care office systems and
      mammography utilization by women older than 50 years. DESIGN: Cross-sectional.
      SETTING: An independent-practice association health maintenance organization
      (HMO) in Massachusetts. PARTICIPANTS: One hundred thirty-two primary care
      practices, representing 321 physicians and 4378 women with at least 12 months of
      recent, continuous assignment to a practice participating in the HMO.
      MEASUREMENTS: Practice characteristics and procedures for mammography referral
      and follow-up were ascertained by interviews of office managers. For each
      practice, the proportion of women older than 50 years who received a mammogram
      during their most recent 12-month period of assignment to the practice was
      calculated. MAIN RESULTS: Forty-five percent of eligible women received a
      mammogram during their most recent year of assignment to an HMO practice. In a
      regression model, use of one particular urban mammography center, group practice,
      and low percentage of Medicaid patients in the practice were each associated with
      9% to 12% higher mammography utilization; use of flowsheets and the scheduling of
      mammograms by the patients themselves were associated with 7% to 9% higher
      utilization. Smaller, nonsignificant increases were associated with the use of
      reminders to patients (5%) and the presence of only internists on staff (5%). The
      model accounted for 51% of the variation in mammography utilization among
      practices. CONCLUSIONS: Mammography utilization among women older than 50 years,
      in a population in which cost was not a barrier, was related to specific office
      characteristics. Features of the mammography center, the process for scheduling
      mammograms, the use of flowsheets to prompt physicians, and the use of reminders
      to patients are important.

PMID- 8480966
TI  - Deciding about screening.

PMID- 8480967
TI  - United we stand.

PMID- 8480968
TI  - Screening for renovascular hypertension.

PMID- 8480969
TI  - Color Doppler ultrasound and deep venous thrombosis.

PMID- 8480970
TI  - Color Doppler ultrasound and deep venous thrombosis.

PMID- 8480971
TI  - Drug interaction of terfenadine and carbamazepine.

PMID- 8480972
TI  - The medical malpractice system.

PMID- 8480973
TI  - The medical malpractice system.

PMID- 8480974
TI  - The medical malpractice system.

PMID- 8480975
TI  - The medical malpractice system.

PMID- 8480976
TI  - More on medical malpractice.

PMID- 8480977
TI  - More on medical malpractice.

PMID- 8480978
TI  - [Annulo--aortic ectasia. Prognosis and treatment].
AB  - Nine cases of aneurysm of the ascending aorta responsible for aortic
      insufficiency were identified between 1975 and 1989. Seven of these fell within
      the context of Marfan's syndrome, while the other 2 were idiopathic. Aortic leak
      was found to be massive from the outset in 5 cases and progressively worsened in
      2 other cases. Mean follow-up was 138 months. Five patients were treated
      surgically, with nil mortality. Three corrective procedures were used: aortic
      valve replacement only or in combination with an additional procedure concerning
      the aorta (3 cases), or composite graft using the Bentall technique as modified
      by Cabrol (2 cases). There were 2 late complications among the incomplete
      procedures (detachment of the valve graft, recurrence of aneurysm). The 4
      patients who did not undergo surgery all died: twice of aortic dissection and as
      a result of myocardial dysfunction in the other 2 cases. These results confirm
      the potentially grave course of this condition and emphasise the usefulness of
      routine surgery. Mastery of surgical techniques now justifies the extension of
      the indications of prophylactic surgery to any aneurysm having reached 6 cm. The
      Bentall technique modified by Cabrol remains the treatment of choice.

PMID- 8480979
TI  - [Mid-term follow-up after transluminal coronary angioplasty. Clinical results,
      mortality, morbidity apropos of 500 consecutive procedures].
AB  - The aim of this study was evaluation of mid-term results, with a mean follow-up
      of 23 months (range: 6 months to 6 years), in 449 patients undergoing 500
      consecutive angioplasty procedures before 1989. All of these 449 patients
      underwent primary angioplasty, and not dilatation after restenosis. Data
      processing of information, based upon a questionnaire filled out by the patient's
      own cardiologist, enabled 100 per cent follow-up. In these patients with a mean
      age of 56 (range: 32-83), angioplasty was single in 93 per cent of cases. The
      indication was unstable angina (45%), following a myocardial infarction (44%) or,
      more rarely, stable angina (10%). The anterior interventricular was dilated more
      often than the right coronary and circumflex (56%, 31% and 22% respectively). The
      cardiac survival rate of 41 months was 94.3 per cent, 78 per cent of patients not
      having experienced any serious coronary events at the time of last available
      information. 65 (sixty five) per cent of patients were asymptomatic and the
      Thallium stress test was normal in 67 per cent of them. Angina recurred in 17 per
      cent of patients, twice as often in women (p < 0.02). 14 (fourteen) per cent had
      undergone a bypass procedure and 14 per cent had been redilated. Comparisons by
      the Kaplan-Meier method showed less good results after the age of 57: higher
      mortality (p < 0.01), more frequent recurrences of angina (p < 0.05), more
      frequent aorto-coronary bypasses (p < 0.001). Aorto-coronary bypasses were
      commoner after dilatation of the anterior interventricular (p < 0.005), after
      multiple dilatations (p < 0.03) or after unstable angina (p < 0.05).

PMID- 8480980
TI  - [Irreversible auriculo-ventricular block of viral origin].
AB  - Transitory disturbances of atrioventricular conduction are an usual feature of
      the acute phase of viral myocarditis. In contrast, the onset of complete heart
      block is rarer. The authors report a case of permanent heart block of progressive
      onset in a context of infectious mononucleosis in a 29-year-old male, requiring
      fitting with a permanent pacemaker. A long term follow-up visit confirmed the
      irreversible nature of the conduction disturbance.

PMID- 8480981
TI  - [Myocardial infarction, late fibrinolysis and resolving cerebral embolism].
AB  - The authors report a case of a cerebral embolism, with a rapidly resolving
      course, during late fibrinolysis using tissue plasminogen activator in a patient
      with a posterolateral myocardial infarction. A review of the literature is used
      as basis for considering the effects of fibrinolytic treatment on left
      intraventricular thrombi during the acute phase of myocardial infarction. The
      risk of systemic embolism during such treatment is stressed.

PMID- 8480982
TI  - [Successive decrease of left ventricular segmental kinetic disorders after
      transluminal coronary angioplasties in the same patient].
AB  - The authors report the case of a patient developing two successive left
      ventricular kinetic abnormalities secondary to acute or chronic ischemia, and
      reversible after transluminal coronary angioplasty. The concept of myocardial
      hibernation is suggested as a possible mechanism.

PMID- 8480983
TI  - [Localized type 2 dissection unrecognized by transesophageal echography. Apropos
      of a case].
AB  - The authors report a case of type 2 dissection, strictly confined to the terminal
      portion of the ascending aorta, not seen by transesophageal echocardiography
      because of the existence of a blind spot and responsible for a false negative.
      The role of TEE in the diagnostic approach to dissections is reviewed, as are its
      limitations, of which it is important to be aware because of the poor prognosis
      of pathology of this type.

PMID- 8480984
TI  - [Simultaneous prescription of digoxin and an anti-arrhythmia agent, is it
      dangerous?].
AB  - Many anti-arrhythmic drugs modify the pharmacokinetics of digoxin and increase
      serum levels. This possibility is considered for the majority of main anti
      arrhythmics on the basis of a review of the literature. Quinidine, propafenone,
      flecainide, amiodarone and verapamil increase blood digoxin levels, sometimes to
      twice their baseline values. Suggested mechanisms involve above all a decrease in
      clearance of digoxin and changes in its volume of distribution. Reported
      accidents considered to be a direct consequence of these interactions are
      nevertheless rare in the literature, and the need for modifying dose and
      increased cardiological surveillance in the case of such a combination is
      essentially a question of precaution. Disopyramide, procainamide and mexiletine
      do not appear to have any reported effects on the pharmacokinetics of digoxin,
      their combined prescription never having had any effect on blood digoxin levels.

PMID- 8480985
TI  - [Ambulatory or single measurement of blood pressure: comparison in a controlled
      trial in patients with hypertension].
AB  - Single measurement during a visit and the calculation of blood pressure pattern
      from an ambulatory record are different criteria for evaluation of the efficacy
      of antihypertensive treatment. Results obtained by these two methods were
      compared in a controlled trial. Acebutolol or enalapril were given double-blind
      to 17 patients with uncomplicated moderate essential hypertension. After a two
      week run-in period (with dummy treatment), patients were allocated at random into
      two parallel groups. They took acebutolol (400 mg) or enalapril (20 mg) as a
      single daily dose for 3 months. Ambulatory measurement of blood pressure for 24
      hours (Spacelabs 5200 SPM) was carried out the day prior to final inclusion, and
      at the end of the first then the third month of active treatment. A single
      measurement of blood pressure took place at the same times. Safety/acceptability
      of treatment based upon clinical and laboratory parameters was good. At
      inclusion, single measurements showed that all patients had a diastolic blood
      pressure (DBP) over 95 mmHg. However, ambulatory BP was significantly lower in
      the enalapril group. With treatment, the fall in DBP by single measurement was
      significant only at the first month with enalapril and at the third month with
      acebutolol while the effects of both drugs were significant on ambulatory
      systolic blood pressure (SBP) and DBP by the first month. Ambulatory BP revealed
      a superior antihypertensive action of acebutolol on SBP at the third month but
      this was not shown by single BP measurements. These results confirm the
      specificity of trial protocols of antihypertensive drugs based upon ambulatory BP
      measurements.

PMID- 8480986
TI  - [Antihypertensive action, clinical and biological acceptability of perindopril:
      main results in 23,460 patients with mild to moderate hypertension treated for 6
      months in general practice].
AB  - Efficacy and acceptability of perindopril (Coversyl) in general practice were
      evaluated in 23,460 hypertensive patients (52.9% women) during an open six month
      trial. Patients had essential mild to moderate hypertension (94 mmHg < supine DBP
      < 115 mmHg) associated or not with obesity (34%), diabetes (12%),
      hypercholesterolemia (36%), smoking habits (24%). Mean hypertension duration was
      6.5 years, 70 p. cent of patients were 50 to 69 years old and 12 p. cent 70 years
      old or more. Perindopril was started at 4 mg except in older and patients with
      renal insufficiency (2 mg). If supine DBP remained > 90 mmHg the dose was doubled
      up to 8 mg/day, then a thiazide diuretic was added. Monotherapy was held in 90 p.
      cent of cases all along the study, more than 8 over 10 times at 2 or 4 mg/day.
      Normalized patients (DBP < or = 90 mmHg) were 69.87 and 95 p. cent respectively
      at the first, third and sixth month. Mean supine SBP and DBP decrease were 27.3
      and 18.0 mmHg. Antihypertensive activity was similar in patients taking
      psychotrope or non steroidal anti-inflammatory agents and in others, as well as
      in older (> or = 70 years), diabetics and obeses, however with a significantly
      more frequent bitherapy in these last three sub-groups. Cough, a well known side
      effect of ACEI led to withdrawal in only 2.6 p. cent of cases. Withdrawals for
      side-effect were more frequent in older patients (6.1%), in those taking
      psychotrope (5.3%) or non steroidal anti-inflammatory agents (6.0%) than in
      diabetics (4.1%) or the others (4.1%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8480987
TI  - [Aneurysm of the interatrial septum. Contribution of transesophageal echography.
      Relation with systemic embolic complications].
AB  - The aim of this study was to evaluate the contribution of transesophageal
      echocardiography to the diagnosis of aneurysms of the interatrial septum and to
      identify the role played by this condition in unexplained systemic embolic
      accidents. Thirty two aneurysms of the interatrial septum were discovered in a
      consecutive series of 751 transesophageal echocardiograms, i.e. an incidence of
      4.2 per cent. The diagnosis was possible by transthoracic echocardiography in
      only 9 cases (28%). Search for a patent foramen ovale by a contrast test was
      positive in 87 per cent of cases of aneurysm of the interatrial septum as
      compared with 45 per cent for patients without an aneurysm (p < 0.01). In
      patients in whom transesophageal echocardiography was requested for etiological
      evaluation of an ischemic vascular accident of embolic origin (n = 191), an
      aneurysm of the interatrial septum was found in 8.3 per cent of cases. In
      patients with no history of a systemic embolic accident (n = 560), the incidence
      of septums of the interatrial septum was 2.8 per cent (p < 0.01). Furthermore, 50
      per cent of patients with an aneurysm of the interatrial septum had a history of
      systemic embolism. Transesophageal echocardiography thus appears to be superior
      to transthoracic echocardiography in the positive diagnosis of aneurysms of the
      interatrial septum and our study is suggestive of their emboligenic nature.

PMID- 8480988
TI  - Myxozyma vanderwaltii sp. nov. (Candidaceae), a new yeast species isolated from a
      flower of Protea repens (L.) L.
AB  - Three strains of an undescribed species of the genus Myxozyma were recovered. The
      new species differs from other accepted species of the genus in its assimilation
      pattern of carbon sources, mol% G + C and low DNA-DNA homology. A description of
      the new species, Myxozyma vanderwaltii, and a key to the species accepted in the
      genus are given.

PMID- 8480989
TI  - Mycelial elongation and sporulation of two fungi on amended media in light or
      dark.
AB  - Botrytis allii and Collectotrichum dematium are onion pathogens which can infect
      in the field and cause decay in storage. Some phenolics can hinder development of
      these fungi, but the effect of cytokinins is not clear. Cytokinins (kinetin or 6
      benzyladenine) or phenolics (caffeic or chlorogenic acids) were added to agar at
      concentrations of 0 to 10(-3) M. Cultures were continuously irradiated with
      fluorescent light or maintained in the dark for 6 days. On unamended media, final
      mycelial elongation was 45 or 17.8 mm and sporulation was 28 or 10.6 x 10(4)
      spores/ml for Botrytis and Colletotrichum, respectively. For Botrytis, mycelial
      elongation was slightly (5%) but significantly increased and sporulation
      increased by 21% by incubation on phenolics as compared to cytokinins. Mycelial
      extension of Colletotrichum was not affected by amendment. Sporulation of
      Colletotrichum on kinetin was 16 to 28% greater than on the other amendments. As
      amendments concentration increased elongation of mycelia of both fungi decreased.
      Sporulation of Botrytis increased by 60% as amendment concentration increased
      from 0 to 10(-5) M and then decreased 25% at 10(-3) M. As amendment concentration
      increased from 0 to 10(-3) M, sporulation of Colletotrichum increased by 45%.
      Incubation in light increased mycelial extension 3 to 17% for Botrytis and
      Colletotrichum respectively, and sporulation was increased approximately 78% for
      both fungi. These compounds do not appear to inhibit development of these
      Botrytis or Colletotrichum species in culture.

PMID- 8480990
TI  - The use of neural networks to aid in microorganism identification: a case study
      of Haemophilus species identification.
AB  - Neural networks were evaluated as a tool for identifying microorganisms. Data
      from a microorganism identification table were used to train a neural network.
      Based on the results of identification tests the neural network could correctly
      identify each Haemophilus species from a group of 13 Haemophilus species.

PMID- 8480991
TI  - Why it pays for bacteria to delete disused DNA and to maintain megaplasmids.
AB  - Genetic information for disused metabolic systems is easily lost. This can be
      understood on the basis of a mathematic model for the description of the growth
      of individual microbial cells. The essential features of the model are that the
      uptake of nutrients is proportional to the surface area of the cell and
      maintenance costs are proportional to the volume. This explains why disused genes
      are easily lost. Growth of the individual cell continues until DNA replication of
      the genome is completed. The consequence is that cells with a large genome size
      are bigger at the moment of cell division. This results in a less favourable
      surface to volume ratio, which has a negative influence on the population growth
      rate. This means that cells with a smaller genome size will have a selective
      advantage. In cells in which the total DNA is divided over several units which
      replicate simultaneously (e.g. a cell with more chromosomes or a cell with one
      chromosome and one or more megaplasmids) a high surface to volume ratio can be
      maintained. The great metabolic differences between phylogenetically strongly
      related bacteria are due to loss of genetic information for complex metabolic
      characters in order to maintain a small genome size and a favourable surface to
      volume ratio.

PMID- 8480992
TI  - The growth kinetics of B. subtilis.
AB  - There has been considerable discussion by Kubitschek and Cooper concerning the
      growth rate of cells of E. coli throughout the cell cycle. Consequently, it is
      relevant to test Kubitschek's linear model against the exponential model espoused
      by Cooper (and many others) with another organism and another technique. Burdett
      et al. measured, by electron microscopy and computer analysis of the
      microphotographs, the distribution of lengths of a population of cells of
      Bacillus subtilis grown in 0.4% succinate in a minimal medium. The data were
      fitted to the extended Collins-Richmond method of Kirkwood & Burdett which
      subdivided the cell cycle into several phases. I have taken their results and
      compared them with the linear and exponential growth models for the entire cell
      cycle after applying correction to the data for the shape of completed and
      forming poles; i.e., to put the data on a cell-volume basis instead of a cell
      length basis. Most of the correction involves no arbitrary assumptions. The
      conclusion is that global volume growth rate is nearly proportional to cell
      volume; i.e. growth of Bacillus subtilis is nearly exponential for almost every
      cell in the growing culture.

PMID- 8480993
TI  - Regulation of the expression of the Pseudomonas stutzeri recA gene.
AB  - With the aid of recA-lacZ fusion strains, the in vivo regulation of the
      Pseudomonas stutzeri recA gene has been studied. It is shown that expression of
      this gene can be induced with a variety of DNA damaging agents, as well as with
      agents that interfere with DNA replication. For this induction, the presence of
      an active RecA protein is essential. Sequence analysis of the promoter region of
      the P. stutzeri recA gene showed that its open reading frame is preceded by an
      SOS-box, suggesting a regulation of its expression, similar to the regulation of
      recA expression in Escherichia coli.

PMID- 8480994
TI  - Anaerobic fungi and their cellulolytic and xylanolytic enzymes.
AB  - Anaerobic fungi are the inhabitants of the digestive tract of herbivorous
      mammals, ruminants as well as non-ruminants. One of the major characteristics of
      all anaerobic fungi examined thus far, is their production and secretion of a
      range of polysaccharide-degrading enzymes, including cellulases, xylanases and
      glucoside-hydrolases. The cellulolytic enzymes of the anaerobic fungus
      Neocallimastix frontalis have been shown to possess a high activity. Therefore
      anaerobic fungi and/or their enzymes could be interesting for many
      biotechnological applications including saccharafication of lignocellulosic
      residues, production of polysaccharidehydrolysing enzymes. This review summarizes
      the present knowledge of anaerobic fungi with special emphasis on their
      cellulolytic and xylanolytic enzymes. Further, a comparison with aerobic fungi is
      made.

PMID- 8480995
TI  - Effect of bacterial lipopolysaccharide on the content of lipid peroxidation
      products in lungs and other organs of mice.
AB  - The influence of lipopolysaccharide from Escherichia coli (LPS, 17 mg/kg body
      weight) on the lipid peroxidation process in organs of mice was studied. The
      content of conjugated dienes (CD), lipid peroxides (LP), malondialdehyde (MDA)
      (all three lipid peroxidation by-products), peroxidase (PO) activity and wet-to
      dry weight ratio in lungs, heart, spleen, kidneys and liver were determined 1.5 h
      after intravenous injection of LPS. Animals observed at this time-point had
      reduced activity and decreased body temperature by about 2 degrees C, however,
      all analysed organs did not reveal any changes of wet-to-dry weight ratio
      comparing to organs from mice injected with sterile, pyrogen free 0.9% NaCl. Only
      extracts from heart and lungs showed significant increase in the tissue level of
      at least two lipid peroxidation products. The heart content of CD, MDA, and LP
      was about 1.5-, 1.3-, and 2.4-fold higher than in control group. In lungs CD and
      MDA increased 3.3- and 1.3-times but in spleen only content of LP was elevated.
      In these organs the suppression of PO activity was also observed. Liver and
      kidneys did not reveal any convincing enhancement of lipid peroxidation process
      and alterations of PO activity. Since free radical reactions are involved in
      lipid peroxidation process and inactivation of PO these results suggest that
      heart, lungs and spleen are the organs mostly exposed to oxidative stress during
      the first 1.5 h after single injection of LPS in mice.

PMID- 8480996
TI  - Biosynthesis and function of trehalose in Ectothiorhodospira halochloris.
AB  - Trehalose 6-phosphate synthase, catalyzing the reaction between UDP-glucose and
      glucose 6-phosphate and forming trehalose 6-phosphate, was isolated and partially
      purified (30-fold) from the phototrophic, halo-alkaliphilic bacterium
      Ectothiorhodospira halochloris. The activity is stabilized by 20 mM MgCl2, 50 mM
      NaCe and 2M glycine betaine. The molecular weight was 63000. The enriched enzyme
      had a MgCl2 optimum at 3-6mM, a pH optimum at 7.5 (in Tris-HCl buffer) and a
      temperature optimum at 50 degrees C. The Km-values were 1.5 x 10(-3) M for UDP
      glucose and 2 x 10(-3) M for glucose 6-phosphate. The enzyme showed a salinity
      dependence with optimal concentrations between 100 and 300mM salt. Higher
      concentrations of salt resulted in a decrease in activity. In the presence of
      inhibitory salt concentrations the compatible solute glycine betaine had a
      protective effect with a maximum between 0.5 and 2.0M.

PMID- 8480997
TI  - In vivo labeling of Escherichia coli cell envelope proteins with N
      hydroxysuccinimide esters of biotin.
AB  - The primary amine coupling reagents succinimidyl-6-biotinamido-hexanoate (NHS-A
      biotin) and sulfosuccinimidyl-6-biotinamido-hexanoate (NHS-LC-biotin) were tested
      for their ability to selectively label Escherichia coli cell envelope proteins in
      vivo. Probe localization was determined by examining membrane, periplasmic, and
      cytosolic protein fractions. Both hydrophobic NHS-A-biotin and hydrophilic NHS-LC
      biotin were shown to preferentially label outer membrane, periplasmic, and inner
      membrane proteins. NHS-A- and NHS-LC-biotin were also shown to label a specific
      inner membrane marker protein (Tet-LacZ). Both probes, however, failed to label a
      cytosolic marker (the omega fragment of beta-galactosidase). The labeling
      procedure was also used to label E. coli cells grown in low-salt Luria broth
      medium supplemented with 0, 10, and 20% sucrose. Outer membrane protein A (OmpA)
      and OmpC were labeled by both NHS-A- and NHS-LC-biotin at all three sucrose
      concentrations. In contrast, OmpF was labeled by NHS-A-biotin but not by NHS-LC
      biotin in media containing 0 and 10% sucrose. OmpF was not labeled by either NHS
      A- or NHS-LC-biotin in E. coli cells grown in medium containing 20% sucrose.
      Coomassie-stained gels, however, revealed similar quantities of OmpF in E. coli
      cells grown at all three sucrose concentrations. These data indicate that there
      was a change in outer membrane structure due to increased osmolarity, which
      limits accessibility of NHS-A-biotin to OmpF.

PMID- 8480998
TI  - Distribution of viral abundance in the reef environment of Key Largo, Florida.
AB  - The distribution of viral and microbial abundance in the Key Largo, Fla., reef
      environment was measured. Viral abundance was measured by transmission electron
      microscope direct counts and plaque titer on specific bacterial hosts in water
      and sediment samples from Florida Bay (Blackwater Sound) and along a transect
      from Key Largo to the outer edge of the reef tract in Key Largo Sanctuary. Water
      column viral direct counts were highest in Blackwater Sound of Florida Bay (1.2 x
      10(7) viruses per ml), decreased to the shelf break (1.7 x 10(6) viruses per ml),
      and were inversely correlated with salinity (r = -0.97). Viral direct counts in
      sediment samples ranged from 1.35 x 10(8) to 5.3 x 10(8)/cm(3) of sediment and
      averaged nearly 2 orders of magnitude greater than counts in the water column.
      Viral direct counts (both sediment and water column measurements) exceeded plaque
      titers on marine bacterial hosts (Vibrio natriegens and others) by 7 to 8 orders
      of magnitude. Water column viral abundance did not correlate with bacterial
      direct counts or chlorophyll a measurements, and sediment viral parameters did
      not correlate with water column microbial, viral, or salinity data. Coliphage,
      which are indicators of fecal pollution, were detected in two water column
      samples and most sediment samples, yet their concentrations were relatively low
      (<2 to 15/liter for water column samples, and <2 to 108/cm(3) of sediment). Our
      findings indicate that viruses are abundant in the Key Largo environment,
      particularly on the Florida Bay side of Key Largo, and that processes governing
      their distribution in the water column (i.e., salinity and freshwater input) are
      independent of those governing their distribution in the sediment environment.

PMID- 8480999
TI  - Microbiological transformations of lipids: acyl-specific hydrolysis of lard by
      yeasts.
AB  - The fatty acid and positional specificities of Saccharomyces cerevisiae (UI
      SACCH) and Schizosaccharomyces octosporus (NRRL Y-854) in the hydrolysis of lard
      were studied by using gas-liquid chromatography. Synthetic triglycerides were
      used to determine the positional specificities of the lipases of both organisms.
      Palmitic acid is specifically cleaved from all three triglyceride ester positions
      by S. cerevisiae, while S. octosporus was able to cleave stearic acid at either
      position 1 or position 3 of the glycerol moiety. Preparative scale fermentation
      with 200 g of lard per liter yielded 48.4 g of palmitic acid per liter with S.
      cerevisiae and 42 g of stearic acid per liter with S. octosporus. The free fatty
      acids produced by microbial transformation of lard were characterized spectrally
      (1H and C nuclear magnetic resonance and mass spectrometry) and
      chromatographically (thin-layer and gas chromatographies).

PMID- 8481000
TI  - Production of high concentrations of ethanol from inulin by simultaneous
      saccharification and fermentation using Aspergillus niger and Saccharomyces
      cerevisiae.
AB  - Pure nonhydrolyzed inulin was directly converted to ethanol in a simultaneous
      saccharification and fermentation process. An inulinase-hyperproducing mutant,
      Aspergillus niger 817, was grown in a submerged culture at 30 degrees C for 5
      days. The inulin-digestive liquid culture (150 ml) was supplemented with 45 g of
      inulin, 0.45 g of (NH4)2SO4, and 0.15 g of KH2PO4. The medium (pH 5.0) was
      inoculated with an ethanol-tolerant strain, Saccharomyces cerevisiae 1200, and
      fermentation was conducted at 30 degrees C. An additional 20 g of inulin was
      added to the culture after 15 h of fermentation. S. cerevisiae 1200 utilized 99%
      of the 65 g of inulin during the fermentation, and produced 20.4 and 21.0%
      (vol/vol) ethanol from chicory and dahlia inulins, respectively, within 3 days of
      fermentation. The maximum volumetric productivities of ethanol were 6.2 and 6.0
      g/liter/h for chicory and dahlia inulins, respectively. The conversion efficiency
      of inulin to ethanol was 83 to 84% of the theoretical ethanol yield.

PMID- 8481001
TI  - Glucose and carbon dioxide metabolism by Succinivibrio dextrinosolvens.
AB  - Growth rates and culture conditions affect the molar yields of catabolic end
      products and cells of Succinivibrio dextrinosolvens growing on glucose. When
      growth in chemostats occurred, a trend toward decreased succinate and acetate
      formation, increased lactate formation, and a higher yield of cells correlated
      with an increase in the growth rate. End product and cellular yields on defined
      medium indicate a high maintenance requirement for S. dextrinosolvens and are
      consistent with energy conservation steps during the formation of acetate and
      succinate. Simultaneous carbon dioxide consumption and production were determined
      from batch studies with NaH14CO3, and the amounts were used to calculate a
      fermentation balance. These data also indicated that CO2 consumption lags behind
      CO2 production early in the growth phase, becoming equivalent to it toward
      stationary phase. Significantly more CO2 was fixed by S. dextrinosolvens when the
      organism was cultured in chemostats sparged with CO2. Formate is in part derived
      from free CO2 in the medium, as shown by 13C nuclear magnetic resonance studies,
      and may be sensitive to CO2 availability. Nuclear magnetic resonance data are
      consistent with the carboxylation of a C3 intermediate of the Embden-Meyerhof
      Parnas pathway of glycolysis to a C4 compound to eventually form succinate.

PMID- 8481002
TI  - Degradation of benzene, toluene, ethylbenzene, and xylenes (BTEX) by the lignin
      degrading basidiomycete Phanerochaete chrysosporium.
AB  - Degradation of the BTEX (benzene, toluene, ethylbenzene, and o-, m-, and p
      xylenes) group of organopollutants by the white-rot fungus Phanerochaete
      chrysosporium was studied. Our results show that the organism efficiently
      degrades all the BTEX components when these compounds are added either
      individually or as a composite mixture. Degradation was favored under
      nonligninolytic culture conditions in malt extract medium, in which extracellular
      lignin peroxidases (LIPs) and manganese-dependent peroxidases (MNPs) are not
      produced. The noninvolvement of LIPs and MNPs in BTEX degradation was also
      evident from in vitro studies using concentrated extracellular fluid containing
      LIPs and MNPs and from a comparison of the extents of BTEX degradation by the
      wild type and the per mutant, which lacks LIPs and MNPs. A substantially greater
      extent of degradation of all the BTEX compounds was observed in static than in
      shaken liquid cultures. Furthermore, the level of degradation was relatively
      higher at 25 than at 37 degrees C, but pH variations between 4.5 and 7.0 had
      little effect on the extent of degradation. Studies with uniformly ring-labeled
      [14C]benzene and [14C]toluene showed substantial mineralization of these
      compounds to 14CO2.

PMID- 8481003
TI  - Antibody-magnetite method for selective concentration of Giardia lamblia cysts
      from water samples.
AB  - An antibody-magnetite method was developed in order to selectively concentrate
      Giardia cysts from water samples. The indirect technique employed a mouse
      immunoglobulin G anti-Giardia antibody as a primary antibody and an anti-mouse
      immunoglobulin G antibody-coated magnetite particle as a secondary labeling
      reagent. The magnetically labeled cysts were then concentrated by high-gradient
      magnetic separation. Ninety percent of the seeded cysts were recovered from
      buffer when this method was employed. An average of 82% of the seeded cysts were
      recovered from water samples with various turbidities. Significantly higher cyst
      recoveries were obtained from water samples with turbidities below 600
      nephelometric turbidity units.

PMID- 8481004
TI  - ScrFI restriction-modification system of Lactococcus lactis subsp. cremoris
      UC503: cloning and characterization of two ScrFI methylase genes.
AB  - Two genes from the total genomic DNA of dairy starter culture Lactococcus lactis
      subsp. cremoris UC503, encoding ScrFI modification enzymes, have been cloned and
      expressed in Escherichia coli. No homology between the two methylase genes was
      detected, and inverse polymerase chain reaction of flanking chromosomal DNA
      indicated that both were linked on the Lactococcus genome. Neither clone encoded
      the cognate endonuclease. The DNA sequence of one of the methylase genes (encoded
      by pCI931M) was determined and consisted of an open reading frame 1,170 bp long,
      which could encode a protein of 389 amino acids (M(r), 44.5). The amino acid
      sequence contained the highly characteristic motifs of an m5C methylase.
      Extensive regions of homology were observed with the methylases of NlaX, EcoRII,
      and Dcm.

PMID- 8481005
TI  - Evaluation of colilert-marine water for detection of total coliforms and
      Escherichia coli in the marine environment.
AB  - A test that allows for early detection of fecally contaminated coastal water
      would enhance public health protection. Colilert-Marine Water (Colilert-MW;
      Environetics, Branford, Conn.) is a rapid 24-h test that has recently been
      developed to detect total coliforms and Escherichia coli in coastal water. We
      performed a premarketing evaluation of the Colilert-MW product, testing it in
      parallel with the multiple tube fermentation (MTF) method for 86 coastal water
      samples in southern California. Statistical analysis was performed by using
      paired t tests and linear regression. Bacterial isolates were evaluated by
      biochemical and genetic analysis. The results of this study showed a strong
      correlation between the traditional MTF and the Colilert-MW method for detection
      of total coliforms (r = 0.95) and E. coli (r = 0.89) in ocean water samples.
      Paired t-test results indicated that the Colilert-MW and MTF were equivalent in
      detecting E. coli and that the Colilert-MW may be more sensitive in the detection
      of total coliforms. We conclude that Colilert-MW would be a useful tool with
      which to monitor coastal beach water.

PMID- 8481006
TI  - Identification of metabolites from the degradation of fluoranthene by
      Mycobacterium sp. strain PYR-1.
AB  - Mycobacterium sp. strain PYR-1, previously shown to extensively mineralize high
      molecular-weight polycyclic aromatic hydrocarbons in pure culture and in
      sediments, degrades fluoranthene to 9-fluorenone-1-carboxylic acid. In this
      study, 10 other fluoranthene metabolites were isolated from ethyl acetate
      extracts of the culture medium by thin-layer and high-performance liquid
      chromatographic methods. On the basis of comparisons with authentic compounds by
      UV spectrophotometry and thin-layer chromatography as well as gas chromatography
      mass spectral and proton nuclear magnetic resonance spectral analyses, the
      metabolites were identified as 8-hydroxy-7-methoxyfluoranthene, 9
      hydroxyfluorene, 9-fluorenone, 1-acenaphthenone, 9-hydroxy-1-fluorenecarboxylic
      acid, phthalic acid, 2-carboxybenzaldehyde, benzoic acid, phenylacetic acid, and
      adipic acid. Authentic 9-hydroxyfluorene and 9-fluorenone were metabolized by
      Mycobacterium sp. strain PYR-1. A pathway for the catabolism of fluoranthene by
      Mycobacterium sp. strain PYR-1 is proposed.

PMID- 8481007
TI  - High-level cryIVD and cytA gene expression in Bacillus thuringiensis does not
      require the 20-kilodalton protein, and the coexpressed gene products are
      synergistic in their toxicity to mosquitoes.
AB  - Interactions among the 20-kDa protein gene and the cytA and cryIVD genes located
      in a 9.4-kb HindIII fragment were studied. A series of plasmids containing a
      combination of these different genes was constructed by using the Escherichia
      coli/Bacillus thuringiensis shuttle vector pHT3101. The plasmids were then used
      to transform an acrystalliferous strain, cryB, derived from B. thuringiensis
      subsp. kurstaki. The results from sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis and immunoblot analyses suggest that although the 20-kDa protein
      is required for the efficient CytA protein production in E. coli, it is not
      required in B. thuringiensis. With or without the truncated 20-kDa protein gene,
      the CtyA and/or CryIVD proteins are produced and form parasporal inclusions in B.
      thuringiensis cells. However, more-efficient expression is obtained when a second
      protein, probably acting as a chaperonin, is present. In addition, the time
      course studies show that the CytA and CryIVD proteins are coordinately produced.
      Both the crude B. thuringiensis culture and purified inclusions from each
      recombinant B. thuringiensis strain are toxic to Culex quinquefasciatus larvae.
      The parasporal inclusions formed in B. thuringiensis cells are mosquitocidal,
      with CytA synergizing CryIVD toxicity.

PMID- 8481008
TI  - Aspartate aminotransferase and tylosin biosynthesis in Streptomyces fradiae.
AB  - Aspartate aminotransferase as well as valine dehydrogenase and threonine
      dehydratase was required for the biosynthesis of tylosin in Streptomyces fradiae
      NRRL 2702. The biosynthesis of these enzymes and tylosin production were
      repressed by high concentrations of ammonium ions. The change in specific tylosin
      production rates in batch cultures with different initial concentrations of
      ammonium ions showed patterns similar to those of the specific production rates
      of aspartate aminotransferase, valine dehydrogenase, and threonine dehydratase.
      Aspartate aminotransferase has been purified by acetone precipitation, DEAE
      cellulose, hydroxyapatite, and preparative electrophoresis chromatographies. The
      purified enzyme (120 kDa) consisted of two subunits identical in molecular mass
      (54 kDa) and showed homogeneity, giving one band with a pI of 4.2 upon
      preparative isoelectric focusing. The enzyme was specific for L-aspartate in the
      forward reaction; the Km values were determined to be 2.7 mM for L-aspartate, 0.7
      mM for 2-oxyglutarate, 12.8 mM for L-glutamate, and 0.15 mM for oxaloacetate. The
      enzyme was somewhat thermostable, having a maximum activity at 55 degrees C, and
      had a broad pH optimum that ranged from 5.5 to 8.0. The mode of action was a ping
      pong-bi-bi mechanism.

PMID- 8481009
TI  - Isolation and characterization of an extracellular glycosylated protein complex
      from Clostridium thermosaccharolyticum with pectin methylesterase and
      polygalacturonate hydrolase activity.
AB  - An extracellular protein complex was isolated from the supernatant of a pectin
      limited continuous culture of Clostridium thermosaccharolyticum Haren. The
      complex possessed both pectin methylesterase (EC 3.1.1.11) and exo-poly-alpha
      galacturonate hydrolase (EC 3.2.1.82) activity and produced digalacturonate from
      the nonreducing end of the pectin chain. The protein consisted of 230- and 25-kDa
      subunits. The large subunit contained 10% (wt/wt) sugars (N-acetylgalactosamine
      and galactose). Under physiological conditions both activities acted in a
      coordinated manner: the ratio between methanol and digalacturonate released
      during degradation was constant and equal to the degree of esterification of the
      pectin used. Prolonged incubation of the enzyme with pectin led to a
      nondialyzable fraction that was enriched in neutral sugars, such as arabinose,
      rhamnose, and galactose; the high rhamnose/galacturonic acid ratio was indicative
      of hairy region-like structures. The smallest substrate utilized by the hydrolase
      was a tetragalacturonate. Vmax with oligogalacturonates increased with increasing
      chain length. The Km and Vmax for the polygalacturonate hydrolase with citrus
      pectate as a substrate were 0.8 g liter-1 and 180 mumol min-1 mg of protein-1,
      respectively. The Km and Vmax for the esterase with citrus pectin as a substrate
      were 1.2 g liter-1 and 440 mumol min-1 mg of protein-1, respectively. The
      temperature optima for the hydrolase and esterase were 70 and 60 degrees C,
      respectively. Both enzyme activities were stable for more than 1 h at 70 degrees
      C. The exo-polygalacturonate hydrolase of Clostridium thermosulfurogenes was
      partially purified while the methylesterase was also copurified.

PMID- 8481010
TI  - Selection of Pseudomonas sp. strain HBP1 Prp for metabolism of 2-propylphenol and
      elucidation of the degradative pathway.
AB  - A mutant of Pseudomonas sp. strain HBP1, originally isolated on 2
      hydroxybiphenyl, was selected for the ability to grow on 2-propylphenol as the
      sole carbon and energy source. In the mutant strain, which was designated as
      Pseudomonas sp. strain HBP1 Prp, the cellular induction mechanism involved in the
      synthesis of the NADH-dependent monooxygenase is changed. 2-Propylphenol, which
      is known to be a substrate of the monooxygenase, does not induce formation of the
      monooxygenase in the wild type but does have an induction effect in the mutant
      strain. Furthermore, in contrast to the wild type, mutant strain HBP1 Prp
      constitutively produces a small amount of monooxygenase and metapyrocatechase.
      The enzymes from strain HBP1 Prp catalyzing the first three steps in the
      degradation of 2-propylphenol--the NADH-dependent monooxygenase, the
      metapyrocatechase, and the meta fission product hydrolase--were partially
      purified, and their activities were measured. The product of the monooxygenase
      activity was identified by mass spectrometry as 3-propylcatechol. The
      metapyrocatechase used this compound as a substrate and produced a yellow meta
      fission product that was identified by mass spectrometry as 2-hydroxy-6-oxo-nona
      2,4- dienoate. Butyrate could be detected as a product of the meta fission
      product hydrolase in crude cell extract of 2-propylphenol-grown cells, as well as
      an intermediate in culture broths during growth on 2-propylphenol. All three
      enzymes expressed highest activities for the metabolites of the degradation of 2
      hydroxybiphenyl.

PMID- 8481011
TI  - Survival of nonculturable Aeromonas salmonicida in lake water.
AB  - The survival of Aeromonas salmonicida subsp. salmonicida was investigated in
      sterile and untreated lake water. In sterile lake water (filtered and
      autoclaved), it was found that cells of A. salmonicida entered a nonculturable
      but viable condition. Viability was determined by flow cytometry with the dye
      rhodamine 123, which is taken up and maintained within cells with a membrane
      potential. For survival studies in untreated lake water, A. salmonicida was
      marked with the xylE gene by using the plasmid pLV1013. Marked cells were
      detected by growth on tryptone soy agar and tryptone soy agar supplemented with
      kanamycin. Cells were also detected by polymerase chain reaction DNA
      amplification of the xylE gene and a chromosomal DNA fragment specific for A.
      salmonicida (pLV1013). The results indicated that A. salmonicida entered a
      nonculturable condition in untreated lake water over a 21-day study. The
      viability of nonculturable cells could not be determined in mixed samples;
      however, the presence of nonculturable cells containing both chromosomal and
      plasmid DNA was confirmed.

PMID- 8481012
TI  - Quality control of bacterial enumeration.
AB  - Standard bacterial suspensions can be used to assess test method performance, via
      control charts, and inhibition of recovery when analyzing water samples.
      Variability in standard suspensions prepared from different strains and species
      and the use of frozen environmental samples for quality control for spore and
      bacteriophage analyses are also discussed.

PMID- 8481013
TI  - Purification, characterization, gene cloning, and sequencing of a new beta
      glucosidase from Bacillus circulans subsp. alkalophilus.
AB  - An intracellular beta-glucosidase was purified from cell extracts of Bacillus
      circulans subsp. alkalophilus by NAD affinity and high-performance anion-exchange
      chromatographies. The enzyme was active against a wide range of aryl-beta
      glucosides and beta-linked disaccharides. The structural gene for beta
      glucosidase was cloned in Escherichia coli. The beta-glucosidase gene consisted
      of an open reading frame of 1,350 bp encoding a protein of 450 amino acids with a
      calculated M(r) of 51,303. The enzyme exhibited from 45 to 66% identity with five
      bacterial beta-glucosidases.

PMID- 8481014
TI  - Comparison of fluorescent gentamicin-thallous-carbonate and KF streptococcal
      agars to enumerate enterococci and fecal streptococci in meats.
AB  - Two selective and differential media were compared for their abilities to
      enumerate enterococci and fecal streptococci in pork, beef, and poultry products.
      Counts obtained on KF streptococcal (KF) agar were compared with counts obtained
      on fluorescent gentamicin-thallous-carbonate (fGTC) agar. Reactions of 13 known
      enterococcal species were also observed. All 13 species of enterococci as well as
      Streptococcus bovis and Streptococcus equinus grew equally well on fGTC agar. KF
      streptococcal medium allowed growth of most species of enterococci but not S.
      bovis and S. equinus. Quantitative comparisons between the two media inoculated
      with pure cultures of known species of enterococci revealed equivalent plate
      counts following incubation. However, when meat samples were plated, counts on
      fGTC agar were consistently and significantly higher than counts on KF agar for
      all sample sources.

PMID- 8481015
TI  - Comparison of chemical assay, bioassay, enzyme-linked immunosorbent assay, and
      dot blot hybridization for detection of aerobactin in members of the family
      Enterobacteriaceae.
AB  - In order to determine the best strategy for detection of aerobactin in members of
      the family Enterobacteriaceae, we compared the results of three phenotypic
      assays, including a chemical assay, a cross-feeding bioassay, and an enzyme
      linked immunosorbent assay (ELISA), with the results of a dot blot hybridization
      assay using a specific probe for the aerobactin genes. The sensitivity and
      specificity of the ELISA were better than those of the chemical and cross-feeding
      assays, but the results of dot blot hybridization were the most reproducible.
      However, none of the Serratia and Enterobacter cloacae strains which produced
      aerobactin hybridized with the probe. We concluded that the best strategy for
      aerobactin detection is a two-step procedure that combines screening by dot blot
      hybridization with an ELISA for negative strains.

PMID- 8481016
TI  - Treatment of a Nocardia brasiliensis mycetoma with sulfamethoxazole and
      trimethoprim, amikacin, and amoxicillin and clavulanate.

PMID- 8481017
TI  - A controlled multiphase trial of ketotifen to minimize neurofibroma-associated
      pain and itching.
AB  - BACKGROUND AND DESIGN: Based on potential contributions of mast cells to
      neurofibroma-associated itching, pain, and tenderness, the mast cell blocker
      ketotifen fumarate (Zaditen, Sandoz Pharmaceuticals Corp, Hanover, NJ) has been
      proposed as a treatment for these symptoms. To test the hypothesis that ketotifen
      decreases neurofibroma-associated itching, pain, and tenderness, data were
      accumulated from two protocols. The first was an open-label protocol involving 25
      patients with relatively severe symptoms (1170 patient-months), and the second
      was a double-blind protocol involving 27 patients with either relatively mild or
      severe neurofibroma-associated symptoms (316 patient-months). All subjects
      received either oral placebo or 2 to 4 mg of ketotifen fumarate per day. Using a
      scale of 1 to 10, symptoms were measured before, during, and after treatment.
      RESULTS: Itching severity scores (means) were as follows: for all patients
      receiving ketotifen, 7.8 before, 2.8 during, and 7.2 after treatment; for
      ketotifen-treated patients in the double-blind protocol, 6.6 before, 3.9 during,
      and 6.4 after treatment; and for placebo-treated patients, 6.0 before and 6.0
      during treatment. Pain and tenderness severity scores (means) were as follows:
      for all patients treated with ketotifen, 7.6 before, 3.6 during, and 6.6 after
      treatment; for double-blind ketotifen-treated patients, 6.3 before, 4.6 during,
      and 6.1 after treatment; and for placebo-treated patients, 7.9 before and 6.7
      during treatment. CONCLUSIONS: Pretreatment, treatment, and posttreatment levels
      of itching, pain, and tenderness associated with neurofibromas, using both open
      label and double-blind protocols, indicate that ketotifen offers a realistic
      approach to treating these symptoms.

PMID- 8481018
TI  - Long-term suppression of recurrent genital herpes with acyclovir. A 5-year
      benchmark. Acyclovir Study Group.
AB  - BACKGROUND AND DESIGN: This multicenter trial (19 sites) was initiated in 1984 in
      more than 1100 immunocompetent individuals with a history of frequently recurring
      genital herpes (mean, > or = 12 episodes per year). The first year of this
      suppressive therapy trial was placebo controlled, with acyclovir being provided
      for episodic treatment in both groups. Thereafter, patients were treated with
      open-label acyclovir suppressive therapy on a long-term basis (400 mg twice
      daily) to continue to assess its long-term safety and efficacy. Complete data are
      available on 389 of the 430 patients who began the fifth year of the study.
      RESULTS: Patients were seen quarterly for review of diaries and clinical
      laboratory evaluations. The percentage of patients recurrence free for any 3
      month quarter of the fifth year ranged from 86% to 90%. The mean annual number of
      recurrences per patient declined from 1.7 during the first year to 0.8 during the
      fifth year of suppressive therapy. The frequency of false prodromes has also
      decreased over time. More than 20% of the patients receiving suppressive therapy
      for 5 years have been recurrence free the entire time. The duration of herpetic
      outbreaks during suppressive therapy has not changed. CONCLUSION: This study
      extends the safety and efficacy profile of oral acyclovir in the suppression of
      genital herpes to 5 years. The majority of the patients were recurrence free on
      an annual basis during suppressive therapy. Therapy was well tolerated. Acyclovir
      usage was not associated with serious side effects or cumulative toxicity.

PMID- 8481019
TI  - Creeping eruption. A review of clinical presentation and management of 60 cases
      presenting to a tropical disease unit.
AB  - BACKGROUND AND DESIGN: Cutaneous larva migrans is an infection with a larval
      nematode, most frequently by dog or cat hookworms. It has a characteristic
      presentation that is easily recognizable. We reviewed the charts of 60 patients
      with cutaneous larva migrans who presented to the Tropical Disease Unit, Toronto
      (Ontario) Hospital, during a 6-year period. RESULTS: Ninety-five percent of the
      patients were Canadians who had recently returned from the tropics or subtropics,
      notably the Caribbean. Almost all patients had a linear or serpiginous, very
      pruritic larval track. Topical thiabendazole was efficacious in 52 (98%) of 53
      patients treated. Albendazole cured six (88%) of seven patients treated. Because
      of adverse effects, oral thiabendazole and liquid nitrogen were not utilized.
      CONCLUSION: We conclude that topical thiabendazole and oral albendazole are very
      effective and safe modalities for the treatment of cutaneous larva migrans.

PMID- 8481020
TI  - Studies on the repopulation of Langerhans cells in partial-thickness wounds. Air
      exposed and occlusively dressed.
AB  - BACKGROUND AND DESIGN: The use of occlusive dressings on partial-thickness wounds
      has been shown to promote early epithelization and connective tissue
      regeneration. Because Langerhans cells (LC) have been implicated in epidermal
      homeostasis we studied the rate of repopulation of LC in air-exposed vs
      occlusively dressed wounds. Partial-thickness wounds on the backs of pigs were
      treated with occlusive dressings (Tegaderm) for 3 days or left air exposed. On
      days 3, 5, 7, and 11 after keratome wounding, epidermal sheets from the
      regenerating wounds were isolated and stained for LC using indirect
      immunofluorescence. The LC populations were quantified in the interfollicular
      regions and expressed as average number of cells per square millimeter of
      epidermis. RESULTS: Normal skin control had 1024 +/- 93 LC/mm2 distributed
      uniformly. On day 3 after wounding occlusive-dressing-treated wounds had an LC
      repopulation of 46% of the original value. Langerhans cells in air-exposed skin
      could not be evaluated until epithelization occurred at day 5. Langerhans cells
      in both air-exposed and occlusive-dressing-treated wounds were 46% to 51%, 65% to
      71%, and 91% of normal value, respectively, on days 5, 7, and 11. CONCLUSIONS: We
      conclude that at least in regenerating epidermis, the degree of repair of the new
      epidermis apparently plays a limited role in the migration of LC, as does the
      earlier growth of blood vessels.

PMID- 8481021
TI  - Autoimmune pemphigus. A distinct staining pattern with an anti-desmoglein
      antibody.
AB  - BACKGROUND AND DESIGN: Diagnosis of autoimmune pemphigus is based on the
      immunodetection of IgG deposits in the epidermal intercellular spaces. Desmoglein
      is a desmosomal component that has been assumed to be the antigen of pemphigus
      foliaceus. We investigated the use of one monoclonal antibody (32-2B) to
      desmoglein 1 on paraffin sections. Twenty-nine pemphigus samples were studied (22
      pemphigus vulgaris, seven pemphigus foliaceus). RESULTS: In 29 patients suffering
      from autoimmune pemphigus, the staining for desmoglein was represented by coarse
      granules along the cytoplasmic borders of epithelial cells in lesional and
      perilesional skin and in mucous membranes. This peculiar staining is different
      from the fine dots along the cytoplasmic membrane observed in normal skin. This
      abnormal staining seems to be specific for pemphigus. Hereditary acantholytic
      diseases and other diseases such as bullous pemphigoid, intraepidermal IgA
      dermatosis, eczema, herpes, and transient acantholytic dermatosis show a similar
      pattern to normal skin. CONCLUSION: The use of 32-2B on biopsy specimens in cases
      of autoimmune pemphigus demonstrated a specific staining pattern. It could be
      used on paraffin sections as a diagnostic test of autoimmune pemphigus. It can
      even be done retrospectively.

PMID- 8481022
TI  - The distribution of IgA pemphigus antigen in human skin and the role of IgA anti
      cell surface antibodies in the induction of intraepidermal acantholysis.
AB  - BACKGROUND AND DESIGN: IgA pemphigus is an uncommon intraepidermal
      vesiculopustular disease that has clinical and histologic similarity to
      subcorneal pustular dermatosis and pemphigus foliaceus. All patients have IgA
      antibodies bound to the epidermal cell surface, and half of the patients have
      circulating IgA anti-cell surface antibodies detected by standard
      immunofluorescence testing. We studied the distribution of IgA pemphigus antigen
      in human skin and the pathogenetic role of circulating IgA antibodies in the
      induction of intraepidermal vesicle formation. We used skin specimens from
      numerous sites of two cadavers, as well as from neonatal foreskin, and serum
      specimens of two patients with IgA pemphigus. OBSERVATIONS: Organ culture and
      immunofluorescence studies revealed the following: (1) IgA pemphigus antibodies
      bound preferentially to the granular layer in the vast majority of skin sites
      that were tested. In one cadaver, binding was preferential to the spinous layer
      of plantar and buttock skin. No binding was observed in oral and esophageal
      mucosa. (2) Neither bound nor circulating IgA antibody was complement fixing. (3)
      One IgA pemphigus serum specimen that was negative by standard immunofluorescence
      had IgA antibodies that bound the epidermal cell surface after incubation under
      explant culture conditions. (4) Both IgA pemphigus serum specimens induced
      acantholysis in skin explant cultures. CONCLUSIONS: When antibodies from one IgA
      pemphigus serum specimen are used, the expression of IgA pemphigus antigen in
      human skin shows regional variability, interindividual variability, and
      variability in the microscopic distribution within the epidermal cell layers. IgA
      pemphigus antibodies play a role in the pathogenesis of IgA pemphigus. The skin
      explant culture is more sensitive than is standard immunofluorescence to detect
      circulating IgA antibodies.

PMID- 8481023
TI  - Childhood discoid lupus erythematosus.
AB  - BACKGROUND: Discoid lupus erythematosus (DLE) is uncommon in childhood. Less than
      2% of patients with DLE develop the disease before 10 years of age. OBSERVATIONS:
      We present eight cases of childhood DLE with onset before age 10 years: four
      black boys with cutaneous DLE, three black girls ages 7, 2, and 6 years at onset,
      who developed systemic lupus erythematosus at ages 12, 9, and 8 years,
      respectively, and a 10-year-old Hispanic boy who had a systemic flare at the age
      of 20 years. CONCLUSIONS: A review of the 16 published cases of childhood DLE
      reveals that it is similar to its adult counterpart in its presentation and
      chronic course. However, several important differences are noted: a lack of
      female predominance, a low incidence of photosensitivity, and frequent
      progression to systemic lupus erythematosus at an early age. A discussion of the
      management of DLE in children is also presented.

PMID- 8481024
TI  - Drug therapy for neurofibromatosis?

PMID- 8481025
TI  - Multiple black nodules on the thumb. Dorsal mucoid cysts of the finger.

PMID- 8481026
TI  - Superficial erosions with some oozing and marked crusting. Pemphigus
      erythematosus (PE).

PMID- 8481027
TI  - A solitary plaque of the cheek--granuloma faciale.

PMID- 8481028
TI  - Burning discomfort and swelling of the hands and face of a young child.
      Erythropoietic protoporphyria (EPP).

PMID- 8481029
TI  - Recall of cutaneous toxicity from fluorouracil.

PMID- 8481030
TI  - Lack of serum selenium rise after overnight application of selenium sulfide.

PMID- 8481031
TI  - Secondary hyperparathyroidism in patients with ichthyosis is not caused by
      vitamin D deficiency or ingestion of retinoids.

PMID- 8481032
TI  - Caustic ingestion.

PMID- 8481033
TI  - Failure to thrive in congenital heart disease.

PMID- 8481034
TI  - Renal stone disease--investigative aspects.

PMID- 8481035
TI  - Gastrointestinal morbidity and growth after repair of oesophageal atresia and
      tracheo-oesophageal fistula.
AB  - Upper gastrointestinal morbidity and anthropometric data in 334 patients aged 1
      to 37 years with repaired oesophageal atresia and tracheo-oesophageal fistula are
      reported. Two thirds were subsequently hospitalised with oesophageal
      complications and half underwent one or more surgical procedures. Thirteen
      percent were hospitalised for more than 50 days. Anastomotic strictures were
      present in one third and just under half had gastro-oesophageal reflux. Dysphagia
      was present in about 65% in all age groups but symptom severity and surgical
      intervention decreased significantly after 5 years of age. Gastro-oesophageal
      reflux symptoms were commoner in the older patients increasing from 18% in the
      group under 5 years of age to 52% in those over 15 years. Height centile
      distribution was normal, but the median weight centile was the 25th. Weight for
      height values greater than 2 SD below the mean were present in 13%, and two
      thirds of these patients were under 5 years of age. The majority of adults
      enjoyed a normal lifestyle and were comparable with their peers.

PMID- 8481036
TI  - Respiratory morbidity after repair of oesophageal atresia and tracheo-oesophageal
      fistula.
AB  - Respiratory morbidity in 334 patients aged 1 to 37 years with repaired
      oesophageal atresia and tracheo-oesophageal fistula is reported. Just under half
      the patients were subsequently hospitalised with respiratory illness. Two thirds
      of admissions were before 5 years of age. Five percent were admitted on more than
      five occasions. Patients with gastro-oesophageal reflux and low birth weight were
      more likely to be admitted. Thirty one percent of patients had one or more
      episodes of pneumonia in the first five years of life and 5% after 15 years. The
      prevalence of annual bouts of bronchitis in these age groups was 74% and 41%
      respectively. The prevalence of wheeze was about 40% in all age groups. Patients
      with symptoms persisting after 15 years were more likely to have had lower
      respiratory tract illness in early childhood and a history of atopy. In the 12
      months before review, weekly episodes of wheezing were present in one third under
      5 years and 15% over 15 years. Thirty two percent of patients aged 5-10 years and
      8% over 15 years missed two or more weeks of school or work in the previous year
      with respiratory illness.

PMID- 8481037
TI  - Investigation of vascular compression of the trachea: the complementary roles of
      barium swallow and echocardiography.
AB  - To determine the preferred investigation of congenital vascular compression of
      the trachea, preoperative investigation in 40 patients undergoing surgery 1981-91
      was analysed. The importance of preoperative identification of detailed arterial
      anatomy in determining surgical technique was also assessed in 122 consecutive
      patients undergoing surgery 1952-91. Of the 40 patients (median age 5 months)
      seen 1981-91, barium swallow before referral suggested the diagnosis of vascular
      compression in 26 of 27 (96%). Angiography (1/3), bronchoscopy (0/6), and
      echocardiography (2/6) were generally unhelpful in diagnosing vascular
      compression before referral. Echocardiography was performed after referral in 18
      consecutive patients since 1986 and the correct arterial anatomy was identified
      in 16 (88%); hyperinflation resulted in inadequate images in the two others.
      Barium swallow is the investigation of choice to screen for suspected vascular
      compression of the trachea; echocardiography at the referral centre can define
      the arterial anatomy in nearly all patients. Further investigation can be
      reserved for selected cases.

PMID- 8481038
TI  - The natural history of congenital myotonic dystrophy: mortality and long term
      clinical aspects.
AB  - Although the genetic basis of the congenital form of myotonic dystrophy has
      recently been clarified, data as to outcome in terms of life expectancy and
      morbidity are scanty. Life table data based on a cohort of 115 patients with a
      confirmed diagnosis of congenital myotonic dystrophy are presented. The data
      suggest a 25% chance of death before 18 months of age and a 50% chance of
      survival into the mid-30s. The profile of disease and complications among
      survivors is also charted.

PMID- 8481039
TI  - Coronary risk factors in schoolchildren.
AB  - Death rates from coronary heart disease (CHD) in Northern Ireland are among the
      highest in the world. However, no data have been available to test the hypothesis
      that the high prevalence of CHD is reflected by the risk status of the childhood
      population. A randomly selected 2% population sample of 1015 children aged 12 and
      15 years was studied to obtain baseline information on blood pressure, lipid
      profile, cigarette smoking, family history, physical activity, cardiorespiratory
      fitness, and dietary fat intake. Using available criteria thresholds, 15-23%
      displayed increased blood pressure, 12-25% had unfavourable lipid profiles, and
      18-34% were overfat. In 15 year old children, 16-21% admitted being regular
      smokers, 26-34% displayed poor cardiorespiratory fitness, and 24-29% reported
      little physical activity in the previous week. Dietary analysis revealed
      relatively low polyunsaturated to saturated fatty acid ratios and high mean fat
      intakes, accounting for approximately 40% total daily energy. Despite the
      exclusion of family history from the analysis, 16% of the older children
      exhibited three or more risk factors. These results justify major concern about
      the level of potential coronary risk in Northern Ireland schoolchildren. Broadly
      based primary prevention strategies aimed at children are essential if future
      adult CHD mortality is to be reduced.

PMID- 8481040
TI  - Noonan's and DiGeorge syndromes with monosomy 22q11.
AB  - A boy with the dysmorphic features of Noonan's syndrome and pulmonary valve
      stenosis who had evidence of hypoparathyroidism and abnormal T lymphocyte numbers
      in the neonatal period is reported. He had a normal karyotype but molecular
      analysis revealed a submicroscopic deletion within chromosome 22q11, the region
      deleted in DiGeorge syndrome. Thus this child has both Noonan's syndrome and
      DiGeorge syndrome; 22q11 is a candidate region for a gene defective in Noonan's
      syndrome.

PMID- 8481041
TI  - International trends in pedestrian injury mortality.
AB  - Trends in pedestrian injury mortality for children aged 0-4 and 5-14 for England
      and Wales, Denmark, Sweden, the USA, and New Zealand were examined from 1968
      onwards. While there has been a reduction in the pedestrian mortality in all
      these countries, there are striking international differences in the extent of
      these reductions. Denmark has achieved the greatest fall in mortality with the
      smallest decrease seen in New Zealand. Countries which have experienced major
      decreases in pedestrian mortality are distinguished by having placed greater
      emphasis on environmentally based prevention strategies rather than pedestrian
      skills education.

PMID- 8481042
TI  - Metabolic effects of growth hormone treatment: an early predictor of growth
      response?
AB  - Fourteen children receiving one year of recombinant human growth hormone (rhGH)
      treatment underwent measurement of serial changes in body composition (measured
      by skinfold thickness, bioelectrical impedance, and H2(18)O dilution), resting
      energy expenditure (REE, estimated by ventilated hood indirect calorimetry), and
      total free living daily energy expenditure (TEE, measured by the doubly labelled
      water technique). Mean height velocity increased from 4.9 to 8.6 cm/year after
      six months of treatment. Fat free mass (FFM) increased more during the first six
      weeks (24.4 g/day) than from six to 26 weeks of treatment (6.8 g/day); fat mass
      decreased by 7.2 g/day and 1.1 g/day respectively. The six week increase in REE
      (kJ/day) was maintained after six months of treatment, though expressed per
      kilogram FFM (kJ/kgFFM/day), returned to pretreatment values by three months.
      Height velocity increases at six months correlated with six week changes in fat
      mass measured by skinfold thickness and REE, though use of this relationship to
      predict growth response in individuals is limited by the wide 95% prediction
      intervals. No significant changes in growth, body composition, or energy
      expenditure were observed between six and 12 months of treatment, in either
      patients who had initially responded well to treatment or those who were poor
      initial responders to treatment and who had their dose of rhGH doubled after six
      months.

PMID- 8481044
TI  - An improved clinical method for detecting meningeal irritation.
AB  - Neck stiffness is the most important sign of meningitis. When the neck is flexed,
      the inflamed nerve roots and meninges of the cervical region get stretched. This
      causes protective muscle spasm manifesting as neck stiffness. Kernig's sign
      represents similar phenomena involving the distal spinal cord and related nerves.
      A manoeuvre that stretches the neural elements of the whole length of the spinal
      canal simultaneously will be a more sensitive test for meningeal irritation.
      Eliciting neck stiffness while the patient sits up with knees extended achieves
      this. This method is more sensitive, specific, and amenable to objective
      assessment.

PMID- 8481043
TI  - Serum amyloid A protein in acute viral infections.
AB  - Concentrations of serum amyloid A protein (SAA) were measured in 254 children
      with viral diseases, including measles, varicella, rubella, mumps, echo-30
      meningitis, chronic hepatitis B and C, and in eight with Kawasaki disease. Latex
      agglutination nephelometric immunoassay was used for assaying SAA. In 191 out of
      195 patients (98%), SAA concentrations became markedly raised in the acute phase
      of the viral disease: measles (97%), varicella (100%), mumps (95%), and echo-30
      meningitis (99%) with mean titres of 82.4, 80.5, 60.2, 75.2, and 101.1
      micrograms/ml respectively. This increase in SAA was followed by a rapid return
      to normal concentrations (< 5 micrograms/ml) during convalescence. Remarkably
      higher concentrations of SAA (mean 1630 micrograms/ml) were detected in the acute
      phase of patients with Kawasaki disease, but in most of the children with chronic
      hepatitis B or C, the titres of SAA remained normal. There was no close
      correlation between SAA and serum concentrations for alpha 1-acid glycoprotein,
      beta 2-microglobulin, transferrin, and IgG. There was a clear correlation between
      SAA and C reactive protein concentrations, although SAA showed a greater
      incremental change than C reactive protein in the acute phase. In the acute phase
      of these viral diseases, 56% of the patients had raised SAA concentrations (> or
      = 5 micrograms/ml) with normal C reactive protein concentrations (< 5
      micrograms/ml). These results indicate that SAA could be useful as an
      inflammatory marker in children with acute viral infections.

PMID- 8481045
TI  - Injuries in primary care practices.
AB  - A study of injuries among 0-15 year old children attending primary care clinics
      in a low social class and a middle class neighbourhood was carried out during a
      period of one year. Data were collected in a structured form by the physicians
      while the patient was in the clinic. The rate of injuries was 121.3/1000 children
      per year in the clinic from the lower social class neighbourhood and 70.7/1000
      children per year in the clinic from the middle class neighbourhood. Injuries in
      playgrounds, and on pavements and streets occurred in higher proportions in the
      low social class than in the middle class neighbourhood clinics. The most
      frequent causes of injuries were falls and being struck and injured by
      cutting/piercing instruments; these caused mostly contusions and lacerations. The
      clinic was the first place of treatment in 65% of the cases in the middle class
      area and in 45% in the lower social class area; 28% and 10% respectively were
      referred to the hospital for additional treatment. Data from primary care clinics
      should be considered when estimating the incidence of injuries in the community,
      in planning intervention programmes, and future research.

PMID- 8481046
TI  - Growth hormone deficiency and combined immunodeficiency.
AB  - The first description of an association of isolated growth hormone deficiency
      (IGHD) and combined immunodeficiency is presented. The findings suggest that IGHD
      should be considered as a cause of short stature in children with combined
      immunodeficiency before attributing growth retardation to infection.

PMID- 8481047
TI  - Hyperphosphataemia after enemas in childhood: prevention and treatment.
AB  - The case of a child with severe hyperphosphataemia and symptomatic hypocalcaemia
      secondary to retention of phosphate administered through an antegrade continence
      enema is reported. Caution should be exercised with the use of phosphate enemas
      and prompt action taken to remedy retention. The use of glucose with insulin in
      the emergency management of acute hyperphosphataemia is discussed.

PMID- 8481048
TI  - Compliance with antibiotic prophylaxis in urinary tract infection.
AB  - Compliance with antibiotic prophylaxis after urinary tract infection was assessed
      in 32 children, using a parent questionnaire, and a urine test for antibacterial
      substances. In 31 (97%) cases, parents reported giving the antibiotics every day
      but only 22 (69%) of urine tests were positive. Failure to understand the reasons
      for prophylaxis and non-compliance were significantly associated.

PMID- 8481049
TI  - Cycle helmets.

PMID- 8481051
TI  - Counted data (1).

PMID- 8481050
TI  - Cows' milk induced intestinal bleeding in infancy.

PMID- 8481052
TI  - Infant rib fracture--birth trauma or non-accidental injury.

PMID- 8481053
TI  - Mycoplasma and thrombocytopenia.

PMID- 8481054
TI  - Synovial lymphocytes and the aetiology of synovitis.

PMID- 8481055
TI  - Role of protein glycosylation in immune regulation.

PMID- 8481056
TI  - A walk round the edges of self tolerance.

PMID- 8481057
TI  - A reappraisal of the evidence that rheumatoid arthritis and several other
      idiopathic diseases are slow bacterial infections.

PMID- 8481058
TI  - Molecular and cellular mechanisms of joint destruction in rheumatoid arthritis:
      two cellular mechanisms explain joint destruction?

PMID- 8481059
TI  - IgG3 cryoglobulins in autoimmune MRL-lpr/lpr mice: immunopathogenesis,
      therapeutic approaches and relevance to similar human diseases.
AB  - MRL-lpr/lpr mice spontaneously develop an autoimmune disease resembling systemic
      lupus erythematosus and rheumatoid arthritis. One of the unique serological
      abnormalities in this strain is remarkably high concentrations of cryoglobulins.
      Analysis of immunoglobulin components in their cryoglobulins has shown selective
      enrichment of a particular IgG subclass, IgG3. As IgG3 enrichment is also found
      in two other cryoglobulins, which are induced after injection with bacterial
      lipopolysaccharides or infection with malaria, IgG3 apparently represents a major
      source of murine cryoglobulins. Studies on murine IgG3 monoclonal antibodies
      (mAbs) have clearly shown that murine IgG3 have the unique physiochemical
      property to self associate through non-specific IgG3 Fc-Fc interaction, and that
      most of them can generate monoclonal cryoglobulins. Most strikingly, IgG3
      monoclonal cryoglobulins with rheumatoid factor (RF) activity induce extensive
      pathological manifestations: skin vascular purpura and glomerulonephritis with
      'wire loop' lesions. Although the cryoglobulin activity of IgG3 RF mAb is solely
      responsible for the generation of glomerular lesions (both RF and cryoglobulin
      activities are necessary for skin vascular lesions), the absence of nephritogenic
      activity by some IgG3 cryoglobulins supports the idea that qualitative features
      of cryoglobulins are critical to determine their pathogenic activity. The
      demonstration of a positive correlation between the production of IgG3
      cryoglobulins and the development of lupus nephritis in MRL-lpr/lpr mice further
      substantiates the pathological importance of cryogenic autoantibodies. On the
      other hand, it should be emphasised that non-cryogenerating IgG3 autoantibodies
      may not be harmful, but even protective, as a result of their interaction with
      pathogenic IgG3 cryoglobulins. Finally, the development of an experimental model
      of cryoglobulinaemia associated with vascular and glomerular disease certainly
      represents an invaluable opportunity to study the molecular mechanisms
      responsible for the generation of cryoglobulins and their associated tissue
      lesions, and also to assess various therapeutic approaches. Our demonstration
      that anti-idiotypic mAb can prevent the pathogenic effects of the
      cryoprecipitable IgG3 RF mAb suggests strongly that such a therapeutic approach
      might be successful in similar diseases in man.

PMID- 8481061
TI  - Renal failure and hyperkalemia associated with ketorolac tromethamine.
AB  - Three patients who were treated with ketorolac tromethamine (Toradol), an
      injectable nonsteroidal anti-inflammatory drug for pain management, developed
      acute renal failure or hyperkalemia or both. These complications were reversible
      in two cases after discontinuing the drug. Clinical conditions preexisted in each
      patient that rendered them susceptible to the renal complications of nonsteroidal
      anti-inflammatory use. It is well known that caution should be observed while
      using nonsteroidal anti-inflammatory drugs in patients whose renal function may
      be preserved through prostaglandin-mediated vasodilatory effects. The same
      cautions apply to ketorolac. Since its major marketed use is as an analgesic and
      its potent effect on prostaglandin synthesis may not be well recognized, those
      cautions must be emphasized.

PMID- 8481062
TI  - The milk-alkali syndrome. A reversible form of acute renal failure.
AB  - The milk-alkali syndrome became rare with the advent of modern ulcer therapy with
      nonabsorbable antacids, histamine2 blockers, and sucralfate. An increased
      frequency of this syndrome seems likely with the growing popularity of the use of
      calcium carbonate as an antacid or as calcium supplementation to prevent
      osteoporosis. We treated five patients who had six episodes of the milk-alkali
      syndrome; four of these cases were diagnosed between 1990 and 1992. All patients
      were ingesting massive quantities of calcium and absorbable alkali and were
      unaware of the toxic effects of these compounds. All patients presented with the
      triad of hypercalcemia, metabolic alkalosis, and renal failure. All metabolic
      abnormalities were corrected, and renal function improved with appropriate
      supportive measures and cessation of calcium and alkali ingestion. In two
      patients, the renal failure was so severe that dialysis was necessary. In four
      patients, either the serum amino-terminal parathyroid hormone or 1,25
      dihydroxycholecalciferol levels were appropriately decreased in response to
      hypercalcemia. The serum carboxy-terminal parathyroid hormone levels were
      increased because of renal failure. Since both physicians and patients are often
      unaware of the calcium and alkali content of many nonprescription medicines, the
      diagnosis of the milk-alkali syndrome, a reversible cause of renal failure, can
      be missed if a detailed history of such intake is not elicited. Measurement of
      the serum amino-terminal parathyroid hormone and 1,25-dihydroxycholecalciferol
      levels may help differentiate milk-alkali syndrome from primary
      hyperparathyroidism.

PMID- 8481060
TI  - Bacterial and viral superantigens: roles in autoimmunity?
AB  - Superantigens are bacterial, viral, or retroviral proteins which can activate
      specifically a large proportion of T cells. In contrast with classical peptide
      antigen recognition, superantigens do not require processing to small peptides
      but act as complete or partially processed proteins. They can bind to major
      histocompatibility complex class II molecules and stimulate T cells expressing
      particular T cell receptor V beta chains. The other polymorphic parts of the T
      cell receptor, which are crucial for classical antigen recognition, are not
      important for this interaction. When this strategy is used a large proportion of
      the host immune system can be activated shortly after infection. The activated
      cells have a wide variety of antigen specificities. The ability to stimulate
      polyclonal B (IgG) as well as T cell responses raises possibilities of a role for
      superantigens in the induction of autoimmune diseases. Superantigens have been a
      great tool in the hands of immunologists in unravelling some of the basic
      mechanisms of tolerance and immunity.

PMID- 8481063
TI  - Measles susceptibility of hospital personnel.

PMID- 8481064
TI  - A clinical model for diagnosis of urinary tract infection in young women.

PMID- 8481065
TI  - Complications of infective endocarditis in the 1980s.

PMID- 8481066
TI  - Pleasure heals. The role of social pleasure--love in its broadest sense--in
      medical practice.

PMID- 8481067
TI  - Cost-effectiveness analysis of various strategies in the diagnostic management of
      pulmonary embolism.
AB  - BACKGROUND: Since the clinical diagnosis of pulmonary embolism is unreliable,
      various objective diagnostic methods (or combinations thereof) are advocated.
      Pulmonary angiography is the accepted reference method but is considered less
      suitable for initial screening due to its invasive nature. Therefore, at least
      nine different diagnostic management strategies employing invasive and
      noninvasive diagnostic tests are used in clinical practice. We assessed the cost
      effectiveness of these strategies to help identify the optimal approach. METHODS:
      Based on assumptions derived from published data, we calculated mortality,
      morbidity, adequacy for the indication of anticoagulant therapy, and associated
      diagnostic and therapeutic costs using a decision analytic model. Additionally, a
      cost-effectiveness analysis was performed using incremental costs per additional
      life saved. RESULTS: The analysis identified three separate categories of
      diagnostic management strategies: (1) Treatment of all patients (or of those with
      an abnormal perfusion scan) results in the lowest mortality and morbidity rates
      but the highest costs due to inappropriate treatment of 55% to 70% of patients.
      (2) Pulmonary angiography strategies with or without prior perfusion-ventilation
      lung scintigraphy and ultrasonography of the legs have comparable low mortality
      and morbidity rates, costs savings of approximately 40%, and inappropriate
      treatment in fewer than 5% of patients. (3) Use of perfusion-ventilation
      scintigraphy with or without ultrasonography results in unacceptably high
      mortality rates. CONCLUSIONS: At present, the optimal diagnostic management
      strategy should include pulmonary angiography. Use of perfusion-ventilation lung
      scintigraphy and ultrasonography results in a 40% to 50% reduction in the number
      of patients requiring pulmonary angiography and is cost-effective.

PMID- 8481068
TI  - 'Subclinical hypothyroidism'. Natural course of the syndrome during a prolonged
      follow-up study.
AB  - OBJECTIVE: To determine the natural course of the syndrome "subclinical
      hypothyroidism." DESIGN: Prospective study of 30 subjects with "subclinical
      hypothyroidism," as documented precisely by normal serum thyroxine and
      triiodothyronine concentrations and high serum thyrotropin levels on three
      occasions at intervals of 2 to 3 weeks. The subjects were followed up for 4 to 15
      years (mean, 8.2 +/- 2.3 years), with repeated determinations of thyroid hormone
      indices at intervals of 3 to 6 months. SETTING: Endocrinology Clinic at the
      Veterans Affairs Medical Center. RESULTS: 16 subjects developed definitive
      primary hypothyroidism within 3 months to 2 years, as reflected by a progressive
      rise in serum thyrotropin level with a gradual decline in serum thyroxine and
      triiodothyronine concentrations, with serum thyroxine levels falling to subnormal
      concentrations. In 14 of these subjects, primary hypothyroidism could be
      attributed to known etiologic factors, whereas in the remaining two the cause was
      not apparent. Persistently elevated serum thyrotropin with normal serum thyroxine
      and triiodothyronine concentrations following a cyclic pattern was observed in 14
      subjects during the follow-up period. In 11 of these subjects, there was a
      history of non-radical surgery or conventional radiation therapy to the neck
      area, whereas in the remaining three subjects, no apparent cause could be
      identified. CONCLUSIONS: "Subclinical hypothyroidism" is not always a forerunner
      of primary hypothyroidism. Two distinct populations evolve: (1) those with true
      preclinical or subclinical hypothyroidism, which may be predicted by the presence
      of one of the well-known etiologic factors responsible for onset of primary
      hypothyroidism, and (2) euthyroidism with reset thyrostat--a permanent state
      without a definitive progression to hypothyroidism, most probably secondary to a
      previous subtle insult to the thyroid gland.

PMID- 8481069
TI  - Factors predicting improvements in lipid values following cardiac rehabilitation
      and exercise training.
AB  - BACKGROUND: Cardiac rehabilitation and exercise training improve prognosis
      following major cardiac events, partly by improving coronary risk factors,
      including plasma lipids. Only limited data are available to define predictors of
      lipid improvements following aggressive nonpharmacologic therapy with cardiac
      rehabilitation. METHODS: We studied 237 consecutive patients from two
      institutions who were enrolled in outpatient phase 2 cardiac rehabilitation and
      exercise programs. By univariable and multivariable analyses, we assessed the
      impact of numerous clinical variables, including indexes of obesity, age, gender,
      lipid concentrations, exercise capacity, and psychological factors, on
      improvements in plasma lipid values with cardiac rehabilitation. RESULTS:
      Coronary risk factors improved following cardiac rehabilitation, including levels
      of low-density lipoprotein cholesterol (-4%; P < .05), high-density lipoprotein
      cholesterol (7%; P < .0001), and triglycerides (-13%; P < .0001); body mass index
      (-2%; P < .0001); percentage of body fat (-5%; P < .0001); and exercise capacity
      (26%; P < .0001). By both univariable and multivariable analyses, corresponding
      dyslipidemic baseline values were the strongest predictors of improvements in
      levels of low-density lipoprotein cholesterol (univariable: r = .51, P < .0001;
      multivariable: t = 8.5, P < .0001), high-density lipoprotein cholesterol
      (univariable: r = .37, P < .0001; multivariable: t = 6.6, P < .0001), and
      triglycerides (univariable: r = .36, P < .0001; multivariable: t = 6.8, P <
      .0001). By multivariable analyses, reductions in body mass index (t = 4.6, P <
      .0001) and older age (t = 4.0, P < .0001) were strong independent predictors of
      reduction in triglyceride values following cardiac rehabilitation. However, low
      baseline triglyceride values were independently associated with improvements in
      both low-density and high-density lipoprotein cholesterol levels. Using a model
      incorporating 13 clinical variables, improvements in lipid values with cardiac
      rehabilitation were only modestly predictable with the variables assessed,
      accounting for only 30% to 40% of the improvements in lipid values. CONCLUSIONS:
      (1) Coronary risk factors markedly improved following cardiac rehabilitation and
      exercise training. (2) Improvements in lipid values are modestly predictable. (3)
      Those patients with the worst baseline lipid values had the most improvements in
      lipid values following cardiac rehabilitation. However, patients with combined
      hyperlipidemia and low levels of high-density lipoprotein cholesterol are likely
      to require drug treatment.

PMID- 8481070
TI  - Variation in utilization of procedures for treatment of peripheral arterial
      disease. A look at patient characteristics.
AB  - OBJECTIVE: To examine associations between demographic characteristics and use of
      interventional procedures in patients with peripheral arterial disease. DESIGN:
      Case series drawn from a statewide hospital discharge database. SETTING:
      Nonfederal acute-care hospitals in Maryland. PATIENTS AND INTERVENTIONS: A total
      of 7080 cases of angioplasty, bypass surgery, or amputation for lower-extremity
      peripheral arterial disease in 1988 through 1989. MAIN OUTCOME MEASURE: Use of
      angioplasty, bypass surgery, and lower-extremity amputation. RESULTS: A total of
      1185 angioplasties, 4005 bypass operations, and 1890 amputations were identified.
      Population-based annual rates showed that angioplasty use peaked at about 70 per
      100,000 at the age of 65 to 74 years, bypass surgery use peaked at more than 250
      per 100,000 at 75 to 84 years of age, and amputation use peaked at about 225 per
      100,000 at 85 years of age and older. The age-adjusted likelihood of having a
      procedure for peripheral arterial disease was 1.7 times higher in men than in
      women and 1.6 times higher in blacks than in whites. Compared with patients who
      had angioplasty or bypass surgery, patients who had amputations were more likely
      to be more than 65 years old, to be black (odds ratio, 2.5), to have Medicaid or
      no insurance (odds ratio, 1.7), to have diabetes mellitus (odds ratio, 3.0), and
      not to have hypertension (odds ratio, 3.1). Compared with patients who had bypass
      surgery, patients who had angioplasty were more likely to be under 65 years old,
      to be white (odds ratio, 1.7), and not to have diabetes mellitus (odds ratio,
      1.3). CONCLUSION: Patient race is associated with differences in the frequency
      with which angioplasty, bypass surgery, and amputation are performed for
      peripheral arterial disease, and insurance status is associated with the
      likelihood of having amputation.

PMID- 8481071
TI  - Epidemic obesity in the United States.

PMID- 8481072
TI  - Changes in undergraduate medical education. A critique.

PMID- 8481073
TI  - Management of gallstones in diabetic patients.
AB  - The management of gallstones in diabetic patients has traditionally been
      considered problematic. Autopsy findings and uncontrolled studies have documented
      a higher prevalence of cholelithiasis in diabetics, and early reports showed
      dramatically increased perioperative morbidity and mortality for treatment of
      diabetics with acute cholecystitis. As a result, some authorities have
      recommended prophylactic cholecystectomy for diabetic patients with asymptomatic
      gallstones, which is in contrast to recommendations for nondiabetics. More recent
      investigators have shown comparable rates of operative morbidity and mortality
      for biliary surgery in diabetics when compared with the general population.
      Recent studies have questioned whether diabetes is an independent risk factor for
      gallstone formation. Decision analyses using these new data have shown that
      prophylactic cholecystectomy is not of clear benefit and should not be routinely
      recommended for diabetics with asymptomatic gallstones. We believe that available
      data, although limited, indicate that asymptomatic patients with diabetes do not
      benefit from screening for gallstones and that cholecystectomy should only be
      performed in cases of symptomatic cholelithiasis, as is the case in the general
      population.

PMID- 8481074
TI  - Total serum cholesterol levels and mortality risk as a function of age. A report
      based on the Framingham data.
AB  - OBJECTIVE: To evaluate the relationship between serum cholesterol level and all
      cause, coronary heart disease (CHD), and non-CHD mortality as a function of age.
      METHODS: The data source was the biennial examination data from 1948 through 1980
      for the 5209 men and women enrolled in the Framingham Heart Study. Age-specific
      analyses by the Cox proportional hazards regression model were performed of
      survival subsequent to ages 40, 50, 60, 70, and 80 years for all subjects
      enrolled and alive at each of the stated ages. Complementary models were studied
      that used high-density lipoprotein cholesterol, low-density lipoprotein
      cholesterol, or total cholesterol level as predictors of survival subsequent to
      the examination at which lipoprotein subfractions were determined (1968) through
      1973). RESULTS: The relationship between total cholesterol level and all-cause
      mortality was positive (ie, higher cholesterol level associated with higher
      mortality) at age 40 years, negative at age 80 years, and negligible at ages 50
      to 70 years. The relationship with CHD mortality was significantly positive at
      ages 40, 50, and 60 years but attenuated with age until the relationship was
      positive, but not significant, at age 70 years and negative, but not significant,
      at age 80 years. Results for the relationship between low-density lipoprotein
      cholesterol and high-density lipoprotein cholesterol and mortality help explain
      these findings. Non-CHD mortality was significantly negatively related to
      cholesterol level for ages 50 years and above. The negative results in the oldest
      age group for all-cause and CHD morality appeared to be due to a negative
      relationship with low-density lipoprotein cholesterol levels rather than the
      protective effect of high high-density lipoprotein cholesterol levels. Similar
      results from several modified analyses make low cholesterol level due to severe
      illness an unlikely explanation for our results. CONCLUSIONS: Physicians should
      be cautious about initiating cholesterol-lowering treatment in men and women
      above 65 to 70 years of age. Only randomized clinical trials in older people can
      settle the debate over the efficacy and cost-effectiveness of lipid-lowering
      interventions for reducing mortality and morbidity in this population.

PMID- 8481075
TI  - Lovastatin 5-year safety and efficacy study. Lovastatin Study Groups I through
      IV.
AB  - BACKGROUND: Inhibitors of hydroxymethylglutaryl co-enzyme A reductase are widely
      used to treat hypercholesterolemia. They have a good short- to medium-term safety
      profile, but long-term safety data are limited. METHODS: Seven hundred forty-five
      patients with severe hypercholesterolemia (mean baseline plasma cholesterol level
      on diet, 9.3 mmol/L [360 mg/dL]) were treated with lovastatin for a median
      duration of 5.2 years. Their mean age at baseline was 50 years, 68% were male,
      60% had familial hypercholesterolemia, and 42% had a history of coronary heart
      disease. Seventy-seven percent of patients had titrations of lovastatin to 80
      mg/d, and 58% took other lipid-lowering agents, usually bile acid sequestrants,
      concomitantly. RESULTS: The mean changes at 5 years in total, low-density
      lipoprotein, and high-density lipoprotein cholesterol were -35%, -44%, and +14%,
      respectively. Eighty percent of patients completed the study, 13% were
      unavailable for follow-up, 4% were discontinued due to adverse events unlikely to
      be related to lovastatin, and 3% (21) were discontinued because of drug
      attributable adverse events: marked but asymptomatic increase in aminotransferase
      values (10 patients), gastrointestinal disturbance (three patients), rash (two
      patients), myalgia (one patient), myopathy (two patients), arthralgia (one
      patient), insomnia (one patient), and weight gain (one patient). Sixteen patients
      died during the study, all of coronary disease. Of these, 14 had coronary heart
      disease at baseline. There were no deaths attributable to trauma, suicide, or
      homicide, and there were only 14 cases of cancer (vs 21 expected). There was no
      evidence for an adverse effect on the lens. CONCLUSIONS: Lovastatin is a
      generally well-tolerated and effective drug during long-term use.

PMID- 8481076
TI  - Excess body weight. An underrecognized contributor to high blood cholesterol
      levels in white American men.
AB  - BACKGROUND: The influence of body weight on serum lipids is often overlooked in
      clinical practice. METHODS: The association between body weight adjusted for
      height as calculated by body-mass index (BMI) and serum lipid and lipoprotein
      levels in white men was examined using the second National Health and Nutrition
      Examination Survey (NHANES II). Lipid results were categorized into six different
      levels of BMI: (1) 21.0 kg/m2 or lower, (2) 21.1 to 23.0 kg/m2, (3) 23.1 to 25.0
      kg/m2, (4) 25.1 to 27.0 kg/m2, (5) 27.1 to 30.0 kg/m2, and (6) greater than 30.0
      kg/m2, and three age groups: (1) young men (20 through 44 years), (2) middle-aged
      men (45 through 59 years), and (3) older men (60 through 74 years). RESULTS:
      Using linear trend analysis, changes in BMI from categories 2 to 5 in young men
      were associated with a total cholesterol level 0.59 mmol/L (23 mg/dL) higher (P <
      .01), a non-high-density lipoprotein (non-HDL) cholesterol level 0.70 mmol/L (27
      mg/dL) higher (P < .01), and a low-density lipoprotein (LDL) cholesterol level
      0.59 mmol/L (23 mg/dL) higher (P = .03). For middle-aged men and older men, the
      same change in BMI was associated with smaller but still significant differences
      in total cholesterol levels (higher by 0.31 mmol/L [12 mg/dL] [P < .01] and 0.28
      mmol/L [11 mg/dL] [P < .01], respectively) and non-HDL cholesterol levels (higher
      by 0.37 mmol/L [14 mg/dL] [P < .01] and 0.25 mmol/L [10 mg/dL] [P < .01],
      respectively), whereas the LDL cholesterol levels were unchanged. Although
      advancing age may blunt the BMI-associated differences in total and LDL
      cholesterol levels, the BMI-associated differences in triglyceride levels (higher
      by 0.70 to 1.33 mmol/L [62 to 118 mg/dL] [P < .001]) and HDL cholesterol levels
      (lower by 0.18 to 0.39 mmol/L [7 to 15 mg/dL] [P < .001]) were of similar
      magnitude in all age groups. CONCLUSION: Excess body weight is associated with
      deleterious changes in the lipoprotein profile. Higher BMI was associated at all
      ages with higher plasma triglyceride level, lower HDL cholesterol level, and
      higher total and non-HDL cholesterol levels. In young men, the higher total
      cholesterol level was reflected mainly in the LDL cholesterol level; in middle
      aged and older men, in the non-HDL fraction. Programs to reduce coronary heart
      disease by improving lipid levels should include more emphasis on achieving and
      maintaining ideal body weight.

PMID- 8481077
TI  - Who should be screened for HIV infection? A cost-effectiveness analysis.
AB  - BACKGROUND: The advent of effective prophylactic treatments for asymptomatic
      persons infected with human immunodeficiency virus has led to interest in
      widespread screening programs. However, the costs of screening programs and
      therapy are high, and the prevalence of infection above which screening becomes
      an appropriate use of scarce health care dollars remains undetermined. METHODS:
      To examine the cost-effectiveness of screening in populations with differing
      prevalences of infection, we developed a Markov model to compare costs and life
      expectancy for two strategies: (1) screening and prophylactic treatment for
      infected persons who have or who develop low CD4+ (T4) cell counts, and (2) no
      screening. Based on studies in the literature, we estimated the prevalence of HIV
      infection, the rate of T4-cell loss, the rates of developing the acquired
      immunodeficiency syndrome and Pneumocystis pneumonia stratified by T4 cell
      counts, the life expectancy with the acquired immunodeficiency syndrome, the
      efficacy of prophylactic therapies, and costs. RESULTS: In populations with a
      prevalence of infection more than 5%, which includes known risk groups, screening
      costs less than $11,000 per life-year gained. In populations with a prevalence as
      low as 0.15%, screening costs only $29,000 per life-year gained. Even when the
      efficacy of zidovudine is assumed to be limited to 3 years, screening still costs
      less than $40,000 per life-year gained in populations with a prevalence of 0.5%
      or greater. However, in populations with a very low prevalence of infection (two
      to 10/100,000), such as members of the general population without reported risk
      factors, screening costs rise to between $290,000 and $1,277,400 per life-year
      gained. CONCLUSIONS: When considering only direct medical benefits, screening for
      asymptomatic human immunodeficiency virus infection in the general population,
      without regard to reported risk factors or seroprevalence data, would be
      expensive. In populations with a prevalence of infection of 0.5% or greater,
      however, the cost-effectiveness of screening falls within the range of currently
      accepted medical practices. These results suggest that screening be offered
      routinely to all persons in defined populations, such as persons receiving care
      at hospitals or clinics, or residing in geographic areas, where the
      seroprevalence is 0.5% or more, and underscore the need to conduct seroprevalence
      studies to identify such populations.

PMID- 8481078
TI  - Fluconazole-resistant Candida albicans after long-term suppressive therapy.
AB  - Candida albicans is generally considered to be susceptible, in vivo, to
      fluconazole. In the population infected with human immunodeficiency virus,
      recurrent bouts of oral and esophageal candidiasis have led to increasing use of
      fluconazole for long-term prophylaxis. With prolonged therapy, the issue of
      developing resistance emerges. We report a case of fluconazole-resistant C
      albicans esophagitis that developed after fluconazole was used for more than 600
      days.

PMID- 8481079
TI  - Hypermagnesemic pseudocoma.
AB  - We treated a case of iatrogenic hypermagnesemia that clinically mimicked a
      central brain-stem herniation syndrome. Hypermagnesemia (magnesium level, 9.85
      mmol/L [24 mg/dL]) can cause parasympathetic blockade, inducing fixed and dilated
      pupils, in addition to neuromuscular blockade. Extreme hypermagnesemia can
      therefore mimic a midbrain syndrome and cause a pseudocomatose state.

PMID- 8481080
TI  - Reversible parkinsonism induced by hypercalcemia and primary hyperparathyroidism.
AB  - We describe a patient who had the recent onset of both primary
      hyperparathyroidism and parkinsonism. Surgical removal of a parathyroid adenoma
      was followed by spontaneous resolution of the parkinsonism. Hypoparathyroidism
      and other disorders of calcium metabolism are recognized causes of secondary
      parkinsonism, while hyperparathyroidism is not. We review the relevant
      literature, which supports the hypothesis that hypercalcemia may have induced
      cytotoxic changes in the basal ganglia of this patient.

PMID- 8481081
TI  - Captopril and the effect of interferon gamma on monocytes.

PMID- 8481082
TI  - Nicotinic receptors in the cerebellar vermis modulate the gain of the
      vestibulospinal reflexes in decerebrate cats.
AB  - 1. The possibility that the cholinergic afferent system terminating in the vermal
      cortex of the cerebellar anterior lobe acts on the target neurons by utilizing
      nicotinic receptors has been investigated in decerebrate cats by testing the
      effects of local microinjection of cholinergic nicotinic agonists and antagonists
      on posture as well as on the dynamic characteristics of the vestibulospinal (VS)
      reflexes. 2. Unilateral injection into the vermal cortex of the culmen of
      nicotine (0.25 microliter at the concentration of 0.05-0.5 microgram/microliter
      saline) decreased the extensor tonus in the ipsilateral forelimb, while the
      extensor tonus in the contralateral forelimb increased. The some agent
      significantly increased the gain of the first harmonic component of the EMG
      responses of the ipsilateral and more prominently also of the contralateral
      triceps brachii to animal tilt. However, the phase angle of the responses
      remained bilaterally unmodified. The effects described above were first observed
      5-10 min after the injection, reached the peak after 40-60 min and persisted for
      at least 2-3 h before disappearing. 3. The effective area was located between the
      second and the fourth folium of the cerebellar vermis rostral to the fissura
      prima, at the laterality of 1.4-1.8 mm. This area, which upon cathodal
      stimulation suppressed the spontaneous EMG activity of the ipsilateral triceps
      brachii, actually corresponds to the zone B of the cerebellar cortex which exerts
      a direct inhibitory influence on the lateral vestibular nucleus. Moreover, the
      effects were dose-dependent. 4. Microinjection of nicotinic antagonists of both
      the ganglionic type (hexamethonium, 0.25 microliter at 4 micrograms/microliters
      saline) and the neuromuscular type (d-tubocurarine, 0.25 microliter at 7
      micrograms/microliters saline) produced a postural asymmetry opposite in sign to
      that elicited by nicotine. The same agents also decreased the response gain of
      the triceps brachii of both sides to animal tilt recorded either under normal
      conditions or after previous injections of nicotine. 5. The experiments indicate
      that the cholinergic system is involved in the control of posture as well as in
      the gain regulation of the VS reflexes. Previous histochemical studies had shown
      that the cholinergic fibers terminate not only on Purkinje (P)-cells, but also
      and more prominently as mossy fibers ending on granular cells. This system may
      thus affect the discharge of P-cells and related inhibitory interneurons not only
      ipsilaterally but also contralaterally to the side of the injection.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8481083
TI  - EEG-blocking before and during voluntary movements: differences between the eyes
      closed and the eyes-open condition.
AB  - Movement-related EEG periods of 1 s duration were analyzed by fast Fourier
      transformation in the Bereitschaftspotential (BP) paradigm in 21 healthy, right
      handed normals. Spectra of the rest period and the BP period before the onset of
      the voluntary movement, and of the rest period and the movement period, were
      compared in order to describe blocking effects before and during movement
      execution (fast fist closure of the right hand). When comparing the rest period
      and the movement period with the eyes closed as well as with the eyes open,
      blocking was pronounced in both conditions within the total frequency range of
      the alpha-band, especially at positions contralateral to the movement over the
      motor cortex (C3') and the parietal cortex (P3) as well as at the parietal
      midline electrode (Pz). Moreover, when comparing the spectra of the rest and the
      BP periods in the eyes-closed condition, significant differences were again seen,
      with lower values during the BP period at C3' and P3. We were, however, able to
      observe over the parietal cortex an increase of alpha power in the 10 Hz range
      during the BP period with the eyes opened and fixated. This increase during the
      BP period in the eyes-open condition was not found when the eyes were closed.
      This paradoxical phenomenon of an increase of power with the eyes opened instead
      of blocking during the BP period, as observed in the eyes closed, may be due to
      an additional activation effect on the already activated (blocked) EEG in the
      eyes-open condition during fixation.

PMID- 8481084
TI  - Transient epileptiform experience affects the duration of penicillin-induced
      convulsive activity in the awake rat.
AB  - 1. Experiments were performed to investigate whether the sensitivity of the
      cerebral cortex to produce convulsive activity was modified by a transient
      epileptic focus. For this reason, 30 awake rats received two intracerebral
      penicillin (PCN) injections (125 IU/0.5 microliter solvent), the first one into
      the motor or visual cortex, the second one two weeks later into the motor cortex.
      Convulsive activity was recorded by means of EEG. 2. After the first PCN
      injection, interictal activity lasted 143.4 +/- 19.3, S.E. min (n = 17) in the
      motor cortex group, but 426 min (n = 13) in the visual group (p < 0.05). The
      median frequency of interictal potentials (np/min) was significantly lower in the
      motor cortex group than in the visual cortex group (18.4 and 25.5 np/min,
      respectively, p < 0.05). The period between the onset of the first and last
      seizure was 110.6 +/- 10.2 min for the motor cortex group, and 119.8 +/- 31.2 min
      for the visual cortex group. The seizures lasted longer and were less frequent in
      the motor than in the visual group (length: 12.5 +/- 1.1 vs 7.5 +/- 2.8 s;
      number: 43 +/- 11 vs 131 +/- 40, respectively, 0.05 < p < 0.1). 3. After the
      second PCN injection which was performed in all rats into the motor cortex, the
      duration but not the frequency of the interictal activity depended on the site of
      the first injection. The duration after this treatment was 96.8 +/- 43.3, S.E.
      min in the visual and 173.2 +/- 30.5 min in the motor cortex group (p < 0.05),
      while the frequency values of both groups were at a similar level (20.5 +/- 2.1
      vs 18.9 +/- 1.7 np/min, respectively). Also the period with generalized activity
      after the second PCN injection was shorter in the visual than in the motor cortex
      group (43.9 +/- 32.3 vs 114.3 +/- 31.8 min, respectively, p < 0.05), and the
      number of seizures slightly lower (8 +/- 210 vs 54 +/- 30, respectively, p <
      0.1). The length of the seizures was rather equal 11.6 +/- 2.5 vs 12.0 +/- 3.5 s,
      respectively, p > 0.1). 4. It is postulated that a transient epileptiform focus
      can induce, in a site-specific manner, long-lasting anticonvulsant effects.
      Therefore, epileptogenic experience may not only sensitize the brain, but also
      desensitize it with respect to the induction and duration of epileptiform
      activity.

PMID- 8481085
TI  - Histochemical assessment upon the striatal distribution of acetylcholinesterase
      in the cat.
AB  - The distribution of acetylcholinesterase (AChE) was explored in the striatum of
      the cat following a slightly modified Geneser-Jensen and Blackstad method. The
      well-known histochemical organization of the cat's striatum, characterized by the
      presence of small areas with poor concentration of AChE, called "striosomal
      bodies" or "striosomes", which were embedded in a prominent tissular matrix
      presenting more intense staining for AChE, was clearly recognized. An additional
      finding, however, was that regional variations in the deposit of AChE both in the
      striosomal bodies and in the matrix-compartment, occurred within different
      rostrocaudal and dorsoventral striatal territories of the cat's caudate nucleus.
      These results point to consider these two striatal compartments as part of a more
      complex histochemical design for the striatum of carnivores.

PMID- 8481086
TI  - The effect of pulvinar-lateral posterior complex stimulation on multiunit
      activity at the cingulate cortex in the cat.

PMID- 8481087
TI  - Early c-fos expression in the rat vestibular and olivocerebellar systems after
      unilateral labyrinthectomy.

PMID- 8481088
TI  - N5,N10-methenyltetrahydromethanopterin cyclohydrolase from the extremely
      thermophilic sulfate reducing Archaeoglobus fulgidus: comparison of its
      properties with those of the cyclohydrolase from the extremely thermophilic
      Methanopyrus kandleri.
AB  - Archaeoglobus fulgidus and Methanopyrus kandleri are both extremely thermophilic
      Archaea with a growth temperature optimum at 83 degrees C and 98 degrees C,
      respectively. Both Archaea contain an active N5,N10
      methenyltetrahydromethanopterin cyclohydrolase. The enzyme from M. kandleri has
      recently been characterized. We describe here the purification and properties of
      the enzyme from A. fulgidus. The cyclohydrolase from A. fulgidus was purified 180
      fold to apparent homogeneity and its properties were compared with those recently
      published for the cyclohydrolase from M. kandleri. The two cytoplasmic enzymes
      were found to have very similar molecular and catalytic properties. They
      differed, however, significantly with respect of the effect of K2HPO4 and of
      other salts on the activity and the stability. The cyclohydrolase from A.
      fulgidus required relatively high concentrations of K2HPO4 (1 M) for optimal
      thermostability at 90 degrees C but did not require salts for activity. Vice
      versa, the enzyme from M. kandleri was dependent on high K2HPO4 concentrations
      (1.5 M) for optimal activity but not for thermostability. Thus the activity and
      structural stability of the two thermophilic enzymes depend in a completely
      different way on the concentration of inorganic salts. The molecular basis for
      these differences are discussed.

PMID- 8481089
TI  - Formylmethanofuran: tetrahydromethanopterin formyltransferase and N5,N10
      methylenetetrahydromethanopterin dehydrogenase from the sulfate-reducing
      Archaeoglobus fulgidus: similarities with the enzymes from methanogenic Archaea.
AB  - The sulfate-reducing Archaeoglobus fulgidus contains a number of enzymes
      previously thought to be unique for methanogenic Archaea. The purification and
      properties of two of these enzymes, of formylmethanofuran:
      tetrahydromethanopterin formyltransferase and of N5,N10
      methylenetetrahydromethanopterin dehydrogenase (coenzyme F420 dependent) are
      described here. A comparison of the N-terminal amino acid sequences and of other
      molecular properties with those of the respective enzymes from three methanogenic
      Archaea revealed a high degree of similarity.

PMID- 8481090
TI  - Purification, partial characterization, and subcellular localization of a 38
      kilodalton, calcium-regulated protein of Rhizobium fredii USDA208.
AB  - Calcium is essential for the growth of rhizobia and the formation of nitrogen
      fixing root-nodules on legumes, but its precise role in these processes remains
      unknown. We have found that Rhizobium fredii USDA208 accumulates a major 38 kDa
      protein when grown in media supplemented with 0.3-2 microM Cacl2. We have
      purified this protein and raised polyclonal antibodies against it. The protein
      initially is synthesized as a 40 kDa precursor which subsequently undergoes
      calcium-dependent processing to give rise to the mature polypeptide. Subcellular
      and immunocytochemical localization studies indicate that the 38 kDa protein
      accumulates preferentially in the periplasmic space. Its N-terminal sequence,
      AETIKIGVAGPMTG, shows significant homology to the N-termini of amino acid binding
      proteins from the periplasm, including leucine-, isoleucine-, and valine-specific
      binding proteins of Pseudomonas aeruginosa and Escherichia coli and a leucine
      specific binding protein of E. coli. The R. fredii protein does not, however,
      bind [3H]-leucine. The 38 kDa protein is encoded by the bacterial chromosome. It
      is absent in several rhizobia other than R. fredii, but antigenically related
      polypeptides are present in Escherichia coli and Erwinia carotovora subsp.
      carotovora.

PMID- 8481091
TI  - Characterisation of mutations in the Klebsiella pneumoniae nitrogen fixation
      regulatory gene nifL which impair oxygen regulation.
AB  - The nifL gene product of Klebsiella pneumoniae inhibits the activity of the
      positive activator protein NifA in response to increased levels either of fixed
      nitrogen or of oxygen in the medium. In order to demonstrate that the responses
      to these two effectors are discrete we have subjected nifL to hydroxylamine
      mutagenesis and isolated nifL mutants that are impaired in their ability to
      respond to oxygen but not to fixed nitrogen. Two such mutations were sequenced
      and shown to be single base pair changes located in different parts of nifL. The
      amino acid sequence of NifL shows limited homology to the histidine protein
      kinases which comprise the sensing component of bacterial two-component
      regulatory systems. In the light of the location of one of the oxygen-insensitive
      mutations (Leu294Phe) we have reassessed this homology and we suggest that the
      Gln273-Leu317 region of NifL may facilitate interactions between NifL and NifA.

PMID- 8481092
TI  - Isolation and characterization of a new spore-forming sulfate-reducing bacterium
      growing by complete oxidation of catechol.
AB  - A new mesophilic sulfate-reducing bacterium, strain Groll, was isolated from a
      benzoate enrichment culture inoculated with black mud from a freshwater ditch.
      The isolate was a spore-forming, rod-shaped, motile, gram-positive bacterium.
      This isolate was able of complete oxidation of several aromatic compounds
      including phenol, catechol, benzoate, p- and m-cresol, benzyl alcohol and
      vanillate. With hydrogen and carbon dioxide, formate or O-methylated aromatic
      compounds, autotrophic growth during sulfate reduction or homoacetogenesis was
      demonstrated. Lactate was not used as a substrate. SO4(2-), SO3(2-), and S2O3(2-)
      were utilized as electron acceptors. Although strain Groll originated from a
      freshwater habitat, salt concentrations of up to 30 g.l-1 were tolerated. The
      optimum temperature for growth was 35-37 degrees C. The G + C content of DNA was
      42.1 mol%. This isolate is described as a new species of the genus
      Desulfotomaculum.

PMID- 8481093
TI  - [2,6-Epoxy-3-benzazocines: centrally acting N/O-acetals produced by cyclization
      of amino- and amidoacetals].
AB  - Under acidic conditions the secondary amines 10a and 10b, the primary amine 15,
      the amide 17a, and the urethane 17b were cyclized to yield the 2,6-epoxy-3
      benzazocines 11a, 11b, 16, 18a and 18b, respectively. Ring closure of the inverse
      amide 5a, however, failed to give the tricyclic N/O-acetal 6. With LiAlH4 the
      epoxy bridge of the urethane 18b was opened to afford the bicyclic 3-benzazocine
      20. While the N-(2-methoxyethyl) derivative 11b did not influence the behaviour
      of mice, the N-methyl derivative 11a showed strong central effects.

PMID- 8481094
TI  - Nonsteroidal antiinflammatory agents, XVII: Inhibition of bovine cyclooxygenase
      and 5-lipoxygenase by N-alkyldiphenyl-pyrrolyl acetic and propionic acid
      derivatives.
AB  - A series of 19 N-alkyl-diarylpyrrolyl-acetic and-propionic acid derivatives was
      synthesized and tested. Using bovine blood as enzyme source the inhibition of
      cyclooxygenase and 5-lipoxygenase, respectively, was applied to determine the
      antiinflammatory activity. In general all compounds tested inhibit 5-lipoxygenase
      more effectively than cyclooxygenase. A structure-activity relationship is
      discussed.

PMID- 8481095
TI  - Platelet aggregation inhibiting and anticoagulant effects of oligoamines, XIX:
      4,4'-Phenylene-bis-sydnone imines.
AB  - Fourteen 4,4'-m-phenylene- and two 4,4'-p-phenylene-bis-sydnone imine
      hydrochlorides have been synthesized. All compounds exhibited good solubility in
      water. In the m-series the 3-(3-phenylpropyl)-derivative 5c and the 3-hexyl
      compound 5l showed antiplatelet activities at or below 10 mumol/L (IC50, Born
      test with collagen). The corresponding p-compounds had the same (6l) or slightly
      lower (6c) activity. No effect on the fibrin formation (Quick-test) could be
      observed.

PMID- 8481096
TI  - [Benzomorphan analogs with doxpicomine partial structure: synthesis
      andpsychopharmacologic investigations of 5-aminomethyl- and 5-(alpha-aminobenzyl)
      substituted 2,6-epoxy-3-benzoxocines].
AB  - Addition of the beta-alanine derivative 6 to the homophthalaldehyde monoacetal 5
      and subsequent LiAlH4-reduction led to the dihydroxy acetal 8, which was cyclized
      with acid to give the 5-aminomethyl-2,6-epoxy-3-benzoxocines 2a and 2b. The
      reaction of 5 with the anion of the beta-lactam 9 yielded two separable
      diastereomers: 10a with u,l-configuration and 10b with 1,1-configuration. Via the
      2-benzopyran 11a (11b), the aminoalcohol 12a (12b), and the secondary amine 13a
      (13b), the beta-lactam adduct 10a (10b) was transformed to give the 5-(alpha
      dimethylaminobenzyl)-2,6-epoxy-3-benzoxocine 3d (3b). The relative configurations
      of all these "beta-lactam route" products (10-13, 3d, and 3b) were established by
      their 1H-NMR-spectra. Attempts failed to get the missing diastereomers 3a and 3c
      by epimerization of the beta-lactams 11a and 11b or by reductive amination of the
      benzoyl derivatives 17a and 17b. Finally, 3a and 3c were obtained by
      phenylmagnesium bromide addition to the nitriles 21a and 21b, followed by LiAlH4
      reduction, formaldehyde/NaBH3CN methylation and chromatographic separation. In
      the Irwin-screen (mouse) only 2a.HCl, 3b, and 3d (100 mg/kg body weight) caused
      weak central effects.

PMID- 8481097
TI  - Volatile metabolites in occupational exposure to organic sulfur compounds.
AB  - Dimethyl sulfide in breath was determined by the gas chromatographic method in 14
      persons exposed to organic reduced sulfur compounds in sulfate pulp mills.
      Dimethyl sulfide concentrations in breath (range 0.04-0.69 cm3/m3 were compared
      to the combined workplace concentrations of methyl mercaptan, dimethyl sulfide
      and dimethyl disulfide. This method of analysis proved to be a practical
      noninvasive way to assess recent exposure, and therefore it should be applicable
      to workplaces contaminated with organic sulfur compounds in the pulp industry.

PMID- 8481098
TI  - Toluene metabolism in isolated rat hepatocytes: effects of in vivo pretreatment
      with acetone and phenobarbital.
AB  - Hepatocytes isolated from control, acetone- and phenobarbital-pretreated rats
      were used to study the metabolic conversion of toluene to benzyl alcohol,
      benzaldehyde, benzoic acid and hippuric acid at low (< 100 microM) and high (100
      500 microM) toluene concentrations. The baseline formation rates of toluene
      metabolites (benzyl alcohol, benzoic acid and hippuric acid) were 2.9 +/- 1.7 and
      10.0 +/- 2.3 nmol/mg cell protein/60 min at low and high toluene concentrations,
      respectively. In vivo pretreatment of rats with acetone and phenobarbital
      increased the formation of metabolites: at low toluene concentrations 3- and 5
      fold, respectively; at high toluene concentrations no significant increase
      (acetone) and 8-fold increase (phenobarbital). Apparent inhibition by ethanol, 7
      and 60 mM, was most prominent at low toluene concentrations: 63% and 69%,
      respectively, in control cells; 84% and 91% in acetone-pretreated cells, and 32%
      (not significant) and 51% in phenobarbital-pretreated cells. Ethanol also caused
      accumulation of benzyl alcohol. The apparent inhibition by isoniazid was similar
      to that of ethanol at low toluene concentrations. Control and acetone-pretreated
      cells were apparently resistant towards metyrapone; the decrease was 49% and 64%
      in phenobarbital-pretreated cells at low and high toluene concentrations,
      respectively. In these cells, the decrease in presence of combined ethanol and
      metyrapone was 95% (low toluene concentrations). 4-Methyl-pyrazole decreased
      metabolite formation extensively in all groups. Benzaldehyde was only found in
      the presence of an aldehyde dehydrogenase inhibitor. Increased ratio
      benzoic/hippuric acid was observed at high toluene concentrations. These results
      demonstrate that toluene oxidation may be studied by product formation in
      isolated hepatocytes. However, the influence of various enzymes in the overall
      metabolism could not be ascertained due to lack of inhibitor specificity.

PMID- 8481099
TI  - Surface binding and uptake of cadmium (Cd2+) by LLC-PK1 cells on permeable
      membrane supports.
AB  - Recent studies have shown that Cd2+ has relatively specific damaging effects on
      cell-cell junctions in the renal epithelial cell line, LLC-PK1. The objective of
      the present studies was to examine the surface binding and uptake of Cd2+ by LLC
      PK1 cells in relation to the disruption of cell-cell junctions. LLC-PK1 cells on
      Falcon Cell Culture Inserts were exposed to CdCl2 containing trace amounts of
      109Cd2+ from either the apical or the basolateral compartments, and the
      accumulation of 109Cd2+ was monitored for up to 8 h. The integrity of cell-cell
      junctions was assessed by monitoring the transepithelial electrical resistance.
      The results showed that the cells accumulated 3-4 times more Cd2+ from the
      basolateral compartment than from the apical compartment. The accumulation of
      Cd2+ from the basolateral compartment occurred in two phases: a rapid,
      exponential phase that occurred in 1-2 h and coincided with a decrease in
      transepithelial resistance, and a slower, linear phase that continued for 6-8 h.
      The Cd2+ that accumulated during the rapid phase was easily removed by washing
      the cells in EGTA, indicating that most of it was bound to sites on the cell
      surface. By contrast, most of the Cd2+ that accumulated during the slower phase
      could not be removed by EGTA, indicating that it had been taken up by the cells.
      Additional studies showed that the rapid phase of Cd2+ accumulation was enhanced
      when Ca2+ was present at low concentrations (0.1 mM), and was greatly reduced
      when Ca2+ was present at high concentrations (10 mM).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8481100
TI  - Electroretinographic assessment of early retinopathy in rats.
AB  - Amoscanate, a substance which damages photoreceptors, was administered orally to
      Wistar rats in doses of 10, 40, and 125 mg/kg body weight once daily for 3 or 10
      days. At both times electroretinographic, ophthalmological, and histopathological
      examinations of the retina were carried out to compare the sensitivity of
      conventional methods and to test electroretinography (ERG) for suitability for
      use in toxicity studies. Time-dependent and dose-dependent effects were found by
      electroretinography and light microscopy. However, signs of retinal changes
      appeared earlier and more distinctly in the electroretinogram. Ophthalmological
      fundus examination in albino rats yielded no characteristic correlate. In
      conclusion, electroretinography constitutes a valuable supplement to
      histopathology and is suitable for use in toxicity studies.

PMID- 8481101
TI  - Effects of high doses of testosterone propionate and testosterone enanthate on
      rat seminiferous tubules--a stereological and cytological study.
AB  - The effects of exogenous testosterone on various testicular variables has become
      of increasing significance because of its potential use in male contraception.
      For this reason, high doses of two testosterone esters [testosterone propionate
      (TP) and testosterone enanthate (TE)] were used in a study of their influence on
      the morphology, length and curvature of the seminiferous tubules of the rat
      testis, and on cytological smears of the seminiferous tubules epithelium. TP was
      given for 14 days (3 mg/100 g body weight, i.m.) to assess the acute effects of
      testosterone on the seminiferous tubules. TE was administered for 60 days (in the
      same manner as TP) to study possible chronic effects on the rat testis. After TP
      and TE treatment the seminiferous tubule epithelium showed disorganization and
      desquamation of spermatogenic cells. In the TP-treated testes the tubules lined
      with Sertoli cells only were observed. The values for the length and curvature of
      seminiferous tubules of the TP- and TE-treated rats were significantly reduced (p
      < 0.001). All these changes were observed earlier in the TP-treated than in the
      TE-treated animals. In cytological smears of the testis of the TP- and TE-treated
      rats an increase of vacuoles and residual bodies in Sertoli cell cytoplasm was
      noted. In addition, a reduction of spermatogenic cells, particularly sperms, was
      manifest in the smears after treatment. Large groups of Sertoli cells were seen
      in the smears from these testes.

PMID- 8481102
TI  - Investigation of possible metabolism of pigment yellow 17, a 3,3'
      dichlorobenzidine-based pigment, after inhalation exposure in rats.
AB  - Rats were exposed by inhalation to the technically highest administrable
      concentration of 230 mg Pigment Yellow 17/m3 air for 4 h. Inhalability of the
      dust was guaranteed by a mass-median aerodynamic diameter of 1.0-1.1 microns. For
      14 days after exposure, urine and serum samples were analysed for 3,3'
      dichlorobenzidine, the parent carcinogenic amine of the test compound. No 3,3'
      dichlorobenzidine could be detected either in urine or blood, the detection limit
      being 5 ng/ml for both media. Based on the results of this study there is no
      evidence for metabolic cleavage of Pigment Yellow 17 to 3,3'-dichlorobenzidine in
      the rat.

PMID- 8481103
TI  - Effect of Sairei-to on gentamicin nephrotoxicity in rats.
AB  - The effect of Sairei-to, an oriental traditional medicine, against gentamicin
      nephrotoxicity was examined in gentamicin nephrotoxicity rat models. Gentamicin
      nephrotoxicity was induced by s.c. injection of gentamicin (100 mg/kg/day, for 3
      days) in male Sprague-Dawley rats. Renal functions of two rat groups were
      compared, one eating rat chow containing 2.5% Sairei-to, the other eating normal
      rat chow. Sairei-to administration reduced the increase of urinary N-acetyl-beta
      D-glucosaminidase (NAG) and protein excretion, and decreased creatinine clearance
      induced by gentamicin. Gentamicin increased renal cortical malondialdehyde (MDA)
      concentration in normal diet group but not in the Sairei-to diet group. The renal
      cortical gentamicin concentration was not different between the two groups. In
      conclusion, Sairei-to shows reno-protective action against gentamicin
      nephrotoxicity, possibly through its anti-oxidant action.

PMID- 8481104
TI  - Poisoning by toxic honey in Turkey.
AB  - One of the food intoxications encountered in Turkey is the case caused by toxic
      honey made by bees from Rhododendron species. R. luteum and R. ponticum are the
      two species which grow in the north regions of Turkey. Grayanotoxins, mainly
      Grayanotoxin I (Andromedotoxin) occurring only in Ericaceae plants, are the
      compounds responsible for poisoning. In this investigation, the diagnosis and
      treatment of 11 cases of poisoning admitted to Kartal Occupational Diseases
      Hospital between 1983 and 1988 are presented. The results of the light
      microscopic and chemical analysis of toxic honey samples are compared with those
      of the ordinary honey samples and the extract of Rhododendron leaves.

PMID- 8481106
TI  - In vitro percutaneous absorption and metabolism in man of 2-chloro-4-ethylamino-6
      isopropylamine-s-triazine (atrazine).
AB  - Atrazine is an extensively used herbicide in the USA. Our objective was to
      determine the absorption and metabolism (detoxification) of atrazine in human
      skin. Percutaneous absorption of atrazine in human skin from four sources was
      examined utilizing a flow-through in-vitro diffusion system. About 16.4% of the
      applied dose was absorbed by the skin. Radioactivity in the receptor fluid at 20
      h was less than 5% of the administered dose. The highest concentration of the
      applied dose was found in the skin supernates, where 12.0% of the dose (68 nmol)
      was recovered. Some metabolites of atrazine were identified by thin layer and
      high pressure liquid chromatography after extraction of receptor fluid and the
      skin supernates. Two metabolites of atrazine [2-chloro-4-ethylamino-6-amino-s
      triazine (desisopropylatrazine) and 2-chloro-4,6-diamino-s-triazine] were found
      in the receptor fluid and the skin supernates. An additional metabolite (2-chloro
      4-amino-6-isopropylamino-s-triazine) was found in the skin supernates. Since
      desisopropylatrazine represented about 50% of the total metabolites formed during
      percutaneous absorption, cleavage of the N-isopropyl to the amino product was a
      key step in the metabolism of atrazine. Further metabolism may proceed by
      cleavage of the N-deethyl group to give totally dealkylated atrazine. The
      biotransformation of atrazine was studied in skin microsomal fraction
      supplemented with an NADPH-generating system. In analogy to metabolism during
      percutaneous absorption, atrazine was metabolized to its deisopropyl and
      deethylpropyl derivatives. In addition, 2-hydroxy derivatives of atrazine were
      formed by the skin microsomal fractions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481105
TI  - Cholinesterase reactivation in organophosphorus poisoned patients depends on the
      plasma concentrations of the oxime pralidoxime methylsulphate and of the
      organophosphate.
AB  - We measured in nine patients, poisoned by organophosphorus agents (ethyl
      parathion, ethyl and methyl parathion, dimethoate, or bromophos), erythrocyte and
      serum cholinesterase activities, and plasma concentrations of the
      organophosphorus agent. These patients were treated with pralidoxime
      methylsulphate (Contrathion), administered as a bolus injection of 4.42 mg.kg-1
      followed by a continuous infusion of 2.14 mg.kg-1/h, a dose regimen calculated to
      obtain the presumed "therapeutic" plasma level of 4 mg.l-1, or by a multiple of
      this infusion rate. Oxime plasma concentrations were also measured. The
      organophosphorus agent was still detectable in some patients after several days
      or weeks. In the patients with ethyl and methyl several days or weeks. In the
      patients with ethyl and methyl parathion poisoning, enzyme reactivation could be
      obtained in some at oxime concentrations as low as 2.88 mg.l-1; in others,
      however, oxime concentrations as high as 14.6 mg.l-1 remained without effect. The
      therapeutic effect of the oxime seemed to depend on the plasma concentrations of
      ethyl and methyl parathion, enzyme reactivation being absent as long as these
      concentrations remained above 30 micrograms.l-1. The bromophos poisoning was
      rather mild, cholinesterases were moderately inhibited and increased under oxime
      therapy. The omethoate inhibited enzyme could not be reactivated.

PMID- 8481107
TI  - Differences in the effects of model inducers of cytochrome P450 on the
      biotransformation of scoparone in rat and hamster liver.
AB  - The hamster is known to display very high rates of monooxygenase-mediated
      biotransformation. In comparison with other species little knowledge has been
      gathered with respect to the nature of its cytochrome P450 enzymes and their
      respective inducibility. We studied the consequences of induction of P450 enzymes
      in rats and Syrian golden hamsters using the regioselective oxidative O
      demethylation of the coumarin derivative scoparone. This metabolic conversion
      indicates differential effects of P450 inducers in the rat, in which various
      types of inducers cause different shifts in the isoscopoletin/scopoletin
      metabolite ratio (I/S-ratio). Liver microsomes from hamster not treated with P450
      inducers oxidized scoparone much more efficiently than liver microsomes of
      untreated rats. In rat liver microsomes total demethylation rates of scoparone
      increased upon in vivo treatment with phenobarbital or beta-naphthoflavone.
      Phenobarbital reduced the I/S-ratio whereas beta-naphthoflavone caused an
      increase in this ratio. In hamster liver microsomes both phenobarbital and beta
      naphthoflavone treatments resulted in a decrease in the I/S ratio. In this
      species the total scoparone demethylation rate was not much affected by
      phenobarbital, but beta-naphthoflavone caused a huge increase in over-all
      scoparone biotransformation. In both species, dexamethasone, isoniazid and
      clofibrate were much less effective. In contrast to the rat, in the hamster the
      scoparone biotransformation profile cannot be used to differentiate between
      phenobarbital- or beta-naphthoflavone-treated animals.

PMID- 8481109
TI  - The disturbed mind.

PMID- 8481108
TI  - Enzyme induction of the early chick embryo by airborne particulate extracts.
AB  - The induction by airborne particulate extracts of aryl hydrocarbon hydroxylase
      (AHH) and 7-ethoxycoumarin O-deethylase (ECOD) in early chick embryos was studied
      to determine whether or not lethality by the extracts was related to the
      induction. The optimal pH values for AHH and ECOD were 7.1 and 6.9, respectively,
      after administering the extracts to early embryos. The AHH inducing capacity was
      significantly increased 4 h after injection of the extracts, then the value
      gradually increased. The ECOD inducing ability was similar to that of AHH,
      although to a lesser extent. Among fractions from the extracts, the neutral
      fraction was responsible for most of the AHH inducing activity. Two neutral
      subfractions (N2 and N3), consisting mostly of polycyclic aromatic hydrocarbons
      (PAH) and their derivatives, had the highest inducing activity. A dose-response
      relationship was observed between the amounts of the N2 and induction of AHH and
      ECOD in 8-day-old embryos. When the N2 was administered at different stages of
      development (days 5-9), the values of induced AHH and ECOD activities increased
      along with the days of development. Extracts of the smaller airborne particulates
      (< 1.1 and 1.1-2.0 microns cut-off diameters) had stronger AHH and ECOD inducing
      abilities than those of the larger, since the former contained high levels of PAH
      and their derivatives. These results suggested that PAH and their derivatives in
      the airborne particulates induced AHH and ECOD activities in the early chick
      embryo. The relationship between the extent of AHH and ECOD inducing activities
      and that of embryolethality caused by extracts of airborne particulates was not
      well established.

PMID- 8481110
TI  - Compliant victims of the sexual sadist.
AB  - This is a descriptive summary of the experiences of a sample of women who have
      been consensually involved with criminal sexual sadists. The paper details the
      physical, sexual, and psychological abuse to which the women were subject as well
      as the process by which they were transformed from independent, competent women
      to the compliant appendages of their criminally active partners. Similarities in
      the sexual sadist's criminal and consensual sexual activities as they reflect a
      specific paraphilic preference are discussed.

PMID- 8481111
TI  - Obsessive compulsive disorder. An update.
AB  - Developments in the neurosciences, neuropharmacology and in cognitive/behavioural
      therapy have helped in providing effective treatment for OCD. That OCD can be
      treated successfully is likely to lead to greater public demands on clinicians
      for diagnosis and treatment. It is thus hoped that the quality of life for
      sufferers will improve and the secretiveness and shame they now feel about their
      illness will no longer occur.

PMID- 8481112
TI  - Assessing the risk of violent and fear-inducing behaviour in the mentally
      disordered.
AB  - Assessing the risks of violence in mentally disordered individuals is, as with
      suicide risk, an uncertain process that tends to produce high numbers of false
      positives, as well as the occasional failure to recognise imminent danger.
      Ideally we should have a data base on which actuarial estimates could be made,
      but in our present state of knowledge careful clinical assessment and common
      sense have to suffice. When the result of assessing a patient as at risk of being
      violent is to increase the level of support and therapeutic activity provided few
      ethical issues arise. When involuntary hospitalisation or curtailment of rights
      follows, the assessment of dangerousness must be soundly based and persuasive.
      The assessment of dangerousness remains a dubious business but on occasion it is
      our business.

PMID- 8481113
TI  - Identifying potential gun offenders.
AB  - According to the results of a Saulwick Age Poll (The Age, 13 June 1988) one in
      three Australians aged 18 to 24 would like to have a gun. Many of them join
      pistol shooting clubs. Target pistol shooting, part of the Olympic Games
      programme, is a safe sport. It develops self discipline, teaches body control, to
      make decisions under pressure, how to handle stress and think logically as an
      individual. There are about 70 pistol clubs in Victoria. Following the rule
      "prevention is better than the cure" MISC introduced screening of new members.
      The system--interview, the questionnaire, a probation period--was found during
      the two year trial period successful as a strategy to identify people who are
      potential risks to society.

PMID- 8481114
TI  - Challenges to the admissibility of DNA profiling evidence in criminal trials.
AB  - This article presents an overview of the credibility of DNA profiling in criminal
      trials. DNA profiling does not provide absolute identification but has to be
      considered as a component of evidence. Apart from being used to help determine
      guilt it can be used to exonerate suspects.

PMID- 8481115
TI  - Youth suicide in the Australian Capital Territory.
AB  - A study was made of all suicides of young people aged under 25 years in the
      Australian Capital Territory (ACT) over the 6 year period 1985 to 1990. The
      rationale was to attempt to identify significant risk factors. 'Psychological
      autopsies' were carried out on material from the coroner's files. The results of
      the study suggest that suicide among the young in the ACT appears to be the
      result of a complex interplay of intrapersonal, interpersonal and social
      environmental factors.

PMID- 8481116
TI  - Criminal investigative analysis.
AB  - In its pursuit of those responsible for the commission of serious violent crime,
      law enforcement will continue to explore and refine the Criminal Investigative
      Analysis process. To this end, it will enthusiastically collaborate with the
      medical profession. The results of continuing studies will be made available to
      relevant bodies. If a general practitioner becomes aware of a patient's
      unexplained changes of behaviour an additional question should perhaps be
      considered: "What else is happening in your life?" The response and its
      evaluation and subsequent intervention may avert a tragedy. Notification of
      police and anonymity of a practitioner are always contentious issues. In my mind,
      responsibility to the community in general completely over-shadows the debate on
      anonymity and confidentiality. In recent discussions with professionals involved
      in the mental health field there was a consensus that if a treating doctor
      becomes aware that a person is likely to be violent or cause harm to themselves
      or the community, the problem of confidentiality does not occur. The safety of
      the public is paramount. In addition, senior vice president of the Australian
      Medical Association, Dr Brendan Nelson, was quoted in the Sunday Age 16 August
      1992 as follows: "If a patient tells you that she is going to kill her husband
      and you believe it is a serious threat, then you have a responsibility to the
      person whose life is in danger to inform the authorities." To do otherwise,
      surely is an injustice and it would appear to therefore follow, also unethical
      and immoral.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481117
TI  - An unlikely pregnancy and its consequences.
AB  - This commentary illustrates the case of a young married woman (who will be
      referred to as Debbie), who presented requesting a tubal ligation, but after a
      joint discussion with her husband (who will be referred to as Boyd), it was
      decided that he would have a vasectomy. Shortly after the operation, Debbie
      became pregnant. The importance of full discussion of medical procedures with
      patients and their families so that informed decisions can be made and a close
      working relationship established will be highlighted.

PMID- 8481118
TI  - Euthanasia in The Netherlands. General practice facts.
AB  - The recent survey of the way general practitioners act in case of euthanasia, did
      point to the fact that procedural requirements were not always observed. This
      concerned particularly the issuing of an appropriate death certificate. It is
      important that the practice of euthanasia be prudently surveyed in order to
      safeguard the standard of euthanasia that general practitioners are able to
      provide. Fear in the community for unwanted medical practice is understandable
      when the history of Hitler Germany is used as a frame of reference. Stories of
      mercy killing in nursing homes or elsewhere will as well increase anxiety. This
      fear is, however, based on a wrong understanding of euthanasia. The formulated
      requirements and prudent surveillance offer the best protection against the fear
      of the community.

PMID- 8481119
TI  - Rehabilitation of elderly patients. Don't give up too quickly!
AB  - Rehabilitation means 'to restore to previous condition, rights, privileges, to
      attain some degree of independence (New Oxford Dictionary). The general
      practitioner will inevitably be involved in deciding when and where the patient
      will go. With increasing care, understanding and effort, it is hoped that with
      the above in mind, an increasing number of seemingly incapable elderly people
      will be helped. Just as with other age groups, an increasing number of elderly
      will be able to continue making a worthwhile contribution to society and to solve
      their own problems in ways that they choose.

PMID- 8481120
TI  - Epilepsy and sport.
AB  - Sport and epilepsy are not mutually exclusive, providing the disease has been
      properly diagnosed and managed and adequate safeguards are taken. The author also
      outlines specific contraindications for the sports-minded person with epilepsy.

PMID- 8481122
TI  - Curing the warts.

PMID- 8481121
TI  - The health information network.
AB  - The health information network concept is certainly visionary. It has much merit
      but it is doomed to failure unless the proposed users of this information show
      much more concern for confidentiality.

PMID- 8481123
TI  - Update in the treatment of schizophrenia.
AB  - The large number of drugs available to treat schizophrenia and the emergence of
      atypical and newer agents that provide efficiency with lessening of side effects
      may not only serve to provide more amelioration against this disease, but may
      also help us to unravel the neurochemical defects of the disorder. Despite these
      encouraging trends, the reality is that schizophrenia is still a devastating
      illness for a sizeable minority affected with the condition, that a 'cure' is not
      yet possible, and that drug therapies alone will not provide all that is required
      in acute or continuing management. Supporting care in the community for patient
      and family are just as important as pharmacotherapy in managing this problem.

PMID- 8481124
TI  - Intellectual disability. The counselling of parents and family.
AB  - A sympathetic general practitioners who is aware of the problems encountered by
      these families has a vital role in their health care. Families who face a
      lifetime of dealing with a myriad of problems appreciate having an accessible
      counsellor they are comfortable with. Being aware of the process of adaptation
      undergone by the family enables practitioners to do their job more effectively.
      Disability and its effect on the family is a worthwhile challenge for holistic
      family practitioners.

PMID- 8481125
TI  - Patient education. Tubal ligation.

PMID- 8481126
TI  - Dr David Hollands. Wildlife photographer.
AB  - Dr David Hollands and his wife, Dr Margaret Hollands, have been a successful team
      -in their professional and family lives. Their working lives and private lives
      have obviously been closely enmeshed and it is difficult to attribute the success
      of one in a particular field to one only--somewhere along the line there has been
      the influence and more often than not the direct help of the other. Country
      medical practice has provided David Hollands with a deeply satisfying
      professional life and allowed him to develop his boyhood love of natural history.
      Although well known in his own locale of Orbost, Victoria, for his medical skill
      he has recently gained wider recognition as a wildlife photographer with the
      publication of his two books. His wife, Margaret, will be the subject of next
      month's Notable Australian Doctors.

PMID- 8481127
TI  - Split skin injuries.

PMID- 8481128
TI  - Marital surprises.

PMID- 8481129
TI  - Extemporaneous prescribing. Module. 1.
AB  - Australian Family Physician is pleased to be able to present a home course in
      extemporaneous prescribing, an interesting area that is poorly understood by many
      practitioners, especially recent graduates. Dr Bernard Kelly has been teaching
      this discipline to Family Medicine Trainees in New South Wales for many years and
      has written a series of modules to be placed in the journal during 1993. A
      question of historical pharmacological interest is included at the end of each
      module.

PMID- 8481130
TI  - True stories.
AB  - Four stories, all true, all upsetting, all with lessons for the discerning
      doctor. In this series, life won 3-1. But none of us are immortal, no matter what
      an over confident American group who call themselves 'The Immortals' I saw on
      television the other day has to say. Lest we forget--families, friends, patients
      and what we do to them, stress and risk factors--the potpourri of our medical
      lives.

PMID- 8481131
TI  - Chronic fatigue syndrome.

PMID- 8481132
TI  - GPs--the missing link.

PMID- 8481133
TI  - Concomitant coronary revascularization and resection of lung cancer.
AB  - As age and smoking are common risk factors, patients with lung cancer frequently
      have coexistent ischaemic heart disease. Ignoring the coronary disease results in
      an unacceptable operative mortality, whilst sequential coronary grafting and lung
      resection may prejudice the results of the resection. A series of 10 patients
      underwent combined coronary revascularization (average 2.9 grafts per patient)
      and lung resection for carcinoma (seven lobectomies, one bilobectomy, one sleeve
      lobectomy, and one pneumonectomy). The majority of patients had unstable angina,
      triple vessel or left main coronary artery stenosis and poorly staged tumours.
      There was no operative mortality and the average hospital stay was 20 days. Half
      the patients had significant peri-operative morbidity; seven are alive and well
      at between 12 and 38 months follow-up; but three have died of recurrent carcinoma
      (one with associated sepsis) at 3, 8, and 13 months. Combined coronary
      revascularization and lung resection can be safely performed in selected
      patients. The early morbidity is mainly related to the cardiac procedure and
      impaired respiratory function preoperatively, but the long-term results are
      dependent upon the control of the lung carcinoma.

PMID- 8481134
TI  - Hip fractures: changing patterns in hospital bed use in NSW between 1979 and
      1990.
AB  - Osteoporotic hip fractures are associated with significant medical, social and
      financial costs. To examine trends in hip fracture incidence, acute hospital
      admissions, bed use and outcome for these fractures were reviewed for the period
      1979-90. In this period, there was a 45% increase in the total number of
      fractures. In women aged 65 and over increases in admission rate were found
      between 1979 and 1986. Fracture admission rates for women stabilized after 1986,
      but remained approximately 7% higher than in the baseline year of 1979. In men
      aged 65 years and over there was no discernible change in fracture incidence.
      Length of stay in hospital was inversely related to the total number of proximal
      femoral fracture cases in each year. As a result of the large decreases in length
      of stay, overall bed use in 1991 was very similar to that in 1979, in spite of
      the large increase in fracture admissions. This reduction in length of stay may
      reflect, not only the pressures of greater demand, but also improved surgical and
      postoperative management and the effects of early intervention and rapid transit
      treatments.

PMID- 8481135
TI  - The cost-efficiency of incentive spirometry after abdominal surgery.
AB  - This report gives the results of a cost-efficiency analysis of a prospective
      longitudinal study evaluating two forms of prophylaxis against postoperative
      pulmonary complications in 876 patients undergoing abdominal surgery. It cost
      $12.19 per patient for conventional chest physiotherapy, and equivalent costs
      accrue when incentive spirometers are recycled and used on average 2.3 times (in
      the Royal Perth Hospital, incentive spirometers are recycled an average of 4.7
      times). Maximum cost-containment can be achieved by carefully selecting patients
      for physical chest care and then instigating a programme of perioperative chest
      care utilizing recycled incentive spirometers. This approach does not compromise
      the clinical benefits of prophylactic chest care and allows physiotherapy
      resources to be directed toward patients with established pulmonary problems.

PMID- 8481136
TI  - Jejunal diverticulosis.
AB  - Jejunal diverticulosis is considered to be a generally asymptomatic condition in
      which the diverticula are pulsion mucosal herniations with walls lacking a muscle
      layer. These opinions in particular are examined in this review of 20 cases of
      jejunal diverticulosis treated during an 8 year period. The predominant
      complication in each case was inflammation or perforation (nine), diarrhoea or
      malabsorption (five), haemorrhage (three), chronic abdominal pain (two) and
      pseudo-obstruction (one). At least 10 patients had more than one complication,
      although this was often unrecognized. Ten patients complained of chronic
      abdominal pain, in eight of whom the cause was not diagnosed until other
      complications supervened. Unrecognized malabsorption may be common, as the mean
      serum albumin in 12 patients presenting acutely with inflammation, perforation or
      haemorrhage, was low (mean 32 g/L, normal 39-48 g/L). Histology sections were
      reviewed in the 12 cases that underwent resection, of whom 11 were suitable for
      classification. Four cases had narrow-mouthed pulsion diverticula with a thin or
      absent muscle coat, and had developed at the point of blood vessel penetration.
      Four cases had wide-mouthed diverticula in which the muscle layer was present,
      suggesting an abnormality of the intestinal wall. Two had features of both. In
      one case a Meckel's type diverticulum was located 10 cm from the duodenal-jejunal
      flexure. Seven had mucosal villous atrophy consistent with bacterial overgrowth.
      In conclusion, jejunal diverticulosis may be associated with complications more
      frequently than has been recognized and pathologically is a diverse condition.

PMID- 8481137
TI  - The safety and duration of non-operative treatment for adhesive small bowel
      obstruction.
AB  - Small bowel obstruction (SBO) due to adhesions is often initially treated non
      operatively but the safety and duration of non-operative treatment is
      controversial. The aims of this study were to assess the safety of non-operative
      treatment and determine the optimal duration of non-operative treatment in
      adhesive SBO. A retrospective analysis of patients admitted with a diagnosis of
      adhesive SBO following an initial period of non-operative treatment was
      performed. Patients whose condition resolved with non-operative treatment were
      compared with patients who required surgical intervention after an initial period
      of non-operative treatment. There were 123 admissions having an initial period of
      non-operative treatment. The SBO resolved in 85, the remaining 38 required
      surgical intervention. Complete resolution occurred within 48 h in 75 (88%)
      cases, the remaining 10 had resolved by 72 h. Thirty-one of 38 patients required
      surgical intervention for SBO more than 48 h duration after admission. The
      difference between cases resolving within 48 h and those requiring surgery after
      48 h was significant (chi 2 = 113, P < 0.001). Three (2.4%) patients, initially
      treated non-operatively, had small bowel strangulation. All three were operated
      on within 24 h of admission when changes in clinical findings suggested small
      bowel strangulation may be present. There were no deaths in the group having an
      initial period of non-operative treatment. In the absence of any signs of
      strangulation, patients with an adhesive SBO can be managed safely with non
      operative treatment. Most cases of adhesive SBO that will resolve, do so within
      48 h of admission.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481138
TI  - Laparoscopic management of pneumatic dilatation resistant achalasia.
AB  - Three patients with achalasia, who were successfully managed by laparoscopic
      Heller myotomy and Nissen fundoplication, are described. Each patient had failed
      to respond to two pneumatic dilatations of the oesophagus.

PMID- 8481139
TI  - Mid-colon oesophagocoloplasty for corrosive oesophageal strictures.
AB  - Corrosive strictures of the oesophagus are common and being long and dense
      frequently require surgical replacement of the oesophagus. Presently available
      techniques of oesophagocoloplasty are associated with a significant mortality and
      major morbidity, such as a high rate of ischaemic necrosis of the colon, cervical
      salivary fistula or oesophagocolic stenosis. A method of mid-colon
      oesophagocoloplasty using an isoperistaltic colonic segment from the mid
      ascending to the mid-descending colon is reported. The procedure was carried out
      in 33 patients. The conduit was placed retrosternally in 27 patients and
      subcutaneously in the rest. The essential steps of the procedure are simultaneous
      neck and abdominal dissection, near-total mobilization of the colon from the
      ileocaecal segment to the sigmoid colon and sequential clamping of ileocolic,
      right colic and usually the middle colic vessels leaving the left colic vessels
      as the major vascular pedicle. The divided ileum is used to pull the colon into
      position thus avoiding traumatization of the colon and leaving the whole length
      of the mobilized colon available for anastomosis. A wide side to side
      oesophagocolic anastomosis in the neck, resection and discarding of the bulky
      terminal ileocaecal segment after completion of the cervical anastomosis, closure
      of the terminal end of the colon and its placement adjacent to the hypopharynx
      and end to side cologastric anastomosis complete the procedure. There was no
      mortality and there was no instance of colonic necrosis. The procedure restored
      an ability to eat normal food in 93.9% of patients compared to only 39.2% of
      patients with bougienage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481140
TI  - Angular vein of the axilla and the anatomy of the subscapular vein important in
      axillary node dissection.
AB  - The anatomy of the subscapular vein and its tributaries is described.
      Importantly, the angular branch of the subscapular vein and its almost constant
      relationship to the thoracodorsal nerve were demonstrated.

PMID- 8481141
TI  - Videothoracoscopic primary repair of early distal oesophageal perforation.
AB  - Distal oesophageal perforation following dilation of oesophageal strictures or
      achalasia is usually recognized soon after the event. Treatment of two patients
      with perforation resulting from vigorous achalasia, diagnosed within hours of the
      procedure, was approached by videothoracoscopic exposure and successful primary
      repair was achieved in both instances. Details relating to patient preparation
      and operative technique are presented. Both patients recovered, with normal diet
      being tolerated by the seventh day after surgery, were discharged on day eight
      and 10 and returned to normal activities within 3 weeks of surgery. The technique
      presented is apparently well suited to distal oesophageal perforations diagnosed
      early, when primary closure can be achieved safely, and significantly improves
      patient recovery after this often iatrogenic injury.

PMID- 8481142
TI  - Use of Blount's epiphyseal staples to control massive iliac venous haemorrhage.
AB  - Significant injuries to major veins are life-threatening events and may lead to
      patient exsanguination. Treatment usually consists of direct suture repair. A
      case in which a serious iliac venous haemorrhage was not able to be controlled
      with the usual surgical procedures is reported. A desperate attempt to achieve
      haemostasis using orthopaedic staples was successful. The simplicity of this
      technique makes it a useful addition to the surgeon's armamentarium when dealing
      with life-threatening venous haemorrhage.

PMID- 8481143
TI  - Branch duct origin of solid type pancreatic ductal carcinoma.
AB  - A case of branch duct origin of solid type pancreatic ductal carcinoma is
      presented. Stepwise tissue sections of an entire specimen, including the
      carcinoma area, and mapping, with special reference to the relationship between
      the main duct and the carcinoma area, were performed. Carcinoma cells of the
      branch duct showed intraductal spread with minimal stromal invasion. No carcinoma
      tissue was observed in the main duct. Therefore this case was considered to be of
      branch duct origin. The finding of histologically identified branch duct origin
      of solid type pancreatic ductal carcinoma indicates a distinct advantage to be
      gained by giving special attention to both the main and branch ducts when using
      image diagnosis for early detection of carcinomas, and may represent the first
      reported surgically resected case.

PMID- 8481144
TI  - Metastasis of pineal germinoma via ventriculoperitoneal shunt.
AB  - The case of a 13 year old boy with pineal germinoma and subsequent metastasis 3
      years later via ventriculoperitoneal shunt to the abdominal cavity is presented.
      The abdominal disease was managed with chemotherapy and subsequent surgical
      resection. He remains free of disease 2 years following the resection. The
      literature regarding this rare complication is reviewed.

PMID- 8481145
TI  - Naevoid basal cell carcinoma (Gorlin's) syndrome.
AB  - The multiple naevoid basal cell carcinoma syndrome (Gorlin's syndrome) is an
      inherited multisystem disorder which affects not only the skin, but also the
      skeletal system and a variety of other tissues and organs. This is a report of
      the case of a 29 year old woman who presented with multiple advanced basal cell
      carcinomas. On the basis of a literature review, guidelines for management are
      suggested and the importance of early diagnosis and regular follow-up is
      emphasized.

PMID- 8481146
TI  - Gallstone ileus complicating endoscopic sphincterotomy.
AB  - A case of gallstone ileus is described complicating an endoscopic sphincterotomy.
      This rare cause of small bowel obstruction should be considered following
      endoscopic treatment of very large bile-duct calculi.

PMID- 8481147
TI  - Delayed cerebrospinal rhinorrhoea.

PMID- 8481148
TI  - Helicobacter pylori.

PMID- 8481149
TI  - Some fallacies of statistical inferences about psychotherapy.
AB  - Statistical methodology does not provide an effective, impartial, or objective
      way to determine the validity of theories of psychotherapy. Furthermore, the
      correlations revealed by statistical studies of psychotherapy are clinically
      irrelevant. Nevertheless there is a growing trend to recognise only statistically
      "proven" techniques of psychotherapy as legitimate medical treatment. The
      replacement of established medical standards for psychotherapy with this bogus
      new scientism is likely to lead to iniquitous clinical and administrative
      restrictions upon psychotherapists which will cause unnecessary suffering to
      patients.

PMID- 8481150
TI  - Adolescent identity disorder: a case presenting with cultural identification
      problem.
AB  - A computer search of the psychiatric literature starting from 1983 showed no
      studies or clinical reports of Identity Disorder. A case history of a 15 year old
      Chinese boy with Identity Disorder presenting with cultural identification
      problems is described. Cultural identification among second generation immigrants
      is discussed in detail. Cultural factors can be very important in the
      consideration of Identity Crisis and Identity Disorder in adolescents.

PMID- 8481151
TI  - Making conscious identifications: a means of promoting empathic contact.
AB  - A rationale for encouraging the development of empathic skills is discussed,
      along with the current status of such training in medical education. The concept
      of empathy and previous approaches to empathy training are discussed briefly. A
      technique, which I have called "conscious identification", is described. In
      essence it involves an attempt by the trainee to "put himself in the patient's
      position" and to write an account in the first person of what he perceives of the
      patient's experience. The technique is illustrated using three case studies.
      Possible applications are discussed as well as the limitations of the technique.

PMID- 8481152
TI  - Psychotherapy supervision in Hong Kong: a meeting of two cultures.
AB  - The experience of psychotherapy supervision of a group of trainee psychiatrists,
      in a university setting in Hong Kong, is reported from the supervisor's
      perspective. The trainees showed difficulties in this exercise. The cultural
      difference between the supervisor and the trainees, and that between the Western
      psychotherapy culture and the Chinese culture, is discussed. It is then followed
      by a description of what is seen as the trainees' resistance in the acceptance of
      psychotherapy and of the supervisor. This is considered to be one of the problems
      in the transcultural application of psychotherapy, and has to be overcome if this
      importation is to be successful.

PMID- 8481153
TI  - Psychiatrist-patient sexual relationships: the ethical dilemmas.
AB  - Sexual relationships between psychiatrists and their patients raise a number of
      important ethical issues. The power inequality, transference and dependence which
      often occur in a therapeutic relationship render patients vulnerable to
      exploitation. Psychiatrists informed by a patient of sexual contact with a
      previous psychiatrist face a complex ethical dilemma. Attempts at regulation by
      professional organisations, or by the legal system, may create conflicts between
      the rights of the persons involved. The role of the psychiatric profession in
      confronting the problem of sexual exploitation of patients is discussed.

PMID- 8481154
TI  - Back to bedlam? Chelmsford and the press.
AB  - The Australian press played a vital part in bringing the events at Chelmsford
      Private Hospital to the attention of the general public, and in pressuring the
      New South Wales government to institute a Royal Commission into Deep Sleep
      Therapy. This paper describes the ways in which the press brought Chelmsford
      events onto the public agenda. It pays particular attention to aspects of the
      press coverage of the findings of the Royal Commission. The paper identifies the
      discourses concerning psychiatric care, the doctor-patient relationship and the
      role of the government in regulating the medical profession which were dominant
      in press accounts of Chelmsford. It is argued that while pre-existing stereotypes
      about mad psychiatrists and asylums were used to describe Chelmsford, more
      confronting ideas concerning the need for medical regulation and patient
      consumerism received press attention and therefore a public airing. The
      implications for psychiatric care in Australia are examined.

PMID- 8481155
TI  - The snake on the caduceus: dimensions of medical and psychiatric responsibility
      in the Third Reich.
AB  - The literature on the activities of medical professionals during the tumultuous
      years of the Third Reich has, over the last decade, increased substantially.
      However, many questions remain unanswered and the subject is likely to receive
      further attention following recent access to previously restricted archival
      material in Eastern Europe. In this paper, based on the English language
      literature, the author explores the role of medicine, and in particular
      psychiatry, in defining the bio-medical vision that was central to Nazi ideology.

PMID- 8481156
TI  - Ethical standards and clinical practice.

PMID- 8481157
TI  - Juries and psychologically disturbing cases.

PMID- 8481158
TI  - The Australian multicentre moclobemide trial.

PMID- 8481159
TI  - A case register for neuroleptic malignant syndrome.

PMID- 8481160
TI  - Sex and gender and the impaired therapist.

PMID- 8481161
TI  - Sex and gender and the impaired therapist.

PMID- 8481162
TI  - Obstructive sleep apnoea and depression.

PMID- 8481163
TI  - Combined fluoxetine and desipramine in resistant depression.

PMID- 8481164
TI  - Referrals from psychologists.

PMID- 8481165
TI  - Stability of psychiatric diagnoses in New Zealand psychiatric hospitals.
AB  - This study examines the stability over a five year follow-up of first admission
      psychiatric diagnoses assigned in New Zealand psychiatric hospitals in 1980 and
      1981. Diagnostic stability is a measure of the degree to which psychiatric
      diagnoses remained unchanged at a later hospital admission. Reasonably high
      levels of stability were found for the initial diagnoses of substance abuse
      disorders (86% stable), anorexia nervosa (70%), schizophrenia (67%), and
      affective disorder (67%). Poor levels of stability were noted for the initial
      diagnoses of personality disorder (36%), other psychosis (excluding schizophrenia
      and affective psychosis) (22%), and other neurosis (excluding neurotic
      depression) (20%). The major trends in diagnostic change are described. Factors
      influencing diagnostic instability are also examined. For patients with an
      initial diagnosis of schizophrenia, a change in hospital is found to be the
      strongest factor causing diagnostic instability, with time between admissions and
      age at first admission also having a significant influence. The implications of
      these findings are discussed.

PMID- 8481166
TI  - Post-traumatic stress disorder in Australian prisoners of the Japanese: a
      clinical study.
AB  - The clinical findings of examination of 11 Australian prisoners of the Japanese
      (POWs (J)) are reported. They were examined for evidence, past or present, of
      Post-Traumatic Stress Disorder (PTSD). Three currently satisfied the DSM-III-R
      criteria for a diagnosis of PTSD and at least three more would probably have done
      so if a complete assessment had been possible. All but two described many of the
      symptoms of PTSD and would probably have satisfied the criteria for the diagnosis
      at some time following their release from captivity. The subjects were all seen
      between mid 1988 and mid 1990 and the difficulties of the study and its
      implications are discussed.

PMID- 8481167
TI  - Screening for psychiatric symptoms and illness behaviour in a pain clinic.
AB  - Evolution of a multidisciplinary pain clinic in a rehabilitation hospital is
      described. The assessment process was facilitated, particularly with respect to
      psychiatric and psychological evaluation, by the preliminary administration of
      two well established but simple self-administered questionnaire instruments, the
      Illness Behaviour Questionnaire (IBQ) and the Crown-Crisp Experiential Index
      (CCEI). The characteristics of our pain clinic population are described. They
      demonstrate questionnaire profiles which are typical of pain patients. Attention
      is drawn to the CCEI profile now shown in three studies of pain patients,
      predominance of the somatic anxiety (S) scale occurring in all. Correlations
      between the IBQ and CCEI showed, inter alia, that the S scale is a measure of
      somatisation in pain patients. This paper aims to describe the changes in the
      clinic since previously published descriptions, to note the characteristics of
      our patient on the questionnaire instruments and to comment on the value of these
      questionnaires in the assessment of psychiatric symptoms and somatisation in pain
      clinic patients.

PMID- 8481168
TI  - Mortality of public mental health patients: a Singapore experience.
AB  - This study reports the Standardised Mortality Ratio (SMR) by age and sex among
      public mental health patients in Singapore. The authors also examine the
      differences between those who were classified as "inpatient deaths" and those who
      were classified as "outpatient deaths". Mortality was 5.1 times that of the
      general population and the SMR was most accentuated in the younger, female
      patients. Of the 217 deaths documented over two years, schizophrenia was the most
      common diagnosis. Inpatient deaths (N = 120) occurred in older patients with
      prior physical illness who died of natural causes. In contrast, outpatient deaths
      (N = 97) involved younger patients with no previous illness and the majority
      jumped to their deaths. Mortality studies are necessary in monitoring the
      efficacy of mental health provisions.

PMID- 8481169
TI  - How many bed-days for an area's psychogeriatric patients?
AB  - Data were obtained concerning all admissions during a four-year period of persons
      aged 65 years and over, from a defined catchment area, to the general hospital
      psychiatric units in the area or to the nearest psychiatric hospital. The mean
      length of stay was 41.3 days. Of 449 admissions, 55% were diagnosed as having
      affective disorder or adjustment disorder with depressed mood, but this group
      accounted for 65% of the bed-days in the acute units with a mean length of stay
      of 49.2 days. Dementia cases accounted for 24% of admissions and 23% of bed-days.
      At present, the recommended number of acute psychogeriatric beds to serve this
      population of 34,000 elderly is 22; development of a comprehensive
      psychogeriatric service with appropriate community staffing may make it possible
      to reduce this number.

PMID- 8481170
TI  - A multicentre double blind trial of fluoxetine versus amitriptyline in the
      treatment of depressive illness.
AB  - The antidepressant efficacy and side effect profile of a fixed dose of 20 mg/day
      of fluoxetine, a specific serotonin reuptake inhibitor, were compared to those of
      amitriptyline. Fifty-eight patients with DSM-III-R depression were randomly
      assigned to receive either fluoxetine or amitriptyline. Fifty-six patients
      (fluoxetine N = 23, amitriptyline N = 23) completed the 6 week study. Comparable
      antidepressant efficacy was demonstrated for the two drugs. Patients taking
      fluoxetine reported less side-effects than those taking amitriptyline.

PMID- 8481171
TI  - Prediction of response to antidepressant medication by a sign-based index of
      melancholia.
AB  - We examine the capacity of a new melancholia index (focussing on CORE signs
      indicative of psychomotor change) to predict response to antidepressant
      medication. In a naturalistic study, depressed patients were assessed and rated
      by their treating psychiatrist, and we focus on those who received
      antidepressants for three weeks or more. Those subjects who returned high CORE
      scores (putative melancholia) at baseline improved more over the initial six
      weeks, but analyses suggested that the differential improvement outcome was
      independent of medication. Thus, CORE scores predicted outcome for those
      receiving antidepressant medication, but possible mechanisms remain unresolved.

PMID- 8481172
TI  - The relationship between psychosocial factors and developmental outcome for very
      low and extremely low birthweight infants: a review.
AB  - Over the last quarter century, the improved survival rate of very low birthweight
      infants has sharpened questions about their residual disabilities. Longitudinal
      studies have devoted attention to the cognitive and neurodevelopmental outcome of
      these infants, but much less is known about their long-term social and emotional
      development. Psychiatrists consulting to neonatal intensive care units and
      assessing these infants in their families, will be assisted by a better
      understanding of the developmental and psychological outcomes of such infants.
      This paper reviews the state of knowledge in both of these areas. It argues the
      paramount importance of psychosocial factors to the infants' developmental
      outcome, and the importance of longitudinal research in further clarifying the
      predictive value of these factors. In a subsequent paper, we consider the
      efficacy of interventions with this group.

PMID- 8481173
TI  - Psychosocial interventions for very low birthweight infants: their scope and
      efficacy.
AB  - With the burgeoning of infant psychiatry, and the increasing survival and
      development of cohorts of very low birthweight (VLBW) infants, psychiatrists are
      becoming increasingly involved with other professionals in designing and
      implementing early intervention programs. Psychosocial interventions for VLBW
      infants generally report positive results regardless of the orientation of the
      practitioners, or the stated goal of the intervention: however, they have often
      taken place independently of longitudinal research, and sometimes without
      grounding in theories of infant and family development. This paper first reviews
      the current state of research and findings related to infant-focussed, parent
      directed, and interactional programs. Second, it addresses a number of basic
      questions to be considered by psychiatrists involved in consulting to neonatal
      intensive care units, who have to appraise, design or implement intervention
      programs with this group. Throughout this discussion, it is proposed that the
      notion of infants at developmental risk needs to be supplemented by that of
      caregivers at risk, and that the professional boundaries which these distinctions
      represent need to be overcome.

PMID- 8481174
TI  - The essentials of psychoanalysis.
AB  - Psychoanalysis, as procedure, theory and therapy, is a unique activity centred
      around a special approach to a formalised intersubjective relationship. The
      phenomena of transference and counter-transference between analyst and analysand
      allow the emergence of a generative interplay between creative impulses
      struggling for expression and a persistent search for clarity by appropriate
      analytic interpretations and synthetic constructions of what takes place.

PMID- 8481175
TI  - Human immunodeficiency virus infection, dementia and the older patient.
AB  - Australian statistics have shown that 10.9% of AIDS cases have occurred in the 50
      years and over age group. To date little attention has been given to the many
      issues surrounding HIV infection in the older population, for example, the
      failure to consider HIV as an aetiological factor in the older person presenting
      with neuropsychiatric disorder and the potential for misdiagnosis of AIDS
      dementia complex as dementia of the Alzheimer type. This paper includes a
      discussion of the clinical features of the AIDS dementia complex, its resemblance
      to the syndrome of "subcortical dementia", and review of the literature reporting
      dementia as the presenting feature of HIV infection in older individuals.

PMID- 8481176
TI  - Surveillance for colorectal cancer.

PMID- 8481177
TI  - Use of the metyrapone test for assessing pituitary-adrenal function.

PMID- 8481178
TI  - HIV prevalence among Washington, DC, residents having abortions.

PMID- 8481179
TI  - Antineoplastons: the controversy continues.

PMID- 8481180
TI  - Breaking of transplantation tolerance after reduction of immunosuppression.

PMID- 8481181
TI  - Breaking bad news.

PMID- 8481182
TI  - Ethics committees: is the tail wagging the dog?

PMID- 8481183
TI  - Therapeutic biliary endoscopy and laparoscopic cholecystectomy.

PMID- 8481184
TI  - Clinical and histopathologic changes in the host cornea after epikeratoplasty for
      keratoconus.

PMID- 8481185
TI  - Microalbuminuria, lipoproteins, and diabetic control.

PMID- 8481186
TI  - Hodgkin disease and HIV.

PMID- 8481187
TI  - Does sucralfate impede levothyroxine therapy?

PMID- 8481188
TI  - Telephone directory listings of presumptive Chinese surnames: an appropriate
      sampling frame for a dispersed population with characteristic surnames.

PMID- 8481189
TI  - Unnecessary morbidity following irradiation of lateralized head and neck
      carcinoma.

PMID- 8481190
TI  - The relation between experience and outcome in heart transplantation.

PMID- 8481191
TI  - Unreconstructed man.

PMID- 8481192
TI  - A method for removal of broken vertebral screw.

PMID- 8481193
TI  - Update on the dementia spectrum of depression.

PMID- 8481194
TI  - Eating disorders and social phobia.

PMID- 8481195
TI  - Another example favouring the location of BPES at 3q2.

PMID- 8481196
TI  - Sustained-release niacin for low levels of high-density lipoprotein cholesterol.

PMID- 8481197
TI  - Liver dysfunction in CJD.

PMID- 8481198
TI  - Flunarizine and essential tremor.

PMID- 8481199
TI  - Reappearance of end-diastolic velocities in the umbilical artery following
      maternal volume expansion: a preliminary study.

PMID- 8481200
TI  - Measles vaccine: titre and safety.

PMID- 8481201
TI  - Brain research in Europe.

PMID- 8481202
TI  - Hazards of antagonizing narcotic sedation with naloxone.

PMID- 8481203
TI  - Twin studies: genetic factors are important.

PMID- 8481204
TI  - Suicide prevention: fact or fiction.

PMID- 8481205
TI  - Pneumocystosis in patients with acquired immunodeficiency syndrome.

PMID- 8481206
TI  - Nursing care of patients receiving long-term infusion of neuromuscular blocking
      agents.

PMID- 8481207
TI  - Re: Mast cell infiltration in intestine used for bladder augmentation in
      interstitial cystitis.

PMID- 8481208
TI  - Patterns of elder abuse.

PMID- 8481209
TI  - Re-emergence of tuberculosis.

PMID- 8481210
TI  - Tuberculosis: the return of an old enemy.
AB  - Tuberculosis is an ancient human scourge that continues to be an important public
      health problem worldwide. The increasing number of multidrug-resistant (MDR) M.
      tuberculosis isolates from both AIDS and non-AIDS patients is an ominous trend
      that threatens tuberculosis eradication programs both in the U.S. and overseas.
      New antituberculosis vaccines with therapeutic properties are urgently needed for
      human immunodeficiency virus-infected individuals, as well as health care
      professionals likely to be exposed to MDR tubercle bacilli. Recombinant DNA
      vaccines bearing protective genes from virulent M. tuberculosis are being
      developed using shuttle phasmids to transfer genetic material from one
      mycobacterial species to another. Improved assay procedures are needed to measure
      the protection afforded by these new vaccines under experimental and field test
      conditions. Tuberculosis vaccine development should be given a high priority in
      current medical research goals.

PMID- 8481211
TI  - Biomass growth rate during the prokaryote cell cycle.
AB  - The rate of biomass growth throughout the cell cycle of prokaryotes is important
      in the study of global regulation. Two limiting cases have generally been
      considered: the exponential model and the linear model. The exponential model is
      a logical expectation because protein, the main component of biomass of a
      bacterial cell, increases continuously during the cell cycle and therefore the
      means for synthesis of other cell components and metabolites also increases. In
      addition, during the cell cycle, ribosomes, the means of production of proteins,
      increase monotonically. As a consequence, the increase of all should be
      autocatalytic and the content of cell substance should be an exponential function
      of time. Two cellular components would not be expected to increase exponentially:
      the DNA and the cell envelope. The former because of the intermittent synthesis
      of the chromosome, and the latter because of changes in the surface-to-volume
      ratio with growth and division. In contrast to the exponential model, the linear
      model of Kubitschek postulates that the cell only increases its membrane
      transport capability over a brief period during the cell cycle, and, thus limited
      by transport, all cell components can increase only at a constant linear rate
      during most of the cell cycle. Other proposed models are intermediate and assume
      that the growth rate of the cell depends on some cell cycle event, such as the
      initiation of chromosome replication. The models have relevance to prokaryotes
      undergoing balanced growth; they may not be relevant to eukaryotic microbes or to
      eukaryotic cells in tissue culture that have endogenous rhythms or are controlled
      by protein growth factors. Logically, the models could possibly apply to a free
      living cell that does not respond to environmental cues. Even under rigidly
      constant conditions, however, cells may try to respond to a stimulus that was
      periodic or regulatory under natural conditions, but is present at a constant
      level under the experimental culture condition. There are four classes of
      experiments that have been used to measure the accumulation of dry biomass or its
      components during the cell cycle of a bacterium, as typified by Escherichia coli.
      For the first class of experiments, the dimensions of living cells are measured
      under the microscope. So far, the experiments have been limited by the resolving
      power of the phase microscope, but adequate resolution should be possible with
      the confocal scanning light microscope or various video computer systems. Such
      experiments are called integral because augmentation of cell constituents is
      followed. The second class involves pulse-chase labeling of cells and then their
      separation into different phases of the cycle or age groups and measurement of
      the radioactivity per cell in the fractions. Such experiments are called
      differential in that the rate is measured directly instead of being deduced by
      comparing the total size at different times.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8481212
TI  - The prochlorophytes: are they more than just chlorophyll a/b-containing
      cyanobacteria?
AB  - The prochlorophytes are a diverse group of photosynthetic prokaryotes that fall
      within the cyanobacterial lineage, yet lack phycobilisomes as light harvesting
      structures. Instead, the prochlorophytes have a light-harvesting apparatus
      composed of the higher plant pigments chlorophylls a and b. This review discusses
      the evolutionary relationships among these bacteria, with focus on the structure
      and function of the photosynthetic apparatus. This analysis yields a consensus
      from studies both on Prochloron sp. and Prochlorothrix hollandica as to how the
      thylakoid membrane is organized. Overall, we propose that the structure of the
      light-harvesting complexes (LHC) from prochlorophytes is very different from
      those of chloroplast systems, and is evolutionarily very ancient. The functional
      association of the light-harvesting apparatus with photosystem I (PSI) in both
      Prochlorothrix and Prochloron, as well as a demonstrated capacity for PSI
      dependent anoxygenic photosynthesis in Prochlorothrix, may indicate that there is
      an increased dependence on cyclic photophosphorylation in these organisms.
      Finally, the structure of the prochlorophyte thylakoid membrane is discussed with
      respect to the forces that drive thylakoid membrane stacking in prochlorophytes
      and chloroplasts. We suggest that the light-harvesting structures in
      prochlorophytes play little, if any, role in this process.

PMID- 8481213
TI  - Disease flare with gonadotrophin-releasing hormone (GnRH) analogues. How serious
      is it?

PMID- 8481214
TI  - Contraceptive choice for women with 'risk factors'.
AB  - Women with many medical conditions need to plan their families with special care.
      For such women, the risk of complications with particular contraceptive methods
      is increased. Women with severe hypertension, a previous myocardial infarction or
      venous thromboembolism, or cerebrovascular stroke have a significant risk of
      problems in pregnancy, and should avoid the combined pill. The combined pill may
      increase the risk of cardiovascular disease in patients with diabetes mellitus
      and may worsen the severity of migrainous headaches in susceptible patients.
      Women with active hepatitis should wait for liver function tests to normalise
      before becoming pregnant or starting the combined pill or injectable progestogen.
      Control of epilepsy may deteriorate with use of the combined pill; this is
      probably because of the risk of drug interactions. Similarly, contraceptive
      control may also fail in women receiving rifampicin (rifampin) concurrently with
      contraceptive steroids. Intrauterine contraceptive devices should not be used in
      women who have experienced previous episodes of pelvic inflammatory disease, or
      with previous malignancy of the genital tract until complete cure is likely.
      Other conditions which may appear, become more common or worsen when the combined
      pill is prescribed include hepatic adenoma, gall bladder disease, ulcerative
      colitis, alopecia, hirsutism and acne. Some of these conditions are potentially
      hazardous to the woman's health, in which case combined pill use should be
      stopped. If the condition is unchanged then the combined pill may sometimes be
      reintroduced with caution.

PMID- 8481215
TI  - Adverse reactions and drug interactions with radiopharmaceuticals.
AB  - Adverse reactions to radiopharmaceuticals are comparatively few in number.
      Various estimates quote an incident rate of 1 to 6 reactions per 100,000
      injections. Other figures quoted are 1 in 800 for the bone-seeking
      radiopharmaceutical methylene diphosphonate, and 1 in 400 for the lung
      visualisation agent macroaggregated albumin. The very low numbers of reported
      adverse effects probably reflect the tiny amounts of material which are used in
      the formulation of radiopharmaceuticals. Adverse reactions to
      radiopharmaceuticals are usually mild and transient and require little or no
      medical treatment. A few reactions involve respiratory or circulatory collapse or
      loss of consciousness. Several fatalities have been reported with the liver
      scanning agent 99mTc (technetium 99m)-albumin colloid. Clinical manifestations
      may be categorised under the headings of vasomotor effects i.e. faintness,
      pallor, diaphoresis or hypotension, and anaphylactoid effects such as nausea,
      dermographism, wheezing, bronchospasm, erythema and pruritus. The most prominent
      group of radiopharmaceuticals that have been reported to produce adverse events
      are the diphosphonates, which are used for scanning the skeleton. Typical
      diphosphonate reactions include erythema (especially over the extremities),
      nausea, vomiting and malaise. The onset of reaction is usually 2 to 3 hours after
      injection. The second group of radiopharmaceuticals which give rise to adverse
      events are the colloids, which are used for liver and spleen scintigraphy.
      Typical colloid reactions include pallor, nausea, flush and pulse changes.
      Adverse events may also occur as a result of the patient's medication interfering
      with the disposition of the radiopharmaceutical. Although not usually hazardous
      or dangerous, such events may be so pronounced that a marked deviation in the
      expected pharmacokinetics may occur. Drug interactions can be conveniently
      categorised under the headings of unusual handling of the radiopharmaceutical
      because of pharmacological action, genuine in vivo interaction between the
      medication and radiopharmaceutical, drug-induced disease and interaction between
      the radiopharmaceutical and catheters or syringes. The most serious drug
      interactions are those where the patient is taking cortisone or cytotoxic agents
      prior to tumour scintigraphy. Other important effects occur in patients
      undergoing bone scanning who are receiving iron preparations. Nifedipine has been
      reported to produce quite severe problems in scanning, including difficulties in
      the radiolabelling of red cells (for cardiac scintigraphy), and other effects
      where the drug appears to prevent the transport of bone-seeking materials into
      the skeleton. Many drugs alter hormonal status and these effects may produce
      marked deviations from the expected biodistribution. Diethylstilbestrol
      (stilboestrol), digitalis, gonadotrophins, phenothiazines and cimetidine all
      increase estrogen levels in high doses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8481216
TI  - Adverse effects of antimalarials. An update.
AB  - Various drugs are widely used in the prophylaxis and treatment of malaria. In the
      prevention of malaria in travellers, a careful risk-benefit analysis is required
      to balance the risk of acquiring potentially serious malaria against the risk of
      harm from the prophylactic agent. Unfortunately, the information needed to
      perform accurate analyses of this type is not available for most antimalarials.
      In the prophylaxis of malaria, chloroquine and proguanil have an excellent safety
      record, being very rarely associated with severe adverse reactions in the
      recommended dosages. However, in many parts of the world they are no longer
      effective prophylactic agents. Pyrimethamine-dapsone (Maloprim) is associated
      with agranulocytosis, especially if the recommended dose is exceeded, and should
      be reserved as a second-line agent for travellers to high risk areas.
      Pyrimethamine-sulfadoxine (Fansidar) and amodiaquine are associated with a
      relatively high incidence of potentially fatal reactions, and are no longer
      recommended for prophylaxis. Mefloquine, a relative newcomer, may provoke severe
      neuropsychiatric reactions with a frequency of 1 in 15,000 to 20,000 users at the
      prophylactic dosage. In the treatment of Plasmodium falciparum malaria, which has
      a high mortality if untreated, a greater risk of adverse reactions to
      antimalarial drugs is acceptable. As chloroquine resistance has become
      widespread, alternative agents including quinine, mefloquine, pyrimethamine
      sulfadoxine, tetracyclines, halofantrine and artemisinin (qinghaosu) and its
      derivatives may be used in treatment regimens. The therapeutic ratios for
      chloroquine, quinine and mefloquine are narrow and toxicity is frequent when
      recommended treatment dosages are exceeded; parenteral administration above the
      recommended dose range is especially associated with the hazards of cardiac and
      neurological toxicity.

PMID- 8481217
TI  - Zidovudine toxicity. Clinical features and management.
AB  - Zidovudine is a dideoxynucleoside analogue of thymidine. It acts by interfering
      with viral reverse transcriptase, thereby inhibiting human immunodeficiency virus
      (HIV) replication. Zidovudine has been shown in clinical trials to prolong
      survival of patients with acquired immune deficiency syndrome (AIDS) and advanced
      AIDS-related complex (ARC), and to delay progression to ARC or AIDS in patients
      with earlier disease. At the present time it is suggested that zidovudine be
      initiated when the CD4 lymphocyte count is less than 500 cells/mm3. Recent
      studies have suggested a delay in the development of AIDS in patients with CD4
      counts over 500 cells/mm3, but ongoing studies will require confirmation. The
      adverse reactions associated with zidovudine have been well described. It appears
      that haematological toxicity is associated with both the dose and stage of
      disease. Anaemia may present more often within the first 3 months of therapy,
      whereas neutropenia can occur early or late. Mild headache and gastrointestinal
      intolerance may occur early and in some cases limit tolerance to the drug. A
      number of neurological adverse reactions have been reported rarely including
      seizures and dose-reduction encephalopathy. The most significant late adverse
      reaction is that of myopathy, which occurs in patients receiving zidovudine for
      more than 6 months. With careful monitoring, the adverse reactions of zidovudine
      are manageable and patient tolerance of the medication is acceptable.

PMID- 8481219
TI  - [Psychotic intoxication and a psychotic episode].
AB  - A man 27 years with a breath alcohol concentration of 0.7 g/kg had delusional
      ideas and other signs that indicate a psychotic intoxication. By the end it was a
      psychotic episode however concerning a patient with a polytoxicomania--the drugs
      were alcohol, cocaine, and Phencyclidine. There are no indications for the
      primary manifestation of a psychosis.

PMID- 8481218
TI  - Effects of terfenadine on psychomotor performance. An overview.
AB  - Sedation and impairment of psychomotor performance are well known adverse effects
      of the traditional antihistamines. These effects appear to be caused by different
      mechanisms, but both may have potentially dangerous consequences. while several
      of the newer antihistamines, such as terfenadine, have overcome the problem of
      sedation, it is also important to establish their propensity to cause psychomotor
      impairment. Many single- and multiple-dose studies (mostly in healthy volunteers)
      have compared the effects of terfenadine on psychomotor performance with those of
      placebo, as well as traditional and other nonsedating antihistamines. Over half
      of the studies employed divided-attention tasks that are considered relevant to
      everyday activities, such as driving. Like several other nonsedating
      antihistamines, single doses of terfenadine of up to 120 mg did not impair
      driving performance and generally had no significant effects on other psychomotor
      tests compared with placebo. In most of the multiple-dose studies, terfenadine 60
      mg twice daily was administered for up to 5 days. Again, the effects of
      terfenadine on psychomotor performance differed little from those of placebo.
      Thus, the available evidence suggests that the problem of impaired psychomotor
      performance associated with the older, traditional antihistamines does not apply
      to terfenadine.

PMID- 8481220
TI  - [Exceptions for revoking the driver's license of alcohol intoxicated drivers at
      apprehension and during initial withdrawal].
AB  - Exceptions from the withdrawal of permission to drive should be allowed primarily
      to first offenders. In case of alcohol conspicuous first offenders a post
      schooling course has a positive influence to exceptions, if a favourable
      prognosis for the future can be made especially in case of total abstinence
      instead of "Controlled Drinking": In spite of longstanding good reputation
      (minimum 25 years) exceptions to the withdrawal of permission to drive are
      excluded if the blood alcohol concentration exceeded 1.8/1000.

PMID- 8481221
TI  - [Revoking the driver's license, assessment of driver competence, re-education and
      therapy in alcohol offenses: approaches to a necessary reorientation].
AB  - After representing figures and facts about drinking behaviour and drinking
      driving offences of the 45 mio. drivers in Germany counter-measures for DWI
      offenders are dealt with. The proceedings practised so far are critically
      analysed and new approaches are discussed. Primarily reviewed are special
      preventive measures and here particularly the selection procedure usually applied
      in Germany, in which on demand of the driver licensing authorities the question
      is to be answered by expert opinions whether there is to be reckoned with driving
      under the influence in die future, too. It is pointed out that the expert
      opinions are not valid enough for making a distinct decision in an individual
      case. Validity coefficients obtained in evaluation studies lie between phi = 0
      and .28, raising the expectancy value of 50% resulting by chance at best only on
      to 65%. Moreover the psychological interview is understandably burdened with
      faked answers of the explored person, in several cases increased by a specific,
      professionally managed preparation for the testing situation. As a way out of the
      dilemma expert opinions prognosticating driver behaviour should be waived in
      favour of making diagnoses and proposals for treatment. The timing of regranting
      the driver license is then only determined by the revocation period pronounced by
      the court and by the performance of the measures recommended by the experts and
      demanded by the licensing authority. As a support for such a procedure a more
      consistent and resolute administration of the judicial revocation of driver
      license with longer periods for repeaters should be provided. Besides there is
      necessary a wider range of rehabilitation programs for drivers with alcoholic
      problems.

PMID- 8481222
TI  - [Effect of Kava-Special Extract WS 1490 combined with ethyl alcohol on safety
      relevant performance parameters].
AB  - The Kava-special extract WS 1490 (3 x 100 mg/d over 8 days) was tested in a
      placebo-controlled randomised double-blind study to establish whether it has any
      adverse effects on safety-related performance when administered together with
      ethyl alcohol (0.05% blood alcohol concentration). The study was carried out as a
      comparison of two independent groups each containing 10 male and 10 female
      healthy volunteers aged between 18 to 60 years (mean: 40.45 +/- 12.2 years). The
      batteries of performance tests consisted of seven procedures. It was conducted
      before treatment without alcohol as well as the 1st, 4th and 8th day of treatment
      together with alcohol. The results showed no negative multiplicative effects
      caused by the Kava-special extract WS 1490 together with alcohol. With the
      concentration test however there was a remarkable advantage of the WS 1490 group
      at the 4th day of treatment (p < 1%). The collection of well-being data as well
      as the description of adverse events proved WS 1490 to be well tolerated.

PMID- 8481223
TI  - Multicenter study of predictors of disease course in Alzheimer disease (the
      "predictors study"). II. Neurological, psychiatric, and demographic influences on
      baseline measures of disease severity.
AB  - The "Predictors Study" is a prospective cohort study of the natural history of
      Alzheimer disease (AD), the aim of which is to identify milestones in disease
      progression and to develop a model to predict disease course in individual
      patients. The empirical background to this study is based on previous reports
      that the presence of extrapyramidal signs (EPS), myoclonus, and psychosis in AD
      may signify greater disease severity at any given stage and a more rapid course
      of the disease over time. The present analyses were conducted to determine
      whether these independent "predictor" variables were associated with greater
      disease severity at baseline within a new cohort of 224 mild AD patients
      recruited from three different medical centers (in New York, Baltimore, and
      Boston). Measures of disease severity were provided by the modified Mini-Mental
      State Examination (mMMSE) and the Blessed Dementia Rating Scale (BDRS), which
      measures functional capacity. Independent variables were EPS, delusions, and
      slowing of the posterior dominant EEG rhythm. The frequency of myoclonus and
      hallucinations was too low to permit adequate statistical assessment of their
      effects at this time. EPS and EEG slowing were associated with low mMMSE scores,
      whereas delusions were primarily associated with impaired functional capacity.
      These effects were independent of the influence of age and disease duration.
      These results indicate that the effects of these independent variables can be
      detected at mild stages of AD and that these effects can be generalized across
      different geographical regions.

PMID- 8481224
TI  - Multicenter study of predictors of disease course in Alzheimer disease (the
      "predictors study"). I. Study design, cohort description, and intersite
      comparisons.
AB  - Clinicians should be able to provide the patient with Alzheimer disease (AD) and
      the family with an accurate prediction of what to expect, but the variability in
      the rate of disease progression precludes this. In several previous studies,
      specific clinical signs such as muscular rigidity, myoclonus, and hallucinations
      or delusions were associated with rapid progression to a more severe stage of
      dementia or death. The "Predictors Study," a longitudinal study at three
      independent sites, was designed to develop a predictor model of the natural
      history of Alzheimer disease. The study was conducted at three study sites, New
      York, Baltimore, and Boston in a cohort of 224 patients with early probable AD.
      This article describes the design and implementation of the Predictors Study, and
      compares features of the study cohort at baseline across sites. Patients were all
      at the mild stage of disease at entry and were relatively comparable across
      sites. Extrapyramidal signs and delusions were common, but myoclonus was rarely
      observed.

PMID- 8481225
TI  - A retrospective study of syphilis seropositivity in a cohort of demented
      patients.
AB  - A retrospective study of 376 patients with dementia was performed to determine
      the rate of syphilis seropositivity. Subjects were seen over a 2.5-year period
      and received medical, social, psychiatric, neurological, and laboratory
      evaluations. Mean age was 74 years and 73% were women. Diagnoses included
      Alzheimer's disease (AD; 29.8%), vascular dementia (VascD; 24.7%), combined
      AD/VascD (14.3%), and other diagnoses (31.2%). Dementia was moderately advanced
      with a mean Folstein Mini-Mental State Score of 16. Fluorescent treponemal
      antibody absorption tests (FA) were performed on 338 of the patients with 10.9%
      being reactive. Two of nine subjects with reactive FA's had reactive rapid plasma
      reagin tests.

PMID- 8481226
TI  - Wide third ventricle correlates with low choline acetyltransferase activity of
      the neocortex in Alzheimer patients.
AB  - We evaluated central, temporal, and cortical atrophy by linear measurements on
      brain computed tomography (CT) in 17 patients with moderate to severe
      histologically verified Alzheimer disease (AD) compared with findings in 84
      nondemented elderly controls. Measurements were adjusted for age and head size.
      The AD patients had wider third and lateral ventricles as well as larger temporal
      horns and Sylvian fissures compared with controls. Cortical atrophy tended also
      to be more pronounced for AD patients relative to controls. Thus measures of
      central and temporal atrophy clearly distinguished AD patients from normal aged
      individuals. In AD patients, the width of the third ventricle was significantly
      correlated with the choline acetyltransferase (ChAT) activity in the post-mortem
      frontal cortex (r = 0.65, p = 0.005) and in the temporal cortex (r = 0.59, p =
      0.006). CT measures did not correlate significantly with neurofibrillary tangle
      or senile plaque scores. The result suggests that the width of the third
      ventricle better reflects the degree of cholinergic deficit than severity of
      histopathological changes, scores of plaques, and tangles in AD.

PMID- 8481227
TI  - Neuropathologic diagnosis of Alzheimer disease: interrater reliability in the
      assessment of senile plaques and neurofibrillary tangles.
AB  - A diagnosis of definite Alzheimer disease (AD) is made when there is a history of
      progressive dementia combined with the pathologic findings of numerous senile
      plaques and neurofibrillary tangles in neocortex. Recent studies have shown,
      however, that there may be significant interrater variability in the quantitation
      of these histopathologic lesions. In the present two-center study, interrater
      reliability and test-retest reliability for plaque and tangle counts were
      examined when histologic staining and sampling were controlled. We report similar
      levels of reliability for plaque and tangle counts in 35 cases of AD, nine normal
      elderly controls and six non-AD dementias: Pearson correlations for interrater
      reliability ranged from 0.68 to 0.88, and from 0.97 to 0.99 for test-retest
      reliability. Using quantitative cut-points, concordance between laboratories for
      experimental diagnoses of AD versus non-AD made on the basis of these lesion
      counts ranged from 84 to 92% (kappa scores: 0.69-0.84). The agreement between
      these experimental diagnoses and the clinicopathologic diagnoses of record ranged
      from 74 to 86% (kappa scores: 0.50-0.71). Thus, under optimal conditions, a
      moderate to substantial degree of interrater reliability can be attained in the
      pathologic diagnosis of AD.

PMID- 8481228
TI  - Alzheimer disease (AD), modified proteins, and aspirin.

PMID- 8481229
TI  - Cellular and molecular aspects of antigen processing and the function of class II
      MHC molecules.
AB  - Antigen processing is the conversion of native antigen molecules into short
      peptides that can then bind to major histocompatibility complex (MHC) molecules.
      Class II MHC (MHC-II) molecules target to endocytic compartments, where they bind
      peptides that are produced by internalization of extracellular antigens and
      subsequent antigen catabolism. The resulting peptide-MHC complexes are displayed
      on the surface of antigen-presenting cells for recognition by T cells. Thus, MHC
      II molecules first serve as peptide receptors that rescue peptides from total
      lysosomal degradation and transport them to the plasma membrane; the MHC-II
      molecules then form a composite peptide-MHC-II determinant that is recognized by
      the T cell receptor. Recent work has begun to clarify the molecular events and
      transport mechanisms that govern antigen processing.

PMID- 8481230
TI  - Early-passage rat lung fibroblasts do not migrate in vitro to transforming growth
      factor-beta.
AB  - Lung fibrosis has been postulated to be mediated by the production of macrophage
      derived growth factors that are both mitogenic and chemotactic for fibroblasts.
      In vitro studies from our laboratory demonstrated that alveolar and interstitial
      macrophages treated with iron and asbestos release platelet-derived growth factor
      (PDGF) and transforming growth factor-beta (TGF-beta) into the media. This
      conditioned media was capable of inducing proliferation and chemotaxis of primary
      rat lung fibroblasts (RLF). TGF-beta is known to be present in the media, and RLF
      have high-affinity receptors for TGF-beta. However, we found that > 95% of the
      chemotaxis was blocked by a polyclonal anti-PDGF antibody, whereas anti-TGF-beta
      did not change cell migration. TGF-beta has been described previously as a potent
      chemoattractant for fibroblasts. Thus, we tested the potential of purified TGF
      beta to induce RLF chemotaxis in an attempt to address this apparent
      contradiction in results. Four separate preparations of RLFs from four different
      rats, Swiss 3T3 cells, human and rat fetal skin fibroblasts, and human foreskin
      fibroblasts were tested for chemotaxis using purified porcine TGF-beta 1 as well
      as human TGF-beta. None of these cells responded chemotactically to TGF-beta over
      a broad range of concentrations used (0.004 pg/ml to 50 ng/ml). RLF plated at
      different densities also did not respond to TGF-beta. On the other hand, all the
      fibroblast types migrated vigorously to PDGF (4 ng/ml).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8481231
TI  - Explant culture of rabbit tracheobronchial epithelium: structure and
      prostaglandin metabolism.
AB  - This study examines the potential usefulness of explant culture of rabbit
      tracheal epithelium as a model for the study of epithelial function under normal
      and potentially pathologic conditions. Accordingly, we assessed the structure and
      prostaglandin E2 (PGE2) release of tracheal epithelial explants obtained from
      adult pathogen-free rabbits. Epithelial cells attached to their native connective
      tissue substratum were maintained in culture for 5 days in serum-free medium,
      under bipolar conditions (air-liquid interface) on a permeable membrane (pore
      size, 0.2 mm), and nourished from the basolateral surface. At 5 days in culture,
      scanning and transmission electron microscopy and light microscopy demonstrated a
      pseudostratified, ciliated columnar epithelium with prominent folds and mucus
      secretion identical in appearance to the mucosa before culture. On the day of
      dissection (day 0) and after 4 days in culture (day 4), explants released PGE2
      into the medium spontaneously. However, day 4 explants produced 3- to 4-fold
      greater amounts of PGE2 than day 0 explants. Moreover, day 4 explants
      demonstrated increased PGE2 release in response to bradykinin, a receptor
      dependent agonist, and ionomycin, a calcium ionophore, while day 0 explants did
      not. Primary tracheal epithelial cell cultures grown to confluence (day 9) on a
      collagen substrate demonstrated PGE2 responses to bradykinin and ionomycin that
      qualitatively resembled those of day 4 explants. We conclude that rabbit tracheal
      explants cultured in vitro under the above conditions maintain cellular
      differentiation, in situ three-dimensional organization, and PGE2 synthetic
      pathways over several days in culture.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481232
TI  - Relationship of secretory granule content and proliferative intensity in the
      secretory compartment of the hamster bronchial epithelium.
AB  - We have previously shown that normal hamster airway epithelial secretory cells
      have a lower proliferative intensity than basal cells, but because of their high
      frequency are a major contributor to cell renewal (Am. J. Respir. Cell Mol. Biol.
      1990; 2:51-58). In the present experiment, the relation between proliferative
      intensity and secretory granule content in bronchial epithelial cells is studied.
      [3H]thymidine (2 microCi/g wt) was given intraperitoneally, 1 h before killing,
      to 5 hamsters treated 21 days earlier with intratracheal saline and to six
      hamsters in which secretory cell metaplasia had been induced by intratracheal
      treatment with 300 micrograms of human neutrophil elastase given 21 days earlier.
      Light microscopic autoradiograms were prepared from 2-microns-thick Epon sections
      of left intrapulmonary hilar bronchi. Cells were categorized as basal, ciliated,
      secretory, or indeterminate. Secretory cells were classified as either: S1, with
      0 to 4 granules; S2, with > or = 5 granules with intervening cytoplasm; or S3,
      with abundant granules and no apparent supranuclear cytoplasm. Proliferative
      intensity was defined by the categorical labeling index (LIc) at 1 h after
      [3H]thymidine injection. LIc was determined by the number of labeled cells in a
      category as the percent of labeled and unlabeled cells of that category. LIc of
      each of the cell categories were similar in the elastase and saline groups. LIc
      was highest for basal cells, reflecting their proliferative intensity, and lowest
      for ciliated cells. In the saline group, LIc of S1 (0.25%) was significantly
      higher compared with S2 (0.13%); S3 cells were rare (0.2%) and none were
      labeled.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481233
TI  - Pulmonary macrophages suppress the proliferation and cytotoxicity of tumor
      infiltrating lymphocytes.
AB  - Adoptive immunotherapy with interleukin-2 and tumor-infiltrating lymphocytes
      (TIL) is rarely effective in primary lung cancer. We hypothesize that pulmonary
      macrophages (PM), which are increased substantially in the lungs of smokers,
      might suppress TIL function. The addition of PM into the TIL cytotoxicity assay
      produced a concentration-dependent suppression of TIL cytotoxicity with up to 71%
      inhibition of autologous tumor killing at the 1:1 PM:TIL ratio. Inhibition was
      not target-specific, as killing of NK-sensitive (K562), NK-resistant (M14), and
      autologous tumor targets were equally suppressed. Nor was inhibition specific for
      lung TIL, as similar inhibition was observed with melanoma and renal TIL. Using a
      model system, we demonstrated that both CD3+ antigen-specific and CD56+
      nonspecific lymphocytes are susceptible to the suppressive effects of the PM.
      Direct co-incubation of PM and TIL for 4 to 44 h resulted in progressive
      suppression of TIL proliferation and cytotoxicity. TIL cytotoxicity remained
      suppressed even if PM were removed from the co-culture after 24 h, but was
      restored if the separated TIL were re-incubated in interleukin-2. These results
      suggest that PM may locally regulate the proliferative and cytotoxic function of
      adoptively transferred TIL.

PMID- 8481234
TI  - Distribution of manganese superoxide dismutase mRNA in normal and hyperoxic rat
      lung.
AB  - Aerobic metabolism requires a continuous oxygen supply, which in turn can form
      partially reduced species (free radicals) that damage cellular components. To
      prevent this, organisms have elaborate free radical-scavenging defenses that
      include the superoxide dismutases. The lungs are unique in their role as an
      oxygen-gathering system, making these defenses critical to lung integrity.
      Manganese superoxide dismutase (Mn-SOD) levels increase in rats exposed to
      sublethal doses of hyperoxia and correlate with the development of tolerance to
      higher levels of hyperoxia. Although pulmonary Mn-SOD protein and mRNA levels
      both change with hyperoxia, the timing and levels differ dramatically. Lung
      heterogeneity makes extrapolation of data from whole tissue homogenates or
      cultures difficult. In this study, in situ hybridization of Mn-SOD in the lungs
      of adult rats exposed to air or to 85% O2 for 3 days was performed. In animals
      exposed to either air or 85% O2, Mn-SOD transcripts were present in arterioles,
      the septal tips of alveolar ducts, alveolar type II cells, and mesothelial cells.
      Hyperoxic lung had an intense, continuous labeling of the pleura that was
      distinctly greater than the intermittent labeling of the pleura found in control
      animals. The high level of expression of Mn-SOD mRNA in alveolar duct septal tips
      in both control and O2-exposed animals may be secondary to increased aerobic
      activity in these regions, which contain collagen and elastin and are important
      stress-bearing elements in the lung. Alveolar type II cells are metabolically
      active secretory cells and thus may experience increased endogenously generated
      oxidative stress. Pleural effusions are common after hyperoxic exposures,
      suggesting damage to the mesothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481235
TI  - Fibulin's organization into the extracellular matrix of fetal lung fibroblasts is
      dependent on fibronectin matrix assembly.
AB  - Fibulin is a newly described extracellular matrix (ECM) glycoprotein whose
      function has not been elucidated. We have observed that cultured fetal lung
      fibroblasts produce fibulin and have postulated that its expression may be
      important during lung development. To begin to understand the potential function
      of fibulin in lung development, we examined its expression and distribution in
      cultured fetal lung fibroblasts. Immunofluorescence staining of cultured
      fibroblasts revealed that fibulin was distributed upon their surface in a
      fibrillar array resembling fibronectin (FN), another ECM glycoprotein expressed
      by fetal lung fibroblasts and implicated in lung and heart development. Detection
      of fibulin by immunofluorescence staining of nonpermeabilized cells, its
      immunoprecipitation from 125I-cell surface-labeled fibroblasts, pulse-chase
      analysis, and temperature-induced phase separation studies revealed that fibulin
      is an ECM peripheral membrane protein that is synthesized and secreted by
      cultured fetal lung fibroblasts shortly after plating and incorporated into their
      matrix in a divalent cation-dependent manner. Because fibulin co-distributes with
      both FN and the FN receptor, the integrin alpha 5 beta 1, we examined the
      possibility that fibulin was interacting with both components. Dissociation of FN
      receptors from FN fibers with anti-FN receptor antibodies did not affect
      fibulin's distribution, suggesting that fibulin binds FN and that this
      interaction is not affected by the state of FN receptor binding. Finally,
      inhibition of FN matrix assembly prevented the deposition of fibulin, providing
      further support for FN-fibulin interactions and suggesting that fibulin
      deposition is dependent on FN matrix assembly.

PMID- 8481236
TI  - Secretion of surfactant protein A and phosphatidylcholine from type II cells of
      human fetal lung.
AB  - Surfactant protein A (SP-A) appears to have a role in lung immune defense as well
      as generation and metabolism of the alveolar surface-active film. Previous
      studies indicated that lamellar bodies isolated from lung tissue had a relatively
      low content of SP-A and that exogenous SP-A was needed for rapid formation of a
      surface-active film in vitro. We therefore tested the hypothesis that SP-A was
      secreted from type II cells primarily by a pathway separate from lamellar bodies.
      Cells were isolated from explants of human fetal lung that had been cultured with
      hormones to promote differentiation of type II cells, and secretion of surfactant
      lipid and SP-A were compared. Cultured cells secreted labeled phosphatidylcholine
      in a nearly linear fashion for 48 h. Basal secretion of SP-A, assayed by enzyme
      linked immunosorbent assay, was linear for only 12 h after plating of cells;
      during this time, there was no accumulation of intracellular SP-A. Addition of
      secretagogues (phorbol ester, calcium ionophore, and beta-adrenergic agonist)
      stimulated phosphatidylcholine secretion approximately 4-fold. In contrast, the
      secretion rate of SP-A was not significantly affected by secretagogues. These
      findings indicate that a relatively small amount of secreted SP-A (approximately
      10%) is released with lamellar bodies. Most SP-A is released by constitutive
      secretion and may be important for both surfactant- and nonsurfactant-related
      functions.

PMID- 8481237
TI  - Distribution of integrin cell adhesion receptors on normal bronchial epithelial
      cells and lung cancer cells in vitro and in vivo.
AB  - The interactions of bronchial epithelial cells with the basement membrane control
      cell morphology, differentiation, and proliferation in addition to having a major
      role in malignant transformation. Since these interactions are mediated by the
      integrin family of cell adhesion receptors, we characterized the integrin
      repertoire and adhesive properties of normal human bronchial epithelial cells in
      culture and cell lines derived from nine lung carcinomas using subunit-specific
      monoclonal antibodies. In addition, the integrin repertoire of three of the
      transformed cell lines was reexamined after the cells formed tumor nodules in
      immunodeficient mice. Bronchial epithelial cells in culture expressed multiple
      integrin subunits with the capability of binding to collagen and laminin (alpha
      2, alpha 3, and alpha 6) and at least two subunits that are capable of mediating
      adhesion to fibronectin (alpha 3 and an alpha v-containing integrin). The alpha v
      beta 3 vitronectin receptor was not present. This distribution closely mimicked
      that seen by bronchial epithelial cells in situ. Cell lines derived from
      transformed pulmonary epithelial cells showed great heterogeneity with respect to
      integrin expression--some showing fewer, some greater, and some the same types of
      integrins as nontransformed epithelial cells. Only slight changes in integrin
      expression were seen in tumor cells propagated in immunodeficient mice. Although
      the adhesion characteristics of the transformed cells mirrored their adhesion
      receptor profile, no correlation between integrin profile and the ability to grow
      in SCID mice was observed. This study defines the integrin repertoire of human
      bronchial epithelial cells and sets the stage for future investigations exploring
      how the regulation and signal transduction mechanisms of these receptors might
      affect important pulmonary processes such as bronchial cell differentiation,
      wound healing, and malignant transformation.

PMID- 8481238
TI  - Spontaneous contractility of human fetal airway smooth muscle.
AB  - Physical forces such as fetal breathing and fluid secretion may influence lung
      development, perhaps by their ability to distend the fetal lung. We found that
      airway smooth muscle cells in first-trimester human lung tissue and cultured lung
      tissue explants spontaneously contract. The contractions caused visible movement
      of intraluminal fluid and distended the distal ends of the epithelial tubules,
      suggesting that they produced significant changes in intraluminal pressure.
      Smooth muscle contractility and responses to pharmacologic manipulations were
      recorded with video microscopy. The interval between contractions ranged from 8
      to 135 s (mean +/- SEM, 54 +/- 5 s; n = 20). Smooth muscle contractility was not
      inhibited by tetrodotoxin or atropine, implying a myogenic rather than neurogenic
      origin. Because cholinergic nerves modulate adult airway smooth muscle
      contractility, we asked whether fetal airway smooth muscle cells were regulated
      by cholinergic agents. The cholinergic agonists acetylcholine and carbachol both
      increased fetal airway smooth muscle contractility. Contractions were inhibited
      by the calcium channel blockers CdCl2 and nifedipine, suggesting that an influx
      of extracellular Ca2+ accompanied airway smooth muscle contractions.
      Isoproterenol dilated the contractile regions of the epithelial tubules and
      stopped contractions. Lemakalim, an activator of smooth muscle ATP-sensitive K+
      channels, also arrested contractions and relaxed fetal airway smooth muscle. In
      conclusion, human fetal airway smooth muscle contacts spontaneously and exhibits
      pharmacologic responsiveness similar to adult airway smooth muscle. We speculate
      that fetal airway smooth muscle contractions, possibly exerting effects through
      phasic changes in intraluminal pressure, may be an important physical force
      contributing to lung development.

PMID- 8481239
TI  - Significant mitral regurgitation is protective against left atrial spontaneous
      echo contrast and thrombus as assessed by transesophageal echocardiography.
AB  - This retrospective study examines whether a relationship exists between the
      severity of mitral regurgitation (MR) and the presence of left atrial spontaneous
      echo contrast and/or thrombus (SEC/THR) as assessed by transesophageal
      echocardiography in 427 consecutive patients. Clinical data were evaluated in 316
      of these patients. Nine percent of patients with MR < or = 2+ versus < 1% of
      those with MR > or = 3+ had SEC/THR (p < 0.03). Atrial fibrillation, left
      ventricular dysfunction, mitral stenosis, and mitral valve prosthesis were
      demonstrated to be independent positive predictors of left atrial SEC/THR,
      whereas MR > or = 3+ was an independent negative predictor of SEC/THR. SEC/THR
      was less common in patients with MR > or = 3+ than in patients with MR < or = 2+
      for any given number of independent positive predictors of SEC/THR. This
      relationship did not hold true in patients with a mechanical mitral prosthetic
      valve. Clinical data revealed a trend towards a lower prevalence of stroke or
      transient ischemic attacks in patients with MR > or = 3+. Stroke and transient
      ischemic attacks were significantly more common in patients with SEC/THR (p <
      0.001). We suggest that significant MR may be protective against the formation of
      left atrial SEC/THR.

PMID- 8481240
TI  - Importance of sampling both pulmonary veins in grading mitral regurgitation by
      transesophageal echocardiography.
AB  - Pulmonary venous flow patterns have been used to assess severity of mitral
      regurgitation; however, the issue of which pulmonary veins to sample has not been
      determined. We performed pulsed wave Doppler transesophageal echocardiography of
      both the left and right upper pulmonary veins in 80 patients who had mitral
      regurgitation determined by independent transesophageal echocardiography color
      flow mapping. Pulmonary venous flow patterns, peak systolic and diastolic flow,
      and the presence of reversed systolic flow were compared between the left and
      right pulmonary veins for each grade of mitral regurgitation. Flow patterns were
      discordant in 20 (25%) of the 80 patients. Of the 43 patients with 4+ mitral
      regurgitation, there was discordant flow in 16 (37%) of the patients with mainly
      reversed systolic flow in the right upper vein, while there was blunted or normal
      systolic flow in the left upper vein. Of the 16 patients with discordant flows,
      14 had eccentric jets, mainly anteromedial jets. We conclude that if discordant
      flow can occur in 25% of patients with mitral regurgitation and in 37% of
      patients with 4+ mitral regurgitation, then both pulmonary veins must be
      evaluated when assessing the severity of mitral regurgitation with pulsed wave
      Doppler transesophageal echocardiography.

PMID- 8481241
TI  - Demonstration of dual parallel jet interaction in an in vitro model of
      multivalvular disease by use of optical visualization and color Doppler flow
      mapping.
AB  - Parallel jets, such as those occurring in the heart in multivalvular diseases
      like combined mitral stenosis and aortic insufficiency, have created difficulty
      when color Doppler flow mapping or continuous wave Doppler has been used to
      localize or to measure the jets because they appear to merge. Dual jet
      interaction was reproduced in an in vitro transparent model by driving two
      parallel adjacent jets, one lower velocity, higher mass, through a 19 mm2
      orifice, and the other higher peak velocity, smaller mass through two orifices,
      0.27 mm2 and 1.5 mm2, by use of a solution of India ink and cornstarch to
      optically visualize the jet interaction and image the interaction by color
      Doppler. Consistent deviation of the lower velocity jet towards the higher
      velocity jet was observed, and the large jet angled more strongly towards the
      small jet for the 1.5 mm2 small jet orifice than for the 0.27 mm2 orifice for
      constant large and small jet velocities. There was a better linear correlation of
      the amount of large jet angulation to the ratio of both jets' Reynolds numbers
      than to the ratio of both flow rates. The jets interacted as close as 1.3 cm from
      their point of origin, and the region after the jets merged was a highly
      turbulent mixing zone where neither jet could be separately imaged or visualized.
      These observations suggest that relative velocity plays a primary role in
      determining jet interaction which is a recruitment phenomena but that other
      hydrodynamic parameters, such as flow rate and Reynolds numbers, determine the
      degree to which the jets deviate.

PMID- 8481242
TI  - Doppler ultrasound of the subclavian artery as an aid to quantification of aortic
      insufficiency.
AB  - Aortic insufficiency (AI) induces backflow of blood in the arterial system that
      is most pronounced in the major arteries close to the heart. Assuming that the
      intensity of the arterial backflow of blood may reflect the severity of AI, the
      systolic and diastolic flow profiles of the subclavian artery were studied in 40
      patients with and 10 patients without AI that was angiographically proved by use
      of continuous wave Doppler ultrasound (8 MHz transducer, supraclavicular
      approach). Patients with angiographically determined severe AI (n = 17) had
      significantly higher diastolic regurgitant flow velocities (V-max) than patients
      with only mild (n = 9) or moderate (n = 14) degrees of AI (Severe AI = 35.0 +/-
      12.0 cm/sec, moderate AI = 16.8 +/- 3.9 cm/sec, mild AI = 7.4 +/- 2.6 cm/sec; p <
      0.01) and also showed significantly higher values with regard to the time
      velocity integral of the regurgitant jet (severe AI = 13.8 +/- 5.6 cm; moderate
      AI = 5.7 +/- 2.4 cm, mild AI = 1.4 +/- 0.9 cm; p < 0.01). After classification by
      jacknife discrimination analysis, the Doppler ultrasound grading was compared
      with a corresponding three-point scale (mild, moderate, severe) from aortic root
      angiography. A correct estimation of the severity of AI was possible in 44 of 50
      patients (88%; overestimation in one, underestimation in five) and in 41 of 50
      patients (83%; overestimation in one, underestimation in eight) with regard to V
      max and the time velocity integral of the regurgitant jet, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8481243
TI  - Detection of proximal stenosis of left coronary artery by digital transesophageal
      echocardiography: feasibility, sensitivity, and specificity.
AB  - To assess feasibility, sensitivity, and specificity of transesophageal
      echocardiography (TEE) in visualizing proximal left coronary artery segments
      (entire left main, proximal left anterior descending, and circumflex) and in
      identifying proximal coronary stenosis, 160 consecutive patients were studied.
      Each patient underwent TEE before coronary angiography; the echocardiographic
      images were digitized and reviewed in a continuous cineloop format. The entire
      proximal left coronary artery was adequately imaged in 111 patients (70%). A
      stenosis was considered to be present at TEE if hyperreflecting plaques narrowing
      the coronary lumen were observed. TEE observed the presence of a stenosis in 6 of
      6, 50 of 63, and 13 of 24 patients with stenosis detected at angiography on the
      left main, left anterior descending, and circumflex, respectively, and 2 of 105,
      5 of 48, and 14 of 87 patients without angiographically detectable coronary
      stenosis in corresponding coronary segments. Thus, sensitivity and specificity of
      TEE in identifying stenosis of the left main coronary artery, proximal left
      anterior descending artery, and proximal circumflex artery were 100% and 98%, 79%
      and 89%, 54% and 84%, respectively. In conclusion, TEE identification of the
      proximal left coronary artery is feasible in most patients. Accuracy in
      identifying significant proximal stenosis varies from segment to segment and is
      higher for the left main coronary artery.

PMID- 8481244
TI  - Resolution limitations in intravascular ultrasound imaging.
AB  - Interest in the use of ultrasound to characterize the structure and composition
      of blood vessel walls has risen dramatically as a result of the development of
      intravascular ultrasonic imaging transducers mounted on the tips of small
      diameter catheters. A study of the resolution of these transducers is needed to
      understand the limitations in the visualization of these structures. Theoretic
      and experimental studies of the resolution of the two principal designs of
      intravascular ultrasonic transducers, the mechanically scanned single element and
      the multielement circular array, were carried out. Comparisons of the two designs
      reveal that they have similar resolutions. However, the resolutions in two of the
      three dimensions are shown to decrease linearly with increasing radial distance.
      Significant errors in image interpretation, particularly in larger diameter
      vessels, will result if this variation in resolution is not accounted for.

PMID- 8481245
TI  - Quantitation of the motion of the cardiac base in normal subjects by Doppler
      echocardiography.
AB  - Because the motion of the base of the heart plays a central role in its filling
      and emptying, we developed an original method to characterize the base motion
      dynamics throughout each cycle by use of pulsed Doppler echocardiography. A 100
      Hz wall filter and low gain settings were used to record the low-frequency, high
      energy Doppler signals generated by the motion of the base. From the apical four
      chamber view, the sample volume was placed at the lateral margin and at the
      common septal margin of the tricuspid and mitral annuli. These signals were
      differentiated from left and right atrioventricular flows by their opposite
      direction, higher energy, timing, and unique audio signal. The dynamics of the
      cardiac base were quantitated in 17 normal subjects (31 +/- 13 years). The time
      relationship between transvalvular flows and the motion of the base was studied
      in nine normal subjects by matching recordings at the same RR interval. The
      Doppler signal of the motion of the cardiac base showed a succession of positive
      (apically directed) and negative (atrially directed) velocity waves. Differences
      in the dynamics of the cardiac base were demonstrated between its left and right
      components, probably related to different loading conditions and different
      myocardial mechanical properties. The relationship between the motion of the base
      and mitral flow as shown in this study suggests that Doppler-measured mitral flow
      velocity underestimates relative left ventricular inflow velocity with respect to
      the atrium by about 17% at peak early flow and by 20% at peak late flow. The
      method reported in the present study allows a more informative noninvasive
      quantitation of the cardiac base motion derived from measurements of its
      velocity, excursion, and acceleration. This new method may provide unique
      information on the left ventricular and right ventricular performance in the
      meridional direction.

PMID- 8481246
TI  - Supine bicycle stress echocardiography versus tomographic thallium-201 exercise
      imaging for the detection of coronary artery disease.
AB  - To compare the accuracy of supine bicycle stress echocardiography (SBSE), a new
      technique for evaluating coronary disease during peak exercise, with tomographic
      thallium-201 exercise imaging (SPECT), 71 patients were evaluated by SBSE, SPECT,
      and coronary arteriography. Twenty patients had normal coronary vessels; 22 had
      single-vessel, 14 had double-vessel, and 15 had triple-vessel disease. There were
      no differences in sensitivity (90% vs 92%), specificity (80% vs 65%), and
      accuracy (87% vs 85%) between SBSE and SPECT for the group of 71 patients. The
      results were similar in patients with and without prior myocardial infarction and
      with single-, double-, or triple-vessel disease. There were no differences
      between SBSE and SPECT for disease detection for the group of 213 individual
      vessels in sensitivity (88% vs 80%), specificity (87% vs 84%), and accuracy (88%
      vs 82%), but SBSE was more sensitive for the left anterior descending artery (97%
      vs 82%, p < 0.005) and for arteries involved in triple-vessel disease (93% vs
      69%, p < 0.01) and more specific for the right coronary artery (88% vs 66%, p <
      0.01). Supine bicycle exercise was associated with significantly lower maximal
      heart rates than treadmill exercise but with significantly higher systolic and
      diastolic blood pressures. There were no differences in heart rate x systolic
      blood pressure. We conclude that SBSE and SPECT are equally reliable for coronary
      disease detection in patients and for evaluation of disease in specific arteries
      with the exception of SBSE's higher sensitivity for the left anterior descending
      artery and arteries involved in triple-vessel disease and higher specificity for
      the right coronary artery.

PMID- 8481247
TI  - Detection of coronary artery disease with upright bicycle exercise
      echocardiography.
AB  - This study examined the advantages and limitations of upright bicycle exercise
      echocardiography in the evaluation of a large series of patients with known or
      suspected coronary artery disease. The study population consisted of 309 patients
      (231 men, mean age 57 +/- 11 years) who underwent exercise echocardiography
      within 8.5 +/- 16.1 days of coronary angiography. All stress
      electrocardiographic, echocardiographic, and angiographic data were reinterpreted
      in a blinded manner by the investigators. No patient was excluded because of poor
      echocardiographic image quality. Wall motion was analyzed at baseline, peak
      exercise, and immediately after exercise with a 16-segment model, and a regional
      wall motion score index was calculated at each stage. Abnormalities were ascribed
      to the distribution of the three coronary arteries and correlated with
      qualitative angiography. There were 126 patients with wall motion abnormalities
      at rest and 211 (75%) with coronary artery disease. The stress electrocardiogram
      (ECG) was negative in 61, positive in 144, and nondiagnostic in 104, yielding a
      sensitivity of 40% and a specificity of 89%. Echocardiography was normal in 76 of
      98 patients without coronary disease (78% specificity) and abnormal in 193 of 211
      patients with disease (91% sensitivity). Sensitivity was higher among patients
      with multivessel disease compared with those with single vessel disease (95%
      versus 86%, respectively, p = 0.03). Among patients with normal wall motion at
      rest (n = 183), sensitivity was 83% and specificity was 84%. Of the 104 patients
      with a nondiagnostic stress ECG, echocardiography correctly identified 95% of
      those with coronary disease and 75% of those without disease. Among 82 patients
      with a wall motion abnormality at rest, an additional exercise-induced wall
      motion abnormality developed in 32 of 46 patients (70%) with multivessel disease
      and seven of 32 (22%) with single-vessel disease. Overall, echocardiography
      detected 258 of 392 (66%) individual coronary lesions. Accuracy was higher for
      lesions in the left anterior descending and right coronary arteries (both 79%)
      compared with the left circumflex artery (36%, p < 0.001). In conclusion, upright
      bicycle exercise echocardiography is an accurate technique for the evaluation of
      patients with known or suspected coronary artery disease and is especially
      valuable in patients with a nondiagnostic stress ECG. The test provides
      supplemental information on the extent and location of coronary lesions and is
      useful in patients with and without prior myocardial infarction.

PMID- 8481248
TI  - Stress echocardiography: is there an optimal type of stress?

PMID- 8481249
TI  - A double-blind trial of glycopyrrolate for transesophageal echocardiography.
AB  - Glycopyrrolate is an anticholinergic agent used to dry oral secretions and has
      been advocated for routine use with transesophageal echocardiography (TEE). To
      evaluate the safety and efficacy of glycopyrrolate for this unique application, a
      prospective double-blind placebo-controlled study of glycopyrrolate was performed
      in 61 patients who were awake while undergoing TEE. Thirty patients were
      randomized to the standard dose of glycopyrrolate (0.2 mg intravenously), and 31
      patients received 1 ml of saline solution as placebo. Intravenous midazolam was
      used for sedation in all but one patient. Heart rate, electrocardiogram, blood
      pressure, and oxygen saturation were continuously monitored before, during, and
      after TEE. The patients scored their comfort immediately after TEE and were
      interviewed at 24 hours for side effects. The operator scored the ease of
      performing the TEE. No complications occurred in either group. Changes in vital
      signs and oxygen saturation were similar in both groups. The operator ease and
      patient comfort was similar in both groups. A significantly higher incidence of
      the following side effects was observed at 24 hours in patients who received
      glycopyrrolate versus those who received placebo: sore throat, 63% versus 19%;
      dry mouth, 43% versus 6%; and urinary retention, 16% versus 0% (p < 0.05 for
      all). No benefit from glycopyrrolate was noted in operator ease or patient
      comfort. In conclusion, glycopyrrolate is not recommended for routine use when
      performing TEE on patients who are awake.

PMID- 8481250
TI  - Outpatient transesophageal echocardiography with intravenous propofol anesthesia
      in children and adolescents.
AB  - Outpatient transesophageal echocardiography (TEE) was performed in 10 children
      and adolescents (aged 3 to 19.5 years, mean 13.5 years; weight 12 to 91 kg, mean
      49 kg), including two with Down's syndrome and one with autism, for diagnostic
      evaluation of issues unresolved by transthoracic echo examination (TTE). Issues
      for TEE: evaluation for atrial septal defect (two patients); anatomy of left
      ventricular outflow tract obstruction (one patient); aortic valve anatomy before
      valvuloplasty for insufficiency (one patient); evaluation for cause of cyanosis
      after Fontan operation (one patient); determination of source of high-velocity
      intracardiac turbulence after atrioventricular septal defect repair (one
      patient); rule out cardiac embolic source in patient with stroke (one patient);
      evaluate prosthetic valve function and rule out thrombus (one patient);
      determination of anatomic relationship of mitral valve to a ventricular septal
      defect before surgery for complex cyanotic heart disease (one patient); and
      evaluation for aortic dissection in Marfan's syndrome (one patient). Intravenous
      propofol anesthesia administered without endotracheal intubation by an
      anesthesiologist allowed successful outpatient TEE in nine patients; midazolam
      conscious sedation was used in one. Outpatient TEE resolved diagnostic issues in
      all patients without complication, thereby avoiding cardiac catheterization in
      six patients and supplementing catheterization for preoperative planning in four
      patients. TEE can be performed safely and effectively with propofol anesthesia in
      the outpatient setting in carefully selected children and adolescents to provide
      vital diagnostic information. However, given the invasive nature of the procedure
      and the use of anesthesia, outpatient pediatric TEE should be used judiciously.

PMID- 8481251
TI  - Problems in timing of respiration with the nasal thermistor technique.
AB  - When one analyzes transvalvular and venous flow velocity patterns, it is
      important to relate them to respiration. For this reason a nasal thermistor
      technique is often used, although it is known that this signal is delayed in
      relation to intrathoracic pressure changes. The magnitude and variation in delay
      have not been investigated previously and were, therefore, studied in a model
      experiment in 10 normal subjects, in 10 patients with obstructive, and in 10
      patients with restrictive pulmonary disease. Esophageal pressure variations
      measured with an air-filled balloon served as a gold standard for intrathoracic
      pressure changes. During basal conditions there was, for both patient groups and
      normal subjects, a considerable delay of the thermistor signal. The average delay
      for all subjects was 370 msec with a wide variation (from 120 to 720 msec). At
      higher breathing frequencies the delay shortened to 310 msec (P < 0.01) but there
      was still a wide variation (ranging from 200 to 470 msec). Theoretic calculations
      show that the delay caused by the respiratory system accounts for only a minor
      portion of the total delay. Model experiments confirmed that the response
      characteristics of the thermistor probes limit the accuracy in timing of
      respiration. The total delay with the investigated thermistor technique is too
      long and variable to fulfil clinical demands.

PMID- 8481252
TI  - Aortic dissection complicating cardiac surgery: diagnosis by intraoperative
      biplane transesophageal echocardiography.
AB  - Aortic dissection is a rare but devastating complication of cardiopulmonary
      bypass. Intraoperative transesophageal echocardiography can be a useful technique
      to define the anatomy of the dissection, to evaluate its extension and
      progression, and to detect the presence of aortic insufficiency. We describe two
      cases in which transesophageal echocardiography helped in making a rapid
      diagnosis of aortic dissection during cardiac surgery and demonstrate how it may
      play a role in therapeutic decision making.

PMID- 8481253
TI  - Tricuspid flail leaflets after orthotopic heart transplant: a new complication of
      endomyocardial biopsy.
AB  - A case of tricuspid flail leaflets in a patient with orthotopic heart transplant
      is reported. The use of echocardiography to document the complication and its
      relationship to endomyocardial biopsy is presented.

PMID- 8481254
TI  - Optimal antithrombotic therapy following aortocoronary bypass: a meta-analysis.
AB  - To evaluate the role of antithrombotic therapy, on preserving graft patency, we
      performed a meta-analysis of randomized clinical trials involving aspirin (ASA),
      dipyridamole (D), anticoagulants (AC) and placebo or nontreatment controls (P).
      Manual literature searches were performed supplemented by computerized MEDLINE
      listings complete to July 1991. Saphenous vein graft occlusion was determined by
      angiography (patients with > or = 1 distal anastomotic occlusion). The trial data
      were aggregated with the methods of Mantel and Haenszel. The results are reported
      as odds ratios (OR) +/- 95% confidence intervals (CI). Seventeen trials were
      evaluated. Aspirin strongly influenced graft occlusion [ASA +/- D vs P: OR 0.60,
      95% CI 0.51, 0.71, P < 0.0001], but dipyridamole provided no additional benefit
      [ASA+D vs ASA: OR 0.94, 95% CI 0.72, 1.24, P = 0.71]. Anticoagulants reduced
      graft occlusion [AC vs P: OR 0.56, 95% CI 0.33, 0.93, P = 0.025] and the results
      were similar to that achieved with aspirin [ASA vs AC: OR 0.95, 95% CI 0.62,
      1.44, P = 0.87]. The combination of aspirin and anticoagulants was superior to
      anticoagulants alone in two limited trials [ASA+AC vs AC: OR 0.55, 95% CI 0.33,
      0.88, P = 0.01]. A low (100 mg) to medium (325 mg) daily aspirin dosage was more
      effective than a high dose (975 mg). Early postoperative treatment (< or = 6 h)
      strongly influenced graft occlusion while preoperative administration provided no
      additional benefit. No mortality advantage was identified for any antithrombotic
      therapy. Aspirin or anticoagulants enhance saphenous vein graft patency following
      aortocoronary bypass surgery, and a combination thereof deserves further
      investigation in a trial large enough to detect the effects of these treatments
      with respect to clinical events.

PMID- 8481255
TI  - Lowered threshold for ventricular fibrillation in amiodarone-treated pigs
      undergoing cardiopulmonary bypass and cardioplegic arrest with St. Thomas'
      cardioplegic solution.
AB  - The antiarrhythmic agent amiodarone has been suspected of causing reduced cardiac
      performance after extracorporeal circulation and cardioplegic arrest in patients.
      This has recently been confirmed in an experimental model where pigs were exposed
      to cardiopulmonary bypass and cold cardioplegic arrest with Bretschneider's
      solution. Due to the high concentration of the cardio-depressant agent procain in
      Bretschneider's solution, it could be speculated whether it is the combination of
      amiodarone and this solution that may be potentially deleterious, rather than
      amiodarone alone. To investigate this, adult pigs (75 +/- 2 kg at surgery) were
      treated with amiodarone for 30 +/- 2 days (1400 mg/day: n = 8, untreated
      controls: n = 4, blind experiment), followed by exposure to cardiopulmonary
      bypass with universal cooling to 28 degrees C and topical cold cardioplegic
      arrest with St. Thomas' solution for 60 min. Apart from 1 g of calcium (Ca2+) at
      the end of bypass, no inotropic drugs were administered. Cardiac reserve was
      tested by right ventricular pacing (200 beats/min until death or up to 30 min).
      The two groups did not differ concerning preload or afterload, heart rate,
      cardiac output, left ventricular pressure, arterial pressure or rate of change in
      left ventricular relaxation (-dP/dt) before or after bypass was terminated, while
      the rate of change in left ventricular contraction (+dP/dt) was lower in the
      amiodarone-treated pigs. The time on bypass, before stable hemodynamics had
      recovered, was prolonged in amiodarone-treated animals, 46 +/- 4 min versus 31 +/
      3 min in the controls (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481256
TI  - Alterations of cell-mediated immune response following cardiac surgery.
AB  - Nosocomial infections in patients following cardiac surgery are frequently
      associated with opportunistic microorganisms indicating a dysregulation of cell
      mediated immune response. The objective of this prospective randomized trial,
      therefore, was to investigate the mechanisms of dysregulation and the
      counterregulatory effects of immunomodulation. Twenty patients underwent
      conventional postoperative therapy, another 20 patients received indomethacin,
      which inhibits synthesis of the down-regulating mediator prostaglandin E2, and a
      further 20 patients were given thymopentin in addition to indomethacin, thereby
      augmenting activation and differentiation of the T-lymphocytes. The immunologic
      parameters studied included T-lymphocytes and monocytes as well as interleucin
      (IL)-1 and IL-6 synthesis by monocytes, and IL-2 and IL-6 synthesis by T
      lymphocytes. Following cardiac surgery a significant, persistent reduction of T
      lymphocytes and IL-2 synthesis as well as significant monocytosis could be
      observed. Indomethacin treatment resulted in a normalization of the cellular
      imbalance at the end of the first postoperative week, but IL-2 synthesis remained
      significantly reduced during the entire observation period. Conversely, with
      combined indomethacin and thymopentin treatment restoration of cellular
      distribution as well as protection of IL-2 synthesis could be achieved. These
      results indicate a quantitative and functional impairment of the forward
      regulation of cell-mediated immunity. It was shown for the first time that
      combined indomethacin and thymopentin treatment could successfully counteract
      these immunomechanistic alterations.

PMID- 8481257
TI  - High incidence of aneurysm formation following patch plasty repair of
      coarctation.
AB  - Repair of aortic coarctation was performed in 152 adolescent and adult patients
      (mean age 28.5 years, range 14-67 years). Ninety patients were treated with patch
      plasty, 33 with end-to-end anastomosis, 18 with interposition of a tubular graft,
      6 with prosthetic bypass and 5 with direct plasty. There were two (1.3%) early
      and ten (6.6%) late deaths after 2.9 to 11.8 (mean 6.6) years. Of the remaining
      140 patients, 129 (92.1%) were reexamined with computed tomography and
      angiography after 1.5 to 17.2 (mean 9.1) years postoperatively. In 27 patients
      (35.1%) of the patch plasty group significant dilatation at the operative site
      was observed and reoperation for aneurysm formation was required in 15 patients
      (19.5%). Resection of the intimal crest did not increase the probability of
      aneurysm formation, whereas Dacron as patch material and late hypertension had a
      significant influence. Six of the ten late deaths occurred in the patch plasty
      group. Rupture of an aneurysm at the operative site was proved in two of these
      patients, and three patients died suddenly for unknown reasons. In the other
      groups significant dilatation was observed in 13 patients and 3 local aneurysms
      required reoperation (2 after end-to-end anastomosis and 1 after direct plasty).
      We conclude that patch plasty repair of coarctation should be abandoned in
      adults. End-to-end anastomosis is advisable only if possible without excessive
      tension. Reoperation with interposition of a tubular graft on left heart bypass
      proved to be a safe method.

PMID- 8481258
TI  - Early results of intravascular oxygenation.
AB  - We have used the intravascular oxygenator (IVOX) in eight patients (14-76 years)
      with acute respiratory failure. At the time of referral for IVOX all patients
      were on inotropic support, five had pneumothoraces and two were on
      haemofiltration. Ventilatory data before IVOX were: ventilated for 2-14 days
      (median 6), PEEP 5-12 cm H2O (12), PIP 34-95 cm H2O (49), FiO2 0.7-1 (1), PaO2
      5.4-26 KPa (8.5) and PaCO2 3.7-23 KPa (8). The intravascular oxygenator was used
      for 6 h-12 days (median 4), the oxygen transfer achieved was 68-140 ml/min (85)
      and the carbon dioxide removed was 40-106 ml/min (59). It was possible to
      decrease the ventilator settings with a significant increase in the PaO2 by 48 h
      (P < 0.05) but the fall in PaCO2 did not reach significance. As the IVOX was
      turned from "off" to "on" the mean PaO2 increase was 0.35 KPa +/- 0.14 SEM (P =
      0.04) and the mean PaCO2 decrease 0.7 KPa +/- 0.2 SEM (P = 0.02) without any
      significant change in cardiac output. Two patients survived and six died from
      multisystem failure with three patients being hypoxic at the time of death.
      Postmortem examinations on five patients did not reveal any IVOX-related
      complications. We conclude that IVOX is safe but it is not as efficient in gas
      exchange as extracorporeal membrane oxygenation at present. Further improvement
      in the gas exchange efficiency of this prototype could render IVOX a very useful
      device.

PMID- 8481259
TI  - Antiplatelet therapy in children with left-sided mechanical prostheses.
AB  - Valve replacement in children has always been associated with a high mortality,
      outgrowth of the prosthetic valve and difficulty in managing anticoagulation.
      Between January 1985 and April 1991, 20 patients (14 males and 6 females)
      underwent replacement of a left-sided cardiac valve. The median age at diagnosis
      was 21.6 months (1 to 120 months) and the median age at surgery was 85 months (11
      to 213 months). Six patients were under 4 years of age. The site of valve
      replacement was aortic in 11 patients and left atrioventricular (AV) valve in 9
      patients. The indications for aortic valve replacement were stenosis (6) and
      incompetence (5). The left AV valve was replaced in three patients following
      repair of AV septal defect, in one patient with corrected transposition of the
      great arteries (LTGA), in one patient with severe dysplasia and insufficiency,
      and in four patients for congenital mitral stenosis. A Bjork-Shiley prosthesis
      was used in three mitral and one aortic position, all the other patients
      receiving a St. Jude prosthesis: six mitral and ten aortic. All patients were
      anticoagulated (warfarin) for 3 months post implantation and then switched to a
      regimen of aspirin and persantine. There was no early or late death. Median
      follow-up was 12.3 months (4 to 72 months). Total follow-up was 59 patient-years
      or 708 months. There was one incident of thromboembolism (1.7%/patient-year) and
      four instances of bleeding (6.8%/patient-year). There was no valve thrombosis.
      Our regime of early warfarin followed by long-term antiplatelet therapy has been
      associated with a low incidence of thromboembolism and no valve thrombosis.

PMID- 8481260
TI  - Incidental lung adenocarcinoma in a 20-year-old woman with bronchiectasis.
AB  - A case of lung adenocarcinoma in a 20-year-old woman with bronchiectasis is
      presented. The patient showed no clinical and radiological findings in regard to
      the carcinoma. The tumor was discovered incidentally in the parenchyma of the
      lung specimen resected due to chronic bronchiectasis.

PMID- 8481261
TI  - Castleman's disease arising from the intercostal space.
AB  - A 27-year-old woman was investigated for a tumour of the posterior chest wall.
      This was excised surgically and histologically it proved to be a hyaline vascular
      type of angiofollicular lymphoid hyperplasia or Castleman's disease. This is the
      third case from the literature of such a tumour arising from the intercostal
      space. Surgical excision has been proved curative until now with no recurrence.

PMID- 8481262
TI  - Coronary artery anastomotic contour--a method for individual surgeons to assess
      their suture techniques.
AB  - A method is described whereby individual surgeons may monitor their coronary
      graft suturing techniques. The coronary artery anastomotic contour is measured
      quantitatively in corrosion resin cast models made of anastomoses between long
      saphenous vein and the left anterior descending coronary artery of a pig's heart.
      The relevant parameter assessing the contour is the mean anastomotic narrowing
      expressed as a percent (MAN%). To provide an example of the potential of the
      method, a single surgeon compared a continuous suture technique (n = 30) with an
      interrupted one (n = 30) using corrosion resin models. There was significantly
      less (P < 0.05) narrowing of the anastomotic contour with the interrupted
      technique (mean MAN% = 0.3 +/- 2.9) than with the continuous (mean MAN% = 10.5 +/
      3).

PMID- 8481263
TI  - Magnetic resonance imaging of vascular rings.

PMID- 8481264
TI  - Choroid plexus cysts: significance and current management practices.
AB  - Choroid plexus cysts are commonly found in normal fetuses in the second
      trimester, but the presence of cysts is an indication for a targeted ultrasound
      scan for signs associated with aneuploidy. In this review the authors explain the
      histological basis for choroid plexus cyst formation, the association with
      aneuploidy, and the management controversies that continues to be debated in the
      literature.

PMID- 8481265
TI  - Routine ultrasound surveillance of the pregnant uterus.
AB  - The routine ultrasound examination of the pregnant uterus is presented in this
      article. The approach is based on published guidelines, dividing the examination
      into studies of the first trimester and studies of the second and third
      trimesters. The discussion emphasizes the standard anatomical views and describes
      the normal sonographic appearances. The methods of obtaining important
      measurements are described, and tables are provided to analyze these
      measurements. A systematic approach to obstetric ultrasound is important in
      ensuring completeness and in maximizing the detection of fetal abnormality.

PMID- 8481266
TI  - Amniotic fluid volume: fluid dynamics and measurement technique.
AB  - Evaluation of amniotic fluid volume is an important aspect of obstetrical
      ultrasound. Several methods are currently used to describe amniotic fluid
      volumes. The most common are the subjective assessment of fluid and the
      semiquantitative methods. The reproducibility of these methods is excellent in
      experienced hands. Because of the multiple methods used to assess fluid, both
      oligohydramnios and polyhydramnios have numerous definitions. Regardless of which
      definition is used, it is clear that both of these entities are associated with a
      variety of fetal and maternal conditions. Abnormal amniotic fluid volume may be
      the only or earliest sonographic sign of an obstetrical problem. Therefore, it is
      important that sonologists are familiar with amniotic fluid volume assessment.
      Although subjective and semiquantitative techniques may produce similar results,
      a numerical scale is no substitute for experience and training. One should be
      able to recognize lesser degrees of fluid abnormality and be able to assess the
      trend of amniotic fluid volume in serial examinations.

PMID- 8481267
TI  - Twin growth problems: causes and sonographic analysis.
AB  - Understanding the significant increased risks associated with twin pregnancies
      requires knowledge of the embryogenesis of twins and the unique placental
      characteristics seen only in twin gestations. Dizygotic "fraternal" twins, 70% of
      all twins, are at relatively low risk when compared with monozygotic twins,
      largely due to abnormalities seen in association with monochorionic placentation.
      The sonographic determination of chorionicity and amnionicity allows better
      estimation of pregnancy risk--up to 50% mortality in monochorionic-monoamniotic
      twins. Careful evaluation of intrauterine twin growth assists in the early
      identification of fetal abnormalities because normal twin growth should parallel
      that of singleton pregnancies until late in the third trimester. A number of the
      unique complications affecting growth in twin pregnancies are discussed,
      including twin transfusion syndrome, the "stuck twin" phenomenon, twin
      embolization syndrome, and development of acardiac twins.

PMID- 8481268
TI  - Condom use among high-risk women in Honduras: evaluation of an AIDS prevention
      program.
AB  - In 1988, the Honduran Ministry of Health initiated an intervention study designed
      to increase AIDS awareness and promote preventive behavior, especially condom
      use, among registered commercial sex workers (CSWs). The program consisted of
      weekly talks and free condom distribution to all CSWs who attended the sexually
      transmitted disease clinic during a 10-week period. Pre- and postintervention
      surveys were used to evaluate change in knowledge and condom use. Condom diaries
      were used to measure condom use during the program. One hundred thirty-four women
      who participated in the intervention completed the initial and follow-up surveys.
      There was a statistically significant increase in mean condom use from 64% to 70%
      of client contacts. Condom use recorded in diaries during the program period
      appeared even higher. Factors found to be associated with increased use
      postintervention include low baseline condom use and higher client fee. The
      reliability of the methods of measuring condom use and the implications of the
      findings for future intervention studies among sex workers and their clients are
      discussed.

PMID- 8481269
TI  - Sexual risk for HIV transmission among gay/bisexual men in substance-abuse
      treatment.
AB  - A sample of San Francisco gay/bisexual men in substance-abuse treatment (N = 314)
      was compared to the San Francisco Men's Health Study (SFMHS) cohort to compare
      levels of sexual behaviors that are high-risk for HIV transmission. Quantitative
      data were supplemented by analysis of transcripts of focus group discussions with
      gay men in treatment at the same agency. Sexual risk for HIV infection was
      significantly higher for gay/bisexual men in substance-abuse treatment than among
      the community-based (SFMHS) sample of gay/bisexual men. Among those entering
      outpatient alcohol/drug treatment, 21% reported unprotected insertive and sex,
      23% reported unprotected receptive anal sex, and 32% reported unprotected
      insertive and/or receptive anal sex during the previous 3 months. In comparison,
      in the SFMHS cohort, 17% reported unprotected insertive and sex, 15% reported
      unprotected receptive anal sex, and 22% reported unprotected insertive and/or
      receptive anal sex during the previous 6 months. Substance abusers in focus
      groups identified a number of factors that made it difficult to reduce their
      sexual risk behavior, including the perceived disinhibiting effects of alcohol
      and other drugs, learned patterns of association between substance use and sex
      (especially methamphetamine use and anal sex), low self-esteem, lack of
      assertiveness and negotiating skills, and perceived powerlessness.

PMID- 8481270
TI  - A contextual model of stress among parent caregivers of gay sons with AIDS.
AB  - This paper examines the impact of AIDS on the parent/adult child relationship
      among parent caregivers of gay sons with AIDS. Drawing on literature on family
      caregiving of older people and research on parents of gay sons with AIDS, the
      theoretical concepts of family ethos of affection/obligation, attitudes toward
      homosexuality, and stress are reviewed. Based on these key theoretical concepts
      and linkages, a model is developed that suggests the family characteristics that
      differentiate low-stressed parent caregivers and high-stressed parent caregivers.
      A case study is presented to illustrate the model. Recommendations for research
      and implications for professionals are discussed.

PMID- 8481271
TI  - Perceptions of vulnerability: impact on AIDS-preventive behavior among college
      adolescents.
AB  - Perceptions of their own and others' risk of contracting AIDS, AIDS knowledge,
      and extent of AIDS-preventive behavior (APB) were assessed in sexually active
      heterosexual college students (N = 80) to investigate why many college students
      fail to enact APB. Personal risk of contracting AIDS was estimated to be
      significantly lower than risk for each of a set hypothetical persons who varied
      in degree of similarity to respondents, p < .0001. ANOVAs indicated that males (F
      = 60.13, p < .0001), homosexual males and females (F = 62.55, p < .0001), and
      young adults not in college (F = 8.17, p < .005) were perceived as more likely to
      contract AIDS than females, heterosexuals, and college students, respectively.
      AIDS knowledge was related to accuracy of risk estimates, but was not predictive
      of APB. Lack of APB is discussed in terms of illusion of unique invulnerability
      and the characterization of AIDS as an outgroup problem. Implications and
      recommendations for AIDS-preventive education programs are discussed.

PMID- 8481272
TI  - Knowledge and attitudes about AIDS among staff of community-based health and
      social service organizations in the Southwest: implications for staff training.
AB  - To ascertain the specific AIDS training needs of staff from community-based
      organizations in the Southwest, a survey of knowledge and attitudes was conducted
      by the National Coalition of Hispanic Health and Human Services Organizations
      (COSSMHO) in the 5 Southwestern cities of Albuquerque, El Paso, Phoenix, San
      Diego, and Tucson. The responses of 1057 staff were examined according to staff
      position: managerial, direct service, clerical, and volunteer. Staff were 60.3%
      Hispanic/Latino and 28.4% white non-Hispanic. Staff responses were examined on 3
      dimensions of AIDS-related knowledge and on 3 attitudinal dimensions. A
      multivariate analysis of covariance (MANCOVA) that controlled for 4 sources of
      group nonequivalence revealed generally that managers and direct service staff
      had higher knowledge and more favorable attitudes than did clerical and volunteer
      staff. Of greatest concern, however, was the number of specific knowledge items
      for which all staff obtained less than 80% correct answers. Disturbing knowledge
      deficits exist on important AIDS-related information across all levels of staff.
      Specific content and strategies are presented for corrective interventions by
      staff type.

PMID- 8481273
TI  - The role of family therapy in decreasing HIV high-risk behaviors among
      adolescents.
AB  - Adolescence is a critical time for the prevention of human immunodeficiency virus
      (HIV) infection and both the prevention and treatment of high-risk-for-HIV
      behaviors such as drug abuse and unprotected sex. Family therapy appears to be a
      promising, yet neglected, source of influence in the prevention of HIV. In this
      paper, the authors identify HIV risk factors among adolescents and provide a
      rationale for the use of family therapy to prevent high-risk-for-HIV behaviors
      among adolescents. Also included are the components of one promising family
      therapy model for addressing risk reduction in adolescents. An illustrative case
      example is provided.

PMID- 8481274
TI  - First Asian/Pacific Island Men's HIV Conference, Los Angeles, California.

PMID- 8481275
TI  - [PTFEe in the treatment of facial wrinkles].
AB  - The first signs of skin aging appear quite early, around 30 years of age, and
      show as glabella and facial wrinkles particularly pronounced around the eye, lips
      and nasolabial area. None of these imperfections can be expressively modified
      through a cervicofacial rhytidectomy (facelift). The use of PTFEe in
      reconstructive surgery has been established by years of positive experience;
      therefore, the well known characteristics of such material suggested the idea of
      extending its use to aesthetic surgery. The corrections performed with this
      material are carried out mostly as day hospital surgery in local anaesthesia,
      requiring, however, technical skill to obtain satisfying results.

PMID- 8481276
TI  - [The diagnostic and therapeutic strategies in neoplasms of the adrenal cortex:
      the authors' own experience].
AB  - The Authors report their limited series of neoplasms of the adrenal cortex, and
      underline the decisive role of the modern diagnostics based on imaging techniques
      (US--TC--NMR). These, in fact, often allow a good definition also in the non
      functioning adrenal masses incidentally discovered (incidentalomas). The authors
      emphasize the high quality of such diagnostic methods offering a good reliability
      in discriminating the nature of the adrenal mass. These undeniable diagnostic
      advantages have a positive impact on the surgical strategy, allowing together
      with a careful morphological study of the lesion, to program in detail possible
      demolitive operations. The authors finally underline the importance of the
      surgical access: they are persuaded the best is the bilateral under-rib incision.
      This surgical approach assures a complete exploration of the abdominal and pelvic
      cavity; moreover, it allows to face every complication.

PMID- 8481277
TI  - [Isolated unilocular hydatidosis of the kidney: a rare clinical event].
AB  - The authors report a case of granulomatous hydatid disease of the kidney recently
      observed in a 47-year-old female patient with a preoperative diagnosis of
      nephrolithiasis. The rarity of the location and the likely asymptomatic nature of
      the disease are, in the authors opinion, of clinical and scientific interest.

PMID- 8481278
TI  - [Malignant mesothelioma located in the pleura: its radical surgical treatment].
AB  - The authors report a rare case of localized malignant pleural mesothelioma
      infiltrating the thoracic wall. The absence of widespread pleural involvement
      allowed for a radical operation with removal of a large portion of the thoracic
      wall. However, due to rarity of such tumor, an hypothesis on long term prognosis
      is difficult to formulate.

PMID- 8481279
TI  - [The surgical treatment of a differentiated thyroid carcinoma infiltrating the
      large mediastinal veins].
AB  - The authors report on 2 patients affected by well-differentiated, locally
      advanced, thyroid carcinoma infiltrating the major mediastinal veins. Removal of
      the neoplastic mass was possible through a combined cervical and trans-sternal
      approach. Surgical indication, operative strategy and follow up are discussed. A
      review of the literature is also reported.

PMID- 8481280
TI  - [Juvenile vascular pathology due to homocystinuria. A clinical case report].
AB  - The authors report a case of juvenile vasculopathy in a homocystinuria patient.
      They point out that thromboembolism may be the only symptomatic expression of
      this genetically determined metabolic disease. Diagnostic approach and surgical
      therapy of the vascular lesions as well as medical therapy to prevent further
      complications are analysed. The opportunity to perform clinical tests for the
      diagnosis of homocystinuria in all those young patients presenting vascular
      lesions without other risk factors is finally stressed.

PMID- 8481281
TI  - [Intestinal obstruction due to phytobezoars].
AB  - The authors report nine cases of small bowel obstruction due to phytobezoars,
      observed from January 1982 to October 1991. The main factors in the pathogenesis
      of phytobezoars, particularly alimentary habits and previous gastric surgery, are
      considered. In five patients the operation, always performed in emergency,
      consisted in a longitudinal enterotomy. In two cases the plasticity of the
      phytobezoar allowed for a manual progression beyond the ileocecal valve. In two
      patients an intestinal resection was necessary. The authors prefer the finger
      fracture technique with manual progression of the phytobezoar beyond the
      ileocecal valve when the ileal loop is well conserved and the phytobezoar itself
      has enough plasticity.

PMID- 8481282
TI  - What is the future of biliary surgery?

PMID- 8481283
TI  - [Loco-regional anesthesia in the surgery of inguinal and crural hernias. The
      authors' own experience with 1730 treated cases].
AB  - The authors report their experience with the use of loco-regional anaesthesia for
      the surgical treatment of inguinal and femoral hernias. Their series includes
      1730 operations, 235 of which for hernia relapses, performed exclusively in the
      outpatient department. In the authors opinion, with loco-regional anaesthesia it
      is possible to treat any type of inguinal-femoral hernia, reducing the risks
      related to total anaesthesia and the complications arising from bedrid. Excellent
      results were achieved especially in the elderly and high risk patients like
      cardiopathic or those affected by respiratory and hepatorenal insufficiency with
      a complete absence of mortality and morbidity.

PMID- 8481284
TI  - [Intermittent electromechanical dissociation of the internal anal sphincter in
      idiopathic fecal incontinence].
AB  - Ten patients with median age of 51 years (range 24-75; 9 female) presenting
      idiopathic faecal incontinence and twelve normal subjects with median age of 34
      years (range 25-71; 5 female) underwent fine wire anal sphincter electromyography
      and anal manometry. The results were analysed using non-parametric methods of
      statistical analysis. The median IAS EMG was 0.30 Hz (range 0.18-0.38), in
      incontinent and 0.48 Hz (range 0.31-0.55) in controls; p. < 0.01. Ambulatory
      resting pressures were a median of 66 cmH2O (range 49-83 cmH2O), for the
      incontinent and 82 cmH2O (range 66-120) for controls; p < 0.04. IAS EMG frequency
      correlated with resting anal pressures in both groups (p < 0.003). IAS EMG
      silence not attributable to electrode movement or to the recto-anal inhibitory
      reflex, lasting 0.5-4 minutes, occurred in all but two of the incontinent
      patients. No recruitment of the external sphincter or puborectalis muscle was
      noted during these episodes. Such electromechanical dissociation was not seen in
      the control group.

PMID- 8481285
TI  - [Anatomicosurgical research on isolating the retrohepatic segment of the vena
      cava inferior].
AB  - The retrohepatic segment of the inferior vena cava is considered of major
      importance in the surgical management of both thoracoabdominal trauma and
      neoplasms involving the venous wall. Twenty autopsies and 10 anatomical specimens
      were employed to examine the patterns of the avascular inter-hepato-caval median
      space. For the isolation and ligation of the hepatic veins a rubber snare was
      inserted into the avascular plane assuring a right tension of the vasculo
      parenchymal lamina which attracts the liver to the vena cava. The number and the
      course of the hepatic veins were clearly identified. Authors' experience, coupled
      with a critical review of the literature, confirms that successful isolation of
      the believed surgically inaccessible retrohepatic vena cava and hepatic veins may
      represent a suitable approach for major injuries or neoplasias of these
      structures.

PMID- 8481286
TI  - Medical consultations for asthma attacks, 1988-1991.

PMID- 8481287
TI  - New immune system vaccines to be tested.

PMID- 8481288
TI  - Test could reveal HIV infection in newborns.

PMID- 8481289
TI  - Protecting the consumer.

PMID- 8481290
TI  - Spurious connection or real risk?

PMID- 8481291
TI  - Sponsorship: seen to be above suspicion.

PMID- 8481293
TI  - Nurses work. Life after redundancy.

PMID- 8481292
TI  - Sex on the ward.

PMID- 8481294
TI  - Nurses work. Why counsel?

PMID- 8481295
TI  - Therapeutic risks in mental health nursing.
AB  - Taking risks would appear to be a part of everyday life for most people, but this
      is not always the case for many long-stay psychiatric patients. Nurses frequently
      over-protect people receiving mental health care because they are concerned that
      the patient may come to harm. Allowing patients to take therapeutic risks which
      can help them to learn from their mistakes can be extremely beneficial. This
      article outlines the importance of incorporating safeguards into the care plan to
      ensure the risk of harm is minimised.

PMID- 8481296
TI  - Delaying attendance at A&E departments.
AB  - In the first article of a new four-part series, Mike Walsh analyses the reasons
      why patients delay before attending an accident and emergency (A&E) department.
      Interviews with a sample of 200 A&E patients were conducted to find out why
      people attend when they do. Factors such as presence of a wound, access to the
      department and type of condition were found to be significant in their decision.
      The concepts of utilisation time, illness time and appraisal time are essential
      in understanding why patients may delay their attendance. Subsequent articles
      will address questions such as why people attend A&E rather than their GP, pain
      and anxiety in A&E, and patients' opinions of their experience.

PMID- 8481298
TI  - Achieving a healthy working environment.

PMID- 8481297
TI  - Open learning for enrolled nurses.
AB  - Within the new market economy of the NHS, it is necessary to provide reliable
      information on the viability of educational initiatives which are planned,
      implemented and evaluated in an economic manner without compromising quality. The
      Sheffield and North Trent College of Nursing and Midwifery offers a unique
      opportunity for enrolled nurses who wish to retake first level nursing
      examinations. An evaluation of the course was undertaken which revealed that 75
      per cent of the students felt the course had enhanced their personal study skills
      and professional awareness.

PMID- 8481299
TI  - Lateral nursing: nursing muddles.

PMID- 8481300
TI  - The pro-am debate.

PMID- 8481301
TI  - Worst among equals.

PMID- 8481302
TI  - The Clay column.

PMID- 8481303
TI  - Migraine: not just a headache (continuing education credit).

PMID- 8481304
TI  - Diabetes care: dispelling the myths (continuing education credit).

PMID- 8481305
TI  - New combinations beat HIV in vitro.

PMID- 8481306
TI  - Not playing God.

PMID- 8481307
TI  - A colour-blind health service.

PMID- 8481308
TI  - Food for thought.

PMID- 8481309
TI  - Employment law: the tender trap.

PMID- 8481310
TI  - Satisfaction with pay: changing nurses' pay.

PMID- 8481311
TI  - Nurses work--cost effectively.

PMID- 8481312
TI  - Nurses work. More nurses are needed.

PMID- 8481313
TI  - Nurses work. Age before duty.

PMID- 8481314
TI  - Epilepsy (continuing education credit).

PMID- 8481315
TI  - Computerised care plans in Tayside.
AB  - The development of ward nursing information systems and, in particular, the
      advent of computerised nursing care plans, have caused some controversy and
      discomfort in professional circles. This article describes how staff in a large
      general hospital in Tayside set about refining their information technology base,
      with particular emphasis on the role of the project nurse who had overall
      responsibility for the implementation of the programme. Despite cautionary words
      from some commentators, it appears that the computerised care planning module has
      been received positively by nursing staff.

PMID- 8481316
TI  - Pain and anxiety in A&E attenders.
AB  - Little research has been carried out into pain and anxiety in the A&E department.
      In the third article in this series, a study of 200 patients is described which
      revealed that only a small number of A&E patients reported having no pain or
      anxiety while substantial numbers were reporting high pain and/or anxiety levels.
      A statistically significant linkage between high pain and anxiety levels was
      demonstrated. The author reviews what factors cause anxiety and fear in patients
      attending A&E and concludes that nurses can alleviate worry and pain by better
      communication.

PMID- 8481317
TI  - Sister Susie. Multiskilling and other hot air.

PMID- 8481318
TI  - Ivory towers of strength.

PMID- 8481320
TI  - The Standard guide to achieving change quietly.

PMID- 8481319
TI  - Bullying: I fought back.

PMID- 8481321
TI  - Call for urgent review of HIV guidelines for health workers.

PMID- 8481322
TI  - Hepatitis A & B: the nurse's role (continuing education credit).

PMID- 8481323
TI  - Fats of life (continuing education credit).

PMID- 8481324
TI  - [The acute abdomen].

PMID- 8481325
TI  - [Poisonous and less poisonous plants].

PMID- 8481326
TI  - [History of alcoholic embryopathy. Historical sources in the visual arts and in
      literature].

PMID- 8481327
TI  - [Analysis of the activities of pediatric nurses in a neonatal intensive care unit
      -study at the county children's hospital in Linz].

PMID- 8481328
TI  - [Viral pneumonia and respiratory distress syndrome in an infant].

PMID- 8481329
TI  - [Maternal protection legislation: Employer may request examination to prove work
      prohibition].

PMID- 8481330
TI  - [Working time in the hospital: the union has the right to determine the working
      hours].

PMID- 8481331
TI  - [Franz von Rinecker (1811-1883)].

PMID- 8481332
TI  - [Perceptual disorders?].

PMID- 8481333
TI  - [Tick bites; health risks].

PMID- 8481334
TI  - Diagnosis and treatment of 17-hydroxylase deficiency.
AB  - Leading symptoms of 17-hydroxylase/17,20-lyase deficiency in childhood are
      hypertension and hypokalemia. We found this enzyme defect in 3 phenotypically
      female siblings aged 12, 15 and 16 years. Two of the sibs have a 46,XY chromosome
      pattern, the third is genetically female. Pubertal development did not occur.
      Both of the 46,XY sibs have male internal and female external genitalia. The
      46,XX sister has normal female internal genitalia. At the time of diagnosis, two
      of the three siblings had hypertension (RR between 190/135 and 160/110 mmHg). Two
      of the three siblings had low serum potassium and metabolic alkalosis. All three
      patients had excessively high plasma levels of 11-deoxycorticosterone (DOC) and
      corticosterone. Aldosterone was also elevated whereas plasma renin activity was
      suppressed. Plasma cortisol and its 17-hydroxylated precursors were low, as were
      plasma testosterone, dihydroepiandrosterone sulphate and estradiol, while the
      gonadotropins LH and FSH were elevated in all three patients. We studied the
      steroid profiles of these three patients during long term glucocorticoid
      treatment with dexamethasone, which is now followed for 13 years. Blood pressure
      and serum potassium became normal. Plasma aldosterone, corticosterone and DOC
      were clearly lower but not fully normalized. The two genetically male sisters
      obtained estrogens for induction of female secondary sex characteristics. The
      third 46,XX sister has normal menstruations during substitution with cyclic
      estrogen/gestagen therapy. All three patients lack pubic and axillary hair, and
      reached normal adult heights both for phenotypic sex and for target height. The
      psychosocial orientation is female in all of them. Apart from rare reports of
      development of malignant hypertension, prognosis is better than in other enzyme
      deficiencies causing congenital adrenal hyperplasia since no Addisonian crises
      occur due to DOC and corticosterone overproduction resulting in apparently normal
      endogenous glucocorticoid activity.

PMID- 8481335
TI  - The pathogenesis of adrenal and extra adrenal hyperandrogenism.
AB  - The data reviewed in this paper suggest that a factor other than ACTH which is
      suppressible by treatment with glucocorticoid, plays an essential role in the
      regulation of adrenal androgen production. Adrenal androgen biosynthesis probably
      takes place exclusively in specific androgen-secreting cells. That availability
      of androgen substrate alone e.g. 17OH-progesterone, is not sufficient to lead to
      hyperandrogenaemia is clear from data which was obtained from treated patients
      with the 21 hydroxylase deficiency type of congenital adrenal hyperplasia. In
      pituitary ACTH excess, cortisol production is relatively greater than that of
      androgens. In contrast, in some patients with ectopic ACTH production, the excess
      production of androgens is relatively greater than that of cortisol. Taken
      together, these observations suggest that a factor closely related to ACTH, i.e.
      a POMC fragment other than ACTH, plays an important role in the regulation of
      adrenal androgen production, that in Cushing's disease the ratio of ACTH to the
      androgen-stimulating fragment increases, and that in some patients with ectopic
      ACTH syndrome the ratio of ACTH to the alternative fragment may be decreased. In
      addition, the data reviewed are consistent with a model for the pathogenesis of
      idiopathic hirsutism and polycystic ovary syndrome whereby mild adrenal androgen
      excess is primary to the development of these disorders. However, the identity of
      the putative adrenal androgen stimulating hormone has yet to be established.

PMID- 8481336
TI  - Partnership and sexuality in adult female patients with congenital adrenal
      hyperplasia. First results of a cross-sectional quality-of-life evaluation.
AB  - In congenital adrenal hyperplasia affected female patients are born with
      ambiguous genitalia caused by prenatally elevated circulating androgens from the
      defective adrenal glands. Surgical correction and life-long medication is needed
      to enable a normal female life. In contrast to androgen-related behaviour little
      information is available regarding the psychosocial consequences of genital
      malformations and lifetime medical treatment on the life of female patients. We
      report the results regarding partnership and sexuality of a comprehensive quality
      of-life evaluation of female patients with congenital adrenal hyperplasia. While
      there was no significant difference in the first overall evaluation between the
      various clinical forms of congenital adrenal hyperplasia, patients differed
      significantly from healthy controls in regard to partnership and sexuality.
      However, overall analysis suggested, that the patients were able to adjust well
      to their condition and were able to lead a normal life. Further longitudinal
      research is needed to more clearly identify problem areas and to improve medical
      and psychological treatment.

PMID- 8481337
TI  - Mass spectrometry in the diagnosis of steroid-related disorders and in
      hypertension research.
AB  - The use of GC/MS and microbore HPLC/electrospray mass spectrometry for clinical
      studies in hypertension and mineralocorticoid research is described. In
      particular, an automated GC/MS method allows nearly quantitative measurements of
      metabolites of major steroids of adrenal, placental and gonadal origin. This
      method is able to distinguish almost all steroid related disorders. Electrospray
      mass spectrometry in conjunction with microbore HPLC is the latest mass
      spectrometry technique applicable to biochemical investigations. It offers high
      sensitivity (15 pg) for measurement of intact steroid conjugates and related
      compounds.

PMID- 8481338
TI  - 19-Nor-corticosteroids in genetic hypertension. Effects of inhibitors of 11 beta,
      18, 19-hydroxylase activity.
AB  - The long-term objective is to understand the role of the adrenal in altering
      systemic arterial blood pressure. This paper summarizes research on genetic
      hypertension in the rat and bears a relationship to several forms of human
      hypertension in which defects of steroid hydroxylases lead to increased secretion
      of mineralocorticoids other than aldosterone in genetic and experimental
      hypertension in rats. We demonstrated that 19-nor-corticosteroids are produced in
      excess in genetic and experimental hypertension in rats and man. We studied the
      enzymatic alteration responsible for excessive production of 19-nor
      deoxycorticosterone (19-nor-DOC) in the salt-sensitive hypertensive rat S/JR.
      Biosynthesis of 19-nor-steroids involves hydroxylation of the C-19 methyl group.
      We characterized the adrenal 11 beta, 18,19-hydroxylase enzyme system in inbred
      salt-sensitive and resistant rats (R/JR). This system is capable of all three
      hydroxylations. The Km for 19-hydroxylation was different from S/JR and R/JR but
      was much greater for 11 beta- and 18-hydroxylation in both. This suggested that
      the catalytic site for 19-hydroxylation is different from that for 11 beta and
      18. The S/JR adrenal enzyme binds the substrate with higher affinity than does
      the R/JR adrenal enzyme. We were unable to distinguish the cDNAs of the S/JR from
      the R/JR adrenal enzyme from bovine 11 beta-hydroxylase cDNA by restriction
      mapping. We were unable to demonstrate restriction length polymorphism. 19
      Acetylenic DOC is an inhibitor which preferentially inhibits the 19-hydroxylation
      of DOC, and does not interfere with the 18- and 11 beta-hydroxylation. This
      inhibition leads to a reduction in blood pressure in the S/JR Dahl rat. We
      suggest that an S/JR 19-nor-DOC is involved in the development of salt
      sensitivity and hypertension and that inhibition of its formation by acetylenic
      DOC and other aromatase and non-aromatase inhibitors is associated with reversal
      of these phenomena.

PMID- 8481339
TI  - Factors controlling steroid biosynthesis in the zona glomerulosa of the adrenal.
AB  - The biosynthesis of aldosterone in the adrenal zona glomerulosa is influenced by
      a number of factors of which the main physiological regulator is the octapeptide,
      angiotensin II (AII). Sodium restriction increases plasma aldosterone, adrenal
      glomerulosa AII receptors and the activity of enzymes of the early and late
      aldosterone biosynthetic pathway. The effects of sodium restriction are mimicked
      by prolonged administration of low doses of AII, and prevented by blockade of AII
      formation using converting enzyme inhibitors, indicating that the effects of
      sodium restriction are mediated by AII. However, the adrenal glomerulotrophic
      actions of AII are impaired in rats on high sodium diet indicating that other
      factors are modulating the effects of AII in these conditions. A number of
      factors are known to influence aldosterone secretion, several of which have been
      shown to preferentially modulate the effect of AII. While the stimulatory effect
      of AII is potentiated by serotonin or increases in extracellular potassium, it is
      inhibited by dopamine, somatostatin and atrial natriuretic peptide. Future
      investigations will be important to understand the relative role of the
      individual regulators in the physiological control of adrenal sensitivity to AII,
      and how activation of various intracellular messenger systems results in changes
      in activity of the enzymes of the aldosterone biosynthetic pathway.

PMID- 8481340
TI  - Final steps of aldosterone biosynthesis: molecular solution of a physiological
      problem.
AB  - The final two steps of aldosterone biosynthesis play a key role in the complex
      physiological adaptation of aldosterone secretion to changes in sodium and
      potassium content of the mammalian organism. The nature and identity of the
      enzyme catalyzing these steps have only recently been established. In the rat as
      well as in the human adrenal, two types of cytochrome P-450(11 beta) are encoded
      by two different genes. The major type of the enzyme catalyzes only the
      conversion of deoxycorticosterone to corticosterone or 18-hydroxy-11
      deoxycorticosterone; it is present in all the zones of the adrenal cortex. The
      second type of the enzyme catalyzes the three steps involved in the conversion of
      deoxycorticosterone to aldosterone and occurs only in the zona glomerulosa. In
      rat zona glomerulosa cells, separate control systems independently regulate the
      expression of the two genes, according to long-term in vivo experiments or to
      experiments with primary cultures of zona glomerulosa cells. Expression of the
      non-aldosterone-producing enzyme is induced by ACTH, whereas the expression of
      the aldosterone-producing enzyme is dependent on the extracellular potassium
      concentration.

PMID- 8481341
TI  - The forms and functions of 11 beta-hydroxysteroid dehydrogenase.
AB  - In this review, we consider the relationship between the structure and function
      of 11 beta-hydroxysteroid dehydrogenase (11-HSD) purified from rat liver. The rat
      liver enzyme is a single domain glycoprotein with a unique active site and
      belongs to the short chain alcohol dehydrogenase family. Evidence supporting the
      presence in other tissues of 11-HSD isoforms is discussed.

PMID- 8481342
TI  - Role of androgens in breast cancer.
AB  - There is a vast amount of information on the concentration of different androgens
      in human breast cancer in pre- and post-menopausal women. Many years ago it was
      suggested that some androgens, in particular dehydroepiandrosterone (DHA), could
      be one of the parameters to establish whether these androgens can predict breast
      cancer. However, the enormous data available on the plasma and tissue
      concentrations, particularly DHA and DHA sulfate (DHA-S) allow confirmation that
      the quantitative values of these androgens are not significantly different in
      normal women from those with breast cancer. Another important aspect of androgens
      in breast cancer is their function as precursors of estrogens, hormones which
      play an important role in breast cancerization. However, it is not clear at
      present what the quantitative contribution of androgens "via aromatase" is to the
      formation of estrogens, because more recently it was found that estradiol in
      breast cancer tissues originates mainly "via sulfatase" using estrone sulfate as
      precursor. A point of further interest is that a series of authors have
      demonstrated that the administration of DHA to experimental animals with breast
      cancer significantly decreased the evolution of the disease. This part of the
      data is also contradictory because other experimental information has shown that
      administration of DHA can increase the incidence of granulosa cell tumors.
      Finally, it has been suggested that androgens, in their capacity as anti
      estrogens, can be used to substitute anti-estrogens in cases where treatment with
      classical anti-estrogens has no response. In conclusion, more information
      concerning the plasma and tissular concentrations of androgens, their
      contribution as estrogen precursors and their biological response(s), is needed
      in order to have a clearer idea of the role of these steroids in breast cancer.

PMID- 8481343
TI  - The pathology of Cushing's disease.
AB  - In this brief review the pathology of Cushing's disease is summarized. The most
      frequent morphologic abnormality is a basophilic microadenoma of the pituitary
      accompanied by the Crooke's hyaline change in the cytoplasm of nontumorous
      corticotrophs. Other tumor variants include chromophobic macroadenomas, Crooke's
      cell adenomas and corticotroph carcinomas. In some cases, no tumor can be
      documented in the pituitary. In the adenohypophyses of a few patients with
      hypercorticism, corticotroph hyperplasia is present which may be the cause of
      Cushing's disease. The pathogenesis of Cushing's disease is not clear. The
      question of whether corticotropin-releasing hormone (CRH) plays a role in its
      genesis has yet to be elucidated. Studies on animals and observations on human
      pituitaries indicate that CRH can induce accumulation of corticotrophs. Although
      no evidence is available to prove that CRH is involved in the neoplastic
      transformation of corticotrophs, it is possible that hypothalamic peptides which
      stimulate ACTH secretion may play a role in the progression of corticotroph
      adenoma of the pituitary.

PMID- 8481344
TI  - The structure of glucocorticoid receptors.
AB  - The glucocorticoid receptor of mouse thymic lymphoma cells was investigated. The
      receptor-hormone complex in cytosolic extracts has a Stokes' radius of 82 A and
      Mw approximately 330 kDa. In the presence of salt at high concentrations,
      however, the receptor-complex has a Stokes' radius of 60 A and Mw approximately
      120 kDa. This receptor form is able to interact with DNA. Chemical cross-linking
      was used to stabilize the high molecular weight receptor structure against
      subunit dissociation and this was found to prevent receptor activation to DNA
      binding. The affinity labeled receptor was submitted to progressive cross-linking
      and the intermediate cross-linked forms were analyzed. This led to the conclusion
      that the high molecular weight receptor structure is a hetero-tetramer consisting
      of one receptor polypeptide of approximately 100 kDa, two molecules of the 90 kDa
      heat shock protein hsp90 and an additional protein subunit. The latter was
      unequivocally identified by immunochemical techniques as the 59 kDa protein p59.
      The 70 kDa heat shock protein was found not to be a bona fide receptor component
      but was a contaminant of our immunopurification procedure. Cross-linking studies
      also showed that the receptor exists in the high molecular weight form in intact
      cells and in the absence of hormone.

PMID- 8481345
TI  - Reduced aldosterone metabolites in hypertension.
AB  - Significant quantities of 5 alpha and 5 beta-Ring A-reduced metabolites and
      several polar cytochrome P-450 dependent hydroxylated neutral metabolites of
      aldosterone (Aldo) (NMA) are soon present in the kidney during the latent period,
      prior to the expression of Aldo's effects on Na+ and K+. Their levels in the
      kidney (a) correlate, in a dose-dependent manner, with the magnitude of
      physiological responses to Aldo in male rats, (b) are lower in the kidneys of
      females, which show smaller responses to Aldo than males, (c) are lower in the
      kidneys of males treated with the anti-mineralocorticoid spironolactone, and (d)
      their synthesis can be regulated by dietary Na+ and K+. Anti-mineralocorticoids
      completely inhibit synthesis of 5 alpha-reduced metabolites of Aldo in both
      kidney and toad bladder and of several of the polar hydroxylated NMA in both
      liver and kidney. 5 alpha-Reduced metabolites and their 2-hydroxylated
      derivatives possess significant mineralocorticoid activity and their synthesis is
      increased in rats fed a low Na+ diet and decreased with a high Na+ diet. We have
      suggested that their synthesis may play a major role in the expression and/or
      regulation of the individual renal anti-natriuretic and kaliuretic actions of
      Aldo.

PMID- 8481346
TI  - Corticosteroid receptors and aging.
AB  - We have measured plasma aldosterone, plasma cortisol, and glucocorticoid and
      mineralocorticoid receptors in mononuclear leukocytes in 54 healthy aged subjects
      (60-97 years old) and in a group of 21 controls (21-50 years old). In addition
      all parameters and age were plotted for correlation. Plasma cortisol was
      significantly higher in the aged group (346 +/- 140 nmol/l) than in controls (260
      +/- 120). Mean plasma aldosterone was not different in the two groups. Both Type
      I and II receptors in mononuclear leukocytes were lower in the aged group than in
      controls (Type I 198 +/- 96 and 272 +/- 97 receptors per cell; Type II 1738 +/-
      801 and 3339 +/- 918 receptors per cell). A direct correlation was found between
      cortisol and age and between Type I and II receptors in aged subjects, and
      between cortisol and Type I receptors, and cortisol and Type II receptors in
      controls. When all subjects are plotted together, a direct correlation was
      observed between cortisol and age and between Type I and II receptors, and an
      inverse correlation between age and Type I and age and Type II receptors. We
      conclude that the parallel reduction of both Type I and II receptors with age is
      not due to prior cortisol increase, but the increase of plasma cortisol can be
      considered the result of age-dependent involution of these receptors.

PMID- 8481347
TI  - The role of vascular steroid receptors in the control of vascular contractility
      and peripheral vascular resistance.
AB  - Evidence is presented that glucocorticoids (GC) and mineralocorticoids (MC)
      control contractility of vascular smooth muscle (VSM). This control is effected
      through the in situ mechanism for the action of these steroids in the arterial
      and arteriolar wall. This action is mediated through GC and MC receptors in the
      VSM cell. Acting through these receptors, MC and GC increase transport capacities
      of different transmembrane transport systems for Na+ and/or Ca2+ through
      induction of synthesis of proteins constituting the transport systems.
      Colocalization of enzymes deactivating cortisol in VSM, with VSM receptors for GC
      and MC further strengthens the concept that the arterial network houses an in
      situ molecular mechanism for the control of VSM contractility, thus peripheral
      vascular resistance.

PMID- 8481348
TI  - Paracrine regulation of the renin-aldosterone system.
AB  - A number of clinical states have been described where there are derangements or
      discrepancies between renin-angiotensin and aldosterone secretion. We have
      studied the potential effect of some cytokines or growth factors (peptide
      regulatory factors) on this system in vitro. Both tumor necrosis factor/cachectin
      and interleukin I are potent regulators acting as renin secretagogues and
      inhibitors of aldosterone synthesis. These actions are mediated by prostaglandin
      cyclooxygenase products and their actions mimic the syndrome of hyperreninemic
      hypoaldosteronism in critical illness. Insulin and insulin-like growth factor I
      are also renin secretagogues in vitro However in a diabetic model (streptozotocin
      rat), there is resistance to both agonists as well as enhanced feedback
      suppression to angiotensin. A third peptide, transforming growth factor (TGF
      beta) has even more complex actions, acting as a secretagogue at low doses (10(
      12) M) but inhibiting renin at higher doses. TGF beta production is increased in
      the diabetic state so that this peptide as well as the insulin family may be
      involved in hyporeninemic hypoaldosteronism.

PMID- 8481349
TI  - Angiotensin II and dexamethasone regulate angiotensinogen mRNA by different
      mechanisms.
AB  - Angiotensinogen synthesis and secretion in the liver is regulated by
      glucocorticoids and angiotensin II. In isolated hepatocytes in suspension
      culture, both dexamethasone and angiotensin II induced an increase in
      angiotensinogen mRNA (2.5- and 4-fold, respectively) with half maximal
      stimulation at 20 and 200 nM, respectively. In a nuclear run on assay,
      transcription of the angiotensinogen gene in nuclei from hepatocytes exposed to
      angiotensin II was not significantly different from controls, whereas
      dexamethasone-pretreatment dramatically stimulated angiotensinogen mRNA
      synthesis. By inhibition of transcription in hepatocytes, as well as in
      [32P]uridine pulse and chase experiments, angiotensin II was shown to stabilize
      angiotensinogen mRNA, prolonging the intracellular half-life from 83 to 191 min.
      In polysomal extracts from hepatocytes, a 12 kDa protein could be identified,
      that binds to a probe of the 3'-untranslated region (UTR) angiotensinogen mRNA.
      The binding activity of this protein appears to be higher in hepatocytes exposed
      to angiotensin II, and to have a stabilizing effect on angiotensinogen mRNA. It
      is proposed that angiotensin II enhances the binding activity of a 12 kDa protein
      the 3'-UTR of angiotensinogen mRNA, which results in increased stability and
      transcription of angiotensinogen mRNA.

PMID- 8481350
TI  - Changes in the renin-angiotensin system after nephrectomy and adrenalectomy.
AB  - The study investigates the change in angiotensinogen (Aogen), angiotensin I
      (AngI) and renin plasma concentration after nephrectomy and adrenalectomy. The
      aim of the study was to elucidate the mechanisms that are involved in the up
      regulation of the Aogen plasma levels after nephrectomy and the contribution of
      the adrenals. Rats were treated with the beta 1-selective adrenoceptor blocker,
      atenolol, and with the angiotensin antagonist, DuP 753 in order to inhibit renal
      renin release and to check whether the increase in plasma Aogen after nephrectomy
      is mediated by angiotensin (AngII), respectively. The plasma Aogen levels
      increase approx. 5-fold 24 h after nephrectomy. This increase is significantly
      reduced in the presence of atenolol. After nephrectomy plus adrenalectomy there
      is a maximal increase of 60% in plasma Aogen levels 8 h after surgery and a
      subsequent decline. In the presence of atenolol this increase is even smaller. In
      contrast after adrenalectomy the plasma Aogen levels continuously declined. In
      the presence of atenolol the plasma Aogen levels were approx. 20% higher at time
      0 but declined with the same slope as after adrenalectomy without atenolol
      treatment. Treatment with DuP 753 caused an almost complete inhibition of the
      increase in Aogen plasma levels after nephrectomy. Significantly higher Aogen
      levels were found only after 24 h. At time 0, immediately after nephrectomy the
      plasma AngI levels were increased compared to the respective control rats.
      Significantly higher AngI values (P < 0.05) could also be observed in
      nephrectomized rats and in nephrectomized plus adrenalectomized rats at time 0 in
      the presence and absence of atenolol and DuP 753, respectively. In contrast after
      adrenalectomy alone the AngI levels at time 0, were not different from those of
      the controls. Subsequently the AngI levels increased at a similar rate as after
      adrenalectomy in the presence of atenolol. These findings suggest that the
      increase in plasma Aogen after nephrectomy is essentially mediated by AngII via
      an adrenal mechanism. It seems likely that this process is triggered by renin
      released during surgery. The increased renin release after adrenalectomy that is
      responsible for the increased degradation of Aogen seems not to be mediated by a
      sympathetic stimulation of the renal beta 1-adrenoceptors.

PMID- 8481351
TI  - Differential diagnosis in primary aldosteronism.
AB  - The diagnosis of primary aldosteronism (PA) is based on the finding of the
      combination of elevated urinary and/or plasma aldosterone and suppressed renin
      activity in patients with hypertension and hypokalemia. However, PA consists of a
      number of subsets, and diagnostic criteria for a correct identification of
      surgically remediable forms are of great interest. The methods and the results
      concerning our series of 113 patients with PA are presented in this review.
      Aldosterone producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) were
      the most frequent forms, 51 and 44%, respectively. They had similar blood
      pressure levels, but hypokalemia was most frequently found in APA. Urinary and
      upright plasma aldosterone were similar, but supine plasma aldosterone was lower
      in IHA. Plasma aldosterone response to upright posture and angiotensin II
      infusion was absent in most cases of APA and present in IHA, but occasionally
      renin-responsive adenoma were found. Captopril failed to decrease plasma
      aldosterone in most patients with APA, and in a subgroup of patients with IHA.
      Patients with adenoma also had higher values of the aldosterone precursor 18
      hydroxy-corticosterone, and of atrial natriuretic peptide, probably as a
      consequence of a greater degree of volume expansion. Among morphological studies,
      CT scan and adrenal radiocholesterol scintiscan provided similar results (85%
      accuracy): adrenal veins catheterization clarified almost all the remaining
      cases. Among the subsets of PA, 3 familiar cases of dexamethasone-suppressible
      hyperaldosteronism were recognized, with characteristically high levels of
      aldosterone, 18-hydroxy-corticosterone, 18-hydroxy-cortisol and 18-oxo-cortisol,
      due to the genetic abnormalities of the 11-18 hydroxylase system. Isolated cases
      of primary adrenal hyperplasia (with all functional tests resulting compatible
      with APA, but no tumour at surgery) and aldosterone producing carcinoma (1 case)
      have also been reported in the present study.

PMID- 8481352
TI  - Mineralocorticoid production of adrenal cortical adenomas.
AB  - We studied in vitro and in vivo corticosteroid production as well as the presence
      of symptoms of an increased mineralocorticoid effect in patients with 'silent'
      adrenal cortical adenomas, and compared these results to those found in patients
      with classical mineralocorticoid excess syndromes. We found that under in vitro
      conditions, cells from 'silent' adrenal cortical adenomas (n = 19) produced
      substantial amounts of both zona glomerulosa and fasciculata steroids, although
      the production of steroids in these cells was lower compared to that in
      mineralocorticoid-producing adenoma cells (n = 26). Patients with aldosterone
      producing and 'silent' adenomas had significantly increased plasma atrial
      natriuretic peptide levels, which remained non-suppressible after upright posture
      and furosemide administration. Of the 25 patients with 'silent' adenomas, 11 had
      low and non-stimulable plasma renin activity (PRA) before but, in most cases, not
      after adrenal surgery. When compared to those with normal PRA (n = 14), patients
      with low PRA 'silent' adenomas (n = 11) had higher blood pressure which was
      significantly reduced after surgery, and a mild hypokalemia before but not after
      surgery. Although basal plasma concentrations of aldosterone, 18-hydroxy
      corticosterone, corticosterone, deoxycorticosterone, 18-hydroxy-DOC, cortisol,11
      deoxycortisol and 17-hydroxy-progesterone (17-OH-P) were not increased in either
      groups of 'silent' adenomas, ACTH stimulation produced a hyperreactive response
      for all measured steroids, of which an extremely high 17-OH-P seemed to be one of
      the most intriguing findings. We consider that these observations in 'silent'
      adrenal cortical adenomas may justify surgical intervention, irrespective of the
      size and potential malignancy of these adenomas.

PMID- 8481353
TI  - Problems in diagnosis and management of congenital adrenal hyperplasia due to 21
      hydroxylase deficiency.
AB  - A number of biochemical tests have been utilized to assist the diagnosis of
      steroid 21-hydroxylase deficiency. The specificity and accuracy of plasma 17
      hydroxyprogesterone assays are important. A profile of steroids in urine by gas
      chromatography and mass spectrometry is the definitive test. Molecular biology is
      not practical for the diagnosis of a new case. The ACTH stimulation test for
      detection of heterozygotes is a poor discriminant. Fertility in patients with
      congenital adrenal hyperplasia may be due to excess of progesterone as well as of
      androgens. Gene amplification offers the best approach in molecular biology for
      the prenatal diagnosis of 21-hydroxylase deficiency.

PMID- 8481354
TI  - Prenatal diagnosis and treatment of 21-hydroxylase deficiency.
AB  - Prenatal diagnosis of 21-hydroxylase deficiency, the most common cause of
      congenital adrenal hyperplasia (CAH), has benefited from the advances in
      endocrinologic and molecular genetic studies. In 1976, prenatal diagnosis of the
      disease was first attempted by measuring 17-hydroxyprogesterone in the amniotic
      fluid in the second trimester of pregnancy. Discovery of a close linkage between
      HLA and the disease gave a second approach for prenatal diagnosis, the latter
      being made by linkage study of the haplotypes of the index case in a given
      family. Diagnosis was later made directly by molecular biology. Currently, the
      studies of the C4-CYP21B gene locus by Southern blotting and the CYP21B gene
      mutations by PCR methods simplify the diagnostic procedure of an early and
      accurate prenatal diagnosis in the first trimester. In these conditions all
      families are now informative. Moreover, using a direct genetic analysis
      associated with the possibility of detecting the heterozygotes in a non-related
      CAH population, a prenatal diagnosis can be done in a family without a previously
      CAH affected child. From our results in a series of 274 pregnancies at risk for
      CAH in whom prenatal diagnosis has been made by these different approaches, it
      can be concluded that steroid analysis in the amniotic fluid is an accurate
      method but provides only a late (second trimester) diagnosis, while an early and
      accurate diagnosis now relies on adequate molecular genetic studies on chorion
      villus biopsies. In the aim to prevent the virilization of the external genitalia
      in CAH female fetuses, prenatal treatment was instituted in our group in 1979 by
      giving dexamethasone to the mother. This prenatal treatment appears safe for the
      fetus and the child and is effective in preventing virilization of CAH affected
      females. Although the degree of prevention is not always complete in all cases,
      the advantages of prenatal treatment are prevailing over the complications
      observed in a few mothers.

PMID- 8481355
TI  - Male pseudohermaphroditism caused by nonsalt-losing congenital adrenal
      hyperplasia due to 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) deficiency.
AB  - We observed a boy with ambiguous genitalia and normal testes. Steroid analyses
      performed during newborn age surprisingly were inconclusive basally and after hCG
      stimulation, but showed an insufficient testosterone response. Possibly during
      the early postnatal period the 3 beta-HSD activity in peripheral tissues may have
      been sufficient to substitute for the deficient 3 beta-HSD activity in the
      adrenal and gonads. In contrast at 11 and 22 months basal as well as ACTH
      stimulated levels of 17OHPreg, DHEA and testosterone were typical for a 3 beta
      HSD defect.

PMID- 8481356
TI  - Congenital lipoid adrenal hyperplasia--genes for P450scc, side chain cleavage
      enzyme, are normal.
AB  - In the most severe form of congenital adrenal hyperplasia (CAH), termed lipoid
      CAH, both the adrenals and gonads fail to convert cholesterol to pregnenolone, so
      that no steroid hormones are made. Newborns have female external genitalia
      irrespective of karyotype, and suffer a severe salt-losing form of CAH. Previous
      studies have shown that adrenal or gonadal mitochondria from these patients also
      fail to convert cholesterol to pregnenolone in vitro, implicating a lesion in the
      single gene for P450scc, which is the sole enzyme converting cholesterol to
      pregnenolone. Two patients with XY karyotypes had female genitalia and
      unmeasurable steroids after stimulation with ACTH and hCG. ACTH stimulation tests
      of parents, obligate heterozygotes, showed normal stimulation of all precursor
      steroids. Southern blotting patterns of the P450scc gene were normal.
      Oligonucleotide-initiated enzymatic amplification (PCR) of all P450scc exons
      showed normal sequences on multiple amplifications and sequencing reactions,
      indicating normal P450scc genes. Northern blots of testicular RNA from a 6-month
      old patient and from a control fetus showed normal P450scc mRNA, indicating a
      normal P450scc promoter. Reprobing of the blot with our cloned human cDNAs for
      adrenodoxin reductase and adrenodoxin showed that these electron transport
      cofactors used by P450scc were also normal. Similarly, probing with cDNAs for all
      three known factors involved in cholesterol transport to the mitochondria-sterol
      carrier protein 2, endozepine, and steroidogenesis activator peptide were also
      normal. These results suggest that the lesion in lipoid CAH is not in the P450scc
      system or in any known step upstream from P450scc.

PMID- 8481357
TI  - Mutations in human 11 beta-hydroxylase genes: 11 beta-hydroxylase deficiency in
      Jews of Morocco and corticosterone methyl-oxidase II deficiency in Jews of Iran.
AB  - Steroid 11 beta-hydroxylase is encoded by two homologous genes, CYP11B1 and
      CYP11B2, located on chromosome 8q21-22. CYP11B1 encodes a specific cytochrome P
      450 (P-450c11) necessary for cortisol biosynthesis, with predominantly 11 beta
      hydroxylase and moderate 18-hydroxylase activity, whereas CYP11B2 encodes another
      isozyme (P-450cmo) necessary for aldosterone biosynthesis, with 11 beta
      hydroxylase, 18-hydroxylase and 18-oxidase activities (the latter two termed
      corticosterone methyl-oxidase I and II; CMO-I and II, respectively). Two steroid
      biosynthetic defects, both relatively frequent in Israel, are caused by specific
      mutations in each of these genes. 11 beta-Hydroxylase deficiency is frequent
      among Jews from Morocco (1 in 5000 to 7000 births), and is characterized by
      virilization, hypertension, impaired cortisol biosynthesis, and increased
      deoxycorticosterone and androgens. Affected individuals have a single base
      substitution in exon 8 of CYP11B1, codon 448, from CGC (arginine) to CAC
      (histidine). This sequence, normally absent in CYP11B2, constitutes a true point
      mutation within the heme binding domain of CYP11B1 that results in marked
      impairment of enzymatic activity. The clinical expression is characterized by a
      wide range of variability in the signs of both androgen and mineralocorticoid
      excess, even though an identical mutation was found in all but one of the
      affected alleles examined. CMO-II deficiency is frequent among Jews from Iran (1
      in 4000 births), and is characterized by a typical salt-wasting syndrome,
      increased 18-hydroxycorticosterone, impaired aldosterone biosynthesis, and a high
      ratio of these steroids. No mutation was found in CYP11B1, but all individuals
      affected were homozygous for two missense mutations in CYP11B2. The first, in
      exon 3, codon 181, from CGG (arginine) to TGG (tryptophane) is a mutation that
      completely abolishes both CMO-I and II activities, whereas the second, in exon 7,
      codon 386, from GTG (valine) to GCG (alanine) is a more conservative substitution
      that produces only a minimal reduction in CMO-I activity. Individuals homozygous
      for either one of these mutations are asymptomatic.

PMID- 8481358
TI  - Stage I endometrial carcinoma: the role of neoadjuvant progesterone therapy.
AB  - A prospective study was devised in 1980 to assess the effect on survival of
      neoadjuvant Provera as part of the primary treatment of endometrial carcinoma in
      conjunction with surgery and radiotherapy. Between June 1980 and June 1985, 218
      patients with Stage I adenocarcinoma of the corpus uteri were allocated on the
      basis of hospital of presentation to receive either neoadjuvant treatment with
      medroxyprogesterone acetate (MPA) 100 mg t.i.d. p.o. from diagnosis for 90 days,
      or no adjuvant treatment (the control group). The minimum follow-up was 5 years.
      There was no significant difference between the overall actuarial survival in the
      treatment group (123 cases) and that in the control group (95 cases). This was
      83.7% and 69.2% at 5 and 10 years respectively in the treatment group and 78.9%
      and 70.7% in the control group (P > 0.1).

PMID- 8481359
TI  - Sustained indomethacin and ranitidine with intermittent continuous infusion
      interleukin-2 in advanced malignant melanoma: a phase II study.
AB  - Experimental work has shown that, during the development of tumours, host
      macrophages are triggered to produce high levels of prostaglandin E2 which
      inactivates natural killer cells and suppresses lymphokine activated killer cell
      development. Sustained, uninterrupted indomethacin treatment, when combined with
      interleukin-2 (IL-2), can totally eradicate experimental metastases. Most trials
      utilizing high dose IL-2 employ indomethacin and ranitidine in order to alleviate
      or prevent IL-2 toxicity, but only administer these medications concurrently with
      IL-2 therapy. A Phase II trial was conducted in patients with advanced melanoma.
      Patients received 50-75 mg indomethacin three times daily and 150 mg ranitidine
      twice daily, starting at least 1 week prior to IL-2 and continuing until
      intolerance or disease progression. Continuous venous infusion IL-2 was
      administered for three courses, each consisting of 5 days of treatment at 18 x
      10(6) iu/m2/day for the first course with escalation of dose for the subsequent
      courses if toxicity allowed. Twenty-one patients were eligible to receive all
      components of therapy. Three patients achieved an objective response (one
      complete and two partial), giving a response rate of 14%. However, two of these
      objective responses (one complete and one partial) were achieved on indomethacin
      and ranitidine alone, prior to the commencement of IL-2 therapy. In this study,
      indomethacin and ranitidine, without IL-2, have been shown to have antitumour
      activity in advanced melanoma; continuous infusion IL-2 appeared to add little to
      the response seen with these two agents.

PMID- 8481360
TI  - Isolated cutaneous relapse in Hodgkin's disease: a case report and review of the
      literature.
AB  - Cutaneous Hodgkin's disease is uncommon, and is usually associated with evidence
      of systemic disease. We report a case of apparently isolated cutaneous relapse in
      a patient with Hodgkin's disease, and review the literature on cutaneous
      Hodgkin's disease as a whole.

PMID- 8481361
TI  - Non-Hodgkin's lymphoma presenting with jaundice and hypercalcaemia.
AB  - A patient is reported with B-cell lymphoma (centroblastic high grade non
      Hodgkin's) with pancreatic involvement, who presented with jaundice and
      hypercalcaemia. Particularly unusual features include the presentation with a
      pancreatic mass and the association of hypercalcaemia with centroblastic
      lymphoma.

PMID- 8481362
TI  - The successful use of radiotherapy for osteoblastoma.
AB  - We report a case of osteoblastoma arising in the petrous temporal bone of a 16
      year-old boy. Attempts at surgical resection were unsuccessful. The patient was
      treated with radiotherapy and is now well 10 years later. A review of the
      literature indicates that radiotherapy has been used rarely for this tumour and
      some have felt it to be detrimental. Our report illustrates a case where planned
      radiotherapy has been successful when full surgical resection had not been
      possible.

PMID- 8481363
TI  - Assessment of visual function for patients on tamoxifen.

PMID- 8481364
TI  - Radiotherapy patient scheduling.

PMID- 8481365
TI  - A comparison of doxorubicin, epirubicin and mitozantrone as single agents in
      advanced breast carcinoma.
AB  - Between July 1985 and December 1987, 87 patients with advanced breast carcinoma
      were randomized to receive single agent doxorubicin (70 mg/m2), epirubicin (70
      mg/m2) or mitozantrone (14 mg/m2) at 3-weekly intervals. The patients had
      received no previous chemotherapy for their advanced disease but 91% had received
      prior hormonal therapy. The response rates were 36% with doxorubicin, 32% with
      epirubicin and 26% with mitozantrone, but these differences did not reach
      statistical significance. The median survival of all patients was 8.3 months.
      There was no significant difference in response rates or survival according to
      menopausal status. The toxicities of the three agents are compared. Nausea,
      vomiting and alopecia were more severe in patients treated with doxorubicin or
      epirubicin than those treated with mitozantrone. Myelosuppression and infective
      episodes occurred more frequently with mitozantrone. Two cardiac complications
      were reported. This study shows that the toxicity and low efficacy of all three
      agents limit their use as single agents in advanced breast carcinoma. The role of
      single agent chemotherapy and the relative toxicities of these drugs are
      discussed.

PMID- 8481366
TI  - Women and clinical oncology.
AB  - In the United Kingdom 20% of consultants and 23% of senior registrars are female.
      A questionnaire sent to female clinical oncologists revealed that 90% have full
      time contracts, although 36% had spent time in part-time training. Sixty-seven
      per cent of the total have children and the husbands of 51% of the 74% who are
      married are doctors. Twenty-four per cent believe they have experienced sexual
      discrimination in clinical oncology and 10% believe they have failed to be
      appointed to a post because of their gender. Problems highlighted were of
      inadequate funding for locums to cover maternity leave and poor child care
      facilities.

PMID- 8481367
TI  - Radiotherapy patient scheduling using a desktop personal computer.
AB  - This paper describes the transition from a conventional paper based patient
      scheduling system for radiotherapy to a computer based system in a busy clinical
      department. The hardware and software requirements are set out, together with a
      description of the current advantages and future potential for development of the
      system as part of a mathematical model of departmental activity.

PMID- 8481368
TI  - Myopic keratomileusis with the excimer laser: one-year follow up.
AB  - BACKGROUND: The possibility of using an argon fluoride excimer laser to perform
      the refractive incision in keratomileusis spurred us to develop the present
      surgical technique of using a microkeratome to make a primary corneal incision
      that yields a corneal disc, then making the refractive excision of stroma with
      excimer laser ablation, and finally suturing the corneal disc in place. METHODS:
      We describe the procedures and a prospective study of 30 consecutive eyes from 22
      consecutive patients with high myopia (range, -11.20 D to -24.50 D) who underwent
      excimer laser myopic keratomileusis. A plano corneal disc was cut with a BKS 1000
      microkeratome, followed by argon fluoride excimer laser ablation of the stroma
      with the Summit Eximed UV 200LA laser (Summit Technology, Inc, Waltham, Mass),
      either of the resected disc (28 eyes) or in situ on the stromal bed (two eyes).
      RESULTS: By 3 weeks after surgery, 83% of the corneas were considered clear. In
      17 eyes (57%), the difference between the intended and achieved refraction was <
      1.00 D; in 9 eyes (30%), the difference was 1.00 to 3.00 D; in 4 eyes (13%), the
      difference was 3.00 to 6.00 D. At 12 months after surgery, uncorrected visual
      acuity was 20/40 or better in 3 (10%) eyes, and 20/50 to 20/100 in the remaining
      27 (90%) eyes, in contrast to 100% of eyes that saw worse than 20/200 before
      surgery. Two eyes had a very deep ablation of the lenticule that led to
      irregularities in Bowman's layer. CONCLUSIONS: Excimer laser myopic
      keratomileusis is an effective way to correct high myopia and may be more
      accurate than other methods of keratomileusis. A new nomogram for the procedure
      is presented.

PMID- 8481369
TI  - Excimer laser photorefractive keratectomy for hyperopia.
AB  - BACKGROUND: Excimer laser photorefractive keratectomy has generated considerable
      interest as a technique for correcting myopia. In this study, the excimer laser
      was used to correct hyperopia. METHODS: A prospective clinical study based on the
      results of photorefractive keratectomy in 23 consecutive hyperopic eyes (one eye
      per patient) is presented. The excimer laser used in this study was a MEL 60
      (Aesculap-Meditec); this laser emits 193-nanometer laser light. A 1-year follow
      up study of two groups of eyes was performed. All patients were followed for 12
      months. The first group comprised 15 hyperopic eyes with preoperative refraction
      between +2.0 and +7.5 diopters (mean spherical equivalent +4.7 +/- 1.6 D). The
      second group comprised eight aphakic eyes with preoperative refraction between
      +11.0 and +16.0 D (mean spherical equivalent +13.1 +/- 2.0 D). RESULTS: In group
      1, 12 eyes (80%) were within +/- 1.0 D of the intended correction (baseline, +2.0
      to +7.5 D) after 1 year. In group II, only three of the eight aphakic eyes (37%)
      were within +/- 1.0 D of the intended final refraction (baseline, +11.0 to +16.0
      D). The stability of refraction in group I was better than in group II. At 12
      months, best corrected visual acuity was unchanged in 14 eyes of group I. One eye
      had lost two lines. In group II, best corrected visual acuity was unchanged in
      six eyes after 12 months. In two eyes, best spectacle-corrected visual acuity was
      lower than the preoperative value, because of decentration of the ablation zone.
      After 1 year, 80% of the eyes in group I and 25% of those in group II had a
      visual acuity of 20/40 or better. CONCLUSION: Photorefractive keratectomy is an
      efficient and relatively safe procedure for correcting hyperopia up to +7.5 D.
      The predictability is good. Results of photorefractive keratectomy to correct
      highly hyperopic (aphakic) eyes are not as encouraging. Three patients in this
      study lost one to three lines of best spectacle-corrected visual acuity due to
      decentration of the clear zone. Two of the patients belonged to group II.
      Therefore, we do not recommend photorefractive keratectomy in highly hyperopic
      eyes, especially if they are aphakic, because even slight decentration may lead
      to loss of best corrected visual acuity. As in other refractive surgical
      procedures, great care must be taken to improve the centration of the clear zone.

PMID- 8481370
TI  - Long-term endothelial cell loss following phacoemulsification: model for
      evaluating endothelial damage after intraocular surgery.
AB  - BACKGROUND: Newer concepts of phakic intraocular lens (IOL) surgery present
      concerns as to their long-term deleterious effect on the endothelium. We examine
      the behavior of the endothelium for up to 6 years following uneventful
      phacoemulsification surgery, to establish a baseline for what might be an
      acceptable level of endothelial cell loss due to intraocular surgical trauma.
      METHODS: Ninety-three eyes undergoing phacoemulsification surgery who had
      multiple endothelial specular microscopy examinations for up to 6 years were
      examined. Central endothelial specular photomicrographs were analyzed in all
      cases and the percent of endothelial cell loss as a function of time was
      calculated. Cell density calculations were corrected for the normal endothelial
      cell loss as a function of age. RESULTS: Routine uncomplicated
      phacoemulsification surgery demonstrated a 9% endothelial cell loss 1 year
      postoperatively. This is in marked contrast to the 16% average endothelial cell
      loss cited in the literature after phakic AC-IOL surgery. In general, anterior
      chamber IOL surgery following cataract removal compares unfavorably to posterior
      chamber IOL insertion long term (20% cell loss versus 12% cell loss).
      CONCLUSIONS: A model is proposed to look at the rate of endothelial cell loss
      that would be significant enough to create the threat for corneal edema long term
      following refractive intraocular surgery in young patients. Suggestions for
      critical comparisons between the observed endothelial aging seen with phakic IOLs
      and values for more routine IOL surgery are proposed to predict the long-term
      threat for endothelial cell loss and corneal decompensation, which might result
      many years after phakic refractive IOL surgery.

PMID- 8481371
TI  - Comparison of excimer laser and microkeratome myopic keratomileusis in human
      cadaver eyes.
AB  - BACKGROUND: There are currently four techniques of keratomileusis in clinical
      use: cryolathe, planar with mold, excimer laser, and in situ. Comparative studies
      among the techniques are rare in human cadaver eyes. We studied the newest of
      these techniques using the argon fluoride (193 nm) excimer laser to perform the
      excision of stroma as compared to the nonfreeze, planar, lamellar myopic
      keratomileusis using the Barraquer-Krumeich-Swinger (BKS) technique. METHODS:
      Corneas were dehydrated in dextran-containing medium. A 9.00-diopter correction
      was attempted with each technique using the manufacturers' parameters. There were
      six eyes in each group. Keratometry was done with the instrument (Bausch & Lomb)
      mounted vertically. RESULTS: The laser group achieved a mean keratometric
      flattening of 5.80 +/- 1.00 D; the BKS group achieved a flattening of 3.80 +/-
      1.30 D. CONCLUSIONS: These results demonstrated the difficulty in obtaining
      results in eye-bank eyes that match those achieved clinically. The different
      results of these two techniques underscore the need to use clinical data to
      adjust laser keratomileusis operating parameters.

PMID- 8481372
TI  - Optics of the corneal epithelium.
AB  - BACKGROUND: The refractive effect of the corneal epithelium in relation to the
      cornea as a whole is relatively unknown, yet it may affect the efficacy of
      keratorefractive surgical procedures, most notably photorefractive keratectomy
      and epikeratoplasty. This article investigates the refractive effect of the
      epithelium on the cornea. METHODS: We measured the corneal keratometry in 10
      fresh human eye-bank eyes with and without epithelium. All readings were
      performed at 2.0- and 3.6-millimeter diameter zones with an automated
      keratometer. RESULTS: When the epithelium was removed, there was an increase in
      corneal refractive power in every case. The mean change was +1.03 D (range, 0.55
      to 1.85 D) at the central 2.0-millimeter diameter zone and +0.85 D (range, 0.29
      to 1.60 D) at the 3.6-millimeter diameter zone. We also found a change in both
      the power and axis of astigmatism in most cases. CONCLUSIONS: The corneal
      epithelium plays an active role in determining the final surface power of the
      cornea. It accounts for an average of 1.03 D of the power of the eye at the
      central 2-millimeter diameter zone. The difference in astigmatism suggests that
      the epithelium does not form a layer of uniform thickness over Bowman's layer. It
      appears that the epithelium attempts to minimize abrupt changes in surface
      contour. These findings suggest that in refractive procedures such as
      photorefractive keratectomy the refractive contribution of the epithelium must be
      taken into account to improve predictability.

PMID- 8481373
TI  - Four-incision radial keratotomy for high myopia after penetrating keratoplasty.
AB  - BACKGROUND: High amounts of myopia can frequently produce anisometropia and limit
      visual rehabilitation by conventional means in eyes with clear corneal grafts.
      This condition is frequently coupled with large amounts of astigmatism. Four
      incision radial keratotomy provides a way to reduce myopia in normal individuals.
      In our present study, we used the technique of four- incision radial keratotomy
      to reduce myopia in a group of keratoplasty patients who failed conventional
      visual rehabilitation. Arcuate or transverse keratotomy was used in conjunction
      with radial keratotomy in eyes with high amounts of astigmatism. METHODS: This
      study retrospectively examined a group of 11 eyes with penetrating keratoplasty
      which underwent four-incision radial keratotomy for the treatment of visually
      disabling myopia. The radial incisions were placed in the graft, inside the graft
      host interface. Seven eyes underwent concomitant arcuate relaxing incisions at
      the graft-host interface for treatment of associated astigmatism. One additional
      eye had paired straight transverse incisions for the treatment of astigmatism.
      The mean postoperative follow up was 16 months (range, 3 months to 5 years).
      RESULTS: There was a mean reduction of the spherical equivalent refraction of
      3.48 diopters (D) (range, 0.25 to 7.75 D). The eight eyes undergoing astigmatic
      surgery showed a mean reduction in keratometric astigmatism of 2.25 D (range, 
      6.75 to +6.50 D) and refractive astigmatism of 4.63 D (range, -1.50 to -9.50 D).
      Nine of the 11 eyes had stable or improved best spectacle corrected visual
      acuity. Two eyes had reduction of best spectacle corrected visual acuity--one due
      to development of irregular astigmatism and one due to worsening of preexisting
      macular edema. CONCLUSIONS: Four-incision radial keratotomy can reduce myopia
      after penetrating keratoplasty when the patient is unable to tolerate spectacle
      or contact lens correction. It can be combined with relaxing incisions or
      transverse keratotomy to reduce astigmatism. There is a high amount of
      variability, and predictability is currently limited by the complex topographical
      changes occurring in corneal transplants. Complex corneal biomechanical changes
      may predispose these eyes to the development of irregular astigmatism.

PMID- 8481374
TI  - Multifocal effect of against-the-rule myopic astigmatism in pseudophakic eyes.
AB  - BACKGROUND: In monofocal intraocular lens (IOL) implants we can sometimes obtain
      a certain degree of pseudoaccommodation. The use of a slight myopic astigmatism
      is proposed for postoperative refraction to achieve a significant increase in the
      depth of field and to reestablish a certain degree of pseudoaccommodation in
      pseudophakic eyes. METHODS: Eighty-one eyes with against-the-rule myopic
      astigmatism were evaluated in 50 patients who underwent IOL implant surgery. We
      selected patients with corrected monocular visual acuity greater than or equal to
      20/30 and with a refraction ranging from +0.50 to -1.25 diopters sph, from -0.50
      to -2.75 D cyl, ax from 55 degrees to 140 degrees. RESULTS: Monocular uncorrected
      distance visual acuity in 68% of eyes was 20/40 or better, while binocular
      uncorrected distance visual acuity in 84% of eyes was 20/40 or better and in 66%
      of eyes was 20/30 or better. Monocular uncorrected near visual acuity in 67% of
      eyes was J3 or better, while binocular uncorrected near visual acuity in 82% of
      eyes was J3 or better and in 68% was J2 or better. Sixty-four percent of patients
      never wear glasses for distance, while 34% use them occasionally and only 2%
      always wear them. Fifty-four percent of patients never wear glasses for near, 32%
      use them occasionally, while 14% always wear them. CONCLUSION: These data show
      that with a low against-the-rule simple myopic astigmatism (about -1.50 D cyl x
      90) we can often offer pseudophakic patients a rewarding independence from
      glasses both for distant and near vision.

PMID- 8481375
TI  - The treatment of persistent wound leak after radial keratotomy.
AB  - BACKGROUND: Macroperforation of the cornea during refractive keratotomy can
      result in persistent wound leak and may need treatment by suturing. METHODS: We
      describe two eyes that developed a macroperforation during radial keratotomy with
      persistent leakage of aqueous. The wounds were sutured with 10-0 and 11-0 nylon
      sutures. RESULTS: The sutures induced irregular astigmatism as shown by corneal
      topography. Removal of sutures improved the topography and led to an acceptable
      outcome. CONCLUSION: Macroperforations with persistent aqueous leaks should be
      sutured. Suture removal within a few weeks after surgery can avoid persistent
      irregular astigmatism and lead to a good refractive result.

PMID- 8481376
TI  - Double Descemet's membrane in penetrating keratoplasty.
AB  - A rare complication of penetrating keratoplasty is incomplete removal of the host
      Descemet's membrane, which can progressively become opaque. Utilizing a Nd:YAG
      laser, we opened the opaque membrane, improving visual acuity from 20/400 to
      20/100.

PMID- 8481377
TI  - Early rehabilitation after small incision cataract surgery.
AB  - BACKGROUND: The use of smaller cataract incision is thought to induce less
      astigmatism, resulting in a more stable refraction and more stable wound.
      METHODS: We have analyzed the early astigmatic changes and rehabilitation in 20
      eyes of 16 patients operated with advanced phacoemulsification techniques. The
      patients operated with small-incision surgery (incision 4.0 mm) were compared to
      those with large-incision surgery (incision 7.5 mm). Keratometric values and
      visual acuity data were evaluated up to 6 months postoperatively. RESULTS: Less
      initial induced astigmatism was demonstrated at day 7 postoperatively with a 4.0
      millimeter incision (0.1 +/- 0.53 D) compared with a 7.5-millimeter incision
      (1.90 +/- 1.97). Similar but not statistically significant changes were seen at
      days 1 and 30 postoperatively. Visual rehabilitation was also faster in the small
      incision group and 70% of the eyes gave uncorrected visual acuity of 20/40 or
      better in this group as early as the first postoperative day. Only 11% of the
      eyes showed that uncorrected visual acuity after large-incision surgery at first
      postoperative day. CONCLUSION: The low amount of induced cylinder, rapid
      stabilization of the wound, and faster visual rehabilitation confirms the
      advantage of small-incision cataract surgery to large-incision surgery.

PMID- 8481378
TI  - Achromobacter xylosoxidans keratitis following penetrating keratoplasty.
AB  - BACKGROUND: Achromobacter xylosoxidans is a bacterium not previously reported in
      a corneal infection. We present a case of infectious keratitis caused by this
      organism, occurring 1 month following penetrating keratoplasty. METHODS:
      Identification of the organism was accomplished by staining, culture, and
      sensitivity testing of the corneal scraping obtained from the involved area. The
      infection responded to subconjunctival ticarcillin, piperacillin eye drops, and
      I.V. azlocillin. RESULTS: Complete healing with a resultant corneal opacity
      involving mostly the anterior and middle stroma was achieved 1 month later.
      CONCLUSIONS: A. xylosoxidans should be considered as a potential pathogen in
      instances of early postkeratoplasty infectious keratitis.

PMID- 8481379
TI  - Isomorphic corneal topography: a clinical approach to 3-D representation of the
      corneal surface.
AB  - BACKGROUND: Newer methods of refractive surgery produce their effect by reshaping
      the corneal surface. It follows that topographic representations, used primarily
      to map refractive power, should now emphasize morphology and contour features.
      METHODS: We introduce a procedure using commercially available instrumentation
      which provides isomorphic three-dimensional corneal topography. The
      representations may be displayed either as refractive power, as is conventionally
      done, or as the more surgically relevant contour configuration. These images
      contain data points that are continuous rather than stepped as in the familiar
      color-coded displays. RESULTS: The technique proved easy to execute requiring no
      special software or mainframe computing. The corneal displays generated were
      freely rotatable and rescalable. CONCLUSIONS: In addition to producing clear and
      intuitive three-dimensional representations, the digital graphics environment
      allows manipulation unavailable in the conventional color-coded format; such
      representations should be particularly valuable for pre- and postoperative
      evaluation.

PMID- 8481380
TI  - In planning the number of incisions, size of the clear zone, etc, for radical
      keratotomy, do you use minus or plus cylinder form?

PMID- 8481381
TI  - Inhibition of electron transport of rat-liver mitochondria by synthesized
      antimycin A analogs.
AB  - A series of antimycin A analogs was synthesized by replacement of a dilactone
      ring moiety of natural antimycin A by various alkyl, substituted phenyl,
      substituted diphenyl ether, or amino acid ester groups. The structure-inhibitory
      activity relationship was studied with rat-liver mitochondria to identify roles
      of the dilactone-ring moiety in the inhibitor binding to a Qi reaction center of
      cytochrome bc1 complex. All derivatives caused further reduction of cytochrome b
      reduced by succinate and the oxidant-induced reduction, showing that the
      derivatives inhibited electron transport by interacting with a Qi reaction
      center. The inhibition tended to increase as the hydrophobicity of the inhibitor
      increased. The mode of binding of inhibitor molecules to a Qi center, which was
      reflected in, for example, a sigmoidal titration curve for respiratory inhibition
      and a time-dependent change in inhibitory activity, varied depending on
      structure. These results suggested that the role of the dilactone-ring moiety of
      antimycin A may be not only to support hydrophobic interaction with the binding
      domain by increasing the hydrophobicity of the molecule, as proposed earlier, but
      also to regulate close fitting of the salicylic acid moiety to the binding
      domain.

PMID- 8481382
TI  - Primary structure, deduced from cDNA, secondary structure analysis and
      conclusions concerning interaction surfaces of the delta subunit of the
      photosynthetic ATP-synthase (E.C. 3.6.1.34) from millet (Sorghum bicolor) and
      maize (Zea mays).
AB  - Lambda gt11 cDNA clones for the nuclear-encoded subunit delta of the chloroplast
      ATP-synthase from Zea mays and Sorghum bicolor were sequenced. The processing
      site for S. bicolor delta was established, and the sequence of the mature subunit
      delta from Z. mays was completed by N-terminal sequencing of the proteins
      isolated from chloroplasts. Only five amino acids are identical and not more than
      16% conservatively exchanged in all sequences of delta subunits from higher
      plants and the corresponding proteins from alga, bacteria and mitochondria (OSCP)
      available. In binary comparison the comparatively high conservation of
      hydrophilic residues indicates the importance of the surface of delta. The degree
      in identities of surface residues correlates with the capacity in hybrid
      reconstitution of photophosphorylation. A hypothetical secondary structure model
      for a typical delta subunit can be deduced from prediction algorithms. Three
      putative amphipathic alpha helices and an antiparallel amphipathic beta sheet
      seem to be conserved. These common secondary structure features should be
      significant for the function of the delta subunit of F0F1 ATPases.

PMID- 8481383
TI  - Identification of an exchangeable non-catalytic site on mitochondrial F1-ATPase
      which is involved in the negative cooperativity of ATP hydrolysis.
AB  - Labeling of mitochondrial F1-ATPase with 8-azido-ATP or 8-azido-ADP under
      turnover conditions with Mg(2+)-ATP resulted in the identification of one
      exchangeable non-catalytic site whose occupation with a ligand does not influence
      the ATPase activity of F1 when measured at Vmax. With 8-azido-ADP two
      exchangeable non-catalytic sites could be labeled, but at one of them the bound
      ligand exchanges, at least partly, during the illumination under turnover
      conditions. After labeling an exchangeable non-catalytic site under turnover
      conditions with 8-azido-ATP or with 8-azido-ADP, F1-ATPase kept the ability to
      bind NAP3-2N3ADP at the slowly exchangeable noncatalytic site, thereby inhibiting
      the ATPase activity by 45%, as recently described (Edel et al. (1992) Biochim.
      Biophys. Acta 1101, 329-338). Covalent modification of the low-affinity non
      catalytic site with 8-nitreno-AT(D)P increased the Km of ATP and abolished the
      negative cooperativity of ATP hydrolysis. This site can therefore be marked as a
      regulatory site, whose occupation with a nucleotide decreases the affinity of the
      catalytic sites for ATP.

PMID- 8481384
TI  - Lipid composition of the vacuolar membrane of Acer pseudoplatanus cultured cells.
AB  - Tonoplast was prepared by osmotic lysis of a pure vacuolar fraction isolated from
      protoplasts derived from Acer pseudoplatanus cultured cells. After their
      extraction, neutral and polar lipids were separated by a thin layer
      chromatography. Phospholipids, glycolipids and neutral lipids represented 44.5%,
      39.1% and 16.4% of total lipids, respectively. Sterols (glycosylated plus non
      glycosylated forms) constituted 30.8% of total lipids; 75% of sterols were
      glycosylated. The most prominent lipids were phosphatidylethanolamine (20.8%),
      phosphatidylcholine (13.5%), ceramide monohexoside (12.8%), steryl glycoside
      (12.2%) and acylated steryl glycoside (10.9%). Glucose was the only sugar
      released by acid hydrolysis of these three later compounds. The major neutral
      lipids were free sterols, triacylglycerols and steryl esters. The phospholipid
      composition was characterised by a high content of phosphatidylethanolamine (50%
      more than phosphatidylcholine). The fatty acid composition of phospholipids
      revealed two major components: palmitic and linoleic acids; they accounted
      together for 60 to 80% of fatty acids. When tonoplast was incubated at pH 5.5
      with 5 mM Ca2+, the free fatty acid content (12% of neutral lipids) increased by
      10% and lysophospholipids were detected. This indicated the presence of a calcium
      dependent phospholipase A2 associated with the tonoplast.

PMID- 8481385
TI  - Octadecatetraenoate synthesis in the unicellular alga Isochrysis galbana: studies
      with intact and broken chloroplasts.
AB  - (1) Monogalactosyldiacylglycerol (MGD) is the major lipid component of Isochrysis
      galbana. In cells incubated for 3 h with [1-14C]]acetate or [1-14C]oleate. MGD
      contained 35.9% and 52.8%, respectively, of the label incorporated into cellular
      lipids. (2) 18:4 amounted to 50-60% of the total FA of MGD. Separation of MGD
      species of cells grown with [1-14C]oleate on AgNO3 impregnated plates revealed 20
      distinct spots. The slowest spot was identified as dioctadecatetraenoyl MGD. Fast
      moving species were enriched with 18:1. (3) In cells incubated for 3 h with [1
      14C]oleate, approx. 60% of the radioactivity was associated with 18:1. Subsequent
      chase resulted in a gradual shift of label and after 48 h [14C]18:1 declined to
      10% and [14C]18:4 reached 52%. This shift was also reflected in the labeling
      pattern of the MGD-species. Dioctadecatetraenoyl-MGD became labelled only after
      24 h. (4) Addition of the substituted pyridazinone herbicide (SAN 9785) during
      the chase period inhibited [14C]18:4 formation; [14C]18:2 and [14C]18:3
      accumulated instead. (5) Isolated chloroplast readily incorporated [14C]oleate
      into MGD and PA. Considerable amounts of [14C]18:1 were desaturated to 18:2 and
      18:3. Only very small amounts of 18:4 were formed. O2 was required for
      desaturation. Cofactor requirement could not be shown. (6) Membranes isolated
      from broken chloroplasts retained the ability to incorporate [14C]oleate into MGD
      and PA and desaturate 18:1 to 18:2 and 18:3.

PMID- 8481386
TI  - In vivo conversion of recombinant human proapolipoprotein AI (rh-Met-proapo AI)
      to apolipoprotein AI in rabbits.
AB  - In vivo conversion of recombinant human proapolipoprotein AI (rh-Met-proapo AI)
      from E. coli to apolipoprotein (apo) AI was investigated. rh-Met-proapo AI was
      labeled with 125I, and then administered intravenously to rabbits. Blood was
      sampled periodically for 6 days. The plasma decay curves of radioiodinated rt-Met
      proapo AI were similar to those of human mature apo AI (fractional catabolic rate
      (FCR); 1.018 +/- 0.090/day vs. 0.976 1 0.031/day, respectively). In vivo
      conversion of rh-Met-proapo AI to mature apo AI was examined by autoradiography
      of the isoelectric focusing (IEF) slab gel, i.e., the HDL fraction from each
      sampling point was semiquantitatively applied to IEF. It was found that the
      radioactivity of rh-Met-proapo AI migrated to more acidic isoproteins, the
      conversion was complete within 24 h, and the FCR of rh-Met-proapo AI was 9.20 +/-
      1.34/day. Although the plasma decay curves of both human pro (rh-Met-proapo AI)
      and mature apo AI were significantly steeper than those of rabbit mature apo AI4
      and apo AI5 (FCR; 0.703 +/- 0.027/day and 0.795 +/- 0.031/day, respectively), the
      conversion rate of human rt-Met-proapo AI to mature apo AI in rabbit was assumed
      to be 1:1. In vitro incubation of rh-Met-proapo AI with rabbit serum produced
      mature apo AI isoproteins, as determined by the apo AI immunoblotting method.
      Prediction of the amino acid sequence at the NH2 terminus of rabbit proapo AI
      showed that the prosegment consisted of an alpha helix with a high probability of
      a beta turn at Pro9, which is close to that in humans. Thus, (1) the proteolytic
      cleavage of proapo AI is an extracellular event, (2) the converting enzyme in
      rabbits can also process human proapo AI, (3) this converting enzyme does not
      specifically and directly attack the Gln6-Asp7 bond which links the carboxyl
      terminal residue of the hexapeptide to the amino-terminal residue of human mature
      apo AI. The conformation of proapo AI at the NH2 terminus (alpha helix of the
      prosegment and a beta turn at Pro9) may have a key role in this cleavage, and (4)
      the examination of rh-Met-proapo AI in rabbits helps to explain the early events
      of HDL biogenesis.

PMID- 8481387
TI  - Adsorption, compression and stability of surface films from natural, lipid
      extract and reconstituted pulmonary surfactants.
AB  - A pulsating bubble surfactometer was used to study the surface activities and
      surface film stabilities of bovine pulmonary surfactants (10 mg/ml) and a
      reconstituted surfactant (10 mg/ml). Pulmonary surfactants were natural
      surfactant (NS), lipid extract surfactant [LES(chol)] and lipid extract
      surfactant without neutral lipids (LES). NS is composed of phospholipids, neutral
      lipids and surfactant-associated proteins (SP-A, SP-B and SP-C). Both LES(chol)
      and LES are organic solvent extracts of NS. LES(chol) retains all the components
      of NS except SP-A. Reconstituted surfactant was dipalmitoylphosphatidylcholine
      (DPPC): 1-palmitoyl-2-oleoyl-phosphatidylglycerol (POPG): SP-B/7:3:1%. All three
      pulmonary surfactants attained the equilibrium surface tension almost
      instantaneously at 37 degrees C. The adsorption rates of NS and LES(chol) at 24
      degrees C were similar to those at 37 degrees C, while LES exhibited a lower
      adsorption rate at 24 degrees C. Reconstituted surfactant adsorbed slower than
      any of the pulmonary surfactants. Film stability was studied by recording the
      spontaneous increase in the pressure gradient of a static bubble at the minimum
      size (Rmin) once near zero surface tension was attained. The order of surface
      film stabilities were: reconstituted surfactant > > NS > LES > LES(chol). Surface
      films of NS and LES could be stabilized by prolonged pulsation, while film
      stability of LES(chol) was only moderately affected by pulsation. These results
      indicate that SP-A in NS promotes formation of some unique structure, possibly
      tubular myelin, which induces selective adsorption of lipids into the surface.

PMID- 8481388
TI  - Metal ion and salt effects on the phospholipase A2, lysophospholipase, and
      transacylase activities of human cytosolic phospholipase A2.
AB  - Human cytosolic phospholipase A2 (cPLA2) is an arachidonic acid specific enzyme
      which may play a role in arachidonic acid release, eicosanoid production, and
      signal transduction. The PLA2 activity of this enzyme is stimulated by microM
      levels of Ca2+. Using a pure recombinant enzyme, we have confirmed that cPLA2 is
      not absolutely dependent on Ca2+, since Sr2+, Ba2+ and Mn2+ also gave full enzyme
      activity. Heavy metals, in contrast, inhibited enzyme catalysis suggesting the
      involvement of an essential cysteine residue. In the absence of Ca2+, high salt
      concentrations overcame the requirement for divalent metals, indicating that Ca2+
      is not required for PLA2 catalytic activity. cPLA2 also displays a
      lysophospholipase (lyso PLA) activity with lysophosphatidylcholine micelles as a
      substrate. Unlike the PLA2 activity, the lyso PLA activity toward these micelles
      is not stimulated by Ca2+. However, upon the addition of glycerol or Triton X-100
      to the assay, Ca2+ activation is observed, indicating that substrate presentation
      can affect the apparent Ca2+ dependence. Glycerol was found to be a potent
      stimulator of lyso PLA activity and specific activities up to 50 mumol min-1 mg-1
      were observed. In addition to the PLA2 and lyso PLA activities, we report that
      cPLA2 displays a relatively low, CoA-independent transacylase activity which
      produces phosphatidylcholine from lysophosphatidylcholine substrate. The
      observation of this novel transacylase activity is consistent with the formation
      of an acyl-enzyme intermediate.

PMID- 8481389
TI  - Competitive inhibition of lipolytic enzymes. IX. A comparative study on the
      inhibition of pancreatic phospholipases A2 from different sources by (R)-2
      acylamino phospholipid analogues.
AB  - The inhibitory power (Z) of a number of (R)-1-alkyl-2-acylamino phospholipid
      analogues was determined for three mammalian phospholipases A2 from pig, ox and
      horse pancreas. All three enzymes display a clear preference for anionic
      (phosphoglycol) inhibitors over the zwitterionic (phosphocholine) derivatives;
      this effect is most pronounced for the bovine enzyme. Upon variation of the 1
      alkyl chain length, the bovine and equine phospholipases, like the porcine enzyme
      in previous studies, show an optimum in Z for a six-carbon alkyl group. The
      introduction of a double bond in the 2-acylamino group generally improves the
      inhibitory power as compared with a fully saturated acyl chain. For the horse
      enzyme, the presence of an (R)-2-undecenoylamino group in the phosphocholine- and
      phosphoglycol-containing inhibitors resulted in affinities which are nearly 4 and
      5 orders of magnitude higher, respectively, than for the substrate molecule.
      Direct determination of the dissociation constant Ki* of several inhibitors
      incorporated in a host lipid/water interface of non-inhibitory n
      octadecenylphosphocholine micelles, was performed by ultraviolet difference
      spectroscopy. The progressive binding of a single inhibitor molecule into the
      active site of the three enzymes was followed quantitatively by an increasing
      tyrosine perturbation. With moderately strong competitive inhibitors (Z values
      ranging from about 50 to 10,000), quantitative values for Ki* were obtained.
      Extrapolation of the experimentally found linear relationship between Z and 1/Ki*
      yields predicted Ki* numbers for the much stronger inhibitors with Z values
      between 10,000 and 100,000.

PMID- 8481390
TI  - Kinetics of the interaction of amphipathic alpha-helical peptides with
      phosphatidylcholines.
AB  - The rate of association of three amphipathic alpha-helical peptides with
      phosphatidylcholine liposomes was examined to provide more detailed information
      on the relationship between peptide length and the kinetics of lipid
      interactions. When added to dimyristoylphosphatidylcholine (DMPC) or
      dipalmitoylphosphatidylcholine (DPPC) liposomes from a guanidine-HCl solution, a
      ten residue peptide rapidly decreased the turbidity of the liposomes. However, a
      related 17-residue peptide had only a minimal effect on liposome turbidity. A 14
      residue peptide was intermediate in effectiveness. Similarly, when liposomes were
      added to peptides dissolved in an aqueous buffer, the ten residue peptide but not
      the 17-residue peptide cleared the turbid liposomes and the 14-residue peptide
      was intermediate in efficacy. The rate of binding to the liposomes was compared
      with the three peptides by measurements of the kinetics of energy transfer from
      the single tryptophan residue of the peptides to a fluorescent probe in the
      bilayer interior. The tryptophan residue of the ten residue peptide effectively
      transferred energy to the probe, while that of the 14-residue peptide was less
      effective. Little or no energy transfer was observed with the 17-residue peptide.
      The binding of the 10 residue peptide was rapid and complete within < 100 ms. The
      14-residue peptide bound more slowly, but still within seconds. The time frames
      for binding are an order of magnitude shorter than those observed for lipid
      clearing. The relationship between peptide length, liposome clearing and lipid
      binding kinetics is discussed in terms of a possible competing peptide-peptide
      interaction in the aqueous phase and a slow rearrangement of the lipid bilayer.

PMID- 8481391
TI  - Incorporation of stearic acid (18:0) and palmitic acid (16:0) in phospholipid
      molecular species studied in isolated rat liver cells.
AB  - The incorporation of [1-14C]16:0 and [1-14C]18:0 in the molecular species of PC
      and PE in isolated rat liver cells was studied. More [14C]18:0 than [14C]16:0 was
      esterified both in PC and PE. Also the chain elongated and desaturated products
      (16:1, 18:0 and 18:1) were incorporated. The main molecular phospholipid species
      formed from [14C]18:0 were 18:0-18:2, 18:0-20:4 and 18:0-22:6. 18:0-18:0 species
      was not detected, independent of the substrate concentration (0.1-0.9 mM). With
      [14C]16:0 at low substrate concentration (0.1 mM) the dominating species are 16:0
      18:2, 16:0-20:4 and 16:0-22:6. These species were detected already after 10 min.
      The same main species are formed both in PC and PE, but the relative amounts
      differ. In PC the combination with 18:2 is most abundant for both saturated fatty
      acid substrates. In PE 18:0-20:4 dominates when 18:0 is the substrate, and 16:0
      22:6 when 16:0 is. At higher substrate concentrations (0.4-0.9 mM) 16:0 is also
      esterified in 16:0-16:0. This molecular species is efficiently degraded in the
      cells within 2-3 h, in contrast to the other species formed. The results suggest
      that 16:0 and 18:0 are directly incorporated in the sn-1 position in
      physiologically important phospholipid molecular species. With an excess of 16:0,
      16:0-16:0 is also formed in substantial amounts, but this uncommon species is
      thereafter removed.

PMID- 8481392
TI  - Inhibition of oxidized low-density lipoprotein metabolism in macrophage J774 by
      helvolic acid.
AB  - The antibiotic helvolic acid inhibited cholesteryl ester accumulation in
      macrophage J774 treated with oxidized low-density lipoprotein (LDL) at a
      concentration of 50-350 microM. The agent reduced oxidized 125I-LDL degradation
      and [14C]oleate incorporation into cholesteryl ester. In a cell-free assay, ATP
      dependent acidification of endosomes and lysosomes was significantly inhibited by
      35 microM helvolic acid, suggesting that this activity accounts for the
      inhibition of oxidized LDL metabolism in the macrophages.

PMID- 8481393
TI  - Characterization of the in vitro conversion of dolichol to dolichoate in bovine
      thyroid.
AB  - The enzymic conversion of dolichol into dolichoic acid has been studied in bovine
      thyroid subcellular fractions using [1-3H]dolichol as a substrate. The presence
      of conversion activity could be demonstrated in both the mitochondrial- and
      supernatant fractions. Investigation of cofactor requirements revealed that NAD+
      was essential for reaching optimal activity. From kinetic studies Km-values of
      3.5-4 microM and 0.29 mM could be calculated for, respectively, dolichol and NAD+
      using the mitochondrial fraction as an enzyme source. No inhibitory effects from
      ethanol or pyrazole were detected suggesting that alcohol dehydrogenase is not
      involved in the dolichol-->dolichoate conversion as observed in a bovine thyroid
      mitochondrial fraction. From inhibitor studies the conversion system behaves
      distinctly differently from the NADP(+)-depending microsomal oxidoreductase as
      well as from catalase. The conversion activity in the supernatant on the other
      hand must be ascribed, at least partially, to a side activity of alcohol
      dehydrogenase.

PMID- 8481394
TI  - Preparation and characterization of spheroidal, reconstituted high-density
      lipoproteins with apolipoprotein A-I only or with apolipoprotein A-I and A-II.
AB  - This study describes the preparation of spheroidal reconstituted HDL which
      contain apolipoprotein (apo) A-I only, (A-I w/o A-II) r-HDL, or apo A-I and apo A
      II, (A-I w A-II) r-HDL. Spheroidal (A-I w/o A-II) r-HDL with diameters of 8.0,
      9.2 and 11.2 nm were prepared by incubating discoidal (A-I w/o A-II) r-HDL with
      lecithin-cholesterol acyltransferase and low-density lipoproteins. Spheroidal (A
      I w A-II) r-HDL were prepared by displacing apo A-I from spheroidal (A-I w/o A
      II) r-HDL with apo A-II. Modification with apo A-II did not significantly affect
      the diameters of the 8.0 and 9.2 nm (A-I w/o A-II) r-HDL. When, however, apo A-II
      was added to the (A-I w/o A-II) r-HDL of diameter 11.2 nm, the size of the
      particles decreased to 9.4 nm. To determine whether modification of (A-I w/o A
      II) r-HDL with apo A-II altered the structure of the r-HDL, the packing of
      phospholipids in the modified and unmodified particles was compared by steady
      state fluorescence polarization and the environments of the apo A-I tryptophan
      residues in (A-I w/o A-II) and (A-I w A-II) r-HDL were compared by fluorescence
      spectroscopy. The results of these studies suggested that modification of
      spheroidal (A-I w/o A-II) r-HDL with apo A-II alters the environment of apo A-I
      tryptophan residues in small, but not large, r-HDL and does not affect the
      packing of phospholipids.

PMID- 8481395
TI  - Is there a specific lysophospholipase in human pancreatic juice?
AB  - The existence of a specific lysophospholipase in human pancreatic juice was
      evaluated. The proteins were separated by a series of chromatographic steps
      including Sephacryl S-200, cholate-Sepharose 4B, Sephadex G-100 and CM-Sephadex G
      50. The enzyme activities against 1-palmitoyl lysolecithin (LL) as well as
      tributyrin (TB) and p-nitrophenyl butyrate (PNPB) were determined in all the
      fractions of these purification procedures. Enzyme activity against LL was always
      eluted in parallel with activities against TB and PNPB, and no unique activity
      against LL could be found. The specific activity against LL was 40-times lower
      than that against PNPB and 200-times lower than that against TB. It is concluded
      that there is no unique lysophospholipase in human pancreatic juice and that the
      hydrolysis of lysolecithin is most likely performed by carboxyl ester lipase.

PMID- 8481396
TI  - The interaction between beta-carotene and lipoxygenase in plant and animal
      systems.
AB  - The effect of beta-carotene (BC) on the activity of lipoxygenase (LOX) from plant
      and animal sources has been examined. Soybean lipoxygenase L-2 activity towards
      linoleate was inhibited by BC by a maximum of 70% at pH 6.5, whereas L-1 activity
      was little affected at pH 9.0. Lineweaver-Burk plots indicated that BC inhibited
      LOX activity by mixed competitive/non-competitive mechanisms. Other hydrophobic
      compounds also inhibited LOX activity; oleic acid and retinol were competitive
      inhibitors whereas tocopherol acetate and 5,8,11,14-eicosatetraynoic acid (ETYA)
      were non-competitive inhibitors. Binding studies with L-2 LOX bound to Sepharose
      indicated BC-binding and inhibition with the immobilized LOX. Activity of LOX
      from animal sources was also inhibited by BC both towards linoleate and
      arachidonate.

PMID- 8481397
TI  - Regulation of synthesis of lactosylceramide in normal and tumor proximal tubular
      cells.
AB  - We have measured the binding and degradation of low-density lipoprotein (LDL) and
      LDL-mediated effects on cholesteryl ester (CE) synthesis in cultured normal and
      tumor proximal tubular (PT) cells. The effects of LDL on the regulation of
      glycosphingolipid metabolism in cells was pursued employing radioactive
      precursors, e.g., [3H]serine, and [3H]glucose and by measuring the activity of
      UDP-galactose: glucosylceramide: B1-4 galactosyltransferase (GalT-2). In normal
      PT cells, there was a saturable and displaceable binding and degradation of 125I
      LDL and a LDL mediated 14-fold stimulation of cholesteryl ester (CE) synthesis.
      This was accompanied by a suppression (70-80%) of incorporation of [3H]glucose
      and [3H]serine into GlcCer, LacCer, GbOse3Cer and GbOse4Cer and suppression (70
      80%) of GalT-2 activity. In tumor PT cells, displaceable binding and degradation
      of 125I-LDL was not observed and LDL failed to stimulate CE synthesis. In such
      cells, LDL exerted a concentration-dependent stimulation of [3H]glucose and
      [3H]serine incorporation into GSL. Maximum stimulation (250%) of GalT-2 activity
      in tumor PT cells occurred with 25 micrograms LDL/ml medium. We conclude that LDL
      taken up via receptor mediated pathway decreases GaIT-2 activity in normal PT
      cells. In contrast, LDL not taken up via the LDL receptor pathway in tumor PT
      cells failed to suppress the incorporation of [3H]glucose and [3H]serine into
      glycosphingolipids and GalT-2 activity leading to a stimulation of
      lactosylceramide synthesis.

PMID- 8481398
TI  - Reaction of aspirin with cysteinyl residues of lens gamma-crystallins: a
      mechanism for the proposed anti-cataract effect of aspirin.
AB  - Incubation of lens crystallins with aspirin inhibits the development of opacities
      caused by cyanate. Cyanate-induced opacities are thought to be due to
      carbamylation of the lysyl residues which causes a decrease in the protein charge
      and subsequent conformational changes that permit disulfide bonding. Because
      aspirin can also react with lysyl residues, it has been proposed that the aspirin
      inhibition of cataractogenesis is due to acetylation of the lysyl residues which
      would block their reaction with cyanate. However, acetylation of lysyl residues
      also lowers the protein charge and would be expected to effect changes in protein
      conformation similar to those caused by carbamylation. Therefore, acetylation of
      the lysyl residues is not a satisfactory explanation for the inhibitory effect of
      aspirin on lens opacification. Our investigations of the reactions of cyanate and
      aspirin with bovine gamma II-crystallins show that the cysteinyl residues are
      also carbamylated and acetylated at pH 7.4. At this pH, the carbamylation at the
      cysteinyl residues is reversible, leading to regeneration of the thiol group and
      disulfide bonding. In contrast, the acetylation at cysteinyl residues is stable
      at pH 7.4 and can prevent disulfide bonding. This difference in stability
      explains how cyanate promotes, and aspirin inhibits, cataractogenesis.

PMID- 8481399
TI  - Phospholipid synthesis in the lymphomatous mouse liver studied by 31P nuclear
      magnetic resonance spectroscopy in vitro and by administration of 14C
      radiolabelled compounds in vivo.
AB  - High phosphomonoester to ATP ratios have been found in 31P magnetic resonance
      spectra from livers of patients with hepatic lymphoma (Dixon et al. (1990) Br. J.
      Cancer 63, 953-958). The present study of a murine lymphoma showed that the
      phosphomonoester in the lymphomatous liver was largely phosphoethanolamine, which
      is an intermediate of phospholipid metabolism. A significant positive correlation
      was found between the concentration of phosphoethanolamine, measured by high
      resolution 31P nuclear magnetic resonance spectroscopy of extracts, and the
      degree of infiltration, assessed by quantitative histology. The
      phosphoethanolamine concentration reached about 10 times its normal level, but
      the phosphocholine concentration remained the same as in the normal liver.
      Radiolabelling studies showed that while the rate of phosphoethanolamine
      synthesis from exogenous [14C]ethanolamine was higher in the lymphomatous mouse
      liver than in control livers, the rate of phosphatidylethanolamine synthesis was
      lower in the lymphomatous liver. The rate of phosphatidylcholine synthesis in
      lymphoma-bearing livers was not significantly different from that in control
      mouse livers.

PMID- 8481400
TI  - Comparison of baculovirus-expressed c-Abl and BCR/ABL protein tyrosine kinases.
AB  - Mouse c-Abl type IV and human BCR/ABL proteins have been expressed in insect
      cells using the baculovirus system. The proteins were expressed as full-length
      polypeptides as judged by electrophoresis in denaturing gels. They were
      identified by immunoprecipitation and immunoblotting with antibodies against ABL
      peptides and, for BCR/ABL, against a BCR peptide. In these immunoprecipitates
      both proteins gave autophosphorylation principally on tyrosine. Both proteins
      were active tyrosine kinases, phosphorylating a variety of tyrosine-containing
      substrates. In fresh extracts both proteins contained phosphotyrosine as shown by
      Western blots with antiphosphotyrosine antibodies. Partial purification could be
      achieved readily using ion exchange columns, and the BCR/ABL protein,
      p210BCR/ABL, could be further purified to near-homogeneity using an
      antiphosphotyrosine column. Both enzymes required a divalent metal ion for
      activity. At low concentrations of ATP (2 microM) and with angiotensin II as
      substrate both enzymes were activated by Mn2+ or by Mg2+. No major differences in
      catalytic properties were found between the two isolated enzymes in solution. The
      oncogenic properties of p210BCR/ABL may be due to its different subcellular
      location, or to the presence of an intracellular inhibitor of c-Abl that does not
      inhibit BCR/ABL, or to altered substrate-specificity such that it can
      phosphorylate a unique substrate which is not recognised by c-Abl.

PMID- 8481401
TI  - Rapid screening method of abnormal insulin-receptor gene expression: allele
      specific oligonucleotide hybridization by using silent polymorphisms.
AB  - An asymmetrical reduction in the levels of the insulin receptor mRNA transcribed
      from one allele was reported in some patients with severe insulin resistance and
      non-insulin-dependent diabetes mellitus (NIDDM). To detect this abnormality, we
      designed the less laborious method; Allele-specific oligonucleotide hybridization
      of the amplified mRNA (cDNA) by using silent polymorphisms in the insulin
      receptor gene (nucleotide positions at 1686 and 1698). The allelic frequencies of
      C-1686 and T-1686 were 0.63 and 0.37, respectively (0.60 and 0.40 in 10 normal
      subjects, and 0.67 and 0.33 in 20 NIDDMs; n.s.). Similarly, the allelic
      frequencies of A-1698 and G-1698 were 0.47 and 0.53, respectively (0.50 and 0.50
      in the normal subjects, and 0.45, and 0.55 in the NIDDMs; n.s.). These results
      suggest that these two polymorphisms are very common in Japanese. Nineteen (64%)
      out of 30 cases are heterozygous at one or two position(s), suggesting that it is
      possible to distinguish the mRNA transcribed from each of two alleles of the
      insulin receptor gene with using allele-specific oligonucleotide hybridization.
      Although we successfully measured the ratio of mRNA expression from two alleles
      of the gene in 20 NIDDMs, there was no patient whose mRNA transcribed from one
      allele of the insulin receptor gene was extremely decreased. We showed that
      allele-specific oligonucleotide hybridization method is useful for the screening
      of abnormal insulin-receptor gene expression.

PMID- 8481402
TI  - Effect of increased gene dosage expression on the alpha-interferon receptors in
      Down's syndrome.
AB  - The gene coding for the alpha, beta-interferon (alpha, beta-IFN) receptor is
      localized to chromosome 21. Cells from patients with Down's syndrome contain an
      extra chromosome 21, and thereby an expected 1.5-times increase in the number of
      genes located to this chromosome and in consequence a 1.5-times increase in cell
      surface alpha-IFN receptors. Actual measurements of these by competition binding
      experiments with human recombinant alpha-IFN on peripheral blood mononuclear
      cells (PBMC) from patients with Down's syndrome resulted in a mean of 1.69, which
      is in accordance to the theoretical 1.50, but slightly overestimated due to the
      calculation method. The increased gene dosage of the alpha-IFN receptor was
      quantitatively verified by Southern blot-hybridizations. Further characterization
      of alpha-IFN receptor binding showed insignificant differences in dissociation
      constants among patients and healthy individuals.

PMID- 8481403
TI  - Glomerular thromboxane A2/prostaglandin H2 receptors: characterization and effect
      of adriamycin-induced nephrotic syndrome.
AB  - We have characterized the thromboxane (TX) A2/prostaglandin (PG) H2 receptor in
      glomeruli isolated from the rat using the agonist radioligand [125I]-BOP. Binding
      of [125I]-BOP was highly specific, stereoselective, and to a single class of high
      affinity binding sites (Kd = 1.16 +/- 0.22 nM and Bmax = 348 +/- 32 fmol/mg
      protein; n = 6). Binding of [125I]-BOP was competed for by the agonist ONO11113
      (Kd = 50.8 +/- 8.0 nM; n = 4) and the antagonists SQ29548 (Kd = 15.8 +/- 1.0 nM;
      n = 3), L657925 (Kd = 12.1 +/- 2.2 nM; n = 3) and L657926 (Kd = 1642 +/- 135 nM;
      n = 3). I-BOP also produced a TXA2/PGH2 receptor-mediated rise in [Ca2+]i in
      isolated glomeruli In adriamycin-induced nephrotic syndrome in the rat, the
      development of proteinuria is reported to be dependent on increased renal TXA2
      production. We therefore examined whether or not changes in glomerular TXA2/PGH2
      receptors occur between control and nephrotic rats. No changes in expression or
      affinity of either glomerular or platelet TXA2/PGH2 receptors were observed. Kd
      and Bmax values for isolated glomeruli were 1.45 +/- 0.24 nM and 406 +/- 72
      fmol/mg for controls and 1.22 +/- 0.25 nM and 321 +/- 62 fmol/mg for nephrotic
      rats (n = 6).

PMID- 8481404
TI  - Applications of biotinylated V3 loop peptides of human immunodeficiency virus
      type 1 to flow cytometric analyses and affinity chromatographic techniques.
AB  - A principal neutralizing determinant of human immunodeficiency virus type 1 (HIV
      1) lies within the V3 loop of gp120, the external major envelope glycoprotein. V3
      loop peptides derived from two HIV-1 strains, HTLV-III BH-10 (V3-BH10) and LAVELI
      (V3-ELI), were synthesized and biotinylated. The binding of both biotinylated V3
      BH10 and V3-ELI to the surfaces of MOLT-4 clone 8 cells was demonstrated by flow
      cytometric analyses. Both the peptides (more than 2 microM) bound to the cells (2
      x 10(5) in a dose-dependent manner. The binding of biotinylated V3-BH10 was
      specifically inhibited by a neutralizing monoclonal antibody (0.5 beta). The
      binding of both of the biotinylated V3 loop peptides was enhanced by the addition
      of unlabeled V3-BH10. In addition, the peptides were employed as ligands on
      affinity columns. A major V3 loop binding protein (V3BP) was purified from the
      membrane soluble fraction of MOLT-4 cells by successive application to two
      different V3 loop columns. V3BP consisted of two major polypeptides (32 and 33
      kDa). The SDS-PAGE profile of V3BP did not change under non-reducing conditions,
      but only a single band was observed after analysis on native PAGE. The major peak
      of the eluate as determined by size exclusion chromatography was broad and the
      estimated relative molecular mass was much larger than 33 kDa, suggesting that
      V3BP comprises several subunits. Taken together, we confirmed that the V3 loop
      peptides are useful in the characterization of V3BP(s) of which they are
      conformational ligands.

PMID- 8481405
TI  - Decreased catalase activity is the underlying mechanism of oxidant susceptibility
      in glucose-6-phosphate dehydrogenase-deficient erythrocytes.
AB  - Historically, it has been theorized that the enhanced oxidant sensitivity of
      glucose-6-phosphate dehydrogenase (G6PD)-deficient erythrocytes arises as a
      direct consequence of an inability to maintain cellular glutathione (GSH) levels.
      This study alternatively hypothesizes that decreased NADPH concentration leads to
      impaired catalase activity which, in turn, underlies the observed oxidant
      susceptibility. To investigate this hypothesis, normal and G6PD-deficient
      erythrocytes and hemolysates were challenged with a H2O2-generating agent. The
      results of this study demonstrated that catalase activity was severely impaired
      upon H2O2 challenge in the G6PD-deficient cell while only a transient decrease
      was observed in normal cells. Supplementation of either normal or G6PD-deficient
      hemolysates with purified NADPH was found to significantly (P < 0.001) inhibit
      catalase inactivation upon oxidant challenge while addition of NADP+ had no
      effect. Analysis of these results demonstrated direct correlation between NADPH
      concentration and catalase activity (r = 0.881) and an inverse correlation
      between catalase activity and erythrocyte oxidant sensitivity (r = 0.906). In
      contrast, no correlation was found to exist between glutathione concentration (r
      = 0.170) and oxidant sensitivity. Analysis of NADPH/NADPt ratio in acatalasemic
      mouse erythrocytes demonstrated that NADPH maintenance alone was not sufficient
      to explain oxidant resistance, and that catalase activity was required. This
      study supports the hypothesis that impaired catalase activity underlies the
      enhanced oxidant sensitivity of G6PD-deficient erythrocytes and elucidates the
      importance of NADPH in the maintenance of normal catalase activity.

PMID- 8481406
TI  - The activity of wheat gliadin peptides in in vitro assays for coeliac disease.
AB  - A fraction of a peptic-tryptic-pancreatinic digest of wheat gliadin (fraction 9),
      known to be toxic to individuals with coeliac disease, together with synthetic
      peptides containing key gliadin sequences, were tested for their effects on
      foetal chick intestine and on rat liver lysosomes. Fraction 9 and a dodecapeptide
      corresponding to residues 75-86 of A-gliadin (RPQQPYPQPQPQ) were the only
      peptides to display appreciable activity in both assays. A synthetic hexapeptide
      corresponding to residues 77-82 was only weakly toxic to lysosomes and non-toxic
      to chick duodenum. A decapeptide corresponding to residues 76-85 was non-toxic in
      both assays. Two serine-containing peptides containing the key sequence PSQQ were
      also tested but were found to be non-toxic, as was the hexapeptide PSQQQP. The
      results suggest that the key sequences QQQP and PSQQ are not sufficient by
      themselves to cause activity. Further tests on synthetic peptides will be
      necessary to define the sequences of highest toxicity.

PMID- 8481407
TI  - Isolation and purification of a squamous cell carcinoma of the head and neck
      associated antigen identified by autologous antibody.
AB  - We have previously shown that detection of autologous antibody activity to
      squamous cell carcinoma of the head and neck may be augmented by dissociation of
      immune complexes. Western blot analysis with autologous antibody has identified a
      60 kDa squamous cell carcinoma of the head and neck-associated antigen in spent
      media and immune complex-dissociated serum ultrafiltrate not recognized by normal
      human sera. Antigen-containing fractions of spent media were eluted from anion
      exchange columns immediately after serum albumin indicating that the antigen has
      an acidic pI < 4. Preparative purification of the squamous cell carcinoma antigen
      was accomplished by anion exchange of concentrated spent media (protein
      concentration 300 mg/ml) followed by lectin affinity chromatography with a
      Triticum vulgaris column. A single 60 kDa band was detected by silver stain and
      Western blot in antigen-containing fractions eluted following lectin affinity
      chromatography and SDS-PAGE. Final concentration of the antigen was determined to
      be 1 microgram/ml of protein with relative activity increased 1600 x over
      unfractionated spent media. We conclude that a squamous cell carcinoma of the
      head and neck-associated antigen, detected by autologous antibody, is an acidic
      60 kDa glycoprotein.

PMID- 8481409
TI  - Study of intracellular deposition of the anti-leprosy drug clofazimine in mouse
      spleen using laser microprobe mass analysis.
AB  - Laser microprobe mass analysis (LAMMA) was used to study the composition of the
      brick-red crystalline material which had accumulated in the spleen of mice that
      had received the anti-leprosy drug Clofazimine in their diet for several months.
      The crystalline deposits light-microscopically resembled pure Clofazimine
      crystals. The presence of the drug in the crystals was indicated by LAMMA by the
      appearance of the chloride mass peaks in the negative mass spectra. More specific
      information was obtained from the positive mass spectra. A mass signal for the
      protonated molecule was present.

PMID- 8481408
TI  - A novel mutation in erythropoietic protoporphyria: an aberrant ferrochelatase
      mRNA caused by exon skipping during RNA splicing.
AB  - An aberrant ferrochelatase mRNA lacking exon 10 was found in a patient with
      erythropoietic protoporphyria (EPP). In her genomic DNA an A-->T transversion at
      position -3 of the donor site of intron 10 appeared to be responsible for the
      exon skipping. Both the patient and her sister were heterozygous for this
      mutation.

PMID- 8481410
TI  - Identification with liquid chromatography-ionspray mass spectrometry of the
      metabolites of the enantiomers N-methyl dextrorphan and N-methyl levorphanol
      after rat liver perfusion.
AB  - To gather more information on stereochemical factors in the hepatic disposition
      of organic cations, mass spectrometry coupled to liquid chromatography was used
      to determine the identity of the metabolites excreted in bile after isolated rat
      liver perfusions with the quaternary ammonium derivatives of the enantiomeric
      drugs dextrorphan and levorphanol. Ionspray mass spectrometry was chosen for its
      soft ionization and absence of thermal degradation of labile compounds. The drugs
      were labelled with a stable (2H) isotope and mixed with unlabelled drugs to
      create an artificial isotope pattern in the mass spectrum and facilitate the
      recognition of unknown metabolites. In mass spectra that were recorded under
      normal conditions, fragmentation was absent and metabolites of N-methyl
      dextrorphan and N-methyl levorphanol were visible as parent-ion 'doublets'.
      Collision-induced fragmentation studies were performed to support the
      identification of the metabolites. For N-methyl dextrorphan the glucuronide, the
      glutathione conjugate and the glucuronide of the N-demethylated metabolite were
      found in bile. For N-methyl levorphanol the glucuronide, the glutathione
      conjugate, the sulphate conjugate and the glucuronide of a hydroxylated N-methyl
      levorphanol were excreted in bile. Thus a remarkable stereoselectivity occurs in
      the metabolism of these quaternary ammonium compounds in the rat liver.

PMID- 8481411
TI  - Determination of amphetamine, methamphetamine and desmethyldeprenyl in human
      plasma by gas chromatography/negative ion chemical ionization mass spectrometry.
AB  - A sensitive and specific assay for the quantitative determination of amphetamine,
      methamphetamine and desmethyldeprenyl in human plasma specimens is described.
      Electron capture/negative ion chemical ionization gas chromatography/mass
      spectrometry is used to determine the extracted plasma concentrations of the
      three target compounds as their N-heptafluorobutyryl derivatives. Quantitation is
      performed by stable isotope dilution using d6-amphetamine and d6-methamphetamine
      as internal standards. Selected ion monitoring of the [M-HF]- ions of both the
      analytes and internal standards results in minimum quantifiable limits of 0.10 ng
      ml-1 for both amphetamine and methamphetamine and 0.25 ng ml-1 for
      desmethyldeprenyl. Excellent linearity (r = 0.998) up to at least 5.00 ng ml-1 is
      demonstrated.

PMID- 8481412
TI  - Electrospray ionization of selected low-molecular-weight natural biotoxins.
AB  - Electrospray ionization (ESI) spectra were acquired for several low-molecular
      weight marine and freshwater biotoxins. Spectra were dominated by ions that
      represented protonated molecules, contained few other ions, and corresponded well
      with spectra acquired by other soft ionization techniques. Each biotoxin was
      successfully analyzed using similar ESI conditions. Nozzle-skimmer differential
      voltage greatly influenced spectra of several compounds by enhancing collision
      induced dissociation in the transport region of the ESI source.

PMID- 8481413
TI  - Determination of serum cholesterol by stable isotope dilution method using
      discharge-assisted thermospray liquid chromatography/mass spectrometry.
AB  - A discharge-assisted thermospray (plasmaspray) liquid chromatography/mass
      spectrometric method for the determination of total serum cholesterol is
      described. The method incorporates stable isotope dilution using (3,4
      13C)cholesterol as an internal standard. Liquid chromatographic separation is
      performed using methanol as a flow solvent and effluents are directly introduced
      to the mass spectrometer. [MH-H2O]+ ions are monitored during liquid
      chromatography/mass spectrometry using the selected ion monitoring method.
      Satisfactory agreement between the analytical result and the certified value of
      the National Institute of Standards and Technology (formerly National Bureau of
      Standards) standard reference material serum is obtained with a relative standard
      deviation of 0.6%.

PMID- 8481414
TI  - Testing for prostate cancer.

PMID- 8481415
TI  - ESRD: pay now or pay later.

PMID- 8481416
TI  - Virginia's 'bold step' eases access for the uninsured.

PMID- 8481417
TI  - Medical center hour: breaking the bad news.

PMID- 8481418
TI  - 'Reform': practical solutions or political gain?

PMID- 8481419
TI  - Antitrust laws and the business of insurance.

PMID- 8481420
TI  - End stage kidney disease: increasing incidence in Virginia.
AB  - The incidence of new cases of end stage renal disease (ESRD) in Virginia
      increased an average of 14.5% annually from 1988 through 1991, producing a
      parallel increase in expenditures for the ESRD program. Hypertension (34%) and
      diabetes mellitus (32%) are the most frequent causes of ESRD in Virginia, with
      highest incidence among Afro-Americans and the elderly. Physicians should be
      aware of those at risk for ESRD so that reversible causes of renal failure can be
      identified and corrected. In addition, they should know which drugs to prescribe
      and which to avoid. Better detection and management of high blood pressure and
      diabetes mellitus can slow progressive renal failure and make a difference in the
      incidence of ESRD in Virginia during the coming years.

PMID- 8481421
TI  - Free radicals: only part of the story?

PMID- 8481422
TI  - Cerebral blood flow in patients with dementia of Alzheimer's type.
AB  - In the normal brain as well as in Alzheimer's disease (AD), regional cerebral
      blood flow (CBF) is coupled to metabolic demand and, therefore, changes in CBF
      reflect variations in neuronal metabolism. The use of radionuclide techniques,
      such as positron emission tomography (PET) and single photon emission computed
      tomography (SPECT), provides an accurate assessment of regional functional
      activity, i.e., CBF and metabolism, and could be very helpful for the
      differential diagnosis of AD. This disease is characterized by a decrease in
      global CBF and metabolism. When found, a symmetric bi-parieto-temporal CBF
      reduction is highly diagnostic for AD, despite the fact that a similar CBF
      pattern could also be observed in other types of dementia. Many AD patients with
      parieto-temporal flow reduction also have a diffuse flow reduction in the frontal
      cortical areas, particularly in advanced stages of the disease. Lateral CBF
      asymmetry is also very frequent; speech disorders are highly characteristic of
      left-sided flow reduction, while visuospatial apraxia is dominating in the right
      sided cases. In advanced and severe cases of AD, CBF and metabolism tend to be
      more uniformly reduced throughout the cortex, sparing only the primary visual and
      sensory-motor cortices. PET and SPECT measurement of brain perfusion and
      metabolism has added a new dimension to the knowledge of dementia disorders, with
      a better differential diagnosis between AD and other forms of dementia. The
      correlation with neuropsychological data has also given new insight into the
      disease.

PMID- 8481423
TI  - Established populations for epidemiologic studies of the elderly: study design
      and methodology.
AB  - A project initiated by the intramural Epidemiology, Demography and Biometry
      Program of the National Institute on Aging, entitled "Established Populations for
      Epidemiologic Studies of the Elderly" (EPESE), has developed information on
      death, chronic conditions, disabilities, and institutionalization for
      representative samples of elderly people living in communities. The EPESE
      consists of prospective epidemiologic studies of approximately 14,000 persons 65
      years of age and older in four different communities: East Boston, Massachusetts;
      two rural counties in Iowa; New Haven, Connecticut; and segments of five counties
      in the north-central Piedmont area of North Carolina. The study design includes
      an initial baseline household interview followed by continued surveillance of
      morbidity and mortality. Participants are re-contacted annually in conjunction
      with the collection of data on cause of death and factors related to
      hospitalization and nursing home admissions. Concurrently, the investigators
      developed substudies focused on specific problems of the elderly. The value of
      this research lies in the longitudinal design which allows for analyses aimed at
      identifying risk factors of diseases, disabilities, hospitalizations,
      institutionalization, and mortality.

PMID- 8481424
TI  - Circadian secretion of melatonin and thyrotropin in hospitalized aged patients.
AB  - Alterations in periodical functions are known to occur in aging and may be
      regarded as markers of the aging process itself. Melatonin and Thyroid
      Stimulating Hormone (TSH) circadian periodicities were studied in 22 aged
      subjects and in 13 adult controls. The study of rhythmicity was performed by the
      Cosinor analysis. Elderly subjects were hospitalized because of various
      concomitant diseases. Circadian periodicity of both hormones was disrupted in the
      aged group, and the deterioration of melatonin periodicity was significantly
      correlated with the decay in cognitive functions, quantified by the Mini Mental
      State evaluation. Diabetes was also found to affect, though not significantly,
      melatonin, but not TSH, periodicity. Melatonin and TSH nocturnal peaks were
      decreased in aged people. TSH oscillation amplitudes were inversely correlated
      with age. No correlation was found between melatonin and TSH secretory features
      both in adult and in aged subjects.

PMID- 8481425
TI  - Body composition and its relation to bone mass and fractures in an urban and a
      rural population.
AB  - A higher incidence of fragility fractures in urban than in rural populations has
      been described. The present study included 954 randomly selected men and women
      between the ages of 40 to 80 years living in the cities of Malmo, an urban
      population, and Sjobo, a typical agricultural community. Lean body mass (LBM) was
      estimated with a bioelectrical impedance method; bone mineral content (BMC) of
      the forearm was evaluated by single photon absorptiometry, and strength of the
      quadriceps, and hamstring muscles of the right knee, and hand grip were measured.
      The age-related difference in LBM between the ages of 50 to 80 were 7.8 kg in men
      and 2.9 kg in women. Urban men aged 60 and 70, and women aged 50 and 70 had a 1.8
      to 3.7 kg lower LBM than rural subjects. One hundred women (17%) and 28 men (11%)
      had experienced fragility fractures. Women aged 70 with fragility fractures had
      3.1 kg lower LBM than women without fractures, and the age-dependent difference
      in LBM was greater in the urban and rural women with fracture, than in women
      without fracture. LBM showed a higher correlation to BMC, in the range of 0.20
      0.28, than the correlation between body weight and BMC. Quadriceps muscle
      strength was lower in the elderly age groups in both sexes, and a 40% decline was
      seen both in those from the highest and lowest quartiles of LBM. Use of LBM
      instead of body weight showed higher correlations to flexion strength of the knee
      and hand grip.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481426
TI  - Bone mineral density in relation to anthropometric properties, physical activity
      and smoking in 75-year-old men and women.
AB  - Bone mineral content (BMC, g.cm-2) and density (BMD, g.cm-3) were studied in 75
      year-old men and women in relation to anthropometric and certain life-style
      factors. This study covered all the men and women born in 1914 who were residents
      in the city of Jyvaskyla in 1989 (N = 388). A hundred and three men and 188 women
      participated in bone measurements performed at the calcaneus using a 125I-photon
      absorption method. BMC was on average 36% and BMD 17% higher in the men than in
      the women. BMC and BMD associated with body mass in both sexes, and with body fat
      and use of estrogen in the women. There was a negative correlation between the
      BMD values and the number of cigarettes smoked over the entire life course in
      both sexes. Moderate physical activity was related to higher BMC in men. Men and
      women who had been physically active earlier in their life tended to show higher
      BMD values than those who had been more sedentary.

PMID- 8481427
TI  - Mutations of mitochondrial DNA support human aging.

PMID- 8481428
TI  - [Encrusted ulcerated lesion after a burn].

PMID- 8481429
TI  - [Paramandibular mass in a diabetic woman].

PMID- 8481430
TI  - [Acute, symmetrical polyarthritis as a manifestation of Staphylococcus aureus
      sepsis in a hemodialyzed patient].

PMID- 8481431
TI  - [Clear-fluid meningitis in a patient with boutonneuse fever].

PMID- 8481432
TI  - [Surgical wound infection and empyema caused by Pasteurella multocida].

PMID- 8481433
TI  - [The toxic shock syndrome: apropos of a case].

PMID- 8481434
TI  - [Alopecia and albendazole].

PMID- 8481435
TI  - [Outbreak of familial botulism].

PMID- 8481436
TI  - [Efficacy of cefsulodin -irgasan-novobiocin agar media in the isolation of
      Aeromonas mesophiles from feces].

PMID- 8481437
TI  - [The Tween-80 test in the identification of Moraxella catarrhalis].

PMID- 8481438
TI  - [Experimental model of Lyme disease in rats].
AB  - BACKGROUND: An experimental model in rats can contribute to the understanding of
      the pathogenesis and improvement of treatment of Lyme borreliosis. OBJECTIVE: To
      develop a Lyme arthritis experimental model in Sprague-Davies rats. MATERIAL AND
      METHODS: An intraperitoneal inoculation of Borrelia burgdorferi in three groups
      of Sprague-Davies rats was made. The first group was inoculated with dead B.
      burgdorferi. The second group was inoculated with low virulence B-31 B.
      burgdorferi. The third group was inoculated with high virulence B-297 B.
      burgdorferi. RESULTS: After six months of follow-up, none of the rats in the
      first two groups presented arthritis whereas in the third group 18 rats (72%)
      developed arthritis in one or more joints. Histologic showed synovial hypertrophy
      and inflammatory infiltration composed of polymorphonuclear leukocytes, plasma
      and mast cells in the infected joint. B. burgdorferi was isolated in the liver
      and spleen cultures taken 14 days after inoculation in 40% of the rats inoculated
      with B-297 strain. CONCLUSION: An easy and inexpensive experimental model of Lyme
      arthritis in rats has been developed.

PMID- 8481439
TI  - [Perinatal Streptococcus agalactiae infections. Clinical epidemiological study
      and evaluation of a prevention program].
AB  - BACKGROUND: To prove both the importance of SGB (group B streptococci) as a cause
      of perinatal infection and the efficacy of a prophylactic treatment in pregnant
      women with cervicovaginal colonization by SGB. METHODS: Retrospective study of
      197 third trimester pregnant women who were carriers of SGB (155 received
      intrapartum prophylaxis) and of 44 patients with SGB infections during pregnancy,
      post-partum and neonatal periods. RESULTS: No neonatal sepsis was detected in the
      group of SGB carrier mothers who received antibiotic prophylaxis. In carrier
      pregnant women who did not receive prophylaxis, one case of neonatal sepsis by
      SGB was detected and a greater prevalence of intrapartum fever, and neonatal
      infection with negative cultures was observed. SGB was frequently isolated as a
      cause of early sepsis and neonatal meningitis (13 cases), intraamniotic infection
      (12 cases) and puerperal endometritis (8 cases). In 45% of the patients with
      perinatal infections by SGB, the cervicovaginal culture performed in the third
      trimester of pregnancy did not detect the presence of SGB. CONCLUSIONS: The
      administration of intrapartum ampicillin to pregnant SGB carriers permits the
      prevention of perinatal infections by this microorganism in a great number of
      patients, although the possibility of late colonization, which may not be
      detected during pregnancy, stil remains.

PMID- 8481440
TI  - [Application of PCR for the detection of mutations in the genes coding for beta
      lactamases].
AB  - BACKGROUND: The purpose of this study was to develop a satisfactory technique to
      detect punctual mutations in blaTEM genes. METHODS: The strains [E. coli HB 101
      pBR322 (TEM-1), E. coli J62 RP4 (TEM-2)] were submitted to PCR with primers PL1
      and PL2 which amplify the genetic region susceptible of punctual mutations. Then,
      we developed Southern blot and hybridization with oligonucleotide probes (GIn 37,
      Lys 37 y Thr 261), corresponding to first and last mutations. RESULTS: A region
      of 841 bp was amplified using the primers previously described. Hybridization
      experiments with the Thr 261 probe gave positive signal with both strains (both
      carry the mutation); GIn 37 only hybridized with TEM-1 and Lys 37 only with TEM
      2. CONCLUSIONS: The use of primers which amplify all the region susceptible of
      mutations in blaTEM and oligonucleotide probes allows the specific detection of
      point modifications in the original genes by the use of digoxigenin-labeled
      oligonucleotide probes.

PMID- 8481441
TI  - [Diagnosis of anaerobic infection of the pleural fluid using gas-liquid
      chromatography].
AB  - BACKGROUND: An assessment of the efficacy of the detection of volatile and non
      volatile fatty acids that are produced by microorganisms aimed at the possible
      diagnosis of pleural empyema. METHODS: 106 pleural fluids were examined by gas
      liquid chromatography in contrast to conventional aerobic and anaerobic cultures.
      The sample previously prepared (1 microliter) was injected in an Hewlett-Packard
      5890 chromatograph, that was equipped with a fused silica capillary column and a
      flame ionization detector. RESULTS: Growth of aerobic or anaerobic microorganisms
      was obtained in 13 (12.3%) of the samples, and volatile or non-volatile fatty
      acids were detected in all of them (sensitivity = 1). No growth was obtained in
      the 93 samples, but volatile or non-volatile fatty acids were detected in 64
      (68.8%) of them (specificity = 0.31). A positive predictive value of 0.17 and a
      negative predictive value of 1 were obtained. Growth of anaerobic microorganisms
      was obtained in 9 samples (8.5%) and volatile fatty acids were detected in all of
      them (sensitivity = 1). Anaerobic microorganisms did not grow in 97 samples,
      however volatile fatty acids were detected in 2 (2.1%) of them. A positive
      predictive value of 0.82 and a negative of 1 were obtained. CONCLUSIONS:
      Referring to pleural fluid samples, the detection of volatile and non-volatile
      fatty acids by gas-liquid chromatography is a highly sensitive method, that may
      be used to quickly reject negative samples in about 30 mins. Furthermore, when
      anaerobic microorganisms exist, the high specificity of gas-liquid chromatography
      will make it possible to confirm their presence in the sample, mainly if there is
      a clinical suspect of anaerobic infection. Thus, the utilization of this
      sensitive method may also change the therapeutic behaviour.

PMID- 8481442
TI  - [Salmonella typhimurium as the causal agent of pulmonary cavitations].
AB  - BACKGROUND: Relation between patients with immunosuppression (malignancy, renal
      transplant) and bacteremia by Salmonella non-typhi, specially by Salmonella
      typhimurium, is known. This relation has been published for patients who suffer
      from AIDS, and so Salmonella bacteremia could even begin the clinical disease.
      But even though the relation between the infection by Salmonella and AIDS is well
      known, and the pulmonary involvement in them has been told, this etiology as a
      producing agent of lung cavitation has not much documentation. METHODS: We
      examined three patients (two women and one man) suffering from fever of one week
      of duration, cough, expectoration and thoracic pain in two of them. The third
      patient had fever and cachexia without clinical symptoms. The man and the two
      women had a blood count with neutrophilia and leucocytosis in two cases and
      leucopenia in the other one. All of them suffered a very important depression of
      cell immunity (CD4 of 140, 70 and 4, respectively) and positive blood cultures
      for Salmonella typhimurium. RESULTS: Chest X-Ray showed, in all the cases,
      pulmonary cavities. CONCLUSIONS: Salmonella typhimurium must be included among
      the agents that can produce pulmonary cavities like Staphylococcus aureus,
      mycobacteria, fungus and other gram-negative bacilli.

PMID- 8481443
TI  - [Typing methods: plasmid analysis. Advantages and disadvantages].

PMID- 8481444
TI  - Intermittent ischemia.

PMID- 8481445
TI  - Oxygenated crystalloid cardioplegia.

PMID- 8481446
TI  - Crystalloid versus blood cardioplegia.

PMID- 8481447
TI  - Technical considerations and logic of antegrade and retrograde blood cardioplegic
      delivery.

PMID- 8481448
TI  - Controlled aortic root reperfusion in cardiac surgery.

PMID- 8481449
TI  - Continuous normothermic blood cardioplegia.

PMID- 8481450
TI  - Myocardial protection in patients with acute myocardial infarction and
      cardiogenic shock.

PMID- 8481451
TI  - Myocardial protection for reoperative cardiac surgery in acquired heart disease.
AB  - We have reviewed a variety of techniques that have recently been used to improve
      the results of reoperation coronary bypass valve re-replacement and redo thoracic
      aortic surgery. The basic tenets of management in these high-risk areas are: (1)
      innovative use of cardiopulmonary bypass techniques to improve patient safety,
      including deep hypothermic arrest, (2) use of retrograde as well as antegrade
      infusion of cardioplegic solutions, (3) meticulous operative technique, (4)
      prevention of left ventricle distension, (5) TEE monitoring of intracardiac air,
      and (6) careful post-bypass hemodynamic monitoring. Reoperative CABG specifically
      requires avoiding injury to previously placed open conduits or atherosclerotic
      conduits, an increasingly recognized risk factor in these patients. Though direct
      myocardial cardioplegic protective techniques are very important for reducing
      operative risk, the importance of the total operative plan is critical for
      maximizing patient safety and ensuring improved long-term survival.

PMID- 8481452
TI  - Pediatric cardioplegic techniques.
AB  - We use warm induction and reperfusion with amino acid enhancement on all neonates
      and preoperatively stressed patients to induce arrest without contracture and to
      replete high-energy substrates. Blood cardioplegia is used in all age groups. We
      then employ hypothermia in the majority of patients (all neonates), ranging from
      deep (18 degrees C), to moderate (26 degrees to 28 degrees C), with warm or near
      normothermia used in only simpler anatomic repairs. The clear benefits of
      hypothermia in conferring additional cardiac and systemic ischemic protection
      along with the relatively greater ease of cooling and rewarming in the pediatric
      patient warrant its continued use in the majority of open-heart cases. Calcium
      levels are maintained in the 0.3 to 0.5 mM/L range during the conduct of the
      operation and reperfusion phase. Before removal from bypass, calcium is
      administered through either bolus or continuous drip technique to provide a
      normocalcemic level of 1 to 1.2 mM/L. This close attention is particularly
      important in the neonate to avoid contracture injuries and to maximize cardiac
      function, and is warranted if citrate-phosphate-dextrose (CPD)-containing
      transfusion or prime components are used. Preoperative evaluation for
      aortopulmonary collaterals with coil embolization is routinely performed, and is
      particularly important in single ventricle physiology where preserved myocardial
      function is so vital to a favorable outcome. The opportunity to perform some
      surgeries off bypass, such as on the RV outflow tract, may be used whenever it
      represents a viable alternative in very young or ill patients. Similarly, the
      majority of Glenn shunts, for example, are performed using a caval-RA shunt
      without formal cardiopulmonary bypass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481453
TI  - Myocardial protection: an overview.

PMID- 8481454
TI  - Redefining nursing's role in Central Africa. Interview by Jim Lavery.

PMID- 8481455
TI  - Home care nursing in Ecuador. Interview by Karen Schmidt.

PMID- 8481456
TI  - A day in the life of a Dutch home care nurse.

PMID- 8481457
TI  - Out of the breast cancer closet.

PMID- 8481459
TI  - B.C. health care: the new vision.

PMID- 8481458
TI  - Camp nurse.

PMID- 8481460
TI  - Responding to anger.

PMID- 8481461
TI  - Let no one be silent.

PMID- 8481462
TI  - Cross border nursing.

PMID- 8481463
TI  - Role of protein synthesis, prostaglandins, and estrogen in rat ovarian
      metalloproteinase inhibitor production.
AB  - Matrix metalloproteinases and their inhibitors regulate follicular connective
      tissue remodeling associated with ovulation. We examined the control of
      metalloproteinase inhibitor activity and gene expression by various treatments in
      cultured rat granulosa cells and intact whole ovaries. Cells were isolated from
      preovulatory follicles of immature eCG-primed rats and cultured with various
      treatments for 24 h. Metalloproteinase inhibitor activity was measured in the
      media. The addition of LH or the phorbol ester 12-O-tetradecanoylphorbol 13
      acetate (TPA) increased inhibitor activity 2.5- and 2.6-fold above that in
      control cultures, respectively. Cycloheximide treatment blocked basal and LH- and
      TPA-stimulated inhibitor activity, suggesting that the increase in granulosa cell
      inhibitor activity resulted from de novo protein synthesis. Indomethacin, a
      prostaglandin synthase inhibitor, had no effect on basal or LH-induced granulosa
      cell inhibitor activity. Addition of the antiestrogen tamoxifen citrate or an
      aromatase inhibitor, 10-propargylestr-4-ene-3,17-dione, did not affect basal or
      LH-stimulated inhibitor activity, implying that estrogen is not involved in the
      signal transduction pathway leading to increased inhibitor activity. Northern
      analysis demonstrated the presence of mRNA for a tissue-derived metalloproteinase
      inhibitor, TIMP-1, which increased with LH stimulation, in rat granulosa cells.
      Similarly, an hCG stimulus increased TIMP-1 mRNA in periovulatory ovaries to the
      highest levels prior to ovulation. Neither cycloheximide nor indomethacin altered
      hCG-stimulated TIMP mRNA levels in periovulatory ovaries. The present study
      demonstrates that the LH- and TPA-induced increase in inhibitor activity resulted
      from de novo protein synthesis; however, de novo protein synthesis does not
      appear necessary for the increase in TIMP mRNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481464
TI  - Perforin-expressing cells during spontaneous abortion.
AB  - The metrial gland of pregnant rodents contains an abundant population of natural
      killer (NK)-like cells called granulated metrial gland (GMG) cells. Since GMG
      cells express the cytolytic protein, perforin, and since cells with NK activity
      have been implicated in spontaneous abortions, we have studied the distribution
      of perforin-containing cells in the uterus of mice undergoing normal pregnancy
      (Swiss mice) and spontaneous abortions (CBA/J x DBA/2 mice). The distribution of
      perforin-positive GMG cells was essentially the same near healthy and aborting
      conceptuses, suggesting that GMG cells are not involved in most cases of
      spontaneous abortion in this abortion model. Small perforin-positive cells were
      observed near the aborting conceptus in about 5% of the cases. However, it is not
      known whether their presence was the result or the cause of abortion.

PMID- 8481465
TI  - Comparative follicular development in Meishan and Large White gilts during
      prepubertal periods and its relation to hormonal stimulation.
AB  - Changes in follicular development in the left ovary and ovarian response to
      hormonal injections (hCG or eCG and hCG) in the right ovary were studied in
      Meishan gilts (n = 36) at 3, 2, and 1 standard deviations (SD) before the mean
      age of puberty (51, 64, and 77 days of age) and in Large White gilts (n = 24) at
      3 and 1 SD (140 and 166 days of age). Left ovaries were removed at the time of
      hormonal treatments and the remaining ovaries were removed 18 h after hCG was
      injected alone (hCG) or 72 h after eCG was injected (eCG-hCG). Both nonatretic
      and atretic (> 4 pyknotic bodies) antral follicles > 0.6 mm in diameter were
      identified in the left ovaries by histological techniques. LH-sensitive follicles
      were identified in the right ovaries by counting follicles with dispersed cumulus
      cells around the oocytes. All large White gilts showed the presence of antral
      follicles at both 3 and 1 SD before puberty while 6, 7, and 12 Meishan gilts had
      antral follicles > 0.6 mm at 3, 2, and 1 SD before puberty, respectively. In
      Large White gilts, the mean number of nonatretic antral follicles > 0.6 mm
      remained constant at 3 and 1 SD before puberty, while in Meishan gilts, the mean
      number increased as gilts got older. Mean percentage of class 1 nonatretic
      follicles (0.6-1.12 mm) of the total number of nonatretic follicles increased
      significantly with age in Meishan gilts (p < 0.02), while those of class 3 (2.01
      3.56 mm) decreased significantly (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481466
TI  - Preparation of an enriched fraction of luteinizing hormone-secreting cells from a
      mixed population of rat anterior pituitary cells.
AB  - To determine whether female rat gonadotropes differentially secrete only LH, only
      FSH, or both LH and FSH, a new method of preparing an enriched fraction of LH
      secreting cells from a mixed population of cells was developed. Dispersed female
      rat pituitary cells were incubated for 4 h in glass tubes with magnetic beads
      coated with anti-LH antibody. The tubes were then placed in a magnetic particle
      concentrator to separate cells bound to antibody-coated beads (518b7-bound) from
      the rest of the cell population (518b7-unbound). Several controls were used in
      this experiment: 1) mixed cells immediately plated without any preincubation
      (control); 2) mixed cells incubated without magnetic beads (incubated-only); 3)
      mixed cells incubated with magnetic beads but not separated (nonseparated); and
      4) mixed cells first incubated with magnetic beads coated with normal mouse serum
      (NMS) and then separated into NMS-bound and NMS-unbound populations. After
      removal of magnetic beads from cell populations, the cells were plated at 200,000
      cells/well. The 518b7-bound cells secreted 1.5-, 2-, 2-, and 5-fold more LH than
      control, incubated-only, nonseparated, or 518b7-unbound cells, respectively (p <
      0.05); 518b7-bound cells secreted 2.5-, 3.8-, 3.8-, and 11-fold more FSH than
      control, incubated-only, nonseparated, and 518b7-unbound cells. The ratio of
      LH:FSH secreted did not vary between the different treatment groups, but the
      ratio of LH:FSH contained in 518b7-selected cells was greater than that for
      unbound cells. Our data indicate that we have prepared an enriched fraction of LH
      secreting pituitary cells that also secrete FSH but have a greater capacity for
      producing LH than FSH in culture. These results are supportive of the view that
      LH and FSH are secreted by the same cells.

PMID- 8481467
TI  - Interference with the cytolytic activity of interleukin-2-treated lymphocytes by
      bovine uterine luminal protein.
AB  - Bovine uterine luminal protein (ULP) components (> or = 4 x 10(6) and 21,000
      M(r)) were obtained from uterine flushings on Day 17 of pregnancy. Experiments
      were conducted to determine the capability of these components to interfere with
      the cytolytic activity of interleukin-2 (IL-2)-treated peripheral blood
      lymphocytes (PBL), designated LAK (lymphokine-activated killer) cells, upon K-562
      tumor cells. Proteins (10-100 micrograms) were added at the onset of a 5-day
      culture period to wells containing PBL (3 x 10(6) + bovine recombinant IL-2
      (12,000 IU). After culture, percentage cytotoxicity (Cyt) was assessed by the
      51Cr release assay at 4 and 22 h of incubation for ratios (5:1-200:1) of LAK:K
      562 cells. Percentage Cyt was affected (p < 0.0001) by time, ratio, protein
      treatment, and all two-way interactions. Although trends were apparent, neither
      ULP component affected (p > 0.05) percentage Cyt at 4 h. By 22 h of incubation,
      mean percentage Cyt values for the > or = 4 x 10(6) and 21,000 M(r) components at
      effector:target cell ratios of 150:1 (p < 0.002) and 200:1 (p < 0.0001) were less
      than percentages for LAK cells alone. BSA and serum protein (control
      preparations) each failed (p > 0.05) to affect percentage Cyt. In conclusion,
      both ULP components interfered with the cytolytic activity of LAK cells,
      presumably by the suppression of LAK cell generation.

PMID- 8481468
TI  - Modulation of preimplantation embryonic development by antisense oligonucleotides
      to major histocompatibility complex genes.
AB  - The Ped (preimplantation embryo development) gene, which controls the rate of
      mouse preimplantation embryonic cleavage division and subsequent survival of the
      embryo, maps to the Q region of the MHC (major histocompatibility complex). Mouse
      embryos were treated with antisense oligonucleotides to mRNA for the Q region
      genes Q7/Q9, each of which encodes the Qa-2 antigen. The reverse transcription
      polymerase chain reaction (RT-PCR) was used to show that antisense treatment, but
      not sense treatment, decreased the level of mRNA for Qa-2 antigen in
      preimplantation embryos. Furthermore, both the expression of Qa-2 protein and the
      rate of embryonic cleavage division were decreased by treatment with antisense
      but not sense oligonucleotides. These results provide direct evidence that the
      Ped gene phenotype is at least partially encoded by the Q7/Q9 genes. It is likely
      that the mouse Ped gene has a human homolog, perhaps within HLA-F. Identification
      of genes--such as the Ped gene--that affect survival of the embryo may be vitally
      important for the enhancement of animal and human reproductive success.

PMID- 8481469
TI  - Localization of a spermatid-specific histone 2B protein in mouse spermiogenic
      cells.
AB  - Mammalian spermiogenesis is characterized by chromatin condensation and
      replacement of the histones typical of somatic and earlier spermatogenic cells by
      protamines in the nucleus. However, a spermatid-specific H2b histone (ssH2b) that
      has an unusual carboxyl-terminus containing a region rich in hydrophobic amino
      acids is transcribed and translated in mouse round spermatids. The hydrophobicity
      of this region suggested that the protein may be localized at the nuclear
      envelope, the initial site of chromatin condensation during spermiogenesis. To
      identify ssH2b in the spermatid nucleus, an antiserum (anti-ss-H2b127-138) was
      generated against a synthetic peptide corresponding to the unique carboxyl
      terminus of the protein. Immunocytochemistry of fixed, frozen testicular sections
      at both the light and electron microscopic levels indicated that ssH2b is present
      in nuclei of round spermatids. Moreover, the protein was not found to be
      preferentially associated with the nuclear envelope, indicating that it is not
      involved in chromatin-nuclear envelope interaction in the round spermatid.
      Rather, it appeared to be distributed uniformly throughout the nucleus with the
      exception of its exclusion from the nucleolus. In addition, the ssH2b protein was
      not found in mature sperm even when the chromatin was partially decondensed,
      suggesting that it is present and functions only during a restricted period of
      spermatogenic development.

PMID- 8481470
TI  - Alteration of growth, advancement of puberty, and season-appropriate circannual
      breeding during 28 months of photoperiod reversal in woodchucks (Marmota monax).
AB  - In woodchucks (Marmota monax), as in other marmotine rodents, endogenous
      circannual metabolic and reproductive cycles persist and free-run at intervals of
      10-12 mo for up to 4 yr in a neutral photoperiod of 12L:12D. The annual metabolic
      cycle is not altered by exposure to constant long days or short days for several
      months. In the wild, changes in food intake cause body weight to peak in late
      summer and reach nadirs in early spring, and there is a single annual breeding
      season in late winter. To determine whether normal changes in photoperiod entrain
      the endogenous circannual cycle, aspects of reproduction, food intake, and body
      weight were studied for 28 mo in eight groups of woodchucks housed in light
      controlled rooms. These included four groups of 7-10 males and four groups of 7
      10 females exposed to automated and continuous daily changes in photoperiod. The
      imposed changes in photoperiod resembled native Northern Hemisphere (boreal)
      changes or Southern Hemisphere (austral) changes in photoperiod. The treatments
      started at the summer solstice shortly after capture as 2.5-mo-old juveniles or
      14.5-mo-old yearling adults. In austral vs. boreal woodchucks, started as
      juveniles, annual increases in testosterone and testis descent at 5, 14, and 23
      mo of study were advanced by 2, 5, and 6 mo, respectively. Annual increases in
      progesterone at 7, 16, and 25 mo of study were advanced by 4, 5, and 6 mo,
      respectively. The older woodchucks were significantly but less dramatically
      affected by austral photoperiod for the first 6 mo of study, and by 8-12 mo were
      advanced the same as the younger animals. At 16-17 and 26-27 mo of photoperiod
      reversal, 16 austral females had normal pregnancy rates (78%) and produced normal
      sized litters (4.3 +/- 0.2) that were advanced by 5 and 6 mo, respectively,
      relative to those of boreal controls. Body weights in austral vs. boreal
      juveniles were reduced at 3-5 mo of study but not in older woodchucks. At 1 and
      then 2 yr of austral lighting, peaks in body weight were advanced by 4 and then 5
      mo relative to boreal controls in young animals, and by 2 and then 5 mo in older
      animals. Between 1 and 2 yr of austral lighting in both age groups the nadirs in
      food intake (45 g per day) were about 16-25% of peak food intake 6-8 mo earlier,
      as in boreals, but advanced by 5-6 mo relative to boreals.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8481471
TI  - Presence of transforming growth factor-alpha messenger ribonucleic acid (mRNA)
      and absence of epidermal growth factor mRNA in rat ovarian granulosa cells, and
      the effects of these factors on steroidogenesis in vitro.
AB  - Granulosa cell steroidogenesis has been reported to be modulated by transforming
      growth factor-alpha (TGF alpha) and its biochemical and physiological analog,
      epidermal growth factor (EGF). In this report, we studied whether TGF alpha or
      EGF mRNA is produced by granulosa cells, examined the morphological effects of
      TGF alpha or EGF on granulosa cell cultures, and measured the changes in
      granulosa cell progesterone production in cells cultured with TGF alpha or EGF.
      RNA from fresh granulosa cells and from those incubated overnight and for 4, 7,
      and 10 days with FSH was studied with reverse transcription-polymerase chain
      reaction for TGF alpha and for EGF. Only TGF alpha mRNA appeared to be present in
      the granulosa cells. Phase-contrast microscopy revealed that the combination of
      FSH plus TGF alpha or EGF resulted in cell shape changes and an increase in lipid
      droplets in the granulosa cells. Electron microscopy revealed that the
      endoplasmic reticulum increased in the granulosa cells incubated with either EGF
      or FSH plus EGF. Mitochondria of granulosa cells incubated with growth factors
      possessed ultrastructural features consistent with those found in preovulatory
      granulosa cells. Culture of the granulosa cells with FSH plus TGF alpha or with
      FSH plus EGF resulted in significantly elevated progesterone and 20 alpha
      hydroxyprogesterone levels. The highest level of progesterone production was on
      the eighth day of culture. We conclude that TGF alpha mRNA is produced by
      granulosa cells and that granulosa cell differentiation, as defined by
      morphological and biochemical criteria, is significantly stimulated in vitro by
      the combination of FSH and TGF alpha.

PMID- 8481472
TI  - Expression of H-2K major histocompatibility antigens on preimplantation mouse
      embryos.
AB  - Genes in the major histocompatibility complex (MHC) have been shown to play a
      role in development and reproduction. In the mouse, class I MHC proteins are
      expressed on oocytes and preimplantation embryos. Each mouse strain contains
      multiple class I genes located in the classical regions, K and D, and the
      nonclassical regions, Q and TL, of the mouse MHC, the H-2 complex. This study was
      undertaken to evaluate the expression of the classical class I MHC antigen, H-2K,
      on preimplantation mouse embryos. Through use of appropriate monoclonal
      antibodies (mAb) and an ELISA procedure, it was shown that H-2K antigens are
      detectable on oocytes and blastocyst-stage embryos, but not on 2-cell or 8-cell
      embryos. This pattern of expression is different from that reported in previous
      studies showing expression of total class I antigens and the nonclassical MHC
      antigen, Qa-2, on all stages of preimplantation embryos, including 2-cell- and 8
      cell-stage embryos. To analyze the nature of the H-2K protein on blastocysts, H
      2K antigens were isolated from an H-2K overproducing cell line (RDM-4) and used
      in blocking experiments. It was found that the purified antigen blocked binding
      to tissue culture cells by 54% and to embryos by 68%. Therefore, H-2K antigens on
      tissue culture cells and embryos appear to be very similar, but perhaps not
      identical. Thus escape of embryos from surveillance by the maternal immune system
      may not be effected by the expression of a different or embryonic form of MHC
      antigens.

PMID- 8481473
TI  - Induction by estradiol-17 beta of polycystic ovaries in the guinea pig.
AB  - In the present study we wished to develop a model for polycystic ovarian syndrome
      (PCOS) using the guinea pig, because this animal's cycle, compared to other
      rodent models, more closely emulates that of humans. Four silastic capsules,
      either empty or containing cholesterol or estradiol-17 beta, were placed
      subcutaneously for 48 h on Day 10 or 12 of the cycle. Vaginal smears were taken
      daily. Cardiac blood was drawn at various intervals. At necropsy, trunk blood was
      collected and ovaries were excised and analyzed histologically. Cycle length was
      extended over that in controls in animals treated with estradiol-17 beta (E2) on
      Day 12 of the cycle. Treatment with E2 resulted in an increase in serum estrogen
      2 h after capsule insertion. No changes were evident in progesterone or
      androstenedione concentrations with treatment. Animals treated with E2 and killed
      late (54 days after capsule removal) showed cysts grossly (group A), while occult
      cysts were present in E2-treated animals killed early (17 days; group B); no
      cysts were observed in control groups. Ovarian weight and size were increased in
      group A over controls. There was an increase in the fraction of atretic:total
      follicles < 500 mm in size in group A compared to group B as well as compared to
      controls. Since these results are similar to those seen in human PCOS, we
      conclude that the guinea pig may serve as an exceptional and unique model for the
      study of PCOS and may be applicable to humans.

PMID- 8481474
TI  - Follicular development and ovulation in the marmoset monkey as determined by
      repeated laparoscopic examination.
AB  - This paper describes the course of follicular development in vivo in the marmoset
      monkey, the only anthropoid primate with a relatively high (2-4) and variable
      ovulation number. Results are presented in relation to predictions from a
      mathematical model of control of follicle selection and ovulation number.
      Repeated laparoscopic examinations during the follicular phase were conducted for
      14 cycles. Ovulatory follicles were 1.0 mm (median) in diameter at Day 6 and
      could be distinguished from nonovulatory follicles by Day 8, at which point they
      were 2.0 mm in diameter. Ovulations were not synchronous; the most common
      observation 1-2 days after the estradiol peak was ovulation of one follicle but
      not the other. Examination of the course of follicular development within a cycle
      and the distribution of ovulation sites both supported predictions stemming from
      a mathematical model of follicle selection developed by Lacker et al. [Biol
      Reprod 1987; 37:570-580]. Specific findings were the following: 1) Variations in
      patterns of follicle growth within a cycle resembled those generated by the
      model; in 64% of cycles, the 2-3 ovulatory follicles grew at similar rates.
      However, in 36% of cycles, ovulatory follicles displayed disparate rates of
      growth. 2) An examination of the distribution of ovulation sites (right versus
      left) revealed no significant difference from a binomial distribution, suggesting
      the likelihood that interovarian (rather than intraovarian) factors control this
      distribution.

PMID- 8481475
TI  - Identification and localization of alternately spliced mRNAs for vascular
      endothelial growth factor in human uterus and estrogen regulation in endometrial
      carcinoma cell lines.
AB  - Repair of human endometrium after menstruation and preparation of the endometrium
      for implantation involves profound angiogenic changes. Vascular endothelial cell
      growth factor (VEGF) is a recently identified growth factor with significant
      angiogenic properties. Four species of mRNA encoding VEGFs were identified in
      human endometrium and myometrium. All species were present throughout the
      menstrual cycle. Two species, VEGF165 and VEGF121, were present in peripheral
      leukocytes, indicating tissue-specific splicing of the two other VEGF
      transcripts. In situ hybridization of mRNA encoding VEGF was not restricted to
      vascular smooth muscle but was present in epithelial and stromal cells of
      endometrium throughout the cycle, and the distribution changed during the course
      of the cycle. All four species of VEGF were expressed by the endometrial
      carcinoma cell lines Ishikawa, HEC 1-A, and HEC 1-B. Estradiol increased steady
      state levels of mRNA encoding VEGF in a dose- and time-dependent manner in HEC 1
      A cells. Conditioned medium from these cells possessed angiogenic activity that
      was depleted by passage through a heparin affinity column. None of the cell lines
      demonstrated mRNA for acidic or basic fibroblast growth factor (FGF), despite
      previous reports of the identification of immunoreactive basic FGF in HEC 1-A and
      HEC 1-B cells. These findings show that VEGFs, not FGFs, are the principal
      angiogenic growth factors secreted by these cells and that human endometrium
      expresses a secreted angiogenic growth factor whose site of expression changes
      during the menstrual cycle.

PMID- 8481476
TI  - Temporary anestrus induced by injection of luteinizing hormone-releasing hormone
      in hamsters.
AB  - The photoperiod-induced anovulatory state of the Syrian hamster (Mesocricetus
      auratus) is characterized by a daily rhythm of circulating LH and FSH with a
      surge in blood levels occurring each afternoon. The association between anestrus
      and the presence of daily gonadotropin surges suggests that initiation of the
      characteristic daily rhythm of LH and/or FSH after transfer to short days results
      in blockade of ovulation. We tested whether daily injection of LHRH affects the 4
      day rhythm of vaginal estrous cycles, induces daily surges of LH and FSH, blocks
      ovulation, and induces regression of the ovaries. LHRH (1 microgram/animal) was
      injected (s.c.) at 1630 h each day into females with regular 4-day estrous
      cycles. Injections began on the afternoon of estrus and continued for 12 days
      (experiment 1) or 8 days (experiments 2 and 3). In saline-injected controls,
      vaginal discharges occurred regularly at 4-day intervals during the injection
      period in all experiments. In contrast, vaginal estrus was not observed during
      the period of LHRH injection in any animals. Ova were found in oviducts of all
      saline-injected controls (8.9 +/- 0.8; n = 8) on the morning of estrus (after 8
      injections), but no ova were found in oviducts of LHRH-injected females. Levels
      of plasma LH but not FSH increased after injection of LHRH each day, whereas the
      4-day estrous cycle rhythm of gonadotropins was not disturbed in saline-injected
      controls. Vaginal estrous cycles and a 4-day rhythm of LH release resumed within
      7 days after LHRH injections were stopped.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481477
TI  - Effect of recombinant bovine somatotropin on the superovulatory response to
      pregnant mare serum gonadotropin in heifers.
AB  - Treatment of mature heifers with recombinant bovine somatotropin (BST) increases
      the number of ovarian follicles of 2-5 mm in diameter. This study was carried out
      to investigate whether the increase in the number of small follicles induced by
      BST treatment can enhance the superovulatory response. In the first experiment,
      24 heifers were assigned, in a randomized block design, to four treatment groups:
      1) control; 2) BST; 3) pregnant mare serum gonadotropin (PMSG); 4) BST+PMSG. On
      Day 7 of the estrous cycle, animals in groups 2 and 4 received injections of 320
      mg BST (in a sustained release formulation), while heifers in groups 1 and 3
      received 10 ml saline. Five days later heifers in groups 3 and 4 were treated
      with a single dose of 2000 IU PMSG to induce superovulation. Embryos were
      recovered nonsurgically on Days 6-8 of the following cycle, and all heifers
      underwent laparoscopy on Day 9 to assess ovulation rate. In a second experiment,
      24 heifers were assigned randomly to four treatment groups: 1) PMSG (1000 IU); 2)
      BST (320 mg) + PMSG (1000 IU); 3) PMSG (2000 IU); 4) BST (320 mg) + PMSG (2000
      IU), and then treated as for experiment I. In both experiments, all heifers were
      scanned daily using real-time ultrasound from the day before BST injection until
      the day of ovulation to monitor dynamics of ovarian follicular growth and
      development, and blood samples were collected daily throughout the experimental
      period for measurement of peripheral progesterone, estradiol-17 beta, growth
      hormone (GH), and insulin-like growth factor-I (IGF-I).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8481478
TI  - Gelatinolytic and caseinolytic proteinase activities in the secretions of the
      ventral, lateral, and dorsal lobes of the rat prostate.
AB  - The ventral, lateral, and dorsal lobes of the rat prostate produce secretions
      rich in protein. We examined these secretions for proteinase activities, using
      gelatin- and casein-containing SDS-polyacrylamide gel zymographies. The ventral
      lobe demonstrated both higher activities and more molecular forms of proteinase
      activities that cleaved these two protein substrates than did the other lobes.
      Ca(2+)-stimulated gelatinolytic activities of approximately 48, 51, 58, 64, 74,
      and 80 kDa were found in ventral prostate secretions in addition to activities
      detected in the absence of added Ca2+: a very strong 27-kDa activity; prominent
      22-, 86-, 90-, and 94-kDa activities; and less active 36-, 41-, 100-, 130-, and
      140-kDa activities. Ca(2+)-stimulated gelatinolytic activities of 51, 58, 74, 80,
      86, 90, and 94 kDa were present in lateral prostate secretions (none were
      detected in secretions of the dorsal lobe), and Ca(2+)-independent activities of
      25, 27, and 100 kDa were found in secretions of both the lateral and dorsal
      lobes. The Ca(2+)-stimulated activities were inhibited by EGTA and EDTA.
      Benzamidine inhibited all gelatinolytic activities except for the 22-, 25-, and
      27-kDa Ca(2+)-independent forms when Ca2+ was not added to the reaction buffer.
      However, in the presence of 5 mM CaCl2, the Ca(2+)-stimulated forms of proteinase
      were unaffected by benzamidine, whereas the other activities sensitive to
      benzamidine were inhibited. Prominent Ca(2+)-independent caseinolytic activities
      of 20, 23, 31, 37, 83, 89, and 94 kDa were detected in ventral lobe secretions
      along with less active forms of about 39, 48, 53, 57, 60, 63, 80, 103, 110, 125,
      and 160 kDa. Caseinolytic activities of approximately 23, 31, 53, 89, 94, 103,
      120, and 125 kDa were found in lateral prostate secretions, and 89, 94, and 103
      kDa activities were found in secretions of the dorsal lobe. Quantitatively, most
      gelatinolytic and caseinolytic activities were present in the soluble portion of
      the secretion of each prostatic lobe. The ventral, lateral, and dorsal prostate
      lobes all secrete gelatinolytic and caseinolytic proteinase activities; however,
      quantitatively the ventral lobe is the most notable in this function since its
      secretions contain more molecular forms and greater activities of these
      proteinases.

PMID- 8481479
TI  - Regulation of messenger ribonucleic acid encoding 3 beta-hydroxysteroid
      dehydrogenase/delta 5-delta 4 isomerase in the ovine corpus luteum.
AB  - Three experiments were conducted to determine how steady-state levels of mRNA
      encoding 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4 isomerase (3 beta
      HSD) in the ovine corpus luteum vary 1) between the two steroidogenic luteal cell
      types, 2) during the estrous cycle, and 3) during prostaglandin F2 alpha (PGF2
      alpha)-induced luteolysis. In the first experiment, RNA (10 micrograms) was
      isolated from purified preparations (n = 4) of large or small steroidogenic
      luteal cells. Large luteal cells contained 42% more (p < 0.05) message for 3 beta
      HSD per microgram RNA than did small luteal cells, while the amount of mRNA for
      tubulin did not differ between the two types of luteal cells. To determine
      whether luteal levels of mRNA for 3 beta-HSD differ during the estrous cycle,
      corpora lutea were collected from cycling ewes (n = 3/day) on Days 3, 6, 9, 12,
      and 15 postestrus. Levels of mRNA for 3 beta-HSD were similar on Days 3, 6, 9,
      and 12 but were lower (p < 0.05) on Day 15 postestrus, while levels of mRNA for
      tubulin were unchanged. In the final experiment, ewes were treated on Day 10
      postestrus with two injections of PGF2 alpha (5 mg each) or saline (control) at a
      4-h interval. Corpora lutea were collected from ewes (n = 4/treatment) 1 h or 8 h
      after the second injection of PGF2 alpha or 8 h after the second saline
      injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481480
TI  - Effect of neonatal diethylstilbestrol exposure on volume of the sexually
      dimorphic nucleus of the preoptic area of the hypothalamus and pituitary
      responsiveness to gonadotropin-releasing hormone in female rats of known
      anogenital distance at birth.
AB  - The effects of neonatal diethylstilbestrol (DES) exposure on the volume of the
      sexually dimorphic nucleus of the preoptic area of the hypothalamus (SDN-POA) and
      on GnRH-stimulated LH secretion were investigated in castrated female rats of
      known anogenital distance (AGD) at birth. The AGD was measured in females on the
      day of birth, and 0.1 microgram DES or corn oil was injected from Days 1 through
      10 of life. The volume of the SDN-POA was significantly larger in animals that
      had received DES than in those that had received corn oil. The largest SDN-POA
      volumes were seen in DES-treated animals that had long (> 1.4 mm) AGDs, and
      smallest volumes in corn oil-treated females that had short (< or = to 1.4 mm)
      AGDs. Within treatment groups, animals with longer AGDs had significantly larger
      SDN-POA volumes than those with short AGDs. Within AGD subgroups, the effect of
      DES was similar in that the percentage increase in SDN-POA volume was equivalent.
      Pituitary responsiveness to GnRH was greater in corn oil-treated females with
      long AGD than in similarly treated females with short AGD. DES treatment blunted
      LH secretion in both AGD subgroups, but the increased LH secretion was preserved
      in rats with long AGD. The results indicate that the individual effects of the
      postnatal environment depend on the androgenicity of the intrauterine
      microenvironment. Further, variations in the individual's response to potential
      environmental hazards may be predicted by antecedent intrauterine events.

PMID- 8481481
TI  - Testicular weight, Sertoli cell number, daily sperm production, and sperm output
      of sexually mature rabbits after neonatal or prepubertal hemicastration.
AB  - The present study was conducted to investigate the influence of hemicastration
      and age at hemicastration on the subsequent testicular development of male
      rabbits through sexual maturity. Thirty New Zealand white rabbits were left
      intact or were hemicastrated on Day 35, 49, 77, or 105 postconception. Beginning
      at 7 mo of age, ejaculates were collected every other day for 1 mo, and the last
      ten ejaculates were used to quantify daily sperm output. At 8 mo, the rabbits
      were killed and their carcases, testes, testicular capsules, and epididymides
      were weighed. Testicular tissue was processed for quantification of sperm
      production rates by enumeration of homogenization-resistant spermatids and via
      histometric evaluation. Regardless of the age at hemicastration, this
      manipulation did not alter the development of the remaining testis as assessed
      from testis weight, numbers of Sertoli cells per testis, daily sperm production,
      or sperm output (p > 0.05). On the basis of these findings, it would appear that
      the development of the spermatogenic capacity of the remaining testis of the
      rabbit is not altered appreciably by hemicastration at a young age.

PMID- 8481482
TI  - Birth of mice after transplantation of early cell-cycle-stage embryonic nuclei
      into enucleated oocytes.
AB  - The present study was conducted to investigate the influence of cell cycle stage
      of the donor nucleus on chromatin structure and development of mouse embryonic
      nuclei transplanted into enucleated oocytes. Donor cell-cycle stage was
      controlled in order to examine, in addition, the developmental potential of
      nuclei from 2-, 4-, and 8-cell-stage embryos. The cell cycle stage of donor
      nuclei was classified as early, middle, or late. After nuclear transfer,
      electrofusion, and activation, early-stage transplants formed a single pronucleus
      like structure, but middle-stage transplants formed very irregular types of
      structures and late-stage transplants extruded a polar body. A high proportion of
      development to the blastocyst stage (77.8%) and an increased cell number (62.1
      cells) were obtained from the early 2-cell-stage transplants as opposed to the
      middle- (0%) and late-stage (20.8%, 37.0 cells) transplants (p < 0.001). With
      transplantation of early-stage nuclei, high proportions of development to the
      blastocyst stage and of offspring were obtained from nuclear transplant embryos
      with a nucleus from a 2-, 4-, or 8-cell-stage embryo. The results confirm that
      the donor cell-cycle stage critically affects the chromatin structure and
      development of nuclear transplant embryos. The results also demonstrate that the
      nuclei from 2-, 4-, and 8-cell-stage mouse embryos in the early stage of each
      cell cycle can be reprogrammed when transplanted into enucleated mature oocytes.

PMID- 8481483
TI  - Suckling-induced inhibition of luteinizing hormone secretion and follicular
      development in the early postpartum sow.
AB  - The endocrine basis of lactational anestrus, the causes of reproductive
      dysfunction after early weaning, and the relationships among LH, FSH, and
      prolactin (PRL) secretion and follicular development were evaluated in sows
      weaned 6 h after farrowing (zero-weaned, n = 8) and in normally lactating sows (n
      = 9). An irregular, high-frequency episodic-type pattern of LH secretion was
      present in the early postpartum period, irrespective of treatment, and in a
      proportion of sows this pattern was associated with a marked elevation of
      baseline LH concentrations. This pattern of LH secretion was maintained in the
      zero-weaned sows but LH secretion was inhibited in lactating sows, resulting in a
      difference (p < 0.05) in mean plasma LH between groups 72-78 h postpartum. There
      were no differences in FSH between groups in any period of sampling. Variable but
      elevated plasma PRL was observed in suckled sows but declined (p < 0.05) to basal
      levels within 12 h of zero-weaning. Follicular development measured at laparotomy
      or slaughter 96 h postpartum was greater (p < 0.05) in zero-weaned than in
      control sows. The development of lactational anestrus in the sow therefore
      requires suckling-induced inhibition of LH secretion by 78 h postpartum. This
      inhibition of LH release does not appear to be causally related to short-term
      changes in PRL secretion.

PMID- 8481484
TI  - Luteinizing hormone and prolactin responses to naloxone vary with stage of
      lactation in the sow.
AB  - The principal aim of this study was to investigate the involvement of an
      opioidergic mechanism in the development of suckling-induced inhibition of LH
      secretion during early lactation in the sow. A preliminary experiment suggested
      that 2 mg/kg naloxone given as a single bolus injection was above the threshold
      for antagonism of endogenous opioid activity in early lactation. In the main
      experiment, injection of 2 mg/kg naloxone 39 h postpartum, followed by injection
      of 1 mg/kg naloxone at 3-h intervals from 42 h to 78 h postpartum, was not able
      to prevent the gradual inhibition of LH secretion observed in untreated lactating
      sows. In contrast, a single injection of 2 mg/kg naloxone at Day 10 of lactation
      was effective in increasing LH secretion (p < 0.05). There were no effects of the
      naloxone treatment at any time on FSH secretion. Naloxone decreased (p < 0.05)
      plasma prolactin at Day 10 of lactation; but again during the first 78 h after
      farrowing, chronic naloxone treatment did not affect plasma prolactin. These data
      suggest that the development of the inhibitory effect of suckling on LH secretion
      in the sow may not be opioid dependent. In contrast, an opiate-dependent
      mechanism was confirmed as an important component of the suckling-induced
      suppression of LH secretion in established lactation.

PMID- 8481485
TI  - Differential genomic imprinting of major histocompatibility complex class I
      antigens in the placenta of the rat.
AB  - The RT1.A and Pa (class I) loci in the major histocompatibility complex (MHC) of
      the rat are genomically imprinted in the placenta, since only the paternally
      derived antigens are expressed. To determine whether the RT1.E (class I) locus,
      which defines the end of the MHC opposite RT1.A, is genomically imprinted in the
      placenta, two different types of crosses were studied: all possible mating
      combinations of the DA (AaE-) and WF (AuEu) inbred strains and various matings of
      the R16 (AaE-), R33 (AaEu), and R34 (AaE-) congenic recombinant strains. The
      results showed that the Eu locus was not imprinted. Thus, genomic imprinting can
      be different at two endogenous loci that are part of a multigene family in tight
      linkage disequilibrium. The lack of Eu imprinting is not due to the locus' being
      monomorphic, since the monomorphic Pa locus is imprinted, and it is most probably
      not due to its distance from the imprinted RT1.A and Pa loci (0.4 cM). We suggest
      that the control of the imprinting may lie in the physical structure of the DNA
      proximate to the imprinted locus.

PMID- 8481486
TI  - A method for reactivation of the movement of demembranated ram sperm models with
      decondensed nuclei and a description of their ultrastructure.
AB  - In the procedure described, demembranated ram sperm models were treated to
      decondense their nuclei, and the movement of their sperm tails was then
      reactivated. The duration of movement was sustained for more than 30 min, with a
      tail-wave frequency of up to 14 Hz. Decondensed sperm models adhered to each
      other and to the slide; but adherence was prevented by addition of an anti
      agglutination factor derived from dialyzed, freeze-dried ram seminal plasma,
      which allowed models to swim freely. Electron microscopy showed that most areas
      of the sperm model nuclei were decondensed and contained fine interconnected
      filaments with structures resembling nucleosomes at anastomosing regions. Some
      central, lateral, and basal regions of the nuclei were not fully decondensed. The
      axoneme, outer dense fibers, and fibrous sheath were not affected
      ultrastructurally by the extraction procedure; the mitochondria of the middle
      piece appeared to be extracted, while the acrosome but not the perforatorium was
      removed. Use of decondensed, reactivated sperm models provides a means to monitor
      the decondensation of sperm in vitro while maintaining minimal disruption to
      sperm tail components. This will allow access to the nucleus for experimental
      manipulation in sperm models.

PMID- 8481487
TI  - Porcine uterine retinol-binding proteins are identical gene products to the serum
      retinol-binding protein.
AB  - Retinol-binding proteins (RBP) are secreted by the porcine uterus under the
      influence of progesterone and consist of multiple charge forms. Evidence has been
      previously presented by this laboratory that these uterine RBP are distinct from
      serum RBP. We have followed the secretion of the uterine RBP during two stages of
      pseudopregnancy, examined their properties and amino acid sequences, and
      attempted to clone their cDNA. Analysis of the charge forms present in uterine
      flushes by anion-exchange chromatography showed that forms 1 (p < 0.01) and 3 (p
      < 0.05) predominated at Day 13, whereas forms 2 (p < 0.05) and 4 (p < 0.01) were
      most abundant at Day 45. All four charge forms appeared to form stable complexes
      with transthyretin (TTR) and were recognized by antiserum to human serum RBP on
      Western blots. Several cDNA clones isolated from an endometrial cDNA library all
      appeared to code for a protein identical to classical RBP. Off-blot amino acid
      sequencing of the first ten residues of two of the more divergent charge forms of
      uterine RBP indicated complete sequence identity with pig serum RBP. These data
      suggest that the uterine RBP charge forms may be slightly modified forms of a
      single protein product corresponding to the classical form of RBP. The change in
      appearance of the charge forms during pseudopregnancy is probably due to chemical
      modifications. These modifications do not appear to influence the binding of each
      charge form to TTR.

PMID- 8481488
TI  - Risk factors for renal cell carcinoma: results of a population-based case-control
      study.
AB  - For a case-control study of risk factors for renal cell carcinoma, a mailed
      questionnaire was used to collect data on 518 cases and 1,381 population-based
      controls in Ontario, Canada. Active cigarette smoking increased risk twofold
      among males (odds ratio estimate [OR] = 2.0, 95 percent confidence interval (CI)
      = 1.4-2.8) and females (OR = 1.9, CI = 1.3-2.6). Passive smoking appeared to
      increase risk somewhat among nonsmokers (males: OR = 1.6, CI = 0.5-4.7; females:
      OR = 1.7, CI = 0.8-3.4). A high Quetelet index (QI) was associated with a twofold
      increase in risk in both sexes, although this was based on reported weight at age
      25 years for males (OR = 1.9, CI = 1.2-3.1) and five years prior to data
      collection for females (OR = 2.5, CI = 1.4-4.6). Diuretic use was associated with
      significantly increased risk among females, but not among males. Phenacetin use
      increased risk, while acetaminophen use was not associated with altered risk,
      although few subjects used either compound. Multiple urinary tract infections
      increased risk, but only significantly in females (OR = 1.9, CI = 1.2-2.9). Our
      data indicate the need for further exploration of passive smoking and diuretics
      as risk factors, as well as elucidation of mechanisms by which high lifetime QI
      and frequent urinary-tract infections might increase risk of this cancer.

PMID- 8481489
TI  - Nasopharynx cancer in Italian migrants.
AB  - Incidence and mortality for nasopharynx cancer in Italian migrants to Australia,
      Brazil (Sao Paulo), Canada, England and Wales, France, Uruguay, and the United
      States (Connecticut; Los Angeles and San Francisco, California) are analyzed.
      While the available incidence and mortality rates in the south of Italy--from
      where a large majority of migrants derive--are comparable to or lower than the
      other Western countries, the study shows a high risk in Italian migrants compared
      with the locally-born populations. These results are consistent in both sexes and
      in all host countries with the exception of the two South American ones. This
      finding possibly reflects a migration from some Italian sub-areas at higher risk,
      consistent with the high risk reported for some other Mediterranean populations
      (Maghreb, Malta).

PMID- 8481490
TI  - Serum lipids and left-sided adenomas of the large bowel: an extended study of
      self-defense officials in Japan.
AB  - In the on-going study of men retiring from the Self-Defense Forces in Japan, we
      previously reported that serum total cholesterol was not related to colorectal
      adenomas but that men with low levels of serum high-density lipoprotein (HDL)
      cholesterol had an elevated adenoma risk. We examined whether the previous
      observation was reproducible in a different set of data accrued subsequently in
      the study. Serum total cholesterol, HDL-cholesterol, low-density lipoprotein
      (LDL) cholesterol, and triglycerides were compared between 138 cases of
      colorectal adenomas at the depth of 60 cm or less from the anus and 909 controls
      with normal sigmoidoscopy in the period from October 1988 to December 1990. There
      was virtually no relation between adenoma risk and any of the serum lipids
      studied with or without adjustment for smoking, alcohol use, and body mass index.
      In the analysis combining the earlier and present data, however, men with large
      adenomas (> or = 10 mm, n = 25) tended to have lower levels of total cholesterol
      and LDL-cholesterol compared with controls (n = 1,612); adjusted mean differences
      were -0.21 mmol/l (P = 0.24) and -0.26 mmol/l (P = 0.13), respectively. These
      findings are inconclusive, but hypocholesterolemia may be associated with the
      growth of colorectal adenoma.

PMID- 8481491
TI  - Tobacco, alcohol intake, and diet in relation to adenocarcinoma of the esophagus
      and gastric cardia.
AB  - Little is known about the etiology of adenocarcinoma of the distal
      esophagus/cardia, a cancer which has increased in incidence in the United States
      over the last two decades. We analyzed data on smoking, alcohol use, dietary
      intake, and other factors obtained from 173 hospitalized males with
      adenocarcinoma of the distal esophagus/cardia (cases) and 4,544 hospitalized
      males with diseases not related to smoking and of other organ systems than the
      gastrointestinal tract (controls). Cases of squamous cell carcinoma of the
      esophagus (n = 136) and adenocarcinoma of the distal stomach (n = 122) were
      included as separate case groups. All subjects were interviewed in 28 hospitals
      in eight cities in the US between 1981 and 1990. After adjustment for covariates,
      the odds ratio (OR) for adenocarcinoma of the distal esophagus/cardia for current
      smokers was 2.3 (95 percent confidence interval [CI] = 1.4-3.9) and that for ex
      smokers was 1.9 (CI = 1.2-3.0) relative to never-smokers. The OR for drinkers of
      four or more ounces of whiskey-equivalents of alcohol per day (relative to those
      consuming less than one drink per week) was 2.3 (CI = 1.3-4.3). Intakes of total
      fat and vitamin A from animal sources were significant risk factors and fiber
      intake was associated inversely with adenocarcinoma of the distal
      esophagus/cardia. Although the number of female cases of adenocarcinoma of the
      distal esophagus/cardia was small (n = 21), significant associations were
      observed for smoking and alcohol.

PMID- 8481492
TI  - Migration to towns, occupation, smoking, and lung cancer: experience from the
      Finnish-Norwegian lung cancer study.
AB  - A total of 4,604 men who were interviewed in Finland in 1962 in connection with
      the Finnish-Norwegian lung-cancer study were followed-up for lung cancer during
      1963-87 to establish why urbanized (via migration) men who smoked had a greater
      lung-cancer risk than native urban smokers. Exposure to occupational carcinogens
      was inferred from the title of the longest job held. A clear dose-response
      relation between occupational exposure and lung cancer was found in the urbanized
      but not among the native urban dwellers. The extra risk associated with migration
      to towns and smoking was found especially by those urbanized subjects who worked
      in heavily exposed industries: their lung cancer risk was more than twice that of
      native urban men in similar jobs, while those urbanized subjects in academic or
      clerical jobs showed no increased risk when compared with native urban men in
      corresponding work. Cardiorespiratory symptoms had a prognostic value in every
      residential group, but especially among the urbanized. Urbanized men who smoked
      and worked in heavily exposed industries, and suffered from shortness of breath,
      had a fourfold risk of lung cancer when compared with native urban smokers
      without this symptom. We conclude that although the joint effect of smoking and
      occupational exposure is the main explanatory factor for high risk of lung cancer
      in urbanized males, environmental and psychosocial factors also may have a
      contributory effect.

PMID- 8481493
TI  - Pesticide exposures and multiple myeloma in Iowa men.
AB  - A population-based case-control study of 173 White men with multiple myeloma (MM)
      and 650 controls was conducted in Iowa (United States), an area with a large
      farming population, to evaluate the association between MM, agricultural risk
      factors, and exposure to individual pesticides. A slight nonsignificantly
      elevated risk for MM was seen among farmers (odds ratio [OR] = 1.2, 95 percent
      confidence interval [CI] = 0.8-1.7). Although slight excesses were observed,
      there were no significant associations between MM and handling either classes of
      pesticides or specific pesticides. Thus, this study found little evidence to
      suggest an association between risk of MM and farming or pesticides.

PMID- 8481494
TI  - Are the known bladder cancer risk-factors associated with more advanced bladder
      cancer?
AB  - Risk factors for superficial and invasive bladder cancer were examined in a case
      control study of 470 cases identified in 1967-68 in the Brockton and Boston
      Standard Metropolitan Areas (MA, United States) and of 500 population-based
      controls. Histologic specimens were reviewed and classified as superficial or
      invasive, following a standardized protocol. The tobacco-associated risk for
      superficial bladder cancer was odds ratio (OR) = 2.6 (95 percent confidence
      interval [CI] = 1.7-4.1) and the risk for invasive bladder cancer was OR = 1.7
      (CI = 1.1-2.5). For subjects less than 60 years of age, the risks were greater
      for invasive tumors (OR = 4.3, CI = 1.2-15) than for superficial tumors (OR =
      2.0, CI = 0.9-4.2), but this pattern for tobacco use was not found in older
      subjects. A strong trend of increased risk with increased amount of cigarettes
      smoked was shown only for invasive bladder tumors. No clear pattern of excess
      risk for invasive bladder tumors was seen for age at first use and years since
      last use of tobacco. The risk associated with occupational exposure to aromatic
      amine bladder carcinogens was OR = 1.7 (CI = 0.8-3.3) for superficial and OR =
      1.5 (CI = 0.8-3.0) for invasive bladder cancer. For subjects less than 60 years
      of age, the risks were greater for invasive (OR = 12.0, CI = 2.1-65) than for
      superficial tumors (OR = 4.3, CI = 0.8-24), but this pattern for occupational
      exposure was not found in older subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481495
TI  - Risk factors for small intestine cancer.
AB  - Small intestine cancer is relatively rare. Clinical reports have suggested that
      several medical conditions may predispose to increased occurrence of this cancer,
      but otherwise its etiology is unknown. In one of the first case-control studies
      of this cancer, we compared questionnaire responses provided by next-of-kin of
      430 persons who died of small intestine cancer cf921 controls who died of other
      causes. Subjects were identified from decedents included in the 1986 United
      States National Mortality Followback Survey. The questionnaires sought
      information on demographic and lifestyle characteristics, including diet and use
      of tobacco and alcohol. Tobacco and alcohol consumption were unrelated to risk of
      small intestine cancer, but weekly or more frequent consumption of red meat and
      monthly or more frequent intake of salt-cured/smoked foods were associated with
      two- to three fold increases in risk. The findings suggest that dietary factors
      probably are involved in risk of small intestine cancer, but additional research
      in other settings is required to clarify the determinants of these rare cancers.

PMID- 8481496
TI  - Accuracy of death certificates in East Germany.

PMID- 8481497
TI  - Epidemiology of the M-component immunoglobulin types of multiple myeloma.
AB  - The purpose of this population-based case-control study was to learn whether risk
      factors differ for the individual immunoglobulin types of multiple myeloma. In
      particular, we sought to determine whether IgA and IgG myeloma were related to a
      history of exposure to reported IgA- and IgG-stimulating conditions,
      respectively, or to a history of selected occupational and physicochemical
      exposures. The M-component immunoglobulin type was determined from
      immunoelectrophoresis as reported in medical records, and exposure status was
      obtained through in-person interviews. IgG (56 percent) and IgA (22 percent) M
      components predominated. For 17 percent of cases, no peak was found on
      immunoelectrophoresis; they were presumed to have light-chain myeloma. Persons
      with these three types of myeloma did not differ with respect to distributions of
      age or race, but a somewhat higher proportion of light-chain cases were women (58
      percent cf 45 percent of all other cases). Detailed analysis of the IgA and IgG
      subtypes provided little evidence that they differ with respect to prior immune
      stimulation or employment in several specific jobs. IgA myeloma, but not IgG
      myeloma, was associated modestly with a history of exposure to chest and dental X
      rays. Our study provides little evidence that IgA and IgG myeloma differ with
      respect to the risk factors examined.

PMID- 8481498
TI  - Recent cohort trends in malignant melanoma by anatomic site in the United States.
AB  - The incidence of malignant melanoma has been increasing steadily in the United
      States. The increase may be due to lifestyle changes in subsequent generations or
      birth cohorts. The nine population-based tumor registries in the Surveillance,
      Epidemiology, and End Results program (SEER) have been in existence for a
      sufficient time to begin to investigate cohort trends for the US population.
      Cases were the 18,787 Caucasians aged 20 to 84 years, who reported to SEER
      registries with a diagnosis of melanoma in 1974-86. Among men born between 1890
      and 1919, each subsequent five-year birth cohort experienced 45 to 57 percent
      increases in age-adjusted melanoma incidence of the arm and trunk, and 14 to 20
      percent increases were experienced across each site (arm, leg, head, and trunk)
      for the 1920-44 cohorts of men. Among women born between 1890 and 1919, 24 to 29
      percent increases were seen for melanoma of the trunk, arms, and legs for each
      subsequent five-year birth-cohort, followed by six to 29 percent increases in the
      1920-44 cohorts. Recent birth cohorts, 1945-64, have shown stabilizing rates,
      even after an attempt to adjust for the increasing tendency for diagnoses to be
      made in doctors' offices. Thus, the dramatic birth-cohort effects appear to have
      ended beginning with those born in 1945. However, melanoma rates will continue to
      rise until those born after 1945 represent the majority of the population.
      Furthermore, for the most recent cohorts, the trunk has become the most common
      site (per square meter of body surface) for men and the second most common site
      for women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481499
TI  - The relationship of stressful life events, health status and stress-resistance
      resources in persons with AIDS.
AB  - Depression and hopelessness are major problems in persons with AIDS (PWAs). This
      study provides a paradigm for viewing these mental health states as outcomes that
      are dependent on stressors, physical health states, and stress-resistance
      resources. The sample consisted of 30 male, English-speaking PWAs with stage IV
      AIDS. A significant positive relationship was found between negative life events
      and the measure of depression, and number of complications and depression.
      Satisfaction with social support, intrapersonal hope, and global hope were all
      significantly, negatively associated with hopelessness. The findings support the
      importance of stress-resistance resources in promoting mental health in PWAs.

PMID- 8481500
TI  - The administration of didanosine (ddI) in the adult: a nursing perspective.
AB  - Until October 1991, zidovudine was the only licensed anti-HIV drug. Because
      zidovudine has limitations, the development of additional drugs is needed. One
      such drug is didanosine, which received FDA approval for patients who are
      intolerant of zidovudine or who have received prolonged zidovudine therapy. The
      authors provide an overview of the administration and adverse effects of
      didanosine, and recommend nursing interventions.

PMID- 8481501
TI  - Standards and evaluation in community-based case management.

PMID- 8481502
TI  - Connecting and disconnecting: bereavement experiences of six gay men.
AB  - This research investigation explored the bereavement experiences of gay partners
      of men who died of AIDS-related complications. Interviews with six men provided
      data for analysis using the qualitative method of grounded theory. Two basic
      social-psychological processes were identified that characterized the bereavement
      experience: connecting and disconnecting. Themes generated from the data that
      described the process of connecting were: sharing the death, caring for the PWA,
      legitimizing the relationship, memorializing, and AIDS-related work. Performing
      death-related tasks, letting go of the relationship, and passage characterized
      the process of disconnecting. Special considerations for bereavement in gay men
      and implications for nursing are discussed.

PMID- 8481503
TI  - Disseminating research: writing abstracts.
AB  - Disseminating research findings is a critical step in making research useful.
      Careful preparation of abstracts allows investigators the opportunity to
      communicate their findings effectively to other healthcare professionals. This
      paper presents criteria developed by the Association of Nurses in AIDS Care
      (ANAC) Research Committee to be used in reviewing research abstracts for future
      ANAC conferences. Content of abstracts and ideas for abstract development are
      provided, along with a brief analysis of the reviews of research abstracts
      submitted for the 1992 ANAC Annual Conference.

PMID- 8481504
TI  - AIDS-designated units or scatter beds: which is better?

PMID- 8481505
TI  - Structure, function, and activation of the erythropoietin receptor.

PMID- 8481506
TI  - Current status of cytogenetic research in childhood acute lymphoblastic leukemia.

PMID- 8481507
TI  - Elevated interleukin-8 serum concentrations in beta-thalassemia and graft-versus
      host disease.
AB  - Neutrophil chemotactic and functional defects occur in beta-thalassemia and in
      patients after bone marrow transplantation (BMT). Interleukin-8 (IL-8) is a novel
      chemotactic and activating peptide for neutrophils and can be detected in the
      circulation. IL-8 serum concentrations were evaluated in 30 beta-thalassemic
      patients before and after BMT. Serial samples from 16 patients were also studied.
      Fourteen sera from healthy children, 43 patients with chronic viral hepatitis, 16
      patients on chronic transfusion treatment for various hematologic disorders, and
      28 healthy adults were studied as controls. IL-8 was evaluated by an enzyme
      linked immunosorbent assay. Patients with beta-thalassemia had higher IL-8
      concentrations than did normal controls, patients with liver disease, and
      patients on chronic transfusion. beta-Thalassemic patients with severe liver
      siderosis and fibrosis had the highest IL-8 concentrations. After BMT in patients
      with successful engraftment, IL-8 concentrations decreased significantly. In
      contrast, in patients with acute graft-versus-host disease (GVHD), IL-8
      concentrations were not statistically different from the concentrations found
      before BMT and were higher than in patients with no complications and patients
      with graft rejection. IL-8 may play a part in the immune dysregulation that
      occurs in beta-thalassemia and may be involved in the immune mechanisms leading
      to GVHD.

PMID- 8481508
TI  - Myeloblastic leukemia cells conditionally blocked by myc-estrogen receptor
      chimeric transgenes for terminal differentiation coupled to growth arrest and
      apoptosis.
AB  - Conditional mutants of the myeloblastic leukemic M1 cell line, expressing the
      chimeric mycer transgene, have been established. It is shown that M1 mycer cells,
      like M1, undergo terminal differentiation coupled to growth arrest and programmed
      cell death (apoptosis) after treatment with the physiologic differentiation
      inducer interleukin-6. However, when beta-estradiol is included in the culture
      medium, M1 mycer cells respond to differentiation inducers like M1 myc cell
      lines, where the differentiation program is blocked at an intermediate stage. By
      manipulating the function of the mycer transgene product, it is shown that there
      is a 10-hour window during myeloid differentiation, from 30 to 40 hours after the
      addition of the differentiation inducer, when the terminal differentiation
      program switches from being dependent on c-myc suppression to becoming c-myc
      suppression independent, where activation of c-myc has no apparent effect on
      mature macrophages. M1 mycer cell lines provide a powerful tool to increase our
      understanding of the role of c-myc in normal myelopoiesis and in leukemogenesis,
      also providing a strategy to clone c-myc target genes.

PMID- 8481509
TI  - Adjuvant immunotoxin therapy with anti-B4-blocked ricin after autologous bone
      marrow transplantation for patients with B-cell non-Hodgkin's lymphoma.
AB  - Anti-B-blocked ricin (anti-B4-bR) combines the specificity of the anti-B4 (CD19)
      monoclonal antibody with the protein toxin "blocked ricin." In blocked ricin,
      affinity ligands are attached to the ricin B-chain to attenuate its lectin
      binding capacity. In a phase I trial, Anti-B4-bR was administered by 7-day
      continuous infusion to 12 patients in complete remission after autologous bone
      marrow transplantation (ABMT) for relapsed B-cell non-Hodgkin's lymphoma (NHL).
      Patients were treated at 20, 40, and 50 micrograms/kg/d for 7 days. Potentially
      therapeutic serum levels could be sustained for 3 to 4 days. The maximum
      tolerated dose was 40 micrograms/kg/d for 7 days (total 280 micrograms/kg). The
      dose-limiting toxicities were reversible grade IV thrombocytopenia and elevation
      of hepatic transaminases. Mild capillary leak syndrome was manifested by
      hypoalbuminemia, peripheral edema (4 patients), and dyspnea (1 patient). Anti
      immunotoxin antibodies developed in 7 patients. Eleven patients remain in
      complete remission between 13 and 26 months post-ABMT (median 17 months). These
      results show that Anti-B4-bR can be administered with tolerable, reversible
      toxicities to patients with B-cell NHL in complete remission following ABMT.

PMID- 8481510
TI  - Post-5-fluorouracil human marrow: stem cell characteristics and renewal
      properties after autologous marrow transplantation.
AB  - The effect of 5-fluorouracil (5-FU) pretreatment on human bone marrow (BM)
      progenitor/stem cells and recovery of hematopoiesis after autologous marrow
      transplant was studied. Twenty-one patients were treated with 5-FU (15 mg/kg to
      45 mg/kg) intravenously (IV) for 1 to 3 days administered 6 to 22 days before BM
      harvest. Post-FU marrow was infused into 15 patients after high-dose
      cyclophosphamide, carmustine (BCNU), and VP-16 (CBV). Seventeen patients
      (historical controls) were treated with CBV and autologous BM transplantation but
      did not receive 5-FU before marrow harvest. The groups were comparable for
      diagnosis and prior therapy. In the 5-FU-treated group and control group, median
      recovery times for platelet count to 50,000/mm3 were 20 and 30 days, respectively
      (P = .007), and for platelet count to 100,000/mm3, 23 and 38 days, respectively
      (P = .007), while neutrophil recovery was not significantly altered. In vitro
      cultures with 1 to 7 growth factors (interleukin-1 [IL-1], IL-3, IL-4, IL-6,
      colony-stimulating factor-1 [CSF-1], granulocyte-macrophage colony-stimulating
      factor [GM-CSF], and G-CSF) were performed. In 8 of 10 patients whose marrow was
      studied before and after 5-FU treatment, the numbers of CFU-C responsive to the
      combination of GM-CSF and IL-3 was increased 6.15-fold by 5-FU pretreatment. In 4
      of these patients, thymidine suicide of GM-CSF- and IL-3-stimulated CFU-C ranged
      from 17% to 42%. High proliferative potential colony-forming cell (HPP-CFC) was
      observed in low frequency in normal marrow and patient's marrow before 5-FU
      treatment. In 11 of 16 patients pretreated with 5-FU, increased numbers of HPP
      CFC were noted. GM-CSF and IL-3 interacted synergistically to stimulate HPP-CFC.
      Multifactor combinations, especially GM-CSF + G-CSF + IL-3 + IL-6 + IL-1 + CSF-1
      did not increase total colony count or classic HPP-CFC but did result in altered
      morphology, producing huge, loose colonies. The marrow from patients pretreated
      with 5-FU is enriched with multifactor-responsive HPP-CFC, renews in vivo
      granulopoiesis in a manner comparable with marrow harvests without 5-FU
      pretreatment, and provides accelerated in vivo platelet recovery. This marrow may
      be an appropriate target marrow for gene insertion in gene-therapy protocols.

PMID- 8481511
TI  - Phenotypic and functional characterization of competitive long-term repopulating
      hematopoietic stem cells enriched from 5-fluorouracil-treated murine marrow.
AB  - Lymphomyeloid stem cells from the bone marrow of C57BL/6 mice treated with 5
      fluorouracil (5-FU) were characterized with respect to 12 parameters using
      fluorescence-activated cell sorting and a competitive long-term repopulation
      assay. Stem cells were larger than lymphocytes and exhibited side light-scatter
      characteristic of blast cells. Most expressed low levels of Thy-1.2, high levels
      of Sca-1 (Ly6-A/E), H-2Kb, and AA4.1 antigens and stained brightly with rhodamine
      123. Significantly, most long-term repopulating cells also expressed CD4, some at
      high density. In addition, a significant proportion displayed low to medium
      levels of the "lineage-specific" markers CD45R (B220), Gr-1, and TER-119. A
      simple and rapid multiparameter sorting procedure enriched the stem cells 100
      fold and substantially removed most other clonogenic cell types, including day 12
      spleen colony-forming cells. Cells able to generate cobblestone colonies on
      stromal cells in vitro were co-enriched. Lethally irradiated mice transplanted
      with limiting numbers of the sorted stem cells did not survive unless
      cotransplanted with "compromised" marrow cells prepared by prior serial
      transplantation and shown to be depleted of long-term repopulating activity. A
      significant number of recipients transplanted with 25 to 100 sorted cells
      contained donor-derived B and T lymphocytes and granulocytes in their peripheral
      blood for at least 6 months. Limiting dilution analysis in vivo indicated that
      the frequency of competitive long-term repopulating units (CRU) in the sorted
      population was at least 1 in 60 cells. The calculated frequency of CRU was
      largely independent of the time of recipient analysis between 10 and 52 weeks,
      indicating that highly enriched stem cells can be recruited relatively early in
      certain transplant settings. This simple enrichment and assay strategy for
      repopulating hematopoietic stem cells should facilitate further analysis of their
      regulation in vivo.

PMID- 8481512
TI  - Echicetin: a snake venom protein that inhibits binding of von Willebrand factor
      and alboaggregins to platelet glycoprotein Ib.
AB  - Echicetin, a new protein isolated from Echis carinatus venom by reverse phase and
      ion exchange chromatography specifically inhibited agglutination of fixed
      platelets induced by several platelet glycoprotein Ib (GPIb) agonists, such as
      bovine von Willebrand factor (vWF), alboaggregins, and human vWF in the presence
      of botrocetin. Unlike alboaggregins, echicetin bound to GPIb but did not induce
      agglutination of washed or fixed platelets. In contrast to disintegrins, it did
      not block adenosine 5'-diphosphate (ADP)-induced platelet aggregation in the
      presence of fibrinogen. The apparent molecular weight of echicetin measured on
      sodium dodecyl sulfate (SDS) gel electrophoresis was 26 Kd under nonreducing
      conditions. On reduction, echicetin showed 16 and 14-Kd subunits suggesting that
      the molecule is a dimer. Reduced echicetin retained its binding activity and its
      inhibitory effect on the agglutination of fixed platelets induced by bovine vWF.
      125I-echicetin bound to fixed platelets with high affinity (kd = 30 +/- 1.8
      nmol/L) at 45,000 +/- 2,400 binding sites per platelet. The binding was
      selectively inhibited by a monoclonal antibody to the 45-Kd N-terminal domain of
      platelet GPIb, but not by monoclonal antibodies to other regions on GPIb. Binding
      of 125I-bovine vWF to fixed platelets was strongly inhibited by echicetin. In
      contrast, bovine vWF showed a much weaker inhibitory activity on binding of 125I
      echicetin to platelets. The half life of echicetin in blood was approximately 170
      minutes with no detectable degradation. Echicetin significantly prolonged the
      bleeding time of mice, suggesting that it may inhibit vWF binding to GPIb in vivo
      as well as in vitro.

PMID- 8481513
TI  - Vanadate activates platelets by enhancing arachidonic acid release.
AB  - Human platelet activation is associated with, and regulated by, the
      phosphorylation of a number of proteins. Recently, attention has been focused on
      tyrosine phosphorylation of proteins and their function in platelet activation.
      Here vanadate, an inhibitor of tyrosine phosphohydrolase, was used to examine the
      role that tyrosine phosphorylation plays in platelet activation. Vanadate (7.5 to
      100 mumol/L) stimulated the dose-dependent aggregation of saponin-permeabilized,
      but not intact, platelets. Electron-microscopic studies indicated small
      degranulated aggregates. Vanadate-induced aggregation was inhibited by
      pretreatment with prostacyclin (1 to 10 nmol/L), genistein (1 to 10
      micrograms/mL), aspirin (100 mumol/L), or BW755C (80 mumol/L). Aggregation was
      associated with the aspirin-sensitive formation of [32P]phosphatidic acid and the
      phosphorylation of platelet proteins, notably pleckstrin and myosin light chain.
      Immunoblotting studies indicated that vanadate caused the tyrosine
      phosphorylation of proteins of approximate molecular weights 26, 29, 32, 40, 42,
      80, and 90 Kd. Preincubation with BW755C abolished the phosphorylation of the 26
      , 29-, 32-, 40-, and 42-Kd proteins but not the 80- and 90-Kd proteins. Vanadate
      stimulated the release of [3H]-arachidonic acid that was not affected by
      pretreatment with BW755C. The subsequent conversion of [3H]-arachidonic acid to
      [3H]-thromboxane A2 was significantly inhibited. These findings show that
      vanadate stimulates platelets by promoting arachidonic acid release from
      phospholipids. Tyrosine phosphorylation, potentially of the 80- or 90-Kd
      proteins, may regulate a platelet phospholipase A2. The release arachidonic acid
      was converted to thromboxane A2 that produced secondary effects such as
      phospholipase C activation, protein phosphorylation, and aggregation, and was
      associated with the tyrosine phosphorylation of the 26-, 29-, 32-, 40-, and 42-Kd
      proteins.

PMID- 8481514
TI  - Double heterozygosity for mutations in the platelet glycoprotein IX gene in three
      siblings with Bernard-Soulier syndrome.
AB  - Bernard-Soulier syndrome (BSS) giant platelets have defective and/or deficient
      glycoprotein (GP) Ib/IX complexes, causing absent ristocetin-induced aggregation,
      defective interaction with von Willebrand factor, morphologic abnormality, and a
      clinical bleeding tendency. Recently several mutations have been described in the
      platelet GPIb alpha gene in individuals exhibiting the BSS phenotype. We have
      studied a family with classical BSS, and have excluded lesions at the GPIb alpha
      locus by restriction fragment length polymorphism linkage analysis. Analysis of
      the genes for two other components of the platelet GPIb:IX complex, namely GPIb
      beta and GPIX, showed two different missense mutations in the coding region of
      the GPIX gene: an A-->G transition in codon 21 results in conversion of an
      aspartic acid to glycine and an A-->G change in codon 45 converts an asparagine
      residue to serine. Three affected individuals are doubly heterozygous for these
      mutations, which alter conserved residues in or flanking the GPIX leucine-rich
      glycoprotein motif. Both mutations create new recognition sites for the enzyme
      Fnu 4H1; therefore, this enzyme was used to screen 60 normal subjects (120
      alleles). Neither mutation was detected in any subject other than direct
      relatives of the affected individuals. Although low levels of GPIb were
      demonstrable by both flow cytometry and immunoblot analysis in an affected
      individual's platelets, there was no evidence of GPIX immunoreactivity. We
      propose that expression of abnormal GPIX prevents stable assembly of the GPIb/IX
      complex, causing BSS in the doubly heterozygous individuals in this family.

PMID- 8481515
TI  - Spreading of platelets on fibrin is mediated by the amino terminus of the beta
      chain including peptide beta 15-42.
AB  - We have investigated the adhesion and spreading of platelets on polymerized
      fibrin of varying structure to identify sites that mediate these interactions.
      Fibrin was prepared with thrombin to remove both fibrinopeptide A (FPA) and
      fibrinopeptide B (FPB) and with reptilase or Agkistrodon contortrix thrombin-like
      enzyme (ACTE) to selectively remove FPA or FPB, respectively. Residual fibrin
      bound enzymes were inhibited with D-phenylalanyl-L-prolyl-L-arginyl chloromethyl
      ketone (PPACK). Platelet adhesion was independent of fibrinopeptide cleavage and
      was equal on fibrin prepared with each of the three enzymes. In contrast, FPB
      cleavage increased spreading as quantitated by fluorescence microscopy of
      platelets stained for glycoprotein IIb-IIIa. The 24% +/- 4% spreading on
      reptilase-fibrin was significantly less than the 70% +/- 8% on thrombin-fibrin or
      65% +/- 9% on ACTE-fibrin (P < .0005 for both). Protease III from Crotalus atrox
      venom was used to specifically cleave residues B beta 1-42 from fibrinogen to
      further investigate the role of the beta chain N-terminus in promoting platelet
      spreading. After clotting with thrombin, this fibrin derivative lacked beta 15-42
      and supported significantly less spreading. A monoclonal antibody (MoAb) reactive
      with beta 15-21 inhibited spreading on thrombin-fibrin as did peptide beta 15-42,
      while control MoAbs and peptides had no significant effect. These results
      indicate that adhesion and spreading of platelets on fibrin are mediated by
      different interactions, and that spreading can be mediated by FPB cleavage and
      the amino terminus of the beta chain including residues beta 15-42.

PMID- 8481516
TI  - Deficiency of plasma plasminogen activator inhibitor 1 results in
      hyperfibrinolytic bleeding.
AB  - A 63-year-old man was evaluated for a lifelong history of bleeding commencing
      with frequent epistaxis as a child; all previous routine coagulation parameters
      were within the normal range. The patient's hemorrhagic disorder is characterized
      predominantly by delayed bleeding at surgical sites. In the resting state, there
      was no clinical or laboratory evidence of excessive fibrin(ogen)olysis. Bleeding
      was not caused by disseminated intravascular coagulation, factor XIII deficiency,
      alpha 2-antiplasmin deficiency, or dysfibrinogenemia. It was found that the
      patient was deficient in plasma PAI-1 antigen and activity but with approximately
      half normal antigen and normal activity of platelet PAI-1. The low concentration
      of plasma PAI-1 was insufficient to neutralize circulating t-PA, resulting in
      high t-PA activity with normal antigen and causing the hyperfibrinolytic activity
      observed. Studies on seven family members of the proband indicated autosomal
      inheritance of plasma PAI-1 deficiency. Studies on this patient emphasize a clear
      correlation between decreased plasma PAI-1 activity and hyperfibrinolytic
      bleeding and also emphasize the unique role of plasma PAI-1 in the balance
      between the coagulation and fibrinolytic mechanisms.

PMID- 8481517
TI  - Role of leuCAM integrins and complement in platelet-monocyte rosette formation
      induced by immune complexes of human immunodeficiency virus-type 1-immune
      thrombocytopenic purpura patients.
AB  - Patients with human immunodeficiency virus-type 1-immune thrombocytopenic purpura
      (HIV-1-ITP) have elevated polyethylene glycol (PEG)-precipitable immune complexes
      (ICs) composed of IgG, IgM, and complement that are threefold to sevenfold higher
      than in healthy control subjects. These complexes contain anti-F (ab')2 as well
      as anti-idiotype antibodies versus anti-HIV-1gp120. Because anti-F (ab')2 and
      anti-idiotype antibodies correlate with thrombocytopenia (r = .83 [J Clin Invest
      77:1756, 1986] and r = .90 [J Clin Invest 89:356, 1992], respectively) we studied
      the binding of ICs to platelets and monocytes as well as their role in platelet
      monocyte rosette formation. ICs bind to platelets in a saturation-dependent
      manner (optimum at 10 micrograms/mL; 0.5% of serum conc). Binding to platelets
      could not be inhibited with platelet saturating concentrations of aggregated IgG
      or with monoclonal antibody (MoAb) IV.3 versus FcR gamma II. Platelet binding
      could be inhibited with Fab anti-C3, anti-Clq, or anti-C4 by 57%, 40%, and 46%
      respectively, not with control Fab (P < .001). Monocytes from HIV-1-ITP patients
      form rosettes with normal platelets 16.8 +/- 5.2 rosettes/100 monocytes compared
      with 4.8 +/- 0.8 control monocytes plus normal platelets (P = .009). Gel-washed
      HIV-1-ITP platelets formed 19 +/- 2.0 rosettes with U937 cells compared to 6.3 +/
      1.0 for normal platelets (P = 0.001). Arming of U937 cells with HIV-1-ITP ICs (5
      micrograms/mL) formed 36.7 +/- 2.5 rosettes compared with 10.6 +/- 1.2 for
      control ICs (P < .01). Rosetting of armed U937 cells could be inhibited with
      MoAbs versus the alpha chains of CD11a (LFA-1), 11b (Mac-1), or 11c (p150,95) by
      67%, 70%, and 61%, respectively (P < .007), whereas binding of ICs to U937 cells
      was unaffected. Isotype-matched control as well as MoAbs versus antigens on U937
      cells (CD13, CD33) or the anti-FcR gamma II receptor had no effect. However, Fab
      fragments of polyclonal anti-C3 inhibited rosette formation by 78% (P < .01);
      control Fab had no effect. Thus, platelet-monocyte rosette formation is not Fc
      dependent. It is complement receptor dependent and requires the cooperation of
      all three leuCAM integrins.

PMID- 8481518
TI  - Phenotypic diversity of natural killer (NK) populations in patients with NK-type
      lymphoproliferative disease of granular lymphocytes.
AB  - Using monoclonal antibodies (MoAbs) termed GL183 and EB6, directed to a novel
      family of natural killer (NK) specific triggering molecules, four functional
      subsets of NK cells have been recently defined (GL183+EB6-; GL183+EB6+; GL183
      EB6+; GL183-EB6-). In healthy individuals, all these subsets are represented in
      variable portion. The expression of EB6 and GL183 surface antigens has been
      analyzed in a series of 14 patients with lymphoproliferative disease of granular
      lymphocytes (LDGL) characterized by a chronic CD3-CD16+ lymphocytosis. Our data
      showed that in 11 of 14 cases, the proliferation was specifically sustained by
      one of the four possible subsets of granular lymphocytes (GLs) (seven cases: EB6
      GL183-; three cases: EB6+GL183-; one case: EB6-GL183+). In the remaining three
      cases, a pattern was demonstrated that is consistent with that of healthy
      individuals (ie, the presence of all four subsets). When expressed on GL
      surfaces, in the majority of cases tested both EB6 and GL183 MoAbs behave as
      functional surface molecules as assessed in the redirected killing of P815 target
      cells. We also provided evidence that EB6+GL183+ proliferating cells show a
      definite (type 1) in vitro NK specificity as do their normal counterparts. The
      unique expansion of a defined subset of NK cells in most patients with LDGL
      suggests that the pathologic noxa leading to GL proliferation selectively acts on
      a specific subset of NK lymphocytes.

PMID- 8481519
TI  - Molecular rearrangements on chromosome 11q23 predominate in infant acute
      lymphoblastic leukemia and are associated with specific biologic variables and
      poor outcome.
AB  - Acute lymphoblastic leukemia (ALL) in infants generally shows distinctive
      biologic features and has a poor prognosis. Cytogenetic studies indicate that
      many infant leukemias have chromosome 11q23 translocations. Because of these
      findings and the distinct clinical features of infant leukemia, we investigated
      30 cases of infant ALL for molecular defects of 11q23. Fourteen cases had
      cytogenetic abnormalities of 11q23, and all of them showed 11q23 rearrangements
      at the molecular level. An additional seven cases also had 11q23 molecular
      rearrangements, including one with normal cytogenetic analysis. Molecular
      abnormalities of 11q23 were significantly correlated with adverse prognostic
      factors, including age under 6 months, hyperleukocytosis, CD10- phenotype, and
      early treatment failure. Molecular analysis identified a group of infants with
      germline 11q23 that had a very good treatment outcome with a projected event-free
      survival of 80% at median follow-up of 46 months compared to 15% in infants with
      rearranged 11q23 (P < .001). These findings suggest that a high proportion (70%)
      of infants with ALL have 11q23 rearrangements and that these rearrangements are
      not always detectable by cytogenetic analysis. The presence of germline 11q23 DNA
      may identify a subgroup of infant ALL patients with a good outcome using current
      therapy and a different etiology for their ALL.

PMID- 8481520
TI  - Granulocyte-macrophage colony-stimulating factor induces sequential activation
      and deactivation of binding via a low-affinity IgG Fc receptor, hFc gamma RII, on
      human eosinophils.
AB  - Eosinophils are important in antibody-mediated immune defense against parasites
      based on interaction with Ig receptors (FcR). Of the three classes of IgG FcR in
      humans, hFc gamma RI, II, and III, solely hFc gamma RII (CD32) is expressed on
      freshly isolated eosinophils. Despite an expression level similar to that found
      on monocytes and polymorphonuclear granulocytes, binding activity of hFc gamma
      RII on eosinophils is constitutively low. Freshly isolated eosinophils had a
      negligible ability to form rosettes with IgG-sensitized erythrocytes (EA-IgG).
      Addition of granulocyte-macrophage colony-stimulating factor (GM-CSF) caused an
      approximately threefold increase in EA-IgG rosettes. This increase was maximal
      after 35 minutes, and declined upon further incubation at 37 degrees C. Analysis
      of hFc gamma RII expression levels showed no significant changes and neither was
      the expression of other hFc gamma R classes induced. Blocking studies with anti
      Fc gamma receptor monoclonal antibody (MoAb) proved hFc gamma RII specificity of
      enhanced IgG complex binding. These phenomena were not restricted to GM-CSF
      action, because the addition of interleukin-3 or interleukin-5 similarly enhanced
      EA-IgG binding. The kinetics of activation of hFc gamma RII binding activity were
      paralleled by the binding of EA-C3bi to CR3 on eosinophils. In contrast to the
      stable expression of hFc gamma RII during activation with GM-CSF, CR3 expression
      increased slowly. Ligand binding via both types of opsonin receptors proved
      receptor specific. However, the kinetics of enhanced binding via hFc gamma RII
      and CR3 suggested the possibility of a common mechanism underlying the
      enhancement of ligand binding via hFc gamma RII and CR3. This hypothesis was
      supported by the fact that binding via hFc gamma RII proved sensitive to both
      high concentrations of F(ab')2 fragments of anti-CD11b MoAb MO1 and chelation of
      bivalent cations with EDTA. In conclusion, our studies indicate that cytokines
      can induce a transient enhancement of hFc gamma RII binding activity.
      Qualitative, and not quantitative, changes in this receptor appear to underly the
      modulation of binding activity, which may be linked to changes in CR3 activity.

PMID- 8481521
TI  - Kinetics of hemoglobin S polymerization and gelation under shear: I. Shape of the
      viscosity progress curve and dependence of delay time and reaction rate on shear
      rate and temperature.
AB  - Polymerization and gelation of deoxyhemoglobin S makes red blood cells (RBCs)
      rigid and is the immediate basis of pathogenesis in sickle cell disease. Hence,
      characterization of hemoglobin S viscosity and its time-dependent development as
      RBCs pass through the microvasculature is important in understanding
      pathogenesis. Because RBCs and the intraerythrocytic milieu in vivo are subject
      to shear, the shear dependence of polymerization kinetics is also important. In
      steady-state cone-plate viscometry we find: (1) gelation under shear progresses
      exponentially with time; (2) shear markedly increases exponential rate and (3)
      shortens delay time independent of when in the delay time it is applied; (4)
      shear greatly decreases the temperature dependence of the exponential rate and
      delay time; (5) simultaneous with its acceleratory effect on polymerization,
      shear breaks down gel structure. We conclude that shear acts to accelerate
      gelation by breaking fibers and creating new growing ends, a process that occurs
      in addition to the homogeneous and heterogeneous nucleation of new fibers that
      occurs in the absence of shear. Fibers that break are part of a gel network
      rather than in free solution. The shear dependence of gelation rates means that
      the critical clinical issue, whether the delay time is long enough and gelation
      slow enough to permit deoxygenated cells to pass through the microvasculature
      before they rigidify, depends on in vivo shear rates as well as on degree of
      unsaturation and hemoglobin concentration.

PMID- 8481522
TI  - Sickle erythrocyte-endothelial interactions in microcirculation: the role of von
      Willebrand factor and implications for vasoocclusion.
AB  - To determine the role of von Willebrand factor (vWF) in adhesion of sickle (SS)
      erythrocytes in microvascular flow conditions, we have perfused the ex vivo
      mesocecum vasculature of the rat with desmopressin, an analogue of vasopressin
      that causes the release of endothelial vWF. Analysis of vWF in the venous
      effluent of the isolated vasculature showed mainly the presence of extra-large
      molecular weight forms characteristic of endothelial vWF, which in the presence
      of desmopressin showed an average increase of 54%. Also, desmopressin induced a
      significant increase in adhesion of washed oxygenated (oxy) unseparated SS
      erythrocytes, accompanied by a persistent microvascular obstruction and a
      pronounced increase in the peripheral resistance (PRU). In contrast, infusion of
      SS deformable discocytes (SS2) in desmopressin-perfused vasculature resulted in a
      significant adhesion but not in persistent vasoocclusion, showing that SS2
      discocytes alone are not sufficient for microvascular obstruction. Furthermore,
      SS4 erythrocytes (dense discocytes and irreversibly sickled erythrocytes) caused
      a persistent microvascular blockage and a significantly higher PRU than SS2
      discocytes. However, the increase in PRU for SS4 erythrocytes following
      desmopressin treatment was 50% less compared with a corresponding increase for
      SS2 discocytes over the control values, which showed a smaller effect of
      desmopressin on the hemodynamic behavior of SS4 dense erythrocytes. Incubation of
      desmopressin-treated vasculature with anti-vWF antibodies resulted in a
      pronounced decrease in adhesion and significantly improved hemodynamic behavior
      of SS cells. Also, in untreated vasculature, similarly incubated with anti-vWF
      antibodies, there was almost complete inhibition of adhesion. Under the described
      perfusion conditions, antibodies to fibronectin and thrombospondin, as well as
      incubation of SS erythrocytes with anti-vWF antibodies did not affect adhesion.
      These results are compatible with a model for SS vasoocclusion in which extra
      large vWF-mediated adhesion of deformable SS erythrocytes is the first step
      followed by an accelerated entrapment of dense SS erythrocytes.

PMID- 8481523
TI  - Low substrate affinity of pyruvate kinase variant (PK Sapporo) caused by a single
      amino acid substitution (426 Arg-->Gln) associated with hereditary hemolytic
      anemia.
AB  - A point mutation (1277 CGG to CAG) was identified in the R-type pyruvate kinase
      (PK) cDNA of a PK variant, PK Sapporo, associated with hereditary non-spherocytic
      hemolytic anemia. The mutation causes a single amino acid substitution from Arg
      to Gln at the 426th amino acid residue of human R-type PK; consequently, the
      hydrophobicity around the mutated site is drastically decreased. The amino acid
      change occurred in the eighth alpha helix of A domain (A alpha 8) of PK, and it
      has been proposed that this region as well as A alpha 7, A beta 7, and A beta 8
      is a potassium (K+) binding site. Because K+ binding to the PK subunit is
      considered to be essential for substrate binding, the mutation might account for
      the decreased affinity for phosphoenolpyruvate (PEP). This is compatible with the
      fact that all the reported PK variants carrying point mutations in those area
      have a high Michaelis constant (Km) for PEP.

PMID- 8481524
TI  - Origin of a soluble truncated transferrin receptor.
AB  - It has recently become evident that elevation of reticulocytes in the circulation
      of several species, including humans, leads to the formation of a noncellular
      transferrin receptor (TFR). In humans, the majority of the released receptor is
      in truncated form (Shih et al: J Biol Chem 265:19077, 1990). In other species
      (sheep, rat, chicken) the receptor is associated with a vesicle (exosome) and is
      full length (Johnstone et al: J Cell Physiol 147:27, 1991). In this report we
      show that in sheep reticulocytes incubated in vitro, the majority (approximately
      75%) of the released receptor is of native size and is exosome associated. A
      fraction (approximately 25%) is a truncated form of approximately 80 Kd
      corresponding to the exofacial domain of the TFR. Herein we also address the
      question of whether the truncated receptor originates by proteolytic cleavage
      directly from the cell surface or by cleavage from exosomes. Using surface 125I
      labeled sheep reticulocytes as the experimental model, we show that during in
      vitro maturation, 125I-TFR of native size appears in exosomes before the soluble,
      truncated, exofacial domain of the receptor is detected in the medium. Because
      cleavage and release of the exofacial domain would likely leave the truncated
      cytoplasmic and transmembrane domains in the originating membrane (plasma
      membranes or exosomes), both fractions were probed with antibodies specifically
      generated against the cytoplasmic domain of the receptor. Only exosomes, not
      plasma membranes, show the presence of a approximately 17-Kd peptide recognized
      by the antibody to the cytoplasmic domain of the transferrin receptor. Thus, it
      is concluded that the truncated, soluble receptor originates from exosomes in
      sheep. A 17-Kd cytoplasmic domain of the TFR was also detected in exosomes from
      the reticulocytes of an anemic man, suggesting that the truncated receptor in man
      may also originate from exosomes. Using in vitro cultures of surface 125I-labeled
      sheep reticulocytes, it is concluded that exosome formation is the principal
      route for maturation-associated loss of the TFR. A similar conclusion was made
      earlier (Johnstone et al: J Cell Physiol 147:27, 1991) for the nucleoside
      transporter of maturing sheep reticulocytes.

PMID- 8481525
TI  - Blood-feeding host preferences of the isomorphic species Simulium venustum and S.
      truncatum.
AB  - Animal-baited traps, using fox, mink, rabbits and ducks, were used in host
      preference experiments in two habitats (Beach and Woods). A generalized linear
      model of blood-feeding host preference is presented to test for significant
      differences between the isomorphic species Simulium venustum and Simulium
      truncatum. The S. truncatum population peaked before that of S. venustum. On any
      given day the two species divided their blood-feeding efforts among the different
      hosts in the same proportions. On the Beach, fox was the preferred host at the
      beginning of the season, but by the end of the season flies fed with equal
      frequency on the fox and the mink. In the Woods fox remained the preferred host
      throughout the season (late May to early July). Possible reasons for these
      feeding trends are discussed.

PMID- 8481526
TI  - Effects of two blood-feeding regimes on mortality and female reproduction in a
      laboratory colony of stable flies, Stomoxys calcitrans.
AB  - Stable flies (Stomoxys calcitrans L.) deprived of a bloodmeal until 3 days post
      emergence had higher mortality rates than control flies fed from the day of
      emergence. Fat bodies of deprived females required one more bloodmeal to reach
      maximum size, and maximum size was smaller, than fat bodies of control females.
      Ovarian development did not commence prior to feeding in deprived flies, and
      proceeded more slowly thereafter, resulting in a one blood-meal delay in egg
      maturation in deprived flies. Deprived females produced fewer (54.7, SD 2.8) eggs
      than controls (75.9, SD 3.7) and eggs from deprived females were smaller (mean
      length 684.0 microns) than control females' eggs (mean length 1165.7 microns).

PMID- 8481527
TI  - Changes in malathion and pyrethroid resistance after cypermethrin selection of
      Culex quinquefasciatus field populations of Cuba.
AB  - Use of the organophosphorus insecticide malathion for mosquito control in Cuba,
      for 7 years up to 1986, selected elevated non-specific esterase and altered
      acetylcholinesterase (AChE) resistance mechanisms in Culex quinquefasciatus. In
      central Havana space-spraying of malathion was replaced by the pyrethroid
      cypermethrin in 1987: alternate cycles of malathion and cypermethrin were applied
      in some of the more rural areas of Havana district during 1987-91. Consequently,
      populations of Cx quinquefasciatus in the central area of Havana developed
      resistance to cypermethrin, but there is no evidence of pyrethroid resistance in
      the outlying areas. Malathion resistance levels declined significantly after
      1986, measured both by bioassay and the frequency of the elevated esterase
      resistance mechanism, and then stabilized with no measurable decline during 1990
      in any of the populations tested. These populations had less than 10% frequency
      of susceptible homozygotes for both the esterase and AChE resistance mechanisms,
      indicating that organophosphate resistance is still prevalent in Cuban Cx
      quinquefasciatus. These two mechanisms appear to be in linkage equilibrium,
      suggesting that current selection for double resistance is not strong. In the
      central Havana region, pirimiphos-methyl, an organophosphorus insecticide
      unaffected by the two common malathion resistance mechanisms, is now being used
      in a resistance management strategy designed to avoid pyrethroid resistance
      spreading.

PMID- 8481528
TI  - Laboratory colonization of Anopheles quadriannulatus from sympatry with other
      sibling species of the Anopheles gambiae complex in Zimbabwe.
AB  - A laboratory colony of the mosquito Anopheles quadriannulatus was established
      from a wild population occurring sympatrically with An.arabiensis in Zimbabwe.
      These sibling species are members of the An.gambiae Giles complex and were
      distinguished primarily by means of their specific polytene chromosome banding
      patterns. By using an ox-baited trap, we sampled selectively for the more
      zoophilic An.quadriannulatus. It was confirmed that An.quadriannulatus has the
      diagnostic slow allozyme of aspartate aminotransferase (AAT95/95). In a mixed
      population under laboratory conditions, An.arabiensis displaced
      An.quadriannulatus within eight generations, without introgression. Colonization
      of An.quadriannulatus was facilitated by pooling the progeny from wild-caught
      mothers of confirmed identity and by using a specially adapted cage to promote
      mating.

PMID- 8481529
TI  - Malaria in urban and rural Kinshasa: the entomological input.
AB  - Mosquitoes were collected on human bait over a 16-month period (September 1988 to
      December 1989) in an urban and a rural area of Kinshasa, Zaire. P. falciparum
      malaria sporozoite rates were determined by ELISA. In the urban area Culex
      quinquefasciatus accounts for 96% of the 121 bites/person/night (b/p/n). The only
      anopheline is Anopheles gambiae, sensu stricto, with an average of 5.1 b/p/n and
      a sporozoite rate of 1.86%. The entomological inoculation rate (EIR) averages
      0.08 infective b/p/n. Malaria transmission is almost interrupted at the end of
      the dry season. In the rural area mosquito nuisance is small (20 b/p/n), almost
      entirely due to six species of Anopheles including four vectors of malaria:
      An.gambiae (13.3 b/p/n), An.funestus (2.4 b/p/n), An.nili (0.4 b/p/n) and
      An.brunnipes (0.7 b/p/n) with mean sporozoite rates of 7.85%, 6.60%, 6.63% and
      0.53% respectively. An.paludis (0.4 b/p/n) and An.hancocki (0.2 b/p/n) were not
      found infective. Malaria transmission is intense and perennial: the overall EIR
      varies monthly between 0.60 and 3.29 infective b/p/n. The specific contributions
      of An.gambiae, An.funestus and An.nili average 1.07, 0.14 and 0.03 infective
      b/p/n respectively. Malaria transmission peaks during the rainy season in both
      study areas. The daily mean survival rates for An.gambiae were 0.91 and 0.78 in
      the rural and urban area, respectively. All An.gambiae examined belonged to the
      forest cytotype (Coluzzi et al., 1979). Through its effect on the sporozoite
      rate, the higher vector survival rate in the rural environment appears to be the
      major determinant of the greater malaria transmission rate in the rural area as
      compared to urban Kinshasa.

PMID- 8481530
TI  - Lice of farm animals in Libya.
AB  - This first report on the lice of farm animals in Libya lists a total of fifteen
      species, as follows: Haematopinus quadripertusus and Linognathus vituli from
      cattle, Bovicola ovis, Linognathus pedalis, L. africanus and L. ovillus from
      sheep, L. stenopsis, L. africanus and Bovicola caprae from goats. Poultry
      harboured Lipeurus caponis, L. heterographus, Menacanthus stramineus, Menopon
      gallinae, Goniocotes gallinae, Goniodes gigas and G. dissimilis.

PMID- 8481531
TI  - Mean life expectancy of Old World screwworm fly, Chrysomya bezziana, inferred
      from the reproductive age-structure of native females caught on swormlure-baited
      sticky traps.
AB  - The reproductive status of native (wild) screwworm fly, Chrysomya bezziana,
      caught on swormlure-baited sticky traps in Papua New Guinea is described. A total
      of 1122 females and 25 males were trapped. Of these females 595 were scored for
      insemination status and stage of ovarian development (on a scale of 2-10) of
      which 20% were in suitable condition for assignment to first, second and third
      ovarian cycles. Of the nulliparous females, only 17% were inseminated at stage 3
      of ovarian development, 70% at stage 4, 93-97% at stages 5 and 6, and all of
      stages 7-10 (gravids). All parous females were inseminated. More than half of the
      captured females were parous (58%) and only 7% of the total were gravid.
      Proportions of females in ovarian cycles 1, 2 and 3 were 41%, 50% and 9%
      respectively. Survival of female Ch.bezziana in the laboratory was adequately
      described by lognormal and Gompertz survival functions, for both of which the
      mortality rate is an increasing function of reproductive age. Analysis of the
      reproductive age distribution of native females estimated their mean life
      expectancy at 9 days under the prevailing mean field temperature of 26.5 degrees
      C. This equates to completion of 1.7 ovarian cycles and an estimated mean
      lifetime fecundity of 146 female progeny. The survival models, which also allowed
      responsiveness of females to swormlure-baited traps (female trappability) to vary
      according to their stage of ovarian development, indicated significant age
      dependent trapping bias. These findings are compared with similar data for the
      New World screwworm fly, Cochliomyia hominivorax.

PMID- 8481532
TI  - Habitat preferences and carcase colonization by sheep blowflies in the northern
      North Island of New Zealand.
AB  - In urban Auckland, from September 1991 to May 1992, only six specimens of the
      Australian sheep blowfly, Lucilia cuprina, were collected in farmed parkland and
      in garden habitats. The common green blowfly, Lucilia sericata, was the most
      common calliphorid trapped in these habitats. Neither of the two Lucilia species
      were found in native bush remnants in urban or rural areas where Calliphora hilli
      was dominant. Similarly very few L.cuprina (0.3% of the total) were trapped in
      rural rubbish tips in January and February where the majority of blowflies were
      again L.sericata. These results are compared with data collected from pastoral
      habitats, where L.cuprina is the major cause of flystrike. Lucilia cuprina was
      reared from five out of ninety-nine carcases found in rural areas. Calliphora
      stygia and L.sericata were the most common blowflies colonizing carrion and were
      reared from 59% and 51% of the carcases respectively.

PMID- 8481533
TI  - A trial to control the tsetse fly, Glossina morsitans centralis, with low
      densities of odour-baited targets in west Zambia.
AB  - A large-scale trial investigated the possibility of eradicating G.m.centralis
      from a traditional cattle rearing area using odour-baited targets at a reduced
      overall target density from 4 to 0.5-2.3 per km2, thus cutting down initial
      material costs by about 50%. Only the periphery of what was thought to be prime
      tsetse habitat (dense woodland) was treated with targets. These were all black or
      blue/black cloth (1.8 x 1 m), sprayed with deltamethrin suspension concentrate
      and baited with butanone and/or acetone (40-130 mg/h) and 1-octen-3-ol (0.5
      mg/h). Although fly catches from traps and flyrounds initially dropped by
      approximately 3% per day and trypanosomiasis cases declined by 99% within a year,
      eradication was not achieved, so that more targets were deployed at a later
      stage. Although initially cheaper, the option of using reduced target densities
      proved financially unattractive because of prolonged periods of target
      maintenance prior to eradication. Revised strategies for tsetse control with
      odour-baited, insecticide-impregnated targets in west Zambia are presented.

PMID- 8481534
TI  - Aspects of sandfly biology in southern Switzerland.
AB  - During three field surveys of phlebotomine sandflies in the region of Sessa,
      Minor Malcantone, southern Switzerland, annually 1987-89, Phlebotomus perniciosus
      and P. mascittii were caught regularly by means of light traps, but only when the
      traps were in close association with humans. The most productive catching sites
      were in the middle of Sessa village, in basements or partially closed shelters in
      the immediate vicinity of human dwellings. All catching sites outside the village
      were negative. The only other sandfly species caught was Sergentomyia minuta,
      four specimens only. P.perniciosus and P.mascittii always occurred together and
      were found to feed--at least occasionally--on human blood. Glucose and fructose
      were identified in wild-caught sandflies of both species. A breeding place of P.
      mascittii was identified in the basement of a house in the middle of Sessa.
      Analyses of soil samples revealed moderately loamy humus with a slightly acidic
      pH (5.6).

PMID- 8481535
TI  - Uptake and fate of specific antibody in feeding larvae of the sheep blowfly,
      Lucilia cuprina.
AB  - The quantity of specific antibody ingested by larvae of Lucilia cuprina and its
      fate after ingestion were studied in larvae grown on sheep and on an artificial
      diet. Larvae grown to late first or early second instar on sheep vaccinated with
      horse myoglobin contained 66% less specific antibody detected by enzyme linked
      immunosorbent assay than larvae grown to a similar stage on an artificial diet
      containing 75% serum from the same sheep. A similar result was obtained when
      larvae were grown to mid-third instar. Larvae grown on sheep to first or second
      instar contained approximately the same quantity of specific antibody per unit
      weight of larvae as those grown to third instar. Larvae grown on diet to third
      instar contained 22% less specific antibody per unit weight than those grown to
      first or second instar. In larvae grown on diet to late third instar, ingested
      diet retained 91 +/- 12% of its original specific antibody activity in the crop,
      50 +/- 11% in the anterior midgut, 8 +/- 2% in the posterior midgut and 13 +/- 6%
      in the hindgut. The mean concentration of total immunoglobulin detectable in the
      haemolymph of individual third instar larvae grown on diet was 1.7 +/- 2.8
      micrograms/ml. Assays of specific antibody in the haemolymph of similarly reared
      larvae indicated that all or most of this immunoglobulin remained functional. The
      implications of the quantities and distribution of ingested functional antibody
      found in feeding larvae of L.cuprina are discussed in relation to the possibility
      of vaccinating sheep against these larvae and the selection of likely internal
      targets as sources of potential protective antigens.

PMID- 8481536
TI  - Changes in immunity to Ixodes ricinus by rabbits infested at different levels.
AB  - Two groups of rabbits were infested twice with different numbers of Ixodes
      ricinus adults: one group (high infestation) with twenty-five females and twenty
      five males and the other group (low infestation) with five pairs. A third
      infestation was performed in both groups with fifteen adult pairs. Tick biology
      was monitored for resistance effects. At the second infestation, the feeding and
      the egg production were more perturbed in ticks fed on high infestation rabbits.
      The embryogenesis was only affected in ticks from high infestation rabbits. At
      the third infestation, resistance was increased only in low infestation rabbits,
      which became more resistant than high infestation rabbits. The blastogenic
      response of peripheral blood lymphocytes and antibody production against ticks
      were assessed. A salivary gland extract and an integumental antigen from I.
      ricinus adult females were able to initiate lymphocyte proliferation. The
      response was significantly higher in high infestation rabbits, especially at the
      end of the second infestation, and higher in low infestation rabbits during the
      third infestation. Non-specific proliferation with concanavalin A was temporarily
      decreased in both rabbits groups during the first and the second infestations.
      Specific antibody response to salivary and integument antigens were always the
      highest in high infestation rabbits. The involvement of tick-induced
      immunosuppression is discussed.

PMID- 8481537
TI  - Enhancement of tick-borne encephalitis virus transmission by tick salivary gland
      extracts.
AB  - To investigate the role of ticks in TBE virus transmission, salivary gland
      extract (SGE) was derived from partially fed female Ixodes ricinus, Dermacentor
      reticulatus and Rhipicephalus appendiculatus ticks. Guinea-pigs were infested
      with uninfected R. appendiculatus nymphs and inoculated with a mixture of TBE
      virus and SGE or with virus alone. The number of ticks which on average acquired
      virus from feeding on animals inoculated with TBE virus and SGE from partially
      fed ticks was 4-fold greater than the number that became infected by feeding on
      animals inoculated with virus alone or virus plus SGE from unfed I. ricinus.
      Viraemia was detected in 67% of guinea-pigs inoculated with virus plus SGE
      compared to 30% of guinea-pigs inoculated with virus alone. Virus titres in the
      blood were similar for both groups of animals [range 2.0-2.8 log10 plaque-forming
      units (PFU)/ml of blood]; however, the number of ticks that became infected was
      significantly higher on animals inoculated with virus plus SGE from partially fed
      ticks. No significant difference was observed with respect to the tick species
      used to derive SGE. The results indicate that TBE virus transmission is enhanced
      by factor(s) associated with the salivary glands of feeding ticks, and that these
      factor(s) may facilitate efficient transmission of TBE virus between infected and
      uninfected ticks even when they feed on hosts that have no detectable viraemia.

PMID- 8481538
TI  - The effect of dung beetle activity on the discharge of Pilobolus sporangia in
      cattle faeces.

PMID- 8481539
TI  - Antisense DNA oligonucleotides. I: The use of ionspray tandem mass spectrometry
      for the sequence verification of methylphosphonate oligodeoxyribonucleotides.
AB  - The sequences of synthetically prepared methylphosphonate
      oligodeoxyribonucleotides have been verified using ionspray tandem mass
      spectrometry with sample introduction via flow injection. The technique involves
      the use of product-ion scans from multiply protonated (4+ and 5+) precursors.
      Among the ions detected are several series of fragments of different charge
      states that indicate the base sequence of the intact molecule. Oligomers as large
      as 18 bases have been successfully characterized.

PMID- 8481540
TI  - Antisense DNA oligonucleotides. II: The use of matrix-assisted laser
      desorption/ionization mass spectrometry for the sequence verification of
      methylphosphonate oligodeoxyribonucleotides.
AB  - Matrix-assisted laser desorption/ionization (MALDI) mass spectrometry has been
      used to measure accurately the molecular masses of synthetic methylphosphonate
      oligodeoxyribonucleotides, up to 18 nucleotides in length. A simple method has
      been developed for the complete sequence verification of these compounds, which
      are intractable by classical means. Sequencing from the 5' end of the molecule is
      possible because of inefficiencies in the synthetic procedure. Complementary
      information from the 3' end can be obtained by partial hydrolysis of the
      methylphosphonate backbone.

PMID- 8481541
TI  - Chemical archaeology of kava, a potent brew.
AB  - Kava lactones, which are present in the intoxicating Pacific Island drink, kava,
      have now been detected in a number of archaeological artefacts using selected-ion
      monitoring techniques in conjunction with gas chromatography/electron impact-mass
      spectrometry. Thus it is now possible to link unequivocally kava drinking, a
      major aspect of the ceremonial culture of many Pacific societies, to the
      archaeological record. In addition, a new variation of the kava lactone skeleton
      was tentatively identified in the form of 7,8-dihydro-5,6-dehydrokawain and 7,8
      dihydro-5,6-dehydromethysticin.

PMID- 8481542
TI  - In situ reduction suitable for matrix-assisted laser desorption/ionization and
      liquid secondary ionization using tris(2-carboxyethyl)phosphine.
AB  - The suitability of the hydrochloride salt of tris(2-carboxyethyl)phosphine (TCEP)
      for in situ reduction with matrix-assisted laser desorption/ionization (MALDI)
      and liquid secondary ionization (LSI) mass spectrometry is evaluated. TCEP can be
      used to irreversibly reduce organic disulfides to thiols in water and is active
      at an acidic pH. We found that TCEP was suitable for partial reduction of bovine
      insulin deposited on the target and mixed with either sinapinic acid in MALDI or
      glycerol and m-nitrobenzyl alcohol in LSIMS. When TCEP was added to insulin
      deposited on the target without prior mixing of sinapinic acid the in situ MALDI
      protocol resulted in almost complete reduction.

PMID- 8481543
TI  - Sequence-ion studies in peptides: the generation of C" ions.
AB  - The mechanism for the formation of C"-type ions from protonated peptides,
      produced under conditions of fast-atom bombardment and collisional activation was
      investigated. Comparison of the tandem mass spectra of the [M + H]+ ions of a
      model peptide and the corresponding [Md + D]+ ions, in which all exchangeable
      hydrogens are replaced with deuterium, revealed that neither the carboxylic
      hydrogen nor a hydrogen from a nitrogen atom is involved in the process of
      migration of a hydrogen which leads to the formation of C"n-type ions. The most
      feasible position from which the transferred hydrogen originates is that at the
      first C-atom in the side-chain of the adjacent amino acid.

PMID- 8481544
TI  - The ethnic distribution of antibodies to glutamic acid decarboxylase: presence
      and levels of insulin-dependent diabetes mellitus in Europid and Asian subjects.
AB  - Our objective was to ascertain the frequency of antibodies to glutamic acid
      decarboxylase (GAD) in Europids and four Asian ethnic groups with insulin
      dependent diabetes mellitus (IDDM) to gain insight into why the prevalence and
      incidence of IDDM varies so widely among ethnic and/or geographically diverse
      population groups. The subjects in this study were Europid (n = 49), Japanese (n
      = 16), Thai (n = 7), Korean (n = 21), and Chinese (n = 13) persons with IDDM with
      a duration ranging from 5 to 14 years. There were similar numbers of healthy
      controls matched for each ethnic group. A validated radioimmunoprecipitation
      assay used GAD from pig brain radiolabeled with 125I using chloramine T. Islet
      cell cytoplasmic antibodies measured by indirect immunofluorescence were
      expressed as Juvenile Diabetes Foundation units. The prevalence of antibodies to
      GAD, compared with Europids (63%), was much lower in all Asian populations with
      IDDM: Japanese (31%), Thai (29%), Korean (5%), and Chinese (27%). The mean level
      of antibodies to GAD, however, among diabetics from each population who gave a
      positive reaction, was similar. For all groups, the prevalence of antibodies to
      GAD was much higher than that of islet cell cytoplasmic antibodies. Almost all
      IDDM subjects positive for islet cell antibodies had antibodies to GAD, but the
      converse did not hold. A radioimmunoprecipitation assay for antibodies to GAD
      applied to serum from subjects with IDDM in various ethnic groups showed that
      Europids with IDDM had a much higher prevalence of such antibodies than did
      Asians. This held for all ethnic groups, and particularly Koreans. Thus, among
      different populations, there may be etiologic heterogeneity of IDDM.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8481545
TI  - Is growth hormone associated with diabetic retinopathy?
AB  - The role of growth hormone (GH) in the pathogenesis of diabetic retinopathy was
      evaluated in 150 patients with non-insulin-dependent diabetes mellitus by
      measuring urinary GH excretion using a highly sensitive enzyme immunoassay.
      Urinary GH excretion was not significantly different among diabetic patients
      without retinopathy (mean, 2.4 ng/day; range, < 0.3-20.0 ng/day), with background
      retinopathy (2.7 ng/day; < 0.3-22.0 ng/day), and with proliferative retinopathy
      (3.1 ng/day, 0.9-15.6 ng/day). These data suggest that GH does not play a role
      for the pathogenesis of diabetic retinopathy through the increased physiological
      secretion.

PMID- 8481546
TI  - Type I diabetic nephropathy: clinical characteristics and economic impact.
AB  - Approximately one-third of type I diabetic patients develop diabetic nephropathy
      with confounding pathogenesis--frequently manifested as heavy persistent
      proteinuria, fall in glomerular filtration rate, and increased arterial
      hypertension. There is increasing incidence and prevalence of type I diabetes,
      particularly in northern Europe and the United States. Increased morbidity and
      mortality occur in type I diabetic patients with renal disease. Among type I
      patients with persistent proteinuria, death occurs on the average within 5-10
      years. The economic impact of endstage renal disease due to diabetic nephropathy
      is overwhelming, and the cost is increasing at an alarming rate.

PMID- 8481547
TI  - Renal hypertrophy as a prognostic index for the progression of diabetic renal
      disease in non-insulin-dependent diabetes mellitus.
AB  - The aim of this study is to elucidate the clinical significance of estimating
      renal size in non-insulin-dependent diabetes mellitus (NIDDM). Renal size was
      compared in 57 NIDDM patients with persistent normoalbuminuria [group I; 19
      cases, albumin excretion rate (AER) < 20 micrograms/min], microalbuminuria (group
      II; 24 cases, AER = 20-200 micrograms/min), or macroalbuminuria (group III; 14
      cases, AER > 200 micrograms/min). Three groups were matched for age and diabetes
      duration. Renal size was estimated using drip-infusion pyelography according to
      Simon's method (mean kidney length/height of second lumbar spine and disc; renal
      ratio, RR). Thirteen patients with persistent microalbuminuria (10 normotensive
      and 3 hypertensive) were traced during at least 3 years. Angiotensin-converting
      enzyme inhibitor (enalapril) was used in 11 cases. The results are as follows:
      (1) Renal size in groups II (RR, 3.47 +/- 0.28; cited as mean +/- SD) and III
      (3.62 +/- 0.32) significantly increased compared with that in group I (3.26 +/-
      0.20) (p < 0.01 and p < 0.001, respectively). No statistical differences could be
      detected between groups II and III. (2) As a whole, good metabolic (glycosylated
      hemoglobin, HbA1) and hemodynamic (systolic blood pressure, SBP) control was
      achieved during the last 12 months (HbA1, 8.4% +/- 0.9%; SBP, 122 +/- 8 mm Hg).
      There was no significant correlation between RR and creatinine clearance, HbA1,
      SBP, or diastolic blood pressure during the first and last 12 months. Initial RR
      significantly correlated with AER during the last 12 months (r = 0.651, p <
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481548
TI  - Audit of the change from twice daily to basal-bolus insulin regimens in insulin
      dependent diabetes.
AB  - Basal-bolus insulin regimens have become popular with patients, but clinicians'
      enthusiasm for their use has been tempered by a number of reports that suggest
      that these regimens do not improve overall glycemic control when compared with
      conventional, twice daily, regimens. Indeed, it has been suggested that basal
      bolus regimens may be abused by certain patients leading to an increase in body
      weight and deterioration in glycemic control. This paper reports the results of a
      retrospective audit of 145 insulin-dependent diabetic patients changed from
      conventional insulin therapy to a basal-bolus insulin regimen. After 3 months on
      the basal-bolus regimen, a small but significant fall in total insulin (10%; p <
      0.001) and intermediate-acting insulin (50%; p < 0.001) dose was recorded. During
      this time period serum fructosamine measurements also fell by 10% (p < 0.001)
      indicating a small but significant improvement in glycemic control. Body-mass
      index (BMI) and body weight data did not support the view that basal-bolus
      regimens lead to an increase in body weight. Analysis of the data by gender did
      not support the view that the basal-bolus insulin regimen is prone to abuse by
      female patients.

PMID- 8481549
TI  - Association of thermal perception thresholds with cardiovascular autonomic
      function in diabetes.
AB  - In order to study the association between warm thermal-perception thresholds
      (WPT), cold thermal-perception thresholds (CPT) and cardiovascular autonomic
      function, we examined 91 otherwise healthy patients with diabetes mellitus (69
      with type I and 22 with type II). The covariance analysis revealed that WPT was
      associated with the deep-breathing E/I ratio and the Valsalva ratio (p = 0.004
      and p = 0.008, respectively) whereas CPT was associated with the Valsalva ratio
      and the postural blood pressure decrement (p = 0.008 and p = 0.004,
      respectively). These associations possibly reflect histological similarities
      between the parasympathetic nerves and those mediating warm sensation, and
      between the sympathetic nerves and those mediating cold sensation.

PMID- 8481550
TI  - Taurine prevents galactose-induced cataracts.
AB  - Intact lenses from New Zealand white rabbits were incubated in tissue culture
      media containing either 5 mM glucose or 5 mM glucose plus 30 mM galactose. The
      standard media did not contain taurine. Lenses were also cultured in a third
      medium containing 30 mM galactose plus 0.2 mM taurine. The frequency of cataract
      formation was evaluated as a function of the culture media. One lens (1/10), in
      media containing 5 mM glucose, developed a lenticular opacification during a 72-h
      incubation. Lenses (12/15) incubated in 30 mM galactose, without taurine,
      developed cataracts; fewer lenses (2/13) exposed to 30 mM galactose plus 0.2 mM
      taurine developed cataracts (p < 0.005). Galactose cataracts have been associated
      with lens edema attributed to the osmotic stress of tissue polyol (galactitol)
      accumulation. The water content of the noncataractous and cataractous lenses in
      this experiment did not differ. Lens edema, therefore, was not thought to be
      important in cataract pathogenesis. Taurine, an organic osmolyte was lower (5.1
      +/- 1.5 mumol/g protein) in cataractous lenses than in control lenses (10.0 +/-
      1.0 mumol/g protein). Malondialdehyde, an indicator of lipid peroxidation, was
      higher (36.6 +/- 5.0 mumol/g protein) in lens-containing opacifications than in
      noncataractous lenses (10.1 +/- 1.9 mumol/gm protein) (p < 0.01). The levels of
      malondialdehyde suggest that lipid peroxidation was increased in the process of
      sugar cataractogenesis. The malondialdehyde content of all the lenses correlated
      inversely (r = -0.53, p < 0.01) with the coincident lens taurine levels. Taurine
      appears to protect the lens against the development of sugar cataracts; its
      inverse relationship with lens malondialdehyde suggests this is an antioxidant
      effect.

PMID- 8481551
TI  - The predictive value of albuminuria for cardiovascular and renal disease. A 5
      year follow-up study of 476 patients with type I diabetes mellitus.
AB  - A 5-year follow-up study of 476 type I adult diabetic patients previously studied
      cross sectionally revealed that, during the observation period, 19 patients died
      and 30 developed cardiovascular or renal disease, such as myocardial infarction
      (n = 8), cerebrovascular disease (n = 3), amputation (n = 6), and renal
      insufficiency (n = 13). The patients were registered by one and the most-severe
      event only. The yearly death rate was 8.0 per 1000, compared with the expected
      death rate of 2.0 for people with corresponding age and sex in the general
      population. In patients with renal insufficiency, one also had myocardial
      infarction, and one had had an amputation. The ages of patients who died, with
      myocardial infarction, cerebrovascular disease, amputation, or renal
      insufficiency, were 44.2 +/- 12.7, 41.3 +/- 6.6, 43.7 +/- 13.2, 45.3 +/- 15.7,
      and 40.8 +/- 9.8 years, respectively. Urinary albumin concentration in a single
      early morning urine sample was found to be a strong prognostic marker for the
      development of cardiovascular disease or death. In contrast, age, gender, age at
      onset and duration of diabetes, levels of blood pressure, serum creatinine, and
      HbA1c, or presence of hypertension, as well as changes in blood pressure and
      hBa1c, during the observation period did not influence the survival or incidence
      of cardiovascular disease. However, blood pressure and HbA1c were associated with
      increased urinary albumin concentrations during the follow-up period.

PMID- 8481552
TI  - Oral health and salivary composition in diabetic patients.
AB  - The salivary composition and flow rate were examined in 20 patients with insulin
      dependent diabetes mellitus (IDDM) and in 19 patients with non-insulin-dependent
      diabetes mellitus (NIDDM) and compared with 20 healthy controls. Resting and
      stimulated whole and submandibular saliva was analyzed. Significantly lower
      resting salivary flow rates were found in the IDDM patients as compared to the
      NIDDM group. In the IDDM patients potassium concentration in resting saliva was
      significantly higher compared with healthy controls and in stimulated whole
      saliva compared with NIDDM patients. No difference in salivary total protein,
      amylase, lactoferrin, or lysozyme was found among the three groups examined. The
      IgA concentration of the IDDM patients was significantly higher in whole resting
      saliva compared with controls and in the submandibular saliva compared with both
      NIDDM patients and controls. No difference was found between controls and the
      diabetic patients examined in prevalence of complaint of dry mouth. The salivary
      flow rates, however, were significantly lower in the three subgroups with dry
      mouth compared with the subgroups without this complaint. Caries were detected in
      100% of the diabetic patients and controls. No correlation was observed between
      the incidence of caries and any of the salivary parameters examined. A higher
      prevalence and severity of periodontal disease was detected in the diabetic
      patients as compared to the controls. A significant positive correlation was
      found between the gingival index and the concentrations of total protein,
      albumin, lysozyme, and lactoferrin in whole resting saliva in the three groups
      examined.

PMID- 8481553
TI  - Rapidly progressing diabetic retinopathy upon improved metabolic control.

PMID- 8481554
TI  - Fecal excretions of hydroxy fatty acid and bile acid in diabetic diarrheal
      patients.
AB  - Thirteen normal subjects, 5 diarrheal controls (Group I) and 13 diabetics without
      peripheral neuropathy (Group II) were compared with 7 diabetic patients (Group
      III) with respect to fecal excretions of bile acids and hydroxy fatty acids for
      pathogenesis of diabetic diarrhea. The mean fecal excretions of bile acids per
      day were 304.9 mg for the normal controls, 297.8 mg for Group I, and 382.4 mg for
      Group II, while those of Group III were significantly higher (958.2 mg, p < 0.01)
      than the foregoing groups, and nearly three times as much as the controls. As to
      the fecal fatty acid excretion, there were no significant differences observed
      among these groups. The percentages of fecal hydroxy fatty acids were not
      significantly different in normal subjects (1.5%), Group I (2.0%), and Group II
      (1.2%). In contrast, the percentage of hydroxy fatty acid for Group III was
      greatly (p < 0.01) increased (13.2%). From the above results, the percentage of
      hydroxy fatty acid in diabetic diarrheal patients was high, suggesting that there
      is bacterial overgrowth. Meanwhile, the fecal bile acid level was increased about
      three times, indicative of poor absorption of bile acid from mild to moderate
      degree. Therefore, it is considered improbable that fecal hydroxy fatty acids and
      bile acids are the cause of diabetic diarrhea.

PMID- 8481555
TI  - Methods for the analysis of enantiomers of racemic drugs application to
      pharmacological and pharmacokinetic studies.
AB  - Although the existence and differences in biological behavior of optical isomers
      have long been appreciated, there has been an apparent reluctance to address
      these differences in pharmacology and the pharmaceutical sciences. At least part
      of this reluctance arises from the belief that the separation of enantiomers
      requires highly specialized analytical equipment and expertise. The purpose of
      this review is to present general principles that allow the separation of
      stereoisomers and demonstrate that these procedures can be accomplished using
      available and convenient chromatography techniques.

PMID- 8481556
TI  - Approaches to the identification and classification of chemical allergens in
      mice.
AB  - During the last 10 years understanding of the immunobiological mechanisms whereby
      chemicals induce allergy has increased significantly. In parallel there have
      emerged opportunities to develop alternative methods for the prospective
      identification and classification of chemical contact and respiratory allergens.
      Attention has focused largely on the mouse, and several novel approaches to the
      identification of contact allergens have been described, among them the local
      lymph node assay, the mouse ear swelling test and, most recently, the noninvasive
      mouse ear swelling assay (MESA). Progress has been made also in defining methods
      for measuring respiratory sensitization potential in mice. Recent evidence
      indicates that respiratory and contact allergens provoke qualitatively different
      immune responses characteristic of selective T helper (Th) cell activation.
      Evaluation of the nature of immune responses induced in mice by chemicals may
      permit not only assessment of allergenic potential, but also prediction of the
      form allergic reactions will take.

PMID- 8481557
TI  - A new method for assessing Ca2+ requirements for vasoconstriction in the rat
      isolated perfused kidney. Effect of norepinephrine and endothelin.
AB  - The consecutive perfusion with three different media containing 1) a high-K+,
      Ca(2+)-free solution with 1 mM of EDTA, 2) a high-K+, Ca(2+)-free solution with
      1mM of EDTA and 0.3-10 microM of norepinephrine (NE) or 1-10 nM of endothelin
      (ET), and 3) a normal K+ solution without EDTA, NE, or ET, respectively, produced
      three rapid and transient vasoconstrictions of the isolated and perfused rat
      kidney. Results obtained from preincubation with prazosin (0.9 nM) and nifedipine
      (10 nM) or reperfusion at various Ca2+ concentrations showed that the responses
      involved are characterized by a different mobilization of cellular and
      extracellular Ca2+. The first phase greatly depends on the influx of
      extracellular Ca2+ and/or membrane Ca2+ through voltage-dependent channels, the
      second from mobilization of intracellular Ca2+, while the third is due mainly to
      the influx of extracellular Ca2+ through receptor-activated channels. NE elicited
      Ca2+ mobilization from both cellular and extracellular sources through activation
      of alpha-1 adrenoceptors. ET is particularly effective in producing extracellular
      Ca(2+)-dependent vasoconstriction in a prazosin-resistant manner. Present results
      show that this method could be suitable to distinguish different Ca2+
      requirements for spasmogen-induced vasoconstriction in the isolated and perfused
      rat kidney.

PMID- 8481558
TI  - A new cannula-inserting method for measuring vascular responsiveness. Separate
      intraluminal and extraluminal perfusion of canine basilar artery.
AB  - We modified the cannula-inserting method to examine the difference in response of
      vessels to intraluminal or extraluminal application of vasoactive substances. A
      polyethylene roof was designed to cover the isolated canine basilar artery so
      that an extraluminal superfusion stream could pass over an artery that
      simultaneously received an intraluminal perfusion. An extraluminal administration
      of KCl produced a monophasic transient vasoconstriction, but intraluminal KCl
      produced relatively small tonic constriction even at high concentrations.
      Serotonin-induced vasoconstrictions were significantly larger with intraluminal
      administration than with extraluminal. Prostaglandin F2 alpha-induced
      vasoconstriction exhibited no significant difference between the administration
      routes. Endothelin caused a long-lasting constriction, which was slightly larger
      in extra- than intraluminal administration. Our modified cannula-inserting
      technique provides a new method to examine the different effects produced by
      intraluminal and extraluminal application of drugs.

PMID- 8481559
TI  - Comparison of liposome fusion and electroporation for the intracellular delivery
      of nonpermeant molecules to adherent cultured cells.
AB  - Intracellular delivery of nonpermeant molecules to cultured cells in situ can be
      problematic. This work is a comparison between two methods of accomplishing this
      delivery; liposome-mediated delivery and electroporation. The final goal was to
      examine the effects of the glutathione S-transferase (GST) inhibitor Basilen Blue
      (BB) on glyceryl trinitrate biotransformation in porcine kidney epithelial (PK1)
      cells after intracellular delivery. Initial evaluation used the fluorescent
      markers carboxyfluorescein and lucifer yellow (LY). This was followed by
      biochemical analysis of glyceryl trinitrate biotransformation. Liposome-mediated
      delivery proved ineffective in spite of variations in the lipid composition of
      the liposomes and the use of an agglutinin and a fusogen. In contrast,
      electroporation was a very effective method for intracellular delivery of both
      lucifer yellow and basilen blue to the PK1 cells. The results show that in cells
      where Basilen Blue was introduced, there was a decrease in both the glyceryl
      trinitrate (GTN) biotransformation and ratio of glyceryl-1,2-dinitrate (1,2-GDN)
      to glyceryl-1,3-dinitrate (1,3-GDN) formed. The technique of in situ
      electroporation shows great promise for the assessment of a variety of
      nonpermeant molecules of pharmacological interest.

PMID- 8481560
TI  - Is pentobarbital appropriate for basal anesthesia in the working rat heart model?
AB  - In the present study we have examined the effects of the general anesthetic
      agents for the excision of the heart on the hemodynamic function of the ischemic
      perfused heart. Animals were divided into three groups. In one group rats were
      anesthetized with sodium pentobarbital intraperitoneally. Animals of the second
      and third groups were anesthetized with inhalation anesthetics, sevoflurane and
      isoflurane, respectively. The hearts were then rapidly excised and perfused by a
      working heart model. After control perfusion, whole-heart ischemia was induced by
      one-way aortic valve for 15 min followed by reperfusion for 30 min. During
      preischemic control period, cardiac output (CO) and left ventricular dP/dT
      maximum (LV dP/dT max) in the isoflurane group were significantly higher than
      those in the pentobarbital group. During reperfusion, CO and LV dP/dT max in the
      isoflurane and sevoflurane groups recovered more rapidly than those in the
      pentobarbital group. Although there were no significant differences in myocardial
      ATP and glycogen levels among the groups, myocardial lactate in the pentobarbital
      group was significantly higher than those in the sevoflurane and isoflurane
      groups. These results suggest that intraperitoneal pentobarbital anesthesia,
      administered prior to heart excision, may affect the performance of the ischemic
      perfused heart thereafter. Therefore, we would suggest that isolation of hearts
      by means of inhalation anesthesia is better than by means of pentobarbital in the
      working rat heart.

PMID- 8481561
TI  - Reproducibility of the model of induced ventricular tachycardia in conscious dogs
      with infarction.
AB  - The canine model of ventricular tachycardias (VT) induced by programmed
      stimulation is used routinely in several laboratories to test antiarrhythmic
      drugs. The aim of the present study was to determine the rate of success and
      reproducibility of this model. We analyzed a group of 58 dogs that underwent a 2
      hr occlusion and were submitted to programmed electrical stimulation at least 4
      days after the surgery. Only 29 dogs (50%) were inducible and included in the
      study, as 22 dogs died following myocardial infarction, and seven dogs were never
      inducible. Out of 130 trials, 92 (70%) performed on inducible dogs were positive
      with 11% of nonsustained ventricular tachycardias, 63% of sustained monomorphic
      ventricular tachycardias, and 26% of ventricular fibrillation. Inducibility
      decreased over time in a subgroup of 19 dogs that was submitted to four trials
      during the first month after the infarction (68% of inducible dogs versus 46% in
      trials 1 and 4, respectively). Ventricular effective refractory period decreased
      significantly from 146 +/- 7 msec at trial 1 to 114 +/- 6 msec at trial 4, and
      the severity of the induced ventricular tachycardias increased. This variability
      should be considered when planning studies on antiarrhythmic drugs in this model.

PMID- 8481562
TI  - Familial recurrence risks and inheritance of multiple sclerosis.
AB  - The cause of multiple sclerosis is unknown. There is considerable circumstantial
      evidence that multiple sclerosis is a complex trait, probably autoimmune in
      nature, and is determined by both genetic and environmental factors. It is
      recognized that relatives of multiple sclerosis patients are at greater risk for
      developing the disease than the general population, although this risk is still
      relatively low in absolute terms. Monozygotic co-twins of multiple sclerosis
      patients appear to have the highest risk of any group of relatives, although the
      absolute risk is well under 100%, as would be predicted if multiple sclerosis is
      purely a genetic disorder.

PMID- 8481563
TI  - Hormonal factors in susceptibility to multiple sclerosis.
AB  - Evidence implies that hormonal factors are involved in susceptibility to multiple
      sclerosis. Diseases associated with a class II allele occur more frequently in
      women than in men. Multiple sclerosis is more frequent in women, particularly in
      the early- and late-onset groups. Pregnancy has a favorable effect on the course
      of multiple sclerosis on both a short- and a long-term basis. Experimental
      allergic encephalomyelitis, an animal model with similarities to multiple
      sclerosis, is also influenced by hormonal factors in both occurrence and
      severity. The multiple levels of interaction between immune, endocrine,
      neurologic, and genetic systems probably explain the action of sex steroids in
      multiple sclerosis susceptibility.

PMID- 8481564
TI  - Magnetic resonance in multiple sclerosis.
AB  - Magnetic resonance and various chemical measurements, such as spectroscopy, are
      being systematically applied to both multiple sclerosis and the experimental
      model (experimental allergic encephalitis). The dynamic aspects of multiple
      sclerosis pathology can be visualized on serial magnetic resonance imaging scans,
      and enhancement techniques help distinguish another type of activity by showing a
      leaky blood-brain barrier in acute lesions. Quantitative measures applied to the
      image also appear to provide an index of the burden of disease both in individual
      patients and in groups. A combination of the dynamic information available from
      serial studies and the quantitative information concerning burden of disease
      promises to provide both sensitivity and objectivity to standard outcome measures
      in multiple sclerosis. In addition, natural history studies of the evolution of
      magnetic resonance imaging and spectroscopy will revolutionize our understanding
      of the evolution of the actual tissue changes in multiple sclerosis pathology
      that can be characterized during life.

PMID- 8481565
TI  - Clinical trials in multiple sclerosis.
AB  - In this past year, there has only been modest progress in the search for an
      effective treatment for multiple sclerosis and its complications, although a
      number of carefully designed trials are in progress. No treatment predictably
      slows the course of active disease. The marginal benefits previously claimed for
      azathioprine have been strengthened by a meta-analysis of previously published
      work. Methylprednisolone may have a minor role in the treatment of very severe,
      acute optic neuritis but prednisone use may predispose patients to recurrent
      optic neuritis. 4-Aminopyridine and 3,4-diaminopyridine may prove useful for the
      symptomatic treatment of some multiple sclerosis patients; pemoline may be an
      alternative to amantadine for the control of fatigue; and acetazolamide may be an
      alternative to carbamazepine and phenytoin for the treatment of painful tonic
      spasms.

PMID- 8481566
TI  - Clinical aspects of epilepsy including diagnosis, management, pharmacotherapy,
      and surgery.
AB  - This review emphasizes clinical manifestations, recognition of specific epileptic
      syndromes, use of antiepileptic drugs, and surgical evaluation and outcome.
      Juvenile myoclonic epilepsy is increasingly recognized but still underdiagnosed.
      Good evidence exists for a relationship between Landau-Kleffner syndrome
      (acquired epileptic aphasia) and electrical status epilepticus during sleep,
      which reflects the course of the aphasia. In focal onset seizures, the type of
      aura may be as valuable for determining the lobe of seizure onset as
      electroencephalographic and neuroimaging techniques. In temporal lobe seizures,
      postictal language assessment was used to determine the side of origin, and
      hippocampal and temporal volumetry using magnetic resonance imaging proved
      reliable indicators of the side of involvement. Valproate sodium and
      carbamazepine were equally effective for secondarily generalized tonic-clonic
      seizures, but carbamazepine was superior to valproate for complex partial
      seizures. One study suggests that in children, increased daytime sleep tendency
      persists 4 to 5 months after discontinuation of antiepileptic drugs and that
      neither drugs nor seizure activity are necessarily involved. Many recent
      publications were devoted to surgical treatment. The main issues reviewed concern
      patient selection and correlation between preoperative parameters and outcome
      after surgery.

PMID- 8481567
TI  - Clinical neurophysiology, neuroimaging, and the surgical treatment of epilepsy.
AB  - Improved neurodiagnostic tools for examining cerebral structure and function have
      greatly enhanced the safety and efficacy of surgical treatment for epilepsy, and
      markedly increased the number of candidates for these surgical interventions. The
      application of new developments in clinical neurophysiology, as well as recent
      advances in neuroimaging, for surgical therapy of medically refractory seizures
      are reviewed. Improvements in surgical results are documented and future
      directions are discussed.

PMID- 8481568
TI  - Pain and disorders of consciousness.

PMID- 8481569
TI  - HIV and interventional radiology: a national survey of physician attitudes and
      behaviors.
AB  - PURPOSE: The frequency of parenteral and cutaneous exposure to blood or body
      fluid during interventional radiologic procedures, current use of barrier
      precautions by interventional radiologists, and physician attitudes about testing
      for the human immunodeficiency virus (HIV) and related issues were assessed.
      MATERIALS AND METHODS: An anonymous survey of interventional radiologists was
      conducted by mail in November 1991. RESULTS: Of 1,530 surveys, 819 (54%) were
      returned and 806 (53%) were completed and evaluable. Ninety-six percent of
      respondents (763 of 794) perform procedures in patients infected with HIV. Sixty
      nine percent oppose mandatory testing of physicians for HIV. Eighty-seven percent
      (693 of 797) reported at least one procedure-related injury (range, 0-99; mean,
      four). Fifty-eight percent of injuries occurred with use of a sharp instrument
      (381 of 662), 20% were due to needle recapping (133 of 662), and 7% (44 of 662),
      to improper disposal of a sharp instrument. Contact between a physician's blood
      and a patient was reported in only one case (0.2%). Eighty-five percent of
      respondents (671 of 789) changed their use of barrier precautions in the last 10
      years; concerns about HIV were cited by 96% as a reason for change. Reported use
      of barrier measures was highly variable. CONCLUSION: Exposure to patients' blood
      or body fluid is not infrequent during interventional radiologic procedures.
      Exposure of patients to the blood or body fluid of health care workers is rare.
      Use of recommended precautions in interventional radiology is variable, and
      practices that could lead to preventable injury remain common. Strategies should
      be developed to reduce risks even further and to encourage universal compliance
      with government guidelines.

PMID- 8481570
TI  - Endovascular treatment of arteriovenous fistulas arising from branches of the
      subclavian artery.
AB  - PURPOSE: The goal of this study was to evaluate the role of endovascular
      techniques in the treatment of arteriovenous fistulas (AVFs) in the subclavian
      region. PATIENTS AND METHODS: Since 1984 six patients with AVFs arising from
      branches of the subclavian artery have been treated. All AVFs were of iatrogenic
      origin (five venous punctures and one pacemaker insertion). Two patients had
      cardiac insufficiency, three had a bruit, and one had upper extremity venous
      hypertension. Angiographically, four of the AVFs were located on the
      thyrocervical trunk and two were on the internal mammary artery. RESULTS: All
      fistulas were treated by means of endovascular occlusion with a detachable
      balloon, with full resolution of symptoms. One AVF recurred after a balloon
      deflated prematurely. The patient was treated again and was subsequently cured.
      No other complications were associated with treatment. CONCLUSION: Endovascular
      balloon occlusion of AVFs in the subclavian region is a simple, effective, and
      safe method that eliminates the need for surgery. It should be the method of
      choice for treatment of these lesions.

PMID- 8481571
TI  - Transcatheter embolization of a superior mesenteric artery pseudoaneurysm and
      arteriovenous fistula.

PMID- 8481572
TI  - Fragmentation of biliary calculi in 71 patients by use of intracorporeal
      electrohydraulic lithotripsy.
AB  - PURPOSE: Failure of percutaneous or endoscopic removal of biliary calculi is
      often associated with impacted stones or stones larger than 1.5 cm. In these
      difficult cases, intracorporeal electrohydraulic lithotripsy (EHL) is a method
      that allows large stones to be fragmented and removed percutaneously or
      endoscopically. In this study, the authors expand their experience with EHL and
      further evaluate the safety and efficacy of this technique to remove biliary
      tract calculi. PATIENTS AND METHODS: Intracorporeal electrohydraulic lithotripsy
      was used to treat 71 patients with calculi in the bile ducts (n = 35) or
      gallbladder (n = 36). Access was obtained by means of a surgical T-tube tract (n
      = 16), percutaneous transhepatic biliary drainage (n = 14), percutaneous
      cholecystostomy (n = 36), an intraoperative approach during common duct
      exploration (n = 2), and at endoscopic retrograde cholangiopancreatography (n =
      3). RESULTS: EHL lithotripsy was effective in fragmenting all biliary stones in
      69 of the 71 patients (97%). All of the stone fragments were removed in 67 of
      these 69 patients (94%). Major complications, including bile peritonitis and
      gallbladder necrosis, occurred in five patients; however, all major complications
      were related to the initial percutaneous drainage or tract dilation. No
      significant complications were directly attributable to the EHL procedure.
      CONCLUSION: Intracorporeal EHL is a safe and effective method that can be used to
      improve the success of percutaneous and endoscopic biliary calculi removal.

PMID- 8481573
TI  - Budd-Chiari syndrome: recanalization of an occluded hepatic vein with
      percutaneous transluminal angioplasty and a metallic stent.

PMID- 8481574
TI  - Treatment of Budd-Chiari syndrome with a transjugular intrahepatic portosystemic
      shunt.

PMID- 8481575
TI  - Vasa vasorum changes following stent placement in experimental arterial stenoses.
AB  - PURPOSE: Experimental stenoses were created in canine aortae to compare the
      effects of stent placement and balloon angioplasty on the vasa vasorum. MATERIALS
      AND METHODS: A balloon-expandable Palmaz stent was placed in the proximal
      stenosis, and angioplasty was performed in the distal stenosis in each of eight
      dogs. Two dogs were killed at 4, 8, 12, and 18 months, respectively. Specimens
      were studied by means of microangiography, histology, scanning electronic
      microscopy, and Spalteholz technique. RESULTS: At up to 12 months, there was
      proliferation of the vasa vasorum and a rich plexus formed in each of the animals
      at each treated site. More vasa vasorum were seen after stent placement than
      after angioplasty. The new vessels were mainly venules located in the media. At
      18 months, there was regression of the venules and the vasa vasorum distribution
      returned to baseline. CONCLUSION: The authors conclude that the effects of stents
      on the vasa vasorum are temporary.

PMID- 8481576
TI  - Recirculation-type Amplatz clot macerator: determination of particle size and
      distribution.
AB  - PURPOSE: A high-speed mechanical clot macerator was tested in vitro, and the
      distributions and sizes of residual particles produced by this device were
      determined. MATERIALS AND METHODS: Human thrombi aged for 4 days and 10 days were
      macerated using a recirculation-type Amplatz thrombectomy device with an 8-F,
      high-speed screw propeller. The device was activated for 15, 30, and 60 seconds.
      Two different methods of particle measurement were used to determine overall
      particle distribution and to determine the size and number of large particles.
      RESULTS: The recirculation device liquefied 99.2% of 4-day-old and 98.8% of 10
      day-old thrombi, producing particles ranging in size from 13 to 1,000 microns;
      all particles were smaller than 1,000 microns. Particle size and distribution
      results were identical for the 30-second and 60-second activation times.
      CONCLUSION: The recirculation-type thrombectomy device appears to perform well as
      a method of macerating human thrombi. Clinical trials need to be conducted to
      test the device further and to determine if it can be used safely on venous as
      well as arterial occlusions.

PMID- 8481577
TI  - Traumatic ischemia of the hand in a tennis player: successful treatment with
      urokinase.

PMID- 8481578
TI  - Pseudoaneurysm formation following directional atherectomy.

PMID- 8481579
TI  - Artifactual occlusion of the anterior tibial artery secondary to patient
      immobilization.

PMID- 8481580
TI  - Massive brachiocephalic artery bleeding due to a Gianturco tracheal stent.

PMID- 8481581
TI  - Resolution of diffuse vein graft narrowing after distal angioplasty.

PMID- 8481582
TI  - Intraperitoneal catheters: percutaneous placement with fluoroscopic guidance.
AB  - PURPOSE: The authors reviewed their experience with percutaneous placement of
      catheters into the peritoneal cavity for the administration of intraperitoneal
      chemotherapy to determine if their approach resulted in a lower complication rate
      than the reported 12%-16% rate and to demonstrate the technical advantages over
      surgically placed catheters. PATIENTS AND METHODS: Seventy-six patients with
      gastrointestinal or gynecologic malignancies underwent 152 procedures during a 20
      month period. The catheters were used to deliver antineoplastic agents and, in
      some patients, to drain ascites. Catheter insertion was performed with local
      anesthesia and a modified Seldinger technique. A 5-F catheter was used in 89% of
      procedures; in the remainder, the catheter was of a larger caliber. RESULTS: The
      procedure was successful in 145 (95%) instances and failed in seven (5%) attempts
      because of peritoneal adhesions. The catheters remained in place for less than 2
      days in 56%, 2-10 days in 25%, and more than 10 days in 19% of patients. One
      catheter remained in place for 15 weeks. Complications occurred in seven
      procedures (5%). Four cases of mild peritonitis responded to a brief course of
      intravenously administered antibiotics, and severe pain in two patients required
      premature catheter removal. A single case of inadvertent transcolonic catheter
      placement occurred without adverse sequelae to the patient. CONCLUSIONS:
      Intraperitoneal catheterization can be performed with local anesthesia by using a
      simple technique with a very low complication rate. The catheters can remain in
      place for prolonged periods without significant risks.

PMID- 8481583
TI  - Bleeding due to needle biopsy: effect of venopirin in an animal model and
      implications for humans.
AB  - PURPOSE: This study was undertaken to address the effect of platelet dysfunction
      on bleeding associated with percutaneous needle biopsy. MATERIALS AND METHODS:
      With use of an established animal model, 199 biopsies were performed on the
      livers of 13 anesthetized pigs (95 on control animals, 104 on venopirin-treated
      animals). The needles used were 16-22-gauge Chiba type, 18-gauge Tru-Cut, and 18
      gauge Menghini. The biopsies were performed under direct vision at laparotomy
      with consistent technique. Blood loss was measured, and the results were
      compared. Statistical analysis was performed with the Student t test and the
      Turkey test, after logarithmic transformation of the data. RESULTS: A substantial
      increase in blood loss resulting from the biopsy procedures was demonstrated in
      the animals with platelet dysfunction. This was much greater than the effect of
      either needle size or prothrombin time prolongation previously reported by the
      authors. CONCLUSION: Platelet function may be an important factor in determining
      the risk of bleeding due to percutaneous needle biopsy.

PMID- 8481584
TI  - Percutaneous nephrostomy for nonoperative management of fungal urinary tract
      infections.
AB  - PURPOSE: Percutaneous nephrostomy has proved to be an important modality in the
      nonoperative treatment of bacterial pyonephrosis. The role of this technique in
      the management of fungal pyonephrosis continues to evolve. The authors
      retrospectively reviewed their experience with percutaneous nephrostomy in the
      management of fungal pyonephrosis. PATIENTS AND METHODS: Seven patients, two
      neonates and five adults, were identified with proved fungal infections. Eleven
      percutaneous nephrostomy tubes were placed, all with use of the Seldinger
      technique. RESULTS: Percutaneous nephrostomy allowed (a) prompt microbiologic
      diagnosis of fungal infection (Candida albicans in six patients, Torulopsis
      glabrata in one); (b) urinary diversion with subsequent improvement in renal
      function, enabling systemic administration of potentially toxic antifungal drugs
      5-fluorocytosine and amphotericin B (four patients); (c) local irrigation with
      amphotericin B (four patients), (d) guidewire fragmentation of fungus balls (two
      patients); and (e) introduction of a Simpson atherectomy device to obtain biopsy
      specimens from an obstructing ureteral polypoid lesion (one patient). The
      funguria was successfully eradicated in six patients, one of whom died on the
      39th hospital day of a pulmonary embolus and another of whom died of extensive
      small bowel infarction during hospitalization. The one patient whose outcome of
      antifungal treatment remains unknown died at home with a functioning percutaneous
      nephrostomy 23 days after the procedure. CONCLUSION: Percutaneous nephrostomy may
      play a role in the non-operative management of fungal urinary tract infection.

PMID- 8481585
TI  - Appropriateness of stent placement in the treatment of celiac artery stenosis.

PMID- 8481586
TI  - Prevalence and incidence of vertebral deformities.
AB  - There is a need to identify vertebral fractures from radiographs taken at a
      single point in time, but considerable controversy surrounds the methods to be
      used. We extended a data set to comprise baseline radiographs of the thoracic and
      lumbar spine on an age-stratified random sample of 762 Rochester, Minnesota,
      women and used revised methods to define vertebral deformities morphometrically.
      Changes in the method of measuring vertebral heights, changes in the source of
      normal values for vertebral measurements and changes in the criteria for
      assessing vertebral deformity had little impact on estimated prevalence and
      incidence in this population. The prevalence of any vertebral deformity was
      estimated at 25.3 per 100 Rochester women aged 50 years and over (95% CI, 22.3
      28.2), while the incidence of a new deformity in this group was estimated at 17.8
      per 1000 person-years (95% CI, 16.0-19.7). Projected nationally, these data
      suggest that over 500,000 white women in the United States develop vertebral
      deformities for the first time each year and that over 7 million white women aged
      50 years and over might be affected at any given time. These estimates are
      limited by the absence of a reliable 'gold standard' with which to determine
      false positive and false negative rates associated with this or any other
      morphometric method. Information on the health consequences of vertebral
      deformities of various sorts would be most helpful in choosing between
      alternative approaches to defining them.

PMID- 8481587
TI  - Predicting vertebral fracture incidence from prevalent fractures and bone density
      among non-black, osteoporotic women.
AB  - We evaluated the ability of bone density and vertebral fractures at baseline to
      predict vertebral fracture incidence in a cohort of postmenopausal women with
      osteoporosis. The study population was 380 postmenopausal women (mean age 65
      years) treated for osteoporosis in a randomized, placebo-controlled, clinical
      trial of the bisphosphonate etidronate at seven geographic centers in the United
      States. Baseline measurements of bone mineral density were obtained in 1986 by
      quantitative computed tomography at the spine and dual-photon absorptiometry at
      the lumbar spine and hip. Vertebral fractures were documented on serial spine
      radiographs. Proportional hazards models were used to evaluate the ability to
      predict the risk of subsequent fractures during an average of 2.9 years of follow
      up. Presence of one or two fractures increased the rate of new vertebral
      fractures 7.4-fold (95% confidence interval = 1.0 to 55.9). Additional fractures
      at baseline further increased the fracture rate. A decrease of 2 standard
      deviations in spinal bone density by absorptiometry was associated with a 5.8
      fold increase in fracture rate (95% confidence interval = 2.9 to 11.6). The
      lowest and highest quintiles of bone density had absolute fracture rates of 120
      and 6 cases per 1000 patient-years, respectively. In general, the simultaneous
      use of two predictors (bone density and prevalent fractures or two bone density
      measurements) improved fracture prediction, compared with the use of a single
      predictor. We conclude that both bone density and prevalent vertebral fractures
      are strong, complementary predictors of vertebral fracture risk. The results
      suggest that physicians can use bone density and prevalent vertebral fractures,
      individually or in combination, as risk factors to identify patients at greatest
      risk of new fractures.

PMID- 8481588
TI  - Changing incidence and residual lifetime risk of common osteoporosis-related
      fractures.
AB  - Changes in incidence and lifetime risk of fractures are of major importance in
      the epidemiology of osteoporosis. We focused on hip fractures in women and men
      and on radial and humeral fractures in women. The study subjects comprised 4500
      women and men 20 years old or more with fractures. In women 1735 fractures of the
      distal radius, 747 fractures of the proximal humerus, 878 cervical and 635
      trochanteric hip fractures were included. In men 273 cervical and 232
      trochanteric hip fractures were included. The fractures were registered during
      the period 1976 to 1984 and changes in age-specific incidence were calculated
      (chi-squared test for linear trend; p-values less than 0.05 were considered
      significant). On the basis of life tables and population background data, the
      lifetime risk was estimated. The incidence of cervical hip fractures in women
      aged 60-89 years decreased significantly (p < 0.05) during the observation
      period, while no significant decrease was found in the incidence of trochanteric
      fractures. No significant changes in incidence were observed in women with radial
      or humeral fractures, or in men with hip fractures. A women 60 years old with a
      life expectancy of 81 years had an estimated residual lifetime risk of radial,
      humeral or hip fracture of 17%, 8% and 14% respectively. A man 60 years of age
      with a life expectancy of 77 years had an estimated risk of hip fracture of
      6%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481589
TI  - Radial and humeral fractures as predictors of subsequent hip, radial or humeral
      fractures in women, and their seasonal variation.
AB  - Hip fractures are common in elderly women, and early risk assessment of future
      hip fractures is relevant in relation to prevention. We studied the predictive
      value of radial and humeral fractures in women. The influence of weather
      conditions on the risk was also studied. Women aged 20-99 years with a fracture
      of the distal radius (n = 1162) or proximal humerus (n = 406) were followed for 0
      to 9 years. The relative risk (RR) and 95% confidence limits (CL) of subsequent
      fracture among women suffering radial or humeral fractures compared with the
      background population were calculated. Women 60-79 years of age who had suffered
      a fracture of the distal radius or proximal humerus had relative risks of
      sustaining a hip fracture of 1.9 (1.3-2.6, 95% CL) and 2.5 (1.3-3.6, 95% CL)
      respectively. The relative risk of hip fracture was highest within the first
      years following a fracture of the radius or the humerus. Women suffering an upper
      extremity fracture (radius or humerus) in snowy or icy weather had a marginally
      increased risk (RR = 1.3, 0.4-2.3, 95% CL and RR = 1.8, 0.3-3.4, 95% CL) for a
      later hip fracture. A woman 50 years old with a radial or a humeral fracture had
      an estimated residual lifetime risk of sustaining a subsequent hip fracture of
      17% and 16% respectively compared with 11% for the background
      population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481590
TI  - The assessment of vertebral deformity: a method for use in population studies and
      clinical trials.
AB  - The absence of specific criteria for the definition of vertebral fracture has
      major implications for assessing the apparent prevalence and incidence of
      vertebral deformity. Also, little is known of the effect of using different
      criteria for new vertebral fractures in clinical studies. We therefore developed
      radiological criteria for vertebral fracture in women for assessing both the
      prevalence and the incidence of vertebral osteoporosis in population and in
      prospective studies and compared these with several other published methods.
      Normal ranges for vertebral shape were obtained from radiographs in 100 women
      aged 45-50 years. These included ranges for the ratios of anterior/posterior,
      central/posterior and posterior/predicted posterior vertebral heights from T4 to
      L5. The predicted posterior height was calculated from adjacent vertebrae. In
      contrast to other methods, our definition of fracture required the fulfillment of
      two criteria at each vertebral site, and was associated with a lower apparent
      prevalence of fracture in the control women due to a lower false positive rate.
      The prevalence and incidence of vertebral deformity using different criteria were
      then compared in a series of women with skeletal metastases from breast cancer in
      whom radiographs were obtained 6 months apart. The prevalence of vertebral
      deformity and the specificity for deformity varied markedly with differing
      criteria. Using a cut-off of 3 standard deviations the prevalence of vertebral
      deformity in the women with breast cancer was 46%. Using other methods, the
      prevalences of deformity ranged from 33% to 74%. Over a 6-month interval 25% of
      patients with breast cancer sustained 61 deformities using our method, of which
      only 8% resulted from errors in reproducibility. The number of patients
      sustaining new deformities was increased twofold when assessed by other methods
      (45%-53%), but errors of reproducibility may have accounted for 21% of the new
      deformities. The magnitude and distribution of these errors have important
      implications for the apparent therapeutic efficacy of agents in clinical trials
      of osteoporosis. The rapid semi-automated technique for assessing vertebral
      deformities on lateral spine radiographs that we have developed has a high
      specificity, and reduces the impact of errors of reproducibility on estimates of
      prevalence and incidence. The method should prove a value in assessing vertebral
      deformity both in population studies and in prospective clinical trials.

PMID- 8481591
TI  - Consequences of a hip fracture: a prospective study over 1 year.
AB  - From a population of 230,000 residents, 1429 consecutive hip fracture patients
      were studied with regard to their social and physical functions both before
      sustaining the fracture and 1 year later. Changes in the patients' accommodation,
      need of help and walking aids were described. Using logistic regression we found
      important factors regarding the ability to return home, mortality within 1 year
      and length of hospital stay. The cost of a hip fracture over the time a patient
      is in hospital is, including the cost of an internal fixation, about US $6000.
      The total cost over 1 year is about US $26,000 per patient, including the
      operation.

PMID- 8481592
TI  - Age-related differences in total and regional bone mass: a cross-sectional study
      with DXA in 429 normal women.
AB  - Total body bone mineral content (TBBMC), total body bone mineral density (TBBMD)
      and regional bone mineral content (BMC) and density (BMD) were assessed by dual
      energy X-ray absorptiometry (DXA) in 429 normal women aged 15-83 years, of whom
      242 were premenopausal and 187 postmenopausal. The population was divided into 5
      year age groups. In the premenopausal women no changes in TBBMC, TBBMD or
      regional BMC and BMD were observed with age, and TBBMC and TBBMD values
      correlated well with body weight (p < 0.001). Postmenopausal women showed an
      overall reduction in bone mass (p < 0.001), more marked at the axial level than
      peripherally (1.6% vs. 0.8%/year). The values of TBBMC and TBBMD correlated well
      with chronological age, time since the onset of menopause and body weight (p <
      0.001). In these women age did not correlate with body weight, which suggests
      that postmenopausal bone mass loss depends more on chronological age and time
      since the onset of menopause than on other variables. The stability observed in
      bone mass values from ages 15-19 to menopause highlights the importance of
      stimulating the acquisition of an appropriate peak bone mass in women before
      adolescence begins.

PMID- 8481593
TI  - Broadband ultrasound attenuation compared with dual-energy X-ray absorptiometry
      in screening for postmenopausal low bone density.
AB  - Broadband ultrasound attenuation (BUA) was investigated as an inexpensive, simple
      and radiation-free method of screening for low perimenopausal bone density. A
      total of 587 women (50-54 years), invited for screening had bone mineral density
      (BMD) measured at the femoral neck and the lumbar spine by dual-energy X-ray
      absorptiometry (DXA). At the same visit the BUA of the calcaneus was measured.
      The correlation between BUA and BMD was approximately 0.4 compared with 0.67
      between femoral neck and spinal BMD. Receiver operating characteristic (ROC)
      curve analysis demonstrated BUA to have the same ability for discriminating
      between low BMD at either the femoral neck or lumbar spine. BUA with a cut-off
      for normality at the median (BUA = 80) had a sensitivity of 68% and specificity
      of 67% for low bone density identified by a BMD less than the 25th centile at the
      femoral neck or lumbar spine. The correlation between BUA and BMD was
      insufficient to allow identification of the same groups as having low bone
      density.

PMID- 8481594
TI  - New bisphosphonates in osteoporosis.
AB  - Bisphosphonates are non-biodegradable compounds characterized by a phosphorus
      carbon-phosphorus bond. By substituting the hydrogens on the carbon atom, a
      variety of bisphosphonates can be synthesized, each with distinct physical
      chemical, biologic, therapeutic, and toxicologic characteristics. Bisphosphonates
      have in general a strong affinity to calcium phosphates, both in vitro and in
      vivo. They inhibit bone resorption through a cellular mechanism that is not yet
      completely understood. When given in large amounts, some bisphosphonates can
      inhibit normal and ectopic mineralization through a physical-chemical mechanism.
      The main difference among the various compounds appears to be their potency in
      inhibiting bone resorption, which can vary from 1 to 10,000. The potential
      efficacy of bisphosphonates in osteoporosis has been investigated extensively in
      animals. In the growing rat, they induce an increase in intestinal absorption and
      body retention of calcium. Various types of experimental osteoporosis, such as
      induced by immobilization, ovariectomy, administration of corticosteroids, or low
      calcium diet, can be prevented. Bisphosphonates are rapidly cleared from plasma,
      with 20%-60% deposited in bone and the remainder excreted in the urine. The half
      life in bone is, however, very long. The toxicity of bisphosphonates is low,
      probably because of their rapid plasma and soft tissue clearance. It varies
      greatly from compound to compound. Bisphosphonates are used successfully in
      diseases with increased bone turnover, such as Paget's disease of bone, tumoral
      bone disease, and recently, osteoporosis. Most results in osteoporosis have been
      obtained with etidronate and pamidronate. Both of these compounds, as well as
      other bisphosphonates, such as tiludronate, alendronate, and clodronate, inhibit
      bone loss and sometimes even increase bone mass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481595
TI  - Rationale for the use of clodronate in osteoporosis.
AB  - Bisphosphonates are widely used in disorders associated with increased resorption
      of bone, particularly in Paget's disease of bone and in the hypercalcemia of
      malignancy. Because of their undoubted efficacy and relatively low toxicity,
      bisphosphonates are attractive candidates for the management of osteoporosis.
      Clodronate, one of the many bisphosphonates being tested in osteoporosis, may be
      given intravenously or by mouth. In contrast to etidronate, even high doses of
      clodronate do not impair the mineralization of bone, making it suitable for long
      term use in osteoporosis. As do all the bisphosphonates tested thus far,
      clodronate appears to delay the rate of bone loss in osteoporosis. Long-term
      studies are relatively few, so that its steady-state effects on bone mass are not
      yet known. Most data suggest clodronate is capable at least of delaying the rate
      of bone loss, but several pilot studies with this agent suggest that increments
      of bone mass might be sustainable for several years. Clodronate is likely to
      decrease the frequency of osteoporotic fractures, but there is no evidence for
      this at present. Well-controlled, long-term prospective studies are needed.

PMID- 8481596
TI  - Visions for the future in osteoporosis research.
AB  - An ideal therapeutic agent for osteoporosis-one that both inhibits osteoclastic
      bone resorption and stimulates new bone formation-is not currently available.
      Currently available resorption inhibitors (estrogen, bisphosphonates, and
      calcitonin) prevent further bone loss and stabilize bone mass. However, they have
      a negligible to very modest effect on bone formation over prolonged periods, and
      do not cause prolonged increases in bone mass. A universally acceptable bone
      formation stimulator is not currently available. Future research is likely to
      focus on the use of peptide growth factors to stimulate appositional bone growth,
      or on the use of low molecular weight compounds that may selectively stimulate
      bone cells to produce these factors in the local bone remodeling
      microenvironment.

PMID- 8481597
TI  - Calcitonins: newer routes of delivery.
AB  - Because of its anti-osteoclastic and analgesic properties, calcitonin is a first
      line choice in the treatment of several bone diseases characterized by absolute
      or relative bone resorption. With regard to the prevention and treatment of
      postmenopausal osteoporosis, the chronic nature of the disease and the subsequent
      long duration of the pharmacological intervention require uncomfortable
      parenteral administration to be repeated on a long-term basis. Newer routes of
      administration have therefore been developed. At present the most promising of
      these are the nasal spray and the rectal suppository. Both routes have been shown
      to induce significant increases in plasma levels of salmon calcitonin. The
      ability of salmon calcitonin to cross the nasal mucosa was shown immunologically
      by the generation of specific anti-salmon-calcitonin antibodies in the plasma. In
      healthy volunteers these alternative routes of administration do not decrease the
      anti-osteoclastic activity of calcitonin, as demonstrated by a significant
      decrease in biochemical parameters that reflect bone turnover. In the prevention
      and treatment of postmenopausal osteoporosis, as well as in the treatment of
      Paget's disease of bone, the properties of calcitonins are generally preserved if
      they are administered non-parenterally. However, the equivalent doses required to
      sustain the effects of calcitonin have not been fully elucidated. This article
      reviews the potential benefits of two methods of non-parenteral administration of
      calcitonins in the prevention and treatment of postmenopausal osteoporosis.

PMID- 8481598
TI  - Criteria for successful estrogen therapy in osteoporosis.
AB  - Estrogens are well established as agents that stabilize the skeleton and reduce
      the risk of osteoporotic fractures among postmenopausal women. For maximum
      benefit, preventive therapy should begin as early as possible after ovarian
      failure begins to occur. Efforts to prevent bone loss are likely to achieve the
      best results when initiated prior to significant loss of bone tissue and
      trabecular penetration. An effect on skeletal bone mass can be obtained by any
      route of administration and transdermal estrogen use is an alternative to oral
      estrogen. Long-term therapy may reduce the risk of hip fracture by 50% and of
      vertebral fracture by a greater amount. The minimum effective dose is probably
      that which achieves circulating estrogen levels in the mid-follicular range. For
      women with a uterus in place, a progestin usually is provided to protect the
      endometrium; it is given cyclically in younger women but may be given
      continuously in women several years past menopause. Progestins do not interfere
      with the effects of estrogen on the skeleton, and it is possible that some
      progestins enhance the skeletal effects of estrogen. For patients with
      osteoporosis, estrogens can be used as first-line therapy since in these patients
      they have the same skeletal stabilizing effect and reduce the risk of recurrent
      fracture.

PMID- 8481599
TI  - Vertical transmission of viral hepatitis.

PMID- 8481600
TI  - Donor deferral registries.
AB  - In the last half of this century, donor deferral registries have grown in size,
      scope, and importance for blood collection organizations and regulatory agencies.
      This has occurred despite the lack of direct evidence that, when used with all
      other methods, they contribute meaningfully to the safety of the blood supply.
      Any decrease in the perceived benefit of deferral registries has been a result of
      the introduction of a panoply of serological testing of donor blood intended to
      detect transmissible disease. As the sensitivity of serological testing improves,
      the relative merit of the subjective methods used for blood supply safety
      diminish. Although computers have become a mainstay in the management of deferral
      registries, accurate and consistent donor identification, good manual systems,
      and quality control of data bases are key features to their successful
      management. As with the other subjective methods used in maintaining blood supply
      safety, techniques must be developed to determine the value of the many features
      of donor deferral registries. Efforts must be made to simplify these processes
      and focus on those elements that provide important contributions to blood supply
      safety. Today, donor deferral registries are major activities in most blood
      centers and are believed to play a significant role in blood supply safety. It is
      time for their role to be carefully reexamined.

PMID- 8481601
TI  - Leukodepletion blood filters: filter design and mechanisms of leukocyte removal.
AB  - Modern leukocyte removal filters have been developed after years of refinement in
      design. Current filters are composite filters in which synthetic microfiber
      material is prepared as a nonwoven web. The filter material may be surface
      modified to alter surface tension or charge to improve performance. The housing
      design promotes effective contact of blood with the filter material and decreases
      shear forces. The exact mechanisms by which these filters remove leukocytes from
      blood components are uncertain, but likely represent a combination of both
      physical and biological processes whose contributions to leukocyte removal are
      interdependent. Small-pore microfiber webs result in barrier phenomena that
      permit retention of individual cells and increase the total adsorptive area of
      the filter. Modifications in surface charge can increase or decrease cell
      attraction to the fibers. Optimum interfacial surface tensions between blood
      cells, plasma, and filter fibers not only permit effective blood flow through
      small fiber pores, but also facilitate cell contact with the material. Barrier
      retention is a common mechanism for all modern leukocyte-removal filters and
      applies to all leukocyte subtypes. Because barrier retention does not depend on
      cell viability, it is operative for cells of any age and will retain any
      nondeformable cell, including whole nuclei from lymphocytes or monocytes. Barrier
      retention is supplemented by retention by adhesion. RBCs, lymphocytes, monocytes,
      granulocytes, and platelets differ in their relative adhesiveness to filter
      fibers. Different adhesive mechanisms are used in filters designed for RBCs
      compared with filters designed for platelets. Although lymphocytes, monocytes,
      and granulocytes can adhere directly to filter fibers, the biological mechanisms
      underlying cell adhesion may differ for these cell types. These differences may
      depend on expression of cell adhesion molecules. In the case of filtration of
      fresh RBCs, platelet-leukocyte interaction seems to supplement other mechanisms
      of leukocyte retention. The interactions of cells with biomaterials is an area of
      important research for implantable medical devices, artificial organs, and
      orthopedic, vascular, and dental prosthetics. Research in these areas is likely
      to contribute to improved biomaterials for blood filters. Improved techniques for
      the preparation of hybrid polymers and new techniques for surface modification of
      existing polymers will increase the technical opportunities for the development
      of synthetic surfaces ideally designed for leukocyte removal. It is therefore
      likely that the performance of leukocyte-removal filters will continue to
      improve. The development of cost-effective leukocyte removal filters specifically
      designed for use during component preparation would permit leukocyte depletion of
      all cellular blood components.

PMID- 8481602
TI  - Recombinant activated factor VII in the treatment of bleeding episodes in
      patients with inherited and acquired bleeding disorders.
AB  - The FVIII/FIX by-passing agent, rFVIIa, offers an alternative approach to the
      treatment of hemophilia patients as well as nonhemophiliacs with antibodies
      against FVIII/FIX. Such treatment can be administered regardless of the inhibitor
      titer in these patients, and rFVIIa is active hemostatically in hemophilia B
      patients also. It is easy to administer but seems to need repeated dosing at 2 to
      3-hour intervals, at least initially, in patients with severe bleeding, with a
      dose of 70 to 100 micrograms/kg body weight required to induce hemostasis.
      Depending on the severity of the bleeding the dose intervals may be prolonged to
      every 3 hours for 1 to 2 days or until clinical improvement is observed.
      Thereafter, the dosage interval can be increased to every 4 hours if continued
      therapy is required.

PMID- 8481603
TI  - Perfluorocarbon-based red blood cell substitutes.
AB  - Since our review 5 years ago, a new generation of PFC emulsion has been developed
      and is undergoing extensive testing. This new generation is the result of the
      application of physicochemical principles, applied to both the choice of the PFC
      itself and the emulsifier, as well as advances in emulsion-producing technology.
      The efficacy of PFCs in general for oxygen transporting capability has been fully
      recognized, as exemplified by the limited license issued to Fluosol. The latter
      also represents the recognition of the relative absence of major toxicity of PFCs
      in general. The development of new products owes much to the lessons learned
      during the past 20 years and to advances made in the physical chemistry of PFCs.
      These advances now permit the rational selection or design of the most
      appropriate PFC and the design of emulsifiers best suited for the purpose.
      Perflubron represents a clear advance over the Fluosol-DA-type formulation. It is
      only one but the most advanced of the second-generation products. At least three
      other commercial entities (Hema-Gen/PFC, Green Cross, Adamantech) are also
      developing products based on the above principles. Five years ago we concluded
      that, in spite of the enormous complexity of PFC emulsions as large volume
      parenterals, they have shown remarkable biocompatibility. The advances in the
      past 5 years have confirmed this conclusion. The advances occurring during the
      past 5 years show that the application of the proper technology can lead to
      product improvement, and that PFC preparations with significant transfusional and
      nontransfusional potential are, in fact, feasible. It remains to be seen whether
      high PFC-content emulsion can be successfully deployed in initial, prehospital
      resuscitation situations. The high PFC content will reduce the absolute
      requirement for the maintenance of FIO2 > 0.8 in the case of Fluosol-DA for
      optimal efficacy. The second-generation products also seem to lend themselves to
      intraoperative use, because they can be removed from the blood postoperatively by
      plasmapheresislike methods. They are also suitable in combination with autologous
      blood donation/transfusion. All of these potential applications are in various
      stages of exploration and, if found to be efficacious, will likely conserve the
      supply of whole blood and blood components. The nontransfusional applications,
      particularly those in diagnostic imaging, seem to show substantial promise.
      Because they involve smaller doses than transfusional applications, they may
      enter clinical use earlier. The applications in radiation and chemotherapy of
      malignant diseases represent an intermediate position between the transfusional
      and nontransfusional uses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8481605
TI  - New program established in naturopathic medicine.

PMID- 8481604
TI  - Challenges in transfusion microbiology.

PMID- 8481606
TI  - Role modeling.

PMID- 8481607
TI  - Nurse chooses life and accountability.

PMID- 8481608
TI  - The creative mind project: in search of healing.

PMID- 8481609
TI  - Nurses for the environment: taking a stand on current issues.

PMID- 8481610
TI  - Parents' and teachers' praxes of and attitudes to the health and sex education of
      young people with mental handicaps: a study in Stockholm and Tokyo.
AB  - In 1989/1990, parents and teachers of young people with mental handicaps in
      Stockholm (41 parents and 20 teachers) and Tokyo (106 parents and 111 teachers)
      were given a questionnaire about their praxes of and attitudes towards health and
      sex education. Results from the study indicated that, compared to parents and
      teachers in Tokyo, parents and teachers in Stockholm gave more information about
      health and sex to their 15-16-year-old young people with mental handicaps. This
      was especially so regarding information about HIV/AIDS. More parents and teachers
      in Stockholm also had positive attitudes towards sex and interpersonal
      relationships--not only for young people in general but also for young people
      with mental handicaps--compared to parents and teachers in Tokyo. Some questions
      of an ethical nature were found difficult to answer in both Stockholm and Tokyo.

PMID- 8481611
TI  - Clinical and cytogenetic survey of institutionalized mentally retarded patients
      with emphasis on the fragile-X syndrome.
AB  - A detailed clinical and cytogenetic survey for the fragile-X syndrome was
      undertaken on 201 institutionalized mentally retarded males with no previously
      recognized cause of retardation, and the causes of mental retardation were
      summarized from a total of 595 institutionalized male and female patients after
      the review of their medical records including clinical and cytogenetic data.
      Among the 201 males clinically and cytogenetically examined, five (2.5%) had
      abnormal chromosome findings with four (2%) having the fragile-X syndrome. Twelve
      of the males (6.0%) were diagnosed with a single gene disorder. In the present
      study, mental retardation was classified as possibly due to multifactorial causes
      when a genetic syndrome, chromosome abnormality or environmental insult was not
      identified, but mental retardation was present in one or more first and/or second
      degree relatives, but did not follow a recognizable inheritance pattern. Hence,
      mental retardation was recorded in other family members and may indicate possible
      multifactorial causes in 45 males (22.4%). An environmental insult was noted in
      25 males (12.4%); unexplained birth defects in three males (1.5%); a specific
      condition or diagnosis identified, but cause unknown (e.g. Rubinstein-Taybi
      syndrome) in 10 males (5%); and no diagnosis made in the remaining 101 males
      (50.2%). Of all 595 patients (334 males and 261 females), including the 201 males
      who had undergone a detailed clinical and cytogenetic evaluation, 39 (6.6%) had
      abnormal chromosome findings, with Down's syndrome noted in 31 of the patients.
      Twenty-five patients (4.2%) were diagnosed with a single gene disorder while
      mental retardation was noted in other family members and may indicate possible
      multifactorial causes in 64 patients (10.8%). An environmental insult was noted
      in 170 patients (28.6%); unexplained birth defects in 17 patients (2.9%); a
      specific condition or diagnosis but cause unknown in 27 patients (4.5%); and no
      diagnosis made in 253 patients (42.5%). Clinical and cytogenetic screening of
      mentally retarded patients for the fragile-X syndrome and other causes of mental
      retardation is helpful in identifying individuals and their families who may
      benefit from genetic services such as counseling and treatment. This study was
      performed over an approximate 2 year period from 1987 to 1989.

PMID- 8481612
TI  - Staff turnover in ordinary housing services for people with severe or profound
      mental handicaps.
AB  - The characteristics and turnover of direct-care staff in two housing services for
      adults with moderate, severe or profound mental handicaps are described. Both
      staff groups were predominantly female with a good representation of staff aged
      under 30, and between 30 and 50 years. Most had prior experience in a caring
      capacity before taking up their current posts, but only a quarter to a third had
      a relevant vocational qualification. Turnover was similar in the two services,
      but varied considerably between settings in each. Average annual turnover ranged
      from 8 to 39% in one and from 5 to 48% in the other. However, most houses still
      had a core of long-serving staff providing continuity over time. The implications
      of the level of staff turnover found for management and staff training are
      discussed, as are the reasons for leaving given by former staff of one of the
      services, together with their views on job satisfaction, conditions of work, and
      the adequacy of management and training.

PMID- 8481613
TI  - Epilepsy, dementia and adaptive behaviour in Down's syndrome.
AB  - Widespread inquiry identified 378 adults with Down's syndrome resident in
      Leicestershire, England. The immediate carer of 351 of these (92.8%) was
      interviewed for the purpose of establishing a past history of seizures, including
      the age at which the seizures began. The immediate carer was also invited to
      provide information to enable the completion of an Adaptive Behaviour Scale
      (A.B.S.) rating. Individuals with a history of seizures were divided into two
      groups on the basis of whether or not seizures commenced prior to or after age 35
      years. Two control groups of individuals with Down's syndrome, but without a
      history of seizures were selected. Adaptive Behaviour Scale scores for those in
      whom seizures commenced at a younger age were similar to those who had no
      recorded history of seizures. However, in those in whom seizures began in later
      life, scores on all domains of the A.B.S. were significantly reduced compared to
      both young epileptic patients and their controls. Adaptive Behaviour Scale scores
      for the older control group held an intermediate position, suggesting that late
      onset epilepsy may be a late manifestation of a dementing process. A clinical
      diagnosis of dementia recorded in the case records was significantly associated
      with the presence of late-onset epilepsy. This is supportive of the hypothesis
      that late-onset epilepsy in individuals with Down's syndrome is associated with
      Alzheimer's disease.

PMID- 8481614
TI  - Factors influencing the expectations of parents for their mentally retarded
      children.
AB  - In terms of treatment for cure, education, training and general information,
      parental expectations for their mentally retarded children are influenced by
      various factors such as the age and sex of the retarded child, the level of
      mental retardation, the education and occupation of the parents, and the socio
      economic status and area of living. In the present study, an attempt has been
      made to find out the correlation of six variables namely, age, sex, literacy,
      locality of living, level of retardation and duration of follow-up on the
      expectation of one hundred parents of mentally retarded children who attend the
      home-based services at the National Institute for the Mentally Handicapped,
      Secunderabad, India. The intercorrelation among the six independent variables and
      the dependent variable revealed that age of the child and duration of follow-up
      have a high correlation (P < 0.01), and literacy of the parents and duration of
      follow-up were positively correlated (P < 0.05 level). It was also found that age
      and duration of follow-up have a positive correlation. Further detailed multiple
      regression analysis was conducted and the results are discussed.

PMID- 8481615
TI  - Surgical treatment of corneal pathology in patients with Down's syndrome.
AB  - Keratoconus is a major cause of blindness in patients with Down's syndrome. A
      retrospective study of 30 corneal grafts for keratoconus in these patients
      revealed a 5-year graft survival of 67%. Postoperative trauma and/or infection
      was the main cause for graft failure. Conditions that should be met before the
      indication for corneal transplantation in a patient with Down's syndrome are
      formulated as a result of 15 years experience with that patient population. In
      appropriate cases, corneal transplantation may undoubtedly improve the quality of
      life in these patients.

PMID- 8481616
TI  - Medical and psychiatric needs of adults with a mental handicap.
AB  - This study describes the assessment of the medical and psychiatric needs of
      adults with a mental handicap recently resettled in community facilities
      including 'staffed houses'. No statistically significant differences were found
      for behaviour problems and psychiatric diagnosis prior to resettlement and one
      year after. However, increased use of primary care and expert psychiatric service
      were found following the resettlement. Clinical and service issues in relation to
      successful maintenance of people with mental handicap in the community are
      discussed.

PMID- 8481617
TI  - Span of apprehension in mentally retarded children: an initial investigation.
AB  - The present investigation is the first to apply Estes' (1965) span of
      apprehension task to the study of attentional functioning in mentally retarded
      persons. Detection accuracies of 25 children diagnosed as mildly mentally
      retarded and 25 non-retarded children were compared under conditions of 100-ms
      exposure duration, and either two, four, six or eight distractor letters.
      Significant main effects of subject group and distractor number were found, with
      no interaction. These results provide converging evidence in support of previous
      positions that posit a structural deficit in mentally retarded individuals with
      respect to centrally mediated processing.

PMID- 8481618
TI  - Possible Asperger's syndrome in a mentally handicapped transvestite offender.
AB  - A 38-year-old man with a moderate mental handicap and Asperger's syndrome is
      described. His transvestism and history of offending behaviour is interpreted in
      the light of this.

PMID- 8481619
TI  - Pathological jealousy and mental handicap.
AB  - Though widely reported in the general population, pathological jealousy has not
      previously been reported in an individual with a mental handicap. We describe the
      case of a 39-year-old man with a borderline mental handicap and an abnormal
      premorbid personality who demonstrates the condition.

PMID- 8481621
TI  - The influence of caffeine on human EEG under resting conditions and during mental
      loads.
AB  - The effect of caffeine (single oral doses of 200 mg and 400 mg) on the CNS was
      tested under resting conditions and while performing a concentration performance
      test in a placebo-controlled pilot study on ten healthy males. The EEG was
      evaluated quantitatively by spectral analysis with a Computer Aided Topographical
      ElectroEncephaloMetry system. Comparison of the averaged frequency content
      revealed a clear difference between the change in the functional state of the
      brain due to the mental arithmetics, on the one hand, and the caffeine effect, on
      the other. Both states of altered brain activity were reflected in a particular
      topographical distribution of the frequency change with respect to a frontal
      occipital accentuation. Comparison of the two periods of mental arithmetics in
      the absence or presence of caffeine showed a tendency to concentration-dependent
      differences from each other. Administration of 200 mg and 400 mg caffeine in the
      relaxed state effected the decrease in spectral power in the theta and alpha
      ranges. The concentration performance test without caffeine effected decreases in
      power in the alpha range in frontal to parietal cortex and enhanced theta power
      in frontal and occipital regions and the alpha power in occipital cortex. The
      caffeine-dependent decrease in theta power and the decrease in delta power seen
      under relaxation conditions after 400 mg are not observed during the
      concentration performance test in the presence of caffeine.

PMID- 8481620
TI  - Alveolar surfactant and adult respiratory distress syndrome. Pathogenetic role
      and therapeutic prospects.
AB  - The adult respiratory distress syndrome (ARDS) is characterized by extended
      inflammatory processes in the lung microvascular, interstitial, and alveolar
      compartments, resulting in vasomotor disturbances, plasma leakage, cell injury,
      and complex gas exchange disturbances. Abnormalities in the alveolar surfactant
      system have long been implicated in the pathogenetic sequelae of this life
      threatening syndrome. This hypothesis is supported by similarities in pulmonary
      failure between patients with ARDS and preterm babies with infant respiratory
      distress syndrome, known to be triggered primarily by lack of surfactant
      material. Mechanisms of surfactant alterations in ARDS include: (a) lack of
      surface-active compounds (phospholipids, apoproteins) due to reduced
      generation/release by diseased pneumocytes or to increased loss of material (this
      feature includes changes in the relative composition of the surfactant
      phospholipid and/or apoprotein profiles); (b) inhibition of surfactant function
      by plasma protein leakage (inhibitory potencies of different plasma proteins have
      been defined); (c) "incorporation" of surfactant phospholipids and apoproteins
      into polymerizing fibrin upon hyaline membrane formation; and (d)
      damage/inhibition of surfactant compounds by inflammatory mediators (proteases,
      oxidants, nonsurfactant lipids). Alterations in alveolar surfactant function may
      well contribute to a variety of pathophysiological key events encountered in
      ARDS. These include decrease in compliance, ventilation-perfusion mismatch
      including shunt flow due to altered gas flow distribution (atelectasis, partial
      alveolar collapse, small airway collapse), and lung edema formation. Moreover,
      more speculative at the present time, surfactant abnormalities may add to a
      reduction in alveolar host defense competence and an upregulation of inflammatory
      events under conditions of ARDS. Persistent atelectasis of surfactant-deficient
      and in particular fibrin-loaded alveoli may represent a key event to trigger
      fibroblast proliferation and fibrosis in late ARDS ("collapse induration").
      Overall, the presently available data on surfactant abnormalities in ARDS lend
      credit to therapeutic trials with transbronchial surfactant administration. In
      addition to the classical goals of replacement therapy defined for preterm
      infants (rapid improvement in lung compliance and gas exchange), this approach
      will have to consider its impact on host defense competence and inflammatory and
      proliferative processes when applied in adults with respiratory failure.

PMID- 8481622
TI  - Does pertussis infection induce manifestation of allergy?
AB  - To evaluate whether pertussis induces the development of allergy, a prospective
      study was performed in 25 children aged 0.8-12.2 years. The patients underwent
      allergy diagnostics during pertussis infection and at a follow-up visit 8-14
      months later. Diagnostic criteria included the medical history of the patients
      and their families, a modified skin prick test, measurement of serum IgE and
      radio-allergosorbent test screening for specific sensitizations. At the time of
      pertussis, serum IgE concentration in the study group was 62 +/- 30 kU/ml. At the
      follow-up visit, there was a significant increase in serum IgE to 137 +/- 51
      kU/ml, which was also significantly higher than IgE in an age-matched control
      group. Children at a significantly higher risk for developing IgE increase or new
      allergic sensitizations were those with a family history of allergy or
      potentially allergic disease in their personal history. Our results indicate that
      pertussis may induce IgE production in affected children.

PMID- 8481623
TI  - Clinical meaning of the torque between stance leg and ground for the analysis of
      gait mechanism.
AB  - Transversal torque between the stance leg and the ground was measured in 169 test
      persons with normal gait (91 women, 78 men; ages 15-79 years) using three
      dimensional force plates. Taking the average of six to ten single steps produces
      reproducible person- and group-specific data. This permits the isolation and
      study of individual solutions to specific problems of locomotion, so-called gait
      mechanisms. The relatively great torque during the double-stance phase is caused
      mainly by the medially directed, short-term impact peak at heel strike, with the
      stride length as lever arm. Double-stance torque is therefore determined by
      motion dynamics and does not help in understanding individual gait mechanisms.
      Torque measured during the single-stance phase is, in comparison, rather small
      and is interindividually relatively variable. Experimentally measured torque is
      considered in terms of various hypotheses concerning the creation of torque in
      the human gait. Men obviously tend, for reasons of equilibrium and stability, to
      compensate the various torques. Better than the more known vertical, sagittal,
      and frontal force components, the remaining torque represents the individual
      problem solution and therefore permits the study of specific gait mechanisms,
      both physiological and pathological. Using the characteristic gait of patients
      with hemiplegia as an example, it is shown that pathological torque observed
      systematically on the nonaffected side in such patients is a quantitative measure
      of the trunk rotation necessary to move the plegic side forward. Measurement of
      this torque therefore permits precise determination of the degree of damage, as
      well as quantitative control and objective documentation of the rehabilitation
      progress.

PMID- 8481624
TI  - HLA-DR3 and HLA-DR5 confer risk for autoantibody positivity against the
      thyroperoxidase (mic-TPO) antigen in healthy blood donors.
AB  - The prevalence of circulating autoantibodies against thyroperoxidase (mic-TPO)
      was determined in 3,000 healthy blood donors (age range: 23 to 60 years) from the
      Hamburg area. Of the blood donors, 153 (5.1%) were found to have high titer of
      mic-TPO (> 350 IU/ml). Only two autoantibody positive subjects (0.06%) were
      chemically hyper- and hypothyroid, respectively. Analysis of HLA-DR specificities
      revealed that HLA-DR specificities DR3 and DR5 were significantly increased when
      compared to controls (n = 1,863). Comparison of the autoantibody-positive
      probands with a group of disease controls, i.e., Graves' patients and patients
      with lymphocytic thyroiditis, revealed a higher prevalence of HLA-DR3-positive
      HLA haplotypes in the disease controls when compared to autoantibody positives.
      Individuals with a mic-TPO level greater than 2,000 IU/ml were almost exclusively
      found to have one HLA-DR3 or HLA-DR5 positive HLA haplotype. We conclude that a
      high prevalence of high-titer mic-TPO can be found in healthy blood donors.
      Circulating signs of thyroid autoimmunity were associated with HLA specificities
      also found to be associated with autoimmune thyroid diseases.

PMID- 8481625
TI  - Clinical application of three-dimensional sonography in internal medicine.
AB  - Three-dimensional sonography represents a development of non-invasive diagnostic
      imaging by real-time two-dimensional sonography. The use of transparent rotating
      scans, comparable to a block of glass, generates a three-dimensional effect. The
      first clinical application of this technique was in the field of gynecology and
      obstetrics, namely in prenatal diagnostics. In this study we describe its first
      application in internal medicine. In preliminary examinations on healthy
      volunteers we obtained specific processing data for optimal imaging results. This
      was followed by secondary examinations on 123 patients who had previously
      undergone conventional sonography with pathological findings. In more than 75% of
      the cases examined we found an optimal reproduction of sonographic findings with
      respect to the evaluation criteria developed by us for the three dimensional
      imaging of processed data. With the inclusion of measurement parameters such as
      distance determination and volume measurements the data gathered will allow the
      generation of reproducible results. Future studies will confirm the value of this
      method in diagnostic imaging.

PMID- 8481626
TI  - Xanthoma disseminatum: a rare normolipemic xanthomatosis.
AB  - Xanthoma disseminatum (XD) is a rare benign histiocytic disorder with extensive
      cutaneous and mucous membrane xanthomas in normolipemic patients. We describe the
      9-year course of a 25-year-old white man who presented with multiple brownish
      reddish papulous skin tumors that developed over 3 years and remained relatively
      constant, with spontaneous regression and progression of individual lesions
      since. In addition, there was asymptomatic xanthomatous infiltration of the
      epipharnyx and symptomatic infiltration of the synovial membrane of the left knee
      joint leading to restriction of movement. Histologically, the corium was
      infiltrated by large lipid-storing macrophages, polynucleated histiocytic giant
      cells of the Touton and the foreign body type. Immunhistochemically, the lipid
      storing cells could be classified as macrophage/monocyte derived cells distinctly
      different from Langerhans' cells without proliferative activity. The clinical
      picture and course as well as laboratory findings indicating normolipidemia made
      it possible to differentiate XD from other normolipemic xanthomatosis, especially
      juvenile xanthogranuloma, eruptive histiocytoma, and histiocytosis X. The
      etiology of XD is still unknown. It is possible to differentiate xanthoma
      disseminatum from malignant histiocytosis X by the clinical picture and
      immunhistochemical studies. Thus it is no longer justified to administer
      cytostatic treatment for this disorder.

PMID- 8481627
TI  - Serum CA 125 levels in patients with non-malignant liver diseases without
      ascites.

PMID- 8481628
TI  - Bioequivalence of allopurinol preparations: to be assessed by the parent drug or
      the active metabolite?
AB  - Allopurinol is converted almost completely into a single active metabolite,
      oxipurinol, which has the same therapeutic pattern but a much longer elimination
      half-life than the parent compound. Therefore both allopurinol and oxipurinol
      were evaluated in our bioequivalence study in healthy volunteers comparing two
      allopurinol brands. Bioequivalence determination was based on the 90% confidence
      intervals (CI) of the area under the plasma concentration time curve from time
      zero to infinity (AUC0-infinity), of the area from time zero to the last
      measurable plasma concentration (AUC0-t (last)), and Cmax. Because of the lack of
      compound-specific criteria we used conventional limits for the bioequivalence
      range. Under these conditions the brand chosen as test preparation was judged to
      be bioequivalent to the reference form with respect to the extent of
      bioavailability, AUC0-infinity, and AUC0-t (last) of the parent drug. The CI of
      Cmax of allopurinol slightly exceeded the upper limit of 130%, so that
      bioequivalence was not confirmed with regard to the rate of bioavailability of
      the parent compound. The CI values of both AUC and Cmax of the active metabolite
      were tighter than those of allopurinol. In addition, the CI values of Cmax of
      oxipurinol were smaller than those of the corresponding AUC. As a consequence the
      test drug can clearly be accepted as bioequivalent, based on metabolite data.
      Since the active metabolite is of greater therapeutic significance than the
      parent drug, assessment of the bioequivalence of allopurinol preparations needs
      to be based on oxipurinol rather than allopurinol.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8481629
TI  - Heterozygotic gene expression in endomyocardial biopsies: a new diagnostic tool
      confirms the Duchenne carrier status.
AB  - Identification of the defective gene and the absent gene product dystrophin can
      substantiate the clinical evidence for manifesting X-linked Duchenne type
      muscular dystrophy (DMD). It is not always possible, however, to rule out
      definitely a clinically asymptomatic carrier status in question, since even in
      the proven carrier DNA analysis is often inconclusive, and multinucleated
      skeletal muscle fibers express a basically normal membrane dystrophin. To
      substantiate the value of endomyocardial biopsy as a new tool for detection of
      the DMD carrier status we examined an endomyocardial biopsy of a volunteer who
      met the clinical criteria of a DMD carrier. Dystrophin immunohistochemistry and
      western blot of her skeletal muscle biopsy were inconclusive, and polymerase
      chain reaction and cDNA analysis failed to locate directly the X-chromosomal
      defect. We observed a clearcut mosaic of dystrophin-positive and -negative
      mononucleated cardiac muscle cells, reflecting a heterozygote carrier status in
      her endomyocardial biopsy, whereas 20 controls were uniformely positive. The
      incidence of DMD (1:3000 males) and especially the 30% spontaneous mutation rate,
      still the major pitfall in DNA analysis, show the need for an additional
      diagnostic tool.

PMID- 8481630
TI  - Diets, lipids, calcium and hypertension.

PMID- 8481631
TI  - Who has the right to end life?

PMID- 8481632
TI  - Laws needed to control gene therapy.

PMID- 8481633
TI  - Preoperative information: the role of the ward nurse.
AB  - Many health care professionals are becoming increasingly aware of the benefits of
      giving preoperative information to patients. However, many nurses still view the
      provision of such information as a luxury, only to be afforded when all the
      'proper' work is done.

PMID- 8481634
TI  - Holism in nursing: its meaning and value.
AB  - The term holism implies the integration of parts to achieve harmony. What can
      this ideal mean in a world which is fragmented and in a nursing context
      constrained by resources? Holism has some valuable applications for nursing and
      some warnings too.

PMID- 8481635
TI  - Child sexual abuse. 2: Techniques for helping adult survivors.
AB  - Nurses play a valuable role in helping victims of child sexual abuse. Through
      constant reassurance and skilled assistance the victims can realize that they can
      survive the abuse experience. The nurse wishing to work with this group of
      patients has an ethical and moral obligation to develop the necessary expertise
      and clinical competence to ensure that the intervention does not cause further
      harm and the development of maladaptive behaviour.

PMID- 8481636
TI  - Quality of life after intensive care.
AB  - Quality of life must be assessed after patients have received intensive care.
      Long-term survival of intensive care patients should be evaluated. TISS
      (Therapeutic Intervention Scoring System) is an extremely useful tool for
      estimating the cost of treatment given to an individual patient. APACHE II (Acute
      Physiology and Chronic Health Evaluation) is an effective index for measuring
      severity of illness. Age of patient and severity of illness dramatically affect
      the cost of treatment in intensive care.

PMID- 8481637
TI  - Do the benefits of continuing education outweigh the costs?
AB  - Debate on the costs and benefits of continuing professional education for nurses
      has intensified following the PREPP proposals. Evidence suggests that nurses who
      consider that their educational needs are being fully met have higher morale and
      work more efficiently than those who do not.

PMID- 8481638
TI  - Distance learning.
AB  - South Bank University boasts the only Diploma in Professional Studies in Nursing
      course in the UK that can be undertaken entirely by distance learning. How does
      it work and what should students hope to gain from such a course?

PMID- 8481639
TI  - In remembrance of nursing pioneers: Tiffany, Wells and Jones.

PMID- 8481640
TI  - The professional role of the nurse.
AB  - The extent to which nurses feel that their contribution is recognized and that
      they are involved in important decisions varies according to grade and location.
      Clinical nurses generally feel that they exert little influence over doctors,
      general management or their own nurse managers.

PMID- 8481641
TI  - Neurological emergencies. 2: Nurse-aid management of fits.
AB  - During the fit, the patient should be protected from further injury. The nurse
      aider should remove or guard the patient against dangerous objects nearby. To
      avoid further injury the nurse aider must carefully restrain and control the
      patient's movements. A clear airway must be maintained. The patient should be
      placed in the recovery position. Details of the fit should be observed.

PMID- 8481642
TI  - How to promote quality of care and preserve patient autonomy.
AB  - This article explores the relationship between the provision of a quality service
      and the promotion of patient autonomy. The key issue of meeting patients' actual
      needs while maintaining their self-worth within a budget-conscious environment is
      examined.

PMID- 8481644
TI  - Home is where the debts are.

PMID- 8481643
TI  - Impediments to advanced practice nursing.

PMID- 8481645
TI  - Live to work, work to live?

PMID- 8481646
TI  - Camp nursing: tips to help you experience success.

PMID- 8481647
TI  - Help! She's in labor!

PMID- 8481648
TI  - Show the $value$ of nursing.

PMID- 8481649
TI  - Pathogenic significance and diagnostic value of lupus autoantibodies.
AB  - Systemic lupus erythematosus (SLE) is characterized by a panoply of
      autoantibodies (more than 50). Some of them are more prevalent (anti-ds DNA >
      80%) while others are less frequently detected, but highly specific for SLE (anti
      Sm, 20%). In this review we will discuss the clinical significance of anti-RNP,
      anti-Ro, anti-La and anti-phospholipid antibodies. We will also summarize the
      clinical and experimental evidence for the pathogenic role attributed to each one
      of these antibodies.

PMID- 8481650
TI  - Iris protein antibodies in serum of patients with juvenile rheumatoid arthritis
      and uveitis.
AB  - Homogenates of bovine iris were fractionated by gel filtration chromatography,
      and the column-eluted proteins were probed with pooled sera obtained from
      patients with pauciarticular juvenile rheumatoid arthritis (JRA). The serum pool
      prepared from patients with pauciarticular JRA and a history of anterior uveitis,
      but not from those without the eye disease, contained IgG antibodies which bound
      a low molecular weight iris antigen (LMW-IA) as measured by a modified ELISA. LMW
      IA was protease-sensitive and contained at least four proteins of approximate
      molecular weights of 16, 13, 9 and 6.5 kD with no uronic acid or carbohydrate.
      Analysis of individual patient sera for IgG anti-LMW-IA antibody demonstrated
      that 1/20 (5%) pediatric non-rheumatic disease controls (NRDC), 1/19 (5.3%) non
      uveitic pauciarticular JRA patients and 6/21 (28.6%) uveitic pauciarticular JRA
      patients were positive by ELISA. Levels of anti-LMW-IA antibody did not correlate
      with serum IgG concentration, the presence of IgG antibody to soluble retinal S
      antigen (S antigen) or reactivity to the low molecular weight fraction of bovine
      choroid (LMW-C). Ten of 21 (47.6%) children with pauciarticular JRA and uveitis
      had serum antibody that reacted with LMW-IA and/or retinal S antigen as compared
      to 1/20 (5%) NRDC patients and 3/19 (15.8%) patients with pauciarticular JRA
      uncomplicated by uveitis. Analysis of patient immunoreactivity to proteins of the
      anterior uveal tract may provide a greater understanding of pathogenic features
      related to arthritis-associated eye disease.

PMID- 8481651
TI  - Use of a high molecular weight Entamoeba histolytica antigen fraction in enzyme
      linked immunosorbent assay and thin layer immunoassay tests.
AB  - A high molecular weight Entamoeba histolytica antigen fraction I was employed for
      the determination of anti-amoebic antibodies in ELISA and thin layer immunoassay
      (TIA) tests. A large number of human serum and immunized guinea pig serum samples
      were tested against this antigen. In comparison, ELISA was found more sensitive
      than the TIA technique. The potent antigen fraction I used in these tests was
      lyophilized at an optimum concentration of 1 mg/ml for obtaining uniform results.

PMID- 8481652
TI  - Expression of the alpha chain of human Fc epsilon RI in transfected rat
      basophilic leukemia cells: functional activation after sensitization with human
      mite-specific IgE.
AB  - The actual dilemma in studying the binding and triggering capacity of IgE from
      allergic patients is the lack of cultured basophils or mast cell analogs of human
      origin. Human IgE binds with exquisite species specificity to the high affinity
      IgE receptor (Fc epsilon RI) expressed on the surface of these cells. In rodents
      this receptor has been characterized as a tetrameric plasma membrane protein
      composed of an IgE-binding alpha chain, a beta chain and two disulfide-linked
      gamma chains. In order to establish a cell line expressing the alpha chain of
      human Fc epsilon RI which can be triggered with IgE from human patients and
      specific allergen, we transfected the cDNA coding for the human alpha subunit
      into rat basophilic leukemia cells. The resulting transfectants express the human
      alpha chain on the cell surface in the form of a hybrid complex associated with
      endogenous rat gamma chains. After sensitization with human IgE from mite
      specific patients, the transfectant produces a calcium response upon incubation
      with allergen. The established cell line can be used as a model system to study
      the mechanism of mast cell triggering through IgE from allergic patients.

PMID- 8481653
TI  - Anticardiolipin antibodies are associated with pulmonary hypertension in patients
      with mixed connective tissue disease or systemic lupus erythematosus.
AB  - Anticardiolipin antibodies (aCL) were studied in relation to pulmonary
      hypertension (PH) in 22 patients with mixed connective tissue disease (MCTD) or
      systemic lupus erythematosus (SLE). The mean pulmonary arterial pressure (mPAP)
      values were similar in the 12 MCTD and 10 SLE patients: 26 +/- 11 and 25 +/- 11
      mm Hg, respectively. However, the frequency of PH was higher in SLE (60%) than in
      MCTD patients (33%). The titers of aCL were significantly higher in SLE (38 +/-
      27 IU/ml) than in MCTD (17 +/- 7 IU/ml; p < 0.02). Two SLE patients with high
      titers of aCL had multiple cerebral infarction and transverse myelitis, and deep
      vein thrombosis, respectively. A significant correlation between the titers of
      aCL and mPAP was observed in patients with MCTD (p < 0.05), but not in patients
      with SLE.

PMID- 8481654
TI  - Relationship among asthma, serum IgE levels and skin test sensitivity to inhaled
      allergens.
AB  - In two groups of subjects, we have shown that increased high total serum IgE
      levels (with and without age and sex correction) are significantly associated
      with the asthmatic phenotype, as diagnosed by a physician. This association was
      confirmed by discriminant analyses; as compared to variables such as specific
      sensitivity to allergens and smoking history, age- and sex-corrected log[total
      serum IgE] was the best predictor of the status of physician-diagnosed asthma in
      these subjects. Additionally, we observed significantly increased skin test
      sensitivity to house dust allergens in asthmatics. These findings support
      previous studies showing that high total serum IgE levels and IgE-mediated
      sensitivity to house dust allergens are associated with the presence of asthma.

PMID- 8481655
TI  - Late phase bronchoconstriction and eosinophilia as well as methacholine
      hyperresponsiveness in Ascaris-sensitive rhesus monkeys were reversed by oral
      administration of U-83836E.
AB  - We used the Ascaris-sensitive primate model to assess the effect of oral doses of
      the 2-aminochroman (U-83836E) lazaroid on the antigen-induced late phase (24 h)
      bronchoconstriction (LPBC), eosinophilia and methacholine hyperreactivity.
      Following establishment of consistent lung resistance measurements and
      bronchoalveolar lavage eosinophilia in 4 Ascaris reactor primates, we determined
      the baseline aerosol mecholyl provocative challenge for 50% increase (PC50 in
      mg/ml) in these animals. Twenty-four hours following antigen challenge, we again
      determined the PC50 (mg/ml). In all 4 animals, there was a statistically
      significant decrease in PC50 (5.4- to 32-fold, n = 5-7; p < 0.029).
      Bronchoconstriction at 24 h increased in all 4 (49-86% over saline aerosol, p <
      0.05). Eosinophilia increased from 21 to an average of 33% of total cells (p <
      0.05 compared to saline). Repeating the antigen challenge in the presence of oral
      doses of 10 mg/kg U-83836E 18 and 3 h before and 6 h after challenge resulted in
      53-70% inhibition of LPBC, 53-81% inhibition of eosinophilia (p < 0.05 compared
      to Ascaris) and return of the mecholyl PC50 (mg/ml) to before antigen levels (p =
      NS) thus blocking increased hyperreactivity. These results indicate U-83836E,
      like steroids, would be an effective drug for asthma and lung inflammation.

PMID- 8481656
TI  - Immunosuppressive factors detected during convalescence in a patient with severe
      serum sickness induced by carbamazepine.
AB  - We report on a patient with severe serum sickness induced by carbamazepine in
      whom anticarbamazepine IgG antibodies were detected in the serum. The T cells of
      the patient showed impairment of phytohemagglutinin-induced proliferation, and
      hypergammaglobulinemia was evident. The clinical features and immunological
      abnormalities were compatible with immunoblastic lymphadenopathy.
      Immunosuppressive factors were also detected in the patient. Their molecular
      weights ranged from 20,000 to 30,000 as evaluated by Sephadex G-200 gel
      filtration. Such immunosuppressive cytokines were not detected in other patients
      with carbamazepine allergy who did not develop the clinical manifestations of
      immunoblastic lymphadenopathy. These results suggest that the T cell functional
      deficiency of immunoblastic lymphadenopathy is induced by these immunosuppressive
      cytokines.

PMID- 8481657
TI  - Lymphoma ...the next questions. Proceedings of a meeting. Orlando, Florida, April
      1-4, 1992.

PMID- 8481658
TI  - Is the working formulation adequate for the classification of the low grade
      lymphomas?

PMID- 8481659
TI  - Bone marrow transplantation for Hodgkin's disease--recent advances and current
      issues.

PMID- 8481660
TI  - Biochemical modulation of arabinosylcytosine for therapy of leukemias.
AB  - Analysis of different ribonucleotide reductase inhibitors to modulate
      arabinosylcytosine (ara-C) metabolism suggested that pretreatment with arabinosyl
      2-fluoroadenine (F-ara-A) significantly potentiated the rate of ara-CTP (5'
      triphosphate of ara-C) accumulation in both quiescent lymphocytes (p = 0.046) and
      in cycling blasts (p = 0.017). In vitro incubations of freshly isolated leukemia
      cells from patients with chronic (n = 7) or acute (n = 5) leukemias with F-ara-A,
      increased the rate of ara-CTP accumulation by a median of 1.5 or 1.7-fold,
      respectively, when subsequently incubated with ara-C. The objective of the
      present investigation was to test the hypothesis that ara-C can be biochemically
      modulated during therapy of leukemias. To test the biochemical modulation of ara
      C in the clinical setting, we designed two protocols to administer fludarabine
      (clinical formulation of F-ara-A) and ara-C in a pharmacologically directed
      sequence for patients with chronic lymphocytic leukemia (CLL) refractory to
      conventional fludarabine therapy or for patients with acute myelogenous leukemia
      (AML) in relapse. Comparison of ara-CTP pharmacokinetics demonstrated a
      significant increase in the area under concentration curve (AUC) of ara-CTP both
      in CLL (median 1.5-fold) and AML cells (median 1.8-fold) after fludarabine
      infusion. Analyses of different processes involved in the metabolism of ara-CTP
      indicated that the increase in AUC was due to potentiation of the rate of ara-CTP
      accumulation. These studies demonstrate that protocols designed on biochemical
      and pharmacological rationales modulate ara-C metabolism during therapies.

PMID- 8481661
TI  - Treatment of relapsed or refractory AML with intermediate-dose arabinosylcytosine
      (ara-C): confirmation of the importance of ara-C triphosphate formation in
      mediating response to ara-C.

PMID- 8481662
TI  - High-dose versus intermediate dose cytosine arabinoside combined with
      mitoxantrone for the treatment of relapsed and refractory acute myeloid leukemia:
      results of an age adjusted randomized comparison.
AB  - 193 patients with relapsed or refractory acute myeloid leukemia (AML) were
      entered into a prospective randomized comparison of high-dose versus intermediate
      dose cytosine arabinoside (AraC) both combined with mitoxantrone (mitox)
      according to the previously established sequential HD-AraC/mitox regimen (S-HAM).
      AraC was administered by 3 hr inf. q 12 hrs on days 1, 2, and 8, 9 at randomly
      assigned doses of either 3.0 versus 1.0 g/m2 in pts. < 60 years of age or 1.0
      versus 0.5 g/m2 in older pts. Mitox was given to all cases at a dose of 10
      mg/m2/d on days 3, 4, and 10, 11. Randomization was stratified for primary
      refractoriness against induction therapy and the length of first remission in
      relapsed cases (< 6 mths., 6-18 mths., > 18 mths.). From 151 presently evaluable
      cases 72 pts (48%) achieved a complete remission (CR), 38 cases (25%) were non
      responders (NR) and 41 pts. (27%) died within the first 6 weeks after the start
      of treatment (early death = ED). No significant differences were found in CR
      rates being 52% and 44% for the 3.0 versus 1.0 g/m2 AraC regimens in pts. < 60
      years and 48% and 45% after 1.0 versus 0.5 g/m2 AraC in older pts. No differences
      between the respective regimens emerged either for the time to CR (median 46
      days) nor remission duration (median 4.5 mths). Analysis of treatment failures,
      however, demonstrated a significantly higher rate of NR after the lower dose
      regimens in both age groups of 41% and 32% versus 11% and 14% in pts. receiving
      AraC at higher doses (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481663
TI  - Asparaginase revisited.

PMID- 8481664
TI  - Can the polymerase chain reaction be used to direct therapy?

PMID- 8481665
TI  - L-asparaginase and PEG asparaginase--past, present, and future.
AB  - L-asparaginase is an enzyme which hydrolyses asparagine. Since the 1960s it has
      been known that some leukemic cells are deficient in asparagine synthetase and
      therefore cannot manufacture sufficient quantities of this essential amino acid
      to maintain cell viability. L-asparaginase is predominantly useful in acute
      lymphocytic leukemia (ALL) although responses have been noted in patients with
      acute myeloid leukemia, lymphoma, and rarely other tumors. L-asparaginase has
      been used in conjunction with methotrexate and ara-C in combination programs in
      leukemia. The major side-effect limiting the usefulness of L-asparaginase is
      allergic reactions. In addition, it is probable that neutralizing antibodies
      develop which shorten the half life of the drug so that the goal of depletion of
      plasma levels of asparagine cannot be attained or maintained. Polyethylene glycol
      (M.W. 5000) can be conjugated to L-asparaginase at sites not involving the active
      site of the enzyme. This enables free access of a small molecule, asparagine, to
      the active site of the enzyme but prevents uptake by the reticuloendothelial
      system, greatly decreasing the probability of developing antibodies against the
      asparaginase and prolongs the circulating half life of the drug. In a phase I/II
      study conducted at the M.D. Anderson Cancer Center, 37 heavily pretreated
      patients with refractory hematologic malignancy were treated. The age range from
      15 to 73 years, median 49 years. Nineteen patients had ALL, 15 lymphoma, two
      myeloma, and one Hodgkin's disease. The dose levels of PEG L-asparaginase varied
      from 250 IU/m2 up to 8000 IU/m2. The pharmacokinetic profile demonstrated a
      monophasic half life consistent with a one compartment model with a single
      elimination phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481666
TI  - The role of interferon in the therapy of low grade lymphoma.

PMID- 8481667
TI  - Combination chemotherapy in the treatment of follicular low-grade lymphoma.
AB  - The therapeutic approach to patients with follicular low-grade non-Hodgkin's
      lymphoma is controversial and has varied over a wide spectrum. A "watch and wait"
      approach in asymptomatic patients has been taken in some studies. In other
      series, single agent therapy with alkylating agents as cyclophosphamide or
      chlorambucil has been employed. Response rates including complete responses are
      high, but relapses inevitably occur. Three-drug combination chemotherapy regimens
      consisting of cyclophosphamide, vincristine, and prednisone (CVP) have been
      utilized, in addition to more intensive regimens consisting of four or more
      drugs. Although responses are commonly achieved, there is no consistent survival
      advantage conferred by these more aggressive regimens. However, the remission
      duration may be prolonged in some subsets of patients as those with follicular
      mixed lymphoma. Due to the prolonged natural history of follicular low-grade
      lymphoma, a long period of follow-up is necessary to adequately evaluate the
      impact of a therapeutic regimen on remission duration and overall survival.
      Future trials may employ more aggressive therapy in combination with growth
      factors or biologic response modifiers in an effort to improve the outcome of
      patients with follicular low-grade lymphoma.

PMID- 8481668
TI  - Treatment of low grade non-Hodgkin's lymphomas with fludarabine.

PMID- 8481669
TI  - Anthracycline containing regimens in intermediate grade lymphoma. Italian
      Cooperative Study Group on Intermediate Grade Malignant Lymphoma.
AB  - From March 1991 to April 1992, 44 previously untreated patients with stage II to
      IV intermediate-grade non-Hodgkin's lymphoma (according to the Kiel
      classification) were entered in a phase III comparative trial. The objectives of
      the study were to compare the efficacy and safety of using idarubicin instead of
      doxorubicin in the combination chemotherapeutic regimen CHOP (cyclophosphamide,
      doxorubicin, vincristine, prednisolone). Forty-four patients were randomly
      assigned to receive either CI(idarubicin)OP or CH(doxorubicin)OP. The study is
      ongoing and so far no significant differences in complete response rate and (non
      )hematologic toxicity have been observed.

PMID- 8481670
TI  - Human B cell lymphomas: in vitro and in vivo studies on growth factors and cell
      growth.
AB  - The B cell non-Hodgkin's lymphomas (NHL-B) are a common, but heterogeneous group
      of human lymphoid neoplasms, consisting of monoclonal populations of neoplastic B
      lymphocytes demonstrating non-random chromosomal abnormalities, often associated
      with proto-oncogene translocations. Clinically and pathologically, these
      lymphomas are classified as low, intermediate, or high grade, according to the
      clinical aggressiveness of the NHL-B subtype. The clinical behavior can also be
      correlated with biological function regarding proliferative capabilities of the
      tumor cells. Our studies have shown that the low grade B cell lymphomas have low
      constitutive proliferative capacity in vitro and do not respond to cytokine
      growth factors (CGF), while the high grade NHL-B respond to the B cell growth
      factor (BCGF) family of CGFs. The high grade NHL-B also secrete BCGFs both in
      vitro and in vivo, as autocrine growth factors that may provide a target for new
      therapeutic approaches to therapy.

PMID- 8481671
TI  - Prognostic factors in large-cell lymphomas.
AB  - A review of the most significant prognostic factors found in large cell lymphomas
      is presented. Prognostic factors are divided in four categories: (a) those
      related to the patient: age at diagnosis; (b) those related to the tumor: stage,
      tumor bulk, spreading of tumor, extranodal sites, LDH and beta 2-microglobulin
      levels; (c) those related to the host-tumor relationship: performance status,
      presence of B symptoms, serum albumin level, and interleukin secretion; and (d)
      those related to the physicians: type of treatment, dose intensity of this
      treatment. Most of these parameters are related to each others and only a few of
      them keep statistically significant correlation with outcome in multiparametric
      studies. New prospective studies with new therapeutic strategies should stratify
      patients before treatment on these most important prognostic factors.

PMID- 8481672
TI  - What is the role of third generation regimens for initial therapy of non
      Hodgkin's lymphomas?
AB  - The advances in therapy for aggressive non-Hodgkin's lymphoma have improved the
      long-term outlook for patients with this disease. However, many questions still
      remain such as: which combination chemotherapy protocol is the best? Is it
      necessary to use a third generation regimen, or is CHOP
      (cyclophosphamide/doxorubicin/vincristine/prednisone) adequate? And finally is
      the extent of dose intensity that can be achieved with conventional therapy
      adequate in poor prognosis patients? Although several smaller comparative trials
      have been done, the four arm trial currently being performed by the South West
      Oncology Group (SWOG) will represent the largest trial designed to address this
      issue. One best protocol has not yet been identified as being superior to others
      for the therapy of patients with aggressive non-Hodgkin's lymphomas. However,
      certain subsets of patients may benefit from specific protocols. This information
      can hopefully be gleaned from subset analysis of the SWOG study in the future. At
      the present time, since one best therapy cannot be identified, physicians should
      chose a regimen that they are confident in and familiar with it's use. By
      utilizing a particular regimen, one can minimize the treatment-related mortality
      and optimize the patient's change for a good outcome. Subset analysis to identify
      particular groups that may benefit from higher dose intensity will be an
      important feature for future analysis.

PMID- 8481673
TI  - Chronic administration of etoposide in the treatment of non-Hodgkin's lymphoma.
AB  - The importance of schedule in the cytotoxic efficacy of etoposide is suggested by
      the mechanism of action and supported by clinical data in the treatment of small
      cell lung cancer. To further evaluate the effects of drug schedule, we studied
      the efficacy of oral etoposide 50 mg/m2 daily for 21 consecutive days, repeated
      every 28-35 days, in the treatment of refractory lymphoma. Twenty-five patients
      were treated; all had received previous chemotherapy and were considered
      incurable. Fifteen patients (60%) responded to treatment (14 partial responses, 1
      complete response), including 5 of 9 patients who had received previous
      intravenous etoposide. Median response duration was 8 months in patients with low
      grade lymphoma and 3 months in those with intermediate or high grade lymphoma.
      The single complete responder remains disease-free 19 months after completion of
      therapy. Two patients responded to chronic oral etoposide immediately after
      progression on intravenous etoposide-containing regimens, demonstrating improved
      efficacy of the chronic schedule. Single agent etoposide, administered at this
      dose for 21 days, provides an effective and convenient treatment option for
      patients with indolent lymphoma. Incorporation of this etoposide schedule into
      combination regimens for aggressive lymphoma is currently under investigation,
      and preliminary results are reported. We are currently conducting a phase I study
      using low dose, continuous infusion etoposide (25 mg/m2/day). By avoiding high
      peak serum levels and maintaining a constant serum level of approximately 1
      microgram/ml, we hope to retain efficacy and minimize or avoid myelotoxicity.
      Continuous infusion was continued for as long as tolerated. Blood counts were
      measured weekly, and therapy temporarily interrupted if WBC < 2000/microL
      developed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481674
TI  - Phase II study of intravenous idarubicin in unfavorable non-Hodgkin's lymphoma.
AB  - Idarubicin, a new analogue of daunorubicin, was administered intravenously at a
      dose of 15 mg/m2 to 31 patients with previously treated patients with unfavorable
      non-Hodgkin's lymphoma. Clinical characteristics included median age 69 years,
      performance status 1, and prior chemotherapeutic regimens 1. Twenty of the
      patients were relapsing after prior therapy and 11 were refractory; 29 had
      received prior anthracycline or anthracenedione. Responses were observed in 43%
      of patient (3 CR and 10 PR) with a median duration of 10+ months (2-29+ months).
      Idarubicin was well tolerated with non-hematologic toxicities (nausea/vomiting,
      mucositis, and anorexia) seen in < 50% of patients. Median hematologic values
      during the first cycle for this dosage included WBC 1300/mm3, platelets
      129,000/mm3, and hemoglobin 10.9 mg/dl. With dose escalation, hematologic
      toxicity was dose-limiting. Symptomatic cardiac toxicity was observed in one
      patient who had received maximum dose doxorubicin and radiotherapy. Median values
      for the cardiac ejection fraction during the full course of therapy for the
      entire group of patients were 0.62 (initial) and 0.60 (final). Idarubicin in
      intravenous form is an active drug in previously treated patients with
      unfavorable non-Hodgkin's lymphoma. Further studies employing idarubicin in non
      Hodgkin's lymphoma should be considered. Cardiac function should be followed in
      trials utilizing anthracycline-type chemotherapeutic agents.

PMID- 8481675
TI  - Can we identify patients with low grade lymphoma for frontline ABMT?
AB  - Autologous Bone Marrow Transplant (ABMT), at this point, is an experimental
      procedure reserved for patients without cure potential with available
      conventional chemotherapy. Unfortunately, the Ann Arbor staging system has not
      been able to identify these cases since there are patients with Stage IV who do
      well and others who do not. We have reported on a risk model based on gender and
      tumor burden (TB) assessment that can stratify patients with uniform Ann Arbor
      stage IV follicular low-grade lymphoma (FLGL) into three prognostic groups: (a) a
      group of females with low TB who have achieved a plateau of failure free survival
      (FFS) and survival of 50% and 92%, respectively, and who should not receive
      frontline ABMT; (b) a group of males with high TB having a median FFS and
      survival of only 12 and 48 months, respectively, and who could potentially
      benefit from ABMT; (c) a large group of patients with other TB-sex combinations,
      who are continuously relapsing at ten year follow-up, and whose survival is
      dismal. Even some of these, who have at best a 50% ten year survival, have not
      reached a plateau in their survival curves. This large group of patients, like
      all stage IV patients, will have a median age of 60 years at the time of initial
      diagnosis and treatment, and will be probably over 60 years old by the time they
      relapse, at which time salvage therapy will have increased morbidity and
      mortality, more so if it includes ABMT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481676
TI  - Who are clinicians?

PMID- 8481677
TI  - "The significance of pain in children's experiences of hemophilia".

PMID- 8481678
TI  - Community elders: prevalence and correlates of depressive symptoms.
AB  - This pilot study examined the prevalence and correlates of depressive symptoms
      among community-dwelling elders 75 years of age and older. Forty subjects were
      recruited from a research volunteer pool. Cross-sectional data were collected
      during structured in-home interviews. High depressive symptoms were reported by
      10 (25%) of the elders; of these, 8 were males. Depressive symptoms were
      positively related to the need for instrumental support. Higher depressive
      symptoms were associated with poorer functional health status and self-rated
      health and with lower morale, life satisfaction, and quality of life. Nurses
      working with community-dwelling elders 75 years of age or older should be alert
      for depressive symptoms among those with indications of poor physical and
      functional health, and instrumental support needs should be assessed. Further
      investigation into the age/gender issue as it relates to the development of
      depressive symptoms is warranted.

PMID- 8481679
TI  - Symptoms reported by older and middle-aged adults after coronary bypass surgery.
AB  - Knowledge of the most prevalent symptoms after coronary artery bypass surgery
      (CABS) can be used to assist patients to anticipate recovery. The purposes of
      this study were to describe the prevalence of symptoms during the first 6 weeks
      after CABS, to assess changes in the number and types of symptoms, and to compare
      symptoms in older and middle-aged adults. The most prevalent symptoms during
      hospitalization (Time 1) were pain, edema, wound drainage, fever, and fatigue. In
      the third through fifth postoperative weeks (Time 2), the most prevalent symptoms
      were pain, edema, sleep problems, fatigue, and wound drainage. At 6 weeks (Time
      3), sleep problems, edema, pain, fatigue, and shortness of breath were the most
      common. Number of symptoms decreased significantly between Times 1 and 3. All
      symptoms were more prevalent at Time 2 than at Time 1 and less prevalent at Time
      3, with the exception of sleep problems, which were reported more frequently at
      Time 3 than at Time 1. The most persistent symptoms were edema, fatigue, sleep
      problems, pain, and shortness of breath. Significantly more middle-aged adults
      than older adults reported anxiety at Time 2. No other age-related differences
      were found. Implications for nursing practice and research are discussed.

PMID- 8481680
TI  - Wandering in Alzheimer's dementia patients.
AB  - The purpose of this research was to describe wandering behaviors of
      institutionalized patients with Alzheimer's disease in their natural environment.
      Such descriptive information is necessary before successful product and/or
      nursing intervention programs can be developed. Videotaped behavioral
      observations yielded detailed data descriptive of patients with middle and late
      dementia. These patients have the physical ability to perform various functions,
      activities, or actions; the individual's mental ability is less supportive of
      physical ability. The degree of task simplicity required to enable the patient to
      complete unsupervised tasks depends on the level of dementia. The need for
      interventions is greatest during unstructured periods of the day.

PMID- 8481681
TI  - Preterm infants in pain: nurses' and physicians' perceptions.
AB  - Within the past few years, the assumption that preterm infants experience little
      or no pain has been challenged in nursing and medical literature. It is not clear
      to what extent changes have taken place in the practice area. The purpose of this
      qualitative study was to explore the beliefs of NICU nurses and physicians about
      the existence and treatment of pain in preterm infants. Respondents to the open
      ended interviews were 5 neonatologists and 10 nurses at two regional referral
      neonatal intensive care units in North Carolina. Interviews took from 20 to 40
      minutes and were analyzed using the Ethnograph program. All respondents agreed
      that preterm infants experience pain. Both groups identified behavioral and
      physiological cues to pain recognition. There were differences in initial
      approaches to treatment. However, both groups indicated that the nurse has the
      pivotal role in recognition and initiation of treatment to reduce or eliminate
      pain.

PMID- 8481682
TI  - Social skills training and cognitive restructuring for adolescents on
      hemodialysis.
AB  - The purpose of this study was to test a social skills and cognitive restructuring
      intervention designed for adolescents undergoing hemodialysis. A single-case
      experimental design with multiple baselines across subjects was used. Cognitive
      restructuring and assertive skills training were incorporated into eight weekly
      instructional modules. A convenience sample of 6 adolescents entered the program;
      3 subjects completed the program. Data were analyzed using visual analysis.
      Although no striking changes could be seen between pre- and post-intervention
      phases for self-efficacy and self-report of assertive behaviors, there was a
      trend toward growth in overall social skills for 2 subjects. Another subject made
      some obvious increases in all areas of self-efficacy in comparison to other
      subjects. This study points out the merit of identifying depression as a factor
      in cognitive impairment and the exercise of personal efficacy.

PMID- 8481683
TI  - Complications of enteral nutrition in hospitalized patients with artificial
      airways.
AB  - This study investigated complications of enteral feeding in hospitalized patients
      with artificial airways. A prospective chart review, using a descriptive design,
      was used in this study of 51 inpatients in a large southeastern teaching
      hospital. A low (5.9%) incidence of pulmonary aspiration was found. Diarrhea was
      also found to be an infrequent complication (2%). The most common complication in
      this sample was interruption in continuous tube feedings: 24 patients (47%)
      experienced such interruptions, resulting in potential underfeeding. Further
      investigation of the adequacy of nutrition of hospitalized tube-fed patients with
      artificial airways is necessary to determine clinical significance.

PMID- 8481684
TI  - The human/animal bond as a correlate of family functioning.
AB  - This study investigated whether selected family characteristics are predictive of
      family functioning. The intent was to examine whether family cohesion and
      adaptability could be predicted from the characteristics of family education,
      income, marital status, and level of pet attachment. A survey research design was
      used to distribute questionnaires to families in therapy in six southeastern
      states. Findings indicated that 15% of the variance in family adaptability could
      be significantly (p < .05) accounted for by the combination of family education,
      income, marital status, and pet attachment. However, variance in family cohesion
      could not be significantly accounted for by this combination of variables. Family
      pet attachment was significantly (p < .05) correlated with both family
      adaptability and family cohesion. Clinical practice implications of these
      findings for nurses and other health care professionals are discussed, and
      recommendations for future studies are identified.

PMID- 8481685
TI  - Setting a research agenda to promote nursing research.
AB  - This study is a first step in the process of focusing research efforts in a
      developing nursing research program. A two-round Delphi technique, a method for
      formulating consensus, was employed to address the aim of organizationally
      reaching consensus regarding nursing research priorities. Questionnaires were
      mailed to "experts," defined as all registered nurses within the division (N =
      634). Round 1 respondents identified 609 different research items, which were
      then sorted and categorized into a 100-item Round 2 questionnaire. Research
      directives and program planning will center around the priority areas.

PMID- 8481686
TI  - [Formation of a complex between glycogen phosphorylase and creatine kinase in
      rabbit skeletal muscles].

PMID- 8481687
TI  - [Comparative-biochemical analysis of right-handed, left-handed, and ambidextrous
      rats].

PMID- 8481688
TI  - [Participation of intestinal, hepatic and pulmonary basins in the formation of
      the lipid profile of blood and lymph in experimental atherosclerosis].

PMID- 8481689
TI  - [A family of ankyrin-like orthopoxviridae proteins].

PMID- 8481690
TI  - [The role of serotonin 1A and dopamine D2 receptors in buspirone effects on the
      electrical activity of white rat brain].

PMID- 8481691
TI  - [Participation of met-enkephalin in the organization of the functional direction
      of the vagus effect on cardiac rhythm].

PMID- 8481692
TI  - [Cytochrome P-448: study of oligomeric structure].

PMID- 8481693
TI  - [Directed mutagenesis of bacterial formate dehydrogenase: the role of Cys-255 in
      the catalysis and stability of the enzyme].

PMID- 8481694
TI  - [Paradoxical toxic effect and antagonism of O-(N-arylcarbamoylated)
      acylhydroxymoylchloride cholinesterase inhibitors with calcium].

PMID- 8481695
TI  - [Anxiety as a possible cause for sex ratio disturbance in a generation ("the war
      years phenomenon")].

PMID- 8481696
TI  - [Somnogenic effects of a delta-sleep peptide analog with an increased resistance
      to hydrolysis].

PMID- 8481697
TI  - [Radiophosphene--an indicator of radiation stimulation of the central nervous
      system].

PMID- 8481698
TI  - [New vectors for highly effective expression of hybrid proteins in E. coli].

PMID- 8481699
TI  - [Migration of colonies of human epidermal keratinocytes in culture].

PMID- 8481700
TI  - [Spontaneous instability of population waves formed by bacteria].

PMID- 8481701
TI  - [EEG pharmacodynamics upon single administration of seduxen in healthy
      volunteers].

PMID- 8481702
TI  - [Basic paths of morphological progress of the mammalian eye].

PMID- 8481703
TI  - [Repeating DNA sequence present in pretelomeric segments of human chromosomes].

PMID- 8481704
TI  - [Molecular-cytogenetic analysis of heterochromatin fragments induced by gene
      inactivation in the variegation position effect in Drosophila].

PMID- 8481705
TI  - [Study of repeating DNA sequences in murine Ehrlich ascites cancer cells upon
      long-term mutagenic action].

PMID- 8481706
TI  - [Mechanism of regulating the activity of glycogen phosphorylase b by adenosine-5'
      monophosphate].

PMID- 8481707
TI  - [The role of nucleoside triphosphates in the motor reaction of living organisms].

PMID- 8481708
TI  - National Advisory Committee on Immunization (NACI). Statement on pertussis
      immunization.

PMID- 8481709
TI  - The effect of proportion overlap and repeated testing on primed work fragment
      completion.
AB  - Subjects studied a list of words (e.g., cheetah) and received an implicit word
      fragment completion test (complete -h-t-h). On the test, the ratio of studied to
      nonstudied items (proportion overlap) was 0, 25, 50, 75, or 100%. Subjects were
      administered the identical test twice. Proportion overlap did not affect priming
      in word fragment completion, on either the first or second test. Also, the
      completion of studied and nonstudied fragments increased over repeated tests, but
      priming (the studied-nonstudied rate) remained unchanged. The proportion overlap
      of items between study and test does not affect performance on primed word
      fragment completion.

PMID- 8481710
TI  - Masking and visual field effects on a lateralized rod-and-frame test.
AB  - The rod-and-frame test (RFT) has been widely used in the study of sex differences
      in spatial abilities. However, laterality studies involving this test are very
      scarce. An experiment was conducted to investigate whether laterality effects
      would be affected by post-stimulus masking. Ninety-six subjects participated in
      the experiment. For half the subjects, stimuli were followed by a blank screen,
      while for the other half, stimuli were followed by a mask. An overall left visual
      field advantage (LVFA) was found in the task. An interaction of sex of subjects,
      masking conditions, and frame tilt was also found. Further analyses showed that
      the sex by angle of frame interaction was significant when a mask was presented
      after the stimuli, but not when no mask followed the stimuli. Data tended to
      confirm the hypothesis that the LVFA was only significant when a mask was
      presented after the stimuli. These findings demonstrate the usefulness of a
      masking procedure in visual field studies, whereas the right hemisphere advantage
      found on the RFT is consistent with previous findings with visuo-spatial tasks.

PMID- 8481711
TI  - Effects of distinctiveness, repetition and semantic priming on the recognition of
      face familiarity.
AB  - Three experiments are reported which provide evidence for the independence of
      effects of repetition from those of distinctiveness and semantic priming in the
      recognition of familiar faces. In Experiment 1, repetition priming is shown to be
      additive with face distinctiveness in a face familiarity decision task, where
      subjects make speeded familiarity decisions to a sequence of famous and
      unfamiliar faces. Experiment 2 examines the combined effects of distinctiveness
      and semantic priming. The results suggest that the effect of distinctiveness is
      additive with that of semantic priming. Experiment 3 uses a more powerful design
      in which effects of distinctiveness and semantic priming were assessed while all
      items were repeated three times during the course of the experiment. Effects of
      repetition and distinctiveness were again additive, as were effects of repetition
      and semantic priming. Distinctiveness and semantic priming were additive at 1,000
      ms SOA, though appeared to interact at 250 ms SOA. The results give further
      evidence for the separation of the mechanisms of semantic from repetition
      priming, and furthermore suggest that distinctiveness operates at a different
      locus from those of either of the priming mechanisms.

PMID- 8481712
TI  - Eye movement control during visual object processing: effects of initial fixation
      position and semantic constraint.
AB  - Eye movement patterns were recorded while subjects viewed arrays of line drawings
      of objects. The initial landing position of the eyes on an object was found to be
      normally distributed around the center of the object, with the modal landing
      position at the center. Landing variability was greater in the direction of the
      eye movement vector than in the direction perpendicular to the movement, and
      there was more of a tendency to undershoot the center of the object than to
      overshoot it. Landing position was found to influence other aspects of eye
      movement behaviour. The duration of the first fixation on an object decreased and
      the probability of refixating an object increased as the deviation of the initial
      landing position from the center of the object increased. The effect of a
      cognitive factor, semantic constraint, was also examined. Landing position and
      semantic constraint were found to interact such that semantic constraint had a
      greater effect the further the eyes landed from the center of the object. The
      results are discussed in terms of their implications for the use of eye movement
      behaviour as an indicator of perceptual and cognitive processing.

PMID- 8481713
TI  - [Attention behavior of infants and modulation of maternal language].
AB  - Language spoken to infants has several peculiarities that are also found in other
      cultures. In this study we have examined the specific relationships between some
      infant's behaviours and the prosodic modulations of maternal speech in a face to
      face interaction. 14 mothers with their four month-old infant were observed in a
      laboratory setting in order to obtain a corpus of 2100 maternal words. There is a
      variation of maternal speech prosody that depends upon the attentional behaviours
      of the infant. When the infant is interacting (the gaze is directed towards the
      mother with a neutral or positive expression, joint gaze), the mother has a
      tendency to produce longer utterances with a more variable fundamental frequency
      than that observed when the infant is not interacting (looking elsewhere or
      alternating). There is also a larger occurrence of complex and bell-shaped curves
      during the infant's positive and joint gazes. The infant appears to be an active
      partner in mother-infant verbal exchange.

PMID- 8481714
TI  - History of laparoscopy: urology's perspective.

PMID- 8481715
TI  - Perirenal hematomas caused by SWL with EDAP LT-01 lithotripter.
AB  - A total of 419 calculi in the upper urinary tract of 402 patients were treated by
      SWL with the EDAP LT-01 lithotripter from July 1988 to September 1989.
      Subcapsular hematomas resulted in 17 kidneys of 16 patients, an incidence of
      4.1%. On CT scan, fractures with subcapsular hematomas were observed in nine
      kidneys, and a retroperitoneal hematoma was observed in one patient. There was no
      significant difference in stone location and size, grade of hydronephrosis,
      number of shock waves, applied energy, or post-treatment fever between the groups
      with and without hematomas. However, the hematoma group revealed significantly (P
      < 0.01) higher incidences of pretreatment hypertension (> 160/95 mm Hg) and use
      of antiplatelet agents. It is difficult to detect some disorders of blood
      coagulation in ordinary laboratory studies in patients receiving low dosages of
      antiplatelet agents; and many drugs including analgesic and anti-inflammatory
      agents, calcium antagonists, coronary vasodilators, antiplatelet agents, beta
      blockers, and lipid-regulating agents have antiplatelet actions. Therefore,
      particular care should be taken in SWL when a patient is using those drugs.

PMID- 8481716
TI  - Absence of long-term gonadotoxicity in primates receiving extracorporeal shock
      wave application.
AB  - Extracorporeal shock wave lithotripsy (SWL) is becoming popular in the management
      of lower ureteral calculi; however, the quantity of data on its potential
      gonadotoxic effects are limited. Eight nonhuman primates had baseline
      measurements of testicular volume, semen analysis, serum testosterone and FSH
      assays, and DNA flow cytometric analysis of testicular aspirates. The
      anesthetized primates were lowered into a Dornier XL-1 lithotripter and at a 20
      kV power setting had various numbers of shocks (0, 500, 1500) directed at each
      testis. Sequential studies were done at 6-week intervals for 9 months. The
      control group showed no significant change in any measure. Semen analysis,
      testosterone, and FSH results were variable and without statistically significant
      differences. There were changes in the DNA histograms, with the tetraploid (4N)
      group of cells being the most sensitive. All changes caused by SWL application
      returned to baseline by 9 months. Data from this primate study document no
      apparent long-term male gonadotoxicity from SWL, but the authors suggest measures
      to protect the testis during clinical use.

PMID- 8481717
TI  - Retroperitoneal laparoscopic nephrectomy: laboratory and clinical experience.
AB  - Laparoscopic nephrectomy using an entirely retroperitoneal approach was performed
      in six anesthetized female pigs. In each animal, the kidney was localized using
      fluoroscopy, following which the retroperitoneum was insufflated with CO2.
      Subsequently, a retroperitoneal laparoscopic nephrectomy was performed in a 48
      year-old man with a chronically obstructed, nonfunctioning kidney. Although the
      retroperitoneal approach provides excellent exposure for the dissection of the
      renal hilum, anatomic factors in the human limit port placement and organ
      entrapment and increase the risk for development of a pneumothorax.

PMID- 8481718
TI  - Laparoscopic nephropexy for symptomatic nephroptosis: initial case report.
AB  - Laparoscopic nephropexy was performed in a 25-year-old woman with intractable
      pain and a palpable pelvic mass associated with right nephroptosis for more than
      1 year. Evaluation by a supine and an erect intravenous urogram (IVU) revealed
      right renal descent of three vertebral bodies with mild hydronephrosis.
      Laparoscopic transperitoneal nephropexy was performed in a 2 and a half hour
      procedure. The patient stayed in the hospital 2 days postoperatively and returned
      to full activities 3 weeks later. At 2 months postoperatively, she is
      asymptomatic. An upright IVU2 months postoperatively revealed renal descent of
      only one vertebral body and no hydronephrosis. This is the first report to our
      knowledge of a successful laparoscopic nephropexy.

PMID- 8481719
TI  - Omental evisceration through small laparoscopy port sites.
AB  - Two children developed omental evisceration through small periumbilical port
      sites after peritoneal endoscopy for nonpalpable testes. Factors that predispose
      to this complication include decompression of the pneumoperitoneum by suction.
      These factors and steps to avoid it such as closure of all endoscopic fascial
      defects under direct vision are described.

PMID- 8481720
TI  - New tip design and shock wave pattern of electrohydraulic probes for endoureteral
      lithotripsy.
AB  - A new tip design of a 3.3F electrohydraulic probe for endoureteral lithotripsy
      was evaluated in comparison to a regular probe. The peak pressure, as well as the
      slope of the shock front, depend solely on the voltage. Increasing the capacity
      leads merely to broader pulses. A laser-like short high-pressure pulse has a
      greater impact on stone disintegration than a corresponding broader low-pressure
      pulse of the same energy. Using the regular probe, only positive pressures were
      obtained. Pressure distribution around the regular tip was approximately
      spherical, whereas the modified probe tip "beamed" the shock wave to a great
      extent. In addition, a negative-pressure half-cycle was added to the initial
      positive peak pressure, which resulted in a higher maximal pressure amplitude.
      The directed shock wave had a greater depth of penetration into a model stone.
      Thus, the ability of the new probe to destroy harder stones especially should be
      greater. The trauma to the ureter was reduced when touching the wall
      tangentially. No difference in the effect of the two probes was seen when placing
      the probe directly on the mucosa.

PMID- 8481721
TI  - Endopyelotomy and endoureterotomy with the acucise ureteral cutting balloon
      device: preliminary experience.
AB  - Endoureterotomy and endopyelotomy usually involve an endoscopic antegrade
      approach. In an effort to simplify this technique, we designed an 8-mm balloon
      catheter with a 100-microns electrocautery cutting wire (Acucise) for retrograde
      incision of the ureter under fluoroscopic control. Twenty-eight patients with
      ureteral or ureteropelvic junction obstruction of 3.5 cm or less underwent
      Acucise endoureterotomy or endopyelotomy. The average operating time was 100
      minutes, and the average hospital stay was 2.6 days. Follow-up was obtained with
      a subjective symptom score, intravenous urography, diuretic renal scan, a
      Whitaker test, or various combinations thereof. All patients had a minimum of 3
      months of follow-up (mean 3.8 months; range 3-9 months). Overall, of the 21
      patients who had symptoms of upper tract urinary obstruction, 14 (67%) had
      complete resolution, and another 4 (19%) had partial resolution, of their
      symptoms. Postoperative studies demonstrated normal upper tracts in 71% and
      improvement in another 14% of the patients. In our experience, the Acucise
      ureteral cutting balloon device provides an effective and efficient means for
      performing a retrograde endoureterotomy or endopyelotomy.

PMID- 8481722
TI  - Endoscopic use of Nd:YAG laser to remove Marlex strut from Kock continent urinary
      reservoir.
AB  - A Marlex strut, which was designed to prevent efferent valve prolapse and
      peristomal herniation in the Kock continent urinary reservoir, eroded through the
      pouch wall, resulting in persistent bacteriuria and the inability to catheterize
      the pouch. The eroding strut was removed endoscopically with the Nd:YAG laser.
      Continence has been preserved and ease of catheterization restored.

PMID- 8481723
TI  - New temporary coil stent (Urocoil) for treatment of recurrent urethral
      strictures.
AB  - The Urocoil is a temporarily inserted self-expanding and self-retaining coil
      stent made of medical-grade stainless steel that is inserted under fluoroscopy
      after topical anesthesia of the urethra. This stent was used for 16 patients with
      a variety of recurring urethral strictures who had been managed in the past by
      repeated dilatations and urethrotomies. The stent was left in place for 6 months.
      Unlike permanently implanted mesh stents, no tissue growth into the lumen
      occurred with this stent, making its removal a simple procedure. With a follow-up
      of 3 to 9 months after removal, no recurrence of the strictures was observed.
      This temporary stent seems to be effective in the treatment of recurring urethral
      strictures. Satisfactory and promising results were obtained without leaving a
      foreign body permanently in the urethra.

PMID- 8481724
TI  - Extracorporeal shock wave lithotripsy for calcified ureteral stent.
AB  - Calcification of a ureteral stent has been an unusual complication of long-term
      stent use for bypassing ureteral obstruction or after surgical repair. Open or
      percutaneous procedures have usually been required to remove the calcification
      before the stent can be extracted. We report six cases of calcified ureteral
      stents successfully managed by extracorporeal shock wave lithotripsy (SWL)
      followed by cystoscopic extraction, thus avoiding open or percutaneous
      procedures.

PMID- 8481725
TI  - Efficacy of endoscopic hydrocele ablation.
AB  - We describe a new endoscopic technique that was used for the treatment of
      symptomatic scrotal hydroceles in 10 men. Through a small skin incision, the
      parietal surface of the tunica vaginalis was ablated endoscopically using either
      electrocautery or the KTP:YAG laser. This approach permitted visual inspection of
      the scrotal contents with minimal manipulation and was performed using monitored
      local anesthesia with bilateral spermatic cord blocks. With a mean follow-up
      interval of 6.1 months, no hydrocele recurrences, wound infections, or hematomas
      have been detected. The mean operative time was comparable (53 minutes) to that
      in a historical control group consisting of 15 men who had undergone open
      hydrocelectomy at our institution (46 minutes). Postoperative scrotal discomfort
      was minimal, with 6 of the 10 patients requiring no analgesics. Patients were
      able to resume their preoperative lifestyles an average of 2 days after surgery.
      In contrast, 11 of the 15 men in the control group was still complaining of
      scrotal pain, requiring oral analgesics, at their 2-week follow-up visit. Thus,
      endoscopic hydrocele ablation appears to be an effective and well-tolerated
      alternative to treat hydroceles with minimal postoperative discomfort.

PMID- 8481726
TI  - Relationship of fluid intake to voluntary micturition and urinary incontinence in
      geriatric patients.
AB  - The aim of this study was to investigate, in a group of geriatric inpatients with
      established incontinence, the relationships among urine loss, voided volumes,
      frequency of voiding, and fluid intake. The investigated included 128 patients:
      76 women and 52 men, with a median age of 79 years. One-half had significant
      cognitive impairment. Patients underwent 24-hr monitoring of fluid intake, urine
      loss, and voiding, as well as conventional videourodynamic testing. Diurnal and
      nocturnal voiding frequencies were significantly but relatively weakly related to
      fluid intake. Diurnal and nocturnal voided volumes were more closely related,
      however, to the fluid intake. There was a strong and easily interpretable
      relationship among nocturnal voided volume, nocturia, cystometric bladder
      capacity, and evening fluid intake. Sixty of 128 patients had urodynamically
      proven urge incontinence, and this group was studied separately. They were more
      cognitively impaired and had significantly greater urine loss and smaller fluid
      intake than was true of the other incontinent patients. Urine loss was
      significantly related to fluid intake in this group. Nocturnal urine loss
      increased by an average of 28 ml/dl of evening fluid intake and decreased by 17
      ml/dl voided at night. These results suggest that nocturnal toileting and evening
      fluid restriction may reduce nocturnal urine loss by a small but useful amount in
      carefully selected older patients with severe urge incontinence.

PMID- 8481727
TI  - Time-series analysis of urethral electrical conductance measurements in the
      assessment of unstable urethral pressure: results in normal patients and in those
      with genuine stress incontinence.
AB  - It is well established that urethral pressure variations occur in patients with
      or without urinary incontinence, but to what extent they contribute to a
      patient's symptoms remains unclear. Previous work has suggested that in stress
      incontinent patients, a rise in bladder neck electrical conductance (BNEC) occurs
      simultaneously with a fall in urethral pressure, and that this represents bladder
      neck opening. Six patients with genuine stress incontinence (gsi), and six normal
      controls underwent simultaneous urethral pressure and BNEC measurements, the
      results being subjected to time-series analysis, to determine whether the
      previous finding could be confirmed statistically, and to establish whether a
      similar association was present in normal women. All six patients with gsi and
      five of the normal patients had unstable urethral pressure. Estimated cross
      correlation of differenced data for the two parameters showed a significant
      negative correlation at zero time lag in three patients with gsi and two of the
      control group. There was no significant correlation between the two parameters in
      the other seven patients. We conclude that the previous finding of a correlation
      between urethral pressure variation and BNEC, suggesting bladder neck opening
      occurs as urethral pressure falls in patients with gsi is confirmed, but appeared
      to be present in only 50% of patients; the finding is just as likely in normal
      patients, and therefore whilst it may be of relevance to the severity of
      symptoms, could not be held to have any aetiological significance.

PMID- 8481728
TI  - Uroflowmetry in the puerperium.
AB  - One hundred women underwent uroflowmetry once per day for the first 3 days after
      delivery, and the results compared to those of 53 nonpregnant controls in an
      effort to determine 1) whether urinary flow in the puerperium is different to
      that found without pregnancy, 2) whether uroflow parameters change as the
      puerperium progresses, and 3) which characteristics of a patient or her labour
      bear most influence upon the results of uroflowmetry. Urinary flow in the
      puerperium was seen to be different from that of the nonpregnant female in that
      mean flow rates were lower. In addition to this, voided volume, total flow time,
      and time to peak flow were all significantly increased on day 1, but were
      comparable on days 2 and 3. Other than for falling voided volumes, uroflow
      parameters did not alter significantly as the puerperium progressed. Correlation
      of the variables age, parity, baby weight, length of first and second stage, use
      of epidural and perineal suturing with the parameters of urinary flow failed to
      show any significant relationship.

PMID- 8481729
TI  - Urothelial permeability of the isolated whole bladder.
AB  - The urothelium of the bladder presents an effective barrier to the penetration of
      solutes from the urine into the bladder wall. Previously, we have demonstrated
      that the dye indigocarmine can be utilized intravesically to study urothelial
      permeability. In general, intravesical indigocarmine (administered in vivo) will
      not penetrate the bladder wall unless the urothelium is damaged by
      overdistension, acetone administration, or mechanical damage. Unfortunately,
      using in vivo methodologies, one is limited in the study of the effect of
      specific conditions and permeations on bladder permeability. In the current study
      an isolated in vitro whole bladder model was developed to quantitatively study
      the permeability of the bladder urothelium. In these studies, the penetration of
      indigocarmine into and through the bladder wall was quantitated under various
      conditions. The in vitro bladder was filled by infusing 1% indigocarmine in
      saline in a step-wise manner at the rate of 10 ml in 10 minutes followed by a
      stabilization period of 10 minutes. Samples were taken from the bath at 20
      minutes intervals for spectrophotometrical analysis of the dye. At the end of
      experiment the bladder was washed in saline for 10 minutes, and stored and
      extracted in formalin. In general, no indigocarmine penetrated the urothelium
      until the in vitro capacity was reached and exceeded. At intravesical volumes
      greater than capacity, the dye concentration in the bath increased very rapidly,
      even though the integrity of the bladder wall remained intact. In bladders
      treated with a gentle 50% acetone wash for 1 minute the dye started to penetrate
      into the bath at intravesical volumes of 25% of capacity and increased rapidly
      thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481730
TI  - A model of the mechanics of smooth muscle reservoirs applied to the intestinal
      bladder.
AB  - A model of the mechanics of smooth muscle reservoirs was derived from the stress
      strain relation in smooth muscle strips. The model was applied to the intestinal
      bladder reservoir but may also be applied to natural reservoirs such as the
      bladder. The relation between reservoir volume and pressure was calculated at
      different values of smooth muscle tone and was found to accord with clinical
      results. The muscle tone of the bowel when measuring off the bowel to construct
      the reservoir was found to have a profound influence on its ultimate volume.
      Stiffening of a part of the reservoir wall as a result of edema or fibrosis will
      cause a substantial decrease in functional capacity, both directly as a result of
      a reduced expansion of the diseased part and indirectly by enhancing the
      stretching of the adjacent normal wall. The pressure rise produced by a slow
      peristaltic contraction was calculated to depend both upon the strength of
      contraction and on the degree of reservoir filling: Almost no pressure rise will
      occur in the near empty reservoir, while the highest pressure rise was calculated
      to occur at a volume of about 300 ml. If only a part of the reservoir contracts,
      more filling is needed before the pressure increases and the maximum pressure
      will be reached at a substantially higher volume. Localized contractions will
      stretch the resting reservoir wall and so activate stretch receptors, which may
      cause a desire to void, resulting in reduced functional capacity.

PMID- 8481731
TI  - Sacral spinal cord and root potentials evoked by the stimulation of the dorsal
      nerve of penis and cord conduction delay for the bulbocavernosus reflex.
AB  - Segmental spinal cord and root potentials in response to stimulations of the
      dorsal nerve of penis, tibial nerve, and the sural nerve were epidurally recorded
      in normal subjects. EMG responses from the bulbocavernosus (BC) and the various
      leg muscles were also recorded in response to bipolar stimulations by the same
      epidural needle electrodes of the sacral cord and lumbosacral roots. The afferent
      conduction velocity from the penis to Th12-L1 intervertebral level was about 40
      m/sec on the average, which is significantly slower than those obtained by the
      stimulation of the mixed and cutaneous nerves at the lower limb. The latency of
      the motor responses of the BC muscle from Th12-L1 spine levels were found
      comparatively longer than those of thigh muscles on maximal epidural stimulation
      in spite of the shorter distances to the BC muscle. The central conduction delay
      within the sacral cord of the bulbocavernosus reflex was calculated and found to
      be about 8.2 msec, while the central conduction time was about 1.1 msec for the
      Soleus-H-Reflex. These findings may suggest that there may be about 5-6 synapsis
      necessary for the first component of the bulbocavernosus reflex, though some
      faster oligosynaptic cord linkage may also exist.

PMID- 8481732
TI  - Regulation of the bladder neck closure by lumbar splanchnic nerves at ejaculation
      in the dog.
AB  - To clarify the role of canine thoracolumbar splanchnic nerves for bladder neck
      closure during ejaculation, these nerves of adult male mongrel dogs were exposed
      under anesthesia using ketamine hydrochloride and pentobarbital, and electrical
      stimulation and anatomical dissection studies were performed. Bladder neck
      closure by the stimulation of each sympathetic nerve was monitored with a 10 Fr
      silicon catheter equipped with pressure-sensitive rubber balloon placed at the
      bladder neck. The dissection study revealed that canine thoracolumbar splanchnic
      nerves consisted of two nerve groups: one branching from the sympathetic trunks
      at thoracic and L1 ganglia, reaching caudal mesenteric plexus (CMP) through the
      anterior wall of the aorta, the other branching from the sympathetic trunks at
      level L2-L5 ganglia, reaching CMP through the posterior side of the bilateral
      spermatic arteries. The former were designated intermesenteric splanchnic nerves,
      the latter lumbar splanchnic nerves. No bladder neck closure was observed by
      electrical stimulation of the distal end of severed intermesenteric splanchnic
      nerves or of the sympathetic trunks at the lumbopelvic level among 10 dogs
      examined. At least one lumbar splanchnic nerve generated the closure in all 10
      dogs and generally, a few lumbar splanchnic nerves, generated the closure. The
      results indicate that bladder neck closure during ejaculation is generated by
      lumbar splanchnic nerves regardless of their branching levels from lumbar
      sympathetic ganglia, but not by either intermesenteric splanchnic nerves or
      pelvic sympathetic trunks.

PMID- 8481733
TI  - Effect of cromakalim on micturition function in rats.
AB  - Although many studies investigating the effect of cromakalim on bladder
      contractility exist, thus far, there are no published studies investigating its
      effect on micturition function in conscious rats. We measured the effect of
      cromakalim i.v. on urine output, frequency, volume of each micturition, and blood
      pressure in saline-diuresed and non-diuresed rats. In saline-diuresed rats
      cromakalim produced significant decreases in urine output (0.1 mg/kg, 32%; 0.3
      mg/kg, 46%; 1.0 mg/kg, 68%) and average frequency (0.1 mg/kg, 36%; 0.3 mg/kg,
      51%; 1.0 mg/kg, 70%) in the first 3 hours. At 3-6 hours after administration of
      cromakalim there were rebound increases in both urine output (0.1 mg/kg, 290%;
      0.3 mg/kg, 373%; 1.0 mg/kg, 538%), and frequency (0.1 mg/kg, 147%; 0.3 mg/kg,
      181%; 1.0 mg/kg, 314%) and by 6-12 hours the effects of cromakalim on micturition
      function were gone. Mean arterial pressure dropped to 50% of control immediately
      after cromakalim administration in saline-diuresed rats and began to return to
      control levels after 3 hours. Cromakalim produced similar results in non-diuresed
      rats. The decrease in urine output 0-3 hours after cromakalim administration may
      have been a consequence of cromakalim's profound decrease in blood pressure that
      occurred during that time.

PMID- 8481734
TI  - Clinicopathological studies of the dementias from an epidemiological viewpoint.
AB  - Studies which examine patients with and without dementia during life and then
      examine brain tissue after death are extremely difficult to conduct. There are
      now several such studies published, representing a major contribution to the
      understanding of the pathologies of the dementias. These studies were not
      designed to represent population samples and, from an epidemiological viewpoint,
      they are flawed because none are population-based and none represent the full
      range of function observed during life. It is therefore important to examine the
      available studies for their contributions and biases.

PMID- 8481735
TI  - The medical complications of anorexia nervosa.
AB  - The physical complications of anorexia nervosa are common and can be life
      threatening, but psychiatrists and the increasing number of non-medical
      therapists involved in treatment programmes often overlook these complications.
      Cardiovascular complications are the most common, and the most likely to result
      in fatalities, particularly in those patients who vomit, purge or abuse
      diuretics, because of the electrolyte abnormalities induced. Osteoporosis is an
      early and perhaps irreversible consequence of severe weight loss. Further, there
      are dangers in rapid intravenous hyperalimentation.

PMID- 8481736
TI  - Attitudes of British psychiatrists to the diagnosis of somatisation disorder. A
      questionnaire survey.
AB  - A postal questionnaire was sent to 195 senior British psychiatrists who were
      asked about their attitudes towards the DSM-III-R diagnosis of somatisation
      disorder (SD) and the ICD-10 diagnosis of multiple somatisation disorder. Of the
      148 respondents, 98 (66%) had experience of liaison psychiatry, and these
      psychiatrists used the diagnosis significantly more often than those without
      liaison sessions. More than half the respondents perceived SD as both a
      personality disorder and a mental state disorder, although 27% thought that
      patients with SD had an undiagnosed physical disease. The marked discrepancy
      between British and North American psychiatrists in diagnostic practices was
      perceived to be a consequence of both the difference in health care systems and
      the interest shown in the disorder by North American psychiatrists, rather than a
      reflection of genuine differences in prevalence.

PMID- 8481737
TI  - Techniques for interviewing the somatising patient.
AB  - Liaison psychiatrists need to interview somatising patients in a way which allows
      a full assessment of the problem. This can best be achieved if the psychiatrist
      has already discussed with the referring physician the reason for referral and
      what the patient has been told about it. The medical notes should always be
      reviewed in detail and independent data obtained from a relative or other
      informant. During the interview itself the psychiatrist must be prepared to use
      techniques which deepen rapport with the patient, who may be initially wary or
      hostile. The psychiatrist should attempt to establish early a treatment alliance.
      Special aspects of the mental state need to be noted, including the patient's
      attitude to his/her symptoms and the strength with which somatic beliefs are
      held. Different approaches may be used according to the nature of the problem and
      the therapeutic style of the doctor. An awareness of these interview techniques
      would greatly reduce the chances of fruitless interviews with a hostile patient
      who believes the symptoms are being dismissed as being 'all in the mind'.

PMID- 8481738
TI  - The management of chronic somatisation.
AB  - 'Somatisation' is a process in which there is inappropriate focus on physical
      symptoms and psychosocial problems are denied. In some patients this process
      becomes chronic (in excess of six months). Special skills and strategies are
      required by non-psychiatrists to manage these patients, for whom the acceptance
      of psychiatric treatment should be facilitated. When taking the history, doctors
      should be aware of psychosocial cues; thereafter they should be consistent and
      unambiguous in their management. An agenda should be set early on, with limits on
      investigations. Failure to manage this group of patients is costly, and further
      intervention studies are required not only to reduce health service and other
      costs, but also to relieve the non-monetary burden of physical and psychosocial
      disability on patients and their relatives.

PMID- 8481739
TI  - The premenstrual syndrome: a twin study.
AB  - Data are presented from 157 monozygotic and 143 dizygotic female twin pairs of
      reproductive age who completed a self-report questionnaire on the premenstrual
      syndrome (PMS). For global PMS scores, the correlation coefficient for the
      monozygotic twins (0.55) was double that of the dizygotic ones (0.28). The
      results are consistent with the hypothesis that aggregation for global PMS scores
      is determined by genetic factors acting additively over a number of loci. Two
      alternative explanations are suggested: that monozygotic twins share greater
      environmental similarities than dizygotic ones; or that PMS scores may be a
      reflection of some other underlying characteristic (such as neuroticism), which
      is itself genetically determined.

PMID- 8481740
TI  - Delusions in children and teenagers admitted to Bethlem Royal Hospital in the
      19th century.
AB  - The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital
      ('Bedlam') in the 19th century were analysed with particular reference to the
      frequency and types of delusions. Delusions were present in 700 (65%), among whom
      there were significantly more boys than girls. There was a statistically
      significant rise in the frequency of delusions from 1830 to the end of the
      century. Sixty-six per cent of the patients were discharged cured and, taken
      overall, the presence of delusions did not affect the prognosis: specifically,
      delusions did not worsen the prognosis in those diagnosed as suffering from mania
      or melancholia. Nevertheless, the prognosis was worse in boys with single
      paranoid delusions, or paranoid delusions in combination with auditory
      hallucinations of people, and worse for girls with delusions of exaltation in
      combination with other types of delusions.

PMID- 8481741
TI  - The postconcussional syndrome: social antecedents and psychological sequelae.
AB  - The study consisted of a prospective investigation of 45 consecutively admitted
      patients who had sustained a mild head injury. In all cases the duration of post
      traumatic amnesia was less than 24 hours. Head injury patients had an average of
      three adverse life events in the year preceding injury compared with 1.5 for
      controls. Using the PSE, 39% of the group were diagnosed psychiatric cases at six
      weeks after the injury. For cases the mean level of chronic social difficulties
      (3.3) was four times that for non-cases (0.8). Six months after injury, 28% of
      the head injury group had three or more symptoms. These chronic cases were on
      average ten years older than those whose symptoms had remitted. Chronic cases
      had, on average, three social difficulties, twice as many as found among those
      whose symptoms had remitted. The emergence and persistence of the
      postconcussional syndrome are associated with social adversity before the
      accident. While young men are most at risk of minor head injury, older women are
      most at risk of chronic sequelae.

PMID- 8481742
TI  - How important is the assessment of social skills in current long-stay in
      patients? An evaluation of clinical response to needs for assessment, treatment,
      and care in a long-stay psychiatric in-patient population.
AB  - Service response to problems in 20 clinical and social competence areas was
      assessed in 156 long-stay in-patients, using the Needs for Care Assessment (NFC).
      Although there were few unmet needs for treatment, over 200 instances of unmet
      needs for the assessment of social skills were found, and reasons for this are
      discussed, as is the importance of social-skills assessment in this group. In
      around a third of the sample most of the social-skill areas in the NFC were not
      applicable.

PMID- 8481743
TI  - The adult adjustment of offspring of parents with drinking problems.
AB  - One hundred and sixty-four 16-35-year-old offspring of parents with drinking
      problems, recruited from a variety of clinical and community sources, were
      compared with 80 respondents of similar ages from similar sources who did not
      have parents with drinking problems. Each was interviewed using a semistructured
      interview. Adult adjustment was similar in the two groups, but the offspring of
      parents with drinking problems did report considerably more disharmony in their
      families of origin, and many more childhood difficulties. Factor analysis of the
      adult adjustment data for the samples combined showed four factors which
      accounted for 41% of the variance; these factors differed little in their effect
      in the two groups. The groups' reports of the drinking problems of their
      siblings, however, suggests that this sample might be unrepresentative of the
      true risk to the children of parents with drinking problems for the development
      of alcohol-related (although not other) difficulties in adulthood: 16% of this
      group reported a sibling with a drink problem and a further 9% were unsure, but
      only one member of the comparison group reported a sibling with a drink problem,
      and one was unsure. Path analysis showed that both parental problem drinking and
      family disharmony are related in complex ways to adjustment difficulties in
      adulthood. 'Demoralisation', the largest of the four factors, was particularly
      related to disharmony in the family of origin: in the absence of disharmony,
      offspring versus comparison status was negatively correlated to demoralisation in
      adulthood, suggesting that having a parent with a drinking problem might
      sometimes be a strengthening experience.

PMID- 8481744
TI  - Head circumference in 'preschizophrenic' and control neonates.
AB  - Head circumference, body weight, body length, and shoulder circumference at birth
      were studied in 70 RDC schizophrenic patients and 70 demographically matched
      controls from the same delivery series, using information recorded in the medical
      records at the time of birth. With preterm babies removed from both samples, only
      head circumference among preschizophrenic infants was significantly smaller than
      that of controls. Preschizophrenic infants also had a disproportionately smaller
      head circumference in relation to body length than did controls. Among the
      former, a small head circumference was systematically related to an absence of
      family history of psychosis, but was not related to season of birth or recorded
      pregnancy complications. The findings were strongest for females. The results
      suggest there is an unidentified non-genetic factor in schizophrenia that
      disturbs prenatal cerebral development.

PMID- 8481745
TI  - A trial of two cognitive-behavioural methods of treating drug-resistant residual
      psychotic symptoms in schizophrenic patients: I. Outcome.
AB  - Despite neuroleptic medication, many schizophrenic patients continue to
      experience residual positive psychotic symptoms. These residual symptoms cause
      distress and disability. We report a controlled trial of two cognitive
      behavioural treatments to alleviate residual hallucinations and delusions. Forty
      nine patients were recruited into the trial, of whom 27 entered the trial and
      completed post-treatment assessment, and 23 were reassessed at six-month follow
      up. Patients were randomly allocated to either coping strategy enhancement (CSE)
      or problem solving (PS). Half the patients were allocated to a high-expectancy
      positive demand condition and half to a counter-demand condition to evaluate
      expectation of improvement. Patients receiving either cognitive-behavioural
      treatment showed significant reductions in psychotic symptoms compared with those
      in the waiting period, who showed no improvement. There was some evidence,
      although equivocal, that patients receiving CSE improved more than those
      receiving PS. There was no evidence that improvements generalised to negative
      symptoms or social functioning, nor was there evidence that expectancy of
      treatment benefit contributed to the treatment effect.

PMID- 8481746
TI  - Institutionalisation and the long-term course of schizophrenia.

PMID- 8481747
TI  - A proposal to classify happiness as a psychiatric disorder.

PMID- 8481748
TI  - Caffeine: use and effects in long-stay psychiatric patients.
AB  - In a double-blind crossover study of 26 long-stay schizophrenic patients, no
      correlation was found between caffeine consumption and levels of anxiety and
      depression. No significant changes in patients' behaviour or levels of anxiety
      and depression occurred when the wards changed to decaffeinated products. Serum
      caffeine levels confirmed compliance. No evidence was found to support a removal
      of caffeinated products from this group of patients.

PMID- 8481749
TI  - Munchausen's syndrome and organic brain disorder.
AB  - A case of Munchausen's syndrome was probably caused by brain damage sustained
      during a necessary cholecystectomy. Doctors should not be discouraged from
      seeking treatable disorder because of such patients' behaviour.

PMID- 8481750
TI  - Behavioural sensitisation and steroid-induced psychosis.
AB  - As yet, there is no satisfactory model with which to understand steroid-induced
      mental disorder. It is suggested that a case of prednisone-induced psychosis in
      an adolescent female with Crohn's disease can be best understood in terms of
      behavioural sensitisation to steroid therapy.

PMID- 8481751
TI  - Cross-dressing in men with learning disabilities.
AB  - Four men with learning disabilities were considered to show transvestic
      fetishism, and a fifth to show transvestism. However, developmental retardation
      and personality problems may modify the concepts behind such categorisation.

PMID- 8481752
TI  - Erotic target location errors in male gender dysphorics, paedophiles, and
      fetishists.

PMID- 8481753
TI  - Puerperal affective psychosis: is there a case for lithium prophylaxis?

PMID- 8481754
TI  - Puerperal affective psychosis: is there a case for lithium prophylaxis?

PMID- 8481755
TI  - Assessment of insight in Singapore.

PMID- 8481756
TI  - In defence of clozapine.

PMID- 8481757
TI  - Clozapine, cognition, and schizophrenia.

PMID- 8481758
TI  - Mentally ill sex offenders.

PMID- 8481759
TI  - Mabi bark tea.

PMID- 8481760
TI  - 'Hidden' spending on community services.

PMID- 8481761
TI  - HIV infection, serotonin, and sexual dysfunction.

PMID- 8481762
TI  - Hysteria in childhood.

PMID- 8481763
TI  - Folate and depression.

PMID- 8481764
TI  - Outdated ECT machines.

PMID- 8481765
TI  - Parental age in schizophrenia in a case-controlled study.

PMID- 8481766
TI  - Women's labour force participation and socioeconomic development: influences of
      local context and individual characteristics in Brazil.
AB  - We address several key hypotheses about the effects of socioeconomic development
      on women's labour force participation during the transition from agriculture to
      industrialism. To this end, we explore differences in women's labour force
      participation in Brazil by education, marital status, age, and urban or rural
      residence. We also show how socioeconomic development affects the overall level
      of women's participation and the differentials by education, etc. Our data are
      drawn from a large 1973 PNAD (Pequisa Nacional por Amostra de Domicilos) survey
      conducted by the Brazilian census bureau. Socioeconomic development in different
      parts of Brazil ranges from pre-industrial agriculture to heavy industry. Using
      logistic regression, we show that the general level of women's labour force
      participation does not change with the level of development. Highly educated
      women are much more likely than the less educated to be in the labour force (net
      of other influences); this difference is substantially greater than in post
      industrial societies. Somewhat surprisingly, the influence of education is the
      same across the range of development levels in Brazil. Single women are more
      likely to be in the labour force than married women, and the difference grows
      during development. Age has a curvilinear relationship to labour force
      participation, and the old are much less likely to participate in more developed
      places. Rural women are slightly more likely to be in the labour force at all
      levels of development.

PMID- 8481767
TI  - Intraocular co-grafts of fetal dorsal raphe nucleus and suprachiasmatic nucleus.
AB  - Serotonergic neurons in the fetal dorsal raphe nucleus were grafted together with
      fetal anterior hypothalamic tissue including the suprachiasmatic nucleus (SCN) to
      the anterior eye chamber of adult rats. After 6 weeks transplantation, the double
      grafts were immunocytochemically examined using antisera against serotonin,
      arginine vasopressin (AVP) and vasoactive intestinal polypeptide (VIP). The raphe
      grafts contained a large number of serotonin-immunoreactive neurons and fibers,
      but only a few AVP-immunoreactive fibers and VIP-immunoreactive neurons and
      fibers. On the other hand, numerous AVP- and VIP-immunoreactive neurons and
      fibers were found in the SCN of the anterior hypothalamic graft. Outgrowing
      serotonin-immunoreactive fibers from the raphe tissue were densely distributed in
      the anterior hypothalamic graft. In the SCN, however, only a few fibers were
      detected. The results demonstrate that the isolated anterior hypothalamic grafts
      can be innervated by the serotonergic neurons from the raphe grafts, but the
      innervation pattern of these fibers was quite different from the normal rat. The
      present results indicate that the isolated SCN has an inhibitory influence on the
      growth of serotonergic fibers.

PMID- 8481768
TI  - Nitric oxide modulates the release of corticotropin-releasing hormone from the
      rat hypothalamus in vitro.
AB  - There is now considerable evidence that nitric oxide (NO) is an important
      neuroregulatory agent, but there has been very little investigation of the
      possible role of NO in neuroendocrine mechanisms. We have previously shown that
      acute rat hypothalamic explants can be used to study the regulation of
      hypothalamic neuropeptide release, and we have now utilised this experimental
      approach to investigate the putative involvement of NO in the control of the
      principal corticotropin-releasing hormone, CRH. We studied the direct effects of
      the NO precursor L-arginine (L-ARG), as well as the NO donors molsidomine and
      sodium nitroprusside, on both the basal and stimulated release of CRH; the
      stimuli used were non-specific depolarisation with potassium chloride (KCl) and
      the specific cytokine, interleukin-1 beta (IL-1 beta; 100 U/ml). L-ARG was tested
      in each experimental condition with and without contemporaneous addition of its
      competitive antagonist NG-monomethyl-L-arginine (L-NMMA). IL-1 beta-induced CRH
      release was also investigated in the presence of D-arginine (D-ARG), which is not
      active as a precursor to NO, and ferrous hemoglobin (Hb), a substance which is a
      potent inactivator of NO. None of the NO precursors (L-ARG, molsidomine, sodium
      nitroprusside) or antagonists (L-NMMA or Hb) was able to affect basal CRH
      release. However, L-ARG 10 and 100 microM were found to significantly inhibit the
      release of CRH induced by 40 mM KCl; CRH fell to 45% of its stimulated level at
      the higher dose of L-ARG. This effect was attenuated in the presence of L-NMMA at
      a ten-fold higher dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481769
TI  - Calcium-binding proteins in the chick Edinger Westphal nucleus.
AB  - It has been suggested that the calcium-binding proteins, parvalbumin and
      calbindin-D28K, are involved in the control of intracellular calcium levels but
      their exact functions are unknown. Immunoreactivity for parvalbumin has been
      associated with rapidly firing cells, while calbindin has been implicated in
      protecting neurons from excitotoxicity. Since the chick Edinger Westphal nucleus
      contains two populations of neurons with different firing patterns, parvalbumin
      and calbindin immunoreactivities were examined in the Edinger Westphal nuclei of
      posthatch chicks to determine whether a particular subpopulation of neurons is
      associated with either protein. Moderate levels of parvalbumin immunoreactivity
      were found consistently associated with repetitively firing neurons in the
      lateral Edinger Westphal nucleus. In contrast, medial neurons expressed much
      lower levels of parvalbumin immunoreactivity. Many medial neurons were negative
      for parvalbumin although occasionally a few medial neurons stained as strongly as
      lateral neurons. Definitive calbindin immunoreactivity was absent from Edinger
      Westphal nuclei despite robust staining of cells in other parts of the brainstem
      and in control sections of cerebellum.

PMID- 8481770
TI  - Receptive fields of single cells from the face zone of the cat rostral dorsal
      accessory olive.
AB  - Natural stimulation was used to map the receptive fields of single cells recorded
      from the rostral medial portion of the dorsal accessory olive (rDAO) and the
      subjacent principal olive (PO) of the barbiturate anesthetized cat. Previous
      reports indicated a somatotopic mapping of the entire contralateral body within
      the rDAO which included a small face zone and a larger zone with a very precise
      map for the limbs. While concentrating on the face zone of the rDAO we confirmed
      the previously reported somatotopy (face: rostral and medial; forelimb: caudal
      and medial; hindlimb; caudal and lateral; and trunk: rostal and lateral) and
      found a somatotopy within, and adjacent to, the face zone. At the border between
      rDAO regions representing forelimb and face, cells with forelimb fields were
      found to lie dorsally to cells with facial fields. Within the rDAO face region,
      cells with large facial fields lie dorsally to cells with small facial fields. In
      both cases, the more ventral cells lie in the ventral lamella of the PO, which
      suggests a functional as well as physical continuity between rDAO and the ventral
      lamella of the PO. We therefore conclude that the face zone in the rDAO and the
      face zone in the PO form one continuous and complete map of the face with an
      orderly progression of receptive fields. Furthermore, we have found that
      stimulation of the red nucleus can inhibit rDAO cells with facial receptive
      fields just as it does cells with receptive fields from the rest of the body.

PMID- 8481771
TI  - Spatial memory and stereotypic behaviour of animals in radial arm mazes.
AB  - The symmetric radial arm maze, described by Olton in 1976, has developed into an
      important tool for the study of spatial memory. In a typical test an animal is
      placed in the centre of the maze, which contains some small piece of food at the
      end of each arm. The sampling behaviour of the animal is then recorded. In such
      studies the score (number of choices of arms which still contain food) of the
      animal is normally compared with the score of an imaginary animal which changes
      arms entirely at random. In a new method of analysis the non-random score of the
      animal is split into two parts, one depending on memory and one on stereotypic
      choice behaviour. Even mild departures from randomness are shown to alter
      considerably the expected 'random' score in an eight-armed maze. The part of the
      score claimed to depend on memory was shown to increase when the animals learn to
      search the maze, the stereotypic part did not. The general effect from
      stereotypic choice behaviour is shown to result, in most animals, in an increase
      in the total score. In an eight-armed maze this increase may amount to more than
      20% of the total non-random score, even in a well-trained animal. The effect is
      less pronounced in mazes with 16 arms. It has been proposed that hippocampal
      lesions produce a stereotypic behaviour. We propose, based on our analysis, that
      the stereotypic behaviour is not produced but revealed by hippocampal lesions
      which destroy almost completely the memory-guided behaviour masking the
      stereotypic behaviour in the intact animal.

PMID- 8481772
TI  - Splitting of locomotor circadian rhythmicity in hamsters is facilitated by
      pinealectomy.
AB  - The role of the pineal gland in the mammalian circadian system has not been well
      established, in contrast to a fair number of reports indicating pharmacological
      effects of melatonin in the circadian organization. In order to establish the
      effects of pinealectomy on the time course of splitting of circadian rhythmicity,
      the wheel running locomotor activity was continuously recorded in golden hamsters
      under light-dark conditions or constant light. The analysis of transients from
      the actograms shows that removal of the pineal gland induces a reduction in the
      latency and an increase in the duration of transients before the splitting
      occurs. The power spectral analysis from selected segments of the data shows that
      concomitant to the development of the splitting there is an increase in the power
      of ultradian components. In pinealectomized animals the changes in the power
      spectrum occurs at least 30 days before that in the control animals. These
      observations suggest that pineal gland could be involved in the coupling
      mechanism among the different oscillators of the rodent circadian system.
      Furthermore, since the light intensity used in this study is enough to completely
      suppress the melatonin synthesis from the pineal, the present results suggest
      that a signal from the pineal other than melatonin is involved in the process.

PMID- 8481773
TI  - Effects of superior olivary complex lesions on binaural responses in rat auditory
      cortex.
AB  - Unilateral or bilateral lesions of the superior olivary complex (SOC) were made
      by local injection of kainic acid through a micropipette lowered stereotaxically
      into the rat's auditory brain stem. The lesions had the effect of destroying cell
      bodies in the superior olive without disrupting fibers of passage. After a
      recovery period of approximately one month physiological recordings were made
      with tungsten microelectrodes from the auditory cortex of normal animals and
      animals with SOC lesions. For animals with unilateral SOC lesions recordings were
      made either ipsilateral or contralateral to the site of damage. Monaural and
      binaural tone bursts (110 ms duration) were presented dichotically through a
      sealed sound delivery system and binaural interaction patterns were determined by
      comparison of monaural and binaural responses. Some cells were excited by
      stimulation of either ear and facilitated by binaural stimulation (binaural
      summation or EE cells), whereas others were excited by contralateral stimulation
      and inhibited by simultaneous ipsilateral stimulation (binaural suppression or EI
      cells). Both binaural summation and suppression responses were still present
      following unilateral SOC lesions. Interaural intensity difference thresholds were
      within the normal range and no differences were found between animals with
      lesions placed ipsilateral or contralateral to the recording site. Following a
      bilateral lesion in one case, both binaural summation and suppression responses
      were still present. The bilateral lesion had the effect of shifting the average
      interaural intensity difference thresholds in favor of the contralateral ear.
      These data suggest that binaural interactions above the level of the superior
      olive contribute to physiological responses in auditory cortex and that binaural
      responses in the rat's auditory cortex are shaped by both olivary and
      supraolivary interactions.

PMID- 8481774
TI  - Long-term increases in the numerical density of synapses in the chick lobus
      parolfactorius after passive avoidance training.
AB  - Passive avoidance training has been shown to cause an increase in synaptic
      density (Nvsyn) in the lobus parolfactorius (LPO) of the one-day old chick. The
      present study was conducted to investigate the time-course over which this
      plastic change takes place. Two groups of chicks were trained to peck at either a
      water coated bead (Control) or a methyl-anthranilate coated bead (M-trained). M
      trained chicks showed avoidance responses when offered a similar but dry bead, 30
      min later. Right and left hemisphere LPOs were obtained at intervals of 1, 6, 12,
      24 and 48 h after training. Synaptic counts were made using a 3-dimensional
      stereological probe; the 'dissector'. A significantly larger mean Nvsyn (31%) was
      found in the left hemisphere of M-trained chicks 24 h after training, compared
      with Control chicks, and the difference fell to 10% at 48 h post-training. M
      trained chicks also had a greater Nvsyn (17%) in the right hemisphere at 48 h
      post-training. The bilaterality of these findings is of particular interest,
      since unilateral lesions of the LPO fail to produce amnesia for the avoidance
      task. The importance of these results in the process of memory formation is
      discussed.

PMID- 8481775
TI  - Rod outer segment disk shedding in rats with lesions of the suprachiasmatic
      nucleus.
AB  - The suprachiasmatic nucleus (SCN) of the hypothalamus constitutes a major
      pacemaker for circadian rhythms in mammals. Rod outer segment (ROS) disk shedding
      follows a circadian rhythm that persists after pre-chiasmatic optic nerve section
      (ONS) (Teirstein et al., Invest. Ophthalmol. Vis. Sci., 19 (1980) 1268-1273),
      suggesting local oscillatory control. However, entrainment and phase-shifting to
      light-dark (LD) cycles are disrupted, suggesting that central efferent signals
      are involved in phase control. In the present experiment, lesions of the SCN were
      administered to 45 rats, resulting in complete behavioral arrhythmicity in 24
      rats, dampened rhythmicity in 11 rats and robust rhythms in 10 rats. The extent
      of lesions was verified by histological and immunocytochemical methods. After
      screening for presence or absence of activity rhythms, rats were assigned to
      separate groups for ROS disk shedding analysis at four phases relative to the
      (LD) 12:12 cycle: 1.5 h after light onset, 1.5 h after dark onset, and at
      corresponding phases immediately upon release into 24 h of constant darkness. The
      disk shedding pattern, with relatively high phagosome numbers during the early
      light phase and low numbers at nighttime, was similar for behaviorally
      arrhythmic, dampened and rhythmic groups. These data indicate an independence of
      the disk shedding rhythm from possible SCN humoral or neuronal efferent
      influences.

PMID- 8481776
TI  - Nucleus ventralis posteromedialis neurons relaying somatosensory lingual input to
      the cerebral cortex in the cat.
AB  - The cortical projection of somatosensory lingual units in the nucleus ventralis
      posteromedialis (VPM) of the thalamus was studied in urethane-chloralose
      anesthetized cats. Ipsilateral lingual units were recorded from the lateral
      subdivision of nucleus ventralis posteromedialis parvocellularis (VPMpcl). They
      were antidromically excited following electrical stimulation of the ventral
      aspect of the coronal gyrus or its caudally adjacent orbital gyrus. From these
      same cortical areas, positive surface potentials were recorded following
      electrical stimulation of the ipsilateral lingual nerve. Electrical stimulation
      of the same cortical areas elicited jaw opening movement. Contralateral
      somatosensory lingual units were recorded from the VPM proper. They were
      antidromically excited following electrical stimulation of the SI somatosensory
      cortex.

PMID- 8481777
TI  - [125I]Vasoactive intestinal peptide binding in rodent suprachiasmatic nucleus:
      developmental and circadian studies.
AB  - The suprachiasmatic nucleus (SCN) of rat and hamster have been studied
      extensively and shown to play critical roles in circadian rhythmicity.
      [125I]Vasoactive intestinal peptide (VIP) binding levels are high in the rat SCN,
      suggesting that VIP receptors may be an important component of SCN function. In
      contrast to previously demonstrated diurnal variations in VIP immunoreactivity
      and VIP mRNA, the present study found [125I]VIP binding to be stable across the
      light-dark cycle in both rat and hamster SCN. High [125I]VIP labeling appeared to
      be coextensive with the rat SCN but extended somewhat beyond the
      cytoarchitectonic boundaries of the hamster SCN. Binding density in hamster SCN
      was slightly higher than in rat. In the developing rat SCN, [125I]VIP binding
      levels distinguished the SCN on embryonic day 18, and appeared to increase to
      postnatal day 10 before declining to adult levels. The early presence of
      [125I]VIP binding suggests possible involvement of VIP receptors in fetal
      entrainment of circadian rhythms.

PMID- 8481778
TI  - Assessing chronic brain damage by quantification of regional volumes in
      postischemic rat brains.
AB  - The present study provides data on fresh volumes of 39 anatomically defined brain
      regions after a 10 min transient forebrain ischemia in the rat. Ischemia was
      induced by occlusion of the carotid arteries and simultaneous hypotension. After
      a survival period of 3 months the rats were transcardially perfusion-fixed with
      Bodian's solution, and the brains processed for paraffin embedding and serially
      sectioned. The sections were Nissl-stained for delineation of the brain regions.
      The volume of a brain region was calculated from 8-10 equidistant sections, using
      the Cavalieri method and corrected for shrinkage of the brain. Fresh volumes were
      reduced by 27-50% in the layers of the hippocampal CA1 sector, by 40-46% in the
      substantia nigra, by 19% in the caudate nucleus, by 13% in the subiculum and the
      cingulate areas 1-3, by 12-14% in the retrosplenial and temporal areas. The
      results show that determination of fresh volumes is a sensitive method for
      quantification and localization of ischemic brain damage in the whole brain.

PMID- 8481779
TI  - Effect of adenosine receptor agonists on spontaneous and K(+)-evoked
      acetylcholine release from the in vivo rat cerebral cortex.
AB  - Repeated applications of elevated K+ (100 mM) in artificial cerebrospinal fluid
      (CSF) were used to evoke an efflux of acetylcholine (ACh) from the in vivo rat
      cerebral cortex using a cortical cup technique. Elevated K+ reproducibly
      increased the levels of ACh in cup superfusates by a factor of 3-5-fold above
      basal levels (27.2 +/- 9.7 nM). The adenosine A1 receptor agonist N6-cyclopentyl
      adenosine (CPA), at a concentration of 10(-8) M, depressed basal, but not K(+)
      evoked ACh efflux. 10(-6) M CPA increased basal, but did not alter K(+)-evoked,
      ACh efflux. The A2 selective agonist CGS 21680 did not alter either basal, or
      K(+)-evoked, ACh efflux. The inhibitory effects of 10(-8) M CPA on ACh efflux
      would be consistent with the presence of adenosine A1 receptors on cholinergic
      nerve terminals in the cerebral cortex. At a higher concentration (10(-6) M) CPA
      elevated basal release, possibly by activating low affinity A2 receptors. The
      failure of CGS 21680 (10(-8) M) to alter basal ACh release suggests an absence of
      high affinity A2 receptors in these terminals. Whereas elevated K+ in cup
      superfusates consistently enhanced ACh efflux from the cerebral cortex, this
      increase was not affected by either CPA or CGS 21680. High K(+)-evoked release of
      cerebral cortical ACh may be an inappropriate model for the study of adenosine's
      actions on neurotransmitter release.

PMID- 8481780
TI  - G-protein effects on retrograde axonal transport.
AB  - Movements of medium and large sized membranous organelles (0.5-1 microns in
      diameter) were visualized within segments of the crab walking leg nerve with
      Nomarski differential interference contrast optics and subjected to video
      contrast enhancement. Accessibility to the axoplasm was demonstrated by intra
      axonal fluorescence following addition of rhodamine conjugated to 40 kDa dextran
      to the external medium. Perfusion of the axons with a 1 microM solution of the 20
      kDa G-protein, cp20, but not control solutions, reduced the number of organelles
      moving in the retrograde direction per unit time, but not the number of
      organelles moving in the anterograde direction. Such alteration of organelle
      movement may contribute to memory-specific changes of neuronal morphology.

PMID- 8481781
TI  - Unmasking human visual perception with the magnetic coil and its relationship to
      hemispheric asymmetry.
AB  - Visual suppression by a magnetic coil (MC) pulse delivered over human calcarine
      cortex after a transient visual stimulus 80-100 ms earlier has been used to
      suppress the representation of a 'masking' visual stimulus and thus to unmask a
      'target' visual stimulus given, e.g., 100 ms before the mask. The resulting
      target unmasking as a function of the interval between mask and MC pulse is
      approximately the inverse of the visual suppression curve. Arbitrary visual
      linear patterns can similarly be unmasked. At the long target-mask interval used,
      the site of masking is deduced to lie beyond calcarine cortex. In several right
      handed subjects tested, powerful MC stimulation of the left (but not right)
      temporo-parieto-occipital cortex also led to (weaker) unmasking.

PMID- 8481782
TI  - Spermine promotes the survival of primary cultured brain neurons.
AB  - The effects of polyamines on the survival of hippocampal and cerebellar neurons
      in primary culture were investigated. Putrescine and spermidine showed no effects
      on the neuronal survival, while spermine increased significantly the number of
      surviving neurons in both hippocampal and cerebellar cultures. The concentration
      effect curve for spermine was bell-shaped with the maximum effect at a
      concentration of 10(-8) M. The survival-promoting effect of spermine was blocked
      by ifenprodil, an antagonist at the polyamine site of the NMDA receptor channel
      complex. These results suggest that spermine exerts trophic effects on brain
      neurons through an ifenprodil-sensitive mechanism.

PMID- 8481783
TI  - An in vitro study of the effects of methylprednisolone on lesioned and uninjured
      mammalian spinal neurons.
AB  - Cultured spinal neurons were subjected to dendrite amputation 100 microns from
      the perikaryon and treated with methylprednisolone (MP). Survival was
      significantly increased by 30 micrograms/ml MP but not by 10, 20 or 60
      micrograms/ml. Survival was reduced by 100 micrograms/ml MP. These results
      suggest: (1) MP protects neurons subjected to physical trauma, and (2) the
      effective dose range is very narrow. These findings may have implications for
      MP's observed bimodal effects in spinal cord injury.

PMID- 8481784
TI  - Median preoptic neurons projecting to the hypothalamic paraventricular nucleus
      are sensitive to blood pressure changes.
AB  - Twenty-one neurons in the median preoptic nucleus (MnPO) were antidromically
      activated by electrical stimulation of the hypothalamic paraventricular nucleus
      (PVN) in male rats under urethane anesthesia. The activity of these identified
      neurons was tested for a response to activation of peripheral baroreceptors,
      achieved by rising arterial blood pressure with an intravenous administration of
      the alpha-agonist metaraminol. Of the neurons tested, 14 displayed a reduction
      and 2 exhibited an increase in neuronal excitability that accompanied a 30- to 50
      mmHg elevation in mean arterial pressure, while 5 were unresponsive. The results
      show that efferent pathways from the MnPO to the PVN may receive neural inputs
      from the peripheral baroreceptors, suggesting the involvement of the pathways in
      the control of cardiovascular function.

PMID- 8481785
TI  - The effect of halothane dose on striatal dopamine: an in vivo microdialysis
      study.
AB  - The relationship between a level of an anesthesia state and striatal dopamine
      concentration was investigated. The effect of halothane administration on
      dopamine level in rat striatal extracellular fluid was determined in
      tracheotomized rats, using an in vivo brain microdialysis method. The striatal
      dopamine was increased by halothane doses. The correlation coefficient between
      halothane and dopamine concentrations was 0.69.

PMID- 8481786
TI  - Effects of ethmoidal nerve stimulation on respiration-related neurones in the
      dorsal medulla of the cat.
AB  - Stimulation of the nasal mucosa produces a number of respiratory reflexes the
      afferent limb of which is provided by the ethmoidal nerve, a branch of the
      trigeminal nerve. In the cat this nerve terminates within the trigeminal nucleus.
      It has no direct projection to brainstem respiratory centres. This study examines
      the response of respiratory-related neurones in the nucleus of the solitary tract
      (NTS) to ethmoidal stimulation. It demonstrates that these neurones show both
      excitatory and inhibitory responses to ethmoidal stimulation. Thus, the NTS
      appears to be involved in respiratory reflexes initiated by stimulation of the
      nasal mucosa.

PMID- 8481787
TI  - Activity-dependent expression of the transcription factor Zif268 reveals ocular
      dominance columns in monkey visual cortex.
AB  - The visualization of neuronal populations activated by sensory stimulation has
      been approached using a number of different methodologies. Recent developments in
      our understanding of transcription factors have provided a new window for
      observing neural activity. We have found that the transcription factor Zif268 is
      expressed throughout the visual cortex of the monkey at high basal levels and
      that monocular visual deprivation produces dramatic changes in its levels
      revealing ocular dominance columns in striate cortex with as little as 2 h of
      selective exposure. These results show that immunodetection for Zif268 may be
      used for labelling activated neuronal populations in the monkey with several key
      advantages over prior techniques.

PMID- 8481788
TI  - Protective effects of basic fibroblast growth factor against hippocampal neuronal
      damage following cerebral ischemia in the gerbil.
AB  - We examined the effects of treatment with basic fibroblast growth factor (b-FGF)
      on hippocampal CA1 neuronal damage following 3 min of forebrain ischemia in the
      gerbil. Continuous infusion of b-FGF (24 or 240 ng/day over 4 days) using an
      implanted osmotic minipump into the lateral ventricle prevented CA1 neuronal
      damage in a dose-dependent manner.

PMID- 8481789
TI  - Naltrexone-induced alterations of the distribution of morphine in brain regions
      and spinal cord of the rat.
AB  - The effects of naltrexone injected intravenously (i.v.) on the pharmacological
      actions and distribution of i.v. injected morphine in brain regions and spinal
      cord of male Sprague-Dawley rats were determined. Naltrexone (0.625- and 2.5
      mg/kg doses) antagonized the analgesic and hyperthermic effects of morphine (10
      mg/kg dose). For distribution studies, naltrexone (0.625- and 2.5-mg/kg doses)
      was co-administered with morphine via indwelling catheters. Rats were sacrificed
      at various times after drug injection and the concentration of morphine in brain
      regions (hypothalamus, hippocampus, cortex, pons and medulla, amygdala, midbrain
      and corpus striatum), spinal cord and serum was determined by radioimmunoassay.
      The concentration of morphine in various brain regions was found to be time
      dependent. Initially, at 5 min, the highest concentration of morphine was found
      in the hypothalamus and the lowest in the striatum. In cortex and spinal cord,
      the concentration of morphine was significantly higher in comparison to the other
      brain regions at 30- and 60-min time points. Co-administration of lower dose of
      naltrexone (0.625 mg/kg) did not significantly alter the distribution of morphine
      in brain regions and spinal cord with some exceptions. The higher dose of
      naltrexone (2.5 mg/kg) increased the concentration of morphine in several brain
      regions and spinal cord. The ratio of the concentration of morphine in brain
      region or spinal cord to serum was decreased by naltrexone. It is concluded that
      naltrexone also alters the distribution of morphine in the central nervous
      system.

PMID- 8481790
TI  - Insulin and insulin-like growth factor I enhance regeneration in cultured adult
      rat sensory neurones.
AB  - Insulin and the insulin-like growth factors (IGFs) may directly affect the
      growth, development, and maintenance of the vertebrate nervous system. Previous
      in vitro studies have focused on embryonic nervous tissue. In this study the
      effects of insulin, IGF-I, IGF-II and nerve growth factor (NGF) on regeneration
      and neuronal survival were studied in cultured adult rat sensory neurones in a
      cell culture environment that limited non-neuronal cell mediated effects.
      Regeneration, as assessed by neurite outgrowth, was significantly enhanced by
      insulin and IGF-I in a dose-dependent manner. The half-maximally effective
      concentrations, ED50's, were approximately 1 nM and 0.1 nM for insulin and IGF-I,
      respectively. Concentrations of IGF-I as low as 10pM were active. There was some
      evidence that IGF-II stimulated regeneration, although this failed to reach
      statistical significance. NGF also promoted regeneration, confirming previous
      studies, exhibiting an ED50 of approximately 0.3 ng/ml and inducing a maximal
      response 2-fold greater than that observed with insulin or IGF-I. Combined
      treatment with NGF and insulin had an additive effect. Specific anti-NGF
      antiserum inhibited the regenerative response to NGF but failed to block the
      response to IGF-I, supporting the view that IGF-I was acting directly on sensory
      neurones rather than stimulating NGF production by non-neuronal cells. Insulin,
      IGF-I and NGF had no effect on neuronal survival in this culture system. These
      results show that adult sensory neurones can respond with enhanced regenerative
      growth to insulin and IGF-I, in addition to NGF although the response to IGF-II
      was less clear.

PMID- 8481791
TI  - Neurofilaments assume a less random architecture at nodes and in other regions of
      axonal compression.
AB  - Neurofilament distributions were mathematically characterized in four chicken
      somatic motor axons at each of four histologically distinct regions: compact
      myelinated regions, compact myelinated regions associated with Schwann cell
      nuclei, Schmidt-Lanterman clefts, and nodes of Ranvier. Compact myelinated
      regions had the largest cross-sectional areas, the lowest neurofilament
      densities, and the most random neurofilament organizations--nodes of Ranvier had
      the smallest cross-sectional areas, the highest neurofilament densities, and the
      most ordered architectures. In these myelinated axons, the closest natural
      neurofilament spacing was 25 nm. Mathematical analyses of serial sections
      suggested that neurofilament interactions are sufficiently weak and transient to
      permit a full range of variation from random to ordered cytoskeletal
      architectures as the neurofilaments move longitudinally through the few micron
      span of the paranodal-nodal region of a single axon.

PMID- 8481792
TI  - Chronic food restriction and weight loss produce opioid facilitation of
      perifornical hypothalamic self-stimulation.
AB  - Electrical stimulation frequency thresholds for lateral hypothalamic (LH) self
      stimulation were monitored throughout a 3 week period of food restriction and a
      subsequent 3 week period of re-feeding. Rats with electrodes placed in the
      perifornical LH were sensitive to this dietary manipulation as evidenced by a
      high positive correlation between body weight and self-stimulation threshold.
      Rats with electrodes in the zona incerta/subincertal region or ventral
      hypothalamus displayed little or no change in threshold. Lateral ventricular
      injection of naltrexone (200.0 nM) reversed the decline in threshold that was
      otherwise present during food restriction in rats with perifornical placements.
      Naltrexone had no effect on thresholds of rats with placements outside the
      perifornical region. These findings suggest that food restriction and weight loss
      activate an opioid mechanism that facilitates perifornical LH self-stimulation.
      The documented association of perifornical LH with the phenomenon of stimulation
      induced feeding, and the reciprocal connections between this region and gustatory
      structures, supports the hypothesis that facilitation of self-stimulation by food
      restriction is related to the natural phenomenon of positive alliesthesia (i.e.
      the hunger-dependency of food reward).

PMID- 8481793
TI  - Retinal afferents innervate functionally tectal but not neocortical grafts placed
      in lesioned superior colliculus of adult rats.
AB  - Solid pieces of tectum or occipital neocortex derived from 17-day rat fetuses
      were placed over the lesioned right superior colliculus (SC) in adult rats as
      sheets retaining the internal structure of the embryonal tissue. The upper
      laminae of the recipient's SC (approximately up to stratum opticum) were removed
      by aspiration after the neocortex overlying the SC was aspirated out. Two to 5
      months after the operation a microelectrode study of the neuronal electrical
      activity in the grafts was performed. Recordings from the tectal transplants
      revealed normal patterns of the spontaneous neuronal activity in all grafts and
      clear neuronal reactions to visual stimuli in a large portion of them (6 out of
      11). Visual reactions in these grafts were recorded from the majority of studied
      neurons (185/226). The properties of the receptive fields as well as the range of
      latencies of the reactions corresponded to those characteristic of the normal SC.
      Topographic representation of the visual field upon the transplants was found.
      Recordings from the cortical grafts showed an abnormal character of the
      spontaneous neuronal activity and the absence of reactions to any sensory
      stimulation of the recipients. The data obtained suggest that regenerating optic
      axons in adult hosts retain specificity in functional innervation of only
      appropriate target neurons and can re-establish the topographic representation of
      the retina upon tectal grafts. Retinal afferents innervate functionally tectal
      but not neocortical grafts placed in lesioned superior colliculus of adult rats.

PMID- 8481794
TI  - Opioid-induced inhibition of voltage-gated calcium channels parallels expression
      of omega-conotoxin-sensitive channel subtype during differentiation of NG108-15
      cells.
AB  - Depolarization-induced increases in intracellular free calcium concentration
      ([Ca2+]i) were measured in single NG108-15 cells using indo-1 based
      microfluorimetry. In cells differentiated for 6 days in serum-free forskolin (5
      microM) supplemented media, application of micromolar concentrations of [D-Ala2-D
      Leu5]enkephalin (DADLE) inhibited Ca2+ influx mediated by voltage-gated Ca2+
      channels. Inhibition of 50 mM K(+)-induced Ca2+ influx by DADLE was concentration
      dependent over the range of 0.1 to 10 microM and blocked by 100 microM naloxone.
      Differentiation increased the amplitude of depolarization-induced [Ca2+]i
      transients from 78 +/- 21 nM in undifferentiated cells to 1,282 +/- 318 nM after
      6 days. One microM nitrendipine inhibited Ca2+ influx by at least 65% at all
      stages of differentiation, while sensitivity to omega-conotoxin GVIa (omega-CgTx)
      did not appear until day 3. omega-CgTx inhibited a dihydropyridine-sensitive Ca2+
      channel. DADLE inhibition of Ca2+ channels did not appear until 3 days of
      differentiation. Thus, opioid inhibition of depolarization-induced Ca2+ influx
      paralleled the expression of omega-CgTx sensitive voltage-gated Ca2+ channels.

PMID- 8481795
TI  - Potentiation by choline of basal and electrically evoked acetylcholine release,
      as studied using a novel device which both stimulates and perfuses rat corpus
      striatum.
AB  - We examined the release of acetylcholine (ACh) and dopamine (DA) using a novel
      probe through which striatal neurons could be both superfused and stimulated
      electrically in both anesthetized and freely moving awake animals. Optimal
      stimulation parameters for eliciting ACh release from cholinergic neurons
      differed from those required for eliciting DA release from dopaminergic
      terminals: at 0.6 ms pulse duration, 20 Hz and 200 microA, ACh release increased
      to 357 +/- 30% (P < 0.01) of baseline and was blocked by the addition of
      tetrodotoxin (TTX). Pulse durations of 2.0 ms or greater were required to
      increase DA release. Unlike ACh release, DA release showed no frequency
      dependence above 5 Hz. The maximal evoked releases of ACh and DA were 556 +/- 94%
      (P < 0.01) and 254 +/- 38% (P < 0.05) of baseline, respectively. Peripheral
      administration of choline (Ch) chloride (30-120 mg/kg) to anesthetized animals
      caused dose-related (r = 0.994, P < 0.01) increases in ACh release; basal release
      rose from 117 +/- 7% to 141 +/- 5% of initial baseline levels (P < 0.05) and
      electrically evoked ACh release rose from 386 +/- 38% to 600 +/- 34% (P < 0.01)
      in rats given 120 mg/kg. However, Ch failed to affect basal or evoked DA release
      although neostigmine (10 microM) significantly elevated basal DA release (from
      36.7 fmol/10 min to 71.5 fmol/10 min; P < 0.05). In awake animals, Ch (120 mg/kg)
      also elevated both basal (from 106 +/- 7% to 154 +/- 17%; P < 0.05) and
      electrically evoked (from 146 +/- 13 to 262 +/- 16%; P < 0.01) ACh
      release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481796
TI  - C-fos expression in rat lumbar spinal cord following peripheral stimulation in
      adjuvant-induced arthritic and normal rats.
AB  - Our previous data reported a maximal expression of the c-fos immediate-early gene
      in the lumbar spinal cord of the non-stimulated polyarthritic rat neurons, three
      weeks after Freund's adjuvant injection. The present study utilises c-fos
      expression to judge the reactivity of spinal neurons to calibrated mechanical
      pressure applied to the ankle joint, in both normal and arthritic rats under
      ketamine anesthesia. The results indicate that the number of Fos-like
      immunoreactive neurons (1) is slightly decreased in ketamine-anesthetized non
      stimulated arthritic rats as compared to the non-anesthetized non-stimulated
      ones, (2) is significantly higher in both stimulated normal and arthritic animals
      as compared to non-stimulated animals, particularly in laminae I, II, V and VI of
      L3 and L4, and (3) is significantly increased in stimulated arthritic as compared
      to stimulated normal rats, in all laminae of lumbar spinal segments. The
      appearance of 'basal' Fos labeling during the adjuvant-induced arthritic disease
      and the increased number of Fos-like immunoreactive neurons in stimulated
      arthritic rats compared to stimulated normal animals indirectly suggests that
      these neurons are abnormally active and thus involved in the hyperalgesia of
      arthritic disease. Therefore the use of Fos-like immunoreactivity in the chronic
      pain model seems to be an appropriate tool to study possible effects of various
      pharmacological compounds, such as analgesics and anti-inflammatory drugs.

PMID- 8481797
TI  - Neurochemical evidence that 5-hydroxytryptaminergic neurons tonically inhibit
      noradrenergic neurons terminating in the hypothalamus.
AB  - The medial zona incerta (MZI) and dorsomedial nucleus of the hypothalamus (DMN),
      which contain cell bodies and terminals of incertohypothalamic dopaminergic (DA)
      neurons, are densely innervated by both noradrenergic (NE) and 5
      hydroxytryptaminergic (5-HT) neurons. In view of emerging anatomical and
      pharmacological evidence suggesting possible interactions between 5-HT and
      catecholaminergic neurons, the effects of experimental procedures that inhibit or
      disrupt 5-HT neurons on the activities of catecholaminergic neurons terminating
      in these regions were examined in the present study. Catecholaminergic neuronal
      activity was estimated by measuring catecholamine synthesis (accumulation of 3,4
      dihydroxyphenylalanine [DOPA] after administration of a decarboxylase inhibitor)
      and metabolism (concentrations of the dopamine metabolite 3,4
      dihydroxyphenylacetic acid (DOPAC) and the norepinephrine metabolite 3-methoxy-4
      hydroxyphenylethyleneglycol (MHPG)) in the MZI and DMN of both male and female
      rats. Inhibition of 5-HT neurons following administration of the 5-HT1A
      autoreceptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) increased
      the accumulation of DOPA in the DMN and the concentrations of DOPAC in the MZI
      and DMN, indicating an activation of catecholaminergic neurons in these regions.
      Concentrations of MHPG were increased in the MZI and DMN by 8-OH-DPAT or 5,7
      dihydroxytryptamine-induced lesions of 5-HT neurons, revealing that NE neurons
      terminating in these regions were activated following procedures that decrease 5
      HT neuronal function. Following destruction of NE neurons projecting to the MZI
      and DMN, 8-OH-DPAT no longer increased DOPAC concentrations in these brain
      regions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481798
TI  - [3H]phorbol ester binding sites and neuronal plasticity in the hippocampus
      following entorhinal cortex lesions.
AB  - Entorhinal cortex lesioning (ECL) produces a loss of more than 80% of the
      synapses in the outer molecular layer of the hippocampus. However, the loss of
      synapses is transient. Beginning a few days after denervation, new synapses are
      formed, virtually replacing the lost inputs within 2 months. Synaptic remodelling
      induced by ECL is associated with specific modifications of neurotransmitters,
      hormones and growth factors. Particularly, protein kinase C (PKC) plays important
      functional roles in receptor-mediated transmembrane signal transduction. PKC is
      also involved in various aspects of synaptic plasticity, such as cellular growth
      and differentiation. To investigate further the potential roles of PKC in
      synaptic plasticity observed in the ECL model, [3H]phorbol 12,13-dibutyrate
      ([3H]PDBu) binding, a putative marker of PKC, was examined at different times
      post-lesion. [3H]PDBu binding sites transiently decreased bilaterally at 2 and 8
      days post-lesion (20%) in different laminae and sub-fields of the rostral
      hippocampus but returned to control values at 14 and 30 days post-lesion. In
      caudal portion of the hippocampus, [3H]PDBu binding was also decreased at 2 days
      post-lesion but only on the contralateral side. Interestingly, [3H]PDBu binding
      sites in the cortex increased by up to 30% in the contralateral side while no
      significant change was observed in the ipsilateral side at any time post-lesion.
      It is known that PKC can be regulated by different systems following alterations
      of neuronal and glial activity. We suggest that these could be involved in the
      response of PKC and [3H]PDBu binding sites following ECL. Moreover, PKC seemed to
      be modified in different brain areas in neuronal inputs from the entorhinal
      cortex and the subsequent reinnervation process.

PMID- 8481799
TI  - Pituitary gland responsiveness to LHRH and LHRH neuronal responsiveness to
      excitatory stimuli are severely impaired in female rats treated neonatally with
      high doses of androgen.
AB  - Treatment of neonatal female rats with androgen renders these animals permanently
      sterile as adults. Previously, we reported that these androgen-sterilized rats
      (ASR) do not respond to the positive feedback effects of estrogen by having LH
      surges. We also reported that this defect might be due to the failure of these
      animals to show increased hypothalamic norepinephrine turnovers (an index of
      secretion) in response to steroid treatment. Although LHRH-catecholamine synapses
      are established before or at birth, whether such synapses are functional remains
      to be resolved. Accordingly, in the present studies, female rats were given 1.25
      mg of testosterone propionate at 5 days of age and, at 100 days of age, these ASR
      and controls were ovariectomized and treated with estradiol. In these animals, we
      examined whether activation of medullary A1 noradrenergic neurons would amplify
      LH release following preliminary depolarization of LHRH neurons with an
      electrochemical stimulus (ECS). As well, we reexamined whether LHRH neuronal
      responsiveness to exogenous NE and pituitary responsiveness to LHRH differ in
      controls versus ASR. In controls, two pulses of LHRH given 60 min apart elicited
      increases in plasma LH with the second pulse inducing greater LH release than the
      first pulse. In ASR, significantly less LH was released after either LHRH pulse
      and particularly after the second pulse. When the spacing between the two LHRH
      pulses was reduced to 25 min, equivalent levels of LH release occurred in
      controls and ASR after the second pulse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481800
TI  - Cellular and intracellular localization of epsilon-subspecies of protein kinase C
      in the rat brain; presynaptic localization of the epsilon-subspecies.
AB  - The cellular and intracellular localization of the epsilon-subspecies of protein
      kinase C (PKC) in the rat brain was demonstrated by immunocytochemistry using
      specific antibodies against epsilon-PKC. The epsilon-PKC-specific
      immunoreactivity was most abundant in the hippocampal formation, olfactory
      tubercle and Calleja's islands, was moderate in the cerebral cortex, anterior
      olfactory nuclei, accumbens nucleus, lateral septal nuclei and caudate-putamen
      and low in the thalamus and medulla. The epsilon-PKC-immunoreactivity was scanty
      in the perikarya, except for the pyramidal cells of CA3 region of the hippocampus
      and the immunoreactivity was mainly present in neuropils and nerve fibers. The
      distribution of epsilon-PKC immunoreactive neurons was consistent with that
      obtained by in situ hybridization histochemistry. Electron microscopic
      observations of the hippocampus revealed that the epsilon-PKC is predominantly
      present in the cytoplasm of axon and nerve terminals and that this enzyme is
      associated with mitochondrial membrane and vesicles. These results suggested that
      epsilon-PKC is probably involved in presynaptic functions in CNS, perhaps even
      neurotransmitter release.

PMID- 8481801
TI  - A novel stretch receptor in the jaw of the rat.
AB  - We report here an unusual type of stretch receptor found on each side of the rat
      jaw. This receptor has unique morphological features: it is quite long (24-28
      mm), lies in connective tissue in between masticatory muscles, and extends
      between the medial pterygoid muscle-tendon on the maxilla and the masseter-tendon
      on the mandible through a zigzag course, forming a Greek capital letter sigma
      when viewed from the side. The receptor is neither in parallel nor in series with
      any masticatory muscles and receives multiple innervation. The receptor increases
      its length when the jaw closes and shortens when the jaw opens. Electron
      microscopy revealed axial structures composed of a central cellular core
      surrounded by tightly packed collagen bundles which are separated from the
      capsule by a wide capsular space. Most of the sensory endings are found among
      axial collagen bundles, some in between core cells. The core cells have many
      finger-like processes on their surface, being coupled by desmosomes. The origin
      and nature of these cells are unclear. The wide capsular space is filled with
      Alcian blue positive substrate, probably acid glycosaminoglycans. The structures
      of outer and inner capsules are similar to those of muscle spindles, the former
      being composed of three to ten layers of thin flattened cells. The response of
      the receptor was examined with in vivo as well as in vitro preparations. In in
      vivo experiments, impulse discharges from this receptor increased with the
      increase in jaw closing. When the jaw was fully opened the impulse discharge from
      this receptor disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481802
TI  - D1 dopamine agonist and antagonist effects on regional cerebral glucose
      utilization in rats with intact dopaminergic innervation.
AB  - The effects of stimulation and blockade of the D1 dopamine receptor on regional
      cerebral glucose utilization (RCGU) were studied using quantitative [14C]2
      deoxyglucose autoradiography in naive rats. Systemic administration of the
      selective D1 antagonist, SCH 23390 (0.5 mg/kg), lowered glucose utilization by 24
      28% in the globus pallidus, entopeduncular nucleus, subthalamic nucleus,
      substantia nigra pars reticulata (SNr), and motor cortex, suggesting that
      stimulation of the D1 receptor by endogenous dopamine contributes to basal
      metabolism in these regions. Administration of SCH 23390 increased RCGU in the
      lateral habenula, as do selective D2 antagonists. The selective D1 agonist, SKF
      38393 (30 mg/kg), increased RCGU in the SNr (up 22%) without affecting the other
      brain regions which were examined. This modest increase contrasts with the large
      increase in RCGU (up 100-200%) in the SNr elicited by similar doses of SKF 38393
      in rats with acute or chronic dopamine depletion. Systemic administration of
      amphetamine (5.0 mg/kg), a dopamine releasing agent, increased RCGU in the
      caudate-putamen (up 33%), globus pallidus (up 23%), subthalamic nucleus (up 46%),
      entopeduncular nucleus (up 78%), and SNr (up 72%) and lowered RCGU in the lateral
      habenula (down 43%). All of these amphetamine effects were blocked by
      pretreatment with either SCH 23390 (0.5 mg/kg) or eticlopride (2.0 mg/kg, a
      selective D2 antagonist). These results suggest that endogenous dopamine
      stimulates both D1 and D2 receptors in vivo and provide metabolic evidence to
      support the concept of a functional linkage of D1 and D2 receptor systems in
      animals with intact dopaminergic innervation.

PMID- 8481803
TI  - Aging alters the entraining effects of an activity-inducing stimulus on the
      circadian clock.
AB  - In young hamsters, a single injection of the short-acting benzodiazepine,
      triazolam, can induce permanent phase shifts in the circadian clock, while
      repeated injections of triazolam entrain the circadian clock to the period of the
      injections. Triazolam appears to act on the circadian clock by inducing an acute
      increase in the activity of the animals, which in turn phase-shifts the circadian
      clock. Surprisingly, single injections of benzodiazepines do not phase-shift the
      activity rhythm of old hamsters, despite the fact that such treatment induces
      similar acute changes in the activity state of young and old animals. We compared
      the entraining effects of repeated injections of triazolam on the circadian clock
      of young and old hamsters; while six out of seven young hamsters were entrained
      to the triazolam injections, only one out of seven old animals was entrained by
      this treatment. Three of the remaining six old hamsters showed a lengthening of
      the activity rhythm, while no consistent effect on the period of the activity
      rhythm was observed in the remaining three old animals. These results indicate
      that the circadian system of old hamsters becomes selectively unresponsive to
      synchronizing signals mediated by the activity-rest state, and suggest that aging
      is associated with a weakened coupling between the activity-rest cycle and the
      circadian clock.

PMID- 8481804
TI  - Evidence for the behavioral supersensitivity of dopamine D2 receptors without
      receptor up-regulation in morphine-abstinent rats.
AB  - The effect of morphine tolerance-dependence and abstinence on the characteristics
      of dopamine D2 receptors in brain regions and spinal cord was determined in the
      rat. Male Sprague-Dawley rats were implanted s.c. under light ether anesthesia
      with 6 morphine pellets for a 7-day period, each containing 75 mg of morphine
      free base. Rats implanted with placebo pellets served as controls. This procedure
      resulted in the development of tolerance to morphine as evidenced by decreased
      analgesic response to a challenge dose of morphine. Similarly, the development of
      physical dependence was evidenced by a decrease in body weight and colonic
      temperature after morphine pellet removal (withdrawal). The binding
      characteristics (Bmax and Kd values) of [3H]spiroperidol to dopamine D2 receptors
      were determined in the tissues of morphine-tolerant and morphine-abstinent rats.
      In the tolerant rats, the pellets were left intact at the time of sacrificing,
      whereas, in the abstinent rats the pellets were removed 18 h prior to
      sacrificing. The binding of [3H]spiroperidol was determined in membranes prepared
      from brain regions (hypothalamus, hippocampus, cortex, pons and medulla,
      midbrain, corpus striatum and amygdala) and spinal cord of rats from various
      treatment groups. [3H]Spiroperidol bound to brain regions and spinal cord at a
      single high affinity site. The Bmax or the Kd values in brain regions and spinal
      cord of morphine-tolerant and -abstinent rats did not differ from their
      respective placebo controls. The behavioral responses to a selective dopamine D2
      receptor agonist, 2-bromo-alpha-ergocryptine were also determine in the morphine
      abstinent rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481805
TI  - Neurofilament in feline primary afferent neurones: a quantitative
      immunocytochemical study.
AB  - Two populations of cat L4 dorsal root ganglion (DRG) neurones were apparent from
      their Nissl staining with Toluidine blue. One had neurones of all sizes and the
      other had predominantly small neurones. The size distribution of neuronal
      profiles in the two populations overlapped and both were approximately normal.
      They corresponded to the light (L) and small dark (SD) cell populations
      previously described in rat DRGs. These neurones were examined with four
      antibodies to neurofilament: RT97, NFH, 155 and anti-68kD. RT97 is specific for
      the phosphorylated form of the 200 kDa subunit; NFH recognises both
      phosphorylated and non-phosphorylated forms of this subunit; 155 and anti-68 kDa
      recognise the 155 kDa and 68 kDa subunits respectively. The clearest differential
      labelling was seen with NFH and RT97 and this labelling was compared with cell
      size. High intensity NFH labelling was in a population of neuronal profiles of
      all sizes and low intensity labelling in a population of predominantly small
      neuronal profiles. These populations corresponded respectively to the L and SD
      populations seen with toluidine blue staining. In the rat, these populations can
      be demonstrated by both NFH and RT97. In contrast in the cat, high intensity RT97
      labelling was seen in only 75% of the L neuronal profiles defined with NFH and
      was also seen in some SD neuronal profiles defined with NFH. It is thus proposed
      that L and SD cell types are present in the cat DRG and can be demonstrated using
      the anti-neurofilament marker, NFH.

PMID- 8481806
TI  - Morphine inhibits antidromic vasodilatation without affecting the excitability of
      C-polymodal nociceptors in the skin of the rat.
AB  - The effect of morphine was examined under identical conditions on (a) antidromic
      vasodilatation, an 'efferent' function of C-nociceptors in the skin, and (b)
      afferent responses to heat and pressure of C-polymodal nociceptors. Morphine
      caused a large, naloxone-reversible, fall in peak antidromic vasodilatation
      (ADV). However it caused no significant change in heat or mechanical excitability
      of C-polymodal nociceptors in normal or mildly inflamed skin. The mechanisms by
      which morphine might affect efferent, but not afferent, functions of C
      nociceptors are discussed.

PMID- 8481807
TI  - Selective alteration in B-50/GAP-43 phosphorylation in brain areas of animals
      characterized by cognitive impairment.
AB  - When methylazoxymethanol acetate is administered to pregnant rats at gestational
      day 19, the offspring are greatly impaired in the learning of a two-way active
      avoidance task and these behavioral changes are paralleled by a change in the
      phosphorylation of the protein B-50/GAP-43 in hippocampus but not in cortex. The
      expression of the protein is not altered, indicating that the phosphorylation of
      B-50 is a sensitive marker of alterations in synaptic plasticity associated with
      impairments of learning abilities in rats.

PMID- 8481808
TI  - Auditory sensory gating in the rat hippocampus: modulation by brainstem activity.
AB  - Auditory stimuli repeated at short intervals result in diminished evoked
      responses recorded from the skull surface and from the hippocampus in the rat.
      The rat has been used to model diminished responses to repeated auditory stimuli-
      a phenomenon seen in normal human subjects, but often absent in schizophrenics.
      In this study, we examined the neural circuitry involved in the processing and
      gating of auditory responses recorded from the hippocampus of the rat. Evoked
      potentials and single neuron activity with diminished responses to the second of
      paired tones were recorded in the brainstem reticular formation in the
      paragigantocellular region at the caudal level of the pons, but diminished
      responses were not observed in the primary auditory relay nuclei. Electrical
      stimulation of this region of the brainstem reticular formation was able to
      substitute for the first, or conditioning, auditory tone to produce sensory
      gating of the response to the second, or test, tone when recording from the
      hippocampus. Stimulation of the auditory nuclei up to the level of the lateral
      lemniscus, but not the superior colliculus, was also able to substitute for an
      auditory stimulus to produce sensory gating in the hippocampus. The gating of
      hippocampal responses to auditory stimuli may thus involve pathways which branch
      from the lemniscal auditory pathway at the level of the lateral lemniscus and
      ascend to the hippocampus via the brainstem reticular formation.

PMID- 8481809
TI  - Gender influences outcome of brain injury: progesterone plays a protective role.
AB  - The contributions of gender and gonadal hormones in the cascade of events
      following brain injury are largely unexplored. We measured cerebral edema
      following cerebral contusion in rats under three hormonal conditions to address
      this issue. Normally cycling females exhibited significantly less edema than
      males, and pseudopregnant females were virtually spared from post-injury edema.
      Subsequent studies of ovariectomized females, with or without hormone treatment,
      indicated that the reduction of cerebral edema was associated primarily with the
      presence of circulating progesterone. We conclude that progesterone has a
      protective effect on the brain following traumatic injury.

PMID- 8481810
TI  - Effect of varying levels of glucose on oxygen deprivation-induced delayed
      neuronal cell death in primary cerebrocortical cultures.
AB  - Calcium accumulation and neuronal injury of rat cortical cell cultures in vitro
      were examined following oxygen deprivation under conditions of normal and low
      glucose. 45Ca2+ uptake and lactate dehydrogenase (LDH) release, measured at 12
      and 24 h after oxygen deprivation, were significantly elevated in cultures
      exposed to combined oxygen deprivation and low glucose (1.7 or 0.6 mM). Although
      those cultures deprived of oxygen combined with no glucose displayed delayed
      increases in 45Ca2+ influx, no significant elevation in LDH release at 24 h was
      observed.

PMID- 8481811
TI  - ATP mediates an excitatory noradrenergic neuron input to supraoptic vasopressin
      cells.
AB  - Although A1 noradrenaline (NA) neurons of the caudal medulla provide a direct,
      excitatory input to supraoptic vasopressin cells, they do not use NA as their
      primary transmitter. We have now tested the possibility that adenosine 5'
      triphosphate (ATP) may fulfill this role. Extracellular recordings from rat
      supraoptic nucleus demonstrated that locally applied ATP excites neurosecretory
      vasopressin cells and that this effect is mimicked by the ATP receptor-agonist
      alpha,beta-methylene ATP and blocked by the ATP receptor-blocker suramin. Suramin
      did not block the excitatory effect of locally applied NA on vasopressin cells
      but did block excitations produced by vagus nerve stimulation, such excitations
      having previously been shown to involve a pathway in which the final relay is an
      input from the A1 cell group. These results indicate that certain central NA
      neurons use ATP as a transmitter and also provide the first demonstration of a
      specific physiological role for central purinergic neurons, i.e. regulation of
      secretion of the neurohormone vasopressin.

PMID- 8481812
TI  - Pulmonary and upper airway afferent influences on the motor pattern of
      vocalization evoked by excitation of the midbrain periaqueductal gray of the cat.
AB  - It has been established previously that natural-sounding vocalization is evoked
      by excitation of the midbrain periaqueductal gray (PAG). It is not known,
      however, whether the motor output for such vocalization is invariant, or whether
      it is influenced by afferent discharge. We have investigated, in the
      unanesthetized precollicular decerebrate cat, the patterns of upper airway and
      respiratory EMG activity evoked by microinjection into the PAG of the excitatory
      amino acid D,L-homocysteic acid (6 to 40 nmol in 30-200 nl), under conditions of
      varied pulmonary and upper airway afferent input. The PAG-evoked pattern in the
      control state consisted of a 1- to 2-min sequence of episodic vocalizations (hiss
      or howl-like) with expiratory (vocalization) durations of generally less than 2
      s, separated by one or more inspirations. During such PAG-evoked vocalization, a
      significant prolongation of the expiratory duration and an extended discharge in
      laryngeal, intercostal and abdominal muscles was evoked by the application of
      warm, humidified static air pressures (5-30 cm H2O) either: (i) to the lungs and
      tracheo-bronchial tree via a tracheostomy, or (ii) as an airflow through the
      upper airways in an expiratory direction. In contrast, if the development of the
      usual vocalization-related air pressures (5-45 cm H2O) in the lungs and airways
      was prevented by opening a tracheal cannula to the atmosphere, shortened
      respiratory durations (inspiratory and expiratory) occurred. The effects evoked
      by static pressure inflations of the lungs could be blocked by bilateral vagotomy
      or reversibly blocked by unilateral vagotomy combined with vagal cooling
      sufficient to abolish Hering-Breuer reflexes. These results indicate that the
      motor pattern for vocalization evoked by excitation of PAG is exquisitely
      sensitive to pulmonary and upper airway afferent input.

PMID- 8481813
TI  - Inhibition of NMDA-evoked electrophysiological activity by ethanol in selected
      brain regions: evidence for ethanol-sensitive and ethanol-insensitive NMDA-evoked
      responses.
AB  - Our laboratory has previously shown that systemically administered ethanol
      inhibits NMDA-evoked electrophysiological activity in some, but not all, neurons
      in the medial septum. In the present report, it was found that ethanol, when
      applied locally via electro-osmosis, potently inhibited NMDA-evoked neuronal
      activity in a current-dependent manner in the inferior colliculus and
      hippocampus. In contrast, locally applied ethanol failed to inhibit NMDA-evoked
      activity in the lateral septum. The inhibition by ethanol of NMDA-evoked activity
      in the inferior colliculus was specific, in that ethanol failed to inhibit
      neuronal activity of the inferior colliculus evoked by the excitatory
      neurotransmitter glutamate. These findings indicate that ethanol can specifically
      inhibit NMDA-evoked activity in vivo via a local action, and that the ability of
      ethanol to inhibit NMDA-evoked activity varies regionally in brain. The
      possibility that these results are explained by the existence of two types of
      NMDA receptors, one sensitive to ethanol, the other insensitive to ethanol, is
      discussed.

PMID- 8481814
TI  - A robust, high-sensitivity algorithm for automated detection of proteins in two
      dimensional electrophoresis gels.
AB  - The automated interpretation of two-dimensional gel electrophoresis images used
      in protein separation and analysis presents a formidable problem in the detection
      and characterization of ill-defined spatial objects. We describe in this paper a
      hierarchical algorithm that provides a robust, high-sensitivity solution to this
      problem, which can be easily adapted to a variety of experimental situations. The
      software implementation of this algorithm functions as part of a complete package
      designed for general protein gel analysis applications.

PMID- 8481815
TI  - Prediction of protein secondary structure by the hidden Markov model.
AB  - The purpose of this paper is to introduce a new method for analyzing the amino
      acid sequences of proteins using the hidden Markov model (HMM), which is a type
      of stochastic model. Secondary structures such as helix, sheet and turn are
      learned by HMMs, and these HMMs are applied to new sequences whose structures are
      unknown. The output probabilities from the HMMs are used to predict the secondary
      structures of the sequences. The authors tested this prediction system on
      approximately 100 sequences from a public database (Brookhaven PDB). Although the
      implementation is 'without grammar' (no rule for the appearance patterns of
      secondary structure) the result was reasonable.

PMID- 8481816
TI  - Prediction of protein secondary structures by a neural network.
AB  - We have studied the prediction of globular protein secondary structures by neural
      networks. Protein secondary structures are allocated to amino acid residues using
      Kabsch and Sander's dictionary of protein secondary structures and the neural
      network is taught the protein secondary structures. The input layer of the neural
      network allows sequences of residues including 20 amino acids, chain break, B, X
      and Z. We consider classifying secondary structures into groups of 3, 4 and 8. In
      each case, we calculate the percentage of correct predictions. We discuss the
      effect of overlearning on the protein secondary structure prediction. In
      addition, we include the application of a neural network with a modular
      architecture to prediction of protein secondary structures. We compare the
      results from neural networks with a modular architecture and with a simple three
      layer structure.

PMID- 8481817
TI  - An approach to systematic detection of protein structural motifs.
AB  - A procedure to detect similar local structures of proteins from C alpha
      coordinates is presented. First, the conformations of seven-residue peptide
      segments are approximated by a limited number of representatives, each of which
      is assigned a symbol. Thus, the overall conformation of a protein is represented
      by a symbol string. The comparison of these symbol strings using a sequence
      alignment technique then gives pairs of similar local structures. These pairs are
      considered candidates of structural motifs. The application of the procedure to
      the analysis of 93 proteins gave 858 pairs of similar local structures, which
      included several well-known structural motifs such as the nucleotide-binding beta
      alpha beta-unit and the calcium-binding EF hand. The characterization of amino
      acid patterns of similar local structures given by the procedure should be useful
      for the development of protein structure prediction based on the acquisition of
      empirical rules from a large-scale database.

PMID- 8481818
TI  - MASCOT: multiple alignment system for protein sequences based on three-way
      dynamic programming.
AB  - A multiple alignment methodology that can produce high-quality alignment is
      extremely important for predicting the structure of unknown proteins. Nearly all
      the methodologies developed so far have employed two-way alignment only. Although
      these methods are fast, the alignments they produce lose reliability as the
      similarity of sequences reduces. We developed the MASCOT multiple alignment
      system. MASCOT can sustain the reliability of alignment even when the similarity
      of sequences is low. MASCOT achieves high-quality alignment by employing three
      way alignment in addition to two-way alignment. The resultant alignments are
      refined by simulated annealing to higher quality. We also use a cluster analysis
      of sequences to produce highly reliable alignments.

PMID- 8481819
TI  - Building multiple alignments from pairwise alignments.
AB  - Given a family of related sequences, one can first determine alignments between
      various pairs of those sequences, then construct a simultaneous alignment of all
      the sequences that is determined in a natural manner by the set of pairwise
      alignments. This approach is sometimes effective for exposing the existence and
      locations of conserved regions, which can then be aligned by more sensitive
      multiple-alignment methods. This paper presents an efficient algorithm for
      constructing a multiple alignment from a set of pairwise alignments.

PMID- 8481820
TI  - TREECON: a software package for the construction and drawing of evolutionary
      trees.
AB  - A package of programs (run by a management program called TREECON) was developed
      for the construction and drawing of evolutionary trees. The program MATRIX
      calculates dissimilarity values and can perform boostrap analysis on nucleic acid
      sequences. TREE implements different evolutionary tree constructing methods based
      on distance matrices. Because some of these methods produce unrooted evolutionary
      trees, a program ROOT places a root on the tree. Finally, the program DRAW draws
      the evolutionary tree, changes its size or topology, and produces drawings
      suitable for publication. Whereas, MATRIX is suited only for nucleic acids, the
      modules TREE, ROOT and DRAW are applicable to any kind of dissimilarity matrix.
      The programs run on IBM-compatible microcomputers using the DOS operating system.

PMID- 8481821
TI  - A fast, sensitive pattern-matching approach for protein sequences.
AB  - Pattern-matching algorithms are a powerful tool for finding similarities and
      relationships among the steadily growing amount of known protein sequences. We
      present a fast, sensitive pattern-matching algorithm that describes a pattern by
      its physico-chemical properties rather than by occurrence of amino acids, using a
      fast, dynamic programming algorithm. Selected examples will demonstrate
      applications and advantages of our approach.

PMID- 8481822
TI  - Dot-plot comparisons by multivariate analysis (DOCMA): a tool for classifying
      protein sequences.
AB  - A method aimed at classifying protein sequences without resorting to pairwise
      alignment is presented. Called DOCMA (DOt-plot Comparisons by Multivariate
      Analysis), it is based on a multivariate analysis of the pairwise dot-plots
      between all the sequences in the set. The dot-plots are first simplified by
      considering only the projections of the 'diagonal' segments of similarity onto
      the axes. From these projections a data matrix is built, in which each column is
      representative of the comparisons of one given sequence with all the other ones.
      This data matrix is then transformed into a distance matrix by a chi-squared
      analysis, from which the coordinates of the sequences in an orthonormal Euclidean
      space are obtained. The sequences are finally classified by a dynamic clustering
      procedure followed by a search for strong clusters. Application of this method to
      protein families such as the globins, the cytochromes c and the aminoacyl-tRNA
      synthetases shows that it is quite effective in delineating subgroups that
      contain even distantly related sequences.

PMID- 8481823
TI  - An interactive graphic program for calculating the secondary structure content of
      proteins from circular dichroism spectrum.
AB  - A graphic program has been developed to calculate the secondary structure content
      of proteins from their circular dichroism spectrum. All the information
      concerning analysis and results are given on a single screen. The actual and the
      theoretical spectra are plotted to allow visual inspection of the fit quality.
      The percentages of secondary structure and statistical parameters (r.m.s.,
      residuals) are provided. The program is fully interactive for spectra analysis.
      Moreover, cursors driven by a mouse or arrow keys are moveable onto spectra
      yielding all the information concerning a given wavelength, such as the
      theoretical and experimental ellipticities, wavelength, values of reference model
      for alpha-helix, beta-sheet and beta-turn. Interfaces are provided for the CONTIN
      program of Provencher and Glockner.

PMID- 8481824
TI  - PCAP: probe choice and analysis package--a set of programs to aid in choosing
      synthetic oligomers for contig mapping.
AB  - In the program, PCAP, we provide a methodology for choosing synthetic
      oligonucleotide probes to be used in contig mapping experiments. The package
      serves the purpose of presenting a series of short oligonucleotides (8-12mers)
      that are chosen based on constraints with respect to frequency of occurrence
      within a particular genome and the G+C content of the oligonucleotides. The four
      programs contained within the package: (i) convert GenBank files to a format
      useable by the package; (ii) calculate trinucleotide and tetranucleotide
      frequencies in available sequence data on a particular species; (iii) present the
      user with upper and lower bounds on the frequencies of hybridization sites for
      oligonucleotide probes of length 8-12, (iv) allow the user to place constraints
      on site frequency and G+C content and provides a list of short probe sequences
      that fit these criteria. These sequences can then be synthetically produced and
      used in hybridization experiments to carry out contig mapping.

PMID- 8481825
TI  - Classification of protein sequences by their dipeptide composition.
AB  - A simple approach to scan quickly a large protein sequence database for homology
      is described. The approach used is strictly dependent on the database
      organization. A database has been compiled in which protein sequences are grouped
      into families of closely related proteins, each family being characterized by its
      average dipeptide composition. A new entry in the database can be allocated in a
      family by comparing its dipeptide composition with the average dipeptide
      composition of the families.

PMID- 8481826
TI  - A hypertext-like approach to navigating through the GCG sequence analysis
      package.
AB  - Programs of the recently released Unix version of the Genetics Computing Group
      (GCG) sequence analysis package can now be accessed via a user-friendly hypertext
      like navigation system, HYGCG. The resultant system organizes the diverse suite
      of programs into logical groups, and provides a guide and explanation of
      commands. In addition, for users unfamiliar with the Unix operating system, the
      program also provides a similar interface to commonly used Unix commands. Options
      for personal customization and expansion to accommodate GCG extensions and other
      software are also provided. This system should be useful especially to the
      inexperienced or infrequent user as context-sensitive on-line help is provided
      within this simple and consistent approach. Written in the C language and using
      the curses and termcap libraries, the system is easily portable to most Unix
      environments and has been made freely available via anonymous file transfer
      protocol (FTP) through the Internet global computer network. No modification of
      the GCG package is needed.

PMID- 8481827
TI  - ODS: ordering DNA sequences--a physical mapping algorithm based on simulated
      annealing.
AB  - In the program ODS we provide a methodology for quickly ordering random clones
      into a physical map. The process of ordering individual clones with respect to
      their position along a chromosome is based on the similarity of binary signatures
      assigned to each clone. This binary signature is obtained by hybridizing each
      clone to a panel of oligonucleotide probes. By using the fact that the amount of
      overlap between any two clones is reflected in the similarity of their binary
      signatures, it is possible to reconstruct a chromosome by minimizing the sum of
      linking distances between an ordered sequence of clones. Unlike other programs
      for physical mapping, ODS is very general in the types of data that can be
      utilized for chromosome reconstruction. Any trait that can be scored in a
      presence--absence manner, such as hybridized synthetic oligonucleotides,
      restriction endonuclease recognition sites or single copy landmarks, can be used
      for analysis. Furthermore, the computational requirements for the construction of
      large physical maps can be measured in a matter of hours on work-stations such as
      the VAX2000.

PMID- 8481828
TI  - A special-purpose processor for gene sequence analysis.
AB  - Advances in computational biology have occurred primarily in the areas of
      software and algorithm development; new designs of hardware to support biological
      computing are extremely scarce. This is due, we believe, to the presence of a non
      trivial knowledge gap between molecular biologists and computer designers. The
      existence of this gap is unfortunate, as it has long been known that for certain
      problems, special-purpose computers can achieve significant cost/performance
      gains over general-purpose machines. We describe one such computer here: a custom
      accelerator for gene sequence analysis. The accelerator implements a version of
      the Needleman-Wunsch algorithm for nucleotide sequence alignment. Sequence
      lengths are constrained only by available memory; the product of sequence lengths
      in the current implementation can be up to 2(22). The machine is implemented as
      two NuBus boards connected to a Mac IIf/x, using a mixture of TTL and FPGA
      technology clocked at 10 MHz. The boards are completely functional, and yield a
      15-fold performance improvement over an unassisted host.

PMID- 8481829
TI  - Euthanasia: honoring a life.

PMID- 8481830
TI  - Serum levels of bone Gla protein (osteocalcin, BGP) and carboxyterminal
      propeptide of type I procollagen (PICP) in acromegaly: effects of long-term
      octreotide treatment.
AB  - We measured serum concentrations of bone Gla-protein (osteocalcin, BGP) and
      carboxyterminal propeptide of type I procollagen (PICP) in 14 patients with
      active acromegaly. Blood was collected at 0800 for measurement of bone Gla
      protein (BGP), carboxyterminal propeptide of type I procollagen (PICP), and
      insulin-like growth factor I (IGF-I); growth hormone (GH) was then determined at
      15-minute intervals for 3 hours and the integrated mean was calculated. The same
      protocol was repeated at regular intervals during treatment with the long-acting
      somatostatin analog, octreotide, 150-450 micrograms/day for 6-33 months (median
      15). In a case-control analysis, serum BGP concentrations recorded in the
      acromegalic patients were significantly elevated (14.2 +/- 4.2 micrograms/liter
      versus 8.0 +/- 3.3 micrograms/liter, P < 0.001). Octreotide treatment induced a
      roughly parallel reduction in serum GH, IGF-I, and BGP. We found a significant
      positive correlation between BGP levels recorded before and during therapy and
      the logarithm of corresponding mean GH levels (r = 0.67, P < 0.001). Also IGF-I
      concentrations were positively correlated with BGP (r = 0.66, P < 0.001). On the
      other hand, PICP levels recorded in the acromegalics did not differ from control
      subjects (146 +/- 46 micrograms/liter versus 127 +/- 44 micrograms/liter, NS) and
      no correlation was found between either GH and PICP or IGF-I and PICP. To
      conclude, the present data are compatible with the view that GH and IGF-I play an
      important role in the control of BGP but not PICP production. It could be that
      BGP and PICP are submitted to different hormonal modulation.

PMID- 8481831
TI  - Impact near the hip dominates fracture risk in elderly nursing home residents who
      fall.
AB  - Hip fractures among the elderly are a significant and rapidly growing public
      health problem. The prevailing view is that most hip fractures are the
      consequence of age-related bone loss or osteoporosis. However, because over 90%
      of hip fractures are the result of falls, we have undertaken a falls surveillance
      study to determine if factors related to the mechanics of falling are associated
      with increased risk of hip fracture. Case subjects with hip fracture and control
      subjects without hip fracture were sampled from falls recorded at the Hebrew
      Rehabilitation Center for Aged, a chronic care facility. Fall information was
      obtained by interview of the subject and witnesses if the fall was witnessed.
      Data were analyzed by multiple logistic regression. Increased risk of hip
      fracture from a fall was associated with impacting on the hip or side of the leg
      and potential energy associated with the fall. Quetelet, or body mass index, was
      inversely related to fracture risk. The adjusted odds ratio of hip fracture for a
      fall involving impact on the hip region was 21.7 (95% confidence interval, 8.2
      58). The potential energy associated with these falls was an order of magnitude
      greater than the average energy required to fracture elderly, cadaveric, proximal
      femurs in earlier in vitro experiments. We conclude, therefore, that a fall from
      standing height should no longer be considered minimal trauma but rather trauma
      of sufficient magnitude to pose a high risk of hip fracture if impact occurs on
      the hip and if energy-absorbing processes are inadequate.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8481832
TI  - Geometric variables from DXA of the radius predict forearm fracture load in
      vitro.
AB  - The purpose of this investigation was to determine the cross-sectional geometry
      of the radius in female and male cadaveric specimens using dual-energy X-ray
      absorptiometry (DXA), to measure the accuracy of this technique compared with a
      digitizing procedure, and to measure the correlation between these DXA-based
      geometric variables and the load required to produce a forearm fracture. Paired
      intact forearms were scanned at a distal site and at a site approximately 30% of
      the forearm length from the distal end. The cross-sectional area and the moments
      of inertia of two sections at 10 and 30% of the forearm length were computed from
      the X-ray attenuation data. One member of each pair was then sectioned at the 30%
      location, which is mostly cortical bone, and the section was traced on a
      digitizing pad. The other forearm was loaded to failure in a servohydraulic
      materials test system. The DXA-based area and moment of inertia at 30% correlated
      significantly with the digitized results (r2 = 0.93 for area; r2 = 0.95 for
      moment; P < 0.001). The conventional bone mineral density from DXA did not
      associate significantly with failure load, but the minimum moment of inertia and
      the cross-sectional area at 10% correlated in a strong and significant manner
      with the forearm fracture force (r2 = 0.67 for area; r2 = 0.66 for moment; P <
      0.001). The determination of radial bone cross-sectional geometry, therefore,
      should have better discriminatory capabilities than bone mineral density in
      studies of bone fragility and fracture risk.

PMID- 8481833
TI  - Plasma levels of parathyroid hormone, vitamin D, calcitonin, and calcium in
      association with endurance exercise.
AB  - Nine male marathon runners were investigated during habitual training (week 0),
      after 3 weeks of training break (week 3), and after 2 weeks (week 5) and 4 weeks
      (week 7) of retraining. Maximal oxygen uptake, body fat (BF), and plasma levels
      of 25(OH)D3, 1,25(OH)2D3, parathyroid hormone (PTH), calcitonin (CT), albumin,
      and albumin-corrected calcium were determined throughout weeks 0-7. The maximal
      oxygen uptake decreased after training break and increased during retraining (P =
      0.002). BF did not change significantly. Plasma 1,25(OH)2D3 was elevated after
      training break and decreased after 2 and 4 weeks of retraining [week 0: 44.0 +/-
      3.7 (SEM) pg x 1(-1); week 3: 52.4 +/- 6.0 pg x 1(-1); week 5: 42.0 +/- 2.8 pg x
      1(-1); week 7: 36.9 +/- 2.3 pg x 1(-1); P = 0.03]. Plasma 25(OH)D3 did not change
      significantly. Plasma PTH increased throughout the training break and retraining
      (week 0: 1.36 +/- 0.25 pmol x 1(-1); week 3: 2.02 +/- 0.43 pmol x 1(-1); week 5:
      2.23 +/- 0.60 pmol x 1(-1); week 7: 2.63 +/- 0.34 pmol x 1(-1); P = 0.03).
      Albumin-corrected calcium values were transiently decreased during retraining
      (week 3: 2.77 +/- 0.08 mM; week 5: 2.47 +/- 0.05 mM; week 7: 2.66 +/- 0.07 mM; P
      = 0.01). Plasma CT did not change during training break, but was transiently
      decreased during retraining (week 0: 9.97 +/- 0.39 pmol x 1(-1); week 3: 9.91 +/-
      0.37 pmol x 1(-1); week 5: 8.19 +/- 0.50 pmol x 1(-1); week 7: 9.02 +/- 0.45 pmol
      x 1(-1); P = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481834
TI  - Marathon running accompanied by transient decreases in urinary calcium and serum
      osteocalcin levels.
AB  - We evaluated the effects of marathon running on bone metabolism in 23
      noncompetitive athletes (15 women, 8 men, age range 23-55 years). The volunteers
      were studied 10 days before, immediately after, and 1, 3, and 5 days after the
      run. Serum osteocalcin levels were decreased on average by 20% (from 4.9 to 3.9
      micrograms/liter, P = 0.005) in men and by 10% (from 4.9 to 4.4 micrograms/liter,
      P < 0.05) in women at the end of the marathon, with lowest osteocalcin levels (67
      55% of the prerun levels) encountered 1 day after the marathon. The activity of
      bone alkaline phosphatase was decreased in women (from 66.3 to 62.3 U/liter, P <
      0.05) after the run, and this drop was detectable at each checkup after the run.
      Urinary excretion of calcium was lowered on average by 82% in men (from 2.8 to
      0.5 mumol/minute, P < 0.05) and by 76% in women (from 2.5 to 0.6 mumol/minute, P
      < 0.005) after the run, but had already returned to prerun levels 1 day after the
      marathon. Urinary excretion of hydroxyproline tended to rise in both men and
      women, but the change did not reach statistical significance in either sex. These
      changes suggest a transient suppression in osteoblast function during the
      marathon.

PMID- 8481835
TI  - Bone mineral density in weight lifters.
AB  - The effect of intense physical training on the bone mineral content (BMC) and
      soft tissue composition, and the development of these values after cessation of
      the active career, was studied in 40 nationally or internationally ranked male
      weight lifters. Nineteen were active and 21 had retired from competition sports.
      Fifty-two age- and sex-matched nonweight lifters served as controls. The bone
      mineral density (BMD) in total body, spine, hip, and proximal tibial metaphysis
      was measured with a Lunar Dual-energy X-ray absorptiometry (DXA) apparatus and
      the BMD of the distal forearm was measured with single photon absorptiometry
      (SPA). Seventeen of the lifters had been measured earlier with SPA in the forearm
      and 23 in the tibial condyle during their active career in 1975. The BMD was
      significantly higher in the weight lifters compared with the controls (10% in the
      total body P < 0.001, 12% in the trochanteric region P < 0.001, and 13% in the
      lumbar spine P < 0.001). All measured regions except the head showed significant
      higher bone mass in the weight lifters compared with the controls. In older
      lifters, the difference from the controls seemed to increase in total body and
      lumbar vertebrae (BMD), but remained unchanged in the hip. Significant
      correlation was found between the SPA measurements in 1975 and the corresponding
      measurements 15 years later in both the forearm (r = 0.51, P < 0.05 at the 1-cm
      level and r = 0.87, P < 0.001 at the 6-cm level) and in the tibial condyle (r =
      0.61, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481836
TI  - Growth hormone involvement in the regulation of tartrate-resistant acid
      phosphatase-positive cells that are active in cartilage and bone resorption.
AB  - Young male Sprague-Dawley rats (5-7 weeks old, 80-120 g) were hypophysectomized
      (HX) and maintained on thyroxin and dexamethasone replacement therapies. Ten days
      after surgery, some HX rats received a single injection of human growth hormone
      (hGH), and others five daily injections of hGH. Tartrate-resistant acid
      phosphatase (TRAP) histochemistry was employed in order to evaluate the number of
      cells of resorptive potential in the metaphyseal bone of the proximal tibiae of
      HX rats and was compared with normal rats and HX rats that further received hGH
      replacement therapy. In normal rats, two populations of TRAP-positive cells were
      identified: multinuclear cells, which showed histological characteristics of
      osteoclasts, and small mononuclear cells, the number of which was overwhelming
      when compared with the number of TRAP-positive multinuclear cells. Both
      populations were reduced in the HX rat, but more so the mononuclear cells, which
      were assumed to represent the precursor pool of mature osteoclasts and
      chondroclasts (P < 0.005). Five daily injections of hGH to HX rats brought about
      a significant increase in the number of TRAP-positive multinuclear cells, the
      number of nuclei of these cells, and the number of mononuclear TRAP-positive
      cells, throughout the metaphyseal bone (P < 0.05). A single injection of hGH
      increased only the number of TRAP-positive multinuclear cells in the
      trabecula/bone marrow interface (P < 0.05), indicating a very rapid fusion of
      precursor cells into mature osteoclasts in that particular location.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8481837
TI  - Proliferative responses to estradiol, IL-1 alpha and TGF beta by cells expressing
      alkaline phosphatase in human osteoblast-like cell cultures.
AB  - The use of primary (nontransformed) bone cell cultures is hampered by their
      cellular heterogeneity. Primary cultures of osteoblast-like cells have been shown
      to proliferate in response to several osteotropic agents, but because mixed cell
      populations are present it is uncertain whether a true osteoblastic response was
      observed. By combining (1) localization of [3H]-thymidine incorporation into the
      nuclei of actively dividing cells by autoradiography with (2) subsequent
      induction of osteoblast differentiation by 1,25(OH)2D3 to optimize the number of
      cells expressing high alkaline phosphatase activity and (3) its localization by
      histochemical staining, it is possible to measure the proliferation of cells that
      are capable of expressing a more mature osteoblastic phenotype in heterogeneous
      human trabecular bone cell cultures. Over a 72-hour incubation period, rhIL-1
      alpha (0.2-2 ng/ml) exerted a dose-dependent stimulation of proliferation of
      cells expressing alkaline phosphatase. Purified human TGF beta 1 produced a
      biphasic increase in the proliferation of these cells (0.01-1 ng/ml) but 17 beta
      and 17 alpha-estradiol (10(-12)-10(-8) M) failed to consistently regulate cell
      growth. Furthermore, 17 beta-estradiol did not reproducibly modulate
      proliferation induced by IL-1 alpha or TGF beta when added together in cultures.
      This procedure represents a more accurate method for the assessment of osteoblast
      proliferation in primary bone cell cultures and demonstrates that estrogen is not
      mitogenic for human osteoblasts and does not potentiate the actions of putative
      local stimulators of osteoblast replication.

PMID- 8481838
TI  - Effect of treadmill exercise on vertebral and tibial bone mineral content and
      bone mineral density in the aged adult rat: determined by dual energy X-ray
      absorptiometry.
AB  - Dual energy X-ray absorptiometry (DXA; Hologic QDR-1000W) in an ultrahigh
      resolution mode, was used to examine the changes in tibial/fibula and vertebral
      L4 + L5 bone mineral content (BMC) and bone mineral density (BMD) in each 14
      month-old female rat at 0, 9, and 16 weeks of study. Twenty rats were randomized
      by a stratified weight method into two groups, control and exercised. Exercise
      consisted of running on a flat-bed treadmill, 17 m/minute, 1 hour/day and 5
      days/week. As compared with the control group, a significant increase in
      tibia/fibula BMC and vertebral BMD was apparent at 9 weeks after exercise
      training (P = 0.014 by 2-way analysis of variance). The slope of the gain of the
      tibia/fibula BMC and BMD by 16 weeks of training was ninefold and fivefold higher
      than that of the control group (P < 0.01 and P < 0.05, respectively, by Mann
      Whitney test). The correlation coefficient (r) between the final dry weight of
      excised bone and the final BMC of the intact rat was 0.843 and 0.71 for
      tibia/fibula and vertebrae, respectively. In summary, we found that in the aged
      rat, by 9 weeks, exercise increases BMC and BMD in the tibia, whereas in the
      vertebrae, only increases in the BMD were found. This study demonstrates that
      this precise and accurate DXA technique is useful in a longitudinal study of in
      vivo bone mineral changes in the rat over time by taking into account the
      individual variation between animals as well as changes between groups.

PMID- 8481839
TI  - Effects of two non-endurance exercise protocols on established bone loss in
      ovariectomized adult rats.
AB  - The effects of non-endurance exercise on bone properties were evaluated in 9
      month-old sham-operated (SH) and ovariectomized (OVX) rats. The studies were
      started 3 months postsurgery, after bone mass was decreased in OVX rats. The sham
      and OVX rats were either kept sedentary (SED) or were trained to run with one of
      two protocols: 12 m/minute, 50 minutes/day, 4 days/week (low intensity, frequent,
      EX-1); or 21 m/minute, 40 minutes/day, 1 day/week (moderate intensity,
      infrequent, EX-2). A group of seven rats evaluated at the beginning of the study
      served as baseline control. The bone mineral was assessed by the ash weight of
      the left femur, tibia, and 4th lumbar vertebra. Biomechanical (strength,
      deformation, stress, strain, and stiffness) and morphometric (length, cortical
      and medullary area, moment of inertia) properties were evaluated for the right
      femur. There was a significantly lower bone mineral and mechanical properties in
      OVX-SED (n = 7) than in SH-SED (n = 10) rats. The OVX-EX-1 (n = 6) rats had
      higher ash content of femur and tibia than OVX-SED rats, but the change was
      significant only for tibia. The EX-2 had no effect on the ash content, but femur
      stress was higher in OVX-EX-2 (n = 8) than in OVX-SED rats. The femur yield force
      and deformation were improved in OVX rats with both exercise protocols, whereas
      the vertebra ash weight, femur strain, modulus of elasticity, length, cortical
      area, and moment of inertia were not changed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481840
TI  - Material damping for monitoring of density and strength of bones.
AB  - The aim of this work was a preliminary assessment of the feasibility of using in
      vivo measurements of mechanical properties of bones to detect mineral loss and
      further to relate them to the tendency of the bone to fracture in the case of
      loss of minerals, such as in osteoporosis. Previous studies of bone strength in
      vitro have demonstrated that the decrease in bone strength in both the spine and
      the femur has strong correlation with the mineral content (BMC) measured with
      bone densitometry. It was demonstrated that loss of mineral in the bone is
      accompanied by substantial change of the main mechanical properties, decrease of
      the Young's modulus, and increase of the damping factor. The change in those
      properties is one order of magnitude greater than the change in bone density.
      Moreover, increase of bone density, by way of training, resulted in decrease of
      the damping factor that also was substantially greater than the change in
      density. The tests showed clearly that the change in mechanical properties was
      much greater than the change in bone mass density. This offers an attractive new
      alternative to the detection of bone mass loss as it appears that the change of
      the bone mass is well correlated to the change in these mechanical properties. In
      particular, the change in the damping factor of the material was found to be much
      more substantial than the bone density change. Therefore, the damping mechanism
      offers the vehicle for a direct assessment of the bone tendency to fracture due
      to the loss of mass, as tendency to fracture and mass loss are known to be
      related.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481841
TI  - Aminoalkylbisphosphonates, potent inhibitors of bone resorption, induce a
      prolonged stimulation of histamine synthesis and increase macrophages,
      granulocytes, and osteoclasts in vivo.
AB  - Aminoalkyl derivatives of bisphosphonates are potent inhibitors of bone
      resorption. A single I.P. injection of 4-amino-1-hydroxybutylidene-1,1-bis
      phosphonate (AHBuBP) induced a prolonged enhancement of histidine decarboxylase
      (HDC) activity in the bone marrow, spleen, lung, and liver of mice and resulted
      in an increase in histamine. The induction of HDC by the agent was dose dependent
      (16-80 mumol/kg) and peaked 3-4 days after its injection (40 mumol/kg). Repeated
      S.C. injections of smaller doses of AHBuBP (0.32 or 1.6 mumol/kg/day) for 4 days
      also enhanced HDC activity. However, the minimum dose capable of inhibiting bone
      resorption (0.064 mumol/kg/day) was lower than that inducing HDC. Unexpectedly,
      AHBuBP, at the doses inducing HDC, increased macrophages, granulocytes, and even
      osteoclasts. The size of osteoclasts was also enlarged by the agent. Another
      aminobisphosphonate, 3-amino-1-hydroxypropylidene-1,1-bisphosphonate, but none of
      non-amino derivatives, also exhibited essentially the same effects as those of
      AHBuBP. These results indicate that in spite of increase in osteoclasts and their
      enlargement, bone resorption is still inhibited by amino bisphosphonates. As
      granulocyte and granulocyte-macrophage colony-stimulating factors and interleukin
      3 induce HDC in hematopoietic organs, and histamine has a hematopoietic activity,
      the HDC induction by aminobisphosphonates may be relevant to the proliferation of
      progenitor cells of macrophages, granulocytes, and osteoclasts.

PMID- 8481842
TI  - Effect of 24R,25-dihydroxyvitamin D3 on the formation and function of
      osteoclastic cells.
AB  - Previous reports demonstrated that the administration of large doses of 24R,25
      dihydroxyvitamin D3 [24R,25(OH)2D3] to animals with normal vitamin D supply
      causes an increase in bone volume with reduced bone resorption and decreased
      osteoclast number. The present study was undertaken to clarify if 24R,25(OH)2D3
      has any inhibitor effect on the formation and function of osteoclasts. The effect
      of 24R,25(OH)2D3 on the formation of osteoclastic cells was examined by measuring
      the number of tartrate-resistant acid phosphatase-positive multinucleated cells
      (MNCs) formed from hemopoietic progenitor cells obtained from spleens of 5
      fluorouracil-treated mice. Treatment with 1,25(OH)2D3 or parathyroid hormone
      fragment 1-34 [PTH(1-34)] stimulated osteoclast-like MNC formation in a dose
      dependent manner. Addition of 24R,25(OH)2D3 alone showed a weak stimulatory
      effect on MNC formation at 10(-6) M, which appeared to be due to its binding to
      1,25(OH)2D3 receptors. In contrast, when 24R,25(OH)2D3 was added together with
      1,25(OH)2D3 or PTH(1-34), it inhibited osteoclast-like MNC formation stimulated
      by these hormones. A significant inhibition of MNC formation was observed with
      10(-7) M 24R,25(OH)2D3, and the stimulatory effect of 1,25(OH)2D3 or PTH(1-34)
      was almost completely eliminated with 10(-6) M 24R,25(OH)2D3. Neither
      24S,25(OH)2D3 nor 25(OH)D3 exhibited a similar inhibitory effect. The effect of
      24R,25(OH)2D3 on the resorptive function of osteoclasts was examined by measuring
      the formation of resorption pits by mouse bone cells on dentine slices. Treatment
      with 24R,25(OH)2D3 also inhibited the resorption pit formation stimulated by
      1,25(OH)2D3 or PTH(1-34) with similar dose response.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8481843
TI  - Detection of renal allograft dysfunction with color Doppler flow ultrasound.
AB  - Thirty-six color Doppler flow (CDF) ultrasound studies were performed on 28
      allograft kidneys to assess the capability of this technique in diagnosing
      transplant dysfunction through morphology and Doppler spectra. The composite
      score obtained from ultrasound images showed no statistical significance.
      Quantitative studies with Pulsatility Index (PI) and Resistive Index (RI) after
      localization of the arcuate, interlobar, segmental and main renal arteries by CDF
      revealed significant differences between normal functioning graft kidneys and the
      group of acute rejection, as well as the group of acute tubular necrosis (ATN) (P
      < 0.05). No apparent change was demonstrated in patients with chronic rejection.
      When PI was greater than 1.60 or RI was greater than 0.80, the transplant kidney
      was more likely to be rejected, though possibility of ATN should be considered.
      RI was easier to calculate, and correlated better than PI with the serum
      creatinine level. CDF expedited the Doppler spectrum study.

PMID- 8481844
TI  - Acute acalculous cholecystitis.
AB  - To demonstrate the importance of early detection and diagnosis of acute
      acalculous cholecystitis, 34 patients with this disease, were studied
      retrospectively. Twenty patients had a delay between the onset of symptoms and
      operative intervention, exceeding 48 hours; five of them were found to have a
      perforated gallbladder during operation; however, no such complication was
      encountered in the 14 patients who underwent surgical treatment within 48 hours
      of onset. Sixteen patients had post-operative complications, and four patients
      who died produced in a mortality rate 11% (4/34). Three mortality cases had
      coexisting cardiovascular disease and the operation was also delayed for more
      than 48 hours.

PMID- 8481845
TI  - Bacteriology of necrotizing fasciitis: a review of 58 cases.
AB  - Necrotizing fasciitis is a relatively rare soft tissue infection that is
      characterized by rapidly widespread necrosis of the fascia and subcutaneous
      tissue. Fifty-eight cases were reviewed over a 5.5-year period. The majority of
      wound cultures were polymicrobial and single culture rate was 18.6%. The
      facultative organisms were most frequently recovered. The most frequently
      discovered bacteria were E. coli, Proteus mirabilis, Klebsiella pneumoniae,
      Staphylococcus aureus and group D enterococcus. The overall mortality rate was
      48.3%. Early recognition, serial radical surgical debridement and strong and
      appropriate antibiotics were essential for survival.

PMID- 8481846
TI  - [Ventilation tube insertion for treating adult otitis media with effusion].
AB  - The etiologic factors and treatment of otitis media with effusion (OME) in
      children are well described and established. On the contrary, little has been
      published with regard to OME in adults and its treatment. To further investigate
      this problem, we reviewed the records of all adult patients who had received
      ventilation tube (VT) insertion for OME in VGH-Taipei from 1983 to 1986. There
      were 335 VT insertions performed on 140 adult patients whose follow-up periods
      were longer than 6 months. Among them, fifty patients received more than one VT
      insertion due to recurrence of OME in one or both ears. The average follow-up
      period was more than 4 years. The coexistence of nasal diseases was found in 46%
      of the adult OME patients. The mean extrusion time of the VT was 10.2 months.
      After VT insertions, the improvements of mean air conduction and mean air-bone
      conduction gap were 10.1 and 11.8 dB respectively. After the extrusion or removal
      of VT, there was no recurrence of OME in 50 ears (14.9%). Recurrence of OME
      occurred in 199 ears (59.4%). Dry persistent perforations of the eardrums were
      found in 27 ears (8.1%). Discharging persistent perforations were noted in 24
      ears (7.2%). No recurrence of OME was observed in 24.2% of the ears with serous
      effusion fluids, whereas only 4.8% of the ears with mucoid fluids were free from
      recurrence during the follow-up period. Post-intubation otorrhea, which was the
      most common complication, developed in 92 ears (27.5%). Our results suggest that
      the recurrence rate of OME after extrusion of VT is high in the adult
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481847
TI  - [Analysis of malignancy of human brain glioma with silver colloid-staining
      technique].
AB  - The nucleolar organizer regions are loops of DNA that exist in cellular nucleolus
      and possess ribosomal ribonucleic acid genes. Ribonucleic acid polymerase I acts
      on these areas. This experience collects 52 primary human gliomas at TSGH from
      1984 to 1989. These included 23 astrocytomas, 8 anaplastic astrocytomas and 21
      glioblastoma multiforms. After thin cutting on slides and deparaffinizing, we
      stained each by the silver colloid technique. We counted the total quantity of Ag
      NOR dots of over 400 tumor cells of each case and average of Ag-NOR dots per cell
      (+/- standard error of the mean) with X1000 oil lens. The results are 1.68 +/-
      0.05, 2.00 +/- 0.10; 2.55 +/- 0.13 respectively, showing significant differences
      among these. The average Ag-NOR paralleled the degree of histopathological
      malignancy. With the average Ag-NOR of tumor cells to predict the patients
      prognosis, we found that the group containing patients with less than 2.00 Ag-NOR
      per cell had better prognosis than the group with 2.00 Ag-NOR or more. The silver
      colloid-staining technique is a simple, rapid and reproducible method to evaluate
      the malignancy of human brain gliomas and to estimate the long-term prognosis of
      patients.

PMID- 8481848
TI  - [Psychogenic dizziness].
AB  - Psychogenic dizziness is defined as recurring or persistent symptoms of balance
      dysfunction, inconsistent with organic vestibular disease as determined by
      history, clinical examination and pertinent investigations, and consistent with
      emotional origin. Of 1,335 patients seen in our dizziness clinic between January
      1988 and August 1991, psychogenic dizziness was diagnosed in 180 (13.5%)
      patients. There were 67 men and 113 women aged from 12 to 77 years (mean age 40.2
      years). The characteristics of psychogenic dizziness are: (1) continuous
      dizziness for long periods of time; (2) younger patients; (3) predominant female;
      (4) associated symptoms of panic attack, such as headache, breathlessness,
      nausea, sleep disturbance, paresthesias, anxiety and palpitation; (5) symptoms of
      aggravation due to stressful life events; (6) normal neurotological bedside
      examination; (7) hyperventilation reproduced accurately. The
      electronystagmographic results of 74 patients show normal bithermal caloric
      responses in 47 patients (63.5%), caloric hyperactivity in 21 patients (28.4%),
      canal paresis in four patients (5.4%), canal paresis with directional
      preponderance in two patients (2.7%), large random voluntary eye swings or severe
      blinking in 35 patients (47.3%), and spontaneous nystagmus (slow phase velocity <
      6.5 degrees/s) in four patients (5.4%). There were 31 patients who consulted
      psychiatrists with diagnoses of anxiety (51.6%), depression (16.1%), insomnia
      (12.9%), psychosomatic disorder and adjustment disorder. Treatment of patients
      with psychogenic dizziness must be directed at the underlying anxiety.
      Psychiatric consultation is necessary.

PMID- 8481849
TI  - [A responses to Ko's mental health questionnaire by patients with peptic ulcer
      disease].
AB  - The author conducted a study of personality characteristics using Ko's mental
      health questionnaire (KMHQ) on 279 patients who received upper gastrointestinal
      endoscopic examination at the Taichung Veterans General Hospital during the three
      months from May 12 to August 11, 1983. Those patients, 203 men and 76 women,
      voluntarily entered the study. Forty-four patients were randomly selected to
      receive the same KMHQ again 18-21 months later. The 13 subscales of the KMHQ were
      confirmed to have a good value of the test-retest reliability (r = 0.419 to
      0.796, p < 0.001). Based on the findings of endoscopic examination, 279 patients
      were divided into two groups: the experimental group of 104 patients (those with
      gastric ulcer, duodenal ulcer and mixed abnormal findings) and the control group
      of 175 patients (those with normal findings, superficial gastritis and
      duodenitis). A comparison of the 13 subscales of the KMHQ between these two
      groups of patients revealed no significant differences in the mean scores except
      that a greater obsessionality index (scale VII) was seen in the experimental
      group than in the control group (t = 2.35, p < 0.05). In conclusion, peptic ulcer
      patients with positive endoscopic findings have the characteristic of significant
      greater obsessionality according to KMHQ.

PMID- 8481850
TI  - One-stage operation for bilateral spontaneous pneumothorax using imaged
      thoracoscopic technique: case report.
AB  - Bilateral apical bullae have previously been approached by staged or one-staged
      bilateral thoracotomy. In a 26-year-old male with bilateral primary spontaneous
      pneumothorax, bilateral apical bullae were successfully removed with thorough
      pleural abrasion using imaged thoracoscopic surgery in one operation.
      Postoperative pain was markedly reduced, pulmonary toilet was easily accomplished
      and cosmetic appearance of the scar satisfactory. Bilateral bullectomy and
      pleurodesis using imaged thoracoscopic surgery can, therefore, provide a simpler
      and safer option for bilateral pneumothorax.

PMID- 8481851
TI  - Triplet pregnancy in premature ovarian failure after oocyte donation and in vitro
      fertilization: a case report and review of literature.
AB  - Oocyte donation in premature ovarian failure patients has become an extended
      indication for In Vitro Fertilization (IVF) procedure. Here the first case report
      is presented in Taiwan, R.O.C. of a triplet pregnancy in a patient with premature
      ovarian failure. After an adequate hormonal replacement therapy with oral
      premarin and intramuscular progesterone for endometrium preparation, the transfer
      on D15 of four embryos (with donated oocytes and IVF) resulted in implantation of
      three. Pregnancy support was provided also by oral premarin and intramuscular
      progesterone until the tenth week of gestational age (GA). The patient received
      Caesarean section at 35 weeks GA with delivery of three healthy babies weighing
      2530 gm, 2420 gm, and 1810 gm respectively on Aug. 17, 1990.

PMID- 8481852
TI  - [Twin pregnancy complicated by single intrauterine death. Report of six cases and
      literature review].
AB  - From 1982 to 1991, six twin pregnancies, in which one of the fetuses died in
      utero, have been encountered. The causes of antepartum death in twin gestation
      could be identified in four cases; one with abruptio placenta, one with twin-to
      twin transfusion syndrome, one with twisting of cord and one with velamentous
      insertion of cord. All six surviving infants had no abnormality in the follow-up
      of two to seven years. Although a conclusion about the prognosis could not be
      drawn from such a small series, these good results may have resulted from 1) 2
      cases having been dichorionic twins, and 2) the other 4 monochorionic twins of 31
      36 gestation weeks were delivered 1 to 5 days after the diagnosis. Conservative
      treatment was usually suggested until the fetal lung was mature enough for
      induction of labor. One case was treated after the death of its counterpart with
      tocolytic agent for a further 15 days because of prematurity. Cesarean section
      was performed finally for fetal distress resulting from chronic abruption
      placenta. The other five cases were delivered through vaginal route. According to
      experience as well as literature review, to improve the prognosis, obstetricians
      should be familiar with the management of one fetal death in twin pregnancy,
      especially in those with monchorionic twins.

PMID- 8481853
TI  - [Cantrell's pentalogy: a case report].
AB  - Cantrell's pentalogy is a congenital anomaly resulting from embryologic
      development defect. The anomalies observed in this disorder were: (1) a midline,
      supraumbilical abdominal wall defect, (2) a defect of the lower sternum, (3) a
      deficiency of the anterior diaphragm, (4) a defect in the diaphragmatic
      pericardium, (5) congenital intracardiac defects. Its occurrence in the newborn
      is quite uncommon, though it was first described by Cantrell and his colleagues
      in 1958. A one-day-old male fullterm newborn was presented. Omphalocele and
      partial ectopia cordis were noted immediately after birth. Echocardiogram
      revealed tetralogy of Fallot with atrium septal defect. Operative findings were
      sternal cleft, pericardial defect and ventral diaphragmatic defect. The
      literature on clinical manifestations, embryogenic defect and management of
      Cantrell's pentalogy is reviewed briefly.

PMID- 8481854
TI  - [Maturation of ganglioneuroblastoma to ganglioneuroma: a case report].
AB  - A 1 year and 7 months old girl had suffered from chronic diarrhea for 6 weeks. A
      huge abdominal mass was found. She received subtotal resection of the tumor and
      the histological picture showed ganglioneuroblastoma. Then, 12 courses of
      chemotherapy (including cyclophosphamide, doxorubicin cisplatin and etoposide)
      were given for 8 months, but the residual tumor mass over the previous surgical
      area was still noted by CT scan. A second excision of the tumor was performed and
      histology showed a picture of ganglioneuroma incidentally. Chemotherapy was
      discontinued. The patient is still alive and well for more than one year.

PMID- 8481855
TI  - [Acute amphetamine intoxication with catatonia: a case report].
AB  - A marked increase of cases of amphetamine intoxication has been witnessed in
      Taiwan over the past two years, and poisoning accounts for the direct cause of
      death in some cases of them. We report a case of 30-year-old woman, who developed
      immobility, rigidity, mutism and staring after the intake of four grams of
      amphetamine powder. She initially had generalized twitching, but finally came to
      a state of total immobility. One hour after admission, apnea and cyanosis
      occurred suddenly and she died about half an hour later. Chronic amphetamine
      intoxication with catatonia has been reported in Japan, but acute amphetamine
      intoxication with catatonia has never been reported in the literature. In this
      report, we explore the possible mechanisms of catatonia in amphetamine
      intoxication and its clinical significance. Catatonia is supposed to be one of
      the poor prognostic signs of acute amphetamine intoxication that requires
      intensive care.

PMID- 8481856
TI  - The advocacy role of the perioperative nurse.

PMID- 8481857
TI  - Endoscopic surgery--scope vs scapel.

PMID- 8481858
TI  - The joys of initiating laparoscopic surgery in a small rural hospital.

PMID- 8481860
TI  - AIDS and health promotion.

PMID- 8481859
TI  - Perioperative care of the neonate.
AB  - The neonate is a unique individual with his/her own needs. This article deals
      with the adjustments the neonate has to make to extrauterine life; some of the
      differences between neonates and older children and adults, and the special needs
      of the neonate who needs surgery.

PMID- 8481861
TI  - AIDS and human sexuality.
AB  - The sexual behaviours placing an individual at risk for HIV infection are those
      also placing him/her at risk for gonorrhoea, syphilis, hepatitis B, chlamydia and
      unplanned pregnancy. This article proposes that approaches to HIV prevention must
      be included within a broad context of human sexuality. To address disease
      prevention in the absence of including people's relationships, social,
      behavioural and emotional needs is futile. Compartmentalization, denial of risk
      by various populations, and societal barriers are all factors to be overcome in
      the fight against HIV transmission. Specific strategies involved in a
      comprehensive approach are outlined under the categories of predisposing,
      enabling and reinforcing factors contributing to healthy sexual behaviour.

PMID- 8481862
TI  - HIV/AIDS education participation by the African community.
AB  - Africans United to Control AIDS, an HIV/AIDS community-based programme, is
      described. The project goal is to increase HIV/AIDS awareness among the African
      community in Metropolitan Toronto within a culturally appropriate context. A
      brief overview of African immigration to Canada is presented. Community
      participation, programme activities, outreach strategies and education sessions
      are discussed. Outreach strategies include the development of education materials
      and media contacts. The section on education sessions includes the preparation,
      delivery and evaluation of these sessions, and subjects such as misconceptions,
      marriage, sexuality, confidentiality, basic HIV/AIDS information, condoms,
      homophobia, use of videos. Success, failures, barriers to HIV/AIDS education and
      overcoming these barriers are discussed throughout this article.

PMID- 8481863
TI  - Grade 6 students benefit from Learning About AIDS.
AB  - The purpose of this study was to assess the impact of an educational program,
      Learning About AIDS, on Grade 6 students' knowledge of HIV/AIDS and attitudes
      towards persons living with AIDS(PLWAs). A pretest/post-test/follow-up comparison
      group design was utilized to evaluate this intervention. Findings indicated that
      Grade 6 students who received Learning About AIDS were significantly more
      knowledgeable about HIV/AIDS at post-test and follow-up than were comparison
      group students. As well, the treatment group students' attitudes toward PLWAs
      were significantly more positive than those of the comparison group at both post
      test and follow-up. It was concluded that Learning About AIDS was a beneficial
      and worthwhile program for these Grade 6 students.

PMID- 8481864
TI  - [Women, AIDS and sexually transmitted diseases: strategies of action for
      prevention and education].
AB  - AIDS and STDs are major health problems among Canadian women. The prevention of
      HIV and STD transmission will possibly be more effective if certain factors
      pertaining to social status and affecting behaviour patterns are understood and
      taken into account. The Ottawa Charter can be used as a reference in designing
      prevention and education programs.

PMID- 8481865
TI  - AIDS education from a front line worker's perspective.

PMID- 8481866
TI  - The epidemiology of HIV and AIDS in Canada: current perspectives and future
      needs.
AB  - There is little doubt the HIV epidemic is of enormous public health importance
      for Canadians. Currently, it is estimated that between one and two in 1,000 adult
      Canadians are infected with HIV. Compared to other industrialized countries,
      Canada is a country of intermediate incidence. Much effort has gone into
      developing and maintaining the AIDS surveillance system as well as carrying out
      HIV seroprevalence studies in selected populations. In spite of under-reporting
      of AIDS cases (estimated to be 12-25%), the available data provide a general
      picture of the HIV epidemic in Canada. Nevertheless, a number of questions remain
      unanswered, and we need more information to plan preventive interventions and
      provide services to persons who are already infected. In this article, we present
      a brief overview of the epidemiology of AIDS and HIV in Canada. We identify some
      disturbing trends in the epidemic and reiterate the need for more information to
      improve our preventive efforts and help set research priorities to help plan
      future studies.

PMID- 8481867
TI  - AIDS prevention programs in a smaller community.
AB  - This paper discusses the development and implementation of an AIDS prevention
      program in a non-urban area. A non-urban area provides challenges, issues and
      barriers not found in a large urban area. Characteristics of smaller centre
      residents, their attitudes and values will shape their response to HIV/AIDS
      issues. To facilitate HIV service delivery and program implementation, a variety
      of strategies to facilitate "ownership" are required to create a supportive,
      caring environment for families affected or infected by AIDS within small
      community settings.

PMID- 8481868
TI  - [Quebec after a decade of epidemic HIV infection: what is the status of
      interventions in health promotion?].
AB  - Quebec has the highest rate in Canada of AIDS among injection drug users (IDU),
      women and individuals originating from Model II countries. Long-term prevention
      of HIV transmission in Quebec calls for intervention measures (individual risk
      reduction) as well as the implementation of health promotion strategies. A
      rigorous conceptual framework like the Ottawa Charter for Health Promotion allows
      us to better identify relevant measures to be developed in order to curb the HIV
      epidemic in the province of Quebec.

PMID- 8481869
TI  - AIDS and the aboriginal community.
AB  - A concise portrait of HIV and AIDS within the Aboriginal community is difficult
      to present. Just as there are different customs and traditions among tribes, so
      are there different ways by which this issue is being addressed. The response to
      HIV/AIDS in the Aboriginal community is the process of moving from an individual
      or personal perspective to an immediate and extended family approach through the
      community, nation or society, and finally to the greater picture, Mother Earth.
      We don't necessarily move through in this order, rather we go back and forth as
      the need arises. When we deal with HIV or AIDS, it is important to view how this
      will affect our whole life: physical, mental, emotional and spiritual aspects of
      ourselves as well as financial, psychosocial and other dimensions. The teachings
      and study of children, youth, adults and elders are also discussed. We recognize
      the work we do in this area now will be a tool for survival in the future.

PMID- 8481870
TI  - HIV/AIDS implications for the social service sector.
AB  - This paper examines the response of the social service sector to the HIV/AIDS
      crisis in Canada. Examples of innovative projects and programs are provided and
      the challenges of responding to needs in rural and remote settings and special
      populations are explored. The importance of forging effective partnerships
      between social service professionals and community-based agencies is highlighted
      and the need for the social service infrastructure to adapt to the highly
      variable needs of PLWAs is highlighted.

PMID- 8481871
TI  - Health promotion and AIDS prevention.

PMID- 8481872
TI  - Shooting off fireworks: the successes and failures of an intensive, broad-based
      AIDS awareness campaign.
AB  - Broad-based AIDS awareness campaigns often involve media advertisements, posters
      and/or pamphlets intended to address a specific concern related to HIV/AIDS. They
      focus on safer sex, prevention for young adults, women's issues in relation to
      HIV, etc. During the autumn of 1991 a group of Manitoba AIDS organizations came
      together to organize, promote and deliver an eight-week AIDS Awareness Campaign
      that would address a broad spectrum of HIV/AIDS-related issues. Instead of
      attempting to solidify one prevention message, this campaign attempted to satisfy
      a variety of organizational agendas. Although it achieved its goals and was a
      very visible, but short-lived exercise in AIDS awareness, this campaign proved to
      be taxing on local community-based resources.

PMID- 8481873
TI  - Making HIV prevention work in the north.
AB  - Meeting the challenges of diverse cultures, numerous languages and great
      distances, the Northwest Territories discovered innovative ways to promote AIDS
      prevention. This article discusses obstacles to HIV prevention and techniques
      used to overcome them commonly found in health services for the NWT. For example,
      techniques for improved service delivery include reliance on decentralized
      services provided by regional health boards and Community Health Representatives.
      Further, the challenges posed by language diversity and cultural taboos against
      speaking openly about sexual matters have been partially overcome through the
      conversion of materials and concepts into aboriginal languages which are
      culturally appropriate. The article specifically discusses two AIDS education
      campaigns in which these techniques were utilized: namely, Health is a Community
      Affair Campaign (or the Door-to-Door Project) and local initiatives which hosted
      presentations by an Aboriginal person living with AIDS.

PMID- 8481874
TI  - Strategic planning for AIDS prevention--city of Toronto's experience.
AB  - This paper chronicles the planning process for the City of Toronto Department of
      Public Health's HIV/AIDS Prevention Program for 1991/1992. The process benefited
      from extensive consultation and input from Department staff, community
      representatives and the local Board of Health. A discussion of various questions
      that arise when planning a multifaceted program as well as practical suggestions
      are offered. The paper is written in the form of a letter to an incoming program
      coordinator.

PMID- 8481875
TI  - A health department's response to AIDS. Condomania: a public education
      intervention.
AB  - Experience gleaned from no smoking campaigns, seatbelt safety crusades, dental
      hygiene programs and other health promotion efforts, have pointed to the
      usefulness of social marketing principles in formulating and implementing broad
      based behaviour change programs. Using social marketing as a tool of health
      promotion, the Vancouver Health Department, in cooperation with the Vancouver
      Women and AIDS Project and the Positive Women's Support Network, implemented a
      three-year plan for six one-month condom awareness campaigns. Two of these
      campaigns have been successfully completed; the third is in the planning stage.
      The purpose of these campaigns is to make condoms a more acceptable feature of
      everyday sexual activity with 19-30 year-olds; women in particular have been
      targeted because of the increasing incidence of HIV among this population. The
      program consists of six major components. They are: design and production of
      campaign materials; public promotion-advertising; focused community education;
      volunteer recruitment and training; media relations; and program evaluation.

PMID- 8481876
TI  - Causal evaluation of impact of support workshop for HIV+ men.
AB  - A program logic model was used to design and evaluate a support workshop for men
      infected with HIV. The model identified three proximal outcomes leading to the
      ultimate goal of motivating participants to initiate ongoing support
      relationships. Path analysis was used to evaluate the workshop. The findings
      indicated the most important motivator to initiating ongoing support was the
      awareness among participants of the need to talk about their HIV status and risk
      of transmission and their feeling capable to do so. The proximal outcomes which
      contributed to this impact were: recognition of their own needs from listening to
      testimonials by others, developing awareness and skills by engaging in role
      plays, and learning options for discussion by participating in a sexual issues
      group. The workshop findings demonstrated the benefits of developing a pre
      program logic model and using causal evaluation to understand factors determining
      impact.

PMID- 8481877
TI  - A framework for health promotion ... a framework for AIDS.
AB  - During the 1980s, many AIDS prevention programs and interventions were
      established. However, program planning was often done with little consideration
      of the theoretical models useful for implementing successful interventions. In
      order to refine our AIDS prevention work in the future, it is necessary to look
      at theoretical frameworks to ensure we are designing and implementing effective
      and efficient AIDS prevention programs. It is suggested in this article that the
      health promotion framework is uniquely suited to AIDS prevention work. Challenges
      involved in the application of this framework are considered. Specific health
      promotion strategies such as community development, mutual aid, public policy and
      strengthening community health services are examined. The author concludes that
      health promotion is an effective model to address a comprehensive, coordinated,
      ethical response to HIV/AIDS prevention in Canada.

PMID- 8481878
TI  - Vascular evaluation.
AB  - This article details a variety of tests to detect venous insufficiency in the
      lower extremities, including palpation, stress testing, thermometry,
      thermography, segmental systolic pressures, Doppler studies, and plethysmography.

PMID- 8481879
TI  - Common peripheral vascular diseases.
AB  - Among the most common causes of morbidity and mortality in elderly individuals
      are the manifestations of the various peripheral vascular diseases. Many chronic
      degenerative diseases, which begin in middle age, are associated with peripheral
      vascular disease. Heart disease, hypertension, hyperlipidemia and diabetes are
      all risk factors for peripheral vascular diseases and also common degenerative
      conditions in our society. Other risk factors, such as diet, smoking, stress,
      lack of exercise, and obesity, are also closely associated with peripheral
      vascular disease. Aging itself is also a risk factor. Appropriate treatment for
      disease processes such as diabetes and hypertension and control of other
      preventable risk factors have been shown to reduce the morbidity and mortality
      seen in peripheral vascular disorders. Our rapidly aging population requires
      increasing amounts of medical resources, placing an enormous burden on society
      because the aged population are generally more dependent upon government
      sponsored health care services. The podiatric practitioner is in a position as a
      primary care provider to influence the health practices of our aging population.
      The implementation of a health practice that stresses prevention and wellness as
      well as the appropriate management and a referral of patients with peripheral
      vascular disorders will limit the morbid results of peripheral vascular diseases.

PMID- 8481880
TI  - Pharmacologic considerations in the geriatric patient.
AB  - A physician has the primary responsibility of first causing no harm.
      Unfortunately, the myriad of pharmacologic agents available to the clinician at
      times may make this directive difficult. When the variable of age-related changes
      is introduced, the clinician's task may seem almost impossible. The most
      important aspect of gerontology is that there are no constants. Age-related
      changes are inconsistent. Although liver function may vary little among the
      general population, virtually every other system is affected by the aging
      process. Additional factors that complicate treatment of the geriatric patient
      are multiple organ diseases, the intervention of multiple practitioners, and
      nutritional variation. Multiple diseases require polypharmacy with its greater
      tendency for drug-drug interaction and iatrogenic disease exacerbation. Multiple
      clinician involvement frequently lacks appropriate communication between the
      various specialties. Aging is commonly associated with drastic changes in dietary
      habits. An older person living alone may tend to miss more meals than other
      groups. Meals that are consumed may be inadequate and lack proper balance,
      especially adequate amounts of protein. Mineral and vitamin depletion are
      additional problems, especially with patients on diuretics and chronic anti
      infective therapy. In this article an attempt has been made to stimulate thought
      and generate an awareness in the podiatric practitioner of the considerations
      necessary when contemplating drug therapy in the geriatric population. Long lists
      of specific agents and recommended dosages, which quickly become outdated as
      newer drugs are introduced into the clinical arena, were intentionally not
      presented in this article. The author hopes that this article will generate
      interest in conducting additional research in podiatric applications of drugs.

PMID- 8481881
TI  - Diabetes mellitus.
AB  - Diabetes mellitus occurs commonly in the older patient and is frequently
      undiagnosed. In many cases, the initial manifestations of diabetes mellitus are
      lower extremity complications with which this disease is known to be associated.
      Unfortunately, these complications are similar to other age-related degenerative
      processes; therefore, vigilance for the detection of undiagnosed diabetes
      mellitus is essential in the evaluation and treatment of lower extremity
      pathologic conditions.

PMID- 8481882
TI  - Infection and the older patient.
AB  - An increasing number of elderly patients are in and out of doctors' offices,
      hospitals, nursing homes, and so forth, under continual medical care. Numerous
      invasive procedures allow for casual transfer of infectious diseases by fellow
      patients as well as health care workers. Dramatic increases in infectious
      diseases such as foot infections, pneumonia, staphylococcal infections and,
      because of necessary invasive and blood transfusion procedures, AIDS can be
      expected in the future. The elderly patient is often a debilitated, compromised,
      immunodeficient host who is highly susceptible to any number of infections. With
      this in mind as the population grows older, clinicians must begin to apply
      Universal Precautions in their practices if they have not already done so, and
      not underestimate any disease or symptom in any patient, regardless of their age
      or their condition.

PMID- 8481883
TI  - Physical medicine and its relationship to patient management.
AB  - In this article, some general concerns for the use of modalities and procedures
      for the older person are given. Management of the geriatric patient requires
      knowledge, understanding, and patience; it requires a clinician and health care
      staff that care about older people. It requires a recognition of the dignity of
      age and the intrinsic worth of each individual as a human being. It requires hope
      and an ability to project a quality of life, regardless of the living condition.
      It requires kind words and a hands-on effort. It requires an appreciation of life
      and a high degree of ethical and moral concern.

PMID- 8481884
TI  - Podiatric services in long-term care facilities.
AB  - The 1981 White House Conference on Aging in its Recommendation Number 148 stated
      that "comprehensive foot care be provided for the elderly in a manner equal to
      care provided for other parts of the body." This key position speaks to the need
      and right of foot care for all. The inclusion of appropriate podiatric services
      in long-term care programs will often produce dramatic effects. Immobility can be
      replaced by activity. Quality of care translates into improved quality of life.
      Support and encouragement can be directed to independence and a strong sense of
      personal identify and worth. Isolation can be replaced by interaction. When the
      quality of life decreases due to disease, disability, or age, those precious
      aspects of dignity must be restored to a maximum level by caring staffs. Because
      ambulation is a catalyst for life, podiatric care can help regain some of the
      lost dignity by keeping the patient walking and moving about, so that he or she
      can accept and participate in the social activities provided by the facility.

PMID- 8481885
TI  - Gerontology-geriatrics education.
AB  - This article provides a conceptual outline for the geriatric component of primary
      podiatric medicine as well as a summary of gerontologic considerations applicable
      to professional, postdoctoral, and continuing education. This article also
      focuses on health promotion and prevention. Given the projected number of older
      patients in the United States and the prevalence of foot problems needing care in
      the older population, the podiatrist of today and tomorrow must become and remain
      a viable member of the primary geriatric care team.

PMID- 8481886
TI  - Medicare. An administrative viewpoint.
AB  - Medicare was the first significant legislation that provided a health insurance
      program for a segment of our nation's population, initially for the elderly
      population and then expanded to include other chronically ill patients that in a
      sense are high risk. It provided a recognition for the special services of
      doctors of podiatric medicine as equivalent to the services provided by other
      practitioners. What we fail to recognize many times is that Congress, as
      representatives of the people, projected a need for podiatric care in this
      particular entitlement program. It provides a scope of practice for podiatrists
      that is governed by state law, which also is a mandate of the people. The
      individual state practice acts are again the will of the people through their
      state legislatures, which established the need and recognition for podiatric
      care. The system designed by Medicare provides for fiscal intermediaries, who are
      the insurance carriers that administer the program. Each carrier then establishes
      its own guidelines to deal with the medical policies of the program. The local
      guidelines for each state or area are additional documents that need to be
      reviewed for local modifications of the Medicare regulations. There are four
      options for patient payment: assignment, direct payment by the patient, billing
      the patient followed by patient payment upon receipt of his or her Medicare
      payment, or the selection of a health maintenance organization or similar private
      insurance option. Under this fourth option, the patient gives up his or her right
      to direct podiatric care, which is clearly a violation of the intent of the
      legislation that added podiatric medicine to Medicare in 1967. Given the changes
      that take place in any system, the original intent of Medicare was to provide an
      availability and access for podiatric care as required by the patient. To modify
      the system to change that intent without a change in law is morally, ethically,
      and legally questionable.

PMID- 8481887
TI  - Ulcer therapy.
AB  - The geriatric patient is at risk for many podiatric conditions. Ulcers can become
      chronic and life-threatening in this population if not treated properly.
      Treatment for ulcers is based on an understanding of anatomy and physiology. This
      article is meant to be used as a guide for the podiatrist serving the elderly
      population.

PMID- 8481888
TI  - Physiological pharmacokinetics and cancer risk assessment.
AB  - There has been considerable progress in recent years in developing physiological
      models for the pharmacokinetics of toxic chemicals and in the application of
      these models in cancer risk assessment. Physiological pharmacokinetic models
      consist of a number of individual compartments, based on the anatomy and
      physiology of the mammalian organism of interest, and include specific parameters
      for metabolism, tissue binding, and tissue reactivity. Because of the
      correspondence between these compartments and specific tissues or groups of
      tissues, these models are particularly useful for predicting the doses of
      biologically active forms of toxic chemicals at target tissues under a wide
      variety of exposure conditions and in different animal species, including humans.
      Due to their explicit characterization of the biological processes governing
      pharmacokinetic behaviour, these models permit more accurate predictions of the
      dose of active metabolites reaching target tissues in exposed humans and hence of
      potential cancer risk. In addition, physiological models also permit a more
      direct evaluation of the impact of parameter uncertainty and inter-individual
      variability in cancer risk assessment. In this article, we review recent
      developments in physiologic pharmacokinetic modeling for selected chemicals and
      the application of these models in carcinogenic risk assessment. We examine the
      use of these models in integrating diverse information on pharmacokinetics and
      pharmacodynamics and discuss challenges in extending these pharmacokinetic models
      to reflect more accurately the biological events involved in the induction of
      cancer by different chemicals.

PMID- 8481889
TI  - Enhancement of gap junctional intercellular communication in tumor promoter
      treated cells by components of green tea.
AB  - Green tea (Camellia sinensis) has been reported to inhibit tumor promotion in
      vivo and in vitro. Many tumor promoters inhibit gap junctional intercellular
      communication (GJIC) which may be an important mechanism of promotion. In the
      present study, we hypothesized that green tea would enhance GJIC in promoter
      treated cells. An aqueous extract of green tea (GTE) and several of its
      constituents were tested for their effects on GJIC in p,p'
      dichlorodiphenyltrichloroethane (DDT)-, 12-O-tetradecanoylphorbol-13-acetate
      (TPA)- and dieldrin-treated WB-F344 rat liver epithelial cells. All three
      promoters inhibited GJIC in a dose-responsive manner at non-cytolethal
      concentrations. (GTE (10-80 gamma/ml) enhanced GJIC 20-80% in promoter-treated
      cells. (-)-Epigallocatechin gallate and (-)-epicatechin gallate also enhanced
      GJIC in DDT-treated cells, but no effects were seen with (+)-catechin, (-)
      epicatechin, (-)-epigallocatechin, caffeine, or theobromine. These data suggest
      GTE may inhibit tumor promotion by enhancing GJIC and that the most active
      components are the catechin gallates.

PMID- 8481890
TI  - Relationships between oestrogen-inducible proteins, oestradiol and electrolyte
      ratio in breast cyst fluid.
AB  - Women who have breast cysts with intracystic Na+/K+ < 3 may have a higher risk of
      developing breast cancer than women who have breast cysts with intracystic Na+/K+
      > 3. In this study wide-ranging intracystic concentrations of cathepsin D and pS2
      (oestrogen inducible proteins/polypeptides) as well as oestradiol were found. The
      concentrations of cathepsin D and oestradiol were significantly higher in the low
      electrolyte ratio cyst group than in the high electrolyte ratio cyst group. No
      significant difference was found between pS2 concentrations in the two groups.
      The significantly higher intracystic concentrations of cathepsin D, a mitogenic
      lysosomal endopeptidase and oestradiol in the low electrolyte ratio group may
      partly provide an explanation for the higher risk of breast cancer which has been
      observed in this group of women.

PMID- 8481891
TI  - Antileukemic effects of non-metabolizable derivatives of spermidine and spermine.
AB  - To determine whether non-metabolizable derivatives of spermidine and spermine
      exert anticancer effects, L1210 leukemic mice were treated with 5,8
      dimethylspermidine and 5,8-dimethylspermine. Both derivatives cured 5% of the
      leukemic mice. The increase in median survival time, however, was slight. In
      combination with alpha-difluoromethylornithine (DFMO), an ornithine decarboxylase
      inhibitor, only 5,8-dimethylspermine had a favorable effect. Treatment with DFMO
      is known to increase the uptake of extracellular polyamines and presumably their
      derivatives, by depleting the intracellular putrescine and spermidine content.
      However, treatment of L1210 leukemia cells in vitro with DFMO did not affect the
      uptake of the methyl-substituted polyamines added to the growth medium. 5,8
      Dimethylspermidine and 5,8-dimethylspermine repressed the ornithine decarboxylase
      activity when added to cultures of L1210 leukemia cells. S-Adenosylmethionine
      decarboxylase activity was only repressed by 5,8-dimethylspermine. This finding
      may explain the potentiation by this derivative and not by 5,8
      dimethylspermidine, of the antileukemic effect of DFMO.

PMID- 8481892
TI  - Effect of asoka on the intracellular glutathione levels and skin tumour promotion
      in mice.
AB  - The bark of Saraka asoca (asoka) is commonly used to treat various diseases by
      the Indian system of medicine and in Sri Lanka. Further purification and chemical
      analysis of the active compound from the bark extract of asoka showed that (-)
      epicatechin was responsible for the observed antitumour/anticarcinogenic
      activity. Papilloma formation in mice initiated with 7,12
      dimethylbenz[a]anthracene (DMBA) and promoted using croton oil was inhibited by
      the topical application of 100 mg/kg body weight (b.w.) of (-)-epicatechin
      isolated from asoka bark extract. Oral administration of the same dose restricted
      the growth of s.c. injected 20 methylcholanthrene (MCA) induced soil tissue
      fibrosarcomas significantly in mice. Elevations of almost 2-4-fold in the
      intracellular reduced glutathione and related enzymes viz., glutathione reductase
      and glutathione S-transferase of sarcoma-180 tumour cells were noted in the
      presence of 1 microgram/ml of (-)-epicatechin, further highlighting its
      antiproliferative effect.

PMID- 8481893
TI  - Modulation of transferrin receptor expression by insulin and granulocyte
      macrophage colony stimulating factor in AML-193 leukemic cells.
AB  - The effects of insulin and granulocyte-macrophage colony stimulating factor (GM
      CSF) on the expression of transferrin receptors in AML-193 myeloid leukemia cell
      line were investigated. Insulin, alone or in combination with GM-CSF, caused an
      increase in surface transferrin receptors within 5 min. This increase was
      inhibited by hyperosmolarity but not by cycloheximide suggesting the involvement
      of receptor recycling from internal pools. In contrast, receptor increase after
      18 h of incubation with insulin and GM-CSF was sensitive to cycloheximide
      indicating that long term effects of these growth factors are mediated through
      protein synthesis. These results may have implications on combined GM-CSF +
      antitransferrin receptor antibody therapy of leukemias.

PMID- 8481894
TI  - Dietary fat promotes mammary tumorigenesis in MMTV/v-Ha-ras transgenic mice.
AB  - The purpose of this study was to investigate the influence of dietary fat on
      mammary tumorigenesis in MMTV/v-Ha-ras transgenic mice. Female MMTV/v-Ha-ras
      transgenics were fed diets providing 0, 5 or 25% of calories from corn oil (CO).
      The mammary tumor incidence was 7% (0% CO), 36% (5% CO) and 52% (25% CO). Ras
      mRNA levels were increased in mammary tumors in the 25% CO group. The ras
      transgene was hypomethylated in mammary tumors, but not in liver or
      nontransformed mammary tissue. Mammary tumors expressed apolipoprotein E mRNA.
      Alterations in gene structure and expression in transgenic mice may suggest
      mechanisms by which dietary fat promotes mammary tumors.

PMID- 8481895
TI  - Tumor growth and adherence change the expression of macrophage Mac-2.
AB  - The galactose-specific animal lectin, Mac-2, has been identified in macrophage (M
      phi) membrane, cytoplasmic, and nuclear fractions. Flow cytometric analyses
      showed that there is a decrease in membrane Mac-2 during tumor growth. After 24-h
      adherence there was an increase in the number of normal host (NH) and tumor
      bearing host (TBH) Mac-2+ M phi. Immunoblot analyses of NH and TBH M phi
      identified changes in the subcellular localization of Mac-2. The increase in
      nuclear Mac-2 during tumor growth, and after prolonged adherence of NH and TBH M
      phi, correlates with an increase in M phi entering the late G1 phases of the cell
      cycle. Northern blot analyses showed an increase in Mac-2 mRNA during tumor
      growth, and an increase in NH and TBH M phi after 24-h adherence. Tumor growth is
      able to manipulate the immune system through M phi by causing a down-regulation
      in membrane Mac-2 and an up-regulation in intracellular Mac-2. NH and TBH M phi
      respond to adherence by expressing increased membrane and nuclear Mac-2, but TBH
      M phi response is lower.

PMID- 8481896
TI  - The androgen receptor status of neuroendocrine cells in human benign and
      malignant prostatic tissue.
AB  - Neuroendocrine (NE) cells containing neurosecretory granules, rich in various
      peptide hormones and biogenic amines, are components of the human prostate
      epithelium and prostatic adenocarcinomas. Neuroendocrine differentiation in
      prostatic adenocarcinomas has been associated with a poor prognosis and,
      following androgen withdrawal therapy, tumor cell populations have been observed
      to become enriched with NE cells. We assessed androgen receptor (AR) expression
      in NE cells in benign and malignant prostatic tissue using double-labeling
      immunocytochemistry with validated monoclonal antibodies to the AR and to
      chromogranin A (a generic NE marker). Neuroendocrine cells in benign and
      malignant prostatic tissue generally showed nuclear staining with AR. Some
      distinct AR-negative nuclei were observed in normal NE cells. In prostatic
      adenocarcinomas with extensive NE differentiation, a subpopulation of AR-negative
      NE cells was demonstrated. In conclusion, benign and malignant prostatic tissue
      contain both AR-positive and AR-negative NE cells that may have significance in
      regards to androgen-independent tumor growth and tumor progression.

PMID- 8481897
TI  - Inhibition of cell motility after nm23 transfection of human and murine tumor
      cells.
AB  - Abstract nm23 gene expression has been inversely correlated with tumor metastatic
      potential in certain tumors including melanomas, breast carcinomas, and
      hepatocellular carcinomas. The cellular mechanisms by which the nm23 protein may
      directly or indirectly modulate the metastatic phenotype is not yet known.
      Because cell motility plays an essential role in metastatic dissemination, we
      have studied whether tumor cells transfected with nm23 complementary DNA have any
      alterations in their ability to migrate. Our results demonstrate that nm23
      transfection inhibits the ability of murine melanoma and human breast carcinoma
      cells to migrate in response to serum or to defined factors such as platelet
      derived growth factor or insulin-like growth factor 1. Random, unstimulated cell
      motility was not depressed in the nm23 transfectants. The results suggest that
      the nm23 gene product may interact with intracellular molecules that are
      essential for stimulated cell motility in two different tumor cell systems.

PMID- 8481898
TI  - Footprinting of individual tumors and their variants by constitutive cytokine
      expression patterns.
AB  - We have examined the cytokine mRNA expression profile of six different human cell
      lines derived from Ewing sarcomas using polymerase chain reaction and found each
      to constitutively express a characteristic pattern. Furthermore, each cell line
      differed in the levels of secreted cytokines. We also analyzed the expression of
      several cytokines in murine UV-induced sarcomas and their heritably stable
      progressive variants. Each murine tumor also constitutively expressed a large
      number of cytokines, and in some cases, the more malignant variants differed from
      their parental tumors. These results demonstrate that tumors of the same type,
      and even in the same lineage, can have distinct cytokine expression and/or
      secretion profiles. Some cytokines may stimulate tumor growth while others may
      have antitumor effects. Cytokine therapy may be tailored depending upon the
      cytokine profile of the individual malignancy.

PMID- 8481899
TI  - Tumor necrosis factor acts as a tumor promoter in BALB/3T3 cell transformation.
AB  - Tumor necrosis factor (TNF), a cytokine, and okadaic acid, a tumor promoter,
      strongly phosphorylated the same proteins, vimentin and heat shock protein 27,
      although their time courses were different. Human TNF-alpha at a concentration of
      0.6 nM markedly stimulated transformation of BALB/3T3 cells initiated with 3
      methylcholanthrene. The human TNF-alpha was about 1000 times more effective than
      the chemical tumor promoters, okadaic acid and 12-O-tetradecanoylphorbol-13
      acetate. TNF induced growth of v-Ha-ras transfected BALB/3T3 cells (Bhas 42
      cells), whereas it did not induce growth of nontransfected BALB/3T3 cells.
      Okadiac acid induced mouse TNF-alpha from Bhas 42 and BALB/3T3 cells. The results
      suggest that a chemical tumor promoter induces the secretion of TNF-alpha from
      various cells. The TNF then acts as an endogenous tumor promoter in vivo.

PMID- 8481900
TI  - Amplification of cyclin genes in colorectal carcinomas.
AB  - The genetic status of cyclin genes was examined in a panel of 47 colorectal
      carcinoma cell lines. Cyclin D2 was found to be amplified in one tumor and cyclin
      E in another. In each of the two cases, the amplified cyclin gene was
      overexpressed at the protein or mRNA level. Cyclin D1, previously shown to be
      amplified in breast and other tumors, was not amplified in these cancers. These
      data suggest that a variety of cyclin genes can play a role in human
      tumorigenesis and that cyclins D2 and E are particularly important in a subset of
      colorectal neoplasms.

PMID- 8481901
TI  - Association of glyceraldehyde-3-phosphate dehydrogenase expression with cell
      motility and metastatic potential of rat prostatic adenocarcinoma.
AB  - Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) expression is increased in
      Dunning R-3327 rat prostatic adenocarcinoma cell lines relative to normal rat
      ventral prostate tissue. GAPDH expression closely correlates with cell motility
      of Dunning prostate cancer cell lines and accurately distinguishes cell lines
      with high metastatic potential from those with low metastatic potential.
      Increased GAPDH expression in the cancer cell lines is not simply related to
      increased growth rate, since rapidly proliferating normal prostate tissue did not
      exhibit elevated GAPDH expression.

PMID- 8481902
TI  - Modulation of murine B16F10 melanoma plasminogen activator production by a
      synthetic peptide derived from the laminin A chain.
AB  - Laminin is a large multidomain protein with diverse biological activities. We
      previously demonstrated that intact laminin as well as an A chain synthetic
      peptide (LamA2091-2108) stimulate tissue plasminogen activator (t-PA)-catalyzed
      plasminogen activation. Here we report that LamA2091-2108 increases t-PA
      production by the highly metastatic murine melanoma cell line B16F10, with no
      effect on the parental B16F1 line, which has a low metastatic capacity.
      Incubation of plasminogen with B16F10-conditioned medium results in direct
      activation of the zymogen to plasmin. Furthermore, following incubation of B16F10
      cells with plasminogen, plasmin is eluted from the cell surface, suggesting that
      these cells contain binding sites for plasminogen/plasmin in close proximity to t
      PA binding sites. Quantitation of t-PA activity using the synthetic substrate Val
      Leu-Lys-p-nitroanilide indicates a minimal 10-fold increase in t-PA in the
      conditioned medium of B16F10 cells grown in the presence of LamA2091-2108, with
      no increased t-PA activity observed in B16F1-conditioned medium. Similar results
      were obtained in immunocapture experiments which are specific for t-PA antigen.
      In addition, B16F10 melanoma-associated t-PA catalyzes the plasminogen-dependent
      hydrolysis of laminin. Together these data suggest that degradation of basement
      membrane proteins by metastatic melanoma cells may release fragments (such as
      LamA2091-2108) which stimulate both the production and activity of metastasis
      associated proteinases such as t-PA, providing a mechanism for augmentation of
      the metastatic capacity of B16F10 melanoma cells.

PMID- 8481903
TI  - Coordinate oncodevelopmental modulation of alternative splicing of fibronectin
      pre-messenger RNA at ED-A, ED-B, and CS1 regions in human liver tumors.
AB  - The molecular diversity of fibronectin arises from alternative RNA splicing at
      regions termed ED-A, ED-B, and IIICS. We investigated the splicing patterns of
      fibronectin pre-mRNA at both ED-B and IIICS regions in various human liver
      tissues with an emphasis on the expression of the alternative cell adhesive site
      CS1 within the IIICS region. The relative abundance of the fibronectin mRNA
      containing the CS1 sequence was significantly increased in both fetal and
      cancerous liver tissues, although it was not affected in nonmalignant tissues
      with chronic hepatitis and cirrhosis. Similarly, the relative abundance of the
      fibronectin mRNA containing the ED-B region was also increased in both fetal
      liver and liver tumors, showing a close parallelism with the splicing pattern at
      the ED-A region. Immunohistochemical examination of cancerous liver tissues with
      monoclonal antibodies directed to the ED-A and ED-B segments revealed that the
      fibronectin isoforms containing these extra peptide segments were specifically
      deposited in the tumor nodules. Other genes encoding kininogen, gamma chain of
      fibrinogen, and beta-amyloid protein precursor, all of which had been shown to be
      alternatively processed, did not show any significant alteration in the splicing
      pattern in cancerous liver tissues. These results indicate that the alternative
      splicing of fibronectin pre-mRNA at the ED-A, ED-B, and IIICS regions is
      coordinately modulated in both fetal and cancerous liver tissues toward inclusion
      of the extra peptide segments and that not all but only selected genes are
      susceptible for "fine tuning" of alternative RNA splicing in cancerous liver
      tissues.

PMID- 8481904
TI  - Coordinate expression of N-myc 2 and insulin-like growth factor II in
      precancerous altered hepatic foci in woodchuck hepatitis virus carriers.
AB  - Over 50% of the hepatocellular carcinomas (HCCs) arising in the livers of
      woodchucks with persistent woodchuck hepatitis virus (WHV) infection contain
      integrations of WHV DNA within, or immediately adjacent to, a unique and
      functional N-myc 2 retroposon [G. Fourel et al., Nature (Lond.), 347: 294-298,
      1990; Y. Wei et al., J. Virol., 66: 5265-5276, 1992]. The integrations are
      believed to activate the expression of N-myc 2 by an enhancer insertion mechanism
      [Y. Wei et al., J. Virol., 66: 5265-5276, 1992]. Since the fetal growth factor
      insulin-like growth factor II (IGF-II) is also expressed in woodchuck HCCs [X. X.
      Fu et al., J. Virol., 62: 3422-3430, 1988; D. Yang and C. E. Rogler,
      Carcinogenesis (Lond.), 12: 1893-1901, 1991] we sought to determine the earliest
      stage in hepatocarcinogenesis at which overexpression of N-myc and IGF-II could
      be detected. The earliest precancerous lesions so far identified in woodchucks
      are altered hepatic foci (AHFs) [K. Abe et al., Jpn. J. Cancer Res., 79: 466-472,
      1988; H. Popper et al., Hepatology (Baltimore), 1: 91-98, 1981]. Using in situ
      hybridization, we have demonstrated that both the N-myc and IGF-II genes are
      coordinately overexpressed in nearly all AHFs in precancerous woodchuck livers.
      In contrast, WHV replication was either repressed or undetectable in the same
      AHFs. The use of probes selective for N-myc 2 versus N-myc 1 (the normal
      mammalian homologue) revealed nearly exclusive expression of N-myc 2 in AHFs.
      Cells within AHFs were generally slow growing, as determined by frequency of
      histone III-expressing hepatocytes; however, a few fast-growing AHFs, with growth
      rates nearly equivalent to those of HCCs, were identified. Furthermore, very
      highly elevated N-myc 2 or IGF-II expression was detected in a few subregions
      within AHFs which otherwise exhibited a uniformly moderate expression, suggesting
      that selection for higher levels of N-myc or IGF-II expression may occur within
      AHFs. These data suggest that coordinate expression of N-myc 2 and IGF-II and
      repression of WHV replication may be functionally involved in the development of
      AHFs and that cells expressing very high levels of N-myc and IGF-II may be
      selectively enriched as AHFs progress to HCC, since high levels of N-myc and IGF
      II are common in HCCs.

PMID- 8481905
TI  - Roles of human hepatic and pulmonary cytochrome P450 enzymes in the metabolism of
      the environmental carcinogen 6-nitrochrysene.
AB  - 6-Nitrochrysene is remarkably tumorigenic in the lung and liver of newborn mice
      and approximates the activities of certain ultimate carcinogenic metabolites of
      polycyclic aromatic hydrocarbons. Previous studies have indicated that the major
      metabolic activation pathway of 6-nitrochrysene in newborn mice is initially
      through the formation of the proximate tumorigen trans-1,2-dihydro-1,2-dihydroxy
      6-aminochrysene with subsequent formation of 1,2-dihydroxy-3,4-epoxy-1,2,3,4
      tetrahydro-6-aminochrysene. In order to provide information on the possible risk
      associated with human exposure to 6-nitrochrysene, the ability of human hepatic
      and pulmonary microsomes to metabolize 6-nitrochrysene was investigated. The
      major metabolites identified in 11 hepatic microsomes were trans-1,2-dihydro-1,2
      dihydroxy-6-nitrochrysene, trans-9,10-dihydro-9,10-dihydroxy-6-nitrochrysene,
      trans-1,2-dihydro-1,2-dihydroxy-6-aminochrysene, 6-aminochrysene, and chrysene
      5,6-quinone. Following the incubations of 6-nitrochrysene with 11 different human
      pulmonary microsomes, qualitatively similar metabolic patterns were obtained,
      although quantitative differences were evident. These results demonstrated that
      human liver and lung are capable of metabolizing 6-nitrochrysene to known potent
      carcinogenic metabolites via ring oxidation and nitroreduction. In an attempt to
      define the roles of individual human hepatic P450 involved in the metabolism of 6
      nitrochrysene, the catalytic activities known to be associated with a specific
      P450 were analyzed and compared with the levels of each metabolite of 6
      nitrochrysene formed with the same microsomes. Rates of phenacetin O-deethylation
      (P450 1A2) and nifedipine oxidation (P450 3A4) were well correlated with the
      rates of formation of trans-1,2-dihydro-1,2-dihydroxy-6-nitrochrysene and 6
      aminochrysene, respectively. Inhibition studies with specific P450 inhibitors and
      antibodies further support the view that P450 1A2 and P450 3A4 are the major
      forms responsible for the formation of trans-1,2-dihydro-1,2-dihydroxy-6
      nitrochrysene and 6-aminochrysene, respectively, in human liver. Further
      metabolism of trans-1,2-dihydro-1,2-dihydroxy-6-nitrochrysene appears to require
      P450 3A4. In the human lung, P450 1A1 appears to play a major role in the
      metabolism of 6-nitrochrysene to trans-1,2-dihydro-1,2-dihydroxy-6-nitrochrysene.
      These results provide some requisite knowledge for evaluating human
      susceptibility to 6-nitrochrysene.

PMID- 8481906
TI  - Coexpression of messenger RNA for TRK protooncogene and low affinity nerve growth
      factor receptor in neuroblastoma with favorable prognosis.
AB  - Nerve growth factor (NGF), essential for differentiation and survival of
      sympathetic neurons is suggested to play a role in differentiation or regression
      of neuroblastoma. Expression of mRNA for the trk protooncogene, encoding a
      tyrosine kinase receptor essential for functional NGF signal transduction, and
      mRNA for the low affinity NGF receptor (LNGFR) was examined in 45 neuroblastomas
      and 3 benign ganglioneuromas using Northern blot analysis. Expression of trk mRNA
      and LNGFR mRNA correlated with young age, favorable clinical stages, and absence
      of N-myc amplification. All children (n = 19) with neuroblastomas coexpressing
      mRNA for trk and LNGFR are alive 8-84 months from diagnosis, regardless of age
      and stage. In contrast, no child (n = 15) with tumor lacking trk mRNA is alive
      without disease. Three subsets of patients were distinguished, one favorable
      (trk+, LNGFR+, n = 19, 100% survival probability), one intermediate (trk+, LNGFR
      , n = 11, 62.3% survival probability), and one unfavorable (trk-, LNGFR +/-, n =
      15, 0% survival probability, P < 0.001). In widespread neuroblastoma stage IVS
      prone to spontaneous regression, three tumors coexpressing trk and LNGFR mRNAs
      regressed after no or minimal therapy while the remaining tumor expressing trk
      but not LNGFR mRNA progressed to a fatal outcome. It is concluded that
      neuroblastomas coexpressing mRNA for both NGF receptor subtypes are favorable
      tumors likely to differentiate or regress spontaneously or respond to
      conventional therapy. It is further hypothesized that loss of functional NGF
      receptors is an important step in tumorigenesis of undifferentiated malignant
      childhood neuroblastoma. For these unfavorable tumors current therapy remains
      futile and first-line innovative therapy is justified.

PMID- 8481907
TI  - Inhibition of doxorubicin-induced apoptosis in vivo by 2-deoxy-D-glucose.
AB  - Previous studies have shown that DNA cleavage by mammalian topoisomerase II is
      ATP dependent and can be inhibited by metabolic inhibitors. Furthermore, it has
      been shown that metabolic inhibitors also have a cytoprotective effect in vitro
      against topoisomerase II-targeting antitumor drugs. However, the nature of the
      ATP-dependent process is not known. We have previously shown that doxorubicin
      induces apoptosis (programmed cell death) in the murine small intestine which can
      be inhibited by the protein synthesis inhibitor cycloheximide. In the present
      study, we have demonstrated that 2-deoxy-D-glucose reduces the incidence of
      doxorubicin-induced apoptosis in vivo if administered within 45 min of the
      doxorubicin. Maximum reduction was observed at 2 h after treatment (approximately
      66%); however, significant reduction was still observable at 9 h after treatment
      (approximately 33%). Significant positive correlation was observed between
      protein synthesis inhibition and apoptosis inhibition. Other possible mechanisms
      of action of the inhibitor do not appear to be important in cytoprotection. The
      inhibitor did not reduce the uptake of doxorubicin into the intestinal
      epithelium; however, it caused a significant increase in retention of the drug.
      The kinetics of inhibition suggest that alteration of cell cycle kinetics,
      inhibition of formation of doxorubicin-topoisomerase II complex or induction of
      glucose-regulated proteins are not significant factors in cytoprotection. These
      studies indicate that at least in the mouse small intestinal epithelium, the ATP
      dependent process in cell killing by doxorubicin may involve protein synthesis.

PMID- 8481908
TI  - Plasma pharmacokinetics of vinblastine and the investigational Vinca alkaloid N
      (deacetyl-O-4-vinblastoyl-23)-L-ethyl isoleucinate in mice as determined by high
      performance liquid chromatography.
AB  - The plasma pharmacokinetics of vinblastine and N-(deacetyl-O-4-vinblastoyl-23)-L
      ethyl isoleucinate (VileE) in mice have been studied as part of the preclinical
      investigations of VileE, a new investigational semisynthetic Vinca alkaloid.
      Groups of animals received the test compounds through i.v. bolus injection at
      LD10, 0.5 x LD10, and 0.1 x LD10 doses. VileE has also been administered p.o.
      Drug plasma levels have been analyzed with a sensitive and selective method using
      liquid-liquid extraction for sample clean-up and high-performance liquid
      chromatography combined with fluorescence detection for quantification. Following
      i.v. injection, plasma kinetics of both vinblastine and VileE can be described
      adequately by a three-compartment open model. VileE demonstrates nonlinear
      pharmacokinetics with decreasing clearance and increasing terminal half-lives at
      increasing doses. Comparison of the plasma concentration versus time curves for
      vinblastine in humans and mice indicates that the toxicity of these compounds may
      not be directly related to the drug exposure expressed by the area under curve in
      plasma but by the terminal half-life and the time that a toxic threshold level is
      attained. Pharmacokinetically guided dose escalation in coming phase I trials of
      VileE is, therefore, discouraged.

PMID- 8481909
TI  - Growth inhibition of hormone-responsive and -resistant human breast cancer cells
      in culture by N1, N12-bis(ethyl)spermine.
AB  - Previous studies have documented differential sensitivity of human lung cancer
      and melanoma cell lines to the cytotoxic effects of N1, N12-bis(ethyl)spermine
      (BESpm). We show here that BESpm can significantly inhibit the growth of six
      human breast cancer cell lines with 50% inhibitory concentration in the microM
      range. The degree of inhibition does not correlate with estrogen receptor status.
      Detailed studies with estrogen receptor-positive MCF-7 and estrogen receptor-
      negative Hs578t cells show a similar dose-response curve with concentrations of 1
      10 microM resulting in maximal growth inhibition. Growth inhibition in both lines
      is associated with an 8-12-fold induction of the polyamine catabolic enzyme,
      spermidine/spermine N1-acetyltransferase, and a progressive decrease in
      intracellular polyamine levels over 6 days even though steady-state levels of
      BESpm are achieved within 24 h. Similar studies on WTMCF7 and AdrRMCF7 cells show
      that the acquisition of resistance to hormonal or doxorubicin therapy is not
      associated with resistance to the growth-inhibitory effects of BESpm. These
      results suggest that BESpm exerts similar growth-inhibitory effects against both
      hormone-responsive and -unresponsive human breast cancer cells, a finding which
      has significance for the potential use of polyamine analogues in treating human
      breast cancer.

PMID- 8481910
TI  - Influence of vascular thermotolerance on the heat-induced changes in blood flow,
      pO2, and cell survival in tumors.
AB  - Vascular thermotolerance in SCK tumors of A/J mice was studied by comparing the
      changes in blood flow, as measured by the 86Rb uptake method, from a single
      heating with those from two heatings. The heat-induced decline in 86Rb uptake in
      tumors could be substantially inhibited when the tumors were preheated,
      indicating the development of vascular thermotolerance. In SCK tumors, the
      vascular thermotolerance peaked 5 or 18 h after the tumors were heated for 1 h at
      41.5 degrees C or 42.5 degrees C, respectively. Consequently, the tumor blood
      flow decreased by 50% in 81 min when the tumors were heated at 43.5 degrees C
      without preheating, whereas the tumor blood flow decreased by 50% in 195 min at
      43.5 degrees C when the tumors were preheated 18 h earlier at 42.5 degrees C for
      1 h. The influence of vascular thermotolerance on the heat-induced changes in
      intratumor pO2 was also investigated. The average intratumor pO2 was 8.9 mm Hg
      before heating. Heating at 43.5 degrees C or 44.5 degrees C for 1 h dramatically
      decreased the intratumor pO2 to 3.0 or 1.2 mm Hg, respectively. However, the
      intratumor pO2 decreased to 6.6 or 3.8 mm Hg when the tumors were heated at 43.5
      degrees C or 44.5 degrees C, respectively, 18 h after preheating at 42.5 degrees
      C for 1 h. Heating the tumors when tumor vasculatures were at peak
      thermotolerance was relatively ineffective in suppressing tumor growth. The data
      demonstrate that vascular thermotolerance in tumors may exert profound effects on
      tumor response to multiple heatings in clinical hyperthermia.

PMID- 8481911
TI  - The spatial distribution of immunotoxins in solid tumors: assessment by
      quantitative autoradiography.
AB  - The spatial distribution of i.v. administered immunotoxins in s.c. human
      rhabdomyosarcoma RD2 xenografts was studied. The toxin and immunotoxins were: (a)
      diphtheria toxin (DT); (b) a binding-deficient form of DT (CRM107) linked to a
      monoclonal IgG1 antibody (454A12) directed against the human transferrin receptor
      (454A12-107); (c) the binding-deficient form of DT linked to the Fab' fragment of
      454A12 (Fab'-107); and (d) the binding-deficient form of DT coupled to MOPC21, a
      monoclonal IgG1 with no significant binding to RD2 cells. DT and the immunotoxins
      were radiolabeled with 125I and injected via the tail vein into tumor-bearing
      athymic mice (median tumor weight, 0.25 g). Tumors were removed 2, 6, and 24 h
      after injection of DT or immunotoxin. Film images of 20-microns frozen sections
      were digitized by video microscopy, and gray levels were converted to tissue
      concentrations based upon the film response to radioactivity standards and the
      specific activity of the radiolabeled toxins. Images of the tumors were
      characterized quantitatively by the kurtosis and the area above threshold; the
      kurtosis is a measure of the spatial heterogeneity of the radiolabeled
      immunotoxins, and the area above threshold is defined here as the fractional
      tumor area that reaches or exceeds 1.5% of the initial plasma concentration. The
      spatial distribution of DT in the tumors was extremely uniform, characterized by
      low kurtosis values. In contrast, the autoradiograms of 454A12-107 were punctate
      in appearance and were characterized by very high kurtosis values. Fab'-107,
      which has approximately one-half the molecular weight of the intact immunotoxin
      and binds only monovalently, also produced punctate images with kurtosis values
      similar to those for 454A12-107. The nonbinding immunotoxin distributed somewhat
      less uniformly than DT but much more homogeneously than either of the binding
      immunotoxins. DT, 454A12-107, and Fab'-107 have similar affinities for their
      respective receptors, but the concentration of binding sites for DT on RD2 cells
      (<3,000 receptors/cell) is much lower than the concentration of transferrin
      receptor (60,000 receptors/cell). Thus, the heterogeneous distribution of 454A12
      107 and Fab'-107 probably reflects retarded penetration due to binding to the
      tumor cells. The area above threshold was greatest for DT and lowest for 454A12
      107; the fragment and nonbinding immunotoxins had intermediate values. The lower
      area above threshold for the nonbinding immunotoxin as compared with DT may be
      due to the considerably large molecular weight and hence the lower capillary
      permeability and diffusion coefficient of the immunotoxin.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8481912
TI  - Induction of differentiation in myeloid leukemia cell lines and acute
      promyelocytic leukemia cells by liposomal all-trans-retinoic acid.
AB  - All-trans-retinoic acid (ATRA) induces complete remissions in the majority of
      patients with acute promyelocytic leukemia. Despite continuous p.o. ATRA
      administration, many patients relapse after a short remission duration. In these
      patients, ATRA plasma concentrations were found to be very low, which was related
      to induction of retinoic acid-binding protein and increased drug catabolism by
      cytochrome P-450-mediated reactions. An i.v. ATRA formulation, which can be
      achieved by encapsulating ATRA into liposomes, may have the potential to overcome
      these unwanted effects. We investigated the ability of liposomal ATRA (L-ATRA) to
      induce differentiation of human myeloid leukemia cell lines (HL-60, KG-1, and THP
      1). Cellular differentiation, as assessed by morphological criteria and by the
      expression of a mature myeloid cell surface antigen (CD11b on HL-60 and KG-1
      cells), was induced by culture in the presence of L-ATRA. The ability of L-ATRA
      treated HL-60 cells to reduce nitroblue tetrazolium demonstrated that they were
      functionally differentiated cells. Cell cycle analysis revealed significant
      growth inhibition of the cells after L-ATRA treatment. Following culture with L
      ATRA, cells from five patients with acute promyelocytic leukemia were found to be
      morphologically and immunophenotypically mature myeloid cells. L-ATRA was as
      effective as free ATRA in inducing differentiation of the cell lines and of the
      cells from patients with acute promyelocytic leukemia. We conclude that L-ATRA
      effectively induces differentiation and may be a useful parenteral ATRA
      formulation for overcoming the pharmacological mechanisms that lead to "retinoid
      resistance."

PMID- 8481913
TI  - Serum interleukin 6 levels are elevated in lymphoma patients and correlate with
      survival in advanced Hodgkin's disease and with B symptoms.
AB  - Several cytokines including gamma-interferon, tumor necrosis factor alpha,
      interleukin 1 beta (IL-1 beta), and interleukin 6 (IL-6) are pyrogenic and can
      inhibit lipogenic processes. Because patients with lymphoma often suffer from
      fever, weight loss, and night sweats (B symptoms), the etiology of which is
      unknown, the authors investigated serum levels of these cytokines in normal
      volunteers and in patients with Hodgkin's and non-Hodgkin's lymphoma. Sixty serum
      samples from patients with Hodgkin's disease (28 patients) or non-Hodgkin's
      lymphoma (32 patients), as well as 20 samples from normal volunteers, were
      collected. The majority of patients had advanced (Stage III or IV) or relapsed
      disease. The assay for gamma-interferon was a specific and sensitive
      radioimmunoassay (lower limit of detection = 0.1 unit/ml); the assays for tumor
      necrosis factor alpha, IL-1 beta, and IL-6 were enzyme-linked immunoassays with
      lower limits of sensitivity of 10 pg/ml, 20 pg/ml, and 22 pg/ml, respectively.
      There were no statistically significant differences in gamma-interferon, tumor
      necrosis factor alpha, or IL-1 beta levels between lymphoma patients and normal
      subjects. In contrast, 20 of 57 patients (35%) with lymphoma as compared with 0
      of 19 normal volunteers (0%) had detectable serum IL-6 levels (P < 0.005, chi 2
      test). Interestingly, 17 of 29 lymphoma patients with B symptoms (59%) as opposed
      to 3 of 28 lymphoma patients without B symptoms (11%) had detectable serum IL-6
      levels (P < 0.001, chi 2 test); the median IL-6 level was 28.9 pg/ml (B symptoms
      present) versus undetectable (no B symptoms) (P < 0.005, Mann-Whitney U test).
      Analyzing Hodgkin's and non-Hodgkin's lymphoma groups separately revealed similar
      results. IL-6 levels showed no significant correlation with time from diagnosis,
      beta 2-microglobulin, or lactate dehydrogenase levels. However, analysis by the
      method of Kaplan and Meir demonstrated that the median survival of Hodgkin's
      disease patients with detectable IL-6 levels (> or = 22 pg/ml) was 10 mo, whereas
      the median survival has not been reached at a median follow-up time of 37.5 mo in
      those patients with lower values (Wilcoxon P value = 0.0012). There were too few
      patients in each subset of non-Hodgkin's lymphoma to determine the correlation
      between IL-6 and survival but, considered as a single group, a statistically
      significant correlation was not found.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8481914
TI  - Genetic construction, expression, and characterization of a single chain anti
      carcinoma antibody fused to beta-lactamase.
AB  - We report the genetic construction and expression of a fusion protein between an
      antibody single chain-linked variable domain fragment specific for human
      carcinomas and beta-lactamase II from Bacillus cereus. Sequences encoding the
      variable regions of the L6 monoclonal antibody were assembled so as to be
      separated from each other by an 18-amino acid linker and from the mature form of
      beta-lactamase by a 6-amino acid linker. The construct was placed under the
      transcriptional regulation of the lac promoter, and the PelB signal sequence was
      used to direct export of the fusion protein to the periplasmic space of
      Escherichia coli. After induction, biologically active material was recovered
      from both culture supernatants and cell lysates. Affinity chromatography yielded
      about 2.5 micrograms of protein/ml of initial culture volume. The fusion protein
      was shown to bind to tumor cells at least as well as chemically prepared F(ab')
      and to maintain beta-lactamase activity at a level similar to that of the native
      enzyme. Tumor cells coated with the fusion protein were sensitive to a
      cephalosporin mustard prodrug in a dose-dependent fashion comparable to that of
      enzyme chemically conjugated to F(ab'). This article demonstrates the feasibility
      of using single chain-linked variable domain-enzyme fusion proteins for the
      activation of anticancer prodrugs.

PMID- 8481915
TI  - p53 mutation is a common genetic event in ovarian carcinoma.
AB  - Using the single-strand conformational polymorphism technique, we have screened
      66 malignant ovarian tumors for p53 mutation in exons 5 to 8. Thirty-four of the
      tumors demonstrated a single-strand conformational polymorphism band shift in
      this region of the gene, including 6 in exon 5, 7 in exon 6, 12 in exon 7, and 10
      in exon 8 (one of the tumors showed a shift for exons 7 and 8). All of the single
      strand conformational polymorphism shifts have been further characterized by DNA
      sequencing, and 31 of 35 have been shown to represent genuine DNA alterations.
      These include 27 point mutations (23 missense, 2 nonsense, and 2 silent
      mutations), 3 deletions (a 2-base pair deletion introducing, by frameshift, a
      stop codon further downstream; a 3-base pair deletion; and an unusual 6-base pair
      deletion made up of separate 2-base pair and 4-base pair deletions), and a 4-base
      pair insertion (introducing a stop codon downstream). In total, 29 of the 66
      (44%) carcinomas analyzed had mutations affecting the primary sequence of the p53
      protein. p53 mutation was found in tumors of all International Federation of
      Gynecologists and Obstetricians stages, suggesting that it might be an earlier
      genetic event in the progression of epithelial ovarian tumors than previously
      thought. A significantly greater number of p53 mutations were seen in high-grade
      serous carcinomas than in those of endometrioid and mucinous types (0.02 > P >
      0.01). Analysis of the distribution of point mutations showed no preference for
      any particular mutation type.

PMID- 8481916
TI  - Effects of cisplatin on the induction of apoptosis in proliferating hepatoma
      cells and nonproliferating immature thymocytes.
AB  - A 2-h exposure of JB1 rat hepatoma cells in late log phase of growth to 50 microM
      cis-diamminedichloroplatinum (II) (cisplatin) resulted in the asynchronous
      detachment of cells from the monolayer over 4 days. Detached but not monolayer
      cells exhibited condensed chromatin and DNA fragmentation, which is indicative of
      endonuclease activation, the hallmarks of apoptosis in epithelial cells. The
      number of cisplatin-treated cells identified as apoptotic at any one time was
      never > 1% of the total cell number present on addition of drug. Two days after
      drug addition there was a decrease from 85% to 29% cells in G1 phase of the cell
      cycle, cells in S phase increased from 9% to 18%, and cells in G2/M phase
      increased from 6% to 51% with respect to untreated cells. Previous studies by
      Eastman and colleagues demonstrated that cisplatin-induced apoptosis of Chinese
      hamster ovary cells occurred in the G2 phase of the cell cycle [A. Eastman,
      Cancer Cells (Cold Spring Harbor), 2: 275-280, 1990]. Continuous exposure of JB1
      cells to cycloheximide (1 microM) during and after exposure to cisplatin
      prevented both drug-induced changes in cell cycle distribution and the engagement
      of apoptosis. Freshly isolated immature rat thymocytes are known to be
      exquisitely sensitive to the induction of apoptosis by multiple stimuli including
      dexamethasone, etoposide, and irradiation. However, no significant increase in
      the amount of apoptosis above control levels was observed up to 36 h after a 2-h
      exposure to 50 microM cisplatin. JB1 cells have a doubling time of 24 h, whereas
      > 90% of immature rat thymocytes are noncycling. The data presented here provide
      indirect evidence that initiation of cisplatin-induced apoptosis may need to be
      coupled to a cell cycle-mediated event.

PMID- 8481917
TI  - Chromosome abnormalities in eighty-three head and neck squamous cell carcinomas:
      influence of culture conditions on karyotypic pattern.
AB  - Short-term cultures from 115 squamous cell carcinomas (SCC) of the head and neck
      were cytogenetically investigated. Thirty-six of the tumors have been reported
      previously, whereas 79 are new cases. The material was divided into two series
      based on the medium used. The 80 tumors of series I were cultured in RPMI 1640
      supplemented with fetal calf serum, glutamine, antibiotics, insulin, cholera
      toxin, and epidermal growth factor. The 35 tumors of series II were cultured in a
      chemically defined, serum-free medium with a low calcium concentration, MCDB 153,
      which stimulates epithelial growth while inhibiting fibroblasts. A total of 83
      tumors with clonal karyotypic abnormalities were detected in the two series.
      Series II had a higher proportion of tumors with complex karyotypic changes than
      series I (43% versus 15%), a lower proportion of tumors with pseudo- or
      neardiploid clones characterized by simple rearrangements (3% versus 34%), and a
      lower frequency of unrelated clones (3% versus 24%), indicating that the
      different culture conditions favored growth of different cell populations. Except
      for rearrangements of 1p22, which were mainly found in series I, the distribution
      of breakpoints in structural aberrations was similar in the two series and
      clustered to several chromosomal bands or regions, in particular 11q13, 1p22,
      1p11-12, 3p11-q11, 5q13, 1q25, 15q10, and 8q10. Unbalanced structural aberrations
      were more common in series II, frequently leading to loss of segments from
      chromosome arms 3p, 7q, 8p, 11q, 13p, 14p, and 15p, whereas gain of genetic
      material often involved chromosome arms 1q, 3q, 8q, and 15q.

PMID- 8481918
TI  - Baculovirus recombinants expressing the human carcinoembryonic antigen gene.
AB  - Carcinoembryonic antigen (CEA), one of the most extensively studied human tumor
      associated antigens, represents a potential target for passive as well as active
      immunotherapy. We describe here the first baculovirus recombinants expressing the
      human CEA gene. Eight baculovirus clones were isolated which expressed products
      of varying molecular weights; one clone, termed BVCEA-140, was shown to contain
      multiple CEA epitopes by reactivity to a panel of anti-CEA monoclonal antibodies.
      When purified protein isolated from this clone was deglycosylated, immunoreactive
      species ranging from M(r) 50,000 to M(r) 110,000 were found. Results of Southern
      blot analysis carried out on BVCEA-140 DNA were consistent with the hypothesis
      that these products result from the stable expression of variants which have
      recombined within the repeated domains of CEA. Other baculovirus recombinants
      expressing products comprising different portions of the CEA gene were also
      derived. One, termed BVCEA-35, was shown to be a recombination between the first
      87 bases of domains I and III of the CEA gene. A variant, termed BVCEA-16,
      contained only the NH2-terminal domain of the CEA gene. Moreover, a recombinant
      expressing the closely related molecule nonspecific cross-reactive antigen was
      also derived. As shown here, commercially available preparations of CEA, which
      are derived from tumor biopsies or cell line supernatants, may contain
      nonspecific cross-reacting antigens and other contaminants. Thus, the recombinant
      CEA molecules described should have numerous uses including validation of the use
      of monoclonal antibodies as standards in CEA serum assays, the characterization
      of immune responses to CEA, the use as immunogen, and the study of structure
      function relationships.

PMID- 8481919
TI  - Transforming growth factor-alpha expression produces only morphological
      transformants of diploid human fibroblasts.
AB  - Transforming growth factor-alpha (TGF-alpha) is a potent mitogen for a variety of
      epithelial and mesenchymal cells and is commonly expressed in many human tumors
      and tumor cell lines. Frequently, this creates a potential autocrine circuit for
      growth stimulation in these cells; however, this is occurring in a background of
      other mutation-generated events. To determine the significance of the TGF-alpha
      circuit alone, we expressed the human TGF-alpha cDNA in a diploid human foreskin
      fibroblast strain, 7-25, under the control of the cytomegalovirus immediate early
      promoter-enhancer region and screened transfectants for TGF-alpha expression by
      Northern analysis and by immunoprecipitation. Partially processed forms (M(r)
      24,000 and 20,000) of the recombinant TGF-alpha were observed in cell lysates and
      a M(r) 5500 fully processed form was secreted by the fibroblasts into the media.
      TGF-alpha-expressing clones showed an altered morphology and an increased
      saturation density (1.4- to 2.1-fold) but did not exhibit anchor-age-dependent
      growth in soft agarose or the ability to form tumors in nude mice. Additionally,
      expression of recombinant TGF-alpha did not extend the lifespan of these
      fibroblast clones. Scatchard analysis revealed approximately 10(5) epidermal
      growth factor (EGF) receptors on the surface of these human fibroblasts,
      indicating that the failure of TGF-alpha expression to strongly transform these
      cells is not due to low EGF receptor levels. These data suggest that cell type
      plays an important role in determining the transforming ability of TGF-alpha.

PMID- 8481920
TI  - Fibroblast growth factor 4 transfection of MCF-7 cells produces cell lines that
      are tumorigenic and metastatic in ovariectomized or tamoxifen-treated athymic
      nude mice.
AB  - Successful antiestrogen treatment in patients with tamoxifen-responsive breast
      tumors is often followed by an outgrowth of tumors cells that are antiestrogen
      resistant, implying that estrogen-dependent tumors can become estrogen
      independent. In an effect to mimic this progression, we have transfected
      fibroblast growth factor 4 into MCF-7 cells, a human breast carcinoma cell line
      that is estrogen-dependent for growth in nude mice. This transfection results in
      cell lines that form progressively growing, metastatic tumors when injected s.c.
      into untreated or tamoxifen-treated ovariectomized nude mice. In contrast to the
      parental cell line, growth of transfected cells in ovariectomized nude mice is
      stimulated by tamoxifen treatment and inhibited by estrogen treatment of the
      mice. Parental MCF-7 cells were transfected with an expression vector for beta
      galactosidase, conferring the ability to convert the chromogenic substrate, 5
      bromo-4-chloro-3-indoyl-beta-galactoside, to a blue color and allowing the
      detection of their presence within tumors developing after coinoculation with
      fibroblast growth factor 4-transfected cells. The fibroblast growth factor 4
      transfected cells could support growth and metastasis of the beta-galactosidase
      expressing parental cell line when both lines were coinjected into the same site
      in untreated or tamoxifen-treated, ovariectomized mice. These data suggest a
      possible role for fibroblast growth factors in the progression of breast tumors
      to an estrogen-independent, antiestrogen-resistant, metastatic phenotype. They
      also support a role for paracrine factors in mixed populations of tumor cells of
      differing states of malignant progression.

PMID- 8481921
TI  - Quantitative demonstration of spontaneous metastasis by MCF-7 human breast cancer
      cells cotransfected with fibroblast growth factor 4 and LacZ.
AB  - We recently established transfectants of MCF-7 human breast cancer cells with
      fibroblast growth factor 4 (fgf-4) that showed rapid growth and spontaneous
      metastasis in ovariectomized and tamoxifen-treated nude mice. To establish a
      spontaneous metastatic model of human breast cancer cells in nude mice with a
      sensitive marker for detection of micrometastasis, the transfection of fgf-4 was
      combined with transfection of the bacterial lacZ gene encoding beta
      galactosidase. MKL-4 cells, a lacZ transfectant of an fgf-4-transfected cell
      line, showed the same level of fgf-4 expression as parental cells and expressed a
      high level of beta-galactosidase activity. When MKL-4 cells were injected s.c.
      into female nude mice, rapidly growing tumors developed. Whole organ staining for
      beta-galactosidase activity was able to detect even small numbers of metastatic
      tumor cells. Micrometastases in lymph nodes, lung, and brain were detected 3
      weeks after the tumor cell injections, the first time point tested. Within 12
      weeks, metastases were observed in lymph nodes, lung, brain, kidney, perirenal
      fatty tissues, liver, spleen, retroperitoneum, heart, and gallbladder. The
      frequency of metastasis and number of foci were correlated with the volume of the
      primary tumors. The distribution of metastatic sites was similar to that in
      breast cancer patients. MKL-4 cells may be a useful model for studying the
      malignant progression of hormone-dependent breast cancer, antimetastatic drugs,
      or early events in metastasis.

PMID- 8481922
TI  - Correspondence Re: H. Nagasawa and J. B. Little, Induction of sister chromatid
      exchanges by extremely low doses of alpha-particles. Cancer Res., 52: 6394-6396,
      1992.

PMID- 8481923
TI  - Environmental carcinogenesis and its prevention: the head and neck cancer model.

PMID- 8481924
TI  - Fourth annual Pezcoller Symposium--adhesion molecules: cellular recognition
      mechanisms.

PMID- 8481925
TI  - Menstrual effects on surgical treatment for breast cancer.

PMID- 8481926
TI  - Diagnosis and treatment of spinal cord compression in malignant disease.

PMID- 8481927
TI  - Diagnosis and management of malignant pleural effusion.

PMID- 8481928
TI  - Prospects for gene-directed therapy with antisense oligodeoxynucleotides.

PMID- 8481929
TI  - Impact of adjuvant chemotherapy in breast cancer on response to tamoxifen at
      relapse.
AB  - A series of 105 patients with operable breast cancer previously entered in the
      WMOA adjuvant therapy trials were reviewed in order to assess methods of
      treatment on relapse and subsequent patterns of relapse and survival, related to
      previous adjuvant therapy. Tamoxifen was the predominant medical therapy offered
      on relapse. Unexpectedly, analysis of the relapse and survival data for these
      hormone-treated patients suggested that prior adjuvant therapy negatively
      influenced response to tamoxifen, with overall survival of treated and control
      patients being identical. Although not statistically significant, possible
      explanations of this trend have been explored.

PMID- 8481931
TI  - Effect of adjuvant systemic therapy on response to treatment after relapse.

PMID- 8481930
TI  - Response to chemotherapy after relapse in patients with or without previous
      adjuvant chemotherapy for breast cancer. The French Epirubicin Study Group.
AB  - The French Epirubicin Study Group undertook a retrospective study to evaluate the
      response rate at relapse, time to treatment failure, and overall survival
      according to previous CMF-type adjuvant chemotherapy in patients who had taken
      part in two successive clinical trials. The statistical significance of the
      comparisons was tested after adjustment for the factors that differed most
      between the two groups. Patients who had received previous adjuvant chemotherapy
      had a lower response rate (p = 0.03), a shorter time to treatment failure (p =
      0.007), and shorter overall survival after relapse (p = 0.008); overall survival
      after initial diagnosis was not significantly different. With respect to patients
      with axillary node metastases at the time of diagnosis (N+ patients), those with
      previous adjuvant chemotherapy had a lower response rate (p = 0.01) and shorter
      time to treatment failure (p = 0.02), but overall survival after relapse and
      after initial diagnosis were not significantly different. This retrospective and
      descriptive study suggests that chemotherapy is less effective after relapse, as
      measured by response rate and time to treatment failure, in patients with
      previous adjuvant chemotherapy.

PMID- 8481932
TI  - Efficacy and tolerability of 4-hydroxyandrostenedione (4-OHA) as first-line
      treatment in postmenopausal patients with breast cancer after adjuvant therapy.
AB  - Aromatase inhibitors are known to be effective in the treatment of advanced
      postmenopausal breast cancer. To assess the efficacy of the aromatase inhibitor 4
      hydroxyandrostenedione (4-OHA) as first-line treatment in patients who were
      either resistant to or had relapsed after adjuvant therapy, 50 eligible patients
      received intramuscular 4-OHA either 250 mg or 500 mg fortnightly until disease
      progression or severe adverse events. Of the 43 patients evaluable for clinical
      response (UICC criteria), 15 (36%) showed objective response (CR+PR), 6 (14%)
      stable disease (SD). In relation to disease site, objective responses were
      obtained in 55% of cases with soft tissue metastases (16/29); in 33% with
      visceral metastases (8/24), and in 24% with bone involvement (5/21). In relation
      to previous adjuvant treatment, there were eight objective responses among the 17
      patients treated with chemotherapy (47%), and seven objective responses among the
      24 treated with tamoxifen (29%). The treatment was well tolerated. These results
      support the hypothesis that adjuvant therapy, whether hormonal or chemotherapy,
      may make patients less responsive to subsequent treatment.

PMID- 8481933
TI  - Experience with aromatase inhibitors in the treatment of advanced breast cancer.
AB  - Inhibition of the aromatase enzyme system has become an established means of
      hormonal treatment for hormone-responsive advanced breast cancer. The widest
      clinical experience is with aminoglutethimide, which achieves around 30%
      objective remissions of metastatic disease for up to 1 year. Due to the sometimes
      serious side-effects of this drug, preclinical and clinical investigations have
      been undertaken and have yielded a number of steroidal and non-steroidal
      aromatase inhibitors that have been shown in early or mature clinical trials to
      give objective disease remissions similar to those with aminoglutethimide but
      with less toxicity. There is thus good reason to believe that newer aromatase
      inhibiting drugs will soon be available for routine use in patients with breast
      cancer. This paper summarizes our experience and reviews data from other groups.

PMID- 8481934
TI  - Cell biological factors associated with the response of breast cancer to systemic
      treatment.
AB  - A large number of cell biological parameters are currently available to predict
      the prognosis of patients with breast cancer, but it is still difficulty
      accurately to predict the response to treatment. A valuable prognostic factor can
      be a poor predictive factor for response, and vice versa. High tumor levels of
      ER, PgR, AR and pS2 predict a relatively good response to endocrine therapy,
      while EGF-R positively, HER2/neu positivity, aneuploidy, high proliferation
      indices and possibly high uPA levels indicate a high chance of poor response to
      endocrine therapy in metastatic breast cancer. With respect to chemotherapy, a
      high proliferation rate and HER2/neu amplification predict a good response to
      therapy in metastatic disease, while MDR gene expression and possibly c-myc
      amplification are related to a worse response. In conclusion, the newer cell
      biological parameters can be used to select high and low-risk patients, type of
      systemic treatment, and as targets for new treatment modalities.

PMID- 8481935
TI  - Use of endocrine therapy to study the biology of breast cancer.
AB  - Drug resistance is the main reason for therapeutic failure and death in breast
      cancer. In vitro investigations have identified some mechanisms that may be
      responsible for resistance to chemotherapeutic agents in breast cancer, but we
      know little about the mechanisms responsible for resistance to endocrine
      treatment in receptor-positive tumors. Accordingly, a major task for future
      studies is to explore the mechanisms of both primary and acquired resistance to
      endocrine treatment as well as to chemotherapy in breast cancer. Drug resistance
      may be related to alterations in endocrine as well as paracrine delivery of
      certain growth factors or hormones, but it may also be caused by alterations in
      drug disposition. Primary resistance may be evaluated by comparing the response
      to drug treatment with the expression of different biochemical parameters in the
      tumor before treatment. To explore the mechanisms of acquired drug resistance
      requires study of the changes in biological parameters developing over time
      during drug therapy. Also, it may be of interest to use certain drugs (like a
      'classical' anti-estrogen and a steroidal anti-estrogen) in a particular sequence
      to explore the possibility of cross-resistance (or lack of it) between particular
      treatment modalities. Possible implications for the design of future trials in
      breast cancer treatment are discussed.

PMID- 8481936
TI  - Raised intracranial pressure, the syndrome of inappropriate antidiuretic hormone
      secretion, and arginine vasopressin in tuberculous meningitis.
AB  - Intracranial pressure (ICP) monitored shortly after admission over a period of 1
      h in 31 children with tuberculous meningitis (TBM) was significantly higher
      (median 22.5 mmHg, range 8.4-50.9 mmHg) in 19 children with laboratory evidence
      of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) than in
      12 children without such evidence (median 16.2 mmHg, range 5.8-42.5 mmHg; P =
      0.027). Neither plasma nor cerebrospinal fluid arginine vasopressin (AVP) was
      related to ICP (r = 0.33 and 0.13 respectively). Mean arterial pressure (MAP) was
      measured in 23 children and a moderate correlation was found with plasma AVP (r =
      0.62; P = 0.0019). In TBM, plasma AVP may be secreted as a response to raised ICP
      in an effort to raise MAP and maintain cerebral perfusion pressure. In this
      setting excess fluid may be inappropriately retained, leading to hyponatremia and
      hypo-osmolemia.

PMID- 8481937
TI  - Cerebrospinal compensation in hydrocephalic children.
AB  - One hundred and fifteen cases of hydrocephalus in children were analysed.
      Cerebrospinal compensatory reserve was assessed by a computerized, constant rate,
      lumbar infusion test. Head circumference and ventricular size were measured and a
      psychometric examination carried out. A classification of hydrocephalus based on
      resting cerebrospinal fluid pressure (CSFP) and resistance to cerebrospinal fluid
      outflow (RCSF) was introduced. Parameters of compensatory reserve were compared
      in atrophy (low CSFP, low RCSF), normal-pressure hydrocephalus (low CSFP,
      increased RCSF), non-communicating hydrocephalus (high CSFP, low RCSF) and acute
      hydrocephalus (high CSFP and increased RCSF). Significant differences were found
      between the factors describing compensatory ability in these groups. Sixty-two
      patients could be classified on the basis of resting CSFP and RCSF.
      Differentiation between the types of hydrocephalus was shown to be more accurate
      when all variables measured during the pressure-volume test were considered. The
      patterns of the time courses of CSFP during rate infusion tests in the different
      types of hydrocephalus are presented.

PMID- 8481938
TI  - Arachnoid cyst of the lateral ventricles.

PMID- 8481939
TI  - Reflex seizures in Down syndrome.
AB  - A unique patient with Down syndrome who developed reflex seizures is described.
      The patient has had recurrent intermittent seizures for the past 3.5 years. These
      seizures were usually precipitated by auditory stimuli such as sudden loud
      noises. While having seizures the patient experienced severe discomfort in the
      posterior neck area. The seizures usually lasted 10-20 s, and there was no aura,
      nor was there a postictal phase. Of the numerous investigations performed, closed
      circuit electroencephalogram video telemetry was most helpful in arriving at an
      accurate diagnosis. Carbamazepine administration resulted in total seizure
      control and reflex stimuli no longer provoke seizure activity. Although it has
      been suggested that reflex seizures may be due to genetic factors or structural
      central nervous system defects, we were unable to uncover the cause of the reflex
      seizures in our patient.

PMID- 8481940
TI  - Circadian rhythm of glucose utilization in the pineal body of rats of different
      ages.
AB  - Employing quantitative autoradiography, pineal body glucose utilization (GU) was
      measured in daytime or at night in prepubertal (aged 1 month), adult (aged 3
      months), and mature (over 12 months old) rats. In prepubertal and adult rats, in
      daytime, GU values within the pineal tissue were homogeneously distributed around
      65 mumol glucose/100 g per min. In prepubertal animals no significant variations
      in GU were observed between daytime and nocturnal measurements. A circadian
      metabolic rhythmicity was evident in adult rats, with a GU peak measured at 2
      a.m. In mature animals, GU also varied between day and night, with an increment
      in the relative difference between the two values. The present investigation is
      the first to demonstrate that circadian metabolic rhythmicity is absent before
      sexual maturation while it is enhanced in 12-month-old rats. These changes in
      pineal energy metabolism with advancing age are intriguing in view of the concept
      that the pineal gland may be involved in functional changes occurring during the
      process of aging.

PMID- 8481941
TI  - Invasive character of an intradural spinal meningioma in early childhood.
AB  - The authors report the case of a 2-year-old baby girl with an intradural
      meningotheliomatous meningioma of the cauda equina which recurred three times.
      Despite four operative procedures and localized radiotherapy, the lesion kept on
      growing to reach the retroperitoneal space. Extensive laminectomy and associated
      radiotherapy were probably responsible for a spinal dislocation which had to be
      operated on. The child was left paraplegic with major bladder dysfunction after
      all procedures. This is the first reported case of well-documented "malignant"
      evolution of a spinal meningioma.

PMID- 8481942
TI  - Ependymomas of the filum terminale in childhood: report of four cases and review
      of the literature.
AB  - Four cases of ependymoma of the filum terminale occurring in childhood are
      reported. The clinical, therapeutic and prognostic features seen at this age and
      in adults were compared.

PMID- 8481943
TI  - Pathologic findings in a patient with a vein of Galen aneurysm treated by staged
      endovascular embolization.
AB  - Vein of Galen aneurysms are uncommon malformations that can be treated with a
      combination of endovascular embolization and surgery. Since the relevant
      techniques are new and innovative, their pathologic sequelae are not yet well
      described. A patient treated with staged embolization over a 15-month period
      developed evidence of cerebral venous hypertension on angiography. At necropsy,
      we observed marked myointimal proliferation of the aneurysm wall, dura, and
      cerebral vessels in addition to severe widespread encephalomalacia, calcinosis,
      and rare mural thrombi. These vascular changes have not been previously described
      in cases of vein of Galen aneurysm, and may, in part, be a consequence of
      embolization therapy.

PMID- 8481944
TI  - Pleomorphic xanthoastrocytoma associated with von Recklinghausen
      neurofibromatosis.
AB  - The authors present a case of pleomorphic xanthoastrocytoma that occurred in a 14
      year-old boy with von Recklinghausen's neurofibromatosis. The circumscribed tumor
      with a cystic component was located in the medial right temporal lobe. The
      designation of pleomorphic xanthoastrocytoma has been suggested for this neoplasm
      on the basis of its unique histological features. These include positive glial
      fibrillary acidic protein staining.

PMID- 8481945
TI  - Supratentorial glioblastoma in children: a series of 27 surgically treated cases.

PMID- 8481946
TI  - Value orientation, health beliefs, and cardiovascular health in young African
      American women.

PMID- 8481947
TI  - Development of antigenic heterogeneity in the splenic meshwork of severe combined
      immunodeficient (SCID) mice after reconstitution with T and B lymphocytes.
AB  - Recently, we produced monoclonal antibodies reacting specifically with the
      reticular meshwork (RM) of lymphoid tissues, and demonstrated that, in the
      splenic white pulp of normal mouse, the antigenic heterogeneity of RM was
      associated with the segregation of the T and B lymphocytes. In the present study,
      we attempted to visualize further the interaction between splenic RM and T and B
      lymphocytes transferred into severe combined immunodeficient (SCID) mice. The
      splenic white pulp of naive SCID mice, containing a few T and B cells, showed
      little tendency for T-B segregation and antigenic diversity of RM. Transfer of
      spleen or bone marrow cells from normal mice resulted in complete recovery of
      lymphocyte populations, showing not only a clear segregation of T and B
      lymphocytes but also a remarkable antigenic diversity of RM. The same results
      were obtained following the transfer of spleen or bone marrow cells from the nude
      mouse. Next, we transferred purified T lymphocytes to one group of SCID mice and
      B cells to another. In mice given T cells, a few B cells were observed in the
      white pulp; T lymphocytes lodged not only in the inner periarterial lymphatic
      sheath (PALS) but also in the outer PALS and follicles. In the animals to which B
      cells were transferred, T cells were few and the homing of B cells occurred only
      into their proper compartments, such as the outer PALS, follicles and marginal
      zone, but not in the inner PALS. Thus, B cells can home into their proper
      compartments of the splenic white pulp independently of T lymphocytes.

PMID- 8481948
TI  - Localization of collagen type VI in articular cartilage of young and adult mice.
AB  - Collagen type VI was demonstrated immunomorphologically in articular cartilage
      (distal femur) of young (2-8 weeks) and adult mice by fluorescence and electron
      microscopy (gold-labelled second antibody--sandwich method) using pre- and post
      embedding techniques. This collagen type was mainly seen in the vicinity of
      chondrocytes, and in larger amounts in adult cartilage. Electron-microscopic
      inspection (pre-embedding technique) revealed labelling above plaques that were
      40-160 nm in size, and from which up to 7 fine filaments (< or = 10 nm) per unit
      sectional plane radiated. Using the post-embedding technique, only labelled
      plaques could be demonstrated; fine filaments were not perceptible. This was
      partly a result of the low contrast. It is assumed that the globular ends of up
      to 20 of the fine type VI filaments are anchored in one plaque and that the
      antibodies bind to the non-collagenous globular domains. Filaments radiated from
      the plaques and formed a three-dimensional network that stabilized the structures
      of the cartilaginous matrix. Antibodies against fibronectin also labelled similar
      plaques. The ends of the type VI filaments are possibly linked into the plaques
      by fibronectin.

PMID- 8481949
TI  - Localization of cholecystokinin-like and calcitonin-like peptides in infant
      carotid bodies: a light- and electron-microscopic immunohistochemical study.
AB  - Previous immunohistochemical studies have identified several regulatory peptides
      in the carotid body chief cells in both humans and animals. These peptides,
      together with amines, may be important in the modulation of the chemoreflex by
      the carotid body. We report the localization and distribution of calcitonin and
      cholecystokinin-like (CCK) immunoreactivity in chief cells of human infant
      carotid body by light- and electron-microscopic immunohistochemical techniques.
      Consecutive sections immunostained with calcitonin and/or CCK antibodies revealed
      positively stained chief cells, both alone and in clusters, scattered throughout
      the carotid body lobule. Generally more chief cells were positive for calcitonin
      than for CCK. This was confirmed by quantitative analysis showing that the ratio
      of calcitonin to CCK immunoreactive cells was consistently > 2:1 in all cases
      studied. There was no apparent correlation between the immunoreactivity for the
      two peptides and the age, sex, or postmortem interval. Calcitonin-like and CCK
      like immunoreactivities were localized electron-microscopically over the dense
      core granules of the chief cells. Calcitonin and CCK-like peptides in carotid
      body chief cells may act as neurotransmitters or neuromodulators involved in
      chemoreception.

PMID- 8481950
TI  - Localization of neuropeptide Y and atrial natriuretic peptide in the endothelial
      cells of human umbilical blood vessels.
AB  - The localization of neuropeptide Y (NPY) and atrial natriuretic peptide (ANP) in
      the endothelial cells of human umbilical blood vessels was studied using the pre
      embedding peroxidase-antiperoxidase (PAP) technique for electron microscopy and
      avidin-biotin-complex (ABC) immunostaining for endothelial cells cultured from
      umbilical vein. Subpopulations of NPY- and ANP-immunoreactive endothelial cells
      were present in term umbilical vein and artery. The umbilical vein contained more
      positive cells than the artery. The percentage of NPY- and ANP-immunoreactive
      umbilical vein cells in culture was 32% and 44%, respectively, out of a total of
      3013 cells examined. The possibility that these potent vasoactive substances
      located in the endothelial cells of the non-innervated umbilical vessels are
      involved in the local regulation of blood flow is discussed.

PMID- 8481951
TI  - Morphology and distribution of Muller cells in the retina of the toad Bufo
      marinus.
AB  - We have previously shown that an antibody against neuron-specific enolase (NSE)
      selectively labels Muller cells (MCs) in the anuran retina (Wilhelm et al. 1992).
      In the present study the light- and electron-microscopic morphology of MCs and
      their distribution were described in the retina of the toad, Bufo marinus, using
      the above antibody. The somata of MCs were located in the proximal part of the
      inner nuclear layer and were interconnected with each other by their processes.
      The MCs were uniformly distributed across the retina with an average density of
      1500 cells/mm2. Processes of MCs encircled the somata of photoreceptor cells
      isolating them from each other by glial sheath, except for those of the double
      cones. Some of the photoreceptor pedicles remained free of glial sheath. Electron
      microscopic observations confirmed that MC processes provide an extensive
      scaffolding across the neural retina. At the outer border of the ganglion cell
      layer these processes formed a non-continuous sheath. The MC processes traversed
      through the ganglion cell layer and spread beneath it between the neuronal somata
      and the underlying optic axons. These processes formed a continuous inner
      limiting membrane separating the optic fibre layer from the vitreous tissue.
      Neither astrocytic nor oligodendrocytic elements were found in the optic fibre
      layer. The significance of the uniform MC distribution and the functional
      implications of the observed pattern of MC scaffolding are discussed.

PMID- 8481952
TI  - Resident macrophages (ED2- and ED3-positive) do not phagocytose degenerating rat
      skeletal muscle fibres.
AB  - Two soleus muscles with degenerating muscle fibres were serially sectioned and
      adjacent sections from various levels of the skeletal muscles were stained with
      antibodies that react with either monocytes and inflammatory macrophages (ED1) or
      with the major subpopulations of resident macrophages (ED2 and ED3). ED2+ and
      ED3+ resident macrophages were abundant throughout the muscles but were not
      present within the degenerating fibres. ED1+ cells, in contrast, were rarely
      observed within the undamaged regions of the muscles but were abundant within the
      degenerating fibres and in the perimysium between arterioles and degenerating
      fibres. It is concluded that the phagocytosis of damaged muscle fibres is not
      carried out by the major subpopulations of resident macrophages.

PMID- 8481953
TI  - Total numbers of neurons in myenteric ganglia of the guinea-pig small intestine.
AB  - Two techniques that are thought to stain all of the neurons in the myenteric
      ganglia of the intestine are NADH diaphorase histochemistry and
      immunohistochemistry using a "nerve cell body" antiserum. However, this
      assumption has never been directly verified. In the present study myenteric
      ganglia of the guinea-pig ileum were prepared as whole-mounts and stained with
      either of these techniques. All nerve cells that could be identified in the whole
      mounts were counted. The whole-mounts were then embedded flat in resin and
      serially sectioned at 1 micron. Nerve cells were identified and counted from the
      serial sections, and the data compared to those obtained from the whole-mounts.
      NADH diaphorase histochemistry did not reveal all the neurons at incubation times
      that gave selective staining. In contrast, "nerve cell body" antiserum stained
      the entire neuronal population. To determine the total number of nerve cell
      bodies/ganglion and the proportion of nerve cell bodies with calbindin
      immunoreactivity, whole-mounts that had been processed for calbindin
      immunohistochemistry were serially sectioned and reconstructed. The total number
      of neurons per myenteric ganglion was 105 +/- 10 (SE). Calbindin-immunoreactive
      neurons comprised about 20% of the myenteric neurons, which is considerably less
      than previous estimates, because previously the total population has been
      underestimated. The spatial density of myenteric neurons in the undistended ileum
      of the guinea-pig is 17,300 nerve cells/cm2.

PMID- 8481954
TI  - Polarized distribution of gamma interferon-stimulated MHC antigens and
      transferrin receptors in a clonal cell line isolated from Fisher rat thyroid (FRT
      cells).
AB  - The characteristics of a polarized epithelial cell line and dynamics of an
      endogenous polarized plasma membrane constituent were studied by use of an
      subclone, FRT-9, from the Fisher rat thyroid cell line, FRT. Transmission
      electron microscopy (conventional, freeze-fracture), determination of
      transepithelial electrical parameters and immuno-fluorescence study, were used to
      establish polarity and demonstrated the basolateral distribution of transferrin
      receptors and the major histocompatibility complex antigens (constitutive Class I
      or gamma interferon-induced Class II).

PMID- 8481955
TI  - Morphofunctional study on prolactin-producing cells of the anterior pituitaries
      in adult male rats following thyroidectomy, thyroxine treatment and/or
      thyrotropin-releasing hormone treatment.
AB  - An immunoelectron-microscopic and morphometric study was carried out on the
      anterior pituitary prolactin (PRL) cells of adult male Wistar rats treated with a
      combination of thyroidectomy and administration of L-thyroxine (T4) and/or
      synthetic thyrotropin-releasing hormone (TRH) in order to clarify the effects of
      changes in the hypothalamus-pituitary-thyroid axis on the ultrastructure and
      function of PRL cells. After thyroidectomy, PRL cells underwent atrophy and
      hypofunction of their cell organelles, but these changes tended to be restored to
      their normal level by T4 treatment. On the other hand, the administration of TRH
      to intact rats produced hypertrophy and hyperfunction in the PRL cells, although
      this treatment had no effect on the PRL cells of thyroidectomized rats. However,
      treatment with a combination of T4 and TRH had a strong effect and led to
      hypertrophy and hyperfunction in the PRL cells of thyroidectomized rats. Serum
      and pituitary PRL levels were measured by radioimmunoassay (RIA) for a comparison
      with the morphological results. They correlated well with the morphological
      changes. These results indicate that TRH stimulates PRL secretion in the presence
      of thyroid hormone, and that the thyroid hormone plays an important role in the
      basic maintenance of PRL cell function and its reactivity to TRH.

PMID- 8481956
TI  - Occurrence, distribution and neurochemical features of small intestinal neurons
      projecting to the cranial mesenteric ganglion in the pig.
AB  - The small intestine of the pig has been investigated for its topographical
      distribution of enteric neurons projecting to the cranial mesenteric ganglion, by
      using Fast Blue or Fluorogold as a retrogradely transported neuronal tracer.
      Contrary to the situation in small laboratory animals such as rat and guinea-pig,
      the intestinofugally projecting neurons in the porcine small intestine were not
      restricted to the myenteric plexus, but were observed in greater numbers in
      ganglia of the outer submucous plexus. The inner submucous plexus was devoid of
      labelled neurons. Retrogradely labelled neurons were mostly found, either singly
      or in small aggregates, in ganglia located within a narrow border on either side
      of the mesenteric attachment. For both nerve networks, their number increased
      from duodenum to ileum. All the retrogradely labelled neurons exhibited a
      multidendritic uniaxonal appearance. Some of them displayed type-III morphology
      and stained for serotonin. This study indicates that, in the pig, not only the
      myenteric plexus but also one submucous nerve network is involved in the afferent
      component of intestino-sympathico-intestinal reflex pathways. The finding that
      some of the morphologically defined type-III neurons participate in these
      reflexes is in accord with the earlier proposal that type-III neurons are
      supposed to fulfill an interneuronal role, whether intra- or extramurally.

PMID- 8481957
TI  - Ultrastructure of the taste disc in the red-bellied toad Bombina orientalis
      (Discoglossidae, Salientia).
AB  - The taste disc of the red-bellied toad Bombina orientalis (Discoglossidae) has
      been investigated by light and electron microscopy and compared with that of Rana
      pipiens (Ranidae). Unlike the frog, B. orientalis possesses a disc-shaped tongue
      that cannot be ejected for capture of prey. The taste discs are located on the
      top of fungiform papillae. They are smaller than those in Ranidae, and are not
      surrounded by a ring of ciliated cells. Ultrastructurally, five types of cells
      can be identified (mucus cells, wing cells, sensory cells, and both Merkel cell
      like basal cells and undifferentiated basal cells). Mucus cells are the main
      secretory cells of the taste disc and occupy most of the surface area. Their
      basal processes do not synapse on nerve fibers. Wing cells have sheet-like apical
      processes and envelop the mucus cells. They contain lysosomes and multivesicular
      bodies. Two types of sensory cells reach the surface of the taste disc; apically,
      they are distinguished by either a brush-like arrangement of microvilli or a rod
      like protrusion. They are invaginated into lateral folds of mucus cells and wing
      cells. In contrast to the situation in R. pipiens, sensory cells of B. orientalis
      do not contain dark secretory granules in the perinuclear region. Synaptic
      connections occur between sensory cells (presynaptic sites) and nerve fibers.
      Merkel cell-like basal cells do not synapse onto sensory cells, but synapse-like
      connections exist between Merkel cell-like basal cells (presynaptic site) and
      nerve fibers.

PMID- 8481958
TI  - Effect of omeprazole-evoked hypergastrinemia on ultrastructure of
      enterochromaffin-like cells in the stomach of portacaval-shunted rats.
AB  - The histamine-producing enterochromaffin-like (ECL) cells in the acid-producing
      portion of the rat stomach responded to long-standing hypergastrinemia
      (omeprazole treatment daily for 8-10 weeks) with hypertrophy (and hyperplasia)
      and with a reduced number of granules and vesicles per unit cytoplasm. There was
      a reduction in the ratio of electron-dense granules versus vesicles and an
      increase in the profile diameter of the vesicles. Also, portacaval shunting (PCS)
      induced changes in the ECL cells, manifesting (i) as an increase in cell number
      and size, and (ii) as a reduced number of granules and vesicles per unit area.
      The cytoplasmic granules and vesicle profiles were enlarged, and the ratio of
      granules versus vesicles was reduced. The combination of PCS and long-standing
      hypergastrinemia (omeprazole treatment) produced a greatly enhanced ECL cell
      hypertrophy (and hyperplasia) and a marked reduction in the number of granules.
      The ratio of granules versus vesicles was markedly reduced while the profile
      diameters of both granules and vesicles were increased. The relative predominance
      of very large vesicles (vacuoles) was a prominent feature of the ECL cells in
      these rats.

PMID- 8481959
TI  - Topography of short portal vessels in the rat pituitary gland: a scanning
      electron-microscopic and morphometric study of corrosion cast replicas.
AB  - We applied scanning electron microscopy combined with imaging and morphometric
      techniques to analyze the dorsal topography and morphology of short portal
      vessels linking the capillary beds of the pituitary neural and anterior lobes in
      adult male albino rats. The pituitary microvasculature was replicated by
      intracarotid injection of Batson's No. 17 compound producing plastic casts that
      were advantageous for comprehensive morphometric analyses using an imaging
      device. The analysis revealed the existence of two types of portal vessels having
      quantitatively different morphological properties. The bilateral venular plexus
      of 3-4 vessels located at the base of the infundibular stalk (each venule
      measuring 300 microns in length and 32 microns in diameter) appears to be the
      major part of the short portal system in the dorsum of the rat pituitary gland.
      Narrower capillary-like shunt vessels (6.8 microns in diameter), of about the
      same length as the venules, were situated throughout other subregions of the
      intermediate lobe cleft. The short portal vessels of both types made direct
      anastomoses with the capillary networks in the neural and anterior lobes. The
      neural lobe capillaries were twice as numerous (1324 per mm2), and only half as
      wide (6.2 microns), as the sinusoidal capillaries in the anterior lobe (density
      of 637 per mm2; diameter of 13.7 microns). The topographical position of the
      portal venular system suggests that the caudolateral subregions of the pituitary
      neural and anterior lobes have a functional relationship dependent on rapid
      interlobe transfer of neurohumoral factors such as hormones via the portal blood.
      This process appears to be supplemented throughout the rest of the cleft between
      the two lobes by a small number of capillary shunts that supply the epithelial
      cell lobules of the intermediate lobe in situ. The findings collectively indicate
      that this portal system provides a constant stream of neurohumoral information
      that is shared moment-by-moment between the pituitary neural and anterior lobes.

PMID- 8481961
TI  - Year-round conditioning for basketball.
AB  - Year-round conditioning specifically designed for basketball has reached a high
      level of sophistication over the past several decades. There is growing evidence
      that it can contribute to improved performance and reduced injury. The major
      components of conditioning for basketball have been identified as anaerobic power
      (stages I and II), aerobic power, muscular strength/power/endurance, and
      flexibility. The concept of year-round conditioning uses the principles of
      periodization in work and rest to achieve peak performance and avoid injury.
      There are unique problems associated with the various levels of competition that
      require diligent monitoring on the part of the coach to maximize physical
      condition and avoid overtraining.

PMID- 8481960
TI  - Catalase-negative peroxisomes in human embryonic liver.
AB  - Hepatic peroxisomes in human embryos with a menstrual age of 6 and 7 weeks have
      been examined via catalase cytochemistry. In the younger sample, the organelles
      show no catalase activity, their matrix being pale and coarsely reticular. In the
      7-week specimen, the peroxisome population consists of catalase-positive and
      catalase-negative organelles. The latter have a morphology identical to that of
      the 6-week sample and represent 66% of the population. The positive organelles
      show a pronounced staining heterogeneity. Together with the simultaneous presence
      of negative organelles, this might reflect the onset of catalase import into the
      peroxisomes during this period. Catalase heterogeneity excludes a continuous
      exchange of matrix contents; moreover, interconnections between peroxisomes have
      not been observed, and no cluster formation occurs. The data therefore also
      suggest that catalase is imported into individual, preexisting organelles in
      embryonic liver. The three peroxisomal beta-oxidation enzymes become detectable
      by immunocytochemistry only later during development. Morphological indications
      for a rapidly dividing population, such as elongated and/or tailed organelles,
      have not been observed. Morphometry has revealed that, in these early stages, the
      organelles are significantly smaller than the peroxisomes of fetal and adult
      human liver.

PMID- 8481962
TI  - A protocol for the health and fitness assessment of NBA players.
AB  - The assessment of the health and fitness of elite basketball players should be a
      multidisciplinary process. We have described an organized, efficient, and
      comprehensive protocol for preseason physical evaluations that could be used at
      the university as well as professional level.

PMID- 8481963
TI  - Assessment and treatment of basketball injuries.
AB  - In this article, we have discussed acute musculoskeletal injuries, acute
      exacerbations of illness related to basketball, and preparation for these
      emergencies. Although the acute nature of the problems require constant diligence
      on the part of the health care provider, the rewards of good management to the
      player and to the treating physician make it all worthwhile.

PMID- 8481964
TI  - Special considerations in the medical management of professional basketball
      players.
AB  - The NBA basketball players are among the finest athletes in the world. That along
      with the increased popularity of the NBA has put a premium on the health of the
      players. The course of the season puts tremendous stress and strain on players.
      As medical illnesses occur, the physician may feel increased pressure to put the
      ill player back into the line-up. One cannot let the pressure for the player to
      return to activity interfere with good medical practice. At times, it is
      difficult to allow for the natural course of an illness, however, as discussed in
      this article, sometimes this is exactly what needs to be done. The temptation to
      overtreat is also seen in some team physicians. This too must be avoided. Along
      with proper treatment, there is the need for education of the athletes both in
      social interactions and in diet and life-style. Then we, as team physicians, can
      sit back and enjoy the performance on the court.

PMID- 8481965
TI  - Common hand and wrist injuries in basketball players.
AB  - Multiple injuries to the hand are relatively common in basketball. This article
      explains the importance of an early and thorough examination, preferably by a
      hand specialist. It is important to obtain a history of prior injury during the
      assessment because treatment and prognosis may be very different. Delayed
      treatment often yields an inferior result and lost time. If an injury is not
      treated initially, it may require operative treatment or even be untreatable.

PMID- 8481966
TI  - Back injuries in basketball players.
AB  - The basketball player with lower back or lower extremity radicular pain needs to
      be carefully evaluated. A complete history of any previous symptomatology and a
      specific history of the new injury are absolutely essential. A careful physical
      examination with an understanding of the anatomy as well as possible causes of
      the lower back pain is crucial. An accurate diagnosis is essential in treating
      every athlete. Most basketball-related lower back injuries will respond to
      conservative nonsurgical treatment. Rehabilitation is a cornerstone in not only
      treating the initial symptoms, but decreasing the risks of reinjury. The goal of
      returning the basketball player to previous performance level as quickly as
      possible, with a minimal risk of re-injury, is the goal of the team physicians.

PMID- 8481967
TI  - Injuries of the posterior cruciate ligament.
AB  - A review of the anatomy and biomechanics of the posterior cruciate ligament, and
      the systematic approach for the diagnosis and treatment of isolated posterior
      cruciate ligament injuries and posterior cruciate ligament insufficiency in
      combination with other ligamentous instabilities is discussed.

PMID- 8481968
TI  - Basketball knee injuries and the anterior cruciate ligament.
AB  - Basketball arguably may present the greatest risk for anterior cruciate ligament
      (ACL) injury because it is well known that ACL injuries may occur with external
      or internal rotation of the tibia with or without hyperextension. All of these
      mechanical phenomena occur repetitively in a running, jumping, and cutting sport
      such as basketball. This article discusses the diagnosis and mechanism of injury
      as well as treatment of ACL injury.

PMID- 8481969
TI  - Rehabilitation of anterior cruciate ligament injuries.
AB  - Rehabilitation of the anterior cruciate ligament absent or reconstructed knee is
      becoming a true artform. Accelerated, but controlled rehabilitation, is becoming
      more commonplace. Scientific-based data along with clinical experiences are the
      basis of the rehabilitation guidelines brought forth in this article. Anterior
      cruciate ligament strain and implications for exercise, continuous passive
      motion, proprioceptive exercise, and the role of knee bracing are all discussed
      in relation to the overall rehabilitation program.

PMID- 8481970
TI  - Overuse injuries of the knee in basketball.
AB  - Overuse injuries of the knee are abundant in basketball players. This article
      discusses the pathophysiology of overuse and the principles of treatment. The
      diagnosis and clinical management of jumper's knee, patellofemoral pain, and
      stress fractures are outlined with specific attention to rehabilitation
      techniques and training.

PMID- 8481971
TI  - Sprained ankles as they relate to the basketball player.
AB  - Concepts based on newer medical information concerning ankle injuries have
      changed in recent years. With these changing concepts, the method of treatment
      has also changed. It is the purpose of this article to review some of the
      commonly known information concerning ankle sprains, to emphasize the association
      of subtalar injury with the ankle sprain complex, to outline new information
      concerning the static stabilizers on the lateral aspect of the ankle, and
      finally, to utilize this information in producing a rationale for a new type of
      surgical treatment for chronic instability of the ankle.

PMID- 8481972
TI  - Pretreatment with glucose infusion prevents fatal outcome after hemorrhage in
      food deprived rats.
AB  - Twenty-four hour food deprivation increases mortality after experimental
      hemorrhage. Survival after hemorrhage is closely related to the capacity of the
      animal to develop hyperglycemia. In this study, 24 hr food deprived rats were
      given a 3-hr infusion of either 0.3 ml/100 g b.wt./h 30% glucose iv (n = 10) or
      the same volume of 0.9% NaCl (n = 10) prior to 60 min of standardized hemorrhage.
      Glucose infusion resulted in a transient hyperglycemia, and 600% greater hepatic
      glycogen content compared to saline (P < 0.001). During hemorrhage, glucose
      treated rats developed substantial hyperglycemia while glucose levels fell in
      saline treated (P < 0.001). Concomitant developments in hematocrits indicated
      improved plasma refill in glucose treated animals (P < 0.01). While saline
      treated rats developed irreversible shock and died within 3 hr of bleeding,
      glucose treated rats had a MAP of 52 +/- 2 (mean +/- SEM) mm Hg by the end of
      hemorrhage (P < 0.01). All glucose-treated rats recovered and survived the seven
      day observation period. It is concluded that glucose infusion leading to hepatic
      glycogen repletion alters outcome after experimental hemorrhage in food deprived
      animals. These experimental results may be of clinical relevance, since elective
      surgery is generally performed after overnight fasting, which substantially
      reduces the hepatic glycogen reserve.

PMID- 8481973
TI  - Endothelin-1-induced increases in microvascular permeability in isolated,
      perfused rat lungs requires leukocytes and plasma.
AB  - Effect of endothelin-1 (ET-1) (10(-8) M) on pulmonary microvascular permeability
      was examined in isolated rat lungs perfused with blood or various blood
      components. Microvascular permeability was assessed by measuring fluid filtration
      rate (FFR) in lungs pretreated with papaverine in order to prevent changes in
      vascular smooth muscle tone. ET-1 significantly increased FFR (131.0 +/- 10.1
      mg/min, P < 0.01) after perfusion with blood for 60 min. In lungs perfused with
      leukocytes resuspended in plasma, ET-1 increased FFR significantly both 30 min
      (40.4 +/- 11.4 mg/min, P < 0.01) and 60 min (97.4 +/- 14.5 mg/min, P < 0.01)
      after it was added to the perfusate. Heat inactivation (56 degrees C; 1 hr) of
      plasma did not attenuate this effect of ET-1 (94.4 +/- 25.1 mg/min, P < 0.01).
      When lungs were perfused with leukocytes resuspended in Krebs Ringer albumin
      instead of plasma, or with plasma only, ET-1 did not cause any change in FFR. In
      conclusion, ET-1 increases microvascular permeability in isolated blood-perfused
      rat lungs. The effect is critically dependent on the presence of leukocytes and
      plasma components other than complement.

PMID- 8481974
TI  - Effectiveness of dual cyclooxygense and leukotriene blockade with ibuprofen and
      LY203647 during canine endotoxic shock.
AB  - Ibuprofen and the leukotriene antagonist, LY203647, were used to evaluate the
      effectiveness of LY203647 in the dual blockade of cyclooxygenase and leukotriene
      to maintain hemodynamic parameters in endotoxemia. Ibuprofen pretreatment alone
      or dual blockade (ibuprofen plus LY203647) protected blood pressure and renal
      blood flow at 1 and 3 hr after endotoxin infusion. Cardiac output at 1 hr after
      endotoxin in dogs treated with ibuprofen was slightly but significantly
      decreased. Dual pretreatment prevented this decrease at 1 hr; however, cardiac
      output was similar in both groups by 3 hr. Dual blockade administered after
      endotoxin induced increases in blood pressure and cardiac output at 3 hr.
      LY203647 pretreatment alone did not prevent the postendotoxemic declines in any
      measured parameters. The increased plasma SGOT and lactate of endotoxemia were
      exacerbated by LY203647 and blunted by ibuprofen treatment. We conclude that the
      addition of LY203647 to ibuprofen treatment offers no additional significant
      protection of hemodynamic parameters.

PMID- 8481975
TI  - Pentoxifylline does not prevent endotoxin induced lung and liver lipid
      peroxidation in the adult sheep.
AB  - Our purpose was to determine the effect of pentoxifylline pretreatment on
      endotoxin-induced (5 microgram/kg) lung and systemic oxidant activity, measured
      as lipid peroxidation. We used the awake adult sheep with lung and soft tissue
      lymph fistulae to monitor microvascular changes as well as to monitor oxygen
      delivery and consumption. Oxidant activity was monitored using the level of
      plasma conjugated dienes, a measure of circulating lipid peroxides, and lung and
      liver malondialdehyde content, a measure of tissue lipid peroxidation. Sixteen
      sheep were given endotoxin, eight of which were pretreated with pentoxifylline
      (20 mg/kg bolus) followed by a 6 mg/kg/hr infusion. We found that the degree of
      early endotoxin-induced pulmonary hypertension and hypoxia and later increased
      pulmonary microvascular permeability was not attenuated with pentoxifylline. In
      addition, a comparable increase in circulating conjugated dienes, lung neutrophil
      sequestration, and a three-fold increase in lung malondialdehyde was seen in both
      groups. Soft tissue QL also increased to the same degree in both groups. Liver
      MDA increased from a control of 110 +/- 20 nM/g tissue to 165 +/- 32 nM/g with
      endotoxin alone and to 260 +/- 55 nM/g with pentoxifylline pretreatment, a
      significant increase over both control and endotoxin alone groups.
      Pentoxifylline, however, did improve hemodynamic stability, required
      significantly less fluid, and prevented the hyperdynamic state seen at 4-5 hr
      post endotoxin. We conclude that pentoxifylline attenuates the initial endotoxin
      induced hemodynamic instability, and later hyperdynamic state. However,
      pentoxifylline pretreatment does not appear to prevent endotoxin-induced oxygen
      radical release in the unanesthetized sheep.

PMID- 8481976
TI  - Removal of the submandibular glands increases the acute hypotensive response to
      endotoxin.
AB  - We investigated the roles of the submandibular glands and of their sympathetic
      innervation on the acute hypotensive response induced by the i.v. injection of
      endotoxin (10 mg/kg; Salmonella typhosa) into rats anesthetized with sodium
      pentobarbital. Endotoxin given to unoperated and sham-operated rats induced a
      transient 30-40 mm Hg drop in blood pressure. Rats that had their submandibular
      glands removed (sialadenectomy) or bilateral resection of the superior cervical
      ganglia (ganglionectomy), exhibited significantly larger drops in blood pressure
      (approximately 65 mm Hg) that were maintained for the 60 min of the experiment.
      This increased responsiveness to endotoxin in sialadenectomized and
      ganglionectomized animals was not related to changes in haematocrit, white blood
      cell counts, or neutrophil activity. Pretreatment of rats with pentoxifylline
      (PTX) produced substantial protection against the hypotensive effects of
      endotoxin in ganglionectomized and sialadenectomized rats, although this xanthine
      did not affect the responses of sham-operated rats. These results suggest that
      the submandibular gland elaborates a factor that protects against acute
      hypotension induced by endotoxin and that this factor is under the control of the
      cervical sympathetic nervous system.

PMID- 8481977
TI  - Triiodothyronine (T3) improves cardiovascular function during hemorrhagic shock.
AB  - Prior work showed that an intact thyroid axis augments survival from hemorrhagic
      shock (HS); this study assesses the effects of specific thyroid-related hormones
      on cardiovascular (CV) function during HS. Following thyroidectomy, 32
      conditioned male dogs were subjected to HS to a mean arterial pressure (MAP) of
      60 mm Hg for 90 min then to 40 mm Hg for 30 min. Postshock (PS), the dogs
      received thyroid-releasing hormone (TRH; 2 mg/kg), thyroid-stimulating hormone
      [control (TSH; 10 IU)], T3 (12 micrograms/kg), or T4 (40 micrograms/kg). Thirty
      minutes following treatment (PTX), they were resuscitated with shed blood and 50
      ml/kg saline. CV and hormonal parameters were measured PS, PTX, postresuscitation
      (PR), and on day 2 (D2). There were no PS differences in CV parameters between
      groups. Following treatment, T3 significantly increased MAP (59.0 +/- 13 vs, 39.9
      +/- 2.2 mm Hg) and cardiac output (CO; 0.92 +/- 0.1 vs. 0.80 +/- 0.1 liter/min; P
      < 0.05 by ANOVA). TRH treatment significantly improved PTX MAP (62.7 +/- 10 vs.
      40.8 +/- 2.1; P < 0.05 by ANOVA). TSH and T4 did not significantly change PTX MAP
      or CO. There were no significant CV differences in the four groups following
      resuscitation or on D2. In conclusion, T3 improves MAP and CO during hemorrhagic
      shock. TRH transiently improved PTX blood pressure. Further study of the
      mechanism of this beneficial response afforded by T3 administration is warranted.

PMID- 8481978
TI  - Hemodynamic responses to changes in carotid sinus pressure after endotoxin and
      ibuprofen.
AB  - The hemodynamic responses to changes in carotid sinus pressure (CSP) were
      evaluated in nine pentobarbital-anesthetized dogs during control, endotoxin
      treatment, and ibuprofen (after endotoxin) treatment periods. Both carotid
      sinuses were isolated and perfused at varying pressures with oxygenated blood in
      the vagotomized animal. Alterations in carotid sinus pressure and the resultant
      responses were measured at 15-min intervals during a 30-min control period, for
      60 min after 1 mg/kg endotoxin, and for 60 min after 10 mg/kg ibuprofen given
      after endotoxin. The results showed a reduction in calculated gain for mean
      arterial pressure (MAP) (change in arterial pressure/change in CSP), heart rate,
      and peripheral resistance (TPR) after endotoxin, without a corresponding
      reduction in cardiac output (CO) gain. These gain changes were accompanied by a
      decrease in absolute MAP, CO, and TPR. An indicator for cardiac performance gain
      also increased. Relatively, arterial pressure was partially maintained by an
      increase in CO despite a loss in ability to vasoconstrict. Ibuprofen failed to
      correct the MAP gain, and only partially restored MAP, but shifted a greater
      relative response to peripheral resistance. To test if TPR would also decrease if
      the decrease in CO was prevented, three additional animals were studied with a
      pump in series with the heart to maintain CO; TPR again dropped after endotoxin.
      The results indicate a loss of peripheral arterial tone after endotoxin,
      partially restored by ibuprofen. The CO response indicates a peripheral vascular
      failure rather than a central or carotid sinus failure mechanism.

PMID- 8481979
TI  - Adrenergic blockade attenuates endotoxin-induced hepatic glucose uptake.
AB  - The purpose of the present study was to elucidate the role of catecholamines in
      mediating the endotoxin-induced increase in glucose uptake of individual tissues.
      In vivo glucose utilization by selected tissues, assessed by the 2-deoxyglucose
      (2dGlc) tracer technique, was determined 3 hr following the i.v. injection of
      Escherichia coli lipopolysaccharide (LPS; 100 micrograms/100 g bw) or saline.
      Catecholamine action was inhibited by the combined administration of alpha and
      beta receptor antagonists, phentolamine and propranolol. Adrenergic antagonists
      alone did not change plasma glucose levels or the glucose metabolic rate (Rg) of
      the investigated tissues; however, adrenergic blockage resulted in mild
      hypoglycemia in endotoxemic animals. LPS administration increased in vivo Rg by
      the liver (571%), lung (229%), spleen (210%), intestine (76%), skin (82%), fat
      (181%), gastrocnemius muscle (70%), and kidney (61%). There was a significant
      elevation in the glucose metabolic clearance rate (MCR) by these tissues as well.
      LPS did not increase Rg by brain and testis. Adrenergic blockade completely
      prevented the LPS-induced Rg increase in the liver and partially inhibited the
      elevation in other tissues. The LPS-induced increase in the MCR in spleen, lung,
      intestine, skin, fat, muscle, and kidney was not altered by adrenergic blockade,
      indicating that the attenuated Rg in these tissues was the consequence of the
      decreased plasma glucose concentration observed under this condition. However, in
      the liver, adrenergic antagonists markedly inhibited the LPS-induced increase in
      both Rg and MCR. Thus our data indicate that the glucose metabolic response to
      LPS is partially mediated by catecholamines through the accompanying changes in
      plasma glucose concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481980
TI  - Endotoxin contamination of superoxide dismutase and catalase.

PMID- 8481981
TI  - Does smoking influence acne?
AB  - One hundred and sixty-five patients with acne completed a questionnaire on
      smoking habits. Amongst 96 males, 19.7% were smokers (95% confidence interval
      12.4-29.2%) compared to an expected prevalence of 34.5% from national statistics
      (P < 0.001). For 69 females, a prevalence of 12.1% (95% confidence interval 6.1
      23.3%) was obtained compared to 32.7% expected (P < 0.001). The findings of this
      study support the hypothesis that some component of cigarette smoke, possibly
      nicotine, has an anti-inflammatory action on acne.

PMID- 8481982
TI  - Levels of fluconazole in serum, stratum corneum, epidermis-dermis (without
      stratum corneum) and eccrine sweat.
AB  - The distribution in the skin of orally active antifungals and other drugs claimed
      to be active in the treatment of skin diseases is of major importance, but to
      date has been studied only rarely. In the present study the distribution of
      fluconazole in stratum corneum, epidermis-dermis (without stratum corneum),
      eccrine sweat and serum was studied in human male volunteers after dosages of 50
      mg daily for 12 days and 150 mg once weekly for 2 weeks. In the present study
      high levels of fluconazole were found especially in the stratum corneum. At a
      dose of 50 mg once daily the concentration of fluconazole after 12 days was 73.0
      micrograms/g and 7 days after cessation of treatment the concentration was still
      5.8 micrograms/g. At the 150 mg once a week dose the concentration 7 days after
      the second dose was still 7.1 micrograms/g in stratum corneum indicating that
      medication once a week may be effective in the treatment of dermatomycoses. High
      concentrations, all above the serum concentrations, were also seen in sweat and
      epidermis/dermis. These results indicate that fluconazole is delivered to the
      stratum corneum, where it is accumulated, through sweat and by direct diffusion
      through the dermis-epidermis. These pharmacokinetic results indicate that the
      drug should be very effective in the treatment of dermatomycoses. An extremely
      high concentration of the drug in the stratum corneum combined with
      concentrations from 2.93 to 4.62 micrograms/g in the rest of the epidermis and
      dermis is important in the treatment of these diseases.

PMID- 8481983
TI  - Improvement in survival rate of patients with acral melanoma observed in the past
      22 years in Sendai, Japan.
AB  - While the incidence of malignant melanoma is much lower in Japanese than in
      Caucasians, the commonest site of melanoma in Japanese has been reported to be
      the acral regions of the limbs. The survival rate for acral and nodular melanoma
      observed at the Department of Dermatology, Tohoku University Hospital in Sendai,
      Japan from 1969 to 1990 was reviewed. Among 150 melanoma patients 125 (83%) and
      17 (11%) had primary cutaneous melanoma and mucous membrane melanomas,
      respectively. Frequent sites for cutaneous melanomas were the sole (31%) and
      subungual regions (15%). Comparison of the stages of plantar melanoma at
      diagnosis showed that the proportion of stages III and IV decreased after 1980
      with a corresponding increase in those with a tumour thickness of less than 4 mm
      (stage II). Concurrently, the prognosis of plantar melanoma has improved; the 5
      year survival rate in each of the three periods 1969-75, 1976-80 and 1981-85 was
      21, 70 and 90%, respectively. This was also the case with subungual melanoma.
      Such improvements in the prognosis are thought to be mainly due to early
      detection through the growing public awareness of this life-threatening disease.
      By contrast cases of nodular melanoma increased sharply after 1980. Among these,
      the high proportion of patients in advanced stages (stages III and IV) remained
      static even after 1980, with a resultant low 5-year survival rate in the above
      mentioned periods of 33, 38 and 18%, respectively.

PMID- 8481984
TI  - Histoanalytical study of the cellular infiltrate in the tuberculin reaction.
AB  - In contrast to the generally held view, in previous studies it has been found
      that the histopathological changes in delayed-type hypersensitivity reactions to
      intradermal purified protein derivative of tuberculin (PPD) in humans were not
      uniform. These were classified into three types based on their resemblance to
      features seen in other dermatoses, i.e.: (i) perivascular dermatitis type; (ii)
      basal spongiotic dermatitis type; and (iii) erythema multiforme type. These
      histopathological patterns correlated well with the clinical response seen in
      tuberculin hypersensitivity of tested subjects. In the present study, the
      immunohistopathological features in 44 skin biopsy specimens were assessed
      quantitatively by using multivariate analysis. The numbers of infiltrating cells
      in the epidermis and in the dermis which were immunohistologically positive to
      monoclonal antibodies against various mononuclear cells were counted separately
      to determine if there was any statistical correlation between the
      histopathological patterns and the phenotypes of infiltrating cells. As a result,
      a significant correlation was found between the histopathological patterns and
      the phenotypes of cells infiltrating the epidermis, such as CD8+ cells, CD4+
      cells, CD11c+ cells and interleukin 2 receptor positive cells. All these cells
      showed a high correlation coefficient to the expression of HLA-DR antigen by
      keratinocytes. Next, factors that might regulate the inflammation and interaction
      among the infiltrating cells were assessed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8481985
TI  - An immunohistochemical study of the distribution of plasminogen and plasminogen
      activators in bullous pemphigoid.
AB  - Abnormalities of the cutaneous plasminogen/plasminogen activator system have been
      associated with acantholytic disorders, psoriasis, keratinocytes in culture, and
      epidermis in healing wounds. The present study was undertaken to investigate the
      possible role of the plasmin/plasminogen protease system in lesion development in
      bullous pemphigoid (BP). Using polyclonal antibodies and a fluorescent technique,
      the immunohistochemical distribution of plasmin/plasminogen, fibrinogen and the
      plasminogen activators, urokinase (uPA) and tissue plasminogen activator (tPA),
      were studied in lesional and non-lesional skin from nine BP patients, one with
      linear IgA disease (LAD) and one with pemphigoid gestationis (PG). The
      distribution of the proteases was compared with that in normal skin (n = 4) and
      in suction blisters (n = 2). In normal skin, fibrinogen, tPA and uPA were absent
      from the epidermis and plasminogen was confined to the basal layer. Uninvolved BP
      skin was identical to controls. Focal areas of suprabasal plasminogen expression
      in the region of a blister was seen in 3/9 BP lesions and in 1/2 suction
      blisters. In 6/9 BP lesions and both uninvolved and lesional LAD and PG skin were
      identical to controls, and no suprabasal expression of plasminogen was present.
      These findings suggest that suprabasal plasminogen expression is unlikely to play
      a fundamental role in the pathogenesis of blister formation in BP as enhanced
      expression was not present in every case and the finding was not specific to BP,
      also occurring in a suction blister. Enhanced plasminogen expression rather may
      be a reflection of the processes of tissue repair.

PMID- 8481986
TI  - Laser therapy of verrucous epidermal naevi.
AB  - Forty-three patients with verrucous epidermal naevi were treated either with
      argon-laser coagulation or with carbon-dioxide laser vaporization. With the argon
      laser, very good to acceptable results could be achieved in 85% of patients with
      'soft', papillomatous lesions. In 'hard', keratotic naevi the argon laser proved
      ineffective. In some of these cases CO2-laser treatment was effective, whereas
      generally there was a tendency to hypertrophic scar formation with this laser. As
      other therapeutic modalities for epidermal naevi are either insufficient or not
      applicable in widespread lesions, we feel that laser treatment is a valuable
      therapeutic alternative.

PMID- 8481987
TI  - Clinical utility of fluorometric scanning of plasma porphyrins for the diagnosis
      and typing of porphyrias.
AB  - The fluorometric emission scanning (using excitation at 405 nm) of plasma
      samples, simply diluted five-fold in phosphate-buffered saline, allows the
      differentiation of three conditions according to their porphyrin content. The
      emission maximum at 626-628 nm is a specific finding in variegate porphyria,
      while in erythropoietic protoporphyria a characteristic peak is found at 636 nm.
      A fluorescence emission maximum at 618-622 nm corresponds to a third group that
      includes normal subjects, non-porphyria patients and patients suffering from
      acute intermittent porphyria, hereditary coproporphyria, congenital
      erythropoietic porphyria (Gunther disease) and porphyria cutanea tarda.
      Therefore, this simple, quick and cheap screening test allows one to establish
      whether a patient with a photocutaneous syndrome has porphyria and whether this
      porphyria belongs to the types: variegate, protoporphyria or other cutaneous
      porphyrias.

PMID- 8481988
TI  - Bacillary epithelioid angiomatosis in acquired immunodeficiency syndrome (AIDS)-
      clinicopathological and ultrastructural study of a case with a review of the
      literature.
AB  - Bacillary epithelioid angiomatosis (BEA) is a rare cutaneous disorder usually
      affecting patients with human immunodeficiency virus (HIV) infection often
      misdiagnosed as a vascular tumour. We describe a 51-year-old, HIV-positive,
      Caucasian, homosexual male who developed scattered papulo-nodular lesions with
      clinicopathological and ultrastructural features of BEA. He had a dramatic
      therapeutic response to systemic antibiotics. There has been a lack of such
      reports in the European literature. The differential diagnosis is discussed and a
      brief review of the English literature to date is included.

PMID- 8481989
TI  - Heparin skin necrosis--an important indicator of potentially fatal heparin
      hypersensitivity.
AB  - Skin necrosis at injection sites is a rare complication of heparin therapy. In
      this report, we describe only the second case of the even rarer complication of
      skin necrosis occurring at sites distant to those of subcutaneous heparin
      injections. The patient had also suffered systemic thrombotic events due to
      heparin-dependent platelet activation prior to the development of the skin
      necrosis, although these had not been recognized as such at the time. The
      development of heparin-induced skin necrosis should result in the immediate
      cessation of heparin therapy in order to prevent potentially fatal thrombotic
      events. This is in contrast to warfarin-induced skin necrosis, where therapy may
      be continued or restarted at a lower dose.

PMID- 8481990
TI  - Familial Jessner's lymphocytic infiltration of the skin, occurring in a father
      and daughter.
AB  - Familial occurrence of Jessner's lymphocytic infiltration of the skin is reported
      in a father and daughter. A definitive diagnosis of Jessner's disease was greatly
      facilitated by the presence of large numbers of plasmacytoid monocytes within the
      dermal infiltrates in both patients. A role for skin-directed lymphocyte
      migration is suggested to account for the presence of this peculiar cell type.

PMID- 8481991
TI  - Localized pachydermodactyly in tuberous sclerosis.
AB  - Pachydermodactyly refers to a rare form of digital fibromatosis involving the
      proximal portions of the fingers. There are only nine cases reported in the
      literature, all idiopathic and occurring in young men. We report a 5-year-old
      Chinese boy with tuberous sclerosis who presented with localized
      pachydermodactyly since birth. This congenital form of pachydermodactyly may
      represent an additional cutaneous sign of tuberous sclerosis.

PMID- 8481992
TI  - Acne induced by inhaled corticosteroids.
AB  - Four cases of acne apparently induced by inhalation of potent corticosteroids
      prescribed for the treatment of asthma are described. In one case there appeared
      to be a dose-dependent relationship. While acne induced by topical or systemic
      administration of corticosteroids is well recognized, acne following inhaled
      corticosteroids has not previously been reported.

PMID- 8481993
TI  - Systemic nodular panniculitis in a patient with alpha-1 antitrypsin deficiency
      (PiSS phenotype).
AB  - The association of alpha-1 antitrypsin deficiency (PiZ phenotype) with systemic
      nodular panniculitis has been well documented. Despite reports of cases of
      systemic nodular panniculitis associated with other alpha-1 antitrypsin
      deficiency phenotypes, it is still not known if this association is fortuitous
      rather than causal. We report a case of systemic nodular panniculitis associated
      with alpha-1 antitrypsin deficiency (PiSS phenotype), with clinico-pathological
      features similar to those reported in cases associated with the PiZ phenotype.

PMID- 8481994
TI  - Cutaneous phaeohyphomycosis due to Alternaria alternata responding to
      itraconazole.
AB  - An 81-year-old man presented with a spreading, eczematous-appearing rash on the
      dorsum of the right hand and forearm, originating from three small, probably post
      traumatic, ulcers over the knuckles. He had the nephrotic syndrome for which he
      was on 60 mg prednisone daily. Histology of a biopsy of lesional skin was
      consistent with phaeohyphomycosis and Alternaria alternata was cultured. The rash
      cleared following treatment with 100 mg itraconazole daily and tapering of his
      prednisone dose.

PMID- 8481995
TI  - Livedo reticularis in a patient with systemic lupus erythematosus and
      anticardiolipin antibodies.
AB  - This report describes a case of livedo reticularis associated with increased
      titres of anticardiolipin antibodies (aCL) in a patient with systemic lupus
      erythematosus. A 38-year-old woman presented with fever, malaise, arthritis and
      livedo reticularis in a severe form. Antibodies to native DNA and an increased
      level of aCL were found. A significant positive correlation exists between livedo
      reticularis and elevated serum antiphospholipid activity in patients with
      systemic lupus erythematosus. aCL are shown to play a possible pathogenetic role
      in thrombotic events. This suggests that thrombosis is the underlying cause of
      livedo in these patients. A biopsy performed in a patient at the site where
      livedo was most marked showed no evidence of thrombi. It is postulated that the
      mechanism of livedo in lupus patients with aCL consists of both thrombosis and
      dysfunction in the regulation of the tone of the peripheral vascular bed.

PMID- 8481996
TI  - Hairy pigmented congenital naevocellular naevus in a patient with alopecia
      universalis.

PMID- 8481997
TI  - Acute lipodermatosclerosis in a pendulous abdomen.
AB  - A 54-year-old female developed tender, hot, erythematous skin at the apex of a
      large pendulous abdomen at the same time as she became symptomatic with
      congestive cardiac failure secondary to respiratory failure. Clinically and
      histologically the changes in the abdominal-wall skin resembled
      lipodermatosclerosis, a condition normally seen in the legs secondary to chronic
      venous insufficiency.

PMID- 8481998
TI  - Erythrodermic psoriasis. Report of a case associated with symptomatic
      hypophosphataemia.
AB  - We describe a patient with a long history of psoriasis who developed severe
      erythrodermic psoriasis associated with lethargy, muscular weakness and collapse.
      Serum biochemical screening at the time revealed severe hypophosphataemia, and
      when this was corrected by intravenous phosphate replacement her symptoms
      resolved and her psoriasis improved. Hypophosphataemia may therefore be another
      metabolic complication of erythrodermic psoriasis.

PMID- 8481999
TI  - Erosive, flexural lichen planus--an uncommon variant.
AB  - An unusual pattern and type of lichen planus is described in a 57-year-old female
      in which the flexures were exclusively involved. The affected areas were
      chronically eroded and ulcerated and resistant to topical treatment. Erosive
      lichen planus is known to occur on mucosal surfaces and cases of ulcerative
      lichen planus have been described involving the feet and lower limbs. Lichen
      planus involving flexures alone is uncommon and for erosion and ulceration to
      occur at these sites seems rare. We report a case of erosive, flexural lichen
      planus of long standing in a middle-aged female.

PMID- 8482000
TI  - Improvement of trigeminal neurotrophic ulceration with pimozide in a cognitively
      impaired elderly woman--a case report.
AB  - Neurotrophic ulceration of the face is a rare but well recognized sequel to
      division of the trigeminal nerve. Trauma is an important contributory factor and
      thought to be due in part to paraesthesiae, which encourages picking and
      scratching, with resultant chronic and persistent ulceration. A case is described
      of an 82-year-old woman with severe trigeminal neurotrophic ulceration which
      improved substantially with pimozide, given for treatment of unrelated paranoid
      symptoms. The possible relevance of this to the established use of pimozide in
      delusional parasitosis is briefly discussed.

PMID- 8482001
TI  - Angiosarcoma in congenital hereditary lymphoedema (Milroy's disease)--diagnostic
      beacons and a review of the literature.
AB  - In cases of congenital lymphoedema the finding of ulceration, violaceous nodules
      or papules, or apparent traumatic ecchymoses should act as a diagnostic beacon
      warning of dangers. A case is reported of a high-grade angiosarcoma developing in
      a patient with congenital hereditary lymphoedema (Milroy's disease). This is the
      second paper to report this complication, the third case report and the first
      case in which the diagnosis is substantiated by immunohistochemistry and lectin
      histochemistry. A review of cases of angiosarcoma complicating congenital
      hereditary and non-hereditary lymphoedema is also presented.

PMID- 8482002
TI  - Abstracts from the Joint Meeting of the Society for Cutaneous Ultrastructure
      Research (18th annual meeting) and the Japanese Society for Ultrastructural
      Cutaneous Biology. Vienna, 23-25 May 1991.

PMID- 8482003
TI  - The treatment of herpes zoster with flamazine--a double-blind placebo-controlled
      trial.

PMID- 8482004
TI  - Subepidermal bullous eruption induced by captopril.

PMID- 8482005
TI  - Lack of reactivity of glutenin and gliadin antisera to normal and dermatitis
      herpetiformis skin.

PMID- 8482006
TI  - Scabies keloid.

PMID- 8482007
TI  - Pustular psoriasis in childhood.
AB  - Recurrent annular pustular psoriasis over the trunk of an 11-year-old boy
      followed infantile psoriasis in the napkin area. Etretinate therapy induced a
      partial remission. The difficulty in distinguishing between annular pustular
      psoriasis and subcorneal pustular dermatosis of Sneddon and Wilkinson is
      discussed.

PMID- 8482008
TI  - Heat shock gene expression and development. I. An overview of fungal, plant, and
      poikilothermic animal developmental systems.

PMID- 8482009
TI  - The independent stage-specific expression of the 18-kDa heat shock protein genes
      during microsporogenesis in Zea mays L.
AB  - The small (18-kDa) heat shock proteins (hsps) of maize are encoded by a complex
      multigene family. In a previous report, we described the genetic information from
      cDNAs encoding two different members of the family. In this communication, we
      report the isolation and characterization of cDNA and genomic clones encoding
      information for a third member of this hsp family (c/gMHSP18-1). DNA fragments
      containing nucleotide sequences common to, or specific for, each of these
      characterized 18-kDa genes were prepared and used as probes to assess the
      expression of these genes during microsporogenesis and development of the
      gametophyte in an inbred line of maize (Oh43). Our results demonstrate (1) that
      mRNA transcripts encoding the 18-kDa hsps are expressed and/or accumulate during
      microsporogenesis, and (2) that genes encoding two of the characterized 18-kDa
      hsps are expressed and/or accumulate independently, in a stage-specific manner
      during microsporogenesis. These observations imply that the stage-specific
      expression of particular 18-kDa hsp genes results from gene-specific regulation
      during microsporogenesis and gametophyte development rather than from an overall
      activation of the heat shock or stress response.

PMID- 8482010
TI  - Expression of endogenous and microinjected hsp 30 genes in early Xenopus laevis
      embryos.
AB  - In the present study, we have examined the regulation of expression of a newly
      isolated member of the hsp 30 gene family, hsp 30C. Using RT-PCR, we found that
      this gene was first heat-inducible at the tailbud stage of development. We also
      examined the expression of two microinjected modified hsp 30C gene constructs in
      Xenopus embryos. One of the constructs had 404 bp of hsp 30C 5'-flanking region,
      whereas the other had 3.6 kb. Both gene constructs had 1 kb of 3'-flanking
      region. RT-PCR assays were employed to detect the expression of these
      microinjected genes. The presence of extensive 5'- and 3'-flanking regions of the
      hsp 30C gene did not confer proper developmental regulation, since heat-inducible
      expression of both of the microinjected constructs was detectable at the
      midblastula stage. The premature expression of the microinjected hsp 30 gene was
      not a result of high plasmid copy number of the presence of plasmid DNA
      sequences. These results suggest that the microinjected genes contain all the cis
      acting DNA sequences required for correct heat-inducible regulation but do not
      contain the elements required for the proper regulation of hsp 30 gene expression
      during development. It is possible that regulatory elements controlling the
      developmental expression of the hsp30 genes may reside upstream or downstream of
      the entire cluster.

PMID- 8482011
TI  - The induction of pyruvate kinase synthesis by heat shock in Xenopus laevis
      embryos.
AB  - Heat-shocked Xenopus embryos have an unusually complex heat shock response. The
      dominant heat shock protein (Hsp) has a relative molecular mass (M(r)) of 62,000
      D (Hsp62). Affinity-purified IgGs against the glycolytic enzyme pyruvate kinase
      (PK; EC 2.7.1.40) specifically immunoprecipitated Hsp62 from extracts of embryos
      that had been heat-shocked at 37 degrees C for 30 min. Thus, Hsp62 and pyruvate
      kinase are immunologically cross-reacting. Electrophoretic separation of PK
      isoforms suggests that heat-shocked Xenopus embryos increase synthesis of an
      isoform of PK. Thermal denaturation studies suggest that this isoform has
      enhanced thermal stability. The identification of PK as an Hsp is discussed
      within the context of a physiological requirement for elevated levels of
      anaerobic glycolysis in heat-stressed cells as a vital component of the
      acquisition of thermotolerance.

PMID- 8482012
TI  - Regulation of two different hsp70 transcript populations in steroid hormone
      induced fungal development.
AB  - In the filamentous oomycete fungus Achlya, the differentiation of gamete bearing
      structures on vegetative hyphae of the male mating type, is induced by the Achlya
      steroid hormone, antheridiol. Among the several metabolically labeled
      intracellular proteins whose synthesis or accumulation is altered by hormone
      treatment are steroid-induced 85-kDa and 68- to 78-kDa proteins. The 85-kDa
      protein was previously shown to be the Achlya heat shock protein hsp85 [Brunt et
      al., 1990; Brunt and Silver, 1991], a component of the putative Achlya steroid
      hormone receptor. It was of interest to determine if the antheridiol-induced "70
      kDa" proteins were hsp70-family heat shock proteins and if hormone treatment
      induced changes in the level of hsp70 transcripts. Two different Achlya hsp70
      genomic sequences were cloned and used to investigate these questions. The two
      hsp70 sequences recognized two different mycelial transcript populations, one of
      which was regulated also by decreased glucose. Of note, both of the two hsp70
      transcript populations were found to be regulated by antheridiol. The hormone
      induced changes in hsp70 transcript levels were temporally correlated with the
      onset of massive lateral hyphal branching and alterations in the pattern of
      secreted N-linked glycoproteins which occur in hormone-treated mycelia. To our
      knowledge, this represents one of the first reports on changes in hsp70 proteins
      and transcripts during fungal differentiation. Our results may have implications
      for the role of heat shock proteins in hyphal branching and secretion in
      filamentous fungi and perhaps other cell types.

PMID- 8482013
TI  - hsp23 and hsp26 exhibit distinct spatial and temporal patterns of constitutive
      expression in Drosophila adults.
AB  - To determine differences in the patterns of expression of Drosophila small heat
      shock proteins (shsp) during normal development in the absence of stress,
      proteins obtained from head, thorax and gonads of young (0-12 h, 3 days), middle
      aged (3-6 days) and 15- to 20-day-old adult flies were separated on SDS-PAGE gels
      and blotted with monoclonal antibodies against hsp23 and hsp26. hsp23 was found
      in the heads and gonads of young males and females. In contrast, the maximum
      expression of hsp26 was seen in gonads of young flies, and it was only lightly
      detected in the brain. The expression of both proteins decreased as flies aged.
      This age-related decrease was particularly striking for hsp23 in females. The
      immunoblot results obtained were complemented by immunostaining of thin
      parasagittal sections of whole fly bodies. Hsp23 was found to be expressed in the
      brain, thoracic ganglion, fat body and gonads of young (0-12 h) males and
      females. On the other hand, hsp26 was essentially detected in ovaries and testes
      of these young flies. The analysis of the tissue expression of both proteins
      demonstrate that each shsp has a distinct cellular localization. In the central
      nervous system, hsp23 and hsp26 were present in the neurocytes of the brain and
      the thoracic ganglion. In addition, hsp23 (but not hsp26) was also detected in
      the central neuropile of these two organs. In testis, hsp26 was localized in the
      cytoplasm of spermatocytes and, probably, in the spermatid bundles. In contrast,
      hsp23 was detected at the periphery of cells (membranes).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8482014
TI  - Development and tissue-specific distribution of mouse small heat shock protein
      hsp25.
AB  - We have investigated the developmental and tissue-specific distribution of the
      mouse small hsp25 by immunohistology using an antibody that specifically
      identifies hsp25. Our analysis shows that the relative amount of hsp25 increases
      during embryogenesis. Through days 13-20 of embryogenesis, hsp25 accumulation is
      predominant in the various muscle tissues, including the heart, the bladder, and
      the back muscles. hsp25 is detectable also in neurons of the spinal cord and the
      purkinje cells. Furthermore analysis of the closely related alpha, B-crystallin
      shows that in several tissues, including the bladder, the notochordal sheath and
      the eye lens both proteins are coexpressed. Our studies demonstrate that
      mammalian hsp25 accumulation is developmentally regulated during mouse
      embryogenesis and support the view of an important functional role of small heat
      shock proteins in normal cell metabolism.

PMID- 8482015
TI  - Tissue-specific expression of heat shock proteins of the mouse in the absence of
      stress.
AB  - The steady-state levels of four members of the heat shock proteins families
      (HSP84, HSC73, HSP71, and HSP25) were examined by immunoblot analysis of several
      different tissues of young and adult mice in the absence of stress. These hsps
      were detected in all tissues but their level was variable. The levels of HSC73
      and HSP84 varied only slightly between different tissues in either young or adult
      mice, with the exception of skin where these hsps were found in reduced amounts.
      In contrasts, the stress-inducible member of the HSP70 family, HSP71, was found
      to be expressed in all tissues but in amounts which differed by as much as two
      orders of magnitude between tissues. In general, the levels of both HSP71 and
      HSP25 were found to be tissue dependent, with higher levels found in tissues such
      as stomach, intestine, colon and bladder, tissues which are exposed to toxic
      environmental or metabolic products, and which may concentrate these substances
      by water resorption and/or be exposed to them for longer periods. The levels of
      HSP71 and HSP25 were generally positively correlated both in young and adult mice
      although this correlation was not found in certain tissues such as kidney,
      testes, and bone. Tissues of young mice contained lower amounts of HSP25 and
      HSP71 than were found in the same tissues from adults. We conclude that hsps are
      expressed in all tissues of the mouse in the absence of stress and that some
      organs, particularly those exposed to potentially toxic metabolites, show a
      higher level of expression of HSP71 and HSP25.

PMID- 8482016
TI  - HSP86 and HSP84 exhibit cellular specificity of expression and co-precipitate
      with an HSP70 family member in the murine testis.
AB  - This study extends to the protein level our previous observations, which had
      established the stage and cellular specificity of expression of hsp86 and hsp84
      in the murine testis in the absence of exogenous stress. Immunoblot analysis was
      used to demonstrate that HSP86 protein was present throughout testicular
      development and that its levels increased with the appearance of differentiating
      germ cells. HSP86 was most abundant in the germ cell population and was present
      at significantly lower levels in the somatic cells. By contrast, the HSP84
      protein was detected in the somatic cells of the testis rather than in germ
      cells. The steady-state levels of HSP86 and HSP84 paralleled the pattern of the
      expression of their respective mRNAs, suggesting that regulation at the level of
      translation was not a major mechanism controlling hsp90 gene expression in
      testicular cells. Immunoprecipitation analysis revealed that a 70-kDa protein
      coprecipitated with the HSP86/HSP84 proteins in testicular homogenates. This
      protein was identified as an HSP70 family member by immunoblot analysis,
      suggesting that HSP70 and HSP90 family members interact in testicular cells.

PMID- 8482017
TI  - Heat-shock gene expression and cell cycle changes during mammalian embryonic
      development.
AB  - Synchronized regulation of cell division during gastrulation is essential for the
      regional proliferation of cells and pattern formation of the early CNS. The
      neural plate and neuroectoderm cells are a rapidly dividing and differentiating
      population of cells with a unique and rapid heat-shock response. Heat shock and
      the heat-shock genes were studied during neural plate development in a whole rat
      embryo culture system at 9.5-11.5 days. A lethal shock can cause cell death and
      severe developmental defects to the forebrain and eye during organogenesis. Heat
      shock can also result in acquired thermotolerance whereby cell progression is
      delayed at the G1/S and S/G2 boundaries of the cell cycle. This delay in cell
      cycle progression caused an overall lengthening of the cell cycle time of at
      least 2 hr. The heat shock genes may therefore function as cell cycle regulators
      in neuroectoderm induction and differentiation. The kinetics and expression of
      the hsp genes were examined in neuroectodermal cells by flow cytometry and
      Northern analysis. The levels of hsp mRNA 27, 71, 73, and 88 were identified
      following exposure at 42 degrees C (nonlethal), 43 degrees C (lethal) and 42
      degrees/43 degrees C (thermotolerant) heat shock. Examination of hsp gene
      expression in the neural plate showed tight regulation in the cell cycle phases.
      Hsp 88 expression was enhanced at Go and hsp71 induction at G2 + M of the cell
      cycle. Cells exposed to a thermotolerant heat shock of 42 degrees C induced hsp71
      mRNA expression in all phases of the cell cycle with the mRNA levels of hsp27,
      73, and 88 increased but relatively constant. Following a lethal heat shock,
      dramatic changes in hsp expression were seen especially enhanced hsp71 induction
      in late S phase. The regulated expression of hsps during the cell cycle at
      various phases could play a unique and important role in the fate and recovery of
      neuroectoderm cells during early mammalian embryo development.

PMID- 8482018
TI  - Lack of concordance between heat shock proteins and the development of tolerance
      to teratogen-induced neural tube defects.
AB  - The present study was undertaken to examine the role of heat shock response in
      the development of tolerance and cross-tolerance in an in vivo murine model of
      teratogen-induced neural tube defects. The experimental paradigm designed to
      address this question was to utilize inbred mouse strains that differed in their
      sensitivity to hyperthermia and valproic acid induced neural tube defects,
      subjecting the dams to subteratogenic pretreatments with either heat or valproic
      acid at two different timepoints during development prior to the administration
      of the teratogenic insult. A statistically significant reduction in the frequency
      of neural tube defects and/or embryolethality following a pretreatment in dams
      subsequently exposed to a teratogenic treatment was considered evidence for the
      induction of tolerance. This was observed in the SWV embryos exposed to the 38
      degrees C pretreatment at 8:06 and to embryos exposed to either pretreatment
      temperature at 8:10 prior to a teratogenic heat shock at 8:12. In the LM/Bc
      embryos, only the 41 degrees C pretreatment at 8:06 induced thermotolerance.
      There was no evidence of tolerance induced in either mouse strain using valproic
      acid. On the other hand, cross-tolerance was clearly demonstrated in this study,
      with a low temperature (41 degrees C) pretreatment successfully protecting SWV
      fetuses from a subsequent teratogenic treatment with valproic acid, while
      valproic acid (200 mg/kg) was effective in reducing the risk of hyperthermia
      induced neural tube defects in the LM/Bc fetuses. In all instances, tolerance was
      induced in the absence of significant induction of hsp synthesis. The lack of
      concordance between hsps and thermotolerance suggests that some other factor(s)
      is involved in conferring thermotolerance on developing murine embryos.

PMID- 8482019
TI  - Changes in heat shock protein synthesis and heat sensitivity during mouse
      thymocyte development.
AB  - Heat shock protein synthesis was examined in mouse thymocytes at three stages of
      development: early embryonic thymocytes, which are CD4-CD8-, adult thymocytes,
      which are primarily CD4+CD8+, and mature spleen T cells, which are CD4+CD8- or
      CD4-CD8+. After either a 41 degrees C or 42 degrees C heat shock, the synthesis
      of the major heat-inducible protein (hsp68) was elevated during the first hour of
      recovery but then decreased abruptly in thymocytes from adult mice. In contrast,
      the synthesis of hsp68 continued for up to 4 h after heating embryonic mouse
      thymocytes or mature spleen T cells. The more rapid termination of the heat shock
      response in the adult thymocytes was not the result of either less heat damage or
      more rapid repair since the recovery of general protein synthesis was more
      severely delayed in these cells. As well, the double positive CD4+CD8+ cells were
      more sensitive to hyperthermia than either the double negative CD4-CD8- or single
      positive CD4+CD8- or CD4-CD8+ cells. Exposure of fetal thymus organ cultures to
      elevated temperature revealed that the double negative thymocytes were able to
      survive and differentiate normally following a heat shock treatment that was
      lethal for the double positive thymocytes. Exposure of thymocytes from adult mice
      to elevated temperatures induced apoptotic cell death. This was evident by the
      cleavage of DNA into oligonucleosome-sized fragments. Quantitation of the extent
      of DNA fragmentation and the number of apoptotic cells by flow cytometry
      demonstrated that the extent of apoptotic cell death was related to the severity
      of the heat stress. Double positive (CD4+CD8+) thymocytes are selected on the
      basis of their T-cell antigen receptor (TCR). Most of these cells are negatively
      selected and die within the thymus by an active process of cell deletion known as
      apoptosis. Restricting hsp synthesis in response to stress might be essential
      during developmental processes in which cell maturation is likely to result in
      death rather than functional differentiation.

PMID- 8482020
TI  - Heat shock gene expression and development. II. An overview of mammalian and
      avian developmental systems.

PMID- 8482021
TI  - Activity of a microinjected inducible murine hsp68 gene promoter depends on
      plasmid configuration and the presence of heat shock elements in mouse dictyate
      oocytes but not in two-cell embryos.
AB  - After fertilization in the mouse, the zygotic genome is activated in two-cell
      embryos by the spontaneous expression, among other genes, of the major inducible
      heat shock gene, hsp68, in the absence of heat-inducibility of heat shock genes.
      To obtain information on this phenomenon, we have probed one- and two-cell
      embryo's ability to express microinjected reporter DNA constructs, containing the
      Escherichia coli lacZ gene driven by promoters from early SV40 genes, the human
      beta-actin gene, and the normal or HSE-deleted mouse hsp68 gene. Activity of
      these promoters was also tested in mouse granulosa cells and dictyate oocytes, as
      a function of circular/linear construct configuration and occurrence of heat
      shock. The hsp68 promoter was heat-inducible in both granulosa cells and oocytes.
      Its heat activation required the presence of HSEs and, in the oocytes, of
      construct linear configuration. In the embryos however, this promoter was
      expressed independently of the presence of HSEs and of construct configuration,
      and its activity was not affected by heat shock. When constructs with early SV40
      and beta-actin promoters were injected into one-cell embryos, they appeared to be
      inactivated with the first embryonic cleavage, in agreement with previous
      observations [Wiekowski et al., 1992]. By contrast, both normal and HSE-deleted
      hsp68 promoters maintained their activity through the first cleavage, providing
      the first evidence of a gene escaping such transcriptional repression. Present
      results confirm previous findings on hsp68 expression during early mouse
      development, and suggest that this activation is mediated by a factor(s) other
      than HSF.

PMID- 8482022
TI  - The variability of processing of technetium-99m DTPA renography. Role of
      interpolative background subtraction.
AB  - In quantitative renography, observer-dependent selection of renal outlines and
      background regions may account for considerable variability. This study of
      differential renal function with Tc-99m DTPA scintigraphy compares interpolative
      background subtraction with the authors' routine techniques; the latter involves
      background-subtracted uptake on data integrated over 1-3 minutes after injection.
      Other techniques considered were omission of background subtraction and use of 1
      2 minute integration. The normal range was established in 24 hypertensive
      patients who had a normal angiogram and a normal radiometric glomerular
      filtration rate. The test set of 52 other hypertensive patients included 27 with
      renal artery stenosis. All techniques correlated well with the routine method (r
      > or = 0.98); however the interpolative background technique was unique in
      preserving the depiction of renal asymmetry but reducing the variability of
      replicate measurements (P < 0.05). Reduced renal function increased the
      variability of routine measurements, but the interpolative background subtraction
      method performed better in this instance (P < 0.01). Thus, the new technique
      appears to improve the definition of renal outlines and increase the reliability
      of measurements of differential renal function.

PMID- 8482023
TI  - Estimating renal function from the visual analysis of Tc-99m DTPA images.
AB  - Eleven visual parameters of Tc-99m DTPA imaging studies were evaluated to
      identify scintigraphic findings that best detect changes in renal function, to
      determine at which GFR levels they appear, and to establish criteria for visual
      estimation of renal function. Visual parameters were compared to in vitro GFR
      determinations in 41 patients. Three visual parameters offered best
      discrimination. The first one appeared at GFR values below 70 mL/min
      (sensitivity: 76%). The renal peak activity on the flow study (normally equal or
      greater than aortic) no longer reached the intensity of the aortic peak (pK <
      pA). The second parameter appeared at GFR values below 50 mL/min (sensitivity:
      85%). The estimated kidney-to-liver ratio in the 2-minute image (usually 3 or
      greater) decreased to values less than 3. The third scintigraphic finding,
      pelvicalyceal system nonvisualization, appeared at GFR levels below 20 mL/min
      (sensitivity 100%). Use of these 3 scintigraphic findings allows categorization
      of patients into four functional groups: 1) severe dysfunction (GFR: 0-20
      mL/min), 2) moderate to severe dysfunction (GFR: 21-50 mL/min), 3) moderate
      dysfunction (GFR: 50-70 mL/min), and 4) Normal study (GFR > 70 mL/min). Visual
      analysis of Tc-99m DTPA images does not identify patients with mildly decreased
      renal function (GFR: 70-90 mL/min).

PMID- 8482024
TI  - Evaluation of myocardial perfusion and function by technetium-99m methoxy
      isobutyl isonitrile before and after percutaneous transluminal coronary
      angioplasty. Preliminary results.
AB  - Myocardial perfusion and function were evaluated with Tc-99m MIBI myocardial
      scintigraphy before and after percutaneous angioplasty in six patients. In
      addition to conventional stress-rest images (3 projections: 45 degrees left
      anterior oblique, anterior, and left lateral), gated images were obtained at rest
      and during stress before and after angioplasty. Improvement in myocardial
      perfusion after angioplasty was demonstrated in all patients. The increase from
      rest to stress of radionuclide fractional shortening (an index of global left
      ventricular function computed on gated images) was greater after angioplasty than
      before (9% +/- 7% versus--0.5% +/- 8%, respectively, p < 0.05). Systolic wall
      thickening (an index of regional left ventricular function) showed a
      significantly greater rest-to-stress increase after angioplasty than before it in
      the regions supplied by treated vessels. Thus, Tc-99m MIBI myocardial
      scintigraphy is capable of evaluating myocardial perfusion and function.

PMID- 8482025
TI  - Basal interventricular septal thallium-201 defects: real or artifact?
AB  - Misinterpretation of reversible defects at the base of the interventricular
      septum is perhaps among the greatest single causes of false positive TI-201
      myocardial perfusion images. This is a report of a patient with angiographically
      documented ischemia at the base of the septum and corresponding reversible
      defects as seen using TI-201 imaging. Illustrated are two different forms of
      malalignment artifact that duplicate this patient's findings in a patient with
      normal perfusion.

PMID- 8482026
TI  - Spurious lung metastases on radioiodine thyroid and whole body imaging.
AB  - In patients with differentiated thyroid cancer, radioiodine uptake in the area of
      the lung usually denotes metastasis; however, it could represent an uptake by
      unrelated pulmonary disease or by the breasts, or external contamination. In this
      study, 22 foci that simulated lung metastasis on 11 thyroid and whole body scans
      were proven not to be metastasis by reimaging after cleaning (15 foci), or were
      strongly suspected to be due to external contamination because of the features of
      other images (7 foci). All foci were noted only on anterior views of the chest.
      Of the 22 foci, 19 were focal, two were smeared, and one was lobar. Foci were
      multiple in 7 scans, unilateral in 10 scans, and were associated with other
      artifacts in 4 scans. Caution should be used in interpreting apparent pulmonary
      radioiodine uptake as lung metastasis; reimaging after cleaning the skin and
      changing garment should be obtained when the uptake is confined to anterior views
      of the chest and/or when its pattern is atypical.

PMID- 8482027
TI  - Reverse mismatch between perfusion and aerosol ventilation in transplanted lungs.
AB  - Thirty ventilation-perfusion pulmonary scintigraphic studies were performed in 13
      patients who had undergone unilateral lung transplantation. Ventilation-perfusion
      mismatch (ventilation better than perfusion) was judged absent, mild, moderate,
      or severe in the transplanted and native lungs. Ventilation-perfusion mismatch
      was significantly worse in the transplanted lungs (p < .0001). Findings of lung
      biopsies and chest roentgenograms failed to correlate with the severity of
      ventilation-perfusion mismatch. Hypoxic pulmonary vasoconstriction appears to be
      significantly impaired in most unilateral lung transplants; the mechanism for
      this impairment is unclear.

PMID- 8482028
TI  - Bile duct leakage after laparoscopic cholecystectomy diagnosed by radioisotopic
      scanning.
AB  - Laparoscopic cholecystectomy is fast becoming the procedure of choice for removal
      of the gallbladder. It offers advantages over traditional cholecystectomy with
      shorter hospital stays, less postoperative pain, and lowered hospital costs.
      Laparoscopic cholecystectomy has been shown to be a safe procedure when performed
      by experienced surgeons, but a higher incidence of injury to the bile duct has
      been noted. Nuclear scintigraphy offers a noninvasive method for the diagnosis of
      traumatic injury to the bile duct. A case is presented in which a patient
      developed a major bile duct leak after undergoing an apparent successful
      laparoscopic cholecystectomy. The complication was promptly diagnosed through the
      use of nuclear scintigraphy. Radioisotopic scanning should be considered when
      evaluating patients who manifest abdominal pain after laparoscopic
      cholecystectomy.

PMID- 8482029
TI  - Correlation between bone imaging and the clinical picture in two unsuspected
      cases of progressive diaphyseal dysplasia (Engelmann's disease).
AB  - Progressive diaphyseal dysplasia was incidentally discovered in two patients
      referred for Tc-99m MDP bone scintigraphy (one for intense sciatica, the other
      for the detection of breast cancer metastases). Tracer accumulation in the
      diaphyses of the lower limbs and the base of the skull was accompanied by bone
      thickening and patency of the medullary cavity, as demonstrated by radiography,
      MRI, and bone marrow scanning. Comparison of the clinical pictures with the
      results of instrumental examinations showed that these were cases of sporadic
      progressive diaphyseal dysplasia of slight and average gravity, respectively. The
      differentiation of Ribbing's disease is explained and reference also is made to a
      finding not mentioned in the literature, namely frontal bone resorption lacunules
      in one patient.

PMID- 8482030
TI  - A comparative I-123 IMP SPECT study in Binswanger's disease and Alzheimer's
      disease.
AB  - The regional cerebral blood flow in 31 patients was semiquantitatively measured
      with SPECT using N-isopropyl iodo-amphetamine (I-123 IMP). Of the 31 patients, 9
      had Binswanger's disease (BD) (mean age: 64.2 years), 10 had Alzheimer's disease
      (AD) (mean age: 66.8 years), and 12 were neurologically normal (mean age: 67.8
      years). Tracer activity was determined in 7 pairs of cerebellar, cortical, and
      subcortical regions and was expressed as two ratios: the activity in each region
      of interest (ROI) compared to the mean count in the cerebellar region (ROI/CER
      ratio) and compared to the mean count in the occipital cortex (ROI/OCC ratio).
      Patients with BD showed a reduction of the ROI/CER ratio in the temporal cortex,
      thalamus, and basal ganglia compared to normal subjects. However, the ROI/CER
      ratio for the occipital region was higher than that of normal controls,
      suggesting that cerebellar blood flow was reduced in patients with BD. AD
      patients showed a decreased ROI/CER ratio in the frontal, temporal, and parietal
      cortices. Both BD and AD patients showed decreased ROI/OCC ratios in all the
      cortical and subcortical regions compared to the neurologically normal patients.
      In BD patients, the most marked reduction of both ratios was found in the
      thalamus, while for AD patients the most prominent reduction was seen in the
      parietal cortex. Our results indicate that these two types of dementia show
      characteristic regional cerebral blood flow patterns, which may be associated
      with their clinical features.

PMID- 8482031
TI  - Role of Ga-67 citrate imaging in extrapulmonary pneumocystis in HIV positive
      patients.

PMID- 8482032
TI  - Localization of Tc-99m MDP in a ureteral tumor.

PMID- 8482033
TI  - A comet-tail imaging artifact. Due to a "hot" point source and faulty
      electronics.

PMID- 8482034
TI  - Scintigraphic detection of a pleuro-biliary fistula. Post-operative complication
      of an amebic liver abscess.

PMID- 8482035
TI  - Salmonella osteomyelitis in an HLA-B27 patient.

PMID- 8482036
TI  - Diffuse liver uptake of Tc-99m phosphate compound associated with intravenous
      injection of iron colloid solution.

PMID- 8482037
TI  - Tc-99m HDP bone scintigraphy of ameloblastoma with panorex, CT, MRI, and gross
      correlation.

PMID- 8482038
TI  - Left ventricular thrombus identification. A scintigraphic and echocardiographic
      correlation.

PMID- 8482039
TI  - Simultaneous diagnosis of acute cholecystitis, intestinal malrotation, and
      duodenal diverticulum by cholescintigraphy.

PMID- 8482040
TI  - SPECT imaging of intense bone tracer uptake by an extensive extraosseous
      hemangioma.

PMID- 8482041
TI  - Dopamine and the kidney: ten years on.

PMID- 8482042
TI  - Enteric disease in early childhood inhibits microvillus expression by potential
      stem cells.
AB  - 1. Enterocyte development of microvillus structure has been measured in
      intestinal biopsies obtained from children suffering from coeliac disease, cow's
      milk protein intolerance and microvillus atrophy, and the results compared with
      similar measurements carried out in control children. 2. All types of enteric
      disease caused a significant 30% reduction in the length of microvilli present on
      undifferentiated basal crypt enterocytes, here referred to as potential stem
      cells. 3. Microvillus growth measured in control enterocytes took place mainly
      over the basal third of the villus. There was then little further change in
      structure during subsequent enterocyte migration to the villus tip. 4.
      Microvillus length in diseased tissue remained more or less constant during
      enterocyte migration to the crypt-villus junction. Microvillus length then
      decreased slightly during subsequent enterocyte migration over stunted villi. 5.
      The present results are discussed in relation to the supposed properties of
      potential stem cells. Comparisons are also made between profiles of microvillus
      development measured in healthy children and mature adults.

PMID- 8482043
TI  - Elevation of serum triacylglycerol concentration in association with hepatic
      microsomal enzyme induction after treatment with phenylbutazone and diclofenac
      sodium in rats.
AB  - 1. The relationship between serum triacylglycerol concentration and hepatic
      microsomal enzyme activity was examined in rats. 2. Two groups of rats were
      injected with diclofenac sodium at doses of 2.5 and 5 mg day-1 kg-1. A third
      group was injected with phenylbutazone at a dose of 20 mg day-1 kg-1. The
      treatment was continued for 15 days and the rats were killed 24 h after the last
      dose. 3. In all drug-treated rats, the serum triacylglycerol concentration and
      the hepatic microsomal activities of aminopyrine N-demethylase and aniline
      hydroxylase were significantly increased as compared with the corresponding
      values in control rats. The correlations between the serum triacylglycerol
      concentrations and the activities of the two enzymes, as indices of the hepatic
      microsomal activity, were highly significant. 4. These results indicate that the
      possibility of hypertriglyceridaemia as an adverse effect of the induction of the
      hepatic microsomal enzymes after the administration of phenylbutazone and
      diclofenac sodium should be considered.

PMID- 8482044
TI  - Ultrastructural characterization of platelet-activating factor-stimulated human
      eosinophils from patients with asthma.
AB  - 1. Purified human eosinophils from asthmatic patients were stimulated with
      platelet-activating factor in vitro and examined for morphological changes by
      transmission electron and light microscopy. Changes were also evaluated by
      morphometric analysis and were related to the platelet-activating factor
      stimulated release of granular eosinophil cationic protein. 2. Stimulation of
      eosinophils with platelet-activating factor induced a dose-dependent shape
      change, including the elongation of cells, loss of microvilli and the formation
      of lamellipodia. This effect was maximal at 25 min and was reversible. 3.
      Stimulation with platelet-activating factor also induced granule movement to the
      cell periphery and fusion of adjacent granules. Granules became swollen and
      vesiculated, whereas both the matrix and core showed evidence of solubilization.
      4. There was a time-dependent secretion of eosinophilic cationic protein from
      human eosinophils upon stimulation with platelet-activating factor which occurred
      without significant lactate dehydrogenase release. 5. Morphometric analysis of
      the transmission electron micrographs indicated a significant reduction in
      cytoplasmic area after 10 min of incubation with platelet-activating factor from
      39.0 +/- 1.7 microns 2 for untreated eosinophils to 33.2 +/- 2.3 microns 2 (P <
      0.02) for platelet-activating factor-treated cells, underscoring the observation
      that the cells change from spherical to ellipsoidal. No significant increase in
      the perimeter of the cells was found. 6. The number of granule-profiles in
      platelet-activating factor-stimulated eosinophils was slightly reduced when
      compared with control, and an increase in granule area was observed 10 min after
      platelet-activating factor challenge (0.215 +/- 0.011 microns 2 versus 0.246 +/-
      0.016 microns 2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482045
TI  - A novel method for measuring antioxidant capacity and its application to
      monitoring the antioxidant status in premature neonates.
AB  - 1. A new method has been developed for measuring the total antioxidant capacity
      of body fluids and drug solutions, based on the absorbance of the ABTS.+ radical
      cation. 2. An automated method for use on a centrifugal analyser, as well as a
      manual method, is described. 3. The procedure has been applied to physiological
      antioxidant compounds and radical-scavenging drugs, and an antioxidant ranking
      was established based on their reactivity relative to a 1.0 mmol/l Trolox
      standard. 4. The Trolox equivalent antioxidant capacity of plasma from an adult
      reference population has been measured, and the method optimized and validated.
      5. The method has been applied to investigate the total plasma antioxidant
      capacity of neonates and how this may be compromised in prematurity.

PMID- 8482046
TI  - Effects of oral alcohol on superior mesenteric artery blood flow in normal man,
      horizontal and tilted.
AB  - 1. The cardiovascular effects of oral alcohol (0.5 g/kg body weight diluted to
      300 ml in sugar-free orange juice) were compared with those of placebo in 10
      normal subjects. Measurements were made while the subjects were supine and
      horizontal for 45 min and after 10 min of 45 degrees head-up tilt. 2. After
      alcohol, plasma alcohol levels rose from 1.9 +/- 1.3 to 61.6 +/- 6.5 mg/100 ml.
      After placebo, plasma alcohol levels did not increase. After alcohol and placebo,
      supine blood pressure was unchanged; heart rate, both supine and during tilt,
      rose after alcohol only. 3. After alcohol, superior mesenteric artery and digital
      skin blood flow increased and calculated vascular resistances fell. There was no
      change after placebo. 4. Forearm blood flow, forearm vascular resistance and
      cardiac index did not change in either phase, except for a fall in cardiac index
      during tilt but only after alcohol. 5. In conclusion, the acute ingestion of 0.5
      g of alcohol/kg body weight in normal subjects raised heart rate and actively
      dilated the superior mesenteric artery and digital skin vessels. There was no
      effect on blood pressure, cardiac output and skeletal muscle vascular tone.
      During head-up tilt after alcohol, there was a tendency for blood pressure to
      fall with a compensatory rise in heart rate.

PMID- 8482047
TI  - Endothelium-dependent modulation of responses to endothelin-I in human veins.
AB  - 1. We have investigated whether local vascular production of nitric oxide or
      prostacyclin regulates venoconstriction induced by the endothelium-derived
      peptide, endothelin-1, in vivo in man. 2. Six healthy subjects received local
      dorsal hand vein infusion of endothelin-1 for 60 min alone or, on two separate
      occasions, co-infused with the donator of nitric oxide, glyceryl trinitrate, or
      the vasodilator prostaglandin, prostacyclin. In further studies, endothelin-1 was
      co-infused with an inhibitor of nitric oxide production, NG-monomethyl-L
      arginine, or after oral administration of the irreversible inhibitor of
      prostaglandin production, acetylsalicylic acid (aspirin). 3. At a low dose (5
      pmol/min), endothelin-1 alone caused slowly developing and long-lasting
      venoconstriction (maximal constriction: 66 +/- 4%). Although glyceryl trinitrate
      partially prevented endothelin-1-induced venoconstriction (maximum: 33 +/- 5%),
      inhibition of nitric oxide production did not affect endothelin-1-induced
      venoconstriction (maximum: 55 +/- 4%). 4. Prostacyclin was more effective at
      blocking the venoconstriction in response to endothelin-1 than glyceryl
      trinitrate (maximum: 12 +/- 3%), and there was substantial potentiation of
      endothelin-1-induced venoconstriction after pretreatment with aspirin (maximum:
      90 +/- 3%). 5. Despite the capacity of nitric oxide to attenuate responses to
      endothelin-1, NG-monomethyl-L-arginine did not potentiate endothelin-1-induced
      venoconstriction, suggesting little or no stimulated production of nitric oxide
      in human veins. However, the potentiation of responses to endothelin-1 by aspirin
      indicates that endothelial production of prostacyclin attenuates responses to
      endothelin-1 in human veins in vivo.

PMID- 8482048
TI  - Long-term insulin treatment of vascular smooth muscle cells from rat aorta
      attenuates the synergistic effect of insulin on angiotensin II- and epidermal
      growth factor-induced DNA synthesis.
AB  - 1. In the present study the effects of acute and chronic insulin treatment on
      growth factor-induced cell growth were investigated in vascular smooth muscle
      cells. Cell growth was quantified by the incorporation of [3H]thymidine into cell
      DNA and by determination of total protein. 2. Insulin in a concentration range of
      10(-9)-10(-6) mol/l had no effect on cell DNA synthesis. Insulin-like growth
      factor-1 in a concentration range of 10(-9)-10(-6) mol/l induced a concentration
      dependent increase in total cell protein, whereas no changes in DNA synthesis
      were observed. 3. Acutely, insulin enhanced the mitogenic effect of epidermal
      growth factor and angiotensin II. Long-term treatment with 10 and 100 ng/ml
      insulin over 14 weeks was associated with a time-dependent reduction in this
      potentiating effect of insulin on growth factor-induced DNA synthesis. To
      evaluate the mechanism of this effect, receptor binding studies were performed
      with 125I-labelled insulin-like growth factor-1. No difference in the Kd value
      (2.1 nmol/l) for insulin-like growth factor-1 was found between untreated and
      chronically insulin-treated cells, whereas the maximal number of binding sites
      decreased from 5.9 x 10(4) (untreated cells) to 4.7 x 10(4) (10 ng/ml) and to 4.3
      x 10(4) (100 ng/ml) binding sites/cell in chronically insulin-treated cells. 4.
      We conclude that insulin acutely enhances the mitogenic effect of various growth
      factors such as epidermal growth factor and angiotensin II on vascular smooth
      muscle cells. Long-term insulin treatment reduced the number of receptor binding
      sites for insulin-like growth factor-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482049
TI  - Treatment of anaemia in haemodialysis patients with erythropoietin: long-term
      effects on exercise capacity.
AB  - 1. The effects of correcting anaemia on exercise capacity were evaluated in 21
      haemodialysis patients (aged 39 +/- 12 years) before starting treatment with
      recombinant human erythropoietin (Hb concentration, 73 +/- 10 g/l; total Hb, 59
      +/- 12% of expected), after correction of the anaemia to a Hb concentration of
      108 +/- 7 g/l and a total Hb 82 +/- 10% of expected, and in 13 of the patients
      after 12 months on maintenance recombinant human erythropoietin treatment (Hb
      concentration 104 +/- 14 g/l, total Hb 79 +/- 17% of expected). Fifteen healthy
      subjects (aged 41 +/- 9 years), who took no regular exercise, constituted the
      control group. Maximal exercise capacity was determined on a bicycle ergometer.
      Oxygen uptake, respiratory quotient, blood lactate concentration, heart rate and
      blood pressure were measured at rest and at maximal workload. 2. After 6 +/- 3
      months on recombinant human erythropoietin, maximal exercise capacity increased
      from 108 +/- 27 W to 130 +/- 36W (P < 0.001) and the maximal oxygen uptake
      increased from 1.24 +/- 0.39 litres/min to 1.50 +/- 0.45 litres/min (P < 0.001).
      No significant changes in respiratory quotient (1.16 +/- 0.13 versus 1.18 +/-
      0.13) and blood lactate concentration (4.0 +/- 1.8 versus 3.6 +/- 1.1 mmol/l) at
      maximal workload were observed, but the blood lactate concentration in the
      patients was significantly lower than that in the control subjects (6.7 +/- 2.3
      mmol/l, P < 0.01). After the correction of anaemia, the aerobic power was still
      38% lower in the patients than in the control subjects and 17% lower than the
      reference values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482050
TI  - Effect of posture and acute glycaemic control on the excretion of retinol-binding
      protein in normoalbuminuric insulin-dependent diabetic patients.
AB  - 1. It has been suggested that tubular damage may precede glomerular damage at the
      onset of diabetic nephropathy. This may be reflected by increased urinary
      excretion of low-molecular-mass proteins, such as retinol-binding protein. 2. We
      have measured the urinary excretion rate of retinol-binding protein overnight,
      during orthostasis and during a hyperinsulinaemic euglycaemic clamp (blood
      glucose concentration 7.0 mmol/l) with stable diuresis in 34 normotensive,
      normoalbuminuric insulin-dependent diabetic patients and in 10 normal control
      subjects. Normal control subjects were not clamped. A further four
      normoalbuminuric insulin-dependent diabetic patients were rendered euglycaemic
      without a water load. 3. Overnight retinol-binding protein excretion rate was 58
      (16-157) [median(range)] ng/min in patients with insulin-dependent diabetes and
      32 (15-72) ng/min in control subjects (P < 0.01). The excretion rate did not
      change during orthostasis [patients with insulin-dependent diabetes, 67 (3-173)
      ng/min; control subjects, 23 (5-78) ng/min]. During the euglycaemic clamp retinol
      binding protein excretion rate increased to 383 (78-4897) ng/min in patients with
      insulin-dependent diabetes (P < 0.01). An average increment in retinol-binding
      protein excretion rate of greater than 4000% was noted after acute euglycaemia in
      those patients with insulin-dependent diabetes who were not water-loaded. 4. In
      insulin-dependent diabetes, both overnight and orthostatic retinal-binding
      protein excretion was not correlated with fasting blood glucose concentration,
      HbA1, fructosamine or duration of diabetes. The absolute and incremental
      excretion rates of retinol-binding protein during the clamp were, however,
      correlated with both fasting blood glucose concentration and glucose excretion
      rate (rs = 0.41-0.48, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482051
TI  - Glucose-dependent uptake of chromium in human and rat insulin-sensitive tissues.
AB  - 1. This study was designed to investigate the influence of insulin and glucose on
      the distribution of trivalent chromium in human plasma and blood cells and in
      human and rat insulin-sensitive and -insensitive tissues. 2. Evidence is provided
      that, in the rat in vitro, a clear difference exists in chromium binding between
      insulin-sensitive and -insensitive tissues in that chromium binding is
      significantly enhanced by glucose in insulin-sensitive tissues. 3. Glucose
      dependent association of chromium with human adipose tissue was blocked by
      inhibitors of glucose transport. 4. Addition of insulin slightly increased the
      response to glucose in muscle and reduced the response to glucose in adipose
      tissue; such effects were less marked than those seen in response to glucose
      alone. 5. The results of this study in vitro support the hypothesis that, in
      vivo, chromium translocates from the blood compartment to insulin-sensitive
      tissues.

PMID- 8482052
TI  - Sulphation in the colon.

PMID- 8482053
TI  - Will health care demand continue to increase?

PMID- 8482054
TI  - The Colorado Women's Cancer Control Initiative: a comprehensive effort to address
      breast and cervical cancer in Colorado women--Part 1.

PMID- 8482055
TI  - A Friendship Bridge from the United States to Vietnam.

PMID- 8482056
TI  - Emergency consultation for HMO-hospital patients.

PMID- 8482057
TI  - Let's talk about America's health system.

PMID- 8482058
TI  - [Physical activity and osteoporosis].
AB  - The aim of the present research was to underline the importance of physical
      activity in the prevention and treatment of osteoporosis. Therefore the authors
      considered age-related bone loss and the value of weight-bearing exercise on bone
      remodeling. Moreover the authors examined current world literature on physical
      exercise in post-menopausal age and bone mineral content in athletes, reporting
      their study's results.

PMID- 8482059
TI  - [Congestive heart failure with frequent hospital readmissions in the elderly].
AB  - Ten elderly patients with heart failure and frequent hospital readmission within
      12 months before the study, were submitted to clinical radiologic,
      electrocardiographic and echocardiographic evaluation in order to find the causes
      of readmission. The most frequent factors were found to be non compliance with
      drug prescriptions and therapy inadequate for the etiology of the heart failure
      and the kind of cardiac dysfunction.

PMID- 8482060
TI  - [Chronic administration of lithium and rubidium in rats. General behavior,
      explorative behavior and electric activity of the brain].
AB  - We have studied the rat under chronic treatment with lithium carbonate and
      rubidium chloride both given ip. For a four week period we have recorded, once a
      week, weight, rectal temperature, tail-flick, motor co-ordination and general
      activity in a one-arm radial maze and in a Boissier-Simon table. At the end of
      the fourth week surface (SEEG) and deep EEGrams (DEEG: hippocampus, amygdala)
      were recorded from treated and control animals. FFT (Hanning window) was
      performed both for SEEG and DEEG. The findings are: 1) No changes in weight,
      rectal temperature, tail-flick and motor coordination (rotarod). 2) In the one
      arm maze and in the Boissier-Simon table rubidium is in contrast to the effects
      of lithium, it causes increased activity and aggression 3) the EEGrams were
      analyzed by means of FFT as power in preselected bands of frequency. The results,
      on the whole, suggest, since these two ions have opposite effects on brain
      norepinephrine metabolism, that they may be useful in the treatment of PMD.

PMID- 8482061
TI  - [Atypical retinitis pigmentosa in Laurence-Moon-Biedl-Bardet syndrome. Report of
      a case of chronic renal insufficiency under periodic hemodialysis treatment].
AB  - A case of Laurence-Moon-Biedl-Bardet syndrome in a patient undergoing
      hemodialysis is reported. The principal characteristics of this congenital
      syndrome are described. A possible pathogenetic mechanism of the atypical form of
      retinitis pigmentosa (sine pigmento) is discussed.

PMID- 8482062
TI  - [Effectiveness and tolerability of simvastatin in subjects with primary
      hypercholesterolemia. Multicenter study].
AB  - The efficacy and safety of simvastatin were evaluated in an open multicenter
      study over a 24-week period. One hundred seventy-two patients (91 men, 81 women)
      with primary hypercholesterolemia (mostly polygenic) were enrolled in 14 Centers
      in Northern Italy. The mean age was 55.8 +/- 9.7 years and the mean baseline
      total cholesterol level was 305 +/- 59 mg/dL. After 4 weeks on an AHA step 1
      diet, patients who met the inclusion criterion (total cholesterol > or = 250
      mg/dL) were given simvastatin 10 or 20 mg in the evening. The dose could be
      titrated up to a maximum of 40 mg o.d. at week 6 and 12. No dose titration was
      allowed after week 12. One hundred forty-nine patients (86.6%) completed the
      study according to the protocol, 2 (1.2%) were withdrawn from the study because
      of adverse events not related to the drug, 21 (12.2%) were unavailable for follow
      up. Simvastatin treatment was associated with a sustained dose-related reduction
      in total and LDL cholesterol (-28% and -39% respectively at the end of the
      study). Triglycerides showed a significant descending trend (-16% at week 24) and
      HDL-C increased by 9%. Apolipoproteins were measured in only 25 patients: apo B
      was reduced by 30% and apo A1 increased by 9%. Clinical side effects were not
      relevant. Mean levels of GOT, GPT and CPK significantly increased after 6 weeks
      on simvastatin, but remained stable and at any rate ioitlin the normal range
      thereafter. Eight patients (5.4%) experienced small transaminase level elevations
      (< 3ULN) and six (4%) small CPK elevations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482063
TI  - [Evaluation of the clinical efficacy of misoprostol for gastric cytoprotection in
      patients under treatment with NSAID after proctologic intervention].
AB  - To perform ambulatorial surgery with local anaesthetics, it is important to carry
      out a correct postsurgical NSAID therapy avoiding the risks induced by these
      drugs. Two groups of patients submitted to ambulatorial hemorrhoidectomy were
      enrolled in a randomized study to evaluate the safety of NSAID therapy with or
      without the coadministration of misoprostol, a PGE1 analogue with
      gastroprotective action. Aim of this study was to evaluate if misoprostol in
      coadministration with NSAID could permit a correct domiciliary postsurgical NSAID
      therapy without gastric symptoms related to the NSAID therapy. From January 1990
      to December 1991, 95 patients underwent hemorrhoidectomy and were discharged with
      analgesic therapy: the first group (n = 45) without gastroprotective therapy, the
      second group (n = 50) with the coadministration of misoprostol 200 mcg bid. After
      7 and 14 days of treatment patients showed the following symptoms: in the first
      group 13.3% of the cases showed mild epigastric pain, 8.8% moderate epigastric
      pain and 4.4% severe epigastric pain with heartburn; in the second group (NSAID +
      misoprostol) only 4% of the cases showed moderate epigastric pain. The incidence
      of epigastric pain was statistically higher (p < 0.05) in patients treated with
      NSAID alone in comparison with the group treated with NSAID + misoprostol. The
      results, according to international literature, show that correct gastro
      protective therapy with synthetic prostaglandins (misoprostol) is necessary for
      patients in treatment with NSAIDs.

PMID- 8482064
TI  - [Therapeutic use of metadoxine in chronic alcoholism. Double blind study of
      patients in a department of general medicine].
AB  - Sixty patients, recognized as chronic alcoholics on the grounds of the case
      history and with a score above 11 of the Munich Alcoholism Test (MALT) have been
      treated with metadoxine or placebo for thirty days according to a double blind
      randomized design. In the group treated with active drug there has been a
      significant reduction higher than in the controls of the scores relating to the
      abstinence symptomatology, in particular regarding the neuropsychic residual
      symptomatology (anxiety, depression, insomnia) after the first week of treatment,
      a reduced requirement of benzodiazepines and/or neuroleptics, and a significant
      decrement higher than in the controls of the score of MALT at the end of
      treatment. Furthermore, metadoxine seems to make easy the maintenance of
      abstinence, at least at short term.

PMID- 8482065
TI  - [Vanadium, an indispensable trace element in living organisms. Current data on
      biochemical, metabolic levels and therapeutic doses].
AB  - Having briefly analyzed the role of vanadium in living organisms, the author
      describes conditions induced by vanadium poisoning and deficit. The most recent
      acquisitions concerning the use of vanadium in the treatment of diabetes mellitus
      and its consequent role in the prevention of atherosclerosis are also
      illustrated.

PMID- 8482066
TI  - [Vitamins. How, when, why].

PMID- 8482068
TI  - Abstracts of scientific papers and posters presented at the British Diabetic
      Association's Medical and Scientific Section spring meeting 1-2 April 1993,
      University of Liverpool.

PMID- 8482067
TI  - [Aspirin: as recommended by WHO].

PMID- 8482069
TI  - Spatial perspective-taking in conversation.
AB  - Speakers can describe the locations of objects from their own perspective ("on my
      left" or "on the left"), their addressee's ("on your right" or "on the right"),
      or some perspective that avoids choosing one or the other person ("closer to both
      of us"). This study shows that speakers set spatial perspectives differently with
      actual conversational partners than with the usually studied imaginary
      addressees. Speakers with partners tended to use more egocentric perspectives
      than solo speakers. Pairs varied idiosyncratically in the perspective-setting
      strategies they picked, but all engaged in the same collaborative process:
      talking until both were sure they had understood each other. When conversational
      roles switched, the new speakers allocated spatial perspectives with remarkable
      precision, taking their partners' perspectives just as often as the partner had
      taken theirs. Speakers were more explicit about whose perspective they were
      taking when they held the floor for only one description than when they gave many
      descriptions in a row.

PMID- 8482070
TI  - What's lost in inverted faces?
AB  - Disproportionate inversion decrements for recognizing faces and other homogeneous
      stimuli are often interpreted as evidence that experts use relational features to
      recognize stimuli that share a configuration. However, it has never directly been
      shown that inversion disrupts the coding of relational features more than
      isolated features. Here we report three studies that compare inversion decrements
      for detecting changes that span the isolated-relational features continuum.
      Relatively large inversion decrements occurred for relational features (Thatcher
      illusion changes, internal feature spacing), with smaller decrements for isolated
      features (presence/absence of facial hair or glasses). The one discrepancy was a
      relatively large inversion decrement for detecting changes to the eyes and mouth,
      which we had classified as an isolated feature change. However, this decrement
      disappeared when the features were presented out of the face context (Experiments
      2 and 3), suggesting that it occurs because subjects spontaneously code relations
      between the features and the rest of the face. Although the results support the
      interpretation of disproportionate inversion effects as evidence of relational
      coding, the difficulty of classifying changes as isolated or relational
      highlights an undesirable ambiguity in the isolated-relational feature
      distinction. We therefore consider alternative construals of the configural
      coding notion.

PMID- 8482071
TI  - Testing a non-decompositional theory of lemma retrieval in speaking: retrieval of
      verbs.
AB  - Theories of lexical access in speaking differ in whether they assume that words
      are accessed in a conceptually decomposed or non-decomposed way. In this paper,
      two experiments are reported that test the non-decompositional theory and
      computer model proposed by Roelofs (1992a). Subjects had to name pictured actions
      using verbs and ignore distractor verbs superimposed on the pictures. According
      to the theory, semantic inhibition should be obtained from distractor cohyponym
      verbs that are the names of other pictures in the experiment. By contrast,
      semantic facilitation should be obtained from hyponyms of the target verbs. Both
      predictions were empirically confirmed, both qualitatively and quantitatively.
      These findings support the proposed non-decompositional theory and computer
      model. Furthermore, they refute a recent attempt to deal with a class of
      retrieval problems within the decompositional framework. Bierwisch and Schreuder
      (1992) propose to solve the hyperonym problem (Levelt, 1989) by an inhibitory
      channel in the mental lexicon between a word and its hyperonyms. This predicts
      semantic inhibition by hyponyms, instead of the observed facilitation.

PMID- 8482072
TI  - Word and world order: semantic, phonological, and metrical determinants of serial
      position.
AB  - Animacy, word length, and prosody have all been accorded prominent roles in
      explanations for word order variations in language use. We examined the
      sequencing effects of these factors in two types of tasks. In recall tasks
      designed to simulate language production, we found selective effects of animacy.
      Animate nouns tended to appear as subjects in transitive sentences, but showed no
      special affinity for initial position in conjunctions within sentences, but
      showed no special affinity for initial position in conjunctions within sentences,
      suggesting a stronger involvement of animacy in grammatical role assignment than
      in word ordering. Word length had no significant impact: Shorter words did not
      appear earlier than longer words within sentences or within isolated conjunctions
      of nouns. Prosody had a weak effect on word order in isolated conjunctions,
      favoring sequences with alternating rhythm, but only in the absence of an animacy
      contrast. These results tend to confirm a hypothesized role for conceptual
      (meaning-based) accessibility in grammatical role assignment and to disconfirm a
      hypothesized role for lexical (form-based) accessibility in word ordering. In a
      judgment task, forms with animate nouns early were preferred across all
      constructions, and forms with short words early were often preferred both in
      sentences and in conjunctions. The findings suggest a possible asymmetry between
      comprehension and production in functional accounts of word order variations.

PMID- 8482073
TI  - Somatic mutations and cellular aging.

PMID- 8482074
TI  - cDNA clones from fish optic nerve.
AB  - 1. The present review describes the results of a cloning that was successfully
      employed in the study of optic nerve regeneration in fish. 2. Three intermediate
      filaments (IFs) expressed by the glial fish optic nerve were cloned. 3. By the
      use of this approach it was possible to resolve the controversial question of
      whether glial fibrillary acidic protein (GFAP) is expressed in the fish optic
      nerve. 4. Moreover, as a result of the information that emerged from the cloning,
      it was possible to raise well-characterized monospecific antibodies and
      successfully exploit them in order to determine glial cell maturation, lineage
      and plasticity, monitor the glial cell response to injury of the fish optic
      nerve, and compare it to that of a non-regenerative system.

PMID- 8482075
TI  - Antioxidant properties of di- and polyamines.
AB  - 1. One diamine, putrescine and two polyamines, spermidine and spermine (PAs) of
      different concentrations, were processed through antioxidant systems in order to
      study their antioxidant effects. The systems investigated were as follows. 2.
      "Oxidative stress" was induced in RBCs to investigate filtration parameters, the
      effect of reduced glutathione (GSH) and the change in lipid peroxidation (LP)
      superoxide dismutase (SOD) activities. 3. Initiated LP-decreasing characteristics
      of the substances were studied in pig brain homogenate. 4. The LP-decreasing
      effect of these PAs were studied in guinea-pig heart tissue homogenate perfused
      with Tyrode solution, stimulated, and then perfused by the Langendorff method. 5.
      In all three tests, the antioxidant characteristics of PAs were unambiguously
      proved.

PMID- 8482076
TI  - Specific adenosine phosphorylase from hepatopancreas of gastropod Helix pomatia.
AB  - 1. Specific adenosine phosphorylase from Helix pomatia hepatopancreas was
      separated from inosine-guanosine phosphorylase and purified 100-165 times;
      molecular weights were found to be 71,000 and 90,000, respectively. 2. The enzyme
      is specific for deoxy- and adenosine; it is inactive for 5'-methylthioadenosine
      and 5-amino-4-imidazole-carboxyamide riboside. Its sensitivity to several
      inhibitors differs from that of eucaryotic and bacterial purine nucleoside
      phosphorylases, and is not identical with the sensitivity of the S. mansoni
      adenosine-splitting enzyme. 3. H. pomatia adenosine phosphorylase differs in its
      mol. wt and Km values for P(i), ribose 1P, Ado and Ade from adenosine
      phosphorylase of B. subtilis.

PMID- 8482077
TI  - Aromatic alcohol oxidase and aldehyde oxidase activities in the digestive gland
      of three species of terrestrial gastropod (Helix aspersa, Arion ater, Limax
      flavus).
AB  - 1. Digestive gland homogenates of three species of terrestrial gastropod mollusc
      were used to prepare sources of soluble aldehyde oxidase and solubilized aromatic
      alcohol oxidase activities. 2. The snail (Helix aspersa) had two aldox isoenzymes
      each able to utilize salicylaldehyde whereas two slug species had a single
      apparent activity inhibitable by salicylaldehyde. 3. Aromatic alcohol oxidase
      activities of the three gastropods differed somewhat in their relative abilities
      to oxidize various methoxy-benzyl and amino-benzyl alcohols but, unlike fungal
      aromatic alcohol oxidase, were all able to utilize crotonyl alcohol as substrate.

PMID- 8482078
TI  - Prediction of protein antigenic sites in human corticotrophin-releasing hormone
      precursor.
AB  - 1. The primary structure of human corticotrophin-releasing hormone precursor (h
      pre-proCRH) has been analysed using a number of computer algorithms to identify
      the areas of highest predicted antigenicity. 2. These results were correlated
      with crossreactivity data obtained from studies of antibodies produced in rabbits
      by immunizing with h pre-proCRH, and a number of related peptides. 3. Six areas
      of high predicted antigenicity were identified in h pre-proCRH by the prediction
      routines utilized. Two of these corresponded almost exactly to the two putative
      cleavage sites of the prohormone, and a third lay within the C-terminal region of
      one of the products of post-translational processing of the prohormone, i.e.
      CRH(1-41). 4. Experimental crossreactivity data also indicated that a number of
      structural factors (e.g. Omega loops, peptide conformation) may also be involved
      in recognition of peptide fragments by antibodies.

PMID- 8482079
TI  - Comparative study of biochemical parameters and kinetic properties of dopamine
      beta-hydroxylase activity from cat and rat adrenals.
AB  - The specific adrenal dopamine-beta-hydroxylase activity measured in cat and rat
      was: (1) two times higher in cat than in rat; (2) significantly enhanced by
      ascorbate (up to 5 mM) that acts as a major activator; (3) differently affected
      by exogenous copper added to the incubation medium, leading to a decrease with
      large concentrations; and (4) similar, according to the kinetic parameters,
      thereby demonstrating a greater affinity for ascorbate than for tyramine.

PMID- 8482080
TI  - Comparative nuclear magnetic resonance studies of diffusional water permeability
      of red blood cells from sheep and cow.
AB  - 1. The diffusional water permeability (p) of sheep and cow red blood cell (RBC)
      membrane has been monitored by a doping nuclear magnetic resonance (NMR)
      technique on control cells and following inhibition with p-chloromercuribenzene
      sulfonate (PCMBS). 2. There were no significant differences in the water
      permeability of sheep and cow RBCs, the values of p being around 3 x 10(-3)
      cm/sec at 20 degrees C and 5 x 10(-3) cm/sec at 37 degrees C. 3. Systematic
      studies of the effects of PCMBS on water diffusion indicated that in both species
      the maximal inhibition is reached in 60-90 min at 37 degrees C with 1 mM PCMBS.
      4. The degree of inhibition increased as the temperature of measurement
      decreased, regardless of PCMBS concentration and incubation time. 5. The values
      of maximal inhibition ranged from 60-70% at 20 degrees C to 50-60% at 37 degrees
      C in the case of sheep RBCs, and from 45-55% at 20 degrees C to 40-50% at 37
      degrees C in the case of cow RBCs. 6. The basal permeability to water of sheep
      RBCs was estimated as 1.0 x 10(-3) cm/sec at 20 degrees C and 2.2 x 10(-3) cm/sec
      at 37 degrees C, and that of cow RBCs as 1.6 x 10(-3) cm/sec at 20 degrees C and
      2.7 x 10(-3) cm/sec at 37 degrees C. 7. In both species the activation energy of
      water diffusion was around 23 kJ/mol in control cells and reached values of
      around 30 kJ/mol after incubation with PCMBS in conditions of maximal inhibition
      of water diffusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482081
TI  - Detection of the 9-kDa vitamin D-dependent calbindin gene in a fruit bat
      (Rousettus aegyptiacus) fibroblast cell line.
AB  - 1. A fibroblast cell line was established from skin and lung tissue of the fruit
      bat (Rousettus aegyptiacus). 2. Genomic DNA, isolated from the fibroblast cells,
      was restriction digested and probed for the 9-kDa calbindin gene with a 180 base
      pair fragment of mouse calbindin-D9K cDNA. Genomic DNA from rats and humans was
      similarly probed. 3. Hybridization and thus homology was observed between the
      mouse probe and DNA from the rat and the fruit bat, but not the human. 4. The
      results are discussed in relation to the detection of calbindin-D9K in the fruit
      bat despite very low circulating levels of its inducer 1,25(OH)2D3.

PMID- 8482082
TI  - Treatment strategies for patients with the Guillain-Barre syndrome.

PMID- 8482083
TI  - Pulmonary microvascular fat in lung injury: an epiphenomenon?

PMID- 8482084
TI  - Pharmacokinetics of catecholamines in critically ill children: "you pays your
      money and you takes your choice".

PMID- 8482085
TI  - Severity of illness scoring: East meets West.

PMID- 8482086
TI  - Plasma exchange morbidity in Guillain-Barre syndrome: results from the French
      prospective, randomized, multicenter study. The French Cooperative Group.
AB  - OBJECTIVES: To describe all adverse events occurring during plasma exchange
      sessions in adult patients with the Guillain-Barre syndrome. To analyze these
      events with regard to the technical modalities and biological changes induced by
      sessions, and to try to identify a population at high risk for adverse events.
      DESIGN: Double-blind, randomized, prospective, multicenter trial. SETTING: A
      total of 28 French and Swiss intensive care units. PATIENTS: The study is based
      on 220 patients allocated either to plasma exchange (n = 109) or not (n = 111).
      This study focused on 105 patients who received at least one plasma exchange,
      with replacement fluid secondly allocated by randomization to albumin, or fresh
      frozen plasma. A total of 105 patients underwent 390 plasma exchanges. Fifty-five
      patients received albumin (208 sessions) as replacement fluid, and 50 patients
      received fresh frozen plasma (182 sessions). INTERVENTIONS: Prospective
      monitoring of patients for each session including technical modalities, adverse
      effects, and biological parameters. MEASUREMENTS AND MAIN RESULTS: A total of 253
      adverse incidents were recorded. At least one adverse incident occurred in 39% of
      plasma exchange sessions among 80 (76%) patients. In 15 patients, plasma exchange
      treatment had to be discontinued because of severe intolerance (six patients,
      including three patients with severe bradycardias), intercurrent complications,
      mainly infections (four patients), and technical difficulties. One patient with
      pneumococcal septicemia and pneumonia died during the second plasma exchange
      session. Fresh frozen plasma was associated with more adverse incidents than
      albumin (135 vs. 118, p = .008). The occurrence of adverse events was also
      related to the preplasma exchange hemoglobin level assessed before the session (p
      = .04). Otherwise, the frequency of adverse effects did not depend on technical
      modalities (type of equipment, anticoagulation). Age, sex, previous history,
      neurologic severity, and the need for mechanical ventilation, as assessed on
      inclusion in the study, did not modify the risk of adverse effects. Finally,
      occurrence of bradycardia did not rely on initial neurologic severity.
      CONCLUSIONS: These results confirm that fresh frozen plasma should be abandoned
      as replacement fluid in plasma exchanges of Guillain-Barre syndrome patients.
      They also underline the need for close monitoring of patients during sessions
      and, especially, the respect of treatment contraindications. Some adverse
      incidents could be attributed to the underlying disease rather than to the plasma
      exchange session.

PMID- 8482087
TI  - Pulmonary microvascular fat: the significance?
AB  - OBJECTIVE: To determine the effects of fat emboli on cardiopulmonary function in
      critically ill patients. DESIGN: A prospective study. SETTING: Tertiary referral
      medical/surgical shock/trauma intensive care unit (ICU). PATIENTS: A total of 51
      critically ill medical and surgical (including acute trauma) patients who
      required supplemental oxygen (FIO2 of > or = 0.35) to maintain arterial blood
      oxyhemoglobin saturation of > or = 90% and who had 62 pulmonary artery catheters
      placed for patient care reasons. INTERVENTIONS: Pulmonary capillary blood samples
      were obtained via the pulmonary artery catheters in the "wedged position" at
      insertion and postinsertion at 8, 24, 48, and 72 hrs. Cytospun smears of the
      buffy coat aspirates of these samples were made and were stained with Oil Red-O
      for fat. MEASUREMENTS AND MAIN RESULTS: One investigator, without knowledge of
      the patients' cardiopulmonary function, examined all smears and graded them 0 to
      4+ for amount of fat. Fat scores were correlated with chest radiograph
      appearance, hemodynamic and respiratory parameters, complete blood cell counts
      with differential white blood cell counts, whether the patient was receiving
      lipid-containing parenteral nutrition, principal organ system failure, and reason
      for ICU admission. Samples from 27 pulmonary artery catheter insertions had no
      fat, 13 samples had low-grade (1+) episodic fat, and 22 samples had repeated
      episodes of > or = 2+ fat or isolated episodes of 4+ fat. There was a significant
      association between the amount of pulmonary microvascular fat and trauma as the
      reason for ICU admission. Of the other parameters, only chest compliance and body
      temperature showed unequivocal significant associations. These associations were
      opposite to the expected findings, but would support a conclusion that fat emboli
      did not cause the observed cardiopulmonary dysfunction. The inconsistent
      associations for the FIO2, PCO2, and mixed venous blood oxyhemoglobin saturation
      may be random events. CONCLUSION: Cardiopulmonary dysfunction commonly attributed
      to fat emboli is likely due to other causes.

PMID- 8482088
TI  - Dobutamine infusions in stable, critically ill children: pharmacokinetics and
      hemodynamic actions.
AB  - OBJECTIVE: To delineate dobutamine pharmacokinetics and hemodynamic responses in
      children. DESIGN: Prospective, pharmacokinetic study using sequential, graded
      dosing of drug. INTERVENTIONS: Graded intravenous dobutamine infusions of 0.5,
      2.5, 5, 10, and 20 micrograms/kg/min were sequentially administered for 25 mins
      each. Plasma dobutamine concentrations and echocardiographically determined
      hemodynamic data were obtained at baseline and at 15 and 25 mins during each
      infusion rate. Hemodynamic responses were evaluated by paired t-test and by
      computerized evaluation of individual dose-response curves. SETTING: Pediatric
      intensive care unit in a university setting. PATIENTS: Eleven stable, critically
      ill children previously requiring inotropic support with dobutamine. Seven
      patients were postcardiac surgical patients; four patients had acute cardiac
      dysfunction with septic shock and/or adult respiratory distress syndrome.
      MEASUREMENTS AND MAIN RESULTS: Mean cardiac index increased from 3.8 to 5.2
      L/min/m2 (p < .05). Increasing the infusion rate from 10 to 20 micrograms/kg/min
      increased cardiac index by 16% (p < .05). Cardiac index increased by > 10% in
      four of seven patients at a dobutamine infusion rate of 0.5 microgram/kg/min
      (mean 21%). The relationship of plasma dobutamine concentration to cardiac index,
      systolic blood pressure, and heart rate fit a threshold model with a log-linear
      relationship after the threshold in seven of nine, seven of 11, and eight of 11
      patients, respectively. As anticipated, in the patients who responded, there were
      linear increases in hemodynamic responses with exponential increases in plasma
      dobutamine concentrations. Mean plasma clearance rate was 82 +/- 3 mL/min/kg.
      First-order kinetics were demonstrated by the direct linear relationship of
      plasma dobutamine concentration to infusion rate (mean r2 = .95; p < .01 for each
      patient) and by independence of clearance from dose and duration of each
      infusion. CONCLUSIONS: Dobutamine effectively improves systolic function in
      critically ill children. Hemodynamic responses to dobutamine generally follow a
      predicted log-linear dose-response model. Dobutamine clearance in this study was
      consistent with first-order kinetics. The wide variability in hemodynamic
      responses and clearance kinetics indicate that dobutamine infusions must be
      titrated individually.

PMID- 8482089
TI  - One-year outcome of elderly and young patients admitted to intensive care units.
AB  - OBJECTIVE: To compare the outcome of patients over and under age 65 admitted to
      two intensive care units (ICUs). DESIGN: Prospective, two-center study.
      Convenience sample of all admissions to two adult ICUs for a 1-yr period, with a
      1-yr follow-up. SETTING: Adult multidisciplinary closed ICUs. PATIENTS: All
      patients (n = 1,040) admitted to two ICUs during a 1-yr period were entered into
      the study, except patients with self-induced poisoning. Of these patients, 145
      patients were lost to follow-up. INTERVENTIONS: Admission statistics on all
      patients included demographic, case mix, and severity data. Variables associated
      with intensive care unit outcomes at discharge (length of stay, mortality) and at
      1 yr from admission (mortality, functional capacity, health attitudes) were
      analyzed. Vital status was confirmed from both Alberta Vital Statistics and
      Alberta Health. Follow-up interviews were conducted with all available survivors.
      RESULTS: The elderly group (> 65 yrs) comprised 46% of patients studied. Both age
      groups (> 65 yrs and < 65 yrs) had comparable demographics and illness severity
      measures. Although ICU and 1-yr mortality rates differed between groups (16% of >
      65 yrs vs. 12.9% of < 65 yrs ICU mortality and 49% of > 65 yrs vs. 31% of < 65
      yrs 1-yr mortality), age was not a major contributor to the variance in outcome.
      At 1 yr, 65% of patients admitted to the study were alive. Follow-up interviews
      were conducted with 75% of survivors. Assessment of activities of daily living
      showed that the elderly patients were similar to younger patients. The elderly
      demonstrated more positive health attitudes than younger survivors. Functional
      capacity was significantly associated with health attitudes of younger patients,
      but not for older survivors. CONCLUSIONS: Age does not have an important impact
      on outcome from critical illness, which is most strongly predicted by severity of
      illness, length of stay, prior ICU admission and respiratory failure.
      Satisfaction with personal health should not be inferred from the functional
      status of elderly survivors of intensive care.

PMID- 8482090
TI  - Functional responses to extremely high plasma epinephrine concentrations in
      cardiac arrest.
AB  - OBJECTIVE: To evaluate the action of high-dose epinephrine by measuring
      simultaneously its vasopressor and norepinephrine releasing effects in humans
      during cardiac arrest. DESIGN: A prospective study on consecutive patients
      admitted with cardiac arrest. SETTING: Emergency Department in a large, urban
      hospital. PATIENTS: Eighteen patients with out-of-hospital cardiac arrest
      undergoing cardiopulmonary resuscitation (CPR). INTERVENTIONS: Catheterization of
      both the aorta and right atrium for the recording of pressure and collection of
      blood samples. Throughout the study period (12.5 mins), 18 patients received
      epinephrine at both the standard dose (1 mg, approximately 0.015 mg/kg) and high
      dose (0.2 mg/kg). Blood samples were drawn five times, every 2.5 mins.
      MEASUREMENTS AND MAIN RESULTS: Plasma epinephrine and norepinephrine
      concentrations; aorta, right atrial, and coronary perfusion pressures.
      Epinephrine concentrations (normal at rest = 160 +/- 10 [SEM] pmol/L) were
      increased at the time of the first sample (2.5 mins) by approximately 3,000-fold
      (to approximately 0.5 mumol/L), and, increased further to 12,000-fold
      (approximately 2.0 mumol/L) during the study. Aortic pressure increased from 20
      +/- 3 to 28 +/- 3 mm Hg (p < .001), and coronary perfusion pressure increased
      from 4 +/- 3 to 10 +/- 3 mm Hg (p < .001). Simultaneous plasma norepinephrine
      concentrations were 30-fold higher than the normal resting value of 1.30 +/- 0.04
      nmol/L, and increased by 90-fold during the study (p < .001). The spectral
      distributions of the individual correlations between plasma epinephrine and
      norepinephrine concentrations were segregated into high correlations (r > .83) in
      12 of 18 patients and low r values (r = .29 to .79) in the remaining six
      patients. The distribution of the correlations was nonuniform by the Kolmogorov
      Smirnov goodness-of-fit test with p < .001; this profile suggests that
      norepinephrine responsiveness to epinephrine can separate two populations, one of
      which (r > .83) would have preserved viability of the corresponding epinephrine
      receptors. The correlations between plasma epinephrine concentrations and
      coronary perfusion pressures were distributed more evenly, also in a nonuniform
      pattern (p < .02 by Kolmogorov-Smirnov goodness-of-fit test) and the relationship
      between the two sets of correlations was not significant. CONCLUSIONS: Despite
      the very high prevailing plasma epinephrine concentrations during cardiac arrest,
      further epinephrine increases still elicit biological responses. The present work
      provides physiologic support for the use of large doses of epinephrine during the
      course of CPR.

PMID- 8482091
TI  - Verification of the Acute Physiology and Chronic Health Evaluation scoring system
      in a Hong Kong intensive care unit.
AB  - OBJECTIVES: To validate the Acute Physiology and Chronic Health Evaluation
      (APACHE II) severity of illness scoring system in Chinese patients in a
      multidisciplinary intensive care unit (ICU) in Hong Kong. To audit the service
      and utilization of an ICU with a low ICU to hospital bed ratio. DESIGN:
      Prospective data collection and review. SETTING: A 12-bed multidisciplinary ICU
      within a 1,430-bed tertiary care university hospital. PATIENTS: Data from 1,573
      of 1,814 consecutive patients admitted to the ICU from May 1988 to November 1990
      were studied. The patients were all Chinese. INTERVENTIONS: None. MEASUREMENTS
      AND MAIN RESULTS: The patients' clinical details and APACHE II scores were
      recorded on day 2 of admission and reviewed at hospital discharge or after death.
      The APACHE II scores, risk of death values, age, and length of ICU stay between
      survivors and nonsurvivors were compared by two-sample t-tests. Relationships
      between mortality and APACHE II score, risk of death, and results from previous
      studies were investigated using the Pearson product-moment coefficient and
      regression analysis. Predictive capacity of risk of death was assessed by
      receiver operating characteristic curve analysis. The hospital mortality rate for
      study patients was 36%. Survivors were younger, had shorter ICU stays, lower
      APACHE scores, and lower risk of death values than nonsurvivors (p < .001). There
      was close correlation (r2 = .81, .77, and .76 for all patients, operative group,
      nonoperative group, respectively) between APACHE II scores and predicted risk of
      death values. Risk of death was an accurate group predictor of death in all
      patients and in separate operative and nonoperative groups. Areas under the
      receiver operating characteristic curves were 0.89 (all patients), 0.85
      (operative), and 0.88 (nonoperative). Neither the Apache II scores nor risk of
      death scores were sufficiently accurate to predict outcome of individual
      patients. There was close concordance between observed and predicted mortality of
      patient groups. Mortality ratio was 0.97 (all patients), 0.89 (operative group),
      and 1.02 (nonoperative group). Chronological age, per se, was not a good
      predictor of mortality. The audit of the ICU service showed a short length (4.2
      days) of ICU stay and high bed occupancy (80%). Subgroups of low-risk,
      postoperative patients with good outcomes and poor-risk patients admitted after
      cardiopulmonary arrest with a high mortality rate were identified. CONCLUSIONS:
      The APACHE II scoring system was an accurate predictor of group outcome in a
      Chinese population, making it suitable for comparisons between countries.
      Application of the APACHE II scoring system in a clinical audit facilitates
      critical appraisal of an ICU service. Problems identified by the study were a
      shortage of ICU beds and delayed referrals of patients.

PMID- 8482092
TI  - Coagulopathy as a predictor of outcome in meningococcal sepsis and the systemic
      inflammatory response syndrome with purpura.
AB  - OBJECTIVE: To identify simple, contemporary predictors of both morbidity and
      mortality in pediatric patients with purpuric sepsis syndrome in order to provide
      a basis for future study of innovative interventions. DESIGN: Retrospective
      study. SETTING: An 18-bed multidisciplinary intensive care unit (ICU) in a large
      pediatric hospital. PATIENTS: A total of 53 patients, ranging in age from 18 days
      to 17 yrs (mean 4.9 yrs) with either culture-proven meningococcal sepsis or the
      systemic inflammatory response syndrome with purpura, who were admitted to the
      ICU during the period from January 1, 1982 through March 15, 1992. METHODS: A
      computerized database was constructed containing the characteristics of these
      patients at presentation, during the first 24 hrs of hospitalization, and on
      discharge. Single variables were screened for significance between "good" (intact
      survival) and "poor" (mortality or survival with significant morbidity) outcome
      groups. Those variables found to be most significant were then tested for
      sensitivity, specificity, and predictive value. The best predictors identified in
      this manner were then compared with the two most-cited prognosticating strategies
      as applied to these patients. MEASUREMENTS AND MAIN RESULTS: Coagulopathy
      (defined as a partial thromboplastin time > 50 secs or serum fibrinogen
      concentration < 150 mg/dL [4.4 mumol/L]) at the referral site or on ICU admission
      was identified as an excellent predictor of poor outcome: sensitivity,
      specificity, positive and negative predictive values of a low serum fibrinogen
      value, being 81%, 95%, 93%, and 88%, and of prolonged partial thromboplastin
      time, being 95%, 90%, 86%, and 97%, respectively. Classical prognosticating
      strategies were found to be inadequately associated with mortality, yet
      comparable with coagulopathy in identifying patients destined for clinically
      important morbidity. CONCLUSIONS: We conclude that: a) outcome of pediatric
      patients with meningococcal sepsis or the systemic inflammatory response syndrome
      with purpura can be predicted rapidly, more easily, and with overall accuracy
      superior to classical prognostication strategies by the simple presence or
      absence of coagulopathy; b) when applied to a contemporary population, classical
      prognostication strategies lack value for prediction of mortality, yet remain
      valid for prediction of "poor outcome" (significant morbidity + mortality); c)
      when evaluating treatment strategies for such patients, the presence of serious
      coagulopathy may potentially be useful as an index of illness severity.

PMID- 8482093
TI  - Effects of pentoxifylline on in vivo leukocyte function and clearance of group B
      streptococci from preterm rabbit lungs.
AB  - OBJECTIVES: Pentoxifylline was evaluated for its ability to enhance inactivation
      of group B streptococci in lungs of prematurely born rabbits. Mechanisms
      associated with intrapulmonary streptococcal clearance and the pharmacodynamics
      of pentoxifylline were also investigated. DESIGN: Randomized, controlled animal
      trial. SETTING: University research laboratory. SUBJECTS: A total of 123 New
      Zealand rabbits were delivered prematurely by cesarean section and were used for
      clearance studies. Twenty-three preterm pups were additionally utilized to study
      the pharmacodynamics of pentoxifylline. INTERVENTIONS: Preterm rabbits were
      infected with group B streptococcal aerosols and given intraperitoneal injections
      of either pentoxifylline (25, 12.5, and 12.5 mg/kg) or placebo at 0, 6, and 12
      hrs after infection. MEASUREMENTS AND MAIN RESULTS: At 0, 4, and 24 hrs, the
      numbers of streptococci were determined in the left lung, while the right lung
      underwent bronchoalveolar lavage to quantify intra-alveolar leukocytes,
      phagocytosis of inhaled bacteria, and concentrations of lysozyme and tumor
      necrosis factor. In a separate experiment, blood and bronchoalveolar fluid from
      infected animals were analyzed for pentoxifylline content. Streptococcal
      proliferation was less in pentoxifylline-treated animals than in controls at 24
      hrs (p < .01). Pulmonary macrophages and polymorphonuclear leukocytes recovered
      from bronchoalveolar lavage fluid did not differ in numbers or phagocytic
      activity. Pentoxifylline-treated animals had lower levels of lysozyme (p < .02)
      and tumor necrosis factor (p < .005) in bronchoalveolar lavage fluid compared
      with placebo-treated pups. Therapeutic levels of pentoxifylline were achieved in
      blood and bronchoalveolar lavage fluid. CONCLUSIONS: Despite lowering lysozyme
      and tumor necrosis factor content in epithelial lining fluid, pentoxifylline
      improves the inactivation of group B streptococci in preterm rabbit lungs. These
      findings suggest that increased group B streptococcal clearance was coincident
      with an anti-inflammatory effect due to pentoxifylline. We conclude
      pentoxifylline may be clinically useful as an adjunctive therapy for group B
      streptococcal pneumonia in newborns.

PMID- 8482094
TI  - Collateral perfusion through overlapping vessels reduces canine right ventricular
      ischemic injury from positive end-expiratory pressure.
AB  - OBJECTIVE: To test, in a canine model of right ventricular ischemia with 15 cm
      H2O positive end-expiratory pressure, whether collateral perfusion through
      overlapping vessels from the left ventricle to the right ventricular free wall
      can reduce infarct size. DESIGN: Randomized, prospective, controlled,
      experimental study in dogs. SETTING: Anesthesia research laboratory of an
      academic medical center. SUBJECTS: Twenty microfilaria-free mongrel dogs.
      INTERVENTIONS: Anesthetized, closed-chest dogs were managed with the application
      of 15 cm H2O positive end-expiratory pressure. The right coronary artery was
      ligated (90 mins) with occlusion (n = 10) and without occlusion (n = 10) of
      overlapping vessels. MEASUREMENTS AND MAIN RESULTS: Myocardial blood flow (using
      radioactive microspheres) was measured in the area at risk (gentian violet) and
      in the area of necrosis (triphenyltetrazolium chloride). With right coronary and
      overlapping vessel occlusion, blood flow in the area at risk decreased from 80.1
      +/- 14.0 to 9.0 +/- 1.7 mL/min/100 g after 5 mins of ischemia (p = .0001) and
      remained depressed at 8.7 +/- 1.8 mL/min/100 g after 75 mins of ischemia. With
      right coronary occlusion alone, blood flow decreased after 5 mins of ischemia
      from 64.8 +/- 5.4 to 14.3 +/- 1.9 mL/min/100 g (p = .0001 compared with
      baseline), which was 60% greater than the group with occluded collateral vessels
      (p = .0055). Moreover, after 75 mins of ischemia, blood flow in the area at risk
      increased further to 28.9 +/- 5.4 mL/min/100 g with patent overlapping vessels (p
      = .0001 compared with 5-min value). The patency of overlapping vessels during
      right ventricular free wall ischemia reduced the area at risk from 68.5 +/- 2.4%
      to 38.6 +/- 5.1% (p = .0001) and the area of necrosis/area at risk from 58.1 +/-
      8.4% to 16.9 +/- 3.6% (p = .0007). CONCLUSIONS: Despite 15 cm H2O positive end
      expiratory pressure, perfusion through overlapping vessels improved peri-ischemic
      blood flow in the area at risk, thereby reducing the size of the risk area and
      the amount of right ventricular free wall necrosis.

PMID- 8482095
TI  - Action of carbon dioxide on hypoxic pulmonary vasoconstriction in the rat lung:
      evidence against specific endothelium-derived relaxing factor-mediated
      vasodilation.
AB  - OBJECTIVES: The effect of hypercapnia on pulmonary vascular tone is controversial
      with evidence for both a vasoconstrictor and vasodilator action. The objective of
      this study was to investigate the possibility that this dual response to CO2
      could be explained by a direct constrictor action on smooth muscle and an
      indirect dilator action via the release of endothelium-derived relaxing factor.
      The effect of ventilation with hypercapnia (FICO2 0.15) on pulmonary pressor
      response to hypoxia (FIO2 0.3) was investigated. DESIGN: Prospective, randomized
      study. SETTING: The National Heart and Lung Institute, UK. SUBJECTS: The
      isolated, blood-perfused rat lung. INTERVENTIONS: Angiotensin-II and a blocker of
      endothelium-derived relaxing factor synthesis, NG-monomethyl-L-arginine (L-NMMA).
      MEASUREMENTS AND MAIN RESULTS: The vasomotor effect of hypercapnia depended on
      pulmonary arterial pressure. Under resting tone, CO2 acted as a mild constrictor
      (change in mean pulmonary arterial pressure from 14 +/- 2 to 15 +/- 2 mm Hg, n =
      4; p < .05. At increased tone, induced either by hypoxia or Angiotensin-II, CO2
      was a vasodilator. Thus, hypoxia increased mean pulmonary arterial pressure from
      17 +/- 2 to 32 +/- 2 mm Hg (n = 8; p < .01), but simultaneous ventilation with
      hypoxia and hypercapnia reduced this by 16 +/- 1% (p < .01). Angiotensin-II (1
      microgram) increased pulmonary arterial pressure from 14 +/- 2 to 39 +/- 5 mm Hg
      (n = 8; p < .01), but with hypercapnia, this angiotensin-induced pulmonary
      vasoconstriction was reduced by 18 +/- 6% (p < .001). The reduction in hypoxic
      pulmonary vasoconstriction induced by hypercapnia was not significantly different
      from that seen with Angiotensin-II hypercapnia. Blocking endothelium-derived
      relaxing factor synthesis using 30 microM NG-monomethyl-L-arginine did not
      significantly change either basal pulmonary arterial pressure or the response to
      hypercapnia, but increased hypoxic pulmonary vasoconstrictor by 24 +/- 4% (n = 4;
      p < .01). There was no significant difference between the change in hypoxic
      pulmonary vasoconstriction induced by hypercapnia after saline control (21 +/- 8%
      decrease) and the change in hypoxic pulmonary vasoconstriction caused by CO2
      after 30 microM L-NMMA (25 +/- 10% decrease, p < .05, n = 8). CONCLUSION:
      Endothelium-derived relaxing factor seems unlikely to specifically modulate CO2
      induced vasodilation in the rat pulmonary circulation.

PMID- 8482096
TI  - Pulmonary venodilation by isoflurane improves gas exchange during Escherichia
      coli bacteremia.
AB  - OBJECTIVE: To determine how isoflurance affects the longitudinal distribution of
      pulmonary vascular resistance and pulmonary gas exchange during Escherichia coli
      bacteremia. DESIGN: Prospective, controlled study with open-label assignment of
      animals to two groups. SETTING: Laboratory. SUBJECTS: Goehingen minipigs.
      INTERVENTIONS: Induction of acute respiratory failure by a 4-hr infusion of live
      E. coli bacteria in 12 animals; six animals anesthetized with
      methohexital/piritramide; six animals anesthetized with isoflurane. The control
      group consisted of four animals that received the same surgical procedure, but no
      E. coli infusion. Two animals were anesthetized with methohexital/piritramide and
      two with isoflurane, respectively. MEASUREMENTS AND MAIN RESULTS: Cardiac output
      and pressures were measured by means of an arterial catheter, Swan-Ganz catheter,
      and a left atrial catheter. Effective pulmonary capillary pressure was evaluated
      graphically from a pulmonary artery occlusion pressure decay. Arterial-alveolar
      PO2 ratio was calculated to evaluate pulmonary function. Measurements were
      performed before and after 1, 2, and 3.5 hrs of E. coli infusion. Statistical
      significance was tested with analysis of variance (ANOVA). E. coli infusion
      caused hypodynamic shock, an increase in pre- and postcapillary pulmonary
      vascular resistance and respiratory failure. Postcapillary pressure gradient and
      effective pulmonary capillary pressure were lower in the isoflurane-group.
      Methohexital-anesthetized animals developed pulmonary dysfunction after 1 hr of
      bacteremia, whereas isoflurane-anesthetized animals developed pulmonary
      dysfunction after 3.5 hrs of E. coli infusion (significantly different, ANOVA, p
      < .05). There were no significant changes in the sham group. CONCLUSIONS:
      Isoflurane is a pulmonary venodilator. During lethal E. coli infusion, it
      ameliorates the increase in pulmonary capillary pressure and preserves pulmonary
      function until vascular permeability increases.

PMID- 8482097
TI  - Diphosphoryl lipid A from Rhodopseudomonas sphaeroides induces tolerance to
      endotoxic shock in the rat.
AB  - OBJECTIVES: To examine the hemodynamic effects of diphosphoryl lipid A from
      Rhodopseudomonas sphaeroides and to examine the ability of this substance to
      induce tolerance to endotoxic shock. DESIGN: Randomized, prospective, controlled
      study comparing the hemodynamic actions of R. sphaeroides diphosphoryl lipid A to
      those effects of lipopolysaccharide form Salmonella minnesota, followed by a
      prospective, randomized, controlled study comparing pretreatment with R.
      sphaeroides diphosphoryl lipid A and phosphate-buffered saline in the induction
      of tolerance to endotoxic shock. SETTING: Laboratory of the Section of Critical
      Care Medicine at a University Hospital. SUBJECTS: Male Sprague-Dawley rats.
      INTERVENTIONS: Eight rats were randomized to receive intravenous R. sphaeroides
      diphosphoryl lipid A, 0.5 mg/100 g body weight or S. minnesota
      lipopolysaccharide, 0.5 mg/100 g body weight. Ten rats were then randomized to
      receive R. sphaeroides diphosphoryl lipid A, 0.5 mg/100 g body weight, or
      phosphate-buffered saline intravenously 48 hrs before receiving S. minnesota
      lipopolysaccharide, 5 mg/100 g body weight, by intravenous infusion. MEASUREMENTS
      AND MAIN RESULTS: Cardiac index was significantly decreased from baseline in rats
      treated with lipopolysaccharide; there was no significant change in the R.
      sphaeroides diphosphoryl lipid A group. Peak circulating tumor necrosis factor
      (TNF) concentrations in the lipopolysaccharide-treated rats were higher than in
      R. sphaeroides diphosphoryl lipid A-treated rats (3.1 +/- 1.0 vs. 1.5 +/- 0.4
      ng/mL). R. sphaeroides diphosphoryl lipid A significantly attenuated
      lipopolysaccharide-induced changes in mean arterial pressure and cardiac index.
      At baseline, there was no significant difference in serum TNF concentrations
      between rats pretreated with R. sphaeroides diphosphoryl lipid A and those rats
      pretreated with phosphate-buffered saline. TNF levels peaked at 1 hr post
      lipopolysaccharide infusion at 4.3 +/- 0.6 ng/mL in the phosphate-buffered saline
      group and at 2.0 +/- 0.5 ng/mL in the R. sphaeroides diphosphoryl lipid A group
      (p < .02). Four of five rats pretreated with R. sphaeroides diphosphoryl lipid A
      survived endotoxic shock, whereas none of the phosphate-buffered saline
      pretreated rats survived (p = .05). CONCLUSIONS: These observations are
      consistent with previous reports of the limited toxic effects of R. sphaeroides
      diphosphoryl lipid A and suggest that this molecule retains the ability to induce
      tolerance to endotoxic shock.

PMID- 8482098
TI  - Role of nitric oxide in the hemodynamic changes of sepsis.
AB  - OBJECTIVE: To study the role of nitric oxide in the hemodynamic changes of
      sepsis. DESIGN: Prospective, randomized, controlled, intervention study.
      SUBJECTS: Twenty-five sheep randomized to four groups: Group A (n = 8, nonseptic
      sheep) received NG-nitro L-arginine (20 mg/kg i.v.) followed 15 mins later by L
      arginine (200 mg/kg i.v.); group B (n = 4, nonseptic sheep) received L-arginine
      followed 15 mins later by NG-nitro L-arginine; group C (n = 7, septic sheep)
      received NG-nitro L-arginine (20 mg/kg i.v.) alone; group D (n = 6, septic sheep)
      received L-arginine (200 mg/kg i.v.) followed by NG-nitro L-arginine (20 mg/kg
      i.v.). INTERVENTIONS: Sheep were anesthetized with pentobarbital, mechanically
      ventilated and monitored with a pulmonary artery catheter, a peripheral artery
      catheter, and a Miller catheter in the left ventricle. Sepsis was induced by the
      intravenous administration of live Escherichia coli (1.5 x 10(9)
      microorganisms/kg over 30 mins), which resulted in systemic hypotension,
      pulmonary hypertension, high cardiac output, and hyperlactatemia. Acetylcholine
      was administered before and after each intervention. MEASUREMENTS AND MAIN
      RESULTS: In nonseptic sheep (groups A and B) NG-nitro L-arginine induced an
      increase in mean blood pressure (BP), pulmonary arterial pressure, and systemic
      and pulmonary vascular resistances, accompanied by a decrease in cardiac index
      and the first derivative of left ventricular pressure. L-arginine administered to
      normal sheep induced systemic vasodilation. In the sepsis groups (groups C and
      D), the increases in BP and systemic vascular resistances induced by NG-nitro L
      arginine were significant but less marked than in nonseptic sheep. Pretreatment
      of septic sheep with L-arginine totally abolished the NG-nitro L-arginine induced
      increases in systemic and pulmonary vascular resistances in this group. The
      administration of L-arginine in these animals induced both systemic and pulmonary
      vasodilation. Acetylcholine-mediated vasodilation was severely impaired in
      sepsis. In this condition, pretreatment with L-arginine improved the response to
      acetylcholine. CONCLUSIONS: These data support the view that nitric oxide plays a
      significant role in modulating systemic and pulmonary vasomotor tone in normal
      and septic sheep. L-arginine produced systemic vasodilation in normal sheep,
      whereas both systemic and pulmonary vasodilation were observed in septic animals.
      The impaired response to an endothelium-dependent vasodilator in sepsis was
      improved by the previous administration of L-arginine.

PMID- 8482099
TI  - Lung lavage with oxygenated perfluorochemical liquid in acute lung injury.
AB  - OBJECTIVE: To investigate the effects of lung lavage with oxygenated liquid
      perfluorochemical on gas exchange, lung mechanics, and cardiac function in
      animals with acute lung injury. DESIGN: Prospective, randomized, controlled
      trial. SETTING: Animal laboratory. SUBJECTS: Eight adult cats (2 to 4 kg, random
      sex). INTERVENTIONS: Two insults were combined to cause lung injury: oleic acid
      infusion and saline whole-lung wash. Animals were assigned to either the control
      or treatment group which consisted of a perfluorochemical liquid (Rimar 101)
      lavage. Perfluorochemical liquid lavage was performed three times at hourly
      intervals after lung injury. Three other cats with identical injury but no
      perfluorochemical liquid lavage served as control animals. All cats were
      ventilated with an FIO2 of 0.95 and positive end-expiratory pressure of 2 cm H2O
      continuously. MEASUREMENTS AND MAIN RESULTS: Arterial blood gas tensions and pH,
      dynamic pulmonary compliance were measured at 15-min intervals. Cardiac index was
      assessed hourly, and lung fluid was collected after each of the three
      perfluorochemical liquid lavages. Arterial oxygen tension and pulmonary
      compliance deteriorated abruptly after lung injury in all cats, and improved
      significantly (p < .001, two-way analysis of variance) 15 mins after
      perfluorochemical liquid lavage. These parameters gradually returned to their
      baseline over 60 mins. Arterial blood pressure and cardiac index decreased after
      injury in all cats, and were not significantly changed after perfluorochemical
      liquid lavage. Hemorrhagic fluid was recovered from distal airways by
      perfluorochemical liquid lavage, despite prior suctioning of the airway.
      CONCLUSIONS: Perfluorochemical liquid lavage removes pulmonary edema fluid and
      improves gas exchange and the mechanical properties of the lung, after acute
      severe lung injury.

PMID- 8482100
TI  - Pediatric intensive care training: confronting the dark side.
AB  - PURPOSE: To describe the dark side of pediatric intensive care fellowship
      training and offer educational approaches for understanding feelings of
      fallibility, anger, frustration, and loss. DATA SOURCES: Listening and observing
      fellows in the courses of their pediatric intensive care training and later
      careers. STUDY SELECTION: Studies that discussed pediatric residency and
      fellowship training, especially in the context of intensive care. DATA
      EXTRACTION: From group meetings, unit conferences, rounds, individual
      discussions, and child psychiatric consultations. RESULTS OF DATA SYNTHESIS:
      Pediatric intensive care unit (ICU) fellows gain a sense of mastery from the
      nature of their work: complex, technological, and frequently lifesaving. They
      face the usual personal stresses of extended training, including long work hours,
      limited financial resources, and relative isolation from family and friends.
      Pediatric ICU fellows confront deeper, "dark" feelings regarding their own high
      expectations, fallibility, anger, sense of loss, frustration, limited control,
      and the need to work closely with tense, grieving families. If the dark side is
      not acknowledged, fellows, team members, and faculty are likely to experience
      anger, detachment, and depression that may extend beyond work into their personal
      lives. CONCLUSIONS: Since the dark side is expected, normal, and inevitable,
      fellowship training programs should help fellows cope with and understand these
      feelings. Such understanding requires a sense of trust among intensive care staff
      and can be gained through group discussions, mentorship, specific team
      conferences, and child psychiatric consultation.

PMID- 8482101
TI  - Mediators of septic shock: new approaches for interrupting the endogenous
      inflammatory cascade.
AB  - OBJECTIVES: To review the molecular pathogenesis of septic shock, with particular
      emphasis on the induction of cytokines by endotoxin. By understanding the
      mechanisms that result in the systemic inflammatory response, novel clinical
      interventions may be more effectively studied. DATA SOURCES: The English medical
      literature was reviewed, including human clinical trials, animal experiments, and
      in vitro studies elucidating cellular and molecular interactions. Expert
      testimony from the Roundtable Conference on Sepsis (Brussels, March 1992) was
      also used to synthesize emerging concepts and to ensure inclusion of ongoing
      investigations. STUDY SELECTION: Emphasis on controlled experimental studies
      which elucidated the molecular and cellular interactions during sepsis. DATA
      EXTRACTION: This study focused only on data that directly involved the induction
      and regulation of protein mediators of sepsis, especially tumor necrosis factor
      (TNF) and interleukin-1. Data concerning the role of TNF during health were
      extracted from the author's peer-reviewed data. DATA SYNTHESIS: Information
      concerning the many facets of the systemic inflammatory response was integrated
      into a chronological, clinically oriented model of cytokine induction during
      endotoxemia. CONCLUSIONS: The induction of inflammation during sepsis is a
      complex, but increasingly understood, biological cascade that is dependent on
      inter- and intracellular signaling. Novel biotherapies may improve patient
      outcome in sepsis by interrupting any or all points of signal transduction.

PMID- 8482102
TI  - Detection of unsuspected imposed work of breathing: case reports.

PMID- 8482103
TI  - Hemodynamic changes and circulating recombinant tumor necrosis factor-alpha
      concentrations in a patient undergoing isolated limb perfusion.

PMID- 8482104
TI  - Dopamine infused continuously at high concentration with a low flow rate affects
      arterial blood pressure fluctuation waves.

PMID- 8482105
TI  - The case for standardized terminology: oxygen "saturation" values can trick the
      unwary and lead to clinical misjudgment.

PMID- 8482106
TI  - Anion gap, lactate, and acid-base status after cardiac surgery.

PMID- 8482107
TI  - Definitions for sepsis and organ failure.

PMID- 8482108
TI  - Clinical use of pulmonary capillary pressure: a technique whose time has arrived.

PMID- 8482109
TI  - Retinal pigment epithelial cells produce interleukin-1 beta and granulocyte
      macrophage colony-stimulating factor in response to interleukin-1 alpha.
AB  - The retinal pigment epithelium (RPE) is clinically involved in diverse ocular
      inflammatory diseases. Because perturbed RPE cells produce a variety of
      inflammatory substances, RPE cells may play an integral part in these diseases.
      Interleukin-1 (IL-1) and granulocyte-macrophage colony-stimulating factor (GM
      CSF) are pleiotropic cytokines with the ability to trigger numerous inflammatory
      responses. This report shows that cultured human RPE cells synthesize interleukin
      1 beta (IL-1 beta) and GM-CSF in response to the potentially inflammatory
      cytokine, IL-1 alpha, but not to E. coli endotoxin. Control RPE cells made little
      or no mRNA or protein for either IL-1 beta or GM-CSF. Upon stimulation of the
      cells by IL-1 alpha, both IL-1 beta and GM-CSF mRNAs were readily apparent by 3
      hours, persisted for over 24 hours, and were translated into immunologically
      detectable proteins. GM-CSF protein was secreted into the culture medium, whereas
      IL-1 beta protein remained cell associated. The IL-1 alpha-induced mRNA and
      protein production were inhibited by dexamethasone. These observations provide
      additional evidence that RPE cells are capable of playing a pivotal role during
      ocular inflammation.

PMID- 8482110
TI  - Reduction in choroidal blood flow occurs in chicks wearing goggles that induce
      eye growth toward myopia.
AB  - Goggles that degrade the retinal image produce axial enlargement of the ocular
      globe and large myopic refractive errors. Many authors have assumed that visual
      image degradation itself leads to myopia. Hodos and co-authors have shown,
      however, that goggled eyes in chicks are considerably warmer than normal. Such
      temperature changes may either underlie or be a consequence of alterations in
      choroidal blood flow (CBF). Since alterations in CBF could affect eye growth, we
      explored the effect of monocular goggling on CBF in chicks. Plastic goggles were
      glued over one eye in four-day old chicks and the goggles were left in place for
      12 or 14 days. Fourteen days after the goggling, CBF was measured using laser
      Doppler velocimetry. Three groups of chicks were studied: 1) chicks with goggles
      for 14 days; 2) chicks with goggles for 12 days followed by no goggles for the
      two days; 3) age matched non-goggled chicks. A -scan ultrasonography confirmed
      that the visual deprivation produced vitreous chamber elongation in the goggled
      eye and that the degree of elongation for the goggled eye was the same for the
      two goggled groups. The results were: 1) blood flow in non-goggled chicks was
      similar in both eyes; 2) blood flow was significantly reduced in the goggled eye
      in chicks wearing goggles for 14 days- 37% of control; and 3) blood flow was
      still significantly reduced in the goggled eye in chicks whose goggles were
      removed two days before measurement- 51% of control. These results show that CBF
      is reduced by goggles that result in myopic eye growth.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8482111
TI  - Choroidal blood flow is reduced in chicks with ocular enlargement induced by
      corneal incisions.
AB  - We have previously reported decreased choroidal blood flow (CBF) associated with
      goggle-induced ocular enlargement and myopia. It was uncertain, however, if this
      change in CBF was related to the occurrence of ocular enlargement or the
      increased ocular temperature produced by the goggle. We therefore used corneal
      surgery-induced ocular enlargement that eliminated the thermal effects observed
      with goggles to investigate the effects of ocular enlargement on CBF. Central
      corneal incisions (2 mm in length) were made in the right eye of 4 day old chicks
      and the wound sutured. In one group, the incision was oriented along the vertical
      meridian (with the head in its natural position -beak tip 30-45 degrees below
      horizontal), while in another group the incision was oriented along the
      horizontal meridian (with the head in its natural position). Age matched controls
      received no corneal incision. Two weeks later, CBF was measured using laser
      Doppler velocimetry. After determining CBF, the eyes were removed and axial
      length, nasotemporal length and dorsoventral length were measured. Ocular
      enlargement was induced in 11 out of 12 chicks with vertical cuts. The CBF in the
      operated eye of these 11 animals was 62% of that in the nonoperated eye. Ocular
      enlargement was also induced in eight of 14 chicks with horizontal cuts. The CBF
      in the operated eye in these eight chicks was 60% of that in the nonoperated eye.
      The extent of eye growth was greater in all dimensions in the vertical cut chicks
      with ocular enlargement than in the horizontal cut chicks with ocular
      enlargement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482112
TI  - Human retinoblastoma cells express alpha B-crystallin in vivo and in vitro.
AB  - alpha B-crystallin is a major lens protein that is a member of the heat-shock
      family of proteins. Using immunohistochemical and northern blot techniques, we
      now demonstrate its presence in freshly-fixed retinoblastoma tissue. The protein
      is also abundantly expressed in cultured human retinoblastoma cells (Y-79 NEI,
      WERI Rb-1) as well as two subcultured Y-79 lines (ATCC and GM01232C). High
      expression of alpha B-crystallin may be involved in tumor growth and/or be a
      marker for general oncogenic "stress" in the tumor tissue.

PMID- 8482113
TI  - An instrument for quantifying meibomian lipid on the lid margin: the Meibometer.
AB  - An instrument, the Meibometer, is described for estimating the casual level of
      meibomian lipid on the human eyelid margins, adapted from a commercially
      available instrument used for measurement of skin surface lipid. A loop of
      plastic tape is pressed onto the everted lower lid margin to lift off a blot of
      lipid. The resultant change in light transmission of the tape is read by a
      photometer. Readings are not affected by side (R or L), time of day or lid
      surface temperature. After cleaning lipid from the lid margins with hexane, the
      rate of recovery per 10 blinks, as a percentage of the pre-cleaned level, was
      measured as 33.7 +/- 5.8 (mean +/- SE). This rate of delivery appears to provide
      enough lipid for complete resurfacing of the preocular tear film with every
      blink. Over short periods no detectable lipid was delivered in the absence of
      blinking.

PMID- 8482114
TI  - The casual level of meibomian lipids in humans.
AB  - Using a modified skin surface lipid measuring instrument, the Meibometer, the
      amounts of meibomian lipid on the lid margins (the casual levels) of 421 subjects
      aged 1 to 94 years were measured. The lowest levels were found in children
      younger than 14 years (means +/- S.E.: males = 1.48 +/- 0.17, females = 1.53 +/-
      0.17 micrograms lipid/mm2 lid margin surface) and rose with age, the highest
      levels being found in males aged 60-69 years (mean +/- S.E. = 3.26 +/- 0.18
      micrograms lipid/mm2 lid margin surface). Male levels were higher than females in
      the 20-29 years age group but male and female levels became indistinguishable
      above the age of 50. These age- and sex-related changes differed markedly from
      those seen in skin surface lipid levels. The age-related changes in the casual
      levels of lid lipids remain unexplained although an endocrinological mechanism
      modified by morphological factors is considered.

PMID- 8482115
TI  - A Na+/Ca2+ exchange mechanism in apical membrane vesicles of the retinal pigment
      epithelium.
AB  - The retinal pigment epithelium (RPE) lying between the neural retina and the
      choroid, performs as a transport organ for solutes and water between the
      choriocapillaries and the subretinal space. It also has the function to maintain
      the microenvironment of photoreceptors including the regulation of calcium ions
      during light or dark adaptation. In order to further elucidate the transport
      functions of the RPE, apical membranes were isolated from RPE by differential
      precipitation with divalent ions. In this work bovine tissues were used as well
      as elasmobranch tissues. For the latter, we have already purified and
      characterized membrane vesicles in a previous paper. Na(+)-K(+)-ATPase, alkaline
      phosphatase, and 5'-nucleotidase, which are marker enzymes of the apical
      membrane, were highly enriched in the final membrane fraction. The majority of
      the fraction consists of right side out vesicles. The fluorescent indicator for
      sodium, SBFI, or the calcium specific indicator, Fura-2, were pre-loaded into the
      apical membrane vesicles of RPE of either dogfish eyes or bovine eyes. When an
      outwardly-directed Ca2+ gradient was formed across the vesicular membranes, the
      Ca2+ influx was also enhanced by 136% for dogfish RPE and 167% for bovine RPE.
      This Na+ gradient dependent Ca2+ influx was blocked by bepridil, an
      antiarrhythmic agent which is a Na+/Ca2+ exchanger inhibitor. These results
      indicate that a Na+/Ca2+ exchanger is present in the apical membrane of bovine
      and dogfish RPE.

PMID- 8482116
TI  - Identification and characterization of arylamine N-acetyltransferase activity
      from the bovine retinal pigment epithelium.
AB  - Arylamine N-acetyltransferase (NAT) activity was identified and characterized in
      bovine retinal pigment epithelium (RPE) cells. Upon examining the RPE supernatant
      for multiple ionic species, one major NAT activity peak was detected. Based upon
      its substrate specificity, it is best described as an arylamine NAT. However,
      there was detectable arylalkylamine NAT activity within this peak. Further
      purification via size-exclusion HPLC revealed multiple peaks of NAT activity,
      although the major peak (around 30 kDa) again predominantly exhibits arylamine
      NAT activity. However, substrate specificity studies indicate that this arylamine
      NAT activity is able to acetylate specific arylalkylamine substrates. This
      arylamine NAT demonstrates a monomorphic pattern of acetylation since it
      acetylates rho-aminobenzoic acid rather than sulfamethazine. It also demonstrates
      a low sensitivity to methotrexate inhibition indicated by the high IC50 value
      (570 microM). The mode of inhibition by methotrexate is uncompetitive as
      demonstrated by kinetic analysis.

PMID- 8482117
TI  - Raman structural characterization of clear human lens lipid membranes.
AB  - Raman spectroscopy was used for the first time to characterize the structure of
      lipid membranes prepared from the nuclear and cortical regions of 48 and 69 year
      old clear human lenses. The interface region carbonyl band appears as a doublet
      at 1742 and 1728 cm-1. The lower frequency band is characteristic of a hydrogen
      bonded carbonyl group, perhaps to bilayer water. From the intensity of the curve
      fit bands, we calculate that 43% of the carbonyl groups are hydrogen bonded. Our
      data show that the hydrocarbon chains of the nuclear lipids are 1.4 times more
      saturated than those of the cortical lipids. The molar ratio of phospholipid
      CH2/= C-H groups was calculated to be 13 and 18 for cortical and nuclear lipids,
      respectively. Hydrocarbon chain disorder was estimated to be 72 and 58% (+/- 8%
      disorder) for the cortical and the nuclear lipids, respectively. Raman
      spectroscopy is sensitive to structural differences in various regions of the
      lipid bilayer and could be an effective tool to explore lipid and protein
      interactions in terms of lens region, age and opacity.

PMID- 8482118
TI  - Advances in maxillofacial imaging.
AB  - The maxillofacial region, extending from the base of the skull to the hyoid bone,
      is one of the most anatomically complex regions of the body. This area contains
      elements and organs belonging to a number of different systems that can be
      affected by a variety of local and systemic pathologic processes. Diagnostic
      imaging has assumed a central role in the evaluation of this region. In the
      following monograph, we present the reader with an overview of contemporary
      maxillofacial imaging, focusing on three areas: recent technical advances that
      impact on the diagnosis of the maxillofacial region, the appearances of various
      maxillofacial lesions on different imaging modalities, and an overview of the
      role of diagnostic imaging in the evaluation of the orthognathic patient. In the
      first section, we focus on recent technical advances in diagnostic imaging as
      they relate to the maxillofacial region. Imaging modalities discussed include
      panoramic radiography and three-dimensional imaging. We also examine the uses of
      recently developed computed tomography software for the evaluation of the dental
      implant patient and discuss the roles of both noninteractive and interactive
      software in this process. The second section focuses on the radiographic
      appearance of a number of common lesions involving the maxillofacial region. In
      this section, we use the gamut approach to examine a number of developmental,
      inflammatory, neoplastic, metabolic, and traumatic lesions or disorders. In the
      last section, we briefly review the subject of orthognathic surgery and the role
      of diagnostic imaging in the preoperative and postoperative evaluation of the
      orthognathic patient. The radiographic appearance of some of the more commonly
      performed midfacial osteotomies are presented.

PMID- 8482119
TI  - [Hygienic prerequisites of ambulatory surgery].

PMID- 8482120
TI  - [Diagnostic and therapeutic arthroscopy in acute trauma of the knee joint].

PMID- 8482121
TI  - [Status of arthroscopy in diagnosis and therapy of injuries of the shoulder
      joint].

PMID- 8482122
TI  - [Indications for diagnostic and therapeutic arthroscopy of "small joints" (elbow,
      upper ankle joint, wrist joint, hip joint].

PMID- 8482123
TI  - [Effect of intraoperative radiotherapy on postoperative follow-up of pancreas
      cancer].
AB  - Surgical therapy alone has not been able to improve significantly long-term
      survival in cases of pancreatic carcinoma. Improvement can only be expected by
      more successful local and systemic tumor control. To achieve the former
      intraoperative radiotherapy (IORT) with high-energy electrons has recently been
      introduced into clinical practice. Between June 1989 und June 1991 23 patients
      underwent IORT while receiving palliative (n = 16) and curative (n = 7)
      procedures. During the same period 36 patients were operated upon without IORT.
      Irradiated patients suffered far more complications. A positive effect on
      survival or pain control in palliatively operated cases could not be
      demonstrated. Prolonged survival after curative resections with IORT seems
      probable but can not be proven due to small number of patients. Further progress
      requires combination of IORT with postoperative radiochemotherapy.

PMID- 8482124
TI  - [Arterial vascular injuries in fractures or dislocations of the lower extremity.
      Therapeutic concept and results].
AB  - Combinations of fractures or dislocations with vascular damage of the leg have a
      high incidence of amputation or severe functional deficit. With this type of
      lesion 22 patients were treated at "Bergmannsheil" from 1986 to 1991. Using a pre
      , intra- and postoperative protocol, the amputation rate decreased to 18%. More
      than 80% of the patients had a good function of their leg with only minor joint
      restrictions.

PMID- 8482125
TI  - [Intramedullary nailing of fractures during the growth period with a new
      implant].
AB  - Intramedullary nailing with flexible titan pins is a simple and safe method for
      the treatment of fractures in children. Avoiding the epiphysis two pins are
      introduced into the medullary space in a double-crossing way to stabilise
      diaphysial fractures of bigger bones such as femur, tibia or humerus. Forearm
      fractures are splinted with a single pin each to radius and ulna. The method is
      also practicable in proximal fractures of the radius, reduction and stabilisation
      can be achieved with an intramedullary pin in one step avoiding arthrotomy.

PMID- 8482126
TI  - [Value of heterotopic finger replantation].
AB  - Multidigital amputations represent a challenging problem with regard in restoring
      optimal sensomotoric hand function. Often orthotopic finger stumps or the
      separated digits are unfit for conventional replantation. This condition is an
      imperative indication for transpositional replantation. Among 24 heterotopic
      replantations the survival rate was 82 percent. The favorable finger transfer was
      a pollizisation, followed by a substitution of the middle finger and finally
      creating an expanding opposite grip on the ulnar site of the hand. Secondary
      corrective procedures have been performed in 37.5 percent. To evaluate the global
      hand function score systems according to Millesi or Tamai have been applied. 65
      percent presented a "good" subjective and objective hand function as to Tamai.
      However the regain of hand function has to be aspired much more in the single and
      individual case of transpositional replantations when compared to the Millesi
      score system.

PMID- 8482127
TI  - [Plasma cell and sclerosing osteomyelitis. A follow-up of 21 patients].
AB  - Plasma cellular osteomyelitis was seen in the metaphysis while sclerosing
      osteomyelitis affected the diaphysis of long bones. In only about 20% of both
      forms local bacteria were noted. The onset of symptoms was inconspicuous and both
      clinical and radiological signs were nonspecific. Curettment or resection usually
      cured the disease. In some cases, however, aggressive surgery was necessary. As
      to surgery and outcome sclerosing osteomyelitis appeared less riskful than plasma
      cellular osteomyelitis. Both forms apparently represent the same basic
      pathological condition.

PMID- 8482128
TI  - [Laparoscopic resection of liver metastasis].
AB  - Six weeks after a partial colon resection because of an adenocarcinoma of the
      sigmoid we removed a solitary liver metastasis (6th segment) by laparoscopic
      technique in a 63-year-old patient. Operation time was 95 min, the postoperative
      course was uneventful and the patient was discharged at day 6 postoperatively.

PMID- 8482129
TI  - [Ackerman tumor (verrucous carcinoma) of the perineal region. Differential
      diagnosis of anus cancer].

PMID- 8482130
TI  - [Transhaesio intestini tenuis supragastrica as a sequela of colon resection in
      childhood].

PMID- 8482131
TI  - [Subcutaneous CO2 emphysema after laparoscopic cholecystectomy].

PMID- 8482132
TI  - [HIV-infection].

PMID- 8482133
TI  - [Blood transfusion].

PMID- 8482134
TI  - [Errors and danger in laparoscopic appendectomy].

PMID- 8482135
TI  - [Errors and danger in laparoscopic cholecystectomy].

PMID- 8482136
TI  - [Errors and dangers of laparoscopic anti-reflux surgery].

PMID- 8482137
TI  - [Errors and danger in hernia surgery].

PMID- 8482138
TI  - [Technique and long-term results of thoracic and thoraco-abdominal aortic
      diseases].

PMID- 8482139
TI  - [Asymptomatic carotid stenosis: is there an indication for operation?].

PMID- 8482140
TI  - [Bypass or thrombendarterectomy?--Reconstructive procedures in arterial occlusive
      disease of the pelvic area].

PMID- 8482141
TI  - [The Gastrointestinal Quality of Life Index. A clinical index for measuring
      patient status in gastroenterologic surgery].
AB  - Since the measurement of quality of life is a relevant endpoint of patient
      assessment, an international team of methodologists and surgeons have developed a
      new system-specific index. In different phases, items were collected, tested,
      rejected or retained and finally verified by international experts. The
      instrument was also validated against other generic measures, it was compared to
      150 normals, tested for reproducibility with 50 stable patients and for
      responsiveness with 159 patients undergoing laparoscopic cholecystectomy. The
      product is a bilingual (German and English) questionnaire containing 36 items.
      Although further testing is in order, we conclude that the Gastrointestinal
      Quality-of-Life Index is ready to be used in clinical practice and research.

PMID- 8482142
TI  - [DNA analysis in stomach cancer--correlation of aneuploidy with tumor site].
AB  - The DNA status and the proliferative activity was determined in 37 gastric
      carcinomas applying computerized image analysis. Aneuploidy was found in 51.4% (n
      = 19) of the tumors. Comparing diploid and aneuploid lesions the latter ones had
      statistically significant increased DNA amount, DNA index and proliferative rate
      (7.4 pg, 1.03 and 16.4% versus 12.8 pg, 1.78 and 30.7%; p < 0.05). Aneuploidy
      occurred more frequently in tumors at proximal sites (p < 0.05), but was not
      associated with histological type, differentiation and tumor stage. The
      prognostic impact of DNA aneuploidy remains controversial, since tumor
      aggressiveness per se is not directly related to aneuploidy.

PMID- 8482143
TI  - [Lung resections for pulmonary infections in intensive care patients].
AB  - Pneumonia occurs in about 60% of ventilated patients with a lethality of
      approximately 40%. Since 1980 we performed a thoracotomy in 16 patients of an
      intensive care unit suffering from a lung infection (mean age 34 years). In all
      patients an adequate antibiotic therapy was unsuccessful. By means of the
      computed tomography we could ascertain a lung infection limited to one part of
      the lung, mostly combined by an abscess. We performed 14 lobectomies and one
      atypical wedge resection and segment resection each. Postoperatively 8 patients
      died: Three of them because of a persisting septic shock and five because of
      their multiple injuries. Lung resection is a good treatment in case of a lung
      infection with septic complications.

PMID- 8482144
TI  - [Resection of liver metastases of colorectal cancers. Results and prognostic
      factors].
AB  - Between 1985 and 1991 268 liver resections were performed at the Department of
      Surgery of the University of Hamburg. 89 patients underwent liver resections
      because of colo-rectal secondaries. 82 patients could be followed for more than 1
      year postoperatively. Their courses were analysed regarding the prognostic
      factors: age, sex, localisation of the primary tumor, size, number and
      localisation of metastases and radicality (R0-R1-R2-stage of resection). The
      results showed, that a significant prognostic influence regarding the long-term
      survival rate could only be observed in patients, in which a R0-resection with a
      tumor-free margin of more than 1 cm was performed. In these patients the
      cumulative 5-year survival rate was 37% with a median survival time of 39 months.
      In patients with a tumor-free margin < 1 cm (R0b) the long-term prognosis did not
      differ significantly from cases with R1 or R2 resections (under 10%).

PMID- 8482145
TI  - [Endorectal ultrasound in diagnosis and therapy planning of broad-base rectal
      adenomas].
AB  - In this study the value of endorectal ultrasound in diagnosis and therapy of
      large rectal adenomas is shown. Between January 1988 and August 1992 93 patients
      with the primary diagnosis of adenoma proven by biopsy were examined by
      endorectal ultrasound. Sonographical differentiation of adenoma and carcinoma was
      done by echo-structure. Enlarged lymph nodes can be detected too. In 34 of 91
      patients carcinoma was found by endorectal ultrasound and 28 were verified
      histologically. Sensitivity of endorectal ultrasound in detection of carcinoma in
      enlarged adenomas is 96%. Only preoperative endorectal ultrasound could give
      decisive criteria to take a second biopsy, to avoid mucosectomy in case of a
      malignoma or give the advice for a radical operation according to the tumor
      stage. Further staging of adenomas and small carcinomas is excellent by
      endorectal ultrasound and the right indication of local therapy can be confirmed.

PMID- 8482146
TI  - [Current status of gallstone surgery in Germany. Results of a survey and
      retrospective analysis of 27,403 interventions--open vs. laparoscopic surgery].
AB  - Based on a representative poll, which included a retrospective data analysis, the
      current surgical approach to gallstone disease in Germany is presented. A total
      of 25,955 procedures in 1991 is analysed. 24.9% of all cholecystectomies were
      done laparoscopically. In 1992, already 81.4% of all surgeons reported own
      experiences with this new technique. Comparing open procedures with laparoscopic
      cholecystectomy the latter showed a lower incidence of complications (6.8 vs
      8.7%) and perioperative death (0.14 vs. 0.43%). In contrast, relaparotomies were
      more frequent in the laparoscopy group (1.48 vs. 0.84%). The diagnostic and
      therapeutic approach for common bile duct stones is currently changing. There is
      a tendency towards less invasive endoscopic and laparoscopic procedures and
      towards their combination, respectively.

PMID- 8482147
TI  - [Laparoscopic cholecystectomy in Austria. The Austrian 1991 register].
AB  - The number of surgical units, performing laparoscopic cholecystectomies (LC) in
      Austria increased from 24 hospitals (20%) in 1990 to 85 hospitals (70%) in 1991,
      performing 7351 LCs. In 97% the outcome was uneventful, the conversion rate was
      2.1%; 0.85% required secondary laparotomy. Common bile duct lesion occurred in
      0.5%, lethality was 0.1% (n = 4). Because of the cooperation of all surgeons
      Austria is the only country to present actual numbers concerning acceptance and
      penetration rate of LC.

PMID- 8482148
TI  - [Laparoscopic cholecystectomy in Switzerland. Critical retrospective evaluation
      of the first 3,722 cases. Swiss Professional Society of Laparoscopic and
      Thoracoscopic Surgery].
AB  - In a national prospective multicenter study 3722 laparoscopic cholecystectomies
      (LC) performed by 179 surgeons in 50 Swiss institutions were analysed with
      special regard to technique and complications. Conversion to open cholecystectomy
      was necessary in 259 patients (7.0%), either expectively without intraoperative
      complications (4.5%) or due to intraoperative complications (2.5%). Three
      patients (0.08%) died within 30 days after operation and a total of 39 patients
      (1.0%) had to be reoperated. 31 (0.8%) bile duct injuries were registered. Common
      bile duct (CBD) stones were treated mainly by ERCP. In 8 cases laparoscopic
      removal of common bile duct stones was attempted and performed successfully in 6
      patients. Postoperatively patients were discharged home after a mean of 4.4 days
      and returned to work after 14.0 days (range: 2-28). Laparoscopic cholecystectomy
      became the gold standard to remove the gallbladder, but further development is
      needed, to establish laparoscopic treatment of biliary tract stones in the near
      future.

PMID- 8482149
TI  - [Laparoscopic splenectomy].
AB  - From August until October 1992 laparoscopic splenectomy has been performed upon
      three patients with idiopathic thrombocytopenia. The splenic vessels were divided
      by an Endo-GIA. The spleen could be removed through a slightly extended trocar
      incision. The Idiopathic thrombocytopenia without an enlarged spleen provides a
      possible indication for laparoscopic surgery.

PMID- 8482150
TI  - [Experiences with laparoscopic technique in anti-reflux surgery].
AB  - The introduction of the laparoscopic techniques in antireflux surgery has created
      hopes for an improvement in the patients' outcome. Initial experience with
      minimally invasive procedures show that the application in antireflux surgery is
      possible without major problems. However, the functional result of antireflux
      surgery rather depends more on a differentiated indication for operation and an
      operative procedure designed to remove or compensate the underlying
      pathophysiologic functional defect. The method of access is of lesser priority.
      The promising results of this series may encourage to continue the demonstrated
      protocol and operative technique. However, generalized application of
      laparoscopic antireflux surgery should not be performed until further data of its
      advantages are available.

PMID- 8482151
TI  - [Thoracoscopic lobectomy in the animal model].
AB  - To evaluate the possibility of a pure thoracoscopic lobectomy by preparation and
      selective division of hilar structures we performed left cranial lobectomies in 5
      Gottingen mini-pigs. The vessels and the main bronchus were isolated and divided
      by an Endo-GIA stapler. As an alternative technique we used clips or endoscopic
      ligation. Inside the thoracic cavity the resected lobes were divided into 2 or 3
      parts by the Endo-GIA. They could be extracted without destroying the tissue
      therefore making macroscopic examination possible. The intraoperative blood loss
      was minimal and all the pigs survived the operation. Two pigs were sacrificed
      initially, the remaining three one month later. These three showed no evidence of
      pleural fistula or atelectasis in remaining lung tissue either macroscopically or
      histologically. It appears that thoracoscopic selective lobectomy is technically
      possible at least in pig studies. Further studies will show whether thoracoscopic
      lobectomy in patient with malignancy is as effective as open radical thoracotomy
      techniques and if endoscopic mediastinal division is possible.

PMID- 8482152
TI  - [Reinforcement of the peritoneal sack using a large prosthesis (Stoppa
      operation)].
AB  - To avoid repeated dissection and repair of used-up defect margins a truly
      innovative concept of eliminating recurrent hernias has been introduced by
      Stoppa. A giant prosthesis of polyester is inserted through a sub-umbilical
      midline incision and envelopes the inferior visceral sac, which is dissected
      bilaterally. The prosthesis is held in place against the bony pelvis and
      abdominal musculature by the pressure of the abdominal viscera and without
      sutures; it has no slit for the spermatic cord and prevents passage of viscera
      through a hernial orifice, even left open.

PMID- 8482153
TI  - [Treatment of recurrent inguinal hernia by implantation of a pre-peritoneal
      prosthesis. Results of a prospective study].
AB  - 44 patients with 47 recurrent inguinal hernias entered a prospective study. All
      patients were operatively managed by a standardized technique using a
      polypropylene (Prolene) mesh inserted through a pre-peritoneal approach.
      Operating in the pre-peritoneal space avoids dissection of the scared cord and
      the "inlay" prosthetic mesh safely creates a new "fascia transversalis" with a
      low rate of recurrences. All patients were personally controlled every 6 months
      with a follow-up time of 12 to 60 months (mean 20.2 months). The low
      postoperative morbidity included only one seroma, no infection and no testicular
      complications. We observed one recurrence occurring 6 months after surgery (2%).
      The described operative technique using an inlay patch is recommended as the
      therapy of choice in all recurrent groin hernias.

PMID- 8482154
TI  - [Laparoscopic repair of inguinal hernia by subperitoneal prosthesis implantation
      (Stoppa operation)].
AB  - The authors present their technique of inguinal hernia treatment by the putting
      of a very tall (15 x 10 cm) polypropylene prosthesis in its place in
      subperitoneal by laparoscopic access. From May 1, 1991 until January 31, 1992,
      110 inguinal hernias (64 right and 46 left hernias) were operated on 93 patients.
      The first results are analysed: there was in particular no recurrence with an
      average of 4.3 months set-back. It should be observed that about 40% of the
      patients were operated under epidural analgesia.

PMID- 8482155
TI  - [Laparoscopic herniorrhaphy of inguinal hernia. Reinforcement of the transverse
      fascia with surgical mesh].
AB  - A basic principle of inguinal herniorrhaphy is the reconstruction of the
      transverse fascia. This laparoscopic technique described, consists in an
      augmentation of the transverse fascia by nonabsorbable mesh in pre-peritoneal
      position. Some aspects should be recommended for laparoscopic herniorrhaphy: The
      anatomic structures must be dissected exactly. The prosthetic mesh should be
      fixed to the fascia by multiple staples. With indirect inguinal hernias the mesh
      should encircle the spermatic cord.

PMID- 8482156
TI  - [Carcinoma of the small intestine in Crohn disease. Case report and review of the
      literature].

PMID- 8482157
TI  - [Pneumatosis coli--a rare cause of invagination ileus in the adult].

PMID- 8482158
TI  - [100 years Murphy button: development, dissemination and further development].

PMID- 8482159
TI  - [Thoracoscopic lobectomies].

PMID- 8482160
TI  - Thoracotomy for colon and rectal cancer metastases.
AB  - Between 1978 and 1990, 23 patients underwent 35 thoracotomies for metastatic
      colorectal cancer. The pulmonary disease was diagnosed within an interval of 0 to
      105 (average, 33.4) months after colon resection. Fifteen patients underwent a
      single thoracotomy; 12 patients had solitary lesions, and three patients had
      multiple nodules. Eight patients underwent multiple thoracotomies. The median
      survival following thoracotomy was 28 months; three-year survival was 45 percent,
      and five-year survival was 16 percent. Factors that had no significant bearing on
      survival included origin and stage of the primary tumor and patient age and sex.
      An interval before thoracotomy of three years had an impact on survival
      approaching statistical significance (P = 0.17). Patients who underwent multiple
      thoracotomies had a significantly prolonged survival (P = 0.04). Patients who
      underwent a single thoracotomy for a solitary lesion had a significantly
      prolonged survival compared with patients who had a single thoracotomy for
      multiple metastases. After thoracotomy, 14 patients eventually developed
      recurrent disease, which was confined to the lung in only four patients. Of these
      14 patients, 11 subsequently died of cancer. We conclude that thoracotomy for
      metastatic disease should be considered when the primary tumor is controlled, the
      lungs are the only site of metastatic disease, and there is adequate lung reserve
      to withstand surgery. Survival following thoracotomy may be influenced by the
      interval before diagnosis, the number of pulmonary nodules, and the number of
      thoracotomies performed.

PMID- 8482161
TI  - How accurate is clinical examination in diagnosing and quantifying pelvirectal
      disorders? A prospective study in a group of 50 patients complaining of
      defecatory difficulties.
AB  - We prospectively evaluated 50 patients (38 females and 12 males; mean age, 44.7
      +/- 15 years) who complained of defecatory difficulties to determine the accuracy
      of the clinical examination in diagnosing and quantifying pelvirectal
      abnormalities. Each parameter was then compared with the features of anorectal
      manometry and evacuation proctography performed by two independent observers.
      Global agreement between clinical diagnosis and the reference method (radiology
      for rectoceles, rectal intussusceptions, and abnormal perineal descent; manometry
      for anismus) was observed in 80 percent of cases. In rectoceles, anismus, and
      rectal intussusceptions especially, excellent negative predictive values were
      obtained (96, 96, and 80 percent, respectively). Clinical examination always
      diagnosed high-grade intussusceptions. Nevertheless, abnormal perineal descent
      was poorly evaluated in 20 patients. When compared with anal manometry, digital
      assessment was able to quantify resting and squeeze pressures and length of the
      anal canal with excellent correlation and good global agreement as well as
      predicting a short or hypotonic anal canal. Clinical assessment is usually
      sufficient and accurate in most pelvirectal disorders encountered in patients
      complaining of defecatory difficulties. Both anorectal manometry and evacuation
      proctography retain a definite but limited place in investigating pelvirectal
      disorders.

PMID- 8482162
TI  - Subcutaneous morphine pump for postoperative hemorrhoidectomy pain management.
AB  - PURPOSE: Many anorectal procedures are currently being performed on an outpatient
      basis, hemorrhoidectomy being the exception because of the need for parenteral
      narcotics postoperatively. We investigated the effectiveness of a subcutaneous
      morphine pump (SQMP) for outpatient posthemorrhoidectomy pain control. METHODS:
      In Phase 1 of our study, 22 patients undergoing radical hemorrhoidectomy were
      started on an SQMP protocol postoperatively. Twenty-nine patients received
      conventional postoperative narcotic dosing. In Phase 2, 19 patients enrolled in
      an SQMP protocol underwent hemorrhoidectomy in an ambulatory setting. Length of
      hospitalization, catheterization rate, and pain control were evaluated. RESULTS:
      In Phase 1, zero patients in the study group and two in the control group
      required additional hospitalization beyond 23 hours for pain control. The rates
      of catheterization were similar between the two groups. Pain control was
      considered satisfactory in 21 of 22 study patients. There was no correlation
      between pain level and morphine dose. Eighteen of 22 patients experienced minor
      side effects, necessitating pump removal in two patients. In Phase 2, 18 of 19
      patients on the SQMP were discharged from the recovery room. Cost analysis shows
      the combination of outpatient hemorrhoidectomy and the SQMP to be cost-effective
      in comparison with an inpatient stay. CONCLUSIONS: The SQMP enables
      hemorrhoidectomy to be done on an outpatient basis. It provides effective pain
      control, enjoys high patient acceptance, and is cost-effective.

PMID- 8482163
TI  - Autologous fibrin glue in the treatment of rectovaginal and complex fistulas.
AB  - This nonrandomized series reports the use of autologous fibrin glue to treat
      complex rectovaginal and anorectal fistulas. The use of an autologous source to
      prepare fibrin glue eliminates the risk of disease transmission. Ten patients,
      six women and four men, with complex fistulas were treated with autologous fibrin
      glue application. Five patients had rectovaginal fistulas; one of them had
      Crohn's disease. Five patients had complex anal fistulas; two of them had Crohn's
      disease, and one had a large postanal ulcer associated with HIV disease. All
      patients had outpatient preoperative mechanical bowel preparation and
      prophylactic parenteral antibiotics. Six of the ten patients (60 percent)
      reported complete healing of the fistulas. Follow-up ranged from three months to
      one year. Four of five rectovaginal fistulas healed. The two patients with
      Crohn's disease and complex anal fistulas and the patient with HIV disease did
      not heal, but all three reported significantly less drainage. Autologous fibrin
      glue is a viable alternative for the treatment of recurrent rectovaginal and
      complex abscess/fistulas.

PMID- 8482164
TI  - Morphometric analysis of colorectal cancer.
AB  - Thirteen nuclear and cellular morphometric variables were measured in 312 cases
      of colorectal adenocarcinoma. All variables, except nuclear shape factors,
      differed significantly (P < 0.001) between normal colorectal and tumor tissue. In
      adenocarcinomas, epithelial nuclei in well-differentiated mucosa tended to be
      elliptic, while those in poorly differentiated mucosa were more spheric.
      Increasing values of maximum nuclear and elliptic diameter were associated with
      progression from none to simple tubule configuration (P < 0.001), none to easily
      discerned nuclear polarity (P < 0.001), and expanding growth pattern (P < 0.001).
      Univariate survival analysis revealed that none of the morphometric variables was
      significantly related to patient survival. Multivariate regression analysis
      showed that no morphometric variable could add significantly to a model
      containing the variables of patient age, Dukes stage, and tumor differentiation.
      Morphometry may be useful in distinguishing malignant from normal tissue and
      degrees of differentiation, but it is of little prognostic value in colorectal
      adenocarcinoma.

PMID- 8482165
TI  - Quantitative determination of pentane in exhaled air correlates with colonic
      inflammation in the rat colitis model.
AB  - Oxygen radicals play a key role in inflammation and inflammatory tissue damage.
      Quantitative determination of pentane, a hydrocarbon generated by membrane lipid
      peroxidation initiated by oxygen radicals, in expired air has been used as a
      noninvasive determinant or index of inflammation in various conditions. Herein we
      report the first examination of the relationship between exhaled pentane and
      colonic inflammation in a rodent model of colitis. Colitis was induced in rats (n
      = 33) using the trinitrobenzene-sulfonic acid (TNB) model of colitis. Exhaled air
      was collected in a closed chamber on randomly selected animals on days 1, 2, 4,
      7, 11, 13, 15, 20, and 25 post-TNB treatment, and pentane was assayed by means of
      gas chromatography. Gross and microscopic evidence of inflammation was compared
      with exhaled pentane levels. Pentane levels varied from 0.0 to 14.6 nmol/l of air
      and were significantly increased in TNB-treated rats compared with control rats
      only on days 7 to 15 after treatment (P < 0.05). Gross inspection showed severe
      colonic inflammation through the first week (mean score = 4.7 out of a possible
      5), persistent inflammation on days 7 to 15 (3.2), and healing and fibrosis from
      the end of week two until day 25 (1.9 to 0). Histologic evaluation confirmed a
      progression of inflammation from acute ulceration to chronic inflammation to
      fibrosis and scarring. We have demonstrated that pentane exhalation is increased
      after the induction of colonic inflammation, with a seven-day lag time, and
      returns rapidly to normal as acute inflammation resolves. This suggests that
      pentane exhalation can be used as a noninvasive measure of colonic inflammation
      in rodent models of colitis and perhaps clinically in humans.

PMID- 8482166
TI  - Initial experience with laparoscopic appendectomy.
AB  - As experience with laparoscopy increases, new applications in general surgery are
      being identified. Treatment of acute appendicitis through the laparoscope has
      been proposed. We present our initial experience with this new technique. Over a
      12-month period, laparoscopic appendectomy was attempted in 29 patients. There
      were no intraoperative complications. Two cases required conversion to the open
      technique owing to gangrene at the appendiceal base. The average operating time
      was 64 minutes. Two of nine patients with perforated appendicitis developed a
      pelvic abscess, and one patient developed wound cellulitis. Pain medication
      requirements were minimal, bowel function returned rapidly, and half of the
      patients were discharged on postoperative day one or two and returned to normal
      activity within one week. Based on our initial experience, it appears that
      laparoscopic appendectomy is a safe and effective technique for managing acute
      appendicitis and offers advantages in terms of decreased pain, decreased hospital
      stay, and a rapid return to normal activities.

PMID- 8482167
TI  - Cellular proliferation at sutured and sutureless colonic anastomoses.
AB  - Elevated cellular proliferation in the vicinity of an anastomosis may explain the
      enhanced susceptibility to carcinogens. The aim of this study was to determine
      whether anastomotic cellular proliferation was altered by different suture
      materials and whether a rise in cell turnover also occurred after a "sutureless"
      closure. A transverse descending colon enterotomy was repaired with interrupted
      sutures of 5/0 silk (n = 20), stainless steel (n = 20), or Vicryl (Ethicon, Inc.,
      Somerville, NJ) (n = 20) or by a sutureless technique (n = 20). Using a
      stathmokinetic technique, crypt cell production rates (CCPR) were calculated at
      the anastomosis and in the adjacent colon at varying intervals between one week
      and six months after treatment. Overall colonic cellular proliferation appeared
      to be elevated at a sutured colotomy for at least three months (P < 0.05). In
      contrast, no significant elevation in cellular proliferation was observed at
      sutureless anastomoses. The duration of elevated proliferative response varied
      among the sutures.

PMID- 8482168
TI  - Parameters of anorectal and colonic motility in health and in severe
      constipation.
AB  - Anorectal function and colonic transit was assessed in 17 severely constipated
      patients and 15 age-matched controls. The constipated patients were divided into
      those who had "immobile perineum" (perineal descent < or = 1.0 cm during
      attempted defecation) and those who had a normal descent (> 1.0 cm) of the
      perineum. When constipation was accompanied by an immobile perineum, patients had
      impaired balloon expulsion, impaired and delayed artificial stool expulsion,
      decreased straightening of the anorectal angle, decreased descent of the pelvic
      floor with defecation, and prolonged rectosigmoid colon transit compared with the
      patients with constipation who had a mobile perineum and with normal controls.
      The mobile-perineum group differed from controls only in colon transit times,
      having prolonged total colon transit. Anal sphincter resting pressures, immediate
      artificial stool expulsion, resting anorectal angles, and electromyography of the
      external anal sphincter and puborectalis did not differentiate the constipated
      patients from the controls. We concluded that descent of the perineum of < 1 cm
      was associated with impaired expulsion, an adynamic anorectal angle, and slowed
      distal colon transit. This simple sign of pelvic floor function distinguished
      constipated patients with disordered expulsion from constipated patients with
      normal pelvic floor function. These patients may respond poorly to surgery and
      conventional management and would therefore be candidates instead for pelvic
      floor retraining. Accurate characterization and appreciation of pelvic floor
      dysfunction in patients with severe chronic constipation may improve the
      selection for and results of surgical and nonsurgical intervention.

PMID- 8482169
TI  - Redo pouches: salvaging of failed ileal pouch-anal anastomoses.
AB  - From October 1, 1984 to December 31, 1991 at the Clinica Chirurgica II of the
      University of Bologna, 140 patients submitted to ileal pouch-anal anastomosis for
      ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Nineteen
      patients (13.5 percent) developed septic complications. Of these, 11 patients
      (7.8 percent) had pelvic sepsis. Eight patients required further surgical
      intervention. Five patients underwent the redo pouch procedure. Another redo
      pouch was performed in a patient who had previously, in another hospital, had an
      ileal pouch-anal anastomosis placed and then removed because of ischemic necrosis
      of the reservoir. No deaths are reported in the reoperated patients. Currently,
      five of the six patients who underwent the redo pouch procedure have a well
      functioning ileoanal anastomosis. The redo pouch procedure should always be
      attempted prior to the establishment of pelvic fibrosis.

PMID- 8482170
TI  - Level of serum gastrin as a predictor of liver metastasis from colorectal cancer.
AB  - There have been no reports on the relationship between serum gastrin level and
      liver metastasis in human colorectal cancer. One hundred forty patients who
      underwent surgery for colorectal cancer (T2 or more) were enrolled in this study.
      Fasting serum gastrin level was determined prior to the surgery. Incidence of
      liver metastasis was significantly (P < 0.01) higher in patients with a serum
      gastrin level of > or = 150 pg/ml (37 percent; 14/38) than in those with a serum
      gastrin level of < 150 pg/ml (12 percent; 12/102). As for the tumors with venous
      invasion, liver metastasis was detected in 11 of 55 patients (20 percent) with a
      serum gastrin level of < 150 pg/ml; however, it was detected in 11 of 19 patients
      (58 percent) with a serum gastrin level of > or = 150 pg/ml (P < 0.01). These
      results suggest that serum gastrin serves as a useful predictor of liver
      metastasis from colorectal cancer and that the predictability of liver metastasis
      can be improved when both serum gastrin level and venous invasion are considered.

PMID- 8482171
TI  - Ripstein procedure is an effective treatment for rectal prolapse without
      constipation.
AB  - The operation of choice for complete rectal prolapse is controversial. We
      reviewed 169 patients undergoing 185 surgical procedures for rectal prolapse over
      a 27-year period. The most common surgical procedure employed was the Ripstein
      procedure (n = 142) and is the focus of this report. Other surgical procedures
      used included resection rectopexy (n = 18), anterior resection (n = 7),
      Altemeier's (n = 9), Delorme's (n = 2), and anal encirclement (n = 7). The median
      age was 59 years (range, 12-94 years), and the female-to-male ratio was 5:1. The
      incidence of fecal incontinence, solitary rectal ulcer syndrome, and prior
      surgery elsewhere for rectal prolapse was 40 percent, 12 percent, and 19 percent,
      respectively. Operative mortality was 0.6 percent; morbidity was 16 percent.
      Median follow-up was 4.2 years (range, 1-15 years). Complete recurrence of
      prolapse after the Ripstein procedure was 8 percent; one-third of these patients
      recurred 3 to 14 years after surgery. Fecal incontinence improved after the
      Ripstein procedure or resection rectopexy in about half the patients. Persistence
      of prior constipation was more common after the Ripstein procedure than after
      resection rectopexy (57 percent vs. 17 percent; P = 0.03, chi-squared). Fifteen
      patients developed constipation for the first time after the Ripstein procedure.
      About one in three patients, irrespective of surgical procedures, remained
      dissatisfied with the final outcome despite anatomic correction of the prolapse.
      The Ripstein procedure has proven to be a safe procedure with good anatomic
      repair of the prolapse and may improve continence. In the presence of
      constipation, procedures other than the Ripstein procedure may be preferable.

PMID- 8482172
TI  - Self-expanding stainless steel stent application in rectosigmoid stricture.
AB  - In recent years, several reports on the experimental and clinical applications of
      the Gianturco stent (self-expanding stainless steel stent) have been published.
      However, to our knowledge, the use of stents in rectosigmoid strictures has not
      been reported. We used self-expanding stainless steel stents to dilate
      rectosigmoid strictures caused by nonresectable recurrent neoplasm. Insertion and
      dilation (sigmoid colon and rectum) in two patients were successful. Accordingly,
      these patients were able to maintain bowel activity and avoid palliative loop
      colostomy. We believe that this procedure is effective for nonresectable
      rectosigmoid stricture due to recurrent neoplasm.

PMID- 8482173
TI  - The management of an ileostomy including its complications. 1952.

PMID- 8482174
TI  - L-carnitine for treatment of nonspecific proctosigmoiditis.

PMID- 8482175
TI  - Study of human gastroduodenojejunal motility. Applied physiology in clinical
      practice.

PMID- 8482176
TI  - Ambulatory esophageal manometry, pH-metry, and Holter ECG monitoring in patients
      with atypical chest pain.
AB  - Standard Holter electrocardiographic (ECG) monitoring was combined with
      ambulatory esophageal manometry and pH-metry in 25 patients with atypical chest
      pain in order to determine whether an association could be found between
      spontaneous pain episodes and ischemic ECG changes or esophageal dysfunction.
      Results of ambulatory testing were compared to those obtained with standard
      esophageal manometry and provocative testing. Twenty-two of the 25 patients
      experienced a total of 88 pain episodes during ambulatory testing. Although 15 of
      the 22 patients (68%) experiencing pain during testing had at least one pain
      episode that correlated temporally with gastroesophageal reflux, esophageal
      dysmotility or ischemic ECG changes, 65% of all pain episodes were unrelated to
      abnormal esophageal events or ECG changes. Seventeen percent of pain episodes
      were associated with gastroesophageal reflux, 15% with esophageal dysmotility,
      and 2% with a combined acid reflux and esophageal dysmotility event. Only one
      pain episode was associated with ischemic ECG changes. Twelve of the 15 patients
      with chest pain episodes associated with reflux or esophageal dysmotility had
      other identical pain episodes in which there was no correlation. Reproduction of
      a patient's pain during standard manometry with provocative testing did not
      predict a strong correlation between the patient's spontaneous pain episodes and
      esophageal dysfunction during ambulatory recordings. In summary, patients with
      atypical chest pain have relatively few spontaneous pain episodes that correlate
      with gastroesophageal reflux, esophageal dysmotility, or ischemic ECG changes. It
      appears that different stimuli can trigger identical episodes of chest pain,
      which suggests that many of these patients may have dysfunction of their visceral
      pain sensory mechanisms.

PMID- 8482177
TI  - Reliability and interobserver variability of ultrasonographic measurement of
      gastric emptying rate.
AB  - Scintigraphy and real-time ultrasound are valid techniques to measure parameters
      of gastric emptying. However, scintigraphy involves exposure to ionizing
      radiation, while the precision of real-time ultrasound has not been previously
      evaluated. The objectives of the present study were to determine the inter
      observer and day-to-day variability of liquid gastric emptying rate measured by
      real-time ultrasonography in healthy volunteers and to compare the gastric
      emptying rate of males and females. Twenty healthy volunteers had
      ultrasonographic measurement of gastric emptying rate after ingestion of 300 ml
      beef broth. Nine subjects had a concurrent assessment by a second observer. Nine
      subjects had two studies performed on different days by the same sonographer. The
      T1/2 for 20 subjects was 24.77 +/- 6.84 min with no difference between the half
      emptying time for males (25.89 +/- 6.99 min) and females (24.02 +/- 6.94 min).
      The Pearson and intraclass correlation coefficients for observations made by two
      observers were 0.83 and 0.625, with a difference due to observer of 2.37 min +/-
      5.26 (NS). The test-retest reliability across successive days was 0.136,
      representing considerable day-to-day variability within subjects. The variability
      between subjects was also large, explaining up to 79% of the total variance. We
      conclude that ultrasound is a useful method to evaluate gastric emptying with
      good interobserver agreement. Due to substantial day-to-day variability, sample
      sizes larger than previously suggested are required to demonstrate clinically
      important changes in gastric emptying rate in clinical trials.

PMID- 8482178
TI  - Objective and subjective results of a randomized, double-blind, placebo
      controlled trial using cisapride to treat gastroparesis.
AB  - Cisapride, a relatively new gastrointestinal prokinetic agent, has been reported
      to increase gastric emptying and improve symptoms of gastroparesis. We
      investigated these effects of cisapride in patients with severe idiopathic and
      diabetic gastroparesis during an eight-week trial. The study design was a two
      week single-blind placebo run in period to exclude placebo responders, followed
      by a six-week randomized, double-blind, placebo-controlled treatment phase.
      Delayed gastric emptying of solids on radionuclide scan and a minimum symptom
      intensity score were inclusion criteria. Forty-three patients were entered: four
      placebo responders and one other patient were excluded, leaving 19 patients
      randomized to cisapride (20 mg per os three times a day before meals), and 19
      patients to placebo. Seven individual symptoms of gastroparesis were scored in a
      daily diary and reviewed at two-week visits. Sixteen patients in the cisapride
      group were able to complete the trial compared to 12 on placebo. The gastric
      emptying study was repeated at the end of treatment or at the time of withdrawal
      for those who dropped out. Cisapride significantly increased solid gastric
      emptying relative to baseline (P = 0.005) whereas placebo did not (P > 0.10).
      Cisapride did not significantly improve any symptom of gastroparesis relative to
      baseline or to placebo. We conclude that in a population of severe, refractory
      gastroparetic patients cisapride significantly accelerates gastric emptying of a
      solid meal without significantly reducing symptoms during a short-term treatment
      trial compared to placebo. Further trials of cisapride in less advanced and "end
      stage" gastroparetics than studied here or combining cisapride with other
      prokinetic agents or antiemetics, are warranted.

PMID- 8482179
TI  - Effect of trimebutine maleate on emptying of stomach and gallbladder and release
      of gut peptide following a solid meal in man.
AB  - We investigated the effect of orally administered trimebutine maleate on gastric
      and gallbladder emptying and on the release of gut peptide, pancreatic
      polypeptide (PP), and gastrin in humans for 120 min after ingestion of a solid
      meal. Gastric emptying was measured by a radionuclide technique. Gallbladder
      emptying was estimated by real-time ultrasonography. The oral administration of
      200 mg of trimebutine maleate significantly shortened the lag time in starting
      gastric emptying (P < 0.05). Considering gallbladder emptying, trimebutine
      significantly inhibited the fasting emptying induced by neural reflex.
      Postprandially, there was a tendency toward an accelerated gallbladder emptying
      in the early phase. Neither the maximal percentage of gallbladder emptying nor
      the time of peak gallbladder emptying were affected. Trimebutine significantly
      blunted the post-prandial PP response in the cephalic and gastric phases,
      reflecting a vagal-cholinergic activity (P < 0.05). The PP response in the
      intestinal phase was also blunted. Gastrin release was significantly augmented
      only during the period of fasting after drug administration (P < 0.05). The major
      effect of trimebutine maleate appears to be a shortening of the lag time at the
      start of gastric emptying probably via its anticholinergic activity.

PMID- 8482180
TI  - Gastric acid inhibits antral phase III activity in duodenal ulcer patients.
AB  - Fourteen patients with duodenal ulcers and eight healthy volunteers were examined
      to measure interdigestive gastroduodenal motility and plasma motilin. In order to
      study the effects of gastric acid on the gastroduodenal motility, 20 mg of
      famotidine was administered intravenously. The motility index of the gastric
      antrum and the duodenum, as well as the pH in the duodenal bulb were calculated.
      The duodenal pH was significantly lower and the gastric motility index was
      significantly weaker before the duodenal interdigestive migrating complex (IMC)
      in the ulcer patients than in the controls. Motilin levels increased before the
      duodenal IMC and decreased afterwards in both groups. Famotidine significantly
      increased the duodenal pH and the gastric motility index before the IMC, but no
      changes in the motilin level were noted. We conclude that duodenal ulcer patients
      have duodenal hyperacidity that results from increased inflow from the antrum and
      antral hypomotility during the gastric IMC and that these changes are normalized
      by the administration of famotidine. These results suggest that gastric acid
      inhibits antral contraction during the gastric IMC.

PMID- 8482181
TI  - Voluntary suppression of defecation delays gastric emptying.
AB  - We wished to test the hypothesis that colonic loading with fecal material leads
      to delayed gastric emptying. Twelve healthy male volunteers were studied. Each of
      these subjects went through two randomized study periods of four days. In one of
      these, the subjects defecated upon urge, in the other period defecation was
      voluntarily suppressed. Gastric emptying of a semisolid meal (mashed potatoes)
      was measured with the noninvasive applied potential tomography technique. On day
      3 no significant changes in gastric emptying were found, but on day 4 the
      emptying rate had decreased from 85.8 +/- 11.0%/hr (mean +/- SEM) to 70.3 +/-
      10.9%/hr (P < 0.05) and the T50 had increased from 38.5 +/- 3.4 min to 46.2 +/-
      4.0 min (P < 0.025). The duration of the lag phase (4.1 +/- 1.5 min) was not
      significantly altered by suppression of defecation. Our conclusion is that
      voluntary suppression of defecation delays gastric emptying in normal subjects.
      This "cologastric brake" may be involved in the pathogenesis of upper abdominal
      symptoms in constipated patients.

PMID- 8482182
TI  - Disturbed gastric and small bowel transit in severe idiopathic constipation.
AB  - Many patients with severe idiopathic constipation complain of upper
      gastrointestinal symptoms, and these often persist after subtotal colectomy. To
      determine if there is a disturbance of upper gastrointestinal motility in this
      condition, we have studied gastric emptying for solids (111In-containing pancake)
      and liquids (99mTc-containing orange juice) for a longer period after a meal (6
      hr) than in previously reported gastric emptying studies. Small bowel transit for
      solids was also measured. All patients had emptied their colon the day before the
      study. Twelve women (mean age 36 years) with a bowel frequency of less than once
      per week, proven slow intestinal transit, and a normal diameter colon were
      studied. Twelve healthy controls (eight female and four male, mean age 33) were
      also studied. As a group the constipated patients demonstrated no statistically
      significant delay in emptying during the first 3 hr, although the emptying rate
      for three of 12 individuals fell outside the normal range. However, at 6 hr after
      ingestion of the meal, six of 10 patients had residual gastric contents greater
      than normal--up to 48% solid residue (median: 11% for patients and 0% for
      controls, P < 0.01) and 40% of liquid (median 9% vs 0%, P < 0.01). Three of four
      patients with upper gastrointestinal symptoms 6 hr after the meal had gastric
      retention of solids markedly outside the normal range (48%, 32%, and 16%; normal
      < 4%). Small bowel transit time was assessed as the time for the solid phase to
      pass from the duodenum to the cecum; the constipated patients demonstrated
      delayed transit (median: 75 vs 55 min, P < 0.01).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8482183
TI  - Centrally administered neuropeptide Y (NPY) inhibits gastric emptying and
      intestinal transit in the rat.
AB  - Neuropeptide Y is distributed abundantly not only in the brain, but also in the
      gastrointestinal tract and suppresses intestinal muscle contraction in isolated
      muscle preparations. The purpose of the present study was to determine whether
      centrally administered neuropeptide Y modulated gastric emptying and intestinal
      transit in conscious rats. Graded doses of neuropeptide Y were administered
      intracisternally 1 min before ingestion of test meals through an oral tube. Four
      hours after ingestion of 60 Amberlite pellets, the rats were sacrificed and
      residual pellets in the stomach and the small intestine segments were counted to
      calculate the solid meal transit rate. The liquid meal transit rate was
      calculated 1 hr after 0.07% phenol red ingestion by determining the residual
      phenol red in the stomach and the small intestine segments. Neuropeptide Y
      elicited potent suppression of gastric emptying and intestinal transit of both
      solid and liquid meals. Pretreatment with propranolol antagonized, whereas
      phentolamine did not affect, the suppressive effect of central neuropeptide Y.
      Although carbachol blocked the effects of neuropeptide Y, neither atropine nor
      hexamethonium altered the actions of neuropeptide Y. In conclusion, centrally
      administered neuropeptide Y strongly inhibited gastrointestinal transit by
      stimulating a beta-adrenergic pathway.

PMID- 8482184
TI  - Effect of misoprostol on postprandial intestinal motility and orocecal transit
      time in humans.
AB  - We measured the effect of misoprostol (M), a PGE1 analog, on duodenojejunal
      postprandial motor activity and orocecal transit in eight healthy volunteers.
      Intestinal motility was studied by an intraluminal catheter with three strain
      gauge transducers connected to a solid-state datalogger, and transit time was
      measured by a hydrogen breath test. Subjects were studied for two consecutive
      days and fed twice a day with a similar, 600-kcal meal. Misoprostol (M) at 800,
      400, or 200 micrograms or placebo were taken orally before every one of the four
      meals. Transit time was measured after the morning meal on both days, after
      ingestion of either 800 micrograms of M or placebo. On four occasions, following
      M, the normal fed pattern was not established and the migrating motor complex
      (MMC) was not interrupted by the meal. In all other occasions, when the higher
      doses of M were given, the first 1-2 hr after the meal revealed a hypoactive
      bowel. This effect was inconsistently seen following 200 micrograms of M.
      Orocecal transit time was consistently and significantly shorter after M than
      placebo: 48.3 +/- 9.5 min vs 104.4 +/- 4.8 min, P < 0.0001. Four subjects had
      diarrhea during the study. We conclude that misoprostol, particularly at higher
      doses, has a profound effect on intestinal postprandial motility and results in
      accelerated transit time. The motility changes induced by M may be responsible,
      in part, for its effect on transit.

PMID- 8482185
TI  - Integration of canine proximal gastric, antral, pyloric, and proximal duodenal
      motility during fasting and after a liquid meal.
AB  - The aim was to investigate the integration of proximal gastric, antral, pyloric,
      and duodenal motility during fasting and after feeding. Using a proximal gastric
      barostat and a manometric assembly with an array of side holes astride the
      gastroduodenal junction, the gastrointestinal interdigestive migrating motor
      complex was detected in five of seven conscious fasting dogs. During phase III of
      the complex, which lasted a mean +/- SEM of 13 +/- 0.5 min, 9.6 +/- 0.9 volume
      waves were present in the proximal stomach. The volume waves were coordinated
      with clusters of antral waves 64 +/- 11% of the time and with inhibition of
      duodenal waves 91 +/- 3% of the time. A 300-ml calorie-dense liquid meal
      abolished the complex and promptly increased proximal gastric volume in five of
      six dogs. Volume waves were nearly completely suppressed, while antral waves
      decreased from 24 +/- 3.0 waves/10 min to 10 +/- 2.8 waves/10 min (P < 0.05) and
      isolated pyloric pressure waves increased from 7.2 +/- 2.8 waves/10 min to 22 +/-
      3.3 waves/10 min (P < 0.005). In summary, proximal gastric motility was
      integrated with antral, pyloric, and duodenal motility under both fasting and fed
      conditions. The integrated patterns likely account for the efficient clearance of
      indigestible solids during fasting and the controlled emptying of nutrients with
      feeding.

PMID- 8482186
TI  - Effect of erythromycin on interdigestive gastrointestinal contractile activity
      and plasma motilin concentration in humans.
AB  - The effects of erythromycin (EM) on gastrointestinal contractile activity during
      the interdigestive period were investigated in seven healthy subjects using an
      infused catheter system, and the changes in the plasma motilin concentration were
      also determined. Graded EM doses (0.1-1.5 mg/kg) were administered intravenously
      over 5 min, usually during gastric phase I. EM induced interdigestive migrating
      contractions (IMCs). Their induction rate was low after low doses of EM, but
      gradually increased as the dose increased to reach 71.4% at an EM dose of 0.375
      mg/kg. Strong contractions, which were quite similar to phase III activity of the
      stomach but did not migrate or migrated incompletely to the duodenum, were
      observed at EM doses above 0.375 mg/kg. Therefore, the optimum dose of EM for
      inducing an IMC was established to be 0.375 mg/kg. In comparison with spontaneous
      IMCs, EM-induced IMCs had a significantly longer duration in the stomach and a
      significantly lower amplitude in the duodenum. These observations indicate that
      EM induced phase III activity more intensively in the stomach than in the
      duodenum. The plasma motilin concentration increased significantly during EM
      induced IMCs, and this suggested a close relationship between this hormone and
      induction of the IMC. The increase in motilin levels was also observed of the
      strong gastric contractions which did not migrate or migrated incompletely to the
      duodenum. Therefore, it seems reasonable to suggest that motilin is involved in
      phase III activity of the stomach rather than in that of the duodenum.

PMID- 8482187
TI  - Evaluation of anorectal physiology in patients with increased mast cells.
AB  - Diarrhea, urgency, and fecal incontinence are common complaints in systemic
      mastocytosis and in patients with increased gastrointestinal mucosal mast cells.
      We performed anorectal manometry on six patients with clinical symptoms of
      mastocytosis and histologic evidence of increased mast cells and compared the
      results to anorectal manometry of six age- and sex-matched controls, with no
      bowel symptoms. Standard techniques with balloon volumes were used to measure
      maximal basal pressure, maximal squeeze pressure, smallest volume sensed, degree
      of relaxation of the internal sphincter, and the volume causing: (1) a strong
      urge to defecate and (2) pain. Patients with mastocytosis, compared with
      controls, had smaller balloon volumes induce rectal urgency (97 vs 164 ml) and
      pain (117 vs 278 ml). A trend was present for lower maximal basal pressure in
      mastocytosis, but was not statistically significant. Sensitivity to balloon
      inflation suggests decreased rectal compliance or overreactive rectal
      contractility. These findings provide an explanation for the anorectal symptoms
      in patients with increased mast cells.

PMID- 8482188
TI  - Ursodeoxycholic acid administration on bile acid metabolism in patients with
      early stages of primary biliary cirrhosis.
AB  - Ursodeoxycholic acid has been proposed for the treatment of primary biliary
      cirrhosis. The aim of this study was to evaluate the effect of ursodeoxycholic
      acid administration on bile acid metabolism in patients with early-stage primary
      biliary cirrhosis. Biliary bile acid composition, primary bile acid pool sizes,
      synthesis, and fractional turnover rate were measured before and after four weeks
      of ursodeoxycholic acid administration (600 mg/day) in nine patients with biopsy
      proven primary biliary cirrhosis (stages I-III). Molar percentages of
      chenodeoxycholic, cholic, and deoxycholic acids in bile were significantly
      decreased by ursodeoxycholic acid administration, while its biliary concentration
      increased to 34.2% at the end of the same four-week period. The cholic and
      chenodeoxycholic acid pools decreased, although not significantly, while the
      deoxycholic acid pool was reduced by 60% (from 0.7 +/- 0.12 to 0.29 +/- 0.07
      mmol, P < 0.002). Primary bile acid synthesis was slightly increased, and
      fractional turnover rate was significantly increased. The conversion rate of
      cholic to deoxycholic acid was measured and found to be significantly increased
      (P < 0.05) after ursodeoxycholic acid administration; however, serum levels of
      both free and conjugated deoxycholic acid were significantly decreased (from 23.2
      +/- 9.7 to 3.8 +/- 1.9 mumol/liter, P < 0.001). We conclude that in patients with
      primary biliary cirrhosis, ursodeoxycholic acid administration replaces
      endogenous bile acids in the enterohepatic circulation by increasing bile acid
      fractional turnover rate without significant increments of their hepatic
      synthesis.

PMID- 8482189
TI  - Concentrated ascitic fluid reinfusion after cascade filtration in tense ascites.
AB  - A new method for concentrated ascitic fluid reinfusion using a double
      ultrafiltration device is reported as 22 procedures in 20 cirrhotic patients (6
      females, 14 males; median age 55 years, range 33-69) with tense, refractory
      ascites. Eight of the 20 patients had elevated creatinine levels. The mean time
      for each procedure was 189 +/- 82 min, during which a mean of 7.7 liters (1.3
      13.3) of ultrafiltered ascitic fluid was removed and 613 ml (140-1700) of
      concentrated ascitic fluid rich in albumin (mean: 60 g, range 14-175) was
      reinfused. The procedure resulted in a mean weight loss of 8.1 kg (2.2-14.0) and
      a mean increase of 163 ml in urine output (24 hr). A reduction in the serum
      creatinine level (P < 0.05) and an increase in the plasma atrial natriuretic
      factor level (P < 0.02) 24 hr after reinfusion, while no changes in serum
      albumin, plasma and urinary electrolytes, plasma renin activity, aldosterone, and
      antidiuretic hormone levels were noted. Although minor evidence for a disturbance
      in coagulation was observed, there were no episodes of clinical bleeding. Four
      patients (20%) had transient chills or fever. Based upon this experience, it can
      be concluded that reinfusion of cascade filtered and concentrated ascitic fluid
      is a rapid, safe, and effective treatment for patients with tense ascites; it
      appears to have less side effects than more traditional methods and importantly
      does not require administration of heterologous plasma derivatives.

PMID- 8482190
TI  - Isolation of mucin from human hepatic bile and its induced effects on
      precipitation of cholesterol and calcium carbonate in vitro.
AB  - Biliary mucin was isolated from human hepatic bile, and its induced effects on
      the appearance time of cholesterol monohydrate crystals (nucleation time) and on
      the precipitation of calcium carbonate were studied in vitro to examine the
      possible significance of mucin for ductular gallstone formation. Mucin was
      isolated by gel filtration on Sepharose CL-4B and a subsequent CsCl density
      gradient ultracentrifugation. Mucin thus obtained had a high purity as shown by a
      high-molecular-weight band on SDS-polyacrylamide gel electrophoresis and by the
      compatible amino acid composition with mucin purified from the gallbladder. The
      mucin at as low a concentration as 100 micrograms/ml significantly shortened the
      cholesterol nucleation time in the supersaturated model bile, mimicking human
      hepatic bile. On the other hand, the addition of mucin inhibited calcium
      carbonate precipitation in vitro. Taking account of that both cholesterol and
      calcium salts are major constituents of ductular gallstones, we conclude that
      biliary mucin is likely to play an important regulating role in the formation of
      ductular stones.

PMID- 8482191
TI  - Lactitol in treatment of chronic hepatic encephalopathy. A meta-analysis.
AB  - The efficacy and side effects of lactitol in the treatment of chronic hepatic
      encephalopathy was compared to that of other disaccharides in a meta-analysis of
      published randomized clinical trials (RCTs). The outcomes assessed were: (1) the
      rate of patients free from episodes of clinically detectable encephalopathy, and
      (2) the rate of patients free from one or more side effects in the different
      treatment groups. Four RCTs were eligible for analysis; in three lactitol was
      compared to lactulose, in one the alternative treatment was lactose in lactase
      deficient patients. The methodological quality of these studies was high. Meta
      analysis showed that lactitol was as effective as other disaccharides in the
      treatment of encephalopathy: pooled odds ratio was 0.83, 95% confidence interval
      was 0.38-1.82. Results were not sensitive to the use of alternative methods of
      counting and attributing events in these trials. Patients experienced fewer side
      effects during treatment with lactitol, but the pooled odds ratio was not
      statistically significant. In all studies lactitol was considered more palatable.
      Clinical effectiveness of lactitol, in long-term treatment of chronic
      encephalopathy, is similar to those of lactulose. It seems that lactitol has
      lower side effects than lactulose. Future RCTs with a double-blind design could
      be mainly aimed at evaluating the side-effect profile of the two disaccharides.

PMID- 8482192
TI  - Is chemotherapy associated with development of Barrett's esophagus?
AB  - Columnar-lined or Barrett's esophagus is a premalignant condition. It is almost
      unvariably due to chronic gastroesophageal reflux. Since there are some reports
      that Barrett's esophagus can be induced by chemotherapy, we investigated 20 male
      patients, treated with chemotherapy for testicular cancer, and 18 female
      patients, treated with high-dose chemotherapy for breast cancer. Only one patient
      in the testicular cancer group had Barrett's esophagus of the circumferential
      type, in addition to typical reflux esophagitis and a hiatal hernia four years
      after chemotherapy. In the breast cancer group one patient had an indeterminate
      junction. Our results do not support the hypothesis that chemotherapy poses a
      substantially increased risk for the development of Barrett's esophagus.

PMID- 8482193
TI  - Treatment and long-term outcome of chronic radiation esophagitis after radiation
      therapy for head and neck tumors. A report of 13 cases.
AB  - The natural history of chronic radiation esophagitis occurring in previously
      normal esophagus is still unknown. We describe here the long-term outcome of
      chronic esophagitis arising after neck irradiation for oropharynx and larynx
      carcinomas in 13 consecutive adult patients. The first clinical signs of
      radiation esophagitis were dysphagia or impossibility of oral intake, which
      appeared within 26 months (range 2-120 months) after the end of radiation for
      pyriform fossae carcinoma (N = 5), tonsil carcinoma (N = 2), larynx carcinoma (N
      = 2), pharynx carcinoma (N = 2), base of the tongue (N = 1), and thyroid
      carcinomas (N = 1). During upper endoscopy, an esophageal stenosis was found in
      11 cases and was associated with ulceration in three cases. An isolated
      esophageal ulceration was present in only two cases. Chronic radiation
      esophagitis diagnosis was confirmed by histology and surgery in seven cases. In
      the last six cases, diagnosis was supported by the absence of first cancer
      relapses within a median follow-up of two years (16 months to nine years) and by
      endoscopic findings. Seven patients received parenteral or enteral nutrition. Ten
      patients were treated by peroral dilatations. These treatments allowed nearly
      normal oral diet in 11/13 patients. Only one patient was lost of follow-up after
      20 months. Four patients died from chronic radiation esophagitis. One of these
      patients died from massive hemorrhage after peroral dilatation. Four patients
      died of a second carcinoma with no first cancer recurrence. Four patients were
      alive after six months to nine years of follow-up. Moderate dysphagia was still
      present, allowing nearly normal oral feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482194
TI  - Serum pepsinogens after interruption of long-term maintenance therapy with
      omeprazole in patients with reflux esophagitis.
AB  - Administration of omeprazole induces increases in serum concentrations of
      pepsinogens A and C. In 10 patients with reflux esophagitis who were on
      continuous maintenance treatment, the effect of cessation of omeprazole
      administration on serum pepsinogens was studied. Pepsinogens A and C were
      measured in serum samples on days 0, 1, 2, 4, 7, and 9 after treatment and the
      results were compared with the values available in eight patients at a time
      before omeprazole treatment. Serum pepsinogen A levels decreased gradually after
      cessation of omeprazole administration, and all values fell into the normal range
      after the seventh day of the study period, but were still higher than before
      therapy. Seven of 10 patients showed a decrease of pepsinogen C after nine days,
      but two patients had still increased levels at the end of the study period. The
      pepsinogen A:C ratio on the ninth day after cessation was significantly lower
      than on day 0 during omeprazole therapy. We conclude that long-term maintenance
      therapy with omeprazole induces significant increases in both serum pepsinogens.
      After cessation of omeprazole treatment, serum pepsinogens rapidly decrease in
      most patients, but continue to be higher before therapy for at least nine days.

PMID- 8482195
TI  - Local cellular and immune response by antral mucosa in patients undergoing
      treatment for eradication of Helicobacter pylori.
AB  - Thirty-six patients with nonhealing or recurrent duodenal ulcers (DU) were
      treated with omeprazole; 20 mg/day for one month followed by triple therapies
      (metronidazole, 400 mg three times a day, tetracycline, 500 mg four times a day
      with either colloidal bismuth, 120 mg four times a day or sucralfate 1 g four
      times a day. At least two gastric mucosal samples were collected from the antral
      portion of the stomach and from the duodenum before and immediately after
      omeprazole therapy and four weeks after completion of triple therapies. Samples
      were fixed in buffered formaldehyde and glutaraldehyde and examined
      histologically and histochemically for inflammation, density of H. pylori
      colonization, and immunohistochemically for the density of gastrin-secreting
      cells, immunoglobulins (IgA, IgG, IgM), kappa and lambda light chains and T
      lymphocyte population. H. pylori colonization of the antral mucosa before
      treatment was noted in 100% and active gastritis in 86% of patients. The
      histologically assessed clearance rate after omeprazole treatment was 47.3%, and
      after triple therapies, 69.5%. The prevalence of gastritis was observed in 63.9%
      and 33.3% respectively. All therapies were associated with an accumulation of
      serous fluid, increased population of lymphocytes and plasma cells, and secretion
      of immunoglobulins, particularly IgG and IgM in the upper part of the lamina
      propria. These changes, together with increased numbers of T lymphocytes within
      the crypt epithelium and the lamina propria, were associated with the presence of
      H. pylori organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482196
TI  - Ferrous sulfate reduces cimetidine absorption.
AB  - A variety of drugs that bind to iron have significant reductions in absorption
      when coadministered with iron compounds. Cimetidine has a structure that would
      suggest strong binding to iron ions. In vitro experiments were performed to
      examine a variety of characteristics of the binding of iron to cimetidine.
      Further studies were conducted to determine the effect of concurrent
      administration of ferrous sulfate on cimetidine absorption in an in vivo isolated
      perfused rat jejunal model of drug absorption. The dose of cimetidine was chosen
      to represent a human dose of 300 mg, while the ferrous sulfate doses were chosen
      to represent 150- and 300-mg doses. The higher ferrous sulfate dose completely
      inhibited cimetidine absorption (P < 0.01), while the lower dose of ferrous
      sulfate caused a 63% reduction in cimetidine absorption (P < 0.05). In vitro iron
      in its ferrous from rapidly oxidizes to the ferric form. The ferric form of iron
      binds to cimetidine and may be the cause of the decreased cimetidine absorption.
      Care should be taken in prescribing iron supplements with cimetidine.

PMID- 8482197
TI  - Squamous metaplasia of extrahepatic biliary system in an AIDS patient with
      cryptosporidia and cholangitis.
AB  - AIDS-related cholangiopathy is an increasingly recognized syndrome associated
      with significant morbidity and mortality. The mechanism of cholangiopathy is
      unknown but is assumed to be related to infectious pathogens such as CMV and
      cryptosporidia. The case of a Haitian with HIV and long-standing intestinal
      cryptosporidiosis who presented with cholangitis and protuberant intrabiliary
      filling defects is reported. Histopathological examination of biliary biopsies
      revealed previously unreported extensive squamous metaplasia of the bile duct
      epithelium, and the histogenesis of this condition is discussed. Chronic
      cryptosporidial infestation may be directly pathogenic resulting in squamous
      metaplasia that mimics biliary malignancy.

PMID- 8482198
TI  - Idiopathic chronic calcifying pancreatitis with diabetes mellitus. Analysis of
      pancreatic stone protein gene.
AB  - We present a case of a 27-year-old female suffering from chronic calcifying
      pancreatitis with diabetes mellitus. Radiographic examinations and exocrine
      pancreatic function tests revealed considerable dilatation of pancreatic ducts
      with large intraductal calculi and exocrine pancreatic insufficiency,
      respectively. Recent literature indicates that a decrease in the activity of
      pancreatic stone protein (PSP), which inhibits CaCO3 crystal formation in
      pancreatic juice, is closely related to the development of chronic calcifying
      pancreatitis. The patient had no apparent cause or family history of
      pancreatitis. We therefore investigated the possibility that alterations in the
      PSP gene might explain the chronic pancreatitis seen in this patient. Six exons
      of the PSP gene amplified by polymerase chain reaction were directly sequenced,
      but there was no apparent base mutation observed. Furthermore, Southern blot
      analysis revealed neither rearrangement nor deletion of the PSP gene in the
      genomic DNA of this case. However, this genetic approach will be useful for
      future study of the etiology of hereditary pancreatitis.

PMID- 8482199
TI  - Esophageal motility impairment in Plummer-Vinson syndrome. Correction by iron
      treatment.
AB  - We report the case of a 41-year-old woman with Plummer-Vinson syndrome and an
      esophageal motility disorder. She complained of dysphagia and odynophagia and had
      cheilitis, glossitis, and hypochromic anemia. An esophageal motility study showed
      low amplitude of contraction and high intrabolus pressure in the esophageal body.
      After iron replacement, the patient was free from symptoms, and a new motility
      study showed increased amplitude of contraction and decreased intrabolus
      pressure.

PMID- 8482200
TI  - Aspiration of bile during laparoscopic cholecystectomy benefits surgeon and
      investigator.

PMID- 8482201
TI  - Personality traits and gastric acid secretion in ulcer disease.

PMID- 8482202
TI  - [Work and health protection of nursing personnel in view of the guidelines of the
      European community on "lifting and carrying". Empiric study on the current
      situation and the potential for its shaping].

PMID- 8482203
TI  - [Moving bodies in strange places and times].

PMID- 8482204
TI  - [Activating care].

PMID- 8482205
TI  - [Basal stimulation].

PMID- 8482206
TI  - [Kinesthetics in nursing--moving with minimum effort].

PMID- 8482207
TI  - [The Feldenkrais method].

PMID- 8482208
TI  - [Proper tension and movement].

PMID- 8482209
TI  - [Osteopathy].

PMID- 8482211
TI  - [School for the back].

PMID- 8482210
TI  - [Body building and movement formation--components of health care].

PMID- 8482212
TI  - [Bobath's treatment of movement disorders].

PMID- 8482213
TI  - [Potentials of physical therapy in cerebral movement coordination disorders in
      infants and children].

PMID- 8482214
TI  - [Vojta's treatment of movement disorders].

PMID- 8482215
TI  - [Perspectives of teacher training in nursing. A discussion with Thomas Bals'
      attempts at normalization].

PMID- 8482216
TI  - [Nursing care of patients following liver and kidney transplantation].

PMID- 8482217
TI  - [Immunosuppression and prevention of infection in patients with liver and kidney
      transplantations].

PMID- 8482218
TI  - ["From health to disease"--the well person. Theoretical introductory article
      within the framework of a holistically oriented educational concept--development
      and implementation].

PMID- 8482219
TI  - [The beautiful body].

PMID- 8482220
TI  - [Plastic covering of skin and reconstruction of scars after scalds and burns].

PMID- 8482221
TI  - [Possibilities of reconstructive plastic surgery].

PMID- 8482222
TI  - [Shape changing and reconstructive surgery on the female breast].

PMID- 8482223
TI  - [Birthmarks on the skin and their therapy].

PMID- 8482225
TI  - [Nursing a child with cleft lip and cleft palate].

PMID- 8482224
TI  - [Therapy of cleft lip and cleft palate].

PMID- 8482226
TI  - [Carrying out the regulations for the nursing personnel. Utilization of data for
      the internal organization].

PMID- 8482227
TI  - [Cough, head colds, hoarseness].

PMID- 8482228
TI  - [The nursing process during nursing education. Legal requirements and reality].

PMID- 8482229
TI  - [Accompanying care].

PMID- 8482230
TI  - [Endoscopic ultrasound in the demonstration and staging of non-Hodgkin's
      lymphomas of the stomach].
AB  - Nine patients (five women, four men, mean age 64.2 [49-77] years) with
      histologically confirmed gastric non-Hodgkin lymphoma (NHL) were investigated
      before starting therapy and during follow up, using endoscopic ultrasound,
      computer-assisted tomography and conventional ultrasound. Of ten gastric NHL
      infiltrations, nine were demonstrable using endoscopic ultrasound, three by
      computed tomography and two with conventional ultrasound. Accurate assessment of
      the primary tumour stage was possible in six out of eight cases using endoscopic
      ultrasound, but in none using tomography or conventional ultrasound. Three of
      these patients had inflammatory changes in enlarged paragastric lymph nodes and
      five malignant lymphomatous involvement. The latter was demonstrable by
      endoscopic ultrasound in all cases, by computed tomography in three cases and by
      conventional ultrasound in two cases. False positive results were obtained in two
      cases using endoscopic ultrasound and computed tomography. Regression of the
      tumour and of paragastric lymph nodes on radio-chemotherapy was demonstrable in
      two cases, and progression in one using endoscopic ultrasound; the other
      techniques showed progression of extragastric lymphoma involvement in only one
      case. Endoscopic ultrasound is an efficient method for demonstration and local
      staging of gastric non-Hodgkin lymphomas.

PMID- 8482231
TI  - [The benefits and risks of percutaneous transhepatic cholangioscopy].
AB  - Percutaneous transhepatic cholangioscopy (PTCS) was undertaken in 101 patients
      (for diagnostic reasons in 64 and/or therapeutic reasons in 56) out of 167
      consecutive patients (56 women, 45 men; mean age 64.2 [27-95] years) in whom
      percutaneous transhepatic drainage had been instituted. In all but one of 64
      patients PTCS clearly defined stenoses which had been unclear in the
      cholangiogram. There was a 90% accuracy of histological diagnosis of biopsies
      obtained under vision in 60 cases. A malignant stenosis was seen in 19 of 25
      cases (sensitivity 76%). Severe stenosis, not passable by contrast medium, were
      recanalized cholangioscopically in 14 of 15 cases. Biliary tract stones were
      completely removed by PTCS in 40 of 41 patients, by mechanical means (n = 4) or
      intracorporeal lithotripsy (n = 37). There were no complications from PTCS. It is
      concluded that PTCS can be performed safely and reliably in patients with
      functioning percutaneous transhepatic drainage. It provides the diagnosis of
      previously unclear cholangiographic findings as well as treatment of difficult
      biliary tract stenoses and/or ductal stones.

PMID- 8482232
TI  - [The thrombolysis of a septic portal vein thrombosis with ultrahigh-dosage
      streptokinase].
AB  - Eight days after an appendicectomy a 40-year-old man developed a fever of up to
      40.5 degrees C. The concentration of the transaminases was elevated (GOT 61 U/l,
      GPT 115 U/l, gamma-GT 226 U/l). Operative revision discovered no unusual wound
      conditions. Ultrasonography revealed splenomegaly (15 x 7 cm) and dilatation of
      the portal vein (diameter of 19 mm). The portal vein contained echo-dense
      constituents indicating thrombosis. Colour Doppler duplex sonography recorded
      only minimal residual flow around the thrombus. The fever gradually subsided
      under antibiotic treatment (metronidazole, 500 mg twice daily; mezlocillin, 2 g
      three times daily; later also gentamicin, 80 mg three times daily). Blood culture
      grew Bacteroides fragilis. 14 days after the wound revision ultra-high short-term
      lysis with streptokinase was instituted (9 mill IU over 6 hours), followed by
      heparin i.v. 25,000-30,000 i.v. daily for 5 days. 12 hours after the start of
      thrombolysis treatment the portal vein thrombus had been dissolved, and after 8
      days the size of the spleen was normal.

PMID- 8482233
TI  - [The fundamentals of gene technology].

PMID- 8482235
TI  - [Why is there a type-2 diabetes?].

PMID- 8482234
TI  - [Abdominal obesity. The metabolic syndrome, arteriosclerosis and mortality].

PMID- 8482236
TI  - [Parenteral vitamin K prophylaxis and the cancer risk].

PMID- 8482237
TI  - [The treatment of acromegaly with octreotide].

PMID- 8482238
TI  - [The long-term success after coronary angioplasty in old age].
AB  - Long-term results of coronary angioplasty (CAP) were compared between two age
      groups of patients. Group 1 had 227 patients (158 men, 69 women) with a mean age
      of 70 (65-88) years, group 2 had 717 patients (611 men, 106 women), mean age 54
      (20-64) years. Unstable angina was more common in group 1 than group 2 (48.9 vs
      37.7%, P < 0.05). Multi-vessel disease was present in 50.7% of those in group 1
      and 41.9% in group 2. Primary success of CAP was similar in the two groups (group
      1: 88.1%, group 2: 90.5%). The long-term effect at the first follow-up
      angiography 3-4 months after CAP was slightly less favourable in group 1 than 2
      (54.9 vs 58.3%; difference not significant). However, there were more patients
      with unstable angina in group 1. Thus the angiographic long-term results were
      worse in the older patients (44.6 vs 60.1%; P < 0.05), while there was no
      difference between the two groups as regards stable angina (64.7 vs 57.2%). After
      a second CAP (because of recurrence), the long-term angiographic effect was, if
      anything, slightly better in the older patients (87.0 vs 77.1%). The death-rate
      (cardiac causes of death) up to one year after CAP was comparable in the two
      groups (1.7 vs 0.8%), as was the rate of non-fatal myocardial infarction (2.2 vs
      1.3%). These data indicate that clinical and angiographic long-term success after
      CAP is comparable in older and younger patient groups and age alone does not
      present a higher risk.

PMID- 8482239
TI  - [Acute myoglobinuric kidney failure in McArdle's syndrome. The diagnostic
      significance of 31P nuclear magnetic resonance spectroscopy].
AB  - A 44-year-old man developed acute renal failure, associated with reddish brown
      urine, after severe physical exertion. Since childhood his physical capacity was
      known to be limited. Muscular indurations, cramps and pains had occurred after
      muscular work. Serum creatinine level on the day before hospitalization was 10.0
      mg/dl, creatine-kinase activity 3,790 U/l, lactate dehydrogenase activity 670
      U/l, myoglobin level 701 ng/ml. Cause of the rhabdomyolysis was thought to be
      McArdle's disease (glycogen storage disease type V: abnormal skeletal muscle
      glycogen utilization). 31P-magnetic resonance spectroscopy, which gives
      characteristic spectra with anaerobic muscle work, provided the diagnosis, which
      was confirmed by measurement of myophosphorylase activity in a muscle biopsy
      (zero activity). After two dialysis sessions and alkalinization of the urine
      diuresis again occurred and the retention indicators fell to normal in the course
      of the subsequent 18 months. Creatinine kinase activity remained elevated.

PMID- 8482240
TI  - [Chronic ethylene glycol poisoning].
AB  - Over a six-week period a 60-year-old patient had several unexplained intoxication
      like episodes. He finally had severe abdominal cramps with changes in the level
      of consciousness and oligoanuric renal failure (creatinine 4.7 mg/dl). The
      history, marked metabolic acidosis (pH 7.15, HCO3- 2.2 mmol/l, pCO2 6.6 mmHg) as
      well as raised anion residue (43 mmol/l) and the presence of oxalates in urine
      suggested poisoning by ethylene glycol contained in antifreeze liquid. Intensive
      haemodialysis adequately eliminated ethylene glycol and its toxic metabolites
      (glycol aldehyde, glycolic acid). Renal function returned within 10 days,
      although the concentrating power of the kidney remained impaired for several
      weeks because of interstitial nephritis. The intoxication had been caused by a
      defective heating-pipe system from which the antifreeze had leaked into the hot
      water boiler (the patient had habitually prepared hot drinks by using water from
      the hot-water tap). Gas chromatography demonstrated an ethylene glycol
      concentration of 21 g per litre of water.

PMID- 8482241
TI  - [Multimodal therapy concepts in esophageal carcinoma].

PMID- 8482242
TI  - [The warning of a chief physician against breach of the service regulations. The
      judgement of the Kempten Labor Court of 6 August 1992].

PMID- 8482243
TI  - [Spring fatigue?].

PMID- 8482244
TI  - [Anticoagulation in ischemic cerebral infarct?].

PMID- 8482245
TI  - [Regional hyperthermic fibrinolytic perfusion].

PMID- 8482246
TI  - [The fibronectin content of the bile].

PMID- 8482247
TI  - [The late results following heart transplantation].

PMID- 8482248
TI  - The increasing importance of allergy.

PMID- 8482249
TI  - Osteomas of the external auditory canal.

PMID- 8482250
TI  - Gastroesophageal reflux laryngitis.

PMID- 8482251
TI  - Allergic arthritis.

PMID- 8482252
TI  - Sudden cardiac arrest during adenotonsillectomy in a patient with subclinical
      Duchenne's muscular dystrophy.
AB  - We describe a four-year-old boy of Indian descent who had elective
      adenotonsillectomy for chronic sore throat and partial airway obstruction. About
      10 minutes into the procedure, the patient suddenly developed cardiac asystole.
      After prolonged cardiac resuscitation, recovery was achieved. No permanent
      neurologic deficits resulted. The child was later found to have a strong family
      history of Duchenne's muscular dystrophy (DMD) and an elevated serum creatine
      kinase level documented since shortly after birth. We reviewed several case
      reports substantiating the risk for cardiac arrest during general anesthesia in
      DMD patients, and we concluded that DMD is a little-known risk for cardiac arrest
      during general anesthesia. The otolaryngologist must be aware of this potential
      complication, because tonsillectomy and adenoidectomy are commonly indicated for
      children at an age when DMD may be subclinical.

PMID- 8482253
TI  - Indirect microsurgery of the vocal folds--videostroboscopy vs. microstroboscopy.
AB  - In spite of the great significance of direct microlaryngeal surgery (DML), the
      inadequacies of this technique are evident. In order to avoid surgical trauma and
      introduce functional control during surgery, indirect microstroboscopic (IMS) and
      indirect videostroboscopic surgery (IVS) of the vocal folds are advocated. Both
      of these meet most criteria for surgical work in this field. The aim of this work
      was to make a comparative study of these techniques. The study is based on 603
      operations conducted for benign lesions of the vocal folds. We are of the opinion
      that indirect vocal fold surgery for small benign lesions has significant
      advantages when compared with the conventional microlaryngoscopy, including laser
      surgery, which was proven elsewhere. When comparing these two indirect surgical
      approaches, the principal advantages of IVS surgery over the IMS method are
      easier surgical manipulation and better view. With respect to other areas of
      comparison, these techniques are quite similar. As complementary methods to
      conventional microlaryngoscopy, we believe that both IVS and IMS surgery should
      be used in practice.

PMID- 8482254
TI  - Functional parathyroid cyst and hypocalciuric hypercalcemia.
AB  - Parathyroid cysts are uncommon. They can be divided into functional and
      nonfunctional cysts depending on whether or not they are associated with
      hypercalcemia. Functioning cysts are very rare with less than twenty reported
      cases. We report a case of functioning parathyroid cyst associated with
      hypocalciuric hypercalcemia. We have been unable to find a similar case
      previously reported in the literature.

PMID- 8482255
TI  - The use of Merocel for temporary medialization of the middle turbinate during
      functional endoscopic sinus surgery.

PMID- 8482256
TI  - Pharyngeal pouch carcinoma.
AB  - Malignant change occurs in 0.3-10% of pharyngeal pouches, with longstanding
      pouches most at risk. Contrast radiology and endoscopy can detect large and
      medium sized tumors but are inadequate for small lesions and carcinoma in situ.
      Expectant treatment and conservative surgery fail to provide an excised pouch for
      histological analysis and small lesions may be missed. Consequently, careful
      consideration must be given to radical excision, particularly if the pouch has
      been longstanding. The role of radiotherapy in conjunction with surgery remains
      unproven.

PMID- 8482257
TI  - Can Rinne's test quantify hearing loss?

PMID- 8482258
TI  - Evaluating the lease vs. purchase decision.
AB  - Each individual lease vs. purchase situation should be analyzed using the Net
      Present Value evaluation Method proposed to decide which method of financing is
      best for a particular practice. As this article is not designed to be a
      comprehensive resource on lease vs. purchase decision making, it is hoped that
      this model can be a starting point for you and your financial manager to develop
      a NPV/lease vs. purchase model that is more relevant to your practice.

PMID- 8482259
TI  - Training in tympanoplasty.

PMID- 8482260
TI  - Serous otitis media.

PMID- 8482261
TI  - Vocal fold varicosities.

PMID- 8482262
TI  - Staging in cholesteatoma surgery.
AB  - The closed technique is the treatment of choice for middle ear cholesteatoma in
      the opinion of the author. Several interventions may be required. At the onset,
      the purpose of the systematic second stage procedure was to verify the absence of
      any residual cholesteatoma. Experience has shown that the interest of this second
      intervention lies equally in the opportunity to observe the evolution of the
      otitis disease process, and the tubal status and in the possibility of restoring
      transmission under optimal conditions, thanks in particular to the utilization of
      thick silastic sheeting. This technique necessitates, however, a long-term follow
      up. On occasion, a third intervention may be required. Despite the iterative
      nature of this surgery, it should be considered as a form of a logical
      progression offering the best chances of a successful anatomic and functional
      outcome for the patient.

PMID- 8482263
TI  - Findings in revision myringoplasty.
AB  - Findings in 38 revision myringoplasty operations were studied. Fascial grafts
      were used in all operations. The majority of immediate failures after primary
      procedures were found to be consequences of technical faults, i.e. poor anterior
      adaptation of the graft. Most of the late re-perforations were caused by atrophy
      of the graft without infection. The success rate for revision myringoplasty did
      not differ significantly from that for primary operations. It was concluded that
      better surgical techniques and better graft materials should be developed.

PMID- 8482264
TI  - Predominance of left ear in Meniere's disease, sudden deafness, inner ear damage,
      tinnitus and abnormally patent eustachian tube.

PMID- 8482265
TI  - The role of retraction pockets in cholesteatoma development: an ultrastructural
      study.
AB  - Persistent retraction pockets causes erosion by adhering to ossicles and other
      structures of the middle ear. These are characterized by lysis of fibrous layer.
      Being in contact the squamous epithelium and the middle ear mucosa, it comprises
      the precursor mechanism of cholesteatoma. The present study discards the
      classical theories assuming epithelial migration through marginal or attic
      perforation; and demonstrates that these secondarily develop as a result of
      cholesteatoma. Retraction pocket specimens obtained from 10 cases of adhesive
      otitis media were examined with light and transmission electron microscopy and
      the presence of papillary ingrowth of the squamous epithelium was demonstrated.

PMID- 8482266
TI  - Future directions in sleep research: a respiratory physician's perspective.

PMID- 8482267
TI  - Squamous cell carcinoma of the nasal septum mucosa.
AB  - Primary squamous cell carcinomas of the nasal septum constitute only 9% of all
      malignant tumors of the nasal cavity. We present 16 cases occurring during a 14
      year period. As the initial signs of these carcinomas are no different from non
      neoplastic disease, a high index of suspicion is necessary in order to correctly
      diagnose these lesions. It seems to us that when the diagnosis of nasal septum
      carcinoma is established, the best method of treatment is wide surgical excision
      and immediate repair of the defect by a split-skin graft.

PMID- 8482268
TI  - A communication from the People's Republic of China: management of labyrinthine
      fistula with cholesteatoma.
AB  - Management and results in 43 cases of labyrinthine fistula with cholesteatoma are
      presented and discussed. The choice of surgical procedure is based on the
      presence or absence of infection; the size and location of the fistula; condition
      of the other ear; cochlear function, and condition of the stapes. Unchanged bone
      conduction has been obtained in 88% of our 43 surgical cases. The planned staged
      operation has produced good functional results.

PMID- 8482269
TI  - Treatment of otorrhea associated with tubes or perforations.

PMID- 8482270
TI  - Special drug communication teleconference.

PMID- 8482271
TI  - William McKim Marriott (1885-1936).

PMID- 8482272
TI  - Retinopathy of prematurity--current diagnosis and management.
AB  - Despite advances in ophthalmological care of premature infants, retinopathy of
      prematurity (ROP) remains a still unsolved problem for paediatricians as well as
      ophthalmologists. A survey of the current literature concerning drug therapy and
      surgical management as related to the different stages of ROP is given. The
      classification system for ROP according to the International Committee is
      presented as well as our screening policy in relation to the literature. The
      effectiveness in preventing severe cases of ROP and the toxicity of vitamin E
      supplementation in high-risk premature infants is still disputed and no
      recommendations can be given. Cryotherapy is recommended in symmetric cases of
      stage 3 + ROP. Nevertheless, quite a number of eyes still progress to more severe
      stages of ROP. Scleral buckling procedures and vitrectomy may lead to anatomical
      success in a few cases of retinal detachment, however, the visual outcome of such
      an operation is usually very poor despite reattachment of the central retina.

PMID- 8482273
TI  - Phytophotodermatitis mimicking child abuse.
AB  - A 13-month-old girl presented with red finger marks on both shoulders thought
      initially to be secondary to child abuse. The appearance of the marks was not
      typical of bruising of the stated age and there were no social concerns or other
      medical features of child abuse. Direct questioning revealed that the mother had
      been gardening on a sunny day and had picked the child up prior to the appearance
      of the marks. The marks are thought to represent a phytophotodermatitis. Many
      paediatric skin conditions can mimic child abuse. Recognition of this further
      possibility will prevent avoidable errors of diagnosis.

PMID- 8482274
TI  - Does constitutional delayed puberty cause segmental disproportion and short
      stature?
AB  - We have reviewed the growth of 98 boys and 34 girls with constitutional delay of
      growth and puberty followed until final height. At presentation chronological age
      was 14.1 (1.3) years (SD) in the boys and 13.0 (1.3) years in the girls. At
      presentation all patients were either prepubertal or in early pubertal maturation
      (4 ml testicular volume in the boys and breast stage II in the girls). Twenty
      nine boys (30%) and 2 girls (6%) were treated with either sex or anabolic
      steroids. Mean height SDS in the boys at presentation was -2.7 (0.7) which rose
      to -1.9 (0.9) at final height attainment. This was significantly lower than the
      predicted final height SDS of -1.4 (0.8) and mid-parental height SDS of -0.5
      (0.7). Similar results were obtained for the girls with a height SDS at
      presentation of -3.2 (0.8) which increased to -2.3 (0.7) at final height which
      was significantly lower than predicted final height SDS of -1.7 (0.6) and mid
      parental height SDS of -0.8 (0.8). Both sexes had a relatively short sitting
      height at presentation; sitting height SDS -3.4 (1.0) and subischial leg length
      SDS -2.2 (1.0) in the boys and sitting height SDS -3.6 (1.1) and subischial leg
      length SDS -2.5 (0.7) in the girls. The relative disproportion between the
      segments had no significant change at final height. We are unable to explain the
      failure to achieve final height potential and the relatively disproportionate
      stature. Our data suggest that the late timing of the onset of puberty may be
      deleterious to spinal growth and consequently final height.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8482275
TI  - The long-term effect of cyproterone acetate on growth in girls with idiopathic
      precocious puberty. Androcur Study Group in Japan.
AB  - To define the effect of cyproterone acetate (CPA) on statural growth, 25 girls
      with idiopathic precocious puberty who had been treated with CPA were studied
      retrospectively. The final height SDS was -1.12 +/- 1.16 (mean +/- SD). The daily
      CPA dose was negatively related to the final height SDS. We divided our subjects
      into two groups according to the daily CPA dose [low dose, 84.9 +/- 15.4 mg/m2 (n
      = 19) vs high dose, 135.8 +/- 17.1 mg/m2 (n = 6)]. In the low dose group, the
      difference of the final height SDS minus height SDS for bone age at the
      initiation of CPA treatment was 0.55 +/- 1.16 and final height SDS was -0.82 +/-
      1.05. The final height was not significantly different from the target height in
      the low dose group subjects whose target heights were obtained. Since the
      increment of height age to the increment of bone age during the treatment was
      significantly less in the group needing and treated with high dose CPA, high
      doses of CPA may reduce growth velocity more than its suppressive effect on bone
      maturation. These results suggest that CPA has an effect on statural growth in
      girls whose clinical symptoms can be controlled with a low dose of CPA, although
      they have not been compared with final height in untreated Japanese girls.

PMID- 8482276
TI  - Clinical settings and vasopressin function in hyponatraemic children.
AB  - Hyponatraemia is one of the most common electrolyte abnormalities in hospitalised
      children. In a prospective study we tested whether hyponatraemia is associated
      with sustained release of the antidiuretic hormone arginine vasopressin (AVP).
      Out of 27 children with persistent hyponatremia (serum sodium < 130 mmol/l), 25
      had measurable plasma concentrations of AVP [median and quartiles 5.0 pg/ml (1.5
      8.3)]. Volume contraction as consequence of sodium loss caused hyponatraemia in
      16 patients. Hyponatraemia in the presence of extracellular volume expansion and
      reduced effective arterial blood volume occurred in 5 patients. Only 3 patients
      had normovolaemic hyponatraemia (so-called syndrome of inappropriate antidiuretic
      hormone secretion) and 3 suffered from chronic renal failure. It is concluded
      that plasma AVP concentration is measurable in most children with hyponatraemia.
      Non-osmotic stimulation of AVP release and lack of suppression of this hormone is
      an important pathogenetic mechanism of hyponatraemia in children.

PMID- 8482277
TI  - A regional experience of red cell aplasia.
AB  - The incidence and current management of red cell aplasia in children was
      determined from a retrospective survey of haematologists and paediatricians in
      the northern health region of England over a 7-year period. Thirty-three children
      were diagnosed: 4 had Diamond Blackfan anaemia, 22 transient erythroblastopenia
      of childhood, and 7 parvovirus B19 aplasia, with annual incidences of 1, 5 and 2
      per 1,000,000 children respectively. Many were over-investigated. Three with
      Diamond Blackfan anaemia were steroid responsive. One with transient
      erythroblastopenia was retrospectively diagnosed because anaemia did not recur
      after steroids were stopped. Transient erythroblastopenia is the most common
      single cause of red cell aplasia in immunocompetent children. Time, observation
      and bone marrow examination before steroid therapy are the ways to distinguish
      transient erythroblastopenia from Diamond Blackfan anaemia or leukaemia.
      Interpretation of red cell indices using age-related percentiles may reduce the
      number of inappropriate investigations of the anaemia, but is often unhelpful in
      distinguishing the various causes of red cell aplasia.

PMID- 8482278
TI  - Cytokines predict coronary aneurysm formation in Kawasaki disease patients.
AB  - In this study, we measured serially the serum levels of cytokines including
      interleukin-6 (IL-6), IL-8, soluble IL-2 receptor (sIL-2R) and tumour necrosis
      factor alpha (TNF-alpha) in 60 patients with Kawasaki disease (KD) and evaluated
      the clinical significance of these cytokines in predicting coronary aneurysm
      formation. Of the 60 patients, 12 were complicated with coronary aneurysm. Blood
      samples were collected within the 1st week after onset of fever, then once a week
      for the 1st month, and once a month for another 5 months. The serum levels of IL
      6, IL-8, sIL-2R and TNF alpha were measured using an ELISA or RIA method. Our
      results show that the changes in serum IL-6 and IL-8 were faster than those of
      sIL-2R and TNF alpha. Within the 1st week, the serum levels of IL-6 and IL-8 were
      significantly higher in the patients with than in those without coronary aneurysm
      (P < 0.001). In addition, the serum levels of IL-6 and IL-8 obtained in the 1st
      week were highly correlated (P < 0.001) with those of C-reactive protein and
      erythrocyte sedimentation rate, and the serum levels of sIL-2R and TNF alpha were
      also increased at the 1st week reaching the highest level in the 2nd week. In the
      2nd week, the serum levels of sIL-2R and TNF alpha were significantly higher in
      the patients with than in those without coronary aneurysm (P < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8482279
TI  - A Japanese family of X-linked auto-immune enteropathy with haemolytic anaemia and
      polyendocrinopathy.
AB  - Three cases of X-linked auto-immune enteropathy with haemolytic anaemia and
      polyendocrinopathy are described from one related Japanese kindred. Two boys had
      died due to severe diarrhoea accompanied by total or subtotal intestinal villous
      atrophy. In contrast, although one patient showed the same symptoms and had
      circulating IgG antibodies against enterocytes, his condition improved
      dramatically and he developed well following the use of cyclosporin A (CSA). CSA
      may be beneficial in patients with this rare disorder. Auto-immune enteropathy
      should be considered as a cause of protracted diarrhoea with unknown aetiology.

PMID- 8482280
TI  - Unmasking of latent hypoparathyroidism in a child with partial DiGeorge syndrome
      by ethylenediaminetetraacetic acid infusion.
AB  - DiGeorge syndrome is a rare congenital anomaly with a wide range of clinical
      manifestations. This syndrome is usually associated with hypocalcaemia resulting
      from primary hypoparathyroidism. We report here a case of an 8-year-old boy with
      partial DiGeorge syndrome who presented initially with neonatal hypocalcaemia,
      but was subsequently normocalcaemic. Latent hypoparathyroidism was unmasked by a
      diagnostic EDTA infusion resulting in hypocalcaemia without a parathyroid hormone
      response. We propose that EDTA infusions can be useful in the diagnosis of latent
      hypoparathyroidism in children.

PMID- 8482281
TI  - Heterogeneity of Clostridium difficile isolates from infants.
AB  - In order to improve our understanding of the role of Clostridium difficile in
      infants we characterised the strains isolated from this population. The
      production of toxin A and toxin B was studied. The toxin A, playing a major role
      in the disease, was searched for in faecal samples. The serogroup of the isolates
      was determined because some serogroups have been shown to be more pathogenic than
      others. Over a 9-month period, 102 faecal samples from 102 hospitalised infants
      (0-12 months) were analysed and 26% of the children were colonised with C.
      difficile. Fifteen isolates secreted neither toxin A nor B (62.5%). Nine isolates
      were toxigenic and secreted both toxins (37.5%). Of the eight toxigenic strains
      tested, six were from serogroup H and two serogroup K. Of the 13 nontoxigenic
      strains tested, 8 belonged to serogroup D, 2 to serogroup X, and 1 each to
      serogroup A, serogroup B and serogroup C. Three infants out of 102 studied had
      toxin A in their faeces. In summary, the infants can be colonised by (1)
      nontoxigenic strains, most of them from nonpathogenic serogroup D, without toxin
      A in the faeces; (2) toxigenic strains of virulent serogroups H and K, with or
      without toxin A in the faeces. Although some infants had diarrhoea, none needed a
      specific treatment for C. difficile. No specific C. difficile pathology could be
      retained and different mechanisms are advanced to explain this absence of
      pathogenicity.

PMID- 8482282
TI  - Acute endocarditis following pneumococcal meningitis.
AB  - Acute mitral valve endocarditis, presenting as a new murmur and haematuria,
      complicated pneumococcal meningitis in a 20-month-old child with a normal heart.
      Awareness of this rare complication of pneumococcaemia and its early diagnosis,
      using cross-sectional echocardiography, improves the clinical outcome of a
      condition associated with a high mortality.

PMID- 8482283
TI  - Bacterial-induced activation of erythrocyte T-antigen complicating necrotising
      enterocolitis: a case report.
AB  - Erythrocyte Thomsen-Friedenreich crypt antigen (T-antigen) activation is not an
      uncommon event in infants with severe necrotising enterocolitis (NEC).
      Transfusion of these infants with blood products containing plasma carries the
      risk of causing intravascular haemolysis. T-antigen activation is easily detected
      using a rapid simple lectin agglutination test. Early recognition of T-antigen
      activation ensures the correct choice of plasma free transfusion therapy. We
      describe an infant with severe NEC complicated by T-antigen activation and
      haemolysis.

PMID- 8482284
TI  - Campomelic dysplasia--an underdiagnosed condition?
AB  - Campomelic dysplasia (CD) is a rare skeletal dysplasia. The incidence, reported
      in the literature, is 0.05-0.09 per 10,000 live births. During the period
      December 1985-December 1990 there were 18,350 live births with 4 cases of CD at
      Aker University Hospital in Oslo, Norway. This gives an incidence of CD in our
      observation period of 2.2 per 10,000. Eliminating our first case, because of
      Pakistani decent, the total incidence is 1.6 per 10,000 among Norwegian infants
      which is much higher than the incidence previously mentioned. Perhaps CD is under
      reported and a high proportion of patients remain undiagnosed. We present four
      cases and discuss the incidence.

PMID- 8482285
TI  - Carnitine palmitoyl transferase I deficiency presenting as a Reye-like syndrome
      without hypoglycaemia.
AB  - An apparently healthy girl aged 2 years 9 months developed a coma with
      hepatomegaly within 24 h after an influenza-like infection. Plasma glucose and
      urinary organic acid profile were normal but plasma and urinary carnitine
      concentrations were increased. Despite symptomatic therapy, she died 11 days
      later. Oxidation of [1-14C] palmitic acid in the patient's fibroblasts was
      severely decreased (13% of controls). Further investigations revealed a
      deficiency of carnitine palmitoyl transferase I (CPT I) in the patient's
      fibroblasts (15% of controls) whereas CPT II activity was normal. Only four
      patients with CPT I deficiency have been reported so far. The subtle clinical and
      biochemical presentation of this disorder, which may account for the small number
      of cases diagnosed, is discussed.

PMID- 8482286
TI  - Isolated defect of peroxisomal beta-oxidation in a 16-year-old patient.
AB  - We describe a 16-year-old boy suffering from psychomotor retardation,
      sensorineuronal hearing impairment, peripheral neuropathy, hepatosplenomegaly,
      short stature and delayed puberty. Postnatally, muscular hypotonia, mild facial
      dysmorphism and delayed fontanelle closure had been noticed. At the time of our
      examination, adrenal cortical function was normal. Biochemical analysis revealed
      accumulation of very long (> C22) chain fatty acids in plasma and fibroblasts.
      Furthermore, elevated levels of intermediates of bile acid synthesis and phytanic
      acid were detectable. These findings are consistent with a defect in the
      peroxisomal beta-oxidation system. A generalised defect of peroxisomal function
      was excluded by normal plasmalogen levels in erythrocytes and normal plasmalogen
      de novo synthesis in fibroblasts. Immunoblotting of the peroxisomal beta
      oxidation enzymes gave normal results suggesting retained immunoreactivity but
      catalytic inactivity of one of the enzymes involved, probably either the
      trifunctional protein or the peroxisomal ketothiolase. This case markedly differs
      clinically from the few published reports on isolated deficiencies of peroxisomal
      beta-oxidation. Among the patients with comparable biochemical findings, this is
      the first report of survival into adolescence.

PMID- 8482287
TI  - Glucose metabolism in a term infant with transient hyperinsulinism and high
      carbohydrate intake.
AB  - Transient hyperinsulinaemia is a well-known cause of hypoglycaemia in newborn
      infants. The hypoglycaemia may be caused by a decreased glucose production and/or
      an increased glucose uptake. Whether the increased uptake is caused by increased
      glucose oxidation or increased non-oxidative disposal is not known. The aim of
      this study was to investigate the fate of the large amount of glucose infused in
      a term infant who developed hypoglycaemia due to transient hyperinsulinaemia
      shortly after birth and was treated with high glucose infusions. On day 6 an
      indirect calorimetry study was performed, together with a glucose turnover study.
      Carbohydrate intake was 13.6 mg/kg per minute (19.6 g/kg per day). Both studies
      were repeated on day 11, when carbohydrate intake was normalised to 7.8 mg/kg per
      minute (11.2 g/kg per day). Glucose oxidation was 28% higher and non-oxidative
      glucose disposal was 257% higher on day 6 as compared to day 11. Our results
      indicate that hypoglycaemia during hyperinsulinism is the result of increased non
      oxidative disposal of glucose and not increased glucose oxidation. The results
      indicate a remarkable capacity of the newborn for lipogenesis during high
      carbohydrate intake.

PMID- 8482288
TI  - Non-specific elevation of immunoreactive trypsinogen in sick infants.
AB  - To determine the effect of neonatal illness on immunoreactive trypsinogen (IRT)
      levels, the IRT values obtained in sick infants transferred to a neonatal
      intensive care ward were compared with those found in matched controls. IRT
      levels from dried blood spots collected on day 4-5 of life from 372 sick infants
      had a mean value of 0.095 log transformed multiples of the median, whilst
      controls had a mean of -0.013: a highly significant difference. Classification of
      the sick infants into principal diagnostic categories failed to show any group
      contributing disproportionately to the observation. In particular, the level of
      elevation observed in 33 infants with gut abnormalities such as bowel
      obstruction, duodenal atresia, exomphalos and gastroschisis, in which some degree
      of pancreatic obstruction might be expected, was not greater than in other
      hospitalised infants. These data show that sick infants are at increased risk of
      being identified by an IRT screening programme aimed at detecting infants with
      cystic fibrosis.

PMID- 8482289
TI  - Determinants of oxygenation during high frequency oscillation.
AB  - Two studies are reported in which the aim was to assess whether oxygenation on
      transfer to or during high frequency oscillation (HFO) was influenced by the mean
      airway pressure (MAP) level. Sixteen infants, median gestational age 28 weeks,
      were recruited into the first study and 14 with a median gestational age of 29
      weeks into the second. In the initial study, blood gases were measured
      immediately before and 30 min after transfer to HFO and comparison made of those
      infants in whom oxygenation did or did not improve. In the second study the
      infants were studied at two MAP levels, 2 and 5 cmH2O, above that used during
      conventional ventilation (baseline MAP) and at two frequencies (10 and 15 Hz),
      arterial blood gases were measured after 20 min on each setting. In the initial
      study, on transfer to HFO, oxygenation improved by a median of 21 mmHg in eight
      infants, but was either unchanged or deteriorated (n = 7) in the other eight
      infants, the median impairment in oxygenation was by 17 mmHg. The infants in whom
      oxygenation improved had required a significantly higher MAP during conventional
      ventilation than the rest of the study group. In the second study, increasing the
      MAP from 2 to 5 cmH2O above baseline resulted in a significant increase in
      oxygenation, which was significantly greater at 10 rather than 15Hz. Infants
      whose MAP remained below 13 cmH2O had impaired oxygenation during HFO compared to
      that experienced during conventional ventilation. The results of these two
      studies demonstrate that the MAP level during HFO is an important determinant of
      oxygenation.

PMID- 8482290
TI  - Long versus standard prednisone therapy for initial treatment of idiopathic
      nephrotic syndrome in children. Arbeitsgemeinschaft fur Padiatrische Nephrologie.
AB  - Two regimens of steroid treatment for the initial attack of idiopathic nephrotic
      syndrome (NS) in children were compared in a controlled prospective multi-centre
      study. Long prednisone therapy consisted of 60 mg/m2 per 24 h for 6 weeks,
      followed by alternate day 40 mg/m2 per 48 h for 6 weeks. The standard prednisone
      therapy was 60 mg/m2 per 24 h for 4 weeks, followed by 40 mg/m2 per 48 h for 4
      weeks. A total of 71 children with an initial attack of idiopathic NS were
      allocated at random to the two groups. The cumulative rate of patients with
      sustained remissions after 2 years was significantly higher after the long course
      than after the standard treatment (49% vs 19%, P = 0.0079). The mean relapse rate
      per patient at intervals of 3, 6 and 12 months was lower in the long-course
      prednisone group than in the standard prednisone group, and the proportion of
      children with frequent relapses during any subsequent 6 months period was lower
      in the long-course group than in the standard group (29% vs 57%, P = 0.03). Mild
      side-effects of corticosteroid therapy were observed more frequently after long
      course prednisone treatment. It is concluded that long-course prednisone therapy
      of the initial attack of steroid responsive NS is preferable to the standard
      regimen because it reduces the rate of subsequent relapses without increasing the
      risk for severe steroidal side-effects.

PMID- 8482291
TI  - Qualitative changes in general movements and their prognostic value in preterm
      infants.
AB  - Qualitative assessments of general movements have been shown to have considerable
      power in predicting neurological outcomes in preterm infants with brain damage.
      In the present study such assessments were made in 35 preterm infants without
      major neurological problems before term age, born between 27 and 34 weeks
      gestation, of whom 12 were small-for-gestational-age (SGA). Most infants
      maintained a normal or (mildly) abnormal quality from 35 weeks postmenstrual age
      through 6, 12, 18 to 24 weeks corrected age. Seven changed from initially
      abnormal movements to a normal quality, six of them after 12 weeks. Differences
      between SGA and appropriate-for-gestational-age infants became less evident with
      age, particularly after 12 weeks. This was not the case when comparisons were
      made on the basis of gestational ages below or above 32 weeks. The prediction of
      neurological and mental outcomes at 1 year also improved after 12 weeks, around
      which age a major transformation in neural functions occurs. It is concluded that
      assessments of movement quality are particularly successful in predicting
      abnormal outcomes in comparison to examinations based on muscle tone and elicited
      responses.

PMID- 8482292
TI  - Sibling cases of a degenerative neurological disease associated with
      hypocupraemia and hypobetalipoproteinaemia.
AB  - We describe two siblings, a boy and his younger sister, with degenerative
      neurological disturbances, hypocupraemia and hypobetalipoproteinaemia. The
      neurological features in both cases were developmental delay, dysarthria,
      hyperkinetics with an attention deficit, dysdiadochokinesis, night blindness,
      myoclonic jerks and convulsions. Their serum cooper levels did not increase
      despite administration of copper sulphate both orally or intravenously. The
      copper contents of the cultured fibroblasts in the patients were 1.5-fold that of
      controls. Although neurological disorders associated with abnormal copper
      metabolism and inherited in an X-linked manner have been previously reported,
      this is the first report of a neurodegenerative disease concurrent with abnormal
      copper metabolism and hypobetalipoproteinaemia.

PMID- 8482293
TI  - Intravenous immunoglobulin in two children with Guillain-Barre syndrome.
AB  - Two children with Guillain-Barre syndrome were successfully treated with high
      dose intravenous immunoglobulin (IVIG) and no relapses occurred over a 1 year
      follow up. No side-effects were observed. These data provide further evidence
      that IVIG may be safely and effectively employed in children with Guillain-Barre
      syndrome.

PMID- 8482294
TI  - The cost associated with intraperitoneal versus subcutaneous administration of
      erythropoietin.

PMID- 8482295
TI  - Ethnic differences in Helicobacter pylori infection.

PMID- 8482296
TI  - 3-Methylglutaconic aciduria in a patient with Pearson syndrome.

PMID- 8482297
TI  - Acute sensorineural deafness following herpes simplex infection.

PMID- 8482298
TI  - Pseudohyperkalaemia in Kawasaki disease.

PMID- 8482299
TI  - Hyponatraemia in "water babies": an underestimated problem?

PMID- 8482300
TI  - The synergistic effect of trauma and infection on interleukin-1 but not tumor
      necrosis factor liberation during posttraumatic gram-negative septicemia.
AB  - The release profiles of interleukin 1 (Il-1) and tumor necrosis factor (TNF) were
      studied during experimental Escherichia coli septicemia and peritonitis with and
      without a preceding (-48 h) moderate trauma (femur marrow nailing). The trauma
      alone did not induce significant Il-1 or TNF liberation to plasma. During
      septicemia, a rapid IL-1-rise (+30 min) and subsequent normalization (+120 min)
      was seen. A previous trauma delayed (30 min), but accentuated (2x) and prolonged
      (> 4 h) the Il-1 response. During peritonitis, a delayed (30 min) but otherwise
      similar Il-1-response was observed. TNF levels rose rapidly (+30 min) in all
      animals, and remained high throughout the experimental period (6 h). The trauma
      did not influence the TNF response. We conclude that a synergism exists between
      trauma and infection with regard to the magnitude of the Il-1 response.

PMID- 8482301
TI  - The role of bile and bile acids in bacterial translocation in obstructive
      jaundice in rats.
AB  - Male Sprague-Dawley rats were randomly divided into five groups in which group 1
      received a sham operation (controls), groups 2-5 underwent common bile duct
      ligation and transection 14 days before the experiments. Two days prior to the
      studies, animals in groups 1 and 2 received saline orally, while groups 3-5
      received an oral administration of either cholic acid, deoxycholic acid or whole
      bile. Specimens were taken for bacterial culture, and blood was collected for
      endotoxin assay. The rate of positive bacterial cultures from mesenteric lymph
      nodes in jaundiced saline-treated animals was significantly higher (p < 0.05) as
      compared with both controls and the other jaundiced animals treated with either
      bile or bile acids. Assays were positive for endotoxin in the jaundiced saline
      treated group, whereas they were negative in both controls and bile- or bile-acid
      treated animals. We conclude that oral administration of cholic acid, deoxycholic
      acid or whole bile inhibited bacterial translocation and endotoxin absorption in
      obstructive jaundice in the rat.

PMID- 8482302
TI  - Feline intestinal ischemia and reperfusion: relation between radical formation
      and tissue damage.
AB  - Experimental ischemia of 15, 30, or 60 min length, followed by 30 min of
      reperfusion, was produced in situ in the cat small intestine by means of an
      adjustable arterial clamp. Arterial perfusion pressure was lowered to such an
      extent that intestinal blood flow decreased from about 25 to 3.5 ml x min-1 x 100
      g-1. The rate of free radical formation was followed intermittently with ESR and
      a modified spin trapping technique in the control period prior to ischemia and at
      various times during reperfusion. Upon reperfusion radical formation increased
      above the preischemic control value in all three series of experiments.
      Cumulative radical production during the 30 min reperfusion period rose from
      about 3 mumol x 100 g-1 after 15 min ischemia to approximately 4.5 mumol x 100 g
      1 after 30 min and 8-10 mumol x 100 g-1 after 60 or 120 min ischemia. At the same
      time mucosal damage became more pronounced, suggesting a causal connection
      between tissue damage and radical formation. More specifically, radical
      production was strongly correlated to histological damage occurring during
      reperfusion as seen when comparing radical production in animals not experiencing
      reperfusion damage to those who did. Radical formation in these two groups were
      0.35 and 9.0 mumol x 100 g-1, respectively (p < 0.0005).

PMID- 8482303
TI  - Impact of ischemia on tissue oxygenation and wound healing: intravital
      microscopic studies on the hairless mouse ear model.
AB  - To determine the effect of ischemia on tissue oxygenation and the healing of
      experimental wounds, chronic ischemia was induced in the ears of hairless mice by
      ligating 2 of the 3 main nutritional arteries. Tissue ischemia was verified by
      measurement of transcutaneous pO2 (tcpO2) prior to and on days 3, 6, 9, 12 and 15
      after vessel ligation. TcpO2 values decreased from 24 to 6 mm Hg at day 2 after
      ligation, and slowly recovered to 12 mm Hg at day 12 after vessel ligation. In
      animals treated with the vasoactive drug buflomedil (3 mg/kg BW i.v., startling 2
      days after vessel ligation) tcpO2 values were significantly higher on days 6 and
      9 when compared to saline-treated control animals. In order to find out whether
      the enhanced tissue oxygenation resulted in enhancement of healing of wounds, we
      created circular wounds (diameter = 2.5 mm, depth 0.1 mm) on ischemic ears 2 days
      after vessel ligation. The wound surface area was measured by means of intravital
      fluorescence microscopy and digital planimetry at 3-day intervals until the time
      of wound closure. These experiments were performed on buflomedil-treated and
      control animals receiving equivalent amounts of saline. The reduction of wound
      surface area was accelerated and wound closure time was reduced from 15 days in
      control animals to 12 days in buflomedil-treated animals (p < 0.01). Functional
      capillary density as well as the microhemodynamic parameters microvessel diameter
      and red blood cell velocity were not different between buflomedil-treated and
      control animals.

PMID- 8482304
TI  - Bursting strength of experimental colonic anastomoses. A methodological study.
AB  - This study was performed to evaluate the validity of the bursting strength test
      of experimental anastomoses. By a combination of measuring the intraluminal
      physiological pressure during the test procedure with a radiological detection of
      the anastomosed intestinal segment until disruption it was demonstrated that the
      bursting pressure is a meaningful parameter since the maximum pressure equals the
      time of anastomotic leak. At day 6 60% of the tested segments disrupted outside
      the anastomotic line. This indicates that the bursting strength test is not a
      valid measure for determining the strength of colonic anastomoses after the 4th
      to 5th postoperative day. Moreover, the bursting wall tension parameter was
      evaluated. Assessment of the anastomotic radius demonstrated significant
      differences when the anastomotic radius at disruption was determined from the
      amount of inflated contrast compared with the radius detected radiologically.
      These differences had the effect that the wall tension at burst compared with the
      wall tension determined from direct radius measurement on day 4 was 61% higher
      than the wall tension determined from the amount of inflated contrast with no
      correction for elongation of the tested segment, and 36% higher than the wall
      tension determined from the amount of inflated contrast and corrected for
      elongation of the segment. No differences in the bursting strength were found
      between inflation rates of 2.5 and 5.0 ml.min-1. In conclusion, the bursting
      strength test is a meaningful parameter since the maximum physiological pressure
      equals the time of anastomotic radiological disruption, and the bursting pressure
      is a more exact parameter for measuring the bursting strength than the bursting
      wall tension.

PMID- 8482305
TI  - Myoelectric activity of an ileal isoperistaltic or antiperistaltic loop
      interposed between colon and rectum: an experimental study in pigs.
AB  - The myoelectric activity of 25-30 cm ileal loops interposed isoperistaltically or
      antiperistaltically between colon and rectum was investigated 1-3 and 20-22 weeks
      after surgery, in growing pigs chronically fitted with intraparietal electrodes
      on the loop and the ileum. The fundamental motor profile of the small intestine
      consisting of migrating myoelectric complexes (MMC) was present on both loops;
      the MMCs were propagated on the antiperistaltic loop in the original anatomical
      direction. There was no coordination between the occurrence of phase 3 on the
      loop and the ileum. Some minor differences concerning the duration, the frequency
      and the velocity of propagation of phase 3 were observed between the loops and
      the ileum. Moreover propagated clusters of spike bursts and propagated long
      duration spike bursts appeared on the isoperistaltic and antiperistaltic loop,
      respectively, but not on the ileum. No prominent differences in the motor
      profiles of the loops have been observed between 1-3 and 20-22 weeks after
      surgery. It is concluded that despite the presence of semisolid contents with an
      abundant microflora the fundamental intestinal motor profile persists in ileal
      loops interposed between colon and rectum.

PMID- 8482306
TI  - Intracerebroventricular infusion of neurotensin suppresses gastric acid secretion
      in dogs.
AB  - Synthetic neurotensin (NT) was infused intracerebroventricularly in 14 mongrel
      dogs to study the effects of the peptide on gastric secretion and on gastrin and
      NT levels. The infusion was performed with a specific apparatus, and gastric
      fluid was collected with a Pavlov pouch. NT was given in two series of
      experiments: as a bolus intracerebroventricular injection of 269.8 pmol/kg and as
      a continuous intracerebroventricular infusion at a rate of 539.6 pmol/kg/h for 30
      min. The bolus injection caused a very significant decrease of gastric fluid
      volume, a significant decrease of HCl output and a significant increase of its
      pH, while serum immunoreactive gastrin increased significantly. The continuous
      infusion of NT caused similar changes in gastric secretion. The plasma NT levels
      did not change. In conclusion, the intracerebroventricular administration of NT
      increases the serum gastrin levels, decreases the volume and HCl content of
      gastric fluid, and increases its pH.

PMID- 8482307
TI  - Comparative study of augmentin versus metronidazole/gentamicin in the prevention
      of infections after appendicectomy.
AB  - Augmentin as single agent was compared to the combination of
      metronidazole/gentamicin in the prevention of sepsis after appendicectomy. Two
      hundred patients admitted to Riyadh Central Hospital with a clinical diagnosis of
      acute appendicitis were enrolled in a prospective randomized study. All patients
      had a preoperative chest X ray, CBC, urinalysis and any other necessary
      investigations. Patients received either drug regime intravenously, 30 min prior
      to surgery. The overall incidence of wound infections in the Augmentin group was
      8% as compared to 14% in the metronidazole/gentamicin group. There were no intra
      abdominal abscesses in either group. Patients with perforated or gangrenous
      appendices received a 3- to 5-day course of treatment. All the early wound
      infection (2-4 days after operation) occurred in patients with gangrenous or
      perforated appendices. The results were studied statistically using chi 2 and
      there was no statistically significant difference between the infection rates in
      the two treatment groups whatever the state of the appendix at operation.
      Augmentin is as effective and well-tolerated as metronidazole/gentamicin in the
      prevention of wound infection following appendicectomy. The ease of
      administration of one drug with added anti-anaerobic property makes Augmentin
      superior to the tested combination.

PMID- 8482308
TI  - Comparison of two methods of autologous intrasplenic hepatocellular
      transplantation in partially hepatectomized dogs.
AB  - Autologous hepatocellular transplantation using reflux into the spleen via the
      venous tributaries was compared in 65% hepatectomized dogs to direct injection
      into the splenic pulp. Transplantation into the spleen via the inferior terminal
      polar splenic vein led to a better survival rate (50 vs. 0%). Hepatocytes
      embolization to the intrahepatic portal vein system was observed. Although
      hepatocyte transplantation into the spleen can be accomplished either by direct
      punction of the spleen or by retrograde injection into a splenic vein, the second
      method decreases the frequency of cell embolization.

PMID- 8482309
TI  - Surgical technique for cardiomyoplasty and iterative transthoracic biopsies in an
      experimental goat model.
AB  - Cardiomyoplasty is a new surgical procedure using transformed skeletal muscle to
      reinforce or substitute for the myocardium. For the purpose of studying surgical
      technique and investigating basic questions, we have developed a model of
      reinforcement cardiomyoplasty. Herein, we describe anesthetic management,
      surgical technique, and the technique for iterative transthoracic biopsies. This
      model has proven to be valuable in several long-term studies involving more than
      30 goats. Preliminary data to ascertain the efficacy of the proposed technique
      are provided.

PMID- 8482310
TI  - Valvular colonic sphincter substitutes. An experimental study in dogs.
AB  - Three types of colonic sphincter substitutes were placed at an abdominal
      colostomy in dogs. Simple valve construction (8) was based on orthograde
      intussusception of the colon over 3.5 cm. In calibrated valves (6) the
      intraluminal pressure was increased by reducing the diameter of the overlying
      muscle coat. Reverse smooth muscle plasties (5) and simple colostomies (5) served
      as controls. Immediately after construction highest pressure (50 +/- 8.9 mm Hg)
      was obtained in calibrated valves. After 1 month the pressure dropped to 20 mm
      Hg, but remained stable thereafter. Although valvular constructions cannot
      maintain high pressure, they may be useful as substitutes for the internal anal
      sphincter by filling up the lumen so that the action of a surrounding striated
      muscle ring becomes more effective.

PMID- 8482311
TI  - Effects of PGE1 in experimental vasoconstrictive pulmonary hypertension.
AB  - The pulmonary vascular and systemic effects of PGE1 were studied in a canine
      model of pulmonary hypertension. Systemic arterial, central venous and pulmonary
      arterial pressures were monitored and an electromagnetic flow probe was placed
      around the ascending aorta for continuous cardiac index (CI) measurements.
      Through a laparotomy, an arteriovenous fistula was created between the abdominal
      aorta and inferior vena cava. Gradual opening of this fistula significantly
      affected CI and these values were used to generate pressure-flow curves
      (pulmonary arterial pressure (PAP)/CI). Following PGF2 alpha infusion (5-10
      micrograms/kg/min) significant pulmonary hypertension was observed (2- to 3-fold
      increase in PAP). PGF2 alpha infusion also resulted in a significant rise in
      heart rate and systemic vascular resistance (SVR) while CI was reduced. PGF2
      alpha significantly increased both the line slope (vascular resistance) and
      intercept (outflow pressure) of the pressure-flow curves. Intravenous PGE1
      infusion in doses ranging from 40 to 320 ng/ml/min elicited a dose-dependent
      reduction of both pulmonary and systemic vascular resistances, the former being
      slightly more affected. With PGE1 infusions only the intercept of the pressure
      flow curve was affected suggesting that specific components of the pulmonary
      vascular bed modulating the outflow pressure were involved. High doses of PGE1
      significantly decreased arterial PO2, indicating that this prostaglandin
      derivative deteriorates pulmonary gas exchanges.

PMID- 8482312
TI  - Immunorestorative effect of thymostimulin on surgery immunodepression:
      experimental model.
AB  - The purpose of the present study is to ascertain the immunorestorative effect of
      two different drugs on immunodepression induced by small bowel surgical resection
      in an experimental model. The potential immunorestorative effect has been
      measured by the ability of the drug to avoid the delay of skin allograft
      rejection induced by surgery and the inhibition of CD4/CD8 index changes induced
      by surgery in spleen tissue. 120 Wistar-Furth rats (age 12-16 weeks) anesthetized
      with a single intramuscular dose of ketamine (25 mg), diazepine (4 mg) and
      atropine (0.1 mg) were allotted to two main groups. One group received a skin
      graft (SG) from Fisher 344 rats and was treated with placebo, Inmunoferon (AM-3
      polypeptidic drug) or TP-1 (thymostimulin) before the experiment (groups I, II,
      III) or treated with placebo, Inmunoferon or TP-1 before the experiment and
      underwent enterectomy and anastomosis (groups IV, V, VI). On the 2nd, 5th and 8th
      postoperative days, biopsies of the SG were taken and the signs of rejection were
      microscopically studied and evaluated by a pathologist as zero, incipient,
      moderate or massive. The other group was treated similarly, but the animals did
      not receive a SG and were splenectomized 5 days later. CD4 and CD8 lymphocyte
      subpopulations were identified by means of immunoperoxidase technique and
      monoclonal antibodies. Thymostimulin is able to stimulate the presence of SG
      rejection signs on the 2nd postoperative day in nonenterectomized animals and on
      the 8th postoperative day in nonenterectomized animals and on the 8th
      postoperative day in enterectomized rats and is able to avoid the decrease of the
      CD4/CD8 index in spleen tissue after surgical immunodepression.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8482313
TI  - In vitro studies on PMN-independent endothelial cell damage in trauma: decrease
      of PMN-endothelial cell adherence by fibrinogen degradation products and
      disturbance of endothelial cell membrane integrity by trauma serum.
AB  - Trauma favors the development of adult respiratory distress syndrome (ARDS).
      Adherence of polymorphonuclear leukocytes (PMN) to endothelial cells (EC) with
      subsequent EC damage by the respiratory burst products and proteases of the PMN
      is thought to be one of the basic mechanisms in the pathogenesis of ARDS. Recent
      studies have shown that there might also be PMN-independent mechanisms of EC
      damage. It would speak for PMN-independent EC damage if in the state of risk for
      this damage factors were found which decrease PMN activity or if EC damage
      appeared without PMN. Because in trauma and sepsis pathologic coagulation with
      high levels of fibrinogen degradation products (FDP) is often diagnosed, we
      investigated whether FDP-D and FDP-E might influence PMN adherence to EC. We also
      investigated whether serum of traumatized patients might provoke EC damage in a
      PMN-independent system in vitro. To achieve this we evaluated the viability of EC
      using a fluorescence staining method. We found that both FDP-D and FDP-E
      decreased PMN adherence to human EC significantly (p < 0.01) at a concentration
      of 50 micrograms/ml. Furthermore we found that EC membrane integrity can be
      disturbed by serum of trauma patients. These results suggest that in trauma also
      PMN-independent mechanisms are important for EC damage.

PMID- 8482314
TI  - The effect of portal hypertension on gastric epithelial proliferation in rats.
AB  - We investigated the effect of portal hypertension over time on gastric epithelial
      proliferation in rats. Portal-vein ligation (PVL) was applied to fourteen Wistar
      rats to produce experimental portal hypertension: seven rats (PVL2) had
      histological analysis after 2 months and the remaining seven (PVL4) after 4. An
      additional group of seven was employed as a control. Each rat was injected with
      bromodeoxyuridine and killed an hour later to assess gastric epithelial
      proliferation by an immunohistochemical staining technique. The labeling index
      between PVL and control animals differed significantly (p < 0.05). Labeling
      indices in fundic mucosa were 5.7 +/- 0.2% in controls, 3.9 +/- 0.3% in PVL2 rats
      and 4.0 +/- 0.3% in PVL4 rats, while in antral mucosa the corresponding figures
      were 7.5 +/- 0.6, 4.6 +/- 0.3 and 4.0 +/- 0.3%. In neither fundic nor antral
      mucosa was the total mucosal thickness significantly different between the
      control and PVL rats. In the PVL2 group, the frequency distribution of labeled
      cells showed a shift toward the mucosal surface in fundic glands. No significant
      differences between the two PVL groups were observed in any of the studied
      parameters. This study suggests that portal hypertension may inhibit gastric
      epithelial proliferation in rats.

PMID- 8482315
TI  - 27th annual scientific meeting of the European Society for Clinical
      Investigation, April 14-17, 1993, Heidelberg, Federal Republic of Germany.
      Abstracts.

PMID- 8482316
TI  - The effect of flunarizine on central nervous system oxygen toxicity in rats.
AB  - The toxicity of hyperbaric oxygen in the central nervous system is expressed by
      generalized tonic-clonic seizures. In the search for drugs effective against
      these seizures, we tested flunarizine, a calcium antagonist known to have
      antiepileptic properties and only minimal cardiovascular side effects. 49 rats
      with chronic cortical electrodes were injected i.p. with six different doses of
      flunarizine (10-300 mg/kg) or vehicle, before exposure to 0.5 MPa oxygen. Two
      doses of flunarizine and vehicle were given to rats exposed to oxygen with 5% CO2
      at an absolute pressure of 0.5 MPa. EEG and spectral analysis of background EEG
      activity were monitored. The duration of the latent period before the appearance
      of electrical discharges in the EEG was used as an index of oxygen toxicity.
      There was no statistical difference between the duration of the latent periods
      for the seven groups treated by flunarizine or by vehicle on exposure to 0.5 MPa
      pure oxygen (P = 0.9 in ANOVA), but on exposure to oxygen with CO2, there was
      significant prolongation of the latent periods in comparison with vehicle (P <
      0.001). Our results suggest that on exposure to hyperbaric oxygen, the
      antiepileptic effect of flunarizine might be masked, probably by its cerebral
      antivasoconstrictive effect.

PMID- 8482317
TI  - An evaluation of the biological significance of aluminium in plasma and hair of
      patients on long-term hemodialysis.
AB  - In hemodialyzed patients, the risk of toxicity attributed to the body
      accumulation of aluminium (Al) justifies the need for monitoring Al in various
      human media. In this study, Al concentrations in the hair and plasma of 78
      hemodialyzed patients with chronic renal failure and of 351 healthy volunteers
      were measured by electrothermal atomic absorption spectrometry with Zeeman
      effect. Plasma Al concentrations in patients were significantly higher than in
      the controls and positively correlated with time on dialysis. Hair Al levels were
      widely distributed with no significant distinction between patients and controls.
      On the subject of establishing correlation, the authors stress the importance of
      taking into account the kinetics of the elimination of minerals from hair. Even
      when this was done, in the patient group there was no statistical link between
      plasma and hair Al levels. Hair Al analysis is of no value as an indicator of
      body Al accumulation.

PMID- 8482318
TI  - Long term effects of amlodipine on organ damage, stroke and life span in stroke
      prone spontaneously hypertensive rats.
AB  - The long term effects of amlodipine, a new long acting Ca2+ channel antagonist on
      organ damage, stroke and life span, were examined in stroke prone spontaneously
      hypertensive rats (SHRSPs). Blood pressure of the SHRSPs increased over the first
      16 weeks and reached a stable level of about 250 mmHg in controls and about 200
      mmHg in the amlodipine treated group. At 15 weeks after starting amlodipine
      treatment, all control SHRSPs exhibited varying degrees of myocardial fibrosis,
      proliferative and/or necrotic vasculitis and glomerular lesions, whereas only a
      few animals in the amlodipine group showed slight lesions. The average life span
      of animals was estimated to be 43.3 weeks and 71.1 weeks for control and
      amlodipine groups, respectively, which suggested a 1.6-fold prolongation of their
      life span by amlodipine treatment. These results indicate that the long term
      treatment of amlodipine suppresses the incidence of organ damage and stroke in
      SHRSPs and prolongs their life span.

PMID- 8482319
TI  - The metabolism and activation of 15,16-dihydrocyclopenta[a]phenanthren-17-one by
      cytochrome P-450 proteins.
AB  - The in vitro metabolism and activation to mutagens of 15,16
      dihydrocyclopenta[a]phenanthren-17-one (CPP-17-one) were investigated using
      hepatic preparations from rats pretreated with prototype inducers of the
      cytochrome P-450-dependent mixed-function oxidases. Aroclor 1254-induced
      microsomes were the most effective metabolisers of this compound, the major
      metabolites being oxidation products of the bay region A ring. To a lesser extent
      hydroxylation of the non-aromatic D ring occurred, the products being the 15- and
      16-hydroxyderivatives. Oxidation of the A ring was also achieved with microsomes
      from benzo[a]pyrene-treated rats but not with those from rats treated with
      clofibrate, phenobarbitone, isoniazid, dexamethasone and CPP-17-one itself, where
      the metabolites were primarily the oxidation products of the D ring. When CPP-17
      one was used as a promutagen in the Ames test, only microsomes from Aroclor 1254
      treated rats could elicit a positive mutagenic response. When 3,4
      dihydrodihydroxy-CPP-17-one, the precursor of the ultimate mutagen, was used as
      the promutagen, a positive response was observed with microsomes from Aroclor
      1254- and benzo[a]pyrene-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482320
TI  - Toxicity of paracetamol in cultured chick hepatocytes treated with methotrexate.
AB  - Cultured chick hepatocytes were used to investigate the hepatotoxicity of
      methotrexate alone and in combination with paracetamol. Treatment with
      methotrexate alone at concentrations as high as 1 mg/ml resulted in no toxicity
      in cultured chick hepatocytes, as indicated by no detachment of cells and no
      effect on protein synthesis or on release of the intracellular enzyme lactate
      dehydrogenase. However, treatment with methotrexate alone resulted in a 30%
      decrease in reduced glutathione levels. Combined treatment with methotrexate and
      paracetamol was toxic, but only in cells preinduced for cytochrome P450 1A by
      treatment with beta-naphthoflavone. Under these conditions, methotrexate lowered
      the threshold concentration of paracetamol at which toxicity was observed. This
      methotrexate-mediated increase in paracetamol toxicity was associated with
      decreased formation of the glucuronide, sulfate and thiol metabolites of
      paracetamol and with increased covalent binding of radiolabeled paracetamol to
      macromolecules. In cells pretreated with beta-naphthoflavone, additional
      treatment with either methotrexate or buthionine sulfoximine, an inhibitor of
      glutathione synthesis, together with paracetamol, was associated with decreased
      restoration of glutathione levels. These results suggest that methotrexate
      increased paracetamol toxicity by decreasing the amount of glutathione available
      for conjugation with reactive metabolites of paracetamol.

PMID- 8482321
TI  - Cytogenetic effects of promutagens in genetically engineered V79 Chinese hamster
      cells expressing cytochromes P450.
AB  - V79 Chinese hamster cell lines genetically engineered to express rat CYP2B1,
      CYP1A1, CYP1A2, and their parental cell lines V79-MZ, without acetyltransferase,
      and V79-NH, with acetyltransferase, were studied for chromosome aberrations and
      sister chromatid exchange induced by aflatoxin B1, cyclophosphamide,
      benzo[a]pyrene, 7,12-dimethylbenz[a]anthracene and dimethylnitrosamine. The
      parental V79 cell lines did not show clastogenic effects. Significant clastogenic
      effects were observed after an 18 h exposure to aflatoxin B1 and cyclophosphamide
      in CYP2B1 expressing cells, to benzo[a]pyrene in CYP1A1 and CYP1A2 expressing
      cells, to 7,12-dimethylbenz[a]anthracene and dimethylnitrosamine in cells,
      expressing CYP1A2 with or without acetyltransferase, and to cyclophosphamide in
      cells expressing both CYP1A2 and acetyltransferase. A significant sister
      chromatid exchange inducing effect was found after a 24 h exposure in each of the
      genetically engineered cell lines, except for benzo[a]pyrene and 7,12
      dimethylbenz[a]anthracene in CYP2B1 expressing cells, and for benzo[a]pyrene in
      cells expressing both CYP1A2 and acetyltransferase. Thus, a battery of cell lines
      genetically engineered for metabolic competence may serve as a tool for
      investigating chromosomal changes induced by activated xenobiotics.

PMID- 8482322
TI  - Nicotine and its major metabolite cotinine have different effects on aldosterone
      and prolactin serum levels in the normal male rat.
AB  - Nicotine (0.01-1.0 mg/kg, i.p.) or cotinine (0.003-1.0 mg/kg, i.p.) treatment was
      administered to Sprague-Dawley male rats. The time-effect curves (5, 10, 30, 60
      and 180 min) were analyzed. Nicotine dose-dependently increased blood aldosterone
      and corticosterone levels with a peak effect 10 min after the intraperitoneal
      injection. Nicotine treatment weakly decreased serum levels of aldosterone at 2
      h, possibly as a consequence of nicotine metabolising to cotinine, resulting in
      higher serum levels of cotinine than nicotine. Cotinine dose-dependently reduced
      serum aldosterone levels, an effect which became more marked with time, leaving
      plasma corticosterone unchanged. Nicotine dose-dependently increased serum
      prolactin levels at 5 and 10 min following treatment, an effect which had
      diminished at 30 min. Cotinine dose-dependently reduced serum prolactin levels at
      5 min followed by a dose-dependent increase at 10 min after which a dose
      dependent reduction was again found after 30 min post treatment. In conclusion,
      acute nicotine and cotinine treatment produced opposite effects on aldosterone
      and prolactin serum levels. The prolonged effect of cotinine on aldosterone
      levels may be involved in changes in brain function, and may be connected to the
      development of withdrawal effects after stopping cigarette smoking. As reported
      by other investigators, nicotine produced enhanced plasma corticosterone levels
      while cotinine treatment was ineffective. Since cotinine induced marked changes
      in serum prolactin levels while leaving LH levels unchanged, it seems plausible
      that cotinine affects neuroendocrine regulation via mechanisms not primarily
      related to circulatory effects. Thus, an action at the median eminence--pituitary
      level seems likely.

PMID- 8482323
TI  - Endothelium-dependent relaxation in rabbit aorta after cold storage.
AB  - The extent of preservation of endothelial, smooth muscle and neurogenic function
      following cold storage was studied in rabbit thoracic aorta. Relaxation responses
      to acetylcholine and sodium nitroprusside were compared between fresh aortic
      rings and rings that had been stored in a refrigerator for 2-8 days at 4 degrees
      C. In fresh aortic rings, the addition of acetylcholine to precontracted vessels
      resulted in dose-dependent relaxation. The magnitude of relaxation was gradually
      decreased after 4-8 days of cold storage. Relaxation in response to sodium
      nitroprusside did not change. Following cold storage contractions of aortic rings
      in response to noradrenaline and phenylephrine were not reduced. Contractile
      responses induced by transmural nerve stimulation were gradually attenuated with
      the length of cold storage. Electron microscopy after 4 days showed partial
      damage of endothelial cells (slightly vacuolized mitochondria). After 8 days,
      endothelial cells were destroyed; only membranous material was present. The
      structure of smooth muscle cells was only partially changed even after 8 days.
      Sympathetic nerve endings on the 4th day were partially, but on the 8th day
      completely destroyed. These results suggest that after cold storage of rabbit
      aorta, the gradual reduction of endothelium-dependent relaxation is probably
      caused by a decrease in production of the endothelium-derived relaxing factor due
      to the destruction of endothelial cells.

PMID- 8482324
TI  - Comparison of cardiac actions of doxorubicin, pirarubicin and aclarubicin in
      isolated guinea-pig heart.
AB  - The cardiac actions of doxorubicin were compared with those of pirarubicin and
      aclarubicin to understand the mechanisms responsible for differences in
      cardiotoxic effects of anthracycline agents. In left atrial muscle preparations
      obtained from guinea-pig heart and stimulated at 2 Hz, anthracyclines produced
      positive inotropic effects. The magnitude of the effect was pirarubicin >
      doxorubicin > aclarubicin. The order for depression of potentiated postrest
      contraction and prolongation of the time to peak twitch tension was doxorubicin >
      pirarubicin > aclarubicin. Drug washout following a 2-h incubation with 100
      microM doxorubicin prevented a further increase in the time to peak twitch
      tension, caused a marked recovery of depressed potentiated postrest contractions,
      and augmented the positive inotropic effect. Pirarubicin and doxorubicin, but not
      aclarubicin, caused a parallel rightward shift of the dose-response curve for the
      negative inotropic effect of acetylcholine. The potency of inhibition of
      [3H]quinuclidinyl benzilate binding was pirarubicin > doxorubicin > aclarubicin.
      These results indicate that three anthracycline anticancer agents share similar
      effects on cardiac muscle contractility and on muscarinic acetylcholine
      receptors. The actions of aclarubicin were weak compared to those of doxorubicin
      or pirarubicin. Increases in the time to peak twitch tension and the depression
      of potentiated postrest contraction are apparently mediated by mechanisms
      different from those responsible for the positive inotropic effects or antagonism
      at muscarinic acetylcholine receptors.

PMID- 8482325
TI  - Hypotensive action of 5-HT receptor agonists in the vitamin B6-deficient
      hypertensive rat.
AB  - Feeding a vitamin B6-deficient diet to rats causes a moderate hypertension. The
      blood pressure responses to 5-HT1A receptor agonists were studied in conscious
      vitamin B6-deficient hypertensive rats. They were all effective in lowering blood
      pressure with the following rank order of potency: 8-hydroxy-2-(di-n
      propylamino)tetralin (8-OH-DPAT) > flesinoxan > 5-methylurapidil > urapidil. The
      putative 5-HT1A receptor antagonist spiroxatrine by itself, did not have any
      effect on the blood pressure at the doses used (0.01-1 mumol/kg). However, dose
      dependently, it antagonized the hypotensive effect of flesinoxan and urapidil.
      The alpha 1-adrenoreceptor antagonist prazosin, on prior treatment, did not
      change the hypotensive effect of either flesinoxan or urapidil. The alpha 2
      adrenoreceptor agonist clonidine dose dependently (0.01-0.1 mumol/kg) reduced
      blood pressure. This effect of clonidine was unaffected by spiroxatrine, but was
      dose dependently antagonized by the alpha 2-adrenoreceptor antagonist yohimbine.
      Binding studies with [3H]8-OH-DPAT indicated that the affinity and Bmax of 5-HT1A
      receptors was increased in vitamin B6-deficient hypertensive rats. The results
      suggest that decreased synthesis of 5-HT in brain regions and the consequent
      alterations in 5-HT receptors in the vitamin B6-deficient rats may be the
      underlying cause of the hypertension seen in these animals.

PMID- 8482326
TI  - Effect of chronic treatment with TFMPP, a 5-HT1 receptor agonist, on food intake,
      weight gain, plasma insulin and neuropeptide mRNA expression in obese Zucker
      rats.
AB  - 1-[3-(trifluoromethyl)phenyl]piperazine (TFMPP), a 5-HT1 receptor agonist,
      decreases food intake in rats when given acutely. The present investigation was
      performed to study the chronic effects of TFMPP on food intake and weight gain in
      genetically obese Zucker rats. Neurochemical and endocrine data on possible
      mechanisms involved in the action of TFMPP were collected at the end of the
      study. TFMPP (4 mg/kg per day s.c.) significantly reduced food intake on the 1st
      and 7th days, but no longer on the 14th and 28th days. Reduced food intake was
      associated with decreased body weight gains during the first two weeks of
      treatment, but no effect was found thereafter. Plasma insulin concentration was
      significantly lowered by TFMPP treatment without impairment of glucose
      homeostasis. In situ hybridization analysis did not reveal changes in the
      expression of preprocorticotropin-releasing factor mRNA in the paraventricular
      nucleus or preproneuropeptide Y mRNA in the arcuate nucleus. Chronic TFMPP
      administration significantly reduced the density of 5-HT2 receptors, as measured
      by quantitative receptor autoradiography, in the claustrum and cerebral cortex,
      but not 5-HT1C receptor density in the choroid plexus. It is concluded that the
      anorectic and weight gain-lowering effects of TFMPP decrease during long-term
      treatment in obese Zucker rats.

PMID- 8482327
TI  - Pharmacological characterization and autoradiographic localization of dopamine D1
      receptors in the human umbilical artery.
AB  - Combined in vitro radioreceptor binding and autoradiographic techniques with
      [3H]SCH 23390 as a ligand were used to analyze the pharmacological profile and
      anatomical localization of dopamine D1 receptor sites in sections of human
      umbilical artery. The ligand was bound to sections of the artery in a manner
      consistent with the labelling of D1 receptors. These receptors, which show a
      fetal-to-maternal gradient with the highest concentration near the placenta, are
      located within the smooth muscle layer of the umbilical artery. The above
      findings suggest that endogenous dopamine may be involved in the control of the
      tone of the umbilical artery through the interaction with D1 receptors.

PMID- 8482328
TI  - Reduction of myocardial infarct size by ramiprilat is independent of angiotensin
      II synthesis inhibition.
AB  - The angiotensin-converting enzyme inhibitor ramiprilat, the angiotensin II
      receptor antagonist losartan, angiotensin II, ramiprilat plus angiotensin II, or
      saline (N = 6 each group), were administered i.v. in anesthetized, open-chest
      rabbit preparations of acute myocardial ischemia. Animals were instrumented for
      measurement of systemic hemodynamics and left ventricular +dP/dtmax, then
      subjected to 30 min of left anterior descending coronary artery occlusion
      (marginal branch) followed by 2 h of reperfusion. Ramiprilat (50 micrograms/kg),
      losartan (10 mg/kg), or saline were administered prior to reperfusion, and
      angiotensin II (2.5 ng/kg per min) was infused 15 min prior to occlusion and
      throughout the remainder of the experiment. Losartan was supplemented (10 mg/kg)
      after 1 h of reperfusion. These non-hypotensive doses of ramiprilat and losartan
      were demonstrated to significantly antagonize the systemic pressor effects of
      i.v. challenge with angiotensin I (15% of control, maximum) and II (5% of
      control, maximum), respectively, for the duration of the experiment. Systemic
      hemodynamic and +dP/dtmax changes due to occlusion/reperfusion or drug
      administration were similar between treatment groups. Infarct size was measured
      post-experimentally using tetrazolium staining and is reported as a percent of
      area at risk. Infarct size/area at risk (%) was significantly lower in rabbits
      administered ramiprilat only (20 +/- 6%*) or ramiprilat plus angiotensin II (26
      +/- 5%*), compared to those receiving saline (41 +/- 6%), angiotensin II (51 +/-
      4%), or losartan (52 +/- 4%, mean +/- S.E.M., * P < 0.05). These data indicate
      that direct angiotensin II receptor stimulation or receptor antagonism does not
      alter the degree of myocardial necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482329
TI  - Anti-leukotriene effects of WY-50,295 tromethamine in isolated guinea pig
      pulmonary tissues.
AB  - The abilities of WY-50,295 tromethamine, a 5-lipoxygenase inhibitor, to inhibit
      antigen-induced leukotriene (LT) release from guinea pig lung fragments, and to
      prevent LTD4 or antigen-induced contraction of isolated guinea pig tracheal
      muscle were compared with the activities of zileuton and MK-886 (two selective 5
      lipoxygenase inhibitors), and LY171883 (a LTD4 receptor antagonist). In
      fragmented guinea pig lung, WY-50,295 tromethamine inhibited antigen-induced LT
      release with an IC50 of 0.63 microM, and was 4.6- and 5.2-fold more potent than
      zileuton and MK-886, respectively. WY-50,295 tromethamine differed from these 5
      lipoxygenase inhibitors, however, in that WY-50,295 tromethamine competitively
      antagonized LTD4-induced tracheal contractions (pA2 = 6.06) at concentrations
      that inhibited LT release. LY171883 was an effective LTD4 receptor antagonist
      (pA2 = 6.96), that only inhibited antigen-induced LT release at higher
      concentrations (IC50 = 7.9 microM). WY-50,295 tromethamine almost completely
      inhibited antigen-induced leukotriene-dependent tracheal contractions, whereas
      high concentrations of zileuton, MK-886, or LY171883 produced only partial
      inhibition. This partial inhibition was likely to result from 'breakthrough' 5
      lipoxygenase activity, because combinations of zileuton plus MK-886 or zileuton
      plus LY171883, were more effective than zileuton, MK-886, or LY171883 alone. The
      greater efficacy of WY-50,295 tromethamine in the antigen-challenged guinea pig
      trachea is likely to result from its combined abilities to prevent LT
      biosynthesis and block LTD4 receptors.

PMID- 8482330
TI  - Selective and complete blockade of acetylcholine-induced relaxation in rabbit
      aortic rings by N omega-nitro-L-arginine but not by glybenclamide.
AB  - This study addressed the possibility that acetylcholine-induced relaxation in the
      rabbit aorta is mediated by dual mechanisms: one N omega-nitro-L-arginine (NLA)
      sensitive, the other glybenclamide-sensitive. Acetylcholine, nitroglycerin and
      BRL38227 (lemakalim), an activator of glybenclamide-sensitive potassium channels,
      were added to an organ bath containing rabbit aortic rings in a cumulative manner
      in the absence or presence of NLA and/or glybenclamide. NLA inhibited
      acetylcholine-induced relaxation and potentiated the relaxant response to
      nitroglycerin. BRL38227 caused a dose-dependent relaxation in rabbit aortic
      rings, and 30 microM glybenclamide produced essentially complete inhibition of
      this relaxation. Glybenclamide alone produced no inhibition of acetylcholine
      induced relaxation. These results indicate that glybenclamide-sensitive potassium
      channels in the rabbit aorta play no role in mediating the relaxant response to
      acetylcholine, while NLA can produce a selective and essentially complete
      blockade of the relaxant response to acetylcholine in the rabbit aorta.

PMID- 8482331
TI  - Flow injection fluorescence microscopy: a novel tool for the study of cells
      through controlled perfusion.
AB  - Current methods of microscope stage perfusion do not take full advantage of
      existing technology for precise fluid control. The concept of flow injection,
      used extensively by analytical chemists, is described and its application to the
      fluorescence microscopic study of cultured cells is proposed. Using this
      technique, cells may be exposed to single or multiple reagent zones of almost any
      profile, sequence, and duration, with computer-controlled precision. A flow
      injection system is employed in conjunction with a novel perfusion chamber--the
      fountain cell. The ability of the flow injection system to perfuse cells with a
      reagent with a reproducibility of 1% RSD is demonstrated. The system was used to
      monitor changes in calcium levels in baby hamster kidney cells loaded with FURA-2
      as a result of stimulation with a precisely timed concentration of ionomycin. The
      unique feature of the technique is that it allows a series of responses of a
      given cell to be directly compared to each other.

PMID- 8482332
TI  - The basement membrane protein BM-600/nicein codistributes with kalinin and the
      integrin alpha 6 beta 4 in human cultured keratinocytes.
AB  - The observation is reported that in low-passage human keratinocyte colonies
      cultured under conditions that allow full epidermal differentiation (i) the
      basement membrane protein BM-600/nicein, identified by the mAb GB3, is
      codistributed with laminin and collagen type IV as well as with the bullous
      pemphigoid antigen in footprints deposited by growing and migrating colonies;
      (ii) the integrin heterodimer alpha 6 beta 4 is codistributed with the same
      molecules suggesting its spatial association with basement membrane components;
      (iii) the distribution pattern of alpha 6 beta 4 and BM-600/nicein underneath
      individual cells is identical and is characterized by a typical "leopard skin"
      pattern complementary to the distribution of submembraneous F-actin microfilament
      network; (iv) a rabbit polyclonal antiserum to kalinin (R4012) used in double
      label immunofluorescence staining with mAb GB3 shows that this protein has the
      same distribution as BM-600/nicein and this suggests that they are identically
      located; and (v) immunoprecipitation with mAb GB3 to BM-600/nicein and BM165 to
      kalinin shows identical bands suggesting that nicein and kalinin represent the
      same molecular entity. We suggest that alpha 6 beta 4 displays not only an
      adhesive role for keratinocytes in view of its reported association to
      hemidesmosomes but may also be involved in organizing the molecules of the
      epithelial extracellular matrix, including those forming the basement membrane
      zone and hemidesmosomes, a function proposed for other integrins in other
      cellular systems.

PMID- 8482333
TI  - Cytochalasin D-induced actin gene expression in murine erythroleukemia cells.
AB  - There is a dynamic equilibrium between monomeric G-actin and polymeric F-actin
      microfilaments (MFs) in eucaryotic cells. We have previously shown that
      disruption of MFs with cytochalasin D (CD) induced beta-actin gene transcription,
      resulting in elevated levels of beta-actin mRNA and protein synthesis. CD also
      inhibited cell growth by arresting progression through the S phase of the cell
      cycle. These CD-induced responses were reversible since recovering cells
      progressed through the G2 phase and resumed normal growth while beta-actin mRNA
      and protein synthesis rapidly returned to control levels. In the present study,
      we show that the response of beta- and gamma-actin genes is due to the synthesis
      of a protein(s) acting at a 5' regulatory element that may be independent of or
      require sequences in addition to the serum response element (SRE). CD induces
      beta- and gamma-actin mRNA in a dose-dependent manner, reaching a maximum of 20
      fold over control mRNA levels at 30 microM. beta- and gamma-Actin gene expression
      was also induced 5-fold by serum stimulation of quiescent murine erythroleukemia
      (MEL) cells, while combined treatment with serum and CD had an additive effect.
      Two protein synthesis inhibitors, cycloheximide and puromycin, blocked the CD
      induced increase in beta-actin mRNA, in contrast to the serum-induced increase
      which is insensitive to inhibitors of protein synthesis. The rapid return of beta
      actin mRNA to basal levels following CD removal did not require protein synthesis
      nor did it require progression through the G2 phase of the cell cycle. A vector
      containing the 5' end of the beta-actin gene linked to a CAT reporter responded
      to CD when transfected into MEL cells, localizing the responsive element to the
      5' portion of the beta-actin gene. By contrast, a minimal 99-bp actin promoter
      CAT construct containing a functional SRE did not respond to CD.

PMID- 8482334
TI  - Transformation of NIH/3T3 to anchorage independence by H-ras is accompanied by
      loss of suppressor activity.
AB  - Despite their familiar sensitivity to transformation by dominant-acting ras
      oncogenes, NIH/3T3 cells carry a ras suppressor. When tested by cell fusion they
      were able to suppress the anchorage-independent phenotype of both mouse and human
      cells transformed by activated H-ras or N-ras. This suppression occurred without
      a decrease in expression of the activated ras oncogene. Ras-transformed NIH/3T3
      clones cured of their oncogene by benzamide treatment reverted to a
      nontransformed phenotype, but had lost the ability to suppress other ras
      transformants, indicating that their initial transformation was accompanied by
      suppressor loss. In hamster cells an active ras oncogene increased the rate of
      chromosome segregation by > 100-fold. These results suggest that in vitro
      transformation of NIH/3T3 cells by ras may be more similar to multistep in vivo
      tumor development than previously suspected, involving not only expression of an
      active oncogene but also loss of a suppressor activity, perhaps induced by the
      clastogenic oncogene.

PMID- 8482335
TI  - The regulation of GTP-binding proteins during fertilization and zygote
      differentiation in Dictyostelium discoideum.
AB  - The development changes in GTP-binding proteins and the regulation of their
      appearance by calcium ions were investigated during early sexual development in
      Dictyostelium discoideum. GTP gamma S strongly inhibited gamete cell fusion,
      while GDP beta S slightly augmented it, suggesting that G-proteins have a
      critical role in cell fusion. A 52-kDa protein recognized by an anti-GTP-binding
      site-specific immune serum, was abundant during calcium-dependent early sexual
      development but decreased in amount concomitant with cell fusion. This protein
      remained at high levels in Ca(2+)-deficient cultures, suggesting that its down
      regulation is linked to the events of sexual development. Analysis of substrates
      for cholera and pertussis toxin-mediated [32P]ADP-ribosylation in D. discoideum
      extracts determined that the 52-kDa protein is a G-alpha subunit similar to
      mammalian Gs. The 52-kDa protein was also detected in vegetative, asexual
      amoebae, but diminished rapidly within the first 2 h of starvation. Together
      these data indicate that the 52-kDa protein functions during the growth phase and
      is lost upon entry into either the sexual or asexual developmental programs. The
      amounts of several lower molecular weight GTP-binding proteins, ranging from 21-
      to 28 kDa, increased during the stage of zygote differentiation and their
      increases were calcium dependent. These data provide the first analysis of G
      proteins during sexual development of D. discoideum and lay the foundation for
      continued analysis of the signal transduction events mediating cell fusion and
      zygote differentiation.

PMID- 8482336
TI  - Secretion of endogenous 16-kDa beta-galactoside-binding lectin from vitamin A
      pretreated chick embryonic cultured skin.
AB  - Localization of endogenous beta-galactoside-binding 16-kDa lectin and its gene
      expression pattern were investigated during differentiation of chick embryonic
      skin in vivo and in vitro and were compared with those of a 14-kDa lectin. By
      light microscopy, immunostaining of the 16-kDa lectin was weak in the
      undifferentiated epidermis, while it became intense in the keratinized epidermis,
      particularly in the intermediate cells. Essentially the same staining pattern was
      observed both in vivo and in vitro. The gene expression pattern was consistent
      with these immunohistochemical observations. These results were similar to those
      of the 14-kDa lectin [1]. On the other hand, in the vitamin A-pretreated cultured
      skin, mucous metaplasia of the epidermis was induced and marked changes in
      localization of these two isolectins were observed. The 16-kDa lectin expression
      was increased in the epidermis, especially in the superficial cells, and the gene
      expression was detected in all layers of the epidermis. However, 14-kDa lectin
      expression was markedly reduced in the metaplastic epidermis. In the keratinized
      epidermis, detailed localization of these lectins under the electron microscope
      was almost the same. Both of them were located primarily along the plasma
      membrane, in the intercellular space, and in the desmosomes. In the mucous
      metaplastic epidermis, however, the localization of the 16-kDa lectin was
      completely different from that of the 14-kDa lectin; e.g., the former was
      detected in the mucous granules and on the microvilli of the superficial cells,
      while the latter was scarcely observed in the epidermis. The present results
      revealed that (1) the 16-kDa lectin as well as 14-kDa lectin were expressed
      during the epidermal differentiation and (2) much of the 16-kDa lectin was
      produced and secreted from the vitamin A-pretreated cultured epidermis, while 14
      kDa lectin disappeared. In the view of these facts, it is suggested that (1) both
      14- and 16-kDa lectins may play an important role in differentiation of the skin
      and (2) the gene expression of 14- and 16-kDa lectins is regulated independently.

PMID- 8482337
TI  - Effect of the tumor promoter phorbol 12-myristate 13-acetate (PMA) on
      proliferation of young and senescent WI-38 human diploid fibroblasts.
AB  - The effects of the tumor promoter phorbol 12-myristate 13-acetate (PMA) on the
      proliferation, protein kinase C activity (PKC), and c-fos gene expression were
      examined in cultures of young and senescent (90-95% lifespan completed) WI-38
      human diploid fibroblasts. We observed that, following stimulation with medium
      containing 10% fetal bovine serum (FBS), the translocation of PKC from the
      cytosol to the particulate compartment was less efficient in senescent WI-38
      cells than in young cells. However, when PMA was added to the medium, the
      intracellular distribution of PKC activity in old cells became nearly identical
      to that observed in young cells. The inducibility of c-fos mRNA by serum
      addition, which is a protein kinase C-dependent event, was significantly
      amplified in the presence of PMA. Moreover, the duration of peak c-fos
      expression, after stimulation by FBS and PMA, increased in senescent cells as
      compared to young cells. Our results reveal that the normal signal transduction
      pathway is altered in senescent, slowly proliferating human fibroblasts and that
      it can be partially restored in the presence of the tumor promoter PMA.

PMID- 8482338
TI  - Three pools of lysosomal enzymes in Tetrahymena thermophila.
AB  - Secretion of lysosomal enzymes into the extracellular surroundings has been
      observed in many eukaryotic cells. We studied the activity of lysosomal enzymes
      in different subcellular fractions of Tetrahymena thermophila to get more insight
      into this general phenomenon. By density gradient centrifugation a light and a
      dense fraction of lysosomal particles were found. Electron microscopy revealed
      that the light fraction mainly consists of cell surface membranes. By
      immunostaining a lysosomal enzyme (beta-hexosaminidase) was detected on the
      plasma membrane. The Triton X-114 assay showed that the light fraction as well as
      purified cilia (an enriched source of plasma membrane) contain lysosomal enzymes
      predominantly covalently bound to the membrane. The dense fraction contains both
      membrane-bound and soluble forms of lysosomal enzymes. By labeling
      phagosomes/phagolysosomes with magnetic particles the dense fraction can be
      subdivided into two lysosomal vesicle populations: phagolysosomes and a further
      population of lysosomal vesicles which can not be labeled. The relationship
      between membrane-bound and soluble enzyme forms in phagolysosomes and this
      unlabeled vesicle population is different: In phagolysosomes 80% of the acid
      phosphatase and 20% of the beta-hexosaminidase are membrane-bound, whereas in the
      unlabeled vesicles 42% of the acid phosphatase and 8% of the beta-hexosaminidase
      are bound to the membrane. Furthermore, we present results suggesting that the
      unlabeled vesicle population of the dense fraction is the source of secreted
      lysosomal enzymes. A working model summarizing our present knowledge about the
      connection of the three pools of lysosomal enzymes in Tetrahymena is presented.

PMID- 8482339
TI  - The large cytoplasmic domain is not required for concentration of N-CAM at cell
      cell contacts in transfected mouse neuroblastoma cells.
AB  - We examined the localization of the 140- and 180-kDa transmembrane isoforms of
      chicken N-CAM following transfection into mouse N2A neuroblastoma cells. Both
      isoforms were expressed at the cell surface and became partially or completely
      localized at areas of cell-cell contact after several days of culture or of in
      vitro differentiation. These results indicate that the presence of the large
      cytoplasmic domain of the 180-kDa N-CAM isoform is not necessary to bring about
      the localization of N-CAM to points of cell-cell contact.

PMID- 8482340
TI  - A sequential staining technique for karyotypic analysis of interspecific somatic
      cell hybrids.
AB  - We describe a sequential staining technique for the karyotypic analysis of
      interspecific mouse x human somatic cell hybrids. Fluorescence in situ
      hybridization of samples, previously stained using standard trypsin/Giemsa
      protocols, was instrumental in the identification of human chromosomes present in
      hybrid lines. This procedure not only provided a simple distinction between human
      and mouse chromosomes, but it also allowed the visualization and monitoring of
      human sequences present in interspecific translocations and subchromosomal
      fragments.

PMID- 8482341
TI  - Oleic acid blocks epidermal growth factor-activated early intracellular signals
      without altering the ensuing mitogenic response.
AB  - In EGFR-T17 cells, which express high levels of the epidermal growth factor (EGF)
      receptor, addition of a saturating dose of EGF (10 nM) leads to an increase in
      Ins(1,4,5)P3/diacylglycerol and also to cytosolic calcium [Ca2+]i due to both
      intracellular redistribution and influx from extracellular medium. Pretreatment
      of cells with cis-unsaturated nonesterified fatty acids such as oleic acid (1 to
      100 microM) inhibited EGF-stimulated Ins(1,4,5)P3 generation and Ca2+ release
      from intracellular stores. Furthermore, such a treatment completely suppress Ca2+
      influx in a dose-dependent manner. At doses capable of suppressing such early
      signals, oleic acid did not alter the process of EGF-mediated internalization of
      the EGF/EGF-receptor complex, suggesting that [Ca2+]i rise did not mediate
      receptor internalization. EGF-induced cell proliferation assessed by either
      thymidine incorporation into DNA, direct cell counting, and microscopic
      observation was not altered by oleic acid, at doses able to block EGF-mediated
      early signals. In conclusion, suppression of Ins(1,4,5)P3 generation and [Ca2+]i
      rises by oleic acid did not alter EGF-receptor internalization nor EGF-induced
      cell mitosis. Such results suggest that [Ca2+]i rise is not instrumental for EGF
      stimulated cell proliferation.

PMID- 8482342
TI  - Polysaccharides influence the aggregation of Dictyostelium discoideum cells and
      bind to developmentally regulated cell surface proteins.
AB  - Six of ten anionic polysaccharides studied were found to significantly reduce the
      adhesion of growth-phase Dictyostelium discoideum cells. However, only hyaluronic
      acid, chondroitin-4-sulfate and chondroitin-6-sulfate interfered with the
      adhesion of aggregation-competent cells. Neither EDTA-stable nor EDTA-sensitive
      adhesion of postaggregation cells were affected by the polyanions. The two
      chondroitin sulfates influenced the aggregation of cells in submerged cultures,
      long and broad aggregation streams being formed and the broad sheets of cells
      eventually building multilayered aggregates. Radioiodination of cell surface
      proteins followed by cellulose fiber affinity chromatography identified the same
      nine proteins bound by hyaluronic acid and the chondroitin sulfates, six of which
      were regulated during development. Protease-resistant anionic material isolated
      from cells bound the same surface proteins as the three glycosaminoglycans.
      Discoidin I bound to the uncoupled cellulose fibers, suggesting a structural role
      for the lectin in the extracellular slime sheath. Anionic polysaccharides and
      cell surface lectins that bind them may be involved in the cell recognition, cell
      aggregation, and the cell sorting that occurs during pattern formation.

PMID- 8482343
TI  - Studies on the cellular pathway involved in assembly of the embryonic sea urchin
      spicule.
AB  - Micromeres from the 16-cell stage sea urchin embryo were isolated and cultured in
      vitro in seawater containing 3% horse serum. Under these conditions these cells
      differentiate into spicule-forming, primary mesenchyme cells. To obtain insight
      into the route traveled by Ca2+ to form the pseudocrystalline spicule composed of
      CaCO3 and matrix proteins, studies with various inhibitors were undertaken.
      Experiments with members of several different classes of Ca2+ channel blockers
      established that the Ca2+ utilized for spiculogenesis must be taken up by the
      cells. Moreover, studies using two agents that disrupt the endomembrane system,
      monensin and brefeldin A, showed that both blocked spicule formation. Based on
      these experiments, we conclude that extracellular Ca2+ must enter the primary
      mesenchyme cells prior to being deposited extracellularly as CaCO3 and that this
      ion and/or the matrix proteins found in the spicule are routed through the
      secretory pathway that has been established to exist in a wide variety of other
      cell types.

PMID- 8482344
TI  - Phagocytosis by normal human melanocytes in vitro.
AB  - Phagocytosis is an important first step in processing of antigens ultimately to
      be presented in the context of MHC class II molecules on the cell surface.
      Degradation of internalized antigens can then proceed by fusion of the phagosome
      with organelles containing lysosomal enzymes. Evidence for the phagocytic
      capacity of cultured normal human skin melanocytes is provided, both by electron
      microscopy and by confocal laser scanning microscopy. The phagocytic capacity of
      melanocytes is approximately 5% of that found for cultured human dermal skin
      fibroblasts. However, in a mixed culture of keratinocytes and melanocytes, uptake
      of 1 micron latex beads in 72 h was found to be comparable for both epidermal
      cell types, implicating in vivo significance for phagocytosis by melanocytes.
      Furthermore, it is shown that phagosomes containing latex beads will fuse with
      melanosomes, indicating that melanosomes can function as specialized lysosomal
      organelles within normal human skin melanocytes. The present investigation
      indicates that melanocytes are equipped with the phagocytic machinery important
      for the processing of antigens and thus may function as accessory cells within
      the skin immune system.

PMID- 8482345
TI  - Enhanced expression of fibronectin during in vivo cellular aging of human
      vascular endothelial cells and skin fibroblasts.
AB  - Vascular endothelial cells are thought to play an important role in human aging
      as their senescence and/or detachment from vascular wall contribute to
      arteriosclerosis and high blood pressure in elderly persons. Since fibronectin is
      necessary for cell attachment and spreading and its increased expression has been
      reported in aging fibroblasts, we checked its expression in aortic endothelial
      cells aged in vivo. We found that the steady-state level of fibronectin
      expression increases with increasing donor age, while the labeling index of
      cultured cells decreases with age. The increased level of fibronectin expression
      correlated well with an increase in cell area. To explore whether these changes
      were a reflection of exhaustion of proliferation potential in vivo, we examined
      fibronectin expression in human umbilical vein endothelial cells aging in vitro.
      Very similar results were obtained, supporting the idea that vascular endothelial
      cells age in vivo by using up division potential. When we examined the expression
      of fibronectin in human skin fibroblasts aged in vivo and fetal lung fibroblasts
      aged in vitro, we obtained similar results. In conclusion, the level of
      expression of fibronectin and cell size increase during in vivo and in vitro
      aging of both endothelial cells and fibroblasts in a coordinate manner.

PMID- 8482346
TI  - Sphingosine blocks both membrane fusion and calmodulin-dependent phosphorylation
      of the 100-kDa protein of chick embryonic myoblasts.
AB  - Sphingosine, a potent inhibitor of protein kinase C, was found to block membrane
      fusion of chick embryonic myoblasts in culture. This effect was dose-dependent
      and could be reversed upon removal of the drug. Treatment with 12-O
      tetradecanoylphorbol 13-acetate, which is a powerful activator of protein kinase
      C and capable of preventing myoblast fusion, further potentiated the inhibitory
      effect of sphingosine. Thus, the sphingosine-mediated inhibition of myoblast
      fusion appears to be independent of protein kinase C. Sphingosine also decreased
      the phosphorylation state of the 100-kDa protein when given to the cell extracts,
      and this inhibition was competitive with calmodulin. Thus, sphingosine seems to
      act as a calmodulin antagonist. These results suggest that the sphingosine
      mediated inhibition of myoblast fusion may be associated with the inhibitory
      effect of the drug against the calmodulin-dependent phosphorylation of the 100
      kDa protein.

PMID- 8482347
TI  - Cell cycle-dependent regulation of Ca2+ in young and senescent WI-38 cells.
AB  - During the in vitro senescence of the normal human diploid cell line WI-38, there
      is a loss of ability to initiate DNA synthesis in response to mitogens. This loss
      of replicative capacity is reflected in an increasing average length of G1 and a
      decreasing fraction of cells in the rapidly proliferating pool. Calcium ion
      (Ca2+) has been shown to be important for progression through the cell cycle and
      we have measured two processes which contribute to the regulation of
      intracellular Ca2+ in the early, mid, and late G1 phase of the cell cycle. Basal
      intracellular Ca2+ concentrations in quiescent cells as well as initial transient
      mobilization of Ca2+ stores following mitogenic stimulation by growth factors
      were equivalent in young and senescent cells. Calmodulin levels in young,
      quiescent cells decreased 50% in the first 4-6 h after stimulation with fresh
      serum and then increased two- to fourfold immediately prior to entry into DNA
      synthesis. Senescent cells did not exhibit this cell cycle-dependent pattern and
      calmodulin levels remained generally constant throughout G1, sometimes increasing
      slightly, prior to S phase. These data suggest that perhaps the intracellular
      Ca2+ concentration is regulated differently in young and senescent cells. Indeed,
      the cell cycle regulation of calmodulin may be uncoupled from the cell cycle
      regulation of calmodulin mRNA. This difference could provide one mechanism for
      the failure of senescent cells to synthesize DNA following mitogenic stimulation.

PMID- 8482348
TI  - Differential effects of TPA and pristane on gene expression and transformation in
      mouse epidermal cells.
AB  - The effects of 12-O-tetradecanoylphorbol-13-acetate (TPA) or 2,6,10,14
      tetramethylpentadecane (pristane) on gene expression and transformation were
      examined using two clones (P+, TPA transformation sensitive and P-, TPA
      resistant) of the mouse epidermal cell line JB6. Results from transformation
      studies indicated pristane was more efficient, i.e., lower concentrations were
      required to elicit an equivalent response, in transforming the P+, but not the P
      , clone of JB6 compared to TPA. Furthermore, results from these studies
      demonstrated either TPA or pristane was effective in the transactivation of the
      chloramphenicol acetyltransferase gene under the regulatory control of most viral
      promoter/enhancer elements transfected into the P+, but not the P-, clone of JB6.
      However, if a consensus cAMP response element was linked to the simian virus 40
      early promoter, pristane activation was observed in both P+ and P- cells. The
      differential effects of these two compounds suggest that while they have similar
      characteristics, they may utilize different pathways to elicit their effects.

PMID- 8482349
TI  - Adhesion and activation of human neutrophils onto collagen chains separated by
      electrophoresis.
AB  - After separation of the various alpha chains of the collagens by SDS-PAGE, the
      binding of polymorphonuclear neutrophils (PMN) to these chains was detected by a
      double-antibody technique and the activation of PMN by nitro blue tetrazolium.
      All of the alpha chains tested were able to bind PMNs. The alpha 1 chain of type
      I collagen activated the PMN when it had not been treated with pepsin. Pepsinized
      types II and VI collagens did not activate PMN. The pepsinized alpha 1(III)
      chains and all three alpha chains from pepsinized type V collagen were able to
      activate PMN.

PMID- 8482350
TI  - Ultrastructural distribution of DNA within the ring-shaped nucleolus of human
      resting T lymphocytes.
AB  - The precise distribution of DNA within the resting human T lymphocyte nucleolus
      has been investigated, at the ultrastructural level, by cytochemical and
      molecular immunocytochemical techniques. The nucleolus is partially enveloped by
      a layer of condensed chromatin which, at several places, penetrates into the
      nucleolar body until in close contact with the fibrillar centers. Morphometric
      analysis reveals that 32% of the fibrillar center surface is essentially occupied
      by condensed chromatin. Using the in situ terminal deoxynucleotidyl transferase
      immunogold procedure for detecting DNA, we further show that evident label is
      exclusively found over the condensed chromatin and over the fibrillar centers,
      whereas no significant label is detected over the dense fibrillar component of
      the nucleolus.

PMID- 8482351
TI  - Cytoplasmic localization and nuclear transport of cofilin in cultured myotubes.
AB  - We used immunofluorescence methods to examine the cellular distribution of
      cofilin in chicken myotubes in primary culture. Cofilin showed mainly diffuse
      distribution in the cytoplasm except for rather strong staining around the nuclei
      and faint striated patterns along myofibrils, but did not stain inside the
      nuclei. Neither stress fiber-like structures nor myofibrils were clearly stained.
      In the presence of 10% dimethyl sulfoxide (DMSO), intranuclear actin-cofilin
      rods, which were composed of alpha-actin isoform and cofilin, were formed in all
      the nuclei of individual myotubes. In the cofilin sequence, a putative nuclear
      localization signal (NLS) was observed. We examined the NLS activity of this
      portion by using a synthetic peptide corresponding to the putative NLS. When the
      NLS peptide conjugated with bovine serum albumin was microinjected into the
      cytoplasm of myotubes, it was rapidly accumulated into the nuclei. The same
      result was obtained with in vitro a nuclear protein import assay system with
      digitonin-permeabilized myotubes. Therefore, we suggest that this portion is
      responsible for the nuclear transport of cofilin. In myotubes, the majority of
      cofilin was present in an unphosphorylated form and this form remained unchanged
      after the DMSO treatment. Thus, we suggest that the phosphorylation of cofilin
      itself is not directly involved in its nuclear transport at least in myotubes.

PMID- 8482352
TI  - T lymphocyte infiltration of two- and three-dimensional collagen substrata by an
      adhesive mechanism.
AB  - Lymphocytes were plated on two-dimensional (2D) and three-dimensional (3D)
      collagen substrata and their distribution and behavior determined using light and
      scanning electron microscopy. When allowed to settle on 2D collagen substrate T
      lymphocytes "rapidly" attached and penetrated and thus virtually never remained
      attached on top of the collagen. As a consequence of this penetration the cells
      appeared below the collagen. In contrast to lymphocytes, fibroblasts and
      macrophages allowed to settle on 2D collagen did not penetrate but underwent
      cytoplasmic spreading on top of the collagen. Lymphocyte attachment and
      penetration of 2D collagen was specifically inhibited by monoclonal antibodies to
      beta 1-integrins, indicating that the process depends on molecular adhesion to
      the collagen. The penetration of 2D collagen appeared to consist of tight binding
      of collagen fibers to the cells, local reorganization of the collagen carpet, and
      redistribution of the cell-attached collagen fibers from the "lower" to the
      "upper" pole/surface of the lymphocyte. Lymphocyte infiltration of 3D collagen
      substrata was also specifically inhibited by monoclonal antibodies to beta 1
      integrins. During the infiltration of 3D collagen lymphocytes exhibited collagen
      fibers attached to their surface and seemed to provoke perturbation of the
      collagen. These results show that T lymphocytes are programmed to penetrate and
      perturb 2D and 3D collagen substrata by a mechanism dependent on adhesive
      interaction. However, deattachment tends to counteract persistent binding of the
      cells to 2D collagen.

PMID- 8482353
TI  - Chondrogenesis in chick limb bud mesodermal cells: reciprocal modulation by
      activin and inhibin.
AB  - Activin and inhibin are members of the transforming growth factor-beta
      superfamily sharing a common beta-subunit, but with opposite biological
      activities on the release of follicle-stimulating hormone from pituitary. Recent
      studies have demonstrated that activin is the long sought after mesoderm
      induction factor in amphibians. To determine if activin and inhibin affect the
      proliferation and differentiation of chick limb bud mesodermal cells during
      cartilage formation of the limb, recombinant human activin A and inhibin A were
      tested on stage 24 chick limb bud mesodermal cells. The results showed that
      activin A has an inhibitory effect on chondrogenic differentiation, as indicated
      by Alcian blue staining and decreased [35S]sulfate incorporation into
      proteoglycans. In addition, the expression of type II collagen mRNA, a specific
      phenotypic marker of cartilage, was greatly inhibited when cultures were exposed
      to activin A for 5 days at a dose of 10 ng/ml. In contrast, inhibin A stimulated
      cartilage formation, as indicated by increased expression of type II collagen
      mRNA and synthesis of proteoglycans. These results imply that activin A and
      inhibin A can modulate chondrogenesis during differentiation of limb bud cells in
      culture.

PMID- 8482354
TI  - 70-kDa heat-shock cognate protein colocalizes with karyophilic proteins into the
      nucleus during their transport in vitro.
AB  - Recently, we showed that antibodies against 70-kDa heat-shock cognate 66otein
      (hsc70) inhibit nuclear transport of karyophilic proteins in vivo. In this study,
      we examined the involvement of hsc70 in nuclear transport using a digitonin
      permeabilized cell-free transport system. Depletion of the cytosolic extract
      required for nuclear transport of hsc70 by incubation with anti-hsc70 antibodies
      reduced the nuclear transport activity significantly, and addition of purified
      hsc70 to the depleted extract restored the transport activity. We examined the
      localization of hsc70 during nuclear transport in vitro by indirect
      immunofluorescence studies. Hsc70 accumulated in the nucleus when bovine serum
      albumin (BSA) conjugated to SV40 large T-antigen nuclear localization signal
      (NLS) peptides (T-BSA) or nucleoplasmin was added exogenously to the cytosolic
      extract, but not when BSA conjugated to transport-incompetent point-mutated NLS
      peptide was added. This karyophilic protein-dependent accumulation of hsc70 was
      dependent on the cytosolic extract, temperature, and ATP and was sensitive to
      wheat germ agglutinin. Addition of excess unlabeled T-BSA to the cytosolic
      extract competitively inhibited the nuclear accumulation of fluorescently labeled
      T-BSA or nucleoplasmin, but did not affect accumulation of hsc70 into the
      nucleus. These results show that hsc70 is required for nuclear transport and that
      it is colocalized with karyophilic proteins during their active import into the
      nucleus in vitro.

PMID- 8482355
TI  - Identification of DNA-binding proteins in the parasitic protozoan Crithidia
      fasciculata and evidence for their association with the mitochondrial genome.
AB  - The single mitochondrion of trypanosomatid protozoans such as Crithidia
      fasciculata has a large and complex network of AT-rich DNA called kDNA. Little is
      known about proteins involved in the packaging and morphogenesis of this network.
      I report the purification of a protein fraction from this parasite which
      preferentially retained kDNA in the gel slot during electrophoresis. The proteins
      had approximate molecular weights of 22, 21, 17.5, 16.5, 15, and 13 kDa. They
      copurified with mitochondrial DNA, parts of which they protected from nuclease
      attack. The proteins resembled histones but they also differed from histones in
      significant ways. Immunological evidence showed that the proteins were enriched
      in a mitochondrial fraction, implying their association with kDNA in vivo.

PMID- 8482356
TI  - Modulation of growth of vascular smooth muscle cells by activin A.
AB  - Activin A is a homodimeric protein structurally related to transforming growth
      factor-beta. The present study was conducted to examine the effect of activin A
      on the growth of rat vascular smooth muscle cells (VSMC) in culture. When serum
      deprived cells were incubated with activin A, nuclear labeling of
      bromodeoxyuridine occurred after a 12-h lag period. The effect of activin A on
      nuclear labeling was dose-dependent, being maximal at 10(-9) M. Activin A also
      increased the number of VSMC after 30 h of incubation. Insulin-like growth factor
      1 (IGF-1) had only a small effect on nuclear labeling by itself but the effects
      of IGF-1 and activin A were additive. When quiescent VSMC were treated with
      activin A for 4 h, the effect of subsequent IGF-1 was markedly enhanced.
      Furthermore, activin A induced an autocrine production of IGF-1 in VSMC. In
      contrast to these positive effects on cell growth, activin A was rather
      inhibitory to the action of IGF-1 in activin-primed cells. In addition, activin A
      inhibited platelet-derived growth factor-induced nuclear labeling. These results
      indicate that activin A modifies growth of VSMC by complex mechanisms involving
      autocrine production of IGF-1 and modification of the action of IGF-1.

PMID- 8482357
TI  - A light microscope study of linker histone distribution in rat metaphase
      chromosomes and interphase nuclei.
AB  - Several subtypes of the linker histone H1 are present in normal rat kidney
      epithelial cells (NRK-52E). Although H1 is essential in nucleosome and chromatin
      packaging or condensation, the unique functions of these very basic proteins are
      largely unknown. There has been much speculation on the role of each H1 variant
      on developmentally regulated or tissue specific gene expression. We have examined
      the global distribution of several H1 subtypes on metaphase chromosomes in an
      attempt to uncover large-scale differences in chromatin condensation. Polyclonal
      antibodies raised against HPLC-purified rat H1 subtypes revealed a pattern much
      like G or Q bands for all H1 variants tested on chromosomes harvested with either
      aqueous or organic spreading methods. H1(0), a less abundant form of H1, may be
      associated with terminally differentiated or senescent cells. In cultures treated
      to induce higher levels of H1(0) there were no visible differences at the light
      microscope level in the antibody banding pattern between induced and noninduced
      cells. The distributions of H1 subtypes on chromosomes may be visible in
      different tissues when viewed at higher magnifications. While chromosome patterns
      were consistent with the antibodies tested, the interphase nuclei displayed clear
      differences. An epitope specific for anti-H1A antibody is present in the nuclear
      envelope and is possibly used for chromosomal location or anchorage. Anti-H1B
      antibody did not specifically label the nuclear envelope, nor did anti-H1(0)
      antibody. Highly concentrated regions of H1(0) surround the nucleoli, possibly
      indicating a cluster of genes that are poised for transcription.

PMID- 8482358
TI  - Insulin induces an unmasking of the carboxyl terminus of G(i) proteins in rat
      adipocytes.
AB  - Several groups have shown a relationship between the insulin receptor and
      inhibitory G proteins, G(i). An antisera, 8729, to a peptide sequence
      (KNNLKDCGLF) corresponding to the carboxyl termini of G(i)alpha subunits was used
      to investigate this relationship by immunoelectron microscopy. Rat adipocytes
      were incubated in the absence or presence of 100 ng/ml insulin for 1 h and fixed
      for immunoelectron microscopy. Insulin-treated adipocytes stained with 8729 were
      labeled at the cell surface at a much higher density than control adipocytes.
      Subcellular fractionation of insulin-treated and control cells was followed by
      PAGE and Western blots of the plasma membrane and low-density microsomes with
      8729. The density of the bands did not change in response to insulin treatment.
      Antibodies to noncarboxyl terminus sequences of the alpha subunit were used for
      immunoelectron microscopy and no difference was noted between insulin-treated and
      control adipocytes. These results indicated that 8729 was detecting a
      conformational change in the structure of G(i)alpha subunit in the plasma
      membrane in response to insulin. This unmasking of the carboxyl terminus was also
      seen in response to treatment with phenylisopropyladenosine and prostaglandin E2.
      Pertussis toxin-catalyzed ADP ribosylation also unmasked the carboxyl terminus.
      In contrast, isoproterenol, an agonist of stimulatory G proteins (Gs), did not
      induce an unmasking of the carboxyl terminus. These results support the
      hypothesis that some of insulin's effects are mediated through G(i) proteins in
      adipocytes.

PMID- 8482359
TI  - Growth control in a human colon carcinoma cell line mediated by cell-associated
      transforming growth factor-alpha (TGF alpha).
AB  - Transforming growth factor-alpha (TGF alpha) is able to elicit growth in many
      target cells expressing a functional epidermal growth factor (EGF) receptor.
      Other laboratories have reported that the TGF alpha precursor polypeptide (proTGF
      alpha) is inefficiently cleaved from many target cells, resulting in accumulation
      of proTGF alpha on the cell surface. Since it has been shown that noncleavable,
      mutated cell-associated TGF alpha can stimulate cell growth on receptor-bearing
      adjacent cells, we have tried to determine whether cell-associated TGF alpha
      populations might be involved in supporting autonomous cell growth regulatory
      mechanisms in a human colon carcinoma cell line, HCT116. To address this
      question, the levels of secreted and nonsecreted TGF alpha produced were
      determined. Cells grown to medium cell density (40-60% confluent) expressed the
      greatest percentage of cell-associated TGF alpha (50%). Incubation of HCT116
      cells with 0.1 U/ml porcine pancreatic elastase resulted in the release of 67% of
      the cell-associated TGF alpha into their medium and caused the treated cells to
      acquire a newly established growth sensitivity to exogenous TGF alpha at a ligand
      concentration of 1.0 nM. Western blot analysis of EGF receptor phosphotyrosine
      levels showed a decrease in phosphotyrosine content after elastase treatment.
      Phosphotyrosine content was restored to basal levels if elastase treatment was
      followed by addition of exogenous TGF alpha or EGF. These results suggest that
      HCT116 cells use a "closed" autocrine loop between cell-associated TGF alpha
      species and their EGF receptor to stimulate their cell growth.

PMID- 8482360
TI  - Interleukin-1 differentially modulates chondrocyte expression of cyclooxygenase-2
      and phospholipase A2.
AB  - Interleukin-1 beta (IL-1) increases the synthesis of prostaglandins as well as
      the expression of synovial fluid phospholipase A2 (PLA2) mRNA and activity by
      chondrocytes. In order to examine the potential involvement of cyclooxygenase in
      the induction of prostaglandins by IL-1, the effect of IL-1 on rabbit articular
      chondrocyte expression of cyclooxygenase enzymes was investigated. By Northern
      analyses, mRNA for cyclooxygenase-2 (COX-2) was found to be constitutively
      expressed, and its expression was increased in cultures treated for 24 h with IL
      1 (100 ng/ml). Cyclooxygenase-1 mRNA was not detected in control or IL-1-treated
      cultures. IL-1 caused a concentration-dependent increase in steady-state levels
      of COX-2 message as assessed by slot-blot analyses. Half-maximal induction of the
      COX-2 message levels was estimated to require 1.2 ng/ml IL-1. In duplicate slot
      blots probed with a cDNA for synovial fluid PLA2, half-maximal induction of PLA2
      mRNA was estimated to require 0.15 ng/ml IL-1, approximately 10-fold less IL-1
      than required for COX-2. In addition, maximal increase in COX-2 message levels
      was only 3-fold as compared with a 13-fold induction of PLA2. No change in
      message levels for the intracellular protein, actin, was found between control
      and experimental cultures. Cycloheximide enhanced COX-2 transcript levels, but
      did not modulate IL-1 induction of COX-2. Actinomycin D did not inhibit IL-1
      augmentation of COX-2 mRNA levels; whereas, induction of PLA2 mRNA levels was
      completely inhibited, implicating transcriptional mechanisms in the induction of
      PLA2 but not COX-2 mRNA. These data demonstrate that chondrocyte expression of
      COX-2 and synovial fluid PLA2 are differentially modulated by IL-1.

PMID- 8482361
TI  - Transcriptional activation of type I collagen genes by ascorbic acid 2-phosphate
      in human skin fibroblasts and its failure in cells from a patient with alpha 2(I)
      chain-defective Ehlers-Danlos syndrome.
AB  - L-Ascorbic acid 2-phosphate (Asc 2-P), a long-acting vitamin C derivative,
      stimulated transcription of genes for pro alpha 1(I) and pro alpha 2(I) collagen
      in normal human skin fibroblasts after 8 h of treatment in the absence or in the
      presence of cycloheximide, indicating Asc 2-P stimulates transcription of type I
      collagen genes in the absence of protein synthesis. The transcriptional rate in
      these cells reached the maximum value after 40 h of treatment, and at that time
      it was three to four times higher than that of the control cells cultured in the
      absence of Asc 2-P. Steady-state levels of mRNAs for pro alpha 1(I) and pro alpha
      2(I) chains were also increased to be three to four times higher than the control
      levels by treatment of the cells with Asc 2-P for 72 h. When the fibroblasts
      obtained from a patient with Ehlers-Danlos syndrome were treated with Asc 2-P,
      the derivative also stimulated transcription of the gene for pro alpha 1(I) chain
      and accumulation of mRNA for pro alpha 1(I) chain. On the other hand, Asc 2-P
      failed to stimulate transcription of the pro alpha 2(I) gene or an increase in
      mRNA for pro alpha 2(I) chain. Sodium ascorbate showed effects quite similar to
      those of Asc 2-P, when fibroblasts obtained from a normal control or the patient
      were cultured for 16 h with it. These results indicate the existence of cis
      regulatory elements responsible for transcriptional activation by Asc 2-P or
      ascorbic acid in pro alpha 1(I) and pro alpha 2(I) genes of normal fibroblasts.
      These data also suggest some defect(s) of these elements in the pro alpha 2(I)
      gene of the patient with Ehlers-Danlos syndrome.

PMID- 8482362
TI  - Monoclonal antibodies targeted against the C-terminal domain of dystrophin or
      utrophin.
AB  - The structure-function relationships of dystrophin, a protein which is absent or
      defective in patients with Duchenne or Becker muscular dystrophies, and utrophin
      can only be compared if specific antibodies are produced. We expressed C-terminal
      parts of dystrophin and utrophin in expression vectors. Mice were immunized with
      recombinant proteins and 26 monoclonal antibodies were produced and analyzed.
      Their respective epitopes were determined using other overlapping recombinant
      products. We observed antibody specificity towards 400 kDa dystrophin and/or
      utrophin protein bands, either by Western blot analysis or immunodetection in
      human skeletal (quadriceps) and smooth (uterus) muscles. These antibodies have
      been used to compare the relative abundance of both dystrophin and utrophin
      relative to the structures analyzed.

PMID- 8482363
TI  - Role of Lys-110 of human NADH-cytochrome b5 reductase in NADH binding as probed
      by site-directed mutagenesis.
AB  - Lys-110 of human NADH-cytochrome b5 reductase was replaced by Ala, Met, or Arg by
      site-directed mutagenesis to evaluate the role of the residue. Km values of
      purified Lys-110-->Ala and Lys-110-->Met mutants for NADH were approximately 200
      fold and 1,100-fold higher than that of the wild-type, respectively, while the
      value of the Arg mutant was almost the same as that of the wild-type. These
      results indicate that the positive charge at position 110 is important for NADH
      binding. The kcat value of Lys-110-->Ala was not affected, indicating that the
      residue only participates in the binding process in the reaction by forming an
      ionic interaction with phosphoryl group of NADH.

PMID- 8482364
TI  - Hepatic apolipoprotein B synthesis in copper-deficient rats.
AB  - The present study was designed to examine if induction of apolipoprotein B
      synthesis is associated with hypercholesterolemia in copper-deficient rats. This
      hypercholesterolemia mainly resides in an increase in the HDL-1 and LDL and is
      associated with a significant increase in plasma apoB concentration. Liver apoB
      mRNA levels were not significantly modified in deficient animals as compared to
      control rats. Studies on liver apolipoprotein synthesis indicated that apoB100
      synthesis was increased in deficient animals whereas apoB48 synthesis was
      unchanged. Thus, it appears that the increase in apoB synthesis in the liver of
      copper-deficient rats occurs at the posttranscriptional level. The selective
      increase in apoB100 synthesis indicates the possible impact of this deficiency on
      the editing of apoB. An increase in apoB100 synthesis by the liver in copper
      deficient rats may significantly contribute to the increase in plasma
      concentration of LDL.

PMID- 8482365
TI  - The VP35 and VP40 proteins of filoviruses. Homology between Marburg and Ebola
      viruses.
AB  - The fragments of genomic RNA sequences of Marburg (MBG) and Ebola (EBO) viruses
      are reported. These fragments were found to encode the VP35 and VP40 proteins.
      The canonic sequences were revealed before and after each open reading frame. It
      is suggested that these sequences are mRNA extremities and at the same time the
      regulatory elements for mRNA transcription. Homology between the MBG and EBO
      proteins was discovered.

PMID- 8482366
TI  - Monoclonal anti-biotin antibodies simulate avidin in the recognition of biotin.
AB  - The sequence of the VH gene of a monoclonal anti-biotin antibody was determined.
      Biotin-binding motifs, similar to those in avidin and streptavidin, were
      identified in complementary determining regions 2 and 3, suggesting that natural
      selection of functional motifs may occur in unrelated protein types.

PMID- 8482367
TI  - Phosphorylation of mitochondrial proteins in bovine heart. Characterization of
      kinases and substrates.
AB  - Protein phosphorylation by [gamma-32P]ATP in total extract and subfractions of
      bovine heart mitochondria has been studied. The results show that, in addition to
      pyruvate dehydrogenase, three mitochondrial proteins, with molecular weights of
      44,000, 39,000 and 31,000 Da, are phosphorylated by a cAMP-independent
      mitochondrial protein kinase. Three other proteins associated with mitochondria,
      with molecular weights of 125,000, 19,000 and 6,500 Da, are phosphorylated by the
      cytoplasmic cAMP-dependent protein kinase (kinase A).

PMID- 8482368
TI  - Identification of mitogen-activated protein kinase phosphorylation sequences in
      mammalian h-Caldesmon.
AB  - h-Caldesmon in vascular smooth muscle is phosphorylated in response to
      pharmacologic stimulation. Although many kinases phosphorylate h-caldesmon, in
      vitro, the responsible kinase in intact tissue is unknown. The sites of
      phosphorylation in caldesmon from intact canine aortas have recently been
      identified and are consensus sequences for a proline-directed protein kinase. In
      this study, we investigated the phosphorylation of h-caldesmon by mitogen
      activated protein kinase (MAPK). Purified, recombinant MAPK phosphorylated
      porcine stomach h-caldesmon to a stoichiometry approaching 2 mol phosphate/mol
      protein. Phosphorylated h-caldesmon was subjected to proteolysis and the
      phosphopeptides were purified by high performance liquid chromatography. Two
      major phosphopeptides were identified and sequenced. These two peptides, VTS*PTKV
      and S*PAPK, were identical to the sequences of the sites phosphorylated in intact
      tissue. Antibodies to several enzymes implicated in the cascade of activation of
      MAPK were used to evaluate vascular smooth muscle by Western blotting. All
      components were found to be present. These data suggest that MAPK can function as
      a 'caldesmon kinase' in vascular smooth muscle.

PMID- 8482369
TI  - Starvation effect on rat kidney peroxisomal and microsomal fatty acid oxidation.
      A comparative study between liver and kidney.
AB  - Microsomal lauric acid 12-hydroxy lauric acid (omega)-hydroxylation and fatty
      acid peroxisomal beta-oxidation were studied in kidney tissue from starved rats.
      Starvation increased the microsomal omega-hydroxylation and peroxisomal beta
      oxidation of fatty acids with a high correlation between both processes. Earlier,
      we reported similar results in liver. Our results support the hypothesis that the
      role of microsomal fatty acids omega-hydroxylation is the generation of substrate
      for peroxisomal beta-oxidation, with the final purpose of contributing to a
      catabolic or gluconeogenic pathway from fatty acids.

PMID- 8482370
TI  - Structural modifications associated with the change in Ca2+ sensitivity on
      activation of m-calpain.
AB  - Autolysis of the Ca(2+)-dependent cysteine protease m-calpain involves cleavage
      of the large (80 kDa) and small (30 kDa) subunits of the enzyme, and an increase
      in Ca2+ sensitivity. The appearance of increased Ca2+ sensitivity was found to
      correlate with the cleavage of the large subunit after residue 9.

PMID- 8482371
TI  - Age-dependent deamidation of alpha B-crystallin.
AB  - Bovine and human alpha B-crystallin undergo deamidation upon aging in the lens.
      In bovine alpha B-crystallin, the specific site of deamidation has been
      identified by peptide mapping after tryptic digestion. Asn-146 was found to be
      subject to deamidation, whereas the only other asparagine residue, at position
      78, is not affected. Asn-146 is flanked at the carboxylic side by a glycyl
      residue. Yet, the rate of in vivo deamidation is low. In vitro studies reveal
      that the deamidation is accompanied by significant racemization, indicating that
      the deamidation proceeds via formation of a succinimide intermediate.

PMID- 8482372
TI  - Presence of the brown fat-specific mitochondrial uncoupling protein and
      iodothyronine 5'-deiodinase activity in subcutaneous adipose tissue of neonatal
      lambs.
AB  - Subcutaneous adipose tissue of neonatal lambs has been examined for the presence
      of markers diagnostic of thermogenic brown fat. Uncoupling protein, uncoupling
      protein mRNA, and iodothyronine 5'-deiodinase activity were each detected in
      subcutaneous adipose tissue, as well as in the major internal fat depot
      (perirenal), of newborn lambs. These brown fat markers were not present, however,
      in adipose tissue of adult sheep. It is concluded that subcutaneous fat in
      newborn lambs is functionally 'brown', and similar to the internal fat;
      subcutaneous and internal adipose tissues follow a similar developmental path-
      from 'brown' to 'white'.

PMID- 8482373
TI  - Procathepsin L-specific antibodies that recognize procathepsin L but not
      cathepsin L.
AB  - Procathepsin L was purified to apparent homogeneity from the culture medium of v
      Ha-ras transformed NIH3T3 (Ras-NIH) cells in three steps; anion-exchange
      chromatography, gel filtration, and re-gel filtration. SDS-PAGE analyses revealed
      that the purified samples contained only the precursor form, procathepsin L, but
      not the mature enzyme, cathepsin L. Antibodies against purified procathepsin L
      were raised. These recognized both rat cathepsin L and the purified procathepsin
      L. To isolate procathepsin L-specific antibodies that did not recognize cathepsin
      L, sequential affinity chromatography procedures were carried out. Immunoblot
      analyses showed that the procathepsin L-specific antibodies recognized only
      procathepsin L, but not cathepsin L.

PMID- 8482374
TI  - The role of protein tyrosine phosphatases in density-dependent growth control of
      normal rat kidney cells.
AB  - In normal rat kidney cells protein tyrosine phosphatases (PTPases) play a role in
      attaining density-dependent growth arrest after stimulation with mitogens. The
      PTPase inhibitor sodium orthovanadate prevents density-dependent growth
      inhibition of EGF-treated cells and mimicks in that respect the action of TGF
      beta and retinoic acid. However, enhanced PTPase activity is not obligatory for
      maintaining cells in a density-arrested state. In contrast to TGF beta and
      retinoic acid, vanadate is unable to restimulate density-inhibited cells,
      indicating that different mechanisms are operating. Yet, vanadate is strongly
      potentiating the effect of low concentrations of TGF beta but not of retinoic
      acid, implicating that tyrosine phosphorylation is linked to TGF beta action and
      that PTPase may represent a negative control element in the TGF beta signaling
      pathway.

PMID- 8482375
TI  - Identification of phytanoyl-CoA ligase as a distinct acyl-CoA ligase in
      peroxisomes from cultured human skin fibroblasts.
AB  - Phytanic acid accumulates in excessive amounts in Refsum disease, a rare
      neurological disorder, due to a defect in its alpha-oxidation enzyme system in
      peroxisomes. The activation of phytanic acid to phytanoyl-CoA by phytanoyl-CoA
      ligase is a prerequisite for its alpha-oxidation. The studies described in this
      manuscript report that phytanoyl-CoA ligase in peroxisomes is an enzyme distinct
      from the previously reported acyl-CoA ligases.

PMID- 8482376
TI  - The antigenic domain of flagellin from S. paratyphi shares a structural fold with
      subtilisin.
AB  - Bacterial flagellin has two domains: the polymerizing domain consisting of N- and
      C-terminal regions which are partly disordered in the monomeric state; and the
      central antigenic domain with compact globular structure. The polymerizing domain
      is highly conserved in flagellins from different species but the antigenic domain
      is diverse in sequence and size. Whereas the former has direct functional
      significance for bacterial motility, the latter has not been identified as having
      a specific function except for defining the distinct serotype of the bacterium.
      The sequence alignment of flagellin from S. paratyphi with proteins of known
      three-dimensional structure reveals significant homology of the central 265
      residue stretch with the bacterial serine protease, subtilisin. This homology is
      evident also in the comparison of the predicted secondary structure of flagellin
      with the observed secondary structural features in subtilisin. The
      deletions/insertions arising due to optimal alignment of the two proteins occur
      on the surface loops in the structure. Thus, a domain of S. paratyphi flagellin
      and subtilisin appear to have similar structural folds.

PMID- 8482377
TI  - Protein kinase C isoenzymes in human neuroblasts. Involvement of PKC epsilon in
      cell differentiation.
AB  - Although neuronal cells are a major target of phorbol ester action, the activity
      of the various protein kinase C (PKC) isoenzymes have not been studied in detail
      in human neuroblasts. Differentiation of the LAN-5 human neuroblastoma cell line
      by interferon-gamma (IFN-gamma) is accompanied by a twofold increase in PKC
      activity. Since PKC is a multigene family, we investigated which isoforms were
      expressed in control and differentiated cells, and which of these isoenzymes is
      involved in neuronal differentiation. We found that: (1) PKC activity is higher
      in differentiated than in undifferentiated cells; (2) RT-PCR analysis showed the
      expression of mRNA for PKC alpha, -gamma, -delta, -epsilon and -zeta and the
      absence of mRNA for beta in untreated LAN-5 cells; (3) Western blot evaluation
      with PKC isoform-specific antibodies showed the same pattern of PKC expression in
      non-differentiated cells; (4) Expression of PKC epsilon mRNA was significantly
      enhanced by IFN-gamma-induced differentiation, while the other isoforms were not
      affected; (5) Differentiation of LAN-5 cells with IFN-gamma or retinoic acid
      induced overexpression of the PKC epsilon protein, while inhibition of cell
      proliferation by fetal calf serum starvation was without effect. These findings
      suggest that expression of PKC epsilon isoform is tightly coupled with neuronal
      differentiation and may play a role in the maintenance of the differentiated
      state.

PMID- 8482378
TI  - Biochemical and immunological evidence that an acidic domain of hsp 90 is
      involved in the stabilization of untransformed glucocorticoid receptor complexes.
AB  - Polyclonal antibodies (AS 232-266) have been raised against the 232-266 amino
      acid sequence of the mouse hsp 84. This sequence possesses 54% acidic residues.
      AS 232-266 react with both the denatured and the free native murine hsp 84, but
      not with the bound hsp 84 present in the untransformed glucocorticoid receptor
      complexes (GR). Both AS 232-266 and peptide 232-266 were shown to decrease
      [3H]dexamethasone binding by GR. Moreover synthetic peptide 232-266, when added
      to 7 nm untransformed GR, convert them into 5 nm hsp 84-free GR. Taken together
      these data suggest that the acidic 232-266 sequence of hsp 84 is involved in the
      stabilization of the hsp 84-GR interaction, which is known to result in 7 nm
      complex formation and in GR ligand binding activity improvement. Both peptide 232
      266 and AS 232-266 destabilize this interaction.

PMID- 8482379
TI  - cDNA cloning of a new type of subunit of mammalian proteasomes.
AB  - The primary structure of a new type of subunit (RN3) of rat proteasomes
      (multicatalytic proteinase complexes) has been determined from the nucleotide
      sequence of the cDNA. The cDNA encodes a protein of 232 amino acids but the
      directly determined N-terminal amino acid sequence suggests that the subunit is
      post-translationally processed to a M(r) = 24k form. Sequence alignments reveal a
      similarity of RN3 to other proteasome subunits. It can be designated a B-type
      proteasomal subunit but is not closely related to the beta subunit of the
      archaebacterial proteinase or to other members of the B group.

PMID- 8482380
TI  - Three-dimensional model of NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase
      and relationships to the NADP(+)-dependent enzyme (carbonyl reductase).
AB  - Modelling the amino acid sequence of NAD(+)-linked 15-hydroxyprostaglandin
      dehydrogenase into the three-dimensional structure of 3 alpha/20 beta
      hydroxysteroid dehydrogenase shows that these two enzymes, as well as the NADP(+)
      linked prostaglandin dehydrogenase (identical to carbonyl reductase) have similar
      conformations, in spite of very limited sequence identity (23-28%). Conservation
      of tertiary structures is greatest over the first two thirds of the polypeptide
      chains, where the typical NAD+ binding fold is retained, including the five first
      beta-strands, with only two short deletions or insertions up to residue 147. The
      remaining thirds of each of the prostaglandin dehydrogenases have significantly
      different architecture, including insertions that may contribute to enzyme
      specificity, and, except for an additional helix (alpha G), are difficult to
      model. Active site relationships can be evaluated and subunit interactions
      predicted, suggesting that the alpha E + alpha F two-helix surface constitutes
      the major subunit interacting area, forming a dimeric unit in the oligomeric
      enzymes.

PMID- 8482381
TI  - The local information content of the protein structural database.

PMID- 8482382
TI  - Endothelin-1 stimulated phospholipase D in A10 vascular smooth muscle derived
      cells is dependent on tyrosine kinase. Evidence for involvement in stimulation of
      mitogenesis.
AB  - The mechanism whereby endothelin stimulates mitogenesis of vascular smooth muscle
      cells is not understood. Here we show that endothelin-1 stimulates phospholipase
      D by a protein kinase C and tyrosine kinase dependent mechanism, and present
      evidence that implicate the phosphatidic acid formed by phospholipase D in the
      mitogenic response.

PMID- 8482383
TI  - Mycalolide-B, a novel and specific inhibitor of actomyosin ATPase isolated from
      marine sponge.
AB  - A toxin isolated from marine sponge, mycalolide-B, inhibited smooth muscle
      contractions without changing cytosolic Ca2+ levels. It also inhibited Ca(2+)
      induced contraction in permeabilized smooth muscles. In native actomyosin
      prepared from chicken gizzard, mycalolide-B inhibited superprecipitation and
      Mg(2+)-ATPase activity stimulated by Ca2+ without changing myosin light chain
      phosphorylation. In the permeabilized muscle and native actomyosin preparation
      thiophosphorylated with ATP gamma S, mycalolide-B inhibited ATP-induced
      contraction and Mg(2+)-ATPase activity, respectively, in the absence of Ca2+.
      Mycalolide-B also inhibited Mg(2+)-ATPase activity of skeletal muscle native
      actomyosin. Mycalolide-B had no effect on calmodulin-stimulated (Ca(2+)-Mg2+)
      ATPase activity of erythrocyte membranes. These results suggest that mycalolide-B
      selectively inhibits actin-myosin interaction.

PMID- 8482384
TI  - Homology of the NifS family of proteins to a new class of pyridoxal phosphate
      dependent enzymes.
AB  - Iterative profile sequence analysis reveals a remote homology of peroxisomal
      serine-pyruvate aminotransferases from mammals to the small subunit of soluble
      hydrogenases from cyanobacteria, an isopenicillin N epimerase, the NifS gene
      products from bacteria and yeast, and the phosphoserine aminotransferase family.
      All members of this new class whose function is known are pyridoxal phosphate
      dependent enzymes, yet they have distinct catalytic activities. Upon alignment, a
      lysine around position 200 remains invariant and is predicted to be the pyridoxal
      phosphate-binding residue. Based on the detected homology, it is predicted that
      NifS has also a pyridoxal phosphate-dependent serine (or related)
      aminotransferase function associated with nitrogen economy and/or protection
      during nitrogen fixation.

PMID- 8482385
TI  - An X-ray absorption study of the reconstitution process of bovine Cu,Zn
      superoxide dismutase by Cu(I)-glutathione complex.
AB  - The Cu(I)GSH complex has recently been shown to be a good candidate for
      delivering copper to the active site of Cu-free Cu,Zn superoxide dismutase both
      in vivo and in vitro. In this work X-ray absorption spectroscopy has been used to
      characterize the Cu(I)GSH complex and to follow in vitro the reconstitution of
      Cu,Zn superoxide dismutase from the copper-free protein and this complex. The
      results obtained indicate that the copper is directly transferred as Cu(I) from
      the GSH complex into the empty copper binding site. No evidence has been obtained
      for a ternary complex in which the metal is bound to both GSH and the protein.

PMID- 8482386
TI  - Electron transfer in pheophytin a-modified reaction centers from Rhodobacter
      sphaeroides (R-26).
AB  - The major part (> 90%) of bacteriopheophytin a in reaction centers (RCs) of
      Rhodobacter sphaeroides was substituted by plant pheophytin a. In modified RCs
      the photochemical formation of P+Qa- occurs with with a quantum efficiency of
      79%. The intermediary state P+I- displayed a recombination time constant of 1.5
      ns, and the electron transfer from I- to Qa was characterized by a time constant
      of 540 ps. On the basis of spectral properties of P+I- for native and modified
      RCs, it was suggested that bacteriopheophytin, as well as bacteriochlorophyll
      monomers located in L protein branch, have a transition at 545 nm with approx.
      equal extinction coefficients. Accordingly, the state P+I- in modified RCs is
      proposed to consist of a thermodynamic mixture of P+BL- (approximately 80%) and
      P+Phe- (approximately 20%).

PMID- 8482387
TI  - A 19F NMR study of the interaction of 3-fluoro-4-demethoxydaunomycin with the
      hexanucleotide d(TCCGGA)2.
AB  - 19F NMR spectroscopy has been used to study the binding of the fluorinated
      anthracycline 3-fluoro-4-demethoxydaunomycin with the hexanucleotide d(TCCGGA)2.
      In the spectrum of the 1:1 anthracycline-d(TCCGGA)2 complex four resonances of
      approximately equal intensity were observed. This indicated that 4
      demethoxydaunomycin intercalated at all possible sites with similar affinity.
      This suggests that the specific high affinity binding sites that are observed in
      anthracycline-DNA footprinting experiments are strongly regulated by the local
      DNA conformation.

PMID- 8482388
TI  - B16-G4F mouse melanoma cells: an MSH receptor-deficient cell clone.
AB  - The two mouse melanoma cell lines B16-F1 and B16-G4F retain their melanogenic
      capacity when cultured in vitro. Melanotropic peptides such as alpha-melanocyte
      stimulating hormone (alpha-MSH) induce formation and release of melanin pigment
      in B16-F1 cells. In contrast, B16-G4F cells do not respond to alpha-MSH. Using
      receptor-binding analysis and photoaffinity crosslinking we demonstrate that the
      lack of response of B16-G4F cells to alpha-MSH is due to the absence of
      functional MSH receptors from the cell surface. Northern blot analysis of
      receptor mRNA revealed that MSH receptor mRNA is not expressed in B16-G4F cells.
      These cells represent a new tool for the study of signal pathways related to the
      control of melanogenesis in melanoma cells.

PMID- 8482389
TI  - The structure of human carbonic anhydrase II in complex with bromide and azide.
AB  - The three-dimensional structure of human carbonic anhydrase II complexed with
      azide and with bromide was investigated crystallographically. Both of these non
      protonated inhibitors replace the zinc and the 'deep' water, two catalytically
      important water molecules in the active site of the molecule. Both the azide and
      the bromide ions bind in a distorted tetrahedral manner 0.4 and 1.1 A from the
      zinc water position, respectively, but are in close contact (2.0 and 2.6 A,
      respectively) with the zinc ion.

PMID- 8482390
TI  - Purification and characterization of the cystinyl bond cleaving yeast
      aminopeptidase yscXVI.
AB  - Aminopeptidase yscXVI was purified from the yeast Saccharomyces cerevisiae. By
      SDS-PAGE the enzyme has a molecular weight of 45,000 Da, and in chromatofocusing,
      elution was observed at pH 6.2. The synthetic substrate cystinyl-4-nitroanilide
      (Km 22.5 microM, Vmax 12.9 mU/mg) is cleaved most efficiently in the pH range 7
      8. Besides cleaving this standard substrate, aminopeptidase yscXVI acts on
      several other 4-nitroanilide substrates with unsubstituted N-terminal L-amino
      acids. Highest hydrolysis rate was measured with Lys-4-nitroanilide and Leu-4
      nitroanilide. The activity of aminopeptidase yscXVI is abolished by chelating
      agents and restored by Zn2+, Mn2+ and Co2+ ions. Bestatin and amastatin are both
      strong inhibitors of the enzyme, with Ki values of 0.53 microM and 0.93 microM,
      respectively. Aminopeptidase yscXVI is detectable in the logarithmic growth
      phase, stationary phase, and in starved cultures of yeast.

PMID- 8482391
TI  - Adenine dinucleotide-mediated cytosolic free Ca2+ oscillations in single
      hepatocytes.
AB  - Single rat hepatocytes microinjected with aequorin respond to Ca(2+)-mobilizing
      agonists, including ADP and ATP, with oscillations in cytosolic free Ca2+. We
      show here that single rat hepatocytes also respond to the adenine dinucleotides
      Ap3A and Ap4A with Ca2+ oscillations which resemble those induced by ADP and ATP.

PMID- 8482392
TI  - Exon/intron organization of the gene encoding the mouse epithelin/granulin
      precursor (acrogranin).
AB  - Mouse genomic clones encoding the epithelin/granulin gene and its 5'- and 3'
      flanking regions have been isolated and sequenced. This gene was found to be a
      single-copy gene, and contained 13 exons interrupted by 12 introns. Eight out of
      the 12 introns are classified as phase 0, and are located within the central part
      of each of the tandem repeats in the amino acid sequence of the
      epithelin/granulin precursor. The first intron is unique because of the
      interruption of the 5'-untranslated region and its fairly large size
      (approximately 2.4 kbp). Consensus sequences for several of the potential
      regulatory elements are present in the 5'-flanking sequence, including a common
      CCAAT sequence.

PMID- 8482393
TI  - CoA esters of valproic acid and related metabolites are oxidized in peroxisomes
      through a pathway distinct from peroxisomal fatty and bile acyl-CoA beta
      oxidation.
AB  - In rat liver homogenates fortified with the appropriate cofactors (ATP and CoA),
      valproic acid induced H2O2 production rates by far lower than those recorded on
      the straight medium-chain fatty acid n-octanoic acid. Using directly the CoA
      esters of these carboxylic acids as substrates for the rat liver H2O2-generating
      enzyme activities, valproyl-CoA, and n-octanoyl-CoA were found to induce similar
      oxidation rates. In the rat liver homogenates, cyanide-insensitive valproyl-CoA
      and octanoyl-CoA oxidations occurred at rates similar to those of valproyl-CoA
      and octanoyl-CoA oxidase(s), respectively. Studies on fractions obtained from rat
      liver postnuclear supernatants by isopycnic centrifugation on a linear sucrose
      density gradient disclose that the density distribution of valproyl-CoA oxidase
      superimposes to those of catalase, fatty acyl-CoA oxidase and cyanide-insensitive
      fatty acyl-CoA oxidation, three peroxisomal marker activities. By contrast, the
      cyanide-insensitive valproyl-CoA oxidation does not adopt the typical peroxisomal
      distribution of these activities but rather exhibits a mitochondrial localization
      with, however, a minor peroxisomal component. Interestingly enough, the
      comparative study of rat tissue distribution, inducibility by clofibrate and
      sensitivity to deoxycholate indicated that valproyl-CoA oxidase is an enzyme
      distinct from fatty acyl-CoA oxidase and bile acyl-CoA oxidase. Taken as a whole,
      the results presented here support the occurrence of a peroxisomal oxidation of
      the CoA ester of valproic acid and its delta 4-enoic derivate which might be
      characterized by two major features: initiation by an acyl-CoA oxidase distinct
      from fatty and bile acyl-CoA oxidases, and inability to complete the beta
      oxidation cycle which would not proceed, at significant rates, further than the
      beta-hydroxyacyl-CoA dehydrogenation step in peroxisomes.

PMID- 8482394
TI  - FNA members meet at White House.

PMID- 8482395
TI  - Are we failing in adolescent health?

PMID- 8482397
TI  - Ethical issues affecting Florida nurses in clinical practice.

PMID- 8482396
TI  - Workplace issues. AIDS update.

PMID- 8482398
TI  - National nurse practitioner leadership summit--1993.

PMID- 8482399
TI  - How to get sponsored for speaking.

PMID- 8482400
TI  - Great things happen when agencies unite!

PMID- 8482401
TI  - Update on public health.

PMID- 8482402
TI  - Legislative and community response to cocaine use in pregnancy.

PMID- 8482403
TI  - Nonaccidental injuries in children.

PMID- 8482404
TI  - Children and violence.

PMID- 8482405
TI  - Genetic analysis of developmental mechanisms in hydra. XX. Cloning of
      interstitial stem cells restricted to the sperm differentiation pathway in Hydra
      magnipapillata.
AB  - Hydra magnipapillata polyps containing a subpopulation of interstitial stem cells
      restricted to the germline differentiation pathway were obtained. Chim-C1 is a
      chimeric strain produced by combining wild-type epithelial cell lineages with a
      temperature-sensitive interstitial cell lineage. It grows normally at 18 degrees
      C. When cultured at 25 degrees C, many polyps lost interstitial cells and their
      differentiation products (nerve cells and nematocytes), and subsequently turned
      into epithelial hydra unable to move or feed. Some polyps, however, turned into
      an unexpected type, termed "pseudo-epithelial hydra." These polyps resembled
      epithelial hydra in the absence of nerve cells or nematocytes in the tissue and
      in their inability to move or feed. In contrast to epithelial hydra, however,
      their tissue contained proliferating interstitial cells. Similar pseudo
      epithelial hydra were also produced from another strain, nem-1, by means of
      hydroxyurea treatment. Clones of pseudo-epithelial hydra were maintained through
      force-feeding over 130 days for chim-C1 and over 2 years for nem-1. In both
      cases, interstitial cells proliferated throughout the period without producing
      any nerve cells or nematocytes. These interstitial cells, however, differentiated
      into sperm. Thus, the interstitial cells present in pseudo-epithelial hydra were
      able to differentiate into gametic cells but not into somatic cells (nerve cells
      and nematocytes). These observations suggest that, as Littlefield (1985, Dev.
      Biol. 112, 185-193) has shown for H. oligactis, the interstitial stem cell
      population in H. magnipapillata includes a subpopulation which can differentiate
      only into gametic cells.

PMID- 8482406
TI  - Patterning of heads and feet during regeneration of Hydra oligactis aggregates.
AB  - The de novo appearance of head organizing centers was monitored during
      regeneration of aggregates made from dissociated body column tissue of Hydra
      oligactis using the head-specific monoclonal antibody CP8 (L. C. Javois, R. D.
      Wood, and H. R. Bode, 1986, Dev. Biol. 117, 607-618). Newly differentiated CP8+
      head organizing centers were present by 24 hr of regeneration and were restricted
      to one half of the aggregate. Depending on subsequent patterning events these
      CP8+ cells went on to develop into heads or body tentacles, or remained as CP8+
      patches. A comparison of the number of initial CP8+ patches with the final number
      of CP8+ structures indicated that this number was fairly constant, suggesting
      that a limited number of head organizing centers were established early during
      regeneration. Examination of fully differentiated head structures revealed that
      they were segregated to one end of the aggregate with feet segregated away from
      the CP8+ structures. Increasing the surface area of the aggregates resulted in a
      more random initial spacing of CP8+ head organizing centers and ultimately a more
      random distribution of differentiated heads and feet. However, polarized polyps
      with one head and foot detached and the remaining structures were then
      segregated. The ability of existing pattern formation models to describe
      interactions between head- and foot-forming systems resulting in the observed
      spacing of heads and feet is discussed.

PMID- 8482407
TI  - Apical orientation of the microtubule organizing center and associated gamma
      tubulin during the polarization of the retinal pigment epithelium in vivo.
AB  - Simple epithelial cells express a morphological and functional polarity along
      their apical-to-basal axis. During the development of epithelia, a unique
      reorganization of microtubule arrays is thought to play a fundamental role in the
      establishment of cell polarity. To begin to understand this process in vivo, we
      have determined the distribution of gamma-tubulin within developing chicken
      retinal pigment epithelium (RPE). gamma-Tubulin is a recently discovered
      centrosomal protein that plays a role in nucleating microtubule growth from the
      centrosome. Although the RPE monolayer becomes established during embryonic Day
      3, cell polarity gradually develops and matures over the next 10-13 days. Our
      studies reveal that gamma-tubulin is located in a distinct focus subjacent to the
      apical membrane by embryonic Day 3, the beginning of the polarization process.
      Using primary cell cultures, we examined the relationship between the
      establishment of junctional complexes and the reorganization of microtubule
      arrays. Despite the recovery of junctional complexes and a transepithelial
      electrical resistance, cultured cells failed to relocate gamma-tubulin foci to a
      position subjacent to the apical membrane. Rather, these foci remained in the
      juxtanuclear region. These data indicate that the rearrangement of unique,
      epithelial microtubule arrays requires more than cell-cell and cell-basement
      membrane interactions.

PMID- 8482408
TI  - Sources of calcium in sea urchin eggs during the fertilization response.
AB  - Shortly after sperm-egg interaction the sea urchin egg is traversed by a Ca2+
      wave, which is necessary for metabolic activation of the quiescent cell. Several
      sources including influx across the egg plasma membrane and release from
      intracellular stores may contribute to the rise in cytoplasmic Ca2+ activity.
      Inositol 1,4,5-trisphosphate (InsP3), cyclic ADP ribose (cADPR), and ryanodine
      have been reported to induce intracellular Ca2+ release. We used confocal laser
      scanning microscopy to image the Ca2+ transient during fertilization and
      parthenogenetic activation by microinjection of Ca2+ release agonists. A near
      instantaneous rise in Ca2+ localized to the egg cortex occurred near the time of
      sperm-egg binding, followed by a distinctive delay before the onset of the Ca2+
      wave. Since the rise in cortical Ca2+ activity was absent when Ca2+ influx was
      prevented, it appeared that this change in Ca2+ activity was due to the opening
      of membrane Ca2+ channels. Blocking the influx did not alter the onset of the
      Ca2+ wave. The Ca2+ wave during the fertilization response seemed to require Ca2+
      release mediated by InsP3-, cADPR-, and ryanodine-sensitive mechanisms.
      Parthenogenetic activation by microinjection of these three agents had different
      spatiotemporal patterns of Ca2+ release. Most significantly the injection of
      either InsP3 or cADPR, but not ryanodine, induced an enhanced pronucleus
      associated Ca2+ release, which was similar to the Ca2+ response during
      fertilization.

PMID- 8482409
TI  - Changes in expression of nonmuscle myosin heavy chain isoforms during muscle and
      nonmuscle tissue development.
AB  - Anti-human platelet myosin antibodies and two anti-peptide antibodies, anti
      peptide IIA and anti-peptide IIB, which recognize macrophage-type (MIIA) and
      brain-type (MIIB) isoforms of nonmuscle myosin heavy chain, respectively, were
      used to study expression of nonmuscle myosin isoforms in various tissues of mice
      during development. Tissue-specific changes in the relative isoform
      concentrations were observed by performing immunoblots of crude myosin extracts
      from nonmuscle and muscle tissues. In fetal and neonatal mouse tissues, the anti
      peptide IIB antibodies stained a single band, called MIIB2, while the anti
      peptide IIA and anti-platelet myosin antibodies stained a band that migrated
      faster than MIIB2. In brain, a slower moving band, MIIB1, started to appear at 2
      weeks after birth, and in the adult cerebellum it was at least as abundant as
      MIIB2. In thymus, MIIB2 decreased selectively shortly after birth, while in liver
      both MIIB2 and MIIA rapidly disappeared, but the isoform(s) detected by anti
      platelet myosin antibodies (MIIApla) remained constant. The MIIB2 and MIIA as
      well as MIIApla found in striated muscles from fetal and neonatal mice decreased
      to levels that were below the limit of detection by 3 weeks of age. In
      cryosections of skeletal and cardiac muscles, MIIB2 was localized within the
      muscle cells, while MIIA and MIIApla were primarily in the blood vessels and
      capillaries.

PMID- 8482410
TI  - Cleavage asynchrony in the Tubifex embryo: involvement of cytoplasmic and nucleus
      associated factors.
AB  - The smaller AB-cell of the 2-cell embryo of Tubifex divides 40 min later than the
      larger CD-cell. The present study was undertaken to elucidate those factors that
      are responsible for this cleavage asynchrony. An examination of chromosome cycles
      showed that the AB-cell entered M-phase 5 min later and spent about 35 min longer
      in the prometaphase portion of M-phase than did the CD-cell. Even if cultured in
      isolation, the length of M-phase of AB isolates continued to be comparable to
      that of intact AB-cells. When AB and CD nuclei were brought into a common
      cytoplasm, they entered M-phase simultaneously. The durations of M-phase portions
      from prometaphase through telophase were not altered even in a common cytoplasm,
      as long as the mitotic figures of AB and CD nuclei were separated from each
      other. Only when the mitotic spindles of both nuclei were united at at least one
      pole was the length of prometaphase of the AB nucleus significantly shortened.
      Whole-mount immunocytochemistry of microtubules revealed that asters were
      involved in mitotic spindle assembly in the CD-cell but not in the AB-cell. The
      fully formed spindle of the AB-cell was anastral and barrel-shaped, while that of
      the CD-cell possessed asters at its poles. The morphology of the spindle was not
      altered by changes in the cytoplasmic environments; that is, the spindle of AB
      nucleus was found to be anastral even in the presence of a CD-cell cytoplasm.
      These results suggest that unlike the case of other animals so far studied,
      cleavage asynchrony in the Tubifex embryo is brought about not only by
      cytoplasmic components but also by nucleus-associated factors.

PMID- 8482411
TI  - Compartmentalized expression of the alpha- and gamma-subunits of the
      acetylcholine receptor in recently fused myofibers.
AB  - The mRNAs encoding the subunits of the acetylcholine receptor are clustered at
      the level of the neuromuscular junction in adult muscle fibers. We have followed
      the distribution of the mRNAs encoding the alpha- and gamma-subunits during
      development of the diaphragm muscle in the mouse by whole-mount in situ
      hybridization. We show that the mRNAs encoding both subunits display a
      nonhomogeneous distribution as early as Day 13.5, when the first neuromuscular
      contacts are formed. Extrajunctional mRNAs disappear during the following days
      with a concomitant increase in contrast of the synaptic domains. gamma-subunit
      mRNAs become undetectable at the end of the first postnatal week, together with
      the appearance of epsilon-subunit mRNAs. Our results imply that the expression of
      the acetylcholine receptor genes, including the gamma-subunit gene, is
      compartmentalized soon after neuromuscular contacts have been established. This
      has important implications for the understanding of the molecular mechanisms of
      neuromuscular junction formation.

PMID- 8482412
TI  - Replication timing and Xenopus 5S RNA gene transcription in vitro.
AB  - The influence of DNA replication in a chromosomal environment on the
      transcription of Xenopus laevis 5S RNA genes has been examined using low-speed
      extracts of Xenopus eggs and Xenopus sperm nuclei. The major oocyte- and somatic
      type 5S RNA multigene families of X. laevis are differentially expressed in these
      extracts dependent on limiting transcription factors and replicate in different
      compartments of S-phase. Under these particular experimental conditions the
      timing of replication of the somatic 5S RNA genes appears to be independent of
      their transcriptional activity. Moreover, differential transcription of the
      oocyte- and somatic-type 5S RNA genes is not influenced by the replication
      process.

PMID- 8482413
TI  - Multiple kinesin-like transcripts in Xenopus oocytes.
AB  - Recent evidence shows that kinesin-like proteins (Klps) form a very large
      multigene family. A recent study using the polymerase chain reaction (PCR)
      identified six new candidate Klps in Drosophila, making the total number of
      members of this family in Drosophila at least 11 (Stewart et al., 1991, Proc.
      Natl. Acad. Sci. USA 88, 4424-4427). The functional basis of this diversity is
      not clear. Different Klps could have cell type-specific functions, or they could
      perform different functions within the same cell type, or a mixture of both. To
      investigate the degree to which different Klps are expressed in the same cell, we
      chose the Xenopus oocyte. During oocyte differentiation, and in the egg,
      different types of microtubule-based motility occur; all are important to the
      normal development of the embryo after fertilization. Using PCR we identified and
      partially sequenced four novel Klp mRNAs from the Xenopus oocyte (denoted XKlps 1
      4). Multialign sequence comparison suggests that one of them, XKlp3, may be the
      Xenopus counterpart of Drosophila Klp4. Similarly Xenopus Eg5 is closely related
      to Drosophila Klp2. Northern blot analysis reveals that the Xenopus XKlps have
      different patterns of expression during embryogenesis. These data show that at
      least four Klps can exist in the same cell and that they can be differentially
      regulated during early development, and suggest their differential function in
      oogenesis and early development.

PMID- 8482414
TI  - Segment-polarity mutations cause stripes of defects along a leg segment in
      Drosophila.
AB  - Various lines of evidence suggest that "segment-polarity" genes, which
      participate in segmenting the Drosophila embryo, may also play a role in the
      development of adult structures. Wilkins and Gubb (1991, Dev. Biol. 145, 1-12)
      have proposed that these genes specify the angular component of the polar
      coordinate system for each imaginal disc. If true, then segment-polarity
      mutations should cause abnormal patterning within well-defined sectors of the
      discs. To test this prediction, a leg segment was used where abnormalities can be
      precisely identified. The second-leg basitarsus bears eight rows of
      mechanosensory bristles, plus five chemosensory bristles between specific rows.
      Abnormalities were sought in the basitarsi of six different segment-polarity
      mutants and their 15 pairwise compounds. Consistent with the prediction,
      sectorial defects were indeed found: (1) deletions of specific rows (or
      chemosensory bristles) or portions thereof and (2) increased bristle number
      within (or between) specific rows. Both types of abnormalities were associated
      with changes in the widths of various parts of the circumference, implying that
      the alterations in bristle patterning may be mediated by regional perturbations
      of growth.

PMID- 8482415
TI  - Aberrant expression of Pax-2 in Danforth's short tail (Sd) mice.
AB  - The pattern of Pax-2 expression was studied in Danforth's short tail homozygous
      mice using Pax-2-specific antibodies. Because these mice lack a notochord in
      caudal regions, the floor plate of the spinal cord is not induced and posterior
      mesoderm-derived structures are also affected. The expression of Pax-2 during
      neural differentiation in the spinal cord was normal in anterior sections, but
      ectopic expression in the ventral half of the basal plate was observed in regions
      lacking the floor plate. The data support the hypothesis that Pax-2 expression
      domains are influenced by signals emanating from the floor plate and that Pax-2
      functions during the dorsal-ventral patterning of the spinal cord. In the
      developing excretory system, Pax-2 expression was normal in the anterior
      structures, such as the mesonephros, and in the mesonephric duct. However, Pax-2
      was not expressed in the uninduced metanephric mesenchyme. Thus, activation of
      Pax-2 in the mesenchyme is an early response to inductive signals emanating from
      the ureter. The Danforth's short tail mutation is a useful model for the study of
      developmentally regulated genes that are under the influence of the notochord or
      floor plate.

PMID- 8482416
TI  - Pronuclear positioning and migration during fertilization in Pelvetia.
AB  - The position and migration of egg and sperm pronuclei were studied in the brown
      alga Pelvetia. The egg pronucleus was located near the center of the cell before
      and after fertilization and, unlike pronuclei in animal eggs, did not migrate.
      Inhibitor studies indicated that anchoring of the egg pronucleus in the cell
      center was dependent on microtubules and microfilaments. An extensive array of
      microtubules, many of which extended into the actin-rich egg cortex, was
      associated with the egg pronucleus. Migration of the sperm pronucleus was
      investigated quantitatively in both living and fixed zygotes. Migration occurred
      linearly at rates from 0.11 to 0.29 microns/min and was oriented directly toward
      the egg pronucleus in the cell center. Sperm penetration was inhibited by
      cytochalasin D, which disrupts F-actin function, whereas sperm pronuclear
      migration was sensitive to the microtubule-depolymerizing drug, nocodazole.
      Microtubules associated with the migrating sperm pronucleus formed a sperm trail
      that terminated at the egg cortex. As these were the only microtubules associated
      with the sperm at early stages of migration, we conclude that they provide the
      force for migration.

PMID- 8482417
TI  - Inhibition of precardiac mesoderm cell proliferation by antisense
      oligodeoxynucleotide complementary to fibroblast growth factor-2 (FGF-2).
AB  - This laboratory recently reported the occurrence of concentrated deposits of
      fibroblast growth factor-2 (FGF-2; basic FGF)-like proteins in the sarcoplasm of
      embryonic cardiac myocytes from the earliest stage of avian heart development (M.
      H. Parlow, D. L. Bolender, N. P. Kokan-Moore, and J. Lough, Dev. Biol. 146, 139,
      1991). To determine the role, if any, of FGF-2 during embryonic cardiogenesis,
      the proliferative and functional effects of treating cultured anterior lateral
      plate mesoderm from Hamburger-Hamilton stage 6 embryos with antisense
      oligodeoxynucleotide (ODN) complementary to FGF-2 mRNA were determined. Within 2
      days of culture in defined medium, the explanted monolayer normally
      differentiates into a multilayer of proliferative cells that express sarcomeric
      alpha-actin and exhibit rhythmic contractions. The inclusion of 25 microM ODN
      that is complementary to the second exon of chicken FGF-2 mRNA caused a 50%
      inhibition in these cells' proliferative ability as judged by incorporation of 5'
      bromodeoxyuridine; contractility was similarly inhibited. These effects were
      prevented by including recombinant human FGF-2 protein in the medium. Treatment
      with sense ODN did not cause inhibition. Inhibition of FGF-2 protein synthesis in
      the explanted tissue by antisense ODN was verified by immunoprecipitation
      analysis. These results point to a critical role for FGF-2 in the autocrine
      regulation of proliferation, and perhaps differentiative function, of embryonic
      cardiac myocytes.

PMID- 8482418
TI  - Enhancer regions responsible for temporal and cell-type-specific expression of a
      spore coat gene in Dictyostelium.
AB  - The extracellular spore coat of Dictyostelium discoideum is composed of three
      major proteins, SP96, SP70, and SP60, encoded by the cotA, cotB, and cotC genes,
      respectively. The spore coat proteins are coordinately synthesized in prespore
      cells shortly after aggregation, stored in prespore vesicles during the slug
      stage, and secreted during encapsulation of spores. We have ligated various
      portions of the upstream region of cotB to lacZ such that a protein consisting of
      the first nine amino acids of SP70 fused to beta-galactosidase is synthesized in
      prespore cells. Individual cells that accumulate the enzyme can be observed in
      situ during early aggregation due to the sensitivity of the assay. We have found
      that prespore cells first appear in a random distribution throughout the
      aggregates with no indication of spatial localization. They subsequently sort out
      from prestalk cells that form a tip on the aggregates. The cotB regulatory region
      was subdivided into a proximal and a distal region, each of which could
      independently direct proper temporal and cell-type control. Transcriptional
      activity directed by these two regions appears to be additive in the full-length
      regulatory region. The proximal region was shown to be complex in that removal of
      certain portions partially reduced transcriptional activity while removal of
      other portions abolished all activity. Nevertheless, cells transformed with
      constructs showing attenuated activity expressed the fusion gene at the proper
      time in development and the activity was localized to prespore cells. The cis
      acting regions responsible for all aspects of cotB regulation appear to be
      closely opposed within the minimal essential sequence of the proximal region.

PMID- 8482419
TI  - PS2 integrin requirements in Drosophila embryo and wing morphogenesis.
AB  - The Drosophila inflated (if) gene encodes the alpha PS2 subunit of the PS
      integrins. We describe the generation of new if mutations, their lethal embryonic
      phenotype, and experiments that examine the spatial and temporal requirements for
      integrins in adult wing morphogenesis. Embryos hemizygous for either new allele,
      ifA7 or ifB2, make reduced amounts of alpha PS2. In a variety of genetic tests,
      these alleles behave similarly to ifk27e, which makes no detectable alpha PS2,
      and all three alleles display the same embryonic phenotype. We therefore conclude
      that all of the lethal alleles retain little or no wild-type alpha PS2 function.
      As seen for strong mutations at the myospheroid (mys) locus, which encodes the
      beta PS integrin subunit, if mutants show extreme defects in somatic muscle
      attachments and in midgut morphogenesis. Unlike mys, however, there is no dorsal
      herniation of the if mutant embryos. With respect to wing morphogenesis, clonal
      analysis experiments demonstrate that if+ function is required only in cells of
      the ventral wing surface. We have rescued the wing blister phenotype of double
      mutants for the hypomorphic mysnj42 and if3 alleles using a heat shock-inducible
      mys+ transgene. By varying times of transgene induction, we find that integrin
      function is required from very early in metamorphosis until at least the last 24
      48 hr of wing development.

PMID- 8482420
TI  - A subtle defect underlies altered lamellar orientation in the Gr16 chorion mutant
      of Bombyx mori.
AB  - Gr16 (chromosome 2, 6.9 cM) is a dominant, grey egg mutation of the domestic
      silkmoth, Bombyx mori, which produces an opaque instead of a translucent chorion.
      To determine the underlying cause of this defect, we examined the effects of the
      mutation on chorion ultrastructure, protein accumulation, and biosynthesis
      patterns, and on the restriction patterns of early chorion structural genes,
      using the presumed wild-type progenitor strain, Old European 16 (OE16), for
      comparison. Cross-sections of mature chorions examined by scanning electron
      microscopy showed that the inner lamellae were oriented perpendicular, rather
      than parallel, to the egg surface, with a smaller vertical zone bordered by
      normally oriented lamellae in the heterozygote, suggestive of codominant
      expression. This defect first appeared in transmission electron micrographs early
      in choriogenesis, probably during framework formation and/or expansion stages.
      Mature chorion protein patterns resolved by isoelectric focusing or two
      dimensional polyacrylamide gel electrophoresis, synthetic profiles of virtually
      all chorion proteins following pulse-labeling with tritiated or [14C]glycine, and
      restriction patterns of early chorion genes examined by Southern blot
      hybridization were identical between mutant, wild-type, and heterozygote. These
      observations ruled out a major deletion of chorion structural genes or defects in
      the production and accumulation of normal chorion proteins as mechanisms
      underlying the mutation, unlike other putative Gr mutants mapping in its
      vicinity. The sole difference that we detected was a set of minor, early protein
      doublets of related size but differing isoelectric point, which showed reciprocal
      labeling intensities in Gr16 vs OE16 and were codominantly expressed. Preliminary
      pulse-chase experiments suggested that these proteins may be post-translationally
      modified forms which undergo differential processing in mutant and wild-type.
      Based on these observations, we postulate that the Gr16 mutation affects the
      primary structure of a minor, previously unidentified chorion or follicular cell
      component which is critical for determining lamellar orientation, and discuss
      models of how this might function.

PMID- 8482421
TI  - The winds of change.

PMID- 8482422
TI  - Tumor necrosis factor-alpha prevents rejection of islet xenografts (rat to
      mouse).
AB  - The effect of in vivo administration of exogenous tumor necrosis factor-alpha on
      the survival of rat islet xenografts in STZ-induced diabetic mice was examined.
      Daily subcutaneous injections of purified recombinant murine TNF-alpha (3
      micrograms/day) for 7 days after transplantation of islets prolonged the survival
      of the xenografts (26.7 +/- 4.9 days) compared with controls (11.2 +/- 1.1 days).
      Extension of the treatment from 0 to 59 days after transplantation produced an
      even greater prolongation of graft survival (53.7 +/- 8.5 days). After cessation
      of treatment, an accelerated rejection of the grafts occurred. A most interesting
      finding was that delaying initiation of treatment until 3 days after
      transplantation and continuing until 60 days produced a remarkable prolongation
      of xenograft survival (mean survival time > 89.8 +/- 17.5 days) with 2 recipients
      still normoglycemic at 124 days. Removal of the grafts at this time returned the
      2 mice to a diabetic state. A second islet transplant from the same donor rat
      strain (Wistar-Furth) had an accelerated rejection, indicating that the long-term
      survival of the xenografts was not because of induction of tolerance. Delaying
      initiation of TNF treatment until 6 days after transplantation produced only a
      slight prolongation of survival (17.5 +/- 1.2 days). Prolongation of islet
      xenograft survival also was obtained by continuous, subcutaneous delivery of TNF
      alpha by a 7-day mini-osmotic pump (3 micrograms/day). Lower daily doses of TNF
      alpha (0.003, 0.3, and 1.0 micrograms) had no effect on graft survival.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8482423
TI  - Biological effects and metabolic rates of glucagonlike peptide-1 7-36 amide and
      glucagonlike peptide-1 7-37 in healthy subjects are indistinguishable.
AB  - The biological effects and the metabolism of the intestinal hormone glucagonlike
      peptide-1 7-36 amide and glucagonlike peptide-1 7-37 were studied in normal
      healthy subjects. GLP-1 7-36 amide and GLP-1 7-37 equipotently stimulated insulin
      secretion (integrated hormone response 0-60 min, 631 +/- 211 vs. 483 +/- 177
      pmol/h x L-1) and C-peptide secretion (integrated hormone response 9064 +/- 1804
      vs. 9954 +/- 2031 pmol/h x L-1) and equipotently lowered plasma glucose
      (integrated decrease 48.3 +/- 5.7 vs. 46.2 +/- 8.4 mmol/h x L-1) and plasma
      glucagon (integrated decrease 80.4 +/- 24.3 vs. 156.0 +/- 34.6 pmol/h x L-1).
      Both GLP-1 7-36 amide and GLP-1 7-37 lowered the plasma concentration of free
      fatty acids significantly. The plasma half-lives of GLP-1 7-36 amide and GLP-1 7
      37 were 5.3 +/- 0.4 vs. 6.1 +/- 0.8 min, and the metabolic clearance rates of the
      two peptides also were similar (14.6 +/- 2.4 vs. 12.2 +/- 1.0 pmol/kg x min). In
      conclusion, COOH-terminal amidation is neither important for the metabolism of
      GLP-1 nor for its effects on the endocrine pancreas.

PMID- 8482424
TI  - Glucose-induced amplitude regulation of pulsatile insulin secretion from
      individual pancreatic islets.
AB  - The insulin secretory response to glucose was studied in single pancreatic islets
      isolated from ob/ob mice and rats. The perfusate from an individual islet was
      collected during 18-s periods and analyzed for insulin with an ELISA technique.
      Increase of the glucose concentration from 3 to > or = 5.5 mM resulted in pulses
      of insulin release often originating from the basal level and having a frequency
      of 0.4/min. Glucose regulation of insulin release from the individual islet was
      manifested by alterations of the amplitudes of the pulses but not of their
      frequency. It is concluded that the large amplitude oscillations of cytoplasmic
      Ca2+ known to occur in the pancreatic beta-cells have their counterpart in pulses
      of insulin release and that glucose stimulation of the secretory activity may be
      the result of recruitment of more beta-cells into an oscillatory state.

PMID- 8482425
TI  - Physical training reverses defect in mitochondrial energy production in heart of
      chronically diabetic rats.
AB  - This study examined the impact of physical training on cardiac mitochondrial
      respiration of rats with chronic diabetes mellitus. Diabetes was induced by an
      intravenous injection of STZ (50 mg/kg) and only rats with a blood glucose level
      between 14 and 22 mM 1 wk later were kept in the protocol. Exercise training was
      conducted on a treadmill with a progressive 10-wk program. Animals were killed at
      the end of the training program, and mitochondria were isolated from ventricular
      tissue by differential centrifugation. Both state 3 respiration and oxidative
      phosphorylation rates were depressed significantly in the mitochondria of
      diabetic rats. These alterations were reversed completely to normal by physical
      training, without any significant changes in plasma glucose or insulin levels.
      The activity of ANT was not affected by diabetes or training. These results
      indicate that the depressed OPR present in isolated heart mitochondria from
      chronically diabetic rats is reversed to normal by physical training, apparently
      by mechanisms independent of blood glucose control. This correction in
      mitochondrial energy production may explain the improvement in cardiac function
      previously reported in trained diabetic rats.

PMID- 8482426
TI  - Trial of insulinlike growth factor I therapy for patients with extreme insulin
      resistance syndromes.
AB  - Extreme insulin resistance occurs in patients with primary defects in insulin
      action at the receptor or postreceptor levels. The condition commonly is
      associated with acanthosis nigricans and ovarian masculinization. Despite a
      marked increase in insulin secretion, some patients develop frank diabetes
      mellitus that does not respond adequately to insulin therapy. Insulinlike growth
      factor I exerts metabolic effects similar to those of insulin. This study
      assessed the potential effectiveness of IGF-I as a blood glucose lowering agent
      in patients with extreme insulin resistance syndromes, including type A insulin
      resistance, congenital generalized lipodystrophy, and leprechaunism. Among the 11
      patients studied, some exhibited mutated insulin receptors, whereas others were
      suspected to have defects in postreceptor sites. In each patient, plasma glucose
      levels decreased in response to subcutaneous injections of recombinant human IGF
      I (0.1-0.3 mg/kg body wt). The degree of the decrease was roughly comparable with
      that observed in normal individuals. IGF-I also reduced plasma insulin
      concentrations. A long-term trial of IGF-I (up to 16 mo) showed that IGF-I (0.1
      0.4 mg/kg body wt twice daily) is effective in lowering both fasting and
      postprandial plasma glucose concentrations with decreases in both fructosamine
      and HbA1c values. Improvement of acanthosis nigricans was observed in some of the
      patients. These results suggest that recombinant human IGF-I could be used
      clinically as a hypoglycemic agent in diabetic patients with extreme insulin
      resistance in whom insulin treatment is ineffective.

PMID- 8482427
TI  - Predicting diabetes. Moving beyond impaired glucose tolerance.
AB  - We developed predictive models for type II diabetes using stepwise multiple
      logistic regression analyses of a cohort of 844 Mexican Americans and 641 non
      Hispanic whites who were nondiabetic at baseline and who were then followed for 8
      yr. Models were developed for the overall population and separately for each sex
      and ethnic group. For optimal models, the multiple logistic regression program
      selected potential risk factors from a panel of 5 categorical and 14 continuous
      demographic, anthropometric, metabolic, and hemodynamic variables. For reduced
      models, the list of candidate variables was restricted to those commonly used in
      ordinary clinical practice, i.e., skinfolds, and serum insulin and postural
      glucose load variables were excluded. For all models, the stepwise process
      selected a mixture of anthropometric, glucose, lipid, and hemodynamic variables.
      The top 15% of the risk continuum for each model was defined as high risk to
      compare the performance of the models with the performance of impaired glucose
      tolerance (15% prevalence) as a predictor of diabetes. The relative risk of being
      high risk ranged from 12.16 to 35.29, whereas the relative risk of having
      impaired glucose tolerance ranged from 7.11 to 10.0. The sensitivity of the
      multiple logistic regression models ranged from 67.7 to 83.3% compared with 56.5
      to 62.1% for impaired glucose tolerance. The results indicate that multivariate
      predictive models perform at least as well, if not better than impaired glucose
      tolerance in predicting type II diabetes but need not require an oral glucose
      load. Moreover, the models highlight the complex metabolic and hemodynamic
      syndrome that precedes diabetes.

PMID- 8482428
TI  - Impact of arterial blood pressure and albuminuria on the progression of diabetic
      nephropathy in IDDM patients.
AB  - To evaluate the impact of systemic blood pressure and albuminuria on the
      progression of diabetic nephropathy, we followed 41 IDDM patients with persistent
      albuminuria (> 300 mg/24 h) by measuring glomerular filtration rate (51Cr-EDTA
      technique), blood pressure, and albuminuria. None of the patients were taking
      drugs other than insulin. Arterial blood pressure, albuminuria, and blood glucose
      were measured four to eight times/yr, whereas glomerular filtration rate was
      determined twice yearly. During the median investigation period of 36 (15-66) mo,
      glomerular filtration rate decreased from 102 +/- 23 to 83 +/- 27 ml.min-1 x 1.73
      m-2 (P < 0.001), albuminuria increased from 633 to 1435 micrograms/min (P <
      0.001), and blood pressure rose from 133/85 +/- 10/9 to 149/93 +/- 8/11 mmHg (P <
      0.001). Univariate analysis revealed a significant correlation between the rates
      of decline in glomerular filtration rate and diastolic blood pressure (r = 0.52,
      P < 0.01) and glomerular filtration rate and albuminuria (r = 0.34, P < 0.02).
      But stepwise multiple linear regression analysis only showed a significant
      correlation between the rate of decline in glomerular filtration rate and
      diastolic blood pressure (P < 0.01). In patients with diastolic blood pressure
      below the mean value of 89 mmHg, stepwise multiple regression analysis showed
      that albuminuria and not blood pressure was correlated significantly with rate of
      decline in glomerular filtration rate. Patients were stratified by average value
      of diastolic blood pressure measured during the investigation period.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8482429
TI  - Thoracic duct lymph. Relative contribution from splanchnic and muscle tissue.
AB  - We have shown previously that thoracic duct lymph insulin dynamics are well
      correlated with tracer-determined whole-body glucose uptake and have suggested
      that thoracic duct lymph insulin is representative of insulin concentration in
      muscle interstitial fluid. However, thoracic duct lymph is comprised of
      interstitial fluid from all sub-thoracic tissue beds. To investigate the relative
      contribution of muscle interstitial fluid to total thoracic duct lymph flow, the
      distribution and elimination of [14C]inulin was investigated in eight experiments
      with conscious dogs. Both plasma and thoracic duct lymph were measured, and a
      three-compartment model that was hypothesized to consist of plasma, splanchnic
      interstitial fluid, and muscle interstitial fluid was identified. Identifications
      were performed with either a bolus protocol (n = 4) or an infusion protocol (n =
      4), and the predicted [14C]inulin dynamics in the splanchnic and muscle
      interstitial fluid compartments were compared with measured values in thoracic
      duct lymph. Neither compartment predicted the thoracic duct [14C]inulin dynamics;
      however, a model based on a percentage contribution from each tissue bed fit the
      thoracic data well. The relative contribution of splanchnic interstitial fluid to
      the total thoracic duct lymph flow averaged 78 +/- 5% for the bolus protocol and
      54 +/- 5% for the infusion protocol. Thus, we conclude that in the conscious
      animal, approximately 25-50% of thoracic duct lymph originates from muscle
      interstitial fluid.

PMID- 8482430
TI  - Limitations in the use of [2-14C]acetate for measuring gluconeogenesis in vivo.
AB  - This study was undertaken to test two assumptions critical for use of [2
      14C]acetate to measure gluconeogenesis in vivo. For the assumption that
      incorporation into glucose of products of [14C]acetate metabolism does not affect
      the distribution of label within the glucose molecule, we infused [2-14C]acetate
      in 17 healthy subjects and [3-14C]lactate in 10 healthy subjects and compared the
      ratio of the resultant specific activities of plasma glucose carbons 1, 2, 5, 6,
      and 3, 4 obtained with each tracer. The ratio obtained with [2-14C]acetate (2.99
      +/- 0.07) was significantly different from the ratio obtained with [3
      14C]lactate, (3.82 +/- 0.2, P < 0.01). Because the model predicts that these
      ratios should be identical, these results indicate that either the model is
      incorrect or that metabolism of [14C]acetate to other compounds affects the
      distribution of the label within the glucose molecule. To test the assumption
      that plasma 3-OH-butyrate specific activity approximates the specific activity of
      hepatic intramitochondrial acetyl CoA, we compared the ratio of specific
      activities of plasma glucose and 3-OH-butyrate obtained in 7 healthy subjects
      infused with [2-14C]acetate and [2-14C]octanoate. The ratio obtained with [2
      14C]acetate (0.18 +/- 0.03) was significantly different from that obtained with
      [2-14C]octanoate, (0.10 +/- 0.02), P < 0.001. These results suggest
      compartmentalization of acetyl CoA within liver mitochondria and indicate that
      plasma 3-OH-butyrate specific activity may not necessarily approximate
      intramitochondrial acetyl CoA specific activity during [2-14C]acetate infusion.
      We conclude that assumptions critical for use of [2-14C]acetate to measure
      gluconeogenesis in vivo are not valid.

PMID- 8482431
TI  - Genotoxic agents increase expression of growth arrest and DNA damage--inducible
      genes gadd 153 and gadd 45 in rat pancreatic islets.
AB  - Pancreatic beta-cells are able to repair themselves after some sublethal injuries
      in vitro. However, little is known of the nature of the repair mechanisms active
      in these cells. This study examined the expression of growth arrest and DNA
      damage--inducible genes gadd 153 and gadd 45 in pancreatic rat islets and in the
      clonal insulin secretory HIT-T15 cells. Rat pancreatic islets were exposed in
      vitro to the alkylating agents streptozocin or methyl methanesulfonate, or to the
      cytokine recombinant interleukin-1 beta. Islet exposure to STZ or MMS reduced
      insulin release by 40-50% over the next 4 h, whereas exposure to rIL-1 beta
      induced a 60% increase in insulin release over the same period. Both gadd 153 and
      gadd 45 mRNA were detectable in rat islets, and their levels were increased
      twofold after STZ exposure, whereas MMS induced a fivefold increase in gadd 153
      and a twofold increase in gadd 45 mRNA. Islet exposure to rIL-1 beta did not
      affect the expression of gadd 153 or gadd 45. HIT cells exposed to STZ or MMS
      also exhibited an increased expression of both gadd 153 and gadd 45. Again, this
      increase in gadd mRNA was more marked after MMS exposure. Moreover, expression of
      both gadd 153 and gadd 45 after MMS exposure lasted for a longer period of time
      than after STZ treatment. The effects of MMS on the expression of both gadd genes
      were inhibited by actinomycin D, suggesting that transcription is necessary for
      acute gadd induction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482432
TI  - Synthesis and expression of transforming growth factor beta-1, beta-2, and beta-3
      in the endocrine and exocrine pancreas.
AB  - The actions of transforming growth factor-beta isoforms as potent regulators of
      growth and differentiation have led to the examination of their presence in the
      human pancreas. The cellular localization of TGF-beta 1, TGF-beta 2, and TGF-beta
      3 was assessed in the normal human pancreas by using immunohistochemical and in
      situ hybridization techniques. Although cytoplasmic immunoreactivity for TGF-beta
      1, TGF-beta 2, and TGF-beta 3 was found in islet cells, acinar cells, and ductal
      cells, a differential immunostaining pattern for TGF-beta isoforms was observed.
      In the endocrine pancreas, the islet cells demonstrated diffuse cytoplasmic
      immunostaining for TGF-beta 1, TGF-beta 2, and TGF-beta 3. However, only TGF-beta
      2 and TGF-beta 3 exhibited an intense pattern of immunostaining in a few
      endocrine cells. Most of the positive islet cells coexpressed insulin. In
      contrast, in the exocrine pancreas, a greater number of acinar cells showed
      immunoreactivity for TGF-beta 1 than for TGF-beta 2 and TGF-beta 3. In the ductal
      cells, all three TGF-beta isoforms showed a similar intensity and pattern of
      immunostaining and were observed more frequently in the smaller distal ductules
      than in the larger pancreatic ducts. TGF-beta 1 and TGF-beta 3, but not TGF-beta
      2, immunostaining was detected strongly in the smooth muscle cells and weakly in
      the endothelial cells of the blood vessels, whereas the fibroblasts of the
      interstitium were completely negative. In situ hybridization revealed that mRNA
      encoding all three TGF-beta isoforms colocalized with their respective proteins
      in islets, acinar cells, and ductal cells. In contrast, mRNA expression was
      absent in the smooth muscle cells and endothelium of the vessels. These results
      suggest that TGF-beta isoforms may act by both autocrine and paracrine mechanisms
      in the pancreas. The differential pattern of expression observed for each TGF
      beta isoform implies unique roles for these proteins in the regulation of the
      endocrine and exocrine pancreas.

PMID- 8482433
TI  - Fasting does not impair insulin-stimulated glucose uptake but alters
      intracellular glucose metabolism in conscious rats.
AB  - Effects of 24-h and 48-h fasting on maximal insulin-stimulated whole-body and
      muscle glucose uptake, glycogen synthesis, and glycolysis were studied in
      conscious rats by combining the glucose clamp technique with tracer methods.
      Fasting decreased body weight and basal plasma glucose, plasma insulin, hepatic
      glucose output, and glucose clearance (P < 0.05 for all). However, maximal
      insulin-stimulated whole-body glucose uptake, normalized to body weight, was
      almost identical in fed, 24-h fasted, and 48-h fasted rats (191 +/- 8, 185 +/-
      14, and 182 +/- 5 mumol.kg-1.min-1, respectively; P > 0.7). Similarly, rates of
      insulin-stimulated glucose uptake by four different skeletal muscles, estimated
      by the 2-deoxyglucose injection technique, were not different among the three
      groups. In contrast to glucose uptake, insulin-stimulated whole-body glycolysis
      was decreased significantly after fasting (36% after 48 h fasting; P < 0.05),
      whereas insulin-stimulated whole-body glycogen synthesis was increased (44% after
      48 h fasting; P < 0.05). In fed rats, glycolysis was the major pathway for
      glucose metabolism during hyperinsulinemia, accounting for 60 +/- 5% of glucose
      uptake. This fraction was decreased significantly by fasting (P < 0.01), so that
      after a 48-h fast, glycolysis accounted for only 40 +/- 3% of insulin-stimulated
      glucose uptake and glycogen synthesis became predominant pathway, accounting for
      60 +/- 3% of whole-body glucose utilization. Whole-body patterns of glucose
      metabolism during hyperinsulinemia were paralleled by glucose metabolism in
      individual muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482434
TI  - In vivo glucose metabolism in obese and type II diabetic subjects with or without
      hypertension.
AB  - This study examined whether the presence of hypertension, an insulin-resistant
      condition, exacerbates the defect in insulin action observed in obesity and type
      II diabetes mellitus. Glucose metabolism in the basal state and in response to
      insulin was quantitated by using the euglycemic insulin (20 mU.min-1 x m-2) clamp
      in combination with 3-[3H]glucose infusion and indirect calorimetry in 20 obese
      nondiabetic subjects (10 hypertensive and 10 normotensive), 26 type II diabetic
      subjects (13 hypertensive and 13 normotensive), and 11 normal nondiabetic
      subjects. The two groups of obese subjects and the two groups of diabetic
      subjects were matched for sex, age, race, body mass index, and fat distribution.
      Both in the basal state and during insulin infusion, glucose disposal rates
      (total, oxidative, and nonoxidative) were similar in obese subjects with or
      without hypertension. Compared with control subjects, both groups of obese
      subjects were markedly insulin resistant. Similarly, type II diabetic
      individuals, whether normotensive or hypertensive, were equally insulin
      resistant. The severity of insulin resistance was nearly identical in obese and
      diabetic groups. In diabetic subjects, the inhibitory effect of insulin on
      hepatic glucose output, lipolysis, and lipid oxidation was blunted compared with
      normal subjects. In obese subjects the ability of insulin to inhibit lipolysis
      and lipid oxidation was impaired. However, hypertension did not alter the
      suppressive effects of insulin on hepatic glucose production, plasma free fatty
      acid levels, or lipid oxidation in either obese or type II diabetic subjects.
      These results indicate that hypertension does not confer a greater severity of
      insulin resistance than that already is present in obesity and type II diabetes
      mellitus.

PMID- 8482435
TI  - Organization of the human GLUT2 (pancreatic beta-cell and hepatocyte) glucose
      transporter gene.
AB  - The gene encoding the predominant facilitative glucose transporter expressed in
      pancreatic beta-cells and hepatocytes, termed GLUT2, has been cloned and
      characterized. The human GLUT2 gene is composed of 11 exons spanning
      approximately 30 kilobases. The sequence of the promoter region and all exons and
      adjacent intron regions has been determined and deposited in the GenBank
      database. Two highly polymorphic simple tandem repeat DNA polymorphisms useful
      for linkage studies were localized in introns 1 and 4a. In addition, a 168-base
      pair insertion/deletion polymorphism was identified in intron 3. The
      characterization of the human GLUT2 gene will facilitate studies of its role in
      the development of diabetes mellitus.

PMID- 8482436
TI  - Banting Lecture. On the honey disease. A dialogue with Socrates.

PMID- 8482437
TI  - Proopiomelanocortin gene expression as a neural marker during the embryonic
      development of Xenopus laevis.
AB  - Proopomelanocortin (POMC) is the precursor protein for a number of peptide
      hormones and neuropeptides, and the POMC gene is transcriptionally very active in
      the pars intermedia of the pituitary of the amphibian Xenopus laevis (Xenopus).
      We analysed the expression of this gene during Xenopus embryogenesis, in order to
      examine whether it can function as a (novel) neural marker. We investigated the
      spatio-temporal distribution of POMC mRNA, using a single-stranded probe that
      corresponds to the 3' untranslated region of Xenopus POMC gene B mRNA. Gene
      transcripts were first detected at stage 25 of development via RNase protection
      assays. In situ hybridization analysis performed at stage 46 showed clearly that
      these transcripts are localised in a region representing the future pars
      intermedia of the pituitary. Experiments using Xenopus explants indicate that the
      POMC gene can be used successfully as an indirect marker in studies on neural
      induction: in the absence of interactions with mesoderm, ectoderm fails to
      express the POMC gene, whereas POMC transcripts are readily detectable in
      conjugates of ectoderm and mesoderm. Artificial application of two different
      signals, which are likely to be relevant for neural differentiation (namely
      retinoic acid and the activation of protein kinase C via phorbol ester), was not
      effective in evoking POMC gene expression in cultured ectoderm explants. However,
      retinoic acid treatment of conjugates of Xenopus ectoderm and mesoderm
      successfully prevented POMC expression. We conclude that POMC gene expression can
      be used as an indirect marker for anterior neural differentiation in Xenopus.

PMID- 8482438
TI  - Altered morphogenesis of the immature hamster uterus following neonatal exposure
      to diethylstilbestrol.
AB  - In previous studies, we found that a single neonatal exposure to
      diethylstilbestrol (DES) resulted in severe hyperplasia and a high incidence of
      endometrial adenocarcinoma in the uterus of adult hamsters. These observations
      prompted us to investigate the consequences of DES exposure on earlier stages of
      uterine morphogenesis. After neonates were treated within 6 h of birth (day 1)
      with 100 micrograms of DES or oil vehicle, uterine tissue morphometry plus cell
      labelling indices following in vivo pulse labeling with [3H]thymidine were
      determined on days 3-21 of life. The sequential findings were: (1) a precocious
      (day 3) burst of cellular proliferation throughout the uterus, (2) an early
      period (days 3-9) of hypertrophy and increased cell density in the luminal
      epithelium, (3) an extreme acceleration of uterine growth resulting in a
      persistent increase in total uterine mass (> threefold enhancement on days 5-21),
      (4) precocious development of endometrial glands (day 9) that were sites of
      intense but transient proliferative activity, (5) a middle period (days 9-15)
      when the percentage of stromal cells engaged in proliferative activity was
      reduced, (6) a second wave (days 15-21) of enhanced proliferative activity in the
      luminal epithelium, and (7) later development (day 21) of reduced cell density in
      the uterine stroma, apparently due to increased intercellular collagen
      accumulation. These results support our working hypothesis that the acute
      uterotropic response to neonatal DES treatment initiates a change in the
      developing hamster uterus, and later estrogenic stimulation promotes neoplastic
      progression in the DES-altered adult organ, perhaps due to disruption of stromal
      epithelial interactions.

PMID- 8482439
TI  - A short, eclectic history of exocrine pancreatic insufficiency and chronic
      pancreatitis.

PMID- 8482440
TI  - Intestinal antibody pattern of celiac disease: occurrence in patients with normal
      jejunal biopsy histology.
AB  - BACKGROUND: Patients with celiac disease have immunoglobulin (Ig) M antibodies
      and IgA antigliadin antibody in gut secretions; this pattern of intestinal
      immunity may be a marker of latent celiac disease. Its frequency in patients
      referred for jejunal biopsy has been examined. METHODS: Serum IgG and IgA
      antigliadin antibody, jejunal fluid IgA and IgM antibodies to gliadin, ovalbumin
      and beta lactoglobulin, and jejunal fluid IgA and IgM concentrations were
      measured by enzyme-linked immunosorbent assay. RESULTS: Seventeen of 19 celiac
      patients on normal diet and 16 of 23 on gluten-free diet had the celiaclike
      antibody pattern, as did 41 of 217 other patients. Jejunal biopsy histology had
      been classified as normal in 38 of these, with minor abnormalities in 3; however,
      intraepithelial lymphocyte (IEL) counts were high in 13 cases. Trial of a gluten
      free diet produced clinical improvement in 6 of 7 antibody-positive patients.
      After extra dietary gluten, one developed subtotal villous atrophy. CONCLUSIONS:
      The celiaclike intestinal antibody pattern and a high IEL count may be markers of
      latent gluten-sensitive enteropathy; some of these patients are clinically gluten
      sensitive in the absence of enteropathy.

PMID- 8482441
TI  - Accuracy of cutaneous recordings of gastric electrical activity.
AB  - BACKGROUND: This study was undertaken to determine the accuracy of cutaneous
      electrogastrography (EGG). METHODS: The ability of EGG to assess gastric
      contractions and electrical frequency, phase lag, and waveform was studied in 4
      healthy volunteers with cutaneous electrodes before and after eating, 4 healthy
      fasting volunteers with intraluminal pressure recording tubes and cutaneous
      electrodes, 1 patient with surgically implanted gastric serosal electrodes, and 4
      anesthetized dogs with serosal force transducers and implanted and cutaneous
      electrodes. In 2 of the dogs, an intragastric distending balloon was introduced.
      RESULTS: The use of long-distance serosal electrodes allowed direct comparison of
      internal and cutaneous signals. Cutaneous electrodes recognized 80%-85% of
      changes in frequency with spectral analysis. Only 30%-40% of increases in EGG
      amplitudes were associated with gastric contractions. Gradual distention of the
      canine stomach after blocking contractions with atropine and glucagon increased
      the EGG amplitudes. No appreciable phase lag could be discerned with EGG. The
      descending portion of the EGG waveform was predominant. CONCLUSIONS: Frequency
      dynamics is currently the only reliable cutaneous EGG parameter.

PMID- 8482442
TI  - Nonspecific motor disorder of the esophagus: a real disorder or a manometric
      curiosity?
AB  - BACKGROUND: Nonspecific esophageal motility disorder (NEMD) has become a catchall
      term to describe abnormal esophageal manometric findings that do not meet strict
      criteria for established esophageal motility disorders. The aim of this study was
      to determine whether NEMD is a real esophageal motility disorder characterized by
      impairment of its motor function or simply a manometric disturbance with no
      clinical consequences. METHODS: Esophageal transit of liquid and semisolids was
      studied using radioscintigraphic techniques in 10 symptomatic patients with
      manometrically diagnosed NEMD, 26 healthy control subjects, and 40 disease
      control subjects. The disease controls included 24 patients with achalasia, 9
      with scleroderma, and 7 with diffuse esophageal spasm. RESULTS: Patients with
      NEMD had no impairment of liquid emptying compared with healthy controls. Liquid
      emptying was markedly delayed in patients with achalasia and scleroderma.
      However, semisolid emptying was markedly delayed in patients with NEMD compared
      with healthy controls (P < 0.001), and the extent of its delayed emptying was
      similar to that seen in patients with achalasia, scleroderma, and diffuse
      esophageal spasm. CONCLUSIONS: NEMD is not a manometric curiosity but a disorder
      characterized by selective impairment of semisolid emptying.

PMID- 8482443
TI  - Mesalamine capsules for the treatment of active Crohn's disease: results of a 16
      week trial. Pentasa Crohn's Disease Study Group.
AB  - BACKGROUND: Mesalamine is released from sulfasalazine in the colon and benefits
      colonic Crohn's disease. The mesalamine used in this study releases the drug
      throughout the small bowel and colon. Therefore, this study was designed to
      detect benefit for Crohn's disease involving the small bowel alone or both the
      colon and small bowel. METHODS: This double-blind, randomized, multicenter
      prospective controlled trial compared placebo and three daily doses of mesalamine
      in 310 patients. The primary outcome criterion was change in the Crohn's Disease
      Activity Index (CDAI) from baseline to final study visit. RESULTS: Patients
      taking 4 g/day mesalamine experienced a decrease of 72 CDAI points compared with
      21 points in the placebo group (P < 0.01). Remission occurred in 43% of the 4-g
      group and 18% of the placebo group. Patients with ileum-only disease showed a 93
      point improvement on 4 g mesalamine, compared with a 2-point improvement in
      similar patients on placebo. Mesalamine in this trial was not associated with
      clinically significant toxicity. CONCLUSIONS: This controlled-release mesalamine
      preparation is safe and effective at 4 g/day as a single agent in treatment of
      active Crohn's disease of the ileum and colon.

PMID- 8482444
TI  - A novel human macrophage-derived intestinal mucin secretagogue: implications for
      the pathogenesis of inflammatory bowel disease.
AB  - BACKGROUND: A novel 68-kilodalton macrophage-derived protein (MMS-68) stimulating
      mucin release from respiratory epithelial cells has previously been described. In
      this study, the effect of MMS-68 on mucin release from intestinal epithelial
      cells was determined. METHODS: Colonic epithelial cells isolated from normal
      colon, ulcerative colitis, Crohn's colitis, and cells from three colon cancer
      cell lines were labeled with [3H]-glucosamine and stimulated with MMS-68. High
      molecular weight glycoproteins were precipitated and counted. RESULTS: In all of
      the cells tested, MMS-68 enhanced mucin secretion by 1.46-2.0-fold above control
      values, comparable to the level achieved with carbachol (10(-5) mol/L).
      Coincubation with anti-MMS-68 monoclonal antibody 1D-10 blocked this bioactivity.
      Freshly isolated intestinal macrophages reacted with monoclonal antibody 1D-10.
      Immunofluorescent staining of frozen sections revealed the presence of MMS-68
      producing cells (macrophages) in the lamina propria of normal colon and Crohn's
      colitis, with weaker expression in ulcerative colitis mucosa. CONCLUSIONS:
      Intestinal macrophages produce a novel mucin secretagogue, which is as potent as
      carbachol for stimulating mucin secretion from colonic epithelial cells. This
      factor may explain, in part, the alterations in mucin secretion often seen in
      inflammatory bowel disease.

PMID- 8482445
TI  - Menetrier's disease: a form of hypertrophic gastropathy or gastritis?
AB  - BACKGROUND: Menetrier's disease is characterized by giant gastric folds and
      foveolar hyperplasia. The extent of mucosal inflammation and glandular atrophy,
      however, is controversial. The aim of this study was to test the hypothesis that
      patients previously diagnosed with Menetrier's disease actually represent at
      least two diseases: (1) Hypertrophic lymphocytic gastritis (HLG) and (2) Massive
      foveolar hyperplasia and minimal inflammation (MFH). METHODS: All cases of
      possible Menetrier's disease were identified, and their clinical, laboratory, and
      pathological data were reviewed. In twenty-three patients with giant fundal
      folds, full-thickness tissue specimens (n = 19) or large suction biopsy (n = 4)
      tissue specimens were obtained. RESULTS: Two distinct, nonoverlapping
      histological patterns were found; 13 patients had HLG and 10 patients had MFH.
      Clinical features and frequency of Helicobacter pylori were similar in these two
      groups. Patients with HLG had severe inflammation with numerous intraepithelial
      lymphocytes and mild foveolar hyperplasia. Alternatively, patients with MFH had
      greater foveolar hyperplasia, significantly thicker mucosa, and greater mucosal
      edema. CONCLUSIONS: Patients with MFH represent a form of hypertrophic
      gastropathy and should be designated as having Menetrier's disease, whereas
      patients with HLG should be considered part of the spectrum of lymphocytic
      gastritis.

PMID- 8482446
TI  - Mechanism of gastroprokinetic effect of EM523, an erythromycin derivative, in
      dogs.
AB  - BACKGROUND: The pharmacological properties of EM523, a nonpeptide motilin
      agonist, have not been well characterized. METHODS: The prokinetic effect of
      EM523 on motor-stimulating activity in the stomach, duodenum, and jejunum in
      seventeen conscious dogs was studied using force transducers implanted long term.
      EM523 (0.3-10.0 micrograms/kg) and receptor antagonists were injected
      intravenously during the interdigestive state. RESULTS: EM523 induced phase III
      like contractions in a dose-dependent manner, and the contractions were inhibited
      dose dependently by pretreatment with cholinergic and 5-HT3 receptor antagonists
      and dopamine but not by adrenoceptor and opiate antagonists or methysergide. The
      plasma immunoreactive motilin level was increased after EM523 to 60% of the mean
      maximum value during the spontaneous phase III contractions. Pretreatment with
      anti-canine motilin serum inhibited EM523-induced contractions by 19.2% in the
      motor index, but the contractile pattern was not affected. CONCLUSIONS: EM-523
      induced phase III-like contractions are brought about through the cholinergic
      neural pathway and 5-HT3 receptors, and endogenous motilin release is partially
      involved.

PMID- 8482447
TI  - Effect of endothelin 1 on ion transport in isolated rat colon.
AB  - BACKGROUND: Endothelin may play a significant role in the regulation of
      gastrointestinal function because it has a variety of biological activities and
      because endothelin-like immunoreactivity as well as its specific binding sites
      have been found in the gastrointestinal tract. This study investigated the
      secretory effect and mechanism of action of endothelin 1 in mammalian large
      intestine. METHODS: Distal colonic segments from Sprague-Dawley rats were
      stripped of their muscle layers and mounted in Ussing chambers. The effects of
      endothelin 1 on short-circuit current in rat colonic mucosa were studied in the
      absence or presence of specific inhibitors. Transmural unidirectional 22Na+ and
      36Cl- fluxes and endothelin 1-induced prostacyclin release were also measured.
      RESULTS: Serosal addition of endothelin 1 evoked a sustained increase in short
      circuit current that was significantly reduced by tetrodotoxin or atropine, and
      virtually abolished by a selective endothelin A receptor antagonist (BQ-123),
      furosemide, piroxicam, d,I-verapamil, or removal of serosal calcium.
      Hexamethonium, amiloride, diphenhydramine, or a specific platelet-activating
      factor antagonist (CV-6209) did not influence the response to endothelin 1.
      Endothelin 1 significantly decreased net sodium and net chloride absorption and
      induced a marked increase in prostacyclin release from the serosal surface of
      stripped colonic mucosa. CONCLUSIONS: Endothelin 1 has a secretory effect in rat
      colon. Its action seems to be mediated by cyclo-oxygenase products and enteric
      nerves via the activation of an endothelin A receptor.

PMID- 8482448
TI  - Restitution of frog gastric mucosa in vitro: effect of basic fibroblast growth
      factor.
AB  - BACKGROUND: Rapid re-epithelialization after superficial gastric mucosal injury
      is caused by migration of persisting viable epithelial cells. Basic fibroblast
      growth factor (bFGF) has been reported to enhance the healing of experimental
      duodenal ulcer, but its mode of action is unclear. The present experiments
      examine whether an effect of bFGF on restitution might contribute to such
      healing. METHODS: Paired halves of bullfrog fundic gastric mucosa in Ussing
      chambers were injured by luminal exposure to 1 mol/L NaCl for 10 minutes.
      RESULTS: Luminal protamine or suramin, both known to interfere with endogenous
      bFGF, significantly inhibited electrophysiological recovery at neutral luminal pH
      (pHL). Luminal sucrose octasulfate, which prevents acid degradation of bFGF, and
      an exogenous, acid-resistant form of bFGF allowed electrophysiological recovery
      at a pHL of 3.0 that completely prevented restitution in control tissues.
      Electrophysiological recovery correlated well with morphological restitution. The
      presence of endogenous bFGF in normal and restituting bullfrog mucosa was
      confirmed by positive staining with a monoclonal antibody. CONCLUSIONS: It is
      concluded that rapid epithelial repair after surface injury is at least in part
      mediated by bFGF.

PMID- 8482449
TI  - Long-term omeprazole therapy in peptic ulcer disease: gastrin, endocrine cell
      growth, and gastritis.
AB  - BACKGROUND: The effects of chronic drug-induced hypergastrinemia on the exocrine
      and endocrine stomach are still incompletely understood. Chronic hypergastrinemia
      in rats and humans is associated with gastric argyrophil cell hyperplasia.
      METHODS: Seventy-four patients with chronic ranitidine-resistant ulcerations were
      treated chronically with omeprazole (median observation period 48 [6-84] months).
      RESULTS: Median fasting serum gastrin levels increased from a pretreatment value
      of 74-145 pg/mL after 3 months. No further increase was observed thereafter. The
      finding of atrophic gastritis increased from 1.8% to 20.8% after 5 years. A
      doubling of the mean argyrophil cell volume density (0.36% vs. 0.74% after 5
      years; P < 0.01%) was paralleled by a decrease in the normal endocrine cell
      growth pattern from 64.3% to 33.3% and an increase in micronodular hyperplasia
      (8.9% vs. 16.7%). These changes correlated with the severity of corpus gastritis
      and seemed to be more disease- than drug-related. No statistically significant
      changes were observed in the antral G- and D-cell volume densities under therapy.
      CONCLUSIONS: Long-term omeprazole therapy in humans results in moderate
      hypergastrinemia and a significant argyrophil cell hyperplasia, which are
      correlated to the grade of corpus gastritis. Because hypergastrinemia and
      gastritis are closely related, it is difficult to quantitatively assess their
      respective role in this process.

PMID- 8482450
TI  - Calretinin and calbindin-D28k immunoreactivity in the human gastrointestinal
      tract.
AB  - BACKGROUND: Calretinin and calbindin-D28k are similar Ca(2+)-binding proteins
      previously described in specific central neurons and other cells. METHODS: The
      immunocytochemical distribution of these two proteins was studied in the human
      gastrointestinal tract. RESULTS: In gastric and small intestinal endocrine cells,
      calbindin-D28k immunoreactivity was confirmed, but calretinin immunoreactivity
      was not found. Nerve cell bodies in both submucous and myenteric ganglia were
      immunoreactive for calbindin (13% and 38% of total cells, respectively) or
      calretinin (23% and 21%), some containing both proteins. In nerve processes,
      calretinin was generally more abundant than calbindin and was found particularly
      around blood vessels. Calretinin co-localized with immunoreactive vasoactive
      intestinal peptide, neuropeptide Y, galanin, or substance P in submucous ganglion
      cells and with substance P in myenteric cells. Calbindin-D28k colocalized with
      fewer peptides, specifically vasoactive intestinal peptide or galanin in
      submucous cells. By 8 weeks of fetal development, discrete neuronal localizations
      for both proteins and for calbindin-D28k in endocrine cells were apparent.
      CONCLUSIONS: In the enteric neuroendocrine system, calretinin and calbindin-D28k
      are useful markers that may help elucidate Ca(2+)-mediated functions in health
      and disease.

PMID- 8482451
TI  - Endogenous dopamine and duodenal bicarbonate secretion in humans.
AB  - BACKGROUND: Catechol-O-methyltransferase (COMT) inhibition prevents tissue
      degradation of catecholamines including dopamine. This study was undertaken to
      investigate the effect of intraluminal nitecapone, a peripherally acting COMT
      inhibitor, on duodenal mucosal bicarbonate secretion in humans and to compare the
      effect with that of the prostaglandin E1 analogue misoprostol. METHODS: The
      duodenal bulb was isolated by means of a three-balloon six-channel tube as
      previously described. Basal bicarbonate secretion and secretion after
      intraluminal administration of 30 and 150 mg nitecapone were determined in 11
      healthy subjects. In 7 of these subjects, effects of intraluminal administration
      of 30 and 150 micrograms of misoprostol were studied in a second experiment.
      RESULTS: Even the lower dose of misoprostol increased duodenal bicarbonate
      secretion from 121 +/- 12 to 221 +/- 36 and the lower dose of nitecapone from 149
      +/- 18 to 277 +/- 48 microEq.cm-1 x h-1, respectively (P < 0.05). With 150
      micrograms of misoprostol or 150 mg of nitecapone there was a further increase in
      secretion to 296 +/- 33 (P < 0.01) and 421 +/- 36 (P < 0.001) microEq.cm-1 x h-1,
      respectively. The rise in bicarbonate secretion in response to nitecapone was
      associated with some increase in the release of prostaglandin E2 to the luminal
      perfusate. CONCLUSIONS: It seems likely that peripheral COMT inhibition increases
      duodenal mucosal bicarbonate secretion and protection by inhibition of mucosal
      degradation of dopamine, an increase similar in magnitude to that obtained by a
      prostaglandin E1 analogue.

PMID- 8482452
TI  - Presynaptic inhibition by adenosine A1 receptors on guinea pig small intestinal
      myenteric neurons.
AB  - BACKGROUND: Adenosine acts at A1 receptors to inhibit the release of most
      neurotransmitters. This study tested the hypothesis that both exogenous adenosine
      (ADO) and tonic release of endogenous ADO act at presynaptic A1 receptors to
      suppress excitatory postsynaptic potentials (EPSPs) and inhibitory postsynaptic
      potentials (IPSPs) in myenteric neurons. METHODS: Intracellular microelectrodes
      were used to study actions of ADO, the agonists 2-chloro-N6-cyclopentyl ADO, its
      1-deaza derivative, 5'-N-ethylcarboxamido ADO, and CGS 21680 or the antagonists 8
      cyclopentyl-1,3-dimethylxanthine, its 1,3-dipropyl analog, and 1,3-dipropyl-8-p
      sulfophenylxanthine on synaptic behavior in myenteric neurons. RESULTS: Each of
      the agonists suppressed slow EPSPs in all 35 AH/type 2, 8 of 10 S/type 1, and 7
      of 7 nonspiking neurons. ADO also decreased neuronal excitability (n = 63) in
      AH/type 2 neurons. Agonists suppressed fast nicotinic EPSPs in all 20 S/type 1,
      10 nonspiking, and 3 AH/type 2 neurons without having any effect on postsynaptic
      responses to nicotinic agonists. CCPA was more potent than CGS 21680 in
      suppressing EPSPs. In 30% of neurons, the only action of antagonists was to block
      the effect of A1 or A2 agonists on EPSPs. Agonists did not inhibit IPSPs, but
      unmasked robust slow IPSPs by preventing slow EPSPs. Antagonists acted alone to
      enhance EPSPs in 70% of neurons. CONCLUSIONS: (1) ADO acts at presynaptic A1
      sites to suppress EPSPs in all neurons, (2) IPSPs are revealed by ADO, and (3)
      ongoing release of endogenous ADO inhibits synaptic transmission.

PMID- 8482453
TI  - Characterization and mediation of inhibitory junction potentials from opossum
      lower esophageal sphincter.
AB  - BACKGROUND: Activating nonadrenergic, noncholinergic (NANC) nerves of the lower
      esophageal sphincter (LES) hyperpolarizes and relaxes its circular smooth muscle.
      This relaxation is mediated by nitric oxide (NO) or an NO-containing compound.
      These studies were undertaken to compare the electrophysiological responses of
      circular smooth muscle from the LES and esophagus in response to NANC nerve
      stimulation and to test the hypothesis that NO mediates LES hyperpolarization.
      METHODS: The transmembrane potential difference was recorded with glass
      microelectrodes. Nerve-mediated membrane responses were evoked by electrical
      pulses of 0.5 msec duration and 50 V amplitude. RESULTS: Responses of LES muscle
      differed from those of the esophageal muscle. The duration of hyperpolarization
      was much longer in sphincteric muscle. The depolarization that followed
      hyperpolarization of esophageal muscle was not observed in sphincteric muscle. NG
      nitro-L-arginine, an inhibitor of NO synthase, attenuated the nerve-induced
      hyperpolarization. L-arginine, the substrate for NO synthase, antagonized the
      effect of NG-nitro-L-arginine. Exogenous NO hyperpolarized of the smooth muscle
      membrane. CONCLUSIONS: These data support the hypothesis that NO or an NO-like
      compound may mediate nerve-induced hyperpolarization of the opossum LES.

PMID- 8482454
TI  - Cigarette smoking, alcohol, and the risk of colorectal adenomas.
AB  - BACKGROUND: The present study was designed to further assess the reported
      association between cigarette smoking, alcohol, and colorectal adenomas. METHODS:
      A number of environmental and life-style risk factors were examined in 236
      patients with histologically proven adenomas and 409 controls with no adenomas.
      RESULTS: Age, sex, race, and indication for procedure were similar in cases and
      controls. Those who had ever smoked were not at increased risk for adenomas
      compared with those who had never smoked. Years of smoking, cigarettes per day,
      and total pack-years showed no dose-response effect. Results for men and women
      were similar. Alcohol was a significant risk factor for men but not for women.
      Men in the highest quartile of daily caloric intake from alcohol were more than
      four times more likely than nondrinkers to develop adenomas, with a statistically
      significant trend in risk from the lowest to the highest quartile. These findings
      persisted after controlling for other potential risk factors for adenomas. The
      risk for colon and rectal polyps were similar. Men in the highest tertile of beer
      consumption were nearly six times more likely to develop adenomas than
      nondrinkers. CONCLUSIONS: Beer drinking is a risk factor for colorectal adenomas
      in this population.

PMID- 8482455
TI  - Percutaneous drainage versus albendazole therapy in hepatic hydatidosis: a
      prospective, randomized study.
AB  - BACKGROUND: Recently, drug treatment and percutaneous drainage have been used
      successfully when treating hepatic hydatid cysts. Until now, there is no
      published study comparing the relative safety and efficacy of these two forms of
      treatment. METHODS: In a prospective study, 33 hepatic hydatid cysts were
      randomly distributed to receive percutaneous drainage (10), albendazole (10 mg.kg
      1.day-1 for 8 weeks) plus percutaneous drainage (12), and albendazole alone (11).
      Patients were serially assessed by clinical and biochemical examinations,
      ultrasonography, and hydatid serology. RESULTS: On serial ultrasonography, cysts
      attained heterogeneous echopattern in 18, uniform echogenicity in 11, and
      disappearance in 3. All 22 cysts treated with percutaneous drainage and only 2
      (18.2%) cysts treated with albendazole alone reduced in size and change in
      echopattern (P < 0.01). Maximum size reduction was observed in cysts treated with
      a combination of percutaneous drainage and albendazole (P < 0.05). Complications
      observed with drainage were cyst infection in 2 patients, fever in 3, cyst
      biliary rupture in 1, and urticaria in 2. These were managed successfully without
      any mortality. Three patients who received albendazole developed reversible
      elevation of liver cell enzymes. CONCLUSIONS: It was concluded that percutaneous
      drainage with albendazole therapy is an effective form of management for hepatic
      hydatid cysts.

PMID- 8482456
TI  - Isosorbide-5-mononitrate versus propranolol in the prevention of first bleeding
      in cirrhosis.
AB  - BACKGROUND: Hemodynamic studies have shown the efficacy of nitrates in reducing
      portal pressure in cirrhosis. We therefore studied the efficacy of isosorbide-5
      mononitrate vs. propranolol in the prevention of first bleeding within a
      prospective controlled trial. METHODS: One hundred eighteen cirrhotics with
      esophageal varices were blindly randomized to receive 20 mg of isosorbide-5
      mononitrate three times a day (n = 57) or propranolol (n = 61) up to the maximum
      tolerated dose. Both groups also received ranitidine (150 mg/day). RESULTS: The
      median follow-up was 29 months. Twenty-six patients dropped out (13 in the
      isosorbide group) because of poor compliance or complications unrelated to
      treatment. Eighteen patients died (9 in the isosorbide-treated group), 6 due to
      bleeding. The 1- and 2-year actuarial percentages of patients free of bleeding
      was 90.8% and 82.2% in the isosorbide-5-mononitrate--and 93.9% and 85.8% in the
      propranolol-treated groups, respectively (P = NS). These values are higher than
      those expected from the North Italian Endoscopic Club predicting scores. There
      were few major side effects in either group. The 2-year survival rate did not
      differ between the two groups (82.2% vs. 85.4%). CONCLUSIONS: Isosorbide-5
      mononitrate administered orally is a safe and effective alternative to
      propranolol in the prophylaxis of bleeding in cirrhosis.

PMID- 8482457
TI  - Sinusoidal endothelial cell damage by activated macrophages in rat liver
      necrosis.
AB  - BACKGROUND: Massive hepatic necrosis caused by fibrin deposition in the hepatic
      sinusoids develops with hepatic macrophage activation in rats given endotoxin
      after administration of heat-killed Corynebacterium parvum. Targeted cells of
      such macrophages were investigated. METHODS: In C. parvum-treated rats, the
      pathological appearance of liver cells was serially measured in serum following
      endotoxin administration and compared with the appearance in the perfusate during
      closed liver perfusion with endotoxin. RESULTS: Serum activities of tumor
      necrosis factor, purine nucleoside phosphorylase present in both hepatocytes and
      sinusoidal endothelial cells, and levels of alanine aminotransferase were higher
      after 30 minutes, 1 hour, and 3 hours, respectively. Pretreatment of rats with
      gadolinium chloride, an inhibitor of macrophage function, reduced this liver
      injury. Although alanine aminotransferase activity remained almost unchanged in
      the liver perfusate, purine nucleoside phosphorylase activity increased. This
      increase was reduced when rats were pretreated with gadolinium chloride. There
      was sinusoidal endothelial cell damage around hepatic macrophages in the liver
      perfused with endotoxin. CONCLUSIONS: Activated hepatic macrophages may cause
      sinusoidal endothelial cell damage leading to hepatocyte necrosis in rats given
      C. parvum and endotoxin.

PMID- 8482458
TI  - Hepatitis C RNA in liver of chronic hepatitis C patients before and after
      interferon alfa treatment.
AB  - BACKGROUND: Successful treatment of chronic hepatitis C with interferon alfa is
      frequently followed by relapse. Because loss of hepatitis C viral RNA (HCV-RNA)
      in serum is not predictive of sustained response, the loss of HCV-RNA in liver as
      a predictor of sustained response was investigated. METHODS: Twenty-one patients
      with chronic hepatitis C treated with recombinant interferon alpha had HCV-RNA
      sequences determined in frozen liver tissue before and after treatment and in
      serum at the end of treatment. Reverse double polymerase chain reaction was used
      to detect sequences to the 5' nontranslated region of the HCV genome using double
      nested primers. RESULTS: HCV-RNA disappeared in the liver in 10 of 11 (91%)
      complete responders whereas it remained detectable in the liver or serum of 7 of
      8 (87%) nonresponders. Five complete responders relapsed biochemically during 6
      month's follow-up; 4 of these had no detectable HCV-RNA in liver at end of
      treatment. CONCLUSIONS: Disappearance of HCV-RNA in liver correlates with initial
      clinical outcome, but as previously reported with serum HCV-RNA, this loss does
      not necessarily allow prediction of a sustained response.

PMID- 8482459
TI  - Early-onset autoimmune hepatitis is associated with a C4A gene deletion.
AB  - BACKGROUND: Autoimmune hepatitis is an immunologically mediated disorder with
      some similarities to systemic lupus erythematosus, including an association with
      HLA-A1, B8, DR3. This haplotype includes a C4A, 21-OHA gene deletion. Low serum
      levels of complement and C4 null alleles have been reported in autoimmune
      hepatitis, but studies have been at the protein level only. METHODS: Twenty-four
      white patients with autoimmune hepatitis were studied by Southern blots using a
      C4A gene complementary DNA probe. HLA A, B, and C typing was determined using
      standard microcytotoxicity assays, and DR and DQ specificities were determined by
      restriction fragment length polymorphism analysis. RESULTS: Thirteen of 24
      patients had the C4A gene deletion compared with 12 of 90 controls. HLA-A1 and B8
      were increased in patients with autoimmune hepatitis, as were HLA-DR3 (DR17),
      Dw24, DQ2. Patients with a C4A gene deletion presented at a younger age than
      those without the deletion and had significantly lower serum C3 and C4 levels.
      The C4A gene deletion was associated with HLA-A1, B8, DR3 in all but 1 patient
      who was HLA-DR3 negative. CONCLUSIONS: A C4A gene deletion is found in patients
      with autoimmune hepatitis, especially those presenting at a young age. This
      complement gene deletion may be an important factor in the development of this
      disease.

PMID- 8482460
TI  - Circulating levels of endothelin in cirrhosis.
AB  - BACKGROUND: Current information concerning endothelin in cirrhosis is
      conflicting. Plasma endothelin concentration has been found to be increased in
      some studies and normal or reduced in others. The present study was aimed to
      investigate the plasma levels of endothelin in cirrhosis and to assess whether it
      is involved in the renal and hemodynamic disturbances and neurohumoral changes
      present in this condition. METHODS: Renal function, plasma renin activity, and
      plasma concentration of aldosterone, norepinephrine, antidiuretic hormone, atrial
      natriuretic factor, and endothelin were measured in 9 healthy subjects, 7
      compensated cirrhotics, and 25 cirrhotics with ascites (10 with functional renal
      failure). RESULTS: Cirrhotics with ascites with and without functional renal
      failure showed higher endothelin levels (15.6 +/- 6.4 and 15.7 +/- 4.6 pg/mL,
      respectively; mean +/- SD) than compensated cirrhotics (6.4 +/- 1.8 pg/mL) and
      healthy subjects (3.4 +/- 1.0 pg/mL) (analysis of variance, F = 21.84; P <
      0.001). These patients also showed higher plasma levels of renin, aldosterone,
      norepinephrine, antidiuretic hormone, and atrial natriuretic factor, although
      plasma endothelin levels only correlated significantly with plasma atrial
      natriuretic factor (r = 0.73, P < 0.001) and antidiuretic hormone concentrations
      (r = 0.59, P < 0.001). In 7 additional nonazotemic cirrhotics with ascites,
      plasma renin activity and the plasma concentration of aldosterone and endothelin
      were measured before and 24 hours after the intravenous administration of a
      saline solution of human serum albumin. Volume expansion markedly suppressed
      renin and aldosterone but not endothelin (21.03 +/- 7.34 vs. 23.97 +/- 14.29
      pg/mL). CONCLUSIONS: Circulating plasma levels of endothelin are elevated in
      cirrhosis with ascites and do not decrease following plasma volume expansion.

PMID- 8482461
TI  - Tumor necrosis factor alpha and interleukin 6 plasma levels in infected cirrhotic
      patients.
AB  - BACKGROUND: Patients with liver cirrhosis disclose both increased production and
      decreased metabolism of tumor necrosis factor alpha (TNF-alpha) and interleukin 6
      (IL-6). The present study analyzes the characteristic pattern of these cytokines
      during sepsis in cirrhotics. METHODS: TNF-alpha and IL-6 plasma levels, measured
      during 15 days from the onset of cirrhotic decompensation or of the septic event,
      were compared between 14 infected patients with liver cirrhosis, 18 uninfected
      decompensated cirrhotic patients, and 35 septicemic patients devoid of liver
      disease. Cytokines were measured using immunoassays. RESULTS: In infected
      cirrhotics, initial levels of both TNF-alpha and IL-6 were significantly higher
      than in noninfected cirrhotic patients (P < 0.0001) or in septicemic patients
      devoid of cirrhosis (P < 0.001). Initial IL-6 plasma levels (threshold, 200
      pg/mL) showed 89% specificity and 100% sensitivity in discriminating cirrhotic
      decompensation due to infection from that caused by other factors. TNF-alpha and
      IL-6 plasma levels remained significantly higher for many days in infected
      cirrhotic patients compared with the other two groups. CONCLUSIONS: Both the
      profoundly increased initial levels of TNF-alpha and IL-6 and their persistence
      over days after sepsis onset seem characteristic of the cirrhotic patients. The
      exact relationship between prolonged exposure to TNF-alpha and poor prognosis in
      these patients is unknown, but it might represent a unique opportunity for the
      use of anti-TNF-alpha antibodies during sepsis.

PMID- 8482462
TI  - In situ kinetics of acinar, duct, and inflammatory cells in duct ligation-induced
      pancreatitis in rats.
AB  - BACKGROUND: Acute pancreatitis remains a disease of uncertain pathogenesis. The
      resolution of the cellular events that underlie the development of pancreatitis
      may allow for significant advances in therapy. METHODS: A new experimental
      approach to acute pancreatitis in the rat, i.e., selective ligation of pancreatic
      ducts and immunohistochemical analysis of cellular kinetics using a panel of
      monoclonal antibodies, was devised. RESULTS: Immunostaining showed that the
      majority of the infiltrating cells bore macrophage-specific antigens (ED1
      positive). Some neutrophils were also among the cellular infiltrate, but only a
      few T (OX19-positive) or B (His14-positive) lymphocytes were seen. At a later
      stage, more than half of the mononuclear cells in the stroma were neither
      macrophages nor lymphocytes, but possibly fibroblasts. In vivo labeling of
      proliferating cells with 5-bromo-2'-deoxyuridine and immunostaining showed active
      proliferation of duct epithelial and wall cells of the interlobular pancreatic
      duct on days 1 and 2, proliferation of nonacinar cells on days 1-4, and
      proliferation of acinar cells on days 2-28. CONCLUSIONS: These results indicate
      an important role of macrophages and the presence of complex processes of
      degeneration and regeneration in duct ligation-induced pancreatitis.

PMID- 8482463
TI  - Bovine gallbladder mucin accelerates cholesterol monohydrate crystal growth in
      model bile.
AB  - BACKGROUND: Gallbladder mucin accelerates cholesterol crystal nucleation, an
      early step in the pathogenesis of gallstones. To examine the role of gallbladder
      mucin in postnucleation gallstone maturation, the influence of mucin on
      cholesterol monohydrate crystal growth was studied in a novel model system.
      METHODS: Cholesterol crystals of a uniform size were incubated in model biles at
      37 degrees C with varying cholesterol saturation indices. Crystal size was
      quantitated by measuring the width and length of individual crystals under
      polarizing light microscopy and calculating average crystal area. RESULTS:
      Crystal growth was dependent on the degree of cholesterol supersaturation of
      bile. Bovine gallbladder mucin (0.5-8 mg/mL) accelerated crystal growth in
      supersaturated model bile in a concentration- and time-dependent fashion compared
      with control incubations with bovine serum albumin or model bile alone (P <
      0.05). Cholesterol crystal growth was accompanied by a progressive decrease in
      cholesterol saturation and an increase in total cholesterol crystal mass. Crystal
      growth was also accompanied by a decrease in total crystal number, suggesting net
      transfer of cholesterol to larger crystals. CONCLUSIONS: The acceleration of
      cholesterol crystal growth by gallbladder mucin may be of pathophysiological
      importance in the postnucleation maturation of cholesterol gallstones.

PMID- 8482464
TI  - Propafenone-induced liver injury: report of a case and review of the literature.
AB  - A case of an acute cholestatic syndrome associated with use of the antiarrhythmic
      drug propafenone is reported here. The close time relationship between the
      administration of the drug and the acute onset of the liver damage, the
      histological findings, and the reappearance of biochemical signs of liver
      dysfunction upon rechallenge with the same medication strongly suggest that
      propafenone was involved in the pathogenesis of this syndrome. Although rare,
      hepatotoxicity from this widely used antiarrhythmic medication should be kept in
      mind in the differential diagnosis of sudden cholestatic syndrome of obscure
      origin.

PMID- 8482465
TI  - Extracorporeal lipid elimination for treatment of gestational hyperlipidemic
      pancreatitis.
AB  - Gestational hyperlipidemia complicated by pancreatitis during the 24th week of
      gestation has been successfully managed by long-term extracorporeal elimination
      of triglyceride-rich lipoproteins. Three modes of treatment (plasma exchange,
      immunospecific apheresis, and a combination of both treatments) were compared for
      efficacy as therapy for metabolic derangements, altered blood rheology, and the
      loss of immunoglobulins. Treatments were performed by means of a peripheral
      venovenous approach. A combination plasma exchange/apheresis technique was highly
      effective; the loss of immunoglobulins remained acceptable. Clinical symptoms of
      pancreatitis subsided within 24 hours of the first treatment. A relapse during
      the 32nd week of gestation necessitated treatments more frequently than once a
      week. At the 36th week of gestation, after confirming lung maturity as indicated
      by a lecithin-sphingomyelin ratio of > 2.0, a cesarean section was performed. A
      healthy boy was delivered (2470 g; Apgar score, 9/10). This is the first report
      to show that long-term extracorporeal elimination of lipoproteins is a highly
      effective treatment of hyperlipidemic gestational pancreatitis.

PMID- 8482466
TI  - Intraluminal pancreatic candidiasis presenting as recurrent pancreatitis.
AB  - An 88-year-old man with closely spaced attacks of acute pancreatitis who was
      found to have ductal changes of chronic pancreatitis with multiple noncalcified
      intraluminal filling defects during endoscopic retrograde pancreatography is
      presented. These defects proved to be fungus balls made up of Candida albicans.
      He was treated with longitudinal pancreaticojejunostomy and oral fluconazole and
      has since remained recurrence free (30 months). It is suggested that Candida
      superinfection may occur in a chronically dilated pancreatic duct and may
      contribute to symptomatic recurrent inflammation of the pancreas.

PMID- 8482467
TI  - Genetics, natural history, tumor spectrum, and pathology of hereditary
      nonpolyposis colorectal cancer: an updated review.
AB  - Hereditary nonpolyposis colorectal cancer (HNPCC) dates to Warthin's description
      of family G, which he began studying in 1895. Warthin's observations were not
      fully appreciated until 1966 when two families with an autosomal dominant
      inheritance pattern of nonpolyposis colorectal cancer (CRC) and endometrial
      cancer were described. This condition was first termed the "cancer family
      syndrome" and was later renamed HNPCC. Some have proposed that HNPCC consists of
      at least two syndromes: Lynch syndrome I, with hereditary predisposition for CRC
      having early (approximately 44 years) age of onset, a proclivity (70%) for the
      proximal colon, and an excess of synchronous and metachronous colonic cancers and
      Lynch syndrome II, featuring a similar colonic phenotype accompanied by a high
      risk for carcinoma of the endometrium. Transitional cell carcinoma of the ureter
      and renal pelvis and carcinomas of the stomach, small bowel, ovary, and pancreas
      also afflict some families. Current estimates indicate that HNPCC may account for
      as much as 6% of the total CRC burden. There are no known premonitory phenotypic
      signs or biomarkers of cancer susceptibility in the Lynch syndromes. This report
      will summarize current knowledge, with emphasis on the manner in which this
      knowledge can be employed effectively for diagnosis and management of HNPCC.

PMID- 8482468
TI  - Gluten sensitivity and latency: can patterns of intestinal antibody secretion
      define the great 'silent majority?'.

PMID- 8482469
TI  - Prolonged achlorhydria and gastric neoplasia: is there a causal relationship?

PMID- 8482470
TI  - Cyclosporin, the biology of the bile canaliculus, and cholestasis.

PMID- 8482471
TI  - Hyperlipidemic gestational pancreatitis.

PMID- 8482472
TI  - Hospital credentialing standards for physicians who perform endoscopies.
AB  - This document was developed to guide hospitals in making credentialling
      determinations involving endoscopy. Granting hospital privileges to a physician
      with inadequate qualifications obviously has important patient-care, economic,
      and legal implications. Particularly when privileges involve expensive, invasive
      procedures such as endoscopy, the prudent hospital will determine if the
      applicant for privileges has the training and experience needed to ensure
      competence in the procedure and in translating the information gained from it
      into an appropriate course of action.

PMID- 8482473
TI  - What constitutes endoscopic competence?

PMID- 8482474
TI  - Zinc in the treatment of Wilson's disease: how it works.

PMID- 8482475
TI  - Nausea and vomiting in pregnancy and cutaneous electrogastrogram.

PMID- 8482476
TI  - More problems with aspirin: it may cause appendicitis.

PMID- 8482477
TI  - Differing chemical content of the neuronal populations of submucosal ganglionic
      plexus of the enteric nervous system.

PMID- 8482478
TI  - Hyperdynamic circulation in cirrhosis: physiology or pathophysiology?

PMID- 8482479
TI  - Absence of false elevations with Kodak Ektachem lipase.

PMID- 8482480
TI  - Etiology of membranous obstruction of the inferior vena cava.

PMID- 8482481
TI  - Rat gastric alcohol dehydrogenase activity and ethanol metabolism.

PMID- 8482482
TI  - Omeprazole and gastric polyposis in humans.

PMID- 8482483
TI  - NS-398, a novel non-steroidal anti-inflammatory drug with potent analgesic and
      antipyretic effects, which causes minimal stomach lesions.
AB  - 1. NS-398 (N-[2-cyclohexyloxy-4-nitrophenyl] methanesulfonamide) is a new non
      steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic effects.
      2. The anti-inflammatory potency of NS-398 in rat carrageenin-induced edema was
      as potent as that of indomethacin and 8 times more potent than diclofenac. In rat
      adjuvant arthritis, NS-398 showed a therapeutic effect comparable to that seen
      with loxoprofen but less than that seen with indomethacin and diclofenac. 3. The
      analgesic potency of NS-398 in rat adjuvant arthritic pain was much the same as
      that of indomethacin, and was about 3-5 times higher than that of diclofenac and
      loxoprofen. In the Randall-Selitto method in rats, NS-398 was 2-7 times as potent
      as loxoprofen, diclofenac and indomethacin. In acetic acid-induced writhing in
      mice, NS-398 was equipotent to indomethacin and diclofenac. 4. In LPS-induced
      fever in rats, NS-398 was 1.5-4.5 times as potent as loxoprofen and indomethacin,
      but less potent than diclofenac. 5. NS-398 produced little gastric ulceration in
      doses of up to 1000 mg/kg, while reference drugs produced distinct stomach
      lesions in doses of 10-30 mg/kg. 6. NS-398 inhibited prostaglandin (PG)
      endoperoxide synthase from sheep seminal vesicle microsomes less potent than that
      of ibuprofen.

PMID- 8482484
TI  - Acetylcholinesterase changes in hearts with sinus rhythm and atrial fibrillation.
AB  - 1. Clinical and experimental evidence suggest that changes in the autonomic tone
      play a role in the pathogenesis of atrial fibrillation. 2. We have studied the
      distribution of molecular forms of acetylcholinesterase (AChE) in atrial biopsies
      obtained from individuals without arrhythmias and in patients with atrial
      fibrillation. 3. Analysis of the distribution of globular and asymmetric AChE
      forms, showed a decrease in the amount of the globular forms of biopsies taken
      from atria during fibrillation. 4. This study is the first attempt to
      characterize the molecular forms of AChE in the human heart of patients with
      sinus rhythm and chronic atrial fibrillation.

PMID- 8482485
TI  - The effect of oral vanadyl treatment on the reactivity of tracheal smooth muscle
      obtained from insulin-dependent diabetic rats.
AB  - 1. In this study, we investigated the contractile effects of acetylcholine (ACh)
      and KCl in tracheas obtained from 12-13 wk insulin-dependent (ID)-diabetic rats.
      2. The maximum contractile responses to ACh and KCl were significantly increased
      in ID-diabetic rat tracheas compared with those from controls. But the
      sensitivity (pD2 values) of ID-diabetic tracheas to these agents were not
      significantly altered relative to controls. 3. The alterations which occurred in
      ID-diabetic rats were prevented with oral vanadyl treatment during a 10 wk
      period.

PMID- 8482486
TI  - Basal and histamine-induced gastric acid secretion in alloxan diabetic rats.
AB  - 1. Effects of alloxan-induced diabetes on the rat gastric acid secretion were
      investigated using a number of biostatistical models described earlier. 2.
      Histamine-induced gastric acid secretion was found to be decreased in alloxan
      diabetic rats when compared with their age-matched controls. 3. Basal acid
      secretion was also decreased depending on experimentally-induced diabetes. 4. The
      above results strongly suggest that alloxan-induced diabetes depresses vagal
      activity and H2-receptor activity in the stomach.

PMID- 8482487
TI  - Subtype of muscarinic receptors mediating relaxation and contraction in the rat
      iris dilator smooth muscle.
AB  - 1. Carbachol produced a relaxation of dilator muscle at a concentration lower
      than 1 microM and a contraction at a concentration higher than 1 microM. 2. We
      studied the effects of the M1-selective antagonist, pirenzepine, the M2-selective
      antagonist, himbacine, the M3-selective antagonist, 4-diphenyl-acetoxy-N
      methylpiperidine methiodide (4-DAMP) and the non-selective antagonist, atropine,
      on carbachol-induced relaxation and contraction of the rat iris dilator smooth
      muscle. All the antagonists competitively inhibited both the responses to
      carbachol. 3. In relaxation and contraction, the low affinity of pirenzepine and
      himbacine suggest that the rat iris dilator smooth muscle receptors are not of
      the M1 and M2 subtypes. In contrast, 4-DAMP potently inhibited the carbachol
      induced relaxation and contraction with affinities similar to those reported for
      the M3 subtype. 4. Carbachol-induced relaxation and contraction of the rat iris
      dilator appears to be mediated through a homogeneous population of M3 subtype.

PMID- 8482488
TI  - Josamycin concentrations in radicular cysts following a single oral
      administration.
AB  - 1. Josamycin concentrations in cyst wall (wall) and cyst fluid (fluid) of
      radicular cyst and serum following a single oral administration of josamycin (600
      mg) were assayed by a paper disk method. 2. The mean peak josamycin
      concentrations in wall, fluid and serum occurred at 1.5, 2 and 1.5 hr,
      respectively, and were 1.33 micrograms/g, 0.53 and 0.74 micrograms/ml,
      respectively. 3. The mean concentration ratios of wall/serum, fluid/serum and
      fluid/wall at the peak times (1.5, 2 and 2 hr) were 1.80, 0.64 and 0.42,
      respectively. 4. Josamycin concentrations in wall and fluid at the peak time
      exceeded MIC for 80% for clinically isolated strains of alpha-hemolytic
      Streptococci.

PMID- 8482489
TI  - Interaction of AZA analogs of chlorpromazine with the dopamine D2 receptor.
AB  - 1. Permanently charged AZA analogs of chlorpromazine inhibited the binding of
      [3H]spiperone and antagonized the apomorphine-induced inhibition of the potassium
      evoked release of [3H]acetylcholine. 2. The AZA analogs were more potent in
      binding affinity and antagonist activity than the trimethylammonium analog of
      chlorpromazine but less potent than chlorpromazine. 3. These results suggest that
      it is possible to enhance the binding of the permanently charged
      trimethylammonium analog of chlorpromazine by the addition of a functional group
      near the quaternary nitrogen which is capable of forming a hydrogen bond with the
      D2 dopamine receptor. 4. However, it appears that for optimal binding, as
      achieved with chlorpromazine, the hydrogen-bonding proton should be on the
      charged nitrogen.

PMID- 8482490
TI  - Effects of an inhibitor of GABA-aminotransferase (gamma-vinyl-GABA) on the
      spatial navigation deficit induced by nicotinic blockade.
AB  - 1. The present study investigated whether stimulation of the GABA-ergic system
      affects spatial navigation (water-maze, WM) deficit induced by nicotinic blockade
      (mecamylamine). 2. The effects of various doses of gamma-vinyl-GABA (GVG: 50, 150
      and 300 mg/kg) and mecamylamine (2.5 and 10 mg/kg) were examined alone and in
      combination. 3. GVG at the dose 150 mg/kg alone did not impair the performance of
      rats in the WM task. 4. Mecamylamine at the dose 2.5 and 10 mg/kg clearly
      impaired the performance of rats in WM task. 5. When the two drugs were co
      administered, no interaction between mecamylamine and GVG was observed. 6.
      Combined nicotinic and muscarinic blockade did not interact as well with GVG
      administration. 7. Our results do not provide support for any interaction between
      cholinergic and GABA-ergic mechanisms.

PMID- 8482491
TI  - The effects of acetylcholine on insulin-dependent and non-insulin-dependent
      diabetic rat tracheal segments.
AB  - 1. In the present study, the contractile effects of acetylcholine (Ach) were
      investigated in isolated tracheal strips obtained from insulin-dependent (ID) and
      non-insulin-dependent (NID) diabetic rats. 2. The maximum responses to Ach were
      significantly decreased in 5-6 week ID diabetic rat tracheal segments compared
      with those from controls but, the sensitivity (pD2 values) of ID diabetic
      tracheas to Ach were not significantly altered relative to corresponding
      controls. 3. Tracheas isolated from 11-12 week NID diabetic rats exhibited
      reduced maximal contractile effect of Ach and also sensitivity (pD2 values) of
      NID diabetic tracheas to Ach were significantly decreased when compared to
      control rat tracheas. 4. Insulin treatment of both group of diabetic rats for 10
      days corrected the changes observed in diabetic tracheas.

PMID- 8482492
TI  - The effects of glyburide and insulin on the cardiac performance in rats with non
      insulin-dependent diabetes mellitus.
AB  - 1. The effects of glyburide were studied on the myocardial contractile force and
      heart rate in the atria isolated from non-diabetic and non-insulin-dependent
      diabetic rats (diabetic). 2. In order to examine the myocardial changes in the
      alloxan model of non-insulin-dependent diabetes, atrial functions of 11-week old
      diabetic rats were evaluated by comparing with the atria from their age-matched
      controls. 3. Diabetic atria were found to possess an increased contractile force
      and reduced inotropic responses to isoprenaline as a consequence of non-insulin
      dependent diabetes induced by neonatal alloxan injection. 4. However, no
      significant change was observed in the heart rate of diabetic atria in response
      to isoprenaline when compared with controls. 5. Since apparent affinity constant
      (pD2 value) calculated for the inotropic response of diabetic atria to
      isoprenaline was also reduced, it might be suggested that non-insulin-dependent
      diabetes causes a decrease in the beta-adrenoceptor affinity of the rat atria. 6.
      Glyburide treatment (5 mg/kg/day per os) for 3 weeks was able to improve the
      reduced responsiveness of rat atria due to non-insulin-dependent diabetes as
      well. The results obtained in this study indicated that glyburide possesses an
      improving effect on the decreased beta-adrenergic responses of rat atria with non
      insulin-dependent diabetes mellitus.

PMID- 8482493
TI  - Pyrazine CH- and NH-acids. Antithrombotic activity and chromatographic behaviour.
AB  - 1. A series of newly synthesized pyrazine CH- and NH-acids was subjected to
      analytical and pharmacological studies. 2. The compounds were chromatographed in
      HPLC systems employing three reversed-phase columns and methanol-buffer solvents
      of various composition at acidic, neutral and alkaline pH. 3. Chemometrical
      analysis by the principal component method allowed for ordering of the compounds
      on a plane determined by the first two principal component axes. 4.
      Pharmacological tests were done for representatives of the series of compounds.
      5. An in vivo antithrombotic assay on mice proved diversified bioactivity within
      the group of agents. 6. Attempts were undertaken to relate chromatographic
      behaviour to antithrombotic activity. 7. Based on the results obtained, an
      approach was proposed to reduce the number of pharmacological tests in selecting
      the most promising agents.

PMID- 8482494
TI  - Effect of testosterone on the response of young rat vas deferens to
      norepinephrine.
AB  - 1. Following in vitro treatment with 12 microM 6-hydroxy-dopamine, 2 microM B
      oestradiol, 0.1 microM propranolol and 10 microM cocaine vasa deferentia isolated
      from young rats (21-23 days old) showed supersensitivity to norepinephrine (NE)
      compared to those from adult (3 months old) rats. 2. The pA2 values for prazosin
      were higher in young (9.6 +/- 0.1) than in adult (8.3 +/- 0.1) rat vas deferens,
      with the slopes of the Schild plots not different from 1.0 (0.78 +/- 0.26 and
      1.14 +/- 0.14, respectively). 3. The treatment of young rats with a single dose
      of testosterone abolished the supersensitivity to NE and the higher affinity for
      prazosin. 4. We conclude that there is a reduction of neuronal NE uptake and a
      decrease in the sensitivity to NE in the vas deferens as the rat matures
      sexually. 5. Testosterone induces a decrease in the sensitivity to NE, probably
      via an action on the alpha 1-adrenoceptor population and the sympathetic nerve
      discharge in this organ.

PMID- 8482495
TI  - Endogenous dopamine differently affects N-[1-(2
      benzo(b)thiophenyl)cyclohexyl]piperidine and cocaine binding to the dopamine
      uptake complex.
AB  - 1. [3H]N-[1-(2-Benzo(b)thiophenyl)cyclohexyl]piperidine ([3H]BTCP) labels in vivo
      the dopamine uptake complex in the mouse striatum. 2. In mice treated with gamma
      butyrolactone (GBL, 400 mg/kg), [3H]BTCP specific binding was increased and ID50
      values of BTCP and cocaine for the prevention of [3H]BTCP binding were
      significantly lowered. 3. In GBL-treated mice, cocaine (5 mg/kg, s.c.) had no
      effect on the BTCP ID50 value, whereas GBR 12783 (2 mg/kg, s.c.) increased it
      significantly. 4. Thus in vivo, endogenous dopamine and cocaine are competitive
      and non-competitive inhibitors, respectively, of the binding of [3H]BTCP.

PMID- 8482496
TI  - The effects of propranolol on skeletal muscle contraction, lipid peroxidation
      products and antioxidant activity in experimental hyperthyroidism.
AB  - 1. The mean levels of lipid peroxidation products, namely conjugated diene and
      malonaldehyde, were increased in the soleus muscles of hyperthyroid cats, while
      the mean glutathione peroxidase activity was decreased. No corresponding similar
      changes were noted in the fast extensor digitorum longus muscles and serum. 2.
      Propranolol administration prevented the increase in conjugated diene level in
      the soleus muscles of hyperthyroid cat but not the malonaldehyde level. It also
      prevented the reduction in glutathione peroxidase activity in the slow oxidative
      soleus muscles of hyperthyroid cats. 3. Maximal twitch tension, subtetanic
      tension and maximum tetanic tension of soleus and EDL muscles were reduced in
      hyperthyroid cats. Propranolol administration for 5 weeks to hyperthyroid cats
      did not prevent the reduction in tension of contractions of these muscles. 4. It
      is suggested that lipid peroxidation might not be responsible for the myopathy in
      hyperthyroidism and propranolol administration does not improve skeletal muscle
      function in hyperthyroid animals.

PMID- 8482497
TI  - Analgesic effects of intracerebroventricular administration of calcium channel
      blockers in mice.
AB  - 1. The antinociceptive action of calcium channel blockers administered
      intracerebroventricularly to mice using the acetic acid writhing test was
      studied. 2. The drugs produced dose-dependent inhibition of the number of writhes
      induced by the intraperitoneal administration of 10 ml/kg of 0.6% acetic acid. 3.
      The CaCBs may be ranked from most to least potent as follows: verapamil >
      nimodipine > diltiazem > flunarizine > nifedipine > cinnarizine. 4. Since
      naloxone pretreatment was not able to inhibit the antinociception produced by
      CaCBs an opioid mechanism of action is excluded. 5. It is suggested that CaCBs
      can induce analgesia through a decrease in cellular Ca2+ availability, increasing
      the nociceptive threshold.

PMID- 8482498
TI  - Hypoxia-induced coronary flow changes in the perfused rat heart: effects of high
      L-carnitine concentrations.
AB  - 1. Hemodynamic effects of physiological (0.04 and 0.07 mM) and high (8, 15 and 25
      mM) L-carnitine (LC) concentrations were tested on the normally oxygenated and
      hypoxic perfused rat heart. 2. No effect was detected on aerobic hearts, whereas
      a dose-dependent rise in coronary flow (CF) during both the hyperemic and
      constrictive phases was observed in hypoxic hearts with 8, 15 and 25 mM LC. This
      action was apparently unrelated to a resting tension (RT) improvement, which was
      observed only with 25 mM LC. 3. When 11 mM glucose was replaced by 11 mM mannitol
      in the perfusion buffer, LC effects on the hyperemic phase were abolished;
      however, 25 mM LC resulted in CF-values still significantly higher than those
      detected without the drug, though RT was similar in these glucose-free groups. 4.
      It may be concluded that LC is ineffective on the perfused rat heart in aerobic
      conditions, whereas high LC concentrations can enhance CF only during hypoxia,
      these effects being independent of heart function improvements and partly
      unrelated to glucose presence.

PMID- 8482499
TI  - Neuroprotective effect of vinconate against postischemic alterations in binding
      of [3H]SCH 23390 in the gerbil brain.
AB  - 1. We investigated alterations in dopamine D1 receptors in the striatum and
      hippocampus after transient cerebral ischemia in gerbils using [3H]SCH 23390
      autoradiography. 2. We also examined the effect of vinconate against the
      alterations in dopamine D1 receptors after transient ischemia. 3. Transient
      ischemia was induced for 10 min, and vinconate (100 and 300 mg/kg) was given
      intraperitoneally 10 min before ischemia. 4. [3H]SCH 23390 binding showed no
      significant alterations in the striatum and hippocampus 5 hr after ischemia,
      whereas severe reduction in these areas was found after 7 days of recirculation.
      5. Vinconate showed no significant alterations in [3H]SCH 23390 binding in the
      striatum and hippocampus except for a decrease in the hippocampal CA3 sector and
      dentate gyrus 5 hr after ischemia. By contrast, vinconate prevented a significant
      reduction in [3H]SCH 23390 binding in the striatum, hippocampal CA3 sector,
      hilus, and dentate gyrus 7 days after ischemia. 6. Vinconate inhibited lipid
      peroxidation in rat brain homogenates in a concentration-related manner. 7. These
      results indicate that free radicals generated from abnormal dopamine metabolism
      may play a key role in the development of ischemic brain damage. Furthermore,
      they suggest that vinconate prevents ischemic brain damage by inhibiting lipid
      peroxidation.

PMID- 8482500
TI  - Effects of class I antiarrhythmic drugs on mitochondrial ATPase activity in
      guinea pig heart preparations.
AB  - 1. The effects of three class I antiarrhythmic drugs quinidine, lidocaine and
      lorcainide on undamaged myocardial mitochondrial ATPase [ATP: phosphohydrolase,
      EC 3.6.1.3] activity were evaluated in guinea pig heart preparations. 2. All
      three drugs inhibited the enzyme activity in a concentration-dependent fashion.
      3. Lorcainide was the most potent, exerting inhibitory effects in the range of
      less than 1.0 nM-2.0 mM, with IC20 and IC50 values of 9.4 +/- 0.6 nM and 87.2 +/-
      5.5 microM. However, in the range of approx. 10 nM-10 microM, the enzyme response
      decreased only slightly with increasing lorcainide concentrations. 4. Quinidine
      and lidocaine, on the other hand, inhibited the enzyme activity in the range of
      1.0 microM-100 mM. 5. The IC20 and IC50 values for quinidine were 0.92 +/- 0.04
      mM and 4.8 +/- 0.6 mM and for lidocaine were 115 +/- 6 microM and 2.3 +/- 0.3 mM.
      6. The results show that all three drugs inhibit mitochondrial ATPase activity
      and that lorcainide is the most potent. 7. These inhibitory effects may be
      related to the lipophilicity and membrane stabilizing activity of this class of
      antiarrhythmic drugs.

PMID- 8482501
TI  - Positive chronotropic and inotropic responses to lysophosphatidylcholine are
      mediated by norepinephrine released from myocardial sympathetic nerve terminals.
AB  - 1. The effects of beta-adrenoceptor blockade and reserpinization on the positive
      chronotropic and inotropic responses to lysophosphatidylcholine (LPC) were
      examined in isolated atrial and ventricular preparations from rat hearts. 2. The
      positive responses to 10(-4) M LPC were about 40-55% of those to 10(-5) M
      norepinephrine (NE) in each preparation. 3. The responses to LPC in the presence
      of propranolol or in the reserpinized preparations were significantly smaller
      than the corresponding values obtained in control preparations, and were about 10
      25% of those to NE. 4. It was concluded that positive chronotropic and inotropic
      responses to LPC are at least partially mediated by release of NE from myocardial
      sympathetic nerve terminals.

PMID- 8482502
TI  - Duration-dependent variability in the responses of diabetic rat aorta to
      noradrenaline and 5-hydroxytryptamine.
AB  - 1. The responsiveness of isolated aortic rings from 1, 4 and 12 week
      streptozotocin-induced diabetic rats to noradrenaline (NA) and 5
      hydroxytryptamine (5-HT) were compared with those of non-diabetic controls under
      standard organ bath procedure. 2. There were significant increases in the maximum
      contractile responses to both agents after 1 and 4 weeks but not after 12 weeks
      of diabetes mellitus. 3. The variable responses show that duration-dependent
      functional changes occur in the course of streptozotocin diabetes in rats.

PMID- 8482503
TI  - Neuropeptide Y-induced inositol phospholipid hydrolysis in blood vessels from
      normotensive and spontaneously hypertensive rats.
AB  - 1. Neuropeptide Y (NPY) increased inositol phosphate (IP) formation in the
      femoral artery and vein of adult Wistar Kyoto (WKY) and spontaneously
      hypertensive (SHR) rats. 2. Noradrenaline (NA, 10(-6) M) induced IP accumulation
      in both strains of rats. 3. Subthreshold concentrations of NPY (3 x 10(-9) M for
      femoral vein and 10(-8) M for femoral artery) failed to modify NA (10(-6) M)
      induced IP formation in both vessels. 4. These results suggest that the direct
      contractile effects but not the potentiation of NA-induced contractions may be
      directly linked to phosphatidylinositol turnover in adult SHR and WKY rats.

PMID- 8482504
TI  - Histamine H1 receptor binding sites in mouse uterine horns.
AB  - 1. The specific binding of both [3H]histamine and [3H]pyrilamine to crude
      membrane preparations obtained from mouse uterine horns was studied with the aid
      of radioligand binding techniques. 2. Saturation isotherms and binding of 300 nM
      of [3H]histamine in the presence of increasing concentrations of unlabelled
      histamine suggested the presence of two populations of [3H]histamine binding
      sites (IC50: 56 +/- 5.6 nM and 100 +/- 9.8 microM, respectively). 3. Pyrilamine
      displaced the high affinity binding site (IC50: 100 +/- 10 nM), while cimetidine
      displaced the low affinity one (IC50: 98 +/- 10 microM). 4. Saturation curve
      analysis by using [3H]pyrilamine as radioligand, revealed that H1 binding site
      varied according to the predominance of sexual hormones (Kd: 29 nM; 102 nM and
      130 nM in uterine membranes from ovariectomized, diestrous and estrous,
      respectively). At the end of pregnancy Kd was found to be 71.1 nM.

PMID- 8482505
TI  - Morphological and electrophysiological changes induced by calcium ionophores
      (A23187 and X-537A) in spontaneously beating rabbit sino-atrial node cells.
AB  - 1. Effects of calcium ionophores (A23187 and X-537A) on the spontaneously beating
      sino-atrial (SA) node cells of rabbit heart were examined using electron
      microscopic and an electrophysiological techniques. 2. During exposure to A23187
      or X-537A (2 x 10(-5) M), the cycle length was significantly prolonged by 11% (n
      = 12) or 118% (n = 11), respectively. But neither ionophore affected other action
      potential parameters. 3. X-537A (2 x 10(-5) M) induced irregular rhythm
      (dysrhythmia), probably due to cellular calcium overload. Similarly, ouabain (3 x
      10(-7) M) also elicited dysrhythmia. In the presence of isoproterenol (ISP, 10(
      7) M), X-537A potentiated dysrhythmia, and A23187 newly induced it. 4. In
      ultrastructural analyses, X-537A caused swelling of the cisternae of Golgi
      apparatus within 10 min, whereas A23187 and ouabain did not produce any changes
      even after 30 min-application. 5. Addition of high Ca2+ (10 mM) and/or ISP (10(
      7) M) to X-537A produced a further dilation and vacuolization. In A23187 or
      ouabain, however, the addition of Ca2+ and ISP did not cause any changes, even
      during dysrhythmia. 6. These results indicate that X-537A elicited a more potent
      calcium overload than A23187, and that a discrepancy between ultrastructural
      damages and electrical changes exists.

PMID- 8482506
TI  - Preferential decarboxylation of L-threo-3,4-dihydroxyphenylserine in rat renal
      tissues.
AB  - 1. Administration of L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS; 3, 10 and
      30 mg/kg, i.p.) produced a dose-dependent increase in the tissue levels of both
      noradrenaline and its deaminated metabolite 3,4-dihydroxyphenylglycol (DOPEG) in
      the rat jejunum, liver and renal cortex, but not in the left ventricle. 2. The
      accumulation of noradrenaline and DOPEG after the administration of L-threo-DOPS
      (30 mg/kg, i.p.) was also found to be a time-dependent effect, reaching its
      maximum 15 min after the injection and then declining progressively. 3. The
      accumulation of noradrenaline and DOPEG after L-threo-DOPS (30 mg/kg, i.p.) was
      found to be similar in control and 6-OHDA treated rats and completely prevented
      by previous treatment with benserazide. 4. Administration of L-threo-DOPS (30
      mg/kg) produced an increase in plasma levels of noradrenaline and DOPEG; this
      effect was maximum, for both noradrenaline (6.2-fold increase) and DOPEG (3.4
      fold increase), at 30 min after the injection of L-threo-DOPS. 5. The results
      presented here support the view that most L-threo-DOPS is decarboxylated into
      noradrenaline by non-neuronal AAAD, a reaction occurring predominantly in renal
      tissues.

PMID- 8482507
TI  - Des-tyrosine-gamma-endorphin effects on morphine analgesia in mice.
AB  - 1. The effects that were induced by a beta-lipotropin fragment des-tyrosine-gamma
      endorphin (DT gamma E) devoid of opiate activity that was administered
      intraperitoneally or intracerebroventricularly to mice under morphine analgesia
      were investigated. The interaction of this peptide with the analgesic effects of
      morphine was examined using the hot plate and the tail flick test. 2.
      Intraperitoneal acute treatment with DT gamma E did not change the analgesic
      effects of morphine. 3. Intraperitoneal semi-chronic treatment performed for 4
      days with DT gamma E enhanced morphine analgesic effects. 4. The
      intracerebroventricular acute treatment with DT gamma E reduced morphine
      analgesia in a dose-dependent way. 5. These results indicate that DT gamma E,
      although devoid of opioid activity per se, may interact with the opioid system,
      probably through an indirect mechanism.

PMID- 8482508
TI  - Effect of potassium on the contractile response of the rat detrusor muscle to
      field stimulation at increasing calcium concentrations.
AB  - 1. At 0.6 and 1.8 mM calcium, increasing the potassium concentration from 2.5 to
      both 7.5 and 12.5 mM significantly increased the contractile response to field
      stimulation at 0.5, 1, 2 and 4 Hz. There were no effects on the contractile
      responses to 8, 16, 32 and 64 Hz. 22.5 mM potassium significantly reduced the
      contractile response to all frequencies of stimulation. 2. At 5.4 mM calcium, the
      contractile responses to all frequencies in the presence of 2.5, 7.5 and 12.5 mM
      potassium were similar. The responses to all frequencies of stimulation in the
      presence of 22.5 mM potassium were significantly reduced. 3. In general, the
      relative responses to low frequencies of stimulation were significantly greater
      in the presence of 5.4 mM calcium than in the presence of 0.6 or 1.8 mM calcium.
      4. The magnitude of the inhibition in the presence of 22.5 mM potassium was
      inversely proportional to the extracellular calcium concentration, i.e. the lower
      the calcium concentration, the greater the inhibition. 5. The bladder base
      responded to alterations in the potassium and calcium concentrations similarly to
      the bladder body. 6. In conclusion, increasing the potassium concentration from
      2.5 mM (normal bath concentration) to 7.5 and 12.5 mM significantly enhanced the
      contractile response to low frequency stimulation at both 0.6 and 1.8 mM (normal
      bath concentration) calcium.

PMID- 8482509
TI  - Maternally-mediated developmental lithium toxicity in the mouse.
AB  - 1. Breast fed maternally-mediated developmental LiCl toxicity was determined in
      mice offspring as a function of offspring's gender and duration of maternal
      intake of LiCl (1 mEq). 2. The female offspring were more sensitive than the
      males to major organ weight changes by maternal exposure to LiCl. 3. Maternal
      intake of LiCl from preconception until weaning of the nurslings induced
      offspring hepatic alcohol dehydrogenase and heart lactate dehydrogenase in both
      sexes which was isoenzyme specific for the latter. 4. The offspring also showed
      induction of liver aldehyde dehydrogenase but only as consequences of postnatal
      exposure to LiCl. 5. The results indicate offspring developmental toxicity as a
      consequence of maternal exposure to Li salts and breast feeding.

PMID- 8482510
TI  - A possible mechanism for increased cerebrovascular permeability in diabetic rats:
      effects of insulin and 2-deoxy-glucose.
AB  - 1. Cerebrovascular permeability estimated as Evans blue extravasation
      significantly increased during insulin-induced hypoglycemia in both non-diabetic
      and diabetic rat groups. 2. Cerebrovascular permeability also increased
      significantly during 2-deoxy-glucose-induced intracellular glycopenia in both
      groups. 3. When a blood glucose level was fixed, cerebrovascular permeability
      showed no more significant change despite the hyperinsulinemic state in both
      groups. 4. Results suggest that hypoglycemia and/or intracellular glycopenia
      seems to be the major factor for increases in cerebrovascular permeability.

PMID- 8482511
TI  - Current trends in the study of potassium channel openers.
AB  - Some eight years ago it was found that certain smooth muscle relaxants exert
      their effect by opening a specific K+ channel resulting in cell membrane
      hyperpolarization. The use of K+ channel openers (cromakalim, pinacidil and RP
      52891) and compounds which antagonize their actions (glibenclamide, phentolamine
      and alinidine) has enabled a great deal of research to be performed into the role
      of this K+ channel, not only in smooth muscle, but also in cardiac and skeletal
      muscle as well as neural and endocrine organ function. Much of the attention has
      centred on the smooth muscle relaxant actions of the K+ channel openers, since
      they have potential therapeutic use in disorders involving smooth muscle over
      reactivity such as hypertension and asthma. More recently the cardiac actions of
      the K+ channel openers have become the focus of interest. Although there appear
      to be good theoretical reasons why K+ channel openers may be of use in some
      arrhythmias and in ischaemic heart disease there are major hurdles to overcome.
      In particular, given that the effect of these compounds on vascular smooth muscle
      occurs at a concentration 20- to 100-fold lower than that required to produce
      cardiac effects, it is likely their therapeutic usefulness will be limited until
      a breakthrough in cardiac/vascular selectivity is made. There is also growing
      interest in endogenous K+ channel openers and the physiological role of the K+
      channel which they open. Opening of K+ channels, either spontaneously or by
      endogenous regulators, could possibly be an important hypotensive mechanism both
      under normal conditions and in a number of pathological conditions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8482512
TI  - The complex interaction of ATP and UTP with isolated hepatocytes. How many
      receptors?
AB  - 1. ATP exerts multiple receptor-mediated effects on isolated hepatocytes:
      glycogenolysis through the activation of glycogen phosphorylase (cAMP
      independent, IP3/calcium-mediated), inactivation of glycogen synthase, inhibition
      of the glucagon effect on cAMP, activation of phospholipase D. The fact that some
      of these effects can be selectively altered and that they are not, or
      differently, reproduced by some other analogues of ATP, suggests the presence of
      more than one receptor. (i) Pertussis toxin abolishes the anti-glucagon effect of
      ATP without affecting its glycogenolytic effect. (ii) Single cell calcium
      measurements reveal major differences between ATP and ADP, (iii) 2MeSATP and ADP
      beta S, in clear contrast to ATP, barely increase the levels of IP3 and their
      glycogenolytic effects is completely blocked by phorbol ester treatment of
      hepatocytes. (iv) 2MeSATP differs from ADP beta S since it has no anti-glucagon
      effect. 2. Effects of UTP on isolated hepatocytes so far do not show any
      difference with effects of ATP, suggesting interaction with the same receptor(s).
      3. It is proposed that liver plasma membranes contain (at least) three different
      receptors mediating (a) the activation of phospholipase C, (b) the activation of
      phospholipase D and (c) the inhibition of adenylate cyclase.

PMID- 8482513
TI  - Effects of oblongine chloride, an alkaloid from Leontice leontopetalum on guinea
      pig isolated smooth muscle and heart.
AB  - 1. The effects of (-)oblongine chloride, a quaternary alkaloid from Leontice
      leontopetalum, on guinea-pig isolated ileal longitudinal segments, main pulmonary
      artery rings, spontaneously-beating atrium and isolated perfused heart were
      studied. 2. Oblongine chloride (3 x 10(-5)-10(-3) M) caused concentration
      dependent relaxation of ileum, an effect which was not blocked by propranolol
      (10(-6) M) alone or in combination with prazosin (3 x 10(-8) M), or by
      indomethacin (10(-6) M), but was reduced by desensitization of the preparation by
      prior exposure to 3 x 10(-5) M ATP and, at high concentrations of oblongine, by a
      combination of propranolol and yohimbine (3 x 10(-6) M). 3. Oblongine chloride
      (10(-5)-3 x 10(-3) M) caused concentration-dependent relaxation of epinephrine
      precontracted pulmonary artery. This effect was not affected by propranolol or by
      indomethacin but was significantly attenuated by pretreatment with 3 x 10(-5) M
      ATP and potentiated by pretreatment with quinacrine (10(-5) M). 4. Oblongine
      chloride (10(-5) M-3 x 10(-3) M) caused concentration-dependent increase in the
      contractility but did not affect the rate of the atrium. Similar effects were
      obtained with isolated perfused heart except that large concentrations of
      oblongine (10(-3), 3 x 10(-3) M) inhibited both contractility and rate of the
      heart. The inotropic effects of oblongine on the atrium were not blocked by
      propranolol or indomethacin but were significantly blocked by
      quinacrine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482514
TI  - Peripheral administration of taurine antagonizes morphine-induced analgesia in
      mice.
AB  - 1. A single i.p. dose of taurine (25 mg/mouse) given to mice 3 hr before an i.p.
      injection of morphine (0.1 mg/mouse) decreased the analgesic response of the
      animals to morphine. 2. Neither a lower dose of taurine nor the same dose of
      another amino acid was effective. 3. The analgesic response to morphine was also
      reduced by inclusion of taurine in the drinking water. 4. The results of the
      present study indicate that peripherally administered taurine antagonized
      morphine-induced analgesia, similar to a previous report that taurine
      administered centrally, diminished the analgesic response to a centrally injected
      opioid peptide.

PMID- 8482515
TI  - The vascular relaxing effect of a factor released by rat atria distension.
AB  - 1. In order to develop a technique to obtain and preserve the atrial natriuretic
      factors (ANFs) which may be useful for eventual studies on the properties of
      these factors, we performed experiments on rat isolated atrium. 2. The two atria
      of adult Wistar rats (200-300 g body wt) deprived of food and water for 48 hr,
      were set up in an organ bath with modified Krebs-Henseleit solution and submitted
      progressively to increasing tensions of 0.5, 1.5 and 3.0 g. A sample of 2 ml
      obtained from the bath was treated with acetic acid 1 M and kept at -12 degrees
      C. Within 2 days the samples were evaluated for the activity of ANFs on isolated
      rat aortic rings. Aortic rings previously contracted with a submaximal
      concentration of phenylephrine were slowly relaxed by the samples. 3. Samples
      from atria submitted to the highest tension shifted the dose-response curve of
      contraction induced by increasing cumulative doses of phenylephrine to the right.
      This activity was absent from samples obtained from the solution in which the
      atria were dissected. This experimental model allows one to obtain and preserve a
      vascular relaxing factor from atrial myocardium.

PMID- 8482516
TI  - Characterization of the nipecotic binding to rat brain membranes.
AB  - 1. The specific binding of [3H]Nip and [3H]GABA to rat brain membranes has been
      reexamined. 2. Specific binding of [3H]Nip and [3H]GABA was exclusively dependent
      on sodium ions in a cooperative manner (Hill coefficient 2.2 +/- 0.2 and 2.4 +/-
      0.3 for [3H]Nip and [3H]GABA binding, respectively). Potassium, lithium or
      choline chloride salts were ineffective for replacing NaCl. 3. Maximal binding
      was observed at 2 degrees C. The association constants were K+1 = 0.033 min-1
      microM-1 for [3H]GABA. The dissociation constants obtained by the addition of 1
      mM of non-labeled GABA were 0.087 +/- 0.01 min-1 and 0.139 +/- 0.025 min-1 for
      [3H]Nip and [3H]GABA, respectively. Scatchard curves were in agreement with these
      constants, KD = 1.6 microM for [3H]GABA and 2.6 microM for [3H]Nip with equal
      Bmax = 138 pmol per mg protein. 4. The dissociation constants for [3H]Nip bound
      increased from 0 to 0.035, 0.18 and 0.58 min-1 at 2, 16, 26 and 37 degrees C,
      respectively, contrary to the hydrophobic derivate of nipecotic acid, NO 328. 5.
      Pharmacological characterization and regional brain distribution of [3H]Nip and
      [3H]GABA binding and uptake, suggest that [3H]Nip specifically labels the
      neuronal GABA uptake system, absent in peripheral tissues.

PMID- 8482517
TI  - Duration-dependent attenuation of acetylcholine--but not histamine--induced
      relaxation of the aorta in diabetes mellitus.
AB  - 1. The relaxations of aortic preparations from 1, 4 and 12 week diabetic rats to
      acetylcholine and histamine were studied. 2. The relaxation to acetylcholine but
      not to histamine was significantly attenuated in the 4th and 12th weeks of the
      disease. In addition, the tissues became less sensitive to acetylcholine but not
      to histamine with increasing duration of the disease. 3. The results show that
      there is differential alteration in the responsiveness of the aorta from diabetic
      rats to both agents.

PMID- 8482518
TI  - Electrophysiological comparison of the effects of MCI-154 on smooth muscles
      between mesenteric artery and vein of dogs.
AB  - 1. Effects of MCI-154, a cardiotonic vasodilator, on smooth muscles were compared
      in isolated mesenteric artery and vein of dog. 2. MCI-154 depolarized the
      membrane, and inhibited Ca(2+)- and K(+)-contractions more in the vein than in
      the artery. 3. Nerve-mediated and noradrenaline-induced contractions, and the
      excitatory junction potential (e.j.p.) were inhibited by MCI-154 in the vein and
      potentiated in the artery. 4. Compound action potentials of perivascular nerves
      and action potentials generated on the e.j.p. were not altered by MCI-154. 5. MCI
      154 predominantly dilates venous muscles, and as a result would reduce cardiac
      outflow and lower systemic blood pressure.

PMID- 8482519
TI  - Effects of two selective dopaminergic antagonists on ethologically-assessed
      encounters in male mice.
AB  - 1. Although it is accepted that dopaminergic antagonists suppress aggressive
      behaviour, the drugs used have been relatively non-selective or specific to the
      D2 receptor. 2. The selective D1 antagonist, SCH 23390, makes it possible to
      evaluate the impact of this receptor on aggressive behaviour. 3. The effects of
      SCH 23390 and Spiperone (a D2 antagonist) on the aggressive behaviour of mice
      were assessed employing a "standard opponent" test. 4. Both drugs markedly
      decreased aggressive behaviour whilst increasing immobility. However, whilst SCH
      23390 increased immobility to a small extent, Spiperone, produced a general
      decline in active behaviours. 5. It appears that the D1 receptor inhibition of
      aggression is the more specific.

PMID- 8482520
TI  - Characterization of maximal intravenous dose volumes in the dog (Canis
      familiaris).
AB  - 1. Pharmacological evaluation of intravenously administered drugs is frequently
      limited by the dose volume. Commonly used osmolytes in dosing solutions are
      isotonic sodium chloride (0.9%) and dextrose (5%). 2. The objective of this study
      was to determine the maximum volume of an isotonic intravenous (i.v.) solution to
      be given to conscious dogs. 3. Four dogs (2 male, 2 female), prepared for urine
      collections and for blood pressure and heart rate determinations, were given
      saline or dextrose intravenously at infusion rates of 0.3 ml(kg min)-1, 1.0 ml(kg
      min)-1 or 3.0 ml(kg min)-1 for 60 min; a sham-infusion was also performed. 4.
      Hematocrit and serum osmolality, BUN, sodium, potassium, chloride, creatinine and
      glucose, urinary excretion of sodium, potassium, chloride, and urine flow rate,
      urine osmolality, and renal creatinine and glucose clearances were determined. 5.
      Intravenous infusion of greater than 1.0 ml(kg min)-1 (60 ml/kg) 0.9% saline was
      associated with significant hemodilution and tachycardia. 6. Intravenous infusion
      of greater than 0.3 ml(kg min)-1 (18 ml/kg) 5% dextrose was associated with
      significant hemodilution, hyponatremia, tachycardia and delayed CNS disturbances
      associated with hyponatremia. 7. Hence, the limiting volumes of isotonic vehicles
      that can be administered intravenously to conscious dogs without contributing
      substantial effects on systemic or renal function are approx. 60 ml/kg 0.9%
      saline (or an equivalent non-metabolizable osmolyte) and approx. 18 ml/kg 5.0%
      dextrose (or an equivalent metabolizable osmolyte), administered over 60 min.

PMID- 8482521
TI  - Characterization of the renal handling of p-aminohippurate (PAH) in the beagle
      dog (Canis familiaris).
AB  - 1. The renal clearance of p-aminohippurate (PAH) is the most commonly used method
      for estimation of renal blood flow in laboratory animals and in humans. 2. This
      study characterizes the renal handling of PAH in 11 beagle dogs and describes for
      this species critical parameters for the valid use of the renal PAH clearance
      technique to estimate renal blood flow. 3. PAH was given as a priming dose plus
      infusion rates of 0.01-6 mg/kg per min. 4. Steady-state plasma concentrations
      were achieved within 60 min. 5. Urinary excretion of PAH accounted for > or = 90%
      of the PAH infused. 6. Plasma PAH concentrations increased linearly with dose. 7.
      Renal secretion of PAH exceeded filtered PAH at plasma PAH concentrations less
      than approx. 6 mg%. 8. The TmPAH for renal PAH secretion was approx. 0.4 mg/kg
      per min. 9. At PAH infusion rates above TmPAH the clearance of PAH decreased and
      asymptotically approached the value of the GFR.

PMID- 8482522
TI  - Comparison of actions of endothelium-derived nitric oxide and sodium
      nitroprusside on mechanical responses evoked in aorta and mesenteric artery of
      the rabbit.
AB  - 1. The effects were investigated of endothelium-derived nitric oxide (EDNO; EDRF)
      and sodium nitroprusside (SNP) on the contraction evoked by noradrenaline (NA) or
      perivascular nerve stimulation in the presence (+E) or absence (-E) of
      endothelial cells in the rabbit mesenteric artery and aorta. 2. Acetylcholine
      (ACh) was more potent in relaxing (+)-tissues of the aorta than those of the
      mesenteric artery. These relaxing effects of ACh were inhibited under
      pretreatment with NG-nitro-L-arginine (L-NNA). 3. SNP relaxed the contraction
      evoked by NA or electric field stimulation in the aorta more than in the
      mesenteric artery in the presence or absence of endothelium. L-NNA (> 15 microM)
      consistently enhanced the amplitude of contraction evoked by either NA or
      electric field stimulation more strongly in (+E)-tissues from the mesenteric
      artery than in these from the aorta. 4. L-NNA accelerated the relaxing actions of
      SNP on contractions evoked by NA in (+E)-tissues prepared from the mesenteric
      artery though this action was less marked in the aorta. 5. Spontaneous release of
      EDNO is more potent in inhibiting contraction evoked in the mesenteric artery
      than in the aorta, whereas derived NO and exogenously applied NO are more potent
      in inhibiting contraction evoked in the aorta than in the mesenteric artery.

PMID- 8482523
TI  - Effect of trapidil on serum lipid and apolipoprotein levels in patients with
      ischemic heart disease.
AB  - 1. Serum total cholesterol (TCH), triglyceride (TG), high density lipoprotein
      cholesterol (HDL-C), low density lipoprotein (LDL-C), atherosclerotic index (AI)
      and apolipoprotein (apo A-I, A-II, B, C-II, C-III and E) levels were investigated
      in patients with ischemic heart disease before and after medication of trapidil.
      2. Twenty-one patients were orally given 100 mg of trapidil, three times daily
      (300 mg/day). After 8 weeks' administration, serum HDL-C level increased (P <
      0.01) and AI decreased (P < 0.02) significantly, whereas TCH, TG and LDL-C levels
      tended to decrease but not significantly. 3. Among the parameters of
      apolipoproteins, apo A-I, a main protein of HDL-C, was significantly increased (P
      < 0.05) by trapidil. 4. These results indicate that trapidil has a beneficial
      effect on the coronary risk profile as reflected by lipid measurements.

PMID- 8482524
TI  - Estrogen and antiestrogen non-genomic effect in rat uterus contraction in calcium
      free solution.
AB  - 1. The effects of estrogens estradiol (E2, 10(-6)-10(-4) M) and
      diethylstilbestrol (DES, 10(-6)-10(-4) M) and the antiestrogens nafoxidine (N,
      10(-6)-10(-4) M), tamoxifen (T, 10(-6)-6 x 10(-4) M), tamoxifen ethyl bromide
      (TEB, 10(-4) M) and ICI 164,384 (ICI, 10(-5) M) on tonic contractions induced by
      oxytocin (2 x 10(-8) M) or vanadate (3 x 10(-4) M) in rat uterus incubated in
      calcium-free EDTA treated solution have been assayed. 2. E2 and DES relaxed the
      tonic contraction induced by oxytocin in a dose dependent way (EC50: 1.11 +/-
      0.01 x 10(-4) M and 1.5 +/- 0.07 x 10(-5) M). The vanadate-induced contraction
      only was relaxed with DES (57.62 +/- 2.38% at 10(-3) M). 3. The effect of DES on
      oxytocin contraction was unmodified by the protein synthesis inhibitor
      cycloheximide (10 micrograms/ml) and by the cyclooxygenase inhibitor indomethacin
      (3 x 10(-6) M), but enhanced by the intracellular calcium release inhibitor TMB-8
      (10(-5) M). The antiestrogen tamoxifen (3 x 10(-5) M) promotes the relaxing
      effect of DES. 4. The antiestrogens N, and T, but not ICI, relaxed the oxytocin
      induced contraction (EC50: 4.51 +/- 0.43 x 10(-5) M and 2.27 +/- 0.05 x 10(-4)
      M). TEB (10(-4) M) produces a relaxation of 74.5 +/- 2.11%. The vanadate
      contraction is also relaxed by T (EC50: 6.03 +/- 0.04 x 10(-4) M). 5. The effect
      of T on oxytocin contraction was unmodified with cycloheximide or TMB-8 but
      decreased with indomethacin.

PMID- 8482525
TI  - Studies on the hypotensive mechanisms of NZ-105, a new dihydropyridine
      derivative, in rats and rabbits.
AB  - 1. Intravenous administration of NZ-105 caused a slow-onset and long-lasting
      hypotension in anesthetized SHR. 2. Centrally administered NZ-105 (0.04 mg/kg)
      slightly decreased blood pressure. 3. The hypotension of NZ-105 (0.1 mg/kg, i.v.)
      was not affected by atropine, propranolol, diphenhydramine plus cimetidine,
      aminophylline or indomethacin. 4. In ganglion-blocked rats, NZ-105 (0.003-0.3
      mg/kg, i.v.) inhibited the pressor response to several hypertensive agents to a
      similar degree. 5. In pithed SHR, NZ-105 (0.03 mg/kg, i.v.) showed the same
      degree of hypotensive action as in non-treated SHR. 6. NZ-105 did not inhibit
      reflex responses to tilting in conscious rabbits. 7. Thus NZ-105 exerts its
      hypotensive action through the mechanisms of peripheral origin.

PMID- 8482526
TI  - Behaviour of leukocyte membrane fluidity in presence of anaesthetic drugs.
      Comparison between allergic patients and control subjects.
AB  - 1. In this study we compared the effects of two anaesthetic drugs on the
      leukocyte membrane fluidity in allergic patients versus control subjects. 2.
      Fluidity was assessed by means of the fluorescence polarization technique. 3. We
      report that the treatment of the whole leukocytes with thiopental or pancuronium
      enhanced membrane fluidity in the allergic group as well as in the control one,
      but the effect was more pronounced in allergics. 4. This finding suggests a
      different biophysical behaviour of the leukocyte membrane towards anaesthetic
      drugs in allergic diseases. 5. This agrees with the hypothesis of the existence
      of an intrinsic abnormality in allergic cells, expressed as an initial
      hyperreactive state.

PMID- 8482527
TI  - The serotonin receptor agonist 5-methoxy-N,N-dimethyltryptamine facilitates
      noradrenaline release from rat spinal cord slices and inhibits monoamine oxidase
      activity.
AB  - 1. The influences of the purported serotonergic agonist 5-methoxy-N,N
      dimethyltryptamine (MeODMT) on noradrenaline release and metabolism were
      investigated in a rat spinal cord release model and a monoamine oxidase (MAO)
      assay. 2. MeODMT inhibited the basal outflow of tritium from rat spinal cord
      slices preincubated with [3H]noradrenaline and enhanced the electrically-evoked
      overflow. 3. Effects on basal outflow were not observed, when monoamine oxidase
      (MAO) was inhibited by pargyline. Effects on the evoked overflow were not
      observed in the presence of metitepine or phentolamine. 4. Preferential
      inhibition by MeODMT of MAO A-type enzyme activity was found in a direct assay.
      5. The results provide evidence for two different effects by which MeODMT
      reinforces noradrenergic neurotransmission in the rat spinal cord: facilitation
      of stimulation-evoked noradrenaline release and inhibition of noradrenaline
      metabolism by MAO inhibition.

PMID- 8482528
TI  - Comparison of alloxan and streptozotocin induced diabetes in rats: differential
      effects on microsomal drug metabolism.
AB  - 1. Liver microsomes from alloxan or streptozotocin diabetic rats displayed
      differential drug metabolizing abilities in vitro. 2. Only streptozotocin liver
      microsomes exhibited changes in the cytochrome P-450 normal spectral
      characteristics. 3. Overall testosterone metabolism was significantly increased
      in streptozotocin diabetic liver microsomes, whereas it was markedly decreased in
      alloxan diabetes. Mixed function oxidase activity for aminopyrine was similar. 4.
      Glucuronidation reaction rates towards morphine, oestrone and p-nitrophenol were
      also markedly distinct in both models as well as after insulin treatment. 5.
      Results suggest that diabetogenic agents modify sex related isoenzymes of
      cytochrome P-450 differently and selectively reduce the synthesis of certain UDP
      glucuronyltransferase forms.

PMID- 8482529
TI  - The effects of the intestinal glucosidase inhibitory BAY M 1099 (miglitol) on
      glycemic status of obese-diabetic rats.
AB  - 1. Groups of lean and obese-diabetic (NIDDM) congenic male SHR/Nutl parallel-cp
      rats were fed a nutritionally adequate, high carbohydrate diet ad libitum with or
      without the alpha-glucosidase inhibitor miglitol (150 mg/kg diet) from 8 until 15
      weeks of age, and key glycemic parameters were monitored throughout the study. 2.
      Miglitol treatment resulted in clinical improvement toward normal in percent
      glycosylated hemoglobin, glycemic and insulinogenic responses to an oral glucose
      tolerance, and in liver glucokinase activity, in concert with modest decreases in
      weight gain in obese rats. 3. These observations are consistent with improved
      insulin sensitivity in peripheral tissues following miglitol treatment, and
      indicate that this drug may be a useful adjunct to diet in the treatment of
      obesity, NIDDM, and possibly other disorders of carbohydrate metabolism.

PMID- 8482530
TI  - Analysis of dinucleotide frequency and codon usage in the phylum Apicomplexa.
AB  - Dinucleotide frequency (DiF) and codon usage (cu) were analysed in gene sequences
      from four parasitic protozoa, Babesia bovis, Theileria parva, Toxoplasma gondii
      and Eimeria tenella, of the phylum Apicomplexa. In keeping with the 'genome
      hypothesis', cu was found to be non-random and species specific in these
      organisms, although cu among members of the same subclass was found to be very
      similar. Several low-usage (lu) codons were identified, and the usage of lu
      codons appears to be related to the taxonomic position of the organisms under
      study. A comparison of the observed/expected DiF ratios obtained from gene coding
      regions revealed a low frequency of the TA and CG dinucleotides in all organisms
      studied. A comparison of these DiF ratios with those found in rRNA-encoding genes
      and in introns, showed that in the parasites, B. bovis and Th. parva
      (representing the piroplasms), the low frequency of dinucleotides appeared to be
      the result of coding pressure alone. In T. gondii and E. tenella (representing
      the coccidia), however, coding pressure could not completely explain differences
      in DiF.

PMID- 8482531
TI  - Adh and Adh-dup sequences of Drosophila lebanonensis and D. immigrans:
      interspecies comparisons.
AB  - We have cloned and sequenced the Adh genomic region of Drosophila lebanonensis
      (subgenus Scaptodrosophila) and D. immigrans (subgenus Drosophila). This region,
      which contains Adh, encoding the alcohol dehydrogenase enzyme, and Adh-dup
      (duplicate of Adh), has been compared with the same fragment from D. subobscura
      (subgenus Sophophora). Even though the flanking regions and introns of both genes
      have been affected by high substitution rates, the consensus sequences have been
      clearly identified. Although the overall homology of the coding regions was 76
      78% among the species compared, there were differences in the exon distribution
      of the nucleotide substitutions when Adh or Adh-dup were compared, thus showing
      that these two genes differ in their evolutionary pattern.

PMID- 8482532
TI  - Induction of the murine class-II antigen-associated invariant chain by TNF-alpha
      is controlled by an NF-kappa B-like element.
AB  - The murine class-II antigen-associated invariant chain (Ii) is a glycoprotein
      whose synthesis is co-regulated with the major histocompatibility class-II
      antigens. The Ii mRNA is inducible by tumor necrosis factor-alpha (TNF-alpha). An
      NF-kappa B protein-binding site (NBS), located in the Ii promoter at bp -121 to 
      111, confers TNF-alpha inducibility on chimeric reporter constructs expressing
      the human growth hormone-encoding gene. A distal NF-kappa B-like protein-binding
      site (NBLS) located at bp -167 to -157 is not required for TNF-alpha
      inducibility, and deletion of this distal NBLS results in increased constitutive,
      as well as TNF-alpha-induced, expression of the reporter gene. The NBS is well
      protected during DNase I footprinting assays and specifically binds proteins in
      electrophoretic mobility shift assays. A distinct protein-DNA complex is observed
      when nuclear extracts from TNF-alpha-treated L-cells are used; this complex is
      not seen in extracts from untreated cells.

PMID- 8482533
TI  - Structure of the gene encoding the mouse 47-kDa heat-shock protein (HSP47).
AB  - HSP47, a 47-kDa heat-shock protein (HSP), is a member of a group of HSPs with the
      unique characteristics of collagen binding as well as transformation sensitivity.
      The protein belongs to the serpin (serine protease inhibitor) superfamily as
      determined from its amino acid sequence homology. We have isolated and
      characterized the mouse HSP47 including about 1 kb of the 5'-flanking region.
      This gene spans about 7.8 kb, consisting of six exons separated by five introns.
      This exon-intron structure is different from other serpin family proteins.
      Southern blot analysis revealed the existence of a single copy of HSP47. The
      promoter region contains a TATA box, four Sp1-binding sites and one AP-1-binding
      site. A complete heat-shock element (HSE) was found between nucleotides (nt) -61
      and -79. Furthermore, the heat inducibility was reproduced by transfecting mouse
      BALB/3T3 cells with a plasmid carrying cat under the control of the HSE
      containing fragment (nt -197 and +38) of HSP47. Computer analysis of the promoter
      region did not show marked homology to other vertebrate promoters.

PMID- 8482534
TI  - DNA-binding proteins and their cis-acting sites controlling hormonal induction of
      a mouse beta-casein::CAT fusion protein in mammary epithelial cells.
AB  - Transcription of the mouse beta-casein (beta CAS)-encoding gene (casB) is
      regulated by the synergistic actions of insulin, glucocorticoid and prolactin in
      the mammary gland (MG). To delineate its regulatory sequence(s), we examined the
      hormonal inducibility of various chimeric constructs containing the promoter
      sequence of casB and the cat reporter gene in primary MG epithelial cells. A DNA
      fragment from bp -258 to +7 of casB was sufficient for the hormonal induction.
      Using a series of 5'- and internal deletions of the casB promoter region, at
      least three DNA elements were found to be necessary for full induction. These
      were located at bp positions -258 to -180, -154 to -136, and -98 to -62. DNase I
      footprinting analysis with a partially purified extract from lactating MG cells
      detected at least seven protected sequences, I(-242 to -219), II(-213 to -202),
      III(-151 to -139), IV(-125 to -110), V(-98 to -90), VI(-79 to -70) and VII(-59 to
      -45). Regions I/II, III and V/VI were included in the three DNA elements required
      for the hormonal induction, and the IV region corresponded to the MG consensus
      sequences of several milk protein-encoding genes. Competition gel retardation
      assays using nuclear extracts of lactating mouse MG revealed the presence of
      specific binding proteins for regions I, II, IV and VI, as well as specific
      protein(s) binding to both regions III and V. The binding activities of these
      proteins, except that associated with region IV, were increased from the virgin
      to lactating periods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482535
TI  - Characterization of the 5' flanking region of the gene encoding rat liver
      glycogen phosphorylase.
AB  - A genomic region encompassing 800 bp of the promoter-regulatory region and exon 1
      of the gene (LGP) encoding rat liver glycogen phosphorylase has been isolated and
      characterized. Transcripts of the LGP gene initiate predominantly within an 8-bp
      region 48-bp upstream from the start codon. Additional transcripts were detected
      that initiate as far as 95 bp upstream from the start codon. To identify cis
      acting sequences involved in regulating transcription, HepG2 cells were
      transfected with vectors containing serial deletions of the promoter-regulatory
      region of LGP ligated to the cat reporter gene. Two upstream regions were found
      to enhance transcription. One of these regions contains an alternating purine
      pyrimidine sequence. LGP, which lacks a consensus TATA sequence, is like TATA
      less and CAAT-less housekeeping genes in that it contains G + C-rich domains
      upstream from multiple transcription start points. Nuclear proteins from adult
      rat tissues bound in a tissue-specific fashion to one of these G + C-rich
      regions.

PMID- 8482536
TI  - Sequence and single-base polymorphisms of the bovine alpha-lactalbumin 5'
      flanking region.
AB  - The alpha-lactalbumin (alpha LA)-encoding gene is a potential quantitative trait
      locus in dairy animals. In cattle, the production of alpha LA is tightly coupled
      to the onset of lactation and it serves as a regulatory subunit of the enzyme
      responsible for lactose synthesis. Lactose is the major osmole controlling water
      movement in the mammary gland. To better understand the control of bovine alpha
      LA expression, the 5'-flanking region of a Holstein alpha LA gene was cloned and
      sequenced. The sequenced clone contains 1952 bp of 5'-flanking region and 66-bp
      of the protein-coding region. Three single-bp polymorphisms were identified
      within this region. These polymorphisms occur at positions +15, +21 and +54
      relative to the mRNA transcription start point (tsp). The +15 and +21 variations
      occur in the region encoding the 5'-untranslated region of the mRNA-coding
      sequence. The +54 polymorphism is a silent mutation in the SP-coding region of
      the gene. A polymerase chain reaction (PCR, Cetus)-based screening method has
      been employed to analyze the genotype of cattle at the +15 position. A total of
      501 randomly selected cattle from seven breeds were screened for this allele. Of
      these animals, only the Holstein breed of cattle was found to contain the +15
      variation and it occurs at a gene frequency of 32%. Sequence comparisons were
      conducted between the 5'-flanking regions of the bovine-milk-protein encoding
      genes, alpha LA, beta-casein and alpha S1-casein, which are coordinately
      expressed. Regions of similarity extending to 350 bp in length were observed
      between these sequences.

PMID- 8482537
TI  - Cloning of human and rat cDNAs encoding the mitochondrial single-stranded DNA
      binding protein (SSB).
AB  - We have retro-transcribed and amplified by PCR the full-length cDNAs specifying
      the rat and human precursors of the single-stranded mitochondrial DNA (mtDNA)
      binding protein (mtSSB). Each deduced sequence is composed of a 16-amino-acid
      (aa) N-terminal basic pre-sequence and a mature protein (132 aa in humans and 135
      aa in the rat). The mature proteins are highly conserved among themselves and
      with the mtSSB from Xenopus laevis (Xl). Moreover, three regions of the protein
      are similar to corresponding domains of the SSB of Escherichia coli and to the E.
      coli F-sex factor SSB, indicating the existence of a broad class of DNA-binding
      proteins with structural and functional similarities both in prokaryotes and in
      prokaryote-derived organelles of higher organisms.

PMID- 8482538
TI  - Human L7a ribosomal protein: sequence, structural organization, and expression of
      a functional gene.
AB  - A cDNA coding for the human L7a ribosomal protein (r-protein) was used to isolate
      the corresponding gene by screening two human genomic libraries constructed in
      bacteriophage lambda and in a cosmid vector. One of the cosmid clones isolated,
      cos1.1, contains the whole L7 alpha gene, composed of eight exons and seven
      introns spanning 3226 bp. As in other mammalian housekeeping genes, the promoter
      and the first exon of the L7 alpha reside within a CpG-rich island. Furthermore,
      similar to the other higher eukaryote r-protein-encoding genes characterized so
      far, the human L7 alpha gene has a C as the major transcriptional start point
      localized in a pyrimidine-rich region and lacks a canonical TATA sequence. We
      show that 130 bp of the human L7 alpha gene 5'-flanking region represent the
      minimal element required to promote its transcription. This element is strikingly
      conserved between the mouse and human L7 alpha genes. Finally, a comparison of
      the human L7 alpha gene coding sequence and the predicted amino acid (aa)
      sequence with the sequences of mouse L7a, rat L7a, and the homologous yeast L4
      shows that the aa sequence has been highly conserved during evolution.

PMID- 8482539
TI  - Cloning and structural organization of a xylanase-encoding gene from penicillium
      chrysogenum.
AB  - The filamentous fungus, Penicillium chrysogenum, is able to grow on xylan as a
      sole carbon source. Under these conditions, high levels of a xylanase (XYLP) are
      secreted into the medium. After purification and characterization of this enzyme,
      we have isolated both the encoding cDNA and the genomic sequence by using
      oligodeoxyribonucleotides derived from partial amino acid (aa) sequences of the
      purified enzyme. The gene is approximately 1.6 kb in length, and comparison of
      the nucleotide (nt) sequence of the genomic and the cDNA clone revealed the
      presence of ten exons and nine introns. All intron/exon splice junctions exactly
      follow the GT/AG rule, except for the seventh intron which shows atypical AT/AC
      splice sites. The immediate 5'-flanking region of the first exon contains one
      putative CCAAT consensus sequence and a perfect TATA box. Primer extension
      analysis revealed two transcription start points located 38 and 34 nt upstream
      from the ATG start codon. A sequence of 23 aa representing a typical signal
      peptide is present at the N terminus of the deduced aa sequence. Northern blot
      analysis of total cellular RNA indicated that xylP encodes a 1.3-kb transcript
      which is induced by xylan. The aa sequence of XYLP shows considerable homology to
      high-M(r) acidic xylanases (Xln) and cellulases from different bacteria, yeasts
      and fungi.

PMID- 8482540
TI  - Structure of the Paramecium caudatum gene encoding the B-type of the major
      hemoglobin component.
AB  - We have found the gene (Hb) encoding the B-type of the major hemoglobin (Hb)
      component in the ciliated protist, Paramecium caudatum, stock K33 of syngen 3.
      Gene Hb, which encodes a protein consisting of 116 amino acids (aa), had the same
      sequence as the A-type Hb in this species, with the exception of 10 nucleotides
      (nt) reflecting 5 single-aa differences. The coding region was interrupted at the
      position between codons 62 and 63 by one short intron, which was comparable with
      the second intron of plant Hb in position, phase and nt sequence. The maximum
      alignment of the P. caudatum Hb aa sequence with the other globin sequences from
      prokaryotes and lower eukaryotes indicates that these globins can be classified
      into two groups: one consists of protist and cyanobacterial globins of about 120
      aa, and the other consists of fungal and other bacterial globins of about 150 aa
      having a significant homology with higher eukaryotic Hbs. These proteins share
      more than 25% homology with one another in each group. Our finding of the P.
      caudatum Hb intron corresponding to the second intron of plant Hb suggests that
      all of the globin-encoding genes have a common origin, and that at least two
      groups had already existed in the globin-encoding gene before prokaryote
      eukaryote radiation.

PMID- 8482541
TI  - Expression of the gene encoding secreted placental alkaline phosphatase (SEAP) by
      a nondefective adenovirus vector.
AB  - A nondefective recombinant human adenovirus 5 (Ad5) carrying the SEAP gene,
      encoding human secreted placental alkaline phosphatase, in the E3 region of the
      Ad5 genome was obtained. The expression of SEAP at the early and late stages of
      Ad5 infection was demonstrated in permissive and semi-permissive cell cultures.
      The amount of SEAP in the culture medium of the 293 cells was 13.6% of the total
      protein.

PMID- 8482542
TI  - Cloning of a cDNA encoding a DNA-binding protein TAXREB302 that is specific for
      the tax-responsive enhancer of HTLV-I.
AB  - The transcriptional activator, Tax, of human T-cell leukemia virus (HTLV-I) has
      been considered to interact with cellular proteins to act on target enhancer
      motifs. Using oligodeoxyribonucleotides containing the tax-responsive element
      (TAXRE) of the HTLV-I enhancer, we have cloned multiple cDNAs coding for TAXRE
      binding proteins (TAXREB), and determined the cDNA and the deduced 200-amino-acid
      sequences for TAXREB302. The recombinant protein binds to the enhancer DNA by
      specific interaction to the CRE-like sequence. A single 1.8-kb species of mRNA
      was detected in cultured cells, as well as in normal human tissues, especially
      brain and skeletal muscle. The 22-kDa native protein was detected in the cultured
      cell lysate by immunoblotting analysis. TAXREB302 does not have structural
      features common to the CRE-binding protein or activating transcription factor
      (CREB/ATF) family, but has homology to chicken erythroid transcription factor
      (Eryf1 or GATA-1), suggesting a possible protein-protein interaction.

PMID- 8482543
TI  - Cloning of a cDNA encoding sheep calcitonin from a thyroid C-cell library.
AB  - A sheep thyroid C-cell cDNA library constructed in lambda ZAPII was screened with
      a probe specific for the human calcitonin (CT)-encoding gene (CT). Plaque lifts
      from a total of 6 x 10(4) recombinant plaques identified six overlapping cDNA
      clones, one of which was an 806-bp cDNA representing an almost full-length copy
      of the sheep CT mRNA. The nucleotide (nt) sequence consists of a 71-bp 5'
      flanking sequence, a protein-coding region of 429 bp with a coding potential for
      a 143-amino-acid (aa) protein with a deduced M(r) of 15,888 and a 306-bp 3'
      untranslated region. Northern blot analysis of sheep thyroid tissue revealed two
      major mRNAs with sizes of 0.9 and 0.65 kb. The sheep CT cDNA shows 71% similarity
      at the nt level to human CT and 58% identity at the predicted aa level.

PMID- 8482544
TI  - Consecutive inactivation of both alleles of the gb110 gene has no effect on the
      proliferation and differentiation of mouse embryonic stem cells.
AB  - The gene gb110 was originally identified by provirus integration in the Mov10
      mouse strain and encodes a 110-kDa protein with potential GTP-binding activity.
      The gene is evolutionarily conserved, and its expression is controlled in a
      developmentally and cell-cycle-specific manner, suggesting that it has an
      important function in differentiation and development. As a first step in
      studying the functional role of gb110, embryonal stem (ES) cell lines were
      derived in which both gb110 alleles were inactivated by consecutive gene
      targeting via homologous recombination. The first allele was interrupted by
      integration of a neomycin resistance-encoding gene (neo) and, subsequently, the
      second allele by integration of a hygromycin B resistance-encoding gene (hyg).
      Selection for homologous recombination was achieved by using promoter and AUG
      codon-deficient hyg or neo whose expression was dependent on integration into the
      host genome next to the transcriptional and translational start signals. The
      efficiency of gb110 gene targeting was very high, with 85-100% of all drug
      resistant colonies having undergone homologous recombination. ES cells lacking a
      functional gb110 were indistinguishable from the wild-type ES cells, indicating
      that this gene is not required for normal ES cell proliferation and
      differentiation in vitro.

PMID- 8482545
TI  - Structure of the gene encoding rat neutrophil chemo-attractant Gro.
AB  - A cloned rat gro gene encoding the neutrophil chemo-attractant Gro was isolated
      from a lambda Charon4A rat genomic library, and the nucleotide (nt) sequence of a
      2500-bp fragment encompassing the coding region and 3'- and 5'-flanking regions
      was determined. The gene consisted of four exons separated by three introns. The
      transcription start point was determined by primer-extension analysis and found
      to be a G located 72 nt upstream from the start codon. The 5'-flanking region of
      the gene contained a 'TATA'-like structure and an NF-kappa B-binding sequence.

PMID- 8482546
TI  - Sequence of a cDNA encoding bovine apolipoprotein H.
AB  - The nucleotide sequence of the ApoH cDNA encoding the bovine apolipoprotein H
      (ApoH) has been determined. The deduced protein, which contains a 19-amino-acid
      (aa) signal peptide and the 326-aa mature ApoH, shows 89% and 86% homology with
      human and rat ApoH, respectively.

PMID- 8482547
TI  - Sequence of human GAS3/PMP22 full-length cDNA.
AB  - We have cloned the human growth arrest-specific gene GAS3 cDNA that encodes a
      transmembrane glycoprotein, the peripheral myelin protein 22 (PMP22). GAS3/PMP22
      is implicated in Charcot-Marie-Tooth disease type 1A, an inherited peripheral
      neuropathy.

PMID- 8482548
TI  - The deduced amino acid sequence of human carbonic anhydrase-related protein
      (CARP) is 98% identical to the mouse homologue.
AB  - A recently reported mRNA, encoding 'carbonic anhydrase-related polypeptide'
      (CARP) from the Purkinje cells of mouse cerebellum, was shown to have a 30-40%
      deduced amino acid sequence identity with the carbonic anhydrases (CA) of
      mammals. In order to compare the mouse and human CARP sequences, we used the
      polymerase chain reaction (PCR) to amplify human CARP sequences from several cDNA
      libraries (salivary gland, testis and placenta). The sequence has an 89.3%
      sequence identity with mouse CARP at the nucleotide level and 97.9% at the amino
      acid level. This extremely high evolutionary conservation suggests an important
      function for the CARP gene product.

PMID- 8482549
TI  - The alternative 5'-end of the Drosophila melanogaster epidermal growth factor
      receptor cDNA (DER) is part of the D14-3-3 cDNA.
AB  - A portion of the cDNA reported as a novel cDNA encoding the Drosophila
      melanogaster homolog of the bovine 14-3-3 protein by Swanson and Ganguly [Gene
      113 (1992) 183-190] already exists in the database. It was originally reported as
      an alternative 5' end of the D. melanogaster homolog of the epidermal growth
      factor receptor (DER). Schejter and Shilo [Cell 56 (1989) 1093-1164] later
      reported that this finding was due to a cloning artifact that joined the 14-3-3
      cDNA onto the DER cDNA.

PMID- 8482550
TI  - Drosophila melanogaster poly(A)-binding protein: cDNA cloning reveals an
      unusually long 3'-untranslated region of the mRNA, also present in other
      eukaryotic species.

PMID- 8482551
TI  - CA125 measurement in epithelial ovarian cancer: a 10-year anniversary of clinical
      investigation.

PMID- 8482552
TI  - Vaginal squamous cell carcinoma with sarcomatoid spindle cell features.
AB  - A vaginal squamous cell carcinoma with prominent sarcomatoid spindle cell
      features found in a 25-year-old female is presented. The exclusively spindle
      shaped growth pattern of the neoplastic cells in the initial biopsy led to the
      diagnostic impression of a sarcoma. This in turn has resulted in an attempt at
      completely resecting the tumor. The 5.2 x 3.5-cm resected lesion, however,
      blended peripherally with a poorly differentiated squamous cell carcinoma.
      Moreover, the sarcomatoid component reacted with vimentin and cytokeratin, and
      tonofilaments and desmosomes were seen by electron microscopy. This apparently
      unique case indicates the need for obtaining representative tissue samples for
      providing an appropriate diagnosis prior to definitive therapy for vaginal
      squamous cell carcinoma. The primary treatment for large stage I squamous cell
      lesions of the vagina is radiotherapy, whereas an equally large sarcoma is best
      treated by wide local excision alone.

PMID- 8482553
TI  - Beta-core fragment of human chorionic gonadotropin in cervical intraepithelial
      neoplasia (CIN).
AB  - A low molecular weight glycoprotein immunologically identical with the beta-core
      fragment of hCG (beta C-hCG) has been described in invasive tumors of the genital
      tract, particularly carcinoma of the cervix. A previous report has also suggested
      increased urinary concentrations in subjects with cervical intraepithelial
      neoplasia (CIN). This prospective study of 107 patients with CIN was conducted to
      determine concentrations of beta C-hCG in the urine compared to a reference
      population without CIN. All subjects underwent a cervical smear and colposcopy,
      with biopsy when indicated. Between 11 and 18% of patients had urinary
      concentrations of beta C-hCG greater than the upper limit of the reference group
      and these results were confirmed when corrected for urinary creatinine
      concentration. A substantial number of subjects (19%) also had a positive result
      in a C-terminal immunoassay. It is concluded that preinvasive carcinoma of the
      cervix may secrete hCG or beta C-hCG in the earliest stages although measurement
      of beta C-hCG is unlikely to prove to be a valuable diagnostic marker in CIN.

PMID- 8482554
TI  - Stage I cervical adenocarcinoma: prognostic evaluation of surgically treated
      patients.
AB  - In order to evaluate clinicopathologic determinants of recurrence in
      adenocarcinoma of the uterine cervix, a detailed retrospective chart review and
      complete pathology analysis were performed for 79 patients who had been treated
      by Type III radical hysterectomy between 1975 and 1988. All patients had clinical
      stage I disease; 77 had cervical diameters of 4 cm or less. Eleven patients (14%)
      developed recurrent disease with a median time to recurrence of 14 months (range,
      7-51). Recurrence location was central in 5 patients, pelvic wall in 2, and
      distant in 4. Seven patients died of disease. Five-year actuarial survival was
      89%. None of the clinical features examined as possible prognostic factors was
      predictive of recurrence, including patient age (P = 0.91), cervical diameter (P
      = 0.30), presence of pain (P = 0.53), presence of abnormal bleeding (P = 0.19),
      and history of oral contraceptive use (P = 0.58). However, univariate analysis
      showed lymph node spread (P = 0.008), lymph-vascular space invasion (P = 0.05),
      and increasing grade (P = 0.05) to be significant predictors of recurrence. Lymph
      vascular space invasion remained significant when patients with positive nodes
      were excluded (P = 0.026). Depth of invasion > 3 mm was associated with greater
      recurrence risk than depth < or = 3 mm (P = 0.01). Number of mitoses (P = 0.10)
      was not significant. Multivariate analysis selected nodal positivity as the major
      prognostic parameter (P = 0.04). Further studies are needed to more clearly
      define the role of lymph-vascular space invasion, as an elevated risk ratio of
      1.6 suggests an increased risk for recurrence. Patients whose pretreatment
      biopsies demonstrate obvious lymph-vascular space invasion might be considered
      for alternate treatment.

PMID- 8482555
TI  - Laparoscopic paraaortic node sampling in gynecologic oncology: a preliminary
      experience.
AB  - Because of the poor accuracy of nonsurgical methods in the detection of occult
      paraaortic lymph node metastasis, and because of the cost and discomfort of
      surgical staging, the feasibility of selective or elective paraaortic
      lymphadenectomy has been investigated in a preliminary series of four cases.
      Selective sampling of the lower paraaortic nodes in two cases of cervical
      carcinoma and of the infrarenal paraaortic nodes in two cases of early ovarian
      carcinomas were successfully completed by laparoscopy. The potential application
      of this new technique are discussed.

PMID- 8482556
TI  - Is serum CA 125 at the time of relapse a prognostic indicator for further
      survival prognosis in patients with ovarian cancer?
AB  - The prognostic significance of serum CA 125 level before treatment of relapse for
      invasive epithelial ovarian cancer has been evaluated in 135 patients. At time of
      relapse, serum CA 125 level was higher than 35 U/ml in 110 (82%) patients. Those
      with serum CA 125 level of 35 U/ml or less at relapse had a better prognosis than
      those with higher values. Among patients with serum CA 125 level higher than 35
      U/ml no difference in survival was observed. By multivariate analysis the
      independent prognostic factors for survival were histologic type (P < 0.0001) and
      serum CA 125 level (P < 0.01). Randomized trials are needed to further evaluate
      whether early detection of disease relapse because of serial serum CA 125
      measurements does have prognostic significance.

PMID- 8482557
TI  - A prospective randomized comparison of 6 and 12 cycles of cyclophosphamide,
      adriamycin, and cisplatin in advanced epithelial ovarian cancer: a Danish Ovarian
      Study Group trial (DACOVA).
AB  - Two hundred-two patients with FIGO stages III and IV epithelial ovarian cancer
      were randomized to 6 or 12 cycles of cyclophosphamide, Adriamycin, and cisplatin
      (CAP). Patients in complete clinical response underwent a second-look laparotomy,
      1 month after cessation of chemotherapy. Patients randomized to 6 cycles and
      found to be in partial remission at second-look were to receive a further 6
      cycles of CAP. Rate of complete pathological response was 23% for 6 cycles of CAP
      and 25% for 12 cycles; the median survival was 23 months for 6 cycles and 27
      months for 12 cycles, and 3-year survival was 29% for 6 cycles and 35% for 12
      cycles. None of these differences were statistically significant. Fifty-four
      patients randomized to 6 cycles were found to be in partial surgical remission at
      second-look laparotomy, and 24 of these patients agreed to a further 6 cycles and
      a third-look laparotomy. Six of these 24 patients had a complete pathological
      response at third-look, improving the complete response rate to 28% in those
      originally randomized to 6 cycles. However, 3 of these patients all had
      macroscopic tumors removed at second-look, and two had microscopic disease at
      second-look. Among patients achieving complete response mean cumulative doses in
      the CAP 6 cycle group were approximately 50% of those in the CAP 12 cycle group.
      However, when all patients were considered, this difference was only
      approximately 15% owing the continuation of chemotherapy in the partial
      responders of the 6 cycle group and early stopping for chemotherapy in the CAP 12
      cycle group due to toxicity or progression. Patients in complete pathological
      response also showed similar survivals for 6 and 12 cycles. In conclusion, the
      study did not show a correlation between mean cumulative doses and complete
      pathological response and survival.

PMID- 8482558
TI  - Cerebral metastases secondary to ovarian cancer: still an unusual event.
AB  - An incidence of cerebral metastases secondary to epithelial ovarian cancer as
      high as 11.6% has been reported in small series and related to the prolonged
      survival of ovarian cancer patients treated with platinum compounds (Hardy, J.
      R., and Harvey, V. J. Gynecol. Oncol. 33, 296-300, 1989). A review of the
      histories of 413 ovarian cancer patients, treated from 1981 to 1989 with platinum
      based combination chemotherapy according to the protocols of the Gruppo
      Oncologico Nord Ovest (GONO) (North West Oncology Group), showed that only 9
      patients (2.2%) developed clinical evidence of cerebral metastases. Six of 9
      patients had FIGO Stage IIIc disease and 1 each with FIGO Stages Ic, IIc, and IV.
      All these patients had received cisplatin or carboplatin-based combination
      chemotherapy. Clinical response to initial cytotoxic therapy was as follows:
      complete response, 3 patients; partial response, 4 patients; stable disease, 1
      patient; progressive disease, 1 patient. Cerebral metastases occurred at a median
      of 19 months (range 3-36) from diagnosis and median survival of patients with
      central nervous system (CNS) metastasis was 26 months (range 10-81) from
      diagnosis of primary disease and 8 months (range 1-45) from diagnosis of CNS
      involvement. The incidence of CNS metastases in our series is similar to that
      reported in the past and significantly lower than figures reported by the above
      mentioned paper. On the basis of our data we do not agree with Hardy and Harvey
      about the relationship possibly existing between prolonged survival and incidence
      of CNS metastases and, particularly, about the need for prophylactic cranial
      irradiation.

PMID- 8482559
TI  - Mesonephric remnant hyperplasia of the cervix: a clinicopathologic analysis of 14
      cases.
AB  - Lesions derived from mesonephric remnants in the uterine cervix are rare. We
      describe 14 patients with benign, hyperplastic mesonephric remnant lesions. The
      patients ranged in age from 31 to 81 years (mean, 47). Four were postmenopausal.
      The lesions were incidental findings in all but 2 of the patients and frequently
      had been submitted for consultative pathologic opinion. Two patients did,
      however, present with symptoms (vaginal bleeding) likely attributable to their
      lesions and 1 of them had a cervical abnormality on clinical examination.
      Microscopically, the lesions were composed of lobular or diffuse proliferations
      of small, round mesonephric tubules which were frequently deep within the
      cervical wall and often extended to the surface of the cervix. Five of the
      patients had a referring diagnosis of probable or definite cervical
      adenocarcinoma due to the infiltrative appearance of the lesions. No mesonephric
      carcinomas were encountered. Hyperplastic lesions of mesonephric remnants are
      usually benign, incidental findings but may on occasion be associated with
      clinical symptomatology and are a potential source of diagnostic confusion for
      the pathologist.

PMID- 8482560
TI  - Phase II study of ifosfamide and mesna in nonsquamous carcinoma of the cervix: a
      Gynecologic Oncology Group study.
AB  - A phase II trial of ifosfamide (IFX) and mesna was conducted by the GOG in
      patients with recurrent or advanced nonsquamous carcinoma of the cervix. A
      starting dose of 1.5 g/m2 IFX iv daily for 5 days and 300 mg/m2 mesna iv every 4
      hr with three doses daily after IFX were given. In patients who had received
      prior radiotherapy or chemotherapy, the starting dose of IFX was reduced to 1.2
      g/m2. Forty-six patients were entered, and 41 are evaluable for toxicity. Forty
      patients are evaluable for response. Age range was 30-72 yr. GOG performance
      status was 0-1 for all but 2 patients. Fifteen patients (37.5%) developed GOG
      grade 3 or 4 granulocytopenia, and 1 developed grade 4 thrombocytopenia. One
      patient developed transient renal insufficiency. There was one complete response
      and five partial responses (12.5%) for a response rate of 15.0%. Median response
      duration was 4.2 months (range, 1.7-22.6 months). Three responses were seen in
      areas with pelvic disease only. Three responses were observed in extrapelvic
      sites. IFX possesses activity which compares favorably with that of other agents
      in this disease.

PMID- 8482561
TI  - Relationship between paraaortic lymph node involvement and intraperitoneal spread
      in patients with ovarian cancer--a multivariate analysis.
AB  - In 125 patients with epithelial ovarian cancer (FIGO stages I-IV), 32 (26%) had
      paraaortic lymph node (PAN) metastases. The estimated 5-year survival rate of PAN
      negative patients was 71%, while that of PAN-positive patients was 17% (P <
      0.0001). Positive rates of PAN metastasis at each stage level, based only on
      intraperitoneal spread of the disease, were 2% for stage I, 9% for stage II, 43%
      for stage III, and 87% for stage IV. According to univariate analysis,
      histological grade, and all disease site parameters examined, such as
      subdiaphragmatic surface, liver and spleen capsule, intestines and mesentery,
      omentum, pelvic peritoneum, sigmoid colon and rectum, uterus and tubes, and
      peritoneal cytology, showed a statistically significant correlation to the
      presence of PAN metastasis. Multivariate analysis using the logistic regression
      model revealed that the omental involvement, uterine and tubal involvement, and
      histological grade were independently correlated with PAN metastasis. The
      relative risk of PAN metastasis in the patients with these three factors is 18.5
      times higher than that in patients without these factors. The present data
      suggested that, for the disease with omental and/or uterine and tubal
      involvement, surgical evaluation of PAN is mandatory in order to perform correct
      FIGO staging.

PMID- 8482562
TI  - Type II estrogen-binding sites in human ovarian cancer: correlation with
      estrogen, progesterone, and epidermal growth factor receptor.
AB  - Type II estrogen-binding sites (Type II EBS) and the recently identified
      bioflavonoid-like ligand methyl-p-hydroxyphenyllactate may be regarded as a
      growth regulatory system active on both normal and neoplastic tissues. It has
      been reported that, in addition to estrogen and progesterone receptors, primary
      ovarian cancers also express Type II estrogen binding sites. These sites are able
      to bind estrogenic compounds and also some naturally occurring flavonoids such as
      quercetin. In this study we report the presence of cytosolic Type II EBS in a
      series of 10 normal ovaries, 42 primary ovarian tumors, and 14 metastatic
      deposits. Scattered levels of Type II EBS were found in normal ovarian tissues
      (median, 1603 fM/mg protein, range, 271-4943). In primary ovarian tumors and in
      omental metastases median levels of Type II EBS were 835 fM/mg protein (range,
      134-4875) and 758 fM/mg protein (range, 204-2007), respectively. Although Type II
      EBS tend to be higher in normal than in malignant tissues the difference was not
      statistically significant. No correlation was found between Type II EBS levels
      and the common clinicopathological characteristics of the tumors. Moreover there
      was no relation between Type II EBS and estrogen and epidermal growth factor
      receptors. A significative inverse correlation with progesterone receptor levels
      was observed. The presence of Type II EBS in ovarian cancer could be of clinical
      importance since it has been demonstrated that bioflavonoids, through the
      interaction with Type II EBS, may exert a growth inhibitory activity both alone
      or in combination with chemotherapeutic agents on ovarian cancer cell lines and
      primary tumors.

PMID- 8482563
TI  - Serum CA 125 level allows early identification of nonresponders during induction
      chemotherapy.
AB  - CA 125 was measured during induction chemotherapy in 119 patients with advanced
      epithelial ovarian cancer who had residual disease after primary surgery in order
      to determine whether patients with poor response to further treatment could be
      identified during early chemotherapy. All patients had a prechemotherapy serum CA
      125 level higher than 35 U/ml. Blood samples were further obtained 4 weeks after
      the first, second, and third course. Four weeks after the second course of
      chemotherapy, all 20 patients with PCR, or microscopic disease at second-look,
      all 17 who achieved complete clinical remission, and 36 of 40 who achieved
      partial remission had serum CA 125 of 65 U/ml or less or had a decrease of 50% or
      more of the prechemotherapy level. Survival analysis showed that patients with a
      serum CA 125 level of 65 U/ml or less 4 weeks after the second course of
      chemotherapy had the best prognosis. In patients with a serum CA 125 level higher
      65 U/ml at that time, a decrease of 50% or more of the prechemotherapy level
      indicated a prognosis better than that with a lesser decrease. The combined
      criteria for serum CA 125 (level > 65 U/ml 4 weeks after the second course and a
      decrease < 50% of the prechemotherapy level) allowed for identification of a real
      high-risk group with a median survival of 8.9 months and was identified by Cox
      regression multivariate analysis as the most powerful indicator for survival (P <
      0.0001).

PMID- 8482564
TI  - Growth inhibition of ovarian cancer cells induced by antisense IL-6
      oligonucleotides.
AB  - In previous work, we saw that interleukin-6 (IL-6), a multifunctional cytokine,
      is produced by epithelial ovarian cancer cells and that ovarian cancer cells
      express the IL-6 receptor. Here, we examined the possibility that IL-6 acts as an
      autocrine growth factor for ovarian cancer cells. Inhibition of IL-6 gene
      expression by exposure to IL-6 antisense oligonucleotides resulted in greatly
      decreased cellular proliferation. Exposure of ovarian cancer cell lines (CAOV-3,
      OVCAR-3, and OC-436), to 1-5 microM of a 15-base single-stranded antisense IL-6
      oligodeoxynucleotide, specific for a sequence in the second coding exon of the IL
      6 gene, resulted in decreased IL-6 production and a > 80-85% inhibition of
      cellular proliferation. However, the addition of exogenous IL-6 failed to restore
      the proliferation of the antisense-treated cells. Antibodies to IL-6 did not
      consistently inhibit cell growth nor did rIL-6 enhance precursor frequency in a
      limiting dilution analysis. These results suggest that IL-6 does not directly
      induce the proliferation of ovarian cancer cells although endogenous IL-6
      production is needed for optimal cell growth. As the majority of epithelial
      ovarian cancers produce IL-6, the direct specific inhibition of IL-6 gene
      expression is of potential therapeutic value.

PMID- 8482565
TI  - Monoclonal antibodies MA54 and MA61 as potential reagents in the prognosis of
      patients with ovarian cancer.
AB  - Monoclonal antibodies (moABs) MA54 and MA61 directed to the O-linked NeuAc alpha
      2-6GalNAc epitope were generated by immunization with culture supernatants of
      lung adenocarcinoma cells. We have examined the correlation between the prognosis
      of patients (overall survival and progression-free survival) and circulating
      serum levels of CA54/61 antigen by comparison with CA125 in patients with
      epithelial ovarian cancer. Circulating serum CA54/61 antigen levels were
      determined by sandwich enzyme immunoassay kits. Serum antigen levels were
      elevated in 44.4% of the patients. Survival at 3 years for ovarian cancer
      patients with CA54/61-negative (serum CA54/61 levels < 15.2 U/ml) versus CA54/61
      positive (CA54/61 > or = 15.2 U/ml) tumors was 64% versus 25% (P < 0.05). In
      contrast, there is no significant difference in the prognosis of patients based
      upon positive or negative CA125 antigen values (51% vs 67%). The overall survival
      rate was worse in patients with CA54/61-positive sera, indicating that positive
      CA54/61 levels in serum is an independent predictor of poor prognosis in ovarian
      cancer. In addition, CA54/61 status has been shown to be associated with early
      relapse of this malignancy.

PMID- 8482566
TI  - Treatment of advanced ovarian carcinoma in the elderly.
AB  - This study retrospectively analyzes the treatment of advanced ovarian cancer
      (Stages III and IV) in elderly patients (> or = 65) compared to that in younger
      patients (< 65). The purpose of this study was to identify possible treatment
      bias toward the elderly and to statistically analyze the nature of these
      differences. Seventy patients were evaluated of which 29 were identified as
      elderly and 41 as young. All patients were treated with platinum-based
      chemotherapy. Chi 2, log rank, Kaplan-Meier, and Cox model analyses were
      performed for multiple variables including age, grade of tumor, adequacy of
      surgery, and dose intensity. The elderly significantly differed from the young in
      the following analyses: median length of hospitalization, 20 days vs 11 days (P <
      0.001); optimum surgery, 79.3% vs 97.5% (P = 0.02); initial chemotherapeutic dose
      reduction, 15.4% vs 0% (P = 0.02); median survival compared to age, 19.2 months
      vs 36.7 months (P < 0.03). When survival analysis was performed comparing 17
      elderly patients and 40 younger patients who had optimum surgery and optimum
      initial chemotherapy, the median survival remained essentially unchanged, 22.0
      months vs 36.7 months. There were differences in treatment intensity between
      young and old, however, the indications generally were valid and when analyzed by
      the Kaplan-Meier and Cox model, these differences became insignificant. It was
      concluded that when elderly patients can undergo aggressive surgical and
      chemotherapeutic management, survival remained significantly decreased for aged
      compared to younger patients. Physician bias was not a major factor accounting
      for the poorer survival observed in elderly patients. Age was the most
      significant variable related to survival and could not be accounted for by
      differences in adequacy of surgery or dose intensity.

PMID- 8482567
TI  - Platinum chemotherapy during pregnancy for serous cystadenocarcinoma of the
      ovary.
AB  - Ovarian carcinoma in pregnancy remains a rare event. Although concern regarding
      the gestation complicates therapy, platinum drug-based combination chemotherapy
      is often deemed warranted in such cases. We report the antepartum use of
      cisplatin, followed by carboplatin, for an ovarian serous cystadenocarcinoma.
      During this treatment, serial sonographic assessment of fetal morphometric
      parameters and biophysical profiles with fetal heart rate monitoring were
      performed to document fetal well being. Platinum-DNA adducts were measured in
      maternal blood, placenta, fetal amniotic cells, and cord blood. This report
      represents an attempt to define platinum drug transfer in utero and fetal growth
      and development during therapy and to document the first use of carboplatin in
      pregnancy.

PMID- 8482568
TI  - Interpreting figurative language expressions.
AB  - Interpretations of figurative language expressions were compared in matched
      samples of 28 language/learning-disabled (LLD) and 28 academically achieving (non
      LLD) adolescents. LLD adolescents performed significantly poorer than their non
      LLD age peers. All but 1 of 12 figurative language expressions contributed to the
      significant group difference. Stepwise discriminant analysis identified 3
      figurative expressions as the best single predictors of an LLD group placement.
      Qualitative analysis indicated that the LLD group produced predominantly literal
      error interpretations while the non-LLD controls produced predominantly partial
      and/or incomplete error interpretations. The results indicate that interpretation
      and matching of figurative language expressions can assess levels of acquisition
      of metaphoric ability by adolescents and provide suggestions for intervention.

PMID- 8482569
TI  - [Psychogenic aspects of functional dysphonia].
AB  - In order to estimate the significance of the psychogenic factor in the etiology
      of functional voice disorders on the basis of relevant psychological dimensions
      we compared patients with functional dysphonia, aphonia and a normal control
      group by means of an empirical-psychological test procedure. Psychogenic
      conditions proved to be a major factor in the etiology of aphonia, whereas such
      an interrelation turned out only partially in patients with functional dysphonia.
      The conclusion can be that psychogenic aspects are not necessarily of exceeding
      importance in the etiology of functional dysphonia. If no differentiation is made
      between the two kinds of voice disorders an overestimation of psychogenic
      influence might occur.

PMID- 8482570
TI  - Normal values and predictive equations for aerodynamic function in British
      Caucasian subjects.
AB  - Many useful objective measurements of air volume and flow may be made with a high
      degree of validity and reliability using present-day respirometers within a
      speech clinic. We have studied measures of aerodynamic function in 76 British
      Caucasian subjects and derived reference equations for mean flow rate (MFR),
      phonation quotient (PQ), vocal velocity index (VVI), phonation time and the
      phonation volume/vital capacity ratio. Measures from resting breathing patterns
      have also been investigated. Age was found to be an important determinant in the
      reference equations. MFR, PQ and VVI were all greater than previously reported.
      The equations derived in this study should provide a more appropriate assessment
      of aerodynamic function than the previously reported normal ranges.

PMID- 8482571
TI  - Evaluation of speech after completed late closure of the hard palate.
AB  - Speech was analyzed about 1 year postoperatively in 30 patients with cleft lip
      and palate who were the first ones to undergo late closure of the hard palate in
      Gothenburg, Sweden. Fourteen had bilateral and 16 had unilateral clefts. Soft
      palate closure had been performed at the mean age of 8 months, and the hard
      palate was closed at the mean age of 8 years with a range of 7-11 years. Imitated
      and spontaneous speech was analyzed at an average of 15 months after palatal
      repair. Six percent had moderate to severe hypernasal speech and 23% had
      retraction of dental consonants. No glottal articulation was found. Hoarseness
      and deviant s articulation were frequent. For 6 of the patients the same speech
      analysis was also made 1-3 months postoperatively. At this time there was no
      change in the speech of these 6 children compared with preoperative speech. Thus,
      the closure of the palate did not improve the speech directly. The improvement of
      the speech seems to be a gradual process.

PMID- 8482572
TI  - Speech rehabilitation in dysarthria.
AB  - Although the usefulness of speech rehabilitation in disorders such as asphasia is
      now recognized, many clinicians estimate that speech treatments for dysarthrics
      are of limited value. The conceptual approach to dysarthrias is a physiological
      approach that emphasizes the component-by-component analysis of the peripheral
      speech mechanism. The selection and sequencing of treatment procedures follow
      directly from the physiological nature and severity of involvement in each
      component.

PMID- 8482573
TI  - Inflammatory changes as a risk factor in the development of phonoponosis.
AB  - Inflammatory changes of the upper respiratory airway mucosa are very often
      observed in phonoponoses. While treating phonoponoses, we frequently find that
      general practitioners and even otorhinolaryngologists, while paying greatest
      attention to this component, neglect treatment for voice and phonatory pattern
      disturbance, and the patients are referred to a phonitrician with delay. The aim
      of the work is to study the frequency of inflammatory processes of the upper
      respiratory airways in phonoponoses and an attempt to establish the connection
      between these changes and the development of phonoponoses. The study involved 358
      patients with different types of phonoponoses. Inflammatory changes were found in
      84.6% of the cases, which was statistically highly significant. With inflammatory
      processes on the vocal organs the appearance of phonoponoses is facilitated. In
      that sense the inflammatory processes are risk factors in the appearance of
      phonoponoses.

PMID- 8482574
TI  - Effect of selegiline on speech performance in Parkinson's disease.
AB  - Comprehensive speech examinations of 10 equally affected subjects with moderate,
      treated Parkinson's disease were performed before and 4 weeks following
      initiation of treatment with selegiline (deprenyl), with other drug therapies
      unchanged. Forty different measures relating to the speech processes of
      respiration, phonation, resonation, articulation and prosody were examined to
      measure changes in performance due to selegiline. Significant improvements were
      noted for 8 of the 40 measures, with these improvements relating to the speech
      processes of articulation and respiration. The potential interactive effects of
      comedication are discussed. In addition, previously undescribed comprehensive
      speech characteristics of moderate Parkinson's disease are presented and
      discussed.

PMID- 8482575
TI  - Sequence divergence of B2m alleles of wild Mus musculus and Mus spretus implies
      positive selection.
AB  - Mouse beta 2-microglobulin (beta 2m) is polymorphic. Sequences of five allelic
      wild mouse B2m genes have been determined from the large exons of genomic DNA
      using the polymerase chain reaction. Relative to the standard B2m(a) allele, the
      products of four alleles of Mus musculus origin (w2, w3, w4, and w5), differ by
      only one or two amino acids. w5 has a single nucleotide change, Asp85-->Val, and
      is identical to the c allele. w3 has two changes, Val(-13)-->Ile and Lys44-->Glu.
      w2 differs at Arg81-->Thr and w4 at His34-->Gln, and they share the Asp85-->Val
      change with B2mc and B2mw5. w5 and c cells are lysed by S19.8, a monoclonal
      antibody specific for beta 2mb (Ala85), in a complement-mediated cytotoxicity
      assay, whereas w4 cells are not. Thus, distant changes appear to introduce subtle
      conformational effects on beta 2m structure. Five independent isolates of Mus
      spretus (w1) differ the most from B2m(a), with 12 amino acid changes and only one
      silent substitution. Replacements predicted from the nucleotide sequence occur in
      loops of the molecule facing away from the class I heavy chain and not in regions
      where beta 2m associates with class I alpha 3 domains. Concordantly, the w1-5
      allelic forms of beta 2m associate well with H-2 heavy chains. The many amino
      acid changes in the spretus sequence and the paucity of silent substitutions
      suggest that B2m has been subject to positive selection.

PMID- 8482576
TI  - Characterization of the rhesus macaque (Macaca mulatta) equivalent of HLA-F.
AB  - Nucleotide sequence analysis of rhesus macaque major histocompatibility complex
      class I cDNAs allowed the identification of the orthologue of HLA-F, designated
      Mamu-F. Comparison of Mamu-F with earlier published human and chimpanzee
      orthologues demonstrated that these sequences share a high degree of similarity,
      both at the nucleotide and amino acid level, whereas a New World monkey (cotton
      top tamarin) equivalent is more distantly related. Exon 7, encoding one of the
      cytoplasmatic domains, is absent for all primate Mhc-F cDNA sequences analyzed so
      far. In contrast to the human, chimpanzee, and rhesus macaque equivalents, the
      cotton-top tamarin Saoe-F gene seems to have accumulated far more nonsynonymous
      than synonymous differences.

PMID- 8482577
TI  - New beta chain-encoding Mhc class II genes in the carp.

PMID- 8482578
TI  - The IL-2 receptor beta chain gene (Il-2rb) is closely linked to the Pdgfb locus
      on mouse chromosome 15.

PMID- 8482579
TI  - Immunodominance in the T-cell response to multiple non-H-2 histocompatibility
      antigens. V. Chromosomal mapping of the immunodominant cytotoxic T-cell target-1
      (CTT-1).

PMID- 8482580
TI  - Peptide motifs of HLA-B35 and -B37 molecules.

PMID- 8482581
TI  - Amino acid sequences of seven V beta, eight V alpha, and thirteen J alpha novel
      human TCR genes.

PMID- 8482582
TI  - "You've come a long way, baby".

PMID- 8482583
TI  - Characterization of a class Ib gene of the rat major histocompatibility complex.
AB  - The cDNA and a partial genomic sequence of a rat class I major histocompatibility
      (RT1) gene, 11/3R, is reported here. The sequence contains several unique amino
      acid residues at certain positions, mutations in exon 7 (which is not expressed),
      a mutation of the canonical exon 8 stop codon to a sense codon, and includes a
      long 3' untranslated region (utr). The structure of exon 7 differs from that
      found in most rat class I genes and resembles exon 7 of most H-2K,D,L,Q genes.
      Parts of the 3' noncoding region are homologous to the RT1.A-4 and certain H-2
      genes. Expression is detectable by northern blot analysis in mitogen-stimulated
      lymphocytes only, by polymerase chain reaction (PCR) in each tissue tested. After
      transfection into L cells 11/3R can be shown to be expressible at the cell
      surface. Probes derived from the 3' noncoding part crosshybridize with a number
      of restriction fragments which map to the RT1.C region, thus defining a subfamily
      of RT1.C region genes. Several members of this subfamily are deleted in the lm1
      RT1 mutant. The 11/3R gene presents typical features of a class Ib gene. Aspects
      of evolution and the potential function of the gene are discussed.

PMID- 8482585
TI  - A genetic analysis of human minor histocompatibility antigens demonstrates
      Mendelian segregation independent of HLA.
AB  - An analysis of the genetic traits of human minor histocompatibility (mH) antigens
      is, unlike with inbred mice, rather complicated. Moreover, the fact that mH
      antigens are recognized in the context of MHC molecules creates an additional
      complication for reliable segregation analysis. To gain insight into the mode of
      inheritance of the mH antigens, we relied upon a series of HLA-A2-restricted
      cytotoxic T-cell (CTL) clones specific for four mH antigens. To perform
      segregation analysis independent of HLA-A2, we transfected HLA-A2-negative cells
      with the HLA-A2 gene: this results in the cell surface expression of the HLA-A2
      gene product and, if present, mH antigen recognition. The mode of inheritance of
      the HLA-A2-restricted mH antigens HA-1, -2, -4, and -5 was analyzed in 25
      families whose members either naturally expressed HLA-A2 or were experimentally
      rendered HLA-A2-positive. Analysis of distribution of the mH antigens in the
      parent population among the mating types, together with their inheritance
      patterns in the families, demonstrated that the four mH antigens behaved as
      Mendelian traits, whereby each can be considered a product of a gene with two
      alleles, one expressing and one not expressing the detected specificity. We also
      showed that the loci encoding the HA-1 and HA-2 antigens are not closely linked
      to HLA (lod scores Z (0 = 0.05) <-4.0). Some indication was obtained that the HA
      4- and HA-5-encoding loci may be closely linked to HLA. While we are aware of the
      limited results of this nonetheless comprehensive study, we feel the similarity
      in immunogenetic traits between human and mouse mH antigens is at least striking.

PMID- 8482584
TI  - Polymorphism and phylogeny of dinucleotide repeats in human T-cell receptor Vb6
      genes.
AB  - The Vb6 subfamily is the largest reported subfamily of human T-cell receptor
      (Tcr) genes, with as many as 14 possible members based on variation in reported
      DNA sequences. A study of the genomic organization of four distinct Vb6 genes
      indicated that they contained within their introns the uninterrupted dinucleotide
      repeat (GT)n, with n > 8. DNA amplification primers and conditions were
      determined which amplified the intron of these four different Vb6 gene segments.
      All four Vb6 genes tested showed length polymorphism when examined in a group of
      unrelated individuals. Careful sizing and DNA sequencing showed that the alleles
      of each gene differed in size by multiples of two base pairs (bp), due to
      different repeat numbers of the dinucleotide (GT)n. These four microsatellite
      polymorphisms had from three to ten alleles, and individual heterozygosities of
      26% to 83%. The large number of alleles and the high heterozygosity make these
      polymerase chain reaction (PCR)-based polymorphisms very attractive genetic
      markers for segregation studies which postulate the presence of autoimmune
      susceptibility genes within the Tcrb region. Vb6 hybridization to genomic DNA
      confirmed the relatively large size of the Vb6 subfamily in several hominoid
      species. Nucleotide sequencing of an intron of the Vb6 genes from other primates
      revealed the presence of dinucleotide repeats similar to those found in human Vb6
      genes. Thus, the (GT)n microsatellite was not only present in the Vb6 intron
      before Vb6 gene duplication, but was present before speciation of the hominoids.

PMID- 8482586
TI  - Increases in polycyclic aromatic hydrocarbon content and mutagenicity in a
      cutting fluid as a consequence of its use.
AB  - The aim of this study was to evaluate the relationships between the length of
      time a cutting fluid was used, its content in polycyclic aromatic hydrocarbons
      (PAHs) and its mutagenic potential. The PAH concentrations were determined by
      means of a high-resolution gas chromatograph-mass spectrometer in samples of new
      cutting fluid and in samples used for 3, 6 and 9 months. The following PAHs were
      measured: phenanthrene, anthracene, fluoranthene, pyrene, benzo[a]anthracene,
      chrysene+triphenylene, benzo[e]pyrene, benzo[a]pyrene and perylene. Mutagenicity
      assays were carried out on the aforementioned samples using the Ames test.
      Salmonella typhimurium TA98 was used as an indicator to show up mutagens capable
      of inducing frame-shift genetic changes, and Escherichia coli WP2 uvrA was used
      as an indicator to detect mutagens capable of inducing base pair genetic changes.
      The mutagenic tests were carried out with and without microsomal activation,
      using 1:1, 1:10, 1:20 and 1:50 dilutions of cutting fluid samples. An increase in
      the concentrations of total PAHs over time was observed in the samples of cutting
      fluid used for 3, 6 and 9 months. The highest percentage increase in PAH
      concentrations was observed in the 6-month-old sample (10 times the initial
      concentration, from 45 to 411.8 micrograms of oil). None of the samples were
      mutagenic to S. typhimurium without metabolic activation or to E. coli with and
      without metabolic activation. All samples except for the 1:1 diluted sample
      showed moderate but significant mutagenic activity in the S. typhimurium test
      with metabolic activation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482587
TI  - Occupational chronic exposure to organic solvents. XIV. Examinations concerning
      the evaluation of a limit value for 2-ethoxyethanol and 2-ethoxyethyl acetate and
      the genotoxic effects of these glycol ethers.
AB  - Two groups of workers occupationally exposed to glycol ethers in a varnish
      production plant or the ceramic industry were examined. For 19 persons the
      external and internal exposure was assessed on the Monday and Tuesday after an
      exposure-free weekend. In the varnish production area the concentrations of 2
      ethoxyethanol (EE), 2-ethoxyethyl acetate (EEAc), and 2-butoxyethanol (BE) in air
      averaged 2.9, 0.5, and 0.5 ppm, respectively, on the Monday, and 2.1, 0.1, and
      0.6 ppm, respectively, on the Tuesday. At the same workplaces the mean urinary 2
      ethoxyacetic acid (EAA) and 2-butoxyacetic acid (BAA) concentrations were 53.2
      and 0.2 mg/l on Monday preshift and 53.8 and 16.4 mg/l on Tuesday postshift. The
      results show that glycol ethers are very well absorbed through the skin.
      Therefore biological monitoring is indispensable. To study the kinetics of the
      toxic metabolite, 17 persons were examined for their excretion of EAA in urine
      during an exposure-free weekend. The median values of the calculated half-times
      were 57.4 and 63.4 h, respectively, which are longer than the values presented in
      literature until now. According to our calculations the limit value should not
      exceed 50 mg EAA per liter of urine, which is the current German biological
      tolerance value (BAT value) for EAA in urine. The maximum concentration value at
      the workplace (MAK value) for EE and EEAc in air should be revised. Finally, the
      subjects from the varnish production plant as well as a group of reference
      persons were studied for cytogenetic effects of glycol ethers (sister chromatid
      exchange, micronucleus test). Such effects could not be detected.

PMID- 8482588
TI  - Patterns of electromyographic shoulder muscle fatigue during MTM-paced repetitive
      arm work with and without pauses.
AB  - Surface electromyographic recordings from the lateral and the cervical portions
      of the descending trapezius muscle and from the infraspinatus muscle were
      assessed for 12 female subjects during performance of a standardized repetitive
      work simulation task involving 1 h of continuous work and 1 h with introduced
      pause activities. Discomfort ratings and ratings of perceived exertion were also
      assessed. Work pace was determined according to MTM-110 (Methods-Time
      Measurement) as 2466 cycles for both working hours. Muscle fatigue with a
      decrease in the mean power frequency and an increase in root mean square
      amplitudes was found both during continuous work and during work with pause
      activities. The muscle fatigue was less pronounced when pause activities were
      introduced into the work. Five-minute fatigue patterns were lower during the
      second hour, indicating adaptation to the work task and work pace. The ratings of
      perceived exertion and discomfort were similar during work with and without
      pauses and were higher during the second hour of work. Both work pace and a
      varied muscle activity pattern are of importance for prevention of muscle
      fatigue.

PMID- 8482589
TI  - Determination of urinary alkoxyacetic acids by a rapid and simple method for
      biological monitoring of workers exposed to glycol ethers and their acetates.
AB  - In control subjects and workers exposed to glycol ethers and their acetates, we
      determined the urinary metabolites (three alkoxyacetic acids) by a simple and
      rapid method. Levels of urinary metabolites were significantly higher in the
      solvent workers than in the nonexposed subjects. The exposure levels measured by
      personal monitoring of breathing zone air were far below the threshold limit
      value. The present results indicate that determination of urinary alkoxyacetic
      acids by the practical method used here is useful for evaluating excessive
      exposure to solvents.

PMID- 8482590
TI  - Salivary cortisol for monitoring circadian rhythm variation in adrenal activity
      during shiftwork.
AB  - To examine the validity of salivary cortisol for monitoring circadian rhythm
      variation in adrenal activity during shiftwork, saliva and blood samples were
      collected at 4-h intervals in experimental short-term shifts, i.e., day (work
      0830-1600 h; sleep 0030-0800 h), evening (work 1630-2400 h; sleep 0430-1200 h),
      and night (work 0030-0800 h; sleep 1230-2000 h) shifts over 2 days. Cortisol
      levels, determined by radioimmunoassay, and the circadian profiles of saliva and
      sera were compared. The salivary cortisol showed relatively low levels, the 2-day
      mean value being 3.1%-3.3% that of serum total cortisol through all shifts.
      Significant differences in the serum to saliva cortisol ratios were noted among
      shifts and subjects. When expressed as a relative percentage of a 2-day mean
      value, however, salivary cortisol paralleled the modified circadian profiles of
      serum total cortisol of the evening and night shifts, with no significant time
      lag and no difference in magnitude. The cosinor analysis supported this finding.
      Thus, salivary cortisol appears to be an excellent measure for monitoring
      circadian rhythm variation in adrenal activity in healthy individuals during
      shiftwork.

PMID- 8482591
TI  - Blood concentrations of carbon disulphide in dithiocarbamate exposure and in the
      general population.
AB  - Blood carbon disulphide (CS2), both free and total, was determined by gas
      chromatography-mass spectrometry in 112 "normal" subjects and in 20 subjects
      employed in a dithiocarbamate factory, comprising ten blue-collar workers
      involved in dithiocarbamate production and ten white-collar office staff. The ten
      production workers were examined over two workshifts, the first at the beginning
      of the week (Monday) and the second after an intervening period of at least 1
      day. Three blood samples were taken for each shift studied, one prior to starting
      work, one at the end of the shift and the third 16 h after the end of the shift
      (on the following morning). The mean CS2 blood levels measured in the 112 normal
      subjects was 663 ng/l for the free fraction and 3178 ng/l for the total. In 16
      blood samples taken from the ten dithiocarbamate factory office workers, the mean
      free and total CS2 blood levels were 846 and 4140 ng/l, respectively, i.e. not
      significantly different from those observed in the normal subjects. At the end of
      the first 8-h shift, the ten dithiocarbamate factory production workers had free
      and total CS2 values of 1070 and 8471 ng/l, respectively, which were
      significantly higher than those observed prior to starting work (240 and 4738
      ng/l). All the total CS2 levels measured in the shop-floor workers, with the sole
      exception of the values recorded prior to the start of the Monday shift (4738
      ng/l), ranged from 7047 to 8471 ng/l and were significantly higher than those
      measured in the white-collar staff (4140 ng/l).

PMID- 8482592
TI  - Hygienic behaviour in chromium plating industries.
AB  - The impact of hygienic behaviour on the uptake of chromium has been studied in
      two small chromium plating factories. The correlation between the environmental
      monitoring measure (Cr-A) and the biological monitoring measure (Cr-U) varied
      between the two factories. In one factory (I) the correlation between Cr-U and Cr
      A was 0.68 (P < 0.001), while in the other factory (II) it was negative (r = 
      0.64, P = 0.03). However, in both populations a significant impact of hygienic
      behaviour on the variance in Cr-U levels could be detected. In factory I,
      explained variance could be enhanced to R2 = 0.94 (P < 0.001) when considering
      expressions of hygienic behaviour. In factory II, a strong relation proved to
      exist between Cr-U and dermal uptake. For the various questions referring to skin
      problems and possible dermal uptake, the correlation with Cr-U is up to 0.70 (P =
      0.03). When comparing the results for the two factories, it is shown that in
      addition to individual differences in hygienic behaviour, general hygienic
      conditions also have an impact on uptake of chromium. In factory II, where many
      efforts were made to prevent exposure to chromium, Cr-U was significantly lower
      than in factory I (P < 0.001).

PMID- 8482593
TI  - Changes in nasal lavage fluid due to formaldehyde inhalation.
AB  - The aim of the study was to characterize the nature of the formaldehyde-induced
      nasal response consisting in symptoms of rhinitis and changes in nasal lavage
      fluid. Eleven healthy subjects and nine patients with specific skin sensitization
      were provoked in a toxicological chamber with formaldehyde at a dose of 0.5 mg/m3
      over 2 h. Nasal lavage was performed prior to and immediately after provocation
      and 4 and 18 h later. Provocation with formaldehyde caused transient symptoms of
      rhinitis and prolonged changes in nasal washings. There were increases in the
      number and proportion of eosinophils and elevated albumin and total protein
      levels in nasal lavage fluid 4 and 18 h after provocation. No difference in the
      nasal response to formaldehyde was found between patients with skin sensitization
      and healthy subjects. These data confirm the irritative effects of formaldehyde
      and are also suggestive of nonspecific proinflammatory properties when
      formaldehyde is inhaled at a low (0.5 mg/m3) dose.

PMID- 8482594
TI  - Respiratory function in greenhouse workers.
AB  - Respiratory findings were studied in a group of 135 female and 32 male workers
      employed in greenhouses. In addition 51 women and 30 men were studied as a
      control group. Exposed women had significantly higher prevalences of chronic
      cough, dyspnea, chest tightness, and rhinitis (P < 0.01) than the controls. Among
      the men, only rhinitis was more prevalent in greenhouse workers (P < 0.01) than
      in controls. Smokers had higher prevalences of all chronic respiratory symptoms
      than nonsmokers, but the differences were statistically significant only for
      chronic cough and rhinitis in women and for chronic phlegm in men. There was a
      high prevalence of acute symptoms during work. A large number of greenhouse
      workers complained of skin reactions to plants and pesticides (women: 37.8%; men:
      34.4%). Workers had significantly lower mean ventilatory capacity measurements
      (except in the case of forced vital capacity) when compared to standard predicted
      values. Smokers and nonsmokers had similar values of lung function expressed as
      percentages of the predicted values. Greenhouse workers exposed for more than 10
      years had a significantly lower FEF25, measured as a percentage of the predicted
      value, than workers exposed for less than 10 years. Our data indicate that
      occupational exposure to greenhouses may be associated with the development of
      acute and chronic respiratory symptoms and impairment of ventilatory capacity.

PMID- 8482595
TI  - Study of the neurobehavioural toxicity of styrene at low levels of exposure.
AB  - Thirty workers in a dockyard exposed to concentrations of styrene lower than the
      TLV-TWA of 50 ppm and 30 control workers not subject to exposure but employed by
      the same company were subjected to three psychometric tests on one Monday morning
      and evening. The results were usually better in the evening than in the morning
      in both groups, which proves the lack of acute intoxication at the end of the day
      at this level of exposure. On the other hand, all of the tests conducted on the
      exposed subjects are significantly less good than those on the controls. The
      results suggest the existence of minor but significant organic mental disorders
      in the subjects exposed to a mean dose of 30 ppm in this study. These results are
      inconsistent with those of several recent studies. The advisability of lowering
      the TLV of 50 ppm in discussed.

PMID- 8482596
TI  - Excretion of methylhippuric acids in urine of workers exposed to a xylene
      mixture: comparison among three xylene isomers and toluene.
AB  - The correlation between exposure to three xylene isomers and resulting urinary
      excretion of corresponding methylhippuric acid (MHA) isomers was studied among
      175 Chinese workers of both sexes who had been predominantly exposed to xylenes
      (exposure to xylenes accounting for 70% or more of the total exposure on a ppm
      basis). Nonexposed controls (281 men and women) were also studied to define the
      background level of MHAs in urine. The solvent exposure of xylene-exposed workers
      during their workshift was monitored by diffusive sampling of breathing zone air,
      and MHAs in shift-end urine were determined by high-performance liquid
      chromatography. Regression analysis showed that the concentration of each MHA
      isomer correlated significantly with the time-weighted average intensity of
      exposure to the corresponding xylene isomer, and therefore the correlation
      between the sum of three xylene isomers in air and that of three MHA isomers in
      urine was also significant; the slope of the regression line was essentially the
      same among the three isomers. The calculated regression line suggested that the
      urinary MHA level after hypothetical exposure to xylenes at 100 ppm will be
      somewhat less than the proposed biological exposure index and biological
      tolerance value. Two social habits of smoking and drinking in combination
      suppressed the conversion of xylenes to MHAs in male workers.

PMID- 8482597
TI  - [The role of cytokines for the pathogenesis of psoriasis].
AB  - Psoriasis is an inflammatory skin disorder characterized by marked
      hyperproliferation of keratinocytes in association with vascular expansion,
      fibroblast activation, leucocyte infiltration, and alterations of eicosanoid
      metabolism and of cytokine production. However, it is unclear at present whether
      these changes are the cause or the effect of the significantly increased
      keratinocyte turnover. More than one mechanism is involved in triggering active
      psoriasis; genetic predisposition and environmental factors affecting the immune
      system have a particularly important role. Most of the therapeutic regimens used
      for the treatment of psoriasis are immunosuppressive. Therefore, it is tempting
      to speculate that a specific defect of the immune system is the major pathogenic
      principle in psoriasis. There are several lines of evidence suggesting that
      changes in cytokine production by keratinocytes and immunocompetent cells in the
      skin of the patients, particularly of interleukin-6 and TGF alpha, may play an
      important part in propagation of the inflammatory response in psoriasis. Further
      studies are required to find how far local T-cell activation is involved as a
      basic mechanism of initiation and maintenance of the psoriatic inflammatory
      response. Accordingly, parameters such as the evaluation of cytokine production
      in vitro and in vivo and the measurement of cellular activation products may be
      useful in the diagnosis and monitoring of psoriasis.

PMID- 8482598
TI  - [Treatment of vitiligo with phenylalanine and UV-A].
AB  - Seven patients with generalized vitiligo were treated with 100 mg/kg body weight
      phenylalanine in combination with UV-A. A 20% repigmentation of the vitiligenous
      area was achieved in only one patient. Three patients each showed either a sparse
      follicular repigmentation or no effect at all. Because of the disappointing
      therapeutic results and possible side effects, we cannot recommend a therapy with
      phenylalanine and UV-A for vitiligo.

PMID- 8482599
TI  - [Prognosis and success of inpatient psychotherapeutic dermatologic treatment of
      neurodermatitis patients].
AB  - A large group of patients with atopic dermatitis underwent a combination of
      psychotherapy dermatological treatment, and 40 were selected for evaluation. Most
      of them had benefited from the cure, particularly those who themselves felt they
      were emotionally disturbed, those who were well educated and those with
      functional complaints.

PMID- 8482600
TI  - [Polymorphous light dermatosis. Clinical data and test results].
AB  - In a retrospective study, the clinical data of 424 patients, 340 (= 80.2%) female
      and 84 (= 19.8%) male, with polymorphous light eruption (PLE) were evaluated;
      89.1% of the patients had skin type II or III (according to Fitzpatrick). 368
      Photoprovocation testing was performed on 332 of these cases. The duration of PLE
      was (mean +/- SD) 7 +/- 6.9 years, and the age at onset of the disease was 28 +/-
      14 years. In 40.1% of the patients PLE developed without seasonal accentuation.
      Predilection sites for skin lesions were the extensor aspects of the upper arm or
      forearm (69.0%/66.7%) and the chest (59.5%); the face and the back of the hand
      were less frequently (41.0%/40.8%) affected. In most cases (53.6%/18.3%), the
      skin lesions were papular or erythemato-urticarial in type. The minimal erythema
      dose for UV-B was found to be normal in all 311 cases in which it was assessed.
      Photoprovocation testing yielded skin lesions of PLE in 38.4% of the female, and
      in 58.5% of the male patients. The frequency of positive reactions to
      photoprovocation testing was directly related to the duration of the disease, the
      persistence of naturally occurring lesions, and the time interval from accidental
      exposure to the development of lesions.

PMID- 8482601
TI  - [The pustular bacterid (Andrews). Are there clinical criteria for differentiating
      from psoriasis pustulosa palmaris et plantaris?].
AB  - A case report on the rare entity of "true" Andrews bacterid and a review of the
      literature are used to illustrate clinical and morphological criteria that allow
      discrimination between Andrews bacterid and psoriasis pustulosa palmaris et
      plantaris. The patient noted the eruption of sterile pustules on palms and soles
      for the first time in his life at the age of 73 during an attack of acute
      tonsillitis. He had no history of psoriasis and it was also unknown in the family
      history. In contrast to psoriasis pustulosa palmaris et plantaris, Andrews
      bacterid becomes manifest as isolated pustules with an erythematous rim, which do
      not destroy the ridged skin. On the rest of the integument disseminated pustules
      are seen but no psoriatic stigmata. Thus, apart from the criterion of coincidence
      with an infection and the short course, we can also differentiate between Andrews
      bacterid and psoriasis pustulosa palmaris et plantaris on the basis of clinical
      criteria.

PMID- 8482602
TI  - [Therapeutic problem. Angiolymphoid hyperplasia with eosinophilia].
AB  - A 35-year-old female patient suffered from angiolymphoid hyperplasia with
      eosinophilia for 9 years, with multiple, exophytic tumours on her left pinna and
      the surrounding skin. Systemic treatment with gamma interferon and
      glucocorticoids, intralesional injections of glucocorticoids and argon laser
      therapy had no effect. After the tumours had been pared away by electrocautery
      the patient was free of symptoms for 1 year and then developed a small local
      recurrence. Recurrences are common in angiolymphoid hyperplasia with
      eosinophilia. Malignant transformation has not been observed. We therefore regard
      non-radical surgery as the therapy of choice.

PMID- 8482603
TI  - [Sweet syndrome. Acute neutrophilic dermatosis in multiple myeloma].
AB  - A 64-year-old woman complained of reddish plaques that had suddenly appeared on
      her upper arms and trunk. Histological investigation revealed perivascular
      distribution of a neutrophilic infiltrate in the upper and mid-dermis; direct
      immunofluorescence showed deposits of C3 and fibrin in and around the vessels.
      Laboratory values in the blood, X-ray of the head and fine-needle biopsy of the
      hip showed the typical pattern of multiple myeloma. After chemotherapy the
      dermatological lesions improved rapidly, and the plasmocytoma reached remission
      stage. The diagnosis of Sweet's syndrome was established on the basis of the
      clinical and histological changes and the improvement observed after steroid
      therapy. The coincidence with plasmocytoma confirms the interpretation of Sweet
      disease as a paraneoplastic syndrome.

PMID- 8482604
TI  - [Extensive metastatic Kaposi sarcoma in chronic immune suppressed bronchial
      asthma].
AB  - In a severely ill 64-year-old man with multilocular Kaposi sarcoma HIV infection
      was excluded. The decisive factor in the pathogenesis, was long-term
      immunosuppression with systemic corticosteroids for bronchial asthma. The patient
      died from cardiorespiratory insufficiency in the course of tumour progression.
      Autopsy revealed a vast visceral manifestation of Kaposi sarcoma.

PMID- 8482605
TI  - [Pityriasis-lichenoides-et-varioliformis-acuta-like drug exanthema caused by
      astemizole].
AB  - We report on a 40-year-old male patient who developed an unusual generalized drug
      eruption taking the form of a histologically confirmed pityriasis lichenoides et
      varioliformis acuta (PLEVA) after oral intake of the H1-antagonist astemizole. On
      two occasions, independently repeated medication with astemizole exacerbated the
      typical rash again. Oral exposure and the specific lymphocyte transformation test
      confirmed the suspected causal connection between astemizole and PLEVA.

PMID- 8482606
TI  - [Cerebriform intradermal nevus].
AB  - A case is reported of an extended cerebriform intradermal naevus of the scalp.
      Additional skin findings were generalized small intradermal and compound-type
      naevi. There were no neurological or other internal anomalies.

PMID- 8482607
TI  - [Symmetrical cyanosis circumscripta e lipomate].
AB  - We report the case of a 78-year-old woman with a symmetrical type of cyanosis
      circumscripta e lipomate above both knees. Clinical symptoms, pathogenesis and
      possible treatments are presented.

PMID- 8482608
TI  - [Osteoma cutis. Multiple miliary osteoma of the face].
AB  - Primary and secondary forms of ossification can be distinguished on the basis of
      the skin, with osteoma cutis occurring in primary forms. Three entities can be
      differentiated: solitary and generalized osteoma cutis and multiple miliary
      osteoma of the face. Clinically, multiple papules 2-3 mm in diameter are present,
      which histologically consist of bony trabeculae enclosing mature fat cells and,
      occasionally, marrow cells. We describe the clinical, radiological and
      histological features of a case of multiple miliary osteoma of the face in an
      otherwise healthy 55-year-old woman.

PMID- 8482609
TI  - [Is the argon laser contraindicated in the summer?].

PMID- 8482610
TI  - [Long-term effect of psoralens?].

PMID- 8482611
TI  - [Perforating cutaneous amyloidosis. Comment on the contribution by M. Bacharach
      Buhles, U. Schultz-Ehrenburg and P. Altmeyer].

PMID- 8482612
TI  - [Ross syndrome. Comment on the contribution by P. Itin, P. Hirsbrunner, T. Rufli,
      P. Fuhr and A. Hagmann].

PMID- 8482613
TI  - [Congress of the "Epidemiology, Biostatistics and Informatics" Professional
      Association of the German Dermatologic Society and the Society of Medical
      Informatics, Medical Biometry and Epidemiology, Zurich 22-23 May 1992].

PMID- 8482614
TI  - [The Berlin Pathogenic Neisseriae Conference].

PMID- 8482615
TI  - [Antimycotic drugs. Part II].

PMID- 8482616
TI  - Therapeutic effect of infused Fluosol-DA/carbogen with ephedrine, flunarizine, or
      nitroprusside.
AB  - The perfluorochemical emulsion Fluosol-DA plus carbogen breathing has been shown
      to increase the effectiveness of radiation therapy in preclinical solid tumors
      when the emulsion was administered by i.v. bolus injection. Much of the
      enhancement in tumor radiation response was lost when the emulsion was
      administered slowly. PURPOSE: We hypothesized that an increase in tumor perfusion
      resulted when Fluosol-DA was administered rapidly. METHODS AND MATERIALS: In the
      present study, the alpha/beta agonist ephedrine, the Ca2+ channel blocker
      flunarizine and the nitric oxide producing vasodilating drug nitroprusside have
      been tested. RESULTS: Ephedrine administration resulted in a decrease in the
      radiation plus Fluosol-DA +/- carbogen antitumor effects in both the Lewis lung
      carcinoma and FSaIIC tumor systems. In contrast, flunarizine administration
      resulted in an increase in the efficacy of the radiation plus carbogen and the
      radiation plus Fluosol-DA/carbogen in both tumor systems. Even with flunarizine
      administration Fluosol-DA delivered slowly was less effective than when the
      emulsion was given rapidly. Flunarizine with Fluosol-DA infused i.v. over 30 min
      followed by carbogen breathing prior to and during radiation therapy resulted in
      a 1.7-1.6-fold increase in response compared with 2.4-2.2-fold with Fluosol-DA
      administered by injection i.v. and carbogen breathing prior to and during
      radiation therapy using growth delay of the Lewis lung carcinoma. The effects of
      nitroprusside were complex. This drug had considerably more effect at 10 Gy than
      at higher radiation doses. CONCLUSION: These studies suggest that Fluosol-DA
      given by i.v. injection may increase tumor perfusion and that a drug like
      flunarizine may be beneficial if the Fluosol-DA is administered slowly followed
      by carbogen breathing and radiation therapy.

PMID- 8482617
TI  - Deep regional hyperthermia: comparison between the annular phased array and the
      sigma-60 applicator in the same patients.
AB  - PURPOSE: Several institutions have accumulated clinical experience with the
      annular array as well as with the Sigma applicator. There exist only limited data
      in comparison of both heating devices possibly favoring the annular array over
      the Sigma applicator with regard to tumor temperatures and acute toxicity. The
      objective of this study was to record temperature distributions at identical
      sites in tumor and normal tissue in the same patients treated with each device.
      METHODS AND MATERIALS: Eighteen patients with advanced pelvic tumors were treated
      on successive occasions with regional hyperthermia using the annular phased array
      applicator usually driven at 60-80 MHz or the Sigma applicator usually driven at
      70-90 MHz. In all patients detailed thermal mapping and temperature analysis for
      tumor and normal tissues could be performed. RESULTS: Regardless the device used
      the acute toxicity was treatment limiting in nearly 50% of the treatments.
      Systemic stress was treatment limiting in 30% of the treatments with both devices
      although systemic parameters (core temperature, heart rate, changes in blood
      pressure) were higher with the annular array. The overall mean minimum, average
      and maximum tumor temperature observed were 39.5 +/- 1.0 degrees C, 40.9 +/- 1.4
      degrees C, 42.7 +/- 2.3 degrees C for the annular array and 39.3 +/- 0.9 degrees
      C, 40.9 +/- 1.4 degrees C, and 42.5 +/- 1.7 degrees C for the Sigma applicator.
      The time-averaged temperatures achieved in 20% (T20), 50% (T50) and 90% (T90) of
      all measured sites were 41.7 +/- 2.1 degrees C, 40.8 +/- 1.4 degrees C, 39.9 +/-
      1.2 degrees C for the annular array and 41.7 +/- 1.4 degrees C, 41.0 +/- 1.3
      degrees C, and 40.1 +/- 1.0 degrees C, for the S-60. The difference was not
      statistically significant. With regard to normal tissue temperatures a trend to
      higher maximum temperatures in the deep muscle and fat tissue was evident for the
      Sigma applicator. The overall minimum and average normal tissue temperatures in
      the deep muscle and fat tissue and the rectum and the time-averaged temperatures
      achieved in 20% (T20), 50% (T50) and 90% (T90) of the measured sites differ not
      statistically significant. CONCLUSION: These results indicate that there continue
      to be unresolved limitations in achieving temperature elevation in deep seated
      tumors of the pelvis with radiative coherent EM wave techniques using amplitude
      and phase steering capabilities without any special optimization procedure.

PMID- 8482618
TI  - Anaplastic carcinoma of the thyroid gland treated by radiation therapy.
AB  - PURPOSE: A retrospective review was performed to investigate the potential role
      of external beam radiation therapy with or without chemotherapy in anaplastic
      carcinoma of the thyroid. METHODS AND MATERIALS: Fifty-one patients with a
      histologically or cytologically proven anaplastic thyroid carcinoma, treated by
      external beam radiation therapy between January 1970 and December 1986 in the Dr.
      Daniel den Hoed Cancer Center are the subject of this report. The overall
      survival, local control rate and pattern of metastasis were analyzed. RESULTS: It
      was found that the impact of lung metastases and local relapse on survival was
      appreciable. Patients with metastases but locally free of tumor achieved a median
      survival of 7.5 months. In patients with local regional residual disease after
      therapy, an actuarial risk of death of 100% at 8 months and a median survival of
      1.6 months was observed. For patients without disease at the end of radiation
      therapy, an actuarial median survival of 8 months was observed. CONCLUSION: This
      retrospective analysis supports the data from the literature that local control
      is indispensable for achieving a higher short-term survival rate, whereas even
      with local regional control patients might still die soon after the completion of
      their treatment because of distant metastases, predominantly in the lungs. A
      potentially new way of treatment, that is the combination of low dose Adriamycin
      with hyperfractionated external beam radiation therapy to the primary tumor and
      prophylactic irradiation to the lung, in order to obtain higher locoregional
      control and diminishing of distant metastases is briefly discussed.

PMID- 8482619
TI  - A prospective trial of accelerated radiotherapy in the postoperative treatment of
      high-risk squamous cell carcinoma of the head and neck.
AB  - PURPOSE: To evaluate the feasibility and toxicity of accelerated fractionation in
      the postoperative setting in high risk squamous cell carcinoma of the head and
      neck. METHODS AND MATERIALS: Thirty-two patients with high risk pathologic
      features (e.g., extracapsular extension, positive margins, > or = 4 nodes
      positive, perineural invasion) were enrolled in an accelerated fractionation
      schedule, using a modification of the M.D. Anderson concomitant boost technique
      delivering 63 Gy in 5.3 weeks at 1.8 Gy per fraction. RESULTS: Thirty patients
      (94%) completed treatment per protocol. Confluent mucositis was seen in 22 (69%)
      and five patients (22%) required 2 to 4 months for complete healing. Only five
      patients (16%) lost more than 10% of body weight. At a median follow-up of 32
      months (range 22-42 months), the crude infield failure rate is 8/32 (25%).
      Infield recurrence was significantly associated with the interval from surgery to
      commencement of radiotherapy; 0/10 (0%) patients beginning radiotherapy within 4
      weeks of surgery had infield failures compared to 8/22 (36%) for patients
      beginning radiotherapy more than 4 weeks after surgery (p = 0.035). CONCLUSION:
      While acute side effects appear to be increased compared to conventional
      radiotherapy, we conclude that postoperative accelerated radiotherapy is feasible
      and has acceptable toxicity in this population. These results support the concept
      of rapid tumor repopulation after resection. A randomized multi-institutional
      trial is currently underway to compare conventional and accelerated fractionation
      in the postoperative setting.

PMID- 8482620
TI  - Malignant spinal cord compression: a prospective evaluation.
AB  - PURPOSE: To determine the influence of treatment on ambulancy, pain control and
      functional outcome of patients with Malignant Spinal Cord Compression. METHODS
      AND MATERIALS: One hundred and thirty-seven patients with Malignant Spinal Cord
      Compression presenting or referred to the Department of Radiation Oncology,
      Westmead Hospital between August 1, 1989 and August 1, 1990 were studied
      prospectively. Patients were treated with palliative radiation therapy alone,
      surgery followed by radiotherapy or surgery alone. Two patients were not treated.
      Post-treatment outcome was assessed in terms of ambulatory status, improvement in
      pain and functional independence using the Functional Independence Measure.
      RESULTS: Thirteen of 16 patients (81%) who were ambulant pre-treatment remained
      ambulant after treatment. Two of 16 patients (16.5%) who were non-ambulant pre
      treatment became ambulant following treatment. Pain improved following treatment
      in 22 of 30 patients (73%). This benefit was seen equally for ambulant and non
      ambulant patients. A high level of functional independence was maintained in
      patients who remained ambulant. CONCLUSION: We conclude that prompt treatment of
      patients with Malignant Spinal Cord Compression while still able to walk is
      effective in maintaining ambulancy and functional independence, and that
      treatment improves pain in most patients.

PMID- 8482621
TI  - 3-dimensional optimization of multiple arcs for stereotactic radiosurgery.
AB  - PURPOSE: During linear accelerator-based radiosurgery, the physicians and
      physicists need to determine which combination of treatment arcs are "best" with
      regard to target coverage and incidental dose to adjacent structures. This is a
      complex problem, especially when targets are geometrically close to critical
      structures. The purpose of this article is to present a method to mathematically
      determine a set of arcs to produce desired target and normal structure dose
      distributions in linear accelerator radiosurgery. METHODS AND MATERIALS:
      Nonlinear least squares regression was used to determine the table angles and
      gantry angle arc ranges and their associated beam weights appropriate to linear
      accelerator radiosurgery. RESULTS: Three cases are presented: (a) critical
      structure close to target volume; (b) target volume too large for the largest
      collimator to cover the volume with one isocenter and a standard plan; (c) target
      volume located within one critical structure and close to another critical
      structure. The optimized treatment plans are all shown to be superior to a
      defined standard plan. CONCLUSION: The method successfully enables one to
      determine nonstandard arcs which achieve the desired results. In particular, the
      method enables one to find clinical treatment solutions, even when the desired
      results cannot be a priori defined.

PMID- 8482622
TI  - The investigation and rectification of field placement errors in the delivery of
      complex head and neck fields.
AB  - PURPOSE: To evaluate a novel technique for resolving field placement errors into
      their components and to quantify the improvement in accuracy potentially
      achievable by translation and rotation of the radiation beam. METHODS AND
      MATERIALS: One hundred and eighty-five films (both simulator and portal) from
      seventeen patients receiving radiotherapy to the head and neck region were
      analyzed in pairs. The computer based comparisons of complex fields with curved
      edges employed the intersections of perpendiculars from two reference points with
      the field periphery to define field match points. Field placement errors were
      resolved into those due to patient motion within the immobilization shell and
      those due to incorrect beam position, orientation, or shape. RESULTS: The median
      and the 95 percentile of the distribution of differences between prescribed
      (simulator) fields and treated (portal) fields referenced to the patients anatomy
      were 4.4 mm and 8.9 mm, respectively. The analysis suggests that with appropriate
      translation and rotation of the beam with respect to the immobilization shell
      these figures could be reduced to 3.1 mm and 8.2 mm, respectively, confirming the
      large contribution of patient motion within the shell to field placement
      accuracy. Comparisons between treated fields indicated smaller variability during
      treatment than between simulation and treatment. CONCLUSION: The perpendicular
      intersection method described here was found appropriate for the identification
      of field match points. The distributions of field placement errors were similar
      to those in a published study of straight edged fields. Translation and rotation
      of the applied field with respect to the immobilization shell would generally
      result in only a small improvement in field placement accuracy.

PMID- 8482623
TI  - A CT-based evaluation method for permanent implants: application to prostate.
AB  - A computerized tomography-based 3-dimensional evaluation scheme, using semi
      automatic seed localization from transverse computerized tomography-images, has
      been developed for permanent implants. The treatment isodose contour is generated
      at each scan plane and overlaid on the corresponding target contour for coverage
      visualization. Volume and surface dose histograms are generated for the target
      and neighboring normal structures. Dose inhomogeneity within the target is also
      estimated from the full-width at half maximum of the differential volume dose
      histogram. The matched peripheral dose is calculated from the ellipsoidal volume
      approximation for the target. The present evaluation method has been applied here
      to 10 actual permanent I-125 prostatic implantations. Coverages by 150 Gy and 100
      Gy levels are found to range from 78-96% and 91-99% of the target volume,
      respectively. The average matched peripheral dose is found to be about two times
      the average peripheral dose (the dose encompassing 99% target) and about three
      times the average minimum peripheral dose (the dose encompassing 100% target).
      The dose inhomogeneities within the target volume, in these 10 cases, range from
      220-420 Gy.

PMID- 8482624
TI  - Dose, volume, and tumor-control predictions in radiotherapy.
AB  - PURPOSE: Tumor volume has a profound influence on the dose required to control a
      given type of tumor. The most obvious explanation for this is related to the
      larger number of stem cells which must be sterilized, leading to a more stringent
      requirement on cell survival. There are, however, other mechanisms by which
      volume may influence tumor control, such as clonogenic fraction, oxygenation or
      inter-cellular communication. We investigate the question of whether the effect
      of volume on tumor control is, in general, predictable on the basis solely of the
      differing number of stem cells. METHODS AND MATERIALS: We investigate whether the
      effect of volume on tumor control in four sites can be predicted, using the
      linear-quadratic formalism, based on the assumption that the number of cells that
      must be sterilized is directly proportional to the tumor volume. We require that
      the biological parameters in the model should have plausible values. RESULTS: We
      find that the results of four clinical data sets, exhibiting a wide range of
      doses, volumes, and tumor control rates, are consistent with the hypothesis that
      the number of potential stem cells which must be sterilized is proportional to
      the tumor volume. CONCLUSIONS: If these considerations are correct, the potential
      exists that realistic radiobiologically-based dose corrections for tumor size
      could be routinely made. This applies both to an entire treatment, and also
      between fractions, as the tumor shrinks. Such an approach may contribute towards
      optimized radiotherapy.

PMID- 8482625
TI  - Postoperative irradiation in head and neck cancer.

PMID- 8482626
TI  - Sequencing adjuvant chemotherapy and radiotherapy in breast cancer patients.

PMID- 8482627
TI  - Inverted papilloma of the nasal cavity or paranasal sinuses: a malignant benign
      tumor.

PMID- 8482628
TI  - Effect of delay in radiation in the combined modality treatment of breast cancer.
AB  - PURPOSE: To study how the timing of radiation influences local control, overall
      survival, and disease-free survival in patients being treated with chemotherapy
      and radiation for a local-regional carcinoma of the breast. METHODS AND
      MATERIALS: Over a ten year period, 105 patients received chemotherapy and
      radiation treatments for a local-regional breast cancer. The population was
      divided into two groups based on the timing of their radiation treatments. Forty
      eight patients began their radiation within 6 months of their diagnosis (early
      radiation group). Fifty-seven patients had a delay in their radiation for 6 or
      greater months in order to first maximize chemotherapy treatments (delayed
      radiation group). There were no significant differences between the two groups
      with respect to nodal status, stage of the primary, estrogen receptor status,
      patient age, or type of surgery performed. The only prognostic parameter that was
      imbalanced was that of a greater percentage of patients with close or positive
      margins in the early radiation group compared to the delayed radiation group (69%
      versus 38%, p < 0.02). RESULTS: Comparisons of local control, overall survival,
      and disease-free survival between the early radiation patients and delayed
      radiation patients all favored the early radiation group. Respective 8-year
      actuarial rates were: local control--98% vs. 76%, p = 0.004; overall survival-
      80% vs. 52%, p = 0.016; disease-free survival--71% vs. 48%, p = 0.008. The
      differences continued to be significant in a multivariate Cox regression model
      comparison: p = 0.011, p = 0.050, p = 0.009. There was only one death from
      intercurrent disease, so that overall survival approximated cause-specific
      survival to an accurate degree. CONCLUSIONS: In patients requiring chemotherapy
      and radiation treatments for a local-regional breast cancer, a delay in the
      initiation of radiation for a period of 6 months or greater from diagnosis
      resulted in a higher local failure rate. Furthermore, this higher local failure
      rate was associated with an increased rate of distant metastases and a decreased
      overall survival rate.

PMID- 8482629
TI  - Evaluation of the dose for postoperative radiation therapy of head and neck
      cancer: first report of a prospective randomized trial.
AB  - PURPOSE: This study was designed to determine in a prospective randomized trial
      the optimal dose of conventionally fractionated postoperative radiotherapy for
      advanced head and neck cancer in relation to clinical and pathologic risk
      factors. METHODS AND MATERIALS: Between January 1983 and March 1991, 302 patients
      were enrolled on the study. This analysis is based on the first 240 patients
      entered through September 1989, of whom 221 (92%) had AJC Stage III or IV cancers
      of the oral cavity, oropharynx, hypopharynx, or larynx. The patients were
      stratified by postulated risk factors and randomized to one of three dose levels
      ranging between 52.2 Gy and 68.4 Gy, all given in daily doses of 1.8 Gy. Patients
      receiving > 57.6 Gy had a field reduction at this dose level such that boosts
      were only given to sites of increased risk. RESULTS: The overall crude and
      actuarial 2-year local-regional recurrence rates were 25.4% and 26%,
      respectively. Patients who received a dose of < or = 54 Gy had a significantly
      higher primary failure rate than those receiving > or = 57.6 Gy (p = 0.02). No
      significant dose response could be demonstrated above 57.6 Gy except for patients
      with extracapsular nodal disease in the neck in whom the recurrence rate was
      significantly higher at 57.6 Gy than at > or = 63 Gy. Analysis of prognostic
      factors predictive of local-regional recurrence showed that the only variable of
      independent significance was extracapsular nodal disease. However, clusters of
      two or more of the following risk factors were associated with a progressively
      increased risk of recurrence: oral cavity primary, mucosal margins close or
      positive, nerve invasion, > or = 2 positive lymph nodes, largest node > 3 cm,
      treatment delay greater than 6 weeks, and Zubrod performance status > or = 2.
      Moderate to severe complications of combined treatment occurred in 7.1% of
      patients; these were more frequent in patients who received > or = 63 Gy.
      CONCLUSION: With daily fractions of 1.7 Gy, a minimum tumor dose of 57.6 Gy to
      the whole operative bed should be delivered with a boost of 63 Gy being given to
      sites of increased risk, especially regions of the neck where extracapsular nodal
      disease is present. Treatment should be started as soon as possible after
      surgery. Dose escalation above 63 Gy at 1.8 Gy per day does not appear to improve
      the therapeutic ratio.

PMID- 8482630
TI  - Brachytherapy for stage I & II oral tongue cancer: an analysis of past cases
      focusing on control and complications.
AB  - An analysis of the therapy used for 370 tongue cancer patients has been made,
      said patients having been treated by interstitial irradiation alone or by
      combined external irradiation and brachytherapy (Stage I:90 cases, IIa: 196
      cases; and IIb: 84 cases). The neck was followed by close follow-up (304 cases),
      treated by elective neck irradiation (56 cases), or underwent operation at the
      time of local recurrence (10 cases). The results have shown that the 5-year
      survivals for Stages I, IIa, and IIb were 84%, 78%, and 72%, respectively.
      further, the 5-year primary control was 85% for tumors of the superficial type,
      79% for tumors of the exophytic type, and 45% for tumors of the infiltrative type
      (p < 0.004). In non-electively irradiated patients, a neck metastasis occurred in
      31% in Stage I, 41% in Stage IIa, and 51% in Stage IIb. Finally, 110 patients
      incurred radiation-induced complications (110/291 = 38%) and 11 patients (11/291
      = 4%) required a surgical procedure. Brachytherapy for tongue cancer achieved
      results that are comparable with surgery. The analysis also revealed that the
      introduction of computer dosimetry and the use of a spacer (a dental guard) in
      brachytherapy have achieved superior results in the management of a tongue
      cancer.

PMID- 8482631
TI  - Radiotherapy is successful treatment for orbital lymphoma.
AB  - PURPOSE: To describe the clinical presentation, treatment technique, outcome and
      complications in a large single institutional experience using radiotherapy for
      treatment of orbital lymphoma. METHODS AND MATERIALS: Twenty-five patients with
      lymphoma of the orbit or ocular adnexa were treated with radiotherapy at Stanford
      University Medical Center during the fourteen year period, 1977-1991. Patients
      were staged using the Ann Arbor criteria with chest x-ray, computerized
      tomography of abdomen and orbits, lymphangiogram, and bone marrow biopsy.
      Patients with disease localized to the orbits as well as those with disseminated
      disease and symptomatic orbital lesions were treated. Thirty-one involved eyes
      were treated. Mean radiotherapy dose was 35.3 Gy, with a range of 28 Gy to 40.2
      Gy. Lens protection was used in all cases. Two patients with diffuse large cell
      lymphoma also received chemotherapy as part of their initial treatment. Follow-up
      ranged from 10 months to 13 years, with a mean follow-up time of 4 years.
      RESULTS: Twenty patients had disease confined to one or both orbits (Stage I).
      One patient had a monoclonal atypical infiltrate, while the remainder had a
      histologic diagnosis of malignant lymphoma: diffuse small lymphocytic, 13;
      follicular mixed, 3; diffuse small cleaved, 3; diffuse large cell, 2; follicular
      small cleaved, 1; follicular and diffuse small cleaved, 1; undifferentiated, 1.
      Two local relapses occurred; the actuarial 5-year freedom from local relapse is
      89%. Actuarial 5-year freedom from distant relapse, freedom from any relapse and
      overall survival are 77%, 70%, and 93%, respectively. Acute complications of
      treatment were mild. Late complications included transient cystoid macular edema
      (one patient), asymptomatic subcapsular and medial sector cataract formation (two
      patients), retinopathy (two patients), mild eyelid retraction (one patient), and
      dry eye with secondary conjunctivitis (one patient). CONCLUSION: Carefully
      planned radiotherapy with lens shielding is an effective and safe treatment in
      the management of orbital lymphoma. We recommend megavoltage radiation doses of
      30-35 Gy in 180-200 cGy fractions for low grade lesions, and 36-40 Gy for
      intermediate and high grade lesions.

PMID- 8482632
TI  - Management of inverted papilloma of the nasal cavity and paranasal sinuses:
      importance of radiation therapy.
AB  - PURPOSE: Locally advanced inverted papilloma and inverted papilloma associated
      with squamous cell carcinoma are at high risk of local failure due to limitations
      of surgical resection resulting in repeat surgical procedures. The role of
      adjuvant radiation therapy is poorly defined. This study reviews a single
      institution experience of radiation therapy in the management of this disease.
      METHODS AND MATERIAL: Between 1977 and 1990 25 patients were treated at the
      Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary with
      radiation therapy for inverted papilloma (seven patients) and inverted papilloma
      associated with squamous cell carcinoma (18 patients) of the nasal cavity and
      paranasal sinuses. All patients presented with locally advanced invasive tumors;
      5 of 7 with inverted papilloma had previous resections and 4 of 18 with
      associated squamous cell carcinoma had history of prior surgical excisions of
      inverted papilloma only (three patients) or inverted papilloma with squamous cell
      carcinoma in situ (one patient). Sixteen patients underwent radiation treatment
      following gross total resection, eight patients after subtotal tumor resection
      and one patient was inoperable by local invasion and received radiation therapy
      alone. RESULTS: Local control was achieved in 6 of 7 patients with inverted
      papilloma only and one patient required additional resection for persistent
      disease. Of 18 patients with associated squamous cell carcinoma, 17 were locally
      controlled after radiation therapy and one had persistent tumor. One patient
      failed locally 3 years after treatment. With a mean observation time of 4.8 years
      (range: 0.5-12.9 years) all seven (100%) patients with inverted papilloma only
      and 15 of 18 (83%) patients with associated invasive carcinoma are alive and
      without evidence of disease. Three patients with inverted papilloma associated
      with squamous cell carcinoma died, two patients as a result of their disease (one
      patient with persistent disease, one patient after local failure) and one patient
      of intercurrent disease. No failure in either regional lymph nodes or at distant
      sites was recorded. In the majority of cases radiation therapy was well
      tolerated. CONCLUSIONS: Combined radiation therapy and surgery can offer
      excellent long-term control and should be considered in patients with history of
      recurrent disease, in the presence of suspected residual disease, after
      incomplete resection or for unresectable lesions. Patients with associated
      squamous cell carcinoma have a more aggressive course, however radiation therapy
      still has the prospect of permanent disease-free survival in patients who achieve
      local control.

PMID- 8482633
TI  - Radiotherapy alone for squamous cell carcinoma of the nasal vestibule: management
      of the primary site and regional lymphatics.
AB  - PURPOSE: To examine patterns of failures and complications in invasive squamous
      cell carcinoma of the nasal vestibule treated with radiotherapy alone. METHODS
      AND MATERIALS: Thirty-nine patients are reported with two-year minimum follow-up.
      Twenty-nine patients had tumors that were previously untreated; 10 were recurrent
      after prior surgical resection. Twelve patients received external beam alone, 18
      had external beam followed by a radium implant, and nine had radium implant
      alone. RESULTS: Local control in patients eligible for analysis was as follows:
      T1, 11 of 13; T2, 6 of 6; and T4, 12 of 17 (1988 AJCC skin cancer staging
      classification). Previously untreated tumors and tumors recurrent after surgical
      excision alone had similar local control, stage for stage. Among T4 tumors, local
      control with radiotherapy was achieved in 11 of 13 lesions measuring < 4 cm in
      diameter versus 1 of 4 of those measuring > or = 4 cm. Of 37 patients with
      clinically negative regional nodes at presentation, 32 were managed with
      observation alone; of those eligible for 1-year minimum follow-up, 4 (15%) of 27
      developed disease in the regional lymphatics. All regional node failures have
      been salvaged. In general, cosmesis was very good and complications were minimal.
      CONCLUSION: Radiotherapy in this series proved to be an effective and
      cosmetically favorable alternative to surgery for nasal vestibule carcinoma.
      Elective treatment of the regional lymphatics is not warranted in early stage,
      previously untreated patients, but should be considered for selected advanced and
      recurrent lesions.

PMID- 8482634
TI  - Alterations in growth phenotype and radiosensitivity after fractionated
      irradiation of breast carcinoma cells from a single patient.
AB  - PURPOSE: To investigate growth regulation and radiosensitivity in surviving
      clonogens after fractionated irradiation. METHODS AND MATERIALS: Four breast
      carcinoma cell lines isolated from the primary tumor (21NT, 21PT) and metastases
      (21MT-1, 21MT-2) of a single patient were exposed to cumulative radiation doses
      of 30 Gy yielding cell lines designated-IR with respect to their parent. The
      irradiated lines were then compared to their parent for serum-and growth factor
      requirements under defined media conditions, ability to proliferate in soft agar,
      concentration of TGF-alpha in conditioned medium, and radiosensitivity. RESULTS:
      The irradiated lines showed no change in proliferative doubling times under serum
      and growth factor-supplemented media conditions. A single line, 21MT-1-IR,
      acquired a limited ability to proliferate in serum-and growth factor-deplete
      medium with a day 2-4 doubling time of 44.5 hr. Three lines, 21MT-1-IR, 21MT-2
      IR, and 21NT-IR, formed colonies in soft agar in contrast to none of the
      unirradiated parent lines. There were significant 6-8 fold increases in
      conditioned media TGF-alpha concentrations for 21MT-2-IR and 21NT-IR cells. The
      21MT-1-IR and 21NT-IR cells were significantly less radiosensitive than their
      respective parent lines. This decrease in radiosensitivity appeared to be at
      least partially mediated by a released factor as the radiosensitivity of 21MT-1
      cells was significantly decreased by pre-incubation with conditioned medium from
      21MT-1-IR cells. CONCLUSION: Radiation-induced changes in growth phenotype vary
      with respect to clonal origin of the cell line and may influence the
      radiosensitivity of surviving clonogens after fractionated treatment.

PMID- 8482635
TI  - Effect of conjoint administration of tamoxifen and high-dose radiation on the
      development of mammary carcinoma.
AB  - PURPOSE: Tamoxifen is currently advocated for post-menopausal breast cancer
      patients receiving definitive irradiation after limited surgery. The purpose of
      this study was to assess in an experimental model for breast cancer whether the
      efficacy of irradiation is altered by conjoint administration of tamoxifen. To
      this end, rats with small tumors induced by 1-methyl-1-nitrosourea (MNU) were
      treated with tamoxifen, radiation, or a combination of the two modalities.
      METHODS AND MATERIALS: Female Sprague Dawley rats were injected i.p. with 50 mg
      MNU/kg body weight at 50 days of age. At 64 days post carcinogen, the majority of
      the rats had at least one palpable mammary tumor. At that time radiation with or
      without tamoxifen treatment was initiated and given 5 days per week for 5 weeks.
      Radiation dose was 4500 cGy delivered as 25, 180 cGy fractions. Tamoxifen, 500
      mg/kg body weight, was administered subcutaneously each day during the
      irradiation interval. The study was terminated 28 weeks after carcinogen
      treatment. RESULTS: High dose radiation alone induced a reduction in the size of
      existing tumors, but resulted in a significant increase in the number of tumors
      that were detected. Treatment with tamoxifen alone also caused a reduction in
      tumor volume, but had no effect on final incidence or number of mammary tumors.
      Combined modality treatment resulted in a significant reduction in the volume of
      existing tumors and suppressed the enhanced occurrence of additional tumors
      observed when only radiation alone was administered. CONCLUSION: The findings of
      this study indicate that in the context of fractionated, high dose radiation
      treatment of established mammary cancers, tamoxifen may reduce the likelihood of
      subsequent tumor development and by so doing prove a helpful simultaneous
      conjoint adjuvant treatment to post-operative irradiation.

PMID- 8482636
TI  - Nicotinamide exerts different acute effects on microcirculatory function and
      tissue oxygenation in rat tumors.
AB  - PURPOSE: Nicotinamide has been reported to preferentially radiosensitize tumor
      tissue, supposedly through a reduction in tumor hypoxia. This may occur as a
      result of nicotinamide-induced changes in tumor blood flow and therefore the
      present study was undertaken to evaluate the effect of nicotinamide on
      circulatory parameters in skeletal muscle and tumor tissue (subcutaneously
      implanted DS-sarcomas) of the rat. METHODS AND MATERIALS: Mean arterial blood
      pressure (measured in the common carotid artery using a pressure transducer) and
      red blood cell flux (as measured by laser Doppler flowmetry) were continuously
      monitored for 120 min following a single intraperitoneal application of
      nicotinamide (500 mg/kg). An arterial blood pressure/laser Doppler flux ratio was
      estimated for tumor and muscle tissue. RESULTS: Nicotinamide significantly
      reduced the mean arterial blood pressure to a minimum value 25% below the
      pretreatment value 20 min after the commencement of drug administration, with
      partial recovery thereafter. Red blood cell flux through tumor tissue, following
      an initial rapid decrease, rose steadily to values 34% above those measured in
      control animals at t = 60 min, while the arterial blood pressure/laser Doppler
      flux ratio in tumor tissue fell to values 34% below those of control animals. In
      skeletal muscle similar trends were seen although the changes were not of the
      same extent as those seen in tumor tissue. Tumor pO2 was measured 60 min
      following i.p. application of nicotinamide using polarographic needle electrodes.
      Despite the significant increase in blood flow following nicotinamide, no
      significant difference was seen between pO2 histograms obtained in tumors in
      nicotinamide-treated and control animals. CONCLUSION: These findings suggest that
      nicotinamide preferentially improves tumor microcirculatory function and
      effectuates a decrease in the arterial blood pressure/laser Doppler flux ratio
      within tumor tissue, effects which reach their maximum approximately 60 min
      following nicotinamide administration.

PMID- 8482637
TI  - Uptake of pulmonary surfactant protein C into adult rat lung lamellar bodies.
AB  - Previous studies have provided evidence that a large proportion of secreted
      surfactant lipids is taken up from the alveolar air space by type II cells,
      incorporated into lamellar bodies, and resecreted. Our goal was to characterize
      the clearance of exogenously administered recombinant surfactant protein C (SP-C)
      and to determine if SP-C is taken up by type II cells and incorporated into
      lamellar bodies. SP-C was radiolabeled by alkylation with [3H]iodoacetic acid and
      retained its ability to enhance phospholipid adsorption to an air-liquid
      interface. A mixture of 100 micrograms phospholipid radiolabeled with
      [14C]dipalmitoylphosphatidylcholine and 10 micrograms SP-C was instilled into the
      lungs of spontaneously breathing anesthetized adult rats. At later times, the
      lungs were lavaged and subcellular organelles were isolated. The radioactivity of
      both phospholipids and SP-C (expressed as disintegrations per minute per
      microgram phospholipid) in lamellar body fractions increased up to 4 h
      postinstillation and began to decline after approximately 4 h. The results of
      this study suggest that SP-C and dipalmitoylphosphatidylcholine are taken up
      promptly from the alveolar air space and are incorporated into lamellar bodies
      with time courses that do not differ greatly.

PMID- 8482638
TI  - Lack of heart rate variation between morning and afternoon exercise testing in
      coronary artery disease patients.
AB  - The purpose of this study was to investigate cardiovascular [heart rate (HR),
      blood pressures, rate-pressure product (RPP)], physiological (oxygen uptake), and
      metabolic (blood plasma lactic acid concentration) responses during symptom
      limited graded exercise testing (SL-GXT) during early morning and late afternoon
      hours in an unmedicated, regularly exercising, coronary artery disease
      population. Subjects, males ages 41-71 yr (n = 11), underwent SL-GXT via cycle
      ergometry at 8:30 A.M. and 4:30 P.M. HR, systolic blood pressure, diastolic blood
      pressure, and RPP were evaluated at rest and at submaximal and peak work. Oxygen
      uptake and rate of perceived exertion were also determined at submaximal and peak
      power output, with blood plasma lactic acid concentration measured at peak work.
      Data, analyzed by the paired t test, failed to demonstrate any significant
      variation in HR, systolic blood pressure, diastolic blood pressure, RPP, or blood
      plasma lactic acid responses during exercise at the two points used. Oxygen
      uptake did not significantly change at any submaximal intensity. Thus SL-GXT
      results obtained at early morning (8:30 A.M.) and late afternoon (4:30 P.M.) are
      a reproducible, reliable means of prescribing exercise HR and work intensities.

PMID- 8482639
TI  - Influence of detergent aerosol on lung microvascular permeability.
AB  - Noncardiogenic edema fluid often contains high levels of plasma proteins, which
      may inhibit the function of the lung surfactant complex and thus decrease
      interstitial hydrostatic pressures. We questioned whether, in the awake and
      standing animal, displacement of the alveolar surface lining would alter the
      permeability of the thin and sparsely supported pulmonary capillaries. Sheep
      prepared with lung lymph fistulae were given an aerosolized detergent (Det) to
      displace the lung surfactant complex. After the sheep were given Det, protein
      flux was significantly increased (P < 0.05). To validate the suggested
      permeability increase, pulmonary vein occluders were surgically implanted and
      experiments repeated with pulmonary arterial pressures elevated 10 mmHg above
      baseline. After 2 h of elevated pulmonary arterial pressure, lung lymph increased
      fivefold. At this time, lymph-to-plasma total protein concentration ratios for
      air and saline-plus-ethanol vehicle were significantly lower (P < 0.01) than
      baseline ratios (0.26 +/- 0.06 and 0.34 +/- 0.07, respectively). No significant
      difference could be shown in lymph-to-plasma ratios after the sheep were given
      Det. We conclude that disruption of the alveolar lining can cause a detectable
      increase in protein flux due, in part, to an increase in microvascular
      permeability.

PMID- 8482640
TI  - Validity of the esophageal balloon technique at high frequencies.
AB  - The reliability of the esophageal balloon technique in measuring high-frequency
      changes in pleural pressure (Ppl) was investigated in six normal subjects by
      studying the amplitude ratio (A) and phase angle (phi) of esophageal (Pes) and
      mouth (Pm) pressures during airway occlusion and while pseudorandom pressure
      variations (2-32 Hz) were applied to the chest. The measurements were made with a
      common esophageal balloon-catheter system connected to a high-impedance
      piezoresistive transducer. When the cheeks were firmly supported, A averaged 1.08
      +/- 0.063 at 2 Hz and 1.06 +/- 0.11 at 32 Hz. Pes increasingly led Pm with
      increasing frequency, and phi averaged 20.8 +/- 4.0 degrees at 32 Hz. Washing the
      airways with 80% He-20% O2 reduced phi by 50%. When the cheeks were not
      supported, A exhibited a strong positive frequency dependence, averaging 1.71 +/-
      0.34 at 32 Hz, whereas phi increased much faster below 20 Hz and tended to
      decrease afterward. Because the esophageal transfer function Pes/Ppl =
      (Pes/Pm)/(Ppl/Pm), we could estimate Pes/Ppl by computing for individual subjects
      the pressure difference between the pleura and the mouth based on the lung and
      upper airway wall properties that were measured separately. The results suggest
      that the ratio of Pes and Ppl remains close to unity from 2 to 32 Hz, but Pes
      lags slightly behind Ppl (phi equals about -7 degrees at 32 Hz).

PMID- 8482641
TI  - Total respiratory input impedance with the upper airway wall shunt minimized.
AB  - Respiratory impedances (Zrs) measured with the cheeks manually supported (Zsc)
      demonstrate an antiresonance (AR) at approximately 170 Hz, whereas those measured
      with the head generator (Zhg) have an AR at significantly lower frequencies (150
      Hz). The differences in the AR between methods were previously attributed to
      upper airway wall (UAW) shunting in Zsc, and Zhg was believed to represent shunt
      free impedance. To test this hypothesis, we measured four independent estimates
      of Zrs (4-256 Hz) in five healthy adults. Applying the oscillations at the mouth,
      we measured Zrs with the cheeks unsupported (Zuc) and when the subject's head and
      neck were enclosed in a rigid chamber completely filled with water (Zwa). We also
      measured Zhg with the oscillations applied around the head. Because water is
      incompressible, Zwa should minimize UAW shunt if not completely eliminate it.
      There were no significant differences in any of the AR features (e.g., location
      and bandwidth) of Zuc, Zsc, and Zwa. Conversely, all AR features of Zwa and Zhg
      were significantly different. To assess wall motion during both forms of
      oscillations (i.e., applied at the mouth and around the head), we measured two
      UAW local impedances by use of accelerometers placed on the cheeks (Zch) and
      submental (Zsm) region. Above 40 Hz, Zch and Zsm estimates were significantly
      dependent on the forcing method. Furthermore, Zch and Zsm made with the standard
      oscillations were consistent with the lumped UAW impedances measured with a head
      plethysmograph, whereas those made with the oscillations around the head were
      not. Therefore we conclude that, at > 32 Hz, Zsc more closely represents shunt
      free impedance than does Zhg and hence should be preferred when Zrs are measured.

PMID- 8482642
TI  - Weight-training-induced attenuation of the circulatory response of older males to
      weight lifting.
AB  - We examined the effects of 12 wk of dynamic strength training on the heart rate
      (HR) and blood pressure of older male subjects during 10 repetitions of single
      arm curl and single- and double-leg press at 60 and 80% of both the pre- and
      posttraining maximum capacities and during single maximum lifts (1 RM). The
      circulatory responses were greater at 80% of 1 RM than at 60% and increased with
      active muscle mass. After training, the 1 RMs increased by 24 (legs) to 54%
      (arms) and there was a marked attenuation of HR and arterial pressure during
      exercise when subjects lifted the same absolute load. Greatest reductions in HR
      (108 +/- 4 to 94 +/- 2 beats/min), systolic blood pressure (BPs, 247 +/- 14 to
      206 +/- 9 Torr), diastolic pressure (156 +/- 9 to 116 +/- 5 Torr), mean arterial
      pressure (143 +/- 6 to 131 +/- 5 Torr), and rate-pressure product (268 +/- 22 to
      196 +/- 12 HR.BPs/100) occurred during double-leg press at 80% of the pretraining
      1 RM. After training, during lifting at 60, 80, and 100% of the posttraining 1
      RMs, the HRs and arterial pressures were the same as those during pretraining
      testing when the same relative, but lighter, absolute loads were used. These
      observations are consistent with a significant part of the circulatory response
      to weight lifting being mediated by a feedforward "central command" mechanism
      coupled to the relative intensity rather than to the absolute level of force.

PMID- 8482643
TI  - Endothelium-derived relaxing factor activity in rat lung during hypoxic pulmonary
      vascular remodeling.
AB  - We have investigated the role of endothelium-derived relaxing factor in
      modulating hypoxic pulmonary vasoconstriction by inhibiting its synthesis with
      the false substrate NG-monomethyl-L-arginine (L-NMMA) in the isolated blood
      perfused lungs of Wistar rats after chronic hypoxia (CH, fractional inspiratory
      O2 concentration 10%) for 15 h, 2 days, and 7 days. Lungs were perfused with
      blood of normal hematocrit at constant flow (18 ml/min) ventilated with 1) 95%
      air-5% CO2 (normoxia) and 2) 2% O2-5% CO2-93% N2 (hypoxia) and were studied in
      the absence and presence of L-NMMA (30 and 300 microM) or L-arginine (L-Arg, 1
      and 6 mM) in separate groups. Pulmonary arterial pressure (Ppa) rose
      incrementally with hypoxic exposure (all P < 0.05 vs. normoxic control group).
      Hypoxic pulmonary vasoconstriction (HPV) was markedly reduced after 15 h and 2
      days of CH: the mean increases in Ppa (delta Ppa) in hypoxia were 15.3, 3.5, 3.8,
      and 13.6 mmHg in control rats and rats exposed to 15 h (P < 0.05 vs. control and
      7 days of CH), 2 days (P < 0.001 vs. control and 7 days of CH), and 7 days of CH,
      respectively. Ppa in control rats and rats exposed to 15 h, 2 days, and 7 days of
      CH were 137, 179, 184, and 166% of control, respectively, after 30 microM L-NMMA
      (all P < 0.05 when expressed as percent change vs. no L-NMMA). Similar
      augmentation in HPV was seen after 30 microM L-NMMA, with all hypoxic groups
      having a greater response than control groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482644
TI  - Centrally driven slow oscillating potential of extrathoracic trachea.
AB  - Spontaneous electrical activity of extrathoracic trachea was recorded along with
      force developed by tracheal smooth muscle and phrenic nerve activity in
      decerebrated, paralyzed, and artificially ventilated dogs with pneumothorax. The
      tracheal electrical activity exhibited slow oscillating potentials that were
      coupled with spontaneous phasic contraction of trachea. Both rhythmic changes
      were synchronous with central respiratory rhythm represented by phrenic burst,
      independent of the respirator's rhythm. The dominant component of the slow
      oscillating potentials consisted of sinusoidal waves with large amplitude that
      occurred shortly after cessation of phrenic burst, i.e., in the postinspiratory
      phase. The concomitant small change in the slow oscillating potentials began in
      the late inspiratory phase just before the initiation of the tracheal
      contraction. This phase relationship was preserved after removal of intrathoracic
      vagal afferents from lungs. Such slow oscillating potentials were also observed
      during lung collapse produced by disconnecting the tube attached to the
      respirator. Transection of recurrent laryngeal nerves abolished the slow
      oscillating potentials. These results indicate that the slow oscillating
      potentials of the extrathoracic trachea are generated by a physiological process
      associated with the central respiratory rhythm. The dominant component of the
      slow oscillating potentials occurs in the postinspiratory phase.

PMID- 8482645
TI  - Breathing periodicity in intact and carotid body-denervated ponies during
      normoxia and chronic hypoxia.
AB  - Periodic oscillations in pulmonary ventilation (VI), tidal volume (VT), and
      inspiratory and expiratory times (TI and TE) were studied during normoxia
      (arterial PO2 = 95 Torr) and 48 h of hypoxia (arterial PO2 = 40-50 Torr) in awake
      intact (n = 8) and carotid body-denervated (CBD; n = 8) ponies. Periodic
      oscillations were identified by fast-Fourier transformation of breath-by-breath
      data and quantitated by determining the power ratio of significant periodic
      oscillations to total power of data sequence. Periodic oscillations of 0.063
      0.500 cycles/breath were observed in all parameters during both normoxia and
      hypoxia. During normoxia, CBD accentuated periodicity of VT (P < 0.02) and VI (P
      < 0.01) but did not change TI or TE periodicity (P > 0.05). These findings
      suggest that carotid chemoreceptors serve to stabilize breathing (i.e., decrease
      periodicity) during normoxia, conceivably because of their shorter response time
      compared with that of central chemoreceptors. During certain periods of hypoxia,
      periodicity of VT and VI was significantly (P < 0.05) increased in intact ponies.
      The response to hypoxia in CBD ponies was variable, with VI periodicity
      significantly (P < 0.05) increasing, decreasing, or unchanging. Because some CBD
      ponies significantly changed their periodicity during hypoxia compared with
      normoxia, we conclude that carotid chemoreceptors are not requisite for hypoxia
      induced changes in periodic breathing. In addition, our observations in both
      groups of ponies during normoxia and hypoxia suggest that multiple mechanisms may
      lead to periodic oscillations in breathing.

PMID- 8482646
TI  - Effect of pulmonary blood flow on measurements of respiratory mechanics using the
      interrupter technique.
AB  - The relationship between respiratory mechanics, changes in pulmonary blood flow
      (PBF), pulmonary arterial pressure, and left atrial pressure is unclear.
      Conventional methods for the measurement of respiratory mechanics model the
      respiratory system as a single compartment, which may not adequately represent
      the respiratory system in a diseased state. The interrupter technique models the
      respiratory system as two compartments, with the "flow resistance" of the
      conducting airways and chest wall (Raw) considered separately from Pdif, a
      measure of the viscoelastic properties of the lung and chest wall, together with
      any pendelluft present. The respiratory mechanics of 15 infants in the first year
      of life were studied during cardiac catheterization with the use of conventional
      methods and the interrupter technique. The infants had a PBF-to-systemic blood
      flow ratio ranging from 0.6 to 4.0:1. The specific dynamic compliance of the
      respiratory system was not related to the PBF; however, there was a significant
      relationship between PBF and the total resistance of the respiratory system (Rrs)
      [analysis of variance (ANOVA) F = 5.69, P < 0.05], Raw (ANOVA, F = 12.30, P <
      0.01), and Pdif (ANOVA, F = 3.79, P < 0.05). Rrs increased significantly with an
      increase in mean left atrial pressure (ANOVA, F = 6.92, P < 0.05); however,
      dynamic compliance, Raw, and Pdif did not. These results suggest that the
      relationship between Rrs and PBF is due an increase in the resistive properties
      of the conducting airways and tissue components.

PMID- 8482647
TI  - Impact of frequency range and input impedance on airway-tissue separation implied
      from transfer impedance.
AB  - In humans, application of the DuBois (DuBois et al. J. Appl. Physiol. 8: 587-594,
      1956) six-element model to respiratory transfer impedance (Ztr) data has been
      proposed as a means to noninvasively estimate airway and tissue properties. This
      approach requires prior knowledge of alveolar gas compressibility (Cg). With
      input impedance (Zin), prior knowledge of Cg is not required, but the data do not
      support a reliable separation of airway from tissue properties. In this study, we
      investigated the separation of airway and tissue properties when Ztr and Zin data
      are measured and analyzed simultaneously over a larger frequency range than
      usual. In 10 healthy adults, we measured Ztr and Zin from 2 to 64 Hz. Zin was
      measured using both the standard approach with oscillations directly into the
      airway opening (Zst) and the head generator approach (Zhg) with oscillations
      applied around the head. With Ztr data alone, we found that the airway resistance
      and inertance estimates were reliable with only 2- to 32-Hz data and were
      unaffected by including the additional 32- to 64-Hz data. Conversely, the
      estimates of tissue resistance and inertance were highly unreliable unless the 32
      to 64-Hz data are included. Because of enhanced sensitivity of Ztr to Cg from 32
      to 64 Hz, inaccuracies in the assigned Cg will distort the estimated tissue but
      not airway properties. The Ztr-based parameters predicted Zhg data far better
      than Zst data, which is consistent with Zhg data being less influenced by upper
      airway shunting over this frequency range. There was no apparent advantage to
      combining Ztr and Zhg data during parameter estimation. With Cg unfixed, the
      estimated Cg was 50-100% higher than expected from an independent measurement of
      functional residual capacity. These results confirm that Ztr alone can provide a
      reliable distinction of lumped respiratory airway and tissue properties that are
      little influenced by upper airway wall shunting but only if 2- to 64-Hz data are
      analyzed. This distinction, however, requires an accurate prior measurement of
      Cg, and this requirement cannot be removed by combining Ztr and Zin data.

PMID- 8482648
TI  - Gas uptake from an unventilated area of lung: computer model of absorption
      atelectasis.
AB  - A computer model of gas uptake from an area of nonventilated lung, such as a
      pulmonary lobe with an occluded bronchus or an alveolus with an occluded airway,
      is presented. Previous analyses have assumed that when an inert gas is present,
      equilibration of O2 and CO2 with mixed venous blood is sufficiently rapid to be
      treated as instantaneous. This is valid for insoluble gases such as N2 or He when
      the fractional concentration of inspired O2 (FIO2) is < or = 0.6 but is invalid
      for a relatively soluble gas such as N2O. When a mixture of O2 and an inert gas
      is breathed, the time for an area of unventilated lung to collapse depends on the
      solubility of the inert gas and FIO2. When the solubility is low (N2 or He),
      collapse takes longer than when 100% O2 is breathed, and the lower the FIO2 the
      longer the time to collapse. When the gas is more soluble (N2O) and FIO2 is >
      0.3, collapse is more rapid than when 100% O2 is breathed.

PMID- 8482649
TI  - Effect of inhaled lyso-platelet-activating factor on airway microvascular leakage
      in the guinea pig.
AB  - Lyso-platelet-activating factor (PAF), the precursor and metabolite of PAF, is
      considered inactive, although it may be converted to PAF by airway cells. We have
      investigated the effects of inhaled lyso-PAF on bronchoconstriction and airway
      microvascular leakage in anesthetized guinea pigs. Lung resistance (RL) was
      measured for 6 min after inhalation of lyso-PAF (0.3, 1, and 3 mM; 30 breaths)
      followed by measurement of extravasation of intravenous Evans blue dye into
      airway tissues, which was used as an index of airway microvascular leakage.
      Inhaled lyso-PAF caused an increase in RL and leakage of dye at all airway levels
      in a dose-dependent fashion, but intravenous lyso-PAF (0.25 mg/kg) had no airway
      effect. The maximum dose of inhaled lyso-PAF increased RL significantly by
      approximately 200%. The amount of extravasation of dye induced was 96 +/- 4 (SE)
      ng/mg of tissue in trachea, 77 +/- 8 ng/mg in main bronchi, and 65 +/- 7 and 25
      +/- 1 ng/mg in proximal and distal intrapulmonary airways respectively; these
      values were all significantly higher (P < 0.01) than control values. These
      responses were completely abolished by a specific PAF-receptor antagonist WEB
      2086 (2 mg/kg iv). Our results show that inhaled lyso-PAF is potent in increasing
      airway microvascular leakage. The effects of lyso-PAF may result from its
      metabolic transformation to PAF by lyso-PAF:acetyl-CoA acetyltransferase in the
      airway.

PMID- 8482650
TI  - Arterial blood pressure responses to graded transient arousal from sleep in
      normal humans.
AB  - During obstructive sleep apnea, transient arousal at the resumption of breathing
      is coincident with a substantial rise in blood pressure. To assess the
      hemodynamic effect of arousal alone, 149 transient stimuli were administered to
      five normal subjects. Two electroencephalograms (EEG), an electrooculogram, a
      submental electromyogram (EMG), and beat-to-beat blood pressure (Finapres,
      Ohmeda) were recorded in all subjects. Stimulus length was varied to produce a
      range of cortical EEG arousals that were graded as follows: 0, no increase in
      high-frequency EEG or EMG; 1, increased high-frequency EEG and/or EMG for < 10 s;
      2, increased high-frequency EEG and/or EMG for > 10 s. Overall, compared with
      control values, average systolic pressure rose [nonrapid-eye-movement (NREM)
      sleep 10.0 +/- 7.69 (SD) mmHg; rapid-eye-movement (REM) sleep 6.0 +/- 6.73 mmHg]
      and average diastolic pressure rose (NREM sleep 6.1 +/- 4.43 mmHg; REM sleep 3.7
      +/- 3.02 mmHg) over the 10 s following the stimulus (NREM sleep, P < 0.0001; REM
      sleep, P < 0.002). During NREM sleep, there was a trend toward larger blood
      pressure rises at larger grades of arousal (systolic: r = 0.22, 95% confidence
      interval 0.02-0.40; diastolic: r = 0.48, 95% confidence interval 0.31-0.62). The
      average blood pressure rise in response to the grade 2 arousals was approximately
      75% of that during obstructive sleep apnea. Arousal stimuli that did not cause
      EEG arousal still produced a blood pressure rise (mean systolic rise 8.6 +/- 7.0
      mmHg, P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482651
TI  - Properties of motor units after immobilization of cat peroneus longus muscle.
AB  - Changes in contractile properties of cat peroneus longus motor units were studied
      2, 5, and 8 wk after selective immobilization of this muscle, which was achieved
      by fixing the distal tendon of the peroneus longus to the fibula either at the
      muscle minimal physiological length ("short" length) or at the length for a 90
      degree ankle joint ("neutral" length). In each muscle, 75-90% of the units [slow
      (S), fast resistant to fatigue (FR), fast intermediate (FI), and fast fatigable
      (FF)] were studied. Immobilization elicited a permanent decrease in tetanic force
      developed by single motor units, which was larger for resistant-to-fatigue units
      (S, FR). In most instances this decrease was not related to the immobilization
      length. In all units, twitch contraction and half-relaxation times underwent a
      transient increase, the extent and time course of which were influenced by
      immobilization length. The relationship between the frequency of motor units
      activation and the ratio of unfused to maximal tetanic force was studied. For
      fast units, there was a transient shift of the relation toward low frequencies
      after 2 and 5 wk of immobilization at neutral and short length, respectively.

PMID- 8482652
TI  - Embolus size affects gas exchange in canine autologous blood clot pulmonary
      embolism.
AB  - Embolic pulmonary hypertension is associated with alterations in gas exchange of
      variable severity, which we hypothesized to be related to embolus size. We
      therefore examined the effects of different-size autologous blood clot
      embolization on pulmonary arterial pressure-cardiac output relationships (Ppa/Q)
      and on the distribution of ventilation-perfusion ratios (VA/Q) in 18 intact
      anesthetized and ventilated (inspired fraction of O2 0.4) dogs. Multipoint Ppa/Q
      plots were generated by a manipulation of venous return before and 60 min after
      sufficient amounts of small (1 mm, n = 6 dogs), medium (5 mm, n = 6 dogs), or
      large (10 mm, n = 6 dogs) clots to increase Ppa to 50 mmHg. The distribution of
      VA/Q was determined by the multiple inert gas elimination technique at the same
      intermediate Q in each of these experimental conditions. All three sizes of
      emboli resulted in an 82-92% mean angiographic pulmonary vascular obstruction and
      increased both the extrapolated pressure intercepts and the slopes of the linear
      Ppa/Q plots. Gas exchange was altered the most after large clots, which were
      associated with lower arterial pH, higher physiological and inert gas dead
      spaces, higher dispersion of ventilation, and also lower mean VA/Q of perfusion
      distributions. In contrast, inert gas dead space was decreased after small clots.
      We conclude that, in autologous blood clot embolic pulmonary hypertension, Ppa/Q
      characteristics are unaffected by embolus size but that gas exchange is affected
      differently, mainly in high-VA/Q regions and most often after the largest clots.

PMID- 8482653
TI  - Myosin and troponin changes in rat soleus muscle after hindlimb suspension.
AB  - We examined the myosin heavy-chain (MHC), troponin T (TnT), and troponin I (TnI)
      isoform composition in the rat soleus muscle after 21 days of hindlimb suspension
      using electrophoretic and immunoblotting analysis with specific monoclonal
      antibodies. The suspended soleus showed a shift in the MHC isoform distribution
      with a marked increase (from 1.0 to 33%) in the relative amount of type IIa and
      IIx MHC and a corresponding decrease in type I MHC. However, type IIb MHC, which
      represents a major component in fast-twitch muscles, was not detected in
      suspended soleus muscles. TnT and TnI isoform composition was also changed with
      the appearance of fast-type TnI and TnT bands. However, a high-mobility TnT band,
      which represents a major component in fast-twitch muscles, was not expressed in
      suspended soleus. These isoform transitions may be related to the increased
      maximal velocity of shortening and higher calcium sensitivity previously reported
      in the rat soleus after hindlimb suspension.

PMID- 8482654
TI  - Dissipation of metabolic heat in the horse during exercise.
AB  - Horses were exercised at 40, 65, and 90% of their maximum O2 uptake (VO2max)
      until moderately fatigued (approximately 38, 15, and 9 min, respectively) to
      assess heat loss through different routes. Approximately 4,232, 3,195, and 2,333
      kcal of heat were generated in response to exercise at these intensities. Of
      this, approximately 7, 16, and 20% remained as stored heat 30 min postexercise.
      Respiratory heat loss, estimated from the temperature difference between blood in
      the pulmonary and carotid arteries and the cardiac output, was estimated to be
      30, 19, and 23% of the heat produced during exercise at the three intensities.
      The kinetics of the increases in muscle and blood temperature were similar, with
      the greatest change in temperature occurring in muscle (+3.8, 5.2, and 6.1
      degrees C after exercise at 40, 65, and 90% of VO2max, respectively). The
      temperature of blood in the superficial thoracic vein was approximately 2 degrees
      C below that of arterial blood at rest. This difference had increased to
      approximately 3 degrees C during the last minute of exercise. The rate of
      sweating at sites on the back and neck increased with exercise intensity to a
      common peak of approximately 40 ml.m-2.min-1. If complete evaporation had
      occurred, water loss in response to exercise (estimated to be 12, 10, and 7.7
      liters for the different intensities of exercise) greatly surpassed that required
      for dissipation of the metabolic heat load.

PMID- 8482655
TI  - Pulmonary interstitial pressure in intact in situ lung: transition to
      interstitial edema.
AB  - In anesthetized rabbits (n = 25) subject to slow intravenous saline loading (0.4
      ml.min-1.kg-1) for 3 h, we measured pulmonary interstitial pressure (Pip) in
      intact in situ lungs with glass micropipettes inserted directly into the lung
      parenchyma via a "pleural window." Measurements were done in apneic animals at
      the end-expiratory volume with O2 delivered in the trachea. Pip was -10 +/- 1.5
      (SD) cmH2O in control and increased to 0.6 +/- 3.8 and 5.7 +/- 3.3 cmH2O at 66
      and 180 min, respectively. The wet-to-dry weight ratio (W/D) of the lung was 5.04
      +/- 0.2 in the control group and 5.34 +/- 0.7 at 180 min (+6%); the corresponding
      W/D for intercostal muscles were 3.25 +/- 0.03 and 4.19 +/- 0.5 (+28%). Pulmonary
      interstitial compliance was 0.47 ml.mmHg-1.100 g wet wt-1. Pulmonary arterial and
      left atrial pressures were 18.4 +/- 2 and 3 +/- 1 cmH2O in control and increased
      to 19.5 +/- 2.9 and 4.6 +/- 1.7 cmH2O at 180 min, respectively. Aortic flow
      (cardiac output) increased from 103 +/- 35 to 131 +/- 26 ml/min; pulmonary
      resistance fell from 0.17 +/- 0.06 to 0.14 +/- 0.05 cmH2O.min.ml-1 (-18%),
      suggesting that the increase in Pip did not limit blood flow. The pulmonary
      capillary-to-interstitium filtration pressure gradient decreased sharply from a
      control value of 10 cmH2O to 0 cmH2O within 60 min because of the increase in Pip
      and remained unchanged for < or = 180 min. Data suggest that the pulmonary
      interstitial matrix can withstand fluid pressures above atmospheric, preventing
      the development of pulmonary alveolar flooding.

PMID- 8482656
TI  - Failure of vasodilator administration to increase blood flow to the fatiguing
      diaphragm.
AB  - Recent studies have suggested that coronary and limb muscle vessels do not
      maximally vasodilate under conditions in which cardiac and limb muscle
      contractile function is dependent on the level of blood flow but, rather,
      maintain a "vasodilator reserve." If a vasodilator reserve is also present in the
      fatiguing diaphragm, it may be possible to augment flow to this muscle with
      vasodilator administration, improving muscle function. The purpose of the present
      study was therefore to examine the effect of administration of a potent
      vasodilator, nitroprusside, on the blood flow and contractile function of the
      fatiguing diaphragm. Studies were performed using an in situ canine diaphragmatic
      strip preparation that permitted direct measurement of force and blood flow;
      cardiac output was monitored with a thermodilution catheter. The effects of
      nitroprusside were examined with the diaphragm rhythmically contracting in
      response to both subfatiguing and fatiguing stimulation paradigms. For both
      contraction paradigms, nitroprusside infusions elicited appreciable increases in
      cardiac output. Nitroprusside infusions also produced significant increases in
      diaphragmatic blood flow during subfatiguing diaphragmatic contractions but had
      no effect on flow during fatiguing contractions. Nitroprusside also had no effect
      on the rate of diaphragmatic fatigue. These data suggest that, under the
      conditions examined, the diaphragm exhausts its vasodilator reserve during the
      development of fatigue and vasodilator administration has no appreciable effect
      on diaphragm blood flow and function. Moreover, although vasodilator drugs with
      actions similar to nitroprusside are used clinically to augment flow to vital
      organs, our data would indicate that these drugs have no functionally significant
      effect on blood flow to the fatiguing diaphragm.

PMID- 8482657
TI  - Effects of intraphrenic injection of potassium on diaphragm activation.
AB  - The purpose of the present study was to determine whether potassium, injected
      into the arterial supply of the diaphragm, would reflexly alter efferent
      diaphragmatic motor outflow and systemic arterial pressure. Studies were
      performed using in situ canine diaphragm muscle strips in which the inferior
      phrenic artery and vein were cannulated and all other sources of strip blood flow
      were ligated. Injection of potassium (0.1 meq) into the inferior phrenic artery
      elicited a small transient (1-2 breaths) decrease in the peak strip tension
      developed during spontaneous muscle contractions, in peak integrated strip
      electromyographic (EMG) activity, and in the peak integrated EMG activity of the
      contralateral hemidiaphragm. This was followed by a more pronounced and more
      sustained increase in each of these parameters as well as an increase in systemic
      arterial pressure. This latter excitatory response was qualitatively similar to
      that induced by the injection of capsaicin (5 and 25 micrograms) into the phrenic
      artery. Section of the left phrenic nerve abolished the effects of intra-arterial
      potassium and capsaicin on systemic arterial pressure and right hemidiaphragm EMG
      activity. These data support the existence of a potent excitatory phrenic-to
      phrenic reflex that can be activated by potassium injection into the diaphragm.
      Activation of this pathway increases diaphragm motor activation and augments
      systemic arterial pressure.

PMID- 8482658
TI  - Bilateral deficit is larger for step than for ramp isometric contractions.
AB  - The force produced by a muscle group during a maximum effort bilateral task has
      been reported to be less than that produced during a maximum effort unilateral
      task. It was hypothesized that if decreased activation of primarily fast motor
      units is responsible for this bilateral deficit, 1) the bilateral deficit would
      be larger in step than in ramp isometric contractions and 2) the rate of torque
      generation in step contractions would be slower in bilateral than in unilateral
      tasks. Twelve healthy male subjects performed unilateral and bilateral isometric
      knee joint extension tasks in which maximum torque was generated under ramp and
      step conditions. The maximum torques produced in the bilateral tasks were 17.0
      and 24.6% less than those produced in the unilateral tasks during the ramp and
      step conditions, respectively (both P < 0.001). The bilateral torque deficit for
      the step condition was significantly greater than that for the ramp condition (P
      = 0.012). The rate of torque generation in the step condition was 19.7% slower in
      the bilateral than in the unilateral task (P = 0.010). Thus the results from
      these torque measurements support the notion that decreased activation of
      primarily fast motor units may be responsible for the bilateral deficit.

PMID- 8482659
TI  - Evaluation of various models for respiratory inductance plethysmography
      calibration.
AB  - We evaluated one nonlinear and two linear models of the ventilatory system while
      calibrating the respiratory inductance plethysmograph (RIP) against a
      pneumotachometer. A calibration method involving voluntary varying rib cage and
      abdominal contributions to tidal volume in a single body position was utilized.
      The influence on accuracy of the choice of respiratory phase during calibration
      was assessed. Both tidal and intratidal volumes were evaluated. Ten adults with
      no history of respiratory disorders went through RIP calibration and validation
      in the sitting and supine positions. A linear calibration model, relating lung
      volume changes from the start of inspiration or expiration to rib cage and
      abdominal excursions from initiation of respiratory motion, had the best
      accuracy. The choice of respiratory phase for calibration did not affect
      accuracy. RIP generally underestimated lung volume at the start of inspiration
      and overestimated lung volume at the end of inspiration. RIP was more accurate in
      the supine than the sitting position, probably because of limited spine flexion
      in the supine position.

PMID- 8482660
TI  - Effects of long-term continuous respiratory resistive loading on rat diaphragm
      function and structure.
AB  - The effects of long-term (24- to 28-wk) continuous respiratory resistive loading
      on diaphragm mass, contractility, fatigue, and fiber types were studied in male
      rats. Increased respiratory resistance was produced by extratracheal banding, and
      results were compared with sham-operated pair-fed controls. At the time the
      animals were killed, banded tracheal segment internal diameter was reduced by 57%
      of control values. Diaphragm surface area and muscle mass (normalized for body
      mass) increased by 19% of control values. Isometric diaphragm contractility and
      fatigue resistance indexes were measured using an in vitro diaphragm costal strip
      preparation at 37 degrees C. Twitch and tetanic stimulations were evoked using
      direct stimulation. Compared with controls, baseline tensions (normalized for
      diaphragm cross-sectional area) were significantly decreased at low frequencies.
      Fatigue resistance (endurance) indexes were significantly increased at all
      frequencies. These findings were consistent with observed increases in number and
      cross-sectional area of type I (low-tension high-endurance) fibers. We conclude
      that the diaphragm adapts to chronic long-term resistive loads by sacrificing
      peak tensions for an increase in endurance capacity.

PMID- 8482661
TI  - Renin-angiotensin system stimulates respiration during acute hypotension but not
      during hypercapnia.
AB  - We reported that intravenous infusion of angiotensin II (ANG II) stimulated
      ventilation (VE) in conscious dogs. Other studies in our laboratory have
      demonstrated that increases in respiration occurred in association with
      activation of the renin-angiotensin system during acute hypotension and during
      hypercapnia. Therefore, in conscious dogs (n = 5), we examined the effects of ANG
      II receptor blockade with intravenous saralasin (0.5 micrograms.kg-1.min-1) on
      respiratory responses during progressive nitroprusside-induced hypotension and
      during the ventilatory response to increased inspired fraction of CO2 (VRC).
      During hypotension (mean arterial pressure decreased approximately 20%) combined
      with ANG II receptor blockade, VE, heart rate, and arginine vasopressin increases
      were attenuated compared within unblocked studies. With ANG II receptor blockade
      during hypotension, alveolar ventilation and arterial PCO2 (PaCO2) were
      unchanged, which contrasted with a doubling of alveolar ventilation and a
      decrease of 4.8 +/- 1 Torr in PaCO2 in unblocked studies. During hypercapnia, the
      slope of the VRC was not affected by ANG II receptor blockade, but with 6.5%
      inspired CO2 fraction, VE and PaCO2 were lower than in unblocked studies. These
      results indicated that ANG II contributed to the respiratory response to a modest
      hypotension but did not affect respiratory sensitivity to CO2.

PMID- 8482662
TI  - Selective brain cooling is affected by wearing headgear during exercise.
AB  - The purpose of this work is to relate the concept of selective brain cooling
      (SBC) during exercise to heat loss from the head while either bare or covered.
      During hyperthermia, SBC is considered to occur if tympanic temperature (Tty) is
      lower than esophageal temperature (Tes). In experiment I the head heat loss was
      measured with and without headgear. Each of four subjects took part in three
      sessions of exercise on a cycle ergometer. The face was cooled to simulate
      outdoor conditions. The first session (no headgear) served as control for the two
      following sessions in which a headband and a woolen cap were worn. Evaporative
      and radiative-convective heat loss were monitored from the head. Wearing a cap
      significantly reduced the heat loss from the head compared with the control
      condition. During the headband session the heat loss was not significantly lower
      than the control values. Tty, Tes, and head skin temperatures (T(sk)) were also
      recorded. Tty was significantly lower (-0.55 +/- 0.15 degrees C) than Tes at the
      end of exercise (150-W exercise load) when no headgear was worn. During headgear
      sessions, Tty was no longer significantly lower than Tes, either during the
      headband (-0.15 +/- 0.31 degrees C) or during the cap session (-0.30 +/- 0.13
      degrees C). In experiment II the influence of wearing headgear on temperature
      regulation was studied. Hand skin blood flow, hand T(sk), and heat loss from the
      hand were recorded in addition to the variables monitored in experiment I.
      Wearing headgear elevated Tty and peripheral vasomotor responses, whereas Tes
      evolved in the opposite direction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482663
TI  - Body fluid compartments, renal blood flow, and hormones at 6,000 m in normal
      subjects.
AB  - We previously described a syndrome of congestive heart failure occurring in
      healthy young men at extreme altitude (Anand et al. Lancet 335: 561-565, 1990).
      The pathogenesis of this condition is unclear. We therefore measured body fluid
      compartments, renal blood flow, and a variety of plasma hormones in 10
      asymptomatic young men staying above 6,000 m for > 10 wk and compared the results
      with controls at sea level. Body compartments were measured with isotope dilution
      techniques and renal blood flow with o-[125I]iodohippurate sodium. There was a
      marked expansion of all the fluid spaces: total body sodium was 14% above normal
      (P < 0.05), total body water was 18% above normal (P < 0.05), plasma volume was
      33% above normal (P < 0.05), and blood volume was 84.5% above normal (P < 0.001).
      The effective renal plasma flow was lower than normal by 55% (P < 0.001), but the
      reduction in the effective renal blood flow was 37% below normal (P < 0.001)
      because the hematocrit was high (41.6% above normal). Plasma norepinephrine was
      nearly 3 times normal (P < 0.01), cortisol 3 times normal (P < 0.001), and growth
      hormone 18 times normal (P < 0.01). Aldosterone was twice normal (P < 0.03).
      Plasma epinephrine, atrial natriuretic peptide, and plasma renin activity were
      unchanged. The degree of fluid retention in these normal subjects was similar to
      that in patients with severe untreated congestive heart failure (Anand et al.
      Circulation 80: 299-305, 1989), whereas sodium retention and reduction in
      effective renal blood flow were less.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482664
TI  - Surfactant treatment effects on alveolar type II cell morphology in rabbit lungs.
AB  - The effects of exogenous surfactant administration on alveolar type II cells and
      the lung parenchyma were examined in adult rabbits. Natural surfactant was
      instilled into the left lobe of New Zealand White rabbits while the right lobe
      served as the control. Four hours post-instillation, the lungs were fixed by
      vascular perfusion. Surfactant instillation did not change alveolar type II cell
      size but was associated with a significant reduction in the volume fraction of
      lamellar bodies in type II cells (20.4% in control lobes compared with 11.9% in
      surfactant-treated lobes). The size distribution of lamellar body profiles was
      different in surfactant-treated lobes compared with control lobes, with a
      significant decrease in lamellar bodies > 0.8 microns in diameter and a twofold
      increase in lamellar bodies 0.2-0.4 microns in diameter. Composite body profile
      number was also increased by 87% (P < 0.05) after instillation of surfactant
      compared with control. Saline instillation decreased lamellar body volume
      fraction in type II cells but three times less than surfactant instillation.
      These observations are consistent with a strong stimulus for secretion of
      endogenous surfactant 4 h after surfactant instillation in normal adult rabbit
      lungs, whereas the increase in composite bodies is consistent with new lamellar
      body formation, probably from both de novo synthesized and exogenous natural
      rabbit surfactant. These observations confirm that the secretory and synthetic
      processes of alveolar type II cells are significantly affected by exogenous
      surfactant instillation.

PMID- 8482665
TI  - Heat stress does not modify lactate exchange and removal abilities during
      recovery from short exercise.
AB  - Arterial and femoral venous lactate concentrations were measured before, during,
      and after short intermittent exercise (55-118% of maximal O2 consumption) in
      thermoneutral (N, 25 degrees C, 10.5 Torr) and hot (H, 45 degrees C, 17.5 Torr)
      conditions. The thermal load induced significantly higher heart rate and rectal
      temperature in H relative to N. All the arterial lactate (La) recovery curves
      were fitted to an equation containing two exponential time functions of the form
      La(t) = La(0) + A1a(1 - e-gamma 1at) + A2a(1 - e-gamma 2at) where the velocity
      constants gamma 1a and gamma 2a are the body's overall ability to exchange and
      remove lactate after exercise, respectively, and t is time. There was no
      significant difference in these constants, regardless of thermal conditions. The
      arterial lactate concentration at the end of exercise, the peak lactate
      concentration during recovery, the amplitudes A1a and A2a of the biexponential
      function, and the arteriofemoral venous lactate concentration difference during
      recovery were not significantly different in H relative to N. However, measured
      and computed arterial lactate concentrations during recovery, especially at the
      end of the tests, were higher in H (P < 0.04). The more elevated lactate
      concentrations in H at rest at the end of recovery denote a higher basal lactate
      production, and they were not due to muscle hypoxia.

PMID- 8482666
TI  - Lung function and surfactant distribution in saline-lavaged sheep given instilled
      vs. nebulized surfactant.
AB  - Adult sheep (35 +/- 3 kg) underwent saline lung lavage and 1.5 h of mechanical
      ventilation to induce acute lung injury. Animals received 100 mg lipid/kg body wt
      of tracheally instilled surfactant (Inst Surf) or either nebulized surfactant
      (Neb Surf) or nebulized saline (Neb Saline) and were killed 3 h later. Inst Surf
      and Neb Surf groups had significant improvements in oxygenation (P < 0.01) and
      peak inspiratory pressures (PIP) (P < 0.05) compared with pretreatment values.
      Improvements in oxygenation and PIP for Inst Surf animals were significantly
      greater than for Neb Surf animals (P < 0.05). Volumes of maximal pressure of
      quasi-static pressure-volume curves measured at the time the animals were killed
      were significantly greater for Inst Surf and Neb Surf animals than for animals
      given Neb Saline (P < 0.05). Alveolar recovery of exogenous surfactant was 100
      times greater for Inst Surf animals (1,732 +/- 70 mg) than for Neb Surf animals
      (15.3 +/- 2.9 mg) at the time they were killed. Although there were no
      differences in exogenous surfactant distribution patterns at the lobar level
      between the two surfactant-treated groups, distribution histograms calculated for
      10-g lung pieces revealed the Neb Surf animals had significantly more pieces
      within 25% of the mean value of 1.0 (42.7 +/- 6.9%) than did Inst Surf animals
      (20.8 +/- 5.5%) (P < 0.01). Exogenous surfactant therapy improved lung function
      with significantly different quantities of surfactant deposited in lung tissue
      for the two delivery methods evaluated.

PMID- 8482667
TI  - Hemodynamic and respiratory responses to carotid sinus pressure alteration in
      experimental hypertension.
AB  - The purpose of this study was to determine whether baroreflex control of
      respiratory responses is diminished in hypertension. Ten dogs were made
      chronically hypertensive with use of a bilateral renal wrap technique. Eight sham
      operated dogs served as normotensive controls. After the development of
      experimental hypertension, carotid baroreflex control of arterial pressure, heart
      rate, respiratory frequency, tidal volume, and ventilation was acutely assessed.
      Under pentobarbital anesthesia and with bilateral vagotomy, the carotid sinuses
      were isolated and perfused at controlled pressures. Before the carotid sinus
      region was manipulated, the mean arterial pressure was significantly higher (P <
      0.005) in the hypertensive group (146.4 +/- 2.3 mmHg) than in the normotensive
      group (124.7 +/- 2.6 mmHg). The mean arterial pressures and heart rates measured
      at every level of carotid sinus pressure were significantly higher in the
      hypertensive group. Reflex gain of heart rate, but not mean arterial pressure,
      was significantly reduced in the hypertensive group. Respiratory frequency, tidal
      volume, and ventilatory responses to changes in carotid sinus pressure were
      significant and resulted in an approximately 40% reflex change in ventilation.
      These responses were not diminished in the hypertensive group. We conclude that
      respiratory baroreflex responses are preserved in experimental hypertension.

PMID- 8482668
TI  - Site and mechanical conditions for failure of skeletal muscle in experimental
      strain injuries.
AB  - Failure in muscle strain injuries has been reported to occur within the muscle
      belly, at the myotendinous junction, or within muscle near the myotendinous
      junction. The goal of this investigation was to determine by electron-microscopic
      examination the site of lesion in whole muscle strained to failure. In addition,
      site and conditions for failure of stimulated and unstimulated muscle were
      compared. Frog semitendinosus myotendinous units with intact tendon-bone
      junctions were strained at physiological strain rates to failure. All failures
      occurred at or near the proximal myotendinous junction in both stimulated and
      unstimulated muscle. Stimulated muscle required approximately 30% more force and
      approximately 110% more energy to reach failure. Electron-microscopic examination
      of longitudinal sections of small bundles of fibers showed that unstimulated
      muscle failed within the muscle near the myotendinous junction. Failure occurred
      in a single transverse plane of each cell within Z disks. Other Z disks near the
      failure site displayed strains of several hundred percent. Stimulated muscle
      failed within the lamina lucida at the myotendinous junction in most fibers. No Z
      disk strain was observed in those fibers. We conclude that the site of failure in
      muscle strain injuries varies with the state of activation of the cell at the
      time of injury. Furthermore, the data show that the breaking strength of the Z
      disk varied with muscle stimulation and indicate the existence of two load
      bearing systems in parallel within Z disks.

PMID- 8482669
TI  - Inhaled nitric oxide reverses hypoxic pulmonary vasoconstriction without
      impairing gas exchange.
AB  - Nitric oxide (NO) is an endogenous endothelium-derived relaxing factor that
      participates in the regulation of vascular tone. We studied the effects of
      inhaled NO gas on transient hypoxic pulmonary vasoconstriction and normal lungs
      in mechanically ventilated sheep. We measured hemodynamics and pulmonary gas
      exchange. For gas exchange measurements we used conventional blood gas analysis
      and the multiple inert gas elimination technique to estimate ventilation
      perfusion heterogeneity. Our hypotheses were 1) inhaled NO reverses hypoxic
      pulmonary vasoconstriction, 2) the hemodynamic effects of inhaled NO are limited
      to the pulmonary circulation, and 3) inhaled NO does not impair pulmonary gas
      exchange and may redistribute blood flow to better ventilated areas of the lungs.
      Hypoxic pulmonary vasoconstriction was induced by using a hypoxic inspiratory gas
      mixture. The addition of 20 ppm NO to the hypoxic inspiratory gases returned
      pulmonary arterial pressure to baseline values. Systemic hemodynamics and gas
      exchange indexes derived from conventional blood gas analysis remained constant.
      Gas exchange indexes for ventilation-perfusion ratios and gas dispersions
      improved. The addition of 20 ppm NO to medical air (21% O2) had no such
      significant effects on hemodynamics or pulmonary gas exchange. Our findings show
      that inhaled NO reverses transient hypoxic pulmonary vasoconstriction. The
      hemodynamic effects of NO are limited to the pulmonary circulation; it does not
      impair pulmonary gas exchange. Moreover, it redistributes blood flow to better
      ventilated alveoli. As such, NO has potential in the treatment of lung diseases
      associated with pulmonary hypertension.

PMID- 8482670
TI  - Breathing volumes and gas exchange during simulated rapid free ascent from 100
      msw.
AB  - The crew of a disabled submarine can be rescued by means of free ascent through
      the water to the surface. Pulmonary gas exchange was studied during simulated
      rapid free ascent in subjects standing immersed to the neck in a pressure
      chamber. The pressure was rapidly increased to 1.1 MPa [100 meters seawater
      (msw)] followed by decompression at 0.03 MPa/s (3 msw/s). Effective inspired
      tidal volume, as estimated by an Ar dilution method, fell gradually to zero
      during decompression from 20 to 0 msw. Directly determined expired tidal volumes
      were increased up to two to three times at the time of return to surface pressure
      compared with pre- and postdecompression volumes. End-tidal PCO2 was increased on
      compression and fell to a nadir of 3.4 kPa (25 Torr) at the time of return to
      surface pressure. Thus, intrapulmonary gas expansion caused simultaneous
      inspiratory hypoventilation and expiratory hyperventilation. If O2-enriched gas
      is to be used to reduce the risk of decompression sickness, it should be
      administered early during decompression to alter the intrapulmonary gas
      composition. The time course of arterial PCO2 changes as reflected by end-tidal
      values during short-lasting compression/decompression would act to promote inert
      gas supersaturation in the brain.

PMID- 8482671
TI  - Cardiopulmonary adaptations to pneumonectomy in dogs. II. VA/Q relationships and
      microvascular recruitment.
AB  - Ventilation-perfusion relationships, diffusing capacity for O2, and hemodynamic
      response were measured at rest and during exercise while five adult dogs breathed
      air and 15% O2 2 mo (Pnx-A, n = 2) or 12 mo (Pnx-B, n = 3) after right
      pneumonectomy (removal of 58% of lung tissue). Results were compared with those
      in five sham-operated controls. The multiple inert gas elimination technique was
      employed. Maximal O2 uptake was reduced by 50% in Pnx-A and by 15% in Pnx-B.
      Ventilation-perfusion matching was impaired in Pnx-A but not in Pnx-B. The
      increase in O2 diffusing capacity during exercise was significantly restricted in
      Pnx-A but was partially restored in Pnx-B. Mean pulmonary arterial pressure at a
      given blood flow through the remaining lung was normal in Pnx-A but lower than
      normal in Pnx-B compared with control values for a single lung. Stroke volume and
      cardiac output were lower in both Pnx-A and Pnx-B than in controls at a given
      exercise level. All functional abnormalities were more severe at 2 mo than at 12
      mo postpneumonectomy. Gas phase diffusion resistance was present in both Pnx-A
      and Pnx-B but not in controls. We conclude that physiological compensation
      postpneumonectomy is progressive. Inability to recruit pulmonary vascular bed
      with incremental perfusion pressure or flow appears to be the major
      pathophysiological process that limits early functional capacity after right
      pneumonectomy.

PMID- 8482672
TI  - Protein kinase C-mediated pulmonary vasoconstriction in rabbit: role of Ca2+, AA
      metabolites, and vasodilators.
AB  - We studied the effects of three chemically distinct protein kinase C activators
      on pulmonary vascular tone in the buffer-perfused isolated rabbit lung. The three
      activators, 12-deoxyphorbol 13-isobutyrate (12,13-phorbol), mezerein, and 1
      oleoyl-2-acetyl-sn-glycerol, produce concentration-dependent increases in
      pulmonary arterial pressure, whereas the inactive compound 4 alpha-phorbol 12,13
      dibutyrate does not affect pulmonary arterial pressure. Reducing calcium
      availability with verapamil, a calcium-free buffer, or a chelator of
      intracellular calcium significantly decreases the response to 12,13-phorbol or
      mezerein. Pretreatment with phloretin, an inhibitor of protein kinase C, has no
      affect on the vasoconstriction caused by infusion of a KCl bolus, but it does
      inhibit in a dose-dependent manner the response to 12,13-phorbol and mezerein.
      12,13-Phorbol at a concentration of 2.5 microM, but not of 1 microM, stimulates
      prostacyclin and thromboxane synthesis by the isolated lung. Because inhibitors
      of thromboxane synthesis significantly decrease the response, thromboxane likely
      contributes to the vasoconstriction produced by higher concentrations of 12,13
      phorbol and mezerein. Pretreatment with isoproterenol or nitroprusside reduces
      the increase in pulmonary arterial pressure caused by the protein kinase C
      activators but does not reverse vasoconstriction, even though subsequent
      treatment with verapamil does. In summary, activating protein kinase C in the
      isolated rabbit lung causes long-lasting pulmonary vasoconstriction, reducing
      calcium availability decreases the response, part of the increase in pulmonary
      arterial pressure appears secondary to thromboxane generation, and pretreatment
      with isoproterenol or nitroprusside prevents the vasoconstriction, but
      posttreatment with these vasodilators is ineffective.

PMID- 8482673
TI  - Relationship of pulmonary arterial pressure and airflow obstruction to emphysema.
AB  - Guinea pigs were exposed to cigarette smoke for 6 mo, after which lung and
      cardiac function and lung morphology were examined. The smoke-exposed animals
      were divided into two groups on the basis of final pulmonary arterial pressure.
      We found that the smoke-exposed animals with increased pulmonary arterial
      pressure had a moderate degree of airflow obstruction compared with the
      normotensive smoke group, which showed only mild airflow obstruction, and with
      the control group. Both smoke groups had similar degrees of emphysema. Although
      both smoke groups had an increased percentage of muscularized small arterioles,
      only the group with increased pulmonary arterial pressure had an altered flow
      pressure response to dobutamine. We conclude that although cigarette smoke
      appears to induce changes in the vascular structure and to produce emphysematous
      lung destruction, the increased pulmonary arterial pressure in guinea pigs
      chronically exposed to smoke is not directly related to either of these findings.
      Instead, it appears that there is a dynamic alteration of both the airways,
      producing airflow obstruction, and the vasculature, producing increased pulmonary
      arterial pressure.

PMID- 8482674
TI  - Effect of inspiratory muscle unloading on arousal responses to CO2 and hypoxia in
      sleeping dogs.
AB  - Chemical respiratory stimuli can induce arousal from sleep, but the specific
      mechanisms involved have not been established. Therefore, we tested the
      hypothesis that mechanoreceptor stimuli arising in the ventilatory apparatus have
      a role in the arousal responses to progressive hypercapnia and hypoxia by
      comparing arousal responses during spontaneous ventilation with those obtained
      when the inspiratory muscles were unloaded by mechanical ventilatory assistance.
      Studies were performed in three trained dogs in which the adequacy of inspiratory
      muscle unloading was verified by diaphragmatic electromyographic (EMG)
      recordings. In rapid-eye-movement (REM) sleep the arousal threshold during
      progressive hypercapnia increased from 68.4 +/- 0.5 (SE) mmHg during spontaneous
      runs to 72.3 +/- 0.8 mmHg during mechanically assisted runs (P < 0.01). In
      contrast there were no changes in arousal responses to hypercapnia during non-REM
      (NREM) sleep or to hypoxia in either NREM or REM sleep. However, during the
      assisted hypoxic runs, EMG activity of the transversus abdominis muscle was
      increased compared with the unassisted runs; therefore, the effects on arousal
      threshold of unloading the inspiratory muscles may have been offset by increased
      loading of the expiratory muscles. The findings indicate that even in the absence
      of added mechanical loads, mechanoreceptor stimuli probably arising in the
      respiratory muscles contribute to the arousal response to hypercapnia during REM
      sleep.

PMID- 8482675
TI  - Inhaled FMLP increases microvascular permeability in the rabbit trachea.
AB  - This study was designed to determine the effect of inhaled N-formyl-methionyl
      leucyl-phenylalanine (FMLP) on microvascular permeability in the rabbit trachea
      and to determine if the effect could be modified by cholinergic antagonism,
      neutral endopeptidase (NEP) inhibition, opioid receptor antagonism, or an opioid
      agonist. New Zealand White rabbits were anesthetized and pretreated intravenously
      with one of the following: saline, dimethyl sulfoxide (DMSO) (both controls),
      thiorphan, phosphoramidon (both NEP inhibitors), thiorphan and naloxone,
      morphine, or atropine. All rabbits were then given intravenous Evans blue before
      inhalation of nebulized DMSO (control) or FMLP. Extravascular tracheal Evans blue
      concentration was subsequently determined spectrophotometrically. FMLP caused a
      highly significant increase in microvascular permeability (92.6 +/- 7.1
      micrograms/g of trachea, control 20.4' +/- 3.4). The effect of FMLP was
      significantly modified by cholinergic blockade (61.1 +/- 6.9) and by NEP
      inhibition (thiorphan 38.8 +/- 5.6, phosphoramidon 52.6 +/- 4.2). This effect of
      NEP inhibition could be reversed by concurrent treatment with the opioid receptor
      antagonist naloxone (95.9 +/- 34.6). Morphine had no significant effect. We
      concluded that FMLP increases microvascular permeability, which may in part
      explain the effect of FMLP on airway resistance in the rabbit. Inhibiting NEP
      decreases the response possibly through an effect on endogenous opioids. The
      response appears to be partially vagally mediated.

PMID- 8482676
TI  - Muscle metabolism during lactate infusion in human phosphofructokinase
      deficiency.
AB  - We studied the effect of intravenous infusion of sodium lactate (La) on muscle
      high-energy phosphate metabolism, pH, and venous effluent [NH3] in three patients
      with muscle phosphofructokinase (PFK) deficiency and three healthy subjects
      during maximal-effort rhythmic handgrip exercise (5 s of contraction alternated
      with 5 s of rest) performed for 3 min. Healthy subjects were matched to PFK
      deficient patients for gender and maximal handgrip strength. Force production was
      recorded and during lactate infusion was matched to that without lactate. 31P
      magnetic resonance spectroscopy was used to measure intracellular phosphocreatine
      (PCr), orthophosphate (Pi), ATP, and pH in the flexor digitorum profundus of the
      exercising forearm. La infusion had no effect on healthy subjects or patients
      during rest. In healthy subjects, La infusion had no effect on depletion of PCr;
      accumulation of Pi, ADP, or venous effluent NH3; or decline in pH in exercising
      muscle. In contrast, during exercise in PFK-deficient patients, [PCr] was higher
      (17.9 +/- 1.9 vs. 13.1 +/- 1.4 mmol/kg) and [phosphomonoester] (11.4 +/- 1.3 vs.
      6.5 +/- 1.4 mmol/kg), [Pi] (9.2 +/- 1.8 vs. 5.0 +/- 0.7 mmol/kg), [ADP] (60.4 +/-
      7.0 vs. 37.9 +/- 9.9 mumol/kg), and venous effluent [NH3] (335 +/- 136 vs. 176 +/
      61 mM) were lower (P < 0.05) during La infusion than in control conditions. The
      effects of La infusion on intracellular [PCr], [Pi], [phosphomonoester], [ADP],
      and [NH3] in PFK-deficient patients are consistent with the hypothesis that
      exogenous La augments the rate of oxidative phosphorylation in active muscle by
      bypassing the enzymatic block at PFK.

PMID- 8482677
TI  - Role of tendon properties on the dynamic performance of different isometric
      muscles.
AB  - The effect of the tendon's viscoelastic stiffness on the dynamic performance of
      muscles with different architecture was determined using the cat's medial
      gastrocnemius and extensor digitorum longus. Dynamic response models were derived
      under sinusoidal contraction-relaxation in the range of 0.4-6.0 Hz and between 20
      and 80% of the muscles' maximal isometric tension, manipulated by orderly
      recruitment-derecruitment of motor units together with firing rate increase
      decrease. It was shown that, for isometric contractions at the muscle's optimum
      length, the dynamic response of the muscles was not significantly different
      before and after dissection of the tendon. Therefore the conclusion that under
      these conditions the tendon acts like a stiff force transmitter without
      significantly modifying the muscle's performance was confirmed and extended to
      muscles with different architecture.

PMID- 8482678
TI  - Quantifying the effect of intravascular perfluorocarbon on xenon elimination from
      canine muscle.
AB  - Intravenous infusions of perfluorocarbon (PFC) may improve decompression sickness
      outcome in animals by accelerating inert gas elimination from tissue, but any
      such effect has not been quantified experimentally. In this study we used an
      animal model of tissue Xe kinetics to test this hypothesis and to quantify the
      effect of PFC. Eight dogs were ventilated with dilute 133Xe in air for 4 h of Xe
      uptake. Four dogs were then given an infusion (20 ml/kg iv) of a 40% (vol/vol)
      perfluorodecalin-glycerol emulsion, and four control dogs were given only
      isotonic glycerol. All were then switched to open-circuit air breathing for 4 h
      of Xe elimination. During this time Xe radioactivity-time curves were recorded
      from two intact hind leg muscles, and the Xe mean residence times during
      elimination were estimated using an analysis by moments and compared by group.
      Tissue blood flows were measured using microspheres once during Xe uptake and
      twice during Xe elimination, and cardiac outputs were measured by thermodilution
      at 30-min intervals. In the PFC group the measured circulating PFC fraction
      increased the calculated Xe solubility by an average factor of 1.77 and so was
      expected to increase the Xe elimination rate by 77%. The observed Xe mean
      residence times on elimination for the PFC group averaged 33.5 min [95%
      confidence interval (CI) 19.5-47.6] compared with the glycerol control average of
      70.1 min (95% CI 56.1-84.2), representing an increase in the rate of Xe
      elimination by a factor of 2.09 or 109%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482679
TI  - Physical and cytochemical properties of neutrophils activated in situ in the lung
      during ZAP infusion in sheep.
AB  - Increased retention of activated neutrophils in the lungs contributes to
      endothelial cell injury. However, characterization of the morphological changes
      that occur in neutrophils during activation in the pulmonary microcirculation has
      not been fully determined in vivo. Therefore, the present study was designed to
      determine structural and cytochemical properties of neutrophils in situ in
      pulmonary arterioles and alveolar capillaries during the infusion of zymosan
      activated plasma (ZAP) or plasma (control) in anesthetized sheep. Quantitative
      morphological methods showed that ZAP infusion caused significant retention of
      neutrophils in alveolar capillaries [2.19 +/- 0.40 (SD) x 10(8) neutrophils/ml of
      capillary blood volume] and pulmonary arterioles (1.02 +/- 0.46 x 10(8)
      neutrophils/ml of arterial blood volume) compared with plasma infusion (1.03 +/-
      0.15 and 0.30 +/- 0.10 x 10(8) neutrophils/ml, respectively; P < 0.05). Harmonic
      mean diameter of ZAP-activated neutrophils in situ (7.19 +/- 0.44 microns) was
      significantly greater than the diameter of neutrophils in plasma-treated sheep
      (6.29 +/- 0.17 microns; P < 0.05). Neutrophil cross-sectional area (54 +/- 3
      microns2) and volume (248 +/- 27 microns3) in situ in alveolar capillaries were
      also significantly greater in ZAP-treated sheep than in control sheep (41 +/- 4
      microns2 and 184 +/- 9 microns3, respectively; P < 0.05). Similarly,
      microvascular neutrophils in ZAP-treated sheep were vacuolated and elongated,
      filamentous actin was redistributed peripherally, and the cells were
      degranulated. We conclude that during ZAP infusion, neutrophils become enlarged
      and degranulated in pulmonary microvessels, especially in alveolar capillaries.
      The structural and cytochemical changes that occur are consistent with the
      hypothesis that neutrophil activation is accompanied by alterations in neutrophil
      physical properties, alterations that may facilitate retention and contribute to
      endothelial cell injury.

PMID- 8482680
TI  - Factors influencing measurement of protein reflection coefficient by filtered
      volume technique.
AB  - In isolated perfused organs, the protein reflection coefficient (sigma) can be
      estimated by comparing increases in hematocrit (Hct) and protein concentration
      (CP) during transvascular fluid filtration. In this study, we developed an
      equation for sigma to examine the potential influences of perfusate leak,
      evaporation, and hemolysis-induced changes in red blood cell volume and perfusate
      water. We also performed experiments in isolated ferret lungs to quantitate the
      magnitude of these potential sources of error and the effects of free hemoglobin
      on measurements of CP. These studies demonstrated that 1) perfusate leak does not
      cause an error because its effects on changes in Hct and CP counteract each
      other; 2) evaporation causes an overestimation of sigma, but in our experiments
      this effect was small; 3) hemolysis-induced changes in red blood cell and
      perfusate water volumes may cause an over- or underestimation of sigma, but these
      effects are small; 4) overestimations of CP due to increasing free perfusate
      hemoglobin concentration can cause substantial overestimations of sigma; and 5)
      values of sigma calculated from previous equations and from our equation were
      virtually identical, suggesting that the assumptions necessary for the previous
      equations were not significant sources of error. In agreement with previous
      workers, we conclude that the most important potential source of error is
      hemolysis-induced increases in free perfusate hemoglobin.

PMID- 8482681
TI  - Skeletal muscle calcium-activated neutral protease (calpain) with exercise.
AB  - The purpose of this study was to investigate whether exercise could induce
      calpain activation by altering the Ca2+ required for half-maximal activity
      (pCa50) and/or susceptibility of digestible muscle protein substrates. Rats (225
      g) were assigned to control, exercise (25 m/min, 0% grade), and 24-h recovery
      groups. Exercise resulted in a generalized 48 +/- 18% loss of muscle glycogen and
      a twofold increase in plasma creatine kinase levels (P < or = 0.05). Exercise
      increased total caseinolysis of diethylaminoethyl Sepharose-prepared low (u) and
      high (m) Ca2+ calpain isoforms by 22 and 30%, respectively (P < or = 0.05). The
      pCa50 of u- and m-calpain with exercise increased from 5.98 +/- 0.12 to 6.20 +/-
      0.15 (P > or = 0.05) and from 3.63 +/- 0.10 to 3.90 +/- 0.16 (P > or = 0.05),
      respectively. In vitro, calpain-mediated degradation/disappearance rates (i.e.,
      percentage of protein degraded in 10 min) for control tropomyosin and alpha
      actinin were 69 and 30% compared with 92 and 61% after exercise (P < or = 0.05).
      The results of this study confirm that level running increases total nonlysosomal
      Ca2+ specific protease activity, which may promote exercise-induced muscle damage
      or fatigue.

PMID- 8482682
TI  - Tissue resistance and the contractile state of lung parenchyma.
AB  - When challenged with a contractile agonist in increasing graded concentrations,
      lung parenchymal tissue assumes a sequence of mechanical states. That sequence is
      mapped here. Isolated lung parenchymal strips from male Hartley guinea pigs were
      mounted in a bath containing Krebs solution at 37 degrees C, aerated with 95% O2
      5% CO2. One end was attached to a force transducer and the other to a servo
      controlled lever arm. After stress adaptation, sinusoidal length oscillations (1%
      strain at 0.31 Hz) yielded force-length loops from which we computed induced
      changes in active tension (F), tissue stiffness (E), and hysteresivity (eta) (J.
      J. Fredberg and D. Stamenovic. J. Appl. Physiol. 67:2408-2419, 1989). Changes of
      tissue resistance (R) were, by definition, governed by those of eta and E.
      Histamine (10(-6) -10(-3) M), prostaglandin D2 (10(-5) -10(-4) M), and
      prostaglandin F2 alpha (10(-5) -10(-4) M) caused dose-related increases of F,
      eta, and E. Plotting induced changes of E vs. those of F revealed a unique
      relationship that was identical for these as well as a wider panel of contractile
      agonists; changes of E and F were closely associated. However, plotting induced
      changes of E vs. those of eta revealed relationships that differed distinctly
      between agonists; changes of eta were dissociated from those of F and E. This
      latter observation demonstrated the existence of distinct mechanical states that
      differed according to the specific agonist by which the tissue was stimulated. In
      producing agonist-induced changes in R, changes of E were of equal or greater
      importance compared with those of eta. We conclude that guinea pig lung
      parenchyma, viewed as an integrated physiological tissue system, exhibits
      different kinds as well as varying intensities of mechanical response according
      to the specific agonist present in the cellular microenvironment. These
      differences in contractile state reveal themselves principally in the hysteretic
      nature of the tissue.

PMID- 8482683
TI  - Abdominal compliance, parasternal activation, and chest wall motion.
AB  - We measured abdominal compliance (Cab) and rib cage displacement (delta Vrc)
      relative to abdominal displacement (delta Vab) during relaxation and tidal
      breathing in upright (U) and supine (S) postures in five normal subjects. In S,
      an abdominal binder was used to decrease Cab in two to five increments. We also
      measured the electrical activity of the parasternal muscle (EMGps) with the use
      of fine-wire intramuscular electrodes during CO2 rebreathing in U and in supine
      unbound (SU) and supine bound (SB) postures. During maximum binding (SB2), Cab
      decreased to 39 +/- 7% of the SU value (P = 0.01), matching Cab in U (P = 0.16).
      In the SB condition, the ratio of tidal delta Vrc/delta Vab to relaxation delta
      Vrc/delta Vab increased as Cab decreased, matching the data in U. For the group,
      this ratio decreased during SU to 47 +/- 10% (P = 0.02) but increased during SB2
      to 86 +/- 7% (P = 0.18) of the value in U. During CO2 rebreathing, EMGps
      increased linearly with tidal volume (r > 0.727, P < 0.01). However, at any given
      tidal volume, the SU and SB2 EMGps were not significantly different (P = 0.12),
      and both were less than that in U (P < 0.02). The results suggest that the
      differences in chest wall motion between U and S may be due to the difference in
      Cab and not to different patterns of respiratory muscle recruitment. The
      mechanism may relate to changes in mechanical coupling between the diaphragm and
      the rib cage.

PMID- 8482684
TI  - Costal and crural diaphragm function during CO2 rebreathing in awake dogs.
AB  - If costal and crural diaphragm segments can perform as separate muscles, then CO2
      stimulated ventilation may elicit differential segmental function. We studied
      diaphragm segmental length, shortening, and electromyogram (EMG) activity in 10
      awake dogs chronically implanted with sonomicrometer transducers and EMG
      electrodes. During CO2 rebreathing, segmental shortening and EMG activity per
      whole tidal breath progressively increased, but segmental responses could not be
      differentiated at any level of CO2. With increasing CO2, resting end-expiratory
      length of both diaphragm segments increased. During the complete intrabreath
      inspiratory-expiratory cycle, costal and crural diaphragm revealed distinctive
      segmental function. At rest, crural shortening exceeded costal shortening in
      earliest inspiration, costal and especially crural shortening persisted into
      early expiration, and EMG activity of the crural segment was greater than that of
      the costal segment in earliest inspiration and showed more end-inspiratory/early
      expiratory [post-inspiratory inspiratory activity (PIIA)] activity. During CO2
      stimulated breathing, neither segment shortened during the inspiratory flow of
      earliest inspiration. During CO2 rebreathing, shortening of the crural segment
      exceeded that of the costal segment during early inspiration and outlasted costal
      shortening during expiration; for both segments, shortening persisted after
      termination of inspiratory airflow. With increased CO2, EMG activity of the
      crural segment preceded that of the costal segment in earliest inspiration and
      was dominant into expiration, whereas costal EMG activity terminated abruptly
      with inspiratory flow. Thus, costal EMG PIIA was not evident during hypercapnia,
      whereas crural EMG PIIA was significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482685
TI  - Effect of nebulized lidocaine on ventilatory response to CO2 in healthy subjects.
AB  - Partial vagal blockade produced by inhalation of a local anesthetic aerosol has
      enhanced CO2 responsiveness in some studies but not in others. The effect of
      inhaled local anesthetic may depend on the amount of drug depositing in the
      central airways, i.e., the degree of airway anesthesia. We examined the
      ventilatory response to CO2 rebreathing in 11 healthy subjects before and after
      inhalation of 4% lidocaine and a normal saline control solution. Lidocaine and
      control solutions were aerosolized via two different nebulizers: one produced
      particles with a mass median aerodynamic diameter of 5.28 microns, and the other
      produced particles with a mass median aerodynamic diameter of 1.76 microns. The
      ventilatory response to CO2 was not affected by the control solution. In
      contrast, the ventilatory response to CO2 was significantly increased after
      aerosolized lidocaine when administered via the moderate-particle-size nebulizer
      (2.13 +/- 0.66 vs. 1.83 +/- 0.54 l.min-1.Torr-1 during control, P = 0.01) but not
      via the small-particle-size nebulizer (1.96 +/- 0.82 vs. 1.94 +/- 0.84 l.min
      1.Torr-1 during control, P = NS). The increase in ventilation was achieved
      predominantly by an increase in frequency (P = 0.01) while tidal volume was
      unchanged. In conclusion, airway receptors accessible to inhaled local anesthetic
      play a role in the control of breathing during CO2 rebreathing. Previous negative
      studies may be due to differences in nebulizer technique, affecting the amount of
      drug depositing within the central airways.

PMID- 8482686
TI  - Polyethylene glycol-conjugated superoxide dismutase protects rats against oxygen
      toxicity.
AB  - Superoxide dismutase (SOD) has an important role in the protection against O2
      toxicity. Conjugation of Cu,Zn-SOD to polyethylene glycol (PEG-SOD) prolongs its
      plasma half-life and facilitates its cellular uptake. However, prior studies have
      shown that intravenous injection of PEG-SOD does not protect animals against O2
      toxicity. In this study, we demonstrated that tracheal insufflation of PEG-SOD
      resulted in a dose-dependent protection against O2 toxicity. Nine of 15 rats
      (60%) insufflated with 25,000 U PEG-SOD survived continuous 100% O2 exposure for
      more than 7 days compared with control rats (n = 45), all of which died within 3
      days of O2 exposure (P < 0.025). In contrast, insufflation of 25,000 U SOD, 9.7
      mg methoxy-PEG (equivalent to the amount of methoxy-PEG present in 25,000 U PEG
      SOD), or a combination of SOD and methoxy-PEG had no protective effect.
      Furthermore, intravenous or intraperitoneal injection of PEG-SOD did not afford
      significant protection. Protection against O2 toxicity by PEG-SOD insufflation
      was associated with attenuated O2-induced pulmonary injury as evidenced by a
      reduced volume of pleural effusion. Insufflation of PEG-SOD markedly increased
      pulmonary SOD activity (to 300 and 370% of controls at 24 and 50 h, respectively)
      without affecting pulmonary catalase activity. We conclude that insufflation of
      PEG-SOD protects rats against O2 toxicity, possibly by enhancing pulmonary SOD
      activity.

PMID- 8482687
TI  - Inhibition of leukocyte adherence and aggregation for treatment of severe cold
      injury in rabbits.
AB  - We tested the hypothesis that blocking neutrophil adherence and/or aggregation
      reduces tissue injury that results when tissue is frozen and rewarmed. The left
      hindlimbs of three groups of New Zealand White rabbits were immersed in a -15
      degrees C salt water bath for 30 min to freeze the foot. The foot was rewarmed in
      a 39 degrees C water bath. In two groups, adherence and aggregation were blocked
      with monoclonal antibody (MAb) 60.3, and the third group was treated with saline.
      Two of the groups were treated at the time of rewarming with either saline or MAb
      60.3, and the third group received MAb 60.3 at the conclusion of rewarming.
      Tissue edema and tissue loss were significantly less in the two groups receiving
      MAb 60.3 than in the control group. Rabbits treated at the time of rewarming had
      less edema and tissue loss than those treated at the completion of rewarming.
      These studies indicate that a substantial component of severe cold injury is
      neutrophil mediated and occurs after rewarming.

PMID- 8482688
TI  - Epithelial modulation of preterm airway smooth muscle contraction.
AB  - To determine if epithelium from immature airways can modulate the responsiveness
      of smooth muscle, we studied paired trachealis muscle strips from preterm sheep.
      The epithelium was removed from one strip and left undisturbed in the other.
      Concentration-effect (CE) curves to acetylcholine (ACh), KCl, and isoproterenol
      were obtained. To evaluate maturational effects, responses to ACh and
      isoproterenol were studied in trachealis strips from adult airways. Maximal
      stress (Po) to ACh increased after epithelium removal in preterm (P < 0.05) but
      not adult strips. Epithelium removal caused a leftward shift of the ACh CE curves
      in both preterm and adult strips (P < 0.001) and a decrease in the dose required
      to achieve a one-half maximal response (ED50) in both preterm (P < 0.005) and
      adult strips (P < 0.05). The magnitude of the change in Po as well as in the ED50
      for ACh between preterms and adults was similar. Epithelium removal did not alter
      either the Po or the CE curves of preterm strips stimulated by KCl. Response to
      isoproterenol in precontracted strips was enhanced in the presence of an intact
      epithelium in both groups (P < 0.05). These data demonstrate that preterm airway
      epithelium is able to modulate the responsiveness of smooth muscle. Additionally,
      the magnitude of the effect is unchanged with maturation. We speculate that
      damage of airway epithelium from mechanical ventilation may contribute to the
      increased incidence of airway hyperreactivity observed in preterm infants.

PMID- 8482689
TI  - Model-free numerical deconvolution of recirculating indicator concentration
      curves.
AB  - This paper investigates two model-free methods for numerical deconvolution of
      recirculating indicator concentration curves. The two methods, damped least
      squares and discrete orthogonal polynomial deconvolution, are applied to
      simulated data to verify the reliability of the algorithms. Both deconvolution
      methods provide damping that results in estimated transport functions that are
      smooth and reasonable estimates of the actual simulated transport function. On
      convolution with the simulated input curve, the estimated transport functions
      provide good fits to the simulated output curve. In addition, methods for
      identifying an optimal solution and for truncating the artifactually long
      oscillatory tails of the estimated transport functions are proposed, which appear
      to allow for reasonably accurate estimation of the mean transit times and
      variances of the transport functions as well. When either method was applied to
      indicator dilution data obtained from the pulmonary artery and left atrium, it
      was computationally stable while producing transport functions that when
      convolved with the input concentration curves provided good fits to the output
      concentration curves. The combined simulation and experimental results suggest
      that the proposed methods should be useful for estimating circulation transport
      functions from indicator dilution data.

PMID- 8482690
TI  - Multielectrode mapping of slow-wave activity in the isolated rabbit duodenum.
AB  - The technique of multiple simultaneous recordings from a large number of
      extracellular electrodes (> 100) is currently used in the study of normal and
      abnormal electrical conduction in the heart and the genesis of cardiac
      arrhythmias. To investigate whether such a system could also be applied in
      gastrointestinal electrophysiology, several studies were performed with this
      technique on segments of isolated rabbit duodenum. A multiple-electrode assembly
      consisting of 240 silver wires was positioned on the serosal surface of the
      duodenum, and the recorded signals were, after suitable processing, stored.
      Thereafter, analysis of all simultaneously recorded slow waves during a selected
      period of time was performed to reconstruct the pattern of conduction in the
      duodenum. The first results show that there is a considerable variation in
      conduction pattern, which is determined by the site of the natural pacemaker.
      Several experiments were performed to rule out possible deleterious effects of
      positioning the multiple-electrode assembly on the duodenum. Furthermore,
      prolonged periods of recording did not influence propagation speed and pattern
      provided that the positioning of the multiple electrode assembly was performed
      with care. Entrainment of the natural pacemaker was possible by applying
      electrical stimuli through 2 of the 240 extracellular electrodes during
      simultaneous recordings. In conclusion, multisite extracellular mapping of
      gastrointestinal smooth muscle is possible and can be used to study origin and
      spread of slow-wave activity.

PMID- 8482691
TI  - Measurement of microhemodynamics in the ventilated rabbit lung by intravital
      fluorescence microscopy.
AB  - Pulmonary microhemodynamic parameters were directly measured along with systemic
      pressures and cardiac output in the ventilated rabbit lung. Subpleural arterioles
      and venules ranging from 10 to 35 microns luminal diameter were investigated
      under zone 2 conditions, i.e., during inspiratory plateau at an airway pressure
      of 8 mmHg. Mean arteriolar and venular diameters (24.6 +/- 3.3 and 21.9 +/- 3.6
      microns, respectively), mean red blood cell (RBC) fluxes (1,549 +/- 501 and 1,257
      +/- 600 cells/s), and mean RBC velocities (0.79 +/- 0.21 and 0.82 +/- 0.21 mm/s)
      were measured using a fluorescence video-microscopic technique. Calculated
      microhematocrit (Hct mu) was below systemic values (Hctsys) (Hct mu/Hctsys:
      arterioles, 0.75 +/- 0.12; venules, 0.67 +/- 0.08). The mean capillary transit
      time of RBC was 0.47 +/- 0.16 s over a mean arteriovenous distance of 173 +/- 70
      m. Significant correlations were demonstrated between microhemodynamic
      parameters. A correlation among cardiac output, pulmonary arterial pressure, and
      RBC velocity demonstrates the connection between macro- and microhemodynamics in
      the rabbit lung. In conclusion, the present model is the first one enabling the
      measurements of the principal circulatory determinants for gas exchange, i.e.,
      microvascular blood flow, Hct mu, and capillary transit time of RBCs in the
      ventilated rabbit lung under simultaneous macrocirculatory control.

PMID- 8482692
TI  - Effects of low-dose dopamine on gut ischemia in a porcine model of hemorrhagic
      shock.

PMID- 8482693
TI  - Exercise and resistance to infection.
AB  - The influence of exercise on resistance to infection has been debated for
      decades. Part of this controversy is due to the complex interactions between
      pathogens and host defense mechanisms as well as to the mutable nature of
      exercise. Psychological influences and normal temporal variations in immune
      mechanisms have also complicated the issue. An understanding of how each of these
      factors affects host defense should help in the design of new experimental
      approaches to the problem as well as in the interpretation of previously
      published results.

PMID- 8482694
TI  - O2-induced changes in lung and storage pool thiols in mice: effect of superoxide
      dismutase.
AB  - Because glutathione (GSH) is an important antioxidant, we hypothesized that
      changes in lung and systemic availability of GSH and its precursor amino acid,
      cysteine, are induced by exposure to hyperoxia and that these changes could be
      modulated by toxic O2 metabolites. In organs and plasma of mice exposed to
      hyperoxia, we measured GSH and sulfur-containing amino acids (SAAs), the latter
      by capillary gas chromatography-mass spectrometry. In relatively O2-resistant
      Swiss-Webster mice, lung GSH increased during O2 exposure, whereas liver GSH (the
      major storage pool of cysteine) and liver and plasma cysteine all decreased. Pair
      feeding studies suggested that nutritional deprivation alone did not cause the
      decrease in plasma cysteine. In lung, SAAs were not decreased by O2 exposure. In
      fact, cystathionine increased sixfold, and gamma-cystathionase was not inhibited.
      These findings suggest that hyperoxia increases transsulfuration pathway activity
      and that cystathionase rate limits this process in lung. In comparative studies,
      lung GSH increased in O2-resistant high-CuZn superoxide dismutase (SOD)
      transgenic mice but not in genetically similar, nontransgenic controls (CBYB/6 x
      B6D/2) during hyperoxic exposure. In addition, liver GSH and plasma cysteine
      decreased in nontransgenic control but not in high-SOD mice, whereas lung
      cystathionine increased similarly in both groups. Thus, superoxide or its
      secondary products can modulate, at least in part, the changes in cysteine and
      GSH. Nonetheless, regardless of strain or SOD status, hyperoxic exposure
      consistently caused thiol and SAA changes, including increased lung cystathionine
      and oxidized GSH, demonstrating a strong association between these dynamic
      changes and oxidant stress.

PMID- 8482695
TI  - Withdrawal of placental prostaglandins permits thermogenic responses in fetal
      sheep brown adipose tissue.
AB  - Significant nonshivering thermogenesis cannot be demonstrated in fetal sheep
      cooled in utero but can be induced by supplemental oxygenation and umbilical cord
      occlusion, which suggests the presence of inhibitor(s) of placental origin. To
      test the hypothesis that an ecosanoid could be such an inhibitor, we studied
      eight fetal sheep at 136-141 days gestation. Thermistors were placed in the fetal
      esophagus, a cooling tube was placed around the trunk, a tracheal cannula and
      carotid catheters were inserted, and a snare was placed loosely around the
      umbilical cord. After indomethacin infusion for 18 h, the fetuses were cooled by
      2.13 +/- 0.13 degrees C by circulating cold water through the coil. Within 60 min
      plasma free fatty acid levels rose threefold to 245 +/- 82 mu eq/l (P < 0.01) and
      glycerol levels rose to 197 +/- 17 mumol/l (P < 0.01). Ventilation caused a
      further rise in thermogenic indexes, and fetal oxygen consumption rose to 19.9 +/
      1.2 ml.kg-1.min-1. In four fetuses we ceased cooling, which caused thermogenic
      indexes to fall and oxygen consumption to fall to 6.9 +/- 1.1 ml.kg-1.min-1. We
      continued to cool three fetuses and infused prostaglandin E2 into the fetuses for
      60 min; thermogenic indexes and oxygen consumption fell rapidly on infusion and
      rose rapidly when infusion ceased. We suggest that placental prostaglandins
      inhibit brown adipose tissue thermogenesis before birth and that withdrawal after
      placental separation is one factor in the initiation of nonshivering
      thermogenesis at birth.

PMID- 8482696
TI  - Utility of predicting group membership and the role of spatial visualization in
      becoming an engineer, physical scientist, or artist.
AB  - This article has two themes: First, we explicate how the prediction of group
      membership can augment test validation designs restricted to prediction of
      individual differences in criterion performance. Second, we illustrate the
      utility of this methodology by documenting the importance of spatial
      visualization for becoming an engineer, physical scientist, or artist. This
      involved various longitudinal analyses on a sample of 400,000 high school
      students tracked after 11 years following their high school graduation. The
      predictive validities of Spatial-Math and Verbal-Math ability composites were
      established by successfully differentiating a variety of educational and
      occupational groups. One implication of our findings is that physical science and
      engineering disciplines appear to be losing many talented persons by restricting
      assessment to conventional mathematical and verbal abilities, such as those of
      the Scholastic Aptitude Test (SAT) and the Graduate Record Examination (GRE).

PMID- 8482697
TI  - Surviving self-employment: a personal case history.
AB  - In the popular perception of what determines one's success as a free-lance
      illustrator, issues other than natural talent or artistic ability are seldom
      emphasized. In addition to a firm philosophical foundation and a good work ethic,
      the organization and management of practical concerns play significant roles in
      the successful operation of any free-lance business. Presented as a personal
      history, this article discusses some of the most important, yet most neglected,
      issues that are essential to the economic security and survival of anyone
      considering a career as a free-lance illustrator.

PMID- 8482698
TI  - Computer utilization trends in biomedical illustration.
AB  - A national study was designed to determine computer utilization trends in
      biomedical art and illustration in North America. In the fall of 1991, 453
      surveys were mailed to the Association of Medical Illustrators and the
      Association of Biomedical Communications Directors; 112 (25%) completed survey
      forms were returned. The survey compares similarities and differences between the
      groups with regard to the impact (e.g., staffing, time, cost, and quality
      control) of computer technology (e.g., hardware, software) on biomedical artwork
      in the health sciences.

PMID- 8482699
TI  - Imaging technologies in cardiovascular interventions.
AB  - New and exciting vascular imaging technologies are assuming increasingly
      important roles in the management of vascular disease. Non-invasive modalities
      such as computerized tomography, magnetic resonance imaging and duplex ultrasound
      supplement the information obtained by invasive techniques including angiography,
      angioscopy and intraluminal ultrasound. This paper outlines the modern and
      developing vascular imaging techniques that are rapidly becoming integral
      components of therapeutic devices as well as advanced diagnostic systems.

PMID- 8482700
TI  - Aortic dissection: anatomic types and surgical approaches.
AB  - Our classification system of acute dissection of the aorta is based on the site
      of the main intimal tear: Type A: on the ascending aorta; type B: on the
      transverse aortic arch; type C: on the descending aorta. The extension of the
      dissecting process is classified as "antegrade" or "retrograde". Acute dissection
      involving the ascending aorta is an absolute surgical urgency. Any delay in
      referring the patient to a proper surgical institution or to the operating room
      increases the risk of death. Fifty per cent of patients, indeed, either untreated
      or medically supported, die within 48 hours after the onset of symptoms. Surgical
      therapy is mainly aimed at preventing the patient from dying from
      intrapericardial rupture of the aorta or from acute massive aortic regurgitation.
      In type A, it is necessary to replace the ascending aorta with a bloodtight
      Dacron prosthesis after resecting the entry site, if possible. Downstream,
      joining the two dissected cylinders by two running sutures and the aid of GRF
      glue, seals the false lumen. Upstream, the reconstruction of the aortic root and
      the resuspension of the aortic valve, also by means of running sutures and GRF
      glue, suppress the aortic valve insufficiency in 90% patients. However, in case
      of pre-existing annulo-aortic ectasia, the ascending aorta must be replaced by a
      composite tube according to the Bentail technique. The use of GRF glue since the
      beginning of 1977, has dramatically improved the immediate and long-term results,
      accounting for a hospital mortality rate of 10%, in patients less than 65 years
      old. In type B, resecting the entry site requires that the transverse arch be
      partially or totally replaced. It is, therefore, mandatory to protect the Central
      Nervous System. In our experience this is best achieved by perfusing the carotid
      arteries with cold blood (6 degrees C) during circulatory arrest at moderate core
      hypothermia (28 degrees C). With this technique of "Cerebroplegia", the hospital
      mortality rate has been lowered to 28%, higher, though, than in patients
      undergoing isolated replacement of the ascending aorta. In type C, only the
      dissections demonstrating symptoms of major complications (rupture or deleterious
      ischemia) require urgent surgical treatment. In the remaining cases, medical
      treatment, based on permanent and accurate control of the patient's blood
      pressure, lead to a good long-term survival rate. Close survey at regular
      intervals, by means of CT scan or MNR is mandatory to detect any aneurysmal
      evolution, which may require surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8482701
TI  - Noninvasive tests in venous insufficiency.
AB  - Chronic venous insufficiency (CVI) is the result of outflow obstruction, reflux
      or a combination of both. Noninvasive tests detect an quantify obstruction and
      reflux if present and define the anatomic localisation of the abnormality. In
      evaluating CVI noninvasive tests combine physiologic and imaging techniques.
      These tests are widely available, simple, quick and cost-effective and therefore
      they are the methods of choice for initial objective evaluation. Different tests
      provide answers to different questions. The optimum clinically useful information
      can be now obtained using only three instruments: pocket Doppler, duplex or color
      duplex scanner and air plethysmography. The value of ambulatory venous pressure,
      photoplethysmography and light reflection reography, air plethysmography, duplex
      and color duplex scanning to assess reflux and the value of tests to assess out
      flow obstruction are presented. Pooled data collected from large studies are also
      presented for reference. Qualitative and quantitative assessment of CVI are
      useful both for clinical assessment and to evaluate the effect of treatments.

PMID- 8482702
TI  - Reconstruction of major arteries of extremities after war injuries.
AB  - This paper reports on the experience regarding the reconstruction of arterial
      injuries gained at the Department of Surgery, Osijek General Hospital during the
      first year of war against Croatia. In the period between May 1991 and May 1992,
      57 wounded with 60 injuries of the major arteries of the extremities were
      admitted to the hospital, all of them directly from the battlefield or from the
      streets of Osijek. As there is no consensus on the application of autologous vein
      graft or allograft in arterial injury reconstruction, our choice of surgical
      management and early results are reviewed. In the surgical repair of 60 injured
      major arteries of the extremities, 17 allografts and 19 autologous vein grafts
      were used. In conclusion, our results indicate that the use of allografts for
      arterial injury reconstruction may be useful in a highly contaminated area of war
      wound.

PMID- 8482703
TI  - Rupture of abdominal aortic aneurysms into the major abdominal veins.
AB  - Over the period January 1965-July 1992 26 spontaneous fistulas between an
      abdominal aortic aneurysm (AAA) and the major abdominal veins were observed and
      surgically treated. Twenty-two were aorto-caval, one iliaco-iliac and 3 aorto
      iliac; since clinical features, pathophysiology, principles of surgical treatment
      and postoperative care are similar, both the conditions are considered as a
      single disease (aorto-caval fistula: ACF). The incidence among 373 ruptured AAA
      operated in emergency conditions in the same period was 6.97%, with an operative
      mortality rate of 34.61% compared to an overall mortality for ruptured AAA of
      34.85%. All subjects were males with a mean age of 67.3 years. Twelve subjects
      showed shock at admission (46.1%): the mortality rate in this subgroup was 50%
      compared to 21.4% among the non-shocked patients. Pain was always present, oedema
      of one or both of the lower limbs in 9 cases (34.6%) and abdominal bruit or
      murmur and thrill in 16 (61.5%). One patient died at laparotomy for irreversible
      cardiac arrest; the 25 completed procedures consisted of endoaneurysmal repair of
      the fistula under venous bleeding control by digital compression and prosthetic
      replacement of the abdominal aorta (7 straight and 18 bifurcated grafts).
      Intraoperative mean blood losses exceeded 4,000 ml, but autotransfusion,
      available only in 12 procedures, allowed significant sparing of heterologous
      blood units. The mortality rate was not clearly improved by autotransfusion, but
      among these 12 patients shock was present in 7 instances (58.3%), compared to 5
      out of 14 subjects (35.7%) operated on before autotransfusion devices were
      available.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482704
TI  - Cardiac myxomas: surgical treatment, long-term results and recurrence.
AB  - Long-term results of the surgical treatment of cardiac myxomas are not completely
      understood due to its recurrence. We review our experience in 27 operated cases
      with a follow-up to 22 years (mean 6.5 years), in order to throw light on results
      and review the problem of recurrence. One patient had a previous recurrent
      myxoma. At surgery we resect all the tumors and their attachment bases. We prefer
      a biatrial approach, ample resection and exploration of all cardiac chambers.
      Hospital mortality was 3.7% (1 case of associated aortic valve replacement) and
      late mortality 7%. Long-term results were satisfactory, without recurrences. The
      postoperative life expectancy of these patients seems similar to that of the
      normal population, except in cases of recurrence or associated valve replacement.
      Recurrence is very low (4.7% in 526 cases reported in the literature), except in
      the case of young patients and recurrent, familial, multiple or complex myxomas.
      The multigrowth potential of the tumor seems more important than an inadequate
      surgical resection.

PMID- 8482705
TI  - Suitability of Doppler echocardiography for the assessment of right heart
      hemodynamics after De Vega tricuspid annuloplasty.
AB  - Cardiac Doppler Echocardiography is a suitable method for to evaluating right
      heart hemodynamics. However, the surgical correction of tricuspid valve
      annuloplasty changes valve geometry and might possibly lead to a technical
      obstacle to this estimation. The accuracy of Doppler echocardiography in the
      assessment of tricuspid regurgitation and systolic pulmonary pressure in patients
      who had undergone De Vega annuloplasty was evaluated in this study. Ten patients
      (9 females and 1 male), mean age 55.7 +/- 7.8 years, who had a previous De Vega
      annuloplasty for the treatment of tricuspid regurgitation due to a severe mitral
      stenosis, underwent a Doppler echocardiography study and, within two hours, right
      heart catheterization for a direct comparison of parameters calculated by
      different methods. Right ventricular-atrial maximal pressure gradient was found
      to be 32.6 +/- 11.07 mmHg by Doppler and 31.4 +/- 11.07 mmHg by catheterization.
      Pulmonary systolic pressure was 42.6 +/- 9.1 mmHg at Doppler and 39.1 +/- 11.3
      mmHg at catheterization, with a highly significant correlation between the 2
      techniques (r = 0.98%, p < 0.01). With semiquantitative Doppler evaluation 10
      patients showed tricuspid insufficiency, which was mild in 8 and medium in 2. At
      catheterization all patients were found to have mild tricuspid insufficiency.
      Cardiac Doppler seems a reliable method in the evaluation of tricuspid
      regurgitation and of pulmonary systolic pressure even in patients who underwent
      De Vega annuloplasty.

PMID- 8482706
TI  - An anatomical variation of the right gastroepiploic artery that excludes its use
      as a pedicled coronary bypass graft.
AB  - In an attempt to perform complete coronary revascularization with only arterial
      conduits in a 44 year-old male, both internal mammary arteries and the right
      gastroepiploic artery were harvested. The right gastroepiploic artery, however,
      showed an anatomical variation that excluded its use as a pedicled graft.

PMID- 8482707
TI  - Venous and arteriovenous vascular malformations: diagnostic and therapeutic
      considerations regarding 239 patients observed in the 1978-1991 period.
AB  - The Authors report their experience in the treatment of venous and arteriovenous
      malformations, which in this paper are divided into two subgroups, pure venous
      malformations (VMs) and arteriovenous malformations (AVMs). A pure surgical
      indication was evident in less than 50% of cases (48.1%), while more conservative
      treatments were performed in remaining patients. Considering the particular
      characteristics of the disease, a complete surgical radicality isn't always
      possible, so surgery must be considered in selected cases.

PMID- 8482708
TI  - Total avulsion of the azygos vein and longitudinal laceration of the mediastinal
      pleura due to blunt chest trauma: a case report.
AB  - Complete avulsion of the azygos venous arch associated with a subtotal
      longitudinal laceration of the posterior mediastinal pleura resulting from blunt
      motor vehicular trauma is reported. A sudden forceful anteromedial rotation of
      the decelerating cardiac mass may be the etiologic mechanism of the rare injury.

PMID- 8482709
TI  - Traumatic tricuspid insufficiency following blunt chest trauma.
AB  - The insufficiency of the tricuspid valve developed due to blunt chest trauma is a
      rare and an insidiously progressing clinical incident. In this article we present
      a case which showed tricuspid insufficiency because of the rupture of the
      anterior papillary muscle due to trauma and which was treated surgically.

PMID- 8482710
TI  - Mycotic aneurysm of the celiac trunk: radical resection and reconstruction
      without prosthetic material.
AB  - The Authors report a case of mycotic aneurysm of the celiac trunk, originating
      from bacterial endocarditis on the mitral valve. The technique was excision and
      revascularization without interposition of any material: for the moment it is the
      first time that a mycotic aneurysm of the celiac trunk is treated in this manner.
      The post-operative course was normal.

PMID- 8482711
TI  - A case of cor triatriatum with end-stage renal disease: successful management of
      open heart surgery under hemodialysis, subsequent renal transplantation and
      pregnancy.
AB  - A female patient who had open heart surgery for cor triatriatum under
      hemodialysis, subsequent kidney transplantation and pregnancy is reported. We
      performed hemodialysis on the patient before, during and after heart surgery to
      control renal failure. Two years after heart surgery, she received a kidney graft
      from her mother. The kidney graft showed good function. She was treated with
      azathioprine and prednisone. Three years after renal transplantation she
      delivered a healthy male infant by elective Caesarean section at 37 weeks'
      gestation. Mother and infant did well following delivery. There was lack of
      hypertension, proteinuria, signs of graft rejection, and recurrence of heart
      failure during pregnancy. She showed serum creatinine level < 2 mg/dl, a
      prednisone of < 2 mg/kg/day. Elective Caesarean section has improved
      hydronephrosis due to the compression of the fetus. The aforementioned good
      criteria contributed to the successful pregnancy of the renal transplant patient
      in our experience. We believe early surgical intervention overcomes complicated
      heart disease even with endstage renal disease, and it gives a chance to receive
      renal transplantation and have a healthy child. To our knowledge, this is the
      first report that has described the successful management of open heart surgery
      under hemodialysis, subsequent renal transplantation and pregnancy in a female
      patient with chronic renal failure.

PMID- 8482712
TI  - Abdominal aortic aneurysmectomy associated with a native iliac kidney. Case
      report.
AB  - Abdominal aortic aneurysm (AAA) repair associated with a pelvic kidney is
      extremely rare. To date only 14 cases have been reported in the literature. The
      main problem during aortic cross clamping is kidney preservation. The purpose of
      this article is to record and additional case of AAA repair associated with a
      native pelvic kidney. The preservation has been successfully achieved by a distal
      aortic double clamping.

PMID- 8482713
TI  - Giant left ventricular aneurysm.
AB  - A 65 year old lady with known inferior left ventricular aneurysm presented with
      acute dysphagia and hoarseness. A barium swallow examination confirmed extrinsic
      compression of the oesophagus. Successful aneurysmectomy resulted in complete
      relief of the dysphagia and hoarseness. The clinical and radiological features
      are reviewed.

PMID- 8482714
TI  - Percutaneous embolization of subclavian pseudoaneurysmatic arteriovenous
      iatrogenic fistula by steel coils.
AB  - A case of iatrogenic subclavian arterio-venous fistula with pseudoaneurysm
      formation is described. Treatment by means of percutaneous embolization, on the
      venous side, with steel coils has been successful; in order to avoid
      complications, the arterial side was blocked by an angioplasty balloon. After
      discussing the more common complications of subclavian vein puncture, the Authors
      conclude that percutaneous embolization is a valuable alternative to surgery even
      in such a lesion, especially when the surgical risk is high.

PMID- 8482715
TI  - Neutrophil adhesion to endothelial cells impairs the effects of catalase and
      glutathione in preventing endothelial injury.
AB  - We studied the effects of the CuZn superoxide dismutase (SOD), catalase (CAT),
      and glutathione (GSH) on endothelial permeability to 125I-albumin after
      activation of neutrophils (PMN) with phorbol 12-myristate-13-acetate (PMA; 10(-8)
      M). PMN were either in direct contact with the endothelial cell monolayer grown
      on a porous gelatin-coated microporous 10-microns-thick polycarbonate filter
      (upright system) or separated from the endothelium by a similar filter (inverted
      system). Transendothelial 125I-albumin clearance rates were measured as an index
      of endothelial permeability. In the absence of antioxidants, activation of PMN
      increased transendothelial 125I-albumin clearance rates in both systems from
      0.041 +/- 0.006 microliters/min (baseline) to 0.262 +/- 0.18 microliters/min
      (upright system) and from 0.063 +/- 0.02 microliters/min to 0.244 +/- 0.06
      microliters/min (inverted system). PMA induced 80-90% of PMN to adhere to either
      gelatin-coated filters or to endothelial cells, from the basal PMN adhesion value
      of 5.3 +/- 2.2% and 4.3 +/- 1.1%, respectively. SOD, which dismutases superoxide
      anion to hydrogen peroxide (H2O2), did not alter the transendothelial 125I
      albumin clearance rates in either system at any concentration from 10-300 U/ml.
      CAT (100-1,000 U/ml) and GSH (0.5-10 mM), which remove the H2O2 generated during
      PMN activation, did not alter the increase in transendothelial 125I-clearance
      rates after PMN activation in the upright system, but both agents prevented the
      increase in transendothelial 125I-clearance rates in the inverted system. We
      conclude that PMN activation with PMA causes endothelial injury irrespective of
      PMN contact to the endothelial monolayer. Moreover, H2O2, a release product of
      PMN activation, is a critical mediator of PMN-dependent endothelial injury.
      Finally, the results indicate that CAT and GSH prevent endothelial injury only in
      the absence of direct PMN contact with endothelial cells, suggesting that
      antioxidants such as GSH and CAT are excluded from sites of PMN-endothelial
      contact and thus are ineffective antioxidants.

PMID- 8482716
TI  - Stretch and anesthetic dependency of atrial natriuretic peptide release
      demonstrated by an ultrastructural assay.
AB  - Using an ultrastructural assay developed to quantify the secretion of atrial
      natriuretic peptide-containing granules, release of the hormone, in response to
      different degrees of atrial distension, is directly demonstrated at the cellular
      level. The ultrastructural assay developed uses an in situ tannic acid perfusion
      technique to arrest the exocytosis of atrial granules in the anesthetized rat.
      Secretory granules, which retain the capacity to undergo exocytosis throughout a
      30-minute tannic acid perfusion, accumulate at the cell surface in a state of
      fusion with the plasma membrane, with the core contents retained. Quantification
      of arrested granules thus provides a measure of the rate of granule release and
      allows the responses to different stimuli to be assessed. By altering the height
      of the perfusate, perfusion pressure and hence the degree of distension of the
      right atrium can be increased, and this causes a proportional rise in the release
      of secretory granules from individual myocytes. An anesthetic regime
      incorporating fentanyl citrate was found to increase significantly the rate of
      granule release, and this was further augmented by atrial distension.
      Quantification of the numbers of cytoplasmic granules under the same conditions
      did not reveal a reduction in granules. This is thought to be because only a
      small pool of granules is recruited for exocytosis, and granule production may
      continue during the perfusion period. Our assay of atrial secretory granule
      release allows the effect of a variety of stimulatory and inhibitory agents to be
      assessed directly at the cellular level and provides an independent comparison
      with previous biochemical data from whole animal and isolated organ studies.

PMID- 8482717
TI  - Inducers of the heat shock response stimulate phospholipase C and phospholipase
      A2 activity in mammalian cells.
AB  - Although the mammalian heat shock response has been well characterized, the
      processes that mediate the induction of the response and the regulation of heat
      shock protein function are not completely understood. We have investigated the
      potential role in heat-shocked cells of phosphoinositide-specific phospholipase C
      (PLC), a membrane enzyme activity involved in transmembrane signal transduction.
      Our studies indicate that heat shock activates PLC in each of seven cell lines,
      including cells of human, rat, mouse, and hamster origin. Heat shock produced
      increases in inositol phosphate concentrations comparable in magnitude to those
      achieved after simulation with growth factors, indicating that heat shock might
      initiate transmembrane signaling cascades of potential importance in cellular
      regulation. Common cellular responses to heat and growth factors also included
      feedback modulation of PLC by its products and the parallel stimulation of
      phospholipase A2 activity. In addition to heat shock, other agents that induce
      the stress response stimulated PLC activity. The data indicate a close
      correlation between expression of the mammalian heat shock response and
      stimulation of PLC activity and indicate a possible role for this enzyme activity
      in the regulation of some aspects of the stress response.

PMID- 8482718
TI  - Characterization of prostaglandin F2 alpha receptor of mouse 3T3 fibroblasts and
      its functional expression in Xenopus laevis oocytes.
AB  - Prostaglandin (PG) F2 alpha increased [3H]thymidine incorporation into quiescent
      NIH 3T3 cells, stimulated phosphoinositide breakdown, and raised intracellular
      Ca2+ concentration ([Ca2+]i) in a dose-dependent manner with ED50 values of 2.0 x
      10(-8) M, 4.6 x 10(-8) M, and 7.5 x 10(-8) M, respectively. The increase in
      [3H]thymidine incorporation with PGF2 alpha was additive with that seen with
      epidermal growth factor (EGF) or insulin. The peak [Ca2+]i increase with PGF2
      alpha was still obvious in the absence of extracellular Ca2+ and was insensitive
      to islet activating protein (IAP) pretreatment. Membranes prepared from NIH 3T3
      cells exhibited a specific binding for PGF2 alpha, which was sensitive to GTP
      gamma S but not sensitive to IAP pretreatment. Xenopus laevis oocytes injected
      with NIH 3T3 cell mRNA between 18S and 28S rRNA fractionated by sucrose gradient,
      expressed a PGF2 alpha-specific Cl- current when examined by voltage clamp. This
      Cl- current was also insensitive to IAP pretreatment and not affected by
      extracellular Ca2+ concentration ([Ca2+]o). These results indicate 1) that the
      NIH 3T3 cells expressed a specific PGF2 alpha receptor which is linked to
      phosphoinositide-specific phospholipase C (PLC) activation and to mobilization of
      Ca2+ via an IAP-insensitive G-protein(s), 2) that this PGF2 alpha receptor may
      play an active role in the proliferation of NIH 3T3 cells, and 3) that this PGF2
      alpha receptor can be expressed in the oocyte system.

PMID- 8482719
TI  - Serum-stimulated cell cycle progression and stress protein synthesis in C3H10T1/2
      fibroblasts treated with sodium arsenite.
AB  - In this work, we demonstrated that a nonlethal dose of arsenite administered to
      quiescent C3H10T1/2 fibroblasts can enhance the mitogenic effect of suboptimal
      concentrations of serum. The mitogenic effect was dependent on the serum
      concentration and on the time interval between the administration of arsenite and
      that of serum. This suggests that mitogen sensitivity changes in time after
      arsenite treatment. It is shown that the concentrations of arsenite that enhance
      the mitogenic effect of serum also increase the mRNA levels of c-fos, HSP68, and
      HSP84 and induce the specific synthesis of Heat Shock Proteins (HSPs). The
      physiological significance of this phenomenon is most likely to counteract the
      long-term toxic effect of arsenite by early induction of compensation for cell
      loss.

PMID- 8482720
TI  - Follicle-stimulating hormone and human chorionic gonadotropin induced changes in
      granulosa cell glycosyl-phosphatidylinositol concentration.
AB  - In the present investigation, a hCG sensitive glycosyl-phosphatidylinositol (GPI)
      was isolated from cultured rat granulosa cells obtained from the ovaries of
      diethylstilbestrol (DES) implanted immature rats. The inositol-phosphoglycan
      (IPG) moiety of the GPI-lipid contains galactose, glucosamine, and myoinositol as
      demonstrated by metabolic labelling of granulosa cells for different time periods
      (5-96 h) with [3H]galactose, [3H]glucosamine, or [3H]myoinositol and treatment of
      the purified [3H]GPI with phosphatidylinositol-specific phospholipase C.
      Labelling equilibrium of the GPI-lipid was achieved after 24 h ([3H]galactose and
      [3H]myoinositol) or 72 h ([3H]glucosamine) incubation, whereas incorporation of
      other labelled carbohydrates tested ([3H]galactosamine, [3H]mannose, and
      [3H]sorbitol) was negligible throughout the time period studied. The glucosamine
      C-1 appears to be linked through a glycosidic bond to the myoinositol molecule of
      the IPG moiety as revealed by the generation of phosphatidylinositol (PtdIns)
      after nitrous acid deamination of dual labelled ([3H]glucosamine/[14C]palmitate
      or [3H]glucosamine/[14C]myristate) glycosyl-phosphatidylinositol. To investigate
      the fatty acid composition of the diacylglycerol (DAG) backbone of the GPI,
      granulosa cells were also labelled (5-72 hr) with [14C]linoleate, [3H]myristate,
      [3H]oleate, [3H]palmitate, or [3H]stearate and the radioactivity associated with
      the purified glycosyl-phosphatidylinositol determined. Incorporation of
      [3H]palmitate and [3H]myristate into the GPI-lipid peaked after 8 h and 24 h of
      labelling, respectively, and both fatty acids were partially released after PLA2
      treatment of the dual labelled ([3H]glucosamine/[14C]palmitate or
      [3H]glucosamine/[14C]myristate) GPI. In parallel experiments no significant
      incorporation of labelled stearate, oleate, or linoleic acid into the DAG
      backbone of the glycosylphosphatidylinositol could be detected. Granulosa cells
      were also labelled with [3H]glucosamine in the presence of FSH (30 ng/ml),
      cholera toxin (1 microgram/ml), or the membrane permeable cAMP analog (but)2cAMP
      (1 mM). Time related increases in GPI-labelling were apparent after 48 h and
      reached a maximum level (3-, 5-, and 7-fold for FSH, CT, and (but)2cAMP,
      respectively) after 72 h in culture. In another set of experiments, granulosa
      cells were labelled for 72 h with [3H]glucosamine in the presence of (but)2cAMP
      (1 mM), TPA (10(-7) M), or combination thereof. The effect of treatment with the
      membrane permeable cAMP analog on GPI labelling was prevented in the presence of
      TPA, whereas no differences in [3H]GPI content could be observed in untreated
      granulosa cells or cells cultured in the presence of the protein kinase C
      activating phorbol ester alone.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8482721
TI  - CSF-1 control of C-FMS expression in normal human bone marrow progenitors.
AB  - We have previously shown (Zhou et al: Blood, 72:1870, 1988) that IL3, added with
      low concentrations of CSF-1 (1 ng/ml) to normal human CD34+ enriched cells,
      promoted the development of various types of colonies including those containing
      immature monocytes. However, when high concentrations of CSF-1 (20 ng/ml) were
      added alone or together with IL3, smaller colonies with mature macrophages were
      found. Here we show by in situ hybridization that IL3 allows the development,
      from CD34+ cells, of a subpopulation of immature progenitors which express the
      CSF-1 receptor (c-fms) mRNA. The expression of c-FMS protein was also
      substantiated by immunocytochemical studies using anti-c-fms antibody. The
      percentage of c-fms positive cells peaked at day 7 and began to decrease
      thereafter. When anti-CSF-1 antibodies were included in the culture, the decrease
      in c-fms mRNA after day 7 was abrogated. This indicated that endogenous CSF-1 was
      produced as CD34+ cells developed into monocytes or progenitors of monocytes and
      that CSF-1 modulates c-fms expression. We further demonstrated that when a high
      dose of CSF-1 (20 ng/ml) was added at day 7 to IL3-stimulated CD34+ cells, a
      rapid down-regulation of c-fms mRNA and protein was seen. No down-regulation was
      observed with low concentration of CSF-1 (1 ng/ml). The possibility that
      different concentrations of CSF-1 could modulate the development of monocytic
      progenitors is discussed.

PMID- 8482722
TI  - Regulation of insulin-like growth factor-IL expression and its role in autocrine
      growth of human neuroblastoma cells.
AB  - Insulin-like growth factor-II (IGF-II) is highly expressed in fetal tissues and
      may act as an autocrine growth factor during early embryogenesis. The SH-SY5Y
      human neuroblastoma cell line also expresses IGF-II and its receptors and
      responds to exogenous IGF-II with increased DNA synthesis, cell division, and
      neuritic outgrowth. For this study, we tested the hypothesis that IGF-II mediates
      autocrine growth of SH-SY5Y cells in serum-free media. SH-SY5Y cells plated at
      high densities proliferated in serum-free media, whereas sparsely plated cells
      did not. IGF-II mRNA levels increased within 24 hours of serum deprivation and
      were associated with increased immunoreactive IGF-II protein. Exogenous addition
      of IGF-II increased 3H-TdR incorporation and cell number in a dose- and time
      dependent fashion. By nuclear labelling experiments using 5-Bromo-2' deoxyuridine
      (BrdU), we detected a twofold higher percentage of S phase nuclei after a 24-hour
      incubation in IGF-II. Treatment of SH-SY5Y cells with anti-IGF-II antibodies in
      serum-free media inhibited cell proliferation, and this inhibition was partially
      overcome by the addition of increasing concentrations of IGF-II. Collectively,
      our results indicate that IGF-II mediates an autocrine growth mechanism in SH
      SY5Y cells that is associated with increased IGF-II expression.

PMID- 8482723
TI  - Protein kinase inhibitor, staurosporine, induces a mature neuronal phenotype in
      SH-SY5Y human neuroblastoma cells through an alpha-, beta-, and zeta-protein
      kinase C-independent pathway.
AB  - Previous studies have shown that the tumour-promoting phorbol ester 12-O
      tetradecanoyl phorbol-13 acetate (TPA) induces both morphological and functional
      differentiation in SH-SY5Y human neuroblastoma cells (Pahlman et al., 1981). In
      order to investigate the role of protein kinase C (PKC) in TPA-induced maturation
      of SH-SY5Y cells, we have used staurosporine, which is a potent inhibitor of
      protein kinases including PKC. Treatment of SH-SY5Y cells with 25 nM
      staurosporine for 72 hours caused an appearance of long, neuritelike processes
      with varicosities, terminated by growth cones. The morphological differentiation
      was accompanied by a cessation of DNA synthesis, induction of growth associated
      protein 43 (GAP-43), and neuropeptide Y (NPY) mRNA. These effects of
      staurosporine were comparable to those elicited by TPA. Staurosporine further
      induced a time-dependent increase in the expression of tyrosine hydroxylase
      protein and a 30-fold increase in the concentration of noradrenaline. TPA only
      induced a marginal increase in tyrosine hydroxylase expression. Both TPA and
      staurosporine induced an appearance of voltage-gated Ca2+ channels in SH-SY5Y
      cells detected with single-cell fluorescent measurements using fura-2. The Ca2+
      channels were found almost exclusively in growth cones and varicosities.
      Staurosporine inhibited both basal and a TPA-induced phosphorylation of an
      endogenous 80kDa PKC substrate (p80), and also blocked c-fos proto-oncogene mRNA
      expression induced by the phorbol ester. Bryostatin 1, a potent activator of PKC,
      has failed to induce morphological or functional differentiation in SH-SY5Y cells
      (Jalava et al., 1990). Incubation of SH-SY5Y cells in the presence of 100 nM
      bryostatin 1 for 24 hours caused a complete disappearance of all immunoreactive
      alpha-, beta-, and zeta-PKC. The level of epsilon-PKC decreased by 70%.
      Staurosporine induced a partial translocation of the epsilon-isoenzyme but it
      failed to cause down-regulation of epsilon-PKC. Bryostatin 1-treatment did not
      interfere in the ability of staurosporine to induce morphological
      differentiation, cessation of DNA synthesis, and GAP-43 and NPY mRNA expression.
      The ability of staurosporine to stimulate tyrosine hydroxylase expression and to
      increase cellular content of noradrenaline was also unaffected. Taken together
      the results of this study show that staurosporine induces a mature neuronal
      noradrenergic phenotype in SH-SY5Y cells through an alpha-, beta-, and zeta-PKC
      independent pathway.

PMID- 8482724
TI  - Mechanism of retinoid-induced activation of latent transforming growth factor
      beta in bovine endothelial cells.
AB  - Cell-associated plasmin is a putative physiological activator of latent
      transforming growth factor-beta (LTGF-beta). Since retinoids enhance the
      production of plasminogen activator (PA) and thereby increase cell-associated
      plasmin activity, we tested the possibility that retinoids might induce the
      activation of LTGF-beta using bovine endothelial cells (ECs) as a model system.
      ECs treated with physiological concentrations of retinol or retinoic acid formed
      active TGF-beta in the culture media in a dose- and time-dependent fashion. Cells
      were treated with 2 microM retinol for 24 h, and the amount of TGF-beta produced
      during a subsequent 12-h incubation period was measured. Out of a total of 14 pM
      LTGF-beta secreted, 0.7 pM was converted to active TGF-beta. Northern blot
      analyses showed that mRNA levels for TGF-beta 2 but not for TGF-beta 1 increased
      in cells treated with retinol. Inclusion of either inhibitors of PA or of plasmin
      or antibody against PA in the culture medium as well as depletion of plasminogen
      from the serum blocked the formation of TGF-beta, suggesting that PA,
      plasminogen, and the resulting plasmin are essential for activation of LTGF-beta
      in retinoid-stimulated cells. Antibody against the LTGF-beta binding protein
      blocked activation implying that localization of LTGF-beta through its binding
      protein may be important. However, inhibition of binding of LTGF-beta to the cell
      surface mannose 6-phosphate receptor did not prevent activation. These data
      indicate that retinoids up-regulate the production of LTGF-beta in ECs and induce
      activation of LTGF-beta, perhaps, by increasing PA and plasmin levels. Thus, TGF
      beta might be a local mediator of some of the biological activities of retinoids
      both in vivo and in vitro.

PMID- 8482725
TI  - Autocrine/paracrine regulation of keratinocyte urokinase plasminogen activator
      through the TGF-alpha/EGF receptor.
AB  - Transforming growth factor-alpha (TGF-alpha) appears to be an important
      autocrine/paracrine regulator of keratinocyte function. Not only does TGF-alpha
      induce keratinocyte proliferation and migration in vitro, but it also has been
      detected in normal human epidermis and at elevated levels in hyperproliferative
      epidermis. In the present study we report that exogenous TGF-alpha increases
      urokinase-type plasminogen activator (uPA) in cultured human keratinocytes.
      Furthermore, in the absence of exogenous growth factors, the "basal" levels of
      uPA are decreased by an antagonist monoclonal antibody to the receptor shared by
      TGF-alpha and epidermal growth factor (EGF). These results suggest that an
      endogenous factor serves as an autocrine/paracrine regulator of keratinocyte uPA.
      We hypothesize that activation of the TGF-alpha/EGF receptor may coordinately
      regulate the keratinocyte response to cutaneous wounding, which includes enhanced
      uPA expression, migration, and proliferation.

PMID- 8482726
TI  - Mevalonate controls cytoskeleton organization and cell morphology in thyroid
      epithelial cells.
AB  - Blockade of mevalonate synthesis by the 3-hydroxy-3-methylglutaryl Coenzyme A
      reductase inhibitor mevinolin (lovastatin) causes FRTL-5 thyroid cells to undergo
      significant morphological changes; these include a transition from a flat,
      polygonal to a round shape, the development of cytoplasmic arborizations, and the
      loss of contact between neighboring cells. Immunofluorescence studies of
      cytoskeletal structures show that, at early times after administering the drug,
      and before the round phenotype develops, stress fibers disassemble while the
      peripheral actin filaments, which are adjacent to the cytoplasmic face of the
      plasma membrane, appear largely unaffected. Subsequently, when this cortical
      actin network becomes fragmented, cells start to round up and become separated
      from neighbors. Microtubules become disconnected from the plasma membrane and
      retract toward the cell center, although they do not appear depolymerized;
      indeed, at this stage, cytoplasmic elongations contain mostly intact
      microtubules. After exposure to mevinolin FRTL-5 cells also lose vinculin-related
      substrate contacts. Treatment of cells with either cycloheximide or colchicine
      abolishes morphological changes induced by mevinolin, suggesting that ongoing
      protein synthesis and microtubule integrity are prerequisites for the drug to be
      effective. Both cytoskeletal and morphological perturbations can be reversed by
      mevalonate, but not by cholesterol or the non-sterol derivatives of mevalonate
      such as dolichol, ubiquinone, and isopentenyladenine, individually or in
      combination. It is suggested that mevalonate deficiency may impair formation of
      isoprenylated proteins important for cytoskeletal organization and stability.

PMID- 8482727
TI  - Expression and loss of the transferrin receptor in growing and differentiating
      HD3 cells.
AB  - During induced differentiation and maturation of HD3 cells (a chicken
      erythroblast cell line infected with a temperature-sensitive mutant of the avian
      erythroblastosis virus), the levels of transferrin receptor (TFR) and nucleoside
      transporter increase. Both these activities increase before elevated levels of
      hemoglobin are detected. Shortly after induction, as cellular TFR levels rise, a
      native-size TFR is detected in the cell-free culture medium, associated with an
      exosome fraction (100,000 xg pellet). Nucleoside transporter (measured as NBMPR
      binding activity) is not increased in this pellet with induction. Previous
      studies have suggested that exosome formation in peripheral reticulocytes may be
      a significant route for loss of specific membrane proteins (Johnstone et al.,
      1991). Although the present experiments in HD3 cells do not address the
      quantitative importance of exosome formation, the studies suggest that exosome
      formation is an early event in commitment to the red cell lineage and is not a
      phenomenon restricted to the terminal stages of red cell maturation.

PMID- 8482728
TI  - Fibroblast contraction of collagen gels requires activation of protein kinase C.
AB  - Fibroblasts stimulated to contract collagen gels with serum were completely
      inhibited by staurosporine, a broad spectrum kinase inhibitor. Further analysis
      demonstrated that staurosporine is potent (IC50 17 nM), rapid in onset, and
      completely reversible. Complete inhibition of gel contraction was also observed
      with calphostin C (IC50 48 nM), an inhibitor specific for protein kinase C (PKC).
      Similar effects were not observed with KT5926 or KT5720, inhibitors for myosin
      light chain kinase and cAMP-dependent kinases, respectively. These data suggested
      that serum-stimulated fibroblast contraction is dependent upon activation of PKC.
      This was also observed with fibroblast contraction stimulated with endothelin-1,
      platelet-derived growth factor, and transforming growth factor beta. PKC
      activated directly with low concentrations of phorbol ester was observed to
      stimulate fibroblast contraction of collagen gels, in some cases within 30
      minutes of exposure.

PMID- 8482729
TI  - Growth state-regulated expression of p52(PAI-1) in normal rat kidney cells.
AB  - In normal rat kidney (NRK) cells, synthesis of the 52-kDa substrate-associated
      type 1 inhibitor of plasminogen activator [p52(PAI-1)] is linked to alterations
      in cell shape and substrate adhesion. Subconfluent NRK cells accumulated
      significantly more ventral undersurface-associated p52(PAI-1) compared to newly
      confluent or 1-to 2-day postconfluent cultures, suggesting that p52(PAI-1)
      expression was also growth state-modulated. Since cytoarchitectural constraints
      function in cell growth control, changes in p52(PAI-1) synthesis were assessed
      with respect to defined morphologic events that accompany growth activation of
      cultured NRK cells. Stimulation of low population density, quiescent NRK cells
      with 20% serum-containing medium resulted in a rapid increase in matrix p52(PAI
      1) protein content (6- and 26-fold after 1 and 5 hr, respectively). Growth
      activation in response to serum reflected activations in p52(PAI-1) cytoplasmic
      mRNA abundance, which peaked at 2 hr (125-fold increase) and subsequently
      declined (100-fold increase) at 5 hr poststimulation. Morphologic analysis
      indicated that quiescent NRK cells were devoid of transcytoplasmic actin
      filaments and focal contact-associated vinculin. A marked increase in the
      fraction of cells that elaborated transcytoplasmic microfilaments and vinculin
      containing focal adhesions was evident within 5 min of serum addition. Such
      cytoarchitectural restructuring preceded p52(PAI-1) induction. Morphologic
      reorganization and p52(PAI-1) induction occurred prior to progression of cells
      through the S-phase, indicating they are early events associated with serum
      stimulation in the NRK cell system. The relevance of p52(PAI-1) induction during
      this growth state transition is not clear but may influence the established
      cytoarchitectural changes observed prior to p52(PAI-1) induction by regulating
      pericellular proteolysis and, thereby, cell-to-substrate adhesion.

PMID- 8482730
TI  - Pericyte growth and contractile phenotype: modulation by endothelial-synthesized
      matrix and comparison with aortic smooth muscle.
AB  - We compared the effects of endothelial-synthesized matrix and purified matrix
      molecules on pericyte (PC) and aortic smooth muscle cell (SMC) growth, heparin
      sensitivity, and contractile phenotype in vitro. When PC are plated on
      endothelial-synthesized (EC) matrix, cell number is, on average, 3.1-fold higher
      than identical populations grown on plastic. Under the same conditions, SMC
      proliferation is stimulated 1.6-fold. Purified matrix molecules, such as collagen
      type IV (COLL) or fibronectin (FN), both major components of the EC matrix,
      stimulate PC/SMC growth 1.2-1.7-fold. Heparin (100 micrograms/ml), which inhibits
      the growth of early passage SMC by 60%, inhibits PC growth approximately 50%,
      when cells were plated on plastic. However, PC plated on EC matrix in the
      presence of heparin (100 micrograms/ml) grow as well as parallel cultures grown
      on plastic (in the absence of heparin). Concomitant with matrix-stimulated
      proliferation, we observed a marked reduction in PC containing alpha vascular
      smooth muscle actin (alpha VSMA), as seen by immunofluorescence using affinity
      purified antibodies (173/615 positive pericytes on DOC matrix (28%) vs. 221/285
      (77%) positive on glass). SMC respond similarly. Whereas alpha VSMA protein is
      markedly altered when PC and SMC are cultured on EC matrix, similar reductions in
      mRNA are not observed. However, Northern blotting does reveal that PC contain 17
      30 times the steady-state levels of alpha VSMA mRNA compared to SMC. When SMC and
      PC cultures on plastic are treated with heparin, the steady-state levels of
      vascular smooth muscle actin mRNA increase 5 and 1.5 fold, respectively.
      Similarly, heparin treatment of PC grown on plastic induces a 1.8 fold increase
      in nonmuscle actin mRNA. These heparin-induced alterations in isoactin mRNA
      levels are not seen when PC are cultured on EC matrix. We also observed
      reductions in alpha VSMA and beta actin mRNA levels when PC are plated on FN,
      where they maintain a ratio of 13:1 (alpha:beta). Similar ratios are found in SMC
      present in rat and bovine aortae in vivo. These steady-state isoactin mRNA ratios
      are slightly different from those seen in cultured PC (8-10:1; alpha:beta). These
      results suggest that selective synthesis and remodelling of the endothelial basal
      lamina may signal alterations in pericyte growth and contractile phenotype during
      normal vascular morphogenesis, angiogenesis, or during the microvascular
      remodelling that accompanies hypertensive onset.

PMID- 8482731
TI  - Effect of phospholipid acyl chain modulation on vitamin E incorporation into
      pulmonary artery endothelial cell membranes.
AB  - Incorporation of vitamin E (alpha-tocopherol) was measured in total membranes of
      pulmonary artery endothelial cells (PAEC) following treatment with eight
      synthetic phosphatidylethanolamines (PE) (Palmitoyloleoyl, 16:0-18:1 PE1;
      distearoyl, 18:0-18:0 PE2; dioleoyl, 18:1-18:1 PE3; stearoyl- linoleoyl, 18:0
      18:2 PE4; dilinoleoyl, 18:2-18:2 PE5; stearoyl-arachidonyl, 18:0-20:4 PE6;
      diarachidonyl, 20:4-20:4 PE7; and stearoyl-docosahexenoyl, 18:0-22:6 PE8).
      Endogenous PE content of native membranes was 0.88 +/- 0.01 nmol/mg protein.
      Incorporation of PE irrespective of fatty acid content significantly (P < 0.02)
      increased the PE content of total membranes. Vitamin E incorporation in control
      membranes was 63 +/- 9 nmol/mg protein. Incorporation of vitamin E in PE1- to PE7
      treated cells were significantly (P < 0.05) increased compared to controls and
      were comparable to each other. Vitamin E incorporation into PE8-treated cells was
      threefold greater (P < 0.001) than controls and twofold greater (P < 0.001) than
      PE1- to PE7-treated cells. Increased PE content results in increased vitamin E
      incorporation into PAEC membranes irrespective of the fatty acids present on the
      acyl chain, and maximal incorporation of vitamin E in PE8-treated cells may
      relate to the increased carbon chain length rather than to the degree of
      unsaturation at the sn2 position.

PMID- 8482732
TI  - Regulation of polyamine transport by polyamines and polyamine analogs.
AB  - Regulation of polyamine transport in murine L1210 leukemia cells was
      characterized in order to better understand its relationship to specific
      intracellular polyamines and their analogs and to quantitate the sensitivity by
      which it is controlled. Up-regulation of polyamine uptake was evaluated following
      a 48-hr treatment with a combination of biosynthetic enzyme inhibitors to deplete
      intracellular polyamine pools. The latter declined gradually over 48 hr and was
      accompanied by a steady increase in spermidine (SPD) and spermine (SPM) transport
      as indicated by rises in Vmax to levels approximately 4.5 times higher than
      control values. Restoration of individual polyamine pools during a 6-hr period
      following inhibitor treatment revealed that SPD and SPM uptake could not be
      selectively affected by specific pool changes. The effectiveness of individual
      polyamines in reversing inhibitor-induced stimulation of uptake was as follows:
      putrescine < SPD < SPM = the SPM analog, N1, N12-bis(ethyl)spermine (BESPM). In
      contrast to stimulation of transport, down-regulation by exogenous polyamines or
      analogs occurred rapidly and in response to subtle increases in intracellular
      pools. Following a 1-hr exposure to 10 microM BESPM, Vmax values for SPD and SPM
      fell by 70%, whereas the analog pool increased to only 400-500 pmol/10(6) cells-
      about 15-20% of the total polyamine pool (approximately 2.8 nmol/10(6) cells).
      SPM produced nearly identical regulatory effects on transport kinetics. Both
      BESPM and SPM were even more effective at down-regulating transport that had been
      previously stimulated four to fivefold by polyamine depletion achieved with
      enzyme inhibitors. A dose response with BESPM at 48 hr revealed a biphasic effect
      on uptake whereby concentrations of analog < 3 microM produced an increase in SPD
      and SPM Vmax values, whereas concentrations 3 microM and higher produced a marked
      suppression of these values. Cells treated with 3 microM BESPM for 2 hr and
      placed in analog-free medium recovered transport capability in only 3 hr. Thus,
      whereas stimulation of polyamine transport is a relatively insensitive and slowly
      responsive process that tends to parallel polyamine depletion, down-regulation of
      polyamine transport by exogenous polyamines and analogs and its reversal are
      rapidly responsive events that correlate with relatively small (i.e., 15-20%)
      changes in intracellular polyamine pools.

PMID- 8482733
TI  - Defensins are mitogenic for epithelial cells and fibroblasts.
AB  - Defensins are a family of structurally homologous peptides contained within
      phagocytic cells. Although these peptides are best known for their broad spectrum
      antimicrobial properties, they also inhibit ACTH (corticotropin) stimulated
      corticosterone production, chemoattract monocytes, and lyse mammalian cells. We
      now report that these peptides are potent mitogens in vitro in the same
      concentration range that they display potent antimicrobial activity in vitro.
      These concentrations are in the same range as those expected to be present in
      vivo during the wound healing process. All defensins tested were stimulatory for
      epithelial cells and fibroblasts and acted synergistically with insulin. These
      are the first data to disclose the strong growth-promoting effects of this unique
      family of peptides and point to another basic mechanism whereby the macrophage
      and neutrophil may participate in a variety of trophic, physiologic, and
      pathologic processes.

PMID- 8482734
TI  - Statement of the Coalition for Oral Health.

PMID- 8482735
TI  - Inclusion of oral health into the National Health Care Reform Program.

PMID- 8482736
TI  - Mentoring the individual student: qualities that distinguish between effective
      and ineffective advisors.

PMID- 8482737
TI  - Supporting Student Research Group activities.

PMID- 8482738
TI  - A student's expectations of the research experience.

PMID- 8482739
TI  - Supporting student research at the administrative level.

PMID- 8482740
TI  - Mentoring during the transition from graduate student to faculty member.

PMID- 8482741
TI  - Pre-admission credentials and dental school performance of dental hygienists.
AB  - This study examined the effect of dental hygiene preparation prior to entering
      dental school on dental school performance. Study participants included 203
      female students who entered a public dental school from 1980-1989. Groups 1 and 2
      had completed dental school prerequisites and a dental hygiene curriculum in a
      community college setting (n = 19) or university setting (n = 22) respectively,
      and Group 3 (n = 162) were traditional students with no dental hygiene education.
      Preadmission variables were predental science and non-science grade point
      averages (GPA) and Dental Admission Test (DAT) scores. Performance variables were
      GPA of years one and two of dental school and National Board scores (Part 1).
      Results showed that Group 2 hygienists had significantly lower predental science
      GPAs than Group 1 or 3 and significantly lower non-science GPAs than Group 3 (p <
      0). Both groups of hygienists had significantly lower DAT scores than Group 3 (p
      < 0). No difference was seen in first and second year GPAs or the National Board
      average. Adjusting performance scores to compensate for deficiencies in
      preadmission variables showed that Group 2 hygienists had significantly higher
      adjusted first-year GPAs and National Board averages than Group 3 (p < 0). Thus,
      hygienists performed as well as non-hygienists in spite of weaker admission
      credentials.

PMID- 8482742
TI  - Preclinical operative dentistry courses in northern Europe and Scandinavia.

PMID- 8482743
TI  - A survey of faculty practice plans in United States and Canadian dental schools.

PMID- 8482744
TI  - Statement of the American Association of Dental Schools on the future of the NIDR
      Intramural Research Program.

PMID- 8482745
TI  - Curriculum guidelines on oral and maxillofacial surgery. American Association of
      Dental Schools.

PMID- 8482746
TI  - Quantitative analysis of stratum corneum lipids in xerosis and asteatotic eczema.
AB  - Sphingolipids, a major constituent of intercellular lipids, are an important
      determinant for both water-holding and permeability barrier function in the
      stratum corneum. To assess the pathogenic role of sphingolipids in the stratum
      corneum of dry skin disorders such as xerosis and asteatotic eczema in leg skin,
      ceramides were quantified by thin layer chromatography after n-hexane/ethanol
      extraction of resin-stripped stratum corneum and evaluated as micrograms/mg
      stratum corneum. In healthy leg skin (n = 49), there was age-related decline in
      the total ceramide, whereas xerosis (n = 25) and asteatotic eczema (n = 16)
      suffering significantly reduced water-holding properties, exhibited no definite
      decrease, rather slight increase in ceramide quantity with the same composition
      of each individual ceramide as compared to healthy age-matched controls. These
      data indicate that the seemingly elevated level of ceramide is an artificial
      effect due to inflammatory processes which result from susceptibility to dryness.
      Analysis of sebum-derived lipids present in the stratum corneum revealed that
      there was a significant decline in free fatty acids in xerosis and asteatotic
      eczema as compared to age-matched healthy controls, and a similar decline in
      triglycerides in the above three groups when compared to younger controls.
      Although the observed decrease in the stratum corneum lipids may well explain the
      high incidence of winter dry skin in older people, the progression toward
      asteatotic eczema can not be accompanied solely by a decrease in ceramide
      quantity, suggesting that the evolution of xerotic skin is associated with other
      moisturizing factors and/or environmental stimuli.

PMID- 8482747
TI  - Evaluation of phenolic glycolipid-I (PGL-I) antibody as a multidrug therapy (MDT)
      monitor.
AB  - Since phenolic glycolipid-I (PGL-I) is an unequivocal marker for Mycobacterium
      leprae, this antigen has been a good candidate for the serodiagnosis and
      monitoring of the effectiveness of leprosy chemotherapy. The present study, a
      continuation of an earlier report, was undertaken to estimate PGL-I antibody
      titers in 40 leprosy patients 3 and 6 months after starting MDT. All the leprosy
      groups showed significant declines in anti PGL-I reactivity after 6 months. There
      was a good correlation between bacteriological indices (BI) and anti PGL-I
      antibody levels. Thus, PGL-I based serology may be useful in monitoring the
      response to multidrug therapy.

PMID- 8482748
TI  - Analyses of serum copper and zinc levels and copper/zinc ratios in skin diseases.
AB  - With the objective of comprehending abnormal metabolisms of the essential metals
      of zinc (Zn) and copper (Cu) in three groups of skin diseases, skin cancer,
      inflammatory diseases, and non-inflammatory disease, we measured serum levels of
      Zn and Cu in 151 cases of various cutaneous manifestations and estimated the
      significance of the ratios between the two metals (Cu/Zn). The serum level of Zn
      was significantly decreased in cases of bullous pemphigoid, decubitus ulcer, and
      alopecia areata. The serum level of Cu was elevated in cases of psoriasis,
      decubitus ulcer, and skin cancer. We observed no elevation of serum Zn level or
      abnormally depressed serum Cu level. The Cu/Zn ratio showed significantly
      different values among these three groups of the diseases, suggesting the utility
      of measuring Cu/Zn ratios for differential diagnosis over that of determining the
      serum level of Zn or Cu alone. It was also demonstrated that, in each skin
      disease, the Cu/Zn ratio clearly reflects the severity of the progress.

PMID- 8482749
TI  - Analysis of lymphocyte subpopulations in peripheral blood in adult and juvenile
      cases of dermatomyositis.
AB  - Dermatomyositis, recognized as an autoimmune disorder, occurs not only in adults
      but also in children. In this study, we evaluated lymphocyte subpopulations in
      the peripheral blood of 24 adult dermatomyositis and 14 juvenile dermatomyositis
      patients and in 17 healthy adults and 9 healthy children by flow cytometry using
      monoclonal antibodies. When compared with healthy adults and adult patients with
      inactive dermatomyositis, the adult patients with active disease had
      significantly lower percentages of CD3+ and CD8+ cells and a significantly higher
      percentage of CD20+ cells. In contrast, juvenile dermatomyositis patients had
      lymphocyte subpopulations not significantly different from those of healthy
      children; the activity/inactivity of disease did not make any difference. These
      results support our hypothesis that adult and juvenile dermatomyositis may be
      diseases of entirely different scope.

PMID- 8482750
TI  - Electron-microscopic observation of a human epidermal Langerhans cell in mitosis.
AB  - Langerhans cells are dendritic cells of the epidermis originating from bone
      marrow precursors which may exceptionally undergo mitosis within the skin. We
      report herein an electron-microscopic observation of a dividing LC within a
      seemingly hyperproliferative human epidermis. This observation further underlines
      the self-reproducing capacity of LC in situ and suggests that LC may respond to
      the same mitogenic stimuli as keratinocytes.

PMID- 8482751
TI  - A case of progressive systemic sclerosis associated with sarcoidosis and
      esophageal adenocarcinoma.
AB  - A 50-year-old Japanese female with progressive systemic sclerosis (PSS, CREST
      syndrome) is reported. During treatment for PSS, she was diagnosed by clinical
      and laboratory findings as having sarcoidosis, which was confirmed by
      histological examination of the skin and lymph nodes in July of 1991. She
      complained of back pain in August of 1991. Reflux esophagitis and Barrett's
      esophagus, found by endoscopy, progressed into a well-differentiated tubular
      adenocarcinoma. This is a very rare case of PSS associated with sarcoidosis and
      esophageal adenocarcinoma developing from Barrett's esophagus.

PMID- 8482752
TI  - Erythroderma, hair loss, and sinus histiocytosis with massive lymphadenopathy in
      a XYY-male.
AB  - This paper presents a case of sinus histiocytosis with massive lymphadenopathy
      (SHML) presenting as erythroderma in an XYY-male aged 27. The patient had little
      or no scalp, axillary, or pubic hair. Histologically, lymph nodes indicated
      dilatation of the sinuses with proliferation of benign-appearing histiocytes
      possessing abundant clear cytoplasm, admixed with giant cells and pericapsular
      fibrosis. Infiltrating histiocytes in the lymph nodes were OKM-1 (CD11b)
      positive, which is characteristic of monocyte-granulocyte lineages. In the
      present case, the abnormal presence of erythroderma, hair loss, SHML, and a
      chromosomal abnormality, XYY, were thought to be incidental features.

PMID- 8482753
TI  - Dyskeratosis congenita: a case report.
AB  - Dyskeratosis congenita, an uncommon situation in females, is described in a 30
      year-old woman. The expression of the disease was partial and was characterized
      by mottled pigmentation, nail dystrophy, palmoplantar keratoderma, and
      hyperhidrosis.

PMID- 8482754
TI  - Acral lentiginous melanoma associated with Down's syndrome.

PMID- 8482755
TI  - Granulomatous tissue reaction and calcification of heterologous elastin implanted
      in hairless mouse skin: light and electron microscopic studies compared with
      reaction of heterologous collagen.
AB  - Heterologous elastin particles were injected into the deep dermis or below the
      panniculus carnosus of hairless mice. A granulomatous tissue reaction with
      concomitant giant cell formation occurred around the implanted elastin in the
      early stages and, subsequently, calcium deposition with disappearance of the
      histiocytes and giant cells occurred in the later stages. Ultrastructural study
      revealed that some elastin particles were engulfed by the giant cells; others
      underwent calcification but remained intact. The heterologous collagen used as a
      control also induced a granulomatous tissue reaction, but did not undergo
      calcification and gradually disappeared. These results suggest that the
      heterologous elastin and collagen particles exhibit different susceptibilities to
      digestion. However, it is not clear why the heterologous elastin underwent
      calcification.

PMID- 8482756
TI  - Reduction in sexual risk behaviors among college students following a
      comprehensive health education intervention.
AB  - Sexually active college students are at risk of contracting sexually transmitted
      diseases, including HIV infection. As a result, health education initiatives to
      prevent these infections are commonplace, but few controlled research studies
      have evaluated behavioral changes as a result of on-campus sex education. In a
      nonrandomized control trial, sexual risk behaviors of 341 students who had
      received a comprehensive health education intervention in a first-year seminar
      were compared with 227 students who were not enrolled in the seminar. The seminar
      curriculum included an intervention addressing facts about sexually transmitted
      diseases, safer sex, values, decision making, and assertiveness skills. Sexual
      abstinence (no sexual intercourse), number of sexual partners, consistent condom
      use, and methods of contraception were assessed at baseline and after 3 months.
      Compared with students who had not received the intervention, men in the seminar
      reported increased sexual abstinence but no change in consistent condom use; the
      women in the intervention group reported no change in sexual abstinence but an
      increase in consistent condom use. Women who had not received the intervention
      reported never using a condom more frequently than women who had received the
      intervention. The health education intervention on a college campus was
      associated with short-term reduction in sexual risk behaviors, but the reduction
      varied according to the students' gender.

PMID- 8482757
TI  - Using focus group interviews to identify salient issues concerning college
      students' alcohol abuse.
AB  - Despite extensive efforts to decrease alcohol abuse among college students,
      prevention approaches have had limited success. This study attempted to clarify
      reasons for this limited success and to identify directions for future
      interventions by directly interviewing college students on this topic. Five
      issues were discussed in the focus group interviews: (1) reasons for drinking
      alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding
      overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender
      differences in drinking patterns. The focus group interviews were found to be a
      valid tool for elucidating sensitive aspects of these issues and the relative
      importance of these issues to each other. The students revealed how susceptible
      they are to societal pressures to drink alcohol and how the limitations of their
      intrapersonal skills affect their alcohol consumption, most notably regarding
      sexuality issues. The authors contend that improving intrapersonal skills should
      be a major focus of programs to prevent alcohol abuse.

PMID- 8482758
TI  - HIV prevention among Asian-American college students: does the health belief
      model work?
AB  - This study examined the predictive utility of the health belief model (HBM) in
      relation to prevention of HIV infection among Asian-American college students.
      Four research hypotheses were proposed. Three of these hypotheses proposed a
      positive relationship between perceived susceptibility, severity, and benefits,
      and HIV-preventive behavior. The fourth research hypothesis postulated a negative
      relationship between perceived barriers to prevention and actual HIV-preventive
      behaviors. Results indicated that severity and barriers are significant
      predictors of the adoption of HIV-preventive behaviors among Asian-American
      students. Severity was a significant predictor of becoming more careful about the
      selection of intimate partners, reducing the number of sexual partners, and
      generally positive changes toward safer sexual behavior, whereas barrier was a
      significant predictor of becoming more careful about the selection of intimate
      partners, reducing the number of sexual partners, and ensuring that sexual
      partners are not HIV infected. It also appeared that cultural factors, such as
      beliefs about HIV, illness, prevention, sexuality, and homosexuality, need to be
      incorporated into tests of the model to enhance its predictive power.
      Implications of the results and suggestions for further research are discussed.

PMID- 8482759
TI  - Effectiveness of a college course focused on evaluation of health claims.
AB  - This study measured the effectiveness of a college course designed to instruct
      students to make critical evaluations of therapeutic claims for foods, nutrient
      supplements, weight-reduction products and diets, and alternative healthcare
      systems. Experimental and comparison groups were pretested and posttested to
      determine changes in source reliance and cognitive learning. The experimental
      group received instruction in five cognitive areas: (1) health and nutrition
      quackery, (2) consumer protection, (3) basic concepts in health and nutrition,
      (4) nutritional supplements and health foods, and (5) conventional and
      unconventional treatment of chronic diseases. The experimental group scored
      significantly higher in all five conceptual areas on the posttest, and in each
      case scored significantly higher than the comparison group did. Both groups rated
      medical/scientific sources of health and nutrition information as highly accurate
      during the two survey periods. The experimental group showed a change in source
      reliance, moving from dependence on the popular print media and individuals
      without formal education in a health field to medical/scientific sources, whereas
      the comparison group continued to use the popular press and electronic media.
      Findings suggest that a source targeted to the needs and interests of a specific
      group can bring about significant increases in knowledge gain and desirable
      changes in source reliance.

PMID- 8482760
TI  - Comparison of the cytology brush with the Dacron swab for detecting Chlamydia
      trachomatis by enzyme immunoassay in female university students.
AB  - Previous studies comparing the cytology brush (Cytobrush) with swabs for the
      detection of Chlamydia trachomatis from the uterine cervix have yielded divided
      results. The authors carried out a retrospective analysis at the University of
      South Florida Student Health Service to evaluate the effect of a change in
      specimen collection technique on C trachomatis prevalence estimates in female
      university students. Samples were collected from 1,003 women in 1989, using a
      small Dacron swab, and 1,229 women in 1990, using a brush; the samples were
      tested by means of the Pathfinder Enzyme Immunoassay (EIA) detection kit.
      Positive test results were 5.88% for 1989 and 11.66% for 1990. Actual C
      trachomatis prevalence for 1989 and 1990 was stable, as determined by three
      control groups. The results suggest that the cytology brush is more effective
      than the Dacron swab for the detection of C trachomatis in the uterine cervix
      when it is used with the Pathfinder EIA test kit.

PMID- 8482761
TI  - Noninvasive detection of Chlamydia trachomatis in men: a comparison of two
      immunoassay tests.
AB  - This investigation compared a rapid enzyme immunoassay test and an enzyme
      amplified immunoassay test with culture for the noninvasive detection of
      Chlamydia trachomatis urethritis in men. Urine specimens from 108 male subjects
      were evaluated for the presence of C trachomatis antigen, using the Kodak
      Surecell Chlamydia rapid enzyme immunoassay test and IDEIA Chlamydia enzyme
      amplified immunoassay test. The test results were then compared with urethral C
      trachomatis culture and urethral Gram's stain analyses. Performance
      characteristics of the two tests were similar. The rapid chlamydial enzyme
      immunoassay test demonstrated several clinical advantages. Appropriate use of
      these tests may decrease patient morbidity and clarify organism etiology for
      enhanced specific medical care of urethritis in men.

PMID- 8482762
TI  - Students and other patients.

PMID- 8482763
TI  - Establishing a student health all-appointment system: making the transition from
      a walk-in approach.
AB  - The authors offer a process for critically evaluating a walk-in system for
      patient and care provider satisfaction, for developing goals for a new patient
      flow system, and for designing and implementing an appointment system at a
      student health center. Their suggestions are based on their recent experience in
      making the transition from a walk-in approach to an all-appointment system in the
      general medicine division of the university's student health service. They give
      specifics of the appointment system established at their facility, including an
      explanation of the weekly appointment schedule, the monthly duty schedule, and a
      strong triage system. Key areas for consideration in converting to an all
      appointment system, such as reeducational techniques for various staffing
      responsibilities and strategies for marketing a new system to patients, are
      outlined in detail.

PMID- 8482764
TI  - Responding to student disruptions: incorporating supported education.

PMID- 8482765
TI  - An abstract error?

PMID- 8482766
TI  - Boosting practice activity and patient service.

PMID- 8482767
TI  - Assessing quality in dentistry: dental boards, peer review vary on disciplinary
      actions.
AB  - Reported inconsistencies in entry level exams and variations in available
      disciplinary mechanisms suggest the need for modifications to improve these
      processes. A quality assurance system combining education with some sanctions is
      likely to engender dentist support and improve quality of care.

PMID- 8482768
TI  - Lasers issue lauded.

PMID- 8482769
TI  - A note on nitrous.

PMID- 8482770
TI  - Pricing and the perception of health care service quality.
AB  - Do patients bargain-hunt when choosing a dentist or physician? Perceptions of
      quality, price and a patient survey are discussed.

PMID- 8482771
TI  - Maxillary sinus grafting for totally and partially edentulous patients.
AB  - The presence of the maxillary sinus and lack of adequate bone to stabilize the
      implants could make traditional implant placement impossible. The solution
      includes grafting bone to the posterior maxilla to provide adequate bone support
      for implant integration and long-term survival.

PMID- 8482772
TI  - CAD-CAM comments.

PMID- 8482774
TI  - Court stops Florida from recognizing Alabama hygiene program.

PMID- 8482773
TI  - Court says surgeon should have disclosed HIV status.

PMID- 8482775
TI  - When is a dentist an employee?

PMID- 8482776
TI  - Anxiety can increase post-surgical complications.

PMID- 8482777
TI  - WSDA issues consumer checklist.

PMID- 8482778
TI  - NYU Kriser Dental Center receives grant to help AIDS patients.

PMID- 8482779
TI  - Current concepts in dentin bonding: focusing on dentinal adhesion factors.
AB  - With greater need for treating root surface lesions, dentinal adhesives are more
      in demand. For successful treatment, all factors--dentin, tooth, patient and
      materials--must be considered.

PMID- 8482780
TI  - Current developments in dentin bonding systems: major progress found in today's
      products.
AB  - The procedures and products used in dentin bonding systems have changed over the
      years. An overview of the evolving systems is provided.

PMID- 8482781
TI  - How dentists classified and treated non-carious cervical lesions.
AB  - All North Carolina general dentists were shown color photographs of three non
      carious cervical lesions. A fourth picture showed cervical caries. Respondents
      were asked how they defined each lesion, its cause, treatment and frequency of
      appearance in practice. Cervical caries was identified and treated by almost all
      responding dentists, but they applied more varied terms, causes and treatments to
      non-carious defects.

PMID- 8482782
TI  - Determining amalgam marginal quality: effect of occlusal surface condition.
AB  - Currently there is no "standard" finishing and polishing procedure for dental
      amalgam restorations. This investigation evaluated the effect of four different
      finishing techniques on the durability of dental amalgam restorations as
      determined by the marginal breakdown. Burnishing immediately before carving or as
      part of the condensation process seems to improve the carving characteristics of
      the amalgam.

PMID- 8482783
TI  - Latex glove reactions found in a dental school.
AB  - When a survey was distributed to students, faculty and staff of a dental school
      to determine the incidence of latex glove reactions, 15 percent reported adverse
      reactions to glove use. The most frequently reported symptom was dermatitis,
      followed by urticaria, sweating, conjunctivitis and rhinitis.

PMID- 8482784
TI  - Conservative color improvement for teeth with fluorosis-type stain.
AB  - This report describes use of carbamide peroxide bleaching gel to lighten the
      enamel of teeth after enamel microabrasion.

PMID- 8482785
TI  - Managing patients with Alzheimer's: the primary care role of dentists.
AB  - The primary care role of a dentist in the comprehensive care and management of a
      patient with Alzheimer's disease and the caregiver is described. As part of a
      geriatric assessment team, the dentist can contribute to a strategy addressing
      these patients' complex needs.

PMID- 8482786
TI  - Speaking out for dentistry.

PMID- 8482787
TI  - Temporomandibular disorders: a survey of dentists' knowledge and beliefs.
AB  - General dentists and specialists likely to treat TMD were surveyed to gain
      information on their understanding of TMD causes, diagnosis and treatment. While
      the role of psychophysiologic factors in the etiology of TMD has been widely
      acknowledged in the practicing community, there is still a high level of
      controversy about the pathophysiologic aspects of TMD and appropriate diagnoses
      and treatment.

PMID- 8482788
TI  - Single-step purification of F(ab')2 mu fragments of mouse monoclonal antibodies
      (immunoglobulins M) by hydrophobic interaction high-performance liquid
      chromatography using TSKgel ether-5PW.
AB  - A procedure is described for preparation and single-step purification of F(ab')2
      fragments, herein designated as F(ab')2 mu' from mouse monoclonal antibodies of
      the IgM class. Hydrophobic interaction high-performance liquid chromatography
      (HPLC) using TSKgel Ether-5PW was well applicable to the purification. The IgM
      was digested with pepsin at the pepsin-to-IgM ratio of 1:200 (w/w) in 100 mM
      citrate buffer (pH 4.2) at 37 degrees C for 2 h. The digests were applied to the
      gel equilibrated with the buffer containing 1 M ammonium sulfate. F(ab')2 mu
      fragments were adsorbed onto the gel with the same buffer, and eluted by reducing
      the ammonium sulfate concentration to 0 M. The fraction containing F(ab')2 mu
      fragments was homogeneous (purity higher than 97%) by both sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and gel-filtration HPLC. The recovery of the
      antigen-binding site was 55-72%. The cycle time of the Ether-5PW HPLC was 40 min,
      and up to 98 mg F(ab')2 mu fragments. The molecular mass of F(ab')2 mu was
      estimated to be 144-146 kDa. In comparison with IgM, F(ab')2 mu lost entirely the
      complement C1q binding activity, and the sugar content was greatly reduced. The
      binding of IgM with non-specific proteins turned to be negligible, when IgM was
      converted to F(ab')2 mu, suggesting that the fragments are useful for
      immunological application.

PMID- 8482789
TI  - Real-time kinetic analysis of limited proteolysis by ion-exchange chromatography
      using compressed, non-porous agarose beads.
AB  - In biotechnology there is a great need for methods that can be used for kinetic
      studies of ongoing processes, such as limited proteolysis. Ion-exchange
      chromatography on a nonporous, compressed agarose matrix was used in the study
      presented in this paper to monitor papain cleavage of fungal cellulases. This non
      porous matrix allows completion of a chromatographic analysis, with baseline
      resolution, within 30-60 s. Utilizing this very fast chromatographic method one
      can monitor a proteolysis 'continuously' by repeated chromatographic analysis of
      the incubation mixture and, if desired, terminate it at the optimal moment.
      Fractions were also collected for identification by activity assays and
      analytical SDS-PAGE.

PMID- 8482790
TI  - The use of phenyl-Sepharose for the affinity purification of proteinases.
AB  - Phenyl-Sepharose is most often used as an adsorbent for hydrophobic interaction
      chromatography (HIC). We report on its effective use for the affinity
      purification of some extracellular thermostable proteinases from bacterial
      sources. Proteinases belonging to the serine, aspartate and metallo mechanistic
      classes were effectively retained by the media. Purification factors in the range
      of 2.9-60 and enzyme activity yields in excess of 88% were obtained. In some
      cases homogeneous enzyme was obtained from culture supernatants in a single step.
      A number of other proteinases from mammalian sources were also retained. The
      specificity of the enzyme/support interaction was studied. Proteinases complexed
      with peptide inhibitors (pepstatin and chymostatin) showed reduced binding to
      phenyl Sepharose indicating interaction with the active site cleft whereas
      modification with low molecular weight active site directed inactivators such as
      PMSF and DAN did not, indicating that binding may not be dependent on the
      catalytic site. Pepsinogen and the pro-enzyme form of the serine proteinase from
      the thermophilic Bacillus sp. strain Ak.1 were not retained by the media and
      could be resolved in an efficient manner from their active counterparts.

PMID- 8482791
TI  - Solute/solvent interaction corrections account for non-ideal freezing point
      depression.
AB  - A new highly accurate curve-fitting technique for looking at freezing-point
      depression data was proposed by Fullerton et al. (Biochem. Cell Biol., in press).
      The method involve plotting mass solvent to mass solute ratio (Mw/M(s)) vs.
      1/delta T (i.e. the inverse change in freezing point). A measured molecular
      weight and a solute/solvent interaction parameter (called I value) are inferred
      from the resultant linear plot. The accuracy of the molecular weight method was
      first demonstrated with the monomers of ethylene glycol, glycerol, propanol,
      mannitol, glucose and sucrose to show a mean molecular weight error of 0.02% with
      root mean square (RMS) error 0.9%. The RMS error (0.9%) is our best estimate of
      the molecular weight measurement accuracy for the method applied to a monomer.
      This error is consistent with the experimental precision (approximately 1%) which
      implies no systematic error. Non-ideality is described with a single constant, I.
      Polyethylene glycol (PEG) polymers of increasing length (vendor designation 200
      to 10,000 Da) were analyzed to show monotonically increasing non-ideality (I
      values of 0.12 to 3.67) with increasing molecular weight. The measured molecular
      weights agreed with the end-point titration value for the three smallest polymers
      (where the number of polymeric units was less than or equal to 7). The method
      underestimates the vendor molecular weights for longer polymers. This
      disagreement is assigned to segmental motion (internal entropy) of longer, more
      flexible, PEG molecules.

PMID- 8482792
TI  - The application of polystyrene waveguides to protein adsorption investigations.
AB  - The possibility of detecting peroxidase adsorption on the surface of a planar
      polystyrene waveguide has been studied using light of the wavelength adsorbed by
      the protein molecules. When a single-mode optical waveguide was employed, maximal
      protein sensitivity was obtained when the thickness of waveguide layer was about
      1.5-times greater than the cutoff thickness. Adsorption kinetics of peroxidase on
      the surface of polystyrene was studied with single-mode waveguides. A minimum
      surface concentration of 0.1 mg/m2 was observed experimentally.

PMID- 8482793
TI  - Colorimetric assay to determine alcohol dehydrogenase activity.
AB  - A colorimetric assay has been developed to quantify alcohol dehydrogenase (ADH)
      activity. The advantage of this method over conventional spectrophotometric
      assays is that many samples can be processed at once in a 96-well plate,
      monitoring the absorbance at 590 nm with a microtiter reader. ADH inhibitors have
      been used to show the specificity of this method. The assay offers an easy and
      reliable test for monitoring routine measurements of ADH activity and could be a
      valuable tool for those involved in the biomedical research of alcoholism, as
      well as in gene expression methodology in which Drosophila Adh has been widely
      used as reporter gene in transfection assays.

PMID- 8482794
TI  - [Bacterial contamination of the anterior chamber and cataract surgery].
AB  - The authors report the results of bacteriologic cultures of the anterior chamber
      aspirate after cataract surgery. The results were positive for 15 cases (24%).
      Nine cultures were positive for 27 eyes operated by phacoemulsification and 6
      cultures were positive for 35 eyes operated by extracapsular cataract extraction.
      The origin of these organisms is the normal bacterial flora of the conjunctiva
      and the inoculum size is very small. The most commonly identified organisms are
      coagulase-negative staphylococcus and propionibacterium acnes.

PMID- 8482795
TI  - [Experimental use of liposomes carrying an antimetabolite (mitoxantrone) in
      filtering surgery].
AB  - Fibroblast proliferation plays a prominent role in closure of conjunctival
      filtering blebs and extensive investigations are being carried out to optimize
      antiproliferative pharmacotherapy in the prevention of filtering bleb failure in
      glaucomatous eyes with a poor prognosis undergoing surgery. Intercalating agents
      such as doxorubicin or daunorubicin have been shown to decrease fibroblast
      proliferation in tissue cultures. A liposomal delivery system was developed in an
      attempt to obtain a sustained release effect and to minimize ocular side effects
      of mitoxantrone (Novantrone, MITX), an antineoplastic agent with intercalating
      properties. The objectives of this study were to demonstrate the entrapment
      stability of MITX in multilamellar vesicles (reaching about 60% and remaining at
      this level for 8-weeks storage) and to investigate its activity in vitro (cell
      cultures) and in vivo (sclerectomy ab externo in rabbits). We showed that
      entrapped MITX inhibited in a dose-dependent manner subconjunctival fibroblast
      proliferation (ID50: 0.03 micrograms/l at D3 in cultures) and prolonged the
      success of filtration surgery in rabbits (decrease of intraocular pressure of 8
      mm Hg in treated eyes versus 1.8 mm Hg in control eyes; p < 0.01). These results
      indicate the potential of MITX-entrapped liposomes in the control of conjunctival
      scarring in filtering bleb surgery.

PMID- 8482796
TI  - [Corneal crystalline deposits in benign monoclonal gammopathies. Apropos of 3
      cases].
AB  - Unusual corneal crystalline opacities at the level of Bowman's membrane and
      superficial stroma were observed in 3 patients with benign monoclonal gammopathy.
      Corneal immunohistochemical examination showed that the deposits consisted of
      immunoglobulin crystals identical to the paraprotein found in the serum (with the
      same light chain: Kappa in 2 cases and Lambda in the third case). The factors and
      mechanisms governing intracorneal immunoglobulin deposition in the cornea are
      discussed.

PMID- 8482797
TI  - [Vitreoretinochoroidal heredo-dystrophy, microcornea, glaucoma and cataract].
AB  - Vitreoretinochoroidopathy with microcornea, glaucoma and cataract must be
      considered to be a distinctively autosomal dominant affection. The authors
      present evidence in the form of 18 carriers of the same anomaly detected with a
      pedigree extending up to six generations. Microcornea and vitreoretinochoroidal
      dystrophy are the prime characteristics; hypertonia and cataract are induced
      complications. The syndrome may be attributed to a hereditary dysgenesis
      affecting the anterior part of the globe with trabecular and preequatorial
      corneal alterations. The dystrophy has a slow development as shown by the
      clinical and electroretinographic course. Present treatment only consists of
      controlling ocular hypertonia and cataract.

PMID- 8482798
TI  - [Complications of secondary implantation in patients with aphakia].
AB  - We analyzed retrospectively the complications and visual results of 154 cases of
      secondary intraocular lens implantation. The follow-up ranged from 1 to 4 years
      (mean 2.8 years). Best corrected final post-operative visual acuity was better or
      the same as the best corrected preoperative vision in 95.5% of the eyes. Vision
      deteriorated in 7 eyes (4.5%): in 3 eyes because of cystoid macular edema, in 2
      eyes because of retinal detachment, in 1 eye because of corneal decompensation
      and in 1 eye because of macular hole. The incidence of complications was 15.4%.
      We believe that, in carefully selected patients, secondary intraocular lens
      implantation is highly successful.

PMID- 8482799
TI  - [Optical power of the corneal epithelium].
AB  - The refracting power of the corneal epithelium is relatively unknown. We measured
      the keratometric refracting power of the cornea in two series of 10 fresh bank
      eyes and on five cat eyes with and without epithelium. The readings were
      performed at the 2 and 3.6 mm optical zones with an automated keratometer and
      with a videokeratoscope (TMS-1). The mean change was +1.30 D (0.55-1.85 D) at the
      2 mm optical zone and 0.85 D (0.2-1.6 D) at the 3.6 mm optical zone in the first
      series of 10 eyes. The optical power of the epithelium was most significant
      within the central cornea. By removing the epithelium there was an increase in
      corneal refracting power and a change in the power and axis of astigmatism. We
      discuss the consequences of these findings and how they might affect the outcome
      of photorefractive keratectomy or other similar keratorefractive procedures.

PMID- 8482800
TI  - [Simultaneous failure of trabeculectomy and sclerotomy using laser holmium: YAG].
AB  - We present a case of a bilateral chronic open-angle glaucoma in a 74 year old
      woman, operated on the right eye by conventional trabeculectomy and the left eye
      by holmium laser ab externo sclerostomy. Both filtering blebs remained elevated
      and functional for 18 months. After this follow-up period, both blebs
      simultaneously collapsed and intra-ocular pressure rose again. This case shows
      that a late conjunctival scarring process, depending on a non surgical factor,
      may still be encountered after Holmium: YAG laser sclerostomy just as after
      standard trabeculectomy despite reduced conjunctival tissue trauma.

PMID- 8482801
TI  - [Bourneville's tuberous sclerosis].
AB  - We present a case of tuberous sclerosis, classified as phacomatosis. The patient
      is a young woman admitted to hospital for a tumor in the right eye. The diagnosis
      of tuberous sclerosis was based on the presence of the various symptoms of this
      disease. The patient's ophthalmological symptoms were severe. Ophthalmologists
      must look for these symptoms in all subjects at risk, particularly in patients
      with epilepsy but also in the presence of cutaneous or visceral symptoms.

PMID- 8482802
TI  - [Epikeratoplasty for post-traumatic aphakia].

PMID- 8482803
TI  - [Conjunctival cyst of the inferior fornix. Apropos of a case].
AB  - Conjunctival cystic lesions are not uncommon and may arise anywhere in the
      conjunctiva, although the inferior fornix is one of the most frequent sites. We
      report the case of a 5 year-old-male black patient who underwent surgical
      excision of an unusually large conjunctival cyst of the inferior left fornix. The
      histopathological study showed that the cyst border was lined by a conjunctival
      epithelium, consistent with a conjunctival inclusion cyst.

PMID- 8482804
TI  - [Preventive treatment of herpetic keratitis with acyclovir tablets].
AB  - Although several drugs are available to treat superficial herpes simplex
      keratitis, viral latency and recurrences represent clinical challenges that have
      been inadequately addressed by current topical antiviral agents. One hundred and
      ninety patients with previous herpes simplex keratitis were entered in an open
      study to evaluate the efficacy of the prophylactic therapy of recurrence with
      Acyclovir (200 mg) four times daily for 1 month to 24 months. Forty patients were
      treated because of frequently recurring herpetic keratitis; 36 were treated
      during a short period because of known risk factors; 23 were treated after ocular
      surgery which needed topical corticosteroid therapy in the postoperative period
      and 91 patients were treated after penetrating keratoplasty for herpetic
      keratitis. The results of this study indicate that oral Acyclovir significantly
      lowered the incidence of recurrences of herpetic keratitis in selected patients.

PMID- 8482805
TI  - [Vitrectomy and diabetic retinopathy].

PMID- 8482806
TI  - [Ocular herpetic dendritic ulcer in a patient wearing soft contact lenses].

PMID- 8482807
TI  - Effects of age and exercise training on size and composition of the rat left main
      coronary artery.
AB  - This study evaluated the effects of age and exercise training on the left main
      coronary artery (LMCA) in young (Y-5 months) and old (O-27.5 months) female
      Fischer 344 rats. Both age groups were divided into trained (T) and weight
      matched sedentary (S) control groups. Training consisted of 10 weeks of treadmill
      running progressing to a maximum workload of 15% grade, 1 hr/day, 5 d/wk at
      speeds of 36 and 15 m/min for the Y and O rats, respectively. Aging resulted in a
      40% increase in left ventricle (LV) weight which was proportional to the
      increased body weight of the old animals. Exercise training produced a mild
      (approximately 10%) but significant left ventricular hypertrophy (LVH) in both
      trained groups. Cross-sectional area of the LMCA lumen and wall, wall thickness,
      and areas of collagen (C), elastin (E), and collagen-to-elastin ratio (C/E) of
      the LMCA wall were determined morphometrically in all four groups. A method for
      pinpointing the coronary ostium for use as a reference point was also developed.
      LMCA lumen area almost doubled (p < .001) across the measured age difference, but
      was unaffected by training. With aging, the increase in LMCA wall area bordered
      on significance (p < .053), while wall thickness, C area, and the C/E ratio were
      unchanged. Our results indicate that there is a disproportionate increase in the
      cross-sectional area of the rat LMCA with respect to LV mass changes with aging.
      This finding presumably reflects adaptation of this vessel to elevated
      resistances further downstream in the coronary circulation so that tissue
      perfusion can be maintained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482808
TI  - Aging and the pharmacokinetics and metabolism of metoprolol enantiomers in the
      rat.
AB  - After i.v. administration of racemic metoprolol in the rat, the plasma
      concentrations of (R)- and (S)-metoprolol were comparable, and no differences in
      pharmacokinetic parameters between the two enantiomers were found. From the 3rd
      to the 12th month, comparable changes were seen for both enantiomers: there was
      an increase in the area under the plasma concentration-time curve (AUC) and a
      decrease in blood and plasma clearance. Half-life showed a significant
      prolongation, volume of distribution decreased between 3 and 12 months and
      increased between 12 and 24 months. After oral administration of the racemate,
      AUC and Cmax (maximum plasma concentration) were slightly higher, while oral
      clearance was slightly lower for (R)-metoprolol than for (S)-metoprolol. With
      aging, Cmax and AUC increased for both enantiomers, while oral clearance
      decreased. The change in oral clearance as a function of age is different between
      (S)- and (R)-metoprolol, and thus enantioselective. In vitro disappearance rate
      in 3-month-old rats was significantly higher for (S)-metoprolol than for (R)
      metoprolol, although the difference was small. With aging, the disappearance
      rates of both enantiomers increased significantly, but not enantioselectively.

PMID- 8482809
TI  - Identification of disease genes and somatic gene therapy: an overview and
      prospects for the aged.
AB  - Positional cloning strategies for identification of disease genes include genetic
      linkage analysis in disease families and identification of individuals in whom
      the disease is associated with a specific chromosomal anomaly. Once a genomic
      region likely to contain the disease gene has been identified, overlapping
      genomic clones are isolated and the candidate gene sought. Somatic gene therapy
      entails introduction of the cloned gene into somatic cells to either replace
      genetically defective functions or alter pathological disease processes. Transfer
      of the gene may be accomplished by either DNA- or viral-mediated methods into a
      variety of tissue targets. Once the success and reliability of ongoing gene
      therapy trials for various human diseases is established, it may then be
      considered in the prevention and treatment of chronic, disabling diseases such as
      Alzheimer's disease, Parkinson's disease, arthritis, and diabetes as well as
      intervention of immunosenescence, when the relevant genes have been cloned.
      Ethical considerations for gene therapy for aging are similar to those for gene
      therapy in general. In addition, the ethics of gene therapy for treating diseases
      versus intervention of the normal aging process must be considered.

PMID- 8482810
TI  - Comparison of the lateral diffusion constant of hepatocyte membrane proteins in
      two wild mouse strains of considerably different longevity: FRAP studies on liver
      smears.
AB  - The liver cells of male and female wild mice (Peromyscus leucopus and Mus
      musculus) have been studied in young, adult, and old age groups. Because P.
      leucopus displays a life expectancy of 7-8 years, the age groups of this strain
      were from 5.5 to 68 months. M. musculus survives only to about 2.5 years;
      therefore, the age groups of this strain ranged from 6 to 27 months. Protein
      lateral diffusion in hepatocyte membranes was measured by means of fluorescence
      recovery after photobleaching (FRAP) in liver smears. The peroxide-induced
      autofluorescence was utilized as a fluorescent label, which in H2O2 treated liver
      smears is caused by the oxidation of riboflavin bound uniformly to all proteins
      of the cell membrane. This way the average lateral diffusion constant (D) and the
      fractional recovery of those proteins can be measured. In both males and females
      of both strains D displayed a negative linear age correlation. Intraspecies sex
      differences were small and statistically insignificant. However, interspecies
      comparisons of males or females resulted in a strongly significant difference:
      although the intercept points of the regression lines describing D were identical
      in both strains (3.1 x 10(-10) cm2/sec), the decay of D with aging was about 2.5
      times faster in the short-living M. musculus than in the long-living P. leucopus.
      By the end of life expectancy, both strains reached practically identical values
      (about 1.9 x 10(-10) cm2/sec). The results lend further support to the membrane
      hypothesis of aging.

PMID- 8482811
TI  - Uptake of serotonin into platelets of senile dementia of the Alzheimer type
      patients.
AB  - [3H]-serotonin uptake in platelets was studied in 26 patients with senile
      dementia of the Alzheimer type (SDAT), 29 age-matched normal elderly persons, and
      21 young subjects. The results showed a significantly lower uptake of serotonin
      into platelets of SDAT patients than in those of elderly controls (p < .02).
      Uptake of serotonin into platelets of elderly normal subjects was significantly
      lower than in the young (p < .01). These differences were due to reduced Vmax,
      whereas Km was unchanged. Isolated plasma from SDAT patients did not affect the
      uptake of serotonin into platelets of elderly controls, and vice versa, i.e.,
      plasma obtained from elderly controls did not affect serotonin uptake in SDAT
      patients. The results indicate that serotonin uptake into platelets is reduced in
      normal aging, and more so in SDAT. Moreover, the reduced uptake in SDAT is not
      caused by a plasma factor in SDAT patients. No correlation was found between
      serotonin uptake and degree of cognitive impairment in SDAT patients.

PMID- 8482812
TI  - Exercise increases average longevity of female rats despite increased food intake
      and no growth retardation.
AB  - In previous studies, male rats given access to voluntary running wheels showed
      improved survival. Because the male runners did not increase food intake, it was
      not clear whether their improvement in average longevity was due to decreased
      availability of energy for cell proliferation and growth or to another effect of
      exercise. In this study, female rats, which increase their food intake in
      response to wheel running, were used to determine whether exercise can increase
      longevity when availability of energy for cell proliferation and growth is not
      decreased. At age 5 mo, the female voluntary wheel runners were running 9173 +/-
      3640 m/day (mean +/- SD); running distance declined to 965 +/- 483 m/d by age 34
      mo. From 5 mo to 10 mo of age, the runners ate approximately 37% more than the
      sedentary rats. Thereafter, the runners ate approximately 20% more. The runners
      and sedentary rats attained similar peak body weights. However, the runners
      gained weight more rapidly, attaining steady state by 11 mo; the sedentary rats'
      weights did not plateau until approximately 15 mo. The runners had a significant
      prolongation of average longevity without an increase in maximal life span. The
      sedentary rats' average age at death was 924 +/- 155 days (mean +/- SD; range,
      619-1263 d) compared to 1009 +/- 132 days (range, 693-1259 d) for the runners, p
      < .001. These results show that exercise improves average longevity of rats
      independent of decreased availability of energy for cell proliferation and
      growth. They also provide evidence that an increase in food intake is not harmful
      when balanced by an increase in energy expenditure.

PMID- 8482813
TI  - Morbidity and mortality in rural community-dwelling elderly with low total serum
      cholesterol.
AB  - BACKGROUND: Low serum cholesterol has been associated with morbidity and
      mortality in the elderly. This study compared the health, functional status, and
      two-year mortality rates of community-dwelling rural elderly with serum
      cholesterol < 150 mg/dl to age- and sex-matched controls with serum cholesterol
      200-240 mg/dl. METHODS: Self-reported disease history, disability, health habits,
      and cognitive function data were collected at a health risk appraisal interview.
      A single blood sample was also collected and analyzed for total serum cholesterol
      at a central lab. RESULTS: Of the 3,874 participants, 109 (2.8%) had total
      cholesterol levels < 150 mg/dl. Seventy-five percent of the low cholesterol group
      were male compared to 44% in the main study population. The low cholesterol group
      had significantly greater smoking history, current cigarettes smoked, diabetes
      history, angina and COPD symptoms, and assistance needed for heavy and light
      work. Men in the low cholesterol group had significantly lower blood pressure.
      After two years, 14 (12.8%) of the low cholesterol group had died vs 16 (7.3%) in
      the control group. There was no relationship to specific causes of death and
      cholesterol level. CONCLUSION: A very low cholesterol level in older individuals
      should be evaluated carefully to determine whether it is due to genetic or life
      style factors such as diet or, more likely, is a marker of disease.

PMID- 8482814
TI  - Age and sleep modify finger temperature responses to facial cooling.
AB  - BACKGROUND: The increased incidence of hypothermia with age suggests that healthy
      80-year-olds might show impaired responsivity to transient, localized thermal
      stimulation. Such a deficit might be particularly clear during sleep, when
      behavioral thermoregulation is less likely. METHODS: We examined finger
      temperature cooling in response to local cooling of the face--a response presumed
      to be centrally mediated. Nineteen healthy 80-year-olds (12 female) and twenty
      seven 20-year-olds (10 female) were exposed to repetitive 20-minute cooling and
      rewarming cycles across a night of sleep deprivation and a night of sleep
      occurring three nights later. We sought to determine whether thermal responsivity
      was altered by age and sleep, but by design avoided inducing core temperature
      hypothermia. RESULTS: In response to facial cooling during sleep deprivation,
      finger temperature decreased significantly more in the young than in old. This
      suggested relatively greater heat retention in the young. During non-REM sleep
      the thermal responsivity of both groups decreased and age-related differences
      were no longer present. Changes in core temperature induced by the stimulation
      were minimal. CONCLUSIONS: The results suggest that the capability of retaining
      heat via peripheral vasoconstriction while awake decreases with age. Despite this
      vulnerability, responsivity during non-REM sleep as well as average core
      temperature were comparable between age groups.

PMID- 8482815
TI  - Hospitals' motivations in establishing or closing geriatric evaluation management
      units: diffusion of a new patient-care technology in a changing health care
      environment.
AB  - BACKGROUND: Although Geriatric Evaluation Management Units (GEMs) are beneficial
      to patients, they are still new and their adoption by hospitals is unknown. This
      study describes the adoption of GEMs in a large sample of hospitals, and explores
      the reasons underlying hospitals' decisions to open (and sometimes close) an
      inpatient GEM. METHODS: A nationwide mail survey was conducted of 3,655
      hospitals. The survey asked whether the hospital had an operating GEM, had a GEM
      that closed, had considered opening a GEM (but had not done so), or had not
      considered opening a GEM. The survey also requested specific information about
      operating or closed GEMs. Descriptive statistics, chi-square, t-tests, one-way
      analysis of variance, and Tukey's standardized range test for multiple comparison
      of means were used to analyze the responses. RESULTS: Among the 1,639 responding
      hospitals, 159 had established GEMs, 200 were evaluating the possibility of
      opening a GEM, and 1,263 had neither opened nor considered opening a GEM.
      Adopters were more likely to be large, urban, teaching hospitals. Evaluators were
      more optimistic than adopters about GEM's potential to meet financial goals. GEMs
      that closed tended to be located in hospitals experiencing budget deficits. Among
      adopters, space and nonphysician staffing were the most critical barriers to
      establishing a GEM whereas, for evaluators, identifying reimbursement sources and
      physician staffing were the greatest barriers. VA GEMs are smaller and initiated
      for different reasons than non-VA hospital GEMs. CONCLUSIONS: Despite their
      demonstrated usefulness, the adoption of GEMs has been limited. The reasons
      underlying decisions to adopt this new technology or close a GEM are often
      related to financial, not clinical concerns.

PMID- 8482816
TI  - Endurance exercise training reduces glucose-stimulated insulin levels in 60- to
      70-year-old men and women.
AB  - BACKGROUND: Aging is frequently associated with development of insulin resistance
      and deterioration of glucose tolerance. Plasma glucose and insulin concentrations
      tend to be higher than in young people, even in those older individuals whose
      glucose tolerance is within the normal range. A sedentary life style could play a
      role in the development of insulin resistance and hyperinsulinemia with advancing
      age. METHODS: We evaluated the effect of 9 mo of vigorous endurance exercise
      training (approximately 80% of maximal heart rate) on the glucose-stimulated
      insulin response and glucose disposal rate, using the hyperglycemic clamp
      procedure, in 12 people aged 65 +/- 1 yr (mean +/- SE) with normal glucose
      tolerance. The post-training hyperglycemic clamps were performed approximately 16
      h after a usual exercise session. RESULTS: VO2max increased approximately 23% in
      response to the exercise program. The plasma insulin concentration (I) during
      hyperglycemia (180 mg.dL-1) was significantly lower (mean 36 +/- 6 microU.mL-1
      before vs 26 +/- 5 microU.mL-1 after; p < .05) after the exercise program.
      Insulin action was improved by the exercise, as the glucose disposal rate (M)
      during hyperglycemia was unchanged despite the blunted insulin response,
      resulting in an increase in the M/I ratio from 24 +/- 5 to 30 +/- 5 (p < .05), a
      value similar to the M/I ratio of 33 +/- 4 found in normally active young
      subjects. CONCLUSION: These results provide evidence that regular exercise is
      effective in reducing hyperinsulinemia and improving insulin action in 65-yr-olds
      to levels typical of young people.

PMID- 8482817
TI  - Nonsteroidal anti-inflammatory drugs and blood pressure in an elderly population.
AB  - BACKGROUND: Short-term clinical studies suggest that nonsteroidal anti
      inflammatory drugs (NSAIDs) may interfere with the effectiveness of
      antihypertensive therapies. We studied the joint effects of these two classes of
      drugs among subjects participating in the cross-sectional baseline interview from
      a population-based cohort study of community-dwelling elderly. METHODS: Blood
      pressure was recorded by interviewers using a standard sphygmomanometer after at
      least 5 minutes in the sitting position. Two recordings were made in rapid
      succession, using the first and fifth Korotkoff sounds. The second recording was
      used for this study. From respondents' medication container labels, interviewers
      recorded the name and dosage regimen of each medication used during the preceding
      two weeks. RESULTS: Persons on antihypertensive therapy taking NSAIDs had
      systolic blood pressures approximately 5 mmHg higher than those not taking
      NSAIDs, and were more likely to have systolic blood pressure above 140 mmHg (odds
      ratio = 2.19, 95% confidence interval 1.33, 3.61). These findings could not be
      explained by differences between NSAID users and nonusers in age, relative
      weight, or the type or dose of antihypertensive regimen. No significant effects
      of NSAIDs were seen for diastolic blood pressure or among persons not taking
      antihypertensive drugs. When analyses were restricted to non-indomethacin NSAID
      use, the findings were unchanged. CONCLUSION: These findings suggest that NSAID
      use may be an important community reason for loss of pharmacologic control of
      hypertension.

PMID- 8482818
TI  - Kinematics of recovery from a stumble.
AB  - BACKGROUND: Injuries most frequently related to accidents in elderly persons are
      falls during locomotion and stair ascent and descent. Although numerous risk
      factors have been related to falling behavior, effective strategies to predict
      and prevent falls have not evolved. The rationale underlying this study was that
      systematic experimental and analytical investigation of the effects of
      perturbations during locomotion and the subsequent requisites for recovery could
      lead to the development of clinically relevant evaluation(s) capable of
      identifying a predisposition to falling. The present study is the first
      biomechanical investigation of recovery from an anteriorly directed stumble.
      METHODS: Seven healthy, young males participated in this study. While the
      subjects walked along a walkway in the laboratory, stumbles were unexpectedly
      induced using a mechanical obstacle. Videotape records of these trials were
      analyzed and selected sagittal plane kinematics extracted. RESULTS: The
      perturbation caused an increase in the maximum trunk flexion angle from 4.3
      degrees (control) to 18.3 degrees (p = .057), and this change was significantly
      associated with preperturbation walking velocity (p = .036). The maximum hip and
      knee flexion angles increased from 26 to 47 degrees (p = .039) and from 60 to 89
      degrees (p = .009), respectively. The increases in maximum hip flexion velocity
      (79%) and maximum knee extension velocity (36%) were not significant.
      CONCLUSIONS: Identification of the principal elements of control during perturbed
      locomotion can contribute to understanding the relationship between specific age
      related performance deficits and some types of falling behavior. The results
      suggest that recovery from a stumble is dependent upon lower extremity muscular
      power and the ability to restore control of the flexing trunk.

PMID- 8482819
TI  - Personality development across the adult life span: subjective conceptions vs
      cross-sectional contrasts.
AB  - This research examined possible contributions of subjective conceptions about
      development to the study of long-term personality stability and change. Young,
      middle-aged, and old adult subjects rated 100 trait-descriptive adjectives with
      respect to perceived stability and change across seven decades of adulthood,
      their desirability, self-descriptiveness, and personal controllability.
      Subjective conceptions indicated growth during early and middle adulthood,
      followed by decline in old age. These conceptions were optimistic. They involved
      more growth than decline, and desirable traits were seen as more descriptive of
      self and more controllable than were undesirable traits. Older subjects were more
      optimistic about late-life development than were young or middle-aged subjects.
      In contrast, cross-sectional comparisons of self-descriptions indicated
      stability. Potential threats to the validity of both approaches are discussed,
      and it is concluded that the use of both measurement procedures will be
      beneficial for research on personality stability and change.

PMID- 8482820
TI  - Associations between early experiences with parents and well-being in old age.
AB  - This study explores the impact of early experiences with parents on health and
      well-being in old age. An interview survey was conducted with a representative
      sample of 267 elderly community residents in the age group 65-74. Standard
      measures for health, self-esteem, anxiety, depression, and loneliness were
      included as dependent variables. Quality of parenting was measured by means of a
      retrospective questionnaire focused on the care dimension of parental behavior.
      The foremost conclusion of this study is that early experiences with parents have
      an impact on the well-being of elderly persons. The effect is stronger among
      those older persons who lack a current attachment figure in the form of an
      affectionate partner; also, it is stronger for unattached older men than for
      unattached older women.

PMID- 8482821
TI  - Early parental loss and personal control in later life.
AB  - There has been a considerable amount of research on the impact of early parental
      loss on children and younger adults, but far fewer studies have examined whether
      the effects of this early traumatic event extend into late life as well. The
      purpose of this research was to see whether early parental loss is associated
      with diminished feelings of personal control among older adults who participated
      in a nationwide survey (N = 519). In the process of examining this relationship,
      a conceptual model was developed and tested to attempt to explain why early loss
      may exert this effect. This model tests the following theoretical sequence.
      First, it is hypothesized that early parental loss is associated with lower
      levels of educational attainment and that people with limited schooling are more
      likely to encounter financial problems in later life. Finally, this model
      predicts that greater financial strain is in turn associated with diminished
      feelings of personal control among older adults. Subsequent analyses of this
      model provide empirical support for these theoretical linkages.

PMID- 8482822
TI  - The role of social comparisons processes in the psychological adaptation of
      elderly adults.
AB  - Social comparison processes were investigated as mechanisms by which elderly
      women maintain or enhance their psychological well-being in the face of health
      related threats or loss. In Study 1, a measure of social comparisons was tested,
      and a preliminary model of the effects of health and social comparisons on
      depression was examined (N = 42). In Study 2, a separate sample of elderly women
      (N = 243) completed self-report measures concerning physical health, upward and
      downward social comparison processes, and positive and negative aspects of
      psychological adaptation. As predicted, worse physical health status was linked
      to more frequent social comparisons; however, more positive social comparisons
      were related to better mental health outcomes, even for women in poor health. In
      fact, the effects of social comparisons were strongest for women in the poorest
      health, resulting in psychological outcomes similar to women in good health.
      Thus, social comparisons appear to play a significant role in psychological well
      being in old age. The findings also point to the importance of distinguishing
      between frequency and consequences of social comparison processes.

PMID- 8482823
TI  - Improved foot position sense as a result of repetitions in older adults.
AB  - This research investigated whether acuity of perceived foot position changes as a
      result of repetitions in older and young adults. Subjects actively held four
      reference positions with one foot and matched these positions 12 times with the
      other foot. The data suggest that young adults performed the matching tasks with
      more overall accuracy and less variability than the older adults. Both young and
      older adults needed progressively less time to perceive an accurate match with
      repetitions. Repeated matching trials improved performance consistency in the
      older adults and resulted in less bias in both age groups. These results imply
      that adult aging affects the quality of the sensory signals conveying foot
      position at the ankle joint, but that repetitions make older adults more aware of
      proprioceptive feedback resulting in faster, more consistent, and more accurate
      performance.

PMID- 8482824
TI  - A comparative analysis of neuropsychological test performance of Spanish-speaking
      and English-speaking patients with Alzheimer's disease.
AB  - Because the diagnosis of dementia is highly dependent on the identification of
      neuropsychological deficits, there have been increasing concerns regarding
      cultural bias in tests designed to measure cognitive and intellectual function in
      English-speaking and Spanish-speaking adults. Despite their widespread clinical
      use, the effects of potential cultural bias on these measures among these two
      groups are largely unknown. We assembled a group of 76 females who received an
      NINCDS-ADRDA clinical diagnosis of Alzheimer's disease (AD). Half of these
      subjects were primary Spanish speakers, and the other half reported English as
      their primary language. All subjects were matched on chronological age and
      severity of memory impairment. Factors such as educational attainment and
      depression were entered into the analyses as covariates. The two groups were
      compared with respect to their performance on a battery of neuropsychological
      tests that are representative of what is typically used to diagnose the presence
      and severity of dementia. The finding that Spanish-speaking AD patients scored
      lower on specific neuropsychological measures is discussed in terms of inherent
      language biases and the possible lack of saliency of a number of these tests. The
      results obtained further suggest the need to modify certain neuropsychological
      indices so that they will better serve diverse ethnic and cultural groups.

PMID- 8482825
TI  - Age differences in mental rotation task performance: the influence of
      speed/accuracy tradeoffs.
AB  - Young and old subjects performed a mental rotation task with a within-subject
      instructional manipulation of speed/accuracy criteria. The three sets of
      instructions emphasized speed, accuracy, or both speed and accuracy equally. Both
      age groups changed reaction time (RT) in response to instructions, but there was
      no Age x Instruction interaction. Whereas young subjects showed decreases in
      accuracy with decreasing RT, older adults showed relatively stable levels of
      accuracy with decreasing RT, suggesting that young subjects were more willing to
      sacrifice accuracy for improvement in speed. Speed/accuracy operating
      characteristics for the two groups did not overlap, suggesting that age
      differences in response criteria cannot completely account for age differences in
      mental rotation performance.

PMID- 8482826
TI  - Time use of caregivers of impaired elders before and after institutionalization.
AB  - Time use was examined by means of time budgets obtained from 165 caregivers of
      older persons recruited from nursing home waiting lists and state nursing home
      assessment programs. "Yesterday interviews" were done at baseline (T1) and,
      again, an average of 5 months later when the elder had either entered a nursing
      home (n = 77) or was still awaiting entry (n = 88). Caregivers who provided more
      help (particularly instrumental assistance) to their elder were more likely to
      see that person placed in a nursing home at follow-up. More caregiving time was
      reported by those living with the elderly person and by nonworking and lower
      income caregivers; the elders being cared for by these groups were also more
      impaired. Less caregiving time (a total gain of 1 hour 47 minutes) was reported
      by caregivers following admission of the older person to the nursing home. The
      gained time was allocated to a significant degree to family interaction,
      recreation, and time outside the home.

PMID- 8482827
TI  - Classification of adult day care: a cluster analysis of services and activities.
AB  - Using data from a 1986 national census survey of 774 adult day care (ADC)
      centers, this study (a) determined whether distinct classes of ADC could be
      identified based on measures of program services and activities, and (b)
      delineated the distinguishing characteristics of such classes on other available
      measures of structure, process, and client population. A cluster analysis of 10
      "process" measures of services and activities identified 6 classes of ADC
      centers: Alzheimer's Family Care, Rehabilitation, High Intensity Clinical/Social,
      Moderate Intensity Clinical/Social, General Purpose, and Low Scoring. Validity
      was examined by developing a set of expectations for pairs of classes on other
      available variables. Of 12 expectations, 11 were supported by the statistical
      tests. Finally, profiles of the 6 classes were developed to describe the classes
      on 30 other characteristics. The findings clarify the settings to which previous
      ADC studies are generalizable and indicate a need for effectiveness studies on
      special classes of ADC.

PMID- 8482828
TI  - Marriage and romantic involvement among aged African Americans.
AB  - This study examined the extent and structural correlates of marriage, romantic
      involvement, and preference for romantic involvement among older adults in a
      national sample of African Americans. Multivariate analyses indicated that
      gender, age, education, income, and urban residence were important predictors of
      marriage and romantic involvement. In particular, men and younger respondents
      were more likely than women and older respondents to be married, have a romantic
      involvement, or be desirous of a romantic involvement. The effects of the
      decreased probability of marriage for future cohorts of older African American
      women on their supportive networks, living arrangements, and income adequacy are
      discussed.

PMID- 8482829
TI  - Conjugal support: factor structure for older husbands and wives.
AB  - The purpose of this study was to investigate the factor structure of social
      support among older spouses. The sample consisted of 298 older marital dyads who
      participated in the Aging Couples Study. Confirmatory factor analysis techniques
      were used to examine conjugal support in a series of nested measurement models at
      the couple and individual levels. Two research questions were addressed: (a) the
      viability of conjugal support as a couple's construct, and (b) the dimensionality
      of social support within the marital dyad. Results showed that conjugal support
      was a husband/wife, rather than a couple, construct. Findings also showed that
      conjugal support was a multidimensional construct consisting of three factors:
      instrumental support, emotional support, and confiding. Moreover, husbands and
      wives perceived the dimensions of conjugal support differently.

PMID- 8482830
TI  - Patterns of nonresponse in a national survey of elderly Japanese.
AB  - Data from a nationwide sample of older adults in Japan were analyzed to determine
      patterns of unit nonresponse. Maximum likelihood logistic regression analyses
      identified age, sex, geographic region, and urbanicity as significant predictors
      of response status. The probability of nonresponse was higher for men, persons
      living in certain regions, and those in large urban areas. Age had a curvilinear
      relationship with response status; the probability of nonresponse decreased from
      age 60 to age 70, and then increased again with the highest rates at the oldest
      ages. When nonrespondents were disaggregated into three different groups based on
      reason for nonparticipation (i.e., refusals, not-at-homes, other reasons),
      variation in the results was found. For example, while men were more likely than
      women to refuse an interview or be absent from home during the survey period,
      they were no more likely to not participate for other reasons. Use of different
      response rate calculations and a substitution sampling procedure were not found
      to seriously affect study results.

PMID- 8482831
TI  - Changes in functional status and the risks of subsequent nursing home placement
      and death.
AB  - This research examined the effects of changes in functional status on the risks
      for subsequent nursing home placement and death. Using data on the 3,646 baseline
      self-respondents to the Longitudinal Study on Aging who were successfully
      reinterviewed at the first follow-up (1986) and who were not in a nursing home at
      that time, a two-stage analysis was conducted. First, the risks for nursing home
      placement and death between the 1986 and 1988 follow-ups were modeled based on a
      static set of baseline (1984) indicators. Measures of the change in functional
      health status between baseline and first follow-up were then introduced to
      determine whether such change had significant net effects and enhanced model fit.
      Substantial improvement in model fit was obtained for both outcomes. The risk of
      nursing home placement was associated with deterioration in advanced (i.e.,
      cognitive) ADLs and lower body function. Deterioration in basic ADLs and lower
      body function was associated with the risk of dying.

PMID- 8482832
TI  - Analysis of IL-2, IL-4, and IFN-gamma-producing cells in situ during immune
      responses to protein antigens.
AB  - Immunohistochemistry has been used to define the patterns and kinetics of IL-2,
      IL-4, and IFN-gamma production at the sites of Ag exposure and in the lymphoid
      tissues of immunized mice, and to examine the anatomic relationships between
      cytokine-producing T cells and various APC or Ag-stimulated B cells. The earliest
      detectable cytokine response to administration of a protein Ag in adjuvant was
      the appearance of IFN-gamma-producing NK cells at the site of immunization by day
      3. T lymphocytes producing IL-2, IL-4, and IFN-gamma were initially detected in
      draining lymph nodes and spleen within 7 days after immunization, and IL-2
      producing cells were present at the immunization site several weeks later. Thus,
      T cell activation is initiated within lymphoid tissues, and these cells migrate
      back to depots of Ag. The IFN-gamma produced by NK cells early after immunization
      may regulate the phenotype of the subsequent Ag-specific T cell response. Using a
      hapten to which the antibody response is oligoclonal and dominated by a single
      idiotype, Ag-stimulated (idiotype-producing) B cells could also be detected by
      immunohistochemistry. These B cells were present in the same areas of lymphoid
      tissues as cytokine-producing T lymphocytes. Two-color staining showed that
      idiotype-producing B cells were in close proximity to both IL-2- and IL-4
      producing T cells, suggesting that T cells producing either of these cytokines
      could provide helper function for the B cells. Finally, after subcutaneous
      immunization with adjuvant, IL-2+ T cells were found adjacent to F4/80+
      macrophages, suggesting that macrophages function as important APC in this
      response.

PMID- 8482833
TI  - A mutant antigen-presenting cell defective in antigen presentation expresses
      class II MHC molecules with an altered conformation.
AB  - Ag presentation by APC to class II MHC-restricted T cells involves a sequence of
      events: 1) intracellular processing of protein Ag into immunogenic peptides, 2)
      specific binding of peptides to class II MHC molecules, and then 3) transport of
      the MHC-peptide complexes to the plasma membrane. The critical event in the
      activation of T cells by APC is the recognition of MHC-associated antigenic
      determinants by the TCR/CD3 complex. In this report we describe the isolation and
      characterization of a mutant APC with a defect in an intracellular process that
      results in its inability to form MHC-peptide complexes for recognition by T
      cells. The mutant APC cannot present many different protein Ag with both I-A and
      I-E molecules but is able to present processing-independent peptides. The
      functional defect in the mutant APC is not caused by either a decrease in
      expression or a structural mutation in class II MHC molecules. Further, there is
      no mutation in the invariant chain (li) and it displays a normal kinetics of
      association and dissociation from the class II MHC molecules during biosynthesis.
      Although the mutation is not in the genes encoding for the class II MHC molecules
      or li, the mutant APC expresses class II MHC molecules with distinct serological
      epitopes suggestive of an altered conformation. Pulse-chase experiments suggest
      that a conformational difference between I-Ad molecules of wild-type and mutant
      cells occurs after the class II molecules exit from the endoplasmic reticulum but
      while they are still associated with li. The mutant cell produces few compact
      (SDS-resistant) class II heterodimers. This mutant APC provides a tool for
      studying the cell biology of Ag processing and presentation.

PMID- 8482834
TI  - Phosphatidylserine enhances the ability of epidermal Langerhans cells to induce
      contact hypersensitivity.
AB  - Phosphatidylserine (PS) modulates several immune functions in vitro, including T
      cell activation, antibody and cytokine production, and macrophage growth. In the
      present work we studied the effects of PS on the induction of contact
      hypersensitivity (CH) in mice. BALB/c mice painted with PS (9.4-75 mg/kg) and
      with a sensitizing dose of DNFB or oxazolone on the same skin site exhibited a
      dose-dependent augmentation of CH reactions to either DNFB (> 60%) or oxazolone
      (> 35%), respectively. Bovine brain PS-enriched phospholipid mixture, lyso-PS,
      and dipalmitoyl-PS also induced similar enhanced CH responses, whereas
      phosphatidylglycerols had no effect. Increased CH was observed only when PS was
      applied from 2 days before to 12 h after DNFB. Immunization of naive syngeneic
      mice with skin grafts that were treated with PS and DNFB also led to enhanced (>
      50%) CH responses. In addition, immunization by iv injection of epidermal cell
      suspensions enriched for Langerhans cells (LC) or of purified LC that were
      treated with PS (1-100 microM, 30 min, 37 degrees C), and then modified in vitro
      with DNBS (1 mg/ml, 30 min, 37 degrees C) led to increased (> 30-75%) CH
      responses in recipient syngeneic animals. Finally, adoptive transfer of DNFB
      immune lymph node cells obtained from mice that were treated with PS induced
      augmented CH responses in recipient animals. The results suggest that PS is
      capable of up-regulating the induction of CH in mice by stimulating the APC
      function of epidermal LC.

PMID- 8482835
TI  - Differential expression of IL-4 receptors in human T and B lymphocytes.
AB  - IL-4R have been described in unstimulated human T and B lymphocytes. However, a
      precise comparative study on the expression and regulation of IL-4R in isolated
      human T and B cell populations has not yet been fully assessed. We examined the
      mRNA levels and the cell membrane expression of IL-4R in freshly isolated T and B
      lymphocytes as well as in in vivo- and in vitro-stimulated cells. IL-4R protein
      expression and transcript levels were higher in tonsillar unstimulated B cells
      than in T cells. Splenic and peripheral blood B lymphocytes also expressed higher
      surface IL-4R in their membranes than T cells did. Large B lymphocytes from
      tonsils (in vivo-activated cells) obtained by Percoll gradient centrifugation
      displayed higher IL-4R levels than resting cells. On activation in vitro of T
      lymphocytes with IL-2 or PHA, slight increments on the IL-4R mRNA and protein
      levels were achieved. However, maximal levels of IL-4R expression were obtained
      on T cell incubation with IL-4 at a concentration of 100 U/ml. Similarly, the
      same concentration of this lymphokine up-regulated the surface IL-4R molecules
      and the IL-4R mRNA levels in purified B lymphocytes. Cross-linkage of surface Ig
      by insolubilized anti-IgM potentiated the effect of IL-4 in up-regulating IL-4R
      expression in B cells, probably by inducing outgrowth of IL-4R positive
      subpopulations. The B cell mitogen, Staphylococcus Aureus Cowan I, although
      inducing cell proliferation, was ineffective in promoting new receptor synthesis.
      Cell proliferation was not required for IL-4-dependent IL-4R up-regulation on
      both T and B lymphocytes.

PMID- 8482836
TI  - T cell receptor antagonism mediated by interaction between T cell receptor
      junctional residues and peptide antigen analogues.
AB  - A major objective of new rational immunosuppressive therapies is to be able to
      inhibit deleterious T cell responses in an Ag-specific manner. Recently, a novel
      approach to inducing Ag-specific nonresponsiveness in T cells, termed receptor or
      TCR antagonism, has been described. Several analogues of the influenza
      hemagglutinin (H3) peptide HA307-319 were shown to block recognition of the
      native HA307-319 peptide by a DR1-restricted T cell clone at concentrations 1,000
      to 10,000-fold less than required to competitively inhibit HA307-319 binding to
      DR1. These Ag analogues that inhibited T cell recognition differed from the
      stimulatory antigenic peptide only at single positions. How such limited changes
      affect the ternary complex interactions of TCR, peptide, and DR remains unclear.
      In the present study, we have utilized two different DR5-restricted T cell clones
      that exhibit mutually exclusive specificities for HA peptides with or without
      substitutions at position 313 to investigate the molecular requirements for
      receptor antagonism. In this reciprocal model system, we show that a single
      peptide/DR complex can antagonize one T cell clone while stimulating another. A
      comparison of nucleotide sequences derived from the TCR of the T cell clones that
      were either antagonized or stimulated by the peptide analogue/DR5 complex
      indicated that the different responses of these T cells result from minor
      differences in the amino acid residues in junctional regions that most likely
      interact directly with position 313 of the peptide analogues. Our results suggest
      that TCR antagonism is an Ag-specific phenomenon in which T cells are inhibited
      by interactions involving TCR residues required for the recognition of
      conventional Ag and the altered residues in peptide analogues.

PMID- 8482837
TI  - Role of TNF-alpha in CD8+ cytotoxic T lymphocyte-mediated lysis.
AB  - The possibility that lymphokines such as TNF-alpha produced by CD8+ CTL are
      responsible for acute (short term) target cell damage induced by CTL has been
      debated for many years. However, the slow kinetics of TNF-induced target cell
      death stands in sharp contrast to the rapid target cell lysis mediated by CTL. We
      find that cloned CD8+ CTL activated through their TCR secrete TNF-alpha. On the
      other hand, our cloned CTL also have a membrane form of TNF-alpha, and they kill
      TNF-alpha-sensitive target cells not recognized through the TCR in a slow (18-h)
      lytic reaction using this surface-associated TNF-alpha. There is no secreted TNF
      alpha release during this interaction. Cyclosporin A and protein synthesis
      inhibitors block TNF-alpha secretion, but have no effect on slow lysis mediated
      by the CTL. On the other hand, TNF-alpha-resistant variants are greatly resistant
      to slow lysis, and antibodies to TNF-alpha strongly inhibit this slow lysis.
      Thus, although secreted TNF-alpha does not seem to be the mechanism behind slow
      lysis, some form of TNF-alpha, most likely the membrane-associated form, must be
      involved. Not only does surface TNF-alpha appear to be biologically active in
      these CTL, but its expression is enhanced severalfold upon activation of the CTL
      through the TCR. This may be important in vivo, where surface TNF-alpha could
      preserve the localized nature of cytolysis and endow a CTL with an additional,
      albeit slower, mechanism of cell lysis. Finally, we find that although activated
      CTL clearly use the membrane form of TNF-alpha in slow lysis, they appear not to
      use TNF-alpha, in any form, during acute lysis, even under conditions in which
      degranulation and perforin assembly are blocked.

PMID- 8482838
TI  - Role of CD8 in staphylococcal enterotoxin B-mediated lysis by cytotoxic T
      lymphocytes.
AB  - Recent evidence has suggested that recognition of superantigens such as the
      staphylococcal enterotoxins by CTL occurs independently of the accessory molecule
      CD8. These conclusions are based on the observation that antibodies to CD8 do not
      appear to be effective inhibitors of T cell lysis that is mediated by
      enterotoxin. This is in contrast to the well-known inhibitory effects of anti-CD8
      antibodies on T cell activation by most peptide/class I complexes. In this study,
      we show that lysis of staphylococcus enterotoxin B (SEB)-bearing target cells by
      the mouse alloreactive CTL clone 2C is inhibited by anti-CD8 antibodies. SEB
      mediated lysis by a polyclonal population of mouse CTL was also inhibited by anti
      CD8 antibodies, but only under conditions where the SEB concentration is low.
      Inhibition occurs even when class I negative Daudi cells are used as targets.
      Thus, the observed inhibition does not appear to be due to the prevention of
      intercellular interactions between CD8 and class I molecules but is probably a
      consequence of preventing the intracellular association of CD8 and TCR. At the
      high ligand densities used in most previous studies, very few of the CD8/TCR
      complexes may be required for activation. Under these conditions, lysis may
      appear to be CD8 "independent" because 1) there are a sufficient number of
      preexisting CD8/TCR complexes for activation; or 2) prohibitively high
      concentrations of antibody would be needed to saturate unassociated CD8.

PMID- 8482839
TI  - Induction of activation-driven death (apoptosis) in activated but not resting
      peripheral blood T cells.
AB  - Signaling via the CD3/TCR complex induces programmed cell death (apoptosis) in
      immature thymocytes and transformed T lymphocytes (hybridomas or leukemic cells).
      Accumulating evidence indicates, however, that apoptosis can be triggered also in
      mature peripheral T cells. Here we show that a significant fraction of cells of a
      given IL-2-dependent TCR-alpha beta + clone or polyclonal short term line is
      killed when cultured for 20 h in the presence of PHA, anti-CD3 (OKT3), or anti
      TCR (BMA031) mAb. Apoptosis can be triggered by these stimuli in CD4+, CD8+, and
      CD4-CD8- (double-negative) TCR-alpha beta+ clones. Activation-driven cell death
      (as quantified by propidium iodide staining and FACS analysis) is associated with
      fragmentation of DNA into oligonucleosomal bands of approximately 200 bp.
      Although freshly isolated peripheral blood T cells are largely resistant to
      apoptosis, the sensitivity to anti-CD3/TCR mAb or PHA-triggered cell death
      gradually increases upon activation and IL-2-dependent culture of T cells, and
      reaches a plateau level after 15 to 20 days. These data indicate that stimuli
      that activate resting T cells initiate death by apoptosis in activated T cells.
      The implications of these results for the regulation of cellular immune responses
      and the establishment of peripheral tolerance will be discussed.

PMID- 8482840
TI  - Rat class III Fc gamma receptor isoforms differ in IgG subclass-binding
      specificity and fail to associate productively with rat CD3 zeta.
AB  - Several new rat class III Fc gamma R isoforms are described here, extending the
      genetic complexity of this receptor family and further distinguishing rat CD16
      from mouse CD16, represented by only one receptor isoform, and human CD16,
      represented by only two isoforms. RNase protection assays reveal that three rat
      tumor cell lines--RBL-1 basophilic leukemia cells, RM-SV1 macrophages, and CRNK
      16 NK cells--all coordinately express multiple and probably identical rtFc gamma
      RIII-related transcripts in similar relative proportions but at significantly
      different levels. These results indicate that no single isoform predominates in
      these cell types but that the overall level of rtFc gamma RIII-related
      transcripts is differentially regulated. Two of the rtFc gamma RIII isoforms
      found to have extensive amino acid sequence differences in their second
      extracellular (EC2) domains are shown to bind rat and mouse IgG subclasses
      differently. This result suggests that the receptor isoform diversity in this
      species may function as a mechanism for extending the IgG-binding capacity of rat
      leukocytes. Cloned cDNA for the rat CD3 zeta protein was also isolated in this
      study and its ability to augment surface expression of class III Fc gamma R was
      tested by rosetting of cDNA-transfected COS cells. Like the structurally
      homologous mouse CD3 zeta, rat CD3 zeta fails to promote surface expression of Fc
      gamma RIII, sharply contrasting the efficient receptor expression produced by
      human CD3 zeta. Variations in the transmembrane amino acid sequences correlate
      with the divergent capacities of these CD3 zeta molecules to augment receptor
      expression. The high levels of CD3 zeta message expressed in rat NK cells may
      indicate that other unidentified hetero-subunits are required for assembly of rat
      CD3 zeta into functional CD16 receptors.

PMID- 8482841
TI  - Ca2+ ionophore A23187-dependent stabilization of granulocyte-macrophage colony
      stimulating factor messenger RNA in murine thymoma EL-4 cells is mediated through
      two distinct regions in the 3'-untranslated region.
AB  - We analyze the role of the Ca2+ ionophore A23187 in the induction of GM-CSF mRNA
      expression in EL-4 thymoma cells. Northern analysis shows that A23187 increases
      the half-life of GM-CSF mRNA. To identify potential Ca2+ response elements in the
      GM-CSF mRNA, we produced stable transfectants containing pRSV-CAT (EL-4cat) or
      hybrid constructs in which most of the GM-CSF 3'-untranslated region (EL-4gm) or
      the adenosine-uridine boxes alone (EL-4au) were placed in a downstream position
      from the CAT coding region. A23187 induces a 4.4-fold increase in CAT activity in
      EL-4cat cells and a 210-fold and 48-fold increase in CAT activity in EL-4gm and
      EL-4au cells, respectively. Actinomycin D chase experiments in transfected cells
      demonstrate that A23187 increases the half-life of CAT mRNA from 15 min to 3 h in
      EL-4au cells and more than 3 h in EL-4gm cells, suggesting that the effect of
      Ca2+ is mediated predominantly by the adenosine-uridine boxes with a smaller
      contribution from upstream regions. To map these upstream regions, we transfected
      cells with constructs containing mutations of the 3'-untranslated region. With
      two of these mutations, corresponding to a region located about 160 bases
      upstream of the adenosine-uridine boxes, CAT activity was induced only 50-fold
      compared to 200-fold in EL-4gm cells. These data indicate that two regions within
      the GM-CSF 3'-untranslated region interact to modulate Ca2+ effects on GM-CSF
      mRNA half-life.

PMID- 8482842
TI  - A functional analysis of the antigenicity of streptokinase using monoclonal
      antibody mapping and recombinant streptokinase fragments.
AB  - Streptokinase (SK), a bacterial product of pathogenic Streptococcus species, is
      now widely used as an effective therapy for the treatment of heart attacks.
      Because naturally occurring antibody to SK is ubiquitous, serious allergic
      reactions to SK therapy are common. To begin to identify regions of the molecule
      that are important for the antigenicity of SK we performed studies using a panel
      of 51 hybridomas producing anti-SK antibodies, recombinant SK fragments, and
      assays of SK activity. Antibodies generated from mice hyperimmunized with wild
      type SK were shown to fall into six distinct complementation groups by
      competitive binding studies. Recombinant SK fragments were used to determine the
      peptide regions recognized by these complementation groups. Correlation of the
      effects of the mAb on SK function, with knowledge of their SK fragment-binding
      pattern, suggested regions of the SK molecule that are important for the
      construction and the catalytic function of the SK-plasminogen activator complex.

PMID- 8482843
TI  - Different effects of substitutions at residues 224 and 228 of MHC class I on the
      recognition of CD8.
AB  - Previous studies indicated that weak xenoresponse to HLA class I by mouse T cells
      is due to the inefficient interaction of mouse CD8 with the alpha 3 domain of HLA
      class I. The present study using chimeric H-2Kb molecules with recombinant alpha
      3 domain between H-2Kb and HLA-B7 as well as single amino acid mutants of H-2Kb
      demonstrated that each substitution at residues 224 and 228 affects recognition
      of CD8-dependent mouse CTL clones. On the other hand, reactivity of IL-2
      producing H-2Kb-specific T cell hybridoma transfected with mouse CD8 alpha was
      abrogated by substitution at residue 224 but not by that at residue 228. This
      indicates that the substitution at residue 228 affects recognition of CD8
      dependent CTL but does not critically affect binding of CD8 to MHC class I
      molecules, although residue 224 abrogates binding of CD8. The model structure of
      the alpha 3 domain of H-2Kb suggests that the substitution at residue 224 induces
      conformational change of CD8 binding loop, whereas minimum structure change by
      the substitution at residue 228 is expected. It is therefore speculated that
      minimum structure change of CD8 binding loop by substitution at residue 228 may
      influence binding affinity of CD8, which abrogates recognition of CD8-dependent
      CTL but not IL-2 production of the CD8-dependent T cell hybridoma.

PMID- 8482844
TI  - Alteration of Leishmania donovani infection levels by selective impairment of
      macrophage signal transduction.
AB  - Leishmania donovani is an obligate intracellular protozoan which residues and
      multiples in macrophages. The molecular basis for this host-parasite interaction
      is poorly understood. Targeting a signal transduction pathway in the macrophage
      would allow this parasite to manipulate cellular gene expression, and this may
      aid in ensuring its survival. We demonstrate that in macrophages infected with L.
      donovani for 18 h, c-fos gene expression mediated through protein kinase A was
      unaffected under conditions where there was an impairment of protein kinase C
      (PKC)-mediated c-fos gene expression. This selective impairment of PKC-mediated c
      fos gene expression was substantially augmented in macrophages put in contact
      with L. donovani promastigotes or amastigotes for only 1 h. Treatment of
      macrophages with L. donovani-conditioned media was not sufficient to
      significantly impair signal transduction. These data revealed that L. donovani
      selectively impaired the transmission of information from the cell surface to the
      nucleus and that this effect is induced very soon after macrophage-parasite
      contact. The biologic significance of this altered signal transduction in the
      macrophage with respect to infection with L. donovani was then examined by
      treating macrophages with various protein kinase inhibitors prior to infection
      with amastigotes. Macrophages that were treated with PKC inhibitors demonstrated
      an increase in the initial uptake of the parasite and carried heavier infection
      levels than did controls. In contrast, treatment of macrophages with an inhibitor
      of calmodulin-dependent protein kinase (CaM-PK) did not show significant
      differences in the initial uptake of parasite, but prolonged impairment of CaM-PK
      resulted in a decrease in the level of macrophage infection. Further experiments
      revealed that promastigote proliferation was severely impaired by the CaM-PK
      inhibitor but not any of the other inhibitors.

PMID- 8482845
TI  - Increased protein kinase C activity in low density eosinophils.
AB  - Eosinophil heterogeneity is expressed in cell density, membrane receptors and
      function. It has been observed that increases in some functional activities
      correlate with decreased sedimentation density in human eosinophils. However, the
      cellular mechanisms to explain the up-regulation of eosinophil function have not
      been fully explored. Protein kinase C (PKC) is an important family of enzymes
      mediating signal transduction for a wide variety of functions in many different
      cell types. Changes in the activity of PKC could explain some of the observed
      differences in function. In these experiments, PKC activity of human granulocyte
      lysate supernatants was measured as the phosphatidyl serine-dependent transfer of
      32P from [gamma-32P]ATP to a protein substrate under conditions of maximal
      stimulation; a measure of activatable PKC concentration. We observed that the
      activity present in eosinophils (87.2 +/- 8.4 pmol PO4 incorporated into histone
      per minute per 10(6) cells, n = 30) was not significantly different from that of
      neutrophils assayed under the same conditions (91.5 +/- 5.6 U, n = 31) but the
      percent of total activity that was phosphatidyl serine dependent was greater in
      eosinophils (97 +/- 1% vs 81 +/- 1% for neutrophils, p = 0.001). Blood
      eosinophils isolated from low density Percoll fractions had a higher activity
      (120 +/- 16 U) than that found in the higher density cells from the same subjects
      (81 +/- 19 U, n = 9, p = 0.011). When eosinophils recovered from bronchoalveolar
      lavage (BAL) fluid after segmental Ag challenges were assayed, the PKC activity
      of BAL eosinophils was similar to that of blood-derived eosinophils of equal
      density and low density BAL eosinophil PKC tended to be equal to or greater than
      higher density cells. The beta isozyme of PKC but not the alpha or gamma was
      detected in eosinophils by Western blotting with isozyme-specific mAb. These data
      indicate that eosinophil PKC activity is primarily caused by the beta-isozyme, is
      related to cell density in blood-derived cells, and may have a relationship to
      cell function.

PMID- 8482846
TI  - Modulation of lipopolysaccharide-induced cytokine gene expression in mouse bone
      marrow-derived macrophages by muramyl dipeptide.
AB  - Previous studies have shown that an i.v. injection of muramyl dipeptide (MDP)
      before a LPS challenge strongly potentiated serum TNF and IL-6 release in mice.
      Therefore the direct action of MDP was examined on TNF-producing cells, namely in
      macrophages stimulated or not by LPS. The level of TNF-alpha, IL-1 alpha, and IL
      6 mRNA was determined in bone marrow-derived macrophages (BMM). A marked TNF
      alpha mRNA accumulation was found between 1 and 6 h after stimulation with MDP or
      LPS. LPS-induced IL-1 alpha mRNA transcript was delayed (3 h) than those after
      MDP induction (1 h). Conversely, kinetic induction of the IL-6 mRNA transcript
      was delayed in MDP-treated BMM as compared with LPS-stimulated cells. MDP
      pretreatment of BMM for 3 h not only enhanced the total level of LPS-induced TNF
      alpha, IL-1 alpha, and IL-6 mRNA (respectively 2.9-, 1.6-, and 2.4-fold
      increase), but it also delayed the kinetics of IL-1 alpha and IL-6 species
      accumulation. The enhancement induced by MDP pretreatment at the level of
      cytokine mRNA accumulation was correlated with an increase in LPS-induced TNF and
      IL-6 biologic activity production in supernatant fluids. In addition, in BMM from
      C3H/Hej mice MDP pretreatment enhanced the weak effect of LPS on TNF mRNA
      transcript accumulation and was required to produce LPS-induced TNF bioactivity.
      Our results suggest that MDP and LPS could act through distinct pathway(s) to
      induce cytokine gene expression. Moreover, the priming effect displayed by MDP
      could result in modulation of the LPS-induced cytokine gene expression at the
      transcriptional and/or post-transcriptional level.

PMID- 8482847
TI  - Uncoupling of early signal transduction events from effector function in human
      peripheral blood neutrophils in response to recombinant macrophage inflammatory
      proteins-1 alpha and -1 beta.
AB  - Macrophage inflammatory proteins-1 (MIP-1) alpha and beta are members of the C-C
      branch of the platelet factor 4 superfamily of cytokines, recently designated the
      "chemokine" superfamily. It has been suggested that the major cellular targets
      for the biologic activities of the C-C chemokines are the mononuclear leukocytes.
      However, the original designation of murine MIP-1 proteins as inflammatory
      mediators was based on suggestions that they activated neutrophil functions such
      as chemotaxis, the respiratory burst, and degranulation. In this study, we have
      evaluated the ability of human (Hu) MIP-1 alpha and beta to affect purified human
      neutrophil function. Although both rHuMIP-1 alpha and -1 beta stimulated
      significant calcium mobilization in human monocytes, only HuMIP-1 alpha exerted a
      detectable effect on neutrophils. HuMIP-1 alpha stimulated a small, dose
      dependent increase in intracellular calcium, which was accompanied by a
      simultaneous change in right-angle light scatter, the latter indicating induction
      of shape change. While the effect of HuMIP-1 alpha on calcium mobilization in
      neutrophils was small when compared with that elicited by IL-8 or Gro alpha, it
      had similar characteristics to that by other receptor-dependent neutrophil
      agonists in that it was dependent on pertussis toxin-sensitive G proteins and on
      both mobilization of calcium from intracellular sources as well as influx from
      the extracellular environment. In addition, stimulation of neutrophils with HuMIP
      1 alpha led to desensitization to subsequent additions of HuMIP-1 alpha. The
      stimulatory effect of HuMIP-1 alpha on neutrophil calcium mobilization and shape
      change was not coupled to other standard measures of neutrophil effector
      function. For instance, neither HuMIP-1 alpha nor -1 beta had any detectable
      stimulatory effect on the Na+/H+ antiport, degranulation, actin polymerization,
      or chemotaxis. Moreover, although HuMIP-1 alpha binding could easily be measured
      on monocytes or monocytic cell lines, the number of sites were too few to
      characterize on neutrophils by the same technique. Taken together, these results
      show that neither HuMIP-1 alpha nor -1 beta stimulate significant neutrophil
      activation and support the concept that the biologic effects of members of the C
      C branch of the platelet factor 4 superfamily are not primarily directed toward
      neutrophils.

PMID- 8482848
TI  - MCP-1 expression by rat type II alveolar epithelial cells in primary culture.
AB  - Recruitment and activation of mononuclear phagocytes are potentially critical
      regulatory events for control of pulmonary inflammation. Located at the boundary
      between the alveolar airspace and the interstitium, alveolar epithelial cells are
      ideally situated to regulate the recruitment and activation of mononuclear
      phagocytes through the production of cytokines in response to inflammatory
      stimulation from the alveolar space. To test this hypothesis, we investigated the
      production of monocyte chemotactic polypeptide-1 (MCP-1), a protein that is
      chemotactic for and that activates monocytes, by rat type II alveolar epithelial
      cells in primary culture. Immunocytochemical staining using anti-murine JE, an
      antibody recognizing rat MCP-1, demonstrated cell-associated MCP-1 Ag throughout
      the monolayer. The intensity of staining was increased in response to IL-1 beta.
      When type II epithelial cells formed a tight monolayer on a filter support, there
      was polar secretion of MCP-1 Ag into the apical compartment by both control and
      IL-1-stimulated cells as measured by specific MCP-1 ELISA. Northern blot analysis
      revealed that IL-1 and TNF-alpha stimulated MCP-1 mRNA expression in a dose
      dependent manner, whereas dexamethasone blocked MCP-1 expression by cells
      stimulated with IL-1. In contrast to previous results using transformed
      epithelial cell lines, MCP-1 mRNA was induced in these primary cultures directly
      by stimulation with LPS. These data suggest that alveolar epithelial cells may
      have an important and previously unrecognized role in the initiation and
      maintenance of inflammatory processes in the lung by recruiting and activating
      circulating monocytes through the production of MCP-1.

PMID- 8482849
TI  - Potent stimulation of monocytic endothelin-1 production by HIV-1 glycoprotein
      120.
AB  - Monocytes/macrophages play a critical role in the pathogenesis of HIV infection,
      both as targets for virus replication and as sources of production of
      multifunctional cytokines. Endothelins, peptides with potent vasoconstricting
      activities originally isolated from endothelial cells, are also produced and
      secreted by macrophages in a manner similar to that of other cytokines. In an
      attempt to explore the potential role of endothelins in HIV-infection, we
      investigated the effect of the HIV-1 envelope glycoprotein, glycoprotein 120, on
      monocytic endothelin-1 production. This glycoprotein has been identified as a
      potent stimulator of monokines such as TNF-alpha and IL-6, which have been
      implicated as potential mediators of HIV-encephalopathy. We found that
      glycoprotein 120, similar to LPS, stimulates the secretion of endothelin-1, as
      well as TNF-alpha, from macrophages in a concentration-dependent manner. Using
      reverse transcriptase polymerase chain reaction, we found that circulating
      monocytes in HIV-infected individuals show a distinct expression of the
      endothelin-1 gene that is not detectable in healthy controls, indicating chronic
      activation of this gene in HIV-infection. In addition, cerebral macrophages in
      patients with HIV-encephalopathy were strongly positive for endothelin. Thus,
      monocytic endothelins appear to be stimulated during HIV infection. Their potent
      vasoactive properties render them potential candidates for mediating alterations
      in the cerebral perfusion pattern associated with the AIDS dementia complex.

PMID- 8482850
TI  - Construction of a bispecific antibody reacting with the alpha- and beta-chains of
      the human IL-2 receptor. High affinity cross-linking and high anti-proliferative
      efficiency.
AB  - A bispecific antibody recognizing both the alpha- and beta-chains of the IL-2R
      was generated by sulfhydryl-directed chemical reassociation of monovalent Fab'
      fragments prepared from the anti-alpha mAb 33B3.1 (rat IgG2a) and from the anti
      beta mAb A41 (mouse IgG1). Whereas the 33B3.1/A41 bispecific mAb (bi-mAb) binds
      to isolated alpha- and beta-chains with low affinity (Kd = 4 nM), its binding to
      cells co-expressing the two chains shows both low and high affinity components.
      The high affinity-binding sites (Kd = 100 pM) most probably correspond to the
      cross-linking by the bi-mAb of alpha- and beta-chains, whereas the low affinity
      component corresponds to the excess of alpha-chains. High affinity binding of bi
      mAb on activated T cells is observed at 37 degrees C and not at 4 degrees C,
      suggesting that i) the two chains are dissociated at 4 degrees C in the absence
      of ligand and ii) the mechanism of bi-mAb catalyzed cross-linking of these two
      chains is temperature dependent. In contrast to parental 33B3.1 and A41 IgG,
      which recognize single positive (alpha + and beta +, respectively) and double
      positive alpha +/beta + cells with similar affinities, the 33B3.1/A41 bi-mAb is
      specific for activated alpha +/beta + cells with respect to its high affinity
      binding. In contrast to A41, which does not affect IL-2-induced proliferation of
      4AS cells or anti-CD3-activated PBL, and to 33B3.1, which do inhibit
      proliferation but only partially and at high doses, the bi-mAb showed full
      blocking efficiencies at low concentrations (IC50 of 300 to 400pM) corresponding
      to the formation of high affinity alpha/bi-mAb/beta complexes. These half-maximal
      effects were observed at 10-fold lower concentrations than when using a
      combination of equimolar concentrations of parental 33B3.1 and A41 IgG. Because
      of their specificity and high blocking efficiencies, anti-alpha/anti-beta bi-mAb
      may constitute a better alternative for IL-2R-directed immunosuppression.

PMID- 8482851
TI  - Analysis of cytokine production by Mycobacterium-reactive T cells. Failure to
      explain Mycobacterium leprae-specific nonresponsiveness of peripheral blood T
      cells from lepromatous leprosy patients.
AB  - Recent analyses of antimycobacterial T cells clones from a small number of
      individuals indicate that mycobacteria preferentially induce Th cells that
      produce high levels of IFN-gamma and no or little IL-4 in Mycobacterium leprae
      resistant tuberculoid leprosy (TT) patients and healthy subjects, whereas in one
      study M. leprae-induced Ts clones from polar lepromatous leprosy (LL) patients
      showed a reciprocal cytokine secretion profile and mediated their suppressive
      activity via the release of high levels of IL-4. We have evaluated these findings
      in peripheral blood T cells from a larger panel of TT and LL patients as well as
      healthy individuals. Mycobacterium-reactive T cell lines generated from the PBMC
      of these individuals were tested for cytokine secretion and proliferative
      capacity in response to M. leprae, Mycobacterium tuberculosis, and various
      individual mycobacterial Ag. The lepromatous pole of the leprosy spectrum was
      additionally investigated by analyzing the cytokine-secretion profile of M.
      leprae-induced (suppressor) T cell clones as well as primary ex vivo PBMC. All T
      cell lines from healthy individuals and TT patients responding to M. leprae, M.
      tuberculosis, or individual Ag, produced high levels of IFN-gamma and TNF-alpha
      but little or no IL-4 and IL-6. At the lepromatous pole, T cell lines failed to
      proliferate upon stimulation with M. leprae but in some cases produced
      significant levels of IFN-gamma. No IL-4 or IL-6 secretion was observed in
      response to M. leprae. These lines displayed strong proliferation and Th1-like
      cytokine production upon stimulation with M. tuberculosis. Similarly, stimulation
      of primary PBMC from LL patients with M. leprae or M. tuberculosis resulted in
      the release of IFN-gamma but no detectable IL-4 production. Control tetanus
      toxoid-reactive T cell lines from the same individuals instead produced large
      amounts of IL-4 and low levels of IFN-gamma. The analysis of M. leprae-induced T
      cell clones, including those with known suppressive activity, revealed that all
      lepromatous T cell clones produced large amounts of IFN-gamma. Most of these
      clones released no or little IL-4, but some clones produced higher levels of IL-4
      in addition to IFN-gamma. Most clones tested produced IL-10 as well. The
      suppressor activity of suppressor T cell clones could not be inhibited by a
      neutralizing anti-IL-4 antibody and only in one case by neutralizing anti-IL-10
      antibody. Anti-IL-4 and anti-IL-10 could not overcome the M. leprae-specific
      unresponsiveness observed in primary PBMC from LL patients.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8482852
TI  - A synthetic peptide analogue of a determinant of type II collagen prevents the
      onset of collagen-induced arthritis.
AB  - The immunization of genetically susceptible strains of mice with type II collagen
      (CII) elicits a collagen-induced arthritis that resembles rheumatoid arthritis.
      Our laboratory previously identified a region of CII, CII-245-270, that contains
      a T cell epitope that is prominent in the immune response to CII. Residues
      critical to the I-Aq-restricted presentation of this determinant have been
      characterized. To produce synthetic peptides with the potential of disrupting I
      Aq-restricted Ag presentation, synthetic analogue peptides were developed that
      contain site-directed substitutions in critical positions. One analogue peptide
      was found to be an efficient competitor for binding to I-Aq and to be capable of
      inhibiting T cell responses in vitro. When DBA/1 mice were coimmunized with CII
      and the analogue peptide, the incidence and severity of arthritis were greatly
      reduced, concordant with the humoral immune responses to CII.

PMID- 8482853
TI  - Induction of circulating IL-1 receptor antagonist by IFN treatment.
AB  - This study was undertaken to determine whether IFN induce IL-1 receptor
      antagonist (IL-1Ra), a specific inhibitor of IL-1. Plasma samples were obtained
      from healthy volunteers (n = 5) and patients with chronic hepatitis C (n = 5)
      treated with IFN-alpha, and from patients with renal cell carcinoma (n = 6)
      treated with IFN-gamma and assayed for IL-1Ra by a specific radioimmunoassay.
      Both types of IFN were administered subcutaneously. In vitro studies were carried
      out with PBMC from healthy volunteers. A single, low and nontoxic dose (1 x 10(6)
      U) of IFN-alpha induced circulating IL-1Ra, which reached peak levels within 12
      h. This effect was dose-dependent and more pronounced with a higher dose (5 x
      10(6) U). Peak IL-1Ra levels 12 h after 5 x 10(6) U IFN-alpha were 4.16 +/- 0.35
      ng/ml in healthy volunteers and 5.7 +/- 0.73 ng/ml in patients with chronic
      hepatitis C (difference not significant). Thereafter levels declined but remained
      elevated for 24 h. IFN-gamma treatment led only to a modest increase of
      circulating IL-1Ra even at a dose of 400 micrograms; this dose, however, was
      associated with side effects similar to those seen after injection of 5 x 10(6) U
      IFN-alpha. PBMC stimulated with IFN-alpha or IFN-gamma produced IL-1Ra in vitro.
      The induction of IL-1Ra may contribute to the antiviral, anti-inflammatory, and
      antiproliferative effects of IFN.

PMID- 8482854
TI  - Surface-exposed conserved region of the streptococcal M protein induces
      antibodies cross-reactive with denatured forms of myosin.
AB  - Vaccines based on a highly conserved cell surface exposed C-repeat region of the
      group A streptococcal M protein molecule have been found to induce protection
      against mucosal challenge by homologous and heterologous streptococcal serotypes.
      Rabbit hyperimmune antisera were produced to four partially overlapping peptides
      of the C-repeat region of M6 protein. These were examined by both direct and
      competitive ELISA and by Western blotting for their reactivity against mammalian
      coiled coil proteins such as laminin, myosin, light meromyosin, heavy meromyosin,
      and cardiac tropomyosin, and to the denatured forms of some of these molecules.
      All sera reacted strongly with the recombinant M6 protein molecule. In addition,
      antibodies to three of the peptides displayed generally low levels of cross
      reactivity with at least one of the mammalian proteins, whereas antibodies to one
      peptide did not cross-react with any of the proteins tested. The observed
      reactivity was found to be directed predominantly against denatured forms of the
      mammalian molecules. For instance, the cleaved forms of myosin bound better to
      the cross-reactive antibodies than the intact molecule. Furthermore, heat
      denatured heavy meromyosin competed severalfold better in competitive ELISA than
      the non-heat-denatured "native" form. Our results demonstrate that M protein
      peptides corresponding to epitopes shared among rheumatic fever-associated
      strains of streptococci can lead to the production of low levels of antibodies
      reactive with mammalian coiled coil molecules. These antibodies are directed
      against the denatured forms of these molecules.

PMID- 8482855
TI  - Mapping human T cell epitopes in Leishmania gp63: identification of cross
      reactive and species-specific epitopes.

PMID- 8482856
TI  - Modulation of host response during infection with Trichinella pseudospiralis
      using immuno-stimulant drug.
AB  - Infection of the mouse with Trichinella pseudospiralis is accompanied by
      pronounced suppression of host inflammatory response. This study examines the
      effect of infection with this parasite on one major component of cell mediated
      immunity: delayed type hypersensitivity (DTH) reaction and the effect of
      administration of immunostimulant drug (Levamisole) on host response to T.
      pseudospiralis infection. Serum cortisol levels and the response of skin test to
      phytohaemagglutinin were used to construct the time table of drug regimen. Three
      groups were studied; group I (infected mice), group II (received levamisole on
      day 6 p.i.) and group II (received Levamisole on day 14 p.i.) Early
      administration of Levamisole restored DTH response to normal and
      histopathological examination of infected muscles revealed evident collagen
      deposition around the muscle larvae.

PMID- 8482857
TI  - Effect of various organic nutrients on the reproductive rates of bacterivorous
      hymnostomes in a freshwater canal, Shibin El-Koum, Menoufia, Egypt.
AB  - The effect of adding two different organic materials; wheat extract and
      bactopeptone was studied on some of the most abundant Bacterivorous Hymnostomes
      collected from freshwater canal in Shibin El-Koum, Menoufia. It was found that
      some of these ciliates prefer plant protein as wheat, others prefer animal
      protein as bactopeptone, someone have the ability to accommodate with both
      organic materials. A significant positive relationship between log doubling times
      and log cell volumes of these hymnostomes was confirmed.

PMID- 8482858
TI  - Counter immunoelectrophoresis, a modified technique for the identification of
      blood meals of sandflies collected from Qualyobia Governorate, Egypt.
AB  - Specificity and sensitivity are very important when investigating the blood meals
      of an insect vector, particularly those having different hosts. Several
      techniques are used for the identification of the blood meals. Counter
      immunoelectrophoresis is the technique of choice. The modification was to secure
      save of time and least amount of materials. In this paper, a modified technique
      of the counter immunoelectrophoresis (CIEP) was used for the identification of
      the blood meal of wild Phlebotomus papatasi collected from different sites in
      Qualyobia Governorate. Eight antisera were used. These were human, cat, dog, rat,
      sheep, goat, bovine and avian. The results showed that 99.52% of 832 female P.
      papatasi contained human blood, 0.12% (one female) contained only avian blood and
      0.36% or three females each contained mixed blood of human together with dog
      blood (One), rat blood (one) or avian blood (one). P. papatasi is an
      anthropophilic insect, but in rare cases, it is zoophilic.

PMID- 8482859
TI  - Population dynamics of some synanthropic fly species in different habitats in
      Buraydah, Saudi Arabia.
AB  - The population dynamics of five synanthropic fly species, Chrysomyia rufifacies,
      Musca d. domestica Muscina stabulans F. Sarcophaga haemorrhoidalis, and Stomoxys
      calcitrans, were studied at three different habitats in Buraydah, Saudi Arabia.
      The chosen habitats were the slaughter house, the cattle market and the rubbish
      dumps. The number of flies caught per twenty sticky bands was taken monthly, for
      a whole year, as an index to the fly population at that habitat during that
      month. M. d. domestica was the most abundant fly species; it made up nearly 98%,
      81% and 75% of the total synanthropic fly population at the rubbish dumps, the
      cattle market and the slaughter house, respectively. It reached its maximum
      abundance in May and minimum occurrence in January. House flies were collected
      throughout the year and survived conditions seemed to be unsuitable for other
      species.

PMID- 8482860
TI  - Scanning electron microscope observations on the digenean intestinal parasite
      Astiotrema reniferum (Plagiorchiidae).
AB  - The body surface of adult digenean intestinal parasite Astiotrema reinferum
      (Looss, 1898) Stossich, 1904 has been studied using scanning electron microscopy
      (SEM). The posterior region of the body forms a slender stalk terminating with
      two ventrolateral lobes. The lobes are armed with numerous large spine that are
      sharply pointed and orientated in all directions. There are regional variations
      in the distribution of spines all-over the body. The spines are abundant on the
      general body surface of the head region, the rim of the oral sucker, the inner
      lip of the ventral sucker and on the posterior ventrolateral lobes. No spines
      were observed on the genital pore and on the excretory opening. The sensory
      papillae found on both the oral and ventral suckers are arranged in a bilateral
      symmetrical patterns. They are dome shaped but some of them possess a short knob
      like process and others have no process. The papillae are more abundant on the
      oral sucker than on the ventral sucker. The possible functions of the spines and
      sensory papillae are discussed relative to their position.

PMID- 8482861
TI  - Delta virus versus HBsAg in chronic active hepatitis and their relation to
      clinical, laboratory, and morbidity findings in bilharzial and non-bilharzial
      patients.
AB  - This work was done to study the effect of delta virus and HBV infection, as two
      aetiological factors on clinical presentation, biochemical liver functions and
      prognosis of chronic active hepatitis (CAH) in schistosomiasis infected and non
      infected patients. 66.7% of the patients were carriers for HBsAg, among them
      41.7% were infected with delta virus. It was evident that the clinical
      presentation of the patients with positive serological markers of HBV and HDV
      demonstrated advancing liver disease than in the other studied groups. Moreover,
      the biochemical liver profile was significantly affected when the triad of
      chronic HBV, delta virus and schistosomiasis infection was present. This could be
      related to the immunosuppression caused by schistosomal infection. Furthermore,
      mortality rate was significantly higher in schistosomiasis infected individuals.

PMID- 8482862
TI  - Studies on T. spiralis and T pseudospiralis larvae recovered from mice immunized
      with heterologous Trichinella antigen.
AB  - In this study, S3 antigen of T. spiralis and T. pseudospiralis was given to the
      heterologous infection in albino mice. The recovered larvae were studied as
      regards: their number, length and steroscan examination. It was found that
      vaccination of mice with T. spiralis (S3) antigen induced reduction in T.
      pseudospiralis larval count by 66.43% and significant reduction in length. Using
      T. pseudospiralis (S3) antigen reduction of 74.77% in T. spiralis larval count
      was detected as well as significant reduction in length. Scanning electron
      microscopic (SEM) examination revealed more or less similar finding in both
      species: loss of integrity of the cuticle, some of the larvae were attacked by
      granulocytes mainly eosinophils and few larvae appeared completely destructed
      with loss of normal architecture. A peculiar finding was noticed in case of T.
      pseudospiralis larvae in form of fine electron dense deposits giving the
      cuticular surface a motling appearance.

PMID- 8482863
TI  - Puffing activity after a heat shock in Musca domestica L.
AB  - Changes in puffing pattern after heat shock in Musca domestica were studied
      during the prepupal stage. Eight puffs which normally do not appear during
      development, were detected. One was found on chromosome X, one on chromosome III,
      two on chromosome IV and four on chromosome VI. Most of the observed puffs were
      large and had a complex structure characterized by visible granules.

PMID- 8482864
TI  - Some immunological aspects on human Schistosoma mansoni infection in Egypt.
AB  - Human Schistosomiasis mansoni is a chronic disease, which ranges from subclinical
      infection to huge hepatosplenomegaly. Reducing the risk of infection remains the
      aim of many control measures. So the present study was designed to evaluate the
      interaction between S. mansoni infection and immunological system of the host.
      The study included 3 groups of 50 adult males each. The first group was control
      group, the second group was early S. mansoni infection and third group was
      advanced schistosomiasis with hepatosplenomegaly. The results showed some changes
      in both humoral and cellular immune response during the course of infection.

PMID- 8482865
TI  - A new species of Eimeria (Apicomplexa) from Cordylus cataphractus (Sauria:
      Cordylidae), from South Africa.
AB  - Three armadillo girdled lizards, Cordylus cataphractus Boie, 1828, housed at the
      Dallas Zoo in Texas, USA but originally imported from Namaqualand, South Africa,
      were found to be passing oocysts of a previously undescribed species of eimerian.
      Oocysts of Eimeria murphyi sp. n. are cylindroidal, 44.1 x 21.3 (41.5-46.5 x 20.5
      24) microns, with a shape index (length/width) of 2.07 (1.75-2.21). A micropyle
      and oocyst residuum are absent, but a polar granule is present. Sporocysts
      ellipsoidal, 13.5 x 10.2 (13-14.5 x 9.5-11) microns (N = 20), with a shape index
      of 1.32 (1.23-1.46). Each sporozoite possesses a single, posterior refractile
      body. This represents the first report of coccidia infecting a member of the
      saurian family Cordylidae.

PMID- 8482866
TI  - Helisoma duryi: its present range of distribution and implications with
      schistosomiasis snails in Egypt.
AB  - The range of distribution of Helisoma duryi, a potential competitor to
      schistosomiasis snail vectors in Egypt, was determined in the south of Nile
      Delta. Results show that H. duryi was found in the River Nile, Geziret El
      Kerateyeen banks, Damietta and Rosetta Branches, Tawfiky and Menoufy Canals and
      their branches and Bassoussiya, Bahadiya and Sheshaa canals and their branches.
      Helisoma was found in all categories of canals and drains co-existing in various
      degrees with other snail species including schistosomiasis vectors (Bulinus
      truncatus and Biomphalaria alexandrina). The population density of H. duryi and
      associated B. truncatus, B. alexandrina and Physa acuta were studied for one year
      in three channels. Statistical analysis of results show that Helisoma has a
      significantly negative correlation with schistosomiasis vectors in these
      channels. Helisoma population showed a major peak in the warmest months of the
      year (July-August) thus showing recovery in population after "Winter Closure"
      later than Bulinus, Biomphalaria and Physa. Helisoma proved to be free of any
      natural trematode infection.

PMID- 8482867
TI  - Studies on tissue cholinesterase in experimental trichinosis in albino rat. 2
      effects of treatment with Mintezol and 5-fluorouracil-Endoxan.
AB  - The changes in cholinesterase (ChE) activity was studied in different tissues of
      normal and 60 days T. spiralis infected albino rats following treatment with
      Mintezol (5 mg/rat/day, for 5 days) and 5-fluorouracil-Endoxan (500 mg/rat/day-
      100 mg/rat/day, for 5 days). In normal rats, administration of either Mintezol or
      5-fluorouracil-Endoxan provoked a general decrease in the ChE activity of the
      various rat tissues. Treatment of 60 days T. spiralis infected rats with Mintezol
      increased markedly the ChE activity of the brain, liver, gastrocnemius muscle and
      serum. Meanwhile treatment with 5-fluorouracil-Endoxan decreased the enzyme
      activity in the selected rat tissues. It can be concluded that treatment with
      Mintezol and 5-fluorouracil-Endoxan in trichinellosis represents a certain
      danger. This danger results from general inhibition of ChE activity which may
      cause accumulation of acetylcholine.

PMID- 8482868
TI  - A survey of gregarines associated with Tenebrio molitor and Opatriodes vicinus in
      the central region of Saudi Arabia.
AB  - The present work recorded five species of septate gregarines in the intestine of
      two species of insects they were: Gregarina polymorpha (Hamm.), in the gut of
      Tenebrio molitor (L.), percentage of infection 100%, with a density of 2-6 and G.
      cuneata (Stein), in the gut of T. molitor (L.), percentage of infection 100% with
      a density of 15-17; Hirmocystis harpali (Watson), in the mid gut of Opatriodes
      vicinus (Fairmaire), percentage of infection 34%, with a density of 19-28 and
      Leidyana sp., in the mid gut of O. vicinus percentage of infection 17%, with a
      density of 2-11 and Spharorynchus chabaudi percentage of infection 33% with a
      density of 100-180 in an infected insect. Members of genus Gregarina are
      considered to be coccidian and malarial organisms, however, till now gregarines
      cause little or no damage to their hosts.

PMID- 8482869
TI  - Serum immunoglobulin and complement values in scabietic patients.
AB  - Immunity entails all the forces concerned with recognition, specific reaction and
      removal of foreign bodies after they again access into the body of the host. The
      immune system interacts with genetics and infectious agents as well as with
      metabolic, endocrine and environmental factors. The serum immunoglobulins (G.M.A.
      & E.) and complement (C3 and C4) were estimated in sixteen parasitologically
      proven patients with scabies. The causative agent was Sarcoptes scabiei. The
      results showed a high significant increase in the mean average of IgG., IgM. and
      in particular IgE pretreatment than in patients three months after treatment and
      in patients after treatment than in controls. On the other hand, there was a
      significant decrease in the mean average in the mean average of IgA after
      treatment was insignificant compared with controls. The C3 and C4 showed no
      significant changes in the mean average in the patients before or after treatment
      compared with controls. The changes in the IgG., IgM. and in particular IgE. may
      be specific reaction to the parasite or a non specific one to the dead parasite
      or its faeces or even to a secondary infection developed. On the other hand, the
      decrease in the IgA. may be due to the mite or its products which interfere with
      its synthesis. It is concluded that scabies is associated with a humoral
      immunological response against the mite infestation.

PMID- 8482870
TI  - A study on Phlebotomus species, the vectors of leishmaniasis in Gassim, Saudi
      Arabia.
AB  - A total 935 adult sandflies were collected and identified from Buraydah, Gassim
      region. Phlebotomus papatasi represented 79.6% of the total population whereas P.
      sergenti represented 20.4% throughout two successive years (October 1990-
      September 1992). Apart from May, female sandflies outnumbered the males in both
      species. The seasonal incidence of both P. papatasi and P. sergenti seemed to be
      highly affected by climatic factors prevailed in the study area.

PMID- 8482871
TI  - Entamoeba bovis Liebetanz 1905 recorded from large ruminants in Egypt.
AB  - Investigations carried out on trematode parasites affecting cattle and buffaloes
      in Ismailia Governorate revealed a degree of infection with Fasciola sp.
      attaining 6.95% among the former, and 16.16% among the latter. Concerning
      Paramphistomum sp. infection, it was 43.83% among cattle and 9% among buffaloes.
      During these studies, it appeared that cattle or buffaloes having no infection
      with Fasciola sp. or those being infected with Paramphistomum sp. only proved to
      harbour Entamoeba bovis trophozoites with a percentage of about 85% in cattle,
      and 80% among buffaloes. This protozoan parasite was also recovered from the gall
      bladders and bile ducts of slaughtered beef cattle that had no infection with
      liver flukes. The morphological picture of the fresh E. bovis trophozoite as well
      as its cyst were described, and the significance of such parasite on its host was
      discussed.

PMID- 8482872
TI  - Clinical and parasitological aspects on human scabies in Qualyobia Governorate,
      Egypt.
AB  - In the last decade, human scabies caused by Sarcoptes scabiei and other non human
      strains is one of the most common contagious parasitic disease. Over a period of
      one year (June 1991--May 1992), a total of 200 scabietic patients were diagnosed
      in the outpatients' clinic of Dermatology and Venereology, Benha University
      Hospitals. They were 120 females and 80 males (sex ratio = 1.5:1). Their ages
      ranged between three months up to 70 years old. Most of the patients were
      parasitologically positive (160 or 80%). The most common signs and symptoms were
      itching, skin burrows, scratch markings, papules and pustules. Regional
      lymphadenitis was sometimes present as well as fever in patients with secondary
      bacterial infection. The most affected sites were the abdomen (100%), followed by
      the buttocks (81.3%), the thigh (50%), legs (50%) and the arms and web spaces
      (62.5%). The male external genitalia was infested in 60% and the female breast
      was infested in 72.7%. The sex and site distribution of the infestations were
      attributed to the risk factor of exposure to infestation. The patients were
      successfully treated with 5% sulfur precipitate and 2-5% permethrin. The whole
      results were discussed on the light of the previous work.

PMID- 8482873
TI  - Isolation and concentration of microfilariae from peripheral blood of Wuchereria
      bancrofti infected patients by density gradient centrifugation.
AB  - A Ficoll-Hypaque gradient centrifugation technique was used for isolation and
      concentration of microfilariae from peripheral blood of 30 subjects with
      clinically and parasitologically diagnosed Wuchereria bancrofti infections. 86%
      of the microfilariae were found in the Ficoll-Hypaque layer. None were detected
      in the plasma, leucocyte layer or lower erythrocyte layer. 14% of microfilariae
      were identified on the top part of the erythrocyte layer. A 35 fold concentration
      and 88% quantitative recovery of parasites was achieved by conventional
      centrifugation of microfilariae-rich Ficoll-Hypaque layer. Following the
      centrifugation procedures, living motile microfilariae were separated. These
      results indicate that Ficoll-Hypaque centrifugation technique could be an
      effective method for the detection of low levels of microfilaraemia, and for
      obtaining relatively pure suspensions of living microfilariae for metabolic
      studies, production of antigen-rich excretory-secretory products and antigen
      analysis.

PMID- 8482874
TI  - Studies on the incidence and pathogenesis of Dicrocoelium dendriticum in
      slaughtered sheep in Riyadh abattoir, Saudi Arabia.
AB  - The incidence of Dicrocoelium dendriticum in slaughtered sheep both local and
      imported was carried out in Al Riyadh abattoir. A percentage of 28 was found
      among condemned livers. The highest rate of Dicrocoelium infection was among
      Naheemi sheep imported from Turkey. Recommendations to control this parasitic
      disease are necessary since it is a modern dangerous zoonotic parasite.

PMID- 8482875
TI  - The seasonal abundance of Gerbillus pyramidum and their flea ectoparasites in Al
      Arish, North Sinai Governorate, Egypt.
AB  - The seasonal abundance and the flea ectoparasites of Gerbillus pyramidum were
      studied. The results showed that the jerboa was more common in Summer (jerboa
      index 0.43) and least common in Winter (jerboa index 0.35). The overall male to
      female ratio was 4.2:1. The flea ectoparasites were more common in Autumn (flea
      index 10.5) and least common in Summer (flea index 6.8). The overall flea index
      was 8.75 and the majority of fleas (90.9%) was collected on male jerboa. The
      collected fleas in a descending order of abundance and flea index were:
      Xenopsylla cheopis (3.1), X. ramesis (2.7), Stenoponia tripectinata (1.4),
      Nosopsylla sinaiensis (0.9), Hopkinsipsylla occulta (0.6), and Pulex irritans.
      (0.01).

PMID- 8482876
TI  - Antifilarial IgM versus IgG antibody determination in the diagnosis of Wuchereria
      bancrofti infection in Egyptians.
AB  - Circulating antifilarial IgM and IgG antibodies were assessed by indirect ELISA
      in 184 serum specimens from 80 patients with clinically and parasitologically
      diagnosed filarial infections (20 with acute filariasis 40 with chronic
      filariasis & 20 asymptomatic microfilaraemic subjects), 64 individuals with other
      parasitic infections, 20 parasitologically-free subjects from filariasis endemic
      areas and 20 normal healthy controls. A soluble surface membrane extract from
      Dirofilaria immitis worms was used as the antigen. Using a single serum dilution
      of 1:128 and optical densities (OD) at 492 nm, the respective cut off values for
      IgM and IgG were found to be 0.24 and 0.22. All healthy non-endemic controls were
      seronegative by IgM and IgG ELISAs. The highest antifilarial IgM OD492 values
      were obtained in 20 patients with acute filariasis (95% sensitivity), while the
      highest antifilarial IgG OD492 values were observed n 40 patients with chronic
      filariaisis (97.5% sensitivity). Asymptomatic microfilaraemic subjects gave IgM
      and IgG OD492 values which were significantly lower than those of other forms of
      clinical disease and endemic control subjects. The antifilarial IgM and IgG
      respective sensitivities in asymptomatic subjects were 75% and 70%. Endemic
      controls had positive antifilarial IgM (65%) and IgG (75%) levels. Of 64 subjects
      with other parasites only one with Ancylostoma duodenale had positive IgM level
      (98.4% specificity); while 9 patients with nematodal infections mainly had false
      positive antifilarial IgG antibody levels (85.9% specificity). These results
      suggest that measuring circulating antifilarial IgM antibody level may have some
      diagnostic advantage over measuring IgG antibody level for the detection of
      active filarial infection and consequently better management of the disease.

PMID- 8482877
TI  - A study of autoimmunity in schistosomiasis.
AB  - Circulating auto-antibodies were estimated in sera of ten normal persons and
      fifty-four schistosomal patients classified into 3 groups: Group I 20 patients
      with early S. mansoni infection, Group II 20 patients with post schistosomal
      hepatic fibrosis and Group III 14 patients with post schistosomal
      glomerulonephritis. A significant high levels of auto antibodies (antinuclear
      antismooth muscle and antimitochondrial antibodies) were noticed in Groups II &
      III. Anti-ds DNA antibodies were significantly higher in Group III than in the
      other two groups. It was interesting to notice absence of rheumatoid factor in
      patients with schistosomal glomerulonephritis which may suggest that RF
      production may have a protective mechanism in patients with schistosomiasis
      against development of renal disease.

PMID- 8482878
TI  - Ecology of Biomphalaria alexandrina the snail vector of Schistosoma mansoni in
      Egypt.
AB  - The patterns of spreading and seasonal variation of population density of
      Biomphalaria alexandrina, the snail vector of Schistosoma mansoni in Egypt, in
      correlation with some environmental parameters were studied for 1988-1990 in four
      irrigation canals in Giza and Qalyoubiya Governorates. Results shown that the
      spreading patterns of snails along canals are changeable because of water current
      and irrigation activities. The snail population density showed two peaks,
      different in height, in April-May and November-December separated by two bottoms
      following the Winter Closure and during the hot summer season. The height of the
      peaks appears to be dependent on the extent of the "Winter Closure" and the
      prevailing water temperature. Two snail sampling tools, the dip-net and drag
      scoop, were used concurrently in this study. No considerable difference in
      sampling efficacy was recognized between these tools in the case of Biomphalaria.
      However, the dip-net appears to be more efficient in sampling other pulmonates
      while the drag scoop is more efficient in sampling prosobranchs. It is also
      realized that double sampling of 50% of sampling sites the next day should be
      satisfactory as a quality control system in snail population studies.

PMID- 8482879
TI  - New records of some of sarcophagid flies with distribution of all known flesh
      flies (Diptera:Sarcophagidae) of Saudi Arabia.
AB  - The Sarcophagidae (Flesh) of Saudi Arabia are reviewed based on collections of
      adult flies. Ten species of sarcophagid flies were recorded of which five are
      considered to be new record in Saudi Arabia. Checklist and information are given
      for each species concerning its geographical distributions and other
      observations.

PMID- 8482880
TI  - Effect of bacteriophage lysogeny on the efficacy of two bacterial larvicide
      formulations under field conditions.
AB  - Two types of man-made ditches were selected for carrying out this experiment; one
      polluted with nitrogenous matters (sewage water) and second filled with
      accumulated irrigated clear non-chlorinated water. No phages were detected in
      samples collected from both types of ditches. However, phage(s) specific to only
      B. sphaericus was (were) detected after spraying the two types with both B.
      thuringiensis H-14 and B. sphaericus commercial formulations. The detection of
      phage(s) was observed after 3 days post-spraying in the polluted ditch and after
      one week in the non-polluted one. This observation was explained by a possible
      transduction of naturally existed phage(s) on other spore forming bacteria to the
      sprayed B. sphaericus only, as its commercial formulation is based on spores
      which germinate to produce vegetative cell, while B. thuringiensis H-14 contains
      only the O-endotoxin as active ingredient, and also due to the increase of the
      number of bacteria in the sprayed ditches due to the recycling of B. sphaericus
      in the aquatic breeding places.

PMID- 8482881
TI  - Descriptions of new parasite species.

PMID- 8482882
TI  - Hydrocele in filarial and non filarial patients. Histopathological, histochemical
      and ultrastructural studies.
AB  - Twenty biopsied material of the testicular tissue were obtained from patients
      with unilateral hydrocele (eight due to lymphatic filariasis and twelve of
      idiopathic causes). Twenty biopsies lymphatic were also obtained from the normal
      unaffected testes and were used as control. The data obtained from
      histopathological, histochemical and ultrastructural studies revealed alternation
      in the testicular tissue with hydrocele than in the normal control testis. In the
      filarial hydrocele 37.5% of the cases showed thickening of the basement membrane
      and fibrosis with arrest of the spermatogenesis at the level of secondary
      spermatocytes. In addition, 12.5% showed thickening with interstitial fibrosis.
      Microfilariae were seen in hydrocele fluid of 3/8 cases (37.5%). In the
      idiopathic hydrocele 50% of the testicular tissue showed marked collagen deposits
      and testicular atrophy with fibrosis and thickening of basement membrane. The
      second 50% of cases showed variable degree of maturation arrests. Explanation for
      these variations in the pathological and anatomical pictures in both types of
      hydrocele is suggested. In the filariasis hydrocele it is due to the inflammatory
      response that may subside and recurrent. In the idiopathic hydrocele, it is due
      to the irreversible hypoxia caused by the continuous mechanical pressure due to
      huge amount of hydrocele fluid resulting in irreversible degenerative process
      with marked fibrosis.

PMID- 8482883
TI  - Assessment of serum copper and zinc levels in chronic Schistosoma mansoni
      patients with and without hepatic involvement before and after praziquantel
      therapy.
AB  - Estimation of serum copper and zinc was carried out on 40 Schistosoma mansoni
      patients with and without hepatosplenic involvement (group A and B respectively)
      before and after single oral dose of 40 mg praziquantel therapy as well as 20
      normal controls (group C). Full clinical examination and assessment of liver
      function tests was done. HBsAg positive cases were excluded. The results showed a
      significant increase in the copper level in both groups (A and B) before
      treatment when compared to normal controls, and a significant reduction in zinc
      level only in group B. Following praziquantel therapy the copper level decreased
      with concomitant increase in the serum zinc level.

PMID- 8482885
TI  - The susceptibility of the Egyptian Phlebotomus papatasi to five insecticides.
AB  - Phlebotomus papatasi is the main vector of zoonotic cutaneous Leishmaniasis
      caused by L. major in nearly all the East Mediterranean Region. Generally
      speaking, control of any arthropod-borne disease should be directed against both
      the parasite and the vector. The present study was undertaken to establish a base
      line susceptibility levels of the Egyptian P. papatasi to five insecticides.
      These insecticides were: B H C and D D T (chlorinated hydrocarbon), permethrin
      (synthetic pyrethroides), malathion (Organophosphorus) and propoxur (carbamate).
      The results obtained revealed that the laboratory bred P. papatasi were more
      susceptible to the five insecticides than the wild caught ones. The insecticidal
      efficiency of the five insecticides based on LC50 was in the following descending
      order: propoxur, permethrin, BHC, DDT and malathion for laboratory bred flies and
      propoxur, permethrin, BHC, malathion then DDT for wild caught flies. The least
      LC50 was when using propoxur for both the wild caught flies (0.0014%) and
      laboratory bred ones (0.00043%). The least LT50 was when using propoxur for both
      the wild caught flies (4.8 seconds) and the laboratory bred flies (2.2 seconds).

PMID- 8482884
TI  - The effect of nifedipine [correction of nifidipine] and cimetidine on the
      haemodynamics of Egyptian bilharzial pulmonary hypertension.
AB  - The pathogenesis of bilharzial pulmonary hypertension differs from the hypoxic
      type of pulmonary hypertension. Nifedipine [corrected] a calcium channel blocker
      was tried as a treatment for lowering pulmonary artery pressure. Nifedipine
      [corrected] 20 mg sublingually was found to lower the pulmonary artery pressure
      but not to a statistically significant level. No significant changes before and
      after 200 mg cimetidine intravenous, were seen.

PMID- 8482886
TI  - Studies on tissue cholinesterase in experimental trichinosis in albino rat. 1.
      Effect of T. spiralis infection.
AB  - Adult male albino rats were orally infected with Trichinella spiralis (T.
      spiralis) larvae (400 larvae/rat). The cholinesterase (ChE) activity was then
      determined in the serum, brain, spinal cord, liver, stomach, intestine, heart,
      diaphragm and gastrocnemius muscle of the infected rats at different time
      intervals (15, 30, 45, 60 and 90 days) after infection. The enzyme activity was
      inhibited at all the time intervals in the brain, liver, heart and diaphragm
      while it increased progressively in the serum. In the spinal cord the ChE
      activity was inhibited at 15, 30 and 45 days postinfection but was markedly
      increased thereafter. In the intestine, stomach and gastrocnemius muscle the
      enzyme activity was generally increased. These alterations in ChE activity may be
      due to the stress effect due to the presence of the larvae in the tissues and/or
      the toxic effect or their metabolites.

PMID- 8482887
TI  - Development of Eimeria stiedae in a non-specific host.
AB  - Infection with E. stiedae was established in immunocompromised mice given
      dexamethasone for ten days prior to the infection and for two weeks later. The
      infection was similar to that of rabbits as regard the pathological and clinical
      picture.

PMID- 8482888
TI  - The management of spinal cord compression in patients with advanced malignancy.
AB  - We retrospectively evaluated the medical records of 17 hospice patients who
      developed spinal cord or cauda equina compression due to metastatic epidural
      tumor to ascertain the nature and outcome of the disorder in this setting.
      Epidural compression occurred following admission to the hospice in five cases
      and prior to admission in 12 cases. Six patients were ambulatory following
      treatment, and this favorable outcome occurred only in those who were ambulatory
      at diagnosis. In the group of patients who were paraplegic after treatment,
      problems related to pain, decubitus ulcers, and constipation were most
      challenging. This experience highlights the need for a more vigilant approach to
      back pain in patients at risk of epidural compression in the hospice setting.
      Further studies are necessary to establish the appropriate management of these
      patients.

PMID- 8482889
TI  - Pain in hospitalized patients with medical illnesses.
AB  - To evaluate the prevalence of pain in hospitalized patients with medical illness,
      we retrospectively reviewed the records of 313 consecutive admissions to the
      medical service of the Hennepin County Medical Center. Of the 224 eligible
      patients, 157 (70.1%) experienced nonprocedural pain on presentation or in the
      hospital, and pain was the chief complaint of 34.8%. In order of frequency, the
      most common types of pain were headache, cardiac pain, abdominal pain, noncardiac
      chest pain, joint pain, and hepatic pain. Female patients were more likely to
      have pain complaints, especially headache and joint pain. Patients with pain
      tended to be older, but this did not reach statistical significance. Among
      patients with pain, no quantitative assessments of pain intensity were documented
      in the medical record by any caregiver. This study underscores both the high
      prevalence of pain and the lack of pain assessment among patients hospitalized
      for acute medical illnesses. Adequate evaluation and management of pain should be
      considered as an important part of quality care.

PMID- 8482890
TI  - Patient-controlled analgesia for sickle-cell-related pain.
AB  - To delineate dose ranges, utilization patterns, and the frequency and types of
      problems encountered, we retrospectively reviewed the medical records of 46
      patients with sickle hemoglobinopathies who used patient-controlled analgesia
      (PCA) a total of 92 times for the management of vasooclusive pain. Patients
      varied widely in the drug administered, use of basal infusion, individual dose,
      and total amount of drug received. On the day of heaviest use, the average
      maximum hourly dose was equivalent to 0.09 mg/kg of morphine. In this study, 11
      patients and two families disliked PCA, one patient had respiratory compromise,
      and one patient tampered with the machine. Patient satisfaction with PCA probably
      reflects interactions among the psychosocial impact of chronic illness and
      chronic pain, individual psychological and temperamental factors, environmental
      contingencies, and the expectations and beliefs of the family and the health-care
      professionals. Based on this experience, recommendations can be proposed for the
      use of PCA in this condition.

PMID- 8482891
TI  - The Cancer Pain Role Model Program of the Wisconsin Cancer Pain Initiative.
AB  - The Cancer Pain Role Model Program was established in 1990 by the Wisconsin
      Cancer Pain Initiative to train physicians to be role models for appropriate pain
      management. Community and academic physicians along with their "clinical
      partners," a nurse or pharmacist, were recruited to attend a 1-day education
      conference that included lectures, small group workshops, and development of an
      action plan. A total of 44 physicians and 55 clinical partners have attended two
      conferences (1990 and 1991). Participants listed 199 activities on their action
      plans; postconference surveys have documented initiation of 212 projects aimed at
      educating others, improving clinical care, resource development, educating self,
      or research. The Cancer Pain Role Model Program appears to be a promising means
      of transferring cancer pain information, legitimizing cancer pain as an important
      treatment issue, and institutionalizing cancer pain management.

PMID- 8482892
TI  - Intrathecal infusional therapies for intractable pain: patient management
      guidelines.
AB  - This article focuses on appropriate patient selection for and management of
      patients selected for continuous spinal infusional opioid therapy. Patients with
      cancer-related pain who have undergone sequential strong opioid drug trials, who
      have intractable, unmanageable side effects, and who have undergone a successful
      spinal opioid efficacy trial are candidates for implantable spinal infusional
      therapy. Patients with noncancer-related chronic pain, who have failed all
      conventional syndrome-specific therapies before neuroablative surgical
      procedures, including sequential strong opioid drug trials, who have intractable,
      unmanageable side effects, and who have undergone successful spinal opioid
      efficacy trial are deemed candidates for implantable spinal infusional therapy.
      Patients with chronic noncancer-related pain and patient with cancer-related pain
      who have life expectancies greater than 3 mo all have implanted programmable
      infusion pumps. Patients with cancer-related pain who have life expectancies less
      than 3 mo have implanted permanent epidural catheters connected to external pump
      systems. Management guidelines for complications of therapy broadly categorized
      as surgical, mechanical, and pharmacologic are presented.

PMID- 8482893
TI  - Strontium-89 therapy in a patient with carcinoma of unknown origin and incurable
      pain from bone metastases.

PMID- 8482894
TI  - The use of opioid analgesics in an 11-year-old with a family history of drug
      abuse.

PMID- 8482895
TI  - Neonatal pain: a comprehensive survey of attitudes and practices.
AB  - We surveyed 352 physicians board certified in neonatal-perinatal medicine on
      their attitudes and practices in the area of pain and pain management in neonates
      and infants. In contrast to earlier surveys of this type, almost all respondents
      indicated that even the youngest and most premature infants are able to perceive
      pain, and most reported that they always advocated anesthesia during the
      intraoperative period. The use of analgesic agents in the postoperative period,
      however, was more variable. Respondents who indicated that neonates perceived
      less pain than adults reported seeing fewer signs of pain and using less
      analgesia in the postoperative period. They were also more likely to believe that
      analgesics are too dangerous to use in neonates and that physiologic factors such
      as incomplete myelination of the pain pathways and neural/physical immaturity
      (factors now known not to play a role) contribute to diminished pain sensitivity.
      Conversely, respondents who indicated that neonates do not perceive less pain
      than adults, the majority of respondents, reported seeing more signs of pain and
      using more medication in the postoperative period. These physicians also believed
      that the physiologic stress associated with pain can be more dangerous than the
      analgesics. We conclude that attitudes and reported practices have changed in the
      area of neonatal pain and pain management. Furthermore, our data indicate that
      these attitudes significantly predict reported postoperative medicating
      practices.

PMID- 8482896
TI  - [Distribution of occlusal stress on mandible, dentition and teeth].

PMID- 8482897
TI  - [Development of a handy dental surveyor].
AB  - A small portable surveyor, easy to use, was newly devised. The surveyor is
      essentially a parallelometer, an instrument used for determining the relative
      parallelism of two or more surfaces of the teeth or other parts of the dental
      cast. The characteristic structures of this instrument is as follows: The
      vertical standard is directly connected to the cast table with a universal joint,
      different from the others, and it can be tilted in any given degree to the table.
      The vertical sliding spindle can move freely parallel to the standard with the
      two horizontal arms, and it carries pencil leads of 0.9mm phi inside just as a
      mechanical pencil in structure. The accuracy of this surveyor is thought to be
      equal to that of the conventional ones in ordinary use.

PMID- 8482898
TI  - [Analysis of expression of p53 tumor suppressor gene in human oral squamous cell
      carcinoma].
AB  - Expression of p53 tumor suppressor gene was examined in oral squamous cell
      carcinomas (OSCC), the precancerous lesions (leukoplakia) and cell lines
      established from OSCC, to investigate (1) whether or not all p53 mutations can be
      detected immunohistochemically and (2) when the alterations of the p53 gene
      and/or protein occur during the genesis of OSCC from leukoplakia. Over-expression
      was detected in 11 out of 16 cell lines with the anti-p53 monoclonal antibody
      PAb1801, although the remaining 5 cell lines have previously been reported to
      have mutations, thus suggesting that the immunohistochemical method has a
      limitation. To answer the second question, the ZA case was chosen as this case of
      OSCC with a point mutation at codon 279 had a history of leukoplakias which
      showed a malignant progression. The polymerase chain reaction/single strand
      conformation polymorphism (PCR/SSCP) method was employed to determine the
      presence of the mutation. Immunohistochemistry showed over-expression of the p53
      protein in all 5 biopsy materials of leukoplakia, while the mutation was detected
      in 2 materials. In other 15 cases of leukoplakia, over-expression has a relation
      to epithelial dysplasia. These results indicate alterations of p53 gene and/or
      protein are observed not only in OSCC but also in leukoplakia and play an
      important role in the genesis of OSCC.

PMID- 8482899
TI  - [Isolation and characterization of oral treponemes].
AB  - The oral treponemes were isolated on nine media and classified according to
      Anaerobe Laboratory Manual (1977). The four media, which were used with the plate
      in-bottle method, were Medium 10 (M10), M10 supplemented with 10% rumen fluid,
      M10 supplemented with 10% rabbit serum and cocarboxylate, and M10 added with
      rifampicin. The five media with the anaerobic glove box method were New Oral
      Spirochetes (NOS) medium, NOS medium added with rifampicin, alternated modified
      Oral Treponemes Isolation (aOTI) medium, and alternated M10 for anaerobic glove
      box. The isolation rate of the oral treponemes from 59 subgingival plaque samples
      of various forms of periodontal diseases was 85 percent. Ninety clinical isolates
      were subcultured and classified into six groups (I-VI) based on the carbohydrate
      fermentation and metabolic end products. Three saccaharolytic groups were further
      divided into nine subgroups by the fermentation patterns of sucrose, lactose,
      maltose and rhamnose. Two saccaharolytic subgroups were identified as Treponema
      socranskii, and two asaccharolytic groups were identified as "T. denticola" and
      "T. vincentii". However, the other subgroups and group could not be identified
      according to the characteristics of the presently recognized species.

PMID- 8482900
TI  - [Clinical study of masticatory movements in complete denture wearers--paths of
      masticatory movements and occlusal contacts].
AB  - Bilateral balanced occlusion is believed to be one of the ideal types of
      occlusion for a complete denture since the occlusal contacts on the non-working
      side are concerned with the stability of the complete denture during mastication.
      In this study, the role of the occlusal contacts on the non-chewing side was
      investigated. The paths of masticatory movements were measured by sirognasograph
      and the occlusal contacts on the non-chewing side were measured by the 6-channel
      telemetry system. The results were follows; 1. The frequency of normal chewing
      pattern was observed to be higher in chewing on the habitual chewing side than in
      chewing on the non-habitual chewing side. 2. The average value in lateral
      deviations at the maximum opening point and maximum lateral closing point was
      larger in chewing on the habitual chewing side than in chewing on the non
      habitual chewing side. 3. Excursive closures were found in 36.0-71.1% among the
      total closures when chewing on the habitual chewing side and 4.9-20.9% on the non
      habitual chewing side. 4. The majorities of the excursive closures consisted of
      glidings from the lateral position to the centric position. 5. The width of the
      gliding in lateral excursion on the occlusal surface of the lower first molar was
      mostly 0.2-1.2mm.

PMID- 8482901
TI  - [Purification of bone morphogenetic protein and investigation of its effects on
      osteoblastic cell line UMR108].
AB  - It is well known that the bone matrix contains proteins which can induce ectopic
      endochondral bone formation in vivo. One class of these proteins is the bone
      morphogenetic protein (BMP). In order to investigate the physiological function
      of the BMP, its purification was attempted from an extract of demineralized bone
      matrix and its actions on the osteoblastic cell line were investigated. To
      isolate the BMP, a demineralized bone matrix was extracted with 4M guanidine-HCl.
      A water-insoluble fraction (G-WI) was separated from the demineralized bone
      extract by dialysis against distilled water and centrifugation. The BMP was
      purified from G-WI by gel filtration on Sephacryl S-200 HR, cation exchange with
      Mono-S, heparin affinity column and finally by C1/8 reverse phase chromatography.
      Peptide sequence analysis revealed that the purified BMP fraction contained "BMP
      3" reported by Wozney et al. (1988). In order to investigate its function, the
      BMP was applied to the rat osteogenic sarcoma cell line UMR108. The BMP inhibited
      the growth of the UMR108 cells and enhanced the alkaline phosphatase activity in
      a dose-responsive manner.

PMID- 8482902
TI  - [Osteopontin mRNA expression in remodeling alveolar bone incident to tooth
      movement--visualized by in situ hybridization].
AB  - The purpose of this study was to investigate the osteopontin mRNA expression in
      the alveolar bone incident to the physiologic and experimental tooth movement.
      The upper jaws of female rats (7 weeks old) which were submitted to experimental
      molar tooth movement and control specimens were decalcified and sliced into
      paraffin sections. Osteopontin mRNA expression and tartrate-resistant acid
      phosphatase (TRACPase) activity were examined in the alveolar bone by use of in
      situ hybridization techniques and enzyme histochemistry, respectively. In the
      control specimens high levels of osteopontin mRNA expression was observed in the
      osteocytes and lining cells close to the osteoclasts which were detected by
      TRACPase staining in the distal areas of the tooth sockets. In the mesial tooth
      socket areas however, low levels of osteopontin mRNA expression was observed. In
      the experimental specimens high levels of osteopontin mRNA expression of both the
      osteoblasts and osteocytes was observed in the mesial areas of tooth sockets in
      response to the experimental tooth movement. These results indicated that
      osteopontin gene expression is related to the alveolar bone remodeling as far as
      the bone resorption incident to the physiologic tooth movement and that this
      expression level significantly increased in response to a certain mechanical
      stress incident to the experimental tooth movement.

PMID- 8482903
TI  - [Change in trigeminal mesencephalic neurons after teeth extraction in guinea
      pig].
AB  - Trigeminal mesencephalic (Mes V) neurons innervating the periodontal
      mechanoreceptor (PMR) are known to play an important role in controlling the bite
      force and jaw-movements during mastication. After teeth loss, the PMR disappears
      due to loss of the periodontal membrane. The present work is a study on whether
      cell death is induced in the Mes V neurons in association with teeth loss. The
      upper and lower incisors were extracted on the right side in 5 guinea pigs
      (extraction group) and the other 5 guinea pigs were kept intact (control group).
      In the extraction group, the animals were kept alive for 58-119 days after teeth
      extraction. Serial coronal sections (50 microns thick) were made of the midbrain
      and pons and stained with cresyl violet. The Mes V neurons were counted on every
      other section. In the caudal half of the Mes V nucleus, where the neurons
      innervating the PMR are reported to be located, the number of neurons was less on
      the right side than on the left side (P < 0.01) in the extraction group, while
      there was no difference between the right and left sides in the control group. We
      conclude that teeth extraction can induce cell death in the Mes V neurons
      innervating the PMR and produce a significant change in the brainstem mechanisms
      controlling mastication.

PMID- 8482904
TI  - [Vascular endothelial cell proliferation suppressing factor produced by oral
      cancer].

PMID- 8482905
TI  - [Right and left symmetry of the diameters of the crowns of the permanent anterior
      maxillary teeth and the relationship of their mutual compensation].

PMID- 8482906
TI  - [Dental pulp irritation by various materials used to pretreat dentin].

PMID- 8482907
TI  - [Oral cancer and tumor suppressive gene p53].

PMID- 8482908
TI  - [Analysis of the path of the movement of the neural crest cells of the mammalian
      head region].

PMID- 8482909
TI  - [Influence of various impression procedures for removable partial denture on
      displacement of soft mucosal tissue].
AB  - In the impression-taking procedure for the distal extension removable partial
      denture, the pressure produced at the interface of the soft mucosal tissue and
      the impression material is the most important factor for the stability of the
      saddle under functional load. However, a review of the literature revealed little
      information about the displacement of the soft tissue caused by the impression
      pressure. In the present study, to investigate the influence of various
      impression procedures on the magnitude of the soft tissue displacement more
      precisely, a new three-dimensional deformation measurement system was devised.
      Compared to the previous studies, the greatest advantage of the system is that
      the hardened impression material can be surveyed directly without substituting a
      dental stone. It was found that, in the investigation using a partially
      edentulous simulated model, the amount of the subsidence in the soft tissue was
      increased as the thickness of the spacer of the impression tray was reduced or
      the seating speed of the tray was fast. Especially in the buccal area, a large
      amount of vertical displacement was present compared to the midridge and lingual
      area. Thus it was suggested that many factors are associated with the form of
      soft tissue under impression loading.

PMID- 8482910
TI  - [In vitro study on biocompatibility of zirconium and titanium].
AB  - The purpose of this study is to evaluate the biocompatibility of zirconium
      compared with titanium by the in vitro study using human osteosarcoma cell line
      (HOS). Various characteristics of the HOS cells cultured on zirconium (99.9%) and
      titanium (99.9%) discs were investigated. On the colony formation of the HOS
      cells, there were no differences between the zirconium and titanium in colony
      size and number. Good proliferation of the HOS cells was observed on the
      zirconium as well as on the titanium. Morphological observation of the HOS cells
      by SEM revealed that the cells on the zirconium as well as on the titanium were
      flat and polygonal in shape with radial pseudopods. Collagen fibers and calcified
      substances were observed in the matrix of the HOS cells by TEM on the zirconium
      as well as on the titanium. The calcium of the HOS cell layer was stained well by
      Dahl's method. Analysis of the HOS cell layer by the Fourier transform infrared
      spectroscopy indicated that the HOS cells formed the same matrices including the
      apatite on the zirconium as on the titanium. Measurements of the zirconium and
      titanium elution into the human saliva indicated that the elution of zirconium
      was less than that of titanium. These results suggest that zirconium possesses as
      excellent biocompatibility as titanium.

PMID- 8482911
TI  - [Expression of glucocorticoid receptor gene during development of mouse embryos].
AB  - Glucocorticoid, one of the steroid hormones, has been known to play important
      roles on homeostasis and development. To obtain information about the effects of
      glucocorticoid on the mouse embryonic development, temporal and spatial
      expression patterns of the glucocorticoid receptor (GR) gene were examined by the
      Northern hybridization and in situ hybridization techniques. Transcripts of the
      GR gene were found on embryonic day (ED) 10 by the Northern analysis. The amount
      of GR mRNA increased drastically on ED12 and was thereafter maintained at similar
      levels. On the other hand, obvious signals of GR gene expression were never
      detected until ED12 by in situ hybridization. On ED14 and afterwards, many
      organs, i.e. the pituitary gland, tongue, thymus, lung, liver and pre-cartilage,
      showed a high GR expression. These tissues were previously reported to be the
      target organs of glucocorticoid. The abrupt increase of GR gene transcripts in
      the embryonic tissues corresponded with the beginning of their maturation or
      function. These result suggest that the timing of the GR gene transcription
      becoming high in the embryonic tissues coincides with the onset of their terminal
      differentiation and function.

PMID- 8482912
TI  - [Influences of cusp inclination on stability and function of removable partial
      dentures].
AB  - The influences of cusp inclination on the stability and the function of removable
      partial dentures were evaluated on 5 subjects with the maxillary unilateral free
      end saddle. An experimental removable partial denture was made with six pressure
      sensors fixed on to the basal surface. The artificial teeth were replaceable by
      attachment. Several metal maxillary canine risers were made to change the
      inclination of the lateral gliding movement. During lateral gliding, the canine
      risers and the artificial teeth were contacted with the opposing mandibular teeth
      simultaneously. The pressures exerted upon the supporting tissues and the
      mandibular movements were measured during mastication with each artificial teeth
      of different cusp inclination. The results were as follows: 1. The steeper cusp
      caused the reduction of the peak pressures as well as the total pressures in most
      measuring spots. 2. The time differences of the first and the peak pressure
      detection between 6 measuring spots extended as the cusp became steeper. 3. The
      mandibular movements were influenced by the cusp inclination especially in the
      subjects with tear-drop type masticatory strokes. 4. It was suggested that the
      moderate cusp of artificial teeth contributed to the denture stability in
      function.

PMID- 8482913
TI  - [Mechanical studies on dental magnetic attachments].
AB  - The purpose of this study is to investigate the force distribution when using
      magnetic attachments in removable partial denture. The experimental magnetic
      attachments used in this study consisted of Nd-Fe-B magnets covered with
      permendur yokes and permendur keepers. The magnetic parts were attached to the
      experimental plate which was made of a titanium plate and an acrylic resin base,
      while the keepers were attached to the abutment teeth. The retentive force was
      measured by pulling the experimental plate vertically and diagonally with a
      tensile testing machine. In addition, the three-dimensional stress distribution
      of the abutment was analyzed by the finite element method when the magnetic
      attachment was removed. The results were as follows: 1. The maximum retentive
      force of the plate was influenced by the total of the attractive force, while the
      minimum force was by the number and arrangement of the attachments. 2. In almost
      all cases, the magnetic attachments worked most effectively when their attractive
      force was the same for each other. 3. When the pulling force was vertically
      applied to the abutment, the maximum stress arose in the alveolar bone around the
      root tip, and, when the force was laterally applied, the maximum stress arose on
      the axis of the 1/3 upper portion of the root.

PMID- 8482914
TI  - Cytokine priming of the respiratory burst in human eosinophils is Ca2+
      independent and accompanied by induction of tyrosine kinase activity.
AB  - We report that pretreatment of human eosinophils with GM-CSF, IL-3, or IL-5
      enhanced the respiratory burst induced by opsonized particles. In order to gain
      more insight into the intracellular mechanism(s) involved in cytokine priming,
      the role of [Ca2+]i and tyrosine kinases was studied. Optimal priming
      concentrations of GM-CSF, IL-3, and IL-5 did not induce a rise in [Ca2+]i, and
      Ca(2+)-depleted eosinophils ([Ca2+]i < 20 nM) were still primed after
      preincubation with these cytokines. GM-CSF, IL-3, and IL-5 induced
      phosphorylation of two proteins (102 and 122 kd) on tyrosine residues, as deduced
      from Western blot analysis with an antiphosphotyrosine monoclonal antibody
      (4G10). This cytokine-stimulated tyrosine phosphorylation was not inhibited under
      Ca(2+)-depleted conditions. In conclusion, this study demonstrates that GM-CSF,
      IL-3, and IL-5 priming of the opsonized particle-induced respiratory burst in
      human eosinophils is completely Ca2+ independent. Moreover the tyrosine
      phosphorylation of a 102-kd and a 122-kd protein is Ca2+ independent, suggesting
      that this event might be involved in cytokine priming.

PMID- 8482915
TI  - Laminin cleavage by activated human neutrophils yields proteolytic fragments with
      selective migratory properties.
AB  - We studied the interactions between human neutrophils, as well as the purified
      human neutrophil serine proteases elastase (HNE) and cathepsin G (HNCG), and
      laminin. Our results show that intact laminin and two proteolytic fragments
      generated by HNE bind to neutrophils and stimulate cell migration. Domain
      specific antilaminin monoclonal antibodies, rotary shadowing electron microscopy,
      and Western blotting mapped the two promigratory fragments on the laminin cross
      to the apical three-armed region and long arm, respectively. In contrast, a
      fragment derived from the terminal ends of short arms neither bound to
      neutrophils nor stimulated migration. When neutrophils embedded in a
      reconstituted basement membrane gel were activated with phorbol myristate
      acetate, several stable, proteolytic laminin fragments were released into
      supernatants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and
      Western blotting showed that these fragments appeared identical to those
      generated after digestion of soluble laminin with HNE and HNCG. Furthermore,
      release of laminin fragments by embedded neutrophils was inhibited by diisopropyl
      fluorophosphate, and duplicated by incubating the basement membrane gel with
      purified HNE and HNCG. Our findings therefore suggest that neutrophils, through
      release of HNE and HNCG, are capable of digesting basement membrane laminin in
      vivo. In addition, the release of laminin fragments from damaged basement
      membranes may promote neutrophil migration and thereby accelerate inflammatory
      processes.

PMID- 8482916
TI  - Human pulmonary macrophages utilize prostaglandins and transforming growth factor
      beta 1 to suppress lymphocyte activation.
AB  - The ability to activate peripheral blood lymphocytes (PBLs) in vitro with
      interleukin-2 (IL-2) is suppressed by the presence of autologous human pulmonary
      alveolar macrophages (AMs). AMs suppress both IL-2-induced proliferation and the
      induction of lymphokine-activated killer cell (LAK) activity in a dose-dependent
      manner (79 +/- 6% suppression of LAK activity at a 0.25:1 AM/PBL ratio).
      Increasing the IL-2 concentration increased baseline LAK activity but did not
      prevent AM-mediated suppression. At least two different mechanisms of suppression
      were observed, one diffusible in nature and the other contact dependent.
      Indomethacin prevented the component of inhibition that diffused across porous
      polycarbonate membranes, indicating prostaglandins as the diffusible inhibitor.
      In contrast, indomethacin had no effect when added alone into conventional AM-PBL
      cocultures, but a combination of indomethacin and anti-transforming growth factor
      beta 1 (TGF-beta 1) antibody did prevent inhibition. This result suggests that
      TGF-beta 1 acts as an additional contact-dependent inhibitor. PBLs that were
      rendered unresponsive to IL-2 completely recovered their responsiveness within 4
      days after removing AMs from the coculture. These features suggest that pulmonary
      macrophages have multiple mechanisms for locally suppressing IL-2 responses and
      lymphocyte activation.

PMID- 8482917
TI  - Affinity purification and subcellular localization of kinesin in human
      neutrophils.
AB  - Studies of granule-microtubule interactions in human neutrophils have suggested
      that mechanochemical ATPases such as kinesin or dynein may play a role in granule
      mobilization during neutrophil activation by inflammatory signals. In this study
      we show that proteins extracted from the surface of neutrophil granules, found
      previously to contain microtubule-dependent ATPase activity, caused microtubules
      polymerized from phosphocellulose-purified rat brain tubulin to move across glass
      slides. Antibodies were generated against peptides based on two regions of the
      amino acid sequence of Drosophila kinesin: the ATPase active site (amino acids 86
      99) in the head of the kinesin heavy chain and the tail of the heavy chain
      (residues 913-933). These antibodies were found to recognize kinesin in rat brain
      extracts as well as kinesin-like polypeptides in extracts of human neutrophils.
      Furthermore, when used in immunoaffinity chromatography, these antibodies
      permitted the isolation of a protein from neutrophil granule extracts that was
      recognized by Drosophila kinesin antibodies. Subcellular localization by
      immunofluorescence microscopy showed this protein to be associated principally
      with the cytoplasmic granules of neutrophils.

PMID- 8482918
TI  - In vitro invasiveness of CTL clones and in vivo dissemination of CTL hybridomas.
AB  - Activated spleen T cells are invasive in hepatocyte and fibroblast cultures, and
      this property is dominantly expressed in T cell hybridomas. The invasive
      potential of the hybrids correlates with their capacity to disseminate in vivo.
      We have used this model to study the invasive and migratory properties of
      cytotoxic T lymphocytes (CTLs). Two murine CTL clones were highly invasive,
      independent of their state of activation. CTL hybridomas, derived from one of the
      clones, were similarly invasive. In vivo, CTL hybridoma cells disseminated to
      extravascular sites in the liver, kidneys, lungs, ovaria, tubae, uterus, and
      lymphoid, mesenchymal, and fat tissues. Within 7 to 14 days, 10(6) cells were
      lethal in 100% of mice. The adhesion molecules CD2, CD8, CD54, L-selectin, and
      CD49d (VLA-4 and LPAM-1 alpha-chain) were not expressed by all CTL hybridomas and
      therefore not indispensable for invasion in vitro and dissemination in vivo. In
      contrast, LFA-1 (CD11a/CD18), CD44, and VLA-6 (CD49f/CD29) were expressed on all
      hybrids. LFA-1 antibodies inhibited CTL hybridoma invasion in vitro, but
      antibodies inhibiting CD44-hyaluronate and VLA-6-laminin interaction had no
      effect. These results suggest that migration of cytotoxic T cells into
      noninflamed tissues is independent of their activation state and does not require
      L-selectin, LPAM-1, CD2, and VLA-4.

PMID- 8482919
TI  - Characterization of a human monocyte antigen, B148.4, regulated during cell
      differentiation and activation.
AB  - We analyzed the phenotypic changes associated with monocyte activation and
      differentiation using a newly developed monoclonal antibody (B148.4). Among
      peripheral blood leukocytes, the antigen recognized by this antibody is expressed
      on monocytes and granulocytes at high and low density, respectively. Antigen
      expression is lost during in vitro differentiation of monocytes and is absent on
      tissue macrophages, indicating that expression of this antigen is related to
      monocyte differentiation. Only 1 alpha,25-dihydroxyvitamin D3 and phorbol
      diesters, of several inducers tested, up-regulate B148.4 antigen expression on
      cells (monocytes and certain myeloid cell lines) that constitutively bear the
      antigen, without, however, allowing its maintenance during monocytic
      differentiation or inducing it on negative cells. By immunoprecipitation from
      B148.4+ U937 cells, the antigen is a complex of a major 116-kd and two minor 38-
      and 46-kd molecules. Analysis of eight different tissues reveals that the antigen
      is shared with endothelial cells. Biochemical characteristics, cellular
      distribution, and expression pattern on monocytes, myeloid cell lines, and AML
      cells upon culture with different stimuli indicate that B148.4 is a novel
      monocyte differentiation antigen.

PMID- 8482920
TI  - Diminished transcription of interleukin-8 by monocytes from preterm neonates.
AB  - Developmental delays, which impair antibacterial host defense, are present in the
      neutrophil system of human preterm neonates. We hypothesized that diminished
      production of interleukin-8 (IL-8), a neutrophil chemotactic peptide, might in
      part be responsible for these defects. To test this, monocytes from the blood of
      preterm neonates, term neonates, and adults were isolated immunologically by
      "negative panning" and subsequently stimulated with interleukin-1 alpha (IL-1
      alpha), tumor necrosis factor alpha (TNF-alpha), or lipopolysaccharide (LPS),
      after which IL-8 levels in the supernatants were measured by ELISA. Total
      cellular RNA was extracted and IL-8 mRNA was assessed by Northern blotting and by
      competitive polymerase chain reaction (PCR) analyses. After stimulation with IL-1
      alpha, IL-8 accumulation was lowest in supernatants of monocytes from preterm
      neonates, intermediate in supernatants of monocytes from term neonates and
      greatest from monocytes of adults. Similarly, when stimulated with TNF-alpha or
      LPS, monocytes from preterm neonates produced less IL-8 than cells from term
      neonates and adults. These differences in IL-8 concentrations paralleled
      differences in IL-8 mRNA expression.

PMID- 8482921
TI  - Functional alterations of human neutrophils by medium-chain triglyceride
      emulsions: evaluation of phagocytosis, bacterial killing, and oxidative activity.
AB  - Medium-chain triglyceride (MCT) and long-chain triglyceride (LCT) emulsions
      currently used in nutritional therapy were evaluated for their in vitro effect on
      neutrophil oxidative metabolism, phagocytosis, and bacterial killing activities.
      Neutrophils from healthy adult male volunteers were assessed after blood
      incubation with commercially available fat emulsions containing LCT, MCT, or a
      mixture of 50% MCT and 50% LCT at a final triglyceride concentration of 20 mg/ml.
      It was observed that MCT-containing emulsions stimulated nitroblue tetrazolium
      (NBT) dye reduction by neutrophils as determined by a cytochemical NBT test
      performed directly on whole blood. This effect was dose dependent. However, after
      lipid removal by cell washing, the MCT-treated neutrophils showed decreased
      production of hydrogen peroxide (H2O2) and NBT reduction in response to bacterial
      lipopolysaccharide or phorbol myristate acetate stimuli as well as impaired
      phagocytosis and killing of Staphylococcus aureus. In contrast, the LCT emulsion
      did not alter any of the neutrophil functions evaluated. The present data suggest
      that MCTs elicit the oxidative metabolism of neutrophils, probably by
      phagocytosis of fat particles and, depending on the lipid concentration, this
      effect may not be reversible, leading to impairment of the cellular response to
      subsequent membrane stimuli.

PMID- 8482922
TI  - The mouse macrophage activation-associated marker protein, p71/73, is an
      inducible prostaglandin endoperoxide synthase (cyclooxygenase).
AB  - The inducible protein p71/73 marks the response of mouse macrophages to one of
      several stimuli (e.g., bacterial lipopolysaccharide or poly I:C) that trigger the
      expression of cytolytic activity when these cells have previously been primed for
      tumor cell killing by interferon-gamma (IFN-gamma). The results reported here
      identify this marker protein as the inducible prostaglandin endoperoxide synthase
      (PES), TIS10/PES-2. Identification was based on four findings: (1) p71/73, like
      the TIS10/PES-2 protein, was associated with cellular membranes; (2) the sequence
      of amino acids in the NH2 terminus of both p71 and p73 was 96% identical to the
      predicted NH2-terminal sequence of the TIS10/PES-2 protein; (3) a polyclonal
      antiserum raised against the COOH-terminal region of the TIS10/PES-2 gene product
      recognized p71/73 in immunoblots; and (4) dexamethasone, which blocks induction
      of TIS10/PES-2 expression, inhibited the induction of both p71/73 synthesis and
      tumoricidal activity in macrophage. Several regulatory roles for this protein in
      the activation process are possible.

PMID- 8482923
TI  - Transmembrane signaling pathways involved in phagocytosis and associated
      activation of NADPH oxidase mediated by Fc gamma Rs in human neutrophils.
AB  - We have previously shown that in neutrophils classical transmembrane signaling
      consisting of increased [Ca2+]i and hydrolysis of phospholipids was not essential
      for phagocytosis mediated by more than one receptor (yeast-IgG, yeast-C3b/bi,
      yeast-Con A). This work deals with the role of this transmembrane signaling in
      phagocytosis of erythrocyte (E) IgG, which is mediated only by receptors for IgG
      (Fc gamma Rs). The ingestion of E-IgG was associated with an increase in [Ca2+]i
      and production of inositol phosphates, phosphatidic acid, diacylglycerol, and
      arachidonic acid, via activation of phospholipases C, D and A2. Related to the
      same number of particles ingested, the respiratory burst and the transmembrane
      signaling during phagocytosis of E-IgG were much smaller than during phagocytosis
      of yeast-IgG. In Ca(2+)-depleted neutrophils, where the increase in [Ca2+]i and
      hydrolysis of phospholipids were lacking, the phagocytosis of E-IgG was depressed
      by about 60%; the respiratory burst was also depressed due to the decrease of
      ingestion and of stimulation of NADPH oxidase by residual phagocytosis. Pertussis
      toxin (PT) did not inhibit the phagocytosis of E-IgG but depressed by about 40%
      the stimulation of lipidic transmembrane signaling and the respiratory burst in
      normal neutrophils. In Ca(2+)-depleted neutrophils the toxin was without effect
      on ingestion and respiratory burst. Staurosporine did not inhibit the ingestion
      of E-IgG in normal and Ca(2+)-depleted neutrophils but depressed by 30-40% the
      respiratory burst in normal and not in Ca(2+)-depleted neutrophils. Genistein, an
      inhibitor of tyrosine kinase, did not inhibit the ingestion of E-IgG but
      depressed by 30-40% the respiratory burst both in normal and Ca(2+)-depleted
      neutrophils. These results demonstrate the following findings in human
      neutrophils. (1) Contrary to the phagocytosis mediated by more than one receptor
      (yeast-IgG, yeast-Con A, yeast-C3b/bi), the transmembrane signaling involving
      increase in [Ca2+]i and hydrolysis of phospholipids plays a role in the
      phagocytosis and respiratory burst mediated by Fc gamma Rs alone. Thus, different
      signal transduction pathways can be involved in phagocytosis and associated
      respiratory burst depending on the receptor or combination of receptors
      activated. (2) Fc gamma Rs alone promote phagocytosis with two signaling pathways
      independent of and dependent on [Ca2+]i changes and phospholipid hydrolysis and
      insensitive to PT, staurosporine, and genistein. (3) The signaling pathways
      promoting phagocytosis triggered by Fc gamma Rs alone are in some way, or at some
      step, different from those that activate the respiratory burst.

PMID- 8482924
TI  - C-reactive protein increases production of IL-1 alpha, IL-1 beta, and TNF-alpha,
      and expression of mRNA by human alveolar macrophages.
AB  - The concentration of C-reactive protein (CRP) increases in human plasma up to a
      thousandfold during inflammatory states. Because tissue macrophages have been
      shown to have receptors for CRP, the question arises of whether these cells may
      respond to increased local concentrations of CRP by producing cytokines capable
      of participating in the inflammatory response. Accordingly, we examined the
      capacity of alveolar macrophages--relatively accessible human macrophages--to
      produce interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) in
      response to CRP. We found that production of IL-1 alpha, IL-1 beta, and TNF
      alpha, as measured by bioassay and immunoassay, increased in a dose-dependent
      manner after stimulation by CRP and that the levels of the respective mRNAs
      analyzed by Northern blot increased proportionally. These findings suggest that
      one of the functions of CRP may be to stimulate the production of IL-1 and TNF by
      macrophages at inflammatory sites where alterations of capillary permeability
      combined with an increased serum level lead to enhanced local concentrations of
      this acute-phase protein.

PMID- 8482925
TI  - Mast cell granules inhibit macrophage-mediated lysis of mastocytoma cells (P815)
      and nitric oxide production.
AB  - The effects of mast cell granules (MCGs) on macrophage-mediated lysis of P815
      mastocytoma cells and nitric oxide (NO) production were studied. Murine
      peritoneal macrophages exhibited tumor cell killing and NO production only when
      activated with lipopolysaccharide (LPS) or interferon-gamma (IFN-gamma).
      Coincubation of macrophages with MCGs during LPS activation dose-dependently
      inhibited macrophage-mediated tumor cell lysis. The MCG effect was not due to
      inactivation or removal of LPS by MCG. The inhibitory effect was also not due to
      histamine or serotonin present in the MCGs. The granules were not toxic to
      macrophages or P815 mastocytoma cells. The effect of MCGs on macrophage-mediated
      tumor cell killing was evident whether MCGs were added before or after a 4-h
      exposure of macrophages to LPS. However, the inhibitory effect was not seen if
      MCGs were added after macrophages had been exposed to LPS for 24 h. To assess
      whether MCGs could inhibit a non-LPS trigger, MCGs were tested on macrophages
      activated with IFN-gamma. In these experiments, MCGs dose-dependently inhibited
      macrophage-mediated tumor cell killing induced by IFN-gamma, LPS, or IFN-gamma
      plus LPS. Furthermore, in parallel experiments, MCGs significantly inhibited
      macrophage NO production induced by LPS, IFN-gamma, or IFN-gamma plus LPS.
      Pretreatment of MCGs with diisopropylfluorophosphate, a serine protease
      inhibitor, only partially abrogated the effects of MCGs. The results demonstrate
      that MCGs inhibit both LPS- and IFN-gamma-induced macrophage killing of P815
      cells and the inhibition is associated with the decrease of NO production.

PMID- 8482926
TI  - Substrate-specific proteases (BLT-esterase) are localized predominantly in the
      natural killer cells of unprimed mice.
AB  - In leukocytes isolated from unprimed mice, the levels of extractable N alpha-Cbz
      Lys-thiobenzylesteresterase (BLT-esterase) closely correlated with the number of
      natural killer (NK) cells. The spleens of mice that exhibit severe combined
      immunodeficiency (SCID) contained much higher levels of this enzyme than other
      mouse strains. Treatments that resulted in a local accumulation of NK cells (as
      assessed by lytic activity) produced a concomitant increase in BLT-esterase
      activity. However, short-term in vitro treatment of spleen cells with interferon
      (IFN)-alpha/beta indicated that BLT-esterase levels correlated more closely with
      absolute numbers of NK cells than with their lytic capacity. There was a very
      good correlation between the numbers of cells bearing the NK phenotype (NK-1.1+)
      and BLT-esterase levels. Cells positively sorted using the NK-specific antibodies
      NK-1.1 and LGL-1 had high enzymatic activity. The BLT-esterase levels were high
      in both the NK-1.1+/LGL-1- and NK-1.1+/LGL-1+ subsets. Highly purified CD4+ and
      CD8+ T cells and sIg+ B cells demonstrated negligible enzyme, as did populations
      of cells highly enriched for macrophages or neutrophils. However, it should be
      stressed that the inbred mice used on this study have been maintained in a
      pathogen-free facility. It would be anticipated that mice maintained under less
      stringent conditions could exhibit appreciable levels of BLT-esterase activity in
      their T cells. Nonetheless, BLT-esterase is present at high levels in NK cells
      and cannot be regarded as a T cell-specific enzyme.

PMID- 8482927
TI  - Reconstitution of recombinant N-formyl chemotactic peptide receptor with G
      protein.
AB  - A recombinant human neutrophil N-formyl peptide receptor (rFPR) expressed in
      transfected mouse fibroblasts (TX2 cells) was analyzed for its ability to couple
      physically with the heterotrimeric G protein, Gi. Immunoprecipitation of
      photoaffinity-labeled rFPR and endogenous neutrophil formyl peptide receptor
      (nFPR) with an anti-FPR peptide antibody demonstrated that the receptors were
      identical in both size and extent of glycosylation. Coupling of rFPR with
      endogenous TX2 Gi was demonstrated by coimmunoprecipitation of the two proteins
      with an anti-Gi antibody. Moreover, rFPR was able to form a physical complex with
      purified Gi in a soluble reconstitution system. We observed similar affinities of
      rFPR and nFPR for Gi. This report provides the first direct evidence that rFPR
      associates physically with Gi and provides a foundation for analysis of the G
      protein coupling capacity of mutant rFPRs.

PMID- 8482928
TI  - LEEP.

PMID- 8482929
TI  - Clarithromycin vs penicillin.

PMID- 8482930
TI  - Clarithromycin vs penicillin.

PMID- 8482931
TI  - Bronc: a parable of compliance and patient care.

PMID- 8482932
TI  - Family secrets: a challenge for family physicians.

PMID- 8482933
TI  - Serum creatinine as an independent predictor of coronary heart disease mortality
      in normotensive survivors of myocardial infarction. POSCH Group.
AB  - BACKGROUND: Serum creatinine has been reported in previous studies to be a
      prognostic indicator for overall mortality, in particular in a hypertensive
      population. METHODS: The Program on the Surgical Control of the Hyperlipidemias
      (POSCH) was a randomized, controlled clinical trial. All patients had survived a
      single myocardial infarction, were normotensive, were not obese, were not having
      heart failure, and were free of diabetes mellitus and renal disease at entry into
      the study. POSCH had followed its control group patients (N = 417) for a minimum
      of 7.0 years. In this group, a prospective post hoc analysis of the relationship
      of baseline serum creatinine with subsequent overall and atherosclerotic coronary
      heart disease mortality was performed. RESULTS: The baseline serum creatinine
      values in the control group patients ranged from 0.7 to 1.9 mg/dL (60 to 170
      mumol/L), and were found to be independent predictors (P < .01) of both overall
      mortality and atherosclerotic coronary heart disease mortality. Each 0.1 mg/dL (9
      mumol/L) increment in the baseline serum creatinine increased the relative risk
      for subsequent overall mortality by 36% and the relative risk for subsequent
      atherosclerotic coronary heart disease mortality by 47%. CONCLUSIONS: These
      results demonstrate that a serum creatinine value, obtained in normotensive,
      nonobese, normoglycemic survivors of a myocardial infarction without preexistent
      renal disease or heart failure, provides independent prognostic information
      regarding subsequent overall and atherosclerotic coronary heart disease
      mortality.

PMID- 8482934
TI  - Randomized placebo-controlled trials of antibiotics for acute bronchitis: a
      critical review of the literature.
AB  - BACKGROUND: Acute bronchitis is a common clinical problem that causes
      considerable morbidity and presents both diagnostic and treatment dilemmas for
      the physician. An evaluation of all published randomized controlled trials of
      antibiotics in the treatment of acute bronchitis was conducted to (1)
      quantitatively assess methodologic rigor, (2) determine if effectiveness of
      antimicrobial therapy is known, and (3) analyze strengths and weaknesses of
      randomized controlled trials in family practice settings. METHODS: A scoring
      system for the evaluation of randomized controlled trials was adapted for this
      study. Four raters, who were blinded to which journals published the studies and
      the type of antibiotic used in each study, assessed the six-randomized clinical
      trials for treatment of bronchitis identified through a literature search. The
      trials were rated according to criteria that measured internal validity. RESULTS:
      Scores for internal validity ranged from 65.5 to 102.5 points with a maximum
      possible score of 120 points (54.6% to 85.4%). The two trials with the highest
      scores assessed doxycycline and showed no benefit from use of this antibiotic.
      Single trials that studied erythromycin and trimethoprim-sulfamethoxazole showed
      improvement in outcome from use of these drugs; however, of the six trials, these
      two studies ranked fourth and fifth for internal validity. Low scores resulted
      from small sample size, possible contamination with other treatment measures, and
      poor assessment of subjects' compliance with antibiotic regimen. CONCLUSIONS: An
      evaluation of the current literature does not support antibiotic treatment for
      acute bronchitis. Further studies of this common illness are indicated. It is
      hoped that this critical review of randomized control trials will prove useful in
      the planning of future studies, in placing greater emphasis on methodologic
      rigor, and in giving greater consideration to the practical constraints of
      research in the family practice setting.

PMID- 8482935
TI  - Colposcopic accuracy in a residency training program: defining competency and
      proficiency.
AB  - BACKGROUND: The determination of proficiency in procedural skills has evoked keen
      interest, but meaningful guidelines are limited by the absence of pertinent
      clinical data. Colposcopic accuracy is defined as the clinical correlation
      between a colposcopic impression and a histologic report. The colposcopic
      accuracy of physicians in a university-based family practice residency colposcopy
      program was evaluated. METHODS: Demographic information, clinical findings, and
      laboratory results of patients evaluated by colposcopy were prospectively
      recorded. Colposcopic accuracy was calculated based on the agreement of the
      colposcopic impression with the histologic interpretation within one histologic
      grade. RESULTS: Colposcopic examinations were performed on 282 patients.
      Histologic evidence of premalignant cervical disease was identified in 115
      patients as follows: mild dysplasia, 72; moderate dysplasia, 24; and severe
      dysplasia, 19. The colposcopic impression agreed within one histologic grade in
      188 of 205 patients for a colposcopic accuracy rate of 91.7% (95% CI = 87.1% to
      95.1%). CONCLUSIONS: Given an acceptable latitude of clinical correlation between
      the colposcopic impression and histologic interpretation, the colposcopic
      accuracy of family physicians compared favorably with that reported by other
      colposcopists. The more common colposcopic errors were overestimation of low
      grade disease and underestimation of high-grade disease. Colposcopic accuracy at
      an essential minimal proficiency level of 80% should form the basis for assessing
      specialized perceptual ability and therefore determining colposcopic competency.

PMID- 8482936
TI  - Health care needs of Appalachian trail hikers.
AB  - BACKGROUND: With a growing interest and participation in hiking, predictions
      indicate that over 45 million Americans will participate in backpacking and day
      hiking in 1993. There has been very little assessment of the health care needs of
      this group. The purpose of this study was to assess the health care needs of
      Appalachian Trail backpackers. METHODS: Backpackers who completed hiking the
      Appalachian Trail in 1987 or 1988 received a 3-page survey questionnaire. The
      survey contained questions to elicit demographic information, general health
      characteristics, and health care experiences during the hike. Information about
      injuries, medications carried and used during the backpacking activities, health
      care needs, and trail time lost because of health problems was also requested.
      RESULTS: Injuries and illnesses were reported by 82% of the respondents,
      incurring an average loss of 4.7 days of hiking. Musculoskeletal complaints,
      traumatic injuries, and gastrointestinal complaints were most often reported. The
      severity of these problems was such that medical attention was sought in 25% of
      these events. CONCLUSIONS: Hikers need to anticipate that musculoskeletal,
      gastrointestinal, and skin problems may occur during hiking. It is prudent to
      carry medications such as analgesics in the form of aspirin or other nonsteroidal
      anti-inflammatory agents, topical antibiotics, and bandages. Methods to purify
      water need to be used regularly, and adequate preparation of food needs to be a
      priority.

PMID- 8482937
TI  - An evaluation of two compact analyzers used for lipid analysis.
AB  - BACKGROUND: A number of relatively inexpensive compact analyzers are available
      for use in physician offices and outpatient clinics to measure total cholesterol
      and, more recently, high-density lipoprotein (HDL) cholesterol and triglycerides.
      This study was designed to document the analytical performance of two of them,
      the Abbott Vision and the Kodak Ektachem DT60, for assays of total cholesterol,
      HDL cholesterol, triglycerides, and calculated low-density lipoprotein (LDL)
      cholesterol. METHODS: Lipid profiles were measured from venous blood samples of
      70 subjects with each test device, and results were compared with those from a
      laboratory standardized to the Centers for Disease Control. Coefficient of
      variation (CV) of multiple measurements from three pools of human serum (ie,
      precision), mean percent difference between device and standard laboratory
      results (ie, accuracy or bias), and 95% tolerance intervals (total error) were
      determined. The correct classification of patients into risk categories with
      device results was compared with the standardized laboratory results. RESULTS:
      The average CVs for total cholesterol, triglycerides, and HDL cholesterol with
      the Vision analyzer were 3.6%, 4.4%, and 10.5%, respectively, and with the DT60,
      5.0%, 4.1%, and 6.8%, respectively. The average percent biases for the same
      analytes with the Vision analyzer were 0.2%, 4.0%, and -2.3%, respectively, and
      with the DT60, -2.1%, 12.1%, and 0.1%, respectively. Total error assessments
      indicated that total and HDL cholesterol measurements in individual patients met
      the guidelines of the National Cholesterol Education Program with both devices,
      but that triglycerides and LDL cholesterol measurements did not. Classification
      of subjects into risk groups based on total or LDL cholesterol gave clinically
      satisfactory results with either device. CONCLUSIONS: More precise measurement
      technology for LDL cholesterol is needed. Physicians and others who rely on
      compact analyzer results for diagnosis and treatment decisions should consider
      the degree of inaccuracy and imprecision in these values.

PMID- 8482938
TI  - Attitudes of Florida family practice residents concerning obstetrics.
AB  - BACKGROUND: The cost of liability insurance for obstetrical care and the fear of
      eventual litigation are reasons commonly cited by family physicians for not
      delivering babies. METHODS: Separate surveys were mailed to residency directors
      and third-year residents in Florida family practice residency programs to
      determine the attitude and practice plans of recently trained family physicians
      in regard to obstetrics. RESULTS: Three hundred twenty residents completed
      civilian family practice residency programs in Florida from 1986 through 1990.
      Only nine (2.8%) delivered babies the first year after residency. The major
      reasons that third-year residents gave for not planning to deliver babies
      included fear of being sued and the cost of malpractice insurance. Residents'
      estimates of first-year insurance costs were 350% higher than actual premiums.
      Furthermore, residents believed that the risk of being sued for the obstetrics
      portion of their practice would exceed the risk for the nonobstetric portion.
      CONCLUSIONS: Residents' estimates of the cost of malpractice insurance and their
      malpractice risk for delivering babies appear to be greatly exaggerated. These
      views are primarily obtained from nonresidency sources.

PMID- 8482939
TI  - Occupational Safety and Health Administration regulations for the physician's
      office.
AB  - Mandatory reporting and recordkeeping on job safety were established for all
      employers by the Occupational Safety and Health Administration (OSHA) Act of
      1970. Physician interest in OSHA regulations recently increased with the
      publication of the Bloodborne Pathogens Standard. This review examines general
      employer communication to employees about new standards as well as reporting
      requirements for physician offices, including special OSHA forms needed to comply
      with illness and injury reporting.

PMID- 8482940
TI  - Insomnia: concerns of the family physician.
AB  - Insomnia is frequently seen in the primary care setting. Although poor sleep can
      impair daytime functioning and directly affect quality of life, insomnia often
      goes untreated, resulting in perpetuation and, sometimes, exacerbation of the
      problem. Reversing this trend requires that family physicians become attuned to
      complaints of insomnia and respond appropriately. Through education about proper
      sleep hygiene and stress management, and with the appropriate use of hypnotic
      agents, most cases of insomnia can be managed effectively by the primary care
      physician and patient without referral to a sleep specialist.

PMID- 8482941
TI  - Bell's palsy in pregnancy and the puerperium.
AB  - The incidence of Bell's palsy is significantly higher during the last trimester
      of pregnancy and the puerperium. Suggested explanations for this association
      include fluid retention, hypertension, compromise of the vasa nervorum, infection
      (particularly with herpes simplex virus), and an autoimmune process. The
      diagnosis is confirmed by identifying lower motor neurone paralysis and excluding
      secondary causes for the symptom complex. The majority of cases resolve
      spontaneously. Recovery may be delayed or incomplete in older patients and those
      with recurrent episodes or severe initial symptoms. The role of diuretics,
      steroids, or surgical decompression in treatment of pregnancy-related cases of
      Bell's palsy has not been well studied.

PMID- 8482942
TI  - Dermal complication of the bowel bypass syndrome: a case report.
AB  - Bowel bypass surgery, which involves shortening the small bowel to about 45 cm,
      is a modality of treatment for morbid obesity. Although this procedure is not
      routinely performed today, patients with complications from this procedure are
      still seen by physicians. The case of a patient who had bowel bypass surgery and
      experienced subsequent complications is discussed.

PMID- 8482943
TI  - Management of suspected perforation following colonoscopy: a case report.
AB  - Early detection of colon cancer is imperative for a good prognosis. Family
      physicians are therefore becoming the front line of defense in the fight against
      colorectal malignancy. Many family physicians are incorporating colonoscopy into
      their practices in an attempt to avoid costly referrals and loss of continuity of
      care. While the complication rate for colonoscopy is extremely low, any physician
      who performs colonoscopy must be fully aware of all possible complications and
      their management.

PMID- 8482944
TI  - A new triterpene glycoside from the roots of Symphytum officinale.
AB  - Chemical investigation of the EtOH-soluble portion of Symphytum officinale roots
      has resulted in the isolation of a new pentacyclic triterpene glycoside of
      oleanolic acid. Its structure was elucidated by spectroscopic studies, including
      2D nmr, and chemical evidences as 3-O-[beta-D-glucopyranosyl-(1-->4)-beta-D
      glucopyranosyl-(1-->4)-alpha-L -arabinopyranosyl]-oleanolic acid [1].

PMID- 8482945
TI  - Appenolides A-C: three new antifungal furanones from the coprophilous fungus
      Podospora appendiculata.
AB  - Appenolides A [1], B [2], and C [3], three new antifungal 2(5H)-furanones, have
      been isolated from liquid cultures of the coprophilous fungus Podospora
      appendiculata (UAMH 7225) by repeated preparative tlc on Si gel. The structures
      were assigned on the basis of nmr and ms data.

PMID- 8482946
TI  - Isolation of pseudoprototimosaponin AIII from rhizomes of Anemarrhena
      asphodeloides and its hypoglycemic activity in streptozotocin-induced diabetic
      mice.
AB  - A hot-H2O extract of rhizomes of Anemarrhena asphodeloides, the Japanese sino
      medicine "chimo," lowered the blood glucose level in alloxan-diabetic mice.
      Hypoglycemic activity-guided fractionation isolated a new glycoside,
      pseudoprototimosaponin AIII [1], which was compared with chemically known
      prototimosaponin AIII [2]. These compounds exhibited hypoglycemic effects in a
      dose-dependent manner in streptozotocin-diabetic mice but showed no effects on
      glucose uptake and insulin release, suggesting that the hypoglycemic mechanism
      may be due to inhibition of hepatic gluconeogenesis and/or glycogenolysis.

PMID- 8482947
TI  - Alkaloids from bufonid toads (Melanophryniscus): decahydroquinolines,
      pumiliotoxins and homopumiliotoxins, indolizidines, pyrrolizidines, and
      quinolizidines.
AB  - Skins of bufonid toads of the genus Melanophryniscus contain several classes of
      alkaloids: decahydroquinolines, pumiliotoxins, allopumiliotoxins,
      homopumiliotoxins, both 3,5- and 5,8-disubstituted indolizidines, 3,5
      disubstituted pyrrolizidines, and a 1,4-disubstituted quinolizidine. Tricyclic
      alkaloids, including precoccinelline [193A] and alkaloid 236, an oxime methyl
      ether, are present in one population of Melanophryniscus stelzneri.

PMID- 8482948
TI  - Triterpenoid saponins from Gouania lupuloides.
AB  - The stems of Jamaican chawstick, Gouania lupuloides, have yielded two novel 16,17
      seco-dammaranoid saponins, designated gouanoside A [4] and gouanoside B [5].
      Structural assignments are based on spectroscopic data including 2D nmr
      experiments on the corresponding aglycones, gouanogenin A [1] and gouanogenin B
      [3].

PMID- 8482949
TI  - Luffariolides F and G, new manoalide derivatives from the Okinawan marine sponge
      Luffariella sp.

PMID- 8482950
TI  - Penfield's homunculus: a note on cerebral cartography.

PMID- 8482952
TI  - Emanuel Swedenborg (1688-1772).

PMID- 8482951
TI  - Acute neuromuscular respiratory paralysis.

PMID- 8482953
TI  - Infarct topography and hemiparesis profiles with cerebral convexity infarction:
      the Stroke Data Bank.
AB  - For the 183 of 1276 patients in the NINDS Stroke Data Bank with convexity
      infarction in the middle cerebral artery territory, the size of the infarct did
      not differ between the two sides but the location of the main site of the infarct
      differed: on the left side, it was centred in the inferior parietal region, and
      was mid-frontal on the right. There was a good correlation between infarct size
      and weakness severity whether estimated by overall motor function on one side,
      arm, or hand alone. There was a poor correlation, however, for lesion location
      (lower third, middle third or upper third on either side of the Rolandic fissure)
      and any of the specific syndromes of focal weakness, no two cases sharing the
      same lesion for the same syndrome and several cases sharing the same lesion with
      a different syndrome. The findings indicated a difference in weakness syndromes
      between the two hemispheres and great individual variation of the acute syndrome
      caused by a given site of focal infarction along the Rolandic convexity. These
      variations may explain some of the difficulties showing effects of a given
      therapeutic agent in studies of acute ischaemic stroke. Large sample sizes will
      be required for the reliable assessment of any treatment using currently popular
      clinical stroke scales.

PMID- 8482954
TI  - The experiences of an acute stroke unit--implications for multicentre acute
      stroke trials.
AB  - The suitability of 200 consecutive patients admitted to a newly established acute
      stroke unit was assessed for participation in two multicentre trials currently in
      their pilot phase: the International Stroke Trial of aspirin and heparin, and the
      Multicentre Acute Stroke Trial of streptokinase versus placebo. Of the 200
      patients (74 men, 126 women, mean age 71 years), 96% had cerebral CT, and 94% had
      a final diagnosis of cerebrovascular disease. Overall, 50% of patients presented
      within 6 hours and 70% within 12 hours of the onset of ictus. A total of 113
      patients (56.5%) were potentially eligible for trial treatment with
      aspirin/heparin. Only 9 patients (4.5%) were eligible for streptokinase
      treatment: 50% were excluded because they presented after 6 hours; 23% had a
      previous stroke with clinical sequelae and 23% had severe systemic illness. Forty
      eight per cent of patients had more than one exclusion criterion. The potentially
      high enrollment rates in trials of antithrombotic agents contrast with the
      restricted recruitment for trials of streptokinase, emphasising the need for
      multiple centres to achieve useful study enrollment.

PMID- 8482955
TI  - Patterns of blood-brain barrier impairment and clinical features in multiple
      sclerosis.
AB  - Seventy four patients with clinically definite multiple sclerosis were studied by
      using polyacrylamide gel electrophoresis of cerebrospinal fluid to assess blood
      brain barrier function. Blood-brain barrier impairment was associated with recent
      clinical relapses of multiple sclerosis and worsened across a spectrum from the
      relapsing-remitting type of multiple sclerosis to secondary and primary
      progressive disease. The association between blood-brain barrier impairment and
      primary progressive disease is particularly interesting in the light of recent
      evidence that focal gadolinium enhancement on MRI is relatively unusual in
      patients with this disease.

PMID- 8482956
TI  - Congenital cervical spinal muscular atrophy: a non-familial, non progressive
      condition of the upper limbs.
AB  - Two patients with congenital cervical spinal muscular atrophy had symmetrical
      severe muscle weakness and wasting confined to the upper limbs, areflexia and
      congenital contractures. The shoulders were internally rotated, elbows extended
      and wrists flexed. There were no sensory or bulbar symptoms, scoliosis, long
      tract signs or lower limb involvement. This condition should be regarded as a
      neurogenic type of arthrogryposis, limited to the upper limbs.

PMID- 8482957
TI  - Focal electroencephalographic abnormalities and computerised tomography findings
      in children with seizures.
AB  - A persistent focal abnormality was observed in 157 (16%) electroencephalograms
      undertaken in 964 consecutive children with epileptic and non-epileptic seizures
      seen over one year. CT head scans were performed in 121 (77%) of the 157 children
      with a focus on the EEG; 26 (21%) showed an abnormality, and 21 (81%) of the
      abnormalities were localised. There was no difference in the proportion of
      abnormal scans associated with a delta or slow wave focus compared with a spike
      or sharp wave focus. An abnormal scan was uncommon after a single seizure. In
      only two patients (1.7% of all scans) did the findings on CT alter or greatly
      influence subsequent management.

PMID- 8482958
TI  - Association of HLA-Bw46DR9 combination with juvenile myasthenia gravis in
      Chinese.
AB  - One hundred and fifty two Chinese patients with myasthenia gravis in Taiwan were
      investigated for HLA-A, B, C and DR/DQ typing. HLA-Bw46 and DR9 frequencies were
      significantly increased in patients compared with the control group, and there
      was a decrease in DR3. Further analysis between different subgroups of patients
      showed Bw46 and DR9 were more significantly increased in the juvenile group than
      in the adult group. No single HLA allele was associated with either clinical type
      or thymic pathology, but there was an excess of BW46DR9 combination in both
      juvenile and ocular type patients. The Chinese population with myasthenia gravis
      is characterised by earlier age at onset, more ocular forms and less clinically
      severe illness than in whites, and these characteristics indicate a special
      subgroup that correlates with the strong Bw46DR9 association.

PMID- 8482959
TI  - Patients with spastic hemiplegia at different recovery stages: evidence of
      reciprocal modulation of early/late reflex responses.
AB  - Reflex electromyographic (EMG) muscle responses were recorded from abductor
      pollicis brevis (APB) and tibialis anterior (TA) muscles of fifty patients with
      spastic hemiplegia. Responses in the muscles were evoked during voluntary muscle
      contraction (about 20% of maximum voluntary effort) by submaximal but
      suprathreshold electrical stimulation of the median (at the wrist) and common
      peroneal (at the neck of the fibula) nerves respectively. Three EMG peaks (R1, R2
      and R3) could be recorded after the direct muscle response (M). There was only a
      slight difference in R1-R2 latency interval of about 5 ms between upper and lower
      limbs on the unaffected side of the patients making it unlikely that this late
      response of the lower limb involves a long loop pathway, although this
      possibility cannot be discounted for the later, R3, response. Reflex behaviour
      was analysed for three clinical identifiable recovery stages of voluntary
      movements in the spastic limbs (synergistic, isolated and useful movements). The
      major finding was that an increase in the amplitude of the early response "R1"
      was associated with a decreased amplitude and delayed latency of the late
      response "R2" on the spastic side. The amplitude of R1 in the three different
      recovery stages decreased significantly, whereas the amplitude of R2 increased
      significantly with improvement of the functional stage of the limb. A significant
      negative linear correlation was found between R1 and R2 amplitude changes in
      upper as well as lower limbs. A refractoriness of the motor neuron pool as a
      possible explanation for the decreased R2 amplitude could be discounted. These
      findings together with recent work on reflex development in children support the
      hypothesis of reciprocal modulation of early and late reflex signals by
      supraspinal motor centers.

PMID- 8482960
TI  - Changes in sensation after nerve injury or amputation: the role of central
      factors.
AB  - Dynamic changes in somatosensory cortical maps are known to occur in experimental
      animals subjected to peripheral nerve transection or amputation. To study the
      sensory effects of central nervous system adaptation to temporary or permanent
      loss of input from a part of the hand, multimodality quantitative sensory tests
      were carried out in 11 patients with complete traumatic division and repair of
      the median or ulnar nerves and in six patients who had undergone amputation of
      one or more digits. As expected, vibration, two point discrimination, and tactile
      thresholds were raised in the territory of the injured nerve in a graded fashion,
      sensitivity being poorest in the patients with the most recent injuries.
      Surprisingly, localisation was better in the tips than at the base of the
      hypoaesthetic fingers, suggesting a central attentional gradient. Stimulus
      response curves conformed to a power function whose exponent was higher in
      denervated than in normal skin. Changes in psychophysical functions were also
      discernible in the intact hand. There was no hyperaesthesia in the territory of
      the nerve adjacent to the injured one or in the stump in the case of amputees.
      Central factors contribute to the sensory changes seen after nerve injury, but
      the functional effects of the cortical reorganisation that follows partial
      deafferentation are more subtle than a simple heightening of sensitivity in the
      surrounding skin.

PMID- 8482961
TI  - The relationship between visuospatial ability and perceptual motor function in
      Parkinson's disease.
AB  - To assess the contribution of visuoperceptual function to complex visuomotor
      responding in Parkinson's disease, 14 patients with idiopathic PD and 12 normal
      controls matched for age, education and general intellectual function were
      administered a visual tracing task. No difference was found between the groups on
      two visuoperceptual tests, the Benton Line Orientation test and a test of
      trajectory judgement. However, patients were significantly impaired in tracing a
      sawtooth design when two consecutive angles of the sawtooth were occluded. This
      impairment occurred in reproducing the basic form of the stimulus and not with
      accuracy of fine detail. These results suggest higher-order perceptual motor
      dysfunction independent of any breakdown in basic visuoperceptual processing or
      loss of fine motor control. It is concluded that Parkinsonian patients are unable
      to use sensory information accurately to plan and execute complex or new
      movements.

PMID- 8482962
TI  - Course and outcome of patients in vegetative state of nontraumatic aetiology.
AB  - A follow up study is reported of 100 consecutive unconscious patients admitted to
      an intensive care coma facility with a history of 30 days or more of
      unconsciousness of nontraumatic cause. Twenty recovered consciousness, all within
      5 months of injury. 31 of the remaining patients died within 6 months following
      injury, while 49 continued unconscious until death. The mean life expectancy of
      these 49 was 26-34 months from that time. All 20 patients who recovered awareness
      continued to suffer from major disability. The prognosis for life or death and
      for recovery or not of consciousness was not significantly correlated with age or
      aetiology of the vegetative state. Among those who recovered consciousness, the
      younger patients showed somewhat better results in three parameters of function:
      locomotion, ADL and day-placement, but not in cognition, behaviour or speech
      accuracy and fluency. The overall results for these nontraumatic patients with
      postcomatose unawareness are clearly worse than those for patients with a similar
      period of unconsciousness following craniocerebral trauma.

PMID- 8482963
TI  - Long-term outcome of head injuries: a 23 year follow up study of children with
      head injuries.
AB  - The purpose of the 23 year follow up study was to determine the relationship
      between trauma variables including measures of head injury and very long-term
      sequelae. The study included 159 individuals with a mean age 31.40 years, of whom
      approximately 90% were admitted to hospital with a mild head injury during
      childhood (mean age 7.96). Extent of head injury was determined by
      unconsciousness, neurological status, skull fracture, EEG, post-traumatic
      seizures and a composite measure. The composite measure of neurological variables
      was the best predictor of long-term outcome. In addition, IQ recorded in the post
      acute phase was a reliable predictor of long-term outcome. Of the sample, 32.7%
      reported physical complaints and 17.6% reported current psychological/psychiatric
      problems unrelated to the head injury. Subjective sequelae (physical,
      intellectual and emotional) specified as due to the head injury were reported by
      31% of the sample, and the sequelae were found to be related to the extent of the
      head injury and initial IQ. There were no discernible relationships between
      attribute variables including premorbid status and age with subjective sequelae.
      There were, however, significant relationships between subjective sequelae and
      objective, psychosocial measures of adaptation including educational lag,
      unemployment, current psychological/psychiatric problems and relationships with
      family members. Finally, there appeared to be continuity of complaints elicited
      during the five year follow up of the original project and current sequelae. The
      severity of the head injury was identified as the primary contributory factor in
      the reconstitution process and in the prediction of long term outcomes.

PMID- 8482964
TI  - Migraine madness: recurrent psychosis after migraine.
AB  - A 69 year old man with longstanding migraine with aura had four episodes of
      psychosis lasting 7-28 days during a 17 year period. During attacks he had formed
      visual hallucination and delusions, including reduplicative paramnesia. His
      mother was similarly affected. His EEG showed symmetrical frontal delta waves.
      The time course and EEG changes are similar to acute confusional migraine. The
      reduplicative paramnesia suggests a focal non-dominant hemisphere dysfunction.

PMID- 8482965
TI  - Coding of movement direction and amplitude in Parkinson's disease: are they
      differentially impaired (or unimportant)?
AB  - A recent study suggested that the preparation of movement direction, but not
      amplitude, may be selectively impaired by Parkinson's disease (PD). The authors
      examined the reprogramming of direction only, amplitude only, and direction and
      amplitude together, and included a control condition in which neither parameter
      was reprogrammed. The findings suggested that neither direction nor amplitude
      coding was differentially impaired in PD. Thus the structures affected by PD may
      not be uniquely involved in specifying only the direction or the amplitude of
      future movements; these structures probably have more complex higher-level roles.

PMID- 8482966
TI  - Acute upside down reversal of vision in vertebrobasilar ischaemia.

PMID- 8482967
TI  - Subcortical environmental reduplication: SPECT findings in a patient with a right
      thalamocapsular haemorrhage.

PMID- 8482968
TI  - Evidence for presynaptic inhibition on trigeminal primary afferent fibres in
      humans.

PMID- 8482969
TI  - Intracranial hypertension following psittacosis.

PMID- 8482970
TI  - Neurogenic effects on the palatopharyngeal muscle in patients with obstructive
      sleep apnoea: a muscle biopsy study.

PMID- 8482971
TI  - Risk of stroke in TIAs with a cerebral infarct on CT.

PMID- 8482972
TI  - Diabetes and stress hyperglycaemia in stroke.

PMID- 8482973
TI  - Cerebrospinal fluid proteins in patients with leucoaraiosis: possible
      abnormalities in blood-brain barrier function.
AB  - Some CSF protein abnormalities have been proposed as a possible marker for
      vascular dementia. We studied the CSF protein levels and albumin ratio in 21
      patients (mean age 64.04 +/- 7.5) with progressive bilateral motor impairment,
      and a CT picture of leucoaraiosis. Seven of these patients also presented with
      dementia. Twenty-seven Alzheimer's disease patients (mean age 59.59 +/- 5.30)
      without leucoaraiosis were taken as controls. We also evaluated the correlations
      of the albumin ratio values with the diagnosis of dementia, the severity of
      cognitive impairment, the degree of cerebral atrophy and presence of infarcts on
      CT, and the abnormalities in CSF circulation, found on isotopic cisternography,
      in the leucoaraiosis group. After controlling for age and sex, the patients with
      leucoaraiosis showed greater CSF albumin levels (0.27 g/l +/- 0.11 vs. 0.21 g/l
      +/- 0.06; covariance analysis P = 0.066), CSF IgG values (4.68 mg/100 ml +/- 1.45
      vs. 2.85 mg/100 ml +/- 1.03; covariance analysis P < 0.001), and a higher albumin
      ratio (0.0078 +/- 0.0027 vs. 0.0058 +/- 0.0019; covariance analysis P = 0.013)
      than those with Alzheimer's disease. The variations of these parameters were not
      apparently related to the presence of dementia in the leucoaraiosis group. A
      significantly higher albumin ratio was observed in patients with a slowed CSF
      circulation compared to those with normal CSF circulation (0.0086 +/- 0.0028 vs.
      0.0059 +/- 0.0019; covariance analysis P = 0.05). We conclude that, independently
      from the presence of dementia, patients with leucoaraiosis have CSF abnormalities
      consistent with functional blood-brain barrier alterations.

PMID- 8482974
TI  - The Extended Disability Status Scale (EDSS) as a predictor of impairments of
      functional activities of daily living in multiple sclerosis.
AB  - We investigated the relationship between the Kurtzke expanded disability status
      scale (EDSS) and an activities of daily living (ADL) scale that assesses
      disability across multiple functional domains based on self report of patients
      with multiple sclerosis (MS). Forty-three patients with definite MS responded on
      a 42-item ADL inventory and were also assigned an EDSS rating as part of their
      regular clinical examination. While a strong correlation was found between the
      EDSS and total ADL disability level, the ADL domain of 'Mobility' fully accounted
      for this relationship. The distribution of ADL scores as a function of EDSS level
      was curvilinear, as ADL variance was inconsistent across EDSS levels. Little ADL
      disability was evident when EDSS levels were below five. At higher EDSS levels,
      ADL variability increased substantially, making predictions regarding ADL level
      less exact.

PMID- 8482975
TI  - 6-[18F]fluorodopa metabolism in patients with hemiparkinsonism studied by
      positron emission tomography.
AB  - A group of 10 healthy control subjects and 10 patients with hemiparkinsonism (HD)
      were studied by positron emission tomography (PET) using 6-[18F]fluorodopa
      (FDOPA). FDOPA metabolism in the caudate nucleus and the putamen was separately
      estimated by measuring target-to-background ratios (TBRs) using composite images
      added between 30 and 60 min after FDOPA injection and by TBR-versus-time slopes
      during PET study. TBRs in the caudate nucleus and the putamen were 1.81 +/- 0.23
      (mean +/- SD) and 1.92 +/- 0.28 in the 10 controls, respectively. In HD patients,
      on the dominantly affected hemisphere related to main clinical symptoms, TBRs
      were significantly decreased in the caudate nucleus (P < 0.01) and the putamen (P
      < 0.05) compared with those in the corresponding areas on the contralateral
      hemisphere, though those TBRs on both hemispheres were significantly decreased
      compared with the TBRs of normal subjects (P < 0.01). TBRs and TBR slopes in both
      the caudate nucleus and the putamen were correlated with disease severity
      according to Hoehn and Yahr. On the dominantly affected hemisphere, TBR and TBR
      slopes in the putamen were well correlated with individual clinical measures for
      bradykinesia and rigidity, and those in the caudate nucleus were also correlated
      with the severity of tremor. Our data suggest that in HD patients, PET study
      using FDOPA may provide unique and efficient information on the dysfunction of
      the dominantly affected caudate nucleus and the putamen which are correlated with
      diseased severity and individual clinical symptoms.

PMID- 8482976
TI  - Cerebral glucose metabolism and striatal 18F-dopa uptake by PET in cases of
      chorea with or without dementia.
AB  - Cerebral glucose metabolism was studied by positron emission tomography with
      [18F]fluorodeoxyglucose in 12 patients with chorea due to different underlying
      diseases. The striatal 18F-dopa uptake was also studied with 6-L-[18F]fluorodopa
      in 6 of them. Five of them were diagnosed as Huntington's disease two were as
      'sporadic progressive chorea and dementia' with characteristic symptoms and signs
      of Huntington's disease but no family histories, two were as
      choreoacanthocytosis, and two had hemichorea caused by suspected vascular lesions
      in the contralateral striatum revealed by MRI. Caudate and putaminal glucose
      metabolism decreased in chorea compared to the controls. Hemichorea showed
      decreased glucose metabolism only in the contralateral striatum. Moreover the
      glucose metabolism decreased in demented each 7 patients in the frontal, temporal
      and parietal cortices as well as in the striatum. The caudate and putaminal 18F
      dopa uptake in patients with chorea showed no difference with that in the
      controls. The pathogenetic mechanism of chorea may involve decreased glucose
      metabolism and normal presynaptic dopaminergic activity in the striatum, and that
      of the demented state in chorea may also involve an additional decrease of the
      glucose metabolism in the frontal, temporal and parietal cortices.

PMID- 8482977
TI  - Mitochondrial DNA mutations at nucleotide positions 3243 and 3271 in
      mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like
      episodes: a comparative study.
AB  - Of 50 patients with the clinical characteristics of mitochondrial myopathy,
      encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), 38 had a point
      mutation at nucleotide position (nt) 3243 in the tRNA(Leu(UUR)) region in
      mitochondrial DNA and 6 at nt 3271 in the same tRNA(Leu(UUR)) gene. Except for
      the later onset of the disease in the patients with the 3271 mutation, there were
      no clinical, biochemical and pathological differences between the two groups.
      Since the nt 3271 region is not located in the binding site for mitochondrial
      transcription termination (mTERM) factor, which has been proposed to be defective
      in the 3243 mutation, a functional defect in tRNA itself might be responsible for
      the enzyme defects in MELAS patients; however the mechanism by which the
      defective tRNA(Leu(UUR)) induces the stroke-like episodes remains to be
      clarified.

PMID- 8482978
TI  - Heparin treatment in patients with human T-lymphotropic virus type I (HTLV-I)
      associated myelopathy: a preliminary study.
AB  - Ten patients with HTLV-I-associated myelopathy (HAM) were treated in an
      uncontrolled preliminary trial of heparin. In 7 patients, motor dysfunction
      improved substantially and the effect continued for more than a month after the
      discontinuation of therapy. Sensory and urinary disturbances also improved in 3
      of 4 and in 2 of 10 patients, respectively. Heparin did not alter the subsets of
      peripheral blood lymphocytes nor the titers of anti-HTLV-I antibodies in serum
      and cerebrospinal fluid. Spontaneous proliferation of peripheral blood
      lymphocytes, however, was depressed significantly (P < 0.05) in all cases.
      Heparin therapy has some advantages in cost, ease of administration and fewer
      side effects compared to other therapies such as plasmapheresis and interferon
      alpha. We conclude that heparin can be administered safely to HAM, and that a
      double-blind placebo-controlled trial is warranted to determine its efficacy in
      HAM.

PMID- 8482979
TI  - The innervation of human epidermis.
AB  - Using immunohistochemical procedures numerous nerve fibers have been found in all
      cell layers of human epidermis. These nerves originate from nerve trunks in the
      dermis, enter the epidermis, then divide distally to eventually end in small
      enlargements, near the surface of the skin and in deeper areas. Some endings may
      be external to stratum granulosum cells. Epidermal nerves appear to have a three
      dimensional territorial distribution in relationship to the skin's surface. The
      presence of epidermal nerve fibers was confirmed by electron microscope studies.
      The nerves are presumed to be sensory in nature. The existence of epidermal nerve
      fibers will necessitate changes in present theory of structure and function of
      peripheral sensation.

PMID- 8482980
TI  - Repair of N-methylpurines in DNA from lymphocytes of patients with amyotrophic
      lateral sclerosis.
AB  - We have previously reported reduced ability of ALS fibroblasts to repair genomic
      DNA damage produced by alkylating agents. This report presents our experience of
      studying DNA repair in lymphocytes from ALS patients. The repair of N
      methylpurines produced by treatment with the alkylating agent, methyl
      methanesulfonate, was studied in T-lymphocytes from patients with sporadic and
      familial ALS, and appropriate controls. Repair of damage was quantitated by using
      alkaline elution for genomic DNA repair, and methoxyamine protection of abasic
      sites in DNA fragments for gene-specific repair in the dihydrofolate reductase
      (dhfr) gene, at time points 0, 6 h and 24 h. No significant repair rate
      differences were observed between ALS and control lymphocytes in either genomic
      or gene-specific DNA repair. The possible reasons for the discrepancy with our
      earlier results in lymphocytes and fibroblasts are discussed.

PMID- 8482981
TI  - Dystrophin isoforms expressed in the mouse retina.
AB  - The dystrophin gene is expressed in various tissues of the mouse. Previous
      immunohistochemical studies suggested the existence of dystrophin protein in the
      outer plexiform layer of the retina. We analyzed mRNAs from the retina and other
      tissues of mice and detected the dystrophin transcripts (DT) with the use of the
      reverse transcription and polymerase chain reaction (RT-PCR) method. The 5'
      sequences, corresponding to the first exon, of DT in the retina was mainly the
      brain type, whereas in the 3' region of DT that corresponds to the C-terminal
      domain of dystrophin, some additional RT-PCR products were detected. Base
      sequences in three of them showed homology to those for previously reported human
      dystrophin isoforms. The DT variations in mice were identical between the retina
      and the brain. It was thus concluded that dystrophin really expresses in the
      mouse retina and most of the retinal dystrophin proteins belong to the brain type
      isoform.

PMID- 8482982
TI  - Age-dependent decline in cognitive information processing of HIV-positive
      individuals detected by event-related potential recordings.
AB  - Cognitive event-related potentials (ERP) were recorded in 100 HIV-positive
      patients of all CDC stages without clinical CNS deficits with an auditory oddball
      paradigm. Four latency peaks and three amplitudes were evaluated (N1, P2, N2 and
      P3 latencies, N1-P2, P2-N2 and N2-P3 amplitudes). In contrast to an age-matched
      control group of comparable education and social environment, a statistically
      significant N2-P3 amplitude reduction was found in the patient group
      deteriorating with the CDC stages. The physiological N2-P3 amplitude reduction
      with age in normals was found to be twice as fast in HIV-positive individuals. No
      group-statistically relevant EEG abnormalities were found in the patient group.
      In psychometric testing, there was no marked depressive syndrome in the HIV
      positive individuals, but a mild slowing of speed-dependent abilities.

PMID- 8482983
TI  - Plasma lipoproteins in cortical infarction versus transient ischaemic attacks: a
      case control study.
AB  - The authors investigated the relationship between plasma lipids and the risk for
      cortical infarction (61 cases) and transient ischaemic attacks (TIA) (35 cases)
      compared with matched controls. They observed a maximal increase of total
      cholesterol, of very low-density lipoprotein and low-density lipoprotein (LDL),
      triglycerides, total apolipoprotein (Apo), B,LDL-Apo B and Apo-A1, and small size
      high-density lipoprotein (HDL) and large size HDL whose separation was not
      possible. In contrast they observed a decrease of HDL-ApoE, a distribution of LDL
      in a single fraction and the presence of LDL of low weight in the group with
      cortical infarction with or without cardiac arrhythmias. For the first time, we
      describe a decrease of the HDL-ApoE/total ApoE ratio. TIA differed from the
      former group by a low level of HDL and the lack of abnormalities of Apo-A1,
      distribution of small and large size HDL, and in the distribution and the weight
      of LDL. These data suggest that previously demonstrated differences in LDL
      cholesterol and HDL-cholesterol levels between patients with ischaemic stroke and
      control subjects may apply to patients with cortical infarction, and that in TIA
      there are changes in the distribution and the weight of LDL.

PMID- 8482984
TI  - Physiological assessment of aspects of autonomic function in patients with
      secondary progressive multiple sclerosis.
AB  - A detailed non-invasive study of systemic and regional haemodynamic responses to
      a range of autonomic tests which assess sympathetic and parasympathetic pathways
      (mental arithmetic, cutaneous cold, isometric exercise, deep breathing, Valsalva
      manoeuvre and head-up tilt) were performed in ten patients with secondary
      progressive multiple sclerosis and ten age- and sex-matched healthy normal
      subjects (controls). Blood pressure rose in controls during the pressor tests and
      was maintained during tilt. In six out of ten patients with multiple sclerosis
      blood pressure was unchanged during one or more of the three pressor tests, but
      was maintained in all during tilt. In the controls, superior mesenteric artery
      blood flow fell during pressor tests and head-up tilt. In multiple sclerosis
      patients, superior mesenteric artery blood flow did not change during pressor
      tests but fell during tilt. Cardiac index rose during isometric exercise and fell
      during head-up tilt in controls. Forearm blood flow rose during mental arithmetic
      in the controls only, but fell during tilt in both groups. Individual analysis
      indicated that of the ten multiple sclerosis patients, four had responses during
      the pressor tests similar to controls. Responses to deep breathing and to the
      Valsalva manoeuvre in controls and multiple sclerosis patients were similar. We
      conclude that some patients with an aggressive and disabling form of multiple
      sclerosis have selective autonomic dysfunction, in particular involving pressor
      responses, despite the lack of postural hypotension. The autonomic abnormality is
      likely to involve central autonomic interconnections rather than afferent or
      sympathetic efferent pathways. Further clarification of the nature, site and
      progression of these lesions is needed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482985
TI  - Ceruletide therapy in action tremor following thalamic hemorrhage.
AB  - Two men, aged 63 and 71 years, developed a gross action tremor and dysesthesias
      several months after an intracerebral hemorrhage. CT and MRI showed a small
      hemorrhage in the posterior region of the lateral nucleus of the thalamus in each
      patient. The tremor occurred on movement, had frequencies of 2.5-4.5 Hz and the
      amplitude varied depending on the joint position of the limb. Ceruletide (a
      cholecystokinin analog) 0.8 micrograms/kg i.m. produced a marked reduction in the
      action tremor and improved motor function. This effect appeared 10-15 min after
      the injection, and lasted for up to 4 weeks. It is suggested that ceruletide may
      be of value in the treatment of action tremors following a thalamic lesion.

PMID- 8482986
TI  - Influence of repetitive magnetic stimuli on verbal comprehension.
AB  - The influence of repetitive magnetic transcranial stimulation over the temporo
      parietal cortex on verbal comprehension was investigated in 44 healthy subjects.
      In right-handed subjects, trains of 50 Hz magnetic stimuli over the left
      hemisphere produced more errors than stimulation over the right hemisphere. The
      result is not very clearcut, however; thus the test cannot be used for diagnostic
      investigation of language dominance.

PMID- 8482987
TI  - On the genetics of complex partial seizures: waking and sleep EEGs in siblings.
AB  - Waking and sleep EEGs were recorded in 29 siblings of 19 patients with complex
      partial seizures. At least 1 sibling with epileptic activity (EA) was found for
      36.8% of the patients. Taking the 29 siblings as a basis, in 7 EA was recorded.
      Most EA was seen during sleep in stage C (29%). More EA was recorded in female
      siblings (28%: 18%) and in siblings of female patients (56%: 20%). All EA was
      seen in the age range 5-14 years. Siblings with occipital theta-delta activity
      with a generalization tendency showed more EA (59%) than those without this
      pattern (8%). Of the siblings of patients with generalized EA 50% showed EA, but
      only 25% of those of patients with localized EEG patterns.

PMID- 8482988
TI  - Treatment of diabetic autonomic neuropathy with an aldose reductase inhibitor.
AB  - To evaluate the effects of the aldose reductase inhibitor Ponalrestat (Statil) on
      diabetic autonomic neuropathy, a double-blind placebo controlled trial was
      carried out on a group of 34 diabetic patients with documented cardiac autonomic
      neuropathy. After a 4-week, placebo run-in period, patients were randomised for
      treatment with 600 mg Statil or placebo for another 24 weeks. Moreover, the
      reliability of the autonomic nerve function tests was investigated by comparing
      the results at onset and at week 4. Fifteen patients treated with Statil and 12
      with placebo completed the study. Neither symptom scores nor cardiovascular
      reflexes, pupil reflexes and skin vasomotor reflexes improved after Statil
      therapy, which led us to conclude that Statil is not effective in the treatment
      of diabetic autonomic neuropathy. Reliability coefficients for cardiovascular
      reflexes and pupil reflex showed high values, ranging from 60% to 80%. Therefore
      these methods are recommended in future therapy trials.

PMID- 8482989
TI  - The coordination of posture and voluntary movement in patients with hemiparesis.
AB  - Postural adjustments associated with the task of raising oneself on tiptoes were
      investigated in a reaction time paradigm in six normal subjects and six patients
      with hemiparesis due to stroke. Body and ankle position in space were measured by
      means of a movement analysis system (ELITE). The findings indicate that the task
      of going up on tiptoes is performed in two steps. First, the centre of gravity is
      shifted forward to a position perpendicular to the forefoot. This movement is
      initiated by a phasic burst of EMG activity in the tibialis anterior (TA). The
      activity of the quadriceps femoris (QUA) aids the forward shift and together with
      the biceps femoris (BF) stabilizes the knee. Following these postural
      adjustments, the action of going up on tip-toes is performed mainly by the
      gastrocnemius medialis (MG). The basic pattern of preparatory (TA, QUA, BF) and
      focal (MG) activity was disturbed in its temporal sequence in patients with
      hemiparesis. The analysis of the biomechanical data showed smaller movement
      velocities for leaning forward and going up on tiptoes in patients, with
      increased movement amplitude on the paretic side. In addition, the correlation
      between the start of horizontal (leaning forward) and vertical (going up on
      tiptoes) hip movement was lost in patients. The preserved correlation between the
      latency of MG activity and the onset of the vertical hip movement on the paretic
      side in patients and the loss of correlation on the non-paretic side indicates
      that the EMG activity on the healthy side is adapted to the functional
      requirements of the affected side.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482990
TI  - Follow-up of neurophysiological tests and CT in late-onset cerebellar ataxia and
      multiple system atrophy.
AB  - The follow-up of neurophysiological tests (brain-stem auditory evoked potentials;
      blink reflex; sensory, motor and visual evoked potentials) and CT was
      investigated in 21 patients with late-onset cerebellar ataxia (CA) or multiple
      system atrophy. The study included an initial investigation and a follow-up
      examination on average 25.3 months later (minimum 8, maximum 36). Patients were
      divided into four groups: (1) those with pure CA after a minimum course of 5
      years; (2) those with pure CA with pathological neurophysiological findings at
      the last examination; (3) those who at the first examination clinically presented
      with pure CA, but at the last examination were seen to have developed a
      multisystem disorder; (4) those with multiple system atrophy (mostly
      olivopontocerebellar atrophy) presenting additional non-cerebellar signs of
      involvement. Conforming to a strict interpretation of pure CA, group 1 patients
      invariably exhibited normal neurophysiological findings at all examinations. All
      patients in group 4, except for 2 only at the first examination, showed
      pathological changes in at least one of the neurophysiological tests. The main
      conclusion of this paper is that individuals who according to clinical criteria
      were initially classified as having CA but finally developed a multisystem
      disorder already had pathological neurophysiological findings at the initial
      examination (group 3). The increasing frequency of pathology in the several
      neurophysiological tests together with the progression of the disease is
      obviously of prognostic significance. CT revealed cerebellar atrophy without
      apparent involvement of brain-stem structures in all patients with CA; the
      majority of patients with multiple system atrophy also had atrophy of the brain
      stem, pointing to olivopontocerebellar atrophy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8482991
TI  - Friedreich's ataxia presenting with pure sensory ataxia: a long-term follow-up
      study of two patients.
AB  - We describe two patients with Friedreich's ataxia whose presenting symptomatology
      was for years progressive tabetic ataxia. Based upon the initial clinical,
      electrophysiological and nerve biopsy data, a diagnosis of idiopathic sensory
      neuropathy was established. Subsequent examination of the kin showed that three
      sisters of case 1 had Friedreich's ataxia. Upon serial clinical and
      electrocardiographic study, both patients eventually developed a florid
      Friedreich's ataxia, including cardiomyopathy. Our findings indicate that at
      onset Friedreich's ataxia may be indistinguishable from sensory neuropathy and
      also that serial examination and investigation of kinship are essential steps for
      accurate diagnosis.

PMID- 8482992
TI  - Decrease in urinary excretion of 3-methylhistidine by patients with Duchenne
      muscular dystrophy during glucocorticoid treatment.
AB  - Seven patients, aged 10-17 years, with Duchenne muscular dystrophy were treated
      orally with prednisolone (PSL) at a dose of 0.8-1.0 mg/kg per day for 8 weeks.
      During the treatment their muscle strength, serum creatine kinase (CK) activity,
      serum levels of myoglobin (Mb), and urinary excretion of 3-methylhistidine (3
      MeH) and glycine (Gly) were measured serially. In all the patients, the motor
      function or muscle strength improved, and the serum CK activity and Mb level
      decreased during PSL treatment. Urinary excretion of 3-MeH, a unique constituent
      of muscle contractile proteins, decreased to 51-63% of the baseline value in
      weeks 6-9 after the start of PSL administration, and returned to the baseline
      level in week 12. The ratios of 3-MeH to creatinine and to Gly also decreased
      during the treatment. Urinary excretion of Gly, which is ubiquitous in all
      tissues including muscle, did not decrease during the treatment. These findings
      suggest that PSL inhibits proteolysis of muscle contractile protein.

PMID- 8482993
TI  - Local steroid treatment in idiopathic carpal tunnel syndrome: short- and long
      term efficacy.
AB  - A clinical and electrophysiological study evaluated the usefulness of local
      steroid therapy for carpal tunnel syndrome (CTS). To evaluate the efficacy of
      local steroid therapy 32 patients (53 nerves) were randomly assigned to one of
      two groups: one (27 nerves) received 15 mg methylprednisolone acetate injected
      locally and the other (26 nerves) received the same amount of saline solution.
      The injections were repeated after a week. Clinical and electrophysiological
      findings were evaluated, double blind, at regular intervals. A clear-cut efficacy
      of steroid treatment was found. Only 8% of nerves were not benefitted while a
      marked early improvement was observed in most of the nerves. In order to appraise
      the long-term effect of local steroid treatment on CTS, 53 patients (91 nerves)
      were studied and followed up by means of clinical and electrophysiological
      examinations performed every 2 months for 2 years. The benefit of steroid
      treatment was transient. About 50% of the nerves became worse within 6 months and
      90% within 18 months. Only a small percentage (8%) of the nerves remained
      improved at the 2-years follow-up. The clinical features were not useful in
      foretelling the duration of the improvement, which appeared to be related to the
      antidromic SAP latency.

PMID- 8482994
TI  - Difference in blood flow volume of the common carotid artery between vascular and
      non-vascular dementia detected by colour duplex sonography.
AB  - Using colour duplex sonography, blood flow volume in the common carotid artery
      was measured in 72 demented patients and 28 normal controls. Thirty-five patients
      with a Hachinski's ischaemic score of 7 or above and marked ischaemic lesions on
      CT were assigned to the vascular dementia (VD) group. Thirty-three patients with
      probable Alzheimer's disease according to the NINCDS-ADRDA criteria, 2 patients
      with Parkinson's disease, 1 patient with spinocerebellar degeneration, and 1
      patient with Pick's disease were assigned to the non-vascular dementia (nonVD)
      group. The sum of blood flow volume in the bilateral common carotid arteries (CCA
      flow) in the nonVD group and in the VD group was lower than that in the control
      group. The CCA flow in the VD group was lower than that in the nonVD group.
      Comparison of patients matched for both age and the Hasegawa's dementia rating
      scale also revealed lower CCA flow in the VD group than in the nonVD group.
      Linear discriminant function analysis showed that nearly 90% of the demented
      patients were correctly diagnosed as having VD or as having nonVD. These results
      show the usefulness of colour duplex sonography in the differential diagnosis of
      patients with dementia.

PMID- 8482995
TI  - Deterioration or onset of migraine under oestrogen replacement therapy in the
      menopause.

PMID- 8482996
TI  - A case of recurrent Guillain-Barre syndrome preceded by different infections.

PMID- 8482997
TI  - Dentine lead and intelligence prior to school entry: a statistical sensitivity
      analysis.
AB  - The relationship between circumpulpal dentine lead and IQ at age 4 years 10
      months was examined in 164 urban children. Negative correlations were observed
      between dentine lead and IQ scores, but were reduced in magnitude after
      adjustment for social covariates. Analyses using errors-in-variables regression
      models indicated that the degree of this reduction depended on difficult-to
      verify assumptions regarding the magnitudes of (i) measurement error in the lead
      variable and the covariates, and (ii) possible changes in the caretaking
      environment resulting from conjectured effect of lead on the child's cognitive
      and behavioral development. Sensitivity analyses were conducted in which
      estimates of the lead effect were repeatedly computed and compared for a range of
      possible values for factors (i) and (ii). It was found that the statistical
      significance of the lead effect on Full Scale IQ depended on the relative
      magnitudes of these factors, and that failure to incorporate measurement error in
      the analysis would have led to gross overestimation of the precision of the
      findings.

PMID- 8482998
TI  - Non-response bias in studies of diabetic complications: the Rochester Diabetic
      Neuropathy Study.
AB  - Non-response can bias studies of disease conditions but its influence has rarely
      been evaluated due to limitations of available data on the non-respondents.
      Because of a detailed medical record review for eligibility, we were able to
      compare clinical as well as demographic characteristics of respondents and non
      respondents in a population-based study of diabetic complications among
      Rochester, Minnesota residents. Non-respondents were older, less well educated,
      more likely to be widowed and more often retired. They were much more likely to
      have cardiovascular disease at baseline, but the prevalence of retinopathy,
      nephropathy and diabetic neuropathy was similar for respondents and non
      respondents, who were also comparable with regard to type of diabetes and
      diabetic therapy. While these findings indicate that data from the Rochester
      Diabetic Neuropathy Study can probably be generalized to diabetic residents
      generally, they reemphasize the potential for non-response bias in epidemiologic
      studies of clinical conditions, especially cardiovascular disease.

PMID- 8482999
TI  - Role of the complete blood count in detecting occult focal bacterial infection in
      the young febrile child.
AB  - Previous studies of the value of the complete blood count (CBC) in distinguishing
      viral from bacterial infection in young febrile children have failed to exclude
      children with clinically evident bacterial infection and thus have inflated the
      positive predictive value of the test for occult focal infection. We
      prospectively studied 2492 children 3-24 months of age who presented to a
      children's hospital emergency department between March 1989 and August 1990 with
      fever (> or = 38.0 degrees C) of acute (< or = 4 days) onset but no evident
      bacterial focus of infection, 433 (17.4%) of whom received a CBC. We also carried
      out an 8-year retrospective analysis to estimate prior, or pre-test,
      probabilities (prevalences) and examine CBC results for rare occult bacterial
      infections (meningitis, osteomyelitis, and septic arthritis). Estimated prior
      probabilities for the four most common categories of infection that can be
      diagnosed at the initial visit were: non-pneumonitic viral infection, 88.6% in
      boys and 86.0% in girls; pneumonia, 8.5% in both sexes; urinary tract infection
      (UTI), 3.0% in boys and 5.5% in girls; and bacterial meningitis, 0.0066% in both
      sexes. The likelihood (sensitivity) of a total white blood cell (WBC) count > or
      = 15,000/mm3 was 25.5, 64.5, 62.5, and 50.0% for viral infection, pneumonia, UTI,
      and meningitis, respectively. Among children with a high total white blood cell
      count, neither a total polymorphonuclear count > or = 10,000/mm3 nor a band count
      > or = 500/mm3 was associated with significantly elevated likelihoods for occult
      pneumonia or UTI, a finding confirmed by multiple logistic regression
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483000
TI  - The clinical course and prognosis of patients with severe, moderate or mild
      sarcoidosis.
AB  - During 1978-1990, 346 patients with sarcoidosis were enrolled in our institute.
      Of 346 patients, 295 patients were eligible for evaluation on the clinical course
      and prognosis. According of their clinical presentations, they were classified
      into 3 groups; severe, moderate and mild sarcoidosis. Of the 295 patients, 27
      (9.2%) were classified as severe sarcoidosis who developed serious illness
      including involvement of the heart (8), lung (6), muscles (5), eyes (3), central
      nervous system (CNS) (3) or liver (2). The mean interval between the onset of
      disease to severe disability was 58.3 months. The interval was particularly long
      in those patients who presented with either pulmonary (100.8 months) or liver
      sarcoidosis (108 months). Of the 27 patients with severe sarcoidosis, 8 (29.6%)
      gradually became worse towards the end of their clinical course despite only mild
      clinical signs and symptoms at the first presentation. Therefore, the initial
      clinical symptoms and findings, including ocular involvement. ECG abnormalities,
      negative reaction to PPD, high value of serum angiotensin converting enzyme (ACE)
      and a small number of lymphocytes in peripheral blood, were not useful in
      predicting prognosis. The relationship between the maximum serum ACE value during
      the clinical course and the duration of the active phase was statistically
      significant in the 123 patients who were monitored throughout their course,
      suggesting that the maximum serum ACE may be a marker for assessing prognosis.
      Corticosteroid was administered to 76 patients (22%) with serious systemic
      involvement. They included 26 (96.4%) of the 27 severe sarcoidosis and 50 (37.9%)
      of the 132 moderate sarcoidosis. Patients with mild sarcoidosis did not receive
      corticosteroids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483001
TI  - Interobserver variation in the assessment of the sampling quality of cervical
      smears.
AB  - In order to assess the interobserver variation among cytological assistants in
      evaluating the sampling quality of cervical smears, all four laboratory
      assistants from one cytological department examined the same set of 71 smears.
      They assessed the presence of endocervical cells, the quality of fixation, the
      number of cells and the undesirable presence of clumps of cells. The
      interobserver agreement, uncorrected for chance, varied from 73 to 93% for the
      presence of endocervical cells and from 86 to 100% for the three other criteria.
      For the presence of endocervical cells, the kappa values, a measure for the
      interobserver agreement corrected for chance, varied from 42 to 84%. This is a
      reasonable outcome. For the three other criteria many kappa values were zero or
      uncalculable. The interobserver agreement in evaluating the sampling quality of
      cervical smears is reasonable to good, but not perfect. Prudence in the
      interpretation of quality data is warranted.

PMID- 8483002
TI  - Is there still an avoidable fraction of post-operative thromboembolic
      complications with heparin prophylaxis? The results of a case-control
      surveillance. Collaborative Group on Heparin Prophylaxis in Surgery (S.E.P.E.C.).
AB  - A case-control multicenter study was set up in 68 general and specialistic wards
      in Italian regional hospitals in order to assess whether underuse of heparin
      prophylaxis may account for at least a fraction of the thromboembolic events
      still occurring in surgical patients. 100 cases with clinically relevant
      thromboembolic or hemorrhagic events occurring during hospitalization for major
      surgery and 200 controls were identified. Controls were selected among patients
      not presenting any of the events under study during the same period of
      observation and were matched with cases for age, sex, and type of surgery. The
      results of the study suggest that heparin use in routine conditions of care
      closely reflects the "consensus" knowledge, patients at higher risk (specifically
      orthopedic surgical patients, those with varicose veins or with preoperative bed
      rest longer than 3 days) being treated more frequently with heparin. Absence of
      heparin prophylaxis does not appear to represent a specific risk factor for the
      occurrence of index events (OR 0.73, 95% CI = 0.42-1.26). Despite the higher
      rates of heparin exposure, the presence of varicose veins is associated with a
      statistically significant increase in the risk of postoperative complications (OR
      2.23, 95% CI = 1.07-4.65). This study indicates that among known pre- and peri
      operative risk factors only varicose veins may be unprotected by the current
      prophylaxis practice.

PMID- 8483003
TI  - The Duke Severity of Illness Checklist (DUSOI) for measurement of severity and
      comorbidity.
AB  - The Duke Severity of Illness Checklist (DUSOI) was evaluated on 414 primary care
      adult patients using data collected both by medical providers at the time of the
      patient visit and later by a chart auditor. Severity scores for individual
      diagnoses were determined by summing the ratings for four non-disease-specific
      parameters: symptom level, complications, prognosis without treatment, and
      expected response to treatment. Mean diagnosis severity scores (scale 0-100)
      among the 21 most prevalent diagnoses varied from a low of 13.9 for menopausal
      syndrome to a high of 43.0 for sprains and strains. An overall severity score was
      calculated by combining diagnosis severity scores and giving highest weights to
      the most severe diagnoses. Provider-generated overall severity scores (mean =
      43.3) and auditor-generated overall severity scores (mean = 38.9) were
      significantly correlated (coefficient of agreement = 0.59, p < 0.0001). Diagnoses
      varied in their individual contribution to the overall severity score, from 8.9%
      for lipid disorder to 90.0% for sprains and strains. Separate comorbidity
      severity scores were calculated to measure the severity of all of each patient's
      health problems except the diagnosis under study. For example, patients with
      menopausal syndrome had co-existing health problems which generated a high mean
      comorbidity severity score of 43.2, while patients with sprains and strains had a
      low mean comorbidity score of 4.7. The DUSOI Checklist can be used in the
      clinical setting by both providers and auditors to produce quantitative severity
      scores (by diagnosis, overall, and for comorbidity) which are based entirely upon
      clinical judgment. This method should be useful in controlling for severity of
      illness in clinical studies and indicating the outcome of medical care in terms
      of reduction in severity of illness following medical interventions.

PMID- 8483004
TI  - Should there be early publication of ancillary studies prior to the first primary
      report of an unblinded randomized clinical trial?

PMID- 8483005
TI  - Dentine lead and intelligence prior to school entry: a statistical sensitivity
      analysis.

PMID- 8483006
TI  - Epidemiology of premenstrual symptoms.

PMID- 8483007
TI  - Effects of passive smoking.

PMID- 8483008
TI  - Effects of passive smoking.

PMID- 8483009
TI  - Use of prostaglandins for induction of labor.
AB  - Nurse-midwives are sometimes required to intervene in the normal process of
      labor. Numerous clinical trials have investigated the use of prostaglandins for
      induction of labor. Research indicates the use of prostaglandins to be a safe and
      effective method of induction of labor with favorable results when compared with
      the more traditional use of oxytocin. Patient acceptance appears to be favorable
      because of the reduced need for restrictive and invasive methods of monitoring
      and administration that accompany intravenous oxytocin. Thus, the use of
      prostaglandins for induction of labor offers nurse-midwives an attractive
      alternative to the use of oxytocin when induction is medically indicated. This
      article provides a description of the biochemical effects of prostaglandins on
      the uterus and cervix, development and clinical use of prostaglandin
      preparations, indications for use of induction, and potential for utilization in
      nurse-midwifery practice.

PMID- 8483010
TI  - Third-trimester ultrasound for nurse-midwives.
AB  - Obstetric ultrasound has become well integrated into management of pregnancy,
      labor, and delivery. An increasing number of nurse-midwives have expanded their
      roles to include the use of this technology. This article reviews the basic
      principles of ultrasound physics, the content of ultrasound examinations, and the
      performance of basic scans. The uses of limited scans for third-trimester
      antepartum assessment and intrapartum management are reviewed. Issues surrounding
      the use of obstetric ultrasound, including limited scans, routine ultrasound
      screening, and necessary education, are discussed. Information on incorporating
      the use of ultrasound procedures into nurse-midwifery practice is included.

PMID- 8483011
TI  - The use of amnioinfusion in nurse-midwifery practice.
AB  - Intrapartum amnioinfusion is being used in a variety of clinical settings and for
      multiple therapeutic modalities to prevent fetal distress and improve outcomes.
      The procedure has demonstrated efficacy in cases of variable decelerations and
      thick, meconium-stained amniotic fluid. Amnioinfusion has been shown to improve
      maternal and neonatal outcomes by decreasing cesarean sections for fetal
      distress, improving cord pH, and decreasing the amount of meconium present below
      the cords at delivery. This article describes the pathophysiology of amniotic
      fluid volume disorders that indicate the use of amnioinfusion, reviews the
      literature regarding the indications and therapeutic effects, and describes
      techniques for the use of amnioinfusion. In addition, there is a discussion of
      the contraindications associated with the use of amnioinfusion and its use in and
      out of hospital settings. The technique for amnioinfusion is simple, easy, and
      inexpensive to initiate. It can be performed in a variety of settings, provided
      there is adequate equipment, personnel, and emergency services available.
      Certified nurse-midwives should become familiar and comfortable with the
      procedure in order to provide complete care for the families they serve.

PMID- 8483012
TI  - External cephalic version.
AB  - External cephalic version has been used periodically for centuries to manage
      breech presentations. As cesarean section rates have escalated in the last two
      decades, ways to curb this rise have been evaluated. By reducing the number of
      infants that arrive in labor in a malpresentation, it is possible to impact the
      overall cesarean section rate. External cephalic version is a safe, effective
      method when used in appropriate cases of breech presentation. A forward or
      backward roll can be accomplished in women at term with singleton gestations,
      adequate amniotic fluid, and reactive nonstress tests. Parity, fetal and
      placental position, and descent of the presenting part may all influence the
      success rate of the version.

PMID- 8483014
TI  - Guide to the use of the vacuum extractor by nurse-midwives.
AB  - The vacuum extractor has become a widely used instrument in many settings. It has
      proven to be a reliable method of ensuring safe passage of the fetus and/or
      enhancing maternal effort during the second stage of labor. The principles of
      vacuum-assisted birth are learned relatively easily and have been incorporated
      into many nurse-midwifery practices. This article reviews the principles of
      vacuum extraction as they apply to the practice of nurse-midwifery. Vacuum
      extractors available to nurse-midwives are compared. Nurse-midwives are
      familiarized with vacuum extraction so that they can make an informed choice
      concerning the vacuum extractor as an appropriate tool within their practice.
      This article is not intended to teach nurse-midwives to use the vacuum extractor.
      It does, however, provide guidelines for credentialing those nurse-midwives
      choosing to incorporate the principles of vacuum extraction into their practice.

PMID- 8483013
TI  - Subdermal contraceptive implants in nurse-midwifery practice.
AB  - Subdermal contraceptive implants have only recently been approved for use in the
      United States. At present, only one subdermal contraceptive implant, Norplant, is
      approved in the United States. This article describes the development of
      Norplant, its efficacy and safety, a description of the system, education for
      clients, side effects, indications and contraindications, insertion and removal,
      incorporation into midwifery practice, and education for health professionals
      regarding its use.

PMID- 8483015
TI  - High-tech skills in low-tech hands. Issues of advanced practice and collaborative
      management.
AB  - Nurse-midwifery practice has been defined by the American College of Nurse
      Midwives (ACNM) as "the independent management of essentially normal newborns and
      women ... occurring within a health care system which provides for medical
      consultation, collaborative management or referral .... "As the health care
      delivery system in the United States becomes increasingly complex and reliant on
      new forms of technology, it has become necessary to clarify roles and
      responsibilities for the nurse-midwife. In addition, mechanisms for acquiring new
      skills and for collaborating with physician colleagues must be well understood. A
      question frequently asked is where the boundaries of nurse-midwifery practice end
      and those of medical practice begin. Although practice scenarios vary for
      individual nurse-midwives and nurse-midwifery services, recent statements
      approved by the ACNM Board of Directors discuss these issues in an attempt to
      clarify the potentially confusing areas of collaboration and skill acquisition.
      This article explores the areas of expanded nurse-midwifery practice and
      collaborative management. Although individual clinical skills are not necessarily
      endorsed, a step-by-step approach that nurse-midwives can use for incorporation
      of new skills is presented. The concepts discussed will be a valuable tool to
      nurse-midwives in their practice.

PMID- 8483016
TI  - Fetal scalp blood sampling.
AB  - Fetal scalp blood sampling (FSBS), in conjunction with fetal heart rate
      monitoring, is a method of fetal surveillance that may avoid cesarean delivery of
      the healthy fetus or indicate the need for immediate delivery of a compromised
      fetus. Some researchers have recently begun to question the efficacy of FSBS. In
      this article, three nurse-midwives discuss FSBS as a tool in assessing fetal well
      being during labor and consider whether FSBS is a nurse-midwifery procedure.

PMID- 8483017
TI  - Differences between calcium antagonists: duration of action and trough to peak
      ratio.
AB  - Comparison of first- and second-generation calcium antagonists: Despite their
      diversity of structure, the first-generation calcium antagonists nifedipine,
      verapamil and diltiazem all have a short elimination half-life and a relatively
      short duration of action. In contrast, there appears to be wide diversity in
      these properties among the newer calcium antagonists, which are mostly
      dihydropyridines. The longer half-life and physicochemical properties of some of
      the newer agents allow full 24-h blood pressure control. Duration of action of
      lacidipine: Taken only once a day, lacidipine has proved as potent an
      antihypertensive agent as slow-release nifedipine administered twice a day.
      Lacidipine produces a satisfactory fall in blood pressure not only during waking
      hours but also during sleep at night, as shown by 24-h ambulatory monitoring.
      Moreover, this blood pressure fall is obtained without any reflex tachycardia or
      associated side effects. Compared with patients treated with placebo, systolic
      and mean arterial blood pressure variability (standard deviation) is reduced by
      lacidipine treatment. CONCLUSIONS: Control of blood pressure using lacidipine
      once a day meets the criteria proposed by the United States Food and Drugs
      Administration for antihypertensive drug efficacy and duration of action.

PMID- 8483018
TI  - Comparative effects of antihypertensive drugs on systolic blood pressure.
AB  - Importance of systolic over diastolic blood pressure measurements: Systolic
      pressure is known to be a more important independent cardiovascular risk factor
      than diastolic pressure in subjects over 50 years of age; after that age, a high
      incidence of two types of systolic hypertension is observed, sustained essential
      hypertension with a disproportionate increase in systolic pressure and isolated
      systolic hypertension. Effects of lacidipine on blood pressure in the elderly:
      The effects of vasodilators on blood pressure have been studied extensively.
      Recently, lacidipine, nitrendipine and enalapril were compared in a multicenter,
      randomly allocated, double-blind trial in elderly hypertensive patients with a
      disproportionate increase in systolic pressure treated for 8 weeks (n = 278). In
      these patients, supine systolic pressure decreased to a greater extent with
      lacidipine and enalapril than with nitrendipine, the difference between
      lacidipine and nitrendipine reaching statistical significance. In another trial,
      lisinopril produced a greater reduction in systolic pressure than atenolol.
      Finally, in a study in elderly patients with systolic hypertension, long-acting
      isosorbide dinitrate induced a selective sustained decrease in systolic pressure.
      Mechanisms of action of vasodilators: A fall in systolic blood pressure may be
      produced by vasodilators through a reduction in peripheral resistance with or
      without an active change in arterial compliance. Dihydralazine-like substances do
      not increase arterial compliance whereas angiotensin converting enzyme
      inhibitors, calcium entry blockers and nitrates tend to increase arterial
      compliance for the same decrease in mean arterial pressure.

PMID- 8483019
TI  - Similarities and differences between calcium antagonists: pharmacological
      aspects.
AB  - Characteristics of three different calcium antagonist groups: Most important
      calcium antagonists used to treat cardiovascular disease belong to one of three
      main groups, phenylalkylamines, dihydropyridines and benzothiazepines. The best
      known drug in each group is verapamil, nifedipine and diltiazem, respectively.
      Dihydropyridines are predominantly vasodilators, with little or no primary
      cardiac activity; the tachycardia caused by these compounds is a reflex
      phenomenon. Verapamil and related drugs are also vasodilators, with an additional
      depressant effect on atrioventricular conduction, heart rate and contractility.
      Diltiazem's pharmacodynamic profile and side effects may be considered as
      intermediate between those of the dihydropyridines and verapamil. Characteristics
      of new calcium antagonists: Several new calcium antagonists have been introduced
      in the last few years, virtually all dihydropyridines. Compared with the older
      generation of calcium antagonists these newer drugs tend to have (1) a longer
      duration of action; (2) some selectivity for a specific vascular bed, such as
      resistance, coronary, renal or cerebral vessels; (3) a potentially useful extra
      component, such as diuretic or anti-atherogenic activity. Newer calcium
      antagonists described in this review: The newer compounds briefly characterized
      in this review are amlodipine, felodipine, isradipine, lacidipine, nimodipine,
      nisoldipine and nitrendipine. New slow-release formulations are also discussed.
      There is a particular emphasis on lacidipine and its potential for cardiovascular
      drug therapy.

PMID- 8483020
TI  - Effects of calcium antagonists on left ventricular structure and function.
AB  - Effects of calcium antagonists on left ventricular hypertrophy: The goals of
      antihypertensive treatment are to lower systemic blood pressure and to reverse
      left ventricular hypertrophy. A number of different drugs can induce a decrease
      in left ventricular mass, some of which are calcium antagonists. In particular,
      verapamil, diltiazem and a number of dihydropyridines (nifedipine, isradipine,
      lacidipine) have proved effective in this respect. Left ventricular systolic
      function: Left ventricular systolic function is often normal at rest in patients
      with hypertension, but is quite commonly abnormal during exercise. Calcium
      antagonists therefore do not affect resting systolic function in this category of
      hypertensive patients. In contrast, in hypertensive patients with heart failure
      the administration of dihydropyridines improves systolic performance. Left
      ventricular diastolic function: Isovolumic relaxation and rapid filling are often
      impaired in patients with hypertension, with or without left ventricular
      hypertrophy. Verapamil is effective in abolishing this diastolic dysfunction when
      given intravenously; in contrast, medium-term therapy with calcium antagonists
      such as diltiazem or dihydropyridines does not improve left ventricular filling
      properties. However, when antihypertensive therapy achieves a reduction in left
      ventricular mass, a consistent improvement in diastolic properties occurs.

PMID- 8483021
TI  - Vascular effects of lacidipine: a review of animal and human data.
AB  - AIM: To compare the vascular effects of lacidipine with those of other calcium
      antagonists. METHODS: A review of published studies. RESULTS: Experimental
      studies have shown that for a similar fall in blood pressure, lacidipine
      increased cardiac contractility while verapamil decreased cardiac contractility.
      In the rat aorta, the dose of lacidipine required to reduce a calcium-induced
      contraction by 50% was lower than that of all other calcium antagonists tested
      except nisoldipine. In human studies, especially, there are inherent limitations
      in the techniques available to measure regional blood flows under physiological
      conditions, making it difficult to compare the effects of different
      antihypertensive drugs. A recent study showed that renal blood flow was increased
      by lacidipine without any reduction in renal function. As in animals, vital organ
      perfusion was either preserved or increased. Further, maximal coronary
      vasodilation was associated with lower coronary resistance values during
      lacidipine treatment compared with pretreatment values. Another lacidipine study
      showed increased brachial artery compliance, while a study on the radial artery
      showed that lacidipine increased the compliance of this artery also. CONCLUSIONS:
      Lacidipine has vascular selectivity. Although regional blood flows are difficult
      to measure, due to inherent limitations in the techniques available, the evidence
      suggests that lacidipine produces vasodilation in essential hypertensive subjects
      while maintaining or even increasing vital organ perfusion. This appears to be
      due to a regression of the structural changes that characterize hypertension.

PMID- 8483022
TI  - Are there differences in the renal effects of calcium antagonists?
AB  - AIM: To review the effects of calcium antagonists, and of the new dihydropyridine
      lacidipine in particular, on the glomerular filtration rate, renal plasma flow,
      and the sodium to water ratio in hypertensive patients. METHODS: Review of
      published data. RESULTS: Different studies have shown a wide range of responses
      to all three subgroups of calcium antagonists in glomerular filtration rates and
      in renal plasma flows. In some studies there was a reduction and in others a rise
      in these two renal parameters. The administration of lacidipine was associated
      with a significant rise in renal plasma flow which disappeared with chronic
      treatment and no change in the glomerular filtration rate. There are only a few
      studies on the long-term natriuretic and diuretic effects of calcium antagonists.
      In the short term, dihydropyridine calcium antagonists appear to produce diuretic
      and natriuretic effects, but these effects are not seen with verapamil.
      Lacidipine showed no trend towards sodium and water retention. CONCLUSIONS:
      Reported differences between calcium antagonists in glomerular filtration and
      renal plasma flow probably reflect differences in the baseline tone of pre- and
      postglomerular arterioles. Calcium antagonists do not cause sodium and water
      retention during chronic therapy. The new dihydropyridine derivative lacidipine
      lowers blood pressure without reducing renal function or causing sodium and water
      retention.

PMID- 8483023
TI  - Calcium antagonists and renal protection.
AB  - AIM: To review the renal benefits of calcium antagonists. METHODS: Review of
      published studies. RESULTS: Both experimental and clinical studies have indicated
      that, apart from being highly potent antihypertensive agents, calcium antagonists
      may also provide tissue protection and preservation. In three well defined
      clinical situations, the use of calcium antagonists has proved to be of value.
      First, in acute renal failure we and others have shown that the administration of
      dihydropyridine or diltiazem can, by preventing an intracellular calcium
      overload, avoid the renal damage induced by the use of a radiographic contrast
      agent. Second, in chronic renal failure, the administration of a calcium
      antagonist has been shown to be safe and at least similar in efficacy to other
      commonly used antihypertensive drug classes. Third, in renal transplant patients,
      calcium antagonists have been shown to prevent both acute and chronic cyclosporin
      nephrotoxicity. Calcium antagonists have a clear advantage in the case of acute
      toxicity because they allow faster renal function recovery and a shorter
      hospitalization time. The mechanisms by which this class reduces cyclosporin
      toxicity may be related to a reduction in the calcium influx into cells during
      ischaemic and reperfusion periods, which would reduce the generation of oxygen
      free radicals and perhaps reduce thromboxane production. CONCLUSIONS: Calcium
      antagonists have potential renal protective effects that favour their use in many
      clinical situations where renal function is impaired.

PMID- 8483024
TI  - Anti-atherosclerotic effects of calcium antagonists.
AB  - Effects of calcium antagonists on atherosclerosis in experimental animals: A
      variety of calcium antagonists can inhibit the development of aortic
      atherosclerosis induced by marked hypercholesterolemia in cholesterol-fed
      animals, following mechanical injury or intoxication with vitamin D, but not in
      the heritable hyperlipidemic rabbit. This effect is not mediated by modifications
      to plasma lipids, blood pressure or other conventional risk factors. Effects of
      calcium antagonists on atherosclerosis in humans: It has been difficult to assess
      the effects of calcium antagonists on the atherogenetic process in humans.
      Studies on the action of calcium antagonists in the primary prevention of
      atherosclerosis are obviously desirable; however, they are almost impossible to
      perform due to the slow development of atherosclerosis and the need for long-term
      follow-up. Data from several clinical trials in patients with established
      coronary artery disease have indicated that calcium antagonists may prevent the
      development of new atherosclerotic plaques and may even slow the progression of
      established lesions. CONCLUSIONS: Present experimental and clinical evidence
      indicates that calcium antagonists may be able to prevent or retard the
      progression of atherosclerosis by mechanisms independent of and in addition to
      blood pressure reduction. Large long-term trials are needed to confirm this
      finding and to determine whether the effect is associated with a decrease in
      atherosclerotic morbid and fatal complications.

PMID- 8483025
TI  - Effects of lacidipine on experimental models of atherosclerosis.
AB  - AIM: To evaluate the effect of lacidipine on the major processes of
      atherogenesis. METHODS: Cell-culture methods were used to study the effect of
      lacidipine. Low-density lipoprotein (LDL) receptor expression and cholesterol
      esterification were evaluated in human skin fibroblasts and in mouse peritoneal
      macrophages, respectively. The effect of lacidipine on cellular proliferation was
      tested on aortic myocytes cultured from rat aorta. RESULTS: Lacidipine did not
      affect LDL receptor expression, but it inhibited the ability of acetyl LDL to
      stimulate cholesterol esterification in macrophages by more than 95%. The drug
      inhibited cellular proliferation in a dose-dependent manner. This
      antiproliferative effect was confirmed in human femoral artery myocytes. In
      accord with the inhibitory effect on cellular growth, preliminary in vivo studies
      suggest that lacidipine may reduce neointimal formation induced by perivascular
      manipulation of the carotid artery in hypercholesterolemic rabbit. CONCLUSIONS:
      Our results indicate that lacidipine may be antiatherosclerotic through an effect
      on the major processes involved in atheroma formation.

PMID- 8483026
TI  - Clinical experience with HIV-infected patients at the University of Oklahoma
      Health Sciences Center: an update.
AB  - We reviewed the course of 545 human immunodeficiency virus (HIV)-infected
      patients seen between 1983 and March 30, 1991. A majority were Caucasian
      homosexual or bisexual men, while parenteral drug abusers represented a smaller
      proportion than seen nationwide. In the 274 patients with the acquired
      immunodeficiency syndrome (AIDS), the distribution of AIDS-defining conditions
      was generally consistent with those reported in studies from elsewhere in the
      United States. However, toxoplasmosis remained relatively uncommon. There was a
      slightly higher incidence of disseminated histoplasmosis compared to other
      studies. HIV encephalopathy (AIDS dementia) was likely underdiagnosed. Although
      data suggested prolongation of the asymptomatic phase of HIV infection, median
      survival after AIDS diagnosis remained approximately 12 months.

PMID- 8483027
TI  - The misuse of cardiopulmonary resuscitation.
AB  - Over a 41-month period, 1,233 "Code Blues" were retrospectively reviewed. Twenty
      five codes on infants and children < 16 years of age were eliminated from the
      study group. The adult survivors of 1,208 codes numbered 243 (20.1%). Clinical
      chart review revealed that 49 (4.0%) did not involve cardiopulmonary
      resuscitation (CPR) or intubation and were "non-codes." Of the remaining 1,159
      codes, there were 194 (16.7%) survivors. Of these survivors, 102 (52.5%) were
      patients with respiratory distress or failure and required intubation only. No
      CPR was needed. Thus, only the remaining 92 survivors of the 1,057 codes were
      cardiac cases for which CPR was appropriate (8.7% survival). Ventricular
      tachycardia and fibrillation, promptly defibrillated, was the most important
      rhythm factor for survival. Underlying ischemic heart disease (acute myocardial
      infarction and chronic ischemic heart disease with arrhythmia) was the most
      common underlying disease entity among the survivors. CPR performed in the group
      of patients unlikely to survive was expensive.

PMID- 8483028
TI  - Firearm-related mortality in Oklahoma, 1985-1989.
AB  - To determine the extent of firearms as a cause of mortality, Oklahoma vital
      statistic records were analyzed. The annual mortality rate in Oklahoma between
      1985 and 1989 was 20% higher than the U.S. rate. Firearms were the second leading
      cause of injury deaths; firearms were the leading cause of injury deaths among
      blacks and the leading cause of all deaths among blacks 15 to 29 years of age.
      Ninety-two percent of the firearm-related deaths were intentional; firearms
      accounted for 70% of suicides and 59% of homicides. The male death rate from
      firearms was 4.5 times the female death rate. Suicide rates were highest among
      white males 65 years and older; homicide rates peaked among black males 25 to 34
      years of age. Residents of eastern Oklahoma had the highest rates. The magnitude
      and preventability of firearm-related deaths and injuries demand attention and
      collaboration from Oklahoma health care providers; public health, mental health,
      and education officials; and criminal justice professionals.

PMID- 8483029
TI  - In vivo effects of naproxen on composition, proteoglycan metabolism, and matrix
      metalloproteinase activities in canine articular cartilage.
AB  - Naproxen is a nonsteroidal anti-inflammatory drug commonly used in the clinical
      treatment of joint disease. In this study, its effect in vivo on the biochemical
      composition, metabolic activities, and metalloproteinase activities of normal
      canine articular cartilage was analyzed. The articular cartilage from the knee
      joints of dogs who had been given naproxen for 4 weeks to maintain a serum level
      of 40-50 micrograms/ml was examined. Control animals were given a placebo.
      Treatment with naproxen was not found to change the composition (water, collagen,
      and proteoglycan) of the articular cartilage. The culture studies of cartilage
      explants indicated that proteoglycan synthesis rates were unaffected by the
      treatment with naproxen but that proteoglycan release from the tissue was
      suppressed. Analysis of the cartilage for matrix metalloproteinase activities
      showed reduced activity of neutral matrix metalloproteinase by 80%, of
      collagenase by 40%, and of gelatinase by 87%, with no change in activity of acid
      metalloproteinase or of tissue inhibitor for metalloproteinase. These findings
      indicate that in vivo treatment with naproxen has the capacity to modulate
      catabolic activities in articular cartilage.

PMID- 8483030
TI  - Functional assessment of joint use in experimental inflammatory murine arthritis.
AB  - A select group of cartilage proteoglycans (fetal human, porcine, and canine
      articular cartilages and human osteophytes, all depleted of chondroitin sulfate)
      produces progressive polyarthritis and spondylitis in BALB/c mice. The
      development of the disease in this murine strain is dependent on the expression
      of both cell-mediated and humoral immunities to host mouse cartilage
      proteoglycan. Autoantibodies have been detected in sera of arthritis animals from
      the fifth to sixth week after immunization, and their appearance precedes the
      development of the first clinical symptoms by a few days in animals with
      passively transferred arthritis. In this preliminary experiment, we describe
      several functional tests and gait analyses in normal mice, in acutely and
      chronically arthritic mice, and in randomly selected mice with proteoglycan
      induced and collagen-induced arthritis. The procedures revealed that changes in
      joint use and gait could predate by weeks the appearance of the first clinical
      symptoms (joint swelling, redness, and joint stiffness) of arthritis in mice.
      Moreover, abnormalities measured by functional tests, such as strength of grip
      and maintenance of posture on sandpaper, wood, or vinyl surfaces at three
      different tilt angles (30, 45, and 60 degrees), and gait analysis preceded the
      appearance of autoantibodies in sera of immunized animals; this indicates that
      such measurements could provide a noninvasive and simple method to assess joint
      function accurately during the development of arthritis.

PMID- 8483031
TI  - Effects of solvent preservation with or without gamma irradiation on the material
      properties of canine tendon allografts.
AB  - We studied the effects of solvent preservation with and without gamma irradiation
      on the material properties and morphology of canine tendons. Twenty-four paired
      tendons were harvested from both hind limbs of eight dogs. The tendons from the
      right legs were divided into three treatment groups of eight tendons each. In the
      first group, the tendons were subjected to solvent preservation for sterilization
      and drying (solvent group). In the second group, the tendons were treated in the
      same manner and then were sterilized by gamma irradiation (solvent/gamma group).
      The same treatments were applied to the tendons in the third group but in reverse
      order (gamma/solvent group). Tendons from the contralateral left legs were frozen
      immediately for use as controls for each corresponding treatment group.
      Histologically, the tendons treated with solvent, with or without gamma
      irradiation, had a more prominent wavy pattern in the collagen fibers than the
      control tendons. Mechanically, the tangent moduli for the solvent, solvent/gamma,
      and gamma/solvent groups were 58, 53, and 99%, respectively, of each
      contralateral control. The respective tensile strengths were 85, 39, and 86% of
      that of the contralateral control. The tendons in the solvent/gamma group
      underwent the most severe changes in material properties; the tendons in the
      gamma/solvent group changed the least. This suggests that gamma irradiation
      followed by solvent drying is the procedure of choice for the preservation of
      tendon allografts.

PMID- 8483032
TI  - Dynamic elongation behavior in the medial collateral and anterior cruciate
      ligaments during lateral impact loading.
AB  - The objectives of this experimental study were to determine (a) how quickly the
      medial collateral ligament (MCL) and the anterior cruciate ligament (ACL)
      elongate when a lateral impact force is imparted to the knee and if a person can
      react rapidly enough to provide protective muscle forces in the case of such an
      impact, (b) if the MCL and the ACL elongate simultaneously during a lateral
      impact, and (c) if resection of the ACL affects elongation of the MCL during a
      lateral impact. Eight whole-leg cadaver specimens were used. Each leg was mounted
      vertically in a testing-frame with the knee in 0 and 30 degrees of flexion. A
      submaximal impact was delivered from the lateral side by a pendulum instrumented
      with a force transducer. Elongation of the midsubstance of the MCL and the ACL
      was measured with Hall-effect displacement transducers. The ACL was resected and
      the entire test sequence was repeated. Following a lateral impact, elongation of
      the MCL and ACL reached peak values by 70 ms. This study indicated that
      contraction of the leg musculature would not protect the MCL and ACL from injury
      when a lateral impact load is applied to the knee. The MCL and the ACL never
      elongated simultaneously during a lateral impact. After lateral impact loading,
      the time required to reach maximum elongation (peak delay) averaged 52 ms in the
      anterior MCL fibers and 61 ms in the ACL when the knee was in 0 degrees of
      flexion. At 30 degrees of flexion, the peak delay averaged 38 ms in the anterior
      MCL fibers and 22 ms in the ACL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483033
TI  - The Maquet procedure: effect of tibial shingle length on patellofemoral
      pressures.
AB  - The Maquet procedure--elevation of the anterior tibial tubercle--has been
      recommended for treatment of symptomatic osteoarthrosis of the patellofemoral
      joint. Although the operation was first described 30 years ago, it remains
      controversial, both on a clinical and on a biomechanical basis. In addition,
      deterioration of the long-term results has been suggested. One of the variables
      that has been ignored in both clinical and biomechanical studies has been tibial
      shingle length. In order to judge its effect, we examined contact pressures and
      areas in 15 cadaver knees with 7 and 20 cm tibial shingle lengths. We found
      significant patellofemoral pressure diminution only with 2 cm elevations. The
      short anterior tibial shingle with 2 cm of elevation tipped the patella on its
      superior pole, with a significant change in angle between the patella and the
      shingle. We suggest that this creates a potentially less than desirable
      biomechanical circumstance and believe it may explain the discrepancies among
      previously published reports.

PMID- 8483034
TI  - Complex balance reactions in different sensory conditions: adolescents with and
      without idiopathic scoliosis.
AB  - We measured simple and complex balance responses with a force plate stabiliometer
      in 70 adolescents: 50 with idiopathic scoliosis (IS) and 20 controls. In stable
      static balance positions, the two groups performed similarly, but when the visual
      and somatosensory systems were challenged simultaneously, the IS group had a
      significantly higher mean body sway than the controls. Within the IS group,
      children with mild, nonprogressive curves that had not been operated on were
      significantly more likely to maintain their balance when the visual and
      somatosensory systems were challenged simultaneously than those with curves > or
      = 40 degrees, who had had surgery, and who had more rapid progression of the
      curve. These findings suggest that adolescents with IS have normal balance in
      static, stable positions but are not able to perform as well as normal
      adolescents in sensory-challenged positions, particularly if they have a severe,
      progressive curve. Longitudinal studies are needed to determine whether balance
      dysfunction can be used to predict progression of the curve.

PMID- 8483035
TI  - Compressive properties of the cartilaginous end-plate of the baboon lumbar spine.
AB  - The viscoelastic behavior of the cartilaginous end-plate of the baboon (Papio
      anubis) was studied in an experiment on compressive creep. Data were analyzed
      with the biphasic poroviscoelastic constitutive theory to assess the relative
      contributions of flow-dependent and flow-independent viscoelastic mechanisms to
      the observed creep behavior. Material coefficients describing the equilibrium
      compressive behavior (HA) and both flow-independent (c, tau 1, and tau 2) and
      flow-dependent (k) viscoelastic effects were determined for the end-plate by the
      curve-fitting of the theoretical solution to the experimental creep data.
      Biochemical analyses were performed to test for potential relationships between
      material properties and composition which may give rise to the viscoelastic
      behavior of the end-plate. The results indicate that the cartilaginous end-plate
      has a hydraulic permeability of 14.3 x 10(-14) m4/N-s, which is associated with
      rapid transport and pressurization of the interstitial fluid in response to
      loading and an increased emphasis on flow-independent viscoelastic effects.
      Biochemical analyses for water, sulfated glycosaminoglycan content, and
      hydroxyproline indicate that the end-plate of the baboon is compositionally
      similar to the cartilaginous end-plate in humans. Interpretation of the
      mechanical and compositional data suggests that fluid pressurization in the
      cartilaginous end-plate may be important in the maintenance of a uniform stress
      distribution across the boundary between vertebral body and intervertebral disc.

PMID- 8483036
TI  - The effects of cisplatin on the incorporation of fresh syngeneic and frozen
      allogeneic cortical bone grafts.
AB  - Allograft transplantation with concomitant chemotherapy has proven successful in
      the treatment of malignant bone tumors. However, these chemotherapeutic agents
      may delay tissue healing, resulting in clinical complications. To clarify the
      effects of cisplatin on the healing of bone grafts, we studied the incorporation
      of stably fixed massive diaphyseal femoral syngeneic and allogeneic grafts in
      rats treated with cisplatin. These data were compared with those of historical
      controls from animals that did not receive cisplatin. Rats that were to receive a
      fresh syngeneic graft or frozen allogeneic graft were given cisplatin every 4
      weeks starting 9 weeks preoperatively and continuing until the time of death. The
      total bone area of the graft in animals that received cisplatin was smaller than
      that of the graft in untreated control rats that did not receive cisplatin. The
      area of the frozen allograft did not increase between 2 and 4 months.
      Revascularization was incomplete in cisplatin-treated groups at 2 months, but by
      4 months, vessel ingrowth in fresh syngeneic grafts approached control values.
      Frozen allografts remained poorly revascularized at 4 months. Host-graft union
      was poor at 2 months in cisplatin-treated rats compared with controls. In
      cisplatin-treated rats, the host-graft union of the frozen allograft remained
      inferior at 4 months while that of the syngeneic graft improved. Allogeneic
      cortical bone grafts are incorporated more slowly and incompletely than syngeneic
      grafts, and this handicap is exacerbated by the administration of cisplatin.

PMID- 8483037
TI  - Antibiotic-loaded biodegradable bone cement for prophylaxis and treatment of
      experimental osteomyelitis in rats.
AB  - A biodegradable, particulate composite bone cement containing gentamicin and
      vancomycin was used for both treatment and prophylaxis of Staphylococcus aureus
      osteomyelitis in rats. Osteomyelitis was established by inoculating S. aureus
      into holes that were drilled in the proximal tibiae and were filled with
      polymethylmethacrylate (PMMA) cylinders. The cylinders were left in place for 3
      weeks. The infections were serially evaluated by clinical and radiographic
      examination and by quantitative culture for colony forming units (CFUs) at the
      time the rats were killed. For treatment, cements containing antibiotic were
      implanted in animals that had established osteomyelitis and were left in place
      for an additional 3 weeks. Sites treated with biodegradable cement containing
      antibiotics exhibited significantly fewer CFUs in comparison with controls (p <
      0.01). Sites treated prophylactically with the biodegradable cement developed no
      infections as evaluated by clinical or radiographic criteria or by quantitative
      culture. At this relatively early time, no significant difference in therapeutic
      effectiveness was found when either the biodegradable cement or PMMA was used as
      a carrier for antibiotics.

PMID- 8483038
TI  - Bioerodible polyanhydrides for antibiotic drug delivery: in vivo osteomyelitis
      treatment in a rat model system.
AB  - Acute and chronic osteomyelitis can be difficult to treat by conventional means.
      Current methods of treatment involve the use of systemic antibiotics, the local
      implantation of non-degradable drug carriers, and surgical debridement. Each
      method has specific drawbacks. We report on the use of a new controlled release
      system utilizing gentamicin and bioerodible, biocompatible polymers
      (polyanhydrides) designed for drug delivery applications for the treatment of
      clinical osteomyelitis. We compared this system's ability to reduce bacterial
      levels in infected bone with that of conventional non-degradable delivery systems
      based on polymethylmethacrylate (PMMA) and gentamicin. Polyanhydride copolymers
      of bis-carboxyphenoxypropane and sebacic acid P loaded with gentamicin sulfate
      and PMMA/gentamicin matrices were implanted in the long bones of Sprague-Dawley
      rats infected with a strain of Staphylococcus aureus. After 3 weeks of
      implantation, the polymeric delivery devices were removed and quantitative
      cultures were used to determine bacterial levels in bone. The
      polyanhydride/gentamicin matrices demonstrated significant degradation over the 3
      week implantation period. Levels of bacteria, measured in colony forming units,
      were significantly lower in bone implanted with the polyanhydride/gentamicin
      release system than in long bones of control animals without an implant (p <
      0.01), of animals with a polyanhydride polymer implant alone (p < 0.01), and of
      animals with a PMMA/gentamicin implant (p = 0.03). Bioerodible polyanhydrides
      show promise as a new treatment modality for infections in bone.

PMID- 8483039
TI  - Effects of severe diabetes and insulin on the femoral neck of the immature rat.
AB  - The interactive effects of severe diabetes and insulin therapy on the
      geometrical, biomechanical, and histomorphological characteristics of the femoral
      neck were studied in rats that had streptozotocin-induced, insulin-dependent
      (Type-I) diabetes. Thirty-six female Sprague-Dawley rats (8 weeks of age) were
      assigned randomly to one of three groups: 12 to control (C), 12 to severe
      diabetes mellitus (SDM), and 12 to severe diabetes with insulin treatment (SDI).
      At the conclusion of 10 weeks, the femoral necks were loaded to failure via
      cantilever-bending tests, and the geometrical, structural, and material
      properties of the femoral neck were measured and correlated with fracture-surface
      cross sections. Decalcified cross sections of the femoral necks were analyzed
      histomorphometrically to determine the porosity, the bone-cell counts, and the
      bone spicule/marrow space ratio. Rats with severe insulin-dependent diabetes had
      significantly lower total body mass than did control rats, as well as
      significantly less femur mass, femur length, total-bone cross-sectional area, and
      cortical-shell cross-sectional area. Insulin therapy ameliorated some, but not
      all, of the detrimental effects of diabetes on femoral neck geometry. Compared
      with control and SDI rats, SDM rats had lower values for femoral neck structural
      properties, although differences in structural properties may have been related
      to retarded growth as well as to diabetes. SDM rats had a significantly lower
      bone spicule/marrow space ratio and number of osteoclasts than did either the
      control or SDI rats and had significantly greater porosity in the femoral neck
      cortex than did control rats. Decrements in femoral neck material properties-
      which were independent of differences in body size--were significantly and
      linearly correlated with severity of diabetes (as measured by blood glucose
      level).

PMID- 8483040
TI  - Load transfer with the Austin Moore cementless hip prosthesis.
AB  - More than 1,300 Austin Moore hemiarthroplasties have been reviewed in the
      literature, with no reports of fracture of the stem. Many patients with these hip
      implants had good function. The lack of stem fractures in patients with good
      functions has not been explained and contrasts with stem fractures that have
      occurred in patients with cemented prostheses of other designs during the same
      time. We used three-dimensional finite-element analysis and free-body diagrams to
      explain the lack of fractures for this device by a description of the probable
      load-transfer mechanisms between the prosthesis and the bone. Results from our
      finite-element analysis indicate that, with good calcar-collar support, the
      stresses in the stem are small because the stem portion of the prosthesis and the
      bone are uncoupled and, consequently, do not share the resultant bending moment
      of the head and abductor forces. If the stem is coupled to the bone so that the
      resultant bending moment is shared, high stresses in the stem are predicted; such
      stresses are inconsistent with the complete absence of fractures of these
      prostheses. The results of the finite-element analysis further showed that loss
      of calcar-collar support with proximal fixation through the fenestrations
      resulted in high stresses in the stem and stress shielding of the proximal medial
      cortex. The uncoupled prosthesis also may be modeled with a free-body diagram as
      a three-force member loaded at the head, stem tip, and in the proximal region.
      With this model, it can be shown that the reaction force of the stem tip, and
      thus the peak bending stress in the stem, increases as calcar-collar support is
      decreased. If there is no calcar-collar support, proximal support must be
      provided by some combination of integration of bone in the fenestrations and
      wedging due to the lateral-medial taper of the device. Stresses in the stem are
      largest when there is no wedging, but high stresses develop in the cancellous
      bone in the fenestrations. When there is wedging, stresses in the stem can be
      low, but stresses in the supporting cancellous bone can be high; additional
      proximal support through the fenestrations substantially reduces these bone
      stresses. If reduced stresses in the cancellous bone are indicative of a stable
      device, these mechanisms indicate that fractures of the Austin Moore prosthesis
      have not occurred in normally loaded hips because load was transferred primarily
      either through the collar or by wedging, with additional support at the
      fenestrations.

PMID- 8483041
TI  - Healing of cancellous bone osteotomy in rabbits--Part I: Regulation of bone
      volume and the regional acceleratory phenomenon in normal bone.
AB  - We performed a simple, undisplaced, incomplete osteotomy of the distal medial
      condyle of mature New Zealand White rabbits and permitted healing without
      fixation for 4 weeks. During the recovery period, the rabbits received the bone
      label calcein in their drinking water. From ground stained and unstained
      sections, we determined histomorphometric parameters in five zones: osteotomy
      gap, juxtaosteotomy, lateral condyle, metaphysis, and diaphysis. At 4 weeks,
      newly formed cancellous bone had obliterated the osteotomy gap. Osteotomy also
      stimulated new bone formation in cancellous bone of the medial condyle around the
      osteotomy. At that site, we found a fivefold increase in new bone without a
      change in bone volume (BV). Stimulation of bone formation was not observed in
      cancellous bone of the lateral condyle that had not been operated on or in
      cortical bone of the metaphysis or diaphysis. The maintenance of BV, despite
      increased new bone formation in the osteotomized medial femoral condyle, was
      probably due to a local acceleration of bone remodeling.

PMID- 8483042
TI  - Healing of cancellous bone osteotomy in rabbits--Part II: Local reversal of
      arthritis-induced osteopenia after osteotomy.
AB  - With use of the intravital bone label calcein, we previously identified, by
      histomorphometry, greatly increased new bone formation and juxtaarticular
      osteopenia (a high turnover state) in carrageenan-induced experimental
      inflammatory arthritis of the knee in rabbits. In Part I of this paper, we showed
      that a large increase in new bone formation after a stable incomplete distal
      femoral condylar osteotomy of normal bone in the rabbit does not increase bone
      volume (BV) in normal tissue adjacent to the osteotomy (zone 1). In this study,
      we performed an osteotomy of bone made osteopenic by experimental inflammatory
      arthritis. After 4 weeks of healing, we examined new bone formation and BV in
      five zones around the osteotomy. In zone 0 (the osteotomy gap), new bone
      formation filled the gap to normal BV, as we found for the normal/osteotomy
      group. In zone 1 (adjacent to but excluding the osteotomy gap), we found greatly
      increased new bone formation and a return to normal BV, increased from the
      osteopenic level induced by experimental inflammatory arthritis. In this model,
      osteotomy apparently reversed the bone-wasting process of inflammatory arthritis.
      This effect was not observed in other zones: the lateral condyle that had not
      been operated on, the metaphysis, or the diaphysis.

PMID- 8483043
TI  - Muscle contraction increases the structural capacity of the lower leg: an in vivo
      study in the rat.
AB  - A model to study the contribution of muscle contraction to the structural
      capacity of the rat tibia was developed. The right lower leg was tested to
      failure in three-point ventral bending during electrically stimulated muscle
      contraction. The left lower leg was tested without stimulation, as a control. The
      mean ultimate bending moment for the stimulated legs was 0.603 Nm, compared with
      0.492 Nm for the unstimulated legs (p < 0.001). The ultimate energy absorption
      was 0.313 and 0.188 J in the stimulated and unstimulated legs, respectively (p <
      0.01). Fracture strength has been studied nearly exclusively in dissected bone
      stripped of all soft tissues. The present investigation suggests that studies of
      dissected bone are incomplete compared with the in vivo situation, as contraction
      of the muscles substantially increased the fracture strength of the lower leg in
      rats.

PMID- 8483044
TI  - A standardized experimental fracture in the mouse tibia.
AB  - The increased use of transgenic mice as experimental animals provides new
      opportunities to study the biology of fracture repair. We have developed a
      technique for the production of a standard closed experimental fracture in the
      mouse tibia. A 0.2 mm stainless-steel rod was introduced into the medullary
      cavity and the pre-nailed tibial shaft was fractured by an impact device, which
      resulted in a reproducible transverse or slightly oblique fracture pattern. The
      intramedullary rod maintained axial alignment, and the fractures united without
      displacement. On the basis of measurements of callus geometry, four-point bending
      tests, biochemical analyses, and quantitative histology, the progress of callus
      formation and remodeling occurred in a predictable sequence of healing phases.
      The ultimate bending loads of the fractures increased with time, reaching 74% of
      the strength of intact control tibias in 4 weeks. The stiffness values of the
      fractures returned to normal levels and, as determined radiographically, the
      fractures united by external callus in 4 weeks. Radiographically, callus size,
      cross-sectional callus area, and callus mass peaked at 2 weeks and decreased
      thereafter, indicating the start of external remodeling. Histologically, the
      amount of mesenchymal tissue was maximal at days 5 and 7. The callus cartilage
      area peaked at day 9; at its maximum, it accounted for 46% of the total callus
      area. Early periosteal formation of membranous new bone, followed by endochondral
      ossification, resulted in a linear increase of callus bone during the healing
      process. The healing sequence of the mouse tibial fracture was similar to that
      seen in the rat tibia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483045
TI  - African-centered drug treatment: an alternative conceptual paradigm for drug
      counseling with African-American clients.
AB  - An alternative conceptual framework is presented for understanding the culturally
      normative behavior of African-Americans in drug abuse treatment and recovery,
      based on an appreciation of core African-centered beliefs. Key ontological and
      epistemological assumptions of traditional clinical and counseling interventions
      are presented that highlight the differences between traditional goals and
      theories and the proposed alternative conceptual system and treatment strategies.
      Implications for African-centered treatment and future research on the course of
      addiction and recovery among African-Americans are discussed.

PMID- 8483046
TI  - Enrollment of drug abusers in HIV clinical trials: a public health imperative for
      communities of color.
AB  - There is an increasing appreciation of the impact of drug abuse on AIDS in the
      United States because of the pivotal role of injecting drug use in the prevalence
      of total AIDS cases and case reporting among ethnic/racial minorities, women, and
      children. While the participation of injecting drug users (IDUs) in HIV clinical
      trails has increased steadily, the IDU accrual rate lags unacceptably behind the
      IDU proportion of AIDS cases. The stigma of drug abuse, issues related to
      poverty, and the underrepresentation of communities of color are the major
      obstacles to IDU participation in HIV clinical research. It is critical to
      overcome these obstacles as the spectrum of HIV disease in IDUs requires the
      development of an IDU-relevant scientific agenda for HIV clinical trials. This,
      in turn, is crucial to the development of effective therapies for the treatment
      of HIV disease in IDUs. To the extent that these endeavors are successful, more
      relevant therapies to communities of color will be developed, as injecting drug
      use is disproportionately more prevalent in these communities.

PMID- 8483047
TI  - Cultural competence: an interview with Warren Hewitt. Special Assistant to the
      Director, Center for Substance Abuse Treatment.

PMID- 8483048
TI  - Priorities for alcohol treatment research among U.S. Hispanics.
AB  - This article reviews the clinical research conducted with U.S. Hispanics and
      discusses priorities for alcohol treatment research in this ethnic group.
      Specific areas in which research is needed include epidemiological descriptions
      of client characteristics, access and utilization of alcohol treatment, the
      structure of alcohol programs, pathways to treatment, alcohol dependence and
      treatment effectiveness, and treatment matching in alcohol treatment.
      Methodological requirements, research funding strategies, and professional
      training needed for implementing the research needs identified in the article are
      also discussed. A concerted effort by funding institutions is needed to emphasize
      the importance of this research, and an increased commitment of funds for
      research and professional training is necessary. Such funds should be earmarked
      for research with minorities and training for minority professionals.

PMID- 8483049
TI  - Substance abuse treatment: cultural barriers in the Asian-American community.
AB  - Asians constitute the largest growing minority in the United States. However,
      inaccurate perceptions and stereotypes continue to mask a full understanding of
      the state of knowledge regarding their alcohol and other drug abuse. Much of the
      existing research has continued this trend by categorizing Asians as "others" or
      persisting in its attempts to explain low incidence rates by investigating
      metabolic phenomena. More recent community-based studies have shown alarming
      incidence rates of specific substance abuse among different Asian ethnic groups.
      Asian heterogeneity and cultural barriers have also contributed to the lack of
      knowledge regarding substance abuse prevalence rates. Issues related to taboo,
      denial, and loss of face further mask understanding of the extent of the problem.
      Institutional barriers and the lack of community infrastructure make treatment
      efforts difficult in serving a myriad of Asian groups. For most Asians undergoing
      treatment, cultural factors need to be considered, including the involvement of
      the family as well as the risk related to its transition under immigration and
      the following acculturation patterns. An example of a specific treatment program
      and activity is discussed in relationship to the cultural factors indicated
      above. Finally, recommendations are specified for future treatment policy,
      research, and services.

PMID- 8483050
TI  - Addressing treatment needs of Southeast Asian Mien opium users in California.
AB  - This report describes efforts in progress to meet the needs of opium smoking Mien
      immigrants in Oakland, California. Translating concepts of addiction and recovery
      into terms that are culturally relevant constitutes the basis for efforts to
      assist the Mien to adjust to an opium-free lifestyle. The acceptability and
      utility of clonidine, acupuncture, methadone, counseling, support groups, and
      other medical services are discussed.

PMID- 8483051
TI  - Is the therapeutic community culturally relevant? Findings on race/ethnic
      differences in retention in treatment.
AB  - The therapeutic community (TC) views cultural diversity as an essential
      ingredient in its treatment approach. However, based on clinical observation and
      some research, questions persist concerning the relevance of TC programming for
      numerical race/ethnic minorities. This article briefly reviews pertinent research
      and presents findings from recent studies on race/ethnic differences in readiness
      and suitability for, and retention in, TC treatment. A framework is outlined for
      the empirical study of cultural relevance issues in TCs.

PMID- 8483052
TI  - International training for drug abuse treatment and the issue of cultural
      relevance.
AB  - During the last ten years, there has been an increased demand for culturally
      relevant drug abuse treatment that is responsive to the unique needs of
      international populations, each with its own special culture and taboos. This
      article explores the assumptions that these distinct cultural characteristics
      require different treatment approaches to be effective, and presents both
      curriculum content and training designs used in educating diverse cultures in
      drug abuse treatment strategies. The authors discuss their training experiences
      in Central Europe, the Mediterranean, China, and Southeast Asian countries and
      conclude that, while cultural uniqueness certainly exists, it may be greatly
      exaggerated in terms of the need for special treatment modalities in the field of
      drug abuse treatment.

PMID- 8483053
TI  - Cross-cultural counseling with the chemically dependent: preparing for service
      delivery within a culture of violence.
AB  - This article prepares the clinician delivering chemical dependency treatment for
      more effective work in therapeutic dyads where there are racial, ethnic, or other
      "differences" between client and therapist. The objective is to prepare
      clinicians for service delivery within the present culture of violence and for
      the receipt of additional training in cross-cultural counseling and trauma
      resolution psychotherapy. Social learning and unconscious processes are reviewed
      in order to explain how this culture of violence operates and impacts treatment.
      The way in which chemically dependent clients of color--especially African
      Americans, Native Americans, and Latinos--have been impacted by both personal and
      cultural trauma is illustrated by a case example. The resolution of clients'
      personal trauma by properly trained clinicians is presented as relapse prevention
      and the clients' best defense against becoming a victim of violence and racism.
      The article ends with a brief description of the recommended clinical technique
      for this kind of work, and a statement of needed research.

PMID- 8483054
TI  - Cultural points of resistance to the 12-Step recovery process.
AB  - This article addresses some of the key issues in developing culturally relevant
      approaches to drug abuse treatment and recovery, using the HAFC/Glide African
      American Extended Family Program as a positive example of effective cultural
      adaptability within recovery. Cultural points of resistance to the recovery
      process are also addressed, including the perception that 12-Step fellowships are
      exclusive and confused with religion, confusion over surrender versus
      powerlessness, and concerns about low self-esteem, dysfunctional family
      structure, communication difficulties, and institutionalized and internalized
      racism. The authors also focus on professional resistance in other countries,
      where different treatment approaches and philosophies block the acceptance of a
      recovery concept in general and the 12-Step process in particular. In explicating
      these issues, addiction is presented as a multicultural problem in need of
      multicultural solutions. The challenge is to adapt the process of recovery to all
      cultures and races, to counter stereotypes on all sides, and to eliminate the
      perception that recovery only works for addicts from the White mainstream.

PMID- 8483055
TI  - Characterization of two monoclonal antibodies against secretory proteinase of
      Candida tropicalis DSM 4238.
AB  - Two murine IgM monoclonal antibodies (mAb; MT1 and MT2), which were produced
      against the secretory aspartic proteinase of Candida tropicalis DSM 4238, are
      described. Both antibodies reacted with the native and denatured conformations of
      the homologous proteinase antigen but showed different patterns of reactivity
      with other related proteinases (Candida albicans CBS 2730, serotype A; C.
      albicans ATCC 48867, serotype B; Candida parapsilosis DSM 4237) and with porcine
      pepsin. Neither of the antibodies inhibited the proteolytic activity of the
      homologous enzyme. MT1 also reacted with mannoproteins of C. tropicalis DSM 4238
      and C. albicans CBS 2730 and immunofluorescence revealed that this antibody bound
      to the surface of blastoconidia and pseudomycelia of these two Candida species. A
      reaction with blastoconidia only was observed with C. albicans serotype B. MT1
      also reacted weakly with Candida guilliermondii, but not with C. parapsilosis,
      Candida glabrata, Candida krusei or Candida kefyr. MT2 did not bind to fungal
      surfaces. Preliminary experiments suggested that mAb MT1 may recognize a
      carbohydrate epitope, while MT2 binds to an epitope consisting of the protein
      part of the enzyme. The two antibodies were used in an ELISA for the detection of
      proteinase antigen. ELISA with MT1 or MT2 as coating antibodies and a specific
      protein epitope recognizing mAb-biotin conjugate was able to detect 4 ng ml-1 of
      antigen. Trials with 26 sera from fungemic patients and 14 sera from controls
      suggest that MT2 is of potential value in antigen-directed serodiagnosis.

PMID- 8483056
TI  - The role of the complement system in the neutrophil functions stimulated in vitro
      by an alkali-insoluble cell wall fraction of Paracoccidioides brasiliensis.
AB  - We investigated the capacity of an alkali-insoluble cell wall polysaccharide
      fraction (F1) of Paracoccidioides brasiliensis to induce rat polymorphonuclear
      neutrophil (PMN) migratory and chemiluminescence (CL) responses. Normal rat serum
      pre-incubated with F1 induced a chemotactic neutrophil response which was fully
      abolished by heat-inactivation. The participation of the alternative complement
      pathway was more effective than that of the classical pathway since depletion of
      factor B by heating at 50 degrees C reduced PMN migration, whereas blockade of
      the classical pathway with EGTA left the migratory response practically
      unchanged. Opsonized serum F1 induced a significant release of oxygen radicals
      from PMN as measured by CL. The complement system was also found to be involved
      in this activity since serum inactivation at 56 degrees C altered the CL
      response. In addition to complement-derived fragments, other serum opsonins,
      probably cross-reacting antibodies, were required for optimal interaction between
      PMN and opsonized particles. These results contribute to the understanding of the
      role of fungal components and of the complement system in the inflammatory
      response observed in paracoccidioidomycosis.

PMID- 8483057
TI  - Calcium stimulates molecular and cellular events during the yeast-to-mycelium
      transition in Sporothrix schenckii.
AB  - Calcium ions (Ca2+) have been identified as mediators of proliferative and
      morphogenetic processes in many eukaryotic cells. The effects of these ions on
      the cellular and macromolecular processes that accompany the dimorphic transition
      from the yeast-to-mycelial form of Sporothrix schenckii have been studied. Ca2+
      were found to stimulate germ tube formation and growth in these cells at an
      optimal concentration of 1.0 mM. Studies concerning the effects of this cation on
      the molecular processes that precede germ tube formation revealed that the
      earliest molecular event which was stimulated by 1.0 mM Ca2+ was RNA synthesis.
      An increased incorporation of radioactivity into RNA in the presence of 1.0 mM
      Ca2+ was first observed at 0-3 h, and subsequently at all other times tested,
      following inoculation. A stimulation in rRNA and tRNA synthesis was detected in
      the presence of 1.0 mM Ca2+. The incorporation of radioactivity into proteins was
      stimulated 3-5 h following induction in the presence of Ca2+ suggesting a
      specific effect of Ca2+ on protein synthesis. This increased incorporation takes
      place prior to the start of DNA synthesis. Incorporation of radioactivity into
      DNA was also stimulated in the presence of Ca2+, 6 and 9 h after inoculation.
      This stimulation resulted in nuclear division taking place with a shorter lag
      period and proceeding with increased kinetics. The results reported here are
      evidence that Ca2+ plays a role in the control of the early molecular and
      cellular processes that accompany the yeast-to-mycelium transition in S.
      schenckii and offer an explanation of how Ca2+ can control the expression of the
      dimorphic potential of this fungus.

PMID- 8483058
TI  - Conditions affecting the adherence of Cryptococcus neoformans to rat glial and
      lung cells in vitro.
AB  - Conditions affecting the adherence of clinical isolates of Cryptococcus
      neoformans to rat glial and lung cell cultures were studied. Adherence to glial
      cells was a time-dependent process that was affected by the yeast culture age and
      growth temperature. The most adherent yeasts were those from 48 h cultures grown
      at 37 degrees C. Formalin-treating the yeasts did not affect adherence but
      formalin-treating the glial monolayers prevented yeast binding. Treating the
      yeasts with trypsin reduced adherence to glial monolayers, indicating that the
      yeast adhesin had a trypsin-labile protein component. Certain carbohydrates
      inhibited cryptococcal adherence to glial and lung cells in a time and
      concentration-dependent manner. Of the carbohydrates tested, N-acetyl-D
      glucosamine, sucrose, lactose, sorbitol and myo-inositol were the most
      inhibitory, while mannose, galactose and xylose were the least inhibitory. The
      results collectively indicated that the mechanisms of adherence of C. neoformans
      to lung cells were similar to those of glial cells and that both involved a
      protein-containing adhesin on the cryptococcal surface that was expressed only
      after growth at 37 degrees C. Carbohydrate receptors also appeared to be involved
      with these interactions.

PMID- 8483059
TI  - Lipase of Malassezia furfur: some properties and their relationship to cell
      growth.
AB  - Lipase activity of Malassezia furfur, detected with alpha-naphthyl palmitate as a
      substrate, appeared to be associated with the insoluble fraction of the organism.
      Profiles of M. furfur lipase were similar to those of Candida cylindracea lipase.
      The pH optimum of the lipase was acidic, pH 5.0, which is very similar to skin
      surface pH. The enzyme activity was strongly activated by a lipase activator,
      sodium taurocholate (STC). Addition of STC to the culture medium activated cell
      growth in a dose-dependent manner and induced hyphae production. These results
      suggest that M. furfur lipase plays an important role in cell growth.

PMID- 8483060
TI  - Cryptococcosis produced by a urease negative strain of Cryptococcus neoformans.
AB  - A urease negative strain of Cryptococcus neoformans was isolated form a patient
      with AIDS. The identification of the yeast was confirmed by physiological and
      pathogenicity tests. Clinically, the disseminated cryptococcal infection in our
      patient was identical to those reported in other patients with AIDS.

PMID- 8483061
TI  - Disseminated adiaspiromycosis in a patient with AIDS.
AB  - A case of disseminated adiaspiromycosis in an AIDS patient is described. The most
      notable characteristic of the infection was the extensive osteomyelitis exhibited
      by the patient. Positive cultures for Chrysosporium parvum var. parvum were
      obtained from pus taken from a lesion of the wrist during surgery as well as from
      sputum samples and a bone marrow aspirate. Treatment with amphotericin B
      controlled the fungal infection.

PMID- 8483062
TI  - Oxygen consumption and carbon dioxide production during liquid ventilation.
AB  - Liquid ventilation with perfluorocarbon (PFCV) has advantages over conventional
      gas ventilation (GV) in premature and lung-injured newborn animals. Indirect
      calorimetric measurement of both oxygen consumption (VO2) and carbon dioxide
      production (VCO2) during PFCV has not been previously performed. In addition,
      comparison to indirect calorimetric measurement of VO2 and VCO2 during GV has not
      been evaluated. Ten fasted normal cats weighing 2.6 to 3.9 kg were anesthetized
      with pentobarbital and pancuronium. Tracheostomy was performed. Gas exchange was
      measured across the native lung during GV and across the membrane lung of the
      liquid ventilator during PFCV. VO2 was measured using a modification of a
      previously described, indirect, closed-circuit, volumetric technique. VCO2 was
      analyzed by capnographic assay of the mixed-expired closed-circuit air. The
      VCO2/VO2 ratio (RQ) was calculated. There was no change in VO2, VCO2, or RQ
      during PFCV when compared with GV (VO2: GV = 5.7 +/- 0.3 mL/kg/min, PFCV = 5.6 +/
      0.5 mL/kg/min [P = NS]; VCO2: GV = 4.9 +/- 1.1 mL/kg/min, PFCV = 4.8 +/- 0.9
      mL/kg/min [P = NS]; RQ: GV = 0.85 +/- 0.21, PFCV = 0.86 +/- 0.21 [P = NS]).
      During GV the PaO2 was higher than during PFCV (PaO2: GV = 335 +/- 70 mm Hg, PFCV
      = 267 +/- 83 mm Hg [P = .04]), as is expected because of the relative reduction
      in the inspiratory PiO2 of the perfluorocarbon during liquid
      ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483063
TI  - Maintenance of the placental circulation to evaluate and treat an infant with
      massive head and neck hemangioma.
AB  - A maternal ultrasound was obtained because of polyhydramnios at approximately 30
      weeks gestation. The study identified a fetus with a large, solid mass involving
      the neck and left face. Because of the concern for airway obstruction, we sought
      an alternative to normal delivery or routine cesarean section. At 35.5 weeks
      gestation the mother underwent deep halothane anesthesia followed by cesarean
      section. Initially, only the head and neck of the fetus were delivered and a
      large hemangioma was noted to involve the anterior and left neck and all of the
      left face to the left eye. While maintaining placental and umbilical cord
      circulation, the infant was successfully nasotracheally intubated. The umbilical
      cord was divided and the delivery completed. At 1 week of age the infant
      underwent partial excision of that portion of the hemangioma overlying the
      trachea and the left external carotid artery was ligated. The infant was
      successfully extubated 12 days later. In the first 4 months of life she had three
      episodes of platelet trapping requiring high-dose systemic steroid therapy.
      Beginning at 8 months of age she was begun on intralesional injections of a 50/50
      solution of triamcinolone and betamethasone with a marked reduction in the size
      of the lesion. Preservation of the placental circulation during delivery resulted
      in the avoidance of a potential hypoxic or fatal event. Intermittent
      intralesional steroid injections appear to have played a role in the marked
      reduction in the size of this large subcutaneous head and neck hemangioma.

PMID- 8483064
TI  - Extracorporeal membrane oxygenation: support for overwhelming pulmonary failure
      in the pediatric population. Collective experience from the extracorporeal life
      support organization.
AB  - Data from the Extracorporeal Life Support Organization (ELSO) regarding the use
      of extracorporeal membrane oxygenation (ECMO) in pediatric patients with
      respiratory failure are reviewed. Two hundred eighty-five children between the
      ages of 14 days and 18 years were supported with ECMO between January 1982 and
      September 1991. Although these data represent the experience of 52 ECMO centers,
      seven centers accounted for over 50% of the total. The patients had a mean age of
      33 +/- 48 months with a median age of 13 months: 137 (48%) were male and 148
      (52%) were female. There were numerous primary pulmonary diagnoses: the two most
      common were presumed viral pneumonia (32%) and adult respiratory distress
      syndrome (28%). Entry criteria for ECMO, although poorly defined and specific to
      each institution, attempted to identify children with an 85% to 100% predicted
      mortality. The survival rate with ECMO was 47% (135/285). Pre-ECMO mechanical
      ventilatory support was extreme with an FIO2 .97 +/- .07 and a mean airway
      pressure (MAP) 23.6 +/- 8 cm H2O used to achieve PaO2 of 50 +/- 39 and PaCO2 51
      +/- 22 mm Hg. The MAP was significantly higher in nonsurvivors versus survivors
      (25.3 +/- 8.7 v 22.0 +/- 7.1 cm H2O, P < .01). The duration of ECMO was 4 hours
      to 35.5 days with a mean of 245 +/- 165 hours, which is approximately 10 days.
      Duration for survivors was 222 +/- 151 hours compared with 266 +/- 176 hours for
      nonsurvivors. ECMO complications are divided into two categories: mechanical
      (directly related to the ECMO circuit) and medical (patient related).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8483065
TI  - Multicenter comparison of conventional venoarterial access versus venovenous
      double-lumen catheter access in newborn infants undergoing extracorporeal
      membrane oxygenation.
AB  - A multicenter trial was designed to compare standard venoarterial (VA) access
      versus single-catheter, venovenous access using the double-lumen catheter (VV
      DLC) for newborns with respiratory failure undergoing extracorporeal membrane
      oxygenation (ECMO). Twenty-seven ECMO centers participated, each submitting data
      from the center's most recent VA cases, and data from VV-DLC cases completed upon
      entering the study. Data from 135 VA ECMO cases and 108 VV-DLC cases were
      submitted. All diagnoses resulting in neonatal respiratory failure were
      submitted, including patients with congenital diaphragmatic hernia (24 patients
      VA bypass, 11 patients VV-DLC bypass). Overall survival in patients undergoing VA
      bypass was 87%, while survival in patients undergoing VV-DLC bypass was 95%.
      Eleven patients required conversion from VV-DLC bypass to VA bypass because of
      insufficient support--10 of these patients survived (91% survival). Average
      bypass time for newborns undergoing VA bypass was 132 +/- 7.4 hours versus 100 +/
      5.1 hours for those undergoing VV-DLC bypass. Neurologic complications were more
      common in the VA bypass patients, although the VV patients were more stable.
      Hemorrhagic, cardiopulmonary, and mechanical complications, other than kinking of
      the DLC, occurred with approximately equal frequency in each group. In
      conclusion, in newborns with adequate cardiac function, venovenous ECMO using the
      DLC can provide the same level of support as conventional VA ECMO, without
      ligation of the carotid artery.

PMID- 8483066
TI  - Aminocaproic acid decreases the incidence of intracranial hemorrhage and other
      hemorrhagic complications of ECMO.
AB  - Since the inception of extracorporeal membrane oxygenation (ECMO), hemorrhage has
      been a major complication often limiting its usefulness. This study was
      undertaken to evaluate the effect of aminocaproic acid (AMICAR), an inhibitor of
      fibrinolysis, on all hemorrhagic complications of ECMO including intracranial
      hemorrhage (ICH). In 1990, 49 neonates and 5 older children received ECMO
      therapy. None of these patients received AMICAR. In 1991, 51 neonates and 5 older
      children received ECMO. Forty-two of these patients who were considered to be at
      high risk for bleeding complications (preexisting or anticipated surgical
      procedures, preexisting ICH, or profound hypoxia, acidosis, coagulopathy, or
      prematurity) were given AMICAR. The remaining 14 low-risk neonates did not
      receive AMICAR, and for purposes of analysis were combined with the 1990 group.
      AMICAR was administered just prior to or after cannulation (100 mg/kg,
      intravenously) and was infused continuously at 30 mg/kg/h until decannulation.
      Except for the addition of AMICAR, the ECMO protocol was identical for these two
      patient groups. Patients who received AMICAR had significantly less bleeding
      while on ECMO (P = .03) and required fewer blood transfusions (P = .01) than
      patients not receiving AMICAR. This difference was most significant in the
      congenital diaphragmatic hernia and cardiac subgroups (P = .0001) and was not
      significant in the meconium aspiration subgroup (P = .1). The incidence of ICH in
      the neonatal subgroup was also significantly reduced with no patient on AMICAR
      developing a new or extending a preexisting ICH (P = .007). Reexploration of the
      cannulation site for bleeding was also reduced in the AMICAR-treated group but
      the difference failed to reach statistical significance.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8483067
TI  - Halothane as an anesthetic for fetal surgery.
AB  - Halothane has become the preferred anesthetic agent during fetal surgery because
      it can be administered via maternal inhalation and it improves surgical exposure
      by relaxing the uterus. However, the effects of halothane anesthesia on fetal
      cardiovascular homeostasis during fetal surgery have not been documented. In 10
      pregnant ewes, inhalation halothane anesthesia was administered and their fetuses
      were instrumented for cardiovascular evaluation. During a 1-hour period we
      evaluated the acute effects of halothane anesthesia on fetal hemodynamics,
      arterial blood gases, cardiac output, placental blood flow, total vascular
      resistance, systemic vascular resistance, and placental vascular resistance.
      Fetal cardiac output and placental blood flow were determined by the
      radiolabelled microsphere technique and resistances were calculated using
      pressure and flow data. These findings were compared to both the results we
      obtained in 15 fetal sheep anesthetized with the maternal administration of
      intravenous ketamine, and to the accepted values found in nonanesthetized,
      chronically instrumented fetal sheep. Our findings indicate that with halothane
      anesthesia during fetal surgery fetal cardiac output and placental blood flow
      significantly decrease, and total vascular resistance increases. Placental
      vascular resistance increases out of proportion to systemic vascular resistance,
      resulting in the shunting of blood away from the placenta. The combination of
      decreased cardiac output and increased shunting of blood away from the placenta
      causes depressed respiratory gas exchange. These findings are not present with
      other anesthetic agents. Halothane has significant negative effects on both the
      fetal heart and the peripheral vasculature which disrupt fetal cardiovascular
      homeostasis. Halothane is a poor anesthetic during fetal intervention.

PMID- 8483068
TI  - Continuous epidural analgesia in newborn infants undergoing major surgery.
AB  - Providing safe, effective analgesia for newborn infants undergoing major surgery
      remains a challenge to pediatric anesthetists and surgeons. Continuous epidural
      analgesia (CEA) has been shown to provide safe and effective analgesia in infants
      and children; however, there is little reported use in neonates. We review our
      experience of CEA in 14 newborn infants (32 to 40 weeks gestation) aged 4 hours
      to 35 days undergoing major surgery, as well as a further 6 ex-preterm (25 to 29
      weeks gestation) infants aged 2 to 5 months at time of surgery. In all cases
      effective analgesia was achieved for up to 69 hours without complication. All
      infants were awake and extubated uneventfully at the completion of surgery, which
      lasted 5 hours in one case. None of the infants developed respiratory depression
      or prolonged apnea. The technique has been widely accepted by surgeons, neonatal
      nursing staff, and neonatologists.

PMID- 8483069
TI  - Epidural fentanyl infusion with patient-controlled epidural analgesia for
      postoperative analgesia in children.
AB  - The use of epidural fentanyl infusion with patient-controlled epidural analgesia
      (PCEA) is becoming popular for postoperative analgesia in adults. Its use has not
      been reported in the pediatric population. We report our initial experience with
      this technique in pediatric patients. The charts of all children who received
      epidural fentanyl infusions for postoperative analgesia between June 1991 and
      February 1992, were reviewed. Thirty-one patients, ages 6 to 17 years (mean +/-
      SD, 13.2 +/- 2.7) received epidural fentanyl infusion with PCEA for 36 operative
      procedures. Epidural catheters were either inserted in the lumbar (n = 14) or
      thoracic (n = 22) epidural space at a level based on the surgery. A fentanyl
      bolus of 1.38 +/- 0.43 micrograms/kg was delivered via epidural catheter just
      prior to the conclusion of surgery. A continuous infusion of fentanyl (0.56 +/-
      0.18 micrograms/kg/h) with a PCEA bolus (0.53 +/- 0.17 micrograms/kg) available
      every 15 minutes was initiated in the recovery room and was utilized for 8 to 110
      hours (59 +/- 27 hours). Pain and sedation were assessed by verbal descriptive
      scales, and side effects were noted. Alterations in dosing regimen were made for
      inadequate analgesia or side effects. Analgesia was assessed as excellent or good
      in 78% of the patients, 91% in the thoracic catheter group and 57% in the lumbar
      catheter group (P < .02). Patients with thoracic catheters were more likely to
      need their infusion and PCEA doses decreased, whereas those with lumbar catheters
      more often needed their doses increased (P < .05). No patient had respiratory
      depression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483070
TI  - Regional anesthesia in pediatric surgery: complications and postoperative comfort
      level in 174 children.
AB  - Postoperative pain control (PPC) in children is a difficult management problem.
      Systemic narcotics often result in respiratory depression, while nonnarcotic
      analgesics are associated with inconsistent PPC. This report reviews a 29-month
      (January 1989 through July 1991) experience with 174 children (aged < 18 years)
      who received regional PPC through indwelling catheters. There were 105 males and
      69 females. Patient age ranged from 1 day to 17 years 10 months (mean age, 97
      months). All catheters were placed using introduction needles ranging from 24 to
      16 gauge. Agents were delivered as either continuous infusion (151 patients, 87%)
      or bolus injections (23 patients, 13%). Analgesics were age- and weight
      determined dosages of bupivacaine with or without narcotic supplementation. All
      patients had surgical procedures except two who had catheters placed for pain
      control after trauma and one who had a catheter for intractable abdominal pain of
      unknown etiology. Twenty-five (15%) children had thoracic incisions, 76 (43%)
      abdominal, 16 (9%) flank, and 54 (31%) extremity. Catheter placement included 40
      thoracic epidurals (23%), 100 lumbar (57%), 27 caudal (16%), and 7 pleural (4%).
      Catheters were utilized for a duration of 0.5 to 8 days (mean, 2.1 +/- 1.2 days).
      One hundred forty-four children required no additional pain medications (83%).
      Thirty (17%) patients required supplemental medications. Acetaminophen was used
      in 6 (3%), acetaminophen with codeine in 4(2%), morphine in 18 (10%), and
      Percocet in 1(1%). Minor complications occurred 21 times in 16 children
      (9%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483071
TI  - A comparison of wound instillation and caudal block for analgesia following
      pediatric inguinal herniorrhaphy.
AB  - Regional analgesia, in a variety of forms, has been shown to afford effective
      postoperative pain relief after pediatric inguinal hernia repair. This study
      compares the efficacy of wound instillation with 0.25% bupivacaine (n = 20),
      caudal block with 0.25% bupivacaine (n = 35), and a control group (n = 15).
      Outcome parameters examined include total operating room time, time to
      extubation, postoperative objective pain scales, and requirement for supplemental
      analgesics. Patients who received caudal blocks had significantly decreased
      emergence times (P < .002), exhibited fewer pain-related behaviors
      postoperatively (P < .0025), and required less narcotic to maintain normal
      hemodynamics (P < .05). Operating room time was not statistically different
      between the three groups. The use of perioperative analgesic blocks resulted in
      quicker awakening, a more comfortable postoperative course, and potentially
      earlier discharge from same-day surgery.

PMID- 8483072
TI  - Incarceration of inguinal hernia in infants prior to elective repair.
AB  - The low morbidity and good results of elective herniorrhaphy in children are
      adversely affected by incarceration. Since incarceration is a potentially
      avoidable complication, we reviewed 908 consecutive cases to determine its
      incidence and consequences in children awaiting elective operation for an
      inguinal hernia. Eighty-five of the 908 children presented with an incarcerated
      hernia. Thirty of these 85 patients (35%) were known to have an inguinal hernia
      prior to incarceration, and 25 of the 30 were awaiting elective hernia repair.
      The median time from surgical office visit to planned operation was 22 days, but
      the mean interval from office visit to incarceration was 8 days. Eighty-five
      percent of the children with incarcerated hernias were infants under 1 year of
      age. Seventy-one of the 85 patients with an incarcerated hernia (84%) had
      successful manual reduction. They were all admitted and had a mean hospital stay
      of 2.5 days. Emergency operation after unsuccessful attempts at reduction was
      required in the other 14 children, increasing the average length of stay to a
      mean of 4.0 days. Significant complications, including infarction of the testis
      or ovary, bowel obstruction, intestinal necrosis, wound infection, and recurrent
      hernia, occurred in 26 of the 85 children (31%). We conclude that incarceration
      is a preventable problem. Even patients scheduled for hernia repair are at risk
      and the operation should be performed soon after the diagnosis is made. Infants
      are the highest priority group, since 35% of children less than 12 months of age
      experienced incarceration while awaiting elective surgery.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8483073
TI  - Musculoskeletal involvement in children with gastroschisis and omphalocele.
AB  - A review of 58 children with gastroschisis and 8 children with omphalocele showed
      14 musculoskeletal problems in 11 children. These problems consisted of limb
      deformities in 6 children, spinal deformities in 4 children, and osteopenia in 3
      children, with 1 of the osteopenic children developing pathological fractures.
      About one third (5/14) of the problems were arthrogrypotic in nature. The
      remainder were mild digital deformities, developmental or spondylodysplastic
      scolioses, and, rarely, congenital spinal deformities.

PMID- 8483074
TI  - Experimental use of high-frequency ultrasound to image bowel wall after porcine
      intestinal transplantation.
AB  - A means to monitor intestinal allografts will be crucial for the future success
      of small bowel transplantation. We have previously demonstrated the ability of
      high-frequency ultrasound (US) to diagnose porcine intestinal ischemia in vitro.
      The aim of this study was to compare the histologic appearance of normal porcine
      small bowel versus bowel undergoing acute rejection, using 8.5-MHz US images. We
      allowed porcine heterotopic small bowel allograft transplants to reject and then
      removed, at scheduled intervals from postoperative day 0 to 12, specimens of both
      the transplanted bowel and the native bowel. We examined the tissues in vitro
      with an 8.5-MHz linear array US system then studied them histologically.
      Histologically, the earliest changes of rejection occurred at days 4 to 5, with
      mild submucosal edema, endotheliitis, and vasculitis affecting the small vessels;
      the mucosa remained normal. By days 7 to 8, the submucosal endotheliitis became
      more prominent, with focal thrombosed small vessels; the mucosa now appeared
      abnormal with flattened villi, erosions, and necrosis. By days 10 to 12, marked
      submucosal edema, vasculitis, endotheliitis, and necrotic mucosa were present.
      Ultrasonically, normal intestinal wall has five wall layers, corresponding to
      mucosa, submucosa, muscularis propria, and subserosal fat. The US criteria for
      abnormality were loss of folds, decreased numbers of echo layers, discontinuity
      of layers, and a homogeneous appearance. Using these US criteria, blinded
      observers differentiated normal from abnormal bowel wall after transplantation
      with a sensitivity of 84% and a specificity of 81%. Most of the errors occurred
      with the day 4 and 5 specimens, which appeared nearly normal on US.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8483075
TI  - Conversion of xanthine dehydrogenase to xanthine oxidase during ischemia of the
      rat small intestine and the effect of trifluoperazine on the conversion.
AB  - The conversion from xanthine dehydrogenase (XD) to xanthine oxidase (XO) and the
      effect of trifluoperazine (TFP), a calmodulin inhibitor, on the conversion were
      examined during the normothermic ischemia of the rat small intestine. Rat
      jejunums were stored in lactated Ringer's solution (LR) at 37 degrees C for
      various hours after intravascular flushing with LR. The extents of the conversion
      from XD to XO (%XO) constituted 21.1% +/- 3.0%, 36.2% +/- 7.0%, 63.2% +/- 8.1%,
      and 88.2% +/- 8.6% after 0, 2, 4, and 6 hours of the preservation, respectively
      (control group). The preservation without the intravascular flushing showed
      significant increase in the %XO (99.5% +/- 6.0%) only after 6 hours compared with
      those in the control group (P < .05). When the intestines were stored in LR
      containing 50 mg/L of TFP at 37 degrees C, or stored in LR at 37 degrees C after
      the intraperitoneal pretreatment with 10 mg/kg of TFP 1 hour before laparotomy
      showed significant decrease in the extents of the conversion after 4 hours (P <
      .005) and 6 hours (P < .025) of the preservation, compared with those in the
      control group. When the dose of TFP for the pretreatment was increased to 50
      mg/kg, the suppressive effect on the conversion was found even after 2 hours (P <
      .025) as well as after 4 hours (P < .005) and 6 hours (P < .025) of the
      preservation. These results suggest that TFP could be effective on reducing the
      XO-mediated postischemic reperfusion injury by means of inhibiting the conversion
      during ischemia of the rat small intestine.

PMID- 8483076
TI  - Mucosal permeability to 51Cr EDTA following subclinical intestinal ischemia
      reperfusion injury in the weanling rat.
AB  - The etiology of necrotizing enterocolitis (NEC) is uncertain. We have
      hypothesized that subclinical intestinal ischemia might result in increased
      mucosal permeability to intraluminal toxins or bacteria, resulting in
      inflammation and NEC. In order to pursue this hypothesis, we designed a series of
      studies to investigate whether the first assumption is correct, ie whether a
      subclinical ischemia-reperfusion injury (IRI) results in increased mucosal
      permeability. Using a model of superior mesenteric artery occlusion (SMAO) in
      weanling rats, we initially defined 10-minute SMAO as "subclinical" IRI (ie, 100%
      survival, no histological changes, and no hemodynamic instability). Mucosal
      permeability to a standard probe molecule (51Cr EDTA) was then measured after
      sham operation, or 2-minute or 10-minute SMAO. There was an early increase in
      permeability 30 minutes after reperfusion in the 10-minute SMAO group, which was
      completely reversed by 2 hours. Further studies suggested that having passed
      through the mucosa, the probe entered the systemic circulation via both portal
      venous and intestinal lymphatic routes. Subclinical intestinal IRI results in an
      early, reversible increase in mucosal permeability to 51Cr EDTA, which may be
      important in the pathogenesis of NEC. Further studies are required to fully
      characterize this phenomenon, and to determine the mechanisms by which it occurs.

PMID- 8483077
TI  - Mesenteric ischemia in hypoplastic left heart syndrome.
AB  - Hypoplastic left heart syndrome (HLHS) has been widely viewed as a uniformly
      fatal form of congenital heart disease. Between January 1984 and December 1990,
      387 patients with the diagnosis of HLHS were treated at this institution.
      Mesenteric ischemia was clinically diagnosed in 31 patients (8% incidence) and
      confirmed by pathology or surgery in 25 of those patients. The mean age at the
      time of onset was 17.5 +/- 5.4 weeks and only 13% were premature newborns. In 80%
      of the patients a low perfusion state and significant hypotension were documented
      within 48 hours prior to the diagnosis of bowel ischemia. Nine patients (29%)
      required operative intervention (bowel resection 4, diffuse ischemia 3, and
      simple drainage 2). Overall, at operation or at autopsy, nine patients (29%) had
      diffuse gastrointestinal ischemia. Of 31 patients with mesenteric ischemia, 26
      children (84%) died shortly after onset of the gastrointestinal symptoms
      regardless of means of management. Five patients (10%) initially improved with
      aggressive medical and/or surgical management; however, 4 subsequently died
      secondary to complications of their primary cardiac disease. Therefore, the
      overall mortality of patients with mesenteric ischemia was 97%. Previous reports
      have estimated that up to 7% of full-term newborns with symptomatic congenital
      heart disease may develop necrotizing enterocolitis (NEC). Our unique group of
      patients with HLHS is comprised mostly of full-term infants who developed onset
      of mesenteric ischemia at a mean age of 4 months associated with an underlying
      low perfusion state. This mesenteric ischemia has been erroneously identified as
      NEC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483078
TI  - Effects of newly introduced chemotherapeutic agents on a cytogenetically highly
      malignant neuroblastoma, xenotransplanted in nude mice.
AB  - A human neuroblastoma xenograft, designated TNB9, was used in this experiment.
      This xenograft is known to have a homogeneously staining region (HSR) on
      chromosome 20 and to exhibit 60- to 100-fold amplification of clones 8, G21 and N
      myc, and showed a rapid tumor weight doubling time of 5.9 days; it represents one
      of the most malignant strains of human neuroblastoma. The effects of nine
      different chemotherapeutic agents on this xenograft were studied according to the
      standard Battelle Columbus Laboratories protocol, and the in vivo
      chemotherapeutic sensitivity assessment disclosed that Mitomycin C, Ifosfamide,
      and Carboplatin were highly effective against it, while VP-16, NK-171, 5
      Fluorouracil, and THP-Adriamycin were ineffective. Cytogenetic and molecular
      cytogenetic analyses suggest that the present data may accurately predict the
      clinical results with these chemotherapeutic agents in treating patients in
      advanced stages, as did those from our previous studies. Inclusion of Mitomycin
      C, Ifosfamide, and/or Carboplatin into a new chemotherapeutic protocol may be
      recommended.

PMID- 8483079
TI  - Imaging of neuroblastoma in patients identified by mass screening using urinary
      catecholamine metabolites.
AB  - Between April 1983 and August 1991, mass screening in Chiba Prefecture found 25
      infants to be positive for neuroblastoma based on elevated urinary levels of
      catecholamine metabolites. Ultrasonography (US), computed tomography (CT),
      magnetic resonance imaging (MRI), bone scintigraphy (BS), and 67Ga scintigraphy
      (GS) detected neuroblastomas in 12 of the 25 infants. The primary site of tumor
      was the mediastinum in 1 patient, the adrenal gland in 7, retroperitoneum in 3,
      and pelvis in 1. To determine the accuracy of each imaging technique, the percent
      sensitivity (SE), percent specificity (SP), and percent accuracy (AC) were
      determined for each technique from surgical findings and a follow-up study. MRI
      showed the highest diagnostic accuracy (100% for SE, SP, and AC), followed by CT
      (100%, 92%, 96%), US (82%, 92%, 88%), BS (58%, 100%, 80%), and GS (42%, 85%, 64%)
      in that order. MRI is most suitable for the imaging of individuals judged to be
      positive in the mass screening for neuroblastoma because of the advantages of
      visualization of the spread of tumor and the relationship of tumor to the great
      blood vessels, important determinants of resectability and therapy.

PMID- 8483080
TI  - How great is the incidence of truly congenital common bile duct dilatation?
AB  - In an attempt to investigate the causes of common bile duct dilatation (CBDD),
      activity of the pancreatic enzymes in bile aspirated from the dilated duct during
      laparotomy was measured in 24 children with CBDD. The reasoning behind this is
      the fact that the existence of activated pancreatic enzymes, namely raised
      activity of all enzymes accompanied by trypsin activation, can be regarded as an
      acquired result of an anomalous choledochopancreaticoductal junction (ACP-DJ).
      All of the pancreatic enzymes measured were activated in 14 cases (58.3%) but no
      evidence of activation of enzymes, such as trypsin or others except for amylase
      and lipase, was observed in the remaining 10 cases (41.7%), whether an ACPDJ was
      present or absent. Eight of the 10 patients with no enzyme activation (33.3% of
      the total) were less than 2 months old. The findings in these eight infants,
      which included cystic dilation or hypoplasia of the intrahepatic duct, provide
      strong suggestive evidence of the congenital nature of these cases. These results
      suggest that at least one third of CBDD cases are congenital and the remaining
      cases are either acquired or a combination of congenital and acquired, or both.

PMID- 8483081
TI  - Persistent catheter-related bacteremia: clearance with antibiotics and urokinase.
AB  - A patient with terminal osteogenic sarcoma and catheter-related coagulase
      negative staphylococcal bacteremia was treated with vancomycin and blood cultures
      were positive for 4 days documented with quantitative colony counts. Urokinase
      therapy was initiated and was associated with a transient bacteremia with
      markedly increased colony counts of coagulase-negative Staphylococcus prior to
      eradication of the catheter-related infection. We feel that the combination of
      urokinase and appropriate antibiotics may be an effective method to eradicate
      line-associated coagulase-negative staphylococcal infection in selected patients.

PMID- 8483082
TI  - Spontaneous umbilical fistula: a rare complication of ventriculoperitoneal shunt.
AB  - Although complications following ventriculoperitoneal shunt for hydrocephalus are
      not uncommon, leak of cerebrospinal fluid from the normal umbilicus following
      ventriculoperitoneal shunt is very rare. One such case is reported.

PMID- 8483083
TI  - Colonic atresia and Hirschsprung's disease association shows further evidence for
      migration of enteric neurons.
AB  - The seventh case of colonic atresia and Hirschsprung's disease association is
      presented. It is proposed that if vascular accident occurs before the eighth week
      of intrauterine life, it does not only result in atresia but also associates with
      Hirschsprung's disease.

PMID- 8483084
TI  - Hirschsprung's disease complicating colon atresia.
AB  - An infant with the rare association of colon atresia, total colonic
      Hirschsprung's disease, and tetralogy of Fallot is presented. While
      Hirschsprung's disease associated with atresia of the colon has been reported
      five times previously, this is the first case with associated congenital cardiac
      disease. As in previous reports, initial operations to relieve obstruction due to
      the colon atresia failed because of the unrecognized aganglionosis. This infant
      initially had an ileostomy performed as a newborn and then two failed attempts at
      closure of the ileostomy. In this case, as in four previously reported cases,
      histological examinations of resected colon from the initial operations were
      first reported as normal and only under the pressure of increasing clinical
      evidence was the pathology reviewed and the absence of ganglion cells
      appreciated. We stress the importance of suspecting the coexistence of
      Hirschsprung's disease and colon atresia when a functional obstruction is present
      after repair of the atresia.

PMID- 8483085
TI  - Does the type of anomalous arrangement of pancreaticobiliary ducts influence the
      surgery and prognosis of choledochal cyst?

PMID- 8483086
TI  - A review of longitudinal studies that compared periodontal therapies.
AB  - There have been numerous longitudinal periodontal studies that have compared the
      effects of two or more therapies on various clinical parameters. These studies
      are reviewed and their results are compiled. Both surgical and non-surgical
      therapy produced improvement in periodontal health. Surgical therapy tended to
      create greater short-term probing depth reduction than non-surgical therapy;
      however, the advantage was lost in some studies over time. In shallow probing
      depths, surgery produced a greater loss of probing attachment than non-surgical
      therapy. In deeper probing sites, the short-term results comparing mean probing
      attachment change following non-surgical and surgical therapy were mixed. In most
      studies, no long-term differences in mean probing attachment level change were
      present between non-surgical and surgical therapy. There were no differences
      between surgical and non-surgical therapy in any of the gingival inflammatory
      indices.

PMID- 8483087
TI  - Periodontal regeneration of human infrabony defects. I. Clinical measures.
AB  - A series of investigations was undertaken to evaluate the extent and
      predictability of periodontal regeneration with barrier membranes in deep
      infrabony defects. This study reports the clinical outcomes in terms of probing
      attachment level (PAL) gains, probing pocket depth (PPD) reduction, and recession
      (REC) of marginal gingiva. Forty deep 1, 2, and 3-wall combination infrabony
      defects treated with membranes were evaluated 1 year postoperatively following a
      strict plaque control regimen (mean plaque score = 6.1%, bleeding score = 4% at 1
      year). A PAL gain of 6.1 +/- 2.5 mm along with a PPD reduction of 5.9 +/- 2.5 mm
      were observed. A PAL gain of 2 mm or more was detected in almost 90% of the
      treated sites. No site lost attachment. Residual PPD was 3 mm or shallower in 95%
      of the sites. It is concluded that treatment of deep infrabony defects according
      to the principles of guided tissue regeneration and a strict plaque control
      regimen represents an efficacious and predictable treatment alternative.

PMID- 8483088
TI  - Periodontal regeneration of human infrabony defects. II. Re-entry procedures and
      bone measures.
AB  - This paper evaluates the osseous healing response of 40 infrabony defects treated
      with guided tissue regeneration. The selected sites presented with deep
      periodontal lesions with a 1-, 2-, and 3-wall combination infrabony component of
      6.1 +/- 2.5 mm. Baseline intrasurgical clinical measurements were compared with
      intrasurgical clinical measurements obtained at the 1 year surgical re-entry. A
      significant regeneration of bone of 4.3 +/- 2.5 mm was observed, along with a 0.4
      +/- 1.9 mm resorption of the alveolar bone crest, which resulted in a 4.7 mm
      reduction of the original infrabony defect. Almost 90% of the sites showed a bone
      gain of 2 mm or more, while no site lost supporting bone; 73 +/- 31.2% of the
      original defect was filled with bone. The 3- and 2-wall components were filled 95
      +/- 6.2% and 82 +/- 18.7% of their original depth, respectively; however, the 1
      wall component was filled only 39 +/- 62.4%. It is concluded that treatment of
      infrabony defects according to the principles of guided tissue regeneration and a
      strict plaque control regimen resulted in clinically significant and highly
      predictable bone regeneration.

PMID- 8483089
TI  - Periodontal regeneration of human infrabony defects. III. Diagnostic strategies
      to detect bone gain.
AB  - Assessment of actual treatment outcome by simple and available diagnostic tests
      represents an important aspect in the evaluation of periodontal regenerative
      procedures. This report focuses on the diagnostic accuracy of different
      strategies to detect the original extent of bone loss and bone gain in deep
      vertical defects following guided tissue regeneration. Characteristics of probing
      attachment level and radiographic bone linear measurements were compared to a
      gold standard obtained as intrasurgical clinical measurements at baseline and at
      the 1 year re-entry operation. Radiographic linear measurements underestimated
      bone loss (CEJ-BD) in 55% of cases while the estimate was within 1 mm in 25% of
      cases. The goodness of agreement could be significantly described by a general
      linear model incorporating measures of defect morphology. The original level of
      bone loss could be best detected by an approach which consisted of adding 1.5 mm
      to the measured attachment level loss. Such an approach correctly estimated bone
      loss within 1 mm in 85% of sites. In terms of ability to detect bone gain,
      radiographic measurements underestimated bone gain in 55% and overestimated it in
      15% of sites. Diagnostic accuracy was assessed at different threshold values of
      true gain. The sensitivity and specificity plots intersected at a threshold value
      of 2.7 mm bone gain. Conversely, measures of probing attachment level gain agreed
      with the gold standard within 1 mm 45% of times. Intersection of the specificity
      and sensitivity plots occurred at 3 mm. Classification tables are presented for
      both diagnostic tests at different threshold values.2+e

PMID- 8483090
TI  - Time-related changes of in vivo projection errors in standardized radiographs.
AB  - Subtraction radiography requires radiographs made with identical projection
      geometry. Recently a new radiographic aiming device and an x-ray beam manipulator
      made it possible to repeat radiographic exposures in vivo with small angular
      errors and to measure the angular errors occurring. The purpose of the present
      investigation was to study in vivo the measuring error and the angular errors
      produced by this new method at different time points (0, 6, and 12 months) and to
      assess the effect of different time intervals between exposures (0, 6, and 12
      months). Ten sites were investigated. At each time point 2 exposures were made,
      resulting in 6 radiographs per site. For each pair of radiographs the measuring
      errors occurring during analysis and the projection errors were determined for
      each time point and for each time interval. Friedman's test and t-test were used
      to evaluate the errors. A difference in the measuring error of the system and in
      the angular errors at the time points 0, 6, and 12 months could not be detected.
      A time interval between exposures also did not have an effect on the measuring
      error. Time did not affect the vertical and horizontal angular errors measured
      between the radiographs producing the smallest oblique error. A combination of
      radiographs producing the largest oblique angular error showed an increase of the
      horizontal and vertical angular errors when the time interval increases. These
      effects, however, were not statistically significant.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8483091
TI  - Development of the murine periodontium. II. Role of the epithelial root sheath in
      formation of the periodontal attachment.
AB  - Experimental manipulation of the developing murine tooth germ has provided
      evidence that basement membrane components on the forming root surface are
      involved in early periodontal attachment formation. The purpose of this
      investigation was to determine the role of epithelial root sheath (ERS) cells in
      murine cementogenesis and periodontal ligament formation using tissue separation
      and recombination techniques. Root dentin specimens, with and without root
      associated basement membrane components (D + RBM or D - RBM), were recombined
      with dental sac in the presence or absence of ERS. Recombinations were cultured
      for 2 weeks, harvested, and examined by light, electron, and immunofluorescence
      microscopy. Mineralized tissue formed in all tissue recombinations. However, when
      ERS was included in recombinations between D + RBM and dental sac, 25% of
      recombinations formed a periodontal ligament with fibrous attachment of the root
      specimen to adjacent bone. These results support the hypothesis that root and
      periodontal ligament formation is influenced by epithelio-mesenchymal
      interactions and further support a key role for ERS in these processes.

PMID- 8483092
TI  - The effect of treatment on the activity of salivary proteases and glycosidases in
      adults with advanced periodontitis.
AB  - Enzyme activity in whole saliva of trypsin-like protease, elastase-like protease,
      general protease, and three glycosidases was measured by colorimetric assays,
      using synthetic substrates. A study group of 24 adults with advanced
      periodontitis was compared to a control group of 25 subjects with healthy
      periodontium. Clinical parameters and levels of enzyme activity were assessed at
      baseline, after non-surgical periodontal therapy (at 8 months), following the
      maintenance phase or periodontal surgery (at 15 months), and after the
      maintenance phase with or without systemic chemotherapy (at 20 months). The mean
      values of the proteolytic enzymatic activity and the activity of two glycosidases
      in whole saliva were significantly higher in the study group than in the control
      group at baseline. After the initial treatment phase at 8 months, all three
      proteases were reduced significantly, but the glycosidases were still high. After
      all treatment phases at 20 months, the activity of both the proteases and
      glycosidases approximated the values of the healthy group. In the saliva samples
      collected prior to treatment and following non-surgical periodontal therapy, the
      activity of salivary elastase correlated significantly with the number of deep
      gingival pockets (PD > or = 6 mm) and with either gingival index (GI) or the
      percentage of bleeding sites (BOP%). The enzyme activity in whole saliva appears
      to reflect the status of periodontal health. Salivary elastase shows good
      potential to serve as a novel adjunct to detect destructive periodontal
      inflammation and to follow periodontal healing after treatment.

PMID- 8483093
TI  - The relationship between restoration and furcation involvement on molar teeth.
AB  - The purpose of this cross-sectional study was to examine the correlation between
      the presence of a crown (CR) or a proximal restoration (RE) and furcation
      involvement (FI) on molar teeth. Data were collected from 134 periodontal
      maintenance patients who had restored and non-restored molars present both with
      and without FI. A majority of the restorations that were present in these
      patients had been in place for at least 5 years prior to the study. First and
      second molars were examined clinically using the following criteria: CR, RE, FI,
      mobility (MO), and probing periodontal attachment level (AL). Data were analyzed
      with a statistical program utilizing Pearson chi-square and the pair-difference t
      test. The results indicated that molars with CR or RE had a significantly (P <
      0.01) higher percentage of FI but no greater mobility when compared to molars
      without restorations. Mean probing periodontal attachment loss was greater for
      restored than non-restored molars but only with marginal significance (P =
      0.051). There was a greater difference in mean AL between restored versus non
      restored maxillary molars than for mandibular molars. This cross-sectional study
      provides evidence that molars with crowns or restorations involving the proximal
      tooth surfaces had a higher prevalence of FI and greater AL than molars without
      restorations.

PMID- 8483094
TI  - Localized osteomyelitis secondary to endodontic-implant pathosis. A case report.
AB  - This case report documents the placement of a single implant fixture in an
      incisor extraction socket, with the adjacent lateral incisor developing
      periapical pathosis within 2 weeks. This root-end inflammatory process proceeded
      to communicate with the surface of the implant fixture. Although endodontic
      therapy was performed within one week on the devitalized tooth, and extensive
      osteomyelitis developed around the implant. Three weeks after placement, the
      fixture had to be removed. The osteotomy site appeared to be healing uneventfully
      during the one month follow-up period. Seven possible causes for this occurrence
      are discussed.

PMID- 8483095
TI  - The results of efforts to improve compliance with supportive periodontal
      treatment in a private practice.
AB  - Patients who receive routine supportive periodontal treatment (SPT) tend to keep
      their teeth longer and enjoy greater periodontal health than those individual who
      do not receive this therapy. Previous studies have found less than optimal
      compliance to suggested SPT. The study reported in this paper covered 5 years of
      patient data and measured the effects of efforts to improve compliance in a
      private periodontal practice. These efforts included attempts at simplifying
      compliance, maintaining records of compliance, informing patients of the
      consequences of noncompliance, and attempting to identify noncompliers before
      active periodontal therapy was initiated. The results were measured against a
      similar group studied in previous work within the same office published in 1984.
      The main finding of the present study was an increase in complete compliance from
      16% in 1984 to 32% in 1991. This increase came largely at the expense of the
      noncompliant group. The reason for the increase in compliance is likely due to
      efforts to increase compliance carried out in the office. However, other factors
      such as change in the hygiene practice law, increased public awareness of dental
      needs, and economic depression may also have affected compliance. This
      information suggests that noncompliance can be reduced if the problem is
      recognized and efforts are made to increase compliance.

PMID- 8483096
TI  - Thick free gingival and connective tissue autografts for root coverage.
AB  - Studies have shown partial to complete root coverage of denuded root surfaces
      with the use of thick free gingival autografts (FGGs) or subepithelial connective
      tissue autografts (CTGs). The purpose of this study was to determine which
      technique would result in more predictable root coverage of Miller Class I and II
      marginal tissue recession defects. Paired defects in 10 patients were randomly
      selected for treatment with either the FGG or the CTG. With stents as reference
      points, soft tissue recession was measured with a calibrated probe presurgically
      and 3 and 6 months postsurgically. No significant differences between paired
      sites in presurgical defect dimensions were found. One patient was dropped from
      the study for noncompliance with postoperative instructions. The mean percentage
      of root coverage for the CTG 3 and 6 months postsurgery for the remaining 9
      patients was 78% and 80%, respectively. The mean percentage of root coverage for
      the FGG was 43% at both periods. The difference in root coverage between the 2
      techniques was significant (P < 0.03). Complete root coverage was gained in 5 of
      9 CTGs but only in one of 9 FGGs. Both techniques resulted in a significant
      improvement in keratinized tissue and probing attachment level, with most of the
      changes having occurred during the first three months postoperatively. Results
      suggest that the CTG may provide a greater percentage of root coverage than the
      FGG and that both techniques will effectively increase the width of keratinized
      tissue.

PMID- 8483097
TI  - [Efforts toward the formulation of the therapeutic stereoisomer of ibuprofen].
AB  - In an on going effort to optimize ibuprofen antiinflammatory therapy, development
      studies on the active stereoisomer of ibuprofen have been conducted. The effects
      of pharmaceutical processing on the racemate (RAC-ibuprofen) and the enantiomer
      (S(+)-ibuprofen) were investigated. The formulation of the new stereospecific
      system, was impossible using wet granulation. The pharmaceutical development of
      S(+)-ibuprofen using direct compression appeared as a practical solution to this
      problem. The biopharmaceutical properties of the resulting tablets were well
      within pharmacopeia requirements. Nevertheless, mixing S(+)-ibuprofen with the
      excipients induced a drop in the enthalpy of fusion and after compaction, a low
      temperature eutectic appeared on the differential scanning calorimetry
      endotherms. Aging studies indicated that the raw material and pharmaceutical
      mixtures of S(+)-ibuprofen should be stored under strictly controlled conditions
      or processed immediately.

PMID- 8483098
TI  - A contribution to the structure-activity relationship in glutamate receptor
      ligands: 1. omega-Aminophosphonic acids do not antagonize NMDA receptors.
AB  - Pharmacological properties of a series of alpha, omega-diamino-omega
      phosphonocarboxylic acids and alpha, omega-diamino-alpha, omega-bis(phosphonic
      acids) on different excitatory amino acids mediated responses have been tested in
      CA1 rat hippocampal neurones, using intracellular recordings and current and
      voltage clamp techniques. In contrast with known antagonists as D(-)2-amino-5
      phosphonopentanoic acid (AP-5) and 2-amino-4-oxo-5-phosphonopentanoic acid, which
      completely abolished the NMDA-response, no antagonistic activity was found. We
      conclude that the introduction of an omega-amino function abolishes the NMDA
      antagonistic activity of alpha-amino-omega-phosphonocarboxylic acids.

PMID- 8483099
TI  - A contribution to the structure-activity relationship in glutamate receptor
      ligands: 2. Characterization of 2-amino-4-oxo-5-pentanoic acid as NMDA receptor
      antagonist.
AB  - Pharmacological properties of 2-amino-4-oxo-5-phosphonopentanoic acid (AOPA) on
      excitatory amino acids mediated responses have been tested in CA1 rat hippocampal
      neurones, using intracellular recordings and current and voltage clamp
      techniques. These properties were compared with those of the well-known NMDA
      antagonist, D(-)2-amino-5-phosphonopentanoic acid (AP-5). AOPA completely
      abolished the response to NMDA but had no effects on the responses to AMPA,
      quisqualate and kainate. In voltage clamp experiments AOPA antagonized NMDA
      induced currents and produced a parallel shift of the NMDA concentration-response
      curve. Schild analysis gave a Kd value of 26 microM. AP-5 also produced a similar
      shift in this curve with a Kd of 6.9 mu.

PMID- 8483100
TI  - The effects of the tabletting machine speed on physical characteristics of
      pharmaceutical powders.
AB  - During compaction, crystallised materials are subjected to fragmentation which
      depends not only on the deformation undergone but also on the punch speed of the
      tabletting machine. Then, this process is followed by reagglomeration of the
      ground particles which also depends on the punch speed. Likewise, it was shown
      that materials with a relatively low specific heat such as Emcompress and
      acetylsalicylic acid are more sensitive to machine speed than boric acid or
      sodium chloride. From the present study it appears that tablet hardness is not a
      sufficient criterion to guarantee the reproducibility of a production batch.

PMID- 8483102
TI  - [Reactions and interactions of drugs].

PMID- 8483101
TI  - [Some factors influencing the bioavailability of zinc in oral pharmaceutical
      dosage forms].
AB  - Absorption and distribution of zinc in 6 dosage forms were determined in 10
      subjects by performing a pharmacokinetic study of the serum zinc profile after
      oral administration of a dose corresponding to 45 mg elemental zinc. The aim of
      this study was to document the influence on zinc bioavailability of factors such
      as the chemical form of zinc, the pharmaceutical form, and the division of the
      administered dose. The pharmacokinetic parameters indicate for gelatin capsules
      without excipients taken in a non divided dose better performances for zinc
      gluconate in comparison to zinc sulfate. Concerning the pharmaceutical form,
      little difference is observed between an aqueous solution and a gelatin capsule
      for zinc sulfate and a non divided dose; on the contrary, a commercial gelatin
      capsule containing zinc gluconate with various excipients show better
      performances than gastro-resistant tablets when zinc intake is 3 times 15 mg.
      Finally, the division in 3 parts of the dose of zinc sulfate given in gelatin
      capsules very significantly improves zinc absorption. These results demonstrate
      the interest of the developed pharmacokinetic method in the assessment of zinc
      bioavailability in different pharmaceutical dosage forms.

PMID- 8483103
TI  - The immunoneuroendocrine role of melatonin.
AB  - A tight, physiological link between the pineal gland and the immune system is
      emerging from a series of experimental studies. This link might reflect the
      evolutionary connection between self-recognition and reproduction. Pinealectomy
      or other experimental methods which inhibit melatonin synthesis and secretion
      induce a state of immunodepression which is counteracted by melatonin. In
      general, melatonin seems to have an immunoenhancing effect that is particularly
      apparent in immunodepressive states. The negative effect of acute stress or
      immunosuppressive pharmacological treatments on various immune parameters are
      counteracted by melatonin. It seems important to note that one of the main
      targets of melatonin is the thymus, i.e., the central organ of the immune system.
      The clinical use of melatonin as an immunotherapeutic agent seems promising in
      primary and secondary immunodeficiencies as well as in cancer immunotherapy. The
      immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived
      opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones.
      Melatonin-induced-immuno-opioids (MIIO) and lymphokines imply the presence of
      specific binding sites or melatonin receptors on cells of the immune system. On
      the other hand, lymphokines such as gamma-interferon and interleukin-2 as well as
      thymic hormones can modulate the synthesis of melatonin in the pineal gland. The
      pineal gland might thus be viewed as the crux of a sophisticated
      immunoneuroendocrine network which functions as an unconscious, diffuse sensory
      organ.

PMID- 8483104
TI  - Antiproliferative effect of pineal indoles on cultured tumor cell lines.
AB  - The in vitro antiproliferative action of pineal indoles on several tumor cell
      lines including melanoma (B16), sarcoma (S180), macrophage-like cell line (PU5),
      fibroblasts (3T3), and choriocarcinoma (JAr) was examined by measuring the
      incorporation of 3H-thymidine by the tumor cells, and, in the case of melanoma
      cells, by also measuring the incorporation of 3H-leucine and 3H-uridine. Uptake
      of crystal violet was used to assess the viability of the tumor cells. The order
      of inhibitory potency of the indoles was found to be methoxytryptamine >
      melatonin, methoxytryptophol, hydroxytryptophol, and methoxyindoleacetic acid >
      serotonin and hydroxyindoleacetic acid. The possibility of an adverse effect of
      the indoles on the viability of normal cells was also investigated by employing a
      primary culture of rat hepatocytes. The release of glutamate-oxaloacetate
      transaminase by hepatocytes was not affected by the indoles, although the release
      of glutamate-pyruvate transaminase was increased to a small extent and the uptake
      of crystal violet was slightly inhibited.

PMID- 8483105
TI  - The role of the pineal in the control of the daily patterns of neurohypophysial
      hormone secretion.
AB  - Plasma concentrations of neurohypophysial hormones show clear rhythms over 24 hr
      which can be suppressed by exposure to constant light, an observation consistent
      with pineal involvement. A study has therefore been performed on the changes in
      the hormone levels in the hypothalamus, posterior pituitary, and plasma over 24
      hr in control, pinealectomised, and sham pinealectomised animals to determine if
      the pineal could play a role. Water intake, urine excretion, packed cell volume,
      plasma osmolality, and electrolytes were also monitored. Pinealectomy had little
      effect on fluid balance, but after 8 weeks for oxytocin and 2 weeks for
      vasopressin the morning values (0700-0800) for the circulating concentrations of
      the hormones were significantly higher in the pinealectomized group compared with
      the combined sham operated and unoperated groups (pineal intact). By contrast,
      the pituitary vasopressin was significantly lower in the pinealectomised group.
      The increase in plasma oxytocin and vasopressin seen over the hours of daylight
      and accompanying fall in plasma osmolality seen in the pineal intact group were
      absent in the pinealectomised group. Similarly, the evening fall in pituitary
      hormone concentrations and increase in hypothalamic hormone content were absent
      in the pinealectomised animals. After 10 days of exposure to constant light, the
      fall in plasma osmolality in the pineal-intact animals over the day was no longer
      significant; instead a significant increase in plasma osmolality and sodium was
      seen in the pinealectomised group. Exposure to constant light, while altering the
      patterns of neurohypophysial activity in the pineal intact group, had little
      effect on the pinealectomised animals.

PMID- 8483106
TI  - A new aspect of tolbutamide metabolism in the rabbit: the role of 1-butyl-3-(p
      formylphenyl)sulphonylurea.
AB  - We investigated the metabolism of tolbutamide by using synthetic 1-butyl-3-(p
      formylphenyl)sulphonylurea (ATB), an intermediate in the metabolic pathway of
      tolbutamide. ATB (40 mg kg-1) administered intravenously to rabbits was oxidized
      to 1-butyl-3-(p-carboxyphenyl)sulphonylurea (CTB) and also reduced to 1-butyl-3
      (p-hydroxymethylphenyl)sulphonylurea (HMTB). Therefore, it is likely that in the
      metabolism of tolbutamide, the oxidation of HMTB to ATB involved the reverse
      reaction, suggesting the reduction of ATB to HMTB. The oxidation of ATB to CTB
      was inhibited by disulfiram pretreatment. ATB was detected in the blood following
      intravenous administration of HMTB in rabbits pretreated with disulfiram. These
      results, confirm that ATB is an intermediate in the oxidative metabolism of
      tolbutamide in the rabbit.

PMID- 8483107
TI  - Pharmacokinetics and extracellular distribution to blood, brain, and muscle of
      alovudine (3'-fluorothymidine) and zidovudine in the rat studied by
      microdialysis.
AB  - Microdialysis was applied to sample the free drug concentration in the
      extracellular fluid in brain, muscle, and blood of rats given alovudine (n = 6)
      (3'-fluorothymidine) or zidovudine (n = 5) (25 mg/kg s.c.). Alovudine and
      zidovudine were analyzed by means of high performance liquid chromatography
      (HPLC) with UV detection. The assay for zidovudine was validated by a
      radioimmunoassay. In addition, the plasma protein binding of the drugs was
      measured by microdialysis in vitro. The concentrations attained in blood and
      muscle were similar for each drug, with a Cmax of 57 microM (blood) and 54 microM
      (muscle) for alovudine and 38 and 46 microM, respectively, for zidovudine. In
      contrast the Cmax in brain was 8 microM for alovudine and 4 microM for
      zidovudine. The peak concentration was attained 20-40 min after injection in
      blood and muscle and 40-60 min after injection in the brain. The half-lives of
      zidovudine in both blood and muscle were 37 min and in brain 69 min. For
      alovudine the corresponding half-lives were significantly longer: 61, 58, and 105
      min, respectively. The ratio of the AUC0-180 brain/blood was 0.257 for alovudine
      and 0.186 for zidovudine. The plasma protein binding of zidovudine was 10%, while
      alovudine was virtually unbound.

PMID- 8483108
TI  - A prospective study of HIV-seropositive asymptomatic women of childbearing age in
      a developing country.
AB  - An observational study of 140 HIV-seropositive asymptomatic women of childbearing
      age was conducted in Haiti from 1984 to 1992 as part of a larger natural history
      study. Forty-four women were pregnant or became pregnant during the study period.
      The progression to HIV-related disease, AIDS, and mortality from AIDS was
      compared in the pregnant and nonpregnant cohorts. The mean follow-up time was 44
      months. Overall, 32 of the 140 women (38%) developed AIDS, and 26 (19%) died from
      AIDS during the study period, with a cumulative AIDS incidence rate of 16% at 3
      years after study entry. There was a trend toward earlier manifestation of HIV
      related symptoms among the pregnant cohort, but no significant difference was
      observed in the rate of progression to AIDS or death between the pregnant and
      nonpregnant women.

PMID- 8483109
TI  - Functional status and well-being in a placebo-controlled trial of zidovudine in
      early symptomatic HIV infection.
AB  - To determine the effect of zidovudine on functional status and well-being in
      patients with early symptomatic human immunodeficiency virus (HIV) infection, 70
      subjects in a randomized, placebo-controlled trial (ACTG Protocol 016) were
      observed for 1 year using a brief quality-of-life questionnaire. Thirty-four
      subjects were assigned to placebo and 36 subjects to zidovudine, 200 mg orally
      every 4 h (1,200 mg daily). Functional status and well-being were measured every
      3 months using a 30-item self-administered questionnaire derived from health
      ratings from the Medical Outcomes Study. The mean changes from baseline for
      zidovudine versus placebo groups were compared using paired and two-sample t
      tests. Subjects receiving a placebo reported better quality of life compared to
      baseline than subjects receiving zidovudine at 24 weeks for all dimensions of
      well-being, including overall health, energy, mental health, health distress,
      pain, and quality of life. The difference between the two groups' changes from
      baseline for overall health was 11.5 points on a 100-point scale (p = 0.02), and
      11.1 points for energy (0.002). There were no differences between changes from
      baseline along various dimensions of functional status (physical, social, role,
      and cognitive function). At 52 weeks both groups reported worse overall health
      than at baseline, and changes in scores were more similar for the two groups.
      Although zidovudine has previously been demonstrated to delay progression of
      disease for patients with mildly symptomatic HIV infection, early in treatment
      the net effect of a 1,200 mg daily dose of zidovudine may diminish patients'
      subjective well-being.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483110
TI  - Disseminated Penicillium marneffei infection associated with human
      immunodeficiency virus: a report of two cases and a review of 35 published cases.
AB  - Penicillium marneffei, a dimorphic fungus that is endemic in southeast Asia,
      causes deep-seated infection in humans and rodents. About 20 cases have been
      reported among the local populations of China, Thailand, and Hong Kong, and 35
      cases have now been described in patients infected with the human
      immunodeficiency virus (HIV). We present a review of the literature and report
      two additional cases. Both immunocompromised and apparently immunocompetent hosts
      tend to develop disseminated, symptomatic infection. HIV-infected patients having
      travelled to southeast Asia and presenting with fever, skin lesions,
      hepatomegaly, adenopathies, or lung disease should be investigated for
      Penicillium marneffei infection. The diagnosis is based on the demonstration of
      the organism in clinical specimens. Treatment with amphotericin B or itraconazole
      is generally successful, but maintenance therapy is warranted for patients with
      an underlying immunodeficiency.

PMID- 8483111
TI  - Quality of life and health service use among HIV-infected patients with chronic
      diarrhea.
AB  - Health-related quality of life and the utilization of health resources are
      important components of the evaluation of patient outcome in HIV infection
      because medical problems are often progressive and debilitating, and treatment is
      palliative. We evaluated quality-of-life measures and resource utilization of
      patients with AIDS and/or CD4 lymphocytes < 200 who had symptoms of chronic
      diarrhea and compared them with similar patients with AIDS and/or CD4 lymphocytes
      < 200 without diarrheal symptoms. Annual charges were 50% higher for patients
      with chronic diarrhea ($24,567 versus $14,471 for the comparison group, p <
      0.01). Higher charges for the patients with diarrhea were a result of more
      physician visits and diagnostic testing. Quality-of-life scores were poor for all
      patients, but deterioration over the year in role functioning (social activity,
      daily living, energy, cognition) and general health was clearly evident (p <
      0.01) for the patients with chronic diarrhea. These patients also suffered
      significant work loss and reported greater need for assistance in the home. These
      data suggest that HIV-infected patients with diarrhea experience marked decreases
      in quality of life and that care for patients with chronic diarrhea is costly.
      Relatively little attention has been paid to this debilitating syndrome, and
      current treatment options rarely provide permanent relief. Research and
      innovation in this area are needed; an estimated 25-50% of HIV-positive
      individuals suffer from this symptom complex.

PMID- 8483112
TI  - HIV vaccine trials: some design issues including sample size calculation.
AB  - Anticipating the availability of one or more candidate HIV vaccines for efficacy
      testing in the next few years, public health agencies are now planning for the
      conduct of large-scale efficacy trials. We expect these trials to be randomized,
      double-blind, placebo-controlled studies with prevention of infection as the
      primary goal. We discuss in detail factors that influence sample size. Factors
      most influential are the incidence rate of HIV infection in the study population
      and the minimum efficacy at which a vaccine is still considered acceptable. The
      smaller either of these factors is, the larger the sample size will be. The
      desire to complete trials quickly, the gradual accrual of benefit from
      vaccination, the inaccuracies of assays to detect infection, the need to counsel
      participants to avoid exposure to HIV, and loss to follow-up all tend to drive up
      sample size. To illustrate, 83 subjects per study arm suffice to detect 90%
      efficacy in a population with a 7% annual risk of infection. This assumes a 3
      year study with accrual completed in 1 year, no loss to follow-up, and Types I
      and II error rates of 5 and 10%, respectively. In contrast, 4,254 subjects per
      arm are required to identify a 60% effective vaccine in a population with a 1%
      annual risk. The study is also shortened to 2 years, assumes a 5% annual loss to
      follow-up, and supposes that the full benefit of vaccination is achieved in 6
      months. The most realistic assumptions indicate that trials are very likely to
      require several thousand participants. Limitations of the proposed designs are
      also discussed.

PMID- 8483113
TI  - Low education as a possible risk factor for cognitive abnormalities in HIV-1:
      findings from the multicenter AIDS Cohort Study (MACS).
AB  - The present study reports new and unexpected results of cognitive abnormalities
      among human immunodeficiency virus type 1 (HIV-1) asymptomatic subjects in the
      Multicenter AIDS Cohort Study. The major purpose of our analyses is to estimate
      the separate and combined effects of serostatus and education level on the
      prevalence of cognitive abnormality. Cognitive "abnormality" was defined as
      performance that deviated > or = 2 SDs below the mean of the total seronegative
      group on at least one of the five neuropsychological screening tests (Grooved
      Pegboard, Verbal Fluency, Digit Span, Symbol Digit Modalities, Rey Auditory
      Verbal Learning). The predicted prevalence of cognitive abnormality was 38% in
      seropositive individuals with no more than 12 years of education, compared with <
      17% in the other education-serostatus groups. This interaction between education
      level and serostatus remained after controlling for the possible confounding
      effects of age, ethnicity, CD4 level, depression, prior drug history, and
      learning disability using logistic regression. To account for these findings, we
      suggest that low education might reflect an indirect index of lower reserve
      capacity (i.e., a risk factor) that lowers the threshold for neuropsychological
      abnormalities in cases of early HIV-1 infection.

PMID- 8483114
TI  - Private medical insurance among Philadelphia residents diagnosed with AIDS.
AB  - We used medical insurance information gathered on each Philadelphia resident with
      AIDS to examine time trends in private medical insurance at the time of
      diagnosis. The proportion of AIDS patients with private medical insurance
      decreased from 51.9% in July-December 1988 to 28.6% in July-December 1991. During
      the same time period, an increasing proportion of people diagnosed with AIDS were
      female, poor, members of minority groups, or abusers of injection drugs. A
      discrete multivariate model showed that the (point) prevalence of private medical
      insurance at AIDS diagnosis decreased significantly with time, even after
      adjustment for changes with time in the age, gender, race, estimated income,
      history of injection drug use, and history of homosexual contact of those who
      were affected with AIDS. Thus the decreasing prevalence of private medical
      insurance among people newly diagnosed with AIDS does not simply reflect changes
      in the demographic and behavioral characteristics of the people affected.

PMID- 8483115
TI  - A comparison of drug use and HIV infection risk behavior between injecting drug
      users currently in treatment, previously in treatment, and never in treatment.
AB  - We compared three groups of injecting drug users in a large cross-sectional study
      on HIV/AIDS and risk behaviors in Sydney, Australia, to determine what
      differences existed between those who had never been in treatment (n = 458), had
      previously been in treatment (n = 387), and were currently in treatment (n =
      367). Drug use for those currently in treatment was assessed during the last
      typical using month before treatment. Those previously and currently in treatment
      were similar in terms of drug use patterns and HIV risk-related injecting
      behaviors. Those never in treatment were younger, had a lower level of HIV risk
      related injecting behaviors, and reported lower drug use and less involvement in
      the drug subculture. There was little difference between the three groups on HIV
      risk-related sexual behaviors. These data suggest that those never in treatment
      are less dysfunctional and possibly less involved in drug-using careers, whereas
      there appears to be a close relationship between being previously and currently
      in treatment.

PMID- 8483116
TI  - HIV-1 HxBc2 strain encodes a truncated vpr gene product of 78 amino acids.

PMID- 8483117
TI  - Cutaneous ultrasound for evaluation of Kaposi's sarcoma.

PMID- 8483118
TI  - Recombinant human erythropoietin in the treatment of anemia in AIDS patients
      receiving concomitant amphotericin B and zidovudine.

PMID- 8483119
TI  - Serosurveillance of HIV infection at a neuropsychiatric center in south India.

PMID- 8483120
TI  - Preventing HIV spread in homo/bisexual men: how effective is it? Experience from
      the National Mandatory HIV Registry in Denmark.

PMID- 8483121
TI  - Repair of fractured porcelain restorations with composite bonded porcelain
      laminate contours.

PMID- 8483122
TI  - Restoring a calcified tooth with a cast pin-retained gold dome as support for a
      fixed prosthesis: a clinical report.

PMID- 8483123
TI  - Immediate rehabilitation after total glossectomy: a clinical report.
AB  - Rehabilitation has psychological and physical components. Planning and discussion
      with the surgeon and patient before surgery can often ease the impact of
      treatment and help to establish reasonable postoperative goals. When prior
      planning is not possible, the physical and psychological impact can be severe. In
      addition, consideration must be given to the needs of the primary postsurgical
      provider, in this case the spouse of 50 years. By allowing the wife to observe
      the procedures and keeping her fully informed of the desired outcome and goals,
      her psychological concerns were also addressed. Use of light-cured resin material
      can aid in providing definitive and rapid maxillofacial prosthetic treatment.

PMID- 8483124
TI  - Five-year study of all-porcelain veneer fixed partial dentures.
AB  - Improvements in enamel-dentinal bonding systems combined with the introduction of
      new ceramics have encouraged replacement of missing anterior teeth in specific
      patients with porcelain veneer fixed partial dentures. Metal substructures are
      not needed, and more natural tooth structure can be preserved because the
      preparation of abutments is conservative. Twelve porcelain veneer fixed partial
      dentures were monitored for 5 years, and fractures attributed to degradation of
      the gingival margins occurred in the veneer surface of the fixed partial
      dentures. The success rate of 75% was dependent on rigid patient selection
      criteria, strength of the major connectors, and precise adjustment of occlusion
      to prevent overloading. The failing margins were attributed to the degeneration,
      attrition, and deterioration of the composite resin cements. Despite these
      limitations, patients were extremely satisfied with the esthetics. Improvement in
      the mechanical properties of composite resin cement will ameliorate the prognosis
      with this approach.

PMID- 8483125
TI  - In vitro marginal leakage in varnished and lined amalgam restorations.
AB  - Black's class I classic cavity preparations were completed in 440 extracted,
      intact human premolars and restored with two silver amalgams and five different
      base materials with and without cavity varnish, which resulted in 20
      combinations. A standard fluorescent dye test was performed and the percentage of
      marginal leakage recorded after storage for 7 days, 3 months, and 1 year in 1%
      NaCl at 20 degrees C. The results were computed by use of a linear logistic
      statistical analysis with a critical level of statistical significance of p <
      0.05. Sealing improved with time and there was consistently better sealing in the
      first months without varnish, but after 1 year this was not significant. The low
      copper amalgam recorded better sealing than the high-copper amalgam. A calcium
      hydroxide base promoted sealing but base-free cavities performed second best.
      Sealing declined with 1 year if Dycal base was used. Zinc-containing bases
      exhibited poor sealing, even those containing tin. Base solubility can improve
      sealing in calcium-containing bases but not in zinc-containing bases.

PMID- 8483126
TI  - Effect of design of prefabricated post heads on core materials.
AB  - This study investigated post-core adaptation as it relates to core materials and
      post-head configuration. A total of 360 samples that consisted of three
      prefabricated post systems and three core materials of amalgam and composite
      resin of 1 and 3 mm post-head-covering thicknesses were made. Composite resin
      with a post-head covering of 3 mm was most resistant to compression, whereas
      amalgam was most resistant to retentive forces. The addition of titanium to
      composite resin as a reinforcement filler did not improve resistance to either
      compressive or tensile forces.

PMID- 8483127
TI  - Scanning electron microscope analysis of tooth enamel treated with rotary
      instruments and abrasives.
AB  - This study compared the effects of various rotary instruments and polishing
      agents on tooth enamel. Topographical features of enamel were studied at
      consecutive stages of polishing with photoanalysis of scanning electron
      micrographs. The results indicate that enamel modified by diamond burs may be
      polished to produce the smoothest surface with white finishing stones, Ceramist
      finishing points, and flour of pumice.

PMID- 8483128
TI  - A new device for blockout procedures in rotational path removable partial
      dentures.
AB  - The rationale of a rotation axis is discussed and on this basis a blockout device
      is designed for rotational path removable partial dentures. This device has three
      basic components, which are (1) the acrylic resin block, (2) the rotation axis,
      and (3) the functional part. In the blockout procedures for removable partial
      dentures with tilted mandibular molars, the rotation axis of the prosthesis is
      first localized by the blockout device. A knife edge, made of Duralay resin that
      corresponds to the survey lines of teeth to be used as supports, is constructed
      and is joined to the functional part of the blockout device. Blockout regions are
      determined by the rotational movement of the Duralay resin knife edge along the
      rotation axis of the blockout device. In addition to the function of blockout,
      the device can also be used to analyze diagnostic casts for critical undercuts.
      Internal and external types of blockout devices are also discussed.

PMID- 8483129
TI  - Minimizing biomechanical overload in implant prostheses: a computerized aid to
      design.
AB  - Implant-supported prostheses must be able to withstand the load capabilities of
      individual patients to overload them. The gold alloy screw in the Branemark
      system is by intention the weakest component. Therefore, if cantilever lengths
      can be designed so that occlusal forces distributed to individual fixtures are
      limited to the gold screws' ability to accept them, breakage-free performance may
      be assured. Models, such as that of Skalak, are capable of developing the
      required analytical processes to provide the information necessary to achieve
      this design. Unfortunately, the overt mathematical complexity of the Skalak model
      has militated against its routine use in the operatory. Its computational aspects
      are, however, eminently suited to computerization and indeed provide the basis
      for the computer program that is described in this article. This program is
      simple to apply clinically and, when used in conjunction with available load
      parameters of gold screw performance, can provide the clinician with a routine
      and scientific basis for rational implant prosthesis design.

PMID- 8483130
TI  - Evaluation of three impression techniques for osseointegrated oral implants.
AB  - The purpose of this in vitro investigation was to determine the accuracy of
      gypsum casts produced from impressions made with polyether, polyether and
      impression plaster, or polyether and acrylic resin for the fabrication of
      osseointegrated implant prostheses. Strain gauges were attached to a master
      framework to determine the passivity of fit of the framework to sample casts made
      by the three impression techniques. Strain values were statistically compared by
      one way analysis of variance and Duncan's multiple range test. A statistically
      significant difference was found between the three impression techniques tested
      (p < 0.05). The results of this investigation revealed that none of the
      impression techniques resulted in an absolutely passive framework fit. However,
      of the techniques tested, the polyether alone resulted in the closest duplication
      of the master cast.

PMID- 8483131
TI  - New surgical obturator prosthesis for hemimaxillectomy patients.
AB  - Many materials have been used to make immediate and intermediate obturator
      prostheses for the hemimaxillectomy patient. The weight of the obturator
      prosthesis is a major hindrance. A new thermoplastic material, Polysar, is
      described to create a hollow obturator extension for immediate and intermediate
      lightweight obturator prostheses.

PMID- 8483132
TI  - Influence of salivary levels of mutans streptococci on colonization of crown
      margins: a longitudinal study.
AB  - Initial colonization of mutans streptococci in 36 crown margins of 21 patients
      was studied. Before cementation, salivary concentrations of mutans streptococci
      and Lactobacillus sp, microorganisms associated with dental caries, were
      determined. Within 1 week 25% of the selected crown margins in subjects with low
      salivary levels of mutans streptococci and 89% in subjects with high salivary
      levels were colonized. High salivary counts of lactobacilli seemed to reflect
      conditions that enhanced the risk of colonization of mutans streptococci. The
      results suggest that, before cementation of fixed prosthodontics, measures should
      be taken to control the salivary concentrations of these organisms to reduce the
      susceptibility to recurrent caries.

PMID- 8483133
TI  - Custom characterization of the provisional restoration.
AB  - The fabrication of esthetic custom provisional restorations that provide optimum
      esthetics and function accomplished with minimal chairside time is described. The
      effects of mamelons, translucency, and incisal haloes are reproduced to mimic
      natural dentition. The technique is based on a provisional shell that is made in
      the laboratory and relined intraorally for a more precise fit. In addition, it
      can be characterized chairside to better satisfy the esthetic demands of the
      patient. The laboratory-processed shell allows us to attain optimal physical
      characteristics with auto-polymerizing methylmethacrylate resin.

PMID- 8483134
TI  - Engraved fixed restorations to facilitate identification in forensic dentistry.
AB  - A procedure for making accurate identification markings on metal crowns and fixed
      partial dentures with minimal cost is described. The markings can aid in
      identification of unknown bodies within a short period of time if this procedure
      becomes routine and is recognized by forensic odontologists.

PMID- 8483135
TI  - Make luster tabs for use in matching texture of porcelain surfaces.

PMID- 8483136
TI  - A technique to reposition dies on the working model during fixed prosthodontic
      procedures.

PMID- 8483137
TI  - An instrument for placing depth cuts in a full-contour wax-up.

PMID- 8483138
TI  - Expeditious delivery of full veneer crowns.

PMID- 8483139
TI  - Elimination of a food impaction problem in the posterior maxillary region.

PMID- 8483140
TI  - Removal of self threading pins from dentin with ultrasonics.

PMID- 8483141
TI  - A threaded ball for the survey of mounted casts.

PMID- 8483142
TI  - Vinyl polysiloxane flasking of an ocular prosthesis.

PMID- 8483143
TI  - The degree of zinc phosphate cement coverage of complete crown preparations and
      its effect on crown retention.

PMID- 8483144
TI  - [Spin-echo anatomy of the larynx in MRI at 1.5 T].
AB  - The larynges of 8 healthy and informed volunteers were studied with a
      superconductive MR unit at 1.5 T together with those of 10 patients with extra
      laryngeal pathologic conditions. The study was performed with round surface coils
      (5'') and with delicated sellar coils in the anterior neck. Slices were 5 mm
      thick, and acquired on the coronal, axial, and sagittal planes, with T1
      weighting; axial scans were repeated in the same locations with double echoes,
      with proton-density and T2-weighting. Five patients underwent additional scans
      after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar
      surface coils, on similar scanning planes and with similar pulse sequences to
      those described above; the larynx was removed, investigated with mammographic
      technique, and subsequently analyzed with thin CT slices and a high-resolution
      reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical
      sections were then compared with MR and CT scans, and the anatomical structures
      were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR
      anatomy of supporting laryngeal structures, the authors describe in detail the
      muscles, plicae, spaces and cavities which can be identified on the various
      planes, together with the changes in signal after Gd-DTPA.

PMID- 8483145
TI  - [Myocardial metastasis of bronchial carcinoma. Disclosed by x-ray computed
      tomography].
AB  - One case of cardiac metastasis of epidermoid carcinoma discovered with CT during
      the preoperative assessment is reported. The authors stress that the discovery of
      cardiac metastases in vivo is relatively infrequent. They emphasize the role of
      imaging, which allows ruling out the operation in these cases.

PMID- 8483146
TI  - [Colonic duplication disclosed in adults. A case].
AB  - We report about one case of asymptomatic duplication of the colon, which was
      diagnosed with a barium enema in an adult. This condition is rare, especially in
      the tubular form such as described in this case. The discussion is associated to
      a review of the literature.

PMID- 8483147
TI  - [Biliary cystadenocarcinoma. Apropos of a case].
AB  - Biliary cystadenocarcinoma is rare biliary ductal neoplasm, usually occurring in
      middle-aged women, which arises in a healthy liver, with a better prognostic than
      other malignant tumors of the liver. We report a new case documented by
      echography, CT scan and MR. Echography showed multiple heterogeneous and septate
      masses with fluid-fluid level and dilatation of the intra-hepatic biliary ducts.
      CT showed multilocular cystic masses with internal septa and papillary
      excrescences showing contrast enhancement and no calcification. MR displayed a
      rather intense and variable signal in some parts of the masses on T1 weighted
      images, flasching on T2 weighted images, corresponding to a hemorrhagic fluid,
      confirmed by surgery. On T1 weighted images after gadolinium administration, the
      masses were less well visualized.

PMID- 8483148
TI  - [The tibial slope. Proposal for a measurement method].
AB  - The posterior inclination of the tibial plateaus relative to the longitudinal
      axis of the bone, also called tibial slope, is important to know for the
      pathology of the cruciate ligaments and to lay some knee prostheses. We have
      chosen a reproducible method to measure it, on the basis of a large radiograph of
      the lower limb. A radio-anatomical analysis of the morphology of the tibia has
      first been carried out to properly choose axes that are easy to find and useful
      in practice. The accuracy of the measurement is to within one degree. In adults,
      the slope ranges from 0 to 18 degrees, according to the subjects, with variations
      form one knee to the other.

PMID- 8483149
TI  - [Adamantinoma of the tibia. X-ray computed tomographic and MRI study. Apropos of
      a case].
AB  - Adamantinoma of the long bones in a very rare tumor that mainly affects the
      tibia. Its diagnosis is difficult both radiologically, as the lesion appears as a
      poorly specific metaphyseal lacuna with or without periosteal reaction, and
      histologically. Its prognosis used to be guarded because of recurrence and of
      possible metastatic diffusion, but it has been considerably improved by wide
      resection with reconstruction. On the occasion of a new case, the authors
      describe the appearance observed with MRI and the merits of this examination for
      the preoperative assessment.

PMID- 8483150
TI  - [MRI in the pre-operative evaluation of lesions of the rotator cuff].
AB  - The authors report a series of 38 patients who had been examined by MRI and then
      operated for a rotator cuff syndrome. The correlation between the description of
      the cuff lesions after MRI and the surgical observations were excellent for 37
      patients. In one case MRI showed a false image of tear of the supra spinatus m.
      on its anterior edge. This was due to a bad knowledge of the anatomy of the
      muscle and tendon and to a poor orientation of the frontal cut plane. This study
      was complete with MRI and anatomic study of 12 non embalmed cadaveric shoulders.
      The results showed that MRI was very sensitive (0.93) and specific (0.94) for the
      diagnosis of rotator cuff tears. MRI allowed also to show partial tears of the
      tendons of the rotator cuff. The authors propose a MRI classification of cuff
      lesions which permits to establish a good surgical planning.

PMID- 8483151
TI  - [Postero-superior glenoid impingement. Another impingement of the shoulder].
AB  - An impingement occurring between the deep side of the supraspinatus tendon and
      the postero-superior edge of the glenoid cavity was evidenced in a young sports
      thrower presenting with a partial tear of the deep side of the tendon. This
      impingement occurred when the arm was in abduction-retropulsion and in forced
      lateral rotation. It was visualized on arthroscopy. The semiology was mixed,
      including signs of anterior instability and cuff impairment. The possible causes
      of partial tears of the deep side of the supraspinatus are discussed: sub
      acromial impingement of NEER, anterior instability with secondary impingement,
      postero-superior glenoid impingement.

PMID- 8483152
TI  - [Acute bilateral parotitis. Isolated prodrome to anaphylactoid shock following
      injection of iodinated contrast media].
AB  - We report a peculiar case of radiocontrast induced anaphylactoid shock following
      an intravenous pyelography, which was announced by an hyperacute bilateral
      parotid enlargement as the sole prodrome. From a review of the literature, two
      clinical presentation of iodide-induced sialadenitis are individualized according
      to their pathogenesis. In patients with normally functioning kidneys, the
      occurrence of a sialadenitis after a short delay (5 minutes to 24 hours) evokes
      an anaphylactoid mechanism. In patients with renal function impairment, the role
      played by extrarenal excretory pathways of iodinated compounds and especially the
      salivary glands, results in a delayed onset (1 to 5 days) of the sialadenitis due
      to an effect of toxicity.

PMID- 8483153
TI  - [Consensus Conference. Acute cerebral ischemia in adults. Study strategies.
      Palais des Congres. 1992 November 2 and 3].

PMID- 8483154
TI  - Aplastic crisis due to human parvovirus (B19) as an initial presentation of
      hereditary spherocytosis.

PMID- 8483155
TI  - Case records of the University of Mississippi Medical Center. Adenocarcinoma of
      the pancreas.

PMID- 8483156
TI  - Reform revisited.

PMID- 8483157
TI  - Waiting for the windfall.

PMID- 8483158
TI  - Relationship between G + C in silent sites of codons and amino acid composition
      of human proteins.
AB  - We have investigated the relationship between the G + C content of silent
      (synonymous) sites in codons and the amino acid composition of encoded proteins
      for approximately 1,600 human genes. There are positive correlations between
      silent site G + C and the proportions of codons for Arg, Pro, Ala, Trp, His, Gln,
      and Leu and negative ones for Tyr, Phe, Asn, Ile, Lys, Asp, Thr, and Glu. The
      median proteins coded by groups of genes that differ in silent-site G + C content
      also differ in amino acid composition, as do some proteins coded by homologous
      genes. The pattern of compositional change can be largely explained by
      directional mutation pressure, the genetic code, and differences in the
      frequencies of accepted amino acid substitutions; the shifts in protein
      composition are likely to be selectively neutral.

PMID- 8483159
TI  - Characterization of the length polymorphism in the A + T-rich region of the
      Drosophila obscura group species.
AB  - In the twelve Drosophila obscura group species studied, belonging to the affinis,
      obscura, and pseudoobscura subgroups, the mitochondrial DNA length ranges from
      15.8 to 17.2 kb. This length polymorphism is mainly due to insertions/deletions
      in the variable region of the A + T-rich region. In addition, one species (D.
      tristis) possess a tandem duplication of a 470-bp fragment that contains the
      replication origin. The same duplication has occurred at least twice in the
      Drosophila evolutionary history due to the fact that the repetition is analogous
      to repetitions found in the four species of the D. melanogaster complex. By
      comparing the nucleotide sequence of the conserved region in D. ambigua, D.
      obscura, D. yakuba, D. teissieri, and D. virilis, we show the presence of a
      secondary structure, likely implied in the replication origin, which could favor
      the generation of this kind of duplications. Finally, we propose that the high A
      and T content in the variable region of the A + T-rich region favors the
      formation of less-stable secondary structures, which could explain the generation
      of minor insertion/deletions found in this region.

PMID- 8483160
TI  - The product of the Drosophila melanogaster segment polarity gene armadillo is
      highly conserved in sequence and expression in the housefly Musca domestica.
AB  - Segmental pattern in Drosophila melanogaster is set up via a set of cell-cell
      interactions mediated by the products of the segment polarity genes. Among these
      is the armadillo gene, whose product seems to be required for the reception of an
      intercellular signal encoded by the wingless gene. As part of our effort to
      relate the structure of the armadillo protein to its function within the cell, we
      have examined the evolutionary conservation of the armadillo gene during insect
      evolution. We have cloned the armadillo gene from the housefly, Musca domestica,
      which diverged from Drosophila 100 million years ago. The Musca protein is 97.5%
      identical to that in Drosophila, while the noncoding sequences have diverged
      extensively. This remarkable degree of conservation at the protein level is
      mirrored in the expression pattern of the armadillo protein. Antibodies against
      the Drosophila protein cross-react with a Musca protein of the appropriate size.
      We have also used these antibodies to show that the Musca armadillo protein has a
      pattern of expression in larval and adult tissues similar to that of Drosophila
      armadillo. We discuss the implications of conservation of structure and
      expression for the cellular role of the armadillo protein and its mammalian
      homologs.

PMID- 8483161
TI  - Functional conservation of a glucose-repressible amylase gene promoter from
      Drosophila virilis in Drosophila melanogaster.
AB  - Previous studies have demonstrated that the expression of the alpha-amylase gene
      is repressed by dietary glucose in Drosophila melanogaster. Here, we show that
      the alpha-amylase gene of a distantly related species, D. virilis, is also
      subject to glucose repression. Moreover, the cloned amylase gene of D. virilis is
      shown to be glucose repressible when it is transiently expressed in D.
      melanogaster larvae. This cross-species, functional conservation is mediated by a
      330-bp promoter region of the D. virilis amylase gene. These results indicate
      that the promoter elements required for glucose repression are conserved between
      distantly related Drosophila species. A sequence comparison between the amylase
      genes of D. virilis and D. melanogaster shows that the promoter sequences diverge
      to a much greater degree than the coding sequences. The amylase promoters of the
      two species do, however, share small clusters of sequence similarity, suggesting
      that these conserved cis-acting elements are sufficient to control the glucose
      regulated expression of the amylase gene in the genus Drosophila.

PMID- 8483162
TI  - Nucleotide divergence of the rp49 gene region between Drosophila melanogaster and
      two species of the Obscura group of Drosophila.
AB  - A 2.1-kb SstI fragment including the rp49 gene and the 3' end of the delta
      serendipity gene has been cloned and sequenced in Drosophila pseudoobscura. rp49
      maps at region 62 on the tip of chromosome II of this species. Both the coding
      and flanking regions have been aligned and compared with those of D. subobscura.
      There is no evidence for heterogeneity in the rate of silent substitution between
      the rp49 coding region and the rate of substitutions in flanking regions, the
      overall silent divergence per site being 0.19. Noncoding regions also differ
      between both species by different insertions/deletions, some of which are related
      to repeated sequences. The rp49 region of D. pseudoobscura shows a strong codon
      bias similar to those of D. subobscura and D. melanogaster. Comparison of the
      rates of silent (Ks) and nonsilent (Ka) substitutions of the rp49 gene and other
      genes completely sequenced in D. pseudoobscura and D. melanogaster confirms
      previous results indicating that rp49 is evolving slowly both at silent and
      nonsilent sites. According to the data for the rp49 region, D. pseudoobscura and
      D. subobscura lineages would have diverged some 9 Myr ago, if one assumes a
      divergence time of 30 Myr for the melanogaster and obscura groups.

PMID- 8483163
TI  - Adaptive evolution in the rat olfactory receptor gene family.
AB  - Comparison of DNA sequences of the rat (Rattus norvegicus) olfactory receptor
      gene family revealed an unusual pattern of nucleotide substitution in the gene
      region encoding the second extracellular domain (E2) of the protein. In this
      domain, nonsynonymous nucleotide differences between members of this subfamily
      that caused a change in amino acid residue polarity were over four times more
      frequent than nonsynonymous differences that did not cause a polarity change.
      This nonrandom pattern of nucleotide substitution is evidence of past directional
      selection favoring diversification of the E2 domain among members of this
      subfamily. This in turn suggests that E2 may play some important role in the
      functions unique to each member of the olfactory receptor family, and that it may
      perhaps be an odorant binding domain.

PMID- 8483164
TI  - Evolution of avian metallothionein: DNA sequence analyses of the turkey
      metallothionein gene and metallothionein cDNAs from pheasant and quail.
AB  - The turkey metallothionein gene (tkMT) was isolated from a phage lambda-turkey
      genomic DNA library by virtue of high identity with chicken MT cDNA. The
      nucleotide sequences of the proximal 240 bp of the 5'-flanking region, of each of
      the three exons, and of the intron/exon boundaries were determined. Comparisons
      of the nucleotide sequences of the tkMT and cMT genes revealed (1) absolute
      conservation of intronic DNA immediately flanking each respective intron/exon
      boundary, (2) high conservation (95.6%) of exonic DNA encoding translated regions
      of the mRNA, and (3) high conservation (95%) of exonic DNA encompassing the
      putative transcription start point and polyadenylation signals. Sequence
      comparisons of the tkMT and cMT promoters regions near the TATA box revealed that
      both promoters contain a highly conserved proximal metal-responsive enhancer (MRE
      enhancer) motif. The deduced amino acid sequence (63 amino acids) of tkMT was
      identical with that of cMT. In order to further explore the degree of
      conservation of the protein coding regions of avian MT genes, partial MT cDNAs
      from turkey, quail (qMT), and pheasant (pMT) were amplified using the reverse
      transcriptase-polymerase chain reaction (RT-PCR) and primers corresponding to the
      amino- and carboxyl-terminal coding regions of cMT mRNA. RT-PCR reaction products
      were cloned and the DNA sequences of multiple cDNA clones from each species were
      determined. The results suggest the existence of a single MT mRNA in zinc-treated
      liver from turkey and pheasant and the existence of a major and possibly a minor
      MT mRNA in quail.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483165
TI  - Tempo and mode of mitochondrial DNA evolution in vertebrates at the amino acid
      sequence level: rapid evolution in warm-blooded vertebrates.
AB  - By using complete sequence data of mitochondrial DNAs, three Markov models
      (Dayhoff, Proportional, and Poisson models) for amino acid substitutions during
      evolution were applied in maximum likelihood analyses of mitochondrially encoded
      proteins to estimate a phylogenetic tree depicting human, cow, whale, and murids
      (mouse and rat), with chicken, frog, and carp as outgroups. A cow/whale clade was
      confirmed with a more than 99.8% confidence level by any of the three models, but
      the branching order among human, murids, and the cow/whale clade remained
      uncertain. It turned out that the Dayhoff model is by far the most appropriate
      model among the alternatives in approximating the amino acid substitutions of
      mitochondrially encoded proteins, which is consistent with a previous analysis of
      a more limited data set. It was shown that the substitution rate of
      mitochondrially encoded proteins has increased in the order of fishes,
      amphibians, birds, and mammals and that the rate in mammals is at least six
      times, probably an order of magnitude, higher than that in fishes. The higher
      evolutionary rate in birds and mammals than in amphibians and fishes was
      attributed to relaxation of selective constraints operating on proteins in warm
      blooded vertebrates and to high mutation rate of bird and mammalian mitochondrial
      DNAs.

PMID- 8483166
TI  - A protein alignment scoring system sensitive at all evolutionary distances.
AB  - Protein sequence alignments generally are constructed with the aid of a
      "substitution matrix" that specifies a score for aligning each pair of amino
      acids. Assuming a simple random protein model, it can be shown that any such
      matrix, when used for evaluating variable-length local alignments, is implicitly
      a "log-odds" matrix, with a specific probability distribution for amino acid
      pairs to which it is uniquely tailored. Given a model of protein evolution from
      which such distributions may be derived, a substitution matrix adapted to
      detecting relationships at any chosen evolutionary distance can be constructed.
      Because in a database search it generally is not known a priori what evolutionary
      distances will characterize the similarities found, it is necessary to employ an
      appropriate range of matrices in order not to overlook potential homologies. This
      paper formalizes this concept by defining a scoring system that is sensitive at
      all detectable evolutionary distances. The statistical behavior of this scoring
      system is analyzed, and it is shown that for a typical protein database search,
      estimating the originally unknown evolutionary distance appropriate to each
      alignment costs slightly over two bits of information, or somewhat less than a
      factor of five in statistical significance. A much greater cost may be incurred,
      however, if only a single substitution matrix, corresponding to the wrong
      evolutionary distance, is employed.

PMID- 8483167
TI  - Pediatric coefficients for TRISS analysis.
AB  - We computed regression coefficients for TRISS analysis for all 4271 pediatric
      patients (aged 1 through 14 years) with complete data from the Major Trauma
      Outcome Study. We then compared predicted pediatric and adult TRISS survival
      probability norms. There were no statistically significant differences in the
      predicted and actual numbers of survivors using either norm. Differences in
      discrimination and reliability between the two norms were minimal. The study
      confirmed that the TRISS adult blunt norm is highly discriminating and reliable
      in predicting survival probabilities for pediatric patients. Given that both
      norms were equally good predictors, and the importance of a consistent system to
      evaluate trauma care, the authors recommend the continued use of the adult blunt
      trauma norm for estimating survival probability in children.

PMID- 8483168
TI  - Emergency department thoracotomy in children: rationale for selective
      application.
AB  - Although emergency department (ED) thoracotomy is performed only in selected
      adult trauma victims, it continues to be widely used in children. To evaluate if
      use of this liberal policy is justified in children, the charts of 23 pediatric
      trauma victims who underwent ED thoracotomy at our institution in the past 5
      years were reviewed. Mechanism of injury was blunt trauma in 65% and penetrating
      injury in 35%. Optimal field care was provided, with the majority (74%) of these
      patients having had intubation and vascular access achieved in the field and
      transported within 10 minutes to the trauma center. Thoracotomy and open cardiac
      massage were performed within 5 minutes of arrival in the ED. Despite this
      aggressive management, only one child (4.4%) survived to discharge, although
      transient restoration of spontaneous circulation (RSC) was achieved in four
      (17.4%) children. There were no survivors in the blunt trauma group. All patients
      with penetrating trauma who had no vital signs in the field died. The cost of ED
      thoracotomy was $2,740 +/- $214; however, the total hospitalization charges per
      patient averaged $14,848 +/- $1,724. Forty-six percent of total charges were
      reimbursed, and financial loss to the hospital per patient was $6,448 +/- $1,441.
      This study demonstrates that children who arrive at the ED following blunt or
      penetrating trauma with no cardiac rhythm are unsalvageable and should not
      undergo ED thoracotomy. The burden of unreimbursed care for this procedure is not
      trivial. Indications for ED thoracotomy in pediatric trauma victims should
      therefore be the same as those currently used for adult trauma victims.

PMID- 8483169
TI  - Thoracic trauma in children.
AB  - Thirty-seven children were admitted for the treatment of thoracic injuries during
      a 15-year period. Two thirds suffered blunt trauma. Of these children with blunt
      injuries, three quarters were male, with a median age of 6 years. Half of all
      victims of blunt trauma were between the ages of 4 and 6 years, and most were
      involved in motor vehicle crashes. Thirteen children (35%) were victims of
      penetrating trauma. Sixty-nine percent were male. The median age was 13 years,
      with 9 of 13 patients in their teenage years. Injuries were evenly distributed
      between stab and gunshot wounds. Eight of the 37 patients (22%) required
      thoracotomy. Fourteen had associated intra-abdominal injuries. Twelve of these
      patients had injuries that required exploratory laparotomy and two were managed
      expectantly. There were 27 patients with lung injuries, three quarters of whom
      were managed with tube thoracostomy alone. Seven children suffered injuries that
      resulted in their deaths. Six had been struck by a motor vehicle. Four of these
      six died of closed head injuries. The overall mortality of patients with blunt
      trauma was 25%.

PMID- 8483170
TI  - Survival determinants in patients undergoing emergency room thoracotomy for
      penetrating chest injury.
AB  - Survival determinants were examined in patients undergoing ERT-PCI who were
      admitted to the Surgical Intensive Care Unit (SICU) between January 1, 1982 and
      August 1, 1991. Twenty-one of 290 patients undergoing ERT-PCI (aged 14-36 years)
      were admitted to the SICU. Of the 21, nine survived to discharge with normal
      neurologic function. Four survived with neurologic impairment. Eight expired 1 to
      12 days after admission. The ERT was done immediately upon hospital arrival or
      subsequently in the Emergency Department for impending arrest despite
      resuscitation. All survivors had a pulse or blood pressure either in the field or
      upon arrival in the ER. Seven of nine who survived neurologically intact were
      awake on arrival in the ER, the other two were moving their extremities. One of
      four who survived with neurologic impairment was awake on arrival; three were
      comatose. Five of the eight who died were in full arrest in the field and upon
      arrival in the ER. Two of these patients were brain dead shortly after SICU
      arrival. All survivors had vital signs either in the field or on ER arrival.
      Patients with penetrating chest wounds without vital signs in the field who do
      not recover vital signs by hospital arrival do not benefit from emergency room
      thoracotomy. Evidence of mentation in the field or on arrival may predict
      ultimate neurologic outcome of survivors.

PMID- 8483171
TI  - Secondary survey following blunt trauma: a new role for abdominal CT scan.
AB  - Computerized tomographic (CT) scanning for blunt abdominal trauma has focused on
      initial emergency department evaluation. At our institution, CT scanning is often
      used on a delayed basis for unexplained drops in hematocrit, investigation of
      bony injuries, or subtle abdominal findings. We reviewed 268 such scans. Over 32
      months, 487 CT scans were done for 5258 blunt trauma admissions. Of these scans,
      268 (55%) were done 8-72 hours after admission on patients under observation.
      Scanning indications were a falling hematocrit (67%), associated injuries (28%),
      and abdominal tenderness (5%). Fifty of the 268 scans (19%) were positive for
      intra-abdominal abnormalities. Pleural effusions were seen in 82 (31%). Sixteen
      abdominal explorations were done. There was no difference in the pre-scan
      hematocrit drop in patients with normal scans (6.6%), positive scans (6.8%), and
      those who were explored (6.4%). There was one false positive (0.4%) and two false
      negative scans (0.8%). Conclusions. (1) A significant number of occult injuries,
      some life threatening, are detected by delayed CT scans. (2) Hematocrit drop
      under observation is not a good predictor of occult intra-abdominal injury. (3)
      Delayed CT scanning for occult abdominal injury is cost effective.

PMID- 8483172
TI  - The etiology of missed cervical spine injuries.
AB  - Missed or delayed diagnosis of cervical spine (C-spine) injuries may lead to
      extension of those injuries and subsequent preventable mortality or morbidity.
      Previous reports examining the incidence of missed C-spine injuries have not
      determined the nature of the causal clinical errors made or the extent to which
      these errors are avoidable. This study was undertaken to (1) determine the
      incidence of delayed or missed diagnosis of C-spine injuries and the consequences
      of those missed injuries; (2) define the clinical errors leading to the delays;
      and (3) to determine if these errors are the result of fundamental problems or a
      lack of advanced diagnostic skills or equipment. Between August 1985 and February
      1991, 32,117 trauma patients were admitted to one of the six trauma centers in
      San Diego county. Cervical spine injuries were identified in 740 patients and the
      diagnosis was delayed or missed in 34 patients (4.6%). Ten of the 34 patients
      (29%) developed permanent sequelae as a result of these delays. The single most
      common error was the failure to obtain an adequate series of C-spine
      roentgenograms. Delayed diagnosis could have been avoided in at least 31 of 34
      injuries by the appropriate use of a standard three-view C-spine series and
      careful interpretation of those roentgenograms. Patients at risk for C-spine
      injuries require a technically adequate three-view C-spine series and skilled
      radiographic interpretation. Cervical spine precautions should be maintained,
      particularly in high risk patients, until appropriate and expert review of the
      cervical spine roentgenograms can be obtained.

PMID- 8483173
TI  - Combined penetrating rectal and genitourinary injuries: a challenge in
      management.
AB  - The standard management of penetrating rectal trauma consists of perioperative
      antibiotics, a diverting colostomy, and presacral drainage. While providing
      optimal results in isolated rectal trauma, this management scheme is inadequate
      in combined penetrating rectal and genitourinary (GU) tract injuries. A review of
      more than 200 cases of penetrating rectal trauma from our institution over a 13
      year period identified 17 concomitant GU tract injuries (13 bladder, three
      urethral, and one ureteral injury). Complications consisted of pelvic,
      suprapubic, or subphrenic abscesses in 3 of 17 cases (18%), rectovesical or
      rectourethral fistulae in 24%, chronic urinary tract infections in 18%, bladder
      stones in 12%, and the development of urethral strictures in 12% of patients.
      Factors implicated in their pathogenesis included failure to perform presacral
      drainage, distal rectal washout, and rectal wound repair; prolonged suprapubic
      drainage; and failure to separate the rectal and GU tract wounds. Careful
      debridement of all necrotic tissue, urinary and fecal diversion, tension-free
      wound closure with well-vascularized tissue, and adequate drainage and separation
      of the injured sites with well-vascularized tissue such as omentum should reduce
      the high incidence of rectourethral and rectovesical fistulae from combined
      rectal-GU tract trauma. Therapeutic recommendations for individualized treatment
      are presented.

PMID- 8483174
TI  - Lidocaine versus diphenhydramine for anesthesia in the repair of minor
      lacerations.
AB  - This prospective study compared the effectiveness of 1% diphenhydramine with 1%
      lidocaine for local anesthesia in repair of minor skin lacerations in adults with
      simple linear lacerations treated at our Emergency Department. Wounds were
      anesthetized with either lidocaine or diphenhydramine according to a random
      numbers table. Ninety-nine patients were included in the final analysis (51
      received lidocaine; 48 diphenhydramine). Patients and physicians rated the pain
      of injection and suturing using a standard visual analog scale. Univariate and
      multivariate linear models were used on rank transformed scores of the patient
      and physician ratings of injection and suturing with p < 0.05 considered
      statistically significant. According to patient rating lidocaine was less painful
      for injection than diphenhydramine, with a statistically significant difference
      between the two anesthetics (p = 0.0017). There was no statistically significant
      difference in pain rating by physicians between the two anesthetics (p > 0.05).
      Pain with suturing was rated as minimal for both lidocaine and diphenhydramine
      with no statistically significant difference in the effectiveness according to
      either patients or physicians (p > 0.05). Lidocaine injection appears to hurt
      less than diphenhydramine injection according to the patients. Pain of suturing
      corresponding to anesthetic effectiveness appears to be equivalent for lidocaine
      and diphenhydramine according to both physicians and patients. Although
      diphenhydramine should not be substituted for lidocaine, it appears to be a
      viable alternative in the management of patients with allergy to amides or
      extremely large lacerations in which a maximum of amide anesthetic has been used.

PMID- 8483175
TI  - Infection in minor gunshot wounds.
AB  - Of the 3684 patients enrolled in our study, 3390 were available for follow-up, of
      which 62 patients developed wound infections related to minor gunshot wounds
      (1.8%). Of these patients, all sustained entry/exit-type wounds while 60% of
      these patients sustained more than one injury. Complications were more likely to
      occur when a prolonged period occurred between the time of injury and the initial
      treatment. The development of infection in minor gunshot wound injuries is an
      unusual occurrence when these injuries are limited to the soft tissue structures.
      Additionally, wound debridement and antibiotics are often unnecessary in minor
      uncomplicated gunshot wounds, but may be beneficial in patients who have
      sustained multiple injuries, gross wound contamination, significant tissue
      devitalization, large wounds, or delay in treatment.

PMID- 8483176
TI  - Baseball bat assault injuries.
AB  - The baseball bat, according to Baltimore City police crime statistics, is a
      commonly used weapon. To assess the severity of injuries inflicted by this modern
      day club, we retrospectively reviewed 75 charts of patients treated at the
      University of Maryland Medical Systems Hospital for baseball bat injuries from
      January 1990 through July 1991. Multisystem trauma was documented, with
      craniocerebral injury being the most frequent and the most frequent cause of
      death. Of the victims struck on the head, 26% sustained an intracranial
      hemorrhage. In our series, the history of loss of consciousness and the Glasgow
      Coma Scale score failed to reliably identify the patients with serious injuries.
      Seventeen percent of our patients with intracranial hemorrhages had both a
      negative or uncertain history of loss of consciousness and a normal Glasgow Coma
      Scale score on arrival.

PMID- 8483177
TI  - Outcome of arterial repairs in 23 consecutive patients at the ICRC-Peshawar
      hospital for war wounded.
AB  - Arterial injuries represent a formidable challenge to surgeons working in war
      zone conditions. A series of 23 consecutive patients with combat wounds from the
      Afghan conflict with acute arterial injury were treated at the ICRC hospital in
      Peshawar. The mean injury-treatment delay (lag time) was 34 hours, with 14 of the
      23 patients (60%) treated more than 12 hours after injury. The overall amputation
      rate was 65%, but only 22% for patients revascularized within 12 hours of injury
      and 93% for those undergoing surgery after 12 hours. This was a highly
      significant statistical difference (Chi-square > 13.0, p < 0.005). We recommend
      attempting revascularization procedures only in patients seen within 12 hours of
      sustaining a military-type injury to an artery in an extremity.

PMID- 8483178
TI  - The effect of secondary insults on mortality and long-term disability after
      severe head injury in a rural region without a trauma system.
AB  - Outcome after head injury appears to be adversely affected by secondary insults
      such as hypoxia or hypotension. Previous work examining the influence of these
      secondary insults on outcome has originated from urban environments with
      organized systems of trauma care. We hypothesized that secondary insults would be
      more frequent and that outcome of severe head injury would be worse in a rural
      region without a trauma system. To validate these hypotheses we retrospectively
      reviewed the course and outcome of all patients admitted to the Medical Center
      Hospital of Vermont with severe head injuries between 1980 and 1985. A cohort of
      170 patients was assigned to one of two groups: group I had neither hypotension
      nor hypoxia at the time of admission; group II had either hypotension or hypoxia
      at the time of admission. The groups were similar in terms of demographics,
      incidence of mass lesions, frequency of craniotomy, and incidence of intracranial
      hypertension. Only 23% of group II patients made a good recovery compared with
      56% of group I patients (p < 0.01). The mortality rate of group II patients was
      twice that of group I patients (66% vs. 33%; p < 0.01). When compared with data
      provided by the National Trauma Coma Data Bank from urban areas with trauma
      systems, there was no difference in outcome of patients similarly grouped
      according to the presence or absence of secondary insults between Vermont's rural
      cohort and the urban cohort. We conclude that hypotension and hypoxia adversely
      effect the outcome of severe head injury.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483179
TI  - Complete dislocation of the knee without disruption of both cruciate ligaments.
AB  - Complete dislocation of the knee is recognized to be an extremely severe injury,
      representing one of the few true orthopedic emergencies. There is major trauma to
      the ligaments, capsule, and tendons, with a high incidence of associated damage
      to the popliteal artery and peroneal nerve. Resulting disability can be great,
      reflected by pain, stiffness, or instability of the knee; neurologic deficits in
      the foot and ankle; and even amputation if the vascular injury is not addressed
      promptly. Most accounts of knee dislocations in the literature have suggested
      that disruption of both cruciate ligaments is necessary for a complete
      dislocation to occur. This consensus is based on clinical observations and some
      laboratory investigations of ligament failure patterns. This report presents four
      cases of complete tibiofemoral knee dislocation without disruption of both
      cruciate ligaments. We also review the literature on knee dislocations with an
      emphasis on the biomechanics of soft tissue restraints about the knee and analyze
      how sufficient laxity can occur, with one cruciate ligament remaining intact, to
      allow for complete knee dislocation.

PMID- 8483180
TI  - Treatment of large bone defects with the Ilizarov technique.
AB  - Between 1985 and 1990 we treated 11 large segmental bone defects (average 6.7 cm)
      in ten patients with the Ilizarov technique. Open fractures, type III according
      to Gustilo, represented the largest group (8 of 11 cases). The average delay
      before the Ilizarov technique was initiated was 8.9 months. The external fixator
      was usually maintained for 1 year. Bone regeneration was obtained in every case.
      Consolidation was not fulfilled with this technique in three cases. The
      complications observed were one refracture, four leg-length discrepancies
      (average 1.5 cm), and five axial deformities exceeding 5 degrees. No pin-track
      infection was observed. In our limited series of four type IIIC open fractures
      treated by the Ilizarov technique, no patients required amputation. The Ilizarov
      technique is particularly useful in the treatment of large bone defects, without
      major complications, especially if there is an adequate initial debridement.

PMID- 8483181
TI  - First experience and complications with the long Gamma nail.
AB  - Treatment of proximal femoral fractures is difficult. A retrospective analysis of
      92 patients treated with a custom-made extended gamma nail with a mean follow up
      of 4 months is presented. The early results of this new method are promising. The
      indications for the use of the long gamma nail were intertrochanteric fractures
      with extension to the subtrochanteric region, imminent and pathologic fractures
      of the intertrochanteric and subtrochanteric region, mostly in elderly patients,
      proximal femoral fractures, and combination injuries in multiple trauma patients
      and delayed unions. In 67 cases the patients were primarily treated with a long
      Gamma nail. In 25 cases the nail was used after the failure of initial treatment.
      Complications occurred in 32 patients; however, 88 patients were able to walk at
      the end of the study. The advantage of this new method is that with a closed
      surgical technique full weight bearing directly after the operation is achieved.
      The long Gamma nail provides a procedure by which most complex fractures in the
      proximal femur can be managed.

PMID- 8483182
TI  - Peripheral nerve elongation with tissue expansion techniques.
AB  - Elongation of peripheral nerves would facilitate the repair of peripheral nerve
      injuries. The purpose of this study was to determine the efficacy of nerve
      expansion and the effect of different levels of intraluminal expander pressure
      upon nerve conduction. A 2-mL Silastic expander was placed under one sciatic
      nerve of adult male rats. The other nerve served as a control.
      Electroneuromyography (ENMG) was done at the time of initial expansion in seven
      animals. At 40 mm Hg expansion pressure a significant change in latency was found
      with an increase of 17% +/- 5%. Expansion was carried out for 14 days in two
      groups of seven rats, group I at 20 mm Hg and group II at 40 mm Hg. Length gain
      on the expanded side was 30% in group I and 40% in group II. No significant
      changes in latency or velocity were found after expansion. We conclude that
      nerves can be expanded at low pressures with no significant conduction changes
      but long-term recovery of histologic changes needs to be evaluated.

PMID- 8483183
TI  - Vicryl mesh for repair of severely injured kidneys: an experimental study.
AB  - We evaluated the efficacy of wrapping the kidney with semi-elastic Vicryl mesh
      for control of hemorrhage and preservation of renal function following grade III
      kidney lacerations (shattered kidney) in dogs in which nephrectomy was indicated
      clinically. Wrapping of fragmented kidneys resulted in prompt, sustained
      hemostasis and reapposition of the renal parenchyma. At an average of 80 days
      after injury the renal lacerations were well healed. The Vicryl mesh had been
      fully reabsorbed and there was considerably less scar tissue at the site of
      parenchymal rupture and neither perirenal or intrarenal abscess nor hematoma was
      found, grossly or microscopically. Among 12 dogs with grade III kidney
      lacerations, the mean ratio of the effective renal plasma flow (ERPF) in the
      affected kidney to the ERPF in the uninjured contralateral kidney was 0.53 +/-
      0.22. The mean ratio of creatinine clearance of the injured kidney to that of the
      uninjured contralateral kidney was 0.41 +/- 0.23. Changes in the serum renin
      levels were not statistically significant following injury. Our results seem to
      confirm that simple and rapid surgical treatment of severely shattered kidneys
      using semi-elastic Vicryl mesh is possible. The method may also be suitable for
      uncontrollable bleeding during nonextirpative kidney surgery.

PMID- 8483184
TI  - A rabbit model of inhalation injury.
AB  - In the course of developing a model of inhalation injury, the relationship
      between the severity of pulmonary injury and specific techniques and doses of
      smoke exposure was examined in pairs of rabbits simultaneously exposed to smoke.
      In group I (5 pairs), one animal in each pair was exposed to smoke with a breath
      hold (BH) at the end of each exposure; the second animal received an exposure
      producing the same level of carboxyhemoglobin without BH. In group II (6 pairs),
      both animals were exposed to 25 units of smoke simultaneously, with BH. In group
      III (3 pairs), one animal received a 20-unit exposure and the other a 25-unit
      exposure, both with BH. In group IV, 9 animals received 25-unit exposures with BH
      and were observed for 4 days. Groups V and VI served as controls. Smoke exposure
      with BH regularly produced severe injury in terms of decreased PaO2 and
      histopathologic changes, while exposure without BH did not, despite high levels
      of carboxyhemoglobin after smoke inhalation. The mean differences in percent
      residual PaO2 (PaO2 at 48 hours x 100/pre-injury PaO2) and in extravascular lung
      water (EVLW) at 48 hours within pairs of animals receiving 25 units with BH were
      12.3% +/- 5.33%, and 0.271 +/- 0.157 mL/g, respectively. Histologic findings such
      as necrotic tracheobronchitis with pseudomembrane were consistently present. No
      differences were observed between animals receiving exposure of 20 and 25 units.
      During the 4 days of observation, three animals in group IV died. PaO2 was lowest
      on the second day and rose thereafter in all surviving animals except in one that
      had massive pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483185
TI  - Effect of thermal injury and sepsis on neutrophil function.
AB  - Burn injury and sepsis have been repeatedly demonstrated to impair the function
      of circulating (blood) neutrophils. As a result of the difficulty in harvesting
      and purifying neutrophils from the burn wound, there have been minimal
      investigations to date on the effect of burn injury and sepsis on the function of
      neutrophils which have reached the wound. We utilized a sponge matrix model in
      order to obtain neutrophils from burned and burned-infected rats. Despite having
      a higher concentration of neutrophils in the blood, both the burned and burned
      infected rats were noted to have a decreased number of neutrophils infiltrating
      the sponge compared with the controls (1.91 +/- 0.30 x 10(6), 2.31 +/- 0.47 x
      10(6), and 4.82 +/- 0.64 x 10(6) neutrophils per sponge, respectively). Blood
      neutrophils from both the burned and burned-infected rats had a greater
      chemiluminescence capacity than neutrophils from the control group (p < 0.0001).
      This enhanced capacity was not present with sponge neutrophils obtained from the
      burned-infected group. The diminished capacity may have been the result of a
      decreased concentration of prostaglandin E in the sponge fluid of the burned
      infected rats compared with that of the burned or control rats (52 +/- 9, 135 +/-
      15, and 114 +/- 13 pg/mL of sponge fluid, respectively).

PMID- 8483186
TI  - Comparison of intraosseous, central, and peripheral routes of crystalloid
      infusion for resuscitation of hemorrhagic shock in a swine model.
AB  - Venous access is often a clinical dilemma in severely hypovolemic children. This
      study compares fluid resuscitation by central vein, peripheral vein, and the
      intraosseous route in a hemorrhagic shock model. Hampshire piglets were bled to a
      mean arterial pressure of 30 mm Hg. This level of shock was sustained for 30
      minutes. Resuscitation was carried out with normal saline delivered at 50 mL/min
      by a manual pressure of 450-475 mm Hg over the ensuing 20 minutes. Bone marrow
      from two intraosseous-infused animals was harvested immediately after the study
      for histologic examination. The hemodynamic response to crystalloid resuscitation
      was comparable among the three groups. There was no significant difference in
      mean arterial pressure, central venous pressure, cardiac output, pulmonary
      capillary wedge pressure, mixed venous oxygen saturation, or arterial oxygen
      saturation. Histologically, cellular washout and necrosis were found in bone
      marrow immediately adjacent to the intraosseous needle infusion site. For fixed
      rate infusion, intraosseous crystalloid resuscitation is as efficacious as that
      delivered by peripheral or central venous routes in reversing hemorrhagic shock.

PMID- 8483187
TI  - Systemic fluoride toxicity in a child with hydrofluoric acid burns: case report.
AB  - We report the case of a 14-month-old child with hydrofluoric acid burns who
      suffered cardiac arrest in association with profound hypocalcemia and
      hyperfluoridemia. Successful treatment included topical, subeschar, and
      intravenous calcium gluconate administration.

PMID- 8483188
TI  - Hemobilia due to gallbladder contusion following blunt trauma--sonography and CT
      scanning for early detection: case report.
AB  - Gallbladder injury following blunt trauma is rare and early diagnosis is
      difficult when it is associated with other injuries. Clinical symptoms and signs
      alone are not necessarily helpful in diagnosing such cases. However, modern
      diagnostic imaging procedures such as ultrasonography and CT scanning are
      valuable for investigating possible gallbladder injuries. Patients with blunt
      trauma should be carefully examined by US and CT for early detection and
      treatment of gallbladder injuries.

PMID- 8483189
TI  - Gunshot wound to the area of a congenitally absent internal carotid artery: case
      report.
AB  - We present the case of a patient who sustained a gunshot wound in very close
      proximity to the left external carotid artery. The bullet was located exactly
      over the typical location of the internal carotid artery. Total agenesis of the
      internal carotid artery, a rare anomaly, was differentiated from thrombosis of
      the internal carotid artery.

PMID- 8483190
TI  - The post-cardiac injury syndrome following blunt chest trauma: case report.
AB  - The case of a 53-year-old man is reported in which the patient developed post
      cardiac injury syndrome 2 weeks after blunt trauma to the thorax. The patient
      failed to respond adequately to ibuprofen but improved on corticosteroids. He
      suffered relapses 8 and 15 months after the original injury following reductions
      in the corticosteroid dosage. The patient at last follow-up had been asymptomatic
      for over 4 years.

PMID- 8483191
TI  - Balloon tamponade for liver injuries: case report.
AB  - A tamponade device for control of refractory liver bleeding is occasionally
      indicated. This report documents to our knowledge the first reported use of Foley
      catheter balloon tamponade for severe liver injury.

PMID- 8483192
TI  - Upper extremity salvage with free ulnar forearm flap from the amputated part:
      case report.
AB  - Preservation of a functional level of amputation in cases of nonreplantable upper
      extremity amputation injury can be accomplished utilizing spare-parts technology.
      A case is presented in which a nonreplantable arm amputated at the mid-humeral
      level was used for a free ulnar forearm flap to preserve bone level and secure
      stable coverage.

PMID- 8483193
TI  - Herniation of the stomach into the pericardial sac combined with cardiac luxation
      caused by blunt trauma: a case report.
AB  - Cardiac luxation caused by blunt thoracic trauma carries a high mortality rate.
      We present a case of traumatic diaphragmatic rupture, in combination with
      herniation of the stomach into the pericardial sac, pericardial rupture, and
      cardiac luxation. The recent literature is reviewed and diagnostic difficulties
      and procedures are discussed.

PMID- 8483194
TI  - Combined severe myocardial and pulmonary contusion: early diagnosis with
      transesophageal echocardiography and management with high-frequency jet
      ventilation: case report.
AB  - We report the case of a 27-year-old patient with blunt thoracic trauma in whom
      transesophageal echocardiography enabled an early diagnosis of severe myocardial
      contusion. Conventional mechanical ventilation dramatically enhanced cardiogenic
      shock because of myocardial contusion, requiring increasing doses of
      catecholamine. High-frequency jet ventilation produced an immediate improvement
      in hemodynamic status, permitting a decrease in catecholamine administration.

PMID- 8483195
TI  - Simultaneous rupture of the patellar tendons bilaterally: case report and review
      of the literature.
AB  - Rupture of the patellar tendon is uncommon. In most cases the rupture occurs at
      the inferior border of the patella rather than through the midsubstance of the
      tendon. Bilateral ruptures are particularly rare and may occur sequentially or,
      as in the case reported here, simultaneously. Surgical repair is necessary to re
      establish the extensor mechanism and produces good results.

PMID- 8483196
TI  - Primary shortening followed by callus distraction for the treatment of a
      posttraumatic bone defect: case report.
AB  - The case of a 10-year-old boy is reported in which a 5-cm defect of the humerus
      sustained 2 months previously was treated by open reduction and external fixation
      followed by distraction beginning on the 20th day after surgery and continuing to
      the 40th day. The result was a 4-cm gain in length, with return of normal
      function and complete resolution of a concomitant radial nerve palsy.

PMID- 8483197
TI  - Rotatory dislocation of the second carpometacarpal joint: case report.
AB  - Isolated dorsal dislocation and rotatory dislocation of the second
      carpometacarpal joint is rare. A case of rotatory dislocation of this joint is
      presented, where reduction was blocked by entrapment of the extensor carpi
      radialis longus tendon in the joint. A roentgenographic technique for evaluating
      dislocation of carpometacarpal joints is also described.

PMID- 8483198
TI  - Inferior locking of the patella: a case report.
AB  - A 87-year-old woman with femoropatellar arthrosis sustained a fixed inferior
      traumatic locking of the patella with the knee in flexed position. After closed
      manipulation locking recurred and surgery was necessary to ensure smooth
      articulation.

PMID- 8483199
TI  - Computerized tomographic appearance of hernias of the bladder.
AB  - Herniation of the bladder is not uncommon and it can occur with any type of
      hernia in the groin. Most bladder hernias are discovered unexpectedly during
      herniorrhaphy, and serious complications can result from intraoperative injury to
      the bladder. The appearance of hernias on excretory urography and cystography has
      been described extensively but experience with computerized tomography (CT) has
      been limited. We describe the appearance of 8 bladder hernias on CT: 2
      incisional, 2 femoral, 3 small direct inguinal, and 1 massive direct inguinal
      hernia with bladder necrosis and perforation. Appearance on CT is characteristic,
      and this modality may be useful for preoperative evaluation.

PMID- 8483200
TI  - Oral methotrexate for superficial transitional cell carcinoma of the bladder.
AB  - A total of 22 patients with superficial transitional cell carcinoma of the
      bladder, uncontrolled cystoscopically and unsuitable for or having failed
      intravesical therapy, received 50 mg. oral methotrexate per week for 12 months.
      Of the patients 7 (32%) achieved or remained in complete remission and 5 achieved
      a partial response, while 4 remained stable, 3 had progression and 3 were not
      evaluable. Patients who were still alive had a median followup of 2.5 years. Two
      patients with complete remission had relapse at 16 and 26.4 months, and 5 were
      disease-free at 34.5, 31.3, 18.6, 17.8 and 16.8 months, respectively. The
      methotrexate was generally well tolerated but 2 patients discontinued therapy
      because of dyspnea (1 subsequently died of respiratory failure that was possibly
      related to the methotrexate) and 1 because of persistent grade 2 mucositis. Grade
      3/4 toxicities occurred in 3 patients: 1 each with reversible increases in
      creatinine and aspartate aminotransferase, and 1 with gastric bloating. There was
      little hematological toxicity. Reversible skin lesions developed in 4 patients.
      This oral treatment may provide an effective alternative to intravesical therapy
      but can be associated with severe toxicity.

PMID- 8483201
TI  - Late invasive recurrence despite long-term surveillance for superficial bladder
      cancer.
AB  - Superficial transitional cell carcinoma of the bladder is associated with a 15 to
      70% recurrence rate within 2 years. Most recurrences are superficial. A
      recurrence after 2 disease-free years is unusual. A review of the tumor registry
      revealed 124 patients followed for superficial disease at the Veterans
      Administration Center in Baltimore. Of the patients 20 were identified with
      either stage Ta (7) or stage T1 (13) papillary transitional cell carcinoma who
      had completed at least 5 years of surveillance without tumor recurrence. Invasive
      transitional cell carcinoma of the bladder requiring cystectomy developed in 7 of
      these 20 patients after remaining tumor-free for 5 years (stage Ta in 4 and stage
      T1 in 3). All 7 patients had organ-confined disease and were alive with no
      evidence of disease at 18 months to 5 years after cystectomy. These results
      demonstrate that superficial, low grade transitional cell carcinoma of the
      bladder can become muscle invasive despite careful surveillance and a long
      dormant period. In our series yearly cystoscopy and urine cytology identified
      tumor recurrence before metastases developed, suggesting that long-term
      surveillance is required in patients with superficial bladder cancer.

PMID- 8483202
TI  - Pubovaginal sling for treatment of female stress urinary incontinence complicated
      by urethral diverticulum.
AB  - To evaluate the practicality of combining urethral diverticulectomy with a
      procedure for stress urinary incontinence, the records of 14 patients who
      underwent urethrodiverticulectomy during a 3-year period were reviewed.
      Noteworthy was that 10 patients (71%) had urinary incontinence as the chief
      complaint, while 8 (57%) had symptoms of stress urinary incontinence and
      underwent fluoroscopic urodynamic testing and the others had post-void dribbling.
      Of the latter 8 patients 7 (50%) demonstrated type II or type III stress urinary
      incontinence and 1 had a normal study. The 7 women then underwent transvaginal
      diverticulectomy with a concomitant pubovaginal sling. Of the diverticula 4 (57%)
      were true diverticula and 3 (43%) appeared to be pseudodiverticula or traction
      diverticula related to a previous urethral suspension. At 3 to 21 months (mean
      17) all patients were cured of stress urinary incontinence. One patient exhibited
      detrusor instability postoperatively, which was ultimately treated with an
      Ingelman-Sundberg procedure. Postoperatively, 1 diverticulum recurred, for a
      recurrence rate of 14%. We conclude that the presence of a urethral diverticulum
      does not compromise successful repair of associated stress urinary incontinence
      when the pubovaginal sling procedure is used.

PMID- 8483203
TI  - Radical retropubic prostatectomy and postoperative adjuvant radiation for
      pathological stage C (PcN0) prostate cancer from 1976 to 1989: intermediate
      findings.
AB  - Between 1976 and 1989, 114 patients undergoing radical retropubic prostatectomy
      and bilateral pelvic lymph node dissection for prostatic adenocarcinoma were
      found to have stage PcN0 lesions. Postoperative adjuvant radiation therapy
      without hormonal treatment was given to 95 of these patients (83%): 26 (27%) with
      stage C1, 37 (39%) with stage C2 and 32 (34%) with stage C3 disease. The median
      radiation dose was 45 Gy. given at 180 cGy. daily. Median followup was 4.4 years
      (range 1.4 to 13.3). The overall 5 and 10-year actuarial rates for the patients
      were 94% and 70%, respectively. Disease-specific 5 and 10-year actuarial survival
      rates were 99% and 78%, respectively. At 5 and 10 years the chance of clinical
      recurrence was estimated as 6% and 13%, respectively, and the chance of
      recurrence (clinical or indicated by prostate specific antigen levels) was
      estimated to be 34% and 46%, respectively. Patients with high Gleason scores (8
      to 10) and seminal vesicle involvement (stage C3) fared worst. There were 5
      patients with clinical distant metastases, 1 with a clinical local recurrence and
      1 with both conditions. Detectable elevation of prostate specific antigen without
      clinically evident recurrence was noted in 25 patients. Radiation therapy was
      well tolerated with minimal morbidity. Disease-specific survival and survival
      without clinical recurrence were improved over historical control in patients
      with stage PcN0 prostate cancer treated by radical prostatectomy alone. These
      data support a role for adjuvant radiation therapy in stage PcN0 prostate
      adenocarcinoma following radical prostatectomy.

PMID- 8483204
TI  - Efficacy of transrectal ultrasound-guided seminal vesicle biopsies in the
      detection of seminal vesicle invasion by prostate cancer.
AB  - Detection of microscopic seminal vesicle invasion with prostate cancer by
      transrectal ultrasound-guided seminal vesicle biopsies provides a method of
      evaluation that is much less subjective than digital rectal examination or
      imaging techniques. The accuracy of seminal vesicle biopsy is analyzed in 73
      patients undergoing transrectal ultrasound-guided biopsy of 145 seminal vesicles
      followed by radical prostatectomy. Of 133 benign seminal vesicle biopsies 11
      (8.3%) were found in the surgical specimen to have cancer involving an average of
      6% of the seminal vesicle area. Of 8 seminal vesicle biopsies showing cancer
      adjacent to seminal vesicle epithelium 100% demonstrated seminal vesicle invasion
      in the surgical specimen extending for an average of 19% of the seminal vesicle
      area. Three biopsies exhibited cancer but no seminal vesicle epithelium; only 1
      (33%) of these had seminal vesicle invasion for 5% of the seminal vesicle area.
      One biopsy revealed normal prostate tissue. Careful placement of bilateral biopsy
      sites cephalad to the prostate base (not traversing any portion of the prostate
      gland) is recommended. Caution should be exercised when basing treatment
      decisions on seminal vesicle biopsies that do not reveal seminal vesicle
      epithelium histologically.

PMID- 8483205
TI  - Adenocarcinoma of the prostate invading the seminal vesicle: definition and
      relation of tumor volume, grade and margins of resection to prognosis.
AB  - An issue relating to uniformity in pathological staging of prostate cancer that
      has received relatively minimal attention is that of seminal vesicle invasion.
      Several studies define tumor in the per-seminal vesicle soft tissue as seminal
      vesicle invasion, while others equate seminal vesicle invasion with tumor
      invading the muscular wall of the seminal vesicle. There are also controversies
      regarding the prognostic significance of seminal vesicle invasion compared to
      capsular penetration, and whether seminal vesicle invasion is a predictor of poor
      prognosis independent of tumor volume and grade. We evaluated 115 cases of
      established capsular penetration, 16 of peri-seminal vesicle invasion and 45 of
      seminal vesicle invasion in patients without lymph node metastases. Patients with
      seminal vesicle invasion had a significantly worse prognosis than those with
      capsular penetration; peri-seminal vesicle invasion was associated with an
      intermediate risk of progression. Gleason grade, surgical margins and seminal
      vesicle invasion were all independent predictors of progression in a multivariate
      analysis, whereas tumor volume was not. In patients with seminal vesicle invasion
      there was a trend for surgical margins and Gleason grade to predict progression;
      with tumor volume there was none. Our study demonstrates that the definition of
      seminal vesicle invasion should be restricted to tumors showing infiltration into
      the muscular wall of the seminal vesicle. Our study further demonstrates that
      when assessing the ability of new prognostic variables to predict prognosis of
      patients with seminal vesicle invasion, margins of resection and Gleason grade
      should be considered.

PMID- 8483206
TI  - Urinary tract infections in healthy university men.
AB  - Acute symptomatic urinary tract infections occurred spontaneously in healthy
      university men. The mean incidence was 5 symptomatic infections per 10,000 men
      per year. Men with symptomatic infections were older than other students (p =
      0.001) and 90% were sexually active. Of 38 patients 35 (92%) responded to a
      single course of antimicrobial therapy. Factors implicated in other male
      populations, such as anatomical abnormalities, urinary tract instrumentation,
      bacterial prostatitis and lack of circumcision, were seldom identified. Extensive
      evaluation appears unnecessary for young men with bacteriuria who respond to
      antimicrobial therapy.

PMID- 8483207
TI  - Urinary immunoreactive interleukin-1 alpha and interleukin-6 in bacteriuric
      institutionalized elderly subjects.
AB  - Urinary immunoreactive interleukin-1 alpha and interleukin-6 levels were measured
      in specimens obtained from elderly institutionalized subjects, including 67
      asymptomatic subjects (51 of whom were bacteriuric), 34 with fever from
      nonurinary sources, 15 with bacteriuria and 9 with symptomatic urinary infection.
      For bacteriuric subjects urinary interleukin-1 alpha and interleukin-6 levels
      were measurable in 18 (35%) and 22 (43%) asymptomatic subjects, respectively, 9
      (60%) and 8 (53%) with nonurinary sources of fever, respectively, and 6 (67%) and
      7 (78%) with urinary infection, respectively. For subjects without bacteriuria 1
      of 16 (6.3%) who were asymptomatic and 5 (25%) with nonurinary sources of fever
      had measurable urinary interleukin-1 alpha, and 2 (13%) and 1 (5.3%),
      respectively, had measurable interleukin-6. Presence of interleukin-1 alpha or
      interleukin-6 was significantly associated with bacteriuria for asymptomatic and
      symptomatic subjects. Interleukin-1 alpha or interleukin-6 quantitative levels
      were lower in subjects without than with bacteriuria. Quantitative levels of
      interleukin-6 tended to decrease for bacteriuric subjects with symptomatic
      infection between acute and convalescent specimens. These observations suggest
      that interleukin-1 alpha and interleukin-6 are produced in association with
      bacteriuria in some elderly subjects. Variation in local cytokine production with
      time and the clinical significance of these observations require further study.

PMID- 8483208
TI  - Laparoscopic surgical training: effectiveness and impact on urological surgical
      practice patterns.
AB  - Urological interest in laparoscopic surgical techniques has dramatically
      increased during the last several years. However, the extent to which these
      methods are being used and the impact of training courses on clinical use are
      unclear. We assessed urologist practice patterns subsequent to a formal training
      course in urological laparoscopic surgery. On 5 dates between January and October
      1991, a total of 163 urologists participated in a 2-day, university sponsored,
      laparoscopic surgery training seminar. Instruction consisted of 8 hours of
      didactic lectures including 2 live video cases, 4.5 hours of simulation and 4.5
      hours in a live animal laboratory. Three months after the course the participants
      were mailed a questionnaire inquiring as to the interval laparoscopic surgery
      experience. Practice demographics, additional training, equipment availability,
      number of laparoscopic surgery candidates identified, percentage of overall
      surgical case load, patient inquiries, cases performed and complications were
      assessed by the questionnaire. Descriptive and correlative information was then
      derived from the data set. A total of 105 course participants (64%) responded to
      the questionnaire and 64 had engaged in some form of additional training
      following the course. During the 3 months since course completion respondents had
      identified an average of 4 candidates for laparoscopic surgery, which represented
      a mean of 2.5% of the total case load. Specific patient inquiries averaged less
      than 1 per physician within 3 months. During this same interval respondents had
      performed a total of 156 laparoscopic procedures (1.7 per urologist). Of the
      participants 45% had not performed their first case and 32% had performed more
      than 1 laparoscopic procedure. A total of 11 complications was reported (7.2%)
      and in 7 instances the surgeon was required to convert to an open approach.
      Veress needle placement was perceived as the most difficult aspect of the
      technique (22% of the respondents). Training subsequent to the course was the
      best predictor of clinical use. Of those who responded 88% believed that their
      future use of laparoscopy would increase. This survey suggests that subsequent to
      training, laparoscopic techniques are being rapidly and safely used by
      urologists. However, in the current state of development the impact of
      laparoscopic surgery on global urological practice patterns appears to be small.

PMID- 8483209
TI  - The risk of exposure to potentially contaminated body fluids in urological
      surgery.
AB  - To determine the risk of exposure to body fluids potentially contaminated with
      infectious organisms we instituted a prospective study of all urological
      procedures performed at our institution. Urological procedures were divided into
      3 categories: open, cystoscopic and endoscopic surgical (transurethral resection
      of the prostate or bladder tumor, ureteroscopy and percutaneous procedures). We
      have complete data analysis on 594 consecutive patients who underwent an
      operation at our institution: 77 (13%) underwent an open procedure, 75 (13%)
      underwent an endoscopic surgical procedure and the remaining 442 (74%) underwent
      cystoscopic procedures. All procedures were performed by supervised house staff
      using universal precautions. The operating surgeon was exposed to potentially
      contaminated body fluids in 173 of 594 cases overall (29%). There was exposure in
      17% of all open procedures, 41% of all endoscopic surgical procedures and 29% of
      all cystoscopic procedures. Urologists must consider themselves at high risk for
      exposure to potentially contaminated body fluids and take appropriate
      precautions.

PMID- 8483210
TI  - A new technique for renal biopsy: the transurethral approach.
AB  - An 18 gauge needle sheathed in an 8F catheter can be advanced into an upper calix
      through the lumen of a transurethrally placed 10F catheter and used to biopsy the
      renal cortex. The transurethral biopsy technique is less painful, less invasive
      and simpler than the open or laparoscopic approach, and it can be used as an
      extension of cystoscopic examination to avoid percutaneous biopsy.

PMID- 8483211
TI  - Incidence and management of autonomic dysreflexia and other intraoperative
      problems encountered in spinal cord injury patients undergoing extracorporeal
      shock wave lithotripsy without anesthesia on a second generation lithotriptor.
AB  - Spinal cord injury patients are at increased risk for urolithiasis and many will
      require treatment, most commonly with extracorporeal shock wave lithotripsy. New,
      second generation lithotripsy devices allow treatment without tub immersion, and
      without general or regional anesthesia for most patients. Spinal cord injury
      patients, with loss of sensation below the level of injury, would seem to be
      ideal candidates for such treatment. We present our experience with 20
      consecutive spinal cord injury patients treated without anesthesia on the
      Medstone STS second generation lithotriptor. All patients were awake and
      experienced no direct sensation from the shock waves. All but 1 patient (T12
      level), however, experienced autonomic dysreflexia, with significant elevations
      in systolic blood pressure (mean increase 44 mm. Hg, maximum 74) and diastolic
      blood pressure (mean increase 24 mm. Hg, maximum 61), with reflex bradycardia
      (mean decrease -22 beats per minute). Autonomic dysreflexia was successfully
      treated in this setting with short-acting sublingual nifedipine. Associated
      bradycardia was treated with atropine in 6 patients. Preoperative bowel
      preparation proved to be useful in spinal cord injury patients to maximize stone
      imaging and may decrease autonomic dysreflexia if this is caused by shock waves
      impacting on the distended bowel. Other problems included uncontrolled skeletal
      muscle spasms elicited by shock waves, which proved to be troublesome in
      maintaining patient position and stone localization. Muscle spasms were decreased
      with benzodiazepines. Care was also observed in spinal cord injury patients to
      pad all pressure points on the hard, dry treatment surfaces associated with
      second generation lithotriptors and, thus, prevent skin breakdown.

PMID- 8483212
TI  - Clean intermittent catheterization in spinal cord injury patients: a followup
      study.
AB  - A followup study on nonhospitalized spinal cord injury patients using clean
      intermittent catheterization was conducted to evaluate long-term clean
      intermittent catheterization for any genitourinary complications, and to
      institute and evaluate prompt management. A total of 50 patients (36 paraplegics
      and 14 quadriplegics) was followed for 3 months to 6.5 years (average followup 22
      months). All patients had a baseline urodynamic study and renal scan before they
      were discharged from the hospital. Patients with a reflex bladder and sustained,
      high intravesical pressures (greater than 40 cm. water) were placed on
      anticholinergic medication to lower voiding pressures and maintain continence.
      Those on clean intermittent catheterization and condom drainage were also given
      alpha-blockers to achieve low pressure voiding and to control autonomic
      dysreflexia. Of 50 patients 43 (86%) acquired a total of 364 events of
      significant bacteriuria (10(4) or more colony-forming units per ml.) at a rate of
      13.63 infections per 1,000 patient-days on clean intermittent catheterization.
      Subclinical symptoms for urinary tract infection were noted in 22 of the 43
      patients (51%), whereas clinical symptoms for urinary tract infection were
      recorded in 16 of 43 (37%). These symptoms included fever in 8 patients, chills
      in 3, hematuria in 3 and flank pain in 2. There were 31 genitourinary
      complications in 21 patients noted during periodic diagnostic evaluations, with 6
      classified as upper tract. Of 50 patients 4 (8%) required rehospitalization for
      urological problems. One patient died of questionable sepsis. Transurethral
      sphincterotomy was performed in 15 of the 50 patients (30%) and transurethral
      prostatectomy was done in 1 for multiple reasons, for example high intravesical
      voiding pressures, difficult catheterization, repeated symptomatic urinary tract
      infections or per patient request to discontinue clean intermittent
      catheterization. Of 7 patients who were catheterized by others 4 elected to
      discontinue long-term clean intermittent catheterization after an average of 13
      months. Overall, 33 patients (66%) discontinued clean intermittent
      catheterization and 17 are still being followed on a long-term basis. Clean
      intermittent catheterization is a successful long-term option to drain bladders
      in spinal cord injury patients who can perform catheterization independently.

PMID- 8483213
TI  - Functional and urodynamic characteristics of an ileal neobladder.
AB  - We examined the urodynamic characteristics and symptoms of 28 patients who had
      undergone the Stanford pouch bladder substitution following cystoprostatectomy.
      Urodynamics were obtained a mean of 18 months (range 6 to 43) after construction
      of the neobladder. Mean cystometric capacity was 699 cc (range 366 to 1,370). All
      patients voided by the Valsalva maneuver and achieved good peak flow rates (mean
      19 cc per second). Of the patients 23 emptied to near completion with a mean post
      void residual of 34 cc, while 5 had post-void residuals of greater than 150 cc
      (mean 630 cc). The neobladders demonstrated good compliance for the storage of
      urine, with a mean basal pressure of less than 15 cm. water at volumes of less
      than 500 cc at which most bladders function, and of 22.4 cm. water (range 1 to
      72) at 100% capacity. Phasic neobladder contractions were present during filling
      cystometrography. While the number increased at higher neobladder volumes, the
      mean length and mean pressure did not. The mean pressure of contractions was less
      than 40 cm. water at lower and higher volumes. Daytime continence was attained in
      26 of 28 patients (93%), while 17 (61%) attained nighttime continence. Of these
      17 patients 14 (82%) had to void at least once at night to stay dry. Daytime
      incontinent patients had decreased neobladder compliance at high volumes compared
      to daytime continent patients (p < 0.05) but there was no difference in the
      maximal urethral closure pressure or the pressure of phasic contractions between
      these 2 groups. No difference was found in any urodynamic parameter between
      nighttime continent and incontinent patients. Patients with poor emptying ability
      (defined as a post-void residual of more than 150 cc) had increased neobladder
      compliance relative to patients with good emptying ability, as well as a
      statistically significant increased capacity (1,067 cc versus 623 cc). There was
      no difference in any important urodynamic parameter between patients who had and
      had not received postoperative chemotherapy. We conclude that a neobladder
      constructed from detubularized ileum achieves adequate capacity at low pressures
      with a satisfactory continence rate. Most patients empty the bladder to
      completion by Valsalva's maneuver. Low compliance at high volumes appears to be a
      factor in daytime incontinence.

PMID- 8483214
TI  - Early presentation of tuberous sclerosis as bilateral renal cysts.
AB  - We report on an infant in whom bilateral renal cysts were the only initial
      manifestation of tuberous sclerosis. We review the reported cases of infants with
      this association and emphasize that tuberous sclerosis can present in infancy as
      bilateral renal cystic disease. The role of the kidney biopsy in providing the
      correct diagnosis is discussed.

PMID- 8483215
TI  - Ossifying renal tumor of infancy.
AB  - Ossifying renal tumor of infancy is a rare but distinctive tumor that presents as
      a mass in the pelvicaliceal system. It is usually suspected to be a calculus
      until surgical exploration reveals dense tumor attachment to the renal
      parenchyma. The histogenesis of this lesion has not been established. We present
      a case of this unusual neoplasm. A renal sparing procedure was performed on this
      biologically benign tumor. Followup after 20 months showed no evidence of
      recurrence.

PMID- 8483216
TI  - Safety and efficacy of pediatric ureteroscopy for management of calculous
      disease.
AB  - Ureteral calculi, although relatively uncommon in children in the United States,
      have traditionally been managed with open surgical removal. Innovations in
      managing ureteral stones in the adult population have not readily been used to
      manage such problems in children due to unknown effects on the ureterovesical
      junction and to the unavailability of smaller caliber ureteroscopes. We report on
      the technique and long-term (average 26 months, range 3 to 56) safety following
      18 successful ureteroscopic procedures for stone removal in 16 patients 16 months
      to 15 years old. All children were rendered stone-free. Followup quantitative
      renal scans and excretory urography showed adequate renal growth. No incidence of
      vesicoureteral reflux occurred in 9 of the 14 patients (64%) available for
      followup who underwent postoperative cystograms. These results suggest that
      judicious use of smaller caliber instruments, improved ancillary equipment and
      experience in such procedures make ureteroscopy a safe procedure for management
      of ureteral calculi in children.

PMID- 8483217
TI  - Rectal duplication as a cause of neonatal bladder outlet obstruction and
      hydronephrosis.
AB  - Duplication of the rectum is a rare embryogenic event with only 70 cases reported
      in the literature. These lesions manifest as bowel obstruction, hemorrhage,
      fistula formation, pain or palpable mass. We report a case of bladder outlet
      obstruction with severe bilateral hydronephrosis caused by rectal duplication.

PMID- 8483218
TI  - Toilet habits and continence in children: an opportunity sampling in search of
      normal parameters.
AB  - An opportunity sampling of 1,192 children regarding parameters of toilet training
      and elimination status was obtained by interview and questionnaire. Toilet
      training ages ranged from 0.75 to 5 years, with a mean of 2.4 +/- 0.6 years
      (standard deviation). Voiding frequency was inversely related to age; most
      children between 3 and 12 years old urinated 5 to 6 times per day. Influences of
      gender, urinary infections and parental recall were investigated. Nocturnal and
      diurnal enuresis was reported in 18% and 10% of our sample, respectively. Bowel
      movements per week ranged from 1 to 21, with a mean of 6.8 +/- 2.5.

PMID- 8483219
TI  - Appendicovesicostomy: a useful adjunct to continent reconstruction of the
      bladder.
AB  - Appendicovesicostomy is a useful adjunct to continent reconstruction of the
      bladder. During the last 3 years we have used this procedure in 14 children with
      difficult incontinence due to spina bifida (7), exstrophy/epispadias (5),
      imperforate anus (1) and urethral agenesis (1). In 4 patients in whom previous
      operations had failed to achieve continence the bladder neck was closed. In the
      remaining 10 children, all of whom had difficulty or discomfort catheterizing the
      native urethra, the bladder neck/urethra was preserved or reconstructed to serve
      as a vent for elevated bladder pressures. Continence was achieved in all 14
      children with no complications related to the appendix. All children in whom the
      bladder neck/urethra was salvaged preferentially empty via the appendix and
      remain dry, except when the bladder is overly full.

PMID- 8483220
TI  - Augmentation ureterocystoplasty.
AB  - Augmentation cystoplasy using the gastrointestinal tract has disadvantages
      related to the intestinal resection and its incorporation into the urinary tract.
      To preclude both sets of complications, we performed augmentation
      ureterocystoplasty in a 5 1/2-year-old meningomyelocele patient with urinary
      incontinence, a low capacity bladder, severe vesicoureteral reflux and a poorly
      functioning kidney. After nephrectomy the ureter was incised longitudinally,
      folded over and placed onto the bladder as a patch. Bladder capacity, only 60 cc
      without the contribution from the refluxing upper tract, increased to 200 cc 6
      months postoperatively. The patient is continent. Augmentation ureterocystoplasty
      is an option for bladder enlargement that obviates many of the risks associated
      with enterocystoplasty.

PMID- 8483221
TI  - The effect of gastric augmentation on bladder function.
AB  - Gastrocystoplasty was performed in 29 female and 14 male patients 1 to 23 years
      old (average age 11 years). Urodynamic studies were completed in 20 patients
      preoperatively and within 6 months postoperatively. When postoperative studies
      were compared with the preoperative evaluation, it was noted that overall
      capacity increased an average of 220% (range 20 to 750%). Compliance also
      improved dramatically postoperatively. Bladder pressures increased from a mean
      volume of 34% of capacity preoperatively to 73% of the post-augment capacity. The
      average maximum filling pressure decreased by 32%, from 57 to 39 cm. water.
      Uninhibited contractions resolved completely in 6 of 10 patients who had them
      preoperatively. No one had uninhibited contractions postoperatively. Cyclical
      contractions of the stomach segment not exceeding 50 cm. water developed in 6
      patients. The gastric patch seems to be an adequate source for improving the
      dynamics of a poorly functioning detrusor muscle in most patients. When a diamond
      shaped patch of stomach is harvested and added to the bladder a spherical
      configuration is created, enhancing the storage properties. This result is in
      sharp contrast to other bowel segments, which must be detubularized to produce a
      suitable reservoir. The long-term effects of gastric augmentation remain to be
      determined.

PMID- 8483222
TI  - Continence in the myelodysplastic patient following enterocystoplasty.
AB  - To evaluate the ability of augmentation cystoplasty alone to provide a low
      pressure bladder and an adequate degree of continence in the myelodysplastic
      patient, the clinical records and urodynamic data of the last 18 consecutive such
      patients undergoing augmentation cytoplasty at our institution were reviewed. Two
      patients underwent colocystoplasty and 16 underwent ileocystoplasty. No patient
      underwent any procedure on the bladder neck or urethra. The 2 colocystoplasty
      patients exhibited episodic dampness attributed to contractions of the
      augmentation but all of the ileocystoplasty patients were dry during the day
      except 1 who had a urethral resistance of only 19 to 22 cm. water. On the basis
      of this review, ileocystoplasty alone appears to be sufficient for satisfactory
      continence in patients with a neurogenic bladder undergoing vesical augmentation
      if bladder outlet resistance exceeds 25 to 30 cm. water.

PMID- 8483223
TI  - Lower urinary tract reconstruction using stomach and the artificial sphincter.
AB  - We implanted the artificial urinary sphincter at gastrocystoplasty in 13 male and
      5 female patients. The diagnoses were classical bladder exstrophy (8 patients),
      myelodysplasia (8), cloacal exstrophy (1) and bilateral ectopic ureters (1). Mean
      patient age was 14.3 years (range 7 to 32.5). Six patients (5 with bladder
      exstrophy and 1 with clocal exstrophy) had failed bladder neck continence
      procedures, 3 myelodysplastic patients had failed artificial urinary sphincter
      placement, and 1 exstrophy patient had failed a Young-Dees bladder neck repair
      and artificial urinary sphincter placement. The sphincter cuff was placed around
      the reconstructed bladder neck in these patients, while in the remainder the
      artificial urinary sphincter was placed around the intact bladder neck. Mean
      followup was 20.3 months (range 1 to 5). Of the patients 16 (88%) are continent
      day and night, while 2 are wet. A total of 11 patients (61%) use Valsalva's
      maneuver alone for voiding and the remainder use Valsalva's maneuver and/or clean
      intermittent catheterization for bladder evacuation. Complications related to the
      artificial urinary sphincter were recurrent pump erosion requiring conversion to
      a Mitrofanoff continent stoma in 1 patient, and mechanical dysfunction requiring
      pump cuff and reservoir replacement in 3. There were no complications due to
      infection. Our report demonstrates that the combination of augmentation
      gastrocystoplasty and an artificial urinary sphincter leads to urinary continence
      and can allow for spontaneous urination. The rate of infectious complications is
      not increased when the 2 procedures are combined simultaneously.

PMID- 8483224
TI  - Complete genitourinary reconstruction in female epispadias.
AB  - While female epispadias is a rare congenital anomaly, the treatment of complete
      epispadias in the female patient does not significantly differ from that of their
      male counterparts, although the female defect can be overlooked as a cause of
      incontinence. Attention must be given to the creation of an adequate urethral
      channel so that an adequate bladder capacity can be achieved and eventual bladder
      neck plasty can be performed. Finally, attention must be given to the
      reconstruction of the external genital defect. During the last 7 years 11 female
      patients with complete epispadias were treated. Of these patients 4 were referred
      from elsewhere and 3 had failed a previous procedure (2 had recently undergone
      external genital and urethral reconstruction, 1 underwent urinary diversion after
      multiple failed bladder neck procedures). Nine patients underwent bladder neck
      plasty: 5 are completely continent day and night, 3 are dry for greater than 3
      hours during the day, and 1 is dry for only 1 to 3 hours during the day and wet
      at night, for an overall continence rate of 87.5%. Our experience with these
      patients has taught us that the bladder in this condition is much like that found
      in complete male epispadias. Therefore, creating a urethral outlet with
      sufficient length and resistance along with simultaneous reconstruction of the
      external genitalia allows for bladder regrowth, thus, facilitating achievement of
      greater volumes and bladder neck reconstruction with an excellent chance of
      success.

PMID- 8483225
TI  - Angiocentric myofibroblastic tumor of the penis in a child: case report and
      literature review.
AB  - A 6 1/2-year-old boy presented with a painless, white pearly nodule on the glans
      penis. Wedge excision was performed and pathological examination revealed a
      benign-appearing, well demarcated nodule confined to the corpus spongiosum.
      Histological examination revealed a peculiar multinodular myofibroblastic
      proliferation centered around the vessels within the penis. He has done well for
      9 months without evidence of recurrence. To our knowledge this is a previously
      undescribed lesion arising from the male genitalia.

PMID- 8483226
TI  - Genitourinary malformations associated with agenesis of the corpus callosum.
AB  - Agenesis of the corpus callosum is an infrequent congenital anomaly that occurs
      in partial or complete forms, and is frequently associated with other
      craniofacial and skeletal abnormalities. An increased association with
      genitourinary abnormalities has not been previously defined. We reviewed the
      records of 22 boys and 11 girls with agenesis of the corpus callosum. Of the
      patients 18 had complete radiological or necroscopic evaluation and 15 had
      physical examinations as the sole means of evaluation. Renal anomalies were the
      most frequent genitourinary abnormalities identified in these children, although
      ureteral, genital and bladder abnormalities were also encountered. There was an
      exceptionally high incidence of undescended testes (23%), approximately 20-fold
      greater than the frequency in the normal population, possibly resulting from
      hypothalamic insufficiency associated with midline cranial defects. We suggest,
      therefore, that all patients with agenesis of the corpus callosum should be
      thoroughly evaluated with bladder and renal ultrasound studies to rule out any
      genitourinary abnormalities. Male patients with agenesis of the corpus callosum
      and undescended testes should undergo hypothalamic/pituitary axis testing.

PMID- 8483227
TI  - Renal capsular hemangioma.
AB  - We present a rare example of hemangioma of the renal capsule. This benign
      mesenchymal tumor can present diagnostic difficulties, since it can
      radiographically and macroscopically simulate more common tumors of the kidney,
      including renal cell carcinoma. If the diagnosis is made or suspected
      preoperatively or during surgery a more conservative surgical approach should be
      considered.

PMID- 8483228
TI  - Unilateral single vaginal ectopic ureter with ipsilateral hypoplastic pelvic
      kidney and bicornuate uterus.
AB  - We report on 2 patients with a unilateral vaginal ectopic ureter associated with
      a single system, ipsilateral hypoplastic pelvic kidney and bicornuate uterus.
      Although there are many reports of concomitant urinary and reproductive system
      malformations, a review of the literature shows these unique associations in the
      same patient to be extremely rare. These findings provide further evidence of the
      intricate interaction between mesonephric (wolffian) and paramesonephric
      (mullerian) ducts in the development of the urogenital system. Embryological
      aspects as well as clinical presentation, diagnostic approach and treatment
      applicable to this group are discussed.

PMID- 8483229
TI  - Uretero-fallopian tube fistula secondary to laparoscopic fulguration of pelvic
      endometriosis.
AB  - Ureteral injuries during laparoscopic surgery have been documented. We present a
      case of the diagnosis and management of a uretero-fallopian tube fistula after
      laparoscopic laser fulguration of pelvic endometriosis.

PMID- 8483230
TI  - Endoscopic management of incidental cystotomy during operative laparoscopy.
AB  - Operative laparoscopy is rapidly becoming an important technique used by all
      surgical specialties. More sophisticated and difficult procedures are continually
      being performed endoscopically. Complications from these procedures are
      inevitable and are more frequently being managed with the laparoscope. We
      describe a case of inadvertent cystotomy during a laparoscopic gynecological
      operation, which was subsequently repaired endoscopically. The technique and
      patient followup are presented.

PMID- 8483231
TI  - Delayed rupture of type I posterior urethral injury: case report.
AB  - Type I posterior urethral injuries are a frequently noted but infrequently
      reported entity in the setting of pelvic fracture. Almost all of these injuries
      will do well with Foley catheter drainage. However, the urethral integrity as
      established by admission retrograde urethrography is not an unalterable state and
      serious septic sequelae may be noted if the evolving injury is unrecognized. We
      report a case of delayed rupture of a type I posterior urethral injury causing
      infection of the pelvic hematoma and subsequent sepsis.

PMID- 8483232
TI  - Congenital abnormality of corpora cavernosa and erectile dysfunction: a case
      report.
AB  - We report on a young man who had absence of the septum and muscle in the corpora
      cavernosa. He had no tumescence or erection with either the nocturnal penile
      tumescence test or intracorporeal injection of a combination of vasoactive drugs.
      No other urological or extra-urological congenital defects were found. A
      malleable penile prosthesis was implanted.

PMID- 8483233
TI  - Necrotizing cavernositis secondary to periodontal abscess.
AB  - Spontaneous cavernositis is a distinctly uncommon entity. Corporeal infection and
      abscess formation have been described in association with priapism,
      cavernosography, intracavernous injection therapy, trauma and penile prostheses.
      We report a case of acute necrotizing cavernositis in a diabetic patient, which
      presumably originated with hematogenous seeding from a periodontal abscess.
      Isolation of typical oral pathogens from corporeal cultures provides
      bacteriological evidence of a dental source for the corporeal infection.

PMID- 8483234
TI  - Congenital prostatic cyst causing ejaculatory duct obstruction: management by
      transrectal cyst aspiration.
AB  - Congenital prostatic cysts are relatively uncommon and rarely symptomatic. We
      describe a 24-year-old man who presented with a 2-month history of anejaculation
      accompanied with bilateral epididymal pain. Transrectal ultrasonography of the
      prostate revealed a large midline prostatic cyst and bilateral dilatation of the
      seminal vesicles. Transrectal aspiration of the cyst resulted in return of
      antegrade ejaculation and resolution of epididymal pain.

PMID- 8483235
TI  - Electroencephalographic changes from hyponatremia during transurethral resection
      of the prostate.
AB  - A patient undergoing transurethral resection of the prostate suffered
      hyponatremia during the perioperative period. Electroencephalography demonstrated
      diffuse slowing although the patient was not clinically encephalopathic. The
      serum sodium level may indicate a trend toward development of the transurethral
      resection syndrome but the sodium level does not necessarily parallel metabolic
      changes in brain tissue. Consequently, electroencephalography may aid in the
      early diagnosis and treatment of encephalopathy during the early phases of the
      transurethral resection syndrome.

PMID- 8483236
TI  - Re: Ascorbic acid overdosing: a risk factor for calcium oxalate nephrolithiasis.

PMID- 8483237
TI  - Re: Acquired cystic disease of the kidney: a management dilemma.

PMID- 8483238
TI  - Re: Renal transplantation in children with posterior urethral valves.

PMID- 8483239
TI  - Re: Use of methylene blue and selective embolization of the pudendal artery for
      high flow priapism refractory to medical and surgical treatments.

PMID- 8483240
TI  - Re: Psoas abscess: case report and review of the literature.

PMID- 8483241
TI  - Implantable penile venous compression device: initial experience in the chronic
      canine model.
AB  - A prosthetic penile venous compression device was surgically placed in 14 dogs to
      assess the effects of chronic device implantation and repeated device cycling on
      cavernous tissue. Duration of device implantation ranged from 37 to 224 days;
      total number of device cycles ranged from 8 to 59. At recovery, erection was
      induced by electrostimulation of the pelvic nerve. The device successfully
      prolonged intracavernous elevation for as much as 30 minutes after inflation.
      Histologic examination of representative tissue sections through the corpora
      revealed no evidence of neural injury, vascular compromise, or tissue atrophy.
      The implantable venous compression device may offer an improved method of
      treatment of venogenic impotence.

PMID- 8483242
TI  - Inhibitory effect of cromakalim in human detrusor muscle is mediated by
      glibenclamide-sensitive potassium channels.
AB  - The effects of cromakalim, a potassium channel activating drug, and
      glibenclamide, a relatively selective antagonist of ATP-sensitive potassium
      channels, have been investigated on isolated detrusor muscle from human bladder.
      Specimens of human bladder were cut into strips and suspended in an organ bath
      filled with modified Tyrode solution for measurement of isometric contractile
      force. Concentration-response curves to acetylcholine were constructed before and
      after pretreatment with cromakalim and cromakalim plus glibenclamide. The
      concentration-response curves to acetylcholine were displaced to the right, and
      the maximal response to acetylcholine was significantly inhibited by cromakalim
      in a concentration-dependent manner. The inhibitory effect of cromakalim on
      acetylcholine-induced contraction was significantly reduced by glibenclamide.
      Following sustained contraction induced by 20 mM. KCl, the cumulative addition of
      cromakalim to the organ bath produced a concentration-dependent relaxation.
      However, in strips precontracted with 60 mM. KCl, the addition of cromakalim in
      concentrations as high as 10(-5) M. did not induce relaxation. The relaxation
      induced by cromakalim in strips precontracted with 20 mM. KCl was significantly
      inhibited by glibenclamide. These results suggest that the inhibitory effect of
      cromakalim in human bladder involves activation of glibenclamide-sensitive
      potassium channels.

PMID- 8483243
TI  - Fluoroscopically guided incision of ureteral strictures in pigs with the cautery
      wire balloon catheter: a phase 1 study.
AB  - We investigated a catheter that can longitudinally incise ureteral strictures
      under fluoroscopic guidance without the need for ureteroscopy and its attendant
      risks. The catheter consists of a low-pressure balloon and an overlying cautery
      wire; the balloon allows precise localization of the stricture, seen as a waist
      in the balloon, and the overlying cautery wire can be fluoroscopically oriented
      at the stricture. One to two centimeter ureteral strictures were created in 6
      swine. Two to four weeks later strictures were incised in a retrograde or
      antegrade fashion with the cautery-wire balloon catheter, and double J stents
      placed for a duration of three weeks. In 5 of 6 renal units strictures improved
      anatomically with resolution of hydronephrosis at 3 to 4 months' follow-up.
      Urodynamic absence of obstruction was verified by Whitaker testing. In one
      animal, the tip of the catheter dislodged in the ureter with subsequent loss of
      the renal unit. The engineering error that lead to this complication has since
      been rectified. With correction of the aforementioned problem, this Phase 1 study
      has demonstrated the feasibility, safety and preliminary efficacy of the cautery
      wire balloon catheter for endourologic management of ureteral strictures.

PMID- 8483244
TI  - Rabbit and human renotropin are not epidermal growth factor.
AB  - Sera obtained from rabbits and humans after unilateral nephrectomy (uni sera)
      compared with sera obtained preoperatively (control sera) significantly stimulate
      3H-thymidine incorporation into the DNA of cultured renal tissue from the
      respective species. In contrast, rabbit liver cells in culture are not stimulated
      by the uni sera compared with control sera obtained from rabbits. Mouse epidermal
      growth factor (EGF) added to tissue cultures significantly stimulates both kidney
      and liver cells of rabbits and kidney cells of humans. Antiserum against EGF
      overcomes, at least to some extent, the enhancing effect of EGF under all
      circumstances, but does not influence the stimulatory ability of uni serum
      obtained from rabbit and human kidney cells from the respective species. In
      addition, the activity of EGF was not different in the presence of uni and
      control sera. This study corroborates the presence of renotropic activity in the
      sera of rabbits and humans after removal of functioning renal mass and shows that
      this activity is not derived from EGF, nor does it work by potentiating some
      aspect of the EGF system.

PMID- 8483245
TI  - Dynamic enhanced magnetic resonance imaging of testicular perfusion in the rat.
AB  - Magnetic Resonance Imaging (MRI) has several theoretical advantages in the
      evaluation of spermatic cord torsion and testicular ischemia. The technique uses
      no ionizing radiation, has both excellent spatial and temporal resolution and,
      when used with an intravenous bolus of a paramagnetic contrast agent, provides a
      semiquantitative assessment of tissue perfusion and vascular injury. In clinical
      instances of testicular torsion, accurate estimates of tissue perfusion are
      desirable since testicular salvage is inversely related to the duration of
      torsion and the degree of tissue ischemia. Perfusion imaging of the rat testis
      was used as a model to demonstrate the potential use of MRI in the experimental
      and clinical analysis of disorders that affect blood flow to the testis.

PMID- 8483247
TI  - Current management of invasive and metastatic transitional cell carcinoma of the
      bladder.

PMID- 8483246
TI  - Sensitivity of human renal cell carcinoma lines to TNF, adriamycin, and
      combination: role of TNF mRNA induction in overcoming resistance.
AB  - We have examined 6 human renal cell carcinoma (RCC) cell lines for their
      sensitivity and resistance to the cytolytic effect of tumor necrosis factor (TNF)
      and adriamycin (ADR), alone or in combination. The results of cytotoxicity
      mediated by TNF and ADR showed no direct correlation as TNF resistant lines were
      sensitive to ADR while the TNF sensitive lines were resistant. The combination of
      TNF and ADR resulted in enhanced cytotoxicity against the tumor lines. Induction
      of TNF mRNA and protein has been suggested as a mechanism of resistance to TNF in
      certain tumors. Resistant and sensitive lines were capable of upregulating TNF
      mRNA after treatment with TNF or PMA+ionophore for periods as short as 1 hour,
      but only the resistant lines were able to secrete detectable levels of TNF
      protein. Therefore, a positive correlation existed between resistance to TNF and
      production and secretion of TNF by the cell lines. In the presence of the protein
      synthesis inhibitor cycloheximide (CHX), the TNF mRNA level in the TNF resistant
      lines was increased while the sensitive lines required an additional signal, such
      as exogenous TNF, to upregulate the mRNA. Due to the enhanced cytotoxicity seen
      with the combination of TNF and ADR, we determined the effect of this combination
      on the levels of TNF mRNA. As examined in a constitutively TNF expressing line,
      ADR alone reduced the constitutive mRNA level and, in combination with TNF,
      reduced the level of induction produced by TNF. This downregulation of TNF mRNA
      by ADR may play a role in the enhanced cytotoxicity seen with combined TNF and
      ADR treatment. The present study demonstrates that RCC cell lines differ in their
      sensitivity and/or resistance to TNF. Further, ADR and/or TNF resistant RCC lines
      can be rendered sensitive by combining TNF and ADR. The constitutive and/or
      inductive secretion of TNF by certain lines and its relationship to tumor
      pathogenesis as well as overcoming resistance are discussed.

PMID- 8483248
TI  - Laparoscopic adrenalectomy: the initial 3 cases.
AB  - Laparoscopic adrenalectomy was performed on 3 patients with primary
      aldosteronism. Traction with 2 steel skewers placed subcutaneously over the
      costal arch was combined with conventional intraperitoneal carbon dioxide gas
      insufflation. This combination provided a good operative field at 8 mm. Hg
      insufflation pressure. The laparoscopic approach to the adrenal gland requires
      neither a large skin and muscle incision nor resection of rib(s), and offers
      lower morbidity and rapid convalescence. Laparoscopic adrenalectomy is a new
      minimally invasive operation for the treatment of adrenal adenoma.

PMID- 8483249
TI  - Renal artery stenosis after renal transplantation: the impact of the hypogastric
      artery anastomosis.
AB  - A review of 402 renal allotransplants performed during a 5-year period revealed
      25 cases of transplant renal artery stenosis in 377 evaluable patients. To our
      knowledge this is the first large study of this transplant complication in which
      all patients received cyclosporine immunotherapy. The incidence of transplant
      renal artery stenosis was 6.6%. The mean internal from transplantation to onset
      of transplant renal artery stenosis was 11 months. No significant differences in
      atherosclerotic risk factors were detected between the groups with and without
      transplant renal artery stenosis. The incidence of acute allograft rejection was
      not increased in the stenosis group. There was no difference in the incidence of
      transplant renal artery stenosis following end-to-end (hypogastric artery) or end
      to-side (common or external iliac artery) arterial anastomoses. Among patients
      having end-to-end hypogastric artery anastomoses the incidence of transplant
      renal artery stenosis was significantly greater (p < 0.01) when endarterectomy
      was required to render the hypogastric artery suitable for use. Percutaneous
      transluminal angioplasty was performed in 20 patients and open repair was
      performed in 18. After percutaneous transluminal angioplasty of hypogastric
      artery anastomoses, more additional procedures were required and there was a
      higher allograft loss rate when compared to percutaneous transluminal angioplasty
      of the external iliac artery. These data suggest that treatment of transplant
      renal artery stenosis in patients with end-to-end hypogastric artery anastomosis
      is more difficult and results in a higher morbidity rate than treatment in the
      external iliac artery group.

PMID- 8483250
TI  - Treatment of renal transplant ureteral complications by percutaneous techniques.
AB  - From January 1985 to October 1990, 487 adult renal transplantations were
      performed at our institution. Of 16 ureteral complications noted 15 were
      initially managed with percutaneous nephrostomy. Of the 8 complications that
      occurred during the last 2 years 5 resolved on percutaneous nephrostomy and
      stenting, or stenting with dilation alone. We conclude that percutaneous
      nephrostomy is indicated as an initial step in the diagnosis and treatment of
      urological transplant complications, and that it allows for nonoperative
      resolution of many of these complications.

PMID- 8483251
TI  - High pressure versus low pressure electromagnetic extracorporeal lithotripsy.
AB  - A low pressure and an upgraded high pressure electromagnetic lithotriptor were
      compared for the treatment of calculi within the ureter. The upgrading allows for
      increased energy density onto the stone surface. We targeted 139 ureteral calculi
      (average diameter 8.1 mm.) with the low pressure system. The mean number of shock
      waves was 7,308, 9,226 and 5,304 for calculi in the upper, mid and lower ureter,
      respectively, and the energy density corresponded to 0.222, mJ./mm.2, 0.224
      mJ./mm.2 and 0.223 mJ./mm.2, respectively. Immediate fragmentation was achieved
      in 39 of 51 upper (77%), 21 of 42 mid (50%) and 22 of 46 lower (49%) ureteral
      calculi. The upgraded shock wave tube was used in 52 calculi (average diameter
      6.1 mm.). The mean number of shock waves was 6,250, 14,150 and 3,400 for calculi
      in the upper, mid and lower ureter, respectively, and the energy density
      corresponded to 0.32 mJ./mm.2, 0.33 mJ./mm.2 and 0.30 mJ./mm.2, respectively.
      Immediate fragmentation was achieved in 11 of 16 upper (69%), 4 of 6 mid (67%)
      and 7 of 30 lower (23%) ureteral calculi. The comminution rate did not
      significantly increase, which implies that the focal energy density is not the
      only decisive parameter in fragmentation by extracorporeal shock wave
      lithotripsy.

PMID- 8483252
TI  - Laparoscopic ureterectomy: initial clinical experience.
AB  - With a combination of cystoscopic and laparoscopic techniques, 3 patients
      underwent total ureterectomy for urothelial cancer without complication. Of the
      patients 2 underwent concomitant laparoscopic nephrectomy. Mean operating time
      was 8.2 hours for the laparoscopic surgery and mean hospital stay was 6 days. In
      2 patients the ureter was removed intact, while in 1 it was morcellated along
      with the kidney before removal. In each case the bladder was closed with a 12 mm.
      GIA laparoscopic stapling device. After 3 to 9 months of followup no patient had
      recurrent disease or bladder stones on the staple line.

PMID- 8483253
TI  - Experience with the hemi-Kock ileocystoplasty with a continent abdominal stoma.
AB  - We describe our experience with the hemi-Kock ileocystoplasty with a continent
      abdominal stoma as an alternative to an indwelling catheter or supravesical
      diversion in 14 women and 4 men with various problems who could not perform
      intermittent urethral self-catheterization. The aim of management was also to
      provide, if possible, a competent urethra for additional access. Mean patient age
      was 37 years (range 22 to 75) and mean followup was 26 months (range 5 to 58).
      Preoperative management in the 11 wheelchair dependent women with neurological
      disease was an indwelling catheter in 7, urethral intermittent catheterization
      with the patient in the supine position in 3 and diapers in 1. Two women with a
      nonneurogenic bladder and a grossly incompetent urethra (1 after multiple
      incontinence and fistula repairs, and 1 after severe obstetrical trauma) wore
      diapers, while 1 with urinary retention and inability to perform self
      catheterization had an indwelling catheter. The 4 men included 2 wheelchair
      dependent incontinent spinal cord injury patients who could not be managed with
      condom drainage, 1 with multiple anomalies who had trouble with self
      catheterization, and 1 with an impassable postoperative stricture and a
      suprapubic tube. Surgery included anti-incontinence procedures in 10 patients and
      bladder neck closure in 3. A total of 15 patients required bladder augmentation
      in addition to the stoma and 3 had a stoma alone. Postoperative intervention was
      necessary in 4 women for stomal incontinence and in 2 of these bladder stones
      were removed simultaneously. One of these women was later treated for recurrent
      stones cystoscopically through the stoma. Overall, 17 of 18 patients are dry on
      intermittent stomal catheterization, with 1 lost to followup. We conclude that
      this procedure is a good alternative in patients with an end stage urethra or who
      cannot perform urethral catheterization because of physical disability.
      Establishing urethral continence and maintaining patency leaves a safety valve
      should the stoma fail. Since the bladder remains as a reservoir no ureteral
      surgery is necessary.

PMID- 8483254
TI  - [66th annual meeting of the Japanese Society for Bacteriology. Nagoya, March 24
      26, 1993. Abstracts].

PMID- 8483255
TI  - [Clinical applications expected in the future--osteoporosis].
AB  - Severe vitamin deficiency causes osteomalacia, but osteoporosis is also
      associated with decreased vitamin D activity. Intestinal calcium absorption is
      decreased and vitamin D metabolites low in osteoporosis and cytokine and growth
      factor abnormalities in osteoporosis may be ascribed to vitamin D deficiency. In
      Japan, 1 alpha (OH) vitamin D3 and 1.25(OH)2 vitamin D3 have been used for
      osteoporosis with beneficial effect and scarcely any side effects for many years.
      World wide, the effect of vitamin D on osteoporosis is gradually recognized. The
      higher the dose, longer the duration of administration and older the age of the
      patients, more positive effects tend to be obtained.

PMID- 8483256
TI  - [Renal osteodystrophy].
AB  - One of the differences of bone X-ray findings with long-term hemodialysis
      patients in 1978 and 1991, is a frequency of subperiosteal bone resorption. High
      incidence of periosteal bone resorption is found in 1978 but in 1991, it is low.
      In 1978 we did not administer active vitamin D but in 1991 it has already
      administered for ten years. Administration of active vitamin D is available for
      the prevalence of periosteal bone resorption but active vitamin D therapy to
      suppress the secondary hyperparathyroidism occasionally fails in advanced cases
      and hypercalcemia is found. Intermittent and pharmacologically high levels of
      plasma calcitriol are reported to suppress the PTH secretion effectively and
      recently 22-oxacalcitriol, a new active vitamin D analogue, is found to suppress
      PTH secretion without increasing plasma calcium. It is thought to be a more
      suitable therapy of secondary hyperparathyroidism.

PMID- 8483257
TI  - [Fat-soluble vitamin therapy in senile dementia and Parkinson's disease].
AB  - In the pathogenesis of Parkinson's disease and senile dementia of the Alzheimer
      type, free radicals might play a role. Fat-soluble vitamins are a kind of anti
      oxidative substance. Therefore, fat-soluble vitamins, such as vitamin E, may be
      useful in treatment of Parkinson's disease and senile dementia of the Alzheimer
      type. However, it is still unclear whether the concentration of vitamin E in the
      blood or in the brain tissue, in patients with Parkinson's disease or with of the
      senile dementia Alzheimer type, is higher than or the same as that in normal
      subjects. Furthermore, although the effectiveness of vitamin E in the treatment
      of Parkinson's disease has been reported, the usefulness of vitamin E is still
      obscure. Further study will be necessary, in order to clarify the role of fat
      soluble vitamins in the treatment of Parkinson's disease and senile dementia of
      the Alzheimer type.

PMID- 8483258
TI  - [Clinical application of fat soluble vitamins to retinopathy of prematurity and
      intracranial hemorrhage].
AB  - More than ten years ago, vitamin E supplementation was proposed as a prophylaxies
      against a syndrome that might be caused by oxygen toxicity and/or membrane
      instability such as retinopathy of prematurity (ROP), bronchopulmonary dysplasia
      (BPD), and periventricular/intraventricular hemorrhage (PVH/IVH). The results
      obtained from several studies to date does not support the usefulness of vitamin
      E supplements in the prevention of BPD. However, several reports have suggested
      the utility of vitamin E in the prevention and/or inhibition of progress of ROP,
      although the use of vitamin E in premature infants for the possible prevention of
      severe ROP should still be considered investigational. On the other hand, the
      aggregate of evidence to date support the efficacy of tocopherol in preventing
      IVH of extremely premature infants. It is postulated that oxidative damage to
      capillary endothelial membranes of the subependymal layer predisposed the
      premature infant to subependymal bleeding and that vitamin E might act as an
      antioxidant to prevent such damage, thereby reducing the risk of hemorrhage.

PMID- 8483259
TI  - [The fat soluble vitamins in obstetrics and gynecology].
AB  - The therapeutic use of vitamin D in the OB-GYN field is well known for
      osteoporosis in the climacteric stage, and vitamin K is for the protection of
      neonatal hemorrhage. The therapeutic use of vitamin E was reviewed, and it was
      concluded that there was a large number of diseases for example, sterility,
      toxemia of pregnancy, IUGR, neonatal jaundice, climacteric syndrome, in which a
      therapeutic value for vitamin E could be clearly establish, vitamin K prophylaxis
      is also under taken for the neonate. This can be done by giving a dose to the
      mother just before or in the early stages of labor. Ubiquinone, was given to the
      man for the treatment of oligospermia. CoQ10 also warrants further investigation
      for the treatment of fetal arrhythmia in utero.

PMID- 8483260
TI  - [Structure and function of the scavenger receptor].
AB  - The macrophage scavenger receptors are consisted of six domains: cytoplasmic,
      membrane-spanning, spacer, alpha-helical coiled-coil, collagen-like and a type
      specific C-terminal. The collagen-like domain is revealed to have important role
      for ligand binding. The receptor gene is located on human chromosome 8. The human
      scavenger gene spans approximately 80 kb and is composed of 11 exons. Two types
      of scavenger receptor mRNA were shown to result from alternative splicing of exon
      9 for type II or 10 and 11 for type I to the common exon 1-8. The scavenger
      receptor proteins were detected in macrophages of various organs and tissues such
      as Kupffer cells, alveolar macrophages, macrophages in the spleen and lymph nodes
      and perivascular macrophages in the brain. In the atheromatous plaques, scavenger
      receptors may participate progression of foam cells. Elimination and detoxication
      of endotoxin by macrophage scavenger receptor may suggest the defending function
      against a wide variety of pathogenic agents.

PMID- 8483261
TI  - [Microwave coagulo-necrotic therapy for hepatocellular carcinoma].
AB  - We performed microwave coagulo-necrotic therapy (MCN), a new surgical treatment
      for hepatocellular carcinoma (HCC) under laparotomy on 41 cases and under
      laparoscopy on 5 cases for a total of 46 cases (70 cancer nodules). The
      indications for MCN include: 1) cases in which an early recurrence is judged as
      likely to occur. For example, multinodular cases, or intrahepatic metastasis (im1
      3) 25 cases (54.3%), 9 cases (19.6%) in which multiple adenomatous hyperplasia
      was detected, VP2 1 case (2.2%). 2) 7 cases (15.2%) in which if hepatectomy is
      conducted, there is a high risk of postoperative liver failure, or cases in which
      it is judged postoperative management will be very difficult. In only 4 cases was
      it because the patients requested laparoscopic MCN (lapa. MCN). Also, the tumor
      size was less than 15 mm in 4 cases, 16 to 20 mm in 6 cases, 21-30 mm in 21
      cases, 31-50 mm in 6 cases, and larger than 51 mm in 9 cases (maximum 90 x 65
      mm). Only 1 case who died on the 17th postoperative day due to sudden ventricular
      arrhythmia, and 3 cases who died cancer death at 1 year 6 months, 2 year 2
      months, and 4 years 1 months after the operation for a total of 4 cases, so that
      42 patients have survived 4 years and 3 months as of this writing. Thus MCN was
      in no way inferior to hepatectomy.

PMID- 8483262
TI  - [The application of confocal laser scanning microscopy (CLSM) in cell biology].
AB  - Confocal laser scanning microscopy (CLSM) is expected to provide new optical
      information different from conventional microscopy in cell biology. CLSM provides
      high contrast images, individual continuous cellular tomograms without slicing
      cells, and stereographs which are observed by three dimensional reconstruction.
      We study the localization of nuclear DNA stained with PI, tumor marker antigen CA
      125 stained with FITC, and signals in fluorescence in situ hybridization (FISH)
      with alpha satellite pericentrometric DNA probe of chromosome 17 to discuss the
      possibility of its application to cell biology or clinical use. Some of the
      applications of CLSM including its structure and principle are reviewed.

PMID- 8483263
TI  - [Fat soluble vitamins].
AB  - The first part of this presentation discusses the history of the discovery of
      vitamins that dates back to the early 20th century. The latter part deals with
      the basic physical and biochemical functions of fat-soluble vitamins, namely,
      vitamin A, vitamin D, vitamin E and vitamin K. Unlike water-soluble vitamins,
      most of which act as a coenzyme binding to an apoenzyme for the formation of
      holoenzyme, fat soluble vitamins have individual biochemical functions that do
      not share the same mechanism. Although studies on the mechanism of fat-soluble
      vitamin function in the cell were hampered due to difficulty in solubilization
      for in vitro studies in the past, recent progress in the understanding of such
      mechanisms has been remarkable.

PMID- 8483264
TI  - [Fat-soluble vitamins: Intestinal absorption].
AB  - General principals of drug absorption and bioavailability after the oral
      administration are discussed in each process of drug release and dissolution from
      the preparation, such as gastric emptying time and flow of drug in intestinal
      track, transport through intestinal mucosal microvilli, and the first pass effect
      of drug elimination in the liver. Character of lipid soluble vitamins in these
      absorption processes are elucidated with the low solubility in water and
      solubilization in bile acids micelle. Our studies on dl-alpha-tocopherol
      solubilization into micelles of bile acids and a detergent and the rat intestinal
      absorption by perfusion of the micellar solutions are introduced. Faster
      absorption of the tocopherol solubilized in bile acid micelles, than polysorbate
      80, was observed in spite of the less solubilizing abilities of bile acids.
      Relatively high dependency on volume flow through the intestinal wall was
      observed in the absorption rate of tocopherol. The dependency is larger in bile
      acid micelles having smaller size than polysorbate 80 having large size.

PMID- 8483265
TI  - [Metabolism of fat-soluble vitamins by intestinal flora and enterocytes].
AB  - Three topics on fat-soluble vitamins in the intestines are described. First, it
      was suggested that novel cellular retinol binding protein type II, intrinsic to
      enterocytes, facilitated not only absorption of retinol and its esterification by
      lecithin:retinol acyltransferase in enterocytes, but also reduction of retinal to
      retinol by microsomal retinal reductase. Second, it was shown that in enterocytes
      the C-24 oxidation pathway from 1,25-(OH)2-D3 to calcitroic acid operated at
      physiological concentrations and the C-23 oxidation pathway to 1,25-(OH)2-D3-26,
      23-lactone was also present as a minor route. Third, it was discussed whether
      menaquinones produced by intestinal microflora could be utilized by the host
      animals. Further, antibiotic-associated hypoprothrombinemia was shown to be
      caused by inhibition of K-epoxide reductase by N-methyletrazole, derived from the
      antibiotics, rather than reduced population of microflora.

PMID- 8483266
TI  - [Fat-soluble vitamins: biotransformation].
AB  - Fat-soluble vitamins are essential for growth and normal functions of human body.
      These vitamins are generally absorbed from the gastrointestinal tract only when
      bile is present. Recently, it is recognized that fat-soluble vitamins have
      hormone-like functions in the human body. The carotene (provitamin A) is a
      remarkably potent source of vitamin A, and beta-carotene is the prominent type of
      carotene in nature. It plays an essential role in the function of the retina.
      With regard to the biotransformation, more than 90% of the intake of performed
      vitamin A is in the form of retinol esters, usually as retinyl palmitate. Vitamin
      A is readily absorbed from the normal gastrointestinal tract, and the absorption
      of the vitamin is related to that of lipid. Prior to entering the circulation,
      the hepatic retinyl ester is hydrolyzed and retinol itself is released from the
      liver. In the blood, vitamin A is present mainly as retinol associated as a
      protein complex. Normal calcium and phosphate metabolism is dependent on proper
      levels of vitamin D, and blood levels of these ions are influenced by
      gastrointestinal absorption, metabolism, and renal excretion of vitamin D. Both
      vitamin D2 and vitamin D3 are absorbed without esterification from the small
      intestine. Most of the vitamin appears first in lymph and primarily in the
      chylomicron fraction as a lipoprotein complex. Bile is essential for adequate
      intestinal absorption and deoxycholic acid is the most important constituent of
      bile.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483267
TI  - [Metabolic regulation on retinoic acid and vitamin E function].
AB  - 1. Retinoic acid is an oxidative metabolite which is produced intracellularly and
      plays role in gene expression via nuclear retinoic acid receptor (RAR), a family
      of steroid receptor. Recently, clinical use of retinoic acid in acute pro
      myelocytic leukemia (APL) was proposed to induce complete remission in the
      leukemic cells, which have the t(15:17) of chromosomal anomaly producing a
      different protein from the normal RAR. From this clinical view, the regulatory
      role of retinoic acid is becoming clear in the cells. 2. Vitamin E is an
      antioxidant in biological membranes to prevent from their oxidative chain
      reaction occurring near the location of vitamin E in the lipid layer of the
      membranes. Thus, the location of vitamin E, especially alpha-tocopherol differing
      from the other analogues, in the living body is important to assess its function.
      From the standpoint of view, absorption of vitamin E from the gut, its
      circulation in the blood, and transportation to tissues and cells will be
      discussed in this paper.

PMID- 8483268
TI  - [Retinoids].
AB  - Retinoid includes vitamins A and synthetic relatives except provitamins A such as
      carotenes. In this review, recent developments on the chemistry and physiological
      functions of retinoid (retinol, retinal and retinoic acid etc.) were surveyed,
      special emphasis being laid on the following subjects: (1) vision (retinal and
      photo-sensitivities; molecular mechanism of scotopic and photopic vision). (2)
      systemic actions of vitamins A (multiple physiological functions and their active
      intermediates). (3) reproduction and morphogenesis (extracellular-transport
      proteins, intracellular-cytoplasmic transfer proteins, and intracellular-nuclear
      transacting factors; RAR and RXR; morphogen). (4) chemical prevention of cancer
      (synthetic retinoid derived from retinoic acid). (5) biological significance of
      cis-retinoid.

PMID- 8483269
TI  - [Vitamin D].
AB  - 1 alpha,25-Dihydroxyvitamin D3 [1 alpha,25(OH)2D3], the active form of vitamin
      D3, stimulates intestinal calcium absorption and osteoclastic bone resorption,
      resulting in the elevation of plasma calcium. Recent studies have revealed that 1
      alpha,25(OH)2D3 also promotes differentiation of various cells such as myeloid
      leukemia cells, lymphocytes, macrophages and skin keratinocytes. The target cells
      of 1 alpha,25(OH)2D3 possess 1 alpha,25(OH)2D3 receptors (VDR) which belong to
      the steroid thyroid retinoic acid receptor gene family. The complex of VDR and 1
      alpha,25(OH)2D3 binds to vitamin D3-responsive elements (VDRE) present in the
      promoter region of target genes of 1 alpha,25(OH)2D3. In bone, osteoblasts
      possess VDR and synthesize several proteins, such as BGP, osteopontin and the
      third component of complement (C3), in response to 1 alpha, 25(OH)2D3. 1 alpha,
      25(OH)2D3 is involved in the differentiation of osteoclast progenitors into
      mature osteoclasts directly and also by an indirect mechanism involving some
      proteins produced by osteoblasts. In this review article, we show the mode of
      action and the biological function of 1 alpha, 25(OH)2D3.

PMID- 8483270
TI  - [The biological activity of vitamin E].
AB  - The relative biopotency of alpha-(RRR(d)-, 2-ambo (dl)-and all-rac (dl)), beta-,
      gamma- and delta-tocopherol, tocotrienol homologues and tocopherol derivatives
      are summarized in the tables. The new United States Pharmacopoeia [USP] XXII
      NFXVII (1990) does not mention the USP (International) Unit of the six different
      forms of alpha-tocopherol that has indicated the difference in biopotency between
      d-alpha-tocopherol and dl-(2- ambo)-alpha-tocopherol and been used for 40 years
      from 1950. Metabolic and bio-discrimination studies of tocopherols are necessary
      to determine the precise relative biopotency of d-(RRR)-and dl-(all-rac)-alpha
      tocopherol. The synergistic effect of all-rac-alpha- tocopherol with its 8
      stereoisomers and the biotransformation from beta-, gamma-and delta-to alpha
      tocopherol are also subjects for further study of the biological activity of
      tocopherols.

PMID- 8483271
TI  - [Vitamin K].
AB  - Vitamin K has several biological functions in which the major role is a cofactor
      for gamma-carboxylation of glutamate residues in Gla proteins, such as, several
      coagulant and anticoagulant proteins for blood clotting. This enzymatic process
      can be wholly dissolved. If adequate amounts of vitamin K are absent or
      anticoagulant drugs are administered, this process will be incomplete and
      abnormal proteins will appear in the blood. Recently, it was found that this
      carboxylation is blocked by the antibiotics having the N-methyltetrazolethiol
      group. These antibiotics inhibit vitamin K epoxide reductase, stop the recycling
      of vitamin K and cause vitamin K deficiency. Vitamin K is also necessary for
      biosynthesis of osteocalcin, which is a important protein in the normal function
      of the bone.

PMID- 8483272
TI  - [Ubiquinones].
AB  - Recent topics on the biochemical and clinical aspects of ubiquinone are reviewed
      in this paper. Dallner and his colleagues have demonstrated that ubiquinone is
      synthesized, not only in mitochondria, but also on the endoplasmic reticulum
      Golgi system of the rat liver. New clinical studies that reduction of ubiquinone
      levels and cardiac functions was induced by treatment with lovastatin, a HMG-CoA
      reductase inhibitor, have been reported by Folkers et al. According to recent
      findings, a greater part of ubiquinone in rat and human tissues exists as a
      reduced hydroquinone form of ubiquinol. On the other hand, good evidence for the
      antioxidative activity of ubiquinol was obtained from experiments using
      phosphatidylcholine liposomes and low density lipoprotein.

PMID- 8483273
TI  - [Determination of retinoids and retinol-binding protein].
AB  - The development of high-performance liquid chromatography (HPLC) in the late
      seventies, enabled us to measure various retinoids in the serum and tissue
      samples and has contributed to exciting new discoveries of retinoid field.
      Mainly, serum, retinoids has been measured by reversed phase HPLC with isocratic
      or gradient mobile eluent. In this paper, several HPLC methods for determining
      serum retinoids are reviewed. The discovery of plasma retinol-binding protein
      (RBP) in 1968 has shed new insight into retinoid metabolism. Due to the
      biochemical character of RBP, serum levels of this protein is a good marker for
      hepatic reserved function and urine levels for tubular proteinuria. Several
      methods for RBP determination are also reviewed.

PMID- 8483274
TI  - [Assay of fat-soluble vitamins--vitamin D].
AB  - Methods for determination of vitamin D, 25-OH-D, 24,25(OH)2D and 1,25(OH)2D in
      plasma are reviewed. A method for simultaneous determination of the D2 and D3
      compounds of vitamin D and the metabolites in plasma is established. The method
      includes extraction of lipid, followed by three steps of HPLC for clean-up and
      separation. Vitamin D and 25-OH-D are quantified by HPLC with a UV detector,
      while 24,25(OH)2D and 1,25(OH)2D are assayed by CPBA and RRA methods,
      respectively. The assayed values for concentrations of the compounds in plasma of
      normal subjects and various kinds of patients are shown. A simplified method for
      assaying 1,25(OH)2D in plasma using calf thymus receptor is also introduced.

PMID- 8483275
TI  - [Measurement of vitamin E from biological samples].
AB  - Recent advances in HPLC have enabled to measure small amounts of tocopherols in
      biological samples. A fluorescence detector is usually used for detection of
      tocopherols, however we have determined tocopherols of blood samples by an
      electrochemical detection (ECD). This ECD method is 1,000 times more sensitive
      than conventional fluorescence methods, and is suitable for detection of small
      amounts of tocopherols of blood cells. In this report, preparation and extraction
      methods from blood samples are described. Preparation of blood to separate
      plasma, platelets, mononuclear cells, and polymorphonuclear cells is performed
      using a density-gradient method. Extraction of tocopherols usually involves
      saponification using ethanolic solution of potassium hydroxide.

PMID- 8483276
TI  - [Vitamin K].
AB  - In this paper, highly sensitive methods for measuring of vitamin K in serum,
      feces and milk are described. Vitamin K1 and the menaquinone family from the
      serum, feces and milk were separated by high performance liquid chromatography.
      The separated K1 and menaquinone families were detected by a fluorescence
      spectrophotometer after their reduction with sodium borohydride or platinum
      catalyst column. In these methods, minimum detectable quantities of K1,
      menaquinone-4 and menaquinone-7 were 10, 10 and 50 pg, respectively. More than
      95% of supplemented vitamin K1, menaquinone-4 and menaquinone-7 were recovered in
      the serum and feces. Furthermore, the method of Hirauchi et al. for measurement
      of vitamin K1 2,3-epoxide in human plasma is introduced.

PMID- 8483277
TI  - [Determination of ubiquinones in biological material by high performance liquid
      chromatography].
AB  - Quantitative high performance liquid chromatographic (HPLC) methods are described
      for the determination of reduced, oxidized, and total ubiquinone (UQred, UQox,
      and total UQ, respectively) in biological material. UQ was extracted into n
      hexane from an aqueous homogenate after precipitation of protein by addition of
      alcohol. The n-hexane extract was evaporated to dryness under a N2 atmosphere at
      30 degrees C. In order to determine the total UQ, UQred was converted into the
      corresponding oxidized form (UQox) with ferric chloride. UQox was separated on a
      reversed-phase column and detected by its ultraviolet absorption (UV275n m). For
      the simultaneous assay of UQred and UQox, the n-hexane extract was injected onto
      a HPLC having a UV detector and an electrochemical detector (ECD) coupled in
      series. UQox was detected by its UV275n m, and UQred by ECD. The HPLC methods
      described here were applied satisfactorily to the determination of UQred, UQox,
      and total UQ in human and animal tissues.

PMID- 8483278
TI  - [Recommended dietary allowances of fat-soluble vitamins].
AB  - In Japan the recommended dietary allowances (RDAs) of vitamin A for adult male is
      calculated at 600 micrograms RE, on the data in a human vitamin A depletion
      repletion study that minimum requirement for maintenance of a adequate retinol
      storage at liver is 6.6 micrograms/kg body weight/day. By contrast, it is
      estimated at 1,000 micrograms RE in U.S., on the basis of a study that minimum
      requirement for prevention of follicular hyperkeratosis, not impaired dark
      adaptation, is 910 micrograms RE/day in most adult men. On fourth edition of
      Japanese RDAs in 1989, the estimated safe and adequate daily dietary intake of
      vitamin E for adult male was established at 8 mg alpha TE, on the data that the
      average of unsaturated fatty acid intake was 14.3 g/day and a desirable [vitamin
      E (mg) to PUFA (g)] ratio of 0.4, whereas the 8-10th editions of U.S. RDAs of
      vitamin E for adult male had been estimated at 10 mg alpha TE. And the RDAs of
      other fat-soluble vitamins were discussed on the differences between Japan and
      other countries.

PMID- 8483279
TI  - [Vitamin deficiency and marginal vitamin deficiency].
AB  - Fat-soluble vitamin deficiency and marginal deficiency of this type of vitamin
      will be discussed. The trias of vitamin A deficiency is composed of nyctalopia,
      xerophthalmia and hyperkeratosis follicularis. Vitamin D deficiency causes
      rachitis and osteomalacia. In Japan, vitamin D deficiency is more often caused by
      impaired vitamin D activation due to renal failure, than by a lack of sunbathing
      or insufficient ingestion of vitamin D from diet. At present, it is quite rare
      that the physician encounters patients with deficiency of vitamin E or other
      vitamins. According to surveys of occult vitamin deficiency, the prevalence of
      marginal fat-soluble vitamin deficiency was lower than that of marginal water
      soluble vitamin deficiency. Marginal vitamin deficiency seems to be absent or
      very rare among healthy individuals. In patients, however, marginal vitamin
      deficiency is sometimes observed. Since marginal vitamin deficiency can modify
      the underlying disease or trigger complications, the physician should take
      adequate measures to prevent the onset of marginal vitamin deficiency in managing
      patients with various diseases.

PMID- 8483280
TI  - [Vitamin A and E deficiency in children, including the marginal deficiency].
AB  - 1. Vitamin A: There are very few reports on vitamin A deficiency in Japan because
      of the rising national status of nutrition, while vitamin A deficiency is still
      an important nutritional problem in developing and poorly developed countries. In
      the pediatric field, relationship between vitamin A nutrition and the mechanism
      for development of bronchopulmonary dysplasia have been discussed, since vitamin
      A acts as a protector from the keratinization of epithelial cells in the mucosal
      layer and the skin. The changes in the lung tissues with inadequately supplied
      vitamin A, probably cause the chronic lung disease resulting from mechanical
      ventilation in neonates, in whom the plasma vitamin A and retinol binding protein
      levels are usually low. 2. Vitamin E: In keeping with the view that newborn
      infants and especially premature infants suffer from vitamin E deficiency. On the
      basis of recent findings of the vitamin E content in the neonatal cells, the
      previous concept would agree, as an existing marginal deficiency in neonates. The
      neurologic deficits manifested in a beta-lipoproteinemia is confirmed to be
      vitamin deficiency in humans. It has also become clear that similar neurologic
      impairment occurs in other chronic fat malabsorptive states, such as cholestatic
      liver diseases, extensive resection of the gut. More recently several patients
      with spinocerebellar degeneration from vitamin E deficiency without other
      evidence of malabsorption in whom progression of the diseases is terminated by
      the vitamin E therapy (isolated vitamin E deficiency) have been reported. The
      above items are discussed.

PMID- 8483281
TI  - [Hypervitaminosis D].
AB  - Excessive vitamin D causes marked and prolonged hypercalcemia by accelerating
      intestinal calcium absorption and bone resorption. Vitamin D induced
      hypercalcemia includes the toxic ingestion of excessive amount of vitamin D
      preparations, granulomatous diseases and lymphoproliferative malignancies. In
      vitamin D toxicity, the clinical courses vary depending on the vitamin D
      preparation responsible for the hypercalcemia. Hypercalcemia state continues for
      several months when D2 or D3 are responsible for the toxicity whereas the
      hypercalcemia would subside in a week when 1 alpha(OH) D3 or 1,25 (OH)2D3 are
      responsible for the toxicity. Abnormal calcium metabolism can be treated by
      hydration and glucocorticoids. Hypercalcemia is associated with variety kinds of
      granulomatous diseases, including sarcoidosis and tuberculosis. The granulomatous
      tissue is believed to be the site of the ectopic production of 1,25(OH)2D3 in
      which the regulation of the synthesis is quite different from that in the normal
      kidney. Glucocorticoid markedly diminishes the synthesis. Hypercalcemia
      associated with elevated serum 1.25(OH)2D3 levels is also found in patients with
      lymphomas and some other malignancies. However, there still are not sufficient
      evidences to prove that the excessive amount of endogenous 1.25(OH)2D3 is the
      primary cause of the hypercalcemia.

PMID- 8483282
TI  - [Clinical application of vitamin A, D and E against malignant tumor in human].
AB  - A great number of epidemiologic studies over the last decade have found that
      vitamin A, D and E are associated with a reduced risk for malignant tumors in
      human, though these high levels in blood do not always establish the low risk of
      a variety of malignant tumors. Consequently, either micronutrient supplementation
      or/and food fortification are going to be recommended as a prevention strategy of
      malignant tumors to the general population. On the other hand, concerning the
      clinical application of these vitamins in the treatment for malignant tumors,
      most recently, active forms of vitamin A and D are said to be effective in some
      leukemias. Especially, the administration of all-trans retinoic acid in acute
      promyelocytic leukemia patients has been established to be more effective and
      safer than conventional chemotherapies to obtain complete remission. In reviewing
      these studies, more detailed elucidation in clinical usefulness of these vitamins
      and as their chemoprevention must await further investigations.

PMID- 8483283
TI  - [Atherosclerosis, with special reference to vitamin E].
AB  - The relationship between atherosclerosis and fat soluble vitamin, especially
      vitamin E is reviewed on the basis of oxidised modification of low density
      lipoprotein (LDL). Data now support the notion that the oxidised LDL is present
      in the blood and arterial wall and antioxidant drugs such as probucol and vitamin
      E, beta-carotene, may prevent the progression of atherosclerosis. LDL alpha
      tocopherol levels are generally correlated to the plasma concentrations and
      supplementation with alpha-tocopherol increases its content in LDL. There is a
      significant correlation between the LDL alpha-tocopherol level and the resistance
      to oxidative modification. Epidemiological data also shows the relation between
      low levels of plasma vitamin E and the increased incidence of coronary heart
      disease. Clinical application of vitamin E should be clarified in detail to
      inhibit the progression of atherosclerosis.

PMID- 8483284
TI  - [Calcium antagonists in the elderly patients].

PMID- 8483285
TI  - [Characteristics of clinical asthma types in elderly patients with bronchial
      asthma].
AB  - Asthma was classified into four types, Ia-1 (bronchospasm with 0-49 ml/day of
      expectoration), Ia-2 (with 5-99 ml/day), Ib (over 100 ml/day) and II (bronchiolar
      obstruction), according to clinical symptoms. Characteristics of airway responses
      in each clinical asthma type were compared between 25 elderly (mean age, 65.2
      years) and 30 younger subjects (mean age, 44.9 years) with bronchial asthma, by
      observing ventilatory function and cellular composition in bronchoalveolar lavage
      (BAL) fluid. 1. In patients with types 1a-2 and Ib, the %V25 value was
      significantly lower in the elderly subjects than in the younger subjects. 2.
      Comparing the values of ventilatory parameters of type Ia-1 cases with other
      asthma types, %V25 value was lower in other asthma types than in type Ia-1 in the
      elderly. All ventilatory parameters examined were generally lower in type II
      cases than in other asthma types in the elderly, but this difference was not
      significant. In contract, in the younger subjects, the values of %MMF, %V50 and
      %V25 were significantly lower in type II cases than in other asthma types. 3. The
      proportion of neutrophils in bronchoalveolar lavage (BAL) fluid was higher in the
      younger patients with type II than in the elderly patients with the same type,
      although there was no significant difference between older and younger subjects.
      The proportion of BAL eosinophils in patients with type Ib was significantly
      higher in younger subjects than in elderly subjects. These results indicate that
      airway responses which are characteristic of each asthma type are stronger in
      younger patients than in elderly patients.

PMID- 8483286
TI  - [Relationship between abdominal fat distribution assessed by computed tomography
      and serum lipids in the elderly].
AB  - A nutritional assessment is necessary to evaluate the pathophysiological state of
      patients, and serum lipids are one of the factors which must be evaluated. Body
      fat distribution is considered to be associated with cardiac diseases, metabolic
      diseases and hypertension. In this study, we performed quantitative measurements
      of fat distribution by X-ray computed tomography (CT) in 31 elderly outpatients.
      Thirteen males (mean age 74.8 years) and 18 females (mean age 75.4 years) were
      examined by abdominal CT. All subjects had body mass indices within the normal
      range and did not have malignant disease, hyperlipidemia, liver dysfunction or
      diabetes mellitus. CT scans were carried out at the level of the middle abdomen;
      these scan slices included intraabdominal fat which consisted of omental,
      retroperitoneal and perirenal adipose tissues. Subcutaneous fat areas and
      intraabdominal fat areas were measured from six 10-mm-thick slice films using a 2
      dimensional computerized calculator. The relationship between serum lipids and
      fat distribution was also examined. The ratio of intraabdominal adipose tissue
      area to subcutaneous adipose tissue area (V/S) was higher in males than in
      females. V/S correlated positively with serum triacylglycerol and correlated
      negatively with serum HDL-Ch. These results suggest that the measurement of body
      fat distribution is important to evaluate lipid metabolism and nutritional states
      in the elderly.

PMID- 8483287
TI  - [An elderly case of thrombotic thrombocytopenic purpura].
AB  - A 78-year-old woman was admitted to our hospital because of disorientation and
      fever on January 21, 1992. Two days before admission she experienced vomiting,
      anorexia and general malaise. Laboratory examinations on admission disclosed a
      hemoglobin level of 11.1 g/dl and a platelet count of 8,000/microliters. The
      peripheral blood smear revealed anisocytosis with numerous schistocytes and
      poikilocytes. Polychromatophilic and nucleated red blood cells were also seen,
      and the reticulocyte count was 38/1000. Her serum lactate dehydrogenase (LDH)
      value was 2,977 WU and the total serum bilirubin level was 3.5 mg/dl with 2.7
      mg/dl indirect reacting fraction. Serum creatinine was 4.7 mg/dl. Her
      consciousness became semicomatose after a systemic seizure which lasted
      approximately 15 seconds and her hemoglobin level decreased to 8.5 g/dl on
      hospital day 2. Therefore, we diagnosed her as having thrombotic thrombocytopenic
      purpura (TTP) because of the presence of all 5 features, that is,
      thrombocytopenia, microangiopathic hemolytic anemia, fluctuating neurologic
      abnormalities, renal dysfunction and fever. A plasmapheresis with fresh frozen
      plasma (FFP) replacement was begun on that day. She was also treated with anti
      platelet agents, 80 mg/day aspirin, and 300 mg/day dipyridamole. Moreover, packed
      red blood cells (PRC) were infused. While also receiving diphenylhydantoin and
      phenobarbital to prevent convulsions, status epilepticus developed on day 3.
      Because of inhibited spontaneous respiration which was an adverse effect derived
      from diazepam and sodium thiamylal administered intravenously to treat the status
      epilepticus, an artificial respiration was initiated.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8483288
TI  - [A case of primary systemic amyloidosis with skeletal muscle atrophy and
      congestive heart failure].
AB  - A 77-year-old male had been noticing progressive weakness of the legs for three
      years. By the age of 75 he had difficulty in climbing stairs. On admission, serum
      level of CPK was moderately high. There were weakness and atrophy of the proximal
      muscles. Deep tendon reflexes were depressed. Sensation was normal. The
      electromyogram and the biopsy of the femoral quadriceps muscles showed
      nonspecific changes. In 1989, he developed difficulty in walking and had
      congestive heart failure. On the second admission, moist rales were heard over
      the chest, and pitting edema was present in the lower extremities. The chest
      roentgenogram showed a cardiothoracic ratio of 63% and bilateral pleural
      effusion. The electrocardiogram showed atrial flutter with 2:1 conduction, QS in
      V1-3, rS in V4, and ST depression and T inversion in V5,6. The echocardiogram
      revealed a thick left ventricular wall and impaired left ventricular contraction
      (EF 22%). Macroglossia, hepatosplenomegaly and renal dysfunction were not noted.
      Congestive heart failure progressed and he suddenly died of ventricular
      tachycardia in December 1989. At autopsy, skeletal muscle fibers varied in size
      and showed fiber splitting. A cellular infiltration was observed in the stroma.
      Amyloid deposit was positively stained with Congo red. The heart weight was 570 g
      with marked left ventricular hypertrophy and moderate bilateral atrial
      dilatation. In both atria and ventricles, extensive amyloid deposition was found
      around myocardial fibers as well as in perivascular spaces. Amyloid was present
      also in the liver, the kidneys, the gastrointestinal tracts, and the other
      organs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483289
TI  - [Complete remission of acute promyelocytic leukemia accompanied by DIC in an
      elderly patient treated with all-trans retinoic acid].
AB  - In this paper we report on a 74-year-old female patient who was suffering from
      acute promyelocytic leukemia (APL) and who, upon admission to our hospital on
      February 20, 1992, was also found to be stricken with disseminated intravascular
      coagulation (DIC). The DIC, however, was quickly arrested by administration of
      heparin and there was no exacerbation. Also, on admission her peripheral blood
      leukocyte count was 700/ul, but after oral administration of all-trans retinoic
      acid (ATRA) (45 mg/m/day) was begun on February 22, this count gradually
      increased and peaked at 35,200/ul on March 7. Some of these matured leukocytes
      revealed dysplastic features; some had Auer bodies. At this time cytogenetic
      analysis of bone marrow cells showed 46XX, t (15;17). The leukocyte count
      gradually decreased to 1,500/ul, and the dysplastic features disappeared. On
      March 21 her thrombocytes and reticulocytes began to increase, and she achieved
      complete remission when her abnormal karyotype disappeared on March 24. She
      suffered no severe complications such as infection or hemorrhage during
      treatment. We therefore suggest that ATRA is very effective for APL in elderly
      patients. It neither exacerbates DIC nor increases the risk of infection. In
      fact, when ATRA treatment is compared to the standard cytotoxic chemotherapy
      there is a reduced risk of infection.

PMID- 8483290
TI  - [Aging and serum protein].

PMID- 8483291
TI  - [77th Congress of the Medico-Legal Society of Japan. April 21-23, 1993/Fukuoka.
      Abstracts].

PMID- 8483292
TI  - Effects of BMY-21502 on anoxia in mice.
AB  - The protective effects of BMY-21502 (1-[[1-[2-(trifluoromethyl)-4-pyrimidinyl]-4
      piperidinyl]methyl]-2- pyrrolidinone) against cerebral anoxia were investigated
      using various models in mice, in comparison with those of other cerebroactive
      drugs. Oral administration of BMY-21502 (10-100 mg/kg) significantly prolonged
      the survival time in KCN (2.4 mg/kg, i.v.)-induced anoxia. Oxiracetam and
      idebenone exerted similar but weak protection at doses above 100 mg/kg, p.o. and
      only at a dose of 100 mg/kg, p.o., respectively. Significant protection by BMY
      21502 against moderate hypobaric hypoxia was observed at doses of 30 and 100
      mg/kg, p.o. Idebenone (100 and 300 mg/kg, p.o.) significantly prolonged the
      survival time of mice in this model, but oxiracetam (30-300 mg/kg, p.o.) did not.
      Oral administration of all of these drugs (BMY-21502, 3-300 mg/kg; Oxiracetam,
      100-1000 mg/kg; Idebenone, 100-1000 mg/kg) failed to increase the number of gasps
      and the duration of gasping in the decapitated head of mice as a complete
      ischemic model. The anti-anoxic effect of BMY-21502 in the KCN-anoxia model was
      blocked by pretreatment with scopolamine. These findings suggest that BMY-21502
      has an anti-anoxic action superior to those of the other cerebroactive drugs
      used, and activation of the CNS cholinergic system is involved as one of the
      causative mechanisms for the anti-anoxic effect of BMY-21502.

PMID- 8483293
TI  - Leakage of the fluorescent Ca2+ indicator fura-2 in smooth muscle.
AB  - The movement of a fluorescent intracellular Ca2+ indicator, fura-2, in smooth
      muscle was examined. Strips of rat and rabbit aortas and bovine trachea were
      loaded with the acetoxymethyl ester of fura-2 (fura-2/AM), followed by washing
      with normal physiological solution. Not only fura-2/AM but also fura-2 was
      detected in the washout solution. The amount of fura-2 in the cells, measured
      fluorometrically, decreased gradually during the washout. The decrease was
      fastest in rat aorta followed by rabbit aorta > bovine trachea. In rat aorta,
      fura-2 leakage was inhibited by an inhibitor of anion transport, probenecid, or
      by a decrease in bath temperature. The Ca2+ ionophore ionomycin (10 microM)
      increased the leakage of fura-2, which was not inhibited by probenecid, possibly
      because a high concentration of ionomycin nonselectively increased membrane
      permeability. These results suggest that fura-2/AM is cleaved to fura-2 in the
      cell which gradually leaked out of the cell mainly by an anion transport system.
      The amount of fura-2 in the cell seemed to be determined mainly by the rate of
      leakage of fura-2, which is the largest in rat aorta followed by rabbit aorta and
      bovine trachea.

PMID- 8483294
TI  - Calcium-induced vasodilation due to increase in nitric oxide formation in the
      vascular bed of rabbit ear preparation.
AB  - Participation of calcium-induced vasodilation (due to an increase in synthesized
      nitric oxide (NO) content in endothelial cells) in the arterio-venous
      circulation, including the vascular bed was investigated by the vessel perfusion
      method in the isolated rabbit ear preparation. The perfusion medium used was a
      tris-buffered solution. When CaCl2 (6.25, 12.5 and 25 mg) was injected in the
      perfused vessel of the rabbit ear preparation, dose-dependent vasocontraction was
      observed when vascular tone was kept at a normal level. However, CaCl2 dose
      dependently induced vasodilation of the vessel when it was continuously
      contracted by norepinephrine (1.2 x 10(-7) M). This calcium-induced vasodilation
      was inhibited in the presence of NG-nitro-L-arginine (5 x 10(-5) M), a selective
      inhibitor of NO synthesis, and methylene blue, a guanylate cyclase inhibitor,
      although it was rarely affected by indomethacin (10(-5) M), a cyclooxygenase
      inhibitor. Calcium-induced vasodilation was also obtained in the in situ
      circulation containing vascular bed, and this suggests that the vasodilation was
      due to a Ca(2+)-induced increase in the synthesis of NO derived from endothelial
      cells.

PMID- 8483295
TI  - Mechanisms of the inhibitory action of semotiadil fumarate, a novel Ca
      antagonist, on the voltage-dependent Ca current in smooth muscle cells of the
      rabbit portal vein.
AB  - Effects of semotiadil on the voltage-dependent Ca current (ICa) were investigated
      in dispersed smooth muscle cells of the rabbit portal vein. At a holding
      potential of -100 mV, semotiadil (> or = 0.1 microM; dissolved in
      dimethylsulphoxide, DMSO) inhibited the ICa in a concentration-dependent manner
      (IC50 = 2.0 microM, Hill's coefficient = 1.0). At a holding potential of -80 mV
      or -60 mV, the concentration-inhibition curve observed in the presence of
      semotiadil was shifted to the left compared with that observed at -100 mV; and
      semotiadil shifted the voltage-dependent inactivation curve to the left. The
      curve for the decay of ICa was fitted with two time constants. Semotiadil (< 1
      microM) reduced the slow but not the fast time constant. The curve for the
      recovery from ICa inactivation also consisted of two time constants, and
      semotiadil (1 microM) prolonged the slow recovery. Semotiadil dissolved in
      deionized water more potently inhibited ICa than semotiadil dissolved in DMSO. At
      pH 10.0, semotiadil did not modify the voltage-dependent inactivation curve.
      However, recovery from the inactivation was much faster at pH 10.0 than at pH
      7.3. These results indicate that the voltage-dependent inhibition of ICa by
      semotiadil may be due to binding of the ionized drug during the inactivated state
      and also inhibition of the transition from the inactivated to the resting state.
      Long-lasting inhibition of ICa after removal of semotiadil may be due to tight
      binding of semotiadil on the channel through a hydrophobic site.

PMID- 8483296
TI  - Circadian rhythm in the cerebral resistance to hypoxia in mice.
AB  - The cerebral resistance to hypoxia in mice was investigated by measuring the
      survival time under both hypobaric and normobaric hypoxic conditions. In the ad
      libitum fed mice, there was a circadian variation in the survival time that was
      longer during the light period than during the dark period under hypobaric
      hypoxic conditions. The survival time under normobaric hypoxic conditions also
      exhibited a similar circadian variation in the ad libitum fed mice, whereas the
      rhythm of the survival time was completely reversed by the restriction of food
      presentation (9:00-15:00). These findings suggest that there is a circadian
      rhythm in the cerebral resistance of mice to hypoxia, which can be shifted by the
      time of food presentation. Furthermore, regression analyses revealed a negative
      correlation between the survival time of mice exposed to hypoxia and body
      temperature, and blood glucose levels. These indicate that the cerebral
      resistance to hypoxia was intimately associated with body temperature and blood
      glucose that both show a circadian rhythm in mice.

PMID- 8483297
TI  - Regulation of spontaneous acetylcholine release in the hypothalamic
      vasopressinergic supraoptic nucleus of a freely moving rat: a study by in vivo
      microdialysis.
AB  - We employed a brain microdialysis method to examine the possible regulation of
      spontaneous acetylcholine (ACh) release in the hypothalamic vasopressinergic
      supraoptic nucleus (SON) of rats. We monitored the basal ACh release in the SON
      microdialysate. The addition of tetrodotoxin (10(-6) M) to the perfusate (saline
      containing 10(-4) M physostigmine) decreased the basal ACh release. A muscarinic
      receptor antagonist, atropine (non-selective) or pirenzepine (M1-selective),
      increased the basal ACh release in a concentration-dependent manner. The maximal
      increase occurred at 20-40 min after the start of the infusion of antagonists.
      The ED50 values for the stimulatory effects of atropine and pirenzepine were 9.4
      x 10(-8) and approx. 10(-4) M, respectively. The effect of atropine (10(-6) M)
      was inhibited by simultaneous addition of the muscarinic agonist oxotremorine
      (10(-5) M). The results showed a negative feedback regulation of the spontaneous
      ACh release through the activation of muscarinic receptors in the SON. The weak
      effect of pirenzepine in increasing the ACh release, compared with atropine,
      suggests that ACh release in the nucleus is mainly regulated by the non-M1
      muscarinic receptor subtype.

PMID- 8483298
TI  - Novel low immunosuppressive derivatives of the antitumor drug fluoropyrimidine,
      UK-21 and UK-25: effect on delayed type hypersensitivity and tumor immunity.
AB  - Previously, we reported that two novel 5-fluoropyrimidine derivatives, 2',3',5'
      tris-O-[N-(2-n-propyl-n-pentanoyl)glycyl]-5-fluorouridine (UK-21) and 1-(6-[N-(2
      n-propyl-n-pentanoyl)glycyl]amino-n-hexylcarbamoyl)- 5-fluorouracil (UK-25), show
      potent antitumor activity with low immunotoxicological effects. The purpose of
      this paper was to evaluate the effect of these drugs on delayed type
      hypersensitivity (DTH). Not only UK-21 and UK-25 but also tegafur (FT-207) and 5
      fluorouracil (5-FU) produced no suppression of picryl chloride (PC)-induced DTH
      in mice but rather enhanced it. It is known that variation of the sensitizing
      antigen dose alters the effect of drugs on the immune response. Because it was
      difficult to control the antigen dose in PC-DTH, the sheep erythrocyte (SRBC)
      induced response was used to examine the effect of drugs on delayed type
      hypersensitivity in the succeeding experiments. Either a therapeutic dose or an
      over-dose of the respective drug was given to mice sensitized with 5 x 10(5) or 5
      x 10(7) SRBC. The suppressive effects of UK-21 and UK-25 on the DTH were lower
      than those of FT-207 and 5-FU. UK-21 and UK-25 enhanced Meth A tumor-specific DTH
      in BALB/c mice, but FT-207 and 5-FU did not. UK-21, UK-25 and FT-207 showed a
      tendency to enhance or restore the Meth A tumor neutralizing activity of spleen
      cells in mice bearing the tumor, but carmofur (HCFU) did not. These results
      indicated that the suppressive effects of UK-21 and UK-25 on the tumor immune
      response were also low.

PMID- 8483299
TI  - Characterization of a novel aldose reductase inhibitor, TAT, and its effects on
      streptozotocin-induced diabetic neuropathy in rats.
AB  - TAT ([5-(3-thienyl)tetrazol-1-yl]acetic acid) is a novel aldose reductase (AR)
      inhibitor. It exhibited highly potent inhibition of partially purified AR from
      rat lens (IC50 = 2.1 x 10(-8) M), rabbit lens (IC50 = 2.3 x 10(-8) M) and human
      placenta (IC50 = 2.8 x 10(-8) M). On the other hand, TAT had a weak inhibitory
      activity against mouse liver aldehyde reductase (ALR) (IC50 = 2.4 x 10(-6) M) and
      poor inhibitory activity against several adenine nucleotide-requiring enzymes.
      Against rat lens AR, TAT exhibited an uncompetitive inhibition at a concentration
      of 1.0 x 10(-8) M and a mixed type inhibition at higher concentrations. TAT
      inhibited sorbitol accumulation in the isolated rat sciatic nerve (IC50 = 1.0 x
      10(-6) M), rat lens (IC50 = 5.7 x 10(-6) M), human erythrocytes (IC50 = 2.5 x 10(
      7) M), and rabbit erythrocytes (IC50 = 2.1 x 10(-7) M) incubated with high
      glucose concentrations. The oral administration of TAT (5-100 mg/kg/day) to
      streptozotocin (STZ)-induced diabetic rats during a 5-day treatment period
      decreased the sorbitol content in the sciatic nerve, dose-dependently (ED50: 8.8
      mg/kg/day for the prevention and 9.0 mg/kg/day for the reversal). Moreover, TAT
      (2.5-40 mg/kg/day) improved the decreased motor nerve conduction velocity (MNCV)
      after a 14-day treatment period. There was a significant correlation between MNCV
      and sciatic nerve sorbitol content. From these results, TAT is expected to be
      useful for the clinical treatment of diabetic complications.

PMID- 8483300
TI  - Comparative effects of cimetidine and famotidine on the vagally stimulated acid
      secretion in the isolated mouse whole stomach.
AB  - We investigated the effects of cimetidine and famotidine on the acid secretory
      response to electrical vagal stimulation, bethanechol and histamine in the
      isolated mouse whole stomach preparation. The acid secretion elicited by
      electrical vagal stimulation at the position of the esophagus (10 Hz, 0.3 msec,
      10 V for 5 min) was reproducible by repeated stimulation in each preparation, and
      it was abolished by tetrodotoxin, atropine and hexamethonium. This vagally
      stimulated acid secretion was abolished by cimetidine (3 mM), while it was only
      partly inhibited by famotidine (10-100 microM). Histamine (100 microM)-induced
      acid secretion was inhibited by cimetidine and famotidine, and the doses of these
      drugs required for complete inhibition were 3 mM and 10 microM, respectively. In
      contrast, bethanechol (10 microM)-induced acid secretion was slightly reduced by
      famotidine (1-100 microM), but markedly reduced by cimetidine (3 mM). In the
      guinea pig ileum, millimolar concentrations of cimetidine and famotidine shifted
      the dose-response curve of the contractile response to acetylcholine rightward.
      These findings suggest that the inhibitory effect of cimetidine on the vagally
      stimulated or bethanechol-induced acid secretion is elicited at least partly
      through mechanisms different from H2-antagonism.

PMID- 8483301
TI  - Involvement of serotonergic receptor subtypes in the production of
      antinociception by psychological stress in mice.
AB  - Besides the important role of emotional factors in the production of
      psychological-stress-induced analgesia (PSY-SIA), recent attention to the
      participation of serotonergic (5-HTnergic) neurons in the fear- and anxiety
      evoking mechanism led us to examine the effects of 5-HTnergic ligands on PSY-SIA.
      Pretreatment of mice with 2.0 to 10 mg/kg of methysergide, a 5-HT receptor
      antagonist, or 1.0 to 10 mg/kg of buspirone, a 5-HT1A receptor partial agonist,
      dose-dependently suppressed the production of PSY-SIA. Ritanserin, a 5-HT2
      receptor antagonist, 1.0 to 5.0 mg/kg, or Y-25,130, a 5-HT3 receptor antagonist,
      0.03 and 0.1 mg/kg, also inhibited PSY-SIA dose-dependently, while (+/-)pindolol,
      a 5-HT1A/1B receptor antagonist, was ineffective at doses up to 3.0 mg/kg.
      Furthermore, the suppressive effect of PSY-stress on the development of
      antinociceptive tolerance to morphine was also antagonized by methysergide,
      buspirone, ritanserin and Y-25,130, but not by (+/-)pindolol. These results
      suggest that 5-HT receptor (5-HT1A, 5-HT2 and 5-HT3 but not 5-HT1B)-mediated
      mechanisms play an important role in the production of PSY-SIA.

PMID- 8483302
TI  - Renal tubular site of action of KW-3902, a novel adenosine A1-receptor
      antagonist, in anesthetized rats.
AB  - The mechanism of the diuretic action of KW-3902 (8-(noradamantan-3-yl)-1,3
      dipropylxanthine), an adenosine A1-receptor antagonist, was investigated by a
      lithium clearance study and stop-flow method in anesthetized rats. KW-3902
      increased urine volume (UV), sodium excretion and renal clearances of sodium
      (CNa) and lithium (CLi), when UV and CNa increased more than CLi. KW-3902 did not
      affect the stop-flow pattern, whereas trichlormethiazide inhibited the
      reabsorption of water and sodium at the distal nephron. These results suggest
      that the adenosine A1-receptor blockade exhibits diuretic effects via the
      inhibition of reabsorption of water and sodium mainly at the proximal tubule. The
      additional small contribution of the distal action can not be ruled out.

PMID- 8483303
TI  - Antisecretory and antiulcer effects of ebselen, a seleno-organic compound, in
      rats.
AB  - The effects of ebselen (2-phenyl-1,2-benzisoselenazol-3(2H)-on), a metal
      containing organic compound, on gastric secretion and gastric ulceration were
      examined in rats. Intraduodenal ebselen (30 to 300 mg/kg) significantly and dose
      dependently inhibited gastric secretion in pylorus-ligated rats. Both aspirin-
      and water-immersion restraint stress-induced ulcers were significantly prevented
      by oral administration of ebselen at doses equivalent to the antisecretory doses.
      These results indicate that the antisecretory effect of ebselen underlies its
      antiulcer effect in these models.

PMID- 8483304
TI  - [Addictive diseases--more understanding through additional education?].

PMID- 8483305
TI  - [Nurses face drug abuse].

PMID- 8483306
TI  - [Rape. How can nurses help?].

PMID- 8483307
TI  - [Hanne Pelzer, geriatric nurse].

PMID- 8483308
TI  - [Attitudes toward HIV positive and AIDS patients. A poll among nurses].

PMID- 8483309
TI  - [The role of nursing in the therapeutic team].

PMID- 8483310
TI  - Effect of conduction distance on amplitude and area of compound action potentials
      of A fiber and C fiber.
AB  - We used 24 sacral dorsal roots of the rat to analyze amplitude and area changes
      of biphasic and monophasic compound action potentials (CAPs) at 4 conduction
      distances. Both the CAPs of the A-fiber and C-fiber were analyzed. The changes
      were examined with the paired t test and linear regression. All the variables
      decreased linearly with increasing conduction distance except area of monophasic
      CAP, which remained constant throughout. CAP data were also compared between the
      S1 and S2 roots by using the pooled t test. Only area of monophasic CAP showed
      good correspondence with the anatomical data. Therefore, area of monophasic CAP
      is suggested as the best parameter for representing the functional state of a
      nerve.

PMID- 8483311
TI  - Oxygen tension clamp around single neurons in vitro: a computerized method for
      studies on O2 deprivation.
AB  - This report presents a novel computerized oxygen tension clamp for use with
      single neurons. One main objective for developing such a system is to be able to
      study the intrinsic response of single neurons to graded hypoxia. The device
      described in this paper is comprised of three major subsystems: (1) an oxygen
      monitoring subsystem, (2) a motorized perfusion subsystem and (3) a computer
      subsystem for data acquisition and control. The clamp uses an oxygen scavenger
      (sodium hydrosulfite) to decrease O2 availability. The system has many
      advantageous features: (a) studies on hypoxia can be carried out without using
      chemical metabolic inhibitors to simulate hypoxia; (b) precise control of the O2
      level around a given cell is feasible for extended periods of time; (c) rapid and
      accurate changes in the O2 level around a cell can be made because the O2 level
      is continuously monitored and adjusted by a computer; (d) other cells outside of
      the immediate vicinity of the cell being studied are not subjected to hypoxic
      exposures; and (e) the system is inexpensively built around readily available
      components.

PMID- 8483312
TI  - An apparatus for controlled stretch of human jaw-closing muscles.
AB  - The design of a special-purpose muscle stretcher for reflex studies of the human
      jaw-closing muscles is described. The device is based on a servo-controlled
      electromagnetic vibrator which imposes controlled displacements on the lower jaw.
      The mechanics of the device keep jaw movements coaxial with the temporomandibular
      joint during the stretches. The design incorporates important safety features
      including mechanical stops and electronic cut-outs to protect the jaws from
      excessive stretches.

PMID- 8483313
TI  - Behavioral evaluating methods in the objective clinical assessment of motor
      function after experimental brachial plexus reconstruction in the rat.
AB  - Unfortunately, the results of brachial plexus surgery have not fulfilled
      expectations. Although the components of the rat brachial plexus are similar to
      those of the human plexus, experimental work in this field is limited. No
      functional test to assess experimental brachial plexus reconstruction has so far
      been published. We worked out a method of evaluating brachial plexus impairment
      in rats in the laboratory. It consists of a simple test in which a bowl of water
      is projected over the animal's head, eliciting grooming movements of the forepaws
      towards the head. This test is therefore called the 'grooming test'. A system of
      scoring the animals' performance is suggested. Rats were also submitted to
      walking tracks analysis, but this was of limited value in assessing brachial
      plexus impairment.

PMID- 8483314
TI  - A new configuration for voltage clamp of axons used to demonstrate nerve
      conduction blockade by a 2,5-disubstituted pyrrolidine.
AB  - An original voltage-clamp technique on axons from crayfish Procambarus clarkii is
      described in this paper. Its advantages are: a fast dissection leading to the
      availability of several fibers of different diameters (10-500 microns) that may
      contain different ion channels; and use of a double-electrode voltage clamp on a
      chosen fiber with good clamping characteristics (short time clamp and good space
      clamp, small leak conductance). Because of the absence of exogenous lipidic phase
      in the superfusion chamber, this technique appears particularly suited to
      studying how liposoluble neurotoxins affect nerve conduction. This method has
      been successfully applied to test the effect of a synthetic derivative (2-(1non
      8enyl)-5(1non-8enyl)pyrrolidine (Pyr 9)) of ant venom alkaloids from Monomorium
      species on nerve conduction. We present here evidence of a strong blocking effect
      on inward current involved in spike conduction. The resting potential of the
      treated axons did not change and it appears that only the inward current was
      affected.

PMID- 8483315
TI  - Algorithm for semi-automatic sorting of objects to specified tissue domains. An
      aid for co-ordinating morphometric data with identified tissue components.
AB  - A personal computer-based technique was developed that reduces the extent of
      human efforts in obtaining data, like numerical density of profiles on area,
      describing the distribution of specific features of histological sections, e.g.,
      density of synaptic profiles or of histochemical reaction products in specified
      tissue compartments. The procedure consists of (i) marking the objects to be
      counted, (ii) recording the borderlines of (reference) tissue domains of
      interest, and (iii) allocating the marked objects to the corresponding domains
      automatically. This automatic sorting of objects into defined tissue domains is
      achieved by an algorithm operating on two sets of coordinates: (i) coordinates of
      points that constitute the boundary of tissue domains (perimeter points) and (ii)
      coordinates of points marking the particular objects to be sorted. The principle
      of the sorting calculation is to construct 'segments' of the loop by lines
      parallel to the ordinate which pass through neighbouring perimeter points. The
      'items' to be sorted are classified by the sign of marker flags allocated to each
      point depending on which side of the perimeter segment they are located.
      Segmentation and classification procedures are sequentially repeated along the
      entire perimeter of each domain specified by the operator which may result during
      the procedure in multiple changes of the sign of the flags. The internal or
      external location of each item finally is represented by the last sign of its
      flag. Objects, allocated to domains can be counted and processed further for
      numerical density determination.

PMID- 8483316
TI  - A technique for recording from spinal neurones in awake sheep.
AB  - A technique is described for implanting a chamber on 1 or 2 vertebrae of the
      spinal column of the sheep. This chamber protrudes permanently through the dorsal
      skin of the back and is covered by a light bandage. Between recording sessions
      the chamber houses an inner cap sealing the hole that gives access to the cord.
      During recording sessions this cap is removed and a miniature manipulator
      inserted instead. This manipulator can accept a motor drive that holds a glass
      coated tungsten microelectrode. The drive has a hole through which an arthroscope
      tube can be passed so that insertion of the electrode can be performed under
      visual control. Extracellular recordings have been made of single spinal neurones
      for up to 4 h in animals that are drug-free, untrained and only lightly
      restrained. Recording sessions can be repeated on a daily basis for several weeks
      until the dura and/or arachnoid becomes too thickened to permit electrode
      penetrations. Animals remain healthy and their behaviour remains normal
      throughout this time.

PMID- 8483317
TI  - Metal (Fe3+) affinity chromatography: differential adsorption of tau
      phosphoproteins.
AB  - Tau is a neuronal cytoskeletal protein consisting of a group of isoforms with
      apparent molecular masses ranging from 45 to 62 kDa. Tau purified from brain
      exists in multiple phosphorylated forms and abnormally phosphorylated tau appears
      to play an important role in the neuropathology of Alzheimer's disease. To
      separate the differentially phosphorylated populations of tau, a chromatographic
      technique using ferric ions adsorbed onto iminodiacetic acid substituted
      Sepharose was developed. Several distinct populations of tau were isolated based
      on the phosphorylation state. These preparations can be used for further
      investigation of how each specific phosphorylation state modulates the metabolism
      and function of tau.

PMID- 8483318
TI  - Induction of DNA strand breaks associated with apoptosis during treatment of
      leukemias.
AB  - A new flow cytometric method is described to detect DNA strand breaks associated
      with apoptosis, by labeling the 3'-OH termini in the breaks with biotinylated
      dUTP in a reaction employing exogenous terminal deoxynucleotidyl transferase. The
      method has been applied in studies on leukemic HL-60 and MOLT-4 cell lines to
      reveal whether it is specific to apoptotic cells, and whether it can be used in
      the clinic to detect DNA breakage in leukemic cells during chemotherapy. There
      was labeling of mononuclear cells in peripheral blood of all 11 patients studied
      during chemotherapy for acute lymphoblastic, acute myelogenous, or chronic
      myelogenous leukemia (ALL, AML, or CML) in blastic crisis, indicating induced DNA
      damage; the number of labeled cells increased from 1-8% before treatment up to
      80% during the course of treatment. The DNA topoisomerase inhibitors
      mitoxantrone, VP-16 (etoposide), and m-AMSA (amsacrine) were more effective in
      inducing DNA breaks than was hydroxyurea or cytosine arabinoside (AraC). Cells
      with DNA breaks were identified in peripheral blood for up to 5 days following
      administration of Mitoxantrone and VP-16. In the case of DNA aneuploid leukemias,
      the DNA breaks were predominant in the aneuploid cell subpopulations, whereas
      presumably non-neoplastic diploid cells were unlabeled. In one case of ALL there
      were two distinct subpopulations of aneuploid cells: one responded to the
      treatment (by DNA breakage) and the other was non-responding. Thus, cells
      undergoing apoptosis can be detected by this method of labeling DNA strand breaks
      and the technique is applicable for analysis of response of leukemic cells to
      chemotherapy. With this method it may be possible to identify tumor cell
      sensitivity or resistance to particular drugs early in the course of treatment.

PMID- 8483319
TI  - Detection and clinical relevance of genetic abnormalities in pediatric acute
      lymphoblastic leukemia: a comparison between cytogenetic and polymerase chain
      reaction analyses.
AB  - The E2A/PBX1 and the BCR/ABL fusion genes result from the t(1;19)(q23;p13) and
      the t(9;22)(q34;q11), respectively, and encode oncoproteins which are thought to
      play an important role in the development of acute lymphoblastic leukemia (ALL)
      subtypes associated with adverse prognosis. The use of the polymerase chain
      reaction (PCR) for the detection of these genetic rearrangements may offer
      advantages over cytogenetic techniques which are often unsatisfactory in patients
      with ALL and, furthermore, provide a useful tool for monitoring of residual
      disease. However, it has not yet been evaluated whether the employment of PCR at
      the time of diagnosis improves the detection rate of these clinically relevant
      genetic anomalies. We have developed a multiprimer-PCR protocol which facilitates
      the detection of each of the four chimeric E2A/PBX1 and BCR/ABL mRNAs in a single
      reaction. This protocol was used for the evaluation of bone-marrow or blood
      samples from 251 children with ALL in whom cytogenetic analyses had been
      performed. Of the 251 patients, 221 had a B-cell precursor immunophenotype. In
      this group, 21 patients (9.5%) carrying the E2A/PBX1 rearrangement and three
      patients (1.4%) with BCR/ABL transcripts were detected by PCR. Twelve of these
      cases had escaped the detection by conventional cytogenetic analysis. In two of
      12 patients with a typical t(1;19)(q23;p13), no E2A/PBX1 transcripts were
      identified by PCR, thus suggesting the presence of different molecular
      rearrangements. Residual leukemic cells were detected by PCR in five of eight
      patients who were followed during complete clinical remission. The frontline use
      of PCR has an important impact on the timely diagnosis, therapeutic decisions,
      and monitoring of high-risk patients with B-cell precursor leukemia who carry the
      E2A/PBX1 or BCR/ABL fusion genes.

PMID- 8483320
TI  - Characterization of acute myeloid leukemia (AML) coexpressing lymphoid markers:
      different biologic features between T-cell antigen positive and B-cell antigen
      positive AML.
AB  - The clinical and biologic characteristics of acute myeloid leukemia (AML) with
      coexpression of lymphoid-associated antigens (Lym+ AML) were studied from 39
      cases who represented 24% of 161 newly diagnosed de novo AML. Twenty-seven cases
      (16.8%) were positive for the expression of T-cell markers (T+ AML) and 12 (7.5%)
      for B-cell markers (B+ AML). Chromosomal abnormalities t(9;22)(q34;q11) and
      t/del(11)(q23), which were considered to be associated with acute leukemia
      coexpressing markers of more than one cell lineage, were detected in five and in
      four patients, respectively. There was no prognostic significance of B-cell or T
      cell antigen expression in AML. Of 12 T+ AML cases in which cells were available
      for gene analysis, all showed germline configuration of immunoglobulin heavy
      chain and T-cell receptor beta chain genes, while seven of nine B+ AML showed
      rearrangements of either or both of the genes. Double labeling of the cells with
      myeloperoxidase and lymphoid markers demonstrated that individual blasts in all
      the five T+ AML tested were simultaneously expressing myeloperoxidase activity
      and CD7; however, most blasts in the three B+ AML studied expressed either
      myeloperoxidase activity or CD10, but not both. In eight of the nine T+ AML
      tested, the T-cell antigen-positive leukemic blasts were significantly decreased
      to less than 10%, after in vitro culture with the differentiation-inducing agent
      phorbol ester. B-cell markers remained positive (> or = 20%) on the cells in the
      two B+ AML who had the same study. These findings suggested that T+ AML and B+
      AML might have different biologic features. Further studies on more patients are
      needed to clarify this point.

PMID- 8483321
TI  - Effect of long-term treatment with recombinant human interleukin-3 in patients
      with myelodysplastic syndromes.
AB  - In a phase II study, involving nine patients with refractory anemia or refractory
      anemia with ring sideroblasts, the effects of treatment with recombinant human
      interleukin-3 (IL-3) on hematopoietic function were assessed. Doses of IL-3
      ranging from 60 micrograms/m2 during weeks 1-6 to 125 micrograms/m2 during weeks
      7-12 were administered as subcutaneous bolus injections three times per week for
      12 weeks. Platelet counts increased in six patients. Platelet increase correlated
      with stable or decreased serum tumour necrosis factor alpha (TNF-alpha) levels,
      while an increase of TNF-alpha levels during IL-3 therapy occurred in patients
      with no change or a decrease of platelet counts. Leukocyte counts increased in
      two patients and reticulocytes in three, without an effect on hemoglobin levels.
      Morphological analysis of the bone marrow revealed an expansion of the myeloid
      compartment in seven of eight evaluable patients, mainly due to stimulation of
      the precursor cells. No improvement of the in vitro growth of hematopoietic
      progenitor cells was observed. Sequential cytogenetic analyses indicate that IL-3
      treatment does not act preferentially on either the cytogenetically abnormal or
      the normal clones. These results suggest that long-term treatment with low-dose
      IL-3 stimulates megakaryopoiesis with increase of platelet counts, but that
      additional later-acting cytokines probably will be required to augment neutrophil
      and erythrocyte counts.

PMID- 8483322
TI  - ABL-BCR mRNAs transcribed from chromosome 9q+ in Philadelphia-chromosome-positive
      chronic myeloid leukaemia.
AB  - Polymerase chain reaction amplification of reverse transcription products has
      demonstrated the presence of abl-bcr hybrid mRNAs in RNA from peripheral blood
      leucocytes of Philadelphia-chromosome-positive chronic myeloid leukaemia
      patients; such hybrid mRNAs can contain either of the alternative first exons of
      c-abl. A survey of 12 CMLs has shown that abl-bcr mRNAs occur in the leucocytes
      of some, but not all, patients, and that they are present both in chronic-phase
      and acute-phase leucocytes.

PMID- 8483323
TI  - Interferon-alpha inducible 2'-5' oligoadenylate synthetase transcripts in
      lymphoid and myeloid leukemias.
AB  - Alpha-interferon (IFN) is effective in the treatment of a proportion of patients
      with hairy cell leukemia (HCL). B-cell chronic lymphocytic leukemia (CLL),
      chronic myeloid leukemia (CML) and multiple myeloma (MM). One of the proteins
      induced by IFN is the enzyme 2'-5' oligoadenylate synthetase (2-5 AS). Peripheral
      blood or bone marrow samples treated with IFN in vitro, or from patients treated
      with IFN were studied for expression of the different 2-5 AS mRNA transcripts. A
      total of four normal individuals and 31 patients (nine HCL, five CLL, six MM,
      nine acute myeloid leukemia (AML) and two T-cell acute lymphoblastic leukemia (T
      ALL) have been investigated. In normal peripheral blood lymphocytes, only the 1.8
      kb transcript was induced with IFN in vitro. In HCL, CLL, and MM all four
      transcript sizes were induced by IFN in vivo and in vitro. The 1.6 and 1.8 kb
      forms were equally and predominantly expressed in HCL and B-CLL. On the other
      hand, the 1.8 kb transcript was predominantly expressed in MM and this increased
      expression was statistically significant. In acute leukemia, the majority of
      samples expressed all four transcripts equally but four of eleven samples
      expressed only the 1.8 kb transcript. These results suggest that the pattern of
      induction of specific 2-5 AS mRNA transcripts may be related to the underlying
      disease. Whether these different patterns of 2-5 AS induction have implications
      for response to IFN treatment, remains to be determined.

PMID- 8483324
TI  - Inhibition of murine hematopoiesis by CAMAL, an inhibitor of human hematopoiesis.
AB  - CAMAL (common antigen of myelogenous acute leukemia) is an antigenic preparation
      isolated in this laboratory from the bone marrow or peripheral blood leucocytes
      of persons with myeloid leukemias and shown using an immunoperoxidase slide test
      to be diagnostic of these leukemias. Material further purified from CAMAL
      preparations, which migrates in the range of 30-35 kilodaltons (kDa) by sodium
      dodecyl sulphate/polyacrylamide gel electrophoresis (SDS-PAGE), which is referred
      to as P30-35 CAMAL, and was previously shown to be inhibitory to colony formation
      by progenitor cells from normal healthy human donors in vitro. This inhibitory
      activity was directed toward neutrophilic granulocyte colonies (CFU-G) in
      particular. We now report that P30-35 CAMAL is inhibitory to colony formation by
      murine progenitor cells in vitro. Colonies from P30-35 CAMAL-treated cultures of
      murine bone marrow cells were reduced in number and in size, an effect similar to
      that seen in cultures of human cells. As in assays using human cells, murine CFU
      G appeared to be preferentially targeted by the inhibitory activity of P30-35
      CAMAL. In addition, day 10 spleen colony formation was inhibited by P30-35 CAMAL
      in an ex vivo assay. Hence, the effects of P30-35 CAMAL on murine progenitor
      cells appear to parallel the effects observed using human cells. These
      observations support the possibility that CAMAL might be a regulatory protein in
      hematopoiesis which is conserved between species.

PMID- 8483325
TI  - Loss of long-term repopulating ability in long-term bone marrow culture.
AB  - We have studied the maintenance of stem cells with long-term multilineage
      repopulating ability from murine bone marrow, cultured on a pre-established bone
      marrow-derived stromal cell layer, both in a qualitative and quantitative way.
      Female bone marrow cells were cultured for a period of 1-4 weeks and compared
      with uncultured cells for their ability to establish and maintain a level of 50%
      chimerism in a sex-mismatched bone marrow transplantation model. Chimerism was
      determined in nucleated cells using fluorescence in situ hybridization with a
      murine Y-chromosome-specific probe. We observed a rapid decline in the ability of
      cultured marrow cells to repopulate the blood, bone marrow, spleen, and thymus of
      sublethally irradiated male recipients. After 4 weeks of culture only 5% of the
      long-term repopulating ability of the inoculated bone marrow cells remained. The
      remaining long-term repopulating cells, however, had similar qualities to
      establish and maintain long-term engraftment compared to fresh bone marrow, as
      judged from their ability to give stable chimerism over a period of 6 months.
      These observations are relevant for the therapeutic applications of long-term
      bone marrow cultures in purging protocols prior to autologous bone marrow
      transplantation of acute and chronic myeloid leukemic patients, and for the use
      of long-term marrow cultures when introducing foreign genetic material in
      hematopoietic stem cells.

PMID- 8483326
TI  - In vitro cytotoxic effect of guinea-pig natural killer cells (Kurloff cells) on
      homologous leukemic cells (L2C).
AB  - The Kurloff cell (KC) of the guinea-pig develops natural killer cytotoxic
      activity in heterologous systems. We report in this paper the effective in vitro
      cytotoxic activity of the KC in a homologous guinea-pig system, i.e. against the
      guinea-pig target leukemic L2C cells. A dual-color flow analysis of homologous
      effector-target conjugates, using calcein-labeled KC and hydroethidine-labeled
      L2C shows a 40% frequency KC-L2C conjugation. The specific cytotoxicity of KC
      against L2C (78%) was estimated as the target-loss of green fluorescence due to
      hydrolysed carboxy-fluorescein diacetate after 4 hours at 37 degrees C. We
      propose that the Kurloff cell could be involved in surveillance against
      spontaneously arising leukemic cells, and this could be an explanation for the
      high degree of resistance to spontaneous or experimentally-induced cancers, in
      the guinea-pig.

PMID- 8483327
TI  - In vitro resistance of the brown Norway rat acute myelocytic leukemia (BNML) to
      lymphokine-activated killer activity.
AB  - In in vivo allogeneic bone marrow transplantation studies with the Brown Norway
      (BN) rat as recipient and the WAG/Rij rat as allogeneic donor a significant graft
      versus-leukemia (GVL) effect is observed. Studies were performed to investigate
      whether lymphokine-activated killer (LAK) cells play a role in this GVL effect.
      Splenocytes from WAG/Rij and BN rats were activated in vitro by recombinant human
      interleukin-2 (rhIL-2) for 5-6 days. The cytolytic activity of these LAK cells
      was tested on four rat solid tumor cell lines, i.e. an ureter carcinoma, a
      rhabdomyosarcoma, and two lung tumors, and on leukemic cells derived from the BN
      rat acute myelocytic leukemia (BNML) and the WAG/Rij acute lymphocytic leukemia
      (L4415). The panel of target cells also included the murine cell lines P815 and
      YAC. Both WAG/Rij and BN LAK cells were not capable of lysing the leukemic cells
      in contrast to significant cytolytic activity on the rat solid tumor cell lines
      and P815 and YAC. BNML cells showed to be resistant to lysis by human NK cells.
      Phenotypical analysis of the rat LAK population revealed a decrease in the
      CD4/CD8 ratio compared to the unstimulated splenocyte population. Rat LAK cells
      displayed no antibody-dependent cellular cytotoxicity (ADCC) on the leukemic
      cells, whereas IL-2-stimulated human peripheral blood cells showed moderate ADCC
      activity on the leukemic cells. To investigate whether cytokines play a role in
      lysis of leukemic target cells, graded numbers of LAK cells and leukemic cells
      were co-cultivated for seven days in an agar-based colony culture system. This
      resulted in moderate suppression of leukemic colony formation. From the current
      in vitro studies it appears that the graft-versus-leukemia observed in in vivo
      allogeneic bone marrow transplantation studies is probably not due to a direct
      leukemic cell kill by LAK cells.

PMID- 8483328
TI  - Identification of novel protein-tyrosine phosphatases in a human leukemia cell
      line, F-36P.
AB  - Polymerase chain reaction (PCR) was used to identify protein-tyrosine
      phosphatases (PTPases) in a human leukemic cell line, F-36P. Degenerate primers
      deduced from the highly conserved amino acid sequences in the catalytic domain of
      known PTPases were used for amplification. Among 16 clones sequenced, 13 were
      identical to known PTPases, whereas the other three clones were disclosed to
      encode novel PTPases. The expression pattern of one of the three newly identified
      PTPases, designated as F-36-12, was further analysed. In murine tissues, the F-36
      12 message was predominantly expressed in brain, kidney, and intestine, and was
      weakly expressed in heart and thymus. In human hematopoietic cell lines, the F-36
      12 message was preferentially expressed in a promyelocytic leukemic cell line,
      HL60, and two factor-dependent leukemic cell lines, F-36P and F-36E, that are
      dependent on granulocyte-macrophage colony-stimulating factor or interleukin-3
      and erythropoietin, respectively. The transcript was approximately 8 kb long and
      the message level in HL60 cells was slightly increased at 24 hours and then
      slowly declined when treated with dimethyl sulfoxide for granulocyte
      differentiation, while the message level was rapidly decreased when treated with
      12-O-tetradecanoylphorbol 13-acetate for monocyte/macrophage differentiation.
      These results show that several PTPases including three novel ones are expressed
      in a human leukemic cell line and that the particular PTPase, F-36-12, might be
      involved in the differentiation process in HL60 cells.

PMID- 8483329
TI  - Influence of graft-versus-host disease on the eradication of minimal residual
      leukemia detected by polymerase chain reaction in chronic myeloid leukemia
      patients after bone marrow transplantation.
AB  - To evaluate the remission quality of Philadelphia chromosome (Ph)-positive,
      BCR/ABL-positive CML patients after allogeneic bone marrow transplantation (BMT)
      we used the polymerase chain reaction (PCR) to detect BCR-ABL specific RNA in
      addition to Southern blotting, cytogenetic, and hematological investigation.
      Fifty-five bone marrow samples of 27 patients in clinical remission were studied
      by PCR, 0.5 to 99 months (median 8 months) after BMT. The median clinical follow
      up of this cohort of patients is 24 months (1-109) after BMT. BCR-ABL transcripts
      could be detected in 16 out of 27 patients (59%). Risk factors for minimal
      residual leukemia (MRD) as defined by PCR were the kind of graft-versus-host
      disease (GvHD) prophylaxis (patients with T-cell-depleted grafts had a higher
      rate of MRD in comparison to patients treated with methotrexate/cyclosporin A)
      and the presence or absence of GvHD after BMT (patients without GvHD had a higher
      incidence of MRD than patients with GvHD). Moreover, the detection of minimal
      residual leukemia had prognostic significance. Out of 16 patients with minimal
      residual leukemia as detected by PCR, four patients relapsed clinically and two
      further cases relapsed cytogenetically. In contrast none of the patients lacking
      evidence of minimal residual leukemia relapsed. Serial PCR analysis may prove
      helpful in deciding about further therapeutic interventions (e.g. interferon
      therapy or adoptive immunotherapy) before leukaemic relapse becomes manifest
      after BMT.

PMID- 8483330
TI  - Detection of trisomy 8 on blood smears using fluorescence in situ hybridization.
AB  - In this study, fluorescence in situ hybridization (ISH) with an alphoid probe was
      used for the detection of trisomy 8 on archival blood smears (BS). The results
      were compared with hybridization experiments performed on methanol/acetic acid
      fixed cells of cytogenetic preparations (CP) which are widely used for ISH. Five
      controls and 20 patients with myeloid leukemias were examined. In the controls,
      CP and BS had the same percentages of cells with two or three fluorescence
      signals. In 5/20 patients, trisomy 8 was detected both on CP and BS. Two of the
      patients had 7 to 10% interphase cells with three hybridization signals,
      indicating the presence of small subclones with trisomy 8; one of the subclones
      was not detected by G-banding analysis. The remaining 15 patients were disomic
      for chromosome 8; hybridization results were within the range of the controls
      both on CP and BS. We conclude that using a chromosome 8 specific alphoid probe,
      fluorescence ISH to interphase cells can be performed on BS with the same
      efficiency that is reached on methanol/acetic acid fixed cells of CP.

PMID- 8483331
TI  - Erythema nodosum associated with all-trans-retinoic acid in the treatment of
      acute promyelocytic leukemia.
AB  - A patient with acute promyelocytic leukemia is presented. During treatment with
      all-trans-retinoic acid, erythema nodosum developed. Treatment with all-trans
      retinoic acid was continued, the erythema nodosum resolved with steroid
      treatment, and a complete remission was attained. This case is the first report
      of erythema nodosum associated with all-trans-retinoic acid.

PMID- 8483332
TI  - Successful treatment of veno-occlusive disease of the liver with urokinase in a
      patient with non-Hodgkin's lymphoma.
AB  - A 38-year-old man with a non-Hodgkin's lymphoma of intermediate grade malignancy
      attained partial remission after three courses of CHOP
      (cyclophosphamide+hydroxydaunorubicin+vincristine+prednisolone). He was assigned
      to undergo autologous bone marrow transplantation (ABMT). The conditioning
      regimen consisted of cyclophosphamide and whole body irradiation. Two weeks later
      he developed veno-occlusive disease (VOD) of the liver. Doppler sonography
      confirmed the diagnosis showing a reversal of the blood flow in the portal vein.
      In addition a large thrombus was present in the inferior caval vein. Protein C
      level was strongly reduced (28%). Because of clinical deterioration intravenous
      urokinase was started. The transaminases normalised rapidly and the patient
      showed a dramatic clinical improvement. There were no major bleeding
      complications. Repeat Doppler sonography showed a normal antegrade flow in the
      portal vein. This case suggests that a coagulopathy in the hepatic vascular bed
      might contribute to the development of VOD and that patients with VOD are at risk
      for other thrombotic complications. Furthermore it shows that urokinase with
      platelet support can be given safely and effectively to a patient with VOD and
      severe thrombocytopenia.

PMID- 8483333
TI  - Involvement of the different members of the NF-kB transcription factor family in
      B-chronic lymphocytic leukemia.

PMID- 8483334
TI  - White House health care reform forum.

PMID- 8483335
TI  - Crisis in community health care on the Eastern Shore. Interview by Edna Quinn.

PMID- 8483336
TI  - Purine nucleoside phosphorylase: a target for drug design.

PMID- 8483337
TI  - Peptidomimetics derived from natural products.
AB  - Although much has been written in recent years about rational drug design, no
      drug has been designed de novo, that is, without using a natural substrate or
      inhibitor or screening lead as a starting point. Instead, as we have seen,
      medicinal chemists continue to depend upon serendipitous discovery of novel
      biological activities and novel chemical entities for structures on which to
      begin work. What rational drug design really means at present is rational drug
      discovery and rational optimization. These result from the application of modern
      structural and mechanistic biochemistry, and good synthetic chemistry, to obtain
      structures with the desired spectrum of biological activities. Traditionally,
      lead compounds were discovered in plant and animal extracts, and more recently in
      microorganisms and chemical libraries. These traditional approaches continue, but
      are augmented by advances in molecular biology, which now provide pure proteins
      in quantity for screening and structure determination, as well as for
      characterization by modern biophysical methods. Remarkably, x-ray and NMR methods
      can now provide the most important information needed to design new drugs, that
      is, the conformations of ligands bound to target proteins. Approaches to
      identifying possible ligands based only on the knowledge of the enzyme active
      site are being developed. Some of these, such as CAVEAT, have been recently
      reviewed. In spite of these impressive gains, de novo design of new drugs will
      not be achieved until we learn how to logically build specific inhibitors of a
      target enzyme knowing only the protein sequence of the enzyme or the amino acid
      sequence of the messenger substances. We have a long way to go, because by this
      very rigorous definition, even the successful design of a new nonpeptide drug
      beginning with enzyme-ligand NMR or x-ray structure constitutes rational
      optimization. However, as this article has illustrated, we have made great
      progress. Some of the current and futuristic approaches to drug design are shown
      in Fig. 8. Development of useful enzyme inhibitors, designed by knowing the
      enzyme catalytic mechanism or discovered by screening for natural inhibitors, is
      a very successful rational method. Discovery of receptor antagonists by screening
      protocols is also productive.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8483338
TI  - Privileged communications: medical confidentiality in late Victorian Britain.

PMID- 8483339
TI  - Pious physic for the poor: the lost Durham County medical scheme of 1655.

PMID- 8483340
TI  - Measuring "the social evil": the incidence of venereal disease in interwar
      Scotland.

PMID- 8483341
TI  - Henry Fogg (1707-1750) and his patients: the practice of an eighteenth-century
      Staffordshire apothecary.

PMID- 8483342
TI  - Illustrations from the Wellcome Institute Library. The life and times of the
      Myers Collection.

PMID- 8483343
TI  - ["No" to grades. Impossible, inadequate and dispensable].

PMID- 8483344
TI  - [Psychosomatic aspects are completely missed in connection with back pain].

PMID- 8483345
TI  - [Who is infected with atypical mycobacterium without having AIDS?].

PMID- 8483346
TI  - [Smoking--parents are often bad examples].

PMID- 8483347
TI  - [Improve the proposal for a new tobacco law].

PMID- 8483348
TI  - [Is diabetes in children caused by cow's milk?].

PMID- 8483349
TI  - [The sour stomach of the smoker. Protective mechanisms of the mucosa are more
      important than the level of acid secretion].

PMID- 8483350
TI  - [Good mental health among adopted children from foreign countries].
AB  - All 181 families living in one county in southern Sweden who during the period,
      1970-77, adopted children via Adoptionscentrum, the largest adoption agency in
      Sweden, were invited to take part in a study of mental health and identity
      development; 152 families (84 percent) accepted, a total of 211 adopted
      youngsters over 12 years of age thus being included in the study. According to
      the results of interviews with the parents and self-rating instruments
      administered to the youngsters, their mental health was good. The results were
      compared with those of an age-matched group of non-adoptive children who had
      taken part in an epidemiological study using the same investigative methods. The
      relevance of family factors and age at adoption is discussed.

PMID- 8483351
TI  - [L-dopa and bromocriptine in Parkinson disease. Early combination therapy has
      better effect].

PMID- 8483352
TI  - [Low number of infections after outpatient surgery. The patients were cared for
      in the same wards independently of the type of surgery].

PMID- 8483353
TI  - [Health risks of gasoline handling. Exposure to benzene can cause leukemia].

PMID- 8483354
TI  - [New studies on Alzheimer's disease. Promising therapeutic results with tacrine].

PMID- 8483355
TI  - [Clozapine treatment of patients with schizophrenia. Great improvements with
      regard to symptoms and social life].

PMID- 8483356
TI  - [Stop the use of mercury].

PMID- 8483357
TI  - [Dandy's phenomenon. Bilateral vestibular loss].

PMID- 8483358
TI  - [The man behind the phenomenon: Walter Dandy. A skillful neurosurgeon who went
      his own way].

PMID- 8483359
TI  - [District health care in Zimbabwe. Drought, starvation and HIV are the worst
      threats].

PMID- 8483360
TI  - [Medical audit. Cataract surgery at a private ophthalmologic clinic].

PMID- 8483361
TI  - [Consensus on otitis. Answers to an inquiry show changed therapeutic practices].

PMID- 8483362
TI  - [Indoctrination. A violation of personal integrity].

PMID- 8483363
TI  - Role of subtotal thyroidectomy in the management of the follicular neoplasm of
      the thyroid.
AB  - Clinically apparent thyroid nodules affect 4% to 7% of the population in North
      America. Malignant neoplasms of the thyroid comprise only about 1% of all cancers
      and are found in only 20% of patients undergoing thyroid surgery for suspected
      thyroid carcinoma. A follicular neoplasm of the thyroid is the most common
      histologic finding. During surgery, using frozen-section techniques, it is often
      difficult to distinguish between a benign and malignant lesion. The diagnosis may
      be deferred following intraoperative frozen-section examination of tissue or
      changed on evaluation of embedded tissue. In this series of 1224 thyroidectomies
      from 1976 to 1990, the pathology data from thyroidectomy surgical specimens
      submitted to tissue analysis were evaluated. It was found that subtotal
      thyroidectomy was effective in the management of the follicular neoplasm. This
      approach significantly reduced the morbidity and complications of patients
      undergoing thyroidectomy.

PMID- 8483364
TI  - Facial nerve dysfunction in osteopetrosis.
AB  - When facial nerve dysfunction occurs in conjunction with one of the rare temporal
      bone dysplasias, the physician faces a therapeutic dilemma. There is no consensus
      in the literature regarding the management of facial paralysis or facial spasm
      under these circumstances. During the past 2 years, four patients were seen with
      forms of osteopetroses and neurotologic symptoms. A patient with malignant,
      recessive osteopetrosis and a patient with Engelmann's disease were surgically
      managed for facial paralysis and facial spasm. The outcome of the treatment is
      discussed as well as the available literature on this subject. A new complication
      of facial nerve decompression in children with osteopetrosis is described, as
      well as appropriate caveats in the management of facial nerve disorders in the
      osteopetroses.

PMID- 8483365
TI  - Prognostic significance of sinus histiocytosis in metastatic laryngeal cancer.
AB  - A histopathologic analysis of regional lymph node specimens in 48 patients with
      previously untreated squamous cell carcinoma of the larynx was performed to
      determine which parameters, if any, correlated with 3-year patient survival. The
      presence of sinus histiocytosis in lymph nodes containing metastatic squamous
      cell carcinoma was statistically related to survival (P < .007). Multivariate
      analysis confirmed the independent significance of this variable compared to
      tumor stage, nodal status, and extracapsular spread from lymph nodes. Previous
      studies have linked improved survival with an active immunologic response in head
      and neck cancer patients. However, few studies have examined a homogeneous group
      of patients who all underwent the same type of treatment. This study's findings
      support the concept that an active immunologic response in lymph nodes has
      prognostic significance in squamous cell carcinoma of the larynx.

PMID- 8483366
TI  - Microbial adherence to and disinfection of laryngoscopes used in office practice.
AB  - This study reports the appropriate disinfection methods for flexible and rigid
      laryngoscopes when used in an outpatient setting. This investigation presents
      evidence that an appreciable number of laryngoscopes are contaminated during use.
      A brief tap water rinse serves to eliminate gross soil of host origin known to
      interfere with disinfectant efficacy. Disinfection with 3.2% glutaraldehyde
      (Cidexplus) for 10 minutes effectively eliminated microbial contaminants. Since
      potentially harmful microorganisms were included among the more than 100 isolates
      during our baseline experiments, the need to eliminate bacteria, viruses, fungi,
      and protozoa from laryngoscopes is obvious and can be attained readily.

PMID- 8483367
TI  - Squamous cell carcinoma in HIV-positive patients under age 45.
AB  - Eight patients 45 years of age and under (range, 29 to 45) with squamous cell
      carcinoma of the head and neck and infection with the human immunodeficiency
      virus are reported. Primary tumor sites include nasopharynx, oral cavity,
      oropharynx, and larynx. Probes for the human papillomavirus were positive in two
      of the patients. Therapy consisted of surgery followed by radiation therapy in
      five patients, surgery alone in one patient, and radiation therapy in the
      remaining two patients. Follow-up ranged up to 2 years and revealed four deaths,
      three patients alive without disease, and one patient recently posttreatment with
      residual disease. The significance of the presence of the human papillomavirus in
      these individuals remains to be determined. The incidence of squamous cell
      carcinoma of the head and neck under age 45 is low, and whether there may be a
      higher incidence in HIV-positive patients cannot be determined from this small
      series.

PMID- 8483368
TI  - The importance of preoperative nasal endoscopy in patients with sinonasal
      disease.
AB  - Functional endoscopic sinus surgery (FESS) has popularized the use of telescopes
      in sinus surgery and has emphasized the importance of nasal endoscopy and
      computed tomography (CT) in the evaluation of patients with diseases of the nose
      and paranasal sinuses. Variations in intranasal and sinus anatomy have been
      implicated in the etiology of chronic and recurrent sinusitis, and CT imaging has
      become an important diagnostic tool. Despite this, some patients present with
      symptoms and telescopic examination suggestive of sinonasal disease, yet
      demonstrate little abnormality on CT scan. The authors reviewed videoendoscopic
      and CT examinations of 100 consecutive patients with symptoms of sinus disease
      and found 9% of patients with abnormal telescopic examination in the context of
      negative CT findings. In those patients whose CT examinations were positive,
      telescopic nasal endoscopy was especially useful in delineating the type of soft
      tissue which obscured the area of the middle meatus. In those patients whose CT
      examinations were negative, telescopic examination demonstrated septal
      deflections, mucosal edema involving the middle meatus, as well as turbinate and
      adenoid hypertrophy. These findings demonstrate that telescopic nasal examination
      is an important diagnostic modality which often yields important information when
      evaluating patients with sinonasal disease.

PMID- 8483369
TI  - Lentigo maligna melanoma of the head and neck.
AB  - Historically, lentigo maligna melanoma has been considered a "favorable"
      histological type of melanoma, and treatment by wide local excision was
      considered curative. A retrospective multivariate analysis of 143 head and neck
      patients with stage I lentigo maligna melanoma was performed from a database of
      1067 head and neck patients followed at Duke Medical Center. Fifty-six percent of
      all lentigo maligna melanomas presented with lesions deeper than 0.76 mm, and 8%
      presented with stage II or III disease. Recurrent disease occurred in 45% of
      stage I patients, with a 5-year disease-free interval of 6 years and a median
      survival time of 10 years. Multivariate analysis demonstrated no significant
      difference in disease-free interval or survival by histological subtype. The data
      suggest that treatment should be based on tumor thickness and not histologic
      subtype.

PMID- 8483370
TI  - Localization of interleukin-1 in human squamous carcinomas of the head and neck.
AB  - Recent investigations revealed that interleukin-1 can promote bone resorption by
      activating osteoclasts. The authors' immunocytochemical studies with monoclonal
      antibody against human interleukin-1 localized interleukin-1 at the bone
      resorption site of the squamous carcinomas as well as within the squamous
      carcinomas. In addition, Western blotting and dot blotting methods were used to
      isolate interleukin-1 from the extracts of the squamous carcinomas in the head
      and neck. Finding interleukin-1, a potent bone resorption-stimulating factor, in
      squamous carcinomas suggests that interleukin-1 might play an important role in
      the extensive local bone destruction seen in the head and neck patients with
      squamous carcinomas.

PMID- 8483371
TI  - Quantitative cytology of nasal secretions under various conditions.
AB  - Quantitative cytology was performed in nasal secretions of normal control (NC),
      seasonal allergic rhinitis in season (SAR), perennial allergic rhinitis (PAR),
      chronic sinusitis with mucoid secretion (MS), and chronic sinusitis with
      mucopurulent secretion (MPS). The majority of inflammatory cells were neutrophils
      in NC, MS, and MPS; the majority were eosinophils in SAR and PAR. The concomitant
      appearance of inflammatory cells in nasal secretions was found, i.e., there were
      significant correlations between neutrophil and eosinophil counts in MPS, and
      between eosinophil and basophil counts in SAR. The eosinophil/neutrophil ratio
      was more than 0.1 in SAR and PAR, but the ratio was less than 0.1 in all NC, all
      MPS, and in 93% of MS; this indicates that 0.1 in eosinophil/neutrophil ratio is
      the critical value between allergic and nonallergic nasal diseases.

PMID- 8483372
TI  - Prognostic value of histopathological parameters in 51 supraglottic squamous cell
      carcinomas.
AB  - The prognosis for supraglottic squamous cell carcinomas is difficult to
      establish. A study of 19 histopathological parameters (14 from the primary tumor
      and 5 from the lymph node metastases) was undertaken in 51 supraglottic
      epidermoid carcinomas. All patients were subjected to supraglottic horizontal
      laryngectomy with bilateral functional neck dissection and postoperative
      radiotherapy. A discriminant analysis was performed to relate the different
      histopathological variables to 5-year survival. Capsule rupture and the number of
      metastatic lymph nodes were the only two parameters significantly related to
      survival (P < .01). Histopathology (in particular, lymph node metastases) proved
      more effective in predicting patient evolution than TNM staging.

PMID- 8483373
TI  - Three-dimensional reconstruction of the temporal bone from a case of E trisomy
      syndrome.
AB  - Computer-assisted three-dimensional reconstruction was performed from histologic
      sections of the left temporal bone removed from a case of E trisomy syndrome. The
      reconstructions included structures such as the bony and membranous labyrinths,
      ossicles, ossicular muscles, tympanic membrane, and facial and eighth nerves. The
      structures could be observed individually or simultaneously in combination.
      Prominent abnormalities observed in these reconstructions included enlargement of
      the utricle, absence of the posterior semicircular canal, slight hypoplasia of
      the cochlea, anomaly of the stapes, abnormally shaped stapedius muscle, abnormal
      course of the facial nerve, and flattening of the tympanic membrane. The results
      were useful for the visual and stereoscopic understanding of abnormal
      configurations and the spatial orientations of these abnormalities.

PMID- 8483374
TI  - Costochondral pharyngeal implants for velopharyngeal insufficiency.

PMID- 8483376
TI  - Endoscopic sinus surgery.

PMID- 8483375
TI  - The role of real-time ultrasonography in an otolaryngology office setting.

PMID- 8483377
TI  - Auditory brainstem response testing.

PMID- 8483378
TI  - Tetracaine base topical anesthesia.

PMID- 8483379
TI  - Chronic ethmoidal sinusitis.

PMID- 8483380
TI  - Evaluation of tissue ascorbic acid status in different hormonal states of female
      rat.
AB  - The distribution pattern of ascorbic acid in the endocrine organs and/or tissues
      was investigated during various sexual states of female rats to demonstrate a
      correlation between ascorbic acid concentration and sex hormone activity. The
      concentration of ascorbic acid was estimated in the plasma, liver, pancreas,
      thyroid, ovary, adrenal and pituitary of contraceptive steroid treated,
      bilaterally ovariectomized, sham-operated and normal control animals at four
      different phases of estrous cycle to delineate a relationship between the level
      of ascorbic acid in different organs/tissues at various sex hormonal states.
      Statistically significant changes were observed in the concentration of ascorbic
      acid in different endocrine organs/tissues following contraceptive steroid
      treatment, ovariectomy and during the estrous phases. Our results suggest that
      the concentration of ascorbic acid in the endocrine organs and/or tissues varies
      during different sexual states of rat.

PMID- 8483381
TI  - Disturbances in autoregulatory responses of rat pial arteries by sulfonylureas.
AB  - It was aimed to test the role of ATP-sensitive K+ channels in the autoregulatory
      response of cerebral arterioles in vivo. Changes in pial arterial caliber (mean,
      43.2 +/- 2.3 microns in diameter) in response to changes in systemic arterial
      blood pressure (mean, 104.3 +/- 1.4 mmHg) were observed directly through closed
      cranial windows in anesthetized normotensive rats. During superfusion with
      vehicle, pial arterial caliber automatically increased in response to hypotension
      induced by arterial bleeding into a reservoir and decreased on reverse of
      arterial blood pressure by infusion of blood. After pretreatment with
      sulfonylureas, glibenclamide (1 and 3 microM) and glipizide (30 and 100 microM),
      arteriolar dilatation and constriction observed during hypotension and its
      reverse were disturbed. A similarity was evidenced when hypotension was induced
      by sodium nitroprusside (750 nmol kg-1min-1, i.v.). Cromakalim, a K+ channel
      opener, exerted a concentration-dependent vasodilatation of the pial artery and
      its effect was antagonized by glibenclamide. These data suggest that the
      endogenous glibenclamide-sensitive K+ channel opener is involved in the
      modulation of cerebral microvascular autoregulation.

PMID- 8483382
TI  - Changes in striatal dopamine metabolism during the development of morphine
      physical dependence in rats: observations using in vivo microdialysis.
AB  - The present study examined the effect of prolonged morphine treatment on striatal
      dopamine (DA) release and metabolism, during the initial phase of the development
      of morphine dependence. Sprague-Dawley rats were implanted with chronic guides
      for microdialysis of the striatum. Morphine (two 75-mg pellets, subcutaneous
      implant) or placebo was given (12 hr) to pentobarbital anesthetized animals.
      Following recovery from anesthesia, morphine physical dependence was verified by
      the naloxone-evoked abstinence syndrome. Morphine produced significant increases
      in the dialysate level of DA nad its metabolites (DOPAC and HVA) above baseline
      compared to placebo treatment. HVA levels began to increase immediately following
      morphine administration, whereas DA and DOPAC levels began to increase after a
      latency of one and three hr, respectively. Morphine effects on striatal DA
      metabolism included changes in the metabolic disposition of DA. Increases in HVA
      concentration accompanied increases in DOPAC concentration up to a threshold
      value of DOPAC efflux; further increases in DOPAC level were associated with
      decreases in HVA level. These in vivo data suggest that morphine-induced changes
      in the regulation of striatal dopaminergic function may be an important component
      of the development of physical dependence.

PMID- 8483383
TI  - Regulation of the dynamic properties of platelet plasma membrane by intracellular
      sodium ions.
AB  - Our previous experiments in human and rat platelets demonstrated that the absence
      of extracellular Na+ increased the fluorescence anisotropy of TMA-DPH
      (trimethylamino-diphenylhexatriene, probe preferentially incorporated into the
      outer leaflet of the plasma membrane). Here we investigated further the in vitro
      effects of Na+ ions on membrane dynamic properties. Na(+)-dependent changes were
      reversible and they required about 10-20 min to be induced. They were
      specifically located in the TMA-DPH environment because they were not observed
      with diphenylhexatriene (probe non-selectively incorporated into all hydrophobic
      domains of the cell). To evaluate the possible influence of the intracellular
      Na+, the effects of sodium replenishment, monensin, ouabain and thrombin on TMA
      DPH anisotropy were measured. A rise in intracellular Na+ above the physiological
      level was associated with unchanged or slightly decreased TMA-DPH anisotropy
      whereas its decrease was accompanied by a pronounced rise in TMA-DPH anisotropy.
      Our data indicate that the changes in intracellular Na+ concentration, rather
      than those in extracellular Na+ concentration, are responsible for the
      alterations in platelet membrane fluidity probed by TMA-DPH.

PMID- 8483384
TI  - Manganese exposure to PC-12 cells alters triacylglycerol metabolism and promotes
      neurite outgrowth.
AB  - Exposure of PC-12 cells to MnCl2 (10-100 microM for 1 to 3 days) resulted in both
      morphological and metabolic changes as indicated by promotion of neurite
      outgrowth and an increased incorporation of labeled fatty acids (14:0, 18:1 and
      20:4) into triacylglycerols (TG). Cells prelabeled with [14C]arachidonic acid
      (AA) showed a time-dependent decrease in labeled TG, and the rate of decline was
      inhibited by Mn (100 microM). In the pulse-chase type of study, the decrease in
      the proportion of labeled TG as well as labeled phosphatidylcholine (PC) was
      marked by an increase in labeled phosphatidylinositol and
      phosphatidylethanolamine. These results support previous notion that TG plays an
      important role in channeling the fatty acid nutrients for biosynthesis of
      membrane phospholipids. Thus, the Mn-induced inhibition of the ability to
      transfer TG fatty acids to other lipids in PC-12 cells may be an underlying cause
      for the observed morphological changes.

PMID- 8483385
TI  - The effects of alcohol on murine macrophage function.
AB  - Animal models used to measure the effects of alcohol on lymphoid cells and their
      functions provide useful ways to evaluate the multisystem effects of this
      substance. The effects of ethanol ingestion on the function of murine peritoneal
      macrophages (M phi) was evaluated. Both the production of reactive oxygen
      intermediates (ROI) and the ingestion of foreign particles (phagocytosis) were
      studied. Mice were pair fed ad libitum a nutritionally complete liquid diet
      containing 7% v/v ethanol or a calorically balanced control diet. Two regimens
      were employed for the administration of the diets. One regimen represented
      "binge" drinking (short term-4 days) while the other represented "chronic"
      consumption (long term-14 days). Following the short term administration of the
      diets, an increase in the respiratory burst (RB), as well as a decrease in
      phagocytosis, were observed with M phi from the ethanol fed mice. The decrease in
      phagocytosis, was noted using either in vitro or in vivo methods. Results
      observed after long term administration indicated no significant change in the RB
      or in in vitro phagocytosis between the ethanol and control groups. Phagocytosis
      measured in vivo, however, was decreased in M phi from ethanol fed mice following
      long term administration. These results indicate an alteration in murine
      peritoneal M phi function following short term an long term administration of
      alcohol.

PMID- 8483386
TI  - Comparative effect of nifedipine and S-adenosylmethionine, singly and in
      combination on experimental rat liver cirrhosis.
AB  - An experimental rat liver cirrhosis, by means of carbon tetrachloride and ethanol
      during 8 weeks, was employed to assay the effect of Nifedipine (a calcium
      antagonist blocker), S-Adenosylmethionine (a precursor of glutathione); singly
      and in combination on rat liver cirrhosis. A slight decrease of cirrhosis (N.S.)
      was observed with the pharmacological therapy employed singly. The combination
      therapy (Nifedipine+S-Adenosylmethionine) significantly inhibited liver cirrhosis
      (p < 0.01).

PMID- 8483387
TI  - Characterization of a peripheral vanilloid (capsaicin) receptor in the urinary
      bladder of the rat.
AB  - Specific binding of [3H]resiniferatoxin (RTX) is thought to represent the
      vanilloid (capsaicin) receptor. In the present study, we have used this binding
      assay to identify for the first time a vanilloid receptor in the periphery and to
      compare it to central vanilloid receptors present in dorsal root ganglia (DRG) as
      well as in spinal cord of the rat. Rat urinary bladder membranes bound [3H]RTX
      with a Kd of 30 +/- 4 pM and a Bmax of 65 +/- 14 fmol/mg protein; the
      corresponding values were 19 +/- 3 pM and 104 +/- 14 fmol/mg protein in DRG, and
      16 +/- 3 pM and 50 +/- 9 fmol/mg protein in spinal cord. Capsaicin inhibited
      [3H]RTX binding to membranes from urinary bladder, spinal cord, and DRG with
      similar potency (Ki values were 0.5 +/- 0.1 microM, 0.3 +/- 0.1, and 0.6 +/- 0.1
      microM, respectively). Interestingly, [3H]RTX bound to urinary bladder in a non
      cooperative fashion in contrast with the apparent positive cooperativity of
      [3H]RTX binding in both DRG and spinal cord (cooperativity index = 1.8 and 1.7,
      respectively). This finding suggests heterogeneity in the properties of the
      vanilloid receptors in the rat.

PMID- 8483388
TI  - Catalytic activity and immunohistochemical localization of flavin-containing
      monooxygenase in rat kidney.
AB  - The presence of flavin-containing monooxygenase activity was examined in rat
      kidney microsomes using N,N-dimethylaniline and methimazole as substrates.
      Western immunoblot analysis using antisera to porcine liver and rabbit lung
      flavin-containing monooxygenase indicated immunological cross-reactivity between
      rat kidney, porcine liver and rabbit lung flavin-containing monooxygenase.
      Immunohistochemical studies using antisera to rabbit lung flavin-containing
      monooxygenase demonstrated localization of this enzyme in the proximal and distal
      convoluted tubules of the renal cortex, the collecting ducts in the renal
      medulla, but not the glomeruli. This observation indicates the colocalization of
      flavin-containing monooxygenase and cytochrome P-450 in the metabolically active
      and absorptive compartment of the renal parenchyma.

PMID- 8483389
TI  - Effect of maternal adrenal deprivation on the content of catecholamines in fetal
      brain.
AB  - Previous studies performed in our laboratory showed the importance of the effects
      that the absence of maternal adrenal hormones have on fetal brain. In the present
      study we investigated the effect of adrenal deprivation during gestation on the
      fetal catecholamines development in several cerebral areas. Fetuses from both
      control and adrenalectomized mothers from the first day of gestation were removed
      on the 20th embryonary day. Plasma corticosterone levels were significantly lower
      in the maternal serum of adrenalectomized rats, while the contents were non
      significantly higher in the adrenalectomized-mothers group of fetuses.
      Catecholamine contents in diencephalon, metencephalon, mesencephalon and
      telencephalon were measured by HPLC-ED. The results obtained showed that when the
      development of the catecholaminergic systems was previous enough to the fetal
      adrenal function, and under maternal adrenal deprivation conditions, the lack of
      corticosterone promotes an increase in the level of the catecholamines, as
      observed in the diencephalic NA, the earlier in maturational process. In those
      areas where the maturation starts at the same time than the fetal adrenal
      hypersecretion, no changes were observed. In the cortex, where both DA and NA
      develop later, the corticosterone produces an inhibition in the proliferation of
      the catecholaminergic neurons, showing decreased telencephalic levels of both
      catecholamines.

PMID- 8483390
TI  - Metallothionein and glutathione as determinants of cellular retention and
      extrusion of cadmium and mercury.
AB  - This work explored cellular trapping and extrusion of Cd and Hg in epithelial
      cells, with special emphasis on the jejunal mucosa. Important determinants of
      these processes are the concentration, diffusibility and relative metal
      affinities of a variety of cellular metal-binding compounds including
      metallothionein (MT). As predicted from the known properties of MT, this protein
      can compete with other sulfhydryl compounds for Cd but not for Hg; this is
      illustrated by the observation that glutathione (GSH) stimulates extrusion of
      only Hg. Similar factors can help explain why, in spite of its tighter binding by
      MT, Hg has a shorter biological half-life in renal cortex than does Cd. Metal
      extrusion from cells presumably involves movement of diffusible complexes such as
      HgGSH.

PMID- 8483391
TI  - Antisecretory and cytoprotective doses of enprostil do not alter gastric mucosal
      blood flow.
AB  - Prostaglandins of the E series are antisecretory and cytoprotective.
      Cytoprotection occurs in the deep but not superficial gastric mucosa. It has been
      hypothesized that the mechanism of cytoprotection involves increased gastric
      mucosal blood flow (GMBF). However, basal and stimulated gastric mucosal blood
      flow is greater in the deep than superficial corpus mucosa. The purpose of this
      study was to investigate the effect of a prostaglandin E2 analog, enprostil, on
      GMBF in the deep mucosa, where cytoprotection is observed, in both antisecretory
      and cytoprotective doses. Gastric mucosal blood flow in the deep half of the
      mucosa was measured by the hydrogen gas clearance method before, during and after
      intragastric perfusion of enprostil, 0.1-100 micrograms/kg, in urethane
      anesthetized rats. Enprostil did not alter GMBF in any of the doses tested.
      Therefore, the cytoprotective action of enprostil is mediated by factors other
      than a primary increase in GMBF.

PMID- 8483392
TI  - Neutral aminopeptidase activity levels during the estrous cycle and the pregnancy
      in the hypothalamus and the pituitary of the rat.
AB  - Neutral aminopeptidase activity levels during the estrous cycle and pregnancy, in
      the hypothalamus and the pituitary of experimental animals, was studied in this
      research. The cyclic stages were the estrous, diestrous and proestrous (at
      morning and afternoon). The pregnancy phases were the 2nd, 7th, 14th and 20th day
      postinsemination. The parturition day was also studied. The higher cyclic enzyme
      levels were found in the proestrous stage (afternoon). No differences between
      estrous and diestrous were observed. During pregnancy, there was a rise at 7th
      and 14th day, with a decrease in the 20th day. In the hypothalamus, significant
      increases after parturition were shown, the latter not being observed in the
      pituitary. In general, the changes seem to be parallel to those of the
      luteinizing hormone.

PMID- 8483393
TI  - Precocious puberty in chicks (Gallus domesticus) induced by central injections of
      neuropeptide Y.
AB  - The objective of the study was to determine the role of neuropeptide Y (NPY) and
      biogenic amines on the onset of puberty in birds. Male broiler chicks were
      administered chronic intracerebroventricular (ICV) injections of 5 micrograms NPY
      which produced sexually precocious chicks, determined by advanced secondary sex
      characteristics. One or two weeks following the beginning of a series of NPY
      injections, the preoptic area (POA), bed nucleus of the pallial commissure
      (nCPa), paraventricular nucleus (PVN), and median eminence (ME) were analyzed for
      biogenic amines. Levels of L-dopa, the precursor of dopamine (DA) were increased
      within the ME of chicks that responded to treatments by showing advanced sexual
      maturation when an amino acid decarboxylase blocker was administered prior to
      sacrifice. The PVN of respondents showed several changes in biogenic amines,
      while the nCPa displayed a biogenic amine metabolite of unknown identity which
      was significantly lower in respondent chicks. In contrast to mammals, L-dopa was
      detectable within the nCPa, PVN, and ME regardless of whether an enzymatic
      blocker of amino acid decarboxylase was administered to chicks prior to
      sacrifice. Results suggest that increased brain levels of NPY and DA, the latter
      specifically occurring within the ME, are associated with the onset of puberty.
      Due to the several significant differences found in biogenic amino levels within
      the PVN of respondent chicks, this nucleus, similar to the ME may be a highly
      active and integrative neural structure during the onset of puberty in chicks.

PMID- 8483394
TI  - Classic versus sequential diagnostic support for chronic nonspecific respiratory
      diseases.
AB  - The authors discuss two approaches to assisted medical diagnosis of chronic
      nonspecific respiratory diseases, Bayes-Fisher linear discrimination and a
      decision tree based on the linear discriminant functions of the individual nodes.
      Only the two most discriminative variables obtained for differentiation of groups
      at individual nodes are used for the node subclassification. They are the four
      linguistic variables cough, character of dyspnea, physical examination of the
      chest, and x-ray examination of the chest obtained by conversion of discrete
      features. No laboratory finding is used. The tree classifier simulates a
      physician's thought process. Results with multigroup linear discrimination on the
      same four variables for both a reclassification and a cross-validation technique
      were comparable to the tree-scheme outcomes. The tree classifier lends itself to
      simple graphic presentation, the patient being created as a point in the plane of
      the two most discriminative variables without the need for mathematical formulas
      and posterior probabilities. The classification errors that appear in the chronic
      bronchitis group can be easily corrected using an additional variable, smoking
      index.

PMID- 8483395
TI  - Teaching clinical decision making in a family practice clerkship.
AB  - Limited health care resources and other social factors are making clinical
      decision making (CDM) a necessary subject of study for medical students. However,
      CDM material is technical and could be perceived by students as arcane. This
      study evaluated student attitudes toward a CDM module imbedded in a third-year
      medical student (MSIII) family medicine clerkship. A survey instrument was used
      for the evaluation and included a within-subject check for response consistency.
      The results show that MSIIIs feel that technical CDM material is within their
      grasp and that it is relevant to their day-to-day care of patients.

PMID- 8483396
TI  - A multiattribute-utility-function approach to weighing the risks and benefits of
      pharmaceutical agents.
AB  - Both the selection of doses of pharmaceutical agents and comparisons between
      pharmaceutical agents have long been based on the nonquantified concept of the
      risk-benefit ratio. Though useful, this concept implies a data comparison that is
      difficult to make: the toxicity versus the efficacy of a drug compound. This
      research demonstrates an approach for weighing risks and benefits by combining
      utility functions for human efficacy and toxicity with animal and laboratory
      toxicity information to develop an overall multiattribute utility function for an
      ophthalmic pharmaceutical agent, I-bunolol, intended for the treatment of
      glaucoma. With this multiattribute function and a small portion of the published
      data available for this drug, the expected utilities for six doses (including a
      control) could be compared and the value of this approach in drug-dosage
      selection demonstrated.

PMID- 8483397
TI  - Using treatment-tradeoff preferences to select diagnostic strategies: linking the
      ROC curve to threshold analysis.
AB  - Selection of optimal diagnostic strategies depends on the accuracy of diagnostic
      tests, the prevalence of disease, and the relative benefits and harms resulting
      from test/treatment choices. One can characterize diagnostic strategies according
      to their net benefit-to-harm ratios. Within the framework of expected-utility
      theory, the benefit-to-harm ratio is equivalent to the marginal tradeoff between
      erroneous and correct treatment choices. Consequently, a physician can identify
      his or her preferred strategy by asking the question: "How many additional
      treatment errors am I willing to make in order to treat one additional person
      correctly?" Family physicians were asked to indicate their lowest and highest
      acceptable tradeoff ratios in a survey about streptococcal pharyngitis. All 53
      respondents indicated uncertainty about their preferred treatment-tradeoff
      ratios. For 58% of respondents, the midpoints of the acceptable range of tradeoff
      ratios corresponded to generally accepted diagnostic strategies: 1) test all or
      2) treat if classic, test all others. In contrast, previously published patient
      utilities yield a treatment-tradeoff ratio that corresponds to the strategy of
      treating all cases. The analysis illustrates the linkage between the optimal
      operating point on a receiver operating characteristic (ROC) curve and the
      selection of a preferred diagnostic strategy based on treatment thresholds
      derived from benefit-to-harm ratios. The survey results indicate that physicians
      can respond directly to questions assessing their preferences for such treatment
      thresholds. Differences between patients and physicians have significant impacts
      on choices of test and treatment strategies.

PMID- 8483398
TI  - Test-retest reliabilities of two treatment-preference instruments in measuring
      utilities.
AB  - The authors assessed the test-retest reliabilities of two treatment-preference
      instruments recently applied to the measurement of the utilities of health states
      after different treatment modalities for cancer. The first instrument measures
      the strengths of preferences concerning a choice between a wait-and-see policy,
      and treatment with radiotherapy after an initial surgical breast-conserving
      procedure for early breast cancer. The second measures the strengths of
      preferences concerning a choice between two hypothetical surgical treatment
      outcomes in cancer of the rectum with different probabilities of expected five
      year survival. Both measure the strength of a subject's treatment preference
      given probabilities of treatment-related costs and benefits. The subjects were
      radiotherapy technicians (n = 20) and cancer patients (n = 20) who were
      interviewed in weeks 2 and 4 of radiotherapy. The test-retest reliabilities of
      both instruments were inconsistent and moderately high, with Spearman's rank
      correlations ranging from 0.38 to 0.81 and weighted kappas ranging from 0.38 to
      0.69. To investigate whether the start of treatment with radiotherapy influenced
      the utilities that patients assigned to health states, the same procedure was
      applied in another, comparable, group of patients with cancer (n = 20). For this
      group, the first assessment was made prior to the start of treatment and the
      second during the second week of radiation therapy. The scores of this group of
      patients indeed appeared to be less stable than the scores of the patients
      assessed in weeks 2 and 4 of radiotherapy. However, the instability of the scores
      could have been the result of test bias.

PMID- 8483399
TI  - Integrating stratum-specific likelihood ratios with the analysis of ROC curves.
AB  - Data used to construct receiver operating characteristic (ROC) curves and to
      calculate the area under the curve (ROC AUC) can be used to derive stratum
      specific likelihood ratios (SSLRs) with their 95% confidence intervals (95% CIs).
      The purpose of this study was to determine whether useful information can be
      obtained by adding SSLRs to the analysis of ROC curves. The authors analyzed four
      previously reported sets of data: 1) serum creatine kinase (SCK) for diagnosing
      acute myocardial infarction (AMI) in the coronary care unit (CCU); 2) SCK in the
      evaluation of chest pain in the emergency center (EC); 3) four predictor
      variables in the diagnosis of strep throat; and 4) the ordinal assessment of
      computed tomographic (CT) images. Use of SCK in the CCU produced four strata that
      had posttest probabilities that were highly discriminating, whereas SCK in the EC
      resulted in only two strata with limited discriminating ability. In either study
      the cutpoint at which the SSLR changed from less than to greater than 1.0 was
      higher than the reported upper normal for the test, thereby quantitating spectrum
      bias. The maximum number of strata of predictor signs and symptoms for strep
      throat was three rather than the five used in previous studies. With a larger
      sample size or pooling, four strata could probably be developed. With CT images,
      "definitely normal," "probably normal," and "questionable" were collapsed to one
      negative stratum. "Probably abnormal" became the true "questionable" stratum and
      "definitely abnormal" was the only positive stratum. The authors conclude that
      additional useful information is obtained by deriving stratum-specific likelihood
      ratios as part of the analysis of an ROC curve.

PMID- 8483400
TI  - A measure of mortality risk for elderly patients with acute myocardial
      infarction.
AB  - The objective of this study was to derive and validate a simple scoring system
      that predicts risk of short-term mortality in elderly patients hospitalized with
      acute myocardial infarction (AMI) and to compare this derived score with the
      MedisGroups admission severity score. A myocardial infarction severity score
      (MISS) was derived from a database of clinical information abstracted using
      MedisGroups and follow-up information on 30-day mortality status. The MISS was
      validated and compared with the MedisGroups Admission Severity Groups (ASGs) in a
      separate database. The derivation set included 2,037 Medicare patients 65 years
      old or older with confirmed AMI who were randomly selected from patients
      discharged from hospitals in seven states during 1985. The validation set
      consisted of 6,323 patients from the 1988 MedisGroups comparative database who
      were at least 65 years of age and had confirmed AMI. Multivariate logistic
      regression analysis found a set of nine abnormal patient characteristics that
      independently predict 30-day mortality. There was good agreement between
      mortality rates predicted by the logistic model and observed mortality rates in
      the validation population. This regression model was then simplified to an
      additive score where eight of the characteristics were weighted as one point and
      one characteristic was weighted as two points. The MISS is the sum of the points
      for each patient. In the validation dataset, the 1,373 patients with the lowest
      MISS scores had a mortality rate of 4.6% and the 400 patients with the highest
      MISS scores had a mortality rate of 64%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483401
TI  - Stability of time-tradeoff utilities in survivors of myocardial infarction.
AB  - To investigate whether time-tradeoff utilities of survivors of myocardial
      infarction change over time and whether changes in utilities correlate with
      changes in functional status, the authors conducted serial interviews using a
      time tradeoff and three measures of functional status in a cohort of 67 patients
      who had recently had myocardial infarction. The patients were also asked to rate
      their overall health on a rating scale and were asked about chest pain, exercise
      status, and employment status. Each patient was interviewed two to five times
      over one and a half years. The mean (95% CI) time-tradeoff score for all patients
      was 0.88 (0.84, 0.93). Over a mean interval of 8.4 months, 28 (42%) patients
      changed Karnofsky scores, 28 (42%) changed Specific Activity Scale classes, and
      11 (16%) changed New York Heart Association classes, with most changes
      representing improvements in functional status. Scores on the rating scale
      improved by a mean (95% CI) of 0.06 [(0.03, 0.10); p < 0.002], but scores on the
      time tradeoff remained stable, with a mean (95% CI) change of 0.03 [(-0.02,
      0.08); p = NS]. Changes in time-tradeoff scores did not correlate with changes in
      Specific Activity Scale classes (Kendall's tau = 0.21), New York Heart
      Association classes (tau = -0.02), or Karnofsky scores (tau = 0.14); with changes
      on the verbal rating scale (R = 0.20); with changes in chest pain status (tau = 
      0.05), exercise status (tau = 0.11), or employment status (tau = 0.11); or with
      interim hospitalizations (tau = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483402
TI  - Assessing the accuracy of physician estimates.

PMID- 8483403
TI  - Risks in utility assessment and risks of medical interventions.

PMID- 8483404
TI  - Using age-specific rates in a Markov model.

PMID- 8483406
TI  - Reanalyzing data.

PMID- 8483405
TI  - Commentary: fine-tuning life-expectancy calculations using Markov processes.

PMID- 8483407
TI  - The descriptive epidemiology of health-state values and utilities.

PMID- 8483408
TI  - The Beaver Dam Health Outcomes Study: initial catalog of health-state quality
      factors.
AB  - The Beaver Dam Health Outcomes Study (BDHOS) is an ongoing longitudinal cohort
      study of health status and health-related quality of life for a random sample of
      adults (age range at interview was 45 to 89 years; mean = 64.1, SD = 10.8) in a
      community population. In a face-to-face interview lasting approximately an hour,
      each participant responds to several batteries of questions. Included are a
      history of chronic medical conditions, current medications, and past surgeries;
      the SF-36 (a general health-status questionnaire); the Quality of Well-being
      index; self-rated health status on a five-point scale from "excellent" to "poor";
      and evaluation of current health using the method of time tradeoffs. The authors
      present results from 1,356 interviews on these four principal measures, reporting
      mean scores by sex, by age, and for persons reporting being affected by various
      medical conditions. They believe data from the BDHOS will provide researchers and
      policy makers a reference collection of vital statistics for health-related
      quality of life. Additionally, the data provide a way to compare results from
      studies that utilize different indices from among the four principal measures of
      the BDHOS.

PMID- 8483410
TI  - Changes in nurse licensure exam.

PMID- 8483409
TI  - A research utilization workshop.

PMID- 8483411
TI  - 40th annual meeting of the American College of Sports Medicine. Seattle,
      Washington, June 2-5, 1993. Abstracts.

PMID- 8483412
TI  - The Klebsiella pneumoniae nifJ promoter: analysis of promoter elements regulating
      activation by the NifA promoter.
AB  - The nifJ and nifH promoters of Klebsiella pneumoniae are divergently transcribed
      sigma 54-dependent promoters that are positively activated by the NifA protein.
      NifA binds to upstream activator sequences (UASs), usually located 60-200 bp
      upstream of the start of transcription. Bound NifA is presented to the RNA
      polymerase-sigma 54 complex (E sigma 54) via DNA loop formation, mediated by the
      binding of integration host factor protein (IHF) between E sigma 54 and NifA. The
      nifJ promoter sequence contains three potential NifA binding sites (UAS1, 2 and
      3) and two potential RNA polymerase-sigma 54-binding sites (downstream promoter
      elements, DPEs 1 and 2). DPE2 is located 420 bp into the coding region and DPE1
      overlaps UAS1 by 5 bp. Mutational and footprinting analyses have shown efficient
      activation of the nifJ promoter requires that NifA is bound at UAS 2 and 3.
      Transcription is initiated at DPE1. Only a weak interaction of NifA with the UAS
      overlapping DPE1 was detected. Footprints demonstrated that E sigma 54 forms a
      closed complex at DPE1 but not DPE2 and that bound E sigma 54 closely approaches
      the -15 region of DPE1. Stimulation of nifJ promoter activity by IHF was not as
      great as that observed for other nif promoters. In the absence of IHF nifH
      promoter sequences stimulated activation of the nifJ promoter. This appeared to
      require NifA bound at the nifH UAS. Thus, one additional role of IHF may be to
      partition NifA between the two promoters by constraining the topology of the DNA.

PMID- 8483413
TI  - The Fis protein: it's not just for DNA inversion anymore.

PMID- 8483414
TI  - Cloning, nucleotide sequence determination and expression of the genes encoding
      cytochrome P-450soy (soyC) and ferredoxinsoy (soyB) from Streptomyces griseus.

PMID- 8483415
TI  - Molecular analysis of spv virulence genes of the Salmonella virulence plasmids.
AB  - Genes on an 8 kb region common to the virulence plasmids of several serovars of
      Salmonella are sufficient to replace the entire plasmid in enabling systemic
      infection in animal models. This virulence region encompasses five genes which
      previously have been designated with different names from each investigating
      laboratory. A common nomenclature has been devised for the five genes, i.e. spv
      for salmonella plasmid virulence. The first gene, spvR, encodes a positive
      activator for the following four genes, spvABCD. DNA sequence analysis of the spv
      genes from Salmonella typhimurium, Salmonella dublin, and Salmonella choleraesuis
      demonstrated extremely high conservation of the DNA and amino acid sequences. The
      spv genes are induced at stationary phase and in carbon-poor media, and optimal
      expression is dependent on the katF locus. The virulence functions of the spv
      genes are not known, but these genes may increase the growth rate of salmonellae
      in host cells and affect the interaction of salmonellae with the host immune
      system.

PMID- 8483416
TI  - Specific binding sites in the alcR and alcA promoters of the ethanol regulon for
      the CREA repressor mediating carbon catabolite repression in Aspergillus
      nidulans.
AB  - The CREA repressor responsible for carbon catabolite repression in Aspergillus
      nidulans represses the transcription of the ethanol regulon. The N-terminal part
      of the CREA protein encompassing the two zinc fingers (C2H2 class family) and an
      alanine-rich region was expressed in Escherichia coli as a fusion protein with
      glutathione-S-transferase. Our results show that CREA is a DNA-binding protein
      able to bind to the promoters of both the specific trans-acting gene, alcR, and
      of the structural gene, alcA, encoding the alcohol dehydrogenase I. DNase I
      protection footprinting experiments revealed several specific binding sites in
      the alcR and in the alcA promoters having the consensus sequence 5'-G/CPyGGGG-3'.
      The disruption of one of these CREA-binding sites in the alcR promoter
      overlapping the induction target for the trans-activator ALCR results in a
      partially derepressed alc phenotype and derepressed alcR transcription, showing
      that this binding site is functional in vivo. Our data suggest that CREA
      represses the ethanol regulon by a double lock mechanism repressing both the
      trans-acting gene, alcR, and the structural gene, alcA.

PMID- 8483417
TI  - Involvement of the RNA polymerase alpha subunit C-terminal region in co-operative
      interaction and transcriptional activation with OxyR protein.
AB  - The role of the alpha subunit of Escherichia coli RNA polymerase in transcription
      activation by the OxyR protein was investigated using in-vitro-reconstituted RNA
      polymerase containing alpha subunits carrying C-terminal truncations or an amino
      acid substitution. Mutant RNA polymerases failed to respond to transcription
      activation of the E. coli OxyR-dependent promoters. DNase I footprinting analysis
      indicates that the OxyR protein exerts a co-operative effect on the binding of
      wild-type RNA polymerase, but not the mutant RNA polymerases, to the katG
      promoter. Together, these results suggest that direct protein-protein contact
      between the OxyR protein and the C-terminal contact site I region of the RNA
      polymerase alpha subunit plays an essential role in transcription activation at
      the OxyR-dependent promoters.

PMID- 8483418
TI  - Organization of Lrp-binding sites upstream of ilvIH in Salmonella typhimurium.
AB  - Lrp, a major regulatory protein in Escherichia coli, controls the expression of
      numerous operons, including ilvIH. Lrp binds to six sites upstream of ilvIH, and
      Lrp binding is required for ilvIH expression. We show here that an Lrp-like
      protein is also present in Salmonella typhimurium. This protein can bind both E.
      coli and S. typhimurium ilvIH DNA, as can E. coli Lrp. Methidiumpropyl-EDTA
      footprinting studies were performed with purified E. coli Lrp and S. typhimurium
      ilvIH DNA. Six binding sites were defined, three of them being similar to
      corresponding sites in E. coli, and three being organized differently. A
      consensus derived from six S. typhimurium sites is compatible with that derived
      from a similar analysis of E. coli sequences.

PMID- 8483419
TI  - Positive transcriptional control of mry regulates virulence in the group A
      streptococcus.
AB  - Transcription of the antiphagocytic M protein in the group A streptococcus
      (Streptococcus pyogenes) is environmentally regulated in response to CO2 and
      requires Mry, a trans-acting positive regulatory protein. We have examined the
      role of Mry in environmental regulation by analysing the factors that regulate
      expression of the gene that encodes Mry (mry). By employing a strategy that
      utilizes integrational plasmids, it was found that expression of mry requires the
      participation of DNA sequences that extend 473 base pairs upstream of the Mry
      coding region. Transcription of mry, as analysed in S1 nuclease protection
      assays, is initiated from two separate promoters located within this extended
      regulatory region. Construction and analysis of transcriptional fusions between
      the mry promoters and a promoterless chloramphenicol acetyltransferase gene
      demonstrated that mry is autoregulated and environmentally regulated in response
      to the level of CO2. These data suggest a model for the regulation of virulence
      in S. pyogenes where positive transcriptional control of mry in response to
      environmental stimuli regulates the expression of the M protein.

PMID- 8483420
TI  - Molecular characterization of the enniatin synthetase gene encoding a
      multifunctional enzyme catalysing N-methyldepsipeptide formation in Fusarium
      scirpi.
AB  - The gene encoding the multifunctional enzyme enniatin synthetase from Fusarium
      scirpi (esyn1) was isolated and characterized by transcriptional mapping and
      expression studies in Escherichia coli. This is the first example of a gene
      encoding an N-methyl peptide synthetase. The nucleotide sequence revealed an open
      reading frame of 9393 bp encoding a protein of 3131 amino acids (M(r) 346,900).
      Two domains designated EA and EB within the protein were identified which share
      similarity to each other and to microbial peptide synthetase domains. In contrast
      to the N-terminal domain EA, the carboxyl terminal domain EB is interrupted by a
      434-amino-acid portion which shows local similarity to a motif apparently
      conserved within adenine and cytosine RNA and DNA methyltransferases and
      therefore seems to harbour the N-methyl-transferase function of the multienzyme.

PMID- 8483421
TI  - In vitro transcription in Chlamydia psittaci and Chlamydia trachomatis.
AB  - Extracts of Chlamydia psittaci and Chlamydia trachomatis were used to transcribe
      molecularly cloned chlamydial genes in vitro. The extracts were prepared by
      lysing reticulate bodies, obtaining the 10,000 x g centrifugation pellet, and
      eluting RNA polymerase from the pellet by treatment with 2M KCl to yield a
      fraction designated SS2. Some in vitro transcription was initiated from non
      chlamydial promoters and a small amount of transcription was from endogenous DNA
      template in SS2. However, optimal transcription from exogenous templates required
      chlamydial promoter sequences, and primer extension analysis indicated that
      chlamydia promoter-specific in vitro transcription was initiated from the same
      start sites recognized in vivo. A monoclonal antibody that was generated against
      Escherichia coli sigma 70 and which immunologically cross-reacts with C.
      trachomatis sigma 66 inhibited in vitro transcription of vector and cloned
      chlamydial DNA, suggesting that transcriptional initiation in the SS2 fraction is
      mediated by sigma 66. An in vitro transcription assay based on detection of
      transcripts of specific lengths was applied to the chlamydial system; this assay
      and others described here should be useful in defining chlamydial promoters and
      other transcriptional regulatory elements.

PMID- 8483422
TI  - A positive feedback loop controls transcription of the spoOF gene, a component of
      the sporulation phosphorelay in Bacillus subtilis.
AB  - The spo0F gene of Bacillus subtilis encodes a protein that functions as a
      secondary messenger in a phosphorelay system controlling the initiation of
      sporulation. Transcription of the spo0F gene was known to be dependent on an
      intact gene for the transcription regulator Spo0A. In vitro footprint analysis
      revealed that Spo0A protein bound to two locations in the spo0F promoter region.
      Deletion of a 40 bp region upstream of one of the promoters (P2) abolished the
      activation of spo0F expression that occurs at the onset of stationary phase and
      sporulation. This 40 bp region contains a Spo0A-binding site. These observations
      are consistent with a hypothesis that Spo0A binding to this region is responsible
      for activating spo0F transcription. Additionally, Spo0A binding at a downstream
      site could modulate the level of this activation. Since Spo0F protein is required
      for the formation of Spo0A-P (the form needed for transcriptional activation) a
      positive feedback loop controls transcription of spo0F.

PMID- 8483423
TI  - Translation across the 5'-splice site interferes with autocatalytic splicing.
AB  - The bacteriophage T4 nrdB gene, encoding the ribonucleotide reductase small
      subunit, contains a self-splicing group IA2 intron with an ochre codon in frame
      with the preceding exon sequence. The stop codon was changed to an amino acid
      codon and splicing efficiency was compared with that of the wild type in the
      presence and absence of translation. In vivo the mutant has a much lower
      efficiency for producing a mature transcript than the wild type. Also, the
      relative production of the full-length translation product is correspondingly
      lower in the mutant than in the wild type. These results confirm the importance
      of the stop codon, which spans the splice site of the nrdB intron. The occurrence
      of stop codons in 56 group I introns in protein-encoding genes was investigated.
      In 33 of those translation is terminated upstream of the first common elements of
      the catalytic core, of group I introns. In the rest translation is terminated in
      intron regions outside the heart of the catalytic core, with one exception. Our
      observations suggest that in situations where transcription and translation are
      coupled events there has been an evolutionary pressure to preserve stop codons in
      the 5'-region of these introns or to prevent translational termination from
      occurring in vital parts of the introns.

PMID- 8483424
TI  - Postmenopausal oestrogen replacement therapy with subcutaneous oestradiol
      implants.
AB  - Ten postmenopausal patients were treated by means of subcutaneous oestradiol
      releasing silastic implants. Half of the patients received 3 implants, each
      containing 12 mg oestradiol valerate (E2V), while the other half received 4
      implants, each containing 27 mg oestradiol benzoate (E2B). Progestogen was added
      to the treatment for 14 days, 6 weeks after implant insertion and every fourth
      week thereafter. Serum levels of oestrone (E1), oestradiol (E2), follicle
      stimulating hormone (FSH) and luteinizing hormone (LH) were followed up. The
      effects on endometrial thickness, uterine volume and breast tissue were evaluated
      by ultrasound, mammography also being used for breast examination. The follow-up
      period was 24 weeks, but the implants were not removed until the climacteric
      symptoms reappeared. E1 and E2 levels remained higher and gonadotrophin levels
      lower than the pretreatment values during the 24-week follow-up period. Oestrogen
      effects were seen in both the uterus and the breasts. Both types of implant were
      effective in relieving climacteric symptoms. The mean time for symptom return was
      10 months (range 6-18 months) in the E2V group and 8 months (range 4-12 months)
      in the E2B group. Our results indicate that nonbiodegradable controlled-release
      oestrogen implants offer a safe, effective, convenient and well-accepted
      alternative means of administering oestrogen replacement therapy.

PMID- 8483425
TI  - Bone mineral density in surgically postmenopausal women receiving hormonal
      replacement therapy as assessed by dual photon absorptiometry.
AB  - A total of 118 postmenopausal women who had undergone hysterectomy and bilateral
      oophorectomy were invited to participate in this study. Patients were randomly
      allocated to one of four study groups which received, respectively, conjugated
      equine oestrogens (CEE) 0.625 mg/day over a 25-day cycle each month (n = 28);
      transdermal 17 beta-oestradiol 50 micrograms/day over a 24-day cycle each month
      (n = 28), CEE 0.625 mg/day every day of the month (n = 32) and no treatment the
      control group (n = 30). All the treated patients also received 2.5 mg/day
      medroxyprogesterone acetate sequentially for the last 12 days of each cycle. Dual
      photon absorptiometry was performed before therapy commenced and repeated after 1
      year in all four groups. The three therapeutic regimens induced increases in bone
      mass, whereas a significant decrease was observed in the control group (P <
      0.05).

PMID- 8483426
TI  - Oestrogen and progesterone receptors in the human vagina during the menstrual
      cycle, pregnancy and postmenopause.
AB  - Oestrogen receptor (ER) and progesterone receptor (PR) concentrations were
      measured by enzyme immunoassays in human vaginal tissues. There were no
      significant differences in either case between the follicular and luteal phases,
      or in ER concentrations between regularly cycling and postmenopausal women. ER
      levels were significantly lower in pregnant than in non-pregnant women. PR levels
      were significantly lower in both postmenopausal and pregnant women than in
      regularly cycling women. A positive correlation between ER and PR was found in
      pregnant women and there were correlations between ER and both oestradiol and
      prolactin in postmenopausal women. This is the first study to compare both ER and
      PR in the human vagina during the menstrual cycle, pregnancy and postmenopause.

PMID- 8483427
TI  - Oestradiol-releasing vaginal ring for treatment of postmenopausal urogenital
      atrophy.
AB  - A silicone vaginal ring releasing 5-10 micrograms oestradiol/24 h for a minimum
      of 90 days has been developed for treatment of urogenital mucosal atrophy. The
      efficacy, safety and acceptability of the oestradiol-releasing ring were studied
      in 222 postmenopausal women with symptoms and signs of atrophic vaginal mucosa.
      The maturation of the vaginal epithelium, as measured by cytological parameters,
      was significantly improved during treatment. No proliferation of the endometrium
      was encountered. The therapy had a significant effect on symptoms (vaginal
      dryness, pruritus vulvae, dyspareunia, urinary urgency) and on signs of atrophic
      vaginitis, with cure/improvement registered in > or = 90%. The patient
      acceptability was high, since > or = 90% did not report any discomfort with the
      ring. Almost all of the sexually active women had the ring in place during coitus
      and in < or = 2% of cases discomfort was noticed by them or the partner. It is
      concluded that a vaginal silicone ring giving a continuous release of an ultra
      low dose of oestradiol is an effective and safe treatment for urogenital
      oestrogen deficiency. No addition of progestagen is needed.

PMID- 8483428
TI  - [Arrow poisons--relics of former times?].

PMID- 8483429
TI  - [ACE inhibitors for therapy of heart failure].

PMID- 8483430
TI  - [Iron deficiency after endurance sports?].

PMID- 8483431
TI  - [Is "clinical" better?].

PMID- 8483432
TI  - [Calmodulin antagonists].

PMID- 8483433
TI  - Dermatology quiz #3. Basal cell carcinoma.

PMID- 8483434
TI  - Utilization of mammography by Missouri women.

PMID- 8483435
TI  - Advances in the treatment of calcaneus fracture.
AB  - The calcaneus is the largest of the tarsal bones and the most commonly fractured,
      being involved in more than half of all major tarsal injuries. Intraarticular
      fractures of the calcaneus are seriously disabling and of significant economic
      consequences. Ninety percent of these injuries occur in working age men, most
      commonly industrial workers. Many of these workers will never return to their
      jobs, and of those who do, 20% will be out for up to 3 years. The optimal
      treatment for intra-articular fractures is controversial. However, in the past
      few years, progress has been made in understanding the nature of calcaneus
      fracture. The availability of computed tomographic scanning and improved surgical
      techniques has improved the outlook for many of these patients to return to
      productive activity.

PMID- 8483436
TI  - Transvaginal electron beam cone used in treating an advanced squamous cell
      carcinoma of the cervix.
AB  - The transvaginal electron beam cone technique was employed to deliver an
      additional or "boost" dose to a bulky stage IV-A squamous cell carcinoma of the
      cervix treated by definitive radiotherapy techniques. The tumor regressed, the
      patient remaining free of carcinoma until her death due to myocardial infarction
      more than two years later.

PMID- 8483437
TI  - Support of collaborative practice.

PMID- 8483438
TI  - Chemical dependency treatment.

PMID- 8483439
TI  - Lead poisoning prevention: current clinical practice.

PMID- 8483440
TI  - Lyme disease--United States, 1991-1992.
AB  - Surveillance for Lyme disease (LD) was initiated by CDC in 1982 (1), and in 1990,
      the Council of State and Territorial Epidemiologists (CSTE) approved a resolution
      making LD nationally reportable. During 1982-1991, states reported 40,195 cases
      of LD. In 1992, LD accounted for more than 90% of all reported vectorborne
      illnesses in the United States (CDC, unpublished, 1993). This report summarizes
      surveillance for LD in the United States during 1991-1992.

PMID- 8483441
TI  - Physician reporting of Lyme disease--Connecticut, 1991-1992.
AB  - Although disease reporting by physicians is an essential component of public
      health surveillance, the extent of physician participation in reporting specific
      diseases is not routinely assessed. As part of an evaluation of Lyme disease (LD)
      surveillance, the Connecticut Department of Health Services (CDHS) conducted a
      study to determine the number and specialty of Connecticut physicians who
      reported LD cases in 1991 and/or 1992. This report summarizes the results of this
      study.

PMID- 8483442
TI  - Commercial fishing fatalities--Alaska, 1991-1992.
AB  - Based on data from the National Traumatic Occupational Fatality surveillance
      system, Alaska had the highest state-specific work-related fatality rate during
      1980-1989. During this period, the annual average private industry fatality rate
      in Alaska was 34.8 per 100,000 workers, nearly five times the annual average for
      the United States (7.0 per 100,000) (1). Fatalities in the commercial fishing
      industry-which accounts for the second largest percentage of revenue and number
      of jobs in the state-are among the highest industry-specific rates in the United
      States (1). Because of the high occupational fatality rates for Alaska, in 1991,
      CDC's National Institute for Occupational Safety and Health (NIOSH) initiated
      efforts in Alaska to improve surveillance and describe risk factors for serious
      occupational injuries associated with the fishing, logging, and air transport
      industries. This report uses data obtained and analyzed by NIOSH to characterize
      fishing industry deaths in Alaska for 1991 and 1992.

PMID- 8483443
TI  - Mandatory bicycle helmet use--Victoria, Australia.
AB  - On July 1, 1990, the first statewide law in Australia requiring wearing of an
      approved safety helmet by all bicyclists became effective in Victoria (1989
      population: approximately 4.3 million) (Figure 1). Implementation of the law was
      preceded by a decade-long campaign to promote helmet use among the estimated 2.2
      million persons who ride bicycles; the campaign included educational programs;
      mass media publicity; financial incentives; and efforts by professional,
      community, and bicycle groups (1,2). This report assesses helmet law enforcement,
      helmet use, and injuries related to bicycling in Victoria.

PMID- 8483444
TI  - Tuberculosis morbidity--United States, 1992.

PMID- 8483445
TI  - Analysis of single protoplasts and regenerated plants by PCR and RAPD technology.
AB  - We investigated the use of the polymerase chain reaction (PCR) and the associated
      random amplification of polymorphic DNA (RAPD) technique in the analysis of DNA
      and specific genes in plant cells at different stages of regeneration in in vitro
      cultures. We demonstrate that both procedures can be used to differentiate
      reproducibly between closely related species as well as to reveal levels of DNA
      polymorphism in regenerated plants. We also demonstrate that both procedures,
      using protocols that we have developed, are applicable at all tissue culture
      stages, from single isolated protoplasts to regenerated plants. Possible
      explanations for the variation levels detected in regenerated wheat plants are
      advanced.

PMID- 8483446
TI  - Analysis of regions essential for the function of chromosomal replicator
      sequences from Yarrowia lipolytica.
AB  - Two DNA segments exhibiting ARS (autonomously replicating sequence) activity in
      the dimorphic yeast Yarrowia lipolytica were cloned from its chromosome on an
      integrative LEU2 plasmid. These ARS segments, designated Y1ARS1 and Y1ARS2,
      conferred on the hybrid plasmids high transformation efficiency and enabled
      extrachromosomal transmission of the plasmids in 1 or 2 copies per yeast cell
      under selective conditions. Deletion analysis showed that at least 728-1003 bp
      for Y1ARS1 and 1377-1629 bp for Y1ARS2 were required for full function. Both of
      these regions contained two 10/11 matches to an ARS core consensus in
      Saccharomyces cerevisiae, whereas neither was similar to the S. cerevisiae
      centromere sequence. Significantly, both Y1ARS elements contained at, or close
      to, their boundaries a 13 bp sequence, 5'-TATATTCAAGCAA-3', which resembles the
      cleavage site for topoisomerase II in Drosophila. A central 524 bp ClaI fragment
      of Y1ARS2 contained four stretches of a 17 bp direct repeat sequence, 5'
      GAAAAACAAAAACAGGC-3', and exhibited the electrophoretic behavior typical of bent
      DNA.

PMID- 8483447
TI  - SSV1-encoded site-specific recombination system in Sulfolobus shibatae.
AB  - We present evidence for the existence of a conservative site-specific
      recombination system in Archaea by demonstrating integrative recombination of
      Sulfolobus shibatae virus SSV1 DNA with the host chromosome, catalysed by the
      SSV1-encoded integrase in vitro. The putative int gene of SSV1 was expressed in
      Escherichia coli yielding a protein of about 39 kDa. This protein alone
      efficiently recombined linear DNA substrates containing chromosomal (attA) and
      viral (attP) attachment sites; recombination with either negatively or positively
      supercoiled SSV1 DNA was less efficient. Intermolecular attA x attA and attP x
      attP recombination was also promoted by the SSV integrase. The invariant 44 bp
      "common attachment core" present in all att sites contained sufficient
      information to allow recombination, whilst the flanking sequences effected the
      efficiency. These features clearly distinguish the SSV1--encoded site--specific
      recombination system from others and make it suitable for the study of regulatory
      mechanisms of SSV1 genome--host chromosome interaction and investigations of the
      evolution of the recombination machinery.

PMID- 8483448
TI  - Cotranscriptional expression of mitochondrial genes for subunits of NADH
      dehydrogenase, nad5, nad4, nad2, in Marchantia polymorpha.
AB  - Three genes for the subunits of the NADH dehydrogenase (nad5, nad4, and nad2) are
      tandemly clustered on the liverwort mitochondrial genome. Their gene products
      showed high levels of amino acid sequence identity with the corresponding
      subunits from higher plant mitochondria (82.8-84.4%), and significant levels of
      identity with those from liverwort chloroplast (32.0-33.5%). Podospora anserina
      mitochondria (21.4-45.9%), and human mitochondria (18.4-27.9%). In addition,
      these three subunits from liverwort mitochondria have conserved amino acid
      residues in their central regions. The gene nad5 is interrupted by a 672 bp group
      I intron, while genes nad4 and nad2 are interrupted by group II introns of 899 bp
      and 1418 bp, respectively. Northern blot analysis using exon-intron specific
      probes indicated that these three genes are transcribed as a single precursor
      mRNA of 9.6 kb in length and are processed into mature mRNA molecules in
      liverwort mitochondria. Several regions of this nad gene cluster are repeated in
      the liverwort mitochondrial genome.

PMID- 8483449
TI  - Molecular structure and genetic regulation of SFA, a gene responsible for
      resistance to formaldehyde in Saccharomyces cerevisiae, and characterization of
      its protein product.
AB  - A 3.7 kb DNA fragment of yeast chromosome IV has been sequenced that contains the
      SFA gene which, when present on a multi-copy plasmid in Saccharomyces cerevisiae,
      confers hyper-resistance to formaldehyde. The open reading frame of SFA is 1158
      bp in size and encodes a polypeptide of 386 amino acids. The predicted protein
      shows strong homologies to several mammalian alcohol dehydrogenases and contains
      a sequence characteristic of binding sites for NAD. Overexpression of the SFA
      gene leads to enhanced consumption of formaldehyde, which is most probably the
      reason for the observed hyper-resistance phenotype. In sfa::LEU2 disruption
      mutants, sensitivity to formaldehyde is correlated with reduced degradation of
      the chemical. The SFA gene shares an 868 bp divergent promoter with UGX2 a gene
      of yet unknown function. Promoter deletion studies with a SFA promoter-lacZ gene
      fusion construct revealed negative interference on expression of SFA by upstream
      sequences. The upstream region between positions -145 and -172 is totally or
      partially responsible for control of inducibility of SFA by chemicals such as
      formaldehyde (FA), ethanol and methyl methanesulphonate. The 41 kDa SFA-encoded
      protein was purified from a hyper-resistant transformant; it oxidizes long-chain
      alcohols and, in the presence of glutathione, is able to oxidize FA. SFA is
      predicted to code for a long-chain alcohol dehydrogenase (glutathione-dependent
      formaldehyde dehydrogenase) of the yeast S. cerevisiae.

PMID- 8483450
TI  - A new yeast gene with a myosin-like heptad repeat structure.
AB  - We isolated a gene encoding a 218 kDa myosin-like protein from Saccharomyces
      cerevisiae using a monoclonal antibody directed against human platelet myosin as
      a probe. The protein sequence encoded by the MLP1 gene (for myosin-like protein)
      contains extensive stretches of a heptad-repeat pattern suggesting that the
      protein can form coiled coils typical of myosins. Immunolocalization experiments
      using affinity-purified antibodies raised against a TrpE-MLP1 fusion protein
      showed a dot-like structure adjacent to the nucleus in yeast cells bearing the
      MLP1 gene on a multicopy plasmid. In mouse epithelial cells the yeast anti-MLP1
      antibodies stained the nucleus. Mutants bearing disruptions of the MLP1 gene were
      viable, but more sensitive to ultraviolet light than wild-type strains,
      suggesting an involvement of MLP1 in DNA repair. The MLP1 gene was mapped to
      chromosome 11, 25 cM from met1.

PMID- 8483451
TI  - DNA base sequence changes induced by diethyl sulfate in postmeiotic male germ
      cells of Drosophila melanogaster.
AB  - The DNA base sequence changes induced by diethyl sulfate (DES) were analyzed in
      postmeiotic male germ cells of Drosophila melanogaster. 31 transmissible
      vermilion mutants were recovered in F1 and F2 generations, with a frequency of
      2.6 x 10(-4) for the F1, and of 1.8-13 x 10(-4) for the F2. The results show that
      DES induces both base pair substitutions (93%) and deletions (7%). In accord with
      its relatively high ability to alkylate oxygens in DNA, the most frequent type of
      sequence alteration among the basepair changes are GC-AT transitions, accounting
      for 73% of mutations, followed by transversions AT-TA (10%). DES also induced AT
      GC transitions and AT-CG transversions. Both induced deletions were intralocus
      deletions, not occurring between basepair repeats. No influence of neighboring
      bases on the mutation position was found.

PMID- 8483452
TI  - Post-transcriptional regulation of IME1 determines initiation of meiosis in
      Saccharomyces cerevisiae.
AB  - The IME1 gene of Saccharomyces cerevisiae is required for initiation of meiosis.
      Transcription of IME1 is detected under conditions which are known to induce
      initiation of meiosis, namely starvation for nitrogen and glucose, and the
      presence of MATa1 and MAT alpha 2 gene products. In this paper we show that IME1
      is also subject to translational regulation. Translation of IME1 mRNA is achieved
      either upon nitrogen starvation, or upon G1 arrest. In the presence of nutrients,
      constitutively elevated transcription of IME1 is also sufficient for the
      translation of IME1 RNA. Four different conditions were found to cause expression
      of Ime1 protein in vegetative cultures: elevated transcription levels due to the
      presence of IME1 on a multicopy plasmid; elevated transcription provided by a Gal
      IME1 construct; G1 arrest due to alpha-factor treatment; G1 arrest following mild
      heat-shock treatment of cdc28 diploids. Using these conditions, we obtained
      evidence that starvation is required not only for transcription and efficient
      translation of IME1, but also for either the activation of Ime1 protein or for
      the induction/activation of another factor that, either alone or in combination
      with Ime1, induces meiosis.

PMID- 8483453
TI  - Restoration of fertility by antisense RNA in genetically engineered male sterile
      tobacco plants.
AB  - Transgenic tobacco plants (Nicotiana tabacum L.) expressing the rolC gene of
      Agrobacterium rhizogenes under the transcriptional control of the 35S RNA
      promoter are male sterile. When these plants are genetically crossed with others
      containing the rolC gene linked in antisense orientation to the 35S RNA promoter,
      hybrid progeny display restoration of male fertility. Moreover, hybrid progeny
      are revertant for other features of the rolC phenotype, such as restoration of
      plant height, leaf pigment content and female fertility. The level of restoration
      of the characteristics of untransformed tobacco appeared to be independent of the
      steady-state level of antisense RNA. Addition of six transcriptional enhancer
      sequences upstream of the 35S transcriptional start region in the antisense
      construct led to a higher steady-state level of antisense RNA than that produced
      using a promoter linked to a single enhancer sequence. However no significant
      difference was observed in the level of attenuation of the rolC phenotype in the
      progeny of crosses with either one or six transcriptional enhancers linked to the
      antisense rolC gene. Antisense constructs comprising only 189 bp of the rolC 5'
      coding region appeared less efficient in attenuating the rolC phenotype than
      those including the whole rolC coding region as well as its 3' untranslated
      region. Furthermore, results from experiments on light-controlled rolC gene
      expression indicate that microsporogenesis is sensitive to rolC gene action
      during the early stages of flower development.

PMID- 8483454
TI  - Escherichia coli RuvA and RuvB proteins involved in recombination repair:
      physical properties and interactions with DNA.
AB  - Escherichia coli RuvA and RuvB proteins are encoded by an SOS-regulated operon,
      which is involved in DNA repair and recombination. RuvB has weak ATPase activity,
      which is enhanced by the addition of RuvA and DNA, and RuvA and RuvB in the
      presence of ATP promote branch migration at Holliday junctions. In this work, the
      physical states of RuvA and RuvB and their interactions with DNA were studied by
      sedimentation analysis and gel filtration chromatography. RuvA formed a stable
      tetramer in solution, which resisted dissociation by SDS at room temperature.
      RuvB formed a dimer in solution. When RuvA and RuvB were mixed, an oligomer
      complex was formed consisting of a tetrameric form of RuvA and a dimeric form of
      RuvB, and this complex bound to DNA. The maximal enhancement of the RuvB ATPase
      activity by RuvA was achieved at this stoichiometry in the presence of excess
      DNA.

PMID- 8483455
TI  - The Azotobacter vinelandii nifL-like gene: nucleotide sequence analysis and
      regulation of expression.
AB  - The nucleotide sequence of the Azotobacter vinelandii nifL-like gene (Av-nifL)
      was determined. The 1.9 kb sequence shows an open reading frame (ORF) of 1577 bp
      which encodes a polypeptide of 519 amino acids, with a calculated molecular
      weight of 57,793. Av-nifL has about 50% homology with the Klebsiella pneumoniae
      nifL gene (Kp-nifL) at the nucleotide level and a little more than 52% homology
      at the amino acid level. The N-terminal regions show more homology than the C
      terminal regions. As is the case in K. pneumoniae, Av-nifL is located just
      upstream of the A. vinelandii nifA gene (Av-nifA) and both genes constitute an
      operon. The expression of Av-nifL, however, seems to be independent of NtrA and
      NtrC. Furthermore, Av-nifL expression is not autogenously regulated by NifA,
      unlike the case in K. pneumoniae. The expression of an Av-nifL::lacZ fusion in A.
      vinelandii is inhibited by novobiocin and coumermycin A, which are inhibitors of
      DNA gyrase.

PMID- 8483456
TI  - A mutation in the dsbA gene coding for periplasmic disulfide oxidoreductase
      reduces transcription of the Escherichia coli ompF gene.
AB  - An insertion mutation in the Escherichia coli dsbA gene, coding for periplasmic
      disulfide oxidoreductase, dramatically reduces the level of OmpF porin protein in
      the cell envelope. Studies with chromosomal ompF-lacZ operon and gene fusions
      indicate that this is due to reduced ompF transcription. Identical effects
      resulted from growth in medium containing the reducing agent dithiothreitol, but
      the combined effects of the reducing agent and dsbA were no greater than the
      effects of each individually. The dsbA mutation did not prevent normal regulation
      of ompF transcription by the local anaesthetic procaine or by osmolarity. OmpF
      does not contain a cysteine residue, and the sole cysteine residue in the
      cytoplasmic membrane regulator of ompF transcription, EnvZ, is predicted to be
      located on the cytoplasmic side of the membrane, and is therefore unlikely to be
      involved in the effects of the dsbA mutation. The effects of the dsbA mutation
      and of the reducing agent on ompF transcription may be due to the failure to from
      an essential disulfide bond in an as yet unidentified envelope protein that
      affects ompF transcription.

PMID- 8483457
TI  - Nucleotide sequence of attP and cos sites of phage CTX and expression of
      cytotoxin in Pseudomonas aeruginosa PA158.
AB  - The gene for Pseudomonas aeruginosa cytotoxin (CTX) has been found to be part of
      a temperate phage with a total size of 35.5 kb. We have investigated several DNA
      fragments of this phage for CTX production. For phage integration, the phage
      genome cohesive (cos) ends covalently associate with host DNA of strain PA158.
      The cos ends and the CTX gene are found on a 3.4 kb EcoRI fragment B and are
      included in the 11 kb HindIII fragment A and the 8.5 kb BamHI fragment B of the
      phage DNA. The cos ends are 20 nucleotides long and are located at 338-357
      nucleotides upstream of the CTX transcriptional initiation site. The phage
      attachment (attP) site is also present on the 3.4 kb EcoRI fragment B. The attP
      site consists of 34 bp and is located at 974-1007 nucleotides upstream of the CTX
      gene start site. Replication of the vegetative form of the phage is increased at
      37 degrees C compared to that at 30 degrees C, while cytotoxin production in
      infected cells is similar at 30 degrees C and 37 degrees C. It can be concluded,
      therefore, that the integrated form of the CTX gene is responsible for CTX
      production. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) showed ten proteins
      in purified phage preparations; however, CTX could not be detected on Western
      blots using an enzyme-linked immunofluorescence assay.

PMID- 8483458
TI  - Toxicity of and mutagenesis by chlorate are independent of nitrate reductase
      activity in Chlamydomonas reinhardtii.
AB  - Spontaneous chlorate-resistant (CR) mutants have been isolated from Chlamydomonas
      reinhardtii wild-type strains. Most of them, 244, were able to grow on nitrate
      minimal medium, but 23 were not. Genetic and in vivo complementation analyses of
      this latter group of mutants indicated that they were defective either at the
      regulatory locus nit-2, or at the nitrate reductase (NR) locus nit-1, or at very
      closely linked loci. Some of these nit-1 or nit-2 mutants were also defective in
      pathways not directly related to nitrate assimilation, such as those of amino
      acids and purines. Chlorate treatment of wild-type cells resulted in both a
      decrease in cell survival and an increase in mutant cells resistant to a number
      of different chemicals (chlorate, methylammonium, sulphanilamide, arsenate, and
      streptomycin). The toxic and mutagenic effects of chlorate in minimal medium were
      not found when cells were grown either in darkness or in the presence of
      ammonium, conditions under which nitrate uptake is drastically inhibited.
      Chlorate was also able to induce reversion of nit- mutants of C. reinhardtii, but
      failed to produce His+ revertants or Arar mutants in the BA-13 strain of
      Salmonella typhimurium. In contrast, chlorate treatment induced mutagenesis in
      strain E1F1 of the phototrophic bacterium Rhodobacter capsulatus. Genetic
      analyses of nitrate reductase-deficient CR mutants of C. reinhardtii revealed two
      types of CR, to low (1.5 mM) and high (15 mM) chlorate concentrations. These two
      traits were recessive in heterozygous diploids and segregated in genetic crosses
      independently of each other and of the nit-1 and nit-2 loci. Three hcr loci and
      four lcr loci mediating resistance to high (HC) and low (LC) concentrations of
      chlorate were identified. Mutations at the nit-2 locus, and deletions of a
      putative locus for nitrate transport were always epistatic to mutations
      responsible for resistance to either LC or HC. In both nit+ and nit- chlorate
      sensitive (CS) strains, nitrate and nitrite gave protection from the toxic effect
      of chlorate. Our data indicate that in C. reinhardtii chlorate toxicity is
      primarily dependent on the nitrate transport system and independent of the
      existence of an active NR enzyme. At least seven loci unrelated to the nitrate
      assimilation pathway and mediating CR are thought to control indirectly the
      efficiency of the nitrate transporter for chlorate transport. In addition,
      chlorate appears to be a mutagen capable of inducing a wide range of mutations
      unrelated to the nitrate assimilation pathway.

PMID- 8483459
TI  - Molecular and genetic characterization of SPT4, a gene important for
      transcription initiation in Saccharomyces cerevisiae.
AB  - Mutations in the SPT4 gene of Saccharomyces cerevisiae were isolated as
      suppressors of delta insertion mutations that interfere with adjacent gene
      transcription. Recent genetic evidence indicates that the SPT4 protein functions
      with two other proteins, SPT5 and SPT6, in some aspect of transcription
      initiation. In this work we have characterized the SPT4 gene and we demonstrate
      that spt4 mutations, like spt5 and spt6 mutations, cause changes in
      transcription. Using the cloned SPT4 gene, spt4 null mutations were constructed;
      in contrast to spt5 and spt6 null mutants, which are inviable, spt4 null mutants
      are viable and have an Spt- phenotype. The DNA sequence of the SPT4 gene predicts
      a protein product of 102 amino acids that contains four cysteine residues
      positioned similarly to those of zinc binding proteins. Mutational analysis
      suggests that at least some of these cysteines are essential for SPT4 function.
      Genetic mapping showed that SPT4 is a previously unidentified gene that maps to
      chromosome VII, between ADE6 and CLY8.

PMID- 8483460
TI  - Telomeric repeat [TTAGGG]n sequences of human chromosomes are conserved in
      chimpanzee (Pan troglodytes).
AB  - Using a series of genetic parameters, attempts have been made for more than two
      decades to establish the close kinship of human (Homo sapiens) with chimpanzee
      (Pan troglodytes). Molecular and cytogenetic data presently suggest that the two
      species are closely related. The recent isolation of a human telomeric probe
      (P5097-B.5) has prompted us to cross hybridize it to chimpanzee chromosomes in
      order to explore convergence and/or divergence of the telomeric repeat sequences
      (TTAGGG)n. On hybridization, the human probe bound to both ends (telomeres) of
      chimpanzee chromosomes, suggesting a concerted evolution of tandemly repeated
      short simple sequences (TTAGGG)n. Even the terminal heterochromatin of chimpanzee
      chromosomes was found to be endowed with telomeric repeats, suggesting that
      evolution of heterochromatin and capping with tandemly repeated short sequences
      are highly complex phenomena.

PMID- 8483461
TI  - Characterization of the cyr1-2 UGA mutation in Saccharomyces cerevisiae.
AB  - cyr1-2 is a temperature-sensitive mutation of the yeast adenylate cyclase
      structural gene, CYR1. The cyr1-2 mutation has been suggested to be a UGA
      mutation since a UGA suppressor SUP201 has been isolated as a suppressor of the
      cyr1-2 mutation. Construction of chimeric genes restricted the region containing
      the cyr1-2 mutation, and the cyr1-2 UGA mutation was identified at codon 1282,
      which lies upstream of the region coding for the catalytic domain of adenylate
      cyclase. Alterations in the region upstream of the cyr1-2 mutation site result in
      null mutations. The complete open reading frame of the cyr1-2 gene expressed
      under the control of the GAL1 promoter complemented cyr1-d1 in a galactose
      dependent manner. These results suggest that at the permissive temperature weak
      readthrough occurs at the cyr1-2 mutation site to produce low levels of active
      adenylate cyclase. An endogenous suppressor in yeast cells is assumed to be
      responsible for this readthrough.

PMID- 8483463
TI  - [Differential expression of recombinant hybrid proteins containing amino- and
      carboxy-terminal regions of the exterior large glycoprotein (gp46) of the human T
      cell leukemia virus (HTLV-I) in Escherichia coli cells].
AB  - Plasmid clones capable of expressing a recombinant fusion proteins containing the
      anthranilate synthase of E. coli (TrpE) and different regions of gp46 HTLV-I were
      constructed on the basis of pATH-vectors. A high extent of TrpE-gp46 proteolytic
      degradation took place independently of the bacterial La-protease. Fusion
      proteins containing an N-terminal part of gp46 were more stable and could be
      purified in preparative quantities but were less antigenic. On the contrary, a
      TrpE-gp46 protein encoded by the TaqI-TaqI DNA fragment and containing only 35 C
      terminal amino acids was still susceptible to degradation but possessed good
      serologic reactivity. Some of the recombinant proteins obtained can be useful for
      diagnostics and for preparing monoclonal or polyclonal antibodies.

PMID- 8483462
TI  - [Expression of the v-src oncogene in Escherichia coli affects the rate of cell
      growth and leads to phosphorylation of cellular proteins].
AB  - The possible influence of expression of v-src oncogene harboring tyrosine
      specific protein kinase activity on the physiological state of E. coli cells,
      carrying plasmid which expresses src oncoprotein was studied. The realization of
      this activity in the cells brings to the phosphorylation of tyrosine in some
      additional cellular proteins and, as a consequence, to an increased proliferative
      activity of cells expressing src oncoprotein.

PMID- 8483464
TI  - [DNAase I hypersensitivity of the 1,5'-flanking region of the tryptophan
      oxygenase gene in recombinant DNA and chromatin reconstituted with it].
AB  - We have examined DNase I hypersensitive sites in the 5'-flanking region of the
      rat tryptophan oxygenase gene in recombinant plasmids. We have found two DNase I
      hypersensitive sites in regions that map between -350 to -210 and -180 to -90 bp
      from the cap site. Both hypersensitive sites are found in supercoiled plasmids
      but not in linear or relaxed DNA molecules. The position of the hypersensitive
      sites of the 5'-flanking sequence of the rat tryptophan oxygenase gene in
      recombinant plasmids correlate with the chromatin sites first determined by
      Becker et al. The hypersensitive regions in the recombinant plasmids include the
      DNase I-hypersensitive sites in chromatin but extend somewhat upstream and
      downstream from these. Computer analysis of the 5'-flanking DNA region of the
      gene suggests that the DNA fragment spanning nucleotides -231 to -207 forms a
      potential hairpin loop with 15 unpaired bases. Chromatin reconstitution with
      histones on supercoiled plasmids carrying the 5'-flanking region of the rat
      tryptophan oxygenase gene suppresses both in vitro DNase I-hypersensitive sites.
      We have also shown that the DNA region containing the supercoil-dependent DNase I
      hypersensitive site in the position between -350 and -210 bp from the cap site
      may form nucleosomes after reconstitution with histones.

PMID- 8483465
TI  - [Russian State scientific research program "Human Genome": instrument and method
      provisions].

PMID- 8483466
TI  - [Acyclic analogs of 2',3'-dideoxy-2',3'-didehydronucleoside-5'-triphosphates-
      terminators of DNA synthesis, catalyzed by a broad set of DNA polymerases].
AB  - O-4'-nor-2', 3'-dideoxy-2', 3'-didehydronucleoside 5'-triphosphates are shown to
      be effective termination substrates of DNA biosynthesis catalyzed by human
      placental DNA polymerases alpha and epsilon, rat liver DNA polymerase beta,
      reverse transcriptases of human immunodeficiency virus and avian myeloblastosis
      virus, and calf thymus terminal deoxynucleotidyl transferase. These compounds do
      not interact only with the Escherichia coli DNA polymerase I (Klenow fragment).
      The probable reasons of interaction of acyclo-d4NTP with the DNA synthesizing
      complexes are discussed.

PMID- 8483467
TI  - [Affinity modification of 40S ribosomal subparticles from human placenta by
      derivatives of oligoribonucleotides, containing an AUG codon. Ribosomal proteins,
      forming a codon-anticodon interaction region].
AB  - Using 2',3'-O-[4-N-(2-chloroethyl)-N-methylamino]benzylydene derivatives of AUGUn
      [32P]pC and 4-[N-(2-chloroethyl)-N-methylamino]benzylmethylphosphoamide
      derivatives of [32P]pAUGUn, the affinity labelling of human placental 40S
      ribosomal subunits was studied within 40S initiation complexes obtained in the
      presence of a ternary complex eIF-2.GTP.Met-tRNA(fMet). Analysis of the ribosomal
      proteins labelled by these mRNA analogues revealed that proteins S3/S3a, S6, S7,
      and S14/S15 play a key role in the interaction of the template with the 40S
      subunit in the presence of the ternary complex eIF-2.GTP.Met-tRNA(fMet). Proteins
      S2, S4, S5, S8, S9, and S17 are also involved in this interaction.

PMID- 8483468
TI  - [Genome loses all 5-methylcytosine a life span. How is this connected with
      accumulation of mutations during aging?].
AB  - The 5-methylcytosine (5mC) content in liver DNA has been determined for rats of
      different age. The rate of the 5mC loss from DNA is maximal in pre- and neonatal
      rats, 1.28% of reduction of the 5mC content per day, then it decreases to 0.33%
      and becomes minimal and constant in adult rats, 0.028% per day. During pregnancy
      and the first 15 days of postnatal development rat genome loses 49% of all 5mC.
      Within the next 45 days 15% of 5mC disappears, and during maximal rat life span,
      about four years, 39% of the genomic 5mC may be lost. Thus, it has been found for
      the first time that the animal genome loses practically all 5mC residues during
      the life span. Analysis of the literature data shows that for embryos the rate of
      the 5mC loss from DNA proves to be higher than that for adult animals by 96 times
      for mice, 69-for rats and 28-for cows. The rate of embryonal DNA hypomethylation
      may be inversely proportional to the pregnancy duration of species. In adult
      animals the rate inversely correlates with their maximal life span and accounts
      for the 5mC loss from DNA of a mouse by 0.028%, of a rat by 0.024%, of a hamster
      by 0.007%, of a cow by 0.004% and of a human being by 0.0005% per day. During the
      entire ontogenesis, the genome of a mouse loses 93% of all 5mC residues, that of
      a rat-101% and of a cow-88%. The age-dependent loss of 5mC from DNA is also
      typical for cell lines aging in vitro. It is constant, as a rule, and correlates
      with the number of cell population doublings (PD). The removal of all 5mC from
      DNA corresponds to 70-130 PD for human, 40-60 PD-for hamster and 6 PD- for mouse
      cells. In immortal lines the level of DNA methylation is stable or grows with
      age. A possible mechanism of an age-related 5mC loss from DNA is discussed. DNA
      hypomethylation may result from 5mC deamination directly at the moment of
      replicative DNA methylation and subsequent reparation of the G.T mispairs which
      leads to accumulation of the 5mC-->T+C substitutions in the genome with each cell
      division. So DNA methylation may serve as an ideal mechanism for counting cell
      divisions in vivo and in vitro.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8483469
TI  - [Synthesis of nucleoside analogs containing a cis-2-pentene fragment and their
      triphosphates].
AB  - Acyclic analogs of thymidine, adenine, and cytosine where the ribose moiety is
      replaced with cis-5-hydroxypenthene, were obtained via condensation of cis-5
      acetoxy-1-bromo-2-pentene with nucleic acid bases. Triphosphate derivatives of
      the new nucleosides were also synthesized to evaluate their action as terminators
      of DNA synthesis catalyzed by DNA polymerases.

PMID- 8483470
TI  - [Cloning the region of chromosome 22 participating in translocation t(9,22) in
      human chronic myeloid leukemia].
AB  - Using oligonucleotide probes, sequences containing the Mbcr locus involved in
      chromosome translocation t(9:22) were cloned form the library of human genes in
      the Charon 4A vector. The recombinant clone lambda BCR 1.1 obtained contained
      Mbcr sequences, but the 3' region of the Mbcr locus in lambda BCR 1.1 clone was
      strongly altered. Subcloning of a fragment of the altered region and blot
      hybridization analysis using it as a DNA probe revealed recombination in the 3'
      region of the Mbcr locus in clone lambda BCR 1.1 which resulted in insertion of
      unknown sequences into the region. A modified system is suggested for chromosome
      22 breakpoint identification using restriction analysis of genome DNA with four
      restriction endonucleases and one 5'-DNA probe.

PMID- 8483471
TI  - [Pathological cleavage of human immunodeficiency virus gp160 protein in infected
      cells as a probable factor for infection becoming chronic].
AB  - The synthesis of HIV-1 (IIIb isolate) structural protein in chronically (CI) and
      acutely infected (AI) MT4 cells was studied. During long-term cultivation the CI
      system was characterized by high involvement of the cells into infection (up to
      100%), high level of virus-specific protein synthesis, moderate virus yield, but
      absence of any virus-induced cytopathic effects and normal growth potential of
      infected cells. AI cells demonstrated a similar level of synthesis of virus
      specific proteins, higher virus yield, and rapid progression of cytopathicity
      followed by total cell death. Most of the HIV gp160 protein molecules undergo
      rapid cleavage in the region between the point of conventional cleavage and the
      transmembrane domain, being removed from the physiologically competent pool, but
      a small portion of gp160s undergo apparently normal intracellular development.
      According to our data, the two HIV variants (normal and defective) persist in CI
      system and pathological cleavage of defective virus gp160 protein results most
      probably in chronization of infection.

PMID- 8483473
TI  - [Genomic DNA as compact particles: morphology, biochemical analysis and optical
      properties].
AB  - Compact DNA particles have been obtained by a new method we developed to isolate
      high-molecular-weight DNA. The method includes exhaustive proteolysis while the
      cellular DNA is folded in compact state in polyethylene glycol-containing aqueous
      salt media. The DNA particles derived from interphase nuclei have a diameter of 8
      10 microns and each of them contains the genome of an individual cell. The DNA
      particles derived from isolated metaphase chromosomes present tightly packed DNA
      of individual chromosomes. The compact particles contain no proteins detectable
      by electrophoretic analysis and so appear to be formed by DNA only. These data
      have been confirmed by electron microscopy, when the particles investigated with
      the protein monolayer technique have revealed only spread DNA molecules.
      Simultaneously the microscopic observations of DNA particles of different origin
      and of their behaviour in the absence of compactizing agents support the idea
      that during formation of compact particles the intrinsic features of DNA folding
      in nuclei and chromosomes have been conserved.

PMID- 8483472
TI  - [Study of the effect of the cDNA for the human apolipoprotein A-I gene in
      transgenic rabbits: modeling the neurological syndrome of human Tangier disease].
AB  - Two transgenic rabbits which carried human apolipoprotein A-1 (apo A-1) cDNA
      under mouse ribosomal protein L/32 promoter were obtained. The effectiveness of
      transgenosis was confirmed by DNA dot/blot and Southern blot hybridizations. Both
      transgenic animals had paralyses of fore or fore and high limbs. Electron
      microscopy demonstrated distinct degradative changes of those parts of spinal
      cord which were responsible for leg skeletal muscle innervation. RNA dot/blot
      hybridization showed transgene expression in liver and brain but not in kidney of
      adult transgenic animal. However, analysis of blood serum lipids and
      immunochemical determinations gave no indications of the presence of human apo A
      1 in adult transgenic rabbit. The data obtained allow us to suggest that the
      observed pathology was due to interference of native and foreign protein products
      of apo A-1 gene expression in CNS in the course of embryo development. This
      suggestion was supported by results of in situ hybridization of 5- and 9-week
      human embryo sections with apo A-1 cDNA, showing effective expression of apo A-1
      gene in neural cells of CNS. Results of transgenosis may be viewed as modeling of
      the neurological syndrome of human Tangier disease.

PMID- 8483474
TI  - [HIV-1 p17 matrix protein is transported into the cell nucleus and binds with
      genomic viral RNA].
AB  - We have shown that gag polyprotein p55 is cleaved in cytosol rapidly after its
      synthesis, during 2 h, and p17 enters the nuclei while p24 resides in cytosol. To
      determine whether the nascent p17 is associated with viral genomic RNA in the
      nuclei, the cells were fractionated, the viral complexes were immunoprecipitated
      by monoclonal antibodies against gag proteins, and RNA was extracted and analyzed
      by slot and blot hybridization. Monoclonal antibodies against p17 precipitated
      all the viral RNA from the nuclei including full-size genomic RNA and essential
      part from membranes while monoclonal antibodies against p24 did not precipitate
      any viral RNA from the nuclei. These data suggest that matrix protein is linked
      to genomic RNA in the nuclei and rise the possibility that p17 may transfer viral
      nucleocapsids from the nuclei to plasma membranes, the site of virus assembly.

PMID- 8483475
TI  - [Effective expression of genes for interleukin-2 and its mutant analogs in E.
      coli cells].
AB  - Recombinant plasmids were constructed for the efficient expression in E. coli
      cells of the human interleukin-2 (HIL-2) gene and two its mutant analogues
      obtained by of chemical-enzymic synthesis and polymerase chain reaction (deletion
      of 14 C-terminal amino acids and a change of the codon for Trp121 to Phe). The
      recombinant HIL-2 but not the mutant analogues were shown to be biologically
      active. Both analogues obtained were weak antagonists to HIL-2.

PMID- 8483476
TI  - [Study of the form of bacteriophage T7 RNA polymerase containing point
      substitutions in the region of functionally important amino acid residues].
AB  - A study was carried out on the influence of point mutations of the functional
      amino acid residues on the secondary and ternary structure of bacteriophage T7
      RNA polymerase as well as on the activity of the enzyme. A change in residue 631
      is accompanied by significant changes in secondary structure (alpha-->beta
      transition). The substitution Lys-172 Leu changes both the secondary and ternary
      structures whereas the deletion of residues 172-173 does not lead to such
      changes. Changes in residues 631-632 do not affect the ability of the enzyme to
      bind the promoter and/or the synthesis of a full-length transcript but disturbs
      phosphodiester bond formation.

PMID- 8483477
TI  - Human estrogen receptor bound to an estrogen response element bends DNA.
AB  - We have used gel mobility shift assays to examine changes in DNA bending induced
      by binding of human estrogen receptor (hER) to a series of estrogen response
      element (ERE) containing DNA fragments. Competition experiments with ERE
      containing DNA fragments and antibody supershift experiments demonstrated that ER
      in crude extracts from MCF-7 human breast cancer cells exhibited specific
      interaction with the ERE. Using DNA bending standards, we found that binding of
      ER to a single ERE induced a reproducible DNA bend of 56 degrees. This was 1.65
      fold greater than the 34 degrees bending angle we recently reported for binding
      of bacterially expressed ER DNA binding domain. The DNA bending angle induced was
      the same whether the salt-extracted receptor was unoccupied, occupied by 17 beta
      estradiol, or occupied by trans-hydroxytamoxifen. To determine if proteins
      associated with ER in MCF-7 cells affect the degree of bending, we examined the
      ability of partially purified hER expressed in yeast to bend DNA. The degree of
      bending induced by the partially purified yeast ER was the same as the bending
      induced by crude MCF-7 cell ER. More highly purified ER from yeast extracts did
      not bind to an ERE-containing DNA fragment, suggesting that additional proteins
      may play an important role in the interaction of the ER with the ERE. When two
      EREs were present in the DNA fragment, a small but reproducible increase in
      bending was observed. Our demonstration that binding of hER to the ERE induces
      DNA bending suggests a possible role for DNA bending in ER-induced transcription
      activation.

PMID- 8483478
TI  - Nerve growth factor induces transcription of NGFIA through complex regulatory
      elements that are also sensitive to serum and phorbol 12-myristate 13-acetate.
AB  - The expression of NGFIA (also known as egr1, zif268, TIS8, krox24, and d2) is
      rapidly and transiently increased by nerve growth factor (NGF) in PC12 cells. The
      5'-region of this gene includes four serum response elements (SREs), a cAMP-like
      response element, an AP1-like response element, and an SP1-binding site. From
      deletion analysis of chloramphenicol acetyltransferase reporter constructs, we
      have established that the first 106 basepairs 5' of the transcriptional start
      site are sufficient for induction of NGFIA by NGF in PC12 cells; deletion beyond
      this point results in dramatically reduced induction of the gene. Using defined
      mutations in the NGFIA promoter and NGFIA-thymidine kinase hybrid promoters, we
      have defined three elements (SRE1, SRE2, and AP1-like) in the first 106 basepairs
      of upstream DNA, each of which contributes to induction of NGFIA by NGF.
      Cooperation by two of these elements (i.e. the two SREs or one SRE and the AP1
      like element) is sufficient to confer transcriptional induction by NGF, but the
      combination of all three elements increased induction by NGF more effectively
      than a pair of elements. This suggests that the response of NGFIA to NGF is
      mediated by a cis-acting sequence that is composed of at least three distinct
      elements. An oligonucleotide composed of SRE1 and SRE2 that can confer the
      ability for NGF induction to heterologous promoter constructs complexes with
      proteins in PC12 cell nuclear extracts, but the protein-DNA complexes do not
      appear to be altered by NGF treatment, as measured by DNA mobility shift assays.
      We have also established that the regulatory region of NGFIA that mediates NGF
      induction also mediates the induction by serum and phorbol 12-myristate 13
      acetate, suggesting that multiple signal transduction pathways must converge on
      these sequences to regulate the expression of this gene.

PMID- 8483479
TI  - Parathyroid hormone represses alpha 1(I) collagen promoter activity in cultured
      calvariae from neonatal transgenic mice.
AB  - We examined the effect of PTH on the activity of alpha 1(I) collagen promoter
      fusion genes in cultured calvariae from transgenic mice. The parent construct,
      ColCAT 3.6, contains 3520 basepairs of 5' rat alpha 1(I) collagen DNA, 115
      basepairs of untranslated alpha 1(I) collagen-coding DNA, and the bacterial
      chloramphenicol acetyltransferase reporter gene, while the 5'-deletion ColCAT 2.3
      contains 2296 kilobases of rat alpha 1(I) collagen promoter sequence. Transgenic
      mouse lines harboring these collagen promoter fusion genes were developed using
      the oocyte microinjection technique, and for each construct, three different
      lines of mice were tested. Calvariae from 6- to 8-day-old transgenic mice were
      cultured for 48 h with or without bovine PTH-(1-34). ColCAT 3.6 and ColCAT 2.3
      were expressed at comparable levels in calvariae and were inhibited by PTH. There
      were parallel decreases in the incorporation of [3H]proline into collagen and
      levels of the endogenous alpha 1(I) collagen mRNA and transgene mRNA. Forskolin
      at 10 microM mimicked the inhibitory effect of PTH on promoter activity in ColCAT
      3.6 and ColCAT 2.3 calvariae. A RNase protection assay showed that the transgene
      was initiated correctly from the transgene promoter. These data show that PTH and
      cAMP can repress collagen promoter activity in calvariae from transgenic mice,
      suggesting that the alpha 1(I) collagen promoter may contain cis elements down
      stream of -2.3 kilobases that mediate PTH and cAMP repression of collagen gene
      expression in bone. Cultured bone explants from transgenic mice can be used as a
      model to study hormonal regulation of alpha 1(I) collagen promoter constructs.

PMID- 8483480
TI  - Follicle-stimulating hormone increases the turnover of G-protein alpha i-1- and
      alpha i-2-subunit messenger RNA in Sertoli cells by a mechanism that is
      independent of protein synthesis.
AB  - We have shown previously that FSH differentially regulated G-protein alpha i
      subunit mRNA levels in primary cultures of rat Sertoli cells. The mechanism by
      which FSH regulated the steady state levels of these mRNAs was investigated by
      assessing the effect of FSH on G-protein alpha-subunit mRNA stability and the
      potential involvement of newly synthesized proteins. The half-life (t 1/2) of
      alpha-subunit mRNA was determined by inhibiting Sertoli cell transcription with
      actinomycin-D and quantifying alpha-subunit mRNA levels by Northern blot
      analyses. Transcripts for alpha i-2 and alpha 3 were extremely stable, possessing
      t1/2 of 44 and 51 h, respectively. In contrast, the t1/2 of alpha i-3 mRNA was
      only 3.6 h. Turnover of alpha i-1 mRNA occurred as a two-phase decay, with an
      initial t1/2, fast of 0.8 h, followed by a second phase with t1/2, slow of 11.1
      h. Treatment of Sertoli cells with FSH in the presence of actinomycin-D
      destabilized the alpha i-1 mRNA to a single phase decay with a t1/2 of 5.7 h. FSH
      also decreased the stability of the alpha i-2 mRNA from a t1/2 of 51 h to a t1/2,
      fast of 16.5 h. These effects of FSH on alpha i-1 and alpha i-2 mRNA stability
      may contribute to the ability of FSH to decrease steady state alpha i-1 and alpha
      i-2 mRNA levels. The effect of FSH on alpha i-3 mRNA stability was not
      significant, suggesting an alternative mechanism regulating the FSH-mediated
      increase of alpha i-3 mRNA levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483481
TI  - The human osteocalcin promoter directs bone-specific vitamin D-regulatable gene
      expression in transgenic mice.
AB  - Osteocalcin is a major noncollagenous protein of bone regulated by 1,25
      dihydroxyvitamin D3 [1,25-(OH)2D3] and is believed to be expressed only by
      differentiated osteoblasts. We introduced a 3.9-kilobase human osteocalcin gene
      promoter (hOCP)-chloramphenicol acetyltransferase (CAT) fusion gene into the germ
      line of mice. Examination of tissue extracts from these transgenic mice
      demonstrated that the expression of CAT was restricted to bone-associated tissues
      and the brain. Immunohistochemical staining of femur tissue sections using CAT
      antibodies localized the production of CAT protein to osteoblasts and maturing
      chondrocytes. Previous studies via transient transfection into osteoblast-like
      cells have identified a vitamin D response element approximately 500 basepairs up
      stream of the hOCP capable of mediating 1,25-(OH)2D3 induction. As a consequence,
      regulation of the transgene was examined in homozygous transgenic lines for
      sensitivity to 1,25-(OH)2D3. Hormonal deficiency was created using a low calcium
      diet supplemented with 0.8% SrCl2 for 7 days and was restored in experimental
      mice by injection of 25 ng 1,25-(OH)2D3/day, ip, for 3 days. The low vitamin D3
      diet decreased CAT activity several-fold in extracts from calvaria, femur, and
      brain compared to that in mice maintained on a normal diet, while 1,25-(OH)2D3
      supplementation restored and enhanced CAT activity over control values. These
      data demonstrate that hOCP is sufficient to direct osteoblast-specific 1,25
      (OH)2D3-sensitive gene expression in mice in addition to the unexpected
      regulatable expression in brain tissue.

PMID- 8483482
TI  - NCLEX is changing.

PMID- 8483483
TI  - A very special vacation.

PMID- 8483484
TI  - Congress agrees to new NIH office for AIDS programmes.

PMID- 8483486
TI  - Hughes institute displays new home.

PMID- 8483485
TI  - Britain's Wellcome Trust stretches its financial wings.

PMID- 8483487
TI  - Congress wrestles with electronic highway bill.

PMID- 8483488
TI  - NIH task force to examine 'culture' of discrimination.

PMID- 8483489
TI  - FDA panel sees problems with labelling of milk hormone.

PMID- 8483490
TI  - Keeping warm.

PMID- 8483491
TI  - Not exclusive.

PMID- 8483492
TI  - Has Duesberg a right of reply?

PMID- 8483493
TI  - DNA repair. Engagement with transcription.

PMID- 8483494
TI  - T cells. Immunological agnosia.

PMID- 8483495
TI  - Aluminium--Alzheimer's link?

PMID- 8483496
TI  - Illusion and view stability.

PMID- 8483497
TI  - C. elegans lin-45 raf gene participates in let-60 ras-stimulated vulval
      differentiation.
AB  - Vulval differentiation in Caenorhabditis elegans is controlled by intercellular
      signalling mediated by a receptor tyrosine kinase and a ras gene product. The lin
      45 gene encodes a homologue of the raf family of serine/threonine kinases and is
      necessary for vulval differentiation. The lin-45 raf gene product appears to act
      downstream of the ras protein in this pathway. A proto-oncogene-mediated
      signalling pathway may be a common feature of metazoan development.

PMID- 8483498
TI  - Induction of T-cell anergy by altered T-cell-receptor ligand on live antigen
      presenting cells.
AB  - Activation of CD4+ T helper cells results from the occupancy of the T-cell
      receptor (TCR) by immunogenic peptide bound to a class II major
      histocompatibility complex (MHC) molecule, together with a co-stimulatory signal
      from the antigen-presenting cell (APC). This activation leads to proliferation,
      cytokine production (Th1 or Th2 profile) and cytolysis. Engagement of the TCR in
      the absence of co-stimulation causes Th1 cells to become unresponsive to
      subsequent antigenic stimulation. We have previously demonstrated that analogues
      of an immunogenic peptide could stimulate Th1 and Th2 cells to carry out some
      effector functions without inducing proliferation, a phenomenon we term partial
      activation. Here we study the consequences of such partial activation through the
      TCR of two Th1 clones using peptide analogues presented by a live APC. A peptide
      analogue that is unable to stimulate clonal proliferation or production of
      cytokine or inositol phosphate can induce the T cells to become profoundly
      unresponsive to subsequent stimulation with the immunogenic peptide. Thus,
      altering the ligand of the TCR by using a peptide analogue on a functional APC
      sends a signal to Th1 clones that results in anergy.

PMID- 8483499
TI  - Regulation of Langerhans cell function by nerves containing calcitonin gene
      related peptide.
AB  - Several observations suggest interactions between the immune and nervous systems.
      Psoriasis and atopic dermatitis may worsen with anxiety and have been associated
      with anomalous neuropeptide regulation. Neurotransmitters affect lymphocyte
      function and lymphoid organs are innervated. Calcitonin gene-related peptide
      (CGRP) is a neuropeptide and vasodilator that modulates some macrophage
      functions, including antigen presentation in vitro. CGRP is associated with
      Langerhans cells (LC) in oesophageal mucosa, particularly during inflammation, is
      present in epidermal nerves and is associated with Merkel cells. We examined the
      ability of CGRP to modulate LC antigen-presenting function and asked if CGRP
      containing nerves impinge on LC. We report here that CGRP-containing nerve fibres
      are intimately associated with LC in human epidermis and CGRP is found at the
      surface of some LC. In three functional assays CGRP inhibited LC antigen
      presentation. These findings indicate that CGRP may have immunomodulatory effects
      in vivo and suggest a locus of interaction between the nervous system and
      immunological function.

PMID- 8483500
TI  - Continuous c-fos expression precedes programmed cell death in vivo.
AB  - The development of a multicellular organism involves a delicate balance among the
      processes of proliferation, differentiation and death. Naturally occurring cell
      death aids tissue remodelling, eliminates supernumerary cell populations and
      provides structural elements such as hair and skin. In the nervous system,
      selective cell death contributes to the formation and organization of the spinal
      cord and sympathetic ganglia, retina and corpus callosum. But cell death also
      occurs in several neuropathological conditions, such as amyelotrophic lateral
      sclerosis and Alzheimer's disease. Therefore an elucidation of the mechanisms
      responsible for cell death is critical for an appreciation of both normal
      development and neuropathological disorders. Using a fos-lacZ transgenic mouse,
      we provide evidence showing that the continuous expression of Fos, beginning
      hours or days before the morphological demise of the cell, appears to be a
      hallmark of terminal differentiation and a harbinger of death.

PMID- 8483501
TI  - p70s6k function is essential for G1 progression.
AB  - An essential step in the pathway by which growth factors trigger cellular
      proliferation is the induction of high levels of protein synthesis. This appears
      in part to be controlled by multiple phosphorylation of the ribosomal protein S6
      (refs 4, 5). The main kinase responsible, p70s6k (refs 6-8), is activated through
      the phosphorylation of four sites clustered in a putative autoinhibitory domain,
      which is mediated by a signalling pathway distinct from those used by other well
      characterized mitogen-activated serine/threonine kinases (such as p42/p44mapk or
      p90rsk; refs 10, 11). Here we investigate the role of p70s6k in the mitogenic
      response. Microinjection of quiescent rat embryo fibroblasts with any of three
      distinct polyclonal antibodies to p70s6k abolishes serum-induced entry into S
      phase of the cell cycle. This effect is preceded by almost complete abrogation of
      the activation of protein synthesis and the expression of an essential immediate
      early gene product, c-fos. The inhibitory effect on DNA synthesis is also
      elicited by microinjection of the antibodies late in G1 phase, consistent with
      the finding that p70s6k activity remains high throughout G1.

PMID- 8483502
TI  - A novel dimer configuration revealed by the crystal structure at 2.4 A resolution
      of human interleukin-5.
AB  - Interleukin-5 (IL-5) is a lineage-specific cytokine for eosinophilpoiesis and
      plays an important part in diseases associated with increased eosinophils, such
      as asthma. Human IL-5 is a disulphide-linked homodimer with 115 amino-acid
      residues in each chain. The crystal structure at 2.4 A resolution reveals a novel
      two-domain structure, with each domain showing a striking similarity to the
      cytokine fold found in granulocyte macrophage and macrophage colony-stimulating
      factors, IL-2 (ref. 5), IL-4 (ref. 6), and human and porcine growth hormones. IL
      5 is unique in that each domain requires the participation of two chains. The IL
      5 structure consists of two left-handed bundles of four helices laid end to end
      and two short beta-sheets on opposite sides of the molecule. Surprisingly, the C
      terminal strand and helix of one chain complete a bundle of four helices and a
      beta-sheet with the N-terminal three helices and one strand of the other chain.
      The structure of IL-5 provides a molecular basis for the design of antagonists
      and agonists that would delineate receptor recognition determinants critical in
      signal transduction. This structure determination extends the family of the
      cytokine bundle of four helices and emphasizes its fundamental significance and
      versatility in recognizing its receptor.

PMID- 8483503
TI  - The dTAFII80 subunit of Drosophila TFIID contains beta-transducin repeats.
AB  - A key component of the RNA polymerase II transcriptional apparatus, TFIID, is a
      multi-protein complex containing the TATA box-binding protein (TBP) and at least
      seven tightly associated factors (TAFs). Although the functions of most TFIID
      subunits are unknown, it is clear that TAFs are not necessary for basal activity
      but that one or more are required for regulated transcription, and so behave as
      coactivators. The presence of multiple subunits indicates that there is an
      intricate assembly process and that TAFs may be responsible for other activities.
      We have described the properties of the subunit dTAFII110, which can interact
      directly with the transcriptional activator Sp1 (ref. 5). In addition, the
      largest subunit, dTAFII250, binds directly to TBP and links other TAFs to the
      complex. Here we describe the cloning, expression and partial characterization of
      the Drosophila TAF of M(r) 80,000, dTAFII80. Sequence analysis reveals that
      dTAFII80 contains several copies of the WD40 (beta-transducin) repeat. Moreover,
      dTAFII80 shares extended sequence similarity with an Arabidopsis gene, COP1,
      which encodes a putative transcription factor that is though to regulate
      development. We have expressed recombinant dTAFII80 and begun to characterize its
      interaction with other members of the TFIID complex. Purified recombinant
      dTAFII80 is unable to bind TBP directly or to interact strongly with the C
      terminal domain of dTAFII250 (delta N250). Instead, dTAFII80 is only able to
      recognize and interact with a higher-order complex containing TBP, delta N250,
      110 and 60. These findings suggest the formation of TFIID may require an ordered
      assembly of the TAFs, some of which bind directly to TBP and others that are
      tethered to the complex as a result of specific TAF/TAF interactions.

PMID- 8483504
TI  - Complementation of the DNA repair defect in xeroderma pigmentosum group G cells
      by a human cDNA related to yeast RAD2.
AB  - Defects in human DNA repair proteins can give rise to the autosomal recessive
      disorders xeroderma pigmentosum (XP) and Cockayne's syndrome (CS), sometimes even
      together. Seven XP and three CS complementation groups have been identified that
      are thought to be due to mutations in genes from the nucleotide excision repair
      pathway. Here we isolate frog and human complementary DNAs that encode proteins
      resembling RAD2, a protein involved in this pathway in yeast. Alignment of these
      three polypeptides, together with two other RAD2 related proteins, reveals that
      their conserved sequences are largely confined to two regions. Expression of the
      human cDNA in vivo restores to normal the sensitivity to ultraviolet light and
      unscheduled DNA synthesis of lymphoblastoid cells from XP group G, but not CS
      group A. The XP-G correcting protein XPGC is generated from a messenger RNA of
      approximately 4 kilobases that is present in normal amounts in the XP-G cell
      line.

PMID- 8483505
TI  - Identical defects in DNA repair in xeroderma pigmentosum group G and rodent ERCC
      group 5.
AB  - Humans with the complementation group G form of the inherited syndrome xeroderma
      pigmentosum (XP) are hypersensitive to solar ultraviolet light because of a
      defect in nucleotide-excision repair of DNA. Some individuals are also affected
      with Cockayne's syndrome, and have neurological abnormalities. Here we report
      that the DNA repair deficiency of XP-G cell extracts can be corrected by addition
      of protein fractions from normal cells. Repair proficiency can also be restored
      by mixing XP-G cell extracts with extracts from different repair-defective cell
      lines, with one exception. Extracts from cells representing group 5 of a set of
      ultraviolet-sensitive rodent mutants fail to complement XP-G extracts. XP-G and
      group 5 correcting activities co-elute after approximately 1,000-fold
      purification from HeLa cells. An antibody directed against a recombinant fragment
      of the XP-G complementing protein (XPGC) inhibits excision repair by normal cell
      extracts, and activity can be restored with an XP-G/group 5 complementing
      fraction. These data strongly suggest that the XPGC and group 5 correcting
      (ERCC5) proteins are identical.

PMID- 8483506
TI  - Clonogenic cytotoxicity testing by microdrop encapsulation.
AB  - Cytotoxicity is defined as the in situ measurement of cellular function in
      response to a toxic substance. Cytotoxicity assays are widely used in drug
      screening and development research to minimize the number of compounds on which
      expensive mammalian animal model toxicology studies are performed.

PMID- 8483507
TI  - NIH: a strategy for the 21st century?

PMID- 8483508
TI  - Peracute surgery of aneurysms with intracerebral hematomas.
AB  - Out of a series of 252 patients who underwent aneurysm surgery, 19 (7.5%) were
      operated on in a "peracute stage" in the poor grades Hunt & Hess IV (n = 11), IV
      V (n = 2), and V (n = 6). All patients suffered from large aneurysmal
      intracerebral hematomas which were evacuated after decompressive craniotomies,
      all aneurysms (ACA: n = 1, ACoA: n = 4, MCA: n = 12, ICA: n = 2) could be
      clipped. 4 patients died within the first 3 postoperative days, 6 patients
      reached a poor result remaining in an apallic syndrome or a state of high
      invalidity, 8 obtained a fair result with personal autonomity, and 1 patient
      recovered completely. Although this kind of aneurysm bleeding is combined with
      high mortality and morbidity, we nevertheless emphasize its surgical treatment as
      soon as possible because of the lack of other efficient therapeutical procedures.

PMID- 8483509
TI  - Classification of frontal fossa fractures associated with cerebrospinal fluid
      rhinorrhea, pneumocephalus or meningitis. Indications and time for surgical
      treatment.
AB  - The classification of anterior fossa fractures with their sequelae: cerebrospinal
      fluid (CSF) rhinorrhea, pneumocephalus, or meningitis is presented. This
      classification is based on five selection criteria which are discussed in this
      paper. This classification resulted in the table of indications for operative
      treatment, according to which the appropriate time for operation in urgent cases
      is immediately, in cases with absolute indication 5 to 6 days after the injury,
      in long-lasting CSF rhinorrhea or pneumocephalus 10 days after the onset, in
      intermittent or delayed rhinorrhea and/or pneumocephalus as soon as these signs
      occur, and in cases of meningitis soon after recovery. This study is based on the
      analysis of 52 consecutive surgically treated cases, collected from 1984 up to
      December 1989.

PMID- 8483510
TI  - [Whiplash trauma of the cervical spine from the neurosurgical, traumatologic and
      psychologic viewpoint].
AB  - Since the early 50's, whiplash injury has been a subject of intensive study in
      order to find out the genesis of this disease. Unfortunately, most of the studies
      were planned retrospectively and were based on inhomogeneous groups of patients.
      In our prospective study, we tried to keep the patient group homogeneous. 62
      patients were examined neurologically and radiologically immediately after the
      accident. Furthermore, they underwent a psychological test, the so-called
      Freiburg personality profile. 6 months later the patients were checked again. On
      the basis on our findings, the suspected psychological influence has to be
      confirmed. Preexisting degenerative lesions of the cervical spine, also, are
      undoubtedly prognostic for longer-lasting symptoms.

PMID- 8483511
TI  - [Value of neuroradiologic procedures in preoperative assessment of cervical
      myelopathy].
AB  - The diagnostic value of computed tomography (CT), myelography, myelo-CT and
      magnetic resonance imaging (MRI) was retrospectively investigated in 94 patients
      in whom Cloward's operation had been performed due to symptoms of cervical
      myelopathy (CM). In 55 patients with "classical" cervical spondylotic myelopathy
      all investigated diagnostic procedures demonstrated a comparably high degree of
      sensitivity and specificity, thus proving comparable for diagnosing pathological
      alterations of the cervical spine. In 39 patients with CM as a consequence of an
      acute cervical disk prolapse, however, MRI was superior and offered the highest
      diagnostic accuracy. The following general diagnostic strategy in patients with
      CM can be suggested: Conventional plain film radiography of the cervical spine,
      axial CT of the involved segments and MRI of the cervical spine in sagittal and
      transversal orientation, using T1 and T2 weighted pulse sequences. The combined
      use of these techniques allows the exact evaluation of any relevant structure
      alterations of the cervical spine that determine differential therapeutic
      approaches.

PMID- 8483512
TI  - Spinal extradural angiolipoma: case report and literature review.
AB  - A case report of a 12-year-old child with a spinal extradural angiolipoma is
      presented. The tumor was totally removed and a good recovery was obtained. In a
      review of 43 previous cases, the clinical, radiological, and histological
      features of the tumor are discussed. It is stressed that spinal angiolipomas and
      spinal lipomas have to be considered as two different clinicopathological
      entities in order to ensure adequate treatment and prognosis.

PMID- 8483513
TI  - Ventral brain stem schwannoma at the entry zone of the hypoglossal nerve.
AB  - The unusual case of a ventral brain stem schwannoma located at the entry zone of
      the hypoglossal nerve in a 49-year-old woman is reported. The diagnosis of a
      schwannoma was confirmed histologically after partial tumor resection via the
      dorsolateral, suboccipital, transcondylar approach. Hypotheses for the
      pathogenesis of intramedullary schwannomas are discussed.

PMID- 8483514
TI  - Middle cerebral artery aneurysm developing apparently de novo.
AB  - The author reports a patient with a fatal subarachnoid and intracerebral
      hemorrhage from a middle cerebral artery aneurysm, which apparently developed de
      novo. 18 years before, the patient was operated for an anterior communicating
      artery aneurysm and, during this procedure, an anterior cerebral artery was
      ligated. Hemodynamic disturbances due to anterior artery occlusion are suggested
      as the cause of new aneurysm formation.

PMID- 8483516
TI  - Surgical treatment and results in patients suffering from lumbar spinal stenoses.
AB  - Stenosis of the lumbar spinal canal is contributing to 3-5% of all patients
      operated on a lumbar nerve root compression syndrome. Morphologically, a
      reduction of the midsagittal diameter of the spinal canal to less than 12 mm or
      stenoses of the lateral recessus or foramen intervertebrale have been described.
      In our department 37 patients with a lumbar spinal stenosis have been surgically
      treated between 1982 and 1987. Spinal stenosis is a disease of aged patients
      mostly suffering for a long history. The main symptoms are lumbar and sciatic
      pains, neurological deficits and a claudicatio intermittens spinalis.
      Neuroradiologically, the diagnosis can be confirmed by CT, myelography or MRI.
      These studies were demonstrating the stenosis in 69% at the level of L4/5,
      multiple stenoses have been found in 22% of all cases. An additional disc
      herniation existed in 35% of the patients. Concerning the specific complaints of
      the patients and their neuroradiological findings, the extent of the surgical
      decompression was decided on individually in each patient. We performed 22
      laminectomies, 11 hemilaminectomies, in 3 cases an extended flavectomy and in one
      case an implantation of a dorsal column stimulation device. The postoperative
      follow-up period, ranging from 3 months to 3 years, demonstrated a complete
      recovery in 53%, a marked reduction of complaints in 44% of all cases. One
      patient did not respond to surgical treatment, but in the remaining cases
      surgical treatment led to satisfactory results.

PMID- 8483515
TI  - Outcome of patients with aneurysmal and presumed aneurysmal bleeding. A hospital
      study based on 100 consecutive cases in a neurological clinic.
AB  - One hundred patients with spontaneous subarachnoid hemorrhage due to aneurysm or
      presumed aneurysm consecutively admitted to a neurological clinic and subjected
      to CCT during the first 72 hours were examined retrospectively. The outcome after
      two months as defined by the Glasgow Outcome Scale (GOS) was relatively good: 23%
      of the patients suffered management mortality (GOS I) (postoperative lethality
      8%), 3% showed GOS-Grade II, 14% grade III, 17% grade IV, and 43% grade V. The
      extent of intracranial hemorrhage correlated well with the initial Hunt-Hess
      Grade which, in turn, had a strong influence on case fatality and the degree of
      disability. Lethal factors were: 1. massive subarachnoid hemorrhage together with
      a massive ventricular hemorrhage (p < 0.001), 2. massive subarachnoid hemorrhage
      together with an intracerebral hematoma > 20 ml (p < 0.05). Case fatality was
      lower when angiography was negative. In our study rebleeding (12%) and delayed
      cerebral ischemia (DCI) (18%) were less frequent and the lethality due to acute
      hydrocephalus (5%) and delayed cerebral ischemia (5%) was less pronounced than in
      comparable studies. The degree of disability (GOS) was directly related to the
      amount of intracranial blood, to the development of acute or chronic
      hydrocephalus, delayed cerebral ischemia and rebleeding. DCI occurred in 60% of
      patients with marked hydrocephalus. Rebleeding was more frequent in patients with
      acute hydrocephalus. Hydrocephalus, DCI, and rebleeding were associated with a
      poorer initial grade on the Hunt and Hess Scale.

PMID- 8483517
TI  - Concentrations of albendazole in serum, cerebrospinal fluid and hydatidous brain
      cyst.
AB  - A young girl with cerebral echinococcosis was treated with albendazole (13
      mg/kg/d, p.o.). The concentrations of albendazole sulphoxide were determined in
      serum, cerebrospinal fluid and hydatidous cyst over a month. The mean ratios of
      concentration were: CSF/serum = 50%, cyst/serum = 40%, cyst/CSF = 80%.

PMID- 8483518
TI  - Somato-sensory evoked potentials in root lesions and stenosis of the spinal canal
      (their diagnostic significance in clinical decision making).
AB  - The aim of the present study was to determine the significance of different SEP
      techniques and parameters in clinical evaluation of cases of lumbar and cervical
      root lesions and stenosis of the spinal canal. Using a qualitative rating scale,
      92 cases were analyzed retrospectively whose primary diagnosis was questioned
      because of conflicting data from clinical, neuroradiological and
      neurophysiological testing. In conclusion SEP techniques proved to be a useful
      tool in exclusing other e.g. demyelinating diseases. Except for the time
      consuming method of segmental stimulation, the demonstration of the functional
      deficit itself by SEP techniques in general was frequently disappointing. The
      contribution of the different SEP parameters to clinical decision making and the
      clinical consequences are briefly discussed.

PMID- 8483519
TI  - The operative treatment of spinal deformities in MMC.
AB  - The results of the operative treatment of scoliosis in 12 patients with MMC and
      in two patients with associated severe kyphosis are presented. In scoliosis only
      multi-segmental methods combined with ventral procedures allow a postoperative
      care without brace or cast. The angle before and after operation with the CDI or
      CDI/VDS procedures averaged 80.3 degrees and 38.2 degrees respectively (mean
      corrections of 41.5 degrees and 51.6%). The results show that patients with
      scoliosis with MMC had a approximately 30% greater preoperative angle than
      patients with idiopathic scoliosis. An early operation (in progressive curves
      with more than 30 degrees) may reduce the number and severity of complications.

PMID- 8483520
TI  - Lipid peroxidation in experimental spinal cord injury: time-level relationship.
AB  - Damage which occurs following spinal traumas is often irreversible. During recent
      years free oxygen radicals formed due to the pathological changes following
      neural tissue ischemia have been identified as being responsible for the ethio
      pathogenesis of such damage. In our experimental study, model lesions are formed
      in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid
      peroxidation product, was measured in the spinal tissues distal to the trauma in
      order to examine indirectly the time-quantity relationship of free oxygen
      radicals in the area. For this study 60 rats in six groups, including one control
      group, were used to determine the formation of MDA. Under a surgical microscope,
      the spines of all rats were exposed by C5-Th6 laminectomy, and pressure was
      applied to the spinal cords of animals, except the members of the control group,
      at the level of C7 by a Yasargil aneurysm clip. MDA was measured in spinal cord
      tissues in order to determine free oxygen radicals at the first and fifteenth
      minutes and at the first, second, and fourth hours. The statistical evaluation of
      the findings revealed a significant increase in MDA, starting from the 15th
      minute after the compression, reaching a maximum at 1 hour, and then decreasing.
      This observation may provide an important guide for studies on prevention of
      neural destruction.

PMID- 8483521
TI  - Chronic compression of the cervical myelon as complication of anterior interbody
      fusion (AIF): neurological improvement after late anterior decompression. Case
      report.
AB  - Severe neurological deficits directly related to intraoperative injury of the
      spinal cord and the nerve roots is a rare complication of anterior interbody
      fusion (AIF) in cervical spondylosis. A case of radiculopathy and Brown-Sequard
      Syndrome caused by a bone fragment following AIF in which a late anterior
      decompression and fusion of the cervical spine was performed four years after the
      initial operation is presented. Immediate relief of the radicular pain,
      improvement of the spasticity, and better sphincter control could be achieved.
      Therefore, patients with chronic anterior compression of an incomplete spinal
      cord injury after AIF may benefit from a late anterior decompression and fusion.

PMID- 8483522
TI  - Syringomyelia: a brief review of ontogenetic, experimental and clinical aspects.
AB  - The generally accepted definition of syringomyelia is that it is a chronically
      progressive illness characterized by the presence of cavities or syrinxes in the
      spinal cord. As manifold as the terminology of syringomyelia are the hypotheses
      of the etiology. Nowadays with MRI without and with gadolinium it is possible to
      recognize intramedullar cavities safely, the MR especially the cine-MR provides
      information on pathophysiological details of the flow and intracavitary pressure
      dependent pulsations of the CSF. Animal models and the findings of own
      experimental studies have enabled us to study a form of syringomyelia which very
      closely resembles that brought about by dysrhaphic malformations in the human
      being and to examine the effectiveness of certain types of surgical therapy. In
      this paper the term syringomyelia is only used for dysrhaphic cavities in the
      medulla. After our experience with 61 patients with syringomyelia now we perform
      the operative decompression of the craniocervical transition as the first step in
      the operative treatment of the progressive syringomyelia combined with severe
      craniocervical malformations. In cases with insufficient treatment response we
      suggest the syringoarachnoid shunting of persisting large intramedullar cavities.

PMID- 8483524
TI  - Play and its relations to other mental functions in the child.

PMID- 8483523
TI  - Somatosensory and auditory brainstem evoked potentials during choroid plexus
      angioma removal.
AB  - Intraoperative combined SEP and BAEP monitoring provides a high level of safety
      for patients undergoing high risk intracranial surgical procedures. We performed
      this type of monitoring in a rare case of choroid plexus angioma, embedded into
      the pulvinar of the right thalamus, which was resected via a transcallosal
      approach. The SEP pattern deteriorated during parietal brain retraction and
      thalamic dissection, but never completely disappeared. The BAEP pattern remained
      unchanged during the entire operation. The patient suffered incomplete
      hemiparesis postoperatively, but recovered completely within 10 days. After this
      time the SEP pattern returned to normal. This case points out that pathological
      change of intraoperative SEP pattern without loss of components suggests an
      incomplete hemiparesis. There is, however, a good chance of full recovery in the
      early postoperative period.

PMID- 8483526
TI  - Ad astra per aspera.

PMID- 8483525
TI  - Exploratory play with objects: basic cognitive processes and individual
      differences.

PMID- 8483527
TI  - No one exempted from the struggle against racism.

PMID- 8483528
TI  - Why don't men choose nursing?

PMID- 8483529
TI  - International Rescue Committee confronts Bosnian horrors.

PMID- 8483530
TI  - Health care reform a politically high-risk venture.

PMID- 8483531
TI  - How states respond to the rural nursing shortage.

PMID- 8483532
TI  - The community as partner in primary health care.

PMID- 8483533
TI  - Nursing's dual role in health care policy.

PMID- 8483534
TI  - Survivors of the century.
AB  - Stereotypical views of the elderly hold that very old persons are less adaptable
      to change and less comfortable handling crisis situations. Over the last five
      years, we have had the privilege of meeting 96 people aged 100 years or older as
      part of the National Institute of Mental Health (NIMH) funded, Georgia
      Centenarian Study (R01 MH 43435-05). We have encountered optimistic, wise
      individuals very engaged in living. Our research team continues to be amazed at
      the quality of life and the individual differences amongst centenarians.

PMID- 8483535
TI  - Why is the AMA complaining?

PMID- 8483536
TI  - Wrong move.

PMID- 8483537
TI  - Second chance.

PMID- 8483538
TI  - Terminating the doctor-patient relationship. When and how.

PMID- 8483540
TI  - Pages from the past.

PMID- 8483539
TI  - A leader in dentistry.

PMID- 8483541
TI  - DSSNY's proud legacy.

PMID- 8483542
TI  - Reflections on 50 years in dentistry.

PMID- 8483543
TI  - A future for occupational health nursing: Part 1.

PMID- 8483544
TI  - Absolute confidentiality--myth or reality.

PMID- 8483545
TI  - Flu vaccinations: are they worth the cost?
AB  - Flu immunisation programmes have been offered by many organisations this year and
      companies will be expecting to see the dividend of reduced absenteeism. But are
      nonselective vaccinations worth the expense? Helen Kogan weighs up the arguments.

PMID- 8483546
TI  - 1993--the year of living safely.
AB  - The Employment Bill aims to safeguard the rights of pregnant workers and those
      victimised at work on the grounds of health and safety. Gillian Howard, a
      barrister and industrial relations consultant, examines the new regulations.

PMID- 8483547
TI  - Plumbo porphyria. A difficult diagnosis.

PMID- 8483548
TI  - AIDS update.

PMID- 8483549
TI  - Ill health retirement in health care workers.
AB  - Discovering why employees take early ill health retirement helps identify areas
      for future preventive action. Helen Sarfas found important areas for further
      investigation after initiating a research survey looking at health care workers
      employed by her health authority. She also discovered that diagrammatic
      illustration was the easiest and simplest way to present her research data.

PMID- 8483550
TI  - A future for occupational health nursing: Part 3.
AB  - Ruth Alston's two previous articles have indicated how some of the current
      developments occurring in the educational provision for nurses and other health
      and safety practitioners may affect the practice of occupational health nursing.
      In this final article she asks whether OHNs are able and willing to respond to
      the challenges facing their profession and survive in increasingly competitive
      occupational settings.

PMID- 8483551
TI  - Carers in crisis.
AB  - Care in the community has left over six million people with a dual function,
      however, combining the duties of work with the responsibilities of being a
      'carer' might just prove to be too much for many employees. P J Whyte, describes
      one such example and argues that the skills of an occupational health
      practitioner can be used to support the growing numbers of carers in our
      workforce.

PMID- 8483552
TI  - Protecting against pesticides.

PMID- 8483553
TI  - Passive smoking: only a question of time.
AB  - It is believed to be just a question of time before an employee successfully sues
      a company for the damaging effects of environmental tobacco smoke (ETS). With No
      Smoking Day on March 10 Helen Kogan looks at current developments in research and
      new health and safety law that add weight to the calls for more stringent
      guidance on workplace smoking.

PMID- 8483554
TI  - Attendance and absence control: whose responsibility?
AB  - Absence control is a management responsibility, nevertheless, OH can make a
      valuable contribution to the creation of a supported system. Kit Artus examines
      management and employee attitudes to absenteeism and presents an argument for a
      multi-disciplinary approach to the problem.

PMID- 8483555
TI  - Malingering: a fraudulent issue.

PMID- 8483556
TI  - Mitomycin: its evolving role in the treatment of breast cancer.
AB  - Investigators have compiled extensive experience with mitomycin in the treatment
      of patients with breast cancer. Given as a single agent in intermittent
      schedules, mitomycin has induced responses of 26-38% in previously untreated
      patients and of 15-25% in those exposed to multiple prior chemotherapy regimens.
      Duration of response has been short. Toxicity, primarily myelosuppression, is
      largely dose-dependent. The dose-dependent efficacy of mitomycin has not yet been
      addressed. Preclinical studies suggest that optimal single-agent results are
      obtained when mitomycin is given in intermittent, high-dose schedules.
      Combination chemotherapy with mitomycin has proven more effective than single
      agent therapy. Mitomycin given in combination with doxorubicin produces higher
      response rates than have been obtained with mitomycin alone. The 3M combination
      (mitomycin/mitoxantrone/methotrexate) appears effective and well tolerated at the
      doses described. Future research should focus on the development of
      polychemotherapeutic regimens that can be delivered in sequential or alternating
      schedules. Such regimens may yield quicker responses, and thus improve survival,
      in patients with breast cancer.

PMID- 8483557
TI  - First-line and salvage therapy of metastatic breast cancer with
      mitomycin/vinblastine.
AB  - The combination chemotherapy regimen of mitomycin/vinblastine has been used in
      the treatment of metastatic breast cancer since the early 1980s. We report
      results of use of mitomycin/vinblastine in 35 women with metastatic breast cancer
      who had failed prior treatment with one to four chemotherapeutic regimens.
      Despite heavy prior treatment and significant tumor burdens, 34% of patients
      achieved a partial remission and another 14% had disease stabilization with a
      very acceptable toxicity profile. This regimen was also used for the first time
      as first-line chemotherapy in 11 women with metastatic breast cancer. Response
      was observed in 9 of 11 patients (82%). Hemolytic-uremic syndrome occurred in 6
      of the 46 women (13%) treated in the two protocols and is the most serious
      potential complication. Mitomycin/vinblastine is an effective salvage regimen and
      an excellent first-line chemotherapeutic treatment for women with metastatic
      breast cancer.

PMID- 8483558
TI  - The use of mitomycin in esophageal cancer.
AB  - Concurrent administration of chemotherapeutic agents and radiation with or
      without surgery has yielded better local disease control and more prolonged
      survival than has standard radiation therapy or surgery alone in patients with
      esophageal cancer. Combinations of 5-fluorouracil (5-FU) and either cisplatin or
      mitomycin have proven most effective in this setting. As a single agent,
      mitomycin has generated response rates of 14-42% in patients with squamous cell
      carcinoma of the esophagus. The response of patients with esophageal
      adenocarcinoma to single-agent mitomycin is unknown. The clinical use of
      mitomycin concurrent with 5-FU and radiation is well established in esophageal
      cancer. There is some experimental evidence to suggest that synergy may occur
      between 5-FU and mitomycin. Mitomycin is preferentially cytotoxic to hypoxic
      cells, which are relatively radioresistant. It is not clear whether use of
      mitomycin with radiation is additive or supra-additive as experimental evidence
      exists to support both types of interaction. Nonrandomized clinical trials
      suggest that using either cisplatin or mitomycin concurrently with 5-FU and
      relatively low-dose radiation (30 Gy) prior to esophagectomy can result in
      comparable rates of pathologic complete response (20-30%) and median survival (12
      19 months). Hematologic toxicity is frequently severe if all 3 drugs are used
      concurrently in combination with radiation. In patients with advanced disease
      (stage III or IV), combination chemotherapy/radiation therapy can result in
      significant palliation with tolerable morbidity. The use of concurrent
      chemotherapy and radiation has changed the pattern of failure in esophageal
      cancer from one dominated by inability to control local disease to one where
      systemic failure predominates. Current and proposed trials in esophageal cancer
      have changed their focus accordingly to meet this new treatment challenge.

PMID- 8483559
TI  - Mitomycin in anal canal carcinoma.
AB  - One hundred and ten patients with primary epidermoid cancers of the anal canal
      were treated in a series of prospectively designed, nonrandomized protocols of
      split-course radiation therapy with concurrent administration of 5-fluorouracil
      (5-FU) with or without mitomycin. The addition of mitomycin was associated with
      improved primary tumor control rates (87 vs. 58% at 4 years, p = 0.005) and
      improved 4-year actuarial cause-specific survival (80 vs. 64%, p = 0.02).
      Hematologic toxicity was the most frequent acute side effect of mitomycin use. No
      long-term toxicity was attributed to mitomycin only. Mitomycin appeared to
      benefit patients principally through improved control of cancer in the irradiated
      volume; there was no evidence of reduced risk of extrapelvic metastases. Several
      investigators have reported high rates of control of epidermoid anal cancers with
      preservation of anorectal function following concurrent treatment with mitomycin,
      5-FU, and radiation. Mitomycin's role in anal cancer is being evaluated in a
      randomized clinical trial by the Radiation Therapy Oncology Group. The mechanisms
      of any interactions between mitomycin and radiation or other cytotoxic drugs in
      clinical practice remain to be determined.

PMID- 8483560
TI  - Mitomycin therapy in gastric cancer.
AB  - Adenocarcinoma of the stomach remains a significant cause of mortality worldwide.
      The majority of patients present with stage III or IV disease, negating surgery
      as a curative option. Numerous drugs have been tested over the past 2 decades in
      single-agent and combination chemotherapy trials. Given by intravenous bolus,
      mitomycin has induced responses as high as 63% and as low as 24% in patients with
      various gastrointestinal malignancies. Mitomycin has also demonstrated efficacy
      when given in combination with doxorubicin and in the three-drug regimen FAM (5
      fluorouracil/doxorubicin/mitomycin). FAM has been explored in multiple phase II
      and III trials and has become the standard with which many new combinations are
      compared. Compared with other doxorubicin-containing regimens, it has
      demonstrated the longest median survival (29.5 weeks) and the lowest incidence of
      severe toxicity. The addition of semustine or leucovorin to FAM has yielded
      responses comparable with those attained by FAM alone. In Japan, where treatment
      of gastric cancer has been more successful, possibly due to earlier diagnosis and
      more aggressive surgical approaches, mitomycin has been given intraperitoneally
      during surgery and postoperatively in combination with fluorinated pyrimidines or
      other agents. Mitomycin will undoubtedly play a role in the development of new
      approaches to the treatment of gastric cancer.

PMID- 8483561
TI  - Comparison of single-agent epirubicin and 5-fluorouracil/epirubicin/mitomycin in
      patients with advanced adenocarcinoma of the pancreas.
AB  - In a randomized trial we compared single-agent epirubicin with the FEM (5
      fluorouracil/epirubicin/mitomycin) combination in patients with locally advanced
      and/or metastatic adenocarcinoma of the pancreas. Sixty patients previously
      untreated with radiotherapy or chemotherapy were randomly assigned to receive
      either 100 mg/m2 epirubicin or FEM in the following doses: 5-fluorouracil, 600
      mg/m2 to a maximum of 1 g; epirubicin, 50 mg/m2; mitomycin, 6 mg/m2 to a maximum
      of 10 mg. Treatment was given every 28 days via intravenous bolus; because of its
      association with delayed myelotoxicity, mitomycin was given every other cycle. A
      total of 47 patients are evaluable for toxicity and survival, 22 who received FEM
      and 25 epirubicin. Preliminary results of this ongoing study show no difference
      in survival between the two arms. Toxicity has been easily managed. A similar
      number of patients in each arm had elevated serum bilirubin levels, but dose
      reductions of 50% allowed all these patients to continue treatment.

PMID- 8483562
TI  - MMM (mitomycin/mitoxantrone/methotrexate): an effective new regimen in the
      treatment of metastatic breast cancer.
AB  - MMM (mitomycin 7-8 mg/m2 i.v.) every 6 weeks; mitoxantrone 7-8 mg/m2 i.v. every 3
      weeks; methotrexate 35 mg/m2 i.v. every 3 weeks) is a new combination
      chemotherapy regimen for advanced breast cancer. It has been compared in two
      complementary randomized trials with CMF (cyclophosphamide 100 mg orally, days 1
      14; methotrexate 35 mg/m2 i.v. days 1 and 8; 5-fluorouracil 1 g i.v. days 1 and
      8; courses repeated at 28-day intervals) and VAC (vincristine 1.4 mg/m2 every 3
      weeks, anthracycline 30 mg/m2 every 3 weeks, cyclophosphamide 400 mg/m2 every 3
      weeks) in patients with advanced metastatic breast cancer. In the first trial,
      which involved 227 patients, 53% of patients receiving MMM and 49% receiving VAC
      responded to treatment. There was no significant difference between treatment
      groups in median response duration or survival. Incidence of neuropathy,
      alopecia, and nausea and vomiting was significantly higher in patients receiving
      VAC. Hematologic toxicity was greater in the MMM group. In the second trial,
      which involved 120 patients, 51% of patients receiving MMM and 60% receiving CMF
      responded to treatment. Again, there was no significant difference between
      treatment groups in median response duration or survival. Both regimens were well
      tolerated with a low incidence of alopecia and serious nausea and vomiting, and
      there were no significant differences in toxicity. Significant reductions in
      serial left ventricular ejection fractions occurred in 4 patients given CMF and
      in 2 given MMM. MMM is an effective, well-tolerated regimen for advanced breast
      cancer, with toxicity similar to that of CMF and less than that of an
      anthracycline-containing regimen.

PMID- 8483564
TI  - The devastation of childhood sexual abuse.

PMID- 8483563
TI  - Standards for immunization practices endorsed by the Oklahoma Nurses Association.

PMID- 8483565
TI  - Anti-fibrosis agents, musicians, and the purposes of medical care.

PMID- 8483566
TI  - Wound healing modulation in glaucoma filtration surgery.
AB  - In some cases, modulation of wound healing, in association with glaucoma
      filtration surgery, results in lower postoperative intraocular pressures than
      would occur without such therapy. Treatments affecting wound healing increase the
      likelihood of achieving long-term filtration, especially in eyes with a poor
      surgical prognosis. After summarizing the wound-healing process following
      filtration procedures, we review the mechanism of action, the effectiveness, and
      the complications associated with some of the most commonly used wound healing
      inhibitors and then discuss new alternatives currently under investigation.
      Although much progress has been made, the challenge remains to develop new drugs
      or combinations of drugs that are less toxic and can yield more predictable
      results.

PMID- 8483567
TI  - Retrobulbar blockade of somatic, motor, and visual nerves by local anesthetics.
AB  - Somatosensory, motor, and visual sensory blockade were investigated after
      retrobulbar injection of 3 mL 2% lidocaine, prilocaine, or mepivacaine plus
      hyaluronidase (15 U/mL) and naphazoline nitrate (1:20,000) in 90 cataract
      patients (n = 30 per group). Before injection as well as 20 and 90 minutes after
      injection, and then every 30 minutes, the quality of the retrobulbar blockade was
      evaluated in terms of the following factors until full recovery of function: (1)
      corneal sensitivity at the three extraincisional quadrants as determined with an
      esthesiometer; (2) horizontal and vertical motility, and elevation of the lid;
      (3) visual acuity on an arbitrary score scale ranging from 0 (no light
      perception) to 6 (visual acuity > 0.05); and (4) the time required for recovery
      from retrobulbar anesthesia. The data were analyzed by one- (anesthetic) and two
      factor (anesthetic and time) analysis of variance. Full somatic recovery of
      corneal sensitivity occurred within 247 +/- 10.2 minutes after lidocaine, within
      221 +/- 9.2 minutes after prilocaine, and within 280 +/- 8.5 minutes after
      mepivacaine (F = 10.1; P < .0001). Full motor recovery (all muscles) occurred
      within 290 +/- 5.8 minutes after lidocaine, within 258 +/- 5.7 minutes after
      prilocaine, and within 295 +/- 4.8 minutes after mepivacaine (F = 13.3, P <
      .0001). On the average, visual acuity decreased most after mepivacaine and least
      after lidocaine administration, although the differences between the three
      anesthetics in this regard were not significant. One patient temporarily lost
      vision after mepivacaine administration. Overall, the somatosensory and motor
      blockade were most pronounced after mepivacaine.

PMID- 8483568
TI  - Transscleral neodymium:YAG cyclophotocoagulation: comparison of 180-degree and
      360-degree initial treatments.
AB  - In order to help clarify how much Neodymium:YAG transscleral
      cyclophotocoagulation (Nd:YAG CPC) treatment should be given to maximize
      effectiveness and minimize complications in the treatment of refractory
      glaucomas, we retrospectively reviewed and compared the results achieved with an
      initial 180-degree noncontact Nd:YAG CPC treatment with those achieved with an
      initial 360-degree treatment. Forty-five patients were in the 180-degree group
      and 21 in the 360-degree group. Mean follow up after the first Nd:YAG CPC
      treatment was 10.2 +/- 7.5 months. The average pretreatment intraocular pressure
      (IOP) in the 180-degree group was 33.5 mm Hg. After one treatment, IOP in these
      patients dropped an average of 8.4 mm Hg and was controlled successfully (5 to 22
      mm Hg) in 14 (31%). After a mean of 2.0 treatments, IOP in these patients dropped
      an average of 15.3 mm Hg, and successful IOP control was ultimately achieved in
      35 (78%). The average pretreatment IOP in the 360-degree group was 41.8 mm Hg.
      After one treatment, IOP in these patients dropped an average of 19.4 mm Hg and
      was controlled successfully in 11 (52%). After a mean of 1.3 treatments, IOP in
      these patients dropped an average of 20.7 mm Hg, and successful IOP control was
      ultimately achieved in 13 (62%). Our study suggests that repeated 180-degree
      treatments can be successful. However, because we found that IOP was controlled
      more rapidly with fewer major complications in the 360-degree group, the risk-to
      benefit ratio may be better for initial 360-degree treatment.

PMID- 8483569
TI  - Drainage tube implants in the treatment of glaucoma following penetrating
      keratoplasty.
AB  - A retrospective review was undertaken to compare outcomes in 26 eyes that
      underwent penetrating keratoplasty (PKP) and drainage tube surgery (Molteno
      double-plate implant or Schocket procedure). Drainage tube surgery was performed
      either before PKP (10 eyes), after PKP (7 eyes), or at the same time as PKP (9
      eyes). Mean follow up was 22 months. The average preoperative intraocular
      pressure (IOP) for all of the eyes was 31 mm Hg; 96% of them achieved a final IOP
      of less than 18 mm Hg (average, 14 mm Hg on a mean of 0.8 medications). Graft
      failure occurred in 11/26 (42%). Eight of these eyes were regrafted, and six of
      these eight have remained clear at a mean follow up of 22 months after
      regrafting. The overall PKP success rate, including the eyes that underwent
      repeat PKP, was 81%. Visual acuity remained stable or improved in 70% of the
      eyes.

PMID- 8483570
TI  - Oculoplastic uses of cranial bone grafts.
AB  - Cranial bone grafting for craniofacial reconstruction has gained wide acceptance
      in recent years and is being used with increasing frequency by ophthalmic plastic
      surgeons. Alloplastic materials (particularly newer materials such as porous
      polyethylene, hydroxyapatite, and rigidly fixated metal alloys) have a clear role
      in orbital reconstruction, and in many oculoplastic applications are the material
      of choice. However, in certain applications cranial bone grafts may be superior,
      eg, in managing large posttraumatic or postsurgical orbital defects or orbito
      sinus defects in the milieu of chronic sinusitis. We describe our current
      techniques for harvesting full-thickness outer-table grafts and split-thickness
      periosteally-bound "fish-scale" grafts. Harvesting cranial bone grafts is not
      without risk and donor site morbidity, and we do not advocate the use of cranial
      bone grafts in those cases that might be managed as well (or better) with
      alloplastic material. At the same time, ophthalmic surgeons involved in orbital
      reconstruction should be familiar with the indications for bone grafts and
      comfortable with harvesting techniques so that they are not limited when
      circumstances warrant the use of autogenous material.

PMID- 8483571
TI  - Basal cell carcinoma originating in the lacrimal canaliculus.

PMID- 8483572
TI  - Melanocytoma of the ciliary body with scleral extension.
AB  - A 35-year-old woman had a circumscribed pigmented scleral lesion overlying a
      pigmented mass in the ciliary body and trabecular meshwork. Sclerectomy and
      iridocyclectomy were performed. Histologically, the lesion proved to be a
      melanocytoma. This represents to our knowledge the fourth reported case of
      scleral extension of a ciliary body melanocytoma.

PMID- 8483573
TI  - Systemic herpetic infection diagnosed by retinal biopsy.
AB  - We describe a patient with systemic lupus erythematosus who developed myelopathy,
      optic neuropathy, retinopathy, and aseptic meningitis unresponsive to
      immunosuppressive and antimicrobial therapy. Although cultures and brain biopsy
      were unrevealing, a Herpes virus was suggested by retinal biopsy. The patient
      recovered dramatically after institution of acyclovir therapy and optic-nerve
      sheath decompression. This case demonstrates that herpetic retinitis can occur in
      an iatrogenically suppressed host and underscores the value of tissue diagnosis.

PMID- 8483574
TI  - Infectious disease risks of fibrin glue.

PMID- 8483575
TI  - Pump shunt success underscored.

PMID- 8483576
TI  - Optical performance of decentered bifocal contact lenses.
AB  - Contact lenses frequently do not center over the pupil. The potential changes in
      optical performance introduced by poor centration of bifocal contact lenses have
      only been described previously from theoretical considerations. The present study
      measured the modulation transfer function (MTF) of rigid concentric-design
      refractive and rigid diffractive bifocal contact lenses with varying apertures
      and amounts of decentration. Decentration was shown to have a greater effect on
      the MTF of the refractive than on the MTF of the diffractive bifocals. The MTF of
      the refractive bifocals was related to the proportion of the aperture covered by
      the central optic zone (COZ). Unexpectedly, the MTF of the distance focus of the
      diffractive bifocal contact lenses was reduced at moderately high spatial
      frequencies. The practitioner should be aware of the effects of decentration of
      bifocal contact lenses.

PMID- 8483577
TI  - Microbial contamination of hydrophilic contact lenses: quantitation and
      identification of microorganisms associated with contact lenses while on the eye.
AB  - Previous studies have demonstrated the presence of microorganisms on hydrogel
      contact lenses under various usage conditions. We conducted this study to
      quantify and identify viable bacteria and fungi associated with hydrogel contact
      lenses while on the eye. We removed the lenses from patients' eyes using aseptic
      techniques and cultured them to identify loosely adherent, as well as lens bound,
      microorganisms. Lenses were vortexed in a transfer medium (thereafter called the
      lens extract) and the lenses were then incubated in an agar sandwich separately
      from the transfer medium. We cultured 108 lenses (82 daily wear and 26 extended
      wear) from 49 patients. Bacteria were cultured from 38% (41) of the lenses; for
      31 of these 41 lenses bacteria were isolated only from the lens extracts (made by
      vortexing lenses in a transfer medium), suggesting a transient association with
      the lenses. No fungi were isolated. Counts of less than 10 colony forming units
      (CFU)/lens were observed on 89% of the lenses. Staphylococcus epidermidis were
      the most frequently isolated bacteria. A statistically significant relation was
      observed between increased CFU/lens and increased lens age for extended wear
      lenses (p = 0.028).

PMID- 8483578
TI  - Crowding and contrast in amblyopia.
AB  - The crowding effect, defined as the ratio of visual acuities for letters
      presented in Snellen (i.e., line) format and isolated-letter format, was measured
      in the amblyopic eyes of 15 children and 15 adults with unilateral amblyopia.
      Normal limits were based on data from 20 children and 20 adults with no history
      of amblyopia. The crowding effect was compared for letters of high (96%) contrast
      and for letters of low (11%) contrast. We report that amblyopia can
      differentially affect line and isolated-letter acuity for both high- and low
      contrast letters. For the patients that show an abnormal crowding effect, this
      effect can be: (1) significantly stronger, (2) significantly weaker, or (3) not
      significantly different for high- than for low-contrast letters. These findings
      are consistent with the hypothesis that the crowding effect is contrast-dependent
      in some amblyopic eyes of both child and adult unilateral amblyopes.

PMID- 8483579
TI  - Intraocular pressure in an unselected sample of 6- to 7-year-old Chinese
      children.
AB  - Intraocular pressure (IOP) was measured in one-hundred-twenty-three 6- to 7-year
      old Chinese children. Children who had at least one myopic parent had higher
      IOP's than children with two nonmyopic parents. There was a trend for myopic
      children to have higher IOP's than nonmyopic children.

PMID- 8483580
TI  - Effect of asymmetry on calculations of convergence in prism diopters.
AB  - Calculations of convergence in units of prism diopters are based on an assumption
      that convergence is symmetrical, that is, the visual axes intersect on the median
      plane. The effect of departure from symmetrical convergence is shown to produce
      systematic errors in calculations of convergence distance, if the convergence
      angle is constrained to be constant. On the other hand, if the convergence
      distance is constrained to be constant, departure from symmetry results in a
      systematic reduction in the convergence angle. Because these errors are
      disregarded in the specification of convergence in prism diopters, care should be
      taken in using these units for larger amounts of asymmetrical convergence.

PMID- 8483581
TI  - Are optometric faculty guilty of ageism?
AB  - Ageism (negative feelings toward the elderly) is common among health care
      students and impacts upon the delivery of health care. Education serves to
      promote positive attitudes toward the elderly and alleviates ageism. As role
      models, faculty in the health professions influence student attitudes and can
      affect the development of ageism in students. This study was designed to evaluate
      whether optometric faculty are guilty of ageism. Twenty-nine optometry faculty
      and 83 optometry students were surveyed using Palmore's "Facts on Aging Quiz:
      Part 1" (FAQ1). The mean percent score for faculty was 64.14% as compared to a
      student mean percent score of 63.96% (p = 0.9422, t-test). The faculty also
      exhibited a larger anti-age bias than the students. Thus, optometry faculty do
      possess prejudicial attitudes toward older adults and would benefit from
      increased education in the field of geriatrics.

PMID- 8483582
TI  - Clinical study of bendazac lysine for in vivo contact lens cleaning.
AB  - Bendazac Lysine (BZL), a nonsteroidal anti-inflammatory drug (NSAID), prevents
      denaturation of proteins secondary to chemical and physical activity. The major
      protein deposited on soft contact lenses is lysozyme, derived from the preocular
      tear film. We evaluated the effectiveness of eye drops formulated with BZL for in
      vivo prevention of proteinaceous deposits on contact lenses and found them to be
      useful in inhibiting protein deposition during a 6-month clinical trial.

PMID- 8483583
TI  - Transient rigid lens-induced striae in keratoconus.
AB  - We have observed spontaneous development of striae and an enhanced visibility of
      them after placing rigid gas permeable contact lenses on six patients suspected
      of having early keratoconus. These fine folds subside upon removal of the rigid
      lens. This observation assists clinicians with the differential diagnosis of
      irregular astigmatism when the definitive biomicroscopic signs of keratoconus are
      either not present or are so subtle that their presence is questionable. Although
      these striae may not occur in all patients suspected of having early keratoconus,
      we find that observation of the posterior cornea in the presence of a rigid lens
      will often confirm the diagnosis of keratoconus. We have not seen similar striae
      in patients whose clinical presentation is not consistent with early keratoconus.

PMID- 8483584
TI  - Psychophysical comparison of four automated perimeters.
AB  - It is not unusual for a doctor to detect a field loss on the office perimeter and
      refer the patient to a setting where a different perimeter is used. In such
      cases, fields are often repeated because of a lack of "comparability." In this
      study, we compared the "hill of vision" produced by four major types of
      perimeters. When possible, we explored alternate user-defined stimulus
      configurations in order to determine if a rough equivalence could be obtained
      among the various instruments. Background intensity and target size accounted for
      many of the differences found in the data. Target color, stimulus duration, and
      noise had relatively little effect. Despite our stimulus manipulations, subtle
      (but perhaps significant) differences in the hills of vision remained.

PMID- 8483585
TI  - Critical review: effects of optical defocus on refractive development and ocular
      growth and relation to accommodation.
AB  - Studies of optical defocus on refractive development and ocular growth in animals
      are presented and discussed in relation to the accommodation hypothesis. None of
      these studies fully support the accommodation hypothesis. The problems
      encountered in these studies are also discussed.

PMID- 8483586
TI  - CCLRU standards for success of daily and extended wear contact lenses.
AB  - Success in contact lens wear is often judged on the basis of patient "survival"
      rather than the achievement of satisfactory performance based on specific
      criteria. In 1971, Sarver and Harris defined a series of standards for successful
      polymethyl methacrylate (PMMA) lens wear which incorporated criteria for wearing
      time, comfort, vision, ocular tissue changes, and patient appearance. In this
      paper we propose a revision of these criteria based on current understanding of
      the ocular response to contact lens wear. These revised CCLRU (Cornea and Contact
      Lens Research Unit) standards for success are intended as realistic performance
      objectives, and can be applied in clinical trials to evaluate and compare the
      clinical performance of present and future rigid and soft contact lenses, worn
      for daily and extended wear.

PMID- 8483587
TI  - Interpupillary distance of females of Arab origin.
AB  - We have investigated the distant and near interpupillary distance (IPD) of three
      groups of females of Arab origin. Average values and range of values have been
      determined for children, young adults, and older adults. Average distant
      interpupillary distance (FIPD) measurements are compared to those of females of
      Caucasian (European and American), African-American, and Chinese (Hong Kong and
      mainland China) origin. Different experimental techniques and some unavailable
      information about previously studied subjects make conclusive statements about
      the ethnic variation of IPD difficult to draw.

PMID- 8483588
TI  - [Definition and clinical importance of thyroiditis].
AB  - Regarding the different forms of thyroiditis our knowledge has so significantly
      grown in the last two decades that their clinical importance has been
      reevaluated. To-day they are ranged among the most often endocrinological
      disorders. Namely, it became obvious that the most often causes of the temporary
      hyper- and hypothyroidism are the most recent recognized forms of subacute
      thyroiditis, and that producing of permanent hypothyroidism the postpartum form
      also joined with Hashimoto's thyroiditis as the most often endogenous
      aetiological factor. The most accepted classification of the large group of
      thyroiditis is the following: acute, subacute and chronic forms. Beyond these
      rigorous frames of terminology the individual forms overstep the conventional
      boundaries relating to time, histology and clinical symptoms; they can overlap of
      follow each other, even they can appear together at the same time. These can be
      better understood and explained by the disturbance of immunoregulation, which is
      detectable or supposed in the majority of discussed disorders. The diagnostic and
      therapeutical characteristics of different forms of thyroiditis have been made
      known.

PMID- 8483589
TI  - [Dobutamine stress echocardiography: a new possibility in the diagnosis of
      coronary disease].
AB  - Authors performed dobutamin stress test since 1987 and combined their
      examinations with 2D-echocardiography in case of suspected coronary artery
      disease since October 1991. In this study they report on their experiences
      obtained in the course of the first 32 examinations. The results of the
      dobutamine stress echocardiography were analysed on the basis of coronarography
      which was performed in every patient. According to their observations dobutamine
      stress echocardiography has very good sensitivity and specificity and it is
      practically a harmless method, but as it requires instruments, assistants, time
      and work. Authors recommend the method first of all as a complementary to the
      physical loading method as well as alternative loading examination.

PMID- 8483590
TI  - [Statistical data on motor handicapped children, aged 0-18 years, based on a
      national survey].
AB  - A computer-based data processing was made at 6762 motor handicapped children. The
      data were obtained by questionnaires about the health status, educational, social
      level and rehabilitation of these children. The authors could state the use of
      therapeutical equipment, the further need for rehabilitation--specialists and the
      waiting list for the admission to institutions. The number of registered children
      was 2.4% of the specific population. The aim of the study was to promote the
      activity of local self governments, local--and national social security--and
      health authorities competent in the rehabilitation for the social integration of
      the Hungarian 0-18 years old motor handicapped persons.

PMID- 8483591
TI  - [Neonatal neuroblastoma detected by ultrasonic screening].
AB  - It was found a solid tumour of 24 x 28 x 31 mm size above the right kidney with
      ultrasound screening in a three days old newborn. After three days appeared
      cystic areas inside the tumour, so it was thought to adrenal haemorrhage. The
      tumour didn't decrease during two months and metastases developed in the liver.
      The urinary VMA level was normal, the HVA elevated. The MIBG scintigraphy was
      first negative, after a month pathognostic. The primer tumour and metastases
      disappeared after cyclophosphamid and Adriablastin treatment. The adrenal
      neuroblastoma can imitate the adrenal apoplexy, so it's important to control all
      neonatal adrenal haemorrhage until their disappearance.

PMID- 8483592
TI  - [Screening and care of pregnancy in diabetics].

PMID- 8483593
TI  - [On the 150th anniversary of the birth of Jozsef Fodor (1843-1901)].

PMID- 8483594
TI  - [Thoughts on the centenary of the death of Lajos Markusovszky].

PMID- 8483595
TI  - [Nursing at the Scheibbs hospital is carried out according to the WHO nursing
      process model].

PMID- 8483596
TI  - [The nursing process--a challenge for all].

PMID- 8483597
TI  - [Experiences with the introduction of a coordinated nursing process].

PMID- 8483598
TI  - [As time goes by ...].

PMID- 8483599
TI  - Drug company sponsorship: blessing or bias?

PMID- 8483600
TI  - Head and neck cancer and the quality of life.

PMID- 8483601
TI  - Possible methods of creating a functional neoglottis and of constructing a
      functionally adequate neolarynx.
AB  - The intention of the following report is to present a concept for constructing a
      substitute glottis (neoglottis). The concept evolved over the years on the basis
      of anatomic studies and in the course of plastic reconstructions on patients. It
      is based on pedicled grafting of a voluntarily controllable--and hence trainable-
      musculature that might be transplanted into the larynx attached to a
      neurovascular pedicle. A rima glottidis might be imitated that could be opened
      and closed from a neutral position. During sleep the neoglottis would be in a
      relaxed, spasm-free position. A sensitive and tactile stimulus response ought to
      be possible, as should variations of the state of tension of the substitute vocal
      muscles.

PMID- 8483602
TI  - Is cis-platinum vestibulotoxic?
AB  - Serial vestibular testing was performed on 34 patients undergoing cis-platinum
      chemotherapy and 12 age-matched normal subjects. Vestibular testing comprised
      caloric and low-frequency, sinusoidal rotational testing (0.01 to 0.16 Hz). Test
      retest variability in the caloric and rotational vestibular assessment of the
      normal subjects formed the basis for evaluation of subclinical loss of vestibular
      function within our patient population. In spite of high-dose cis-platinum
      chemotherapy (100 mg/m2) with cumulative dosages to 1600 mg, no clear evidence of
      vestibular toxicity was found.

PMID- 8483603
TI  - The benefits of cochlear implantation in the geriatric population.
AB  - The deterioration of speech-understanding abilities in the aged that results from
      factors such as reduced speed and accuracy in processing has been well
      documented. The purpose of this study was to evaluate whether the geriatric
      population could benefit from a cochlear implant, despite the possibility of
      reduced processing abilities. Twenty patients, ages 65 to 85 years, with
      bilateral profound sensorineural hearing loss received the Nucleus multichannel
      cochlear prosthesis at NYU Medical Center. All patients underwent extensive
      preoperative medical and audiologic assessments to determine candidacy. The
      surgical procedure was well-tolerated by all patients. Mean postoperative test
      results revealed significant improvements in both auditory performance and
      quality of life as a result of implant usage. These data support the concept that
      although a reduction in the processing of sensory stimulation might exist, the
      elderly can process a new auditory code delivered by means of a cochlear implant.

PMID- 8483604
TI  - Bone-anchored reconstruction of the irradiated head and neck cancer patient.
AB  - Titanium implants in facial bones for retention of epitheses or dental bridges
      were used for reconstruction in cancer patients after tumor surgery. Even heavily
      irradiated bones could integrate the implants and bear the load from the
      epithesis. No major complications, such as wound infection, fistulation, or
      osteoradionecrosis, occurred after implant surgery. There was, however, an
      increased loss of implants with time after irradiation, especially in the orbital
      region. When hyperbaric oxygen was used as adjunctive treatment, implant losses
      were reduced.

PMID- 8483605
TI  - Kawasaki disease: early presentation to the otolaryngologist.
AB  - Kawasaki disease is an acute febrile illness of unknown etiology that occurs
      primarily in childhood. Early diagnosis and treatment can reduce the risk of
      cardiac complications of Kawasaki disease, which carries a 1% to 2% mortality for
      cardiovascular events. Clinical features include: (1) fever; (2) conjunctival
      injection; (3) oral cavity changes; (4) changes in the peripheral extremities;
      (5) erythematous rash; and (6) cervical adenopathy without suppuration. We
      describe three cases in detail and survey a series of 42 patients at our
      institution. Otolaryngologic manifestations were found to occur in the early
      stages of Kawasaki disease. The otolaryngologist may see these patients early in
      the disease and should be alert to the signs and symptoms for appropriate
      diagnosis and treatment. Characteristics of Kawasaki disease, difficulties in
      diagnosis during the initial febrile stage, and the importance of early diagnosis
      by the otolaryngologist is stressed.

PMID- 8483606
TI  - Fluorescein use in the detection of perilymphatic fistula: a study in cats.
AB  - A stained or colored perilymph would be a valuable tool to otologists for the
      detection of a perilymph fistula. We studied the effect of intravenously injected
      fluorescein on the inner ear in seven cats. Still and video photography was used
      to clearly document our findings. Intravenously injected fluorescein appeared
      within the soft tissue in less than 1 minute and stayed there for at least 3 1/2
      hours. Fluorescence around the round window niche resulted from soft tissue
      (mucosal) fluorescence and extravasation of interstitial fluid (transudate). No
      fluorescence of perilymph was detected. Because of this, we do not believe
      intravenously injected fluorescein is useful in the detection of perilymph
      fistula. Intrathecal injection caused quick and intense staining of labyrinthine
      fluid.

PMID- 8483607
TI  - Laser welding of fascial grafts and its potential application in tympanoplasty:
      an animal model.
AB  - This study evaluates the welding effect of argon laser on fascial grafts and its
      potential application in tympanoplasty. An animal model was designed so that
      surgically induced perforations of the lumbar fascia of the animals were grafted
      in an underlay fashion. Each graft was "spot welded" around the circumference of
      the perforation using a hand-held argon laser. Various lasing parameters were
      used on different grafts. Control perforations were grafted but not welded. A
      total of 96 perforations was studied. Weld sites were evaluated both
      histologically and by tensile strength measurement at the end of surgery, and at
      7, 14, and 21 days postoperatively. Comparison with controls showed a higher
      tensile strength for welded grafts, which was most significant in the early
      postoperative period (p < 0.001). Histologically, it seems that the basic
      mechanism of fascial welding involves liquification and denaturation of
      extravasated proteins at the weld sites. Correlation between the extent of
      thermal damage on the tissues and the various lasing parameters is described.
      Based on the well-documented safety of argon laser in otologic surgery, and the
      successful welding of fascial grafts in this study, argon laser may prove
      beneficial in welding temporalis fascia grafts in tympanoplasty.

PMID- 8483608
TI  - Facial paralysis in a benign osseous parotid tumor: a case report.
AB  - This unique lesion has not been described in the literature so far. It appears to
      have originated from the base of the skull (i.e., styloid process of the temporal
      bone). Its pathology was extensively reviewed and it appeared to be a benign
      proliferative mass, but had produced a total facial nerve paralysis with invasion
      and destruction of the nerve. Although not palpable clinically, it had invaded
      the deep lobe of the parotid gland, thus reinforcing the importance of a work-up
      with CT scans and MR imaging to work-up a facial paralysis of unknown cause
      lasting more than 6 months.

PMID- 8483609
TI  - Sebaceous choristoma of the middle ear.

PMID- 8483610
TI  - Laryngeal infiltrating intramuscular lipoma.

PMID- 8483611
TI  - Piriform sinus fistula--the role of endoscopy in its management.

PMID- 8483613
TI  - Eleven excuses for not having a will--what's yours?

PMID- 8483612
TI  - From the National Institute on Deafness and Other Communication Disorders.

PMID- 8483614
TI  - Affirmative action revisited for the '90s.

PMID- 8483615
TI  - Home infusion therapy report.

PMID- 8483616
TI  - Childhood immunizations: controversy and change.

PMID- 8483617
TI  - Mothers who use nurse midwives have fewer C-sections, episiotomies and shorter
      hospital stays.

PMID- 8483618
TI  - Editorial fairness and the "Cantekin affair".

PMID- 8483619
TI  - Cephalosporins are superior to penicillin for treatment of streptococcal
      tonsillopharyngitis: is the difference worth it?

PMID- 8483620
TI  - Cefpodoxime proxetil vs. penicillin V in pediatric streptococcal
      pharyngitis/tonsillitis.
AB  - This multicenter, randomized, parallel treatment, observer-blinded study was
      designed to evaluate the safety and efficacy of cefpodoxime proxetil (5 mg/kg
      twice daily for 10 days) compared with penicillin V (13.4 mg/kg three times daily
      for 10 days) for treatment of Group A streptococcal pharyngitis and tonsillitis
      in pediatric patients. Clinical and microbiologic results were evaluated before
      therapy, during therapy (Study Days 3 to 5), at the end of therapy (Study Days 14
      to 18) and at long term follow-up (Study Days 30 to 32). Both drugs were well
      tolerated in 578 patients evaluable for safety. Mild gastrointestinal complaints
      were noted in 6.7% of 386 cefpodoxime-treated patients and in 5.2% of 192
      penicillin-treated patients. In 413 patients evaluable for efficacy, both
      treatment regimens resulted in comparably favorable clinical outcome; cure rates
      were 83.8% for 275 cefpodoxime-treated patients and 77.5% for 138 penicillin
      treated patients. However, eradication of S. pyogenes at end of therapy was
      significantly higher with cefpodoxime (93.1%) than with penicillin (81.2%) (P <
      0.01). Cefpodoxime proxetil provides an effective alternative to penicillin V for
      the treatment of streptococcal pharyngitis and tonsillitis.

PMID- 8483621
TI  - How common is whooping cough in a nonvaccinating country?
AB  - In Sweden general vaccination with a whole cell pertussis vaccine was recommended
      from 1953. In 1979 the recommendation was withdrawn because the Swedish-made
      vaccine had become ineffective. In order to determine the incidence of the
      disease in a nonvaccinating country, 400 children born in 1980 were randomly
      selected from the population register of Goteborg, Sweden. The parents of the
      children were interviewed in 1990, when the children were 10 years old. The
      parents of 377 children could be reached, and of those 372 were not vaccinated
      against pertussis. Of the nonvaccinated children 61% had experienced clinically
      typical whooping cough; 195 (119 with and 76 without a history of whooping cough)
      agreed to donate a serum sample for determination of antibodies against pertussis
      toxin, filamentous hemagglutinin and pertactin. Of the children with a history of
      whooping cough, 91% had antibodies against pertussis toxin, as had 64% of the
      children without a history of disease. All but 3 children had antibodies against
      filamentous hemagglutinin and all 195 children had antibodies against pertactin.
      The antibody titers against the 2 last mentioned proteins did not differ between
      children with and without a history of whooping cough or between children with
      and without antibodies against pertussis toxin.

PMID- 8483622
TI  - High attack rates and case fatality during a measles outbreak in groups with
      religious exemption to vaccination.
AB  - Beginning in October, 1990, a large measles outbreak involving predominantly
      unvaccinated preschool age children occurred in Philadelphia. By June, 1991, 938
      measles cases had been reported to the Philadelphia Health Department. In
      addition to these cases, 486 cases and 6 measles-associated deaths occurred
      between November 4, 1990, and March 24, 1991, among members of 2 Philadelphia
      church groups that do not accept vaccination. We identified measles cases and
      collected information on symptoms and potential risk factors for complications.
      Telephone interviews were conducted to collect demographic and clinical
      information on measles cases in church member households. We identified 486
      measles cases among 892 mostly unvaccinated church members. Age-specific attack
      rates were highest among children 1 to 4 years of age (94%) and 5 to 14 years of
      age (91%). Five (83%) of the 6 deaths occurred in females, 3 of whom had
      underlying illnesses. The overall case-fatality rate was 1.2%. The case-fatality
      rate was 2% for females, 0.4% for males (P = 0.22), 1.7% for primary cases and
      0.7% for secondary household cases (P = 0.67). Only one of the children who died
      had received medical care. Measles spread rapidly in this group, sparing few
      susceptible individuals. Lack of medical care and underlying disease appear to
      have contributed to the high case-fatality rate in the church communities.

PMID- 8483623
TI  - Investigation of a measles outbreak in a fully vaccinated school population
      including serum studies before and after revaccination.
AB  - A measles outbreak in early 1989 among approximately 4200 students at a high
      school and two intermediate schools in suburban Houston, TX, was investigated to
      evaluate reasons for vaccine failure and to predict the efficacy of a booster
      dose of measles vaccine. Seventy-seven cases occurred (71 at the high school, 6
      at intermediate schools; attack rate, 3.2 and 0.3%, respectively). Vaccination in
      the first year of life an 13 to 14 years since last vaccination were independent
      risk factors for being a case. Forty-three (18%) of 239 sera collected from
      students just before revaccination during the outbreak were negative by enzyme
      immunoassay; a neutralization assay confirmed these 43 lacked antibody predicting
      protection against measles infection. Of 43 enzyme immunoassay-negative students
      24 gave another blood sample 9 to 10 months after revaccination. Revaccination
      appeared to reduce the portion of all students with neutralization titers
      predicting susceptibility to measles illness with rash from 7.9% to 3.0% and left
      the portion predicted to be susceptible to illness without rash unchanged (45%).

PMID- 8483624
TI  - Pharmacokinetics of intravenous vancomycin in pediatric cardiopulmonary bypass
      surgery.
AB  - The purposes of this investigation were to characterize the disposition of
      vancomycin in children undergoing cardiopulmonary bypass (CPB) surgery and to
      determine whether a 15-mg/kg intravenous dose provides adequate serum
      concentrations during and after CPB. Six children (age range, 0.8 to 4.8 years)
      received intravenous vancomycin 15 mg/kg 1 to 2 hours before CPB surgery. Serial
      blood samples (mean, 10/patient) were collected before, during and after CPB
      surgery. The mean (+/- SD) vancomycin concentrations at the end of the infusion
      and 5 hours after the infusion were 27.3 +/- 5.7 and 5.9 +/- 3.0 mg/liter,
      respectively. The initiation of CPB resulted in an abrupt decrease (44.5%) in
      serum vancomycin concentrations; however, concentrations remained constant
      (range, 6.2 to 14.1 mg/liter) throughout the rest of the CPB procedure. The mean
      (+/- SD) values for the apparent volume of distribution, total body clearance and
      elimination half-life were 0.59 +/- 0.15 liter/kg, 2.94 +/- 0.93 ml/min/kg and
      2.4 +/- 0.8 hours, respectively. These values were similar to those reported in
      the literature for children not undergoing CPB surgery. A single vancomycin dose
      of 15 mg/kg before pediatric CPB surgery provides serum concentrations greater
      than 5 mg/liter throughout the duration of the CPB procedure. To sustain these
      concentrations subsequent dosing of vancomycin is necessary within 6 hours after
      the initial vancomycin dose.

PMID- 8483625
TI  - Pediatric human immunodeficiency virus infection in a low seroprevalence area.
AB  - Although increasing information is available regarding human immunodeficiency
      virus (HIV) infections of children in high seroprevalence areas, few data are
      available describing trends in low seroprevalence populations. In San Diego
      County approximately 1 in 1450 live births are to women infected with HIV as
      identified by nonlinked heel stick testing. Seventy-seven HIV-infected children
      were identified and followed in our clinics during the period 1983 to 1991, of
      whom 32 (42%) were infected perinatally, 32 (42%) were hemophiliacs and 13 (17%)
      were infected by blood transfusions. During the last 4 years of the study period
      (1988 to 1991), most (28 of 37, 76%), newly identified HIV-infected children less
      than 13 years old were perinatally infected. Of the 32 perinatally infected
      children 50% were Hispanic, 34% were Caucasian and 16% were African-American. The
      prospective vertical transmission rate was 16%. Twenty-nine (38%) of the HIV
      infected children have a diagnosis of acquired immunodeficiency syndrome and 17
      (22%) have died. Comparatively few of the HIV-infected hemophiliac patients (4
      (12%)) have progressed to an acquired immunodeficiency syndrome diagnosis. The
      number of acquired immunodeficiency syndrome diagnoses declined in the last 2
      years of the study as a result of fewer cases of Pneumocystis carinii pneumonia;
      11 cases of P. carinii pneumonia were diagnosed in 1988 to 1989 compared with 4
      cases in 1990 to 1991. Survival analysis for the perinatally infected group
      yielded a median survival of 9.2 years. The apparent trend in our data toward
      improved outcomes of children infected with HIV suggests the beneficial effects
      of early identification, antiretroviral treatment, and P. carinii pneumonia
      prophylaxis.

PMID- 8483626
TI  - Survival experience of 789 children with the acquired immunodeficiency syndrome.
AB  - To define predictors of survival we studied longitudinal histories of 789 New
      York State Medicaid-enrolled children diagnosed with acquired immunodeficiency
      syndrome (AIDS) from 1983 to 1989 and followed through 1990. Median survival
      times for 3 severity groups of AIDS-defining conditions were 66, 48 and 9 months.
      In a proportional hazards model, the relative risk of death for the most vs.
      least severe group was 3.33 (95% confidence interval, 2.53, 4.37) and the
      relative risk for children < 6 months old at diagnosis vs. older children was
      1.81 (95% confidence interval, 1.41, 2.34). We increased our ability to predict
      death by using a 4-category severity index that assesses both the AIDS-defining
      diagnosis and clinical complications within 3 months of diagnosis (relative risk,
      5.27; 95% confidence interval, 3.16, 8.78 for most vs. least severe). These
      analyses offer new clinical severity measures and reveal that, regardless of the
      AIDS-defining diagnosis, children with AIDS who are < 6 months old have a poor
      prognosis.

PMID- 8483627
TI  - The Rhino-Probe nasal curette for detecting respiratory syncytial virus in
      children.
AB  - During two outbreaks of respiratory syncytial virus (RSV) infection, 68 children
      with acute respiratory illnesses were cultured for RSV using a Rhino-Probe (RP)
      nasal curette and either a nasopharyngeal (NP) swab or a nasal wash (NW). In the
      first outbreak isolations of RSV by the RP nasal curette and NP swab methods were
      compared. RSV was cultured from 25 of 42 (60%) subjects using the RP nasal
      curette and from 20 of 42 (48%) subjects using the NP swab. In the second
      outbreak the RP nasal curette and the NW collection techniques were compared. RSV
      was isolated from 15 of 26 (58%) children evaluated. RSV was cultured from 14 of
      15 (93%) patients by RP and 13 of 15 (87%) when using NW. In the group of culture
      positive subjects, the TESTPACK RSV rapid antigen test was positive in 10 of 15
      (67%) using the RP and in 6 of 15 (40%) using the NW. Like the NP swab the RP
      nasal curette was simple, noninvasive and relatively inexpensive, yet it was as
      sensitive as the NW for detection of RSV.

PMID- 8483628
TI  - Management of fever in granulocytopenic children with cancer.

PMID- 8483629
TI  - Diagnostic efficacy of a Mycoplasma pneumoniae hybridization test in
      nasopharyngeal aspirates of children.

PMID- 8483630
TI  - Neonatal Blastocystis hominis diarrhea.

PMID- 8483631
TI  - Congenital toxoplasmosis presenting with eosinophilic meningitis.

PMID- 8483632
TI  - Pyogenic liver abscess complicating ingestion of sharp objects.

PMID- 8483633
TI  - Griseofulvin significantly decreases serum salicylate concentrations.

PMID- 8483634
TI  - Shigellosis complicated by perforated appendix.

PMID- 8483635
TI  - Bone pain and facial nodule in an adolescent female.

PMID- 8483636
TI  - Group A beta-hemolytic Streptococcus: issue of resistance.

PMID- 8483637
TI  - Role of Pseudomonas aeruginosa in chronic suppurative otitis media.

PMID- 8483638
TI  - Recalcitrant "acute" otitis media secondary to glue ear.

PMID- 8483639
TI  - Personality characteristics and duration of ATA Taekwondo training.
AB  - Students in ATA Taekwondo schools were administered the 16 Personality Factor
      Questionnaire. The students were divided into two groups of 15 persons each based
      on 0-1.4 yr. vs 1.5 + yr. spent in formal Taekwondo training. From the 16 PF,
      scores on two second-order and one derived factor were calculated for Anxiety,
      Independence, and Leadership. The groups having longer Taekwondo training times
      scored significantly lower on Anxiety and higher on Independence. Although
      Leadership scores were higher for the longer trained group they were not
      statistically significant.

PMID- 8483640
TI  - Critical values for evaluating CELF-R Receptive and Expressive Language Score
      discrepancies.
AB  - Psychoeducational evaluation of school-aged children may involve a comparison of
      examinees' language comprehension and production skills. To facilitate the
      diagnostic process, this paper presents a table of critical values for the
      Clinical Evaluation of Language Fundamentals--Revised, which can be used to
      evaluate the statistical significance of observed-score discrepancies.
      Theoretical implications of such discrepancies are also discussed.

PMID- 8483641
TI  - Case's developmental model and children's drawings.
AB  - 109 children in four age groups were administered two memory measures designed by
      Case in 1985, the Beery Visual Motor Integration Test and five drawing tasks from
      Dennis. Scores on working memory were correlated positively with age; children's
      drawings corresponded to Case's four developmental substages; and a direct
      relationship was found between the children's drawings and their performance on
      the psychometric measure of visuomotor integration. These findings are
      interpreted as evidence that important developmental changes in children's
      drawing can reliably illuminate changes in intellectual development.

PMID- 8483642
TI  - Beta-endorphins and mood states during resistance exercise.
AB  - Research examining the relationship between beta-endorphin immunoreactivity and
      affect has resulted in equivocal findings. To examine this relationship further,
      10 male and 10 female college-age students participated in a controlled free
      weight exercise session. Blood plasma samples were procured both prior to and
      following the exercise bout and beta-endorphin levels were determined by
      immunoassay. Analysis indicated that plasma beta-endorphin levels following
      exercise were significantly decreased from pre-exercise levels. Pearson
      correlations showed no significant relationship between pre- or postexercise
      plasma beta-endorphins and either total mood disturbance or Profile of Mood
      States subscores. The data support previous failure of resistance exercise to
      produce an increase in beta-endorphin immunoreactivity as well as the lack of a
      significant relationship between affect and the beta-endorphin response to
      exercise.

PMID- 8483643
TI  - Changes in body size of elite high school football players: 1963-1989.
AB  - An examination of the heights and weights of members of the Parade Magazine's
      High School All-American Football Teams from 1963-1971 indicates no significant
      changes in the Body Mass Index of these elite athletes whereas an increased
      pattern in Body Mass Index was noted within this group from 1972-1989. The large
      increases in Body Mass Index after 1971 among the All-American high school
      football players raise interesting research questions; in particular, what
      portion of these gains can be attributed to improved nutrition and training
      techniques and what portion is the result of use of performance enhancing drugs
      such as anabolic steroids?

PMID- 8483644
TI  - The mere exposure effect for stimuli presented below recognition threshold: a
      failure to replicate.
AB  - Repeated exposure to a stimulus increases one's affect toward that stimulus. This
      finding, termed the mere exposure effect, has been obtained even when the
      exposure durations are below the threshold of recognition. Reported are three
      experiments designed to assess whether the mere exposure effect for stimuli
      presented below the threshold of recognition could be obtained for meaningful
      stimuli. Analysis showed that meaningfulness of the stimuli had no effect on
      ratings of affect; however, we did not replicate previous findings of a mere
      exposure effect for stimuli that were not recognized. The robustness of the mere
      exposure effect for stimuli presented below the threshold of awareness was
      questioned.

PMID- 8483645
TI  - Self-other differentiation among psychotic and conduct-disordered adolescents as
      measured by human figure drawings.
AB  - 24 psychotic-spectrum adolescents were compared with 23 conduct-disordered
      adolescents on a self-other drawing differentiation task. Of the 24 psychotic
      spectrum disordered adolescents, 14 received the diagnosis of Psychotic Disorder
      NOS (Group 1) and the remaining 10 had diagnoses of Schizophrenia, Bipolar
      Disorder with Psychotic Features, and Schizoaffective Disorder (Group 2).
      Interestingly, less impaired adolescents (Groups 1 and 3, the conduct-disordered
      group) showed significantly more difficulty than the more impaired adolescents
      (Group 2) on self-other differentiation as measured by their differentiated
      drawings.

PMID- 8483646
TI  - Force perception before and after maximal voluntary contraction.
AB  - Capacity to match a low level of elbow flexion force maintained in the control
      arm was measured in the experimental arm in 16 subjects before and after maximal
      voluntary contraction (MVC). Prior to a 1-min. MVC, the mean force exerted by the
      experimental arm was 3.4 +/- 1.0 kg when attempting to match the tension of a 2.3
      kg weight in the control arm. After the MVC, the mean force exerted in the
      experimental arm was 4.4 +/- 2.6 kg. The change in perception of force after a
      prolonged MVC as demonstrated in this study may be due to postcontraction
      potentiation of contraction, which has been demonstrated by others after a brief
      MVC.

PMID- 8483647
TI  - A replay of the baseball data.
AB  - Fudin, Renninger, Lembessis, and Hirshon (1993) reported a nonsignificant
      longevity advantage for right-handers in their analysis of archival baseball
      data, although the absolute values are still in the predicted direction.
      Differences in specific data entries and analyses are difficult to resolve;
      however, there is some indication that the data base that they analyzed differs
      from that in our study. Further, their use of parametric statistics, given
      distributional problems and grossly unequal group sizes, may account for the
      nonsignificance they observed, when compared to the nonparametric analyses that
      we used. While we considered our original study a pilot project, the literature
      now contains hundreds of studies that show that left-handedness is associated
      with a wide range of health-risk factors including serious accidents, immune
      system disorders, and birth-related complications that involve reduced oxygen. A
      recent study of the archival records of over 3000 cricket players showed a
      significant advantage of over 2 years in longevity for right-handed cricket
      players. On the basis of these findings, we still believe that left-handedness is
      a marker for reduced longevity.

PMID- 8483648
TI  - The relationship between trait and precompetitive state anxiety among high school
      athletes.
AB  - A sample of 270 tennis players representing 56 high school programs were assessed
      on competitive trait and state anxiety during the active season. A series of
      multivariate analyses of variance indicated that highly trait-anxious athletes
      reported greater cognitive A-state, greater somatic A-state, and lower state self
      confidence than low trait-anxious athletes.

PMID- 8483649
TI  - Effects of force output and preparatory period on fractionated reaction time.
AB  - The effects of force output and its preparatory period on fractionated reaction
      time were investigated. Eight subjects responded with an isometric elbow flexion
      to light stimuli under three experimental conditions, adjusting force output to
      match two target forces (10% or 40% of maximal isometric voluntary elbow flexion
      strength) displayed on an oscilloscope. Analysis indicates that the relationship
      between premotor time and force output is affected by preparatory states in the
      central nervous system, and the preparatory time necessary for exertion of a
      specific force varies with the magnitude of exerted force.

PMID- 8483650
TI  - A short measure of self-esteem: some data on reliability.

PMID- 8483651
TI  - Phonological similarity effect is abolished by a silent mouthing task.
AB  - This experiment was designed to examine the effect of silent mouthing on the
      phonological similarity effect. 16 undergraduates were tested for serial recall
      of visually presented letter sequences that were either phonologically similar or
      dissimilar. The letter sequences had to be remembered under two conditions, a
      control condition and a silent mouthing condition in which subjects had to
      articulate irrelevant words silently during the study period. Analysis showed the
      clear advantage of the dissimilar sequence over the similar one in the control
      condition. In contrast, this phonological similarity effect disappeared in the
      silent mouthing condition. This result is consistent with the working memory
      model.

PMID- 8483652
TI  - Control issues and body image in panic disorder.
AB  - Mean perceived emotional control and body image were compared for 7 subjects with
      and 6 without panic disorder, all physically healthy. The former had a lower mean
      on sense of emotional control and showed greater emphasis on the back of the
      body. These preliminary data encourage replication with a larger group.

PMID- 8483653
TI  - Personality dynamics of adolescent boys where the father was absent.
AB  - The effects of substitute adult male role-models were examined for 60 adolescents
      between the ages of 13 and 18 years. Significant mean differences were found on
      Depression, Hypochondriasis, and Suspiciousness scales of the MMPI and Guilt and
      Assaultiveness of the Buss-Durkee Hostility Inventory. Interpretation of scores
      showed that fatherless boys who had substitute male role-models were similar in
      personality to boys with fathers. Adolescent boys without fathers and from lower
      socioeconomic families were significantly more similar in personality to young
      offenders.

PMID- 8483654
TI  - Hand preference in the use of tools by infant baboons (Papio cynocephalus
      anubis).
AB  - Hand preference in the use of tools was examined in a peer group of five infant
      baboons, Papio cynocephalus anubis. Hand preference was noted for all subjects on
      a sponging task and for one subject on a probing task. The baboons exhibited the
      highest percentage of bimanual actions on the initial segment of each three
      component task. These results are consistent with the hypothesis that immature
      nonhuman primates exhibit lateral asymmetries when they use tools and bimanual
      coordination when they perform complex manipulative tasks.

PMID- 8483655
TI  - Effects of music on Alzheimer patients.
AB  - From a large nursing care facility, 60 elderly patients diagnosed as having
      Alzheimer disease were randomly separated into three groups of equal size and
      given tests to measure their mood and mental state. For music Group 1, "Big Band"
      music from the 1920s and 1930s was played during their daily recreation period
      while Group 2 were given puzzle exercises during their activity sessions. Members
      of Group 3 participated in the standard recreational activities of drawing and
      painting. After six months, the questionnaire was again given to all
      participants. Analysis of variance showed the individuals in Group 1 were more
      alert, happier, and had higher recall of past personal history than patients in
      the other two groups. This suggests that music can be of therapeutic value to
      Alzheimer patients.

PMID- 8483656
TI  - Failure to demonstrate gender differences in interference to information
      processing of body-shape stimuli.
AB  - The Stroop test was adapted to assess disruption to processing of body-shape
      stimuli. Women are usually considered to be more concerned with personal body
      shape and weight issues than men. This analysis yielded no differences between
      men and women when processing body-shapes and weight stimuli.

PMID- 8483657
TI  - Influence of age, sex, balance, and sport participation on development of
      throwing by children in grades K-8.
AB  - The purpose of this study was to examine the contributions of age, sex, balance,
      and sport participation on development of throwing by children in Grades K-8. The
      subjects were 381 boys and 338 girls (ages 4-14) enrolled in a medium-sized
      school system in southeastern Maine. Each subject was individually assessed in
      throwing development and static and dynamic balance. In addition, all subjects
      completed a survey relative to their participation in school- or community
      sponsored sports. To determine the independent effects of age, sex, static
      balance, dynamic balance, and sport participation within each grade, data were
      subjected to multiple regression analysis, which indicated that mature throwing
      development was influenced by sport participation and sex. Boys performed better
      at all grades.

PMID- 8483658
TI  - Differential effects of aging on two verbal fluency tasks.
AB  - The effect of age on verbal fluency was studied in 84 healthy volunteers, ages 45
      to 91 years, who performed letter-fluency and semantic-fluency tasks. Older
      subjects (75 to 91 yr.) performed as well as younger (50 to 64 yr.) on letter
      fluency but did significantly worse on semantic category fluency. This pattern is
      similar to that observed in Alzheimer-type dementia.

PMID- 8483659
TI  - Self-generated mnemonics for number recall in young and old adults.
AB  - Self-generated strategies for recall of number facts were examined in 164 adults
      who ranged in age from 20 to 86 years. Participants recalled a number list that
      included six 2-digit prices and six 4-digit phone numbers. Following recall,
      participants reported their encoding strategies. A larger percentage of the
      younger subjects (< 49 yr.) reported using a specific verbal mediator to
      facilitate encoding, and younger subjects recalled more 2-digit and 4-digit
      numbers. Across age groups, the self-reported use of encoding strategies
      facilitated recall.

PMID- 8483660
TI  - Self-concepts of Nigerian adolescents.

PMID- 8483661
TI  - Theoretical parallels between the Ponzo illusion and the Wundt-Jastrow illusion.
AB  - Misapplied-size-constancy, assimilation, and contrast theories are discussed as
      explanations for the Wundt-Jastrow and Ponzo illusions. An experiment is reported
      that questions the need to include a contrast function in the assimilation theory
      of Pressey and Wilson to account for the Wundt-Jastrow illusion. Several
      directions for further research are proposed.

PMID- 8483662
TI  - Laterality effects for music perception among differentially talented
      adolescents.
AB  - To examine the comparative nature of laterality patterns for music perception
      among differentially talented adolescents, 138 right-handed subjects (56 boys, 82
      girls) trained in music, mathematics, and dance, respectively, were tested on
      dichotic chords and dichotic melodies tasks. Analyses demonstrated that only the
      musically trained subjects displayed task-dependent ear asymmetry, that is, a
      left-ear advantage for dichotic chords and a right-ear advantage for dichotic
      melodies. The mathematically and dance-talented students displayed a left-ear
      bias for both tasks of music perception. A control dichotic speech task showed a
      right-ear bias for all talent groups. The findings speak to how sensory
      information is managed by the mental-processing systems of differentially
      talented students and how talent training plays a role in shaping ear asymmetry.

PMID- 8483663
TI  - Scores on exercise dependence among dancers.
AB  - A number of researchers have suggested that the syndrome of exercise dependence
      (addiction) is paralleled by a tendency towards eating disorders such as anorexia
      nervosa and bulimia. As considerable research has reported a high incidence of
      eating disorders among dancers and as rigorous physical demands are inherent in
      dance, we hypothesized that dancers would present a higher profile of exercise
      dependence on the Negative Addiction Scale than other athletes. To test this
      hypothesis, 47 female ballet and modern dancers completed a survey on exercise
      dependence adapted from Hailey and Bailey (1982) to assess quantitatively
      exercise dependence. Scores were compared with those obtained from 39 female
      endurance (running) athletes and 16 female nonendurance (field hockey) athletes.
      Significantly higher scores on dependence for dancers than for endurance or
      nonendurance athletes were noted. The data indicate that dancers may be at
      greater risk for psychophysiological problems associated with exercise dependence
      than other athletes and so should be monitored for symptoms.

PMID- 8483664
TI  - Handedness and sexual preference: a re-analysis of data presented by Rosenstein
      and Bigler.
AB  - Rosenstein and Bigler reported in 1987 that sexual orientation (exclusively
      versus nonexclusively heterosexual) was not related to right- versus nonright
      handedness. However, re-analysis of their published data indicated that
      nonexclusive heterosexuals were 3.13 times more likely to be nonright-handed than
      were exclusively heterosexual subjects (p < .03).

PMID- 8483665
TI  - Body satisfaction and self-concept of third- and sixth-grade students.
AB  - Pubertal development has been implicated as the point of origin for decreased
      body satisfaction and self-concept for girls from prepubertal levels and an
      increase in body satisfaction and self-concept for boys. Two groups of boys and
      girls in Grades 3 and 6 completed a Body Satisfaction Questionnaire and the Piers
      Harris Self-concept Scale to test this assumption. The third graders were
      considered to be prepubertal and sixth graders as early pubertal. The sixth-grade
      boys scored lower on body satisfaction than third-grade boys, and their self
      concept scores were positively correlated with body satisfaction scores. For
      girls, body satisfaction scores were correlated with self-concept in both grades,
      and few significant differences were found between grades. For girls apparently
      the relationship between body satisfaction and self-concept may be present before
      the onset of puberty.

PMID- 8483666
TI  - Gender differences in test anxiety among South African university students.
AB  - Prior research has shown a sex difference in scores on test anxiety, with men
      having a lower mean score than women. The present study was undertaken to confirm
      such a difference among African university students, but the t ratio was
      nonsignificant for means of 28.4 for men and 28.0 for women (SDs of 5.3 and 5.0).

PMID- 8483667
TI  - Geophysical variables and behavior: LXXI. Differential contribution of
      geomagnetic activity to paranormal experiences concerning death and crisis: an
      alternative to the ESP hypothesis.
AB  - A total of 621 reports (experienced over an approximately 70-year period) of
      putative psi experiences concerning death or crisis were differentiated according
      to traditional labels: telepathic, precognitive, and postmortem phenomena. The
      232 telepathic experiences occurred during 24-hour periods in which the global
      geomagnetic activity was significantly less (quieter) than during the days before
      or after the experiences; this relationship was not displayed by the 186
      precognitive or 203 postmortem cases. Key day differences in geomagnetic activity
      for the three classes of experiences were equivalent to a correlation of about
      0.35. Although content analysis suggests that nocturnal psi experiences and
      temporal lobe epilepsy may share a similar mechanism, different classes of
      subjective psi experiences may not be affected by the same stimuli.

PMID- 8483668
TI  - Emotional behavior during the learning of a contingency task in a chimpanzee.
AB  - A female chimpanzee's behavior was videotaped during the learning of contingency
      tasks and used to code her facial expressions, vocal expressions, and other
      behavior. The chimpanzee showed negative emotional behaviors to negative feedback
      and seemed to depend not only on the lack of food as reward. The most negative
      emotional situation for the chimpanzee seemed to be one in which she made an
      error.

PMID- 8483669
TI  - Dimensions of Sensation Seeking Scale Form VI: cross-cultural comparison.
AB  - In this study the factor structure of the Sensation Seeking Scale Form VI was
      compared for the Kuwaiti and American subjects. Thrill and adventure seeking
      Factor, Part II Intention, showed good cross-cultural reliability for men only.
      The differences between findings of this analysis and that of Zuckerman could be
      interpreted as evidence of cultural differences between Kuwaiti and American
      subjects in sensation seeking.

PMID- 8483670
TI  - Hassles, uplifts, and quality of sleep.
AB  - This study examined whether events which occur during the previous day affect
      sleeping behavior. Specifically, whether minor irritants (hassles), positive
      experiences (uplifts), or both hassles and uplifts of the previous day affect
      night sleep for people without sleeping disorders. 41 subjects completed the
      Hassles and Uplifts scale as well as four questions (which were combined into a
      total score) assessing quality of sleep. Quality of sleep was correlated with
      scores on Hassles and Uplifts (.36), Hassles (.34), and Uplifts (.30). When the
      sample was divided into good and bad sleepers, correlations with Hassles, and
      Hassles and Uplifts were significant, but not Uplifts.

PMID- 8483671
TI  - The Easter bunny in October: is it disguised as a duck?
AB  - To study the influence of motivational expectancy on perception, the ambiguous
      drawing of a duck/rabbit was shown to 265 subjects on Easter and to 276 subjects
      in October. The ambiguous drawing, though perceived as a bird by a majority of
      subjects in October, was most frequently named a bunny on Easter. This biasing
      effect of expectancy upon perception was observed for young children (2 to 10
      years) as well as for older subjects (11 to 93 years).

PMID- 8483672
TI  - Age and test anxiety among African university students.
AB  - As studies in Western countries have shown, scores on test anxiety increase with
      age during elementary school. Whether such a difference would be observed among
      African university students who ranged in age from 18 to 35 years was examined.
      The difference in mean scores on the Achievement Anxiety Test for two groups,
      ages 18 to 25 years (n = 132) and 26 to 35 years (n = 267), was not statistically
      significant.

PMID- 8483673
TI  - Children's creative thinking and color discrimination.
AB  - 60 children in Grades 3 through 6 from two schools were administered the
      Farnsworth Munsell 100-Hue Test and teachers provided a measure of different
      aspects of each child's creative thinking on the Williams Scale of Children's
      Divergent Thinking. Fluency and imagination scores were positively associated
      with color discrimination. While other dimensions of creative thinking did not
      correlate with color discrimination, some correlations suggested thematic
      connections between color discrimination and other manifestations of creative
      thinking as evaluated by teachers. Color discrimination was also positively
      associated with age, as older children differentiated between small differences
      in colors better than younger children. As intelligence or other variables may be
      relevant, further study is needed.

PMID- 8483674
TI  - Time perception: effects of task speed and delay.
AB  - The study examined the effect of task speed and delay on the perception of time.
      60 subjects were randomly allocated to four groups in a 2 x 2 design. The first
      factor related to the speed of the task (fast or slow) undertaken during the time
      to be estimated, while the second factor related to when time estimates were
      obtained (immediately after the task versus following a delay). Analysis
      supported the hypothesised interaction, with time estimates being shorter in the
      fast than in the slow condition when obtained immediately after the task but
      longer in the fast than the slow condition when obtained after a delay. Results
      are discussed in relation to cognitive theories of time perception.

PMID- 8483675
TI  - Young children's human figure drawings and cognitive development.
AB  - The age-stage relationship between young children's human figure drawings and
      Piaget's levels of cognitive development was investigated using 45 young children
      ages 4 through 6 years. Analyses indicated a distinct monotonic trend between
      cognitive stage and drawing level; as cognitive ability increased so did drawing
      level. This suggests that children's human figure drawings can be a simple tool
      for the quick assessment of cognitive levels in young children.

PMID- 8483676
TI  - Children's perceptions of responsibility: attitudes while working with peers with
      disabilities.
AB  - The purpose of this study was to examine whether participation in a community
      based cooperative learning program affected attitudes toward responsibility of 13
      talented and gifted students toward 49 peers with disabilities. A survey was
      administered to measure role perception of these students as they interacted in
      gross motor recreational activities with students with disabilities. There was a
      significant difference between pre- and posttest scores on three of six attitude
      items. Ordinal data suggested the gifted subjects showed an increase in their
      felt responsibility in this cooperative learning.

PMID- 8483677
TI  - A dynamic balance measure for persons with severe and profound mental
      retardation.
AB  - The present study's purpose was to probe into the reliability and validity
      measurement of dynamic balance for individuals with IQs below 29. The 91 subjects
      were asked to complete the Papcsy-DePaepe test and the Bruininks test according
      to each test's protocol. Correlations of odd-even scores produced a reliability
      of .98 for the Papcsy-DePaepe test. Concurrent validity was indicated by a
      Pearson product-moment correlation of .64 between the two tests. Subsequent 3 x 2
      x 2 multivariate analyses of variance confirmed a significant difference between
      the two tests and that retardation was associated with balance performance
      although age and gender were not.

PMID- 8483678
TI  - Profiles of Hispanic adolescents and adults on the Myers-Briggs type indicator.

PMID- 8483679
TI  - Pleasantness-unpleasantness of environmental sounds and gender difference in
      evaluation.
AB  - The present experiment examined emotional evaluation of 40 environmental sounds
      which were presented to 388 college students in a lecture room. Students were
      required to rate pleasantness-unpleasantness, to identify the sounds, and to rate
      their confidence about their identifications. Analysis showed that the pleasant
      sounds were natural and musical sounds and that the unpleasant sounds were sounds
      of a belch, of a dentist's drill, and of scratching on a blackboard. It is
      interesting that for pleasant sounds confidence was always high, which suggested
      that emotional evaluation of the environmental sounds was closely related to the
      confidence of observers in their identifications of the sounds. Gender
      differences were noted on the ratings on pleasantness-unpleasantness of
      environmental sounds, that is, women evaluated the pleasant sounds as more
      pleasant than men, and men evaluated the unpleasant sounds as not so unpleasant
      as did women.

PMID- 8483680
TI  - Blocking and countering in traditional Shotokan karate kata.
AB  - Analysis of the 1183 techniques forming the twenty-seven Shotokan karate kata
      (forms) widely practised today shows a significant preference for blocking over
      counter-offensive techniques. This may be interpreted as evidence to support
      Karate-do as a Way of self-defense and non-violence.

PMID- 8483681
TI  - Validation of criterion-referenced archery cutting scores.
AB  - This study investigated an empirical method for setting optimal cutting scores
      for a criterion-referenced archery test. The classification-outcome probabilities
      and approaches to validity suggested by Berk were utilized. Pretest scores were
      obtained on 35 uninstructed college-age women on six ends (six arrows each) from
      20 yards (18.3 m) after an unrecorded warm-up end. Posttest scores were after 15
      weeks of instruction. Score distributions were the primary determinant for
      accurately classifying students as true mastery and true nonmastery. Accuracy is
      a function of the amount of overlap between distributions. Using the point at
      which the distributions overlapped, classification accuracy was estimated.
      Probabilities associated with 80 points were p(TM) + p(TN) = .83 and p(FM) +
      p(FN) = .14. Scores above and below 80 points had lower probabilities of
      classification accuracy. Reliability estimated using Kappa was .59. Statistical
      validity of the cutting score (phi) was .68.

PMID- 8483682
TI  - Does motor cerebral dominance develop secondary to sensory dominance?
AB  - Current research and theoretical frameworks for understanding motor dominance
      assume that motor dominance is primary. Various developmental clues, however,
      suggest that the maturation of proprioceptive sensory processing predates that of
      motor control. We hypothesized that the observed adult pattern of lateralized
      motor dominance may develop as a consequence of preexisting lateralized "sensory"
      or "proprioceptive dominance." To test whether motor preference could develop in
      response to sensory dominance, we investigated sighting eye dominance, eye lid
      winking, and handedness in 164 individuals. Subjects winked the nondominant eye
      significantly more frequently than the dominant eye and independently of their
      handedness, lending partial support to the idea that motor function can develop
      in response to sensory function. Specific investigation of the development of the
      proprioceptive system would be needed to evaluate whether lateralization of motor
      handedness develops as a consequence of "proprioceptive" lateralization.

PMID- 8483683
TI  - Frame-and-spot-induced motion: range effects and the difference between fixation
      and nonfixation of the induced stimulus.
AB  - For frame-and-spot-induced linear motion, Humber and Sherrick report that induced
      motion of a nonfixated static spot reduces as its separation from a fixated
      static spot increases. The authors invoke sensory factors, but range effects may
      undermine this interpretation.

PMID- 8483684
TI  - Attention and visual dominance in motor learning.
AB  - Two experiments examined the role of attention in visual dominance during motor
      learning. On the movement task 10 acquisition trials were given; each included a
      movement presentation and a blindfolded reproduction. After completion of
      acquisition trials and a 5-min. interval, subjects were given 5 retention trials
      with reproduction attempts only. In Exp. 1, subjects receiving only kinesthetic
      information during movement presentation reproduced criterion movement length
      more accurately than subjects receiving visual and kinesthetic information. Other
      subjects, presented both visual and kinesthetic stimuli for the movement, were
      given instructions to ignore vision and focus on kinesthesis. These subjects
      exhibited no effects of visual dominance in reproductions. In Exp. 2, subjects
      were presented visual and kinesthetic stimuli during half of the movement
      presentations and only kinesthetic stimuli during the other half. They did not
      exhibit the effects of visual dominance in reproductions. Such effects in motor
      learning may be modified by manipulation of attention or an alternating
      presentation of specific sensory stimuli.

PMID- 8483685
TI  - A dominant-subordinate unit-against-unit theory of decreases in visibility.
AB  - When simultaneous stimuli or stimuli in metacontrast and related research are
      perceived (recognized, apprehended) as two different phenomenal groups (wholes,
      things), the visibility of the group with less intense, smaller, no-onsetting,
      terminating, and briefer features decreases. This decrease also occurs when one
      of two groups with equally intense, etc. features is made less visible through
      masking. Therefore, the relative visibility of two groups predicts a decrease in
      the visibility of one of them better than does their relative intensity, etc.
      Further, (1) the visibility of all the parts (perceived features, attributes) of
      both groups is similarly affected, so each group functions as one entity and (2)
      decreases in visibility are eliminated when stimuli produce only one group. The
      theory: a neural unit underlies the perception of one group and its parts, and
      two such units underlie the perception of two groups and their parts (one unit
      for each group). In addition, the unit for a dominant (high visibility) group
      inhibits the unit for a subordinate (low visibility) group, thereby decreasing
      the visibility of the subordinate group. Also, when stimuli produce only one
      group (hence one unit), unit-against-unit inhibition and hence a decrease in
      visibility is precluded.

PMID- 8483686
TI  - Effects of depressed mood on social perception.

PMID- 8483687
TI  - Variable word initial and medial consonant relationships in children's speech
      sound articulation.
AB  - The heterogeneous nature of consonants in the medial position of words may have
      prevented earlier studies from depicting a clear phonetic relationship between
      them and consonants in the initial and final positions. In this study, auditory
      perceptual judgments of children's consonant productions in the initial position
      of words were compared with those on medial consonants varying in number and
      order. Neither the perceived frequency of correct articulation nor the error
      pattern differentiated single consonants in the initial and medial positions of
      words at any age. Performance on consonant blends in the initial position of
      words differed from that on both types of medial sequences, but it was more
      similar to medial consonant sequences that corresponded with permissible word
      initial blends than to those that did not. It was concluded that initial and
      medial consonants may be regarded as performance equivalents only under certain
      conditions.

PMID- 8483688
TI  - Use of visual feedback during rapid aiming at a moving target.

PMID- 8483689
TI  - A "fair" comparison of progressive and imaginal relaxation.
AB  - Progressive and imaginal relaxation-training procedures are difficult to compare
      because the latter takes many forms. In this study, an imaginal procedure was
      used that closely followed progressive operations except that muscle tension was
      imagined rather than experienced. The dependent variable was the total score on
      the Relaxation Inventory. College students were placed in groups (ns = 50) high
      and low on suggestibility based on scores on the Creative Imagination Scale,
      assigned in equal numbers to the imaginal and progressive relaxation conditions
      and given four sessions of relaxation training. The pre- and posttrials effects
      were significant within each of the four training sessions. There were no
      significant differences in reports of relaxation by the progressive and imaginal
      treatments. The expected cumulative effect of relaxation training across the four
      sessions was not found; in fact, the imaginal condition showed a significant
      decrease. The only significant suggestibility effect was an interaction between
      suggestibility and trials in which highly suggestible subjects reported less pre
      session relaxation. These results are consistent with reports of no differences
      between progressive and imaginal relaxation training.

PMID- 8483690
TI  - Association between physical activity and blood pressure in normotensive adults.

PMID- 8483692
TI  - The perceptual analysis of structure from motion for rotating objects undergoing
      affine stretching transformations.
AB  - In two experiments, we evaluated the ability of human observers to make use of
      second-order temporal relations across three or more views of an apparent motion
      sequence for the perceptual analysis of three-dimensional form. Ratings of
      perceived rigidity were obtained in Experiment 1 for objects rotating in depth
      that were simultaneously subjected to sinusoidal affine stretching
      transformations along the line of sight or in a direction parallel to the image
      plane. Such transformations are theoretically interesting because they cannot be
      detected by analyses that are restricted to first-order temporal relations (i.e.,
      two views), but they can be detected by more conventional analyses of structure
      from motion in which second-order temporal relations over three or more views are
      used. The current results show that human observers can perceive stretching
      transformations of a rotating 3-D object in a direction parallel to the image
      plane but that they fail to perceive stretching transformations along the line of
      sight. This result suggests that human observers can make use of some limited
      second-order temporal information. This finding was confirmed in Experiment 2, in
      which we investigated the effects of several specific optical consequences of
      sinusoidal stretching transformations applied in different directions. The
      results indicate that observers may be sensitive to the sign of acceleration, but
      that they cannot make use of the precise magnitude of second-order relations
      necessary to recover euclidean metric structure.

PMID- 8483691
TI  - Neural dynamics of motion perception: direction fields, apertures, and resonant
      grouping.
AB  - A neural network model of global motion segmentation by visual cortex is
      described. Called the motion boundary contour system (BCS), the model clarifies
      how ambiguous local movements on a complex moving shape are actively reorganized
      into a coherent global motion signal. Unlike many previous researchers, we
      analyze how a coherent motion signal is imparted to all regions of a moving
      figure, not only to regions at which unambiguous motion signals exist. The model
      hereby suggests a solution to the global aperture problem. The motion BCS
      describes how preprocessing of motion signals by a motion oriented contrast (MOC)
      filter is joined to long-range cooperative grouping mechanisms in a motion
      cooperative-competitive (MOCC) loop to control phenomena such as motion capture.
      The motion BCS is computed in parallel with the static BCS of Grossberg and
      Mingolla (1985a, 1985b, 1987). Homologous properties of the motion BCS and the
      static BCS, specialized to process motion directions and static orientations,
      respectively, support a unified explanation of many data about static form
      perception and motion form perception that have heretofore been unexplained or
      treated separately. Predictions about microscopic computational differences of
      the parallel cortical streams V1-->MT and V1-->V2-->MT are made--notably, the
      magnocellular thick stripe and parvocellular interstripe streams. It is shown how
      the motion BCS can compute motion directions that may be synthesized from
      multiple orientations with opposite directions of contrast. Interactions of model
      simple cells, complex cells, hyper-complex cells, and bipole cells are described,
      with special emphasis given to new functional roles in direction disambiguation
      for endstopping at multiple processing stages and to the dynamic interplay of
      spatially short-range and long-range interactions.

PMID- 8483693
TI  - The harmonic bandwidth of phase-reversal discrimination.
AB  - Previous studies have shown that 180 degrees relative phase shifts in f + 2f
      gratings are discriminated when the cosine or the sine component of the shift
      exceeds some criterion (Bennett & Banks, 1987; Field & Nachmias, 1984). The
      current experiments demonstrate that this result holds for other two-component
      gratings, provided that the components are within two to three octaves of each
      other. For frequency differences greater than two to three octaves, phase
      reversal discrimination is impossible. A simple model that discriminates phase
      shifts on the basis of changes in the responses of even- and odd-symmetric
      spatial filters can account for the results.

PMID- 8483694
TI  - Postsaccadic processing of the retinal image during picture scanning.
AB  - Eye movements were monitored while observers inspected photographs of natural
      scenes. At the end of each saccade (i.e., at the beginning of each period of
      steady fixation), the stimulus was replaced for a certain period of time by a
      uniform field (Experiment 1) or a blurred version of the stimulus scene
      (Experiment 2). Total fixation duration was measured as a function of the
      duration of the initial uniform field or the blurred image that followed the
      saccade. It was found that fixation duration increased proportionally with the
      duration of the initial replacement field, even for durations as short as 25
      msec. These results suggest that the visual system uses information on the retina
      right after each saccade is completed and that the blurred, low-resolution
      information used in Experiment 2 (cutoff frequency of 0.8 cpd) is not sufficient
      for the requirements of picture processing in this task.

PMID- 8483695
TI  - The role of haptic versus visual volume cues in the size-weight illusion.
AB  - Three experiments establish the size-weight illusion as a primarily haptic
      phenomenon, despite its having been more traditionally considered an example of
      vision influencing haptic processing. Experiment 1 documents, across a broad
      range of stimulus weights and volumes, the existence of a purely haptic size
      weight illusion, equal in strength to the traditional illusion. Experiment 2
      demonstrates that haptic volume cues are both sufficient and necessary for a full
      strength illusion. In contrast, visual volume cues are merely sufficient, and
      produce a relatively weaker effect. Experiment 3 establishes that congenitally
      blind subjects experience an effect as powerful as that of blindfolded sighted
      observers, thus demonstrating that visual imagery is also unnecessary for a
      robust size-weight illusion. The results are discussed in terms of their
      implications for both sensory and cognitive theories of the size-weight illusion.
      Applications of this work to a human factors design and to sensor-based systems
      for robotic manipulation are also briefly considered.

PMID- 8483696
TI  - Perceiving heading with different retinal regions and types of optic flow.
AB  - We examined the ability to use optic flow to judge heading when different parts
      of the retina are stimulated and when the specified heading is in different
      directions relative to the display. To do so, we manipulated retinal eccentricity
      (the angle between the fovea and the center of the stimulus) and heading
      eccentricity (the angle between the specified heading and the center of the
      stimulus) independently. Observers viewed two sequences of moving dots that
      simulated translation through a random cloud of dots. They reported whether the
      direction of translation--the heading--in the second sequence was to the left or
      right of the direction in the first sequence. The results revealed a large and
      consistent effect of heading eccentricity: Judgments were much more accurate with
      radial flow fields (small heading eccentricities) than with lamellar fields
      (large heading eccentricities), regardless of the part of the retina being
      stimulated. The results also revealed a smaller and less consistent effect of
      retinal eccentricity: With radial flow (small heading eccentricities), judgments
      were more accurate when the stimulus was presented near the fovea. The variation
      of heading thresholds from radial to lamellar flow fields is predicted by a
      simple model of two-dimensional motion discrimination. The fact that the
      predictions are accurate implies that the human visual system is equally
      efficient at processing radial and lamellar flow fields. In addition, efficiency
      is reasonably constant no matter what part of the retina is being stimulated.

PMID- 8483697
TI  - A ratio principle for a red/green and a yellow/blue channel?
AB  - There is strong empirical evidence that, under adaptation to another achromatic
      color stimulus, the lightness of an achromatic color stimulus depends on the
      ratio of the luminances of the two stimuli. In the present study, the suitability
      of this ratio principle is tested for two chromatic postreceptoral opponent
      channels. A Hering red/green channel and a non-Hering yellow/blue channel are
      specified as chromatic channels. The yellow/blue channel is defined by
      extrapolating the plane corresponding to unique green-white linearly to the
      reddish part of color space, using the plane's surface as the channel's
      equilibria. The experiment was run on an isoluminant plane, measured individually
      for each observer. Moving along an observer's measured opponent axes, eight
      adaptation stimuli were selected for each channel and spanned the whole range of
      the channel's coordinates. Red/green equilibria or yellow/blue equilibria were
      measured as excursions along the adaptation axes. For both presumed channels, the
      ratios of the equilibrium coordinates of test and adaptation stimuli were
      essentially constant. This supports the principle's suitability. However, small
      asymmetries were found with respect to each channel's opponent hues. The status
      of the proposed yellow/blue channel is discussed, as are conditions that might
      have favored the present findings.

PMID- 8483698
TI  - An element in the visual field is just a conjunction of attributes: a critique of
      Bundesen (1991)
AB  - Nissen (1985) presented results showing that in partial-report experiments,
      selection by location was different from selection by color or by shape. Bundesen
      (1991) presented a reinterpretation of these results, claiming that they can also
      be explained by a model in which location selection is treated on a par with
      selection by color or by shape. We will show that the analysis given by Bundesen
      is based on a special relation between an "element" in the visual field and its
      location, which in fact reduces the expressions given by Bundesen to those given
      by Nissen. Furthermore, we will show that in Bundesen's theory, it is assumed
      that in the process of perceptual categorization an element in the visual field
      can be referred to without the use of one of its attributes. This assumption is
      untenable from a theoretical point of view. In all, the results presented by
      Nissen can still be regarded as evidence for the difference between selection by
      location and selection by color or by shape.

PMID- 8483699
TI  - Dividing attention between color and shape: evidence of coactivation.
AB  - When attention is divided between spatially distinct objects, the time to detect
      a target decreases when two or more targets are present. This redundancy gain can
      be accounted for by an interactive race model (Mordkoff & Yantis, 1991) in which
      separate decisions are made about each object, but environmental contingencies
      among the objects can influence decision times. In the present study, we examined
      whether the model also accounts for performance when attention must be divided
      between stimulus attributes other than spatial location. Subjects made target
      present responses when displays included a prespecified color, a prespecified
      letter, or both target features. The data violated the predictions of all
      separate-activations models, including the interactive race model. Two control
      experiments ruled out an alternative account based on task complexity. We
      conclude that coactivation occurs when target attributes from two separable
      dimensions are simultaneously present, but not when target attributes come from
      the same dimension. A modular hybrid of race and coactivation models is
      tentatively proposed.

PMID- 8483700
TI  - Moving phantom visibility as a function of fundus pigmentation.
AB  - Moving phantom visibility was measured for subjects with a fundus classified as
      either lightly or darkly pigmented. The phantom-inducing pattern was a black-and
      white square-wave grating drifting continuously from left to right, with a black
      horizontal occluder interrupting the middle of the grating. Moving phantom
      visibility was significantly reduced for darker relative to lighter pigmented
      subjects. The results show that fundus pigmentation can influence the perception
      of illusory contours and surfaces (i.e., phantoms). This finding supports and
      expands on previous research concerning fundus pigmentation influences on real
      contour perception.

PMID- 8483701
TI  - Saccadic overhead: information-processing time with and without saccades.
AB  - Information-processing time was compared for serial and spatially distributed
      visual presentations with performance measures that permit the separation of
      total time into its during-display and post-display components. For all subjects,
      there was a significant saccadic overhead, that is, less time was required with
      the serial format, which allowed data access without eye movements. However, the
      magnitude of the overhead decreased as task complexity increased. All subjects
      were able to exercise some control over the distribution of total processing
      time, trading off short during-display times with longer post-display times and
      vice versa.

PMID- 8483702
TI  - Looking for two targets at the same time: one search or two?
AB  - A considerable amount of evidence suggests that, under conditions of high
      discriminability, subjects are able to process multiple elements in a visual
      display simultaneously when searching for a single target among distractors.
      Relatively little emphasis, however has been placed on the question of whether
      subjects can search for and detect multiple targets simultaneously. This latter
      question is the focus of the present report. In two experiments, we compare
      performance in single-target and multiple-target detection tasks in order to
      investigate whether or not multiple targets can be detected simultaneously. In
      Experiment 1, subjects searched for one or two targets that were defined by
      color. In Experiment 2, subjects searched for a color and/or a letter target.
      When the two targets were presented in the same location (e.g., a red X when
      Target 1 was red and Target 2 was an X), they seemed to be detected
      simultaneously. Implications for object-based processing of visual information
      are discussed.

PMID- 8483703
TI  - Feature processing during high-rate auditory selective attention.
AB  - Auditory event-related brain potentials (ERPs) and reaction times were analyzed
      in a selective attention task in which subjects attended to tone pips presented
      at high rates (interstimulus intervals [ISIs] of 40-200 msec). Subjects responded
      to infrequent target tones of a specified frequency (250 or 4000 Hz) and location
      (left or right ear) that were louder than otherwise identical tones presented
      randomly to the left and right ears. Negative difference (Nd) waves were isolated
      by subtracting ERPs to tones with no target features from ERPs to the same tones
      when they shared target location, frequency, or both frequency and location cues.
      Nd waves began 60-70 msec after tone onset and lasted until 250-350 msec after
      tone onset, even for tones with single attended cues. The duration of Nd waves
      exceeded the ISIs between successive tones, implying that several stimuli
      underwent concurrent analysis. Nd waves associated with frequency processing had
      scalp distributions different from those associated with location processing,
      implying that the features were analyzed in distinct cortical areas. Nd waves
      specific to auditory feature conjunction were isolated. These began at latencies
      of 110-120 msec, some 30-40 msec after the Nds to single features. The relative
      timing of the different Nd waves suggests that auditory feature conjunction
      begins after a brief parallel analysis of individual features but before feature
      analysis is complete.

PMID- 8483704
TI  - Evaluating a computational model of perceptual grouping by proximity.
AB  - A formal approach to the phenomenon of perceptual grouping by proximity was
      investigated. Grouping judgments of random dot patterns were made by the CODE
      algorithm (van Oeffelen & Vos, 1982) and several related algorithms, and these
      judgments were compared with subjects' grouping judgments for the same stimuli.
      Each algorithm predicted significantly more subject judgments than would be
      expected by chance. The more subjects agreed on how a given dot pattern should be
      grouped, the more successful was the algorithms' ability to match the judgments
      for that pattern. CODE predicted significantly fewer subject judgments than did
      some of the other algorithms, largely because of its overemphasis on the extent
      of interactivity among dots as they are being grouped.

PMID- 8483705
TI  - Mechanisms in the haptic horizontal-vertical illusion: evidence from sighted and
      blind subjects.
AB  - The haptic horizontal-vertical illusion was studied in two experiments. In
      Experiment 1, the illusion was relatively weak in sighted subjects and depended
      on stimulus size and the nature of the figure, that is, whether the pattern was
      an inverted-T or L shape. Experiment 2 compared early blind and late blind
      subjects. The illusion was present for an inverted-T figure but absent for an L
      figure in late blind subjects. However, the early blind subjects treated both the
      L and T figures as similar and showed the illusion to both. These results support
      the idea that visual experience may alter haptic judgments in sighted and late
      blind subjects.

PMID- 8483706
TI  - Properties of curvilinear vection.
AB  - Approximately linear relationships were observed between contrast, spatial
      frequency, temporal frequency, or velocity of stimulation and perceived velocity
      of curvilinear vection--that is, a visually induced self-motion in a curved path.
      Similarly, linear relationships were also found between the perceived degree of
      curvature of curvilinear vection and spatial frequency or velocity of
      stimulation. Since the perceived velocity of curvilinear vection varies with
      contrast, spatial frequency, temporal frequency, and angular velocity, and the
      perceived degree of curvature of curvilinear vection varies only with spatial
      frequency and angular velocity, peripheral vision is not sufficient for computing
      accurately the curvilinear component of induced self-motion in a curved path.
      Concurrently, it was shown that the perceived direction of curvilinear vection is
      not always unambiguously perceived (Sauvan & Bonnet, 1989). Consequently, it is
      suggested that two different types of visual processing, which involve the
      peripheral or the central vision, underlie the processing of curvilinear vection.

PMID- 8483707
TI  - Influences of closure, occlusion, and size on the perception of fragmented
      pictures.
AB  - Two experiments examined the ability to recognize a repeated figure in stimuli
      where only fragments of the figures were presented. Fragments were either closed
      or open regions presented either with or without an occluder that filled the
      spaces between the fragments (Experiment 1). Recognition performance was
      significantly better for open fragments, with or without an occluder, contrary to
      previous assertions that the occluder is the important factor for recognition.
      When stimulus size was varied, an occluder hindered recognition performance in
      the smallest size condition relative to unoccluded stimuli, which were equally
      easy to recognize across all size conditions (Experiment 2). The size results
      support the idea of size invariance in object naming. The difficulty in the
      smallest occluded condition is discussed in terms of differences in global and
      local processing depending on visual angle and sparsity.

PMID- 8483708
TI  - Event-related brain potentials reflect traces of echoic memory in humans.
AB  - In sequences of identical auditory stimuli, infrequent deviant stimuli elicit an
      event-related brain potential component called mismatch negativity (MMN). MMN is
      presumed to reflect the existence of a memory trace of the frequent stimulus at
      the moment of presentation of the infrequent stimulus. This hypothesis was tested
      by applying the recognition-masking paradigm of cognitive psychology. In this
      paradigm, a masking sound presented shortly before or after a test stimulus
      diminishes the recognition memory of this stimulus, the more so the shorter the
      interval between the test and masking stimuli. This interval was varied in the
      present study. It was found that the MMN amplitude strongly correlated with the
      subject's ability to discriminate between frequent and infrequent stimuli. This
      result strongly suggests that MMN provides a measure for a trace of sensory
      memory, and further, that with MMN, this memory can be studied without
      performance-related distortions.

PMID- 8483709
TI  - Perceived numerosity of spatiotemporal events.
AB  - Numerosity discrimination was examined when items were varied in space-time
      position rather than in space only. Observers were instructed to indicate which
      of two adjacent streams of visual events contained more items. The precision of
      numerosity discrimination of dynamic events was not remarkably different from
      that of static patterns. Two basic numerosity biases previously found for static
      dot patterns--inhibitory overestimation and satellite underestimation--were
      demonstrated for items distributed randomly over a spatiotemporal interval. It
      was also demonstrated that two streams, equated in the number and luminous energy
      of items, are not judged equal in their visible number if items in one of these
      two streams have longer duration than items in the second stream. These findings
      can be accounted for by the occupancy model of perceived numerosity (Allik &
      Tuulmets, 1991a) if it is supposed that the impact that each element has on its
      neighborhood is spread along both spatial and temporal coordinates. Perceived
      numerosity decreases with both spatial and temporal proximity between the visual
      items. Space and time have interchangeable effects on perceived numerosity: the
      amount of numerosity bias caused by the spatial proximity of items can also be
      produced by the properly chosen temporal proximity of items.

PMID- 8483710
TI  - A message to students--for all nurses.

PMID- 8483711
TI  - New Jersey State Nurses' Association history: what is past is prologue.

PMID- 8483712
TI  - Current nursing concerns--ethics arena.

PMID- 8483713
TI  - Practical nursing programs test catalog 1993.

PMID- 8483714
TI  - Community health concepts in associate degree curriculum.

PMID- 8483715
TI  - Educational accountability for an aging society.

PMID- 8483716
TI  - The prospective of long-term care educational partnerships: an essential
      community collaboration.

PMID- 8483717
TI  - Developing management skills through a preceptor-based experience in community
      nursing homes.

PMID- 8483718
TI  - Nursing education and computers: in retrospect and prospect.

PMID- 8483719
TI  - Innovation in the classroom: how to meet the technological challenge.

PMID- 8483720
TI  - Interactive videodisc technology in nursing education.

PMID- 8483721
TI  - The success project: a model to increase admission, retention, and graduation of
      minority students.

PMID- 8483722
TI  - Culture in curriculum: a process for integrating multicultural elements into the
      nursing curriculum.

PMID- 8483723
TI  - Prospectives: creating the future. The story of a teacher-student partnership.

PMID- 8483724
TI  - Caring: a meaning of competence.

PMID- 8483725
TI  - Teaching nursing content to the 90s learner.

PMID- 8483726
TI  - The curriculum revolution: implications for associate degree nursing education.

PMID- 8483727
TI  - Journal usage in the clinical area: a guide for nursing educators.

PMID- 8483728
TI  - Partnership for change: improving the medication experience.

PMID- 8483729
TI  - A unique approach to first semester.

PMID- 8483731
TI  - Grading bypass.

PMID- 8483730
TI  - What's your poison?

PMID- 8483732
TI  - Difficult choices.

PMID- 8483733
TI  - Capital gains.

PMID- 8483734
TI  - Great expectations.

PMID- 8483735
TI  - Lessons for the teacher.

PMID- 8483736
TI  - Modern studies.

PMID- 8483737
TI  - Systems of life. The nervous system. 7.

PMID- 8483738
TI  - Transfer time?

PMID- 8483739
TI  - Home truths.

PMID- 8483740
TI  - One of the family.

PMID- 8483741
TI  - The new game in town.

PMID- 8483742
TI  - Facial expressions as pain indicators.

PMID- 8483743
TI  - Extent of glove damage during surgery.

PMID- 8483744
TI  - Do women prefer single-sex GUM clinics?

PMID- 8483745
TI  - Intensive therapy. High-tech mix.

PMID- 8483746
TI  - New advice on hepatitis B.

PMID- 8483747
TI  - Students with HIV may be barred from training.

PMID- 8483748
TI  - Primary care teams for HIV/AIDS clients.

PMID- 8483749
TI  - Safer sex package designed to help young offenders.

PMID- 8483750
TI  - Testing time.

PMID- 8483751
TI  - Out in the cold.

PMID- 8483752
TI  - Getting it wrong.

PMID- 8483753
TI  - One step back.

PMID- 8483754
TI  - Saved by the pig?

PMID- 8483755
TI  - Transplants. Gift of life.

PMID- 8483756
TI  - Transplants. Tissue of progress.

PMID- 8483757
TI  - Transplants. Match point.

PMID- 8483758
TI  - Proper precautions?

PMID- 8483759
TI  - No room for change.

PMID- 8483760
TI  - Living and learning in supported housing.

PMID- 8483761
TI  - Prescription for change.

PMID- 8483762
TI  - Road to recovery.

PMID- 8483763
TI  - UKCC beefs up guidance on HIV-positive staff.

PMID- 8483764
TI  - Talking it through.

PMID- 8483765
TI  - Coughing in infants after thickened feeds.

PMID- 8483767
TI  - Quality assurance and infection control.

PMID- 8483766
TI  - Does counseling help hysterectomy patients?

PMID- 8483768
TI  - Protective instincts.

PMID- 8483769
TI  - Continence. Well disposed?

PMID- 8483770
TI  - Continence. Mix and match.

PMID- 8483771
TI  - Continence. A helping handle.

PMID- 8483772
TI  - An evaluation of the physical and functional characteristics of infant
      resuscitators.
AB  - Self-inflating resuscitators (SIRs) are commonly used to assist ventilation in
      the newborn. Despite their widespread use, there is limited information available
      on the functional and physical characteristics of SIRs. We studied five new
      infant bag-valve units to compare their physical characteristics, including
      reservoir, accumulator, and dead space volumes (VD), pressure relief mechanism
      (PRM), inspiratory resistance (RI), and functional mechanics including stroke
      volume (SV), fraction of delivered oxygen (FDO2), and cycle frequency at -5
      degrees C, 20 degrees C, and 49 degrees C, using a test lung apparatus and
      experienced respiratory therapists. In addition, deficiencies and features that
      may render them less than ideal were sought. All SIRs met minimum standards for
      reservoir and accumulator volumes, RI (< 20 cmH2O/L/sec), SV (20-70 ml), and FDO2
      (> 90%) as determined by the Canadian Standards Association (CSA) and the
      American Society for Testing of Materials (ASTM). However, the following
      deficiencies were noted: 1) MPR and Pulmanex had no PRM (ASTM requirement); 2)
      MPR could not cycle at -5 degrees C; 3) the VDs for Pulmanex (10 ml) and MPR (15
      ml) were high; 4) the CPR connector broke during normal use, and the MPR
      connector frequently disconnected; 5) the Laerdal expiratory valve was
      incompetent; and 6) the Laerdal and CPR could be misassembled for use. Our study
      shows that some commercially available SIRs do not meet all CSA and ASTM
      standards and may not be ideal in specific clinical situations. The choice of a
      SIR may be dictated by the clinical situation in which its use is intended.

PMID- 8483773
TI  - Do not resuscitate.

PMID- 8483774
TI  - A five year old with a pacemaker.

PMID- 8483775
TI  - Elbow injury.

PMID- 8483776
TI  - Case 01-1993: a six-year-old girl with respiratory distress following involvement
      in a motor vehicle crash.

PMID- 8483777
TI  - Bronchodilator therapy in wheezy infants: a commentary.

PMID- 8483778
TI  - Pediatric emergency medicine fellowship programs.

PMID- 8483779
TI  - Legal concerns about the private patient in the pediatric emergency department.

PMID- 8483780
TI  - Examining the common dilemma of whether to order skull radiographs on
      asymptomatic infants with minor head injury.

PMID- 8483781
TI  - Emergency transport and positioning of young children who have an injury of the
      cervical spine.

PMID- 8483782
TI  - Transport stabilization times for neonatal and pediatric patients prior to
      interfacility transfer.
AB  - The stabilization times for 2863 neonatal and pediatric interfacility transports
      are reported. Appropriate stabilization of the sick neonate and pediatric
      patients prior to transfer is considered essential to reduce the adverse events
      that may otherwise occur during the transfer process. The median stabilization
      time for a neonate was 80 minutes, and it was 45 minutes for a pediatric patient.
      These times can be used by other transport systems to evaluate their services
      through quality assurance, as well as for staff and budgeting purposes. New
      interventions that reduce stabilization times can be evaluated with these times
      as a reference.

PMID- 8483783
TI  - Referral, admission, and discharge patterns in a pediatric emergency department
      in Israel.
AB  - The pediatric emergency department (PED) is an important component of the medical
      services provided by a hospital. The purpose of the study was to describe the
      patterns of referrals, admissions, and discharges in a PED to determine to what
      extent the PED is used solely as an emergency unit, as opposed to being used as a
      part of a set of primary care facilities. Data were recorded from 1200 patient
      charts, out of 19,000 visits to a PED in Israel in 1988. Variables such as age,
      sex, ethnicity, and distance between residence and hospital were checked. About
      half of the patients arrived during the morning shift. There was an inverse
      relationship between the distance from the patient's home to the hospital and the
      rate of visits to the PED. Fifty-eight percent of the total were self-referred;
      this rate increased to 84% during the night shift. Only one quarter of all
      children had additional laboratory or x-ray tests. Most of the diagnoses did not
      require emergency services. Eighty-one percent of the patients were discharged
      from the PED to their community physician. The rate of admissions was low (11%).
      This study shows that a large part of the PED work is actually primary care. Some
      of the demographic, cultural, and ethnic reasons for these patterns are reviewed.

PMID- 8483784
TI  - Inefficacy of intraperitoneal fluid administration in a shock model.
AB  - Intraperitoneal (IP) fluid administration has been previously used to treat
      dehydrated children. The relative ease and reported safety of this route suggests
      its potential utility for volume resuscitation in the acutely ill child. Previous
      research regarding IP fluid infusion has not examined its use in shock states.
      This experiment sought to examine the efficacy of an IP fluid infusion in a shock
      model. Ten immature swine were randomized to receive either no treatment (n = 5)
      or 30 ml/kg of warmed lactated Ringer's solution (n = 5) IP 20 minutes after a
      graded 40% hemorrhage. Mean arterial pressure (MAP), heart rate (HR), hematocrit
      (Hct), pH, and PCO2 were determined serially, and the experiment concluded 60
      minutes after intervention. A mean of 89.5% of the administered fluid load was
      recovered from the peritoneal cavity, and the IP infusion had no ameliorative
      effect on MAP or HR. The lack of clinically significant absorption of an
      administered isotonic intraperitoneal fluid infusion in this model suggests that
      this route should not be relied upon in the critically ill child presenting in
      shock.

PMID- 8483785
TI  - Prevention of hypoxemia during lumbar puncture in infancy with preoxygenation.
AB  - Hypoxemia has previously been reported during lumbar puncture (LP) in infancy.
      The purpose of this study was to determine whether preoxygenation before the LP
      would reduce hypoxemia during the procedure in infants. Twenty-one infants (one
      to 15 weeks of age) undergoing LP for evaluation of possible sepsis were randomly
      assigned to the control group (12) or treatment group (9). The treatment group
      was preoxygenated breathing oxygen (FiO2 = 1.0) spontaneously via snug face mask
      for three minutes prior to being positioned for the LP. The control group
      spontaneously breathed room air during this interval. Oxyhemoglobin saturation
      was measured prior to, and continuously during, the LP with pulse oximetry. The
      groups were comparable in age, resting respiratory rate, baseline saturation, and
      duration of the procedure. The treatment group developed significantly less
      desaturation during the procedure than the control group (P < 0.05). We conclude
      that preoxygenation prior to LP prevents most of the hypoxemia resulting from the
      procedure in infants.

PMID- 8483786
TI  - Correlating infectious outcome with clinical parameters of 1130 consecutive
      febrile infants aged zero to eight weeks.
AB  - The study objectives were to characterize the infectious outcomes and associated
      clinical parameters of a large group of febrile young infants who received
      outpatient sepsis evaluation. This retrospective review of consecutive cases
      during a seven-year period was set in an urban pediatric emergency department.
      Febrile infants, aged zero to eight weeks, were the participants. All received a
      standard evaluation for sepsis, including complete blood count/blood culture,
      lumbar puncture/cerebrospinal fluid culture, and urinalysis/urine culture. Of
      1130 patients, 447 (42%) were aged zero to four weeks, and 683 (58%) were aged
      four to eight weeks. In 96 cases (8.5%), a bacterial pathogen was isolated by
      culture of cerebrospinal fluid, blood, urine, or stool; 58% were aged zero to
      four weeks and 42% were aged four to eight weeks. The rate of positive cultures
      per patient age was doubled in those aged zero to four weeks (12%) compared with
      those aged four to eight weeks (6%). The 49 cases of invasive bacterial
      infections (bacterial meningitis/bacteremia) were most commonly associated with
      lower degrees of fever, as slightly over one half (25/49) had temperature < 39
      degrees C. The most common pathogens of invasive bacterial infection were group B
      streptococcus and Escherichia coli, accounting for 33 of 49 cases (67%); the most
      common pathogens of invasive bacterial infection in older children (Haemophilus
      influenzae type b and Streptococcus pneumoniae) were relatively underrepresented,
      accounting for only five of these 49 (10%) cases.

PMID- 8483787
TI  - Neonatal psoas pyomyositis simulating pyarthrosis of the hip.
AB  - Osteomyelitis with concomitant pyarthrosis or isolated pyarthrosis heads the
      differential list for a newborn with limb disuse and a flexion deformity of the
      hip. The diagnosis of psoas abscess, a primary suppurative myositis, should
      additionally be entertained. Stronger consideration should be given to this
      clinical entity after pyarthrosis of the hip has been excluded by an
      arthrocentesis performed under fluoroscopy. Radiologic imaging may facilitate the
      diagnosis. A blood culture may yield the organism responsible for the skeletal
      muscle abscess, even in nontoxic patients.

PMID- 8483788
TI  - Penile zipper entrapment: a simple and less threatening approach using mineral
      oil.
AB  - Penile zipper entrapment, when it presents to the office or emergency department,
      can prove to be a challenging management problem. An easily implemented
      alternative approach is presented, along with a review of previously reported
      experience with this problem.

PMID- 8483789
TI  - An infant with transient intracranial hypertension associated with a febrile
      illness.

PMID- 8483790
TI  - Injuries sustained during flipping--a new fad activity.
AB  - This article describes a small series of injuries resulting from a new fad
      activity among children in Baltimore. "Flipping" involves jumping from an
      elevated surface and executing an aerial flip, with the intent to land upright.
      Because this activity takes place frequently on hard surfaces such as concrete,
      injuries often result. The spectrum of injuries is described and categorized, and
      injuries are compared with those received during similar activities, such as
      break dancing or skateboarding, and with playground injuries. Pediatricians and
      emergency physicians should be aware of the potential for injury in this
      activity.

PMID- 8483791
TI  - Pediatric cardiopulmonary resuscitation: an update based on the new American
      Heart Association guidelines.

PMID- 8483792
TI  - Synthetic peptides inhibit the interaction of von Willebrand factor-platelet
      membrane glycoproteins.
AB  - We synthesized peptides of the general formula Argn, Lysn, and (Lys-Arg)n. These
      agents inhibited the ristocetin-mediated binding of vWF to GPIb and the binding
      of asialo-vWF to platelets. This inhibitory activity was proportional to the
      number of lysine and/or arginine residues/molecules present. Peptides to which
      the sequence of Arg-Gly-Asp-Val (RGDV) had been added at the carboxy-terminus of
      (Lys-Arg)n, Lysn, or Argn also inhibited vWF binding. Peptides with an RGDV
      sequence were found to block the binding of 125I-fibrinogen to ADP-stimulated
      platelets. These findings indicate that the general formulae (Lys-Arg)n, Lysn,
      and Argn with an RGDV sequence inhibit the binding of fibrinogen to activated
      platelets as well as the binding of vWF to GPIb. Thus, these peptides may behave
      as bifunctional antiplatelet agents.

PMID- 8483793
TI  - Isolation of <Glu-Asn-Phe-His-Leu-Arg-Pro-NH2 (Antho-RPamide II), a novel,
      biologically active neuropeptide from sea anemones.
AB  - Using a radioimmunoassay against the C-terminal sequence Arg-Pro-NH2 (RPamide) we
      have isolated the neuropeptide <Glu-Asn-Phe-His-Leu-Arg-Pro-NH2 (Antho-RPamide
      II) from extracts of the sea anemone Anthopleura elegantissima. Addition of low
      concentrations of Antho-RPamide II to a tentacle preparation of sea anemones
      inhibited the spontaneous, rhythmic contractions, suggesting that the peptide is
      a neurotransmitter or neuromodulator.

PMID- 8483794
TI  - Interactions between corticotropin-releasing factor and endogenous opiates on the
      cardioaccelerator, hypothermic, and corticoid responses to restraint in the rat.
AB  - These experiments investigated the effect of either systemic opiate blockade by
      naloxone (5 mg/kg) or intracerebroventricular CRF (250 pmol), or the two
      treatments combined, on physiological and endocrine responses of male rats to two
      types of stress: restraint by itself (representing a psychological stress), and
      restraint combined with a tail clip (representing an additional mild physical
      nociceptive stress). Rats were restrained in a plastic container for 15 min, with
      or without a tail clip. Heart rate, body temperature, and serum corticosterone
      were measured. The first experiment showed that restraint induced marked
      tachycardia, maximal at 5 min, and declining thereafter. There was also a
      pronounced hypothermia, maximal at 10 min, and serum corticosterone was elevated
      10 min after the end of the period of restraint. The presence of a tail clip
      increased the cardioaccelerator response, but had no effect on hypothermia.
      Naloxone had no effect on heart rate during restraint or on postrestraint
      corticosterone, but accentuated hypothermia. The effects of naloxone occurred
      independently of the presence of a tail clip. A subsidiary experiment showed that
      rats transferred to an unfamiliar cage showed a marked hyperthermic response, as
      described by others. The second experiment showed that CRF (250 pmol ICV) did not
      modify the tachycardiac response to restraint, but reduced hypothermia. This also
      occurred irrespective of the presence of a tail clip. The third experiment
      investigated the interaction between naloxone and CRF, and showed that the
      ameliorative effects of ICV CRF on restraint-induced hypothermia were prevented
      by systemic naloxone, but that neither tachycardia nor corticosterone responses
      were altered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483795
TI  - The peripheral modulation of duodenal and colonic motility in rats by the
      pancreatic polypeptide-fold family: neuropeptide Y, peptide YY, and pancreatic
      polypeptide.
AB  - Neuropeptide Y (NPY), peptide YY (PYY), and pancreatic polypeptide (PP) altered
      intraluminal pressure in the duodenum and colon of fasted anesthetized rats
      following intravenous bolus administration. There were rapid increases in
      intraluminal pressure of the duodenum and colon of anesthetized rats following
      peripheral injections of NPY, PYY and PP. Administration (IV) of NPY, PYY, and PP
      increased intraduodenal pressure +1.8, +3.2, and +3.7 mmHg compared to saline
      baseline. Prazosin, an alpha-2 adrenergic antagonist, did not alter the response
      of the duodenum of urethane-anesthesized rats to any of the PP-fold peptides
      following peripheral administration. Yohimbine, an alpha 2-adrenergic antagonist,
      attenuated the excitatory response of rat duodenum following NPY (IV) but did not
      alter the duodenal response to PP (IV). Intravenous NPY, PYY, and PP increased
      intracolonic pressure +2.0, +3.3, and +6.2 mmHg compared to saline baseline. In
      the presence of prazosin, an alpha 1-adrenergic antagonist, the intraluminal
      pressure of the colon increased +2.6, +2.4, and +8.1 mmHg compared to saline
      baseline by NPY, PYY, and PP (IV), respectively. In the presence of alpha 2
      adrenergic blockade by yohimbine, NPY, PYY, and PP (IV) increased intraluminal
      pressure of the colon +4.2, +2.9, and +2.5 mmHg compared to saline baseline. The
      response of the duodenum to the excitatory effect of PYY (IV) was enhanced in the
      presence of yohimbine. Duodenal and colonic tone were modulated by the PP-fold
      peptides following peripheral administration. The alpha-adrenergic nervous system
      played only a minor role in the modulation of GI motility by the PP-fold peptides
      at peripheral sites.

PMID- 8483796
TI  - Experience-dependent regulation of Leu-enkephalin hydrolysis in rat plasma.
AB  - We examined experience-dependent alterations in the production of individual
      enkephalin metabolites during Leu-enkephalin hydrolysis in rat plasma in vitro.
      High performance liquid chromatography separation and electrochemical detection
      were used to quantify accumulation of the primary N-terminal products of
      enkephalin hydrolysis, Tyr and Tyr-Gly-Gly. Blood was sampled from rats through
      indwelling femoral artery catheters before, during, and after active avoidance
      training or appropriate control treatments. Avoidance training increased Tyr
      production, as did handling and exposing animals to the novel avoidance chamber
      without foot-shock training. On the other hand, Tyr-Gly-Gly production was
      elevated by blood sampling alone, by handling/novelty, and by training, but the
      effect of training was significantly greater than the effects of either of the
      other treatments. Interestingly, Tyr-Gly-Gly production was highly correlated (r
      = -0.885) with a measure of escape performance. Since the enzymes that
      participate in enkephalin hydrolysis act upon a number of peptides, regulation of
      enzyme activity may be one mechanism whereby an organism can modulate levels of
      circulating peptides in response to environmental experiences; this may
      contribute to the expression of appropriate behavioral responses to those
      environmental experiences.

PMID- 8483797
TI  - Peptidergic modulation of in situ canine intrinsic cardiac neurons.
AB  - In order to determine which peptides are involved in modulating intrinsic cardiac
      neurons, angiotensin II, atrial natriuretic peptide, bradykinin, calcitonin gene
      related peptide, enkephalin, neuropeptide Y, oxytocin, substance P, and
      vasoactive intestinal peptide dissolved in saline were administered individually
      by microinjection adjacent to spontaneously active canine intrinsic cardiac
      neurons. No neuronal or cardiac responses were elicited when saline was
      administered into active loci or when peptides were administered into loci with
      no spontaneous activity. Each peptide elicited neuronal responses when
      administered into active loci in most animals, bradykinin eliciting neuronal
      responses in every active locus studied. Concomitant cardiovascular responses
      were elicited in many cases when every peptide except atriopeptin was studied.
      After cardiac decentralization, neuronal and cardiovascular responses to repeat
      doses of peptides occurred with less frequency than before decentralization,
      implying that connections with central and other intrathoracic neurons can
      influence the function of peptide-sensitive intrinsic cardiac neurons. After
      atropine and timolol administration, cardiovascular, but not neuronal, responses
      to peptides were eliminated, indicating that cardiovascular responses were
      dependent upon efferent parasympathetic and sympathetic neurons. It is concluded
      that a number of neuropeptides may be involved in regulation of cardiac function
      by intrinsic cardiac neurons.

PMID- 8483798
TI  - Circadian effects of beta-endorphin, melatonin, DSIP, and amphetamine on
      pentylenetetrazol-induced seizures.
AB  - Circadian effects on PTZ-induced seizure thresholds alone and following drug
      pretreatment were studied in 720 male rats, divided into 40 groups of 18 each.
      Each rat was tested only once, at one of eight clock hours and under one of five
      drug pretreatments. Clear cyclic changes in thresholds were found. Drug effects
      on the rhythm were similar for DSIP and beta-endorphin, which produced higher
      thresholds during the night periods, while d-amphetamine and melatonin decreased
      the threshold during that period. All drugs increased the vulnerability to
      seizures relative to the saline control during the daytime, while only beta
      endorphin and DSIP offered improved protection during the night hours. The
      possibility of dopaminergic mediation is suggested to account for the effects.

PMID- 8483799
TI  - Cholinergic regulation of motilin release from isolated canine intestinal cells.
AB  - An in vitro model was developed to study the regulation of motilin release from
      its endocrine-producing cell. Enzymatically dispersed cells from canine
      duodenojejunal mucosa were separated by centrifugal counterflow elutriation to
      enrich motilin content. From the motilin-enriched cell preparation, the release
      of motilin was determined under stimulation with various agents. Carbachol dose
      dependently stimulated the release of motilin from its producing cell. Bombesin,
      morphine, and erythromycin, recognized stimulants for motilin release in vivo,
      failed to influence the secretion of motilin in vitro. Serotonin, GIP, CCK,
      pentagastrin, cisapride, neosynephrine, isoproterenol, or muscimol were also
      ineffective in the in vitro model. The response to carbachol was abolished by
      atropine but was not affected by somatostatin, serotonin, secretin, CCK, or GIP.
      These results suggest that muscarinic receptors are present on the motilin cell
      membrane and that acetylcholine is a major regulator of motilin release.

PMID- 8483800
TI  - Differential distribution of chicken-I and chicken-II GnRH in the turtle brain.
AB  - Chicken-I and chicken-II gonadotropin-releasing hormone (cI-GnRH and cII-GnRH)
      were shown to be differentially distributed in the brain of a turtle, Trachemys
      scripta, by HPLC and specific radioimmunoassays. The cI-GnRH was most
      concentrated in the median eminence (ME), while cII-GnRH was most concentrated in
      the caudal brain regions, especially medulla and cerebellum. The ratio of cI- to
      cII-GnRH in the ME of adults was 8:1. Age- and sex-related differences in GnRH
      concentrations were observed exclusively in the ME: adult females had
      significantly higher cI-GnRH than younger females and adult males; adult females
      also had significantly higher cII-GnRH than hatching females. Their differential
      distribution and sex- and age-related differences suggest that the two peptides
      may have distinct physiological roles; cI-GnRH is likely the form responsible for
      stimulating gonadotropin release.

PMID- 8483801
TI  - Cardiovascular and abdominal motor responses evoked by intravenous neurotensin in
      guinea pigs.
AB  - The intravenous (IV) infusion of neurotensin (NT) in anesthetized guinea pigs was
      found to elicit dose-dependent increases of systemic blood pressure (BP) and of
      heart rate (HR), accompanied by abdominal motor responses consisting in
      transient, twitch-like contractions of the abdominal wall (TAWC), and a slowly
      developing, relatively sustained increase of the basal abdominal wall tension
      (AWT). The TAWC responses were inhibited in animals pretreated with pancuronium,
      morphine, clonidine, and CP-96,345 [a neurokinin (NK) antagonist], were
      potentiated by naloxone, but were not modified by atropine or prior (30 s)
      intraperitoneal (IP) injection of lidocaine. The BP increases caused by IV NT
      were reduced by clonidine and by IP lidocaine only. The HR increases were
      attenuated by morphine and clonidine only. Increases of the basal AWT were
      resistant to all drug treatments and were attributed to a passive stretch of the
      abdominal wall caused by cecal distension. No defecation was observed in any of
      the animals given IV NT. These results were interpreted as an indication that the
      pressor and TAWC responses to IV NT represent an integrated nociceptive response
      likely to be triggered in part by NT-induced activation of abdominal visceral
      afferents. A NK acting through NK-1 receptors may participate in TAWC responses
      to IV NT.

PMID- 8483802
TI  - Pituitary adenylate cyclase activating polypeptide (PACAP) increases cytosolic
      free calcium concentration in folliculo-stellate cells and somatotropes of rat
      pituitary.
AB  - Pituitary adenylate cyclase activating polypeptide (PACAP) is a new member of the
      secretin/VIP peptide family. In order to identify pituitary target cells for
      PACAP, we examined the effect of PACAP on the cytosolic-free Ca2+ concentrations,
      [Ca2+]i, in cells using Fura-2 and a digital imaging system. In a concentration
      dependent manner, PACAP increased [Ca2+]i in pituitary cells, from 10(-11) to 10(
      8) M. Some cells responded to PACAP at 10(-11) M, while others only at 10(-8) M,
      showing a diversity among cells in the sensitivity to PACAP. Both PACAP and
      growth hormone-releasing factor (GRF) at 10(-8) M increased [Ca2+]i in 25% and
      33% of the total pituitary cells, respectively. About 38% of the GRF-responsive
      cells also responded to PACAP. Some of the cells that responded to PACAP were
      immunocytochemically identified as growth hormone (GH) cells or folliculo
      stellate (FS) cells using antisera against GH or S-100 protein, respectively. The
      results indicate that both the folliculo-stellate cells and GH cells of the
      pituitary are the direct targets for PACAP, but the possibility that other cell
      types also respond to PACAP cannot be excluded.

PMID- 8483803
TI  - The effects of neonatal capsaicin on plasma levels and tissue contents of CGRP.
AB  - Tissue contents and plasma levels of IR-CGRP were studied following
      administration of capsaicin to newborn rats. A depletion of > 50% of IR-CGRP
      content was seen in the cardiovascular tissues (e.g., heart and peripheral
      arteries), lungs, gastrointestinal tract (e.g., esophagus, stomach, and
      intestine), genitourinary tract (e.g., ureter, bladder, uterus, and penis), and
      in the nervous system (e.g., dorsal root and trigeminal ganglia, sciatic and
      trigeminal nerves, and dorsal spinal cord) in capsaicin-treated rats, in
      comparison with the control rat tissues (p < 0.01). These findings are compatible
      with the known involvement of capsaicin of the unmyelinated sensory C and A delta
      fibers and hence their distribution in the nervous system and other organs.
      Plasma IR-CGRP levels were also significantly lower in the capsaicin-treated rats
      throughout their life span (p < 0.001), suggesting that, at least in part,
      circulating CGRP is derived from the nervous system. RP-HPLC confirmed the
      identity of CGRP in both tissue and plasma extracts.

PMID- 8483804
TI  - Different effects of CCK antagonists on gastric-acid response to CCK and
      pentagastrin.
AB  - The role of CCK receptor subtypes in peptide-stimulated acid secretion was
      assessed in six unanesthetized rats. The CCK-stimulated acid secretion was not
      blocked by L-365,260, a CCKB/gastrin receptor antagonist, and was significantly
      increased by devazepide, a CCKA receptor antagonist, given alone or together with
      L-365,260. L-365,260, but not devazepide, blocked pentagastrin-stimulated acid
      secretion, and, when given together, devazepide abolished the effect of L
      365,260. We conclude: 1) pentagastrin stimulates acid secretion through a gastrin
      type receptor, but CCK may not, and 2) pentagastrin and CCK can stimulate acid
      secretion despite simultaneous blockade of CCKB/gastrin and CCKA receptors.

PMID- 8483805
TI  - Modulatory effects of vasopressin on glucose and protein metabolism during food
      restriction stress.
AB  - Plasma levels of glucose and urea nitrogen were compared in vasopressin
      containing (LE) and vasopressin-deficient (DI) rats under ad lib and food
      restricted conditions. In the ad lib situation, DI and LE rats had similar levels
      of glucose and urea nitrogen. Variations in this pattern were observed under food
      restricted conditions. The DI animals exhibited lower levels of glucose and
      higher levels of urea nitrogen than their LE counterparts. During food
      restriction, the glucose levels of LE animals were not different from that
      observed under ad lib conditions. A significant decrease, however, was observed
      in the glucose levels in DI animals during food restriction. Urea nitrogen levels
      in LE animals decreased during food restriction as compared to the ad lib
      situation, whereas urea nitrogen levels of DI animals increased during food
      restriction. These observations indicate that vasopressin has a modulatory role
      on glucose and protein metabolism during the stress of food restriction.

PMID- 8483806
TI  - Mitogenic effect of neuropeptide Y in rat vascular smooth muscle cells.
AB  - Neuropeptide Y (NPY) is a vasoconstrictor released with norepinephrine from
      perivascular sympathetic nerves. Since sympathetic nerves appear to play a role
      in vascular smooth muscle cell (SMC) hypertrophy, we studied the effects of NPY
      on proliferation of cultured rat aorta- and vena cava-derived SMC. Both cell
      types displayed high-affinity NPY binding sites with displacement characteristics
      of [Pro34]NPY > NPY(13-36) > NPY(18-36) in aorta and [Pro34]NPY = NPY(13-36) =
      NPY(18-36) in the vena cava. Incubation with NPY (50-1000 nM) for 48 h increased
      by up to twofold cell number and [3H]-thymidine incorporation in both cell types
      (aortic more sensitive to NPY than venous). Following incubation with NPY, the
      disappearance of NPY immunoreactivity (-IR) from media was markedly delayed in
      the presence of SMC, and cell content of NPY-IR increased in a dose-dependent
      manner, indicating that SMC either diminish degradation of the peptide (possibly
      by internalization) or secrete endogenous NPY (or both). Structure-activity
      relationship studies with NPY(18-36) indicated involvement of Y1 receptors in
      mitogenesis. Thus, NPY has a mitogenic effect (probably mediated by Y1 receptors)
      and, therefore, may be a sympathetic trophic factor involved in vascular
      hypertrophy.

PMID- 8483807
TI  - Parathyroid hormone-induced dopamine turnover in the rat medial basal
      hypothalamus.
AB  - The parathyroid hormone (PTH) gene is expressed and translated in the rat
      hypothalamus, and the possibility that PTH may modulate neural activity was
      therefore examined in anesthetized rats. Intracerebroventricular (ICV) injections
      of 1.0 or 10.0 micrograms rat, human, or bovine PTH(1-34) was followed 60 min
      later by increased concentrations of DOPAC (dihydroxyacetic acid) and the
      DOPAC:dopamine (DA) ratio in the medial basal hypothalamus (MBH), but not in
      other (brainstem, cerebral cortex, cerebellum) regions of the brain. Tissue
      concentrations of norepinephrine and serotonin were unchanged by ICV PTH
      administration, although MBH concentrations of 5-hydroxyindolacetic acid (5-HIAA)
      were increased following PTH administration. An increase in MBH DA turnover (as
      indicated by an increased DOPAC:DA ratio) was also induced by the ICV injection
      of 10 micrograms PTH-related protein [PTHrP(1-34)]. Pretreatment with the
      receptor antagonists PTH(7-34) or PTHrP(7-34) completely blocked the subsequent
      DOPAC response to ICV PTH or PTHrP, respectively. The DOPAC concentrations in
      hypothalamic extracellular fluid (ECF), sampled by microdialysis, were also
      increased within 20 min of PTH(1-34) perfusion, in the absence of changes in the
      ECF concentrations of 5-HIAA. These results demonstrate that PTH and PTH-like
      peptides specifically increase DA turnover in the rat MBH and suggest novel roles
      for these hormones in neural regulation.

PMID- 8483808
TI  - Testosterone increases TRH biosynthesis in epididymis but not heart of zinc
      deficient rats.
AB  - Enzymes responsible for the posttranslational processing of precursor proteins to
      form alpha-amidated peptide hormones require the availability of several
      cofactors, including zinc, copper, and ascorbic acid. For this reason, we studied
      the effects of 6 weeks of a zinc-deficient diet (ZD1; 1 microgram zinc per g
      diet), pair-feeding (PF), and marginal zinc deficiency (ZD6; 6 micrograms zinc
      per g diet) compared to a control diet (36 micrograms/g zinc) on the conversion
      of prepro-TRH to TRH in epididymides, testes, prostate, pancreas, and heart of
      young adult, male Sprague-Dawley rats. In the epididymis, severe zinc deficiency
      (ZD1 diet) reduced TRH and TRH-like peptides to undetectable levels. In ZD6
      animals, TRH was selectively inhibited 80%, while pair-feeding increased all of
      these peptide levels compared to controls. A similar effect of zinc deficiency on
      the TRH precursor peptides was observed. A quantitative loss of TRH from the
      testes of ZD1 was also observed. Zinc deficiency results in a substantial
      reduction in body weight and testosterone production in male rats. Exogenous
      testosterone (T) supplementation of ZD1 rats resulted in a selective increase in
      the TRH concentration of the epididymis but not of the heart. The change in
      steady-state levels of TRH precursor peptides in the hearts of the ZD1+T rats was
      consistent with a reduction in the activity of the zinc-dependent
      carboxypeptidase H enzyme. We conclude that severe zinc deficiency inhibits TRH
      biosynthesis in reproductive tissues of the male rat due to the combined effects
      of hypogonadism and inhibition of the zinc-dependent carboxypeptidase H.

PMID- 8483809
TI  - Preparation of N epsilon B28-monoazidobenzoyl insulin-like growth factor I and
      photoaffinity labeling of insulin-like growth factor I receptor.
AB  - Recombinant human insulin-like growth factor I (hIGF-I) was reacted with
      azidobenzoyl hydroxysuccinimide to produce a mixture of photoactive hIGF-I
      derivatives. The mixture was purified by reversed-phase HPLC to yield three mono
      substituted azidobenzoyl hIGF-Is. One of the derivatives was identified by amino
      acid sequencing as N epsilon B28-monoazidobenzoyl hIGF-I. This derivative was
      indistinguishable from native hIGF-I when bioassayed in Rat-1 fibroblasts. A 120
      kDa band, the alpha subunit of the IGF-I receptor, was specifically labeled in
      Rat-1 plasma membranes by this photoprobe. The labeling of this band was reduced
      by hIGF-I at 1 nM and completely abolished by hIGF-I, but not insulin, at 100 nM,
      indicating the specificity of the photolabeling of the IGF-I receptor by this
      fully active IGF-I photoprobe.

PMID- 8483810
TI  - The flp-1 propeptide is processed into multiple, highly similar FMRFamide-like
      peptides in Caenorhabditis elegans.
AB  - Previously, we described a gene, flp-1, that encodes seven FMRFamide-like
      peptides from two alternatively spliced transcripts in the nematode
      Caenorhabditis elegans. To determine whether all or a subset of the predicted
      peptides coded for by flp-1 are produced in vivo, we undertook the isolation of
      FMRFamide-like peptides from C. elegans. Six FLRFamide-containing peptides, all
      contained within the putative translation products of the flp-1 gene, were
      isolated from extracts of mixed stage animals. By quantitative PCR analysis of
      RNA from mixed stage animals, we found that the shorter transcript of flp-1 has a
      higher level of expression than the longer transcript.

PMID- 8483811
TI  - Bombesin acts in the brain to decrease gastric vagal efferent discharge in rats.
AB  - The central nervous system action of bombesin to influence basal gastric vagal
      efferent discharge (GVED) was investigated in urethane-anesthetized rats.
      Bombesin (62, 620, and 6200 pmol) injected intracisternally (IC) decreased GVED
      to 78 +/- 10%, 50 +/- 4%, and 43 +/- 3% of preinjection levels, respectively.
      Bombesin (620 pmol) injected IV also reduced GVED to 36 +/- 6%. Pretreatment with
      bombesin monoclonal antibody 2A11 completely prevented the decrease in GVED
      induced by bombesin (620 pmol) given IV but not IC. These data indicate that both
      IC and IV injections of bombesin decrease basal GVED, and that the inhibitory
      effect of IC injection represents a central nervous system-mediated action.

PMID- 8483812
TI  - Peptidases and smooth muscle cell angiotensin II receptor pharmacology.
AB  - Angiotensin (A) II receptors on rat aortic smooth muscle (RASM) cell membranes
      were characterized using the radioligand [125I][Sar1Ile8]AII ([125I]SI-AII).
      Angiotensin I, AII, and AIII inhibited specific [125I]SI-AII binding, and their
      rank order of potencies, and Ki values (nM) were: AII (3.7) > AI (32.5) > or =
      AIII (54.0), which differed from that observed for rat adrenal cortex: AII (0.85)
      > AIII (3.3) >> AI (100). Similar results were observed for RASM membranes in the
      presence of guanine nucleotides, and for intact cells in the absence or presence
      of an internalization inhibitor. Lowering the incubation temperature from 37
      degrees C to 4 degrees C, or inclusion of PMSF (1 mM), and preparing membranes in
      the presence of EGTA (1 mM) altered the rank order of potencies and Ki values
      (nM) of the angiotensin peptides to: AII (1.1) > AIII (7.0) >> AI (144).
      [125I]Angiotensin I was metabolized completely over the course of 90 min to small
      (<tetrapeptide) fragments as measured by HPLC. There was no evidence for
      formation of AII or AIII from AI, which would have explained the unusually high
      potency of AI. [125I]Angiotensin I metabolism could be attenuated by inhibitors
      of serine proteases PMSF, aprotinin, and chymostatin. The beneficial effects of
      PMSF and EGTA suggested that serine protease(s) and metalloproteases contribute
      to the observed anomalous pharmacological characteristics of AI and AIII,
      respectively. The RASM cell membranes contained a homogeneous population of
      binding sites for losartan, and its Ki value differed in the absence (50 nM) or
      presence (16 nM) of protease inhibitors, which suggests that the receptor may
      also be a target for these peptidases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483813
TI  - The role of the RGD peptides and the gamma chain peptide of fibrinogen on
      fibrinogen binding to activated platelets.
AB  - The interaction of fibrinogen with platelet membrane glycoprotein (GP) IIb/IIIa
      complex is inhibited by the RGD peptides and the peptides corresponding to a
      sequence unique to fibrinogen in the carboxyl-terminal domain of the gamma chain.
      The present study was designed to examine the effects of these synthetic peptides
      on fibrinogen binding to thrombin-activated platelets. The order of potency of
      these peptides was as follows: RGDS = RGDF > GQQHHLGGAKQAGDV (G15). The RGES
      peptide had no inhibitory activity. The inhibitory effects of the peptides were
      synergistic when fibrinogen binding was measured in the mixture of the RGD
      peptide and the gamma chain peptide. By contrast, the inhibitory effect was
      additive when the binding was measured in the presence of the RGDS peptide and
      the RGDF peptide. Thrombin-induced platelet aggregation was also inhibited by
      these synthetic peptides. The order of potency was the same as that of the
      inhibition binding assay. These results provide evidence that the RGD sequences
      present at two different sites in the alpha chain and the gamma chain sequence
      inhibit fibrinogen binding to the GPIIb/IIIa complex, are mutually exclusive, and
      are in close spatial proximity in the folded molecule. We conclude that the
      presence of the RGD sequence and the gamma chain sequence involved in fibrinogen
      binding domains increases the affinity of fibrinogen to activated platelets.

PMID- 8483814
TI  - Effects of age and hyperlipidemia on rabbit coronary responses to neuropeptide Y
      and the interaction with norepinephrine.
AB  - In coronary arteries from New Zealand White (NZW) rabbits up to 12 months of age,
      both direct vasoconstriction to neuropeptide Y (NPY) and inhibition of relaxation
      to norepinephrine (NE) by NPY were age dependent (p < 0.02 and p < 0.05,
      respectively); maximal relaxation to NE was unaffected. NPY had no significant
      effect on arteries from NZW rabbits at 4 months of age, while vessels from
      Watanabe Hereditable Hyperlipidaemic (WHHL) rabbits showed enhanced direct (p <
      0.001) and indirect effects of NPY (p < 0.02). We conclude that the postsynaptic
      vasoconstrictor effects of NPY on the epicardial coronary artery increase with
      age and the presence of hyperlipidemia.

PMID- 8483815
TI  - Pituitary adenylate cyclase activating polypeptide (PACAP)-like immunoreactivity
      in pheochromocytomas.
AB  - Pituitary adenylate cyclase activating polypeptide (PACAP) is a novel
      hypothalamic peptide consisting of 38 amino acids [PACAP(1-38)] with a potent
      stimulatory action on adenylate cyclase in rat pituitary. The presence of
      immunoreactive (IR-) PACAP in the tumor tissue of pheochromocytomas was studied
      by radioimmunoassay and immunocytochemistry. The antibody to PACAP was raised in
      a rabbit injected with a peptide containing amino acids 28-38 of PACAP. This
      antibody showed no significant cross-reactivity with either PACAP(1-27) or
      vasoactive intestinal polypeptide. The tumor tissue concentrations of IR-PACAP(1
      38) were 0.5-57.5 pmol/g wet weight (n = 13) (24.5 +/- 22.4 pmol/g wet weight,
      mean +/- SD), while those in the normal adrenal glands were 3.58 +/- 2.02 pmol/g
      wet weight (n = 7) and those in the adrenal cortical tumors were 5.58 +/- 2.02
      pmol/g wet weight (n = 6). The IR-PACAP(1-38) concentrations in 7 out of 13
      pheochromocytomas exceeded 18 pmol/g wet weight. Sephadex G-50 column
      chromatography revealed that the IR-PACAP(1-38) in extracts of pheochromocytomas
      eluted in both the positions of PACAP(1-38) and a larger molecular weight.
      Reverse-phase high performance liquid chromatography of the tumor extracts
      revealed a peak in the position of PACAP(1-38) and at least four other peaks.
      Immunocytochemistry of pheochromocytomas showed numerous immunoreactive cells.
      The immunostaining was abolished by absorption of the antiserum with synthetic
      PACAP(1-38). These findings indicate that multiple forms of IR-PACAP(1-38) are
      present in pheochromocytomas.

PMID- 8483816
TI  - Growth regulatory properties of endothelins.
AB  - Endothelins are produced by endothelial and epithelial cells, macrophages,
      fibroblasts, and many other types of cells. Their receptors are present in
      numerous cells, including smooth muscle cells, myocytes, and fibroblasts.
      Evidence now suggests that the three isoforms of endothelins (ET-1 and the other
      two related isopeptides, ET-2 and ET-3) regulate growth in several of these
      cells. Endothelin-1 influences DNA synthesis, the expression of protooncogenes,
      cell proliferation, and hypertrophy. The participation of ET in mitogenesis
      involves activation of multiple transduction pathways, such as the production of
      second messengers, the release of intracellular pools of calcium, and influx of
      extracellular calcium. Moreover, ET-1 acts in synergism with various factors,
      such as EGF, PDGF, bFGF, TGFs, insulin, etc., to potentiate cellular
      transformation or replication. Several of these factors may in turn stimulate the
      synthesis and/or the release of endothelins. The production and release of
      endothelins are also increased in acute and chronic pathological processes, e.g.,
      atherosclerosis, postangioplastic restenosis, hypertension, and carcinogenesis.
      It is postulated that endothelins act in a paracrine/autocrine manner in growth
      regulation and play an important role mediating vascular remodeling in some
      cardiovascular diseases. The present review analyses the implication of
      endothelins (ET-1, -2, and -3) in physiopathology related to their growth
      regulatory properties.

PMID- 8483817
TI  - Atriopeptin III degradation by endopeptidase 24.11: the Cys-Phe bond is not the
      preferential cleavage site.
AB  - Incubation of rANP(5-28)--also called atriopeptin III (AP III)--with purified
      endopeptidase 24.11 led preferentially to the production of Phe-Arg-Tyr, while
      other products of minor importance were detected. One of these was identified as
      rANP(5-25) (atriopeptin I) (AP I). This hydrolysis pattern of endopeptidase 24.11
      towards AP III differs from the known favored site of cleavage at the Cys7-Phe8
      bond of rANP(1-28). Moreover, by comparison with rANP(1-28), the degradation rate
      of AP III was slower. These data suggest that N-terminal peptide truncation
      results in conformational and/or charge modifications leading to a different
      positioning of the peptide in the endopeptidase 24.11 active site. In most
      hypothalamic nuclei of the rat brain known to contain AP III and endopeptidase
      24.11, the preferential Ser25-Phe26 bond hydrolysis, although supposed to be
      responsible for a reduced degradation rate, might represent an effective
      enzymatic pathway of catabolism for AP III.

PMID- 8483818
TI  - Aortic valve stenosis. Management in children and adults.
AB  - Aortic valve stenosis may be congenital or acquired. Medical management includes
      advice to avoid heavy physical effort, prevention of infective endocarditis, use
      of digitalis and diuretics for cardiac failure, and preservation of atrial
      systole. When operation is necessary, open aortic valve commissurotomy is
      preferred in children and replacement of the valve is preferred in adults. Women
      of childbearing age should use conventional barrier contraceptives, and those
      with severe stenosis should have valve replacement before becoming pregnant.
      Aortic valvuloplasty, particularly in adults, is only of temporary benefit.

PMID- 8483819
TI  - Making sense of hypothyroidism. An approach to testing and treatment.
AB  - Development of the newer, sensitive assay for thyrotropin (thyroid-stimulating
      hormone [TSH]) has simplified the diagnosis and management of hypothyroidism.
      Serum free thyroxine (T4) levels measured by analogue techniques or free T4 index
      may be used in conjunction with TSH test results to confirm the diagnosis.
      Treatment consists of daily doses of levothyroxine sodium (Levothroid, Levoxine,
      Synthroid), which are increased slowly to achieve an optimal dose. Close
      monitoring with TSH assay is important to ensure adequate treatment. In euthyroid
      sick syndrome, results of thyroid function tests are abnormal in patients with
      nonthyroidal illness; treatment is indicated if symptoms of hypothyroidism are
      present. Patients with subclinical hypothyroidism also may benefit from
      treatment.

PMID- 8483820
TI  - Milk-alkali syndrome. A consequence of chronic antacid abuse.
AB  - The case described here illustrates the need to consider milk-alkali syndrome in
      the differential diagnosis of hypercalcemia, even in this age of histamine2
      blockers and mucosal protectors. Thorough history taking and gastrointestinal
      workup help rule out alternative causes of hypercalcemia, such as cancer,
      hyperparathyroidism, and other metabolic and endocrine diseases. Milk-alkali
      syndrome is managed by administration of saline solution and loop diuretics and
      avoidance of thiazide diuretics. Patient education regarding the hazards of
      abusing calcium-containing antacids is essential.

PMID- 8483821
TI  - Detecting the presence and cause of pulmonary edema.
AB  - Prompt recognition of pulmonary edema is important to avoid life-threatening
      complications. Chest radiography and other tests are key to establishing the
      diagnosis and distinguishing between the two types of pulmonary edema-
      cardiogenic and noncardiogenic. Dr Colice discusses the mechanisms that lead to
      pulmonary edema, the various diagnostic methods, prognosis, and management.

PMID- 8483822
TI  - Common bacterial skin infections. Diagnostic clues and therapeutic options.
AB  - Prompt, accurate characterization of skin infections can help avoid serious, more
      invasive complications. With appropriate empirical therapy, treatment failure can
      be prevented. The authors of this article discuss several common skin infections,
      including bite wound infections, and recommend various drug regimens to consider
      when planning initial therapy.

PMID- 8483824
TI  - Health plan made in secret by folks who don't know they don't know!

PMID- 8483823
TI  - Gait disorders in the elderly. Distinguishing between normal and dysfunctional
      gaits.
AB  - Normal gaits in the elderly population vary widely. Characteristics of normal and
      abnormal gaits often overlap, making diagnosis of ambulation disorders difficult
      in some patients. Abnormal gaits are usually caused by musculoskeletal and/or
      neurologic abnormalities, which can be readily identified in the clinical
      setting. Prompt diagnosis and appropriate treatment may save an elderly patient
      from immobility, fall-related injury, loneliness, and depression.

PMID- 8483825
TI  - Future of healthcare.

PMID- 8483826
TI  - Mitral valve prolapse. Avoiding complications of a progressive disease.
AB  - Mitral valve prolapse is a common disorder, but it carries low morbidity and
      mortality. Patients require close follow-up, however, to prevent development of
      serious complications. In addition, patients with thickened mitral valve leaflets
      or mitral regurgitation require antibiotic prophylaxis against infective
      endocarditis. Family members of patients with primary mitral valve prolapse
      should be screened for the disease, because it often is asymptomatic.

PMID- 8483827
TI  - Aortic regurgitation. Identifying and treating acute and chronic disease.
AB  - Aortic regurgitation is a serious disorder that can challenge the best clinicians
      in terms of both diagnosis and management. The chronic form requires valve
      replacement when patients have symptoms or show evidence of left ventricular
      dysfunction. The acute form requires urgent aortic valve replacement. In all
      cases, medical management is only a temporizing procedure that can potentially
      mask the progression of left ventricular dysfunction. Endocarditis prophylaxis
      for indicated procedures is mandatory for all patients.

PMID- 8483828
TI  - Rheumatic mitral stenosis. On the rise again.
AB  - Rheumatic mitral stenosis remains an important cause of exertional dyspnea,
      pulmonary congestion, atrial fibrillation, and stroke. Detection rests on careful
      auscultatory examination and detailed review of chest films. Diagnosis is
      confirmed by echocardiographic examination; cardiac catheterization is important
      in symptomatic patients to evaluate the severity of stenosis and associated
      lesions. Treatment of pulmonary congestion and control of heart rate in patients
      with atrial fibrillation remain major medical goals. Percutaneous balloon
      commissurotomy is preferred for most patients with predominant mitral stenosis
      and for those with contraindications to valve replacement. Implantation of a
      prosthetic valve is best for patients with significant mitral regurgitation,
      multivalve disease, associated coronary artery disease that requires bypass, or
      mitral valve deformity too severe to allow adequate balloon commissurotomy.

PMID- 8483829
TI  - Strategies for indirect computer-aided drug design.
AB  - This review is intended to describe some of the methods and procedures used for
      computer-aided drug design when the structure of the macromolecular target is
      unknown, as is the case for CNS active drugs. Strategies and methods used in
      computer-aided design of drugs in such instances must be "indirect," i.e.,
      focusing on the characterization of the ligands themselves. This situation is
      different from one in which the three-dimensional structure of the macromolecular
      target for a drug is known, for example, for drugs that are enzyme inhibitors,
      allowing "direct" characterization of ligand-receptor interactions. Two
      qualitatively different "indirect" approaches are described here. One, called 2D
      QSAR, is briefly reviewed. It is based on delineating regression relationships
      between a specified biological end point and properties of the compounds
      eliciting it. The other, based on pharmacophore development, constitutes the main
      part of this review. Several levels of pharmacophore development are described,
      which differ in the extent to which they encompass fundamental molecular
      properties that are determinants of receptor recognition and activation. The
      strengths and limitations of each procedure are discussed and illustrated by
      examples. Two methods for obtaining model receptor structures are then briefly
      described. Both rely on the prior success of the indirect methods in obtaining
      ligand properties that modulate receptor recognition and activation. These
      emerging capabilities have the potential to bridge the gap between indirect and
      direct methods of drug design, since, if successful, the design process can
      continue in a direct mode using explicit characterization of drug-receptor
      interactions. Strategies for hypothesis validation and use of hypothesis for drug
      design and discovery are also briefly reviewed. The final sections of this review
      describe specific computational tools such as molecular mechanics and quantum
      mechanical methods used to characterize and identify relevant molecular
      properties and indicate some areas for future development of computational
      chemistry methods that could increase its effectiveness in the design of novel
      drugs.

PMID- 8483830
TI  - Controlled delivery systems for proteins using polyanhydride microspheres.
AB  - A method to provide near-constant sustained release of high molecular weight,
      water-soluble proteins from polyanhydride microspheres is described. The
      polyanhydrides used were poly(fatty acid dimer) (PFAD), poly(sebacic acid) (PSA),
      and their copolymers [P(FAD-SA)]. P(FAD-SA) microspheres containing proteins of
      different molecular sizes--lysozyme, trypsin, heparinase, ovalbumin, albumin, and
      immunoglobulin--were prepared by a solvent evaporation method using a double
      emulsion. The microspheres containing proteins were spherical, with diameters of
      50-125 microns, and encapsulated more than 80% of the protein, irrespective of
      the protein used. Enzymatic activity studies showed that encapsulation of enzymes
      inside polyanhydride microspheres can protect them from activity loss. When not
      placed inside polyanhydride microspheres, trypsin lost 80% of its activity in
      solution at 37 degrees C at pH 7.4 in 12 hr, whereas inside the polyanhydride
      microspheres the activity loss was less than 10% under these conditions. About
      47% of the enzymatic activity of heparinase encapsulated in the microspheres was
      lost at 37 degrees C in 24 hr, while in solution it lost over 90% of its
      activity. The protein-loaded microspheres displayed near-zero-order erosion
      kinetics over 5 days as judged by the release of sebacic acid (SA) from the
      microspheres. The microspheres degraded to form SA and FAD monomers. All proteins
      were released at a near-constant rate without any large initial burst,
      irrespective of polymer molecular weight and protein loading. The period of
      protein release was longer than that of SA and continued protein release was
      observed even after the microsphere matrix had completely degraded. Differential
      scanning calorimetric studies demonstrated an interaction between protein and the
      FAD monomers produced with microsphere degradation. It is likely that the protein
      interaction with FAD monomers permits formation of water-insoluble protein
      aggregates which slowly dissolve and diffuse out of the matrix, leading to
      delayed protein release. For trypsin-loaded microspheres, trypsin lost 40% of its
      activity during microsphere preparation. Activity studies demonstrated that the
      sonication process was primarily responsible for activity loss. A reduction in
      the period of ultrasound exposure decreased the loss of protein activity to
      around 20%.

PMID- 8483831
TI  - A new method for estimating dermal absorption from chemical exposure. 1. General
      approach.
AB  - To evaluate systemic chemical exposure from dermal absorption, one must know the
      mass of chemical absorbed including the portion that has entered the skin but not
      yet entered the body's interior system. Algebraic equations are presented for
      estimating dermal absorption including the effects of exposure time and chemical
      nature of the compound, in particular lipophilicity and molecular weight. The
      proposed equations account for larger absorption rates during the initial
      exposure period as well as the hydrophilic barrier which the viable epidermis
      presents to lipophilic chemicals. These algebraic expressions are shown to
      represent adequately the exact solution of the unsteady-state diffusion equations
      for a two-membrane composite. Finally, procedures are proposed for estimating a
      priori the required physicochemical data when experimental values are not
      available. Specifically, the Potts and Guy permeability correlation is split into
      parts separately representing stratum corneum partitioning and diffusivity.

PMID- 8483832
TI  - Immunotargeting of liposomes containing lipophilic antitumor prodrugs.
AB  - Potential therapeutic applications of recently developed liposomes with a reduced
      affinity to the reticuloendothelial systems and a prolonged circulation time as
      targeting systems for lipophilic prodrugs were examined. In these studies,
      liposomes composed of phosphatidylcholine and cholesterol, additionally
      containing monosialoganglioside (GM1) or polyethylene glycol conjugated to
      phosphatidylethanolamine (PEG-PE), were used. Three antitumor lipophilic
      prodrugs, N-trifluoroacetyl-adriamycin-14-valerate (AD32), araC-diphosphate
      diglyceride (araCdPdG), and 3',5'-o-dipalmitoyl-5-fluoro-2'-deoxyuridine
      (dpFUdR), were used to examine the effect of lipophilic prodrug incorporation
      into long-circulating liposomes and immunoliposomes on their biodistribution in
      mouse. Biodistribution studies with antibody-free liposomes containing lipophilic
      prodrugs showed that the activities of GM1 or PEG2000-PE in prolonging the
      circulation time of liposomes appeared to be preserved in the presence of each of
      the three lipophilic prodrugs at a drug/lipid molar ratio of 3:97. The effect of
      lipophilic prodrug incorporation on target binding of immunoliposomes was then
      examined using a mouse model. Incorporation of AD232 or dpFUdR into
      immunoliposomes, directed to the normal endothelium, did not affect the
      targetability of immunoliposomes, suggesting a potential effectiveness of these
      lipophilic prodrug-containing immunoliposomes in therapy for lung tumors. On the
      contrary, incorporation of araCdPdG resulted in significantly reduced target
      binding of immunoliposomes by yet unknown mechanism(s).

PMID- 8483833
TI  - Synthesis and testing of new antileukemic Schiff bases of N-hydroxy-N'
      aminoguanidine against CCRF-CEM/0 human leukemia cells in vitro and synergism
      studies with cytarabine (Ara-C).
AB  - A series of eight new N-hydroxy-N'-aminoguanidine (HAG) Schiff bases [ArCH =
      NNHC(= NH)NHOH.tosylate] was synthesized as potential antitumor agents through
      the inhibition of the enzyme ribonucleotide reductase (EC 1.17.4.1). Five of the
      HAG derivatives (LK02 through LK06) were designed to contain an orthohydroxy
      group on the phenyl ring of ArCH = to increase the stability of the Schiff base
      formed. In addition, two compounds with a substituted quinoline [LK10; ArCH = (4
      hydroxy-7-trifluoromethylquinolin-3-yl)methylene] or isoquinoline (LK11; ArCH =
      (5-nitroisoquinolin-1-yl)methylene] moiety were synthesized through multiple-step
      reactions involving reduction and/or oxidation. The IC50 values of the newly
      synthesized HAG Schiff bases were determined against human leukemic CCRF-CEM/0
      cells in culture. The IC50 values of two previously reported HAG derivatives
      [ATL25; ArCH = (5-nitro-isoquinolin-1-yl)methylene] and [LW02; ArCH = 2-hydroxy-3
      allyl-benzylidene)] were also determined for the first time against CCRF-CEM/0
      cells. Among the compounds tested, LK11 was found to be the most potent (IC50,
      2.95 +/- 0.1 microM) and the 4-methoxy-2-hydroxyphenyl derivative (LK02) to be
      the least potent (IC50, 121 +/- 16 microM). LK11 was about 15-fold more potent
      against CCRF-CEM/0 cells compared to the parent compound hydroxyguanidine sulfate
      (IC50, 46 +/- 7.1 microM) and was about 32 times more potent than LK10 (IC50,
      97.6 +/- 0.9 microM). LK11 in combination was incubated in sequence with
      cytarabine (ara-C) at various molar ratios against CCRF-CEM/0 cells for 48 hr.
      The results were analyzed using both the isobologram and the median-effect
      methods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483834
TI  - Aqueous ethylcellulose dispersion of ethylcellulose. I. Evaluation of coating
      process variables.
AB  - Formulation and process variables play an important role in the film-forming
      properties of coating polymers. Three selected independent coating process
      variables, namely, percent solids content in the coating polymeric dispersion,
      inlet-air temperature, and spray rate of the polymeric dispersion, were
      investigated in this study to determine their effect on the performance
      characteristics of tablets coated with a plasticized aqueous ethylcellulose
      dispersion (Sure-lease) in a fluid-bed equipment. Response surface methodology
      (RSM) was utilized to study the complex relationship between these process
      variables and selected response variables. Three response variables were
      considered, namely, rate of drug release from the "untreated" coated tablets and
      the "thermal-treated" coated tablets and microindentation hardness of the
      untreated coated tablets. A 12-point factorial experimental design was utilized,
      and three-dimensional (3-D) response surface plots were generated using a second
      order polynomial model. The model provided information needed to predict optimal
      process conditions. Drug release from the coated tablets followed zero-order
      kinetics. Inlet-air temperature was found to be the most critical process
      variable for all the three response variables studied. A correlation was observed
      between the drug release rate and the microindentation hardness of the applied
      polymeric coat in the case of untreated coated tablets. The 3-D response surface
      plots indicated that lower rates of drug release from the coated tablets may be
      obtained by using high inlet-air temperature and low spray rate of the polymeric
      dispersion during coating.

PMID- 8483835
TI  - A method for the early evaluation of the effects of storage and additives on the
      stability of parenteral fat emulsions.
AB  - The combination of sedimentation field-flow fractionation (SedFFF) and photon
      correlation spectroscopy (PCS) is shown to provide a detailed record of the
      droplet sizes present in fat emulsions commonly used in parenteral nutrition. The
      technique presented has been used to record size distribution data for a
      particular emulsion (Liposyn-II), demonstrating its high stability and lot-to-lot
      uniformity. The technique is also able to demonstrate how additions of small
      amounts of electrolytes [0.45% (w/v) NaCl, 0.05% (w/v) CaCl2] tend to destabilize
      the emulsion, suggesting some caution in the use of total parenteral nutrition
      (TPN) mixtures. In contrast, a 1:1 mixture with human serum caused no sign of
      instability in the Liposyn-II. Using the emulsion as a carrier for lipophilic
      drugs necessitates adding solutions of the drug in nonaqueous solvents, such as
      DMSO (dimethyl sulfoxide). This solvent's destabilizing effect results in a
      droplet coalescence that becomes severe after 3-5 days following a 10% (v/v)
      addition, while a 5% (v/v) addition reaches the same level of coalescence in 10
      days.

PMID- 8483836
TI  - The influence of thermal treatment on the physical-mechanical and dissolution
      properties of tablets containing poly(DL-lactic acid).
AB  - Five molecular weight grades of poly(DL-lactic acid) (PLA) were incorporated as
      organic and aqueous pseudolatex binders into matrix tablet formulations
      containing microcrystalline cellulose and the model drug theophylline. The
      tablets were thermally treated to temperatures above and below the glass
      transition temperature (Tg) of the PLA. The results of the dissolution studies
      showed that thermally treating the tablets to temperatures above the Tg of the
      PLA significantly retarded the matrix drug release compared to tablets which were
      not thermally treated. The retardation in drug release could be attributed to a
      stronger compact and a more efficient redistribution of polymer throughout the
      tablet matrix, based on fundamental principles of annealing. In addition, results
      from tablet index testing supported the dissolution results. The bonding index of
      the compact formulations increased after thermal treatment above the Tg of the
      PLA. Gel permeation chromatography and differential scanning calorimetry studies
      demonstrated that thermal treatment had no significant effect on the molecular
      weight and the glass transition temperature of (PLA) alone and in combination
      with other components of the tablet formulation.

PMID- 8483837
TI  - Uptake of phosphatidylserine liposomes by rat Peyer's patches following
      intraluminal administration.
AB  - Uptake of the nonabsorbable marker 6-carboxyfluorescein was investigated both
      free and encapsulated in liposomes as a function of their surface charge and
      hydrodynamic diameter in rat Peyer's patch and nonpatch tissue. Significant
      uptake of the marker occurred only when encapsulated in liposomes consisting of
      at least 25 mol% phosphatidylserine and was highest in Peyer's patches. 6
      Carboxyfluorescein encapsulated in liposomes equal to or greater than 374 nm was
      preferentially taken up by Peyer's patches. There was a trend to higher uptake in
      lower intestinal segments. These findings were supported by fluorescence
      microscopic observations. Uptake by Peyer's patches was specific for negatively
      charged liposomes as judged from competition studies.

PMID- 8483838
TI  - In vitro nasal transport across ovine mucosa: effects of ammonium glycyrrhizinate
      on electrical properties and permeability of growth hormone releasing peptide,
      mannitol, and lucifer yellow.
AB  - Transport of growth hormone releasing peptide across ovine nasal mucosa in the
      absence or presence of ammonium glycyrrhizinate (AMGZ) was studied in vitro.
      Ovine nasal mucosa was stripped from underlying cartilage and mounted in Ussing
      chambers. Transepithelial conductance (Gt) and short-circuit current (Isc) were
      monitored during experiments to assess tissue viability and integrity.
      Radiolabeled mannitol (Man; MW 182) and growth hormone releasing peptide (GHRP,
      SK&F 110679; MW 873) were employed to measure transport rates across the
      epithelium, and fluorescence spectroscopy was employed to measure rates of
      lucifer yellow (LY; MW 521) transport. Effects of AMGZ on ovine nasal mucosal
      viability and transport were determined from changes in electrical properties of
      fluxes of [3H]GHRP, [3H]Man, and LY. Results demonstrate that electrical
      properties of ovine nasal mucosa are stable over the time course of the
      experiments (Gt = 8.3 +/- 0.5 mS/cm2 and Isc = 3.7 +/- 0.2 microEq/hr.cm2; n =
      21). Man fluxes were comparable in the mucosal (m)-to-serosal (s) and s-to-m
      directions [0.10 +/- 0.01 (n = 17) and 0.10 +/- 0.01 (n = 4) %/hr.cm2,
      respectively]. Transport of GHRP and LY in the m-s direction was similar to that
      of Man [0.08 +/- 0.01 (n = 11) and 0.09 +/- 0.01 (n = 3) %/hr.cm2, respectively].
      GHRP flux was equivalent in the m-s and s-m directions. GHRP did not
      significantly alter ion transport processes as indicated by the lack of any
      change in Gt or Isc.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483839
TI  - Development of activity assays for high-volume evaluation of human
      immunodeficiency virus (HIV) protease inhibitors in rat serum: results with
      ditekiren.
AB  - We showed previously that a commercially available synthetic tetradecapeptide,
      Asp-Arg-Val-Tyr-Ile-His-Pro-Phe-His-Leu-Leu-Val-Tyr-Ser, produces authentic
      angiotensin I (Ang I) upon incubation with the HIV-1 protease (S. K. Sharma et
      al., Anal. Biochem. 198:363, 1991). Therefore, we developed an Ang-I based
      activity assay for HIV protease inhibitors based on the technology developed
      earlier (M. J. Ruwart et al., Pharm. Res. 7:407, 1990; S. K. Sharma et al., Anal.
      Biochem. 186:24, 1990) for tracking renin inhibitors in rat sera. Ditekiren was
      either extracted from sera with ethyl acetate or assayed after the interfering
      substances in sera were precipitated with acetonitrile. Purified recombinant HIV
      1 protease was added to extracted rat serum and the enzymatic reaction was
      initiated in the presence of the tetradecapeptide substrate. The inhibition of
      Ang I production was measured by a commercially available RIA kit. The cleanup
      methodology also enabled a commercially available Proteinase Scintillation
      Proximity Assay (SPA, Amersham) to quantify ditekiren in rat serum through the
      addition of recombinant HIV-1 protease and cleavage of substrate from SPA beads.
      Results were confirmed by HPLC or by the renin assay for ditekiren, which
      inhibits both aspartyl proteases. These technologies should prove useful for
      assessing serum levels of HIV protease inhibitors in rat.

PMID- 8483840
TI  - Pharmacokinetics of recombinant human interferon-beta ser in healthy volunteers
      and its effect on serum neopterin.
AB  - The pharmacokinetics of and biologic response modification by recombinant human
      interferon-beta ser (rIFN-beta ser) were evaluated in 12 healthy male volunteers.
      Subjects received a single intravenous (iv) injection of 90 x 10(6) IU of rIFN
      beta ser followed by a single or eight consecutive daily 90 x 10(6) IU
      subcutaneous (sc) doses. Blood samples collected after the iv, first sc, and last
      sc doses and prior to each sc dose were assayed for interferon antiviral activity
      and the interferon-inducible marker neopterin. Following iv administration, serum
      interferon concentrations generally declined biexponentially, with a mean serum
      clearance of 0.76 +/- 0.28 L/hr-kg, a mean steady-state volume of distribution of
      2.88 +/- 1.81 L/kg, and a mean terminal half-life of 4.29 +/- 2.29 hr as
      determined by noncompartmental analysis. Following sc administration, absorption
      of rIFN-beta ser was prolonged, with serum concentrations generally below 100
      IU/mL. No accumulation of rIFN-beta ser in serum was noted after eight daily sc
      injections. In contrast, serum neopterin levels did not increase above baseline
      levels until 12 hr after iv dosing and 24 hr after sc dosing. The mean increase
      in serum neopterin at 24 hr post iv injection was significantly greater than that
      at 24 hr post sc dosing.

PMID- 8483841
TI  - Physicochemical stability of phenobarbital polymorphs at various levels of
      humidity and temperature.
AB  - The physicochemical stability of six phenobarbital modifications [forms A, B, C
      (monohydrate), D (dioxane solvate), E (hemihydrate), and F] at various levels of
      humidity and temperature were measured using X-ray diffractometry and
      differential scanning calorimetry. Form D was identified as a new crystalline
      form (dioxane solvate). Polymorphic transformations of the modifications were
      investigated by the Kissinger method under nonisothermal conditions. Change of
      polymorphic content of phenobarbital modifications under various humidity levels
      at 45 degrees C was evaluated by X-ray powder diffraction. The polymorphic
      stability under isothermal conditions was estimated kinetically, based upon the
      Jander equation. Forms A, B, and F were stable at 0 and 75% RH and 45 degrees C
      for 3 months. On the contrary, forms C, D, and E transformed during storage. The
      transformation rates of form D were larger than that of forms C and E.

PMID- 8483842
TI  - An in vitro study of diamorphine permeation through premature human neonatal
      skin.
AB  - The permeation kinetics of diamorphine through human premature neonatal cadaver
      skin over a range of gestational ages between 24 and 36 weeks was investigated
      using small diffusion cells. A strong inverse correlation was noted between the
      apparent permeability coefficient and the gestational age of the skin (P < 0.01;
      n = 26). The calculated apparent permeability coefficients decreased with
      gestational age from 6.0 x 10(-2) cm.hr-1 at 24 weeks' gestation to 5.2 x 10(-6)
      cm.hr-1 at 36 weeks' gestation. The amount of diamorphine remaining bound within
      the skin at the end of the in vitro experiments did not change significantly with
      gestational age of the skin. Diamorphine was subject to degradation over the
      course of the in vitro experiments to produce significant amounts of 6
      monoacetylmorphine and evidence is presented to suggest that this was due to
      residual skin esterase activity. It is calculated that the steady-state flux rate
      of diamorphine through neonatal skin observed in these experiments would be
      sufficient to obtain a therapeutic plasma concentration of morphine assuming a 2
      cm2 area for application and a delivery rate of 15 micrograms hr-1 kg-1. However,
      the prolonged half-life of morphine in the premature neonate would result in a
      delay of some hours before the attainment of this level.

PMID- 8483843
TI  - In vivo/in vitro correlation of experimental sustained-release theophylline
      formulations.
AB  - A novel multiparticulate sustained-release theophylline formulation, which
      consisted of spherical drug pellets coated with a rate-controlling membrane, was
      evaluated in vivo. Two preparations that differ solely in the coat thickness, and
      hence rate of in vitro drug release, were studied in comparison with a solution
      of the drug. Both preparations produced serum concentration profiles that are
      reflective of a slow and sustained rate of absorption. The in vivo release versus
      time profiles calculated using a deconvolution procedure showed that the two
      preparations differed in the rate but not the extent of drug release.
      Satisfactory correlation was also obtained between the in vivo and the in vitro
      results. When the two preparations were further compared using the parameters,
      time to reach peak concentration (Tp), peak concentration (Cp), and total area
      under the serum concentration versus time curves (AUC), a statistically
      significant difference was observed in the Tp and Cp values but not the AUC
      values, suggesting that the preparations differed in the rate but not the extent
      of absorption. In addition, the extent of absorption from both preparations was
      comparable to that obtained with the drug solution.

PMID- 8483844
TI  - Comparison of the pharmacokinetics and pharmacodynamics of the aldose reductase
      inhibitors, AL03152 (RS), AL03802 (R), and AL03803 (S).
AB  - The pharmacokinetics of AL03152 (RS) and its enantiomers, AL03802 (R) and AL03803
      (S), were studied in the Sprague-Dawley rat following intravenous bolus
      administration. The enantiomers had differing pharmacokinetic profiles, while the
      racemic compound exhibited pharmacokinetic parameters approximating the mean
      values of the individual enantiomers. The total clearance (CLT) values of the two
      enantiomers were similar, but the intrinsic clearance (Cl(int)) was much greater
      for the S-enantiomer than for the R-enantiomer. The volume of distribution (Vss)
      for AL03802 (R) was threefold greater than that for AL03803 (S). The
      stereoselectivity in Vss could not be totally accounted for by the slight
      difference in serum protein binding of the isomers and resulted in a difference
      in the half-lives of the enantiomers. Only the R-isomer exhibited a persistent
      terminal elimination phase, consistent with more extensive tissue binding than
      the S-isomer. AL03152 enantiomers were equivalent in potency assessed from in
      vitro IC50 values toward rat lens aldose reductase and rat kidney L-hexonate
      dehydrogenase and lens EC50 values in diabetic rats.

PMID- 8483845
TI  - Pharmacokinetic monitoring in subcutaneous tissue using in vivo capillary
      ultrafiltration probes.
AB  - Capillary ultrafiltration probes were utilized for in vivo sampling of
      therapeutic drugs in awake rats. Capillary ultrafiltration probes implanted into
      subcutaneous tissue were able to follow the disposition of acetaminophen and
      theophylline. Ultrafiltration probes provided samples at a rate of 2-3
      microL/min. Ultrafiltrates were analyzed by liquid chromatography with either UV
      or electrochemical detection. Simultaneous ultrafiltration and microdialysis
      probes and multiple ultrafiltration probes were used in individual animals to
      validate the technique. The pharmacokinetics of two well-established drugs,
      acetaminophen and theophylline, were monitored in awake, freely moving rats to
      demonstrate the viability of the technique. The half-life for acetaminophen was
      determined to be 20.9 +/- 1.0 min (n = 6) for a 2 mg/kg dosing. The half-life of
      elimination for theophylline was determined to be 3.0 +/- 0.1 hr (n = 4) for a 4
      mg/kg dose. The capillary ultrafiltration probes exhibited a constant flow rate
      of 2.4 +/- 0.1 microL/min and removed 50 nL/min/mm of fluid from the
      extracellular space. Capillary ultrafiltration sampling is shown to be an
      excellent tool for in vivo monitoring of drug disposition and a suitable method
      for determining pharmacokinetic parameters in awake animals.

PMID- 8483846
TI  - Clinical pharmacokinetics and relative bioavailability of oral procaterol.
AB  - The pharmacokinetics and relative oral bioavailability of procaterol, an orally
      active beta 2-adrenergic agonist bronchodilator were evaluated in healthy
      volunteers. Procaterol was rapidly absorbed after oral administration. Mean
      plasma procaterol concentration-time profiles and pharmacokinetic parameters for
      both formulations were essentially superimposable. Following tablet
      administration, the mean Cmax was 358 pg/mL and the corresponding mean tmax was
      1.6 hr. Mean renal clearance was 163 mL/min and accounted for approximately one
      sixth of the mean apparent oral plasma clearance (988 mL/min). The mean apparent
      elimination half-life of procaterol was 4.2 hr. Hepatic metabolism appears to be
      the primary mechanism for elimination of procaterol from the body, and first-pass
      metabolism may limit systemic bioavailability.

PMID- 8483847
TI  - Distinction between the depletion of opsonins and the saturation of uptake in the
      dose-dependent hepatic uptake of liposomes.
AB  - Opsonins play a role in the hepatic uptake of particles such as bacteria, lipid
      emulsion, and liposomes. The objective of this study was to distinguish between
      opsonin depletion and uptake saturation in the dose-dependent hepatic uptake of
      liposomes. The uptake of opsonized and unopsonized liposomes was determined in
      the isolated perfused liver. Serum (2.9 mL) was required to opsonize 1 mumol
      liposomes fully, indicating that a rat (250 g with 10 mL of serum) can opsonize
      3.5 mumol liposomes. Next the dose effect on hepatic uptake of opsonized and
      unopsonized liposomes was examined. Saturation of uptake was found only for the
      opsonized liposomes. On the other hand, the hepatic uptake clearance decreased
      dose dependently from 4.31 to 0.79 (mL/min), with increasing doses from 0.075 to
      17 mumol/250 g, respectively, after i.v. administration. Thus, the decrease in
      the hepatic uptake clearance at the medium dose was due to the saturation of
      uptake alone, and at the high dose it was due to opsonin depletion as well. These
      results show that the saturation of liposomal uptake in the liver and the
      depletion of opsonins occurred at different liposome dosage levels.

PMID- 8483848
TI  - Formycin B elimination from the cerebrospinal fluid of the rat.
AB  - The goal of this study was to determine whether specific transport systems are
      involved in nucleoside elimination from the cerebrospinal fluid (CSF). First, in
      vitro studies were carried out in isolated choroid plexus tissue slices from rat
      to ascertain the mechanisms of transport of formycin B, a model nucleoside
      analogue. 3H-Formycin B accumulated against a concentration gradient in the
      presence of an Na+ gradient in the isolated ATP-depleted choroid plexus tissue
      slices. This accumulation was reduced by high concentrations of unlabeled
      formycin B. Nitrobenzylthioinosine (NBMPR), an equilibrative nucleoside transport
      inhibitor, inhibited the uptake of formycin B in the absence of an Na+ gradient.
      These data suggest that both equilibrative and secondary active Na(+)-nucleoside
      transport systems are present in rat choroid plexus. In vivo, formycin B,
      together with inulin as a bulk flow marker, was injected into the lateral
      ventricle of the anesthetized rat with the aid of a stereotaxic device, and CSF
      was sampled from the cisterna magna at various times after injection. Twelve rats
      were randomized and divided into a low- and a high-dose group. The CSF clearance
      (CLCSF) of formycin B was significantly higher than the CLCSF of inulin in both
      animal groups (P < 0.01), indicating that formycin B is cleared from CSF by a
      pathway(s) in addition to bulk flow. Formycin B CLCSF was significantly lower in
      the high-dose group than in the low-dose group (P < 0.05), suggesting a saturable
      CSF elimination. The CLCSF of formycin B was also significantly reduced in
      animals treated with NBMPR (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483849
TI  - The determination of diffusion coefficients in semisolids by Fourier transform
      infrared (FT-IR) spectroscopy.
AB  - A Fourier transform infrared (FT-IR) spectrometer with a horizontal attenuated
      total reflectance (ATR) cell was used to determine the diffusion coefficients of
      several liquids in two semisolid materials. The experimental setup was that of a
      system with one open and one closed boundary wherein the open boundary was
      maintained at constant concentration. While the liquid of interest was diffusing
      through the film of ointment, the concentration of liquid at the film surface in
      contact with the ATR crystal was determined at various times by means of IR
      absorption measurements. The depth of penetration of the IR radiation into the
      sample was approximately 0.6-0.9 microns at the wavelengths of analysis. Since
      the ointment thickness was 157 microns, it was reasonable to assume that only the
      penetrant reaching the lower boundary was being measured. The values of the
      diffusion coefficients were then calculated using an equation that appropriately
      modeled the aforementioned conditions. The liquids tested exhibited diffusion
      coefficients in anhydrous lanolin and in polyethylene glycol ointment that ranged
      from 0.56 to 7.2 x 10(-7) and 0.68 to 5.7 x 10(-7) cm2/sec, respectively. The
      expected molecular weight dependency was observed.

PMID- 8483850
TI  - Optimization of conditions for preparing 2- to 5-micron-range gelatin
      microparticles by using chilled dehydration agents.

PMID- 8483851
TI  - Molecular cloning of the alcohol/hydroxysteroid form (mSTa1) of sulfotransferase
      from mouse liver.

PMID- 8483852
TI  - Micellar solubilization of clofazimine analogues in aqueous solutions of ionic
      and nonionic surfactants.

PMID- 8483853
TI  - The influence of molecular volume and hydrogen-bonding on peptide transport
      across epithelial membranes.

PMID- 8483854
TI  - Cost of health care.

PMID- 8483855
TI  - Effective control of hypercholesterolemia in children with dietary interventions
      based in pediatric practice.
AB  - BACKGROUND: Based on recent recommendations, the number of hypercholesterolemic
      children who would require dietary therapy could overwhelm current preventive
      pediatric cardiology resources. No previous studies have established the efficacy
      of such therapy in the pediatrician's office. The purpose of this study was to
      evaluate two programs of office-based therapy. METHODS: We randomly assigned 295
      children with hypercholesterolemia (> 185 mg/dl) two interventions: one single or
      four multiple 90-min sessions of family-oriented nutritional education, based in
      pediatric practices. We examined total cholesterol, 3-day food records, height
      and weight, and in the multisession group high-density lipoprotein cholesterol
      and triglycerides at the beginning and at intervals of 8.5-9 and 21 to 33 weeks
      (single-session and multisession groups, respectively). RESULTS: Total
      cholesterol was lowered equally in both treatment groups over the course of the
      study. This was accompanied by dietary changes: a decrease in calories derived
      from total and saturated fats, and increased intake of fiber, protein, and
      carbohydrate. However, more single-session patients withdrew from the program
      during the study. CONCLUSIONS: The two interventions were equally effective in
      lowering total and low-density lipoprotein cholesterol and in reducing intake of
      total and saturated fat. However, the higher completion rate of the multisession
      group suggests that this approach may be the more effective.

PMID- 8483856
TI  - Do obese children become obese adults? A review of the literature.
AB  - BACKGROUND: Obese children may be at increased risk of becoming obese adults. To
      examine the relationship between obesity in childhood and obesity in adulthood,
      we reviewed the epidemiologic literature published between 1970 and July 1992.
      Comparison between studies was complicated by differences in study design,
      definitions of obesity, and analytic methods used. Although the correlations
      between anthropometric measures of obesity in childhood and those in adulthood
      varied considerably among studies, the associations were consistently positive.
      RESULTS: About a third (26 to 41%) of obese preschool children were obese as
      adults, and about half (42 to 63%) of obese school-age children were obese as
      adults. For all studies and across all ages, the risk of adult obesity was at
      least twice as high for obese children as for nonobese children. The risk of
      adult obesity was greater for children who were at higher levels of obesity and
      for children who were obese at older ages. CONCLUSION: The wide range of
      estimates in this literature are, in part, due to differences in study designs,
      definitions of obesity, ages at which participants were measured, intervals
      between measurements, and population and cultural differences.

PMID- 8483857
TI  - Consistent lack of association between breast cancer and oral contraceptives
      using either hospital or neighborhood controls.
AB  - BACKGROUND: Case-control studies of oral contraceptive use and breast cancer have
      used neighborhood, population, or hospital controls. METHODS: To determine
      whether this association differs according to type of controls, interview data
      from 131 incident cases of breast cancer were compared with those of 189 hospital
      controls and 182 neighborhood controls Study subjects were white females
      recruited between 1973 and 1975 from among residents of Baltimore City and County
      ages 18 to 59 years. RESULTS: Adjusted relative odds of breast cancer related to
      ever versus never use of oral contraceptives were 1.0 and 0.8, using hospital and
      neighborhood controls, respectively. Relative odds did not increase
      proportionally to duration of oral contraceptive use or to progestogen potency.
      Although few subjects had used oral contraceptives for more than 2 years, almost
      all pill brands contained more than 49 micrograms of ethinyl estradiol or of
      mestranol. CONCLUSIONS: Results from the present study do not support the
      hypothesis that early preparations of oral contraceptives increased breast cancer
      risk among white women, regardless of whether controls are neighbors of the cases
      or hospital patients. However, its conclusions cannot be generalized to women who
      began taking the pill before their first full-term birth or took it for more than
      2 years.

PMID- 8483858
TI  - An ecological study of the relationship between dietary fat intake and breast
      cancer mortality.
AB  - METHODS: An ecologic study of the relationship between the per person supply of
      animal fat, vegetable fat, and fish fat obtained from the Food and Agricultural
      Organizations of the United Nations food balance sheets and female breast cancer
      mortality rates from 1961 to 1986 was carried out using data from 30 countries.
      RESULTS: In univariate analysis, a lag period of about 10 years was found for the
      highest correlations between breast cancer mortality rates and animal fat minus
      fish fat intake in the age groups 50 years and above. Age classes 50 years and
      above showed higher correlations between fat intake and breast cancer mortality
      than those below 50 years over the periods examined. In multiple regression
      analysis, animal fat minus fish fat intake showed a highly significant positive
      relationship with the breast cancer mortality rates (P < 0.001) in age groups 50
      years and above for all the periods examined. Whenever significant, dietary fish
      fat intake correlated negatively (P < 0.001) and vegetable fat positively (P <
      0.01) with breast cancer mortality. Moreover, a significant positive relationship
      (P < 0.001) between the change over time in animal fat minus fish fat intake and
      that in breast cancer mortality was found. To confirm these findings we also
      examined the correlation between breast cancer mortality and fat consumption data
      obtained from 46 dietary surveys performed in 17 countries. CONCLUSIONS: Although
      slightly less significant, the findings corroborate the relationships obtained by
      using FAO data. Our findings confirm the highly significant positive association
      between dietary fat and breast cancer mortality. The effect differs according to
      the type of fat consumed.

PMID- 8483859
TI  - Age, sex, educational attainment, and race/ethnicity in relation to consumption
      of specific foods contributing to the atherogenic potential of diet.
AB  - BACKGROUND: We examined which specific foods contributed to the atherogenic
      potential of diet in population segments defined by age, sex, educational
      attainment, and race/ethnicity. Data from the 1989 New York State Healthy Heart
      Program baseline survey were analyzed. METHODS: This telephone survey was
      conducted in eight communities (total population approximately 1.24 million
      people) in New York State. Response rate was 65.5% (N = 4,179); 3,606 subjects
      ages 20 to 64 years who reported their level of educational attainment with self
      described ethnicity of white (N = 1,935), black (N = 1,035), or Hispanic (N =
      636) were retained in the analysis. Diet was assessed using a 17-item food
      frequency questionnaire which focused on commonly eaten food high in saturated
      fat and cholesterol. Connor's cholesterol/saturated-fat index was used as a scale
      of the atherogenic potential of the diet. RESULTS: Eggs, whole milk, cheese,
      beef, and butter/margarine were the foods contributing most to the
      cholesterol/saturated-fat index score in all age-, sex-, and race/ethnicity
      specific population segments examined, together contributing a total of 52 to 72%
      of the cholesterol/saturated-fat index score as measured by the 17-item diet
      questionnaire. CONCLUSIONS: The implication for public health campaigns directed
      at reducing the atherogenic potential of diet atherogenicity and for primary care
      practitioners seeking to influence the diet of patients with high blood
      cholesterol is that substitutions of less atherogenic food choices for these five
      foods would appear to be appropriate for most adults.

PMID- 8483860
TI  - Coffee consumption and serum cholesterol. GISSI-EFRIM Study Group.
AB  - The relationship between coffee consumption and serum cholesterol was examined in
      the comparison group of a case-control study of myocardial infarction involving
      642 patients from various Italian regions who were hospitalized for diseases
      having no relationship to cardiovascular disease risk factors. Overall mean total
      cholesterol was 198.9 mg/dl. Mean cholesterol values (in mg/dl) standardized for
      age, sex, and smoking habits were 204.0 for nonconsumers of coffee, 194.8 for
      drinkers of one cup per day, 196.5 for two, 202.9 for three, 205.9 for four, and
      206.5 for five or more cups per day. Thus, serum cholesterol levels were higher
      in non-coffee drinkers than in moderate drinkers; among coffee drinkers, however,
      there was a direct, although moderate, relationship between the amount of coffee
      consumed and the total cholesterol levels. A similar though less consistent
      pattern was also evident across separate strata of sex, age, and smoking habits,
      and the association was appreciably greater among younger subjects (below age
      50). Although mean cholesterol levels in this Italian dataset were lower than
      those in other populations from northern Europe and the United States, the
      relative difference between moderate and heavy drinkers was proportionally
      similar to that reported in other studies. These results are of special interest
      since most Italian coffee (i.e., mocha or espresso) is unfiltered.

PMID- 8483861
TI  - The role of childbirth in smoking cessation.
AB  - BACKGROUND: Many women abstain from smoking during pregnancy, but relapse rates
      in the first year postpartum are high. The impact of childbirth on long-term
      abstinence from smoking is unknown for both women and men. METHODS: We assessed
      the impact of childbirth on long-term abstinence from smoking (minimum: 17
      months, much longer in most cases) in a retrospective cohort analysis of 925
      women and 1,494 men who were interviewed in 1984 to 1986 in the national baseline
      survey of the German Cardiovascular Prevention Study. RESULTS: Among women,
      smoking cessation rates resulting in long-term abstinence were about three times
      higher during the year of childbirth and the year before than in other years
      (adjusted rate ratio, 2.98; 95% confidence interval, 2.21-4.03). Childbirth was
      also associated with increased cessation rates among better educated men
      (adjusted rate ratio for this subgroup, 1.84; 95% confidence interval, 1.16
      2.92), but not among less educated men. Nevertheless, childbirth led to long-term
      abstinence from smoking only in a small minority of smoking mothers and fathers.
      CONCLUSION: Despite increased cessation rates around childbirth, more effective
      measures are needed to promote sustained abstinence after childbirth among both
      parents.

PMID- 8483862
TI  - Diffusion of a school-based substance abuse prevention program: predictors of
      program implementation.
AB  - BACKGROUND: The present study addresses diffusion of a psychosocial-based
      substance abuse prevention program, including: (a) teacher adoption,
      implementation, and maintenance; (b) teacher characteristics associated with
      implementation; (c) the relationship between integrity of program delivery and
      program outcomes; and (d) the effectiveness of teacher training and school
      principal involvement in increasing implementation. METHODS: Participants were
      teachers (n = 60), school principals (n = 25), and fifth-grade students (n =
      1147) from four Los Angeles area school districts. Districts were randomly
      assigned to an intensive or brief teacher training condition. Schools were
      randomly assigned to a principal-intervention or a no-principal-intervention
      condition. Assessments included teacher and principal self-reports, classroom
      observations of program delivery, and evaluation of immediate program outcomes.
      RESULTS: During the first year, 78% of trained teachers implemented one or more
      program lessons. During the second year, only 25% maintained implementation of
      the program. Implementors reported fewer years of teaching experience and
      stronger self-efficacy, enthusiasm, preparedness, teaching methods compatibility,
      and principal encouragement than did nonimplementors. The principal intervention
      increased rates of implementation, but the intensive teacher training did not.
      Integrity of program delivery was positively associated with immediate program
      outcomes. CONCLUSIONS: Program implementation was highly variable, suggesting
      that widespread teacher use of psychosocial-based programs cannot be taken for
      granted. Strategies for increasing implementation and maintenance need to be
      developed.

PMID- 8483863
TI  - Predictors and reasons for relapse in smoking cessation with nicotine and placebo
      patches.
AB  - BACKGROUND: The reasons for relapse to smoking are not fully understood but
      several factors are of importance. Addiction to nicotine seems to play a
      prominent role but there are several other contributing factors. METHODS: To
      determine predictors of outcome in smoking cessation, we performed univariate and
      multivariate analyses in a large smoking cessation trial comprising 289 subjects.
      Weight gain and withdrawal symptoms were analyzed separately as predictors. To
      determine self-perceived reasons for relapse we created a questionnaire, which
      was answered by 132 relapsers. RESULTS: Previous attempts to quit smoking and a
      low saliva cotinine concentration were significantly associated with abstinence
      in the nicotine-treated group. A trend toward higher abstinence rates was found
      among males and among subjects with a low nicotine dependency score. Logistic
      regression analysis showed higher success rates in subjects with the largest
      weight gain during the first weeks of quitting in contrast to higher relapse
      rates in subjects who had the greatest weight gain after 3 months. A high score
      on withdrawal symptoms was not predictive of relapse. Subjects with "slips" had a
      markedly increased relapse rate. Craving for cigarettes was the most often self
      reported (48%) reason for relapse. CONCLUSIONS: The relation between weight gain,
      withdrawal scoring, and outcome seems rather complex. Craving for cigarettes was
      the most reported reason for relapse.

PMID- 8483864
TI  - Cigarette smoking recidivism after participation in the "Five-Day Plan to Stop
      Smoking" in northeastern Italy.
AB  - BACKGROUND: This study was designed to evaluate the efficacy of the "Five-Day
      Plan to Stop Smoking" (the "Five-Day Plan") in helping smokers to give up the
      habit and to identify the characteristics of those smokers who succeeded in
      quitting. METHODS: Five hundred and forty-five smokers (363 men, mean age 41
      years, and 182 women, mean age 37 years) of a total of 683 (80%) who participated
      in eight courses of the Five-Day Plan, held in northeastern Italy between October
      1985 and April 1988, constitute the study group. They were contacted from 28 to
      70 months after their participation in the Five-Day Plan. RESULTS: Approximately
      70% of smokers tried to stop smoking for fear of smoking-related health hazards,
      and 15% (18% of men and 9% of women, P < 0.001) of these stopped because of
      smoking-related diseases or symptoms. Overall, 18% of the participants
      interviewed relapsed to cigarette smoking within 1 month after having taken the
      course, 44% within 1 year, and 59% after 5 years. Higher rates of recidivism
      after the Five-Day Plan were recorded among women than among men (55 and 39%
      after 1 year, respectively). Among men, older age and heavy smoking were
      significantly associated with a reduced probability of relapsing. Among women, a
      high level of education was the only significant predictor of smoking recidivism.
      CONCLUSIONS: These data indicate that the Five-Day Plan is useful in helping
      smokers who are already predisposed to quit their habit, but its efficacy seems
      to be largely restricted to men, in particular to older and heavier smokers.

PMID- 8483865
TI  - Interest in genetic testing for colon cancer susceptibility: cognitive and
      emotional correlates.
AB  - BACKGROUND: Recent advances in human genetics have led to the identification of
      markers for cancer susceptibility. Nevertheless, little is known about the
      public's interest in clinical genetic testing for cancer-related markers.
      METHODS: A random-digit-dial telephone survey of 401 adult residents of Utah was
      conducted during the summer of 1990. Respondents were randomized to one of three
      question frames and asked about their interest in a potential genetic test for
      colon cancer susceptibility. They were also asked to rate their risk for colon
      cancer, how often they worried about contracting any type of cancer, and how
      often they felt worried and nervous during the past year (trait anxiety).
      RESULTS: Eighty-three percent of respondents expressed interest in genetic
      testing. Level of interest was most strongly correlated with perceived risk for
      colon cancer (r = 0.21, P < 0.001). Responses were not affected by the use of
      different question frames. CONCLUSIONS: These results show a high level of public
      interest in genetic testing for colon cancer susceptibility. The data also
      suggest that anxiety does not undermine interest, but future research must
      determine whether this relationship is limited to hypothetical judgments such as
      those studied here.

PMID- 8483866
TI  - [Local and systemic side effects of inhaled corticosteroids--what is reliable?].

PMID- 8483867
TI  - [Thoracoscopic lung biopsy in diagnosis of interstitial lung diseases].
AB  - Thoracoscopic lung biopsy is accepted to be an appropriate method in diagnosing
      interstitial lung diseases when lung tissue examination is needed for accurate
      diagnosis. In our study of 30 patients with chronic interstitial lung diseases a
      high sensitivity of 97% was reached similar to the yield reported from open lung
      biopsy techniques. The manyfold described handicap of long lasting pleural
      fistula after thoracoscopic biopsies could be prevented in most cases by sealing
      the biopsy site with a fibrin layer. Thus the mean pleural drainage-time was
      reduced to 3.7 +/- 1.0 days and only 3 out of the 30 patients required a
      prolonged drainage up to 11 days. There were only a few minor complications
      except in one patient who developed an etiologically unclear pulmonary edema
      shortly after the procedure. However the results obtained by this modified
      bioptic technique are encouraging and confirm again the efficacy and safety of
      thoracoscopic lung biopsy in diagnosing interstitial lung diseases.

PMID- 8483868
TI  - [Autochthonous European dirofilariasis of the lung].
AB  - Two intrapulmonary round nodules were identified by x-ray examination in a 45
      year old German woman during an examination conducted before her employment who
      had been complaining of pain in the right side of the thorax and of mild coughing
      irritation and tiredness for several months prior to the health check. Since the
      intraoperative frozen section did not show any malignancy, and atypical resection
      of the two involved segments was performed. Histological processing of the
      surgical specimens showed two spherical ischemic necroses surrounded by a
      connective tissue border with inflammatory infiltration. In the centre of the
      larger of the two necrotic lesions a parasite was seen intravascularly, which
      because of morphological and serological findings, was identified as a
      Dirofilaria. It must be assumed that the infection of this patient occurred
      during a stay in Corsica where these nematodes are endemic in several mammal
      hosts. The patient was therefore suffering from an autochthonous European
      dirofilariasis of the lung. Only two cases of this infection acquired in Europe
      have been reported so far.

PMID- 8483869
TI  - Characterization of new monoclonal antibodies directed against normal human
      exocrine pancreas and pancreatic adenocarcinomas.
AB  - A series of 12 cell fusions of BALB/c mice spleen cells with the SP2/O-Ag14 mouse
      myeloma cell line were performed after immunizations with normal human pancreas
      to generate monoclonal antibodies (mAbs) with high affinity against antigens of
      the exocrine pancreas. The immunohistologic tissue screening resulted in the
      selection of 14 clones that were further characterized on frozen tissues, tumor
      cell lines, and lectin binding assays. Four mAbs reacting with pancreatic acini
      detected granular antigens and three mAbs reacted with acinar cell membrane
      antigens. Six other clones reacted with pancreatic ducts; among these were three
      clones positive with antigens in both acini and ducts. Among the clones reactive
      with secretory products, there was one pair of mAbs identified as pancreas
      specific (P78C9/P79D4); the other secretory antigens (identified by P97F3 and
      P109H1) were also detectable in other exocrine organs, but were absent from the
      gastrointestinal mucosa. Two clones reactive with acinar cell membranes (P96H2
      and P100H1) were also positive with hepatocytes. All but four antigens were
      detectable in pancreatic cancer cell lines Capan-1, Capan-2, and DAN-G. On the
      whole, immunizations were more effective using whole pancreatic tissues (eight
      clones selected) compared with single-cell suspensions as immunogen (four clones)
      or cell membrane preparations (two clones). Therefore, the immunization and
      screening strategies used in this study resulted in the generation of new mAbs
      against specific substructures of the exocrine pancreas. The shared expression of
      some of these antigens with other exocrine organs and pancreatic adenocarcinoma
      cell lines suggests that these mAbs detect antigens that are characteristic for
      the exocrine system and could therefore be useful for the study of the exocrine
      pancreas and pancreatic adenocarcinomas.

PMID- 8483870
TI  - Radioimmunoimaging of xenograft pancreatic cancer with 131I-monoclonal antibody
      P2.
AB  - Monoclonal antibodies (McAbs) to pancreatic cancer were developed by fusing SP2/0
      cells and splenocytes from Balb/c mice immunized with CH-2 cells. The specific
      binding rates of McAb P1 and P2 were 40.1 and 43.8%, respectively, shown by
      binding radioreactivity assay in vitro, which were in sharp contrast with those
      of control groups (p < 0.05). The biodistribution of radioiodinated McAb P2 was
      studied by measuring parameters of tumor-specific radioreactivity in nude mice
      bearing CH-2 tumors. The ratios of tumors to nontumors were all > 2 at 48 h. The
      localization index of cancer and the ratio of tumor to pancreas were 4.05 and
      4.16, respectively, at 72 h. Therefore, 131I-McAbs may be useful for
      radioimmunoimaging (RII) of pancreatic cancer. After intraperitoneal injection of
      131I-McAb P2 into tumor-bearing nude mice, imaging of xenograft pancreatic cancer
      became increasingly distinct with the nonspecific background fading, especially
      in the period of 72-96 h. Examination of pancreatic cancer tissues by
      immunohistochemical methods revealed that McAb P2 was strongly positive (86%) in
      comparison with other tumors and normal tissues. The results demonstrated that
      clinical RII of pancreatic cancer was feasible with McAb P2.

PMID- 8483871
TI  - Resistance of the human fetal beta-cell to the toxic effect of multiple low-dose
      streptozotocin.
AB  - The human fetal beta-cell is different from the adult beta-cell not only in that
      it is unable to release significant amounts of insulin during an acute glucose
      challenge, but also in that it is resistant to the toxic effects of a bolus of
      streptozotocin (STZ) and chronic exposure to cytokines tumour necrosis factor
      alpha and interferon-gamma. To examine further the differences between the
      immature and mature beta-cell, these cells were exposed to multiple low doses of
      STZ (MLS) both in vivo and in vitro, the regimen used being classically toxic to
      rodent adult beta-cells. The in vivo experiments were conducted after the tissue
      had been grafted into the athymic mouse. There was no adverse effect of MLS on
      the insulin content of engrafted human fetal pancreatic explants, either 1, 4, or
      15 weeks after the injection of 70 mg/kg/i.p. STZ daily for 5 days. Diabetes,
      induced in the mice by MLS or a bolus of STZ, was reversed in five of seven MLS
      treated mice at 59 +/- 8 days and four of seven STZ-treated animals at 75 +/- 10
      days (no significant difference). The growth rate of the implanted tissues also
      was not adversely affected by the MLS, nor was the percentage of beta-cells 2
      weeks after completion of the MLS. In contrast, mouse fetal beta-cells
      transplanted into the athymic mouse were adversely affected, their insulin
      content 2 weeks after MLS being only 0.7% that of controls.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8483872
TI  - Marked islet amyloid polypeptide-positive amyloid deposition: a possible cause of
      severely insulin-deficient diabetes mellitus with atrophied exocrine pancreas.
AB  - An insulin-deficient 51-year-old man was put on dietary therapy and sulfonylurea
      (SU). Although there was good glycemic control for 2 years, the fasting blood
      glucose (FBG) level increased gradually over the subsequent 4-year period, and
      there was a marked increase in body weight. Secondary failure of SU therapy 20
      years after the initial diagnosis led to insulin therapy. The FBG became
      unstable, and the C-peptide response disappeared. The patient died of nonketotic
      hyperosmolar coma and pneumonia at the age of 87. At autopsy, the pancreas showed
      marked atrophy (32 g) with extensive fatty degeneration. Islets replaced by islet
      amyloid polypeptide (IAPP)-positive amyloid (IAPP-AM) amounted to 77% in the
      tail, 74% in the body, and 73% in the head of the pancreas. All islets were
      positive for IAPP-AM throughout the pancreas, except for a pancreatic polypeptide
      rich lobe, where none were positive. IAPP-AM-positive islets had also undergone
      fatty change of the surrounding pancreatic acinar cells. beta-Cells decreased
      remarkably in number and were displaced to the periphery of the islets by the
      IAPP-AM deposits. These findings suggest that IAPP-related diabetes could have a
      progressive course, with secondary oral hypoglycemic agent failure and the
      subsequent development of severe insulin deficiency similar to that seen in
      insulin-dependent diabetes mellitus.

PMID- 8483873
TI  - Synthesis-secretion coupling of insulin: effect of pregnancy and lactation.
AB  - Synthesis-secretion coupling of insulin was determined using perfused pancreata
      taken from either control, pregnant, or lactating female Sprague-Dawley rats. The
      pancreata were stimulated for 3 h with one of the two glucose concentrations
      used: either 150 or 300 mg/dl. In the case of pregnancy, the pancreata exhibited
      a twofold hypersecretory activity in response to the physiological glucose level
      of 150 mg/dl. Net insulinogenesis did not occur in response to the normoglycemic
      glucose concentration, and, as with the controls, there was an overall depletion
      of insulin stores. There was no insulin hypersecretion at the hyperglycemic level
      of 300 mg/dl, but net insulinogenesis did occur; however, it matched that of the
      controls. Therefore, the hypersecretion of insulin ascribed to pregnancy appears
      to be a function of the secretory process only, to be most demonstrable under
      normoglycemic conditions, and not to be due to enhanced synthesis-secretion
      coupling. In the case of pancreata from lactating rats, just the converse was
      observed. Compared with controls, there was no substantial difference in insulin
      secretion by pancreata from lactating rats at either glucose level or of
      insulinogenesis under normoglycemia conditions. However, when glucose was at a
      hyperglycemic load in the lactating group, not only was there no net
      insulinogenesis, but this condition actually resulted in a depletion of
      intracellular insulin stores (as opposed to both the control and the pregnant
      groups). This suggests that the hypoinsulinemia noted during lactation may be
      related to a reduced capacity of those beta-cells to synthesize insulin the face
      of prolonged hyperglycemic stimulation.

PMID- 8483874
TI  - Nesidioblastosis as a mechanism to prevent fibrosis-induced diabetes after
      pancreatic duct obstruction.
AB  - Does obstruction of the main pancreatic duct that results in exocrine atrophy
      also result in diabetes? We followed 11 mongrel dogs for 3 years after
      approximately three-fourths of the pancreas had been removed and the main
      pancreatic duct obstructed in the pancreatic tail remnant. At 3 years after
      surgery, all dogs showed total exocrine atrophy (remnants weighed 0.2-1.2 g).
      None of the animals became diabetic despite only 6% of the original pancreatic
      tail remaining. During the 3-year period, fasting blood insulin increased during
      the last half of the study, and this was associated with islets that were 1,300%
      larger than in control animals (nesidioblastosis). An in situ pancreatic remnant
      with an obstructed duct and total exocrine atrophy can maintain a nondiabetic
      state for > 3 years. Perhaps the mechanism is associated with the observed
      nesidioblastosis.

PMID- 8483875
TI  - Effects of pancreaticobiliary diversion and gastric fundectomy on azaserine
      induced pancreatic carcinogenesis in the rat.
AB  - The effects of pancreaticobiliary diversion (PBD) and gastric fundectomy on the
      pancreas in azaserine-treated rats were studied over 14 months. Sham-operated
      azaserine-treated animals served as controls. A significant increase in
      pancreatic weight and total DNA and protein content was found in PBD-operated and
      fundectomized animals. DNA flow cytometry showed a significantly increased ratio
      of tetraploid to diploid cells in pancreatic tissue in both experimental groups.
      Mean values of all these variables were significantly higher after PBD than after
      fundectomy. Acidophilic atypical acinar cell foci of the pancreas were observed
      in all of the experimental and 75% of the control animals. The volume density of
      these foci was significantly higher in each experimental group than in the
      controls. The volume density, radioactive thymidine labeling index, and mitotic
      index of the foci were significantly higher after PBD than after fundectomy.
      Changes consistent with pancreatic adenoma were diagnosed in the PBD group only.
      It is concluded that not only PBD with endogenous hypercholecystokininemia, but
      also fundectomy with endogenous hypergastrinemia lasting about half of the life
      span in rats, induces pancreatic hypertrophy and enhances the development of
      precancerous pancreatic changes after azaserine treatment. In comparison with
      PBD, fundectomy caused less pronounced changes and no observable neoplasia.

PMID- 8483876
TI  - Severe subcellular damage in the rat exocrine pancreas after pancreatobiliary
      diversion.
AB  - Cholecystokinin (CCK) may contribute to the genesis of both pancreatic carcinoma
      and acute pancreatitis. By transposing a long segment of jejunum to lie between
      the pylorus and the duodenal papilla, pancreatobiliary diversion (PBD) causes a
      persistent increase in circulating CCK levels, as the normal feedback inhibition
      of jejunal CCK release by pancreatic juice is evaded. A number of morphological,
      physiological, and acinar cytokinetic changes ensue. This investigation has
      examined the ultrastructural changes in pancreatic acinar cells after PBD in the
      presence and absence of CR1409 (lorglumide), a CCK receptor antagonist. After 14
      days there was degranulation and vacuolation of acinar cells with involvement of
      the enzyme acid phosphatase. The presence of morphologically distinct
      extracisternal acid phosphatase indisputably predisposed acinar cells to severe
      damage. Treatment with CR1409 largely prevented degranulation after PBD, but
      vacuolation of acinar cells still occurred, indicating a possible toxic effect of
      the receptor antagonist. This is the first report of CCK itself, rather than one
      of its analogues, causing in vivo pancreatic damage that is generally considered
      as a forerunner to acute pancreatitis. This is of fundamental importance to the
      understanding of the earliest stages of the disease.

PMID- 8483877
TI  - Acute pancreatitis is not a cause of chronic pancreatitis in the absence of
      residual duct strictures.
AB  - It has been shown that intraductal injections of bile salts into the bile
      pancreatic ducts of dogs or rats were immediately followed by acute hemorrhagic
      pancreatitis and, some months later, by persisting chronic pancreatitis. The
      study described in this article was designed to test the assumption that these
      chronic lesions were due to ductal strictures secondary to the toxic effect of
      bile salts. The bile-pancreatic ducts of 100 rats were injected with 0.2 ml of a
      solution containing 4 microM Na taurodeoxycholate and 0.2 microM trypsin. The 66
      survivors were killed at intervals from 1 day to 2 months following the induction
      of acute pancreatitis. Four to six sections were done in the first series, and
      serial 15-micron sections of the entire pancreas were taken from rats surviving 2
      months. These showed that from the sixth day on, the largest ducts draining
      pathological areas were obstructed by fibrosis. Distal to this obstruction,
      intralobular ducts were dilated and their epithelia flattened or atrophied. Acini
      were atrophied and replaced by peri- and intralobular fibrosis. Lesions were
      limited to areas drained by obstructed ducts, with the rest of the parenchyma
      being normal. We conclude that in experimental animals, as in human beings,
      chronic lesions that persist after acute pancreatitis are due to duct
      obstruction, not to acinar necrosis.

PMID- 8483878
TI  - Pancreatic necrosis: an early finding in severe acute pancreatitis.
AB  - Despite the clinical importance of pancreatic necrosis in the course of acute
      pancreatitis, little is known about when it develops. Serum C-reactive protein
      (CRP) is a reliable parameter with a high deduction rate for pancreatic necrosis.
      We analyzed 199 patients with acute pancreatitis. The development of pancreatic
      necrosis was ascertained by a daily measurement of serum CRP in 45 patients with
      contrast-enhanced computed tomographic-proven necrotizing pancreatitis. In all 45
      cases, the criteria for pancreatic necrosis were satisfied within the first 4
      days of the onset of symptoms. This indicates that pancreatic necrosis is an
      early finding that develops within hours.

PMID- 8483879
TI  - Effect of L-364,718 (CCK receptor antagonist) on exocrine pancreatic secretion of
      adrenalectomized rats.
AB  - The exocrine pancreatic secretion of control and adrenalectomized rats treated
      with L-364,718 was studied. The blockade of the action of endogenous
      cholecystokinin (CCK) in the control animals was reflected in a reduction of
      basal pancreatic secretion. This effect was reversed by the administration of
      submaximal doses of CCK-8. Under treatment with L-364,718, no decrease in
      pancreatic weight was observed. From this it may be deduced that factors other
      than CCK act on the pancreas to maintain the processes of enzyme synthesis and
      storage. Adrenalectomy reduced the weight of the pancreata; the main cause of
      this was the depletion of zymogen granules, which has been reported in
      adrenalectomized rats and is accompanied by a reduction in enzyme secretion,
      especially that of amylase. By contrast, the administration of L-364,718 from the
      very first moments after adrenalectomy leads to a retention of pancreatic
      enzymes. This effect is reflected in the maintenance of pancreatic weight and a
      secretory capacity in response to submaximal doses of CCK-8 similar to that of
      nonadrenalectomized animals. Accordingly, in the absence of glucocorticoids,
      endogenous CCK dominates the secretory process because when the action of this
      secretagogue is prevented by the administration of L-364,718, the discharge of
      proteins able to be secreted in response to a suitable stimulus is inhibited.

PMID- 8483880
TI  - To immunostain or not to immunostain, that is the question.

PMID- 8483882
TI  - H-ras-1 point mutations in soft tissue sarcomas.
AB  - The H-ras-1 protooncogene is activated by single base substitutions occurring in
      either codon 12, 13, or 61. These mutations have been described with varying
      frequencies in several human tumor types. Since ras oncogenes were first
      discovered as the transforming sequences of Harvey and Kirsten murine sarcoma
      viruses (which also contain activating point mutations compared to the homologous
      cellular sequences), we wished to investigate the possibility that ras mutations
      might also occur in human sarcomas. We extracted DNA from six malignant fibrous
      histiocytomas (MFH), three embryonal rhabdomyosarcomas (ER), one alveolar
      rhabdomyosarcoma, one pleomorphic rhabdomyosarcoma, and one leiomyosarcoma. The
      DNA from regions flanking codons 12/13 and codon 61 was amplified by the
      polymerase chain reaction and sequenced with an automated DNA sequencer. As
      controls, we amplified and sequenced normal DNA (placenta) and DNA with known
      point mutations (T24 bladder carcinoma cells). We found three cases with
      mutations, all occurring in codon 12. One ER showed a G-to-T mutation in the
      second position of codon 12 (coding for valine instead of glycine). Two MFHs
      showed G-to-A mutations in the second position of codon 12 (coding for aspartic
      acid instead of glycine). Although a limited number of cases were sampled, we
      conclude that study of H-ras-1 mutations may be relevant to MFH and ER.
      Additional studies of N and K-ras mutations as well as more cases investigating H
      ras will be required before we can ascertain the significance of ras mutations in
      the oncogenesis of human soft tissue sarcomas.

PMID- 8483881
TI  - Focal and segmental glomerulosclerosis in nephrotic syndrome: a new profile of
      adult nephrotic syndrome in Zaire.
AB  - In order to assess renal pathology, 92 clinically well-documented cases of
      nephrotic syndrome (NS) in adults (median age: 29) were systematically biopsied
      upon admission to the University Hospital of Kinshasa, between 1986 and 1989. All
      biopsies were paraffin embedded and histologically assessed by the routine
      methods of light microscopic examination. Histologic lesions were classified
      according to standard criteria. Focal and segmental glomerulosclerosis (FSG) was
      found in 41% of patients. The remaining 59% included minimal epithelial disease
      or minimal change nephropathy (MCN) responsive to corticosteroid therapy (14%),
      proliferative glomerulonephritis (PGN) (11%), membranous glomerulopathy (MGP)
      (10%), amyloidosis (10%), membrano-proliferative glomerulonephritis (MPGN) (8%),
      and "end stage kidney" (ESK) (7%). These results strikingly indicate the high
      prevalence of FSG. In comparison with previous findings from the same milieu,
      there is a seven-fold increase of this entity (41% versus 6%). The findings
      herein reported define a new histologic profile of NS in Zaire, characterized by
      the predominance of FSG. While in the past the vast majority of NS (52%) were
      putatively related to the intercurrent parasitic diseases, among which malaria
      was the chief etiology, similar associations were less important. Instead, no
      definite causative agent emerged for this apparently idiopathic condition.
      Further epidemiological and morphological intercorrelation studies, as well as
      the studies aimed at the relationships with AIDS, are in progress, with the
      purpose of identifying putative etiologies and risk factors responsible for the
      increase of FSG in Zaire.

PMID- 8483883
TI  - Immunohistochemistry of childhood sarcomas: old and new markers.
AB  - The frequent difficulties encountered in the diagnosis of pediatric sarcomas,
      caused by the lack of observable differentiation at the light microscopic level,
      has led to the routine use of immunohistochemistry in pediatric surgical
      pathology. To a large degree the advent of this staining technique has led to the
      correct assessment of many perplexing lesions that previously would have been
      given inconclusive diagnoses. However, with increased usage and testing, it has
      become apparent that there are few, if any, "magic bullets" in
      immunohistochemistry for pediatric pathologists. Thus, it behooves diagnosticians
      to be careful in the usage of this technique, to be aware of possible
      discrepancies in its results, and to remember the ancillary nature of its
      application. The following article will review selected markers commonly used in
      pediatric surgical pathology, from both previous reports and the author's
      perspective, and will briefly consider several new phenotypic markers which have
      potential utility with childhood sarcomas.

PMID- 8483884
TI  - Immunohistologic characterization of gastrointestinal stromal tumors: a study of
      82 cases compared with 11 cases of leiomyomas.
AB  - The histogenesis of stromal tumors of the gastrointestinal tract (GIST) is still
      controversial. Recent immunohistologic and ultrastructural studies have been
      inconsistent and suggest various cells of origin. In view of these uncertainties,
      we studied the immuno-profiles of 82 cases of GISTs and 11 cases of stromal
      tumors that we classified as leiomyomas based on histology. The 82 cases of GIST
      were subclassified as spindle or epithelioid type stromal tumors based on the
      predominant pattern and further divided into benign (< 5 cm in size and < 5
      mitosis/50 HPF), malignant (> 5 mitosis/50 HPF), and borderline lesions (> 5 cm
      and < 5 mitosis/50 HPF). A panel of antibodies was used to characterize
      differentiation toward myogenic cells [pan-muscle actin (HHF-35), alpha-smooth
      muscle actin (SMA) and desmin], Schwann cells (S-100 protein), enteric glial
      [(glial fibrillary acidic protein (GFAP)], and nerve cells (neurofilaments). All
      leiomyomas were strongly positive for the three muscle markers. Of the 82 GISTs,
      only four cases (5%) were positive for desmin. However, 63% (52 cases) were
      positive with anti-pan-muscle actins and 39% (32 cases) were positive with anti
      SMA. Compared with gastric tumors, the positivity rates were much higher for
      small bowel tumors. Seventy-nine cases (96%) were positive for vimentin, only
      five cases and two cases were focally and weakly reactive for S-100 protein and
      GFAP respectively, and none stained for neurofilaments.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8483885
TI  - Quantitative criteria for clonality in the diagnosis of B-cell non-Hodgkin's
      lymphoma by flow cytometry.
AB  - Fifty-three cases of B-cell non-Hodgkin's lymphoma (BNHL) and 41 cases of non
      BNHL lesions were retrospectively evaluated for the quantitative features of
      restricted surface light chain expression, pan B-cell antigens, pan T-cell
      antigens, and T-helper and T-suppressor phenotype using flow cytometry. Decision
      limit analyses were applied to multiple quantitative indices of immunophenotype
      to establish criteria for the detection of clonal proliferation associated with
      BNHL or non-BNHL conditions. Two data expressions (percent population and
      relative ratios) were simultaneously analyzed. The percent population measures
      were amenable to parametric analyses; the ratio data were amenable to
      nonparametric analyses only. Acceptable diagnostic specificity and sensitivity
      were obtained using decision limits of 75% kappa light chain and 65% lambda light
      chain for the detection of clonal proliferations associated with BNHL. Comparable
      diagnostic criteria for light chain ratios of 3:1 and 2:1 were similarly
      confirmed for cases of kappa clonal and lambda clonal proliferations,
      respectively. Neither the percent of B-cells present nor the ratio of T-helper
      cells to T-suppressor cells were of utility in the diagnosis of BNHL. These data
      confirm the numerical criteria for clonality previously obtained by cell counting
      studies of immunocytochemical preparations and characterize quantitative criteria
      for aid in the diagnosis of BNHL based on restricted surface light chain
      expression as measured by flow cytometry.

PMID- 8483886
TI  - Immunocytochemical identification of T-cells in HIV-1 encephalitis: implications
      for pathogenesis of CNS disease.
AB  - T-lymphocytes enter the brain in viral encephalitides. The monoclonal antibodies
      UCHL1 and Leu22 are widely used to identify these cells; however, both antibodies
      cross-react with peripheral blood monocytes, cells ontologically related to brain
      macrophages and microglia. This study examines the nature of UCHL1- and Leu22
      positive cells in HIV-1 encephalitis, and investigates whether they carry the
      gp41 epitope of HIV-1. Formalin-fixed sections of brain from eight AIDS patients
      were double-stained using combinations of UCHL1 and Leu22 antibodies with the
      lectin Ricinus communis agglutinin (RCA), a lectin that binds to microglia,
      macrophages, and multinucleated giant cells (MNGC), or antibody to the gp41
      transmembrane protein of HIV-1 and UCHL1. Some sections were also stained with
      the OPD4 antibody to helper/inducer T-cells. Small round cells were single
      stained for UCHL1 and Leu22 in all cases. A few cells having morphologic
      characteristics of microglia, macrophages, and MNGC were observed using double
      stains employing UCHL1 or Leu22 and RCA, or UCHL1 or Leu22 and anti-gp41. Small
      round cells positive for both UCHL1 or Leu22 and gp41 could represent either
      macrophages or lymphocytes. The presence of small round cells positive only for
      UCHL1 or Leu22 in double-stained sections strongly suggests that T-cells are
      present in the brain in HIV encephalitis. Only a few of these cells were positive
      with OPD4 antibody for T-helper cells. Inability to demonstrate unequivocally HIV
      1-infected T-cells suggests that microglia and macrophages, not T-cells, are the
      more important reservoirs of retrovirus in the brain.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8483887
TI  - Occurrence of melanin in pheochromocytoma.
AB  - Melanin or a melanin-like pigment was observed in six of 19 pheochromocytomas.
      The intracellular pigment was Fontana-positive, bleach-labile dark brown to black
      material and distinct from coincidental hemosiderin and lipochrome.
      Ultrastructural components of the pigmented tumors include melanosomes and
      premelanosomes. Two patients with pigmented tumors had associated von Hippel
      Lindau syndrome, and one had neurofibromatosis. The occurrence of melanin and
      melanosomes in pheochromocytoma has not been previously reported in the English
      literature. It is probably a reflection of the neural crest origin of this
      neoplasm.

PMID- 8483888
TI  - Immunocytochemistry in the differential diagnosis of effusions: use of logistic
      regression to select a panel of antibodies to distinguish adenocarcinomas from
      mesothelial proliferations.
AB  - Many studies have shown immunohistochemistry to be beneficial in discriminating
      between adenocarcinoma and mesothelial reactions in effusions. Although many of
      these studies suggest using a panel of antibodies, none of them used statistical
      methods to optimize their choice of assays. In the current study, stepwise
      logistic regression was applied to our data to select an appropriate panel of
      antibodies to differentiate between adenocarcinoma and all types of mesothelial
      proliferations. One hundred effusions (64 cases of adenocarcinoma, 27 cases of
      benign mesothelial proliferations, and 9 cases of malignant mesothelial
      proliferations) were analyzed for their reactivity with anti-EMA, anti-MFG, anti
      CEA, Leu-M1, B72.3, and the newly described epithelial membrane marker BER-EP4.
      An abbreviated panel consisting of anti-CEA, EMA, and B72.3 was shown to be
      sufficient in over 95% of our cases to accurately characterize a given effusion.
      When all three assays are negative, a diagnosis of adenocarcinoma is extremely
      unlikely, while when two or three of the assays are positive a diagnosis of
      adenocarcinoma is almost certain. The use of stepwise logistic regression has
      proven useful in the design of antibody panels as an adjunct to the differential
      diagnosis of effusions and may be applicable to the selection of panels in other
      diagnostic problems.

PMID- 8483889
TI  - Identification of Toxoplasma gondii in formalin-fixed, paraffin-embedded tissue
      by polymerase chain reaction.
AB  - We investigated the use of polymerase chain reaction (PCR) for diagnosis of
      toxoplasmosis in formalin-fixed, paraffin-embedded tissue, using seven cases in
      which the diagnosis was certain based on histologic examination and eight cases
      in which histologic findings only suggested Toxoplasma gondii infection. After
      amplification the PCR products were subjected to agarose gel electrophoresis
      followed by Southern blotting with a 32P-labeled oligonucleotide probe. In six of
      seven proven cases of toxoplasmosis, organisms were detected using DNA extracted
      from 1/50 to 3/50 of a 6-microns tissue section. In addition, organisms were
      detected in one of eight cases in which infection was suspected, but not proven
      by identification of organisms. We conclude on the basis of this study that PCR
      may be useful for detection of T. gondii in a few cases in which routine
      histologic examination or immunoperoxidase staining is not definitive. Since PCR
      has 1000-fold higher sensitivity when applied to fresh, rather than paraffin
      embedded, tissues, we expect PCR to be more sensitive in fresh tissue.

PMID- 8483890
TI  - p53 protein immunostaining in routinely processed paraffin-embedded sections.
AB  - Mutation of the p53 tumor suppressor gene is the most common genetic alteration
      in human tumors. The altered protein product of the mutant gene is stabilized in
      tumor cells and can be detected using monoclonal antibody immunohistochemistry.
      We report a technique for immunostaining of the altered p53 protein in routinely
      processed paraffin-embedded tissue sections, comparing this method with a frozen
      section immunostain method for concordance. Similarly processed tumor cell lines
      with known mutations or deletions of the p53 gene served as positive or negative
      controls. The results in 25 human gliomas and 20 colorectal carcinomas showed a
      100% correspondence of positive reactivity in the colorectal carcinomas and an
      83% correspondence in the gliomas. In no case did the paraffin-embedded sections
      react in the absence of frozen section reactivity (that is, there were no false
      positives). Three of 18 gliomas showed reactivity in frozen sections without
      reactivity in the companion paraffin-embedded sections. This discrepancy could
      have been caused by technical factors such as length of fixation time. We propose
      that this new paraffin-embedded section immunostaining method will be of value as
      a screening technique for the investigation of p53 mutations in archived human
      tumors. The data thus obtained may then be correlated with clinical information
      and perhaps be of value in diagnosis or predicting outcome for various human
      cancers.

PMID- 8483891
TI  - RT-PCR detection of mRNA recovered from archival glass slide smears.
AB  - This manuscript describes a protocol for the utilization of glass slide
      preparations of hematologic specimens for the recovery of mRNA that is of a
      quality suitable for the reverse transcription-polymerase chain reaction (RT-PCR)
      detection of specific gene expression. Total cellular RNA obtained from archival
      bone marrow aspirate smears of 23 leukemia patients, which had been stored for
      periods of time from 1 day to 34 mo, were extracted, and 1 to 2 micrograms of
      each were subjected to RT-PCR using primer pairs specific for the amplification
      of beta-actin cDNA. Three pairs of primers for the amplification of beta-actin
      cDNAs of 83,260, and 540 base pairs were used to evaluate the length of mRNA that
      could be analyzed; the results indicate the consistent amplification of cDNA for
      the short- and intermediate-sized fragments as revealed by ethidium bromide
      fluorescence of agarose gel-resolved PCR products. To address the utility of RT
      PCR analysis towards the detection of mRNA associated with specific gene
      alterations in such specimens, a primer pair for amplification of the E2A-PBX1
      fusion cDNA was used in PCRs of RT cDNAs for each of the 23 specimens, three of
      which were pre-B-cell acute lymphoblastic leukemias known to have the t(1;19)
      karyotype alteration resulting in the fusion of the E2A and PBX1 genes. Agarose
      gel electrophoresis analysis of the products of these RT-PCR amplifications
      revealed the amplification of the fusion gene cDNA in only those cases for which
      there was cytogenetic documentation of t(1;19); these results were confirmed by
      the Southern filter hybridization of an internal E2A-PBX1
      oligonucleotide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483892
TI  - Methods of radical prostatectomy specimen processing: a novel technique for
      harvesting fresh prostate cancer tissue and review of processing techniques.
AB  - Standard processing techniques for radical prostatectomy specimens uniformly
      require initial formalin fixation. Fresh prostate cancer tissue is needed for
      many types of prostate cancer research and may be needed for diagnostic purposes
      in the future. We describe a method for processing radical prostatectomy
      specimens that allows pre-fixation sectioning and harvest of fresh prostate
      cancer tissue. Because of increased difficulty interpreting capsular margin
      sections, however, we do not recommend it for routine use. We review other
      methods of radical prostatectomy specimen processing and provide an algorithm for
      their appropriate use.

PMID- 8483893
TI  - An immunocytochemical search for infectious agents in Crohn's disease.
AB  - Microorganisms have long been suspected of causing Crohn's disease (CD); however,
      an etiologic agent has yet to be identified. Few studies have employed
      immunocytochemistry (ICC) to examine tissue from patients with CD for microbial
      antigens. We investigated 36 formalin-fixed tissues from 16 patients with CD with
      ICC. No evidence of adenovirus, Borrelia, Brucella, BVDV, Campylobacter,
      Campylobacter-like organisms, Chlamydia, coronavirus, CMV, EBV, Legionella,
      mycobacteria, Pseudomonas, rotavirus, Salmonella, Shigella, staphylococci,
      Toxoplasma gondii, Treponema, or Yersinia was found. ICC identified E. coli and
      streptococcal antigens in 11 (69%) and 10 (63%) of the 16 cases studied,
      respectively. Escherichia coli immunoreactivity was located in ulcers, within the
      lamina propria, and along fissures. Streptococcal immunolabeling occurred within
      mucosal epithelial cells, in the lamina propria, in ulcers, along fissures, in
      granulomatous inflammation including multinucleate giant cells, and in lymph
      nodes. These results suggest that some of the granulomas in CD may result from
      immunologic processing of bacterial antigens following their penetration through
      a compromised mucosa. E. coli and streptococcal antigens may contribute to the
      pathogenesis of CD.

PMID- 8483894
TI  - Economic analysis of the clinical laboratory: labor implications.
AB  - Expenditures on laboratory tests have increased by 468% in real dollars in two
      decades although the cost per test has remained constant. Cost of labor has
      doubled over that period, with an approximately similar increase in personnel
      productivity as the offset. Part of the increased labor cost relates to increased
      pay for technologist work of apparent increased complexity. We found that
      technologists perceived less than 20% of all work and less than 4% of all tests
      performed to be highly complex or of moderately high complexity. Implications of
      these findings for test complexity analysis and for technologist training are
      discussed.

PMID- 8483895
TI  - Clear cell adenocarcinoma of the urinary bladder: report of a case of probable
      mullerian origin.
AB  - A 35-yr-old woman with a history of endometriosis and several recent episodes of
      hematuria was found to have an exophytic tumor arising from the mucosa of the
      posterior bladder wall. Microscopic examination showed a typical clear cell
      adenocarcinoma with a predominant tubulo-cystic pattern. A radical cystectomy was
      performed. Pathologic examination showed no residual tumor, but grossly visible
      intramural cysts at the site of the tumor had features of endometriosis on
      microscopic examination, strongly suggesting that the clear cell adenocarcinoma
      arose from endometriosis and was of mullerian derivation. Only one other
      adenocarcinoma of the bladder, an endometrioid adenocarcinoma, has had a probable
      mullerian origin. Although rare, these cases indicate that some vesical
      adenocarcinomas are of mullerian type.

PMID- 8483896
TI  - Intraluminal obstruction of distal ileum caused by a uterine leiomyoma.
AB  - A 64-yr-old woman with nausea, vomiting, abdominal pain, and fecal impaction was
      found at autopsy to have an ileal obstruction by an intraluminal, calcified,
      spiculated mass. Examination revealed that this calcified mass had the features
      of a uterine leiomyoma. We postulate that a calcified, pedunculated uterine
      leiomyoma formed adhesions with the distal ileum, eroded through the ileal wall,
      and came to rest in the bowel lumen. Here, it was partially digested by the flow
      of intestinal contents, freed from its pedicle, and ultimately created an ileal
      obstruction. This rare complication of uterine leiomyomas has not been previously
      documented.

PMID- 8483897
TI  - Evidence for covalent binding of acyl glucuronides to serum albumin via an imine
      mechanism as revealed by tandem mass spectrometry.
AB  - Acyl glucuronide metabolites of bilirubin and many drugs can react with serum
      albumin in vivo to form covalent adducts. Such adducts may be responsible for
      some toxic effects of carboxylic nonsteroidal antiinflammatory agents. The
      mechanism of formation of the adducts and their chemical structures are unknown.
      In this paper we describe the use of tandem mass spectrometry to locate binding
      sites and elucidate the binding mechanism involved in the formation of covalent
      adducts from tolmetin glucuronide and albumin in vitro. Human serum albumin and
      excess tolmetin glucuronide were coincubated in the presence of sodium
      cyanoborohydride to trap imine intermediates. The total protein product was
      reduced, carboxymethylated, and digested with trypsin. Six tolmetin-containing
      peptides (indicated by absorbance at 313 nm) were isolated by high-pressure
      liquid chromatography and analyzed by liquid secondary-ion mass spectrometry and
      collision-induced dissociation, using a four-sector tandem mass spectrometer. All
      six peptides contained tolmetin linked covalently via a glucuronic acid to
      protein lysine groups. Major attachment sites on the protein were Lys-195, -199,
      and -525; minor sites were identified as Lys-137, -351, and -541. Our results
      show unambiguously that the glucuronic acid moiety of acyl glucuronides can be
      retained within the structure when these reactive metabolites bind covalently to
      proteins, and they suggest that acyl migration followed by Schiff base (imine)
      formation is a credible mechanism for the generation of covalent adducts in vivo.

PMID- 8483898
TI  - Atomic force microscopy of biochemically tagged DNA.
AB  - Small fragments of DNA of known length were made with the polymerase chain
      reaction. These fragments had biotin molecules covalently attached at their ends.
      They were subsequently labeled with a chimeric protein fusion between
      streptavidin and two immunoglobulin G-binding domains of staphylococcal protein
      A. This tetrameric species was expected to bind up to four DNA molecules via
      their attached biotin moieties. The DNA-protein complex was deposited on mica and
      imaged with an atomic force microscope. The images revealed the protein chimera
      at the expected location at the ends of the strands of DNA as well as the
      expected dimers, trimers, and tetramers of DNA bound to a single protein.

PMID- 8483899
TI  - Actin is a surface component of calf pulmonary artery endothelial cells in
      culture.
AB  - An angiogenin binding protein isolated previously from endothelial cells has been
      shown to be a member of the actin family. Calf pulmonary artery endothelial
      (CPAE) cells were investigated for the presence of surface actin by
      immunoblotting of isolated surface proteins and by immunofluorescence. CPAE cell
      surface proteins were isolated by selective apical biotinylation and recovery of
      biotinylated proteins by avidin affinity chromatography. Immunoblotting with a
      specific smooth muscle alpha-actin antibody detected the presence of this type of
      actin among the isolated cell surface proteins. Immunofluorescence confirmed that
      smooth muscle alpha-actin is localized at the surface of nonpermeabilized CPAE
      cells. Exposure of CPAE cells to angiogenin prior to cell surface immunostaining
      diminished the signal. When CPAE and rat aortic smooth muscle cells were made
      permeable before staining, stress fibers could be recognized by the antibody in
      smooth muscle cells but not CPAE cells. The results indicate that a smooth muscle
      type of alpha-actin is localized specifically on the surface of cultured CPAE
      cells where it might interact with angiogenin and other actin binding proteins
      present in the extracellular environment.

PMID- 8483900
TI  - Assembly of cartilage collagen fibrils is disrupted by overexpression of normal
      type II collagen in transgenic mice.
AB  - Cartilage collagen fibrils, which are characterized by their thin, uniform
      diameters, are formed of a multicomponent system of three collagen types (II, IX,
      and XI) and interacting proteoglycans. We have used a genetic approach to test
      whether the proper assembly of this multiprotein structure was altered by
      overexpression of one of its normal components. Here we show that in transgenic
      mice in which the normal mouse alpha 1(II) collagen is overexpressed, thick
      abnormal collagen fibrils are generated. Mice that showed the highest expression
      of the transgene also displayed a larger proportion of abnormal fibrils and died
      at birth. We propose that an imbalance among the constituents of the cartilage
      collagen fibrils disrupts the mechanism that controls their assembly. The results
      show the applicability of the transgenic mice system to studies of complex
      multicomponent protein assemblies in intact animals.

PMID- 8483901
TI  - Predicting protein diffusion coefficients.
AB  - Diffusion coefficients for proteins in water are predicted. The numerical method
      developed is general enough to be applied to a wide range of protein surface
      shapes, from rodlike to globular. Results are presented for lysozyme and tobacco
      mosaic virus, and they are compared with actual data and with predictions made by
      less general methods.

PMID- 8483902
TI  - Synthesis of (1-->3), (1-->4)-beta-D-glucan in the Golgi apparatus of maize
      coleoptiles.
AB  - Membranes of the Golgi apparatus from maize (Zea mays L.) were used to synthesize
      in vitro the (1-->3), (1-->4)-beta-D-glucan (MG) that is unique to the cell wall
      of the Poaceae. The MG was about 250 kDa and was separated from a much larger (1-
      >3)-beta-D-glucan (callose) by gel-permeation chromatography. Diagnostic
      oligosaccharides, released by a sequence-dependent endoglucanase from Bacillus
      subtilis, were separated by HPLC and GLC. The trisaccharide beta-D-Glcp-(1-->4)
      beta-D-Glcp-(1-->3)-D-Glc, the tetrasaccharide [beta-D-Glcp-(1-->4)]2-beta-D-Glcp
      (1-->3)-D-Glc, and longer cellodextrin-(1-->3)-D-Glc oligosaccharides were
      synthesized in proportions similar to those found in purified MG. Activated
      charcoal added during homogenization enhanced synthesis of MG, presumably by
      removing inhibitory compounds. The Golgi apparatus was determined as the site of
      synthesis by a combination of downward and flotation centrifugations on sucrose
      step gradients. The rate of synthesis did not reach saturation at up to 10 mM UDP
      Glc. Chelators completely abolished synthesis, but synthase activity was restored
      by addition of either MgCl2 or, to a lesser extent, MnCl2. Synthesis continued
      for well over 1 h; addition of KOH to raise the pH from 7.2 to 8.0 during the
      reaction increased the rate of synthesis, which indicates that a transmembrane pH
      gradient may facilitate synthesis of MG.

PMID- 8483903
TI  - Long-term treatment of human immunodeficiency virus-infected cells with antisense
      oligonucleotide phosphorothioates.
AB  - The antiviral activity of antisense oligodeoxynucleotide phosphorothioates
      complementary to the tat gene, the gag mRNA, and the rev mRNA were studied in a
      long-term infection model. Three antisense oligonucleotides directed to the
      splice-acceptor site of the tat gene failed to suppress human immunodeficiency
      virus type 1 replication at 1 microM concentration in long-term culture. In
      contrast, two oligodeoxynucleotide phosphorothioates (28-mer) complementary to
      the gag and the rev mRNAs inhibited viral replication for > 80 days, and the
      antiviral activity was sequence- and length-dependent. In addition, after
      pretreatment of cells we could reduce the concentration of the antisense
      oligodeoxynucleotides by > 10-fold and still maintain the inhibition of viral
      replication. These results suggest that chemotherapy for human immunodeficiency
      virus type 1 infection with antisense oligodeoxynucleotide phosphorothioates may
      be achieved by an initial high-dose treatment followed by a lower maintenance
      dose.

PMID- 8483904
TI  - Glucose modulates the binding of an islet-specific factor to a conserved sequence
      within the rat I and the human insulin promoters.
AB  - In cultured rat and human pancreatic islets, glucose stimulated transcription of
      the rat insulin I gene through the mini-enhancer (FF) located between residues 
      196 and -247. The glucose-sensitive element was delineated to the region -193 to 
      227. The mini-enhancer bound islet nuclear proteins to form three major complexes
      (C1-C3). A 22-bp subfragment, spanning the sequence -206 to -227, was sufficient
      to retain all binding activities of the entire FF. The homologous sequence of the
      human insulin promoter interacted with rat islet nuclear extracts to form a
      single complex, corresponding to the C1 complex of the rat insulin I sequence. C1
      was present only in insulin-producing cells; it was the major complex detected in
      isolated human islets with both rat and human insulin sequences. Furthermore, the
      DNA binding activity of the C1 factor(s) was selectively modulated by
      extracellular glucose in a dose-dependent manner; a 4.5-fold increase in binding
      intensity was detected when rat islets were incubated for 1-3 h in the presence
      of 20 vs. 1-2 mM glucose. We therefore suggest that the factor(s) involved in the
      C1 complex corresponds to the glucose-sensitive factor and, consequently, may
      play a determining role in glucose-regulated expression of the insulin gene.

PMID- 8483905
TI  - Initial localization of regulatory regions of the cardiac sarcolemmal Na(+)-Ca2+
      exchanger.
AB  - We have analyzed the regulatory properties of the wild-type cardiac Na(+)-Ca2+
      exchanger expressed in Xenopus laevis oocytes using the giant excised patch
      technique. The exchanger is activated by cytoplasmic application of chymotrypsin
      and exhibits a number of properties that can be changed or abolished by
      chymotrypsin treatment, including cytoplasmic Na(+)-dependent inactivation,
      secondary regulation by free cytoplasmic Ca2+, and inhibition by exchanger
      inhibitory peptide. Thus, the cloned exchanger expressed in oocytes exhibits
      regulatory properties similar to those of the native sarcolemmal exchanger. The
      exchanger protein contains a large (520 amino acids) hydrophilic domain modeled
      to be intracellular. The role of this region in exchanger function and regulation
      was examined by deletion mutagenesis. Mutants with residues 240-679 and 562-685
      deleted exhibited exchange activity, indicating that this extensive region is not
      essential for transport function. Both mutants were stimulated by chymotrypsin
      treatment. Neither mutant demonstrated regulation by free cytoplasmic Ca2+
      (Ca2+i) or inhibition by exchanger inhibitory peptide (XIP). However, mutant
      delta 562-685 but not delta 240-679 displayed Na(+)-dependent inactivation. The
      data suggest that the binding sites for XIP and regulatory Ca2+ may reside in the
      region encompassed by residues 562-685. A chimera made from renal and cardiac
      exchangers has normal regulatory characteristics and helps to further define
      these sites.

PMID- 8483906
TI  - Biochemical interaction of the Escherichia coli RecF, RecO, and RecR proteins
      with RecA protein and single-stranded DNA binding protein.
AB  - The Escherichia coli RecF, RecO, and RecR proteins were analyzed for their effect
      on RecA-mediated pairing of single-stranded circular DNA and homologous linear
      duplex DNA substrates. As shown by other workers, joint molecule formation by
      RecA was inhibited by E. coli single-stranded DNA binding protein (SSB) when it
      was added to single-stranded DNA before RecA. This inhibitory effect was overcome
      by the addition of RecO and RecR or RecF, RecO, and RecR. Both the rate and
      extent of joint molecule formation were restored to the maximal level observed
      when SSB was added after RecA. RecF, RecO, and RecR proteins had no effect on the
      conversion of joint molecules to final products and only appeared to stimulate an
      early step in the pairing reaction. The stimulatory effect of RecF, RecO, and
      RecR was not seen without SSB or when SSB was added after RecA. RecF protein by
      itself inhibited reactions in mixtures containing RecA and SSB, and this
      inhibition was overcome by the addition of RecO and RecR. These data suggest that
      RecO and RecR, and possibly RecF, help RecA overcome inhibition by SSB and
      utilize SSB-single-stranded-DNA complexes as substrates.

PMID- 8483907
TI  - A single protein catalyzes both N-deacetylation and N-sulfation during the
      biosynthesis of heparan sulfate.
AB  - Heparan sulfate is a highly sulfated carbohydrate polymer that binds to and
      modulates the activities of numerous proteins. The formation of these protein
      binding domains in heparan sulfate is dependent on a series of biosynthetic
      reactions that modify the polysaccharide backbone; the initiating and rate
      limiting steps of this process are the N-deacetylation and N-sulfation of N
      acetylglucosamine residues in the polymer. We now report that in the rat liver,
      biosynthesis of heparan sulfate utilizes a single protein that possesses both N
      deacetylase and N-sulfotransferase activities. This was accomplished by
      demonstrating that both activities resided in a purified soluble fusion protein
      containing the Golgi-lumenal portion of the enzyme. We propose that this protein
      be renamed the rat liver Golgi heparan sulfate N-deacetylase/N-sulfotransferase.

PMID- 8483908
TI  - Appearance of heparin-binding EGF-like growth factor in wound fluid as a response
      to injury.
AB  - Wound fluid was obtained from porcine partial-thickness excisional wounds and
      analyzed for heparin-binding growth factors. Two heparin-binding growth factor
      activities were detected, a relatively minor one that was eluted from a heparin
      affinity column with 0.65 M NaCl and a major one that was eluted with 1.1 M NaCl.
      These activities were not present in wound fluid 1 hr after injury but appeared 1
      day after injury, were maximal 2-3 days after injury, and were not detectable by
      8 days after injury. The heparin-binding growth factor eluted with 0.65 M NaCl
      was identified as a platelet-derived growth factor (PDGF)-like activity by the
      use of specific anti-PDGF neutralizing antibodies. The heparin-binding growth
      factor eluted with 1.1 M NaCl was shown to be structurally related to heparin
      binding epidermal growth factor (EGF)-like growth factor (HB-EGF) by several
      criteria, including binding to heparin affinity columns and elution with 1.1 M
      NaCl, competition with the binding of 125I-EGF to the EGF receptor, triggering
      phosphorylation of the EGF receptor, immunodetection on a Western blot, and
      stimulation of fibroblast and keratinocyte growth. It was concluded that HB-EGF
      is a major growth factor component of wound fluid and, since it is mitogenic for
      fibroblasts and keratinocytes, that it might play an important role in wound
      healing.

PMID- 8483909
TI  - Tandem double CC-->TT mutations are produced by reactive oxygen species.
AB  - Oxidative damage to DNA is mutagenic and thus may play a role in carcinogenesis.
      Because of the large number of different DNA lesions formed by oxidative species,
      no genetic alteration so far identified is exclusively associated with oxygen
      damage. Tandem double CC-->TT mutations are known to occur via UV damage to DNA
      and are thought to be a specific indicator of UV exposure. Using a sensitive
      reversion assay that can detect both single and double mutations within the same
      codon of the M13-encoded lacZ alpha gene, we show that treatments that produce
      reactive oxygen species can also produce tandem double CC-->TT mutations. The
      frequency at which these mutations occur is less than that for single base
      mutations by a factor of approximately 30. The induction of these mutations is
      inhibited by treatment that scavenges hydroxyl radicals. This unique mutation
      provides a marker of oxygen free radical-induced mutagenesis in cells that are
      not exposed to UV-irradiation and an indicator for assessing the involvement of
      oxidative damage to DNA in aging and tumor progression.

PMID- 8483910
TI  - Mice lacking major histocompatibility complex class I and class II molecules.
AB  - Mice lacking major histocompatibility complex (MHC) antigens were generated by
      mating beta 2-microglobulin-deficient, and therefore class I-deficient, animals
      with MHC class II-deficient animals. When housed under sterile conditions, the
      resulting MHC-deficient mice appear healthy, survive for many months, and breed
      successfully. Phenotypically, MHC-deficient mice are depleted of CD4+ and CD8+ T
      cells in peripheral lymphoid organs due to a lack of appropriate restricting
      elements. In contrast, the B-cell compartment of these animals appears intact,
      and MHC-deficient mice can mount specific antibody responses when challenged with
      a T-independent antigen. Spleen cells from MHC-deficient animals are poor
      stimulators and responders in a mixed lymphocyte reaction. Despite their
      relatively weak cellular immune responses in vitro, MHC-deficient mice reject
      allogeneic skin grafts with little delay, and grafts from MHC-deficient animals
      are rapidly rejected by normal allogeneic recipients. Taken together, these
      results emphasize the plasticity of the immune system and suggest that MHC
      deficient mice may be useful for examining compensatory mechanisms in severely
      immunocompromised animals.

PMID- 8483911
TI  - Histone H1 deposition and histone-DNA interactions in replicating chromatin.
AB  - An immunochemical method for analyzing protein interactions with BrdUrd
      substituted DNA was used to study binding of histones to nascent DNA in nuclei.
      The results indicate that in Ehrlich ascites tumor (EAT) cells, histone H1
      deposits on newly replicated DNA simultaneously with or immediately after core
      histone deposition so that in chromatin replicated for 3 min, the stoichiometry
      of the histones is the same as in bulk chromatin. All histones, and especially
      histone H1, interact with nascent DNA more weakly than with bulk chromatin,
      although the efficiency of interaction via the globular domains seems to be the
      same for both types of chromatin.

PMID- 8483912
TI  - In vivo expression of mutant preproendothelins: hierarchy of processing events
      but no strict requirement of Trp-Val at the processing site.
AB  - Endothelin-1 (ET-1), a 21-residue vasoconstrictor peptide, originates in human
      cells from a 212-amino acid precursor (preproET-1). Big ET-1, an intermediate
      form of 38 amino acids, is generated by cleavage at basic-pair residues of proET
      1, while a specific "ET-converting enzyme" was proposed to process the unusual
      Trp-Val site at positions 21 and 22 of big ET-1. We have previously shown that
      expression of synthetic RNA encoding human preproET-1 in Xenopus oocytes results
      in secretion of putative ET-1 and big ET-1. Here, to further dissect the
      processing pathway of preproET-1, we designed and expressed in oocytes a set of
      preproET-1 mutants. Four mutants affecting the Trp-Val site always originated
      putative ET-1(s) at levels comparable to the wild type, suggesting that there is
      only a conformational requirement for cleavage at this site. An Arg-->Ile
      mutation at the basic-pair site after the C terminus of big ET-1 fully inhibited
      the formation of both big ET-1 and ET-1, indicating that processing at this site
      is an early event and that big ET-1 is an obligate intermediate for the synthesis
      of ET-1 in vivo. Also, a truncated mutant bearing a stop codon after the C
      terminus of the big ET-1 sequence was totally stable and further processed into
      mature big ET-1 and ET-1, indicating that the second part of the precursor is not
      necessary for maturation.

PMID- 8483913
TI  - Increased intracellular Ca2+: a critical link in the pathophysiology of sepsis?
AB  - Severe bloodstream-borne infection--i.e., sepsis--and the resulting multiorgan
      failure are now the most common cause of death in many intensive care units. One
      of the most fundamentally important and controversial issues concerning the
      pathophysiology of sepsis is the role of intracellular free calcium concentration
      ([Ca2+]i) in this disorder. Because of the critical role of calcium as an
      intracellular second messenger and as a potential cellular toxin, resolution of
      this issue is crucial. Using 19F NMR spectroscopy and the calcium indicator 5,5'
      difluoro-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetate we demonstrate in the
      intact perfused organ, the rat thoracic aorta, that [Ca2+]i in aortic smooth
      muscle is increased > 2-fold during sepsis. Furthermore, we determined that
      sodium dantrolene, a drug that decreases release of calcium from the sarcoplasmic
      reticulum and that is lifesaving in malignant hyperthermia (a disorder due to
      increased [Ca2+]i), is able to reduce the elevated [Ca2+]i in sepsis to control
      values when added in vitro or when given in vivo to the animal. These results
      suggest that an increase in [Ca2+]i is an early event in sepsis and that
      increased [Ca2+]i may be responsible for, or contribute to, cellular injury.
      Dantrolene may offer a therapeutic strategy in the treatment of sepsis.

PMID- 8483914
TI  - Evidence from in vitro replication that O6-methylguanine can adopt multiple
      conformations.
AB  - The effect of O6-methylguanine (m6G) on replication, in a partially double
      stranded defined 25-base oligonucleotide, has been studied under nonlimiting
      conditions of unmodified dNTPs and over an extended time period, using the Klenow
      fragment of Escherichia coli DNA polymerase I. The sequence surrounding m6G has
      flanking cytosines (C-m6G-C), and the initial steady-state kinetics have been
      reported. When the primer was annealed so that the first base to be replicated
      was m6G, replication was virtually complete in approximately 5 min, although the
      reaction appears biphasic. When annealed with a primer where thymine or cytosine
      is paired opposite template m6G, about half the molecules were replicated in the
      first 15 sec, and no significant further replication was seen over a 1-hr period.
      When m6G was dealkylated by DNA-O6-methylguanine-methyltransferase, replication
      was rapid with no blockage. These data suggest that there can be two (or more)
      conformations of m6G. In these studies the term syn refers to conformers
      interfering with base-pairing, whereas anti refers to those allowing such base
      pairing. Previous physical studies by others indicate that syn- and anti
      conformers of the methyl group relative to the N1 of guanine are possible. Here
      molecular modeling/computational studies are described, suggesting that syn- and
      anti-m6G can be of similar energy in DNA, and, therefore, these two conformers
      may explain the two types of species observed during in vitro replication. An
      alternative explanation could be the possibility that the different species may
      manifest differential interactions of m6G with Klenow fragment. These results may
      provide a rationale for why m6G lesions in vivo have been reported to be lethal
      as well as mutagenic.

PMID- 8483915
TI  - Missense mutations in the beta-myosin heavy-chain gene cause central core disease
      in hypertrophic cardiomyopathy.
AB  - Hypertrophic cardiomyopathy (HCM) is an important cause of sudden death in
      apparently healthy young individuals. In less than half of kindreds with HCM, the
      disease is linked to the beta-myosin heavy-chain gene locus (MYH7). We have
      recently described two missense MYH7 gene mutations [Arg-403 to Gln (R403Q) and
      Leu-908 to Val (L908V)] and found that the mutant message is present in skeletal
      muscle soleus) and that the mutant beta-myosin obtained from soleus muscle has
      abnormal in vitro motility activity. Having identified a second kindred with the
      R403Q mutation, and 3 other kindreds with two additional mutations (G741R and
      G256E), we performed histochemical analysis of soleus muscle biopsies from 25 HCM
      patients with one of these four mutations. Light microscopic examination of the
      NADH-stained biopsies revealed the presence of central core disease (CCD) of
      skeletal muscle, a rare autosomal dominant nonprogressive myopathy characterized
      by a predominance of type I "slow" fibers and an absence of mitochondria in the
      center of many type I fibers. CCD was present in 10 of 13 patients with the L908V
      mutation, 5 of 8 patients with the R403Q mutation, 1 of 3 patients with the G741R
      mutation, and 1 patient with the G256E mutation. Mild-to-moderate myopathic
      changes with muscle fiber hypertrophy were present in 16 patients. Notably, CCD
      was present in 2 adults and 3 children with the L908V mutation who did not have
      cardiac hypertrophy. In contrast, soleus muscle samples from 5 patients from 4
      kindreds in which HCM was not linked to the MYH7 locus showed no myopathy or CCD.
      Soleus muscle biopsies from 5 control subjects also showed normal histology. This
      work demonstrates that (i) MYH7-associated HCM is often a disease of striated
      muscle but with predominant cardiac involvement and (ii) a subset of HCM patients
      with MYH7 gene missense mutations have CCD.

PMID- 8483916
TI  - Assembly of pericellular matrices by COS-7 cells transfected with CD44 lymphocyte
      homing receptor genes.
AB  - The capacity to assemble and retain a pericellular matrix is correlated with the
      expression of the cell surface binding sites specific for the extracellular
      matrix macromolecule hyaluronan. These binding proteins have been termed
      hyaluronan receptors. The lymphocyte-homing receptor CD44 may have identity with
      these hyaluronan receptors. To determine whether hyaluronan receptors function
      independently in this capacity for matrix assembly, mammalian cells were
      transfected with cDNA encoding the putative hyaluronan receptor CD44. After
      transfection with CD44 cDNA, COS cells gained the capacity to assemble hyaluronan
      dependent pericellular matrices in the presence of exogenously added hyaluronan
      and proteoglycan. Thus, CD44 receptors do function as matrix-organizing, matrix
      anchoring hyaluronan-binding proteins. In addition, the expression of
      CD44/hyaluronan receptors alone is sufficient to direct this matrix assembly. If
      matrix assembly is a function of cells in vivo that express hyaluronan receptors,
      this raises interesting possibilities for the role of the receptors in cell
      migration, when new extracellular matrix environments are encountered.

PMID- 8483917
TI  - Increasing the chemical potential of the germ-line antibody repertoire.
AB  - To augment the chemical potential of the immunological repertoire, a metal ion
      binding light chain has been introduced into the murine genome. Mice containing
      the transgene were subsequently immunized with a fluorescein conjugate. The
      transgenic light chain was found at a high frequency in the anti-fluorescein
      memory B-cell compartment. This general method should be applicable to other
      cofactors and small molecules and should lead to generation of antibodies with
      unique catalytic activities.

PMID- 8483918
TI  - Characterization of the rat neutral and basic amino acid transporter utilizing
      anti-peptide antibodies.
AB  - High-titer, site-specific antibodies have been produced against the rat kidney
      broad-spectrum, sodium-independent neutral and basic amino acid transporter (NBAA
      Tr) whose cDNA we cloned earlier. These antibodies have allowed us to
      characterize the transporter protein in normal rat tissues and in various
      cellular and in vitro expression systems. Western analysis detected 84- to 87-kDa
      glycosylated species enriched in rat renal and jejunal epithelial cell brush
      border membranes. In vitro translation of NBAA-Tr complementary RNA in the rabbit
      reticulocyte lysate system yielded a 78-kDa protein, a molecular mass that was
      predicted by the amino acid sequence deduced from the cloned cDNA. Translation in
      the presence of rough microsomal membranes yielded a glycosylated 89-kDa species.
      Glycosylated 87- to 89-kDa species were also expressed in Xenopus oocytes
      microinjected with NBAA-Tr complementary RNA and in COS-7 cells transfected with
      NBAA-Tr cDNA. Localization of NBAA-Tr in renal and intestinal brush border
      membranes is consistent with its proposed role in transepithelial transport of
      amino acids.

PMID- 8483919
TI  - Genetic and molecular characterization of a Notch mutation in its Delta- and
      Serrate-binding domain in Drosophila.
AB  - The Drosophila Notch gene product is a transmembrane protein that functions as a
      receptor of intercellular signals in several Drosophila developmental processes.
      Two other transmembrane proteins, encoded by the genes Delta and Serrate,
      genetically and molecularly behave as Notch ligands. All these proteins share the
      presence of epidermal growth factor (EGF)-like repeats in their extracellular
      domain. The Notch protein has 36 EGF-like repeats, 2 of which, numbers 11 and 12,
      are required for the interaction with the Delta and Serrate ligands. We have
      isolated and molecularly characterized a Notch mutation in its Delta- and Serrate
      binding domain that behaves genetically as both a Notch antimorphic and a loss-of
      function mutation. This mutation, NM1, carries a Glu-->Val substitution in the
      Notch EGF repeat 12. The NM1 allele interacts with other Notch alleles such as
      Abruptex and split and with mutations in the Notch-ligand genes Delta and
      Serrate. The basis for the genetic antimorphism of NM1 seems to reside in the
      titration of Notch wild-type products into NM1/N+ nonfunctional dimers and/or the
      titration of Delta products into nonfunctional ligand-receptor complexes.

PMID- 8483920
TI  - Arachidonic acid stimulates glucose uptake in cerebral cortical astrocytes.
AB  - Arachidonic acid (AA) has recently been shown to influence various cellular
      functions in the central nervous system. Here we report that AA increases, in a
      time- and concentration-dependent manner, 2-deoxy-D-[1-3H]glucose ([3H]2DG)
      uptake in primary cultures of astrocytes prepared from the cerebral cortex of
      neonatal mice. This effect is mimicked by an unsaturated fatty acid such as
      linolenic acid, while palmitic and arachidic acids, two saturated fatty acids,
      are inactive. Pharmacological agents that increase the endogenous levels of AA by
      stimulating AA release (melittin) or by inhibiting its reacylation (thimerosal)
      also promote [3H]2DG uptake by astrocytes. We also report that norepinephrine
      (NE) stimulates the release of [3H]AA from membrane phospholipids, with an EC50
      of 3 microM; this effect is accompanied, with a temporal delay of approximately 4
      min, by the stimulation of [3H]2DG uptake, for which the EC50 of NE is 1 microM.
      Since the cerebral cortex, the brain region from which astrocytes used in this
      study were prepared, receives a massive noradrenergic innervation, originating
      from the locus coeruleus, the effects of NE reported here further stress the
      notion that certain neurotransmitters may play a role in the regulation of energy
      metabolism in the cerebral cortex and point at astrocytes as the likely targets
      of such metabolic effects.

PMID- 8483921
TI  - Cell type-preferred expression of maize cab-m1: repression in bundle sheath cells
      and enhancement in mesophyll cells.
AB  - Different sets of genes for photosynthesis are expressed in mesophyll cells (MCs)
      and bundle sheath cells (BSCs)--the two adjacent but morphologically and
      functionally distinct types of photosynthetic cells in leaves of maize and other
      C4 plants. For example, light-harvesting chlorophyll a/b-binding proteins of
      photosystem II, which are encoded by a family of cab genes, are 3- to 4-fold more
      abundant in maize MCs than in BSCs. Each maize cab gene is different from the
      others in its relative expression in MCs vs. BSCs and in its degree of
      photoresponsiveness. The gene cab-m1 is positively photoregulated and is highly
      preferentially expressed in MCs. A 159-bp sequence in the 5' flanking region of
      this gene (-1026 to -868 relative to the translation start site) is required for
      MC-preferred expression of a reporter gene in greening maize leaves. Deletion as
      well as gain-of-function experiments have now shown that all of the sequence
      information required for MC-preferred expression resides within this mesophyll
      specifying region and that cab-m1 is preferentially expressed in MCs because of
      the presence of two types of sequence elements: one is required for suppressing
      expression in BSCs and the other for promoting expression in MCs. One of the four
      cis-acting regions mapped within the mesophyll-specifying region resembles the AT
      1 box of some plant gene negative regulatory elements. Various combinations of
      such MC-specific enhancing and BSC-specific repressing regions could make maize
      cab gene family members different from one another in their relative expression
      in MCs vs. BSCs.

PMID- 8483922
TI  - Saturation mutagenesis of the human interleukin 6 receptor-binding site:
      implications for its three-dimensional structure.
AB  - Interleukin 6 is a 184-aa polypeptide postulated to belong to the class of
      helical cytokines. We built a three-dimensional model of human interleukin 6
      based on the similarity of its hydrophobicity pattern with that of other
      cytokines and on the x-ray structure of growth hormone, interleukin 2,
      interleukin 4, interferon beta, and granulocyte-macrophage colony-stimulating
      factor. The resulting model is a bundle of four alpha-helices and suggests
      possible alternative conformations for the 9 C-terminal amino acids; in this
      region, the importance of Arg-182 and Met-184 for biological activity has been
      demonstrated [Lutticken, C., Kruttgen, A., Moller, C., Heinrich, P.C. & Rose
      John, S. (1991) FEBS Lett. 282, 265-267]. Therefore, we generated a large
      collection of single-amino acid variants in residues 175-181. Analysis of their
      biological activity in two systems and the receptor binding properties of a
      subset of the mutants indicates that the entire region is involved in forming the
      receptor binding surface and supports the hypothesis that this region does not
      assume an alpha-helical conformation. Remarkably, we also found a mutant with
      receptor affinity and biological activity much higher than wild type; the
      potential therapeutical value of this finding is discussed.

PMID- 8483923
TI  - Photoisomerization mechanism of the rhodopsin chromophore: picosecond photolysis
      of pigment containing 11-cis-locked eight-membered ring retinal.
AB  - The primary photochemical event in rhodopsin is an 11-cis to 11-trans
      photoisomerization of its retinylidene chromophore to form the primary
      intermediate photorhodopsin. Earlier picosecond studies have shown that no
      intermediate is formed when the retinal 11-ene is fixed through a bridging five
      membered ring, whereas a photorhodopsin-like intermediate is formed when it is
      fixed through a flexible seven-membered ring. Results from a rhodopsin analog
      formed from a retinal with locked 11-ene structure through the more flexible
      eight-membered ring (Ret8) are described. Incubation of bovine opsin with Ret8
      formed two pigments absorbing at 425 nm (P425) and 500 nm (P500). P425, however,
      is an artifact because it formed from thermally denatured opsin or other proteins
      and Ret8. Excitation of P500 with a picosecond green pulse led to formation of
      two intermediates corresponding to photo- and bathorhodopsins. These results
      demonstrate that an appearance of early intermediates is dependent on the
      flexibility of the 11-ene and that the photoisomerization of P500 proceeds by
      stepwise changes of chromophore-protein interaction, which in turn leads to a
      relaxation of the highly twisted all-trans-retinylidene chromophore in
      photorhodopsin.

PMID- 8483924
TI  - Identification of a cell line that expresses a cell surface and a soluble form of
      the gp330/receptor-associated protein (RAP) Heymann nephritis antigenic complex.
AB  - gp330 is a large glycoprotein located in clathrin-coated pits at the surface of
      the glomerular and proximal tubule epithelia in the rat kidney. It was originally
      identified as the target of autoimmune antibodies in Heymann nephritis (HN) and
      has since been shown to be a member of the low density lipoprotein receptor gene
      family and to form a stable association with receptor-associated protein (RAP),
      which together constitute the HN antigen complex (HNAC). Progress in defining the
      normal functions of gp330 as well as the molecular mechanisms of HN has been
      hampered by the lack of an available kidney cell line that expresses this
      protein. We here report the identification of a rat yolk sac carcinoma cell line
      (L2) that synthesizes HNAC and expresses it in coated pits at the cell surface.
      gp330 and RAP from L2 cells are immunologically identical to their kidney
      counterparts, and peptide maps of gp330 yielded identical peptide fragments.
      Characterization of the cell line revealed that there are 3.3 x 10(4) gp330
      molecules per L2 cell and that the cells produce a soluble form of gp330 that is
      released into the medium. Heparin ligand blot analysis demonstrated that RAP but
      not gp330 binds heparin. By heparin affinity chromatography, gp330 and RAP
      copurify, indicating that the glycosaminoglycan binding site within RAP is
      accessible when the subunit is complexed with gp330. These results indicate that
      the L2 cell line provides a valid and useful model for studies on the function of
      HNAC and the pathogenesis of HN.

PMID- 8483925
TI  - Body size, metabolic rate, generation time, and the molecular clock.
AB  - There is increasing evidence for variation in rates of nucleotide substitution
      among divergent taxonomic groups. Here, we summarize published rate data and show
      a strong relationship between substitution rate and body size. For instance,
      rates of nuclear and mtDNA evolution are slow in whales, intermediate in
      primates, and fast in rodents. A similar relationship exists for poikilothermic
      vertebrates. However, these taxa have slower mtDNA substitution rates overall
      than do homeotherms of similar size. A number of physiological and life history
      variables are highly correlated with body size. Of these, generation time and
      metabolic rate explain some patterns of rate heterogeneity equally well. In many
      cases, however, differences in metabolic rate explain important exceptions to the
      generation time model. Correlation between metabolic rate and nucleotide
      substitution may be mediated by (i) the mutagenic effects of oxygen radicals that
      are abundant by-products of aerobic respiration, and (ii) increased rates of DNA
      synthesis and nucleotide replacement in organisms with higher metabolic rates.
      Both of these factors increase mutation rate by decreasing the "nucleotide
      generation time," the average length of time before a nucleotide is copied either
      through replication or repair. Reconsideration of the generation time hypothesis
      to include physiological effects such as metabolic rate improves the theoretical
      underpinnings of molecular evolution.

PMID- 8483926
TI  - Coevolution of persistently infecting small DNA viruses and their hosts linked to
      host-interactive regulatory domains.
AB  - Although most RNA viral genomes (and related cellular retroposons) can evolve at
      rates a millionfold greater than that of their host genomes, some of the small
      DNA viruses (polyomaviruses and papillomaviruses) appear to evolve at much slower
      rates. These DNA viruses generally cause host species-specific inapparent primary
      infections followed by life-long, benign persistent infections. Using global
      progressive sequence alignments for kidney-specific Polyomaviridae (mouse,
      hamster, primate, human), we have constructed parsimonious evolutionary trees for
      the viral capsid proteins (VP1, VP2/VP3) and the large tumor (T) antigen. We show
      that these three coding sequences can yield phylogenetic trees similar to each
      other and to that of their host species. Such virus-host "co-speciation" appears
      incongruent with some prevailing views of viral evolution, and we suggest that
      inapparent persistent infections may link virus and most host evolution.
      Similarity analysis identified three specific regions of polyoma regulatory gene
      products (T antigens) as highly conserved, and two of these regions correspond to
      binding sites for host regulatory proteins (p53, the retinoblastoma gene product
      p105, and the related protein p107). The p53 site overlaps with a conserved
      ATPase domain and the retinoblastoma site corresponds to conserved region 1 of
      E1A protein of adenovirus type 5. We examined the local conservation of these
      binding sequences and show that the conserved retinoblastoma binding domain is
      characteristic and inclusive of the entire polyomavirus family, but the conserved
      p53-like binding domain is characteristic and inclusive of three entire families
      of small DNA viruses: polyomaviruses, papillomaviruses, and parvoviruses. The
      evolution of small-DNA-virus families may thus be tightly linked to host
      evolution and speciation by interaction with a subset of host regulatory
      proteins.

PMID- 8483927
TI  - Altered processing of Alzheimer amyloid precursor protein in response to neuronal
      degeneration.
AB  - In the brains of individuals with Alzheimer disease, senile plaques containing
      aggregates of beta-amyloid peptide, derived from the beta-amyloid precursor
      protein (APP), are seen in association with degenerating nerve terminals. It is
      not known whether the degenerating nerve terminals cause the formation of these
      aggregates or whether beta-amyloid peptide in the aggregates causes nerve
      terminal degeneration. In the present study of rat brain, degeneration either of
      local neurons or of nerve terminals caused decreased levels of a neuron-enriched
      isoform of APP, increased levels of a glia-enriched isoform of APP, and increased
      levels of potentially amyloidogenic, as well as nonamyloidogenic, COOH-terminal
      fragments of APP. Our results demonstrate that neuronal degeneration affects APP
      processing and suggest that it may contribute to amyloid formation in mammalian
      brain.

PMID- 8483928
TI  - Recombination sequence-binding protein in thymocytes undergoing T-cell receptor
      gene rearrangement.
AB  - Rearrangement of T-cell antigen receptor and immunoglobulin genes occurs in
      immature lymphoid cells by an unknown mechanism. To identify components of the
      rearrangement machinery, we isolated a population of murine thymocytes enriched
      for rearranging pre-T cells. In the nuclear fraction of these cells, we detected
      a protein that specifically bound the recombination sequences that flank T-cell
      receptor and immunoglobulin genes and are required for their rearrangement. This
      protein recognized both heptamer and nonamer motifs of the recombination
      sequence, separated by either 12 or 23 bp. The protein complexed with the
      recombination sequence oligonucleotide had an apparent molecular mass of 30 kDa.
      The binding characteristics of the protein and its presence in rearranging
      thymocytes and cell lines suggest that it could serve as the recognition unit of
      a recombinase complex.

PMID- 8483929
TI  - Gene inoculation generates immune responses against human immunodeficiency virus
      type 1.
AB  - Recently, immunization techniques in which DNA constructs are introduced directly
      into mammalian tissue in vivo have been developed. In theory, gene inoculation
      should result in the production of antigenic proteins in a natural form in the
      immunized host. Here we present the use of such a technique for the inoculation
      of mice with a human immunodeficiency virus type 1 (HIV-1) envelope DNA construct
      (pM160). Mice were injected intramuscularly with pM160 and were subsequently
      analyzed for their anti-HIV envelope immune responses. Antisera collected from
      inoculated animals reacted with the recombinant HIV-1 envelope in ELISA and
      immunoprecipitation assays. The antisera also contained antibodies that were able
      to neutralize HIV-1 infection and inhibit HIV-1-mediated syncytium formation in
      vitro. Furthermore, splenic lymphocytes derived from pM160-inoculated animals
      demonstrated HIV-envelope-specific proliferative responses. The gene inoculation
      technique mimics features of vaccination with live attenuated viruses and,
      therefore, may ultimately prove useful in the rapid development of safe and
      efficacious vaccines as it provides for production of relevant antigen in vivo
      without the use of infectious agents.

PMID- 8483930
TI  - Translation of mRNAs with degenerate initiation triplet AUU displays high
      initiation factor 2 dependence and is subject to initiation factor 3 repression.
AB  - The influence of the rare initiation triplet AUU on mRNA translation was
      investigated by comparing the activity of two pairs of model mRNAs that differ in
      the length of Shine-Dalgarno and spacer sequences. Irrespective of the initiation
      triplet (AUG or AUU), all mRNAs had similar template activity in vitro, but
      translation of AUU mRNAs depended more on initiation factor (IF) 2 and less on
      IF3 than that of AUG mRNAs. Increasing the IF3/ribosome ratio from 2 to 10
      progressively inhibited the AUU mRNAs and abolished their capacity to compete for
      translating ribosomes with other mRNAs but did not affect activity of the AUG
      mRNAs. The effects induced by IF3 are from its different influence on on- and off
      rates of the transition 30S preinitiation complex<==>30S initiation complex;
      depending on the nature of the initiation triplet (AUG or AUU) of the mRNA, IF3
      shifts the position of equilibrium toward binding or dissociation of fMet-tRNA,
      respectively. Stimulation of fMet-tRNA binding and dissociation yields
      superimposable IF3 titration curves that saturate at an IF3/30S ratio of
      approximately 1, indicating that the data are from the interaction of one
      molecule of IF3 with the same 30S binding site. Both effects are either lost or
      strongly reduced with 30S mutants defective in IF3 binding. Translational
      repression of AUU mRNAs by IF3 is from the factor-dependent dissociation of fMet
      tRNA from 30S subunits, which becomes relevant when excess IF3 interferes with
      the formation of 70S initiation complex, presumably by interacting with 50S
      subunit.

PMID- 8483931
TI  - Controlled release of polypeptides from polyanhydrides.
AB  - The effects of both polymer hydrophobicity and addition of stabilizers on the
      release and integrity of polymer-encapsulated proteins were studied. By using
      very hydrophobic poly[1,3-bis(p-carboxyhydroxy)hexane anhydride] with sucrose as
      an excipient, both recombinant bovine somatotropin and zinc insulin were released
      intact over 3 weeks. The released proteins appeared to maintain their integrity
      as judged by acidic reverse-phase HPLC, size-exclusion HPLC, radioimmunoassay,
      and conformation-sensitive immunoassays. Our results also suggest how polymer
      hydrophobicity can be used to enhance protein stability.

PMID- 8483932
TI  - Interaction of translation factor SELB with the formate dehydrogenase H
      selenopolypeptide mRNA.
AB  - The SELB protein from Escherichia coli is a specialized elongation factor
      required for the UGA-directed insertion of the amino acid selenocysteine into
      selenopolypeptides. Discrimination of the UGA codon requires the presence of a
      recognition element within the mRNA, which is located at the 3' side of the UGA
      codon; a hairpin structure can be formed within this mRNA region. By gel shift
      assays, a specific interaction between SELB and the mRNA recognition element
      could be demonstrated. Footprinting experiments, using nucleases or iodine as
      cleaving agents, showed that SELB binds to the loop region of the hairpin
      structure. In the presence of selenocysteinyl-tRNA, SELB formed a complex with
      the charged tRNA and the mRNA. The results indicate that targeted insertion of
      selenocysteine is accomplished by the binding of the SELB protein to this mRNA
      recognition element, resulting in the formation of a selenocysteinyl-tRNA.SELB
      complex at the mRNA in the immediate neighborhood of the UGA codon.

PMID- 8483933
TI  - Proposed atomic structure of a truncated human immunodeficiency virus
      glycoprotein gp120 derived by molecular modeling: target CD4 recognition and
      docking mechanism.
AB  - The atomic structure of a truncated glycoprotein gp120 from human
      immunodeficiency virus 1 (HIV-1) that contains the principal neutralizing
      antigenic sites and the CD4 binding domain has been derived by molecular dynamics
      and calculation of potential energy using the DREIDING force field. The resultant
      N-glycosylated molecular model is consistent with known properties of gp120 and
      docks with CD4 with a substantial reduction in the sum of the internal potential
      energies of the individual proteins (delta E = -200 kcal/mol). The primary
      mechanism of recognition and binding is the insertion of the solvent-accessible
      Phe-43 of CD4 into a gp120 solvent-accessible acceptor pit formed by Trp-427, Tyr
      435, and the high-mannose oligosaccharide N-linked to Asn-230. delta E for the
      nonglycosylated complex is reduced significantly (-75 kcal/mol). Binding is by pi
      pi* interactions of the aromatic groups forming a hydrophobic, thermodynamically
      stable environment for these functional noncovalent bonding participants. This
      model for gp120 provides a theoretical basis for the evaluation of HIV molecular
      pathogenesis involving the env proteins, the analysis of conformation on
      functional immune response of the host, and the design of nonproteinaceous
      inhibitors specific for the CD4 binding site on gp120.

PMID- 8483934
TI  - Cloning and characterization of a fourth human somatostatin receptor.
AB  - We have isolated a gene coding for a fourth human somatostatin (somatotropin
      release-inhibiting factor) receptor. This additional somatostatin receptor
      (hSSTR4) is specifically expressed in human fetal and adult brain and lung
      tissue. The deduced amino acid sequence of the receptor displays both sequence
      and structural homology to three cloned somatostatin receptors as well as to
      other members of the family of GTP-binding-protein-coupled seven-helix
      transmembrane-spanning receptors. Pharmacological characterization of the
      expressed receptor reveals specific, high-affinity binding of somatostatin 14 and
      somatostatin 28. Surprisingly, several well-characterized synthetic somatostatin
      analogs fail to exhibit high-affinity binding to hSSTR4, indicating the existence
      of pharmacologically different receptor subtypes. Our data suggest that the
      diverse biological effects exerted by somatostatin are mediated by a family of
      receptors with discrete patterns of expression and different pharmacological
      properties.

PMID- 8483935
TI  - Functional coupling of the src-family protein tyrosine kinases p59fyn and
      p53/56lyn with the interleukin 2 receptor: implications for redundancy and
      pleiotropism in cytokine signal transduction.
AB  - The binding of interleukin 2 (IL-2) to the IL-2 receptor (IL-2R) induces a rapid
      increase in tyrosine phosphorylation of cellular proteins. In a previous study,
      we have shown that p56lck (lck), a src-family protein tyrosine kinase (src-PTK),
      physically and functionally associates with the IL-2R beta chain (IL-2R beta). To
      further investigate a role of src-PTKs in IL-2 signaling, we analyzed a mouse pro
      B-cell line, in which lck is not expressed detectably. We observed that in this
      cell line, IL-2 induces activation of at least two src-PTKs, p59fyn (fyn) and
      p53/56lyn (lyn). Interestingly, stimulation of this cell line with IL-3 also
      induces activation of src-PTKs. The activation of fyn or lyn seems to be
      selective for stimulation with IL-2 or IL-3 since stimulation with IL-6 fails to
      activate them. Furthermore, we provide evidence for the physical association of
      fyn with IL-2R beta. Taken together with previous results, our current study
      suggests that different src-PTKs, each of which is expressed in a cell-type
      specific manner, can participate in the IL-2 signal transduction.

PMID- 8483936
TI  - Functional replacement of the hemolysin A transport signal by a different primary
      sequence.
AB  - Secretion of the 107-kDa hemolysin A (HlyA) from Escherichia coli is mediated by
      the membrane proteins hemolysin B and hemolysin D. Hemolysin B is a member of the
      so-called ATP binding cassette transporter superfamily, which includes the
      multidrug resistance P-glycoprotein, the cystic fibrosis CFTR protein, and the
      major histocompatibility complex-associated transporter of antigenic peptides.
      Recognition of HlyA by the hemolysin B/D transporter is dependent on a signal
      sequence mapped to the C-terminal 50 or so amino acids of the HlyA molecule. We
      show that the C-terminal 70 amino acids of leukotoxin from Pasteurella hemolytica
      can substitute functionally for the HlyA signal sequence. This 70-amino acid
      sequence contains no primary sequence similarity to the HlyA signal sequence;
      however, structural motifs of helix-turn-helix followed by strand-loop-strand can
      be deduced for both sequences. We also demonstrate by site-directed mutagenesis
      that changes to these predicted motifs affect transport function. It thus appears
      that the transport signal of HlyA may be defined by a higher-order structure and
      that the hemolysin transporter may recognize a much wider diversity of primary
      sequences than previously anticipated. This finding may have implications for
      understanding the basis of substrate specificity of other ATP binding cassette
      transporters.

PMID- 8483937
TI  - Mutation hotspots due to sunlight in the p53 gene of nonmelanoma skin cancers.
AB  - To identify the sites in the p53 tumor suppressor gene most susceptible to
      carcinogenic mutation by sunlight, the entire coding region of 27 basal cell
      carcinomas (BCCs) of the skin was sequenced. Fifty-six percent of tumors
      contained mutations, and these were UV-like: primarily CC-->TT or C-->T changes
      at dipyrimidine sites. Such mutations can alter more than half of the 393 amino
      acids in p53, but two-thirds occurred at nine sites at which mutations were seen
      more than once in BCC or in 27 previously studied squamous cell carcinomas of the
      skin. Seven of these mutation hotspots were specific to skin cancers. Internal
      cancer hotspots not located at dipyrimidine sites were not mutated in skin
      cancers; moreover, UV photoproducts were absent at these nucleotides. The
      existence of hotspots altered the process of inactivating p53 in BCC compared to
      other cancers: allelic loss was rare, but 45% of the point mutations were
      accompanied by a second point mutation on the other allele. At least one of each
      pair was located at a hotspot. Sunlight, acting at mutation hotspots, appears to
      cause mutations so frequently that it is often responsible for two genetic events
      in BCC development.

PMID- 8483938
TI  - Mapping the determinants of human immunodeficiency virus 2 for infectivity,
      replication efficiency, and cytopathicity.
AB  - Human immunodeficiency virus 2 (HIV-2) ISY and the newly derived HIV-2KR are
      infectious molecular clones that yield viruses differing markedly in their
      abilities to infect and/or induce syncytia in various T- and monocytoid-cell
      lines. Chimeric viruses were constructed from these two viral genomes to localize
      the genetic determinants of some of these properties. Envelope sequences,
      particularly those spanning the CD4 binding site, appear to be critical for the
      ability of HIV-2KR to infect MOLT-4 clone 8 and SupT1 cells and to efficiently
      infect the H9 cell line. On the other hand, multiple determinants may contribute
      to cytopathicity (gp41 and nef) in H9 cells and replication efficiency in
      monocytic (THP-1) cells.

PMID- 8483939
TI  - DNA sequencing: modular primers assembled from a library of hexamers or
      pentamers.
AB  - Here we report a striking effect displayed by "modular primers," which consist of
      hexamer or pentamer oligonucleotide modules base-stacked to each other upon
      annealing to a DNA template. Such a combination of modules is found to prime DNA
      sequencing reactions uniquely, unlike either of the modules alone. We attribute
      this effect in part to the increase in the affinity of an oligonucleotide for the
      template in the presence of an adjacent module. All possible pentamer (or
      hexamer) sequences total 1024 (or 4096) samples, a manageable size for a
      presynthesized library. This approach can replace the synthesis of primers, which
      is the current bottleneck in time and cost of the primer walking sequencing, and
      can allow full automation of the closed cycle of walking.

PMID- 8483940
TI  - Additivity of mutant effects assessed by binomial mutagenesis.
AB  - Eleven amino acid positions in the helix-turn-helix of lambda repressor have been
      mutagenized by using a combinatorial method in which alanine is substituted at
      each position with a probability of 0.5. Approximately 25% of the 2048 proteins
      in the resulting binomial library are active, including some variants with as
      many as seven alanine substitutions. The frequency of alanine substitutions in
      the set of active variants is a measure of the importance of the wild-type
      residue at each mutagenized position, and comparison of the frequencies of
      pairwise mutations with those expected based upon the single-position frequencies
      allows the additivity of mutant effects to be tested. For the positions examined
      here, we find that the effects of multiple substitutions are largely additive and
      are able to predict the activity class of the binomial mutants with 90% accuracy
      by using a model that simply sums penalty scores derived from the alanine
      substitution frequencies. We also find, however, that several residue pairs,
      including some that are distant in the three-dimensional structure, do display
      nonadditive effects that appear to be statistically significant.

PMID- 8483941
TI  - Low density lipoprotein- and high density lipoprotein-mediated signal
      transduction and exocytosis in alveolar type II cells.
AB  - Low density lipoproteins (LDL) and high density lipoproteins (HDL) from serum
      stimulate signal-transduction pathways and exocytosis in rat alveolar type II
      cells. Both LDL and HDL stimulated primary cultures of type II cells to secrete
      phosphatidylcholine (PtdCho), the major phospholipid component of pulmonary
      surfactant. The effects on secretion were preceded temporally by stimulation of
      inositol phospholipid catabolism, calcium mobilization, and translocation of
      protein kinase C from cytosolic to membrane compartments. Heparin, which blocks
      the binding of ligands to the LDL receptor, completely inhibited the effects of
      LDL on signal transduction and PtdCho secretion but did not inhibit the effects
      of HDL. Unilamellar PtdCho liposomes the size of native LDL had no effect on type
      II cells; however, PtdCho complexes containing either apolipoproteins E or A-I
      stimulated both signal transduction and PtdCho secretion. LDL receptors were
      present in type II cell membranes by immunoblotting. In contrast to findings with
      hepatic membranes, type II cells exhibited two major bands of 130 kDa and 120 kDa
      and a minor band at 230 kDa that also was present under reducing conditions.
      These results are consistent with our hypothesis that the LDL-receptor pathway
      functions in vivo to deliver cholesterol to type II cells and that this process
      is coupled to surfactant assembly and secretion via signal-transduction
      pathway(s). HDL elicits similar responses independent of the LDL receptor,
      suggesting that type II cells may use the selective uptake pathway to obtain
      cholesterol or that HDL triggers signal transduction by mechanisms unrelated to
      lipid delivery.

PMID- 8483942
TI  - Transmission-blocking activity of a chitinase inhibitor and activation of
      malarial parasite chitinase by mosquito protease.
AB  - During development in the mosquito midgut, malarial parasites must traverse a
      chitin-containing peritrophic matrix (PM) that forms around the food bolus.
      Previously Huber et al. [Huber, M., Cabib, E. & Miller, L. H. (1991) Proc. Natl.
      Acad. Sci. USA 88, 2807-2810] reported that the parasite secretes a protein with
      chitinase activity, and they suggested that parasite chitinase (EC 3.2.1.14)
      plays an important role in the parasite's egress from the blood meal. We found
      that allosamidin, a specific inhibitor of chitinase, completely blocked oocyst
      development in vivo and thus blocked malaria parasite transmission. Addition of
      exogenous chitinase to the blood meal prevented the PM from forming and reversed
      the transmission-blocking activity of allosamidin. Using exogenous chitinase, we
      also found that the PM does not limit the number of parasites that develop into
      oocysts, suggesting that the parasite produces sufficient quantities of chitinase
      to penetrate this potential barrier. In addition, we found that treatment of
      parasite chitinase with a diisopropyl fluorophosphate-sensitive trypsinlike
      protease from the mosquito midgut or endoproteinase Lys-C increased its enzymatic
      activity. These results suggest that malaria parasite has evolved an intricate
      mechanism to adapt to the PM and the protease-rich environment of the mosquito
      midgut.

PMID- 8483943
TI  - Three-dimensional structure of a human immunoglobulin with a hinge deletion.
AB  - X-ray analysis at 3.2-A resolution revealed that the Mcg IgG1 (lambda chain)
      immunoglobulin is a compact T-shaped molecule. Because of the hinge deletion, the
      Fc fragment lobe is pulled tightly upward into the junction of the Fab arms.
      Along the molecular twofold axis, the Fab arms are joined by an interchain
      disulfide bond between the two light chains. The antigen combining sites consist
      of large irregular cavities at the tips of the Fab regions. Potential complement
      (C1q) binding sites on Fc are sterically shielded by the Fab arms, but putative
      attachment sites are accessible for docking with the FcRI receptor on human
      monocytes and with protein A of Staphylococcus aureus.

PMID- 8483944
TI  - Associative learning potentiates protein kinase C activation in synaptosomes of
      the rabbit hippocampus.
AB  - Using electrophysiological, biochemical, and autoradiographic techniques, changes
      in protein kinase C (PKC) activity in specific regions of the hippocampus have
      been previously implicated in classical conditioning of the nictitating membrane
      response of the rabbit. Here we report that activation of PKC is potentiated 2-
      to 3-fold in synaptosomes of the hippocampal CA1 and CA2 to -3 regions in rabbits
      that have undergone classical conditioning of the nictitating membrane response.
      This potentiation is apparently due to a change in the biochemical properties of
      PKC within the synaptosomes and is not a result of an increase in total PKC
      activity. This observation correlates a subcellular biochemical change with
      classical conditioning of a mammal.

PMID- 8483945
TI  - Dexamethasone negatively regulates the activity of a chimeric dihydrofolate
      reductase/glucocorticoid receptor protein.
AB  - A chimeric gene was constructed encoding the entire murine dihydrofolate
      reductase (DHFR) protein with a carboxyl-terminal extension encompassing amino
      acids 494-795 of the rat glucocorticoid receptor (GR). The chimeric DHFR/GR gene
      encoded a functional DHFR protein, as measured by the ability to transform DHFR
      deficient Chinese hamster ovary (CHO) cells to a DHFR-positive phenotype. The
      DHFR/GR protein bound [3H]dexamethasone with a similar affinity as wild-type GR.
      Selection of stable CHO transformants in increasing concentrations of
      methotrexate resulted in increased expression of DHFR/GR. Addition of
      dexamethasone, a synthetic glucocorticoid agonist, decreased the activity of the
      chimeric protein, as measured by colony formation in selective medium, binding of
      fluoresceinated methotrexate, and direct enzymatic assay for DHFR. Addition of
      RU486, a glucocorticoid antagonist, antagonized the effect of dexamethasone. In
      the absence of dexamethasone, the chimeric protein was primarily localized to the
      cytoplasm. In the presence of dexamethasone or RU486, DHFR/GR translocated into
      the nucleus. However, RU486 did not decrease DHFR activity, distinguishing
      subcellular location from functional activity. These results demonstrate that
      glucocorticoids negatively affect the function of DHFR/GR.

PMID- 8483946
TI  - PutA protein, a membrane-associated flavin dehydrogenase, acts as a redox
      dependent transcriptional regulator.
AB  - The proline utilization (put) operon of Salmonella typhimurium is
      transcriptionally repressed by PutA protein in the absence of proline. PutA
      protein also carries out the enzymatic steps in proline catabolism. These two
      roles require different cellular localizations of PutA. Catabolism of proline
      requires PutA to associate with the membrane because reoxidation of the FAD
      cofactor in PutA needs the presence of an electron acceptor. Repression of the
      put operon requires PutA to bind to the put control-region DNA in the cytoplasm.
      The presence of proline, the inducer, is necessary but not sufficient for PutA to
      discriminate between its roles as an enzyme or as a repressor. Two conditions
      that prevent PutA protein binding to the put control region are (i) when proline
      and an electron acceptor or the cytoplasmic membrane are present or (ii) when
      PutA is reduced by dithionite. These two conditions increase the relative
      hydrophobicity of PutA protein, favoring membrane association and therefore
      enzymatic activity.

PMID- 8483947
TI  - Two Neurospora mitochondrial plasmids encode DNA polymerases containing motifs
      characteristic of family B DNA polymerases but lack the sequence Asp-Thr-Asp.
AB  - We have determined the DNA sequence of the mitochondrial plasmid from Neurospora
      intermedia strain Fiji N6-6. The plasmid contains a 1278-codon open reading frame
      that is 49% identical to the open reading frame of the mitochondrial plasmid from
      the LaBelle strain of N. intermedia, which is known to encode a DNA-dependent DNA
      polymerase. The results of polymerase assays and photolabeling studies, the high
      degree of identity with the LaBelle plasmid polymerase, and the observation that
      the Fiji polymerase activity in a reaction utilizing endogenous template is not
      affected by removal of RNA suggest that the Fiji plasmid also encodes a DNA
      dependent DNA polymerase. Comparison of regions of amino acids that are highly
      conserved in the two plasmid polymerases to family B polymerases reveals good
      correlates for the three major polymerase motifs and suggests that previously
      identified motifs characteristic of reverse transcriptase found in the LaBelle
      sequence are not significant. The polymerases encoded by the Fiji and LaBelle
      plasmids are unusual in that the amino acid sequence Asp-Thr-Asp, which forms the
      core of the third motif in family B polymerases, is not present in either Fiji or
      LaBelle. A version of the motif containing Thr-Thr-Asp exists in both sequences.

PMID- 8483948
TI  - Localization of the mRNA for a chicken prion protein by in situ hybridization.
AB  - The infectious agent (prion) responsible for transmissible spongiform
      encephalopathies in humans and animals is composed primarily of a 33- to 35-kDa
      glycoprotein called PrPSc (scrapie isoform of prion protein), which is a
      posttranslationally modified form of the normal cell-surface protein PrPC. Little
      is known about the function of PrPC. Interestingly, chPrP, the chicken homologue
      of PrPC, copurifies with a factor from brain that stimulates synthesis of
      acetylcholine receptors on skeletal muscle cells. Using in situ hybridization, we
      report here that chPrP mRNA is widely distributed in cholinergic and
      noncholinergic neurons throughout the adult central nervous system, including
      those in the telencephalic striata, thalamus and hypothalamus, optic tectum,
      medulla, cerebellum, and spinal cord. The mRNA is present in the brain and spinal
      cord as early as embryonic day 6 and is also found in dorsal root ganglia,
      retina, intestine, and heart. Our data suggest that if chPrP serves to regulate
      acetylcholine receptor number on postsynaptic targets, this is not its only
      function. It is likely that the protein plays a more widespread role in the
      central nervous system and perhaps elsewhere, possibly one related to
      intercellular communication, adhesion, or recognition. The chicken embryo
      represents an attractive experimental system in which to investigate the normal
      developmental function of PrPC.

PMID- 8483949
TI  - Interferon gamma-induced transcription of the high-affinity Fc receptor for IgG
      requires assembly of a complex that includes the 91-kDa subunit of transcription
      factor ISGF3.
AB  - A 39-nt DNA sequence, the interferon gamma (IFN-gamma) response region (GRR), is
      necessary for the IFN-gamma-induced transcription of the high-affinity Fc
      receptor for IgG (Fc gamma RI) and sufficient for the IFN-gamma-induced
      transcription of transfected plasmids. By using extracts from IFN-gamma-treated
      cells, three protein complexes will assemble in vitro on a 9-nt core region in
      the 3' domain of the GRR. The sequence of this core resembles the IFN-gamma
      activated sequence (GAS) described for the GBP gene. Mutations in this GAS core
      region prevent complex assembly and result in the loss of IFN-gamma induction of
      reporter constructs containing the mutation. In addition to the GAS core region,
      a 5' region of the GRR is necessary for optimal IFN-gamma induction and for
      formation of one of the DNA-protein complexes. By antibody reactivity, we show
      that a 91-kDa protein, first identified as a component of ISGF3, the IFN-alpha
      induced transcription complex, is present in at least two of the DNA-protein
      complexes. IFN-alpha can induce the formation of the faster-migrating 91-kDa
      protein-GAS complex but not the slower-migrating complex. Furthermore, IFN-alpha
      does not result in appreciable transcriptional activation of Fc gamma RI or
      constructs containing the GRR. Thus, these data demonstrate that the IFN-gamma
      activated 91-kDa protein is required for IFN-gamma induction of Fc gamma RI and
      suggest that an additional complex may be required for optimal expression and
      specificity.

PMID- 8483950
TI  - The sizes of the CDR3 hypervariable regions of the murine T-cell receptor beta
      chains vary as a function of the recombined germ-line segments.
AB  - A method using PCR amplification and primer extension with fluorescent
      oligonucleotides was developed to analyze T-cell repertoires. The sizes of the
      hypervariable CDR3-like regions of the murine T-cell antigen receptor beta chains
      were measured for all possible V beta-J beta combinations. This analysis shows
      that beta chains are distributed into at least 2000 groups, a value that provides
      a lower limit to their complexity. The CDR3 sizes appear to be dependent on the J
      beta and especially the V beta segment used and correlates with amino acid
      sequence motifs in the corresponding CDR1 region. This feature of T-cell
      receptors is discussed.

PMID- 8483952
TI  - Let's get PREP up and running quickly.

PMID- 8483951
TI  - Analysis of pyruvate kinase-deficiency mutations that produce nonspherocytic
      hemolytic anemia.
AB  - The intron sequences of the human L-type pyruvate kinase gene (PKLR) were
      determined by using primers selected from the known cDNA sequence.
      Oligonucleotide primers for these determined intron sequences were used to
      sequence the exons. When this technique was applied to the DNA of 10 unrelated
      patients with pyruvate kinase deficiency, the following eight different mutations
      in the coding region were detected: del391-393, A401, C464, G721, A1076, T1456,
      T1484, A1529. The A1529 mutation was found repeatedly in unrelated individuals,
      even in the homozygous state. The context with respect to a polymorphism at nt
      1705 was compatible with a single origin for this mutation, and it may represent
      a balanced polymorphism. In normal subjects, five differences from the published
      cDNA sequence were documented.

PMID- 8483953
TI  - Which way out of the crisis? Coping strategies for dealing with cancer.
AB  - Following a diagnosis of cancer, patients are faced with the awesome challenge of
      responding positively to treatment and undertaking appropriate self-care. By
      offering patients support and encouraging their coping abilities, nurses can do
      much to improve their quality of life.

PMID- 8483954
TI  - Support can reduce the stress factor. Stress in neonatal nursing.
AB  - The emotional stresses involved in neonatal nursing are well-documented. By
      establishing support groups for nurses to discuss problem areas, the working
      environment of neonatal units can be made less stressful.

PMID- 8483955
TI  - A first step in effective communication. Providing a supportive environment for
      counselling in hospital.
AB  - Counselling is becoming an accepted part of the nursing process. Caring for sick
      and dying people, however, inevitably arouses feelings of sadness and failure.
      Learning to empathise rather than identify with patients can help prevent health
      professionals from perceiving illness and death as a personal failure.

PMID- 8483956
TI  - Preventive measures to maintain control. Management and treatment of vertigo.
AB  - Vertigo is a distressing problem which can leave sufferers feeling disorientated
      and lacking in confidence. There is much nurses can do to offer practical advice
      on how to minimise the risk of attack.

PMID- 8483957
TI  - Be alert to an avoidable problem. Management and prevention of antibiotic
      acquired diarrhoea.
AB  - Antibiotic-associated diarrhoea is an unpleasant and distressing problem for
      patients and health professionals alike. Although this condition can be treated
      with drugs, patient relapses are common. Implementation of rigorous infection
      control policies are therefore required.

PMID- 8483958
TI  - An audit of comfort and convenience. Comparison of oxygen mask and nasal catheter
      in the provision of postoperative oxygen therapy.
AB  - Postoperative oxygen therapy is most commonly administered either by an oxygen
      mask or a nasal catheter. An audit was, therefore, undertaken to assess the
      relative benefits of both forms of administration in terms of patient comfort and
      clinical efficacy.

PMID- 8483959
TI  - A case for emotional support and human contact. Management of cardiogenic shock.
AB  - 1. Cardiogenic shock is a state of acute circulatory failure precipitated by
      extensive left ventricular damage. 2. Nursing care of patients with cardiogenic
      shock must treat the 'whole person', and incorporate such elements as maintaining
      a safe environment; effective communication; nutrition and mobility. 3.
      Cardiogenic shock has a high mortality rate and is, therefore, very distressing
      for patients. Nursing care must ensure all patients are treated with respect and
      dignity.

PMID- 8483960
TI  - Assessment brings its own relief. Nursing care of individuals suffering from
      ischaemic leg pain.
AB  - Although pain has been the focus for much recent nursing research, little
      attention has been paid to relief of ischaemic leg pain. A structured and
      thorough assessment, which clearly identifies the pain experienced, and the use
      of analgesia and complementary methods of pain control can help reduce the
      chronic pain associated with this condition.

PMID- 8483961
TI  - How do inhaled bronchodilators work?
AB  - 1. Beta-agonists affect bronchodilation of the airways by their action on the
      bronchial smooth muscles. 2. Anticholinergic drugs affect bronchodilation of the
      airways by blocking the effect of acetylcholine and its bronchoconstrictor
      action. 3. Receptors are protein molecules found in cell membranes; they can
      selectively bind to messenger molecules and transduce a chemical signal into a
      response in a target cell.

PMID- 8483962
TI  - A barrier to continuity of care. Effects of the drug tariff on wound care in the
      community.
AB  - In light of the recent implementation of the Community Care Act, it is
      paradoxical that many products and dressings needed by community nurses are not
      available to them. This causes particular problems for patients discharged from
      hospital requiring continuity of wound care. What can be done to improve
      community nurses' access to the full range of products?

PMID- 8483963
TI  - The case for change. Implications of the 'Caring for People' White Paper.
AB  - The 1989 White Paper 'Caring for People' announced a radical shift in the way
      community care was to be delivered. The changes are now upon us and will affect
      all people with disabilities living in the community. They will also require
      nurses and social workers to work more closely together.

PMID- 8483964
TI  - Who cares about paediatric intensive care?

PMID- 8483965
TI  - Effects of calcium antagonists on K(+)-induced contraction in isolated aorta from
      diabetic and age-matched control rats.
AB  - The effects of nifedipine, verapamil and diltiazem on K(+)-induced contraction
      were investigated in isolated aortic rings from diabetic and age-matched control
      rats. Six weeks after streptozotocin injection there was no significant
      difference between the maximum isometric contraction to KCl (80 mmol/l), when
      expressed per milligram tissue weight, in aortic rings from diabetic rats and
      those from controls. A concentration-dependent inhibition of the K(+)-induced
      contraction was observed for the three Ca antagonists in aortic rings from both
      diabetic and age-matched control rats. Notably, the K(+)-induced contraction in
      aortic preparations from diabetic rats was more sensitive to nifedipine compared
      to control preparations (pD2: 8.61 vs. 8.31, p < 0.05), while no significant
      change in sensitivity towards verapamil (pD2: 6.99 vs. 6.92, p > 0.05) or
      diltiazem (pD2: 6.33 vs. 6.28, p > 0.05) could be demonstrated. Our data indicate
      a greater interference of nifedipine with voltage-operated channels in diabetic
      aortas compared with controls. Since a similar antispasmodic activity was found
      for diltiazem and verapamil it might be specific for dihydropyridine Ca
      antagonists.

PMID- 8483966
TI  - Effect of chronic treatment with losartan potassium (DuP 753) on the elevation of
      blood pressure during chronic exposure of rats to cold.
AB  - Elevation of diastolic, systolic, and mean blood pressures and cardiac
      hypertrophy occur in rats exposed to cold (5 degrees C) for 1-3 weeks. The renin
      angiotensin-aldosterone system is believed to play a role in the development of
      cold-induced hypertension since plasma renin activity increases within the first
      2 weeks, presumably initiating the hypertensive process, and then returns to
      control level. The present study was designed to assess the role of angiotension
      II (Ang II) in the hypertensive process by chronic administration of losartan
      potassium, an Ang II1 receptor antagonist. Twenty-four rats were divided into
      four equal groups. After a 1-week control period, one group was kept at 25
      degrees C while the remaining three groups were exposed to cold (5 degrees C).
      One of the cold-treated groups was untreated while the remaining two were given
      losartan in drinking water at a concentration calculated to provide 56 and 112
      mg/kg/day. The untreated cold-exposed group had a significant elevation of
      systolic blood pressure within 1 week of exposure to cold. Losartan at both doses
      prevented the elevation of blood pressure and blocked both the dipsogenic and
      vascular responses to administration of Ang II. Exposure to cold increased food
      intake, urine output and water intake significantly above that of warm-adapted
      controls. Treatment with losartan tended to decrease each of these toward the
      level of controls. At the conclusion of the seventh week of exposure to cold, the
      rats were sacrificed and heart, kidneys, and brown fat removed and
      weighed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8483967
TI  - Effect of methylene blue on blood pressure in rats.
AB  - Methylene blue (MB) is a soluble guanylate cyclase inhibitor, and known as an
      endothelium-derived relaxing factor (EDRF) inhibitor in vitro. In the present
      study, it was demonstrated that intravenous administration of MB caused a dose
      dependent hypertensive effect in rats. The hypertensive responses to the higher
      doses (10 and 20 mg/kg) of MB was followed by a reflex hypotension which did not
      appear in pithed rats. Noradrenaline depletion by reserpine pretreatment did not
      inhibit MB-induced hypertension, but abolished the hypotensive response. Both
      hypertensive and hypotensive phases were not altered by indometacin. These
      results may suggest that in vivo guanylate cyclase inhibition leads to an
      increase in blood pressure; prostaglandins and noradrenaline release from
      sympathetic nerve endings do not contribute to MB-induced hypertension and it may
      be due in part to the inhibition of EDRF.

PMID- 8483968
TI  - Production of 15-HETE by cultured smooth muscle cells from cerebral artery.
AB  - Hydroperoxyeicosatetraenoic acids (HPETEs) are potent vasoconstrictors which have
      been implicated in the pathogenesis of the delayed cerebrovascular spasm which
      follows subarachnoid haemorrhage. We have previously shown that one of their
      stable breakdown products, 15-hydroxyeicosatetraenoic acid (15-HETE), is the
      major lipoxygenase product released from isolated cerebral arteries. To
      investigate the vascular cell type responsible for their production we have
      established the culture of smooth muscle cells from cerebral arteries and have
      measured their release of HETEs upon stimulation with arachidonic acid. The
      cultured cells isolated from bovine cerebral arteries expressed smooth muscle
      phenotype as they stained positively for smooth muscle alpha-actin and not factor
      VIII-related antigen. Furthermore, these cells possessed the calcium and
      potassium conductances characteristic of smooth muscle cells. Upon incubation
      with arachidonic acid, the major lipoxygenase product was 15-HETE; no
      leukotrienes were detected. The formation of 15-HETE was concentration-dependent
      and was attenuated by nordihydroguaiaretic acid, but not by indomethacin. Similar
      to intact cerebral artery, cultured cerebrovascular smooth muscle cells have
      lipoxygenase activity, the major product of which is 15-HETE. These results are
      consistent with a possible role of the HPETEs in the pathogenesis of cerebral
      vasospasm.

PMID- 8483969
TI  - Inhibitory cholinergic effects of esaprazole on gastric secretion and plasma
      gastrin levels in the dog.
AB  - The effects of esaprazole, a novel antiulcer drug, on gastric acid secretion and
      plasma gastrin levels were investigated in dogs provided with a gastric fistula
      or Heidenhain pouch. Esaprazole affected in a different extent the tests
      performed on dogs with a gastric fistula. The greatest inhibitory effect was
      obtained against 2-deoxy-D-glucose-induced acid output and gastrin release. An
      intermediate inhibition by esaprazole was detected on bethanechol-evoked
      secretion, and the lowest activity was found versus histamine-stimulated
      secretion. All these responses were strongly inhibited by the antimuscarinic drug
      pirenzepine used as reference drug. Moreover, both esaprazole and pirenzepine
      prevented the acid secretory response to a test meal in dogs with a Heidenhain
      pouch, without significantly affecting plasma gastrin levels. The present results
      suggest that the depressant action of esaprazole on gastric secretion depends on
      its peripheral anticholinergic activity, consisting of a partial blockade of acid
      output and a main reduction of vagally mediated gastrin release. On the basis of
      these findings, the antiulcer activity of esaprazole might be in part ascribed to
      its inhibitory effects on gastric secretion.

PMID- 8483970
TI  - The NIH Strategic Plan: biomedical research as an investment for humanity.

PMID- 8483971
TI  - High intake of sweets late in the day predicts a rapid and persistent response to
      light therapy in winter depression.
AB  - Demographic characteristics, depression ratings, and detailed daily records of
      symptoms were examined as possible predictors of the response to light therapy of
      51 patients with seasonal affective disorder. Of 26 items, high intake (> 1
      portion) of sweets in the second half of the day was the best predictor of a
      rapid and persistent response to light therapy. The intake of sweets may either
      act on similar neurochemical substrates to those affected by light or provide a
      behavioral marker for individuals susceptible to light response.

PMID- 8483972
TI  - Lateral asymmetries in auditory acuity distinguish hallucinating from
      nonhallucinating schizophrenic patients.
AB  - Bilateral absolute auditory thresholds for frequencies ranging from 250 to 8000
      Hz were examined on two occasions in schizophrenic patients and normal control
      subjects. Patients were classified as hallucinators and nonhallucinators on the
      basis of symptom ratings on both occasions. Previous evidence of better right
      than left ear acuity in schizophrenia was replicated but was found to
      characterize nonhallucinating patients only. Hallucinators showed no lateral
      asymmetry and inferior right ear acuity as compared with that in
      nonhallucinators. The results were reliable on retest. Brief Psychiatric Rating
      Scale scores of positive and negative symptoms in some cases differentiated
      hallucinators from nonhallucinators. The relationship of verbal hallucinations
      and right ear-left temporal lobe functions is discussed, together with
      complexities in cerebral laterality-syndrome relationships.

PMID- 8483973
TI  - Clozapine response and plasma catecholamines and their metabolites.
AB  - The atypical neuroleptic clozapine has an unusual profile of clinical effects and
      a distinctive spectrum of pharmacological actions. Plasma measures of
      catecholamines and their metabolites have been used in the past to study the
      action of typical neuroleptics. We obtained longitudinal assessments of plasma
      measures of dopamine (pDA), norepinephrine (pNE), and their metabolites,
      homovanillic acid (pHVA) and 3-methoxy-4-hydroxyphenylglycol (pMHPG), in eight
      treatment-resistant or treatment-intolerant schizophrenic patients who were
      treated with clozapine for 12 weeks following a prolonged drug-washout period.
      Our findings from the study of these eight patients suggest the following: Plasma
      levels of HVA and possibly NE derived from the neuroleptic-free baseline period
      may predict response to clozapine; plasma levels of HVA and MHPG decrease during
      the initial weeks of treatment in responders but not in nonresponders; and plasma
      levels of DA and NE increase in both responders and nonresponders to clozapine.

PMID- 8483974
TI  - Treatment with clozapine and its effect on plasma homovanillic acid and
      norepinephrine concentrations in schizophrenia.
AB  - Measurement of plasma concentrations of the dopamine metabolite, homovanillic
      acid (pHVA), is an indirect tool to assess changes in dopamine turnover. Levels
      of pHVA have been reported to decrease during treatment with conventional
      antidopaminergic, neuroleptics, with the decrement correlating with symptomatic
      improvement in schizophrenic symptoms. Clozapine, an atypical neuroleptic, is the
      only drug proved to be effective in treatment-refractory patients. However, the
      mechanism mediating this unique efficacy has not been fully elucidated. This
      study examined the effect of clozapine on pHVA concentrations in schizophrenic
      patients. Since clozapine potently binds to alpha 2-adrenergic receptors, plasma
      norepinephrine (pNE) concentrations were also measured. Twenty-eight treatment
      refractory schizophrenic patients (24 men, 4 women) were treated with clozapine
      (up to 600 mg/day) for 5 weeks, after a minimum 1-week drug-free period.
      Symptomatology and pHVA and pNE concentrations were measured at the last drug
      free day and weekly for 5 weeks. Fourteen patients responded to clozapine
      treatment, while an equal number did not. Mean pHVA concentrations did not
      significantly change during treatment with clozapine. Although clozapine tended
      to lower pHVA concentrations in treatment responders, the effect was small and
      not significant. Clozapine treatment significantly raised pNE concentrations, but
      this did not differentiate responders from nonresponders to clozapine. These
      findings suggest that clozapine's effect on DA turnover is small and that
      clozapine may be effective in treatment-refractory schizophrenia by mechanisms
      other than, or in addition to, dopamine receptor blockade. However, since about
      one-third of NE is metabolized into HVA, the clozapine-induced increase in pNE
      may have overshadowed a possible lowering effect of clozapine on pHVA.

PMID- 8483975
TI  - The contribution of dream masochism to the sex ratio difference in major
      depression.
AB  - Twenty-five women and twenty-one men undergoing divorce had three laboratory
      nights of sleep on two occasions 1 year apart. On the third night, dream reports
      were elicited from subjects for each period of rapid eye movement (REM) sleep.
      Three groups differing on dream "masochism" were compared on personality, sex
      role, and social adjustment. Women "masochistic" dreamers had significantly
      higher scores on a scale of negative aspects of traditional feminine sex role
      identity than men or women without such dreams. They also showed less improvement
      at followup and had more need for emotional support. Dream masochism may be a
      continuing cognitive characteristic that contributes to the vulnerability of
      women to major depression.

PMID- 8483976
TI  - Factors of the Wisconsin Card Sorting Test as measures of frontal-lobe function
      in schizophrenia and in chronic alcoholism.
AB  - The purpose of this study was to examine the factor structure of the Wisconsin
      Card Sorting Test (WCST). The scores of 22 patients with schizophrenia, 20
      patients with chronic alcoholism, and 16 normal control subjects were entered
      into a principal components analysis, which yielded three factors: Perseveration,
      Inefficient Sorting, and Nonperseverative Errors. WCST performance of seven
      patients with lesions invading the dorsolateral prefrontal cortex, available from
      another study, provided criterion validity for the Perseveration factor and, less
      strongly, for the Inefficient Sorting factor. Two patterns of performance
      characterized the three patient groups: the schizophrenic group and frontal lobe
      group had the highest Perseveration factor scores, whereas the alcoholic group
      had the highest Inefficient Sorting scores; the Nonperseverative Errors factor
      showed no significant group differences. Construct validity of these factors
      involved assessing, in all but the frontal group, the degree of overlap
      (convergent validity) and separation (discriminant validity) of each WCST factor
      with scores from tests of other cognitive functions. The convergent and
      discriminant validity of the Perseveration factor, but not the remaining two
      factors, received support only within the group of schizophrenic patients.

PMID- 8483977
TI  - Migraine and the eating disorders.

PMID- 8483978
TI  - No change in viscosity of lipid phase of RBC membrane in Alzheimer's disease.

PMID- 8483979
TI  - Fatigue scale lacks adequate validation.

PMID- 8483980
TI  - Spatial cognitive maps in animals: new hypotheses on their structure and neural
      mechanisms.
AB  - This article provides a hierarchical model of animal spatial cognitive maps. Such
      maps include both topological information, which affords loose, yet operational,
      representations of the connectivity of space and its overall arrangement, and
      metric information, which provides information about angles and distances. The
      model holds that maps can be initially described as a set of location-dependent
      reference frameworks providing directional information about other locations. The
      addition of an overall directional reference allows for the buildup of more
      complete (allocentric) representations. A survey of recent neurobiological data
      provides some hints about the brain structures involved in these processes and
      suggests that the hippocampal formation and the posterior parietal cortex would
      act differently by handling topological and metric information, respectively.

PMID- 8483981
TI  - TODAM2: a model for the storage and retrieval of item, associative, and serial
      order information.
AB  - This article presents an extended version of the convolution-correlation memory
      model TODAM (theory of distributed associative memory) that not only eliminates
      some of the inadequacies of previous versions but also provides a unified
      treatment of item, associative, and serial-order information. The chunking model
      extended the basic convolution-correlation formalism by using multiple
      convolutions, n-grams (multiple autoassociations of sums of item vectors), and
      chunks (sums of n-grams) to account for chunking and serial organization. TODAM2
      extends the chunking model by including rn-grams (reduced n-grams), labels, and
      "lebals" (the involution or mirror image of a label) to provide a general model
      for episodic memory. For paired associates, it is assumed that subjects store
      only labeled n-grams and lebaled rn-grams. It is shown that the model is broadly
      consistent with a number of major empirical paired-associate and serial-order
      effects.

PMID- 8483982
TI  - Sexual strategies theory: an evolutionary perspective on human mating.
AB  - This article proposes a contextual-evolutionary theory of human mating
      strategies. Both men and women are hypothesized to have evolved distinct
      psychological mechanisms that underlie short-term and long-term strategies. Men
      and women confront different adaptive problems in short-term as opposed to long
      term mating contexts. Consequently, different mate preferences become activated
      from their strategic repertoires. Nine key hypotheses and 22 predictions from
      Sexual Strategies Theory are outlined and tested empirically. Adaptive problems
      sensitive to context include sexual accessibility, fertility assessment,
      commitment seeking and avoidance, immediate and enduring resource procurement,
      paternity certainty, assessment of mate value, and parental investment.
      Discussion summarizes 6 additional sources of behavioral data, outlines adaptive
      problems common to both sexes, and suggests additional contexts likely to cause
      shifts in mating strategy.

PMID- 8483983
TI  - Creation of prosody during sentence production.
AB  - Phrase-final words tend to be lengthened and followed by a pause. The dominant
      view of prosodic production is that word lengthening and pausing reflect the
      syntax of a sentence. The author demonstrates that, instead, lengthening and
      pausing reflect a distinctly prosodic representation, in which phonological
      constituents are arranged in a hierarchical, nonrecursive structure. Prosodic
      structure is created without knowledge of words' phonemic content. As a result,
      within a single sentential position, greater word lengthening necessitates
      shorter pauses, but across positions, word and pause durations show a positive
      correlation. The author presents a model of prosodic production that describes
      the process of prosodic encoding and provides a quantitative specification of the
      relation between word lengthening and pausing. This model has implications for
      studies of language production, comprehension, and development.

PMID- 8483984
TI  - Transitions in concept acquisition: using the hand to read the mind.
AB  - Thoughts conveyed through gesture often differ from thoughts conveyed through
      speech. In this article, a model of the sources and consequences of such gesture
      speech mismatches and their role during transitional periods in the acquisition
      of concepts is proposed. The model makes 2 major claims: (a) The transitional
      state is the source of gesture-speech mismatch. In gesture-speech mismatch, 2
      beliefs are simultaneously expressed on the same problem--one in gesture and
      another in speech. This simultaneous activation of multiple beliefs characterizes
      the transitional knowledge state and creates gesture-speech mismatch. (b) Gesture
      speech mismatch signals to the social world that a child is in a transitional
      state and is ready to learn. The child's spontaneous gestures index the zone of
      proximal development, thus providing a mechanism by which adults can calibrate
      their input to that child's level of understanding.

PMID- 8483985
TI  - Primary error detection and minimization (PEDMIN) strategies in social cognition:
      a reinterpretation of confirmation bias phenomena.
AB  - A broad empirical literature demonstrates what has been termed a confirmation
      bias or positive test strategy heuristic in reasoning (Klayman & Ha, 1987), a
      potentially maladaptive pattern of data preferences that coexists with more
      normative preferences for highly diagnostic information (Skov & Sherman, 1986). A
      model is developed to account for these variations in test strategies, beginning
      with the premise that cognitive processes are adapted to reducing particularly
      costly errors rather than to detecting "truth" (Cosmides & Tooby, 1992). By
      specifying the information required to minimize various errors of primary
      concern, the model clarifies the adaptiveness of certain confirmatory
      preferences, identifies conditions under which such preferences should diminish,
      and outlines how error minimization goals might produce data preferences
      coincidentally consistent with normative prescriptions.

PMID- 8483986
TI  - The process of recurrent choice.
AB  - Recurrent choice has been studied for many years. A static law, matching, has
      been established, but there is no consensus on the underlying dynamic process.
      The authors distinguish between dynamic models in which the model state is
      identified with directly measurable behavioral properties (performance models)
      and models in which the relation between behavior and state is indirect (state
      models). Most popular dynamic choice models are local, performance models. The
      authors show that behavior in different types of discrimination-reversal
      experiments and in extinction is not explained by 2 versions of a popular local
      model and that the nonlocal cumulative-effects model is consistent with matching
      and that it can duplicate the major properties of recurrent choice in a set of
      discrimination-reversal experiments. The model can also duplicate results from
      several other experiments on extinction after complex discrimination training.

PMID- 8483987
TI  - McCollough effects as conditioned responses: reply to Dodwell and Humphrey.
AB  - P. C. Dodwell and G. K. Humphrey (1990) criticized the Pavlovian conditioning
      analysis of the McCollough effect, claiming that it was conceptually flawed and
      that it did not assign the McCollough effect any useful function. In this
      article, it is suggested that the error-correction interpretation that Dodwell
      and Humphrey proposed as an ostensible alternative to the conditioning
      interpretation can be subsumed by the conditioning interpretation. Furthermore,
      the conditioning interpretation does ascribe a useful function to the McCollough
      effect.

PMID- 8483988
TI  - Infectious diseases now.

PMID- 8483989
TI  - 'Healthy living' and sulphonylurea therapy have different effects on glucose
      tolerance and risk factors for vascular disease in subjects with impaired glucose
      tolerance.
AB  - This study was undertaken to determine whether impaired glucose tolerance and
      associated risk factors for cardiovascular disease can be improved with 'healthy
      living' by diet and exercise or with sulphonylurea therapy. Patients were
      recruited by screening subjects with either a family history of type II diabetes,
      previous gestational diabetes, or a previously raised plasma glucose (5.6-6.6
      mmol/l). Impaired glucose tolerance was defined as hyperglycaemia on two separate
      tests, an achieved glucose level after a glucose infusion test above the 90th
      percentile of an age-matched normal population (> 9.3 mmol/l) or a fasting plasma
      glucose above the 95th percentile (> 5.6 mmol/l). Thirty-seven subjects with
      impaired glucose tolerance were entered into a randomized, prospective study for
      6 months with allocations to healthy living or double blind to sulphonylurea
      (gliclazide 40 mg twice daily) or placebo tablets. The study took place in an out
      patient setting, with three times weekly exercise sessions at a Sports Centre.
      After 6 months the placebo group showed no change in plasma glucose, cholesterol
      and blood pressure. The subjects receiving gliclazide showed improved glucose
      levels (mean fasting plasma glucose levels fell from 5.8 to 5.1 mmol/l, p < 0.05)
      but no significant change in plasma cholesterol or blood pressure. The healthy
      living group, after exclusion of four non-compliant subjects, showed no change in
      glucose levels, but a decreased systolic blood pressure (fall in mean from 124 to
      116 mmHg, p < 0.05) and plasma cholesterol levels (fall in mean from 5.2 to 4.5
      mmol/l, p < 0.01). with an increase in HDL:LDL ratio (rise in mean from 0.39 to
      0.46, p < 0.05). Subjects with impaired glucose tolerance may benefit in
      different ways from gliclazide and healthy living. The metabolic responses to
      each therapy may help to decrease the risk of developing diabetes and
      cardiovascular disease.

PMID- 8483990
TI  - Renal impairment with chronic hydrocarbon exposure.
AB  - Occupational hydrocarbon exposure is believed by some investigators to play an
      important role in the development of several non-neoplastic renal diseases. In
      view of the continuing debate in this area of nephrology we adopted a cross
      sectional approach by investigating the prevalence of clinical or sub-clinical
      renal dysfunction in subjects chronically exposed to hydrocarbons at their work
      site. Three groups of healthy men working in different and separate areas of a
      major car manufacturing plant in the North-west of England participated in the
      study. Group 1 comprised 112 paint sprayers with exposure to paint-based
      hydrocarbons, group 2 comprised 101 volunteers working in the transmission area
      of the plant with exposure to petroleum-based mineral oils, and group 3 comprised
      92 automated press operators with minimal background exposure to lubricants who
      acted as internal controls. Early markers of renal dysfunction such as serum
      creatinine, urinary total protein, albumin, transferrin, retinol binding protein,
      N-acetyl-glucosaminidase, gamma-glutamyl transferase, and leucine-amino-peptidase
      excretion were measured. Upper reference values of the parameters measured were
      derived from 105 comparable laboratory based controls with no occupational
      exposure to hydrocarbons or heavy metals. Group 1 had a significantly higher
      prevalence of elevated serum creatinine than the other groups and a higher
      prevalence of abnormal urinary total protein, N-acetyl-glucosaminidase, gamma
      glutamyl transferase, and leucine-amino-peptidase excretion than groups 2 and 3.
      Group 2 had normal serum creatinine but a significantly higher prevalence of
      abnormal urinary total protein, transferrin, retinol binding protein, N-acetyl
      glucosaminidase, and leucine-amino-peptidase excretion than group 3. Serum
      albumin was similar in all groups. There was some clustering of abnormal findings
      but the markers of renal dysfunction used in the study identified 37 individuals
      in group 1 and 31 subjects in group 2 with at least one abnormal parameter,
      compared to only five individuals in internal controls. This difference between
      the two target groups and group 3 was highly significant (p < 0.001). Subjects
      with chronic paint exposure had renal impairment and tubular dysfunction. Tubular
      dysfunction was also prominent with petroleum oil exposure. We therefore conclude
      that chronic hydrocarbon exposure may be associated with clinical and sub
      clinical renal dysfunction. We advocate careful monitoring of workers exposure to
      hydrocarbons and for more effective preventive measures.

PMID- 8483991
TI  - Respiratory involvement in primary muscle disorders: assessment and management.
AB  - Eighty-four patients with primary disorders of muscle were referred for
      assessment of respiratory insufficiency between 1978 and 1991. The eventual
      diagnoses were: 'limb girdle syndromes' (18 patients), adult onset acid maltase
      deficiency (14), dystrophia myotonica (13), inflammatory disorders (10),
      congenital myopathies (nine), rigid spine syndromes (five), dystrophies (Duchenne
      (six), facioscapulohumeral (four), Becker (one)) and miscellaneous (four).
      Presentations were often insidious, with progressive nocturnal hypoventilation
      culminating in respiratory failure or arrest, recurrent respiratory tract
      infections, or obstructive sleep apnoea. Respiratory symptoms developed
      relatively early in patients with acid maltase deficiency and inflammatory
      disorders but parallelled the development of limb weakness in limb girdle,
      myotonic and congenital syndromes. Sixty-six patients received respiratory
      support for a median of 5 years (1-34 years) using various techniques of negative
      and positive pressure ventilation. Fourteen patients received short-term support
      for an episode of respiratory failure before being weaned, 51 required nocturnal
      domiciliary ventilation and one was dependent on continuous domiciliary support.
      Tracheostomy was performed in 32 patients and used for domiciliary nocturnal
      ventilation in 25. Twenty-eight patients have subsequently died.

PMID- 8483992
TI  - Albendazole is effective treatment for chronic strongyloidiasis.
AB  - A total of 301 British ex-Far East prisoners of war, many of whom worked on the
      Thai-Burma Railway during World War II, consecutively attended The Liverpool
      School of Tropical Medicine for clinical review between January 1987 and August
      1990. Fifty-two (17%) were found to have chronic strongyloidiasis. Diagnostic
      criteria included any of the following: characteristic larva currens rash,
      positive Strongyloides serology, and positive stool examination. Forty-seven were
      evaluable 6 months, after therapy with albendazole 400 mg twice daily for 3 days,
      which resulted in a 75% cure rate. Cure was defined as disappearance of the rash,
      if present, negative serology and negative stool examination. Patients who had
      more than one positive diagnostic feature were only considered cured if both or
      all had disappeared or become negative. All 12 of the patients in whom initial
      treatment failed were given a second course of albendazole: three further cures
      were obtained in eight evaluable patients. The overall cure rate was 81%. The
      only side-effects recorded were mild nausea and diarrhoea in one patient. We
      suggest that albendazole should be the treatment of choice for chronic
      strongyloidiasis.

PMID- 8483993
TI  - Thermoregulation and afterdrop during hypothermia in patients with
      poikilothermia.
AB  - The pathophysiology of afterdrop of core temperature during rewarming in patients
      with induced or accidental hypothermia remains controversial. We studied the
      effect of cooling and rewarming in four female patients with acquired
      poikilothermia and in four normal females. Exposure to cold air (16.5 degrees C)
      induced shivering and adequate vasoconstriction in normal individuals, without a
      fall in rectal temperature (Tr; 36.3 +/- 0.2 degrees C [mean +/- SD]); subsequent
      heating (40 degrees C) induced a rise in Tr to 37.0 +/- 0.3 degrees C and
      generalized sweating. The four patients all had spontaneous hypothermia (Tr 34.1
      +/- 0.9 degrees C) before cooling. Tr decreased by 0.3-0.9 degrees C during cold
      exposure, and a marked afterdrop of Tr (0.3-0.5 degrees C) occurred during
      rewarming: this did not occur in normal individuals. Cooling failed to induce
      shivering and vasoconstriction in three patients. No patient showed visible
      sweating during heating despite a Tr of up to 38.0-38.5 degrees C and skin
      temperature of up to 37.7-38.5 degrees C. The basal metabolic rate was decreased
      by 71-82% in all patients during steady-state hypothermia and remained lowered
      during normothermia in two patients. We conclude that during hypothermia three of
      the four patients showed severe disorders of peripheral vasomotor function and
      shivering response. These data provide evidence for thermal conduction as the
      major mechanism of afterdrop during hypothermia.

PMID- 8483994
TI  - Comprehensibility of papers.

PMID- 8483995
TI  - Percutaneous transluminal renal angioplasty.

PMID- 8483996
TI  - The fine specificity of anti-GM1 antibodies.

PMID- 8483997
TI  - TNF in cerebral malaria.

PMID- 8483998
TI  - Lipids in cardiovascular disease.

PMID- 8483999
TI  - Cardiac arrest patient diverted by telemetry nurse.

PMID- 8484000
TI  - Hospital "self-insured": nurse's insurer liable. Case in point: Wake County Hosp.
      System v. National Casualty Co. (804 F. Supp. 2d 768--NC [1992]).

PMID- 8484001
TI  - Legal case briefs for nurses. WI: pharynx torn in fibe intubation attempts: res
      ipsa loquitur issue; OH: termination for sexual harassment: hospital policy
      conflicts with "at will" status.

PMID- 8484002
TI  - Death after E.R. treatment: proximate cause issue. Case in point: Godeaux v.
      Rayne Branch Hosp. (606 So. 2d 948--LA [1992]).

PMID- 8484003
TI  - Intracellular recordings from neurones of the submucous plexus.

PMID- 8484004
TI  - Regulation of the hypothalamic corticotropin-releasing hormone neurosecretory
      system.

PMID- 8484005
TI  - Integrated activity of cardiovascular and pain regulatory systems: role in
      adaptive behavioural responses.

PMID- 8484006
TI  - Mechanism and pathogenesis of ischemia-induced neuronal damage.

PMID- 8484007
TI  - CCK peptides and mRNA in the human brain.

PMID- 8484008
TI  - Effects of phenols on eicosanoid synthesis in A23187-stimulated human whole
      blood.
AB  - We have previously demonstrated that catecholamines have opposite effects on
      leukotriene (LT) and prostanoid synthesis. The aim of the present study was to
      test the effects of phenols (catechol, hydroquinone, phenol and resorcinol) on
      LTB4, LTE4 and thromboxane (TX)B2 synthesis in A23187-stimulated human whole
      blood. All tested compounds inhibited LTB4 and LTE4 synthesis. The IC50 values
      for catechol were 3 microM, 6 microM; for hydroquinone 4 microM, 3 microM; for
      phenol 285 microM, 226 microM and for resorcinol 180 microM, 902 microM. The
      compounds did not stimulate TXB2 synthesis but only inhibited it. The IC50 value
      for catechol was 3 microM, for hydroquinone 7 microM, for phenol 18 microM and
      for resorcinol 25 microM. Catechol and hydroquinone had hardly any effect on the
      LT/TX ratio. Phenol and resorcinol even increased the LT/TX ratio. The positions
      of hydroxyl groups of phenolic compounds are thus important for their actions on
      the LT/TX ratio.

PMID- 8484009
TI  - Tissue distribution, elimination and metabolism of [3H]-leukotriene C4 in the
      American bullfrog, Rana catesbeiana.
AB  - Tissue distribution, elimination, and metabolism of [3H]-leukotriene C4 were
      studied at 2.5 hours after injection in the conscious and anesthetized American
      bullfrog, Rana catesbeiana. Conscious frogs were injected via the dorsal lymph
      sac or the sciatic vein. Anesthetized frogs were injected via the abdominal vein.
      The organs containing the greatest percent of injected radioactivity at 2.5 hours
      after injection were liver, small intestine and kidney. Route of injection and
      anesthesia appears to alter distribution and elimination of leukotrienes. [3H]
      leukotrienes were eliminated into bladder water and bile. In addition, 7.8 +/-
      2.2 and 5.2 +/- 2.5 percent of the injected radioactivity was found in the pan
      water bathing the ventral surface of the venously and dorsally injected conscious
      frogs, respectively, suggesting transfer of radioactivity across the skin. At 2.5
      hours, polar metabolites represented 50% of the radioactivity found in liver,
      bile, and bladder water. These polar metabolites were determined to be 18-carboxy
      19,20-dinor-leukotriene E4, 20-carboxy-leukotriene E4, and 20-hydroxy-leukotriene
      E4. Of the non-oxidized leukotrienes, bile contained mainly LTD4 while bladder
      water contained primarily LTE4. N-acetyl LTE4 was not detected in any samples.
      The tissue distribution, elimination and metabolism of leukotrienes in the
      bullfrog was similar to mammalian studies and suggests evolutionary conservation
      of leukotriene processing.

PMID- 8484010
TI  - 11-Dehydro thromboxane B2: a reliable parameter of thromboxane A2 production in
      dogs.
AB  - Plasma concentration of 11-dehydro thromboxane B2 (TxB2) is reported to be a
      reliable indicator of TxA2 production in human and rabbit. The purpose of this
      study is to examine whether we can use this parameter in dogs. The plasma
      concentration of 11-dehydro TxB2 was determined by enzyme immunoassay method
      using anti-11-dehydro TxB2 monoclonal antibody. When 10 micrograms/kg of TxB2 was
      intravenously administered to dogs in which endogenous production of prostanoids
      was blocked by aspirin, the plasma concentrations of 11-dehydro TxB2 before and
      2, 5, 15, 60 min after TxB2 administration were 6.2 +/- 1.4, 54.2 +/- 5.0, 65.2
      +/- 14.3, 65.2 +/- 16.4 and 31.0 +/- 7.5 pg/ml, while the corresponding TxB2
      levels were 20.1 +/- 3.1, 3143.3 +/- 379.5, 1432.6 +/- 120.5, 356.8 +/- 38.9, and
      128.9 +/- 13.6 pg/ml, respectively. Platelet-activating factor (PAF, 0.5
      micrograms/kg) induced pulmonary vasoconstriction which was blocked by aspirin
      and OKY-046 (TxA2 synthetase inhibitor), indicating that TxA2 mediated this
      change. Plasma concentration of 11-dehydro TxB2 was increased by PAF. This change
      was also blocked by aspirin and OKY-046. These data suggest that the
      determination of plasma concentration of 11-dehydro TxB2 is useful to estimate
      the in vivo production of TxA2 in dogs.

PMID- 8484011
TI  - The enhancement by prostaglandin E2 of cumulus cell outgrowth in vitro.
AB  - Oocyte-cumulus cell complexes (OCCC) were aspirated from medium-sized (3-5 mm
      phi) porcine follicles to study quantitatively the process of forming monolayers.
      A monolayer index (MLI) was therefore developed. This index was evaluated by
      addition of graded quantities of fetal bovine serum. Furthermore, we observed
      that addition of prostaglandin E2 accelerated the monolayer formation (P < 0.001
      at 20 hours versus 40 hours). The effect of PGE2 regarding both monolayer
      formation and cumulus cell expansion has been discussed.

PMID- 8484012
TI  - Prostaglandin F2 alpha stimulates inositol phosphate production in human pregnant
      myometrium.
AB  - We examined the effect of prostaglandin F2 alpha (PGF2 alpha) on phosphoinositide
      (PI)-hydrolysis in the outer layer of the human myometrium at the end of
      pregnancy. After pretreatment of myometrial explants with a cyclo-oxygenase
      inhibitor (indomethacin), the PGF2 alpha dose-response curve was shifted to the
      left and a maximal level of PGF2 alpha-induced IP accumulation was reached. In
      contrast, the well-known OT-induced IP accumulation was decreased in the presence
      of indomethacin, whereas potency was unchanged. Incubation of the myometrial
      explants with calcium-depleted medium, not only decreased the basal IP production
      but completely abolished the OT- and PGF2 alpha-induced IP accumulation. A L-type
      calcium channel inhibitor, verapamil 100 microM, significantly decreased PGF2
      alpha-induced total inositol production whereas it had no effect on OT-response,
      suggesting that the first event of PGF2 alpha action is the activation of a
      calcium channel. These results point to marked differences in the mechanisms by
      which OT and PGF2 alpha exert their contractile effects in human myometrium at
      the end of pregnancy.

PMID- 8484013
TI  - Effects of lumbar epidural analgesia on prostaglandin F2 alpha release and
      oxytocin secretion during labor.
AB  - The concentrations of plasma oxytocin and prostaglandin F2 alpha metabolite
      (PGFM) were measured in 10 parturients with and 10 without lumbar epidural
      analgesia. A blood sample was taken immediately before analgesia and another 60
      min later. The control patients were matched for the stage of cervical dilatation
      at the time of the first blood sample; the second was drawn 60 min later. Plasma
      PGFM decreased significantly after lumbar epidural anesthesia and increased in
      controls resulting in a highly significant difference between the groups (P <
      0.005). Plasma oxytocin concentrations levels also changed in opposite directions
      in the two groups but the difference did not reach statistical significance (P <
      0.1). Uterine activity increased in the controls and decreased in the analgesia
      group resulting in a significant difference between the groups (P < 0.05). All
      subjects delivered vaginally. The total duration of labor was longer in the
      analgesia group (7.8 +/- 1.0 h vs. 4.7 +/- 0.6 h; P < 0.05) as was the duration
      after analgesia (5.1 +/- 0.9 h vs. 2.5 +/- 0.8 h; P < 0.05), whereas the duration
      of the second stage was not significantly different. We conclude that lumbar
      epidural anesthesia results in suppression of PGF2 alpha release which may be the
      cause of the diminished uterine activity and the prolonged duration of the first
      stage of labor.

PMID- 8484014
TI  - Immunoactive iso-ANP/BNP in plasma, tissues and atrial granules of the rat.
AB  - We have developed a specific radioimmunoassay (RIA) for iso-rANP(1-45)/rBNP(51
      95) using antiserum produced against a peptide comprise of the first 20 amino
      acid sequence of this cardiac hormone. Using this RIA, we found that atria
      contained the highest amount of iso-rANP(1-45) (567.37 pmol/g) which is about 140
      fold higher than ventricles (4.32 pmol/g). With the exception of the lung and
      kidney, all other tissues had negligible amounts. The plasma level was 1.4
      fmol/ml and the only molecular form found was the 45 amino acid form. HPLC
      analysis of extracts of isolated, purified atrial granules revealed that, like
      atrial natriuretic peptide (ANP), iso-rANP/rBNP is also stored in these granules.
      However, while ANP is stored predominantly as pro-ANP(1-126) and cleaved during
      or after release, iso-ANP/BNP is stored as the 45 amino acid form and may be
      processed prior to storage in the granules.

PMID- 8484015
TI  - Epidermal growth factor interferes with the effect of adrenaline on glucose
      production and on hepatic lipase secretion in rat hepatocytes.
AB  - We studied the interaction of epidermal growth factor (EGF) and adrenaline in the
      control of several metabolic functions in isolated hepatocytes from fed rats. EGF
      did not modulate glucose release, urea production or hepatic lipase secretion,
      but interfered with the stimulatory effect of adrenaline on both glucose and urea
      production and also with the inhibitory effect of this hormone on hepatic lipase
      secretion. EGF also interfered with the effect of both angiotensin II and
      vasopressin on glucose release and on hepatic lipase secretion. While the effect
      of EGF interfering with the action of adrenaline on glucose release was
      potentiated in the absence of extracellular calcium, the effect on the inhibition
      of hepatic lipase secretion was abolished. These results suggest that EGF
      interfered with catecholamine actions in the liver at a site distal from the
      generation of the calcium signal.

PMID- 8484016
TI  - Effect of water deprivation, desmopressin (DDAVP) infusion, and oral loads of
      water, Na+ and NH4+ on urinary excretion of epidermal growth factor in the rat.
AB  - Epidermal growth factor (EGF) is synthesized in the kidneys and excreted in
      urine. Administration of exogenous EGF modulates the reabsorption of Na+ and the
      vasopressin stimulated reabsorption of water in the collecting tubules. In order
      to clarify whether this reflects a physiological role for urinary EGF we examined
      the effects of changes in the oral loads of water, Na+ and NH4+ as well as the
      effect of infusion of the vasopressin analogue, desmopressin (DDAVP) on the
      endogenous urinary EGF excretion in the rat. Water deprivation for 48 h reduced
      the urinary excretion of EGF by 25% and the urinary EGF/creatinine ratio by 8%.
      Also, urinary volume, Na+ excretion, and urinary pH were reduced by water
      deprivation. Infusion of DDAVP, low plasma vasopressin induced by polydipsia, and
      changes in the renal excretion of Na+ and H+ did not affect the urinary excretion
      of EGF. IN CONCLUSION: it seems unlikely that nephrogenous EGF excreted in the
      urine plays a physiological role in the regulation of the renal excretion of Na+
      and H+ and in the vasopressin stimulated reabsorption of water in the rat.
      However, since water deprivation reduced the urinary excretion of EGF it remains
      possible that urinary EGF plays a role in the complex physiological response to
      dehydration.

PMID- 8484017
TI  - Role of neurotensin in the regulation of exocrine pancreatic secretion in dogs.
AB  - A potential physiological function of the regulatory gastrointestinal peptide
      neurotensin (NT) is the stimulation of exocrine pancreatic secretion. We
      investigated therefore whether immunoneutralization of the postprandially
      circulating peptide, intravenous application of either atropine or the highly
      specific CCK receptor antagonist, L-364,718, could influence neurotensin-mediated
      pancreatic secretion in dogs. The use of CCK receptor antagonist (0.1 mg kg-1
      intraduodenally) inhibited postprandial and NT-mediated exocrine pancreatic
      secretion. The integrated postprandial protein secretion fell from 31 +/- 1.6 to
      23 +/- 2.1 g 180 min-1 while the corresponding values in response to i.v.-NT
      (postprandial neurotensin concentration course was imitated by the infusion of 50
      pmol kg h-1 NT) fell from 22 +/- 1.9 to 7.5 +/- 0.8 g 180 min-1.
      Immunoneutralization of postprandial NT led to a simultaneous significant
      reduction in postprandial pancreatic secretion (integrated protein release 31 +/-
      1.6 and 15.5 +/- 1.4 g 180 min-1 respectively). The i.v. application of atropine
      lowered NT-mediated pancreatic secretion (e.g., protein output) from 22 +/- 1.9
      to 7.1 +/- 7.1 +/- 0.9 g 180 min-1. We conclude that NT plays an important role
      in the endocrine regulation of exocrine pancreatic secretion. This influence
      could be mediated by a CCK-dependent cholinergic mechanism.

PMID- 8484018
TI  - PYY: a neuropeptide in the canine enteric nervous system.
AB  - This study re-examined the anatomical locations of PYY in the canine
      gastrointestinal tract. Immunohistochemical studies with two relatively selective
      PYY antisera demonstrated PYY-LI immunoreactivity in nerve cell bodies and nerve
      fibres in the intestinal and gastric myenteric plexus and the intestinal
      submucosal plexus and in nerve fibres of the intestinal deep muscular plexus.
      Immunoreactive PYY-LI was also present in ileal endocrine cells. All PYY-LI
      immunoreactivity was completely abolished by pre-incubation of the antibodies
      with synthetic PYY but was unaltered by pre-incubation with synthetic NPY.
      Individual synaptosomal preparations obtained from canine intestinal and gastric
      myenteric plexus, and intestinal deep muscular plexus and submucous plexus,
      contained considerable quantities of PYY-LI which, on reverse-phase HPLC, co
      eluted with a synthetic canine/porcine PYY standard. In contrast, isolated
      myenteric ganglia from rat and guinea pig did not contain detectable amounts of
      PYY-LI. These studies demonstrate that PYY is not confined to distal intestinal
      endocrine cells in the dog but is also an enteric neuropeptide with maximal
      concentrations being present in the intestinal myenteric plexus.

PMID- 8484019
TI  - In vivo modulation of gastrointestinal motor activity by Met-enkephalin, morphine
      and enkephalin analogs in chickens.
AB  - The main objectives of this work have been to study (1) whether or not opioid
      effects on gastrointestinal motility in chicken are mediated through central or
      peripheral pathways; (2) the receptors involved; (3) the correlation of the motor
      response to the distribution of Met-enkephalin in the gastrointestinal tract and
      (4) to evaluate the physiological role of endogenous opioids in spontaneous MMCs.
      Intravenous infusion of Met-enkephalin and morphine (5 x 10(-7) mol/kg) induced
      gastric inhibition and a migrating intestinal hyperactivity. Induced intestinal
      activity was faster in vagotomized chickens. In the stomach there was a
      correlation between the duration of the inhibitory response and the affinity of
      the agonists for mu-receptors ([D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAGO) >
      morphine > Met-enkephalin > Tyr-D-Pen-Gly-Phe-D-Pen (DPDPE)). DPDPE induced
      duodenal hyperactivity which was not propagated. Immunohistochemistry showed that
      Met-ENK like material is mainly located at the myenteric plexus and the outer
      circular muscle in stomach. In the intestine, it was found in the myenteric and
      the deep muscular plexuses. When endogenous MMCs were studied, i.v. infusion of
      naloxone lengthened significantly their duration. In conclusion, the fact that
      Met-enkephalin and their analogs induced a migrating activity in the intestine
      and the lengthening of MMC by naloxone, suggest a physiological role for opioids
      on induction of MMC in birds, acting at peripheral level.

PMID- 8484020
TI  - Influence of glucagon-like peptide-1 on beta cell responsiveness.
AB  - The postulated incretin factor glucagon-like peptide-1 (GLP-1) causes a glucose
      dependent increase in insulin secretion from perifused rat islets. In the
      presence of 6 mM glucose the response to 10 nM GLP-1 is characterized by a large
      initial spike of secretion, followed by a brief, slowly rising phase. However,
      after 30-40 min of stimulation, this phase subsides to prestimulatory secretory
      rates. Raising the glucose level to 8 mM, however, amplifies and sustains the
      stimulatory effect of 10 nM GLP-1. The response to GLP-1 (10 nM) in the presence
      of 8 mM glucose is abolished by the metabolic inhibitor mannoheptulose (15 mM),
      and reduced by the calcium channel antagonist nitrendipine (5 microM), or the
      protein kinase C inhibitor of staurosporine (20 nM). A significant synergistic
      effect of GLP-1 (10 nM) and 10 microM carbachol, a cholinergic agonist, on
      insulin secretion was observed in the presence of 6 mM glucose. In the presence
      of either 6 or 8 mM glucose, GLP-1 (10 nM) has no significant effect on glucose
      usage or on inositol phosphate generation in [3H]inositol prelabeled islets. The
      results support the concept that GLP-1 may function as an important physiologic
      incretin factor, particularly when accompanied by agonists that activate
      phosphoinositide hydrolysis.

PMID- 8484021
TI  - Discussion paper: towards a systematic classification for regulatory peptides.
AB  - Advances in microsequencing technology have led to the elucidation of primary
      structures of peptidic messengers from many eukaryotic and prokaryotic life
      forms. Existing peptide nomenclature is based upon such factors as bioactivity,
      source of isolation (tissue or species), chemical attributes, acronyms derived
      from a combination of these factors, or by other arbitrary means. In order to
      overcome many of the problems arising from current nomenclature, a standardised
      classification scheme for peptidic messengers is proposed which utilises an
      alphanumeric code string analogous to EC enzyme classification to convey
      information on origin, chemistry and relatedness to other similar molecules. It
      is anticipated that the scheme outlined will provide the basis for the rational
      classification of new peptides.

PMID- 8484022
TI  - Physical injury risk versus risk from hazardous waste remediation: a case
      history.
AB  - This study was conducted to estimate the transportation risks associated with the
      removal of contaminated soils near the ASARCO copper smelter in Ruston,
      Washington. Three remediation options involving removal of differing amounts of
      soil were considered. The risks of death, disabling, and nondisabling injury were
      estimated. Under the scenario requiring the greatest soil removal, 3.62 disabling
      injuries, 14.46 possibly disabling injuries, and 0.67 deaths are expected to
      result from transporting the contaminated soil to an approved hazardous waste
      disposal facility. If the contaminated soil is not removed, the U.S.
      Environmental Protection Agency estimates that 2 arsenic-related skin cancers per
      1000 lifetimes for exposed persons will occur.

PMID- 8484023
TI  - Birth defects, cancer, chemicals, and public hysteria.
AB  - The "media" consistently inform us of all the "things" that are dangerous to us.
      However, time/space constraints, along with lack of knowledge and understanding
      of the area, often lead to inaccurate and/or insufficient dissemination of
      information. The areas of cancer and birth defects are particularly
      misrepresented. Such dissemination of inaccurate/incomplete/misleading
      information has resulted in almost a state of hysteria. As a result, the public's
      perception of the role of chemicals in the incidences of cancer and birth defects
      is inconsistent with what has actually been documented in these areas. Although
      no one wants to be exposed to risks, people generally do not wish to be
      encumbered with unnecessary safety precautions. Thus, accurate information in the
      areas of carcinogenicity and teratogenicity should be documented in an effort to
      show how one can better assess the risks involved in work/home exposures to
      specific chemicals. A better understanding of how society perceives risk should
      enable one to better appraise the situation when confronted with information that
      could lead to "chemophobia." The consequences of misinformation about drugs and
      other synthetic chemicals have been particularly unfortunate with pregnant women:
      negligence in necessary drug use, unnecessary anxiety, and termination of planned
      pregnancies without reasonable cause.

PMID- 8484024
TI  - Food safety: are human activities really worse than nature's?
AB  - Those chemicals that are added to food during modern processing are most
      stringently examined for toxic effects and, if they demonstrate toxicity, are
      strictly controlled. Despite this, a considerable proportion of the North
      American human cancer burden has been associated with diet and nutrition. The
      possible contributions of excess calories, excess and wrongly balanced fats,
      natural contaminants, and naturally occurring carcinogens within the food supply
      to this horrendous burden of cancer is considered. The theoretically possible use
      of bioengineering techniques to modify the composition of food crops and thus to
      minimize the levels of carcinogens in the food supply is discussed. This is
      considered important since failure to monitor the effect of bioengineering may
      lead to an increase in the level of such noxious agents, especially if the goal
      of such bioengineering is to develop food crops with increased intrinsic
      resistance to pests and other spoilage organisms.

PMID- 8484025
TI  - Subsurface agricultural irrigation drainage: the need for regulation.
AB  - Subsurface drainage resulting from irrigated agriculture is a toxic threat to
      fish and wildlife resources throughout the western United States. Studies by the
      U.S. Department of the Interior show that migratory waterfowl have been poisoned
      by drainwater contaminants on at least six national wildlife refuges. Allowing
      this poisoning to continue is a violation of the Migratory Bird Treaty Act under
      U.S. Federal law. Critical wetlands and waterfowl populations are threatened in
      both the Pacific and Central flyways. The public is also at risk and health
      warnings have been issued in some locations. Subsurface irrigation drainage is a
      complex effluent containing toxic concentrations of trace elements, salts, and
      nitrogenous compounds. Some of the contaminants are classified by the U.S.
      Environmental Protection Agency (EPA) as priority pollutants and they can be
      present in concentrations that exceed EPA's criteria for toxic waste. The on-farm
      drainage systems used to collect and transport this wastewater provide point
      source identification as well as a mechanism for toxics control through the
      National Pollutant Discharge Elimination System (NPDES) permit process. A four
      step approach is presented for dealing with irrigation drainage in an
      environmentally sound manner. This regulatory strategy is very similar to those
      commonly used for industrial discharges and includes site evaluation, contaminant
      reduction through NPDES, and compliance monitoring. The EPA must recognize
      subsurface irrigation drainage as a specific class of pollution subject to
      regulation under the NPDES process. Active involvement by EPA is necessary to
      ensure that adequate controls on this wastewater are implemented.

PMID- 8484026
TI  - Infant formulas: evidence of the absence of pesticide residues.
AB  - Concern about the effect of potential pesticide residues on the safety of the
      U.S. food supply has led to extensive modeling and projections of worst-case
      scenarios. Many risk assessment models project risk based on an assumption of the
      presence of pesticide residues at the tolerance level or at a level equivalent to
      the limit of analytical detectability. Often, actual residue data, and the
      variability of analytical detection limits, are ignored in favor of simpler
      models. Data presented here demonstrate the absence of detectable levels of
      pesticides in infant formula. The range of detection limits of analytical
      methodology employed also are presented. A rationale for the absence of pesticide
      residues in infant formulas derived from plant and animal sources is presented
      which obviates worst-case scenario calculations of risk based on pesticide
      residue tolerance levels or method detection limits.

PMID- 8484027
TI  - Development and implementation of a safety evaluation program for chemical
      fibers.
AB  - Polyester and acrylic fibers often have prolonged contact with human skin: the
      sucking of childrens' toys may lead to ingestion. During manufacture,
      occupational exposure to fiber components may occur. An evaluation of these
      possible hazards was undertaken by data appraisal, chemical analyses, and animal
      plus human testing. Occupational exposure limits have already been set for the
      chemicals used in polymer manufacture. Finishing agents (applied to the fibers)
      were examined in bacterial mutation and rat acute oral toxicity tests. Finished
      fibers were tested for acute toxicity and then for sensitizing potential (on
      guinea pig skin). Human volunteer trials for skin irritance and sensitization
      followed. No adverse reactions were seen. Only when fibers were burnt was
      toxicity seen: smoke from acrylic fiber proved more toxic than that from
      polyester fiber (due principally to hydrogen cyanide release). Migration tests
      showed that little material leached out from the fibers: < 1 mg/dm2 surface area
      in saline, 0.4 mg/dm2 from acrylic fibers in methanol, 3.6 mg/dm2 from polyester
      fibers in chloroform. Analysis showed only fiber polymer components and finish in
      saline and methanol leachates. Whilst further testing may be required for areas
      of special concern, since only a limited range of biological endpoints have been
      addressed, it is concluded that current and foreseeable future uses of these
      chemical fibers pose little or no toxicological hazard.

PMID- 8484028
TI  - Chronobiology as it relates to toxicology, pharmacology, and chemotherapy.
AB  - Examples of circadian (daily) rhythms in man are presented and discussed. This is
      followed by presentation of experimental data indicating how the temporal
      organization affects the response of the host to potentially toxic agents, namely
      amphetamine and sodium pentobarbital. Data also are presented indicating that one
      unequivocally can improve therapeutic efficacy using the L1210 mouse leukemia
      model. This was accomplished by taking into consideration the circadian host
      toxicity response to anticancer agents, namely cytosine arabinoside, adriamycin,
      and cyclophosphamide. The subject monitored was the "cure rate" subsequent to
      treatment of different tumor loads.

PMID- 8484029
TI  - Health risk assessment.
AB  - In the United States the hazards posed by chemicals are often enormously
      exaggerated. In "calculating" risks of human cancer and establishing regulations,
      the United States Environmental Protection Agency makes a series of
      "conservative" assumptions that have no sound scientific basis. In consequence,
      trillions of dollars could be wasted. Exaggerations of risks are inherent in the
      procedures by which rodents are employed as stand-ins for humans. Dependence on
      results of maximum tolerated doses in the most sensitive strain or species of
      rodent is questionable. Important examples involve B6C3F1 mice, which in contrast
      to humans in developed countries, have a high control incidence of liver cancer.
      Those mice often respond with liver tumors when exposed to large doses of a
      substance. Other rodents are less often affected. Questionable assessments
      involving liver cancer in B6C3F1 mice include the risks posed by
      trichloroethylene, perchloroethylene, methylene chloride, butadiene, and
      phenobarbital. Spurious assessments for humans have also been noted when the male
      rat was the most sensitive animal. A unique mechanism in them gives rise to
      kidney tumors while female rats and male and female mice are not affected.

PMID- 8484030
TI  - Whither risk assessment? An overall perspective.
AB  - Major regulatory initiatives in health and safety are increasingly viewed as too
      costly, not objectively justified, and thus failing in their mandate to ensure a
      fair social distribution of rights and burdens. Official but arbitrary
      assumptions in cancer risk assessment and open-ended statutory language encourage
      regulatory agencies to overregulate. Also, institutional self-serving motivations
      of regulatory agencies add incentives to expand regulation. Mitigation of the
      current regulatory crisis may come from curbing these selfish incentives, and
      from requiring that regulation be justified on the basis of strict scientific
      standards of evidence, rather than on arbitrary assumptions and conjectures.

PMID- 8484031
TI  - Environmental health science research and human risk assessment.

PMID- 8484032
TI  - Toward a new national strategy on risk.

PMID- 8484033
TI  - Safety assessment of ingested heterocyclic amines: initial report.

PMID- 8484034
TI  - [On euthanasia].

PMID- 8484035
TI  - [The descriptive and analytical epidemiology of traumatic spinal cord lesions
      occurring in Spain during 1984 and 1985].
AB  - Descriptive and analytic epidemiology of traumatic spinal cord injury (Traumatic
      SCI) in Spain, with a sample of 33% of all incidental cases between 1984 and
      1985, underlining the traffic accidents as the origin of those lesions. OR was
      obtained next of different variables of T-SCI, after controlling possible
      confusing factors through logistic regression and taking as "control group" Non
      Traumatic-SCI. OR in Traumatic-SCI decreases with age and in females. These
      Traumatic-SCI produce especially "cervical" lesions (OR = 3) and "complete" (OR =
      4) with higher dependence on second persons. In the rest of variables there are
      no significative differences.

PMID- 8484036
TI  - [Endocarditis due to Candida albicans with peripheral arterial embolism and a
      cerebral mycotic aneurysm in an IV drug addict].
AB  - Endocarditis due to Candida albicans (EC) is a rare cause of endocarditis in IV
      drug addicts (IVDA). Its diagnostic is usually difficult and high peripheral
      embolization is characteristic, and could affect big vessels. The case of a
      female patients (IVDA) 21 years old is discussed, who showed bilateral
      iliofemoral embolism and cerebral hemorrhage due to mycotic aneurysm breakage in
      a EC. These two complications appeared during an EC episode are exceptional. We
      insist in the importance of the echographic images in the suspicion diagnosis of
      EC.

PMID- 8484037
TI  - [Listeria monocytogenes infection in HIV patients: 2 new cases].
AB  - Two new cases of infection due to Listeria monocytogenes in two females with HIV
      are discussed, one of them with full blown AIDS and the other pregnant and
      without knowledge of her seropositivity until that moment. Its clinical
      manifestation as a meningeal manifestation and bacteremia, coincide with the few
      cases described until now; different hypothesis invoked until now are reviewed to
      justify this infrequent association HIV-Listeria.

PMID- 8484038
TI  - [The current panorama of euthanasia in Spain].
AB  - Due to the fact of the continuous advances of medical technology, physicians are
      able to prolong life even in those patients who suffer from a terminal illness to
      whom no hope to recover from it is left. Frequently the use or not of different
      therapies on these type of patients is questioned, who demand the autonomy over
      the self person to decide the cessation of a treatment. That is why it was
      proposed to investigate on the opinions and attitudes on the omission or
      cessation of treatments which could prolong life (passive euthanasia) or active
      euthanasia in terminal patients. A survey, which preserved the confidentiality of
      patients, was done in which 1,109 individuals took part coming from three
      different sectors of the population: hospital health professionals (physicians n
      = 346 and nurses n = 346) from San Carlos University Hospital, Madrid; students
      (n = 261) from Madrid Complutense University, and retired individuals (n = 156)
      from an elderly people club located at the Madrid province (Pinto). Sample was
      formed by 40% of males and 60% of females, with ages between 20 and 90 years.
      Most of the surveyed people agreed in certain circumstances or totally agree with
      omission or cessation of drugs which could prolong life (passive euthanasia) in
      terminal patients (70%). Regarding active euthanasia more than half (55%) opposed
      to it, 34% agreed in certain circumstances and 10% agreed completely. Significant
      differences were detected (p < 0.05) related to age, religious beliefs and
      political thoughts of the subjects. These results are compared to others already
      available.

PMID- 8484039
TI  - [Colonic tuberculosis].

PMID- 8484040
TI  - [The epidemiological and diagnostic aspects of brucellosis].

PMID- 8484041
TI  - [Wegener's granulomatosis: a case with fulminant presentation].

PMID- 8484042
TI  - [Calcium, magnesium and asthma: apropos an incongruity].

PMID- 8484043
TI  - [Severe pericardial effusion and skin metastases as the initial manifestations of
      a pulmonary epidermoid carcinoma].

PMID- 8484044
TI  - [The effect of heparin treatment on the rose bengal test for Brucella].

PMID- 8484045
TI  - [Primary psoas abscess].

PMID- 8484046
TI  - [Septic thrombophlebitis of the portal vein].

PMID- 8484047
TI  - [Visceral leishmaniasis in HIV-infected patients. A diagnostic criterion of
      AIDS?].

PMID- 8484048
TI  - [The history and current status of lung transplantation].

PMID- 8484049
TI  - [An overview of techniques for lung transplantation].

PMID- 8484050
TI  - [Patient selection for lung transplantation from the aspect of surgery].

PMID- 8484051
TI  - [Patient selection for lung transplantation from the aspect of internal
      medicine].

PMID- 8484052
TI  - [Practice of the flow measurement using nonradioactive microspheres and X-ray
      fluorescence spectrometer].

PMID- 8484053
TI  - [Characteristics of plasma levels of myosin light chain I in patients under aorta
      coronary bypass grafts].
AB  - After cardiac operation plasma level of ventricular myosin light chain I (LCI),
      determined with monoclonal antibodies to myosin fragment, were studied in 30
      patients under bypass surgery to assess its possible role as a marker for
      perioperative myocardial injury. LCI rapidly increased and reached peak levels
      (15.8 +/- 9.0 gn/ml; T-peak) at 88 +/- 28 minutes after aortic declamp (T-Time).
      Then LCI rapidly decreased with fast half-time disappearance (1.1 +/- 0.7 hours).
      In 7 out of 30 patients LCI improved to normal range and MB reached maximum
      levels (28.8 +/- 11.9 U/L) at 6.3 +/- 2.3 hours after declamp. No abnormal change
      was noted in ECG and no new defects were noted in T1-201 myocardial images. In
      the remaining 23 patients LCI decreased to minimum levels (4.1 +/- 2.1 ng/ml; min
      LCI) at 9.2 +/- 5 hours (min-Time) and then gradually increased to peak levels
      (8.4 +/- 5.8 ng/ml; M-peak, M-value) on day 3.3 +/- 1.0 (M-Time). MB reached
      maximum level (77.6 +/- 82.4 U/L, p < 0.1) at 3.4 +/- 1.4 hours (p < 0.001). Good
      correlation was noted among min-LCI, min-Time, M-value and summation of daily
      value of LCI (omega(LCI)) x min-LCI = 5.7-0.17 min-Time (r = -0.42) and M-value =
      2.1 min-LCT(r=0.74) and omega(LCI) = -9.6 + 6.1 M-value (r = -0.96). From the
      rapid appearance of LCI peak levels after aortic declamp it was concluded that
      LCI, accumulated during aortic clamp, was washed out by aortic declamp.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8484054
TI  - [An experimental study on transcoronary chemical ablation: comparison of
      ventricular tachyarrhythmias induced by chemical ablation according to different
      chemical materials].
AB  - The purpose of this study was to compare heart rate, appearance rate and duration
      of ventricular tachycardia (VT) by transcoronary chemical ablation using 95%
      ethanol and 1% aethoxysclerol respectively. After the balloon which was guided to
      the left or right coronary artery with PTCA technique in anesthetized dogs was
      inflated, chemical ablation was performed using ethanol (n = 5) or aethoxysclerol
      (n = 5). These chemicals were administered at 0.05 ml/sec with total dose of 0.50
      1.50 ml. A quadripolar electrode catheter was used to record the intracardiac
      electrogram. VT occurred in all dogs (100%) after the administration of both
      ethanol and aethoxysclerol. In one dog using ethanol, VT developed into
      ventricular fibrillation, resulting in death. In dogs using aethoxysclerol, the
      heart rate and duration of VT were significantly lower and shorter than in those
      using ethanol (p < 0.05). There were no significant differences determined
      histologically in the ablated lesions caused by these different chemicals. We
      conclude that the severity of VT induced in all subjects by chemical ablation is
      different according to the materials applied, and that aethoxysclerol seems to be
      safer in comparison with ethanol.

PMID- 8484055
TI  - [Linkage analysis in a Japanese long QT syndrome family].
AB  - Romano-Ward syndrome is an autosomal dominant trait disease, which is
      characterized by QT prolongation and normal hearings and shows predisposal to
      sudden death from cardiac arrhythmia. Recently, Keating et al. reported that
      Harvey ras-1 locus (H-ras-1) was closely linked to long QT syndrome (LQTS), being
      located on the short arm of chromosome 11. In this study we have examined a three
      generation Japanese family whose members had recurrent fainting with prolongation
      of the QT interval on electrocardiogram. Using the H-ras-1 probe as DNA marker,
      we could not determine that the H-ras-1 gene was linked to LQTS. LQTS seems to be
      a genetically heterogeneous disease. Further study is needed to clarify the
      chromosomal location of the LQTS.

PMID- 8484056
TI  - [Coronary vasodilation during intracoronary injection of papaverine and
      acetylcholine in syndrome X: evaluation by coronary arteriograms and coronary
      venous oxygen saturation dynamics].
AB  - To evaluate coronary vasodilatory reserve in syndrome X, left coronary
      arteriography and continuous measurement of coronary venous oxygen saturation
      (CSO2-Sat) were performed during intracoronary injection of papaverine (PAP) and
      acetylcholine (ACh) in 11 patients of syndrome X and 13 control subjects.
      Coronary diameter after PAP increased 10.2% in the control group and 9.8% in the
      syndrome X group, but after ACh decreased 1.7% in the control group and decreased
      2.3% in the syndrome X group. These changes in coronary diameter by PAP and ACh
      in the two groups were not significantly different. However, coronary
      vasodilatory responses estimated by CSO2-Sat dynamics to ACh and to ACh/PAP were
      significantly lower in the syndrome X group than those in the control group (p <
      0.05), although coronary response to PAP in the 2 groups was not significantly
      different. These findings suggest that endothelial-dependent vasodilation of
      coronary microcirculation is decreased in syndrome X.

PMID- 8484057
TI  - [A case of Buerger's disease solitary involved in the left subclavian and
      axillary artery].
AB  - A 26-year-old male with about a ten-year history of smoking was admitted to our
      hospital for evaluation of ischemic symptoms including numbness, easy
      fatigability on exercise and lack of pulse in his left arm. His left axillary,
      brachial and radial pulse could not be palpated and a needle reaction was
      negative on physical examination. Laboratory data showed no diabetes mellitus or
      hyperlipidemia. C-reactive protein, Wassermann's reaction, rheumatoid reaction,
      anti-nuclear factor, anti-DNA antibody, hypocomplementemia and circulating immune
      complex were negative. Invasive arteriography using contrast medium revealed
      segmental occlusion with multiple collateral arteries showing a typical
      "corkscrew" appearance at the left subclavian artery. However, no stenotic and
      aneurysm-like lesions suggesting aortitis syndrome, vasculo-Bechet disease and
      giant arteritis were found on the aorta or other arteries including the pulmonary
      artery. Although no pathological study could be carried out, the angiographic and
      laboratory findings strongly suggested Buerger's disease as a possible cause of
      solitary stenosis of the left subclavian artery in this patient.

PMID- 8484058
TI  - [One family having 5 members with hypertrophic cardiomyopathy with similar
      pattern of left ventricular inflow and distribution of hypertrophy].
AB  - We examined, in one family, 5 cases of hypertrophic cardiomyopathy (HCM) with a
      similar pattern of left ventricular inflow (LVIF) and distribution of
      hypertrophy. Its clinical background and significance were discussed. Because a
      variety of morphologic expressions of HCM may be observed in the same family,
      distribution of left ventricular hypertrophy (LVH) varies in even first-degree
      relatives of the family. In all five cases in this study, however, LVH was
      localized between the anterior wall and the interventricular septum. On the other
      hand, typical pattern of LVIF in HCM is "decreased peak velocity and prolonged
      deceleration time of the early diastolic wave (E), and compensatory augmentation
      of the atrial contraction wave (A)". All of the five cases in this study had a
      pattern of three characteristic peaks of LVIF, which showed the mid-diastolic
      wave between the E and A waves. The above findings suggested that the myocardial
      characteristics of the five cases in this family were very similar, and could be
      important clues clarifying the mode of inheritance of HCM.

PMID- 8484059
TI  - [ST-T changes associated with severe hypoxia in a case of obstructive sleep apnea
      syndrome].
AB  - A 59-year-old man with obesity was admitted with nocturnal dyspnea and nocturnal
      precordial oppression. Catheter data disclosed no cardiac failure.
      Polysomnography was performed for a total of 3 nights. The diagnosis of
      obstructive sleep apnea syndrome was made because apnea index was 50 times/hour
      in average, the max apnea time was about 80 seconds and disappearance of airflow
      during decrease of endoesophageal pressure was observed. At the max apnea time,
      ST-T change in leads V2-5 was observed with severe desaturation (arterial oxygen
      saturation: 49%). It was considered that myocardial hypoxia following sleep apnea
      might be the cause of nocturnal precordial oppression.

PMID- 8484060
TI  - [A case of an idiopathic enlargement of the right atrium, lacking in prominent
      right atrium contour and mimicking left pericardial defect on the chest X ray].
AB  - A 47-year-old man was admitted for evaluation of heart murmur in 1982. On
      admission, two-dimensional echocardiogram showed a giant right atrium with mild
      tricuspid regurgitation, but a chest X ray showed no prominent right atrium
      contour. Echocardiographic finding at various postures and chest X ray with
      artificial pneumothorax indicated little likelihood of left pericardial defect.
      An angiocardiogram and computed tomography showed the dilated right atrium with
      clockwise rotation. There was no indication of right atrial overload. Therefore,
      we made the diagnosis of an idiopathic enlargement of the right atrium. For about
      10 years after discharge, we have followed up this patient. He has received no
      treatment and has been asymptomatic. On the other hand, echocardiography shows
      that the right atrium has gradually enlarged. Electrocardiogram has clearly
      revealed only a tall and slender peaked P wave in chest leads for the last 5
      years. This may indicate not only an increasing load on the right atrium but also
      that the enlarged atrium is getting closer to the walls of the chest. We report
      this case of an idiopathic enlargement of the right atrium lacking in prominent
      right atrium contour, and mimicking left pericardial defect on chest X ray.

PMID- 8484061
TI  - [A case of percutaneous removal of a catheter fragment from the pulmonary artery
      using a long sheath].
AB  - A case of successful removal of a catheter fragment from the pulmonary artery is
      reported. We employed the loop snare designed for transcolonoscopic polypectomy
      through a 9F long sheath. The sheath was advanced into the pulmonary artery over
      the balloon catheter. Handling of the loop snare was smooth and safe because of
      there being enough inner diameter of the sheath. Other instruments such as
      grasping-forceps or basket stone-catcher were also able to be advanced through
      the sheath. We recommend the employment of the 9F long sheath for retrieval of
      intravenous foreign bodies.

PMID- 8484062
TI  - [A case of successful tissue plasminogen activator in young-onset pulmonary
      embolism].
AB  - A 16-year-old boy was admitted to the hospital because of chest pain, dyspnea,
      and syncope. Physical examination revealed blood pressure of 100/60 mmHg, regular
      pulse of 120 beats/min, and respiratory rate of 30/min. Pulsation of the right
      ventricle was palpable in the left margin of the parasternum. An increased second
      sound was audible in the second inter-costal lesion of the left subclavicle mid
      line. Results of blood tests were close to normal limits, except for slight
      leukocytosis and elevation of the LDH value. Analysis of artery blood gas showed
      hypoxia. The chest x-ray film showed cardiac enlargement. The value of systolic
      pulmonary artery pressure was estimated to be 47 mmHg by the cardiac echogram,
      which revealed enlargement of the right ventricle. Pulmonary embolism was
      suspected from the above findings. The value of pulmonary artery pressure was
      found to be 49/19 mmHg by Swan-Ganz catheter. Angiography of the pulmonary artery
      revealed filling defects of right in the right pulmonary artery. Tissue
      plasminogen activator was injected directly to the right pulmonary artery. After
      that, chest pain and dyspnea were relieved. In addition, arterial oxygen improved
      and pulmonary artery pressure decreased. At the 6th day after admission, the
      defect in the pulmonary artery angiography disappeared. Deep vein thrombosis of
      both femoral veins was recognized as a cause of pulmonary embolism by angiography
      of the femoral vein.

PMID- 8484063
TI  - [Obesity as a cardiovascular risk factor in Mexico. Study in an open population].
AB  - We present the results of a population based study designed to estimate the
      prevalence of obesity defined as body mass index (BMI males > or = 27.7 kg/m and
      females > or = 27.31 kg/m) and to characterize the adipose tissue distribution
      pattern in our population, using subscapular and triceps skinfolds and waist and
      hip circumferences. In addition we assess the effect of obesity on the various
      metabolic indices that define cardiovascular risk, and explore the attitude of
      the participants towards obesity and its health consequences. The survey was
      performed in a low income neighborhood of Mexico City. Anthropometric
      measurements, laboratory determinations and protocol procedures used in the study
      were all performed according to international recommendations. The community had
      4411 inhabitants, of whom 931 were age eligible (35-64 years): 452 (48.5%) men,
      479 (51.5%) women. The response rate for the home interview was 91.7% and for the
      physical examination with interview and laboratory determinations it was 69.9%.
      The crude prevalence of obesity in men was 36.8% and in women 60.0%. Subscapular
      and triceps skinfold measurements were significantly higher in obese patients
      when compared to non obese participants. Adiposity tended to be distributed
      preferentially in the lower segment of the body, both in males and females. This
      pattern showed a tendency to reverse in the obese population. Fat distribution
      also showed a centrally predominant pattern, especially in obese males. In
      patients with obesity systemic blood pressure was higher than without obesity,
      though this was significant only in the first two age groups in males and the
      youngest age group in females.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484064
TI  - Reliability of reference models for vital capacity in young Mexican males.
AB  - The reliability of 33 prediction models for vital capacity was assessed in
      university students living in Mexico City (altitude = 2,240 m). Forced vital
      capacity (FVC) was predicted and measured in 83 healthy male students, 18 to 30
      years old and non-smokers. Spirometric tests were performed with a 9 liter bell
      spirometer, according to ATS guidelines. Mean measured FVC was 5,094 +/- 555 mL
      (BTPS) while mean predicted FVC by the models ranged from 3,700 mL to 5,350 mL
      (BTPS) with a small but significative correlation between actual and reference
      values (r = 0.398 to 0.474, p < 0.05). The residual standard deviation showed
      values from 503 to 577 mL which were similar to those seen in the original
      population. Although 11 of the 33 models were able to predict mean observed FVC
      by Dunnett's test (p < 0.05), all of them showed significant bias on the
      regression between measured values and residuals of predicted values, i.e.
      intercepts (2,435 to 4,127 mL), slopes (-0.61 to -0.87) and correlations (-0.59
      to -0.95) were statistically different from zero (p < 0.01). Our data remark the
      need to obtain appropriate reference FVC values in young Mexican males due to the
      questionable predictability of the models tested.

PMID- 8484065
TI  - [Cytogenetic study of 22 adults and 3 children with acute lymphoblastic
      leukemia].
AB  - Between 1987 and 1990 cytogenetic studies of bone marrow and lymphocytes from
      peripheral blood from 25 patients with de novo ALL were performed. All cases had
      chromosomal aberrations; however in 23 patients a normal cell line was also
      present. The most important structural aberrations found were: t(17;19)(q11;p13),
      t(2;9;22)(q34;q34;11), t(1;7)(p13;q33), t(6;11)(q26;p16), t(3;4)(q24-25;q26),
      t(1;12)(q23;q34), t(2;18)(q15;p12), t(2;4)(q23;q35) and t(4;11)(q21;q23). These
      chromosome abnormalities correlate with the response to treatment and survival
      and improve the identification of high-risk patients. Our study shows the
      presence of some chromosomal abnormalities different to those reported in the
      literature; however the breakpoints involved seem to be the same which suggests
      that these critical regions may be directly involved in the pathogenesis of these
      disorders.

PMID- 8484066
TI  - Image-guided fine needle aspiration biopsy. One year experience.
AB  - An analysis of one year experience with fine needle aspiration biopsies (FNAB)
      guided by computed tomography or ultrasound was conducted in a tertiary care
      reference center. We performed 66 procedures, two of them considered insufficient
      (97% technical success). The overall sensitivity was 90% and the specificity
      100%. There were five false negative and no false positive results. The
      cytological diagnosis was confirmed with core biopsy of surgical specimen
      (available in 30 patients, 47%), discharge diagnosis and/or clinical evolution.
      Twenty seven patients had a positive FNAB for malignancy. The complication rate
      was 12%, all of them considered as minor complications which resolved with
      conservative management. There was a concordance between FNAB results and final
      diagnosis in 91.5% of the cases. Fine needle aspiration biopsy is a very useful
      diagnostic procedure if performed adequately.

PMID- 8484067
TI  - [Thyroid nodule. Study of 88 cases].
AB  - We present a prospective study of 88 patients with thyroid nodules seen in our
      institution in 1985-86 and the results of a 5 year follow up. The algorithm for
      resolution among different therapeutic options was established in regard to the
      clinical characteristics, imaging and particularly the histopathologic studies.
      Their age ranged from 18 to 79 years; 94% of the patients were females. Most of
      the nodules were solid (69%) and measured 1-4 cm in diameter. The image of 62% of
      the thyroid scans was of a non-functioning nodule and 13% were hyperfunctioning.
      In 80% the ultrasonographic pattern was solid or mixed. Surgery was undertaken in
      19 patients (21%). In 58%, a diagnosis of malignancy was established. The biopsy
      (aspiration and tru-cut) suggested the presence of the malignant tumors when
      taken together in 90% of the cases. Hormonal treatment was given to 62 patients;
      in 40-45% of them there was a significant reduction in the size of the nodule.
      Aspiration and sclerosis of cystic nodules were performed in 19 patients with
      significant shrinkage in 82%. Radioactive iodine was used in 11 patients. Our
      algorithm reduces costs and precludes unnecessary morbidity in patients with
      thyroid nodules.

PMID- 8484068
TI  - [Histoplasma capsulatum in the peripheral blood of patients with AIDS. Report of
      4 cases with an increase of lactate dehydrogenase].
AB  - This paper describes the clinical course of four patients with AIDS who were
      found to have H capsulatum in peripheral blood. The evolution of the infection
      was fulminant and all died within the first 96 hours following hospitalization.
      In every case the presence of the characteristic mycelium and "tuberculate"
      macroconidia of Histoplasma was established in cultures. All cases showed the
      hematological abnormalities common in other AIDS associated diseases. In
      addition, there was an increase in serum lactic dehydrogenase over ten times our
      normal level: the lowest LDM assay was 2137 IU/mL and the highest 4839 IU/mL.
      This clinical course resembling septicemia and the demonstration of H capsulatum
      in a peripheral blood smear has had a rate of 12% in our experience (four out of
      the 34 cases of AIDS with histoplasmosis seen in our institution from January
      1984 to March 1991).

PMID- 8484069
TI  - Diffuse small lymphoplasmacytic lymphoma of the GI tract associated with massive
      intestinal amyloidosis.
AB  - We report the case of an 80 year old man who developed a small diffuse
      lymphoplasmacytic lymphoma that involved the entire gastrointestinal tract. The
      malignant lymphoma was associated with intestinal amyloidosis presumably produced
      by the neoplastic lymphocytes. The outstanding symptoms were asthenia, fever,
      marked weight loss, diarrhea and melena. The postmortem study disclosed, in
      addition, lymphomatous infiltration to the gallbladder, mesenteric lymph nodes
      and testis. The case represents an exceptionally widespread type of diffuse
      gastrointestinal lymphoma.

PMID- 8484070
TI  - [Allogenic bone marrow transplant].

PMID- 8484071
TI  - [Flow cytometry in the immunotyping of acute leukemias].

PMID- 8484072
TI  - [Regarding the article "Adjuvant chemotherapy in gastric cancer. Experience at
      the National Institute of Nutrition"].

PMID- 8484073
TI  - Management of vitamin B12 deficiency in outpatient care.

PMID- 8484074
TI  - Rape victims--assaults, injuries and treatment at a medical rape trauma service
      at Oslo Emergency Hospital.
AB  - OBJECTIVE: To describe assaults, injuries, and treatment in the 168 patients who
      attended the medical rape trauma service in 1987. To give an impression of the
      medico-legal documentation that is required. DESIGN: Prospective study. SETTING:
      A rape trauma service (RTS) established at the Emergency Hospital in Oslo. The
      service is free, open around the clock, and independent of police notification.
      RTS has standardized the medico-legal report used for rape victims. PARTICIPANTS:
      All patients attending RTS from 1 January to 31 December. RESULTS: Eighty-two
      (49%) patients reported the incident to the police. Two-thirds of the patients
      were assaulted by strangers, one-fifth by two or more assailants, and 16 were
      subjected to attempted rape. Weapons were used in 50 of the assaults. Eighty-one
      patients had physical injuries requiring documentation but no special treatment.
      Fourteen patients were infected with sexually transmitted diseases, three
      patients became pregnant. Seventy-eight patients returned for a medical follow
      up. As many as 128 patients (76%) needed care from all parts of the emergency
      medical and psycho-social services. CONCLUSION: RTS shows that primary health
      service can be responsible for the treatment of rape victims and for the medico
      legal documentation of rape trauma.

PMID- 8484075
TI  - Reference values for 24-hour non-invasive ambulatory blood pressure: a population
      study of men aged fifty.
AB  - All 50-year-old men (N = 126) living in a defined neighbourhood were invited to
      undergo 24-hour ambulatory, non-invasive blood pressure (BP) monitoring. The
      participation rate was 90%. Seven per cent of the subjects were taking
      antihypertensive drugs and 19% had a current diagnosis of hypertension or had
      been so diagnosed sometime previously. The 5th, 50th, and 95th percentiles of the
      subjects' ambulatory BP are presented. On average, daytime, night-time, and 24
      hour ambulatory BP were 135/86, 114/68, 128/80 mmHg, respectively, and the
      average casual BP was 137/86 mmHg. The ambulatory BP in the present study was
      higher than in previous reference studies. No attempt was made to select the
      stratified subjects according to casual BP or any other medical or social
      variable. This and a high participation rate probably account for the difference
      in ambulatory BP vis-a-vis those found in other reference studies.

PMID- 8484076
TI  - Computer-based simulation model for evaluation of variations in practice patterns
      of general practitioners: a feasibility study.
AB  - Our study aimed at developing a computer-based simulation model for the
      consultation process in general practice. The model was developed in the computer
      language COM-CATS and makes use of an IBM-compatible personal computer with an
      automated diasprojector attached. A feasibility study comprised 122 general
      practitioners (108 male and 14 female), participating in the 6th Nordic Congress
      of General Practice (Aarhus, Denmark, 1989). All participants were given a short
      introduction to the patient and his symptoms, but all further information was
      optimal and selected by the doctor. There was a large variation in practice
      patterns of the general practitioners. Their actions were, however, performed
      selectively, i.e. a few tests were requested by most doctors and none of the
      doctors performed large numbers of tests. The great advantage of the computer
      model in research into clinical decision-making is that it allows for a
      standardization of the clinical situation, gives the doctor an opportunity to
      select between optional information, and permits an automatic gathering of huge
      amounts of information about the decision-making process.

PMID- 8484077
TI  - Why we need a new clinical method.

PMID- 8484078
TI  - Use of primary medical care: does place of residence play a role?
AB  - The present paper is based on a prospective study of the use of primary health
      care in the municipality of Forde in 1988. The population of about 8,300 could
      easily be divided into two groups: semi-urban and rural. We wanted to investigate
      whether there were differences in the use of primary medical care between the two
      groups. The empirical study showed higher total contact rates for the rural women
      than for the semi-urban women, and virtually no difference among the men. The
      semi-urban population was more apt to use direct contacts and had more frequent
      contacts for new health problems than the rural population. Higher age and female
      gender were associated with more use of all types of and all reasons for contact.
      In multivariate analyses, a number of interaction effects between age, sex, and
      place of residence were demonstrated.

PMID- 8484079
TI  - Frequent attenders in general practice: a study from Slovenia.
AB  - To compare frequent with infrequent attenders at GPs' surgeries in a rural area
      in Slovenia with respect to morbidity, type of contact with the GP, referral
      pattern and the prescriptions given, a random sample of 623 records from a
      population-based register was analysed retrospectively. The frequent attenders
      had a higher proportion of contacts for malignant disease, mental disorder, and
      gastrointestinal disease. They also had a greater probability for a "superficial
      contact", were more likely to be referred to a specialist, were less likely to
      receive a psychotropic drug, and were more likely to receive a prescription for
      an antibiotic. We conclude that there are differences in morbidity between the
      two groups. The high referring pattern and the high proportion of "superficial
      contacts" of the frequent attenders may reflect poor doctor/patient relationship
      of this group.

PMID- 8484080
TI  - The intensity and variability of symptoms in dyspepsia.
AB  - During the waiting time for upper gastrointestinal endoscopy 165 patients with
      dyspepsia completed a questionnaire and a diary for daily measurements of the
      symptoms pain, heartburn, and global complaints. 23 patients (14%) had peptic
      ulcer disease (PUD), 18 oesophagitis (11%), and the rest were labelled nonulcer
      dyspepsia (NUD). NUD was further subdivided into ulcer-like, reflux-like,
      dysmotility, and essential NUD by means of predefined symptom profiles. 39 (24%)
      patients were on H2 receptor antagonist treatment. In general, the intensity of
      the daily symptoms was rather low, and except for a higher rating of heartburn in
      oesophagitis, there were no significant differences between PUD, oesophagitis,
      and NUD--treated or untreated. NUD patients with reflux-like dyspepsia had
      significantly more heartburn than the group with essential NUD; otherwise there
      were no differences between the subgroups of NUD. The individual daily ratings
      for abdominal pain, heartburn, and global symptoms varied by an average standard
      deviation of 64%, 97% and 47% of the mean values, respectively, and were
      independent of treatment or diagnoses. There was an approximately 40% probability
      that two successive days had different levels of symptoms. Only 10% of the
      patients showed stable symptoms, and the patients were completely symptom-free
      for 20% of the observation period. Symptoms in dyspepsia patients disclosed low
      intensity and high variability in this study. Such factors may be important
      sources of bias in clinical trials.

PMID- 8484081
TI  - ADL capacity and loneliness among elderly persons with cognitive impairment.
AB  - Advancing age brings a natural weakening of functions, making the individual rely
      more on support from the community and next-of-kin. The purpose of this study was
      to investigate, in relation to subjective loneliness, the ADL dependence of
      elderly persons with and without impaired cognitive capacity. 264 persons were
      interviewed. The Mini-Mental State Examination was used as a screening instrument
      for obtaining a cognitively-impaired and a normal group of elderly. Persons with
      impaired cognitive capacity who experienced loneliness had the greatest ADL
      dependence.

PMID- 8484082
TI  - Factors associated with consultation length and characteristics of short and long
      consultations.
AB  - Consultation length illustrates how general practitioners balance contradictory
      concerns such as productivity and quality, listening to patients, and handling
      their own stress. Important factors for consultation length are list size,
      characteristics of doctors and patients, and character of the problem. The
      purpose of this study of 463 consultations was to describe factors that are
      associated with short and long consultations and to examine the relative
      influence on the consultation length of patients' age and sex, character of the
      problem, continuity, and the 'doctor's speed'. A questionnaire was used for both
      doctors and patients. Short consultations were often made by younger male
      patients about physical problems, while long consultations often were made by
      older patients about problems with both psychological and physical dimensions.
      The 'doctor's speed' explained 22.5%, character of the problem 11.6%, and
      patient's age 2.9% of the variation in consultation length.

PMID- 8484083
TI  - Prevention of cardiovascular disease within the primary health care system-
      feasibility of a prevention programme within the Sollentuna primary health care
      catchment area.
AB  - OBJECTIVE: To integrate prevention of cardiovascular disease within the primary
      health care. DESIGN: A prevention programme which combines population and
      individual high-risk strategy. SETTING: The Primary Health Care in Sollentuna,
      Stockholm, Sweden. MAIN OUTCOME MEASURE: Characteristics of, and risk factor
      prevalence among, persons registered in the prevention programme. RESULTS: During
      the first year more than 2000 persons, representing every tenth visitor and 6% of
      the population aged 15-60 years, were registered in the prevention programme. 90%
      were < or = 60 years and 62% were women. A large proportion (70%) had risk
      factors that required advice, treatment, and follow up. 24% of the men and 27% of
      the women were smokers, 68% and 62% respectively, had serum cholesterol > or =
      5.2 mmol/l, and 33% and 22% had a diastolic blood pressure > or = 90 mmHg.
      CONCLUSION: The present study implies that it is possible to integrate a large
      scale prevention programme in the existing primary health care organization. The
      prevalence of risk factors in those who enter the prevention programme is high,
      which places great demands for treatment and follow up.

PMID- 8484084
TI  - Medical audit based on computer-stored patient records exemplified with an audit
      of hypertension care.
AB  - OBJECTIVE: To audit hypertension care at a health centre using computer-based
      patient records as the source of information and a query language as the analysis
      tool. DESIGN: Retrospective database study comparing hypertension care in 1989
      with hypertension care in 1990. SETTING: One health centre in Sweden with six
      general practitioners and two doctors on vocational training. PARTICIPANTS: All
      patients with hypertension in 1989 and 1990. MAIN OUTCOME MEASURE: The percentage
      of records that complied with the criteria in the hypertension care protocol.
      RESULTS: 585 records in 1989 and 574 records in 1990 were reviewed automatically
      by a series of 30 database queries. The computer time needed for the review was
      eight hours. The first audit showed deficiencies in the management of
      hypertension, in particular concerning patient history taking and risk factor
      analysis. The second audit, after the introduction of the hypertension care
      protocol, showed some minor improvements in the recording and also an increased
      rate of well treated hypertensive patients. CONCLUSION: Computer-based patient
      records may facilitate the review of medical records that is needed in medical
      audit. The audit demonstrates the gap between optimal care and clinical reality.

PMID- 8484085
TI  - Who consults for rape? Sociodemographic characteristics of rape victims attending
      a medical rape trauma service at the Emergency Hospital in Oslo.
AB  - OBJECTIVE: To consider the number of victims of rape and attempted rape in a city
      (Oslo) who sought treatment when medical help had been made available. To examine
      the sociodemographic characteristics of the patient group that applied for help.
      DESIGN: Prospective study. SETTING: A rape trauma service (RTS) established at
      the Emergency Hospital in Oslo. The service is free, open around the clock, and
      independent of police notification. PARTICIPANTS: All patients attending RTS from
      1 January to 31 December. RESULTS: 164 women and four men applied for medical
      treatment in 1987, four times as many as in 1985, before RTS was started. Their
      ages varied between 14 and 89 years, with a median of 27 years. Women aged 14-39
      years were significantly over-represented in relation to the general female
      population of Oslo. Married women were significantly under-represented among the
      female patients, both married women raped by their spouses and married women
      raped by other men. 45 patients stated that they had been sexually assaulted on a
      previous occasion without reporting the incident or applying for help.
      CONCLUSION: Compared with the police an available medical service for rape
      victims reached four times as many rape victims as in 1985, from a larger share
      of the population.

PMID- 8484086
TI  - [The definition and epidemiology of bacterial vaginosis].
AB  - Bacterial vaginosis is a condition with a flora change in the vaginal where a
      lactobacilli-dominated flora is exchanged with an abundant complex flora
      dominated by strict and facultative anaerobic bacteria. The condition seldom
      occurs in prepubertal girls and post-menopausal women, suggesting an hormonal
      component in its etiology. Recurrent episodes of bacterial vaginosis are
      frequent. Three out of four criteria should be fulfilled for establishing the
      diagnosis of bacterial vaginosis, i.e., an increased (often homogeneous) vaginal
      discharge, a positive amine test, the presence of a great number of clue cells, a
      vaginal pH > or = 4.5. There are no hard data supporting that bacterial vaginosis
      is a sexually transmitted disease. Cytological changes (CIN I, II, III) have been
      found more often in women with bacterial vaginosis than in those without this
      condition. It has been proposed that nitrosamines from the abundant vaginal
      bacterial flora may be oncogenic, a correlation which, however, needs to be
      proved. The reservoir for one or more of the bacterial vaginosis-associated
      organism, e.g., some Bacteroides and Mobiluncus spp., Gardnerella vaginalis and
      Mycoplasma hominis, is probably the distal intestinal tract and the mouth. Sparse
      or even a moderate number of clue cells are present in many women who do not have
      bacterial vaginosis. A vaginal pH of 4.7 seems to be a better cut-off level than
      4.5. There is a statistical correlation between bacterial vaginosis and
      obstetrical complications.

PMID- 8484087
TI  - [Clinical and colposcopic aspects of bacterial vaginosis].
AB  - Bacterial vaginosis is characterized by an uniform, malodorous, white-grey
      discharge. The presenting symptom is generally the unpleasant smell of the
      vaginal discharge, particularly following the menses or intercourse. Other
      functional signs, such as pruritus, dysuria and dyspareunia are rare.
      Inflammatory signs are frequent, and can be revealed by colposcopy with the Lugol
      test: this shows punctuate colpitis with small regular points corresponding
      histologically to an inflammatory focus in the connective tissue. The term
      "vaginitis" is avoided because of the absence of polymorphonuclear cells in the
      vaginal discharge, despite the presence of inflammation. Bacterial vaginosis has
      been held responsible for prematurity, small birthweight and post-partum
      infection. Nonetheless, Gardnerella vaginalis and Mobiluncus spp can be recovered
      from the vaginal flora of women with no signs of inflammation.

PMID- 8484088
TI  - [The bacteriologic diagnosis of bacterial vaginosis in an urban practice].
AB  - The term "bacterial vaginosis" carries both bacteriologic and clinical
      connotations. Indeed, it implies that the vagina is uninflamed (as shown by the
      absence of polymorphonuclear neutrophils), but that potential pathogens
      (particularly Gardnerella vaginalis) are present. Many studies conducted over the
      last 10 years have shown that a tentative diagnosis is simple to make, based on
      the sniff test, the aspect of the vaginal discharge, the presence of clue cells,
      and the absence of polymorphonuclear cells and lactobacilli on fresh smears.
      However, classical treatment with metronidazole can be insufficient given the
      innumerable microbial associations, and a more thorough bacteriological diagnosis
      is required. The presence of anaerobes is suggested by a positive sniff test.
      Direct examination reveals small Gram-negative rods in clue cells, but cannot
      differentiate between commensal atypical lactobacilli and Gram-positive
      anaerobes. Culture with CO2 supplementation or in anaerobic conditions yields
      Bacteroides and Mobiluncus spp, frequently associated with Gardnerella vaginalis
      and pathogenic Fusobacterium spp. Culture in appropriate conditions will detect
      metronidazole-resistant Propionibacteria and pathogenic anaerobic cocci.
      Antibiotic susceptibility testing of these organisms is costly and time
      consuming, but can avoid therapeutic failures. Gardnerella vaginalis is also
      frequently associated in bacterial vaginosis with endogenous (mainly E. coli and
      group B streptococci) and Ureaplasma. Antibiotic susceptibility testing is useful
      if the predominant members of the flora are Gram-negative aerobes, group D
      streptococci or pathogenic anaerobes. Bacterial vaginosis is simple to diagnose
      but poses a real therapeutic problem since some cases call for a simple
      readjustment of the commensal flora while others require full
      chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484089
TI  - [Recent bacteriologic data: from physiopathology to treatment].
AB  - Bacterial vaginosis is characterized by a change in the vaginal ecosystem in
      which Lactobacillus spp, the dominant members of the normal flora, are replaced
      by an association of various bacterial species including Gardnerella vaginalis,
      anaerobes (Bacteroides spp, Prevotella spp, Porphyromonas spp, Peptostreptococcus
      spp and Mobiluncus spp) and Mycoplasma hominis. The reasons for this imbalance
      are unknown, although the loss of lactobacilli that produce hydrogen peroxide
      (which is toxic for G. vaginalis and numerous anaerobes) may be an essential
      element. The introduction of one or several of these species into the vagina
      (they can occasionally be isolated in small numbers even in the absence of
      vaginosis) following intercourse or from the intestinal tract may also play a
      role. G. vaginalis itself is not considered to cause vaginosis, but is almost
      always present and multiplies rapidly; in addition, it has a high capacity for
      adherence to epithelial cells both in vivo and in vitro. It is now agreed that
      the concomitant growth of one or several anaerobic species is required for
      bacterial vaginosis to develop. Our knowledge of the bacteriology of bacterial
      vaginosis has implications for diagnosis and treatment. It is now possible to
      obtain a precise bacteriologic diagnosis, not by culturing G. vaginalis (a costly
      and low-yield procedure), but by direct examination of the vaginal flora after
      Gram staining, which shows the replacement of lactobacilli by a characteristic
      polymorphic flora. Therapy is based on the use of antibiotics such as the
      imidazoles, which are active against G. vaginalis and anaerobes, but not against
      the commensal lactobacilli.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484090
TI  - [Bacterial vaginosis: what risks for the mother and child?].
AB  - Bacterial vaginosis are characterized by a polymicrobial proliferation of
      anaerobic organisms and the disappearance of the commensal lactobacilli, which
      can cause ascending utero-adnexitis and endanger ongoing pregnancy. The role of
      anaerobes in utero-adnexitis and tubal abscess was first raised in 1973 par
      Eschenbach. Several authors have since established correlations between bacterial
      vaginosis and both pain from the uterine appendages and gynecologic infections,
      particularly post-abortum. Bacterial vaginosis is a major problem in pregnant
      women, given its high prevalence (15-20 p. cent) and significant relationship
      with premature delivery and premature rupture of the membranes (at less than 37
      weeks of amenorrhea) in epidemiological case-control and cohort studies taking
      into account demographic and concomitant obstetric characteristics. In
      particular, histological lesions indicative of chorioamniotitis have been
      correlated with prematurity and with the presence of bacteria (usually those
      involved in vaginosis) in the amniochorial space. Bacterial vaginosis can give
      rise to ascending infections which reach the amniochorial space and cause uterine
      contractions or alter the amniochorial membrane, leading to premature rupture of
      the membranes. These epidemiological data must, however, be confirmed by
      controlled trials of antibiotics active in bacterial vaginosis and their
      preventive effect on prematurity and premature rupture of the membranes. Finally,
      bacterial vaginosis can play a role in endometritis following both natural and
      caesarean delivery; this has been shown in multivariate analyses with adjustment
      for maternal age, duration of labor and rupture of the membranes, and isolation
      of bacteria associated with bacterial vaginosis from the endometrium.

PMID- 8484091
TI  - [Antibiotics and bacterial vaginosis].
AB  - The two questions that arise in the treatment of bacterial vaginosis are: who
      should be treated and how can the frequent recurrences be avoided? Metronidazole
      is the reference agent in this setting. At a dose of 500 mg bid for 3-7 days, the
      clinical and bacteriologic cure rates range from 80 to 100 p. cent. Clindamycin
      and amoxycillin-clavulanic acid are both effective; amoxycillin is less effective
      but can be used when other antibiotics are contraindicated (pregnancy, etc.). Not
      all cases of bacterial vaginosis should be treated, as about 50 p. cent are
      totally asymptomatic. However, the risk of occasionally serious infectious
      complications calls for treatment of patients with risk factors, such as
      symptomatic vaginosis, high-risk pregnancy, a history of gynecological infection,
      pelvic surgery (particularly by the vaginal route), and sterility. Although
      bacterial vaginosis is not strictly a sexually transmitted disease, treatment of
      the partner can reduce the risk of recurrence. Suitable antibiotic treatment is
      usually associated with clinical and bacteriological resolution of bacterial
      vaginosis. Unfortunately, long-term follow-up of these patients has shown a risk
      of recurrence as high as 80 p. cent at nine months, for reasons which remain to
      be elucidated.

PMID- 8484092
TI  - Reduction of tumor necrosis factor alpha and interleukin-1 beta levels in human
      synovial tissue by interleukin-4 and glucocorticoid.
AB  - The effects of recombinant human interleukin-4 (IL-4) and the glucocorticoid,
      dexamethasone, on tumor necrosis factor alpha (TNF alpha) and interleukin-1 beta
      (IL-1 beta) levels in cultures of rheumatoid and osteoarthritic synovial tissue
      were studied. Low concentrations of IL-4 and dexamethasone suppressed the levels
      of both cytokines in the supernatants of both types of tissue after stimulation
      with lipopolysaccharide (LPS); the IL-1 beta and TNF alpha levels were measured
      by ELISA. It is suggested that it is the monocyte/macrophage in the synovial
      tissues that is responsive to the inhibitors. It is proposed that glucocorticoids
      may act on synovial tissue in this manner in vivo and IL-4 may do so if
      administered intraarticularly.

PMID- 8484093
TI  - T-cell receptor V beta chain expression in patients with juvenile rheumatoid
      arthritis.
AB  - The V beta chain repertoire in peripheral blood T-cell was analyzed in 23
      patients with juvenile rheumatoid arthritis (JRA). Of these, 15 patients had
      active disease as defined by tender and swollen joints. The ESR was elevated in
      all but three patients, C-reactive protein (CRP) was elevated in eight. Three
      patients were investigated during active and inactive phases of the disease. In
      the active phase of the disease T-cell composition was characterized by an
      increased number of CD4+ helper cells due to a marked increase in the CD4+CD45RA+
      subgroup (34.0 +/- 10.9%, P < 0.001) and a decrease in CD8+CD29+ T-cells (10.3 +/
      5.6%, P < 0.05) compared to controls (15.4 +/- 10.0% and 17.8 +/- 12.3%,
      respectively). Using the monoclonal antibodies available to determine T-cell
      receptor (TCR) expression, patients with active disease demonstrated a
      significant predominance of T-cells bearing TCRs of the V beta 5 family as
      determined by flow cytometry (7.6 +/- 6.7 vs 3.4 +/- 1.3 in controls, P = 0.01).
      In active polyarthritis, up to 24% of peripheral blood T-cells expressed TCRs of
      the same family. In the majority of JRA patients and especially in non-active
      disease, no preferential TCRs were found compared to controls. However, even
      defining only a part of TCRs by immunofluorescence, in certain patients a
      preferential or dominant expression of a single V beta gene family in the T-cells
      was found, supporting the concept of an involvement of T-cells in the autoimmune
      pathogenesis of JRA.

PMID- 8484094
TI  - Repeated detection of Borrelia burgdorferi DNA in synovial fluid of a child with
      Lyme arthritis.
AB  - In the pathogenesis of late Lyme borreliosis the relative importance of the
      causative organism, Borrelia burgdorferi, and the immune response of the host,
      including autoimmune phenomena, is not yet known. We describe a 7-year-old boy
      with Lyme arthritis from whom two synovial fluid samples were obtained 5 months
      apart and up to 17 months after the first appearance of arthritis. Both synovial
      fluid specimens were shown to contain borrelial DNA by nested polymerase chain
      reaction for the amplification of portions of the genes for flagellin and OspA.
      Thus, Borrelia burgdorferi may persist within the joint even during late stages
      of the disease.

PMID- 8484095
TI  - Serological profile of rheumatoid arthritis in west Africa.
AB  - Rheumatoid arthritis (RA) in West Africa is atypical in a number of respects. In
      order to investigate this we evaluated the serological profile of a series of
      West African patients diagnosed as having RA. We found the presence of a wide
      range of autoantibodies including antinuclear antibodies (ANA), anticardiolipin
      antibodies and antineutrophil cytoplasmic antibodies but the pattern of these
      autoantibodies was similar to that reported in other studies. Our serological
      studies support the hypothesis that these patients do have RA and the presence of
      these autoantibodies is of interest with regards to implications for diagnosis.

PMID- 8484096
TI  - Does sport negatively influence joint scores in patients with juvenile rheumatoid
      arthritis. An 8-year prospective study.
AB  - The influence of sporting activities performed using joint protective measures on
      deterioration in hand and lower extremity function was evaluated over 8 years in
      62 patients with juvenile rheumatoid arthritis (JRA). Sporting activities usually
      recommended to patients with JRA, such as cycling and swimming, did not
      negatively influence hand or lower extremity function as compared to a control
      group of patients not taking part in sporting activities. Besides cycling and
      swimming, other sporting activities were only performed by a minority of patients
      (less than 10%). Decreases in total joint scores of both the hands and lower
      extremities, showed significant correlations with disease duration in patients
      taking part and in patients not taking part in sporting activities. Polyarticular
      onset of disease was associated with higher total joint scores of the hands as
      compared to pauciarticular onset of disease. In lower extremity function, no
      difference was found between patients with polyarticular onset and patients with
      pauciarticular onset. Disease duration of longer than 10 years, accompanied by
      severe functional deterioration, was followed by low participation in sporting
      activities. Therefore, we suggest that appropriate sporting activities, such as
      cycling and swimming, can be advised to patients with JRA regardless of disease
      duration, since no negative effects were observed in our study over a period of 8
      years.

PMID- 8484097
TI  - Chromosome abnormalities in peripheral lymphocytes from patients with progressive
      systemic sclerosis.
AB  - Chromosomal abnormalities in cultured peripheral lymphocytes from 14 progressive
      systemic sclerosis (PSS) patients and 15 normal subjects were examined. No
      increase was observed in the frequency of chromosome aberrations in PSS patients
      who had not received any medical treatment. Those who had received medication
      showed an increased frequency of dicentrics (0.3%) although the frequency was not
      significantly higher than that for normal subjects. It is not clear, however,
      whether the increase was due to the hypersensitivity of PSS patients to agents
      used for therapeutic purposes.

PMID- 8484098
TI  - Nodules of the shoulder girdle in two Indonesian villages.
AB  - During a community survey of rheumatic complaints in a Javanese rural population,
      fibrous shoulder girdle nodules having a consistent form and position were
      observed in seven men. This was 2.3% of 303 men with complaints examined from a
      total population of 2184 men surveyed by house-to-house interviews (response rate
      95.2%). Nodules were not seen in any of the 640 women examined with complaints
      from a total population of 2499, nor were they seen in 130 men and 159 women with
      complaints from an urban population of 481 men and 590 women over the age of 15
      years. It was considered most likely that these shoulder nodules were the result
      of longstanding repetitive mechanical irritation due to carrying heavy loads by a
      resilient wooden pole balanced across the shoulder.

PMID- 8484099
TI  - Multicentric Castleman's disease in a patient with primary Sjogren's syndrome.
AB  - A 38-year-old woman suffering from primary Sjogren's syndrome for 2 years
      developed angiofollicular hyperplasia (multicentric Castleman's disease). In
      Sjogren's syndrome (SS) a number of findings indicate the presence of a B-cell
      hyperactivity that may evolve to a lymphoproliferative disorder. This report adds
      another pathological event to the complex spectrum of lymphoproliferative
      diseases in SS.

PMID- 8484100
TI  - Excessive fibrosis of supraclavicular lymph-node granulomas in a patient with
      progressive systemic sclerosis.
AB  - The case of a 29-year-old white female with a 7-year history of typical
      scleroderma is presented who developed excessive fibrosis of the supraclavicular
      lymph nodes. After 3 years of disease, firm right supraclavicular lymphadenopathy
      appeared, accompanied by a high fever. Biopsy revealed non-caseating granulomas
      and short-term antituberculous therapy was ineffective. The symptoms finally
      responded to steroids, but adenopathy persisted. A second biopsy, 40 days after
      the first, disclosed a similar picture with some degree of fibrosis of the
      granulomas. Four years later, with stony hard right supraclavicular adenopathy
      persisting, a third biopsy showed excessive fibrosis of the granulomas within the
      node and destruction of its architecture. It is postulated that the primary
      disease of this patient might be responsible for this clinical picture. The
      present seems to be the first report of such a case in the literature.

PMID- 8484101
TI  - Evidence for an ongoing role of class I histocompatibility molecules for the
      production of interleukin-2 in response to suboptimal concentrations of
      phytohaemagglutinin.
AB  - To examine the role of cellular interactions involving class I histocompatibility
      antigens in the response to low concentrations of phytohaemagglutinin, we studied
      the effect of antibodies to components of these antigens on proliferative
      responses, interleukin-1 and interleukin-2 production, and IL-2 receptor
      expression. Antibody to human beta 2-microglobulin (beta 2m) had an inhibitory
      effect both on IL-2 accumulation at 48 h of culture and on the proliferative
      response 24 h later. Exogenous IL-2 completely reconstituted the inhibited
      proliferative responses, and also restored the modest decrease in IL-2 receptor
      expression that was induced by anti-beta 2m. Pretreatment of either purified
      monocytes or T cells with anti-beta 2m had a similar inhibitory effect both on
      proliferation and on interleukin-2 production. By contrast, IL-1 production by
      LPS- or silica-stimulated monocytes was not affected by this antibody. Kinetic
      experiments demonstrated that anti-beta 2m was equally inhibitory when added at
      the initiation of culture or after 24h, and significant inhibition occurred when
      the antibody was added as late as 48 h. Our results are consistent with an
      ongoing role for class I antigens in the cellular interactions between
      lymphocytes and accessory cells required for the production of IL-2.

PMID- 8484102
TI  - Organ-specific regulation of interferon-gamma, interleukin-2 and interleukin-2
      receptor during murine infection with Trypanosoma cruzi.
AB  - We have studied the expression of IFN-gamma, IL-2 and IL-2 receptor (IL-2R) at
      the mRNA and protein levels in spleen and lymph node cells from Trypanosoma cruzi
      infected BALB/c mice. At 21 days post infection (dpi) (peak of parasitaemia),
      spleen cells stimulated with Con A for 16 h showed a reduced IFN-gamma, IL-2 and
      IL-2R mRNA production compared with non-infected controls. Lymph node cells
      obtained at 4, 21 or 60 dpi produced similar amounts of IFN-gamma, IL-2 or IL-2R
      transcripts after mitogen stimulation as uninfected controls. Spleen cells
      obtained at 21 dpi showed a lower Con A proliferative response and IL-2R
      expression compared with non-infected controls, while the proliferation and IL-2R
      expression of lymph node cells at 21 dpi was unaltered. Supernatants from 48 h
      Con A-stimulated spleen and lymph node cells from mice at 21 dpi had very low
      levels of IL-2 but contained significantly higher levels of IFN-gamma compared
      with the supernatants of cells from non-infected mice. The latter phenomenon
      correlates with an accelerated rate of IFN-gamma mRNA accumulation.

PMID- 8484103
TI  - Protective opsonic activity of antibodies against fibronectin-binding proteins
      (FnBPs) of Staphylococcus aureus.
AB  - In this report, opsonic activity of hyperimmune rabbit IgG against fibronectin
      binding proteins (gal-FnBP A and ZZ-FnBP B) of Staphylococcus aureus is
      described. Moreover, the action of IgG purified from serum of rabbits immunized
      with 'combined vaccine' (fibronectin-binding protein A+collagen-binding
      protein+alpha-toxoid) is shown. The opsonic activity has been studied in an in
      vitro phagocytosis assay as well as in vivo. Mice which had been infected
      intraperitoneally with S. aureus strain Cowan 1 pretreated (opsonized in vitro)
      with specific anti-FnBPs IgG were able to eliminate the staphylococci from the
      peritoneal cavity and liver more rapidly than controls. Also, clearance from the
      bloodstream of intravenously injected S. aureus Cowan 1 as well as S. aureus
      U320, opsonized with IgG anti-FnBPs or anti-FnBP+CnBP+alpha-toxoid, was more
      effective than observed in control groups. In other in vivo experiments it was
      shown that mice passively immunized with hyperimmune IgG anti-FnBP (one or two
      doses, intravenously) before challenge with S. aureus Cowan I eliminated the
      bacteria better than controls injected only with preimmune IgG.

PMID- 8484104
TI  - Cyclosporin A does not inhibit IL-1 alpha-induced epithelial cell IL-6 secretion.
AB  - Trauma and infection activated a murine mucosal IL-6 response in different ways:
      the IL-6 response to bacteria was sensitive to Cyclosporin A (CsA); the IL-6
      response to trauma was not. The aim of the present study was to identify possible
      activators of the CsA-insensitive IL-6 secretion at the epithelial cell level.
      Two human epithelial cell lines from the kidney (A498) and bladder (J82) were
      exposed to Escherichia coli Hu734, interleukin-1 alpha (IL-1 alpha) and tumour
      necrosis factor alpha (TNF-alpha). The E. coli strain had been used for the in
      vivo experiments which led to this study, and IL-1 alpha and TNF-alpha were
      likely to be released during infections and trauma. The secretion of IL-6 into
      the supernatants was compared between cells stimulated in the presence or absence
      of CsA. E. coli Hu734, IL-1 alpha and TNF-alpha stimulated an IL-6 response in
      the two epithelial cell lines. The IL-1 alpha-induced IL-6 response was rapid,
      and the secreted IL-6 levels were significantly higher than those induced by E.
      coli Hu734 or TNF-alpha. The IL-6 response to IL-1 alpha was insensitive to CsA.
      By contrast, the IL-6 response to E. coli Hu734 and TNF-alpha was inhibited by
      CsA. These results demonstrated that the inhibitory effect of CsA depends on the
      stimulus triggering the IL-6 response. IL-1 alpha may play a role in the
      induction of trauma-associated CsA-insensitive IL-6 secretion.

PMID- 8484105
TI  - Aggregated human immunoglobulins bind to modified proteins.
AB  - Human immunoglobulins treated at 55 degrees C in vitro are able to interact with
      maleylated bovine serum albumin (mBSA), but not with unmodified BSA. Gel
      filtration experiments demonstrated that the mBSA binding is associated with a
      high molecular weight complex of aggregated IgG. This aggregated IgG with binding
      capacity for mBSA could also be generated in vitro by treatment of human IgG at
      37 degrees C or 40 degrees C and by incubation with human neutrophils.
      Furthermore, IgG aggregates with binding activity for mBSA could be detected in
      untreated synovial fluids from rheumatoid arthritis patients, indicating that
      these complexes occur in vivo. The phenomenon of binding to aggregated IgG was
      extended to other modified proteins such as maleylated human serum albumin
      (mHSA), acetyl low density lipoprotein (Ac-LDL) and BSA reacted with oxidized
      linolenic acid. Soluble forms of these modified proteins were able to compete for
      the interaction between aggregated IgG and surface-bound mBSA. We also found that
      aggregated IgG enhanced the Ac-LDL-dependent foam cell formation. These findings
      suggest a role for aggregated IgG in the metabolism of oxidized proteins.

PMID- 8484106
TI  - Oligoclonal development of germinal centre cells as detected by anti-idiotype
      antibodies.
AB  - Experimental models using immunization with known haptens have shown that
      germinal centres develop from only a limited number of precursor cells which
      expand in an oligoclonal fashion. Using a panel of antibodies raised against the
      idiotype of follicle centre cell lymphomas and known to be reactive only with a
      few normal B cells, we could demonstrate that individual clones can be identified
      within germinal centres of individual follicles of human lymph nodes and tonsils.
      Therefore also in humans in a non-experimental, natural situation, germinal
      centres expand in an oligoclonal fashion.

PMID- 8484107
TI  - Evaluation of nutritional status in persons with spinal cord injury: a
      prerequisite for successful rehabilitation.
AB  - Evaluation of nutritional status is a pre-requisite for planning a comprehensive
      and appropriate nutritional care plan for spinal cord injured (SCI) patients. A
      nutritional assessment reveals the nutritional status of a patient and identifies
      the objectives of nutritional care. There is no single measurement that totally
      reflects the state of a patient's nutritional health. Besides anthropometric,
      laboratory, and dietary intake, a patient's social and medical history are needed
      to develop an individualized plan. The outcome of establishing a screening and
      assessment program results in quality and cost-effective nutritional care for
      patients. Providing optimal nutritional care at the onset of SCI can help reduce
      complications, decrease length of hospital stay, and enhance the rehabilitation
      outcome.

PMID- 8484108
TI  - Methylprednisolone after spinal cord injury.
AB  - The assumption that maximal spinal cord injury occurs at the moment of trauma is
      being challenged by emerging evidence that cellular injury continues after the
      acute event. Efforts are now being made to alter the course of secondary injury
      in order to improve the functional outcome of survivors. Methylprednisolone has
      been studied in two clinical trials--the National Acute Spinal Cord Injury
      Studies (NASCIS I, NASCIS II)--to determine its ability to protect compromised
      but viable cellular elements, and thus improve outcome. The purpose of this paper
      is threefold: (1) to explore the putative mechanisms of secondary spinal cord
      injury, (2) to examine the role of methylprednisolone in spinal cord injury, and
      (3) to discuss the findings and clinical implications of NASCIS I and NASCIS II.

PMID- 8484109
TI  - Carbon monoxide and dilation of blood vessels.

PMID- 8484110
TI  - UCSF Research Institute: no Hughes approval.

PMID- 8484111
TI  - Big science enters the clinic.

PMID- 8484112
TI  - Affirmative action for clinical trials.

PMID- 8484113
TI  - Proposal to counter scientist 'shortage' draws fire.

PMID- 8484114
TI  - New test catches drug-resistant TB in the spotlight.

PMID- 8484115
TI  - New colon cancer gene discovered.

PMID- 8484116
TI  - Zagury probe concluded.

PMID- 8484117
TI  - The many roads that lead to Ras.

PMID- 8484118
TI  - The nitrogenase FeMo-cofactor and P-cluster pair: 2.2 A resolution structures.
AB  - Structures recently proposed for the FeMo-cofactor and P-cluster pair of the
      nitrogenase molybdenum-iron (MoFe)-protein from Azotobacter vinelandii have been
      crystallographically verified at 2.2 angstrom resolution. Significantly, no
      hexacoordinate sulfur atoms are observed in either type of metal center.
      Consequently, the six bridged iron atoms in the FeMo-cofactor are trigonally
      coordinated by nonprotein ligands, although there may be some iron-iron bonding
      interactions that could provide a fourth coordination interaction for these
      sites. Two of the cluster sulfurs in the P-cluster pair are very close together
      (approximately 2.1 angstroms), indicating that they form a disulfide bond. These
      findings indicate that a cavity exists in the interior of the FeMo-cofactor that
      could be involved in substrate binding and suggest that redox reactions at the P
      cluster pair may be linked to transitions of two cluster-bound sulfurs between
      disulfide and sulfide oxidation states.

PMID- 8484119
TI  - Sequences and structures required for recombination between virus-associated
      RNAs.
AB  - RNA recombination has been described for a number of viruses in the plant and
      animal kingdoms, but the mechanisms of selection of recombination sites are
      poorly understood. The nonrandom recombination between two subviral RNAs
      associated with turnip crinkle virus was used to study the requirement for
      specific sequences and structures in the generation of recombinant molecules.
      Single-base mutations that disrupted either the stem or the loop of one of the
      two computer-predicted stem-loop structures eliminated detectable recombinant
      molecules. However, recombinants were detected if compensatory mutations were
      generated that re-formed a stable hairpin structure. These results provide
      evidence for the necessity of specific structures in the formation of recombinant
      molecules in this system.

PMID- 8484120
TI  - Genetic mapping of a locus predisposing to human colorectal cancer.
AB  - Genetic linkage analysis was used to determine whether a specific chromosomal
      locus could be implicated in families with a history of early onset cancer but
      with no other unique features. Close linkage of disease to anonymous
      microsatellite markers on chromosome 2 was demonstrated in two large kindreds.
      The pairwise lod scores for linkage to marker D2S123 in these kindreds were 6.39
      and 1.45 at zero recombination, and multipoint linkage with flanking markers
      resulted in lod scores of 6.47 and 6.01. These results prove the existence of a
      genetically determined predisposition to colorectal cancer that has important
      ramifications for understanding and preventing this disease.

PMID- 8484121
TI  - Clues to the pathogenesis of familial colorectal cancer.
AB  - A predisposition to colorectal cancer is shown to be linked to markers on
      chromosome 2 in some families. Molecular features of "familial" cancers were
      compared with those of sporadic colon cancers. Neither the familial nor sporadic
      cancers showed loss of heterozygosity for chromosome 2 markers, and the incidence
      of mutations in KRAS, P53, and APC was similar in the two groups of tumors. Most
      of the familial cancers, however, had widespread alterations in short repeated
      DNA sequences, suggesting that numerous replication errors had occurred during
      tumor development. Thirteen percent of sporadic cancers had identical
      abnormalities and these cancers shared biologic properties with the familial
      cases. These data suggest a mechanism for familial tumorigenesis different from
      that mediated by classic tumor suppressor genes.

PMID- 8484122
TI  - Microsatellite instability in cancer of the proximal colon.
AB  - Colorectal tumor DNA was examined for somatic instability at (CA)n repeats on
      human chromosomes 5q, 15q, 17p, and 18q. Differences between tumor and normal DNA
      were detected in 25 of the 90 (28 percent) tumors examined. This instability
      appeared as either a substantial change in repeat length (often heterogeneous in
      nature) or a minor change (typically two base pairs). Microsatellite instability
      was significantly correlated with the tumor's location in the proximal colon (P =
      0.003), with increased patient survival (P = 0.02), and, inversely, with loss of
      heterozygosity for chromosomes 5q, 17p, and 18q. These data suggest that some
      colorectal cancers may arise through a mechanism that does not necessarily
      involve loss of heterozygosity.

PMID- 8484123
TI  - Rapid assessment of drug susceptibilities of Mycobacterium tuberculosis by means
      of luciferase reporter phages.
AB  - Effective chemotherapy of tuberculosis requires rapid assessment of drug
      sensitivity because of the emergence of multidrug-resistant Mycobacterium
      tuberculosis. Drug susceptibility was assessed by a simple method based on the
      efficient production of photons by viable mycobacteria infected with specific
      reporter phages expressing the firefly luciferase gene. Light production was
      dependent on phage infection, expression of the luciferase gene, and the level of
      cellular adenosine triphosphate. Signals could be detected within minutes after
      infection of virulent M. tuberculosis with reporter phages. Culture of
      conventional strains with antituberculosis drugs, including isoniazid or
      rifampicin, resulted in extinction of light production. In contrast, light
      signals after luciferase reporter phage infection of drug-resistant strains
      continued to be produced. Luciferase reporter phages may help to reduce the time
      required for establishing antibiotic sensitivity of M. tuberculosis strains from
      weeks to days and to accelerate screening for new antituberculosis drugs.

PMID- 8484124
TI  - Tyrosine kinase-stimulated guanine nucleotide exchange activity of Vav in T cell
      activation.
AB  - The hematopoietically expressed product of the vav proto-oncogene, Vav, shared
      homology with guanine nucleotide releasing factors (GRFs) [also called guanosine
      diphosphate-dissociation stimulators (GDSs)] that activate Ras-related small
      guanosine triphosphate (GTP)-binding proteins. Human T cell lysates or Vav
      immunoprecipitates possessed GRF activity that increased after T cell antigen
      receptor (TCR)-CD3 triggering; an in vitro-translated Vav fragment that contained
      the putative GRF domain was also active. Vav-associated GRF stimulation after TCR
      CD3 ligation paralleled its tyrosine phosphorylation; both were blocked by a
      protein tyrosine kinase (PTK) inhibitor. Vav also was a substrate for the p56lck
      PTK. Thus, Vav is a PTK-regulated GRF that may be important in TCR-CD3-initiated
      signal transduction through the activation of Ras.

PMID- 8484126
TI  - New study of nurse vs. physician care shows nurses offer same or better treatment
      at lower costs.

PMID- 8484125
TI  - Health care reform. Message from SDNA president.

PMID- 8484127
TI  - Rural health nursing perspective. Interview by Sara Becker and Kathleen Muir
      Molton.

PMID- 8484128
TI  - LPN task force recommends expanding role in i.v. therapy.

PMID- 8484129
TI  - Sternocostoclavicular hyperostosis.
AB  - Sternocostoclavicular hyperostosis is a chronic arthro-osteitis affecting mostly
      juxtasternal structures. It is characterized clinically by painful swelling of
      the upper anterior chest wall and occasionally is associated with pustulosis
      palmaris and plantaris. Pathologically there is osteitis, periostitis, and new
      bone formation of periarticular structures. Two patients are described, and the
      clinical, laboratory, and radiological findings of 251 reported cases in the
      English literature are reviewed.

PMID- 8484130
TI  - Candida arthritis in adult patients who are not intravenous drug addicts: report
      of three cases and review of the literature.
AB  - Candida species are an uncommon cause of infectious arthritis, although the
      frequency has increased during recent years. Three cases of septic arthritis
      caused by Candida species are reported, and the literature is reviewed. The first
      patient developed a popliteal cyst infected by Candida albicans after multiple
      intravenous antibiotic treatments. The second patient had acute myelogenous
      leukemia and experienced knee arthritis after chemotherapy, and the third
      suffered oligoarthritis after a second heart transplantation. All patients
      received treatment with a standard dose of intravenous amphotericin B. Responses
      were achieved only in the first two cases; the third patient died despite
      therapy. Thirty-six previously reported Candida arthritis cases are reviewed, and
      epidemiologic, diagnostic, therapeutic, and prognostic features are analyzed.
      Cases are divided into two categories: direct inoculation of fungus and
      hematogenously disseminated disease; these two categories are compared in terms
      of sex, age, pathogen species, treatment, and survival. Arthritis induced through
      direct inoculation of fungus is seen in older individuals, is more frequently
      produced by species other than C albicans (Candida parapsilosis especially), and
      has a better prognosis than arthritis caused by disseminated candidiasis.
      Arthritis can be resolved even in the persistence of the systemic disease. It is
      believed that the first case of Baker's cyst infected by C albicans and the first
      case of Candida arthritis in a heart transplant patient are reported here.

PMID- 8484131
TI  - Psychopathology associated with systemic lupus erythematosus: a methodological
      review.
AB  - Psychiatric dysfunction is believed to be a common manifestation of systemic
      lupus erythematosus (SLE). In fact, psychosis is 1 of 11 criteria the American
      Rheumatism Association used to provide a classification scheme for the disease.
      Nonpsychotic symptomatology also is frequently attributed to SLE disease
      pathophysiology. This article is a methodological review of the literature
      relating to the prevalence of psychiatric dysfunction and whether these problems
      can be attributed to disease activity. Given the serious methodological
      limitations in the available literature, definitive point prevalence or lifetime
      prevalence estimates for psychopathology in patients with SLE are not available.
      In addition, there is no conclusive evidence that the disease causes nonpsychotic
      psychiatric dysfunction in these patients.

PMID- 8484132
TI  - Hypogammaglobulinemia and rheumatic disease.
AB  - Primary hypogammaglobulinemia describes a heterogeneous group of immunoglobulin
      disorders mainly composed of X-linked agammaglobulinemia, common variable
      immunodeficiency, and selective immunoglobulin (Ig) A deficiency. The most
      serious problems are related to recurrent infections with high-grade encapsulated
      bacteria. However, a wide variety of rheumatologic disorders also occur in
      association with hypogammaglobulinemic states. Septic arthritis with usual
      bacterial pathogens such as Staphylococcus aureus, and unusual bacteria such as
      Mycoplasma and Ureaplasma species, have been described in these patients. An
      aseptic nonerosive polyarticular arthritis that resembles rheumatoid arthritis is
      seen in 10% to 30% of hypogammaglobulinemic patients. Autoimmune disorders such
      as immune thrombocytopenic purpura, immune hemolytic anemia, juvenile rheumatoid
      arthritis, systemic lupus erythematosus, dermatomyositis, Sjogren's syndrome,
      essential mixed cryoglobulinemia, chronic active hepatitis, and sarcoidosis have
      been reported in hypogammaglobulinemic patients. Finally, to complicate matters,
      many disease-modifying antirheumatic drugs, including gold, D-penicillamine,
      sulfasalazine, azathioprine, and cyclophosphamide, cause symptomatic
      hypogammaglobulinemia in some patients.

PMID- 8484133
TI  - Autoantibody studies in juvenile rheumatoid arthritis.
AB  - Early studies showed few immunologic abnormalities in juvenile rheumatoid
      arthritis (JRA) patients. There were no specific laboratory markers useful for
      diagnosis and assessment of the course of disease in JRA. Previous work showed an
      association of antinuclear antibodies (ANA) with early-onset pauciarticular
      disease and iridocyclitis. Similarly, the presence of 19S immunoglobulin (Ig) M
      rheumatoid factors (RF) was associated with late-onset polyarticular disease in
      girls. More recent studies have detected many unique autoantibodies. Newer assays
      show 19S IgM RF in up to 35% of JRA patients, although still mainly in girls with
      late-onset polyarticular disease. Hidden 19S IgM RF can be shown in up to 75% of
      JRA patients using different procedures, primarily in those with active
      polyarticular-or pauciarticular-onset disease. Immune complexes have been
      detected in JRA patients by means of different techniques; their presence usually
      correlates with active disease. Studies on a specific ANA in JRA have shown no
      common extractable nuclear antigen, but antihistone antibodies have been found in
      up to 75% of cases, again mainly in those with pauciarticular onset and iritis.
      Finally, a variety of unusual immunologic proteins have also been detected,
      including anti-ocular, anti-cellular, anti-cardiolipin, anti-perinuclear factor,
      and anti-collagen antibodies. This review evaluates the significance of these
      antibodies that can now be found in JRA.

PMID- 8484134
TI  - Rheumatologic disease among Air Force recruits: a multimillion-dollar epidemic.
AB  - A retrospective analysis of medical discharge diagnoses of Airmen Basic
      undergoing basic military training in the Air Force for a 1-year period from 1990
      to 1991 was performed. The weighted variable cost to replace each recruit
      discharged was then used to estimate the cost to the Air Force attributable to
      rheumatologic disease. Musculoskeletal disorders were found to account for 67% of
      medical discharges, costing the Air Force at least 2.70 million dollars during
      the period under study. The patellofemoral syndrome, pes planus deformity, and
      low back pain were the most frequently encountered diagnoses.

PMID- 8484135
TI  - Diabetic muscular infarction.
AB  - In the evaluation of patients with a painful atraumatic mass in an extremity, the
      clinician should consider a number of clinical entities: primary tumor of muscle,
      focal or localized nodular myositis, local muscular abscess or soft-tissue
      infection, osteomyelitis, and thrombophlebitis. A rare complication of diabetes,
      viz, diabetic muscular infarction, heretofore not reported in the rheumatic
      disease literature is reviewed. This entity is compared with the conditions of
      focal and localized nodular myositis, which are nearly as rare.

PMID- 8484136
TI  - [Opportunistic infections in patients with disordered immune status].
AB  - Dysfunction of the immune system can result in opportunistic infections, which
      are frequently responsible for high morbidity and mortality. With regard to
      surgery, opportunistic infections are found in specific risk groups, including
      individuals with tumors, AIDS, thermic or mechanical trauma and organ
      transplantation. These infections can be caused by bacteria, fungi, viruses and
      protozoa. If there are indications of a possible opportunistic infection, a rapid
      diagnosis is required, followed by immediate therapeutic intervention.

PMID- 8484137
TI  - [Necrotizing soft tissue infections].
AB  - Necrotizing soft tissue infections are a group of life- and limb-threatening
      infections. They are caused by aerobic and anaerobic bacteria occasionally in a
      synergistic polymicrobial combination. The literature describing necrotizing soft
      tissue infections is controversial and often contradictory. Depending on their
      clinical appearance, tissue level and microbiological findings, necrotizing soft
      tissue infections are classified into two major groups, infections within the
      subcutaneous/fascia niveau and within the muscle level. Necrotizing infections of
      the subcutaneous level are further differentiated in hemolytic streptococcal
      gangrene, necrotizing fasciitis, clostridium fasciitis, and anaerobic
      nonclostridium fasciitis. In particular, necrotizing fasciitis is a rapidly
      progressing process, which is characterized by suppurative fasciitis, following
      by vascular thrombosis and cutaneous gangrene and is often accompanied by severe
      systemic toxicity, seen as septic-toxic shock and progressive (multi-) organ
      failure. Nineteen cases of necrotizing soft tissue infections were treated at the
      Department of Surgery, University Hospital of Zurich, between 1989 and 1992.
      These infections originated from "neglected trauma" in 9 (9/19), drug injections
      in 4 (4/19), acute infections in 3 (3/19), operative wounds in 2 (2/19) and
      perforation of the intestine in 1 case (1/19). Most of the patients (13/19)
      suffered from chronic debilitating diseases and were compromised by a suppressed
      immune system. We treated two groups of patients, one with septic-toxic clinical
      course and the other without. Eleven patients (11/19) belonged to group one and
      four of them, showing necrotizing fasciitis of the trunk, died as a result of
      multiorgan failure (MOF). Furthermore, three patients in this group had a limb
      amputated. In the other group without septic-toxic signs, no one died or lost a
      limb. The two groups differed also in length of hospital stay, an average of 60
      days in group one (23 days intensive care) and 25 days in group two. Our results
      suggest that prompt recognition and treatment of necrotizing soft tissue
      infections are essential for the patient's survival. Often the full extent of the
      infections is underestimated initially, resulting in delayed surgical therapy. To
      control the rapidly spreading necrosis, early diagnosis and radical debridement
      of the affected tissue are essential and should be done without compromise, even
      if the affected limb must be amputated.

PMID- 8484138
TI  - [Tuberculosis of bones and joints].
AB  - In developing countries tuberculosis of the bones and joints is a disease with an
      endemic character. In industrialized nations it is also gaining importance again
      as a result of social problems and of cases of immune deficiency. After the
      bacteriologic/histologic diagnosis of tuberculosis of the bones and joints, the
      primary therapy is non-operative with immobilization and antituberculous
      chemotherapy. Nevertheless, there are indications when an abscess and arthrodesis
      or spondylodesis must be cleaned operatively. An absolute and urgent indication
      for operative cleansing and stabilization is acute progressive paraplegia.

PMID- 8484139
TI  - [Immunologic monitoring after severe trauma].
AB  - Trauma, burn injury, and major surgery lead to severe suppression of the immune
      system with an increased susceptibility to septic complications. Therefore, the
      monitoring of essential immune functions in the early and late post-traumatic
      course may permit trauma patients with an increased risk for infectious
      complications to be identified. Most functions of the specific and non-specific
      immune system can be determined with ELISA, RIA, or other immunological
      techniques. However, only a small number of these techniques demonstrate an
      acceptable sensitivity and specificity for infectious complications. Moreover,
      the techniques used in daily monitoring should be simple, reproducible and not
      expensive with regard to materials. For immunological monitoring we suggest two
      scoring systems (ISS; APACHE II), biochemical parameters (elastase, neopterin,
      CRP, lactate), and interleukin-6 plasma levels. The clinical relevance of this
      monitoring must be proven in clinical studies.

PMID- 8484140
TI  - [A new procedure for removal of foreign bodies in the area of the head].
AB  - Identification and extraction of penetrating cranial foreign bodies can cause
      problems in some cases. Small fragments localized deep in the orbit or cerebrum
      can be especially hard to detect. Severe bleeding and traumatized anatomy can
      make orientation difficult. We used a new localizing device, computer-assisted
      surgery (CAS), to good effect in six such cases. CAS is a localizing technique
      designed to assist the head surgeon during surgery, providing real-time position
      information. The method is based upon a three-dimensional volume model of the
      patient's skull generated by preceding computed tomography imaging procedures (CT
      or MRI). Intraoperative correlation of a 3D-model and the patient's skull allows
      for real-time position display of a surgical instrument on the monitor screen.
      Thereby the surgeon is able to localize even small foreign bodies without
      extensive exploration. In the case of multiple foreign bodies the surgeon calls
      up a simple documentation facility recording which of the visible fragments have
      already been extracted. We successfully used the system for extraction of orbital
      foreign bodies in four and intracerebral foreign bodies in two cases. In a 4-year
      old child with gunshot injury the bullet was located in the precentral region and
      was easily extracted with the CAS system. In a 21-year-old man 39 glass fragments
      were extracted from the left orbit. In a 36-year-old man a bone fragment was
      dislocated to the apex of the orbit directly under the optic nerve. Location and
      extraction were achieved without damage to the orbital structures with the help
      of the CAS system.

PMID- 8484141
TI  - [Management of unstable forearm shaft fractures in children].
AB  - Complete dislocation fractures of the forearm are rare in children. Operative
      treatment is indicated if it is an open fracture and if neurovascular injury is
      present. There is no accepted standard treatment--operative or nonoperative--for
      fractures that cannot be accurately reduced and stabilized. In the last 10 years
      we have operated on 37 fractures of the forearm in children. In 22 cases the
      indication for operative treatment was that the fractures could either not be
      reduced or could not be stabilized. Our results show that most fractures were not
      recognized as unstable (17 out of 22 cases), and therefore several reduction
      maneuvers (2 to 4 times) were performed before definitive stabilization was
      obtained via an operation. It is therefore mandatory that unstable fractures of
      both bones or of one bone be operated on whereas semistable fractures (one bone
      completely fractured) should be reduced under general anesthesia and operative
      standby. For the surgical treatment of unstable forearm fractures we recommend
      intramedullary fixation by dynamic nailing or plate osteosynthesis in younger
      patients (5-10 years) and open reduction and plate osteosynthesis in older
      patients and in open fractures or fractures with primary neurovascular
      impairment.

PMID- 8484142
TI  - Adolescent idiopathic scoliosis--early menarche, normal growth.
AB  - Growth has long been known to be relevant to the development and prognosis of
      spinal deformity and abnormalities have been considered in the etiology of
      idiopathic scoliosis. Age at menarche, as an indicator of puberty, in 303 girls
      with idiopathic scoliosis 10 degrees or more from the Dublin school screening
      program was 13.13 years, 0.39 years earlier than the national mean for Irish
      girls. This difference is statistically significant (P < 0.01). The heights of
      214 of these girls aged 10-15.5 years at diagnosis and at least 14 years at
      follow-up, after a minimum 6 months, were compared with the national standards.
      It was found that, although those diagnosed at a younger age were generally
      taller than their peers, this was not true for those diagnosed at a later age or
      for anyone at final follow-up. This points to an early pubertal growth spurt in
      girls with adolescent idiopathic scoliosis but not to any outright abnormality of
      growth or development.

PMID- 8484143
TI  - A biomechanical analysis of short segment spinal fixation using a three
      dimensional geometric and mechanical model.
AB  - Vertebral stabilization using spinal fixation devices is a widely used technique.
      A three-dimensional geometric and mechanical finite element model has been used
      as a simulation tool for the evaluation of the mechanical behavior of spinal
      devices. The geometry of lumbar vertebrae was parameterized, which allows the
      construction of the geometric model for a given lumbar segment from the
      digitization of two roentgenographs. This procedure was used to construct a
      finite element model for a three-vertebra segment with simulation of fractures in
      the middle vertebra, and with simulation of a restoration using an osteosynthesis
      device, implemented in a frame fashion with four screws and two rods linked by
      two transverse rods, and/or an anterior bone graft. Compression force and torsion
      moment were considered, and different cases were investigated, by varying the
      severity of the fracture, the geometric characteristics of the device, and the
      mechanical characteristics of the material joining the two intact vertebral
      bodies. Results were analyzed considering the mobility of the vertebral segment,
      which indicates the ability of the restoration system to stabilize the vertebral
      segment, and considering the forces and moments distribution in the device, which
      gives information on part of the forces that pass through the device in each
      situation. Results show that maximum values of forces and moments in the device
      are more important in compression than in torsion. Adding an anterior bone graft
      has an effect mainly for compression, whereas in torsion its effect is
      negligible. For a rigid fixation device, no significant difference was found
      between different fracture models, indicating that the posterior arch does not
      play an important role for an instrumented segment. For compression, a rigid
      posterior wall, or the presence of a bone graft, reduces greatly the mobility of
      the instrumented segment. For torsion, suppressing the two transverse rods in the
      device greatly increases the mobility of the instrumented segment. Using a finite
      element model of a lumbar vertebral segment appears to be an interesting tool to
      analyze the behavior of an instrumented spine and to compare between different
      stabilization systems.

PMID- 8484144
TI  - Monitoring of the motor pathway during spinal surgery.
AB  - Paraplegia caused by irreversible lesions of the spinal cord is one of the major
      possible complications after scoliosis surgery. Several monitoring methods have
      been proposed but none are completely satisfactory. Since 1986 the authors
      assessed motor pathways during scoliosis surgery, using electrical stimulation of
      the motor cortex and lower limb muscle recordings (tibialis anterior muscle).
      Twenty-seven patients were included in this study: 25 with idiopathic scoliosis
      and 2 with dorsal kyphosis. Recordings in anesthetized patients with hypothermia
      were performed before and after spinal derotation during the surgical procedure.
      Magnetic cortical stimulation was carried out in ten awake patients before and
      after surgery. Reproducible responses were obtained in 22 patients under
      anesthesia. In eight patients no difference of the latency of the muscle response
      was detected before and after the correction of the spinal angulation. In 14
      patients the increase of latency ranged from 0.4 ms to 5.2 ms. No correlation was
      found between the slowing of motor conduction and the magnitude of spine
      correction. No central neurologic complications were seen after surgery. The
      authors concluded that their study demonstrated that motor pathway assessment in
      anesthetized patients can be performed at different times during the surgical
      procedure. This technique should help in the future monitoring spinal function
      during scoliosis surgery.

PMID- 8484145
TI  - Magnetic stimulation for monitoring of motor pathways in spinal procedures.
AB  - Transcranial magnetic stimulation was used for intraoperative motor evoked
      potential monitoring during surgery of intramedullar, extramedullar, and
      extradural spinal tumors in 13 patients. Anesthesia was based on etomidate.
      Magnetic stimulation for motor evoked potential monitoring was successful in 10
      of 13 patients, 12 of whom were neurologically impaired. Motor evoked potentials
      were recorded from limb muscles or from the fibers of the cauda equina.
      Amplitudes of baseline recordings (the initial recording obtained after induction
      of anesthesia) were decreased by 64 +/- 34% (mean +/- SD) and baseline latencies
      were increased by 7 +/- 8% compared with the preoperative recordings. Subsequent
      recordings were analyzed for amplitude and latency changes in comparison to
      baseline. Amplitude changes exceeding 50% and latency changes higher than 3 ms
      compared with the baseline correctly indicated an impending lesion of motor
      pathways with increased paresis postoperatively. In cases where motor evoked
      potential monitoring was successful prediction of short-term postoperative motor
      outcome was always correct. There were no "false-negatives" or "false-positives."

PMID- 8484146
TI  - Intensive dynamic back exercises with or without hyperextension in chronic back
      pain after surgery for lumbar disc protrusion. A clinical trial.
AB  - Sixty-two patients with chronic low back pain occurring 14-60 months after
      undergoing discectomy for the first time were randomized to two physical
      treatment groups: 24 sessions of intensive dynamic back exercises with
      hyperextension or 24 sessions of intensive dynamic back exercises without
      hyperextension. At the conclusion of therapy and at one-year follow-up, no
      difference was seen between the randomized groups, with regard to the combined
      assessments of pain, disability and objective measurements. A difference for back
      exercises without hyperextension to be superior to the other treatment regimen
      was statistically significant at the three-month follow-up. In the patient's
      qualitative assessment of treatment outcome there were seen no significant
      differences between back exercises with or without hyperextension. There was a
      similar and significant improvement of the isometric endurance of back muscles in
      both groups, but the flexibility of the spine was significantly improved only in
      the group using hyperextension exercises. The overall response rate of an earlier
      published investigation was reproduced. It is concluded that chronic back
      patients after first time discectomy may benefit from an intensive rehabilitation
      protocol including intensive exercises. The added use of hyperextension exercises
      does not confer any independent benefit. Furthermore, the training had to
      continue for more than 2-3 months before a statistical significant decrease in
      back pain was reported in the patient pain diary.

PMID- 8484147
TI  - The lumbar multifidus muscle five years after surgery for a lumbar intervertebral
      disc herniation.
AB  - Biopsy specimens of the lumbar multifidus were obtained from 18 patients with
      lumbar disc herniation at operation and after a postoperative follow-up period of
      5 years. The structure and morphometry of the muscle fibers were analyzed and
      these data were compared with intraoperative biopsy results and the clinical
      outcome of the operation. The main findings were: 1) on the basis of occupational
      handicap score 10 patients belonged in the "positive" and 8 in the "negative"
      outcome group; 2) the intraoperatively recorded selective type 2 muscle fiber
      atrophy and the extent of pathologic inner structure changes both decreased in
      the "positive" outcome group, whereas they persisted in the "negative" group; 3)
      grouping as a definite sign of reinnervation was seen in only two versus four
      patients of the "positive" versus "negative" outcome group; 4) the relative
      amount of adipose tissue within the muscle decreased more markedly in the
      "positive" outcome group. The authors propose that both inactivity and axonal
      injury (mainly of neurapraxia type) contribute to the selective type 2 atrophy
      and inner structure changes in disc patients' multifidus muscle. These pathologic
      structural changes correlated well with the clinical outcome, and most
      importantly they are reversible and can be diminished by adequate therapy.

PMID- 8484148
TI  - Local denervation atrophy of paraspinal muscles in postoperative failed back
      syndrome.
AB  - Impairment and disability after back surgery is a common diagnostic and
      therapeutic problem. For the most part the reasons are unclear. Of 178 patients
      who had undergone laminectomies 2-5 years earlier, 14 patients with good recovery
      and 21 patients with poor recovery but no evidence of restenosis on computed
      tomography were selected by the Oswestry index. According to radiologic,
      neurophysiologic, and muscle biopsy evidence most patients (13 of 15 studied)
      suffering from the severe postoperative failed back syndrome had dorsal ramus
      lesions in one or more segments covered by the scar and local paraspinal muscle
      atrophy at the corresponding segments. Disturbed back muscle innervation and loss
      of muscular support leads to the disability and increased biomechanical strain
      and might be one important cause to the failed back syndrome. It may be possible
      to develop operating techniques that save back muscle innervation better than the
      usual ones.

PMID- 8484149
TI  - Lumbar muscle usage in chronic low back pain. Magnetic resonance image
      evaluation.
AB  - Methods for detecting recruitment patterns of the lumbar muscles during exercise
      in patients with chronic low back pain are limited. This article discusses the
      use of magnetic resonance imaging with Roman chair extension exercise to examine
      lumbar muscle usage in five normal volunteers, five chronic low back pain
      patients without surgery, and five chronic low back pain patients with surgery.
      Changes in signal intensities of psoas, multifidus, and longissimus/iliocostalis
      with graded exercise were measured at three lumbar disc levels. At rest, there
      was a difference between multifidus and longissimus/iliocostalis signal intensity
      in chronic low back pain subjects without surgery (P = 0.0162) and in chronic low
      back pain subjects with surgery (P = 0.0036), but not in normal subjects. At peak
      exercise, there was a difference in signal intensities between multifidus and
      longissimus/iliocostalis in all groups (normal volunteers, P = 0.0069; chronic
      low back pain patients without surgery, P = 0.0125; chronic low back pain
      patients with surgery, P = 0.0060). The exercise response was attenuated in
      chronic low back pain patients with surgery. Thus, MRI demonstrates static and
      dynamic differences in lumbar paraspinal musculature in chronic low back pain
      subjects compared to normal subjects.

PMID- 8484150
TI  - Primary prevention of back symptoms and absence from work. A prospective
      randomized study among hospital employees.
AB  - The personnel at a geriatric hospital were randomized into two groups. One group
      was allowed to exercise during working hours to improve back muscle strength,
      endurance, and coordination. The other group did not participate in the exercise
      program and received no further advice or information. After 13 months, the
      training group had increased back muscle strength. One subject had been absent
      from work 28 days in the training group whereas 12 subjects had been absent 155
      days from work because of low back pain in the control group (P < 0.004). The
      back pain complaints and intensity of back pain in the training group also
      decreased in a statistically significant way. Every hour spent by the
      physiotherapist on the training group reduced the work absence among the
      participants by 1.3 days, resulting in a cost/benefit ratio greater than 10.

PMID- 8484151
TI  - An epidemiologic study of non-occupational lifting as a risk factor for herniated
      lumbar intervertebral disc. The Northeast Collaborative Group on Low Back Pain.
AB  - An epidemiologic case-control study of herniated lumbar intervertebral disc was
      conducted in Springfield, Massachusetts, New Brunswick, New Jersey, and New York,
      New York, to evaluate the role of several possible risk factors in the etiology
      of this disorder. Patients with signs and symptoms of herniated lumbar disc (N =
      287) were matched to control subjects without back pain by age, sex, source of
      care, and geographic area. Of the total case-subject group, 177 were confirmed by
      surgery, computed tomographic scan, myelogram, or magnetic resonance imaging.
      This article focuses on non-occupational lifting, an activity not previously
      reported on. Frequent lifting of objects or children weighing 25 or more pounds
      with knees straight and back bent was associated with increased risk of herniated
      lumbar disc. This association was particularly strong among confirmed case
      subjects (relative risk = 3.95). Positive associations among confirmed case
      subjects were also seen for frequent lifting with arms extended (relative risk =
      1.87) and twisting while lifting (relative risk = 1.90). No associations were
      found for frequent stretching or carrying. If confirmed in other investigations,
      these data suggest that instruction in lifting techniques should be extended into
      the home.

PMID- 8484152
TI  - Quantification of trunk muscle performance in standing, semistanding and sitting
      postures in healthy men.
AB  - The purpose of this study was to determine trunk muscle performance in the
      sitting, semistanding, and standing postures during isometric and dynamic
      extension and flexion movements. Twenty-five male subject volunteers, with no
      previous history of back pain participated in the study. A triaxial dynamometer
      that measures torque, angular position, and velocity was used to measure
      isometric and dynamic motor output. The dynamometer allows testing in the sitting
      and standing postures. A custom-designed module also allowed testing in the
      semistanding posture. Each subject was tested in two sessions. The first session
      included the physical examination and three trials of isometric maximum voluntary
      contractions in the three postures. The second session included the dynamic
      performance against a resistance equal to 50% of the effort, as measured in the
      first session. Subjects were instructed to perform five repetitive flexion and
      extension cycles as fast and accurately as possible with maximum effort. An
      analysis of variance with repeated measures design was used to investigate the
      effects of the postures (standing, semistanding and sitting), the direction of
      exertion (flexion and extension), and the interaction effects of the isometric
      and dynamic parameters (maximum and average torque, velocity, power, and range of
      motion). The effects of direction (F = 98, P < 0.0001) and the interaction of
      posture and direction (F = 7.9, P < 0.001) were significant. The maximum
      isometric flexion strength was significantly higher in the standing posture than
      in semistanding and sitting. The maximum isometric extension was not affected by
      the posture (sitting, semistanding and standing).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484153
TI  - Increased central drive during fatiguing contractions of the paraspinal muscles
      in patients with chronic low back pain.
AB  - In low back pain patients the paraspinal muscles demonstrate excess fatigability.
      Whether the cause is "central" as could result from impaired motor unit
      recruitment due to poor motivation or fear of pain, or "peripheral", and caused
      by defects in the contractile apparatus, is unknown. Using surface
      electromyography in conjunction with a standardized isometric fatigue test, this
      study investigates the mechanisms causing paraspinal muscle dysfunction in
      patients with both nonsurgical and postsurgical chronic low back pain. During the
      fatigue test normal subjects and both patient groups exhibited electromyographic
      increases. These were significantly greater in both patient groups, indicating
      increased central drive to their muscles. These findings may suggest that
      patients' excess fatigue is peripheral in origin, with increased central drive
      arising secondary to muscle wasting or denervation, although a central activation
      defect has not been excluded. Impaired physical performance in low back pain
      patients does not seem to be caused by lack of central drive.

PMID- 8484154
TI  - The role of dynamic three-dimensional trunk motion in occupationally-related low
      back disorders. The effects of workplace factors, trunk position, and trunk
      motion characteristics on risk of injury.
AB  - Current ergonomic techniques for controlling the risk of occupationally-related
      low back disorder consist of static assessments of spinal loading during lifting
      activities. This may be problematic because several biomechanical models and
      epidemiologic studies suggest that the dynamic characteristics of a lift increase
      spine loading and the risk of occupational low back disorder. It has been
      difficult to include this motion information in workplace assessments because the
      speed at which trunk motion becomes dangerous has not been determined. An in vivo
      study was performed to assess the contribution of three-dimensional dynamic trunk
      motions to the risk of low back disorder during occupational lifting in industry.
      More than 400 repetitive industrial lifting jobs were studied in 48 varied
      industries. Existing medical and injury records in these industries were examined
      so that specific jobs historically categorized as either high-risk or low-risk
      for reported occupationally-related low back disorder could be identified. A
      triaxial electrogoniometer was worn by workers and documented the three
      dimensional angular position, velocity, and acceleration characteristics of the
      lumbar spine while workers lifted in these high-risk or low-risk jobs. Workplace
      and individual characteristics were also documented for each of the repetitive
      lifting tasks. A multiple logistic regression model was developed, based on
      biomechanical plausibility, and indicated that a combination of five trunk motion
      and workplace factors distinguished between high and low risk of occupationally
      related low back disorder risk well (odds ratio: 10.7). These factors included 1)
      lifting frequency, 2) load moment, 3) trunk lateral velocity, 4) trunk twisting
      velocity, and 5) the trunk sagittal angle. This analysis implies that by suitably
      varying these five factors observed during the lift collectively, the odds of
      high-risk group membership may decrease by almost 11 times. The predictive power
      of this model was found to be more than three times greater than that of current
      lifting guidelines. This study, though not proving causality, indicates an
      association between the biomechanical factors and low back disorder risk. This
      model could be used as a quantitative, objective measure to design the workplace
      so that the risk of occupationally-related low back disorder is minimized.

PMID- 8484155
TI  - Measurement of vertebral foraminal dimensions using three-dimensional
      computerized tomography.
AB  - The dimensions of lumbar intervertebral foramina were measured in cadaveric
      spines using three-dimensional computerized tomography. Six different image
      reconstruction protocols were used. The results were compared with measurements
      of the same foramina using calipers after dissection. All the three-dimensional
      computerized tomographic measurements underestimated the true foraminal
      dimensions. The best agreement, as well as the best images, were obtained using
      4/3 slices and a reconstruction threshold of 300 Hounsfield Units. This method is
      not recommended for measurement of foraminal dimensions. However, there may be a
      use in assessment and planning surgical management.

PMID- 8484156
TI  - Structural properties of the anterior longitudinal ligament. Correlation with
      lumbar bone mineral content.
AB  - The relationship between the amount of bone in the lumbar spine and ligamentous
      properties has not been studied. This article reports the tensile structural
      properties of bone-ligament-bone preparations of the anterior longitudinal
      ligament from 15 human lumbar spine segments. Significant correlations were found
      between the vertebral bone mineral content expressed as BMC (g/cm) and BMA
      (g/cm2) and BMD (g/cm3) and the structural properties of the vertebral bone
      anterior longitudinal ligament-bone complex determined at yield and failure.
      These findings suggest that the amount of bone tissue in the spine may be
      functionally related to structural properties of the spinal ligaments.

PMID- 8484157
TI  - A geometric model of the lumbar spine in the sagittal plane.
AB  - This article describes a geometric model using the skin profile and five
      anthropometric measurements to estimate the position of S1, T12, and all lumbar
      vertebrae for all postures assumed in the sagittal plane. This method involves a
      normalization process by which different skin profiles can be compared between
      postures and individuals. The skin profile is transformed by taking the
      differences with the lumbar spine into consideration. The model was developed and
      validated with 20 and 7 subjects, respectively. An error analysis shows an
      adequate level of accuracy for the absolute (1.68-1.82 cm) and relative (0.32
      0.54 cm) linear positions of vertebrae as well as their absolute (2.6-6.7
      degrees) and relative (1.4-3.6 degrees) angular positions except for T12;
      however, the validity of the model was limited to specific angular motions in
      flexion for the pelvis (12 +/- 3%), the entire lumbar spine (14 +/- 13%) and the
      intervertebral motion of L4/L5 (13 +/- 10%). The data obtained are very useful,
      especially in models designed to evaluate loadings on the lumbar spine.

PMID- 8484158
TI  - A poroelastic-swelling finite element model with application to the
      intervertebral disc.
AB  - The swelling process that occurs in soft tissue is incorporated into a
      poroelastic finite element model. The model is applied to a spinal segment
      consisting of two vertebrae and a single intervertebral disc. The theory is an
      extension of the poroelastic theory developed by Biot and the model is an
      adaptation of an axisymmetric poroelastic finite element model of the
      intervertebral disc by Simon. The model is completely three-dimensional although
      the results presented here assume symmetry about the sagittal plane. The theory
      is presented in two stages. First the development of the poroelastic theory.
      Following this, the effects of swelling caused by osmotic pressure are developed
      and expressed as a modification of the constitutive law and initial stresses. In
      the case of the disc, this pressure is produced mainly by the fixed negative
      charges on the proteoglycans within the disc. In this development we assume that
      the number of fixed charges remains constant over time and that the distribution
      of mobile ions has reached equilibrium. The variations over time in osmotic
      pressure, and thus in swelling effects are therefore only dependent on the
      initial state and the change in water content. Variations of the swelling effects
      caused by changes in mobile ion concentrations will be the subject of a future
      paper. The results reported in this article illustrate the dramatic effect of
      swelling on the load carrying mechanisms in the disc. The authors believe it is
      likely that this will have important useful implications for our understanding
      not only of normal disc function, but also of abnormal function, such as disc
      degeneration, herniation, and others.

PMID- 8484159
TI  - Spinal epidural abscess complicated closed vertebral fracture. A case report and
      review of literature.

PMID- 8484160
TI  - [Anterior cruciate ligament-plasty with the Insall iliotibial tract transfer.
      Long-term results after 5 years].
AB  - For the reconstruction of the anterior cruciate ligament we performed the bone
      block iliotibial tract transfer in 56 patients from May 1984 until December 1987.
      The results were followed up for 2 to 6 1/2 years (average 53 months). The
      clinical results showed a positive Lachman test in 20 degrees flexion (3-5 mm) in
      50% of the knees. There was no Lachman test ++ or and no sign of pivot shift. At
      the time of follow-up, the Lysholm-score was very high with 98.67 points.
      Subjectively, 91.3% of the knees were rated excellent, 4.3% good and 4.3% poor.
      93% of the patients were engaged in some kind of sport before their accident, 87%
      of all patients were able to practice their sport at the same level after the
      operation. Long-term results after 5 years are consistent with the physiological
      aspects of this transfer. The immediate fixation of bone allows early motion of
      the knee and the rehabilitation time is much shorter.

PMID- 8484161
TI  - [Conservative therapy of ruptures of the medial collateral ligament of the knee.
      Results of a comparative follow-up study].
AB  - The rupture of the medial collateral ligament of the knee joint due to sports
      injuries is the most common lesion of ligaments of the knee in athletes. The
      treatment is usually non-operative. We compared in a retrospective study the
      conservative treatment of these ruptures by two different methods. One group of
      patients was immobilised in a plaster cast for six weeks, one group of patients
      was partially immobilised with a brace, initiating early functional therapy. The
      results proved that the group of early mobilisation was significantly better in
      late results, in shorter rehabilitation and in all other aspects regarded as
      important for the treatment of such an injury. Therefore we feel the treatment
      with plaster casting for isolated ruptures of medial collateral ligaments as the
      knee should be abandoned.

PMID- 8484162
TI  - [Rehabilitation after cruciate ligament repair with the middle third of the
      patellar ligament in the athlete].
AB  - Rehabilitation of athletes following surgical reconstruction of complex
      instabilities of the knee joint focuses on four goals: 1. the restoration of
      ligament stability, 2. the restoration of muscular stabilisation ability, 3. the
      restoration of coordinative muscular function in sport specific kinesiology, 4.
      the retention and improvement of the general state of fitness. These aims can
      only be reached by a close cooperation between physician, physiotherapist,
      trainer, and coach. In order not to put the rehabilitation process at risk,
      everybody involved has to have knowledge about functional anatomy, surgical
      technique, and biology of the transplant as well as knowledge about the long
      duration thereof that cannot substantially be shortened by knee ortheses. No
      athlete should compete until he has demonstrated sufficient fitness, strength,
      and coordination for his sport under laboratory conditions.

PMID- 8484163
TI  - [Control of the rear foot in lateral movements in sports].
AB  - The goals of this investigation were to establish the frequency distribution of
      different movements in various ball sports (1) and to test the influence of
      altered shoe sole constructions on the stability in lateral breaking movements
      (2). Firstly, a video analysis was carried out to establish the frequency
      distribution of different movements in sporting activities such as volleyball,
      basketball, team handball and football (soccer). It is shown that a selected
      number of lateral cutting movements can represent more than half of all movements
      observed in one of the sporting activities. For part 2 an investigation with
      three systematically varied shoes was undertaken. The results show that with
      altered shoe sole constructions (torsion and change of shape of the shoe-sole)
      the supination movement with shoes comes close to the barefoot values. In respect
      of abduction/adduction of the foot the systematic changes of the shoe soles had
      no measurable influence.

PMID- 8484164
TI  - [Novel functional studies of the stabilizing behavior of ankle joint ortheses].
AB  - For functional treatment of acute ankle sprain after surgical or nonsurgical
      management various special shoes and braces are in use. For a comparison under
      functional conditions we applied controlled inversion movements of 20 and 30
      degrees to 13 subjects. The reduction of angular displacement was measured for
      the following orthosis: Aircast, Adimed Stabil 2, Adipromed Stabil Super, Mikros
      Ankle Brace, MHH-Splint Caligamed, Puschbrace and Tape. For evaluation of the
      neuromuscular activation surface EMGs of selected leg muscles were analyzed. A
      significant reduction of the induced inversion displacement was observed in all
      devices, although a complete inhibition of this movement was not possible. EMG
      activation was comparable to physiological conditions and is not correlated to
      the displacement characteristics. It is concluded that functional evaluation must
      take into consideration both the optimal reduction of the inversion and the high
      functional innervation.

PMID- 8484165
TI  - [Stress fractures of the tibia in nuclear magnetic resonance tomography].
AB  - To demonstrate the usefulness of MR-imaging seven cases of suspected stress
      fractures are demonstrated and discussed (six stress fractures, one osteoid
      osteoma). The results indicate that stress fractures of the tibia may be
      differentiated early and easily from tumorous lesions, especially in atypical
      cases. In one case the fracture line could be detected only by MRI. In this
      respect, MRI is of high diagnostic value in differentiating unclear bone
      anomalies.

PMID- 8484166
TI  - [Early functional conservative therapy of fresh fibular capsular ligament rupture
      from the socioeconomic viewpoint].
AB  - The expected direct and indirect costs following a fresh fibular rupture of the
      capsular ligament, and hence the socioeconomic burden on the patient, was
      investigated by a prospective randomised study comprising 120 males and females
      between 18 and 45 years of age. A comparison of three different conservative
      treatment methods A (immobilisation in a plaster cast for three weeks, followed
      by mobilisation with the aircast splint), B (mobilisation with the aircast
      splint) and C (Unna's paste dressing for two weeks with subsequent tape dressings
      and in each case immediate mobilisation) showed a significantly better stability
      after 6 months in the groups B (2.6 +/- 2.3) and C (3.6 +/- 3.8) than in A (4.8
      +/- 3.5). The direct subsequent costs were also significantly lower in the groups
      B (DM 175.-) and C (DM 206.-) than in A (DM 340,-). Taking an average daily
      hospital care fee of DM 319.- (1991 in West Germany) as basis, the direct costs
      sequential to early functional treatment are the lowest also in comparison with
      surgical treatment in a hospital. The indirect sequential costs due to loss of
      working hours are mainly dependent on professionally conditioned physical stress
      but increase with the period of immobilisation after a fresh fibular rupture of
      the capsular ligament.

PMID- 8484167
TI  - [Comparison of combined extra- and intra-articular stabilization versus isolated
      arthroscopic semitendinosus repair after rupture of the anterior cruciate
      ligament].
AB  - In a prospective study we examined 32 patients with a combined reconstruction of
      the anterior cruciate ligament, with arthroscopical use of a loop of
      semitendinosus tendon for the intraarticular portion and an iliotibial band
      tenodesis for the extraarticular augmentation in comparison to an isolated
      intraarticular semitendinosus reconstruction in 26 patients. Additionally the
      importance of a standardized rehabilitation program in this study was evaluated
      in comparison to a study on 58 athletes without standardized rehabilitation after
      an arthroscopic ACL-semitendinosus reconstruction. Lysholm-Score, clinical and
      radiological findings, KT-1000 stability values and isokinetic tests were
      evaluated monthly over a year. This data suggests that while both procedures
      under standardized rehabilitation conditions may obtain excellent functional
      results, adding the iliotibial band tenodesis to an intraarticular reconstruction
      significant improvement in stability and muscular strength was observed. Patients
      were able to resume all activities without pivoting.

PMID- 8484168
TI  - Threshold variation in automated perimetry.
AB  - A physiologic fluctuation in threshold levels exists in automated perimetry,
      which is greater in glaucoma and ocular hypertensive patients than in normal
      subjects. Fluctuation increases with greater eccentricity from fixation and in
      areas of reduced retinal sensitivity. Other factors related to automated
      perimetry testing potentially may influence threshold fluctuation including: a
      learning effect, reliability, pupil size, age, and the mode of stimulus
      presentation. Statistical software may aid in analyzing both the single field and
      the changes between successive fields. However, statistical programs cannot
      replace physician judgment, and all factors that may influence threshold levels
      should be considered when interpreting automated visual fields.

PMID- 8484169
TI  - Peripapillary hemorrhage.
AB  - On routine examination, a 61-year-old man was found to have a deep peripapillary
      hemorrhage surrounding his left optic nerve head. Further examination revealed a
      left sixth nerve paresis, a subtle right homonymous quadrantanopia, and jerky
      pursuit to the left. The diagnostic work-up was delayed by the patient because of
      business commitments. He returned confused and obtunded. Neuro-imaging showed a
      large frontal mass, which turned out to be an anaplastic astrocytoma. Diagnosis
      of the lesion had been obscured by three false localizing signs. Discussion deals
      with the definition of Terson's syndrome and the occurrence of peripapillary
      hemorrhages. Other causes of peripapillary hemorrhages are illustrated.

PMID- 8484170
TI  - Wegener's granulomatosis presenting with sclerokeratitis diagnosed by
      antineutrophil cytoplasmic autoantibodies (ANCA).
AB  - A 23-year-old male presented with bilateral sclerokeratitis. He reported recent
      bronchitis, sinusitis, dyspnea on exertion, hemoptysis, arthralgias and myalgias.
      Wegener's granulomatosis was diagnosed by a positive antineutrophil cytoplasmic
      autoantibody (ANCA) test and a nasal and subglotic biopsy showing granulomatous
      inflammation. Treatment with cyclophosphamide, systemic corticosteroids and
      trimethoprim/sulfamethoxazole resulted in resolution of the sclerokeratitis and
      remission of the disease.

PMID- 8484171
TI  - Conjunctival and uveal melanoma in the dysplastic nevus syndrome.
AB  - The dysplastic nevus syndrome was conceptualized in the late 1970s, and the
      subsequent proposal of a genetic relationship with ocular melanoma has stimulated
      debate in the literature which remains unresolved. We present the case of a 60
      year-old man with histologically proven sporadic dysplasic nevus syndrome and a
      prior history of nine cutaneous melanomas, who developed a large, exophytic
      melanoma of the cornea and limbal conjunctiva. Cytogenetic analysis of this
      melanoma revealed a clonal 1;14 translocation. We believe this is the first
      reported case to use cytogenetic techniques in the analysis of conjunctival
      melanoma, either associated with dysplastic nevus syndrome or in isolation. We
      review the clinical literature as well as the cytogenetic and molecular genetic
      data related to the possible association of cutaneous melanoma, conjunctival and
      uveal melanoma and the dysplastic nevus syndrome.

PMID- 8484172
TI  - Symptomatic retrochiasmal lesions in multiple sclerosis: clinical features,
      visual evoked potentials, and magnetic resonance imaging.

PMID- 8484173
TI  - Expanding school-linked health services: a role for nurses?

PMID- 8484174
TI  - Legal issues for nurses. Document, document, document, document.

PMID- 8484175
TI  - Pharmacists administering meds? No!

PMID- 8484176
TI  - Gridlock? Try new paradigm.

PMID- 8484177
TI  - 12th National Congress of the Italian Society for the Study of Haemostasis and
      Thrombosis. Parma, Italy, September 27-October 1, 1992. Abstracts.

PMID- 8484178
TI  - [Can fertility in cattle be improved by administration of Gonadotropin releasing
      hormone (GnRH)?].
AB  - In this article a review is given of the results obtained with gonadotrophin
      releasing hormone (GnRH) in the treatment of repeat breeder cows, cows used for
      embryo transfer and of cows in the early post partum period. It is concluded that
      the results of GnRh administration to repeat breeders is very variable. It is
      quite sure that the positive effect of GnRH, if any is so low that from an
      economic point of view, treatment, can not be advised. The usefulness of
      administration of GnRH to embryo-transfer cows is very doubtful. There are as
      many publications with positive as with negative results. The administration of
      GnRH in the early post partum period can not be recommended. With this 'therapy'
      conflicting results have been obtained and occasionally negative side effects
      have emerged.

PMID- 8484179
TI  - [Dehorning of calves and removal of teats].

PMID- 8484180
TI  - [Lymphosarcoma in a horse].
AB  - A sixteen-year old pregnant Dutch Warmblood mare was referred to the Faculty of
      Veterinary Medicine because of sluggishness since eight days. The main clinical
      features were depression, pale mucous membranes with petechiae, ventral oedema
      and fever. Haematological evaluation revealed severe anaemia (haematocrit 0.15
      L.L.-1) and leukopenia (2.3 G.L-1 with 96% lymphocytes). There was no
      thrombocytopenia. The horse died following a hospitalisation period of six days.
      At necropsy a (multicentric) lymphosarcoma was found in the bone marrow with
      neoplastic infiltration of the kidneys.

PMID- 8484181
TI  - Dikke darm-diarree [Large intestine diarrhea].

PMID- 8484183
TI  - Professional security notebook: workplace advocacy.

PMID- 8484182
TI  - [European registration of veterinary drugs].
AB  - An overview is given for the harmonization of veterinary medicines in the EC.
      What is the influence of the review caused by this process on the existing
      veterinary medicines? Besides the role of the Committee of Veterinary Medicinal
      Products (CVMP) in the registration process of mutual recognition and central
      registration, the role of its working parties are dealt with. Also the
      consequences of the recent residue legislation on the basis of Maximum Residue
      Levels (MRL's) are discussed for as well the existing as the new products.
      Recently adverse events have to be reported too and evaluated by the authorities.
      Are all the member states ready for this task? The tasks and procedures of the
      future European Agency for the Evaluation of Medicines and the future
      registration procedures are also discussed.

PMID- 8484184
TI  - An efficient synthesis of 4 beta- and 6 alpha-hydroxylated bile acids.
AB  - An efficient method for the preparation of 4 beta- and 6 alpha-hydroxylated bile
      acids has been developed. It involved a highly stereoselective acetoxylation at
      the 4 beta and 6 alpha positions of 3- and 7-oxo bile acids, respectively, with
      lead tetraacetate in the presence of boron trifluoride etherate in acetic acid.
      Reduction of the resulting alpha-acetoxy ketones with sodium borohydride or tert
      butylamine borane complex, and alkaline hydrolysis, provided the desired bile
      acids in good yields.

PMID- 8484185
TI  - 18-Substituted steroids. Part 18. Chemical synthesis and mineralocorticoid
      activity of 2 alpha- and 2 beta-hydroxyaldosterone.
AB  - The 2 alpha-hydroxy and 2 beta-hydroxy derivatives of aldosterone have been
      synthesized chemically from aldosterone, after the earlier identification of 2
      alpha-hydroxylated metabolites formed in liver. Both 2 alpha- and 2 beta
      hydroxyaldosterone are potent mineralocorticoids, with activities on the order of
      1/10 that of aldosterone on the basis of a rat bioassay.

PMID- 8484186
TI  - Synthesis of novel 6-aza-B- and 11-aza-C-homoestranes as antifertility agents.
AB  - Reaction of 3,9 alpha, 17 beta-trihydroxyestra-1,3,5(10)-trien-11-one 17-acetate
      3-methyl ether (3) with N3H-BF3 etherate leads mainly to lactam (4) along with
      the N-azido compound (5) as a minor product. Under similar conditions, 3,17 beta
      dihydroxyestra-1,3,5(10)-trien-6-one 17-acetate 3-methyl ether gives lactam (12)
      and the tetrazole derivative (9). Similar reaction of the diacetate (8) gives
      only the tetrazole derivative (11). Compounds 4, 6, and 10 prevent implantation
      in rats at 5-, 10-, and 5-mg/kg doses, respectively. Compounds 4, 6, 9, and 10
      show significant estrogenic activity at the respective contraceptive doses.

PMID- 8484187
TI  - Effect of sterol biosynthesis inhibitor, SSF-109, on cholesterol synthesis in
      isolated rat hepatocytes.
AB  - The inhibitory effect of SSF-109 on cholesterol synthesis in isolated hepatocytes
      was studied using a radio-high-performance liquid chromatography system, and the
      results were compared with those of other inhibitors, triparanol and AMO-1618.
      SSF-109 caused accumulation of two trimethylsterols: lanosterol and 24
      dihydrolanosterol. The distribution profile of [2-14C]mevalonate-originated
      radioactivity in cholesterol, lanosterol, dihydrolanosterol, 2,3-oxidosqualene,
      and squalene indicates that SSF-109 inhibits the 14 alpha-methyl demethylase
      activity. Triparanol accumulated the radioactivity of [2-14C]mevalonate in
      desmosterol and 2,3-oxidosqualene suggesting that triparanol inhibits sterol
      delta 24-reductase and 2,3-oxidosqualene cyclase. AMO-1618 caused enrichment of
      the radioisotope from [2-14C]mevalonate in 2,3-oxidosqualene but reduced it in
      squalene, suggesting that AMO-1618 acts on 2,3-oxidosqualene cyclase and some
      enzyme that catalizes a metabolic pathway between mevalonate and squalene.

PMID- 8484188
TI  - Bile acid transformations by Alcaligenes recti.
AB  - Metabolism of cholic acid, chenodeoxycholic acid, ursodeoxycholic acid, and
      deoxycholic acid by the grown cells of the bacterium Alcaligenes recti suspended
      in water was studied. Each isolated metabolite was characterized by the
      application of various spectroscopic methods. Cholic acid, chenodeoxycholic acid,
      ursodeoxycholic acid, and deoxycholic acid yielded methylated derivatives 3 alpha
      methoxy-7 alpha, 12 alpha-dihydroxy-5 beta-cholanoic acid, 3 alpha-methoxy-7
      alpha-hydroxy-5 beta-cholanoic acid, 3 alpha-methoxy-7 beta-hydroxy-5 beta
      cholanoic acid, and 3 alpha-methoxy-12 alpha-hydroxy-5 beta-cholanoic acid,
      respectively. In addition, cholic acid furnished 7 alpha, 12 alpha-dihydroxy-3
      oxochol-4-en-24-oic acid; chenodeoxycholic acid gave 7 alpha-hydroxy-3-oxo-5 beta
      cholanoic acid and 7 alpha-hydroxy-3-oxochol-4-en-24-oic acid while
      ursodeoxycholic acid yielded 7 beta-hydroxy-3-oxochol-4-en-24-oic acid and 3
      oxochola-4,6-dien-24-oic acid. The formation of various metabolites showed that
      two competitive enzymic reactions, i.e., selective methylation of the 3 alpha
      hydroxy group and dehydrogenation in the A/B rings, were operative. The
      methylation process was found to be enzymic involving an S-adenosyl-L-methionine
      (AdoMet)-dependent methyl transferase, and this reaction appeared to be
      inhibitory to the process of degradation of the ring system. In the other
      reaction sequence, degradation of the ring system was initiated by
      dehydrogenation of the 3 alpha-hydroxy group. A 7 beta-dehydratase activity
      producing the delta 6 double bond was also noticeable in the metabolism of
      ursodeoxycholic acid.

PMID- 8484189
TI  - Stage-related changes in steroid-converting enzyme activities in Squalus testis:
      synthesis of biologically active metabolites via 3 beta-hydroxysteroid
      dehydrogenase/isomerase and 5 alpha-reductase.
AB  - To investigate the relationship between steroidogenesis and spermatogenesis, two
      key enzymes of androgen biosynthesis, 3 beta-hydroxysteroid
      dehydrogenase/isomerase (3 beta-HSD) and 5 alpha-reductase, were compared at
      premeiotic (PrM), meiotic (M), and postmeiotic (PoM) stages. Staged tissues were
      obtained by dissection from the testis of the spiny dogfish Squalus acanthias, in
      which spermatogenesis is a simple diametric progression. Microsomal 3 beta-HSD
      activity was measured by conversion of [3H]dehydroepiandrosterone (DHEA) to
      androstenedione (AE). Reaction constants were: Km = 3.2 microM and Vmax = 243
      pmol/min/mg protein. 3 beta-HSD increased progressively with maturation,
      resulting in three- to four-fold higher levels in PoM than in PrM stages.
      Absolute values and stage-related differences were the same, whether microsomes
      were derived from whole testis or from isolated spermatocysts (germ cell/Sertoli
      cell units), thus supporting microscopic studies showing that Sertoli cells are
      the primary steroidogenic elements of dogfish testis. In vitro conversion of
      [3H]testosterone to [3H]dihydrotestosterone (DHT) was used to estimate 5 alpha
      reductase activity. Apparent substrate affinity was similar to that of 3 beta-HSD
      (Km = 2.9 microM), but maximal product yields were two to three orders of
      magnitude lower (Vmax = 208 fmol/min/mg protein). Also, the stage-related pattern
      of 5 alpha-reductase activity (PrM > PoM >> M) differed from that of 3 beta-HSD
      (PoM >> M > PrM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484190
TI  - [The elderly in 2005: healthy or in need of care?].

PMID- 8484191
TI  - [Care requirements and psychosocial care problems in nursing homes].
AB  - Residential homes were initially conceptualized to offer relatively independent
      elderly people room and board, rather than the nursing, medical, and
      rehabilitative care provided in nursing homes. Yet in the Netherlands an
      increasing number of frail elderly people are cared for in residential homes. By
      means of standardized rating scales data were collected in 1991 on the ability to
      perform 12 activities of daily living (ADL), cognitive disabilities, frequency of
      mood and behavioural problems, and social activities of all 1045 residents of 12
      homes. The mean age of the 842 women (80.6%) and 203 men (19.4%) in this sample
      was 84.9 years (SD = 6.1). Using cutoff points that indicated the presence of
      serious impairment, we found that 11.9% of the residents were severely disabled
      in ADL. Severe cognitive impairments were detected in 10.2%, mood and behavioural
      problems in 13.7% and lack of social contacts in 11.6%. Multivariate cluster
      analysis revealed five patterns of care requirements, ranging from slight
      assistance (61.4%) to continuous skilled nursing care (4.9%). Residents are not
      homogeneous in their care requirements: 12.1% were found in a cluster that
      indicated a selective need of social contacts, 11.6% clustered together because
      of mood disorders, and 10.0% was found to have serious problems in three areas
      (ADL, cognition and social activity), except mood. This study suggests that about
      15% of the elderly in residential homes need intensive and round-the-clock
      (psychogeriatric) nursing care. We conclude that residential homes have become a
      major component of the Dutch health care system for frail elderly patients.

PMID- 8484192
TI  - [Substitutes in care of the elderly? The artifact of a null correlation].
AB  - On theoretical grounds or as a consequence of social policy measures
      (substitution), a negative correlation between formal and informal help is
      expected. A remarkable finding in most of the cross-sectional research is however
      a zero-correlation. Some researchers are tempted to conclude that substitution in
      care is not possible. In this article the composition of the population under
      investigation is suggested as an explanation for the absence of the correlation.
      If the population contains many young and healthy elderly, neither formal nor
      informal help is mostly necessary. The existing substitution in care for the
      needy elderly is consequently obscured and a zero-correlation between formal and
      informal help is found. This zero-correlation suggests that no substitution has
      taken place, but results from the composition of the population. In this article
      data on a life situation survey among 304 elderly people in a rural area are
      presented to illustrate this assumption.

PMID- 8484193
TI  - [A closer look at the Scale for Subjective Well-being of the Elderly].
AB  - The Dutch Scale for Subjective Well-being of the Elderly (SSWO, 30 items) is a
      reliable and valid measure of well-being of the elderly. In this article, this
      instrument is subjected to a psychometric evaluation. First, as it is known that
      the SSWO has a weak subscale 'SSWO-Contacts', a new and reliable subscale 'SSWO
      Contacts' was developed. Four SSWO-items were replaced by six items from an
      existing and valid Loneliness-scale. Cronbach's alpha for the new subscale
      increased from .61 to .86. This also led to a slight increase in reliability of
      the new SSWO (32 items) as a whole from .88 to .90. Secondly, the hierarchical
      order of the items in the SSWO-subscales was tested with a Mokken-scaling
      procedure. Of the five subscales, four showed a (weak to rather strong)
      hierarchy. Thirdly, a short version (8 items) was developed to maximize the
      possibilities of implementing the SSWO. This short version has 85% of variance in
      common with the 32-item version. Validity of the SSWO-32 and SSWO-8 was explored
      by correlating the instruments with measures of health and personality. All
      expected relations were found. Also, the newly developed instruments proved to be
      reliable measures in a dataset of 119 elderly persons. The SSWO-32 is recommended
      for the investigation of specific dimensions of well-being in elderly people. The
      SSWO-8 can be used to obtain a quick and global impression of well-being.

PMID- 8484194
TI  - [Comprehensive care for the elderly in The Netherlands: current status and
      potential improvements].
AB  - Family care is important for older people who are in need of some kind of care
      and who live in their own home. Sometimes support from services for family
      caretakers is essential for them to continue caring. The existing possibilities
      to get this support are not sufficiently available in the Netherlands: if someone
      is in need of support at the emotional, practical or material level, services are
      scarce. In order to change this situation, some recommendations are made. A
      change in attitude towards family caregiving is the most important one.

PMID- 8484195
TI  - Ultrasound scattering properties of Albunex microspheres.
AB  - Albunex is an ultrasound contrast agent used in echocardiography and in other
      areas, it consists of microspheres of which more than 95% have a diameter in the
      range 1-10 microns. The scattering properties of this agent as functions of
      ultrasound frequency and microsphere diameter and concentration are investigated.
      A model of the Albunex microspheres has been previously described, considering
      the individual microspheres as air bubbles surrounded by a thin elastic shell. In
      the present study this model is extended by including into it the internal
      friction in the shell when the microsphere vibrates. Acoustic scattering and
      transmission are measured in the frequency range from 700 kHz to 12.5 MHz. The
      measured transmitted power is used to estimate the two parameters in the
      theoretical model: the shell elasticity parameter, Sp and the shell friction, Sf.
      Introduction of the shell friction into the model improves the agreement between
      theory and measurements. For the scattered power, differences between measured
      and calculated values lie within 3 dB. It is concluded that for the frequencies
      2.5 and 5 MHz, microspheres with a diameter between 5 and 12 microns are
      preferred as these deliver the most significant contribution to the total
      scattered power and cause relatively little attenuation.

PMID- 8484196
TI  - [Expert commissions and arbitration boards. A report of current status].
AB  - Since 1975 all German Land Medical Councils (Landesarztekammern) have launched
      either boards of experts or arbitration panels with the intention to settle
      disputes on medical malpractice by arbitration, on a voluntary base, free from
      commitment, and without any costs for the parties concerned. Numbers of
      arbitrator's awards and rates of affirmed cases of malpractice are given for the
      years 1988 to 1991, for all panels or boards, respectively. More details are
      reported from the boards of experts of the Land Medical Council of Baden
      Wurttemberg with special reference to possible relations of affirmed awards to
      some demographic and professional factors. The probability of being involved in a
      procedure of arbitration is broken down by medical specialty and by site of
      employment, e.g. in hospital or in medical practice. The highest rates are found
      in specialties operating on and in hospital doctors. But the percentage of
      affirmed awards is higher for doctors working in their own office. Evaluating the
      consequences following the awards of two different periods shows a high degree of
      acceptance by the patients. Without affirmation less than ten percent of all
      patients involved apply to the courts but this is done by about thirty percent if
      the award is affirmating. In these cases the amount of the compensation wanted is
      contested.

PMID- 8484197
TI  - [Nursing care insurance--facts and prognosis].
AB  - There are in the Federal Republic of Germany at present 2% of the population
      "needing care" (80 m/1,65 m), 450,000 citizens are getting now in-patient
      treatment, 1.2 m are being looked after in family circles. The public opinion
      dilemma (rise in the rate of old people to the total population--declining birth
      rate) will be in 2010 so marked, that the number of people needing care will rise
      to 3.5 m. 85% of these patients will be then past 65 years. At the moment social
      discussions of drafts regarding financial guaranty for nursing, questions of
      infrastructure and compassion of the welfare are partly controversial. Unanimity
      has been reached, that prevention, active treatment and rehabilitation must be
      intensified before the onset of the nursing requirements is initiated. The paper
      informs of the actual making-up of the people's mind. Preliminary works regarding
      a statutory regulation for a welfare guaranty should be settled by the end of
      1992.

PMID- 8484198
TI  - [Cost development in health care with special reference to unconventional
      procedures].
AB  - The cost of healthcare continues to escalate. At the same time alternative
      medicine is becoming more popular. Therefore it seems necessary to consider the
      price of unconventional therapies: they are more expensive than generally
      supposed. The reasons are distinct modes of therapy, polypragmasy, long term
      therapies, and consecutive costs. Finally there is the question, whether it is
      ethical to ask for the cost efficiency ratio in the treatment of seriously ill.

PMID- 8484199
TI  - [Freedom to cure and alternative medicine].
AB  - The problem area of unconventional methods of treatment involves addressing a
      complex web of legal questions (constitutional law, criminal law, medical
      liability law, social insurance law, medical professional law). However,
      proceeding from the basis of statutory health insurance law, all individual
      questions can be resolved uniformly if the customary statutory or contractual
      "scientific-basis-clauses" intended to restrict the use of unconventional methods
      of treatment are understood merely as a criterion for a medical-acceptability
      test that respects the individual physician's discretion as regards treatment and
      appraisal. Methods of "outsiders" are then not generally excluded; rather, an
      individual weighing-up of the benefits has to be carried out in each case.

PMID- 8484200
TI  - [The environment and health. Environmental pollution and its health effects].
AB  - Both environment and health are terms of far-reaching meaning, which impedes a
      complete survey of their interactions. Originating from considerations about
      global phenomena, as e.g. the extinction of biological species, of the so called
      "forest dying", or of the extensive consumption of energy and material resources,
      on the hierarchy of effects on health of environmental damages on one hand or on
      the undisputable adaptivity of man in particular on the other, only actual
      examples are outlined. The groups of dioxins, asbestos and radon are outlined,
      considering them as representatives for the vast number of substances potentially
      harmful to the environment and for the complexity of the toxicological and
      oecological interactions with oecosphere, biosphere and man. By the examples, the
      principles of toxicological/oecological thinking are explained, finally never
      resulting in yes/no alternatives, but in compromises by sober balances of risk
      and benefit. The basically correct vigilance of the public against avoidable
      risks may not lead to hysteric reactions, impeding the concentration onto
      necessary and practicable solutions.

PMID- 8484201
TI  - [Death in bronchial asthma. Findings and forensic importance].
AB  - In 23,707 forensical and 25,564 clinical post-mortem examinations a total number
      of 196 deaths from bronchial asthma were determined retrospectively. Furthermore
      investigated were 29 cases in which asthma had the importance of a pathological
      side finding. Described are the histories, epidemiological data as well as
      morphological and histological findings. The characteristic morphological triad
      of thickening of the epithelial basement membrane, hypertrophy of the muscle coat
      in the bronchi and mucus plugging were found in almost all cases of asthma death.
      Regarding to forensical and insurance medical aspects it is important to consider
      the accompanying circumstances and supporting facts of the death, therapeutical
      procedures and death causing concurrent non-natural organ damages. They form the
      basis for reproaches in terms of neglected help or accidental homicide and can
      call the way of death in question,--which is illustrated in examples.

PMID- 8484202
TI  - [Seat-belt syndrome. Is "securing" children in back seats of cars exclusively
      with a lap belt defensible?].
AB  - In automobile accidents the "seat belt syndrome" describes a combination of
      injuries involving the thoraco-lumbar vertebrae and intraabdominal organs. This
      may result from wearing of only a pelvic seatbelt. Children are often involved.
      Analysis of two separate cases showed the "assurance" of children as passengers
      on the backseat with a pelvic belt to be dangerous and not longer justifiable.
      Anatomical proportions and posture in childhood necessitate backseats especially
      designed for children. They should include the possibility of installing a three
      point safety belt system.

PMID- 8484203
TI  - Biochemistry of the nematode cuticle: relevance to parasitic nematodes of
      livestock.
AB  - The cuticle of nematodes is a thin, flexible outer covering composed primarily of
      protein with trace amounts of lipid and carbohydrate. There has been considerable
      recent interest in the biochemistry, immunology and molecular biology of the
      cuticle of parasitic nematodes because of its role as an interface between
      parasite and host. The cuticle consists of: (1) collagen-like proteins that form
      the medial and basal layers; (2) non-collagen proteins that form the epicuticular
      and external cortical regions; (3) non-structural proteins associated with the
      external surface. The collagen-like proteins are solubilized by reducing agents,
      have molecular weights of 30-120 kDa and exhibit stage and species variations.
      Nematode collagen genes, however, code only for proteins with molecular weights
      of 30 kDa. The non-collagenous proteins, referred to as cuticlin, exhibit unusual
      chemical properties as indicated by their resistance to solubilization even under
      strongly denaturing conditions. Recent studies of Ascaris suum have demonstrated
      the presence of tyrosine-derived cross-links, dityrosine and isotrityrosine, that
      may form the linkage between subunits in assemblage of the collagenous and
      noncollagenous structural components of the cuticle. A peroxidase enzyme has been
      implicated in the synthesis of these cross-links. Recent 125I labeling studies of
      Haemonchus contortus have identified and characterized stage-specific proteins on
      the cuticular surface.

PMID- 8484204
TI  - Anthelmintics.
AB  - Anthelmintics remain the principal means for the prevention and control of
      subclinical and clinical ostertagiasis. The selection of an appropriate
      anthelmintic depends on whether one is controlling or preventing Type I
      ostertagiasis (caused by the establishment of adult worms derived from recently
      acquired infective larvae), preventing Type II (treating pre-Type II or inhibited
      larvae) or controlling Type II ostertagiasis (caused by the development of
      inhibited larvae to adults), or using the anthelmintic as part of an
      epidemiologically based plan to reduce pasture contamination with infective
      Ostertagia ostertagi larvae. In the latter case, the choice of an anthelmintic
      may depend on whether the targets for treatment are only adult worms and
      developing larvae or whether the targets include hypobiotic larvae. Thus for
      Ostertagia control, anthelmintics must be divided into those that normally
      control all stages, such as the avermectin group (ivermectin, abamectin and
      moxidectin) and some of the benzimidazoles (albendazole, oxfendazole and
      fenbendazole at appropriate dose rates), and those that only control adult worms
      and developing larvae (levamisole, morantel, coumaphos, phenothiazine and
      thiabendazole).

PMID- 8484205
TI  - Anthelmintic resistance.
AB  - In populations of livestock in which anthelmintics have become the only means of
      control, individual worms in some species of helminths evade the effects of
      specific anthelmintics. If these resistant individuals are selected (by removing
      the susceptible individuals in the population) then the resistant worm population
      on individual farms becomes dominant in both numbers and effect. This selection
      of anthelmintic resistant populations is most often reported in equids and small
      ruminants (the hosts in which anthelmintics are used most frequently). There is
      little evidence of anthelmintic resistance by Ostertagia in cattle but an
      understanding of the problem in other grazing species may aid in delaying its
      onset. Benzimidazole/phenothiazine resistance by small strongyles in horses in
      widespread. Resistance by various geographic strains of Haemonchus, Teladorsagia
      and Trichostrongylus against all of the commonly used classes of anthelmintics in
      small ruminants has been verified. The failure of levamisole to remove adult
      Ostertagia ostertagi from cattle has been reported in several geographical areas.
      Resistance is an individual farm problem and each premise has to be evaluated as
      to which anthelmintics can be used. Drug rotation, especially rapid rotation
      (less than 1 year) selects for multiple drug resistance. Epidemiologic treatment
      selects for resistance, but if properly used, requires considerably fewer
      treatments to prevent disease and the development of resistant populations will
      be slowed. A combination of strategic and tactical treatments along with
      evaluation of anthelmintics will be required to enable producers to raise
      livestock in maximum production units.

PMID- 8484206
TI  - Control strategies to prevent resistance.
AB  - Anthelmintics will continue to play a central role in nematode control programs
      of livestock for the foreseeable future. However, to prevent the emergence of
      resistance, anthelmintics need to be either so effective that there are no
      survivors following treatment or treatment should be so infrequent that those
      that survive make little or no contribution to subsequent generations of the
      parasite populations. In this regard, the record for the sheep, horse and
      particularly the goat industry is not good, whereas the second factor is almost
      certainly responsible for the lack of a significant resistance problem in the
      cattle industry. In Australia, where high levels of resistance prevail, control
      programs designed to limit the increase and spread of resistance have been
      promoted for some time. However, their development, and certainly their
      implementation, has tended to be reactive rather than proactive--attempting to
      deal with the problem when it threatens future productivity, rather than
      preventing it in the first instance. Regions and/or livestock industries with
      relatively less of a resistance problem should heed these developments and
      endeavour to establish a responsible ethos amongst users of anthelmintics. In
      concert with the general philosophy of Integrated Pest Management (IPM), parasite
      control schemes should focus on the planned integration of a range of techniques,
      rather than relying almost entirely on anthelmintics. By these means, sustainable
      control strategies to prevent resistance could be achieved.

PMID- 8484207
TI  - Pathophysiology of infection with Ostertagia ostertagi in cattle.
AB  - Infection with the abomasal nematode, Ostertagia ostertagi, is an important cause
      of impaired productivity in young cattle in temperate parts of the world. Such
      losses have been associated with marked changes in feed intake, gastrointestinal
      function, protein, energy and mineral metabolism, and in body composition. The
      reduction in feed intake is an important factor in the pathogenesis of infection
      and may account for a large part of the difference in weight gain between ad
      libitum fed control and infected calves. Despite the obvious importance of
      inappetance, only recently has an association been made between reduced intake,
      altered gut motility and elevated levels of certain gastrointestinal hormones,
      such as gastrin. It has been suggested that the elevated gastrin levels
      accompanying abomasal parasitism may impair reticulo-ruminal motility and slow
      down abomasal emptying, leading to a stasis of ingesta and a reduction in feed
      intake. The rise in blood gastrin levels may also be partly responsible for the
      marked hyperplasia of the fundic mucosa seen in abomasal infections. Pronounced
      changes in protein metabolism have also been associated with Ostertagia
      infection. Radioisotopic studies have demonstrated increased losses of albumin
      into the gastrointestinal tract which are accompanied by an increase in the rate
      of synthesis in the liver. Dietary protein breakdown in the abomasum is also
      likely to be impaired, although there is evidence of a compensatory increase in
      protein digestion in the lower gut of parasitised calves. Increased losses of
      albumin are not always accompanied by increases in faecal nitrogen, suggesting
      that albumin is broken down and recycled as ammonia. Radioisotopic studies in
      animals with intestinal nematode infections have demonstrated a marked reduction
      in muscle protein synthesis and an increase in protein synthesis in
      gastrointestinal tissue. Such changes in the balance of protein synthesis are
      likely to be brought about by alterations in the balance of certain metabolic
      hormones. Marked changes in energy metabolism also accompany Ostertagia
      infection. Parasitised calves exhibit a marked increase in non-esterified fatty
      acid levels, resulting from the mobilisation of adipose tissue, and a reduction
      in digestive efficiency of energy, probably associated with the increase in
      cycling of protein through the gastrointestinal tract and the compensatory
      increases in protein synthesis. Mineral metabolism may also be affected although
      relatively little work has been conducted in cattle. Changes in body composition
      reflect a reduction in deposition of muscle protein and fat, and an increase in
      bone content and water retention.

PMID- 8484208
TI  - Economic benefits of parasite control in cattle.
AB  - The economic losses often associated with parasitism in cattle are universally
      accepted. The degree of economic significance related to these losses, the
      burdens of parasites required to cause such losses, and the specific control
      measures needed to avoid these losses are, however, topics of serious debate and
      outright disagreement among parasitologists and veterinarians. This is because
      most cattle have parasite burdens that are truly subclinical, with no obvious
      signs of parasitism but significant losses in potential production. These losses
      are often very insidious in nature and often difficult to prove statistically in
      a consistent manner. This discussion focuses on the need to: (1) define the
      benefits related to parasite control in cattle; (2) develop clear and effective
      parasite control recommendations that will allow the producer to realize these
      benefits; (3) effectively transfer this information to the cattleman.

PMID- 8484209
TI  - Evaluation of pepsinogen, gastrin and antibody response in diagnosing
      ostertagiasis.
AB  - Ostertagia ostertagi is widely distributed and is one of the most important
      parasites affecting young bovine livestock. There is, therefore, a substantial
      need for sensitive and specific parameters in support of diagnosis of
      ostertagiasis, especially for subclinical disease related to production losses.
      In this review, the value and application of pepsinogen, gastrin and antibody
      response as diagnostic tools are discussed. These three parameters are useful and
      comparable for confirming clinical disease in calves during their first grazing
      season. However, their value for detecting subclinical parasitism is
      questionable. Differences in the course of gastrin and pepsinogen late in the
      grazing season can be correlated with larval inhibition and the possibility of
      ostertagiasis Type II. Relatively few serological methods have been developed for
      the immunodiagnosis of Ostertagia and until now the indirect antibody-detecting
      enzyme-linked immunosorbent assay (ELISA) has been the method of choice. Antibody
      measuring methods have several disadvantages, most notably a lack of sensitivity
      and specificity, which limits their use in longitudinal epidemiological studies.
      Considering the necessity of cost effectiveness and ease of use, it is
      anticipated that additional work will result in the enhancement and quality of
      current immunodiagnostic methods.

PMID- 8484210
TI  - Estimation of the numbers of trichostrongylid larvae on pastures.
AB  - Estimates of the density of larvae on herbage are used in epidemiologic studies
      to determine seasonal or monthly variations in contamination of pastures with
      third-stage larvae of the trichostrongyles, and to provide an index of the risk
      of exposure of grazing animals. Estimates of density are affected by many
      variables, including laboratory techniques, climate, forage types, and farm and
      animal management methods. Thus, a comparison of results given by different
      workers is not desirable. In obtaining and interpreting larval density estimates,
      it is important to standardize the technique over the period of observation.
      Because techniques for estimation of larvae are cumbersome and time-consuming,
      statistical design is often compromised. Herbage samples should be taken randomly
      and with sufficient replication to overcome the variability of the herbage
      sampling technique. Studies to determine an appropriate sampling design to obtain
      the best estimate for pastures of all sizes have not as yet been carried out.

PMID- 8484211
TI  - Notes on necropsy and herbage processing techniques for gastrointestinal
      nematodes of ruminants.
AB  - Necropsy techniques for the digestive tract of ruminants used at the University
      of Utrecht differ from those used elsewhere in three respects: (1) the abomasum
      is opened immediately after slaughter and the "contents" are treated separately
      from the "washings"; (2) the first 10 m of the small intestine are treated
      separately from the remainder of the intestine; (3) the aliquots are coloured
      with iodine before being examined for worms. The majority of the worms are found
      in the washings of the abomasum and the first part of the small intestine,
      whereas the contents of the abomasum and the remainder of the small intestine
      contain the bulk of the digesta. Because inhibited stages of Ostertagia,
      Haemonchus and, particularly, the very small third stage larvae (L3) of
      Trichostrongylus can be overlooked easily in digesta, these methods imply a more
      rapid and accurate enumeration of worms. This is more important in small
      ruminants than in cattle because a much higher proportion of the inhibited larvae
      will be washed out of the mucosa and because Trichostrongylus is more important
      in small ruminants. Herbage sampling methods for monitoring gastrointestinal
      nematode infections on cattle pastures in northwest Europe should also be
      suitable for lungworm. The agar-bile technique of Jorgensen is an elegant method,
      but disadvantages are that many gastrointestinal nematode larvae exsheath,
      resulting in identification difficulties, and recovery of lungworm larvae
      decreases as a result of ageing. A simple sucrose flotation method, based on the
      principle that a sucrose solution does not mix easily with water containing
      nematodes, has been tested at our laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484212
TI  - Effects of grazing management practices on parasite load and weight gain of beef
      cattle.
AB  - Stocking rate, method of grazing (rotational vs. continuous) and supplementation
      are three grazing management variables which strongly affect weight gain of beef
      cattle. However, reports on the interaction between these variables and
      parasitism in beef cattle are often conflicting or not conclusive. Although
      several studies have shown increased parasite loads with increased stocking
      rates, few studies have included animals treated and untreated with anthelmintics
      at several stocking rates. Those that did have this treatment combination did not
      show greater response in weight gain to treatment with anthelmintics at high
      stocking rates than at low stocking rates. Experiments designed to investigate
      the effect of rotational and continuous grazing on parasitism have provided
      variable results. However, as the high stock densities associated with rotational
      grazing will probably cause animals to graze closer to the ground and to dung
      pats, and to spread dung more with their hooves, it is not likely that rotational
      grazing will reduce the need for chemotherapy. Some studies have shown reduced
      parasite loads with supplementation of untreated animals, but none has apparently
      investigated whether weight gain response to treatment with anthelmintics is
      greater for non-supplemented animals than for supplemented animals. Published
      studies on the interaction between management factors and parasitism in grazing
      animals reveal many weaknesses. Elimination of these weaknesses and cognisance of
      recent trends in design and conduct of grazing experiments will substantially
      improve the quality and value of research in this field.

PMID- 8484213
TI  - Gastrointestinal nematode infections and weight gain in dairy replacement stock:
      first-year calves.
AB  - For the evaluation of control strategies against, and economic impact of
      gastrointestinal nematode infection, the quantitative relationship between level
      of exposure to infection and growth performance is important. Available data in
      the literature are summarised. Based on questions derived from earlier work
      concerning the relationships between infection, growth performance and acquired
      immunity during the entire rearing period, two experiments were set up. In these
      experiments, groups of calves were exposed to different levels and patterns of
      infection with Ostertagia ostertagi and Cooperia oncophora. The experimental
      design simulated the stereotypic pattern of herbage infestation under conditions
      of set-stocking. A significant negative linear relationship between the level of
      exposure and growth performance was found (P < 0.001). The time sequences
      observed for body weight changes in response to infection and the magnitudes of
      the effects of infection on weight gain in both experiments suggested a good
      predictability of the relationship between infection and growth performance. By
      comparison, it is also suggested that in the Netherlands parasite control is
      excessive in the first grazing season. A more limited use of anthelmintic
      treatments is proposed.

PMID- 8484214
TI  - Control of gastrointestinal nematodes in Australia in the 21st century.
AB  - Because the Australian livestock industries rely overwhelmingly on year-round
      grazing of pastures, nematode parasites are of major concern. Nematode parasitism
      is recognized as the cause of the most economically important diseases of sheep,
      while in cattle, the relative importance of nematode parasitism will probably
      increase following the eradication of diseases such as brucellosis and
      tuberculosis. The extraordinarily high prevalence of resistance to
      benzimidazoles, levamisole and morantel in nematodes parasitising sheep has
      stimulated the formulation and, to a surprisingly large extent, adoption by
      farmers of strategic control programmes aimed at preserving the useful life of
      ivermectin. Even so, it is highly likely that we will enter the 21st century with
      ivermectin resistance. Current research aimed at control in the next century is
      progressing in three broad directions. First, towards better control using
      existing anthelmintics through modifications to pharmacokinetics, together with
      integrated management aided by computer simulation models of nematode population
      biology. Secondly, towards immunological control arising from a better
      understanding of the ruminant immune response to helminths, particularly in young
      animals, and finally, a coordinated investigation of genetic resistance, within
      breeds, of sheep to nematode parasitism. The appearance in the 21st century of
      novel anthelmintic compounds, most probably as a result of research by the
      international pharmaceutical industry, may well reduce the sense of urgency
      driving current Australian research. Nevertheless, success in one or more of
      these three lines of endeavour will mean a longer and more profitable life for
      the next generation of anthelmintics marketed in Australia.

PMID- 8484215
TI  - Mathematical models for the population biology of Ostertagia ostertagi and the
      significance of aggregated parasite distributions.
AB  - Parasite frequency distributions are frequently aggregated. Such distributions
      are conveniently described using the negative binomial frequency distribution.
      This distribution is completely characterized by two parameters: the mean of the
      distribution and an exponent, k. The degree of aggregation is inversely
      proportional to the value of k. Aggregated parasite distributions enhance the
      ability of regulatory processes to maintain parasite populations at or near their
      equilibrium level but incorporating parasite frequency distributions in realistic
      models of parasite population biology is fraught with difficulty (several
      simplified examples are given). Indeed, it is not always possible to incorporate
      parasite frequency distributions and the question arises whether this compromises
      model performance. Trichostronglyid nematodes, including Ostertagia ostertagi,
      are aggregated but the estimated value of k for such populations is usually
      greater than 1. This is typical of populations with high population means (tens
      of thousands). It is shown that when the degree of aggregation is such that k >
      1, the results of a model which recognizes parasite frequency distribution is not
      much different from the results of a model which assumes all hosts contain
      exactly the same number of parasites.

PMID- 8484216
TI  - The role of inhibited development in the epidemiology of Ostertagia infections.
AB  - Seasonal patterns of inhibited larval development have been described for
      Ostertagia spp. from many parts of the world; winter inhibition is found in areas
      where transmission of infections occurs mainly in summer and summer inhibition in
      areas where transmission is mainly from autumn to spring. There is no fixed
      regional seasonal inhibition pattern. Depending on weather and farm management,
      the timing and level of inhibition will vary from year to year. Moreover,
      differences in the propensity for inhibition have been observed between field
      strains of Ostertagia in cattle in Australia and in the Netherlands. Simultaneous
      resumption of development of large numbers of inhibited larvae can result in Type
      II ostertagiasis, usually in only part of the heard. For reasons as yet unknown,
      there appear to be differences between regions in the prevalence of this disease.
      Development of immunity is also involved in the onset of inhibition and the
      occurrence of two separate inhibited populations in one host population,
      "seasonal" and "immunological", has been suggested. Seasonal fluctuations in the
      proportion of inhibition in naturally infected animals do not necessarily imply
      that the main trigger for inhibition is environmental conditioning, because
      infection levels and thus the degree of immunity will also fluctuate seasonally.
      In some Ostertagia field populations during late autumn in the Netherlands, worm
      burdens of permanently grazed calves consist mainly of inhibited larvae, but
      burdens of tracer calves consist of adults. Inhibited larvae may also be involved
      in the development of immunity. Some protection against reinfection with
      Haemonchus contortus has been demonstrated in barren ewes infected 6 months
      earlier with a single dose of 15,000 inhibition-conditioned larvae. Such an
      immunogenic role may be more important in Ostertagia, because inhibited larvae
      are found deeper in the mucosa than those of Haemonchus.

PMID- 8484217
TI  - Ostertagiasis in the cow and weaned calf in the northeastern USA.
AB  - Most gastrointestinal nematode infections of cattle in the northeast USA are
      combinations of Ostertagia ostertagi and Cooperia oncophora. These infections are
      usually of little consequence in adult cattle because of immunity and consequent
      low levels of infection. Some work has been done on the effects of infection on
      milk production but the results are equivocal. Clinical ostertagiasis in calves
      can lead to mortality. Such outbreaks are often associated with situations where
      calves are pastured at an early age onto special calf pastures that are used
      consistently for this purpose. Subclinical ostertagiasis is more usual in this
      region where light infections become established in calves with no obvious
      clinical signs. Such infections exact a toll on productivity in the form of
      decreased weight gains, decreased carcass quality, reduced nitrogen balance and
      negative effects on post-absorptive protein metabolism. Subclinical infections
      can also cause transient suppression of cell-mediated immune responses in calves.
      Increases in fecal worm egg counts of cows have been shown to occur during the
      spring months and these may contribute to increased contamination of pastures.
      Ostertagia infective larvae overwinter successfully on pasture and can persist
      until midsummer. Typical egg production patterns in calves involve a prepatent
      period, after introduction to pasture in mid to late May, of approximately 3
      weeks. Peak egg production occurs at about 6-8 weeks and is followed by a gradual
      decline in egg counts into the fall. Hypobiosis is very apparent in this region
      and is most pronounced in late fall (October-November).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484218
TI  - Epidemiology of Ostertagia ostertagi in cow-calf herds in the southeastern USA.
AB  - Ostertagia ostertagi is commonly found in the brood cow and nursing calf in the
      southeastern USA, this information being derived from fecal egg counts,
      coproculture and necropsy results; however, clinical disease and large burdens of
      this parasite are rarely reported. Fecal egg counts in brood cows are routinely
      low and are generally reported to be 10 eggs per gram of feces (EPG) or less.
      Nematode egg counts in spring-born calves are also generally low prior to
      weaning; they increase steadily during the spring and summer and peak from late
      summer to fall weaning. That egg counts in spring-born calves are low for several
      months after birth is probably a reflection of minimal grazing activity. It
      appears that Ostertagia ostertagi may be of equal or less importance than other
      nematode genera for spring-born calves in the southeastern USA. The role that
      Ostertagia ostertagi plays in fall-born calves or in year-round calving herds has
      not been adequately investigated. Also, the role that the adult cow plays, with
      low egg counts and small Ostertagia ostertagi burdens, in contamination of
      pasture is not understood during either lactation or dry periods. Treatment of
      beef calves prior to, or at weaning can reduce contamination and transmission of
      gastrointestinal parasites on pastures which may be subsequently grazed by these
      or other weaned calves. Data on parasite population dynamics from tracer calf
      studies in cow-calf herds in the southeastern USA have identified peak periods of
      transmission and incidence of specific genera or stages. This information, in
      conjunction with routinely used cattle production and management practices such
      as time of calving, should provide means to more accurately define optimal timing
      for strategic parasite treatment programs and their overall effect on beef
      production in the southeastern USA.

PMID- 8484219
TI  - Observations on nematode parasitism in cow-calf production systems in
      southcentral/southwestern USA.
AB  - Observations on fecal egg count (FEC) and nematode identification data were
      compiled to help determine the extent of nematode parasitism in cows and their
      nursing calves. Overall mean FEC values for cows in Utah, Louisiana, Nevada,
      Texas, and California were 7 eggs per gram (EPG), 6 EPG, 9 EPG, 10 EPG, and 15
      EPG, respectively. Overall mean FEC values for nursing calves from the same
      states were 7 EPG, 228 EPG, 3 EPG, 60 EPG, and 398 EPG, respectively. The overall
      mean FEC value for Arizona cows was 33 EPG. Relatively complete seasonal FEC data
      were available from California and Louisiana where fall-born calves acquired high
      nematode burdens (i.e. 400-500 EPG) as early as 3 months of age, and spring-born
      calf FEC started low (10-30 EPG) and reached high levels (200-400 EPG) at about 5
      months of age. In California, tracer calf data indicated that Ostertagia and
      Cooperia were the predominant nematodes acquired from pasture. In Louisiana,
      tracer calf, tracer cow, slaughtered calf (at weaning) and coproculture data
      indicated that Ostertagia (fall/winter) and Haemonchus (summer/fall) were the
      predominant nematode genera acquired by cows and that Ostertagia (winter/spring),
      Haemonchus (summer) and Cooperia (all seasons) were the predominant nematode
      genera acquired by calves. The acquisition of nematodes in tracer cows was much
      lower than in calves; however, the percentage of inhibited Ostertagia (ranging
      from 0% in summer to more than 80% in spring) was similar. A survey of abomasal
      nematodes in culled dairy and beef cows in Louisiana indicated that cows can
      harbor large (mean of 24,543 for beef and 16,383 for dairy) burdens.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8484220
TI  - Epizootiology of Ostertagia ostertagi in cow-calf production systems in the
      American Midwest.
AB  - The most common gastrointestinal nematodes found in cattle in the Midwest are
      Ostertagia ostertagi and Cooperia oncophora. Other parasites include Haemonchus
      placei, Bunostomum phlebotomum and Nematodirus helvetianus. Parasite numbers are
      generally low in this region, as indicated by fecal egg counts and tracer calf
      worm recoveries, and the numbers of parasites decrease as one travels farther
      north. This decrease in parasite numbers also corresponds to a similar reduction
      in the prevalence of clinical disease. The dynamics of fecal egg shedding are
      similar throughout the Midwest. Cow fecal egg counts begin to increase just prior
      to calving in the spring, continue to rise, reaching a peak in July and August,
      and return to low numbers (2 or less eggs per gram of feces (epg)) in October.
      Calves born in the spring (March-May) show increasing numbers of eggs in their
      feces throughout the grazing season, with peak recoveries in October and
      November, after which the numbers decline as the calves develop an immunological
      response. Tracer calf worm recoveries demonstrate pasture contamination for the
      period grazed. These recoveries show adult O. ostertagi increasing throughout the
      grazing season then falling to low levels over the winter. Larval inhibition of
      O. ostertagi, as shown by recovery of inhibited fourth stage larvae (L4) occurs
      throughout the year, with increasing numbers of larvae recovered in the fall. The
      production robbing effects of these parasites has been demonstrated by the use of
      a controlled strategic deworming program. Weaning weight advantages of 14 to more
      than 20 kg have been reported in this region of the country when compared with an
      untreated group.2+ !%"

PMID- 8484221
TI  - Current and future prospects for control of ostertagiasis in northern Europe-
      examples from Denmark.
AB  - This review primarily discusses the status and prospects for control of bovine
      ostertagiasis in northern Europe, with examples from Denmark. There are different
      ongoing developments in agricultural systems and practices, and methods and
      possibilities for practical control depend on the intensity and specialisation of
      these; the modern dairy farm remains at highest risk of parasitism, owing to
      increasing stocking densities and limited natural control elements at hand.
      Epidemiology and course of infections are significantly influenced by the gradual
      build-up of acquired immunity, which usually contributes to prevent loss
      producing effects in second season and older animals. It may be of doubtful value
      to exaggerate worm control in first season animals, because this may reduce
      development of immunity with the risk of translocating parasite problems from the
      young to the older, economically more important age categories of animals. A
      number of reasons for adopting an overall consideration on worm control and
      performance throughout adolescence is emphasised. Control by management relies on
      a fairly detailed insight into local transmission factors of Ostertagia ostertagi
      and related trichostrongyles. No doubt future investigations will provide
      important additional knowledge in this area. Anthelmintics will continue to
      constitute a major control measure, but it is unlikely that there will be any
      acceleration in the rate of commercial release of new compounds. However, ongoing
      modifications and new formulations of existing anthelmintics will continue to be
      produced, and implementation at the farm level of the proper use of anthelmintics
      and other control measures will be one of the important tasks of the coming
      century. Until now, the development of anthelmintic resistance in cattle has been
      negligible, but it may possibly pose a potential risk over the coming decades.
      With regard to some new anthelmintics that have environmental concerns related to
      their faecal excretion, this should be carefully examined in the future. Control
      in the form of vaccination or biological control by microfungi or others would be
      attractive alternatives that should be given a high research priority. Yet, at
      present it is not easy to predict which of these may lead to feasible, practical
      control.

PMID- 8484222
TI  - Epidemiology of Ostertagia in the Northwestern USA.
AB  - The two most significant environmental factors that influence the epidemiology of
      Ostertagia are temperature and moisture. These factors vary more in the west and
      northwest than in any other part of the USA because of extreme regional
      differences in climate, topography, and land use. Consequently, patterns of
      Ostertagia transmission and inhibition also vary widely from region to region and
      from year to year. Recent data require revisions of previously accepted concepts
      of northern/southern transmission and inhibition. In particular, the flaw of
      liberal extrapolation of information from one region to another has now been
      recognized. Inhibition may not occur along the coast of the Pacific Northwest.
      Although not completely delineated, the transition zone between northern and
      southern patterns of inhibition appears to be significantly wider and more
      variable than previously recognized; Oregon data suggest a possible indeterminate
      and variable band extending north of the 45th parallel and south of the 43rd
      parallel. Summer inhibition has now been documented in areas of Oregon and
      Montana. Other than the recent Oregon and Montana studies, data on this
      transition zone in the Rocky Mountain region and high plains are sparse to non
      existent. In contrast to previously accepted doctrine, the fall rise in egg count
      generally exceeds the traditionally accepted spring rise in many areas. From the
      Pacific Northwest to the Midwest, year-round transmission patterns have been
      observed. The presence of geothermal ground water sources produces microclimates
      that favor larval survival in many areas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484223
TI  - Epidemiology of Ostertagia ostertagi in weaner-yearling cattle.
AB  - Epidemiologic events in the life cycle of Ostertagia ostertagi are best known in
      the weaner-yearling phase of cattle development throughout the concentrated
      cattle-rising areas of the world. Animal and pasture management demands placed on
      this age class are greater than for suckling calves and adult stock in either
      beef or dairy breeds. This fact alone would likely account for a higher
      prevalence of clinical and subclinical disease in weaner-yearlings. Additionally,
      the developing immune response provides relatively early protection against
      intestinal genera such as Cooperia and Oesophagostomum, but is delayed against
      Ostertagia ostertagi and Trichostrongylus axei. Both Type I and Type II disease
      may occur within the weaner-yearling stage. Factors affecting population changes
      of Ostertagia ostertagi have been described as extrinsic, i.e. weather-climate
      and grazing management, and intrinsic or host factors, i.e. age, sex, immune
      status, heredity and reproductive state. Immune status, particularly in weaner
      yearlings, may be of primary importance, as affected by host and extrinsic
      factors. With slow development of protective immunity against Ostertagia
      ostertagi in calves, the possible role of immunity in both induction of
      inhibition and larval maturation, the potential immunopathologic involvement in
      pathogenesis of Type II disease, hypersensitivity to larval intake in resistant
      adult cows, and the reported delay of a protective response following
      anthelmintic prophylaxis in younger cattle, the immune response may have profound
      influence on epidemiologic variation through age classes. Although continual
      epidemiological observations from birth to early adulthood in the same cattle
      have not been undertaken, some notable studies in the UK, the Netherlands, and
      Denmark have closely examined epidemiological events through first and second
      grazing seasons.

PMID- 8484224
TI  - The systematics of nematodes that cause ostertagiasis in domestic and wild
      ruminants in North America: an update and a key to species.
AB  - Studies of medium stomach worms (Subfamily Ostertagiinae) of domestic and wild
      ruminants in North America have refined our understanding of the systematics,
      host distribution and biogeography of these nematodes. Strong support for
      recognition of monophyly for the Ostertagiinae has resulted from preliminary
      phylogenetic analyses of morphological characters among these and other
      trichostrongylids. Evaluation of morphological and biochemical characters in our
      laboratory and elsewhere has not refuted the polymorphism hypothesis where paired
      major and minor morphotypes are postulated to represent polymorphic species
      within the genera Ostertagia (Ostertagia ostertagi/Ostertagia lyrata; Ostertagia
      leptospicularis/Ostertagia kolchida; Ostertagia gruehneri/Ostertagia arctica;
      Ostertagia mossi/Ostertagia dikmansi), Teladorsagia (Teladorsagia
      circumcincta/Teladorsagia trifurcata (= Teladorsagia davtiani), and Marshallagia
      (Marshallagia marshalli/Marshallagia occidentalis). The minor morphotype of
      Ostertagia bisonis, recognized in Eurasia (considered to be Teladorsagia
      kazakhstanica), has yet to be discovered in North America. The taxonomy of these
      species has remained stable since an earlier overview of Ostertagia spp. and
      Teladorsagia spp. in North American domestic stock at the 1986 Ostertagia
      Workshop. Investigations since 1986 have focused on comparative morphology and
      the clear differentiation of Ostertagiinae, primarily from wild ruminants, that
      have been reported or may potentially occur in domestic bovids. Among these are
      species which infect wild and domestic sheep (Marshallagia marshalli/Marshallagia
      occidentalis), bovids (Ostertagia bisonis), and cervids (Ostertagia
      mossi/Ostertagia dikmansi, Ostertagia leptospicularis/Ostertagia kolchida,
      Ostertagia gruehneri/Ostertagia arctica, Mazamastrongylus odocoilei and
      Mazamastrongylus pursglovei) in North America. A key is presented for identifying
      15 species of the Subfamily Ostertagiinae that are parasitic in domestic and wild
      ruminants of North America. Four exotic species (Camelostrongylus mentulatus,
      Spiculopteragia spiculoptera (= Spiculopteragia boehmi), Spiculopteragia
      asymmetrica and Longistrongylus curvispiculum) have been reported in North
      America, but only in game farms and are not included in the key. Hyostrongylus
      rubidus, a member of the Ostertagiinae normally parasitic in pigs and only rarely
      reported from domestic ruminants, is not included in the keys. Additional data
      from comparative morphology and molecular analyses will promote a reassessment of
      the generic-level systematics of the Ostertagiinae and allow an evaluation of
      host-parasite evolution and historical biogeography.

PMID- 8484225
TI  - Regulation of immunity to Ostertagia ostertagi.
AB  - Knowledge of bovine immune response to ostertagiasis is important to
      understanding the mechanisms of innate and acquired immunity to this economically
      important helminth parasite that infects cattle worldwide. Infection causes both
      antibody and cellular immune responses. Evidence shows that Ostertagia possesses
      excretory-secretory (ES) molecules that may regulate immune cell responses that
      affect acquired immunity and pathophysiological changes to infection. Ostertagia
      can down-regulate antibody and cellular immune responses. One of these ES
      regulatory molecules is a lectin that causes eosinophil chemotaxis. In addition
      to its antigenicity, this regulatory molecule serves as a means of communication
      between the parasite and cells of the host immune system. It is suggested that,
      lacking this type of communication, Ostertagia infection may not be readily
      recognized by the host immune cells. A hypothesis is proposed for the mechanisms
      of acquired immunity to Type I ostertagiasis. Regulatory molecules of Ostertagia
      ES are suggested as suitable vaccine candidates.

PMID- 8484226
TI  - Influence of host genetics upon antibody responses against gastrointestinal
      nematode infections in cattle.
AB  - Previous studies have shown that the number of gastrointestinal nematode eggs
      released per gram of feces (EPG) of calves is strongly influenced by host
      genetics. The purpose of this study was to determine if host genetics also
      influenced immune recognition of parasite antigens in these same calves. Serum
      samples were taken at monthly intervals from calves during their first grazing
      season, from approximately 4 months after the onset of calving and were continued
      until weaning. Serum samples were analyzed for antibodies against Ostertagia
      ostertagi, Haemonchus placei, Cooperia oncophora, and Oesophagostomum radiatum.
      Significant rises in antibodies of the IgG1 class were seen against Ostertagia
      ostertagi, H. placei, and C. oncophora. In addition, rises in anti-Ostertagia
      antibodies of the IgG2 and IgM isotypes were also noted. During periods of
      elevated antibody responses, the sire of the individual calves was found to
      influence significantly the level of circulating antibody. The heritability of
      serum anti-parasite antibody levels was demonstrated to be between 70 and 80%,
      depending upon the time and antibody isotype. The antibody levels did not appear
      to be correlated with parasite EPG values. These results indicate that the
      ability of calves to recognize parasite antigens is strongly influenced by
      genetic factors, and that the genetic factors which control antibody responses
      may differ from those controlling EPG values.

PMID- 8484227
TI  - [The principles of aviation support for rescue-evacuation operations in
      eliminating the consequences of disasters].
AB  - Analysing practical results of an Air Force participation in liquidation of the
      earthquake consequences in Armenia, 1988, and after technological catastrophe in
      Bashkiria, 1989, the authors substantiate the role and significance of air
      transportation in the system of rescue and evacuation measures, define main tasks
      for aviation, propose methods for calculation of required number of aircraft and
      its types. The data cited in this article have formed a basis for the principles
      of air support during rescue and evacuation procedures.

PMID- 8484228
TI  - [The work organization of the diagnostic module in a mobile medical-diagnostic
      unit].

PMID- 8484229
TI  - [Skilled and specialized surgical care in the current system of medical
      evacuation support for the wounded].

PMID- 8484230
TI  - [The experience of medical support for local wars and the problems of evacuating
      the wounded and sick by air].
AB  - The authors disclose the constant up-grade in the role of air transportation for
      medical evacuation. This problem is studied on the basis of the Korean war (1951
      1953), and the Afghan war (1979-1988). Thus, the average quota of wounded
      evacuated by air from combat areas in Afghanistan was 68.8%. In several
      operations it was up to 90-95%. Air transportation made it possible to shorten
      the time throughout the chain of evacuation and exclude some intermediate stages
      of evacuation.

PMID- 8484231
TI  - [Changes in the internal organs of wounded patients].

PMID- 8484232
TI  - [Neurodystrophic disorders in mine blast trauma and the potentials for their
      correction].

PMID- 8484233
TI  - [The organization of anesthesiological and resuscitation care under military
      field conditions].
AB  - On the basis of the latest achievements in anesthesia and reanimation, as well as
      the results of special military medical exercises and documents which depict the
      experience of local wars, the article shows the basic features of a conception
      about field anesthesia and reanimation. Taking into account the experience gained
      in Afghanistan the author determines the principles of its organization and
      approaches towards the solution of important tasks assigned to anesthesiological
      and reanimation service in combat conditions.

PMID- 8484234
TI  - [The treasures of Russian medicine (the 170th anniversary of Voenno-meditsinskii
      zhurnal)].

PMID- 8484235
TI  - [The peripheral blood indices following penetrating wounds of the chest and
      abdomen and their prognostic significance].
AB  - Blood losses and traumatic stress provoke changes in cellular composition of
      blood. The greatest blood losses are more frequent in penetrating chest wounds
      than in penetrating abdominal injuries. A great number of wounded contract
      leukocytosis which is also more frequent among patients with chest wounds. The
      lethal cases are definitely more frequent among patients that have no
      leukocytosis. Immature forms of neutrophils in peripheral blood are more natural
      for patients with abdominal injuries. More than a half of patients had no
      eosinophiles in peripheral blood after having been wounded.

PMID- 8484236
TI  - [Complications and the proximate causes of death in typhoid].
AB  - The article analyses the 65 lethal cases by typhoid in the period 1980-1986
      during an outbreak of infection among the servicemen of the 40-th Army. All the
      deceased had the age of 18-37, 79.8% of them were 18-20 years old. The most
      frequent complications were: myocarditis (84.6%), pneumonia (75.4%), hemorrhagic
      syndrome (50.8%), intestinal perforation (49.2%), intestinal ulcer hemorrhage
      (21.5%), pleuritis (20.0%), purulent complications (11.7%), endotoxic shock
      (12.3%). The structure of proximate causes of death was as following: perforative
      peritonitis (30.8%), pneumonia (20.0%), acute heart failure (13.8%), intestinal
      ulcer hemorrhage (12.3%), suprarenal hemorrhage (7.7%). The results obtained
      during this study prove the fact that this outbreak of epidemic infection had the
      features of classical typhoid.

PMID- 8484237
TI  - [An epidemiological assessment of the results of laboratory research on
      environmental objects].
AB  - On the basis of the experience in antiepidemic protection of troops several
      methods were worked out to make epidemiological estimation of laboratory
      researches which were conducted in order to disclose the risk factors that
      provoke infectious diseases. The main attention was focused on the problem of
      intestinal infections. It was stressed that the practical evaluation of fecal
      pollution index of water had to be done taking into account the level of
      infectious morbidity. In unsatisfactory indices of colimetry a threat of diseases
      in troops is much higher in the regions with frequent intestinal infections. In
      unfavourable regions with high viral intestinal infections the studies of water
      must be done after its purification and decontamination in order to reveal the
      presence of coliphages. On the basis of catering objects the article gives
      methods for differential estimation of the results of colon bacillus tests
      depending on epidemiological signification of environmental objects.

PMID- 8484238
TI  - [The improvement of the information activities in the system of the health and
      hygiene support for the troops].
AB  - The system of information on health care measures in the Armed Forces of Russian
      Federation needs to be improved and developed. The aims and contents of record
      documentation must be reoriented from the tasks of uninterrupted extensive
      control over environmental conditions to the intensive study of health status in
      military units. It is desirable that the system of information support in the
      Ministry of Defence should be more open and accessible for other ministries and
      institutions occupied with environmental protection. Computer application should
      raise the quality of information support, restrict the number of documents inside
      the system, and make use of analytical and decision-making programs.

PMID- 8484239
TI  - [The concept of the primary prevention of diseases in servicemen].

PMID- 8484240
TI  - [The occupational health problem in aviation medicine].

PMID- 8484241
TI  - [The biochemical mechanisms of the decrease in work capacity in sailors exposed
      to high temperatures and the possible means for their pharmacological
      correction].
AB  - The studies conducted on experimental animals and volunteers have proved that the
      increase of adrenalin, histamine, and serotonin ration in blood was caused by
      hyperthermic conditions. Activation of hormonal systems leads to acceleration of
      biochemical processes and to reduction of substrates in organs and tissues (such
      as regenerated glutathione, histidine) which are necessary for normal health
      status. A conclusion is made that the metabolite depletion of biochemical
      reactions provoke the reduction of job performance of man in the conditions of
      hyperthermic influence. Methods of medicamentous therapy are proposed to maintain
      the normal job performance of seamen in the conditions of unfavourable influence
      of high temperatures.

PMID- 8484242
TI  - [The use of current methods for analysing bacterial pyrogens in the pharmacies of
      treatment and prevention institutions].

PMID- 8484243
TI  - [The determination of the required frequency of the represervation of technical
      goods for the medical service in long-term storage].

PMID- 8484244
TI  - [The efficiency of the production processes in medical supply agencies studied by
      the network planning and management method].

PMID- 8484245
TI  - Platelet concentrates in an additive solution prepared from pooled buffy coats.
      In vivo studies.
AB  - Leukocyte-depleted platelet concentrates were prepared from pools of 4 buffy
      coats on the day after blood collection (BC-PC). The storage medium was composed
      of citrate phosphate dextrose plasma and a platelet-additive solution. Autologous
      transfusions of 111In-labelled platelets in 9 healthy volunteers were performed
      on the day of preparation (day 1) and on day 5. The recovery was 54.6 +/- 8.7
      (day 1) and 51.9 +/- 10.4% (day 5), T1/2 was 101 +/- 28 and 61 +/- 9 h,
      respectively. The survival was 8.3 +/- 1.7 and 5.7 +/- 1.0 days, respectively,
      using linear plot, and 7.8 +/- 2.0 and 5.8 +/- 0.5 days using the multiple hit
      method. In a prospective clinical study a comparison of the corrected
      posttransfusion increments was made between BC-PCs and apheresis-PC, and between
      fresh (1-2 days) and stored (3-5 days) preparations. No difference was found
      between BC-PCs and apheresis PCs. However, fresh BC-PCs gave higher increments
      than stored BC-PCs. A slight numerical difference between fresh and stored
      apheresis-PCs was not statistically significant. It is concluded that the BC-PC
      method results in platelets of equal quality to apheresis-PC.

PMID- 8484246
TI  - Rheological evaluation of X-ray irradiated blood.
AB  - CPD blood, in glass containers and polyvinyl chloride (PVC) bags, was X
      irradiated with 50 Gy (n = 4), and then stored for up to 4 weeks. Rheological,
      hematological and biochemical changes of the red cells during storage were
      examined. Changes in blood viscosity and various properties of red cells
      (deformability, shape, hematological indices and concentrations of 2,3
      diphosphoglycerate and nucleotides) during storage at 4 degrees C were not
      altered by the irradiation. The rheological, biochemical and morphological
      properties of red cells were as well preserved in PVC bags as in glass
      containers. No abnormal and/or cross-linked proteins in red-cell membranes were
      induced by the irradiation. Irradiation of PVC bags did not affect the above
      properties of red cells through any changes in the bag constituents. In
      conclusion, X-ray irradiation with 50 Gy to CPD blood in PVC bags does not affect
      the rheological functions of red cells.

PMID- 8484247
TI  - Taiwan Blood Donation Program: a model for development.
AB  - In 1974, the Taiwan National Blood Program had not yet been fully developed. The
      volunteer donor base was less than 5% and there was no organized national
      structure or regulation of blood services. Following the founding of the Blood
      Donation Association and the Blood Services Foundation, promotion of an all
      volunteer blood program, increased utilization of blood components and the
      standardization of laboratory methods were strategies that led to the development
      of the Taiwan National Blood Program. In 1991, 1,066,082 units of blood were
      collected in Taiwan, serving a population of about 20 million. There are
      currently 6 major blood centers and 13 blood stations. Blood donation is now 100%
      volunteer and 78% of all blood collected is separated into 10 available
      components. With national organization and regulation, the transition has taken
      17 years and has resulted in a community-based, all-volunteer blood supply.

PMID- 8484248
TI  - Production of stable human-mouse hybridomas secreting monoclonal antibodies
      against Rh D and c antigens.
AB  - Peripheral blood lymphocytes from donors immunized against Rh antigens were fused
      with mouse myelomas and heteromyelomas in order to obtain human-mouse hybridomas
      secreting antibodies specific for these antigens. Three cell lines secreting anti
      D IgG and two secreting anti-c IgM were stabilized and produced immunoglobulins
      for several months. These human monoclonal antibodies were evaluated as reagents
      for Rh phenotyping. Their complementary activity towards weak D and partial D
      antigens is examined.

PMID- 8484249
TI  - Antibodies to platelet glycoprotein V in polytransfused patients with
      haematological disease.
AB  - Polytransfused patients often develop platelet-reactive antibodies (PRAb). These
      give positive reactions in the platelet immunofluorescence test (PIFT) and may be
      either lymphocytotoxic (LCTAb) or platelet-specific antibodies (PSAb). The latter
      may be detected in the PIFT using chloroquine-treated platelets (Chl-PIFT) or by
      immunoblotting. Serial samples from 106 multiply transfused patients with bone
      marrow failure were screened by PIFT using a microplate method and flow
      cytometric analysis. PSAb activity was confirmed by Chl-PIFT. In 45 (42%) of the
      patients studied PSAb were detected; 37 (35%) formed LCTAb and 19 (51%) had co
      existent PSAb. Sera from 25 of 27 patients with a positive Chl-PIFT, retested by
      immunoblotting, recognised determinants of Mr 82-160 kD on whole platelets. A
      large group became sensitised to a component of Mr 105-115 kD reduced (99 kD non
      reduced) with similar electrophoretic mobility to GPIIIa using a monoclonal anti
      GPIIIa and two human polyclonal anti-HPA-1a sera; some also produced anti-GPIIb.
      The largest group recognised a determinant of Mr 80-83 kD, probably glycoprotein
      V (GPV). Three sera were immunoblotted against thrombin-treated platelets and the
      results confirmed GPV specificity.

PMID- 8484250
TI  - Molecular genetic analysis of the ABO blood group system: 3. A(X) and B(A)
      alleles.
AB  - We have employed a PCR approach to determine the nucleotide sequences of the
      coding region in the last two coding exons of the histo-blood group ABO genes
      from one A(X) and one B(A) individual. Compared with A1 alleles, the (A(X))
      allele has a single nucleotide substitution (T-->A at nucleotide 646) resulting
      in an amino acid substitution (phenylalanine-->isoleucine at amino acid 216).
      Compared with B alleles, the B(A) allele has two nucleotide substitutions (T-->C
      at nt. 657 and A-->G at nt. 703) resulting in an amino acid substitution (serine-
      >glycine at aa. 235). The amino acid substitution resulting from this B(A) allele
      is located at the second of the four amino acid substitutions which discriminate
      human A and B transferases, and the amino acid residue (glycine) is identical to
      that of A transferase suggesting the involvement of this amino acid or its
      surrounding area for the recognition and/or binding of the donor nucleotide
      sugars.

PMID- 8484251
TI  - Molecular genetic analysis of the ABO blood group system: 4. Another type of O
      allele.
AB  - We have encountered an allele which seems to be another type of O allele at the
      human histo-blood group ABO locus. We have determined the nucleotide sequence of
      this allele over the coding region in the last two coding exons. This allele does
      not possess the single-nucleotide deletion found common among all the O alleles
      previously analyzed. Compared with A1 allele, this allele has three nucleotide
      substitutions resulting in two amino acid substitutions. The introduction of
      these amino acid substitutions into the A1 transferase expression construct
      apparently abolished the enzymatic activity of A1 transferase.

PMID- 8484252
TI  - Positive antiglobulin test in association with sulindac: involvement of the Rh
      factor.
AB  - We investigated the development of a positive direct antiglobulin test associated
      with the use of the nonsteroid anti-inflammatory drug sulindac. The drug was
      shown to be the cause of the positive direct antiglobulin test using red cells
      treated in vitro with solutions of native sulindac and its two major metabolites.
      Serum from the patient contained sulindac-dependent red cell antibodies which
      could not be demonstrated when red cells having the Rh phenotype D-- were
      employed in the test procedure. An eluate prepared from the patients' red cells
      reacted against untreated red cells having common Rh phenotypes, but not against
      target red cells with the Rh phenotypes D-- or Rh null. The eluate showed
      stronger reactivity against the cells having common Rh phenotypes when they were
      treated with solutions of a metabolite of sulindac, but failed to react against
      treated red cells having the Rh phenotype D-- or Rh null. The results of our
      investigations point to an interaction between sulindac and/or its metabolites
      and Rh structures on the red cell membrane as the initial step in the production
      of drug dependent and autoantibodies leading to the positive direct antiglobulin
      test.

PMID- 8484253
TI  - Severe immune haemolytic anaemia caused by intravenous immunoglobulin anti-D in
      the treatment of autoimmune thrombocytopenia.

PMID- 8484254
TI  - A new action mechanism of intravenous immunoglobulin for idiopathic
      thrombocytopenic purpura.

PMID- 8484255
TI  - Change in Fc gamma II receptor during platelet storage.

PMID- 8484256
TI  - HTLV-1 in multiply transfused patients in Trinidad and Tobago, West Indies.

PMID- 8484257
TI  - Zinc status in intensely transfused patients.

PMID- 8484258
TI  - Mild hemolytic disease of the newborn due to anti-Lewis(a)

PMID- 8484259
TI  - A cDNA clone encoding an rh polypeptide detected in RhD-negative erythroid cells.

PMID- 8484260
TI  - Metabolism of mephentermine and its derivatives by the microsomal fraction from
      male Wistar rat livers.
AB  - 1. The N-demethylation of mephentermine (MP), p-hydroxymephentermine (p-hydroxy
      MP) and N-hydroxymephentermine (N-hydroxy-MP), to produce phentermine (Ph), p
      hydroxyphentermine (p-hydroxy-Ph) and N-hydroxyphentermine (N-hydroxy-Ph), and
      the p-hydroxylation of MP and Ph, to produce p-hydroxy-MP and p-hydroxy-Ph, were
      examined using rat liver microsomal preparations containing NADPH. Microsomal
      reduction of N-hydroxy-Ph to Ph was also examined using various cofactors. In
      addition, enzymic system for the N-demethylation and p-hydroxylation were
      examined using various inhibitors. 2. N-Hydroxy-MP demethylation to N-hydroxy-Ph
      proceeded at a rate almost 10-fold faster than other reactions. MP demethylation
      to Ph, MP oxidation to P-hydroxy-MP, Ph oxidation to p-hydroxy-Ph proceeded at
      similar rates, whilst p-hydroxy-MP demethylation to p-hydroxy-Ph was catalysed at
      the slowest rate. Microsomal reduction of N-hydroxy-Ph to Ph required NADH, and
      the activity was similar to that of MP oxidation to p-hydroxy-MP. 3. N
      Demethylation of MP, p-hydroxy-MP and N-hydroxy-MP were inhibited not only by
      inhibitors of cytochrome P450, but also by methimazole, an inhibitor of the FAD
      monooxygenase system. p-Hydroxylations of MP and Ph were inhibited only by
      inhibitors of cytochrome P450.

PMID- 8484261
TI  - The metabolism of 2,3,7,8-tetrabromodibenzodioxin in the rat.
AB  - 1. 2,3,7,8-Tetrabromodibenzodioxin was administered to bile-duct-cannulated rats
      in a single oral dose. 2. The compound was metabolized in the liver and
      metabolites were secreted into the bile. 3. Several phenolic metabolites were
      identified as their methyl ether derivatives by gas chromatography-mass
      spectrometry after clean-up and methylation of bile samples. 4. The main
      metabolites were formed by aromatic hydroxylation and via displacement of Br
      substituents (hydrolytic debromination). 5. Trace amounts of unmetabolized TBDD
      were also present in the bile.

PMID- 8484262
TI  - Inhibition of beta-glucuronidase by natural glucuronides of kampo medicines using
      glucuronide of SN-38 (7-ethyl-10-hydroxycamptothecin) as a substrate.
AB  - 1. 7-Ethyl-10-[4-(piperidino)-1-piperidino] carbonyloxycamptothecin (CPT-11), a
      potent anticancer agent currently under development for clinical use, is
      metabolized in vivo to 7-ethyl-10-hydroxycamptothecin (SN-38), which is
      subsequently conjugated to 7-ethyl-10-hydroxycamptothecin glucuronide (SN-38
      glucuronide). The SN-38-glucuronide was hydrolysed by beta-glucuronidase from E.
      coli to aglycones and glucuronic acid. 2. Four purified natural glucuronides
      including baicalin, wogonoside, luteolin-3'-glucuronide, and glycyrrhizin,
      inhibited beta-glucuronidase using SN-38-glucuronide as substrate. The inhibition
      potencies of these natural glucuronides toward beta-glucuronidase were similar to
      that of saccharic acid 1,4-lactone. 3. These results indicate that plant
      materials of Kampo (Japanese herbal) medicines containing these glucuronides
      could be used in vivo to decrease the enterohepatic circulation of SN-38 and
      possibly that of other drugs.

PMID- 8484263
TI  - Dose-dependent distribution of 3H-pentamidine following intra-tracheal
      administration to rats.
AB  - 1. The acute toxicity to the lung, and disposition, of pentamidine isethionate as
      a function of a pulmonary-delivered dose was investigated in the rat. 2. Acute
      toxicity 24 h following intra-tracheal instillation of pentamidine was determined
      by analysis of acellular surface protein concentration and differential cell
      counting of bronchoalveolar lavage fluid. These two parameters indicated that
      pentamidine doses > 10 mg/kg lead to increasingly severe oedematous and
      inflammatory responses within the lung. 3. Following intra-tracheal
      administration of sub-toxic doses of 3H-pentamidine (0.2-10 mg/kg), the extent of
      activity in liver, kidney, gut and lavage fluid at 24 h correlated significantly
      with dose, whereas the level of activity in lung was saturated at doses > 0.8
      mg/kg. 4. Values of << 1 for liver:lung and kidney:lung ratios of 3H-activity at
      low pentamidine doses demonstrated the high affinity of the lung for the
      compound. These ratios substantially increased with pentamidine dose, reflecting
      distribution of the drug to liver and kidney. Association of radioactivity with
      these organs was rapid (< 30 min), and indicated that pentamidine is effectively
      absorbed from the respiratory tract following intra-tracheal instillation.

PMID- 8484264
TI  - Pharmacokinetics of nefiracetam and three metabolites in humans and
      stereoselective hydroxylation of its pyrrolidine ring.
AB  - 1. The kinetics of nefiracetam (I) and three metabolites (II-IV) were
      investigated in healthy volunteers. Compounds I-IV in serum and urine were
      measured by h.p.l.c. 2. After a single 200 mg dose of nefiracetam the drug was
      absorbed rapidly and showed peak serum levels of 16.3 +/- 0.9 nmol/ml. Cmax
      values of the three metabolites were comparatively low (0.96-4.89 nmol/ml), and
      tmax and t1/2 values of the metabolites (4.1-9.6 h and 7.8-21.9 h, respectively)
      were longer than those of I (1.6 h and 3.9 h respectively). Urinary excretion of
      I in 24 h was about 5% of the dose. The major urinary metabolite, a pyrrolidine
      ring scission product (IV), had a mean total excretion of 17.8% dose. The total
      of all four compounds in urine amounted to 43.4% dose. 3. In a multiple-dose
      study (daily 3 x 200 mg doses of nefiracetam for 7 days), the serum concentration
      profile of each compound indicated that the steady state was reached in 7 days.
      4. Metabolite II existed as a racemate and III mainly as the (-)-enantiomer in
      human urine.

PMID- 8484265
TI  - Fluidity of the microsomal membrane and cytochrome P450 reduction kinetics of pig
      liver microsomes as a consequence of organic solvent impact.
AB  - 1. The effect of the aromatic solvents toluene, xylene and ethylbenzene on
      microsomal membrane fluidity and anaerobic NADPH-reduction kinetics were studied.
      2. The relation of membrane fluidity to the kinetics of cytochrome P450 reduction
      by NADPH-cytochrome P450 reductase was examined with regard to a membrane
      mediated molecular organization of the multienzyme components of the
      monooxygenase system. 3. Membrane fluidity changes were detected with the steady
      state pyrene excimer formation method and with fluorescence lifetime measurements
      after incubation of the microsomes with organic solvents. 4. Increase in membrane
      fluidity in presence of organic solvents leads to a small but significant
      decrease of the rate constant of the cytochrome P450 reduction kinetics and a
      change in the relative amplitudes of the components of the biphasic response. 5.
      The results support the idea of a molecular organization of cytochrome P450 in
      clusters. Fluidization of the microsomal membrane by organic solvents increase
      the cytochrome P450 cluster formation.

PMID- 8484266
TI  - [Bioavailability of amino acids from several industrially-prepared protein
      containing products].
AB  - To evaluate the bioavailability of amino acids from proteins and protein
      containing products, the area under the postprandial plasma-concentration-time
      curve of the amino acids after oral administration needs to be calculated.
      Therefore, basic values depending on circadian plasma concentration rhythms have
      to be subtracted from measured values after loading. To determine the relative
      bioavailability of two tested samples, e.g., a protein-containing product before
      and after processing or two technologically different preparations of the same
      protein, it is sufficient to compare their absorption-curves, both corrected by
      the basic values. For that purpose the mean value-curves corresponding to the
      group of subjects are used, because the individual courses show considerable
      differences, in particular due to discontinuous gastric emptying. Enzymatic
      hydrolysis of a lactalbumin reduces the quantitative bioavailability of the amino
      acids by 12%. Concerning products used in nutrition of patients and babies, the
      availability from ready-to-drink liquid products is about 7-10% better than that
      out of the same dry products in powdered form. Compared with sterilization,
      ultrahigh heat treatment of milk protein products improves the availability
      slightly, by about 1%. Processing of dried green peas destined for use in
      convenience food increases the protein availability by 20%.

PMID- 8484267
TI  - [Factors influencing the vitamin A concentration in the liver of cattle].
AB  - Nineteen long-term individual- and group-feeding experiments with 180 male
      calves, 338 growing bulls, 302 heifers, and 344 dairy cows were carried out in
      order to measure the influence of feeding (straw, silages or green fodder as
      roughages) and different vitamin-A supplies (0-40,000 IU per 100 kg body weight
      per day in growing cattle or 0-120,000 IU per dairy cow per day) on liver vitamin
      A concentration. All together, 2,127 biopsies from livers were taken for retinol
      analysis. At the end of six growth experiments animals were slaughtered. Liver
      vitamin-A concentration of calves depends on their term at birth and is
      associated with the carotene intake of their mothers. The carotene content of
      feeds and the vitamin-A supply are the most important influencing factors on
      liver vitamin-A concentration of growing and lactating cattle. On the average,
      livers of calves fed with colostrum contained 100-200 IU, those of growing cattle
      fed with grass and legumes or with silages contained 200-300 or 100-200 IU resp.,
      and those of cows fed with green fodder or silage contained 300-600 or 100-300 IU
      vitamin A resp. per g fresh liver. There were also values outside of the
      variations mentioned above. The vitamin-A storage capacity of liver and the
      effects of oral and parenteral vitamin-A supply to depleted calves and growing
      cattle were also tested.

PMID- 8484268
TI  - [The effect of unsaturated dietary fatty acids on the distribution of cholesterol
      in individual lipoprotein fractions and on serum lipids of rats].
AB  - In six groups of nine young Sprague-Dawley rats each, the coconut fat used in the
      basal diet (group I) was replaced to 60% by pure oleic acid (group II) or
      linoleic acid (group III), respectively, by 0.6% of alpha-linolenic acid (IV),
      eicosatrienoic acid (V) and eicosapentaenoic acid (VI). A 60% replacement of the
      coconut fat in the basal diet by pure oleic acid, respectively, by 0.6% of
      eicosapentaenoic acid or eicosatrienoic acid significantly decreased the total
      cholesterol concentration in serum by 21% (HDL -28%; LDL -15%; VLDL -48%),
      respectively, 19% (HDL -12%; LDL -42%; VLDL +69%) or 15% (HDL -11%; LDL -21%) and
      the total free cholesterol concentration by 22% (HDL -27%), respectively, 41%
      (HDL -31%; LDL -66%) or 23% (HDL -21%; LDL -31%). The substitution of the coconut
      fat by 60% oleic acid or 0.6% alpha-linoleic acid had no influence on the total
      and total free cholesterol concentration in serum, though in the LDL-fraction a
      significant decrease of cholesterol could always be found. The concentrations of
      free fatty acids in serum were not influenced by the unsaturated dietary fatty
      acids while the phospholipid concentration was reduced by linoleic acid (-15%)
      and by eicosapentaenoic acid (-18%). The triglyceride content in serum was
      decreased by linoleic acid (-29%) and by eicosatrienoic acid (-25%).

PMID- 8484269
TI  - [The effect of different food forms on the urine composition and the risk of
      calcium oxalate stone formation].
AB  - The aim of this 17-day study was to examine the influence of four different diets
      on urine composition and the risk of calcium oxalate stone formation in 10
      healthy male subjects. In the course of phase 0, the subjects were on their
      individual diet for 2 days. In the following phases I, II, and III the subjects
      received three different standard diets for a duration of 5 days each. Whereas
      DIET 1 (normal mixed diet) corresponded to the dietary habits of men aged 19 to
      35 years, DIET 2 (balanced mixed diet) and DIET 3 (ovo-lacto-vegetarian diet)
      were calculated according to the dietary recommendations of the German Society of
      Nutrition (DGE) for the same age-group. The risk of calcium oxalate stone
      formation, calculated by the computer program EQUIL of FINLAYSON, was highest on
      the self-selected diet and on DIET 1, but declined significantly on the intake of
      DIET 2 by 50% on average compared to DIET 1 and by 61% compared to phase 0. On
      DIET 3 no further significant decline in the risk of calcium oxalate stone
      formation was observed. Therefore, it can be concluded that the change of usual
      dietary habits into a balanced mixed diet significantly reduces the risk of
      calcium oxalate stone formation. With a vegetarian diet a comparable decline in
      urine supersaturation of calcium oxalate can be achieved with respect to a mixed
      diet according to requirements. Since urinary oxalic acid excretion increased
      significantly, a vegetarian diet is not recommend for calcium oxalate stone
      patients with absorptive hyperoxaluria.

PMID- 8484270
TI  - [Repeated perioperative administration of fructose and sorbitol in a female
      patient with hereditary fructose intolerance [HFI)].
AB  - The present paper reports on an adult female patient whose hereditary fructose
      intolerance (HFI) was at first not diagnosed and who, within the space of 2 years
      after repeated elective surgery and the perioperative administration of fructose
      and sorbitol, developed "hepatic and renal failure of unclear origin." At a later
      stage we were able to establish the diagnosis of HFI by means of a fructose
      tolerance test in both she and her brother, for whom intolerance to fruit and
      desserts had been known since early childhood. In addition, literature references
      to fatalities following the parenteral application of fructose and sorbitol were
      analyzed. During the course of fructose infusion in both the patient and her
      brother with HFI, the following metabolic changes were noted: hypoglycemia,
      elevated rise in the blood fructose concentration, hyperlactacidemia, elevated
      rise in the blood fructose concentration, hyperlactacidemia, and hyperammonemia.
      These metabolic changes proved to be reversible after discontinuing the fructose
      infusion. Analysis of the literature on the fatalities following parenteral
      fructose administration established that fruit and dessert intolerance was known
      for all collated patients with HFI, and that, clearly, no regular metabolic tests
      had been conducted.

PMID- 8484271
TI  - Comparative absorption of ferrous and heme-iron with meals in normal and iron
      deficient subjects.
AB  - The relative intestinal absorption of heme- and non heme-iron in connection with
      a standardized test meal was studied in a group of fertile women given 16 mg Fe
      in the form of FeSO4 and 2 mg Fe in the form of hemoglobin. Both in normal
      subjects and in women with iron deficiency, the heme-iron was significantly
      better absorbed (16.13% +/- S.D. 8.0 vs 4.59 +/- 3.4, p < 0.01 and 22.03 +/- 8.9
      vs 9.45 +/- 7.8, p < 0.05). For targeted prophylaxis of iron deficiency with
      small, side-effect-free doses, heme-iron is thus a valuable component which
      increases the absorption by about 40%. Heme-iron does not cause high
      concentrations in the intestinal lumen of free radical inducing, possibly harmful
      ferric iron.

PMID- 8484272
TI  - [Circadian rhythm of pregnancy contractions].
AB  - Continuous measurement of normal contractions in 57 primiparae and multiparae
      showed a minimum in the mornings and a marked peaking of frequency between 8:30
      PM and 2:00 AM. This could be due to a periodic fluctuation in the parameters
      influencing uterine motility. At night, motility-enhancing factors such as
      estrogens and prostaglandins predominate. These results suggest that in cases at
      high risk for premature delivery, with high pelvic scores, therapy should be
      continued at night. In addition, the time when the contractions were recorded
      should be taken into account when assessing their frequency, and the measurement
      repeated if necessary.

PMID- 8484273
TI  - [3d ultrasound in prenatal diagnosis].
AB  - Three-dimensional sonography is a logical development of conventional sonography,
      and is a consequence of the fact that every examiner tries to imagine the three
      dimensional appearance of an organ on the basis of the tomographic images of it.
      In a long development process starting with the first 3D images in 1986/87 and
      lasting until today, we succeeded in developing a 3D system suitable for routine
      examinations, which the manufacturer is now marketing commercially. With a 3D
      transducer a coordinated sequence of tomograms is obtained; all the images are
      then computed transparently and subsequently imaged three-dimensionally as a
      crystalline volume. Movement of the 3D image on the computer screen is important
      for three-dimensional identification. The volume thus computed can then be
      bisected in longitudinal, transverse and horizontal planes and thus examined in
      real-time without any interference such as fetal movements. The horizontal
      sections cannot be obtained by conventional sonography. On the basis of more than
      600 patients examined by this new method it was established that 3D imaging of
      malformations improves diagnosis and assessment, that examinations deliver
      accurate and reproducible results, and that section analysis can substantially
      facilitate diagnosis of fetal malformations.

PMID- 8484274
TI  - [Observations and considerations on fetal risk by umbilical cord entanglement].
AB  - Mean actual pH-values in umbilical arterial (UA) and venous (UV) blood as well as
      mean AV-pH-differences (AVD-pH) were computed for individual Apgar-scores (1 min)
      in a sample of 10,580 term neonates, which were born vaginally from vertex
      position. The newborns of the study group showed all different kinds of cord
      entanglements (CE, N = 3430); neonates without CE were used as controls (N =
      7144). In addition infants of the study group were attributed to two different
      birth weight-centile groups: < 25. and > 75. percentile. RESULTS: In the study
      group mean AVD-pH-values in individual Apgar-scores showed a significant (P < 10(
      5)) increase when compared with controls. The numerical value of AVD-pH seems to
      be a function of the clinical condition of the newborn: maximum value (mean =
      0.113) was reached at Apgar 7; increasing neonatal distress was accompanied by
      low AVD-pH-values. This phenomenon was due to a decrease of actual pH in UA-blood
      and an increase in UV-blood; the latter was statistically feasible (P = 0.025)
      only in neonates with Apgar 8. AVD-pH-values of neonates above the 75. weight
      centile showed a different reaction-pattern in individual Apgar-scores when
      compared with infants below the 25. centile: They remain constant or are slightly
      increased. We concluded, that blood-flow reduction in the umbilical vessels leads
      to a flow-dependent improvement of fetal pCO2-excretion at the placental level,
      which counteracts the developing metabolic fetal acidosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8484275
TI  - [Ultrasound imaging of the symphysis fissure for evaluating damage to the
      symphysis in pregnancy and postpartum].
AB  - In a cross-sectional study of 211 patients with a normal pregnancy the distance
      of the symphysis was sonographically measured during pregnancy and normal values
      were evaluated. Physiologically a continuous widening of the symphysis was shown
      up to 3 mm an average. The sonographical sign of the damage of the symphysis was
      a deviation in widening and also a difference in height. The value of the
      sonographic examination is shown in 2 cases with damage of the symphysis and
      compared to the x-ray picture results.

PMID- 8484276
TI  - [Prospective study of the clinical value of C-reactive protein in amniotic
      infection syndrome].
AB  - In an open prospective investigation the median levels of C-reactive protein were
      determined in annormal collective. The median lies at 0.8 mg/dl in maternal serum
      withdrawn sub partu and in umbilical vein blood, and at 1.45 mg/dl immediately
      after ligation of the cord. Hopes on finding a biochemical parameter that could
      supply reliable information already during labour on a possible inflammatory
      infection in mother and child, did not materialize from the data found.
      Prediction of an infection of the newborn using CPR is only minimal. The most
      important practical information is given by the negative CRP in the umbilical
      vein blood. In this case the probability of an infection of the newborn is very
      slight. A high temperature during labour was the best predictor of the
      probability of endometritis puerperalis. This clinical finding, due to its
      specificity, is superior to CRP and the other parameters investigated.

PMID- 8484277
TI  - [The value of Doppler ultrasound studies of insulin-dependent diabetic patients].
AB  - Measurement of umbilical, uterine and arcuate velocity waveforms was used to
      study 40 pregnancies complicated by insulin dependent diabetes. Continuous wave
      doppler velocimetry was used to identify flow velocity profiles during the second
      and third trimester of pregnancy. Resistance index (RI) was calculated to
      evaluate waveforms. In most of the patients with fetal growth retardation and/or
      pregnancy induced hypertension an increase in vessel resistance was found in
      uterine and arcuate arteries as well as diastolic notching. In comparison to that
      fact White's classification showed no significant correlation to vascular
      resistance determined by doppler flow measurement. This study indicates that
      doppler ultrasound examination may have an adjunctive role in the surveillance of
      pregnancies complicated by diabetes.

PMID- 8484278
TI  - [Obstetric-perinatal status 1990 in the Oder region (a contribution to the
      obstetric-perinatal care in East Brandenburg)].
AB  - On the background of the first All-German-Perinatal-Study in 1992 the results in
      obstetrics and perinatology in the Oder-Region (east part of the State of
      Brandenbourg) in 1990 are described. In comparison to the results in a previous
      study (1985) we found a drastical decline in the number of births (newborns 1985:
      10244; 1990: 7723); in addition to the changing in the reproduction- and health
      care behaviour, too, we have noted a decreasing perinatal mortality from 7.5% in
      1985 to 4.9% in 1990. The ameliorated monitoring-rate (cardiotocography-rate) of
      the fetus (1985: 71%, 1990: 88.4%) and the decreasing still-birth-rate may be the
      main cause of this phenomenon. Clinic-births were the most common deliveries, the
      house-birth was the great exception; only 0.2% of all deliveries occurred at home
      or otherwhere. Our data support that there is no difference, except the birth
      rate, in relation to the situation in the "old" Federal Republic of Germany.

PMID- 8484279
TI  - [Patterns of cell functioning in starvation (exemplified by isolated roots)].
AB  - Comparison is made over physiology of the cells of isolated roots with those of
      animals under long-term starvation conditions. General mechanisms of functioning
      of such cells are exposed. It is shown that cut-off roots could be used as proper
      model for the studying physiology of the cell starvation.

PMID- 8484280
TI  - [The biological aspects of chromatin diminution].
AB  - The chromatine diminution (CD), first discovered by Boveri (1887) in ascarids,
      represents programmed elimination of a part of genetic material in the nuclei of
      the somatic cells in cyclops and ascarids, and in the protist macronuclei. The CD
      can be considered as a macromutation sharply changing chromosomal structure,
      though minimally effecting the phenotype. The analysis of CD is of significance
      for discussing mechanisms of origin of chromosomal organization, transformation
      of genome molecular structure in eucaryote evolution, role of the extra DNA.

PMID- 8484281
TI  - [The biomechanics of the neuroepithelium in vertebrates].
AB  - Results of experiments with biomechanical interactions of neuroepithelial cells
      from growing brain in various vertebrate taxa are analyzed. It is shown that
      neuroepithelium fulfills a number of mechanical functions at the stages of
      blastula, gastrula, neurula, and nerve tube. The cells develop mechanical
      tensions differing by their form, strength and duration. Tensions and
      compressions are resulted from local or global changes in the form of the cells
      possessing mechanical sensitiveness. Regular distribution of mechanical tensions
      and compression is related topologically to various zones of neurons
      differentiations. This allows to suppose mechanical dependence of processes of
      determination of the nerve system development at its earlier stages. The place of
      biomechanical interactions in the brain formation is considered in the framework
      of the evolution of structural organization of the vertebrate neuroepithelium.

PMID- 8484282
TI  - [Current status and development of kidney transplantation].
AB  - Since the first successful procedure in 1954 kidney transplantation has become a
      standard therapy of end stage renal disease. The knowledge of immunoregulation
      and immune response of the body has enabled people to recognize acute rejection
      of organs. HLA-testing and organ exchange on basis of HLA-compatibility are
      extremely important for a successful kidney transplantation. A shortage of organs
      is limiting the further increase of transplantations. Chronic rejection is in
      most cases the reason for late graft failure. Further investigations to develop
      new immunosuppressive drugs and to clarify immunological processes underlying
      chronic rejections are necessary in the future.

PMID- 8484283
TI  - [Dialysis treatment of chronic renal failure].
AB  - Of the patients with chronic renal replacement therapy in Germany, only 27% are
      living with a functioning graft, while the other 73% are dialysis patients. At
      the end of 1990, there were about 30,000 patients on regular dialysis treatment
      in Germany. Without selection for chronic dialysis, the average age of newly
      accepted patients is 61 years. More than 30% of the new dialysis patients are
      diabetics. Intermittent haemodialysis (89.5%), intermittent haemofiltration
      (4.5%), and peritoneal dialysis (6%) are the different methods of chronic
      dialysis treatment in Germany. The 5-year-survival rate with regular
      haemodialysis treatment is 67%, for 50 years old patients without diabetic
      nephropathy (EDTA, Europe).

PMID- 8484284
TI  - [Development of colorectal tumor surgery in the last 20 years].
AB  - Early and longterm results in surgery for colorectal cancer during the last two
      decades were investigated by a retrospective analysis of the data of 1,203
      patients. During the last 10 years we registered a significant increase in more
      advanced tumors of the stage III and IV from 37 to 52%. Nevertheless operative
      mortality was reduced from 8.5 to 3.5%. The amount of curative resections was 80%
      constantly. The incidence of local recurrence decreased from 18 to 12%, distant
      metastases however were observed twice as much during the last decade (16%) as
      compared to the first 10 years of the observation period. Longterm survival has
      only slightly improved, concerning mainly stage III patients with an increase of
      5-year-survival from 31 to 48%. The results of a rigorous follow up after surgery
      for colon and rectal carcinoma were disappointing.

PMID- 8484285
TI  - [Crohn disease: resection therapy over the course of two decades].
AB  - Between 1972 and 1992 394 bowel resections were performed on 344 patients with
      Crohn's disease at the Surgical University Hospital Mannheim. The aim of this
      retrospective study was to examine the changes in indication, surgical technique,
      complication rate and mortality during this period. With the increasing incidence
      of Crohn's disease, the yearly number of resections has increased (from 9.8 to
      30.8), while the frequency of emergency operations has declined (from 24.8% to
      15.4%). During the last ten years, surgery was performed at an earlier stage;
      more often stenoses were resected before complications (chronic or acute
      intestinal obstruction, fistula and perforation) occurred. Complication rate and
      mortality has been reduced in the last ten years (complication rate: from 35.6%
      to 10.6%, mortality: from 3% to 0.7%). A significant higher complication rate was
      seen after emergency operations (37.1%) as compared to elective operations
      (12.6%) (p < 0.0001).

PMID- 8484286
TI  - [Laparoscopic cholecystectomy--advantages and disadvantages].
AB  - From march 1990 to february 1992 we performed 600 laparoscopic cholecystectomies.
      In 18 cases we had to change to a laparotomy because of intraoperative problems,
      in 3 cases we had to laparotomise patients because of postoperative
      complications. 9 patients (1.5%) had a wound infection. In two prospective
      studies we could prove that patients after laparoscopic cholecystectomy have less
      pain and are in a better respiratory condition than after open cholecystectomy.

PMID- 8484287
TI  - [Chemoembolization of liver tumors (VX-2) using lyophilized Spherex].
AB  - Chemoembolisation is a new promising approach. Until now no standardized
      procedures exist for the production of the embolisate-cytostatics mixture. A main
      technical problem when doing chemoembolisation is the proof of the complete
      peripheral vascular occlusion. By using lyophilized Spherex and cytostatics,
      diluted in x-ray contrast media, frozen pictures can be obtained and the complete
      proof of the embolisation is possible. Therefore the conventional x-ray
      examination can be used to monitor the embolisation treatment instead of the much
      more sophisticated DSA technique.

PMID- 8484288
TI  - [The importance of lectins for formation of tumor metastases and bacterial
      infection processes].
AB  - Adhesion of bacteria and adhesion of tumor cells have much in common, especially
      the participation of lectins in this process. In the future it might be possible
      to inhibit the metastatic process into the liver (e.g. during surgical operations
      of malignant tumors) and bacterial adherence to mucosal linings or plastic
      devices by blocking of adhesion molecules (lectins) with appropriate
      glycoconjugates. Initial clinical trials are very promising.

PMID- 8484289
TI  - [Treatment principles of chronic recurrent elbow dislocation].
AB  - The chronic recurrent luxation of the elbow is a seldom event. The specific
      diagnostic uncovers the pathomorphology of the injury. Stabilization has to be
      carried out according to the pattern of injury. Clinical findings and treatment
      are described on the basis of three observed cases.

PMID- 8484290
TI  - [Acute upper gastrointestinal hemorrhage caused by ruptured aneurysm of the right
      gastroepiploic artery].
AB  - Visceral aneurysms are very rare (0.1% in autopsy-statistics). In our own review
      of literature we have found only 9 described cases of an aneurysm of the
      gastroepiploic artery. In the presented case an aneurysm was found when the
      patient developed an acute upper gastrointestinal bleeding. Due to the high risk
      of rupture (20% of all visceral aneurysms), which can be either
      intraperitoneally, intraluminally or into the satellite vein, the treatment
      should be surgically on finding.

PMID- 8484291
TI  - [Menetrier disease--a rare disease of the stomach].
AB  - The present reports on a 51-year-old patient who presented with weight loss,
      anaemia, hypoalbuminaemia and ankle oedema, and was referred for laparotomy by a
      radiologist on the grounds of suspected carcinoma of the stomach suggested by an
      upper gastrointestinal x-ray series. Surgery revealed excessively thickened rugae
      with gyrus-like, tortuous surface epithelium folds (histologically Menetrier's
      disease). A gastrectomy was performed, and the patient has been symptom-free and
      active ever since. In addition, the author presents a review of the literature
      published to date describing case reports of patients with Menetrier's disease.
      Menetrier's disease is a benign condition of the gastric mucosa in which gastric
      loss of albumin has been shown to be responsible for hypoalbuminaemia. The
      diagnostic procedure of choice is gastroscopy because upper gastrointestinal x
      ray series cannot distinguish between carcinoma of the stomach with certainty.
      Since this is a chronic disease that does not respond to medication, treatment of
      choice today is (partial) gastrectomy dictated by the extent and severity of the
      findings.

PMID- 8484292
TI  - Thalamic afferents of the rat barrel cortex: a light- and electron-microscopic
      study using Phaseolus vulgaris leucoagglutinin as an anterograde tracer.
AB  - Anterograde tracers, Phaseolus vulgaris leucoagglutinin (PHA-L) and horseradish
      peroxidase (HRP), were used to study the thalamocortical afferents of the
      posteromedial barrel subfield (PMBSF) in rat primary somatosensory cortex (SI) at
      both light- and electron-microscopic levels. The PMBSF, also known as the barrel
      cortex, can be subdivided into barrel and interbarrel areas on the basis of
      cytoarchitectonic characteristics. Restricted injections confined to either the
      ventroposterior medial (VPM) or the rostral part of the posterior (Pom) nucleus
      allowed us to study and compare their projection patterns to the barrel cortex.
      We found that the interbarrel area receives inputs exclusively from the Pom,
      whereas the barrel area receives inputs from both the Pom and VPM. The laminar
      distributions of these two projections are largely segregated. After an injection
      of PHA-L or HRP into the VPM, labeled bouton-like swellings are found in layer VI
      and in layers IV through I of the barrel area, with the highest concentration in
      layer IV. On the other hand, after an injection of PHA-L or HRP into the Pom,
      labeled bouton-like swellings are distributed from upper layer V to layer I of
      the interbarrel area, as well as in layers V and I of the barrel area.
      Ultrastructural analysis showed that labeled bouton-like swellings of the VPM and
      the Pom pathways make synaptic contacts onto cortical neurons, and that these
      contacts are asymmetrical. Therefore, the VPM and the Pom projections are
      complementary to each other in the barrel cortex, and together they provide
      thalamic inputs to most layers of both the barrel and interbarrel areas. The
      differential patterns of terminations of the VPM and the Pom projections in the
      barrel cortex suggest that they may be involved in different types of cortical
      processing. Furthermore, our present findings may provide the anatomical basis
      for two parallel thalamocortical pathways, which previous physiological studies
      have indicated are each concerned with particular submodalities of somatic
      information.

PMID- 8484293
TI  - Finger movement deficits in the stumptail macaque following lesions of the
      fasciculus cuneatus.
AB  - Four stumptail macaques were trained to perform a key press with the index finger
      without associated movement of the adjacent (third) finger. Successful
      performance on this task required selective control over one finger
      (fractionation) and differential activation of muscles producing flexion or
      extension at different joints (multiarticulation). Following section of the
      fasciculus cuneatus (FC), a number of enduring deficits in finger movement
      capacities were observed. Over test periods of up to 2 years, fractionated key
      presses with the index finger could not be made, and the combination of flexion
      at the proximal joint with extension at the distal joints was absent.
      Coarticulated flexion at all the joints of each finger was substituted for the
      original multiarticulated, fractionated movements. We conclude that previous
      failures to observe impairments of finger movements following section of the
      dorsal columns (DCs) have resulted from the use of tasks that permit response
      substitution and therefore do not isolate specific movements for observation.

PMID- 8484294
TI  - Multidimensional scaling of painful electrocutaneous stimulation: INDSCAL
      dimensions, signal detection theory indices, and the McGill Pain Questionnaire.
AB  - Individual-differences multidimensional scaling (INDSCAL) determined the
      dimensions underlying ratings of electrocutaneous stimuli, which ranged from
      innocuous levels to individual pain intolerance at each of three frequencies.
      Twenty-five healthy males made pairwise similarity judgments of these 15 stimuli
      for the INDSCAL procedure, and then rated each stimulus on nine property scales.
      Signal detection theory indices, as well as ratings on the McGill Pain
      Questionnaire (MPQ), were also obtained. A Sensory Magnitude dimension scaled the
      stimuli from lowest to highest perceived intensity; this dimension was related to
      sensory, affective, and arousal property scales. A Frequency dimension ordered
      the stimuli from lowest to highest frequency; this dimension was related to the
      Fast-Slow property. Compared to the Frequency dimension, the Sensory Magnitude
      dimension was more salient to subjects who better discriminated among painful
      stimulus intensities, set a more stoical pain report criterion, and were less apt
      to endorse frequency-related MPQ descriptors. Thus, variation of physical
      intensity and frequency elicited complementary dimensions of subjective judgment,
      which were related to perceptual and attitudinal differences among individuals.

PMID- 8484295
TI  - Effects of baroreceptor stimulation on sensorimotor control of the hand.
AB  - Finger movements are presumed to be controlled by somatosensory and motor areas
      of neocortex via the corticospinal tract. Since baroreceptor activation appears
      to reduce central nervous system activity, an effect on sensorimotor control
      during precise manual manipulations is expected. To test this hypothesis, motor
      responses to slow and fast perturbations during grasping of a small object
      (precision grip) were examined. Baroreceptor activation was manipulated with the
      phase-related external suction (PRES) technique, which allows the application of
      baroreceptor stimulation and control conditions in a well-controlled and
      indiscernible way. Motor reactions following slow perturbations were influenced
      in the expected way in good-performance subjects. The time to stop slow
      perturbations was longer and the electromyographic (EMG) activity of the small
      thumb muscles was lower during baroreceptor stimulation than in the control
      condition. These effects did not appear in the fast-perturbation task. Fast
      perturbations were followed by EMG activity onset after about 50 msec, which
      indicates that a prominent part of the EMG activity must be attributed to a more
      automatic motor response. EMG activity following slow perturbations began after
      about 90 msec, and it may be assumed that these motor reactions are primarily
      under voluntary control. The fact that we found effects of baroreceptor
      stimulation in slow but not in fast perturbations could have been caused by at
      least partially different pathways utilized for automatic versus voluntary motor
      responses, which seem to be differentially vulnerable to baroreceptor activation.
      An electrocortical sign that precedes voluntary movements is the
      Bereitschaftspotential, or readiness potential. Since this potential is a slow
      brain potential, and baroreceptor activation is known to reduce slow brain
      potentials, it is plausible that baroreceptor activation primarily affects motor
      responses following slow but not fast perturbations.

PMID- 8484296
TI  - Modulation of sustained electromyographic activity by single intracortical
      microstimuli: comparison of two forelimb motor cortical areas of the rat.
AB  - In rats, a rostral and a caudal forelimb motor area (RFA and CFA, respectively)
      have been distinguished on the basis of intracortical microstimulation effects
      (see Neafsey et al., 1986, for a review). The goal of the present study was to
      assess and compare their relative connectional strength with target motor units
      of the forelimb. This was achieved by averaging modulation responses of sustained
      electromyographic (EMG) activity triggered by single intracortical microstimuli
      (S-ICMS) of relatively low intensity (mostly below 35 microA) to minimize both
      direct and transsynaptic current spread. In chronically prepared and ketamine
      sedated rats, this method produced prominent peaks and troughs in the averaged
      EMG at short latencies with S-ICMS currents as low as 5 microA. S-ICMS at 30-50
      microA in CFA sometimes even elicited visible twitches and an EMG burst of the
      contralateral wrist or digits following each stimulation pulse. Increasing S-ICMS
      currents to about 1.5 mA revealed a sudden shortening of EMG response latencies,
      which was most likely induced by current spread to brainstem motor centers. S
      ICMS at near-threshold intensity in the majority of effective sites in both CFA
      and RFA produced modulation responses in more than one group of forelimb muscles,
      frequently also including muscles of the ipsilateral forelimb. Usually the
      ipsilateral responses were weaker, as were the suppression effects. Comparison of
      CFA and RFA revealed similar effects in terms of the number of modulated muscle
      groups and the response latencies. In contralateral wrist/digit muscles,
      facilitation responses were elicited at latencies of 9.7 +/- 1.8 msec (CFA) and
      9.6 +/- 1.9 msec (RFA), with the shortest latencies around 6 msec. However,
      modulations by S-ICMS in RFA had significantly smaller amplitudes, had slower
      rates of buildup, and required higher thresholds than those obtained from S-ICMS
      in CFA. It is concluded, on the basis of the S-ICMS method, that both the CFA and
      the RFA exert a prominent and relatively direct influence on forelimb
      motoneurons. The present findings, together with calculations of conduction time,
      suggest that a contingent of corticospinal axons of the rat has oligosynaptic and
      possibly even monosynaptic connections with forelimb motoneurons. The recruitment
      of a relatively large number of muscles, including those of the ipsilateral
      forelimb, by S-ICMS in both areas may be explained by the prominent divergence of
      corticospinal axons. Further investigations are required to understand the
      relative positions and roles of the two areas in motor control and their possible
      homology with primary and nonprimary motor areas of primates.

PMID- 8484297
TI  - The relationship between skin compliance, age, gender, and tactile discriminative
      thresholds in humans.
AB  - Earlier research has suggested that tactile sensitivity, like visual and auditory
      acuity, may decrease with increasing age. But are decrements in tactile
      sensitivity attributable to changes in the nervous system, or simply to
      alterations in the mechanical properties of the skin? In the present study, skin
      compliance and discriminative thresholds for two-point and gap stimuli were
      measured on the pad of the left index finger of 102 persons ranging in age from
      18 to 84 years. For both types of stimuli, age was found to be a significant
      predictor of tactile sensitivity, even when skin compliance and gender were
      controlled. The relationship between increasing age and decrements in tactile
      discrimination is apparently not attributable to changes in the mechanical
      properties of the skin, but to other factors, which may include changes in the
      nervous system affecting the speed, quantity, or quality of information
      processing.

PMID- 8484298
TI  - The immediate effects of peripheral denervation on inhibitory mechanisms in the
      somatosensory thalamus.
AB  - Multiunit recordings were made in the ventroposterior lateral nucleus of the
      thalamus in anesthetized raccoons. During recording from cells responding to
      cutaneous stimulation of a forepaw digit, the corresponding digit was denervated
      permanently (by cutting its four digital nerves) or temporarily (by injecting
      lidocaine into the base of the digit). Both procedures resulted in immediate
      increases in the inhibition that could be induced by stimulation of the adjacent
      digits when the original cutaneous receptive field was on the glabrous skin. In
      each case with temporary denervation, this enhanced off-focus inhibition
      decreased when the excitatory responses returned to normal. In contrast,
      temporary denervation of the digit during recording at sites in the hairy skin
      representation did not reveal this increased inhibition from adjacent digits.
      When capsaicin was applied to the digital nerves in two animals, the excitatory
      receptive fields of thalamic neurons increased in area, but were still restricted
      to the same part of the digit. These data indicate that the immediate unmasking
      of inhibitory responses, previously reported in primary somatosensory cortex of
      the raccoon, is also present in the thalamus. The capsaicin-induced expansion of
      excitatory receptive fields confirms previous experiments in other species, and
      suggests that C fibers play a role in modulating the size of cutaneous receptive
      fields. However, the enlargement of excitatory receptive fields by capsaicin is
      much less than the unmasking of inhibitory fields induced by digit denervation,
      and indicates that different mechanisms are involved in controlling these various
      inputs to thalamic neurons.

PMID- 8484300
TI  - Nursing in Texas--a personal account.

PMID- 8484299
TI  - Effects of dorsal root cut on the forces evoked by spinal microstimulation in the
      spinalized frog.
AB  - Spinalized frogs were microstimulated in the intermediate grey layers of the
      lumbar spinal cord; the forces evoked in the hindlimb were measured at several
      limb positions. The data were expressed as force fields. After the collection of
      many force fields, the dorsal roots were cut with the stimulating electrode in
      place, and the position-dependent stimulation-evoked forces were again measured
      repeatedly. We found that the position-dependent pattern of evoked forces--the
      force fields--did not change after the dorsal roots were cut. In other words, the
      postcut evoked forces pointed in the same direction as the precut evoked forces.
      This result was predicted and confirmed by the muscle activations (EMGs): Before
      and after the dorsal roots were cut, the same muscles were activated in the same
      proportions. In all limb positions, the rank ordering of the muscle activations
      remained fixed. The stimulation needed to evoke forces was increased by
      deafferentation, and there were subtle changes in the force magnitudes that were
      consistent with a linearization of the muscle stiffness by the afferents. We
      conclude that the microstimulation activated specific muscle synergies that
      resulted in limb forces pointing toward a particular posture. The patterns of
      evoked forces were predominantly attributable to feedforward activation of these
      muscle synergies.

PMID- 8484301
TI  - Helpful information for members considering employment outside Alberta.

PMID- 8484302
TI  - PARTY in Central Alberta.

PMID- 8484303
TI  - Needlestick injuries--cause for concern!

PMID- 8484304
TI  - Nursing research: an opportunity to improve.

PMID- 8484306
TI  - Pain corner. Analgesics: alternate routes.

PMID- 8484305
TI  - Breastfeeding tidbits: nipple candidiasis in the breast feeding mother.

PMID- 8484307
TI  - Edmonton's short stay maternity program.

PMID- 8484308
TI  - Cost-saving idea.

PMID- 8484309
TI  - On reading and writing journal articles.

PMID- 8484311
TI  - Holistic nursing: educational kinesiology.

PMID- 8484310
TI  - Taking political action.

PMID- 8484312
TI  - [Severe and chronic lateral sprains of the wrist with axial deviation, and their
      treatment].
AB  - Firmly established lateral carpal instability may be practically corrected by a
      ligamentoplasty of the distal scaphoidal ligamentous complex. It may be entirely
      and definitively cured by a double ligamentoplasty of the distal scaphoidal
      complex and of the scapholunate ligament. Four cases with a postoperative follow
      up of more than 2 years are presented.

PMID- 8484313
TI  - The clinical use of pedobarography.
AB  - Several years' experience with different pedobarograph systems has demonstrated
      that foot pressure measurements can be used as a clinical tool. This tool can aid
      a surgeon's decision making, but it cannot be used diagnostically in isolation
      from clinical data. The clinical uses are both direct and indirect. The direct
      uses can be summarized as follows: to assess the effect of treatment by
      examination before and after a surgical procedure; to monitor progress by means
      of sequential measurements and to design and assess the effectiveness of
      orthoses. These uses are demonstrated with reference to a number of studies of
      normal subjects compared to patient groups using the dynamic pedobarograph.
      Indirect uses come from the growing body of knowledge emerging from laboratories
      using this equipment for research. This is helping us to understand weightbearing
      foot function both in health and disease. Clinicians intending to invest in the
      equipment can also obtain useful guidelines on the reliability of the different
      systems and measurements and best ways to standardize methodology. Some examples
      of these indirect uses are illustrated with results from studies using the
      dynamic pedobarograph and the EMED F system.

PMID- 8484314
TI  - Extensive vertebral hydatidosis. A study.
AB  - An exceptional case of vertebral hydatidosis with involvement of the cervical,
      dorsal, lumbar and sacral segments of the spine is presented. Vertebral
      hydatidosis is a rare form of hydatid disease. It is found in less than 2% of all
      cases in echinococcosis. The initial parasite localization is usually
      univertebral. Extensive primary lesions were related to massive infestation by
      tapeworm ova at multivertebral levels. At this stage, the disease presents as a
      malignant tumor resistant to all surgical procedures. The prognosis is poor
      because of severe neurological complications and inexorable spinal destruction.
      The hope remains that in the future an effective medical parasiticidal treatment
      will be available.

PMID- 8484315
TI  - Fracture-dislocation of the hamatometacarpal joint. A case report.
AB  - A case of carpometacarpal dislocation involved dorsal dislocation of the fourth
      and fifth metacarpal, associated with a fracture of the hamate. Reduction and Ki
      wire fixation resulted in good hand function.

PMID- 8484316
TI  - Isolated posterior dislocation of the radial head without fracture of the ulna in
      a child.
AB  - An isolated posterior dislocation of the radial head is a rare injury. We present
      a case report on an 11-year-old boy with a traumatic posterior radial head
      dislocation without fracture or bending of the ulna. The diagnosis can be
      difficult and should be supported with good radiographic images, since clinically
      the injury can be missed or misdiagnosed.

PMID- 8484317
TI  - Fractures of the odontoid process. Conservative and operative treatment.
      Prognostic factors.
AB  - In a retrospective study 33 fractures of the dens were analyzed. Nonoperative
      treatment was successful in types I and III, but unsuccessful in 48.5% of type II
      fractures. In addition to the poor outcome factors of Schatzker, the
      classification of Roy-Camille is a valuable prognostic factor.

PMID- 8484318
TI  - [Treatment of trochanteric fractures of the femur using the gamma nail (apropos
      of a series of 92 cases)].
AB  - The authors treat inter- and subtrochanteric fractures with the Gamma nail. This
      device, which can be placed through the skin, immediately gives a stable internal
      fixation and offers possibilities of compression during and after surgery without
      any risk of head perforation. The authors discuss the results and complications
      of 92 operated cases reassessed after a delay of 6 to 28 months. The average age
      was 78 years, and 95% of the patients had been injured in home accidents. The
      surgical technique must be strict. Weight-bearing is complete 48 hours
      postoperatively, whatever the type of fracture, in 82% of the patients. Early
      standing postoperatively has allowed a definitive reduction in the general
      complications which are otherwise frequent in this type of fracture. The authors
      analyze the various complications they experienced during and after the surgery.
      Six complications during surgery have been noted and result from technical
      errors. These include 4 diaphyseal fractures, one case of reamer breakage and one
      case of drill breakage. Thirteen complications occurred after surgery: 3
      diaphyseal fractures, 3 loose screws, one pseudarthrosis and 6 painful diaphyses.
      The authors also noted that painful diaphysis occurs when the cervical diaphysis
      angle of the nail is greater than 130 degrees.

PMID- 8484319
TI  - [Osteosynthesis of fractures of the trochanteric region using the gamma nail,
      apropos of 76 reviewed cases].
AB  - The authors present 76 cases of trochanteric fractures, treated by a Gamma nail.
      The minimal follow-up was 6 months, with clinical and roentgenographical check
      ups. The mean age was 74 years, with a female majority as classically; the most
      common cause was a simple fall. Unstable fractures represented 53% of the cases,
      with 39% subtrochanteric; nevertheless, full weight bearing was possible in 83%
      of the cases. The mechanical complications of this new technique have been
      studied in details and compared with other most common methods of osteosyntheses:
      the Ender rod and the sliding screw plate. The Gamma nail shows an uncontestable
      superiority compared to Ender's rods, but it has little advantage to D.H.S.
      T.H.S., particularly because of the delay in full-weight bearing and deep
      infection rate. The Gamma nail moreover seems to be better adapted for the
      treatment of subtrochanteric fractures.

PMID- 8484320
TI  - The Geomedic knee prosthesis. A long-term follow-up study.
AB  - A retrospective long-term follow-up study of 189 Geomedic total knee
      arthroplasties in 143 patients was performed. One hundred and eighteen knees were
      replaced in patients with rheumatoid arthritis and seventy-one knees were
      replaced in patients with osteoarthritis. Fifty-seven knees were examined
      clinically with an average follow-up of 11 years. Seventy percent of these knees
      were painless. Lucent lines at the tibial bone-cement interface were observed in
      62% of the follow-up radiographs (81 knees, mean follow-up: 10.5 years). Thirty
      four prostheses (18%) were removed, with loosening of the tibial component as the
      main cause. Retropatellar pain was not a significant problem. The 13-year
      survival rate was 78%, with implant removal as an endpoint. Radiographically
      loosened components included, the 13-year survival rate was 58%.

PMID- 8484321
TI  - Results of excision of calcaneal prominence.
AB  - Calcaneal prominence in 22 patients (37 heels) with moderate-to-severe symptoms
      was treated by excision after a minimum of 6 months of conservative treatment.
      There were 21 good, 12 fair and 4 poor results. Calcaneal exostectomy is a useful
      procedure in carefully selected patients.

PMID- 8484322
TI  - [Hospital management and short-term outcome of the severely injured: Lausanne
      experience].
AB  - Several physiological and anatomical methods of scoring severely injured patients
      have been developed since the 1970s, based on very large series of patients. In
      this study, 59 patients are assessed by the ISS (Injury Severity Score) and the
      RTS (Revised Trauma Score). The mean ISS is 28, and the mean RTS is 6; the
      overall evolution shows a 42.4% mortality. Analysis by the TRISS method shows 12
      out of 18 "unexpected" deaths, the majority of which can be explained by the fact
      that the ISS underestimates severe neurological trauma, and that the RTS is not
      consistently obtained in the early patient notes in our emergency care system.

PMID- 8484323
TI  - Split skin grafting of defects from fasciotomy after compartment syndrome.
AB  - Proper treatment of compartment syndrome is fasciotomy. Secondary skin defects
      often complicate the course and require skin-grafting procedures. The present
      investigation is a retrospective study based on 17 fasciotomies. Their courses
      are reported, and the possibility of primary skin excision with the purpose of
      delayed grafting is demonstrated. This procedure would probably reduce the number
      of hospital days and the number of surgical procedures.

PMID- 8484324
TI  - [Review of 19 cases of dislocation and fracture-dislocation of the cervical spine
      treated with anterior screw plates without intersomatic graft].
AB  - In comparison to posterior fixation by Roy-Camille plates which does not require
      bone grafting, 19 cases of anterior plate fixation, also without bone grafting,
      are presented (11 dislocations, 2 severe sprains, 4 fracture-dislocations and 2
      "tear-drop" fractures of the lower cervical spine). A satisfactory
      osteoligamentary consolidation was obtained in every patient. The advantages of
      this technique are discussed.

PMID- 8484325
TI  - Osteogenic sarcoma in children. A retrospective study of 58 cases.
AB  - Fifty-eight children between age 6 and 18 years were treated for osteogenic
      sarcoma in the period 1962 to 1987. Fifty-one patients with no preoperative
      pulmonary metastases (group A) had an overall 5-year survival rate (T5) of 41%;
      they were subdivided into three subgroups. In subgroup A1 treated with surgery
      and/or radiotherapy (15 cases), the 5-year survival rate (T5) was 33.3%, as in
      the classical historical series. In subgroup A2 treated with surgery and
      postoperative chemotherapy (19 cases) the T5 was 38.8%. In subgroup A3 treated by
      surgery and pre- and postoperative chemotherapy (17 cases) the T5 was 66.6%,
      which was statistically the best therapy (p < 0.5). This confirms the general
      trend in orthopedic oncology. Further data proved the negative prognostic value
      of male sex, while the grade of tumor and the surgical margins were important
      factors, but not statistically significant. Seven patients with preoperative
      metastases (group B) had a T5 of 0%.

PMID- 8484326
TI  - [Effect of a valgization osteotomy with external wedge removal on patellar height
      and femoro-patellar arthritis].
AB  - This retrospective study assesses the effect of proximal tibial lateral closing
      wedge osteotomy on the patellar height and patellofemoral osteoarthritis. This
      osteotomy was performed on 59 knees (53 patients) for medial gonarthrosis. No
      cast immobilization was used. The patients presented a mean varus deformity of
      9.4 degrees before surgery and a mean valgus angulation of 4.2 degrees at maximum
      follow-up. The theoretical effect of the osteotomy was evaluated using a
      geometrical model. The actual effect was evaluated using Caton's index which was
      measured 3 times (before the osteotomy, after one day and with a mean follow-up
      of 24.8 months after the osteotomy). The theoretical measure showed an increase
      in the patellar height. Conversely, in the patients, the measured Caton's index
      did not significantly increase (0.85 to 0.835) (epsilon = 0.882; risk = 5%)
      because of shortening of the patellar ligament. Clinical improvement in the
      patellofemoral compartment was noted. No radiological progression of the
      arthritis occurred in the patello-femoral compartment. We advocate proximal
      tibial lateral closing wedge osteotomy to treat femoro-tibial osteoarthritis in
      patients with femoropatellar osteoarthritis or with patella infera.

PMID- 8484327
TI  - Secondary chondrosarcoma. Four cases and review of the literature.
AB  - The authors present four new cases of chondrosarcoma secondary to multiple
      osteochondromatosis (MOC). As MOC is a familiar and hereditary condition, the
      patients should be evaluated throughout their lives, from childhood to adulthood.
      Because of the risk of malignant transformation in this condition, any adult
      patient complaining of pain and excessive increase in tumor size should be
      investigated for sarcomatous degeneration. Wide resection, when possible, must be
      the elected treatment in this type of patient, in order to avoid the risk of
      local recurrence.

PMID- 8484328
TI  - [Villonodular synovitis of the large joints].
AB  - The authors report 11 cases of villonodular synovitis of large joints. The
      problems, related to diagnosis and treatment, are discussed. The results are
      satisfactory when a total synovectomy is performed early, before any joint damage
      occurs.

PMID- 8484329
TI  - En-bloc resection of the distal fibula for aneurysmal bone cyst.
AB  - A 21-year-old woman who presented with a voluminous aneurysmal bone cyst in the
      distal left fibula was treated with en-bloc resection. After 30 months of follow
      up, the stability and range of motion of the left ankle were similar to that of
      the contralateral ankle.

PMID- 8484330
TI  - [Sacrococcygeal teratoma in adults].
AB  - This report describes a case of sacrococcygeal teratoma, a rare pathology
      belonging to the group of presacral tumors. Its clinical presentation is very
      variable. In this case, the tumor presented as a pilonidal cyst, which is an
      atypical form. The teratoma was associated with a spinal malformation, described
      in 25% of all cases. It was treated by "en bloc" resection with sacrectomy.

PMID- 8484331
TI  - A case of stenosing peroneal tendovaginitis.
AB  - At the foot and ankle, stenosing peroneal tendovaginitis has only rarely been
      described in literature. The superior and inferior peroneal retinacula, however,
      may cause symptoms of stenosis similar to other tendons in the foot and the hand.
      A case of a forty-three year-old woman is presented, where posttraumatic
      stenosing peroneal tendovaginitis caused sudden pain on supination of the foot.
      Nodular tendon swelling was present on a preoperative CT-scan. The condition was
      treated successfully by transsection of the peroneal retinacula.

PMID- 8484332
TI  - [Acute osteomyelitis of the patella].
AB  - The authors report on an observation of acute osteomyelitis of the patella in a
      non-sickle-anemic 8-year-old child. The literature helps confirm the scarcity of
      the disease, the difficulties of diagnosis and the good prognosis of the lesion
      in the child.

PMID- 8484333
TI  - Cytometric analysis of testicular seminoma and spermatocytic seminoma.
AB  - DNA analysis of testicular seminoma (typical seminoma [TS] and anaplastic
      seminoma [AS]) and spermatocytic seminoma (SS) was performed to evaluate the
      relationship between the proliferative activity and clinical outcome, and also to
      determine the proliferative characteristics of SS. Nuclear DNA contents of 15
      cases of TS, 17 of AS and three of SS were measured by flow cytometry.
      Cytofluorometric DNA analysis was performed on three cases of every tumor. All 35
      cases showed aneuploidy in the flow cytometry. In comparison with TS, AS tended
      to have a higher percentage of G2M phase in one cell cycle, having more cell
      cycle numbers and containing cells of various DNA values. Many mitotic figures
      with larger atypical cells that characterize AS could be explained by these
      results. In SS, the diploid formation by the small cells and the appearance of
      large cells with a maximum DNA value of 40C were demonstrated. These ploidy
      characteristics were considered to result in the morphological expression of
      large, small and intermediate cells. The application of both flow cytometry and
      cytofluorometry to the same cases was beneficial.

PMID- 8484335
TI  - Pulmonary hypertension due to tumor emboli: a report of three autopsy cases with
      morphological correlations to radiological findings.
AB  - Three cases of pulmonary hypertension caused by tumor emboli to the lungs are
      described. Two of the three cases had a clinical diagnosis of pulmonary
      thromboembolism until surgical embolectomy, and the other had a diagnosis of
      primary pulmonary hypertension. Autopsy disclosed chondrosarcoma, choriocarcinoma
      and gastric cancer as the primary tumors, respectively. Pulmonary vascular
      obstruction due to tumor embolism leading to pulmonary hypertension is a
      previously rare clinical entity, and obstructed pulmonary vessels are believed to
      tend to be small vessels. We compared the autopsy and radiological findings and
      concluded that pulmonary tumor embolism involved not only the small peripheral
      arteries but also the segmental and/or lobar arteries.

PMID- 8484334
TI  - Extracranial meningioma in the parapharyngeal space.
AB  - A case of extracranial meningioma in the parapharyngeal space is reported. A 24
      year old woman presented with swelling and tenderness of the parapharyngeal
      region. A tumor was palpable in this region, and the tumor was surgically
      removed. Macroscopically the tumor occurred from the portion between the axis and
      atlas. Histologically the tumor cells, which had oval nuclei and a slightly
      eosinophilic cytoplasm, proliferated in fibrous connective tissues to form small
      nests. As the cell borders were not clear, the tumor structure appeared to be
      syncytium-like. Immunohistochemically the tumor cells were positive for anti
      vimentin antibodies, anti-S-100 protein antibodies and anti-epithelial membrane
      antigen (EMA) antibodies in part. Electron microscopically the tumor cells had
      complex interdigitations of their adjacent plasma membranes. These were studded
      with many desmosomes. Bundles of intermediate filaments were visible in the
      cytoplasm. On the basis of the clinical, histological, immunohistochemical and
      electron microscopical features, the tumor was diagnosed as extracranial
      meningotheliomatous meningioma. The parapharyngeal space is an extremely rare
      location for extracranial meningioma, and our case is the first in Japan as far
      as we know.

PMID- 8484336
TI  - Selective zonal change of the renomedullary interstitial cells in hypokalemic
      rats.
AB  - Electron microscopic morphometry was undertaken to quantitate the morphological
      change of the renomedullary interstitial cells (RIC) of hypokalemic rats by using
      large montages. Two weeks of potassium depletion resulted in an increase of the
      RIC, which were restricted to the interbundle region of the inner stripe of the
      outer medulla. The increase of the RIC is characterized by a preferential
      increase in volume density (+340.0%; P < 0.01) and numerical density (+61.4%; P <
      0.01) in the interbundle region but not in the vascular bundle of the inner
      stripe or in the inner medulla. The increased RIC in the interbundle region of
      the inner stripe demonstrated an increase of lipid droplets, which are known to
      contain prostaglandin precursors. The selective zonal change of RIC with
      increased lipid droplets is a characteristic lesion of hypokalemic rats and
      suggests an enhanced vasoactive function of RIC associated with hypokalemic
      nephropathy.

PMID- 8484337
TI  - Localization of E-cadherin adhesion molecules in human gingiva and gingival
      carcinoma.
AB  - Immunohistochemical investigations were carried out on the localization and
      expression of the Ca(2+)-dependent intercellular adhesion molecule E-cadherin in
      human gingiva and gingival carcinoma. Although E-cadherin did not appear in the
      parakeratinized layer of either clinically healthy or inflamed gingiva, it did
      appear strongly in the prickle layer and somewhat more weakly in the basal layer.
      Immunogold particles reactive to anti-E-cadherin monoclonal antibody in the
      electron microscopic findings were localized only in the vicinity of the
      desmosomes of the prickle and basal layers. In the case of gingival carcinoma,
      although E-cadherin was strongly expressed in the cells surrounding the
      keratinized region in the cancer nests, the expression decreased towards the
      marginal portion of the cancer nests. The distribution of E-cadherin in these
      cells may be dependent on the condition of the cancer cells that are potentially
      invasive. These findings suggest that cells of the parakeratinized layer of
      gingiva and cells of the marginal portion of the gingival carcinoma nests may
      easily detach or invade. In addition, the findings suggest that the gingival
      carcinoma used in this study tended to be invasive.

PMID- 8484338
TI  - Measurement of subjective phenomena in primary care research: the Visual Analogue
      Scale.
AB  - The visual analogue scale is a technique used to measure subjective phenomena. It
      is a self-reporting device consisting of a line of predetermined length that
      separates extreme boundaries of the phenomenon being measured. The purpose of
      this review is to report on the characteristics of the visual analogue scale
      technique, including its reliability, validity, accuracy, and scale value. This
      review presents several examples of the usefulness of the visual analogue scale
      technique in primary care research projects, describes its advantages and
      limitations, and presents suggestions for constructing visual analogue scales.

PMID- 8484339
TI  - Provider confidence in breast examination.
AB  - Many physicians have reported interest in further training in clinical breast
      examination, and it has been speculated that health care providers may lack
      confidence in their breast examination skills. At a multisite family practice
      residency, we surveyed a group of physicians and nurse practitioners about
      confidence in clinical breast examination. Forty-three percent of respondents
      reported impairment of the clinical breast examination by lack of confidence in
      skills, and 50% reported feeling only "somewhat" or "moderately" confident in
      their clinical breast examination skills. Residents often reported encountering
      few patients with breast lumps; experience with breast lumps was associated with
      reported confidence in the clinical breast examination. To improve and maintain
      breast palpation confidence and skills, residents and practicing physicians need
      longitudinal educational programs.

PMID- 8484340
TI  - Evolving colonoscopy skills in a rural family practice: the first 293 cases.
AB  - During the 1980s, many family physicians acquired flexible sigmoidoscopy skills
      for the early detection and secondary prevention of colorectal cancer. As these
      skills have matured, some family physicians have advanced from flexible
      sigmoidoscopy to the performance of colonoscopy. This is a descriptive report of
      this phenomenon from the private practice of one family physician. The first five
      years of total colonoscopy experience (293 procedures) were analyzed. No
      complications were encountered. A learning effect (measured in terms of scope
      depth and anatomical depth) was present during the first 50 procedures; an
      improvement in examination depth between the 25th and 50th procedure was present.
      Previous abdominal surgery had an effect on limiting scope-insertion depths.
      There were no complications, and among sedated patients, 137/253 (54%) of
      procedures reached the cecum. Important findings included cancer, polyps, and
      colitis. Twenty-seven percent (9/34) of important pathological findings were
      located beyond the reach of the 60 cm sigmoidoscope. This study of full
      colonoscopy in private family practice suggests it is safe, and the diagnostic
      yield is substantial. Additional studies by family physicians are needed
      regarding technique, quality assurance, and patient satisfaction.

PMID- 8484341
TI  - Diabetic limb infections: identification of microorganisms and selection of
      treatment.
AB  - Polymicrobial lower limb infections are common complications among diabetic
      patients, yet their antimicrobial management remains mostly empiric. A
      retrospective study of the clinical circumstances of 74 patients accounting for
      101 hospital admissions was performed. Risks for vascular disease, clinical and
      microbiologic evidence for infection, as well as antimicrobial drug selection in
      these patients, were compiled. Culture materials were obtained from either swab
      or incision and drainage techniques in 65 (64.4%) patients. Eighty-two (81.2%)
      patients received antimicrobial therapies. Of the 172 antimicrobial agents
      prescribed, cephalosporins were utilized 83 times. Twenty-nine (28.7%) patients
      received amputations. Average total hospital charges were $7,368 per hospital
      stay, $485 per day.

PMID- 8484342
TI  - Public perceptions of radon risk.
AB  - Since 1984, a significant amount of media attention has focused on health threats
      from radon gas exposure. Using a probability telephone survey of adults (n =
      685), we studied public perceptions of risk from radon exposure versus other
      environmental health risks. The results indicated that 92% of those individuals
      who had heard of radon believe radon to be a health risk, although only 4%
      believe they are currently exposed to high levels of radon gas. Perception of
      risk from radon was positively related to other perceptions of environmental
      risks. Younger and less educated individuals were more likely to perceive radon
      as a health risk. Women were three-and-one-half times as likely as men to
      perceive risk from radon. However, there was no significant relationship between
      perceived risk from radon and cigarette smoking. Media attention has apparently
      led to public awareness of radon hazards, but further attention is needed to
      improve smokers' awareness of their special risks from radon.

PMID- 8484343
TI  - Family practice research in Spain.

PMID- 8484344
TI  - A pilot study of white-coat and labile hypertension: associations with diagnoses
      of psychosocial dysfunction.
AB  - Variable blood pressure responses, manifesting either as a "white-coat"
      phenomenon or lability between office visits, confound hypertension management
      decisions. An attempt was made to determine whether these phenomena are
      associated with concurrent diagnoses of psychosocial dysfunction, therefore
      mitigating against antihypertensive medical therapy. Forty-seven patients with
      such variable blood pressure responses were identified in a rural family practice
      over a three-year period and compared to randomly selected age- and sex-matched
      controls for the following concurrent diagnoses: generalized anxiety, psychogenic
      spastic bladder, panic disorder, depression, alcohol use, chronic headache,
      fibromyalgia, temporomandibular joint syndrome, irritable bowel syndrome, and
      premenstrual syndrome. No statistical associations between white-coat
      hypertension and these diagnoses were demonstrated although a small sample size
      tempers conclusions. However, chi-square analysis (P < 0.01) of the phenomenon
      characterized by lability of blood pressure between different office visits
      demonstrated a statistical association with alcoholic hepatitis in men. White
      coat hypertension is a diagnosis that may warrant disassociation from other
      psychosocial disorders, although further study is indicated. Physicians should
      remain attuned to the presence of lability of blood pressure in males and
      consider possible associations with alcoholism.

PMID- 8484345
TI  - Differentiation of physical and psychological fatigue.
AB  - Although chronic fatigue is a common complaint in family practice, little
      research has focused upon differentiating physical causes from psychological
      causes based upon historical information. This pilot study was conducted to
      determine whether psychological and fatigue scales could be used to identify
      potential causes, and to assess the utility of using fatigue characteristics to
      distinguish psychological from physical fatigue. Family health center patients
      were randomly selected and interviewed for the presence of fatigue. Those with
      significant fatigue were asked to participate in a structured, in-depth interview
      concerning fatigue characteristics, psychiatric conditions, and symptom
      checklists. Of 248 patients interviewed, 17 (6.9%) had fatigue. Fourteen patients
      had at least one psychiatric disorder. Fatigue severity correlated with
      depression severity in depressed patients (r = 0.83, p < 0.02) and with severity
      of phobic anxiety (r = 0.55, p < 0.1) in panic attack patients. However, fatigue
      characteristics generally did not differentiate between those with and without
      associated psychological disorders.

PMID- 8484346
TI  - Whole language.

PMID- 8484347
TI  - Constraints on communication in classrooms for the deaf.
AB  - One explanation for the relatively low scholastic achievement of deaf students is
      the character of communication in the classroom. Unlike aural communication
      methods, line-of-sight methods share the limitation that the receiver of the
      message must look at the sender. To assess the magnitude of this constraint, we
      measured the amount of time signers were looked at by potential receivers in
      typical secondary school classes for the deaf. Videotaped segments indicated that
      on average the messages sent by teachers and students were seen less than half
      the time. Students frequently engaged in collateral conversations. The
      constraints of line-of-sight communication are profound and should be addressed
      by teaching techniques, classroom layout, and possibly, the use of computer
      communication technology.

PMID- 8484348
TI  - Social support, motivation, language, and interaction. A longitudinal study of
      mothers and deaf infants.
AB  - This project examined the effect of early cognitive, social, and communicative
      experiences on later social and language development in deaf infants with hearing
      mothers. Interactions between mothers and deaf infants were found to be
      positively influenced by social support provided to mothers in the early months
      of the infants' lives, mothers' visual and tactile responsiveness when their
      infants were 9 months of age, infants' ability to cope with interactive stress at
      9 months of age, and fewer attempts by infants to engage with the social
      environment during the mastery motivation assessment at 9 months of age. Neither
      mother-infant affective matching nor maternal visual-tactile responsiveness
      correlated with the deaf infants' language level.

PMID- 8484349
TI  - Accessibility of mental health services and crisis intervention to the deaf.
AB  - The percentage of deaf and hard of hearing people who need mental health services
      and crisis intervention is similar to that of the general population. Hence, a
      survey was conducted to evaluate the accessibility of these services to the deaf
      population in Rhode Island. Staff members at agencies were asked about the number
      of deaf clients they serve, and asked to judge the accessibility of their basic
      services (e.g., TDD, interpreters). The results indicated that although more than
      70% of respondents indicated they had served deaf people during the past year,
      only 25% provided certified interpreters and only 39% were accessible to the deaf
      community via TDD. Other services as well as the needs of the deaf community are
      also discussed.

PMID- 8484350
TI  - Deaf and hard of hearing adolescents' memory for concrete and abstract prose.
      Effects of relational and distinctive information.
AB  - In two experiments, we examined deaf and hard of hearing adolescents' memory for
      prose as compared to that of hearing students. The study focused on the
      possibility that deaf and hard of hearing readers might make relatively less use
      of relational information in textual materials. Text structure and material
      concreteness were manipulated, and memory for relational and distinctive
      information was assessed. Results indicated that deaf and hard of hearing
      students remembered the abstract materials as well as they did the concrete
      materials. They were less likely than hearing students to remember idea units
      (concrete or abstract) holistically within passages, but they showed relatively
      better memory for individual words. This difference disappeared when the same
      sentences were presented without global paragraph coherence. The findings suggest
      that deaf and hard of hearing readers may be less likely than hearing readers to
      integrate text information across idea units, although they may retain as much
      information from within units.

PMID- 8484351
TI  - Perceptions of the oldest hearing child of deaf parents. On interpreting,
      communication, feelings, and role reversal.
AB  - Sixteen hearing children of deaf parents were matched with sixteen hearing
      children of hearing parents on age, school grade, sex, parent education level,
      and socioeconomic status. All children in the study were the oldest in the
      family. The children completed a questionnaire and a structured interview. Both
      the questionnaire and the interview investigated the issues of feelings toward
      parents, communication with parents, interpreting, and role reversal. The results
      indicated no significant difference between the two groups on the feelings,
      communication, and role-reversal scales. A significant difference was found
      between the groups on the interpreting scale as well as on the responses to the
      interview situations. The ages of the children and the degrees to which the
      parents relied on them to interpret appeared to have a strong influence on the
      children's feelings toward parents, communication with parents, and views on role
      reversal.

PMID- 8484352
TI  - The use of speech-based recoding in reading by prelingually deaf children.
AB  - We evaluated the extent to which prelingually deaf school children who were
      educated orally made functional use of speech-based codes in reading processes.
      The study involved two experimental reading tasks: (1) memorizing written words
      in association with meaning and (2) serial order recall of written word strings.
      The subjects were 78 school children 6 to 13 years of age. The results revealed a
      developmental change in the use of coding strategies: up to 9 years of age, most
      children seem to process written words by means of visual codes; older children
      tend to differentiate and appear to prefer either a visual or a speech-based
      strategy. The latter was found to be associated with better performance in
      reading tasks.

PMID- 8484353
TI  - Improvements in the English syntax of deaf college students.
AB  - The present study was designed to determine whether prelingually deaf students
      continue to improve in their knowledge of English syntax once they reach the
      college level. Students were assessed on their knowledge of nine English
      structures at the beginning and the end of the academic year. The results
      revealed significant improvement on all structures; however, students with lower
      general English proficiency improved to a significantly greater extent than
      students with higher general English proficiency. This suggests that deaf
      students with low proficiency might benefit from an increase in explicit grammar
      instruction. The results of this study are promising in that improved English
      syntax provides deaf students with more degree options and greater access to
      college-level reading materials.

PMID- 8484354
TI  - Dextropropoxyphene addiction--a drug of primary abuse.
AB  - In order to establish a profile of the abuser of dextropropoxyphene (DPX) in our
      community, we reviewed all the records from the Detoxification Unit in the Mental
      Health Institute in Mexicali, Baja California, Mexico. A total of 209 records
      were reviewed, and 73 were included in our study. Those included had a diagnosis
      of DPX dependence according to DSM-III-R and no associated psychiatric pathology.
      Most of them were single, unemployed males, with a history of at least 4 years of
      continuous DPX abuse. They were consuming an average dose per day 3.5 times
      higher than the maximum therapeutic dose recommended. The onset of generalized
      seizures associated with the DPX abuse was confirmed in 53% of the cases. The
      drug most frequently abused along with DPX was a benzodiazepine (p < .01),
      followed by marijuana, heroin, alcohol, stimulants (cocaine and amphetamines),
      and inhalants; 17% of the cases were pure DPX abusers. DPX was the first opiate
      ever abused in 67% of the cases, 19% had abused heroin before DPX, and 14%
      started the use of both at the same time. The difference among these groups (p <
      .01) suggests DPX as an opiate of primary abuse and not as secondary to heroin
      dependence.

PMID- 8484355
TI  - Cocaine in the hair of mother-infant pairs: quantitative analysis and
      correlations with urine measures and self-report.
AB  - A sample of mothers who had used crack cocaine while pregnant was evaluated
      during the postpartum period before random assignment to drug treatment. Mean
      infant age was 74 days. Paired hair samples were acquired from 63 mothers and 63
      infants. Maternal urine was screened for cocaine and benzoylecgonine; three
      different drug use self-report measures were also collected. Normalizing
      transformations of all hair and urine data preceded analyses. The initial
      correlation of mother and infant hair (r = .41, N = 62, P = .001) was
      strengthened (r = .62, N = 30, P < .0005) by removing from the dataset maternal
      hair independently judged to be damaged. Damage to hair is associated with
      certain types of "hair care" products. The damaged maternal hair bore no
      quantitative relationship to infant hair (r = -.04, N = 30, P = .41). Poor
      quality hair samples could have been partly anticipated because self-reported use
      of hair products had a significant contingent relationship to laboratory-judged
      damage to hair (Z kappa = 2.28, P = .01). Maternal urine benzoylecgonine
      correlated with maternal hair (r = .41, N = 60, P = .001) and, of course, with
      maternal urine cocaine (r = .63, N = 60, P < .0005). None of the three self
      report measures (use in past 30 days, duration since first use, average regular
      use) significantly correlated with any of the hair or urine measures. Factor
      analysis of drug use variables identified three factors possibly representing
      long-term use, recent use, and some artifact of self-report. In summary, hair
      analysis may provide a quantitative index of exposure when the hair is not
      damaged. The amount of self-reported drug use could not be corroborated with
      analytic measures of hair or urine. Studies in which self-reported cocaine use is
      a scalar variable should be interpreted cautiously.

PMID- 8484356
TI  - Comorbidity in pregnant patients in a psychiatric inpatient setting.
AB  - The impact of substance abuse on mental illness is substantial. The consequences
      of comorbidity on pregnant women has not been previously reviewed. This paper
      discusses the implications of interrelationship of substance use and mental
      illness on pregnancy. We present data from a retrospective study of pregnant
      women admitted for psychiatric care, reviewing the relationships of comorbidity
      to their demographic, psychiatric, and obstetrical histories and follow-up
      prenatal care.

PMID- 8484357
TI  - Cigarette smoking and methadone dose levels.
AB  - Cigarette smoking has been shown to increase consequent to the acute
      administration of methadone. This suggests the possibility that differences in
      maintenance dose levels might be associated with differential smoking rates. It
      is of special concern that higher maintenance levels of methadone may lead to
      more cigarette smoking because of the putative beneficial effects of higher doses
      on illicit drug use, treatment retention, and the like. Two experiments were
      conducted to test the hypothesis that higher maintenance doses of methadone are
      related to more cigarette smoking. Smoking was measured by self-report and
      expired carbon monoxide, and the amounts were correlated with subjects' methadone
      dose levels. The results showed smoking rates of 85% and that self-reported
      smoking significantly correlated (r = -.52) with CO. Maintenance doses, however,
      were not correlated with smoking levels. This suggests that the acute effects of
      methadone on smoking are nullified as clients habituate to dose level, and that
      decisions regarding appropriate methadone dosage can be made on other grounds.

PMID- 8484358
TI  - Alcohol and heroin use patterns of narcotics addicts: gender and ethnic
      differences.
AB  - Data on lifetime alcohol and heroin use by 443 White and Chicano addicts of both
      genders were obtained from a sample of admissions to several Southern California
      methadone maintenance programs. Patterns of alcohol and heroin use were examined
      with respect to gender and ethnic differences. Repeated-measures MANOVA
      established an inverse pattern of alcohol and heroin use for all four groups,
      confirming and extending the findings of a previous study by the authors. With
      this additional evidence, the authors propose a compensatory model that explains
      the obtained inverse pattern of alcohol and heroin use and that may be suitable
      in examining concurrent or sequential use of other psychoactive substances in
      addition to alcohol. Significantly higher levels of heavy alcohol use were
      reported by Chicano than by White addicts. Overall findings indicate that after
      heroin addiction occurs, there is a convergence in patterns of substance use by
      both genders, although variations related to ethnicity persist, particularly for
      alcohol use.

PMID- 8484359
TI  - Attrition from an evening alcohol rehabilitation program.
AB  - In recent years many groups have become interested in the potential cost savings
      and efficacy of outpatient treatment for chemical dependency. This study was
      originally conceived to answer questions of both patients and staff concerning
      graduation and attrition rates in an evening outpatient alcohol treatment
      program. Of particular interest were gender effects, rates of attrition across
      two progressive program levels, and whether alcohol-only users and self-initiated
      clients fared better in treatment than did polysubstance users and patients who
      were referred by others. Medical records were available for 103 of the 107
      treated patients, and of these, 27 remained in the program until graduation.
      Women were more likely to graduate and remain in the program longer than men.
      Alcohol users were more likely to graduate than subjects with additional
      substance use disorders. Graduation rates did not differ significantly between
      contact initiators and noninitiators; however, the former dropped out of
      treatment more quickly. The study is an example of the potential use of data
      obtained from an existing agency data base.

PMID- 8484360
TI  - Air pollution and respiratory morbidity among adults in southern California.
AB  - This paper reports the results of an investigation of the acute effects of air
      pollution in 321 nonsmoking adults residing in Southern California. Previous
      epidemiologic investigations of effects of acute exposure to ozone have focused
      on groups who may not be representative of the general public, such as asthmatics
      or student nurses. For this study, participants recorded the daily incidence of
      several respiratory symptoms over a 6-month period between 1978 and 1979. The
      authors examined the impact of ambient concentrations of ozone, particulate
      sulfates, and other air pollutants on the incidence of respiratory morbidity,
      measured as either upper or lower respiratory tract symptoms. Using a logistic
      regression model, the authors found a significant association between the
      incidence of lower respiratory tract symptoms and 1-hour daily maximum ozone
      levels (odds ratio (OR) = 1.22, 95% confidence interval (Cl) 1.11-1.34, for a 10
      parts per hundred million (pphm) change), 7-hour average ozone levels (OR = 1.32,
      95% Cl 1.14-1.52), and ambient sulfates (OR = 1.30, 95% Cl 1.09-1.54, for a 10
      micrograms/m3 change), but no association was found with coefficient of haze, a
      more general measure of particulates. The existence of a gas stove in the home
      was also associated with lower respiratory tract symptoms (OR = 1.23, 95% Cl 1.03
      1.47). The effects of ozone were greater in the subpopulation without a
      residential air conditioner. In addition, ozone appears to have had a greater
      effect among individuals with a preexisting respiratory infection.

PMID- 8484361
TI  - Air pollution and emergency room admissions for chronic obstructive pulmonary
      disease: a 5-year study.
AB  - An association between sulfur dioxide levels in urban air and the daily number of
      emergency room admissions for chronic obstructive pulmonary disease was
      previously reported in Barcelona, Spain, for the period 1985-1986. The present
      study assesses this association over a longer period of time, 1985-1989. This
      made it possible to carry out separate analyses for the winter and summer seasons
      and thus to control more adequately for weather and influenza epidemics. An
      increase of 25 micrograms/m3 in sulfur dioxide (24-hour average) produced
      adjusted changes of 6% and 9% in emergency room admissions for chronic
      obstructive pulmonary disease during winter and summer, respectively. For black
      smoke, a similar change was found during winter, although the change was smaller
      in summer. The association of each pollutant with chronic obstructive pulmonary
      disease admissions remained significant after control for the other pollutant.
      The present findings support the conclusion that current levels of sulfur dioxide
      and black smoke may have an effect on the respiratory health of susceptible
      persons.

PMID- 8484362
TI  - Ethnic differences in risk factors associated with the prevalence of non-insulin
      dependent diabetes mellitus. The San Luis Valley Diabetes Study.
AB  - Non-insulin-dependent diabetes mellitus is 2-5 times more common in Hispanics
      than in non-Hispanic whites in the United States. The authors conducted this case
      control study in two Colorado counties from 1984 to 1986 to determine whether
      known risk factors for non-insulin-dependent diabetes mellitus explained the
      excess incidence in Hispanics. There were 279 subjects with prevalent diabetes
      and 488 subjects with normal glucose tolerance who were eligible for this
      analysis. After adjustment for age and sex, results showed that Hispanics were
      3.5 times more likely than non-Hispanic whites to have non-insulin-dependent
      diabetes mellitus (95% confidence interval 2.4-4.9). The excess risks of diabetes
      associated with body mass index, subscapular and triceps skinfold thickness,
      family history of diabetes, and income were similar in Hispanics and non-Hispanic
      whites, after adjustment for age and sex. However, 1-unit increases in
      subscapular/triceps skinfold ratio and waist/hip ratio were associated with
      greater increases in risk among non-Hispanic whites than among Hispanics. When
      risk factors were entered into logistic regression models simultaneously, higher
      subscapular skinfolds, a higher waist/hip ratio, family history of diabetes,
      older age, male sex, and lower income were independently associated with non
      insulin-dependent diabetes mellitus in both ethnic groups. No association was
      found with skin reflectance, a marker for Amerindian admixture. While the excess
      risk of diabetes in Hispanics was reduced, a significant 1.9-fold excess risk in
      Hispanics remained. Further studies are needed to understand factors contributing
      to the excess prevalence of diabetes in Hispanic Americans.

PMID- 8484363
TI  - Effect of multiple risk factors on differences between blacks and whites in the
      prevalence of non-insulin-dependent diabetes mellitus in the United States.
AB  - The higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in US
      blacks as compared with whites may be due to a higher frequency of NIDDM risk
      factors in blacks, a higher inherent susceptibility to NIDDM among blacks, or the
      risk factors' having a greater effect in blacks. The authors evaluated 4,379
      subjects from the Second National Health and Nutrition Examination Survey (1976
      1980) for whom NIDDM was ascertained by medical history and oral glucose
      tolerance test, and for whom data on a number of risk factors were available. The
      prevalence of NIDDM was 60% higher in blacks than in whites (p < 0.001) and was
      highest in black women. Although most risk factors for NIDDM were more common in
      blacks, this higher frequency did not completely explain the racial disparity in
      the prevalence of NIDDM. After adjustment for all risk factors by logistic
      regression, an elevated risk of NIDDM was particularly evident at higher obesity
      levels in blacks as compared with whites; the odds were 70% higher for blacks at
      a percentage of desirable weight of 150 (95% confidence interval 1.1-2.8). The
      risk of NIDDM associated with obesity was greatest in black women: The odds in
      this group were sevenfold higher at a percentage of desirable weight of 150
      versus 100 (95% confidence interval 2.6-18.8). The possibility of racial
      differences in metabolic adaptation to obesity highlights the importance of
      preventing this condition in blacks, particularly in black women.

PMID- 8484364
TI  - Invited commentary: do risk factors explain ethnic differences in type II
      diabetes?

PMID- 8484365
TI  - Heart rate, physical activity, and mortality from cancer and other
      noncardiovascular diseases.
AB  - The relations between resting heart rate on electrocardiogram, usual physical
      activity, and risks of all noncardiovascular mortality, cancer mortality, and
      other noncardiovascular mortality were examined in 7,735 middle-aged British men
      drawn from general practices in 24 British towns. Subjects were examined and
      administered questionnaires in 1978-1980. During a follow-up period of 9.5 years
      (to December 1989), there were 334 deaths from noncardiovascular causes,
      including 225 cancer deaths. A strong positive association was seen between heart
      rate and all noncardiovascular mortality, cancer mortality, and other
      noncardiovascular mortality, even after adjustment for age, blood cholesterol,
      body mass index, heavy alcohol drinking, physical activity, preexisting ischemic
      heart disease, smoking, social class, and systolic blood pressure (p < 0.01). The
      relative risks in men with heart rates of > or = 90 beats/minute, in comparison
      with those with heart rates of < 60 beats/minute, were 2.33 (95% confidence
      interval (CI) 1.42-3.74) for total noncardiovascular mortality, 1.68 (95% CI 0.92
      3.10) for cancer mortality, and 3.56 (95% CI 1.65-7.65) for mortality due to
      other noncardiovascular causes. The positive associations with cancer and all
      noncardiovascular mortality persisted even after further adjustment for lung
      function (forced expiratory volume in 1 second) and exclusion of men with
      underlying ill health and of deaths occurring within the first 5 years of follow
      up. A significant inverse association with seen between physical activity and
      risk of cancer death, even after adjustment for the above factors and heart rate,
      with a significant reduction only in those engaged in high levels of usual
      physical activity (relative risk = 0.62, 95% CI 0.39-0.98). The data suggest that
      in middle-aged men, resting heart rate and physical activity are independent
      prognostic factors for cancer mortality.

PMID- 8484366
TI  - Risk factors for idiopathic rhegmatogenous retinal detachment. The Eye Disease
      Case-Control Study Group.
AB  - The objective of this case-control study of idiopathic retinal detachment was to
      evaluate previously suggested hypotheses about risk factors for retinal
      detachment and to investigate whether new ocular or systemic risk factors could
      be identified. Between 1986 and 1990, data were obtained at five US clinical
      centers on 253 patients with idiopathic retinal detachment and 1,138 controls.
      Patients with pathologic myopia were excluded. Data were collected from
      interviews, clinical examinations, and laboratory analyses of blood samples. Only
      one clearly relevant risk factor, myopia, emerged from the analyses. An eye with
      a spherical equivalent refractive error of -1 to -3 diopters had a fourfold
      increased risk of retinal detachment compared with a nonmyopic eye; if the
      refractive error was greater than -3 diopters, the risk was increased 10-fold.
      The data suggest that almost 55% of nontraumatic detachments in eyes without
      previous surgery are attributable to myopia. The etiology of retinal detachment
      appears to be related to the architecture of the eye. The study found no evidence
      that systemic factors, particularly cardiovascular factors, play a role.

PMID- 8484367
TI  - Validation of 1989 Tennessee birth certificates using maternal and newborn
      hospital records.
AB  - In 1989, the state of Tennessee adopted a new birth certificate which
      incorporates changes recommended by the National Center for Health Statistics in
      the revised US Standard Certificate of Live Birth. The data now being collected
      are intended to provide improved information for understanding maternal and
      infant health issues. To assess data quality, the authors compared information
      reported on the 1989 Tennessee birth certificates with the same data obtained
      from an ongoing case-control study in which the delivery hospital medical records
      of mothers and infants were reviewed by trained nurse abstractors using a
      structured data collection instrument. Cases (n = 1,016) were all infants born in
      Tennessee in 1989 with birth weights less than 1,500 g or other infants who died
      during the first 28 days of life. The infants were identified from linked birth
      death certificate files. Control infants (n = 634) were randomly selected from
      the noncase population. The most reliable information obtained from birth
      certificates was descriptive demographic data and birth weight. The quality of
      information obtained from the new birth certificate checkboxes varied. Routine
      medical procedures were better reported on the birth certificates than relatively
      uncommon conditions and occurrences, even serious ones. Caution is needed in
      using birth certificate data for assessment of maternal medical risk factors,
      complications of labor and delivery, abnormal conditions of the newborn, and
      congenital anomalies, since sensitivity is low.

PMID- 8484368
TI  - How safe were today's older drivers when they were younger?
AB  - Data from the Fatal Accident Reporting System for 1975-1990 were used to perform
      longitudinal analyses of car driver fatality rates (driver fatalities per million
      population) for a 16-year period; for example, the fatality rate of drivers born
      in 1960 was examined for ages 15 years through 30 years. It was found that
      fatality rates for male drivers of a given age systematically decline with
      increasing birth year; for example, 20-year-olds born in 1970 have lower fatality
      rates than do 20-year-olds born in 1960. The fatality rates for cohorts of
      drivers of either sex do not begin to increase appreciably until about age 70
      years, and then they approximately double by age 80 years. These increases are of
      a lesser magnitude, and occur later, than those found in the earlier cross
      sectional analyses that identified the "older driver problem."

PMID- 8484369
TI  - Estimating the variance of standardized rates of recurrent events, with
      application to hospitalizations among the elderly in New England.
AB  - Usual approaches for estimating the variance of a standardized rate may not be
      applicable to rates of recurrent events. Where individuals are prone to repeated
      health events, Greenwood and Yule (J R Stat Soc [A], 1920;83:255-79) advocated
      use of the negative binomial distribution to account for departures from the
      assumption of randomness of recurrent events required by the Poisson
      distribution. In this paper, the authors implemented the negative binomial
      distribution in the computation of annual hospitalization rates within certain
      hospital market areas. Data used were from 1,549,915 New England residents aged
      65 years or more who were enrolled in Medicare between October 1, 1988, and
      September 30, 1989, and who had 458,593 hospital admissions during that year. New
      England was partitioned into 170 hospital market areas ranging in population size
      from 162 to 70,821 elderly Medicare enrollees. The negative binomial distribution
      demonstrated substantially better fits than the Poisson distribution to the
      numbers of hospitalizations within hospital market areas. Estimated standard
      errors for indirectly standardized rates based on the negative binomial
      distribution were 25-51 percent higher than estimated standard errors that
      assumed an underlying Poisson distribution. Using regression analysis to smooth
      overdispersion parameters across hospital market areas produced similar results.
      The approach described in this paper may be useful in estimation of confidence
      intervals for standardized rates of recurrent events when these events do not
      recur randomly.

PMID- 8484370
TI  - Sample sizes for prevention trials have been too small.
AB  - Planners of several large prevention trials have overestimated the expected
      incidence of events in the control group, largely because they failed either to
      recognize or to adequately correct for various effects of population selection.
      Consequently, the studies have been too small in size or too short in duration to
      achieve their stated objectives. The selection effects include those engendered
      by the choice of the target population, the self-selection of volunteers, and
      protocol exclusions. This paper presents a taxonomy of these effects and the
      likely direction of their influence on the incidence of events and on mortality
      rates from other causes. Little information is available to help sample-size
      planners in adjusting for these effects. A few studies have provided information
      on the extent to which control group incidence rates have fallen short of
      expectations. In particular, researchers from the University of Minnesota's Colon
      Cancer Control Study have provided a detailed comparison of event incidence and
      all-cause mortality rates with general population rates. (AM J Epidemiol
      1993;137:797-810). Other studies should publish similarly detailed information to
      assist sample-size planners of prevention trials. Until more information is
      published, this paper provides preliminary guidelines for prevention trial sample
      size planning.

PMID- 8484371
TI  - Estimating the duration of ongoing prevention trials.
AB  - The authors present a method of estimating the duration of ongoing prevention
      trials, showing how the method was applied to the Colon Cancer Control Study, a
      University of Minnesota study of occult blood testing undertaken to screen for
      colorectal cancer in older Minnesotans. In that study, begun in 1975 and ongoing,
      as in several other recent large prevention trials, it was necessary, after the
      start of the study, to revise upward the initial estimates of study duration
      derived from general population experience. The underestimates arose because the
      planners had not adequately taken various population selection factors into
      account in estimating the expected number of events in the control group. In this
      paper, the authors outline a method for estimating control group event rates and
      study duration requirements (and, in some circumstances, also sample size
      requirements) of prevention studies, via models of disease-specific and all-cause
      standardized mortality ratios which adjust for various selection effects. The
      authors also validate the model for disease-specific standardized mortality
      ratios by means of independent estimates of disease incidence and case survival.

PMID- 8484372
TI  - Re: "Total energy intake: implications for epidemiologic analyses".

PMID- 8484373
TI  - Comparative epidemiology of Down syndrome in two United States population, 1970
      1989.
AB  - This study compared the epidemiology of Down syndrome over a 20-year period, 1970
      1989, in two populations in which livebirths with Down syndrome were believed to
      be highly ascertained. One population was a 10-county region in southwest Ohio;
      the second was a five-county region in metropolitan Atlanta, Georgia. The major
      objectives were to 1) compare observed incidences of Down syndrome over the
      entire study period; 2) calculate expected incidences of Down syndrome for each
      population and compare these with observed incidences; 3) determine incidence
      trends throughout the period; and 4) examine the impact of prenatal diagnosis on
      the observed incidence of Down syndrome in each population. Excluding aborted
      fetuses with Down syndrome diagnosed prenatally, the observed incidence of Down
      syndrome, 0.98, was significantly lower than that expected, 1.27, within the
      Atlanta white data set. Once the observed data were adjusted to include aborted
      fetuses with Down syndrome (total incidence = 1.17), no statistically significant
      differences remained. No differences were found between observed and expected
      incidences of Down syndrome for whites in southwest Ohio or for other races in
      either population. Although uncorrected observed incidences were significantly
      different between the two populations of whites for the entire 20-year period,
      the differences again disappeared after the data were corrected to include
      aborted fetuses. No significant effect of prenatal diagnosis on those of other
      races was found in either population. Expected Down syndrome incidences rose from
      the late 1970s throughout the 1980s for both racial groups in Ohio and Atlanta,
      Georgia; however, because the termination of fetuses with Down syndrome increased
      over the decade, the observed incidence among whites in southwest Ohio remained
      at earlier levels and actually fell among whites in Atlanta. These results
      indicate the increasing importance of prenatal diagnosis and selective abortion
      in the epidemiology of Down syndrome and of correcting for it when comparing
      incidences between populations, even within the same time period. These data from
      2 decades show that differences in both observed and expected incidences of Down
      syndrome exist between both populations and races, principally because of
      differences in demographic age structure and maternal age fertility rates and
      because of differential use of prenatal diagnosis and selective abortion.

PMID- 8484374
TI  - Breast cancer risk associated with abnormal cytology in nipple aspirates of
      breast fluid and prior history of breast biopsy.
AB  - The authors previously reported an increased risk of breast cancer in women from
      the San Francisco Bay Area first enrolled between 1973 and 1980 with
      proliferative cytologic findings (hyperplasia, moderate hyperplasia, and atypia)
      compared with women with normal cytologic findings in breast fluids obtained by
      nipple aspiration and with women from whom breast fluid could not be obtained. To
      look for factors which might modify the risks associated with cytology, the
      authors examined several standard breast cancer risk factors: parity, age at
      first pregnancy, age at menarche, family history of breast cancer, and prior
      history of breast biopsy. Among women aged 30 years or over, only prior biopsy
      modified the effect of proliferative cytologic findings on the risk of breast
      cancer (p < 0.10). For those women with no prior biopsy, breast cancer incidence
      was 5% (47 of 985) among women with normal cytology and 5% (13 of 277) among
      women with proliferative findings, whereas among those women with normal cytology
      and 18% (11 of 62) among women with proliferative cytology. Age-adjusted as well
      as multivariate-adjusted relative risks indicated that the increased risk of
      breast cancer associated with proliferative cytologic findings was largely
      confined to women who had a prior history of breast biopsy.

PMID- 8484375
TI  - Childhood asthma and indoor environmental risk factors.
AB  - In a case-control study carried out in Montreal, Quebec, Canada, between 1988 and
      1990, indoor environmental factors were studied in relation to the incidence of
      asthma among 3- and 4-year-old children. Cases (n = 457), whose parents were
      recruited at a hospital emergency room, were children who had a first-time
      diagnosis of asthma (International Classification of Diseases, Ninth Revision,
      code 493) made by a pediatrician. Controls (n = 457) were chosen from family
      allowance files and were matched with case children on age and census tract. A
      telephone interview was administered to the children's parents. A 20% feasibility
      subsample was chosen to wear a nitrogen dioxide monitoring badge during a 24-hour
      period. Multiple conditional logistic regression analysis showed that after
      personal susceptibility factors were controlled for, the following were
      independent risk factors for asthma: the mother's heavy smoking (odds ratio (OR)
      = 2.77, 95% confidence interval (CI) 1.35-5.66), use of a humidifier in the
      child's room (OR = 1.89, 95% CI 1.30-2.74), and the presence of an electric
      heating system in the home (OR = 2.27, 95% CI 1.42-3.65). The presence of other
      smokers in the home was not quite significant (OR = 1.82, 95% CI 0.98-3.38). A
      history of pneumonia, the absence of breast feeding, and a family history of
      asthma were also significant risk factors. In a separate unmatched multivariate
      analysis of subjects who had worn the nitrogen dioxide badge, there was a dose
      response relation between nitrogen dioxide (in parts per billion) and asthma.
      These results confirm the role of susceptibility factors in asthma and show that
      indoor environmental factors contribute to the incidence of asthma.

PMID- 8484376
TI  - Maintaining mobility in late life. I. Demographic characteristics and chronic
      conditions.
AB  - To assess the role of demographic factors and chronic conditions in maintaining
      mobility in older persons, this study utilized longitudinal data collected as
      part of the Established Populations for Epidemiologic Studies of the Elderly
      between 1981 and 1987 on 6,981 men and women aged 65 years and older in East
      Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven,
      Connecticut. Results are presented for those who at baseline reported intact
      mobility, defined as the ability to climb stairs and walk a half mile without
      help, and who were followed annually for up to 4 years for changes in mobility
      status. Age, income, education, and chronic conditions present at baseline and
      occurring during follow-up were evaluated for their association with loss of
      mobility. Over the follow-up period, 55.1% of subjects maintained mobility, 36.2%
      lost mobility, and 8.7% died without evidence of mobility loss prior to death. In
      both men and women, increasing age and lower income levels were associated with
      increased risk of losing mobility, even after controlling for the presence of
      chronic conditions at baseline. After adjustment for age, income, and chronic
      conditions, lower education levels were a significant risk factor for mobility
      loss in men, but not in women. Baseline reports of previous heart attack, stroke,
      high blood pressure, diabetes, dyspnea, and exertional leg pain were associated
      with small but significant risks for mobility loss. There was a stepwise increase
      in the risk of mobility loss according to the number of chronic conditions
      present at baseline that was very consistent between men and women. The
      occurrence during the study of a new heart attack, stroke, cancer, or hip
      fracture was associated with a substantially greater risk of mobility loss than
      was associated with the presence of these conditions at baseline.

PMID- 8484377
TI  - Maintaining mobility in late life. II. Smoking, alcohol consumption, physical
      activity, and body mass index.
AB  - While positive health behaviors have been shown to extend life, their association
      with extending active life has not been well investigated. In this report,
      several health behaviors were investigated in relation to maintaining mobility
      during 4 years of follow-up among 6,981 men and women aged 65 years and older
      with intact mobility at baseline between 1981 and 1983 who lived in one of three
      communities: East Boston, Massachusetts; Iowa and Washington counties, Iowa; and
      New Haven, Connecticut. Intact mobility, defined as the ability to climb up and
      down stairs and walk a half mile, was determined annually by interview, and study
      subjects were classified into one of three categories at the end of 4 years of
      follow-up: 1) maintained mobility (55.1%); 2) lost mobility (36.2%); or 3) died
      without evidence of having lost mobility prior to death (8.7%). After adjustment
      for age and all of the health behaviors, risk of losing mobility was
      significantly associated with current smoking, not consuming alcohol compared
      with small-to-moderate amounts of alcohol consumption, high (> 80th percentile)
      compared with moderate (21-80th percentiles) body mass index, and low physical
      activity levels in both men and women. These findings suggest that positive
      health behaviors can not only extend longevity but also reduce the risk of losing
      mobility and independence in later life.

PMID- 8484378
TI  - Predictors of decline in social relationships in the rural elderly.
AB  - Prospective evidence for predictors of decline in social relationships over a 3
      year follow-up period in an elderly cohort are presented. The cohort consisted of
      men (n = 903) and women (n = 1,673) over age 65 years in two rural Iowa counties
      who were interviewed in 1982 and again in 1985. Three separate measures of social
      relationships were dichotomized into lower and higher levels and included the
      number of close friends and relatives (less than three vs. three or more), church
      attendance (less than once per month or not at all vs. once per month or more),
      and membership in a group (nonmember vs. member). Those with higher social
      relationship levels at both interviews were compared with those who had higher
      levels at baseline but lower levels at follow-up (i.e., a decline in social
      relationship level) using logistic regression. In multivariate analysis,
      important baseline predictors of decline in social relationship levels included
      greater age, lower educational level, lower memory test score, the presence of
      physical disabilities, and a higher level of depressive symptoms. Marital status
      and lower self-perceived health status were less consistent predictors, and
      having any living children, history of major illness, and continence status were
      generally not important predictors of decline in social relationship levels.
      These findings underscore the multifactorial and complex influences on changes in
      social relationships, but they also identify factors for possible prevention and
      intervention strategies.

PMID- 8484379
TI  - Relation of smoking and low-to-moderate alcohol consumption to change in
      cognitive function: a longitudinal study in a defined community of older persons.
AB  - To determine whether smoking habits and alcohol consumption are related to
      changes in cognitive function, the authors conducted a prospective, community
      based study of persons aged 65 years and over in East Boston, Massachusetts. In
      1982 and again in 1985, the subjects were given three brief tests of cognitive
      function: immediate memory, digit span, and a mental status questionnaire, which
      primarily assessed orientation. The 1,201 individuals who performed well in 1982
      were included in linear regression analyses of 3-year change in performance,
      adjusted for age, sex, education, and income. Relative to nonsmoking, current
      smoking, past smoking, and pack-years were not significantly related to change in
      immediate memory. None was significantly related to change in orientation. Only
      pack-years was significantly related to normal change score in digit span (normal
      change score change per unit of predictor = 0.001, 95% confidence interval 0.0003
      0.002). Low-to-moderate alcohol consumption during the month preceding baseline
      testing was not significantly related to a subsequent 3-year change in
      performance in two of the three tests. However, people who consumed a very small
      amount of alcohol had a normal change score that was 0.088 (95% confidence
      interval 0.015-0.160) better for digit span than did nondrinkers. This study
      provides evidence that the reported levels of smoking and alcohol use among older
      persons are not consistent or substantial predictors of the longitudinal change
      in cognitive function observed in a community.

PMID- 8484380
TI  - Differences in risk factors for human immunodeficiency virus type 1
      seroconversion among male and female intravenous drug users.
AB  - To examine sex-specific risk factors for human immunodeficiency virus (HIV) type
      1 seroconversion among intravenous drug users, the authors conducted a nested
      case-control study in Baltimore, Maryland, from 1988 to 1992 comparing 146
      seroconverters and 539 HIV seronegative controls. Controls were matched on sex,
      race, date of study entry, and duration of follow-up. Risk factor data were
      obtained from interviews conducted at the first seroconversion visit for the case
      and the closest visit for the corresponding seronegative control. Since test
      results were not available until several weeks after interview, both interviewers
      and participants were unaware of seroconversion status at the time of interview.
      When data were analyzed using conditional logistic regression techniques, the
      variables which were significantly associated with seroconversion among male
      intravenous drug users included age less than 35 years, a sexually transmitted
      disease within the past 6 months, lifetime history of syphilis, and current
      intravenous drug use with an abscess at the injection site. Among women, only a
      history of three or more sex partners was positively associated with
      seroconversion and having a biological child under age 18 years was inversely
      associated with HIV seroconversion. Although the small sample size may have
      limited the ability to ascertain differences in risks of seroconversion among
      males and females, these data suggest that sexual transmission contributes to HIV
      infection among intravenous drug users, especially women.

PMID- 8484381
TI  - Risk of human immunodeficiency virus infection from unprotected receptive anal
      intercourse increases with decline in immunologic status of infected partners.
AB  - To determine whether human immunodeficiency virus (HIV) type 1 infection among
      unprotected receptive anal partners of HIV type 1-infected men varies by the
      immunologic status of the HIV type 1-infected index case, 187 sexual partners of
      164 HIV type 1-infected index subjects were enrolled at a community health center
      in Boston, Massachusetts, from 1985-1990. All subjects were interviewed regarding
      their sexual practices and tested for HIV type 1. Fifty-seven of the 187 sexual
      partners were infected with HIV type 1. The strongest risk factor for HIV type 1
      infection among these partners was unprotected receptive anal intercourse with a
      known HIV type 1-infected index subject (odds ratio (OR) = 7.2, 95% confidence
      interval (CI) 3.1-16.3). The risk of unprotected receptive anal intercourse was
      highest among partners of HIV-infected index subjects who had a T lymphocyte
      subset ratio of 0.50 or less (OR = 11.4, 95% CI 3.0-43.5) compared with partners
      of HIV type 1-infected index subjects with a T cell ratio of greater than 0.50
      (OR = 5.3, 95% CI 1.9-15.2). After adjustment for confounding, the risk of HIV
      type 1 infection remained substantially higher among sexual partners who had had
      unprotected receptive anal intercourse with infected index subjects with a T
      lymphocyte subset ratio of less than or equal to 0.50 (OR = 7.0, 95% CI 1.8-28.0)
      compared with partners who had had unprotected receptive anal intercourse with
      infected index subjects with a T cell ratio of greater than 0.50 (OR = 3.3, 95%
      CI 1.1-10.0). It would appear that the risk of HIV type 1 infection from
      unprotected receptive anal intercourse increases as the immunologic status of the
      HIV type 1-infected insertive anal partner decreases.

PMID- 8484382
TI  - Epidemiology of human immunodeficiency virus type 1 infection among homosexual
      men participating in hepatitis B vaccine trials in Amsterdam, New York City, and
      San Francisco, 1978-1990.
AB  - Homosexual/bisexual men from Amsterdam, The Netherlands, New York, New York, and
      San Francisco, California, were entered into trials of the efficacy of hepatitis
      B vaccine shortly before the acquired immunodeficiency syndrome (AIDS) epidemic
      was recognized (1978-1980). The authors analyzed data, including serial blood
      samples tested for antibody to human immunodeficiency virus type 1 (HIV-1) as
      well as demographic and behavioral information, to characterize the spread of HIV
      1 infection within the cohorts. By the end of 1982, the cumulative incidence of
      HIV-1 infection within the cohorts. By the end of 1982, the cumulative incidence
      of HIV-1 infection was 7.5% in Amsterdam, 26.8% in New York City, and 42.6% in
      San Francisco. Covariate analysis showed that differences in sexual activity
      (number of male sexual partners) and correlates of sexual activity (age and
      hepatitis B incidence) accounted for the differences in incidence of HIV-1
      infection between the New York City and San Francisco cohorts. These covariates
      did not explain the lower incidence in the Amsterdam cohort. In conclusion,
      significant differences were found in the spread of HIV-1 in cohorts of
      homosexual men in Amsterdam, New York City, and San Francisco. These
      dissimilarities were probably due to a combination of differences in sexual
      activity at the time the epidemic began and a later introduction of HIV-1 in
      Amsterdam.

PMID- 8484383
TI  - Dietary patterns associated with a low-fat diet in the national health
      examination follow-up study: identification of potential confounders for
      epidemiologic analyses.
AB  - To identify systematically the nutrient and food group intakes associated with a
      low-fat diet, the authors used the detailed dietary information collected from
      10,306 individuals aged 32-86 years in the 1982-1984 National Health
      Epidemiologic Follow-up Study. Intakes of vitamin C and percentages of calories
      from carbohydrates, dietary fiber, poultry, low-fat dairy products, fruits,
      vegetables, cereals, and whole grains were markedly higher, while intakes of
      protein, total fat, saturated fat, oleic and linoleic acids, cholesterol, sodium,
      all red meats, high-fat dairy products, eggs, nuts, white bread, fried potatoes,
      desserts, fats, and oils were much lower in the quartile with the lowest
      percentage of calories from fat. These dietary patterns associated with a low-fat
      diet were essentially constant across strata of age, sex, race, and socioeconomic
      status. This study suggests that individuals on a low-fat diet substitute certain
      carbohydrate-rich foods such as fruits and vegetables for fat. Given these
      associations between low-fat diets and other dietary factors independently
      associated with certain cancers, these dietary factors should be considered
      potential confounders in studies of dietary fat and these cancers.

PMID- 8484384
TI  - Re: "Characteristics relating to ovarian cancer risk: collaborative analysis of
      12 US case-control studies. II. Invasive epithelial ovarian cancers in white
      women".

PMID- 8484385
TI  - p53 expression in incidental prostatic cancer.
AB  - Incidental prostate cancer is an indolent disease typically characterized by a
      benign clinical course. This is not clearly established, however, as recent
      reports suggest that up to 27% of cases progress with long-term follow-up. The
      indolent history of this disease led initially to the hypothesis that mutations
      of the p53 gene would be an infrequent event in this patient population. Archival
      specimens from 24 patients with Stage A1 carcinomas were evaluated for abnormal
      p53 expression. In 23 patients the disease was diagnosed after transurethral
      resection for bladder outlet obstructive symptoms, and in one patient after a
      radical prostatectomy. Using a monoclonal antibody (PAb 240) and an
      immunohistochemical technique, a total of 36 microfoci of tumor were evaluated.
      Thirteen (36%) microfoci were positive with an intense nuclear staining pattern
      (2+), and eight (22%) microfoci had an intermediate staining pattern. Four areas
      of prostatic intraepithelial neoplasia also stained positively with a 2+ staining
      pattern. These results suggest that abnormal p53 expression is a feature of a
      significant number of incidental prostatic carcinomas and that this occurrence is
      an early event in the development of the malignant phenotype.

PMID- 8484386
TI  - Machiavellianism in medical students.
AB  - To be more responsive to the nation's health needs, medical educators should
      identify those personal qualities associated with effective primary medical care.
      For this research Machiavellianism was chosen as a tracer character trait opposed
      to the characteristics embodied in an ideal family physician. A survey was
      conducted of 167 freshmen from one medical school and 823 seniors from four
      medical schools, with Machiavellianism scores used to predict their professional
      role characteristics, attributional style toward patients, and choice of a career
      specialty. Results showed that 15% of all students scored positively on the
      Machiavellianism scale. Mean Machiavellianism scores for seniors did not differ
      from those for freshmen. Men had higher Machiavellianism scores than women. Those
      students with high Machiavellianism scores relied excessively on high-tech
      medicine and were externally controlled, intolerant of ambiguity, and
      authoritarian. Seniors' high Machiavellianism scores predicted a negative
      attributional style toward geriatric and hypochondriac patients, thereby
      validating the use of Machiavellianism to measure medical students' indifference
      to patients and their problems.

PMID- 8484387
TI  - Ibuprofen fails to increase plasma growth hormone levels in humans.
AB  - In eight healthy volunteers, basal and arginine-stimulated plasma glucose and
      growth hormone levels were determined during administration of a placebo and
      after 3 days of ibuprofen (800 mg four times daily). Ibuprofen had no significant
      effect on basal or stimulated plasma glucose or growth hormone levels. As is not
      the case with indomethacin, ibuprofen fails to increase basal and arginine
      stimulated plasma growth hormone levels. This suggests that the effect of
      indomethacin on growth hormone secretion is due to a mechanism unrelated to
      inhibition of prostaglandin synthesis.

PMID- 8484388
TI  - Primary spontaneous pneumothorax in men.
AB  - To determine the risk factors, clinical presentation, and long-term outcome of
      primary spontaneous pneumothorax (PSP), all available cases of PSP in the Israeli
      Defense Forces (IDF) were retrospectively reviewed. Using the computerized IDF
      database, all men who had pneumothorax were identified and a telephone interview
      obtained with 343 individuals, 286 of whom had PSP and agreed to participate in
      this study. These 286 persons experienced 498 episodes of PSP, with 314 medical
      records available for review. Average length of follow-up from the first episode
      of PSP was 107.2 months. Of the study population, 11.5% had a positive family
      history for PSP. The height-to-weight ratio was significantly and positively
      correlated with the number of PSP episodes per person, with the regression
      coefficient being 0.49. The age distribution of those with PSP had a monophasic
      pattern, with the average age being 25.3 years on first episode. More than one
      episode of PSP occurred in 41.3% of patients. No ipsilateral recurrences were
      observed after surgery. Treatment with a sclerosing agent seemed to be more
      effective in preventing ipsilateral recurrences of PSP than chest tube insertion
      alone (26.5% vs. 38.3%). Primary spontaneous pneumothorax is an important medical
      problem, especially in men of military age. It has a significant inherited
      component in its etiology, with asthenic body build being an additional risk
      factor. Based on a literature review and the data obtained from this study, it
      was concluded that chest tube insertion with intrapleural instillation of a
      sclerosing agent is the preferred nonsurgical invasive treatment modality in PSP.

PMID- 8484389
TI  - Case report: silent thyroiditis after adrenalectomy in a patient with Cushing's
      syndrome.
AB  - A case of silent thyroiditis after unilateral adrenalectomy for treatment of
      Cushing's syndrome is reported. The left adrenocortical adenoma was resected.
      Glucocorticoid was replaced after the operation and was gradually tapered.
      Thyrotoxic symptoms with painless goiter occurred 9 months after the
      adrenalectomy when a replacement dose of prednisolone was tapered to 5 mg/d.
      Plasma-free thyroid hormones increased and thyrotropin was suppressed. Thyroidal
      uptake of radioactive iodine was extremely low. Both titers of antimicrosomal and
      antithyroglobulin antibodies stayed at high levels throughout the observation
      period from the preoperative stage. Normalization of thyroid functions was
      obtained 3 months after the onset of thyrotoxicosis with beta-adrenergic blocker
      alone. It was speculated that exposure to a large amount of endogenous and
      supplementary exogenous glucocorticoid protected the patient's immune system from
      autoimmune attack of thyroid antigens and that tapering of the supplementary
      glucocorticoid caused exacerbation of immune responses, resulting in overt
      thyroid dysfunction even 9 months after adrenalectomy.

PMID- 8484390
TI  - Case report: alpha G-Philadelphia, beta O-Arab, and beta C globins present in a
      single patient.
AB  - The case of a 7-month-old Nigerian child who presented with anemia and
      microcytosis is described. Hemoglobin electrophoresis studies revealed a band
      with pronounced cathodic mobility. This represented a heterohybrid hemoglobin
      tetramer composed of an alpha-globin mutant, G-Philadelphia (alpha GPhil), and
      two variant beta-globin chains, beta C and beta O-Arab. The absolute amounts of
      alpha GPhil found in the propositus were less than expected for an alpha 2-globin
      gene product. It has not been established whether alpha G-Philadelphia
      interacting with beta O-Arab and beta C globin chains is the cause of the
      microcytosis.

PMID- 8484391
TI  - Case report: effects of iron deficiency and the -88 C-->T mutation on HbA2 levels
      in beta-thalassemia.
AB  - Hemoglobin A2 levels in members of an African American family with -88 C-->T
      beta(+)-thalassemia were measured, and two patients in whom iron deficiency
      anemia developed were evaluated during treatment. Iron deficiency may diminish
      the level of HbA2 in healthy control subjects and in patients with heterozygous
      beta-thalassemia; in addition, it may reduce the amount of variant hemoglobin in
      certain hemoglobinopathies. Although iron deficiency appeared to be associated
      with a reduction in HbA2 quantity in the patient with heterozygous beta
      thalassemia, the level of HbA2 did not fall below the range characteristic of
      beta-thalassemia. It had been proposed that mutations in the beta-globin gene
      promoter may be associated with higher-than-expected levels of HbA2. However,
      this "mild" beta-globin gene promoter mutation did not seem to result in HbA2
      concentrations higher than anticipated in the heterozygous beta-thalassemias.

PMID- 8484392
TI  - Case report: hyponatremia associated with nonsteroidal antiinflammatory drugs.
AB  - The effects of renal prostaglandins on medullary blood flow, active chloride
      transport, and antidiuretic hormone are important in urine dilution. It is
      surprising, therefore, that drugs that inhibit prostaglandin synthesis rarely
      cause hyponatremia. A patient in whom hyponatremia developed during ibuprofen
      administration is described and other reported cases of this association in
      adults are reviewed. The previous case reports fall into two well defined groups:
      first, neonates treated with indomethacin for patent ductus, and second, adults,
      often elderly, who usually have other diseases that impair urinary dilution.
      Although hyponatremia is a rare consequence of therapy with prostaglandin
      inhibitors, certain individuals are at increased risk and should be monitored for
      this side effect.

PMID- 8484393
TI  - Hypothalamic-pituitary-adrenal function in non-AIDS patients with advanced HIV
      infection.
AB  - Patients with acquired immune deficiency syndrome (AIDS) are reported to have
      increased basal cortisol and reduced stimulated cortisol release, but the
      dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis is not yet
      understood in patients with human immunodeficiency virus (HIV) infection during
      the advanced stage of disease that precedes the development of AIDS. To
      understand the status of the HPA axis during this phase of HIV infection, 25 non
      AIDS ambulatory patients with advanced HIV infection and without evidence of
      adrenal or pituitary insufficiency were studied. Ovine corticotropin-releasing
      hormone was administered (1 microgram/kg BW) intravenously and plasma cortisol
      and adrenocorticotropin (ACTH) were measured over the following 120 minutes.
      Based on a standard response curve, obtained from CRH testing of 10 HIV negative
      volunteers with no HPA abnormalities, 13 patients were found to have normal
      response (group 1), 6 patients had reduced ACTH and cortisol response (group 2)
      and 6 patients had normal ACTH with reduced cortisol response (group 3). Basal
      cortisol and basal ACTH were comparable for control subjects and groups 1, 2, and
      3. This suggests that, in advanced non-AIDS HIV patients with no clinical
      evidence of pituitary or adrenal disease, about 25% (group 2) have reduced
      pituitary reserve with high basal ACTH and cortisol, and about 25% (group 3) have
      reduced adrenal reserve with high basal cortisol and inappropriately normal basal
      ACTH, whereas about 50% (group 1) maintain normal HPA axis activity with
      increased basal cortisol secretion. The exact physiopathologic mechanism is not
      yet known, but an enhanced CRH production by the hypothalamus may explain the
      alterations in the HPA axis in advanced HIV disease.

PMID- 8484394
TI  - The acute chest syndrome of sickle cell disease.
AB  - The acute chest syndrome (ACS), characterized by fever, chest pain, leukocytosis
      and a new infiltrate on chest roentgenogram, is a common complication of sickle
      hemoglobinopathies. The major differential diagnoses of ACS are pneumonia and
      pulmonary vaso-occlusive disease, which may occur simultaneously. Bacterial
      pulmonary infections are documented infrequently in ACS with the exception being
      in the pediatric population under 5 years of age. Because there are no clinical
      or laboratory parameters that clearly allow for distinction between pneumonia and
      vaso-occlusive disease, empiric use of antibiotics directed against S. pneumoniae
      and other pathogens commonly seen in community-acquired pneumonias remain a
      mainstay of therapy.

PMID- 8484395
TI  - Competing stochastic models of the incubation period: an investigation of age-at
      diagnosis of familial and sporadic retinoblastoma.
AB  - This study is based on the assumption that the distribution of age-at-diagnosis
      (a synonym for the incubation period) of a disease can convey information with
      respect to its pathogenetic mechanisms. To this end, an analysis of 3
      retinoblastoma (RB) international data sets was undertaken. The molecular and
      cellular basis of RB is well understood and may serve our purpose well. RB is
      broken down into familial bilateral, unilateral, and sporadic unilateral forms.
      Survival and hazard functions were computed. Several competing stochastic models
      (up to 9 per RB form) were fit. Each conveyed a meaningful pathogenetic
      mechanism. Between-model discrimination was achieved by examining chi-square
      goodness-of-fit values to select the best fitting model. Well-known survival
      models, such as the simple exponential and the lognormal (Sartwell model) were
      ruled out. Age-at-diagnosis of familial RB proved to be best explained by 2
      interfering exponentials (a diffonential function); the logistic was retained as
      the best adjusted model of the incubation period of sporadic cases of RB. As to
      familial unilaterals, both the diffonential and the logistic models fit equally
      well. The 3 data sets are consistent in these results, ruling out the less well
      fit competing models. The results suggest the existence of 2 opposing but
      independent balancing internal mechanisms at the origin of familial RB. Sporadic
      RB appears to be due to a single host-dependent self-limiting cellular mechanism.
      Familial unilaterals which share both of these component mechanisms would involve
      a lower retinoblast turnover rate. The cellular implications of these findings
      are discussed with regard to the relative importance of endogenous and exogenous
      induction factors in RB. It is concluded that, according to the RB form, RB
      occurrence results from 2 cellular interfering forces of different strength and
      organization.

PMID- 8484396
TI  - Chromosome cultures from human cartilage.
AB  - Choosing the best post-mortem biological tissue source for chromosomal studies is
      a challenge for cytogeneticists. Acceptable cytogenetic results are difficult to
      obtain from macerated and necrosed tissues. This report describes a method that
      is carried out after enzymatic digestion of cartilage from human fetuses and
      infants. It is currently employed successfully in our laboratory and our
      experience has shown that human cartilage could well be the tissue of choice for
      cytogenetic studies in stillborn fetuses and dead infants.

PMID- 8484397
TI  - Heterogeneity versus variability in megalocornea-mental retardation (MMR)
      syndromes: report of new cases and delineation of 4 probable types.
AB  - Megalocornea (corneal diameter > or = 13 mm) is associated with mental and
      neurological impairment, and minor anomalies in Neuhauser syndrome (megalocornea
      mental retardation syndrome). Here we report 4 new cases of megalocornea and
      mental retardation. Those unrelated patients have a consistent pattern of
      anomalies with possible recessive inheritance which clearly differs from that of
      the original patients of Neuhauser et al. [1975]. We discuss the heterogeneity of
      the syndromes with megalocornea and mental retardation. Based on these cases and
      on a review of the literature, we suggest a provisional clinically oriented
      classification in 5 subtypes: (1) a recessive form type Neuhauser (with iris
      hypoplasia and minor anomalies), (2) a recessive form type Frank-Temtamy (with
      camptodactyly, scoliosis and growth retardation), (3) a recessive type 3,
      including our 4 personal cases (with normal irides, severe hypotonia, relative or
      absolute macrocephaly and minor anomalies), (4) a possible Frydman type (with
      normal irides, megalencephaly and obesity), and (5) provisionally unclassifiable
      cases.

PMID- 8484398
TI  - Brachydactyly, mesomelia, mental retardation, aortic dilatation, mitral valve
      prolapse, and characteristic face.
AB  - We report on a male with brachydactyly, thin habitus with narrow shoulders,
      mesomelic shortness of the arms, long lower face with obtuse mandibular angle,
      maxillary hypoplasia with beaking of the nose, aortic root dilatation, and mitral
      valve prolapse. This combination of findings has not been reported previously.

PMID- 8484399
TI  - 18q-mosaicism associated with Rett syndrome phenotype.
AB  - Rett syndrome consists of a characteristic progressive encephalopathy in females.
      The cause of this syndrome is unknown. We present a patient with 18q-mosaicism
      who, along with the characteristics of this autosomal deletion, also fulfills the
      clinical criteria for Rett syndrome. This may demonstrate heterogeneity within
      this as yet clinically defined syndrome. A thorough chromosomal analysis should
      be performed in suspected cases of Rett syndrome.

PMID- 8484400
TI  - Proteus syndrome with cardiomyopathy and a myocardial mass.
AB  - Proteus syndrome is an overgrowth syndrome principally affecting cutaneous and
      skeletal tissues, accompanied by subcutaneous hamartomas. We report on a patient
      with predominantly skeletal and visceral involvement, including a cardiac mass
      and thickening of the myocardial septum affecting cardiac conduction and
      contraction.

PMID- 8484401
TI  - Decrease in calcitonin-containing cells in truncus arteriosus.
AB  - Experimental studies in chick embryos have demonstrated that truncus arteriosus
      (TA), a form of conotruncal cardiac defect, is due to abnormalities in the
      cranial neural crest. However, no data are available to support this hypothesis
      in humans with isolated TA. In the present study, the assessment of calcitonin
      immunoreactive cells (C-cells) has been employed to evaluate whether or not the
      proportion of thyroid cells derived from the cranial neural crest is normal in
      patients with isolated TA. Thyroid sections from 15 such patients in which no
      other extracardiac malformations were neither clinically nor pathologically
      found, and from 11 control age-matched patients were studied
      immunohistochemically at autopsy in order to determine the number and
      distribution of calcitonin-containing cells. The volume density of C-cells
      (0.888%) and the number of C-cells per follicle (0.991) was significantly lower
      in patients with TA than in control patients (3.475%, and 2.367, respectively).
      The decrease of neural crest-derived cells in the thyroid of patients with
      "isolated" TA documents more extent abnormalities than clinically suspected and
      supports the hypothesis of neural crest disturbance as the pathogenetic factor
      responsible for this heart malformation.

PMID- 8484402
TI  - Effect of laboratory or clerical error on presymptomatic risk calculations for
      Huntington disease: a simulation study.
AB  - Linked markers are useful in prenatal diagnosis as well as presymptomatic
      diagnosis in late age-of-onset diseases such as Huntington disease (HD). It is
      widely assumed that most laboratory or clerical errors will be detected because
      of incompatibility of marker haplotypes within the family. However, errors in
      marker phenotypes that are compatible but wrong may result in a consultand being
      given an incorrect risk estimate. We have addressed this issue using simulated
      marker data in pedigrees similar to those seen in our HD testing program. In
      Family Structure I (an 11-member, 3-generation family), a particular family was
      more likely to be detected as inconsistent than incorrectly assigned. In a small
      nuclear family (Family Structure IV), fewer errors would be detected, and more
      would appear consistent but give incorrect risk estimates (e.g., low risk
      misclassified as noninformative or high). Given the presence of tight linkage,
      risk estimates are often calculated based on a small number of relatives.
      However, these computer simulations demonstrated that increasing the number of
      relatives typed decreases the probability that the family will remain consistent
      with an error present, and, therefore, decreases the probability of an incorrect
      assignment of risk. It is important to decrease the level of such errors by
      duplicated readings of raw marker data and validation of computer input.

PMID- 8484403
TI  - Segregation analysis of rare autosomal folate sensitive fragile sites.
AB  - We have studied 12 families with rare autosomal folate sensitive fragile sites
      (RAFSFS). Of these, 9 were informative for segregation analysis of fragile sites
      in order to assess differences in parental transmission. We identified 20
      families with RAFSFS from the literature from 1985 to 1989; thirteen of these
      were informative for segregation analysis. Segregation analysis confirmed that
      paternal fragile site transmission rates deviated significantly from the expected
      50% for a Mendelian co-dominant trait. Sex ratio comparisons showed a significant
      excess of transmitting females and a significant excess of males among fragile
      site non-carriers from the literature families. Comparison of the fragile site
      carriers with non-carriers in the combined data showed a non-significant excess
      of non-carriers. We confirmed a deficiency of offspring expressing fragile sites
      when transmission was through fathers, suggesting gametic selection or the
      phenomenon of parental genomic imprinting.

PMID- 8484404
TI  - Severe nonspecific X-linked mental retardation caused by a proximally Xp located
      gene: intragenic heterogeneity or a new form of X-linked mental retardation?
AB  - X-linked mental retardation (XLMR) can be subdivided into syndromic and
      nonsyndromic or nonspecific. Patients with non-syndromal XLMR show no
      characteristic manifestations, biochemical defects, or distinct fragile sites.
      Nevertheless, nonspecific XLMR seems to be heterogeneous. To determine the number
      and location of the genes responsible for XLMR, linkage studies in large
      pedigrees have to be performed. Here we report the data of linkage analysis in a
      large Brazilian family with 7 patients affected by a severe form of XLMR, with no
      other associated malformations. All the obligate carriers are normal. A close
      linkage without recombination (lod scores 1.95 and 3.25) was found between the
      disease locus and polymorphic DNA loci DXS255 (Xp11.22), DXS14 (Xp11.21). These
      results suggest that the gene responsible for the disease in this family maps in
      the Xp11-cent of the X chromosome. Positive lod scores in this region have also
      been reported for other XLMR genealogies, but with a much milder phenotype. The
      possibility of intragenic or locus heterogeneity is discussed.

PMID- 8484405
TI  - Index finger hyperphalangy and multiple anomalies: Catel-Manzke syndrome?
AB  - We describe a boy with short stature, developmental delay, unusual face, right
      iris coloboma, malformed ears, micrognathia, and skeletal anomalies including
      hyperphalangy of the index fingers, bilateral fifth finger clinodactyly, short
      halluces, and scoliosis. Internal anomalies included asymmetric and dilated
      cerebral ventricles and ventricular septal defect. The neonatal history of small
      jaw with feeding and respiratory difficulties suggested a Pierre Robin sequence,
      but there was no cleft palate. Two maternal uncles with similar anomalies had
      died at ages 13 months and 5 years, respectively. RFLP studies with the DNA
      probes DXS72 and F8C were consistent with but not diagnostic of X-linked
      recessive inheritance. The pattern of anomalies was compatible with a diagnosis
      of Catel-Manzke syndrome, but a novel dysostosis syndrome must also be
      considered.

PMID- 8484406
TI  - New lethal syndrome of fetal akinesia with characteristic facial appearance,
      severe microphthalmia, microtia, and truncus arteriosus in two male sibs.

PMID- 8484407
TI  - Mutations in von Recklinghausen neurofibromatosis: an hypothesis.
AB  - Von Recklinghausen neurofibromatosis or neurofibromatosis type I (NF1) is a
      relatively frequent (1/3,000 livebirths) autosomal dominant condition. Some
      unusual aspects are noted in this disorder: new mutations are frequent and almost
      all are of paternal origin without parental age effect. The recurrence of NF1
      among children of healthy parents is rare as opposed to other dominant disorders.
      I propose that in NF1 (1) new mutations occur often in somatic cells or in late
      germinal cells, however, they occur very rarely in early germinal cells leading
      to germinal mosaicism and (2) the individual with somatic mosaicism presents
      symptoms of the disease. Therefore, an NF1 patient with an apparent new mutation
      is often a somatic mosaic for the mutation and if the mosaic is also present in
      germinal cells some of his children will be affected. This hypothesis may explain
      the unusual aspects of mutation in NF1.

PMID- 8484408
TI  - Vascular anomalies in campomelic syndrome.
AB  - We report on 4 patients with the campomelic syndrome (CS) in whom postmortem
      angiography of the lower limbs was performed. Of the 4 patients, 3 were
      phenotypic females (2 of them with a 46,XY karyotype) and one was a male with a
      normal 46,XY karyotype. Three fulfilled the criteria of CS, and one
      (phenotypically female with a 46,XY karyotype) lacked the lower limb bowing and
      the talipes equinovarus typical of CS. This infant may constitute a further
      example of the recently reported CS without campomelia. The results of the
      angiographic study are compared with 46 postmortem angiographies of normal
      fetuses and newborn infants at different gestational ages. In the first 3 CS
      patients the main arterial axis of the lower limb, formed by the superficial
      femoral and anterior tibial arteries, had smaller diameters than expected while
      the profunda femoris and posterior tibial arteries had greater diameters than age
      matched controls. However, the most striking abnormality was the absence or
      marked deficiency of the anterior tibial artery. Its terminal branch, the
      dorsalis pedis artery, was also absent and the plantar arch was abnormally formed
      by the posterior tibial artery either alone or in conjunction with the peroneal
      artery. The normal arterial pattern was found in the patient who lacked bowed
      bones. This finding supports a developmental association between vascular defects
      and lower limb anomalies in CS. This aberrant arterial pattern in CS may affect
      or be affected by muscle development. The shortness of the posterior femoral and
      calf muscles fix the knee and the ankle joints.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484409
TI  - Trisomy 4 in a fetus with cyclopia and other anomalies.
AB  - We report on an 18-week fetus with cyclopia, alobar holoprosencephaly, complex
      congenital heart defect, anal atresia, oligosyndactyly, cystic hygroma, and
      skeletal abnormalities with trisomy 4. Structural anomalies were detected on
      routine ultrasound of the pregnancy of a 17-year-old G3 P1 TAB1 woman with sickle
      cell trait. Trisomy 4 conceptuses usually miscarry in the first trimester. We are
      aware of no other reports of a fetus with trisomy 4 and cyclopia. Causal
      association of chromosome abnormalities and holoprosencephaly sequence may be
      more apparent in embryos and early fetuses than term fetuses because of poor
      viability of affected conceptuses.

PMID- 8484410
TI  - Bromodeoxyuridine induces chromosomal fragile sites in the canine genome.
AB  - Peripheral blood lymphocytes from 3 clinically normal domestic dogs were cultured
      for bromodeoxyuridine (BrdU) induction of fragile site expression. BrdU induced
      fragile site expression in cells from all 3 dogs. The mean percent of cells with
      fragile sites and the mean number of fragile sites per cell were significantly
      increased in all BrdU incubated cultures compared to control cultures. The
      frequency of BrdU fragile site expression did not vary significantly among the
      dogs. Lymphocytes from all 3 dogs expressed BrdU induced autosomal fragile sites.
      Two BrdU induced fragile sites were identified on the long arm of chromosome 1,
      one of which was close to or coincident with a previously identified folate
      sensitive fragile site on this canine chromosome. Lymphocytes from the 2 female
      dogs also expressed BrdU induced fragile sites on the X chromosome, but BrdU
      failed to induce fragile sites on the X chromosome from the one male dog in the
      study. The 2 BrdU-induced fragile sites identified on the long arm of the X
      chromosome were close to, or coincident with 2 previously described folate
      sensitive common fragile sites on the canine X chromosome. This is the first
      report of induction of BrdU-inducible fragile sites in the genome of the domestic
      dog.

PMID- 8484411
TI  - Congenital scalp defects and vitreoretinal degeneration: redefining the Knobloch
      syndrome.
AB  - An apparently autosomal recessive syndrome of hereditary vitreoretinal
      degeneration (VRD) with retinal detachment, high myopia, and congenital
      encephalocele was described in 1971 by Knobloch and Layer [J Pediatr Ophthalmol
      8:181-184]. Clinical confirmation of the presence of encephaloceles was lacking,
      and no neuropathologic studies were reported. We have evaluated a similarly
      affected family with 2 sibs with high myopia, VRD, and occipital scalp defects.
      Histologic examination of the scalp defects showed heterotopic neuronal tissue in
      both instances. The older girl has had a unilateral retinal detachment. Her other
      eye and both eyes of the younger sib have so far been treated successfully with
      prophylactic retinal cryotherapy. Both children have normal to above normal
      intelligence. The family reported by Knobloch and Layer [1971] and the sibship
      herein described appear to represent a distinct autosomal recessive trait.
      Analysis of the associated defects suggests an underlying defect in early
      cephalic neuroectodermal morphogenesis. Data from these families imply that
      congenital occipital scalp defects rather than true encephaloceles may, as is
      true in some cases of Meckel syndrome, accompany Knobloch syndrome. The presence
      of a congenital midline scalp defect should alert the clinician to possible
      underlying central nervous system and/or ocular pathology and should lead to
      consideration of further diagnostic evaluations and prophylactic measures.

PMID- 8484412
TI  - Long-term outcome of Hurler syndrome following bone marrow transplantation.
AB  - Previous reports suggested a therapeutic response of lysosomal storage diseases
      such as Hurler syndrome following bone marrow transplantation. However, a clearer
      understanding of outcome has awaited long-term follow-up. We evaluated
      prospectively 11 consecutive patients with Hurler syndrome receiving marrow from
      an HLA-identical sib donor between September 1983-October 1988. Follow-up
      evaluations included assessment of donor engraftment by restriction fragment
      polymorphism analysis, determination of leukocyte alpha-L-iduronidase level,
      measurement of lumbar cerebrospinal fluid (CSF) pressure, computerized tomography
      (CT) of the brain, and psychometric testing. In this series there was a survival
      rate of 9/11 (82%) with all survivors showing complete (7 patients) or partial (2
      patients) donor engraftment. Prospective longitudinal evaluation of the 9
      surviving children, now 3.8-8.9 years posttransplantation (median 5.5)
      demonstrated persistence of previously deficient leukocyte alpha-L-iduronidase at
      levels reflecting the donor genotype and degree of donor engraftment. Urinary
      glycosaminoglycan excretion declined to near-normal within 5 months of donor
      engraftment. Prior to treatment, 7 of 8 children studied were found to have
      occult intracranial hypertension (lumbar CSF pressure > 20 cm CSF); however, all
      surviving children attained normal or near-normal pressure within 18 months of
      donor engraftment. Longterm follow-up CT imaging of the brain did not show
      progressive volume loss (cerebral atrophy) after donor engraftment. Of 9
      survivors, 4 children having a developmental quotient (DQ, Mental Development
      Index on Bayley Scales of Infant Development) above 80 prior to transplantation
      subsequently maintained IQ scores above this level. However, 5 patients with
      lower pretransplant DQ scores now have significant cognitive deficits and
      attention deficit hyperactivity disorder. Progressive brain damage resulting from
      communicating hydrocephalus may be prevented by successful engraftment. Early
      transplantation of children with Hurler syndrome who have normal intelligence is
      likely to have the clearest benefit because long-term intellectual outcome will
      be limited by brain damage which has occurred prior to treatment.

PMID- 8484413
TI  - Autosomal dominant preaxial deficiency, postaxial polydactyly, and hypospadias.
AB  - We report on 3 individuals, a man and his son and daughter, who were born with
      preaxial deficiencies of the hands and feet and postaxial polydactyly of the
      hands. Both males also had glandular hypospadias. Certain of these findings
      resemble those found in the hand-foot-genital syndrome; however, we conclude that
      this family has a hitherto unreported autosomal dominant condition. Production by
      a single gene defect of preaxial deficiencies and postaxial polydactyly in the
      same individual is of note.

PMID- 8484414
TI  - Bone dysplasia, midface hypoplasia, and deafness: three new patients and review
      of the literature.
AB  - We report on 3 unrelated patients with a syndrome of sensorineural deafness
      (3/3), midface hypoplasia (3/3), disproportionate shortness with short limbs
      (3/3), cleft palate or bifid uvula (3/3), and lack of high myopia (3/3). This
      brings the number of reported patients with this condition to 11. Different names
      such as oto-spondylo-megaepiphyseal dysplasia (OSMED) or the Insley-Astley
      syndrome have been used. We propose the name "syndrome of bone dysplasia, midface
      hypoplasia, and deafness" which lists the 3 main manifestations of the condition.

PMID- 8484415
TI  - New multisystemic disorder involving heart valves, skin, bones, and joints in two
      brothers.
AB  - We report on 2 brothers with a severe progressive disorder characterized by thick
      skin, acne conglobata, "coarse" face, osteolysis, gingival hypertrophy,
      brachydactyly, camptodactyly, and mitral valve prolapse. The youngest brother
      died at age 24 years because of heart failure. Biochemical and pathological
      studies excluded known metabolic diseases. We think that this is a new genetic
      disorder inherited in autosomal recessive or X-linked recessive manner.

PMID- 8484416
TI  - On Charles Darwin and other great men in correspondence with Carl Wilhelm von
      Naegeli.

PMID- 8484417
TI  - Charles Darwin and other great men in correspondence with Carl Wilhelm von
      Naegeli.
AB  - The great Swiss-German botanist Carl Wilhelm von Naegeli (1817-1891) was a
      student of Lorenz Oken, A.P. de Candolle, and Matthias Jacob Schleiden and became
      a key figure in "genetic" (i.e., evolutionary-developmental) biology in the mid
      late 19th century. He was an expert on the hawk-weed, Hieracium and also made
      important contributions to microbiology. One of his many outstanding students was
      Carl Correns, one of the 3 rediscoverers of Mendel's work. Naegeli was an early
      proponent and defender of Darwin. The correspondence preserved in the Naegeli
      family contains many important letters between Naegeli and his contemporaries.
      Those from Mendel to Naegeli have passed out of the Naegeli family and were
      published by Correns earlier in the century. However, exceptionally notable items
      still in the archives of the Naegeli family include 4 surviving letters from
      Darwin, 2 letters from Virchow, and 10 from Justus von Liebig. In spite of a lack
      of appreciation of Mendel's work, we call attention to the importance of those
      surviving documents from an era in which very few of the greatest naturalists and
      founders of modern biology--including Goethe, Darwin, Galton, Agassiz, von
      Humboldt, von Baer--were without "blind spots."

PMID- 8484418
TI  - Microcephaly in Rubinstein-Taybi syndrome.

PMID- 8484419
TI  - Manifestation of heterozygosity in Papillon-Lefevre syndrome?

PMID- 8484420
TI  - Inbreeding among medical geneticists.

PMID- 8484421
TI  - Clinical practice and service delivery: getting back on track.

PMID- 8484422
TI  - The future in the making: recent trends in the work-family interface.
AB  - Following a review of recent demographic trends in family life and gender roles,
      and of new developments in the American economy, their interactive effects are
      discussed. Directions for socioeconomic change are then suggested with a view to
      easing the burden on married adults that results from the combination of family
      and work obligations.

PMID- 8484423
TI  - Growing up with a psychotic mother: a retrospective study.
AB  - Nine adults who had been reared by mothers diagnosed with psychosis reported on
      their childhood experiences. Analysis of the retrospective data revealed the five
      common themes of abuse and neglect, isolation, guilt and loyalty, grievances
      about mental health services, and social supports. The resilience and coping
      strategies of the participants are examined, and implications for therapeutic
      interventions with such families are discussed.

PMID- 8484424
TI  - A clinical typology of interparental violence in disputed-custody divorces.
AB  - From two studies of high-conflict divorcing families in child custody disputes,
      four characteristic profiles of interparental violence were identified: ongoing
      or episodic battering by males, female-initiated violence, interactive violence
      controlled by males, and violence engendered by separation or postdivorce trauma.
      A fifth profile, culled from a subsample of members of the first two groups, was
      characterized by psychotic and paranoid reactions.

PMID- 8484425
TI  - Counseling and psychotherapy with Japanese Americans: cross-cultural
      considerations.
AB  - The literature of the past two decades on Japanese-American culture, behavior,
      and mental health services and issues is reviewed. Counseling and psychotherapy
      with these clients are then discussed, taking into account traditional Japanese
      cultural values, with particular emphasis on verbal and nonverbal factors
      affecting therapeutic approaches and communication.

PMID- 8484426
TI  - Handling bodies after violent death: strategies for coping.
AB  - Interviews with and observations of experienced and inexperienced personnel were
      conducted to determine their coping strategies before, during, and after their
      work with the bodies of people who had died violently. Avoidance, denial, and
      social support from the work group and spouse appeared to facilitate coping. The
      implications of these findings for therapeutic intervention are discussed.

PMID- 8484427
TI  - Reactions to perinatal loss: a qualitative analysis of the National Maternal and
      Infant Health Survey.
AB  - Women who had experienced an infant or fetal death responded to an open-ended
      question on the 1988 National Maternal and Infant Health Survey about their
      perinatal experience. A qualitative analysis of the 413 responses identified six
      major themes, including need for further information, problems with the mourning
      process, and unresolved questions about the cause of the death. Implications of
      the findings for health care practice are discussed.

PMID- 8484428
TI  - Mental health status of Cambodian refugees ten years after leaving their homes.
AB  - The mental health status of a general population sample of Cambodian refugees
      living in the United States was assessed ten years after they had left their
      homes in Cambodia. Subjects were found to be experiencing extremely high levels
      of post-traumatic stress disorder, dissociation, depression, and anxiety. Ninety
      percent of these refugees exhibited marked symptomatology in one or more of these
      categories.

PMID- 8484429
TI  - Divorced women: individual differences in stressors, mediating factors, and
      adjustment outcome.
AB  - Individual differences in exposure and response to stress in a sample of 56
      divorced mothers were examined. Compared with normative data, the sample reported
      significantly more negative life events, more psychiatric symptoms, and poorer
      social adjustment. Social support and income emerged as the mediating factors
      most strongly associated with adjustment outcome.

PMID- 8484430
TI  - Threat of missile attacks in the Gulf War: mothers' perceptions of young
      children's reactions.
AB  - Mothers' perceptions of their infants' and toddlers' reactions to stressors
      related to the Gulf War were examined. Substantial distress reactions were
      displayed in somatic symptoms, behavioral disturbances, difficulties in routine
      functioning, and regressive behavior. Coping reactions were manifested in
      cooperative, helpful, and symbolic behavior. Reactions were found to be related
      to proximity to missile target zones, family reactions, and age of the child.

PMID- 8484431
TI  - Burdens and gratifications of caregiving: appraisal of parental care of adults
      with schizophrenia.
AB  - The caregiving experiences of 60 parents of adults with schizophrenia were
      investigated for the presence of gratification; the role of the interpersonal
      caregiver-child relationship; and the effects of burden, gratification, conflict,
      and intimacy. Results indicate that relationships, as measured by intimacy and
      conflict, were more highly associated with burden and gratification than were
      severity of schizophrenic symptoms or degree of caregiving involvement.
      Implications for therapeutic interventions are discussed.

PMID- 8484432
TI  - Emotional distress in Israeli women before and after abortion.
AB  - Emotional distress in a group of Israeli women who requested legal abortion was
      compared with that in a group of women on the verge of delivery and in a random
      group of nonpregnant women on measures of anxiety and depression. Emotional
      consequences of the abortion were evaluated by before-and-after comparisons of
      the same measures in a subgroup of the aborting women. Findings indicated
      significantly greater distress in the aborting women, with lower levels after the
      abortion. The effects on emotional well-being of personal and contextual factors
      and their interactions were also examined.

PMID- 8484433
TI  - Lesbians and HIV: clinical, research, and policy issues.
AB  - Sources of risk for HIV infection in members of the lesbian community are
      surveyed, together with factors that adversely affect access to appropriate
      health care by women in general and lesbians in particular. Issues of clinical
      practice, research, and public policy are examined with a view to promoting more
      effective prevention and treatment strategies.

PMID- 8484434
TI  - Mood disorders in children with oppositional defiant disorder: a pilot study.
AB  - The nature and prevalence of comorbid mood disorders were explored in a group of
      28 latency-age children diagnosed with oppositional defiant disorder. Findings
      are preliminary in nature but suggest that children with oppositional defiant
      disorder are at significant risk for low-grade depressive illness and that this
      may commonly be overlooked in the presence of their primary disorder's more overt
      symptoms.

PMID- 8484435
TI  - Childhood sexual abuse and parental alcoholism: interactive effects in adult
      women.
AB  - Symptoms associated with histories of childhood sexual abuse and parental
      alcoholism were investigated in a sample of 364 university women. A significant
      association was found in occurrence between the two stressors, and a
      substantially higher level of symptoms was revealed in women who had experienced
      both during childhood.

PMID- 8484436
TI  - Paternal involvement, maternal employment, and adolescents' academic achievement:
      an 11-year follow-up.
AB  - An 11-year follow-up study explored the effects of paternal involvement in child
      rearing and maternal employment in prior years on grades and educational
      expectations of a group of white, middle-class adolescents from intact families.
      Past maternal employment was found to be a more powerful predictor of children's
      academic performance and expectations than was amount of father involvement. Part
      time maternal employment appeared to be optimal for children's academic
      expectations.

PMID- 8484437
TI  - Woman battering in Israel: the relative contributions of interpersonal factors.
AB  - Interpersonal factors were examined in 60 couples who reported violence by male
      against female partner and in 60 couples who did not. Violent men reported lower
      partnership quality and less social support than did nonviolent men. Battered
      women reported lower partnership quality but more positive social support than
      did women with nonviolent partners. Level of violence was predicted by level of
      child-rearing conflict and the availability of social support for the violent
      men.

PMID- 8484438
TI  - Munchausen syndrome by proxy: diagnosis and prevalence.
AB  - A review of the literature and a survey of pediatric neurologists and
      gastroenterologists yield data indicating that the prevalence of Munchausen
      syndrome by proxy is greater than is generally estimated. This possibility is
      further supported by follow-up data on siblings of victims, together with wide
      variability among practitioners in case identification.

PMID- 8484439
TI  - Fear, embarrassment, and relief: the tuberculosis epidemic and public health.

PMID- 8484440
TI  - Talking past each other about risks and the importance of context.

PMID- 8484441
TI  - A proposal for the mandatory inclusion of helmets with new children's bicycles.
AB  - To reduce bicycle-related head injuries in children, we propose new regulations
      be established that mandate the inclusion of approved helmets with the sale of
      all new children's bicycles. Currently, purchasing a helmet is a separate
      economic decision that acts as a barrier to helmet ownership and use. The
      inclusion of a helmet with the bicycle would markedly increase helmet ownership.
      The increased demand would reduce the manufacturing cost per helmet, so the cost
      of the bicycle with the helmet would be lower than the current retail price of
      the two separately. This proposal could potentially be implemented by federal or
      state legislation, a Consumer Product Safety Commission regulation, or voluntary
      adoption of a practice or standard by bicycle manufacturers. Increased helmet
      ownership is necessary but not sufficient to raise helmet use rates. The
      increased ownership generated by this proposal, complemented by enhanced
      educational, promotional, and legal interventions, is probably the most practical
      and cost-effective public health strategy available to increase helmet usage and
      prevent bicycle-related head injuries in children.

PMID- 8484442
TI  - Tuberculosis, again.

PMID- 8484443
TI  - The dual epidemics of tuberculosis and AIDS: ethical and policy issues in
      screening and treatment.
AB  - As the recent increase in cases of tuberculosis is addressed, there is a danger
      that the need for increased protection of the public health will create a climate
      in which the rights of individuals with tuberculosis and human immunodeficiency
      virus (HIV) infection may be disregarded. This paper considers ethical and policy
      issues in the control of tuberculosis. The authors conclude that mandatory HIV
      testing is not critical to effective tuberculosis control, and that although
      individuals infected with HIV are at increased risk for developing tuberculosis,
      exclusionary employment practices are not justified. Because failure to complete
      the course of tuberculosis treatment increases the prospect that drug-resistant
      strains will develop, it is crucial to require all those who commence treatment
      to complete their therapy. To ensure the completion of treatment, special
      attention must be paid to the needs of the homeless, drug users, and those with
      psychiatric impairments. In addition, all tuberculosis patients should begin
      their posthospital care under direct observation. Patients who fail to complete
      treatment despite efforts to encourage and facilitate their cooperation should be
      subject to confinement after a hearing with full due process protections.

PMID- 8484444
TI  - Forging the future: the public health imperative.
AB  - During the 1980s, national policy promoted military expenditures and downsized
      domestic programs. These priorities, along with tax reform and deregulation,
      created a "domestic gulf crisis" with a new wave of vulnerable populations--poor
      children, the homeless, the elderly, and the uninsured. Our lack of a national
      health program compounds the problem. The 1990s will be a decade of change and
      challenge. To forge a healthier and stronger future for our nation, we must
      implement five public health imperatives: (1) We must have a national health
      program that is universal, comprehensive, and prevention-oriented, with built-in
      assurances for quality, efficiency, and a strong public health infrastructure.
      (2) We must have a comprehensive national health education and promotion program
      for all schoolchildren. (3) Women must have freedom of choice. (4) Prevention and
      public health must become one of our country's highest health priorities. (5) The
      federal government must increase its leadership, commitments, and resources to
      reach the goals set forth in Healthy Communities 2000 and Healthy People 2000.

PMID- 8484445
TI  - Automobile driver fatalities in frontal impacts: air bags compared with manual
      belts.
AB  - OBJECTIVES: The effectiveness of air bags was estimated in this study by
      comparing driver fatalities in frontal crashes with driver fatalities in
      nonfrontal crashes, for cars with air bags and manual belts and cars with manual
      belts only. METHODS: Fatal Accident Reporting System data for drivers fatally
      injured during 1985 to 1991 in 1985 to 1991 model year cars that were equipped
      with air bags in or before model year 1991 were analyzed. RESULTS: Driver
      fatalities in frontal crashes in air bag cars were 28% lower than those in
      comparable cars with manual belts only. This percentage was used for estimating
      the overall fatality reduction in air bag cars. The reduction was greater in
      large cars (50%) than in midsize cars (19%) or in small cars (14%). Air bags
      reduced driver fatalities in frontal crashes involving ejection by about 9%.
      Fatalities in frontal crashes among drivers who were reportedly using manual
      belts at the time of the crash were reduced by about 15%. The comparable
      reduction among drivers who were reportedly not using manual belts was 31%.
      CONCLUSION: It was estimated that air bags reduced the total number of all driver
      fatalities by about 19%.

PMID- 8484446
TI  - Bicycle helmet laws and educational campaigns: an evaluation of strategies to
      increase children's helmet use.
AB  - OBJECTIVES: The passage of a mandatory bicycle helmet law for children in Howard
      County, Maryland, provided an opportunity to compare legislation and education as
      strategies to increase helmet use. METHODS: In 1991, a survey was mailed to
      fourth-, seventh-, and ninth-grade students attending a stratified sample of
      public schools in Howard County and in two similar suburban/rural counties
      without helmet laws. RESULTS: Of 7217 students surveyed, 3494 responded (48.4%).
      Self-reported helmet use in Howard County rose from 11% to 37% after the law and
      accompanying educational campaign went into effect. Helmet use changed from 8% to
      13% in Montgomery County, where educational efforts were undertaken, and from 7%
      to 11% in Baltimore County, where helmet promotion activities were minimal.
      Predictors of helmet use included having friends who wore helmets, believing
      helmet laws are good, being in fourth grade, living in Howard County, and using
      seatbelts regularly. CONCLUSIONS: Legislation combined with education appears to
      increase bicycle helmet use substantially more than does education alone. The
      Howard County law may be considered a successful model of a strategy to increase
      children's helmet use.

PMID- 8484447
TI  - An injury prevention program in an urban African-American community.
AB  - OBJECTIVES: Injury is a major US public health problem, particularly in urban
      minority communities. This paper evaluates the impact of the Safe Block Project,
      a comprehensive injury prevention trial, on home hazards and injury prevention
      knowledge in a poor urban African-American community. METHODS: Nine census tracts
      in the community were allocated to either the intervention area or the control
      area. The intervention, carried out by trained community outreach workers,
      consisted of (1) home modification for simple prevention measures, (2) home
      inspection accompanied by information about home hazards, and (3) education about
      selected injury prevention practices. Approximately 12 months after the
      intervention, random samples of control and intervention homes were assessed for
      home hazards and injury prevention knowledge. RESULTS: A significantly larger
      proportion of intervention homes than control homes had functioning smoke
      detectors, syrup of ipecac, safely stored medications, and reduced electrical and
      tripping hazards. No consistent differences were observed between control and
      intervention homes on home hazards requiring major effort to correct.
      CONCLUSIONS: There was a distinct difference between control and intervention
      homes with respect to safety knowledge and home hazards requiring minimal to
      moderate effort to correct. The Safe Block Project could serve as a model for
      future urban injury prevention efforts.

PMID- 8484448
TI  - Racial misclassification of American Indians: its effect on injury rates in
      Oregon, 1989 through 1990.
AB  - OBJECTIVES: We assessed the extent to which injury rates among American Indians
      in Oregon are underestimated owing to misclassification of race in a surveillance
      system. METHODS: The Oregon Injury Registry, a population-based surveillance
      system, was linked with the Indian Health Service patient registration file from
      Oregon, and injury rates for American Indians were calculated before and after
      correcting for racial misclassification. RESULTS: In 1989 and 1990, 301 persons
      in the Oregon registry were coded as American Indian. An additional 89 injured
      persons who were coded as a race other than American Indian in the registry were
      listed as American Indian in the Indian Health Service records. The age-adjusted
      annual injury rate for health service-registered American Indians was 6.9/1000,
      68% higher than the rate calculated before data linkage. American Indian
      ancestry, female sex, and residence in metropolitan counties were associated with
      a higher likelihood of concordant racial classification in both data sets.
      CONCLUSION: Injury rates among American Indians in an Oregon surveillance system
      are substantially underestimated owing to racial misclassification. Linkage of
      disease registries and vital records with Indian Health Service records in other
      states may improve health-related data regarding American Indians.

PMID- 8484449
TI  - Occupational injury deaths in Alaska's fishing industry, 1980 through 1988.
AB  - OBJECTIVES: Studies from other countries have identified fishing as a hazardous
      industry, but little is known about occupational injury mortality related to
      fishing in the United States. Alaska was chosen for this study because
      approximately 45,000 people annually participate in Alaska's fishing industry and
      fishing is thought to be a major contributor to occupational injury mortality in
      the state. METHODS: Work-related injury deaths in Alaska's fishing industry were
      identified by means of death certificates and US Coast Guard mortality data.
      Fatality rates were calculated by using average annual fishing industry
      employment estimates. RESULTS: The 5-year average annual fishing-related fatality
      rate was 414.6 per 100,000 fishermen. The majority of the decedents were
      Caucasian men who drowned while fishing. CONCLUSIONS: This study emphasizes that
      fishing is a dangerous industry in Alaska and demonstrates the benefit of using
      multiple data sources to identify fishing-related deaths in the state.

PMID- 8484450
TI  - The fluoridation of drinking water and hip fracture hospitalization rates in two
      Canadian communities.
AB  - OBJECTIVES: The purpose of this study was to compare hip fracture hospitalization
      rates between a fluoridated and a non-fluoridated community in Alberta, Canada:
      Edmonton, which has had fluoridated drinking water since 1967, and Calgary, which
      considered fluoridation in 1991 but is currently revising this decision. METHODS:
      Case subjects were all individuals aged 45 years or older residing in Edmonton or
      Calgary who were admitted to hospitals in Alberta between January 1, 1981, and
      December 31, 1987, and who had a discharge diagnosis of hip fracture. Edmonton
      rates were compared with Calgary rates, with adjustment for age and sex using the
      Edmonton population as a standard. RESULTS: The hip fracture hospitalization rate
      for Edmonton from 1981 through 1987 was 2.77 per 1000 person-years. The age-sex
      standardized rate for Calgary was 2.78 per 1000 person-years. No statistically
      significant difference was observed in the overall rate, and only minor
      differences were observed within age and sex subgroups, with the Edmonton rates
      being higher in males. CONCLUSIONS: These findings suggest that fluoridation of
      drinking water has no impact, neither beneficial nor deleterious, on the risk of
      hip fracture.

PMID- 8484451
TI  - Hip fracture rates in Hong Kong and the United States, 1988 through 1989.
AB  - OBJECTIVES: Prior studies have suggested that hip fracture rates are
      substantially lower in Asian countries than in the United States. However,
      comparisons have been limited by unavailability of recent data, differences in
      case definition, lack of data from similar time periods, and small sample sizes.
      This study sought to examine trends by age and sex, with separate statistics for
      those aged 85 or older. METHODS: Hospital discharge data were used to obtain hip
      fracture incidence in Hong Kong and the United States from 1988 through 1989.
      RESULTS: Within each population, women had higher hip fracture rates than men.
      Fracture rates in the United States were significantly higher for both sexes than
      rates in Hong Kong. For persons over the age of 80, rates of hip fracture among
      White US males exceeded those for Hong Kong women. Inclusion of transferred cases
      in hip fracture rates minimized differences between the countries. CONCLUSIONS:
      Despite increasing hip fracture rates in Hong Kong, those rates are still
      substantially lower than the rates in the United States. Identifying factors
      responsible for this variation may prove useful in the search for preventive
      strategies.

PMID- 8484452
TI  - Factors affecting gay and bisexual men's decisions and intentions to seek HIV
      testing.
AB  - OBJECTIVES: This paper describes the relationships of sociodemographic,
      attitudinal, and behavioral variables to (1) decision to be tested, (2) expressed
      intention to be tested, and (3) reasons for not being tested for the human
      immunodeficiency virus (HIV) antibody. METHODS: A sample of 1295 men completed an
      anonymous questionnaire in gay-identified venues. Factor analysis was used to
      group reasons for not being tested and logistic and multiple linear regression
      were used to model the dependent variables. RESULTS: Fifty-three percent of the
      respondents had been tested, of whom 26% tested positive. Metropolitan residence
      and anal intercourse most strongly correlated with previous test-seeking.
      Previous test experience correlated most strongly with intention to be tested.
      Reasons for not being tested fell into three groups: (1) desire for anonymity,
      (2) self-perceived health, and (3) no benefit and denial. The odds were lower for
      gay men than bisexuals and men who did not participate in anal intercourse to
      express a desire for anonymity. CONCLUSIONS: Public health agencies should be
      prepared to individualize testing policies and education to deal with specific
      concerns and fears. Improving access to the test by removing some of the current
      psychological and physical barriers will enhance its medical and public health
      value.

PMID- 8484453
TI  - Pregnancy and contraception use among urban Rwandan women after HIV testing and
      counseling.
AB  - OBJECTIVES: This study examined hormonal contraceptive use and pregnancy in urban
      Rwandan women, following human immunodeficiency virus (HIV) antibody testing and
      counseling. METHODS: A sample of 1458 childbearing urban Rwandan women aged 18 to
      35 years was tested and followed for 2 years. RESULTS: At enrollment, 17% of 998
      HIV-negative women and 11% of 460 HIV-positive women were pregnant, and 17% vs
      23%, respectively, were using hormonal contraceptives. One year later, half of
      the HIV-positive and one third of the HIV-negative hormonal-contraceptive users
      had discontinued use. The 2-year incidence of pregnancy was 43% in HIV-positive
      and 58% in HIV-negative women. HIV-positive women with fewer than four children
      were more likely to become pregnant than those with four or more; this
      association persisted in multivariate analyses but was not noted among HIV
      negative women. At the end of the study, over 40% of non-users said that they
      would use hormonal contraception if it was provided at the study clinic, but 40%
      of HIV-positive women desired more children. CONCLUSIONS: Research is needed to
      identify the practical and psychosocial obstacles to effective long-term
      contraception among HIV-positive women. HIV counseling programs must specifically
      address the issue of childbearing.

PMID- 8484454
TI  - Treatment for glaucoma: adherence by the elderly.
AB  - OBJECTIVES: The purpose of this study was to determine the extent of nonadherence
      to treatment for glaucoma among elderly patients. METHODS: This was a
      retrospective cohort study of 2440 patients older than age 65 who were enrolled
      in the New Jersey Medicaid Program and who were newly initiated on a topical
      agent for the treatment of glaucoma. Two patient-specific measures of
      nonadherence were employed: (1) no filled prescription for any glaucoma
      medication over a 12-month period after the initiation of therapy and (2) number
      of days without therapy for glaucoma during this 12-month period. RESULTS: By the
      first measure, 569 patients (23%) were found to be nonadherent. The mean number
      of days without therapy during the study year was 112. Factors associated with
      nonadherence included the use of glaucoma medication requiring more than 2
      administrations per day and the presence of multiple other medications in the
      patient's drug regimen. Patients started on multiple glaucoma medication were
      more adherent than those started on a single agent. Age and sex were not found to
      be predictors of nonadherence. CONCLUSIONS: Substantial nonadherence was found to
      be common in this population. More attention to the issue of nonadherence could
      result in important benefits in the preservation of sight.

PMID- 8484455
TI  - Potential health benefits of nutrition label changes.
AB  - OBJECTIVES: The Nutrition Labeling and Education Act of 1990 mandates the Food
      and Drug Administration to promulgate changes in nutrition labeling regulations.
      This study investigates the potential health benefits associated with expected
      changes in food consumption resulting from the act. METHODS: This paper provides
      four estimates of the potential health benefits from the dietary changes expected
      to occur as a result of the 1990 act. The upper bound estimates begin with the
      premise that all consumers will adopt the daily reference values of total fat,
      saturated fat, and cholesterol. The lower bound estimate is based on consumers'
      responses to a shelf-labeling program sponsored by the Food and Drug
      Administration in the 1980s. A computer model developed by Dr. Warren Browner and
      his associates was used to estimate the health benefits from reduced nutrient
      intakes. RESULTS: Estimates of the number of discounted life-years gained
      nationwide for the first 20 years after the implementation of the act range from
      a high of 1.2 million to a low of 40,000. CONCLUSIONS: The results of the study
      highlight that relatively small changes in nutrient intakes may generate large
      public health benefits.

PMID- 8484456
TI  - Race/ethnicity patterns in the homicide of children in Los Angeles, 1980 through
      1989.
AB  - This study investigated age, sex, and race/ethnicity risk patterns for homicide
      based on 246 children (newborn to 14 years old) who were murdered in the city of
      Los Angeles 1980 through 1989. Rates of homicide are higher for newborn to 4-year
      olds than for 5- to 14-year-olds. Boys and girls have similar rates of homicide
      at young ages; among 5- to 14-year-olds, however, boys have higher rates.
      Characteristics of the victim, suspect, and event were fairly consistent across
      victim race/ethnicity. Rates vary by the victim's race/ethnicity; paralleling
      patterns among adults, rates of homicide are lowest for non-Hispanic White,
      higher for Hispanic, and highest for Black children.

PMID- 8484457
TI  - Bicycle helmet counseling by pediatricians: a random national survey.
AB  - A random sample of 1201 pediatricians who are members of the American Academy of
      Pediatrics completed questionnaires regarding bicycle injury prevention
      counseling. Of the 871 pediatricians in the sample who provide health
      supervision, 80% reported that they discuss bicycle helmet use with their
      patients at least once before the patient reaches the age of 12 years. Provision
      of bicycle helmet counseling did not vary significantly by pediatricians' age,
      gender, or practice location. The most important predictor of provision of
      bicycle helmet counseling was professional experience with injured children,
      including having had a patient who experienced a serious injury or death due to a
      bicycle accident in the last year.

PMID- 8484458
TI  - The risk of childhood injury on Boston's playground equipment and surfaces.
AB  - The Childhood Injury Prevention Program of the Boston Department of Health and
      Hospitals conducted a survey of injury risk in Boston's playgrounds. A
      standardized checklist was used to assess a 25% sample of public playgrounds for
      hazards. Climbers accounted for 34% of the hazards observed and had the greatest
      proportion of significant hazards. The surfacing material in 100% of the
      playgrounds observed was unsafe. Urban children risk exposure to hazardous
      playground equipment frequently situated above unsafe surfacing material.

PMID- 8484459
TI  - Surface-specific fall injury rates on Utah school playgrounds.
AB  - The purpose of this study was to estimate surface-specific rates of fall injuries
      on school playgrounds. Playground injuries related to falls from climbing
      equipment and the surfaces involved were identified from injury reports for 1988
      to 1990 from 157 Utah elementary schools. Enrollment data and playground
      inspections were used to estimate student-years spent over each surface. The fall
      injury rates per 10,000 student-years were asphalt, 44; grass, 12; mats, 16;
      gravel, 15; and sand, 7. These data did not show that impact-absorbing surfaces
      reduce fall injuries on playgrounds better than grass. Improved field studies are
      needed to guide policy decisions for playground surfacing.

PMID- 8484460
TI  - A proposed classification code for farm and agricultural injuries.
AB  - A fundamental problem with classifying agriculturally related injury is that
      there is neither a rational nor a comprehensive scheme for grouping incidents
      into categories describing actual exposures encountered on farms and in
      agricultural work. Current surveillance systems are unable to differentiate
      between work that is related to farm production and work that is not, and to
      include all exposed persons in the surveillance. The proposed Farm and
      Agricultural Injury Classification Code is a step toward overcoming these
      problems. When it was applied to previously analyzed fatality data, 40% of cases
      previously identified as farm production work were reclassified into other
      categories.

PMID- 8484461
TI  - Occupational and environmental exposures reported to poison centers.
AB  - This analysis of 25,368 occupational and 7,565 environmental exposure cases
      characterizes the occupational and environmental exposures reported to the
      American Association of Poison Control Centers Toxic Exposure Surveillance
      System. Compared with other poisonings, occupational and environmental exposures
      were predominantly inhalation exposures rather than ingestions, were more often
      subacute or chronic, and demonstrated greater morbidity, mortality, and increased
      use of health care resources. As regional poison centers evolve to fill a
      critical information void in the management and assessment of environmental and
      occupational exposures, the American Association of Poison Control Centers Toxic
      Exposure Surveillance System provides an important, untapped passive surveillance
      mechanism.

PMID- 8484462
TI  - Hip fracture incidence before and after the fluoridation of the public water
      supply, Rochester, Minnesota.
AB  - Recent ecological comparison studies have suggested a positive association
      between fluoridation and hip fracture. Using data from the Rochester Epidemiology
      Project, we found the incidence of hip fracture for the 10 years before the
      fluoridation of the Rochester, Minn, public water supply was 484 per 100,000,
      compared with 450 per 100,000 in the following 10 years. When the effects of
      calendar time and age were controlled for, the relative risk associated with
      fluoridation was 0.63. These ecologic trend data suggest that the fluoridation of
      public water supplies is not associated with an immediate increase in rates of
      hip fracture. Further studies of this association at the individual level are
      clearly required before public policy decisions can be made.

PMID- 8484463
TI  - Antidepressants and falls among elderly people in long-term care.
AB  - All eligible residents of a long-term care facility (488 women and 147 men with a
      6-month minimum stay) were prospectively followed for 1 month for the development
      of falls. Use of psychotropic medications (excluding as needed prescriptions),
      functional status, and a history of falls were assessed at the start of the study
      month. Results of analyses using logistic modeling procedures suggest that
      institutionalized women on antidepressants may have an increased risk of falling,
      regardless of fall history, functional status, or age. A relationship between
      antidepressants and falls was not found for men. These results may help target
      high-risk individuals for future preventive efforts.

PMID- 8484464
TI  - Anergy compromises screening for tuberculosis in high-risk populations.
AB  - Anergy may occur in groups at high risk for tuberculosis, compromising tuberculin
      skin testing. Within New York City's correctional system, anergy prevalence was
      25% among opiate users referred to detoxification programs and 3% in the general
      population. Correlates of anergy were recent weight loss and needle sharing. The
      high prevalence of anergy among opiate users compromises the utility of
      tuberculosis screening and suggests the need for routine chest x-rays to detect
      pulmonary tuberculosis in some high-risk-populations.

PMID- 8484465
TI  - Local health officers' views on hazardous waste remediation.
AB  - Hazardous waste sites are a priority for local health officers in New Jersey.
      However, most officers feel that they are not adequately briefed or consulted by
      federal and state officials who manage site remediation. Consequently, many local
      health officers tend to be neutral or negative about federal and state site
      remediation plans. Consultation with local health officers should be formally
      built into the site remediation process, and officers should directly approach
      their state governments to gain access.

PMID- 8484466
TI  - Continuing female predominance in depressive illness.
AB  - This paper examines gender differences in temporal trends for major depressive
      disorder in childhood, adolescence, and young adulthood. The study sample, a high
      risk group from the National Institute of Mental Health Collaborative Study on
      the Psychobiology of Depression, includes 2000 first-degree relatives of probands
      with affective disorder. The age-specific incidence rates were analyzed to
      determine the effect of gender, age, period, and cohort on depression by age 35.
      Women had nearly a twofold increase in risk of major depressive disorder, with
      rates peaking between adolescence and early adulthood. Vulnerability to
      depression was highest in the 1960s and 1970s. The rate increase in recent
      decades has not corresponded to a reduction in the gender differences.

PMID- 8484467
TI  - New York City's tuberculosis control efforts: the historical limitations of the
      "war on consumption".
AB  - New York City began America's first campaign to control tuberculosis in 1893, and
      the disease declined until the 1970s. Throughout the 20th century, New York
      relied on three control strategies: screening, supervised therapy, and detention
      of noncompliant persons. Officials consistently identified the persistent foci of
      tuberculosis to be minorities and the poor, and they concentrated efforts among
      these populations. Recently, however, in the setting of rising human
      immunodeficiency virus infection and homelessness, tuberculosis--including
      multidrug-resistant strains--has returned to New York with a vengeance.
      Tuberculosis control in the city has been limited by two problems that hamper
      many public health programs: (1) antituberculosis measures, while appropriately
      targeting the poor, have been inconsistently funded and poorly coordinated; and
      (2) efforts have emphasized detection and treatment of individual cases rather
      than improvement of underlying social conditions. Renewed efforts by New York and
      other cities must address these limitations.

PMID- 8484468
TI  - Commentary: tuberculosis in New York City--the consequences and lessons of
      failure.
AB  - The resurgent tuberculosis epidemic represents--especially in New York City--a
      failure to maintain a public health infrastructure that was focused on preventing
      active disease in high-risk populations (i.e., individuals with the human
      immunodeficiency virus [HIV]) and on treating active tuberculosis patients until
      cured. Although the tuberculosis problem in New York City and other localities is
      worsened by homelessness, poverty, and substance abuse, it is possible to bring
      tuberculosis under control by directing public health resources into targeted
      programs that enhance compliance with tuberculosis treatment regimen and expand
      chemoprophylaxis efforts among HIV-infected individuals. These two avenues will
      decrease, respectively, the number of cases of multidrug-resistant tuberculosis
      and the total number of new cases.

PMID- 8484469
TI  - The validity of Medicaid diagnoses of hip fracture.

PMID- 8484470
TI  - Handedness, traffic crashes, and defensive reflexes: an indirect test.

PMID- 8484471
TI  - Potential bias in cardiovascular risk behavior study.

PMID- 8484472
TI  - The origins of infant salmonellosis.

PMID- 8484473
TI  - Accuracy of an automatic impedance apparatus in a population with secretory
      otitis media: principles in the evaluation of tympanometrical findings.
AB  - INTRODUCTION: The primary demand for a screening procedure for secretory otitis
      media (SOM) is to identify an objective test with sufficient sensitivity and
      specificity to meet the needs of the screening program. This study was designed
      to estimate the value of a portable automatic impedance apparatus to meet these
      needs. SUBJECTS AND METHODS: Two hundred twenty children with unilateral or
      bilateral SOM were evaluated in a double-blind, cross-sectional study. All have
      fulfilled two of the following three criteria for surgical intervention: (1) SOM
      by physical examination, (2) greater than 20 dB hearing impairment, and/or (3)
      adenoid symptoms. All ears were evaluated using tympanometry, following which
      myringotomy was performed. RESULTS: Otomicroscopy showed fluid behind the
      tympanic membrane in 393 ears. All underwent myringotomy. Thirteen percent (51
      ears) were empty. Of the otomicroscopic findings consistent with SOM, 82% had B
      curves, 6% had C2 curves, 8% had C1 curves, and 4% had A curves. Both C2 and B
      curves were considered abnormal. Sensitivity of the apparatus is 94.4% and of the
      specificity is 52.9%. There was no statistical correlation between
      tympanometrical findings and fluid viscosity. RESULTS: A test intended for
      screening has to be simple, easy, and quick to perform. Furthermore, the test
      should have high sensitivity. The automatic impedance apparatus is able to meet
      these demands; however, the individual results have to be confirmed by another
      method, eg, otomicroscopy, pure-tone audiometry, and/or manual tympanometry.

PMID- 8484474
TI  - Change of bone conduction thresholds by total footplate stapedectomy in relation
      to age.
AB  - INTRODUCTION: The influence of age on threshold changes of bone conduction after
      stapedectomy has not been thoroughly studied. Improvement of the Carhart notch by
      stapes surgery might be related to age as well as an increase in cochlear
      sensitivity to surgical trauma. PATIENTS AND METHODS: A retrospective study on
      the outcome of stapedectomy was undertaken. The results of surgery performed on
      387 ears in 315 patients for otosclerosis between 1962 and 1989 were obtained.
      Stapedectomy, performed by a single surgeon, consisted of total stapedectomy,
      seal of the oval window with tragal perichondrium, and insertion of a free tragal
      cartilage graft. RESULTS: Analysis of bone conduction changes with stapedectomy
      shows an average improvement of 5 to 6 dB at 0.5, 1, and 2 kHz with best
      improvement at 2 kHz. At 4 kHz a mean decrease of 4 dB is recognized. The
      improvement of bone conduction at 2 kHz is 12 dB in patients younger than 30
      years compared with 4 dB in patients older than 60 years (P < .05). The youngest
      group was improved by 2 dB at 4 kHz, whereas the oldest group deteriorated by 5
      dB (P < .05). Age relationship was apparent in all 4 frequencies. CONCLUSIONS:
      With increasing age there is less improvement in bone conduction at 0.5, 1, and 2
      kHz with correction of the Carhart notch and more deterioration at 4 kHz. The
      cochlear sensitivity to surgical trauma increases with age. In younger patients
      the preoperative bone conduction levels do not reflect the true cochlear reserve.
      Patients younger than 40 years of age might profit more from a partial or total
      footplate removal in stapedectomy, as this better corrects the Carhart notch.
      Patients older than 40 years of age might profit from a stapedotomy as this
      better preserves high frequencies.

PMID- 8484475
TI  - Surgical approach to pyriform sinus fistula.
AB  - INTRODUCTION: Congenital pyriform sinus fistula is recognized as a potential
      cause of recurrent cervical inflammation, recurrent abscess, and acute
      suppurative thyroiditis. Failure to recognize this diagnosis may result in
      recurrence following administration of antibiotics and incision and drainage.
      This study reflects the authors' experience in treating four patients with this
      diagnosis. MATERIALS AND METHODS: Patients included three children and one adult
      ranging in age from 7 to 34 years. The steps necessary to confirm the diagnosis
      and the subsequent surgical treatment are reviewed. RESULTS: All fistula occurred
      on the left side. In each case the fistula originated in the apex of the pyriform
      sinus. It subsequently penetrated the inferior constrictor in three cases and the
      thyroid cartilage in one to end in the thyroid gland or perithyroid tissue. The
      opening of the pyriform sinus fistula could be identified by either barium
      swallow or direct endoscopy. Complete fistulectomy resulted in resolution of
      symptoms in all cases. CONCLUSION: Pyriform sinus fistula is a rare entity. It
      may be of fourth branchial pouch origin. Identification of the fistula opening in
      the pyriform sinus may be difficult or impossible during acute inflammation
      because of edema. The authors advocate the fistula be exposed through incision of
      the inferior constrictor muscle, which facilitates total removal. Resection of
      the fistula, adjacent scar tissue, and a portion of the thyroid gland when the
      fistula is attached, should be regarded as essential steps in curing this entity.

PMID- 8484476
TI  - Results of curative laser microsurgery of laryngeal carcinomas.
AB  - INTRODUCTION: Between 1979 and 1991 the author treated more than 1,200 patients
      with malignant tumors of the upper-aerodigestive tract transorally using laser
      microsurgery with curative, palliative, or symptomatic intention. PATIENTS AND
      METHODS: This report is based on 240 patients without prior treatment, treated
      between 1979 and 1985 with curative intention for cancer of larynx (pTis-pT4
      (p)N0-pN2c). Patients with simultaneous second primaries and/or distant
      metastases were excluded. Neck metastases of the category N3 (UICC 1987) were not
      found in the group. Patients were divided into two groups. Group A (n = 159)
      includes glottic cancer as follows: Tis, 29; T1, 96; T2 (small, vocal cord
      mobile), 34. All patients were treated by laser microsurgery. There were only 6%
      local recurrences with one patient needing total laryngectomy. The overall 5-year
      survival rate (Kaplan-Meier) was 86.5%. The adjusted 5-year survival rate was
      100%. The group B patients (n = 81) included 30 supraglottic patients. Fifty
      eight patients were in tumor category pT2, among them there were 38 with glottic
      cancer (so called T2b, with vocal cord mobility impaired). Seventeen patients had
      pT3 and 6 pT4 tumors. RESULTS: Treatment consisted of laser microsurgery
      plus/minus neck dissection (23/81 = 28%) (mainly regionally limited functional
      surgery, only four radical neck dissections) plus/minus postoperative
      radiotherapy (29/81 = 35%). There were 22% local recurrences with six patients
      requiring total laryngectomy. The overall 5-year survival rate (Kaplan-Meier) was
      59%. DISCUSSION: This study confirms the usefulness of laser microsurgery for
      laryngeal carcinoma. Surgery is individualized and adapted to the size of the
      tumor. Multiinstitutional studies are needed to compare laser microsurgery with
      radiation therapy.

PMID- 8484477
TI  - Prognostic factors in glottic carcinoma clinical stage I and II treated by
      surgery or radiotherapy.
AB  - INTRODUCTION: Decision making regarding selection of treatment for early glottic
      carcinoma remains controversial. This study was undertaken to assess the impact
      of such factors as patient age, stage of tumor, site and size of characteristic
      of the lesion, and other characteristics relative to disease free and overall
      survival rates. PATIENTS AND METHODS: The records of 145 consecutive patients
      with stage I and II glottic carcinomas treated between 1954 and 1990 were
      reviewed retrospectively. Surgery was performed on 50 patients (34.5%), and
      irradiation therapy was performed on 95 (65.5%). Cox's regression model was used
      to estimate the hazard ratios of recurrence and death. RESULTS: Median follow-up
      was 69.3 months. Death due to cancer or treatment complications occurred in 29
      patients, whereas 25 patients died due to causes not related to cancer. Five-year
      rates for overall survival and disease-free intervals were 94.6% and 70.8%,
      respectively. Tumor control was achieved by initial surgery or irradiation in 78%
      and 69.5%, respectively. T stage and vocal cord mobility in this series were not
      associated with prognosis. Arytenoid involvement intended to indicate a worse
      prognosis. Other site involvement such as anterior commissure had no prognostic
      impact. DISCUSSION: Although stage I and II glottic cancers represent a
      heterogenous group, survival rates after surgery or radiotherapy vary relatively
      little. Death due to occurred in 17.9% of patients included in this series,
      whereas 17.2% died due to causes not related to cancer. Local recurrence
      following irradiation (29.5%) occurred more frequently than following surgery
      (10%). The choice of treatment modality for stage I and II glottic cancer should
      be justified by patient preference, involvement of anterior commissure, and
      impairment of vocal cord mobility and should not be a contraindication to
      radiotherapy.

PMID- 8484478
TI  - Extramedullary plasmacytoma of the larynx.

PMID- 8484479
TI  - Acquired laryngomalacia secondary to obstructive adenotonsillar hypertrophy.

PMID- 8484480
TI  - Osteogenesis imperfecta.

PMID- 8484481
TI  - Possible autocrine growth stimulation of cholesteatoma epithelium by transforming
      growth factor alpha.
AB  - INTRODUCTION: Transforming growth factor alpha (TGF-alpha) is known to be
      produced by normal human keratinocytes and to stimulate their proliferation. The
      squamous epithelium of middle ear cholesteatoma is believed to exhibit
      hyperproliferative characteristics. This study was undertaken to determine if
      growth factors can be identified in cholesteatoma. MATERIALS AND METHODS:
      Cholesteatoma samples (n = 6) and retroauricular skin (n = 9) were obtained
      during surgery. Monoclonal antibody against epidermal growth factor (EGF) and TGF
      alpha were evaluated in these specimens using immunohistochemical techniques.
      RESULTS: Epidermal growth factor receptor (EGF-R) was highly expressed in the
      basal layer of the epidermis, hair follicles, eccrine sweat glands, and the
      capillary system of normal skin. In the majority of cholesteatoma samples,
      expression of EGF-R was not confined to the basal layer but persisted in
      suprabasal cells of the stratum spinosum and stratum granulosum. In two cases,
      heterogenous standing was found in different parts of the same cryosection.
      Staining for TGF-alpha was consistently stronger in cholesteatoma than in normal
      skin, and encompassed all epithelial cell layers. Immune cells infiltrating the
      stroma of cholesteatoma stained positively for TGF-alpha. CONCLUSION: These data
      are consistent with autocrine stimulation of the squamous epithelium of
      cholesteatoma by TGF-alpha contributing to its unrestrained growth in the middle
      ear cavity.

PMID- 8484482
TI  - Current national trends in the posttreatment follow-up of patients with squamous
      cell carcinoma of the head and neck.
AB  - INTRODUCTION: Follow-up of individuals treated for a primary squamous carcinoma
      of the upper aerodigestive tract is critical because of the high risk of
      development of either recurrent disease or a new primary tumor. A mail survey of
      physicians actively practicing head and neck surgery was undertaken. MATERIALS
      AND METHODS: A multiple-choice survey was distributed to 400 members of the
      American Society for Head and Neck Surgery. Respondents indicated approach to
      post-treatment follow up. RESULTS: Surveys were returned from 290 members (73%).
      Routine monthly follow up is advocated by 73% of respondents during the first
      postoperative year. Patients are followed every 2 to 3 months in the second
      postoperative year by 90% of respondents. During postoperative years, 3 to 5
      patients are seen every 4 to 6 months by 97% of respondents. All respondents see
      patients either semiannually or annually for the remainder of their lives. Sixty
      percent of respondents advocate annual screening chest radiographs, whereas 14%
      do not order routine chest radiographs. The overwhelming majority of respondents
      reserve barium swallow and computed tomographic (CT) scans for evaluation of
      symptomatic patients. Similarly, nuclear imaging is reserved for patients with
      specific symptoms or abnormal laboratory tests. Blood tests most frequently
      monitored include complete blood cell count (CBC) (43%), thyroid function test
      (22%), and liver function test (20%). Follow-up endoscopic evaluation under
      anesthesia is reserved for symptomatic patients by over 95% of respondents.
      CONCLUSION: These data demonstrate that head and neck surgeons rarely use
      supplemental studies other than chest radiograph during routine follow up. The
      authors speculate that routine chest radiograph may be valuable in screening for
      a second primary carcinoma. Techniques to screen for esophageal tumors remain
      contentious.

PMID- 8484483
TI  - Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced
      hearing loss.
AB  - INTRODUCTION: This study examines the incidence of vitamin B12 deficiency in
      three groups of noise-exposed subjects: patients with chronic tinnitus and noise
      induced hearing loss (NIHL), patients with NIHL only, and subjects demonstrating
      normal hearing. MATERIALS AND METHODS: A group of 113 army personnel exposed to
      military noise was studied. The mean age was 39 years. Chronic tinnitus and NIHL
      existed in 57 subjects. NIHL alone was observed in 29 subjects, and 27 subjects
      had normal audiograms. All subjects were queried about noise exposure and dietary
      habits. Vitamin B12 serum levels were measured. RESULTS: Patients with tinnitus
      and NIHL exhibited vitamin B12 deficiency in 47% of cases (blood levels < or =
      250 pg/mL). This was significantly more (P < .023) compared with NIHL and normal
      subjects who exhibited vitamin B12 deficiency in 27% and 19%, respectively.
      CONCLUSION: These observations suggest a relationship between vitamin B12
      deficiency and dysfunction of the auditory pathway. Some improvement in tinnitus
      and associated complaints were observed in 12 patients following vitamin B12
      replacement therapy. The authors recommend that routine vitamin B12 serum levels
      be determined when evaluating patients for chronic tinnitus.

PMID- 8484484
TI  - [The value of the anamnesis and physical examination in surgical pathology of the
      thyroid gland. Report on 423 thyroidectomies].
AB  - The purpose of this paper is to present a retrospective study of 423 cases of
      surgical pathology of the thyroid gland. All the cases underwent surgery during a
      period of 11 years. The data gained through these ways were statistically studied
      and compared with those provided by histological diagnosis, with the aim of
      searching any clinic situations that can lead to the suspicion of oncological
      pathology of the gland.

PMID- 8484485
TI  - [Kniest syndrome. An audiological study].
AB  - In this syndrome there is a disproportionate dwarfism with kyphoscoliosis,
      stiffness of the joints, minor facial dysmorphia, myopia and both conductive and
      sensorineural deafness in 50 percent of patients. It is a dominant autosomic
      heritable malady of unknown incidence, but both sexes seems equally affected. The
      patient's condition is diagnosed at birth, because of the short limbs and the
      enlargement of the joints. In the presented case, diagnosed at birth, the
      deafness was suppose to be transmissive, owing to the coexistence of a cleft
      palate, and consequently a grommet was inserted in the tympanum. Only afterwards,
      when the girl was 12 years old, the cochlear component of the hypoacusis fell in
      consideration.

PMID- 8484486
TI  - [The value of the computer tomography (CT) and magnetic resonance (MR) in tumors
      of the ear].
AB  - The first case report is an undifferentiated squamous cell carcinoma of the ear.
      This patient complained with pain and discharging ear, which led us to practice a
      TC followed by an attico-antrotomy. The pathologist could detect in the removed
      tissue the neoplasm in its early evolutive stages. In the other case the earache
      and the suppuration suggested at first a carcinoma. In spite of the TAC and MR
      exams the surgery that followed was not confirmative of the tumor presence.

PMID- 8484487
TI  - [Lateral isolated neurofibroma of the neck].
AB  - The neurofibroma (NF) of the neck is a neurogenic tumor seldom presented.
      Sometimes solitary, as the case reported, or within the context of von
      Recklinghausen's disease. When diagnosis is doubtful either the TAC, the RMN of
      the PAAF show its usefulness. However the ultimate diagnosis is made through the
      histologic exam of the removed lump, which is the elective treatment.

PMID- 8484488
TI  - [Evaluation of the possible ototoxicity of josamycin by high frequency
      audiometry].
AB  - Josamycin is an antibiotic macrolide similar to erythromycin, with some
      differences in its biologic behaviour. There have been no reports of ototoxic
      effects caused by this drug, but its similitudes with erythromycin have prompted
      us to undertake a study about its possible cochleo-toxicity. Most trials of this
      kind have been carried out using conventional audiometry (up to 8,000 Hz), thus
      not being able to detect threshold shifts above this frequency. Ototoxic lesions
      usually begin in the upper frequency limit. Twenty-eight patients without
      previous auditory impairment were studied with conventional (up to 8,000 Hz) and
      high-frequency audiometry (up to 20,000 Hz) before and after oral treatment with
      josamycin during eight days. No significant differences were found in auditory
      thresholds registered before and after treatment in any of the patients. These
      results suggest that josamycin is devoid of any cochleo-toxic effect in all the
      frequencies that a normal subject can hear.

PMID- 8484489
TI  - [Myringoplasty. . 5-year study on the anatomic and functional results].
AB  - The AA. consider both anatomical and functional results with the "on-lay"
      procedure for closure of central tympanic perforations in 131 cases, treated at
      their Department in a 5 years term. They report the end conditions pointing out
      several parameters implicated as type and size of the perforation, anesthetic
      used, source of the graft and surgical approach. Finally they confront the
      anatomical and the functional results. The aim of the paper is to emphasize the
      value of the procedure followed in the attempt of re-stablishing the integrity of
      the ear drum.

PMID- 8484490
TI  - [Complications of phonatory fistuloplasty. Case report].
AB  - The paper deals with a severe mediastinal complication when performing, in a
      laryngectomee, a secondary fistuloplasty. Brief review of possible failures of
      this surgery, which are not common, but sometimes can be severe and even deadly.

PMID- 8484492
TI  - Historical overview: comparison of nursing research classification systems.

PMID- 8484491
TI  - [Laryngeal myoplasty. Cancer T2 T3].
AB  - The possibility of autoplasties given for the sternohyoid muscle allows the step
      of reconstructive surgery in all cancers of the larynx. This possibility has been
      reasserted gradually during the elapsed years, and luckily there are updated
      methods, proved enough with a wide reach, regarding the physiology of the larynx,
      that is to say: swallowing, respiration and phonation. Our commitment in
      functional surgery has been accomplished under the clinical points of view and we
      have the pleasure to inform with this historical synthesis of those procedures.

PMID- 8484493
TI  - Rethinking the typology of nursing research.

PMID- 8484494
TI  - Classification of nursing-related dissertations: genesis of a taxonomy of
      nursing's research knowledge.

PMID- 8484495
TI  - Sigma Theta Tau International's classification system for nursing research.

PMID- 8484496
TI  - The grassroots lobbying handbook: empowering nurses through legislative and
      political action.

PMID- 8484497
TI  - Nurse practitioners and certified nurse-midwives: a meta-analysis of studies on
      nurses in primary care roles.

PMID- 8484498
TI  - The safety of intravenous phentolamine administration in patients with
      neuropathic pain.
AB  - The safety of intravenous (i.v.) infusion of large doses of phentolamine as an
      outpatient diagnostic tool for sympathetically maintained pain was studied
      retrospectively in 100 consecutive patients (73 females and 27 males) with
      chronic pain. All patients were pretreated with i.v. fluids followed, in most
      cases, by propranolol, 1-2 mg i.v. (n = 95). Ten minutes later the phentolamine
      infusion commenced, lasting for 20 min. In 90 patients, the dose of phentolamine
      was 35 mg. Two patients received 25 mg, and 8 patients received larger doses of
      50-75 mg. No major complications occurred during or after the test, and only
      small changes in arterial blood pressure or heart rate were observed. All
      patients developed mild nasal stuffiness, but no decline in oxygen saturation was
      observed. Five patients developed one of the following minor complications for a
      brief duration, that resolved spontaneously: sinus tachycardia, premature
      ventricular beats, dizziness, or wheezing. We conclude that i.v. phentolamine
      administration is safe in patients with neuropathic pain.

PMID- 8484499
TI  - Transcutaneous electrical nerve stimulation reduces the incidence of vomiting
      after hysterectomy.
AB  - The possible postoperative antiemetic effect of transcutaneous electrical nerve
      stimulation (TENS) on the P6 point (on the Pericardium Channel of Hand-Jueyin)
      was evaluated in 103 women undergoing hysterectomy. TENS on the P6 point was
      applied 30-45 min before induction of anesthesia in 51 patients and continued for
      6 h postoperatively. The control group, 52 patients, was treated exactly in the
      same way but with the electrical stimulator turned off. Incidence of vomiting was
      assessed blindly 2 h, 4 h, 6 h, and 8 h postoperatively. The incidence of
      vomiting postoperatively was significantly less in the TENS-treated group when
      compared with the control group (between 0 h and 2 h: 23% vs 43%, P < 0.05;
      between 2 h and 4 h: 27% vs 50%, P < 0.025; and between 4 h and 6 h: 31% vs 67%,
      P < 0.001, respectively). Six hours postoperatively TENS was discontinued, and 8
      h postoperatively the two groups did not differ significantly for incidence of
      vomiting (between 6 h and 8 h: 51% vs 65%). The authors conclude that TENS
      reduces the incidence of vomiting after hysterectomy.

PMID- 8484500
TI  - Density, specific gravity, and baricity of spinal anesthetic solutions at body
      temperature.
AB  - One of the most important physical properties affecting the level of analgesia
      achieved after intrathecal administration of a local anesthetic is its density
      relative to the density of the cerebrospinal fluid (CSF) at 37 degrees C. In this
      study, density, specific gravity, and baricity of local anesthetic solutions at
      body temperature were determined volumetrically to five significant figures.
      Standard solutions of 2% lidocaine, 0.5% and 0.75% bupivacaine, and 0.9% sodium
      chloride were tested. Bupivacaine, 0.75%-water dilutions and tetracaine, 0.2%, in
      water were also studied. The densities of all commercially prepared solutions
      were less than that of the normal range of CSF at 37 degrees C. The density of
      0.2% tetracaine was the same as water. Continued dilution of 0.75% bupivacaine
      with water resulted in increasingly hypobaric solutions. However, only the 0.075%
      bupivacaine (1:9 dilution) solution had a density comparable to water. Knowledge
      of relative baricities aids in the selection of an appropriate local anesthetic
      for intrathecal use.

PMID- 8484501
TI  - Retrobulbar hemorrhage after 12,500 retrobulbar blocks.
AB  - To determine the incidence of hemorrhage after retrobulbar nerve block, 12,500
      consecutive cases were reviewed. Fifty-five retrobulbar hemorrhages occurred
      after retrobulbar injection, a prevalence of 1 in 227 (0.44%). This compares
      favorably with the quoted prevalence of 1%-3% in the literature. Acquired
      vascular disease was a significant risk factor (P < 0.017). Surgery was postponed
      in 41 (75%) of the cases in which a hemorrhage developed. Although retrobulbar
      hemorrhage is considered a serious complication of retrobulbar anesthesia, the
      eventual visual outcome after surgery in these patients was not significantly
      different from the control group.

PMID- 8484502
TI  - Comparison of an ephedrine infusion with crystalloid administration for
      prevention of hypotension during spinal anesthesia.
AB  - This study was designed to compare the efficacy of an ephedrine infusion with
      crystalloid administration for reducing the incidence of hypotension during
      spinal anesthesia. Fifty-four ASA I patients scheduled for postpartum tubal
      ligations under spinal anesthesia were randomly allocated to receive either 15
      mL/kg of crystalloid (crystalloid group) or an ephedrine infusion (infusion
      group). Spinal anesthesia was performed using 70-90 mg of hyperbaric 5%
      lidocaine. Patients in the infusion group immediately thereafter received an
      ephedrine infusion at a rate of 5 mg/min for the first 2 min and then 1 mg/min
      for the next 18 min. The incidence of hypotension was 15/27 (55%) in the
      crystalloid group and 6/27 (22%) in the infusion group (P < 0.05). There was no
      significant difference between the groups in relation to the level of anesthesia
      or maximal heart rate, and hypertension did not occur in either group. We
      conclude that a prophylactic ephedrine infusion is effective for minimizing and
      managing hypotension associated with spinal anesthesia and compares favorably
      with crystalloid administration in this patient population in terms of efficacy
      and incidence of side effects.

PMID- 8484503
TI  - Hemodilution induces stable changes in global cardiovascular and regional
      myocardial function.
AB  - The cardiovascular responses associated with isovolemic hemodilution have been
      described. However, the stability of these responses over time remains
      controversial. We hypothesized that the hemodynamic responses to isovolemic
      hemodilution are stable over time. Nine fentanyl-midazolam-anesthetized dogs were
      monitored to follow global cardiovascular and regional myocardial function.
      Isovolemic hemodilution was performed to a moderate (hemoglobin = 7.5 g%) target
      hemodilutional state that was maintained for 4 h. Data were obtained at each
      hemodilutional state and each hour during the 4-h period of sustained moderate
      hemodilution. During acute hemodilution, cardiac output increased from 2.6 +/-
      0.5 L/min to 3.0 +/- 0.5 L/min (P < 0.05) and mean coronary flow increased from
      20.8 +/- 2.4 mL/min to 31.4 +/- 5.5 mL/min (P < 0.05). Cardiac output and mean
      coronary flow remained elevated during the extended hemodilutional period. In
      addition, norepinephrine increased from 586 +/- 152 pg/mL to 1135 +/- 247 pg/mL
      (P < 0.05) during acute isovolemic hemodilution and remained at this increased
      level during extended hemodilution. Epinephrine levels did not change with
      hemodilution. Compensatory mechanisms such as increases in cardiac output and
      mean coronary flow observed during acute hemodilution persist during extended
      periods of hemodilution.

PMID- 8484504
TI  - Human alfentanil metabolism by cytochrome P450 3A3/4. An explanation for the
      interindividual variability in alfentanil clearance?
AB  - Alfentanil undergoes extensive hepatic metabolism and exhibits a high degree of
      interindividual variability in hepatic clearance. The purpose of this
      investigation was to determine the specific hepatic cytochrome P450 isozyme(s)
      that catalyzes alfentanil metabolism. Alfentanil metabolism by microsomes from
      rat and human livers was determined by using gas chromatography-mass
      spectrometry. Rat liver alfentanil oxidation was increased threefold by treatment
      with pregnenolone 16 alpha-carbonitrile, an inducer of cytochrome P450 3A, but
      not by treatment with phenobarbital, beta-naphthoflavone, or pyrazole (which
      induce P450s 2B, 1A, and 2E1, respectively). Human liver microsomal alfentanil
      metabolism was correlated strongly with the content of cytochrome P450 3A3/4 (r =
      0.85, P < 0.005), measured by Western blot analysis with a rabbit anti-human P450
      3A3/4 probe. Alfentanil metabolism was diminished by the P450 3A3/4 substrate and
      competitive inhibitor midazolam, and was abolished by the specific P450 3A3/4
      inhibitor troleandomycin. No other selective inhibitor of P450 isozymes (P450s
      1A2, 2A6, 2C9/10, 2D6, 2E1) diminished alfentanil metabolism. These results
      establish that human alfentanil metabolism is catalyzed predominantly, if not
      exclusively, by P450 3A3/4. Interindividual variability in human alfentanil
      disposition and alfentanil drug interactions may be attributable to individual
      differences in P450 3A3/4 activity.

PMID- 8484505
TI  - Effects of alfentanil on the hemodynamic and catecholamine response to tracheal
      intubation.
AB  - A randomized, placebo-controlled study was conducted in 60 ASA Class I, II, and
      III patients to determine the dose response of alfentanil in moderating the
      cardiovascular and catecholamine response to tracheal intubation (INT). Patients
      were randomly allocated into one of four groups to receive either 15
      micrograms/kg alfentanil (A15), 30 micrograms/kg alfentanil (A30), 45
      micrograms/kg alfentanil (A45), or normal saline (control), given intravenously
      (i.v.) before induction of anesthesia. One minute after administration of 4.0
      mg/kg thiopental and 1.5 mg/kg succinylcholine i.v., tracheal intubation was
      performed using direct laryngoscopy. In response to INT, increases in heart rate,
      systolic blood pressure, and systemic vascular resistance occurred in the control
      group. These changes were significantly more than corresponding changes of heart
      rate, systolic blood pressure, and systemic vascular resistance in all three
      alfentanil groups (P < 0.05). In contrast, cardiac index and ejection fraction
      decreased moderately in every group during the study period, but there were no
      differences among groups with respect to either cardiac index or ejection
      fraction at corresponding times following INT. In the control group, epinephrine
      and norepinephrine serum concentrations increased by 152 +/- 52% and 58 +/- 62%,
      respectively, following INT (different from A30 and A45, P < 0.05). However, up
      to a dose of 30 micrograms/kg (A30), a dose-dependent decrease in the maximum
      percent changes of both epinephrine and norepinephrine occurred in response to
      INT. A larger dose of alfentanil was no more efficacious as the catecholamine
      response to tracheal intubation was not significantly different when comparing
      the A45 and A30 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484506
TI  - Intranasal meperidine titration for postoperative pain relief.
AB  - A prospective, randomized, double-blind study investigating the efficacy of
      intranasal meperidine as compared with intravenous (i.v.) administration for
      postoperative pain relief is described. The study was limited to the initial
      titration of pain relief during a 2-h period immediately after surgery. Sixty
      women having undergone a hysterectomy were studied. Initially and when
      complaining of a pain intensity > or = 40 on the 101-point numerical rating scale
      (NRS), 30 patients received 6 sprays (27 mg) meperidine intranasally and
      simultaneously 6 mL NaCl 0.9% i.v. (nasal group); another 30 patients received 6
      sprays of NaCl 0.9% intranasally and 6 mL of a diluted meperidine solution (27
      mg) i.v. (intravenous group). Patients already having a pain reduction < 40 on
      the 101-point NRS, received half of the above dose. Meperidine was repeated every
      5 min until the patients were pain free or refused further analgesic. Before the
      onset of meperidine titration and at 5- to 10-min intervals for 2 h thereafter,
      pain was evaluated with a 101-point NRS and a verbal rating scale. Within 20 and
      35 min the pain scores evaluated by the NRS and verbal rating scale decreased in
      the intravenous and nasal group to a median of zero. The total dose of meperidine
      was 76.5 mg (range, 40.5-135.0) in the intravenous group and 104.4 mg (range, 27
      135.0) in the nasal group (P < 0.05). One patient in each group showed a brief
      decrease in arterial hemoglobin oxygen saturation to < 90%. No patient complained
      of pain or burning in the nose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484507
TI  - Inhibition of morphine-induced tolerance and dependence by a benzodiazepine
      receptor agonist midazolam in the rat.
AB  - We investigated whether midazolam administration influenced morphine-induced
      antinociception and tolerance and dependence in the rat. Antinociception was
      assessed by the tail-flick (TF) and the hot-plate test (HP 52 degrees C).
      Morphine tolerance developed after daily single injections of morphine for 11
      days. The effect of midazolam on morphine-induced antinociception and tolerance
      was assessed by giving daily injections of various doses of midazolam for 11
      days. The first injection of saline or midazolam was given intraperitoneally and
      30 min later morphine (10 mg/kg body weight) was administered subcutaneously.
      Antinociception was monitored by measuring TF and HP latencies 60 min after the
      second injection. Midazolam was injected at four different concentrations: 0.03,
      0.1, 0.3, and 3 mg/kg body weight. Chronic administration of morphine resulted in
      the development of tolerance to antinociception in both TF and HP tests, with
      rats exhibiting baseline antinociception on Day 9. Animals treated with midazolam
      alone showed little antinociception on Days 3-9. However, midazolam
      administration in morphine-treated animals attenuated morphine-induced tolerance
      to antinociception on Days 1-11 as measured by the tail-flick test. Midazolam
      also decreased the jumping behavior following naloxone injections in morphine
      dependent rats. These results suggest that midazolam may prolong the effects of
      morphine by delaying morphine-induced development of tolerance to
      antinociception. Midazolam also attenuated a decrease in weight gain induced by
      chronic injections of morphine.

PMID- 8484508
TI  - Effects of ketorolac on postoperative analgesia and ventilatory function after
      laparoscopic cholecystectomy.
AB  - Ketorolac, a nonsteroidal anti-inflammatory drug, is alleged to produce
      postoperative analgesia without opioid-related side effects. Patients undergoing
      laparoscopic cholecystectomy were assigned randomly to receive either ketorolac
      or a placebo (saline) according to a double-blind protocol. Preoperative
      (baseline) pulmonary function was evaluated using a Respiradyne II monitor.
      Patients received midazolam, 2 mg, and 2 mL of either ketorolac, 60 mg (n = 31),
      or saline (n = 29), 20-40 min before surgery. Anesthesia consisted of thiopental,
      4-5 mg/kg, and vecuronium, 0.1 mg/kg, for induction, and isoflurane, 0.5%-2.0%,
      with 67% nitrous oxide in oxygen for maintenance. A second 2-mL dose of the same
      study medication (ketorolac, 60 mg, or saline) was administered 4 h after the
      initial dose. Postoperatively, 66% of patients in the saline group complained of
      pain requiring treatment with fentanyl compared to 32% in the ketorolac group (P
      < 0.05). There were no significant differences between the two groups with
      respect to postoperative sedation, anxiety, pain, or nausea visual analog scores.
      Compared to the preoperative values, significant decreases in pulmonary function
      tests were noted in both groups at 4 h after the operation and the following
      morning (P < 0.01). In the ketorolac group, only values of forced expiratory
      volume at 1 s and forced expiratory flow at 25%-75% of the forced vital capacity
      at 4 h after the operation were significantly higher than those in the saline
      group (P < 0.05). Incidences of nausea (45% vs 52%) and vomiting (10% vs 10%)
      were similar in both groups. In conclusion, ketorolac decreased the postoperative
      requirement for opioid analgesic medication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484509
TI  - Hemodynamic changes during laparoscopic cholecystectomy.
AB  - Hemodynamics during laparoscopic cholecystectomy under general anesthesia
      (isoflurane in N2O/O2 (50%)) were investigated in 15 nonobese ASA Class I
      patients by using invasive hemodynamic monitoring including a flow-directed
      pulmonary artery catheter. During surgery, intraabdominal pressure was maintained
      automatically at 14 mm Hg by a CO2 insufflator, and minute ventilation was
      controlled and adjusted to avoid hypercapnia. Hemodynamics were measured before
      anesthesia, after the induction of anesthesia, after tilting into 10 degrees head
      up position, 5 min, 15 min, and 30 min after peritoneal insufflation, and 30 min
      after exsufflation. Induction of anesthesia decreased significantly mean arterial
      pressure and cardiac index (CI). Tilting the patient to the head-up position
      reduced cardiac preload and caused further reduction of CI. Peritoneal
      insufflation resulted in a significant increase (+/- 35%) of mean arterial
      pressure, a significant reduction (+/- 20%) of CI, and a significant increase of
      systemic (+/- 65%) and pulmonary (+/- 90%) vascular resistances. The combined
      effect of anesthesia, head-up tilt, and peritoneal insufflation produced a 50%
      decrease in CI. Administration of increasing concentrations of isoflurane, via
      its vasodilatory activity, may have partially blunted these hemodynamic changes.
      These results demonstrate that laparoscopy for cholecystectomy in head-up
      position results in significant hemodynamic changes in healthy patients,
      particularly at the induction of pneumoperitoneum.

PMID- 8484510
TI  - Pupillary response to noxious stimulation during isoflurane and propofol
      anesthesia.
AB  - We studied the effects of noxious stimuli on arterial blood pressure, heart rate,
      pupil size, and the pupillary light reflex in 13 volunteers anesthetized with
      either isoflurane or propofol. Those given isoflurane (n = 8) were anesthetized
      twice, in a randomly selected order, once at an end-tidal concentration of 0.8%
      and once at 1.2%. An intense noxious stimulus was provided by electrical
      stimulation applied to skin of the abdominal wall (65-70 mA, 100 Hz). Hemodynamic
      values and pupillary responses were recorded immediately before stimulation and
      at 15-60-s intervals during 8 subsequent min. In the volunteers given isoflurane
      (both concentrations), stimulation significantly increased pupil size (265 +/-
      44%) and the amplitude of the light reflex (233 +/- 23%). In contrast, mean heart
      rate and systolic blood pressure increased only 19 +/- 7% and 13 +/- 7% after
      stimulation. Five additional volunteers were anesthetized twice with propofol
      (approximately 3 micrograms/mL plasma concentration) and 60% nitrous oxide. The
      same electrical stimulus was applied, and hemodynamic and pupillary measurements
      were obtained. During one propofol anesthetic, an esmolol infusion (100
      micrograms.kg-1 x min-1) was started 10 min before stimulation to determine
      whether this agent would blunt the pupillary response. The pupillary light reflex
      increased more than 200% during both propofol anesthetics with or without
      esmolol; once again, heart rate and blood pressure changed little. We conclude
      that with these experimental conditions, the pupil is a more sensitive measure of
      noxious stimulation than the commonly used variables of arterial blood pressure
      and heart rate.

PMID- 8484511
TI  - Intrathecal acetylsalicylic acid and indomethacin are not analgesic for a
      supramaximal stimulus.
AB  - Intrathecal acetylsalicylic acid and indomethacin are analgesic for painful
      stimuli, and this has been demonstrated when the noxious stimuli are applied to
      normal and inflamed tissue. This study determined whether these drugs would alter
      the response to a supramaximal stimulus, e.g., tail-clamp. Rabbits were
      anesthetized with halothane and after arterial and venous cannulation, an
      intrathecal catheter was placed via a lumbar laminectomy. The minimum alveolar
      anesthetic concentration was then determined. Groups 1 (n = 8) and 2 (n = 6)
      received 0.5 mg/kg acetylsalicylic acid intrathecally and Group 3 (n = 7) 0.5
      mg/kg indomethacin intrathecally. Group 4 (n = 8) did not undergo a laminectomy
      and received acetylsalicylic acid 25 mg/kg intraperitoneally. In addition, in
      Groups 2-4, before the surgical procedures, carrageenin 1 mg was injected into
      the tail to evoke an inflammatory response. Approximately 20 min after injection
      of the study drugs, minimum alveolar anesthetic concentration was determined
      again. In Groups 1-4, control minimum alveolar anesthetic concentration was 1.2
      +/- 0.2%, 1.4 +/- 0.3%, 1.2 +/- 0.2%, and 1.5 +/- 0.1%, respectively; there was
      no statistically significant change in any group after injection of the study
      drugs. There were no temperature, hematocrit, or arterial blood pressure
      differences between groups or after injection of the study drugs. In this model
      intrathecal acetylsalicylic acid and indomethacin do not provide analgesia for a
      supramaximal stimulus.

PMID- 8484512
TI  - Canine tracheal blood flow after endotracheal tube cuff inflation during
      normotension and hypotension.
AB  - Tracheal tissue damage associated with endotracheal intubation may be a direct
      result of high mucosal contact pressure (MCP) generated by the endotracheal tube
      cuff. Tracheal blood flow (TBF) was measured at MCPs in the normotensive and
      hypotensive (mean arterial blood pressure, 50 mm Hg) canine model. Control TBFs
      through the individual rings in contact with the endotracheal tube cuff ranged
      between 26.6 +/- 2.7 and 44.5 +/- 5.0 with a mean of 35.0 +/- 2.5 mL.min-1 x 100
      g-1 during normotension, and 15.0 +/- 4.9 and 22.5 +/- 5.0 with a mean of 18.9 +/
      0.9 mL.min-1 x 100 g-1 during hypotension. TBF was reduced significantly at all
      elevated MCPs in both groups. TBF also was measured during normotension and
      hypotension after cuff inflation to 15 mm Hg MCP at 1-h intervals for 3 h. TBF
      was reduced significantly from control to 14.9 +/- 1.5 mL.min-1 x 100 g-1 after 1
      h during normotension, and continued to decline to 6.1 +/- 0.9 mL.min-1 x 100 g-1
      after 3 h. During hypotension, TBF decreased significantly from control to 6.1 +/
      0.6 mL.min-1 x 100 g-1 at 1 h and remained unchanged at 3 h. These findings
      suggest that even at 20 mm Hg MCP, significant reductions in TBF may occur. For
      prolonged endotracheal intubation, especially during hypotension, significant
      reductions in TBF may occur at even lower MCP.

PMID- 8484513
TI  - Ventilation with nitrous oxide during open cholecystectomy increases the
      incidence of postoperative hypoxemia.
AB  - The effect of intraoperative use of air versus nitrous oxide (N2O) on
      postoperative oxygen (O2) saturation in blood was evaluated in 40 ASA Class I and
      II patients undergoing elective, open cholecystectomy. Patients were allocated
      randomly to two groups on the basis of whether they received air (Group A, n =
      20) or N2O (Group B, n = 20) intraoperatively. Oxygen saturation was recorded on
      arrival of the patients in the ward, 24 h, and 48 h postoperatively. Although
      mean O2 saturation did not differ significantly (P > 0.05) between the groups
      over the first 24 h postoperatively, it was significantly higher (P < 0.05) in
      Group A as compared to Group B 48 h postoperatively. Incidence of hypoxemia (O2
      saturation < 90%) was 40% in Group B as compared to 0% in Group A at the end of
      48 h postoperatively. We conclude that the use of N2O during cholecystectomy is
      associated with a higher incidence of hypoxemia postoperatively.

PMID- 8484514
TI  - Does isoflurane alter mesenteric venous capacitance in the intact rabbit?
AB  - Volatile anesthetics act at a number of sites to alter cardiovascular function
      and the response of the cardiovascular system to barostatic reflexes. We examined
      the effects of isoflurane on reflex regulation of mesenteric venous capacitance
      vessels. To determine whether isoflurane alters mesenteric venous capacitance,
      continuous direct observations of mesenteric vein diameter, intravenous pressure,
      and mesenteric sympathetic efferent nerve activity (SENA) were made in 31
      chloralose-anesthetized New Zealand white rabbits. Simultaneous measurements were
      obtained for aortic pressure and heart rate. The responses to changes in
      baroreceptor activation by means of either bilateral carotid occlusion (BCO) or
      aortic nerve stimulation (ANS) were studied in one group of 18 rabbits, while the
      response to direct electric activation by means of celiac ganglion stimulation
      (CGS) was studied in another group of 13 rabbits. In both groups, isoflurane
      vapor was administered at levels of 0.75% or 1.5%, and superfused isoflurane was
      administered directly to the vessel in doses of either 3% or 5% equilibrated with
      physiologic salt solution. Anesthetic levels were verified by mass spectrometry
      for expired gas and by gas chromatography for blood and superfusate levels.
      Inhaled isoflurane reduced hemodynamic variables and SENA in a dose-dependent
      fashion, but these same variables were unaffected by superfused isoflurane. One
      and one-half percent inhaled isoflurane abolished all reflex responses to
      baroreceptor stimulation in mesenteric capacitance veins and in SENA, but
      superfused isoflurane produced no corresponding attenuation of reflex responses
      to baroreceptor stimulation. Neither inhaled nor superfused isoflurane suppressed
      the reflex venoconstriction in response to CGS. Both inhaled and superfused
      isoflurane dilated the baseline vein diameter before stimulation. These results
      indicate that isoflurane dose increase the diameter of mesenteric venous
      capacitance vessels and inhibits reflex-induced constriction of mesenteric veins,
      whereas mesenteric sympathetic efferent nerve activity decreases and the reflex
      responses to activation of the carotid sinus and aortic baroreceptors are
      attenuated by inhaled isoflurane. The mechanism of this action appears to be
      primarily through the inhibition of central or peripheral sympathetic ganglionic
      transmission of barostatic control.

PMID- 8484515
TI  - Halothane inhibits the intraalveolar recruitment of neutrophils, lymphocytes, and
      macrophages in response to influenza virus infection in mice.
AB  - The effect of halothane anesthesia on the influenza A specific immune response
      and the pathogenesis of infection was evaluated in mice. Three-wk-old CD-1 mice
      were anesthetized with either 2% halothane for 2 h or ketamine (100 mg/kg
      intraperitoneally) and subsequently inoculated intranasally with a sublethal dose
      of influenza type A/PR/8/34 virus. Bronchoalveolar lavage was performed on
      animals from each group at 4 h postinoculation and daily thereafter for 14 days.
      Total and differential white blood cell counts were measured in the lavage fluid
      and the lungs were examined histologically for evidence of injury. Infected mice
      anesthetized with halothane had lower daily cell counts in the lung than animals
      anesthetized with ketamine and a marked change in cell type distribution. On Days
      4 and 11 postinoculation, there were significantly (P < 0.05) more white blood
      cells in the lavage fluid of animals anesthetized with ketamine than halothane
      (mean/mL, 738,000 +/- SEM, 128,000 vs 196,000 +/- 51,400, respectively, and
      1,020,000 +/- 227,000 vs 117,000 +/- 34,600, respectively). Differential counts
      were significantly higher (P < 0.05) in the ketamine group compared to the
      halothane for neutrophils on Day 4 (452,000 +/- 77,900 vs 72,000 +/- 46,000,
      respectively) and on Day 11 for lymphocytes (340,000 +/- 59,000 vs 33,000 +/-
      17,000, respectively) and macrophages (480,000 +/- 120,000 vs 130,000 +/-
      61,000). Infected mice that were given ketamine were qualitatively "sicker" than
      the halothane-treated group as evidenced by the appearance of ruffled fur,
      tachypnea, and cachexia. Animals anesthetized with ketamine demonstrated a
      greater degree of pulmonary histopathology including diffuse infiltration of
      macrophages, neutrophils, hemorrhage, and fibrin deposition.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8484516
TI  - The use of needles in the practice of anesthesiology and the effect of a
      needleless intravenous administration system.
AB  - Anesthesia personnel are at risk for occupationally acquired blood-borne
      infections transmitted through needlestick injuries. To formulate strategies for
      the prevention of needlestick injuries, it is necessary to identify the types of
      needles used by anesthesia personnel and the devices associated with injuries.
      The introduction of a needleless intravenous (i.v.) administration system
      provided an opportunity to assess its effect on needle usage in the practice of
      anesthesiology. The contents of needle disposal containers placed in the
      preoperative holding area and five operating rooms before (control) and after the
      introduction of a needleless administration system (study) were categorized by
      needle type. The information on needles used by anesthesia personnel was compared
      with that on needles purchased for the entire hospital. During the control
      period, most of the needles used were 18-23-gauge hollow needles (51.6%), i.c.
      catheter stylets (23%), and 25-26-gauge small-bore hollow needles (17.1%). There
      was no difference in the total number of needles collected after the introduction
      of the needleless administration system, but there was an increase in capped 18
      23-gauge hollow needles. Anesthesia personnel used a relatively greater number of
      small-bore hollow needles (25-26 gauge), i.v. catheters, and spinal and epidural
      needles, but fewer hollow needles (18-23 gauge) than were purchased for hospital
      wide use. Small-bore hollow needles (25-26 gauge) were responsible for 31.6% of
      the 19 needlestick injuries reported by anesthesia personnel to the Employee
      Health Service.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484517
TI  - Probable venous air embolism during caudal anesthesia in a child.

PMID- 8484518
TI  - Probable venous air embolism during epidural placement in an infant.

PMID- 8484519
TI  - Is uvular edema a complication of endotracheal intubation?

PMID- 8484520
TI  - Complete airway obstruction caused by a pseudomembranous cast with subsequent
      negative pressure pulmonary edema.

PMID- 8484521
TI  - Anesthetic management of a patient with severe cold agglutinin hemolytic anemia
      utilizing forced air warming.

PMID- 8484522
TI  - Acute deterioration of mental status following epidural blood patch.

PMID- 8484523
TI  - Intravascular migration of an epidural catheter during postoperative patient
      controlled epidural analgesia.

PMID- 8484524
TI  - Severe hypotension during epidural anesthesia in a prazosin-treated patient.

PMID- 8484525
TI  - Cholestasis after interpleural bupivacaine for chronic upper limb pain.

PMID- 8484526
TI  - Forearm compartment syndrome following intravenous infusion with a manual "bulb"
      pump.

PMID- 8484527
TI  - Pediatric anesthesia without vascular access: intramuscular administration of
      atracurium.

PMID- 8484528
TI  - Is fentanyl appropriate for postoperative epidural PCA?

PMID- 8484529
TI  - The Augustine Guide as a fiberoptic bronchoscope guide.

PMID- 8484530
TI  - Concerning the complications of the Patil-Syracuse Mask.

PMID- 8484531
TI  - Delivery of excessive airway pressure to a patient by the anesthesia machine.

PMID- 8484532
TI  - Yet another place for the pulse oximeter probe.

PMID- 8484533
TI  - A modified portable system for oxygen supply using anesthetic rebreathing bags.

PMID- 8484534
TI  - Reducing epistaxis after nasogastric intubation.

PMID- 8484535
TI  - Broken inner sleeve of a Y-connector: course of a circuit leak and a potential
      foreign body aspiration.

PMID- 8484536
TI  - Another case report of opisthotonos and propofol.

PMID- 8484537
TI  - Inexpensive, convenient transducer holder.

PMID- 8484538
TI  - The cost of desflurane and propofol anesthesia.

PMID- 8484540
TI  - An alternative approach to intravenous regional anesthesia (IVRA)

PMID- 8484539
TI  - Bronchial or pulmonary artery obstruction by a transesophageal echocardiography
      probe?

PMID- 8484541
TI  - Epidural test dose and intravascular injection in obstetrics: sensitivity,
      specificity.

PMID- 8484542
TI  - Modification of a nasopharyngeal airway and transfusion extension tubing as an
      earpiece.

PMID- 8484543
TI  - DIC after intraoperative autotransfusion.

PMID- 8484544
TI  - Precipitous decrease in oxygen saturation during laparoscopic surgery.

PMID- 8484545
TI  - Venous air embolism during identification of the epidural space in children.

PMID- 8484546
TI  - The practice of anesthesiology and the package insert: decision-making regarding
      drug use in anesthesiology.

PMID- 8484547
TI  - Vaso-vagal reactions in an ambulatory surgery center.
AB  - This prospective study was undertaken to determine the incidence and factors
      predisposing to vaso-vagal reactions during venous cannulation in an ambulatory
      surgery population. In 141 ambulatory surgery patients, signs and symptoms of a
      reaction together with mean arterial pressure and heart rate were recorded at 1
      min intervals during and for 6 min after venous cannulation. Overall, 10.6% of
      patients were symptomatic (95% confidence interval [CI] 6%-17%). The incidence
      was 16.6% (95% CI 8.4%-24.9%) in patients < or = 40 yr and 33.3% (95% CI 6.7%
      60.0%) with a prior fainting history. Young age, duration or number of attempts
      at venous cannulation, and fainting history were independently associated with
      increased risk of a reaction (P < 0.03-0.004 by multiple repression analysis).
      Minimum mean arterial pressure was less in symptomatic patients than in those who
      were asymptomatic (58 mm Hg +/- 11.3 SD versus 82 mm Hg +/- 14.3 SD, P < 0.0001).
      We conclude that reactions occur commonly, particularly in the young or in
      patients with a history of fainting. Reactions are typically associated with
      significant hypotension that may require treatment.

PMID- 8484548
TI  - Desflurane versus propofol anesthesia: a comparative analysis in outpatients.
AB  - This study compares the induction, hemodynamic, and recovery characteristics of a
      general anesthetic with desflurane to one with propofol. Sixty outpatients
      presenting for orthopedic surgery received either a propofol induction of
      anesthesia followed by desflurane and nitrous oxide (Group 1), a propofol
      induction followed by propofol infusion and nitrous oxide (Group 2), a desflurane
      and nitrous oxide induction and maintenance (Group 3), or a desflurane induction
      and maintenance (Group 4). The quality of induction was inferior in Groups 3 and
      4 with more breath-holding and excitation than in Groups 1 and 2. However, there
      was a more rapid emergence in Group 4 patients than any of the other groups.
      Group 4 patients were able to say their names (5.6 +/- 2.0 min vs 10.3 +/- 3.3
      min, 8.6 +/- 3.1 min, and 9.3 +/- 1.5 min for Groups 1, 2, and 3, respectively)
      sooner after the discontinuation of anesthesia. Nonetheless, intermediate
      recovery was similar in Groups 2 and 4 being numerically but not statistically
      more rapid than in Groups 1 and 3. This pattern of intermediate recovery was also
      demonstrated by psychomotor function test results. Although there was no
      difference between the groups in postoperative narcotic requirement, more
      patients in Group 3 vomited (50%) than in either Group 2 (0%) or Group 4 (12.5%).
      Hemodynamically, the anesthetics were very similar. Although desflurane was a
      difficult drug to use for induction of anesthesia, this study demonstrates that
      desflurane is a suitable maintenance anesthetic for ambulatory surgery because it
      provides a rapid awakening and an intermediate recovery similar to propofol.

PMID- 8484549
TI  - Intraoperative hemodynamic changes are not good indicators of myocardial
      ischemia.
AB  - Intraoperative myocardial ischemia is associated with an increased risk of a
      perioperative myocardial infarction (PMI) in patients undergoing coronary artery
      bypass graft surgery. If reversible physiologic variables could be identified
      that are indicators of myocardial ischemia, treatment might be instituted early
      to prevent cardiac morbidity. In patients undergoing elective coronary artery
      bypass graft surgery, we evaluated the relationship between several premorbid
      patient characteristics, selected hemodynamic variables, intraoperative
      myocardial ischemia, and a PMI. In addition we evaluated these selected
      hemodynamic variables as intraoperative indicators of myocardial ischemia. The
      following variables were evaluated: heart rate, > 80 beats/min; systolic arterial
      blood pressure, > 160 mm Hg; systolic arterial blood pressure, < 80 mm Hg; mean
      arterial blood pressure, < 60 mm Hg; pulmonary artery diastolic pressure, > 18 mm
      Hg; a 5 mm Hg increase in pulmonary artery diastolic pressure; rate pressure
      product, > 12,000 beats/min.mm Hg; and a pressure rate quotient, < 1.0 mm
      Hg/beats/min. The premorbid patient characteristics selected were previous
      myocardial infarction, recent myocardial infarction (within 1 wk of surgery),
      type and number of coronary lesions, beta-blocker therapy, and calcium blocker
      therapy. One hundred consecutive (n = 100) patients for elective coronary artery
      bypass graft surgery were studied prospectively before the initiation of
      cardiopulmonary bypass (CPB). Patients were monitored with a Hewlett Packard
      computer ST segment analyzer using leads II and V5. Ischemia was defined as the
      new onset of ST segment deviation of > or = 1 mm from the baseline
      electrocardiogram (ECG) (preinduction) for at least 2 min.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8484550
TI  - Supplemental oxygen does not reduce myocardial ischemia in premedicated patients
      with critical coronary artery disease.
AB  - This randomized, prospective clinical study investigated the effects of
      supplemental inspired oxygen on arterial hemoglobin desaturation and myocardial
      ischemia in premedicated patients who have critical coronary artery stenosis,
      identified predictors for these adverse events, and examined the temporal
      relationship between hemoglobin desaturation and myocardial ischemia. Before
      elective coronary artery bypass surgery, 104 patients were monitored continuously
      by using a real-time electrocardiogram (V4 and V5 leads) recorder and a digital
      pulse oximeter. After a 2-h baseline monitoring period (Interval A), patients
      were given sublingual lorazepam 0.03 mg/kg, and were randomized to receive
      continuous supplemental inspired oxygen by nasal catheters [4 L/min (Oxygen
      Group, n = 52)] or to receive no supplemental inspired oxygen (Control Group, n =
      52) (Interval B). One hour later, all patients received intramuscular morphine
      0.15 mg/kg with perphenazine 0.05 mg/kg (Interval C). Interval C lasted 1 h, and
      the study was terminated. In the Oxygen Group, the incidence of desaturation was
      25% before premedication and 11.5% after premedication (NS). In the Control Group
      after premedication, the incidence of desaturation increased from 25% to 56.9% (P
      < 0.001). There was no significant difference in the incidence of myocardial
      ischemia before or after premedication within or between the two groups. Arterial
      hemoglobin desaturation was not associated temporally with myocardial ischemia at
      any time. Predictors of desaturation after premedication included absence of
      supplemental O2, increased weight, age, and occurrence of desaturation before
      premedication. There were no identifiable predictors for myocardial ischemia
      after premedication. During Intervals A and C, episodes of hemoglobin
      desaturation were associated with small but statistically significant increases
      in mean heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484551
TI  - Fentanyl plasma concentrations maintained by a simple infusion scheme in patients
      undergoing cardiac surgery.
AB  - The ability of a simple infusion scheme for fentanyl to achieve and maintain one
      of two target concentrations of fentanyl in plasma was studied in 17 patients
      having cardiac surgery that required the use of moderate hypothermic
      cardiopulmonary bypass (CPB). All patients received preanesthetic medication
      including morphine, a benzodiazepine, and/or scopolamine. Anesthesia was induced
      and maintained by one of two fentanyl infusion regimens: HIGH-FEN (n = 6), a
      priming infusion of 2.4 micrograms.kg-1 x min-1 for 20 min in combination with a
      continuous infusion of 0.3 microgram.kg-1.min-1 for the duration of the operation
      to produce a plasma fentanyl concentration of 20-25 ng/mL; or LOW-FEN (n = 11),
      priming and maintenance infusions of 2.4 and 0.15 micrograms.kg-1 x min-1
      designed to produce a fentanyl concentration of 12-15 ng/mL of plasma. The six
      patients receiving HIGH-FEN had plasma fentanyl concentrations maintained between
      20 and 27 ng/mL and none required anesthetic supplementation before CPB; one
      patient required a single dose of thiopental 50 mg after the termination of CPB.
      The total fentanyl dose for the operation (3.2 +/- 0.1 h) averaged 107 +/- 2
      micrograms/kg (range 100.5-115.5 micrograms/kg). The 11 patients receiving LOW
      FEN had a plasma fentanyl concentration maintained below 20 ng/mL (range 13-17
      ng/mL). Eight patients before and 10 patients after CPB required anesthetic
      supplementation for adverse hemodynamic or somatic responses. For comparison
      purposes, another eight patients received a single 75 micrograms/kg dose of
      fentanyl during 20 min for induction of anesthesia, and 7 of the 8 required
      supplemental anesthetic agents before and after CPB.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484552
TI  - Assessment of renal blood flow with contrast ultrasonography.
AB  - Sonicated albumin microspheres, a digitalizing ultrasound system, and a
      mathematical model for flow were used to determine whether blood flow in the
      canine kidney could be assessed with contrast ultrasound. Albunex ultrasound
      contrast microspheres were injected into the aorta while ultrasound images of the
      kidney and aorta were recorded simultaneously. Ultrasound data were obtained
      during contrast injections at 93 different renal blood flow rates in nine dogs.
      Contrast dose was calibrated to ultrasound system response for both aortic and
      renal images. A linear relationship between microbubble concentration used and
      pixel intensity was established (r = 0.89 for aortic images and r = 0.91 for
      renal images). Renal blood flow was manipulated from baseline by means of a
      hydraulic renal artery occluder and by intravenous dopamine or fenoldopam
      infusion. Blood flow calculated with contrast ultrasonography was compared with
      direct measurement obtained with an electromagnetic flow probe at each flow rate.
      Direct measurement correlated with rates calculated with contrast ultrasonography
      (r = 0.84, 95% confidence limits from 0.75 to 0.90). Overall, calculations tended
      to overestimate absolute flow measurements, and overestimation of flow tended to
      be greater during pharmacologically manipulated flow rates. We conclude the
      changes and trends in renal blood flow can be serially assessed in vivo with
      contrast ultrasonography, but technical limitations of present commercial
      ultrasounds systems preclude absolute quantification at this time.

PMID- 8484553
TI  - The effects of propofol on cerebral and spinal cord blood flow in rats.
AB  - The effects of low and high doses of propofol on global cerebral blood flow (CBF)
      and spinal cord blood flow (SCBF) as a function of mean arterial blood pressure
      were investigated. CBF and SCBF during propofol infusion were compared to the
      levels in rats anesthetized with nitrous oxide (N2O) and fentanyl. Rats in the
      fentanyl/N2O group (control, n = 13) received 70% N2O in O2 plus fentanyl (bolus:
      10 micrograms/kg; infusion: 25 micrograms.kg-1 x h-1). Rats in the low-dose
      propofol group (n = 10) received 30% O2 in air and propofol infusion (0.5 mg.kg-1
      x min-1). Rats in the high-dose propofol group (n = 8) received 30% O2 in air and
      propofol infusion (2.0 mg.kg-1 x min-1). Blood flow autoregulation was tested by
      manipulating the mean arterial blood pressure with phenylephrine infusion or
      trimethaphan infusion and blood withdrawal by measuring CBF and SCBF using
      radioactive microspheres. Arterial blood gases, pHa, and skull temperature were
      controlled. Cerebral and spinal cord vasculature showed autoregulation in all
      treatment groups with a pressure range of 50-140 mm Hg. Within this pressure
      range, when compared to fentanyl/N2O, propofol decreased cortical CBF 60% (P <
      0.001), subcortical CBF 40% (P < 0.001), midbrain blood flow 30% (P < 0.001), and
      SCBF 20% (P < 0.05). These results indicate that propofol maintains CBF and SCBF
      autoregulation.

PMID- 8484554
TI  - Sedative doses of propofol increase beta activity of the processed
      electroencephalogram.
AB  - The effects of sedative infusions of propofol on the processed
      electroencephalograms (EEG) of eight healthy male volunteers were studied. EEG
      data for aperiodic analysis were collected during three 5-min periods: before
      propofol, during propofol infusion, and 30 min after termination of the infusion.
      After an initial dose of 1 mg/kg, subjects received a propofol infusion titrated
      to produce a standard level of conscious sedation. The infusion rate was 84 +/-
      27 micrograms.kg-1 x min-1 (mean +/- SE) and plasma propofol levels were 2180 +/-
      43 ng/mL. Total EEG power, defined as the sum of the squares of peak-to-peak
      amplitudes during each 5-s epoch, increased from 1350 +/- 295 microV2 x epoch-1
      to 9675 +/- 2390 microV2 x epoch-1 during the propofol infusion (P < 0.05); it
      returned to 1445 +/- 145 microV2 x epoch-1 30 min after the infusion was
      discontinued (P < 0.05 vs the result during propofol). The change in total power
      was accompanied by a change in the distribution of power within the EEG spectrum,
      as the fraction of activity in the beta-band (12-35 Hz) increased during the
      infusion from 23% +/- 3% to 44% +/- 5% (P < 0.05). Thirty minutes after the
      infusion was terminated, the distribution of activity within the EEG spectrum had
      reverted to pre-propofol patterns. The similarity of EEG effects seen with
      sedative doses of propofol and benzodiazepines suggests that these drugs may
      share some neurochemical effects.

PMID- 8484555
TI  - Effect of atracurium-induced neuromuscular block on cortical motor-evoked
      potentials.
AB  - The effect of nondepolarizing neuromuscular block (NMB) with atracurium on
      transcranial magnetic motor-evoked potentials (tcMMEP) was examined in 10 adult
      cynomolgus monkeys. The monkeys were anesthetized initially with ketamine (15
      mg/kg intramuscularly) and maintained with a continuous ketamine infusion (10-15
      mg.kg-1 x h-1). NMB was then adjusted from no block to profound block and then
      back to no detectable block by adjustment of an atracurium infusion (0-7.25 mg.kg
      1 x min-1). NMB was assessed by measuring the peak-to-peak amplitude of the
      evoked electromyographic (EMG) activity of the thenar muscles and by measuring
      the ratio of the 4th to 1st peak in the train of four (TOF) of the mechanical
      action from direct stimulation of the median nerve (direct EMG). NMB was adjusted
      incrementally, whereas cortical magnetic motor-evoked potentials were assessed by
      measuring the onset latency and amplitude of the thenar EMG response. Cortical
      stimulation was accomplished with a Cadwell MES-10 magnetic stimulator. tcMMEP
      and direct EMG amplitude and the mechanical response were reduced with increasing
      NMB. The average tcMMEP amplitude remained near baseline values (no NMB) until
      the direct EMG decreased < 0.4 of the unblocked value and when the TOF ratio
      decreased < 0.3. Further increases in NMB resulted in decreasing amplitude with a
      statistically significant reduction below baseline when the direct EMG decreased
      < 0.2 of baseline and TOF ratio decreased < 0.1. The tcMMEP onset latency was
      unchanged from baseline with TOF or with direct EMG reductions above 0.1 of
      baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484556
TI  - The effect of fentanyl, sufentanil, and alfentanil on cerebral arterioles in
      piglets.
AB  - The effect of fentanyl, sufentanil, and alfentanil on cerebral arterioles was
      determined in 17 halothane-anesthetized newborn piglets. A closed cranial window
      was inserted over the parietal cortex, and changes in the luminal diameter of
      pial arterioles were measured by intravital microscopy as increasing
      concentrations of opioid (10(-9)-10(-5) M) were suffused over the cortical
      surface. Each opioid caused a dose-dependent decrease in arteriolar diameter that
      was attenuated by coadministration of naloxone (10(-5) M). Fentanyl was more
      potent than either alfentanil or sufentanil. Naloxone alone had no effect at
      concentrations < or = 10(-5) M, suggesting that endogenous opioids contribute
      little to resting cerebrovascular tone. These results indicate that fentanyl,
      sufentanil, and alfentanil produce cerebral vasoconstriction by action at an
      opioid receptor and that their vasoconstrictive potency appears to differ from
      their analgesic potency.

PMID- 8484557
TI  - A comparison of the cerebral protective effects of etomidate, thiopental, and
      isoflurane in a model of forebrain ischemia in the rat.
AB  - We evaluated the effect of etomidate, thiopental, and isoflurane on ischemic
      neuronal injury in rats. Control group animals received 1.2% isoflurane. The
      animals in the etomidate and thiopental groups received an infusion of either
      etomidate or thiopental until electroencephalographic (EEG) burst-suppression was
      attained. In the fourth group, the isoflurane concentration was increased to 3%
      (sufficient to produce EEG burst-suppression). Forebrain ischemia was induced by
      bilateral carotid artery occlusion with simultaneous hypotension for 10 min.
      Three days after ischemia, two blinded observers evaluated neuronal injury in
      coronal brain sections stained with hematoxylin and eosin. Injury to the ventral
      CA1 of the hippocampus was less in the etomidate group than in the control group.
      Injury to the entorhinal cortex was less in the thiopental group than in the
      control group. Histopathologic outcome in animals anesthetized with 1.2%
      isoflurane and 3% isoflurane was not different. Although these data indicate that
      etomidate and thiopental might reduce ischemic injury in some structures, the
      magnitude of the protective effects observed was small.

PMID- 8484558
TI  - Accelerated onset and delayed recovery of neuromuscular block induced by
      mivacurium preceded by pancuronium in children.
AB  - The goal of this study was to describe a technique which could shorten the time
      from mivacurium administration to peak neuromuscular block (NMB) after
      administration of the maximum recommended dose of mivacurium. Forty-eight
      pediatric patients were randomized into three groups and studied during nitrous
      oxide-alfentanil-thiopental anesthesia. Every patient received two blinded
      injections 3 min apart: either 15 micrograms/kg of pancuronium in 1 mL of saline
      followed by 170 or 200 micrograms/kg of mivacurium or saline followed by 200
      micrograms/kg of mivacurium. Intravenous induction of anesthesia followed the
      first injection. Thenar electromyogram response to supramaximum train-of-four
      stimulation of the ulnar nerve at 10-s intervals was used for neuromuscular
      monitoring. Pretreatment with pancuronium significantly shortened the time to NMB
      and prolonged spontaneous recovery from NMB in comparison to the temporal course
      of NMB after administration of 200 micrograms/kg of mivacurium. Time from
      injection to 90% NMB averaged 116 (SEM 11) s after administration of 200
      micrograms/kg of mivacurium, and 71 (7) s and 94 (11) s when 200 micrograms/kg or
      170 micrograms/kg of mivacurium, respectively, was preceded by pancuronium (P =
      0.0095). Mean times from injection to recovery of neuromuscular function to > 25%
      of baseline (T25) and to train-of-four ratio of 0.75 were 9.1 (0.7) and 15.8
      (1.2) min, respectively, after administration of 200 micrograms/kg of mivacurium
      alone. T25 and train-of-four of 0.75 occurred significantly later at 21.9 (1.8)
      and 35.0 (2.8) min, respectively (P = 0.0001), when 200 micrograms/kg of
      mivacurium was preceded by 15 micrograms/kg of pancuronium.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8484559
TI  - Computer simulation of geometry and hemodynamics of canine pulmonary arteries.
AB  - Assuming that along the pulmonary arteries, mathematical expectations of
      branching are equal to matrix (Ei,j; i: parent branch class, j: daughter branch
      class number), we made computer drafts of patterns of pulmonary arterial
      branching trees from the published data of canine pulmonary arterial casts with
      the "Monte Carlo methods" by FORTRAN, calculating from these data, the numbers of
      branches, size and resistance of the trees. We also analyzed blood flow
      distribution in a pulmonary branch according to the pathlength from the entrance
      of the tree. The graphics of the trees were similar to the original arterial
      casts, and numbers of the branches were nearly the same as the previous reported
      values. Calculated resistance was reasonable. The rate of blood flow per unit
      vessel in the short pathlength group was calculated as 1.5 times that of the long
      pathlength group of the same diameter. We believe that our method of describing
      the branching pattern matrix (Ei,j) provides a reasonable simulation of complex
      branching patterns such as pulmonary arteries and a useful means to analyze local
      hemodynamics.

PMID- 8484560
TI  - Tauberian-prony feature extraction technique for esophageal motility patterns.
AB  - For the esophageal contractile activity recorded during swallowing, a feature
      extraction scheme has been developed. It recognizes the time, duration, and
      amplitudes of local peaks for each peristaltic wave. The method is based on the
      Tauberian approximation for modeling waveforms as a sum of identically shaped
      pulses with different time delays and amplitudes. Initial conditions on the pulse
      properties are set and an optimal solution is sought. The method is completely
      automated and can be utilized for characterization and classification purposes.

PMID- 8484561
TI  - Modeling of the heart's ventricular conduction system using fractal geometry:
      spectral analysis of the QRS complex.
AB  - Many biological systems having one or more characteristics that remain constant
      over a wide range of scales may be considered self-similar or fractal.
      Geometrical and functional overview of the ventricular conduction system of the
      heart reveals that it shares structures common to a tree with repeatedly
      bifurcating "branches," decreasing in length with each generation. This system
      may further simplify by assuming that the bifurcating and decreasing process is
      the same at any generation, that is, the shortening factor and the angle of
      bifurcation are the same for each generation. Under these assumptions, the
      conduction system can be described as a fractal tree. A model of the heart's
      ventricles which consists of muscle cells and a fractal conduction system is
      described. The model is activated and the dipole potential generated by adjacent
      activated and resting cells is calculated to obtain a QRS complex. Analysis of
      the frequency spectrum of the QRS complex reveals that the simulated waveforms
      show an enhancement in the high frequency components as generations are added to
      the conduction system. It was also found that the QRS complex shows a form of an
      inverse power law, which was predicted by the fractal depolarization hypothesis,
      with a highly correlated straight line for a log-power versus log frequency plot
      with a slope of approximately -4. Similar results were obtained using real QRS
      data from healthy subjects.

PMID- 8484562
TI  - Complex bioelectric impedance measurement system for the frequency range from 5
      Hz to 1 MHz.
AB  - Analytic techniques that have been successfully employed in materials science,
      and to a lesser extent in the study of biologic systems, have potential for
      improving the application of bioelectric impedance provided that both real and
      imaginary impedance components can be measured with sufficient accuracy over a
      given frequency range. Since biologic tissue, particularly animal tissue, is
      typically highly conductive, phase angles are small, making accurate measurements
      difficult. A practical four-terminal system employing commercial lock-in
      amplifiers is described and error sources and corrective techniques are
      discussed.

PMID- 8484563
TI  - Evaluation of regional load in acute ischemia by three-dimensional curvatures
      analysis of the left ventricle.
AB  - Geometric remodeling of the left ventricule (LV) following myocardial infarction
      and ischemic insult is associated with myocardial load redistribution. Regional
      curvatures based on 3-D reconstructions of the LV are used to calculate the
      regional loads. The technique uses surface normals to derive local
      circumferential and meridional curvatures. Following the validation of the
      procedure on simple geometric shapes, the effect of acute ischemia on the
      regional load redistribution was studied in six open chest dogs. Short axis
      magnetic resonance imaging (MRI) scans were used to reconstruct end-diastolic
      (ED) and end-systolic (ES) LV images by applying our helical shape descriptor,
      before and after acute coronary occlusion. Regional curvatures as well as local
      wall thickness by the volume element method were calculated before and after
      acute ischemia, and were used to approximate regional loads, by a regional stress
      index (sigma/P). Postmortem evaluation using monastral blue staining was used to
      divide each LV to normal (NZ), ischemic (IZ), and border (BZ) zones in the
      ischemic case, and to the anatomically matched regions in the preischemic LVs.
      Ischemia affects the local curvatures and loads both at ED and ES. At ED, sigma/P
      rose significantly only in the IZ. Similarly, at ES, the highest increase in load
      was detected in the IZ, but increases in circumferential and meridional load were
      seen in all regions. Identifying the load redistribution following acute ischemia
      helps delineate the mechanisms affecting geometric LV remodeling following
      myocardial infarction.

PMID- 8484564
TI  - Improved LAboratory Prototype ELectrolarynx (LAPEL): using inverse filtering of
      the frequency response function of the human throat.
AB  - The electrolarynx (EL) provides a valued means of verbal communication for people
      who have lost their larynx. Existing ELs have some drawbacks such as harsh,
      raucous, and unpleasant sound and the presence of background noise. This study
      presents an experimental analysis of two commercial ELs and describes the
      development and testing of an improved LAboratory Prototype ELectrolarynx (LAPEL)
      which more accurately simulates the sound of a natural larynx and has lower
      background noise. This natural sound is obtained by determining the frequency
      response function (FRF) of the tissue of the human neck and using this
      information to tailor the input signal to the EL by inverse filtering such that
      its output spectrum resembles that of the natural larynx. The result was
      subjectively judged to have a superior and more natural sound than existing
      electrolarynxes.

PMID- 8484565
TI  - Noninvasive characterization of the sound pattern caused by coronary artery
      stenosis using FTF/FAEST zero tracking filters: normal/abnormal study.
AB  - In this article, a new approach has been proposed to investigate the extraction
      of useful information from diastolic heart sounds caused by partially occluded
      coronary arteries. This method, which estimates and tracks the zeros (poles) of
      the diastolic heart sounds directly, takes advantage of the FTF/FAEST (Fast
      Transversal Filters/Fast a Posteriori Error Sequential) technique which possesses
      the fast convergence property of the Recursive Least Square (RLS) method and the
      computational simplicity of the Least Mean Square (LMS) method. In previous
      studies, the main assumption was that the diastolic heart sounds were a
      stationary process. Since the production of the heart sounds were a stationary
      process. Since the production of the heart sounds is not a stationary process, a
      new approach that performs well not only for stationary but also for
      nonstationary processes can be required. This requirement can be satisfied by the
      adaptive FTF/FAEST zero tracking method which provides fast and stable
      convergence as well as computational efficiency since the adaptive FTF/FAEST zero
      tracking method is based on the exact minimization of least squares criteria and
      the filter weights of this method are optimal at each time instant. The zero
      trajectories of the diastolic heart sounds were used to diagnose patients as
      diseased or normal. Results showed that the normal and abnormal records were
      incorrectly distinguished in only 6 of 35 cases using a blind protocol where
      analysis was done without knowledge of the actual disease states of the patients.
      The most discriminant time region of the zero trajectories of the diastolic heart
      sounds associated with coronary artery disease was between 200 and 300 msec after
      the second heart sound during the diastolic period.

PMID- 8484566
TI  - Signal analysis of noninvasive Xenon-133 cerebral blood flow measurements.
AB  - An anatomical model in conjunction with experimentally determined absorption data
      provides a framework to simulate signals as obtained from the noninvasive Xenon
      133 cerebral blood flow technique. The contribution of individual tissue
      compartments to the total signal as well as the effect on the computed results
      were investigated under normal conditions. The introduction of physiological
      abnormalities into the model allowed the determination of sensitivity of the
      technique with respect to size, position, and perfusion level of the lesion. In
      addition, effects of cross-talk between hemispheres and signal overlap of
      adjacent detectors were quantified. It was found that the change of externally
      measured blood flow is proportional to the decrement/increment of flow in the
      lesion. Contrary to earlier reports, the effects of cross-talk and signal overlap
      were not found to be serious limitations in identifying lesions.

PMID- 8484567
TI  - Incorporating vessel taper and compliance properties in Navier-Stokes based blood
      flow models.
AB  - A popular and useful technique used to model blood flow in cardiovascular
      simulations is to divide each blood vessel into a series of segments, each with
      its own lumped resistance, inertance, and compliance parameters. The values of
      these parameters are usually obtained through a simplification of the Navier
      Stokes equations for fluid flow. However, the simplification often ignores the
      nonlinear and convective terms of the equations, resulting in errors in the
      parameter values, especially in the value found for resistance per unit length.
      We report a new method for the calculation of vessel resistance per unit length
      which takes into account the effects of vessel taper and wall compliance. It is
      shown that these effects can be addressed by the addition of two time-varying
      terms to the calculation of resistance per unit length. One term, due to vessel
      taper, is proportional to volumetric flow rate Q. The other term, due to vessel
      compliance, is proportional to delta p/delta t. These variables are readily
      available in computer simulations of blood flow in lumped parameter systems.
      Using data for the descending aorta, the new parameter values, when averaged over
      a cardiac cycle, compare favorably with results in the literature.

PMID- 8484568
TI  - Accuracy of a reflectance pulse oximeter in anesthetized horses.
AB  - The accuracy of a reflectance pulse oximeter was determined in 22 anesthetized
      horses. Oximetric blood oxygen saturation was measured with the pulse oximeter
      probe attached to the mucosa of the mandible. Arterial blood oxygen saturation
      (SaO2) was calculated from arterial blood gas values and the equine blood oxygen
      dissociation curve. The mean +/- SD difference between oximetric blood oxygen
      saturation and SaO2 was -1.3 +/- 3.1% for values of SaO2 ranging from 80 to 100%.
      The difference between oximetric blood oxygen saturation and SaO2 was influenced
      by SaO2, the mean arterial blood pressure, and preanesthetic medication
      administered, but not by age, sex, or body weight of the horse, individual animal
      effect, anesthetic induction or maintenance agent, procedure performed, body
      position, mode of lung ventilation, time of sampling, arterial pH, or carbon
      dioxide tension.

PMID- 8484569
TI  - Ultrasonographic observations of the flexor tendons and ligaments of the
      metacarpal region of horses.
AB  - Observations were made in dorsal and sagittal planes of the ultrasonographic mean
      gray scale of the flexor tendons and ligaments of the metacarpal regions of 5
      Thoroughbred geldings, during weight bearing and nonweight bearing. In images
      made when the horses were nonweight bearing, the mean gray scale of the
      superficial and deep digital flexor tendons and accessory ligament was
      significantly reduced, but that of the interosseous medius muscle (suspensory
      ligament) was not. When relaxed, collagen fiber bundles in the tendons and
      ligaments acted as diffuse, rather than specular, reflectors of ultrasonic waves
      leading to localized regions of hypoechogenicity and a consequent reduction in
      mean gray scale. The suspensory ligament, however, remained under tension during
      nonweight bearing and so mean gray scale was not reduced. Analyses of the
      ultrasonographic mean gray scale have the potential to provide quantitative data
      relating to the changes in echogenicity that develop in injured equine tendons
      and ligaments.

PMID- 8484570
TI  - Distribution of dopamine beta-hydroxylase and neuropeptide Y-immunoreactive
      nerves in healthy equine lungs.
AB  - Immunohistochemical methods were used to determine the distribution of pulmonary
      nerves containing either an enzymatic marker of adrenergic nerves, dopamine beta
      hydroxylase, or the putative neurotransmitter neuropeptide Y in 7 equids with
      healthy lungs. Nerves immunoreactive for these substances were found on airway
      smooth muscle in nearly all the samples of healthy equine lung examined. These
      nerves were generally more numerous in the larger airways but could be detected
      even in noncartilaginous bronchioles. Pulmonary and bronchial vessels also
      contained numerous immunoreactive nerves. On the basis of these findings, we
      suggest that dopamine beta-hydroxylase- and neuropeptide Y-immunoreactive nerves
      may be involved in the regulation of airway and vascular diameter in equids.

PMID- 8484571
TI  - Expression of calbindin-D28k in developing and growing ovaries of chicken
      embryos.
AB  - Immunoreactivity for 28 kd vitamin D-dependent calcium-binding protein (calbindin
      D28k) has been localized in the germinal epithelium and cells surrounding oogonia
      and oocytes (future granulosa cells) of developing and growing ovaries of chicken
      embryos. The protein first appeared prominently in the germinal epithelium of the
      developing left ovary in 8-day embryos. At the twelfth day of incubation, cells
      surrounding oogonia and oocytes reacted intensely for calbindin-D28k. The number
      and intensity of calbindin-D28k-containing cells increased in both types of cells
      as the embryos further developed. Calbindin-D28k remained in the germinal
      epithelium throughout the study period observed (up to 10 weeks). However, the
      protein was present transiently in the future granulosa cells. It gradually
      decreased after hatching, and was virtually absent from granulosa cells in a 10
      week old chicken. Compared with the known process of onset of sexual development,
      these results indicated possible involvement of calbindin-D28k in the early
      phases of oogenesis in chicken ovaries.

PMID- 8484573
TI  - In vitro susceptibility of Actinobacillus pleuropneumoniae strains to 42
      antimicrobial agents.
AB  - Minimal inhibitory concentration of 42 antimicrobial agents was determined
      against 57 field strains of Actinobacillus pleuropneumoniae isolated from pigs in
      Spain. Penicillins, aminoglycosides, and tetracyclines had irregular activity;
      ticarcillin, tobramycin, and doxycycline were the most active of each group,
      respectively. Macrolides, vancomycin, dapsone, and tiamulin, to which strains had
      high rate of resistance, were almost ineffective. Thiamphenicol, colistin,
      rifampin, fosfomycin, mupirocin, and metronidazole had good activity, with
      resistance ranging between 0 and 8.8%. Finally, cephalosporins (except
      cephalexin) and quinolones (especially ciprofloxacin, enrofloxacin, and
      sparfloxacin) were the most active antibiotics against A pleuropneumoniae.

PMID- 8484572
TI  - Clinical and laboratory changes after administration of milbemycin oxime in
      heartworm-free and heartworm-infected dogs.
AB  - Adverse reactions to oral administration of milbemycin oxime were investigated in
      heartworm (HW)-free and HW-infected dogs given either the minimal HW prophylactic
      dose (0.25 mg/kg of body weight) or the hookworm anthelmintic dose (0.5 mg/kg).
      In 12 HW-free control dogs treated with lactose excipient (100 mg/kg), abnormal
      signs were not observed. There were no differences between the 2 doses in
      prevalence of clinical signs of disease and laboratory test results. In 60 HW
      free dogs (50 dogs administered the low dose, and 10 dogs given the high dose)
      and 46 nonmicrofilaremic HW-infected dogs (35 dogs administered the low dose, and
      11 dogs given the high dose), only a transient and slight paleness of the visible
      mucous membranes, intestinal hyperperistalsis, or both were observed in some
      dogs. In 77 microfilaremic (MF) dogs (41 dogs administered the low dose, and 36
      dogs given the high dose), weakness or loss of appetite was observed in 13 dogs
      (16.9%). Paleness of the visible mucous membranes was observed in 16 dogs
      (20.8%), intestinal hyperperistalsis was observed in 27 dogs (35.1%), and
      respiratory signs, such as mild labored respiration, were observed in 13 dogs
      (16.9%). Dullness of heart sounds was noticed in 4 dogs (5.2%). In 12 (9 dogs
      administered the low dose, and 3 dogs given the high dose) of 89 MF dogs (13.5%),
      adult heartworms migrated from the pulmonary arteries to the right atrium,
      causing signs of caval syndrome, including heart murmurs, jugular pulsations, and
      weakness. In HW-free dogs, rectal temperature tended to decrease gradually, and
      heart and respiratory rates were transiently decreased.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484574
TI  - Effects of dietary electrolyte balance on subluxation of the femoral head in
      growing dogs.
AB  - Effects of increased dietary chloride and reduced sodium and potassium ion
      concentrations on coxofemoral joint conformation, as assessed by radiography,
      were examined in growing dogs. Dietary electrolyte balance was quantified by
      dietary anion gap (DAG), defined as Na+ + K+ - Cl- in milli-equivalents per 100 g
      of food. Diets had anion gap ranging from 8 to 41 mEq/100 g of food. One hundred
      sixty-seven pups from 27 litters representing 5 breeds were studied during the
      period of rapid growth. The extent of subluxation of the femoral head was
      measured on radiographs, using the method of Norberg. On average, less
      subluxation of the femoral head (P < 0.05) was observed when diets with lower DAG
      were fed. Differences in DAG balance did not result in different rates of weight
      gain; therefore, the reduction in coxofemoral joint subluxation attributable to
      low DAG was unrelated to weight gain. Norberg angles measured at 30 weeks of age
      were highly correlated with coxofemoral joint status at 2 years of age, as
      measured by the Swedish diagnostic system and the scoring system of the
      Orthopedic Foundation for Animals (lrl > or = 0.70, P < 0.0002, n = 24). This
      diet-related improvement in coxofemoral joint subluxation would be expected, on
      average, to delay or mitigate the characteristic clinical and radiographic signs
      of hip dysplasia in growing dogs.

PMID- 8484575
TI  - Comparison of taurine, alpha-tocopherol, retinol, selenium, and total
      triglycerides and cholesterol concentrations in cats with cardiac disease and in
      healthy cats.
AB  - Epidemiologic relations were evaluated between plasma concentrations of nutrients
      and cardiovascular diseases. A total of 220 cats were assessed: 144 cats with
      noninduced acquired heart disease and 76 clinically normal cats. Plasma was
      assayed for taurine, alpha-tocopherol, selenium, retinol, and total cholesterol
      and triglycerides concentrations. Cardiovascular disease groups included dilated
      cardiomyopathy (n = 53), left ventricular hypertrophy (n = 28), hyperthyroidism
      (n = 11), and uncertain classification (n = 52). In cats with dilated
      cardiomyopathy, mean plasma taurine concentration was the lowest of that in cats
      of any group, being only 38% of the value in healthy cats; females had less than
      half the mean value of males. Tocopherol concentration was 20% lower than normal,
      and retinol concentration was 40% higher than normal. Total cholesterol
      concentration was 36% lower than normal. Triglycerides concentration was higher
      in these cats than in any other group--twice the value recorded in healthy cats
      and 67% higher than that in hyperthyroid cats. In cats with hypertrophic
      cardiomyopathy, almost 15% had mean plasma taurine concentration < 30 mumol/L.
      Retinol concentration was 15% higher, and triglycerides concentration was 54%
      higher than normal. Approximately 27% of hyperthyroid cats had mildly decreased
      plasma taurine concentration. Hyperthyroid cats had the lowest tocopherol and
      cholesterol values; both were at least 30% lower than normal. Retinol
      concentration was 30% higher than normal. Approximately 14% of cats with
      uncertain classification had mildly decreased plasma taurine concentration.
      Plasma retinol and triglycerides concentrations were higher than normal in 25 and
      38% of these cats, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484576
TI  - Correlations between histologic endometrial lesions in mares and clinical
      response to intrauterine exposure with Streptococcus zooepidemicus.
AB  - The relationship between histologic lesions in endometrial biopsy specimens and
      susceptibility to chronic uterine infection (CUI) in mares was investigated.
      Mares were allotted to 4 groups on the basis of degree of endometrial lesions.
      Mares in group 1 (n = 6) had no pathologic changes, mares in group 2 (n = 5) had
      only mild pathologic changes, group-3 mares (n = 7) had moderate changes, and
      group-4 mares (n = 7) had severe inflammatory and fibrotic endometrial changes.
      Susceptibility to CUI was determined by the inflammatory response to intrauterine
      inoculation of 5 x 10(6) Streptococcus zooepidemicus. The inoculum was given on
      the third day of behavioral estrus and in the presence of a follicle > 30 mm.
      Mares with > 1 neutrophil/5 high-magnification (400 x) microscopic fields and >
      20 colonies of S zooepidemicus at 96 hours after inoculation were considered to
      be susceptible to CUI. There was a significant association between biopsy grade
      and susceptibility to CUI among the groups. Histologically normal endometrium was
      associated with resistance to CUI, and severe histopathologic changes in the
      endometrium were associated with susceptibility to CUI. Mild to moderate
      endometrial lesions did not correlate consistently with susceptibility or
      resistance to CUI.

PMID- 8484577
TI  - Pharmacokinetics and concentrations of ceftiofur sodium in body fluids and
      endometrium after repeated intramuscular injections in mares.
AB  - Each of 5 healthy mares was given 5 consecutive IM injections of ceftiofur sodium
      (2 mg/kg of body weight; 50 mg/ml) at 12-hour intervals. Ceftiofur concentrations
      were measured serially in serum, synovial fluid, peritoneal fluid, and urine, and
      were measured in CSF and endometrial tissue after the fifth dose. Mean
      elimination rate constant was 0.354 +/- 0.101 h-1 and elimination half-life was
      2.49 +/- 0.49 hour. Mean serum ceftiofur concentrations peaked approximately 1
      hour after each injection. The highest mean ceftiofur concentration was 5.09
      micrograms/ml at 1 hour after the fifth dose for serum, 3.02 micrograms/ml at 2
      hours after the fifth dose for synovial fluid, and 3.23 micrograms/ml at 4 hours
      after the fifth dose for peritoneal fluid. Mean urine concentrations reached
      15.72 micrograms/ml at 1 hour after the fifth dose. Ceftiofur was not detected in
      CSF or endometrial tissue. None of the mares had adverse reactions to the drug.

PMID- 8484578
TI  - Pharmacokinetics of cefotaxime in neonatal pony foals.
AB  - Serum concentrations of cefotaxime and desacetylcefotaxime were measured in 1
      week-old pony foals after IV administration of a single dose of cefotaxime. The
      cefotaxime disposition data conformed to a two-compartment model with elimination
      half-life of 0.60 hour. The combined cefotaxime and desacetylcefotaxime data was
      best described by a four-compartment model. The apparent half-life describing the
      disappearance of desacetylcefotaxime was 1.69 hours. Dosage of 40 mg/kg of body
      weight given IV every 4 to 6 hours for neonatal foals with gram-negative
      septicemia and every 2 hours for foals with meningitis is recommended for further
      study.

PMID- 8484579
TI  - Blockade of endotoxin-induced cecal hypoperfusion and ileus with an alpha 2
      antagonist in horses.
AB  - Stimulation of alpha 2 adrenergic receptors inhibits colonic motility and may
      constrict some peripheral vascular beds. Endotoxemia elicits release of
      sympathetic neurotransmitters and increases sympathetic nerve activity, which may
      result in stimulation of alpha 2 adrenergic receptors. The objective of this
      study was to determine whether blockade of alpha 2 adrenergic receptors would
      restore cecal motility and blood flow during endotoxemia in horses. Strain-gauge
      force transducers and ultrasonic flow probes were used to measure cecal and
      colonic mechanical activity and lateral cecal arterial blood flow. Intravenous
      infusion of endotoxin (cumulative dose of 0.03 mg/kg) significantly decreased
      cecal and right ventral colon contractile activity and lateral cecal arterial
      blood flow. Slow IV infusion of yohimbine (cumulative dose of 75 micrograms/kg)
      significantly attenuated those effects of endotoxin. On the basis of our
      findings, we concluded that endotoxemia causes cecal and proximal colonic ileus
      and cecal hypoperfusion via a mechanism that involves alpha 2 adrenergic
      receptors.

PMID- 8484580
TI  - Characterization of serum alpha 1-acid glycoprotein in fetal and newborn calves
      during development.
AB  - Serum alpha 1-acid glycoprotein (alpha 1-AG) in bovine fetuses and newborn calves
      was characterized. Serum alpha 1-AG concentration increased during fetal
      development and neonatal stages. Mean +/- SD serum alpha 1-AG concentration
      reached a peak of 1,368 +/- 207 micrograms/ml immediately after birth, but
      thereafter gradually decreased to 249 +/- 100 micrograms/ml, similar to the
      normal adult bovine range. By use of isoelectric focusing of thin-layer gels, we
      detected 7 microheterogeneity bands ranging from pI 3.2 to 3.8 in adult bovine
      serum. Twelve bands ranging from pI 2.6 to 3.8 were found in 9-month fetuses and
      in neonates. The 5 most-acidic bands, which are absent in adult serum, ranged
      between pI 2.6 and 3.1 and decreased with maturation as band patterns assumed
      adult characteristics. By crossed affinity electrophoresis, alpha 1-AG of adult
      bovine serum was separated into 4 peaks according to its differential affinity to
      concanavalin A (conA). Seventy-five percent of the alpha 1-AG concentration was
      represented by peak 3 (P-3) and peak 4 (P-4), which had moderate or strong
      binding to conA. In contrast, fetal sera contained only peak 1 (P-1), which did
      not have conA-binding affinity. In neonatal sera, 4 peaks were recognized, of
      which P-1 comprised 70% of the total alpha 1-AG. Thereafter, with aging,
      percentage of P-3 and P-4 increased as band composition approached the normally
      expected adult pattern.

PMID- 8484581
TI  - Effects of acute physical stress on immune competence in pigs.
AB  - Some interrelations between physical stress and immune competence were studied in
      pigs. One group of pigs underwent 2 intense short-term treadmill exercise tests,
      separated by an interval of 1 week, and another group served as controls. In
      vitro production of interferon alpha by blood mononuclear cells and the ability
      of lymphocytes to proliferate and produce interleukin 2 were chosen as markers of
      immune competence; plasma concentrations of cortisol, lactate, and purines were
      used as markers of physical stress. Blood samples were drawn from a catheter in
      situ 60 minutes before, immediately after, and at 10, 30, and 60 minutes, and 7,
      24, and 72 hours after exercise. Physical stress resulted in immediate increase
      in the plasma concentrations of cortisol, lactate, and hypoxanthine, but had no
      effect on the blastogenic capability of lymphocytes or on their interleukin-2
      production on either of the test occasions. Ability of blood mononuclear cells to
      produce interferon alpha in vitro was not affected by exercise stress.

PMID- 8484582
TI  - Electrocardiographic findings in rats with cardiomyopathy.
AB  - The purpose of this study was to evaluate changes in the ECG in a strain of rats,
      SHHF/Mcc-cp that developed cardiomyopathy and congestive heart failure naturally.
      Lead-I, -aVF, and -V5 ECG were obtained from male rats at approximately 6, 10,
      and 19 months of age, corresponding to early, mild, and severe heart failure,
      respectively. Electrocardiograms also were obtained from male Wistar-Furth rats
      matched for age with SHHF/Mcc-cp rats. Heart rate, amplitude and duration of
      component deflections, degree of notching of P waves and QRS complexes, and
      orientation of means QRS vectors in the frontal plane were analyzed from the ECG.
      Durations of P waves, PQ intervals, QRS complexes, and QT intervals were
      prolonged and amplitude of R waves in lead aVF was decreased only in SHHF/Mcc-cp
      rats at the 19-month recording. Increased notching in QRS complexes, but not in P
      waves, was observed more frequently at all ages, in SHHF/Mcc-cp rats than in
      Wistar rats, and notching was greatest at 19 months. Arrhythmias were not
      observed in Wistar rats, but infrequent supraventricular premature
      depolarizations were observed in 2 of 10 SHHF/Mcc-cp rats at 19 months. In leads
      aVF and V5, T waves increased in amplitude as Wistar rats aged; however, in
      SHHF/Mcc-cp rats, T-wave amplitude peaked in all leads at 10 months, but returned
      to the 6-month value at month 19. We conclude that cardiomyopathy, heart failure,
      or both, resulted in changes in the ECG, but that these changes could be used to
      detect heart failure only when rats reached 19 months of age and were severely
      affected.

PMID- 8484583
TI  - Contributions to variance in force-plate analysis of gait in dogs.
AB  - Coefficients of variation were calculated for peak vertical force and for
      vertical, cranial, and caudal impulses recorded from the left forelimb and left
      hind limb of 5 dogs that were trotted across a force plate 5 times by 5 handlers.
      To determine the percentages of variance attributable to dogs, handlers, and
      trial repetitions, data recorded for each force measurement were analyzed
      according to a two-factor ANOVA. Coefficients of variation for peak vertical
      forces and for vertical impulses varied between 5.8 and 8.5%. Coefficients of
      variation for the forelimb cranial and caudal impulses and for the hind limb
      cranial and caudal impulses were 26.4 and 30.5%, and 63.0 and 25.9%,
      respectively. The percentage of the total variance attributable to dogs and to
      trial repetitions ranged from 14 to 69% and from 29 to 85%, respectively,
      depending on the force or impulse evaluated. The percentage of variance
      attributable to handlers varied between 0 and 7%. The trivial amount of variation
      attributable to handlers indicated that multiple handlers may be used in
      experiments without an appreciable influence on the results.

PMID- 8484584
TI  - Clinicopathologic findings after experimental implantation of synthetic
      intraocular lenses in dogs.
AB  - Clinical findings indicate that canine eyes tolerate implantation of
      polymethylmethacrylate (PMMA) intraocular lenses (IOL) well, although
      inflammation and ocular damage attributable to the implants is not known. The use
      of silicone or polyhydroxyethylmethacrylate (HEMA) IOL has not been reported in
      dogs. In this study, 15 conditioned, mixed-breed dogs were allotted to 3 groups:
      5 received PMMA IOL; 5 received silicone IOL; and 5 received HEMA IOL. The IOL
      optic was inserted into the anterior chamber of the right eye and anchored to the
      cornea. An identical surgical procedure was done on the left eye, except that no
      lens optic was inserted. Clinical examination and measurement of corneal
      thickness were done immediately prior to and after surgery. Aqueous humor samples
      were collected at the time of surgery and 28 days after surgery. Only mild and
      transient inflammation was observed in IOL-implanted eyes. On several
      postoperative days, it was found that PMMA IOL induced significantly greater
      corneal thickness, aqueous flare, anterior uveal irritation, and corneal edema
      than did other IOL. Significantly more anterior uveal irritation and increased
      aqueous humor protein concentration was observed with HEMA IOL than with PMMA or
      silicone IOL. Silicone IOL induced significantly less fibrin deposition than did
      PMMA or HEMA IOL.

PMID- 8484585
TI  - Relation between reduced glutathione content and Heinz body formation in sheep
      erythrocytes.
AB  - To clarify the oxidant defense functions of reduced glutathione (GSH) in
      erythrocytes, the effect of GSH deficiency on in vitro oxidant defense was
      studied, using GSH-deficient sheep erythrocytes (low-GSH cells). The formation of
      Heinz bodies in low-GSH cells was higher than that in high-GSH cells when the
      cells were incubated with an oxidant drug, acetylphenylhydrazine (APH).
      Artificial depletion of GSH by 1-chloro-2,4-dinitrobenzene in high-GSH cells
      resulted in increased Heinz body formation in these cells incubated with APH.
      Furthermore, high negative correlation was observed between Heinz body formation
      and GSH content in sheep erythrocytes exposed to APH. These results clearly
      indicate that erythrocyte GSH is indispensable for erythrocyte defense against
      oxidative damage induced by APH, and support the previous observations that sheep
      with low-GSH erythrocytes were more susceptible to oxidative agents than were
      sheep with high-GSH erythrocytes.

PMID- 8484586
TI  - Kinematic gait analysis of the trot in healthy greyhounds.
AB  - A noninvasive computer-assisted kinematic gait analysis was used to describe
      flexion and extension movements of 6 joints in Greyhounds at a trot. Distinct
      patterns of movements were described for each joint studied. The coxofemoral and
      carpal joints were characterized by a single peak of maximal extension. The
      femorotibial, tarsal, scapulohumeral, and cubital joints had 2 peaks of maximal
      extension, with 1 peak preceding stance phase and a second peak within stance
      phase. A two-factor repeated-measures ANOVA was used to determine the variance in
      measurement of joint angles in degrees that was attributable to trial repetitions
      and to differences between dogs. The coxofemoral, femorotibial, tarsal,
      scapulohumeral, and cubital joints had a mean variance attributable to trial
      repetition of 6.6 (range, 1.7 to 12.9), and a mean variance attributable to
      differences between dogs of 5.1 (range, 0.9 to 9.2). The carpus had more
      variance, with a mean variance attributable to trial repetition of 16.3 (range,
      13.3 to 20.5), and that attributable to differences between dogs of 31.8 (range,
      20.5 to 46.7). Kinematic gait analysis provided a reliable description of flexion
      and extension movements in Greyhounds with minimal variance attributable to trial
      repetitions and to differences between dogs.

PMID- 8484587
TI  - Preparation and transfusion of canine platelet concentrates.
AB  - A protocol was developed for preparation of platelet concentrates (PC) to support
      thrombocytopenic dogs. Four clinically normal dogs with platelet counts that
      ranged from 200 to 330 x 10(9) platelets/L were used as donors. One unit (450 ml)
      of blood was collected by venipuncture into a double blood bag. Whole blood (WB)
      was centrifuged for 4 minutes at 1,000 x g (braking time = 2 minutes, 30 seconds)
      to prepare platelet-rich plasma (PRP). The PRP was expressed into the satellite
      bag and was centrifuged for 10 minutes at 2,000 x g (braking time = 2 minutes, 36
      seconds). The platelet-poor plasma was expressed, leaving 40 to 70 ml of plasma
      and the pelleted platelets in the satellite bag. The resulting PC was left
      undisturbed for 60 minutes to promote disaggregation, and the platelets were then
      resuspended by gentle manual agitation. Forty-eight PC were prepared. Mean (+/-
      SD) platelet yield from WB to PRP was 78 (+/- 13)% (range, 35 to 97%); yield from
      PRP to PC was 94 (+/- 6)% (range, 75 to 100%); and overall yield (PC from WB) was
      74 (+/- 13)% (range, 36 to 91%). Mean PC platelet count was 8.0 (+/- 3.0) x
      10(10) platelets/PC (range, 2.3 to 13.4 x 10(10) platelets/PC). The WBC content
      was 0.1 to 2.3 x 10(9) platelets/PC, representing 3 to 74% of WBC in the WB.
      Hematocrit was 0.1 to 26.2%. Results of bacterial and fungal culturing were
      negative. The PC were irradiated (18 Gy) and transfused to 5 cross-matched dogs
      undergoing bone marrow transplantation that developed profound thrombocytopenia
      of up to 8 weeks' duration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484588
TI  - Hillary Clinton seeks nursing's input on reform.

PMID- 8484589
TI  - Liaison nurses ensure continuity of care.

PMID- 8484590
TI  - Implementing the Safe Medical Devices Act.

PMID- 8484592
TI  - Why give to ANA-PAC?

PMID- 8484591
TI  - Syringe attack by AIDS patient may be first documented.

PMID- 8484593
TI  - Nurses must be visible in political arena.

PMID- 8484594
TI  - Activism in '92: the political year in review.

PMID- 8484595
TI  - ANA: one year in Washington.

PMID- 8484597
TI  - Texas nurse takes her place in Congress. Interview by Robin A Cassetta.

PMID- 8484596
TI  - CDC/SC network: the force behind ANA's political action.

PMID- 8484598
TI  - Students embrace political activism.

PMID- 8484599
TI  - Preparing nursing for the 21st century.

PMID- 8484600
TI  - Second focus group discusses reform.

PMID- 8484601
TI  - Women's health concerns integral to reform.

PMID- 8484602
TI  - Grassroots lobbying: influencing the legislative process.

PMID- 8484603
TI  - ANA endorses cataract guideline. Interview by Joan B Meehan.

PMID- 8484604
TI  - Educate patients on critical need for donors.

PMID- 8484605
TI  - Correctional facilities experience TB outbreaks.

PMID- 8484606
TI  - Community nursing organization project shapes future of health care.

PMID- 8484607
TI  - Life insurance: preparing for your family's future.

PMID- 8484609
TI  - One nurse can make a difference. As I see it.

PMID- 8484608
TI  - Positions abound for advanced practice nurses.

PMID- 8484610
TI  - Nurses, the White House and health care reform.

PMID- 8484611
TI  - Elected officials provide a variety of perspectives on health care reform.

PMID- 8484612
TI  - No bandwagon, yet. Inhaled nitric oxide (NO) for neonatal pulmonary hypertension.

PMID- 8484613
TI  - Effect of inhaled nitric oxide during group B streptococcal sepsis in piglets.
AB  - Group B streptococcus (GBS), a common gram-positive pathogen, causes similar
      pathophysiologic changes in newborn humans and animals. Infusion of GBS into
      neonatal animals produces pulmonary hypertension and ventilation/perfusion (Va/Q)
      mismatch in both early-phase (< 1 h) and late-phase (2 to 6 h) responses.
      Contrary to early phase, late phase causes pulmonary vascular injury. Nitric
      oxide (NO) is an inhaled vasodilator whose effect on pulmonary hypertension and
      Va/Q matching during early and late phases of GBS sepsis is unclear. We
      hypothesized that inhaled NO (150 ppm) would: (1) reverse early-phase GBS-induced
      pulmonary hypertension; (2) demonstrate less effectiveness in reversing late
      phase GBS-induced pulmonary hypertension because of vascular injury; (3) improve
      late-phase GBS-induced Va/Q mismatching. Anesthetized, mechanically ventilated
      piglets (n = 10; 14 +/- 4 days of age) received a 240-min infusion of GBS (1.5 x
      10(9) CFU/kg/h). Piglets received 30 min of NO (Study) or N2 (Control) at 30 and
      210 min of GBS infusion. We found that inhaled NO selectively reversed early- and
      late-phase GBS-induced pulmonary hypertension and that NO was equally as
      effective in each phase. Inhaled NO did not reverse Va/Q mismatching during late
      phase GBS. We conclude that 4 h of GBS sepsis does not injure neonatal pulmonary
      vascular smooth muscle sufficiently to impair its response to inhaled NO.

PMID- 8484614
TI  - Exogenous surfactant rapidly increases PaO2 in mature rabbits with lungs that
      contain large amounts of saline.
AB  - Neonatal respiratory distress syndrome (RDS) is characterized by a relative
      surfactant deficiency and air-space edema. We tested the hypothesis that
      exogenous surfactant would improve gas exchange in mature surfactant-replete
      lungs containing large amounts of saline. Healthy young rabbits weighing 550 to
      1,000 g were anesthetized and tracheotomized, and they received assisted
      ventilation with a FlO2 = 1. Baseline PaO2 decreased when 20 ml/kg of warmed
      saline (n = 6) was instilled into the lung; average PaO2 was stable and remained
      less than 200 mm Hg during the next 180 min. When either 50 mg/kg of natural
      surfactant (n = 6) or lipid-extracted surfactant (LES) (n = 6) was included in
      the saline solution, the PaO2 was higher (p < 0.05) than in the saline-alone
      group. To evaluate the effect of delayed addition of the surfactant we performed
      six additional experiments; the PaO2 fell to 60 +/- 6.9 SEM mm Hg after saline
      instillation, but within 15 min of administering LES, the PaO2 increased to 246
      +/- 44.1 mm Hg, and it rose to 469 +/- 29.6 mm Hg by the end of the experiment (t
      = 180 min). Similar ventilator settings maintained comparable PaCO2 values in
      untreated and surfactant-treated groups. Gravimetric lung water contents (ml/kg
      body weight or ml/total lung hydroxyproline content) were markedly increased, but
      similar, in all groups. These studies show that the increase in PaO2 after
      surfactant administration to mature lungs containing large amounts of saline is
      similar to the increase in PaO2 seen when surfactant is given to premature
      infants with RDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484615
TI  - Four markers of collagen metabolism as possible indicators of disease in the
      adult respiratory distress syndrome.
AB  - During the adult respiratory distress syndrome (ARDS), an irreversible fibrotic
      process can occur extremely rapidly. To establish indices of ARDS in pneumonia as
      well as the severity of the lung fibrosis, we have undertaken for the first time
      a study of four markers of collagen metabolism obtained from both bronchoalveolar
      lavage fluid (BALF) and serum: Type I (CI), Type III (CIII), N-terminal peptide
      of Type III procollagen (PIIINP), and galactosylhydroxylysylglucosyltransferase
      activity (GGT). We studied 61 patients (13 coma controls, 29 with pneumonia, and
      19 with ARDS). In BALF, the average values of CI, CIII, PIIINP, and GGT were
      significantly higher in ARDS than in the control patients. The values for
      patients with pneumonia, although increased, were significantly lower than those
      in ARDS for CI, CIII, and PIIINP. In serum, the mean CI and PIIINP were
      significantly increased in pneumonia and ARDS, but the mean CIII was
      significantly increased only in ARDS compared with the control group. Significant
      positive linear correlations were observed for ARDS between CI and CIII or PIIINP
      and CIII in BALF and serum. Such correlations were observed for pneumonia only in
      serum. Molecular mass determinations demonstrated that CI- and CIII-related
      antigens in BALF were essentially intact triple helices of collagens or
      procollagens. Among patients with histologically defined interstitial fibrosis,
      the level of PIIINP in BALF was significantly higher for those with an additional
      intraalveolar fibrosis. In conclusion, measurements of these collagen markers may
      be useful for assessing disease activity and reflecting the flux of collagen
      molecules in the lung.

PMID- 8484616
TI  - Increased pulmonary response to inhaled endotoxin in lactating rats.
AB  - An important aspect of risk assessment is identification of subpopulations
      particularly susceptible to the effects of inhaled pollutants. The present study
      examined whether female rats were more sensitive during lactation to the acute
      pulmonary injury produced by inhaled endotoxin. Lactating and age-matched virgin
      female rats were exposed to aerosols of saline or endotoxin for 3 h and lavaged
      at 24 h after exposure. No significant differences in lactate dehydrogenase, beta
      glucuronidase, total protein, and total cell and PMN counts were observed between
      virgin and lactating rats after exposure to saline. Each marker of pulmonary
      injury except beta-glucuronidase was 1.5- to 3-fold greater in lactating than in
      virgin female rats exposed to 29.6 micrograms/m3 endotoxin. PMNs (6-fold), total
      cell counts, and protein were also significantly increased (p < 0.05) in
      lactating rats exposed to 1.3 micrograms/m3 endotoxin, a concentration reported
      to occur in a number of agricultural settings. These results demonstrate that the
      physiologic state of lactation is associated with an increased sensitivity to the
      acute pulmonary injury produced by inhaled endotoxin and are consistent with
      previous work demonstrating a similar increased sensitivity to ozone exposure.
      The possibility of a similar pattern of enhanced response in analogous groups of
      humans merits examination.

PMID- 8484617
TI  - Acute exposure to acid fog. Effects on mucociliary clearance.
AB  - Submicrometric sulfuric acid (H2SO4) aerosol can affect mucociliary clearance
      without eliciting irritative symptoms or changes in pulmonary function. The
      effect of larger fog droplets containing H2SO4 on mucociliary clearance is
      unknown. We quantified mucociliary clearance from the trachea (n = 4) and small
      airways (n = 7) of young healthy male adults after an acute exposure to H2SO4 fog
      (MMAD = 10.3 microns; pH = 2.0; liquid water content = 481 +/- 65 mg/m3;
      osmolarity = 30 mOsm). Acid fog (AF) or saline fog (SF) (10.9 microns; 492 +/-
      116 mg/m3; 30 mOsm) was administered for 40 min of unencumbered breathing (no
      mouth-piece) at rest and for 20 min of exercise sufficient to produce oronasal
      breathing. Fog exposures were followed by a methacholine (MCh) challenge (a
      measure of airway reactivity) or inhalation of technetium-99M radioaerosol (MMAD
      = 3.4 microns) on 2 study days each. Changes in symptoms and forced ventilatory
      function were also assessed. Clearance was quantified from computer-assisted
      analyses of gamma camera images of the lower respiratory tract in terms of
      %removal/min of the radiolabel from the trachea 25 min after inhalation and from
      the outer zone of the right lung after 1.9 to 3 h. Symptoms, forced ventilatory
      function, and MCh response were unaffected by either fog. Tracheal clearance was
      more rapid in four of four subjects after AF (0.83 +/- 1.58% removal/min)
      compared with that after SF (-0.54 +/- 0.85% removal/min). Outer zone clearance
      was more rapid in six of seven subjects after AF (0.22 +/- 0.15% removal/min)
      compared with that after SF (0.01 +/- 0.09% removal/min).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8484618
TI  - Prevalence of exercise-induced airway narrowing in schoolchildren from a
      Mediterranean town.
AB  - A cross-sectional study was carried out on a random sample of 2,216
      schoolchildren 9 to 14 yr of age to determine the prevalence of exercise-induced
      airway narrowing (EIAN) in a Mediterranean town (Mataro). A complementary case
      control study measured the association between EIAN and respiratory symptoms. A
      free-running test was performed during school time. Peak expiratory flow rate
      (PEFR) was measured at rest and at 2, 5, 10, and 15 min after exercise. A total
      of 136 of 2,056 satisfactory runs showed a decrease of PEFR equal to or higher
      than 15% at each of these times after exercise. Five more children developed
      wheezing during running and were considered to have EIAN. Prevalence of EIAN was
      6.9% (95% CI = 5.9 to 7.9). Prevalence decreased progressively with age. No sex
      difference was found. In the case-control study a questionnaire of respiratory
      symptoms was applied to the mothers of hyperresponsive children, as well as to
      two matched control subjects for each case. Questionnaire analysis showed a
      strong association between EIAN and respiratory symptoms or rhinitis. Association
      with bronchitis before 2 yr of age and parental asthma was less but significant.

PMID- 8484619
TI  - Role of arachidonic acid metabolites in airway responses induced by trimellitic
      anhydride in actively sensitized guinea pigs.
AB  - We studied the role of arachidonic acid metabolites, histamine, and 5-HT in
      airway responses to trimellitic anhydride (TMA) in actively sensitized guinea
      pigs. Sensitization was produced by two intradermal injections of free TMA (0.1
      ml of 0.3% TMA in corn oil). After 21 to 28 days, guinea pigs were anesthetized
      and challenged with intratracheal instillation of 0.5% TMA conjugated to guinea
      pig serum albumin (TMA-GPSA; 50 microliters). Lung resistance (RL) was measured
      to assess airflow obstruction, and the tissue content of Evans blue dye was
      measured to assess airway plasma exudation. Before challenge, sensitized animals
      were pretreated intravenously with inhibitors of different mediators: pyrilamine
      (antihistamine: 2 mg/kg, indomethacin (cyclooxygenase inhibitor: 10 mg/kg), OKY
      046 (thromboxane synthetase inhibitor: 30 mg/kg), ICI-198,615 (leukotriene
      receptor antagonist: 10(-6) mol/kg), ketanserin (5-HT2 receptor antagonist: 1
      mg/kg), or azelastine ("antiallergic agent": 1 mg/kg). Intratracheal instillation
      of TMA-GPSA induced a slowly progressing increase in RL and produced
      extravasation of Evans blue dye at all airway levels in sensitized animals.
      Pyrilamine and azelastine abolished the increase in RL induced by TMA-GPSA until
      2.5 min after the challenge. Indomethacin and OKY-046 significantly attenuated
      the increase in RL 3 min after the challenge. ICI-198,615 and ketanserin did not
      significantly affect the increase in RL. Extravasation of Evans blue dye induced
      by TMA-GPSA was decreased by pyrilamine, azelastine and ICI-198,615 in main
      bronchi and intrapulmonary airways. Indomethacin, OKY-046 and ketanserin did not
      significantly affect the extravasation of dye into the airway tissue.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8484620
TI  - Cellular and biochemical analysis of induced sputum from asthmatic and from
      healthy subjects.
AB  - To determine the feasibility of cellular and biochemical analysis of sputum
      induced after inhalation of hypertonic (3%) saline, we analyzed sputum induced in
      10 healthy and in 18 asthmatic subjects. We also analyzed saliva samples from all
      subjects. The entire sputum sample and the saliva sample were reduced using
      dithiothreitol, and cell counts and differentials were determined. Biochemical
      analysis was performed on sputum and saliva supernatants obtained after
      centrifugation. We found that induced sputum from asthmatic subjects had a higher
      percentage of eosinophils [8.1 +/- 3.43 (mean +/- SEM) versus 0.03 +/- 0.02%, p <
      0.009] (after excluding squamous cells) and also had higher levels of albumin
      (232.3 +/- 54.8 versus 79.5 +/- 9.7 micrograms/ml, p < 0.02), fibrinogen (44.2 +/
      11.6 versus 11.9 +/- 2.5 micrograms/ml, p < 0.008) and eosinophil cationic
      protein (ECP) (142.6 +/- 34.2 versus 26.1 +/- 4.7 ng/ml, p < 0.006) but not of
      histamine or tryptase. In saliva, squamous cells made up more than 99% of the
      cells in both groups, and protein concentrations were not significantly
      different. We conclude that cellular and biochemical analysis of induced sputum
      is feasible in healthy and in asthmatic subjects and that it reveals differences
      similar to those reported from analyses of bronchial lavage fluid.

PMID- 8484621
TI  - Markers of mucus secretion and DNA levels in induced sputum from asthmatic and
      from healthy subjects.
AB  - To determine whether markers of mucus secretion can be quantified in airway
      lining fluid from asthmatic and from healthy subjects, we measured levels of a
      mucin-like glycoprotein (MLG) and lactoferrin in sputum induced by inhalation of
      hypertonic (3%) saline in 18 asthmatic and in 10 healthy subjects. Because DNA,
      like mucin, contributes to the viscosity of airway secretions, we also measured
      DNA levels in the induced sputum samples. To control for the presence of saliva
      in sputum, we also analyzed saliva samples from all subjects. The entire sputum
      sample and the saliva sample were reduced using dithiotreitol, and biochemical
      analysis was performed on supernatants obtained after centrifugation. We found
      that induced sputum from asthmatic subjects had higher levels of MLG [2,574.4 +/-
      907.8 (mean +/- SEM) versus 562.2 +/- 90.5 micrograms/ml, p < 0.007] and DNA (7.1
      +/- 1.6 versus 3.6 +/- 0.6 micrograms/ml, p < 0.05), but the difference in
      lactoferrin levels failed to reach statistical significance. However, in the
      subgroup of asthmatic subjects who gave a history of sputum production (n = 9),
      lactoferrin levels were higher than in the healthy control subjects (118.9 +/-
      46.3 versus 35.2 +/- 6.5 micrograms/ml, p < 0.05). The very low levels of MLG,
      DNA, and lactoferrin measured in saliva were not significantly different in
      asthmatic subjects from those in healthy subjects. We conclude that measurement
      of markers of mucus secretion in induced sputum is feasible in asthmatic and
      healthy subjects, and it reveals abnormally high markers of mucus secretion in
      subjects with stable asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484622
TI  - Dietary fish oil effects on seasonal hay fever and asthma in pollen-sensitive
      subjects.
AB  - The effects of taking 18 capsules a day of Max-EPA (3.2 g/day eicosapentaenoic
      acid) on clinical symptoms and bronchial hyperresponsiveness were studied in
      pollen-sensitive subjects over a pollen season in a parallel, double-blind,
      placebo-controlled (olive oil) fashion. The study was conducted over the 1990 and
      1991 pollen seasons in London, England. A total of 37 nonsmoking pollen-sensitive
      asthmatic subjects were entered into the trial, and 25 completed the 6-month
      study period over the 2 yr. The preseasonal geometric mean PD35 SGaw of histamine
      for the fish oil (n = 12) and placebo (n = 9) groups were 0.62 and 0.42 mumol,
      respectively. During the middle of the pollen season, histamine PD35 SGaw fell
      significantly for both the fish oil (0.11 mumol, p < 0.0001) and placebo groups
      (0.10 mumol, p < 0.007), indicating increased bronchial reactivity compared with
      preseasonal values, but there was no significant difference between the groups.
      Similarly, morning and evening peak expiratory flow (PEF), diurnal variability in
      PEF, nocturnal cough and wheeze, daytime wheeze, and activity, as well as nasal
      symptoms and increased usage of medication, were not significantly different
      between the groups. Compliance was confirmed by neutrophil and plasma
      phospholipid analysis, which showed significant rises in eicosapentaenoic acid
      content in the fish oil group but not in the placebo group. We conclude that
      dietary fish oil supplementation does not prevent seasonal hay fever and asthma
      in pollen-sensitive subjects during the pollen season.

PMID- 8484623
TI  - Effect of electrical stimulation of the hypoglossal nerve on airflow mechanics in
      the isolated upper airway.
AB  - To determine the influence of electrical hypoglossal (HG) nerve stimulation on
      upper airway airflow mechanics, we analyzed pressure-flow relationships obtained
      during bilateral supramaximal HG nerve stimulation over a range of frequencies
      from 0 to 100 Hz in the isolated feline upper airway. Inspiratory airflow (VI),
      hypopharyngeal pressure (Php), and pharyngeal pressure (Pph) immediately upstream
      from the flow-limiting site (FLS) were recorded while Php was rapidly lowered to
      achieve inspiratory flow limitation in the isolated upper airway. Pressure-flow
      relationships were analyzed to determine the maximum in VI (VImax) and the
      mechanical determinants of VImax, the upper airway critical pressure (Pcrit) and
      the nasal resistance (RN) upstream to the FLS. In groups of decerebrate spinally
      anesthetized (n = 6) and unanesthetized (n = 6) cats, graded increases in VImax
      (p < 0.05) and decreases in Pcrit (p < 0.001) were observed as the stimulation
      frequency of the intact HG nerves was increased. In the cats with and without
      spinal anesthesia, VImax increased by 139 and 201%, and Pcrit decreased by 159
      and 280%, respectively. RN was also correlated with stimulation frequency in the
      cats without spinal anesthesia (p = 0.01) and increased in four of six cats with
      spinal anesthesia. In an additional six decerebrate cats, significant increases
      in VImax (p < 0.001) and decreases in Pcrit (p = 0.01) were elicited by
      stimulating the distal cut HG nerve ends (50 Hz), whereas no changes were noted
      in these parameters when the proximal ends were stimulated. The findings suggest
      that HG stimulation increases VImax by decreasing Pcrit, which indicates a
      decrease in upper airway collapsibility at the FLS.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484624
TI  - Prevalence and characteristics of nutritional depletion in patients with stable
      COPD eligible for pulmonary rehabilitation.
AB  - Prevalence and characteristics of nutritional depletion were established by body
      composition measurements in 255 COPD patients in stable clinical condition
      admitted to a pulmonary rehabilitation center. Depletion of body weight, fat-free
      mass (using bioelectrical resistance measurements), and muscle mass [from
      creatinine height index (CHI) and midarm muscle circumference] was most
      pronounced (40 to 50%) in patients suffering from chronic hypoxemia and in
      normoxemic patients with severe airflow obstruction (FEV1 < 35%) but also
      occurred in +/- 25% of patients with moderate airflow obstruction. Classification
      of the patients in four groups by body weight and fat-free mass revealed that
      depletion of fat-free mass may occur in normal-weight COPD patients (Group 3).
      These patients also exhibit a decreased CHI (61 +/- 21%, mean +/- SD) and suffer
      from physical impairment (12-min walking distance, WD, 532 +/- 152 m) to an even
      greater degree than underweight patients with relative preservation of fat-free
      mass (Group 2) (CHI = 73 +/- 16%; WD = 744 +/- 233 m). No systematic differences
      were established between the four groups in serum protein concentrations or
      medication use. We conclude that fat-free mass is a better indicator of body mass
      depletion than body weight. Classification of COPD patients by body weight and
      fat-free mass may have consequences for planning and interpretation of
      intervention strategies, particularly in Group 2 and 3 patients.

PMID- 8484625
TI  - Limited contribution of emphysema in advanced chronic obstructive pulmonary
      disease.
AB  - Previous studies on autopsy specimens or surgically resected lobes or lungs have
      reached varying conclusions regarding the importance of small airways disease and
      emphysema in causing fixed expiratory airflow limitation in patients with chronic
      obstructive pulmonary disease (COPD). We obtained high resolution CT scans of the
      lung and lung function in 56 consecutive patients with fixed expiratory airflow
      limitation. There was poor correlation between CT emphysema score and either
      FEV1/FVC% (r = -0.36) or FEV1 % predicted (r = -0.20). In only 10 of the 35
      patients with FEV1 < 50% predicted, the CT emphysema score was > 40, indicating
      significant emphysema. A strong negative correlation between diffusing capacity %
      predicted and diffusing capacity per alveolar volume and CT emphysema score was
      found only in patients with FEV1 > or = 1 L (r = -0.75, p < 0.0001). Thus,
      emphysema does not appear to be primarily responsible for expiratory airflow
      limitation in COPD. A low diffusing capacity may be spuriously misleading in
      patients with FEV1 < 1 L and no or trivial emphysema.

PMID- 8484626
TI  - Effects of one night without nasal CPAP treatment on sleep and sleepiness in
      patients with obstructive sleep apnea.
AB  - Nasal continuous positive airway pressure (CPAP) has become the nonsurgical
      treatment of choice for obstructive sleep apnea syndrome (OSAS). Recent evidence
      suggests that intermittent use of CPAP by patients is more common than nightly
      compliance. To determine the consequences of intermittent CPAP use, in terms of a
      return of sleep-disordered breathing and daytime hypersomnolence, 15 OSAS
      subjects were evaluated at three times: (1) before CPAP treatment (pretreatment),
      (2) after 30 to 237 days posttreatment during a night of CPAP use (on CPAP), and
      (3) during a night without CPAP (off CPAP). Evaluations of sleep-disordered
      breathing and three domains of hypersomnolence, physiologic sleep tendency,
      subjective sleepiness, and performance, were accomplished with the respiratory
      disturbance index (RDI), multiple sleep latency test (MSLT), Stanford sleepiness
      scale (SSS), and psychomotor vigilance task (PVT), respectively. CPAP use was
      encouraged and monitored from pretreatment to post-treatment by daily diaries for
      most subjects and an electronic device for a subset of subjects. As expected,
      CPAP eliminated apneas and hypopneas, and following the on CPAP night, there were
      statistically significant improvements in objective measures of sleepiness (MSLT
      and PVT). Subjective measures of sleepiness and fatigue also showed improvement.
      Sleeping without CPAP for one night reversed virtually all of the sleep and
      daytime alertness gains derived from sleeping with CPAP. This occurred despite a
      statistically significant reduction in the RDI on the night off CPAP (M = 36.8,
      SD = 28.0 events/h) relative to the pretreatment night (M = 56.6, SD = 24.8
      events/h), which may be due to a lessening of the edema of the upper airway
      following CPAP use.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484627
TI  - Adequacy of prescribing positive airway pressure therapy by mask for sleep apnea
      on the basis of a partial-night trial.
AB  - We tested the hypothesis that a prescription for positive-pressure therapy
      (including pressure level, patient-device interface, and positive-pressure
      modality, e.g., CPAP or BiPAP) for obstructive sleep apnea (OSA) can be developed
      on the same night as the polysomnographic (PSG) diagnosis is made. Fifty
      consecutive patients with OSA in whom a partial-night PSG diagnosis was made
      (PSGD) underwent a therapeutic trial of positive-pressure therapy during the
      remainder of the night (PSG-PPP). The average apnea index during PSGD was 54.96
      +/- 36.3 (mean +/- SD). On a subsequent full-night PSG (PSG-PPF), the
      prescription was tested. Thirty-one of the 50 patients were satisfactorily
      treated with CPAP, without variation of the interface during both PSG-PPP and PSG
      PPF. In these patients the average pressure prescription while receiving PSG-PPF
      was statistically higher than during PSG-PPP (11.77 +/- 3.6 versus 10.56 +/- 3.6
      cm H2O, respectively, p = 0.002). In 14 of these 31 patients (45%) some
      alteration in pressure requirement was necessary during PSG-PPF. Eleven patients
      required 2.5 cm H2O higher pressure and three patients required 5 cm H2O higher
      pressure during PSG-PPF than during PSG-PPP. There was a change of interface
      across the two therapeutic trials in 15 patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484628
TI  - Asynchronous chest wall movements during non-rapid eye movement and rapid eye
      movement sleep in children with bronchopulmonary dysplasia.
AB  - The aim of this study was to assess whether age-related changes in thoracic shape
      modify patterns of thoracoabdominal asynchrony (TAA) or applicability of phase
      angle analysis during sleep in young children with increased respiratory loads.
      We assessed TAA during polysomnographic monitoring in 14 young children (mean age
      32 months, range 19 to 46; mean weight 12.5 kg, range 9.3 to 17) with severe
      bronchopulmonary dysplasia (BPD). Of the patients 10 were severely enough
      affected to require tracheostomy. We measured asynchrony of rib cage (RC) and
      abdominal (AB) movements at midinspiration and the corresponding phase angle from
      oscillographic recordings during both non-REM and REM sleep. We measured the
      amplitude of "paradoxical" displacement of either RC or AB during inspiration and
      expressed this as a percentage of the total displacement of the compartment. Of 9
      children who manifested early inspiratory AB paradox during non-REM sleep, 7
      showed a figure eight on the Konno-Mead diagram. The magnitude of abdominal
      paradox during non-REM sleep was significantly positively correlated with age (n
      = 14, r = 0.68; p < 0.01). Phase angle was significantly negatively correlated
      with dynamic lung compliance (n = 14, r = -0.66; p < 0.01). During REM sleep,
      expiratory abdominal muscle activity was abolished and all patients with
      abdominal paradox "converted" to an open loop with RC paradox during inspiration.
      Graphic assessment of the Lissajous figure on the Konno-Mead diagram indicated
      when midinspiratory phase angle analysis did not reflect the severity of TAA and
      can be used to infer patterns of respiratory muscle recruitment. We conclude that
      young children manifest patterns of TAA that differ from the early inspiratory RC
      paradox commonly observed in infants. Comparison of RC-AB loops between non-REM
      and REM sleep in the same child can assess increased thoracic inspiratory efforts
      and expiratory muscle activity as potential mechanisms for abdominal paradox, as
      distinct from diaphragm ineffectiveness.

PMID- 8484629
TI  - Ventilatory response to exercise in children with congenital central
      hypoventilation syndrome.
AB  - The role of the central and peripheral chemoreceptors in the hyperpnea of
      exercise has been controversial. We studied five children, age 6 to 11 yr, with
      absent hypercapneic and hypoxic ventilatory responses during wakefulness
      (congenital central hypoventilation syndrome, CCHS). Each child performed an
      incremental treadmill exercise test. Maximal oxygen consumption (VO2) and minute
      ventilation (VE) at maximal exercise were lower than but not significantly
      different from these values in a group of nine normal control children of similar
      age, height, and weight (VO2/kg, 33.7 +/- 5.0 versus 45.4 +/- 2.9 ml/kg/min, mean
      +/- SEM, NS; VE 28.3 +/- 7.3 versus 43.8 +/- 3.9 L/min, NS). Oxygen tension and
      saturation fell and CO2 tension rose significantly at maximal exercise in CCHS
      but not in control subjects. In contrast to control subjects, CCHS subjects
      increased VE largely by increasing respiratory frequency (f) rather than tidal
      volume (VT). In the oldest child, submaximal exercise tests at 50% VO2, with
      varying pacing rate, showed a significant positive relation between pacing rate
      and f, but not VT. Thus, VE was higher at the faster pacing rate. Further
      incremental testing in the two oldest subjects with recording of the pacing rate
      showed positive linear relations between pacing frequency and breathing frequency
      and between pacing frequency and VE up to a maximum pacing rate of 48 to 50 paces
      per 15 s. VE beyond this level varied randomly around the maximum level. We
      conclude that exercise-induced hyperpnea can occur in the absence of
      chemoreceptor function. In the CCHS children, limb movement is an important
      determinant of the ventilatory response to exercise.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8484630
TI  - Dyspnea sensation and chemical control of breathing in adult twins.
AB  - To examine possible genetic influence on the sensation of dyspnea and on load
      compensation, we conducted a twin study using healthy adult pairs (10
      monozygotes, MZ, and 9 dizygotes, DZ). The ventilatory response to progressive
      hypercapnia (HCVR) was examined under three different conditions: hyperoxia
      (PETO2 > 150 mm Hg), hypoxia (PETO2 maintained at 50 to 55 mm Hg), and hyperoxia
      with an inspiratory flow-resistive load (17 mm H2O/L/s), with simultaneous
      assessment of the dyspnea sensation by visual analog scale (VAS). Although the
      VDZ/VMZ ratio (VMZ and VDZ are within-pair variances in MZ and DZ, respectively)
      for the slope value of the minute ventilation-PETCO2 regression line was not
      different from 1 in hyperoxia either with or without an inspiratory load, it was
      significantly larger than 1 in hypoxia (F = 5.17, p < 0.05), suggesting that a
      genetic influence on HCVR existed only in the presence of hypoxia. During 3% CO2
      inhalation, the VDZ/VMZ ratio for the tidal volume (VT) was larger than 1 in
      hyperoxic HCVR with loading (F = 7.89, p < 0.01), and that for respiratory
      frequency (f) was larger than 1 only in hypoxic HCVR (F = 3.59, p < 0.05). At a
      PETCO2 of 55 mm Hg, the VT ratio was larger than 1 under all conditions (F =
      5.91, p < 0.05; F = 6.99, p < 0.05; F = 3.75, p < 0.05; respectively), and the f
      ratio was significantly larger than 1 again only in hypoxic HCVR (F = 3.48, p <
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484631
TI  - Speech breathing in patients with lung disease.
AB  - Lung volumes and breathing patterns used during speech differ from those of quiet
      respiration and may be expected to vary with different types of lung disease. To
      test this possibility, 41 patients with asthma, emphysema, or sarcoidosis and 16
      healthy subjects completed a speech protocol. Volumes, times, and flow rates were
      recorded during conversation and during a counting task. A total of 16 measured
      variables were derived for each breath and analyzed statistically. Alterations in
      speech breathing were disease and task specific. Discriminant function analysis
      applied to data from either speech task could correctly classify subjects with
      more than 50% accuracy, showing that different patterns were significantly
      disease specific. Compared with healthy subjects during conversation, all
      patients averaged a more rapid respiratory rate and increased the proportion of
      time spent on inspiration (Ti/Ttot). During counting, patient groups showed a
      variety of patterns, most commonly subordinating metabolic need to communication
      drive and sounding more breathless to observers. Regression analysis was used to
      determine how strongly changes in measured speech variables related to degree of
      physiologic impairment. The effect of severity of disease on speech production is
      distinguishable from the effect of the diagnostic category.

PMID- 8484632
TI  - Transtracheal delivery of gas decreases the oxygen cost of breathing.
AB  - Transtracheally administered gases decrease inspired minute ventilation in both
      dogs and humans. To test if this is associated with a decrease in the oxygen cost
      of breathing and to evaluate subsequent changes in the breathing pattern, we
      studied five patients with chronic respiratory diseases while they spontaneously
      breathed air and different flows of tracheally administered gases. In a blinded
      crossover design, the gas consisted of either oxygen or air at 2, 4, and 6 L/min.
      Oxygen cost of breathing was estimated by the calculation of pleural pressure
      time index (PPTI). The pattern of breathing was evaluated utilizing the tension
      time index for the diaphragm (TTdi). There were significant decreases in PPTI
      when the patients received 2, 4, and 6 L/min of transtracheal oxygen or air. TTdi
      also decreased as gas flow increased. This drop was significant at 6 L/min flow
      for both gases. We conclude that transtracheally administered gas reduces the
      oxygen cost of breathing. It also changes the respiratory pattern of the
      diaphragm to a less demanding pattern. This may offer an alternative form of
      treatment to rest overworked respiratory muscles.

PMID- 8484633
TI  - Distribution of asbestos bodies in the human lung as determined by
      bronchoalveolar lavage.
AB  - Asbestos-related lung diseases tend to have distinct local distributions, for
      example, asbestosis first appears and tends to be more severe in the peripheral
      parts of the lower lung zones. The risk for asbestosis is related to the total
      asbestos burden of the lung. This suggests that the lower lobes in asbestos
      exposed individuals may contain more asbestos than the other lobes. To test
      whether such topographic differences exist, we compared the number of retrieved
      asbestos bodies (AB) per ml BAL fluid in three groups of occupationally asbestos
      exposed subjects who underwent BAL at different sampling sites. In Group 1 (n =
      24) we performed BAL at three sites, namely in a segment of the right upper,
      right middle, and right lower lobe, to evaluate differences in asbestos body
      burden from lung apex to basis. There was a distinct increase in BAL asbestos
      body concentrations from the upper (21.2 +/- 9.1 AB/ml BAL fluid) to the middle
      (30.4 +/- 12.8 AB/ml BAL fluid) and to the lower lobe (56.0 +/- 20.2 AB/ml BAL
      fluid), all differences being significant (p < 0.01). In Group 2 (n = 40), we
      found good interlobar correlations for asbestos body counts between the right
      middle lobe (21.0 +/- 5.8 AB/ml BAL fluid) and the lingula (22.4 +/- 5.9 AB/ml
      BAL fluid) (r = 0.941, p < 0.001) and, in Group 3 (n = 15), between the ventral
      basal segment of the right (41.2 +/- 13.6 AB/ml BAL fluid) and left lung (39.0 +/
      13.6 AB/ml BAL fluid) (r = 0.966, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484634
TI  - Single-cycle bronchoalveolar lavage to determine solute concentrations in
      epithelial lining fluid.
AB  - An accurate and reproducible measure of solute concentration of lung epithelial
      lining fluid (ELF) by bronchoalveolar lavage would be valuable in lung research
      and in patient care. Measurements of the albumin/total protein ratio in a
      previously proposed rewash lavage procedure showed that albumin enters the lavage
      fluid. Therefore, the rewash lavage may measure ELF volume accurately, but it
      overestimates ELF protein concentration (PELF). To avoid problems of solute
      exchange, we examined five sequential fractions of lavage fluid obtained from
      sheep after a single 60-ml lavage containing a 99mTcO4- tracer. Assays of
      albumin, 99mTcO4-, total protein, and endogenous urea concentrations allowed
      calculation of PELF from each fraction. PELF was 8 +/- 4 mg/ml when calculated
      from dilution of either endogenous urea or 99mTcO4- in fractions collected after
      the first 15 to 20 ml. Paired lavages provided a reproducible measure of PELF
      (SD, 1.2 mg/ml) that was unaffected by any solute exchange that occurred during
      the 40-s procedure. Accuracy was verified by comparisons of lung lymph and ELF
      protein concentrations during high pressure lung edema in anesthetized sheep. The
      single-cycle lavage procedure is an accurate and reproducible procedure for
      measuring PELF.

PMID- 8484635
TI  - The effects of combined histamine and platelet-activating factor antagonism on
      systemic anaphylaxis induced by immunoglobulin E in the rabbit.
AB  - Of the mediators released during IgE-induced allergic reactions, it is not known
      which have the greatest physiologic import in systemic anaphylactic responses.
      This study describes the effects of histamine and platelet-activating factor
      (PAF) antagonism (combined) on IgE-induced systemic anaphylaxis in the rabbit.
      Pretreatment with 30 mumol/kg chlorpheniramine and 30 mumol/kg cimetidine with
      (Ch/Ci/WEB group) or without (Ch/Ci group) 2.2 mumol/kg of the PAF antagonist WEB
      2086 inhibited the anaphylactic alterations in right ventricular pressure, total
      pulmonary resistance, and decrease in dynamic compliance but not systemic
      hypotension. Lethality was inhibited only in the Ch/Ci/WEB group. Because
      previous studies had shown WEB 2086 alone could inhibit the increase in pulmonary
      resistance, specificity studies were done to determine if WEB 2086 affected
      histamine activity or release. Responses to intravenously administered histamine
      (0.54 mumol/kg) were unaffected by WEB 2086 (13.1 mumol/kg). Also, WEB 2086 did
      not inhibit in vitro antigen-induced basophil degranulation. Thus, the decrease
      in dynamic compliance and pulmonary hypertension in IgE anaphylaxis appear to be
      mediated primarily by histamine and the increase in pulmonary resistance by
      histamine and/or PAF, whereas lethality appears to involve PAF. Some alterations,
      most notably systemic hypotension, likely involve other allergic mediators.

PMID- 8484636
TI  - Adrenergic modulation of the pulmonary circulation during strenuous exercise in
      sheep.
AB  - In paired experiments, we exercised sheep at a constant rate of 4 mph on a
      treadmill and measured the hemodynamic effects of alpha receptor blockade
      (phentolamine 5 mg intravenously), beta receptor blockade (propranolol 1 mg
      intravenously), and combined alpha and beta receptor blockade. Beta blockade
      increased pulmonary vascular resistance (PVR) at rest and during steady-state
      exercise compared with control runs. PVR decreased slightly at rest with alpha
      blockade, but it was not different during exercise from that of control runs.
      Combined alpha and beta blockade restored PVR to that of control runs, showing
      that the vasoconstrictor effect of beta blockade was due to unopposed alpha
      receptor activation. In all sheep an early rapid decrease in PVR within the first
      20 s of the onset of exercise was followed by a smaller, slower change over the
      next 40 to 240 s. The early decrease in PVR was unaffected by either alpha or
      beta receptor blockade, suggesting that it was due to recruitment of nonmuscular
      microvessels. We conclude that alpha and beta receptor activation occurs during
      exercise but that the net vasoactive effect is neutral. The changes in PVR during
      normal exercise are a combination of rapid recruitment of microvessels followed
      by slower vasodilation of resistance vessels.

PMID- 8484637
TI  - Operation Everest. II: Spirometric and radiographic changes in acclimatized
      humans at simulated high altitudes.
AB  - We report spirometry and radiographic data on eight normal male human subjects
      during prolonged graded altitude exposure to as high as 8,848 m above sea level
      in a hypobaric chamber. We found a significant and progressive drop in FVC by 14
      +/- 3% over 40 days, which resolved slowly during the first 48 h after descent.
      With altitude, midrange forced expiratory flow (FEF25-75) increased by 82 +/- 3%,
      probably because of reduced air density. FEV1, however, did not change. Chest
      radiographs on subjects taken 2 h after descent to sea level showed a pattern of
      pulmonary artery enlargement and interstitial edema. These data suggest that
      increased pulmonary blood volume and edema may be causes of the restricted
      pulmonary function pattern.

PMID- 8484638
TI  - Evaluation of a new ambulatory spirometer for measuring forced expiratory volume
      in one second and peak expiratory flow rate.
AB  - A new pocket-sized ambulatory spirometer (meter) that measures FEV1 and PEFR was
      evaluated. The meter determines flow rate (V) from the differential pressure (P1
      P2) across a sharp-edged orifice (V alpha square root of[P1-P2]). Ten meters were
      evaluated for accuracy using a computerized syringe to deliver the 24 ATS
      recommended waveforms and nine scaled versions of a single waveform (PW#24).
      Within-meter reproducibility of FEV1 and PEFR was evaluated in two meters by
      passing five versions of waveform PW#24 through each meter 10 times. Reliability
      in the ambulatory setting was assessed in six meters on several occasions over a
      10-week period using five versions of waveform PW#24. Results show that the 10
      meters conform to the ATS accuracy specifications for PEFR with one or less
      errors and marginally outside these limits for FEV1 with four errors. For the
      nine versions of PW#24, the 95% confidence intervals indicate that the meter is
      accurate to within +/- 5.5% or +/- 15 L/min for PEFR and +/- 3.5% or +/- 0.12 L
      for FEV1. The mean within-meter coefficient of variation was 1.24% for FEV1 and
      0.35% for PEFR. There was no significant change in meter accuracy or performance
      over the 10-wk reliability study. We conclude that the meter is suitable for use
      as an ambulatory spirometer for measuring FEV1 and PEFR.

PMID- 8484639
TI  - Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging
      of lung cancer.
AB  - Transbronchial needle aspiration (TBNA) offers the unique opportunity to
      pathologically stage patients with lung cancer at the time of diagnostic
      bronchoscopy. The purpose of this study was to compare the staging sensitivities
      of the Wang 22-gauge and 19-gauge needles. We studied 64 patients with
      bronchogenic carcinoma and mediastinal adenopathy. Before bronchoscopy each
      patient underwent chest CT. Three to four aspirates were obtained with each
      needle from endotracheal sites adjacent to paratracheal lymphadenopathy. In 47
      patients malignant mediastinal adenopathy was confirmed by the 19-gauge needle. A
      total of 29 patients had malignant 22-gauge needle aspirates. Of the 64 patients,
      9 had benign, reactive mediastinal lymph nodes. There were 20 patients in whom
      only the 19-gauge needle demonstrated malignancy and 2 patients with malignant 22
      gauge needle aspirates as the sole identifier of paratracheal malignancy. As a
      staging tool, the 19-gauge needle was significantly more sensitive than the 22
      gauge needle, 85.5 versus 52.7% (p = 0.0001). Overall, in 49 of 55 patients
      (89.1%) with malignant mediastinal lymphadenopathy paratracheal tumor was
      confirmed by TBNA. The 19-gauge TBNA staging of the mediastinum is an effective,
      safe, and cost-saving alternative to surgical mediastinal exploration that can be
      performed during initial diagnostic bronchoscopy.

PMID- 8484640
TI  - Peripolesis in alveolar sarcoidosis.
AB  - We observed that in bronchoalveolar lavages (BAL) of patients with active
      sarcoidosis (SARC) a mononuclear cell infiltrate is present that often contains
      clusters consisting of lymphocytes adhering to a macrophage. In order to
      investigate what kind of cellular interactions are involved in such a process,
      cell suspensions obtained from BAL of patients with SARC or extrinsic allergic
      alveolitis (EAA) were cultured for 1 to 2 days, during which time lapse
      cinematography was applied. We were able to show that such clusters consist of
      lymphocytes gathered around a macrophage. This is known as peripolesis.
      Peripolesis, as observed in our BAL, could last for some minutes or for some
      hours during which time a number of lymphocytes were moving around a single
      alveolar macrophage, without losing contact with the macrophage. Short
      interactions were mostly observed in EAA, whereas SARC was characterized by long
      periods of lymphocyte-macrophage cooperation. We also found a correlation between
      the time-dependent peripolesis t > 30 min/t < 30 min and the CD4/CD8 ratio.
      Although the precise mechanisms of peripolesis are not well understood, some
      interactions between lymphocytes and macrophages have now become more
      comprehensive.

PMID- 8484641
TI  - Pulmonary drug toxicity in patients with primary breast cancer treated with high
      dose combination chemotherapy and autologous bone marrow transplantation.
AB  - A protocol consisting of standard-dose adjuvant chemotherapy, high-dose
      combination alkylating agent chemotherapy, and autologous bone marrow transplant
      (ABMT) used at our institution for patients with primary breast cancer and
      extensive axillary lymph node involvement has been associated with a clinical
      syndrome of pulmonary drug toxicity in 23 of 59 patients (39%). In 10 patients in
      whom open-lung biopsies or transbronchial lung biopsies were obtained, we
      correlated the pulmonary pathology with the clinical features of the syndrome.
      These 10 patients presented with dyspnea, cough, fever, and hypoxemia at a mean
      time of 48 +/- 14 days after initiation of high-dose chemotherapy. Chest
      radiographs and CT scans showed interstitial and alveolar opacities. Pulmonary
      function tests revealed restrictive lung disease and reduced diffusing
      capacities. Open-lung and transbronchial lung biopsies showed alveolar septal
      thickening with fibrosis, atypical Type II pneumocytes, and pulmonary endothelial
      cell injury characteristic of drug toxicity. Corticosteroid therapy resulted in
      clinical improvement in 7 of 10 patients, but significant pulmonary function
      abnormalities remained. Local radiation therapy to the chest wall and regional
      lymph nodes appeared to exacerbate preexisting pulmonary drug toxicity in 4
      patients. Two agents in the protocol, cyclophosphamide and carmustine (BCNU), can
      be implicated in the pathogenesis of this syndrome, and these agents most likely
      act synergistically to deplete reduced glutathione and impair antioxidant
      defenses. Since these drugs appear to contribute to the protocol in prolonging
      disease-free survival, prophylactic therapy of the lung should be investigated to
      reduce the high incidence of pulmonary toxicity.

PMID- 8484642
TI  - Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An
      analysis of 154 patients.
AB  - The role of rapidly growing mycobacteria (RGM) as pulmonary pathogens has been
      unclear. We identified 154 cases of lung disease caused by RGM using the
      microbiologic and radiographic criteria of the American Thoracic Society (ATS)
      and availability of the causative organism for study. More than one third of
      patients had positive lung biopsy cultures. Patients were predominantly white
      (83%), female (65%) nonsmokers (66%), and they had prolonged periods from onset
      of symptoms to diagnosis of their disease. Cough was an almost universal
      presenting symptom, whereas constitutional symptoms became more important with
      progression of disease. Upper lobe infiltrates were most common (88%), with 77%
      of patients developing bilateral disease. Cavitation was present in only 16% of
      the patients. Specific underlying diseases were infrequent, but they included
      previously treated mycobacterial disease (18%), coexistent Mycobacterium avium
      complex (8%), cystic fibrosis (6%), and gastroesophageal disorders with chronic
      vomiting (6%). The majority of isolates (82%) were M. abscessus (formerly M.
      chelonae subsp. abscessus). Effective treatment for M. fortuitum long disease was
      accomplished with drug therapy, whereas surgical resection of localized disease
      was the only effective long-term therapy for M. abscessus. Although the disease
      was generally slowly progressive, 21 of 154 (14%) patients died as a consequence
      of progressive RGM lung disease and respiratory failure. RGM should be recognized
      as a cause of chronic mycobacterial lung disease, and respiratory isolates should
      be assessed carefully.

PMID- 8484643
TI  - Lung distribution and pharmacokinetics of aerosolized tobramycin.
AB  - Aminoglycosides are commonly used in the treatment of nosocomial pneumonia in
      association with beta-lactams. Unfortunately, penetration of intravenously
      administered aminoglycosides into the lung tissue remains low. In animal models,
      aerosolization of these drugs provides high lung concentrations and low serum
      levels. Three-hundred milligrams of tobramycin and 1 ml of 99mTc-DTPA were
      administered via a pneumatic nebulizer to five healthy volunteers and to five
      mechanically ventilated patients. Lung scintigraphy was then performed, and
      plasma and urine pharmacokinetics were studied. In a second group of patients
      undergoing thoracic surgery, 300 mg of tobramycin alone were administered in the
      same way; a fragment of healthy lung was then removed, and tobramycin was
      measured. In the first group, the scintigraphy showed radioactivity distribution
      in the whole lungs both in healthy volunteers and in ventilated patients. Urine
      samples contained 5.5% of the initial amount of tobramycin. The mean serum half
      life of tobramycin was 8.96 h in healthy volunteers and 11.23 h in ventilated
      patients. In the second group, mean lung tissue concentrations were 5.5 and 3.61
      micrograms/g, respectively, 4 and 12 h after nebulization, respectively.
      Aerosolization of tobramycin thus produced high lung concentrations and low serum
      levels.

PMID- 8484644
TI  - HIV testing in patients with tuberculosis. Physician response to national
      recommendations.
AB  - The epidemic of human immunodeficiency virus (HIV) disease has contributed to the
      resurgence of tuberculosis in the United States. For clinical and public health
      reasons, the Advisory Council for the Elimination of Tuberculosis has recommended
      that all patients with tuberculosis be tested for HIV antibodies. We reviewed the
      medical records of all patients with tuberculosis in whom a diagnosis was made at
      a Detroit medical center from July 1, 1986 to June 30, 1990, before and after
      recommendations were issued. Of 195 patients, 69 (35.4%) were tested for HIV
      antibodies: 73.7% of 57 patients whose medical records documented risk behaviors
      for HIV infection, and 19.6% of 138 patients who denied high-risk behaviors or
      whose medical records contained no risk information (relative risk of testing
      among patients with documented risk factors compared with others, 3.8; 95%
      confidence interval, 2.6 to 5.5). Testing of patients who denied risk behaviors
      or had no information in their records increased from 14.9% in the first 12
      months to 30.4% in the last (p = 0.08, test for trend). In this population,
      national recommendations appear to have stimulated HIV testing, although most
      patients still are not being tested.

PMID- 8484645
TI  - Comparison of the Raja and the Abrams pleural biopsy needles in patients with
      pleural effusion.
AB  - In 31 patients with exudative pleural effusions, we compared the diagnostic yield
      of the Abrams pleural biopsy needle with that of a new instrument, the Raja
      pleural biopsy needle. Each patient was randomly biopsied with both needles, and
      a total of 153 pleural biopsies were done, 73 with the Abrams needle and 80 with
      the Raja needle. No complications resulted from biopsies with either needle.
      Etiologic diagnoses were possible in 38 (52%) biopsies obtained using the Abrams
      needle, compared with 66 (82.5%) for those using the Raja needle; the difference
      in proportions for the diagnostic yield was statistically significant (p < 0.01,
      two-tailed Fisher's exact test). There were no significant differences between
      the needles in obtaining etiologic diagnoses in any specific disease category.
      The difference between the mean size of the pleural specimens obtained with the
      two needles was also statistically significant (p < 0.001, Mann-Whitney U test).
      The Raja pleural biopsy needle is easy and safe to use, and despite its smaller
      external diameter yields a significantly larger pleural tissue sample and
      significantly increases the diagnostic yield of pleural biopsies compared with
      the Abrams pleural biopsy needle.

PMID- 8484646
TI  - PEEP does not improve pulmonary mechanics in infants with bronchiolitis.
AB  - Positive end-expiratory pressure (PEEP) may improve pulmonary mechanics, work of
      breathing, and gas exchange in some patients with respiratory failure. These
      beneficial effects do not occur consistently, however, and side effects, such as
      gas trapping due to expiratory flow limitation, may be exacerbated. We determined
      the effects of PEEP (0, 3, 6, and 9 cm H2O applied in random order) on the
      expiratory airway resistance and static compliance of nine infants mechanically
      ventilated for acute bronchiolitis. We also noted the presence of inadvertent
      PEEP (PEEPi) to determine its influence on the response to applied PEEP. Applied
      PEEP at any level failed to consistently improve passive expiratory airway
      resistance or increase compliance from baseline (PEEP = 0 cm H2O, resistance = 92
      +/- 32 cm H2O/L/s; compliance = 0.71 +/- 0.19 ml/cm H2O/kg). Increases in end
      expiratory lung volumes ranged from 18 to 40% of the tidal volume at maximal
      PEEP. Although all infants had PEEPi (5 +/- 2 cm H2O), PEEPi had no influence on
      the response of mechanics to applied PEEP other than that peak inspiratory
      pressures increased when PEEP > PEEPi. We conclude that the routine use of PEEP
      in infants with bronchiolitis does not consistently improve passive expiratory
      pulmonary mechanics and may increase the risk of barotrauma from gas trapping.

PMID- 8484647
TI  - Silicone fluid-induced pulmonary embolism.
AB  - Silicone fluid injection for mammary augmentation is a well-known illegal
      procedure. It has been associated with many complications, including local tissue
      granulomatous reaction, chronic infection, and sclerosis, but pulmonary
      involvement in human beings has been documented in only six cases. We describe
      three more such cases of pulmonary embolism. These three patients were all
      female, young, and previously healthy. They received the procedures only for
      cosmetic reasons. Unfortunately, one of them died and another lived with the
      sequelae of pulmonary fibrosis. The mortality rate of the nine total patients
      with pulmonary embolism induced by silicone fluid, including our three cases, is
      33%. Because of this high mortality rate and long-term sequelae of pulmonary
      fibrosis, no silicone fluid injection should be given for cosmetic reasons,
      especially in mammary augmentation in which a large volume of silicone fluid is
      more likely to be used, and the early use of corticosteroid therapy may be
      helpful.

PMID- 8484648
TI  - Nortriptyline-induced depression of ventilatory control in a patient with chronic
      obstructive pulmonary disease.
AB  - Psychiatric disorders occur frequently in patients with COPD, but therapy with
      psychotropic drugs is often limited by concomitant depression of ventilatory
      drive. We present a patient with COPD and major depression who developed
      hypercapnic respiratory failure while receiving nortriptyline and oxazepam.
      Because of known respiratory depressant effects of the latter drug, nortriptyline
      alone was resumed upon recovery. Depression of CO2 sensitivity and ventilatory
      load compensation with a concomitant increase in exercise tolerance with
      decreased dyspnea was observed while she was receiving nortriptyline. These
      results demonstrate a previously unreported depressant effect of nortriptyline on
      ventilatory control, and they suggest the need for further investigation of the
      ventilatory effects of this drug in patients with pulmonary disease.

PMID- 8484649
TI  - Dosages of corticosteroids in asthma.

PMID- 8484650
TI  - When tuberculosis treatment fails. A social behavioral account of patient
      adherence.
AB  - Several conclusions about measuring adherence can be drawn. Probably the best
      approach is to use multiple measures, including some combination of urine assays,
      pill counts, and detailed patient interviews. Careful monitoring of patient
      behavior early in the regimen will help predict whether adherence is likely to be
      a problem. Microelectronic devices in pill boxes or bottle caps have been used
      for measuring adherence among patients with tuberculosis, but their effectiveness
      has not been established. The use of these devices may be particularly
      troublesome for some groups such as the elderly, or precluded for those whose
      life styles might interfere with their use such as the homeless or migrant farm
      workers. Carefully designed patient interviews should be tested to determine
      whether they can be used to predict adherence. Probably the best predictor of
      adherence is the patient's previous history of adherence. However, adherence is
      not a personality trait, but a task-specific behavior. For example, someone who
      misses many doses of antituberculosis medication may successfully use prescribed
      eye drops or follow dietary recommendations. Providers need to monitor adherence
      to antituberculosis medications early in treatment in order to anticipate future
      problems and to ask patients about specific adherence tasks. Ongoing monitoring
      is essential for patients taking medicine for active tuberculosis. These patients
      typically feel well after a few weeks and either may believe that the drugs are
      no longer necessary or may forget to take medication because there are no longer
      physical cues of illness. Demographic factors, though easy to measure, do not
      predict adherence well. Tending to be surrogates for other causal factors, they
      are not amenable to interventions for behavior change. Placing emphasis on
      demographic characteristics may lead to discriminatory practices. Patients with
      social support networks have been more adherent in some studies, and patients who
      believe in the seriousness of their problems with tuberculosis are more likely to
      be adherent. Additional research on adherence predictors is needed, but it should
      reflect the complexity of the problem. This research requires a theory-based
      approach, which has been essentially missing from studies on adherence and
      tuberculosis. Research also needs to target predictors for specific groups of
      patients. There is clear evidence of the effect on adherence of culturally
      influenced beliefs and attitudes about tuberculosis and its treatment. Cultural
      factors are associated with misinformation about the medical aspects of the
      disease and the stigmatization of persons with tuberculosis. Culturally
      sensitive, targeted information is needed, and some has been developed by local
      tuberculosis programs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8484651
TI  - Bacteriology of ventilator-associated pneumonia.

PMID- 8484652
TI  - Aspergillus epidural abscess and cord compression in a patient with aspergilloma
      and empyema.

PMID- 8484653
TI  - The triplex hypothesis of vision.
AB  - The duplex theory of vision is concerned with the light level and dual retinal
      function and refers only to the rod and cone photoreceptor cell systems. There
      are some visual functions that are not represented by the duplex theory, visual
      field, or the dark-adaptation curve. There is some confusion as to whether the
      relationship between visual threshold and bleached pigment is logarithmic or
      linear. I do not know how many photopigments exist and which pigment and what
      circuit plays a role in the photoperiod. The complexity of the retina appears to
      exceed its known functions. Finally, I wonder how the rate of eye growth is
      regulated. To clarify these concerns, I propose a new cell type and a third
      mechanism of vision, which has not been described previously to my knowledge. On
      the basis of this study and the data from the literature, it appears that early
      retinal ganglion cells cannot project into the visual cortex because the latter
      has not been formed. Therefore, their axons may progress into the diencephalic
      centers that are developing and are differentiating. So, there is a novel
      photoreceptive system with its associated ganglion cells that is the basis for
      the visual foundation. These are the first photoreceptors to form and are not
      engaged directly in the visual process, but they play a significant role in
      nutrition, function, and the well-being of the other parts of the visual
      apparatus. This, of course, requires much investigation and research. I believe
      there are three classes of photoreceptors and submit the following triplex
      hypothesis.

PMID- 8484654
TI  - A comparison of the ocular tolerability of a single dose of timolol and
      levobunolol in healthy normotensive volunteers.
AB  - Subject acceptance of a single dose of timolol and levobunolol was compared in a
      three-center, double-masked, randomized, crossover study in healthy normal
      subjects. We tested 115 subjects who received the medications OU, in a random
      order, separated by a washout period of three to seven days. At the end of the
      administration, the subjects were asked to report any symptoms and were monitored
      by ophthalmologic examination. Those receiving levobunolol reported a two- to
      threefold higher frequency of symptoms than did those receiving timolol (P =
      .0002, by Mainland-Gart chi-square test). Thirty-five subjects (30.4%) treated
      with levobunolol complained of burning versus 14 (12.2%) receiving timolol (P =
      .0021). Similar results were obtained in regard to stinging (31 versus 10
      subjects; P = .0011). The duration of these symptoms did not differ between the
      two groups (P > .05). Timolol induced considerably less burning and stinging on
      day 1 compared with levobunolol, using a visual analog scale over time (P =
      .0004). Seventy-nine percent of those stating a preference chose timolol (P < 3 x
      10(-9).

PMID- 8484655
TI  - Treatment of diabetic macular edema: a comparison between argon and dye lasers.
AB  - To compare the efficacy of argon green and dye yellow photocoagulations, 85 eyes
      of 85 diabetic patients with diffuse macular edema were included in a prospective
      randomized clinical trial. One year after treatment, visual acuity was unchanged
      or better in 85.1% of eyes treated with an argon and 89.5% of eyes treated with a
      dye laser. A reduction of macular edema was accomplished in 67.3% of eyes in the
      argon-laser group and in 71.1% of eyes in the dye-laser group. No statistically
      significant differences were observed between the two groups in regard to visual
      acuity results or the reduction of macular edema.

PMID- 8484656
TI  - Fatigue effect within 10 degrees visual field in automated perimetry.
AB  - We studied the effect of fatigue within a 10 degree visual field measured with
      automated perimetry in normal volunteers (10 eyes), patients who have recovered
      from optic neuritis with multiple sclerosis (10 eyes), and patients with glaucoma
      (10 eyes). Using an Octopus 201, the visual field was tested with Program 61,
      which was centered (0.0), and 25 test locations were determined three times.
      Eight of the 25 points were selected for the evaluation. The mean sensitivity of
      the eight points was compared among the three measurements. Normal subjects and
      patients with optic neuritis showed no effect of fatigue within the 10 degrees
      visual field, but the patients with glaucoma indicated fatigue during the third
      measurement.

PMID- 8484657
TI  - Occlusion therapy of Japanese children with anisometropic amblyopia without
      strabismus.
AB  - We examined 38 children (20 boys and 18 girls) with anisometropic amblyopia
      without strabismus who had been treated with occlusion therapy. At the initial
      visit, their ages ranged from five to ten years. Their visual acuity scores
      improved after therapy, and this was unrelated to patient age. The amount of
      anisometropia, visual acuity at the initial visit, and compliance were related to
      improved visual acuity in the amblyopic eye. The visual acuity improved for six
      months after therapy. No further gains were detected thereafter.

PMID- 8484658
TI  - Conjunctival lymphoid hyperplasia.
AB  - Our patient had uncommon features of conjunctival lymphoid infiltrates, including
      patient age, bilaterality, and lesion location. We describe his case and discuss
      the prognosis based on a literature review.

PMID- 8484659
TI  - Fluorescein angiographic appearance of Dalen-Fuchs nodules in sympathetic
      ophthalmia.
AB  - A case of sympathetic ophthalmia is presented in which a single lesion located
      posteriorly at the level of the retinal pigment epithelium caused a serous
      macular detachment. We believe that this lesion represented an atypical Dalen
      Fuchs nodule. Most reports of the fluorescein angiographic appearance of Dalen
      Fuchs nodules describe multiple sites of choroidal leakage during the early
      phases, which may coalesce during the late phases of the angiogram. The lesion we
      detected was hypofluorescent in early phases of the fluorescein angiogram and
      showed late staining. The early hypofluorescence seen in the lesion may be
      explained by an intact retinal pigment epithelium over the presumed Dalen-Fuchs
      nodule, blockage of choroidal fluorescence by the nodule, and areas of
      granulomatous inflammation in the inner choroid and choriocapillaris. The
      staining in the late phases of the fluorescein angiogram may be explained by
      accumulation of fluorescein into the presumed Dalen-Fuchs nodule.

PMID- 8484660
TI  - Wasp sting-induced retinal damage.
AB  - A 36-year-old man was stung by a wasp OD. He became delirious and had dyspnea,
      ocular pain, and severely decreased visual acuity OD. A broken stinger was found
      in the central deep cornea. Additional ocular findings were keratitis, iritis,
      cataract, secondary glaucoma, and unrecordable electroretinographic responses.

PMID- 8484661
TI  - [Saying what we mean].

PMID- 8484662
TI  - [Rehospitalization and early discharge in neonatology: retrospective evaluation].
AB  - This retrospective study compared discharge summary data in neonates discharged
      from the Brest Teaching Hospital Neonatology Unit between May 1, 1980 and April
      30, 1981 (Period I) or between May 1, 1990 and April 30, 1991 (Period II). Birth
      weight, gestational age, duration of hospitalization, corrected age at discharge
      and rehospitalization rate were compared. Among infants with intrauterine growth
      retardation (IUGR) with or without prematurity, weight at discharge was 2,500 g
      or less in none of Period I patients (n = 144) versus 67.8% of Period II patients
      (n = 87). Four Period II infants weighted 2,000 g or less at discharge (1,850,
      1,930, 1,960, and 2,000 g). Among premature infants without growth retardation,
      weight at discharge was 2,500 g or less in 2.2% of Period I infants versus 52.5%
      of Period II infants (p < 0.0001). Period II infants were not rehospitalized more
      often or earlier than Period I infants. Early discharge reduces the duration of
      separation of the child from his or her parents without increasing the
      rehospitalization rate.

PMID- 8484663
TI  - [Lipoma of the corpus callosum. 3 case reports and review of the literature].
AB  - Lipoma of the corpus callosum is a rare congenital intracranial tumor. Although
      only 153 cases had been reported as of March 1992, the incidence of this tumor is
      underestimated (some cases are unpublished and others are asymptomatic). Three
      cases of lipoma of the corpus callosum diagnosed in children are reported herein.
      These tumors may be either discovered fortuitously in an asymptomatic patient or
      responsible for manifestations of which the most common are seizures, headache,
      and mental disorders. Diagnosis rests on imaging techniques. The main
      investigation is computed tomography which discloses a mass composed of fat, with
      or without peripheral calcifications, and also identifies any other malformations
      such as dysgenesis of the corpus callosum.

PMID- 8484664
TI  - [Depression in childhood].
AB  - Depressive syndromes occur at any age and require appropriate therapy. Available
      classifications include the French Classification of Mental Disorders in
      Children, the Diagnostic and Statistical Manual of Mental Disorders IIIrd edition
      Revised (DSM-III-R), and the International Classification of Diseases. Prevalence
      of depression approximates 1% to 3% in children and adults. Recent studies have
      investigated relationships between depression and anxiety or behavior disorders
      familial clustering of depression, and adult outcome of depression in children
      and adolescents. Early onset of major depression (before the age of 20) is an
      established risk factor for depression in adulthood. Pediatricians may encounter
      depression in emotionally deprived infants (hospitalism), victims of child abuse,
      and children who attempt suicide. Concepts concerning major affective disorders
      are changing; adolescents have specific characteristics regarding symptoms and
      risk of subsequent relapsing disease. Although biochemical and sleep pattern
      markers have not as yet been adequately studied in pediatric patients, the
      clinical efficacy of drug therapy has been established.

PMID- 8484665
TI  - [The "blue rubber bleb nevus" (Bean's syndrome): uncommon cause of
      gastrointestinal bleeding].
AB  - A ten year old boy had six cutaneous angiomas and recurrent rectal bleeding
      responsible for iron deficiency anemia. Histological examination established the
      diagnosis of blue rubber bleb naevus syndrome. Endoscopy, arteriography, computed
      tomography, and angioscintigraphy disclosed additional angiomas in the stomach
      and rectum and along the blood vessels in the lower limbs. The value of
      angioscintigraphy for identifying angiomas escaping detection by other means was
      illustrated in this case. Embolization of the inferior mesenteric artery was
      successful in preventing further rectal bleeding. Treatment of this disorder
      remains controversial.

PMID- 8484666
TI  - 6th International Conference on Antiviral Research. Venice, Italy, April 25-30,
      1993. Abstracts.

PMID- 8484667
TI  - Assessment of lupus: where are we now?
AB  - Decisions about treatment for patients with SLE are based on numerous criteria,
      including the rate of change of clinical features and disease markers (especially
      antibodies to dsDNA and markers of complement turnover), which organ systems are
      affected, the severity of manifestations, and the presence of pre-existing damage
      (which may reduce the reserve capacity of the organ system). Most of the
      currently available organ systems calculate a single overall score, at a single
      point in time, and take few of these considerations into account. SLAM is the
      only index to consider directly the scoring of severity as well as activity,
      though this concept is probably inherent in most of the other indices because of
      various methods for weighting the scores. Preliminary studies have indicated that
      four of the scales (BILAG, SLAM, LAI, and SLEDAI) are sensitive to change. Few of
      the indices have been tested longitudinally, hence their role in clinical trials
      remains to be established. None of the indices considers the impact of damage,
      indeed this is not their remit, but this concept is being considered by an
      international working group. Outcome in SLE has been shown to be determined by,
      among other things, the number of exacerbations and the presence of renal or
      neurological disease. It would seem, therefore, important to measure disease
      activity in designated organ systems, which most of the indices fail to do. The
      inclusion of immunological tests in some scales (for example, SIS, SLEDAI, LAI)
      makes them unsuitable for use as instruments to validate immunological or other
      scatological markers. Furthermore, given the heterogeneity of disease
      manifestations in SLE, and evidence linking scatological abnormalities with
      specific clinical manifestations, it is perhaps naive to expect a new
      scatological test to correlate strongly with overall disease activity. Three of
      the currently available activity scales have been shown to be reliable, both
      between and within raters (BILAG, SLAM, SLEDAI). The lack of a 'gold standard'
      for measuring disease activity in SLE makes it difficult to be sure that these
      scales are actually measuring what they are supposed to be measuring (criterion
      validity), but they do correlate strongly with each other in cross sectional
      studies, suggesting that they are, at least, all measuring the same thing
      (convergent validity). Convergent validity for these instruments used
      longitudinally remains to be established, particularly for patients with very
      active disease. In conclusion, measurement of disease activity in SLE is central
      to patient care, and a number of instruments are available fro this purpose.
      Although none is perfect, most are reliable and valid, and are suitable for
      classifying and monitoring groups of patients in the research setting. In
      reality, the indices are used with the additional benefit of laboratory markers
      and, as yet, no one has found the instruments sufficiently sensitive and specific
      to rely entirely upon them. The exact choice of instrument should be governed by
      the purpose for which it is required in clinical practice. Disease activity
      scales are unlikely to be appropriate for dictating treatment decisions in
      individual cases. An instrument which would be comprehensive and flexible enough
      for this purpose would necessarily prove too complicated and cumbersome for
      widespread use.

PMID- 8484668
TI  - Mortality and causes of death in 398 patients admitted to hospital with
      ankylosing spondylitis.
AB  - The mortality and causes of death in 398 patients (47 women, 351 men) with
      definite ankylosing spondylitis, admitted to hospital for the first time between
      1961 and 1969, were investigated. The mean age at first admission was 36.5 years
      (SD 11.8). After a mean follow up time of 25.7 years, a total of 152 patients (12
      women, 140 men) had died. The expected mortality based on the mortality
      statistics of the general population of the same sex and age was 103.1 (9.4 women
      and 93.7 men). Thus the overall mortality of the patients with ankylosing
      spondylitis was 1.5 times that expected. Those patients who had died were
      significantly older, had a higher erythrocyte sedimentation rate, and more
      inflamed peripheral joints when first seen than the surviving patients. The main
      difference between the observed and expected causes of death was the high
      incidence of deaths from ankylosing spondylitis, which was the underlying cause
      of death in 27 patients. The mechanism of death in these patients was secondary
      amyloidosis in 19, cardiovascular complications in six, fracture of the spine in
      one, and it was not known in one patient. Excess deaths due to circulatory,
      gastrointestinal and renal diseases, and violence were also observed.

PMID- 8484669
TI  - Identification of tissue inhibitor of metalloproteinase-2 (TIMP-2)-progelatinase
      complex as the third metalloproteinase inhibitor peak in rheumatoid synovial
      fluid.
AB  - The metalloproteinases are a family of enzymes that can degrade all the
      components of the extracellular matrix. These potent enzymes are often found in
      proenzyme forms and require activation before the substrate can be digested. To
      prevent unlimited connective tissue destruction a number of inhibitors exist to
      limit their activity. In a previous study it was found that metalloproteinases in
      proenzyme form and metalloproteinase inhibitors were often present in rheumatoid
      synovial fluids. Two of these inhibitors were identified in rheumatoid synovial
      fluid as alpha 2 macroglobulin and tissue inhibitor of metalloproteinase (TIMP),
      the specific metalloproteinase inhibitor. A third inhibitory peak was
      unidentified. In the study reported here it was shown that this third inhibitor
      can be purified using gelatin-Sepharose chromatography and consists of TIMP-2
      bound to progelatinase (relative molecular weight 72,000) in a similar way to
      that found in concentrated connective tissue culture medium. The importance of
      these proteinase inhibitors in synovial fluid is discussed.

PMID- 8484670
TI  - Protection from interleukin 1 induced destruction of articular cartilage by
      transforming growth factor beta: studies in anatomically intact cartilage in
      vitro and in vivo.
AB  - The modulation of interleukin 1 (IL-1) effects on proteoglycan metabolism in
      intact murine patellar cartilage by transforming growth factor beta (TGF-beta)
      was investigated in vitro and in vivo. In vitro TGF-beta (400 pmol/l) had no
      effect on basal proteoglycan degradation. Proteoglycan degradation induced by IL
      1, however, was suppressed by TGF-beta in serum free medium alone and in medium
      supplemented with 0.5 micrograms/ml insulin-like growth factor 1. This suggests a
      specific regulatory role for TGF-beta under pathological conditions. In contrast
      with the suppression of breakdown, synthesis of proteoglycans was stimulated by
      TGF-beta for both basal and IL-1 suppressed proteoglycan synthesis in cultures
      without insulin-like growth factor. In the presence of insulin-like growth factor
      no extra effect of TGF-beta on proteoglycan synthesis was observed. With insulin
      like growth factor, however, TGF-beta potentiated the ex vivo recovery of IL-1
      induced suppression of proteoglycan synthesis. Analogous to the in vitro effects,
      TGF-beta injected intraarticularly suppressed IL-1 induced proteoglycan
      degradation. Furthermore, TGF-beta injected into the joint counteracted IL-1
      induced suppression of proteoglycan synthesis. This indicates that in vivo also
      TGF-beta can ameliorate the deleterious effects of IL-1 on the cartilage matrix.

PMID- 8484671
TI  - Altered Golgi apparatus in hydrostatically loaded articular cartilage
      chondrocytes.
AB  - OBJECTIVES: Articular cartilage proteoglycan content is controlled by joint
      loading. This study aimed to elucidate the role of hydrostatic pressure in this
      regulation. METHODS: Primary cultures of chondrocytes from bovine articular
      cartilage, grown on coverslips, were subjected to 5, 15, or 30 MPa hydrostatic
      pressure, applied continuously or cyclically at 0.125 or 0.05 Hz. The Golgi
      apparatus was visualised either by a fluorochrome coupled wheat germ agglutinin
      or by transmission electron microscopy. Proteoglycan synthesis was studied by the
      incorporation of sulphur-35 labelled sulphate. RESULTS: After 30 MPa continuous
      hydrostatic pressure, the Golgi apparatus was observed in a compact form with a
      concomitant decrease in proteoglycan synthesis. The normal stacked appearance of
      the Golgi apparatus was no more visible in the electron microscopy preparation of
      the pressurised chondrocytes. This effect was reversible and was also noticed
      after 15 MPa continuous load, though to a minor extent. Cyclic pressures (5-30
      MPa) caused no apparent change in the Golgi apparatus. The shape of some cells
      changed to a more retracted form after 30 MPa continuous pressure. Nocodazole,
      which causes disassembly of the microtubules, blocked the compacting influence of
      pressurisation on the Golgi apparatus, and reduced proteoglycan synthesis to
      about half of the control level. CONCLUSIONS: The packing of the Golgi apparatus
      is dependent on microtubules and may contribute to the inhibition of proteoglycan
      synthesis observed in articular cartilage subjected to high hydrostatic pressure.

PMID- 8484672
TI  - Expression of public idiotypes in patients with Lyme arthritis.
AB  - OBJECTIVE: Joints are often affected in Lyme disease and in some instances this
      may be due to immune autoreactivity. To characterise further the immune response
      in this disease investigations were carried out to determine the expression of
      three public idiotypes on serum immunoglobulins in patients with Lyme disease
      during the development of varying degrees of arthritis. METHODS: The expression
      of idiotypes (Ids) 16/6, BEG2, and PR4, first identified on monoclonal antibodies
      to DNA, was determined by an enzyme linked immunosorbent assay (ELISA) in serial
      blood samples from 12 patients with Lyme disease over a mean period of six years
      during the development of a variety of arthritic symptoms, and in serum samples
      from healthy control subjects and control subjects with systemic lupus
      erythematosus. RESULTS: Expression of serum IgM or IgG public Ids 16/6 and BEG2
      was significantly increased in patients with Lyme disease. IgA Id 16/6
      expression, in contrast, was significantly increased only during episodes of
      arthritis and was also related to its severity. IgM and IgG Id 16/6 expression
      was related to their respective total immunoglobulin concentration and, in the
      case of IgM, to the level of IgM antibodies to Borrelia burgdorferi, whereas
      similar findings were not apparent with IgA antibodies. This may indicate that
      the IgA response is related to the pathogenesis of arthritis, especially as total
      IgA and IgA Id 16/6 levels were found to increase over the duration of disease.
      Sequential analysis of antibodies also showed restriction in the expression of Id
      16/6 as it was never found on all immunoglobulin isotypes at the same time, and
      Id PR4 was never expressed. Ids 16/6 and BEG2 expression, however, may be
      associated as seven patients expressed these idiotypes simultaneously.
      CONCLUSIONS: These data indicate the use of public idiotypes in the immune
      response against B burgdorferi, which may be restricted in terms of idiotype
      class and isotype expression, and a possible association between IgA antibodies
      bearing Id 16/6 with arthritis.

PMID- 8484673
TI  - Rational diagnosis and treatment in unclassified arthritis: how clinical data may
      guide requests for Lyme serology and antibiotic treatment.
AB  - To improve the appropriateness and efficiency of diagnostic serological tests and
      subsequent antibiotic treatment, clinical data from 102 patients with
      unclassified arthritis were analysed to investigate whether the presence of
      positive IgG antibodies to Borrelia burgdorferi could be predicted. The clinical
      data were blindly ranked from 1 to 4 (1, Lyme arthritis unlikely; 4, Lyme
      arthritis very likely). Antibodies to B burgdorferi were positive in nine of 102
      patients (9%). Six of 15 (40%) patients with rank numbers 3 and 4 were positive
      for antibodies to B burgdorferi, in contrast with only three of 87 (3%) patients
      with rank numbers 1 and 2. The likelihood ratio of positive Lyme serology for
      patients ranked 3 and 4 was 12.0, for patients ranked 2 to 4, 4.5, and for
      patients with arthritis of the knee, 3.0. These likelihood ratios were associated
      with a post-test probability of 55, 30, and 20% respectively. The clinical
      history in patients with unclassified arthritis can largely predict the presence
      of antibodies to B burgdorferi. The absolute value of a likelihood ratio can be a
      contributing factor in deciding to request tests for antibodies to B burgdorferi
      in patients with unclassified arthritis.

PMID- 8484674
TI  - Depressed levels of dehydroepiandrosterone sulphate in postmenopausal women with
      rheumatoid arthritis but no relation with axial bone density.
AB  - The sex hormones dehydroepiandrosterone sulphate (DHEAS), oestradiol, and sex
      hormone binding globulin (SHBG) were measured in 185 postmenopausal women (aged
      45-65 years) with rheumatoid arthritis (RA) and related to assessments of bone
      mineral density at the spine and proximal femur. Compared with 518 postmenopausal
      control women (aged 45-65 years), DHEAS levels were below normal in the 120
      patients with RA who had never taken corticosteroids and levels were further
      depressed in 39 patients currently using steroids. Twenty six patients who had
      completed steroid treatment also had lower DHEAS levels, suggesting a delayed
      recovery of adrenal androgen secretion. Oestradiol and SHBG levels were similar
      in all groups. There was no correlation between sex hormones and disease
      activity. Oestradiol correlated with bone mineral density at all sites. Although
      oestradiol correlated with DHEAS, there was no relation between DHEAS and bone
      mineral density. The cause of below normal levels of DHEAS in RA is unclear,
      whether a consequence of chronic illness, immune dysfunction, or a defect of
      adrenal androgen synthesis.

PMID- 8484675
TI  - Modified suprascapular nerve block with bupivacaine alone effectively controls
      chronic shoulder pain in patients with rheumatoid arthritis.
AB  - Chronic shoulder pain is a common and disabling symptom in patients with
      rheumatoid arthritis (RA). It has been previously shown that a suprascapular
      nerve block (SSNB) using the standard mixture of bupivacaine and adrenaline (Ba)
      plus methylprednisolone (P), which is routinely used in pain clinics, results in
      a considerable improvement in pain relief and range of movement compared with
      conventional intra-articular steroid injections in such patients. A double blind
      study was carried out in 29 patients (58 shoulders) with RA to compare SSNB
      induced with Ba alone with that induced using the conventional mixture of Ba plus
      P. Highly significant improvements were noted in measures of pain, stiffness, and
      range of most movements for both treatments (up to three months) compared with
      baseline. Results favoured Ba alone; the differences between the two treatments
      reached statistical significance for stiffness (at 12 weeks) and active abduction
      (at one week). It is concluded that the addition of P to the SSNB mixture confers
      no benefit in these patients.

PMID- 8484676
TI  - Cutaneous manifestations associated with antiphospholipid antibodies in patients
      with suspected primary antiphospholipid syndrome: a case-control study.
AB  - OBJECTIVE: To study the association of a variety of dermatological manifestations
      related to vascular abnormalities with antiphospholipid antibodies in patients
      with suspected primary antiphospholipid syndrome. METHOD: Case-control study.
      Consecutive patients referred to the coagulation and haemostasis service of a
      general hospital for the first determination of antiphospholipid antibodies
      (lupus anticoagulant and anticardiolipin antibodies) and newly diagnosed
      disorders (for example, thrombocytopenia, thrombotic disorders, and unexplained
      repeated abortions) were selected. Patients were examined by two dermatologists
      according to predefined criteria, and information about general characteristics
      and relevant dermatological and medical histories were collected using an ad hoc
      questionnaire. The study was limited to patients without evidence of systemic
      lupus erythematosus. A total of 35 patients was examined; 13 subjects were
      positive for lupus anticoagulant or anticardiolipin antibodies, or both (cases),
      and 22 were negative (controls). RESULTS: Moderate to severe livedo reticularis
      and acrocyanosis were significantly associated with antiphospholipid antibodies,
      with relative risks of 13.1 (95% confidence interval 1.1 to 149.0) and 8.6 (95%
      confidence interval 1.1 to 65.1). Capillaritis was also associated with the
      antibodies. Histories of Raynaud's phenomenon and superficial thrombophlebitis
      were more common in cases than controls. CONCLUSIONS: This study provides
      quantitative evidence of the association of antiphospholipid antibodies with
      several cutaneous diseases in which vascular abnormalities seem to play a major
      part. The study suggests that these manifestations might appear early in the
      development of the antiphospholipid syndrome.

PMID- 8484677
TI  - Yersinia associated arthritis in SHR rats: effect of the microbial status of the
      host.
AB  - Following the intravenous injection of live Yersinia enterocolitica O:8, 50-69%
      of SHR rats developed arthritis; these rats were antibody free against all rat
      pathogens tested. In contrast, only 20-25% of SHR rats which had serum antibodies
      against Bacillus piliformis, Kilham rat virus, and Toolan H-1 virus developed
      arthritis. The results indicate that the microbial load of the host has a
      profound effect on the susceptibility to experimental arthritis.

PMID- 8484678
TI  - Levels of insulin related growth factor 1 in osteoarthritis of the knee.
AB  - OBJECTIVES: Insulin related growth factor 1 (IGF1) is an important growth
      promoting peptide which has anabolic effects on in vitro cartilage metabolism.
      The fact that serum levels tend to decrease in elderly subjects while
      osteoarthritis (OA) increases in prevalence suggests that suboptimal levels may
      play a part in the development of OA. This study therefore considers the
      hypothesis that IGF1 levels are low in subjects with OA of the knee. METHODS:
      Serum IGF1 levels in a community derived sample with symptomatic knee OA were
      compared with those in normal controls matched by age and gender. Overall
      radiographic score, osteophyte score, sclerosis score, and joint space narrowing
      score were correlated with IFG1 levels. RESULTS: One hundred and seventy-seven
      elderly subjects (83 with knee pain, 94 without knee pain) participated, allowing
      the identification of 78 case-control pairs matched by age and gender (mean 71.8
      v 71.9 years, SD 7.6 for the two groups). No difference was found in serum IGF1
      levels between the cases and controls (mean(SD) 15.9(4.7) nmol/l, for cases,
      16.4(5.4) for controls). Significant negative correlations were found between
      IGF1 levels and age, total radiographic score, osteophyte score, and sclerosis
      score. In a multiple regression model, however, only age remained significant.
      CONCLUSIONS: This study provides no evidence that serum IGF1 levels are low in
      OA. Apparent correlations with radiographic features of OA may be due to the
      confounding effects of age.

PMID- 8484679
TI  - Serum interleukin 6 levels in rheumatoid arthritis: correlations with clinical
      and laboratory indices of disease activity.
AB  - In rheumatoid synovium interleukin 6 (IL-6) is the most abundantly expressed
      cytokine. Increased serum levels have been previously reported in patients with
      rheumatoid arthritis (RA). In this study serum IL-6 levels were measured in a
      well defined cohort using a bioassay (B9 cells) and levels were correlated with
      conventional clinical and laboratory indices of disease activity. Levels were
      significantly higher in serum from patients with RA (median 55 IU/ml;
      interquartile range 28-139) compared with serum from disease (median 7 IU/ml; 1
      23) and normal controls (median 10 IU/ml; 7-12). No difference was observed
      between men and women. Levels did not correlate with disease duration.
      Significant associations were observed between IL-6 and C reactive protein and
      between the Ritchie articular index and duration of morning stiffness. No other
      correlations were observed. The value of these findings in the monitoring of RA
      and as an indicator of response to second line treatment needs to be established.

PMID- 8484680
TI  - New application of myocardial antimyosin scintigraphy: diagnosis of myocardial
      disease in polymyositis.
AB  - Heart disease is a rare but important complication of polymyositis. Diagnosis of
      myocardial disease is usually based on non-specific clinical,
      electrocardiographic, and echocardiographic data. This paper reports a case of
      polymyositis with myocardial disease diagnosed by myocardial imaging with
      radiolabelled antibody to myosin, a specific marker of the necrotic myocardial
      fibre.

PMID- 8484681
TI  - Rapidly progressive sacroiliitis in a patient with lymphocytic lymphoma.
AB  - Rheumatological manifestations may develop as paraneoplastic syndromes in
      patients with malignancy. Sacroiliitis and spondyloarthropathy have not, however,
      been previously associated with cancer. The case is described of a patient with a
      stage IV diffuse well differentiated lymphocytic lymphoma who developed
      concomitant sacroiliitis and enthesopathies with rapid progression following the
      diagnosis of malignancy.

PMID- 8484682
TI  - Why are non-steroidal anti-inflammatory drugs so variable in their efficacy? A
      description of ion trapping.

PMID- 8484683
TI  - Dorsal vertebral fractures with 'normal' bone mineral density.

PMID- 8484684
TI  - RA sex ratios, HLA-DR, and testosterone.

PMID- 8484685
TI  - von Willebrand factor, exercise, and ischemia/reperfusion injury.

PMID- 8484686
TI  - Elusive 'alpha-delta' sleep in fibromyalgia and osteoarthritis.

PMID- 8484687
TI  - Buerger's disease and antiphospholipid antibodies in pregnancy.

PMID- 8484688
TI  - Fibromyalgia in the workplace: a 'management' problem.

PMID- 8484689
TI  - Prevalence of rheumatoid arthritis and rheumatoid factor in women: evidence for a
      secular decline.
AB  - OBJECTIVE: To determine the current prevalence of rheumatoid arthritis (RA) and
      rheumatoid factor positivity in the United Kingdom middle aged female population
      and to compare this with previous estimates to assess whether the disease is
      becoming less prevalent. METHODS: A cross sectional prevalence study was
      undertaken. All women aged 45-64 from the age and sex register of a large 11,000
      general practitioner group practice in Chingford, East London were contacted and
      responders examined clinically and radiographically for the presence of RA by a
      single observer. Blood was also taken for rheumatoid factor testing (sheep cell
      agglutination test (SCAT), latex, and IgG). The prevalence in non-attenders was
      assessed from general practitioner and local hospital records. A diagnosis of
      definite or classical RA according to 1958 American Rheumatism Association
      criteria was used, and seropositivity was defined by a SCAT rheumatoid factor of
      1/32 or more. RESULTS: From the 1003 women examined (response rate of 78.8%), 12
      women had definite RA (1.2%, 95% confidence interval 0.6 to 1.8). Of these, 7/12
      had definite erosive changes on radiography and 3/12 had a positive SCAT (>
      1/32). Three cases of RA were also found in the 284 non-responders (prevalence
      1.1%) by case-finding techniques. The rate of SCAT positivity in the whole study
      group was 0.5%. The rates of RA and SCAT positivity currently found in this group
      were less than those obtained in previous surveys. In the only previous large
      scale United Kingdom survey, performed in the north of England between 1958 and
      1960, 406 women aged 45-64 were examined and 10 cases of definite RA were found,
      a prevalence of 2.5%. In the patients with RA 68% had erosions and 63% positive
      SCAT. The population SCAT positive rate in this and other surveys sampled between
      1954 and 1961 was in the range of 4-5%, since when there has been a progressive
      decline according to a number of other studies. CONCLUSIONS: The prevalence of RA
      and rheumatoid factor in middle aged women is lower than previously believed and
      supports a variety of other data which indicate that RA is declining in incidence
      and severity.

PMID- 8484690
TI  - Determinants of disability in osteoarthritis of the knee.
AB  - OBJECTIVES: To evaluate the influences of radiographic severity, quadriceps
      strength, knee pain, age, and gender on functional ability in patients with
      osteoarthritis of the knee. METHODS: Equal numbers of knee pain positive and
      negative respondents to a survey of registrants aged more than 55 years at a
      general practice were invited to attend for knee radiographs and quadriceps
      femoris isometric strength estimations. Disability was measured using the
      Stanford Health Assessment Questionnaire. RESULTS: Complete data were available
      on 70 men (mean age 72.7 years) and 89 women (mean age 68.1 years); 44% reported
      knee pain, 48% had radiographic features of osteoarthritis, and 32% reported some
      degree of disability. Significant correlations were observed between disability
      and radiographic score, quadriceps strength, and knee pain. Logistic regression
      analysis, however, showed significant independent contributions from quadriceps
      strength (odds ratio 0.84 kgF), knee pain (odds ratio 1.67), and age (odds ratio
      1.06 per year) only; the radiographic score had no influence on the model. These
      results were not influenced by confining the analysis to the group with
      radiographic features of osteoarthritis. CONCLUSIONS: Quadriceps strength, knee
      pain, and age are more important determinants of functional impairment in elderly
      subjects than the severity of knee osteoarthritis as assessed radiographically.
      Strategies designed to optimise muscle strength may have the potential to reduce
      a vast burden of disability, dependency, and cost.

PMID- 8484691
TI  - Radiographic progression of hospital referred osteoarthritis of the hip.
AB  - Various factors have been considered important in the rate of progression of
      osteoarthritis of the hip, though few data are available from large longitudinal
      studies. One hundred and thirty six patients referred to hospital (85 women, 51
      men; mean age 65 years, range 29-86 years) with osteoarthritis of the hip (192
      affected hips) were followed up for a median of 27 (range 3-72) months. One
      hundred and six patients (144 affected hips) were reviewed for a minimum of one
      year (median 28, range 12-72 months). Fifty three per cent of all osteoarthritic
      hips required an operation at a median of 14 (range 3-48) months from entry. All
      radiographs before and after entry were examined (median four films for each
      patient over a median of three years, range 0.5-19 years). Hips showing rapid
      radiographic progression on prospective films more often had superior migration,
      or an atrophic bone response; those with no progression more often had an
      indeterminate, medial, or axial migration pattern, protrusio or mild
      osteoarthritis at presentation. A higher occurrence of rapid progression was seen
      in women, in those of older age at symptom onset, and in hips with a higher
      Kellgren grade at entry; men more often showed no progression. Age at
      presentation, body mass index, symptom duration, or presence of
      chondrocalcinosis, hand osteoarthritis/nodes, or Forestier's disease did not
      influence progression. This study supports the contention that, at the time of
      hospital referral, certain patient characteristics and radiographic features at
      the hip may help to identify those at high risk of rapidly progressive hip
      osteoarthritis.

PMID- 8484692
TI  - Expression of systemic lupus erythematosus in various ethnic Jewish Israeli
      groups.
AB  - OBJECTIVES: To assess the expression of systemic lupus erythematosus (SLE) in
      Jewish Israeli patients according to ethnic origin. METHODS: Eighty four patients
      with SLE were divided into groups according to origin and compared for history,
      physical examination, and laboratory variables. RESULTS: Patients of Sephardic
      origin had more serious disease manifestations than Ashkenazi patients in 60 of
      the 76 variables examined. They had significantly worse muscle pain, alopecia,
      and cutaneous vasculitis, higher antibodies to DNA and erythrocyte sedimentation
      rate, and significantly lower complement and leucocytes. Sephardic patients were
      divided into subgroups according to country: Mediterranean area, Iran-Iraq-India,
      and Yemen. All three subgroups had more serious disease manifestations than the
      Ashkenazi group, and the Yemenite patients had the most serious manifestations
      among the Sephardic subgroups. The Sephardic patients had a significantly lower
      education level, but only origin, and not education level or age, was
      significantly related to disease manifestations on multivariate analysis.
      CONCLUSION: More serious manifestations of SLE are found among Jewish patients of
      Sephardic origin, but these are not related to level of education or age.

PMID- 8484693
TI  - Early phenotypic activation of circulating helper memory T cells in scleroderma:
      correlation with disease activity.
AB  - OBJECTIVES: The differential expression of several accessory/activation molecules
      (CD26, CD29, CD45RA, CD25, MLR4, HLA-DR) on peripheral blood CD4+ and CD8+ T
      lymphocytes in patients with scleroderma was compared with that in controls and
      patients with other connective systemic diseases to look for evidence of the
      involvement of T cells in the disease process of scleroderma. METHODS: The two
      colour expression of surface molecules by circulating T cells was analysed with a
      panel of monoclonal antibodies and flow cytometry in 17 patients with
      scleroderma, 10 patients with systemic lupus erythematosus, and five patients
      with rheumatoid arthritis, and the results compared with those for 10 normal
      controls. The two colour T CD4+ phenotype was further compared between patients
      with active and quiescent disease in these patients with scleroderma. The
      coexpression of surface molecules by CD4+ T cells was also analysed by three
      colour flow cytometry in eight patients with scleroderma. RESULTS: Patients with
      scleroderma showed increased CD4+CD26+ and CD4+CD25+ percentages and absolute
      numbers and decreased CD8+CD29+ percentages compared with controls. Moreover, a
      significant correlation between the higher CD4+CD26+ T cell percentage and
      absolute cell numbers with disease activity was observed. Most of the CD4+
      peripheral blood T cells from patients with scleroderma showed the CD26+CD45RA-
      phenotype by three colour flow cytometry analysis. CONCLUSIONS: The distinctive
      pattern of early helper memory T cell activation in these patients with rapidly
      evolving scleroderma supports the role of a T cell mediated mechanism in the
      progression of scleroderma.

PMID- 8484694
TI  - Detection of Luse bodies, spiralled collagen, dysplastic collagen, and
      intracellular collagen in rheumatoid connective tissues: an electron microscopic
      study.
AB  - BACKGROUND: Rheumatoid arthritis is a chronic inflammatory disease leading to
      alterations of the extracellular matrix in tendons, ligaments, and cartilage. The
      structural changes of the collagenous systems in rheumatoid connective tissues
      are largely unknown, however. METHODS: Thirty four samples of menisci, 36
      cruciate ligaments, and four tendons were taken during joint surgery in patients
      with rheumatoid arthritis. Eighteen menisci, 35 ligaments, and 30 tendons
      obtained at necropsy served as a control group. The extracellular matrix in the
      two groups was analysed by the combined use of transmission and scanning electron
      microscopy, immunohistochemistry with monoclonal antibodies recognising collagen
      types IV and VI, and ultramorphometry. RESULTS: Normal tendons and ligaments
      predominantly showed a unidirectional fibril arrangement. Whereas type IV
      collagen showed a positive staining pattern along all basement membranes, type VI
      collagen formed fine, filaments aligned in parallel. In patients with rheumatoid
      arthritis a significant reduction of the mean diameter of the collagen fibrils
      was found owing to the presence of thin collagenous fibrils 20-60 nm in diameter.
      Most of these fibrils showed considerable changes in their arrangement with
      irregular courses (so-called interfibrillar dysplastic collagen). Up to 410 nm
      thick frayed fibrils with irregular outlines (spiralled collagen) and
      intracellular collagen forms were found in rheumatoid tissues. In addition,
      atypical thick collagenous structures with 41 nm periodicity (Luse bodies) were
      detected in the matrix. The upregulation of type IV collagen in rheumatoid
      arthritis was associated with an increase in the vascular density. The expression
      of type VI collagen was upregulated in fibrotic zones. CONCLUSIONS: The dramatic
      ultrastructural collagen changes lead to a structural and functional
      insufficiency of the extracellular matrix in rheumatoid connective tissues. The
      results suggest that collagen alterations may contribute to the development of
      tendon and ligament ruptures in rheumatoid arthritis.

PMID- 8484695
TI  - Protective effect of androgens against inflammation induced cartilage degradation
      in male rodents.
AB  - OBJECTIVES: Rheumatoid arthritis (RA) is a disease which predominantly affects
      women. Interestingly, low serum androgen levels and clinical improvement with
      androgen replacement have been reported in male patients. The aetiopathogenic
      role of sex hormones in arthritis and their potential long term effects on joint
      destruction and disability remains unclear, however. This study was designed to
      investigate the potential influence of sex hormones on inflammation induced
      cartilage degradation in male rodents. METHODS: An in vivo model of cotton
      wrapped cartilage implants was used to assess the effects of androgen,
      oestradiol, and progesterone on inflammation induced cartilage degradation, and
      in vitro techniques were used to investigate the direct actions on cartilage
      metabolism and cytokine production in male animals. RESULTS: Orchidectomy
      resulted in accelerated cartilage damage which was reversed by replacement of
      physiological levels of androgens. Granulomatous tissue from castrated male
      rodents produced higher amounts of interleukin 1. Sex hormones reduced
      spontaneous proteoglycan loss in vitro but did not interfere with the effects of
      interleukin 1 on cultured cartilage. CONCLUSIONS: Androgens appear to protect
      cartilage from inflammation induced breakdown in male animals. These results
      support a pathogenic role for hypoandrogenism in rheumatoid arthritis and suggest
      that long term androgen replacement may help prevent joint damage and disability.

PMID- 8484696
TI  - Effect of tenidap on cartilage integrity in vitro.
AB  - OBJECTIVES: The maintenance of articular cartilage integrity during long term
      treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is of clinical
      importance. These experiments were set up to test the action of tenidap,
      naproxen, and diclofenac on bovine and porcine cartilage, matrix synthesis, and
      catabolism. METHODS: Short term organ culture techniques were used to determine
      the effect of interleukin 1 (IL-1) on synthesis and degradation, and the action
      of tenidap and the other drugs on these parameters. The retention of
      glycosaminoglycans (GAGs) and the synthesis of GAGs by incorporation of sulphur
      35 labelled sulphate was used to determine the chondrocyte metabolic activity.
      RESULTS: The action of human recombinant interleukin 1 alpha (hrIL-1 alpha) in
      increasing catabolic activity and inhibiting synthetic activity of the animal
      cartilages was confirmed. Tenidap was shown to give substantial and significant
      protection against the catabolic effects of hrIL-1 alpha and, to a lesser degree,
      against the inhibition of matrix synthesis by the cytokine. Neither diclofenac
      nor naproxen in doses expected to occur in the synovial fluid showed this action.
      Tenidap also inhibited the GAG loss from cocultures and, to a moderate degree,
      reversed the inhibition of synthesis by synovial tissue. Tenidap also stimulated
      cartilage repair activity during recovery from IL-1 treatment. The optimum
      concentration of the action against IL-1 was between 5 and 10 micrograms/ml.
      Above this concentration tenidap itself showed some inhibitory action on GAG
      synthesis. CONCLUSIONS: Bearing in mind the problems in extrapolating from in
      vitro work on animal cartilages to humans, it seems possible that tenidap may be
      useful in decreasing the deleterious action of cytokines such as IL-1 on
      cartilage integrity during arthritic disease and in stimulating chondrocyte
      repair processes.

PMID- 8484697
TI  - Gold induced nephropathy in rheumatoid arthritis and HLA class II genes.
AB  - OBJECTIVES: To elucidate the role of HLA-DRB, -DQA, and -DQB genes in patients
      with rheumatoid arthritis (RA) who developed gold induced nephropathy. METHODS:
      Southern blot analysis of HLA-DRB, -DQA, and -DQB genes was performed on DNA from
      27 patients with RA with gold induced nephropathy, 37 patients with RA who were
      treated with gold but did not develop nephropathy, and 122 ethnically matched
      normal subjects. RESULTS: The 4.7 kb DQA1/Taq I band associated with DQA1*0501
      and DR3 and DR5 was found in 16 (59%) patients with gold induced nephropathy
      compared with five (14%) patients without gold induced nephropathy. CONCLUSION:
      It is concluded that HLA-DQA region genes may be an important susceptibility
      factor for the development of gold induced nephropathy in patients with RA.

PMID- 8484698
TI  - Adjuvant oestrogen treatment increases bone mineral density in postmenopausal
      women with rheumatoid arthritis.
AB  - OBJECTIVES: The beneficial effect of oestrogens on bone mineral density in women
      with osteoporosis is well known. Patients with rheumatoid arthritis (RA) are at
      risk for osteoporosis. A study was therefore set up to investigate the effects of
      adjuvant oestrogen treatment on bone metabolism and bone mineral density in
      postmenopausal women with RA. METHODS: Forty postmenopausal women with active RA
      were admitted to a placebo controlled, double blind study investigating the
      beneficial effect of adjuvant oestradiols or placebo on bone metabolism and bone
      mineral density. Thirty three patients completed 52 weeks of treatment. RESULTS:
      At the start both treatment groups were comparable for all parameters. In the
      oestrogen group serum concentrations of osteocalcin decreased and concentrations
      of sex hormone binding globulin increased during the study. Bone mineral density
      measured by dual energy x ray absorptiometry increased significantly in the
      lumbar vertebral spine and femoral neck in the oestrogen group compared with the
      placebo group. CONCLUSIONS: This study shows that the use of adjuvant oestrogens
      in post-menopausal women with active RA increases bone mineral density.

PMID- 8484699
TI  - Ossification of the ligamentum teres as a possible mechanism of lateral
      subluxation in coxopathy associated with ankylosing spinal hyperostosis.
AB  - The cases are reported of two patients with coxopathy associated with ankylosing
      spinal hyperostosis who showed ossification of the ligamentum teres. It is
      suggested that considerable ossification at the medial acetabular floor including
      the ligamentum teres can explain the mechanism of development of coxopathy with
      lateral subluxation of the femoral head which is often seen in patients with
      ankylosing spinal hyperostosis.

PMID- 8484700
TI  - Rapid development of a tophus following ipsilateral hemiparesis.
AB  - An 85 year old man with a longstanding history of non-tophaceous gout developed a
      single large tophus, unassociated with inflammation, on his paretic leg over a
      six week period following an acute hemiplegia. The rapidity of tophus formation,
      its localisation to the paretic limb, and the apparent blunting of the acute
      inflammatory response represent a previously unreported interaction between gout
      and neurological deficit.

PMID- 8484701
TI  - Epidemiological approaches to the immunogenetics of autoimmune rheumatic disease.

PMID- 8484702
TI  - Spontaneous splenic rupture in Wegener's vasculitis.

PMID- 8484703
TI  - Menstrual arthritis.

PMID- 8484704
TI  - Folate supplementation and methotrexate.

PMID- 8484705
TI  - Bone mineral density and osteoarthritis.

PMID- 8484706
TI  - The antiquity of rheumatoid arthritis.

PMID- 8484707
TI  - Anaerobic transformation of 2,4,6-trinitrotoluene (TNT).
AB  - A sulfate-reducing bacterium using trinitrotoluene (TNT) as the sole nitrogen
      source was isolated with pyruvate and sulfate as the energy sources. The organism
      was able to reduce TNT to triaminotoluene (TAT) in growing cultures and cell
      suspensions and to further transform TAT to still unknown products. Pyruvate, H2,
      or carbon monoxide served as the electron donors for the reduction of TNT. The
      limiting step in TNT conversion to TAT was the reduction of 2,4-diamino-6
      nitrotoluene (2,4-DANT) to triaminotoluene. The reduction proceeded via 2,4
      diamino-6-hydroxylaminotoluene (DAHAT) as an intermediate. The intermediary
      formation of DAHAT was only observed in the presence of carbon monoxide or
      hydroxylamine, respectively. The reduction of DAHAT to triaminotoluene was
      inhibited by both CO and NH2OH. The inhibitors as well as DANT and DAHAT
      significantly inhibited sulfide formation from sulfite. The data were taken as
      evidence for the involvement of dissimilatory sulfite reductase in the reduction
      of DANT and/or DAHAT to triaminotoluene. Hydrogenase purified from Clostridium
      pasteurianum and carbon monoxide dehydrogenase partially purified from
      Clostridium thermoaceticum also catalyzed the reduction of DANT in the presence
      of methyl viologen or ferredoxin, however, as the main reduction product DAHAT
      rather than triaminotoluene was formed. The findings could explain the function
      of CO as an electron donor for the DANT reduction (to DAHAT) and the concomitant
      inhibitory effect of CO on triaminotoluene formation (from DAHAT) by the
      inhibition of sulfite reductase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484708
TI  - Morphological, physiological and enzymatic characteristics of cephalosporin
      acylase-producing Arthrobacter strain 45-8A.
AB  - A bacterial strain producing cephalosporin acylases was isolated from soil. The
      morphological and physiological properties of this strain suggest that it belongs
      to the genus Arthrobacter, and the isolate was therefore designated Arthrobacter
      strain 45-8A. Substrate specificity of the enzyme was examined. The enzyme can
      convert both cephalosporin acid to 7-aminocephalosporanic acid. An interesting
      feature of the acylases is their temperature-dependent regulation. Activity of
      acylases was detected in strain 45-8A grown at temperature below 30 degrees C,
      but was not observed at higher temperature. Arthrobacter strain 45-8A did not
      exhibit beta-lactamase activity, even though its resistance to cephalosporin C
      was very strong (> 2000 micrograms/ml). This is quite beneficial for its
      application in the manufacture of 7-aminocephalosporanic acid.

PMID- 8484710
TI  - Keep Medicare healthy.

PMID- 8484709
TI  - Pentose utilization and transport by the ruminal bacterium Prevotella ruminicola.
AB  - Plant cell wall polysaccharides are primarily composed of hexose or hexose
      derivatives, but a significant fraction is hemicellulose which contains pentose
      sugars. Prevotella ruminicola B14, a predominant ruminal bacterium,
      simultaneously metabolized pentoses and glucose or maltose, but the organism
      preferentially fermented pentoses over cellobiose and preferred xylose to
      sucrose. Xylose and arabinose transport at either low (2 microM) or high (1 mM)
      substrate concentrations were observed only in the presence of sodium and if
      oxygen was excluded during the harvest and assay procedures. An artificial
      electrical potential (delta psi) or chemical gradient of sodium (delta pNa) drove
      transport in anaerobically prepared membrane vesicles. Because (i) transport was
      electrogenic, (ii) a delta pNa drove uptake, and (iii) the number of sodium
      binding sites was approximately 1, it appeared that P. ruminicola possessed
      pentose/sodium support mechanisms for the transport of arabinose and xylose at
      low substrate concentrations. Pentose uptake exhibited a low affinity for xylose
      or arabinose (> 300 microM), and transport of xylose exhibited bi-phasic kinetics
      which suggested that a second sodium-dependent xylose transport system was
      present. Little study has been made on solute transport by Prevotella
      (Bacteroides) species and this work represents the first use of isolated membrane
      vesicles from these organisms.

PMID- 8484711
TI  - Women's health initiatives: promoting women's health; early detection of breast
      cancer--a national program.

PMID- 8484712
TI  - Australian Nursing Federation health policy.

PMID- 8484713
TI  - Toward a social theory of psychiatric phenomena.
AB  - This essay relies on a positivistic/scientific perspective to define psychiatric
      phenomena. However, it draws a distinction between a biomedical versus a social
      science approach. The aim is to review some of the theoretical and empirical
      considerations that pertain to psychiatric phenomena that need to be addressed in
      order to develop a social theory about them. The object of the theory is to
      explain how psychiatric phenomena are labeled, interpreted, and handled across
      societies that differ in terms of social structure and culture. Some of the kinds
      of variables and questions that would allow for cross-cultural analyses are
      identified. In addition, two topics that a social theory could address--that of
      the medicalization and stigmatization of psychiatric phenomena--are introduced.
      These topics are elaborated by developing propositions that substantively
      illustrate the questions/hypotheses of a social theory of psychiatric phenomena.
      The essay illustrates that a social theory constitutes a complex enterprise that
      requires dealing with philosophical, methodological and empirical issues.

PMID- 8484715
TI  - Activation of oxidized cysteine proteinases by thioredoxin-mediated reduction in
      vitro.
AB  - Activity of the cysteine adducts of the cysteine proteinases papain and
      thaumatopain can be recovered by treatment with thioredoxin, thioredoxin
      reductase and NADPH. Recovery of proteinase activity did not occur if any of the
      components of the thioredoxin system were omitted, or if thioredoxin or
      thioredoxin reductase were heat-inactivated. Such an enzyme-mediated process may
      be of significance in the recovery of cysteine proteinases inactivated by
      oxidative attack.

PMID- 8484714
TI  - Protein kinase C isoenzymes: divergence in signal transduction?

PMID- 8484716
TI  - A novel N-terminal motif for palmitoylation of G-protein alpha subunits.
AB  - We have examined the post-translational processing of G alpha subunits expressed
      endogenously in rat PC12 and NG108-15 rat/mouse hybrid cells, and after
      transfection of cDNA expression constructs into COS cells. Thioester-linked
      palmitoylation of alpha o, alpha s, alpha q/alpha 11 and alpha 12 has been
      detected by metabolic labelling with [3H]palmitate and immunoprecipitation.
      Palmitoylation of alpha o occurs post-translationally in cells treated with
      protein-synthesis inhibitors, suggesting possible dynamic acylation.
      Palmitoylation of the C-terminal CAAX motif has been excluded. Site-directed
      mutagenesis of alpha o has been used to implicate the site of modification as a
      cysteine residue next to the N-terminal myristoylated glycine, in a novel protein
      lipid modification motif Met-Gly-Cys. The non-palmitoylated alpha o mutant is
      still myristoylated but shows reduced membrane binding, suggesting that
      reversible palmitoylation may regulate G alpha localization and function.

PMID- 8484717
TI  - Involvement of microtubules in the swelling-induced stimulation of transcellular
      taurocholate transport in perfused rat liver.
AB  - An increase of the hepatocellular hydratation state, induced by hypotonic
      exposure, amino acids or tauroursodeoxycholate, was shown to increase within
      minutes the Vmax of transcellular taurocholate transport and excretion into bile
      [Haussinger, Hallbrucker, Saha, Lang and Gerok (1992) Biochem. J. 288, 681-689].
      This stimulatory effect of cell swelling on taurocholate excretion into bile is
      abolished in the presence of colchicine (5 microM). On the other hand, colchicine
      did not affect the stimulatory action of hypotonic cell swelling on 14CO2
      production from [1-14C]glycine or [1-14C]glucose. Likewise, volume regulatory K+
      fluxes following anisotonic exposure were not influenced in the presence of
      colchicine. Lumicolchicine (5 microM), a stereoisomer of colchicine without an
      inhibitory effect on microtubules, did not abolish the stimulation of
      taurocholate excretion into bile following hypo-osmotic exposure. Hypertonic cell
      shrinkage decreased taurocholate excretion into bile by about 35%; this effect
      was fully reversible upon normotonic re-exposure. With colchicine pretreatment,
      however, the hypertonicity-induced inhibition of taurocholate excretion was
      blunted and was no longer reversible upon normotonic re-exposure. The results
      suggest that stimulation of taurocholate excretion into bile in response to cell
      swelling involves a colchicine-sensitive, probably microtubule-dependent,
      mechanism, but not the stimulation of other cell-volume-sensitive pathways such
      as glycine oxidation or the pentose-phosphate shunt. It is hypothesized that the
      swelling-induced stimulation of taurocholate excretion into bile is due to a
      microtubule-dependent insertion of bile acid transporter molecules into the
      canalicular membrane.

PMID- 8484718
TI  - Versican gene expression in human articular cartilage and comparison of mRNA
      splicing variation with aggrecan.
AB  - The chondrocytes in human articular cartilage from subjects of all ages express
      mRNAs for both of the aggregating proteoglycans aggrecan and versican, although
      the level of expression of versican mRNA is much lower than that of aggrecan
      mRNA. Aggrecan shows alternative splicing of the epidermal growth factor (EGF)
      like domain within its C-terminal globular region, but there is no evidence for a
      major difference in situ in the relative expression of this domain with age. At
      all ages studied from birth to the mature adult, a greater proportion of
      transcripts lacked the EGF domain. The relative proportions of the two
      transcripts did not change upon culture and passage of isolated chondrocytes. In
      contrast, the neighbouring complement regulatory protein (CRP)-like domain was
      predominantly expressed irrespective of age, but cell culture did result in
      variation of the splicing of this domain. Versican possesses two EGF-like domains
      and one CRP-like domain, but at all ages the three domains were predominantly
      present in all transcripts. This situation persisted upon culture and passage of
      the chondrocytes. Thus, unlike aggrecan, the versican expressed by human
      articular cartilage does not appear to undergo alternative splicing of its C
      terminal globular region, either in cartilage in situ or in chondrocytes in
      culture.

PMID- 8484719
TI  - G-protein from Medicago sativa: functional association to photoreceptors.
AB  - G-protein subunits were characterized from Medicago sativa (alfalfa) seedlings.
      Crude membranes and GTP-Sepharose-purified fractions were electrophoresed on
      SDS/polyacrylamide gels and analysed by Western blotting with 9193 (anti-alpha
      common) and AS/7 (anti-alpha t, anti-alpha i1 and anti-alpha i2) polyclonal
      antibodies. These procedures led to the identification of a specific polypeptide
      band of about 43 kDa. Another polypeptide reacting with the SW/1 (anti-beta)
      antibody, of about 37 kDa, was also detected. The 43 kDa polypeptide bound
      specifically [alpha-32P]GTP by a photoaffinity reaction and was ADP-ribosylated
      by activated cholera toxin, but not by pertussis toxin. Irradiation of etiolated
      Medicago sativa protoplast preparations at 660 nm for 1 min produced a maximal
      increase in the guanosine 5'-[gamma-thio]triphosphate (GTP[35S])-binding rate.
      After this period of irradiation, the binding rate tended to decrease. The effect
      of a red-light (660 nm) pulse on the binding rate was reversed when it was
      immediately followed by a period of far-red (> 730 nm) illumination. These
      results may suggest that activation of GTP[S]-binding rate was a consequence of
      conversion of phytochrome Pr into the Ptr form.

PMID- 8484720
TI  - Binding of the calcium antagonist flunarizine to phosphatidylcholine bilayers:
      charge effects and thermodynamics.
AB  - We have examined the partitioning/transfer of the Ca2+ antagonist flunarizine
      from the aqueous phase into phospholipid bilayers. We show that the binding of
      the cationic amphiphilic drug flunarizine to phospholipid bilayers displays
      traditional linear concentration-dependent characteristics once unmasked of
      electrostatic effects. The coefficient for the binding/partitioning of
      flunarizine to phosphatidylcholine was found to be 28700 M-1, supporting the
      notion that this drug may be particularly membrane-active. The thermodynamics of
      the partitioning/transfer process have also been studied using high-sensitivity
      titration calorimetry. Binding was found to be predominantly enthalpy-driven with
      only a small entropic contribution; delta H = -22.1 kJ.mol-1 (-5.3 kcal.mol-1) at
      27 degrees C. This is in conflict with established ideas of entropy-driven
      partitioning of drugs into phospholipid membranes as a result of the 'hydrophobic
      effect'. The strong enthalpic nature of binding is interpreted as being
      indicative of strong lipophilic interactions between the drug and the
      phospholipid phase.

PMID- 8484721
TI  - Interaction of caldesmon with phospholipids.
AB  - The interaction of caldesmon with liposomes composed of various phospholipids has
      been examined by tryptophan fluorescence spectroscopy. The results indicate that
      caldesmon makes its strongest complex with phosphatidylserine (PS) vesicles
      (Kass. = 1.45 x 10(5) M-1). Both electrostatic and hydrophobic interactions
      contribute to the stability of this complex. The site for strong binding of PS
      seems to be located in the N-terminal part of the 34 kDa C-terminal fragment of
      caldesmon. Binding of PS at this site results in displacement of calmodulin from
      its complex with caldesmon.

PMID- 8484722
TI  - ADP-ribosylation of Drosophila indirect-flight-muscle actin and arthrin by
      Clostridium botulinum C2 toxin and Clostridium perfringens iota toxin.
AB  - Purified Drosophila indirect-flight-muscle actin and arthrin, an actin-ubiquitin
      conjugate, were ADP-ribosylated by Clostridium botulinum C2 toxin and Clostridium
      perfringens iota toxin. Phalloidin treatment inhibited the ADP-ribosylation of
      Drosophila actin and arthrin. Like actin, the ADP-ribose-arthrin linkage was
      sensitive towards hydroxylamine treatment, indicating arginine as the amino acid
      acceptor. Actin translated in vitro from the indirect-flight-muscle-specific gene
      Act88F was ADP-ribosylated by C. botulinum C2 toxin and C. perfringens iota
      toxin. Actin from the R177Q mutant of Act88F translated in vivo was not ADP
      ribosylated confirming Arg-177 as the ADP-ribose acceptor. Mutant L176M actin was
      modified by both toxins, indicating that amino acid 176 of actin does not define
      the substrate specificity of C. botulinum C2 toxin. Whereas the gene products of
      various C-terminal mutants of Act88F translated in vitro (E334K, V339I, E364K,
      G368E, R372H) were substrates for ADP-ribosylation by C. botulinum C2 toxin and
      by C. perfringens iota toxin, neither toxin modified the N-terminal O-12 deletion
      mutant.

PMID- 8484723
TI  - The lithocholic acid 6 beta-hydroxylase cytochrome P-450, CYP 3A10, is an active
      catalyst of steroid-hormone 6 beta-hydroxylation.
AB  - CYP 3A10 is a hamster liver cytochrome P-450 (P450) that encodes lithocholic acid
      6 beta-hydroxylase, an enzyme that plays an important role in the detoxification
      of the cholestatic secondary bile acid lithocholate. Western-blot analysis
      revealed that the expression of CYP 3A10 protein is male-specific in hamster
      liver microsomes, a finding that is consistent with earlier analysis of CYP 3A10
      mRNA. Since it has not been established whether the specificities of bile acid
      hydroxylase P450s, such as CYP 3A10, are restricted to their anionic bile acid
      substrates, we investigated the role of CYP 3A10 in the metabolism of a series of
      neutral steroid hormones using cDNA directed-expression in COS cells. The steroid
      hormones examined, testosterone, androstenedione and progesterone, were each
      metabolized by the expressed CYP 3A10, with 6 beta-hydroxylation corresponding to
      a major activity in all three instances. CYP 3A10-dependent steroid hydroxylation
      was increased substantially when the microsomes were prepared from COS cells co
      transfected with NADPH:P450 reductase cDNA. In this case, the expressed P450
      actively catalysed the 6 beta-hydroxylation of testosterone (288 +/- 23 pmol of
      product formed/min per mg of COS-cell microsomal protein), androstenedione (107
      +/- 19 pmol/min per mg) and progesterone (150 +/- 7 pmol/min per mg). Other major
      CYP 3A10-mediated steroid hydroxylase activities included androstenedione 16
      alpha-hydroxylation, progesterone 16 alpha- and 21-hydroxylation, and the
      formation of several unidentified products. CYP 3A10 exhibited similar Vmax.
      values for the 6 beta-hydroxylation of androstenedione and lithocholic acid (132
      and 164 pmol/min per mg respectively), but metabolized the bile acid with a 3
      fold lower Km (25 microM, as against 75 microM for androstenedione). Together,
      these studies establish that the substrate specificity of the bile acid
      hydroxylase CYP 3A10 is not restricted to bile acids, and further suggest that
      CYP 3A10 can play a physiologically important role in the metabolism of two
      classes of endogenous P450 substrates:steroid hormones and bile acids.

PMID- 8484724
TI  - Regulation of the ovine intestinal Na+/glucose co-transporter (SGLT1) is
      dissociated from mRNA abundance.
AB  - We have investigated the mechanisms of regulation of the Na+/glucose co
      transporter (SGLT1) in a ruminant animal, which is an exceptional model system
      for studying intestinal glucose transport. Pre-ruminant lambs absorb glucose,
      produced by hydrolysis of the milk sugar lactose, in the intestine via apical
      SGLT1 and basolateral facilitative glucose transporters (GLUT2). Weaning
      coincides with the development of the rumen, and consequently the amount of
      hexoses reaching the small intestine of the ruminant sheep is undetectable.
      During development, SGLT1 activity and abundance in intestinal brush-border
      membranes decreased by over 200-fold, and either maintaining lambs on a milk
      replacer diet or infusing sheep intestine with D-glucose restored co-transporter
      activity and expression. We have measured ovine intestinal SGLT1 mRNA levels
      during development, with changes in diet and after direct infusion of D-glucose
      or methyl alpha-D-glucopyranoside into the intestinal lumen, in order to
      determine the level of regulation. During development, mRNA levels decreased only
      4-fold. Lambs maintained on a milk replacer diet showed no change in mRNA levels
      relative to age-matched controls. Finally, upon infusion of the intestine of the
      ruminant sheep with sugars, D-glucose infusion increased SGLT1 mRNA, but only by
      2-fold, compared with a 60-90-fold increase in co-transporter number and
      activity. Since the change in Na(+)-dependent glucose transport activity is
      correlated with SGLT1 protein abundance, and since changes in mRNA levels do not
      account for the dramatic changes in protein abundance, we conclude that the
      principal level of SGLT1 regulation by luminal sugar is translational or post
      translational.

PMID- 8484725
TI  - Intracellular Ca2+ pools in Jurkat T-lymphocytes.
AB  - Jurkat T-lymphocytes comprise at least four intracellular Ca2+ pools. Pool I was
      agonist-sensitive and contained 23 +/- 8% (n = 18) of the total Ca(2+)-storage
      capacity, as shown in intact cells in the presence of EGTA. The time courses of
      the agonist-induced formation of Ins(1,4,5)P3 and of the Ca2+ release from pool I
      were nearly superimposable, indicating that the agonist-sensitive pool I is
      emptied by Ins(1,4,5)P3. Likewise, in permeabilized cells, the size of the
      Ins(1,4,5)P3-sensitive Ca2+ pool I was 27 +/- 11% (n = 14). Pool II contained 26
      +/- 5% (n = 9) of intracellularly stored Ca2+ and was liberated by thapsigargin,
      an inhibitor of the endoplasmic-reticulum (ER) Ca(2+)-ATPase. Addition of
      thapsigargin before addition of agonist abolished the agonist-induced Ca2+
      release in both intact and permeabilized cells, indicating that pool I is a
      subcompartment of the ER Ca2+ pool. The content of this ER Ca2+ pool (pools I and
      II) amounted to 51 +/- 15% (n = 9) in intact cells and 49 +/- 16% (n = 16) in
      permeabilized cells. Caffeine released Ca2+ even when the ER pool (pools I and
      II) was emptied by previous addition of thapsigargin, indicating the presence of
      a third pool independent of pools I and II. Pool III contained 23 +/- 6% (n = 8)
      in intact cells, but 41 +/- 8% (n = 5) in permeabilized cells. The remaining
      intracellularly stored Ca2+ was released by addition of the Ca2+ ionophore
      ionomycin. This fourth pool contained 27 +/- 8% (n = 9) in intact cells, but less
      than 10% in permeabilized cells. The size of pool III was increased when pools I
      and II were emptied before addition of caffeine, whereas the size of pool IV was
      decreased under such conditions. In conclusion, this first comprehensive
      description of intracellular Ca2+ pools in Jurkat T-lymphocytes demonstrates the
      presence of four different Ca2+ pools, provides estimates of their sizes and
      describes relationships between each other. Release of Ca2+ from pool I
      [Ins(1,4,5)P3-sensitive] has previously been shown to play a major role in T-cell
      activation, whereas the physiological role of pools II-IV remains to be
      established.

PMID- 8484726
TI  - Effects of hyperbilirubinaemia on glutathione S-transferase isoenzymes in
      cerebellar cortex of the Gunn rat.
AB  - The glutathione S-transferases (GSTs) are a family of isoenzymes involved in the
      detoxication of a variety of electrophilic xenobiotics. The present investigation
      demonstrates that GST activity and the concentration of cytosolic GSTs in
      cerebellar cortex of Gunn rats were increased in hyperbilirubinaemic animals
      compared with non-jaundiced controls. Age-dependent and region-specific increases
      in GST isoenzymes were seen in three regions of the cerebellar cortex of
      jaundiced Gunn rats, whereas GST concentrations were not altered in the
      brainstem, thalamus/hypothalamus, cortex or liver. Cytosolic GST activity was
      increased 1.3-fold in the flocculus and lateral hemispheres of 20-day-old and 1.7
      fold in the flocculus, lateral hemispheres and vermis of 60-day-old jaundiced
      (jj; homozygous) Gunn rats compared with non-jaundiced (Jj; heterozygous) Gunn
      rats. H.p.l.c. was used to determine the GST subunit protein concentrations in
      cytosolic fractions isolated from liver and brain regions of jaundiced and non
      jaundiced animals. In all regions of the cerebellum from 20-day-old animals, the
      levels of Alpha-class GST subunits 2 (Yc1; 3.0-fold) and 8 (Yk; 2.0-fold) were
      increased in jaundiced rats. In 60-day-old animals, the concentrations of Alpha
      class GST subunits 2 (Yc1; 5.0-fold) and 8 (Yk; 3.0-fold), Mu-class subunit 11
      (Yo; 2.5-fold) and Pi-class subunit 7 (Yp; 2.0-fold) were increased in all
      regions of cerebellar cortex of jaundiced animals. In cerebellum of 10-, 20- and
      60-day-old non-jaundiced and jaundiced Gunn rats, the flocculus had the highest
      concentration of Mu-class GST subunit 4 (Yb2) and vermis the lowest;
      hyperbilirubinaemia increased the concentration of subunit 4 (Yb2; 3- to 5-fold)
      in the flocculus and lateral hemispheres, but not the vermis, of 20- and 60-day
      old rats. Intraperitoneal injection of sulphadimethoxine, a long-acting
      sulphonamide which displaces bilirubin from its albumin-binding sites and
      increases the bilirubin levels in tissues, further increased the already elevated
      concentrations of GST subunits in the lateral regions of cerebellar cortex of
      hyperbilirubinaemic rats. For example, the concentration of subunit 4 (Yb2) was
      increased 2.2-fold (compared with non-jaundiced controls) in Gunn rats injected
      with saline and 7.4-fold in rats injected with 100 mg of sulphadimethoxine/kg
      body weight. In contrast, GSTs in the vermis of jaundiced animals were not
      affected by sulphadimethoxine injection. Sulphadimethoxine had no effect on GST
      concentrations in lateral regions and vermis of heterozygous (Jj) Gunn
      rats.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8484727
TI  - Selective labelling and inactivation of creatine kinase isoenzymes by the thyroid
      hormone derivative N-bromoacetyl-3,3',5-tri-iodo-L-thyronine.
AB  - Besides their well-known regulation of transcription by binding to nuclear
      receptors, thyroid hormones have been suggested to have direct effects on
      mitochondria. In a previous study, incubation of rat heart mitochondria with 125I
      labelled N-bromoacetyl-3,3',5-tri-iodo-L-thyronine (BrAcT3), a thyroid hormone
      derivative with an alkylating side chain, resulted in the selective labelling of
      a protein doublet around M(r) 45,000 on SDS/polyacrylamide gels [Rasmussen,
      Kohrle, Rokos and Hesch (1989) FEBS Lett. 255, 385-390]. Now, this protein
      doublet has been identified as mitochondrial creatine kinase (Mi-CK).
      Immunoblotting experiments with the cytoplasmic and mitochondrial fractions of
      rat heart, brain and liver, as well as inactivation studies with the purified
      chicken CK isoenzymes have further demonstrated that all four CK isoenzymes (Mia
      , Mib-, M- and B-CK) are indeed selectively labelled by BrAcT3. However, in
      contrast with their bromoalkyl derivatives, thyroid hormones themselves did not
      compete for CK labelling, suggesting that not the thyroid hormone moiety but
      rather the bromoacetyl-driven alkylation of the highly reactive 'essential' thiol
      group of CK accounts for this selective labelling. Therefore the assumption that
      CK isoenzymes are thyroid-hormone-binding proteins has to be dismissed. Instead,
      bromoacetyl-based reagents may allow a very specific covalent modification and
      inactivation of CK isoenzymes in vitro and in vivo.

PMID- 8484728
TI  - Rapid cellular removal of a membrane-inserted foreign polypeptide.
AB  - We have developed a system that makes it possible to study the fate of a foreign
      polypeptide that is inserted in the plasma membrane. Diphtheria toxin is a
      bacterial protein toxin that, upon acidification, has the ability to insert into
      the plasma membrane from the outside of eukaryotic cells. We present results that
      indicate endocytic uptake and degradation of the diphtheria toxin B-fragment
      after insertion into the membrane of Vero cells. The degradation rate of the
      fragment was found to be very high (t1/2 = 6 min) and dependent on cleavage of
      the extracellular part of the polypeptide with protease. Degradation was strongly
      inhibited in ATP-depleted cells, as well as at temperatures below 18 degrees C,
      and it was partially inhibited when the cytosol was acidified to block
      endocytosis from clathrin-coated pits. Degradation was also reduced in the
      presence of NH4Cl. The results indicate that the inserted and cleaved B-fragment
      is degraded by a process requiring endocytosis and transport to late endosomes or
      to lysosomes.

PMID- 8484729
TI  - Substitution of His-181 by alanine in yeast phosphoglycerate mutase leads to
      cofactor-induced dissociation of the tetrameric structure.
AB  - The structure and stability of a mutated yeast phosphoglycerate mutase in which
      His-181 has been replaced by alanine have been studied. The secondary, tertiary
      and quaternary structures of the mutant enzyme in the absence of ligands are
      essentially identical to those of the wild-type enzyme as revealed by c.d.,
      fluorescence and cross-linking studies. The mutant enzyme is slightly less stable
      than the wild-type enzyme towards denaturation by guanidium chloride (GdnHCl). On
      addition of cofactor 2,3-bisphosphoglycerate, the wild-type enzyme shows
      increased stability towards GdnHCl. However, addition of cofactor causes dramatic
      changes in the structure of the mutant enzyme, leading to dissociation of the
      tetrameric form to dimeric and monomeric species.

PMID- 8484730
TI  - Determination of the order of substrate addition to MspI DNA methyltransferase
      using a novel mechanism-based inhibitor.
AB  - The cloning and overexpression of the MspI DNA methyltransferase as a functional
      fusion with glutathione S-transferase is described. The fusion enzyme retains
      full biological activity and has been used to investigate the interaction of
      substrates and inhibitors with MspI DNA methyltransferase. The fusion enzyme has
      been purified to homogeneity in a single step on GSH-agarose and is free from
      contaminating exonuclease activity. The enzyme can be photolabelled with S
      adenosyl-L-methionine and the level of incorporation of label is enhanced by the
      presence of a nonspecific DNA duplex. In the presence of a cognate
      oligodeoxynucleotide, no photolabelling was observed since methyl transfer occurs
      instead. The inclusion of a mechanism-based inhibitor of C-5 deoxycytidine DNA
      methylation (an oligodeoxynucleotide containing the base 2-pyrimidinone-1-beta-D
      2'-deoxyribofuranoside in the position of the deoxycytidine to which methyl
      addition occurs), which is thought to form a covalent interaction with the
      reactive cysteine of such enzymes, led to an enhancement of S-adenosyl-L
      methionine photolabelling which suggests that, in contrast with results obtained
      with EcoRII DNA methyltransferase [Som and Friedman (1991) J. Biol. Chem. 266,
      2937-2945], methylcysteine is not the photolabelled product. The implications of
      the results obtained with this mechanism-based inhibitor are discussed with
      respect to other C-5-specific DNA methyltransferases. Gel-retardation assays in
      the presence of cognate oligodeoxynucleotides that contain the reactive
      pyrimidinone base in place of the deoxycytidine target base are described. These
      demonstrate that most probably a stable covalent bond is formed between the
      methyltransferase and this oligodeoxynucleotide. However, the alternative of
      extremely tight non-covalent binding cannot be rigorously excluded. Furthermore,
      the results from these experiments indicate that the reaction mechanism proceeds
      in a manner similar to that of HhaI DNA methyltransferase with sequence-specific
      DNA binding being followed by addition of S-adenosyl-L-methionine and concomitant
      isomerization of the ternary complex leading to methyl transfer. S-Adenosyl-L
      homocysteine appears to inhibit the reaction pathway as a result of either
      competition with the methyl donor and potentiation of a high-affinity interaction
      between the enzyme and DNA in an abortive ternary complex or through an
      allosteric interaction.

PMID- 8484731
TI  - Transgenic mice over-producing putrescine in their tissues do not convert the
      diamine into higher polyamines.
AB  - We recently described a transgenic mouse line over-expressing the human ornithine
      decarboxylase gene virtually in all tissues. Despite strikingly elevated tissue
      putrescine concentrations, no or minimal changes were found in the levels of the
      higher polyamines spermidine and spermine. We have now extended these studies by
      further increasing tissue putrescine with the aid of 5-fluoromethylornithine, a
      specific inhibitor of ornithine transaminase and hence the catabolism of L
      ornithine. As a result of the treatment with the latter drug, the concentration
      of putrescine was further increased by a factor of 2-3 without any changes in the
      concentrations of spermidine and spermine. In the testis of transgenic mice
      treated with 5-fluoromethylornithine, the concentration of putrescine was nearly
      60 times that in non-transgenic untreated animals, yet the concentration of
      spermidine was only 1.5-fold higher. A similar small increase in brain spermidine
      was accompanied by a 40-fold elevation in the concentration of putrescine. The
      apparent blockade between putrescine and spermidine was in all likelihood not
      attributable to an inhibition of S-adenosylmethionine decarboxylase, the rate
      controlling enzyme in the biosynthesis of spermidine and spermine. Our results
      are more compatible with the view that in non-dividing adult tissues putrescine
      is sequestered through some unknown mechanisms in a way that makes it unavailable
      for the synthesis of the higher polyamines.

PMID- 8484732
TI  - Direct observation of hexokinase translocation in stimulated macrophages.
AB  - 1. Fluorescence imaging of antibodies was used to show that phorbol 12-myristate
      13-acetate (PMA) induces a 4-fold increase in the amount of hexokinase relative
      to the control in the cortical shell of rat peritoneal macrophage cytosol
      adjacent to the plasma membrane, and a corresponding depletion in the amount of
      hexokinase in the central core of the cytosol. However, there was no significant
      PMA-dependent change in the distribution of glucose-6-phosphate dehydrogenase. 2.
      Cytochalasin D, an inhibitor of actin microfilament polymerization, prevented the
      PMA-induced hexokinase translocation and also reduced the PMA-dependent increases
      in 2-deoxy-D-glucose transport and glucose-dependent PMA-stimulated superoxide
      production. 3. PMA caused a contraction of the width of the cortical F-actin
      zone. Cytochalasin D caused some dispersal of F-actin within the cell, increasing
      the density of F-actin within the central cytosolic core and causing aggregation
      of the F-actin within the cortex. These data are consistent with the view that
      PMA induces attachment of hexokinase to microfilaments within the cortical zone
      adjacent to the cell membrane of macrophages, and cytochalasin D prevents this
      attachment. This is the first direct demonstration of the translocation of
      hexokinase to the plasma membrane in activated cells, and supports the view that
      enhanced hexokinase activity in the cortical region of the cytosol is an
      important early component of the macrophage activation process.

PMID- 8484733
TI  - Oxidative alterations in the experimental glycation model of diabetes mellitus
      are due to protein-glucose adduct oxidation. Some fundamental differences in
      proposed mechanisms of glucose oxidation and oxidant production.
AB  - Modification of human serum albumin (HSA) with formaldehyde resulted in a loss of
      75% of available lysine residues, but there was no change in histidine content or
      susceptibility to free-radical-mediated fragmentation. The modified HSA appeared
      resistant to glycation and glucose-mediated fragmentation. Native HSA inhibited
      oxidant production by free glucose, as assessed by the hydroxylation of benzoic
      acid, but modified HSA had little effect. Thus the oxidation of free glucose
      appeared to be inhibited by glycatable protein, but not by unglycatable protein.
      Also, a close proximity of glucose to protein (decreased in the case of modified
      HSA) would seem to be a prerequisite for glucose-mediated protein fragmentation.
      This latter observation, in particular, led us to examine the role of oxidation
      of glucose attached to HSA in the production of reactive oxidants and subsequent
      molecular damage. Glycated HSA, washed free of unbound glucose, became fragmented
      and generated oxidants capable of hydroxylating benzoic acid and oxidizing
      cholesteryl linoleate-HSA complexes. Significant levels of benzoate hydroxylation
      and HSA fragmentation occurred with HSA (10 mg/ml) containing 3.3 mol of glucose
      bound/mol of HSA. This is equivalent to incubation of 10 mg/ml native HSA with
      0.66 mM glucose, conditions which lead to little fragmentation or oxidant
      formation. The oxidative activity of glycated HSA was dependent on transition
      metal concentration. The level of protein-bound glucose appeared to decrease
      during the oxidant production and protein fragmentation. Thus glucose can oxidize
      and generate reactive oxidants, whether in solution or attached to protein. We
      discuss which is the more likely mechanism of glucose oxidation under the near
      physiological conditions used to study the effects of protein exposure to glucose
      in vitro.

PMID- 8484734
TI  - The mechanism of action of DD-peptidases: the role of tyrosine-159 in the
      Streptomyces R61 DD-peptidase.
AB  - Tyrosine-159 of the Streptomyces R61 penicillin-sensitive DD-peptidase was
      replaced by serine or phenylalanine. The second mutation yielded a very poorly
      active protein whose rate of penicillin binding was also drastically decreased,
      except for the reactions with nitrocefin and methicillin. The consequences of the
      first mutation were more surprising, since a large proportion of the
      thiolesterase activity was retained, together with the penicillin-binding
      capacity. Conversely, the peptidase properties was severely affected. In both
      cases, a drastic decrease in the transferase activity was observed. The results
      are compared with those obtained by mutation of the corresponding residue in the
      class A beta-lactamase of Streptomyces albus G.

PMID- 8484735
TI  - Co-purification of human serum lipoamidase and biotinidase: evidence that the two
      enzyme activities are due to the same enzyme protein.
AB  - A more than 20000-fold purification of human serum lipoamidase is described. This
      was accomplished by (NH4)2SO4 precipitation and chromatography on DEAE-Sepharose,
      Blue Sepharose CL-6B and phenyl-Sepharose CL-4B, followed by preparative
      isoelectric focusing (IEF) and finally by gel-permeation chromatography. Co
      precipitation and co-chromatography of lipoamidase and biotinidase activities
      with equal yields and purification were obtained in all the purification steps,
      indicating that lipoamidase and biotinidase activities in human serum are due to
      the same enzyme protein. After preparative IEF, two fractions with both
      lipoamidase activity and biotinidase activity were found at pI 4.0 and pI 4.4
      respectively. The molecular mass of the enzyme was found to be 76 kDa. When 2
      mercaptoethanol was used instead of cysteine as stabilizer during the
      purification procedure, only one major form (pI 4.0) of the enzyme was obtained
      after preparative IEF. By addition of cysteine, this form was transformed to an
      enzyme with pI 4.4, indicating that this latter form is a cysteine adduct,
      produced during the IEF procedure.

PMID- 8484736
TI  - Site-directed mutagenesis of mouse steroid 7 alpha-hydroxylase (cytochrome P
      450(7) alpha): role of residue-209 in determining steroid-cytochrome P-450
      interaction.
AB  - We have cloned a cDNA encoding mouse steroid 7 alpha-hydroxylase P450(7) alpha
      (cytochrome P-450(7) alpha) and expressed it in Saccharomyces cerevisiae. Mouse
      P450(7) alpha is 70% identical in its amino acid sequence with the mouse steroid
      15 alpha-hydroxylase P450(15) alpha (2A4). The Leu at position 209 of P450(15)
      alpha is the most important residue to determine the steroid hydroxylase activity
      of the P450 [Lindberg and Negishi (1989) Nature (London) 339, 632-634]. The
      P450(7) alpha contains Asn at the position corresponding to the Leu-209 of
      P450(15) alpha, although both P450s hydroxylate testosterone. The CO-reduced
      P450(7) alpha complex is unstable, so that it is quickly converted into the
      inactive P420, whereas the P450(15) alpha is very stable. The P450(7) alpha,
      however, is stabilized either by addition of testosterone or by a mutation of Asn
      209 to Leu. The mutant P450(7) alpha displays a 17-fold lower Vmax. value than
      the wild-type enzyme. Unexpectedly, it also has 3-fold lower Km and Kd values.
      Residue 209 in P450(7) alpha, therefore, appears to be located at a critical site
      of the haem-substrate-binding pocket. Corticosterone inhibits the testosterone 7
      alpha-hydroxylase activity of the wild-type P450(7) alpha, whereas it does not
      inhibit the mutant P450(7) alpha. Conversely, the P450(15) alpha activity becomes
      inhibited by corticosterone upon the replacement of Leu-209 by Asn. In addition,
      this mutation increases the corticosterone 15 alpha-hydroxylase activity of
      P450(15) alpha at least 20-fold. Whereas the inhibition by corticosterone depends
      on the presence of Asn at position 209, deoxycorticosterone inhibits the
      activities of the P450s regardless of the type of residue at 209. The results
      indicate, therefore, that the identity of residue 209 determines the affinity as
      well as specificity of steroid binding to both P450(7) alpha and P450(15) alpha.

PMID- 8484737
TI  - Arthrobacter D-xylose isomerase: protein-engineered subunit interfaces.
AB  - Mutants of Arthrobacter D-xylose isomerase were constructed in which one or two
      disulphide bridges or additional salt bridges were introduced at the A-A* subunit
      interfaces. These showed no change in enzyme activity or stability compared with
      the wild-type enzyme. However, a Tyr253 mutant in which a disulphide bridge was
      introduced at the A-B* subunit interface showed reduced thermostability that was
      identical in both oxidized and reduced forms, and also reduced stability in urea.
      X-ray-crystallographic analysis of the Mn(2+)-xylitol form of oxidized Y253C (the
      Tyr253-->Cys mutant) showed a changed conformation of Glu185 and also alternative
      conformations for Asp254, which is a ligand to the Site-[2] metal ion. With
      fructose, Mg(2+)-Y253C has a similar Km to that of the wild-type, and its Vmax.
      is also similar below pH 6.4, but declined thereafter. In the presence of Co2+,
      Y253C has lower activity than wild-type at all pH values, but its activity also
      declines at alkaline pH. These results suggest that electrostatic repulsion from
      the new position of Glu185 causes Asp254 to move when His219 is unprotonated,
      thereby preventing M2+ binding at Site [2]. These results also suggest that
      subunit dissociation does not lie on the pathway of thermal inactivation of D
      xylose isomerase, but that movements of active-site groups are a trigger for
      conformational changes that initiate the unfolding process.

PMID- 8484738
TI  - Quantitative determination of the steady-state kinetics of multienzyme reactions
      using the algebraic rate equations for the component single-enzyme reactions.
AB  - Methods are given whereby the steady-state kinetic characteristics of multienzyme
      reactions consisting of individual single-enzyme reactions linked by freely
      diffusible intermediates can be determined quantitatively from the experimentally
      determined complete algebraic rate equations for the individual reactions. The
      approach is based on the fact that a valid steady-state rate equation for such a
      multienzyme reaction, in terms of the rate equations for the individual
      reactions, can be obtained simply from knowledge of the relative rates of the
      individual reactions when the multienzyme reaction is in the steady state. A
      number of model multienzyme reactions, which differ as to structural arrangement
      of the individual reactions, are examined by this approach. Simple mathematical
      methods which are applicable to most of these models are given for direct
      calculation of dependent variables. It is either pointed out or demonstrated with
      Mathematica that the rate equations for all of these models can be handled very
      easily with the aid of a personal computer equipped with appropriate equation
      solving software. Since the approach permits evaluation of all dependent
      variables for any specific combination of values for the kinetic parameters and
      independent variables, numerical values for the flux control coefficients of the
      individual enzymes can be obtained by direct calculation for a wide variety of
      conditions and can be compared with those obtained according to the methods of
      Metabolic Control Analysis. Several such comparisons have been made and in all
      cases identical results were obtained. The intuitive notion that the individual
      enzymes of a multienzyme reaction would be equally rate limiting if the total
      amount of enzyme were being used with maximum efficiency is tested and shown to
      be incorrect. In the course of this test the flux control coefficient for the
      individual enzymes were found to be appropriate indicators of relative rate
      limitation or control by the enzymes and to account properly for differences in
      specific activity among the enzymes.

PMID- 8484739
TI  - The sub-cellular localization of annexin V in cultured chick-embryo fibroblasts.
AB  - The Ca(2+)- and phospholipid-binding protein, annexin V, has been shown by an
      immune assay to represent 0.4% of total cell protein in cultured chick-embryo
      fibroblasts. Immunofluorescent localization studies indicate that in primary
      cultures the protein is abundant in the cytoplasm of the cells and also extends
      into the nucleus. Nuclear staining is no longer detectable, however, in approx.
      25% of the cells following sub-culture. Sub-populations of annexin V are
      associated with cytoskeletal structures and with the inner face of the plasma
      membrane in a Ca(2+)-independent manner. In addition, we report results
      indicating the secretion of annexin V from this cell type.

PMID- 8484740
TI  - Isolation, characterization and localization of annexin V from chicken liver.
AB  - Annexin V has been purified from chicken liver; 40 mg of annexin V was obtained
      per kg of tissue. In contrast with mammalian liver, very little annexin VI was
      obtained. Surprisingly, chicken liver annexin V resembles mammalian annexin IV in
      its M(r) (32,500) and its isoelectric point (5.6), but amino-acid-sequence
      analysis demonstrates identity with chicken annexin V (anchorin CII). It binds to
      phospholipids in a Ca(2+)-dependent manner with free-Ca2+ concentrations for half
      maximal binding to phosphatidylserine and phosphatidic acid of 10 microM;
      phosphatidylethanolamine of 32 microM and phosphatidylinositol of 90 microM. No
      binding to phosphatidylcholine was observed at Ca2+ concentrations up to 300
      microM. In isolated liver membranes a significant proportion of annexin V was not
      extractable with EGTA but could only be extracted with Triton X-100, suggesting
      the existence of a tightly membrane-associated form of annexin V. A specific
      antiserum to chicken annexin V was used to localize the protein in adult and
      embryonic chicken liver. In the adult, annexin V was highly concentrated in
      epithelial cells lining the bile ducts, and along the bile canaliculi. In
      embryonic liver, strong staining of the bile-duct epithelial cells was again
      evident, and in addition, endothelial cells were strongly immunoreactive.

PMID- 8484741
TI  - Different N-terminal forms of alpha 2-plasmin inhibitor in human plasma.
AB  - Mature alpha 2-plasmin inhibitor in human plasma has 12 more N-terminal residues
      than hitherto anticipated. The first residue is the methionine at position 28,
      downstream from the N-terminus of the pre-protein. The cDNA sequence predicts
      that the site cleaved upon formation of the mature inhibitor is a typical signal
      peptidase recognition site. The mature inhibitor (464 residues) and the
      previously reported, and presumably degraded, form with N-terminal asparagine
      (452 residues), are present in plasma in about equal amounts. They both form a
      stable complex with plasmin. Recent studies on a recombinant alpha 2-plasmin
      inhibitor suggest that the 12 additional residues have functional implications
      [Sumi, Ichikawa, Nakamura, Miura and Aoki (1989) J. Biochem. 106, 703-707].

PMID- 8484742
TI  - Identification, purification and characterization of a membrane-associated N
      myristoyltransferase inhibitor protein from bovine brain.
AB  - N-Myristoyl-CoA: protein N-myristoyltransferase (NMT) is the enzyme that
      catalyses the covalent transfer of myristic acid from myristoyl-CoA to the N
      terminal glycine residue of a protein substrate. Subcellular fractionation of
      bovine brain indicates that NMT activity was located in both the cytosolic and
      the particulate fraction of the cell. Removal of the particulate fraction
      resulted in a 2-fold enhancement of NMT activity. Reconstitution of the
      particulate fraction and cytosolic fraction resulted in inhibition of the
      elevated cytosolic NMT activity. These results indicated the existence of
      putative inhibitor(s) activity of NMT located in the particulate fraction of
      bovine brain. The inhibitor was stable to heat and was identified as a protein,
      on the basis of its susceptibility to the proteases trypsin and chymotrypsin.
      Protease degradation first required the delipidation of the particulate fraction.
      The inhibitor was purified to near-homogeneity by heat treatment, solvent
      extraction and Sephacryl S-300 gelfiltration column chromatography. The inhibitor
      was purified 630-fold from the particulate fraction with a 20% yield. The protein
      inhibitor had an apparent molecular mass of 92 kDa by gel filtration and 71 kDa
      by SDS/PAGE, indicating the protein is monomeric. The inhibitor did not interact
      directly with myristoyl-CoA and possessed no protease, thioesterase or
      demyristoylase activity. Purified inhibitor protein inhibited the formation of
      1167 pmol of myristoyl-peptide/min per mg of protein.

PMID- 8484743
TI  - Constitutive and inducible profile of glutathione S-transferase subunits in
      biliary epithelial cells and hepatocytes isolated from rat liver.
AB  - The constitutive and inducible cytosolic glutathione S-transferase (EC 2.5.1.18)
      subunit compositions of parenchymal cells (hepatocytes) and biliary epithelial
      cells (BEC) from rat liver have been quantitatively analysed using reverse-phase
      h.p.l.c. Hepatocytes, analysed in the absence of non-parenchymal cells, expressed
      constitutively the following subunits, in order of their concentration: 3, 4, 2,
      1a, 1b, 8, 6 and 10. BEC express constitutively only four of the GST subunits
      expressed by hepatocytes and these are, in order of their concentration: subunits
      2, 7, 4 and 3. Notable differences from hepatocytes are that BEC completely lack
      the Alpha-class subunits 1a and 1b that are major subunits in hepatocytes, Mu
      class subunits make up a very low proportion of the total, and the Pi-class
      subunit 7 is a major subunit in BEC, whereas it is essentially absent from
      hepatocytes. For the first time, the effects of the inducing agents
      phenobarbitone (PB), beta-naphthoflavone (beta-NF) and ethoxyquin (EQ) have been
      characterized in a comprehensive and quantitative manner in both cell types. PB,
      beta-NF and EQ increased total GST protein in hepatocytes by approx. 2-fold, 3
      fold and 4-fold respectively. Subunits significantly induced in hepatocytes were
      (in order of fold-induction): by PB, 1b > 8 > 3 > 2 > 4; by beta-NF, 1b > 8 > 2 >
      3 > 4; and by EQ, 7 > 1b > 10 > 8 > 3 > 2 > 1a > 4. In BEC, neither PB nor beta
      NF had significant effects on the total amount of GST protein, although PB did
      significantly induce subunit 3 at the expense of other subunits. EQ increased
      total GST protein nearly 5-fold in BEC, subunits 7 and 3 being induced
      dramatically above constitutive levels.

PMID- 8484744
TI  - Recombinant truncated thrombospondin-1 monomer modulates endothelial cell
      plasminogen activator inhibitor 1 accumulation and proliferation in vitro.
AB  - The angiogenic and malignant phenotypes of hamster tumor cells are inversely
      correlated with the expression of an amino terminally truncated thrombospondin
      (TSP) subunit. In the present study, we have constructed a truncated TSP subunit
      from a human fibroblast cDNA library (rt-TSP1) and expressed it in Chinese
      hamster ovary (CHO) cells. Increased concentrations of plasminogen activator
      inhibitor-1 (PAI-1) were detected in endothelial cell conditioned medium
      following treatment with rt-TSP1. This rt-TSP1-induced increase in PAI-1 was
      neutralized by monoclonal antibodies to both TSP and TGF beta. rt-TSP1 also
      inhibits the proliferation of endothelial cells and this response is also
      neutralized by TSP and TGF beta antibodies. Serine and cysteine proteases
      inhibitors were used to determine if rt-TSP1 activated the latent TGF beta.
      However, these protease inhibitors did not neutralize the effect of rt-TSP1. The
      data indicate that the anti-angiogenic properties of TSP may be due to inhibition
      of the pericellular proteolysis required for endothelial cell migration and
      endothelial cell proliferation.

PMID- 8484745
TI  - Suppressive role of sialylated N-glycans in Fc receptor-mediated phagocytosis by
      macrophages.
AB  - By culturing with tunicamycin A1, an inhibitor of N-glycosylation, or by
      sialidase digestion, mouse monocytic cells P388D1 were induced to carry out Fc
      receptor-mediated phagocytosis of IgG-coated sheep red blood cells. There was no
      significant difference in the numbers of IgG-coated sheep blood cells bound to
      the cells at 4 degrees C before and after exposure to tunicamycin or sialidase.
      These results suggest that sialylated N-glycans expressed on the cell surface
      have a suppressive role in the induction of phagocytosis, and their decreased
      expression or reduced sialylation results in acquisition of the phagocytic
      ability of the cells by affecting some processes involved in the ingestion of the
      particles bound to Fc receptors.

PMID- 8484746
TI  - The ability of murine leukocytes to bind lipocortin 1 is lost during acute
      inflammation.
AB  - Lipocortin 1, a member of the annexin superfamily of calcium and phospholipid
      binding proteins, mediates some of the anti-inflammatory actions of the
      glucocorticoid hormones. Lipocortin 1 binds to the surface of murine peripheral
      blood monocytes and polymorphonuclear leukocytes (Kd estimate 2 x 10(-8) M) but
      not lymphocytes. Resident peritoneal macrophages exhibit binding (Kd estimate 1.3
      x 10(-8) M) but lymphocytes do not. A 95-98% reduction in lipocortin 1 binding
      was observed to leukocytes obtained from air pouch or peritonitis models of
      inflammation. When given intravenously, lipocortin 1 binds rapidly to murine
      leukocytes within 5 min but disappears before 10 min, leaving the binding
      capacity of the cells unaltered. Modulation of lipocortin 1 binding sites could
      be an important step in regulating the function of inflammatory cells.

PMID- 8484747
TI  - Lipocortin 1 binding to human leukocytes correlates with its ability to inhibit
      IgG interactions with Fc gamma receptors.
AB  - The anti-inflammatory protein lipocortin 1 has been proposed as a mediator of
      some of the anti-inflammatory actions of glucocorticoid hormones. In view of
      reported glucocorticoid effects on leukocyte Fc gamma receptors, the effect of
      short-term lipocortin 1 pre-incubation on expression and IgG binding capacity of
      human Fc gamma receptors was examined in vitro. The formation of erythrocyte
      antibody rosettes, binding of fluoresceinated IgG ligand and the expression of
      three defined types of Fc gamma receptors were observed following lipocortin 1
      treatment. Maximal inhibition of EA rosetting (70%) by peripheral blood
      mononuclear cells and a 30-50% inhibition of binding of fluoresceinated human
      IgG1 to purified human monocytes occurred in the presence of 400 nM lipocortin 1
      (p < 0.01). However, there was no accompanying decrease in expression of the
      three known Fc gamma receptor types measured by specific monoclonal antibodies.
      Similar observations were made for peripheral blood polymorphonuclear cells. On
      the other hand, IgG binding was not inhibited by lipocortin 1 in lymphocytes or
      in a panel of cell lines which express Fc gamma receptors and none of these cell
      types had the capacity to bind lipocortin.

PMID- 8484748
TI  - Apolipoprotein E: binding to soluble Alzheimer's beta-amyloid.
AB  - Apolipoprotein E (apo E) is associated with Alzheimer's beta-amyloid (A beta) in
      senile plaques. A beta is now known to be a normal soluble peptide (sA beta)
      found in the cerebrospinal fluid (CSF) and other biological fluids. We have used
      synthetic A beta peptides bound to affinity membranes in order to determine
      whether apo E or any other amyloid associated protein will bind to these
      membranes, when they are bathed in CSF. Under these conditions apo E, as well as
      another apolipoprotein, apolipoprotein J (Apo J), bound to the membranes. Using
      ELISA and ligand binding studies, we found a high avidity binding of A beta
      peptides to apo E. This suggests that apo E, as well as other related proteins
      may bind not only amyloid A beta but also sA beta. This interaction may be
      critical in amyloid formation.

PMID- 8484749
TI  - Purification of a 28 kD non-aggregating tryptic peptide of the Duffy blood group
      protein.
AB  - Duffy blood group antigenic epitopes are located on a 35-43 kD integral membrane
      protein of the erythrocyte membrane. This protein functions as a receptor for the
      human malaria parasite, Plasmodium vivax. The Duffy protein has been difficult to
      purify because of its tendency to form aggregates. Here we describe purification
      of a 28 kD tryptic fragment of the Duffy protein and purification of an 18 kD de
      glycosylated form of the Duffy tryptic peptide using Thiopropyl Sepharose 6B
      chromatography and preparative SDS-PAGE. These Duffy-reactive peptides do not
      form aggregates and may prove amendable to protein sequencing.

PMID- 8484750
TI  - Isolation and characterization of four basic proteins from horse eosinophilic
      granules.
AB  - Four new basic proteins were isolated from horse eosinophils and purified. The
      eosinophils release these proteins after permeabilization with saponin and
      degranulation stimulized by guanosine 5'-O-thiotriphosphate. The proteins were
      separated and purified on a Superose P12- and a Mono S-column by fast protein
      liquid chromatography. The amino acid composition, the relative molecular mass,
      the isoelectric point and the partial N-terminal sequence of the four proteins
      were determined. Papain-activation and ribonuclease activity of the four proteins
      were tested for comparison with the human eosinophil basic granular proteins. The
      cytotoxicity of the hole granular extract and of the isolated basic proteins
      against Escherichia coli K12 was also studied.

PMID- 8484751
TI  - Studies of the relationship between cell proliferation and cell death. III. AP-1
      DNA-binding activity during concanavalin A-induced proliferation or dexamethasone
      induced apoptosis of rat thymocytes.
AB  - In previous papers we started to investigate the possible relationship existing
      between cell proliferation and cell death. We reported that in rat thymocytes,
      undergoing cell proliferation upon stimulation with Concanavalin A or cell death
      following dexamethasone treatment, an induction of c-fos and c-jun occurs with
      different but partially overlapping kinetics (Grassilli et al., BBRC, 1992, 188,
      1261-1266). To test the hypothesis that, in both processes, the early induction
      of these nuclear oncogenes is necessary to allow the induction of later-expressed
      genes regulated at the transcriptional level by AP-1 complex, AP-1 DNA-binding
      activity was investigated in the aforementioned model. Indeed, we found that AP-1
      is activated not only in proliferating but also in apoptotic cells, with a
      kinetics in accord with our data about c-fos and c-jun mRNA accumulation in the
      same experimental model. Moreover, our findings suggest that an interaction
      between AP-1 and glucocorticoid receptor also occurs in our model of
      dexamethasone-mediated apoptosis.

PMID- 8484752
TI  - Comparison of COS cell transfected AT1A and AT1B angiotensin II receptors and
      angiotensin II receptor isoforms in rat tissues using isoelectric focusing.
AB  - Rat adrenal AT1A and AT1B receptors from transfected COS-7 cells were labelled
      with 125I-Angiotensin II, solubilised, and run on isoelectric focusing gels.
      Receptors from rat tissues were treated similarly. COS-7 cell-expressed AT1A and
      AT1B receptors each produced a single peak of specific radioactivity at pI 6.8.
      Rat liver and rat ovary tissue preparations gave peaks at pI 6.8 and 6.5,
      respectively. In contrast, rat adrenal tissue preparations gave four peaks at pI
      7.0, 6.8, 6.5, and 6.3. The additional isoforms found in the rat adrenal tissue
      preparations may represent post-translationally modified or novel receptors.

PMID- 8484753
TI  - Alteration of the product specificities of prenyltransferases by metal ions.
AB  - Effect of several kinds of metal ions on the chain-length distribution of
      reaction products of polyprenyl diphosphate synthases was investigated. In the
      presence of Co2+ or Mn2+ octaprenyl-, solanesyl- and decaprenyl diphosphate
      synthases gave a variety of polyprenyl products with the longest chains being
      shifted by one or two isoprene units longer than those of the products formed in
      the presence of Mg2+. Thus octaprenyl diphosphate synthase became to give
      solanesyl (C45) and decaprenyl (C50) diphosphates when Mg2+ is replaced with Co2+
      or Mn2+. Similarly solanesyl diphosphate synthase produced C50- and C55-
      diphosphates in the presence of Co2+ or Mn2+, and decaprenyl diphosphate synthase
      gave C55- diphosphate as the longest product in the presence of Mn2+. More
      remarkable effects were observed with Mn2+ than with Co2+.

PMID- 8484754
TI  - Genomic organization of the human HBNF gene and characterization of an HBNF
      variant protein as a splice mutant.
AB  - The organization of the human heparin-binding neurite outgrowth promoting factor
      (HBNF) gene is presented. Based on Southern analysis and the isolation of genomic
      DNA clones from a lambda phage library, the minimum size of the gene is 42 kb.
      Sequences comprising the HBNF mRNA are contained in five exons which account for
      the 1650 nt mRNA size observed by northern analysis. From the structure of the
      gene it is predicted that a variant human HBNF cDNA with a three basepair
      deletion is a result of alternative splicing at the acceptor site of exon 5.
      Evidence is presented that indicates the existence of a variant HBNF protein, des
      Ala119-HBNF, in bovine brain which has a corresponding amino acid deletion. This
      alternate form comprises approximately 20% of the total HBNF protein present in
      bovine brain.

PMID- 8484755
TI  - Transplasma membrane redox system in HL-60 cells is modulated during TPA-induced
      differentiation.
AB  - Besides its effect in inhibiting proliferation and inducing differentiation of HL
      60 cells to macrophage-like cells, TPA also produces a transient increase of
      transplasma membrane redox activity and pyridine nucleotide levels and a shift in
      the NAD+/NADH ratio. After 24 h of incubation NADH ferricyanide reductase
      activity of isolated plasma membranes was significantly higher than that of
      plasma membrane from non-differentiated cells. This correlated with the enhanced
      short-term oxidation of NADH in response to ferricyanide by HL-60 cells incubated
      with TPA for 24 h. Since differentiated cells with similar levels of NADH showed
      different redox activities, the redox chain itself seems to be modulated during
      differentiation induced by TPA.

PMID- 8484756
TI  - Platelet-activating factor stimulates protein kinase C translocation in cerebral
      microvessels.
AB  - The effects of platelet-activating factor (PAF) on distribution of protein kinase
      C activity in brain microvessels have been examined. Our results indicate that
      PAF caused an increase of protein kinase C activity in membrane, accompanied by a
      loss of activity in the cytosol. This effect resulted to be dose-dependent and
      the translocation was evident after 30 min of PAF treatment. These results
      suggest that PAF could play a role in transport processes in the blood-brain
      barrier, involving protein phosphorylation by activation of protein kinase C.

PMID- 8484757
TI  - Molecular cloning of rat cytokine synthesis inhibitory factor (IL-10) cDNA and
      expression in spleen and macrophages.
AB  - Rat cytokine synthesis inhibitory factor (IL-10) was cloned. Like mouse and human
      IL-10 (mIL-10, hIL-10), rat IL-10 exhibits strong DNA and amino acid sequence
      homology to the open reading frame in the Epstein-Barr virus, BCRFI. The
      supernatant of COS-7 transfectants with rat IL-10 was found to inhibit the
      production of IFN-gamma by murine Th1 cells. A probe from the rat IL-10 was used
      in an RNase protection assay to demonstrate that IL-10 was expressed in LPS
      stimulated rat spleen and FACS-purified OX-42-reactive peritoneal macrophages.
      The production of IL-10 by macrophages, as shown in the current study, suggests
      that IL-10 may have an autocrine function in inflammation.

PMID- 8484758
TI  - Tissue-specific expression of rat light neurofilament promoter-driven reporter
      gene in transgenic mice.
AB  - We have produced nine transgenic mice lines carrying either 5 kbp or 407 bp of
      the 5' flanking sequence of the rat light neurofilament gene linked to the
      chloramphenicol acetyltransferase (CAT) structural gene. With the 5kb light
      neurofilament 5' flanking region governing the expression of CAT, reporter gene
      activity was detected not only in brain but also in the eye lens and skeletal
      muscle, yet not in other tissues. With the 407 bp construct, reporter gene
      activity was detected only in the brain, although expression was approximately
      one tenth of that found with the 5 kb 5' region. These results, together with
      earlier observations, indicate that the sequence -407 to -292 of the proximal
      promoter region for the light neurofilament gene or sequence +15 to +75 bp after
      the transcription initiation site is crucial for brain-specific expression of a
      fusion gene in transgenic mice.

PMID- 8484759
TI  - Plasma membrane dependent reduction of 2,4,6-trinitrotoluene by Phanerochaete
      chrysosporium.
AB  - A plasma membrane redox system of Phanerochaete chrysosporium was found to reduce
      2,4,6-trinitrotoluene (TNT). Reduction required intact, live mycelia. No
      reduction was observed with either supplemented (NADPH, NADH or ATP) or
      unsupplemented extracellular or intracellular fractions, either under aerobic or
      anaerobic conditions. Reduction was inhibited by potassium ferricyanide, 3-(4,5
      dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium, carbonyl cyanide p
      trifluoromethoxyphenyl hydrazone, 2,4-dinitrophenol, sodium azide, and
      tetranitroblue tetrazolium but not by nitroblue tetrazolium, 2,3,5-triphenyl
      tetrazolium and blue tetrazolium. At higher pH, the rate of reduction as well as
      proton pumping was enhanced.

PMID- 8484760
TI  - Metabolism and detoxification of TNT by Phanerochaete chrysosporium.
AB  - Several lines of evidence suggest that TNT detoxification by Phanerochaete
      chrysosporium is through reduction. Rates of TNT reduction were directly
      correlated with mycelial mass and TNT concentration. Toxicity was inversely
      related to the amount of fungus. TNT toxicity was identical in both ligninolytic
      and nonligninolytic cultures. Rapid disappearance of the reduced metabolites
      coincided with production of the manganese-dependent peroxidases and
      mineralization of TNT was not observed until the lignin peroxidases were
      detected.

PMID- 8484761
TI  - Abundant production of nitric oxide from murine macrophages by direct stimulation
      of tumor cells.
AB  - By the coculture of tumor cells and resident murine peritoneal macrophages, we
      found that P1HTR tumor cells, which were the subline of P815 mastocytoma,
      stimulated syngeneic or allogeneic peritoneal macrophages to produce nitric
      oxide. This nitric oxide in turn kills P1HTR target cells. The cytotoxicity and
      nitric oxide production were completely abolished by the addition of L-arginine
      homologue NG-monomethyl-L-arginine. The original P815 tumor cells had only weak
      activity to stimulate macrophages to produce nitric oxide and were weekly killed
      by coculture of P815 and resident macrophages. Macrophage cell line, RAW264-7,
      was also stimulated to produce nitric oxide by P1HTR cells. The ability to
      stimulate macrophages to produce nitric oxide resided on the membranous fragment
      of P1HTR cells.

PMID- 8484762
TI  - Modification of energy metabolism and radiation response of a murine tumour by
      changes in nitric oxide availability.
AB  - The nitric oxide donor, SIN-1 and nitric oxide synthase inhibitor, nitro-L
      arginine were examined for their effects on energy metabolism using 31P magnetic
      resonance spectroscopy, and on radiation sensitivity in the transplantable murine
      tumour, SCCVII/Ha. SIN-1 at 2 mg/kg i.v. reduced Pi/total by 40-50% within 10 min
      and increased X-ray sensitivity 3 fold, consistent with increased tumour
      oxygenation. Nitro-L-arginine at 10 mg/kg i.v. increased Pi/total by 250% at 45
      min and was maintained for at least 2 hr. Nitro-L-arginine also increased
      radiation resistance 3-5 fold, consistent with the induction of tumour hypoxia.
      The results indicate that tumour energy metabolism may be altered through drug
      induced modification of nitric oxide availability, and that these changes are
      sufficient to modify tumour sensitivity to X-rays.

PMID- 8484763
TI  - Homogeneous catalytic deuteration of fatty acyl chains as a tool to detect lipid
      phase transitions in specific membrane domains: a Fourier Transform Infrared
      spectroscopic study.
AB  - Synthetic phospholipid molecules have been deuterated by using a water soluble
      catalyst and deuterium gas. The physical state of both deuterated segments and
      unaffected bulk part of the lipid molecules can be monitored simultaneously by
      Fourier Transform Infrared Spectroscopy. It is shown on multilamellar
      phospholipid systems that the deuterated segments can be used as structural
      probes. Whereas the nu(C-H) frequencies represent an average conformational order
      along all the alkyl chains present, by following changes in nu(C-D) vibrations,
      mobility of those membrane domains deuterium labeled at specific depths in the
      hydrocarbon core can be estimated. The potential importance of this new approach
      in the study of biological membranes is discussed.

PMID- 8484764
TI  - Evidence for C-type natriuretic peptide production in the rat kidney.
AB  - To elucidate the physiological role of C-type natriuretic peptide (CNP) as a
      local mediator, we examined the production of CNP in the rat kidney. The content
      of CNP in the kidney was 0.47 +/- 0.02 [SE] fmol/mg wet weight and the major
      molecular form of CNP was CNP-53. An established cell line from the rat kidney,
      NRK-52E cell, secreted CNP at a rate of 9.15 +/- 0.96 fmol/24 hr/mg protein.
      Furthermore, CNP mRNA was detected in the rat kidney and NRK-52E cell utilizing
      reverse transcription-polymerase chain reaction (RT-PCR). On the other hand, ANP
      in the rat kidney (2.56 +/- 0.19 fmol/mg wet weight) had the molecular form of
      alpha-ANP, but ANP mRNA was not detected by RT-PCR. No BNP immunoreactivity was
      found in the rat kidney, although BNP mRNA was detected by RT-PCR. These results
      indicate that only CNP among the natriuretic peptides is produced in significant
      amounts in the rat kidney under normal physiological conditions and that renal
      parenchymal cells may produce CNP.

PMID- 8484765
TI  - The major mutation among Japanese patients with infantile Tay-Sachs disease: a G
      to-T transversion at the acceptor site of intron 5 of the beta-hexosaminidase
      alpha gene.
AB  - A G-to-T substitution at the 3'-splice site of intron 5 in the beta
      hexosaminidase alpha-subunit gene has been identified among Japanese patients
      with infantile Tay-Sachs disease. Of the 24 patients from 24 unrelated families,
      15 were homozygous and 8 were heterozygous for this mutation (38/48 mutant
      alleles). The mutation causes a splicing abnormality, and the resultant mRNA
      lacks the exon 6 sequence. Northern blot analysis showed a single band of mRNA,
      distinctly shorter in size and slightly smaller in quantity than normal. Since
      exon 6 consists of 102 nucleotides, the mRNA should generate a beta
      hexosaminidase alpha-subunit missing 34 amino acids in the middle but otherwise
      normal in the primary structure. It must be catalytically inactive or unstable,
      or both. The high frequency of this mutation among the Japanese patients with the
      infantile form of Tay-Sachs disease and its apparent absence outside of Japan
      suggests that this mutation may have originated in Japan.

PMID- 8484766
TI  - Dynamic infrared imaging of cardiac pacemaker induction and cortical muscle
      contractions of embryonic avian heart.
AB  - The dynamic nature of electromagnetic (EM) pacemaker induction of cardiac tissue
      contractions in cultured embryonic avian heart was analyzed with noninvasive real
      time infrared (IR) imaging at normal physiological conditions. This technique was
      used to visualize the endogenous sarcomeric Ca2+ oscillation induced cortical IR
      EM radiation within an 8-12 micron IR emission spectra. The results reported here
      establishes the fact that cardiac energetics produce topographical IR-EM
      radiation that can be visualized directly without invasive dyes or external light
      sources to noninvasively study the mechanisms of striated muscle tissue
      morphogenesis. Since IR microscopy capitalizes on imaging the inherent radiation
      from biological molecules in tissue, no external light sources are needed to
      reflect a visual spectrum. These findings provide the framework for future
      noninvasive investigations and characterizations of the endogenous energetics in
      living cells.

PMID- 8484767
TI  - The primary structure of rat ribosomal protein L29.
AB  - The amino acid sequence of the rat 60S ribosomal subunit protein L29 was deduced
      from the sequence of nucleotides in a recombinant cDNA. Ribosomal protein L29 has
      155 amino acids, the NH2-terminal methionine is removed after translation of the
      mRNA, and has a molecular weight of 17,183. Hybridization of the cDNA to digests
      of nuclear DNA suggests that there are 20 to 22 copies of the L29 gene. The mRNA
      for the protein is about 750 nucleotides in length. Rat L29 is related to yeast
      ribosomal protein YL43.

PMID- 8484768
TI  - The primary structure of L37--a rat ribosomal protein with a zinc finger-like
      motif.
AB  - The amino acid sequence of the rat 60S ribosomal subunit protein L37 was deduced
      from the sequence of nucleotides in a recombinant cDNA. Ribosomal protein L37 has
      96 amino acids, the NH2-terminal methionine is removed after translation of the
      mRNA, and has a molecular weight of 10,939. Ribosomal protein L37 has a single
      zinc finger-like motif of the C2-C2 type. Hybridization of the cDNA to digests of
      nuclear DNA suggests that there are 13 or 14 copies of the L37 gene. The mRNA for
      the protein is about 500 nucleotides in length. Rat L37 is related to
      Saccharomyces cerevisiae ribosomal protein YL35 and to Caenorhabditis elegans
      L37. We have identified in the data base a DNA sequence that encodes the chicken
      homolog of rat L37.

PMID- 8484769
TI  - Biotransformation of pravastatin sodium (I). Mechanisms of enzymic transformation
      and epimerization of an allylic hydroxy group of pravastatin sodium.
AB  - One of the major metabolites, R-416(3'alpha-OH), of pravastatin sodium(PV, 6'beta
      OH), and a minor metabolite, R-418 (6'alpha-OH), were produced in rat liver
      cytosol in the presence of adenosine 3'-phosphate 5'-phosphosulfate as a
      cofactor. The reactions were inhibited by the inhibitors for sulfotransferases,
      and 18OH was introduced to the 3'alpha- and 6'alpha-positions of R-416 and R-418,
      respectively, by incubation with H2 18O. These results strongly suggested that PV
      was metabolically activated by sulfation at the 6'beta-hydroxy group by
      sulfotransferases, followed by nucleophilic attack of hydroxy anions at the
      3'alpha- or 6'alpha-position, to give R-416 or R-418, respectively.

PMID- 8484770
TI  - Early and selective induction of apoptosis in human leukemic cells by the alkyl
      lysophospholipid ET-18-OCH3.
AB  - We have found that the alkyl-lysophospholipid 1-octadecyl-2-methyl-rac-glycero-3
      phosphocholine (ET-18-OCH3) was able to induce apoptosis in human promyelocytic
      HL-60 leukemic cells, as evidenced by the internucleosomal degradation of the
      cellular DNA into the characteristic 180-200 bp DNA fragments. This effect was
      observed after short periods of cell incubation (6 h) with low doses of ET-18
      OCH3 (3 micrograms/ml). Furthermore, we found that ET-18-OCH3 also induced
      rapidly apoptosis in human promonocytic U937 leukemic cells. In contrast, 3T3
      fibroblasts were resistant to the alkyl-lysophospholipid. ET-18-OCH3 induced
      apoptotic cell death of tumor epithelial-like HELA cells, but this process
      required prolonged times of incubation. These data demonstrate that ET-18-OCH3
      promotes a rapid and selective programmed cell death in human leukemic cells,
      providing an explanation to the previously described cytotoxic effects of this
      compound on leukemic cells.

PMID- 8484771
TI  - Nitric oxide-regulated endogenous ADP-ribosylation of rod outer segment proteins.
AB  - Both membrane and cytosolic fractions of retinal rod outer segments contain ADP
      ribosylases that modify proteins in the respective fractions. Nitroprusside and
      endogenously produced NO regulate the activities of these ADP-ribosylases. The
      ADP-ribosylation of the membrane proteins of molecular weight 116K, 66K and 46K
      is inhibited by NO and nitroprusside, while that of the 38K cytosolic protein and
      the 39K membrane-associated protein is activated. The 39K protein is identified
      as the alpha-subunit of G-protein. The ADP-ribosylation of this protein is
      activated 6 to 11-fold by NO suggesting that NO may play a significant role in
      modulating the activity of G-protein in visual transduction.

PMID- 8484772
TI  - Mammalian mitochondrial DNA sequences can function as in vivo bacterial
      transcription terminators.
AB  - We have used a prokaryotic terminator identification vector, pDR721, to isolate
      regions from rat mitochondrial DNA (mtDNA) that can act as transcription
      terminators in vivo. Three independent fragments having terminator capability
      have been mapped to three general regions of the mitochondrial genome. Two
      terminators, pRMT1 and pRMT3, are found within and around the D-loop and
      cytochrome b gene, respectively, while the third, pRMT5, is located at the 3'-end
      of the 16S ribosomal RNA gene. After subcloning into host cells which carried
      temperature sensitive mutations in the termination factor, rho protein,
      galactokinase assays at the permissive and non-permissive temperatures suggested
      that pRMT3 acted as a rho-independent termination element while the other two,
      pRMT1 and pRMT5, were dependent on rho protein (or a rho-like protein) for
      efficient transcription termination.

PMID- 8484773
TI  - Polyamine regulation of S-adenosylmethionine decarboxylase synthesis through the
      5'-untranslated region of its mRNA.
AB  - The effect of the 5'-untranslated region (5'-UTR) of S-adenosylmethionine
      decarboxylase (SAMDC) mRNA and of polyamines on the translation of SAMDC mRNA was
      studied in a rabbit reticulocyte cell-free system. Using synthetic SAMDC mRNAs
      possessing different sizes of 5'-UTR, it was shown that nucleotides in the 5'-end
      of 5'-UTR were responsible for polyamine inhibition at high concentrations.
      Existence of the 5'-end nucleotides decreased SAMDC synthesis and slightly
      increased the degree of polyamine stimulation of the synthesis at low
      concentrations. When poly(A)+ RNA from mouse SAMDC-overproducing cells was used
      as mRNA, the degree of polyamine inhibition at high concentrations was nearly the
      same, but that of polyamine stimulation at low concentrations was greater than
      with synthetic SAMDC mRNAs. The reason for this difference is discussed.

PMID- 8484774
TI  - Analogues of butyric acid that increase the expression of transfected DNAs.
AB  - Butyric acid has many strong effects on gene expression in mammalian and viral
      systems, as well as in increasing the expression of recombinant DNAs artificially
      introduced into cultured cells. We screened 14 analogues of butyric acid for
      their ability to upregulate expression from 3 different recombinant
      chloramphenicol acetyltransferase expression vectors stably integrated into NIH
      3T3 cells that had been transformed by calcium phosphate transfection or
      electroporation. Butyric acid, 2-bromobutyric acid, 3-bromopropionic acid, 3
      mercaptopropionic acid, vinylacetic acid, and butyraldehyde were found to
      upregulate human immunodeficiency viral long terminal repeat-, SV40 early gene
      promoter-, and glucocerebrosidase promoter-directed expression of heterologous
      genes in cultured cells. Three other analogues had lesser effects; and 6
      additional analogues had very little, if any, effect.

PMID- 8484775
TI  - Molecular characterisation of a human aryl sulfotransferase cDNA.
AB  - A full-length aryl sulfotransferase cDNA was isolated from a human liver cDNA
      library. It was 1155 bp long containing a coding region of 885 basepairs encoding
      a cytosolic protein (M(r) 34178 Da) of 295 amino acids. This human cDNA shared
      80% homology to the rat aryl sulfotransferase cDNA, 58% to the bovine and rat
      oestrogen sulfotransferase cDNAs, 53% to the rat hydroxysteroid sulfotransferase
      cDNA and 51% to the human liver dehydroepiandrosterone sulfotransferase cDNA over
      its whole 885 bp coding region. The deduced amino acid sequence of this human
      cDNA was 79% homologous to that of the rat aryl sulfotransferase cDNA and the
      putative common-substrate binding site motif GXXGXXK of the sulfotransferases has
      been conserved in this human amino acid sequence. At least two sizes of this
      human aryl sulfotransferase mRNA were detected in the human liver and lung.

PMID- 8484776
TI  - Activation of MCP-1 gene expression is mediated through multiple signaling
      pathways.
AB  - Multiple signal transduction pathways including protein kinase C, tyrosine
      phosphorylation, and an independent third signaling mechanism are involved in the
      activation of monocyte chemotactic protein-1 gene. Northern blot analysis showed
      that the incubation of endothelial cell with dioctanoylglycerol induced maximum
      level of monocyte chemotactic protein-1 transcripts. The TPA-induced monocyte
      chemotactic protein-1 expression was abolished by treating the cells with both
      staurosporine and genistein; however, only a portion of the LPS-induced
      expression was inhibited by staurosporine/genistein. This is in accordance with
      the observation that LPS induced the expression of monocyte chemotactic protein-1
      in desensitized cells. Thus, a third signal transduction pathway other than
      protein kinase C or tyrosine kinase is involved in the LPS-induced monocyte
      chemotactic protein-1 expression in human endothelial cell.

PMID- 8484777
TI  - Thiol groups are involved in NADH-ascorbate free radical reductase activity of
      rat liver plasma membrane.
AB  - Plasma membranes purified by two-phase partition from rat liver showed an NADH
      ascorbate free radical reductase activity of about 14 nmoles NADH oxidized/min/mg
      protein. This activity was inhibited by N-ethyl maleimide, iodoacetate and
      iodoacetamide, reagents that covalently block thiol groups. NADH-ascorbate free
      radical reductase was also inhibited by reduced glutathione and the inhibitions
      observed with blocking reagents and reduced compounds were additive. These
      results support the involvement of sulphydryl groups in NADH-AFR reductase and
      point out the idea that a balance between reduced sulfhydryls and oxidized
      disulfides is required for the optimal function of this activity, considered as
      part of the transplasma membrane electron transport system.

PMID- 8484778
TI  - p53 gene is up-regulated during skeletal muscle cell differentiation.
AB  - Differentiation of cells in the mouse myogenic cell line C2, or a primary culture
      of chicken satellite cells was induced by low serum levels in the growth medium.
      Endogenous wild-type p53 mRNA was substantially expressed after approximately 5 h
      of incubation. Induction of p53 mRNA expression was also observed in cells
      treated with 10(-8) M retinoic acid, after 18 h of incubation. In both cases, the
      increase in p53 mRNA was transient. c-fos mRNA levels decreased rapidly and were
      barely detectable after 2 h of exposure to retinoic acid. The down-regulation of
      c-fos confirms its role in muscle cell differentiation, whereas the up-regulation
      of wild-type p53 suggests its role during this process.

PMID- 8484779
TI  - Bacterially expressed murine CSF-1 possesses agonistic activity in its monomeric
      form.
AB  - CSF-1 is a dimeric peptide growth factor, stabilized by disulfide bonds. We
      expressed mouse CSF-1 in bacteria as a fusion protein either with glutathione S
      transferase (GST) or with a six histidine tag (His-tag). Large amounts of
      recombinant material were obtained and purified by a single affinity
      chromatography step. Purified CSF-1-His-tag monomers efficiently dimerized in
      vitro, but the presence of variable amounts of GST-moiety in CSF-1 preparations
      obtained by thrombin cleavage of GST-fusion proteins (thrombin-released CSF-1)
      interfered with dimerization. However, the thrombin-released CSF-1 monomers
      possessed agonistic activity, being capable of stimulating tyrosine
      phosphorylation of the CSF-1 receptor and of an array of cellular proteins in
      living macrophages and of supporting their growth. These results show that CSF-1
      dimerization is not essential for receptor activation in vivo.

PMID- 8484780
TI  - Comparison of the disulfide bond arrangements of human recombinant and bovine
      brain heparin binding neurite-promoting factors.
AB  - Heparin binding neurite-promoting factor (HBNF) is a highly basic 136 amino acid
      protein containing 10 cysteine residues. We have determined the redox status and
      the disulfide arrangement of the cysteine residues in HBNF from bovine brain and
      refolded human recombinant protein produced in E. coli. Our data indicate that
      all 10 cysteines are involved in disulfide bond formation. The disulfide linkages
      of human recombinant and bovine brain HBNF, as determined after proteolytic
      digestions of the non-reduced proteins by peptide mapping and sequence analysis
      are: Cys15-Cys44, Cys23-Cys53, Cys30-Cys57, Cys67-Cys99 and Cys77-Cys109. Thus,
      recombinant HBNF has the same disulfide arrangement as the native brain-derived
      protein.

PMID- 8484781
TI  - Identification of active-site residues in Aspergillus ficuum extracellular pH 2.5
      optimum acid phosphatase.
AB  - Primary structure elucidation of peptides generated by cyanogen bromide,
      endoproteinase Glu-C, and clostripain cleavage of an Aspergillus ficuum
      extracellular pH optimum 2.5 acid phosphatase identified a region which contains
      the active site of the enzyme. The 23-residue segment contains the fragment
      RHGXRXP, which is homologous to acid phosphatase from Saccharomyces spp.,
      Aspergillus ficuum, mammals, and bacteria. Homologous or conservative
      substitutions are observed in the 10-amino acid fragment preceding this region.

PMID- 8484782
TI  - Thioredoxin from activated macrophages as a trophic factor for central
      cholinergic neurons in vitro.
AB  - The conditioned medium from gamma-interferon-stimulated macrophages elevated the
      choline acetyltransferase activity in mouse septal neurons as well as in
      cholinergic hybrid cell lines SN6.10.2.2 in vitro. After purification and
      sequencing, the active fraction was identical to thioredoxin (TRX), and the
      neurotrophic activity of recombinant TRX was confirmed.

PMID- 8484783
TI  - Strand breaks in DNA induced by a thiol/Fe(III)/O2 mixed-function oxidase system
      and its protection by a yeast antioxidant protein.
AB  - Strand breaks can be produced in pBluescript plasmid DNA and calf thymus DNA by a
      mixed-function oxidase (MFO) system comprised of Fe3+, O2, and dithiothreitol as
      an electron donor. Superoxide dismutase does not block this damage whereas a 27
      KDa yeast antioxidant protein specifically inhibits strand breaks in DNA induced
      by the dithiothreitol MFO system. In contrast, this protein does not inhibit
      strand breaks in DNA induced by an ascorbate MFO system although catalase
      inhibits damage in DNA caused by both MFO systems. Based on the specificity of
      this protein, we propose that the antioxidant protein functions as a sulfur
      radical scavenger.

PMID- 8484784
TI  - Differentiation of monocytoid THP-1 cells with phorbol ester induces expression
      of prostaglandin endoperoxide synthase-1 (COX-1).
AB  - Prostaglandin endoperoxide synthase (PGH synthase) is responsible for converting
      arachidonic acid to PGH2, the common precursor of prostaglandins. It has been
      shown previously that phorbol ester-induced differentiation of the THP-1 human
      monocytic leukemia cell line is accompanied by induction of PGH synthase enzyme
      and enhanced capacity to produce prostaglandins. However, the identity of the
      isoform of PGH synthase that is induced under these conditions has not been
      established. Northern and Western analyses revealed a dramatic increase in levels
      of PGH synthase-1 mRNA and protein levels within 24 hr after treatment of THP-1
      cells with phorbol ester. No significant increase in PGH synthase-2 mRNA or
      protein was observed. The increases in PGH synthase-1 were accompanied by
      enhanced capacity of the cells to produce PGE2. These findings indicate that
      expression of PGH synthase-1 is greatly enhanced in THP-1 cells by treatment with
      an agent that induces differentiation.

PMID- 8484785
TI  - Lipoproteins induce expression of the early growth response gene-1 in vascular
      smooth muscle cells from rat.
AB  - Recently, we reported that low-density lipoprotein (LDL) induces in vascular
      smooth muscle cells (VSMCs) intracellular effects such as an elevation of
      intracellular free Ca2+ concentration ([Ca2+]i) and intracellular pH (pHi). The
      early growth response gene-1 (Egr-1) has been identified as a transcription
      factor belonging to a class of immediate-early genes expressed upon growth,
      and/or differentiation signals in a large variety of cells and species. Here we
      show that LDL induces a dose-dependent expression of the Egr-1 mRNA with a
      maximum at 30 min. Experiments in the presence of the dihydropyridine calcium
      blocker isradipine suggest that the lipoprotein-induced Egr-1 mRNA induction
      occurs via a Ca2+ dependent pathway. To demonstrate whether these intracellular
      responses are only specific to LDL we examined the effects of high- and very low
      density lipoprotein (HDL and VLDL) on [Ca2+]i and expression of Egr-1 mRNA. The
      present results show that all lipoproteins induce expression of Egr-1 mRNA and
      elevation in [Ca2+]i in VSMCs.

PMID- 8484786
TI  - Induction of differential heat shock gene expression in heart, lung, liver, brain
      and kidney by a sympathomimetic drug, amphetamine.
AB  - Amphetamine, a sympathomimetic drug, can elevate the body temperature by causing
      enhancement of endogenous lipolysis. This study was designed to examine whether
      this drug could induce the expression of the genes of heat shock proteins (HSP)
      in different tissues. Subcutaneous administration of amphetamine (10 mg/kg wt) to
      the rats increased the rectal temperature of the rats to 42 degrees C within 60
      min. After 3 hr rats were sacrificed; and heart, lung, liver, kidney and brain
      tissue were removed to examine the induction of mRNAs for HSPs by Northern blot
      analysis using cDNA probes of 27 kDa, 70 kDa and 89 kDa HSPs. The results of this
      study indicate striking regional and cell type differences in the pattern of
      induction of the HSP mRNAs by amphetamine suggesting that different organs and
      cell types respond differently to amphetamine.

PMID- 8484787
TI  - Functional genes found for three different plant ferritin subunits in the legume,
      Vigna unguiculata.
AB  - The iron storage protein, ferritin, in plants can occur in multiple molecular
      forms that, until now, were proposed to be derived from degradation of a single
      mature polypeptide subunit (2,7,17), which is assembled into the holoprotein and
      functions in plastids. We have carried out some definitive experiments with the
      diploid legume, Vigna unguiculata (cowpeas), which show that there are
      functioning genes for three different ferritin subunits in the developing leaves.
      Unique segments of mRNAs which code for subunits with substantially different
      mature sequences were detected by PCR. Separate genes for each subunit were found
      by showing that each gene contained a unique intron. Thus, multiple molecular
      forms of ferritin can arise through differential expression of a family of genes
      in plants.

PMID- 8484788
TI  - Strong promoter activity of human and rat islet amyloid polypeptide/amylin gene
      constructs in mouse beta cells (beta TC 3).
AB  - Islet amyloid polypeptide (IAPP)('amylin') is co-produced with insulin in
      pancreatic beta cells and is the formative polypeptide of pancreatic amyloid in
      patients with type 2 (non-insulin-dependent) diabetes mellitus. Islet amyloid and
      type 2 diabetes occur in man, but not in rat. To study transcription regulation
      of IAPP gene expression in man and rat, luciferase reporter constructs containing
      different portions of the upstream region of both IAPP genes were expressed in
      transfected cells. Both the human and the rat IAPP gene constructs revealed
      higher promoter activity in beta cells (particularly in beta TC3 cells) than in
      non-beta cells. In both IAPP genes potential transcription elements, with
      homology to insulin gene transcription elements, were identified. beta TC3 cells
      provide a good model system in which to study regulation of human and rat IAPP
      gene expression.

PMID- 8484789
TI  - The primary structure of rat ribosomal protein L36.
AB  - The amino acid sequence of the rat 60S ribosomal subunit protein L36 was deduced
      from the sequence of nucleotides in a recombinant cDNA. Ribosomal protein L36 has
      104 amino acids, the NH2-terminal methionine is removed after translation of the
      mRNA and has a molecular weight of 12,128. Hybridization of the cDNA to digests
      of nuclear DNA suggests that there are 8 to 11 copies of the L36 gene. The mRNA
      for the protein is about 500 nucleotides in length. Rat L36 is related to yeast
      ribosomal protein YL39.

PMID- 8484790
TI  - Mitochondrial Ca2+ uptake at submicromolar [Ca2+]i in permeabilised pancreatic
      acinar cells.
AB  - We studied the uptake of Ca2+ in different intracellular Ca2+ pools by use of
      steady-state measurement of 45Ca2+ in a preparation of digitonin-permeabilized
      pancreatic acinar cells. The Ca2+ content of all intracellular pools was assessed
      at different free Ca2+ concentrations between 0.1 and 1 microM. At low Ca2+
      concentrations, almost 50% of Ca2+ was taken up, ATP-dependent, in a non
      mitochondrial pool. Even at 0.1 microM free Ca2+ the mitochondrial Ca2+ pool
      contained 26% (3.4 +/- 0.8 nmol Ca2+/mg prot) of the total Ca2+ and this
      percentage was increased to 49% at 1 microM Ca2+ (16.7 +/- 1.1 nmol Ca2+/mg
      prot). Our data also show that the uptake into the non-mitochondrial pool can be
      further differentiated on the basis of ATP-dependence, and that the ATP
      independent uptake has a biphasic dependency on the free Ca2+ concentration.

PMID- 8484791
TI  - Epidermal growth factor and isoproterenol stimulation of the Ras-guanine
      nucleotide exchange factor in proliferating rat parotid gland acinar cells.
AB  - Chronic treatment of rat parotid gland acinar cells with either epidermal growth
      factor (EGF) or the beta-adrenergic receptor agonist isoproterenol leads to cell
      proliferation through activation of the tyrosine kinase second messenger
      signalling pathway. Activation of p21ras activity in acinar cells was evaluated
      by measuring the levels of protein bound GTP and GDP. Both EGF and isoproterenol
      increased the amount of p21ras-GTP complex during active proliferation. The
      increase in bound GTP appears to be the result of an increased activity for the
      Ras-guanine nucleotide exchange factor.

PMID- 8484792
TI  - Interaction of dystrophin with cytoskeletal proteins: binding to talin and actin.
AB  - Dystrophin, the protein product of the Duchenne gene, is thought to be a member
      of muscle membrane cytoskeleton. In this work we studied the interactions of
      purified dystrophin from rabbit skeletal muscle sarcolemma membranes with other
      cytoskeletal proteins. The interaction of dystrophin with purified talin from
      chicken gizzard was tested by solid phase immunoassay. Under these conditions
      dystrophin bound talin with high affinity (Kd 3.5 nM). Vinculin purified from
      chicken gizzard did not bind dystrophin, but it inhibited the binding of
      dystrophin to talin. Furthermore, co-sedimentation and solid phase immunoassay
      experiments both demonstrated that native dystrophin binds purified actin from
      rabbit skeletal muscle. In conclusion, our results show that dystrophin can
      interact in vitro with proteins that are members of muscle membrane cytoskeleton.
      These proteins may represent additional sites for anchoring dystrophin to
      sarcolemma.

PMID- 8484793
TI  - Mutation of arginine 86 to proline in the insulin receptor alpha subunit causes
      lack of transport of the receptor to the plasma membrane, loss of binding
      affinity and a constitutively activated tyrosine kinase in transfected cells.
AB  - We have investigated the role of Ser 85 and Arg 86 of the human insulin receptor
      (HIR) in insulin binding and tyrosine kinase activity by mutational analysis.
      Four mutant cDNAs were created (R86P, R86N, S85T+R86N, S85W+R86K) and stably
      transfected into BHK cells. R86P-HIR was also transiently expressed in 293 cells.
      Only the R86P receptor had substantially altered properties: lack of transport to
      the plasma membrane, loss of insulin binding, a constitutively activated
      autophosphorylation and tyrosine kinase, and an incomplete processing. Some of
      these alterations mimic those reported for the insulin receptor of the leprechaun
      Atl, which has a homozygous R86P mutation (Longo, N., et al, Biochem. Biophys.
      Res. Commun., 167, 1229, 1990; Clin. Res., 40, 2, 329, 1992).

PMID- 8484794
TI  - Effect of sulfhydryl reagents on spectrin states on the erythrocyte membrane.
AB  - The unique properties of erythrocytes are largely determined by its fibrillar
      network under the plasma membrane. Spectrin, one major component of the membrane
      skeleton, has been suggested to play a central role in this process. To
      understand the mechanism underlying this process, the effect of the sulfhydryl
      groups of erythrocyte membrane on spectrin structure and function was studied. By
      using non-denaturing gel analysis, dithiothreitol was found to protect spectrin
      in its tetramer state. In contrast, iodoacetamide and N-ethylmaleimide enhanced
      conversion of the spectrin tetramer to dimer and decreased its binding to the
      membrane. Moreover, when the membrane was treated with cadmium, the tetramer was
      converted to the dimer on the membrane, while zinc had no effect. Hemolysis
      experiments showed that cadmium could lyse erythrocytes in vitro. These results
      indicated that preservation of the spectrin tetramer or even higher oligomer
      states, by the sulfhydryl groups may be important to the membrane integrity and
      the intact cell functions.

PMID- 8484795
TI  - Recombinant f1 phage particles can transfect monkey COS-7 cells by DEAE dextran
      method.
AB  - Recombinant f1 phage particles containing cDNA of the human urokinase type
      plasminogen activator (u-PA) under the control of the simian virus 40 (SV40)
      early promoter were used for transfection of monkey COS-7 cells using a DEAE
      dextran method. The fibrinolytic activity of u-PA was detected in the culture
      medium of the 10(5) cells transfected with the phage particles containing single
      stranded (ss) DNA of more than 0.2 ng. This finding will lead us to develop a
      simple and efficient method for expression cloning using mammalian cells.

PMID- 8484796
TI  - Facile cloning and sequence analysis of goose delta-crystallin gene based on
      polymerase chain reaction.
AB  - To facilitate the cloning of delta-crystallin gene, the product of which is a
      major lens protein present in the avian and reptilian lenses, polymerase chain
      reaction (PCR) was employed to amplify cDNAs constructed from the poly(A)+RNA of
      goose lenses. The PCR product was then subcloned into pUC19 vector and
      transformed in E. coli strain JM109. Plasmids purified from the positive clones
      were prepared for nucleotide sequencing by dideoxynucleotide chain-termination
      method. Sequencing several clones containing 1.4 kb DNA inserts encoding delta
      crystallin constructed a complete and unambiguous full-length reading frame of
      1401 base pairs covering a deduced protein sequence of 465 amino acids excluding
      the universal translation-initiating methionine. The goose delta-crystallin shows
      88, 94, 88 and 69% sequence identity to pigeon delta, duck delta 2, chicken delta
      1 crystallins and human argininosuccinate lyase respectively. It is also shown
      that, similar to duck delta 2 and in contrast to pigeon delta crystallin, goose
      delta-crystallin appears to possess high argininosuccinate lyase activity despite
      the fact that a highly homologous structure is shared among these homologous
      proteins. Structural analysis and comparison of these closely related delta
      crystallin homologues with or without enzymatic activity should be of value in
      unraveling the intriguing evolutionary process leading to the development and
      evolution of active enzymatic crystallins in the lenses of certain avian species.

PMID- 8484797
TI  - Salen-manganese complexes are superoxide dismutase-mimics.
AB  - Complexes of manganese have previously been shown to exhibit SOD activity. In
      this study, we tested the ability of several (salen)-manganese complexes to
      scavenge O2.. Both neutral and cationic complexes were determined to be SOD
      mimics. The activity of the complexes was not affected by the presence of bovine
      serum albumin in the assay. For most compounds, the activity was inhibited by the
      addition of EDTA. The stability and high catalytic activity of some of these
      molecules suggest that they might have potential use in a variety of conditions
      which involve overproduction of oxygen free radicals.

PMID- 8484798
TI  - Catalytic properties and stability of a Pseudomonas sp.101 formate dehydrogenase
      mutants containing Cys-255-Ser and Cys-255-Met replacements.
AB  - Two mutants of bacterial formate dehydrogenase from Pseudomonas sp.101 (EC
      1.2.1.2, FDH)-C255S (FDH-S) and C255M (FDH-M), were obtained and its properties
      were studied. Both mutations provided the high resistance to inactivation by
      Hg2+. Slow inactivation of mutants by DTNB reveals the presence in FDH molecule
      of another essential cysteine residue. Specific activities of FDH, FDH-S and FDH
      M were 16, 16 and 9.5 U/mg of protein, respectively. Km on formate was 7.5, 7.5
      and 20 mM and Km on NAD(+)-0.1, 0.3 and 0.6 mM for FDH, FDH-S and FDH-M,
      respectively. Mutations of Cys255 on Ser or Met resulted in increasing of enzyme
      stability at 25 degrees C and decreasing of thermostability (above 45 degrees C).
      Data obtained show that Cys255 is unique residue for providing both enzyme
      thermostability and catalytically optimal binding of coenzyme.

PMID- 8484799
TI  - Maintenance and induction in co-cultured rat hepatocytes of components of the
      cytochrome P450-mediated mono-oxygenase.
AB  - Hepatocytes grown in culture rapidly lose many of the cytochromes P450 (CYP)
      responsible for metabolizing foreign compounds. Among the proteins most readily
      lost are members of the CYP2B subfamily. We have investigated, by RNase
      protection assays, the ability of rat hepatocytes, cultured conventionally or co
      cultured with rat liver epithelial cells, to maintain the expression of genes
      encoding members of the CYP2B subfamily, and the inducibility of this expression
      by phenobarbital. After 4 days of conventional hepatocyte culture CYP2B mRNAs
      were undetectable, but remained inducible by phenobarbital. In co-cultured
      hepatocytes the abundance of the mRNAs remained relatively constant from 4-14
      days. After 7 days of co-culture the concentration of the mRNAs was increased 12
      15-fold by phenobarbital. RNase protection assays with probes capable of
      distinguishing between CYP2B1 and 2B2 mRNAs demonstrated that the ratios of the
      abundance and inducibility of the two mRNAs were the same in co-culture as in
      vivo. Co-cultured hepatocytes also maintained the expression of genes coding for
      two other components of the cytochrome P450-mediated mono-oxygenase, namely
      cytochrome P450 reductase and cytochrome b5.

PMID- 8484800
TI  - Uptake of acetaminophen (paracetamol) by isolated rat liver cells.
AB  - The characteristics of the uptake of acetaminophen (N-acetyl-p-aminophenol or
      paracetamol, APAP) in incubations of isolated rat liver cells were consistent
      with diffusion of the drug being the predominant mechanism of APAP influx in
      these cells at concentrations above 0.5 mM. At lower substrate concentrations
      (below 0.5 mM) a saturable component was apparent. Both uptake processes could
      have a role in the control of the metabolism of APAP, because, at low
      concentrations, there was no intracellular accumulation of unconjugated drug, all
      the APAP entering the cell being converted to sulphate and glucuronide. After
      addition of drug, there was a lag phase of approximately 5 min before APAP
      glucuronide and APAP-sulphate appeared in the incubation medium; during this time
      both conjugates accumulated inside the cells. These results have implications for
      our understanding of the mechanisms of APAP transport, and indicate how these
      processes may affect the drug's overall metabolism.

PMID- 8484801
TI  - Structure-activity relationships of cysteine esters and their effects on thiol
      levels in rat lung in vitro.
AB  - Pretreatment with cysteine esters increases cysteine (CySH) levels in rat lung
      and protects against the lethal effects of inhaled perfluoroisobutene in vivo.
      There are marked differences in the duration of protection achieved with
      different cysteine esters. In this study we have compared the uptake and
      metabolism of CySH, N-acetyl cysteine (NAc), cysteine esters and cystine esters
      in vitro using rat lung and liver homogenates and lung slices. Liver homogenates
      metabolized CySH and cysteine esters faster than lung homogenates. The half life
      (T1/2) of CySH in lung was 58.8 +/- 17.3 min and in liver was 14.0 +/- 1.6 min
      (mean +/- SEM). T1/2 of the esters in lung ranged between 6.5 and 12.1 min and in
      liver between 1.9 and 5.3 min. Cysteine tertiary butyl ester, which does not
      protect in vivo, was not hydrolysed to CySH by lung or liver homogenates. All
      esters increased and prolonged intracellular CySH concentrations in lung slices
      to a much greater extent than CySH itself. NAc did not raise intracellular CySH
      above that of the controls and no NAc appeared within the slice. After CySH
      incubation intracellular CySH was 0.9 +/- 0.1 nmol/mg wet wt at 10 min whereas
      after incubation with the esters it ranged between 2.60 and 3.65 nmol/mg wet wt.
      Cysteine cyclohexyl ester prolonged the increase of CySH the longest and cysteine
      methyl ester the shortest. CySH levels with cysteine cyclohexyl ester were 2.74
      +/- 0.15 and 4.13 +/- 0.37 nmol/mg wet wt at 10 and 60 min, respectively, whereas
      with cysteine methyl ester, CySH levels were 2.60 +/- 0.5 and 1.25 +/- 0.08
      nmol/mg wet wt at similar times. Cystine esters increased intracellular
      concentrations of both cystine and CySH. CySH concentrations ranged between 2.92
      and 3.19 nmol/mg wet wt and cystine between 1.39 and 1.47 nmol/mg wet wt at 60
      min. The elevation and duration of CySH in lung slices is well correlated with
      the duration of protection against perfluoroisobutene achieved in vivo.

PMID- 8484802
TI  - Derivatives of cinnamic acid interact with the nucleotide binding site of
      mitochondrial aldehyde dehydrogenase. Effects on the dehydrogenase reaction and
      stimulation of esterase activity by nucleotides.
AB  - A wide variety of cinnamic acid derivatives are inhibitors of the low Km
      mitochondrial aldehyde dehydrogenase. Two of the most potent inhibitors are alpha
      cyano-3,4-dihydroxythiocinnamamide (Ki0.6 microM) and alpha-cyano-3,4,5
      trihydroxycinnamonitrile (Ki2.6 microM). With propionaldehyde as substrate the
      inhibition by these compounds was competitive with respect to NAD+. alpha
      Fluorocinnamate was a much less effective inhibitor of the enzyme, with mixed
      behaviour towards NAD+, but with a major competitive component. These cinnamic
      acid derivatives were ineffective as inhibitors of the aldehyde dehydrogenase
      catalysed hydrolysis of p-nitrophenyl acetate, but inhibited the ability of NAD+
      and NADH to activate this activity. Inhibition of the stimulation of esterase
      activity was competitive with respect to NAD+ and NADH, and the derived Ki values
      were the same as for inhibition of dehydrogenase activity. NAD+, but not
      acetaldehyde, could elute the low Km aldehyde dehydrogenase from alpha
      cyanocinnamate-Sepharose, to which the enzyme binds specifically (Poole RC and
      Halestrap AP, Biochem J 259: 105-110, 1989). The cinnamic acid derivatives have
      little effect on lactate dehydrogenase, glyceraldehyde-3-phosphate dehydrogenase
      or a high Km aldehyde dehydrogenase present in rat liver mitochondria. It is
      concluded that some cinnamic acid derivatives are potent inhibitors of the low Km
      aldehyde dehydrogenase, by competing with NAD+/NADH for binding to the enzyme.
      They are much less effective as inhibitors of other NAD(+)-dependent
      dehydrogenases.

PMID- 8484803
TI  - Contribution of 4-methylthio-2-oxobutanoate and its transaminase to the growth of
      methionine-dependent cells in culture. Effect of transaminase inhibitors.
AB  - The growth in culture of methionine-dependent transformed cells of human, rat and
      mouse origin was arrested in the absence of L-methionine (Met) but took place in
      the presence of 4-methylthio-2-oxobutanoic acid (MTOB), the keto acid of Met.
      From 24 hr after seeding, cells grew in 0.1 mM MTOB medium at a rate comparable
      to that in 0.1 mM Met medium. Using [35S]MTOB, it was found that the Met
      synthesized was used in normal MRC-5 cells and in transformed HeLa cells to the
      same extent for protein, adenosylmethionine and adenosylhomocysteine syntheses.
      However, when the free Met content was examined, it was found to be 3-fold
      greater in HeLa than in MRC-5 cells. To examine the importance of this free Met
      for the growth of transformed cells, the transaminase responsible for converting
      MTOB to Met was chosen as a target enzyme for the synthesis of compounds with
      potential inhibitory activity. Since this is a multisubstrate enzyme, reduced
      Schiff bases were prepared containing both pyridoxal or other aromatic groups, as
      one constituent, and L-Met or other amino-acids in the free acid or ester or
      amide form, as the other constituent. Only esters containing the pyridoxal moiety
      and Met or certain of its structural analogues exhibited good selective growth
      inhibitory activity in that there was little (20%) or no effect on the growth of
      normal MRC-5 and derm cells, respectively, while that of transformed HeLa, HEp-2
      and L1210 cells was strongly inhibited (80%). This inhibition was accompanied by
      a concomitant decrease in the activity of the MTOB transaminase in both HeLa and
      MRC-5 cells treated with 3c the most potent inhibitor. However, using [35S]MTOB
      it was found that MTOB itself accumulated 48% in HeLa but only 12% in MRC-5 cells
      treated with 3c. On the contrary [35S]Met formed from [35S]MTOB increased 3.7
      fold in MRC-5 inhibitor-treated cells showing 20% growth inhibition whereas it
      decreased 38% in HeLa-treated cells showing 80% growth inhibition. This decrease
      in cellular Met in HeLa is not responsible for growth arrest. Indeed the growth
      of HeLa cells could not be restored by adding a 10-fold excess of Met. Since MTOB
      can alleviate Met-dependence, the intracellular homeostasis of this metabolite
      may play a hitherto unsuspected role in controlling cell growth.

PMID- 8484804
TI  - Evidence that rat liver microsomal glutathione transferase is responsible for
      glutathione-dependent protection against lipid peroxidation.
AB  - Evidence that rat liver microsomal glutathione transferase is responsible for the
      glutathione-dependent inhibition of lipid peroxidation in liver microsomes has
      been obtained. Activation of the microsomal glutathione transferase in microsomes
      by cystamine renders this organelle even more resistant to lipid peroxidation in
      the presence of glutathione compared with untreated microsomes. Upon examining
      the effect of seven glutathione analogues on lipid peroxidation, it was found
      that only those that serve as good substrates for the microsomal glutathione
      transferase (Glutaryl-L-Cys-Gly and alpha-L-Glu-L-Cys-Gly) can inhibit lipid
      peroxidation. The lack of inhibition by the other five analogues (alpha-D-Glu-L
      Cys-Gly, gamma-D-Glu-L-Cys-Gly, beta-L-Asp-L-Cys-Gly, alpha-L-Asp-L-Cys-Gly and
      alpha-D-Asp-L-Cys-Gly) shows the specificity of the protection and rules out any
      non-enzymic component. Inhibitors of selenium-dependent glutathione peroxidase
      (mercaptosuccinate at 50 microM) and phospholipid hydroperoxide glutathione
      peroxidase (iodoacetate, 1 mM + glutathione, 0.5 mM) do not inhibit the
      glutathione-dependent protection of rat liver microsomes against lipid
      peroxidation. Purified microsomal glutathione transferase, NADPH-cytochrome P450
      reductase and cytochrome P450 were reconstituted in microsomal phospholipid
      vesicles by cholate dialysis. The resulting membranes contained functional
      enzymes and did display enzymic lipid peroxidation induced by 75 microM NADPH and
      10 microM Fe-EDTA (2:1). This model system was used to investigate whether
      microsomal glutathione transferase could inhibit lipid peroxidation in a
      glutathione-dependent manner. The results show that 5 mM glutathione did inhibit
      lipid peroxidation when functional microsomal glutathione transferase was
      included. This was not the case when the enzyme had been pre-inactivated with
      diethylpyrocarbonate. Furthermore, the protective effect of glutathione could be
      partly reversed by an inhibitor (100 microM bromosulphophtalein) of the enzyme.
      Apparently, rat liver microsomal glutathione transferase has the capacity to
      inhibit lipid peroxidation in a reconstituted system.

PMID- 8484805
TI  - An unusual profile of musk xylene-induced drug-metabolizing enzymes in rat liver.
AB  - We have demonstrated previously that musk xylene, a non-mutagenic carcinogen, is
      a novel and specific inducer of CYP1A2 in rats (Iwata et al., Biochem Biophys Res
      Commun 184: 149-153, 1992). In the present study, the effects of musk xylene (50,
      100 or 200 mg/kg body weight, i.p., for 5 consecutive days) on both Phase I and
      Phase II metabolizing enzymes in rat liver were investigated further and more
      completely. Among the mixed-function oxidases monitored, 7-ethoxycoumarin
      deethylase and 7-pentoxyresorufin depentylase activities were increased at all
      dose levels from 1.6- to 1.7-fold and 2.6- to 3.1-fold, respectively.
      Benzo[a]pyrene hydroxylase activity was increased significantly at only the 200
      mg/kg dose level of musk xylene (1.5-fold). Regarding Phase II enzymes,
      activities of both cytosolic DT-diaphorase and glutathione S-transferase (GST)
      were increased up to 2.0- to 2.4-fold by musk xylene in a dose-dependent manner.
      Western blot analysis revealed that the changes in these activities were caused
      by increases in the amounts of DT-diaphorase and GST Ya subunit. Microsomal UDP
      glucoronyltransferase (UDPGT) activity assayed with p-nitrophenol as substrate
      was increased 1.6- to 2.0-fold. These results show that musk xylene induces both
      Phase I cytochrome P450 mixed-function oxidase (CYP1A2 specific) and Phase II
      metabolizing enzyme systems (DT-diaphorase, GST Ya subunit and UDPGT) in rat
      liver.

PMID- 8484806
TI  - Early response gene induction following DNA damage in astrocytoma cell lines.
AB  - Early response genes (ERGs) are a group of genes with low or absent expression in
      quiescent cells that can be induced rapidly by a variety of proliferation and
      differentiation stimuli. c-jun and c-fos are prototypes for this group of genes.
      Recent evidence suggests that DNA damaging agents such as cytotoxic drugs and
      ionizing radiation can elicit strong ERG induction, suggesting that these genes
      may be involved in DNA damage repair and/or cell death. Paralleling this interest
      in drug-induced ERG expression is a growing body of evidence implicating ERG
      expression as important to the intrinsic function of the central nervous system.
      We therefore set out to explore the pattern of chemotherapeutic drug- and
      radiation-induced c-jun and c-fos expression in neuroectodermally (astrocytic)
      derived cell lines. We have demonstrated that various chemotherapeutic agents and
      ionizing radiation can induce c-jun in a time- and concentration-dependent
      manner. Furthermore, this induction can be prevented by pretreatment of the cells
      with agents that protect against DNA damage. Finally, we have demonstrated that c
      fos and c-jun expression and induction are discoordinately regulated, reflecting
      a difference in astrocytic cell lines compared to hematopoietic cell lines. The
      possible relevance of these observations to the clinical resistance of astrocytic
      tumors to standard chemotherapy and radiation is discussed.

PMID- 8484807
TI  - Activation of the anti-cancer drug ifosphamide by rat liver microsomal P450
      enzymes.
AB  - The NADPH-dependent metabolism of ifosphamide catalyzed by rat liver microsomes
      was investigated in order to identify individual P450 enzymes that activate this
      anti-cancer drug and to ascertain their relationship to the P450 enzymes that
      activate the isomeric drug cyclophosphamide. Pretreatment of rats with
      phenobarbital or clofibrate increased by up to 8-fold the activation of both
      ifosphamide and cyclophosphamide catalyzed by isolated liver microsomes. Studies
      using P450 form-selective inhibitory antibodies demonstrated that constitutively
      expressed P450s belonging to subfamily 2C (forms 2C11/2C6) make significant
      contributions to the activation of both oxazaphosphorines in uninduced male rat
      liver microsomes, while the phenobarbital-inducible P450 2B1 was shown to be a
      major catalyst of these activations in phenobarbital-induced microsomes.
      Pretreatment of rats with dexamethasone increased liver microsomal activation of
      ifosphamide approximately 6-fold without a corresponding effect on
      cyclophosphamide activation rates. Ifosphamide activation catalyzed by
      dexamethasone-induced liver microsomes was minimally inhibited by anti-P450 2B or
      anti-P450 2C antibodies, but was selectively inhibited by anti-P450 3A
      antibodies. Selective inhibition of liver microsomal ifosphamide activation was
      also effected by the macrolide antibiotic triacetyloleandomycin, an inhibitor of
      several dexamethasone-inducible 3A P450s. These studies establish that a
      dexamethasone-inducible family 3A P450 can make an important contribution to rat
      liver microsomal ifosphamide activation, and suggest that dexamethasone
      pretreatment might provide a useful approach for modulation of ifosphamide
      metabolism in order to improve its therapeutic efficacy in cancer patients.

PMID- 8484808
TI  - Interindividual variability of carbonyl reductase levels in human livers.
AB  - Interindividual variability of carbonyl reductase levels in human livers (N = 11)
      was examined by measuring reductase activity toward various substrates and by
      western blot analysis using anti-rat ovarian carbonyl reductase CR2 antibody. The
      carbonyl reductase activity toward p-nitrobenzaldehyde (PNBA) (58.1 +/- 5.4
      nmol/mg protein/min, mean +/- SE) was highest among the substrates examined,
      followed by 4-benzoylpyridine (4BP) (14.4 +/- 2.0 nmol/mg protein/min) and p
      nitroacetophenone (PNAP) (2.00 +/- 0.37 nmol/mg protein/min). The reductase
      activity (6.33 +/- 0.56 pmol/mg protein/min) toward 13,14-dihydro-15-keto
      prostaglandin F2 alpha (15KD-PGF2 alpha), which is a diagnostic substrate for rat
      ovarian carbonyl reductases, was relatively high compared to that in other
      species. Western blot analysis revealed that each human liver contained several
      immunoreactive proteins to anti-CR2 antibody. The activities toward 15KD-PGF2
      alpha (r = 0.85, P < 0.01) and 4BP (r = 0.84, P < 0.01), but not PNBA (r = 0.53,
      not significant) or PNAP (r = 0.52, not significant), were closely correlated
      with the relative amounts of the high molecular weight immunoreactive proteins
      determined with a densitometer. Thus, the major carbonyl reductases in human
      liver are similar to those of rat ovarian enzymes.

PMID- 8484809
TI  - New procedure for analysing drug binding data, exemplified by warfarin binding to
      human serum albumin.
AB  - Determination of binding constants for multiple binding of a ligand usually
      results in highly variable figures. We have found that the variations depend
      mainly upon cooperativity of ligand binding, and that cooperativity is generally
      absent on binding to human serum albumin. When this is taken into account it
      becomes possible to obtain binding constants with only slight variation. A
      computerized curve fitting procedure for analysing binding data has been
      established consisting of the following steps. (1) Fitting of Scatchard's
      equation to observed binding equilibrium data to obtain a best-fit set of
      Scatchard binding constants. (2) Repetition of the fitting procedure, not to
      obtain a best fit but to generate 30 acceptable sets of Scatchard binding
      constants. (3) Fitting of Adair's equation to the observed points to obtain a
      best fit. If the sum of weighted and squared deviations is significantly smaller
      than the fitting of Scatchard's equation, cooperativity should be considered. If
      not, cooperativity cannot be demonstrated and the binding constants obtained by
      fitting Scatchard's equation can be accepted, with the variations found. (4)
      Final transformation of all Scatchard constants to Adair's. To illustrate the
      method warfarin data obtained by equilibrium dialysis was used.

PMID- 8484810
TI  - Lipid peroxidation in rat liver microsomes during naproxen metabolism.
AB  - Naproxen, a non-steroidal anti-inflammatory drug, is known to be highly effective
      and relatively safe, but some side-effects in the liver have been reported. In
      the present study, the effect of naproxen metabolism on rat liver microsomes was
      studied by determining lipid peroxidation in terms of thiobarbituric acid
      reactive substances (TBA-RS), high molecular weight protein aggregates and
      fluorescent substances formed in the microsomal suspension containing naproxen,
      NADPH and MgCl2. Lipid peroxidation was found to occur at 10 mM naproxen.
      Production of chemiluminescence from the microsomal suspension was observed
      during naproxen metabolism. The time course of 6-demethyl-naproxen formation by O
      demethylation of naproxen appeared to be comparable to that of the
      chemiluminescence production in their initial periods of production. These
      results suggest that the lipid peroxidation was provoked through the reactive
      oxygen species generated during the oxidative metabolism of naproxen.

PMID- 8484811
TI  - [Conformation of fragment 66-72 of interleukin-2 complexed with a monoclonal
      antibody to interleukin-2].
AB  - 1H-NMR spectra of the interleukin-2 synthetic fragment Ac-Leu66-Glu-Glu-Val-Leu
      Asn-Leu72-OCH3 in the presence or absence of the monoclonal antibody were
      analysed. The data obtained are consistent with an extended unordered
      conformation of the free peptide. Measurements of NOESY cross-peak intensities
      allowed us to determine the spatial structure of the peptide bound to the
      antibody. The peptide has an amphiphilic surface with hydrophobic and hydrophilic
      amino acid side chains clustered on the opposite sides of its alpha-helical-like
      structure. The hydrophobic and hydrophilic clusters are located on the opposite
      sides of the bound peptide's surface. The hydrophobic side chains contact the
      antibody surface, while the hydrophilic ones are oriented into the solvent (T. A.
      Balashova et al. (1991) Bioorgan. Khim. (USSR), v. 17, p. 1470-1486). Hydrolysis
      of the methyl ester slowly ocurs in the presence of the antibody. This process
      does not alter the conformation of the peptide bounded with the antibody, though
      decreases the peptide's affinity to the antibody.

PMID- 8484812
TI  - [X-ray structural study of the crystalline structure of human progastricsin by a
      molecular replacement method].
AB  - The human progastricsin crystal structure has been solved by the molecular
      replacement method. The intensities of reflections from native progastricsin
      crystals were measured at the 4.0 A resolution by the omega-scan method with a
      Nicolet P3 diffractometer operated in automatic regime. To determine the
      orientation and position of progastricsin molecules in the unit cell, programme
      packages MERLOT and BRUTE were applied running on a MicroVAX-II computer. Prior
      to the translation search, several rotation function peaks were subjected to a
      rigid body refinement against the correlation coefficient between the observed
      and calculated structure factors. This approach clearly identified the correct
      orientation of the molecule. The solution obtained from the BRUTE translation
      function map was refined by the 6-dimensional correlation search and then by
      programme CORELS. The human progastricsin molecules packing in the crystal unit
      ell is described.

PMID- 8484813
TI  - [Synthesis and biological properties of new analogs of delta-sleep peptide. I.
      Antiepileptic effect].
AB  - To study structure-functional relationship in the series of DSIP, eleven DSIP
      analogues varying in positions 1, 2 and 6 were synthesized by the solid-phase
      method using both Boc- and Fmoc-approaches. The antiepileptic action of these
      analogues was compared with that of DSIP. The seizure activity was induced by the
      corazol or picrotoxin i. p. injection. Some analogues proved more efficient as
      antiepileptic agents than DSIP after their central (50 micrograms/kg in rats) and
      peripheral (1.0 mg/kg in mice) administration.

PMID- 8484814
TI  - [2D-1H-NMR-study of the conformation of transmembrane segments of C, E, and G
      bacteriorhodopsin].
AB  - Conformations of synthetic peptides, analogues of the membrane spanning segments
      C (residues 67-106), E (128-162) and G (190-233) of bacteriorhodopsin
      Halobacterium halobium were studied by two-dimensional 1H-NMR spectroscopy.
      Peptides were solubilized in the mixture chloroform-methanol (1:1), 0.1 M LiC1O4.
      The spectrum resonances were assigned by means of phase-sensitive DQF-COSY, TOCSY
      and NOESY techniques. Interproton nuclear Overhauser effects were derived from
      NOESY spectra. Amide protons with slow deuterium exchange rates were determined.
      Analysis of the obtained data showed that segments C, E and G form right-handed
      alpha-helices including residues 77-101, 131-159 and 198-227, respectively.

PMID- 8484815
TI  - [Solid-phase synthesis of peptides modelling the transmembrane segment of
      bacteriorhodopsin].
AB  - Peptides modelling transmembrane segments C, D, E and G of bacteriorhodopsin were
      obtained by solid phase method using the conventional Boc strategy. Protected
      peptides were assembled on PAM polystyrene support. Side chain protecting groups
      were: Tos for Arg, Bzl for Thr and Ser, cHx for Asp and Glu, Bzl(Cl2) for Tyr,
      For for Trp, Z(Cl) for Lys. Syntheses were performed on a modernized Beckman 990
      synthesizer in the automatic mode. Double couplings by a preformed
      hydroxybenzotriazole ester were used for all residues. Qualitative and
      quantitative ninhydrine tests were used to monitor coupling efficiency. Removal
      of protecting groups and peptide cleavage were achieved by hydrogen fluoride,
      containing p-cresol and p-thiocresol as scavengers. Preparative reverse phase
      HPLC was used for purification. Peptide structure and homogeneity were confirmed
      by amino acid analysis, 1H-NMR and analytical HPLC.

PMID- 8484816
TI  - [Cloning the Staphylococcus aureus enterotoxin B gene, obtained by polymerase
      chain reaction, and its expression in Escherichia coli cells].
AB  - To determine the Staphylococcus aureus enterotoxigenicity, we have developed an
      approach based on polymerase chain reaction (PCR). Using this method several S.
      aureus strains have been screened for the presence of the enterotoxin B gene. A
      DNA fragment of the selected strain (FRI 722H) containing enterotoxin B gene has
      been obtained by the PCR method and cloned in the pUC19 vector. It is shown that
      enterotoxin B with the leader peptide forms insoluble complexes in E. coli cells,
      whereas the mature toxin is present in cytoplasmic fraction in a soluble form.
      The recombinant toxin made up for 1.7% of the total cellular protein in E. coli
      JM 109 cells.

PMID- 8484818
TI  - 1993 Regional Meetings of the American College of Rheumatology. Abstracts.

PMID- 8484817
TI  - [Synthesis of oligodeoxyribothymidylate derivatives containing alkylating groups
      and residues of biotin, for directed modification of chromatin].
AB  - An oligodeoxythymidylate derivative bearing an alkylating group at the 5'-end and
      biotin at the 3'-end (RCl-(pdT)16-bio) was synthesized. This reagent alkylates
      polyA-tracts of DNA in HeLa nuclei specifically via complementary complexes with
      single-stranded segments of DNA and by the preliminary treatment of chromatin
      with S1-nuclease, since the reaction is inhibited by an excess of the
      corresponding free oligothymidylate. The reagent will be used to study the
      distribution of local unwinded parts of polyA-repeats of DNA in human chromatin
      by the electron microscopy.

PMID- 8484819
TI  - Practitioners speak out.
AB  - Most of our colleagues report that the recession has caused them to alter the way
      they have been providing services on a day-to-day basis. Even though changes,
      cutbacks, and concessions have been made, our professions have, for the most
      part, been resilient and have been spared the massive layoffs and salary cuts
      seen in other sectors of the workforce. In fact, given our colleagues' comments,
      our professions seem to have fared well in what have been gloomy times for many
      other industries and careers. The number of vacant positions far exceeded the
      number of people seeking positions at the 1992 ASHA convention (many report
      position vacancies that have gone unfilled for some time); salaries appear to be
      keeping up with or in some cases even exceeding inflation; and the number of
      clients who need us keeps growing. No one knows what lies ahead. We do know that
      our professions survived the recession. In the years ahead we will be preparing
      the groundwork for the practice of the professions in the next century. It will
      be a time of change in the delivery of care. We will be required to be as
      creative or even more creative than we have been.

PMID- 8484820
TI  - Consumers speak out.

PMID- 8484821
TI  - ASHA speaks out.

PMID- 8484822
TI  - The state of infant hearing impairment identification programs.

PMID- 8484823
TI  - Ethics education in speech-language pathology and audiology training programs.

PMID- 8484824
TI  - Gender-related issues.

PMID- 8484825
TI  - Medications alert.

PMID- 8484826
TI  - Marketing for Native Americans needed.

PMID- 8484827
TI  - Identification in the chicken of GRL1 and GRL2: two granule proteins expressed on
      the surface of activated leukocytes.
AB  - We report the production of two monoclonal antibodies reacting, respectively,
      with a 92-kDa protein (GRL1) and a 40- to 65-kDa membrane glycoprotein (GRL2),
      both present in chicken thrombocyte and myelocyte granules. We examined the
      expression of GRL1 and GRL2 during the development of the hematopoietic system:
      GRL1 is restricted to thrombocytes and myelocytes, whereas GRL2 is present in
      thrombocytes, myelocytes, myeloid progenitors, and a subpopulation of erythroid
      progenitors. In the lymphoid lineages, neither GRL1 nor GRL2 is expressed during
      thymus and bursa ontogeny or on resting peripheral blood lymphocytes. However,
      CD3+ T lymphoblasts obtained by mitogenic stimulation of GRL2-negative quiescent
      T lymphocytes are stained on their surface by anti-GRL2 Mab. In vitro stimulation
      of thrombocytes and granulocytes with their specific secretagogues results in the
      expression of GRL1 and in the overexpression of GRL2 on the cell surface. These
      observations are consistent with the following two conclusions: the presence on
      the cell surface of GRL1 epitope is a marker of thrombocyte and myelocyte
      activation; GRL2 epitope is present on the granule membrane of leukocytes,
      including T cells. In that respect, GRL2 appears to share certain features with
      leukocyte activation antigens recently described in human.

PMID- 8484828
TI  - Aural neoplasms.

PMID- 8484829
TI  - Prognostic significance of progression of coronary atherosclerosis.
AB  - BACKGROUND: Angiographic progression of coronary atherosclerosis is frequently
      observed in clinical practice and is used as an end point in clinical trials;
      however, its prognostic significance is unclear. METHODS AND RESULTS: Progression
      defined as an increase in diameter stenosis by > or = 15% of at least one
      coronary lesion was seen in 141 (42%) of 335 patients who underwent repeat
      coronary arteriography after a 2-year interval as part of clinical trial.
      Coronary lesions were measured quantitatively from comparable end-diastolic
      frames selected by a radiologist viewing each pair of films together. During a
      mean follow-up of 44 +/- 10 months after the second arteriogram, cardiac death
      occurred in 19 patients (5.7%), cardiac death or nonfatal infarction was seen in
      40 cases (11.9%), and 90 patients (26.9%) underwent coronary revascularization.
      At least one end point event occurred in 112 of the 335 patients. Sixteen of the
      19 cardiac deaths were in progressors, a relative risk of 7.3 (95% CI, 2.2-24.7;
      p < 0.001). The relative risk of cardiac death or nonfatal infarction for
      progressors was 2.3 (1.3-4.2, p = 0.009) and of any cardiac event was 1.7 (1.3
      2.3, p < 0.001). A stepwise multivariable Cox regression model of time to event
      was used to assess the relative contribution of progression as a predictor of
      coronary events. Low ejection fraction (p = 0.001), progression (p = 0.001), and
      hypertension (p = 0.011) were retained as predictors of cardiac death. Angina and
      the number of diseased vessels were the strongest predictors of
      revascularization. CONCLUSIONS: Coronary progression is a strong, independent
      predictor of future coronary events, particularly cardiac death, and its use as a
      surrogate end point in clinical trials is justified.

PMID- 8484830
TI  - Chlamydia pneumoniae-specific circulating immune complexes in patients with
      chronic coronary heart disease.
AB  - BACKGROUND: An association of chronic Chlamydia pneumoniae infection to coronary
      heart disease has been suggested recently. In a recent study, we demonstrated
      circulating immune complexes containing chlamydial genus-specific
      lipopolysaccharide in patients with coronary heart disease. The objective of the
      present study was to investigate whether C. pneumoniae species-specific immune
      complexes are present in chronic coronary heart disease. METHODS AND RESULTS: The
      presence of Chlamydia-specific circulating immune complexes was studied in 46
      patients with chronic coronary heart disease and in control subjects. Chlamydial
      lipopolysaccharide-containing immune complexes were detected with the antigen
      specific capture method, and they were present in 41% of patients and 15% of
      control subjects (p < 0.01). The presence of C. pneumoniae antibodies in
      circulating immune complexes was studied by testing the specificity of antibodies
      derived from isolated and dissociated immune complexes by microimmunofluorescence
      testing and immunoblotting. The C. pneumoniae indexes based on the relative
      amount of immune complex-derived antibodies and free antibodies were
      significantly higher among patients compared with control subjects (median, 1/8
      versus 1/16; p < 0.001). Immune complex bound antibodies showed specificity for
      98-kd and 42-kd proteins of C. pneumoniae. CONCLUSIONS: The results suggest that
      the majority of the patients with chronic coronary heart disease have a chronic
      C. pneumoniae infection in which chlamydial components have an easy access to
      circulation to form immune complexes with preexisting antibodies. These findings
      give further evidence for the association of chronic C. pneumoniae infection with
      coronary heart disease.

PMID- 8484831
TI  - Chlamydia in atherosclerosis.

PMID- 8484832
TI  - The development and evaluation of a sexual harassment contact person training
      package.
AB  - The effectiveness of a training package to teach listening and helping skills to
      three pairs of sexual harrassment contact person trainees was evaluated, using a
      multiple probe design. The training package comprised five components: behavioral
      specifications, rationales, situational examples, study guides, and role-play
      exercises, provided in a written instructional format based on guidelines
      developed by Fawcett and Fletcher. Evaluation involved pre- and posttraining
      measures of target behavior occurrence, relevant knowledge, and self-rated
      confidence level. Ratings of performance were also provided by potential
      consumers as a measure of social validity. Findings indicated that the package
      was effective in increasing listening and helping skills, knowledge, and
      confidence of trainees and that skills generalized to new simulated cases and
      were maintained over time.

PMID- 8484833
TI  - Financial impact of the Medicare Fee Schedule on a large multispecialty faculty
      practice in an academic medical center.
AB  - Although there have been preliminary studies of the financial impact of the
      Medicare Fee Schedule (MFS) on specialty-specific groups of practicing physicians
      in an academic setting, there has been no published report of the financial
      impact of the MFS on an entire multispecialty academic faculty practice. This
      1992 study reports the estimated financial impact of the MFS on the faculty
      practice at the University of Michigan Medical School (UMMS). The authors
      calculated the difference between the Medicare payments to be received when the
      MFS is completely implemented in 1996 and the payments received in 1991, and then
      repeated this process for each year of the transition period, 1992-1996. The UMMS
      will experience a $1.2 million (-4.7%) loss under the fully implemented MFS. The
      medical departments project an 8% gain, while substantial losses are projected
      for the surgical departments (-10%) and hospital-based departments (-15%).
      Projections indicate that obstetrics-gynecology and ophthalmology will lose
      nearly 20% and that surgery will lose 9%. But large percentage gains are
      projected for neurology (+43%), physical medicine (+25%), and family practice
      (+17%). Analysis of the MFS transition's effects shows an abrupt and
      unpredictable financial impact in the first year. Faculty practice plans may be
      more disadvantaged under the MFS than other physician groups, yet the uncertain
      impact of the MFS in the first year (1992) may inhibit accurate financial
      planning for all physician groups.

PMID- 8484834
TI  - Attitudes toward the medical career: findings from the Alpha Omega Alpha survey
      of college and university undergraduates.
AB  - In 1989, when the number of applicants to medical schools had been comparatively
      low for several years, trustees of Alpha Omega Alpha commissioned Louis Harris
      and Associates to conduct a survey to investigate the attitudes that led college
      undergraduates toward or away from choosing medical careers. A total of 1,780
      college students and 93 premedical advisors from 100 U.S. schools were
      interviewed in early 1990. The students were in three groups: a national cross
      section of 1,003 undergraduates who were not applicants to medical school; 500
      medical school applicants for the entering class of 1990; and 277 students who
      had taken the Medical College Admission Test (MCAT), were qualified for
      admission, but had not applied. The authors acknowledge that the reasons that the
      medical school applicant pool was so low in the late 1980s and has fluctuated so
      widely in the last two decades are only partly understood. The data gathered
      indicate that job satisfaction was an extremely important factor in career choice
      for high percentages of students in all the groups surveyed; that 77% of all the
      students had never seriously considered applying to medical school; and that 70%
      saw no attraction in becoming a physician. Data on other problems that many of
      the students saw in medical education and the practice of medicine are reviewed,
      the role of premedical advisors is examined, and the advisors' views on what
      makes a promising applicant are described. Regarding the students who took the
      MCAT exam but did not apply to medical school, 81% indicated that they eventually
      planned to or were likely to apply.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8484835
TI  - "Academic" CME and the social contract.
AB  - The term academic continuing medical education (CME) is defined and explored from
      the perspective of forces that have made its usage necessary. These forces
      include the new understandings of the place, impact, and scope of CME, and, in
      particular, the increasing entrepreneurial interests in the field, unrelated to
      the improvement of physicians' competence or performance, or to health care
      outcomes. In addition to principles of CME provision promulgated by the
      Accreditation Council of CME, and those of ethical CME providers, academic CME
      implies the critical appraisal of the providers' activities, the creation of new
      knowledge about how physicians learn and change, and the dissemination of
      information based on such knowledge. Finally, the nature of academic CME
      providers is discussed, and the potential role of CME in fostering the social
      contract between the medical professional and society is explored.

PMID- 8484836
TI  - Centralized decision making in management of the curriculum at the University of
      Michigan Medical School.

PMID- 8484837
TI  - Community-oriented medical education in Vellore, India.

PMID- 8484838
TI  - Curbing Congress' appetite for pork.

PMID- 8484839
TI  - Understanding and eradicating bias against women in medicine.

PMID- 8484840
TI  - Why don't more women choose surgery as a career?

PMID- 8484841
TI  - Broader implications of new CME guidelines for commercial support.

PMID- 8484842
TI  - Shared training experiences between health professionals.

PMID- 8484843
TI  - Clinical teaching by voluntary faculty.

PMID- 8484844
TI  - Teaching of medical students by neurology and neurosurgery faculty.

PMID- 8484845
TI  - Women physicians and their spouses.

PMID- 8484846
TI  - Freshman students' attitudes toward homosexuality.

PMID- 8484847
TI  - A health science center's pre-matriculation retreat.

PMID- 8484848
TI  - An information card on exposure to infectious body fluids.

PMID- 8484849
TI  - Mental health services for medical students: perceptions of students, student
      affairs deans, and mental health providers.
AB  - PURPOSE: To examine (1) whether there is any consistency among medical schools in
      mental health services provided and (2) how these services are perceived by
      student affairs deans, mental health service providers, and the students
      themselves. METHOD: Questionnaires were sent in October 1991 to the student
      affairs dean (or director), the individual responsible for student mental health
      services, and a student representative in each of the 126 U.S. and Canadian
      medical schools. Data were sought regarding personnel, individuals served,
      location, hours, administration, funding, confidentiality, administrative
      referrals, and respondents' suggestions for improvement. Possible differences
      among the three groups of respondents were tested by chi-square. RESULTS:
      Responses were received from 75 student affairs deans, 53 mental health
      providers, and 30 students. There was much diversity among schools in services
      provided, especially in the areas of administration and funding. Although
      perceptions of the three respondent groups were often the same, they differed
      significantly in a number of areas. Suggestions for improvement of services
      involved funding, personnel, hours, confidentiality and privacy, specialty
      services, preventive and support programs, and visibility. The suggestion most
      frequently made by the students was for increased information and visibility.
      CONCLUSION: The differences among schools coupled with the differing perceptions
      within schools indicate a need for a comprehensive consideration of what kinds of
      mental health services are needed and how they can best be made accessible to a
      diverse body of students experiencing a variety of academic and personal
      challenges.

PMID- 8484850
TI  - The triple-jump examination as an assessment tool in the problem-based medical
      curriculum at the University of Hawaii.
AB  - BACKGROUND: The three-step triple jump (TJ) examination aims to assess students'
      clinical problem-solving processes predominantly by means of subjective
      assessments administered by faculty. But training TJ administrators to ensure
      interrater reliability is both time- and cost-intensive, and difficult at best-
      hence the desire to test a more objective system of scoring students' TJ
      performances. METHOD: The sample was the 58 first-year students of the class of
      1995, who in March 1992 were finishing the second 13-week unit in the problem
      based curriculum at the University of Hawaii John A. Burns School of Medicine. To
      determine how well the school had succeeded in standardizing and objectifying its
      TJ examination (used for all units in the first two years), scores were
      correlated for various objective examinations independent of the TJ, the TJ
      administrators' subjective assessments, and the TJ objective assessments
      (regarding number of problem-based hypotheses generated and number of hypothesis
      testing clinical database items elicited). The statistical methods used were
      linear regression, Student's unpaired t-test, chi-square, and the z-test.
      RESULTS: The TJ scores and independent objective examinations did not correlate
      significantly (suggesting that they assess different aspects of student
      achievement), but the TJ subjective and objective scores did correlate
      significantly. There were large standard deviations on the TJ objective scores,
      largely because one problem was significantly more difficult than the others
      (each student works on only one of several problems). However, the
      administrators' subjective scores for all problems were comparable. CONCLUSION:
      Because problems vary in difficulty, objective scores cannot be used across
      problems as a major component of all students' grades; but when a student has
      received an unsatisfactory score, an external reviewer can evaluate the
      appropriateness of the subjective score by comparing the student's objective
      performance with those of students who had the same problem and received higher
      subjective scores. That the administrators' subjective assessments for all
      problems were comparable not only suggests that the administrators were able to
      adjust for problem variability but also reinforces the appropriateness of using
      subjective assessments for the TJ examination.

PMID- 8484851
TI  - Senior medical students' knowledge of universal precautions.
AB  - BACKGROUND: Few data exist concerning the assessment of medical students'
      knowledge of universal precautions. The purpose of this study was to assess what
      students know--immediately before they graduate--about universal-precautions
      procedures. METHOD: The 151 fourth-year students of the class of 1992 at the
      University of Washington School of Medicine were given a questionnaire one week
      before graduation. They were asked to indicate the protective equipment required
      to safely complete ten common clinical procedures. For each procedure, the
      proportion of students who correctly indicated the protective equipment was
      calculated. RESULTS: The questionnaires were completed by 137 (91%) of the
      students. The mean percentage of correct answers by the responding students was
      67%. For five of the ten procedures, from 104 to 123 (76-90%) of the students
      reported the proper levels of protection. For the remaining five procedures, from
      58 to 75 (42-55%) of the students knew the proper levels of protection.
      CONCLUSION: The results of the survey are worrisome, because many students-
      immediately before they graduated--lacked adequate knowledge of universal
      precautions regarding the ten common clinical procedures. More emphasis on
      universal precautions during undergraduate medical education is needed.

PMID- 8484852
TI  - A training program in universal precautions for second-year medical students.
AB  - BACKGROUND: A training program in universal precautions was developed and
      implemented in 1991-92 for second-year students at the George Washington
      University School of Medicine and Health Sciences. The students were required to
      participate in a three-hour session that consisted of lecture, demonstration, and
      practice components focused on the risks of bloodborne-disease exposure and the
      techniques of phlebotomy and intravenous insertion using universal precautions.
      METHOD: All 135 second-year students participated in the lecture component, but
      only 120 students, who were unfamiliar with the procedures, were required to
      participate in the demonstration and practice components. Each of these students
      was asked to answer pre- and postsession knowledge questions and to rate his or
      her preparedness on a five-point Likert scale, ranging from 1, "not prepared at
      all," to 5, "well prepared." Paired t-tests were used to compare the pre- and
      postsession knowledge scores and self-assessed preparedness scores. At the end of
      the training program, the students were offered the opportunity to volunteer for
      additional, individualized training with the hospital phlebotomy service.
      Unpaired t-tests were used to compare differences between the postsession
      knowledge scores of the volunteers and nonvolunteers. RESULTS: A total of 103
      students completed both pre- and posttests. The students' knowledge scores
      increased from means of 64.7% to 88.5% (p = .001). Their self-assessed
      preparedness scores also increased, ranging from a low of means of 1.6 presession
      and 3.4 postsession for intravenous insertion to a high of means of 3.19
      presession and 4.26 postsession for addressing personal concerns about possible
      exposure. The 43 students who volunteered for additional training scored
      significantly better on the postsession knowledge questions than did the
      nonvolunteers, suggesting that those who may have needed it most failed to sign
      up for additional training. CONCLUSION: The training session significantly
      improved the students' knowledge and sense of their own competency.

PMID- 8484853
TI  - Changes in students' attitudes toward HIV-infected patients as the students
      progress through medical school.
AB  - PURPOSE: To examine how medical students' attitudes and intentions toward the
      treatment of persons infected with human immunodeficiency virus (HIV) changed as
      the students progressed through medical school. METHOD: Similar 44-item self
      administered questionnaires, to be completed anonymously, were given to 394
      medical students at the University of Michigan Medical School in February 1989,
      when the students were in their first or second years, and to 378 of the same
      students in February 1991, when they were in their third or fourth years. Seven
      subscale variables were created, and their effects on students' willingness to
      treat HIV-infected patients were assessed. Bivariate statistics and logistic
      regression were used to relate the dependent and independent variables. RESULTS:
      In 1989, 201 (51%) of the students responded; in 1991, 208 (55%) responded. The
      students showed a high--but declining--degree of willingness to care for patients
      infected with HIV or at high risk of infection. Homophobic attitudes decreased,
      but so did the students' intentions to follow infection-control guidelines. The
      students who expressed a career interest in surgery specialties indicated less
      willingness to provide care for HIV-infected patients, presumably because these
      students felt that they would be at a higher risk of exposure. CONCLUSION:
      Overall, the students' responses indicated that over the two years of the study
      they became more restrictive in their attitudes toward HIV-positive patients,
      felt less personal obligation toward caring for these patients, and were less
      likely to use appropriate infection-control methods to ensure their own safety.

PMID- 8484854
TI  - Hospital-based versus community-based clinical education: comparing performances
      and course evaluations by students in their second-year pediatrics rotation.
AB  - BACKGROUND: Increasing use of outpatient settings for clinical education raises
      the question of their effectiveness compared with that of inpatient settings.
      METHOD: At the University of Minnesota Medical School-Minneapolis in 1987-88, the
      190 second-year students participated in a six-week tutorial rotation introducing
      them to clinical pediatrics: 52 (27%) were in hospital settings and 138 (73%)
      were in community outpatient settings. Almost all the students (178) evaluated
      their rotations by responding to both structured and open-ended questions, using
      a Likert scale for the structured questions. At the completion of the second
      year, all 190 students took an objective structured clinical examination (OSCE)
      that included five pediatrics stations. Student's t-test was used to compare (1)
      the mean ratings the hospital-based and community-based students gave their
      pediatrics rotations and (2) the mean scores earned by the two groups of students
      on the five pediatrics stations in the OSCE. RESULTS: There were no statistically
      significant differences between (1) the two groups' mean ratings of the clinical
      experience overall or of the quality of teaching or (2) the groups' mean scores
      on any of the OSCE stations. CONCLUSION: That the hospital-based and community
      based students performed comparably on the OSCE and gave similar evaluations of
      their pediatrics rotations supports the use of community practitioners to provide
      students with their initial clinical training. Moreover, community-based teaching
      sites replicate situations in which most students will eventually practice
      medicine.

PMID- 8484855
TI  - Teaching medical ethics to first-year students by using film discussion to
      develop their moral reasoning.
AB  - PURPOSE: To evaluate a project on teaching medical ethics to first-year students
      by using film discussion to develop the students' moral reasoning. METHOD: The
      participants were 114 first-year students at Texas A&M University Health Science
      Center College of Medicine in 1989-90, 1990-91, and 1991-92: (1) 48 (20 women and
      28 men) who participated during the fall quarter in an elective course on social
      issues in medicine, which consisted of weekly one-hour discussions of short
      films; (2) 37 (18 women and 19 men) who participated in the course during both
      the fall and winter quarters; and (3) a control group of 29 (8 women and 21 men)
      who did not take the course and so had no exposure to the film discussions. The
      influence of the discussions on the students' moral reasoning was measured by
      using Rest's Defining Issues Test for pretests and posttests. The scores of the
      three groups were compared by using multivariate analysis of variance. RESULTS:
      There were statistically significant increases in the moral reasoning scores of
      both the course registrants with one-quarter exposure to the film discussions (p
      < .002) and those with two-quarter exposure (p < .008) compared with the scores
      of the students who did not take the course and had no exposure (p < .109).
      CONCLUSION: No doubt there was a self-selecting bias on the part of the course
      registrants; however, since both groups of registrants showed significant
      increases on their posttest scores, clearly the course did have a positive
      influence on these students' moral reasoning. Thus, it is possible to develop
      young people's moral reasoning in medical school as well as in earlier
      educational environments.

PMID- 8484856
TI  - Extent to which guided-discovery teaching strategies were used by 20 preceptors
      in family medicine.
AB  - BACKGROUND: Learners learn more and are able to categorize problems at higher
      levels when their teachers use guided-discovery strategies (e.g., questions and
      advice to investigate relationships between concepts), as opposed to directly
      telling learners the answers. This study examines the extent to which clinician
      preceptors of residents use guided-discovery strategies when faced with a
      diagnostic problem-solving situation. METHOD: Twenty family medicine preceptors
      from four residencies volunteered in 1991-92 to role-play with a simulated first
      year resident on a single standardized case. Judges coded the preceptors' verbal
      behaviors by type (question, statement, or advice) and by category. The
      categories were teacher, i.e., behaviors relating to more than the present case
      (hence exemplifying guided-discovery strategies), and consultant, i.e., behaviors
      relating to the successful disposition of the case (without overt concern for the
      education of the resident). RESULTS: Of the preceptors' 846 verbal behaviors, 602
      (71%) were coded as teacher behaviors, but only 329 (39%) were teacher behaviors
      that were of the specific types (high-level advice or questions promoting
      reflectivity, i.e., mindfulness) described in the literature as being most likely
      to promote learners' reflectivity and transfer of knowledge and skills from a
      lower level of abstraction to a higher level. CONCLUSION: The results suggest
      that the 20 perceptors were aware of the importance of "getting residents to
      think" and did use teaching strategies known to promote transfer. However, their
      repertoire of strategies was limited.

PMID- 8484857
TI  - Comparing the academic performances of geriatricians and other family physicians
      and internists.

PMID- 8484859
TI  - Medical specialty choice: A selected bibliography with abstracts.

PMID- 8484858
TI  - Internal medicine residents' attitudes toward giving feedback to medical
      students.

PMID- 8484860
TI  - Up-regulation of insulin-like growth factor-I (IGF-I) receptor gene expression in
      patients with reduced serum IGF-I levels.
AB  - We have analysed the expression of the IGF-I receptor gene in lymphocytes of
      patients with low levels of circulating IGF-I (four patients with isolated GH
      deficiency (IGHD) and one Laron-type dwarf (LTD)) in comparison with a control
      group exhibiting normal serum IGF-I levels and endocrine profiles. 125I-Labelled
      IGF-I binding assays were performed on erythrocytes to determine the number of
      IGF-I binding sites per cell and their dissociation constants. Erythrocytes from
      patients with IGHD or LTD contained significantly (P = 0.002) more receptors per
      cell (10.9 +/- 3.1 binding sites/cell), with a reduced affinity (Kd = 0.49 +/-
      0.05 nM), than erythrocytes from controls (2.0 +/- 0.4 sites/cell; Kd = 0.14 nM).
      The levels of IGF-I receptor mRNA in circulating lymphocytes were determined by
      an RNA template-specific reverse transcription/polymerase chain reaction method.
      There was a statistically significant increase in IGF-I receptor mRNA levels in
      lymphocytes from patients with LTD or IGHD when compared with controls (3108.1 +/
      775.9 vs 576.0 +/- 465.7 arbitrary units, P = 0.006). The increased level of IGF
      I binding due to increased IGF-I receptor gene expression may represent a
      compensatory up-regulation process activated in response to the low levels of IGF
      I in the circulation of patients with LTD or IGHD.

PMID- 8484861
TI  - The human insulin gene-linked polymorphic region adopts a G-quartet structure in
      chromatin assembled in vitro.
AB  - The insulin gene-linked polymorphic region (ILPR), located 363 bp upstream of the
      human insulin gene, is composed of tandem repeats of the consensus sequence
      ACAGGGGT(G/C)(T/C)GGGG. It has previously been shown that an insulin gene
      fragment containing the ILPR adopts an altered DNA structure in vitro.
      Furthermore, oligonucleotides containing the consensus repeat sequence exhibit
      multiple quadriplex DNA structures. The present study was undertaken to determine
      whether such altered DNA structures existed within the ILPR when the insulin gene
      was assembled into chromatin in vitro. Chromatin assembly was achieved using
      histones and an extract from unfertilized eggs from Xenopus laevis. The presence
      of altered DNA conformations within the 5' region of the human insulin gene was
      investigated using the structural probe nuclease P1. Nuclease P1 recognized
      multiple distinct sites in the 5' flanking region of the human insulin gene in
      naked DNA. Most of these sites disappeared when the recombinant plasmid DNA was
      treated with histones and unfertilized egg extract. In the assembled DNA, the
      ILPR appeared as the major site of nuclease P1 hypersensitivity. Fine-mapping of
      the multiple reactive sites within the ILPR showed a pattern characteristic of G
      quartet foldback structures similar to those that have been observed for
      telomeric DNA.

PMID- 8484862
TI  - The thyrotrophin hormone receptor of Graves' disease: overexpression of the
      extracellular domain in insect cells using recombinant baculovirus,
      immunoaffinity purification and analysis of autoantibody binding.
AB  - Since the cloning of the TSH receptor (TSH-R), the target autoantigen of Graves'
      disease, the receptor has been expressed in a variety of eukaryotic cells to
      obtain a functional molecule. Despite this success, the levels of receptor
      expression have been marginally higher than the extremely low levels found in
      thyroid cells, preventing any progress on the purification of the molecule. In
      this study, the large extracellular region of the TSH-R, without the membrane
      spanning segments, has been expressed in insect cells using recombinant
      baculovirus to generate substantial quantities of the receptor protein. A
      monoclonal antibody previously generated to a bacterial TSH-R fusion protein was
      used to characterize and monitor the expression of the truncated receptor in
      insect cells. Two polypeptides of 63 and 49 kDa were recognized as the components
      of the truncated recombinant receptor. The 63 kDa protein was shown to be the
      glycosylated form of the smaller, 49 kDa, component. Expression in different
      insect cell lines showed that an increase in expression of approximately tenfold
      was apparent in High Five cells when compared with Sf21 cells. Very small
      quantities of the truncated receptor were secreted by the three insect cell lines
      examined, with the majority of the molecule being retained within the cells.
      Immunoaffinity purification of milligram quantities of the truncated receptor was
      achieved using the monoclonal antibody. The availability of the purified TSH-R
      has allowed the establishment of an enzyme-linked immunosorbent assay to measure
      autoantibodies in the sera of patients with Graves' disease. Although the
      truncated receptor interacts with autoantibodies, our results show that it does
      not bind TSH and differs in this respect from other glycoprotein hormone
      receptors.

PMID- 8484863
TI  - Identification of a functional role for the 3' region of the human oestrogen
      receptor gene.
AB  - A well-conserved feature of the steroid receptor gene family is the presence of
      an exceptionally long 3' untranslated region (UTR). Analysis of this sequence
      from the human oestrogen receptor (hER) gene showed the presence of a number of
      AT-rich regions that included thirteen repeats of the ATTTA motif, an element
      known to have a destabilizing effect in other systems. In the region 3' of the
      gene there were a further eight copies of this pentamer. Also located in this
      sequence were two members of the Alu repetitive family in inverse orientation and
      in a tandem arrangement. Transfection experiments in which the 3' UTR and 3'
      flanking sequence were included in chloramphenicol acetyltransferase expression
      vectors revealed a large destabilization effect with several different fragments.
      This inherent instability appears to be determined by the primary nucleotide
      sequence but may act in conjunction with other factors. This post-transcriptional
      regulatory mechanism may contribute to the control of the level of the hER mRNA.

PMID- 8484864
TI  - Human chorionic gonadotrophin (CG)-induced down-regulation of the rat luteal
      LH/CG receptor results in part from the down-regulation of its synthesis,
      involving increased alternative processing of the primary transcript.
AB  - To elucidate the molecular mechanisms involved in the homologous regulation of
      LH/chorionic gonadotrophin (CG) receptors, the receptor and its mRNA levels were
      analysed in the same pseudopregnant rat ovarian samples after human (h)CG-induced
      down-regulation using a binding assay, ligand blotting, immunoblotting and
      Northern blotting together with the polymerase chain reaction (PCR). Treatment of
      the animals with 500 IU hCG resulted in a loss of 125I-labelled hCG binding and
      the 90 kDa receptor on the ligand and immunoblots within 12 and 24 h
      respectively, followed by a transient partial recovery on days 4 and 5, while a
      distinct decline occurred only on day 7 in the controls. Northern blots of total
      ovarian RNA, as probed with a 293 bp AvaI/HindIII fragment from the extracellular
      domain of PCR-generated full-length rat LH/CG receptor cDNA, revealed six major
      mRNAs of 7.0, 4.2, 2.8, 2.0, 1.4 and 1.1 kb. The 4.2 kb mRNA, which was the most
      abundant, possibly encodes the 90 kDa receptor, while the smaller species
      probably represent alternatively spliced forms of the LH/CG receptor pre-mRNA, as
      also supported by the finding that PCR produced three cDNA bands of 2.1, 2.0 and
      1.8 kb when oligomers derived from the N and C termini of rat LH/CG receptor cDNA
      were used as primers and rat ovarian total RNA as a template. Treatment with hCG
      led to the down-regulation of all six mRNAs in a fashion parallel to the changes
      in receptor protein. No smaller receptor components capable of binding
      radiolabelled hCG or receptor antibody appeared on the ligand or immunoblots
      prior to or during down-regulation or the subsequent transient period of up
      regulation, suggesting that the smaller mRNA species are translated in minute
      amounts in vivo or are not translated at all. Laser densitometric analysis of the
      Northern blots revealed that the amounts of the four smallest mRNA species
      increased during the period of down-regulation in relation to the 4.2 kb mRNA,
      and correspondingly decreased during the subsequent period of up-regulation,
      indicating changes in the alternative splicing of the primary transcript. The
      data suggest that hCG-induced transient down-regulation of the LH/CG receptor
      results in part from down-regulation of its mRNA levels, and that changes in
      alternative processing of the receptor pre-mRNA may play a regulatory role in the
      expression of functional LH/CG receptor during down- and up-regulation.

PMID- 8484865
TI  - Changes in progesterone and oestrogen receptor mRNA and protein during maternal
      recognition of pregnancy and luteolysis in ewes.
AB  - This study characterized changes in levels of mRNA and protein for endometrial
      oestrogen receptors (ERs) and progesterone receptors (PRs) during luteolysis and
      maternal recognition of pregnancy. For cyclic and pregnant ewes, endometrium was
      collected on days 10, 12, 14, or 16 post-oestrus (4 ewes/day for each status) for
      the measurement of ER and PR mRNA and protein. The amount of receptor mRNA is
      expressed in relative units above background, measured from radiographs of dot
      blot hybridization of total endometrial RNA with ER and PR cDNAs. At
      hysterectomy, jugular vein blood samples were collected and assayed for
      progesterone, total corpus luteum weight was recorded and, in vitro, endometrial
      oxytocin-stimulated inositol phosphate formation was estimated. In pregnant ewes,
      plasma progesterone increased gradually between days 10 and 16 (P < 0.01), corpus
      luteum weight was stable at approximately 0.8 g and oxytocin did not stimulate
      endometrial formation of inositol phosphates in vitro. In contrast, in cyclic
      ewes, plasma progesterone decreased from day 10 to day 16 (P < 0.01), corpus
      luteum weight decreased after day 14 to approximately 0.48 g (P = 0.05) and
      oxytocin stimulated an increase of approximately 1300% in the endometrial
      formation of inositol phosphates on day 16. cDNAs specifically hybridized with
      1.6 and 3.1 kb transcripts for PR mRNA and a 6.5 kb transcript for ER mRNA. In
      cyclic ewes, the amount of PR mRNA increased from day 10 to maximum levels on
      days 14-16. The number of PRs decreased from day 10 (2.25 pmol/mg DNA) to day 12
      (0.98 pmol/mg DNA) and then increased from day 14 to day 16 (2.8 pmol/mg DNA). In
      pregnant ewes, PR mRNA levels were greatest on days 10-12 and decreased by
      approximately 50% by day 16. In contrast, the number of PRs was relatively
      unchanged from day 10 to day 16 (1.53 to 1.03 pmol/mg DNA). In cyclic ewes, the
      amount of ER mRNA was lowest at day 10 and increased fivefold by day 16. The
      number of ERs remained relatively unchanged from day 10 to day 14 (6.07 pmol/mg
      DNA) and increased by day 16 (16.12 pmol/mg DNA). In pregnant ewes, ER mRNA
      decreased by approximately 80% from day 12 to day 16. Similarly, the number of
      ERs decreased from day 10 to day 16 (5.41 to 2.05 pmol/mg DNA). Correlations
      between ER mRNA and PR mRNA (r = 0.68), ERs and PRs (r = 0.50) and ER mRNA and
      ERs (r = 0.50) were high (P < 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8484866
TI  - Nutritional enrichment of bakery products by supplementation with nonwheat
      flours.
AB  - Bakery products are important ready-to-eat processed foods. The nutritional
      quality of these products is low because of the inferior nutritional composition
      of wheat grain per se. This is further accentuated with the use of refined flours
      in their preparations. Nutritional composition of these products can be improved
      by using quality wheat for milling, increased extraction rates, air
      classification of flours to obtain protein-rich nonwheat flours and their
      products. The flours and protein products of legumes, oilseeds, other cereals,
      tubers, corn gluten and germ, and rice bran can be used effectively as vegetable
      protein sources for nutritional enrichment of the bakery products. In this
      article, recent literature concerning the nutritional composition of major bakery
      products, sources of vegetable proteins for product enrichment, and modifications
      in conventional processing methods to maintain the rheological and sensory
      properties of supplemented bakery products are reviewed critically.

PMID- 8484867
TI  - Hard-to-cook phenomenon in common beans--a review.
AB  - Legumes are one of the world's most important sources of food supply, especially
      in developing countries, in terms of food energy as well as nutrients. Common
      beans are a good source of proteins, vitamins (thiamine, riboflavin, niacin,
      vitamin B6) and certain minerals (Ca, Fe, Cu, Zn, P, K, and Mg). They are an
      excellent source of complex carbohydrates and polyunsaturated free fatty acids
      (linoleic, linolenic). However, common beans have several undesirable attributes,
      such as long cooking times, being enzyme inhibitors, phytates, flatus factors,
      and phenolic compounds, having a "beany" flavor, and being lectins and allergens,
      which should be removed or eliminated for effective utilization. Grain quality of
      common beans is determined by factors such as acceptability by the consumer,
      soaking characteristics, cooking quality, and nutritive value. Acceptability
      characteristics include a wide variety of attributes, such as grain size, shape,
      color, appearance, stability under storage conditions, cooking properties,
      quality of the product obtained, and flavor. Storage of common beans under
      adverse conditions of high temperature and high humidity renders them susceptible
      to a hardening phenomenon, also known as the hard-to-cook (HTC) defect. Beans
      with this defect are characterized by extended cooking times for cotyledon
      softening, are less acceptable to the consumer, and are of lower nutritive value.
      Mechanisms involved in the HTC defect have not been elucidated satisfactorily.
      Attempts to provide a definitive explanation of this phenomenon have not been
      successful. The most important hypotheses that have been proposed to explain the
      cause of bean hardening are (1) lipid oxidation and/or polymerization, (2)
      formation of insoluble pectates, (3) lignification of middle lamella, and (4)
      multiple mechanisms. Most researchers have reported that the defect develops in
      the cotyledons. Recently, some authors have suggested that the seed coat plays a
      significant role in the process of common bean hardening. A better knowledge of
      cotyledon and seed coat microstructure may lead to a better understanding of the
      causes of seed hardness. In order to prevent the development of the HTC defect
      several procedures have been proposed: (1) appropriate storage, (2) controlled
      atmospheres, and (3) pretreatments. Probably, the most workable solution to the
      hardening phenomenon may be the development of materials less prone to HTC
      phenomenon. Decreasing cooking time, increasing nutritive value, and improving
      sensory properties of seeds with HTC defect would have great nutritional and
      economical impact.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8484868
TI  - [Nursing documentation: consensus in practice (3). The application in stages 2
      and 3: Mr. Roozendaal].

PMID- 8484869
TI  - [Empathy project in nursing home Bernardus (1). 'Being empathetic is a 24-hour
      activity].

PMID- 8484870
TI  - [Empathy project in nursing home Bernardus (2). Being empathetic with
      psychogeriatric residents].

PMID- 8484871
TI  - [Environment and health care (8). Pollution of the inside environment].

PMID- 8484872
TI  - [The BVG (Occupational Board for Health, Mental and Social Affairs) or: the
      campaign against illness absence and bureaucracy. 'Simpler legislation promised?
      Where does it say so?].

PMID- 8484874
TI  - [Nursing--medicine. How do we define the limits?].

PMID- 8484873
TI  - [Safe handling of nitrogen mustard. Risks for nurses in the treatment of mycosis
      fungoides].

PMID- 8484875
TI  - [Stimulating to an age-conscious personnel management].

PMID- 8484876
TI  - [Foundation Nursing and Media, or Toward a different nursing image. 'The media
      did not grow along'].

PMID- 8484877
TI  - [Environment and health care (10). Risk communication: the nurse as mediator].

PMID- 8484878
TI  - [Nursing documentation: consensus in practice (5). The application in stage 4:
      Trees].

PMID- 8484879
TI  - [Transfer as a link in emergency health services].

PMID- 8484880
TI  - [Nursing informatics: an orientation].

PMID- 8484881
TI  - [Information needs by nurses].

PMID- 8484882
TI  - [Knowledge systems: possibilities and pitfalls].

PMID- 8484883
TI  - [The VISIT information system (Nursing Information System Individual Home Care)].

PMID- 8484884
TI  - [Management information for the primary process].

PMID- 8484885
TI  - [Electronic data exchange].

PMID- 8484887
TI  - [Nursing informatics: from small town to big city].

PMID- 8484886
TI  - [Topics of research].

PMID- 8484888
TI  - Hippocampal lesions do not impair negative patterning: a challenge to configural
      association theory.
AB  - According to configural association (CAS) theory (Sutherland & Rudy, 1989), an
      intact hippocampus is required for rats to solve learning problems that are based
      on "configural" processes. This theory identifies the negative patterning
      discrimination as a critical example of this type of problem. Rudy and Sutherland
      (1989) reported disruption of negative patterning following hippocampal formation
      damage produced by intracranial infusion of a mixture of kainic acid + colchicine
      (KA + COL). We assessed acquisition of negative patterning in rats with
      hippocampal damage produced by KA + COL compared with rats with more selective
      ibotenate lesions of hippocampus. Neither group showed impaired negative
      patterning relative to controls. A transfer test provided evidence that all
      groups used configural processes to solve the problem. Thus contrary to CAS
      theory, the hippocampus is not an important substrate for the operation of
      configural processes.

PMID- 8484889
TI  - Effects of amygdala central nucleus lesions on blocking and unblocking.
AB  - The effects of lesions of the amygdala central nucleus (CN) on blocking and
      unblocking of appetitive Pavlovian conditioning were examined in 2 experiments
      with rats. In both lesioned and unlesioned rats, prior pairing of one conditioned
      stimulus (CS) with a food unconditioned stimulus (US) blocked the acquisition of
      conditioning to a second CS when a compound of both stimuli was paired with that
      same US. If the value of the US was increased or decreased when the second CS was
      added, unlesioned rats acquired substantial conditioning to the second cue
      (unblocking). Unblocking occurred in lesioned rats only when the US value was
      increased. In both lesioned and unlesioned rats, unblocking was prevented if the
      compound cue was paired with the original US prior to the change in US value.
      These data suggest that the CN is involved in increasing attention to signals for
      significant events but not in tuning out redundant cues.

PMID- 8484890
TI  - Amygdala central nucleus lesions disrupt increments, but not decrements, in
      conditioned stimulus processing.
AB  - The effects of neurotoxic lesions of the amygdala central nucleus (CN) on changes
      in the associability of a conditioned stimulus (CS) in appetitive Pavlovian
      conditioning were examined in 2 experiments with rats. In Experiment 1, CN
      lesions had no effect on the reduction in the associability of a CS produced by
      preexposure to that cue (latent inhibition). In Experiment 2, CN lesions
      prevented the enhancement of the associability of a CS that is normally observed
      when an inconsistent predictive relation is arranged between that CS and another
      cue. The results support previous claims that the amygdala CN is involved in
      broad-based incremental, but not decremental, changes in the processing of CSs in
      Pavlovian conditioning.

PMID- 8484891
TI  - Role of the amygdala complex in early olfactory associative learning.
AB  - Although olfactory associative conditioning in newborn rats produces marked
      structural and functional changes in the olfactory bulb, recent evidence suggests
      that extrabulbar circuits must be involved in storing these early memories. The
      present experiments examined the role of the amygdala complex on early olfactory
      learning. Bilateral amygdala lesions or sham lesions were performed on Postnatal
      Day (PN) 5. On PN6, pups were trained in a standard classical conditioning
      paradigm associating odor with tactile stimulation. Behavioral testing on PN7
      revealed that amygdala lesions blocked odor preferences but had no effect on
      conditioned behavioral activation. Similar sized neocortical lesions did not
      impair odor preferences. Importantly, amygdala lesion effects on learned odor
      preferences could be reversed by extensive overtraining. These results suggest
      that the amygdala complex plays a critical role in modulating associative
      learning as early as the first postnatal week in the rat.

PMID- 8484892
TI  - Reversible lesions of the red nucleus during acquisition and retention of a
      classically conditioned behavior in rabbits.
AB  - Previous lesion, recording, and stimulation studies implicated the cerebellum and
      its associated brain-stem circuitry as essentially involved in classical
      conditioning of discrete, somatic muscle responses. This is a companion to our
      study of interpositus cooling, which showed that the formation of a memory was
      prevented. In the present study, we assess the red nucleus for its role in the
      plasticity associated with learning and memory by using local cooling as a
      reversible lesion technique. A cooling probe was implanted lateral to the red
      nucleus. Recording electrodes were implanted in the right red nucleus and the
      left interpositus nucleus. Animals were trained for 5 days with the cooling probe
      activated. No behavioral conditioned responses (CR) developed, and multiple unit
      recordings related to learning did not develop in the red nucleus. However, a
      learning related model did develop in the interpositus. After 5 days of training
      while cooling, animals were given 5 days of normal training (cooling probe
      inactive) to assess retention. Substantial savings were evident when normal
      training was given. CRs appeared quickly on the first day of normal training, and
      multiple unit models were present in both red nucleus and interpositus nucleus.
      These results support the idea that the red nucleus is a necessary efferent for
      the memory trace formed in the cerebellum.

PMID- 8484893
TI  - Effects of ablation of the presumed equivalent of the mammalian prefrontal cortex
      on pigeon homing.
AB  - Pigeons (Columba livia) with bilateral ablation of the postero-dorsolateral
      neostriatum and the overlying corticoid were compared with unoperated control
      subjects in homing from both familiar and unfamiliar sites. Before the operation
      all the pigeons were subjected to 8 training flights from a site destined to be
      the familiar one. Postoperatively, the groups did not differ in orientation from
      the familiar site. In their releases from unfamiliar sites, however, the operated
      birds oriented in the training flight direction, whereas the control subjects
      were oriented homeward. In all the releases the homing performance, including
      both the homing speed and the number of returned birds, was significantly higher
      in the control group. Thus, the ablated tissue plays a role in homing behavior
      possibly through mediation of spatial orientation, of olfactory navigation, or of
      both.

PMID- 8484894
TI  - Lateral hyperstriatal lesions disrupt simultaneous but not successive conditional
      discrimination learning of pigeons (Columba livia).
AB  - In 2 experiments we explored the effects of lateral versus medial laminar lesions
      of the hyperstriatum in pigeons (Columba livia); medical lesions were largely
      confined to the hyperstriatum accessorium, and lateral lesions to the
      hyperstriatum dorsale and hyperstriatum ventrale. In Experiment 1, lateral, but
      not medial, lesions disrupted acquisition of a simultaneous conditional
      discrimination; both medial and lateral lesions disrupted reversal of the
      discrimination. The reversal deficits of the medial and lateral groups were
      quantitatively similar, and both groups showed exaggerated positional responding.
      In Experiment 2, neither medial nor lateral lesions disrupted acquisition of a
      successive conditional discrimination. We conclude that lateral hyperstriatal
      damage does not obtain a general disruption of conditional learning; we speculate
      that the lateral hyperstriatum may play a critical role in configural learning.

PMID- 8484895
TI  - Decreased testosterone levels and accelerated extinction of a conditioned taste
      aversion in fluid-deprived male rats.
AB  - The hypothesis that fluid deprivation accelerates extinction of a conditioned
      taste aversion in male Sprague-Dawley-derived rats by reducing serum testosterone
      levels was tested. Serum testosterone levels were found to be lower in fluid
      deprived males than in nondeprived males (Experiments 1 and 2). Exogenous
      testosterone treatment that results in high physiological levels of serum
      testosterone slowed the extinction of fluid-deprived gonadectomized males to
      rates comparable with those of nondeprived sham males (Experiment 3). It was
      noted, however, that testosterone treatment was less effective in slowing
      extinction in fluid-deprived gonadectomized males than in nondeprived
      gonadectomized males even though the serum testosterone levels were the same
      (Experiments 3 and 4). These results provide strong support for the original
      hypothesis, but they suggest that fluid deprivation also reduces sensitivity to
      testosterone.

PMID- 8484896
TI  - Additivity of taste-specific effects of sucrose and quinine: microstructural
      analysis of ingestive behavior in rats.
AB  - Effects of sweet and bitter tastes on ingestion were studied by timing licking
      responses. Twelve water-deprived rats were given 15-min access to sucrose (S)
      solutions (0.00%, 1.25%, 2.50%, and 5.00%) with and without quinine (0.01%) and
      to quinine (Q) solutions (0.00%, 0.0025%, 0.005%, and 0.01%) with and without
      sucrose (5.00%). Volume ingested and number of licks increased with S and
      decreased with Q. In response to S, the number of bursts increased, and interlick
      intervals lengthened. In response to Q, licks to ingest 1 ml of solution, burst
      number, and percentage of slow licks increased, and burst size decreased. When Q
      and S were mixed in the same solution, the pattern of ingestive responses
      manifested attributes of both tastes. Results suggest 2 separate, parallel
      systems that operate simultaneously to govern rats' licking behavior. One system
      expresses the effect of S on the pattern of ingestion and the other expresses the
      effects of Q.

PMID- 8484897
TI  - Learning that food is inedible in freely behaving Aplysia californica.
AB  - Freely behaving Aplysia californica can learn that food is inedible. Animals were
      given access to seaweed tied into canvas and attached to a force transducer.
      Animals repeatedly found the stimulus, attempted to ingest it, and failed. The
      force transducer provided an objective record of the number of attempts made by
      the animal to ingest the stimulus, the length of each attempt, and its intensity
      (i.e., peak force exerted). Within 2.5 hr, animals showed significant declines in
      these 3 measures of response to the stimulus. When exposed to the same stimulus
      the next day, animals showed more rapid declines in responsiveness, which
      indicate a retention of learning. Training appeared to be specific: Responses to
      the seaweed Laurencia of animals previously trained on the seaweed Ulva do not
      differ from the responses of naive animals to Laurencia.

PMID- 8484898
TI  - Ethanol-induced changes in plasma proteins, angiotensin II, and salt appetite in
      rats.
AB  - Sodium depletion in rats elicits a sodium appetite that results from a cerebral
      action of angiotensin II (ANG II) and aldosterone. Alcohol also activates the
      renin-angiotensin system, but the mechanism is poorly understood and not related
      to sodium excretion. In this study, 2.5 g/kg ip ethanol produced a 20% decline in
      plasma volume and plasma protein concentration in 1-2 hr and elicited salt
      appetite beginning in 3-4 hr. Blockade of ANG II synthesis in the brain and
      periphery with the angiotensin-converting enzyme inhibitor captopril eliminated
      the thirst and salt appetite. Peripheral captopril alone enhanced fluid intake,
      which indicated that alcohol elevated renin secretion. Ethanol-induced
      suppression of hepatic plasma protein secretion and the consequent fall in plasma
      colloid osmotic pressure apparently resulted in hypovolemia and renin secretion,
      which then produced thirst and salt appetite through an action of ANG II on the
      brain.

PMID- 8484899
TI  - Effect of meal composition on mood.
AB  - The influence of simple carbohydrate, complex carbohydrate, protein, and delayed
      meal conditions on plasma tryptophan ratios and mood of normal subjects was
      investigated. In Experiment 1, 27 women consumed 1 of 4 meal conditions, had
      blood samples drawn, and completed mood assessment measures before and at 5 times
      during the next 3 hr. Experiment 2 replicated Experiment 1 except that blood
      samples were not drawn and an additional simple carbohydrate condition was
      included. The carbohydrate meal conditions elevated blood glucose levels and
      plasma ratio of tryptophan to other large neutral amino acids over that of the
      protein condition. A decline in feelings of fatigue and distress occurred 30 min
      postprandial regardless of condition and persisted for the rest of the study.

PMID- 8484900
TI  - Ultrasonic vocalization, laryngeal braking, and thermogenesis in rat pups: a
      reappraisal.
AB  - In these experiments we tested the hypothesis that the respiratory events
      underlying rat pup ultrasonic vocalization (USV) facilitate brown adipose tissue
      (BAT) thermogenesis, as proposed by Blumberg and Alberts (1990). Laryngeal
      denervation or tracheostomy were used to reduce or eliminate laryngeal braking
      and prevent USV in 9- to 10-day-old pups during recovery from deep hypothermia
      and during cooling induced by isolation for 1 hr at room temperature. Both forms
      of devocalization slowed rewarming of hypothermic pups, but neither had any
      effects on cooling rate or BAT thermogenesis in normothermic pups that were
      allowed to cool from 35 degrees C to 29 degrees C. Physiological effects of
      laryngeal braking on thermogenesis appear to be limited to conditions, such as
      severe hypothermia, in which ventilatory and oxygen transport functions are
      compromised. The results have implications for understanding the regulation and
      evolution of USV.

PMID- 8484901
TI  - The role of the amygdala and dorsal raphe nucleus in mediating the behavioral
      consequences of inescapable shock.
AB  - It has been argued that exposure to inescapable shock produces later behavioral
      changes such as poor shuttle box escape learning because it leads to the
      conditioning of intense fear, which later transfers to the shuttle box test
      situation and interferes with escape. Both fear, as assessed by freezing, and
      escape were measured in Sprague-Dawley rats 24 hr after exposure to inescapable
      shock. Lesions of the basolateral region and central nucleus of the amygdala
      eliminated the fear that transfers to the shuttle box after inescapable shock, as
      well as the fear conditioned in the shuttle box by the shuttle box shocks.
      However, the amygdala lesions did not reduce the escape learning deficit produced
      by inescapable shock. In contrast, dorsal raphe nucleus lesions did not reduce
      the fear that transfers to the shuttle box after inescapable shock, but
      eliminated the enhanced fear conditioning in the shuttle box as well as the
      escape deficit. The implications of these results for the role of fear and
      anxiety in mediating inescapable shock effects are discussed.

PMID- 8484902
TI  - Subjective reward magnitude of medial forebrain stimulation as a function of
      train duration and pulse frequency.
AB  - The growth of the subjective reward magnitude of medial forebrain bundle
      stimulation in the rat (Sprague-Dawley) as a function of train duration and pulse
      frequency was measured in 2 ways: (a) a titration method, which used differences
      in rate of reward on 2 levers to compensate for differences in the magnitude of
      the rewards; and (b) a direct method, in which the ratio of the reward magnitudes
      at the 2 levers was assumed to be given by the ratio of times spent on each
      lever. The results of the 2 methods agree. Reward magnitude grows as
      approximately a power function of train duration up to train durations of about 1
      s, then declines somewhat over the interval from 2-20 s. The exponent of growth
      varies from 0.4 to 2.3. With stronger stimulation (higher pulse frequency), peak
      reward magnitude is bigger, but the saturating train duration is approximately
      the same.

PMID- 8484903
TI  - The amygdala is necessary for the expression of conditioned but not unconditioned
      analgesia.
AB  - Lesions of the basolateral region and central nucleus of the amygdala prevent
      conditioned analgesia (Helmstetter, 1992). In general, these regions of the
      amygdala are more critically involved in the expression of conditioned reactions
      to aversive events than in the mediation of unconditioned reactions. The impact
      of amygdala lesions on both conditioned and unconditioned analgesia was explored
      in Sprague-Dawley rats. The lesions completely prevented the expression of
      conditioned analgesia, but had no effect on unconditioned analgesia.

PMID- 8484904
TI  - Purification of basic fibroblast growth factor and alkaline phosphatase from
      human placenta.
AB  - Human placenta is an available hospital waste which is known to contain many
      valuable biochemicals that may be commercially exploited. Using placental tissue
      previously extracted for haemoderivatives, we purified basic fibroblast growth
      factor (bFGF), a soluble protein, and placental alkaline phosphatase (PALP), a
      membrane-linked protein, as a coupled process. bFGF purification comprises three
      steps: extraction and chromatographies on S-Sepharose and heparin-Sepharose. The
      final product includes a major 17 kDa and a minor 16 kDa component with a
      specific activity of 8.0 x 10(6) units/mg yielding 0.5-1.0 microgram/kg of
      placenta. PALP purification comprises four steps: acidic butan-1-ol extraction
      and chromatographies on Q-Sepharose, concanavalin A-Sepharose and Q-Sepharose.
      The purified PALP has a molecular mass of 70 kDa, a specific activity of 800
      units/mg and yielded 50 micrograms/kg of placenta. The results show the
      possibility of purifying substances in placental haemolysed blood, soluble
      products from placental cellular mass and proteins from the cellular membrane in
      a one-stream process.

PMID- 8484905
TI  - Influence of the reaction medium on enzyme activity in bio-organic synthesis:
      behaviour of lipase from Candida rugosa in the presence of polar additives.
AB  - Lipase from Candida rugosa immobilized on Celite was employed as the biocatalyst
      in order to examine the effect of the reaction medium upon enzymic activity and
      selectivity. As the model reaction, transesterification between tributyrin and
      pentan-2-ol in iso-octane (2,2,4-trimethylpentane) was chosen. A small amount of
      water (0.05%, v/v) was added to the reaction medium. Enhanced transesterification
      yields and increased selectivity of the lipase could be obtained by manipulating
      the microenvironment of the catalyst. Addition of 0.2% NN-dimethylformamide
      allowed a 93% higher ester yield compared with that obtained when no extra
      addition was made. Under the same conditions, the ratio of the amount of
      transesterification product over the amount of hydrolysis product after 48 h,
      became 52% higher than the ratio determined in the absence of additives. It was
      concluded that addition of compounds that have low logP3 (P is the partition
      coefficient in the octanol/water two-phase system) values and high dielectric
      constant was advantageous in order to favour transesterification over hydrolytic
      processes.

PMID- 8484906
TI  - Cyclomaltodextrin glucanotransferase from Bacillus circulans E 192: nitration
      with tetranitromethane.
AB  - Nitration of tyrosine residues was performed on Bacillus circulans E 192
      cyclomaltodextrin glucanotransferase (CGTase) using tetranitromethane (TNM). A
      maximum of 15 out of 28 tyrosine residues is modified with 8 mM TNM, entailing a
      concomitant loss of enzymic activity and tryptophan fluorescence. Spectroscopic
      studies suggest that these two phenomena are related to an impairment of the
      enzyme conformation as a consequence of the tyrosine nitration. The presence of 5
      mM acarbose during the CGTase nitration results in the protection of one tyrosine
      residue and the rate of inactivation is reduced 9.4-fold. These results support a
      contribution of a tyrosine residue in the CGTase catalytic site. The nitration of
      CGTase also entails a decrease in the enzyme's affinity for a beta-cyclodextrin
      (beta-CD) co-polymer. Kinetic and analytical investigations on isolated modified
      enzymes support the concept that this phenomenon is unrelated to the modification
      of tyrosine residues, but rather concerns a side reaction of the reagent
      occurring at the raw-starch-binding site of the CGTase.

PMID- 8484907
TI  - Peptide synthesis catalysed by Pseudomonas aeruginosa elastase.
AB  - Pseudomonas aeruginosa elastase was used for peptide-bond synthesis with
      benzyloxycarbonylalanine and amino acid amides as nucleophilic substrates.
      Dipeptide-bond synthesis was observed only for hydrophobic amino acid amides. The
      rate of peptide synthesis, measured by h.p.l.c., was in the decreasing order: Phe
      > Leu > Tyr > Val, Ile > Ala, which is consistent with the decreasing order of
      hydrolysis rates of the corresponding tetrapeptides Ala-Ala-Xaa-Ala. In contrast
      with thermolysin, Ps. aeruginosa elastase permits the synthesis of tyrosine
      containing peptides with tyrosine in the P'1 position. Furthermore, the rates of
      synthesis for other hydrophobic amino acid amides are higher with elastase than
      with thermolysin.

PMID- 8484908
TI  - Exo-glucosidase activity and substrate specificity of the beta-glycosidase
      isolated from the extreme thermophile Sulfolobus solfataricus.
AB  - The enzyme with beta-galactosidase activity from Sulfolobus solfataricus strain
      MT-4, like other enzymes of this type isolated from thermophilic sources, has
      broad specificity for beta-D-gluco-, fuco- and galacto-sides. The beta
      galactosidase activity was purified by a new procedure that improved yields (44%)
      and final specific activity (182 units mg-1 at 75 degrees C using chromogenic
      beta-D-galactoside as substrate). The enzyme hydrolysed a large number of beta
      linked glycoside dimers and oligomers; chromogenic beta-glucosides and beta
      fucosides are the preferred substrates, and kinetic analysis indicated that they
      bind to a common catalytic site. The order of catalytic efficiency was beta 1-3 >
      beta 1-4 > beta 1-6 and cellotetraose > cellotriose > cellobiose for glucose
      dimers and oliogomers respectively. The cleavage occurred at the non-reducing end
      of the oligosaccharide, and the enzyme showed noticeable specificity also for the
      aglycone part of substrates. From these results the enzyme from S. solfataricus
      strain MT-4 is defined as a true glycosyl hydrolase with remarkable exo
      glucosidase activity and it is designated S beta-gly.

PMID- 8484909
TI  - Chitinolytic digestibility of cross-linked chitosan gels by an enzyme complex
      from Streptomyces kurssanovii.
AB  - The action of a microbial chitinolytic enzyme complex from Streptomyces
      kurssanovii on chitosan gels with various degrees of cross-linking and on the O
      derivatives of the gels was examined. The rate of digestion of the gels was shown
      to depend on the degree of cross-linking as well as on the size of the O
      substituent, decreasing greatly with a rise in substitution.

PMID- 8484910
TI  - [Evolution of the microbiological parameters of cured ham].
AB  - The main microbiological and physico-chemical parameters in dry-salted ham
      previously selected were determined along the elaboration process. All
      determinations were performed at 2 levels: surface and internal. All bacterial
      groups showed a similar behaviour, increasing along the first stages up to the
      third month of drying, then decreasing to numbers similar to the initial ones.
      Only the halotolerants maintained fairly high numbers during last stages. Some
      groups were almost absent at internal levels. The hazardous bacteria showed
      different behaviour: whereas the faecal streptococci were fairly abundant during
      the whole study, coliforms almost disappeared at the final stages. During the
      elaboration process at different stages of ripening they were analysed in order
      to know the moulds population at surface level. Aspergillus and Penicillium were
      the dominant genera. The latter, mainly represented by 10 species, dominated
      during the first stages of elaboration. Aspergillus was present throughout the
      whole making process. The glaucus group was clearly dominant at the final stages
      due to the low aw values together with the high NaCl percentages. Aspergillus
      halophilicus was the most abundant species identified (18%) and the most
      frequently isolated at the final stages.

PMID- 8484911
TI  - [Experimental design and data handling in food microbiology].
AB  - A discussion on the problems associated with designing experiments in Food
      Microbiology research is presented. After defining what is meant by Design of an
      Experiment, a series of questions are raised that, once answered, will help in
      properly designing the experiment. It is emphasized the chain research-design
      model-analysis-design and the danger in blindly using well-known designs and
      canned programs.

PMID- 8484912
TI  - [Lipid- and protein-degrading processes during the maturation of ham].
AB  - In the present work we review the main degradative pathways for lipids and
      proteins along the ripening of dry cured hams, with special emphasis on Iberian
      pig hams. Maximum proteolytic activity is found around the first stages (salting)
      and specially at the dryer. Lipolytic activity seems to be also higher in this
      stage. During the steps that follow the post-salting period the oxidation seems
      to be activated. The products from proteolytic and lipolytic processes might
      react among each other during the final steps in the cellar.

PMID- 8484914
TI  - [Monographic issue on foods].

PMID- 8484913
TI  - Biochemical and microbiological events of Parma ham production technology.
AB  - Parma ham technology relies on a few basic points. They are: a fresh meat
      substantially free of microbial deep contamination, a relatively long phase (up
      to 100 days) at cold temperatures at the beginning of processing, an uncovered
      muscular surface as reduced as possible, a long period of maturation. The final
      product, the matured ham, is the result of a slow process of dehydration which,
      combined with a limited penetration of salt into the muscles, lowers the water
      activity to values around 0.90. Surface bacterial contamination is mainly made up
      by Enterobacteriaceae and Pseudomonadaceae. Among them E. agglomerans and S.
      liquefaciens are able to grow at 2 degrees C and salt concentrations up to 7.5%
      and can be responsible for taint development. Micrococci penetrate into the meat
      during salting and can reach values of 10 x 6 but decrease substantially towards
      the end of maturation. Maturation, from a biochemical point of view, is
      characterized by hydrolytic phenomena interesting nitrogen compounds and fats. As
      a result free amino acids, non protein nitrogen, volatile fatty acids and
      carbonylic molecules are produced. Such products are important for the
      development of typical organoleptic characters.

PMID- 8484915
TI  - [Technology for the production of cured ham].
AB  - The main factors to be considered in the preservation of hams are: pH level,
      temperature and level of water activity. There are four different stages in the
      process of curing. (1) Selection of the raw material: the longer the time of
      curing, the higher the percentage of marbled fat has to be (to control the drying
      process). The temperature within the ham should be kept between 1 and 3 degrees
      C. (2) In the salting stage, nitrifiers are added and the hams are either coated
      with salt for 1 day per kg of ham, or a specific quantity of salt is applied in a
      massager or a tumbler. (3) In the post-salting stage, hams are kept below 5
      degrees C for at least one month. During this stage salt diffuses throughout the
      ham. Some dehydration, and selection of bacteria occurs. On the outside of the
      ham fungi will grow, while inside Micrococcaceae are the dominant flora. Finally
      the hams pass to a drying-maturing stage. As the level of water activity falls,
      the temperature is increased, causing proteolysis and lipolysis, which are
      important for the development of texture and flavour of the ham.

PMID- 8484916
TI  - [Utilization of lactic bacteria in the control of pathogenic microorganisms in
      food].
AB  - The lactic acid bacteria have the potential to inhibit the growth of pathogenic
      and spoilage bacteria and the possibility exists of using them to improve the
      hygienic quality and to extend the shelf-life of different foods. Among the many
      inhibitory substances produced by the lactic acid bacteria, the bacteriocins are
      of particular interest. It has been the objective of this work to review the
      bacteriocins produced by lactic acid bacteria from the genera Lactococcus,
      Lactobacillus and Pediococcus, as well as Leuconostoc and Carnobacterium to
      understand their relevant biochemical, immunological and genetic characteristics.
      The lactic acid bacteria may also express foreign genes codifying metabolites
      with antimicrobial activities against foodborne pathogens of interest, and this
      will also permit hypothesize about theoretical and experimental models of
      microbial antagonism mediated by the lactic acid bacteria.

PMID- 8484917
TI  - [Incidence, behavior and control of Aeromonas hydrophila in meat and dairy
      products].
AB  - This review deals with several aspects of Aeromonas hydrophila and other motile
      Aeromonas species associated with foodborne illness. Although it is mainly
      dedicated to the factors affecting growth and survival of this species in foods
      of animal origin, information on other topics is also provided. This paper
      includes sections on: Taxonomy, diseases caused by Aeromonas, virulence factors,
      reservoirs and prevalence in foods and water, factors affecting growth and
      survival, isolation and identification, and control measures.

PMID- 8484918
TI  - Incidence and control of Campylobacter in foods.
AB  - Campylobacter jejuni is known as the most common human enteropathogen in
      developed countries. The epidemiology of the organism has now been adequately
      determined and indicates that campylobacteriosis is a zoonotic disease. Pets,
      water, and contaminated foods are the main sources of sporadic infections in
      humans, and no single animal food source can be excluded as a potential vehicle
      for infection of humans. The available information indicates that 50 to 70% of
      cases of enteritis in man are associated with poultry. Cross-contamination and
      improper handling and cooking of foods of animal origin account for the majority
      of disease. Hygienic measures must be applied in order to reduce the incidence of
      campylobacteriosis in humans.

PMID- 8484919
TI  - [Applications of molecular biology techniques for the control of aflatoxin
      contamination].
AB  - Aflatoxins are mycotoxins produced by species of Aspergillus flavus group. These
      toxins have received increased attention from the food industry and the general
      public because they shown a high toxicity against humans and animal. Different
      methods are applying to control the aflatoxin contamination. But these
      conventional methods do not seem to resolve the problem. So, new methods using
      techniques in biotechnology are now being developed: a) Inhibit the biosynthetic
      and secretory process responsible for aflatoxin contamination. b) Using
      biocompetitive agents that replace aflatoxigenic strains with non aflatoxigenic
      strains in the field. c) Using genetic engineering techniques to incorporate
      antifungal genes into specific plant species.

PMID- 8484921
TI  - Predictive modelling of growth, survival and inactivation of pathogenic and
      spoilage organisms in foods.

PMID- 8484920
TI  - [Genetic manipulation of the synthesis of fungal enzymes for use in the food
      industry].
AB  - Food industries use a great variety of enzymes as additives. The main percentage
      of them are produced by species of filamentous fungi. In this review we present
      the strategies to purify and overproduce this kind of enzymes using recombinant
      DNA techniques.

PMID- 8484922
TI  - Structure of 1-(4-[2-(diethylamino)ethoxy]phenyl)-2-(4-methoxyphenyl)-1
      phenylethan- 1-ol, the non-steroidal antiestrogen MER25.
AB  - C27H33NO3, M(r) = 419.6, monoclinic, P2(1)/a, a = 22.833 (6), b = 9.370 (3), c =
      11.434 (4) A, beta = 110.71 (8) degrees, V = 2288.2 A3, Z = 4, Dx = 1.22 g cm-3,
      lambda (Cu K alpha) = 1.54178 A, mu = 5.8 cm-1, F(000) = 904, T = 138 K, R =
      0.049 for 3265 observed reflections. The molecule of MER25 assumes an extended
      conformation with rings alpha' and beta in an antiperiplanar (trans) conformation
      giving the solid-state conformer a closer resemblance to the estrogenic (E)
      isomer of tamoxifen than the antiestrogenic (Z) isomer. The geometrical features
      of the triarylethan-1-ol moiety are comparable to related structures but the
      orientations of the phenyl rings are different. The O-C-C-N segment in the
      (diethylamino)ethoxy side chain has the uncommon trans conformation instead of
      the more commonly observed gauche conformation seen in tamoxifen and many of its
      derivative structures. The amino N atom forms a hydrogen bond with the hydroxyl
      group of a neighboring molecule to form an infinite chain along the b axis.

PMID- 8484923
TI  - Structure of ethyl phenyl selenone.
AB  - C8H10O2Se, M(r) = 217.13, monoclinic, P2(1)/n, a = 9.511 (2), b = 15.741 (3) c =
      11.467 (2) A, beta = 91.31 (2) degrees, V = 1716.3 (6) A3, Z = 8 (two molecules
      per asymmetric unit), Dx = 1.68 Mg m-3, lambda (Mo K alpha) = 0.71069 A, mu =
      4.19 mm-1, F(000) = 864, T congruent to 295 K, R(obs) = 0.060 for 1944 unique
      reflections with I > 2 sigma (I). The two molecules in the asymmetric unit are
      very similar; they differ only in the conformation of the ethyl side chain. There
      is considerable disorder in one molecule, that possibly can be represented by
      torsion about the Se-C(ethyl) bond. In each case the O atoms of the SeO2 group
      lie near the plane of the phenyl group. Se-O ... H-C interactions appear to be
      the only significant intermolecular interactions. These involve an H atom of the
      alpha-C atom of the ethyl group in addition to the H atoms of the phenyl group.

PMID- 8484924
TI  - Structure of the molecular complex of anthracene with 1,8:4,5
      naphthalenetetracarboxylic dianhydride.
AB  - C14H10.C14H4O6, M(r) = 446.42, monoclinic, P2(1)/a, a = 17.572 (10), b = 7.727
      (4), c = 7.398 (4) A, beta = 101.90 (4) degrees, V = 982.9 (9) A3, Z = 2, Dx =
      1.508 Mg m-3, lambda (Mo K alpha) = 0.71069 A, mu = 0.100 mm-1, F(000) = 460, T =
      293 K, R = 0.050 for 1429 unique reflections with I > 3 sigma (I). The molecules
      stack with alternating rows of anthracene and dianhydride molecules. The two
      types of molecule do not lie parallel to each other in these stacks, possibly as
      a result of interactions between the peripheral H atoms of the anthracene and O
      atoms of the anhydride.

PMID- 8484925
TI  - Structures of quinone imine metabolites related to the anti-cancer drug
      amsacrine.
AB  - (5): N-(9-Acridinyl)-3-methoxy-1,4-benzoquinone monoimine, C20H14N2O2, M(r) =
      314.3, monoclinic, P2(1)/c, a = 13.451 (8), b = 7.007 (4), c = 17.864 (12) A,
      beta = 117.26 (4) degrees, V = 1497 (2) A3, Z = 4, Dm = 1.36 (1), Dx = 1.395 g cm
      3, Mo K alpha, lambda = 0.71069 A, mu = 0.99 cm-1, F(000) = 656, T = 138 (5) K, R
      = 0.049 for 1556 reflections. (8): N-(9-Acridinyl)-2-methoxy-1,4- benzoquinone
      monoimine, C20H14N2O2, M(r) = 314.3, triclinic, P1, a = 9.365 (1), b = 13.318
      (2), c = 6.918 (3) A, alpha = 96.45 (3), beta = 105.30 (2), gamma = 110.11 (1)
      degrees, V = 761.6 (4) A3, Z = 2, Dm = 1.35 (1), Dx = 1.371 g cm-3, Mo K alpha,
      lambda = 0.71069 A, mu = 0.98 cm-1, F(000) = 328, T = 292 (1) K, R = 0.075 for
      1009 reflections. (13): N-(9-Acridinyl)-5-dimethylamino-2- methoxy-1,4
      benzoquinone monoimine, C22H19N3O2, M(r) = 357.4, triclinic, P1, a = 8.091 (7), b
      = 10.078 (2), c = 11.716 (3) A, alpha = 108.39 (2), beta = 99.63 (4), gamma =
      95.87 (3) degrees, V = 881.4 (9) A3, Z = 2, Dm = 1.33 (1), Dx = 1.347 g cm-3, Mo
      K alpha, lambda = 0.71069 A, mu = 0.95 cm-1, F(000) = 376, T = 173 (5) K, R =
      0.034 for 1460 reflections. The molecular geometries are described and discussed.

PMID- 8484926
TI  - The TAPS Project. 8: Design of the research study on the long-stay patients.

PMID- 8484927
TI  - The TAPS Project. 9: The reliability of the Patient Attitude Questionnaire.
AB  - The development of the hospital and community versions of the Patient Attitude
      Questionnaire is described. The instrument rates the attitudes of psychiatric
      patients towards their treatment settings and staff, and is framed specifically
      to assess attitudinal change during the transfer of patients from hospital. For
      the items rated using the kappa coefficient of agreement, the mean test-retest
      reliability value was 0.51, and the average inter-rater value was 0.82. This
      study shows that long-term psychiatric patients are able to give clear and
      consistent views about their living arrangements--views that should be sought and
      respected by staff.

PMID- 8484928
TI  - The TAPS Project. 10: The long-stay populations of Friern and Claybury hospitals.
      The baseline survey.
AB  - As part of the TAPS project, the baseline long-stay populations of Friern and
      Claybury Hospitals were compared using the TAPS assessment schedules. Each
      hospital has reduced bed numbers by two-thirds, and although the two have been
      subjected to different influences, their remaining long-stay patients were
      similar, and characterised by severe problems with hygiene, florid psychotic
      symptoms, a high prevalence of negative symptoms, and impoverished social
      networks.

PMID- 8484929
TI  - The TAPS Project. 11: The selection of patients for reprovision.
AB  - The selection of patients for community reprovision during the first three years
      of an active closure programme at two large mental hospitals in the North East
      Thames Regional Health Authority was studied. It was found that a strong
      selection bias was operating: the patients selected were significantly younger,
      had spent less time in full-time psychiatric care, were less likely to have a
      diagnosis of schizophrenia, had larger social networks, and were more likely to
      want to leave hospital.

PMID- 8484930
TI  - The TAPS Project. 12: Crime, vagrancy, death and readmission of the long-term
      mentally ill during their first year of local reprovision.
AB  - The extent of crime, vagrancy, death, and readmission in a prospective cohort of
      long-term mentally ill patients was measured during their first year out of
      hospital. All 278 long-stay psychiatric patients discharged during the first
      three years (1985-1988) of the closure of Friern and Claybury Hospitals were
      included. One patient was imprisoned, one committed suicide, and one became
      vagrant; five others may also have become vagrant. The mortality rate was similar
      for the leavers and their matched controls, who remained in hospital. There was
      one suicide among the matches. Mental deterioration most often caused
      readmission. On recovery, most patients returned to their community home. Six per
      cent of the cohort were readmitted and have remained in hospital for a year or
      more. With careful planning and a financial 'dowry' for each patient, the closure
      of large mental hospitals does not lead to a marked increase in vagrancy, crime,
      and mortality for the long-term mentally ill. However, the patients who have yet
      to leave have more problems of social behaviour and are likely to be more
      difficult to resettle.

PMID- 8484931
TI  - The TAPS Project. 13: Clinical and social outcomes of long-stay psychiatric
      patients after one year in the community.
AB  - The first prospective, controlled study of a large, long-stay, in-patient
      population as their hospital services were reprovided in the community is
      reported. Two-hundred-and-seventy-eight patients were matched individually with
      similar patients who remained in hospital. Clinical and social outcomes over a
      one-year follow-up are presented for the first three years of the reprovision
      process. Compared with matches, the leavers at follow-up had more diverse social
      networks that contained a higher proportion of contacts named as friends. The
      care facilities in the community allowed more opportunities for patient autonomy
      than the hospitals across all aspects of the environments measured. At follow-up,
      more leavers than matches wanted to remain in their current placement, while
      fewer leavers than matches said there was nothing they liked about their current
      placement. More leavers than matches found their medication helpful.

PMID- 8484932
TI  - Evaluating the transfer of care from psychiatric hospitals to district-based
      services.

PMID- 8484933
TI  - The TAPS Project. 7: Mental hospital closure--a literature review of outcome
      studies and evaluative techniques.
AB  - Various techniques have been used to assess the results of
      'deinstitutionalisation'. This paper reviews these outcome studies, most of which
      have concluded that a new long-stay group will replace the old long-stay
      patients, and that a residual group of ageing patients, mostly with organic
      syndromes, is difficult to accommodate in the community.

PMID- 8484934
TI  - A tribute to Jack Anderson (1917-1992)

PMID- 8484935
TI  - The physician as professional and the physician as honest businessman.

PMID- 8484936
TI  - Remobilization of paralyzed vocal cord by anticus-lateralis muscle suturing.
AB  - A new method of dynamic reconstruction by suturing the cricothyroid (anticus) and
      the lateral cricoarytenoid (lateralis) muscles was devised for the treatment of
      unilateral recurrent laryngeal nerve paralysis. Eighteen adult dogs underwent
      this surgical procedure after sectioning a recurrent laryngeal nerve. Immediate
      postoperative observations revealed a marked increase in tension of the paralyzed
      vocal cords and remobilization to the median line of 17 of 18 dogs. More than 4
      months later, fiberscopic examination revealed a satisfactory adduction of the
      cords. Electrophysiologic and histologic examination showed reinnervation of the
      affected lateralis muscle by the external branch of the superior laryngeal nerve.
      The clinical applications of this surgery may serve as a dynamic reconstruction
      for unilateral recurrent laryngeal nerve paralysis.

PMID- 8484937
TI  - Laryngeal reconstruction in children. Assessment of vocal quality.
AB  - During the past decade, the outcome of laryngotracheal reconstruction in children
      has improved substantially regarding airway patency. Now that we feel comfortable
      with airway results, attention should be directed toward vocal quality. The aims
      of this article are to present our evaluation process, which has been developed
      during the past 3 years, and our assessment of results. Six patients who
      underwent successful laryngotracheal reconstruction and could be examined
      preoperatively and postoperatively were studied. Information about disease and
      reconstruction techniques was recorded. Vocal quality assessment was done using
      psychoacoustic evaluation and objective techniques, including acoustic analysis.
      Children offer a specific challenge, especially when their chronological or
      developmental age is younger than 3 years. Objective assessment still lacks the
      ability of using cooperative patients, and adequate samples for acoustic analysis
      are difficult to obtain and standardize. Preoperative abnormalities continued to
      persist postoperatively. Laryngotracheal reconstruction is instrumental in making
      oral communication possible, but the vocal quality is disturbed in most patients.

PMID- 8484938
TI  - A comparative study of speech after total laryngectomy and total
      laryngopharyngectomy.
AB  - Quality of voice is an important factor in the consideration of treatment for
      advanced laryngeal cancer. This prospective study compared the speaking
      proficiency of patients who used the Blom-Singer valve after total laryngectomy
      and after total laryngopharyngectomy with jejunal graft reconstruction with that
      of a group of normal subjects. The total laryngectomy group demonstrated
      excellent communication ability both face-to-face and on the telephone. They
      exhibited superior scores for objective intelligibility, subjective
      intelligibility, acceptability, and intonation when compared with the total
      laryngopharyngectomy group. Both surgical groups produced similar amplitude and
      frequency parameters during normal conversation but had limited reserve when
      these functions were stressed. Despite these quantitative variations, patient
      acceptance was very high in both surgical groups. These results serve as a
      foundation for the evaluation and improvement of rehabilitation techniques.

PMID- 8484939
TI  - Experimental mandibular regrowth by distraction osteogenesis. Long-term results.
AB  - The use of gradual distraction to grow bone (distraction osteogenesis) has gained
      widespread orthopedic acceptance, but has only recently been applied to
      craniofacial skeletal defects. The use of bifocal distraction osteogenesis to
      fill experimental segmental mandibular defects with regenerate bone was recently
      reported. Though all canines in that study demonstrated normal oromandibular
      function, they were observed for only 4 weeks following defect closure. The study
      that is now reported describes the long-term (12-month) functional, morphologic,
      and biomechanical results when bifocal distraction osteogenesis was applied to
      the same model. In this long-term study, three canines had 2.5-cm unilateral
      segmental mandibular body defects filled with structurally stable bone using
      bifocal distraction osteogenesis. These dogs exhibited normal oromandibular
      function for 1 year following segment regrowth and external fixator removal.
      Macroscopic and histologic evaluation of the regrown segments revealed a re
      formation of the cortical and medullary architecture. Stress testing demonstrated
      the average ultimate strength of the regrown segment at 53 MPa, which
      corresponded to 77% +/- 5.7% of normal mandibular bone. The data suggest that
      clinical trials applying this technique to segmental mandibular reconstruction
      are warranted.

PMID- 8484940
TI  - Predicting occult lymph node metastasis in parotid cancer.
AB  - To determine the factors predictive of occult cervical metastases, we
      retrospectively reviewed the charts of 99 previously untreated patients with a
      primary parotid malignancy who underwent elective neck dissection between 1960
      and 1985. Univariate and multivariate analyses were performed to determine the
      predictive value of 11 factors. The univariate study found facial nerve
      paralysis, extraparotid extension, and perilymphatic invasion statistically
      significant. In the multivariate analysis of preoperative factors, facial nerve
      paralysis was most predictive of occult disease. If the variable pool was
      expanded to include a fine-needle biopsy, tumor grade became the most important
      preoperative variable. When the analysis was further expanded to include a
      parotidectomy, the most influential factors were patient age, perilymphatic
      invasion, and extraparotid tumor extension. This report identifies the variables
      predictive of occult neck disease in parotid cancer.

PMID- 8484941
TI  - Peritonsillar abscess. Clinical and microbiologic aspects and treatment regimens.
AB  - This prospective study shows that acute peritonsillar abscess can be successfully
      treated by three-point puncture and aspiration. The results (recurrence in 19%)
      are comparable with published data on drainage of the peritonsillar space through
      the incision procedure. By proper selection of patients, the rate of recurrences
      can be further reduced. Because the occurrence of Streptococcus pyogenes in the
      aspirate seems to be associated with a favorable prognosis of therapy with
      puncture and antibiotics only, testing for the presence of this bacterial species
      might give a useful clue to the type of treatment needed. If the bacterial
      culture shows mixed aerobic and anaerobic flora, but not S pyogenes, and if the
      patient has a history of recurrent tonsillitis, incision or proceeding directly
      to tonsillectomy may be the best therapeutical choice.

PMID- 8484942
TI  - Pediatric cochlear implantation. Radiologic observations of skull growth.
AB  - We investigated the effects of long-term implantation of auditory prostheses on
      skull growth in young animals. Four monkeys were implanted with dummy cochlear
      implants at 6 months of age. To simulate implantation in children, the bed for
      the receiver-stimulator or interconnecting plug was drilled across a calvarial
      suture down to the underlying dura. Plain skull roentgenograms were periodically
      taken to monitor head growth for up to 3 years after implantation. These
      longitudinal measurements revealed no significant asymmetric skull growth.
      Postmortem measurements using computed tomographic scans confirmed these results
      and showed no significant difference in the intracranial volumes between the
      implanted and control sides of each animal or between experimental and
      nonimplanted control monkeys. These results suggest that long-term cochlear
      implantation in very young children will not cause any significant deformity of
      the skull.

PMID- 8484943
TI  - The male facelift. An analysis of 115 cases.
AB  - Based on the anatomic differences in female and male cervicofacial skin, a
      retrospective study of 115 male facelifts was undertaken to identify those
      factors that contributed to a satisfactory esthetic result and the avoidance of
      complications. Incision modifications are reported, as well as the need for
      ancillary procedures (in 37% of the patients) to obtain facial rejuvenation. An
      increased incidence of hematomas (9.6%) was noted.

PMID- 8484944
TI  - Skin excision revision rhinoplasty.
AB  - A technique of skin excision revision rhinoplasty is described for application in
      patients undergoing rhinoplasty. This group of patients includes those with soft
      tissue polly beak deformities and a variety of other difficult post-rhinoplasty
      deformities. Horizontal nasal dorsal skin excision affects tip elevation and
      eliminates supratip fullness, while vertical midline nasal dorsal skin excision
      enhances tip definition, decreases dorsal height, and eliminates supratip
      fullness. We describe several patients who underwent either horizontal or
      vertical nasal dorsal skin excision for a variety of cosmetic deformities
      following conventional closed and open rhinoplasty. The techniques presented
      herein are meant to be added to the list of techniques available to the revision
      rhinoplasty surgeon rather than to replace existing techniques.

PMID- 8484945
TI  - Facial nerve paralysis from slag injury to the ear.
AB  - Transtympanic facial nerve paralysis resulting from a penetrating injury through
      the external auditory canal is a rare occurrence. The common mechanism of
      paralysis is direct fracture or penetration of the fallopian canal. Slag injuries
      of the ear caused by hot sparks or molten metal are well known to
      otolaryngologists because they often result in chronic tympanic membrane
      perforations and chronic otorrhea. We have encountered two unusual cases of
      transtympanic slag injury to the ear that resulted in facial nerve injury. In one
      patient, a significant inner ear injury also occurred. A pathophysiologic
      mechanism of thermal injury is proposed, and the use of ear protection in welders
      is discussed.

PMID- 8484946
TI  - Actinomycosis otomastoiditis.
AB  - We reviewed the reported experience with actinomycosis otomastoiditis in the
      international literature, along with a recent case from our experience. All
      recently reported cases presented with persistent drainage and partial response
      to multiple courses of antibiotics. Diagnosis was uniformly made postoperatively,
      and the outcome was excellent following a prolonged course of antibiotic
      treatment.

PMID- 8484947
TI  - The otolaryngologist and the patient with velocardiofacial syndrome.
AB  - Velocardiofacial syndrome is the most common syndrome associated with clefting of
      the secondary palate. The endoscopically diagnosed occult submucous cleft palate
      is the most common palate anomaly associated with this syndrome. Patients with
      velocardiofacial syndrome present a special challenge to the otolaryngologist,
      who must be familiar with the diagnostic and therapeutic aspects of this
      syndrome. We report the findings in 21 patients with velocardiofacial syndrome.
      Only 11 (52%) had the typical manifestations, and others had only partial
      phenotype. Adenoidectomy must be avoided in these patients, since undiagnosed
      occult and overt submucous cleft palate are the most common cause of
      velopharyngeal insufficiency after adenoidectomy. Three patients had aberrant
      carotid arteries. This anomaly must be excluded by nasoscopy and computed
      tomographic scanning before pharyngeal flap surgery is considered in these
      patients. Criteria for exclusion of high-risk patients from adenoidectomy are
      presented and discussed.

PMID- 8484948
TI  - Pathologic quiz case 2. Laryngeal syngamosis.

PMID- 8484949
TI  - Pathologic quiz case 1. Spindle cell lipoma.

PMID- 8484950
TI  - Goode T tubes.

PMID- 8484951
TI  - [Developing a health mind-set--description of caritative health promotion].
AB  - This investigation describes health promotion from a caring science perspective.
      Caring is defined as an act of "caritas" c.e. love and mercy (Eriksson 1991). The
      investigation is theoretical and comes as a result in a model for health
      education. The model will be empirically tested in the future further on. The
      research method is qualitative and descriptive consisting of three processes: the
      abductive, deductive and inductive. This method was created by Charles Peirce
      (1839-1914). The inductive process will be implemented by testing the model.
      Abduction is the process of forming an explanatory hypothesis. The abductive
      hypothesis of this investigation is formed in the following way: "the kind of
      mood od mind, the kind of health". Main emphasis has been in examining the
      meaning of the mood of mind for ones health and the possibilities to develop it.
      The following question were asserted; 1. What is meant by the mood of mind? 2.
      What attributes are required in order to talk about health's mood of mind? 3.
      What are the possibilities of developing the mood of mind as a way for health
      education? The result of this investigation is presented as a model for health
      promotion. The model is upbuilt by the caritative elements featuring belief,
      hope, love and the concept of virtue. The model shows the consequences for a
      human beings daily living. In the case of having too much belief a human being
      may develop some kind of health fanatism. In the case of having too much belief a
      human being may develop some kind of health fanatism. In the case of having too
      much hope a human being puts forward the decisions about health for tomorrow. In
      the case of having too much love it may lead to a irresponsible lifestyle. An
      assumption is that a balance between belief, hope and love leads in choosing
      health, planning for health and living in health.

PMID- 8484952
TI  - [Life control, the core of being healthy. Theoretical-empirical definition of the
      concept "life control"].
AB  - In this article the concept 'life control' is being analysed and defined. A need
      to define the concept 'life control' emerged during a research that deat with a
      human being's descriptions being healthy. 'Life control' turned out to be the
      central category and the main concept organising the whole data. The data were
      collected by focused interviews (N = 60). Those interviewed represented five
      different styles of 'life control'. One of these styles that were discovered in
      the research was chosen as the basis of the conceptual analysis. This style was
      characterised by 'laissez faire' attitude towards life. Hybrid model was used as
      the theoretical frame of reference in the conceptual analysis. Thorough study of
      Finnish and foreign literature about 'life control' leads into an explicit
      definition of 'life control' describing the data collected by focused interviews:
      'Life control' is an individual's basic belief concerning the possibilities to
      control the course of human life and the extent of this control. An individual
      either controls his/her life quite independently and completely or only to a
      certain extent, or it is controlled by factors beyond the influence of a human
      being. The definition of the 'life control' -concept in the sense that it
      displays basic beliefs should be examined by studying people's way of thinking
      with the help of interviews, essays, questionnaires or analysis of
      autobiographies.

PMID- 8484953
TI  - [Phenomenography--a way to do qualitative research].
AB  - The purpose of this paper is to describe and evaluate theoretical principles,
      possibilities and limits of the qualitative research method called
      phenomenography. The article is based on a literature review. Phenomenography is
      a research methodology initiated by Ference Marton and his research group in
      Sweden in the 1970s. Unlike phenomenology, phenomenography is not a philosophical
      school. It is a pragmatic method for doing qualitative research. In
      phenomenography, the aim of research is to describe the qualitatively different
      ways in which people perceive the world around them (the second-order
      perspective). The most common method of data collection is thematic interviewing.
      The results are categories of description representing the different conceptions
      of a phenomenon found among a certain population. Phenomenography is a useful
      method for qualitative analyses. However, it has also been criticized for a
      static view of human thought--a criticism that points toward the risks of relying
      on a single method in qualitative research.

PMID- 8484954
TI  - [Opinions of student nurses and student care assistants concerning adequate care
      of a patient with dementia, and how to learn it].
AB  - The research investigated the views which the student nurses and the student care
      assistants had received from their studies concerning the care of demented
      patients. It also dealt with the opinions they had received about the good care
      of a demented patient. The data was gathered by interviewing 11 student care
      assistants and 14 student nurses who were to finish their studies within a month.
      The data was analyzed by using qualitative analytical methods. The student care
      assistants emphasized the care itself and the patient more than the student
      nurses did. The student care assistants emphasized the rehabilitation and the
      physical care. While evaluating their studies, the student nurses considered the
      teaching in the nursing school in a more negative way than the student care
      assistants. Both groups regarded the prevailing nursing practice as a difficulty
      in learning the good care of the demented patients.

PMID- 8484955
TI  - The effect of alpha-interferon on thymidine, uridine, and leucine uptake and
      ultrastructure of peripheral blood mononuclear cells from multiple myeloma
      patients.
AB  - The effect of IFN alpha-2b on thymidine, uridine, and leucine uptake was examined
      on peripheral blood mononuclear cells (PBMC) of healthy donors and 15 patients
      with multiple myeloma (MM). In addition, the surface ultrastructure of the cells
      incubated without or with IFN alpha-2b was examined with a scanning electron
      microscope. The results showed that IFN had no effect on thymidine, uridine, or
      leucine uptake of unstimulated MM and control PBMC. On the other hand IFN
      inhibited thymidine, and uridine uptake of PWM-stimulated MM PBMC, but had no
      effect on healthy donor stimulated PBMC. IFN inhibited also thymidine and uridine
      uptake in PHA-stimulated healthy donors and MM patients' PBMC. The cellular
      surface ultrastructure of MM lymphocytes incubated with 100 u/ml IFN showed
      disappearance of the microvilli and formation of cellular pits, whereas in
      healthy donor lymphocytes IFN caused flattening of microvilli.

PMID- 8484956
TI  - Decreased cholesterol biosynthesis in fibroblasts from patients with Parkinson
      disease.
AB  - The underlying cause of cellular degeneration in the substantia nigra of patients
      with Parkinson disease has not been clearly established. With the objective of
      investigating whether metabolic abnormalities would be detected in peripheral non
      neuronal cells, we began assessing key metabolic parameters in skin fibroblasts
      of these patients. The present report focuses on the finding of a remarkably
      reduced cholesterol biosynthetic capability of fibroblasts from patients with
      Parkinson disease. 14C-Acetate incorporation into cholesterol of these
      fibroblasts was 27.8 +/- 9.4% that observed in normal fibroblasts, and the
      reduced cholesterol synthesis was confirmed by measuring the activity of the rate
      limiting enzyme HMGCoA reductase which averaged 6.64 +/- 2.50 nmol/h/mg protein
      in the patient's fibroblasts compared to 14.70 +/- 0.69 nmol/h/mg protein in the
      control fibroblasts. Cholesterol esterifying activity, as cholesteryl oleate
      formed from 14C-oleate, of the fibroblasts from Parkinson patients, was reduced
      by an average 43%. Two hypotheses are put forward to link these findings with the
      current experimental evidences for both increased lipid peroxidation and
      defective mitochondrial respiratory chain complex I activity in a number of cell
      types from Parkinson patients. Considering that decreased cholesterol
      biosynthesis has been detected in all the Parkinson cell lines thus far
      investigated, it is suggested that this may be a hallmark of the disease.

PMID- 8484957
TI  - HIV screening of newborns.
AB  - Iowa has participated in the national survey for the prevalence of HIV infection
      in childbearing women since July of 1989. As of February 1992, blinded testing
      for antibodies to HIV has been performed on blood spot specimens from 100,717
      newborns. Of this number, 14 were confirmed as positive by Western blot. In the
      Iowa survey the prevalence of HIV infection in childbearing women was 0.14/1000
      or 1/7000. This is similar to the prevalence that was observed for PKU in
      newborns during this time period. However, assuming only 30% of mothers transmit
      HIV to their babies, the predicted prevalence of HIV infection in Iowa newborns
      is 1/23,000. Certainly HIV disease is a public health concern with a frequency in
      Iowa mothers similar to that of other diseases screened for in the Iowa program.
      HIV meets the remaining WHO criteria for newborn screening, as well: the HIV
      screening test is simple and reliable and has a low incidence of false-positive
      and false-negative results; confirmatory testing, counseling, and medical care
      are available; the quality and length of life of affected individuals are
      improved by treatment; and data show that early diagnosis and treatment result in
      a cost advantage to society. The major obstacle to the addition of HIV testing to
      a newborn screening program is obtaining informed consent without jeopardizing
      program effectiveness.

PMID- 8484958
TI  - Sandwich enzyme immunoassay for rat retinol-binding protein using antibody
      against recombinant antigen and its application.
AB  - The development of a sandwich enzyme immunoassay for rat retinol-binding protein
      using molecular biological techniques was described. Rat retinol-binding protein
      gene cloned by the PCR method was expressed by a fusion vector pEZZ18 in
      Escherichia coli strain HB101. A recombinant retinol-binding protein fused with
      IgG-binding domain ZZ of protein A was purified with IgG-Sepharose. Antibody
      against the recombinant protein was found to be specific to rat retinol-binding
      protein in plasma by immunoblot analysis. Affinity-purified anti-recombinant
      protein IgG was biotinylated and used for the sandwich enzyme immunoassay. In
      this assay, the measurable range is 1.9-60 ng/ml and the coefficients of
      variation within and between the assay series (assay range: 4-30 ng/ml) are 4.30
      +/- 4.33 and 5.32 +/- 1.45%, respectively. Cross-reactivity of the immunoassay
      was examined using bovine, human, and mouse serum. There was a cross-reaction
      only with mouse serum. In an in vitro experiment, retinol-binding protein
      produced by rat hepatocytes could be measured by the sandwich enzyme immunoassay.

PMID- 8484959
TI  - The dual effects of Ca2+ on binding of the glycolytic enzymes,
      phosphofructokinase and aldolase, to muscle cytoskeleton.
AB  - We show here that in rat diaphragm muscle, a short time of incubation with the
      Ca(2+)-ionophore A23187 induced an increase in cytoskeleton-bound
      phosphofructokinase (EC 2.7.1.11) and aldolase (EC 4.1.2.13), whereas a longer
      period of incubation, which causes a pathological rise in intracellular Ca2+,
      induced a decrease in bound enzymes. Lactate concentration correlated with both
      phases of Ca2+ action on the binding of the enzymes. The increase in cytoskeleton
      bound enzymes could be prevented by treatment with the calmodulin antagonists
      trifluoperazine or CGS 9343B (a novel, potent, and selective inhibitor of
      calmodulin activity). These results suggest that calmodulin is involved in the
      Ca(2+)-induced binding of the enzymes to muscle cytoskeleton.

PMID- 8484960
TI  - Metabolic response to nonglucidic nutrient secretagogues and enzymatic activities
      in pancreatic islets of adult rats after neonatal streptozotocin administration.
AB  - In islets from adult rats injected with streptozotocin during the neonatal
      period, both a nonmetabolized analog of L-leucine and 3-phenylpyruvate augmented
      14CO2 output from islets either prelabeled with L-[U-14C]glutamine or exposed to
      D-[2-14C]glucose and D-[6-14C]glucose, in a manner qualitatively comparable to
      that found in islets from control rats. The islets of diabetic rats differed,
      however, from those of control rats by their unresponsiveness to both the L
      leucine analog and a high concentration of D-glucose in terms of increasing 3HOH
      generation from [2-3H]glycerol, an impaired sparing action of the hexose upon
      14CO2 output from islets prelabeled with [U-14C]palmitate, and, most importantly,
      by a decreased rate of D-[2-14C]glucose and D-[6-14C]glucose oxidation when
      either incubated at a high concentration of the hexose (16.7 mM) or stimulated by
      nonglucidic nutrient secretagogues at a low concentration of D-glucose (2.8 mM).
      In islet homogenates, the activity of glyceraldehyde phosphate dehydrogenase,
      glutamate decarboxylase, and NADP-malate dehydrogenase was lower in diabetic than
      control islets. Such was not the case for glutamate-alanine transaminase,
      glutamate-aspartate transaminase, or glutamate dehydrogenase. The neonatal
      injection of streptozotocin thus affected, in the adult rats, the activity of
      several islet enzymes. Nevertheless, the metabolic data suggest that an impaired
      circulation in the glycerol phosphate shuttle, as observed in response to
      stimulation of the islets by either a high concentration of D-glucose or
      nonglucidic nutrient secretagogues, represents an essential determinant of the
      preferential impairment of glucose-induced insulin release in this model of non
      insulin-dependent diabetes.

PMID- 8484961
TI  - Possible mechanism of interleukin-2-induced decline of serum cholesterol during
      adoptive cellular immunotherapy in cancer patients.
AB  - The serum levels of total, LDL, and HDL cholesterol of patients receiving
      intravenous infusion of interleukin-2 as part of adoptive cellular immunotherapy
      were analyzed. The total, LDL, and HDL cholesterol significantly decreased to
      about one-half of the pretreatment levels after 5 days of infusion (183 +/- 34 to
      110 +/- 19, 112 +/- 40 to 48 +/- 24, and 41 +/- 10 to 16 +/- 7 mg/dl,
      respectively). The decrease was gradual during each day of the treatment.
      Lymphocyte concentration increased markedly during treatment (4.0 +/- 0.52 to
      12.3 +/- 2.95 million cells/ml) and the low-density lipoprotein receptor levels
      in the lymphocytes also increased significantly (1188 +/- 240 to 1442 +/- 276 ng
      of bound LDL/million cells). The decrease in cholesterol levels may be related to
      the cholesterol needed for membrane synthesis during lymphocyte proliferation.

PMID- 8484962
TI  - Complementation analysis of patients with intact peroxisomes and impaired
      peroxisomal beta-oxidation.
AB  - Complementation analysis, using peroxisomal beta-oxidation of very long chain
      fatty acids (VLCFA) as the criterion for complementation, is useful in the study
      of patients who are suspected of having a single enzyme defect in the peroxisomal
      beta-oxidation pathway. Laboratory findings for these patients include elevated
      plasma VLCFA and impaired VLCFA oxidation in fibroblasts. Some of these patients
      have slightly abnormal phytanic acid oxidation in fibroblasts. In addition,
      elevated levels of bile acid intermediates have been reported in some cases.
      Plasmalogen synthesis, pipecolic acid levels, and subcellular distribution of
      catalase are normal. Using complementation analysis, we show that six patients,
      who were suspected of having a single enzyme defect in the peroxisomal beta
      oxidation pathway, are deficient in peroxisomal bifunctional enzyme [enoyl-CoA
      hydratase (EC 4.2.1.17)/3-hydroxyacyl-CoA dehydrogenase (EC 1.1.1.35)] activity.
      This group of six patients, deficient in bifunctional enzyme activity, may be
      subdivided into two complementation groups. It would appear that patients in each
      of these two groups are deficient in only one of the bifunctional enzyme
      activities.

PMID- 8484963
TI  - Effects of cycloheximide and tunicamycin on lysosomal cystine transport in rat
      FRTL-5 cells.
AB  - Rat thyroid FRTL-5 cells were employed to study the synthesis and degradation of
      a functional integral lysosomal membrane protein, the lysosomal cystine
      transporter. This carrier exhibited countertransport and closely resembled the
      cystine transport system of human leucocytes, fibroblasts, and lymphoblasts shown
      to be defective in the lysosomal storage disease, nephropathic cystinosis. Using
      cycloheximide to prevent new protein synthesis, the half-life of the FRTL-5 cell
      lysosomal cystine carrier was determined to approximate 21 h. Carrier function
      was not influenced by the N-glycosylation inhibitor tunicamycin, nor by the
      oligosaccharide processing inhibitors castanospermine and deoxymannojirimycin.
      The data suggest that the lysosomal cystine carrier is a protein without strict
      functional requirements for N-linked oligosaccharides, and that rat FRTL-5 cells
      can be employed in future investigations into the structure and function of other
      integral lysosomal membrane proteins as well.

PMID- 8484964
TI  - Purification of nonantibiotic insulinase inhibitors from bacitracin.
AB  - Bacitracin is commonly used in metabolic studies as an insulinase inhibitor. The
      many isoforms of the commercial preparation were fractionated by charge and size
      in order to find the most active rat-muscle insulinase inhibitors. CM-Sepharose
      chromatography revealed that most of the inhibitory activity was contained in a
      fraction (CM-Inh) that amounted to less than 5% of the mixture. The CM-Inh
      fraction could be further separated by size on Bio-Gel P4 columns. Six subgroups,
      each with characteristic specific activity, were isolated. The most potent
      inhibitor fractions have no antibiotic activity and have molecular weights about
      twice that of bacitracin A. The peaks isolated by means of Bio-Gel P4
      chromatography can be further fractionated by reversed phase HPLC on a C8 column,
      and by electrophoresis on nonreducing acrylamide gels.

PMID- 8484965
TI  - Sulfite inhibits oxalate production from glycolate and glyoxylate in vitro and
      from dichloroacetate infused i.v. into male rats.
AB  - The effect of sulfite on oxalate production from glycolate and glyoxylate was
      investigated in an in vitro assay system using rabbit muscle LDH and rat liver 35
      60% ammonium sulfate fraction as enzymes. A > or = 50% inhibition in oxalate
      production was observed at sulfite to glyoxylate ratio of 0.4. LDH activity
      (change in A340 nm) was inhibited by > or = 40% at sulfite to glyoxylate ratio of
      0.5. Male Sprague-Dawley rats fasted for 24 h and infused with dichloroacetate
      (150 mg/rat/h, iv, n = 6), without and with sodium sulfite (150 mg/rat/h, n = 6)
      excreted oxalate in urine, respectively, at the rate of 1.13 +/- 0.29 and 0.61 +/
      0.09 mumol/h/100 g body wt, showing a nearly 50% reduction due to sulfite. The
      present report demands further experimentation to define the role of sulfite as
      an intracellular modulator of oxalate production.

PMID- 8484966
TI  - Characterization of the response of erythrocyte sodium-lithium countertransport
      to inhibitors.
AB  - To clarify the biochemical characteristics of the sodium-lithium
      countertransporter (SLC) the responses of SLC to two probes of ion transport-
      4,4'-diisothiocyanostilbene-2,2' disulfonate, and N-ethylmaleimide--were
      assessed. The results suggest that the SLC transporter is associated with the
      band 3 protein in the plasma membrane and demonstrate that a sulfhydryl group is
      essential for transport function.

PMID- 8484967
TI  - Axillary surgery in breast cancer--there still is a debate.

PMID- 8484968
TI  - Neuroblastoma: a multiple biological disease.
AB  - Neuroblastoma (NB) is a paediatric tumour showing an appreciable variability in
      clinical evolution. Localised tumours (especially stage 1) can be mildly treated
      with good success while metastatic tumours (stage 4) are highly aggressive. This
      suggests a great biological diversity. In fact, molecular and genetic studies
      have revealed distinct abnormalities in localised and non-localised tumours. Loss
      of heterozygosity for the short arm of chromosome 1, 1p deletion, and MYCN
      amplification are present in stages 3 and 4 but rarely in stages 1 and 2.
      Metastatic stage 4S in infants is peculiar and does not show the same genetic and
      molecular abnormalities found in advanced metastatic tumours. Considering the
      biological alterations associated with NB, it would appear that advanced stage NB
      conforms to the multistep model of tumour development while stage 4S can be
      divided into two groups: one arising from a lack of cellular differentiation and
      the other as a consequence of an additional 'one hit' mutation.

PMID- 8484969
TI  - Histopathological grade and response to chemotherapy in advanced soft tissue
      sarcomas.
AB  - In a retrospective analysis, we evaluated the possible significance of
      histopathological grade with regard to response to chemotherapy in advanced soft
      tissue sarcomas. In three EORTC protocols, the same dose-schedule was used for
      patients randomised to treatment with doxorubicin as a single agent (75 mg/m2
      every third week). The submitted pathological slides from 94 of these patients
      were reviewed and graded. The following parameters were subjectively graded
      (+/++/+ + +): nuclear pleomorphism, necrosis, cellularity and vascularity.
      Mitoses were counted in 20 high-power fields, and a final grade assigned as I,
      II, IIIA or IIIB. The results were tested both with regard to response (complete
      response + partial response vs. no change + progressive disease) and survival.
      However, no statistically significant correlations or trends could be
      demonstrated. Thus, tumour grade, although a prognostic factor by itself, does
      not seem to be able to predict response to chemotherapy in the advanced stage.

PMID- 8484970
TI  - The effect of danazol on tumour control and weight loss in patients on tamoxifen
      therapy for advanced breast cancer: a randomised double-blind placebo controlled
      trial.
AB  - To assess the effect of danazol in advanced breast cancer 183 patients were
      randomised to receive either tamoxifen plus danazol or tamoxifen plus placebo.
      Patients underwent systemic work-up pretreatment then every 12 weeks or sooner if
      they clinically progressed. There were no differences in objective response rates
      with tamoxifen plus danazol vs. tamoxifen plus placebo (27% vs. 24%), time to
      progression (median 6.4 vs. 6.2 months) or survival (median 22.6 vs. 23.5 months)
      when the two arms were compared (all P > 0.5). The addition of danazol to
      tamoxifen had no effect on time to progression when adjusted for significant
      prognostic factors in a multivariate analysis. However, it was found incidentally
      that weight was stable on tamoxifen plus danazol (average gain 0.6 kg, S.E. 0.6
      kg) compared with a significant loss on tamoxifen plus placebo (average loss 2.0
      kg, S.E. 0.6 kg, P = 0.003). The average weight was maintained on tamoxifen plus
      danazol even in patients who did not respond to treatment.

PMID- 8484971
TI  - Long-term effects of cancer treatment and consequences of cure: cancer survivors
      enjoy quality of life similar to their neighbours.
AB  - To assess the long-term effects of cancer treatment and consequences of cure, 102
      index cancer cases were compared with 95 neighbourhood controls of similar age
      and sex and with 78 cardiac controls. The quality of life experienced by these
      three groups was examined using multiple instruments with proven psychometric
      properties. All the major quality of life domains (physical, psychological and
      social) were covered. The findings revealed that the index cases were similar to
      their neighbours in areas of subjective well-being. However, the index cases
      exhibited more sexual dysfunction, were more conscientious, determined and
      emotionally disciplined, and applied the defence mechanisms of displacement and
      reaction formation more often than the neighbourhood controls. The cardiac
      controls were older, more anxious, more conventional/less imaginative and used
      suppression as a defence mechanism to a greater degree than the index cases. In
      conclusion, young adult cancer survivors enjoy a quality of life similar to their
      neighbours, whereas coronary bypass survivors adjust less well psychosocially.

PMID- 8484972
TI  - Validity of the histopathological criteria used for diagnosing dysplastic naevi.
      An interobserver study by the pathology subgroup of the EORTC Malignant Melanoma
      Cooperative Group.
AB  - Ten (dermato)pathologists studied 50 cutaneous melanocytic lesions including
      common naevocellular naevi, dysplastic naevi (DN), melanomas in situ and invasive
      primary melanomas, with emphasis on the histological criteria of DN. Using a
      standardised form, 20 defined histopathological features were scored
      (semi)quantitatively. Concordance of diagnosis, efficacy and reproducibility of
      features were investigated. DN were distinguished well from the other entities
      (mean Po 0.87). Agreement on the degree of atypia of DN was low. The
      reproducibility of the scoring was best for the following features: irregular
      nests, lymphohistiocytic infiltrate, marked junctional proliferation and large
      nuclei. The overall values of these features to discriminate between DN and non
      DN were better than for the other features studied. Using the presence of at
      least three of the four features as a condition for the diagnosis of DN, values
      for sensitivity, specificity and positive and negative predictive values were
      0.86, 0.91, 0.96 and 0.73, respectively. On the basis of the results these
      features seem best suited as histological criteria for the diagnosis of DN.

PMID- 8484973
TI  - Lipid-bound sialic acid, prostaglandin E and histamine in head and neck cancer.
AB  - Blood concentration of lipid-bound sialic acid (LBSA), prostaglandin E (PGE) and
      histamine were determined in 37 patients with carcinoma of hypopharynx and larynx
      (supraglottic and glottic), in 12 non-cancer patients and in 10 healthy subjects.
      The concentration of LBSA was significantly increased in 94.4% cancer patients
      preoperatively and fell to somewhat lower levels within 1 month after tumour
      resection. In patients with complete tumour resection and no tumour recurrences
      within 2 years, it steadily decreased thereafter, reaching normal levels within 6
      24 months after surgery, whereas in patients with tumour recurrences or
      incomplete tumour resection it rose again within 6 months after tumour resection.
      Similarly, the concentration of PGE was significantly increased in about two
      thirds of cancer patients (67.6%) preoperatively, dropped significantly within 1
      month after tumour resection and rose again in patients with tumour recurrences.
      Preoperative histamine concentration was decreased in 24.3% of cancer patients
      and postoperatively it rose both in patients with or without tumour recurrences.

PMID- 8484974
TI  - A prognostic score for patients resected for gastric cancer.
AB  - This paper describes the construction, validation and use of a simple prognostic
      score suitable for predicting survival of patients undergoing a curative gastric
      resection. Using death from all causes as outcome, the prognostic significance of
      age, sex, tumour site, stage of disease (nodal status and wall invasion),
      surgical treatment and histological type was investigated in a set of 213
      patients recruited in a multi-centre clinical trial. A Weibull multiple
      regression model was adopted to evaluate the joint effect of these variables on
      survival. From a full model, containing all the variables, a final parsimonious
      model was obtained by means of a backward selection procedure. The prognostic
      score is based on the final model, including four variables which are easily
      detected in every institution: age, wall invasion, site of tumour, and nodal
      status. Three groups of patients with different probabilities of surviving 5
      years from surgery were identified: group I (survival probability > or = 70%),
      group II (30%-69%) and group III (< 30%). The prognostic score, obtained from the
      multicentre trial patients, was tested on a set of 135 consecutive patients in an
      independent institution, confirming its reliability in predicting survival. The
      score system presented can supply a simple tool for classifying patients
      radically operated for gastric cancer into three well discriminated groups from
      the prognostic point of view.

PMID- 8484975
TI  - First-line combination chemotherapy with mitoxantrone, methotrexate, vincristine
      and carboplatin (MIMOC) in advanced breast cancer.
AB  - 51 patients with stage IIIB and IV breast cancer entered a prospective phase II
      study of combination chemotherapy that consisted of mitoxantrone (8 mg/m2) day 1,
      methotrexate (25 mg/m2) day 1, vincristine (1 mg/m2) day 2 and carboplatin (250
      mg/m2) day 2 (MIMOC) given in a 3-weekly schedule. None had received prior
      chemotherapy for metastatic disease, although 16 patients were given adjuvant
      chemotherapy. Objective response to treatment was seen in 29 of 48 patients
      analysed for response (60%) with 8 complete responses (CR). 7 out of 8 patients
      with stage IIIB disease responded, 2 of them completely. Responses were seen in
      all sites but the best results were achieved in lung metastases with 50% CR. The
      median duration of response was 8 months and the median time to disease
      progression was 12 months. The main toxicity was nausea and vomiting which was
      severe in 20% of the patients. Other toxicities were mild. MIMOC was administered
      on an out-patient basis and appears to be effective as first-line treatment in
      advanced breast cancer.

PMID- 8484976
TI  - Prevention of emesis by ICS 205-930 in children receiving cytotoxic chemotherapy.
AB  - Nausea and vomiting are among the most frequent and severe acute side-effects of
      cytotoxic therapy and are not optimally controlled by conventional antiemetics.
      This situation warrants the evaluation of new classes of antiemetic agents such
      as the 5-HT3 receptor antagonists. 19 children with a median age of 9 years
      (range 2-16 years), treated with cytotoxic drug combinations that had previously
      caused nausea and vomiting refractory to conventional antiemetics, were given the
      selective 5-HT3 receptor antagonist ICS 205-930. The drug was given intravenously
      (i.v.) at 0.2 mg/kg (maximum 5 mg) during the chemotherapy infusion period and
      was continued orally for up to 5 days in chemotherapy courses containing
      cisplatin. The number of emetic episodes was recorded and the response was scored
      according to following scale: grade 1 = no nausea, no emetic episode; grade 2 =
      up to four episodes of vomiting and less than 5 h of nausea; grade 3 = five or
      more than five emetic episodes and/or nausea for at least 5 h. The 19 patients
      received a total of 169 various courses of chemotherapy combined with ICS 205
      930. A score of 3 was observed during one course only, a score of 2 in 37 out of
      the 169 courses, including the four courses with cisplatin. The drug was very
      well tolerated. Side-effects possibly related to ICS 205-930 were mild to
      moderate headache in 4 patients during seven courses overall and obstipation in 3
      patients during 11 courses. The results strongly suggest that ICS 205-930 is a
      highly effective and safe antiemetic agent in non-naive pediatric patients
      receiving non-cisplatin cytotoxic chemotherapy and who had failed conventional
      antiemetic treatment.

PMID- 8484977
TI  - Phase II study of elliptinium acetate salvage treatment of advanced breast
      cancer.
AB  - Elliptinium acetate (Celiptium) is an intercalating agent belonging to the
      ellipticine family. This agent has demonstrated clinical activity as salvage
      treatment in breast cancer using a weekly regimen. However, its clinical use was
      hampered by important toxicities such as xerostomia and immune-mediated
      haemolytic reactions due to development of anti-elliptinium IgM antibodies. We
      have studied 83 patients previously treated for metastatic breast cancer using
      elliptinium acetate with a different schedule: 80 mg/m2 daily for 3 consecutive
      days every 21 days. In 80 evaluable patients, an objective response (complete +
      partial response) was obtained in 5 of 30 patients with visceral metastases
      (13%), in 6 of 21 patients with soft tissue metastases (29%), and in 3 of 20
      patients with mixed metastases (15%). The overall objective response rate was
      14/80 (18%, 95% confidence interval = 10-26%). Moderate to severe xerostomia
      occurred in 10% of patients, while no anti-elliptinium antibodies or haemolytic
      reactions were detected using this schedule. No significant haematological
      toxicity, as usually reported with this drug, was observed. Elliptinium acetate
      has modest but definite activity as salvage treatment of breast cancer. The 3
      week schedule seems as active as and less toxic than the weekly schedule.

PMID- 8484978
TI  - Psychological reactions in public melanoma screening.
AB  - Participants in public screening for malignant melanoma (n = 190) completed a
      questionnaire containing items regarding cognitive and emotional responses to
      skin examination on two occasions, before screening and 7 months later. The
      results suggest subjective susceptibility to melanoma in participants in public
      screening, especially in women. No increase in psychosomatic problems, anxiety or
      depressive symptoms or signs of "false security" were seen as an effect of the
      screening, neither in the total sample nor in those who at the screening were
      recommended further medical procedures.

PMID- 8484979
TI  - Oral tegafur in the treatment of metastatic breast cancer: a phase II study.
AB  - Between February 1985 and October 1989, 26 patients previously treated for
      metastatic breast cancer received oral tegafur, at a median daily dose of 1200
      mg. Of these, 21 were evaluable for response. The overall response rate was 29%;
      six (two in lungs, two in skin and two in lymph nodes) of 44 evaluable lesions
      (14%) responded to therapy. Haematological toxicity was mild, and no other dose
      limiting toxicity was seen. The data indicate some activity in heavily pretreated
      metastatic breast cancer even after previous 5-FU therapy.

PMID- 8484980
TI  - Prevalence of anticipatory nausea and other side-effects in cancer patients
      receiving chemotherapy.
AB  - 98 patients receiving chemotherapy for cancer were interviewed to determine the
      prevalence of anticipatory nausea and vomiting, anxiety and dietary changes.
      Among those who had received at least four treatments 41% reported at least mild
      anticipatory nausea (AN). For 24% this was a moderate to severe problem, which
      was significantly associated with a high level of anxiety about treatment.
      Prevalence at this level was independent of whether the subject was receiving
      treatment as an in- or an outpatient. Anticipatory vomiting (AV) was reported by
      only 12 patients, of whom 11 were women; this was the only effect of gender found
      in the sample. Independence between moderate AN and AV was also suggested by a
      difference in type of event triggering the effect: predominantly odours for AN
      and thoughts of the treatment for AV. Changes in diet after commencing
      chemotherapy were reported by 50% of patients who had received at least four
      treatments. These most commonly took the form of aversions to meat and then to
      coffee, and were attributed most frequently to changes in taste and then to loss
      of appetite.

PMID- 8484981
TI  - Correlation between changes in the tumour markers CA-M26 and CA-M29 and standard
      response evaluation in patients with metastatic breast cancer.
AB  - In this study we correlated response evaluated by standard WHO criteria to strict
      defined criteria of tumour marker response in 63 patients with metastatic breast
      cancer. Pretreatment sensitivity at first evaluation was 71% and 85% for CA-M26
      and CA-M29, respectively. Of the 156 evaluations for CA-M26 and 178 for CA-M29 in
      26 and 30 patients with evaluable lesions 72% and 67% were concordant with the
      results of the clinical evaluations. When the discordant evaluations due to lead
      time were included the concordances were 87% for CA-M26 and 83% for CA-M29. Of
      the 70 evaluations for CA-M26 and 92 for CA-M29 in 19 and 24 patients with non
      evaluable lesions 59% and 72% were concordant with the results of the clinical
      evaluations. Most importantly, progressive disease according to the changes in
      the marker level nearly always predicted disease progression. Such knowledge
      obtained in a simple way may prevent continuation of ineffective treatment in
      patients with metastatic breast cancer.

PMID- 8484982
TI  - Trends and survival in AIDS-associated malignancies.
AB  - Data from 1569 AIDS cases reported to the population-based AIDS Registry of
      Catalonia have been analysed to describe the epidemiology and temporal evolution
      of both Kaposi's sarcoma (KS) and non-Hodgkin lymphoma (NHL). Of the 1569 cases
      reported, 53 (3.4%) presented with NHL and 135 (8.6%) with KS. KS cases were more
      frequent among homosexual/bisexual men and the age of KS cases was significantly
      higher than all others presenting diseases (38.22 years). NHL cases were more
      frequently among men but no significant age difference was found. The percentage
      of KS over time decreased significantly only among intravenous drug users. Cases
      presenting with a NHL had by far the worst prognosis (median survival time = 169
      days). Biases affecting the measurement of AIDS associated malignancies (AAM)
      using surveillance data are analysed. The prevalence of AAM will increase during
      the next few years, and NHL may be one of the leading causes of death among AIDS
      patients in the near future.

PMID- 8484983
TI  - Immunochemical analysis of the p53 oncoprotein in matched primary and metastatic
      human tumours.
AB  - There is much interest in the range of genetic aberrations which occur in human
      malignancies. An immunohistochemical study has been carried out to investigate
      the consistency of expression of abnormally accumulated p53 protein in paired
      samples of archival primary and metastatic carcinomas. The staining of methacarn
      fixed tissue from 136 matched pairs of mammary carcinoma and 20 cancers from
      other sites was completed using antibody CM-1 and DO1 in a sensitive peroxidase
      conjugated streptavidin-biotin technique. The majority of tumour cells were
      positive in 25% and the tumours were negative in 17% of the primary carcinomas;
      staining was heterogeneous in the remaining cases. Staining was identical in
      180/186 (96%) metastatic lesions. An ELISA assay carried out on 12 matched pairs
      of the tumour specimens demonstrated that altered conformation of the aberrant
      p53 protein present in a primary lesion was maintained in its metastasis. These
      data indicate that alterations in the p53 gene result in a relatively stable
      phenotype and that progression of disease is not usually accompanied by either
      further mutation or loss of the mutant allele.

PMID- 8484984
TI  - EO9: a novel bioreductive alkylating indoloquinone with preferential solid tumour
      activity and lack of bone marrow toxicity in preclinical models.
AB  - EO9 is a novel and fully synthetic bioreductive alkylating indoloquinone.
      Although structurally-related to mitomycin C, EO9 exhibits a distinct preclinical
      antitumour profile and there are also differences in its biochemical activation.
      In this study, EO9 was found to demonstrate preferential cytotoxicity against
      solid tumours in vitro as compared to leukaemia cell lines both in the Corbett
      two-tumour assay and in the disease-oriented human tumour cell line panel of the
      U.S. National Cancer Institute. In the latter system activity was particularly
      apparent in colon, melanoma and central nervous system lines, together with some
      renal and non-small cell lung lines. Preferential cytotoxicity towards hypoxic
      versus aerobic EMT6 mouse mammary tumour cells was observed. In vivo, EO9 was
      inactive against the P388 murine leukaemia, while exerting significant
      antiproliferative effects against several murine and human solid tumours,
      including the generally resistant MAC mouse colon tumours and gastric, ovarian
      and breast xenografts. These results confirmed in vitro observations of
      preferential solid tumour activity. In animal toxicology studies, EO9 induced
      vascular congestion in the gastrointestinal tract, but no significant bone marrow
      toxicity. The LD10 value of EO9 after a single intravenous injection into mice
      was 9 mg/kg (27 mg/m2). A dose of one-tenth of the mouse equivalent LD10 (2.7
      mg/m2), the recommended starting dose for clinical phase I studies, was found to
      be safe in rats. Considering its distinct mechanism of bioactivation as compared
      to mitomycin C, its preferential solid tumour activity, its excellent activity
      against hypoxic cells, and lack of significant bone marrow toxicity in animals
      studies, EO9 has been selected for clinical evaluation within the framework of
      the EORTC.

PMID- 8484985
TI  - Towards an international register of cancer trials: the UKCCCR register of U.K.
      trials.

PMID- 8484986
TI  - Axillary surgery in breast cancer: what debate?

PMID- 8484987
TI  - Side-effects of GM-CSF treatment in advanced testicular cancer.

PMID- 8484988
TI  - Hodgkin's disease as pyrexia of unknown origin in a patient with chronic
      lymphocytic leukaemia.

PMID- 8484989
TI  - The prophylactic use of fluconazole 50 vs. 100 mg daily in haematological
      malignancies.

PMID- 8484990
TI  - Response of soluble IL-2 receptor levels to repeated cycles of IL-2
      immunotherapy/chemotherapy.

PMID- 8484991
TI  - Is kidney the real dose-limiting organ after total body irradiation and bone
      marrow transplantation?

PMID- 8484992
TI  - Mike Grace talks to Norman Whitehouse.

PMID- 8484993
TI  - 'A study of the quality of impressions for anterior crowns received at a
      commercial laboratory'.

PMID- 8484994
TI  - A study of the quality of impressions for anterior crowns received at a
      commercial laboratory.

PMID- 8484995
TI  - 'G.A. for tooth extraction for children in London'.

PMID- 8484996
TI  - 'Current classifications of HIV-associated periodontal disease'.

PMID- 8484997
TI  - Current classifications of HIV-associated periodontal disease.

PMID- 8484998
TI  - Orthodontics in the general dental service of England and Wales: a critical
      assessment of standards.
AB  - Out of a sample of 1210 orthodontic patients treated within the General Dental
      Services in England and Wales, a high proportion showed no improvement. Upper and
      lower fixed appliances had the greatest influence on the outcome of treatment in
      terms of aesthetics, dental health need and standards. When treatment was
      analysed according to the appliance used, there were no statistically significant
      differences in the standard of treatment undertaken by specialist orthodontists
      and general dental practitioners. Methods for improving British orthodontic
      standards are considered.

PMID- 8484999
TI  - Rubber dam usage related to restoration quality and survival.
AB  - The effects of rubber dam or cotton roll isolation on the initial quality and
      later survival of 644 amalgam and 149 anterior enamel-bonded composite resin
      restorations were evaluated over periods of up to 15 and 10 years, respectively.
      All restorations were placed by one operator and their quality assessed at the
      time of finishing, using seven clinical characteristics. The influence of six
      other clinical parameters on the survival of the restorations was also evaluated.
      There were no clinically-significant differences present in the initial high
      quality of the restorations, or in their later survivals, which could be directly
      related to the use or otherwise of rubber dam. Overall, the restoration survivals
      were excellent. However, there were significantly more amalgam restoration
      failures, from bulk fracture, in patients with severe bruxism.

PMID- 8485000
TI  - Transient uniocular blindness after dental extraction under general anaesthetic.
AB  - A 14-year-old boy suffered transient uniocular blindness after extraction of four
      permanent first molar teeth under general anaesthetic. We discuss the theoretical
      basis for ocular vasospasm secondary to the minor trauma of dental extraction
      being relayed to the orbit.

PMID- 8485001
TI  - Images of your future.
AB  - Would you buy something without seeing it first, and without any real idea of
      what it was you were buying, or whether you really wanted it? In the past, that
      is what dental patients have been expected to do when their dentist has offered
      them restorative dentistry, but now, using a dental imager, you can show your
      patients quickly and simply just what you can do to improve their appearance; and
      they can show you exactly what it is they want.

PMID- 8485002
TI  - A turn up for the books?
AB  - They say that waiting is the worst part but if it is true for patients it is just
      as true for dentists. The missed appointment, or the appointment cancelled leaves
      us waiting. It is wasteful and expensive but more than either of these economic
      irritations it is straight forwardly frustrating.

PMID- 8485003
TI  - [Spontaneous bacterial peritonitis during liver cirrhosis: the clinical findings
      and therapeutic considerations].
AB  - Among 1211 consecutive patients admitted to hospital for liver cirrhosis, 625
      (51.6%) had ascites. Forty-four of them (7%) had ascitic infection. Thirty-four
      cases (5.4%) of spontaneous bacterial peritonitis (SBP) and 10 cases (1.6%) of
      culture-negative neutrocytic ascites (CNNA) were diagnosed. The infecting
      organism was most likely Gram-negative of enteric origin (80%), CNNA mortality
      (30%) was lower than that of SBP (47%). High mortality suggests to treat patients
      affected by either SBP or CNNA with antibiotics.

PMID- 8485004
TI  - Effect of plasma exchange in a patient with prolonged deep coma from thrombotic
      thrombocytopenic purpura.
AB  - The clinical, laboratory and instrumental data of a patient with thrombotic
      thrombocytopenic purpura (TTP) are reported in detail, with reference to an
      articulated therapeutic regimen including plasma exchange, high-dose
      methylprednisolone and dipiridamole. Particular emphasis is placed on the
      dramatic improvement obtained with this treatment despite a very delayed
      diagnosis and prolonged, severe neurological involvement. A short discussion and
      review of the literature concerning the role of plasma-exchange in the treatment
      of TTP is reported.

PMID- 8485005
TI  - Complete regression of iatrogenic Kaposi's sarcoma due to corticosteroid
      treatment in a patient with tubercular pericarditis. A case report.
AB  - We report a case of drug-induced Kaposi's sarcoma (KS) on the sole of the right
      foot in a 71-year-old man, treated for 6 months with corticosteroid therapy
      (prednisolone 25 mg/day) for pericardial effusion. After corticosteroid
      withdrawal, a tuberculin skin test became strongly positive and pericardial
      effusion was considered to be of tubercular origin. The patient remained
      constantly HIV negative during 14 months of follow-up. Seven months after
      continuous antitubercular treatment, the KS nodules regressed spontaneously and
      finally disappeared. Histological studies confirmed the diagnosis of KS and
      documented its complete regression. Laboratory investigation confirmed prior
      exposure to CMV, EBV and HSV and suggested drug-induced immunological
      suppression. Analysis of the HLA system revealed the positivity of locus DR5,
      associated with classical KS. This case report underscores the relationship
      between genetic background, environmental factors, drug-induced immunosuppression
      and the evolution of this peculiar neoplasm.

PMID- 8485006
TI  - [Necrotizing lymphadenitis (Kikuchi's disease) and systemic lupus erythematosus:
      a single entity?].
AB  - Kikuchi's necrotizing lymphadenitis is a histologically alarming but self
      limiting lesion typically affecting the cervical lymph nodes of young women. The
      authors report 2 cases of systemic lupus erythematosus with the finding of
      Kikuchi's disease on lymph node biopsy. Considering the common infectious and/or
      immunologic etiologies described in both disorders, coexistence of both
      conditions suggests the possibility that they share a common etiology.

PMID- 8485007
TI  - Hematological changes in infectious diseases. Hematological consequences of
      bacterial, protozoal and spirochetal infections (2).
AB  - A number of distinct hematological alterations take place in the presence of
      infectious diseases. This review seeks to provide a diagnostic guide and
      prognostic criteria for the clinician in the light of the concomitant
      hematological changes occurring in course of acute and chronic viral, bacterial,
      spirochetal and protozoal infections. The authors emphasize the fact that
      although certain broad principles may be applied to each type of infection, these
      principles may have to be interpreted with considerable latitude in any
      individual case, on account of the variable factors of virulence and resistance.
      The careful examination of blood films and bone marrow smears, supplemented when
      appropriate by cytochemical reactions, may be useful in the differential
      diagnosis of various infective states and in assessing both the severity of the
      pathological condition and the response of the patient.

PMID- 8485008
TI  - [Risk factors for the progression of chronic kidney failure].
AB  - Virtually all renal diseases progress, although at different rates, to end-stage
      renal failure. The main clinical factors which may explain such relentless
      progression are reviewed and include: the underlying renal pathology, with the
      most rapid progression rate observed in glomerular disease and in polycystic
      kidney disease; systemic hypertension, a significant risk factor for progression
      in any renal disease; the magnitude and duration of proteinuria with the fastest
      progression rate found in the nephrotic syndrome; the degree of functional renal
      deterioration at which so called conservative treatment is prescribed. The proper
      identification of these risk factors may result in rational dietary and non
      dietary intervention with the aim of slowing the progression of chronic renal
      disease.

PMID- 8485009
TI  - Refractory ascites: definition, pathogenesis and treatment.
AB  - Refractory ascites, that is ascites which cannot be mobilized by low sodium diet
      and maximal doses of diuretics (up to 400 mg spironolactone or potassium
      canrenoate and 160 mg furosemide per day), occurs in 5% of cirrhotic patients
      with ascites. The development of refractory ascites is mainly related to the
      progression of arterial vasodilation-mediated vascular underfilling and to the
      imbalance between reduced synthesis of renal vasodilating factors (especially
      renal prostaglandins) and extreme activation of vasoconstricting systems. Further
      features include increased sodium reabsorption in the proximal tubule and altered
      pharmacokinetics and pharmacodynamics of diuretics. In patients with impaired
      renal function (as is the case for most patients with refractory ascites), the
      marked reduction of renal perfusion and glomerular filtration rate, with the
      consequent decrease of filtered sodium load, becomes the main pathogenetic
      factor. The principal therapeutic options for refractory ascites include repeated
      paracentesis and implantation of the LeVeen shunt. Paracentesis is a rapid and
      safe procedure to remove ascites, but it does not correct sodium retention.
      Ascites recurrence, therefore, may occur after a brief interval. The LeVeen shunt
      allows for better long-term control of ascites, but severe complications may
      supervene, and shunt occlusion is common. Neither therapeutic procedure improves
      survival. Different experimental therapeutic procedures have been proposed.
      Administration of ornipressin corrects hyperdynamic circulation and improves
      renal function. Thromboxane synthase inhibitors, by reducing renal synthesis of
      thromboxane A2, potentiate the diuretic and natriuretic response to furosemide.
      More invasive procedures, including portosystemic shunt and transjugular
      intrahepatic stent, are rarely used in the treatment of refractory
      ascites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485010
TI  - The case of primary systemic amyloidosis in chronic diarrhea, weight loss and
      hypotension.

PMID- 8485011
TI  - The clinical spectrum of the immunocompromised host: a pathology engineered by
      progress.
AB  - The term "immunocompromised host" (ICH) embraces patients with a remarkably
      heterogeneous array of disease forms whose common feature is an immunologic
      deficiency of varying gravity and extent. From the clinical standpoint, too, they
      display a heterogeneous spectrum, ranging from virtually symptom-free pictures
      through all the intermediate stages to the appearance of typical manifestations
      including: a) high susceptibility to recurrent infection by opportunistic germs;
      b) frequent though not always clinically significant autoimmune phenomena; c) the
      occasional appearance of some tumors (mostly Kaposi's sarcoma and
      hemolymphopoietic system neoplasias), also referred to as "opportunistic" by
      analogy with opportunistic infections. The existence of a variety of modern
      treatments (organ and bone marrow transplantation, aggressive combination
      chemotherapy and/or radiotherapy of tumors, prolonged administration of
      immunodepressants in a number of immune-mediated disease conditions, etc.) that
      prolong survival in patients with chronic immunodeficiency states previously
      responsible for early death has led to a new "pathology engineered by progress".

PMID- 8485012
TI  - The role of clinical pharmacology in the development and assessment of drugs for
      cerebrovascular disease and stroke.

PMID- 8485013
TI  - Non-steroidal anti-inflammatory drugs and angiotensin converting enzyme
      inhibitors: a commonly prescribed combination with variable effects on renal
      function.

PMID- 8485014
TI  - Disagreement between standard transthoracic impedance cardiography and the
      automated transthoracic electrical bioimpedance method in estimating the
      cardiovascular responses to phenylephrine and isoprenaline in healthy man.
AB  - 1. Impedance cardiography is a well-established noninvasive method to assess
      within-subject changes of cardiovascular function. We compared the standard
      approach (ZCG) which requires tedious signal analysis with an automated approach
      (TEB: NCCOM 3) with its own specific equipment, algorithms and equations in order
      to assess agreement of the method-specific measurements and calculations. 2. Ten
      healthy men were studied on two occasions with either ZCG or TEB, at rest and at
      the end of 5 min i.v.-infusions with 1 microgram min-1 isoprenaline and 100
      micrograms min-1 phenylephrine. 3. There was good agreement for the method
      independent changes (HR, SBP/DBP), but there were large differences for method
      specific measurements: dZ/dtmax [TEB-ZCG] = -0.68, CI: -0.83 to -0.53 ohm s-1,
      PEP [TEB-ZCG] = -22.1, CI: -35.0 to -9.2 ms and QS2c [TEB-ZCG] = -16.5, CI: -32.4
      to -0.6 ms and for the calculated stroke volume SV [TEB-ZCG] = 30.3, CI: 15.5 to
      45.2 ml. The responses of dZ/dtmax and SV to isoprenaline and phenylephrine,
      although qualitatively similar, reached no quantitative agreement either. A
      substantial disagreement was evident for the STI responses to isoprenaline where
      TEB failed to detect the expected reduction of VETc and thus grossly
      underestimated the shortening of QS2c. 4. It is concluded that TEB-measurements
      and -calculations did not agree with standard ZCG, that the methods, albeit
      related, cannot be considered as interchangeable and that suspicion is justified
      that TEB might yield erroneous results under specific circumstances.

PMID- 8485015
TI  - Responsiveness of human isolated bronchial segments and its relationship to
      epithelial loss.
AB  - 1. The responsiveness of human and bovine bronchi was examined by comparing the
      magnitude of responses to agonists applied to the adventitial (outside) and to
      the luminal (inside) surfaces. The development of smooth muscle tone was measured
      as both an increase in pressure in isovolumic bronchial segments and narrowing in
      perfused segments. 2. In both closed and perfused human segments, ACh added to
      the adventitial surface produced highly homogeneous responses while responses to
      ACh added to the luminal side were extremely variable. 3. Histological
      examination of the human segments showed that they possessed variable degrees of
      pre-existing epithelial loss from the mucosal circumference, ranging from 0 to
      82%. 4. Denuded human isovolumic segments (exhibiting > 30% epithelial loss) were
      40 fold more sensitive to ACh inside than intact segments (< 30%). Denuded
      segments were also equally responsive to KCl inside or outside while KCl inside
      produced a contraction that was 50% of that to KCl outside in intact segments. 5.
      A strong and highly significant relationship was determined between the
      proportion of epithelial loss and both the responsiveness and rate of contraction
      of human segments to ACh and KCl introduced onto the lumen. No relationship was
      observed between epithelial denudation and responsiveness or contractility to
      agonists added to the adventitial surface. 6. Mechanical denudation of the
      epithelium from bovine segments had no effect on responsiveness to ACh or KCl
      added to the outside while significantly augmenting the sensitivity to ACh (9
      fold) and reactivity to KCl introduced into the lumen to the extent that it
      became the same as outside.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485016
TI  - Partial mediation by nitric oxide of the relaxation of human isolated detrusor
      strips in response to electrical field stimulation.
AB  - 1. A method for reproducing relaxation of human isolated detrusor smooth muscle
      in vitro in response to electrical field stimulation is described. 2. The
      parameters of stimulation associated with relaxation were those which would be
      expected to give a largely nerve-mediated response: the relaxations were not
      reduced by tetrodotoxin (3 x 10(-7) M) and were therefore not dependent on
      voltage sensitive sodium channels. 3. The relaxations were decreased (mean 74.1%)
      by nitro L-arginine (NOARG, 10(-5) M). 4. Methylene blue (10(-5) M), an inhibitor
      of soluble guanylate cyclase, abolished the relaxations. 5. These results
      indicate that there may be a relaxation mechanism in the human bladder which is
      at least partly mediated via the production of nitric oxide.

PMID- 8485017
TI  - A comparison of the potassium and magnesium-sparing properties of amiloride and
      spironolactone in diuretic-treated normal subjects.
AB  - 1. The relative potencies of amiloride (5 and 20 mg) and spironolactone (25 and
      100 mg) for plasma and erythrocyte electrolytes were investigated in a double
      blind, randomised, balanced, crossover study in 12 normal men treated
      concomitantly with hydrochlorothiazide 100 mg daily for 1 week. 2. Participants
      satisfied an a priori requirement for a fall in plasma potassium concentration of
      at least 0.5 mmol l-1 after 7 days of treatment with hydrochlorothiazide alone.
      3. After hydrochlorothiazide alone, plasma potassium and sodium concentrations
      fell (P < 0.001). There were associated reductions in erythrocyte sodium (P <
      0.01). Plasma magnesium concentration did not change, although erythrocyte
      magnesium decreased (P < 0.001). 4. Both amiloride and spironolactone attenuated
      the thiazide-induced fall in plasma potassium (relative potency,
      amiloride:spironolactone 10:1, 95% confidence interval 6.3-16.2:1). Amiloride but
      not spironolactone was associated with a dose-related increase in plasma
      magnesium; a relative potency estimation was precluded. There was little evidence
      of influences of amiloride or spironolactone on erythrocyte electrolytes. 5. On a
      weight basis, amiloride is ten times more potent than spironolactone as a
      potassium-sparing agent in diuretic-treated subjects but neither agent had major
      effects on erythrocyte potassium. The drugs may have divergent actions on
      magnesium handling; hydrochlorothiazide alone had no influence on plasma
      magnesium.

PMID- 8485018
TI  - Defining small differences in efficacy between anti-parkinsonian agents using
      gait analysis: a comparison of two controlled release formulations of
      levodopa/decarboxylase inhibitor.
AB  - 1. Stride length is highly relevant to mobility and is sensitive to the effects
      of levodopa in Parkinsonism. Its selection as the primary outcome criterion
      allowed comparison of two levodopa/decarboxylase inhibitor formulations using a
      small number of subjects. 2. It is also desirable to improve stability. An
      instrumental method, based on infrared telemetry, has been developed which
      obtains both distance/time measures of gait and broadness of base, as measured by
      foot separation at mid-swing. The latter was used as a subsidiary outcome
      criterion. 3. Nine patients (aged 57 to 77 years) then receiving maintenance
      therapy for idiopathic Parkinsonism with Sinemet CR alone, but who had previously
      experienced end of dose effect within 4 h of receiving a dose of a conventional
      formulation of levodopa/decarboxylase inhibitor, were studied. 4. They received,
      in random order and at least 4 days apart, single doses of one tablet of Sinemet
      CR (200 mg levodopa/50 mg carbidopa) and of two capsules of Madopar CR (each 100
      mg levodopa/25 mg benserazide), with placebo balance, at 10.00 h. Gait analysis
      was carried out immediately before and half-hourly for 7 h after a challenge. No
      routine doses of Sinemet CR were taken between 22.00 h on the night before and
      17.00 h on the day of a challenge. 5. Analysis of variance showed a highly
      significant difference in mean stride length (P < 0.001) and in mean foot
      separation (P = 0.01) between serial time points, irrespective of the nature of
      treatment. There appeared to be a useful therapeutic response to both
      challenges.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485019
TI  - The effects of BRL 46470A, a novel 5-HT3 receptor antagonist, and lorazepam on
      psychometric performance and the EEG.
AB  - 1. The effects of single doses of a novel 5-HT3 receptor antagonist, BRL 46470A
      (0.1 microgram, 0.01 mg, 1 mg or 50 mg) and lorazepam (2.5 mg) on psychometric
      performance and the EEG were investigated in a randomised, double-blind,
      crossover, placebo controlled study of 16 healthy male volunteers. 2. There was
      strong evidence that lorazepam had a marked effect on the EEG, increasing power
      in the 1 Hz to 7 Hz and 13 Hz to 20 Hz wavebands, whilst reducing power in the 8
      Hz to 12 Hz waveband. Lorazepam also produced an impairment of daytime function
      as assessed by psychometric performance and subjective measures. 3. In contrast,
      there was little evidence to suggest that BRL 46470A had any effect on the EEG or
      that it impaired daytime function.

PMID- 8485020
TI  - The pharmacokinetics of methotrexate and its 7-hydroxy metabolite in patients
      with rheumatoid arthritis.
AB  - 1. The pharmacokinetics of MTX and its 7-hydroxy metabolite (7-OHMTX) were
      investigated in nine patients with rheumatoid arthritis (RA). Each patient
      received 15 mg MTX i.v., i.m. and p.o. after an overnight fast in a randomized
      cross-over design. The plasma concentrations of MTX and 7-OHMTX were measured
      over 7 days and their urinary excretion over 24 h. 2. Plasma concentrations of
      MTX were described by a triexponential function after i.v. administration, a
      triexponential function with zero or first order absorption after oral
      administration, and a biexponential function with zero of first order absorption
      after i.m. injection. Plasma concentrations of 7-OHMTX were described by a
      biexponential function after all three routes of administration. The median
      terminal elimination half-lives of MTX and 7-OHMTX were 55 h and 116 h,
      respectively. The area under the plasma concentration-time curve (AUC (0,170 h))
      of MTX did not differ between i.m. and oral administration indicating similar
      bioavailability after these routes of administration. The AUC (0,170 h) values of
      7-OHMTX after i.v., oral and i.m. administration were similar. Over 80% of MTX
      was excreted in urine as intact drug and about 3% was excreted as 7-OHMTX during
      24 h after drug administration. 3. Plasma concentrations of MTX and 7-OHMTX were
      measurable at the end of the dose interval in most of the patients and may help
      to identify non-responders or patients with increased risk of side-effects.

PMID- 8485021
TI  - Stereoselective sulphate conjugation of salbutamol in humans: comparison of
      hepatic, intestinal and platelet activity.
AB  - 1. The oral bioavailability of the beta 2-adrenoceptor agonist salbutamol has
      been proposed to be stereoselective, presumably due to presystemic sulphate
      conjugation. In the present study we examined the stereochemistry of the
      sulphation reaction in vitro using human tissue preparations. 2. Sulphation of
      salbutamol was studied with partially purified hepatic M and P form phenol
      sulphotransferases (PSTs), 100,000 g cytosol of jejunal mucosa and platelet
      homogenate. The cosubstrate PAP35S was used as the sulphate donor. The acceptor
      substrate was either (+)-, (-)-or (+/)-salbutamol. 3. Sulphation was catalyzed by
      the M form PST of the liver but not the P form. The sulphation efficiency
      (Vmax/Km) was 11.9-fold greater for the (-)- than for the (+)- enantiomer, due
      entirely to a lower apparent Km for (-)-salbutamol, 103 microM, than for (+)
      salbutamol, 1394 microM. 4. Sulphation by the jejunal mucosa (n = 3) was very
      similar to that of the M form PST with the efficiency being 9.8-fold greater for
      the (-)-enantiomer and apparent Km values 95 microM and 889 microM for (-)- and
      (+)-salbutamol, respectively. 5. Sulphation by the platelet (n = 3) was also very
      similar to that of the M form PST with the efficiency being 9.9-fold greater for
      the (-)-enantiomer and apparent Km values 141 microM and 1190 microM for (-)- and
      (+)-salbutamol, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485022
TI  - The pharmacokinetics, tolerability and pharmacodynamics of tucaresol (589C80; 4[2
      formyl-3-hydroxyphenoxymethyl] benzoic acid), a potential anti-sickling agent,
      following oral administration to healthy subjects.
AB  - 1. Tucaresol (589C80; 4[2-formyl-3-hydroxyphenoxymethyl] benzoic acid) interacts
      stoichiometrically with haemoglobin to increase oxygen affinity. By decreasing
      the proportion of insoluble deoxy sickle haemoglobin at capillary oxygen
      concentrations, tucaresol may be of therapeutic benefit in sickle cell anaemia.
      2. In this study, which involved the first administration to man, the
      pharmacokinetics and pharmacodynamics of tucaresol were studied in healthy male
      volunteers following oral doses of 200-3600 mg. 3. Peak drug concentrations in
      plasma and erythrocytes were linearly related to dose; mean (s.d.) values were
      95.8 (26.1) and 1035 (67) micrograms ml-1, respectively, at the highest dose.
      Median tmax in plasma was 6.5 h and in erythrocytes 24.5 h, when approximately
      60% of the administered dose was in the target tissue. Plasma drug concentrations
      fell biexponentially with commencement of the apparent terminal elimination phase
      at approximately 24 h. The terminal elimination half-life from plasma increased
      with dose (r = 0.77; P < 0.0001) from 133-190 h at 400 mg to a mean (s.d.) of 289
      (30) h at 3600 mg. Erythrocyte drug concentrations declined mono-exponentially
      with a half-life that was always shorter than the apparent terminal half-life in
      plasma: overall mean (95% CI) of t1/2 erythrocyte/t1/2 plasma ratio was 0.57
      (0.53, 0.61). The erythrocyte AUC/plasma AUC ratio increased with dose (r = 0.67;
      P < 0.001). 4. The proportion of haemoglobin modified to a form with high oxygen
      affinity (%MOD) increased in a dose-related manner above doses of 800 mg reaching
      19-26% after the 3600 mg dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485023
TI  - The metabolism of aprindine in relation to the sparteine/debrisoquine
      polymorphism.
AB  - 1. Incubation of the class I antiarrhythmic drug aprindine (AP) with human liver
      microsomes resulted in the formation of two hydroxylated metabolites (HA1 and
      HA2) and desethylaprindine which were identified by GC-mass spectrometry. In
      liver microsomes isolated from a poor metaboliser (PM) of sparteine no
      hydroxylated metabolites of AP were detected whereas AP N-dealkylation was
      unimpaired. Thus hydroxylation of AP is mediated by cytochrome P450 2D6 (CYP2D6).
      2. AP was found to be a competitive inhibitor of CYP2D6 as indicated by its
      ability to impair the formation of (2S)-hydroxysparteine, 5,6-didehydrosparteine
      and 5-hydroxypropafenone by human liver microsomes. 3. These in vitro findings
      are consistent with a major role of CYP2D6 in the clearance of AP in vivo, with
      its ability to impair the metabolism of other CYP2D6 substrates in vivo, and an
      ability to cause phenocopying (conversion of extensive metaboliser phenotypes for
      sparteine/debrisoquine to apparent 'poor metabolisers).

PMID- 8485025
TI  - The effect of tocainide on theophylline metabolism.
AB  - The effect of 5 days of oral tocainide (400 mg every 8 h) on the kinetics of
      theophylline given as a single 5 mg kg-1 i.v. infusion over 30 min was
      investigated in eight healthy male nonsmokers. Treatment with tocainide decreased
      the plasma clearance of theophylline from 37.5 +/- 6.9 (mean +/- s.d.) to 33.7 +/
      5.0 ml kg-1 h-1 (difference -3.8, 95% CI, -1.7 to -5.9; P = 0.004) and increased
      its terminal elimination half-life from 9.7 +/- 2.5 to 10.4 +/- 2.1 h (difference
      0.7, 95% CI, 0.2 to 1.2; P = 0.011). Tocainide decreased the formation clearances
      of 3-methylxanthine and 1-methyluric acid, but the formation clearance of 1,3
      dimethyluric acid was unaltered. These data indicate that tocainide exerts a
      modest inhibitory effect on theophylline metabolism. The magnitude of this change
      is substantially smaller than that reported to be produced by mexiletine.

PMID- 8485024
TI  - Inhibitory effect of grapefruit juice and its bitter principal, naringenin, on
      CYP1A2 dependent metabolism of caffeine in man.
AB  - 1. The effects of grapefruit juice and naringenin on the activity of the human
      cytochrome P450 isoform CYP1A2 were evaluated using caffeine as a probe
      substrate. 2. In vitro naringin was a potent competitive inhibitor of caffeine 3
      demethylation by human liver microsomes (Ki = 7-29 microM). 3. In vivo grapefruit
      juice (1.2 l day-1 containing 0.5 g l-1 naringin, the glycone form of naringenin)
      decreased the oral clearance of caffeine by 23% (95% CI: 7%-30%) and prolonged
      its half-life by 31% (95% CI: 20%-44%) (n = 12). 4. We conclude that grapefruit
      juice and naringenin inhibit CYP1A2 activity in man. However, the small effect on
      caffeine clearance in vivo suggests that in general the ingestion of grapefruit
      juice should not cause clinically significant inhibition of the metabolism of
      other drugs that are substrates of CYPIA2.

PMID- 8485026
TI  - The pharmacokinetics of intravenous ondansetron in patients with hepatic
      impairment.
AB  - The pharmacokinetics of the 5-HT3 receptor antagonist ondansetron were
      investigated following a single 8 mg intravenous dose given over 5 min in 19
      patients with varying degrees of hepatic impairment and in six young healthy
      subjects. In comparison with the healthy controls, the patients with severe
      hepatic impairment had a lower mean plasma clearance (96 ml min-1 vs 478 ml min
      1) and increased AUC (1383 ng ml-1 h vs 279 ng ml-1 h) and t1/2 (21 h vs 3.6 h).
      These differences were all statistically significant (P < 0.001). The
      corresponding values for patients with mild or moderate hepatic impairment fell
      between these extremes. Vss was greater in all patient groups than the control
      group, but the magnitude of the change was smaller than for the other parameters
      and did not reflect the increasing severity of hepatic impairment. There were no
      significant changes in Cmax. There were no drug-related adverse events in the
      patients studied. It is recommended that the dosing frequency of ondansetron be
      limited to once daily in patients with severe hepatic impairment.

PMID- 8485027
TI  - The pharmacokinetics of quinine in patients with hepatitis.
AB  - The pharmacokinetics of quinine were studied in six patients with hepatitis B
      infection (during acute and convalescent periods) and six healthy subjects. A
      single 10 mg kg-1 dose of quinine was given intravenously over 2 h.
      Pharmacokinetic parameters of quinine during the acute phase of the infection
      were not different from those during the recovery phase. However, when compared
      with those obtained from healthy subjects, significant changes were found. The
      terminal elimination half-life was prolonged (17 and 15 vs 10 h) and clearance
      was lower (2.9 and 2.3 vs 3.5 ml min-1 kg-1). Unbound quinine concentration in
      plasma at 2 h was approximately 10% of the total concentration in all subjects in
      the three study groups. A prolonged QTc interval (< 25%) was observed in all
      groups. The present data suggest that current dosage regimens of quinine used in
      the treatment of falciparum malaria may not be suitable for malaria patients with
      acute hepatitis or those who have had hepatitis within the past 3 months.

PMID- 8485028
TI  - In vitro interaction between cyclosporin A and macrolide antibiotics.

PMID- 8485029
TI  - Maternal mortality in the Americas.

PMID- 8485031
TI  - Central American subregional meeting on theory and practice of public health.

PMID- 8485030
TI  - HIV and AIDS research in Latin America and the Caribbean: 1983-1991.

PMID- 8485033
TI  - Edging up tobacco taxes--differences between the United States and Canada.

PMID- 8485032
TI  - Trends in prostate cancer: United States, 1980 to 1988.

PMID- 8485034
TI  - Causes and management of headaches in cancer patients.
AB  - Headache is a frequent accompaniment of brain tumors. Since management of
      patients with these tumors is often palliative, proper treatment of symptoms such
      as headache becomes a key issue in preserving the patient's quality of life.
      Successful management of brain tumor headache requires an understanding of the
      etiology and pathophysiology of the various types of brain tumor headaches,
      followed by appropriate application of the specific therapeutic modality.

PMID- 8485035
TI  - Invasion and metastasis: new approaches to an old problem.
AB  - The progressive process of tumor invasion and generation of metastases is the
      primary cause of death for most patients with cancer. Recent advances have led to
      identification of novel sites for investigation and intervention. These advances
      include the definition of regulatory components of the metastatic cascade and
      characterization of the processes of angiogenesis, adhesion, proteolysis, and
      migration. This further understanding of the complex process of cancer
      progression has allowed the development of new diagnostic tools and potential
      therapeutic approaches.

PMID- 8485036
TI  - Psychosocial impact of cancer screening.
AB  - Cancer screening programs, including tests for early detection and programs aimed
      at identifying people with carcinogenic occupational exposure, may have
      psychological and behavioral sequelae. An abnormal screening result can lead to
      distress and anxiety that may continue even after further workup rules out
      cancer. Such psychological distress can affect subsequent health behavior. When
      testing or counseling indicates risk factors for cancer, the individual generally
      tries to adhere to the recommended preventive guidelines. A moderate amount of
      anxiety about the results may even be a motivating factor in getting subsequent
      check-ups. However, in some cases such knowledge leads to extreme levels of
      distress that can actually interfere with adherence behavior. Intervention
      studies now suggest that simple strategies can successfully reduce screening
      related anxiety. Such interventions are particularly important to assure that
      people with positive tests do not drop out of the system for future screening.

PMID- 8485037
TI  - What's new in the management of infectious diseases.
AB  - The 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)
      was held late last year in Anaheim, California. Sponsored by the American Society
      for Microbiology, the conference is designed to encourage the exchange of new
      information among microbiologists, clinicians, pharmacologists, pathologists, and
      members of related disciplines. The following highlights include those that may
      be of particular clinical interest to physicians in the oncology specialties.

PMID- 8485038
TI  - Incidence of non-Hodgkin's lymphoma in AIDS patients: sixty times greater.

PMID- 8485039
TI  - Expanded programme on immunization. An estimate of measles vaccine efficacy in a
      Canberra primary school.

PMID- 8485040
TI  - Diarrhoeal disease control (CDD) and acute respiratory infections (ARI). Combined
      CDD/ARI/breast-feeding survey, 1992.

PMID- 8485041
TI  - Influenza.

PMID- 8485042
TI  - Role of granulocyte-macrophage colony-stimulating factor, interleukin-3 and
      interleukin-5 in the eosinophilia associated with T cell lymphoma.
AB  - We studied two patients with a leukaemic T cell lymphoma who presented with a
      marked increase in blood eosinophilia. To investigate the mechanism of the
      eosinophilia, supernatants of peripheral blood cells containing more than 80%
      lymphoma cells were tested by biological assays for the presence of colony
      stimulating factors (CSF). In one case supernatants stimulated the growth of
      granulocyte-macrophage (GM), erythroid and eosinophil colonies. These effects
      were neutralized by anti-GM-CSF antibodies; anti-IL5 antibodies slightly
      decreased eosinophil colony formation. Supernatants derived from the second
      patient cells stimulated the same lineages. Neutralizing experiments demonstrated
      that in addition to GM-CSF it contained interleukin 3 (IL-3) and interleukin 5
      (IL-5). In agreement with the biological data, RNA studies using the polymerase
      chain reaction showed that cells from the first patient expressed GM-CSF
      transcripts; IL-5 transcripts were also detected in very low amounts. GM-CSF, IL
      3 and IL-5 transcripts were detected in cells from the second patient. Thus
      eosinophilia associated with some T cell lymphoma is likely due to secretion of
      different combinations of cytokines by malignant cells.

PMID- 8485043
TI  - Serum erythropoietin in patients with myelofibrosis with myeloid metaplasia.
AB  - Serum erythropoietin levels (s-Epo) were measured by radioimmunoassay in 61
      consecutive anaemic patients (Hb < 12 g/dl) with myelofibrosis with myeloid
      metaplasia (MMM). S-Epo was inversely correlated with Hb (r = -0.48, P < 0.0001).
      When observed s-Epo values were compared with predicted levels based on the
      relationship between s-Epo and Hb in control subjects, all but eight patients
      (87%) had s-Epo levels appropriate for the degree of anaemia. The
      observed/predicted (O/P) s-Epo ratio was significantly lower in patients with
      signs of active disease, and a significant inverse correlation was found between
      the O/P ratio and erythrokinetic measurement of the extent of erythropoiesis (r =
      0.31; P = 0.02). Circulating Epo levels were appropriate for the variations in Hb
      during the postsplenectomy period in three patients. In conclusion, this study
      does not support the idea that therapy with erythropoietin should be extensively
      used in anaemic patients with MMM, but rather that it should be considered only
      in selected cases.

PMID- 8485044
TI  - MDS-macrophage derived inhibitory activity on myelopoiesis of MDS abnormal
      clones.
AB  - We studied the effect of myelodysplastic syndrome (MDS)-derived adherent cells on
      colony formation of granulocyte-macrophage progenitors (CFU-GM) in both normal
      and MDS bone marrow cells. MDS-adherent cells suppressed the growth of normal CFU
      GM colony formation. Antibodies against ferritin almost totally neutralized the
      haematopoietic inhibitory activity. Antibody against gamma-interferon (gamma-IFN)
      did not have such effect. By cytogenetic analysis using G-staining method, MDS
      derived CFU-GM colony showed abnormal clones. MDS have been recognized to be a
      mosaic of normal and abnormal clones. MDS-macrophages suppressed the growth of
      progenitor cells derived from normal clones by soluble factors, but did not
      suppress the growth of those from abnormal clones. It is suggested that
      progenitor cells derived from abnormal clones are freed from the negative
      myelopoietic regulator that may be related to the progress of leukaemia.

PMID- 8485045
TI  - Impact of interferon alpha-induced cytogenetic improvement on survival in chronic
      myelogenous leukaemia.
AB  - The objective of this study was to investigate the prognostic impact of the
      reduction of Philadelphia chromosome (Ph) positive metaphases by treatment of
      chronic myelogenous leukaemia (CML) with interferon (IFN) alpha. Therefore, we
      evaluated the outcome of patients with previously untreated chronic phase Ph
      positive CML, enrolled from 1984 to 1990 into two consecutive IFN trials at our
      institution. Of a total of 71 patients, 62 (87%) were evaluable for cytogenetic
      response. No cytogenetic improvement was seen in 16 patients (23%), 28 patients
      (38%) had a decrease in Ph-positive bone marrow metaphases to levels ranging from
      35% to 95%, and nine patients (13%) to levels between 5% and 34%. In nine
      patients (13%), Ph-positive metaphases were no longer detectable. After a median
      follow-up period of 33 months, the projected 5-year survival is 55% for the 62
      patients evaluable for cytogenetic response. In this patient population there was
      no significant difference in the survival probability according to patients' risk
      status as defined by the Sokal score. Categorization according to the extent of
      Ph reduction, however, allowed three groups with significantly different
      prognoses to be identified. Patients achieving a Ph reduction to less than 35%
      were found to constitute a low risk group with a median survival not yet known
      and a projected 5-year survival of 90%. The 5-year survival rate was 55% for
      patients with a Ph reduction to levels between 35% and 95%, and less than 10% for
      those without any cytogenetic improvement. Thus, this study demonstrates that
      cytogenetic improvement on IFN treatment is an important prognostic factor for
      survival.

PMID- 8485046
TI  - The significance of detection of minimal residual disease in childhood acute
      lymphoblastic leukaemia.
AB  - In acute lymphoblastic leukaemia (ALL), minimal residual disease (MRD) can be
      defined as disease occurring at a subclinical level and beyond detection by
      conventional methods of assessment. Application of the polymerase chain reaction
      (PCR) to the hypervariable segment of the immunoglobulin heavy chain (IgH) gene,
      allows detection of MRD at a level of one leukaemic cell in 10(4)-10(5) normal
      marrow cells. We have performed a retrospective study using this technique in the
      assessment of children with precursor B-cell ALL in whom the clinical outcome is
      known. In the early treatment period MRD is commonly detected in children who
      remain in complete remission on subsequent follow up. Thus, the detection of MRD
      at this time may have little value in the prediction of future relapse. However,
      at the end of treatment, children who remain in complete remission have no
      evidence of MRD. Conversely, detectable MRD at this time would seem to predict
      for future relapse, though this can be a delayed event. Remarkably, in two
      children who suffered a bone marrow relapse 8.5 and 9 years after completing
      therapy for their initial disease, MRD was detected, in their end of initial
      treatment marrow samples. Clearly PCR technology is changing the definition of
      the remission state in childhood ALL, and may have predictive value in the
      assessment of children who are at a high risk of future relapse. Large
      prospective studies of molecular monitoring are now required to confirm these
      preliminary results.

PMID- 8485047
TI  - T cell function in children with acute lymphoblastic leukaemia.
AB  - Modern intensive chemotherapy has dramatically improved the prognosis of acute
      lymphoblastic leukaemia (ALL) in children. However, once remission has been
      established, quality of life and even survival may be threatened by exacerbation
      of viral infections in the prolonged period of continuation therapy necessary to
      prevent relapse. Often the viruses involved in the most severe infections are
      from the herpesvirus and paramyxovirus groups, suggesting that patients suffer
      from a defect in the cellular immunity thought essential to control such cell
      associated infections. This may result from a T cell defect and, in this study, T
      cell responsiveness of patients under therapy for leukaemia has been
      investigated. In vitro proliferative responses of peripheral blood leucocytes
      (PBL) to the T cell mitogen phytohaemagglutinin (PHA) were impaired in children
      with ALL before treatment and in the induction of remission. Impairment was
      attributable to reduced T cell numbers, the presence of inhibitors in the
      patient's serum and direct damage to lymphocytes. On achieving remission,
      proliferative responses to PHA of both CD4+ and CD8+ T cell subsets quickly
      returned to normal levels with the switch to continuation chemotherapy.
      Proliferative responses to Herpes simplex virus antigens were also apparently
      normal in the majority of patients tested in remission. Further investigations,
      however, have suggested a persisting defect in CD8+ lymphocyte function. Gamma
      interferon secretion by PHA-stimulated PBLs was severely reduced for children
      with ALL in remission when compared with control children of similar age.
      Further, cytotoxic T lymphocyte responses to allogeneic cells could only be
      induced in PBL isolated from two of 13 children in remission from ALL whilst all
      control children of similar age and adults produced anti-allogeneic responses.

PMID- 8485048
TI  - Altered expression of the human retinoblastoma gene in monocytic leukaemias.
AB  - Inactivation of the retinoblastoma growth suppressor gene (RB) is responsible for
      the development of retinoblastomas and occurs frequently in osteosarcomas and
      small cell lung carcinoma. Knowledge about the involvement of RB in the
      pathogenesis of myeloid leukaemias is still scarce. In this study we looked at
      the expression of the retinoblastoma gene product (p105) in 20 primary
      myelomonocytic and monoblastic leukaemias by Western blotting and
      immunocytochemistry using the anti-p105-monoclonal antibody PMG3-245. We found
      absence of or barely detectable levels of p105 in 11 patients (55%). Absence of
      or low levels of p105 were correlated with a higher leucocyte count at
      presentation (133 x 10(9)/l v 83 x 10(9)/l) and with the occurrence of
      extramedullary leukaemia (8/10 v 2/10). We conclude that abnormal expression of
      RB with absence of p105 or strongly reduced p105 levels occurs frequently in
      myelomonocytic and monoblastic leukaemias and that this may be correlated with a
      more malignant course of the disease.

PMID- 8485049
TI  - High IL-6 levels in ascitic fluid correlate with reactive thrombocytosis in
      patients with epithelial ovarian cancer.
AB  - Non-haematopoietic malignancies are commonly associated with thrombocytosis. The
      aetiology of tumour-associated thrombocytosis is still unclear but may be related
      to tumour-derived thrombopoietin-like factors. Epithelial ovarian tumour cells
      have been shown to release IL-6 in vitro and high IL-6 levels have been
      identified in ascites of patients with ovarian cancer. Since IL-6 is a potent
      stimulator of megakaryocytopoiesis we examined IL-6 production at the tumour site
      and its relationship to serum IL-6 levels and circulating platelet counts in
      patients with ovarian cancer. Forty patients undergoing exploratory laparotomy
      for epithelial ovarian cancer [stage I+II: 6 (15%); stage III: 25 (62.5%); stage
      IV: 9 (22.5%)] and 24 women with benign ovarian conditions were evaluated. Sera
      were available from 39 cases with ovarian cancer and from 19 cases with benign
      ovarian tumours. Ascites was obtained from 35 patients with ovarian cancer. IL-6
      activity in serum and ascitic fluid was determined by the standard B9
      proliferation assay (detection level: 1 pg/ml). IL-6 bioactivity was detectable
      in 22 (56%) sera from patients with ovarian cancer, but in only five (26%) of the
      serum samples obtained from benign cases (P < 0.001). Serum IL-6 levels in
      patients with ovarian cancer were significantly higher (median 3 pg/ml; range < 1
      to 1221 pg/ml) than in patients with benign ovarian conditions (median 0 pg/ml;
      range < 1 to 4 pg/ml) (P < 0.001). However, much higher concentrations of IL-6
      were measured in malignant ascites specimens (median 22,100 pg/ml; range < 1 to
      182,600 pg/ml). IL-6 bioactivity in serum and ascites samples was completely
      inhibited by a neutralizing goat anti-human IL-6 antiserum. Thrombocytosis
      (platelet counts > 400 x 10(9)/l) occurred in 25 (62.5%) of the 40 patients with
      ovarian cancer, but in only two (8%) of the 24 cases with benign ovarian tumours.
      In eight (20%) cases with malignant disease platelet counts ranged between 600 x
      10(9)/l and 1060 x 10(9)/l. IL-6 bioactivity in ascitic fluid correlated
      significantly with circulating platelet counts (r = 0.5916; P < 0.001). Maximum
      IL-6 bioactivity in ascites and highest platelet counts occurred in patients with
      undifferentiated ovarian adenocarcinoma or advanced disease. In conclusion, these
      observations strongly suggest a role for IL-6 in the development of tumour
      associated thrombocytosis.

PMID- 8485050
TI  - Identification of a nonsense mutation at amino acid 584-arginine of platelet
      glycoprotein IIb in patients with type I Glanzmann thrombasthenia.
AB  - Using Southern blot, the restriction digests of genomic DNAs in 11 patients with
      Glanzmann thrombasthenia from 10 unrelated kindreds were probed with a full
      length GPIIb cDNA. An additional 2.3 kb Taq I fragment and two 1.65 kb and 0.65
      kb fragments with reduced band intensity were found in the genes of two affected
      siblings from a family originating from the city of Huang Yan in the Zhejiang
      province. The Taq I digest of the abnormal gene was further probed with three
      portions of GPIIb cDNA, revealing that the heterozygous mutation was present in
      the region around exons 15-17 of the GPIIb gene. Two primers for polymerase chain
      reaction (PCR) were then designed, and a 394 bp PCR product was generated and
      sequenced, indicating that a stop codon (TGA) was substituted for an Arg codon
      (CGA) at amino acid position 584 of GPIIb, and resulted in a premature
      termination of translation and production of a shortened protein. The Western
      blot analysis showed that GPIIIa at the platelet surface was apparently
      deficient, it may be ascribed to the rapid turn-over of GPIIIa uncomplexed with
      the truncated GPIIb. The abnormal 2.3 kb Taq I fragment was used as a specific
      genetic marker to detect the carrier status of the patient family. The abnormal
      allele was proved to be derived from the mother, the two affected siblings are
      double heterozygotes, and one clinically unaffected daughter has also inherited
      this defective allele, while the father carries another recessive abnormal allele
      unidentified.

PMID- 8485051
TI  - Mutations in haemophilia A.
AB  - In the present study DNA from 281 unrelated haemophilia A patients including 15
      inhibitor patients has been analysed by Southern blotting technique. Using
      various restriction enzymes, cloned factor VIII cDNA probes and genomic fragments
      we have identified 14 mutations. Six of the mutations are novel partial factor
      VIII gene deletions. One deletion affects exon 1, two deletions concern exon 6,
      another deletion, of which breakpoints are sequenced, takes part of exon 16 and
      two deletions affect exon 26. Besides the deletions, eight point mutations have
      been found at the TaqI restriction sites of exons 18, 24 and 26. Five C-->T
      mutations resulted in nonsense mutations, one in exon 18, one in exon 26 and
      three in exon 24. Two G-->A mutations caused a missense mutation in exon 24
      leading to an arginine/glutamine exchange. Although two patients showed this
      mutation, their clinical phenotypes were different, possibly due to an additional
      unidentified sequence polymorphism. A G-->T mutation in exon 26 substituted the
      arginine with leucine. All deletions and seven of the point mutations are
      associated with severe disease with a detectable inhibitor in the patient with
      the TaqI-point mutation in exon 18. One of the G-->A mutations is associated with
      mild haemophilia but the patient also has developed an inhibitor. Amongst these
      mutations the origin of the mutation could be determined in four kindred, one of
      which showed maternal mosaicism.

PMID- 8485052
TI  - Sickle cell disorders and chronic intravascular haemolysis are associated with
      low plasma heparin cofactor II.
AB  - Thrombotic events are known to be increased in patients with sickle cell
      syndromes and a variety of abnormalities of coagulation or endothelial function
      have been described, although the relevance of these findings either to the
      pathogenesis of vaso-occlusive phenomena or the risk of thrombosis are unclear.
      Heparin cofactor II (HCII) and antithrombin III are circulating inhibitors of
      thrombin and low plasma levels have been associated with an increased risk of
      thrombosis in otherwise healthy individuals. We describe for the first time
      abnormally low plasma levels of HCII in patients with sickle cell syndromes. 45
      adult patients with sickle cell syndromes (31 SS, 10 SC, 4 S beta Thal) were
      compared with 61 age matched control patients for HCII in plasma. There was a
      highly significant reduction in HCII in SS patients irrespective of crisis or
      transfusion state 0.68 +/- 0.15 U/ml (mean +/- SD) compared with controls 1.00 +/
      0.19 U/ml (P < 0.001). HCII antigen was also significantly reduced (0.53 +/-
      0.19 U/ml) compared with controls (1.02 +/- 0.23 U/ml, P < 0.0001). By contrast
      there was no reduction in antithrombin III in this group. HCII (0.63 +/- 0.13
      U/ml, P < 0.001) and HCII antigen (0.54 +/- 0.08 U/ml, P < 0.001) are also
      significantly reduced in SC patients HCII levels increased towards control values
      during sickle cell crises, in patients taking the contraceptive pill, or with
      regular blood transfusion; however, plasma HCII concentrations were not increased
      acutely by exchange transfusion. HCII was also decreased in thalassaemia
      intermedia and pyruvate kinase deficiency, suggesting that intravascular
      haemolysis may be the cause of reduced HCII levels.

PMID- 8485053
TI  - Effect of antiphospholipid antibodies on procoagulant activity of activated
      platelets and platelet-derived microvesicles.
AB  - We have recently described the in vitro mechanism of action of anticardiolipin
      (aCL) and lupus anticoagulant (LA) antibodies in patients with the
      antiphospholipid syndrome. LA antibodies inhibit coagulation reactions in plasma
      because they appear to recognize the complex of lipid-bound (human) prothrombin,
      whereas aCL antibodies require beta 2-glycoprotein I (beta 2-GPI) for binding to
      anionic phospholipids. aCL antibodies can be divided into two subgroups,
      according to their behaviour in lipid-dependent coagulation reactions: aCL-type A
      enhances the anti-coagulant effect of beta 2-GPI, whereas aCL-type B does not. In
      the present study we investigated the effect of purified aCL-type A and B and of
      LA antibodies on the procoagulant activity of both Ca-ionophore activated
      platelets and platelet-derived microvesicles, using an assay system with highly
      purified bovine coagulation factors Xa, Va, and prothrombin from human and bovine
      origin. In the absence of beta 2-GPI neither type of aCL was able to inhibit the
      prothrombinase activity of platelets or microvesicles. However, a strong and dose
      dependent inhibition of the prothrombinase activity of both platelets and
      platelet-derived microvesicles was observed within a few minutes, when aCL-type A
      antibodies were added in combination with beta 2-GPI. This inhibitory effect was
      dependent also on the concentration of beta 2-GPI. Conversely, no inhibitory
      effect of aCL-type B antibodies on platelet- (or microvesicle) prothrombinase
      activity in the presence of beta 2-GPI could be observed. LA antibodies were able
      to inhibit in a dose-dependent way the procoagulant activity of activated
      platelets and platelet-derived microvesicles. With two LA preparations this
      inhibition was only apparent when human prothrombin was used as substrate, while
      a third preparation exhibited its inhibitory effect both in the presence of human
      and bovine prothrombin. The data indicate that, in the presence of their
      respective cofactors beta 2-GPI and prothrombin, aCL and LA antibodies interact
      with the membrane of activated platelets and platelet-derived microvesicles in a
      very similar way as previously observed for their interaction with anionic
      phospholipid surfaces.

PMID- 8485054
TI  - Assessment of graft status following allogeneic bone marrow transplantation for
      haematological disorders in children using locus-specific minisatellite probes.
AB  - We have examined peripheral blood or bone marrow DNA following allogeneic bone
      marrow transplantation (BMT) in children suffering from a variety of
      haematological disorders. Using either locus-specific minisatellite probes
      separately or in combination with a Y specific probe for sex-mismatched
      transplants, complete haematological chimaerism, autologous reconstitution, or
      mixed chimaeric states have been defined immediately post-BMT. We have also been
      able to identify emerging autologous cells or relapse prior to morphological
      diagnosis. Forty-two children, mean age 6.4 years (range 9 months to 15 years),
      received an allogeneic BMT for: acute lymphoblastic leukaemia (ALL), n = 17;
      acute myeloid leukaemia (AML), n = 5; biphenotypic leukaemia, n = 1;
      myelodysplastic syndrome (MDS), n = 5; chronic granulocytic leukaemia (CGL), n =
      1; severe aplastic anaemia (SAA), n = 7; familial erythrophagocytic
      lymphohistiocytosis (FEL), n = 2; beta thalassaemia major (beta thal), n = 1; and
      juvenile chronic myeloid leukaemia (JCML), n = 3. Immediately post-transplant,
      78% had achieved complete haematological chimaerism, 12% had failed to engraft
      (DNA analysis confirmed autologous reconstitution) and 10% had mixed chimaerism.
      SAA was the underlying disease in two of the chimaeric cases, the third case
      having had a matched unrelated donor (MUD) BMT for MDS. In 3/4 cases which
      subsequently relapsed, DNA analysis showed re-emergence of autologous cells
      (indicative of relapse), prior to their morphological identification. We conclude
      that DNA analysis using minisatellite probes to assess graft status provides a
      useful contribution to patient management following allogeneic BMT.

PMID- 8485055
TI  - Dimethyl sulphoxide and haemin induce ferrochelatase mRNA by different mechanisms
      in murine erythroleukaemia cells.
AB  - The level of mRNA encoding ferrochelatase (FeC), the terminal enzyme of the haem
      biosynthetic pathway, was examined in murine erythroleukaemia (MEL) cells when
      they were induced to undergo erythroid cell differentiation by treatment with
      dimethyl sulphoxide (DMSO), or haemin. FeC mRNA increased within 12 h after DMSO
      or haemin treatment of MEL cells, and its level continued to increase for 48 h.
      Treatment of cells with succinylacetone (SA), a potent inhibitor of haem
      synthesis, suppressed a DMSO-mediated increase in FeC mRNA, and haemin treatment
      reversed a SA-mediated decrease in FeC mRNA. Nuclear runoff analyses showed that,
      while DMSO increased the rate of transcription of FeC mRNA, haemin did not. These
      results indicate that the induction of FeC mRNA by DMSO is largely
      transcriptional, while that by haemin is post-transcriptional.

PMID- 8485056
TI  - Iron status in red cell pyruvate kinase deficiency: study of Italian cases.
AB  - We investigated the iron status of 33 pyruvate kinase (PK) deficient patients,
      most of the cases reported in Italy. Serum ferritin (SF) was higher than the
      upper limit of the range of matched controls in 15/25 (60%) non-transfused
      patients (median 228 micrograms/l, range 58-3160 v 43, 22-310). Liver siderosis
      and fibrosis were found in 8/9, and cirrhosis in two who died at age 39 and 42 of
      complications of iron overload. SF was independent of age, sex, or severity of
      haemolysis. The prevalence of HLA-A3 antigen in PK deficient patients was not
      significantly different from that of our healthy population (29.6% v 23%). The
      HLA-A3 positive, non-transfused patients had significantly higher SF values than
      the HLA-A3 negative ones (median 675 micrograms/l, range 340-3160 v 145, 58-400).
      A pedigree study of six high SF-probands indicated that iron overload has a
      multifactorial pathogenesis. In particular, the association of PK deficiency
      induced haemolysis, splenectomy and an additional factor (heterozygosity for
      idiopathic haemochromatosis, ineffective erythropoiesis) leads to severe iron
      accumulation. We suggest that monitoring iron status would be useful in PK
      deficient patients, particularly in splenectomized and HLA-A3 positive ones, to
      identify those at risk of iron overload and prevent the clinical consequences of
      iron accumulation.

PMID- 8485057
TI  - Transient and persistent expansions of large granular lymphocytes (LGL) and NK
      associated (NKa) cells: the Yorkshire Leukaemia Group Study.
AB  - A survey of 870 different adult blood samples (primarily from patients with non
      haematological disorders) found that 269 (31%) had increased proportions (> 25%)
      and/or absolute numbers (> 1.0 x 10(9)/l) of morphologically-defined large
      granular lymphocytes (LGL), and/or phenotypically-defined NK-associated (NKa)
      cells. Of these, 112 were re-analysed at least 6 months after initial
      presentation and were classified as 'persistent' (92/112) or 'transient' (20/112)
      according to whether or not the original abnormality was still present.
      Lymphocyte counts in most patients with persistent abnormalities were within
      normal limits (18/92) or slightly increased (68/92), with only six having a
      lymphocytosis exceeding 10.0 x 10(9)/l. With the exception of five persistent LGL
      expansions in which the granular lymphocytes did not express NKa determinants
      (designated LGL+NKa-), the remaining 87 cases could be phenotypically grouped
      according to their primary abnormality as CD8+NKa+ (n = 33), CD4+ NKa+ (n = 14),
      CD8dim+NKa+ (n = 7) or CD8-NKa+ (n = 33). TCR genotypic studies in 58 patients
      showed that the 16 patients with rearranged TCR components were restricted to the
      CD8+NKa+ group and that, in most of these, the CD8+ fraction showed abnormal
      relative CD16/CD56 expression. Persistent neutropenia (n = 15) also appeared to
      be associated with primary abnormalities of CD8+NKa+ cells (12/15), with 10 of
      these additionally showing rearranged TCR genes. In contrast, persistently
      increased CD8dim+NKa+ and CD8-NKa+ components did not appear to phenotypically
      differ from their corresponding 'counterparts' in normal bloods or in patients
      with transient LGL/NKa+ abnormalities. This survey has therefore established that
      persistent LGL/NKa+ abnormalities are considerably more common than suggested in
      published work, that a high proportion of patients with expanded CD8+NKa+
      components, with quite diverse clinical histories, show evidence of clonal
      lymphoid populations, and that the clonal nature of such disorders appears to be
      associated with abnormal NKa phenotypic patterns.

PMID- 8485058
TI  - Blood film features of sickle cell-haemoglobin C disease.
AB  - The blood films of patients with sickle cell-haemoglobin C disease (SC) were
      compared with those of patients with related haemoglobinopathies in order to
      establish the most characteristic features. The blood films from SC patients
      generally permitted the distinction from sickle cell anaemia (SS) but not
      necessarily from haemoglobin C disease (CC) or C/beta thalassaemia. About half of
      the SC films showed characteristic SC poikilocytes and a minority also had some
      cells containing haemoglobin C crystals. In addition, SC differed from SS in
      having fewer classical sickle cells and nucleated red cells, more irregularly
      contracted cells and less polychromasia and evidence of hyposplenism.

PMID- 8485059
TI  - Acute myeloid leukaemia following interferon-alfa treatment of hairy cell
      leukaemia.

PMID- 8485060
TI  - Omitting the antiglobulin crossmatch.

PMID- 8485061
TI  - Omitting the antiglobulin crossmatch.

PMID- 8485062
TI  - A new beta zero-thalassaemia nonsense mutation (codon 112, T-->A) not associated
      with a dominant type of thalassaemia in the heterozygote.

PMID- 8485063
TI  - Human mast cells in cases of cutaneous, systemic and malignant mastocytosis do
      not show immunohistochemically detectable overexpression of p53 protein.

PMID- 8485064
TI  - Platelet quality and reduction of HLA expression in acid-treated platelet
      concentrates.

PMID- 8485066
TI  - Nifedipine does not improve survival in AMI patients without heart failure. The
      SPRINT Study Group.

PMID- 8485065
TI  - Renal effects of xamoterol in patients with moderate heart failure.
AB  - The acute renal effects of xamoterol, a partial beta 1-agonist, were studied in
      12 patients with congestive heart failure (NYHA II-III) in stable condition on
      diuretic therapy for at least 6 weeks. Each patient was given a single
      intravenous infusion of xamoterol (0.2 mg/kg) or placebo in random order 2 weeks
      apart. Using constant infusion and lithium clearance techniques, clearance and
      excretion measurements were made in the supine position at 30- to 60-min
      intervals before, during, and up to 6 hours after infusion. Blood pressure, heart
      rate, renal plasma flow, glomerular filtration rate, and urinary flow rate
      remained unchanged, but xamoterol lowered sodium excretion by 30% (p < 0.05). The
      decrease started 120 minutes after infusion. Proximal reabsorption of sodium
      increased after xamoterol infusion, whereas plasma values of aldosterone and
      angiotensin II were unaffected. It is concluded that the acute renal effects of
      xamoterol imply an impaired sodium excretion determined by the tubular actions of
      the drug. The present results suggest that xamoterol may aggravate one of the
      important abnormalities intrinsic to the pathology of congestive heart failure.
      These findings are in contrast to the beneficial effects of xamoterol
      demonstrated in many clinical trials where xamoterol was given orally for a
      longer period.

PMID- 8485067
TI  - A double-blind comparison of nicorandil and metoprolol in stable effort angina
      pectoris.
AB  - The antianginal activities of nicorandil, 10 and 20 mg bid, and metoprolol, 100
      mg bid, were compared in patients with stable effort angina pectoris in a
      randomized, double-blind parallel group study lasting 7 weeks. Twenty patients
      were enrolled into the trial and 16 patients completed the study. To evaluate the
      anti-ischemic effects of the two drugs, a treadmill exercise test was performed
      after a 1-week placebo run-in period and 6 weeks of treatment. On the same
      occasions, weekly sublingual nitroglycerin consumption and the number of anginal
      attacks were also recorded in the patient's diary. The total duration of exercise
      increased significantly with both nicorandil, 10 and 20 mg, and metoprolol (p <
      0.01). Similar improvements were observed in the time to onset of ischemia with
      both treatments (p < 0.01). The double product at maximal comparable workload
      (MAX 1) was reduced with the two drugs (p < 0.05 for nicorandil and p < 0.01 for
      metoprolol), while at the maximal exercise time (MAX 2) it was reduced with
      metoprolol (p < 0.01) and slightly but not significantly increased with both
      doses of nicorandil. Weekly sublingual nitroglycerin consumption and anginal
      attacks were also significantly reduced a similar manner by both treatments (p <
      0.01). In conclusion, nicorandil, 10 and 20 mg bid, exerted an anti-ischemic
      effect comparable with that of metoprolol in patients with stable effort angina
      pectoris.

PMID- 8485068
TI  - Dose titration study of isradipine in Chinese patients with mild to moderate
      essential hypertension.
AB  - In order to assess the effective dose, tolerability, and safety of isradipine as
      a monotherapeutic antihypertensive agent for Chinese patients in Taiwan, an open
      trial was carried out. This study consisted of a 2-week, placebo, run-in period
      and an 8-week active treatment period, starting with isradipine 1.25 mg twice
      daily (bid) for the first 4 weeks, followed by 2.5 mg bid if the blood pressure
      was not normalized (diastole < 90 mmHg). One hundred and one patients (M/F =
      48:53) were valid for efficacy analysis. Their age ranged from 30 to 64 years
      (mean +/- SD, 52 +/- 8). The blood pressure before active treatment was 160 +/-
      2/104 +/- 1 mmHg. At the end of treatment period I (week 4), 12-14 hours after
      the last dose, 38 (37.6%) patients were normalized and 47 (46.5%) subjects
      responded (diastolic blood pressure reduction > or = 10 mmHg). At week 8, 68
      (67.3%) patients were normalized and 79 (78.2%) subjects responded. Isradipine
      reduced both systolic and diastolic blood pressures within 2 weeks of treatment.
      There were no significant differences in blood pressure reduction between both
      genders and among age groups. Safety analysis showed two subjects with severe
      flushing, dizziness, and palpitation who used the dose of 1.25 mg bid. They
      withdrew from the study. The adverse reactions of other patients were transient,
      mild, and tolerable. Most of the side effects were related to vasodilatation, but
      edema was not found. There was no change in body weight or heart rate, nor any
      atrioventricular conduction disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485069
TI  - The therapeutic and diagnostic cardiac electrophysiological uses of adenosine.
AB  - Adenosine is a purine nucleoside with a rapid onset and brief duration of action
      after intravenous bolus administration. Its most prominent cardiac effect is
      impairment or blockade of atrioventricular nodal conduction, but other effects
      are depression of automaticity of the sinus node and attenuation of catecholamine
      related ventricular after-depolarizations. The cardiac cell surface receptor is
      the A1 purinoceptor. The therapeutic value of adenosine is predominantly in those
      arrhythmias in which the atrioventricular node forms part of a reentry circuit,
      as clearly demonstrated by the high success rate for termination of
      atrioventricular nodal reentry tachycardia and of atrioventricular reentry
      tachycardia involving an accessory pathway in the Wolff-Parkinson-White syndrome.
      Ventricular tachycardias are generally unresponsive, with the exception of right
      ventricular outflow tract tachycardia. A diagnostic role has emerged for
      adenosine. The transient blockade of the atrioventricular node that it causes can
      reveal important electrocardiographic features in arrhythmias, such as atrial
      flutter, or can unmask latent preexcitation. In wide-QRS tachycardias, adenosine
      can help to distinguish ventricular tachycardia from supraventricular tachycardia
      with QRS aberration. Unlike verapamil, adenosine is safe in ventricular
      tachycardia. A suggested dosing scheme is to give incremental doses at 1-minute
      intervals, starting at 0.05 mg/kg and continuing until complete atrioventricular
      block is induced or a maximum of 0.25 mg/kg is reached. Side effects are
      transient, sometimes uncomfortable, and not hazardous; dyspnea and chest
      discomfort are most frequent. A history of asthma is a relative contraindication.
      Aminophylline antagonizes and dipyridamole potentiates the effects of adenosine.

PMID- 8485070
TI  - Effects of trimetazidine on in vivo coronary arterial platelet thrombosis.
AB  - We used Folts' model of critical coronary artery stenosis with endothelial
      damage, which measures platelet-rich thrombus accumulation from cyclic flow
      reductions (CFRs). This paper reports results applied to trimetazidine, a member
      of the piperazine group. Trimetazidine at a dose of 1 mg/kg completely abolished
      CFRs caused by accumulating thrombus in the circumflex coronary artery in 4 of 8
      open-chest anesthetized beagles. More trimetazidine (up to 5 mg/kg) abolished
      CFRs in two more and attenuated them in the remaining two dogs. There were no
      systemic hemodynamic effects observed. Adrenaline was then infused to stimulate
      platelet activation. At a rate of 0.4 microgram/kg/min, CFRs were restored in one
      dog only. Adrenaline given at 1.6 micrograms/kg/min resulted in restoration or
      increase in the slope of CFRs in all animals. A further six nonoperated dogs were
      anesthetized and given trimetazidine 3 mg/kg. Routine coagulation studies were
      not altered. However, aspirin 5 mg/kg significantly increased bleeding time,
      whereas trimetazidine alone did not. These findings suggest that trimetazidine is
      effective in preventing intracoronary platelet aggregation in this model. Because
      of its demonstrated sparing of coagulation factors and its lack of effect on
      bleeding time, the cause is unlikely to be inhibition of the fibrinogen or
      thrombin receptors, or interference with arachidonic acid metabolism.

PMID- 8485071
TI  - Influence of isosorbide dinitrate on superior mesenteric artery impedance in
      humans.
AB  - In a randomized, double-blind, placebo-controlled crossover study the acute
      effect of isosorbide dinitrate (ISDN) on the superior mesenteric artery velocity
      waveform was studied in 10 healthy subjects (mean age 48.2 years) over a 10
      minute period. The superior mesenteric artery pulsatility index (PI), which
      quantifies the blood velocity waveform, increased from the second minute
      following sublingual administration of 5 mg ISDN (basal PI 4.88 +/- 0.32) and
      reached its upper level (8.22 +/- 1.38) from the fourth minute on. In comparison
      with placebo, the significant rise of PI (second minute) occurred before the
      significant decrease of systolic blood pressure (ninth minute) and before the
      significant increase in the heart rate (fourth minute). Diastolic and mean
      arterial blood pressures remained unchanged. These observations suggest an
      immediate vasoconstrictive effect of ISDN on the resistance vessels of the
      vascular bed of the superior mesenteric artery.

PMID- 8485072
TI  - Calcium antagonists for congestive heart failure: is it really one bridge too far
      to cross?

PMID- 8485073
TI  - Calcium antagonists for congestive heart failure: evolving concepts in bridge
      building.

PMID- 8485074
TI  - Transactional escalation in rigidity and intensity of interpersonal behaviour
      under stress.
AB  - The present study provides empirical support for a new interpersonal concept of
      transactional escalation. This proposition hypothesizes that an individual's
      typical pattern of interpersonal behaviour will become more extreme and rigid
      under stressful interpersonal conditions. Thirty Caucasian females participated
      in brief interviews that had two stages: low-stress and high-stress conditions.
      The half of the subjects who were assigned to a high-stress interview condition
      were predicted to show an escalation of their typical friendly-submissive
      patterns during the second half of the interview. Findings revealed that
      escalation was evidenced by an increase in the extremeness and rigidity of their
      interpersonal behaviour. Implications for interpersonal theory, and for
      diagnostic and psychotherapy endeavours are discussed and directions for future
      research are provided.

PMID- 8485075
TI  - The phases and focus of empathy.
AB  - Interpersonal empathy is a subtle and multisided phenomenon which can,
      nevertheless, lend itself to systematic portrayal and investigation. This paper
      further refines the author's account of empathy as involving a sequence of
      distinct steps or phases. Freshly introduced here is the idea of empathic
      response not only to self-experience but also towards relationships conceived as
      emergent living wholes with their own felt presence and individuality. Given
      described preconditions for empathy, three main phases in a complete empathic
      process are distinguished: reception and resonation by the listener; expressive
      communication of this responsive awareness by the empathizing person; and the
      phase of received empathy, or awareness of being understood. The phases are not a
      single closed system, thus do not occur in lock step and are semi-autonomous in
      practice. Responding empathically to relationship systems (existing as 'we' or
      'us' to the participants and as a joint 'you' to others) may be interwoven with
      empathic response to individual 'I' experience. Although differing in focus, the
      empathic process follows the same phasic course in both cases. An underlying view
      is that individual selves are only one of the forms human life takes; other forms
      include relationships, families and living communities.

PMID- 8485076
TI  - The music therapy of an anorectic mentally handicapped adult.
AB  - Where words fail, music may be a medium through which to explore one's inner
      world and experiences. Psychodynamic approaches have helped us to understand what
      it means to be handicapped (e.g. Sinason, 1992). The subtleties of diagnosing
      anorexia nervosa have recently been recognized in this group (e.g. Cottrell &
      Crisp, 1984). Music therapy has been used with clients of normal intelligence who
      have eating disorders (Nolan, 1989; Sloboda, 1993; Smeijsters & van den Hurk
      1993). This article illustrates the music therapy of a woman with Down's syndrome
      (IQ = 50) and anorexia nervosa. It describes her management and progress in music
      therapy in relation to her external world and anorectic behaviours.

PMID- 8485077
TI  - The role of psychological processes in the aetiology and treatment of cervical
      cancer: a biopsychological perspective.
AB  - Cervical cancer is one of the most serious illnesses affecting women today,
      particularly in developing societies. Despite medical advances in treatment and
      the success of cervical screening programmes in detection, the incidence of the
      disease is increasing. In this paper it is argued that one of the reasons for
      this is that the aetiological model employed for cervical cancer takes little
      account of psychological and psychophysiological factors. Both of these factors
      are now thought to play important roles in disease processes. Research in these
      areas is reviewed and a new aetiological model for cervical cancer described.
      This model incorporates existing epidemiological and medical formulations into a
      new multifactor framework. The implications of this model for treatment are
      explored and it is suggested that psychological interventions could play a much
      greater role than they have in the past.

PMID- 8485078
TI  - Crazy talk: thought disorder or psychiatric arrogance?
AB  - The crazy talk exhibited by some mental patients is re-examined. Our inability to
      understand the other is not a valid reason for concluding that he is insane, much
      less than he has a brain disease. The seemingly senseless speech of persons
      called 'psychotic' resembles glossolalia or the religious phenomenon of 'gift of
      tongues' rather than a speech disturbance, such as aphasia, indicative of brain
      disease.

PMID- 8485079
TI  - Thomas Szasz, crazy talk and the myth of mental illness.
AB  - In this article, Szasz's analysis of 'crazy talk' is considered in the context of
      his wider critique of psychiatric theory. We argue that Szasz has performed an
      important service by drawing attention to psychiatric prejudice regarding the
      causes of abnormal behaviour, and by pointing to the role of values in
      psychiatric decision making. However, Szasz may be criticized for his oversimple
      analysis of the concept of 'illness' and for his failure to recognize that values
      are central to all clinical decision making, including the diagnosis of physical
      illness. In the light of these criticisms we identify important weaknesses in his
      arguments about the incoherent speech of psychiatric patients.

PMID- 8485080
TI  - Comment on crazy talk: Thought disorder or psychiatric arrogance by Thomas Szasz.

PMID- 8485081
TI  - Post-traumatic anorexia nervosa--a case study.
AB  - The nature of the relationship between accidental trauma and psychopathology may
      not always be clear. Cases of post-traumatic anorexia nervosa have been described
      but without detailed attention to pre-existing psychopathological processes. This
      may give rise to spurious conclusions about direction of casualty. We describe a
      male patient who developed anorexia nervosa on two occasions, both episodes
      occurring during the convalescent period following traumatic accidents several
      years apart. The intervening period was characterized by strict self-regulation
      and conflict avoidance, typical of anorexia nervosa but with the body maintained
      at only a moderately low weight. We suggest that accidents can arise at times of
      crisis in such ongoing attempts at intense self-regulation. They may then reflect
      the escape from control of impulsivity and also provide an ultimate means of
      avoidance of further guilt-laden behaviour. They can be understood in the light
      of pre-existing psychopathology. The difficulties in early recognition and
      diagnosis of anorexia nervosa, especially in the male and in the absence of
      extreme weight loss are also discussed.

PMID- 8485082
TI  - Abnormal grief and eating disorders within a mother-son dyad.
AB  - A 50-year-old married woman with a history of recurrent depression developed a
      severe abnormal grief reaction following the death of her son (who had recovered
      from an eating disorder) in a car crash. The patient reported a number of bizarre
      rituals involving her son's ashes and personal effects obtained post mortem. She
      developed anorexia nervosa four months after his death.

PMID- 8485083
TI  - Perceived and desired facilitativeness of one's closest friend, need for approval
      and self-esteem.
AB  - The hypothesis that the positive association between self-esteem and the
      perceived facilitativeness of one's closest friend can be explained by the
      presumed greater desire of low self-esteem individuals for a facilitative
      relationship was not confirmed in 262 16-17-year-old females, who completed the
      Rosenberg (1965) Self-Esteem Scale and a shortened version of the Barrett-Lennard
      (1964) Relationship Inventory. Although desired facilitativeness correlated
      significantly positively with self-esteem, the correlation between perceived
      facilitativeness and self-esteem remained significantly positive when desired
      facilitativeness was partialled out. The further prediction that the correlation
      between perceived facilitativeness and self-esteem would be more positive for
      those scoring higher on the Jones' (1969) Need for Approval Scale was also not
      confirmed. The opposite result was obtained in that this correlation was
      significantly positive for those with low need for approval but not for those
      with a high need.

PMID- 8485084
TI  - Packaging of rhodopsin and porphyropsin in the compound eye of the crayfish.
AB  - The distribution of 3-dehydroretinal (Ral2) in dorsal, middle, and ventral slices
      of eyes of the crayfish Procambarus clarkii was examined by HPLC. No pronounced
      differences were found. Similar results were obtained when the eyes were cut into
      anterior, intermediate, and posterior portions. Dichroic difference spectra were
      measured in single halves of microvillar layers of isolated rhabdoms and the
      proportions of rhodopsin (P1) and porphyropsin (P2) estimated by comparison with
      computer-generated mixtures of these pigments, whose spectra are known from
      previous work. The fraction of visual pigment that is porphyropsin appears to be
      uniform throughout individual retinular cells and among the retinular cells of
      individual rhabdoms, but various substantially among different rhabdoms from the
      same eye. The interommatidial variation in the amount of P2 greatly exceeds the
      gross regional variation in Ral2. This means there is an intermingling of
      ommatidia with different levels of P2. The variability in P2 among ommatidia is
      not likely to have important implications for the vision of the crayfish but
      suggests that in the metabolism of retinoids, individual ommatidia are quasi
      independent metabolic units. The results are compatible with a single opsin for
      both crayfish rhodopsin and porphyropsin.

PMID- 8485085
TI  - Organotypic slice culture of the mammalian retina.
AB  - Vertical slices of 6-day postnatal (P6) rat retina were cut at a thickness of 100
      microns and cultured using the roller-tube technique. After 14-21 days in vitro
      there was significant distortion of normal retinal architecture, but localized
      areas of the slices showed the typical pattern of layering of mature retina. The
      following immunocytochemical markers were used to characterize the different
      retinal cell types: antibodies against protein kinase C (PKC), calcium binding
      protein (CabP 28kD), neurofilaments (NF), glia-specific antibodies (GFAP,
      vimentin), and transmitter-specific antibodies (GABA, TH). The expression of
      these markers was compared in P6 retina, adult retina, and slice culture. To
      further characterize the cultured cells, patch-clamp recordings were performed in
      combination with intracellular injection of Lucifer Yellow (LY). Transmitter- and
      voltage-gated membrane currents were recorded from morphologically identified
      neurons. The experiments show that a mammalian slice culture can be used to study
      differentiation and function of retinal cell types.

PMID- 8485086
TI  - Mature, growing ganglion cells acquire new synapses in the retina of the
      goldfish.
AB  - The goldfish retina grows throughout the animal's life, primarily by a balloon
      like expansion. With this expansion, dendritic arbors of ganglion cells show
      scaled growth; arbors increase in size from small to large with no change in
      their architecture (Hitchcock & Easter, 1986; Bloomfield & Hitchcock, 1991). The
      study reported here showed that ganglion cell arbors acquire new synapses with
      this growth. Arbors from a single type of ganglion cell in retinas of small,
      young and large, old fish were intracellularly filled with horseradish
      peroxidase, examined electron microscopically, and the synapses contacting them
      counted and compared (small arbors vs. large arbors). The small and large arbors
      had similar numbers and orders of dendritic branches (i.e. similar
      architectures), but the large arbors were significantly larger than the small
      ones. The increase in arbor size was correlated with a 2.7x and 1.9x increase in
      the number of ribbon and conventional synaptic contacts, respectively. The
      addition of new synapses is proposed as a mechanism by which the signaling
      properties of the enlarging ganglion cells can remain constant.

PMID- 8485087
TI  - The histaminergic innervation of the lateral geniculate complex in the cat.
AB  - The histaminergic innervation of the thalamic dorsal and ventral lateral
      geniculate nuclei and the perigeniculate nucleus of the cat was examined
      immunohistochemically by means of an antibody to histamine. We find histamine
      immunoreactive neurons in the cat brain are concentrated in the ventrolateral
      portion of the posterior hypothalamus, confirming a previous report. However,
      this cell group also spreads into medial, dorsal, and extreme lateral regions of
      the posterior hypothalamus and extends as far rostral as the optic chiasm.
      Histamine-labeled fibers cover all regions of the lateral geniculate complex, but
      the density of labeling varies. The ventral lateral geniculate nucleus (vLGN) is
      most densely labeled, the A laminae of the dorsal lateral geniculate are sparsely
      labeled, and the geniculate C laminae and the perigeniculate nucleus show
      intermediate amounts of label. Thus, histaminergic fibers demonstrate a
      predilection for zones innervated by the W-cell system. Labeled fibers exhibit
      few branchings and numerous en passant swellings, lending a beaded appearance.
      The vLGN showed more instances of fibers with larger-sized swellings (up to 2
      microns). Following injections of biotinylated tracers into the hypothalamus, we
      find labeled fibers throughout the lateral geniculate complex. The anterogradely
      labeled fibers resemble the histaminergic fibers in morphology, distribution, and
      relative bouton size. Thus, the hypothalamus appears to be the source of the
      histaminergic fibers in the lateral geniculate complex. Histamine-labeled fibers
      in the dorsal lateral geniculate nucleus (dLGN) exhibit uncommon ultrastructural
      morphology. Many extremely large, round, or elliptical vesicles fill the fiber
      swellings. Swellings are directly apposed to a variety of other dendritic and
      axonal profiles, but thus far no convincing synaptic contacts have been seen. The
      distribution and appearance of these histaminergic fibers resembles those
      reported for serotonergic fibers. Our results support the idea that histamine
      works nonsynaptically as a neuromodulator in the lateral geniculate complex,
      affecting the level of visual arousal.

PMID- 8485088
TI  - Selective depletion of beta cells affects the development of alpha cells in cat
      retina.
AB  - The results of previous studies suggest that class-specific interactions
      contribute to the development of the different classes of retinal ganglion cells.
      We tested this hypothesis by examining the morphologies and distributions of
      alpha (alpha) cells in regions of mature cat retina selectively depleted of beta
      (beta) cells as a result of visual cortex lesions at birth. We find that alpha
      cells in regions of central retina depleted of beta cells are abnormally large
      while alpha cells in regions of peripheral retina depleted of beta cells are
      abnormally small. The normal central-to-peripheral alpha cell soma-size gradient
      is absent in hemiretinae depleted of beta cells. The dendritic fields of alpha
      cells in the border of beta-cell-depleted hemiretina extend preferentially into
      the beta-cell-poor hemiretina. In spite of this, alpha cell bodies retain their
      normal retinal distribution and remain distributed in a nonrandom mosaic-like
      pattern. Thus, it appears that the development of alpha retinal ganglion cells is
      influenced by interactions both with other alpha cells (class-specific
      interactions) and with surrounding beta cells (nonclass-specific interactions).

PMID- 8485089
TI  - Brain stem and cortical contributions to the generation of horizontal optokinetic
      eye movements in humans.
AB  - We evaluated the subcortical pathways' contribution to human adults' horizontal
      OKN by using a method similar to that used previously with cats (Harris & Smith,
      1990; Smith & Harris, 1991). Five normal adults viewed plaids composed of two
      drifting sinusoidal gratings arranged such that their individual directions of
      drift were 60 deg or more from the direction of coherent motion of the overall
      pattern. Physiological evidence indicates that under monocular viewing, nasalward
      coherent motion gives advantage to any crossed subcortical contribution while
      temporalward coherent motion minimizes it. We recorded horizontal eye movement by
      infrared reflection and asked subjects to report the perceived direction of
      motion. During both binocular and monocular viewing, the direction of the slow
      phase of OKN fell closer to the direction of coherent movement than to that of
      the oriented components. Monocular viewing produced no nasal-temporal asymmetries
      in the influence of coherent motion on the direction of OKN. This suggests that
      in humans the influence of coherent motion is mediated primarily by cortical
      mechanisms and, unlike in cats, with little or no involvement of subcortical
      mechanisms in the generation of horizontal OKN.

PMID- 8485090
TI  - Currents in the presynaptic terminal arbors of barnacle photoreceptors.
AB  - We have described the currents flowing across the presynaptic membranes of the
      four median photoreceptors of the giant barnacle, Balanus nubilus, using a quasi
      voltage clamp arrangement. Membrane potential, measured in the terminal region of
      one photoreceptor, was controlled in all four terminals by feedback current
      supplied through the nerve containing the photoreceptors' axons. The [Ca2+]o in
      the saline was reduced to decrease the Ca2+ current, enabling better voltage
      control, and tetraethylammonium ion (TEA, 20 mM) was added to block a fast
      voltage-dependent K+ conductance. Depolarizing voltage steps from the resting
      potential in the dark (-60 mV) evoked slow, inward Ca(2+)-dependent currents
      which could be blocked by Co2+, Mg2+, or Cd2+. The Ca2+ currents were followed by
      large outward currents that persisted for many seconds after the offset of
      moderate or large pulses. These tail currents increased in magnitude and duration
      with pulse duration and reversed at about -80 mV, consistent with previous
      evidence for a Ca(2+)-activated K+ conductance in this membrane. When the Ca(2+)
      activated outward current was reduced to zero by increasing the [K+]o so as to
      set EK at -20 mV, and then stepping the voltage to this value, the step evoked a
      steady inward Ca2+ current. Thus, the Ca2+ current did not show voltage- or
      Ca(2+)-dependent inactivation. When Ba2+ was substituted for Ca2+, 500-ms
      depolarizing steps evoked steady inward currents but no outward currents. In any
      given experiment, the activation voltage of the Ca2+ or Ba2+ current did not
      depend on holding potential. At the barnacle photoreceptor's synapse, the
      postsynaptic cell adapts to maintained presynaptic voltage by a mechanism that is
      not understood. We conclude that neither Ca2+ current inactivation nor a shift in
      activation voltage with holding potential can account for this adaptation.

PMID- 8485091
TI  - Gap-junctional properties of electrically coupled skate horizontal cells in
      culture.
AB  - Whole-cell voltage-clamp recordings were used to examine the unusual
      pharmacological properties of the electrical coupling between rod-driven
      horizontal cells in skate retina as revealed previously by receptive-field
      measurements (Qian & Ripps, 1992). The junctional resistance was measured in
      electrically coupled cell pairs that had been enzymatically isolated and
      maintained in culture; the typical value was about 19.92 M omega (n = 45), more
      than an order of magnitude lower than the nonjunctional membrane resistance.
      These data and the intercellular spread of the fluorescent dye Lucifer Yellow
      provide a good indication that skate horizontal cells are well coupled. The
      junctional conductance between cells was not modulated by the neurotransmitters
      dopamine (200 microM) or GABA (1 mM), nor was it affected by the membrane
      permeable analogues of cAMP or cGMP, or the adenylate cyclase activator,
      forskolin. Although resistant to agents that have been reported to alter
      horizontal-cell coupling in cone-driven horizontal cells, the junctional
      conductance between paired horizontal cells of skate was greatly reduced by the
      application of 20 mM acetate, which is known to effectively reduce intracellular
      pH. Together with the results obtained in situ on the receptive-field properties
      of skate horizontal cells, these findings indicate that the gap-junctional
      properties of rod-driven horizontal cells of the skate are fundamentally
      different from those of cone-driven horizontal cells in other species. This
      raises the possibility that there is more than one class of electrical synapse on
      vertebrate horizontal cells.

PMID- 8485092
TI  - A second episode of ganglion cell death takes place when an optic nerve
      regenerates for a second time in the frog.
AB  - We have previously reported that during optic nerve regeneration in the frog, 30
      40% of retinal ganglion cells die, the loss being complete within 10 weeks. In
      the present study, we crushed the optic nerve, waited 10 weeks, and then
      recrushed the nerve at the same site. Retinae were examined 10 weeks later. We
      estimated ganglion cell numbers from cresyl-violet-stained wholemounts and found
      a fall of 53% compared to normals. The loss was significantly greater than the
      losses of 36% and 35%, respectively, in frogs which received a single optic nerve
      crush and were examined 10 or 20-24 weeks later. The results indicate that a
      second episode of ganglion cell death took place when the optic nerve regenerated
      a second time. We conclude that ganglion cells in the frog are not comprised of
      two subpopulations, only one of which intrinsically possesses the ability to
      regenerate.

PMID- 8485093
TI  - The segregation of ON- and OFF-center responses in the lateral geniculate nucleus
      of normal and monocularly enucleated ferrets.
AB  - We have investigated the distribution of ON- and OFF-center responses in the
      lateral geniculate nucleus of ferrets with normal and abnormal retinal
      projections. Electrophysiological recordings in normal pigmented animals confirm
      previous studies on mustelids showing that ON-center responses are found in the
      anterior, inner parts of laminae A and A1 and OFF-center responses in posterior,
      outer leaflets. In albino animals, lamina A displays normal patterns of ON/OFF
      segregation but in lamina A1', which receives an abnormal crossed retinal
      projection, no consistent patterns of segregation are found. Following monocular
      enucleation on the day of birth, the uncrossed projection in pigmented ferrets
      remains expanded across the LGN. Anatomically and physiologically, this
      projection is segregated into two leaflets: an anterior, inner ON-center leaflet
      and a posterior outer OFF-center leaflet. We conclude that the persistence of
      ON/OFF segregation, independent of geniculate location, suggests that self
      sorting of retinal input is an important factor in generating the segregation.

PMID- 8485094
TI  - Dendritic competition in the developing retina: ganglion cell density gradients
      and laterally displaced dendrites.
AB  - Dendrites of retinal ganglion cells (RGCs) tend to be distributed preferentially
      toward areas of reduced RGC density. This, however, does not occur in the retina
      of normal pigmented rats, in which it has been suggested that the centro
      peripheral gradient of RGC density is too shallow to provide directional guidance
      to growing dendrites. In this study, laterally displaced dendrites of RGCs
      retrogradely labeled with horseradish peroxidase were related to cell density
      gradients induced experimentally in the rat retina. Neonatal unilateral lesions
      of the optic tract produced retrograde degeneration of contralaterally projecting
      RGCs, but spared ipsilaterally projecting neurons in the same retina. These
      lesions created an anomalous temporal to nasal gradient of cell density across
      the decussation line, opposite to the nasal to temporal gradient found along the
      same axis in either normal rats or rats that had the contralateral eye removed at
      birth. RGCs in rats that received optic tract lesions had their dendrites
      displaced laterally toward the depleted nasal retina, while in either normal or
      enucleated rats there was no naso-temporal asymmetry. The lateral displacement
      affected both primary dendrites and higher-order branches. However, the gradient
      of cell density after optic tract lesions was less steep than the gradient in
      either normal or enucleated rats. To test for the presence of steeper gradients
      at early stages of development, RGC density gradients were also examined at
      postnatal day 5 (P5). In normal rats, the RGCs were homogeneously distributed
      throughout the retina, while rats given optic tract lesions at birth already
      showed a temporo-nasal density gradient at P5. Still, this anomalous gradient was
      less steep than that found in normal adults. It is concluded that the time
      course, rather than the steepness of the RGC density gradient, is the major
      determinant of the lateral displacement of dendritic arbors with respect to the
      soma in developing RGCs. The data are consistent with the idea that the overall
      shape of dendritic arbors depends in part on dendritic competition during retinal
      development.

PMID- 8485095
TI  - Brain-stem influence on visual response of lagged and nonlagged cells in the cat
      lateral geniculate nucleus.
AB  - This study examined the influence of the pontomesencephalic peribrachial region
      (PBR) on the visual response properties of cells in the dorsal lateral geniculate
      nucleus (LGN). The response of single cells to a stationary flashing light spot
      was recorded with accompanying electrical stimulation of the PBR. The major
      objectives were to compare the effects of PBR stimulation on lagged and nonlagged
      cells, to examine how the visual response pattern of lagged cells could be
      modified by PBR stimulation and to examine whether the physiological criteria
      used to classify lagged and nonlagged cells are applicable during increased PBR
      input to the LGN. During PBR stimulation, the visual response was enhanced to a
      similar degree for lagged and nonlagged cells and the latency to half-rise of the
      visual response was reduced, particularly for the lagged X cells. The latency to
      half-fall of the visual response of lagged cells was not changed by PBR
      stimulation. Accordingly, the division of LGN cells into lagged and nonlagged
      cells based on visual response latencies was maintained during PBR stimulation.
      The initial suppression that a visual stimulus evokes in lagged cells was
      resistant to the effects of PBR stimulation. For the lagged cells, the largest
      response increase occurred for the initial part of the visual response. For the
      nonlagged cells, the largest increase occurred for the tonic part of the
      response. The results support the hypothesis that the differences in temporal
      response properties between lagged and nonlagged cells belong to the basic
      distinctions between these cell classes.

PMID- 8485096
TI  - Differential staining of neurons in the human retina with antibodies to protein
      kinase C isozymes.
AB  - Monoclonal antibodies to the three isozymes of protein kinase C (PKC) (alpha,
      beta, and gamma) were applied to postmortem human retina. Immunostaining was done
      on wholemount, or cryostat-sectioned retina, and visualized after ABC/DAB
      procedures by light (LM) and electron (EM) microscopy. The PCK-alpha antibody
      stained rod bipolar cells throughout the retina. EM analysis confirmed they were
      PKC-alpha-immunoreactive (IR) on their characteristic dendritic and axonal
      synaptology. Putative blue cone bipolar cells with wide-field axon terminals,
      stratifying in s5 of the inner plexiform layer (IPL), were also PKC-alpha-IR, and
      EM showed them to engage in narrow-cleft ribbon junctions in blue cone pedicles.
      The PKC-beta antibody stained cone bipolar cells, many amacrine cells, and most
      ganglion cells. Cone bipolar cells were stained all the way into the foveal
      center: both midget and diffuse varieties were included. The IPL was densely PKC
      IR and individual neurons could not be identified on stratification patterns. EM
      of the outer plexiform layer (OPL) revealed that both flat and invaginating cone
      bipolar types were IR and that IR axon terminals were presynaptic in all strata
      of the IPL. The occurrence of PKC-beta-IR bipolar axons in stratum 2 of the IPL
      suggests that OFF-center as well as ON-center types were included. The PKC-gamma
      antibody gave inferior staining compared with results from the other two
      antibodies; however, two varieties of wide-field monostratified amacrine cell and
      a large-bodied ganglion cell type were discernible. PKC in one form or another
      appears to be a second messenger used in neurotransmission by both rod and cone
      systems and ON- and OFF-center systems in the human retina.

PMID- 8485097
TI  - Whole-cell currents activated at nicotinic acetylcholine receptors on ganglion
      cells isolated from goldfish retina.
AB  - We have recorded whole-cell membrane currents in response to exogenously applied
      acetylcholine (ACh), nicotine, and 1,1 dimethyl-4-phenyl piperazinium iodide on
      retinal ganglion cells enzymatically dissociated from goldfish retina. Agonist
      applications induced nicotinic-type responses in a majority of cells when cells
      were isolated under optimal conditions. Currents were reminiscent of nicotinic
      type ganglionic responses. Dose-response measurements of ACh-induced currents
      indicated an EC50 of 52 microM and a Hill coefficient of 0.6. Currents were
      selective for Na+ over Cl- and were highly inwardly rectifying. Responses were
      blocked reversibly by d-tubocurarine, hexamethonium chloride, and N-methyl-D
      glucamine. In 50% of the cases, alpha-bungarotoxin reversibly blocked the current
      induced by ACh application. The blocking action of mecamylamine was irreversible
      and independent of the presence of agonist but was more effective in the presence
      of ACh. We conclude that functional nicotinic ACh receptors exist on most
      goldfish retinal ganglion cells.

PMID- 8485098
TI  - Center/surround relationships of magnocellular, parvocellular, and koniocellular
      relay cells in primate lateral geniculate nucleus.
AB  - As in other primates, the lateral geniculate nucleus (LGN) of the prosimian
      primate, bush baby (Galago crassicaudatus), contains three morphologically and
      physiologically distinct cell classes [magnocellular (M), parvocellular (P), and
      koniocellular (K)] (Norton & Casagrande, 1982; Casagrande & Norton, 1991). The
      present study examined quantitatively the center/surround relationships of cells
      in all three classes. Estimates of receptive-field center size (Rc) and
      sensitivity (Kc) and of surround size (Rs) and sensitivity (Ks) were obtained
      from 47 LGN relay cells by fitting a difference of Gaussians function to contrast
      sensitivity data. For M and P cells, center size (Rc) increases with eccentricity
      but is about two times larger for M than for P cells at a given eccentricity.
      Surround size (Rs) increases with eccentricity for P but not for M or K cells.
      The center sensitivity (Kc) is inversely related to center size (Rc) and surround
      sensitivity (Ks) is inversely related to surround size (Rs) for cells in all
      classes, a result consistent with the sensitivity regulation that is produced by
      light adaptation. High spatial-frequency cutoff (acuity) is inversely related to
      center size (Rc). However, the peak contrast sensitivity is relatively
      independent of Rc. The ratio of the integrated strength (volume) of the surround
      to the volume of the center remains relatively constant (median, 0.87) across all
      three cell classes. This ratio is an excellent predictor of a cell's rolloff in
      contrast sensitivity at low spatial frequencies: cells with a low surround/center
      ratio have less low-frequency rolloff. Although M, P, and K cells generally
      display similar center/surround relationships, differences in center size and the
      other parameters between the classes distinguish most M, P, and K cells. These
      findings demonstrate that both similarities and differences in the visual
      response properties of primate LGN cells in these three parallel afferent
      pathways can be explained by basic center/surround relationships.

PMID- 8485099
TI  - The cone photoreceptor mosaic of the green sunfish, Lepomis cyanellus.
AB  - Recent empirical and theoretical evidence has implicated the geometrical
      birefringence of the double cones of the green sunfish (Lepomis cyanellus) as the
      biophysical basis of this vertebrate's sensitivity to polarized light. Because of
      the intimate link between the organization of the cone-photoreceptor mosaic and
      the psychophysical details of polarization sensitivity, we have examined the
      structural features of the green sunfish cone-photoreceptor mosaic, in particular
      the orientation of the elliptical cross sections of the double cones. Our primary
      observations are that (1) the arrangement of the cone-photoreceptor mosaic is
      constant across the retina (with two regional exceptions), with double cones
      arranged in a rhombic mosaic and aligned roughly +/- 45 deg to the nearest
      retinal margin; (2) the double-cone/single-cone ratio is everywhere the same; (3)
      cone density is inhomogeneous across the retina, with the highest densities in
      the temporal hemiretina. These results are discussed as they relate to the
      animal's retinal growth and visual mechanisms, particularly the sensitivity to
      polarized light.

PMID- 8485100
TI  - American Society of Regional Anesthesia, annual meeting. Seattle, Washington, May
      13-16, 1993. Abstracts.

PMID- 8485101
TI  - Periodicity and sequence degeneration in eggcase precursors (vitelline proteins)
      from Fasciola hepatica.
AB  - Studies of two 3,4-dihydroxyphenylalanine (dopa) containing eggcase precursor
      proteins (vitelline proteins vpB1 and 2) from the trematode Fasciola hepatica
      recently concluded that although oligopeptide motifs occurred in the amino acid
      sequence, the overall structure (in contrast to dopa proteins from other phyla)
      was highly degenerate and irregular. An analysis of the distribution of
      individual amino acids and of oligopeptide motifs by two independent
      probabilistic pattern analysis methods, however, has now shown that despite
      superficial amino acid variability, an overall periodic structure exists.
      Moderately conserved hexadic domains account for almost 70% of the secreted
      protein, and characteristically contain glycine in position 5 of the hexad (76%
      of all glycine residues), and tyrosine, dopa or phenylalanine in positions 1 and
      4 (88% of all aromatic residues).

PMID- 8485102
TI  - Hemicelluloses as structure regulators in the aggregation of native cellulose.
AB  - The influence of hemicelluloses on the aggregation of cellulose in higher plant
      cell walls was modelled by adding hemicelluloses to cultures of the cellulose
      producer Acetobacter xylinum. Characterization of the celluloses by X-ray
      diffractometry showed them to be more like those that occur in higher plants; the
      coaggregation of the hemicelluloses suggests their occlusion within and between
      the crystalline domains of the celluloses. The authors propose that
      hemicelluloses may be primary moderators of the tertiary structure of cell wall
      celluloses, allowing the development of a wide range of properties.

PMID- 8485103
TI  - Hydrodynamic characterization of chitosans varying in degree of acetylation.
AB  - The molecular weights and gross aqueous solution conformation of two chitosans of
      different degrees of acetylation, 'Sea Cure +210' (11% acetylated) and KN50 (58%
      acetylated) were characterized by viscometry, analytical ultracentrifugation and
      dynamic light scattering. The hydrodynamic parameters obtained were used to
      determine both the molecular weights and the gross solution conformation of the
      two chitosans. Using the Wales-Van Holde ratio of sedimentation coefficient
      concentration regression coefficient (ks) to intrinsic viscosity [eta], the Sea
      Cure +210 chitosan, which is much less acetylated than the KN50, is highly
      asymmetric in conformation. This, in conjunction with the charge on the molecule,
      would suggest a rod-like conformation in solution. The two largest KN50 chitosans
      have widely differing values for the Wales-Van Holde ratio, suggesting different
      solution conformation. However, when the series is examined as a whole using the
      Mark-Houwink-Kuhn-Sakurada relationships relating molecular weight to both
      intrinsic viscosity and translational diffusion coefficient, then a more
      spheroidal structure, approximating to a random coil, is predicted.

PMID- 8485104
TI  - Thermodynamic and kinetic studies of competitive inhibition of adenosine
      deaminase by ring opened analogues of adenine nucleoside.
AB  - Ring opened analogues of adenine nucleosides substituted at the ninth adenine
      positions, with and without esterification (compounds I and II), have been
      studied kinetically and thermodynamically at various temperatures in order to
      determine the sites of ring opened analogues. These are deemed to be important
      for binding to the adenosine deaminase. Adenosine deaminase is found to bind more
      strongly to compound I than to compound II, therefore compound I is a stronger
      inhibitor than II, because the position of (5') OH on the ribose moiety decreases
      the inhibitory strength on the ring opened analogue.

PMID- 8485105
TI  - Agarose chain conformation in the sol state by neutron scattering.
AB  - We report on small-angle neutron scattering investigations into the agarose
      conformation in water. We show that at 70 degrees C in the sol state agarose
      chains are fairly rigid with a lower limiting value for the persistence length of
      about 9 nm and a mass per unit length of muL = 360 +/- 36 g/mol x nm. The value
      of the latter parameter is consistent with single-stranded helices as those
      proposed recently by Foord and Atkins. Such a high rigidity together with such a
      low linear mass leads one to wonder how would the chains manage to intertwine
      should they form double helices in the gel state.

PMID- 8485106
TI  - Unfolding and refolding of the NAD(+)-dependent isocitrate dehydrogenase from
      yeast.
AB  - The unfolding of the NAD(+)-dependent isocitrate dehydrogenase from yeast in
      guanidinium chloride (GdnHCl) has been monitored by changes in c.d. and
      fluorescence. Major structural changes occur over the range of GdnHCl
      concentrations from 0.5 to 1.5 M, although loss of catalytic activity is complete
      at 0.3 M. After incubation in GdnHCl, activity can be regained on dilution;
      however, the extent of this regain is dependent on the initial concentration of
      GdnHCl and is very small at a concentration of 2 M or above. Under these
      conditions there is only limited regain of the secondary and tertiary structure
      of the enzyme. Considerably more structure and activity can be regained if the
      concentration of GdnHCl is lowered by dialysis. The implications of these results
      for the folding and assembly of the enzyme are discussed.

PMID- 8485107
TI  - Molecular bending and networks in a basement membrane-like collagen: packing in
      dogfish egg capsule collagen.
AB  - Low-angle X-ray diffraction data have been obtained from three mutually
      perpendicular axes through sheets of the collagenous egg capsule of the dogfish
      Scyliorhinus caniculus, a collagen that resembles type IV collagen. The data are
      interpreted in the light of the body of knowledge of the structure derived from
      transmission electron microscopy by Knight and Hunt. A model to account for the X
      ray data is proposed incorporating the main dimensions of the Knight and Hunt
      model which are confirmed by the diffraction data. Several features of the
      diffraction patterns are not explained by the existing model however, and a new
      model is proposed to account for these features. This consists of antiparallel
      packed pairs of two mutually parallel molecules, each kinked and rotated so as to
      produce a four-fold helix resembling a crankshaft. This has the advantage of
      conferring intermolecular linkage in three dimensions throughout the structure
      with tetragonal symmetry and unit dimensions a = b = 22.6 nm, c (fibre axis
      direction) = 39.3 nm. The result is a fairly rigid open polygonal network or
      sponge-like architecture that is capable of accommodating large quantities of
      water and other molecules.

PMID- 8485108
TI  - Refined structure of the aminobenzolamide complex of human carbonic anhydrase II
      at 1.9 A and sulphonamide modelling of bovine carbonic anhydrase III.
AB  - The binding of aminobenzolamide to human carbonic anhydrase (HCA II) has been
      investigated by X-ray crystallography. The three dimensional atomic structure of
      the enzyme inhibitor complex has been refined at 1.9 A resolution. The
      crystallographic R-factor is 17.8%. All inhibitor atoms are clearly possible to
      identify from the difference electron density map in the active site of the
      enzyme. The nitrogen of the sulphonamide group of the inhibitor is bound as a
      fourth ligand to the zinc ion, the other three are all histidyl residues. The
      binding conformation of the sulphonamide groups is similar to the previously
      described sulphonamide inhibitors. One of the oxygens of the outer sulphonamido
      group of the inhibitor forms a hydrogen bond to the amino group of Gln 92. The
      higher affinity of the benzolamide inhibitor compared with acetazolamide can be
      accounted for by the strong aromatic and hydrophobic interactions between the
      amino benzene ring of the inhibitor and the residues Phe 131 and Leu 198. In
      modelling studies of bovine carbonic anhydrase III (BCA III) it was evident that
      Phe 198 prevents an optimal interaction with sulphonamides.

PMID- 8485109
TI  - Skin concentration of 8-methoxypsoralen, 5-methoxypsoralen and 4,5,8
      trimethylpsoralen in guinea pigs.
AB  - The skin concentrations of 8-methoxypsoralen (8-MOP), 5-methoxypsoralen (5-MOP)
      and 4,5,8-trimethylpsoralen (TMP) were studied in the albino guinea pig following
      oral administration and intraperitoneal injection. The skin concentration of
      phototoxic drugs after oral administration peaked at 1.5 h, and the concentration
      of 8-MOP was 3.5 times greater than that of 5-MOP. The skin concentration of TMP
      was not detected in our study (limit of sensitivity 5 ng/ml). The highest skin
      concentrations of 8-MOP and 5-MOP after intraperitoneal injection were achieved
      for both drugs at 0.5 h, with the level of 8-MOP approximately 1.3 times higher
      than that of 5-MOP. The level of TMP could not be measured even in the case of
      intraperitoneal injection.

PMID- 8485110
TI  - Simultaneous and separated culture of keratinocytes and fibroblasts on each side
      of a collagen membrane.
AB  - We have developed a new cell culture system which is of benefit for the research
      of dermal-epidermal interaction. In this system, normal human keratinocytes are
      cultured on the upper surface of a permeable collagen membrane, on the
      undersurface of which human fibroblasts are simultaneously and separately
      cultured in a lifted condition. Both the keratinocytes and fibroblasts showed
      good proliferation and differentiation which were revealed by phase contrast
      microscopy as well as light and electron microscopies. A permeability test of the
      collagen membrane used in the present study showed that peptides of less than 30
      kDa are able to penetrate through the membrane. Using this system, we estimated
      the total protein content and cornified envelope formation in the keratinocytes
      cultured with or without fibroblasts. We found that the total protein and
      cornified envelope formation were significantly increased when keratinocytes were
      cultured together with fibroblasts. When keratinocytes were cultured with
      fibroblasts in the condition of air-liquid interface, synthesis of the cornified
      envelope was further enhanced. These results indicate that fibroblasts really
      effect not only the proliferation but also the differentiation of keratinocytes,
      and the air-liquid interface enhances their effect on differentiation. This bi
      phase separated cell culture system is a useful tool for the study of
      keratinocyte-fibroblast interaction.

PMID- 8485111
TI  - The location of Ted-R-1 antigen on the cell membrane of the stratum corneum:
      immunoelectron microscopic study.
AB  - As the Ted-R-1 monoclonal antibody yields fluorescence on the keratohyalin
      granules, in the cytoplasm of the lower stratum corneum cells and on the cell
      membrane region of the stratum corneum in indirect immunofluorescent examination,
      the location of the antigen of this Ted-R-1 monoclonal antibody was examined by
      the post-embedding, immunoelectron microscopic technique using gold labelled
      antibody. The number of gold particles located on the keratohyalin granules was
      184.00 +/- 28.69 per micron2. In contrast, there were only a few gold particles
      in the nucleus and the cytoplasm of the stratum granulosum (3.85 +/- 1.34) and
      none were found in the intercellular spaces of these cells (< 1.00). On the other
      hand, they were diffusely located in the lower two to three cell layers of the
      stratum corneum (319.75 +/- 44.41) and on the inner surface of the marginal band
      of the upper cell layers of the stratum corneum, but only a few were located in
      the cytoplasm of the upper stratum corneum cells (12 +/- 7.00). These
      observations indicate that the Ted-R-1 antigen locates on both keratohyalin
      granules and the inner surface of the marginal band of the upper part of the
      stratum corneum cell layers.

PMID- 8485112
TI  - Proteoglycans in cultures of skin fibroblasts in recessive dystrophic
      epidermolysis bullosa.
AB  - The proteoglycans of cultured fibroblasts from the skin of three patients with
      recessive dystrophic epidermolysis bullosa and three normals were compared after
      labeling with [35S]sulfate and [3H]leucine. The behavior in gel chromatography of
      the intact proteoglycans and several properties of their component
      glycosaminoglycans (size, content of iduronic acid, and content of 4- and 6
      sulfate) showed no statistical differences. In addition, the binding of intact
      proteoglycans and of their constituent proteins and glycosaminoglycans to type I
      collagen were measured by affinity chromatography. No differences were found that
      could account for the skin lesions in recessive dystrophic epidermolysis bullosa.

PMID- 8485113
TI  - A proposed guideline for psoralen photochemotherapy (PUVA) with atopic
      dermatitis: successful therapeutic effect on severe and intractable cases.
AB  - Psoralen photochemotherapy with UVA (PUVA) has been reported to be successfully
      substitutional for, or an adjunct to, conventional treatments in patients with
      atopic dermatitis (AD). Against the considerable advantages of utilizing PUVA for
      AD patients, however, it must also be balanced against the possible hazards for
      individual patients. We attempted herein to formulate a guideline for the
      selection of AD patients assigned to PUVA. According to this guideline, 114
      patients were selected for PUVA treatment. Forty-five percent of the patients did
      not respond adequately to other conventional forms of treatment. Side effects
      from former treatments, particularly steroids, appeared in 39% of the patients.
      Subsequent to the treatments, the skin lesions significantly decreased in 81% of
      the inpatients and 67% of the outpatients, while some patient's lesions
      disappeared, despite that other forms of treatment had been unsuccessful in many
      cases.

PMID- 8485114
TI  - Substrate delivery as a determinant of hepatic apoB secretion.
AB  - The evidence that apoB particles secreted by the liver can differ in number and
      composition has been reviewed. No evidence has yet emerged that changes in
      apoB100 itself affect the rate of its secretion from the liver. The metabolic
      role of apoB appears to be the prevention of lipid accumulation within the liver
      cell: when delivery of lipid to the liver increases, apoB secretion will increase
      pari passu. This reality in no way detracts from the critical role played by the
      LDL receptor in determining the number of LDL particles in plasma, nor does it
      diminish the potential importance of intracellular processes such as 7 alpha
      hydroxylase activity to also mediate LDL receptor activity. However, it should be
      obvious that variation in catabolism by itself cannot explain all that has been
      observed in physiological and pathological studies. On the contrary, the whole
      process must be taken into account--the rate at which apoB particles are added to
      the circulation, the rate at which they are converted to LDL, and the rate at
      which they are irreversibly removed from plasma--if we are to understand and
      appreciate this most peculiar and most important of transport systems.

PMID- 8485115
TI  - Nifedipine inhibits accumulation of LDL and cholesterol in the aorta of the
      normocholesterolemic rabbit.
AB  - The effect of 5 days of oral nifedipine treatment (approximately 1 mg/kg per day
      in drinking water) on low density lipoprotein (LDL) and cholesterol accumulation
      in rabbit arteries was determined. Compared with control aortas, nifedipine
      treatment (n = 5) significantly reduced homologous 125I-tyramine cellobiose-LDL
      accumulation (control versus nifedipine: 45.93 +/- 4.3 versus 20.14 +/- 3.1 ng
      LDL per milligram dry weight x10(-3), p = 0.001) while the reduction of human LDL
      accumulation (n = 5) was not significant (49.1 +/- 6.1 versus 35.5 +/- 4.1 ng LDL
      per milligram dry weight x10(-3)). Aortic accumulation of orally administered
      [3H]cholesterol was also inhibited by nifedipine (352 +/- 34 versus 257 +/- 16 ng
      cholesterol per milligram dry weight x10(-3), n = 10, p = 0.022). These findings
      suggest a possible mechanism for the antiatherosclerotic effect of nifedipine.

PMID- 8485116
TI  - Prevalence and risk factors of asymptomatic extracranial carotid artery
      atherosclerosis. A population-based study.
AB  - To evaluate the prevalence and risk factors of asymptomatic carotid artery
      disease, we analyzed a sample of 909 men and women (aged 40-79 years) drawn from
      the community-based Bruneck Ischemic Heart Disease and Stroke Prevention Study.
      For the four decades of age (40-49, 50-59, 60-69, and 70-79 years), respective
      prevalence rates as assessed by duplex scanning were found to be 8.2%, 39.7%,
      66.4%, and 82.5% in men and 3.3%, 22.3%, 48.7%, and 76.7% in women. High-grade
      stenosis (> 80%) classified by Doppler criteria was twice as frequent in men
      (2.4%) as in women (1.1%). Age and sex were found to be particularly strong and
      independent predictors of asymptomatic carotid artery disease. Accordingly,
      separate logistic regression models were developed for both men and women in the
      elderly (65-79 years) and middle-aged (50-64 years) groups. Systolic blood
      pressure turned out to be the only attribute with independent significance in all
      subgroups examined. Cigarette smoking, recorded as pack-years, emerged as the
      leading risk factor of carotid atherosclerosis in men. Serum fibrinogen levels
      were found to be highly indicative of carotid artery disease in elderly men and
      women. For apolipoprotein B predictive significance was observed in the middle
      aged populations, whereas apolipoprotein A-I had a protective effect in elderly
      women. Diabetes mellitus completed the risk factor profile for elderly men. In
      summary, the relation between cardiovascular risk factors and asymptomatic
      carotid artery disease showed a dynamic dependence on sex and age. These findings
      may help to improve the efficacy of risk prediction in the general population and
      facilitate well-directed preventive measures.

PMID- 8485117
TI  - Plasminogen activator inhibitor-1 mRNA is expressed in platelets and
      megakaryocytes and the megakaryoblastic cell line CHRF-288.
AB  - Plasminogen activator inhibitor-1 (PAI-1) is present in the platelet alpha
      granule and is released on platelet activation. Platelet PAI-1 could either be
      synthesized by the megakaryocyte or taken up from the plasma. In this report we
      confirm the presence of PAI-1 protein in human megakaryocytes by Western blot
      analysis and show its synthesis in guinea pig megakaryocytes by metabolic
      labeling. We document the presence of PAI-1 mRNA in human platelets and show a 3
      kb mRNA species on Northern blot analysis of guinea pig megakaryocytes. Neither
      untreated CHRF-288 cells, a megakaryoblastic cell line, nor human erythroleukemia
      (HEL) cells expressed PAI-1 mRNA. Phorbol ester (phorbol 12-myristate 13-acetate,
      160 nM) treatment of CHRF-288 and HEL cells for 4 days induced PAI-1 mRNA
      expression in CHRF-288 cells but not in HEL cells. These studies show that PAI-1
      is synthesized by megakaryocytes. Megakaryocytes most likely determine the PAI-1
      content of platelets and thereby establish the antifibrinolytic potential of the
      platelet.

PMID- 8485118
TI  - Relation between sex hormones and serum lipoprotein and lipoprotein(a)
      concentrations in premenopausal obese women.
AB  - Lipoprotein(a) (Lp[a]) is generally considered to be a risk factor for the
      development of cardiovascular disease, but little is known about the possible
      influence of obesity on the circulating levels of this lipoprotein. The present
      study was undertaken to examine this aspect in 136 menstrually active women by
      comparing the serum concentrations of Lp(a) between 72 obese and 64 age-matched
      nonobese women. Since an adverse effect of androgens and a protective effect of
      estrogens have been described for plasma lipoprotein profiles in obese women, the
      relation between the circulating levels of Lp(a) and those of these other
      hormones was also investigated in obese patients. In addition, other
      lipoproteins, anthropometric parameters (body mass index and waist-to-hip ratio),
      and insulin were evaluated. The levels of Lp(a) were not significantly different
      (Mann-Whitney U test chi 2, 3.59; p = 0.0582 [NS]) between obese (rank sum,
      5,367) and control (rank sum, 3,949) women; in addition, the percentage of
      patients with high Lp(a) levels (cutoff defined at 30 mg/dL) did not differ
      between the two groups (obese women, 30%; control, 21.8%; chi 2, 0.90; two-sided
      p = 0.341 [NS]). Moreover, no correlation was found between Lp(a) and body mass
      index. Lastly, when the Lp(a) prevalence odds ratio for obesity was examined by
      adjusting the levels of this lipoprotein for age, triglycerides, total
      cholesterol, and high density lipoprotein cholesterol, the probability value
      (0.88) was far from significant. In obese women, no correlation was found between
      the logarithmically transformed Lp(a) concentrations and all the other variables
      evaluated in the study. In conclusion, the present study shows that the
      circulating levels of Lp(a) are not influenced by body weight and cardiovascular
      risk factors commonly associated with obesity, such as enhanced androgenic
      activity, hyperinsulinemia, adverse lipoprotein profile, and abdominal fat
      accumulation.

PMID- 8485119
TI  - Basic fibroblast growth factor in the extracellular matrix suppresses collagen
      synthesis and type III procollagen mRNA levels in arterial smooth muscle cell
      cultures.
AB  - To determine the effects of an intact extracellular matrix on collagen synthesis,
      arterial smooth muscle cells (SMCs) were plated sparsely on a cell-free, SMC
      derived matrix and examined the following day. Collagen synthesis during a 5-hour
      incubation by cells on the matrix was reduced to 67% of the control values
      obtained from cultures on plastic. Total protein synthesis was unaffected.
      Treatment of the matrix with heparitinase to remove basic fibroblast growth
      factor (bFGF) before seeding the SMCs abolished the inhibitory effect of the
      matrix on collagen synthesis. The inhibitory effect was also eliminated by
      treating the matrix with a neutralizing polyclonal antibody directed against
      bFGF. Collagen synthesis by SMC cultures grown in wells coated with purified bFGF
      was only 61% that of control cultures, whereas total protein synthesis remained
      unchanged. Slot-blot analysis revealed that the relative message level for alpha
      1(III) procollagen was reduced in cultures grown on the preexisting matrix or on
      plastic precoated with bFGF, whereas the alpha 1(I) procollagen message was
      unaffected. These results demonstrate the ability of the extracellular matrix to
      modulate the synthesis of collagen by arterial SMCs and indicate that bFGF in the
      matrix is responsible for these effects.

PMID- 8485120
TI  - Genetics of LDL subclass phenotypes in women twins. Concordance, heritability,
      and commingling analysis.
AB  - Low density lipoprotein (LDL) subclass phenotype B, characterized by a
      predominance of small LDL as determined by gradient gel electrophoresis, has been
      associated with increased risk of coronary heart disease and an atherogenic
      lipoprotein profile. Previous studies employing complex segregation analysis have
      demonstrated a major, single gene effect on the inheritance of this phenotype in
      families. Recently, linkage between this phenotype and variation at the LDL
      receptor locus on chromosome 19 has been reported. However, variation in LDL
      subclass phenotypes has also been associated with age, gender, diabetes status,
      beta-blocker medication, and diet. The present study further evaluates the
      relative importance of genetic and nongenetic influences on LDL subclass
      phenotypes and on LDL peak particle diameter (as a reflection of the size of the
      major LDL subclass) in monozygotic and dizygotic women twin pairs. The analysis
      is based on 203 monozygotic and 145 dizygotic pairs of adult female twins who
      participated in the second examination of the Kaiser Permanente Women Twins
      Study. The average age was 51 years at this exam and 90% were white. Concordance
      analysis revealed that monozygotic cotwins shared LDL subclass phenotypes more
      frequently than dizygotic cotwins, and this was confirmed using logistic
      regression analysis after controlling for potential confounding factors.
      Heritability analyses suggested that approximately one third to one half of the
      variation in LDL peak particle diameter, a continuous variable reflecting LDL
      size, could be attributed to genetic influences. Commingling analysis of the
      frequency distribution of LDL peak particle diameter identified three distinct
      subgroups of subjects, one of which corresponded to those subjects with LDL
      subclass phenotype B.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485121
TI  - Platelet aggregation induced by the endoperoxide analogue U46619 is inhibited by
      polymorphonuclear leukocyte ADPase activity.
AB  - Platelet activation by the stable endoperoxide analogue U46619 is mediated
      largely by ADP released from platelet-dense granules. Polymorphonuclear
      leukocytes (PMNs) endowed with ecto-ADPase activity may operate as
      antiaggregatory cells in platelet aggregation induced by U46619. Unstimulated
      PMNs were effective in reducing aggregation when platelets were stimulated by
      threshold concentrations of U46619, whereas at higher concentrations of the
      stimulus, PMN activation is required. Evidence that the inhibition was mediated
      by PMN ecto-ADPase activity was obtained by high-performance liquid
      chromatography analysis, indicating that PMNs were able to efficiently metabolize
      platelet-active ADP into AMP. Moreover, PMN-derived supernatants were able to
      inhibit platelet aggregation, suggesting that under this circumstance the
      inhibition was exerted by an uncharacterized, releasable ADPase activity. This
      study supports the hypothesis that, besides nitric oxide and hydrogen peroxide,
      ADPase activity may represent another PMN-mediated pathway capable of regulating
      platelet activity in areas of reduced blood flow, such as those found in
      conditions of myocardial ischemia.

PMID- 8485122
TI  - Fenofibrate and LDL metabolic heterogeneity in hypercholesterolemia.
AB  - Metabolic heterogeneity in low density lipoprotein (LDL) may be detected by
      examination of the daily urinary excretion rate of radioactivity after injection
      of trace-labeled lipoprotein. Two distinct pools are observed within LDL. The
      first (pool A) is cleared rapidly from the plasma, whereas the second (pool B) is
      catabolized more slowly. In the present study we examined LDL metabolism in seven
      hypercholesterolemic subjects (six women and one man) before and during
      fenofibrate therapy. Comparison with normocholesterolemic individuals showed that
      the pretreatment high LDL levels in the hypercholesterolemic subjects resulted
      from an accumulation of apoprotein-LDL (apo-LDL) mass in pool B (2,077 +/- 174 mg
      versus 787 +/- 70 mg in normal subjects, p < 0.002). Pool A apo-LDL was present
      at normal levels (approximately 1,000 mg), although its fractional catabolic rate
      was reduced (0.39 +/- 0.06 versus 0.61 +/- 0.03 pool/day in normal subjects, p <
      0.01). Fenofibrate therapy (100 mg t.i.d. for 8 weeks) produced substantial
      reductions in plasma cholesterol (29%; p < 0.001), triglycerides (36%; p <
      0.001), and LDL cholesterol (30%; p < 0.001). The latter was associated with a
      30% decrease in circulating apo-LDL mass (2,312 +/- 200 mg versus 3,279 +/- 264
      mg before treatment, p < 0.005). This resulted from a combination of two effects.
      First, although overall LDL apoprotein B production did not change, there was a
      shift from pool B to pool A. Pool A input was 400 +/- 74 mg/day pretreatment
      versus 706 +/- 62 mg/day on fenofibrate; pool B input was 422 +/- 35 mg/day
      pretreatment versus 258 +/- 41 mg/day on the drug. At the same time, catabolism
      of pool A rose from 0.39 +/- 0.06 to 0.66 +/- 0.08 pool/day (p < 0.05). We
      hypothesize that the shift from pool B to pool A resulted from a drug-induced
      decrease in the particle size of very low density lipoprotein made by the liver,
      which in turn favored the formation of more rapidly catabolized LDL. Overall, the
      rate of apo-LDL degradation by the receptor route (as detected using a
      combination of native and 1,2-cyclohexanedione-modified LDL tracers) rose 43% on
      the drug, whereas the amount cleared by the receptor-independent pathway did not
      change. Fenofibrate, therefore, appears not only to promote LDL catabolism via
      the receptor-mediated pathway but also, by lowering plasma triglyceride levels,
      inhibits the formation of slowly metabolized, potentially atherogenic LDL
      particles.

PMID- 8485123
TI  - Identification of multiple dense LDL subfractions with enhanced susceptibility to
      in vitro oxidation among hypertriglyceridemic subjects. Normalization after
      clofibrate treatment.
AB  - The influence of different plasma triglyceride concentrations on the
      heterogeneity of low density lipoprotein (LDL) and on the susceptibility of LDL
      to copper oxidation was investigated. By density gradient ultracentrifugation,
      LDL subfractions were isolated from the plasma of 10 normolipidemic control
      subjects and 12 hypertriglyceridemic patients both before and after clofibrate
      treatment. In the plasma of control subjects three LDL subfractions were present:
      LDL1 (d = 1.030-1.033 g/mL), LDL2 (d = 1.033-1.040 g/mL), and LDL3 (d = 1.040
      1.045 g/mL). In the plasma of nine moderately hypertriglyceridemic subjects up to
      five LDL subfractions could be detected: LDL1-LDL3, LDL4 (d = 1.045-1.049 g/mL),
      and LDL5 (d = 1.049-1.054 g/mL). This polydispersity of LDL was replaced by
      monodispersity with increasing plasma triglyceride concentrations in three
      subjects with chylomicronemia, in whom LDL was concentrated in the narrow LDL5
      density range. Clofibrate treatment resulted in a lighter LDL subfraction pattern
      (LDL1-LDL4). In both the control and the moderately hypertriglyceridemic
      subjects, the small dense LDL subfractions appeared more prone to oxidative
      modification in vitro than the light LDL subfractions, as measured by the
      decreased lag time preceding the onset of lipid peroxidation. Furthermore, the
      dense LDL subfractions were more extensively modified over time, as shown by an
      increased oxidation rate and a greater number of dienes formed after 6 hours of
      oxidation. These results suggest an enhanced atherogenic potential of the small,
      dense LDL subfractions within each LDL subfraction profile. The
      hypertriglyceridemic LDL subfractions before therapy (LDL3-LDL5) were less
      resistant to in vitro oxidation than the light, control LDL subfractions (LDL1
      LDL3).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485124
TI  - Hepatic lipase deficiency. Clinical, biochemical, and molecular genetic
      characteristics.
AB  - Hepatic lipase (HL) is an important enzyme in the metabolism of triglyceride-rich
      lipoproteins and high density lipoproteins. The clinical syndrome of HL
      deficiency is rare and difficult to identify. We studied carriers of mutant HL to
      ascertain whether there are distinctive clinical and/or biochemical
      characteristics of the heterozygous state. In an Ontario kindred, compound
      heterozygosity for two HL mutations, S267F and T383M, underlies the clinical
      syndrome of complete HL deficiency. We report that simple heterozygotes for
      either HL mutant do not have a discrete lipoprotein abnormality, except for
      relative triglyceride enrichment of lipoprotein fractions with d > 1.006 g/mL.
      Postheparin HL activity is depressed to a greater degree in carriers of S267F
      compared with carriers of T383M. Retinyl palmitate loading studies in a compound
      heterozygote revealed impaired clearance of chylomicron remnants. The
      dyslipoproteinemia in a compound heterozygote was ameliorated by lovastatin.
      There was no difference in the quantity and distribution of HL mRNA in the liver
      of a compound heterozygote when compared with that of a normal subject. Thus, HL
      deficiency associated with structural variation of the HL gene is characterized
      by premature atherosclerosis, triglyceride enrichment of lipoprotein fractions
      with d > 1.006 g/mL, the presence of circulating beta-very low density
      lipoproteins, and abnormal catabolism of postprandial triglyceride-rich
      lipoproteins.

PMID- 8485125
TI  - Intravenous and endobronchial administration of G4120, a cyclic Arg-Gly-Asp
      containing platelet GPIIb/IIIa receptor-blocking pentapeptide, enhances and
      sustains coronary arterial thrombolysis with rt-PA in a canine preparation.
AB  - G4120, L-cysteine, N-(mercaptoacetyl)-D-tyrosyl-L-arginylglycyl-L-alpha- aspartyl
      cyclic(1-->5)-sulfide, 5-oxide, a synthetic cyclic Arg-Gly-Asp-containing
      pentapeptide, has a high affinity (dissociation constant of 4 nM) for the
      platelet glycoprotein (GP) IIb/IIIa receptor. The effects of its intravenous or
      endobronchial administration on thrombolysis, reocclusion, and bleeding time
      prolongation induced with 0.45 mg/kg bolus injections of recombinant tissue-type
      plasminogen activator in combination with intravenous heparin (4,000-unit bolus
      and 1,000 units each hour) were studied in a canine model consisting of an
      erythrocyte-rich blood clot in the left anterior descending coronary artery.
      Coronary patency was monitored for 3 hours both by ultrasonic flow probe and by
      repeat coronary angiography. Four groups of six to 10 dogs were studied with
      intravenous infusions of 0, 0.1, 0.2, or 0.3 mg/kg G4120 over 60 minutes. G4120
      at a dose of 0.3 mg/kg reduced the time to reflow from a mean control value of 45
      to 8 minutes (p = 0.036) and delayed reocclusion (p = 0.001). Four groups of five
      or six dogs were studied with endobronchial instillation of G4120 in a
      randomized, blinded study design using 0, 0.13, 0.25, or 0.5 mg/kg G4120.
      Endobronchial G4120 at a dose of 0.5 mg/kg reduced the time to reflow from a mean
      control value of 52 to 7 minutes (p = 0.039) and abolished cyclic reocclusion and
      reflow (p = 0.008). G4120 induced a dose-related transient prolongation of the
      template bleeding time and inhibition of ADP-induced platelet aggregation. G4120,
      a synthetic low-molecular-weight GPIIb/IIIa inhibitor that may be produced by
      chemical synthesis, may be of clinical value as a conjunctive agent for
      thrombolysis in patients with ischemic coronary syndromes.

PMID- 8485126
TI  - Isolation of heparin-insensitive aortic smooth muscle cells. Growth and
      differentiation.
AB  - Previous work has shown heparin and heparan sulfates to be potent inhibitors of
      vascular smooth muscle cell (VSMC) growth. This laboratory has previously
      isolated a VSMC line insensitive to the antiproliferative action of heparin by
      subjecting VSMCs that grew out from rat aortic medial explants to continuous
      passage in media containing heparin at 200 micrograms/mL. In the present study,
      we have isolated two additional heparin-resistant (HR) cell lines and have used
      the HR cells to investigate cellular mechanisms responsible for the potent
      antiproliferative activity of heparin. In contrast to normal heparin-sensitive
      VSMCs, the HR cells were smaller, displayed elongated processes, and possessed
      altered growth characteristics; however, both HR and normal cells bound and
      internalized comparable amounts of heparin. Immunohistochemical detection of
      smooth muscle cell-specific actin in growth-arrested cells showed staining of
      nearly all normal VSMCs and of a much smaller percentage of HR cells; heparin
      treatment caused a marked increase in the percentage of HR cells expressing
      smooth muscle cell alpha-actin, indicating that the antiproliferative and
      differentiation-promoting actions of heparin are independent. Proteins from
      control VSMCs and HR cells were analyzed by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis and heparin affinity chromatography. Several proteins were
      expressed preferentially by either HR cells or normal VSMCs, with the most
      significant difference being the secretion of a high-affinity, heparin-binding
      protein (M(r), 38,000) by control VSMCs but not by HR cells. We conclude that the
      aortic VSMC population may give rise to HR cells under selective conditions and
      that their unique characteristics, such as alterations in their ability to
      produce heparin-binding proteins, will prove useful in deciphering the cellular
      mechanisms involved in heparin's regulation of VSMC growth and differentiation.

PMID- 8485127
TI  - Molecular cloning of the cDNA for a human amyloid precursor protein homolog:
      evidence for a multigene family.
AB  - Alzheimer's disease is a degenerative neurological disorder characterized by
      neural loss and brain lesions associated with plaques containing large amounts of
      the beta/A4 amyloid peptide. Molecular cloning of the cDNA for this peptide from
      human brain has shown it to be derived by proteolysis from a much larger
      precursor called the amyloid precursor protein (APP). The biological role of the
      precursor is unknown, but it has been shown to be transcribed in many human
      tissues in addition to brain. In the present report, we describe the molecular
      cloning from a human placental library of a full-length cDNA for a molecule
      closely related to APP. This novel molecule, which we have called amyloid
      precursor protein homolog (APPH), shares overall domain organization with APP. It
      is 763 amino acids in length and appears to encode a signal peptide, a large
      apparent extracellular domain including a Kunitz inhibitor domain, a
      transmembrane region, and a short cytoplasmic domain. Northern analysis indicates
      that it occurs in at least two molecular forms and is transcribed in human brain,
      heart, lung, liver, and kidney, in addition to placenta. On the basis of its
      extensive sequence similarity and conservation of domain structure, APPH is the
      nearest relative of APP yet identified in an emerging multigene family.

PMID- 8485128
TI  - Kinetic and spectroscopic studies of hydrophilic amino acid substitutions in the
      hydrophobic pocket of human carbonic anhydrase II.
AB  - The functional importance and structural determinants of a conserved hydrophobic
      pocket in human carbonic anhydrase II (CA II) were probed by preparing and
      characterizing 13 amino acid substitutions at Leu-198, situated at the mouth of
      the pocket. The pH dependence of the esterase activity reveals that activity
      decreases (up to 120-fold) as the amino acid size and charge at position 198 are
      varied while the pKa of the zinc-bound water molecule increases (up to 1 pH
      unit). Intriguingly, the pH dependence of the Leu-198-->Glu substitution is
      parabolic (pKas approximately 6 and 9), consistent with introduction of a general
      base-catalyzed mechanism. Kinetic characterization of CO2/HCO3- interconversion
      catalyzed by four variants (Leu-198-->Ala, His, Arg, and Glu) reveals that
      increasing the size of the hydrophobic pocket (Ala) does not compromise catalysis
      (approximately 3-fold decrease); however, substitution of charged (Arg and Glu)
      and larger (His) amino acids decreases kcat/KM for CO2 hydration substantially
      (17-fold, 19-fold, and 10-fold, respectively) but not completely. log kcat/KM for
      CO2 hydration, HCO3- dehydration, and p-nitrophenyl acetate hydrolysis correlates
      with the hydrophobicity of the residue at 198, likely reflecting desolvation or
      electrostatic destabilization of the ground state. The X-ray crystal structures
      of the Leu-198-->His, Glu, and Arg variants (Nair & Christianson, 1993) indicate
      that the His and Glu side chains are accommodated by minor structural
      reorganization leading to a wider mouth for the hydrophobic pocket while the Arg
      side chain blocks the pocket. Infrared spectroscopy of CO2 bound to either wild
      type CA II or the Leu-198-->Arg variant indicates that the Arg substitution both
      decreases the affinity and alters the position of CO2 binding, suggesting that
      the hydrophobic pocket forms the CO2 binding site in CA II. Finally, a 1.5-fold
      increase (Leu-198-->Ala) and 12-fold decrease (Leu-198-->Arg) in kcat for CO2
      hydration, indicative of the rate constant for intramolecular proton transfer
      from zinc-bound water to His-64, are likely mediated by changes in the active
      site solvent structure.

PMID- 8485129
TI  - Structural consequences of hydrophilic amino acid substitutions in the
      hydrophobic pocket of human carbonic anhydrase II.
AB  - The three-dimensional structures of Leu-198-->Glu, Leu-198-->His, Leu-198-->Arg,
      and Leu-198-->Ala variants of human carbonic anhydrase II (CAII) have each been
      determined by X-ray crystallographic methods to a resolution of 2.0 A. The side
      chain of Leu-198 is located at the mouth of the active site hydrophobic pocket,
      and this pocket is required for substrate association. Hydrophobic-->hydrophilic
      amino acid substitutions at the mouth of the pocket decrease kcat/KM for CO2
      hydration: the CO2 hydrase activities of Leu-198-->Glu, Leu-198-->His, and Leu
      198-->Arg CAIIs are diminished 19-fold, 10-fold, and 17-fold, respectively,
      relative to the wild-type enzyme; however, the substitution of a compact
      aliphatic side chain for Leu-198 has a smaller effect on catalysis, in that Leu
      198-->Ala CAII exhibits only a 3-fold decrease in CO2 hydrase activity [Krebs, J.
      F., Rana, F., Dluhy, R. A., & Fierke, C. A. (1993) Biochemistry (preceding paper
      in this issue)]. It is intriguing that CO2 hydrase activity is not severely
      diminished in Leu-198-->Arg CAII, even though the side chain of Arg-198 blocks
      the hydrophobic pocket. Therefore, the bulky side chain of Arg-198 must be
      reasonably mobile in order to accommodate substrate association. Significantly, a
      residue larger than the wild-type Leu-198 side chain does not necessarily block
      the substrate association pocket; e.g., the side chain of Glu-198 packs against a
      hydrophobic patch, the net result of which is a wider mouth for the
      pocket.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485130
TI  - Fourier transform infrared spectroscopy and electrochemistry of the primary
      electron donor in Rhodobacter sphaeroides and Rhodopseudomonas viridis reaction
      centers: vibrational modes of the pigments in situ and evidence for protein and
      water modes affected by P+ formation.
AB  - Protein electrochemistry in an ultra-thin-layer electrochemical cell suitable for
      UV/vis and IR spectroscopy has been used to characterize the vibrational modes of
      the primary electron donors of Rhodobacter sphaeroides and Rhodopseudomonas
      viridis reaction centers in their neutral and cation radical states (P and P+,
      respectively). The P-->P+ redox transitions could be well separated from redox
      reactions of other cofactors according to their redox midpoint potential. The IR
      difference bands of the primary electron donor bacteriochlorophylls all titrate
      in unison and exhibit the correct midpoint potential. Comparison of the
      difference spectra with those of isolated bacteriochlorophylls a and b in organic
      solvents of different polarity and proton activity [Mantele, W., Wollenweber, A.
      M., Nabedryk, E., & Breton, J. (1988) Proc. Natl. Acad. Sci. U.S.A. 85, 8468
      8472] leads to similar conclusions on the binding and interaction of the pigments
      within the protein matrix as previously obtained from light-induced P+Q-/PQ
      difference spectra. Equilibration of the reaction centers in D2O leads to few but
      distinct shifts of bands and changes of band intensities at 1662, 1634, and 1526
      cm-1 (Rhodobacter sphaeroides) and 1694, 1664, 1648, 1630, and 1532 cm-1
      (Rhodopseudomonas viridis) as well as to smaller deviations at other wavenumbers.
      The H-->D-sensitive band at 1662 cm-1 is interpreted in terms of a histidine NH2+
      bending mode. A second H/D-sensitive difference band around 1648 cm-1 in the
      Rhodopseudomonas viridis reaction center may be associated with the peptide C = O
      of one of the amino acids surrounding P [eventually of the histidine(s) ligating
      the Mg] which is affected by P+ formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485131
TI  - R and T states of fluoromethemoglobin probed by ultraviolet resonance Raman
      spectroscopy.
AB  - Ultraviolet resonance Raman spectra are reported for the fluoride complex of
      methemoglobin (metHbF), with and without added inositol hexaphosphate (IHP), an
      allosteric effector known to stabilize the T quaternary structure. Environmental
      changes in Trp and Tyr residues give rise to the difference features, which are
      similar to those observed in the difference spectrum between deoxyHb and the CO
      adduct, consistent with T-state formation in metHbF in the presence of IHP. There
      are, however, important differences. The intensities of the difference signals
      are attenuated by about one-third, indicating a lower T-state population in the
      IHP-bound metHbF than in native deoxyHb. And a new signal is seen which arises
      from the interior tryptophans, probably reflecting a change in their H-bond
      status associated with the presence of fluoride as the sixth heme ligand in the T
      state. Implications of these results for the nature of the molecular forces
      opposing ligation in the T state are discussed.

PMID- 8485132
TI  - Inter-tryptophan distances in rat cellular retinol binding protein II by solid
      state NMR.
AB  - Structural constraints for the tryptophans in rat cellular retinol binding
      protein II (CRBP II) have been obtained by rotational-echo double-resonance
      (REDOR) solid-state NMR. CRBP II was labeled with L-[6-19F]tryptophan and L-[2
      13C]tryptophan. The 13C-19F dipolar coupling was determined for various possible
      tryptophan geometries. The allowed distance between the closest two of the four
      tryptophans in CRBP II was obtained for each geometry. The minimum possible
      distance between these two tryptophans in CRBP II is 7 A, and the maximum
      possible distance is 11 A.

PMID- 8485133
TI  - Inhibitor-induced conformational change in cytochrome P-450CAM.
AB  - The X-ray crystal structures of cytochrome P-450CAM complexed with both
      enantiomers of a chiral, multifunctional inhibitor have been refined to R-factors
      of 21.0% [(+)-enantiomer] and 19.6% [(-)-enantiomer] at approximately 2.1-A
      resolution. Binding of either enantiomer, both considerably larger than the
      natural substrate camphor, results in similar, dramatic structural changes in the
      enzyme. In contrast to all previous P-450CAM crystallographic structures, the
      Tyr96 side chain is not pointing "down" toward the heme but is rather directed
      "up" into the proposed substrate access channel. This conformational change is
      accompanied by the displacement of the Phe193 side chain out into the solvent at
      the enzyme surface. These changes are consistent with the assignment of this
      region of the enzyme as the access channel [Poulos et al. (1986) Biochemistry 25,
      5314-5322] and suggest that several aromatic residues lining the channel may be
      involved in substrate recognition and channeling to the active site. The cation
      usually observed coordinated to the Tyr96 carbonyl oxygen is missing in the
      presence of the (+)-enantiomer but is present with the (-)-enantiomer. The Phe87
      side chain, located near the inhibitor binding site, adopts different
      orientations depending upon which enantiomer is bound. Finally, electron density
      reveals that although the inhibitor enantiomers were dichlorinated as provided,
      when bound to P-450CAM the chlorine atoms are present at only 0-20% occupancy,
      probably reflecting selective binding of impurities in the samples. Coordinates
      of these inhibited P-450CAM complexes have been deposited in the Brookhaven
      Protein Data Bank [Bernstein et al. (1977) J. Mol. Biol. 112, 535-542].

PMID- 8485134
TI  - Effect of pH on solubility and ionic state of lipopolysaccharide obtained from
      the deep rough mutant of Escherichia coli.
AB  - The dissociation of the highly aggregated form of lipopolysaccharide (LPS) from
      Gram-negative bacteria to the monomeric (or soluble) form is though to be the
      initial step in the activation of responding cells (macrophages, B-cells,
      neutrophils, monocytes, and endothelial cells) by LPS. This process is presently
      not adequately understood. Using the equilibrium dialysis apparatus and a highly
      purified and well-characterized radiolabeled deep rough chemotype LPS
      ([14C]ReLPS) from Escherichia coli D31m4, we have examined the effect of pH on
      its solubility (CT) and ionic states in aqueous media. The solubility range of
      [14C]ReLPS suspended in 50 mM Tris-HCl-100 mM KCl buffer (or 50 mM MES-100 mM KCl
      buffer at pH 6.5) was determined to be from (2.91 +/- 0.01) x 10(-8) to (4.55 +/-
      0.07) x 10(-8) M over a pH range of 6.50-8.20, respectively. These experimental
      data satisfactorily fitted the curve generated by the solubility equation CT =
      S0(1 + K5/[H+])/([H+]/K4' + 1), where S0 is the concentration of the tetraanionic
      ReLPS, K5 is the dissociation constant of the tetraanionic ReLPS in solution, and
      K4' is the dissociation constant of the trianionic ReLPS at the surface of the
      solid particles in suspension. The increase in solubility of ReLPS with increase
      in pH from 7.00 to 8.20 is primarily caused by the formation of the pentaanionic
      form from the tetraanions. The pK5 (primarily the second dissociation of the 1
      phosphate) of ReLPS was determined to be 8.58 from experimental data.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8485135
TI  - Phosphorylation of human and bovine prothymosin alpha in vivo.
AB  - Prothymosin alpha is post-translationally modified. When human myeloma cells were
      metabolically labeled with [32P]orthophosphoric acid, they synthesized
      [32P]prothymosin alpha. The incorporated radioactivity was resistant to DNase and
      RNases A, T1, and T2, but could be completely removed by alkaline phosphatase. No
      evidence was found for an RNA adduct as postulated by Vartapetian et al.
      [Vartapetian, A., Makarova, T., Koonin, E. V., Agol, V. I., & Bogdanov, A. (1988)
      FEBS Lett. 232, 35-38]. Thin-layer electrophoresis of partially hydrolyzed
      [32P]prothymosin alpha indicated that serine residues were phosphorylated.
      Analysis of peptides derived from bovine prothymosin alpha and human
      [32P]prothymosin alpha by treatment with endoproteinase Lys-C revealed that the
      amino-terminal 14-mer, with serine residues at positions 1, 8, and 9, was
      phosphorylated at a single position. Approximately 2% of the peptide in each case
      contained phosphate. Further digestion of the phosphopeptide with Asp-N followed
      by C18 reversed-phase column chromatography produced two peptides: a phosphate
      free 9-mer containing amino acids 6-14 and a labeled peptide migrating slightly
      faster than the N-terminal 5-mer derived from the unmodified 14-mer. Positive
      identification of the phosphorylated amino acid was obtained by colliding the 14
      residue phosphopeptide with helium in the mass spectrometer and finding phosphate
      only in a nested set of phosphorylated fragments composed of the first three,
      four, and five amino acids. The results prove that prothymosin alpha contains N
      terminal acetylserine phosphate. In a synchronized population of human myeloma
      cells, phosphorylation occurred throughout the cell cycle. Furthermore,
      prothymosin alpha appeared to be stable, with a half-life slightly shorter than
      the generation time. Although prothymosin alpha is known to be essential for cell
      division, the constancy of both the amount of the protein and the degree of its
      phosphorylation suggests that prothymosin alpha does not directly govern mitosis.

PMID- 8485136
TI  - Cholesterol is poorly available for free apolipoprotein-mediated cellular lipid
      efflux from smooth muscle cells.
AB  - To study the mechanism for resistance of smooth muscle cells (SMC) to cholesterol
      efflux caused by lipid-free apolipoproteins [Komaba, A., et al. (1992) J. Biol.
      Chem. 267, 17560-17566], the efflux of phospholipids and cholesterol was induced
      from mouse peritoneal macrophages (MP) and rat aortic SMC by
      phospholipid/triglyceride microemulsion, by human plasma high- and low-density
      lipoproteins (HDLs and LDLs), and by lipid-free human apolipoprotein (apo) A-I.
      The efflux of both lipids by the lipid microemulsion showed essentially the same
      kinetic profile for these two types of cells except that the rate of phospholipid
      efflux was 5-6 times slower by weight than cholesterol in both cases. The same
      ratio of cholesterol to phospholipid was also found in the efflux to LDLs. Lipid
      free apoA-I mediated cellular cholesterol efflux, but the rate was much slower
      from SMC than from MP. However, the rate of apoA-I-mediated phospholipid efflux
      was similar between these two cells generating HDL-like particles, resulting in a
      high phospholipid:cholesterol ratio, (4-5):1 by weight, in the lipid efflux from
      SMC, in contrast with (0.8-1):1 in the lipid efflux from MP. When standardized
      for the cellular free cholesterol, the Vmax of cholesterol efflux induced by
      lipid-free apoA-I was 10 times slower from SMC than from MP, but only by at most
      2-fold slower when lipid microemulsion was the acceptor. Thus, free cholesterol
      of SMC is less available than that of MP for free apolipoprotein-mediated
      generation of HDLs with cellular lipids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485137
TI  - Unfolded structure and reactivity of nucleosome core DNA-histone H2A,H2B
      complexes in solution as studied by synchrotron radiation X-ray scattering.
AB  - It has been previously found using different physicochemical techniques [Aragay,
      A., Diaz, P., & Daban, J.-R. (1988) J. Mol. Biol. 204, 141-154] that histones
      H2A,H2B in the absence of H3,H4 can associate with nucleosome core DNA (146 base
      pairs). Here we describe a synchrotron X-ray scattering study of core DNA
      (H2A,H2B) complexes in solution. Our results obtained using different histone to
      DNA weight ratios and ionic conditions ranging from very low ionic strength to
      0.2 M NaCl show that histones H2A,H2B are unable to fold core DNA. Model
      calculations indicate that histones H2A,H2B produce very elongated structures
      even when the reconstituted complexes are prepared at physiological ionic
      strength. In contrast, our scattering data indicate that the reconstituted
      complexes prepared at physiological salt concentration either with the four core
      histones or with histones H3,H4 without H2A,H2B are completely folded particles
      with a radius of gyration similar to that corresponding to the native nucleosome
      core (4.2 nm). Furthermore, our results show that the DNA of the extended
      complexes containing histones H2A,H2B becomes completely folded after the histone
      pair exchange reaction that occurs spontaneously between preformed DNA-(H2A,H2B)
      and DNA-(H3,H4) complexes. These observations, together with our previous
      studies, suggest that the open conformation of DNA-(H2A,H2B) complexes
      facilitates the involvement of this structure as a transient intermediate in the
      reaction of nucleosome formation at physiological ionic strength.

PMID- 8485138
TI  - Translesional synthesis on DNA templates containing 8-oxo-7,8
      dihydrodeoxyadenosine.
AB  - This study was designed to establish the miscoding potential of 8-oxo-7,8
      dihydrodeoxyadenosine (8-oxo-dA). Oligodeoxynucleotides modified site
      specifically with 8-oxo-dA were used as templates in primer extension reactions
      catalyzed by DNA polymerase I (Klenow fragment), DNA polymerase alpha (pol
      alpha), or DNA polymerase beta (pol beta). dTMP or dGMP is incorporated opposite
      8-oxo-dA when either of these dNTPs is provided as substrate for DNA polymerase.
      dTMP is incorporated exclusively opposite 8-oxo-dA when all four dNTPs are
      present in the reaction mixture at equimolar concentrations. Chain extension is
      catalyzed efficiently by Klenow fragment and pol beta under conditions where 8
      oxo-dA is paired with dT at the 3' terminus of the primed DNA template. Chain
      extension catalyzed by pol alpha proceeds more slowly. As shown by steady-state
      kinetic experiments, incorporation of dGMP is higher in reactions catalyzed by
      pol beta than by Klenow fragment or pol alpha. The dG-8-oxo-dA pair is extended
      efficiently from the 3' terminus in the absence of dTTP. We conclude that DNA
      containing 8-oxo-dA is capable of miscoding; however, unlike 8-oxo-dG, the
      mutagenic potential of this lesion is limited.

PMID- 8485139
TI  - New insights into sequence recognition process of esperamicin A1 and
      calicheamicin gamma 1I.: origin of their selectivities and "induced fit"
      mechanism.
AB  - This study addresses the DNA sequence recognition event of the enediyne
      antibiotics esperamicin A1 and calicheamicin gamma 1I by the use of synthetic DNA
      oligomers, salt effects, and circular dichroism studies. The results reported
      here provide several important insights: (1) esperamicin A1 requires a
      purine/pyrimidine trimer in host DNA for favorable interaction, (2) the sequence
      selectivity of esperamicin C is an origin of esperamicin A1 and calicheamicin
      gamma 1I selectivities, (3) in the target recognition by esperamicin C, its total
      structure and hydrophobicity are important, and (4) the binding of hydrophobic
      esperamicin to DNA duplex induces dehydration and conformational change of the
      host DNA. The specific sequence recognition process of esperamicin/calicheamicin
      has been discussed.

PMID- 8485140
TI  - Lipoprotein(a) binds to human platelets and attenuates plasminogen binding and
      activation.
AB  - Lipoprotein(a) [Lp(a)] is a unique lipoprotein consisting of a low-density
      lipoprotein moiety (LDL) covalently linked to apoprotein(a). Previous work has
      demonstrated that Lp(a) can compete with plasminogen (PGN) for binding to
      endothelial and mononuclear cells and can inhibit PGN activation in cell-free
      systems. We have assessed the binding of Lp(a) to platelets and the influence of
      binding on the activation of PGN by tissue-type plasminogen activator (t-PA) in
      this system. In direct binding experiments, Lp(a) bound specifically, saturably,
      and reversibly to platelets with an estimated apparent Kd of 0.20 microM.
      Scatchard analysis revealed a single class of binding sites with 81,000 +/-
      22,000 particles of Lp(a) bound at saturation. Interestingly, Lp(a) bound to a
      similar extent to thromboasthenic platelets. Activation of platelets with ADP or
      thrombin reduced Lp(a) binding capacity by approximately 50% without changing
      affinity. Lp(a) also inhibited the binding of PGN to platelets with an IC50 of
      approximately 0.23 microM. Over a similar concentration range, LDL did not
      inhibit PGN binding to platelets. In addition, Lp(a) inhibited PGN binding to
      plasmin-treated platelets with an IC50 of approximately 0.2 microM. Kinetic
      experiments demonstrated that Lp(a) acted as a competitive inhibitor of PGN
      activation by t-PA on the platelet surface, with an estimated Ki of 0.49 microM.
      In the presence of platelets, Lp(a) decreased the kcat/Km for t-PA by 3-fold,
      owing primarily to an increase in the Km of t-PA for PGN. In contrast, LDL did
      not alter the kinetics of PGN activation by t-PA on the platelet
      surface.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485141
TI  - Aggregation of phospholipid vesicles by a chimeric protein with the N-terminus of
      annexin I and the core of annexin V.
AB  - A chimeric protein was produced with the N-terminal domain (amino acids 1-45) of
      annexin I and the core of annexin V (amino acids 19-320). This protein, annexin
      IN-VC, has a similar Ca2+ requirement for binding to phospholipid bilayers of 20%
      phosphatidylserine (PS)/80% phosphatidylcholine (PC) as annexin V. In contrast to
      annexin V, this protein has a strong potency to aggregate phospholipid vesicles
      as is shown by turbidimetric measurements and cryo-electron microscopy.
      Ellipsometry was employed to study quantitatively the phenomenon of phospholipid
      vesicle adhesion to annexin IN-VC bound to a planar phospholipid bilayer. The
      amount of phospholipid vesicles bound by annexin IN-VC on the planar bilayer is
      proportional to its surface coverage and can be inhibited by coadsorption of
      annexin V on the planar bilayer or by shielding the phospholipid surface of the
      vesicles with blood coagulation factor Va. Annexin IN-VC, like annexin V, does
      not bind to pure PC bilayers, but its adsorption on anionic phospholipid bilayers
      brings about the capacity to bind pure PC vesicles. This suggests that annexin IN
      VC generates or exposes after binding to anionic phospholipids another
      phospholipid binding site, that differs from the annexin V phospholipid binding
      site. Collectively, the data suggest that two-dimensional cluster formation of
      annexin IN-VC on a bilayer with anionic phospholipids is involved in vesicle
      adherence.

PMID- 8485142
TI  - The role of protein charge in protein-lipid interactions. pH-dependent changes of
      the electrophoretic mobility of liposomes through adsorption of water-soluble,
      globular proteins.
AB  - The role of electrostatics in the adsorption process of proteins to preformed
      negatively-charged (phosphatidylcholine/phosphatidylglycerol) and neutral
      (phosphatidylcholine) liposomes was studied. The interaction was monitored at low
      ionic strength for a set of model proteins as a function of pH. The adsorption
      behavior of trypsin inhibitor (pI = 4.6), myoglobin (pI = 7.4), ribonuclease (pI
      = 9.6), and lysozyme (pI = 10.7) with preformed liposomes was investigated, along
      with changes in the electrophoretic mobility of liposomes through the adsorption
      of charged proteins. Mean protein charge was determined by acid/base titration.
      Significant adsorption of the proteins to negatively-charged liposomes was only
      found at pH values where the number of positive charge moieties exceeds the
      number of negative charge moieties on the protein by at least three charge units.
      Negligible adsorption to liposomes composed of zwitterionic lipids was observed
      in the pH range tested (4-9). The absolute value of the electrophoretic
      mobilities of negatively-charged, empty liposomes decreased after adsorption of
      positively-charged proteins. With increasing protein to phospholipid ratio, the
      drop in the electrophoretic mobility leveled off and reached a plateau; protein
      adsorption profiles showed a similar shape. Analysis of the data demonstrated
      that neutralization of the liposome charge due to the adsorption of the
      positively-charged proteins is the controlling factor in their adsorption. The
      plateau level reached depended on the type of protein and the pH of the
      incubation medium. This pH dependency could be ascribed to the mean positive
      charge of the protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485143
TI  - Dimethyl methylphosphonate (DMMP): a 31P nuclear magnetic resonance spectroscopic
      probe of intracellular volume in mammalian cell cultures.
AB  - Dimethyl methylphosphonate (DMMP), when added to a suspension of erythrocytes,
      has been reported to have a lower frequency chemical shift inside of cells than
      outside. This work further investigates the same phenomenon in hollow-fiber
      bioreactor cultures of six mammalian cell lines and describes the application of
      DMMP as a measure of intra- versus extracellular volumes in mammalian cell
      cultures. No toxic effects of the DMMP were observed at the concentrations used
      here. The dependence of the shift of intracellular DMMP on intracellular protein
      content was shown to be similar for cultured mammalian and red blood cells. Also
      consistent with shifts in erythrocytes, an increase in the intracellular protein
      concentration due to a reduction in cultured cell volume increased the magnitude
      of the shift to lower frequency. Longitudinal relaxation (T1) values for intra-
      and extracellular DMMP were measured so that partially saturated DMMP peaks in
      31P NMR spectra of mammalian cell cultures can be corrected to give the relative
      volumes of the intra- and extracellular compartments; this information provides a
      relative measure of culture growth. Intracellular volume measured by this method
      can also be used to quantify intracellular metabolites such as ATP during the
      growth of the culture. To explore the mechanism behind the intracellular shift,
      we have also addressed the three possible contributions to the chemical shift of
      DMMP: hydrogen-bonding interactions, magnetic susceptibility, and ionic strength.
      Data is presented which eliminates the latter two mechanisms and strongly
      supports the hypothesis that the observed intracellular shift is due to a
      reduction in hydrogen bonding between water and DMMP in the cytoplasm.

PMID- 8485144
TI  - Characterization of the folate-dependent mitochondrial oxidation of carbon 3 of
      serine.
AB  - The folate-dependent catabolism of serine was studied in intact rat liver
      mitochondria and soluble extracts from sonicated mitochondria. Formate and CO2
      are both known to be products of the mitochondrial oxidation of carbon 3 of
      serine. The present work tests the proposal [Barlowe, C. K., & Appling, D. R.
      (1988) Biofactors 1, 171-176] that carbon 3 of serine is first oxidized to 10
      formyltetrahydrofolate, which can be either oxidized to CO2 or converted to
      formate. Oxidation of carbon 3 of serine to formate and CO2 was shown to be
      dependent on the respiratory state of the mitochondria. Formate production was
      greatest in state-3 (actively respiring) mitochondria and lowest in uncoupled
      mitochondria. In contrast, CO2 production was greatest in uncoupled mitochondria
      and lowest in respiratory-inhibited mitochondria. Formate production appeared to
      be favored when high concentrations of NADP+ and ADP were present, but there was
      no clear correlation between the NADP+:NADPH redox state and CO2 production. In
      soluble mitochondrial extracts, CO2 production depended on NADP+ and
      tetrahydrofolate, whereas formate production required ADP in addition to NADP+
      and the reduced folate cofactor. Unlike CO2 production, however, formate
      production showed a complete dependence on a polyglutamylated form of the folate
      cofactor. These experiments support the proposed folate-mediated serine oxidation
      as a major pathway for the flux of one-carbon units through mitochondria.

PMID- 8485145
TI  - Expression, purification, and characterization of the Drosophila kinesin motor
      domain produced in Escherichia coli.
AB  - The Drosophila kinesin heavy-chain gene was truncated to obtain the N-terminal
      401 amino acid motor domain (designated K401) containing both the microtubule and
      ATP binding sites. The plasmid construct with the truncated kinesin gene was used
      to transform Escherichia coli. After induction, K401 was expressed as soluble
      kinesin protein at high levels and purified to homogeneity in milligram
      quantities. The purified protein was active and behaved as native kinesin with
      respect to its steady-state kinetic properties: K401 demonstrated a very low
      ATPase activity (kcat = 0.01 s-1) which was stimulated approximately 1000-fold by
      the addition of microtubules (kcat = 10 s-1; K0.5,MT = 0.9 microM tubulin; Km,ATP
      = 31 microM). Like native kinesin, K401 when purified contained ADP tightly bound
      at its active site, and the release of ADP from the active site occurred at a
      rate equal to the steady-state ATPase kcat. Active-site measurements using [alpha
      32P]ATP demonstrated a stoichiometry of one ATPase site per K401 molecule. Like
      native kinesin, K401 can also hydrolyze MgGTP, and in the presence of
      microtubules, the rate of hydrolysis was increased dramatically from 0.03 to 16 s
      1 (K0.5,MT = 2 microM tubulin; Km,GTP = 3.5 mM). These results establish that an
      active kinesin motor domain can be bacterially expressed and that this domain,
      the N-terminal 401 amino acids of the Drosophila kinesin heavy chain without
      light chains or additional eukaryotic factors, has full catalytic activity with
      microtubules.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485146
TI  - Glucose metabolism in Escherichia coli and the effect of increased amount of
      aldolase.
AB  - We present a comparative study of Escherichia coli with normal and increased
      amounts of fructose-1,6-bisphosphate aldolase. Most experiments employed a
      resting cell system involving a high cell density (so as to obtain the soluble
      pool by direct extraction) and anaerobic incubation in the presence of
      chloramphenicol. Glucose use is linear with time with a rate ca. half of that in
      growth, fermentation is almost quantitative, and metabolite concentrations reach
      a quasi steady state. Increased amount of aldolase had little effect on glucose
      flux; fructose-1,6-P2 concentration decreased by ca. one-third, and the extent of
      equilibration of its two halves, measured by a dismutation procedure on samples
      taken during metabolism of [6-14C]glucose, increased from 0.33 [(cpm in C1
      3)/(cpm in C1-6)] to 0.43. Using the simplest model, that increased amount of
      aldolase does not perturb net flux or later metabolites, together with the steady
      state rate equations for aldolase and triose-P isomerase, we show that the
      results with resting cells fit with the extra enzyme being fully active, and do
      not necessitate special assumptions concerning a glycolytic complex, metabolite
      compartmentation, or secondary mechanisms assuring high metabolite concentration.
      However, the fit does require that the measured Vmax values substantially
      underestimate the actual ones. Calculation also shows that the forms of the
      predicted curves--and hence the fit with experimental data--of fructose-1,6-P2
      concentration and labeling as a function of the amount of aldolase are highly
      dependent on glyceraldehyde-3-P concentration but independent of the kinetic
      parameters of aldolase.

PMID- 8485147
TI  - POU domain transcription factors.

PMID- 8485148
TI  - Two developmentally regulated mRNAs encoding actin-binding proteins in Physarum
      polycephalum.
AB  - A cDNA library from amoebae of Physarum polycephalum was screened by differential
      hybridization. Two clones contained inserts for mRNAs present in amoebae and
      absent in plasmodia. The LAV3-4 cDNA encodes a 402 aa protein (ABP-46) that shows
      sequence similarity to the actin binding site in the N-terminal region of the
      alpha-actinin family. The LAV3-5 cDNA is 76% identical to the Dictyostelium actin
      bundling protein, which cross-links and stabilizes actin filaments in amoebal
      filopodia.

PMID- 8485149
TI  - Structural analysis of an extremely long 5'-noncoding region of rat brain
      argininosuccinate lyase mRNA: presence of multiple B1 repeats and multiple
      upstream AUG codons, and a possibility of translational control.
AB  - The present detailed analysis of the sequence of the extremely long (967 bp) 5'
      noncoding region of a rat brain argininosuccinate lyase cDNA clone, reveals
      several features of interest. Multiple copies of partial and inverted (antisense)
      B1 repeats and multiple upstream ATG codons are present in the region, which
      suggests a possibility of translational control of the argininosuccinate lyase
      gene expression in rat brain.

PMID- 8485150
TI  - Cloning and characterization of an alpha-amylase gene from Streptomyces lividans.

PMID- 8485151
TI  - Expression and characterization of a recombinant maize CK-2 alpha subunit.
AB  - CKIIB, one of the CK-2 like enzymes which have been isolated from maize, has been
      shown to be a monomeric enzyme that cross-reacts with anti CK-2 alpha specific
      antibodies suggesting a possible relationship between the two proteins
      (Dobrowolska et al. (1992) Eur. J. Biochem. 204, 299-303). In order to support
      the immunological data also by biochemical and biophysical experiments the
      availability of a recombinant CK-2 alpha from maize was a prerequisite. A maize
      cDNA clone of maize CK-2 alpha was expressed in the bacterial strain BL21 (DE3).
      The recombinant protein was purified to homogeneity; its molecular mass on one
      dimensional SDS PAGE was estimated to be 36.5 kDa. The calculated molecular mass
      according to the amino acid composition is 39,228 Da (332 amino acids). The
      recombinant maize CK-2 alpha (rmCK-2 alpha) exhibited mostly the same properties
      as the recombinant human CK-2 alpha (rhCK-2 alpha). In several respects it
      behaved differently from CKIIB, thus supporting the notion that either CKIIB is
      encoded by another gene or it undergoes extensive posttranscriptional and/or
      posttranslational alterations. Three observations in particular disprove any
      close relatedness between CKIIB and rmCK-2 alpha, namely: (a) the phosphorylation
      of calmodulin by CKIIB is dramatically stimulated by polylysine, whereas
      polylysine inhibits rather than stimulating the phosphorylation of calmodulin by
      rmCK-2 alpha (and by rhCK-2 alpha). (b) Addition of rhCK-2 beta has no
      significant influence on the stimulation of the calmodulin phosphorylation by
      CKIIB whereas in the case of rmCK-2 alpha and rhCK-2 alpha addition of rhCK-2
      beta is required for optimal stimulation by polylysine. (c) CKIIB does not self
      assemble with rhCK-2 beta to form a high molecular mass complex as it is
      demonstrated for rmCK-2 alpha.

PMID- 8485152
TI  - Structure and conformation of N4-hydroxycytosine and N4-hydroxy-5-fluorocytosine.
      A theoretical ab initio study.
AB  - Optimal molecular geometries and molecular energies were obtained for N4
      hydroxycytosine and its 5-fluoro congener with the use of the theoretical ab
      initio quantum mechanical calculations within the Self Consistent Field method
      corrected for the electron correlation effects by the second-order Many Body
      Perturbation Theory (SCF + MBPT(2)). The 6-31G Gaussian basis set was employed.
      Several tautomeric and rotameric forms were considered. For N4-hydroxycytosine
      and N4-hydroxy-5-fluorocytosine the imino tautomer (in the conformation syn
      relatively to the N3-nitrogen atom) appeared to be the most stable form. The
      imino tautomer of N4-hydroxy-cytosine in the anti rotameric form is by 12.8 kJ
      mol-1 less stable than the imino-syn form. The 5-fluoro substituent raises the
      energy difference between the syn and anti rotamers up to 38.5 kJ mol-1. The
      potential energy barrier for the syn-anti rotation in the imino form of N4
      hydroxycytosine is estimated to be about 180 kJ/mol. The results presented in
      this paper suggest that the syn-imino and anti-imino forms can be treated as two
      structural isomers that do not interconvert at temperatures relevant to
      biochemical conditions. The theoretical results also show that the amino
      tautomeric forms do not compete with the imino forms in the gas-phase and in non
      polar and weakly-polar environment. In a polar environment (e.g., in aqueous
      solutions), however, one may expect an increased population of the amino forms.
      Qualitatively, the results of the present study agree well with the available
      experimental and theoretical data for N4-hydroxycytosine and some of its
      derivatives. The implications of the present study are discussed in relation to
      the molecular mechanisms of mutagenesis caused by NH2OH and of enzyme
      (thymidylate synthase) inhibition by N4-hydroxydeoxycytidine monophosphate.

PMID- 8485153
TI  - Protection of mRNA against nucleases in cytoplasmic extracts of mouse sarcoma
      ascites cells.
AB  - The mRNA present in extracts of mouse sarcoma 180 (S-180) ascites cells is
      relatively resistant to degradation when compared to added tracer ribosomal RNA.
      Deproteinized mRNA added to the extract is about as resistant as the endogenous
      mRNA, an indication that the protection is not due to any protein present in the
      endogenous mRNP structure. A major determinant of protection lies at the 5' end
      of RNA chains, where the presence of a triphosphate or a cap enhances the
      stability of mRNA transcripts. Addition of poly(A) to a capped transcript had
      little effect on stability. Stabilization by the cap structure is apparently not
      due to association of transcripts with a cap-binding protein. The discrimination
      in RNA decay rates appears to be based on interaction of the different RNA
      species with an exonuclease, which represents the predominant ribonuclease
      activity in the extract. Other major cytoplasmic nucleases are suppressed by an
      RNase inhibitor that is present in excess.

PMID- 8485154
TI  - A 5' exoribonuclease from cytoplasmic extracts of mouse sarcoma 180 ascites
      cells.
AB  - An exonuclease that appears to represent the predominant nuclease activity in
      cytoplasmic extracts of sarcoma 180 ascites cells has been partially purified and
      characterized. The enzyme attacks RNA chains in a 5' to 3' direction, and
      releases 5'-mononucleotides. The initial cleavage, however, can occur at either
      the first, second and probably third phosphodiester linkage in some RNAs. The
      enzyme attacks transcripts terminated with a 5'-triphosphate more slowly than
      those with a 5' monophosphate, and releases a compound larger than GTP from
      transcripts that begin with a pppG. Capped transcripts are cleaved at least as
      readily as those with a 5'-P, yielding a compound larger than 7mGpppGm. The
      occurrence of an such an exonuclease capable of attacking capped RNAs would make
      it possible for mammalian cells to initiate mRNA degradation by a 5'
      exonucleolytic mechanism.

PMID- 8485155
TI  - Molecular cloning and sequencing of the murine alpha-2-macroglobulin receptor
      cDNA.
AB  - We have molecularly cloned and sequenced the mouse alpha-2-macroglobulin receptor
      cDNA. The cDNA contained 14849 bases with one large open reading frame of 4545
      codons which is one more than in the corresponding human cDNA. Comparison of the
      predicted mouse and human receptor proteins revealed the very conserved nature of
      this receptor with an overall amino acid identity of more than 97%. A dramatic
      example of this is the presence of 331 cysteine residues predicted in the mouse
      protein, of which 327 are positionally conserved relative to human.

PMID- 8485156
TI  - Primary structure of Tetrahymena hemoglobins.
AB  - The primary structure of hemoglobins of Tetrahymena thermophila and T. pyriformis
      was determined by peptide and cDNA sequence analysis. Their sequences were 83.5%
      identical to each other and homologous to other protozoan and cyanobacteria
      hemoglobins, but not to proteins of the globin family. An intron was not present
      in the T. thermophila hemoglobin gene.

PMID- 8485157
TI  - Characterization of two sheep insulin-like growth factor II cDNAs with different
      5'-untranslated regions.
AB  - We have isolated two sheep IGF-II clones which have the same coding regions but
      have different 5'-untranslated regions. There is no homology between these 5'-UTR
      sequences which are homologous to exons 5 and 6 of the human IGFII gene. In
      humans these exons are transcribed only during fetal development, but in the
      sheep these transcripts were detected up to 28 weeks after parturition. The sizes
      of the sheep IGF-II mRNA transcripts are the same as those observed for the human
      gene, suggesting structural and transcriptional similarity between the human and
      sheep IGF-II genes. The sheep could therefore be a good model system in which to
      study IGF-II expression.

PMID- 8485158
TI  - cDNA sequence for bovine biglycan (PGI) protein core.
AB  - The nucleotide sequence of the protein core for bovine aortic smooth muscle cell
      biglycan was determined using recombinant DNA technology. Analysis of the deduced
      amino acid sequence for bovine biglycan revealed a striking homology, 94.6% and
      95.7%, to human and rat biglycan, respectively. The bovine biglycan protein core
      has four potential O-linked and two potential N-linked glycosylation sites and is
      composed of 11 leucine-rich repeat units.

PMID- 8485159
TI  - Characterization of the gene for seminalplasmin, a secretory protein of the
      bovine seminal vesicle.
AB  - As part of an attempt to understand the androgen-regulated expression of
      seminalplasmin, a major basic protein of bovine seminal vesicle secretion, we
      have characterized the bovine seminalplasmin gene. The compact gene of
      approximate size of 2.1 kb is organized in four exons and three introns.
      Regulatory sequences involved in regulation of transcription could not be
      identified by simple sequence homologies. A putative promoter element TATAA is
      located 29 bp upstream of exon 1.

PMID- 8485160
TI  - Molecular cloning and sequence of two cDNAs for human subunit c of H(+)-ATP
      synthase in mitochondria.
AB  - Two cDNAs encoding different signal peptides (61 and 66 amino acid residues) and
      the same mature protein have been cloned from a human cDNA library with a rat
      subunit c cDNA. The amino acid sequence of the mature human subunit c of
      mitochondrial H(+)-ATP synthase was completely identical with those of the mature
      bovine, sheep and rat subunit c.

PMID- 8485161
TI  - A Plasmodium vinckei cysteine proteinase shares unique features with its
      Plasmodium falciparum analogue.
AB  - The gene encoding a cysteine proteinase of the murine malaria parasite Plasmodium
      vinckei has been identified and characterized. The gene encodes a papain-family
      proteinase that shares unique features with a previously described P. falciparum
      cysteine proteinase. We hypothesize that both enzymes mediate the hydrolysis of
      hemoglobin, and perhaps other Plasmodium-specific functions.

PMID- 8485162
TI  - The isolation and characterization of a Drosophila gene encoding a putative NAD
      dependent methylenetetrahydrofolate dehydrogenase-methenyltetrahydrofolate
      cyclohydrolase.
AB  - Mammalian NAD-dependent 5,10-methylenetetrahydrofolate dehydrogenase-5,10
      methenyltetrahydrofolate cyclohydrolase is a bifunctional mitochondrial enzyme
      expressed in most established cell lines but only in developing normal tissues.
      We report the cloning and molecular characterization of a Drosophila gene
      (DNMDMC) that encodes a protein with 56% identity to the mammalian bifunctional
      protein. Like the mammalian bifunctional proteins, the Drosophila protein
      contains a putative mitochondrial targeting sequence and its transcripts are
      expressed in developing tissues. Unlike its mammalian homologs, DNMDMC is
      expressed at high levels in adult tissues. DNMDMC maps to polytene chromosome
      band 85C, is encoded in three exons, and is closely flanked by two additional
      genes.

PMID- 8485163
TI  - Sequence of a gene coding for a cytoplasmic alcohol dehydrogenase from
      Kluyveromyces marxianus ATCC 12424.
AB  - Using a Saccharomyces cerevisiae ADH1 probe, a gene coding for a cytoplasmic
      alcohol dehydrogenase from Kluyveromyces marxianus ATCC 12424 (formerly K.
      fragilis) has been cloned. This gene is able to restore alcoholic fermentation in
      an ADH-null strain of S. cerevisiae and its encoded protein shows strong
      similarity with other yeast alcohol dehydrogenases (from S. cerevisiae,
      Schizosaccharomyces pombe and its close relative K. lactis). The product of the
      gene expressed in S. cerevisiae co-migrates on native gel with a K. marxianus ADH
      isozyme which is more active in cells growing on non-fermentable carbon sources
      than on glucose. This behaviour is in contrast with that of the two cytoplasmic
      ADH isozymes of K. lactis which are both more active in glucose-growing than in
      ethanol-growing cells.

PMID- 8485164
TI  - Ca2+ antagonists do not protect isolated perfused rat hepatocytes from anoxic
      injury.
AB  - Ca2+ antagonists were studied during anoxia in perfused isolated rat hepatocytes.
      Cytosolic free calcium (Ca2+i) was measured with aequorin. Anoxia was induced for
      2 h by saturating the perfusate with 95% N2/5+ CO2. Anoxia increased Ca2+i in two
      distinct phases reaching a maximum of 1.5 microM. The increase in Ca2+i was
      caused by Ca2+ influx from the extracellular fluids because the main Ca2+i surge
      was totally abolished in Ca(2+)-free media. LDH release increased 6-fold during
      the second hour of anoxia, but when Ca2+ was removed from the perfusate during
      the anoxic period, LDH rose only 2.7-fold. Ca2+ antagonists (10(-7) to 10(-5) M)
      did not prevent the increase in Ca2+i and the rise in LDH release. On the
      contrary, high concentrations (10(-6) and 10(-5) M) of the blockers nifedipine
      and diltiazem significantly increased anoxic cell injury. The observation that
      the increase in LDH and the rise in Ca2+i were not suppressed by Ca2+ antagonists
      suggests that (i) Ca2+ antagonists protect the whole liver from anoxic injury by
      acting on cells other than parenchymal cells; (ii) the influx of Ca2+ responsible
      for the massive increase in hepatocyte Ca2+i evoked by anoxia did not take place
      through voltage-sensitive Ca2+ channels but must have occurred via the Na(+)-Ca2+
      antiporter operating in the reverse mode (Ca2+ influx vs. Na+ efflux), and (iii)
      high concentrations of Ca2+ antagonists may be deleterious to the parenchymal
      cells of the liver.

PMID- 8485165
TI  - Binding sites for short-term glycated albumin on peritoneal cells of the rat.
AB  - The interaction of in vitro short-term glycated rat serum albumin with rat
      peritoneal cells (40% macrophages) was investigated. Using 125I-labeled albumins
      the following results were obtained. Glycated albumins showed a binding reaction
      at 4 degrees C, which appeared to reach equilibrium within 2 h. The concentration
      dependent binding of glycated albumin showed saturation. Binding data evaluated
      for glycated albumin using the Sips equation are: average association constant Ko
      = 3.15 x 10(7) M-1 with a heterogeneity index of a = 0.8 and 1.12 x 10(4) binding
      sites per cell. Such binding sites were identified in 40% of the peritoneal cell
      preparations studied. Native albumins, maleylated albumin, chondroitinsulfates,
      polylysine, lysine, fructose, glucose and hexitol-lysine could not compete with
      radio-labeled glycated rat albumin for its binding site on peritoneal cells.
      Effective competitors were glycated human serum albumin, glycated polylysine and
      fructose-lysine. Although the contamination with minute amounts of advanced
      glycosylation end products (AGE) could not be excluded, short-term glycated
      albumin was found to be bound to membranes of peritoneal phagocytotic cells by
      fructose-lysine specific proteins, whose approximately defined molecular masses
      of 290 kDa are distinct from hitherto described binding proteins for AGE- and
      aldehyde-modified proteins or for the scavenger receptors.

PMID- 8485166
TI  - Identification and characterization of nuclear calmodulin-binding proteins of
      Saccharomyces cerevisiae.
AB  - Nuclear calmodulin-binding proteins of the yeast Saccharomyces cerevisiae were
      investigated. The soluble fractions after serial treatments of the isolated
      nuclei with buffers containing the nonionic detergent NP-40 (F1), 0.5 M KCl (F2)
      and 2.0 M KCl (F3) in this order, and the residual proteins (F4) were obtained.
      The calmodulin-binding proteins of the nucleus and nuclear subfractions were
      identified using the gel overlay method using 125I-calmodulin. Each subnuclear
      fraction contained a large number of components that bound calmodulin in a Ca(2+)
      dependent or -independent manners. The calmodulin-binding proteins were isolated
      from F1 and F2 subnuclear fractions by affinity chromatography. The affinity
      purified proteins bound calmodulin in a Ca(2+)-dependent manner when analyzed
      using the gel overlay method. The major calmodulin-binding components of F1 were
      44, 42, 36, 32 and 29 kDa proteins, and those of F2 were 200, 100, 40, 42, 36, 34
      and 32 kDa proteins. The isolated proteins also contained several Coomassie-blue
      stained proteins that did not bind calmodulin and, therefore, may represent the
      proteins associated with the calmodulin-binding proteins. Antisera raised against
      the affinity-purified preparation of F1 and F2 recognized almost all of the
      calmodulin-binding proteins present in the fraction and several other proteins of
      the nucleus. The presence of Ca(2+)-dependent protein phosphatase (type 2B) in
      the nucleus was demonstrated by Western blotting. The enzyme was localized
      predominantly in F1 and F4.

PMID- 8485167
TI  - Thapsigargin, an inhibitor of endoplasmic reticulum Ca(2+)-ATPase, enhances c-fos
      expression but antagonizes vacuole formation of human hepatoma cells induced by
      teleocidin.
AB  - Teleocidin, a phorbol ester-type tumor promoter, enhanced actin redistribution,
      vacuole formation and c-fos expression of PLC/PRF/5 hepatoma cells. This tumor
      promoter also inhibited calcium mobilization induced by epidermal growth factor
      (EGF). Thapsigargin, a specific inhibitor of endoplasmic reticulum Ca(2+)-ATPase,
      elevated cytosolic calcium, enhanced c-fos expression and antagonized the vacuole
      formation induced by teleocidin without interfering with actin redistribution and
      Lucifer yellow uptake. On the other hand, a calcium ionophore ionomycin elevated
      both cytosolic Ca2+ and c-fos mRNA but could not antagonize the vacuole formation
      induced by teleocidin. From these results it was speculated that the Ca2+ leak
      from the endoplasmic reticulum rather than the elevation of cytosolic Ca2+
      appeared to be responsible for the specific inhibition of vacuole formation by
      thapsigargin.

PMID- 8485168
TI  - Differential effects of the phorbol ester TPA on DNA-mediated transfection in a
      variety of cell lines.
AB  - The efficiency of stable gene transfer and expression in NIH3T3 cells has been
      shown to be significantly enhanced by a brief treatment with the phorbol ester
      tetradecanoylphorbol 12,13-acetate (TPA) immediately following calcium-phosphate
      transfection. Several lines of evidence indicated that this effect was mediated
      through protein kinase C activation. These studies were expanded to determine
      whether this was a consistent and widespread phenomenon among other cell lines.
      The efficiency of transfection in two other established fibroblast lines, LMtk-
      and 2A3 3T3, was unaffected by TPA treatment, and primary human foreskin
      fibroblasts were similarly unaffected. Transfection was inhibited by TPA
      treatment in the transformed cell lines EJ and HeLa. Protein kinase C enzyme
      assays indicated that TPA causes a translocation of the enzyme from cytosol to
      membrane in both NIH3T3 and EJ cells, suggesting that the PKC translocation event
      does not account for the TPA effect on transfection. The TPA-mediated inhibition
      of transfection in EJ cells was not blocked by sphingosine, suggesting that this
      phenomenon is unrelated to PKC activation. The results suggest that TPA treatment
      may either enhance, inhibit, or have no effect on transfection, depending on the
      cell line.

PMID- 8485169
TI  - Hexose metabolism in pancreatic islets: time-course of the oxidative response to
      D-glucose.
AB  - The time-course for the generation of 3HOH from D-[5-3H]glucose and for the
      production of 14CO2, 14C-labelled acidic metabolites and radioactive amino acids
      from D-[3,4-14C]glucose, D-[2-14C]glucose and D-[6-14C]glucose was monitored,
      over 60 to 120 min incubation, in both rat pancreatic islets and parotid cells
      exposed to a low or high concentration of the hexose. In islets stimulated by D
      glucose, a progressive increase in the oxidation rate of glucose-derived acetyl
      residues was observed. Such a phenomenon was not observed in islets exposed to a
      low concentration of D-glucose, concerned specifically the oxidation of acetyl
      residues in the Krebs cycle as distinct from their generation in the reaction
      catalyzed by pyruvate dehydrogenase, and failed to occur in parotid cells. It is
      concluded that the increase in the oxidation rate of glucose-derived acetyl
      residues found in pancreatic islets represents an unusual phenomenon not
      encountered in other cell types and specifically regulated in terms of its time
      course, concentration dependency and relationship to other oxidative events.

PMID- 8485170
TI  - Inhibition of stimulated bone resorption in vitro by TIMP-1 and TIMP-2.
AB  - Recombinant human TIMP-1 and TIMP-2 (tissue inhibitors of metalloproteinases)
      inhibited bone resorption induced by either parathyroid hormone or 1,25
      dihydroxyvitamin D3 in cultured neonatal mouse calvariae. The inhibition was
      reversible, dose-dependent and complete at 1 microgram/ml inhibitor
      concentration. TIMP-2 was more potent than TIMP-1. TIMP-1 and TIMP-2 also
      inhibited basal bone resorption. Neither metalloproteinase inhibitor affected
      protein synthesis, DNA synthesis, the PTH-enhanced secretion of beta
      glucuronidase or the spontaneous release of lactate dehydrogenase. These results
      suggest that endogenous TIMPs play a central role in regulating both
      physiological and pathological bone resorption.

PMID- 8485171
TI  - Increase of adipose differentiation by hypolipidemic fibrate drugs in Ob 17
      preadipocytes: requirement for thyroid hormones.
AB  - The action of hypolipidemic fibrate drugs (HFD) (clofibrate, bezafibrate,
      fenofibrate) was studied in relation to thyroid hormone (TH) action in the TH
      sensitive Ob 17 preadipocyte cells which require an early presence of TH for
      terminal differentiation. HFD markedly amplified the adipose differentiation and
      the development of several lipogenic enzymes, thus accelerating their appearance
      after cell growth arrest. This amplifying action could be obtained whatever the
      time of drug addition to the cells and required the continuous presence of the
      drug. HFD action was strictly dependent on the presence of TH. Within the active
      concentration range (0.01-0.25 mM) in serum-containing medium, HFD moderately
      down-modulated the nuclear TH receptor level (and c-erb alpha mRNA abundance),
      this being additive to the known maximal but partial down-regulation provoked by
      TH. The results strengthen the TH obligatory role for Ob 17 cell differentiation
      and give arguments against a TH-like role of HFD. In this cell line, HFD mainly
      behave as amplifiers for the expression of lipogenic phenotypes in already
      committed cells.

PMID- 8485172
TI  - Unilateral nephrectomy selectively stimulates phospholipase D in the remaining
      kidney.
AB  - The activation of phospholipase D in the kidney could be detected in vivo in rats
      treated with ethanol by the accumulation of phosphatidylethanol. Unilateral
      nephrectomy stimulated the activity of phospholipase D in the remaining kidney as
      indicated by an increase in the level of phosphatidylethanol. A significant
      increase in phosphatidylethanol level was observed as early as 5 min after
      contralateral nephrectomy and peak accumulation (200% of control) was observed
      after 15 min. The phosphatidylethanol level decreased again to the basal level
      after 2 h. The accumulation of phosphatidylethanol was specific for kidney and
      the product was localized primarily in the cortex. Phospholipase D activity in
      kidney cortical slices from untreated rats was stimulated in vitro by plasma
      obtained from unilaterally nephrectomized rats, indicating that circulating
      factors in the plasma are responsible for the activation of phospholipase D. The
      phospholipase D activation by plasma from uninephrectomized animals was
      selectively inhibited by the tyrosine kinase inhibitor genistein, but not by the
      protein kinase C inhibitor H7. It is concluded that phospholipase D activity is
      stimulated as an early signal transduction event in compensatory kidney growth.

PMID- 8485173
TI  - Development of an antiserum to rat-brain A1 adenosine receptor: application for
      immunological and structural comparison of A1 adenosine receptors from various
      tissues and species.
AB  - An antiserum was developed in a rabbit against rat-brain A1 adenosine receptor.
      This antiserum recognized the denatured form of the purified rat-brain A1
      adenosine receptor in immunoblot analysis and the native form of the receptor in
      the immunoprecipitation analysis. Immunoblot analysis of unpurified or purified
      adenosine receptor preparations from rat-brain membranes revealed a major
      immunoreactive band at a position of molecular mass of approx. 35 kDa, which
      corresponds to the position of purified rat-brain A1 adenosine receptor. Although
      A1 adenosine receptors from other rat tissues such as testis and adipocyte were
      also found to be immunoreactive with this antiserum by immunoblot analysis,
      purified human-brain A1 adenosine receptors showed a poor reactivity with this
      antibody. The order of the relative immunoreactivity of these A1 adenosine
      receptors with the antiserum was found to be brain > adipocyte > or = testis.
      Moreover, the immunoreactivity of these receptors significantly increased after
      these receptor preparations were deglycosylated by endoglycosidase F. After the
      deglycosylation, no significant differences in both the immunoreactivity and
      molecular mass among these receptor preparations were found on the immunoblot.
      These results suggest that the differences in the molecular mass or
      immunoreactivity among the A1 adenosine receptor preparations from three rat
      tissues were mainly due to the difference of sugar moiety present in each
      receptor molecule. These data are the first to provide analyses of immunological
      characteristics of A1 adenosine receptors from different tissues and species.

PMID- 8485174
TI  - Who writes for GNJ? Plans for an authors' survey.

PMID- 8485175
TI  - Exposure to human immunodeficiency virus in the endoscopy setting: a personal
      experience.
AB  - Physicians and staff in the endoscopy unit are seeing an increasing number of
      patients who are human immunodeficiency virus positive or who have acquired
      immunodeficiency syndrome. Despite the practice of universal precautions,
      exposure can occur very easily. It happened to me. This article describes some of
      the details of my experience in the hope that it will increase awareness and
      promote the use of better precautions in all hospital settings.

PMID- 8485176
TI  - Infection control aspects for office endoscopy.
AB  - While preventing cross-infection has always been important, the current epidemic
      of human immunodeficiency virus has brought about a greater awareness that
      infection control standards should be the same regardless of the practice
      setting. This article discusses infection control practices in office endoscopy
      including cleaning of endoscopes and the issues surrounding disposable and
      nondisposable accessories. Staff safety and government agency regulations are
      also reviewed.

PMID- 8485177
TI  - Budget for a research proposal.
AB  - As a result of the growing consumer demand to cut health care costs, employing
      institutions cannot be expected to finance research studies. Therefore, outside
      funding must be found. The proposal budget is critical to the success of a study.
      A reviewer can determine much about the principal investigator's ability to
      conduct the proposed study by scrutinizing the budget; therefore, the budget
      should not be treated as an afterthought. A good budget consists of three
      separate parts: the budget, the budget explanation, and a section in the
      narrative devoted to the budget. Ask for the funds that are needed to complete
      the study and then justify the need. The goal of a good budget is to answer the
      reviewers' questions before they occur.

PMID- 8485178
TI  - Orally administered gallbladder therapeutic agents, Part 1: Chenix
      (chenodeoxycholic acid, CDCA).
AB  - Chenix is an orally administered gallstone solubilizer that reduces biliary
      cholesterol in the bile acid pool, which in effect helps to dissolve floating
      radiolucent cholesterol gallstones. Chenix is an agent used to treat cholesterol
      gallstones in the patient with a higher than average risk for surgical
      intervention for the removal of gallstones.

PMID- 8485179
TI  - Foreign body ingestion and removal in adults.

PMID- 8485180
TI  - [Thermodynamic and spectroscopic study of complex formation of dipeptides with
      dimethyl sulfoxide in their aqueous solutions].
AB  - Peculiarities of intermolecular interactions in water-dimethylsulfoxide solutions
      of dipeptides-glycyl-glycine, beta-alanyl-glycine, beta-alanyl-beta-alanine, DL
      alpha-alanyl-DL-alpha-alanine, DL-alpha-alanyl-DL-valine-were analysed on the
      basis of thermodynamic characteristics and data on IR-spectra. Dimethylsulfoxide
      additions were shown to cause destruction of peptide associates present in
      aqueous solutions due to the formation of stronger bonds "peptide-DMSO". The
      existence of complexes between dimethylsulfoxide and beta-alanyl-glycine, beta
      alanyl-beta-alanine, DL-alpha-alanyl-DL-alpha-alanine was found. The mechanism of
      their formation was determined by the dipeptide structure.

PMID- 8485181
TI  - [Difference in DNA enthalpies in the helical and coiled states near 0 K].
AB  - On the basis of experimental data of DNA heat capacity in a wide range of
      temperatures the fundamental characteristics of DNA-H(0)0-the enthalpy of helix
      coil transition at 0(0)K were estimated. H(0)0 = 8.41 +/- 1.6 kJ/MBP. It was
      shown that a deviation from Nernst theorem (resulting from metastability of the
      system) was not obtained within the range of experimental error.

PMID- 8485182
TI  - [Preparation and study of Langmuir films of nucleic acid and octadecylamine
      complexes].
AB  - Formation conditions of langmuir films of nucleic acids (DNA and poly-U)
      octadecylamine complexes are determined. Successive transfer of the monolayers of
      these complexes from the aqueous subphase surface to solid substances (quartz,
      silicon) is carried out. The structure of multilayer langmuir films of nucleic
      acid-octadecylamine complexes is studied by small angle X-ray scattering,
      ellipsometry and UV-spectroscopy. The produced films are shown to have high
      lamellar orderliness with the multilayer structure period D = 57.0 A. A scheme of
      the realized structure of these films is proposed in which the nucleic acids are
      located between octadecylamine bilayers. A suggestion is discussed based on
      similar results for poly-U and DNA containing langmuir films concerning possible
      untwisting of double helical DNA in the langmuir film of octadecylamine, as well
      as biological significance of the discovered phenomena.

PMID- 8485183
TI  - [Emergence of contraction waves on the surface of fertilized frog eggs under the
      effect of inositol triphosphate].
AB  - It was shown that the injection of the membrane messenger-myo
      inositoltrisphosphate into frog eggs provokes the propagation of surface
      contraction waves. Such waves are not accompanied by the changes of membrane
      potential. We have analyzed the spatial-temporal characteristics of observed
      waves and have compared them with the data from models for diffusion and
      autocatalytic mechanisms of wave propagation.

PMID- 8485184
TI  - [Computer analysis of ultrastructural and functional parameters of rat liver
      mitochondria].

PMID- 8485185
TI  - [Hysteresis properties of excitable membranes--the basis for neuronal memory].
AB  - It is supposed that "fixed" membrane charges are spaced on protein lateral chain
      terminals and have limited ability to move with the chains. Interactions of the
      charges that are located on the opposite sides of the membrane depend on the
      membrane potential and can be described by a hysteresis volt-conformation
      characteristics with trigger transitions for one stable state to another. The
      value of the charges, that are shifted in the hysteresical loop limit, is close
      to the experimental data for gate currents. Possibility of interaction of
      chemoreceptive and electroexcitable mosaics of the neuron somato-dendrite
      membrane in eeg forming process is analysed.

PMID- 8485186
TI  - [Optimization of randomly organized distributive associative memory].
AB  - Sub- and intersynapsal randomly placed mosaics of somato-dendritical membrane are
      regarded as a neuronal memory system. The first (linear) subsystem seems as a
      mean for access (addressing) to the second (nonlinear, hysteresis) one. An
      informative model is created and optimal relations are detected on the threshold,
      geometrical and temporal parameters of the synapse fields. The relations being
      settled transform the synapse field to associative memory with optimal
      distributive features. The reliability of such memory is equal to one of the
      holograms.

PMID- 8485187
TI  - [Recording, consolidation, and reproduction of information in the neuronal
      memory].
AB  - The electroexcitable mosaic of neuron SD-membrane is considered to be a
      hysteresis medium: a set of bistable memory units (MU) that capture or give back
      the energy in state transitions. The consolidation is shown to be achieved by
      inactivation of a part of MU (which had lost their energy) by means of transit of
      their volt-conformative characteristics to the non-hysteresis form. The MU
      hysteresis features are the result of moderate mobility of the membrane charges.
      The consolidation results in immobilization of the charges. It seems that
      immobilization of gate charges is the same phenomenon. Great importance of time
      delay pertaining to this process is emphasized. The time delay and working point
      shift beyond the hysteresis loop limits into the hyperpolarization side ensures
      the non-destructive reading.

PMID- 8485188
TI  - [A method of mapping intracortical interactions during perception and
      reproduction of emotions].
AB  - By a new method of mapping intracortical interaction participation of the
      cerebral cortical zones in the process of perception and mental reproduction of
      human emotional states was studied. At identification of emotions the maximum
      value of connections was found in the left cortical temporal area. At mental
      reproduction of emotional states the maximum value of connections was found
      predominantly in the frontal cortical areas and left temporal cortical zone.

PMID- 8485190
TI  - [Use of nonlinear dynamics methods for detecting and describing chaotic
      deterministic EEG components].

PMID- 8485189
TI  - [Interneuronal functional connections in the canine sensomotor cortex].
AB  - Multiple unit activity (MUA) of the sensomotor cortex was recorded from
      chronically implanted semimicroelectrodes in dogs. The spike trains of 6-8 neural
      units were selected from MUA. The character and temporal parameters of
      interneuronal functional connections were examined by the method of computerized
      cross-interval analysis. For this purpose the autocorrelation and cross-interval
      histograms were constructed. One of the main results was complete absence of
      symmetrical central peaks (shared input). The functional interrelations of
      selected neurons were characterized by unilateral and bilateral nonsymmetrical
      excitatory connections with short (1-10 ms), middle (10-80 ms) and late (80-2000
      vs) delays. The peculiarities of these interneuronal connections are discussed.

PMID- 8485191
TI  - [Analysis of nonlinear dynamic states of the brain during different activation
      levels of it (studies in the high frequency EEG range of the rabbit)].
AB  - With the use of the nonlinear analysis method the existence of the determinant
      chaotic high-frequency EEG component of the rabbits' brain cortex was shown. Its
      parameters depend on the brain area and reflect the functional state of the
      animal.

PMID- 8485192
TI  - [Averaged impulse activity in a neuronal network model].
AB  - Every neuronal pool is proposed to contain identical neurons with identical
      interneuronal connections. A neuronal net containing two neuronal pools is
      considered. Two regimes are possible: 1) the asymptotically stable stationary
      solution of smooth equations system exists, the neuron pulses are periodical with
      different frequency in each pool; 2) the stationary sliding regime solution of
      smoothed equations exists. Periodical pulse train solution is impossible. The
      situation of "chaos" type is probable.

PMID- 8485193
TI  - [Studies of spatial relationship of various electrical processes of the human
      brain during their simultaneous registration].
AB  - Results of investigations of spatiotemporal relationships for electrical
      processes of human brain, different in their frequency bands and simultaneously
      recorded from a number of brain zones intracerebrally or extracerebrally are
      reviewed. Spatiotemporal relationships for EEG and infraslow processes are
      significantly different.

PMID- 8485194
TI  - [Spatial-temporal coding of simultaneously entering information on several visual
      signal signs by frog brain neurons].
AB  - Experiments were performed on frogs. It was shown that 9 neuron types with narrow
      and wide-band sensitive characteristics were present in the tectum. These
      neurons used different modifications of spatio-temporal codes for transfer
      information about three features of a moving visual object--its orientation,
      direction and speed. There are proposed conceptual models of neural networks
      which perform analysis of the visual object orientation, direction and speed of
      its movement. These models include conceivable structures composed of narrow- and
      wide-band neurons which "calculate" the parameters of a visual signal through
      "synaptic interplay" of excitatory and inhibitory inputs based on their different
      weights on the "recognitive" ("calculative") neuron membrane.

PMID- 8485195
TI  - [Display of activities of integrative brain mechanisms in its bioelectrical
      activity].
AB  - Integrative processes taking place in CNS lie in the basis of the activity of the
      whole brain, i.e. they perform as a system-creating factor; they maintain the
      system stability, succession of its functioning, regularity of intra-system
      connections and their reproduction. Can this activity appear in extremely mobile,
      polyform EEG processes? The results of EEG factor analysis show the existence of
      the very stable uniform structure of spatial interactions of cortical potentials.
      This structure can be reproduced from EEG of different adult individuals, as well
      as of children at various stages of ontogenesis. EEG from any point of the cortex
      can be represented as a linear combination of only three orthogonal components.
      These components are the same for all the cortical regions. Especially local,
      independent fluctuations in EEG constitute less than 10% for adults and not more
      than 20% for newborns. Apparently, the continuous reflection of oscillations of
      the whole biopotential field in any point of the cortex reveals in EEG the
      functioning of a mechanism providing the activity of the brain as a whole.

PMID- 8485196
TI  - [Modular organization of the cerebral cortex].
AB  - Light and electron microscopy original data and other physiological and
      morphological findings testify that neurons of the cerebral cortex were joined in
      compact cell ensembles (modules, block). These neuronal modules are self
      organized in a united morpho-functional system under the repeating impulses which
      are converged via association callosal and projectional thalamic afferents. A
      comparative analysis of original and literature data concerning modular
      organization of the cerebral cortex was performed. A hypothetical model of
      distinguishing and self assembling of the cortical modules is discussed.

PMID- 8485197
TI  - [A possible mechanism of action of biogenic amines on the activity of cortical
      neurons].
AB  - Monoaminergic systems are considered as modulating effectiveness of cortical
      synapses depending on their preceding state and reaction of the whole organism. A
      differential equation describing activity of cortical cells upon prolonged
      increased concentration of monoamines in the cerebral cortex is deduced and
      analysed. A comparison with described experimental data made it possible to
      consider the serotoninergic system as connected with the positive reinforcement
      and the noradrenalinergic system--with the negative one.

PMID- 8485198
TI  - [A unified autocorrelated method of electroencephalogram analysis and some
      results of its use].
AB  - Unified autocorrelation method of EEG analysis (UNIFAC-EEG) represents some
      optimized algorithms of EEG-signals processing according to the sign of maximum
      stability to the broadband noise. These algorithms are united by the common aim
      to identify generation models of these signals narrowband components on the basis
      of concrete empirical data and estimation of their source dynamic parameters
      according to the identification results. On the basis of this method it was
      proved that alpha-rhythm sources belonged to the type of structural stable
      dynamic systems, and its decrement value could serve as one of the parameters of
      the functional state of the central nervous system. The effect was found of the
      interaction between the heart electric fields and human brain in EEG frequent
      alpha-range.

PMID- 8485199
TI  - [Non-thermal microwave effect on nerve fiber function].
AB  - Effects of microwave radiation (915 MHz, PW, peak SAR 20-30 W/g, pulse duration 1
      mcs, 50.000 and 25.000 p.p.s.) were investigated in isolated frog nerve cord
      preparation. Nerve VHF heating didn't exceed 2.2 degrees C due to intense
      Ringer's solution perfusion. It was established that nerve irradiation
      simultaneously with its stimulation lead to significant decrease of action
      potential amplitude and peak latency. Since the equal conventional heating of the
      nerve caused the opposite changes (amplitude increase), the results obtained
      argue for non-thermal mechanism of microwave action.

PMID- 8485200
TI  - [Visualization of the effects of millimeter radiation on blood plasma].
AB  - Experiments on millimeter wave radiation (range 37.5-78.5 Ghz incident radiation
      power density 1-10 mVt/cm2) upon index refraction of 2-10% water solution of
      human blood plasma are presented. Investigations were carried out by holographic
      interferometry with sufficient sensitivity for estimating the index refraction 
      10(-6). Index refraction variations in 2% water solution of human blood plasma
      are detected to be equal to 10(-4). Such index refraction variations upon
      millimeter wave is one order greater than that of the temperature effect and two
      order greater than the sensitivity of settlement. The mechanism of these
      phenomena is discussed.

PMID- 8485201
TI  - The transferrin receptor.
AB  - Transferrin receptor (TfR) is a membrane receptor involved in the control of iron
      supply to the cell through the binding of transferrin, the major iron-carrier
      protein. This receptor plays a key role in the control of cell proliferation
      because iron is essential for sustaining ribonucleotide reductase activity, and
      is the only enzyme that catalyzes the conversion of ribonucleotides to
      deoxyribonucleotides. Furthermore, TfR is overexpressed in several tumors. The
      synthesis of the receptor is controlled through an iron-dependent negative
      feedback in cells where the receptor is involved in the control of cell
      proliferation, but through a positive feedback in cell types involved in iron
      storage (monocytes-macrophages). Recent studies have shed light on the molecular
      basis by which iron regulates TfR expression. Thus, the 3' untranslated region of
      TfR mRNA contains a cis-acting RNA element, termed the iron-regulatory element
      (IRE), that interacts with an IRE-binding protein (IRE-BP). The high-affinity
      interaction between IRE-BP and IRE in the TfR mRNA leads to repression of mRNA
      degradation and thus to higher synthesis of TfR. Hence, the study of IRE-BP
      activity will elucidate the mechanisms that modulate TfR expression in normal and
      malignant cells.

PMID- 8485202
TI  - Neoplastic transformation of human cells in vitro.
AB  - Efforts to investigate the progression of events that lead normal human cells in
      culture to become neoplastic in response to carcinogenic agents have been aided
      by the development of the suitable in vitro model systems. For initial human cell
      transformation studies, a flat, nontumorigenic clonal line, originally derived
      from a human osteosarcoma (HOS), was used. When treated with chemical carcinogens
      such as N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and 3-methyl-cholanthrene
      (3MC), the HOS cells underwent morphological alterations and acquired tumorigenic
      properties. These cell lines were very useful inasmuch as a non-ras cellular
      transforming gene, met, and an activated H-ras oncogene have been isolated from
      MNNG-transformed and 3MC-transformed HOS lines, respectively, by DNA transfection
      procedure. Alteration of p53 gene in chemically transformed HOS cell lines has
      recently been shown. Although carcinogens cause human cancer, normal human cells
      in culture have proven difficult to achieve. Neoplastic transformation of human
      cells in culture has recently been achieved by a stepwise fashion-immortalization
      and conversion of the immortalized cells to tumorigenic cells. One of the
      critical initial events in the progression of normal human cells to tumor cells
      is the escape from cellular senescence. With few exceptions, normal human cells
      require immortalization to provide a practical system for transformation studies.
      Thus, the role of carcinogenic agents in the development of human cancers is now
      being defined using a variety of human cells. The neoplastic transformation in
      human cell cultures is reviewed. In doing so, this author attempts to put into
      perspective the history of human cell transformation by carcinogenic agents, and
      to discuss the current state of the art in transformation of human cells in
      culture; thus providing insight into the molecular and cellular mechanisms
      involved in the conversion of normal cells to a neoplastic state of growth.

PMID- 8485203
TI  - Clinical aspects of acute myeloid leukemias of the FAB types M3 and M4Eo. The AML
      Cooperative Group.
AB  - Acute promyelocytic leukemia (AML FAB M3, APL) and acute myelomonocytic leukemia
      with abnormal eosinophils (AML M4Eo) are considered distinct entities with
      characteristic clinical, morphological, cytogenetic, and prognostic features.
      Promyelocytic leukemia is characterized by abnormal promyelocytes replacing
      normal hematopoiesis associated with a translocation between the long arms of
      chromosomes 15 and 17 t (15; 17), severe coagulopathy, and responsiveness to all
      trans retinoic acid (tretinoin). Characteristic features of AML M4Eo are a
      myelomonocytic marrow infiltration, eosinophils with abnormal immature granules
      positive for chloroacetate esterase, an inversion or translocation of chromosome
      16, and an increased risk of meningeal relapses. Prognosis of both types of AML
      has been reported to be better than prognosis of the other entities combined.
      Since most of the published data were collected from heterogeneous patient
      populations treated with various chemotherapeutic regimens, we have analyzed
      treatment outcome of AML M3 and M4Eo in the AMLCG-85 study for patients younger
      than 60 years. For the total population of 594 patients of this study, CR rate
      was 68.89%, early death rate 11.60%, and no or partial remission was achieved in
      19.51% of the cases. Of 40 patients with AML M3 or M3 v complete remission was
      attained in 62.5%. Nine patients died within 42 days after the start of
      antileukemic therapy (22.5%). Of these nine, four died because of infection, five
      because of bleeding. Relapse-free survival rate was 59% after 3 years,
      significantly better than the respective curve of the other FAB types combined
      (35% after 3 years). In AML M4Eo, 91.7% of the 24 patients reached complete
      remission. The early death rate was 8.3%. No case of nonresponse was seen.
      Relapse-free survival rate was 49% after 3 years compared with 35% for the other
      types combined.

PMID- 8485204
TI  - Reproducibility of the morphological diagnostic criteria for acute myeloid
      leukemia: the GIMEMA group experience.
AB  - Diagnostic reproducibility of the FAB morphological subtypes of acute leukemia is
      a basic step in the assessment of the clinical outcome in multicenter trials.
      Unusual cytologic variables and slightly different interpretations of the FAB
      morphological criteria have been the most significant factors affecting the
      overall diagnostic concordance rate among the various centers. An evaluation of
      the diagnostic concurrence between 35 institutions of the Italian Cooperative
      Study Group GIMEMA and two reviewers of the ad hoc morphological committee has
      been performed on 377 patients entering the AML 8A and AML 8B GIMEMA protocols.
      Overall concordance rate was 62.6%. The most significant differences were
      observed for M2 vs M4, M4 vs M5, M1 vs M2, and M2 vs M5 subtypes. In order to
      minimize the impact of some diagnostic deviations on the mean cytologic
      concordance rate, a distinction between "major" and "minor" discrepancies in the
      diagnostic procedures has been proposed. When the results of the single
      institutions were corrected by considering the "major" discrepancies only, a mean
      diagnostic agreement of 78.1% was reached.

PMID- 8485205
TI  - Serial changes in endogenous erythropoietin levels in patients with
      myelodysplastic syndromes and aplastic anemia undergoing erythropoietin
      treatment.
AB  - Recombinant human erythropoietin (rhEpo) was administered to 14 patients with
      myelodysplastic syndrome (MDS) and seven patients with aplastic anemia (AA). In
      19 patients, doses of 6000 units were given intravenously three times a week
      (t.i.w.) with the dose being doubled up to 24,000 units every 8 weeks until a
      response was obtained. RhEpo was given subcutaneously in two patients. Seven
      patients, four with MDS and three with AA, showed a significant response with an
      increase of hemoglobin concentration during therapy. The response occurred at
      doses of 12,000 units in five and 24,000 units in two patients. Responding
      patients with both MDS and AA had a relatively low serum Epo (s-Epo) level prior
      to Epo therapy. MDS responders had either refractory anemia (RA) or RA with ring
      sideroblasts (RARS), while two of the Epo responders in AA had a severe form of
      the disease. However, since some of the Epo responders had a high initial s-Epo
      concentration, a high s-Epo level does not preclude the use of rhEpo. Serial
      determination of s-Epo levels showed a progressive decline in six of the seven
      responders even when they were on rhEpo therapy, while the s-Epo levels remained
      elevated or further increased with time in most nonresponders. RhEpo was well
      tolerated by all patients. The results suggest that rhEpo is a safe and effective
      treatment for a certain proportion of patients with MDS and AA. Moreover, serial
      determination of s-Epo during therapy may be useful in monitoring and predicting
      the therapeutic effect of rhEpo.

PMID- 8485206
TI  - Treatment of aplastic anemia with a monoclonal antibody directed against the
      interleukin-2 receptor.
AB  - Severe aplastic anemia (SAA) has been related in most cases to underlying
      autoimmune conditions. Various immunosuppressive regimens have been recommended
      in the absence of an HLA-identical bone marrow donor. Prednisolone, antithymocyte
      globulin, and cyclosporin A have been shown to be effective. This report
      describes the successful treatment of a 23-year-old woman suffering from severe
      aplastic anemia who had become multiresistant against previously administered
      immunosuppressive agents, using a monoclonal IL-2-receptor blocking antibody. The
      patient responded within 4 weeks. The time to the next relapse was 8 months;
      however, another remission with a second course of horse-antithymocyte globulin
      was achieved and has been maintained for 27 months to date with low doses of
      cyclosporin A. Although this is an anecdotical report, IL-2-receptor blockade
      using a monoclonal antibody might be considered as a further alternative in multi
      resistant SAA, perhaps increasing the susceptibility to further immunosuppressive
      trials.

PMID- 8485207
TI  - Acute sterile inflammation--correlation between cellular changes and
      extramedullary-produced regulators in vivo.
AB  - Rats with polyvinylpyrrolidone (PVP)-induced sterile inflammation were used as a
      model in vivo for investigation of granulopoiesis and extramedullary-produced
      regulators. The data obtained demonstrated the invasion of massive numbers of
      granulocytes at the site of inflammation (peritoneal cavity) during the first 24
      h of the acute phase of inflammation. To meet the organism's needs for
      granulocytes the activation of granulopoiesis in bone marrow occurred
      simultaneously. Accelerated production of granulocytic cells is manifested by
      involvement of granulocytic proliferative compartment in various stages of
      differentiation (CFU-GM and morphologically recognizable proliferative
      granulocytes--PG). Together with cellular changes within the granulocytic cells
      line, the changes in the content of investigated regulators influencing
      granulopoiesis were observed. At different time intervals the levels of
      interleukin-6 (IL-6), colony-stimulating activity (CSA), and granulocytic
      stimulating activity (GSA) were increased locally at the site of inflammation as
      well as in serum. The data obtained provide evidence that inducible
      granulopoiesis during the acute phase of inflammation is under the control of
      extramedullary-produced regulators, thus confirming their role in the regulation
      of granulocytic production in vivo.

PMID- 8485208
TI  - Relation between bone marrow hemosiderin iron, serum iron status markers, and
      chemical and histochemical liver iron content in 82 patients with alcoholic and
      nonalcoholic hepatic disease.
AB  - Bone marrow hemosiderin iron was assessed in 48 patients with alcoholic, and in
      34 patients with nonalcoholic liver disease (53 men, 29 women, median age 55
      years, range 18-84) and correlated to serum (S)-iron status markers (iron,
      transferrin, ferritin), as well as to histochemical hepatocyte iron and chemical
      liver iron content. In a control group of 53 healthy subjects (23 men, 30 women,
      median age 28 years, range 18-90) marrow hemosiderin iron and iron status markers
      were evaluated as well. Among liver patients, the marrow iron grade was higher in
      men than in women (p = 0.03). Correlations were found between marrow iron and
      histochemical liver iron (rho = 0.38, p = 0.0001) as well as chemical liver iron
      (rho = 0.33, p = 0.01). Marrow iron was correlated to S-ferritin (rho = 0.53, p =
      0.0001), mean red cell volume (rho = 0.34, p = 0.003), and S-transferrin (rho = 
      0.24, p = 0.02). Alcoholics had a higher marrow iron grade than nonalcoholics (p
      = 0.001) and controls (p = 0.0001). Among controls, the marrow iron grade was
      likewise higher in men than in women (p = 0.01). Correlations were found between
      marrow iron and ferritin (rho = 0.64, p = 0.0001), transferrin saturation (rho =
      0.56, p = 0.001), transferrin (rho = 0.53, p = 0.001), S-iron (rho = 0.37, p =
      0.01), and hemoglobin in women (rho = 0.38, p = 0.05). The results indicate that
      alcoholics either have increased marrow hemosiderin iron stores, or display a
      redistribution of iron in reticuloendothelial cells from soluble ferritin-bound
      iron to insoluble hemosiderin iron. Among patients with absent marrow hemosiderin
      iron, 81% had absent hepatocyte hemosiderin iron as well. Among patients with
      absent hepatocyte hemosiderin iron, 23% had absent and 77% normal or increased
      marrow hemosiderin iron. Therefore, in patients with iron depletion, assessment
      of marrow hemosiderin iron yields more relevant information of iron status than
      assessment of hepatocyte hemosiderin iron.

PMID- 8485209
TI  - Treatment of the hematological manifestations of dyskeratosis congenita.
AB  - Dyskeratosis congenita is a congenital multisystem disorder, characterized by
      skin pigmentation, dystrophic nails, and leukoplakia. Hematologic abnormalities
      progressing to severe pancytopenia play a significant role in the poor prognosis
      of afflicted patients. We report on a patient with dyskeratosis congenita and
      severe aplastic anemia, complicated by life threatening infection. The patient
      was treated with recombinant granulocyte-macrophage colony-stimulating factor.
      This therapy resulted in a moderate and transient improvement in absolute
      neutrophil counts. Current concepts regarding the pathogenesis and etiology of
      dyskeratosis congenita are discussed, while reviewing the available therapeutic
      options.

PMID- 8485210
TI  - Change of paraprotein from IgG lambda to lambda chain in myeloma.
AB  - We describe a unique case of IgG lambda myeloma in which a plasma cell leukemia
      developed and the paraprotein changed from IgG lambda to lambda chain, the latter
      inducing fatal renal failure. In addition, J-chain was detected in the cytoplasm
      of the plasma cell leukemia cells.

PMID- 8485211
TI  - [Structure of lipopolysaccharides from gram-negative bacteria. I. Common
      characteristics of lipopolysaccharides and lipid A structure (Review)].
AB  - The data on the structure and properties of outer membrane lipopolysaccharides of
      gram-negative bacteria are reviewed with special reference to the general
      organization of the lipopolysaccharide molecule and the structure of the lipid
      moiety (lipid A). The correlation between the structure of the
      lipopolysaccharides and lipid A and their biological properties and functions are
      discussed.

PMID- 8485212
TI  - [Structure of lipopolysaccharides from gram-negative bacteria. II. Core structure
      (Review)].
AB  - The review summarizes the data on the core structure of bacterial
      lipopolysaccharides (LPS) which represents an oligosaccharide binding the lipid
      moiety of the macromolecule to the O-antigenic polysaccharide chain. Both S
      strains with complete LPS and R-mutants having various defects of the core
      biosynthesis are considered. The role of the core in the outer membrane
      functioning and manifestation of antigenic specificity of LPS is discussed.

PMID- 8485213
TI  - [Phosphorus-containing polysaccharides from the cell wall of Actinoplanes sp. INA
      3697 cell wall].
AB  - A phosphorus-containing polysaccharide has been isolated from defatted cells of
      Actinoplanes sp. INA 3697. The structure of the polymer has been established by a
      non-destructive method including one- and two-dimensional NMR 1H-spectroscopy as
      well as by NMR 13C-spectroscopy and confirmed by chemical analysis of the
      monosaccharide composition and the repeating link. Association of the repeating
      units-2-acetamido-2-deoxy-beta-D-mannopyranosyl-(1-->3)-2-acetamido -2-deoxy-D
      glucopyranoses, is provided by phosphodiester bonds between C1 of N
      acetylglucosamine and C6 of N-acetylmannosamine. The polymer molecule is made up
      of about 12 disaccharides and is localized in the cell wall of the actinomycete.
      No structurally identical phosphorylated polysaccharides have as yet been found
      in prokaryotes.

PMID- 8485214
TI  - [Features of interaction of Escherichia coli DNA polymerase I and its Klenow
      fragment with dTTP gamma-p-azidoanilide].
AB  - gamma-p-Azidoanilidate of dTTP was used to study the photoaffinity modification
      of DNA polymerase I and Klenow fragment. The analog was found to be a mixed-type
      inhibitor with respect to dTTP of the polymerization reaction catalyzed by DNA
      polymerase I and Klenow fragment. In the absence of the reagent both UV
      irradiated enzymes were rapidly inactivated. Substrates (dNTP and template
      primer) protected the enzymes from inactivation by UV-light with different
      efficiency. In the presence of the template-primer UV-irradiation induced
      activation of DNA polymerase I. The effect of the analog on both enzyme forms
      under irradiation is different. At concentration of 10(-5)M gamma-p-anilidate of
      dTTP accelerated the activation of DNA polymerase I initiated by UV-irradiation
      and at 10(-4)M concentration it inactivated the enzyme by 20-25%. Under such
      conditions one enzyme molecule covalently bound two molecules of the analog.
      While the template-complementary substrate (dTTP) protected DNA polymerase I both
      from inactivation and modification, the non-complementary one (dCTP) worked only
      against modification. In contrast to DNA polymerase I Klenow fragment was not
      inactivated when exposed to UV-irradiation and gamma-p-anilidate of dTTP neither
      modified the protein nor exerted any significant effect on its polymerization
      activity. The data accumulated suggest the presence on the DNA polymerase I
      molecule of a regulatory region providing additional dNTP binding sites.

PMID- 8485215
TI  - [Creation of Delta mu(H)+ equal to 250 mV on the inner mitochondrial membrane is
      necessary, but not a sufficient condition for ATP synthesis].
AB  - Electron transport in the NADH-ferricyanide and succinate-->O2 chains and ATP
      synthesis in mitochondria under different incubation conditions have been
      studied. Ferricyanide which substitutes oxygen as a terminal acceptor provides
      the generation on the membrane potential, delta microH+, but does not initiate
      the functioning of the proton cycle. It is suggested that mitochondria can
      utilize delta microH+ only during the functioning of the redox chain under
      aerobic conditions. Presumably, under normal conditions oxygen implements two
      (but not one) functions; the second function of O2 may consist in the formation
      of a superoxide radical anion. Under conditions of decoupling caused by the free
      radical scavenger propylgallate, the ATP synthesis in mitochondria may be
      stimulated de novo through superoxide generation. This effect is abolished by
      superoxide dismutase.

PMID- 8485216
TI  - [Effect of 5H-alpha-cholest-8(14)-en-3-beta-ol-15-one on cholesterol metabolism
      in cultured rabbit hepatocytes].
AB  - The effects of 15-ketosterol on cholesterol metabolism in cultured rabbit
      hepatocytes were characterized by the following parameters: a) cholesterol
      synthesis, b) apo B and apo E secretion, c) bile acid synthesis. 15-Ketosterol
      used at therapeutic concentration (0.25 microM) reduced cholesterol synthesis (by
      50%). Marked inhibition (by 70%) of apo B and apo E secretion was observed for
      this agent. Synthesis and secretion of the total [14C]-labeled protein remaining
      unchanged. 15-Ketosterol did not influence the bile acid synthesis in primary
      culture of rabbit hepatocytes. These results are suggestive of a new putative
      mechanism of hyperlipidemic action of 15-ketosterol by a simultaneous decrease of
      hepatic cholesterol synthesis and secretion of apo B-containing particles.

PMID- 8485217
TI  - [Certain functional characteristics of enzymatic antioxidant defense in human
      blood plasma].
AB  - It has been shown that human blood plasma displays a low activity of superoxide
      dismutase, a key enzyme of antioxidative protection. This enzyme was isolated and
      purified from human blood plasma by using a novel procedure based on gel
      filtration on Ultrogels AcA-34 and AcA-44. Data from gel filtration and disc
      electrophoresis in the presence of sodium dodecyl sulfate and beta
      mercaptoethanol suggest that the molecular mass of the enzyme decreased with time
      and a simultaneous change in activity. Purification of superoxide dismutase from
      blood plasma revealed the presence of low molecular mass peptides (1000 and 5000
      Da) which inhibited the enzyme activity. A possibility was considered for
      superoxide dismutase transition into an active, conformationally labile state
      after a split-off of the inhibiting fragment under conditions of oxidative
      stress.

PMID- 8485218
TI  - [Regulation of cholesterol absorption in human and rat small intestine epithelial
      cells].
AB  - Cholesterol absorption in human small intestine organ culture and rat small
      intestine epithelial cell culture IRD-98 has been studied using [14C]
      cholesterol, [3H] cholesterol and [14C] sitosterol. It has been found that
      cholesterol absorption is a dose- and time-dependent process, while sitosterol
      absorption is not and makes up to about 25% of the total cholesterol absorption.
      Cholesterol absorption appeared to be a specific process. The endocytosis
      inhibitor monensin decreased specific cholesterol absorption by 37%. Cholesterol
      absorption was examined under different conditions influencing cholesterol
      metabolism in the cell. Loading of IRD-98 cells with non-lipoprotein cholesterol
      caused a dose-dependent decrease of cholesterol absorption. The inhibitor of acyl
      coenzyme A:cholesterol acyl transferase (ACAT), compound Sandoz 58-035, had a
      similar effect on cholesterol absorption. Lovastatin, an inhibitor of 3
      hydroxymethyl-3-glutaryl coenzyme A (HMG-CoA) reductase, stimulated cholesterol
      absorption in a dose-dependent manner. Loading of cells with cholesterol,
      lovastatin and Sandoz 58-035 had no effect on sitosterol absorption. The
      possibility has been demonstrated of using human small intestine organ culture
      and rat small intestine epithelial cell culture IRD-98 as models for studying
      cholesterol absorption.

PMID- 8485219
TI  - [Simulating and inhibiting effect of individual blood serum transport proteins on
      thyroid hormone binding with human placental cell membrane].
AB  - Binding processes in in vitro systems modelling specific interactions between
      transport and receptor proteins, thyroid hormones of human placental tissue and
      the washing blood, have been studied. These systems included syncytiotrophoblast
      villous membranes, thyroxine (T4), triiodothyronine (T3) and iodothyronine
      binding proteins: transthyretin, albumin, immunoglobulins (Ig) M and G,
      apolipoprotein A-I, and the T4-binding globulin purified from human
      retroplacental serum. All of the transport proteins at concentrations close to
      the Ka values of their complexes with thyroid hormones produced inhibitory
      effects on the binding of [125I]T3 or [125I]T4 to the thyroid hormone membrane
      receptor. The dependence of [125I]T4 membrane binding on IgM concentration in the
      system was characteristic of all proteins studied. In the case of T3 such
      dependence was unique for IgM, and included the phase of the IgM stimulatory
      effect (10(-11)-10(-9) M) and the phase of inhibition (10(-8)-10(-7) M). In the
      presence of 30 pM IgM, the concentration of the membrane T3-binding sites
      increased by 75% with a 2.2-fold decrease of the association constant (Ka). It
      was shown that IgM interacts specifically with two classes of binding sites on
      the plasma membranes with Ka(1) = 5.0 x 10(9) M-1, Bmax(1) = 34 fmol/mg of
      membrane protein and Ka(2) = 2.7 x 10(7) M-1, Bmax(2) = 2.0 pmol/mg of membrane
      protein. It is suggested that the stimulatory effect of IgM is caused by
      increases in the number of T3-binding sites on the placental villous membranes as
      a result of complex formation between IgM and its membrane receptor which
      displays an enhanced T3-binding activity.

PMID- 8485220
TI  - [Metabolism of nuclear neutral lipids and rat thymocyte chromatin under normal
      conditions and after gamma-irradiation].
AB  - The levels and specific radioactivities of cholesterol and free fatty acids in
      nuclei and chromatin of thymocytes from normal and gamma-irradiated (10 Gy) rats
      have been studied. The radioactivity of the total lipid fraction of gamma
      irradiated cells was decreased significantly in the absence of inhibition of [2
      14C]acetate incorporation into the total protein and lipid reactions and the
      [3H]uracil incorporation into the acid-insoluble RNA. The concentration of free
      fatty acids in the nuclei increased significantly after irradiation. The specific
      radioactivity of cholesterol in chromatin was higher than in the nuclei. The
      differences in specific radioactivities of free fatty acids were less pronounced.
      After irradiation the ratio of specific radioactivities of free fatty acids in
      chromatin to that in the nuclei showed a tendency to increase.

PMID- 8485221
TI  - [Isolation and characteristics of catalytic antibodies to DNA in systemic lupus
      erythematosis].
AB  - A method for purifying DNA-specific catalytic antibodies based on affinity
      chromatography on protein A Sepharose and on both modified and non-modified DNA
      cellulose as well as HPLC has been developed. The elution conditions with high
      yields of DNA-hydrolyzing activity of antibodies have been optimized. The
      biochemical and immunological properties of catalytic antibodies have been
      examined. The kinetic parameters of the enzyme interaction with an
      oligonucleotide substrate have been determined. The influence of effectors on DNA
      hydrolysis by antibodies has been investigated.

PMID- 8485222
TI  - [Characteristics of phospholipid hydrolysis kinetics by phospholipase C from
      Bacillus cereus. Hydrolysis of phosphatidylinositol in various aggregated
      states].
AB  - The process of phospholipase C hydrolysis of phosphatidylethanolamine (PE) in the
      form of mixed micelles phospholipid-detergent or in the form of vesicules in the
      mixture with phosphatidylcholine (PC) was studied. The size of the micelles was
      measured by dynamic light-scattering and their structure was determined by 31P
      NMR spectroscopy. It was found that the kinetics of PE hydrolysis in the micelles
      by phospholipase C from Bacillus cereus do not follow Michaelis-Menten equation,
      but at all concentrations studied PE was hydrolyzed significantly slower than PC.
      The rate of PC hydrolysis was measured in the previous work. The hydrolysis of PE
      in PC-vesicules was followed with use of Victoria blue R dye method. It was shown
      that the rate of PE hydrolysis in the vesicules is similar to that of PC.

PMID- 8485223
TI  - [Modification of RNA ligase histidine residues by diethylpyrocarbonate].
AB  - The practicality of Tris-HCl buffer for modification of histidine residues by
      diethylpyrocarbonate (DEPC) was studied using a model protein-hexokinase. It was
      found that modification was selective at pH 7.5. Conditions for modification of
      one histidine residue in the protein molecule were specified. In 30 mM Tris-HCl
      buffer pH 7.5, 10-min interaction of RNA-ligase with 0.3 mM DEPC was accompanied
      by modification of one histidine residue, as a result of which the ability to
      form a covalent AMP-RNA-ligase complex decreased 3 times. Modification of two
      histidine residues of RNA-ligase resulted in a complete loss of the enzyme
      activity. At increasing DEPC concentration modification affected all of the seven
      histidine residues of RNA-ligase. The kinetic parameters (Km and V) for the
      native and modified enzymes were determined and compared.

PMID- 8485224
TI  - [Comparative characteristics of some parameters of the cell nucleus in the series
      myeloma-hybridoma-lymphocyte].
AB  - A comparative study of several parameters of the cell nuclei of hybridoma MLC-1c
      and its parent cells--myeloma X-63.Ag8.653 and spleen lymphocytes of Balb/c mice,
      has been carried out. The results of cytogenetic studies suggest that although
      the hybridoma and myeloma cell lines used in this study are rather stable, they
      contain some proportion of the altered chromosomal material. Two-dimensional
      electrophoresis performed according to O'Farrell revealed that the similarity
      between the relative presentation and reciprocal location of the nuclear proteins
      expressed by the myeloma and the hybridoma was greater than that between these
      cell lines and lymphocytes. Probing of the chromatin structure by micrococcal
      nuclease showed no significant differences in the degree of nuclease resistance
      of chromatin between myeloma, hybridoma and lymphoid cells. A comparative study
      of the Ca/Mg-dependent endonuclease activity of the nuclei in situ and in nuclear
      extracts demonstrated that whereas its content in lymphocytes was rather high, in
      myeloma and hybridoma it was practically absent. At the same time, cell nucleus
      extracts of the myeloma and the hybridoma contained high amounts of DNA-binding
      proteins which were undetectable in mouse spleen lymphocytes.

PMID- 8485225
TI  - [Change in adenine nucleotide pool in E. coli 1257 bacterial cells under the
      action of a low intensity He-Ne laser].
AB  - Evidence is presented of co-immobilized bioluminescent reagents which include
      firefly luciferase, pyruvate kinase and adenylate kinase used for an adenylate
      assay in bacterial cells. The changes in the ATP, ADP and AMP content induced by
      irradiation with a low-power He-Ne-laser depend on the laser power and
      irradiation dose. The data obtained suggest that laser irradiation causes the
      activation of adenine nucleotide synthesis de novo.

PMID- 8485226
TI  - [The effect of monovalent cations on the structure of chromatin from Ehrlich
      ascites carcinoma cells].
AB  - Changes in the intracellular ratio of monovalent cations resulting in the
      alteration of transcriptional activity in some cell-specific genes have been
      investigated. It was found that at varying intracellular Na+/K+ concentration
      ratios the accessibility of the beta-actin gene to the effect of exogenous
      DNAaseI changes drastically. The use of hybridization of restricted DNA of the
      nuclear matrix with appropriate probes revealed that the number of copies for
      oncogenes c-fos and c-myc within this DNA changes with alteration of the
      intracellular ratio of monovalent cation concentrations.

PMID- 8485227
TI  - [Nuclear proteins, specifically binding the regulatory region of rat tryptophan
      oxygenase].
AB  - Using electrophoretic mobility shift assay we have analysed the binding of rat
      liver nuclear proteins to the fragments from -466 to -292 and from -292 to -178
      relative to the transcriptional start site of the rat tryptophan oxygenase gene.
      Studies of the competition with a synthetic consensus sequence for the NF 1
      recognition site have shown that the liver nuclear proteins, responsible for the
      formation of specific complexes with these fragments belong to the family of the
      nuclear factor 1 (NF 1). We have also found that the trans-acting factors of the
      NF 1 family form several complexes with each of the two tested fragments of the
      tryptophan oxygenase gene.

PMID- 8485228
TI  - [Probucol and alpha-tocopherol stimulate the synthesis of bile acids in cultured
      rabbit hepatocytes].
AB  - Primary cultures of rabbit hepatocytes were used to examine the effect of
      probucol and alpha-tocopherol on cholesterol and bile acid metabolism. After 24
      hour preincubation of cells with 100 microM probucol, the cholesterol and
      cholesteryl ester content increased--by 30% and 50%, respectively. This was
      accompanied by decreasing incorporation of [14C]acetate into cholesterol (down to
      25-35%). At the same time, alpha-tocopherol had no effect on cholesterol
      accumulation in hepatocytes, while cholesterol synthesis was stimulated by 30
      50%. Addition of 100 microM probucol or alpha-tocopherol to a culture medium
      containing 10% fetal calf serum and [14C]cholesterol caused a significant (30
      40%) stimulation of bile acid synthesis. Stimulation by probucol was dependent on
      the presence of exogenous plasma or HDL2 cholesterol, while alpha-tocopherol
      enhanced this process in a cholesterol-free medium. Stimulation (40%) of bile
      acid secretion by probucol in the presence of physiological concentrations of apo
      E-free HDL2 was found. Study of receptor-mediated uptake of HDL2 revealed that:
      (i) probucol stimulated apo E secretion; (ii) HDL2 isolated from a medium of
      probucol-treated cells contained 2-3 times more apo E than the particles
      preincubated with cells without the drug; (iii) apo E-enriched HDL2 particles
      were incorporated into cultured human skin fibroblasts 1.5-3.0 times more
      effectively than apo E depleted HDL2; (iv) monoclonal antibody against the LDL
      receptor binding domain of apo E effectively (by 40%) inhibited the apo E
      enriched HDL2 uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485229
TI  - [Properties of beta-carotene-15,15'-dioxygenase, stabilized during purification
      with lutein and dithiothreitol].
AB  - Preparations of beta-carotene 15,15'-dioxygenase (EC 1.13.11.21) obtained with or
      without lutein and dithiothreitol (DTT) as stabilizers display similar
      properties. The stabilized preparation has an apparent Km of 17 microM and Vmax
      of 2.8 nM/h/mg of protein, a pH optimum of 8.1, is sensitive to SH-agents and is
      activated by Fe2+, DTT or glutathione used at optimal concentrations of 0.5 mM, 2
      mM, and 5 mM respectively. At DTT concentration above 2 mM the enzyme activity
      decreases drastically, which testifies to the importance of maintaining the thiol
      and disulphide group ratio in the protein molecule at an optimal level. At 4 mM
      Fe2+ there occurs a nonenzymatic formation of apo-carotenals; however, retinal is
      formed only after addition of commensurate amounts of thiol compounds. The enzyme
      activity depends on the ionic strength of the incubation medium, the maximal
      effect being observed with 0.4 M K-phosphate buffer. Substitution of phosphate
      for Cl- partly inhibits the enzyme. The optimal temperature for this reaction is
      45 degrees. A simultaneous use of optimal incubation parameters (2 mM DTT, 0.4 M
      K-phosphate buffer pH 8.1 and 45 degrees C) increases the retinal yield 2.5-fold
      against control.

PMID- 8485230
TI  - [Signal-conducting and low molecular weight GTP-binding proteins from the lung
      and endothelium: localization in membranes and cytosol, interaction with F
      actin].
AB  - The following proteins have been identified in mammalian lung and endothelium,
      using [32P]ADP-ribosylation by bacterial ADP-ribosyltransferase, immuno- and
      [alpha-32P]GTP-blottings: 41 kDa Gi1 alpha, 40 kDa Gi2 alpha, 41 kDa Gi3 alpha,
      40 kDa and 45 kDa subunits of GS alpha, 36 kDa beta 1 and 35 kDa beta 2 subunits
      of signal-transmitting GTP-binding proteins (G-proteins), the 19-26 kDa low
      molecular weight GTP-binding proteins (SMG-proteins) ras, rho, rac, G25K (Gp), as
      well as ARF and SMG proteins binding with a high affinity to [alpha-32P]GTP.
      These G- and SMG-proteins are contained in various proportions in membrane and
      cytosol fractions of lung and endothelium cells. Subunits Gi2 alpha and GS alpha
      (but not beta 1 or SMG-proteins) my partially (approximately 1%) dissociate from
      the membrane by the action of the GTP analogs GTP[S] or Gpp(NH)p in the presence
      of magnesium ions. Extraction with low ionic strength buffer solutions in the
      presence of EDTA is accompanied by the release of G-actin sensitive to whooping
      cough toxin Gi2 alpha and beta i subunits. The functionally coupled into a alpha
      beta gamma heterodimer Gi-protein subunits (predominantly Gi2 alpha and beta i)
      present in the cytosol fraction as well as the SMG-proteins revealed by [alpha
      32P]GTP-blotting (but not the SMG-proteins sensitive to the botulinic C3
      exoenzyme, rho/rac, or ARF, may interact with F-actin. Approximately 20% of these
      proteins are associated with the Triton X-100 insoluble (cytoskeletal) fraction
      of the endothelium. A conclusion is drawn that interactions of G- and SMG
      proteins with actin filaments may be the reason for the formation of
      "multidisperse" structure in a cell.

PMID- 8485231
TI  - [The role of GTP-binding proteins in regulating the activation of Na+/H+-exchange
      and Na+, K+, 2Cl- cotransport: effect of fluoride ion].
AB  - The effects of NaF and AlCl3 on basal and stimulated by hyperosmotic shock
      activities of Na+/H(+)-exchange and Na+, K+, 2Cl(-)-cotransport in rat smooth
      muscle and red blood cells have been studied. Preincubation of cells with 10 mM
      NaF leads to inhibition of basal and hyperosmotic shock-activated Na+, K+, 2Cl(-)
      cotransport in smooth muscle cells--by 45% and 190%, respectively. Sodium
      fluoride causes 80% activation of basal Na+, K+, 2Cl(-)-cotransport in red blood
      cells with no effect on the transport induced by hyperosmotic shock. The effect
      of NaF on Na+, K+, 2Cl(-)-cotransport in red blood cells does not depend on Al3+.
      Basal Na+/H(+)-exchange is stimulated by NaF by 780% in smooth muscle cells and
      is insensitive to the fluoride in red blood cells. Under hyperosmotic conditions
      NaF activates Na+/H(+)-exchange by 100% in smooth muscle cells and by 130% in red
      blood cells; in the latter case its effect is potentiated by Al3+. The data
      obtained suggest that GTP-binding proteins are involved in the activation of
      Na+/H(+)-exchange under hyperosmotic conditions.

PMID- 8485232
TI  - [Effect of training on the structural-metabolic indicators in athletes' skeletal
      muscles].
AB  - Muscle biopsy samples were taken from m.vastus lateralis of ski-runners during
      the training season and 4 months after training (consisting presumably of aerobic
      exercises). Metabolic enzyme activities, fiber cross-sectional areas, capillary
      supply indices and parameters of oxygen uptake by intact mitochondria in skinned
      fibers were measured. Training did not induce any appreciable changes in the NADH
      tetrazolium reductase activity, maximal oxygen uptake by mitochondria, mean fiber
      size or capillary density. At the same time, there were significant increases in
      the cytochrome c oxidase activity, respiratory control index and creatine
      stimulated respiratory rate. The activities of alpha-glycerophosphate
      dehydrogenase, malate dehydrogenase and myoglobin peroxidase as well as the basal
      respiratory rate of mitochondria decreased as a result of training. The data
      obtained testify to the possibility of qualitative adaptations in the respiratory
      chain of mitochondria.

PMID- 8485233
TI  - [Binding of phenyldicarbaundecaborane with proteins, membrane fragments, and
      whole cells].
AB  - The binding of the lipophilic synthetic anion, phenyldicarbaundecaboran, to inner
      and outer membranes of myocytes, platelets and erythrocytes as well as to
      integral and surface membrane proteins has been studied. It has been found that
      the distribution of lipophilic synthetic ions in the system biopreparations-
      aqueous phase is not determined by the value of the transmembrane difference of
      electric potentials but, rather, by ion adsorption by the protein-lipid
      components of the cell. The latter is controlled by the correlation between the
      volume of hydrophobic areas and the local electrochemical characteristics of the
      cell.

PMID- 8485234
TI  - Tumor necrosis factor-alpha gene expression in mouse oocytes and follicular
      cells.
AB  - Ovarian cells that transcribe and translate the gene for tumor necrosis factor
      alpha (TNF alpha) were identified in the adult cyclic mouse by using in situ
      hybridization and immunocytochemistry. TNF alpha mRNA was observed in > 97% and
      protein was contained in approximately 53% of the oocytes of healthy follicles
      with two or more layers of granulosa cells, but neither was detectable in oocytes
      of primordial follicles and follicles with a single layer of granulosa cells. In
      early atretic follicles, only 13% contained TNF alpha protein and 40% contained
      TNF alpha mRNA. In late stages of atresia, intense immunoreactive TNF alpha was
      observed in all of the oocytes, but TNF alpha mRNA was present in only 13%. In
      approximately 85% of follicles, theca and/or granulosa cells exhibited TNF alpha
      mRNA hybridization signals. Macrophage-like cells within the interstitium were
      positive for TNF alpha mRNA and protein. In corpora lutea, luteal cells and
      macrophage-like cells contained TNF alpha message, while only the latter lineage
      contained immunoreactive TNF alpha. Hybridization signals and immunoreactivity
      were more intense in older corpora lutea than in corpora lutea of the present
      cycle. Northern blot analysis revealed a 2.2-kb TNF alpha mRNA in the ovary that
      was unchanged relative to 28S rRNA (constitutive RNA) during the cycle.
      Similarly, TNF alpha hybridization signals and immunoreactivity did not appear to
      change throughout the cycle. These results indicate that TNF alpha gene
      transcription in the oocyte coincides with the synthesis of immunoreactive TNF
      alpha and that these complex biochemical processes occur at distinct steps of
      follicular development in the mouse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485235
TI  - Multiple generational bovine embryo cloning.
AB  - Repeated cycles (multiple generations) of nuclear transfer procedures have the
      potential of producing a large number of identical offspring from the
      micromanipulation of one mammalian embryo. This paper outlines the differences in
      nuclear transfer procedure efficiencies and developmental rates for the various
      stages and generations of embryos. We report the production of 54 genetically
      identical embryos that developed to the morula stage from one parent embryo. When
      a limited number of nuclear transfer embryos (clones) were transferred to
      recipient females, first, second, and third generation calves were born. Clones
      cultured for 5 days in the sheep oviduct had a greater number of cells (28.1 +/-
      1.7) than clones cultured for 4 days (17.8 +/- 1.7). However, fusion rates were
      lower for Day 5 clones (Day 5, 57% vs. Day 4, 68%; p < 0.001) used as donors for
      the next generation of cloning. Different generations of clones also varied in
      fusion rates. Fusion rates generally declined with each additional generation and
      ranged from 66% for the parent-donor embryos to 52% for second generation donors
      (p < 0.01). Developmental rates were highest for first and third generation
      donors (20% and 19%) and lowest for second generation donors (10%; p < 0.001).
      Further understanding of the factors that are conducive to high developmental
      rates and nuclear reprogramming may make it possible to produce an unlimited
      number of genetically identical animals.

PMID- 8485236
TI  - Involvement of cyclins and cdc2 serine/threonine protein kinase in human sperm
      cell function.
AB  - The presence and roles of mitotic cyclins (cyclin A and cyclin B1), and cdc2 and
      related (having an N-terminal PSTAIRE conserved sequence) serine/threonine
      protein kinases were investigated by use of specific antibodies. The cyclin A and
      cyclin B1 antibodies reacted specifically with the acrosomal regions of human
      sperm cells in the indirect immunofluorescence technique (IFT) and recognized the
      specific band of p60 (cyclin A) and p62 (cyclin B1) on the Western blot of sodium
      deoxycholate (DOC)-solubilized noncapacitated human sperm preparation. Both
      antibodies reacted more strongly with the specific cell region/band of
      capacitated sperm than with that of noncapacitated sperm. The cdc2 and PSTAIRE
      antibodies also reacted predominantly with the acrosomal regions of human sperm
      cells in IFT and recognized the specific band of 34 kDa corresponding to p34 cdc2
      protein on the Western blot of DOC-solubilized noncapacitated human sperm
      preparation. Again, both antibodies reacted more strongly with the specific cell
      region/band of capacitated sperm than with that of noncapacitated sperm. The
      cyclin A antibodies (but not the cyclin B1 antibodies) and cdc2 antibodies as
      well as the PSTAIRE antibodies significantly (p = 0.02 to p < 0.001) increased
      (rather than decreased) the human sperm penetration rates of zona-free hamster
      ova; the cyclin A and cdc2 antibodies showed the strongest enhancing effects.
      These three antibodies significantly increased the acrosome reaction and release
      of acrosin activity from the sperm cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485237
TI  - Neonatal porcine endometrial development involves coordinated changes in DNA
      synthesis, glycosaminoglycan distribution, and 3H-glucosamine labeling.
AB  - To determine whether neonatal porcine endometrial development involved
      alterations in endometrial DNA synthesis, glycosaminoglycan (GAG) distribution,
      and/or 3H-glucosamine labeling, gilts were assigned randomly at birth (Day 0) to
      be hysterectomized on either Day 0, 7, 14, 28, 42, or 56. Uteri were processed
      for histology and Alcian blue-8GX (AB) histochemistry or cultured as explants in
      the presence of [methyl-3H]thymidine (3H-Thd) or D-[6-3H]glucosamine (3H-GlcN)
      and processed for subsequent autoradiography. For 3H-Thd-labeled tissues,
      labeling index (LI; % of nuclei labeled) was determined for two endometrial
      tissues (epithelium and stroma); two epithelial areas (luminal and glandular);
      and, for glandular epithelium, in three endometrial zones (zone 1 = shallow, zone
      2 = intermediate, zone 3 = deep). For 3H-GlcN-labeled tissues, LI (grains/100
      microns2) was determined for two stromal zones (shallow and deep). Endometrial
      glands were absent on Day 0, present in shallow stroma on Days 7 and 14, and
      extended to the myometrium in tissues from Day 28 through Day 56. Appearance of
      endometrial glands was associated with a dramatic increase in glandular
      epithelial 3H-Thd LI, which was maximal on Days 7 and 14 and declined thereafter.
      When glands were present in all three endometrial zones (Days 28-56), glandular
      epithelial 3H-Thd LI was consistently greatest in zone 2. Stromal 3H-Thd LI
      decreased after Day 0. In tissues obtained after Day 0, a distinct zone of
      alcianophilia was observed in shallow stroma adjacent to luminal epithelium and
      surrounding the necks of newly developed endometrial glands. This staining
      pattern was marked in tissues from Days 7, 14, and 28. Generally, stromal 3H-GlcN
      LI was greater in shallow than in deep stromal zones; it decreased after Day 0 to
      minimum values on Days 28 and 42 in both zones, and increased slightly in shallow
      stroma on Day 56. Data indicate that development of the neonatal porcine
      endometrium between birth and Day 56 involves coordinated alterations in patterns
      of DNA synthesis, GAG distribution, and glycoconjugate biosynthesis. The
      morphogenetic processes characterized here are likely to be regulated locally via
      changes in tissue microenvironment.

PMID- 8485238
TI  - Neonatal age and period of estrogen exposure affect porcine uterine growth,
      morphogenesis, and protein synthesis.
AB  - To determine whether neonatal age and estrogen exposure affect uterine growth,
      morphogenesis, and protein synthesis, crossbred gilts were randomly assigned at
      birth (Day 0) to receive either corn oil vehicle (CO) or estradiol-17 beta
      valerate (EV; 50 micrograms/kg BW/day). Gilts were treated for 7 days, chosen to
      coincide with specific periods of uterine development, prior to hysterectomy on
      Day 7, 14, or 49. Uteri were weighed, and tissues were fixed for histology or
      explanted with L-4,5-[3H]leucine (3H-leu) for 24 h. Endometrial and myometrial
      thicknesses were measured in uterine wall cross sections. Radiolabeled proteins
      produced by uterine wall tissues from 3H-leu and released into explant medium
      were identified by fluorography of two-dimensional SDS-PAGE gels. Proteins for
      which fluorographic spot intensities were consistently affected by age and/or
      treatment were excised from gels, and associated radioactivity was quantified.
      Normal growth and histogenesis were observed in uteri from CO-treated gilts.
      Exposure to EV increased (p < 0.01) uterine wet weight on all days examined,
      although effects were most pronounced on Day 49 (day x treatment, p < 0.01).
      Histologically, uteri of EV-treated gilts exhibited precocious or altered
      patterns of development of endometrial glands and folds. Endometrial thickness
      was greater (p < 0.01) in EV-treated gilts, and response was most pronounced on
      Day 49 (day x treatment, p < 0.01). Treatment with EV increased (p < 0.01)
      myometrial thickness on Day 49 only. Twenty-five uterine proteins were identified
      to be affected consistently by neonatal age, EV, or both. Production of four of
      these proteins was affected by age alone, while six were affected exclusively by
      treatment with EV alone, and 15 were affected differentially by both age and EV.
      Treatment with EV affected production of three of these 25 proteins on Day 7, 8
      of 25 on Day 14, and 14 of 25 on Day 49. Results indicate that uterine growth and
      development of the porcine uterine wall during early neonatal life are
      accompanied by predictable alterations in patterns of uterine protein synthesis.
      Data also demonstrate that the neonatal porcine uterus is estrogen-sensitive and
      that both physical and biochemical responses of uterine tissues to estrogen vary
      with period of exposure. It is suggested that EV may be useful as a tool with
      which to induce developmental lesions in neonatal porcine uterine
      tissues.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8485239
TI  - Short-day effects of melatonin on luteinizing hormone secretion in the ewe:
      evidence for central sites of action in the mediobasal hypothalamus.
AB  - Experiments were designed to localize the central sites of action of melatonin
      involved in the control of seasonal reproduction. Ewes were exposed to long days
      and received microimplants of melatonin in the preoptic area (n = 9), anterior
      hypothalamus (n = 4), dorsolateral hypothalamus (n = 4), or mediobasal
      hypothalamus (n = 12). The effects of implants were determined by comparison with
      control ewes (untreated or sham-operated, n = 10) and with ewes treated with an
      s.c. implant of melatonin (n = 8) or ewes subjected to short days (n = 8). All
      ewes were ovariectomized and treated s.c. with a silastic capsule of estradiol.
      Melatonin released in the preoptic area as well as in the anterior and lateral
      hypothalamus did not cause any difference as compared with the controls (no
      stimulation of LH secretion and no inhibition of prolactin secretion). In
      contrast, melatonin implanted in the mediobasal hypothalamus caused an increase
      in LH secretion in 7 of the 12 ewes on Day 53.0 +/- 4.2 after implantation (mean
      +/- SEM). Their response was not different compared with that of ewes treated
      s.c. with melatonin or exposed to short days either in terms of timing (Day 56.3
      +/- 6.2 and 59.5 +/- 3.1, respectively, for controls) or of amplitude of the LH
      response. Similarly, melatonin caused only a reduction of prolactin secretion in
      the mediobasal, s.c., and short-day groups. It is concluded that the mediobasal
      hypothalamus or the surrounding tissues could be the sites of action of melatonin
      involved in the control of seasonal reproduction.

PMID- 8485240
TI  - Spermatogonial cell proliferation in organ culture of immature rat testis.
AB  - Regulatory mechanisms of male germ cell proliferation in mammals were
      investigated by using in vitro organ culture of immature rat testis. Nutritional
      and hormonal requirements for maintenance and differentiation of germ cells in
      vitro were first characterized by testing different culture conditions. FSH was
      essential for the progression of type A spermatogonia up to the stage of
      pachytene spermatocytes after 3 wk of in vitro culture, while vitamins A, C, and
      E, LH, and testosterone were not effective. The proliferative activity of Sertoli
      cells markedly declined after 1 wk of in vitro culture, irrespectively of the
      presence of FSH in the medium. In addition, basal testosterone production by
      Leydig cells was maintained after 1 wk of culture, provided that FSH was present
      in the medium. The appearance of differentiating type I and type B spermatogonia
      and meiotic cells in the seminiferous cords throughout culture was accompanied by
      a significant reduction in the number of undifferentiated spermatogonia.
      Moreover, a similar labeling index of undifferentiated spermatogonia was observed
      in both unstimulated and FSH-stimulated testis fragments at all culture times
      considered. Therefore, FSH did not influence the mitotic activity of
      undifferentiated spermatogonia, suggesting a differential role of this
      gonadotropin during the mitotic phase of spermatogenesis. These results indicate
      that the organ culture system of immature rat testis represents a useful
      experimental model for studying regulatory mechanisms of spermatogonial cell
      proliferation.

PMID- 8485241
TI  - Differential expression of distinct mRNAs for ovine trophoblast protein-1 and
      related sheep type I interferons.
AB  - An antiluteolytic substance secreted by the ovine conceptus and primarily
      responsible for maternal recognition of pregnancy is ovine trophoblast protein-1
      (oTP-1), a new type I interferon (IFN). The objectives of this research were 1)
      to investigate whether multiple, distinct genes encode oTP-1 and other type I
      IFNs in the ovine genome and 2) to examine expression of oTP-1 and other IFN
      mRNAs during conceptus development. Genes for type I IFNs were isolated from a
      subgenomic library constructed from Day 25 (Day 0 = estrus) ovine conceptus high
      molecular-weight DNA. Six clones were isolated and nucleotide-sequenced from 
      1000 to +900 (bases relative to cap site). Comparisons of inferred amino acid
      sequences demonstrated that four clones were distinct oTP-1 genes and that two
      clones, defined as o9 and o12, were related type 1 IFNs (deduced aa homology of
      o9 and o12 to oTP-1 was 71% and 54%, respectively). The presence of mRNAs encoded
      by oTP-1 and type I IFN genes was examined quantitatively via reverse
      transcription-polymerase chain reaction (RT-PCR) analysis of total cellular RNA
      (tcRNA) extracted from Day 13-45 concepti. Total cellular RNA obtained from Day
      75 placenta and adult lymphocytes was also analyzed by RT-PCR, coupled with
      Southern blot hybridization of the PCR reaction products with specific DNA
      probes. PCR products were sequenced in order to confirm primer specificity, and
      mRNAs corresponding to two of the four oTP-1 genes and to both related IFN clones
      (o9 and o12) were identified. Furthermore, quantitation of the PCR products
      revealed that of the two oTP-1 genes examined, one was highly expressed on Days
      13-20 and transcripts were weakly detectable on Days 30 and 45. In contrast, the
      other oTP-1 gene examined was weakly expressed on Days 13-20 only. Densitometric
      analysis of hybridization signals revealed that IFN o9 mRNA was detected in Day
      75 placenta but only weakly detected in conceptus (Days 13-45) and adult
      lymphocytes. IFN o12 mRNA was abundant in lymphocytes relative to the other
      tissues examined. Collectively, these results demonstrate the existence of
      distinct oTP-1 and related type I IFN genes. The data suggest that these genes
      display differential, tissue-specific expression and developmental regulation
      during pregnancy.

PMID- 8485242
TI  - Comparison of the myometrial response to oxytocin during daylight with the
      response obtained during the early hours of darkness in the fetectomized rhesus
      monkey at 160-172 days gestational age.
AB  - Six rhesus monkeys, fetectomized at 122-129 days gestational age (dGA), were
      studied to evaluate photoperiod-dependent differences in the myometrial
      sensitivity to exogenous oxytocin in the absence of a live fetus. One to two
      weeks before the study, at 150-162 dGA, sixteen maternal arterial samples were
      taken every 4 h to assess plasma concentrations as well as the presence of 24-h
      rhythmicity in plasma estradiol and cortisol. At 160-172 dGA, oxytocin was
      administered via the maternal inferior vena cava to elicit regular myometrial
      contractions. Each animal was studied twice: once during daylight and once during
      the early hours of darkness. Oxytocin was infused in a pulsatile fashion during
      the first minute out of every five over four consecutive 30-min intervals, during
      which the dose rate was increased after each 6-h oxytocin pulse (400, 800, 2000,
      and 4000 pg.kg-1.min-1). The overall response of the myometrium of the
      fetectomized animals, evaluated as the number of contractions per pulse of
      oxytocin, was higher during the daytime study (p = 0.006). The response to
      oxytocin in intact pregnant animals is greatest during the early hours of
      darkness. Comparison of the overall myometrial response of the fetectomized
      monkeys with the response of intact pregnant animals showed that the daytime
      responses were similar, but that the nighttime response of the fetectomized
      animals was significantly lower (p < 0.0002). These contrasting findings may be
      due to differences in the maternal neuroendocrine environment depending on the
      presence or absence of a fetal adrenal steroid contribution acting directly on
      the myometrium or acting indirectly through provision of precursors for estrogen
      formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485243
TI  - Local regulation of testicular immunoreactive-arginine vasopressin and
      steroidogenesis by naloxone.
AB  - The effects of intratesticular injection of naloxone, a universal opioid
      antagonist, on testicular immunoreactive (IR)-arginine vasopressin (AVP) content
      and on in vitro testosterone production by Leydig cells were investigated in the
      mouse. Bilateral intratesticular injection of increasing doses of naloxone (0.1
      10 micrograms/testis) resulted 24 h later in a dose-dependent increase in
      testosterone production by Leydig cells incubated for 3 h in the presence or
      absence of hCG (100 ng/ml). Unilateral intratesticular injection of naloxone (10
      micrograms) similarly enhanced basal and hCG-stimulated testosterone production
      by Leydig cells, but production was not modified in Leydig cells from the
      contralateral vehicle-injected testis, nor was it changed when the same dose was
      injected subcutaneously. Unilateral intratesticular injection of 10 micrograms
      naloxone led to a dose-dependent increase in the hCG-responsiveness without
      altering the slope of the hCG dose-response curve. In vitro exposure of Leydig
      cells to increasing doses of naloxone (10(-9) to 10(-7) M) did not alter either
      basal or hCG-stimulated testosterone production. Testicular IR-AVP content
      declined in a dose-dependent manner in naloxone-injected testis, but remained
      unchanged in the contralateral vehicle-injected testis and in testis from animals
      that received similar doses of naloxone subcutaneously. Since AVP has been shown
      to locally exert a negative control on testosterone production within the testis,
      it might be hypothesized that the increased Leydig cell activity after local
      naloxone administration results from reduced intratesticular IR-AVP
      levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485244
TI  - Pattern of lactate production and steroidogenesis during growth and maturation of
      mouse ovarian follicles in vitro.
AB  - A model culture system for the study of follicular metabolism has been developed
      from existing methods of whole-follicle culture. The modified system mimics the
      in vivo growth and maturation of mouse ovarian follicles from primary to
      preovulatory stages and the modulating influences of the LH and FSH. This is the
      first study to demonstrate ovulation in vitro from individual ovarian follicles.
      The pattern of follicular lactate production relative to steroidogenesis was
      studied throughout in vitro follicular development over a period of 6 days.
      Twenty-four-hour samples of medium from individual follicles were analyzed for
      lactate and pyruvate by an automated analytical technique, and for estradiol and
      progesterone by an immunoenzymatic method. Follicles produced remarkably large
      quantities of lactate and estradiol during FSH-stimulated development in vitro.
      LH further stimulated lactate production but resulted in a significant decrease
      in estradiol secretion and an ovulation rate of 30%. Progesterone production was
      not detectable throughout the culture period, and follicles showed no evidence of
      pyruvate uptake. These findings demonstrate the validity of using this model
      culture system for the study of follicular metabolism and provide new information
      on the pattern of carbohydrate metabolism relative to steroidogenesis during
      follicular growth and maturation.

PMID- 8485245
TI  - Comparison of luteinized unruptured follicles and corpora lutea: steroid hormone
      production and response to luteolytic and luteotropic agents.
AB  - Administration of hCG prior to spontaneous ovulation induces the formation of
      luteinized unruptured follicles (LUFs) in guinea pigs. Serum progesterone (P) in
      animals with LUFs is significantly lower. This study was designed to determine
      whether follicular maturity affected the incidence of LUFs and P production as
      well as to compare isolated LUFs with corpora lutea (CL) in relation to hormone
      production and response to luteotropic and luteolytic agents. Ovarian histology
      and serum steroids following injection of hCG at various times during the estrous
      cycle indicated that greater follicular maturity increased the incidence of
      ovulation and P production. LUFs and CL contained equivalent amounts of P/mg
      tissue, but LUFs were significantly smaller than CL. Cells from CL and LUFs
      responded to hCG in vitro with significant increases in P release, but the
      response was greatest with LUFs. Prostaglandin F2 alpha (PGF) attenuated the
      response to hCG in vitro by mid-cycle CL and LUFs, but not by CL obtained during
      the early luteal phase. We conclude that the attenuated luteal-phase P profile
      following induction of LUFs is not an intrinsic deficiency in hormone production,
      but may arise from the smaller mass of luteal tissue and from earlier than normal
      development of responsiveness to the luteolytic effects of PGF.

PMID- 8485246
TI  - Increased glutamine metabolism in bovine cumulus cell-enclosed and denuded
      oocytes after in vitro maturation with luteinizing hormone.
AB  - The effects of LH on tricarboxylic acid (TCA) cycle activity within denuded and
      cumulus cell-enclosed bovine oocytes were investigated by measuring the
      metabolism of L-[14C(U)]glutamine and [2-14C]pyruvate to 14CO2 after in vitro
      maturation (IVM) with LH in serum-free, defined culture conditions. Initially,
      intact cumulus cell-enclosed oocytes or oocytectomized cumulus cell complexes
      were incubated for 24 h for IVM in control medium alone or supplemented with LH
      (10 micrograms/ml) before assessment of glutamine metabolism. Glutamine oxidation
      was increased (p < 0.01) only after IVM of intact cumulus cell-enclosed oocytes
      with LH when compared to either intact untreated controls, untreated
      oocytectomized controls, or oocytectomized cumulus cell complexes after LH
      treatment (0.23 +/- 0.02 vs. 0.13 +/- 0.01, 0.12 +/- 0.01, and 0.12 +/- 0.01 nmol
      14CO2/micrograms protein/3 h, respectively). Glutamine metabolism was greater (p
      < 0.001) in denuded oocytes from cumulus cell complexes that were exposed to LH
      during IVM versus nontreated controls (6.4 +/- 0.3 vs. 5.1 +/- 0.2 pmol
      14CO2/oocyte/3 h, respectively). Glutamine metabolism was increased (p < 0.05) in
      cumulus cell-enclosed oocytes after LH exposure during IVM but was unchanged
      after exposure to either FSH or thyroid-stimulating hormone when compared to
      control treatments (0.23 +/- 0.01, 0.20 +/- 0.02, 0.19 +/- 0.01 vs. 0.16 +/- 0.02
      nmol 14CO2/micrograms protein/3 h, respectively). Pyruvate metabolism was not
      different between LH and control treatments. Evidence demonstrated that LH acts
      via the cumulus cells to increase glutamine metabolism within intact cumulus cell
      enclosed oocytes and in mature oocytes denuded after LH exposure.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8485247
TI  - In vitro phosphorylation sites of stallion and bull P1-protamines for cyclic
      adenosine 3',5'-monophosphate-dependent protein kinase and protein kinase C.
AB  - Fish and mammalian protamines are phosphorylated after their synthesis during
      sperm cell maturation. Cyclic AMP-dependent protein kinase (PKA) and protein
      kinase C (PKC), both requiring basic amino acids at their recognition sites, have
      previously been found to phosphorylate fish protamines in vitro. In this study,
      these enzymes were used to phosphorylate stallion and bull sperm P1-protamines in
      vitro. A species-specific difference was found, since PKA was able to
      phosphorylate both protamines while PKC phosphorylated only stallion protamine.
      Thr-41, the only threonine residue in stallion P1-protamine, and most probably
      the homologous Thr-43 in bull P1-protamine are the sites for PKA phosphorylation
      in addition to an internally located Ser-29 present only in stallion protamine.
      This Ser residue was phosphorylated in vitro by both kinases. Protamine
      phosphorylation by PKA was found to be almost independent of cAMP and was
      inhibited only by a tenfold concentration of PKI when compared to phosphorylation
      of a model peptide, kemptide. Addition of calcium, phosphatidylserine, and
      diolein caused a twofold stimulation in phosphorylation of stallion protamine by
      PKC, indicating that specific cofactors of PKC may have a role in mammalian
      protamine phosphorylation. We suggest that PKA is a good universal candidate for
      in vivo phosphorylation of P1-protamines.

PMID- 8485248
TI  - Effect of neonatal diethylstilbestrol exposure on luteinizing hormone secretion
      following ketamine anesthesia and gonadotropin-releasing hormone in castrated
      postpubertal rats.
AB  - Neonatal diethylstilbestrol (DES) exposure diminishes pituitary responsiveness to
      GnRH in castrated postpubertal rats 4 h after placement of intra-atrial cannulae
      under ketamine anesthesia. Ketamine anesthesia has been reported to blunt the
      preovulatory LH surge in female rats and to decrease baseline LH levels in males
      immediately following administration, although its effect lasted less than 2 h.
      It is not known what impact ketamine has on baseline LH levels or on GnRH
      stimulated LH release in estrogen-exposed castrated rats. This study was designed
      to determine 1) whether the changes in GnRH-induced LH secretion in DES-exposed
      castrated rats are partially attributable to a direct effect of ketamine; 2) the
      gender-specific effects of ketamine on LH secretion; and 3) the DES-dependent
      effects of ketamine on LH secretion. In this experiment we ascertained the effect
      of ketamine anesthesia for right heart cannulation on LH levels in male and
      female 42-day-old castrated rats that were exposed to either corn oil or DES (0.1
      microgram/day) on Days 1 through 10 of life. LH secretion in DES-exposed animals
      increased, in contrast to that in control animals, immediately (< 10 min) after
      anesthesia and cannulation. Mean LH levels in DES-exposed females were lower than
      in controls before GnRH administration and were blunted following GnRH. While
      ketamine and catheterization were associated with decreased LH titer in males,
      the extent of that decrease was not dependent on exposure to DES. Both sexes and
      exposure groups achieved baseline catheter LH values by 4 h.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8485249
TI  - Glycine and alanine supplementation of culture medium enhances development of in
      vitro matured and fertilized cattle embryos.
AB  - One-cell cattle embryos were prepared by in vitro oocyte maturation and
      fertilization (IVM/IVF) and cultured with or without oviductal cells. Embryos
      were evaluated after 7 days in culture to determine the percentage developing
      from the 1-cell stage to the morula or blastocyst stage. The combination of
      glycine (2 mM) and alanine (1 mM) with oviductal cells (experiment 1) improved
      embryo development over that in control culture (29 vs. 13%; p < 0.05). An
      optimum response was obtained with 10 mM glycine and 1 mM alanine in coculture
      (experiments 2 and 3). In experiment 4, the effects of glycine (0 or 10 mM),
      alanine (0 or 1 mM), and the presence or absence of oviductal cells were tested.
      In the absence of oviductal cells, the addition of glycine, alanine, or glycine
      and alanine combined improved embryonic development over that in control medium
      (45, 33, 42 vs. 24%, p < 0.001, p < 0.05, p < 0.001, respectively). However, the
      effect of the combination of glycine and alanine was not different from that of
      glycine alone when oviductal cells were absent (42 vs. 45%, p > 0.10). In the
      presence of oviductal cells, glycine or the combination of glycine and alanine
      improved embryonic development over that in the control medium with cells (47, 55
      vs 37%, p < 0.01, respectively). However, supplementation with alanine alone gave
      no improvement over controls when oviductal cells were present (40 vs. 37%, p >
      0.10). These results indicate that glycine and alanine, when used independently,
      directly affect cattle embryo development, but in combination affect embryo
      development indirectly, possibly by altering oviductal cell function.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8485250
TI  - Induction of acrosome reactions of canine sperm by homologous zona pellucida.
AB  - In this study the induction of the acrosome reaction of canine sperm by
      homologous zona pellucida (ZP) was examined. Twelve semen samples obtained from 6
      normal beagle dogs were evaluated after sperm incubation in vitro with canine
      capacitation medium (CCM). Washed sperm were preincubated at 37 degrees C in 5%
      CO2 in air for 4 and 7 h prior to experimental treatment. Sperm were co-incubated
      for 1 min with intact oocytes collected from canine ovaries. Half of the oocytes
      were then fixed, and the bound sperm were assessed for acrosome reactions through
      use of a polyclonal antisperm antiserum and indirect immunofluorescence. The
      remaining oocytes were incubated in sperm-free medium for an additional 1-h
      period, and the acrosomal status of sperm bound to the ZP was evaluated
      similarly. The percentage of acrosome-reacted sperm on the ZP increased
      significantly during the 1-h incubation period. In other experiments, capacitated
      canine sperm were incubated with heat-solubilized ZP for 1 h and their acrosomal
      status was determined using fluoresceinated Pisum sativum lectin. The percentages
      of acrosome-reacted sperm increased significantly in ZP solution compared with
      controls. These data demonstrate that intact and solubilized canine ZP are
      capable of inducing acrosome reactions of canine sperm.

PMID- 8485251
TI  - De novo protein synthesis by bovine uterine tube (oviduct) epithelial cells
      changes during co-culture with bull spermatozoa.
AB  - Polypeptides secreted by uterine tube epithelial cells (UTEC) may facilitate
      sperm cell capacitation in vivo. This experiment evaluated the effect of sperm
      UTEC co-culture on de novo protein synthesis by epithelial cells of the tubal
      isthmus. Comparisons of the patterns of proteins secreted into medium were made
      between four culture groups incubated for 24 h in the presence of 35S-methionine:
      group 1, sperm cells alone; group 2, control UTEC monolayers; group 3, UTEC co
      cultured with sperm cells; and group 4, UTEC partitioned by a diffusible membrane
      from sperm cells during culture. Two-dimensional PAGE followed by fluorography
      was used to analyze conditioned medium containing secreted proteins from each
      group. The experiment was replicated four times. Sperm cells alone secreted no
      detectable proteins, whereas control UTEC monolayers produced a wide array of
      polypeptides. Sperm cells attached to UTEC in co-culture within minutes, and the
      resultant protein profile for these UTEC differed markedly from that of the
      control UTEC. Several new proteins were seen only from co-cultured cells, whereas
      other protein groups that were present with UTEC alone were absent in the co
      culture medium of group 3. The protein pattern expressed by UTEC partitioned from
      sperm cells (group 4) was intermediate between that of the group 2 controls and
      that of co-cultured UTEC (group 3). In summary, the attachment of sperm cells to
      the UTEC during co-culture changed the types and quantities of proteins secreted
      into the conditioned medium as compared to those of control UTEC
      monolayers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485252
TI  - Differential gonadotropin responses to N-methyl-D,L-aspartate in metestrous,
      proestrous, and ovariectomized rats.
AB  - Peripheral administration of N-methyl-D,L-aspartate (NMA), an analogue of the
      excitatory amino acid aspartate, elicits LH and prolactin (PRL) release in rats,
      most likely by increasing endogenous releasing-hormone secretion. These
      experiments were carried out to assess the degree to which NMA stimulates FSH and
      to analyze the relationship between endocrine status and responsiveness to NMA in
      female rats, in contrast to male rats, as described in the companion paper [Biol
      Reprod 48:000-000]. In experiment 1, estrous rats (n = 10) and diestrous rats (n
      = 10) and in experiment 2, estrous rats (n = 11) and rats ovariectomized (OVX) 8
      days previously (n = 10) were fitted with atrial catheters and injected s.c. with
      100 micrograms of an LHRH antagonist or vehicle at 2100 h. Starting at 0900 h the
      next day (metestrus, proestrus, or Day 9 post-OVX), blood was withdrawn every 10
      min for 3 h. Each animal received i.v. 5 mg NMA after the first hour and i.v. 500
      ng LHRH after the second hour. NMA significantly increased LH in metestrous and
      proestrous females, and LHRH antagonist blunted the increases. In OVX females, LH
      decreased after NMA. FSH was not affected by NMA in any group. PRL increased
      after NMA in proestrous and metestrous animals. LHRH caused surge-like LH and
      small FSH increases in vehicle groups; these increases did not differ in
      amplitude between intact and OVX animals and were blunted by pretreatment with
      LHRH antagonist. In experiment 3, 10 diestrous rats were fitted with atrial
      catheters and were serially bled at 2-h intervals from 1200 h on the following
      day (proestrus) until 0600 h on estrus morning. After the first sample the
      animals were injected s.c. with 0.2 mg/kg MK801, a noncompetitive NMA receptor
      antagonist, or with saline. Four of the 5 saline-treated animals exhibited surges
      of LH and FSH as well as elevated progesterone levels, with LH and progesterone
      peaking at 2000 h. Five of 5 MK801-treated animals failed to have elevated LH,
      FSH, or progesterone levels at any time point. These data demonstrate that LHRH
      mediates the LH response to NMA in rats and that endogenous NMA receptor binding
      may be necessary for the preovulatory gonadotropin surges. The lack of FSH
      responses to NMA during periods of low-level gonadotropin secretion suggests that
      physiological increments in endogenous LHRH secretion sufficient to induce a
      pulse of LH are insufficient to stimulate pulse-like FSH release.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8485253
TI  - Differential gonadotropin responses to N-methyl-D,L-aspartate in intact and
      castrated male rats.
AB  - Peripheral administration of N-methyl-D,L-aspartate (NMA), a neuroexcitatory
      amino acid agonist, probably stimulates LH release through an increase in
      endogenous LHRH secretion. In the present study, NMA and a potent LHRH antagonist
      were used to determine the degree to which release of FSH is similarly dependent
      upon the acute secretion of LHRH. A second aim was to compare responsiveness of
      LHRH neurons to NMA in castrated and intact male rats. Adult male rats were
      castrated (n = 10) or sham castrated (n = 11) on the morning of Day 0. After 8
      days, rats were fitted with atrial catheters between 0900 and 1200 h; at 2100 h
      they received s.c. either oil vehicle or 100 micrograms of an LHRH antagonist.
      Starting at 0900 h on Day 9, 0.5-ml blood samples were collected every 10 min for
      3 h. After 1 h of sampling each animal received i.v. 5 mg of NMA in 0.5 ml 0.9%
      saline. An hour later each rat received i.v. 500 ng of LHRH in 0.5 ml saline.
      Plasma LH, FSH, and prolactin (PRL) levels were determined by RIA. In the oil
      treated sham castrates, mean plasma LH levels were increased by 110% (p < 0.01)
      within 10 min and remained elevated for 30 min after the injection of NMA. The
      profile of this LH secretory response was similar to or slightly more robust than
      endogenous LH pulses observed previously. The NMA-induced LH release was
      completely blocked by pretreatment with LHRH antagonist. In both oil- and
      antagonist-treated sham-castrated rats, NMA administration failed to elicit a
      concomitant increase in plasma FSH levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485254
TI  - Catecholamines stimulate testicular steroidogenesis in vitro in the Siberian
      hamster, Phodopus sungorus.
AB  - We have examined direct effects of catecholamines on testicular testosterone
      production in a seasonally breeding species, the Siberian hamster, Phodopus
      sungorus. Testicular parenchyma from gonadally active long photoperiod (LD)
      exposed and gonadally regressed short photoperiod (SD)-exposed animals was
      incubated for 6 h with norepinephrine, epinephrine, beta-adrenoceptor agonist
      isoproterenol, or alpha-adrenoreceptor agonist phenylephrine (all at 10 microM),
      as well as with various concentrations of norepinephrine (10 nM-10 microM), and
      10 microM norepinephrine with or without hCG (0.7, 3.1, and 12.5 mIU/ml). In
      addition, effects of alpha-adrenoreceptor antagonist prazosin and beta
      adrenoreceptor antagonist propranolol (50 microM) were tested in the incubations
      containing 10 microM norepinephrine. In the incubations of testes from both LD
      and SD Siberian hamsters, norepinephrine was most effective in stimulating
      testosterone production, followed by epinephrine and phenylephrine, while
      isoproterenol failed to increase testosterone accumulation. The stimulatory
      effects of norepinephrine were dose-dependent and were prevented by coincubation
      with prazosin, but not affected by coincubation with propranolol. In combination
      with various doses of hCG, norepinephrine failed to stimulate testosterone
      production above the levels obtained with hCG alone. These data indicate that the
      testicular receptors mediating the action of catecholamines on testicular
      steroidogenesis in Phodopus sungorus are of the alpha 1-subtype, a result in
      accordance with a previous study in the golden hamster. However, the results of
      the present study are strikingly different from the findings obtained in the
      golden hamster in terms of the effects of photoperiod on the responsiveness of
      testicular steroidogenesis to catecholamines.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485255
TI  - Effects of chimerism in sheep-goat concepti that developed from blastomere
      aggregation embryos.
AB  - Chimeric sheep-goat pregnancies were established in 24 ewes and 29 does by
      transferring 251 embryos, prepared by the blastomere-aggregation technique, to 52
      ewes and 61 does. Fifteen does experienced early pregnancy failure; however, term
      offspring were delivered by 24 ewes (17 lambs, 3 kids, 6 chimeras) and 14 does (6
      lambs, 9 kids, 6 chimeras). (Fetal classifications were based on phenotype, red
      blood cell isozymes, and lymphocyte antigen expression). RIAs for ovine and
      caprine placental lactogen detected chimerism in the binucleate cell population
      of the trophoblast throughout the pregnancies of 2 ewes and 7 does; these
      pregnancies resulted in the birth of 12 healthy offspring. Histological
      examinations of intact placentomes from 2 of these recipients revealed a
      continuous cellular trophoblast apposed to a syncytium as in normal placentas.
      Chimerism was detected electrophoretically in the membranes of the placentas with
      binucleate cell chimerism and in 17/28 of the other placentas. Data collected on
      placental lactogen production, chimerism in the conceptus, and placental
      morphometry were examined with respect to the stages of the blastomeres
      aggregated to form the chimeric embryo and with respect to fetal status at
      delivery. For comparison, analogous data were collected on sheep-goat concepti
      that developed from embryos prepared by inner cell mass transplantation.

PMID- 8485256
TI  - Uterine extracellular fluid volume and blood flow after artificial uterine
      stimulation to rats differentially sensitized for the decidual cell reaction.
AB  - Uterine extracellular fluid volume (ECFV) and blood flow (BF) were assessed after
      unilateral intrauterine injection of sesame oil to rats given either ideal
      sensitization for the decidual cell reaction or one of several forms of non-ideal
      sensitization. The study was intended to determine how changes in uterine ECFV
      and BF might contribute to the Evans blue dye reaction that can be elicited
      during early decidualization. Uterine ECFV was determined by the uterine volume
      of distribution of 51Cr-EDTA after its i.v. injection; BF was determined by the
      radioactive microsphere technique. ECFV was significantly greater in oil-injected
      than in control horns by 8 h after deciduogenic stimulation, reaching a maximum
      of 0.63 +/- 0.06 microliter/mg (p < 0.05) in oil-injected horns at 16 h. Ideal
      temporal sensitization and sensitization with estrogen both were essential to
      obtain the significantly increased ECFV in stimulated horns. Although absolute
      uterine BF increased to oil-injected horns, the increase matched uterine weight
      gains, making relative uterine BF similar for both horns (3-4 microliters/min/mg)
      at all times after unilateral deciduogenic stimulation. Ideal sensitization did
      not significantly alter the relative uterine BF. The increase in ECFV occurs at a
      similar time and requires the same ideal sensitization as the stimulation-induced
      increase in endometrial vascular permeability described previously, suggesting
      that these events are under similar control. We suggest that enzymatic changes to
      the uterine extracellular matrix may contribute to the Evans blue reaction by
      creating a larger compartment into which protein-dye complexes may
      diffuse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485257
TI  - Hypothalamus-pituitary-ovarian axis in cyclic rats lacking progesterone actions.
AB  - Antagonizing diestrous progesterone actions in cyclic rats by s.c. injections of
      the antiprogesterone RU486 (2 mg twice a day from metestrus through proestrus)
      increased LH and decreased FSH basal serum concentrations. Ovariectomy at
      metestrus (0800 h) increased serum levels of both gonadotropins in controls and
      reversed the RU486-induced dissociation of basal gonadotropin secretion. RU486
      dissociated gonadotropin secretion is also dependent upon LHRH, since treatment
      (s.c.) with 1 mg GnRH antagonist (ORG 30276) twice a day on metestrus and
      diestrus completely prevented both the RU486-induced increase in LH and the
      decrease in FSH serum concentrations. The LHRH content in the medial basal
      hypothalamus and median eminence increased on proestrous morning in RU486-treated
      rats. The LH pituitary response to an exogenous i.v. bolus of 25 ng LHRH
      (Peninsula 7201; Peninsula Laboratory, Inc., Merseyside, UK) at 1700 h on
      diestrus was enhanced in rats treated with RU486. No differences in pituitary FSH
      response were noted with respect to oil-injected rats. The pituitary content of
      both gonadotropins decreased in RU486-treated rats on proestrous morning. All
      these effects due to RU486 in cyclic rats were reversed by ovariectomy.
      Testosterone serum levels increased significantly from diestrus onward, and the
      estradiol concentration increased on proestrous morning in RU486-treated rats.
      Ovariectomy as well as LHRH antagonist treatment eliminated the effects of RU486
      on ovarian steroid production. Moreover, antiestrogen tamoxifen treatment
      reversed RU486-dissociated gonadotropin secretion, while antiandrogen flutamide
      treatment had no effect. The results of this experiment have confirmed previous
      findings that RU486 treatment dissociates basal gonadotropin secretion in cyclic
      rats. In addition, the present results show that: (1) this effect of RU486 is not
      due to a direct effect of this compound or to the blockade of progesterone action
      at a central level; (2) the effect of RU486 on pituitary gonadotropin secretion
      depends on ovarian substances other than progesterone and LHRH, since it is
      reversed by ovariectomy and completely abolished by LHRH antagonist treatment;
      (3) the reduction in FSH serum levels in rats treated with RU486 seems to be
      exerted by inhibin and estradiol at the pituitary level by reducing FSH synthesis
      and secretion; and (4) the hypersecretion of LH in rats treated with RU486, as
      compared to that resulting from ovariectomy, seems to be the consequence of,
      first, a lack of progesterone inhibitory action on LH secretion, and, second, an
      inappropriate feedback system involving increased hypothalamic LHRH activity and
      pituitary sensitivity to LHRH of moderately high levels of estradiol in the
      presence of abnormally high levels of testosterone.

PMID- 8485258
TI  - Long-term effect of a urinary chemosignal on reproductive fitness in female mice.
AB  - The effect of synthetic 2,5-dimethylpyrazine (a compound naturally produced by
      grouped females) on the overall reproductive success of female mice was
      investigated. The exposure of tested females to control or experimental stimuli
      began on the day of birth and lasted throughout maturation, mating, pregnancy,
      and the lactating of their first litters. Females exposed to this urinary
      compound attained their first estrus significantly later than the animals exposed
      to water only. On average, the prepubertal, exposed females reached puberty 3.7
      to 3.9 days later than the unexposed animals. The females in which puberty was
      delayed by this synthetic chemosignal did not show a single fully completed
      estrous cycle before the age of 35 days. Only 52-64% of exposed females
      successfully bred and reared their litters as compared to 86-96% of the
      unexposed, control females (p < 0.05). A significantly higher mortality of pups
      associated with 2,5-dimethylpyrazine exposure during lactation was observed. The
      reproductive deficit displayed by females born into a 2,5-dimethylpyrazine
      environment is qualitatively similar to the effect observed in dense populations,
      in both laboratory and free-living conditions.

PMID- 8485259
TI  - Effects of decidual cell supernatants and lymphokines on murine trophoblast
      growth in vitro.
AB  - Blastocysts were flushed from CD1 mice and were cultured in plastic or laminin
      coated plates as an in vitro model of implantation. The purified cytokines
      epidermal growth factor (EGF) and platelet-derived growth factor (PDGF) markedly
      stimulated 3H-thymidine incorporation; but recombinant murine granulocyte
      macrophage colony-stimulating factor (GM-CSF), which might be produced by
      alloantigen-stimulated T cells at the feto-maternal interface, had no growth
      stimulating effect. Indeed, higher nonphysiological concentrations of GM-CSF
      manifested a toxic inhibition. Surprisingly, a purified nonrecombinant murine GM
      CSF preparation induced proliferation of both blastocyst and ectoplacental cone
      trophoblast whereas recombinant murine (and human) GM-CSF had no effect,
      indicating that the growth stimulation may have been due to a contaminant.
      Decidual supernatants prepared on Days 5.5-6.5 of pregnancy from mice with high
      abortion rates (DBA/2-mated CBA/J) had no toxic or stimulating effect on
      blastocyst trophoblast outgrowth compared to similarly prepared supernatants from
      low-abortion-rate DBA/2-mated C3H/HeJ mice. These data suggest that it is not GM
      CSF that is crucial for the trophoblast proliferation that determines the success
      of pregnancy.

PMID- 8485260
TI  - The African-American cancer crisis, Part II: A prescription.
AB  - To appreciate the causes of the African-American cancer crisis, contemporary
      myths and perceptual gaps regarding cancer in blacks must be analyzed and placed
      in historical context. Since ancient times, racism has permeated western
      scientific, medical, and social cultures. Yet contemporary analysts typically
      frame a 370-year-old African-American health deficit in nonracial terms, and
      ignore both the metamorphosis of racism and the impact of racism on the
      prevention, diagnosis, and treatment of cancer; exposure to cancer-causing
      industrial pollutants; educational opportunities for black health professionals
      and policymakers, and other factors. If the African-American cancer crisis is to
      be halted, the growing divergence between urgent needs and meager resources
      devoted to preventing, detecting, and treating cancer in blacks must be sharply
      reversed.

PMID- 8485261
TI  - The effectiveness of Florida's "Improved Pregnancy Outcome" program.
AB  - The development of a national program to assure access to prenatal care for all
      women, regardless of income, is believed to be an effective means of reducing low
      birthweight and neonatal mortality in the U.S. Yet scarce empirical evidence
      concerning the effectiveness of large-scale prenatal care programs is available.
      This paper summarizes an evaluation of a statewide public prenatal care program
      which grew out of the federal Improved Pregnancy Outcome (IPO) project. Using
      linked birth and infant death-certificate data, and IPO program records from a
      four-year period (1985-1988), this study compares the neonatal mortality rates of
      participants of Florida's IPO program with those of a matched comparison group.
      The results indicate an inverse relationship between IPO participation and the
      risk of neonatal mortality in a low-income population. These findings suggest
      that large-scale prenatal care programs can be effective in improving birth
      outcomes.

PMID- 8485262
TI  - No more "Let them eat admonitions": the Clinton Administration's emerging
      approach to minority health.
AB  - The startling health disparities between whites and racial and ethnic minorities
      in the United States are partly the result of six major assumptions about health
      promotion that permeated the Reagan and Bush Administrations. These assumptions,
      which placed the responsibility for maintaining health on individual Americans,
      are consistent with policymakers' reliance on market forces to address social
      issues. While this model may serve persons with a continuum of options and
      resources to elicit change, it does not benefit the underserved. In contrast, the
      Clinton Administration's approach, rooted in broad-based participation and
      multisector planning, is consistent with international models and promises long
      overdue recognition that health problems in underserved communities stem from
      poverty--not the poor.

PMID- 8485263
TI  - The African-American cancer crisis, Part I: The problem.
AB  - Over the past 40 years, increasing numbers of Americans have benefited from
      cancer prevention, early detection, and improved treatment. But a review of site
      specific cancer data from 1950 to the present shows that contemporary African
      Americans have the highest age-adjusted rates of cancer incidence and mortality
      of any racial or ethnic group in the United States. Compared to whites, blacks
      have significantly higher incidence rates for cancers of the lung, prostate,
      breast (under age 40), colon, pancreas, esophagus, cervix, larynx, stomach, and
      multiple myeloma. Blacks have significantly higher mortality rates for cancers of
      the lung, prostate, breast (all ages), colon, pancreas, esophagus, cervix,
      uterine corpus, larynx, stomach, and multiple myeloma. Moreover, the gap between
      whites and blacks is widening dramatically. These startling statistics suggest
      that cancer researchers and policymakers, and the institutions they represent,
      may not fully appreciate the black cancer experience.

PMID- 8485264
TI  - Review article: immunosuppressive therapy for inflammatory bowel disease.
AB  - Refractory inflammatory bowel disease can be treated by surgery or using
      nutritional supplementation or replacement. Immunosuppressive agents may also
      play a role for refractory disease; they have gained widespread acceptance, due
      not only to trials that demonstrate efficacy but also to the realization that
      these side-effects are minor compared to those associated with long-term, high
      dose corticosteroids. To date, 6-mercaptopurine and azathioprine remain the drugs
      of choice based upon extensive clinical experience, but both methotrexate and
      cyclosporin are promising immunosuppressants for otherwise refractory disease.

PMID- 8485265
TI  - Review article: topical corticosteroids in inflammatory bowel disease.
AB  - It would be ideal to treat inflammatory bowel disease with topical
      corticosteroids that are either not absorbed through the mucosa, or have a
      substantial first-pass hepatic metabolism. The topical use of hydrocortisone,
      prednisolone-21-phosphate or betamethasone is often associated with systemic side
      effects. Newer corticosteroid preparations (prednisolone metasulphobenzoate,
      tixocortol pivalate, fluticasone propionate, beclomethasone dipropionate and
      budesonide) are usually associated with minimal systemic corticosteroid activity.
      This article reviews the clinical activity and safety of these newer
      preparations.

PMID- 8485266
TI  - Efficacy of bile acid therapy for gallstone dissolution: a meta-analysis of
      randomized trials.
AB  - To define better the efficacy of bile acid therapy for dissolution of radiolucent
      gallstones, we performed a meta-analysis of published trials from January 1966 to
      September 1992. Studies were identified using a MEDLINE computer search followed
      by an extensive manual search. The inclusion criteria used were: randomized
      trial, radiolucent gallstones in a visualizing gallbladder on oral
      cholecystography, and complete stone dissolution confirmed by oral
      cholecystography or ultrasound. Study results were pooled into 6 groups: placebo:
      high- and low-dose chenodeoxycholic acid (CDCA) (> or = 10 mg.kg/day and < 10
      mg.kg/day); high- and low-dose ursodeoxycholic acid (UDCA) (> or = 7 mg.kg/day
      and < 7 mg.kg/day) and combined CDCA plus UDCA. Homogeneity calculations were
      performed and the percentage of complete stone dissolution calculated for each
      group with 95% confidence intervals. Of 66 trials identified, 23 comprising 1949
      patients met the inclusion criteria. A total of 1062 patients were treated with
      CDCA, 819 with UDCA and 78 combination therapy. In studies > 6 months' duration,
      high-dose UDCA completely dissolved stones in 37.3% of patients (95% C.I. 33
      42%), low-dose UDCA in 20.6%) and high-dose CDCA 18.2% (95% C.I. 15-21%). Based
      on only two studies, combination therapy achieved dissolution in 62.8% (95% C.I.
      51-74%) of patients. Stones less than 10 mm dissolved significantly more
      frequently than stones larger than 10 mm. This analysis shows that UDCA in doses
      greater than 7 mg.kg/day taken for greater than 6 months will dissolve
      radiolucent gallstones in 38% of patients. The combination of UDCA and CDCA may
      be more efficacious but this observation is based upon only 78 patients and
      requires confirmation in further randomized trials.

PMID- 8485267
TI  - Two-week eradication regimen for metronidazole-resistant Helicobacter pylori.
AB  - At present there is no generally accepted treatment regimen for eradicating
      metronidazole-resistant Helicobacter pylori. This study determines the
      eradication rate after treatment with 40 mg omeprazole o.m. and 500 mg
      amoxycillin q.d.s. for 14 days, with 120 mg tripotassium dicitrato bismuthate
      q.d.s. for the first week (Days 1-7) and 750 mg ciprofloxacin b.d. for the second
      week (Days 8-14). Thirty patients (16 male, mean age 45 years, range 16-80 years)
      with duodenal ulcers (n = 18) or non-ulcer dyspepsia (n = 2) and metronidazole
      resistant H. pylori detected by histology, culture, in vitro sensitivity tests
      and a positive 13C-urea breath test entered the study. Follow-up was by 13C-urea
      breath test at the end of treatment and at 1, 3, 6, and 12 months. Eradication
      was defined as a negative 13C-urea breath test at least 1 month after finishing
      treatment. H. pylori was successfully eradicated in 21/30 (71%) patients (median
      follow-up 10.2 months, range 4-12 months). A pre-treatment ciprofloxacin
      resistant strain was isolated in 1/9 patients in whom eradication failed. Of 30
      patients 29 completed the 2-week regimen; one patient experienced dizziness after
      3 days of treatment. The most common side-effect was increased stool frequency (n
      = 6). This 2-week treatment regimen for metronidazole-resistant H. pylori is well
      tolerated and achieves an eradication rate of 70%.

PMID- 8485268
TI  - Oral tobramycin in ulcerative colitis: effect on maintenance of remission.
AB  - Oral tobramycin for 7 days has been shown to be of benefit as an adjunct to
      conventional medication in acute ulcerative colitis. Eighty-one patients (40 who
      had received tobramycin; 41 placebo) who had been enrolled in a double-blind
      placebo-controlled trial of this drug in acute disease were subsequently followed
      to determine whether this short-term benefit persisted. Relapse was defined as a
      liquid stool frequency of three times daily with rectal bleeding. Results were
      analysed by the log-rank test on Kaplan-Meier survival curves. Treatment failure
      was defined as a lack of response by the end of the acute trial period, or
      subsequent relapse. In a second analysis, only those entering remission at the
      end of the acute trial were considered, and followed to relapse. Although at the
      start of the follow-up period significantly fewer patients in the tobramycin
      group had failed (failed: tobramycin 9, placebo 24; not failed tobramycin 31;
      placebo 17; P = 0.001), the failure-free survival curves subsequently converged
      and did not differ significantly. After 1 and 2 years, the failure-free survival
      rates were 40% (S.E. = 7.8%) and 20% (S.E. = 6.3%) for the tobramycin group and
      24% (S.E. = 6.7%) and 12% (S.E. = 5.1%) for the placebo group. When only those
      entering remission were considered, there was no significant difference in the
      relapse rates in the two groups. Benefit from tobramycin is therefore short-lived
      and may reflect short-term changes in the faecal flora.

PMID- 8485269
TI  - A randomized controlled study of evening primrose oil and fish oil in ulcerative
      colitis.
AB  - In a placebo-controlled study, 43 patients with stable ulcerative colitis were
      randomized to receive either MaxEPA (n = 16), super evening primrose oil (n =
      19), or olive oil as placebo (n = 8) for 6 months, in addition to their usual
      treatment. Treatment with MaxEPA increased red-cell membrane concentrations of
      eicosapentaenoic acid (EPA) at 3 months by three-fold and at 6 months by four
      fold (both P < 0.01), and doubled docosahexaenoic acid (DHA) levels at 6 months
      (P < 0.05). Treatment with super evening primrose oil increased red-cell membrane
      concentrations of dihomogamma-linolenic acid (DGLA) by 40% at 6 months (P <
      0.05), whilst treatment with placebo reduced levels of DGLA and DHA at 6 months
      (both P < 0.05). Clinical outcome was assessed by patient diary cards,
      sigmoidoscopy and histology of rectal biopsy specimens. Super evening primrose
      oil significantly improved stool consistency compared to MaxEPA and placebo at 6
      months, and this difference was maintained 3 months after treatment was
      discontinued (P < 0.05). There was however, no difference in stool frequency,
      rectal bleeding, disease relapse, sigmoidoscopic appearance or rectal histology
      in the three treatment groups. Despite manipulation of cell-membrane fatty acids,
      fish oils do not exert a therapeutic effect in ulcerative colitis, while evening
      primrose oil may be of some benefit.

PMID- 8485270
TI  - Efficacy of long-term therapy with low doses of omeprazole in the control of
      gastric acid secretion in Zollinger-Ellison syndrome patients.
AB  - Thirteen patients with Zollinger-Ellison syndrome were investigated: 8 without,
      and 5 with, previous gastric surgery. After 7-34 months of treatment with
      famotidine, 8 out of 13 patients were resistant to this drug. Omeprazole 60
      mg/day was administered to these 8 patients; after one month, the dose was
      reduced to 40 mg/day, and after another month to 20 mg/day. Basal acid secretion
      was inhibited by every dose of omeprazole. The patients were then treated with a
      low dose (20 mg/day) of omeprazole for a longer period. Periodic clinical and
      endoscopic assessments, and measurement of basal acid secretion showed the
      efficacy of this low dose of omeprazole in our Zollinger-Ellison syndrome
      patients. The drug was discontinued after 12-32 months of omeprazole treatment,
      and gastric acid recovery was evaluated. Four patients recovered 50% of their
      'initial basal acid secretion' after 5 days, while two patients who had been
      treated with omeprazole for a longer time (30-32 months) recovered only 38 and
      40%, respectively, of their 'initial basal acid secretion' at the tenth day. Our
      results indicate that the omeprazole dosage to be used in the treatment of
      Zollinger-Ellison syndrome must be chosen principally on the basis of basal acid
      secretion determination. A low daily dose of omeprazole is able to control acid
      secretion in Zollinger-Ellison syndrome for a long period (10-30 months). The
      slow recovery of gastric secretory function demonstrates the prolonged inhibitory
      effects of omeprazole.

PMID- 8485271
TI  - Cisapride in the treatment of gastro-oesophageal reflux disease.
AB  - Prokinetic agents are being used increasingly in medical therapy for gastro
      oesophageal reflux disease (GERD). This study examined the effect of 10 mg
      q.d.s., oral cisapride, or placebo, taken for 12 weeks, on 48 patients with
      symptoms and endoscopic evidence of GERD. Objective evaluation of benefit was
      obtained by endoscopy and biopsy, oesophageal manometry, acid reflux provocation
      test and 24-h oesophageal pH monitoring. Cisapride significantly increased lower
      oesophageal sphincter pressure (P = 0.003) against baseline and also against
      placebo, in patients (n = 9) with an hypotensive lower oesophageal sphincter
      pressure (P < 0.01). The frequency of dyspeptic symptoms was significantly
      improved in the cisapride group (P = 0.03). Antacid intake, global evaluation of
      symptoms and a VAS score for symptoms were all better than placebo but failed to
      reach significance (global evaluation by patients, P = 0.07). Overall, there was
      no significant improvement in oesophagitis at either 6 weeks (P < 0.05 > 0.3) or
      12 weeks (P = 0.07). However, if patients with grades I and II oesophagitis at
      entry were excluded, cisapride had a significantly greater effect than placebo, 6
      weeks (P = 0.05), 12 weeks (P = 0.04). In those with oesophageal ulceration,
      cisapride was significantly more effective than placebo in inducing healing.
      Gastro-oesophageal reflux was very variable on both 24-h pH monitoring and acid
      reflux provocation test. In spite of a 50% decrease in acid exposure on 24-h pH
      monitoring (cisapride group, mean % pH < 4 day: entry 18.9%, 12 weeks 9.6%),
      there were no significant intra- or intergroup differences for percentage of time
      < pH 4, or frequency and duration of episodes, neither pre- or post-prandially,
      day or night, except for the number of post-prandial episodes during acid reflux
      provocation tests, which decreased significantly more with cisapride than with
      placebo (P < 0.05). Thus, oral cisapride when taken for 12 weeks promoted healing
      of oesophagitis and improved symptoms in patients with GERD; although an increase
      in lower oesophageal sphincter pressure was observed and a reduction in acid
      reflux was measured, no significant decrease of acid exposure was seen.

PMID- 8485272
TI  - The effects of lansoprazole, 30 or 60 mg daily, on intragastric pH and on
      endocrine function in healthy volunteers.
AB  - Seven days of dosing with either 30 mg or 60 mg of lansoprazole were compared
      with placebo in a double-blind, randomized, three-way cross-over study in 12 male
      healthy volunteers. Twenty-four-hour intragastric pH was measured after 7 days of
      dosing with each regimen, as well as 3 and 7 days after the end of dosing. During
      dosing with placebo, intragastric pH was above 4 for a median of 51 minutes. pH
      values were significantly raised to above 4 for 8.45 and 8.33 hours on Day 7 of
      dosing with lansoprazole 30 and 60 mg, respectively, but returned to normal by
      the third day after stopping dosing. No clinically relevant influence on
      endocrine function (serum concentrations of insulin, aldosterone, testosterone,
      parathormone, glucagon, T3, T4, TSH, LH, FSH, STH, prolactin, circadian cortisol
      profile, ACTH test) was observed. No serious adverse clinical or laboratory
      events were noted.

PMID- 8485273
TI  - Ileo-caecal ulceration associated with the use of diclofenac slow release.
AB  - A 38-year-old man with seropositive arthropathy on long-standing treatment with
      diclofenac slow release presented with abdominal pain, diarrhoea and anaemia.
      Upper gastrointestinal endoscopy and barium series were unremarkable. Five months
      later he presented with a right iliac fossa mass. Investigations revealed
      discrete ulceration in the terminal ileum and caecum confirmed at laparotomy.
      Other possible causes of intestinal ulceration were excluded suggesting a
      diagnosis of non-steroidal anti-inflammatory drug associated intestinal
      ulceration.

PMID- 8485274
TI  - Effect of methylprednisolone on small bowel, spleen and liver changes in a murine
      model of inflammatory bowel disease.
AB  - The aim of this study was to evaluate the influence of methylprednisolone (1
      mg/kg, i.p.) on inflammatory lesions in the small bowel, liver (pericholangitis)
      and spleen (lymphofollicular proliferation), in a model of inflammatory bowel
      disease induced by 2.4-dinitrofluorobenzene in previously sensitized BALB-c mice.
      As a parameter of corticosteroid anti-inflammatory and immunosuppressive action,
      we simultaneously investigated its effects on mononuclear cell accumulation
      within the ileal lamina propria and submucosa during the observed time period (1
      30 days). We noted a significant decrease in accumulation of mononuclear cells
      within the lamina propria (P < 0.001). An effect on mononuclear cell infiltration
      within the ileal submucosa was also noted but was not statistically significant.
      In addition, pericholangitis in the liver and lymphofollicular proliferation in
      the spleen were not observed in the experimental group during treatment with
      methylprednisolone. The results of this study indicate that the previously
      described model of intestinal inflammation could be used in further research of
      present and new therapeutic modalities for inflammatory bowel disease.

PMID- 8485275
TI  - Rolling review: upper gastrointestinal bleeding.

PMID- 8485276
TI  - Short report: effect of ranitidine on duodenal ulcer healing in patients with
      cirrhosis of the liver.
AB  - The effect of ranitidine (300 mg daily) on the healing of acute duodenal ulcer
      was investigated in patients with and without cirrhosis of the liver. Of the 109
      patients who entered the study, two patients from each group were excluded.
      Healing rates after 4 and 8 weeks were significantly different between patients
      with cirrhosis and controls (4- and 8-week healing rates in cirrhotics and non
      cirrhotics: 49 and 69%, and 71 and 91%, respectively). This study demonstrates
      that duodenal ulcer healing is delayed in patients with cirrhosis.

PMID- 8485277
TI  - [Transjugular intrahepatic portosystemic shunt].

PMID- 8485278
TI  - [A prognostic multifactorial study of sepsis in an internal medicine service].
AB  - All cases of sepsis attended at the Service of Internal Medicine from 1985 to
      1989, both inclusive, were retrospectively analyzed by the statistical study of
      several clinical, epidemiological, bacteriological and laboratory factors. The
      parameters acting as prognosis factors were analyzed using Cox's method of
      logistic regression, in order to obtain more reliable information on the
      multifactorial spectrum determining "death due to sepsis". The unifactorial
      analysis (UFA) suggested that the following factors were associated to an
      statistically significant increase in the mortality due to sepsis: age above 70;
      male sex; presence of shock upon hospitalization; nosocomial etiology; high
      levels of urea, creatinine and LDH; proteinuria; family of the causal germ (gram
      positive coccus) and underlying pathology. The relative risks (RR) or "odd
      ratios" of creatinine and LDH were, respectively, 2.8 and 2.9 in the UFA; 3 and
      3.3 in the multivariant analysis (MVA). In the older patients developing sepsis
      within their communities, RR were respectively 2.7 and 1.98 in the UFA and 1.1
      and 2.7 in the MFA. The results of the univariant and multivariant analysis
      showing the relative risk (odd ratio) associated to each of these variables with
      statistical significance, demonstrate that the mortality rate due to sepsis
      increases with age, nosocomial etiology and elevation of creatinine and
      lactodehydrogenase (LDH) levels. We stress the great importance of the LDH as a
      prognostic factor of sepsis.

PMID- 8485279
TI  - [The value of pulse oximetry during the performance of a forced spirometry
      maneuver].
AB  - Given that forced spirometry is the main routine exploration in any laboratory of
      pulmonary functional assessment, we have analyzed the behaviour of O2 arterial
      saturation (SaO2) during such maneuver in patients with airflow chronic
      obstruction (AFCO), in order to verify any potential alterations. We have studied
      three groups of patients: Group A, control, 17 healthy subjects; group B, 18
      patients with AFCO and initial saturation higher than 90%; group C, 15 patients
      with AFCO and saturation equal to or lower than 90%. Total duration of the
      maneuver was significantly higher in groups B and C compared with the control
      group (p < 0.001). In groups A and B, we did not observed any significant
      reductions in SaO2 with respect to the initial value, although we did observed
      such differences in group C (p < 0.001). None of the patients presented a
      subjective clinical disorder, although the absence of both complexity and risk
      suggest the convenience of including the oximetry as an additional parameter when
      conducting a forced spirometry in patients with AFCO and respiratory failure.

PMID- 8485280
TI  - [The indications for the antipneumococcal vaccine in Spain].
AB  - The anti-pneumococcal vaccine, with 23 capsular polysaccharides, is an effective
      vaccine used in most of the developed countries, although still not commercially
      available in Spain. Between January 1981 and June 1992, we isolated 784
      Streptococcus pneumoniae from clinical samples (excluding asymptomatic carriers),
      728 of which could be serotyped (300 isolated in hemoculture and/or LCR). 91.5%
      of the total and 93.3% of the most invasive strains, as well as 98.1% of the
      penicillin-resistant strains or 98.8% of the isolated multiresistant strains,
      presented a serotype covered by the current vaccine. The high resistance to
      antibiotics of the pneumococcus in Spain makes more urgent the indication of the
      vaccine in our community.

PMID- 8485281
TI  - [Captopril in a single daily dose in arterial hypertension in the elderly. The
      Badajoz cooperative study. The Badajoz Cooperative Group].
AB  - The response to the therapy with captopril administered in one daily dose
      (between 25 and 100 mg) to a group of 468 old patients with arterial hypertension
      has been studied. In 87% of the cases, normalization of the arterial pressure was
      achieved at six months (values lower than 160/95 mmHg). The therapy resulted in a
      progressive reduction during the follow-up period, with a significant initial
      reduction (p < 0.001). Just 7.5% of the patients needed the administration of
      diuretics in addition to the therapy. Just nine patients had to discontinue the
      follow-up due to side effects (dry cough in 4; gastrointestinal disorders in 4;
      postural hypertension in 1 case). We conclude that captopril administered in one
      daily dose is a safe and effective therapy for the treatment of mild to moderate
      arterial hypertension among the elderly.

PMID- 8485282
TI  - [Tuberculous liver abscesses as the form of presentation of human
      immunodeficiency virus infection].
AB  - In patients infected by the human immunodeficiency virus (HIV), it has been
      observed and increase in the incidence of extrapulmonary tuberculosis. Recently,
      the presence of abdominal tuberculous abscesses has been described as a
      manifestation of this form of tuberculous disease. However, hepatic abscesses by
      Mycobacterium tuberculosis are rare among patients infected by the HIV. In the
      literature, just two patients with this type of abscesses have been described as
      a form of presentation of the infection by the HIV. In this paper, we present the
      case of one patient with positive serology to the HIV and two tuberculous
      abscesses at the hepatic level as part of a disseminated tuberculosis. The main
      symptoms were fever and lumbar pain. We established the mycobacterial etiology of
      the abscesses using Ziehl-Neelsen's tinction and culture in Lowenstein's medium
      of the sample isolated from the abscesses. Abscess drainage under echographic
      control, in addition to antituberculous chemotherapy, resulted in a quick
      recovery of the patient, with disappearance of such abscesses as demonstrated by
      the ultrasonic study performed at three months.

PMID- 8485283
TI  - [Tracheobronchopathia osteochondroplastica . Apropos a case].
AB  - We present one case of osteochondroplastic tracheobronchopathy in a patient with
      right laterocervical tumoration as a manifestation of a normofunctional nodular
      goiter detected in a thyroid morphofunctional study, and tracheal stenosis
      secondary both to the goiter and the tracheobronchial process. The coincidence of
      these two processes, probably fortuitous, has never been described before.

PMID- 8485284
TI  - [Imported malaria: 6 cases, 2 of them with an erythrocyte glucose-6-phosphate
      dehydrogenase deficiency].
AB  - We present six cases of imported malaria in Spanish and foreign patients who had
      visited or lived in areas of malaria endemic. Two patients presented deficit of
      erythrocytic glucose-6-phosphate dehydrogenase. The main aspects of these two
      pathologies are analyzed, stressing their similar geographic distribution and the
      mechanisms by which such deficit protects against the malaria infection. In
      addition, we describe the problems that may arise with the use of anti-malaria in
      carriers of this enzymatic deficit; in our patients, the use of chloroquine did
      not raise any problem.

PMID- 8485285
TI  - [Systemic mastocytosis. A little-known disease].

PMID- 8485286
TI  - [Infection in the cancer patient. The management of neutropenic fever].

PMID- 8485287
TI  - [Bearable truth as the crux of information for the cancer patient].
AB  - The communication with the patient suffering cancer is attracting an increasing
      attention. The change of attitudes towards death in our society, the poor
      training of physicians in this field and other factors have raised this new
      problem. In addition to the patient and the physician, the relatives and the
      nursing staff are also involved in the communication process. From the studies
      already performed, it can be derived that the "bearable truth" has to be supplied
      to the patient. The application of this concept needs time and dedication to the
      patient.

PMID- 8485288
TI  - [Acne conglobata and arthritis].

PMID- 8485289
TI  - [Atrial myxoma: its initial manifestations that simulate a systemic disease].

PMID- 8485290
TI  - [Ketoconazole and dexamethasone suppression tests].

PMID- 8485291
TI  - [Acute cocaine poisoning].

PMID- 8485293
TI  - [Marfan's syndrome and thyroid hemiagenesis].

PMID- 8485292
TI  - [Pyomyositis of the sternocleidomastoid due to Staphylococcus aureus].

PMID- 8485294
TI  - Characterization of beta-turns in cyclic hexapeptides in solution by Fourier
      transform IR spectroscopy.
AB  - The beta-turn represents a structural element frequently encountered in globular
      proteins. However, in spite of various theoretical and experimental studies the
      ir signature bands of pure beta-turns are still not established beyond doubt.
      Although considerable information exists now on the ir spectra of alpha-helical
      and beta-sheet structures, the lack of knowledge concerning turn structures in
      general, and that of beta-turns in particular, presents a major uncertainty in
      the estimation of global protein secondary structures from ir spectroscopic data.
      To obtain more specific information about the characteristic amide bands in beta
      turns, we report herein an ir spectroscopic analysis of a series of five cyclic
      pseudo-hexapeptides known to form beta-turns from previous CD and nmr studies [A.
      Perczel, M. Hollosi, B. M. Foxman, and G. D. Fasman (1991) Journal of the
      American Chemical Society, Volume 113, pp. 9772-9784]. We show here that in these
      cyclic peptides the amide groups involved in beta-turns that comprise a ten
      membered hydrogen-bonded ring (and represent the first H-bond pair in a beta
      sheet), give rise to characteristic amide I bands in the range 1638-1646 cm-1,
      with the exact position depending on the solvent and the nature of the side-chain
      substituents.

PMID- 8485296
TI  - Approximation and characterization of molecular surfaces.
AB  - The representation and characterization of molecular surfaces are important in
      many areas of molecular modeling. Parametric representations of protein molecular
      surfaces are a compact way to describe a surface, and are useful for the
      evaluation of surface properties such as the normal vector, principal curvatures,
      and principal curvature directions. Simplified representations of molecular
      surfaces are useful for efficient rendering and for the display of large-scale
      surface features. Several techniques for representing surfaces by expansions of
      spherical harmonic functions have been reported, but these techniques require
      that the radius function is single valued, that is, each ray from an origin
      inside the surface intersects the surface at one and only one point. A new
      technique is described that removes this limitation and can be used to compute
      surface shape properties.

PMID- 8485295
TI  - Peptide design 3(10)-helical conformation of a linear pentapeptide containing two
      dehydrophenylalanines, Boc-Gly-delta ZPhe-Leu-delta ZPhe-Ala-NHCH3.
AB  - alpha,beta-Dehydroamino acids are expected to provide conformational constraint
      to the peptide backbone. A pentapeptide containing two dehydrophenylalanines
      (delta ZPhe) separated by one L-amino acid has been synthesized and its solid
      state conformation determined. The pentapeptide, Boc-Gly-delta ZPhe-Leu-delta
      ZPhe-Ala-NHCH3, crystallizes from aqueous methanol in the orthorhombic space
      group P2(1)2(1)2(1). There are four formula units, C35H46N6O7, in a unit cell of
      dimensions a = 10.155(3), b = 15.175(1), and c = 23.447(2) A, at room
      temperature. The structure was solved by direct methods program, SIR88, and
      refined to a final R = 0.038 based on 3049 reflections with I > 2 sigma (I). All
      the peptide links are trans and the backbone conformation of the pentapeptide can
      be described as a 3(10)-helix, with mean phi,psi values of -65.1 degrees and 
      22.8 degrees (the value is averaged over the first four residues). There are four
      intramolecular 4-->1 type hydrogen bonds characteristic of 3(10)-type helices. In
      the crystal, the helices are held together by intermolecular N-H...O = C head-to
      tail and lateral hydrogen bonding between symmetry related molecules. This mode
      of packing is similar to the packing motifs observed so often in other
      oligopeptides that adopt a 3(10)-helical structure.

PMID- 8485297
TI  - Shape analysis of molecular surfaces.
AB  - The description of molecular shape is important in the analysis of protein
      protein and protein-ligand interactions. We describe volumetric and surface-based
      techniques for computing shape properties of molecular surfaces. The surface is
      defined as an isocontour of an approximate electron density function. Each
      technique can compute several scalar and vector surface properties such as the
      Gaussian and mean curvature, principal curvatures, and principal curvature
      directions. Shape properties are derived from the eigenvalues and eigenvectors of
      a 3 by 3 matrix for each surface point. In the volumetric approach, the matrix is
      the second derivative of an approximate electron density function. In the surface
      based approach, the matrix is the approximate gradient of the surface normal.
      Derivatives are computed by convolving the density or the surface normals with
      the derivatives of a Gaussian function. The variance of the Gaussian determines
      the effective length scale at which the surface is analyzed. Scalar surface
      properties are displayed as colored dots or shaded triangles, and vector
      properties are displayed as line segments from each surface point. This report
      describes the implementation of these procedures and their use in computing the
      shape properties of Cu-Zu superoxide dismutase.

PMID- 8485298
TI  - Photodynamic induction of DNA-protein cross-linking in solution by several
      sensitizers and visible light.
AB  - The combined effect of several sensitizers and light on H2O or D2O solutions of
      DNA-histone complexes, as well as the significance of singlet oxygen (1O2), in
      this photosensitizing reaction has been studied. On H2O solutions, the production
      of 1O2, as well as the formation of DNA-protein cross-links (DPCs), were found to
      be dependent on light dose for all the sensitizers. Mesotetra (4N-methylpyridyl)
      porphine (T4MPyP), methylene blue (MB), and toluidine blue (TB) were the best
      photosensitizers with regard to tryptophan photolysis, followed by
      hematoporphyrin (HP), thioflavine T (TT), and pyronin G (PG). The formation of
      DPCs showed high initial rates, reaching a plateau at doses over 90 J/cm2. Under
      these irradiation conditions, the percentage of DPCs induced by the sensitizers
      decreases in the order T4MPyP > MB > TB >> HP approximately TT >> PG
      (approximately 0). These DPCs were totally destroyed with proteinase K (15
      micrograms/ml). The irradiation of the DNA-histone-sensitizer solutions in the
      presence of L-carnosine (5 x 10(-4) M) produced approximately a 50% of DPCs
      inhibition for T4MPyP, MB, and TB, and a total inhibition for HP, TT, and PG. The
      substitution of H2O by D2O as solvent significantly increased the
      photodegradation of tryptophan, as well as the photoinduction of DPCs by the
      sensitizers. The results obtained indicate that singlet oxygen is the main agent
      responsible in the DNA-protein cross-linking formation.

PMID- 8485299
TI  - Linear dichroism demonstrates that the bases in poly[d(AC)].poly[d (GT)] and
      poly[d(AG)].poly[d(CT)] are inclined from perpendicular to the helix axis.
AB  - Flow linear dichroism is used to measure specific inclinations for each of the
      four bases in poly[d(AC)].poly[d(GT)] and poly[d(AG)].poly[d(CT)] in both the B
      and A forms. For the B form in solution the bases are found to have a sizable
      inclination. Inclination is increased in the A form, as expected. In all cases
      the pyrimidines are more inclined than the purines.

PMID- 8485300
TI  - Conformational preference functions for predicting helices in membrane proteins.
AB  - A suite of FORTRAN programs, PREF, is described for calculating preference
      functions from the data base of known protein structures and for comparing
      smoothed profiles of sequence-dependent preferences in proteins of unknown
      structure. Amino acid preferences for a secondary structure are considered as
      functions of a sequence environment. Sequence environment of amino acid residue
      in a protein is defined as an average over some physical, chemical, or
      statistical property of its primary structure neighbors. The frequency
      distribution of sequence environments in the data base of soluble protein
      structures is approximately normal for each amino acid type of known secondary
      conformation. An analytical expression for the dependence of preferences on
      sequence environment is obtained after each frequency distribution is replaced by
      corresponding Gaussian function. The preference for the alpha-helical
      conformation increases for each amino acid type with the increase of sequence
      environment of buried solvent-accessible surface areas. We show that a set of
      preference functions based on buried surface area is useful for predicting
      folding motifs in alpha-class proteins and in integral membrane proteins. The
      prediction accuracy for helical residues is 79% for 5 integral membrane proteins
      and 74% for 11 alpha-class soluble proteins. Most residues found in transmembrane
      segments of membrane proteins with known alpha-helical structure are predicted to
      be indeed in the helical conformation because of very high middle helix
      preferences. Both extramembrane and transmembrane helices in the photosynthetic
      reaction center M and L subunits are correctly predicted. We point out in the
      discussion that our method of conformational preference functions can identify
      what physical properties of the amino acids are important in the formation of
      particular secondary structure elements.

PMID- 8485301
TI  - Permethylation alters the conformational transitions and the complexing ability
      of melittin: a model for methylated proteins.
AB  - Melittin exhibits a transition from random-coil monomer to helical tetramer as a
      function of peptide concentration [J. Bello, H. R. Bello, and E. Granados (1982)
      Biochemistry, Vol. 21, pp. 461-465]. When permethylated on each of the four amino
      groups (Gly-1 N alpha and Lys-7, 21, and 23 N epsilon) to yield trimethylammonium
      groups, melittin exists as a random coil and does not show any concentration
      dependent conformational transition (up to 290 microM). Acylation of the amino
      groups of melittin with glycine or 5-aminopentanoic acid followed by
      permethylation increases helix formation, but to a lesser extent than for the
      unmethylated aminoacylmelittin derivatives. The results are discussed in relation
      to hydrophobicity, charge repulsions, and ion binding. Melittin, and more weakly,
      permethylated melittin (MLT-Me) form helical hybrids with an anionic random-coil
      melittin analogue (E-MLT), in which all the lysine and arginine residues of
      melittin were replaced by glutamate residues. The hybrid between MLT-Me and E-MLT
      shows a concentration-dependent increase in helicity. E-MLT, when succinylated at
      the N-terminal glycine (E-MLT-suc), forms a stronger hybrid with MLT-Me, possibly
      as a result of increased electrostatic interaction between equal but opposite
      charges in E-MLT-suc (net charge -6) and MLT-Me (net charge +6). The hybrids
      exhibit both cold- and heat-induced denaturation, similar to the phenomenon
      exhibited by proteins. The hybrids also exhibit significant residual structures
      in the temperature range of 80-100 degrees C, which may be similar to the molten
      globular states that have been suggested for proteins.

PMID- 8485302
TI  - Vibrational CD study of the thermal denaturation of poly(rA).poly(rU).
AB  - The vibrational cd (VCD) of a double-stranded RNA, poly(rA).poly(rU), at pH 7 and
      moderate added salt concentration (0.1 M) has been measured in both the base
      stretching and phosphate-stretching regions of the ir as a function of
      temperature. The data in both cases show two distinct phase transitions. The
      first is from double- to a triple-stranded form, and the second is from triple-
      to single-stranded forms, which still retain substantial local order even up to
      80 degrees C. The nature of these transitions has been identified by comparison
      of the VCD and ir absorption spectra of the initially double-stranded samples
      with those of single-stranded poly(rA) and poly(rU) and with triple-stranded poly
      (rA).poly-(rU).poly(rU). The large differences in the VCD band shapes allows
      positive identification of the intermediate and final states. Thus under VCD
      concentration conditions, a simple helix-to-coil transition can be eliminated for
      poly(rA).poly(rU) while such a two-step transition can be seen at low salt
      conditions. All of these observations are consistent with previous studies of the
      phase transitions of poly(rA).poly(rU) under various salt conditions.
      Additionally, the VCD is indicative of premelting for all the triple-, double-,
      and single-strand complexes studied. The triple-strand complex did not show
      disproportionation to double strand on heating under these added salt conditions.
      The unusual VCD pattern for low temperature poly(rA).poly(rU), as compared to
      high G--C content RNAs and DNAs, is qualitatively, but not quantitatively,
      explained using exciton coupling of localized dipolar transitions in each type of
      base within the strand.

PMID- 8485303
TI  - Generation of monoclonal antibodies against HILDA/LIF and their use in the
      quantitative assay of the cytokine.
AB  - An adoptive transfer immunization/fusion protocol in mice has been successfully
      used to raise a series of monoclonal antibodies directed against the Human
      Interleukin for DA-1a (HILDA)/Leukemia Inhibitory Factor (LIF) cytokine. These
      antibodies which were raised using recombinant HILDA/LIF purified from
      conditioned medium of transfected Chinese Hamster Ovary (CHO) cells also react
      with natural HILDA/LIF from the HSB2 T lymphoma cell line and unglycosylated
      HILDA/LIF produced in E. coli. They define four separate epitopes, one of which
      is involved in receptor binding and induction of biological activity. A sensitive
      sandwich immunoradiometric assay which is linear up to 5 ng/ml HILDA/LIF and can
      detect as low as 25 pg/ml of the cytokine has been developed.

PMID- 8485304
TI  - Analysis of enteropathy induced by tumour necrosis factor alpha.
AB  - Tumour necrosis factor (TNF)-alpha has been implicated in the pathogenesis of
      experimental and clinical enteropathy, but its exact role is unknown. We show
      here that a single dose of TNF-alpha causes significant small intestinal
      pathology in normal adult mice, which develops within 15 minutes, persists for up
      to 48 hours and is enhanced by interferon-gamma (IFN-gamma). The enteropathy
      consists of villus atrophy and crypt hyperplasia and is therefore similar to that
      found in immunologically mediated enteropathies such as graft-versus-host
      reaction (GvHR). TNF-alpha is also cytotoxic to an intestinal crypt cell line in
      vitro. Thus, a direct action of TNF-alpha on crypt cells may be involved in its
      enteropathic effects in vivo. Together, these findings indicate that TNF-alpha
      alone, or in concert with other cytokines, may be an important effector molecule
      in immunologically mediated intestinal pathology and may ultimately provide a
      target for specific immunotherapy for clinical enteropathies.

PMID- 8485305
TI  - Different regulatory levels are involved in the generation of hemopoietic
      cytokines (CSFs and IL-6) in fibroblasts stimulated by inflammatory products.
AB  - In this present study we have characterized the array of hemopoietic cytokines
      generated by fibroblasts in response to inflammatory signals. It was shown that
      murine embryo fibroblasts (MEF) are able to generate colony stimulating factors
      (CSFs) [granulocyte-macrophage (GM-CSF), macrophage-CSF (CSF-1) and granulocyte
      CSF (G-CSF)] as well as the hemopoietin interleukin 6 (IL-6), while the
      production of IL-3, IL-4 or tumor necrosis factor (TNF) could not be detected in
      MEF, as assessed by bioassays or expression of specific mRNA. The production of
      colony promoting activity was observed when fibroblasts were stimulated by
      lipopolysaccharide (LPS) or individual cytokines [IL-1, interferon-gamma (IFN
      gamma), IL-2, IL-4 or TNF] in serum-free conditions as well as by serum itself.
      These inducers differentially stimulated in MEF the production of various CSFs;
      LPS induced mainly CSF-1, while cytokines or serum induced equivalent amounts of
      GM-CSF and CSF-1. The production of IL-6 was induced by LPS in serum-free
      conditions, while stimulation by cytokines (IL-1 or IFN-gamma) resulted in IL-6
      production only in serum-supplemented cultures. Serum by itself did not induce IL
      6 production by MEF. The secretion of IL-6 by fibroblasts was detected early and
      peaked after 6 hours, while CSF activity peaked after 24-72 hours, depending on
      the inducer. Constitutive mRNA expression of CSF-1 was detected in serum-free
      conditions in unstimulated MEF, however colony-promoting activity was detected
      only upon stimulation with cytokines, LPS or serum.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8485306
TI  - In-vivo effect of interleukin 3 and erythropoietin, either alone or in
      combination, on the hematopoietic toxicity associated with zidovudine.
AB  - We studied the effect of erythropoietin (EPO) and interleukin 3 (IL-3), either
      alone or in combination, on the hematopoietic toxicity associated with zidovudine
      in vivo, as determined by peripheral blood indices, and assay of hematopoietic
      progenitors, i.e. erythroid (CFU-E/BFU-E), myeloid (CFU-GM) and megakaryocyte
      (CFU-Meg) from bone marrow and spleen. Previous studies from this laboratory have
      established that dose escalation of zidovudine to normal mice induced a dose
      dependent decrease in hematocrit, white blood cells and platelets with altered
      populations of marrow and splenic erythroid, myeloid and megakaryocyte
      progenitors. Daily administration of EPO (50 U/animal, i.p.) and/or IL-3 (5
      U/animal, i.p.) was associated with altered peripheral blood indices and
      progenitor cells. In general, use of EPO and IL-3 alone reduced zidovudine
      induced toxicity, notably in erythropoiesis; however, combination EPO/IL-3 was
      associated with enhanced toxicity with an observed rebound only with the use of <
      2.5 mg/ml drug; 2.5 mg/ml drug in the presence of combination EPO/IL-3
      accelerated zidovudine-erythroid toxicity. A similar response was noted with
      circulating platelets and megakaryocyte progenitors. Use of EPO or IL-3, either
      alone or in combination, failed to reverse zidovudine-induced neutropenia. These
      studies demonstrate that use of EPO or IL-3, either alone or in combination may
      serve as an effective adjuvant therapy to modulate the erythroid toxicity
      associated with lower doses of zidovudine; however, this cytokine therapy was
      ineffective modulating zidovudine-induced myelosuppression when used in vivo. A
      reversal in zidovudine-induced myeloid toxicity, therefore may require the use of
      a myelopoiesis inducing cytokine.

PMID- 8485307
TI  - High-affinity IgG autoantibodies to IL-6 in sera of normal individuals are
      competitive inhibitors of IL-6 in vitro.
AB  - Nano- to picomolar concentrations of high affinity IgG antibody to interleukin 6
      (IL-6ab) were detected in sera of 71 of 467 normal Danish blood donors (15%). IL
      6 bound to the Fab fragments of IL-6ab, and the antibody specifically and
      competitively interfered with enzyme-linked immunosorbent assays for human IL-6.
      Only IL-6ab-positive sera interfered with these ELISAs. A statistically positive
      correlation was found between total IL-6 binding and specific IL-6 binding to
      serum (P < 0.0001), suggesting that IL-6ab dominates as IL-6 binding factors in
      normal human serum. The IL-6ab also inhibited binding of IL-6 to receptors on the
      human U-937 macrophage-like cell line, the human U-266 myeloma cell line and the
      mouse hybridoma cell line B13.29, clone B9 (B9 cells). IL-6-induced proliferation
      of the B9 cells was competitively inhibited by IL-6ab. We conclude that sera of
      normal individuals may contain appreciable levels of autoantibodies to IL-6.
      These IgG autoantibodies may be physiologically and pathophysiologically
      important because they are potent inhibitors of IL-6 in vitro.

PMID- 8485308
TI  - Expression of functional beta-platelet-derived growth factor receptors on
      hematopoietic cell lines.
AB  - The beta-type receptor of platelet-derived growth factor (beta PDGFR) is a class
      III transmembrane receptor with tyrosine kinase activity. The beta PDGFR gene is
      located on mouse chromosome 18 close to the c-fms gene which codes for the colony
      stimulating factor-1 receptor (CSF-1R). We previously reported that in a high
      percentage of myeloblastic leukemias induced by the Friend helper murine leukemia
      virus (F-MuLV), proviruses were integrated in the first intron of the c-fms gene
      leading to an enhanced expression of c-fms mRNA. Since activation by proviral
      insertion can act at long distance, we studied beta PDGF receptor gene expression
      in murine myeloblastic leukemias. This gene was found to be frequently expressed
      but the level of beta PDGF receptor mRNA was weak and not related to proviral
      activation. High affinity binding sites were expressed on myeloblastic cells and
      ligand binding induced cell proliferation. To determine whether beta PDGFR
      expression is a common feature in hematopoietic cells, we tested cell lines
      belonging to other hematopoietic lineages. We found that multipotent stem and
      mast cell lines also expressed the beta PDGF receptor gene. This suggests that
      PDGF, known as a mitogen for connective tissue cells, could also play a role in
      normal hematopoiesis.

PMID- 8485309
TI  - Reliability of fine needle aspiration cytology for distinguishing between
      carcinoma, lymphoma and sarcoma; the influence of clinical information.
AB  - To investigate interobserver variation of fine needle aspiration (FNA)
      cytological diagnosis with respect to distinguishing between carcinoma, sarcoma
      and lymphoma, a set of 80 randomly sampled slides was randomized twice and read
      'blindly' by five cytopathologists. In the first round the slides were read
      without any information, and in the second round clinical information was
      provided. Histology was used as a reference standard. In the first round, the
      positive predictive values for the cytological diagnosis of carcinoma, sarcoma
      and lymphoma were 93%, 94% and 86% respectively. In the second round the positive
      predictive values for the cytological diagnoses of carcinoma, sarcoma and
      lymphoma were 95%, 99% and 99%, respectively. Interobserver variability, tested
      with weighted kappa scores (range 0.73-0.92) between histological and cytological
      diagnosis, was low. The most accurate FNA cytologic classification was obtained
      when the clinical context was known.

PMID- 8485310
TI  - Bladder involvement in disseminated malignant lymphoma diagnosed by voided urine
      cytology.

PMID- 8485311
TI  - Intraocular lymphoma--a case report.

PMID- 8485312
TI  - Disseminated strongyloidiasis: a case report.

PMID- 8485313
TI  - Some aspects of cervical screening in southern New Zealand; the situation before
      implementation of the national cervical cancer prevention programme.
AB  - To gain some idea of cervical screening in Otago and Southland (two southern
      provinces of New Zealand), before the implementation of a national cervical
      cancer prevention programme, a questionnaire was sent to all doctors identified
      as smear takers. Questionnaires were returned by 75% of the doctors. Only 53.8%
      of practice nurses were involved in taking smears. Well Women Clinics staffed by
      nurses were not widespread in either province. Just under half (46.4%) of doctors
      took cervical smears as part of a health check programme. Sixty-three per cent
      (63.3%) routinely performed a pelvic examination when taking a smear.
      Surprisingly few doctors were familiar with the technique of placing spatula and
      cytobrush samples on one slide, a manoeuvre which could significantly reduce the
      workload of the cytology laboratories. Only a minority of doctors were aware of a
      new sampler which can provide samples equivalent to combined spatular-cytobrush
      smears. There was confusion over the timing of a repeat smear following two
      normal ones. The recommended interval of 3 years was only complied with by 44.2%
      of doctors. However, 71.4% of respondents did remind women to have smears. The
      study indicates that many doctors already provide patients with a good cervical
      screening service, and this augers well for the national screening programme.

PMID- 8485314
TI  - The effect of filtration on the cellular components in bronchoalveolar lavage
      fluid.
AB  - The effect of filtration through two layers of cotton gauze on the cellular
      composition of bronchoalveolar lavage (BAL) fluid was studied in 25 patients with
      pulmonary disease. There was no significant difference between median total cell
      count in unfiltered and filtered BAL (P = 0.73) or in the distribution of
      neutrophils or eosinophils. The percentage of bronchial epithelial cells was
      significantly higher in unfiltered than in filtered BAL (P = 0.02). Furthermore,
      differential cell counts showed a significantly lower percentage of alveolar
      macrophages (P = 0.04), and a significantly higher percentage of lymphocytes (P =
      0.04) in unfiltered compared with filtered BAL. Thus, gauze filtration results in
      a loss of bronchial epithelial cells and lymphocytes, and is not recommended in
      the routine analysis of cellular components in BAL fluid.

PMID- 8485315
TI  - Expression of vimentin and epidermal growth factor receptor in effusions from
      patients with breast cancer; correlation with oestrogen and progesterone receptor
      status.
AB  - The epidermal growth factor receptor (EGFr) status and the vimentin (V) status of
      malignant cells in pleural fluids from patients with breast cancer were
      determined using an immunoperoxidase labelling technique. The results were
      correlated with the oestrogen receptor (ER) and the progesterone receptor (PR)
      status of the primary tumour and with disease-free survival time of the patient.
      A negative correlation between EGFr and V status and hormone receptor status was
      found. The longest mean survival time occurred in patients with negative EGFr and
      V status and positive hormone receptor (ER and PR) status. The shortest mean
      survival time occurred in patients with positive EGFr and V and negative ER and
      PR status.

PMID- 8485316
TI  - Fine needle aspiration cytology of myxoid liposarcoma; a study of 18 tumours.
AB  - The cytological features of 18 myxoid liposarcomas from 12 patients were
      analysed. The most consistent cytological features were: abundant myxoid matrix,
      several small tissue fragments with uniform small, round or stellate cells and a
      network of branching thin-walled capillaries. The presence of univacoulated or
      multivacuolated lipoblasts was noted frequently, but not in all aspirates. The
      diagnostic importance of vacuolated lipoblasts and the main problems of
      differential cytodiagnosis are discussed.

PMID- 8485317
TI  - A mitotic role for a novel fission yeast protein kinase dsk1 with cell cycle
      stage dependent phosphorylation and localization.
AB  - The fission yeast dsk1+ gene, a multicopy suppressor for cold-sensitive dis1
      mutants, encodes a novel 61-kd protein kinase. It is a phosphoprotein, and
      phosphoserine is the major phosphorylated amino acid. Hyperphosphorylation of
      dsk1 causes a mobility shift, resulting in two dsk1-specific protein bands. The
      phosphorylation pattern is strikingly altered when cell cycle progression is
      delayed or arrested. The slowly migrating phosphorylated form is prominent in
      mitotically arrested cells, and the fast migrating form is enriched in interphase
      arrested cells. dsk1 is a protein kinase. It auto-phosphorylates as well as
      phosphorylates myelin basic protein (MBP). Phosphotyrosine as well as
      phosphoserine/threonine were found in autophosphorylation, but no tyrosine
      phosphorylation occurs when MBP was used as the substrate. The dsk1
      immunoprecipitates from mitotically arrested cells have a several-fold higher
      kinase activity than that from wild type. The haploid gene disruptant is viable,
      indicating that the dsk1+ gene is non-essential for viability. High dosage of
      dsk1+, however, strongly delays the G2/M progression. Immunofluorescence
      microscopy using anti-dsk1 antibody shows that localization pattern of dsk1
      protein strikingly alters depending on cell cycle stages. In G2-arrested cells,
      dsk1 locates in the cytoplasm, whereas in mitotically arrested cells, nuclear
      stain is intense. In wild-type cells, nuclear stain is seen only in mitotic
      cells. Hence dsk1 protein may play an important role in mitotic control by
      altering cellular location, degree of phosphorylation and kinase activity. We
      discuss possible roles of dsk1 kinase as an add-on regulator in mitosis.

PMID- 8485318
TI  - Requirement for diacylglycerol and protein kinase C in HeLa cell-substratum
      adhesion and their feedback amplification of arachidonic acid production for
      optimum cell spreading.
AB  - Release of arachidonic acid (AA) and subsequent formation of a lipoxygenase (LOX)
      metabolite(s) is an obligatory signal to induce spreading of HeLa cells on a
      gelatin substratum (Chun and Jacobson, 1992). This study characterizes signaling
      pathways that follow the LOX metabolite(s) formation. Levels of diacylglycerol
      (DG) increase upon attachment and before cell spreading on a gelatin substratum.
      DG production and cell spreading are insignificant when phospholipase A2 (PLA2)
      or LOX is blocked. In contrast, when cells in suspension where PLA2 activity is
      not stimulated are treated with exogenous AA, DG production is turned on, and
      inhibition of LOX turns it off. This indicates that the formation of a LOX
      metabolite(s) from AA released during cell attachment induces the production of
      DG. Consistent with the DG production is the activation of protein kinase C (PKC)
      which, as with AA and DG, occurs upon attachment and before cell spreading.
      Inhibition of AA release and subsequent DG production blocks both PKC activation
      and cell spreading. Cell spreading is also blocked by the inhibition of PKC with
      calphostin C or sphingosine. The inhibition of cell spreading induced by blocking
      AA release is reversed by the direct activation of PKC with phorbol ester.
      However, the inhibition of cell spreading induced by PKC inhibition is not
      reversed by exogenously applied AA. In addition, inhibition of PKC does not block
      AA release and DG production. The data indicate that there is a sequence of
      events triggered by HeLa cell attachment to a gelatin substratum that leads to
      the initiation of cell spreading: AA release, a LOX metabolite(s) formation, DG
      production, and PKC activation. The data also provide evidence indicating that
      HeLa cell spreading is a cyclic feedback amplification process centered on the
      production of AA, which is the first messenger produced in the sequence of
      messengers initiating cell spreading. Both DG and PKC activity that are increased
      during HeLa cell attachment to a gelatin substratum appear to be involved. DG not
      only activates PKC, which is essential for cell spreading, but is also hydrolyzed
      to AA. PKC, which is initially activated as consequence of AA production, also
      increases more AA production by activating PLA2.

PMID- 8485319
TI  - The surface cyclic AMP receptors, cAR1, cAR2, and cAR3, promote Ca2+ influx in
      Dictyostelium discoideum by a G alpha 2-independent mechanism.
AB  - Activation of surface folate receptors or cyclic AMP (cAMP) receptor (cAR) 1 in
      Dictyostelium triggers within 5-10 s an influx of extracellular Ca2+ that
      continues for 20 s. To further characterize the receptor-mediated Ca2+ entry, we
      analyzed 45Ca2+ uptake in amoebas overexpressing cAR2 or cAR3, cARs present
      during multicellular development. Both receptors induced a cAMP-dependent Ca2+
      uptake that had comparable kinetics, ion selectivity, and inhibitor profiles as
      folate- and cAR1-mediated Ca2+ uptake. Analysis of mutants indicated that
      receptor-induced Ca2+ entry does not require G protein alpha subunits G alpha 1,
      G alpha 2, G alpha 3, G alpha 4, G alpha 7, or G alpha 8. Overexpression of cAR1
      or cAR3 in g alpha 2- cells did not restore certain G alpha 2-dependent events,
      such as aggregation, or cAMP-mediated activation of adenylate and guanylate
      cyclases, but these strains displayed a cAMP-mediated Ca2+ influx with kinetics
      comparable to wild-type aggregation-competent cells. These results suggest that a
      plasma membrane-associated Ca(2+)-influx system may be activated by at least four
      distinct chemoreceptors during Dictyostelium development and that the response
      may be independent of G proteins.

PMID- 8485320
TI  - Intracellular free Ca2+ in the cell cycle in human fibroblasts: transitions
      between G1 and G0 and progression into S phase.
AB  - Intracellular free calcium ([Ca2+]i) has been proposed to play an important part
      in the regulation of the cell cycle. Although a number of studies have shown that
      stimulation of quiescent cells with growth factors causes an immediate rise in
      [Ca2+]i (Rabinovitch et al., 1986; Vincentini and Villereal, 1986; Hesketh et
      al., 1988; Tucker et al., 1989, Wahl et al., 1990), a causal relationship between
      the [Ca2+]i transient and the ability of the cells to reenter the cell cycle has
      not been firmly established. We have found that blocking the mitogen-induced
      elevation of [Ca2+]i with the cytoplasmic [Ca2+]i buffer dimethyl BAPTA (dmBAPTA)
      also blocks subsequent entry of cells into S phase. The dose response curves for
      inhibition of serum stimulation of [Ca2+]i and DNA synthesis by dmBAPTA are
      virtually identical including an anomalous stimulation observed at low levels of
      dmBAPTA. Reversal of the [Ca2+]i buffering effect of dmBAPTA by transient
      exposure of the cells to the Ca2+ ionophore ionomycin also reverses the
      inhibition of DNA synthesis 20-24 h later. Ionomycin by itself does not stimulate
      DNA synthesis. These data are consistent with the conclusion that a transient
      increase in [Ca2+]i occurring shortly after serum stimulation of quiescent
      fibroblasts is necessary but not sufficient for subsequent entry of the cells
      into S phase. This study is the first to show a direct relationship between early
      serum stimulated Cai2+ increase and subsequent DNA synthesis in human cells. It
      also goes beyond recent studies on BALB/3T3 cells by providing dose response data
      and demonstrating reversibility, which are strong indications of a cause and
      effect relationship.

PMID- 8485322
TI  - Biochemical and cellular basis for potential therapeutic value of n-3 fatty acids
      derived from fish oil.

PMID- 8485321
TI  - Dynamics of microtubules from erythrocyte marginal bands.
AB  - Microtubules can adjust their length by the mechanism of dynamic instability,
      that is by switching between phases of growth and shrinkage. Thus far this
      phenomenon has been studied with microtubules that contain several components,
      that is, a mixture of tubulin isoforms, with or without a mixture of microtubule
      associated proteins (MAPs), which can act as regulators of dynamic instability.
      Here we concentrate on the influence of the tubulin component. We have studied
      MAP-free microtubules from the marginal band of avian erythrocytes and compared
      them with mammalian brain microtubules. The erythrocyte system was selected
      because it represents a naturally stable aggregate of microtubules; second, the
      tubulin is largely homogeneous, in contrast to brain tubulin. Qualitatively,
      erythrocyte microtubules show similar features as brain microtubules, but they
      were found to be much less dynamic. The critical concentration of elongation, and
      the rates of association and dissociation of tubulin are all lower than with
      brain microtubules. Catastrophes are rare, rescues frequent, and shrinkage slow.
      This means that dynamic instability can be controlled by the tubulin isotype,
      independently of MAPs. Moreover, the extent of dynamic behavior is highly
      dependent on buffer conditions. In particular, dynamic instability is strongly
      enhanced in phosphate buffer, both for erythrocyte marginal band and brain
      microtubules. The lower stability in phosphate buffer argues against the
      hypothesis that a cap of tubulin.GDP.Pi subunits stabilizes microtubules. The
      difference in dynamics between tubulin isotypes and between the two ends of
      microtubules is preserved in the different buffer systems.

PMID- 8485323
TI  - Long-term parenteral nutrition in cystic fibrosis.
AB  - The effects of parenteral nutrition (PN) with high lipid content were studied in
      18 cystic fibrosis patients in this pilot investigation. The patients were
      randomly assigned to one of two groups. During the first 4-mo period, group 1
      received PN and group 2 received routine therapy. During the second 4-mo period,
      PN was discontinued in group 1 and instituted in group 2. When the effect of PN
      was considered for both treatment groups, its general effect was to increase body
      fat content with little or no impact on respiratory function, exercise tolerance,
      or recurrent infections. However, subsequent analysis and clinical observation
      suggested that patients receiving PN responded in two seemingly distinct
      patterns: some demonstrated apparent clinical improvement and benefit, and others
      did not. A positive response in pulmonary and exercise function was closely
      correlated to a rise in serum dihomo-gamma-linolenic acid (DHLA) concentrations
      during PN. Pulmonary function improved in patients who normalized their DHLA
      levels (vital capacity increased from 2.2 +/- 0.3 to 2.6 +/- 0.3 area %, p <
      0.05), whereas those who continued to have undetectable levels of DHLA
      deteriorated (forced expiratory volume in 1 s decreased from 0.7 +/- to 0.6 +/-
      0.1, p < 0.001). PN applied to malnourished patients with cystic fibrosis results
      in beneficial effects in a subgroup characterized by the presence of DHLA in
      serum; for the group as a whole, the positive effects are minimal.

PMID- 8485324
TI  - Patterns of energy expenditure in intensive-care patients.
AB  - We studied the changes in energy expenditure (EE) in response to multiple injury
      (n = 6), subarachnoidal hemorrhage (n = 8), low-cardiac-output syndrome after
      open-heart surgery (n = 6), and uncomplicated coronary artery surgery (n = 10).
      Measurements were made during 5 consecutive days. In the multiple injury group,
      EE was 30% higher than predicted basal EE (range 10-52%) within 27 h after
      trauma, and this hypermetabolism remained unchanged throughout the study. After
      subarachnoidal hemorrhage, EE was 18% higher than predicted (range 0-45%) and the
      operation caused only a minor further increment in EE. Also, these patients
      remained hypermetabolic throughout the study. In the low-cardiac-output syndrome
      group, the increase in EE was less prominent (mean 15%, range 0-34%), but the
      pattern of hypermetabolism was similar to that observed in the multiple injury
      and subarachnoidal hemorrhage groups. The metabolic response to uncomplicated
      coronary artery surgery resembled the response to general surgery. We conclude
      that 1) there is an early consistent increase in EE in various groups of surgical
      intensive-care patients; 2) with appropriate treatment of the circulation, a
      prompt hypermetabolic response to surgical trauma is maintained even during low
      cardiac-output syndrome; and 3) the marked hypermetabolism after subarachnoidal
      hemorrhage at the central nervous system is an integral part of the
      hypermetabolic response to injury.

PMID- 8485325
TI  - Distal splenorenal shunt and insulin secretion, plasma glucagon, and glucose
      homeostasis in cirrhosis.
AB  - Over the 1st postoperative yr, distal splenorenal shunt (DSRS) in cirrhotic
      patients is followed by a reduction in portal perfusion resulting from a
      spontaneous opening of portal-systemic collaterals. This can influence plasma
      levels of insulin and glucagon. Fasting plasma glucose, insulin, C-peptide, and
      glucagon and their 5-h responses to a protein meal (which directly stimulates the
      hormone secretions) were measured before and 3 and 12 mo after DSRS in 10
      cirrhotic patients. Hormone effectiveness and pancreatic alpha- and beta-cell
      sensitivities to ammonia (NH3), amino acids, and glucose were also calculated.
      Liver function and portal vein diameter were assessed before each study. Seven
      cirrhotic patients treated with injection sclerotherapy of esophageal varices
      served as a control group. Liver function did not deteriorate in either patient
      group. An increase in fasting glucagon (from 181 +/- 22 to 242 +/- 22 and 255 +/-
      22 pg/ml, p = 0.02) and NH3 (from 57 +/- 8 to 84 +/- 11 and 97 +/- 14
      micrograms/dl, p = 0.04) and a decrease in glucagon effectiveness (from 0.56 +/-
      0.06 to 0.39 +/- 0.05 and 0.035 +/- 0.03, p = 0.047) and portal vein diameter
      (from 16.0 +/- 1.1 to 11.3 +/- 0.8 and 9.4 +/- 0.6 mm, p < 0.001) was found only
      in DSRS patients. The elevation in glucagon was correlated with that of NH3 at 3
      mo (r = 0.83, p = 0.003) and with the reduction of portal vein diameter at 1 yr
      (r = -0.81, p = 0.005). In cirrhosis, DSRS does not influence insulin secretion
      or its plasma level and effectiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485326
TI  - Effect of nutrition status and other factors on length of hospital stay after
      major gastrointestinal surgery.
AB  - Various factors may prolong postoperative recovery and the length of stay (LOS)
      in the hospital. In a retrospective study of 245 adult patients who had no oral
      intake for 5 days after major gastrointestinal surgery, we used a correlation
      matrix to describe the population and determine the effects of the following
      factors on LOS: malnutrition, complication status, stress level, type of surgery,
      pathology, period of inadequate nutrient intake, and use of nutritional support.
      LOS was markedly prolonged in malnourished patients compared with those who were
      not (23.5 +/- 16.5 vs. 16.5 +/- 10.7 days, means +/- SD, p < 0.001). Patients
      were then grouped into those who had nutritional support and those who had not,
      and a nutrition classification was derived by examining the uncertainty (entropy)
      in the data matrix that allowed separation of the population into distinct
      groups. Nutrition and complication status and days without oral nutrient intake
      were discriminative. Analysis of variance and multivariate studies were also used
      to determine whether the presence of malnutrition, complications, both together,
      or neither could predict LOS and to determine the confounding effect of
      nutritional support on LOS. A significantly extended LOS persisted for patients
      with malnutrition or complications and was most prolonged for those with both,
      but patients who received nutritional support had a greater LOS than those who
      did not. In addition to the effects of nutritional support, malnutrition, and
      complication status, LOS correlated with the duration of the postoperative period
      without oral nutrient intake. We therefore recommend systematic and early
      nutritional intervention for selected gastrointestinal surgical patients.

PMID- 8485327
TI  - Leucine and manifestation of antitumor activity by valine-depleted amino acid
      imbalance.
AB  - With a commercially available balanced 10% amino acid solution as control (I),
      imbalance solutions were prepared by the removal of valine (II), valine and
      leucine (III), valine and isoleucine (IV), and valine, leucine, and isoleucine
      (V). The solutions, in combination with total parenteral nutrition, were given to
      rats with AH-109A hepatoma for 7 consecutive days to evaluate antitumor activity.
      Although there were no significant differences in carcass weight after treatment
      among groups I-IV, a decrease was noted in group V. Tumor weights in groups II-V,
      relative to that in group I, were 39, 57, 43, and 44%, respectively. Antitumor
      activity was thus noted in all imbalance groups, although activity in group III
      was lower than that in group II. These results indicate that the concurrent
      depletion of leucine and/or isoleucine along with valine is undesirable because
      of lower antitumor activity and an adverse effect on host development. Leucine is
      thus suggested to play an important role in augmenting the activity of valine
      depleted imbalance.

PMID- 8485328
TI  - Alteration of pulmonary function by filtration of intravenous nutrient mixture.
AB  - In view of contradicting results concerning alteration in lung function during
      hyperalimentation and the administration of intravenous lipid emulsion, a study
      was planned to determine possible changes in pulmonary blood perfusion during
      administration of total nutrient admixture (TNA) and the effect of filtration.
      Sixteen patients (8 men, 8 women; mean age 65.6 yr) with no previous lung disease
      received TNA at the rate of 4-5 g lipid/h as preoperative treatment for 5-9 days
      (mean 6.7 days). The 5-microns filter was randomly used in eight patients. The
      lung blood perfusion parameters measured repeatedly during this period included
      blood gases, percentage of the predicted value of vital capacity (VC), and
      pulmonary diffusing capacity for carbon monoxide (DLCO), as well as the value of
      the dead space volume and the tidal volume ratio (VD/VT) and the calculated shunt
      (QS/QT). TNA infusion appears to cause only a slight decrease in PaO2 and DLCO
      and a similar increase in VC and QS/QT, whereas VD/VT decreased significantly.
      The latter effect was abolished by filtration of TNA. There were no significant
      differences between the two groups. We therefore conclude that short-term
      preoperative administration of TNA at the rate of 4-5 g lipid/h in patients
      without preexisting lung disease does not jeopardize lung functions. Filtration
      of the TNA is, however, recommended to avoid the potential hazardous effects of
      long-term treatment of TNA on lung function.

PMID- 8485329
TI  - Stillbirth rates and folic acid and zinc status in low-socioeconomic pregnant
      women of Brazilian Amazon.
AB  - Twenty-five women in their first trimester and 25 women in their third trimester
      of pregnancy were randomly chosen from the slum areas of eight towns in the
      Brazilian Amazon (Manaus, Sao Luis, Boa Vista, Porto Velho, Sao Gabriel,
      Santarem, Tefe, and Benjamin Constant). Blood samples were removed from the
      subjects for folic acid and zinc analyses, and the women were asked questions
      about whether they had suffered from complications during previous pregnancies.
      It was found that the stillbirth rates reported ranged from 0 to 20/1000
      pregnancies. The town that had the highest stillbirth rate (Santarem) also had
      the highest percentage of women with deficient erythrocyte (red blood cell, RBC)
      folate status. All of the women in Santarem also had deficient serum folate
      levels in both trimesters of pregnancy, as well as the lowest average RBC folate
      value in the third trimester of pregnancy. The same town was also one of two in
      which the pregnant women had the lowest mean serum zinc levels in the third
      trimester.

PMID- 8485330
TI  - Acute tetany in the Crohn's patient with osteomalacia.

PMID- 8485331
TI  - Carbohydrate metabolism and requirements for nutritional support: Part II.

PMID- 8485332
TI  - Calorie-restricted weight reduction, blood pressure, and atrial natriuretic
      peptides.
AB  - Calorie restriction with resultant weight loss lowers arterial blood pressure in
      obese people. The mechanism of this blood-pressure reduction has been unknown,
      but recent evidence suggests that the atrial natriuretic peptide hormonal system
      may play a role in the blood-pressure changes associated with calorie-reduction
      induced weight loss. This newly described hormonal system consists of a 126-amino
      acid (aa) prohormone synthesized primarily in the heart with a 98-aa NH2-terminal
      and a 28-aa COOH-terminal of this prohormone released into the circulation. Four
      peptides consisting of aa 1-30, 31-67, 79-98, and 99-126 of this prohormone each
      have blood-pressure-lowering properties. The circulating concentrations of these
      peptides increase in people with high blood pressure in an apparent attempt to
      overcome the constriction of blood vessels. With calorie-induced weight
      reduction, the elevated levels of these peptides decrease and correlate in a
      linear fashion (p < 0.001) with blood-pressure reduction. During this blood
      pressure reduction, plasma aldosterone and plasma renin activity inversely
      correlate with the concentration of atrial natriuretic peptides and blood
      pressure. This observation is consistent with the ability of atrial natriuretic
      factor (i.e., aa 99-126 of the prohormone) to inhibit renin release and
      aldosterone secretion from the adrenal gland. The atrial natriuretic peptide
      hormonal system appears to be important in blood-pressure regulation in people
      who are at their ideal body weight and in those who are overweight.

PMID- 8485333
TI  - Oxygen consumption in critical illness.

PMID- 8485334
TI  - Do carbohydrates make you fat?

PMID- 8485336
TI  - New food labeling addresses major health concerns.

PMID- 8485335
TI  - Hypothesis tests.

PMID- 8485337
TI  - Ischemic heart disease and dietary copper--towards a unifying hypothesis.

PMID- 8485338
TI  - Routine sensitive peptide mapping using LC/MS of therapeutic proteins produced by
      recombinant DNA technology.
AB  - At the Sixth International Conference on Methods in Protein Sequence Analysis
      held in Seattle, Washington, August 17-21, 1986, Frank Robey of the Food and Drug
      Administration (FDA) proposed a "wish list" of possible future techniques for the
      analysis of recombinant products. Included in this list was liquid chromatography
      (HPLC) in-line with mass spectrometry for peptide mapping. This wish has come
      true. In 1988, a new technique, electrospray ionization (ESI) of liquids with
      quadrupole mass analysis, became a major breakthrough in accurately measuring
      molecular weights of proteins up to 100,000 daltons or more. Now, using an
      affordable, simple, easy-to-use single-stage quadrupole mass spectrometer,
      peptide mapping is routine.

PMID- 8485339
TI  - Solution synthesis of mu-conotoxin GIIIB: optimization of the oxidative folding
      reaction.
AB  - mu-Conotoxin GIIIB, a skeletal muscle sodium channel specific blocker, was
      synthesized by the solution procedure. The whole molecule, which is composed of
      22 amino acid residues including six cysteinyl and three trans-4-hydroxy-L-prolyl
      residues, was constructed from three segments. After removal of all protecting
      groups, the hexa-SH peptide was subjected to an oxidative folding reaction at a
      peptide concentration of 1 x 10(-5) M. Three major products 1, 2 and 3 were
      formed in a ratio of 1:4:3. Determination of the disulfide structures in each
      product revealed them to be disulfide isomers, with similar connectivities in the
      latter two. Study of the biological activities of the three products in mice
      indicated that only product 1, which is a minor component, has the same potency
      as the natural product. Analysis of the folding process at a peptide
      concentration of 1 x 10(-5) M showed that the disulfide bond between Cys10 and
      Cys15 was initially formed, thus leading to the predominant generation of
      products 2 and 3. The optimal conditions for the formation of product 1 (mu
      conotoxin GIIIB) were obtained by increasing the peptide concentration in the
      oxidation reaction mixture or by using redox reagents, both of which functioned
      as promoters for the thiol-disulfide exchange reaction of the mismatched
      disulfide bond between Cys10 and Cys15.

PMID- 8485340
TI  - Peptide-based assay for the identification of endothelin-converting enzyme
      inhibitors.
AB  - A simple, solid-phase assay usable for the detection of endothelin-converting
      enzyme activity and inhibitors has been developed. It uses a multimeric peptide
      immobilized on microtiter plates that is able to specifically recognize the Big
      Endothelin fragment 16-32 derivatized with biotin. This fragment is cleaved
      between residues 21-22 by alpha-chymotrypsin with almost the same proteolysis
      rate as Big Endothelin, and after enzyme treatment it does not bind to the
      multimeric peptide adsorbed on the microtiter plates. The amount of uncleaved
      peptide bound to the plate is detected by subsequent treatment with streptavidin
      conjugated to peroxidase, followed by a chromogenic reaction. Model inhibitor
      profiles generated for alpha-chymotrypsin, a protease known to convert Big
      Endothelin in endothelin, demonstrated the utility of this assay as a rapid high
      throughput aid in the study of Big Endothelin enzymatic processing and possibly
      in the identification of putative enzyme inhibitors.

PMID- 8485341
TI  - Comparative multiple synthesis of fifty linear peptides: evaluation of cotton
      carrier vs. T bag-benzhydrylamine resin.
AB  - Parallel simultaneous synthesis of fifty linear peptides has been carried out in
      order to compare in detail two promising methodologies of simultaneous multiple
      peptide synthesis (SMPS): the "T bag" method, utilizing 4-methyl-benzhydrylamine
      resin (MeBHA), and synthesis on derivatized Fmoc-Gly-O-cotton fabric strips. The
      basic set of experiments, which utilizes identical Fmoc/Bu(t) strategy for both
      approaches, shows that the peptides synthesized on cotton are superior in purity
      to those synthesized using T bags. In experiments utilizing Boc/Bzl strategy in T
      bags, the purities of peptides were higher than in the case of peptides
      synthesized in T bags by Fmoc/Bu(t) strategy, and comparable with the purities
      achieved in synthesis performed on cotton. The lower yields on cotton are caused
      by mechanical losses in the given experimental arrangement.

PMID- 8485342
TI  - Investigation of cyclic depsipeptides by fast atom bombardment-mass spectrometry.
AB  - In recent years, the synthetic analogue elcatonin has been used successfully in
      the treatment of osteoporosis. During an investigation of synthetic strategies
      for the production of elcatonin, a number of peptide products were generated.
      These could be purified by liquid chromatography and were shown to have identical
      amino acid compositions. Investigation by fast atom bombardment-mass spectrometry
      revealed three of the peptides to have a common pseudomolecular ion but notably
      dissimilar fragmentation patterns. Further studies involving chemical
      modification, mass spectrometry and chromatographic separation showed these
      products to be novel depsipeptides, cyclized with an ester bond between either
      the serine or the threonine residue and the side chain of aminosuberic acid.

PMID- 8485343
TI  - Ethical awareness, understanding and collaboration.

PMID- 8485344
TI  - Haemodynamic profiles and the critical care nurse.
AB  - The last decade has witnessed phenomenal developments available for the
      critically ill, especially for the patient in shock. These advances have
      implications for all members of the health care team as new roles and functions
      are constantly emerging. As the therapies practised today continue to expand,
      this demands a greater level of expertise for all those involved in critical
      care. This ever-increasing complexity mandates that we examine the future
      direction of critical care nursing. This paper examines one area of clinical
      development--the haemodynamic profile. From a theoretical knowledge base on shock
      with a review of patient goals of therapy, the discussion is developed with
      reference to the clinical application of the haemodynamic profile. The
      parameters, their calculation and meaning for patient treatment is examined using
      clinical exemplars. The paper concludes by re-affirming the themes drawn on
      throughout the paper of holistic care, independent and interdependent team
      relationships and accountable professional practice.

PMID- 8485346
TI  - Breaking the news: informing visitors that a patient has died.
AB  - Most nurses working in critical care areas for any length of time will be
      involved in informing visitors that a patient has died. This paper describes some
      of the methods which may be used to give this news and some of the means of
      providing support to visitors at this time.

PMID- 8485345
TI  - Ventricular assist devices for the failing heart: a nursing focus.
AB  - The last decade has witnessed phenomenal advances in the therapies available for
      critically ill patients, especially for those patients in circulatory failure.
      This paper presents an overview of mechanical assist devices, focusing on the use
      of ventricular assist for the failing heart. From a basic review of cardiac
      failure, the principles of ventricular assist and the indications for its use are
      examined. After reviewing the ventricular assist devices currently available, the
      discussion moves to the expert nursing skills required by a patient receiving
      ventricular assist therapy. All aspects of clinical practice are discussed, with
      particular emphasis on the full use of assessment skills in order to facilitate
      care planning and ensure safe delivery of care. These expert nursing skills are
      considered within the framework of collaborative care. Patients needing
      ventricular assist may require some of the most advanced holistic nursing skills
      that critical care nurses possess.

PMID- 8485347
TI  - Monoclonal antibodies--the future of pharmacology.

PMID- 8485348
TI  - The needs of a patient in severe status asthmaticus: experiences of a nurse
      patient in an intensive care unit.
AB  - Biopsychosocial being is now accepted in nursing as a term which can be used to
      describe any human being. This is an account of what it means, illustrated in the
      life of one person. Pilar Arcas Ruiz is a Spanish nurse who left medical
      education to train as a nurse, but later completed the requirements for medical
      qualification in order to use it when necessary to advance nursing in Spain.

PMID- 8485350
TI  - Performing endotracheal suction on children: a literature review and implications
      for nursing practice.
AB  - The purpose in this paper is to review the literature concerning endotracheal
      tube suction as a nursing procedure used for children, and to discuss common
      techniques and problems. From the discussion, recommendations for care are
      extrapolated in order to minimise discomfort for, and risks to, the patients.

PMID- 8485349
TI  - The communication process with ventilator patients in the ICU as perceived by the
      nursing staff.
AB  - Intensive care unit (ICU) nurses (n = 27) were interviewed about their
      experiences and opinions of the communication process with ventilator treated
      patients. Nurses with limited ICU experience considered the initial contact with
      a new critically ill ventilated patient more frustrating than experienced nurses.
      The nurses thought that the content of the communication commonly requested by a
      patient was dominated by factors related to the clinical condition, prognosis and
      reassurance that the situation was under control. Factors considered to limit the
      communication and to create feelings of uncertainty and stress for nurses with an
      ICU experience of less than 5 years were: work overload, unstable condition of
      the patient, impaired communication with the patient, and their own personal
      problems or worries. For nurses with an ICU experience of more than 5 years
      stress was more commonly evoked by the presence of worried and anxious
      spouses/relatives, and by the feeling that something was wrong with the patient
      but they were unable to identify the problem. Failure to understand a ventilated
      patient could induce feelings of incompetence, stress and sometimes even despair.
      The present small scale study shows that there are many factors, in addition to
      ICU experience, that may influence the ability of an ICU nurse to establish and
      maintain a well functioning communication with ventilated patients and the
      likelihood of doing so.

PMID- 8485351
TI  - Empathy and technology in the coronary care unit.
AB  - This paper explores the emergence of nursing in the mid 19th century as a
      'caring' or 'curing' occupation. Nursing evolved as the discipline of caring
      whilst cure was the doctor's domain. Important though caring was, it was
      perceived as women's work and therefore of low status and considerably less
      powerful than the male dominated curing role. The definitions and practice of
      caring have changed since the Victorian era, but it continues to be perceived by
      many as secondary to medicine's curing role. The paper explores this issue in the
      speciality of coronary care nursing and also whether coronary care nursing is
      more 'cure' than 'care' orientated. Coronary care nursing began as a
      technological and physical speciality--more 'cure'-orientated than 'care'
      orientated and this has led to the specialty being especially attractive to male
      nurses. However, since the purpose of CCU began as the prevention of death, and
      the possibility of death is an inescapable part of the nurses' work, the ability
      to be empathic is essential. The paper concludes that coronary care nursing
      appears to contain both 'curing' elements (technological/physical) and 'caring'
      elements (empathy), both of which are practised by many coronary care nurses. The
      'cure' elements of physical observation, treatment and technological maintenance
      may still be perceived by some as of primary importance, however both technology
      and empathy emerge as essential and equal components in the provision of quality
      coronary care.

PMID- 8485352
TI  - The nurse's role in caring for patients undergoing LDL-Apheresis.
AB  - LDL-Apheresis is a new, exciting, highly computerised treatment which is
      currently being researched. It selectively removes the harmful lipoproteins, in
      particular Low Density Lipoprotein (LDL) to which is attributed accelerated
      coronary artery disease 2-3 years after cardiac transplantation. Accepting the
      rather unique nursing role caring for patients receiving this treatment, the
      author has found that the research programme has opened up a challenging and very
      interesting variation in her career using advanced computerised technology. But
      it has also provided increased opportunity for her to use nursing skills,
      particularly in the area of communication, to enhance her relationship with the
      patients and raise the standard of care given.

PMID- 8485353
TI  - The role of nurses and technicians in intensive care.

PMID- 8485354
TI  - Implications of the James Bulger case for community nurses.

PMID- 8485355
TI  - Skill mix does not work.

PMID- 8485356
TI  - Management of the patient with altered body image.
AB  - Nurses are well placed to help patients come to terms with altered body image.
      However, in order to do so they must discard some of the prejudices that they
      hold.

PMID- 8485357
TI  - Developing a model for theatre nursing.
AB  - There has been much debate about the nature of theatre work and whether the
      activities performed by theatre nurses represent real nursing. This article
      examines the potential for constructing a nursing model to depict the variety of
      environments in which theatre nurse's work.

PMID- 8485358
TI  - Child sexual abuse. 1: Definitions, incidence and consequences.
AB  - It is estimated that over 6600 children under the age of 16 years are sexually
      abused each year in England and Wales (NSPCC, 1990). Of these incidents, 78%
      involve female children and 22% male children. The effects on the child range
      from self-mutilating behaviour and dissociative disorders to suicide.
      Consequently, nurses caring for victims of sexual abuse need to be aware of the
      trauma involved.

PMID- 8485359
TI  - Patient-controlled analgesia.
AB  - Patient-controlled analgesia is an effective method of controlling postoperative
      pain, providing its introduction is planned carefully and both staff and patients
      have been fully trained in the technique.

PMID- 8485360
TI  - Nursing a teenager with burns.
AB  - Development of body image is an integral part of a teenager's psychological
      growth. Burned teenagers experience great difficulty in readjusting
      psychosocially after injury as they have not yet formed their own self-concept
      and sense of worth. Burns patients experience a range of psychological problems
      as a consequence of disfigurement. These include depression, phobias, insomnia,
      sexual problems, high divorce rates, juvenile delinquency and impaired employment
      or academic status. Few nursing research articles have addressed the psychosocial
      problems of burns patients. Even if nurses are not skilled in counselling they
      must be able to recognize problems and refer patients to colleagues with the
      appropriate skills.

PMID- 8485361
TI  - Social perception and the nurse educator.
AB  - This article illustrates how psychological theory may be applied to nurse
      education. Nurse educators need to be aware of the impact of social perception,
      i.e. perception of others and perception of self, if they are to be objective and
      effective in teaching and assessing student nurses.

PMID- 8485362
TI  - The Bland truth: 2.

PMID- 8485363
TI  - Child sexual abuse and the right to compensation.
AB  - Adults who were sexually abused as children can sue the perpetrator in the civil
      courts. However, if they do not do so within the time period set down by the
      Limitation Act 1980, they may not be entitled to any compensation. Is the law,
      therefore, biased against them?

PMID- 8485364
TI  - Nurse-aid management of neurological emergencies.
AB  - People with altered levels of consciousness cannot be responsible for themselves.
      This article highlights the steps a nurse aider must take at the scene of an
      accident and discusses the importance of the environment in the neurological
      emergency.

PMID- 8485365
TI  - A career in renal nursing.
AB  - By the time we qualify, most of us are aware of the things we like and dislike
      about nursing. However, deciding on an area of specialism is difficult. This
      article examines renal nursing as an option for those nurses who know what
      factors they are looking for in a job.

PMID- 8485366
TI  - Definitions and explanations of the new financial vocabulary.
AB  - NHS reforms have led to a new vocabulary for nurses. This article explains the
      meaning of the terms budgetary control, establishment, pay and non-pay, zero
      based budgeting, trust regimens and the external financing limit. An
      understanding of these terms will help nurses implement the reforms.

PMID- 8485367
TI  - [Ultrasound-controlled percutaneous drainage of subhepatic liver abscess after
      conventional cholecystectomy].
AB  - From February 1984 to August 1991 subhepatic abscesses were detected by
      ultrasound in 7 patients with fever following conventional cholecystectomy.
      Cholecystectomy had been performed in all these patients 6 to 27 days previously.
      All patients had received antibiotic prophylaxis at the time of cholecystectomy.
      Three of the 7 patients were at first afebrile, later on again febrile. In the
      remaining 4 of the 7 patients antibiotic treatment was continued in the face of
      persistent fever. Percutaneous catheter drainage was performed in all patients.
      In all of the 7 cases the subhepatic abscesses resolved completely within 10 days
      to 7 weeks.

PMID- 8485368
TI  - Sonographic aspects of the Cruveilhier Baumgarten syndrome.
AB  - A rare case of Cruveilhier-Baumgarten syndrome with exceptional deep subcutaneous
      portosystemic collaterals is reported. Undetected these anastomoses represent
      potentially dangerous sites for hemorrhage complications. Ultrasound in
      combination with color-coded duplex sonography is a reliable technique in
      identifying portosystemic anastomoses as well as in providing valuable
      information about the etiology of portal hypertension.

PMID- 8485369
TI  - [Value of magnetic resonance tomography for diagnosis of bone tumors].
AB  - Primary bone tumors are well investigated with magnetic resonance imaging (MRI).
      Depending on the tumor site and localization the examination technique has to be
      tailored to the particular situation. Using MRI, the delineation of extraosseous
      tumor spread and the intramedullary extension of malignant bone tumors is
      superior as compared to other imaging modalities.

PMID- 8485370
TI  - Pyogenic hepatic abscess: long resolution time despite adequate therapy.
AB  - A 50-year-old male patient with a pyogenic hepatic abscess was successfully
      treated with an antibiotic regimen and percutaneous drainage of the abscess.
      Although this treatment was successful, it took more than 3 months for the
      abscess cavity to be completely resolved. A slow resolution of hepatic abscesses
      is therefore no evidence for the ineffectiveness of treatment.

PMID- 8485371
TI  - [Ultrasound diagnosis '92. 16th Three Country Karlsruhe Meeting, 21.-24. October
      1992].

PMID- 8485372
TI  - Micropreparative ion exchange high performance liquid chromatography:
      applications to microsequence analysis.
AB  - Data on the characterization of anion and cation micropreparative (50 x 1.6 mm
      i.d.) HPLC columns is presented. It is shown how subnanomole quantities of
      protein can be efficiently recovered from such columns, rendering them compatible
      for use in multidimensional chromatographic strategies for the purification of
      trace biological samples. By selection of appropriate solvent systems (e.g.,
      buffer-free sodium chloride solutions), the small eluant peak volumes can be
      loaded directly onto the gas phase sequencer, and N-terminal sequence data
      obtained. The potential of the technique is illustrated for the purification of a
      GTPase activating protein (GAP-3).

PMID- 8485373
TI  - The determination of a new inhalational anaesthetic, sevoflurane, using an
      internal standard, xenon, by gas chromatography/mass spectrometry/selected ion
      monitoring.
AB  - A novel determination method for a new inhalation anaesthetic, sevoflurane, in a
      closed circuit in the presence of carbon dioxide absorbents is investigated using
      gas chromatography/selected ion monitoring with xenon as an internal standard.
      The decrease rate of sevoflurane with soda lime was 0.22% +/- 0.158/h (mean +/-
      SD), while that with baralyme was 0.57% +/- 0.115/h (mean +/- SD).

PMID- 8485374
TI  - Drug monitoring of clomipramine and desmethylclomipramine in depressed patients
      using a new liquid chromatographic assay.
AB  - A method has been developed for the quantitative analysis of clomipramine and its
      major metabolite desmethylclomipramine in plasma, using normal phase
      chromatography with UV detection at 254 nm. This rapid (6 min) and highly
      sensitive methodology (detection limits 0.5 ng/mL and 2 ng/mL for clomipramine
      and desmethylclomipramine, respectively; S/N = 3, 0.001 aufs) allows
      pharmacokinetic studies and drug monitoring of the two compounds. Using the
      described methodology we report an application which involved 10 depressed
      inpatients.

PMID- 8485375
TI  - Study of chemobiological reactions. 1. Selectivity of aromatic amino compounds
      and saccharides in glycosylation reactions.
AB  - The reactivities between saccharides and primary amino compounds were studied by
      liquid chromatography on an amino-bonded column and by measurement of the
      reaction rates of aromatic amines with saccharides. The recoveries from the
      column and the reaction rates were correlated with their physicochemical
      properties calculated by the CAChe program. The reactivities between amines and
      saccharides correlated well with their hydrogen bonding energies calculated by
      molecular mechanics.

PMID- 8485376
TI  - High performance gel filtration using monodisperse highly cross-linked agarose as
      a one-step system for mucin purification.
AB  - High performance gel filtration on monodisperse cross-linked agarose (Superose 6)
      has been assessed as a system for purification of mucus glycoproteins. Comparison
      with the conventional two-step purification of mucus glycoprotein by Sepharose
      CL4B gel filtration followed by caesium chloride density gradient centrifugation
      shows that purification by high performance gel filtration is at least as
      thorough, yielding mucin that is free from non-mucin glycoproteins as defined by
      buoyant density, mobility on sodium dodecyl sulphate-polyacrylamide gel
      electrophoresis and absence of Concanavalin A binding (mannose-containing)
      material. This technique allows mucus glycoprotein to be purified from
      lyophilized crude mucin in 120 min compared with approximately 72 h using the
      conventional techniques. This makes the comparative study of mucus glycoprotein
      changes in disease states much more feasible.

PMID- 8485377
TI  - Free-solution capillary electrophoretic separation of small hydrophilic peptides.
AB  - Small hydrophilic peptides differing in only one glycine amino acid group have
      been successfully separated by free-solution capillary electrophoresis (FSCE)
      using phosphate buffer at acid pH. The effects of column temperature and
      operating current on the migration times of these small peptides have been
      investigated. The results from FSCE have been compared with those from reversed
      phase high performance liquid chromatography.

PMID- 8485379
TI  - Simultaneous determination of NK611, a novel water-soluble derivative of
      etoposide, and its metabolite (DeNK611) in dog plasma by column-switching high
      performance liquid chromatography.
AB  - A simple, selective, reversed phase liquid chromatographic method using a column
      switching technique has been developed for the simultaneous determination of a
      novel derivative of etoposide (NK611) and its O-demethyl metabolite in dog
      plasma. A good linear response was obtained for both drugs in the range 0.1-12.0
      micrograms/mL. The mean recoveries were within 100 +/- 5%. The within- and
      between-day precisions were within 3.5% and 4.6%, respectively. This method was
      used in a pharmacokinetic study following intravenous and oral administration of
      NK611 to beagle dogs.

PMID- 8485378
TI  - A high performance liquid chromatographic method for the determination of
      febantel and its major metabolites in lamb plasma.
AB  - A high performance liquid chromatographic (HPLC) method for the determination of
      the anthelminthic pro-benzimidazole febantel and its major metabolites in lamb
      plasma has been developed. Samples were extracted after addition of albendazole
      as internal standard, NH4OH and distilled diethyl ether. The extracted phase was
      dried under a stream of nitrogen redissolved in methanol and chromatographed by
      HPLC. Detection was by UV absorbance at 292 nm. Recovery from the plasma was
      97.2, 97.1, 54.5 and 88.0% for febantel, fenbendazole, oxfendazole and
      oxfendazole sulphone respectively, and within-day and between-day coefficients of
      variation were 4.03, 4.69, 3.57 and 5.06% and 4.25, 3.73, 5.12 and 4.12%,
      respectively, for febantel, fenbendazole, oxfendazole and oxfendazole sulphone.
      The specificity and sensitivity of this method (limit of detection in plasma
      0.025 micrograms/mL and < or = 0.0125 micrograms/mL for febantel and its
      metabolites, respectively) were sufficiently high to enable us to characterize
      the time course of the drug in the plasma after oral administration of
      therapeutic doses to sheep.

PMID- 8485380
TI  - Rapid liquid chromatographic assay of glutathione in cultured cells.
AB  - A rapid, sensitive and selective method for the assay of glutathione in cultured
      cells has been developed using ion-pair reversed phase rapid high performance
      liquid chromatography. The use of a 4 micron particle, 5 cm long column
      (Superspher 100 RP 18 end-capped) allowed complete analysis of glutathione within
      3 min. A postcolumn derivatization reaction with o-phthalaldehyde and
      fluorometric detection made the assay fully selective with regard to other
      endogenous thiols and sensitive (the detection limit was 0.5 ng of glutathione
      injected). The linearity range was between 0.1 and 2.0 microgram/mL with good
      repeatability (relative standard deviation less than 5% for the lowest
      concentration quantitated). Recoveries of GSH from cultured cell samples were
      above 98%. The rapid analysis enabled the processing of a large number of samples
      in a short time (up to 20 per hour). The method was applied to the measurement of
      the intracellular glutathione amount in V79 fibroblasts along cell growth in
      culture.

PMID- 8485381
TI  - Determination of paracetamol (acetaminophen) in blood and plasma using high
      performance liquid chromatography with dual electrode coulometric quantification
      in the redox mode.
AB  - A simple, but sensitive, micro-assay for paracetamol in blood and plasma is
      described. Samples were prepared by precipitation with trichloroacetic assay
      solution and the drug quantified by reversed phase liquid chromatography with
      dual electrode electrochemical detection in the redox mode (oxidation at +0.25 V
      followed by reduction at -0.15 V). The limit of detection was 0.1 mg/L for a 10
      microL sample of blood or plasma, the coefficient of variation at this
      concentration being 11.4%. The method was applied to a study of gastric emptying
      in patients before and after cardiac surgery.

PMID- 8485382
TI  - Purification and characterization of hedgehog liver metallothioneins.
AB  - Two forms of liver metallothioneins (MTs) were purified from hedgehog exposed to
      zinc, using gel filtration on Sephacryl S-100 and DEAE Sepharose Fast Flow
      chromatography. The peptide chain weight of both MT-1 and MT-2 was found to be
      about 10,000, as determined by high performance liquid chromatography. This value
      was higher than that calculated from amino acid analysis. The amino acid
      composition of hedgehog liver MT-1 and MT-2 resembles that of liver to MTs from
      rabbit and other species. Their distinctive features include an extremely high
      cysteine content, about 33% of all the amino acid residues, and an absence of
      aromatic amino acids and histidine. In addition, a rapid method for the
      determination of MTs during animal tissue purification has been established. The
      samples were directly added in an ammoniacal solution of a Co(II) salt for
      recording linear sweep polarograms. By comparison with the commonly used metal
      determination method, our method is direct, rapid, credible and suitable for all
      the MTs or MT-like samples.

PMID- 8485384
TI  - Evaluation and nursing education: where to now?

PMID- 8485383
TI  - Determination of felodipine enantiomers using chiral stationary phase liquid
      chromatography and gas chromatography/mass spectrometry, and the study of their
      pharmacokinetic profiles in human and dog.
AB  - A stereoselective and sensitive method for the determination of the enantiomers
      of felodipine, a dihydropyridine calcium antagonist, has been developed and the
      pharmacokinetic profiles of the enantiomers comparatively studied after oral
      administration to dogs and humans. D6-Felodipine, the internal standard, was
      added to the plasma, extracted with a solvent and then optically resolved into S(
      ) and R(+) enantiomers on a high performance liquid chromatographic Chiralcel OJ
      column. Each enantiomer in the effluent was analysed by capillary column gas
      chromatography/positive ion electron impact mass spectrometry. After oral
      administration of the felodipine racemate, the Tmax and t1/2 values hardly
      differed between the two enantiomers in dogs and humans. The Cmax and AUC0-24 h
      values of the S(-) enantiomer were slightly higher than those of the R(+)
      enantiomer in humans but the difference between the enantiomers was not
      significant. These results suggested that there is no large difference in the
      absorption, distribution and elimination of felodipine enantiomers after oral
      administration of the racemate in either dog or human.

PMID- 8485385
TI  - The newly formed College of Nurses.

PMID- 8485386
TI  - Where are the Maori nurses who were to become those "efficient preachers of the
      gospel of health?".
AB  - In an article published in Nursing Praxis in New Zealand Pamela Wood outlines the
      1898 scheme for educating Maori nurses. This article gives an overview of the
      history of the nursing programme for Maori women. Wood states that "Far from
      being attempts to smooth the pillow of a dying race, [this programme was]
      grounded in a real concern to improve Maori health". I seek here to contribute to
      the debate on the development of Maori nursing education in New Zealand between
      the years of 1900 to 1910. In my opinion Maori nurses did not become 'efficient
      preachers' not because of lack of will, but rather because of the inequalities
      which existed between Pakeha and Maori nurse training schemes. The 'separatist'
      approach to the training of the Maori nurses, and the universal belief in the
      'native' inability to learn, 'native' being a generic term for all races other
      than European, led to a scheme which failed to provide the number of Maori nurses
      envisaged at its inception. In little more than a decade from the scheme's
      inception to its Health Department launch the ideal of training for Maori women
      was abandoned. By examining resistance from within nursing and the wider socio
      political environment, this paper demonstrates how certain groups are
      consistently discriminated against. It further shows that reforms are not
      necessarily progressive but rather are double edged and always, in part, reflect
      the views of the most powerful.

PMID- 8485387
TI  - A moment of nursing: a case study.

PMID- 8485388
TI  - Cultural safety: a framework for changing attitudes.

PMID- 8485389
TI  - An ethnography of caring and control in an acute psychiatric unit.
AB  - The setting for this study was a 19 bed general hospital psychiatric ward serving
      a heterogeneous population. The objective of the study was to generate thick
      description of the cultural knowledge patients and nurses used to organise their
      behaviour and interpret their experience in an acute psychiatric unit. Further
      aims were to describe the nature of the service provided, and more specifically
      to identify relationships between caring and controlling in this social context,
      and the outcomes for patients of caring and controlling interventions by nurses.

PMID- 8485390
TI  - A peaceful death.

PMID- 8485391
TI  - Stevie.

PMID- 8485392
TI  - Relationship cataract density and visual field damage.
AB  - In interpreting visual field results, two questions arise: a) what type of visual
      field damage is produced by cataract, and b) can the influence on the visual
      field somehow be predicted? To answer these questions, cataract density was
      quantified with the Opacity Lens Meter (OLM) 701, and visual field tests were
      done before and after IOL-implantation surgery with Octopus Program G1 in 58 eyes
      of 58 patients (mean age 71 +/- 8 years) with cataract but with no other
      detectable ocular diseases. The average improvement of mean damage (MD) after
      surgery was 5.4 dB, and that of D (20) (defect 20 on the Bebie Curve) was 5.7 dB.
      The improvement of the visual fields was, as expected, statistically highly
      significant (p < 0.0001). The corrected loss variance (CLV), however, increased
      on the average only by 2.5 dB2, which was not significant. The predictive value
      of the OLM reading for opacity-induced MD depends on the type of cataract. It is
      good for cortical and nuclear cataracts but poor for posterior subcapsular
      opacifications. The overall predictive value (R = 0.66) is, nevertheless, better
      than for preoperative visual acuity (R = -0.54). If OLM and visual acuity (VA)
      are considered together, the predictive value is slightly higher (R = 0.72).
      Thus, optical density influences on visual field performance can be subtracted
      from general visual field results.

PMID- 8485393
TI  - Clinical correlations in HIV-1 and HIV-2 infected patients.
AB  - In Portugal, the prevalence of human immunodeficiency virus type 2 (HIV-2)
      seropositivity is higher than in other European countries or North America.
      Recent literature data points out a possible difference on the pathogenic
      potential and on the natural history of HIV-1 and HIV-2, suggesting a lower
      virulence of HIV-2. Facing these hypothesis and the increasing number of HIV-2
      cases, we analysed two infected groups HIV-1 and HIV-2, trying to correlate the
      ophthalmologic lesions present in both populations and searching for a difference
      in the clinical presentation of the ocular disorder. We studied prospectively 214
      patients with HIV infection at several stages, 83% HIV-1 and 17% HIV-2. Ocular
      manifestations were present in both populations with a significant prevalence in
      HIV-1 (48%), compared to HIV-2 (19%) (p < 0.005). The ophthalmologic pathology
      found, particularly noninfectious retinopathy, infectious retinitis and neuro
      ophthalmic disorders, were considered important for the disease's diagnosis and
      prognosis. All these ophthalmic findings were present in the HIV-1 population. In
      the HIV-2 group the most frequent lesion was noninfectious retinopathy. Within
      each group, HIV-1 and HIV-2, the comparison of the survival between AIDS patients
      with and without ocular lesions, revealed a significant shorter survival time in
      those with ocular pathology (p < 0.001 and p < 0.05). There seems to exist a
      certain analogy in clinical expression in both groups, although it is possible to
      admit a lower severity in ocular involvement in patients infected by HIV-2.

PMID- 8485394
TI  - Visual field indices for the nasal step: different calculation procedures and
      their correlation with the clinical classification of visual field defects.
AB  - We calculated normal values for the normal population of the Octopus G1 program
      (n = 836) and values for defective fields due to glaucoma and other diseases (n =
      147) to determine indices for a nasal step in the interpretation of glaucomatous
      visual fields. We used different calculation procedures and correlated the
      results with the clinical evaluation of the visual field. All indices tested were
      able to detect and quantify nasal steps in defective fields and to separate them
      from normal findings (area under curve of Receiver Operating Characteristic
      curves 0.963 to 0.999). Indices calculated excluding sensitivity values of
      positions with the greatest distance from the horizontal meridian or weighting of
      sensitivity values according to their closeness to the horizontal meridian showed
      the best results (auc = 0.999). We can thus conclude that the calculation of an
      index for nasal step is a simple and effective adjunct to any interpretation
      system for visual fields.

PMID- 8485395
TI  - Imipenem reaches therapeutic concentrations in aqueous humor, as determined by
      HPLC.
AB  - The majority of ocular infections in the industrialized countries arise after
      surgical interventions. An appropriate antibacterial prophylaxis is therefore
      highly desirable in eye surgery. We used high performance liquid chromatography
      (HPLC) to measure the concentrations reached by imipenem, a modern wide-spectrum
      beta-lactam antibiotic, in plasma and aqueous humor of 26 patients scheduled for
      cataract surgery. Even a single 500 mg dose of imipenem achieved therapeutic
      levels of the molecule for the most common ophthalmic pathogens (1 microgram/ml
      or above) in the aqueous humor within one to two hours after administration. This
      drug may therefore be suitable for antibacterial prophylaxis in eye surgery.

PMID- 8485396
TI  - Sagittal magnetic resonance imaging of dysthyroid ophthalmopathy.
AB  - Sagittal magnetic resonance imaging (MRI) scans of the eye and orbit were made of
      30 eyes in 15 cases of dysthyroid ophthalmopathy (DO). On the basis of these
      scans, we sought to elucidate relationships between the morphological condition
      of the levator palpebrae muscle, fatty tissue in the upper eyelid and the
      superior, inferior recti muscles and the occurrence of such symptoms as lid
      retraction, lid swelling and vertical disturbance of eye movement. The levator
      palpebrae muscle was enlarged in all 15 DO eyes (100%) with upper eyelid
      retraction. In 16 (88.9%) of 18 eyes with apparent lid swelling, enlargement of
      the preaponeurotic fat or submuscular fat pad was clearly evident. In the control
      eyes, no such enlargement was seen in either the levator palpebrae muscle or
      orbital fatty tissue. The clear space between the superior recti and the levator
      palpebrae muscles that was seen in control eyes was absent in all five eyes that
      presented a disturbance in infraduction. In 8 (80%) of 10 eyes with a disturbance
      in supraduction, the inferior rectus muscle was enlarged and muscle extension was
      impaired. Sagittal MRI seemed to be a useful means of obtaining a better clinical
      understanding of a variety of eye symptoms associated with DO.

PMID- 8485397
TI  - Is the type of VDT work important in asthenopia?
AB  - The Authors studied the relationship between visual fatigue (or asthenopia) and
      different types of work with display units on about 30,000 videoterminal (VDT)
      operators of the Italian telecommunication company. Visual fatigue was reported
      with data entry, data checking, word processing, dialogue enquiry, and various
      services. The Chi-square test showed that asthenopia was not related to any
      particular type of VDT work, comparing subjects working at the VDT for similar
      times each week. These findings provide further confirmation that the main factor
      determining visual fatigue in VDT operators is the amount of time spent at the
      display units.

PMID- 8485398
TI  - The fate of eyes with anterior chamber intra-ocular lenses.
AB  - A total of 143 anterior chamber (AC) intra-ocular lenses (IOL) of various designs
      were implanted in a five-year period and followed for 18 to 76 months. The lenses
      were inserted as a secondary implant after extracapsular cataract extraction
      (ECCE) complicated by vitrectomy, or after primary intra-capsular extraction. The
      complications (corneal edema, uveitis/glaucoma, extrusion/imbedding, cystoid
      macular edema), the final visual acuity and the need for removal of the IOL were
      analyzed. Only small differences were found between the different lenses but some
      association was found between complicated surgery (ECCE + vitrectomy) and a
      higher rate of complication, poorer visual outcome and more frequent need for IOL
      removal. Cystoid macular edema was encountered only in cases with complicated
      ECCE. A high percentage of other ocular pathologies was found among the cases,
      possibly implying that diseased eyes are more prone to surgical complications. An
      alternative to the AC-IOL in cases with a ruptured posterior capsule is the
      suture-supported posterior chamber IOL, but the flexible-loop AC-IOL may not yet
      be obsolete.

PMID- 8485399
TI  - Full-thickness macular hole and retinal detachment complicating Best's disease.
AB  - The unusual association of Best's vitelliform macular dystrophy and a full
      thickness macular hole causing retinal detachment is reported. Successful
      reattachment was achieved with pneumatic retinopexy and postoperative laser
      photocoagulation. The mechanisms underlying the combination of full-thickness
      macular hole and retinal detachment in Best's disease remain to be elucidated.

PMID- 8485400
TI  - Electroretinographic changes during childhood and adolescence.
AB  - Electroretinogram (ERG) changes with age have been studied widely, but there is
      no general agreement about the age at which ERG parameters reach adult values. We
      studied 296 eyes from 148 healthy subjects, divided into 14 age groups, ranging
      from 1 week to 21 years. Although most of the maturational changes or ERG take
      place during the first six months, the a wave completes development at three
      years of age and the b component shows a smooth increase in latency between 3 and
      18-21 years. The latter component also shows an increase in amplitude from 7-8 to
      12-14 years. During the first period of maturation the b wave parameters follow a
      multiplicative model. These data are discussed in relation to previously reported
      findings on ERG maturation and to morphological and functional eye changes with
      age.

PMID- 8485401
TI  - Regulation of carotenoid biosynthesis during tomato development.
AB  - Phytoene synthase (Psy) and phytoene desaturase (Pds) are the first dedicated
      enzymes of the plant carotenoid biosynthesis pathway. We report here the organ
      specific and temporal expression of PDS and PSY in tomato plants. Light increases
      the carotenoid content of seedlings but has little effect on PDS and PSY
      expression. Expression of both genes is induced in seedlings of the phytoene
      accumulating mutant ghost and in wild-type seedlings treated with the Pds
      inhibitor norflurazon. Roots, which contain the lowest levels of carotenoids in
      the plant, have also the lowest levels of PDS and PSY expression. In flowers,
      expression of both genes and carotenoid content are higher in petals and anthers
      than in sepals and carpels. During flower development, expression of both PDS and
      PSY increases more than 10-fold immediately before anthesis. During fruit
      development, PSY expression increases more than 20-fold, but PDS expression
      increases less than threefold. We concluded that PSY and PDS are differentially
      regulated by stress and developmental mechanisms that control carotenoid
      biosynthesis in leaves, flowers, and fruits. We also report that PDS maps to
      chromosome 3, and thus it does not correspond to the GHOST locus, which maps to
      chromosome 11.

PMID- 8485402
TI  - Protein isoprenylation in suspension-cultured tobacco cells.
AB  - Many mammalian and yeast proteins, including small ras-like GTP binding proteins,
      heterotrimeric G protein gamma subunits, and nuclear lamins, have been shown to
      be covalently linked to isoprenoid derivatives of mevalonic acid. Isoprenylation
      of these proteins is required for their assembly into membranes and, hence, for
      their biological activity. In this report, it is shown that cultured tobacco
      cells, when pretreated with an inhibitor of endogenous mevalonic acid synthesis
      (lovastatin), incorporate radioactivity from 14C-mevalonic acid into proteins.
      Most of these proteins are membrane associated, and many are similar in mass to
      mammalian ras-like GTP binding proteins and nuclear lamins. Furthermore, it is
      shown that tobacco cell extracts catalyze the transfer of radioactivity from 3H
      farnesyl pyrophosphate and 3H-geranylgeranyl pyrophosphate to protein substrates
      in vitro. These studies indicate the presence of at least two distinct
      prenyl:protein transferases in tobacco extracts: one that utilizes farnesyl
      pyrophosphate and preferentially modifies a substrate protein with a CAIM carboxy
      terminus (farnesyl:protein transferase) and one that utilizes geranylgeranyl
      pyrophosphate and preferentially modifies a substrate protein with a CAIL carboxy
      terminus (geranylgeranyl:protein transferase type I). This work provides a basis
      for future work on the role of protein isoprenylation in plant cell growth,
      signal transduction, and membrane biogenesis.

PMID- 8485403
TI  - The N- and C-terminal regions regulate the transport of wheat gamma-gliadin
      through the endoplasmic reticulum in Xenopus oocytes.
AB  - Following sequestration into the endoplasmic reticulum (ER), wheat storage
      proteins are naturally either retained and packaged into protein bodies within
      this organelle or exported to the Golgi apparatus. To identify protein domains
      that control the sorting of wheat storage proteins within the ER, a wild-type
      gamma-gliadin storage protein as well as two of its deletion mutants, each
      bearing either of the two autonomous N- and C-terminal regions, were expressed in
      Xenopus oocytes. Our results demonstrated that the N-terminal region of the
      gliadin, which is composed of several tandem repeats of the consensus sequence
      PQQPFPQ, was entirely retained within the ER and accumulated in dense protein
      bodies. In contrast, the C-terminal autonomous region was efficiently secreted to
      the medium. The wild-type gamma-gliadin, containing both regions, was secreted at
      a lower rate and less efficiently than its C-terminal region. These results
      suggest that sorting of the wheat gamma-gliadin within the ER may be determined
      by a balance between two opposing signals: one functions in the retention and
      packaging of the storage protein within the ER, while the second renders the
      protein competent for export from this organelle to the Golgi apparatus.

PMID- 8485404
TI  - Dissection of the functional architecture of a plant defense gene promoter using
      a homologous in vitro transcription initiation system.
AB  - CHS15 is one of a family of bean genes encoding chalcone synthase, which
      catalyzes the first reaction in a branch pathway of phenylpropanoid biosynthesis
      for the production of flavonoid pigments and UV protectants and isoflavonoid
      derived phytoalexins. The functional architecture of the CHS15 promoter was
      dissected by a novel homologous plant in vitro transcription initiation system in
      which whole-cell and nuclear extracts from suspension-cultured soybean cells
      direct accurate and efficient RNA polymerase II-mediated transcription from an
      immobilized promoter template. Authentic transcription from the CHS15 promoter
      template was also observed with whole-cell extracts from suspension-cultured
      cells of bean, tobacco, and the monocot rice, and the soybean whole-cell extract
      transcribed several other immobilized promoter templates. Hence, this procedure
      may be of general use in the study of plant gene regulation mechanisms in vitro.
      Assay of the effects of depletion of the soybean whole-cell extract by
      preincubation with small regions of the CHS15 promoter or defined cis elements
      showed that trans factors that bind to G-box (CACGTG, -74 to -69) and H-box
      (CCTACC, -61 to -56 and -121 to -126) cis elements, respectively, make major
      contributions to the transcription of the CHS15 promoter in vitro. Both cis
      element/trans factor interactions in combination are required for maximal
      activity. Delineation of these functional cis element/trans factor interactions
      in vitro provides the basis for study of the mechanisms underlying developmental
      expression of CHS15 in pigmented petal cells established by G-box and H-box
      combinatorial interactions, and for characterization of the terminal steps of the
      signal pathway for stress induction of the phytoalexin defense response.

PMID- 8485405
TI  - The evolution of informed consent: beyond an ethics of care.

PMID- 8485406
TI  - Response to "Ethical Dimensions of Informed Consent".

PMID- 8485407
TI  - An aside on the role of autonomy in informed consent.

PMID- 8485408
TI  - "Ethical dimensions of informed consent": a psychiatric perspective.

PMID- 8485409
TI  - Ethics versus law: a lawyer's road map to the Ethics Committee opinion on
      informed consent.

PMID- 8485410
TI  - Confusing law and ethics: why the Committee's report on informed consent should
      be reconsidered.

PMID- 8485411
TI  - Commentary: "Ethical dimensions of informed consent".

PMID- 8485412
TI  - Informed consent: commentary on the ACOG Ethics Committee statement.

PMID- 8485413
TI  - Commentary on "Ethical issues of informed consent".

PMID- 8485414
TI  - Commentary: Ethical issues of informed consent.

PMID- 8485415
TI  - Organization and delivery of perinatal health care services at the community
      level. National Perinatal Information Center and University of South Florida
      School of Public Health.

PMID- 8485416
TI  - Prenatal diagnosis and abortion.

PMID- 8485417
TI  - Image: celebrates 25th anniversary.

PMID- 8485418
TI  - Data versus information versus knowledge.

PMID- 8485419
TI  - The knowledge bank ... a library update.

PMID- 8485420
TI  - National Library of Medicine offers nursing resources.

PMID- 8485421
TI  - The Online Journal of Knowledge Synthesis for Nursing.

PMID- 8485422
TI  - INTERNET: linking nurses, scholars, libraries.

PMID- 8485423
TI  - Are drug policies based on 'fake' statistics?

PMID- 8485424
TI  - Should the controlled provision of heroin be a treatment option? Australian
      feasibility considerations.
AB  - A proposal for a trial to provide heroin to dependent users in a controlled
      manner is currently being considered in the Australian Capital Territory. The
      political background to this proposal is outlined, as is the current 'drug
      scene'. A Stage 1 examination found that a trial of controlled provision of
      heroin is feasible in principle and recommended a further stage (Stage 2) of
      feasibility investigations to explore the practicalities. The results of the
      Stage 1 investigations and the proposals for Stage 2 are incorporated into
      discussion about three important issues: the feasibility research process, the
      therapeutic relationship, and social control. These considerations have wider
      applicability, both for treatment services for illegal drug users generally and
      for informing drug policy debates. Much can be learnt from the feasibility
      considerations, whether or not a trial of the controlled provision of heroin
      eventuates in Australia.

PMID- 8485425
TI  - Modelling the interactions between alcohol, crime and the criminal justice
      system.
AB  - Similarities in the trends of the number of offences and the level of alcohol
      consumption are often used as evidence as a link between alcohol and many forms
      of criminal activity. However, such crude correlations may be misleading as they
      neither take account of other factors that might be important, not assist the
      understanding of the causal links between alcohol and crime. In this paper, the
      role that economic models may play in furthering the understanding of the
      potential links between alcohol and crime are explored. A complete model is
      presented which allows for complex interactions between alcohol, crime and the
      criminal justice system. Results from testing this model with time series data
      (1960-88) for England and Wales for different types of crime are discussed in
      detail. Data defined by standard regions and for the years 1980 to 1988 were also
      compiled and a summary of the results discussed. The argument that alcohol
      consumption may be one of the determinants of a wide range of crimes receives
      some support and is also found that alcohol consumption may affect the
      probability of detection for some types of crime.

PMID- 8485426
TI  - Physical, subjective, and social availability: their relationship to alcohol
      consumption in rural and urban areas.
AB  - The alcohol availability literature indicates that under some conditions,
      physical availability is positively associated with per capita alcohol
      consumption. Smart (1980) suggested that at the individual level, subjective and
      social aspects of availability may mediate and outweigh the influence of physical
      availability. The study described here examined the simultaneous effects of
      physical, subjective, and social availability on alcohol consumption.
      Standardized telephone interviews were conducted with 781 adult drinkers. As
      hypothesized, physical availability was not a significant multivariate predictor
      of alcohol consumption for residents of high, medium, and low alcohol outlet
      density counties in Michigan (USA). Subjective and social availability indicators
      were significant predictors of alcohol consumption. Similar patterns of results
      were found in multiple regression analyses for blacks and whites and women and
      men, although blacks and women consumed less alcohol than did whites and men. The
      theoretical and practical implications of these results are discussed.

PMID- 8485427
TI  - The origin of alcohol-related social norms in the Saami minority.
AB  - The present paper addressed the problem of the origin of alcohol-related social
      norms in the Saami minority in northern Norway. Based on data from studies of
      comparable ethnic minorities in Greenland, North America and Australia it could
      be expected that alcohol use- and abuse would be more prevalent in the Saami than
      in the Norwegian populations of northern Norway. No data to support this
      hypothesis exist. On the contrary, available data suggest that drinking problems
      in this group are similar to those of the majority in the area. The present paper
      developed the hypothesis that Saami alcohol-related social norms originated in
      the Laestadian religious revival. The paper investigated the impact of the
      Laestadian culture in the formation of alcohol-related social norms. It was
      concluded that the Laestadian sobriety norm, and the norm of abstinence from the
      use of adiafora, have influenced alcohol-related behaviour in the Saami group in
      such a way that this group does not conform to the drinking behaviour found in
      comparable minorities.

PMID- 8485428
TI  - Patterns of drug use and risk-taking among injecting amphetamine and opioid drug
      users in Sydney, Australia.
AB  - Data are presented on the patterns of drug use and HIV risk-taking of daily
      amphetamine and opioid injectors among 1245 injecting drug users who were
      interviewed in Sydney in 1989. About one-third of the sample had injected
      amphetamines during a typical month of injecting, and 12% were using amphetamines
      on a daily basis. Daily amphetamine injectors were younger, less well educated,
      and less likely to have engaged in drug treatment, but they were no more likely
      than daily opioid users to have shared injection equipment or to have engaged in
      other behaviour likely to transmit HIV. Although there seemed to be no special
      cause for concern about HIV risk-taking among amphetamine injectors, there was
      nonetheless a high prevalence of sharing injecting equipment, with over half of
      daily amphetamine and heroin injectors having shared in the past several months.
      In addition, approximately a third of amphetamine injectors were injecting on a
      daily basis, a pattern of use which increases the risk of developing a severe
      dependence syndrome, and of experiencing an amphetamine-induced psychosis.

PMID- 8485429
TI  - Socially desirable responding and self-reported HIV infection risk behaviors
      among intravenous drug users.
AB  - This study examined the extent to which self-report of human immunodeficiency
      virus (HIV) risk behaviors might depend upon socially desirable response
      tendencies, and whether socially desirable responding might serve as a
      confounding variable in the study of risk behaviors and HIV serostatus. The
      subjects were 2885 intravenous drug users participating in the ALIVE study in
      Baltimore, Maryland. Participants completed an interview and were tested for HIV
      serostatus. The interview covered HIV risk behaviors, and included established
      scales to measure 'self-deception' and 'impression management', two separate
      dimensions of socially desirable responding. Seven items for each scale were
      scored true/false, with a summary score used for analysis. Scores on self
      deception and impression management were inversely related to self-reports of
      sharing injection equipment, injecting at shooting galleries, and injecting more
      than once a day. Neither self-deception nor impression management was associated
      with cocaine use. Self-reported receptive anal intercourse was associated
      inversely with self-deception but not with impression management. HIV serostatus
      was not associated with social desirability, and statistically controlling for
      social desirability had a negligible impact on the magnitude of associations
      between risk behaviors and HIV serostatus. The results indicate that measures of
      social desirability may be used to ascertain sensitive areas of inquiry in
      interviews of intravenous drug users.

PMID- 8485430
TI  - Effect of low and moderate doses of alcohol on driving hazard perception latency
      and driving speed.
AB  - Both driving speed and speed of detection of potentially hazardous events while
      driving have been found to correlate positively with accident rates across
      individuals. Alcohol ingestion is also known to increase risk of a traffic
      accident. This paper reports two double-blind, placebo-controlled studies: one on
      the effect of alcohol on driving speed and the other on the effect of alcohol on
      time taken to detect potential traffic hazards. Moderate drinkers aged between 30
      and 55 took part. Each subject underwent three experimental conditions on
      separate days: no alcohol, low alcohol (0.025% BAC) and moderate alcohol (0.05%
      BAC). The order of conditions was counterbalanced. The moderate alcohol dose
      increased mean time taken to respond to hazards (2.5 s in no alcohol condition
      compared with 3.2 s in moderate alcohol condition) but did not affect mean
      driving speed (indexed by time taken to travel sections of a fixed route; 19.3 s
      in no alcohol compared with 19.0 s in moderate alcohol). The results support the
      view that at least part of the excess risk of accident associated with alcohol
      ingestion is attributable to an increase in the time taken to respond to traffic
      hazards.

PMID- 8485431
TI  - Recycling with nicotine patches in smoking cessation.
AB  - The aim was to evaluate if recycling of failures from a smoking cessation study
      may be of value. The study comprised 126 smokers (50%) of 252 failures, from a
      double-blind smoking cessation trial with nicotine patch, who accepted recycling
      after 1 year. Subjects were allocated nicotine patches delivering 15, 20 or 25 mg
      of nicotine (over 16 hours) according to their base-line saliva cotinine
      concentrations in an open trial. The treatment period was 12 weeks followed by
      tapering over 6 weeks. The percentage of quitters after 3, 12, 26, and 52 weeks
      was 44, 20, 7 and 6%, respectively. After 26 weeks, all subjects had relapsed in
      the group previously treated with active nicotine patch compared with 12%
      abstainers in the previous placebo subjects. The sustained abstinence rate
      without slips after one year was 2%. Recycling does not seem to be of long-term
      clinical relevance in our set-up for subjects initially treated with nicotine,
      but of some value in subjects quitting without nicotine therapy initially.

PMID- 8485432
TI  - Sensation seeking, gambling and gambling addictions.
AB  - Male off-course bettors were assessed using: the Sensation-Seeking Scale (SSS)
      Form V, two measures of subjective arousal while betting, and questions
      concerning chasing, preferences for gambling activities and other aspects of
      betting behaviour. The SSS was also administered to a random sample of the male
      general population of Glasgow, together with questions concerning preferences for
      gambling activities to allow comparison between regular gamblers and the general
      population. In comparison with the general population and with non-gamblers, off
      course bettors scored lower on SSS; gamblers preferring the casino and/or the
      race-track scored higher on SSS; gamblers betting on many different forms scored
      higher on SSS. A further analysis produced a cluster of variables among off
      course bettors associated with impaired control of gambling, among which both SSS
      scores and chasing were prominent features.

PMID- 8485433
TI  - Alcoholics anonymous, other 12-step movements and psychotherapy in the US
      population, 1990.
AB  - Based on the 1990 US National Alcohol Survey, this note provides the first
      available comprehensive findings on self-reported utilization of a variety of
      sources of personal support and counselling for alcohol and other problems.
      Respondents were queried about lifetime attendance and number of times they went
      to identified sources of help in the prior year. Twelve-step groups included
      Alcoholics Anonymous, Al-Anon, Adult Children of Alcoholics, and other non
      alcohol-oriented groups like Gamblers Anonymous, Narcotics Anonymous, and
      Overeaters Anonymous; additional questions inquired about support or therapy
      groups and individual counselling for non-alcohol problems. Of the US adult
      population, 9% have been to an AA meeting at some time, 3.6% in the prior year,
      only about one-third of these for problems of their own. About half these
      percentages, mostly women, have attended Al-Anon. Of the same population, 13.3%
      indicate ever attending a 12-step meeting (including non-alcohol-oriented
      groups), 5.3% in the last year. During the prior year a further 2.1% used other
      support/therapy groups and 5.5% sought individual counselling/therapy for
      personal problems other than alcohol. In contrast to this high reported
      utilization, only 4.9% (ever) and 2.3% (12-months) reported going to anyone
      including AA for a problem (of their own) related to drinking.

PMID- 8485434
TI  - Selden Daskam Bacon (1909-1992).

PMID- 8485435
TI  - Q-switched CTE:YAG laser sclerostomies on human autopsy eyes.
AB  - Experimental laser sclerostomies were performed on human eye-bank eyes with a new
      mid-infrared solid-state laser that is characterized by adequate optic-fiber
      transmission and low-thermal tissue interaction. The laser presented herein works
      with a chromium thulium erbium-doped (CTE): YAG crystal as the active medium,
      emitting radiation at a wavelength of 2.69 microns. In the Q-switch mode, the
      pulse duration is tunable from 0.5 to 2.5 microseconds. The maximal energy is 50
      mJ/pulse (1-10 Hz). Attenuation of energy transmission in quartz (0.3 ppm) optic
      fibers is < 8 dB/m (diameter, 200 microns). Absorption depths of 2.69 microns
      radiation in water is 12.5 microns. In vitro procedures performed were ab-interno
      and ab-externo full-thickness sclerostomies. Histological and micro-morphological
      examination was performed by light microscopy and scanning electron microscopy.
      Collateral tissue damage in processed sclerostomies did not exceed 50(+/- 10)
      microns at typical fluences (10 J/cm2). In contact guidance, 10-15 laser pulses
      were required in the full-thickness ab-externo procedure, whereas up to 50 pulses
      were required in the ab-interno procedure. The number of laser pulses applied
      corresponded to the length of the filtration canals created. The canal was
      significantly longer (2.5 +/- 1 mm) in the ab-interno approach than in the ab
      externo approach (1 +/- 0.2 mm). The intraocular ostium of the filtration canal
      in the ab-externo procedure showed enhanced signs of mechanical deterioration. It
      is concluded that both the wavelength (2.69 microns) and the pulse duration (0.5
      2.5 microseconds) of the CTE: YAG laser are appropriate for laser
      sclerostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485437
TI  - Simulation of the growth pattern of the central retinal artery using a fractal
      modeling technique.
AB  - Assisted by computer, we simulated the typical growth pattern of the central
      retinal artery by a fractal modeling technique. When processing was started with
      two fertile sides, an iterative processing function generated a ramiform fractal.
      The branching angle was chosen at random within a certain range. In addition, a
      feedback restriction forbade any intersection of branches. We demonstrated that
      the curved shape of the temporal vessels is caused by simultaneous growth of the
      vessels and the retina. When processing was begun with only one fertile side, the
      typical vascular pattern of a retinal coloboma was designed.

PMID- 8485436
TI  - Hexadecylphosphocholine may produce reversible functional defects of the retinal
      pigment epithelium.
AB  - Hexadecylphosphocholine is a synthetic phospholipid derivative that has antitumor
      activity due to its interference with membrane functions. Animal experiments have
      shown photoreceptor and retinal pigment epithelium (RPE) degeneration after its
      systemic application. In a phase II trial of hexadecylphosphocholine therapy in
      23 patients with advanced metastatic colorectal or lung cancer, visual acuity and
      color vision testing, slit-lamp examination, tonometry, fundoscopy (including
      photodocumentation), visual field testing, electrooculography (EOG), and
      electroretinography (ERG) were performed. A baseline examination was carried out
      prior to therapy. Patients were reexamined after 2 months and after 5 months. In
      all, 71% of the patients had a reduced light peak in the EOG during therapy.
      After the end of therapy the light peak improved again and became normal in most
      patients. The statistical analysis showed that the light-peak values during
      therapy were significantly lower than the baseline and posttreatment values. This
      indicates that hexadecylphosphocholine might be capable of producing a partly
      reversible functional defect of the RPE. Apart from this finding, no other
      functional or morphological ocular side effect was detected. The functional
      changes observed in our patients as well as the morphological changes found in
      animal experiments are similar to those reported for known diseases of the RPE
      photoreceptor complex. Therefore, hexadecylphosphocholine-induced retinopathy
      might become useful as an animal model for such diseases.

PMID- 8485438
TI  - Vitreous body-derived mitogenic activity for retinal pigment epithelial cells. A
      further characterization.
AB  - To obtain a better insight into the possible role of vitreous body in
      proliferative vitreoretinopathy (PVR), we examined the influence of bovine
      vitreous body fractions separated by fast protein liquid chromatography (FPLC) on
      the growth of porcine retinal pigment epithelial (RPE) cells in vitro.
      Tetrazolium colorimetric assay (MTT assay) and cell counting were used for
      quantification. After fractionating proteins of the physiological vitreous body
      by FPLC gel chromatography (Superose 12/Superdex 75), we determined the mitogenic
      effect of the resulting fractions by either cell counting or MTT assay. With both
      columns we were capable of separating two fractions (20-40 kDa and 1-2 kDa) that
      induced RPE cell proliferation. A comparison of the mitogenesis and the protein
      content of the fractions indicated that we were not dealing with a nonspecific
      protein effect. The low-molecular fraction weighing less than 2 kDa was of
      particular interest to us. This was further separated by FPLC reversed-phase
      chromatography.

PMID- 8485439
TI  - Studies on the origin of the glycoproteins of the rabbit vitreous body using a
      protein-synthesis inhibitor and radioactive fucose and amino acids.
AB  - Rabbits were injected intravitreally with [3H]-fucose and were killed at 0.5, 4,
      24, and 40 h postinjection. The radiometric measurements and sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) plus fluorography performed
      on the vitreous bodies of these rabbits were compared with those carried out on
      excised vitreous bodies of noninjected rabbits incubated with [3H]-fucose for the
      same periods. The results of these in vitro experiments demonstrated that at all
      test intervals there were only two lightly labeled bands in the fluorograms, and
      this was interpreted as nonenzymatic binding of [3H]-fucose to proteins
      (glycation), occurring in the extracellular environment. In contrast,
      intravitreal injections resulted in about 14 conspicuously labeled bands, mainly
      after the longer time intervals, and the nature of these bands was revealed by
      additional experiments. In another series of experiments, rabbits were injected
      intravitreally with either [3H]-fucose or [3H]-amino acids and their vitreous
      bodies were processed as described above. The specific activity (counts per
      minute per microgram of protein) of the glycoproteins labeled with [3H]-fucose
      was always higher than that of the proteins labeled with any of the amino acids.
      In fluorograms, eight bands unequivocally labeled with the [3H]-amino acids were
      detected, and corresponding bands almost invariably appeared in the [3H]-fucose
      lane. Cycloheximide, a protein-synthesis inhibitor, blocked almost completely the
      incorporation of both [3H]-proline and [3H]-fucose into the vitreous proteins as
      revealed by the radiometric measurements and fluorography.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8485440
TI  - Successfully treated sympathetic ophthalmia with typical histological
      confirmation.

PMID- 8485441
TI  - Four years' experience with triple procedures in herpes-afflicted eyes.
AB  - Keratoplasties are performed relatively frequently in herpes-afflicted eyes.
      However, intraocular lenses (IOLs), for eyes with intraocular recurrent herpes
      simplex virus (HSV) disease remain a verdict in most surgical centers. As most
      herpetic disease is uniocular and cataract is a frequent complication in the long
      run, a real need exists for triple procedures in such eyes so as to achieve their
      full visual rehabilitation. Taking full advantage of systemic aciclovir therapy
      and prophylaxis, we started with triple procedures in herpes-afflicted eyes in
      1987. Up to July 1991, we operated on 29 eyes, and 28 could be optically
      rehabilitated. One eye was given up and received a conjunctival cover for
      sociomedical reasons. Three repeat keratoplasties (10%) were necessary, and a
      considerable number of complications had to be overcome; ten eyes suffered from
      sustained fibrinous exsudations (35%), ten were threatened by one or more
      endothelial immune therapy reactions (35%), and ten experienced one or more
      herpes recurrences (35%), mostly intraocular recurrences. As this study was not
      performed as a randomized, placebo-controlled, double-blind study, no absolute
      scientific proof of aciclovir's value in these patients can be presented.
      Nonetheless, we would conclude from the exceedingly good rehabilitation rate of
      96% observed during an average follow-up period of 19 months that in all
      probability, systemic aciclovir was in the first rank responsible for this
      success rate. Thus, there is good clinical evidence that systemic aciclovir
      prophylaxis and therapy is indeed the most important key for successful triple
      procedures in eyes afflicted with herpetic disease.

PMID- 8485442
TI  - Preliminary results following implantation of iris-suture-fixated posterior
      chamber lenses.
AB  - Iris-suture-fixated posterior-chamber lenses with a 7-mm optic zone and modified
      C-loops with 2 holes were implanted in 30 patients (8 men and 22 women), of whom
      13 received simultaneous corneal transplantations. The mean follow-up period was
      13.3 months. The iris was penetrated from behind and the intraocular lens was
      sutured with two double-armed 9-0 prolene sutures, the knot being positioned on
      the anterior surface of the iris. Most patients showed an increase in visual
      acuity except for two who had pre-existing retinopathy and one who developed a
      seclusio pupillae. The complications seen were: mild distortion of the pupil (7),
      iris capture (1), posterior synechiae (1) and ablatio chorioideae (1). This new
      technique yields good results in cases of intraoperative rupture of the capsule.
      In patients undergoing simultaneous corneal transplantation, a longer follow-up
      period is needed.

PMID- 8485443
TI  - Perforating injuries: causes and risks are changing. A retrospective study.
AB  - We reanalyzed all 384 records of perforating injuries primarily admitted to the
      University Eye Hospital of Freiburg during the years 1981-1983 and 1987-1989.
      Complete data could be obtained from 369 records. Injuries from 1987-1989 were
      compared with those from 1981-1983 with regard to the cause and extent of the
      perforation as well as sex, age, occupation, and activity of the patient at the
      time of injury. The following significant trends were observed. Seat-belt
      legislation in 1984 was extremely beneficial for the prevention of penetrating
      occular injuries, especially among women aged 16-25 years. Of 39 injuries to
      women, 17 (43%) were related to traffic accidents in 1981-1983 as opposed to only
      1 of 16 injuries (6%) in 1987-1989. Therefore, the male/female ratio increased
      from 4.1 to 9.6 (P = 0.006). Perforations during traffic accidents declined from
      26% (52/199) to 11% (19/170). The number of occupational injuries remained
      constant, although their proportion increased from 42.7% (85/199) in 1981-1983 to
      50% (85/170) in 1987-1989. High-risk activities at work as well as during leisure
      time changed from hammering to work with rotating machines (drills, lathes) and
      wires. The incidence of agricultural injuries rose from 4% to 9% (from 8 to 15).
      Injuries during leisure activities remained constant (66 vs 62). Among this
      group, injuries related to a hobby increased, whereas perforations occurring
      during visits to pubs or festivities decreased. Pediatric injuries remained
      constant and were responsible for 15.6% and 14.7%, respectively, of all injuries
      (age, < or = 15 years).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485444
TI  - Visual learning in the hyperacuity range in adults.
AB  - We investigated the amount, speed, and specificity of the learning of new visual
      tasks in adult humans using stereoscopic depth perception and vernier
      discrimination as the sensitive probes for learning. The results of
      psychophysical experiments in untrained adult observers indicate two phases of
      highly specific perceptual learning in humans: a fast phase and a slower one.
      Both types of learning might take place relatively "early" during pattern
      recognition in the visual cortex, since learning was very specific, without
      transfer between different stimulus orientations.

PMID- 8485445
TI  - Variation of temporal stimulus characteristics to evaluate visual function prior
      to pars plana vitrectomy.
AB  - Electrophysiological examinations were carried out prior to pars plana vitrectomy
      in a series of consecutive patients with complicated diabetic retinopathy,
      proliferative vitreoretinopathy, and perforating injuries. In 141 eyes
      electroretinograms were evaluated. The amplitude of the a- and b-waves at dark
      and light adaptation and of the 30-Hz flicker response correlated with the
      postoperative visual acuity and the retinal morphology. Due to the variability of
      these parameters, however, the preoperative electroretinogram has no predictive
      value. In 245 eyes, flash and flicker (5, 10, 20, 30 Hz) visual evoked cortical
      potentials (VECP) were recorded. The flash VECP was of no value. The presence of
      a response to a flicker stimulus of 10 Hz or higher frequencies, however,
      indicated a better functional recovery (P < 0.02). More eyes with an attached
      central retina showed a 30-Hz flicker response as compared to eyes with central
      retinal detachment (P < 0.01). The flicker VECP therefore, has a predictive value
      prior to vitrectomy.

PMID- 8485446
TI  - Evaluation of numerical displays of visual field data by human observers--the
      definition of scotomas and clusters by human interpreters.
AB  - Numerical printouts of 23 visual field examinations performed with glaucoma
      program G1 were analyzed by 3 perimetrists. The task consisted of defining the
      existence of clusters or scotomas. Considerable discrepancy with regard to the
      existence or the size of clusters and/or scotomas was found among the three
      perimetrists. The median difference in number of clusters as compared for each
      pair of interpreters was found to differ from zero at a significance level of 5%
      (Wilcoxon's signed-rank nonparametric test). These findings suggest that the
      interpretation of a visual field status by human observers will always remain
      subjective and to a large extent contradictory. This situation calls for the
      implementation of interpretative computer software to supplement the currently
      available algorithms.

PMID- 8485447
TI  - Oral clonidine premedication prevents the rise in intraocular pressure following
      succinylcholine administration.
AB  - The objective of the study was to assess the effects of premedication with
      clonidine on intraocular pressure (IOP) after the administration of
      succinylcholine. Fifty elderly patients undergoing ophthalmic surgery were
      randomly allocated to two study groups. Group 1 patients (n = 25) received
      clonidine, 300 micrograms p.o. In group 2 (n = 25), the benzodiazepine
      dipotassium clorazepate was given p.o. at a dose of 0.3 mg.kg-1. Anesthesia was
      induced with thiopental 3-4 mg.kg-1, alfentanil 10 micrograms.kg-1, atracurium
      0.07 mg.kg-1, and succinylcholine 1 mg.kg-1. Nine IOP measurements were taken in
      each patient starting before premedication and ending 3 min after endotracheal
      intubation. In both groups, there was a decrease in IOP after induction of
      anesthesia with thiopental and alfentanil. Succinylcholine administration and
      endotracheal intubation had no further effect on IOP in the clonidine group. In
      group 2, succinylcholine caused an increase in IOP when compared with the post
      induction value. We conclude that clonidine premedication can prevent the
      increase in IOP following succinylcholine administration.

PMID- 8485448
TI  - How is protein kinase C activated in CNS.
AB  - Protein kinase C (PKC) enzyme family consists of the Ca(2+)-dependent and 
      independent subgroups of phospholipid/diacylglycerol (DAG)-stimulated
      serine/threonine protein kinases. These enzymes exhibit distinct cellular and
      subcellular localizations in CNS and subtle differences in their biochemical
      characteristics and substrate specificities. It is believed that each of these
      isoenzymes respond differently to different input signals. However, detailed
      mechanism for the functioning of these enzymes in vivo is largely unknown; this
      is in part due to the absence of specific activator, inhibitor, or substrate for
      each of these enzymes. Recent advances in biochemical, biophysical, and molecular
      characterizations have defined certain structural features important to confer
      the stimulatory responses of these enzymes to Ca2+, DAG or phorbol ester, and
      Zn2+; other features important for the binding of anionic phospholipids,
      Ca2+/phospholipid complexes, and cis-unsaturated fatty acids have not yet been
      characterized. Activation of PKC requires the increase in [Ca2+]i and DAG and/or
      cis-unsaturated fatty acids. Ca2+ promotes the interactions of the Ca(2+)
      dependent subgroup of PKCs with membrane phosphatidylserine (PS) and the enzymes
      become partially active when simultaneously associated with phosphatidylinositol
      4,5-bisphosphate or fully active when DAG is available. Free fatty acids such as
      arachidonic acid, generated by the activation of phospholipase A2, could
      synergize with DAG to activate the enzyme maximally. The Ca(2+)-independent
      subgroup of PKCs also become active when associated with PS at elevated level of
      DAG. Sustained activation of PKCs leads to the conversion of these enzymes into
      membrane-inserted and membrane protein-associated forms, which may be responsible
      for certain long-term neural responses. Activation of PKC results in the
      phosphorylation of cellular proteins; among them, several calmodulin (CaM)
      binding proteins are the prominent substrates of these kinases. Phosphorylation
      of these proteins by PKC favors the release of CaM, which is required for the
      Ca2+/CaM-dependent enzymes. Thus, activation of PKCs can lead to diverse cellular
      responses through such amplification steps. Future studies should be directed at
      the elucidation of the activation of each PKC isoform in vivo to correlate with
      the physiological responses.

PMID- 8485449
TI  - Cytokines in neuronal cell types.
AB  - Cytokines are signals in the immune system, and may have effects on cells distant
      from the cells of origin. These proteins have been suggested as messengers in the
      communication between the immune system and the nervous system, in which signals
      travel only short distances. Neuroimmune interactions have been discussed in view
      of findings that nervous signals are important for the immune response. The
      occurrence of neurotransmitter receptors on lymphocytes and cytokine receptors on
      nerve cells or glia has initiated further studies e.g. on the localization of
      different cytokines in the nervous system and on long and short term actions of
      cytokines in the nervous system. Interleukin-1 has been studied extensively along
      these lines, and found to occur in the nervous and endocrine system, for example
      in the adrenal chromaffin cells, and to have effects such as induction of slow
      wave sleep and stimulation of adrenocortical and gonadotropic hormones. Other
      cytokines implicated as signals in neuroimmune interactions are IL-2, IL-6, IFN
      gamma and TNF-alpha. The functional studies suggest the occurrence of cytokine
      receptors in the brain, and experiments using 125iodine-labelled IL-1 alpha
      demonstrate differential distribution of binding sites in the mouse brain.
      Recently, evidence emerged of an endogenous receptor antagonist for IL-1, which
      may prove useful for the understanding of the mechanisms of IL-1's actions in the
      nervous system. A role for cytokines in regulation of the immune response but
      also in adjusting the organism to the host reaction is implicated. Furthermore,
      several findings indicate their role as growth promoting factors, and for example
      the induction of NGF production by IL-1 suggests involvement of this cytokine in
      regeneration and development in the nervous system. The significance of
      neuronally produced cytokines may be based upon the anatomically distinct
      releasing sites that the specific synaptic organization of the nervous system
      offer and future studies should determine whether cytokines act as
      neurotransmitters.

PMID- 8485450
TI  - Two cytosolic puromycin-sensitive aminopeptidase isozymes in chicken brain:
      molecular homology to brain-specific 14-3-3 protein.
AB  - Two puromycin-sensitive aminopeptidase isozymes (PSA-I and PSA-II) were isolated
      from chicken brain cytosol by ammonium sulfate fractionation followed by column
      chromatography on Cellex D and AH-Sepharose 4B and separated on Bio-Gel HTP. Each
      was purified to homogeneity on Sephadex G-200, Arg-Tyr-AH-Sepharose, Bio-Gel HTP,
      and preparative gel electrophoresis. On sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, PSA-I appeared to be a monomer with a molecular mass of 105 kDa,
      and PSA-II to be composed of two subunits of 25 kDa and 100 kDa. The tryptic maps
      of 100 kDa and 105 kDa protein in HPLC are different in peak frequency, height,
      and composition. The internal peptide sequence of PSA-I has a considerable
      homology to PSA-II. Both isozymes have repeated copies of common peptide segments
      and have no significant sequence homology to other peptidases and proteinases.
      These thio and Co(2+)-activated isozymes have a neutral pH optimum and are
      inhibited by puromycin and bestatin. PSA-II is more sensitive to trypsin and heat
      treatment, has a lower Km to Met-enkephalin, and is more active on Arg BNA and
      Pro BNA. Our results suggest that PSA-I and PSA-II derive from translation of two
      RNAs of a new gene family related to the brain-specific 14-3-3 protein.

PMID- 8485451
TI  - Characterization of [3H]staurosporine binding in protein kinase C-II purified
      from rat brain.
AB  - The type II protein kinase C (PKC-II) densely present in mammalian brain plays
      functional roles in CNS. We examined the characteristics of [3H]staurosporine
      binding to PKC-II purified from rat brain, compared to [3H]phorbol 12, 13
      dibutyrate (PDBu) binding. In brief, [3H]staurosporine binding increased by
      phosphatidylserine (PtdSer) in a concentration-dependent manner and the binding
      was enhanced by Ca2+ and phorbol 12-myristate 13-acetate (PMA). In the presence
      of Ca2+, PMA and PtdSer, Bmax of these bindings markedly increased, but KD did
      not change. These characteristics of binding were similar to [3H]PDBu binding to
      PKC-II. Although [3H]PDBu binding was not affected by protein kinase inhibitors
      such as staurosporine, H-7, K-252a and K-252b, [3H]staurosporine binding was
      inhibited by these inhibitors. [3H]staurosporine binding was inhibited by several
      ATP analogues, but was not by guanine nucleotides. PtdSer-induced increase in
      [3H]PDBu binding was inhibited by Zn2+, but Zn2+ induced increase in
      [3H]staurosporine binding as well as PtdSer and/or Ca2+. Staurosporine would thus
      appear to bind to a domain different from phorbol ester-binding one in PKC,
      interactions between both domains may regulate kinase activity, and 1 mol
      staurosporine and 4 mol phorbol ester may bind to 1 mol PKC-II.

PMID- 8485452
TI  - Sulfation of proteins in the primate cerebellum and young rat brain.
AB  - Protein tyrosine sulfotransferase activity in a 20,000 g sedimentable fraction of
      monkey cerebellum was demonstrated. Both endogenous proteins and the exogenous
      substrate poly (Glu, Ala, Tyr) random copolymer were sulfated. The copolymer in
      the low molecular mass range (approx 20 kDa) was preferentially sulfated.
      Addition of copolymer inhibited sulfation of endogenous proteins. Mg2+ and Mn2+
      promoted sulfation. 35S-Labeled proteins from monkey cerebellum and young (10
      days old) rat brain were subjected to lectin-Sepharose chromatography to identify
      the presence of sulfated glyco-proteins. Labeled proteins from both these sources
      could bind and get eluted from Concanavalin A-Sepharose and Ricinus Communis
      agglutinin-Sepharose column suggesting the presence of mannose or galactose
      containing glycosulfoproteins.

PMID- 8485453
TI  - Is there a significant somatodendritic uptake of dopamine in the substantia
      nigra? Evidence from the weaver mutant mouse.
AB  - Slices of the substantia nigra from normal mice and from mice with the weaver
      gene were used to study somatodendritic uptake of dopamine. The substantia nigra
      of the homozygous weaver mouse is deficient in both cell bodies and dendrites
      whereas the substantia nigra of the heterozygous weaver mouse is deficient only
      in dendrites. Accumulation of [3H]dopamine by nigral slices obtained from each
      genotype was not different from that observed in slices obtained from control
      mice. The observed accumulation of [3H]dopamine was apparently taking place
      predominantly into serotonergic and noradrenergic elements since significant
      reductions were obtained by both fluoxetine and desipramine at concentrations
      that were selective for the serotonin and norepinephrine carriers, respectively.
      In the absence, as well as in the presence of fluoxetine and desipramine,
      dopamine accumulation in the substantia nigra was only slightly attenuated by the
      known dopamine uptake blocker GBR 12909. These data argue against a significant
      presence of somatodendritic uptake systems for dopamine in the substantia nigra
      and suggest that caution be used in the interpretation of results from studies on
      dopamine release from nigral slices when [3H]dopamine has been used to preload
      the tissue. Under such experimental conditions, it is likely that a large
      proportion of the released tritium might come from neurons other than those which
      contain endogenous neurotransmitter dopamine.

PMID- 8485454
TI  - Partial restoration of choline acetyltransferase activities in aging and AF64A
      lesioned rat brains by vitamin E.
AB  - It has been suggested that the activity of the enzyme responsible for the
      synthesis of acetylcholine, choline acetyltransferase (ChAT), is substantially
      reduced in the neocortex and hippocampus of Alzheimer's and other aging brains. d
      alpha-Tocopherol (vitamin E), a free radical scavenger fat-soluble vitamin, was
      utilized in the present study to determine whether its supplementation in aging
      and ethylcholine mustard aziridinium (AF64A)-lesioned rats would improve the
      cholinergic hypofunction. Vitamin E (given 24 h and 15 min prior to AF64A
      administration) significantly (P < 0.01) reversed the effect of AF64A in
      hippocampal choline acetyltransferase activity, but it did not cause any change
      of this enzyme activity in other brain regions (striatum and frontal cortex), nor
      did it cause any significant change after 30-day daily treatment in AF64A
      lesioned rats. Furthermore, vitamin E (50 mg/kg, i.p. for 30-day treatment)
      significantly (P < 0.01) partially restored the enzyme activity in striatum of
      aging (20-28 month old) rats. The present result indicates that vitamin E can
      partly restore the hypofunction of the cholinergic system in aging and partly
      prevent the toxicity in AF64A-lesioned rats.

PMID- 8485455
TI  - Concentrations of noradrenaline at neuronal uptake sites during sympathetic
      nervous inhibition and activation in rabbits.
AB  - Concentrations of noradrenaline at peripheral neuronal uptake sites were examined
      during sustained changes in sympathetic nervous activity produced by
      intracisternal infusion of yohimbine or clonidine in conscious rabbits. The
      gradient between concentrations of noradrenaline in plasma and at neuronal uptake
      sites was estimated by comparing the formation of the intraneuronal metabolite of
      noradrenaline, dihydroxyphenylglycol (DHPG), from intravenously infused and
      endogenously released noradrenaline. At resting levels of sympathetic activity
      the noradrenaline concentration at neuronal uptake sites (4.2 +/- 0.5 nmol/l) was
      3.4-fold greater than the concentration in arterial plasma (1.3 +/- 0.1 nmol/l).
      Noradrenaline at neuronal uptake sites increased to 9.4 +/- 1.3 nmol/l after
      yohimbine and decreased to 2.4 +/- 0.1 nmol/l after clonidine. The noradrenaline
      concentration gradient was not altered by intracisternal infusion of yohimbine or
      clonidine. Thus, a positive linear relationship (r = 0.97) was observed between
      concentrations of noradrenaline at neuronal uptake sites and in plasma. The
      gradient was positively related to the efficiency of noradrenaline reuptake (r =
      0.81). The results show that arterial plasma concentrations of noradrenaline are
      considerably less than concentrations close to sites of release, but accurately
      reflect changes in amounts of noradrenaline at release sites during sustained
      changes in sympathetic activity. The gradient in noradrenaline concentrations
      between neuronal uptake sites and plasma is largely dependent on the efficiency
      of neuronal reuptake. Since the gradient is not altered by sympathetic nervous
      inhibition or activation, the proportion of noradrenaline removed by neuronal and
      extraneuronal uptake does not appear to be altered by moderate changes in
      transmitter release.

PMID- 8485456
TI  - Retroviral-mediated gene transfer of the porcine choline acetyltransferase: a
      model to study the synthesis and secretion of acetylcholine in mammalian cells.
AB  - We have constructed a recombinant retrovirus that expresses choline
      acetyltransferase (ChAT) by placing the porcine enzyme cDNA under the control of
      the 5' long terminal repeat of the retroviral vector pMMuLV. Using retrovirus
      mediated gene transfer, we have expressed ChAT in astroglial (STR-SVLT) and
      neuroendocrine (RIN) cell lines. Both genetically modified cell types synthesize
      acetylcholine (ACh). ACh is also present in the culture medium at a low
      concentration relative to that found in the modified cells. This result suggests
      that the synthesized ACh is retained within the cells and released by these two
      cell types. Release of ACh is not increased in the presence of the calcium
      ionophore A23187 or by depolarizing concentrations of potassium in either STR
      SVLT or in RIN cells. The implications of these studies for understanding ACh
      release mechanisms are discussed.

PMID- 8485457
TI  - Occurrence of heterogeneity of N-linked oligosaccharides attached to sycamore
      (Acer pseudoplatanus L.) laccase after excretion.
AB  - The N-linked oligosaccharide moieties of sycamore (Acer pseudoplatanus L.)
      laccase are known to be highly heterogeneous. We confirmed that this
      oligosaccharide heterogeneity was caused not only during the oligosaccharide
      biosynthesis in Golgi apparatus, but also after the excretion of laccase protein
      into a culture medium. The culture medium for the sycamore cells (Acer
      pseudoplatanus L.) contained beta-galactosidase, alpha-L-fucosidase, beta-N
      acetylglucosaminidase, alpha-mannosidase and beta-xylosidase activities. We
      showed that the largest sugar chain in laccase, oligosaccharide F, [formula: see
      text] was degraded to [formula: see text] by a crude exoglycosidase mixture in
      the culture medium.

PMID- 8485458
TI  - Changes in translatable mRNA populations induced in rice seedlings by exposure to
      freeze-thaw stress.
AB  - In order to examine whether changes in gene expression are induced by injury in
      seedlings of rice (Oryza sativa) after a lethal freeze-thaw stress. mRNAs were
      extracted and their in vitro translation products were compared with those of the
      control plants by polyacrylamide gel electrophoresis. An mRNA encoding an
      entirely new protein with M(r) of ca. 37 kDa was detected as early as 30 min of
      thawing at 28 degrees C. Two-dimensional gel electrophoresis revealed the
      induction of mRNAs for at least 10 additional proteins, including those in a
      range of 15 to 20 kDa. Most of these proteins appear to be distinct from heat
      shock proteins. The steady state level of mRNAs encoding putative major light
      harvesting chlorophyll a/b binding protein-I and -II were, on the other hand,
      very low as compared with those of the control plants. The changes observed
      resemble those previously seen in cold-sensitive plants exposed to sub-lethal
      chilling temperatures (4-10 degrees C).

PMID- 8485459
TI  - Cold stability of microtubules of Mimosa pudica.
AB  - The unique property of Mimosa pudica microtubules is that they are cold stable in
      nature. They do not dissociate at 0 degrees C unlike animal microtubules. No
      other protein fractions of M. pudica are responsible for the cold-resistance
      property of these microtubules. It seems that tubulin, itself, has an intrinsic
      cold resistance which makes it unique compared with animal tubulin. Moreover, M.
      pudica microtubule makes cold-sensitive goat brain microtubule cold-resistant
      when used in greater than the suboptimal concentration.

PMID- 8485460
TI  - Integration of porin into the outer mitochondrial membrane through the common
      import machinery located in contact sites.
AB  - Although no binding of porin-precursor to trypsin-pretreated rat liver
      mitochondria was detectable, its integration into these mitochondria was observed
      to some extent, possibly by the bypass-import system first demonstrated in fungus
      mitochondria. A topographical study of this bypass-import system demonstrated
      that import of porin occurs at contact sites between the outer and inner
      membranes. Furthermore, antibodies to 29 kDa outer membrane protein, a component
      of the import machinery in contact sites for precursors of ornithine
      aminotransferase and sulfite oxidase, inhibited the integration of porin,
      suggesting that the 29 kDa protein is involved in the imports of most
      mitochondrial precursor proteins.

PMID- 8485461
TI  - Status of tryptophan residue in cobrotoxin and alpha-bungarotoxin.
AB  - Acrylamide quenching studies indicated that the exposure degree of the Trp
      residue in cobrotoxin was higher than that in alpha-bungarotoxin. The Trp residue
      of cobrotoxin was in a positively charged environment as revealed by iodide
      quenching, while the Trp residue of alpha-bungarotoxin was not accessible for
      iodide. Analysis of hydrophilicity profile and local concentration of positively
      charged residues of toxin molecule also indicated that Trp in cobrotoxin was in a
      highly hydrophilic and positively charged environment. Measurement of Trp
      fluorescence with increasing temperature showed that the stability of environment
      of Trp in alpha-bungarotoxin was higher than in cobrotoxin. Result of competitive
      binding for nicotinic acetylcholine receptor (AchR) between cobrotoxin and alpha
      bungarotoxin revealed that the molecular interaction of the two toxins with AchR
      was not the same. These, together with the fact that the cationic groups of the
      two toxins are involved in the binding with AchR, suggest that the observed
      different environment surrounded Trp residue and different AchR binding mechanism
      might fulfill a different requirement of the invariant Trp in the lethality of
      cobrotoxin and alpha-bungarotoxin.

PMID- 8485462
TI  - Nitecapone protects the Langendorff perfused heart against ischemia-reperfusion
      injury.
AB  - We assessed the protection afforded against myocardial ischemia/reperfusion by
      nitecapone in the Langendorff heart model using male Sprague-Dawley rats. We
      found that when present in the perfusate 10 microM nitecapone improved the
      mechanical function of the heart and lowered the enzyme leakage of lactate
      dehydrogenase after 40 minutes of global ischemia. In nitecapone treated hearts
      the content of oxidized proteins and lipids (carbonyl groups and endogenous lipid
      fluorescent products) decreased. Nitecapone partially prevented the loss of total
      sulfhydryl groups and vitamin E after ischemia and reperfusion. We suggest that
      the mechanism of nitecapone protection most likely involves direct antioxidant
      action and enhancing the activity of other antioxidants.

PMID- 8485463
TI  - Base specificity and binding of anti-ss/dsDNA monoclonal antibody. Application to
      the determination of ssDNA.
AB  - An anti-DNA murine hybridoma was generated and selected in a fusion of Sp2/0
      myeloma cells with splenocytes derived from BALB/c mice immunized with
      DNA/protein complex. The monoclonal antibody designated as 4C7 was assessed by
      competitive immunoassay for binding to denatured, structurally single-stranded
      (ss)DNA, double-stranded (ds)DNA and oligodeoxynucleotides. The monoclonal
      antibody exhibited a marked preference for the ss conformation. Competitive
      inhibition assay performed with nucleosides and homopolynucleotides indicated
      that the deoxyadenosine residue was essential for antibody recognition and
      binding. The monoclonal antibody was purified by poly(A)-Sepharose chromatography
      and biotinylated. The ssDNA detection limit in the enzyme-linked immunosorbent
      assay with the biotinylated antibody ranged from 1 to 16 ng/ml. A dot
      immunobinding test was developed which was sensitive for the quantitation of
      picogram amounts of single-stranded DNA deposited on nitrocellulose filters and
      applied to the immunoenzymatic detection in human sera of target DNA.

PMID- 8485464
TI  - Preferential stimulation by D-glucose of oxidative glycolysis in pancreatic
      islets: comparison between B and non-B cells.
AB  - In purified pancreatic islet B cells, a rise in D-glucose concentration from 2.8
      to 16.7 mM increased the production of both 14CO2 from D-[3,4-14C]glucose and
      3HOH from D-[5-3H]glucose to a much greater relative extent than in purified non
      B islet cells. Moreover, the paired ratio between D-[3,4-14C]glucose oxidation
      and D-[5-3H]glucose utilization was significantly increased, as a result of the
      rise in hexose concentration, in purified B cells, but not so in purified non-B
      cells. It is proposed, therefore, that a preferential stimulation by D-glucose of
      oxidative relative to total glycolysis represents an intrinsic attribute of
      insulin-producing cells, as distinct from other endocrine islet cells.

PMID- 8485465
TI  - Opposite response to starvation of Trp/LNAA ratio in lean and obese Zucker rats.
AB  - Total blood and plasma free amino acids and plasma urea levels were studied in
      fed and 24 h fasted Zucker rats. In fed animals there were no differences between
      obese and lean rats in the overall essential and non essential blood free amino
      acids. However, starvation reduced blood amino acid levels in the obese animals
      compared to the lean group, mainly due to changes in the plasma compartment. The
      reduction of available amino acids from plasma in the obese rats during
      starvation affected most of the amino acids, including the branched chain amino
      acids, which showed higher levels in the fed situation than in lean rats. Of
      particular interest is the opposite response to starvation in lean and obese
      Zucker rats concerning the plasma ratio of tryptophan (Trp) to the large neutral
      amino acids (LNAA) which could be implicated in the alteration of food intake and
      energy expenditure characteristic of obesity.

PMID- 8485466
TI  - Steroid induced single strand breaks in DNA mediated by active oxygen species and
      its biological consequences.
AB  - A mutagenic steroidal derivative (3 beta-Acetoxy-5 alpha-Cholestano[6 alpha,5
      d']1'-3'oxathiolane-2' thione) structurally related to cholesterol caused strand
      scission and induced nicks in calf thymus, supercoiled pBR322 and single stranded
      M13 mp8 phage DNAs. S1 nuclease hydrolysis, reaction with pBR322 and M13 phage
      DNA as well as treatment of E. coil mutant strains and phage was used to evaluate
      the effect of test steroid on the DNA molecule. The strand scission/nicking of
      DNA by the test steroid was enhanced by some metal ions, especially the Cu(II).
      Scavengers of active oxygen radical species significantly inhibited the S1
      nuclease hydrolysis by the test steroid indicating the major role of active
      oxygen species in DNA strand scission and nicking. The steroid brought about the
      DNA degradation even in the absence of S1 nuclease. There was an appreciable
      reduction in the survival of steroid treated polA and lig mutants of E. coli K12
      compared to the wild type strain. Phage on steroid treatment also lost its plaque
      forming units (P.F.U.) which was more pronounced in the polA and rec A
      background.

PMID- 8485467
TI  - Local anaesthetic effects on trophoblast membrane fluidity.
AB  - Previous studies showed that anaesthesia with the barbiturate Thiopental induces
      an increase in membrane fluidity and a decrease in acetylcholinesterase activity
      in syncytiotrophoblast plasma membranes (SPM) obtained from placentas after
      Cesarean section. The aim of the present work was to compare the effect of a
      local anaesthetic (bupivacaine hydrochloride, trade name Marcaine) on SPM in vivo
      and to establish whether the anaesthetic is still present in the membrane after
      tissue preparation. The acetylcholinesterase activity was lower in Marcaine
      anaesthetized SPM (27 +/- 3 against 39 +/- 6 in the control). The Marcaine action
      on the SPM can be ascribed to a competitive inhibition, similar to that reported
      for Thiopental. Fluorescence studies of the order parameter P showed it to be
      higher in SPM obtained from control (0.253 +/- 0.012) than in SPM obtained from
      Marcaine-exposed membranes (0.240 +/- 0.015). The local anaesthetic is still
      present in the SPM after their preparation (20.1 ng per mg membrane protein). It
      appears that the local anaesthetic exhibits an effect similar to that of the
      general anaesthetic, apparently due to binding to the membrane.

PMID- 8485468
TI  - Lipid peroxidation on dialysis membranes.
AB  - The aim of this study was to compare the changes of lipid peroxidation during
      haemodialysis (HD), using various types of dialyser membranes. A significantly
      higher concentration of total and free TBARS (thiobarbituric acid reacting
      substance) was found in blood and in plasma of HD patients, compared with the
      control group of blood donors. During the HD session the TBARS levels grow
      significantly, compared to the initial levels on both membranes (Alpha 500,
      Pro500), and are significantly higher after 15 min of HD on Alpha 500 membrane.
      The levels of TBARS appear to be significantly higher in patients on regular HD
      treatment, which may be due to a more intensive lipid peroxidation. There were
      significant acute changes in lipid peroxidation during one HD session. The
      changes in lipid peroxidation differ with the use of various HD membranes.

PMID- 8485469
TI  - B-->Z transition in native calf thymus DNA depends on its microenvironment.
AB  - Z-DNA forming potentiality of native calf thymus DNA was investigated under
      varying experimental conditions. Ethidium intercalation and Scatchard analysis
      data showed decreased binding of ethidium to nDNA at 4.27 M NaCl. A comparison of
      ethidium binding to DNA in low and high salt indicated the formation of Z-DNA.
      The binding of monoclonal anti-Z-DNA antibody to nDNA fragments brominated in
      high salt reiterated the transition of B-->Z conformation.

PMID- 8485470
TI  - The major fat-globule membrane proteins, bovine components 15/16 and guinea-pig
      GP 55, are homologous to MGF-E8, a murine glycoprotein containing epidermal
      growth factor-like and factor V/VIII-like sequences.
AB  - The glycoproteins, Components 15/16 and GP 55, were partially purified from
      bovine and guinea-pig fat-globule membrane (FGM), respectively. Peptides prepared
      from immunoblots of Component 16 and GP 55, were shown by sequencing, to be
      similar to mouse MFG-E8 and a human milk protein of M(r) 46,000. Both of these
      latter proteins are associated with the FGM and contain epidermal growth factor
      like domains and/or factor V/VIII-like sequences. These data complement earlier
      biochemical studies on the biosynthesis, tissue distribution and topology of
      Components 15/16 and GP 55, and indicate that MFG-E8-like proteins are expressed
      on the apical surfaces of mammary epithelial cells and are secreted both in a
      soluble form and as major components of the FGM in diverse species. The possible
      function of these proteins in lactation and in mammary and neonatal development
      is discussed.

PMID- 8485471
TI  - Calcium binding site mutants of calmodulin adopt abnormal conformations in
      complexes with model target peptides.
AB  - We have examined the ability of two series of calcium binding site mutants of
      Drosophila calmodulin to form complexes with the model target peptides melittin
      and mastoparan. Unlike the wild-type complex, the 1:1 protein:melittin complexes
      formed by mutants of the C-terminal sites are unable to bind a second molecule of
      melittin. In contrast, a site 2 mutant shows increased ability to bind two
      molecules of melittin. For the shorter peptide mastoparan, most mutants form
      aberrant complexes that are best interpreted in terms of a model in which
      mastoparan interacts with both terminal domains of calmodulin. For two of the
      target enzymes of calmodulin, the three mutants which form mastoparan complexes
      most similar to the wild-type complex are also the best enzyme activators.

PMID- 8485472
TI  - Two interconvertible forms of glucose-6-phosphate isomerase in rat muscle.
AB  - Chromatography of crude rat muscle extracts on CM-cellulose resulted in
      separation of glucose-6-phosphate isomerase (GPI) into two active peaks
      (designated types I and II in order of elution). Incubation of type I and type II
      at pH 6.0, 7.0, or 8.0 in the presence and absence of KCI revealed that one type
      of GPI is converted to the other type under certain conditions and that the two
      types are interconvertible by changing the incubation conditions. The two types
      were similar in molecular weight, kinetic property, and optimum pH. A remarkable
      difference was observed in pH-activity profile: the activity of type I, but not
      type II, was detectable at pH 6-7. The present results suggest that rat muscle
      has two types of GPI which are interconvertible and that the two types may be
      conformational variants of the same enzyme. It is conceivable that the
      interconversion between the two types is related to the regulation of glycolysis
      at lower intracellular pHs.

PMID- 8485473
TI  - Sickle cell disease: the transplant issue.
AB  - A legal moot (mock trial) was held in London in the Middle Temple Hall on
      Saturday 31 October 1992 to debate the place of BMT in sickle cell disease. The
      exact wording of the motion, which allowed a very full discussion to take place,
      was as follows: Bone marrow transplantation should forthwith be offered to all
      children in the UK with symptomatic sickle cell anaemia who have HLA compatible
      siblings.

PMID- 8485474
TI  - Microbial carriage, sepsis, infection and acute GVHD in the first 25 BMT at the
      Royal Liverpool Children's Hospital.
AB  - The first 25 BMTs at the Royal Liverpool Children's Hospital (Alder Hey) were
      performed between April 1987 and July 1991. The aim of this report is to evaluate
      selective decontamination of the digestive tract (SDD) during the first post-BMT
      month in this series of 14 allografts and 11 autografts. SDD is a method used to
      abolish carriage of potentially pathogenic microorganisms including yeasts,
      Staphylococcus aureus and Gram-negative bacilli (GNB). Chlorhexidine mouth wash
      was used to decontaminate the oropharynx, and neomycin, colistin (polymyxin E)
      and nystatin (NEOCON) were given to eradicate gut carriage. Oropharyngeal
      decontamination was successful in 48% of patients, gut carriage was abolished in
      60%, and eradication of the carrier state at both sites was achieved in 33%. A
      septic response was seen in 76% of children and 36% developed septicaemia
      (indigenous Gram-positive cocci only). A low carriage index for the target
      microorganisms during the study manoeuvre of SDD was associated with negative
      blood cultures (p < 0.01). Acute GVHD occurred in 28% of allografts, but was seen
      in none of the successfully decontaminated children (p < 0.05). It is concluded
      that septicaemia from yeasts and GNB, but not the septic response, were
      successfully prevented by SDD.

PMID- 8485475
TI  - Detection of residual host cells after bone marrow transplantation using non
      isotopic in situ hybridization and karyotype analysis.
AB  - Karyotype analysis and interphase cytogenetics by means of non-radioactive in
      situ hybridization (NISH) with Y and X-specific probes were used to detect
      residual host cells in BM of 18 male patients who had received a BMT from their
      sisters. All patients but one had a malignant blood disease; 17 patients were
      clinically in continuous remission at the time of the investigations and
      throughout the follow-up period. No host cells were detected by karyotype
      analysis in patients who were in clinical remission. NISH with a biotinylated Y
      specific probe showed residual host cells in 16 of the 17 patients in clinical
      remission. In samples from three patients the existence of host cells was further
      confirmed by revealing the XY-containing cells with two-color fluorescence in
      situ hybridization (FISH) using X- and Y-specific probes on direct BM smears
      showed > 3% residual host cells in 50% of the samples studied at or later than 2
      months post-BMT. On conventional cytogenetic preparations < 1% Y-specific cells
      were detected in all but two samples at > or = 2 months post-BMT. There was no
      difference in the proportion of host cells between patients conditioned with
      total body irradiation and CY and those who received busulphan and CY. The
      recipient's stromal or epithelial cells in the aspirates probably account for
      most of the host cells detected. In conclusion, small numbers of residual host
      cells detected by interphase cytogenetics with a Y-specific probe do not indicate
      an imminent relapse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485476
TI  - Dynamics of erythropoietic recovery following bone marrow transplantation: role
      of marrow proliferative capacity and erythropoietin production in autologous
      versus allogeneic transplants.
AB  - The mechanisms of erythrocyte recovery after BMT are not known. We investigated
      the respective role of marrow function and erythropoietin production in 31 ABMT
      and 47 allogeneic BMT by analysing peripheral counts, serum erythropoietin
      levels, and serum transferrin receptor (TfR) levels which have been shown to be a
      quantitative measurement of erythropoiesis. Median times to complete neutrophil
      (25 vs 48 days, p < 0.0001) and platelet (45 vs 263 days, p < 0.001) recovery
      were faster after allogeneic BMT than ABMT, but complete erythrocyte recovery was
      slower (218 vs 101 days, p < 0.001). After ABMT, erythrocyte recovery paralleled
      that of neutrophils and platelets, and erythropoietin levels remained appropriate
      for the degree of anemia. After allogeneic BMT, erythrocytes developed
      independently of the other cell lines and defective erythropoietin production
      delayed recovery of adequate erythropoietic activity. This correlated with an
      alteration of renal function only in those patients remaining erythropoietin
      deficient beyond day 180. However, supranormal erythropoietin levels in
      interstitial pneumonia suggests that erythropoietin response to hypoxia is not
      abrogated. CMV infection could also affect erythropoiesis through erythropoietin
      production after ABMT as well as allogeneic BMT. It is concluded that after ABMT
      the development of erythropoiesis is determined by the overall marrow
      proliferative activity and erythropoietin plays only a facilitating role. After
      allogeneic BMT, erythropoiesis depends on erythropoietin levels which remain
      inadequate for prolonged periods of time. The results suggest that the
      administration of recombinant human erythropoietin could reduce transfusion
      requirements after BMT.

PMID- 8485477
TI  - Use of an anti-interleukin-2 receptor monoclonal antibody for GVHD prophylaxis in
      unrelated donor BMT.
AB  - Severe acute GVHD remains the main complication in unrelated donor BMT (UD-BMT).
      The previous encouraging reports on the use of anti-IL-2 receptor monoclonal Ab
      (33B31) for GVHD prophylaxis in genoidentical BMT led us to add this Ab to the
      standard GVHD prophylaxis regimen (MTX plus CsA). Sixty-four consecutive patients
      received 33B31, 20 mg on days 1 and 2, then 10 mg per day from day 3 to day 28 in
      association with CsA and MTX. They were compared with a historical control group
      of 89 patients who received conventional GVHD prophylaxis. The 33B31 was well
      tolerated. We did not find any statistical difference in terms of incidence and
      time of onset of severe GVHD, occurrence of chronic GVHD, engraftment, relapse or
      survival among the two groups. Immunization occurred but did not influence serum
      levels of 33B31. No correlation was found between the severity of GVHD and serum
      Ab levels. We conclude that other approaches for reducing acute GVHD should be
      developed to improve UD-BMT results.

PMID- 8485478
TI  - Alterations in natural anticoagulant levels during allogeneic bone marrow
      transplantation: a prospective study in 27 patients.
AB  - The natural anticoagulants (antithrombin III, protein C, protein S), plasminogen
      and tissue plasminogen activator antigen (t-PA ag), were measured in 27
      consecutive patients following allogeneic BMT. Thrombosis and veno-occlusive
      disease were not seen in this study. Changes in the levels of these proteins
      occurred mainly during acute GVHD. There were 14 patients who had no acute GVHD
      (group I) and 13 patients who had acute GVHD (group II). No changes in
      antithrombin III (ATIII), protein C, protein S and t-PA levels were found in
      group II before the appearance of acute GVHD when compared with group I. However,
      we noted a significant rise in protein S (p = 0.01), antithrombin III (p = 0.001)
      and t-PA ag (p = 0.0004) levels during acute GVHD. In contrast, protein C levels
      decreased early in GVHD (p = 0.005), and then increased progressively over the
      course of a month post-GVHD. No changes in plasminogen levels were observed.
      These results might reflect activation of and/or damage to endothelial cells
      during GVHD.

PMID- 8485479
TI  - Recovery after allogeneic marrow transplantation: prospective study of predictors
      of long-term physical and psychosocial functioning.
AB  - No prospective data have documented the physical and psychosocial functioning of
      patients before and after BMT. In this study 67 allogeneic transplant patients
      completed standardized self-report measures pre-transplant. Survivors were re
      assessed at 90 days (n = 34) and 1 year (n = 31) post-transplant. Telephone
      interviews established 4-year work history and performance status. Physical
      function was most impaired at 90 days post-transplant, with a return to pre
      transplant levels of functioning by 1 year in most areas. By 2 years post
      transplant, 68% of patients had returned to full-time work. Only 9% of 4-year
      survivors failed to return to full-time occupations. Mean levels of anxiety and
      depression did not change over the first year. Pre-transplant, 27% of patients
      reported depression and 41% reported elevated anxiety. Greater emotional distress
      at 1 year was predicted by pre-transplant family conflict, non-married status and
      development of less severe chronic GVHD. Impaired physical recovery at 1 year was
      predicted by more severe chronic GVHD, pre-transplant physical impairment and
      family conflict. The large majority of long-term survivors returned to full-time
      employment with normal physical and psychosocial functioning, although recovery
      took longer than 1 year for approximately 40%. Family relationships were
      important determinants of physical and emotional recovery.

PMID- 8485480
TI  - Delayed infusion of normal donor cells after MHC-matched bone marrow
      transplantation provides an antileukemia reaction without graft-versus-host
      disease.
AB  - When allogeneic BMT is used for the treatment of leukemia, depletion of T cells
      from the donor BM to avoid GVHD may be accompanied by persistence of host cells
      and post-transplant relapse. In this report, a murine model of MHC-compatible BMT
      was used to show that delayed infusion of immunocompetent donor cells early after
      T cell-deficient BMT eliminated residual host cells and provided an antileukemic
      effect without causing lethal GVHD. AKR (H-2k) recipient mice were pre
      conditioned with 9 Gy total body irradiation (LD50) and transplanted with 10(7)
      BM cells from MHC-matched B10.BR donors. These mice did not develop GVHD and
      became stable, long-term mixed (donor-host) T cell chimeras. In this model, mixed
      or incomplete donor T cell chimerism was associated with decreased GVL
      reactivity. AKR hosts that were transplanted with B10.BR bone marrow admixed with
      3 x 10(7) B10.BR spleen cells (as a source of T cells) became complete donor T
      cell chimeras, but they developed severe and lethal GVHD. However, when the
      infusion of donor spleen cells was delayed until 21 days after BMT, few mice
      exhibited any clinical signs of GVHD, and > 95% of the mice became long-term
      survivors. The infused spleen cells eliminated residual host T cells by 21 days
      after infusion, and most chimeras were able to resist a supralethal challenge
      with AKR leukemia/lymphoma cells. Thus, post-transplant adoptive immunotherapy
      with normal mononuclear cells from the marrow donor may be an effective way to
      eliminate residual disease or treat leukemia relapse after BMT without causing
      significant GVHD.

PMID- 8485481
TI  - Disseminated subcutaneous Nocardia asteroides abscesses in a patient after bone
      marrow transplantation.
AB  - We describe an unusual case of disseminated subcutaneous abscesses caused by
      Nocardia asteroides in a 17-year-old female with AML undergoing allogeneic BMT.
      She was receiving immunosuppressive therapy with CYA and a corticosteroid for
      acute GVHD, and maintenance therapy with ganciclovir for interstitial pneumonia
      (IP) caused by CMV, but was not neutropenic. The subcutaneous abscesses spread
      from the primary infection on her right anterior leg to both thighs, the left
      buttock, both upper arms, the left forearm and right shoulder, indicating
      hematogenous dissemination. Nocardia asteroides was identified from biopsy
      material in culture. The patient was successfully treated with a combination of
      trimethoprim/sulfamethoxazole (TMP/SMX) and minocycline, given for 3 months. The
      possibility of nocardiosis should be considered in the differential diagnosis of
      such patients.

PMID- 8485482
TI  - Comparative study of intact A7 MoAb and F(ab')2 fragments for radioimmunoimaging
      of human colon cancer in nude mice.
AB  - Differences of pharmacokinetics and tumor imaging ability between intact
      monoclonal antibody A7 (A7 MoAb) and F(ab')2 fragments were studied in human
      colon cancer (LS-174T)-bearing nude mouse. First of all, we examined the yield
      and the immunoreactivity of F(ab')2 fragments after treatment with ficin as a
      function of time. The yield of F(ab')2 fragments reached about 50% after ficin
      treatment for 8 h, and the F(ab')2 retained about 80% of the immunoreactivity of
      the corresponding MoAb. Longer digestion with ficin produced smaller fragments
      (less than 92 kDa) with a lower yield and most of the immunoreactivity was lost.
      In pharmacokinetics studies, the F(ab')2 was preferentially taken up by the
      tumor, was cleared more rapidly from the blood circulation and seemed to have
      less non-specific tissue binding than intact A7 MoAb. In addition, the tumor
      image obtained at an early time using 131I-F(ab')2 was much superior in quality
      to that with intact 131I-A7 MoAb. The use of F(ab')2 fragments may be effective
      for tumor diagnosis and therapy.

PMID- 8485483
TI  - [11C] beta-CIT, a cocaine analogue. Preparation, autoradiography and preliminary
      PET investigations.
AB  - beta-CIT (2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane) is a cocaine analogue
      with a high affinity for the dopamine transporter. [11C] beta-CIT was prepared by
      N-methylation of nor-beta-CIT with [11C]methyl iodide. The total radiochemical
      yield of [11C] beta-CIT was 40-50% with an overall synthesis time of 35-40 min.
      The radiochemical purity was > 99% and the specific radioactivity at the time of
      injection was about 1000 Ci/mmol (37 GBq/mumol). Autoradiographic examination of
      [11C] beta-CIT binding in human brains post-mortem demonstrated a high level of
      specific binding in the striatum. PET examination of [11C] beta-CIT in a
      Cynomolgus monkey showed a marked accumulation of radioactivity in the striatum.
      The ratio of radioactivity in the striatum-to-cerebellum approached 5 after 87
      min. In a displacement experiment, radioactivity in the striatum but not in the
      cerebellum, was markedly reduced after injection of unlabelled cocaine. [11C]
      beta-CIT has a potential as ligand for PET examination of cocaine effects in man.

PMID- 8485484
TI  - Biological activities of phthalocyanines--XV. Radiolabeling of the differently
      sulfonated 67Ga-phthalocyanines for photodynamic therapy and tumor imaging.
AB  - Phthalocyanines have been advanced as photosensitizers for the photodynamic
      therapy of cancer and selectively sulfonated derivatives have shown promise as
      tumor imaging agents. In order to study the effect of the degree of sulfonation
      on their biodistribution pattern, we prepared a series of sulfophthalocyanines
      (PcS) labeled with 67Ga. Direct chelation of metal free phthalocyanines with 67Ga
      gave chelates which demetallated on further purification whereas condensation of
      67Ga with phthalic acid precursors, following purification and fractionation on
      Sep-Pak C18 cartridges, gave stable products. The distribution pattern of the
      [67Ga]GaPcS among human plasma proteins was strongly affected by the degree of
      sulfonation of the PcS. The lower sulfonated GaPcS showed significant binding to
      the various lipoprotein fractions whereas increased sulfonation favored
      association to albumin. The use of the 67Ga allowed for the validation of
      spectrophotometric quantification of GaPcS in biological samples and confirmed
      the in vivo stability of the radiolabeled complex.

PMID- 8485485
TI  - Synthesis, characterization and biodistribution of new 99mTc Oxo and nitrido
      complexes of unsaturated tetradentate (N2S2)ligands.
AB  - Three unsaturated Schiff base tetradentate (N2S2 or N2SO) ligands were
      synthesized and characterized. Oxo and nitrido 99m-technetium complexes were
      obtained with these ligands. The nitrido complexes were formed using a new easy
      method available as a kit. When injected into rats and mice, these lipophilic
      complexes were able to cross the blood-brain barrier but brain perfusion imaging
      could not be performed due to the insufficient uptake and retention time.

PMID- 8485486
TI  - Synthesis and in vivo evaluation of [18F]-N-(p-nitrobenzyl)spiperone ([18F]PNBS)
      in rats.
AB  - [18F]-N-(p-nitrobenzyl)spiperone, [18F]PNBS, was prepared and its in vivo uptake
      in rat brain was measured. A temporal increase in striatum:cerebellum ratio and
      frontal cortex:cerebellum (FC:Cb) ratio was observed. Blocking studies suggested
      the formation of a radiolabeled metabolite, presumably [18F]spiperone, that is
      capable of crossing the blood-brain barrier and labeling cortical 5-HT2
      receptors. This was confirmed using the ISRP method of metabolite analysis
      indicating [18F]PNBS is not a suitable tracer for studying D2 receptors in vivo
      with PET.

PMID- 8485487
TI  - Preparation and biological characteristics of 99mTc-diol a renal agent.
AB  - The present work concerns the production of 1,2-dihydroxypropyl-1-phosphonic acid
      (diol) by acid hydrolysis of (-cis) 1,2-epoxypropylphosphonic acid
      (phosphomycin), and its formulation as a kit easily labeled with
      [99mTc]pertechnetate. Biodistribution studies and whole-body autoradiographies in
      mice show that 99mTc-diol has a specific affinity for the kidneys: it is rapidly
      cleared from the blood and excreted in urine (12.09 +/- 6.40% ID are excreted in
      urine at 5 min and 70.81 +/- 2.41% ID at 30 min post-injection). Part of the
      injected activity remains in the kidney cortex sufficiently long to permit kidney
      imaging (5.66 +/- 0.91% ID is still in kidneys 1 h post-injection). In comparison
      with other agents which also localize in the kidney cortex, such as 99mTc-DMSA
      and 99mTc-glucoheptonate (99mTc-GHA), the main differences are the following: the
      peak of renal activity is reached early in the 5 min post-injection period for
      99mTc-diol, only at about 10 min post-injection for 99mTc-GHA and after 3 h post
      injection for 99mTc-DMSA. The uptake of 99mTc-diol by other organs, especially by
      bones, is much smaller than in the case of 99mTc-DMSA (1.25 +/- 0.11% ID of 99mTc
      diol compared to 11.31 +/- 1.17% ID of 99mTc-DMSA, 1 h post-injection). Unlike
      99mTc-DMSA, the biodistribution of 99mTc-diol is not significantly influenced by
      acid-base imbalance, in addition, its renal uptake decreases in the presence of
      probenecid whereas its urinary excretion increases.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8485488
TI  - Complexes of technetium-99m with phosphomycin, obtained by pH shifting:
      biological characteristics, whole-body autoradiography, gamma-camera study.
AB  - Phosphomycin (phos), a large spectrum antibiotic with preferential localization
      into the kidneys, can be labeled with technetium-99m at various pHs. However, the
      final pH in the labeling of phos by [99mTc]pertechnetate in the presence of SnCl2
      seems to play a significant role in determining the biological properties of the
      final labeled product. Radiopharmacological characteristics of various forms of
      99mTc-phos obtained at pHs 6.8, 4.5 and 2.5 were studied in mice, rats and
      rabbits. Significant differences in these products were shown by biodistribution
      studies in Balb/C mice and Wistar rats and confirmed by whole-body
      autoradiographies in mice and gamma-camera studies in rats and rabbits. 99mTc
      phos, pH 6.8, has a high uptake in kidneys from 2 min after injection (10.25 +/-
      1.11 %ID) to 3 h after injection (8.26 +/- 0.42 %ID) and a rapid urinary
      excretion (19.9 +/- 7.35 %ID at 2 min after injection and 75.11 +/- 3.48 %ID at 3
      h). Intrarenal pharmacokinetics studied by autoradiography showed a high
      concentration in the inner medulla and pelvis at 1 min after injection followed
      by an increased localization in kidney cortex, like 99mTc-DMSA. Preferential
      uptake in bones was shown by 99mTc-phos, pH 2.5, from 5 min to 3 h after
      injection (15.05 +/- 2.67 %ID at 3 h compared to 1.79 +/- 0.19 %ID of 99mTc-phos,
      pH 6.8, at the same time). A high urinary excretion of 99mTc-phos, pH 2.5, is
      shown as in the case of other bone agents (76.5 +/- 3.46 %ID at 3 h post
      injection) but without any kidney retention (1.80 +/- 0.26 %ID in kidneys 3 h
      post-injection).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485489
TI  - Influence of fatty acid backdiffusion on compartmental analysis of external
      detection curves obtained with 123-iodohexadecenoic acid in isolated rat heart.
AB  - In isolated rat hearts, we investigated a possible backdiffusion of fatty acids
      and tried to determine whether it impaired our compartmental analysis of
      myocardial time-radioactivity curves obtained with an iodinated fatty acid, 16
      iodo-9-hexadecenoic acid (IHA). Backdiffusion was not observed directly in the
      coronary effluents but was estimated by analysis of the external detection
      curves. Furthermore, when backdiffusion was not taken into account in the
      mathematical analysis, we obtained similar data on IHA intramyocardial
      metabolism.

PMID- 8485490
TI  - A simple method for affinity purification of radiolabeled monoclonal antibodies.
AB  - A simple method is described for affinity purification of radiolabeled antibodies
      using glutaraldehyde-fixed tumor target cells. The cell-bound antibody fraction
      is removed from the cells by an acid wash and then immediately subjected to
      buffer-exchange chromatography. The method was applied to the D3 murine
      monoclonal antibody which binds to a 290 kDa antigen on the surface of Line 10
      guinea pig carcinoma cells. No alteration in the molecular size profile was
      detected after acid washing. Purification resulted in a significant increase in
      immunoreactivity by an average of 14 +/- 47% (SD; range 4-30%).

PMID- 8485491
TI  - Preparation, characterization and biological evaluation of cationic 99Tc/99mTc
      dioxime complexes.
AB  - New cationic 99Tc/99Tc complexes formed with various symmetrical and asymmetrical
      vicinal dioximes of different carbon chain length (C5-C8) were synthesized by
      reduction of pertechnetate with BH4-, separated by HPLC and characterized by
      i.r./u.v./vis. spectroscopy, FAB mass spectrometry and electrophoresis. All
      complexes studied are trisdioximes containing boron as a constituent. Their
      lipophilicity, as assessed by the octanol/saline partition coefficient, ranges
      over almost four orders of magnitude. The myocardial uptake of the 99mTc
      complexes in mice proves to be lower than expected. The organ distributions are
      distinctly affected by the lipophilicity, the position of the dioxime group and
      the introduction of a terminal methoxy group.

PMID- 8485492
TI  - Radioimmunoimaging of human breast carcinoma xenografts in nude mouse model with
      111In-labeled new monoclonal antibody EBA-1 and F(ab')2 fragments.
AB  - Radioimmunoimaging characteristics of a new monoclonal antibody EBA-1 and its
      F(ab')2 fragments utilizing nu/nu mice bearing human breast carcinoma xenografts
      are described. 111In-DTPA conjugates of EBA-1 localized with tumor/blood ratios
      of 0.99 +/- 0.10 (P < 0.3) and 4.65 +/- 1.60 (P < 0.05), and localization indices
      of 1.25 and 2.61 at 24 and 72 h, respectively. A tumor/blood ratio as high as
      28.86 +/- 6.90 (P < 0.025) was obtained with EBA-1 F(ab')2 radioconjugates at 48
      h. These results suggest that EBA-1 and its F(ab')2 might be useful reagents in
      radioimmunoimaging and radioimmunotherapy.

PMID- 8485493
TI  - Simultaneous measurements of twenty-four-hour whole-body retention of 47Ca
      chloride and 99mTc-MDP: early differentiation of metabolic bone diseases in rat
      models.
AB  - The 24-h whole-body retention (24-h WBR) of 47Ca-chloride and 99mTc-MDP was
      measured in four rat models over a 6-week period at 2 week intervals. Fine detail
      bone radiographs of the femurs and histologic bone specimens were also obtained
      simultaneously. In the osteomalacic (M) and steroid-induced osteoporotic (S)
      groups the 24-h WBR values of 47Ca were significantly lower, and in the
      osteoporotic (P) group were higher than in the control (C) group from the second
      week. The 24-h WBR values of 99mTc-MDP were significantly higher in the M group
      and were lower in the S group from the second week. Simultaneous measurements of
      24-h WBR of these two radiopharmaceuticals facilitated the early differentiation
      of metabolic bone diseases in the animal models prior to the detection of
      radiologic bone changes.

PMID- 8485494
TI  - Development and validation of a solvent extraction technique for determination of
      Cu-PTSM in blood.
AB  - The partitioning of [67Cu]Cu-PTSM between plasma and red blood cells (RBC) was
      investigated in vitro with human, rat, pig and dog blood. Significant inter
      species variability is observed in the plasma/RBC partitioning of tracer, ranging
      from c. 75% association with plasma in human blood to only c. 35% association
      with plasma in dog blood. This inter-species difference results from selective
      association of the [67Cu]Cu-PTSM tracer with human albumin. When [67Cu]Cu-PTSM is
      mixed with human blood in vitro at 37 degrees C the fraction of 67Cu
      radioactivity that remains plasma-associated decreases with time, apparently due
      to the expected intracellular decomposition of the Cu-PTSM complex by RBC;
      however, this process is sufficiently slow that it should have limited influence
      on [62Cu]CU-PTSM biodistribution following intravenous injection. Octanol
      extraction of blood was found to be an effective technique for quantitating the
      amount of intact [67Cu]Cu-PTSM complex in blood samples. When imaging with
      [62Cu]Cu-PTSM, octanol extraction may be useful for determining the [62Cu]Cu-PTSM
      content of arterial blood samples to establish a true radiotracer input function.

PMID- 8485495
TI  - Synthesis, receptor binding and tissue distribution of 17 alpha-E[125I]iodovinyl
      11 beta-ethyl-estradiol.
AB  - In this study we prepared and evaluated a derivative of estradiol with an ethyl
      group at the 11 beta-position and an E-iodovinyl group at the 17 alpha-position.
      This new ligand binds to the estrogen receptor with an affinity slightly less
      than estradiol (RBA = 43%) at 0 degree C but much greater (RBA = 890%) at 25
      degrees C. The 125I-labeled derivative was obtained by radioiododestannylation of
      the tri-n-butylstannyl precursor in good radiochemical yield with a specific
      activity exceeding 1500 Ci/mmol. The tissue distribution in immature female rats
      was evaluated over a 48 h period to determine uterine uptake and selectivity.
      Peak uterine uptake at 2 h was 6% ID/g and was significantly greater than that of
      [3H]estradiol, 2.4% ID/g. Substantial uptake in the uterus was still present at
      48 h (2.4% ID/g). Co-administration of estradiol reduced the uptake at 2 and 24 h
      by 85%. Uterus-to-plasma ratios increased with time, from about 25:1 at 2 h to
      nearly 90:1 at 48 h. The affinity, ease of radiosynthesis and tissue distribution
      of the 17 alpha-E-[125I]iodovinyl-11 beta-ethyl-estradiol suggest that further
      evaluation of this agent as an imaging agent for estrogen-receptor-positive
      breast cancer is warranted.

PMID- 8485496
TI  - Evaluation of [11C]thymidine for measurement of cell proliferation in fast
      dividing tissues.
AB  - The purpose of this study was to investigate the possibility of using
      [11C]thymidine as a tumor marker for positron emission tomography studies.
      Biodistribution studies were set up to investigate the in vivo behavior of
      [11C]thymidine. Simultaneously, the DNA incorporation in fast dividing tissues
      and catabolism was studied. Our results confirm that [11C]thymidine can be used
      for detection of cell proliferation by positron emission tomography. As such, it
      can produce supplementary information in cancer research.

PMID- 8485497
TI  - Interaction of 99mTc-radiopharmaceuticals with transport proteins in human blood.

PMID- 8485498
TI  - Direct analysis of Kryptofix 2.2.2 in 18FDG by gas chromatography using a
      nitrogen-selective detector.

PMID- 8485499
TI  - A revised method for the synthesis of 1,1-bis(4-hydroxyphenyl)-2-phenylethylene
      (BHPE) and its derivatives.

PMID- 8485500
TI  - Comment on "An improved method of direct labeling monoclonal antibodies with
      99mTc" by M. M. Alauddin, L. A. Khawli and A. L. Epstein, Nucl. Med. Biol. 19,
      445-454.

PMID- 8485501
TI  - Development and registration of chiral drugs.
AB  - In this review we describe the impact of chirality on drug development and
      registration in the United States, Japan and the European Community. Enantiomers
      may have differences in their pharmacological profiles, and, therefore, chiral
      drugs ask for special analytical and pharmacological attention during their
      development. However, the registration authorities have no clear policy towards
      the registration of chiral drugs. The absence of a clear policy regarding
      chirality causes a great deal of confusion and frustration at various levels and
      is not in the interest of industries developing newer and more beneficial drugs.

PMID- 8485502
TI  - Generalized convulsive status epilepticus: pathophysiology and treatment.
AB  - The treatment of generalized convulsive status epilepticus according to a
      protocol, including a time schedule, prevents unnecessary delay and improves
      outcome. Based on a literature study and our own clinical experiences a treatment
      protocol is discussed with special emphasis on medical complications, choice of
      antiepileptic drugs, route of administration and a proper time schedule.

PMID- 8485503
TI  - Drug transport across the blood-brain barrier. III. Mechanisms and methods to
      improve drug delivery to the central nervous system.
AB  - This is the third part of a review on the transport of drugs across the blood
      brain barrier. In the first two parts, the anatomical and physiological aspects
      and the various techniques that can be used to study blood-brain transport have
      been discussed and reviewed. This third part focuses specifically on the
      mechanisms that are involved in drug transport across the blood-brain barrier. In
      addition, the opportunities to improve drug transport into the brain will be
      reviewed. Emphasis is on the transport of peptides.

PMID- 8485504
TI  - Evaluation of two prediction models for digoxin dosing.
AB  - The relationship between the digoxin elimination parameter (A%) and creatinine
      clearance (CLCr) was determined, from blood level data of 160 hospital patients
      receiving digoxin tablets. The linear regression equation obtained, which varied
      only slightly from that reported by Jelliffee previously, was used to predict
      serum digoxin concentrations in 140 patients of four age groups (50-60, 60-70, 70
      80 and 80-90 years). The predictions made were found to be less biased and more
      precise, irrespective of the age of the patients, than those produced using
      another predictive method known as Dobbs method. However, correlation
      coefficients of predicted versus measured serum digoxin concentrations for each
      method did not differ significantly and frequency distribution analyses of
      prediction errors gave poor results (up to 63% only). Therefore, neither method
      can be considered to be superior to the other nor can they be said to ensure
      accurate predictions of serum digoxin concentrations.

PMID- 8485505
TI  - Stability of cisplatin in sodium chloride 0.9% intravenous solution related to
      the container's material.
AB  - The stability of cisplatin in sodium chloride 0.9% intravenous solutions
      contained in glass bottles, polyvinyl chloride bags, polyethylene and
      polypropylene containers was studied over two weeks. The solubility of cisplatin
      at 4 degrees C was also studied for possible precipitation. The type of container
      had no effect on cisplatin decomposition. No precipitation at 4 degrees C was
      observed within the time period studied.

PMID- 8485506
TI  - Biopharmacy and Pharmaceutical Technology Meeting. Oss, The Netherlands, 14 May
      1993. Abstracts.

PMID- 8485507
TI  - Synthesis of [1-11C]D-glucosamine and evaluation of its in vivo distribution in
      rat with PET.
AB  - D-Glucosamine is a structural unit of many biologically interesting
      macromolecules. To investigate the feasibility of using labelled D-glucosamine as
      a tracer for anabolic processes, a two-step synthetic procedure for specifically
      labelling D-glucosamine in position 1 with carbon-11 was developed. [11C]Cyanide
      was reacted with an imine precursor, N-benzyl-D-arabinosylamine, to generate the
      [1-11]alpha-amino nitrile. Reduction to [1-11C]D-glucosamine was accomplished by
      catalytic hydrogenation using PdCl2 and the N-benzyl group was simultaneously
      removed. The total synthesis time from end-of-trapping of [11C]cyanide was 40-45
      min and the decay-corrected radiochemical yield was 5-10% after HPLC isolation.
      The biodistribution of [1-11C]D-glucosamine in rat following i.v. bolus injection
      was investigated using positron emission tomography and showed that the
      availability of this substance for CNS anabolism is low with the primary
      limitation being the intact blood-brain barrier.

PMID- 8485508
TI  - A microcomputer-based whole-body counter for personnel routine monitoring.
AB  - The paper describes a cost-effective NaI(Tl) whole-body counter developed for
      routine examinations of worker intakes at an isotope production facility. Signal
      processing, data analysis and system operation are microcomputer-controlled for
      minimum human interactions. The pulse height analyzer is developed as an
      microcomputer add-on card for easy manipulation. The scheme for radionuclide
      analysis is aimed for fast running according to a knowledge base established from
      background samples and phantom experiments in conjunction with a multivariate
      regression analysis. Long-term stability and calibration with standards and in
      vivo measurements are reported.

PMID- 8485509
TI  - Structure-localization relationships of 11C-labeled phentermine derivatives:
      effect of aromatic substitution.
AB  - A series of phentermine analogs, including the unsubstituted, the para-F, -Cl, 
      Br and -I, and the meta-CF3 derivatives, were labeled by [11C]methylation and
      evaluated in rats to determine the structure-localization relationships for this
      class of regional cerebral blood flow imaging agents. All the phentermines were
      well-localized in the brain; however, only the para-substituted agents were well
      retained. Localization in the nontarget tissue was affected by the lipophilicity
      of the substituent. Comparison with the radioiodinated analogs showed virtually
      identical results, which suggests that the compounds were not significantly
      metabolized. The agent with the best biodistribution characteristics was the N
      [11C]methyl-p-iodophentermine, with the p-bromo analog almost equivalent.

PMID- 8485510
TI  - Speech-language interventions in Alzheimer's disease. A functional communication
      approach.
AB  - Alzheimer's disease is a progressive degenerative neurogenic disease that is more
      prevalent among the old than the young. The primary symptoms are forgetfulness,
      repetitiousness, losing one's way, and the loss of ability to perform complex
      tasks on the job. Diagnostic confirmation of Alzheimer's disease is determined by
      autopsy. As of this writing, there is no specific drug that can stop or reverse
      the disease. Medical management is focused on treating behavioral symptoms and
      managing the individual's general well-being. The communication needs of the
      Alzheimer's client depend on the individual's level of cognition, degree of
      independence, circumstance, and communicative abilities. Due to their poor
      rehabilitation potential, the majority of persons with Alzheimer's disease are
      not suitable candidates for traditional therapy programs. An alternative to
      traditional therapies is the Tri-Model system. The Tri-Model philosophy of
      rehabilitation and service delivery systems (Glickstein and Neustadt, 1992) lends
      itself readily to the needs of the dementia client because the model is designed
      to maintain the continuum of rehabilitation care for individuals with "red flag"
      diagnoses such as dementia. Establishing a treatment protocol based on the Tri
      Model philosophy of rehabilitation not only assures the individual treatment
      based on his or her level of functional ability and rehabilitation need, it
      provides a framework for the rehabilitation specialist to use as reference for
      the various stages of disability and change during rehabilitation. The Tri-Model
      System is a decision tree which allows movement in any direction according to the
      client's needs (Figure 1). Clients, staff, and families are encouraged to set
      realistic goals at the outset of the rehabilitation program. By delineating three
      overlapping phases in the recovery process a base is established which allows the
      rehabilitation professional to appropriately follow the client after discharge
      and maintain the continuum of care. Since each restorative phase in the system
      requires the design of restorative programs which address that particular phase
      of the rehabilitation process and cooperation of an interdisciplinary team,
      addressing all three phases of rehabilitation at the time of the initial
      evaluation maintains the continuity of the client's treatment protocol throughout
      the course of the disease. Inclusion of Restorative III (functional maintenance)
      assures the continuum of care. The strength of the Tri-Model philosophy and
      system of rehabilitation is the inclusion of the definition and delineation of
      functional maintenance, the most neglected and for many clients the most
      important part of a complete rehabilitation program. When an incomplete
      definition of rehabilitation is used, questions regarding the efficacy of
      treatment is common.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8485511
TI  - Consultation and collaboration programs for individuals with autism.
AB  - Students with autism present a challenge to the SLP not only because of the
      severity of their communication disorders, but also because of the great variety
      of learning styles and social skills. Collaboration- and consultation-based
      service delivery systems offer an alternative to traditional therapy for these
      students. This model uses the strength of a team approach and permits strategies
      for improving communication that are not possible in other environments.

PMID- 8485512
TI  - Structural features critical to the activity of an ecdysone receptor binding
      site.
AB  - Two ecdysone-response elements from the hsp27 (hsp27 EcRE) and the Fbp1 (D EcRE)
      genes of Drosophila melanogaster were used as probes in a gel shift assay to
      investigate the interactions of the ecdysone receptor (EcR) with its cognate DNA
      response element. The source of EcR was a nuclear extract from the late third
      larval instar fat body. The hsp27 and D EcREs share a sequence similarity at 12
      positions over a 15bp region including an imperfect palindromic structure
      consisting of two pentamer half-sites separated by a single intervening
      nucleotide. We have shown that a short oligonucleotide containing this 11bp
      imperfect palindrome of the hsp27 EcRE and three flanking bp on each side is an
      efficient EcR binding site. Mutational analysis confirms that the integrity of
      both these half-sites as well as their 1bp spacing are critical for binding of
      the ecdysone receptor. The D EcRE behaved as a much weaker EcR binding site than
      the hsp27 EcRE but a single bp substitution was sufficient to confer upon it a
      binding capacity equivalent to that of the hsp27 EcRE. These results have led us
      to propose the sequence PuG(G/T)T(C/G)A(N)TG(C/A)(C/A)(C/t)Py as a revised
      version of a previously proposed EcRE consensus sequence.

PMID- 8485513
TI  - Cloning of a Chironomus tentans cDNA encoding a protein (cEcRH) homologous to the
      Drosophila melanogaster ecdysteroid receptor (dEcR).
AB  - We have cloned a cDNA sequence coding for a Chironomus tentans steroid hormone
      receptor homologue which exhibits extensive amino acid sequence co-linearity with
      the ecdysteroid receptor of Drosophila melanogaster (dEcR; cell 67, 59-77). The
      DNA-binding domain has 95% and the hormone-binding domain 75% amino acid sequence
      identity with the cloned dEcR. The gene for this C. tentans protein is located on
      chromosome II, region 17C, as determined by in situ hybridization to polytene
      chromosomes of salivary glands. On Northern blots cDNA probes of the cloned gene
      hybridize to polyadenylated RNA of ca 4.2 kb. The expression of the cloned gene
      seems to be developmentally regulated and correlates to changes in ecdysteroid
      titer. Transfection of this C. tentans protein into D. melanogaster Schneider's
      line 2 cells leads to transcriptional interference with endogenous dEcR on an
      ecdysteroid-regulated promoter.

PMID- 8485514
TI  - Early steps in ecdysteroid biosynthesis: evidence for the involvement of
      cytochrome P-450 enzymes.
AB  - The first step in the biosynthesis of ecdysteroids by Manduca sexta prothoracic
      glands, the conversion of cholesterol to 7-dehydrocholesterol, is mediated by an
      enzyme with characteristics of a microsomal cytochrome P-450, i.e. sensitivity to
      CO and fenarimol, and a requirement for NADPH. The enzyme responsible for
      hydroxylation at C-25 of the putative 3-dehydroecdysone precursor, 14-hydroxy-5
      beta-cholest-7-en-3,6-dione, is also microsomal, while those mediating
      hydroxylations at C-22 and C-2 of 3,14,25-trihydroxy-5 beta-cholest-7-en-6-one
      are mitochondrial. Indirect evidence revealed that the steps between 7
      dehydrocholesterol and the trideoxyecdysteroids occur in the mitochondria,
      suggesting that extensive shuttling of intermediates between the endoplasmic
      reticulum and mitochondria takes place in the prothoracic gland cell during
      ecdysteroid biosynthesis. During the fifth larval instar, cholesterol 7,8
      dehydrogenase activity is evident from days 2 to 9, while the conversion to
      [3H]ecdysteroids is not significant prior to the ecdysteroid commitment peak on
      day 4. Terminal hydroxylase activity shows little change throughout the instar.
      These data support the hypothesis that regulation of the biosynthetic pathway by
      PTTH occurs at the step immediately following the formation of 7
      dehydrocholesterol. The steroid biosynthesis inhibitor, fenarimol, has been shown
      to inhibit each of these P-450 enzymes, as well as fat body ecdysone 20
      monooxygenase, with an I50 of 10(-4) M in disrupted glands, suggesting that it is
      a general P-450 inhibitor. The secretion of ecdysteroids by the glands in vitro
      is very sensitive to fenarimol, i.e. I50 of 10(-6) M. RH5849, 1,2-dibenzoyl-1
      tert-butylhydrazine, fails to inhibit any of these prothoracic gland reactions,
      yet strongly inhibits fat body ecdysone 20-monooxygenase activity. This suggests
      that RH5849 is a specific ecdysteroid substrate/product mimic in this reaction.

PMID- 8485515
TI  - Enhancer and silencer elements within the first intron mediate the
      transcriptional regulation of the beta 3 tubulin gene by 20-hydroxyecdysone in
      Drosophila Kc cells.
AB  - We have studied the transcriptional regulation of the beta 3 tubulin gene by the
      steroid hormone 20-hydroxyecdysone (20-E) in Drosophila Kc cells. A series of
      hybrid genes, with different fragments of the beta 3 tubulin gene driving the
      bacterial chloramphenicol acetyl transferase (CAT) gene were constructed. The
      promoter activity was assayed after transient expression in Kc cells, in the
      presence and the absence of 20-E. Constructs with 0.91 kb upstream from the
      transcription start site and 360 bp from the first large intron allowed the
      hormonal regulation, i.e. a repression in the absence of 20-E and a derepression
      activation in the presence of the hormone. This 360 bp fragment contains several
      enhancers and silencer(s) sequences. The regulation of the expression of the beta
      3 tubulin gene results from the combined activity of all the positive and
      negative regulatory sequences of the first intron, and a dialogue with the
      promoter sequences. The nucleotide sequence of this intronic regulatory-fragment
      has been established and we have identified several EcRE (ecdysone responsive
      element) consensus sequences.

PMID- 8485516
TI  - The IVth Karlson Lecture: ecdysone-responsive genes.
AB  - Those of us who study ecdysone action share at least two important long-range
      goals: (i) to understand the developmental specificity of steroid action in full
      molecular detail, by integrating ecdysone action with our rapidly expanding
      knowledge of the molecular biology of insect development, and (ii) to better
      understand the nature of the steroid response and its evolution by taking
      advantage of the unparalleled opportunities for both genetic and comparative
      study afforded by the diversity of the "ecdysone world". However, until recently,
      the molecular fundamentals of the ecdysone system were unknown and our efforts
      have, of necessity, been devoted to their elucidation. Now that the situation has
      changed: we have a small but varied catalog of ecdysone-responsive genes for
      study and it is clear that some of these are tissue- and stage-specific in their
      expression. The ecdysone receptor (EcR), like other steroid receptors a member of
      the nuclear receptor family, is now accessible to molecular study, and we have a
      preliminary understanding of the DNA sequences (EcREs) that bind receptor and
      specify a gene as ecdysone-responsive. With these tools in hand and with the
      opportunity to turn to larger questions, it is a propitious moment to consider
      the nature of those questions and how ecdysone can contribute to the answers.

PMID- 8485517
TI  - The ultrastructure of the prothoracic gland/corpus allatum/corpus cardiacum ring
      complex of the Australian sheep blowfly larva Lucilia cuprina (Wied.) (Insecta:
      Diptera).
AB  - The ultrastructure of the constituent endocrine glands within the ring complex of
      Lucilia cuprina larvae has not been previously described. This study investigated
      the ring complex of mid-third instar larvae. Three distinct endocrine cell types
      were identified: (1) prothoracic gland (PTG) cells which constituted the major
      cell type; (2) corpus allatum (CA) cells, localized in the anterior central
      region, and (3) corpus cardiacum (CC) cells, located posteriorly, ventral to the
      aorta. PTG cells were identifiable by their large ovoid nuclei (9-14 microns dia,
      length 12-18 microns) and numerous cytoplasmic lipid vacuoles. The plasma
      membrane of peripheral PTG cells were invaginated to form intercellular channels.
      The CA cells are characterized by ovoid nuclei (6-7.5 microns dia, 6.5-9 microns
      length) and electron dense staining cytoplasm. Compared to PTG cells the CA cells
      had smaller nuclei and lower nucleus:cytoplasm cell ratio. Extensive networks of
      highly irregular, electron-lucent intracellular spaces, dispersed throughout the
      cytoplasm were also characteristic of CA cells at this developmental stage. These
      spaces often contained membrane bound lipid vacuoles occurring singly or as
      aggregates. The CC contained both intrinsic and extrinsic neural components. The
      intrinsic cells were characterized by circular nuclei (6.5-8.5 microns dia),
      prominent nucleolus and numerous cytoplasmic electron-dense neurosecretory
      granules (100-240 nm dia). The extrinsic axons and terminals within the CC
      contained electron-dense neurosecretory granules (80-150 nm), neurotubules and
      mitochondria.

PMID- 8485518
TI  - Effects of plant flavonoids and other allelochemicals on insect cytochrome P-450
      dependent steroid hydroxylase activity.
AB  - The plant flavonoids flavone, chrysin, apigenin, kaempferol, morin, quercetin,
      myricetin and phloretin were found to inhibit in a dose-dependent manner the
      cytochrome P-450 dependent ecdysone 20-monooxygenase activity associated with
      adult female Aedes aegypti, wandering stage larvae of Drosophila melanogaster,
      and fat body and midgut from prewandering and wandering stage last instar larvae
      of Manduca sexta. The concentrations of these flavonoids required to elicit a 50%
      inhibition of the steroid hydroxylase activity in all the insects ranged from ca
      1 x 10(-5) to 1 x 10(-3) M. In addition, lower concentrations (1 x 10(-6) to 1 x
      10(-5) M) of the flavonols kaempferol, morin, quercetin and myricetin
      significantly stimulated (50-100% above control) M. sexta fat body ecdysone 20
      monooxygenase activity. Other plant allelochemicals examined and found to
      significantly inhibit insect ecdysone 20-monooxygenase activity include
      corynanthine, quinidine, and quinine; whereas, indican and mimosine were found to
      significantly stimulate M. sexta fat body steroid hydroxylase activity. Several
      allelochemicals were without effect at all concentrations tested. Although none
      of the compounds tested in this study elicited effects at very low concentrations
      (1 x 10(-9) to 1 x 10(-8) M), the in vitro monooxygenase radioassay does hold
      considerable promise as a screening tool for the detection and identification of
      plant allelochemicals which may function as biopesticides affecting insect
      ecdysteroidogenesis.

PMID- 8485519
TI  - The arthropod initiator: the capsite consensus plays an important role in
      transcription.
AB  - Approximately 25% of arthropod RNA polymerase II-transcribed promoters contain
      one or more copies of the sequence TCAGT beginning within the interval (-10,
      +10). The clear statistical overrepresentation of this sequence and, to a lesser
      extent, of its cognates ACAGT, GCAGT, and TCATT, implies that they may be
      significant promoter elements. Their collective sequence similarity to vertebrate
      initiators (Inrs) of the TdT class suggests that the vertebrate and arthropod
      elements are homologous. Prior work in vertebrate systems has emphasized the role
      of the Inr in promoters lacking TATA boxes, where it can serve as an alternate
      staging site for polymerase II initiation. However, it is clear that the Inr
      sequence is by no means restricted to TATA-deficient promoters. Functional tests
      using the TATA-containing Drosophila gene Eip28/29 support the idea that the Inr
      is a facultative promoter element, required for efficient transcription under
      some conditions. For example, the Inr protects basal expression of Eip28/29 from
      the silencing effect of ecdysone response elements. In addition, the Inr is
      required for the function of an enhancer of basal activity in Eip28/29. We
      conclude that Inrs are promoter elements found sporadically throughout the higher
      eukaryotes, that the requirement for an Inr depends upon the array of other
      promoter elements which may be present in a given gene, and that Inrs may permit
      enhancers to discriminate among promoters.

PMID- 8485520
TI  - The E75 gene of Manduca sexta and comparison with its Drosophila homolog.
AB  - The ecdysone-inducible E75 gene responsible for the 75B puff of Drosophila
      melanogaster encodes a family of proteins which are members of the steroid
      receptor superfamily. These proteins are believed to be involved in the
      regulation of ecdysone response. In order to investigate the evolutionary
      conservation of E75, we have identified the E75 gene of Manduca sexta. We show
      here the structure of a cDNA believed to encode the Manduca homolog of the E75B
      protein, and demonstrate that the putative DNA binding, hormone binding and amino
      and carboxy terminal flanking domains are conserved. However, due to a relative
      reduction in intron size and number and the absence of homopolymeric amino acid
      repeats, the E75 B transcription unit and protein are considerably smaller in M.
      sexta than in D. melanogaster. These findings have implications for the
      identification of critical structural features of E75 and also suggest that E75
      has a conserved function and a shared ligand in Lepidoptera.

PMID- 8485521
TI  - The reaction with polytene chromosomes of antibodies raised against Drosophila
      E75A protein.
AB  - The steroid insect molting hormone ecdysone rapidly induces a small number of
      polytene chromosome puffs in Drosophila. The Ashburner model proposes that the
      corresponding early genes encode proteins involved in both the induction of the
      late genes and the repression of the early genes. The Drosophila E75 early gene
      has been isolated and two of its products, E75A and E75B, have been shown to be
      members of the steroid receptor superfamily. We have now prepared antisera
      directed against A- and B-specific regions of the E75 proteins. Antisera and a
      monoclonal antibody raised against E75A, the major larval protein product of the
      E75 gene, bind to discrete sites in native salivary gland chromosomes. These
      sites are closely correlated with early and late ecdysone responsive loci.

PMID- 8485522
TI  - The galactose binding lectin from the beet armyworm, Spodoptera exigua:
      distribution and site of synthesis.
AB  - The Spodoptera exigua galactose binding lectin, extracted from hemolymph by
      affinity chromatography, was comprised of large molecular weight aggregates (100
      700 kDa). SDS-PAGE of this lectin preparation revealed it to contain 2 subunits
      of 33.2 and 34.4 kDa in equimolar concentrations. These subunits had similar
      amino acid profiles, possessed identical N-terminal sequences and reacted equally
      to a bank of antilectin monoclonal antibodies. By staining Western blots with
      various lectin conjugate probes, we demonstrated that the 34.4 kDa subunit
      contains complex mannose residues, suggesting that this subunit is the
      glycosylated form of the 33.2 kDa subunit. The N-terminal sequence of the S.
      exigua lectin was distinct from other invertebrate galactose binding lectins.
      Light microscopy in combination with immunoelectron microscopy was used to
      localize the S. exigua lectin in the granules of the granulocyte class of
      hemocytes. Degranulation of these cells resulted in the release of the lectin.
      Isotope incorporation studies followed by immunoprecipitation with a S. exigua
      monoclonal antibody demonstrated that the fat body was the major site of lectin
      synthesis. Similar studies with hemocyte monolayers did not result in the
      production of detectable levels of 35S-labeled S. exigua lectin.

PMID- 8485523
TI  - Transcripts from a mosquito dihydrofolate reductase gene: evidence for
      heterogeneity at the 5' end.
AB  - Heterogeneity among transcripts from the mosquito (Aedes albopictus)
      dihydrofolate reductase (DHFR) gene in wild-type C7-12 cells and in methotrexate
      resistant Mtx-5011-128 cells has been analyzed by Northern blotting, RNAase
      mapping, and primer extension. In both sensitive and resistant cells, a major
      transcription initiation site mapped c. 11 nucleotides downstream of the TATAA
      box, near position -66 relative to the AUG codon. Two other major transcription
      initiation sites mapped approx. eight and 45 nucleotides, respectively, upstream
      of the TATAA box. In addition, at least six minor sites were detected, four of
      which mapped within TATA-like sequences. Within the AT-rich region flanking the
      5'-end of the mosquito DHFR gene were four T-rich motifs and three "GTTTGTG"
      repeats. Additional "GTTTGTG" repeats occurred in the first exon and in the
      single 56 nucleotide intron of the mosquito DHFR gene. In contrast to the
      heterogeneity at the 5'-ends of mosquito DHFR transcripts, the 3'-end terminated
      at a single position, c. 22 nucleotides downstream of the polyadenylation signal.

PMID- 8485524
TI  - In vitro and in vivo proteolysis of the Bacillus thuringiensis subsp. israelensis
      CryIVD protein by Culex quinquefasciatus larval midgut proteases.
AB  - Proteases with trypsin-, chymotrypsin- and thermolysin-like specificity were
      detected in Culex quinquefasciatus larval midguts. Their activities were
      monitored by N-terminal amino acid sequence analysis of the Bacillus
      thuringiensis subsp. israelensis CryIVD toxin proteolytic fragments. These
      proteases are located in the larval midgut and in different fractions obtained
      during the preparation of brush border membrane vesicles. The activity of the
      midgut proteases increased with an increase in pH. Both the chymotrypsin- and
      thermolysin-like activities are involved in the processing of solubilized CryIVD
      toxin, whereas an additional trypsin-like protease is necessary for the CryIVD
      parasporal inclusion processing. The solubilized CryIVD toxin was first cleaved
      between Thr347 and Phe348 and between Phe348 and Tyr349, generating a 40-kDa N
      terminal fragment and a 32.5-kDa C-terminal fragment. The C-terminal domain was
      resistant to further processing, with only a small amount of a 31-kDa product
      appearing due to the action of a thermolysin-like protease. However, the N
      terminal domain was very unstable, and was further degraded to about 30 kDa.
      Unlike the solubilized CryIVD toxin, the processing of the CryIVD parasporal
      inclusion was very slow at neutral pH. Three protease-resistant products were
      detected at pHs higher than 9.5 with an overnight incubation at 37 degrees C. The
      30- and 28.5-kDa C-terminal peptides are proteolytic products of trypsin- and
      chymotrypsin-like proteases, respectively; while the 28-kDa N-terminal peptide
      has 27 amino acids deleted from the N-terminal end by a thermolysin-like
      protease.

PMID- 8485526
TI  - Identification of two storage hexamers in the ant, Camponotus festinatus:
      accumulation in adult queenless workers.
AB  - Two electrophoretically and immunologically distinct storage hexamers (Hex 1 and
      Hex 2) have been identified in Camponotus festinatus workers. The molecular
      weights of the native molecules were estimated to be 460,000 (Hex 1) and 580,000
      (Hex 2) by pore limiting gradient electrophoresis. Hex 1 partially dissociates
      with moderate alkaline pH. Both proteins are composed of a single type of
      apoprotein of approx. 73 (Hex 1) and 80 kDa (Hex 2). While most of Hex 2 is
      sequestered by the fat body before pupation, Hex 1 remains largely in the
      hemolymph during the last larval and pupal stages. Both proteins were detected
      only in low concentrations in the hemolymph of newly emerged adults, and they
      gradually disappear from adult workers maintained in the colonies. In queenless
      workers, however, Hex 1 and Hex 2 accumulate in the hemolymph and fat body,
      constituting the most abundant proteins together with vitellogenin. Camponotus
      festinatus storage hexamers bear some homologies in their N-terminal sequence
      with the arylphorins of Diptera and Lepidoptera, as well as with a crab
      hemocyanin. However, with respect to their amino acid composition, they can not
      be classified as arylphorins.

PMID- 8485525
TI  - Expression and characterization of cDNAs for cecropin B, an antibacterial protein
      of the silkworm, Bombyx mori.
AB  - To analyze the induction mechanism of antibacterial protein gene expression,
      cDNAs coding for cecropin B have been cloned from the B. mori fat body cDNA
      library. Nucleotide sequences of two positive clones were determined and their
      amino acid sequences deduced. They revealed that these clones coded for the same
      cecropin, which is identical to purified cecropin B. However, the cDNAs contained
      different nucleotides at the third codon position and 5' or 3' non-coding
      regions. Results obtained by Northern blot analysis showed that the gene
      expression of B. mori cecropin B was rapidly induced by Escherichia coli and
      reached maximum levels 8 h after immunization. The expression of cecropin B gene
      occurred specifically in tissues, mainly in the fat body and hemocytes.

PMID- 8485527
TI  - DNA polymerase-beta from the pupal ovaries of Bombyx mori.
AB  - The silk glands of Bombyx mori, a highly replicative tissue contains high levels
      of DNA polymerases alpha, delta and epsilon but not DNA polymerase-beta. However,
      we detected the latter activity in the gonadal tissues, viz. the pupal ovaries
      and testes of B. mori. The enzyme has been purified to homogeneity from the pupal
      ovaries by a series of column chromatographic and affinity purification steps.
      The enzyme satisfied the criteria to be designated as DNA polymerase-beta based
      on its small size, requirement for high concentration of monovalent cations for
      catalytic activity, sensitivity to ddTTP and insensitivity to aphidicolin. It is
      a monomeric polypeptide of M(r) 40 kDa, and the Km for dNTPs ranges between 8-20
      microM. DNA polymerase-beta is biochemically and immunologically distinct from
      DNA polymerase-alpha from the silk glands of B. mori. The enzyme showed a
      preference for gapped DNA, and could not elongate ultraviolet irradiated template
      beyond the pyrimidine dimers. The absence of any associated primase and
      exonuclease activities from this enzyme, and its conspicuous absence in the
      highly replicative tissue, imply that it is unlikely to participate in the DNA
      endoreplication process.

PMID- 8485528
TI  - Levels of biogenic amines and peptides in individual corn earworm moths,
      Helicoverpa zea, using high performance liquid chromatography with
      electrochemical detection.
AB  - Quantitative levels of octopamine, serotonin, and dopamine were measured from
      brain and corpus cardiacum in individual male and female Helicoverpa zea, using
      high performance liquid chromatography (HPLC) with electrochemical detection. By
      increasing the proportion of organic modifiers in the mobile phase we were also
      able to quantify two peptides, adipokinetic hormone and hypertrehalosemic
      hormone. Levels of amines in both tissues were similar in males and females, but
      with greater quantities in the brain than the corpus cardiacum. In contrast, the
      two hormones were found predominantly in the corpus cardiacum, with the level of
      adipokinetic hormone three times greater than that of the hypertrehalosemic
      hormone, a finding in agreement with other studies. The described methodology
      demonstrates the power of HPLC with electrochemical detection for analysis of
      amines and peptides found in small quantities within the nervous tissue of
      individual insects.

PMID- 8485529
TI  - Primary structure of a 14 kDa basic structural protein (Lm-76) from the cuticle
      of the migratory locust, Locusta migratoria.
AB  - The complete amino acid sequence of a 14 kDa structural protein (LM-76) isolated
      from pharate cuticle of the locust, Locusta migratoria, was determined by Edman
      degradation of the intact protein and enzymatically derived peptides. Plasma
      desorption and electrospray mass spectrometry was used as an integrated part of
      the structure determination. Protein Lm-76 has characteristics similar to
      proteins previously isolated from the pharate locust. The amino acid composition
      shows a high content of alanine (32%) and absence of the amino acids Glu, Cys,
      Met, Phe and Trp. The sequence has a central hydrophilic region surrounded by two
      hydrophobic regions with 7 repeats of a (Tyr)-Ala-Ala-Pro-Ala/Val motif. The
      conservation around the prolyl residues within this sequence motif is
      demonstrated for the hitherto sequenced presumptive exocuticle proteins from L.
      migratoria. The N-terminal region of protein Lm-76 is enriched in the amino acids
      Gly, Leu and Tyr located in the conserved sequence NH2-Gly-Tyr-Leu-Gly-Gly-(Tyr)
      .

PMID- 8485530
TI  - Multivariate nonparametric analysis for the two-period crossover design with
      application in clinical trials.
AB  - Nonparametric methods are presented for the analysis of the two-treatment, two
      period crossover design with multivariate response. After forming within-subject
      sums and differences, the usual tests, including those for carry-over effects and
      direct treatment effects, can be constructed using a multivariate analysis of
      variance. When the assumptions relevant to traditional analysis are in question,
      multivariate nonparametric tests based on ranks provide a realistic alternative.
      However, multivariate response gives rise to a wider class of hypotheses than is
      seen in crossover designs with univariate response. We discuss these hypotheses
      and formulate nonparametric tests for associated analyses.

PMID- 8485531
TI  - Statistical methods for a three-period crossover design in which high dose cannot
      be used first.
AB  - Design and analysis methods for the three-period crossover trial defined by the
      sequences: (D0, D1, D2), (D1, D0, D2), and (D1, D2, D0), where D0 is a placebo,
      and D1 and D2 are a low dose and a high dose of a drug, respectively, are
      developed. This design may be used when investigators are unwilling to administer
      a higher dose of a new drug to a patient before administering a lower dose. In
      using this design, patients should be randomized to sequences in blocks that are
      integer multiples of 3. Both parametric and non-parametric analysis methods are
      based on contrasts that capture intrapatient variability only and provide
      unbiased estimates and hypothesis tests of pairwise differences between
      carryover, direct dose, and period effects. The design and methods are
      illustrated with data reflecting the cognitive component of the Alzheimer's
      disease assessment scale collected in a large clinical trial of Tacrine at doses
      of 0, 40, and 80 mg/day.

PMID- 8485532
TI  - Analysis of the 2 x 2 crossover design with subsampling.
AB  - Subsampling can be used in experimental design to investigate extraneous sources
      of variability. One useful strategy is to make independent replicate measurements
      of the response variate. This can be achieved in clinical studies, for example,
      by dividing a blood or urine specimen from each of a sample of subjects into
      aliquots and processing these through a chemistry laboratory in such a way that
      the replicate determinations are independent. This procedure can be used to
      increase design efficiency. This paper addresses considerations in the design and
      analysis of the 2 x 2 crossover plan with this type of subsampling.

PMID- 8485533
TI  - Exposure analysis of dichotomous response measures in long-term studies.
AB  - Differential exposure to study medications in long-term studies of some
      cardiovascular compounds complicates analyses, particularly the usual intention
      to-treat analyses and inferences therefrom of the data collected. Analysis
      methods that incorporate exposure are developed, presented, and illustrated by
      applying them to primary response data from a long-term, placebo-controlled,
      ancillary trial of gemfibrozil. The analysis methods address the extent to which
      end-points are correlated with the actual use of the compound rather than the
      extent to which end-points are correlated with the random assignment to double
      blind study medications.

PMID- 8485534
TI  - A simple stopping rule for declaring treatment ineffectiveness in clinical
      trials.
AB  - We consider the problem of stopping a clinical trial before its scheduled
      termination due to the apparent ineffectiveness of the experimental therapy, as
      compared with a control. We propose a simple-to-implement, intuitive decision
      rule based on the unadjusted attained significance levels from any appropriate
      statistical test. The proposed procedure may be used at any time during the study
      as an aid to help determine whether the study of an experimental treatment should
      be terminated early with the conclusion of treatment ineffectiveness. Much of the
      power of the usual fixed-sample test is retained while maintaining the nominal
      test size.

PMID- 8485535
TI  - Some general estimation methods for nonlinear mixed-effects models.
AB  - A nonlinear mixed-effects model suitable for characterizing repeated measurement
      data is described. The model allows dependence of random coefficients on
      covariate information and accommodates general specifications of a common
      intraindividual covariance structure, such as models for variance within
      individuals that depend on individual mean response and autocorrelation. Two
      classes of procedures for estimation in this model are described, which
      incorporate estimation of unknown parameters in the assumed intraindividual
      covariance structure. The procedures are straightforward to implement using
      standard statistical software. The techniques are illustrated by examples in
      growth analysis and assay development.

PMID- 8485536
TI  - Analysis of multivariate parallel-line bioassay with composite responses and
      composite doses, using canonical correlations.
AB  - The use of a composite response to estimate the relative potency in a
      multivariate parallel-line bioassay is described by Finney. Occasionally a
      multivariate bioassay has multiple drugs also. Such a situation arises, for
      example, when a treatment contains several drugs. A procedure for combining
      multiple responses and combining multiple drugs is proposed in this paper, in
      order to obtain point and interval estimates of the relative potency. A composite
      response and a composite dose level for this purpose are obtained by using
      canonical analysis.

PMID- 8485537
TI  - The likelihood ratio for comparing means when a portion of the subjects fail to
      respond.
AB  - Results of clinical studies are often obscured by the fact that some of the
      subjects improve with treatment while others do not. As a consequence, for
      example, we may obtain a contaminated distribution in a treatment group, having
      one component similar to the entire distribution for a control group and the
      other shifted by the treatment effect. Maximum-likelihood estimation and the
      likelihood ratio test for investigating the proportion of responders together
      with the treatment effect are based on asymptotic theory and use iterative
      maximization techniques. We investigate the sampling distribution of the
      estimates and the test and demonstrate their use in statistical inference. Our
      results suggest that the chi-square distribution with 1.4 degrees of freedom
      provides a useful test criterion even when the sample sizes are as small as 10.
      Only in obvious testing situations is the t-test adequate.

PMID- 8485538
TI  - Evaluation of parametric and nonparametric two one-sided tests procedures for
      assessing bioequivalence of average bioavailability.
AB  - A simulation study was conducted to compare the levels of significance and power
      between Schuirmann's and nonparametric two one-sided tests procedures for a 2 x 2
      crossover design under different combinations of sample sizes, intrasubject
      variabilities, and underlying distributions. Empirical results suggest that
      Schuirmann's two one-sided tests procedure is robust to minor departure from the
      assumption of normality.

PMID- 8485539
TI  - Radial glia-like cells in the supraoptic nucleus of the adult rat.
AB  - Conventional light and confocal microscopy of thick vibratome sections of the
      hypothalamus of adult male and female rats immunostained for the astrocytic
      marker glial fibrillary acidic protein (GFAP) revealed that the supraoptic
      nucleus (SON) contains two morphologically distinct types of astrocytes. One has
      a stellate form, similar to that of most astrocytes in the adult CNS. The other
      has a morphology reminiscent of radial glia in the developing CNS: from their
      cell bodies, located along the ventral glia lamina (VGL), arise one long thick
      process that spans the SON in the coronal plane, several horizontally-oriented
      processes that form a dense network in the VGL, and a short process oriented
      towards the pia. The latter astrocytes are immunoreactive for vimentin, an
      intermediate filament protein of immature glial cells and a marker for radial
      glia. The stellate astrocytes showed no vimentin immunoreactivity. The functional
      significance of each type of supraoptic astrocyte is at present unknown but the
      presence of radial glia-like cells in this hypothalamic region suggests that the
      SON retains a certain degree of immaturity during adulthood, that may be linked
      to its well known capacity to undergo neuronal-glial plasticity under
      physiological and experimental stimulation.

PMID- 8485540
TI  - Altered ratios of beta-endorphin: beta-lipotropin released from anterior lobe
      corticotropes with increased secretory drive. I. Effects of diminished
      glucocorticoid secretion.
AB  - Previous studies have demonstrated that acute stress or ovine corticotropin
      releasing hormone (oCRH) in vivo, or oCRH in vitro, stimulates release of beta
      endorphin over beta-lipotropin from anterior pituitary corticotropes. This occurs
      despite the predominance of beta-lipotropin in corticotrope peptide stores. In
      vitro studies with primary anterior pituitary cultures suggested that chronic
      exposure to oCRH results in a shift towards more beta-lipotropin secretion into
      the media than with short-term exposure. The current studies explored whether
      increased secretory drive in vivo results in a similar shift towards more beta
      lipotropin. We used removal of glucocorticoids by adrenalectomy or metyrapone
      blockade of corticosterone synthesis, to stimulate endogenous secretion of CRH
      and vasopressin. Both treatments resulted in shifts of the ratio of beta
      endorphin: beta-lipotropin in plasma of experimental animals in comparison to the
      sham-treated control rats. In vitro testing with oCRH of anterior lobe cultures
      from adrenalectomized or metyrapone-treated rats demonstrated similar effects of
      these treatments on the ratio of beta-endorphin:beta-lipotropin. These changes
      occurred despite similar ratios of beta-endorphin:beta-lipotropin in anterior
      pituitary peptide stores.

PMID- 8485541
TI  - Arginine vasopressin-induced sensitization in brain: facilitated inositol
      phosphate production without changes in receptor number.
AB  - Arginine vasopressin (AVP) has been shown to have a unique sensitization effect
      whereby repeated injection of AVP into a lateral cerebral ventricle or a
      mediobasal region of the rat forebrain below the lateral septum and including the
      anterior hypothalamus referred to as the ventral septal area, causes enhanced
      motor responses to the ligand. To elucidate possible neuronal mechanisms
      responsible for AVP sensitization, 1) we determined the dose and the time
      required for the development and expression of AVP sensitization, and 2) we
      tested the hypotheses that AVP sensitization may result in a) alteration of
      septal AVP V1 receptor affinity or number, and/or b) alteration of septal AVP V1
      receptor signal transduction (phosphatidylinositol hydrolysis) mechanisms. Our
      behavioral data show that the magnitude of AVP sensitization varies with dose and
      time, and the effect is dependent on the time interval between injections, in
      that an initial intracerebroventricular AVP injection enhances the sensitivity of
      the animals to the motor effects of similar AVP injections given 6 h to 6 days
      later but not to injections given hourly or weekly. No changes in septal AVP
      binding site density and affinity, as measured by [3H]AVP binding to septal
      synaptic plasma membrane, were found in sensitized animals; [3H]inositol
      monophosphate stimulation in response to AVP in septal slices, however, was found
      to be significantly enhanced. This enhanced [3H]inositol monophosphate
      stimulation appears specific to a V1-type receptor because it was significantly
      reduced in the presence of the V1 receptor antagonist, d(CH2)5Tyr(Me)AVP, and was
      not found using oxytocin or the V2 receptor agonist, DDAVP.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8485542
TI  - Ovariectomy increases in vivo luteinizing hormone-releasing hormone release in
      pubertal, but not prepubertal, female rhesus monkeys.
AB  - In pubertal, but not prepubertal, monkeys ovariectomy (OVX) results in an
      elevation of circulating luteinizing hormone (LH) levels. To determine if the
      castration-induced LH increase in pubertal monkeys is due to an increase in
      pulsatile LH-releasing hormone (LHRH) release, effects of OVX on in vivo LHRH
      release in the stalk-median eminence were examined in fully conscious monkeys
      using a push-pull perfusion method. The average ages (+/- SEM) of female rhesus
      monkeys in each group at OVX were 14.5 +/- 0.6 months (n = 6; prepubertal), 25.0
      +/- 1.3 months (n = 5; early pubertal) and 37.8 +/- 2.1 months (n = 6;
      midpubertal). Perfusate samples from the stalk-median eminence were obtained in
      10-min fractions for 6 h in the morning (0600 to 1200 h) and 6 h in the evening
      (1800 to 2400 h), from the same subjects before OVX, and at 29 days and
      approximately 100 days after OVX. LHRH levels in perfusates were measured by
      radioimmunoassay. LH levels throughout the experiment were monitored by periodic
      blood sampling. OVX resulted in a significant LH increase in early and
      midpubertal monkeys (P < 0.001 for both), but not in prepubertal monkeys.
      Similarly, OVX in early and midpubertal monkeys increased mean LHRH release when
      examined 29 days after surgery (P < 0.05 and P < 0.01, respectively). The OVX
      induced LHRH increases in early and midpubertal monkeys remained elevated at
      approximately 100 days postcastration. Furthermore, it was found that effects of
      OVX on the increased LHRH release were primarily due to the elevation of basal
      release and pulse amplitude, but not pulse frequency. In contrast, OVX did not
      cause any significant effects on pulsatile LHRH release in prepubertal monkeys.
      The results indicate that an increase in LHRH release and a concomitant increase
      in circulating LH occurs after OVX in pubertal monkeys, but not in prepubertal
      monkeys. These data are consistent with the hypothesis that the low level of LH
      in circulation before the onset of puberty is due to a low amount of LHRH release
      which is independent of ovarian steroid feedback and that the maturity of the
      neuronal control system for the pulsatile LHRH release is responsible for the
      onset of puberty. After the onset of puberty, the negative feedback of ovarian
      steroid hormones becomes important to the regulation of gonadotropin release.

PMID- 8485543
TI  - Effects of lipocortin 1 and dexamethasone on the secretion of corticotrophin
      releasing factors in the rat: in vitro and in vivo studies.
AB  - Lipocortin 1 (LC1: also called annexin 1) was first described as a putative
      second messenger protein for the anti-inflammatory steroids in peripheral
      tissues. In the present study, in vitro and in vivo methods were used to examine
      its potential role within the hypothalamus as a mediator of the regulatory
      actions of the glucocorticoids on the hypothalamo-pituitary-adrenocortical axis
      of the rat. In the in vitro studies, the effects of human recombinant LC1 (hu-r
      LC1) on the concomitant release of the two major corticotrophin-releasing factors
      (CRF-41 and arginine vasopressin, AVP) from isolated hypothalami removed from
      chronically adrenalectomized rats were compared with those of dexamethasone in
      the presence and absence of appropriate secretagogues, namely phospholipase A2
      (PLA2), interleukin-6 (IL-6) and a non-specific depolarizing agent, K+ (56 mM).
      The spontaneous release of CRF-41 in vitro was unaffected by either hu-r-LC1 (5
      to 100 ng/ml) or dexamethasone (1 microM). Both compounds however reduced the
      release of the neuropeptide evoked by IL-6 (5 ng/ml) but failed to modify the
      secretory responses to PLA2 (25 U/ml) or K+ (56 mM). Dexamethasone (1 microM) had
      no effect on the basal release of AVP but effectively blocked the secretion of
      the peptide induced by either IL-6 (10 ng/ml) or PLA2 (25 U/ml). In complete
      contrast, hu-r-LC1 (5 to 100 ng/ml) stimulated the release of AVP and potentiated
      the secretory responses to IL-6 (10 ng/ml) and PLA2 (25 U/ml) but not to K+ (56
      mM). The hypothalamic responses to PLA2 stimulation (25 U/ml) were associated
      with significant (P < 0.01) increases in prostaglandin E2 release which, in some
      instances, were potentiated by hu-r-LC1 (5 to 20 ng/ml). In vivo, administration
      of histamine (0.6 mg/100 g body wt, ip) produced significant (P < 0.01) increases
      in the serum corticosterone concentration and in the hypothalamic LC1 content.
      Neither hu-r-LC1 (0.6 to 1.2 micrograms) nor a polyclonal anti-LC1 antibody (3
      microliters, diluted 1:200), injected intracerebroventricularly (icv), influenced
      either the resting serum corticosterone concentration or the hypersecretion of
      the steroid evoked by histamine stress. A lower dose of the recombinant protein
      (0.3 micrograms icv) also failed to alter basal corticosterone release but, in
      contrast to the higher doses, potentiated the pituitary-adrenocortical responses
      to histamine. The results suggest that LC1 may contribute to some aspects of
      peptide release in the hypothalamus but that its actions are not necessarily
      related to those of the glucocorticoids.

PMID- 8485544
TI  - Colchicine-induced accumulation of estrogen receptor and progestin receptor
      immunoreactivity in atypical areas in guinea-pig brain.
AB  - Using immunocytochemical techniques, cells containing estrogen and progestin
      receptors have been observed in many discrete regions of the guinea-pig
      forebrain, including the mediobasal hypothalamus and preoptic area. While most
      reaction product is located within cell nuclei, we have reported abundant
      reaction product in perikaryal cytoplasm and neuronal processes as well.
      Ultrastructural analysis has revealed the presence of estrogen and progestin
      receptors in atypical subcellular sites within the hypothalamus, including
      dendrites and axon terminals. In order to determine if microtubule-dependent
      intracellular transport is involved in intraneuronal transport of steroid hormone
      receptors, ovariectomized guinea-pigs were injected intracerebroventricularly
      with the microtubule inhibitor, colchicine, and brain sections at the level of
      the hypothalamus were immunostained for estrogen receptors. This treatment
      resulted in the appearance of estrogen receptor immunoreactivity in the
      paraventricular and mediodorsal thalamic region, areas typically devoid of
      estrogen receptor-immunoreactive cells in guinea-pigs. In a second study on
      progestin receptors, we observed the colchicine-induced accumulation of progestin
      receptor immunoreactivity in the paraventricular thalamic, mediodorsal thalamic
      and lateral dorsal thalamic areas as well as in the medial amygdala, all areas
      typically devoid of progestin receptor immunoreactivity. While estradiol
      injection induced progestin receptor immunoreactivity in the hypothalamus and
      preoptic area as described previously, it had no effect on the colchicine-induced
      accumulation in the thalamus and amygdala. These results provide evidence that in
      some neurons, progestin receptors and estrogen receptors are transported
      intracellularly, apparently at a rapid enough rate that they do not ordinarily
      accumulate within the perikaryon.

PMID- 8485545
TI  - The maintenance of normal parturition in the rat requires neurohypophysial
      oxytocin.
AB  - The neuropeptide oxytocin has long been known as a potent contractor of the
      uterus. However, it has remained difficult to attribute a definite role for
      neurohypophysial oxytocin in either the initiation or continuation of labour.
      Most recently, Lefebvre and colleagues have suggested that oxytocin produced in
      the uterus, rather than in the hypothalamus, may be more important in parturition
      since at term the uterus of the rat contains 70-fold more mRNA for oxytocin than
      the hypothalamus, and this disappears at about the time of parturition. Despite
      the high levels of mRNA the uterus contains only nanogram quantities of
      immunoreactive oxytocin per gram wet weight at term, compared to microgram
      quantities present in the pituitary. Here we show that activation of the
      neurohypophysial oxytocin system occurs, as reflected by expression of
      immunoreactivity for Fos in the hypothalamic supraoptic nucleus, and that this
      activation is indeed critical for normal parturition, since its inhibition
      results in a significant prolongation of parturition. In addition, we present
      evidence that pulsatile delivery of oxytocin into the circulation is important
      for the efficient progress of parturition, indicating that a major role of the
      neuronal circuits regulating oxytocin secretion for parturition, as is already
      known for suckling, is to produce an appropriately patterned hormonal output for
      efficient biological action.

PMID- 8485546
TI  - Hormonal control of sex differences in the brain, behavior and accessory sex
      structures of whiptail lizards (Cnemidophorus species).
AB  - The effects of steroid hormones on sexual dimorphisms in the brain, behavior and
      accessory sex structures were investigated in two species of whiptail lizards.
      The studies were conducted both in adults and hatchlings of a sexually
      reproducing species (Cnemidophorus inornatus) and an all-female species (C.
      uniparens) which displays 'sexual' behaviors typical of males and females. Adults
      were gonadectomized and approximately 3 months later given either a Silastic
      capsule filled with sex steroid or an empty capsule. Young animals of both
      species were left intact and given a capsule on the day of hatching. An
      additional group of C. uniparens was ovariectomized on the day of hatching.
      Following treatment, measures of oviduct (estrogen-dependent), renal sex segment
      (androgen-dependent) and wolffian duct (androgen-dependent) hypertrophy were
      taken in some experiments. Animals were also tested for sexual behavior in some
      of the studies. The volumes of the anterior hypothalamus-preoptic area and
      ventromedial hypothalamus were measured in each individual. Estrogen,
      testosterone and dihydrotestosterone stimulated peripheral structures at both
      time periods in both sexes and species. The hormones also stimulated courtship
      and copulatory behaviors in many of the adult animals. However, testosterone in
      the anterior hypothalamus-preoptic area of male C. inornatus was the only
      treatment which produced parallel effects on the volume of a brain area and the
      behaviors which it controls. These data add whiptail lizards to the list of
      species in which steroid hormones affect the volume of brain regions in
      adulthood, but suggest that such changes in morphology are not necessarily
      predictive of functional differences.

PMID- 8485547
TI  - Potential corticotropin-releasing factor pathways in the rat brain as determined
      by bilateral electrolytic lesions of the central amygdaloid nucleus and the
      paraventricular nucleus of the hypothalamus.
AB  - The projection fields of corticotropin-releasing factor (CRF)-containing
      perikarya in the rat central nervous system were studied using a combination of
      electrolytic lesions, microdissection and radioimmunoassay. The effects of
      bilateral electrolytic lesions of the central nucleus of the amygdala (Ce) or the
      paraventricular nucleus (PVN) of the hypothalamus were measured by a sensitive
      and specific radioimmunoassay. Following lesions of the Ce, CRF concentrations in
      the locus ceruleus (LC) were significantly decreased. Following lesions of the
      PVN, CRF concentrations in the median eminence were markedly decreased (> 85%),
      with smaller but consistent reductions of CRF in the hippocampus as well. In
      contrast to the Ce lesions, PVN lesions resulted in increases in CRF
      concentrations in the LC. These results further confirm the projection of CRF
      containing cells from the PVN to the median eminence, provide evidence for a PVN
      hippocampal CRF pathway, and suggest that the PVN modulates CRF neurons
      innervating the LC. Moreover, the existence of a CRF-containing pathway from the
      Ce to the LC appears likely, and such a circuit may play a role in the behavioral
      and physiological responses to stress.

PMID- 8485548
TI  - Lesions of the suprachiasmatic nucleus indicate the presence of a direct
      vasoactive intestinal polypeptide-containing projection to gonadotrophin
      releasing hormone neurons in the female rat.
AB  - In non-seasonal breeders like the rat, the influence of the suprachiasmatic
      nucleus (SCN) on reproduction is most clearly expressed in the female. Complete
      lesions of the SCN induce persistent oestrus (anovulation) in intact female rats,
      whereas oestrogen implantation in ovariectomized rats results in daily
      luteinizing hormone surges. Vasoactive intestinal polypeptide (VIP), a peptide
      synthesized in cell bodies of the SCN, inhibits the increase in pulsatile
      luteinizing hormone release observed in ovariectomized female rats. In search of
      the anatomical basis for these observations, the present study employs an
      immunocytochemical double staining for VIP and gonadotrophin-releasing hormone
      (GnRH) at the light microscopical level. It was demonstrated that approximately
      45% of the GnRH positive neurons in the diagonal band of Broca, the preoptic and
      anterior hypothalamic area of female rats are innervated by VIP-containing
      processes. To investigate whether these VIP-containing fibres represent a direct
      projection of the SCN to the GnRH system, unilateral thermic SCN lesions were
      made. Lesions that unilaterally destroyed the majority of the VIP synthesizing
      cells in the SCN resulted in at least a 50% decrease of the VIP innervation of
      GnRH cell bodies at the lesioned side compared to the intact side. Lesions not
      affecting the VIP synthesizing cell population in the SCN did not change the
      percentage of GnRH neurons innervated by VIP-containing fibres, while partial
      lesions resulted in intermediate effects. These results indicate that the
      majority of the light microscopical VIP-containing input on GnRH neurons in the
      hypothalamus is derived from the SCN.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485549
TI  - Acetyl-L-carnitine effect on pituitary and plasma beta-endorphin responsiveness
      to different chronic intermittent stressors.
AB  - The aims of the present study were: 1) to compare the effect of two different
      chronic intermittent stressors i.e. cold-swimming versus ether, on the pituitary
      opioidergic system; 2) to evaluate the response of pituitary and plasma beta
      endorphin (beta-EP) to an acute stress in chronically stressed rats; and 3) to
      evaluate the effect of acetyl-l-carnitine treatment (10 mg/day/rat per os at
      night) on pituitary and plasma beta-EP changes induced by two different types of
      chronic stress. The stressors were applied twice a day for 10 days. Rats were
      killed either before, during or after the last swimming or ether stress session.
      beta-EP was measured by radioimmunoassay in anterior pituitary and in
      neurointermediate lobe extracts and in plasma. The following observations were
      made: 1) Chronic intermittent cold-swimming stress increased anterior pituitary
      contents and plasma beta-EP levels; 2) both chronic intermittent cold-swimming
      stress and ether stress caused an increase of neurointermediate lobe beta-EP
      contents; 3) as in control animals, rats exposed to chronic intermittent swimming
      stress reduced pituitary beta-EP contents and raised plasma beta-EP levels in
      response to the last acute swimming stress; 4) in contrast to control animals,
      rats exposed to chronic intermittent ether stress did not show any significant
      response of the pituitary-plasma opioidergic system to the last acute ether
      session; 5) the acetyl-l-carnitine treatment counteracted the changes evoked by
      chronic intermittent cold-swimming stress on the pituitary and plasma beta-EP
      levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485550
TI  - Development of gonadotrophs and thyrotrophs in the female foetal sheep pituitary:
      immunocytochemical localization studies.
AB  - In order to investigate the ontogenesis of cell types in the pituitary gland,
      anterior pituitaries were collected from female foetal sheep at days 70, 100 and
      130 of gestation (term = 145 days). Cells containing the common alpha-subunit and
      the specific beta-subunits of luteinizing hormone (LH), follicle-stimulating
      hormone (FSH) and thyroid-stimulating hormone (TSH) were immunolocalized using
      the avidin-biotin immunoperoxidase technique. LH beta-containing cells were first
      detected in the foetal pituitary by day 70 of gestation. The number and intensity
      of staining of these LH beta cells increased by day 100 but had declined again by
      day 130. Immunopositive alpha-subunit and FSH beta-cells appeared by day 100 of
      gestation and had further increased in number and staining intensity by day 130.
      Cells containing TSH beta were present at day 70 and progressively increased in
      abundance and intensity through gestation. These data indicate that the
      development of LH- and FSH-containing cells in the female foetal sheep pituitary
      is differentially regulated during foetal life, and that in the sheep free alpha
      subunit is not produced in significant amounts before the specific beta-subunits.

PMID- 8485551
TI  - Endocrine actions of central neuropeptide Y in the ewe: activation of the
      hypothalamo-pituitary-adrenal axis by exogenous neuropeptide Y and role of
      endogenous neuropeptide Y in the secretion of luteinizing hormone during the
      oestrous cycle.
AB  - Neurons immunoreactive for neuropeptide Y (NPY) are abundant in the
      hypophysiotrophic areas of the brain. In particular, there is considerable
      anatomical evidence for the influence of this neuropeptide on the reproductive
      and hypothalamo-pituitary-adrenal axes. We therefore investigated whether central
      administration of NPY can alter the activities of the reproductive and
      hypothalamopituitary-adrenal axes in the ewe, and whether ovarian steroids are
      involved in the modulation of these events. We also attempted to investigate
      whether endogenous NPY is important in the control of luteinizing hormone
      releasing hormone/luteinizing hormone (LHRH/LH) secretion in the sheep oestrous
      cycle. Central injection of NPY (0.15 and 1.5 nmol in 50 microliters saline),
      delivered by gravity flow into the third cerebral ventricle, had no effect on LH
      levels in ovariectomized (OVX) ewes (n = 6) or OVX ewes implanted with oestradiol
      (OVX/E2) (n = 7), nor was LH secretion altered by central NPY (1.5 nmol) in
      intact cycling animals in either the follicular or the luteal phase (n = 5).
      However, central administration of 1.5 nmol NPY to intact ewes during both the
      follicular (P < 0.05) and the luteal phase (P < 0.01), and in OVX/E2 ewes (P <
      0.05) caused a large and significant increase in plasma cortisol levels. High
      titre antibodies were raised to NPY in sheep and the effects of peripheral and
      central (intracerebroventricular) administration of anti-NPY antibodies on the
      timing and/or characteristics of the E2-induced LH surge in anoestrous ewes and
      of the preovulatory surge of LH in cycling ewes were determined. Intravenous
      administration of anti-NPY antibodies (n = 6) had no effect on the oestradiol
      benzoate-induced LH surge, compared with the control injection of non-immune
      plasma (n = 6). Likewise, passive systemic immunization against NPY (n = 10) was
      without effect on the characteristics of the preovulatory LH surge, compared with
      the control group (n = 10). However, central (intracerebroventricular)
      administration of anti-NPY antibodies (n = 4) delayed or abolished the
      preovulatory LH surge when compared with non-immune plasma treatment in the same
      animals. In summary, tonic LHRH/LH secretion is unaffected by centrally
      administered NPY at the doses used in this study. However, the same doses of NPY
      activate the hypothalamo-pituitary-adrenal axis, thus lending clear support to
      the hypothesis that NPY is involved in the multifactorial regulation of
      adrenocorticotrophin and cortisol secretion in this species, probably by
      stimulating corticotrophin-releasing hormone and/or arginine vasopressin
      secretion within the hypothalamus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8485552
TI  - Corticotropin-releasing hormone neurons in the paraventricular nucleus project to
      the external zone of the median eminence: a study combining retrograde labeling
      with immunocytochemistry.
AB  - Corticotropin-releasing hormone (CRH) is the major regulator of the pituitary
      adrenal axis. CRH-immunoreactive perikarya are widely distributed in the central
      nervous system; however, only those which participate directly in the regulation
      of adrenocorticotropin are connected to the portal circulation in the external
      zone of the median eminence. The present study describes the identification of
      these hypophysiotropic neurons using retrograde labeling and CRH
      immunocytochemistry. Fluoro-Gold was injected peripherally then, 5 days later,
      the animals were treated with colchicine. Twenty-four hours later the animals
      were sacrificed, and their brains were immunostained for CRH with the indirect
      immunofluorescence technique. The results indicate that the vast majority of the
      Fluoro-Gold-accumulating and CRH-immunopositive perikarya (hypophysiotropic
      neurons) are located in the medial parvicellular subdivision of the
      paraventricular nucleus (PVN). However, not each CRH-immunoreactive neuron
      contains Fluoro-Gold, i.e. a small portion of these neurons project to areas of
      the brain other than the median eminence. The anterior, lateral and
      periventricular subdivisions of the PVN also contain hypophysiotropic CRH
      immunoreactive perikarya, however, their number is much less than in the medial
      parvicellular subdivision. Scattered double-labeled cells are also present in the
      medial preoptic area and the dorsal hypothalamus, just behind the PVN. These
      results support previous observations that the PVN, particularly the medial
      parvicellular subdivision, is the predominant source of the hypophysiotropic CRH
      neurons.

PMID- 8485553
TI  - In vitro regulation of rat prolactin messenger ribonucleic acid poly(A) tail
      length: modulation by bromocriptine.
AB  - Recent analysis of endocrine gene transcripts has revealed that several hormone
      mRNAs exhibit regulated size changes (due to alterations in length of the 3'
      poly(A) tail) which may function as an additional level of control in the
      determination of gene expression. We have now shown, through the novel
      application of an organ culture technique, that prolactin mRNA exhibits a similar
      regulated change in poly(A) tail length when rat anterior pituitary glands are
      explanted. The effect is observed in glands of either male or female rats and is
      specific with respect to growth hormone and alpha-tubulin mRNAs. Furthermore, we
      have also found that the size change in prolactin mRNA is attenuated in the
      presence of bromocriptine, indicating regulation through a dopaminergic pathway.

PMID- 8485554
TI  - Does lupus flare during pregnancy?

PMID- 8485555
TI  - The clinical significance of autoantibody profiles in patients with systemic
      lupus erythematosus.
AB  - We have evaluated the autoantibody profiles in the sera of 117 patients with
      systemic lupus erythematosus (SLE) and compared and contrasted the clinical and
      laboratory features of the disease of patients segregated according to an
      autoantibody profile. Using this approach we are able to demonstrate that
      autoantibody profiles identified subsets of patients with SLE. Patients with a
      negative autoantibody profile had fewer clinical and laboratory features of their
      disease when compared to the other subsets of patients. In contrast, patients
      with profile A (anti-nDNA and/or anti-Sm antibodies) had a statistically
      significant increase in malar rash, renal and hematologic involvement and
      hypocomplementemia when compared to patients with a negative profile. Patients
      with profile B (anti-nRNP antibodies) had a clinical pattern of disease different
      from that of patients with profile A and had a statistically significant increase
      in Raynaud's phenomenon when compared to patients with a negative profile.
      Patients with profile C (anti-SSA and/or anti-SSB antibodies) had a statistically
      significant increase in lupus-related rashes and photosensitivity. None of the
      lupus patients reviewed in this study has profile D (antibodies to centromere
      and/or Scl-70), this profile being seen largely in patients with scleroderma or
      one of its variants. Both patients with profile E (anti-histone antibodies) had
      drug-induced lupus. We conclude that the use of autoantibody profiles defines
      subsets of patients with lupus that may have clinical, therapeutic and prognostic
      implications.

PMID- 8485556
TI  - Expression and relationships of seven public idiotypes of DNA-binding
      autoantibodies on monoclonal antibodies and serum immunoglobulins.
AB  - Many studies have shown that DNA-reactive autoantibodies share cross-reactive
      public idiotypes that are defined, usually, by single anti-idiotype reagents.
      Because anti-idiotype antibodies or antisera will be limited in their ability to
      detect all the idiotopes of a particular antibody, their use will tend to
      underestimate the full extent of idiotype sharing between different antibodies.
      In order to define more comprehensively the extent of idiotype sharing in DNA
      autoantibodies, a panel of DNA-binding monoclonal autoantibodies from lupus mice
      was examined with a range of anti-idiotype antisera prepared in rabbits (five
      sera), guinea pigs (four sera) and a sheep. Each idiotype was detected on more
      antibodies than its original reference monoclonal antibody, and idiotopes of each
      were also present on serum immunoglobulins from lupus mice. Of 23 monoclonal
      antibodies 65% reacted with one or more of the anti-idiotype reagents. On these
      criteria, all the idiotypes were public; none was private in its expression. In
      about half the cases the idiotypes were located in or near the antigen-binding
      sites of the antibodies, but a direct relationship to specificity was not obvious
      except in the case of Id.228 present on antibodies with a relatively high
      affinity for single-stranded DNA. In other cases there was no obvious
      relationship between idiotype and specificity. Antibodies from the same mouse did
      not each express the same array of idiotopes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485557
TI  - Systemic lupus erythematosus in Argentina: an overview.

PMID- 8485558
TI  - Brain synaptosomal antibodies in systemic lupus erythematosus.
AB  - Nervous system involvement in systemic lupus erythematosus (SLE) has been linked
      to the production of autoantibodies that may bind to surface antigens on neuronal
      cells and cause cellular dysfunction. At present, little is known of the target
      antigens recognized by these antibodies. The aim of the present study was to
      examine reactivity to rat brain synaptosomes (RBS) in sera from patients with
      SLE. Sera from 73 unselected SLE patients and controls were studied. Crude RBS
      were prepared by differential centrifugation and enriched fractions of
      synaptosomes (SY-E), myelin (MY-E) and mitochondria (MI-E) were obtained by
      sucrose density centrifugation. Rat liver (RL) was used for control antigens.
      Wheat-germ lectin affinity chromatography yielded membrane-enriched fractions of
      RBS, RL and whole rat brain (WRB). Antibody binding was examined by Western
      blotting. IgM reactivity was detected in 12/73 sera (16%) and was directed to
      proteins of 62K, 48K 37K molecular weight. IgG reactivity was present in 5/73
      sera (7%) to proteins of 52K, 48K, 37K and 29K molecular weight. Except for
      binding to the 52K and 37K proteins these autoantibodies were not detected in
      control sera. Reactivity was usually absent, or present in reduced amounts, in
      WRB and RL. Additional experiments revealed that binding of IgM to 62K was found
      predominantly in SY-E and MY-E fractions, 48K in SY-E and MI-E fractions and 37K
      in the SY-E fraction. Binding of IgG to 48K and 29K was detected in the SY-E and
      MI-E, but reactivity to 52K and 37K was restricted to the SY-E fraction. Thus,
      sera from SLE patients contain antibodies to synaptosomal antigens that may
      contribute to the neuropsychiatric manifestations of the disease.

PMID- 8485559
TI  - Calprotectin in patients with systemic lupus erythematosus: relation to clinical
      and laboratory parameters of disease activity.
AB  - Calprotectin (L1) is a granulocyte and monocyte cytosolic protein released during
      activation of these cells. The plasma level of L1 has been shown to be a good
      marker of disease activity in rheumatoid arthritis. In this cross-sectional study
      of 100 patients with systemic lupus erythematosus (SLE), the serum level of L1
      was found to be higher in patients than in matched controls (3661 micrograms/l
      versus 1051 micrograms/l; P < 0.001). The serum level of L1 was the only
      laboratory parameter with significant association to the disease activity index
      SLEDAI (r = 0.28; P < 0.01). Furthermore, the serum level of L1 was significantly
      higher in SLE patients with anti-DNA antibodies compared to patients without anti
      DNA antibodies (4501 micrograms/l versus 3279 micrograms/l; P = 0.01). SLE
      patients with arthritis had higher serum levels of L1 than patients without
      arthritis (7652 micrograms/l versus 2811 micrograms/l; P < 0.01), indicating that
      the serum level of L1 also reflects arthritis activity in SLE.

PMID- 8485560
TI  - Autoimmune thyroid disorders in SLE in Singapore.
AB  - One hundred and twenty-nine patients with systemic lupus erythematosus were
      screened for thyroid function tests. Of these, 8.9% had hyperthyroidism and 3.9%
      Hashimoto's thyroiditis. Euthyroid sick syndrome was present in 47.8% of
      patients. There was a high prevalence of antimicrosomal and antithyroglobulin
      antibodies (32.2%). Aberrations in thyroid function tests are common in SLE but
      the incidence of thyroid failure is low.

PMID- 8485561
TI  - Salmonella infection in systemic lupus erythematosus.
AB  - Patients with systemic lupus erythematosus (SLE) are susceptible to infections,
      notably salmonellosis. We report 37 cases of salmonella infection in 24 patients
      with SLE. These cases were detected in a group of 770 patients with SLE. All the
      patients were women, with a mean age of 25.6 years. At the onset of salmonella
      infection, 81% were taking prednisolone and 27% were taking cytotoxic drugs.
      Renal involvement was present in 75% of patients, which was approximately the
      same as in other SLE patients. Bacteremia, arthritis, osteomyelitis and rare
      manifestations of salmonellosis, including pulmonary and urinary tract
      involvement, were encountered. Diagnosis was based on isolation of the
      microorganism, mostly from blood cultures. Salmonella species other than typhi
      and paratyphi were often responsible. Widal agglutination test was positive in
      less than half the cases, and leukopenia was not seen frequently. Recurrence of
      infection in 29% of the patients and the high mortality rate (28.5%), despite the
      conventional period of appropriate antimicrobial treatment, show a poor prognosis
      of salmonellosis in SLE patients. This special picture of salmonellosis argues
      for a much longer period of treatment in these patients.

PMID- 8485562
TI  - Anticardiolipin syndrome, aspirin therapy and fetal malformation.
AB  - A patient with systemic lupus erythematosus and elevated cardiolipin antibody
      levels was given low-dose aspirin therapy prior to and throughout her third
      pregnancy to minimize the risk of miscarriage. She delivered a boy at 38 weeks
      with the skeletal deformity of two thoracic hemivertebrae. The putative role of
      aspirin causing this birth defect is discussed.

PMID- 8485563
TI  - Anti-Ro and lymphopenia in SLE.

PMID- 8485564
TI  - Refractory nephrotic syndrome in lupus nephritis: favorable response to
      indomethacin therapy.
AB  - The effects of indomethacin on urinary protein excretion, levels of serum albumin
      and renal function were studied prospectively in six patients with systemic lupus
      erythematosus (SLE) and refractory nephrotic syndrome due to lupus nephritis. Two
      had membranoproliferative glomerulonephritis, two had diffuse proliferative
      glomerulonephritis, and one each had mesangioproliferative and membranous
      glomerulonephritis. All experienced a considerable reduction in urinary protein
      excretion and an increase in serum albumin. Indomethacin was discontinued in two
      patients because of side effects, and proteinuria recurred to pretreatment
      levels. The decrease of proteinuria continued during long-term treatment in three
      patients. Indomethacin did not cause a permanent decline in renal function. Our
      results suggest that therapy with indomethacin may be beneficial for the
      treatment of refractory nephrotic syndrome in selected SLE patients. However,
      because of potential side effects the administration of indomethacin should be
      monitored closely.

PMID- 8485565
TI  - The relevance of antimalarial therapy with regard to thrombosis,
      hypercholesterolemia and cytokines in SLE.
AB  - Hydroxychloroquine has several less well-known actions that may have clinical
      relevance in treating systemic lupus erythematosus (SLE). (1) Hydroxychloroquine
      has a possible anti-thrombotic action. It is a platelet inhibitor and appears to
      decrease the risk of thromboembolism in patients with anticardiolipin antibodies.
      (2) Hydroxychloroquine is associated with lower serum cholesterol and low-density
      lipoprotein levels compared to those present in patients who are taking
      corticosteroids but not antimalarials for SLE. (3) It may also decrease abnormal
      levels of cytokines. Interleukin-6 (IL-6), soluble CD8 and soluble IL-2 receptors
      (sIL-2R) are lower in patients taking antimalarials compared to those on
      corticosteroids alone or on neither medication. Serum levels of CD8 and sIL-2R
      decrease after 6 weeks of hydroxychloroquine treatment. These findings may help
      explain the favorable response of SLE patients treated with antimalarials.

PMID- 8485566
TI  - Ophthalmologic safety profile of antimalarial drugs.
AB  - The ophthalmologic safety of antimalarial drugs is well established, but absolute
      safety cannot be assured. Three types of side effects may develop. Corneal
      deposits and neuromuscular-associated blurred vision are always reversible and
      therefore benign. Visual loss has occurred in patients with retinopathy.
      Retinopathy may be divided into true retinopathy and premaculopathy. It is true
      retinopathy that may be associated with visual loss, while premaculopathy
      consists of subtle visual field and funduscopic abnormalities. These
      premaculopathic changes are generally completely reversible with drug
      discontinuation and have not been shown to progress. Hydroxychloroquine appears
      safer than chloroquine when currently accepted equivalent doses are used. Fewer
      than 20 patients with true retinopathy caused by hydroxychloroquine have been
      reported; more patients have developed true retinopathy when taking chloroquine.
      The safety profile is most dependent on low daily dose and regular ophthalmologic
      monitoring. The optimal strategy of ophthalmologic testing has not yet been
      determined, but visual acuity, funduscopic examination and visual field
      examination should be monitored. Self-administered ophthalmologic testing with
      Amsler grids may contribute additional safety but is not a replacement for
      physician testing.

PMID- 8485567
TI  - Antimalarial drugs, pregnancy and lactation.
AB  - Disease activity has been demonstrated to be one of the major factors
      contributing to fetal loss in SLE patients, and discontinuation of antimalarial
      therapy can precipitate a flare of disease. It is therefore important to
      determine whether it is safe to continue antimalarial therapy throughout
      pregnancy. We have previously stated that we consider lupus patients and their
      fetuses to be at risk for disaster if antimalarial therapy is discontinued during
      pregnancy, and it has been our experience that lupus patients can produce normal
      offspring even if they are taking daily chloroquine or hydroxychloroquine.
      Several other reports now support our findings that it is probably safe to
      continue antimalarial therapy during pregnancy, although there are no large
      studies published. Data on the secretion of hydroxychloroquine in the breast milk
      of patients on steady-state hydroxychloroquine therapy are minimal, and further
      studies are required to determine whether these women can safely nurse their
      infants while taking hydroxychloroquine daily.

PMID- 8485568
TI  - The efficacy of antimalarials in systemic lupus erythematosus.
AB  - The use of antimalarial drugs to treat systemic lupus erythematosus (SLE) is
      reviewed regarding their value in SLE of mild-to-moderate disease activity, as
      corticosteroid-sparing agents, and as an adjunctive therapy in severe SLE. A
      retrospective controlled study of a variety of antimalarials and a randomized
      discontinuation trial of hydroxychloroquine support the considerable clinical
      belief that antimalarials are of benefit in mild-to-moderate SLE. Anecdotal
      reports and the opinion of experienced clinicians suggest that antimalarials
      permit the use of lower doses of corticosteroids. No controlled study has
      confirmed a corticosteroid-sparing role for antimalarials, although no controlled
      study has been conducted specifically to address this hypothesis. The data on
      antimalarials in severe SLE are scant. Antimalarials are likely effective in at
      least a subgroup of SLE patients with mild-to-moderate disease activity. Whether
      these agents are corticosteroid sparing and prevent severe disease exacerbations
      is unproven. Given the low toxicity of antimalarials, further studies are clearly
      warranted.

PMID- 8485569
TI  - Adding to the amyloidoses.

PMID- 8485570
TI  - Gene delivery into the brain using virus vectors.

PMID- 8485571
TI  - Finding new genes faster than ever.

PMID- 8485572
TI  - A medley of retinal dystrophies.

PMID- 8485573
TI  - Universal community carrier screening for cystic fibrosis?
AB  - Approximately 5% of the Caucasian North European and North American populations
      are carriers of the gene defect causing cystic fibrosis (CF). Since the CF gene
      was isolated in 1989 and the common mutations identified, there has been debate
      as to whether community-wide screening for CF carriers should be offered. Pilot
      studies and new discussions are leading to a consensus that screening is now
      possible and will not lead to undue anxiety, but there is still no agreement as
      to cost, or how it will be used by those screening positive.

PMID- 8485574
TI  - Butterfly-shaped pigment dystrophy of the fovea caused by a point mutation in
      codon 167 of the RDS gene.
AB  - Butterfly-shaped pigment dystrophy of the fovea is an autosomal dominant eye
      disease characterized by a bilateral accumulation of yellowish or pigmented
      material at the level of the retinal pigment epithelium. It shares some clinical
      and histopathologic features with age related macular degeneration which is the
      most common cause of legal blindness in older patients. We screened affected
      patients from a three generation family with butterfly dystrophy for mutations in
      candidate genes. A base substitution was identified in the peripherin (RDS) gene
      and DNA sequencing revealed a G to A transition in codon 167 that substitutes
      aspartic acid for a highly conserved glycine. The mutation segregates with the
      disease phenotype (Zmax = 4, theta = 0) strongly suggesting that it causes the
      macular disease in this family.

PMID- 8485575
TI  - A null mutation in the human peripherin/RDS gene in a family with autosomal
      dominant retinitis punctata albescens.
AB  - The murine rds (retinal degeneration slow) allele is a semidominant null allele
      that causes photoreceptor degeneration. The wild-type sequence at the rds locus
      encodes a photoreceptor disc membrane protein named peripherin/RDS. Mutations in
      the homologous human peripherin/RDS gene can cause autosomal dominant retinitis
      pigmentosa, but these are missense mutations or deletions of single codons. No
      obvious null alleles have been reported in humans, so that the human phenotype
      corresponding to rds is as yet unknown. Here we report a 2-basepair deletion in
      codon 25 of the human gene in a family with autosomal dominant retinitis punctata
      albescens, suggesting that this disease, rather than retinitis pigmentosa, is the
      comparable human phenotype.

PMID- 8485576
TI  - Mutations in the human retinal degeneration slow (RDS) gene can cause either
      retinitis pigmentosa or macular dystrophy.
AB  - Mutations in the RDS gene, which encodes the photoreceptor glycoprotein
      peripherin, have been sought in families with autosomal dominant retinal
      dystrophies. A cysteine deletion at codon 118/119 is associated with retinitis
      pigmentosa in one. Three families with similar macular dystrophy have mutations
      at codon 172, arginine being substituted by tryptophan in two and by glutamine in
      one. A stop sequence at codon 258 exists in a family with adult vitelliform
      macular dystrophy. These findings demonstrate that both retinitis pigmentosa and
      macular dystrophies are caused by mutations in RDS and that the functional
      significance of certain amino-acids in peripherin-RDS may be different in cones
      and rods.

PMID- 8485577
TI  - Transfer of a foreign gene into the brain using adenovirus vectors.
AB  - The ability of a replication-deficient adenovirus vector to transfer a foreign
      gene into neural cells of adult rats in vivo has been analysed. A large number of
      neural cells (including neurons, astrocytes and ependymal cells) expressed an E.
      coli lacZ transgene for at least 45 days after inoculation of various brain
      areas. Injecting up to 3 x 10(5) pfu in 10 microliters did not result in any
      detectable cytopathic effects--these were only observed for very high titres of
      infection (> 10(7) pfu 10 microliters-1). Adenovirus vectors therefore appear to
      be a promising means for in vivo transfer of therapeutic genes into the central
      nervous system.

PMID- 8485578
TI  - Direct in vivo gene transfer to ependymal cells in the central nervous system
      using recombinant adenovirus vectors.
AB  - To evaluate the potential for adenovirus-mediated central nervous system (CNS)
      gene transfer, the replication deficient recombinant adenovirus vectors Ad.RSV
      beta gal (coding for beta-galactosidase) and Ad-alpha 1AT (coding for human alpha
      1-antitrypsin) were administered to the lateral ventricle of rats. Ad.RSV beta
      gal transferred beta-galactosidase to ependymal cells lining the ventricles
      whereas Ad-alpha 1AT mediated alpha 1-antitrypsin secretion into the cerebral
      spinal fluid for 1 week. These observations, together with beta-galactosidase
      activity in the globus pallidus and substantia nigra following stereotactic
      administration of Ad.RSV beta gal to the globus pallidus, suggest that adenovirus
      vectors will be useful for CNS gene therapy.

PMID- 8485579
TI  - Production of a model for Lesch-Nyhan syndrome in hypoxanthine
      phosphoribosyltransferase-deficient mice.
AB  - The inherited disease Lesch-Nyhan syndrome, which is caused by a deficiency of
      the enzyme hypoxanthine phosphoribosyltransferase (HPRT), is characterized by
      behavioural alterations, including self-injurious behaviour and mental
      retardation. Although HPRT-deficient mice have been generated using the embryonic
      stem cell system, no spontaneous behavioural abnormalities had been reported. We
      examined whether mice were more tolerant of HPRT deficiency because they were
      more reliant on adenine phosphoribosyltransferase (APRT) than HPRT for their
      purine salvage. The administration of an APRT inhibitor to HPRT-deficient mice
      induced persistent self-injurious behaviour. This combined genetic and
      biochemical model will facilitate the study of Lesch-Nyhan syndrome and the
      evaluation of novel therapies.

PMID- 8485580
TI  - Physical mapping of the holoprosencephaly critical region on chromosome 7q36.
AB  - Holoprosencephaly (HPE) is a developmental field defect involving the brain and
      face. Cytogenetic deletions in patients with HPE have localized one of the HPE
      genes to chromosomal region 7q36. We have characterized the 7q deletions in
      thirteen HPE patients. The result is the construction of a high resolution
      physical map of 7q32-qter. As a first step towards cloning an HPE gene crucial
      for normal brain development, we have defined the HPE minimal critical region in
      7q36 between D7S292 and D7S392.

PMID- 8485581
TI  - Cerebral autosomal dominant arteriopathy with subcortical infarcts and
      leukoencephalopathy maps to chromosome 19q12.
AB  - Cerebral autosomal dominant arteriopathy with subcortical infarcts and
      leukoencephalopathy (CADASIL) has been recently reported as a cause of stroke. It
      is characterized, in the absence of hypertension, by recurrent subcortical
      ischaemic strokes, starting in early or midadulthood and leading in some patients
      to dementia. Magnetic resonance imaging and pathological examination show
      numerous small subcortical infarcts and a diffuse leukoencephalopathy underlaid
      by a non-arteriosclerotic, non-amyloid angiopathy. We performed genetic linkage
      analysis in two unrelated families and assigned the disease locus to chromosome
      19q12. Multilocus analysis with the location scores method established the best
      estimate for the location of the affected gene within a 14 centimorgan interval
      bracketed by D19S221 and D19S222 loci.

PMID- 8485582
TI  - A de novo pathological point mutation at the 21-hydroxylase locus: implications
      for gene conversion in the human genome.
AB  - More than two hundred characterized 21-hydroxylase deficiency alleles appear to
      result exclusively from sequence exchanges involving the 21-hydroxylase gene
      (CYP21B) and a closely related pseudogene (CYP21A). Gene conversion-like events
      have also been reported in many other human gene clusters, but in the absence of
      a de novo mutation, the alternative explanation of a multiple recombination is
      possible. We now report a de novo pathological mutation at the 21-hydroxylase
      locus. DNA sequence analysis suggests that the mutation arose by a
      microconversion event involving exchange of up to 390 nucleotides between
      maternal CYP21A and CYP21B genes. This putative de novo gene conversion event
      appears to be the first characterized in humans.

PMID- 8485583
TI  - Identification of protein coding regions by database similarity search.
AB  - Sequence similarity between a translated nucleotide sequence and a known
      biological protein can provide strong evidence for the presence of a homologous
      coding region, even between distantly related genes. The computer program BLASTX
      performed conceptual translation of a nucleotide query sequence followed by a
      protein database search in one programmatic step. We characterized the
      sensitivity of BLASTX recognition to the presence of substitution, insertion and
      deletion errors in the query sequence and to sequence divergence. Reading frames
      were reliably identified in the presence of 1% query errors, a rate that is
      typical for primary sequence data. BLASTX is appropriate for use in moderate and
      large scale sequencing projects at the earliest opportunity, when the data are
      most prone to containing errors.

PMID- 8485584
TI  - Predicting the cytochrome P450 mediated metabolism of xenobiotics.
AB  - The cytochrome P450s play a unique role in the metabolism of xenobiotics.
      Characteristics which allow a vast number of foreign compounds to be metabolized
      by a limited number of enzymes include broad substrate specificity and broad
      regioselectivity. Because of their importance in both the metabolism and toxicity
      of drugs and environmental contaminants, efforts are being made to use
      computational methods to predict these biotransformation pathways. This review
      describes the recent progress towards the prediction of the tertiary structures
      of the various P450s and the determination of the electronic characteristics of
      substrates which determine their tendency to be oxidized by the P450s.

PMID- 8485585
TI  - Characterization of a human cell line expressing high levels of cDNA-derived
      CYP2D6.
AB  - We have developed a human B-lymphoblastoid cell, designated h2D6v2, which
      expresses high levels of CYP2D6 cDNA. Microsomal P450 contents of 160 pmol mg-1
      protein were observed. NADPH-fortified microsomes exhibited a substantial
      capacity to hydroxylate the prototype CYP2D6 substrates bufuralol and
      debrisoquine. Kinetic parameters, apparent Km, turnover number, Ki for quinidine
      inhibition and stereospecificity of bufuralol hydroxylation, observed with the
      human lymphoblast expressed enzyme were similar to those observed in human liver
      microsomes or purified liver CYP2D6 proteins. Therefore, the human lymphoblast
      expressed material appears to faithfully reflect the authentic protein. Relative
      to control cells, h2D6v2 cells were more sensitive to the cytotoxicity and
      mutagenicity of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), supporting
      our previous observation with a cell line expressing lower levels of CYP2D6.
      h2D6v2 microsomes were capable of metabolizing NNK and NNK metabolism and
      mutagenicity were markedly inhibited by the addition of quinidine, a CYP2D6
      inhibitor. h2D6v2 cells coupled with control cells, represent a useful in vitro
      system for studying xenobiotic metabolism by the clinically important,
      polymorphic CYP2D6. The human lymphoblast system offers the desirable ability to
      couple metabolic transformation studies with toxicological endpoints such as
      cytotoxicity and mutagenicity.

PMID- 8485586
TI  - Molecular genetics of the flavin-dependent monooxygenases.

PMID- 8485587
TI  - Utilizing urinary metabolite data in studying the variability of acetaminophen
      metabolism.

PMID- 8485588
TI  - [The active forces of continence. Illustration by quantified analysis of the
      electromyographic signal of the urethral striated sphincter combined with
      urethral pressure studies].
AB  - Continence in women, ensured by a constantly positive urethral closing pressure,
      is the result of two phenomena: purely passive factors (urethral pressure and
      compliance, transmission of bladder pressure to the urethra) and active factors
      mediated by a voluntary and reflex neuromuscular mechanism (contraction,
      reflexivity, sphincter endurance). In order to define these active forces of
      continence, we simultaneously studied the quantitative electromyographic activity
      of the striated sphincter and the bulbocavernosus muscle and variations in the
      urethral and vesical pressure under various conditions (rest, coughing,
      stimulation of the pudendal nerve). During coughing, the urethral pressure peak
      occurred earlier (100 milliseconds) than the vesical peak, associated with
      hypertransmission of 20%, the bulbocavernosus muscle contracted first, followed
      by contraction of the striated urethral sphincter (150 ms delay) and this
      electrical activity preceded the rise in vesical and urethral pressures.
      Stimulation of the pudendal nerve eliminated the possibility of an artefact
      related to coughing and induced the same sequence of events.

PMID- 8485589
TI  - [Bladder sparing in infiltrating tumors of the bladder: a reasonably sound
      option?].

PMID- 8485590
TI  - [Decreased urethral pressure after coughing: the concept of urethral
      fatigability. Its relationship with active forces of continence].
AB  - The existence of urethral fatiguability was demonstrated by a sphinctometric
      study in 30 women. Comparison of the baseline urethral pressure values and after
      6 maximal coughs demonstrated a mean reduction in urethral pressure of 40%
      (range: 24.5 to 90%) in 10 out of 18 women with stress incontinence. This
      decreased pressure lasted for several seconds. Spectral analysis of the
      electromyographic recording of the striated urethral sphincter under basal
      conditions and then after coughing confirmed the intervention of the striated and
      periurethral musculature with a marked quantitative decrease in the electrical
      activity of the sphincter. The clinical pathophysiological, prognostic and
      therapeutic implications of this new concept are discussed.

PMID- 8485591
TI  - [Treatment of interstitial cystitis with sub-trigonal cystectomy and
      enterocystoplasty].
AB  - Eight patients with interstitial cystitis were treated by supratrigonal
      cystectomy and enterocystoplasty. The indications for this procedure are
      functionally disabling interstitial cystitis refractory to conservative treatment
      and associated with severely altered cystomanometric parameters. 6 patients
      obtained an excellent functional result and 2 patients obtained a poor result,
      due to sphincter hypotonia responsible for total incontinence in one case.

PMID- 8485592
TI  - [Value of elective cure of fibrodysplastic aneurysms of the renal artery in
      hypertensive patients].
AB  - Renal artery aneurysms (RAA) are rare lesions, often associated with
      hypertension. In order to evaluate the benefit in terms of blood pressure of
      elective cure of a fibrodysplastic renal artery aneurysm in hypertensive
      patients, 22 patients were studied retrospectively. With a mean follow-up of 66
      months, correction or improvement of hypertension was obtained in all patients
      with an isolated aneurysm or an aneurysm associated with haemodynamic lesions of
      the renal artery, treated at the same time, but only 40% of cases when the
      aneurysm was associated with non-heamodynamic lesions. Direct criteria
      attributing the hypertension to the aneurysm were generally absent.

PMID- 8485593
TI  - [Color echo-doppler of the ureterovesical stream. Normal aspects. Application to
      the acute ureteral obstruction].
AB  - A colour Doppler ultrasound study of the ureterovesical was performed to define
      the normal features, variants and abnormalities of the ureteric stream by
      comparing 50 normal subjects and 19 subjects with renal colic due to ureteric
      stones. The examination included assessment of the frequency, intensity,
      morphology and symmetry of the ureterovesical stream. In normal subjects, the
      stream was either absent, especially in the case of fluid restriction (36%),
      present and symmetrical (34%) or asymmetrical (30%). In patients with ureteric
      stones, during a non-painful period and in the absence of obstruction on IVU, the
      stream was normal and symmetrical (9%) while during a painful period with
      obstruction on IVU, the ureteric stream was either absent (47%) or abnormal and
      asymmetrical (31%). A continuous stream, very suggestive of obstruction, was
      observed in 5 cases. Colour Doppler ultrasound is a new, simple method which may
      be helpful in the diagnosis of renal colic, particularly in cases in which the
      pyelocaliceal cavities are not dilated.

PMID- 8485594
TI  - [Extracorporeal lithotripsy or ureteroscopy for the treatment of calculi of the
      lower ureter].
AB  - Two therapies, ureterolithotripsy (URL) and extracorporeal shock wave lithotripsy
      (ESWL) can be used in the treatment of lower ureteral calculi. In a retrospective
      analysis ureterolithotripsy and extracorporeal shock wave lithotripsy for lower
      ureteral calculi were compared to evaluate morbidity. During a 3 year period 161
      patients treated with ureterolithotripsy and 71 who underwent extracorporeal
      shock wave lithotripsy (Siemens Lithostar) were analysed as to the success rate,
      effectiveness quotient, complication rate and length of hospitalization. Followup
      consisted of ultrasound and a plain film of the kidneys, ureteres and bladder 1
      day and 1 to 3 months postoperatively. Complete removal of all stone fragments
      was achieved in 95.5% of the patients treated endourologically with a 1.2%
      retreatment rate. In the group treated with extracorporeal shock wave lithotripsy
      success rate was 82.1% with a 19.6% retreatment rate. Among the patients who
      underwent ureteroscopy and stone removal 16.1% had complications compared to
      10.7% in the ESWL group. The mean stone diameter was 0.8 cm in the endourological
      group and 0.7 cm in the ESWL group. Stone size was not a determining factor for
      the stone free rate and effectiveness quotient in the patients treated
      endourologically. Indeed, in patients who underwent ESWL for large stones the
      stone-free rate and effectiveness quotient decreased to 78.9% and 57.7%.
      Ureterolithotripsy will continue to have a primary role in the management of
      lower ureteral stones. As extracorporeal shock wave lithotripsy is an effective
      noninvasive procedure, requiring no anesthesia and hospitalization as routine, it
      may be considered an alternative either primarily or after failed ureteroscopy.

PMID- 8485595
TI  - [Surgical cure of anomalies of the pyelo-ureteral junction with posterior
      vertical lumbar excision: report of 25 cases].
AB  - Posterior vertical lumbar (PVL) incision does not involve any muscle or nerve
      section. It is minimally painful, does not give rise to incisional hernias and
      reduces the hospital stay. Pyeloplasty for cure of the ureteropelvic junction
      (UPJ) is a good indication, as this incision provides access to the renal pelvis
      without renal mobilisation and without interference by the vascular pedicle and
      allows a more superficial operative field. This retrospective study is based on
      25 PVL incisions performed between 1979 and 1992 in 24 patients (15 females and 6
      males with a mean age of 31.8 years) on the left kidney in 11 cases, right kidney
      in 12 cases and bilaterally in 1 case. No intraoperative complications were
      observed. The anastomosis was stented with a Gil-Vernet ureteronephrostomy tube
      for an average of eight days in every case. Early complications (< or = 1 month)
      consisted of six cases of fever, one wound abscess and one urinary fistula.
      Normal feeding was always rapidly restored. Long-term follow-up did not reveal
      any incisional hernias, but two cases of recurrence (8%), two cases of stones and
      one case (4%) of refractory neuralgia (> or = 6 months) in the territory of the
      ilioinguinal nerve. In this indication, there is no gain in terms of hospital
      stay due to the need to maintain the ureteronephrostomy tube for at least five
      days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485596
TI  - [Hydatid cyst of the kidney. Contribution of imaging techniques].
AB  - The authors report a case of renal hydatid disease, a rare disease in France.
      After reviewing the recent data of the literature, they stress the value of
      computed tomography and especially MRI in the presumptive diagnosis.

PMID- 8485597
TI  - [Supernumerary urethras in men. Report of supernumerary blind epispadias].
AB  - Supernumerary urethra, a rare anatomical anomaly, can be explained by various
      embryological theories, accounting for the multitude of classifications proposed.
      Its diverse, minor or very severe clinical manifestations suggest the diagnosis,
      which is confirmed by retrograde and voiding cystourethrography. Treatment is
      surgical or, more rarely, endoscopic.

PMID- 8485598
TI  - [Ectopic prostatic polyp in the bladder. Report of 2 cases].
AB  - An ectopic prostatic polyp situated in the bladder is a rare cause of terminal
      haematuria. The authors present an extensive review of the literature concerning
      this lesion which must be recognised not only by histologists, responsible for
      establishing the diagnosis, but also by urologists, who must be aware of its
      benign nature.

PMID- 8485599
TI  - [Review of phase III clinical trials on combined anti-androgen therapies in
      patients with metastasized prostatic cancer].

PMID- 8485600
TI  - [Neuroendocrine cancers of the prostate].
AB  - This article is a transcription of several papers on neuroendocrine cancers of
      the prostate presented to the Uropathology Club in Angers in 1990. It consists of
      three parts: Firstly, a study of neuroendocrine cells in various organs of the
      human body, followed by the demonstration of these cells in the normal and
      pathological prostate. The second part reports 3 cases of neuroendocrine cancers
      as they are observed in routine practice. A total of 66 cases of pure
      neuroendocrine cancers have been reported to date in the English language
      literature. This type of cancer is characterised by a rapid, hormone-resistant
      course with the development of multiple metastases, frequently visceral. Periods
      of remission in response to chemotherapy may be observed in some cases. The third
      part concerns the systematic demonstration of neuroendocrine cells in prostatic
      adenocarcinoma. The percentage of neuroendocrine cells demonstrated by various
      histological techniques is directly correlated to an increasingly severe
      prognosis of the cancer.

PMID- 8485601
TI  - [Interstitial cystitis].
AB  - Interstitial cystitis, described for many years, remains a mystery for several
      reasons. Although the clinical and therapeutic understanding of this disease have
      improved, the histological features are non-specific and the pathogenesis is
      still unclear. The aim of this article is to briefly review the current state of
      knowledge and to remind the reader that this disease must not be underestimated
      or ignored.

PMID- 8485602
TI  - Management of cataract in adults. Agency for Health Care Policy and Research.

PMID- 8485603
TI  - Depression in primary care: detection, diagnosis, and treatment. Agency for
      Health Care Policy and Research.

PMID- 8485604
TI  - Sickle cell disease: comprehensive screening and management in newborns and
      infants. Agency for Health Care Policy and Research.

PMID- 8485605
TI  - Maternal characteristics of women delivered of twins: natural vs. induced.
AB  - This study retrospectively compared sociodemographic and anthropometric data, as
      well as selected obstetric outcomes, of 13 mothers of twins who conceived after
      ovulation induction with clomiphene citrate or Pergonal with similar data from
      255 mothers who conceived naturally. Infertile women were significantly (P <
      .011) older and likely to be married, of the white race, and more educated than
      women who conceived naturally. Treated women were also taller and heavier prior
      to conception (NS). Treated women gained significantly more weight (45.9 lb vs.
      30.1 lb). They also had a higher proportion of gestations > 32 weeks (91.7% vs.
      74.1%) and longer mean gestations (36.5 weeks vs. 35.4 weeks) compared to
      naturally conceiving mothers of twins, but neither of these differences was
      significant. The infants of treated mothers had birthweights 9.5% heavier than
      the infants of mothers who conceived naturally. These retrospective findings
      suggest that previously infertile women who conceive twins do not suffer worse
      reproductive outcome than women who conceive naturally.

PMID- 8485606
TI  - Does ovulation stimulation improve fertility in women with minimal/mild
      endometriosis after laser laparoscopy?
AB  - Cycle fecundity was retrospectively analyzed in a group of infertile women after
      minimal/mild endometriosis had been treated by carbon dioxide laser laparoscopy.
      Patients were followed in spontaneous (observation) cycles as well as in
      treatment cycles using ovulation stimulation. Treatment protocols included
      clomiphene citrate (CC), sequential CC/human menopausal gonadotropins/human
      chorionic gonadotropin (CC/hMG/hCG), and hMG/hCG. Some patients who failed to
      conceive with ovulation stimulation protocols underwent in vitro fertilization
      (IVF). Eighty-nine patients were followed for a total of 605 cycles, during which
      37 pregnancies occurred. Cycle fecundity was 0.028 in observation cycles, and was
      higher with the use of CC (0.066), and significantly higher (P < .05) with use of
      CC/hMG/hCG (0.114) and hMG/hCG (0.073). The highest cycle fecundity was attained
      in IVF cycles (0.222). This retrospective analysis suggests that active ovulation
      management in patients with minimal/mild endometriosis treated by carbon dioxide
      laser laparoscopy may significantly increase cycle fecundity.

PMID- 8485607
TI  - Comparative efficacy of gestrinone and danazol in infertile women with
      endometriosis.
AB  - The relationship between endometriosis and infertility is observed frequently.
      Patients with both conditions require a conservative approach to their
      management. Since hormonal therapy is one of those approaches, we sought to
      compare the efficacy of Danazol and Gestrinone in 80 infertile patients (48 and
      32, respectively). Therapy lasted 6 months in both treatment groups, and all
      patients studied had laboratory tests performed and were clinically evaluated and
      classified through laparoscopy before and after therapy. The improvement of
      symptoms and favorable follow-up were similar with both treatments. The
      reestablishment of menstrual patterns and fertility were also nearly alike in
      both groups. However, Gestrinone was associated with fewer secondary effects and
      is easier to administer than Danazol. We conclude that Gestrinone is a useful
      medication in the management of the infertile patient with endometriosis.

PMID- 8485608
TI  - Treatment of infertility patients with hMG-IUI in a private practice.
AB  - Between December 1988 and September 1990, 132 patients were treated with 432
      cycles of superovulation with hMG and timed IUI for various infertility subgroups
      in a private office setting. All patients had a complete infertility evaluation,
      including semen analysis, postcoital testing, hysterosalpingogram, endometrial
      biopsy and laparoscopy, and immunological testing in most cases. Abnormal factors
      were treated by conventional surgical and/or medical means. Most patients had at
      least a 6-month trial at achieving normal conception prior to hMG-IUI therapy.
      Patients received up to six cycles of treatment. Forty-five patients (34%) are
      still under treatment; thus far, the overall pregnancy rate is 58 of 132 or 44%.
      Of the 58 pregnancies, there were 13 abortions (22.5%) and two ectopic
      pregnancies (3.5%). The pregnancy rate per cycles has been 58/432, or 13.5%. The
      on-going pregnancy rate is 43/132, or 32.6%, or 32/432 (10%) per cycle. Treatment
      with hMG-IUI seems to approach that for IVF for most conventionally treated
      infertility subgroups. It can be done at a much lower cost per cycle, thus
      allowing a greater number of couples the availability of treatment. The authors
      suggest that most infertility patients be offered hMG-IUI therapy prior to IVF
      referral.

PMID- 8485609
TI  - Measurement of placental protein 14 (PP14) not helpful in predicting infertility
      or spontaneous abortion.
AB  - Placental protein 14 (PP14) can be measured in the serum by radioimmunoassay. The
      level rises from mid to late luteal phase in a manner similar to the endometrial
      biopsy. A study was initiated to determine if a clinical association could be
      found between the late luteal phase serum PP14 level and subsequent pregnancy and
      spontaneous abortion rate. No difference was found in the preconception PP14
      level in patients conceiving versus those not conceiving, nor in those aborting
      versus those not aborting. A trend toward higher levels in conception versus non
      conception cycles was noted, but a large patient group will be needed to
      demonstrate statistical significance.

PMID- 8485610
TI  - Risk factors in men and women consulting for infertility.
AB  - In three regions of France, over a period of 1 year, we registered all couples
      (women and men) who have consulted and obtained a medical evaluation (medical
      causes and risk factors) for primary or secondary infertility. For women with
      secondary infertility caused by tubal disorders (compared to other causes) the
      risk factors are: STDs (RR = 7.5; 4.8-11.6); previous surgery, including
      appendectomy (RR = 4.7; 3.4-6.5); history of salpingitis (RR = 32.1; 18.8-55.3);
      and ectopic pregnancy (RR = 21.5; 11.4-41.3). For consulting men, secondary
      infertility risk factors are varicocele (RR = 4.1; 2.0-8.5) and previous genital
      infection (RR = 5.8; 2.8-11.7) for oligoteratosasthenospermia, and histories of
      major treatment or exposure to toxic agents such as X-rays, benzenes, or
      pesticides (RR = 6.6; 1.3-30.4) for secretory azoospermia. These results
      underline the importance for physicians of making a systematic exploration for
      all the different infertility risk factors in men and women, enabling greater
      control and effectiveness in medical diagnosis.

PMID- 8485611
TI  - Psychological sequelae of surgical reversal or of IVF after tubal ligation.
AB  - This study investigates the psychological concomitants and sequelae of surgical
      reversal (tubal reanastomosis) or of IVF after tubal ligation. We held semi
      structured interviews and used the Giessen test and the Strauss-Appelt body image
      questionnaire. The sample comprised 25 women; a new partner was the leading
      reason for reversal in 16 cases ('New Partner'), while in 9 cases experiences of
      loss (of a child or of ideal values) prevailed ('Loss'). The two groups differed
      in a number of relevant demographic and psychological data. 'New Partner'
      patients showed a pattern of factors known to be associated with regret of
      sterilization. 'Loss' women were less satisfied with reversal than 'New Partner'
      subjects (P < .01). Satisfaction with reversal was independent of an achieved
      pregnancy. Patients considered surgical reversal to be preferable to IVF because
      of the "restoration of the mutilation." In the Giessen test, 'New Partner' women
      were more depressive (P < .05) and more submissive (P < .05) than 'Loss'
      subjects. Cluster analysis of the whole sample revealed four well distinguishable
      profiles. 'Loss' patients experienced less insecurity of their body image than
      both 'New Partner' women and the general female population. We conclude that
      reversal of sterilization helps to restore body-image and self-esteem, but it may
      counteract mourning. Consequences for pre-reversal counseling are discussed.

PMID- 8485612
TI  - A randomized study to compare the effectiveness, tolerability, and acceptability
      of two different transdermal estradiol replacement therapies. The Transdermal HRT
      Investigators Group.
AB  - This randomized trial was designed to assess the efficacy, tolerability, and
      acceptability of two different transdermal estradiol replacement therapies: Cilag
      Estradiol-TTS (a matrix system) and Ciba-Geigy Estradiol-TTS (a reservoir
      system). Five hundred and fourteen patients were evaluable for efficacy, and all
      patients who had received the study medications were evaluated for safety (n =
      530). Both treatments significantly improved systemic and urogenital symptoms as
      evidenced by a decrease in the number of hot flushes and the Kupperman Index
      score; there was no difference in effectiveness between the two treatments.
      Safety evaluation revealed a low incidence of adverse events, mainly compatible
      with exogenously administered estrogen and progestagen. Endometrial biopsies at
      the end of treatment were similar between groups and consistent with balanced
      hormone replacement therapy. Analyses of acceptability data revealed a low
      incidence of skin reactions and an added benefit with the Cilag-Estradiol-TTS
      patch in terms of convenience owing to the adhesiveness of the patch. In
      conclusion, both transdermal estradiol replacement therapies were effective and
      well tolerated in the treatment of postmenopausal estrogen deficiency symptoms,
      and the Cilag Estradiol-TTS patch had an advantage in terms of convenience and
      adhesiveness.

PMID- 8485613
TI  - Gonadotropin-releasing hormone has a biphasic action on aromatase activity
      through protein kinase C in granulosa cells.
AB  - Gonadotropin-releasing hormone (GnRH) exerts direct effects on the ovary by
      binding to its specific receptor, and stimulates inositol phospholipid turnover
      in granulosa cells. This study was undertaken to determine the involvement of
      protein kinase C in the action of GnRH on follicle-stimulating hormone (FSH)
      stimulated aromatase activity in rat granulosa cells. The aromatase activity was
      examined by conversion of exogenously supplied androstenedione to estrogen. FSH
      stimulated aromatase activity, with a low rate of estrogen production for the
      first 18 hours, followed by a high rate of production on further incubation.
      Addition of GnRH potentiated the aromatase response to FSH in the first 18 hours,
      but caused a dose-dependent inhibition of the FSH-stimulated aromatase activity
      from 20 to 45 hours of incubation. Half-maximal effects of GnRH occurred at 10
      nM. Both of the biphasic actions of GnRH on aromatase response to FSH were
      mimicked by protein kinase C activators, phobol myristate acetate (PMA) and
      oleoylacetyl glycerol; maximal effects occurred at 1 to 10 ng/mL. When the cells
      were exposed first to FSH for 18 hours and then to PMA, the second phase of
      estrogen production was also suppressed. The second phase, producing quantitative
      estrogen, might result from induction of the enzyme, because cycloheximide (100
      ng/mL) prevented the FSH-induced activation of aromatase from 20 hours of
      incubation. These results indicate that the biphasic actions of GnRH on FSH
      stimulated aromatase activity are mediated by protein kinase C. The inhibitory
      action of GnRH on quantitative steroidogenesis caused by prolonged FSH
      stimulation might be expressed through the impaired induction of aromatase.

PMID- 8485614
TI  - Analysis of oviduct-derived embryonic growth stimulator activity.
AB  - A co-culture study was carried out using primary cultures of hamster oviduct
      tissues to analyze oviduct-derived embryonic growth stimulating factor. In co
      cultures of mouse pronuclear embryos and hamster oviduct tissue, the 4-cell rate
      after 48 hours (53.2%, 109/205) and blastocyst rate after 96 hours (22.4%,
      46/205) were significantly higher than those of the standard culture group (4
      cell rate, 41.8%, 76/182; blastocyst rate, 4.4%, 8/182), suggesting an embryonic
      growth stimulating effect of the co-culture. Similar effects were observed in co
      cultures of both 2-cell mouse embryos collected 40 or 48 hours after the hCG
      administration and morulae collected 64 hours after hCG, but no such effect was
      observed in co-cultures of hamster embryos. When mouse embryos were cultured in a
      conditioned medium, which was the supernatant of the hamster oviduct tissue
      culture in Biggers-Whitten-Whittingham's (BWW) solution, no embryonic growth
      stimulating effect was observed. Further, no stimulating effect was observed in
      the conditioned medium obtained from 24-hour co-cultures of embryos and oviduct
      tissue. From these results, we considered the embryonic growth stimulating factor
      to be labile, with concentration-dependent effects. The absence of a stimulatory
      effect of co-culturing on the growth of hamster embryos also suggests the
      presence of species variations in the in vitro arrest of embryogenesis.

PMID- 8485615
TI  - Regulation of neural responses in the canine pyloric sphincter by opioids.
AB  - 1. Regulation of excitatory and inhibitory junction potentials (e.j.ps and
      i.j.ps) by opioid peptides was studied in isolated muscle strips from the pyloric
      sphincter of the dog. 2. Methionine enkephalin (MetEnk; 10(-10) to 10(-6) M) and
      [D-Ala2, D-Leu5] enkephalin (DADLE; 10(-11) to 10(-7) M), a delta-specific opioid
      agonist, inhibited i.j.ps and e.j.ps recorded from cells in the myenteric and
      submucosal regions of the circular muscle layer. These compounds had no effect on
      resting potential or slow wave activity suggesting that the effects on junction
      potentials were not due to direct effects on smooth muscle cells. 3. MetEnk and
      DADLE caused similar effects on junction potentials in preparations in which the
      myenteric plexus was removed, suggesting that opioids inhibit pre-junctional
      effects on nerve fibres within the muscularis externa. 4. Inhibition of junction
      potentials by MetEnk and DADLE was blocked by approximately the same extent by
      naloxone (10(-6) M) and ICI 174,864 (10(-6) M), a delta-specific antagonist. 5.
      MetEnk and DADLE blocked a portion of the i.j.p. that was sensitive to arginine
      analogues; after treatment with N omega-nitro-L-arginine methyl ester (L-NAME,
      10(-4) M), MetEnk and DADLE had no further effect on i.j.ps. These data suggest
      that opioids regulate nitric oxide-dependent neurotransmission. 6. Naloxone (10(
      6) M) alone had no effect on i.j.ps elicited by short trains of electrical field
      stimuli. 7. I.j.p. amplitude was reduced after a period of conditioning
      stimulation (2 min, 30 Hz, 30 V). Naloxone blocked the post-stimulation
      inhibition. Repetitive stimulation at high frequencies (30 Hz) resulted in
      sustained hyperpolarization. Naloxone increased the amplitude of the
      hyperpolarization responses elicited by high frequency stimulation.8. These
      results show that e.j.ps and i.j.ps in the canine pylorus are inhibited by
      opioids. A portion of the inhibitory effects appears to be mediated via delta
      receptors.9. Although pyloric muscles are richly innervated by nerves containing
      opioid peptides, brief trains of stimuli do not appear to release concentrations
      of opioids that are effective in regulating junction potentials. Higher frequency
      stimulation (or longer durations of stimulation) appear to be necessary to
      release concentrations of opioids that are effective in modulating the amplitude
      of junction potentials.

PMID- 8485616
TI  - Evidence for a nucleotide receptor on adrenal medullary endothelial cells linked
      to phospholipase C and phospholipase D.
AB  - 1. We have investigated whether the 'atypical' P2-purinoceptor previously
      described on adrenal microvasculature endothelial cells is a nucleotide receptor
      (responds to pyrimidines and purines) and is linked to phospholipase D as well as
      phospholipase C. 2. Cultured bovine adrenal medullary endothelial (BAME) cells
      responded to the pyrimidine UTP, as well as the purines. The total [3H]-inositol
      phosphate responses were with a rank order of UTP > ATP- = adenosine 5'-O-(3-thio
      triphosphate) (ATP gamma S) >> 2MeSATP. The selective P2x agonist beta, gamma
      methylene ATP was inactive. 3. Construction of dose-response curves to ATP, ATP
      gamma S and UTP in the presence and absence of additional agonists showed that
      responses to ATP gamma S and UTP were not additive, nor were those to UTP and
      ATP. This suggests that purines and pyrmidines acted via a common nucleotide
      receptor. 4. 32P-labelled BAME cells, in the presence of butanol, produced [32P]
      phosphatidylbutanol (PBut) when stimulated with ATP gamma S or the protein kinase
      C activator, tetradecanoyl phorbol acetate (TPA). 5. Cells labelled with [3H]
      palmitate and stimulated in the presence of butanol generated [3H]-PBut with the
      same order of agonist potencies seen for inositol phosphate responses. 6. The
      protein kinase C inhibitor, Ro 31-8220, abolished TPA and agonist stimulation of
      [3H]-PBut production. 7. These observations, and our related studies on bovine
      aortic endothelial cells, provide the first demonstration of a phospholipase C
      linked nucleotide receptor on vascular endothelial cells. It is concluded that
      BAME cells express a nucleotide receptor linked to phospholipase C and
      phospholipase D, but that activation of phospholipase D is probably down-stream
      of phospholipase C.

PMID- 8485617
TI  - Effects of dicentrine on haemodynamic, plasma lipid, lipoprotein level and
      vascular reactivity in hyperlipidaemic rats.
AB  - 1. The effects of dicentrine on haemodynamic, plasma lipid, lipoprotein level and
      vascular reactivity were investigated in Wistar-Kyoto (WKY) and spontaneously
      hypertensive (SH) rats, fed a high fat-high cholesterol diet. 2. In high fat-high
      cholesterol (HF-HC) diet fed WKY and SH rats, oral administration of dicentrine
      (5 and 10 mg kg-1, twice a day) for 4 weeks caused significant reductions in
      total plasma cholesterol (CE) by reducing the low density lipoprotein (LDL)
      fraction, and reductions in total plasma triglyceride (TG) by reducing the very
      low density lipoprotein (VLDL) fraction. 3. Dicentrine therapy was associated
      with increased high density lipoprotein (HDL)-cholesterol levels; thus the ratio
      of total plasma cholesterol to HDL-cholesterol was improved. 4. In HF-HC diet fed
      conscious WKY and SH rats, oral administration of dicentrine (5 and 10 mg kg-1,
      twice a day) also evoked dose-related decreases in mean arterial pressure (MAP)
      which were of greater magnitude in SH rats. Neither dose of dicentrine caused a
      significant change in heart rate (HR). 5. The aortic arches from SH rats fed the
      HF-HC diet for 8 weeks were significantly more affected by the atherosclerotic
      lesions than the abdominal aortae and renal arteries of WKY and SH rats. Oral
      administration of dicentrine (5 and 10 mg kg-1) for 4 weeks did not diminish the
      atherosclerotic lesion areas in WKY and SH rats. 6. In aortae of the
      hyperlipidaemic rats, significantly attenuated EC50 values and augmented maximal
      responses for phenylephrine-induced contraction were obtained. Endothelium
      dependent relaxation to acetylcholine was abolished, while endothelium
      independent relaxation to nitroprusside was well preserved. Dicentrine therapy
      caused significantly augmented EC50 values and attenuated maximal responses for
      phenylephrine-induced contraction in hyperlipidaemic rats. However, dicentrine
      neither prevented the impaired relaxation to acetylcholine, nor affected the
      relaxation to nitroprusside during atherosclerosis progression.7. It is concluded
      that dicentrine decreases MAP, plasma CE, LDL-CE, plasma TG, VLDL-TG,vascular
      hyperreactivity to phenylephrine and increases HDL-CE levels. Dicentrine may thus
      hold potential for the reduction of two of the major risk factors, hypertension
      and hyperlipidaemia, for cardiovascular disease.

PMID- 8485618
TI  - Effects of nifedipine and ryanodine on adrenergic neurogenic contractions of rat
      vas deferens: evidence for a pulse-to-pulse change in Ca2+ sources.
AB  - 1. The effects of nifedipine and ryanodine on the adrenergic component of
      neurogenic contractions of the rat isolated vas deferens were studied in an
      attempt to identify the sources of Ca2+ mediating the contraction. The tissue was
      electrically stimulated by single pulses or pairs of widely spaced pulses. The
      purinergic component of contraction was suppressed by the presence of 300 microM
      suramin. 2. In Mg(2+)-free medium, nifedipine (0.01-10 microM) reduced the first
      and, to a greater extent, the second twitch elicited by two pulses 3 s apart.
      This pattern of inhibition was observed both in the absence of rauwolscine (when
      twitch 2 was smaller than twitch 1) and in the presence of 0.1 microM rauwolscine
      (when, due to interruption of prejunctional alpha 2-adrenoceptor-mediated
      autoinhibition, twitch 2 was of similar height to twitch 1). Nifedipine reduced
      only twitch 2 but not twitch 1 in medium containing 1.2 mM Mg2+. 3. Single pulses
      of increasing current strength elicited increasing contraction. Nifedipine
      reduced contractions by about the same absolute extent at all current strengths,
      so that the relative contribution of the nifedipine-sensitive component decreased
      with increasing current strength. 4. When the pulse interval in a pair was
      increased from 5 to 60 s, the inhibition by nifedipine of the second twitch was
      most marked at an interval of 5 s and declined as the interval increased. 5. In
      contrast to nifedipine, 20 microM ryanodine reduced the first twitch of a pair to
      a greater extent than a second twitch 5 s later, so that twitch 2 became greater
      than twitch 1. The inhibition by ryanodine of twitch 2 increased with increasing
      pulse interval.6. In vasa deferentia preincubated with [3H]-noradrenaline, I
      microM nifedipine and 20 microM ryanodine did not change the electrically evoked
      overflow of tritium, whereas 10 microM nifedipine increased it.7. It is concluded
      that, when the sympathetic axons of the vas deferens are stimulated by a single
      pulse(or the first pulse of a pair) in Mg2+-free medium, both Ca2+ mobilization
      inside the smooth muscle cells and Ca2+ entry contribute to the ensuing
      adrenergic contraction. The relative contribution of Ca2+ entry is small at
      maximal stimulus strength but increases with decreasing stimulus strength. When a
      second pulse follows the first after an appropriate interval, a switch of Ca2+
      sources occurs: intracellular Ca2+mobilization is decreased during twitch 2,
      whereas Ca2+ entry is increased.

PMID- 8485619
TI  - Cellular mechanism of U78517F in the protection of porcine coronary artery
      endothelial cells from oxygen radical-induced damage.
AB  - 1. The aim of this study was to clarify the role of lipid peroxidation in
      cellular injury as assessed by lactate dehydrogenase (LDH) release from cultured
      coronary artery endothelial cells of the pig. Cells exposed to H2O2 at
      concentrations of 0.1 to 20 mM or to a xanthine and xanthine oxidase (X/XO)
      reaction mixture released LDH into the medium. Significant release from X/XO
      treated cells took place with a delay of 2 h. 2. Superoxide dismutase (SOD),
      catalase or dimethylthiourea attenuated the release of LDH from X/XO-treated
      cells. Similarly the putative inhibitor of lipid peroxidation, U78517F attenuated
      the release of LDH by X/XO with an IC50 of 0.08 microM. 3. H2O2 was continuously
      produced by the addition of X/XO to the medium alone. However, in the presence of
      endothelial cells, H2O2 was eliminated at 1 h. U78517F had no effect on either
      process. 4. The oxygen radical-induced release of LDH was associated with
      malondialdehyde (MDA) formation. U78517F inhibited the formation of MDA with an
      IC50 of 0.27 microM. 5. Reduction of the Ca2+ concentration in the incubation
      medium from 1.6 mM to 0.016 mM markedly attenuated the release of LDH from
      endothelial cells. Nifedipine (1 microM) did not attenuate the LDH release from
      the cells. 6. It is likely that porcine coronary artery endothelial cells can be
      thus injured by oxygen radicals presumably through hydroxyl radicals formed and
      consequent lipid peroxidation, and that the extracellular Ca2+ concentration
      plays an important role in the genesis of such endothelial cell damage.

PMID- 8485620
TI  - Ap4A and ADP-beta-S binding to P2 purinoceptors present on rat brain synaptic
      terminals.
AB  - 1. Diadenosine tetraphosphate (Ap4A) a dinucleotide stored and released from rat
      brain synaptic terminals presents two types of affinity binding sites in
      synaptosomes. When [3H]-Ap4A was used for binding studies a Kd value of 0.10 +/-
      0.014 nM and a Bmax value of 16.6 +/- 1.2 fmol mg-1 protein were obtained for the
      high affinity binding site from the Scatchard analysis. The second binding site,
      obtained by displacement studies, showed a Ki value of 0.57 +/- 0.09 microM. 2.
      Displacement of [3H]-Ap4A by non-labelled Ap4A and P2-purinoceptor ligands showed
      a displacement order of Ap4A > adenosine 5'-O-(2-thiodiphosphate) (ADP-beta-S) >
      5'-adenylyl-imidodiphosphate (AMP-PNP) > alpha,beta-methylene adenosine 5'
      triphosphate (alpha,beta-MeATP) in both sites revealed by the Ki values of 0.017
      nM, 0.030 nM, 0.058 nM and 0.147 nM respectively for the high affinity binding
      site and values of 0.57 microM, 0.87 microM, 2.20 microM and 4.28 microM
      respectively for the second binding site. 3. Studies of the P2-purinoceptors
      present in synaptosomes were also performed with [35S]-ADP-beta-S. This
      radioligand showed two binding sites the first with Kd and Bmax values of 0.11 +/
      0.022 nM and 3.9 +/- 2.1 fmol mg-1 of protein respectively for the high affinity
      binding site obtained from the Scatchard plot. The second binding site showed a
      Ki of 0.018 +/- 0.0035 microM obtained from displacement curves. 4. Competition
      studies with diadenosine polyphosphates of [35S]-ADP-beta-S binding showed a
      displacement order of Ap4A > Ap5A > Ap6A in the high affinity binding site and Ki
      values of 0.023 nM, 0.081 nM and 5.72 nM respectively. The second binding site
      potency order was Ap5A> Ap4A > Ap6A,with Ki values of 0.28 microM, 0.53 microM
      and 5.32 microM respectively.5. Displacement studies of [35S]-ADP-beta-S with P2
      purinoceptor agonists showed the following potency pattern: ADP-beta-S > AMP-PNP
      >alpha,beta-MeATP with Ki values of 0.021 nM, 0.029 nM 0.215 nM respectively in
      the high affinity binding site. 2-Methylthio-adenosine 5'-triphosphate (2MeSATP)
      was unable to displace [35S]-ADP-beta-S in this binding site. The second binding
      site showed a profile of ADP-beta-S> a,beta-MeATP> AMP-PNP > 2MeSATP and Ki
      values of 0.0 18 microM, 0.212 microM, 0.481 microM and 18.04 microM
      respectively.6. These studies suggest the presence of a new P2-purinoceptor in
      rat brain synaptosomes with high affinity for diadenosine polyphosphates which we
      tentatively designate as P2d.

PMID- 8485621
TI  - Antiepileptic drug pharmacokinetics and neuropharmacokinetics in individual rats
      by repetitive withdrawal of blood and cerebrospinal fluid: milacemide.
AB  - 1. The kinetics and metabolism of milacemide have been studied in an animal model
      which allows the simultaneous investigation of the temporal inter-relationships
      of drugs and metabolites in blood (pharmacokinetics) and cerebrospinal fluid
      (CSF, neuropharmacokinetics) in individual freely moving rats. 2. Milacemide dose
      dependently increased CSF glycine and glycinamide (intermediary metabolite)
      concentrations. This confirms that milacemide is a CNS glycine prodrug. 3.
      Pretreatment with L-deprenyl (2 mg kg-1), a specific inhibitor of monoamine
      oxidase type B (MAO-B), almost completely prevented the formation of glycinamide
      and increased milacemide accumulation in CSF. Tmax and t1/2 were significantly
      increased and Cmax and AUC values were decreased for glycinamide compared to
      controls. Pretreatment with clorgyline (5 mg kg-1), a specific inhibitor of MAO
      type A, only moderately decreased glycinamide Cmax and AUC values. 4. After
      milacemide administration (100, 200 and 400 mg kg-1, i.p.) serum and CSF
      milacemide concentrations rose linearly and dose-dependently. Serum glycinamide
      concentrations exhibited small dose-dependent rises but these were not linearly
      related. In contrast, CSF glycinamide concentrations rose linearly and dose
      dependently with Cmax values 2.5, 3.2 and 4.1 times greater than the
      corresponding values for serum glycinamide after giving 100, 200 and 400 mg kg-1
      respectively of milacemide. 5. Serum glycine concentrations were unaffected but
      CSF concentrations increased dose-dependently and these were significant at the
      higher milacemide doses (200 and 400 mg kg-1). Animals given 400 mg kg-1
      milacemide had glycine values which were still significantly elevated 7 h later.
      6. In conclusion, serum milacemide rapidly enters and equilibrates with the CNS
      compartment where it is metabolised primarily by MAO-B to glycinamide and finally
      to glycine. Metabolism in the peripheral compartment is negligible.

PMID- 8485622
TI  - Differential changes of adrenoceptor- and muscarinic receptor-linked prostacyclin
      synthesis by the aorta and urinary bladder of the diabetic rat.
AB  - 1. The effect of experimental diabetes mellitus (DM; hyperglycaemic, non
      ketototic; 2 months duration) in the rat on receptor-linked prostacyclin (PGI2)
      synthesis (measured as 6-oxo-PGF1 alpha by radioimmunoassay) was studied in the
      aorta and urinary bladder using adrenaline, angiotensin II (AII) and
      acetylcholine (ACh). Signal transduction systems were studied via stimulation of
      PGI2 synthesis with phorbol ester dibutyrate (PDBU; a protein kinase C activator
      [PKC]), Ca2+ ionophore A23187 (A23187) and thapsigargin (both elevate
      intracellular Ca2+, activating phospholipase A2 [PLA2]) and arachidonate (AA;
      substrate for PGI2 synthesis). 2. In response to adrenaline, AII and phorbol
      ester, aortic PGI2 release was markedly reduced (all > 75%) in diabetic rats
      compared to controls. EC50s of the dose-response curves for adrenaline, AII and
      PDBU were also markedly increased in aortae from DM rats compared to controls.
      Although there was decreased output of PGI2 in response to A23187 by aortae from
      diabetic rats compared to controls, there was no difference in the EC50s (mean +/
      s.e. mean: diabetic, 2.7 +/- 0.2 x 10(-6) M; controls 2 +/- 0.18 x 10(-6) M).
      There were no differences in PGI2 release (or in the EC50s) in response to
      thapsigargin or AA between aortae from diabetic and control rats. 3. In the
      urinary bladder, there was a marked increase in PGI2 output in response to ACh
      and a marked decrease in EC50s for the ACh-PGI2 dose-response curves in diabetic
      rats (EC50 = 5.8 +/- 0.32 x 10(-7) M) compared to controls (EC50 = 2.2 +/- 0.15 x
      10(-6) M). Although there was an increase in PGI2 output in the urinary bladders
      from diabetic rats in response to A23187, there were no differences in the EC50s
      (control, 1.8 +/- 0.2 x 10-6 M; diabetic, 1.1 +/- 0.15 X 10-6 M). In the urinary
      bladders, there were no differences in PGI2 output (or the EC50s) in response to
      PDBU, thapsigargin or AA between diabetic or control rats.4. These data indicate
      that: (i) reduced PGI2 synthesis coupled to adrenoceptors and AII receptors in
      the aortae of diabetic rats may be due to diminished PKC activity and not to
      changes in receptor density and/or affinity, Ca2+ stores, PLA2, cyclo-oxygenase
      or PGI2 synthase; (ii) the diametrically opposite effect of DM on ACh-stimulated
      PGI2 synthesis is not due to an increase in PKC activity, but possibly to an
      increase in muscarine receptor number and/or affinity; (iii) changes in receptor
      linked PGI2 synthesis are not ubiquitous in experimental DM and may be organ
      specific.

PMID- 8485623
TI  - Inhibition of spinal opioid antinociception by intrathecal beta-endorphin1-27 in
      the rat.
AB  - 1. The effects of intrathecal (i.t.) administration of beta-endorphin and two
      shorter fragments, human and ovine beta-endorphin1-27, were examined for
      antinociceptive activity in the tail-flick and paw-pressure tests in the rat.
      Additionally, the ability of ovine beta-endorphin1-27 to influence the action of
      i.t. beta-endorphin, morphine and [D-Pen2-D-Pen5]enkephalin (DPDPE) was also
      examined in these tests. 2. After i.t. injection, beta-endorphin produced potent
      dose-related antinociception in the tail-flick and paw-pressure tests. Shorter
      endorphins produced much weaker effects. The order of antinociceptive efficacy
      was beta-endorphin > human beta-endorphin1-27 > ovine beta-endorphin1-27. 3.
      Administration of ovine beta-endorphin1-27 (0.72, 1.44 nmol, i.t.) significantly
      attenuated the antinociceptive effect of beta-endorphin (2.88 nmol, i.t.) in the
      tail-flick and paw-pressure tests. 4. Both i.t. morphine and DPDPE produced dose
      related antinociception in the tail-flick and paw-pressure tests. The potency of
      DPDPE was lower than that of morphine in both tests; however, the effect of DPDPE
      was weaker in the paw-pressure test. 5. Administration of ovine beta-endorphin1
      27 (1.44 nmol, i.t.) significantly attenuated the antinociceptive effect of
      morphine (14.9 nmol, i.t.) in both tests and the effect of DPDPE (38.7 nmol) in
      the tail-flick test. 6. The results show that beta-endorphin1-27 acts as an
      opioid antagonist at the spinal level in the rat. Its ability to inhibit the
      action of morphine and DPDPE suggests that it may attenuate beta-endorphin action
      by an interaction with mu- and/or delta-opioid receptors.

PMID- 8485624
TI  - Pharmacological characterization of the contractile responses to angiotensin
      analogues in guinea-pig isolated longitudinal muscle of small intestine.
AB  - 1. The contractile responses to angiotensin II, angiotensin III and two synthetic
      analogues, [Lys2]angiotensin II and [Sar1]angiotensin II, in the guinea-pig
      isolated longitudinal muscle preparation of small intestine have been
      characterized in vitro. 2. Tachyphylaxis to the angiotensin analogues was reduced
      by use of a Krebs-Henseleit solution containing a raised (sub-contractile)
      concentration of potassium (11.2 mM). Under these conditions. reproducible
      cumulative concentration-response curves to all agonists were established. The
      pD2 estimates for angiotensin II, [Lys2]angiotensin II, angiotensin III and
      [Sar1]angiotensin II were 9.15 +/- 0.14, 7.42 +/- 0.06, 7.69 +/- 0.18 and 9.50 +/
      0.15 respectively and the maximum responses achieved were not significantly
      different. 3. The contractile responses to angiotensin II, angiotensin III and
      [Sar1]angiotensin II were reduced by greater than 80% by tetrodotoxin (TTX; 0.1
      microM). However, the responses to [Lys2]angiotensin II were reduced by only 63
      +/- 5%. Atropine (0.1 microM) also reduced the responses to angiotensin II,
      angiotensin III and [Lys2]angiotensin II, although its effect was less than that
      produced by TTX. Furthermore, while responses to these agonists were not
      significantly modified by the NK1 receptor antagonist (+/-)-CP-96,345 (30 nM)
      alone, the combined pre-incubation with both atropine and (+/-)-CP-96,345 reduced
      maximum agonist responses to a level not significantly different from those
      produced by TTX. 4. Indirect and direct contractile responses to angiotensin II
      and [Lys2]angiotensin II (in the presence of TTX) respectively were characterized
      by use of the selective AT1 receptor antagonist, losartan and the AT2 receptor
      antagonist, PD123177. Losartan produced parallel rightward displacement of the
      concentration-response curve to angiotensin II and [Lys2]angiotensin II, with an
      estimated pKB of 8.56(8.42-8.68) and 9.18 (8.63-9.50) respectively. The AT2
      receptor antagonist, PD123177 (3 microM) failed to modify the contractile
      responses to either angiotensin II or [Lys2]angiotensin II.5. We conclude that
      two populations of angiotensin II receptors exist in the guinea-pig longitudinal
      muscle of small intestine, one located neuronally mediating the release of both
      acetylcholine and substance P and the other located on the smooth muscle
      mediating direct contractile responses. The neuronal component provides the major
      contribution to the agonist responses. Both receptor populations are of the AT1
      receptor subtype.

PMID- 8485625
TI  - The glycine/NMDA receptor antagonist, R-(+)-HA-966, blocks activation of the
      mesolimbic dopaminergic system induced by phencyclidine and dizocilpine (MK-801)
      in rodents.
AB  - 1. The effects of the glycine/N-methyl-D-aspartate (NMDA) receptor antagonist, R
      (+)-HA-966 on the neurochemical and behavioural responses to phencyclidine (PCP)
      and dizocilpine (MK-801) have been determined in rodents. 2. In rats,
      pretreatment with PCP (5 and 10 mg kg-1) or MK-801 (0.25 and 0.5 mg kg-1) dose
      dependently stimulated dopamine turnover in nucleus accumbens, amygdala and
      medial prefrontal cortex, but had no effect in striatum. In contrast,
      pretreatment with (+)-HA-966 (10 and 30 mg kg-1) did not affect dopamine turnover
      in any brain region investigated. 3. Pretreatment with (+)-HA-966 (10 and 30 mg
      kg-1) significantly antagonized the stimulation of dopamine turnover induced by
      both PCP (10 mg kg-1) and MK-801 (0.5 mg kg-1) in rat nucleus accumbens, amygdala
      and medial prefrontal cortex. 4. Intracerebral dialysis studies in conscious rats
      demonstrated that systemic injection of PCP (10 mg kg-1) markedly stimulated
      dopamine release from the nucleus accumbens, an effect that was abolished by
      pretreatment with (+)-HA-966 (30 mg kg-1). 5. Pretreatment with PCP (3-30 mg kg
      1) or MK-801 (0.1-1.6 mg kg-1) significantly increased locomotor activity in
      mice. In contrast, subcutaneous injection of (+)-HA-966 (10-100 mg kg-1) failed
      to stimulate activity. 6. Pretreatment with (+)-HA-966 (10 and 30 mg kg-1) dose
      dependently antagonized both PCP (10 mg kg-1) and MK-801 (0.4 mg kg-1) induced
      hyperactivity in mice. 7. Blockade of PCP-induced hyperactivity by (+)-HA-966 is
      unlikely to be explained by the induction or potentiation of sedation/ataxia
      since PCP-induced rotarod deficits were not significantly different in mice
      pretreated with (+)-HA-966 (30 mg kg-1) or saline.8. The results demonstrate that
      (+ )-HA-966 antagonizes both the neurochemical and behavioural effects of PCP and
      MK-801, possibly through interactions at the glycine/NMDA receptor.

PMID- 8485626
TI  - Analysis of the CCKB receptor antagonism of virginiamycin in guinea-pig ileum
      longitudinal myenteric plexus.
AB  - 1. Virginiamycin, a macrolide reported to bind selectively to CCKB/gastrin
      receptors has been studied in a functional test, namely cholecystokinin-induced
      contraction of guinea-pig ileum myenteric plexus (LMMP). 2. Virginiamycin (1-10
      microM) antagonized the selective CCKB agonist cholecystokinin tetrapeptide (CCK
      4). The antagonism appeared not to be competitive as the highest concentration
      (10 microM) caused a reduction of its maximal effect. An apparent pA2 of 6.64 +/-
      0.06 (s.e.) could be estimated if this depression was ignored. The selective CCKB
      antagonist, L-365,260 (0.01-0.3 microM) antagonized competitively the CCK-4
      induced contraction and a pKB of 8.60 +/- 0.16 (s.e.) was estimated. 3. The
      combined dose-ratio analysis for virginiamycin, tested at 3 and 10 microM in
      association with 0.03 and 0.1 microM L-365,260, respectively, resulted in
      observed log dose-ratios of 1.39 and 1.53. That was consistent with both
      antagonists acting on the same receptor in LMMP. 4. These data, represent the
      first evidence of the antagonism of virginiamycin in a functional assay and they
      support the hypothesis of homogeneity between CCKB receptors in the CNS and in
      peripheral tissues.

PMID- 8485627
TI  - Inhibition by N omega-nitro-L-arginine methyl ester of the electrocortical
      arousal response in rats.
AB  - In rats chronically implanted with cannulae into one lateral cerebral ventricle
      and recording electrodes onto the fronto-parietal cortex, the effects of systemic
      or intraventricular administration of the nitric oxide (NO) synthesis inhibitor,
      N omega-nitro-L-arginine methyl ester (L-NAME), on electrocortical (ECoG) arousal
      response evoked by sound stimulation were studied. In control animals, a single
      acoustic stimulation (80 dB for 15 s) produced a significant decrease in ECoG
      total voltage power lasting approximately 25 s. No tolerance developed after
      repeating the same sound stimulation at 15, 30, 60 min and 24 h intervals. Under
      these experimental conditions, pretreatment with L-NAME, given systemically (10
      mg kg-1, i.p.) or intracerebroventricularly (300 micrograms), significantly
      reduced the sound-evoked arousal response 1 h and 15 min later, respectively. In
      conclusion, the present data are in favour of a physiological role of NO in the
      control of arousal mechanisms.

PMID- 8485628
TI  - Fendiline inhibits L-type calcium channels in guinea-pig ventricular myocytes: a
      whole-cell patch-clamp study.
AB  - 1. Fendiline, a diphenylalkylamine type of antianginal drug, was examined for its
      effects on L-type calcium channels in guinea-pig ventricular myocytes by the
      whole-cell patch-clamp technique. 2. Fendiline (0.3-100 microM) applied
      extracellularly inhibited the calcium channel current (ICa) in a concentration-
      and time-dependent manner. The IC50 of fendiline was 17.0 +/- 2.43 microM and the
      Hill slope was 1.39 +/- 0.23. 3. Inhibition of ICa by fendiline appeared with an
      onset of less than 3 s. 4. Fendiline inhibited ICa at all the membrane potentials
      tested and shifted the current-voltage curve upwards. The overall calcium channel
      conductance (gCa) of the cell was reduced and conductance-voltage curve was
      shifted to the left in the presence of fendiline. 5. Isoprenaline (0.5-1 microM),
      a beta-adrenoceptor agonist, partially reversed the inhibitory effect of
      fendiline on ICa. 6. It is suggested that fendiline applied extracellularly
      blocks L-type calcium channels and reduces calcium channel conductance of the
      cell. The calcium channels thus inhibited are, nevertheless, still available for
      beta-adrenoceptor stimulation.

PMID- 8485629
TI  - Redirection of arachidonic acid metabolism by ICI D1542: effects on thrombus
      formation in the coronary artery of the anaesthetized dog.
AB  - 1. The effects of simultaneous redirection of arachidonic acid metabolism, by
      inhibition of thromboxane A2 (TXA2) synthase and blockade of the platelet
      thromboxane A2 receptor (TP-receptor), was examined on the rate of thrombus
      formation in a stenosed coronary artery with damaged endothelium in an
      anaesthetized dog. 2. Redirection of arachidonic acid metabolism was achieved by
      intravenous doses of ICI D1542, a selective and potent inhibitor of TXA2 synthase
      and the TP-receptor. 3. Redirection of arachidonic acid metabolism was
      demonstrated in whole blood, stimulated ex vivo by collagen. The ED50 for
      inhibition of TXB2 production was 7.1 micrograms kg-1, i.v.; there were
      corresponding increases in the production of the eicosanoids prostaglandin D2
      (PGD2), PGE2 and PGF2 alpha. 4. Thrombus formation was inhibited by D1542 (ED50
      0.55 micrograms kg-1, i.v.), but could be restarted by an intravenous infusion of
      adrenaline (0.2-38 micrograms kg-1 min-1, i.v.). In the presence of the maximum
      effective dose of D1542 (1 mg kg-1, i.v.) a 190 fold increase in the infusion
      rate of adrenaline was required to restore thrombus formation. 5. In the presence
      of D1542, removal of endoperoxide metabolites by inhibition of cyclo-oxygenase
      with aspirin (5 mg kg-1, i.v.) caused thrombus formation to restart, indicating
      the ability of the endoperoxide metabolites to inhibit thrombus formation in
      vivo. 6. These results indicate that, in the stenosed and damaged coronary artery
      of the dog, redirection of arachidonic acid metabolism by D1542 is more effective
      at preventing thrombus formation than inhibition of cyclo-oxygenase by aspirin.

PMID- 8485630
TI  - Degradation of acetylcholine in human airways: role of butyrylcholinesterase.
AB  - 1. Neostigmine and BW284C51 induced concentration-dependent contractions in human
      isolated bronchial preparations whereas tetraisopropylpyrophosphoramide (iso
      OMPA) was inactive on airway resting tone. 2. Neostigmine (0.1 microM) or iso
      OMPA (100 microM) increased acetylcholine sensitivity in human isolated bronchial
      preparations but did not alter methacholine or carbachol concentration-effect
      curves. 3. In the presence of iso-OMPA (10 microM) the bronchial rings were more
      sensitive to neostigmine. The pD2 values were, control: 6.05 +/- 0.15 and
      treated: 6.91 +/- 0.14. 4. Neostigmine or iso-OMPA retarded the degradation of
      acetylcholine when this substrate was exogenously added to human isolated
      airways. A marked reduction of acetylcholine degradation was observed in the
      presence of both inhibitors. Exogenous butyrylcholine degradation was prevented
      by iso-OMPA (10 microM) but not by neostigmine (0.1 microM). 5. These results
      suggest the presence of butyrylcholinesterase activity in human bronchial muscle
      and this enzyme may co-regulate the degradation of acetylcholine in this tissue.

PMID- 8485631
TI  - Arterial endothelial barrier dysfunction: actions of homocysteine and the
      hypoxanthine-xanthine oxidase free radical generating system.
AB  - 1. Endothelial barrier function was assessed by use of an in vitro model in which
      transfer of trypan blue-labelled albumin was measured across monolayers of bovine
      aortic endothelial cells grown on polycarbonate membranes. 2. Addition of either
      hypoxanthine (0.2 mM) or xanthine oxidase (20 mu ml-1) alone during a 90 min
      incubation did not affect albumin transfer across endothelial cell monolayers,
      but a combination of both increased transfer. 3. The increase in albumin transfer
      induced by hypoxanthine and xanthine oxidase was abolished by catalase (3 u ml
      1), reduced by allopurinol (4 mM), but unaffected by superoxide dismutase (6000 u
      ml-1), the hydroxyl radical scavengers, mannitol (15 mM), dimethylthiourea (10
      mM) and N-(2-mercaptopropionyl)-glycine (1 mM), the iron chelator, deferoxamine
      (0.5 mM), ferric chloride (50 microM), an inhibitor of nitric oxide synthase, NG
      nitro-L-arginine (30 microM), or the antioxidant, dithiothreitol (3 mM). 4.
      Hydrogen peroxide (0.1-30 mM) itself increased albumin transfer across
      endothelial cell monolayers, exhibiting a biphasic concentration-response curve.
      The increase induced by 0.1 mM hydrogen peroxide was abolished in the presence of
      0.3 u ml-1 catalase whilst that induced by 10 mM hydrogen peroxide was abolished
      by 3000 u ml-1 catalase. 5. Homocysteine (0.5-1.5 mM) did not affect albumin
      transfer across endothelial monolayers when added alone, but when added in
      combination with copper sulphate (50 microM), which catalyses its oxidation, a
      significant increase in albumin transfer was observed. 6. The increase in albumin
      transfer induced by the combination of homocysteine (1.5 mM) and copper sulphate
      was abolished by catalase (1 u ml-1), but was unaffected by superoxide dismutase
      (6000 u ml-1), mannitol (15 mM), dimethylthiourea (1 mM) or deferoxamine (0.5
      mM).7. The data suggest that the endothelial barrier dysfunction induced by the
      combination of hypoxanthine and xanthine oxidase is mediated solely by the action
      of hydrogen peroxide and not by superoxide anion, hydroxyl radical, peroxynitrite
      anion or hypochlorous acid. The copper-catalysed oxidation of homocysteine also
      induces endothelial barrier dysfunction through the generation of hydrogen
      peroxide.These findings may have relevance to the endothelial barrier dysfunction
      associated with ischaemia reperfusion injury and the atherogenic actions of
      homocysteine.

PMID- 8485632
TI  - The effects of N omega-nitro-L-arginine methyl ester, sodium nitroprusside and
      noradrenaline on venous return in the anaesthetized cat.
AB  - 1. The vascular actions of N omega-nitro-L-arginine methyl ester (L-NAME), sodium
      nitroprusside and noradrenaline were investigated in cats under chloralose
      anaesthesia with controlled vascular tone and ventilation. Cardiac output, heart
      rate, vascular pressures and mean circulatory filling pressure (MCFP) were
      measured. Total peripheral resistance (TPR) and resistance to venous return (Rvr)
      were calculated from steady-state readings. 2. L-NAME (37 mumol kg-1, i.v.)
      administered to ten cats receiving noradrenaline (6 nmol kg-1 min-1, i.v.)
      increased aortic pressure by 47.5 +/- 7.1 mmHg from 106 mmHg, and MCFP by 1.56 +/
      0.36 mmHg from 10.0 mmHg (means +/- s.e. means). Mean changes in portal venous
      pressure, RAP and heart rate were not significant. Cardiac output fell by 29.7 +/
      3.3% from 130 ml min-1 kg-1. TPR rose by 108 +/- 7.2% from 796 mmHg l-1 min kg
      and Rvr by 58.4 +/- 4.5% from 64 mmHg l-1 min kg. 3. Infusion of sodium
      nitroprusside into cats receiving noradrenaline evoked dose-related falls in
      aortic pressure, MCFP, TPR and Rvr. Changes in portal venous pressure, RAP and
      heart rate were not significant and cardiac output fell slightly. After L-NAME,
      sensitivity to nitroprusside was increased by 139 +/- 34% for MCFP, 176 +/- 19%
      for TPR and 351 +/- 39% for Rvr, and cardiac output rose slightly. The
      nitroprusside infusion required to restore TPR after L-NAME was estimated to be
      5.8 x 10(+/- 0.41) nmol kg-1 min-1, which was approximately three times more than
      that required to restore MCFP. 4. Infusion of noradrenaline evoked dose-related
      increases in aortic and portal venous pressures, heart rate, cardiac output,
      MCFP, TPR and Rvr. After L-NAME and nitroprusside (4.4 nmol kg-1 min-1, i.v.),TPR
      and Rvr were not significantly different, but MCFP was reduced by 1.76 +/- 0.24
      mmHg, and cardiac output by 22 +/- 1.9%. After subsequent expansion of the
      circulating blood volume (5-7.5 ml kg-1 dextran-saline), mean values for all
      parameters were restored to their previous levels. Sensitivity to noradrenaline
      was not significantly altered for heart rate, TPR and Rvr but was reduced by 31.8
      +/- 12%for MCFP and by 66.5 +/- 18% for cardiac output.5. The depression of
      cardiac output by L-NAME is attributed to the increase in Rvr, partly compensated
      by the rise in MCFP. For a given rise in MCFP, the increase in R, was seven times
      greater after L-NAME than after noradrenaline, and the difference in the relative
      actions of the two drugs on resistance and capacitance vessels largely accounts
      for their contrasting effects on venous return. A procedure is suggested for
      replacement of vascular nitric oxide by nitroprusside infusion and blood volume
      expansion.

PMID- 8485633
TI  - Relaxing actions of corticotropin-releasing factor on rat resistance arteries.
AB  - 1. Although it well established that corticotropin-releasing factor (CRF)
      injected i.v. can cause hypotension and vasodilatation, there is no in vitro
      evidence that CRF acts as a vasodilator. We have therefore tested the hypothesis
      that the hypotensive effect of i.v. CRF is due to a direct vasodilator action by
      carrying out experiments in vitro on rat resistance arteries (i.d. 150-300
      microns). 2. Initial in vivo experiments confirmed that CRF (1.5 nmol.kg-1)
      injected i.v. caused hypotension in rats, this being partially antagonized by the
      CRF analogue CRF9-41. 3. For the in vitro experiments, vessels were taken from
      the mesenteric, cerebral and femoral vascular beds, and mounted as ring
      preparations in an isometric myograph. The vessels were pre-contracted with one
      of 3 agonists (prostaglandin F2 alpha, arginine vasopressin or noradrenaline) or
      with a high-potassium solution (K+). 4. With maximal concentrations of the
      agonists, CRF caused relaxation of mesenteric and cerebral vessels with 10 nM,
      and near complete relaxation with 100 nM. Femoral vessels pre-constricted with
      agonists and all vessels pre-constricted with K+ were less affected by CRF. In
      the mesenteric vessels, with sub-maximal levels of pre-constriction, CRF caused
      substantial relaxation at 1 nM and could cause complete relaxation at 10 nM. 5.
      The relaxant effect of CRF on contractions of mesenteric vessels was antagonized
      by 100 nM CRF9-41. Neither tetraethyl ammonium (30 mM) nor glibenclamide (3
      microM) antagonized the relaxant effect of CRF. 6. The relaxant effect of CRF on
      mesenteric small arteries was found to be unaffected by removal of the
      endothelium. 7. The results indicate that CRF causes an endothelial-independent
      vasodilatation of rat resistance arteries under in vitro conditions at
      concentrations which are consistent with this being an important cause of the
      hypotension observed with i.v. injection of CRF.

PMID- 8485634
TI  - Effects of high calcium diet on arterial smooth muscle function and electrolyte
      balance in mineralocorticoid-salt hypertensive rats.
AB  - 1. The effects of a high calcium diet (2.5%) on blood pressure, electrolyte
      balance, plasma and tissue atrial natriuretic peptide (ANP), cytosolic free Ca2+
      concentration ([Ca2+]i), and arterial smooth muscle responses were studied in one
      kidney deoxycorticosterone (DOC)-NaCl hypertensive Wistar rats. 2. Calcium
      supplementation for 8 weeks markedly attenuated the development of DOC-NaCl
      hypertension and the associated cardiac hypertrophy, and prevented the DOC-NaCl
      induced sodium-volume retention as judged by reduced plasma Na+, and decreased
      plasma and ventricular ANP concentrations in high calcium-fed DOC-NaCl rats.
      However, calcium supplementation did not affect the DOC-NaCl-induced rise in
      platelet [Ca2+]i. 3. Smooth muscle contractions of isolated mesenteric arterial
      rings in response to depolarization by K+ (20-30 mM) were enhanced in DOC-NaCl
      treated rats, this enhancement being abolished by concurrent oral calcium
      loading. The Ca2+ entry blocker nifedipine (10 nM) inhibited the contractions
      induced by K+ (30-125 mM) more effectively in DOC-NaCl rats than in controls,
      while the inhibition in calcium-loaded DOC-NaCl rats was significantly greater
      than in controls only with 30 mM K+. 4. The contractions of mesenteric arterial
      rings induced by omission of K+ from the organ baths were used to evaluate cell
      membrane permeability to ions. In chemically denervated rings the onset of the
      gradual rise in contractile force in K(+)-free medium occurred earlier, and the
      rate of the contraction was faster in DOC-NaCl-treated rats than in controls and
      high calcium-fed DOC-NaCl rats. Smooth muscle relaxation induced by 0.5 mM K+
      upon K(+)-free contractions was clearly slower in DOC-NaCl rats than in controls
      and calcium-supplemented DOC-NaCl rats. 5. The functions of arterial smooth
      muscle Na+, Ca2+ exchange and Ca(2+)-ATPase were evaluated by the aortic
      contractions elicited by low Na+ medium, and the subsequent relaxation responses
      induced by Ca(2+)-free solution (in the presence of 5 mM caffeine, 1 microM
      nifedipine and 10 microM phentolamine). The rate of aortic low Na+ contractions
      (evaluating Ca2+ influx via Na+, Ca2+ exchange), as well as that of subsequent
      relaxations was slower in DOC-NaCl-treated rats than in controls, whether the
      relaxation was induced in normal (144.0 mM) or low (1.2 mM) organ bath Na+
      concentration (reflecting Ca2+ extrusion by both Ca(2+)-ATPase and Na+, Ca2+
      exchange, and by Ca(2+)-ATPase alone, respectively). However, in calcium
      supplemented DOC-NaCl rats the aortic responses did not differ from control. The
      difference between the relaxation rate in normal and low Na+ concentration in
      each aortic ring,representing the contribution of Na+, Ca2+ exchange in these
      relaxations, was comparable in all groups.6. In conclusion, calcium
      supplementation clearly attenuated the development of hypertension, cardiac
      hypertrophy, and sodium retention induced by the DOC-NaCI treatment. However, the
      associated rise in platelet [Ca2+], was not prevented, suggesting that in this
      form of experimental hypertension increased dietary calcium does not lower blood
      pressure by reducing [Ca2+]i. The results from vascular responses in vitro
      suggest that in arterial smooth muscle the DOC-NaCl treatment increased
      contractile sensitivity to depolarization, voltage-dependent Ca2+ entry and cell
      membrane permeability to ions, and attenuated relaxation responses and vascular
      Na+, K+-ATPase function. The results further suggest reduced ability of the cell
      membrane to transport Ca2+ (possibly via Ca2+-ATPase) in DOC-NaCl hypertension.
      The high calcium diet opposed these alterations. The present results thus provide
      evidence that the antihypertensive effect of a high calcium diet in
      mineralocorticoid-salt hypertension is mediated by its beneficial effects on
      systemic sodium balance and arterial smooth muscle function.

PMID- 8485635
TI  - Cholecystokinin as a factor in the enhanced potency of spinal morphine following
      carrageenin inflammation.
AB  - 1. Cholecystokinin (CCK) has been shown to diminish opioid analgesia. Here we
      investigate whether changes in the physiological levels of spinal CCK are
      responsible for the enhanced potency of spinal morphine in animals following
      carrageenin inflammation, as compared with normal animals. 2. Single dorsal horn
      nociceptive neurones were recorded in intact halothane-anaesthetized rats in the
      presence and absence of carrageenin-induced inflammation and comparisons were
      made between the two groups of animals. Inflammation was induced by the injection
      of 100 microliters of 2% lambda-carrageenin into the hind paw. 3. The inhibitory
      effect of intrathecal morphine on the C-fibre-evoked responses of the neurones
      was enhanced in the carrageenin-treated animals such that the effects of 0.25
      microgram and 10 micrograms of morphine in normal animals were comparable to
      those of 0.01 microgram and 2.5 micrograms in the carrageenin animals. The effect
      of 0.2 mg kg-1 of the CCKB antagonist, L-365,260, on the antinociceptive potency
      of intrathecal morphine was examined in both groups of animals. In normal
      animals, L-365,260 produced a significant enhancement in the effect of morphine
      indicating a tonic CCK modulation in these animals, but it had no effect on the
      inhibitions produced by either dose of morphine in the carrageenin animals. 4.
      The inhibition of the C-fibre-evoked response produced by intrathecal morphine in
      the presence of 1 microgram of CCK was examined in both groups of animals. CCK
      attenuated the effects of morphine only in animals with carrageenin inflammation,
      having no effect on the action of morphine in normal animals. 5. The effects of
      both CCK and L-365,260 were therefore dependent on the inflammatory state of the
      animal, with each drug being active in opposite situations.6. We propose that in
      normal animals, morphine may produce a maximal stimulation of the release of CCK
      such that exogenous CCK is unable to reduce further the analgesic effects under
      these conditions.However, the differential effects of the agonist and antagonist
      in the normal and inflamed rats points to a role of CCK in the enhanced opiate
      actions. This enhancement of the potency of spinal morphine in inflammation is
      best explained by a reduction in spinal CCK release by morphine in this state.

PMID- 8485636
TI  - Quinapril treatment and arterial smooth muscle responses in spontaneously
      hypertensive rats.
AB  - 1 The effects of long-term angiotensin-converting enzyme inhibition with
      quinapril on arterial function were studied in spontaneously hypertensive rats,
      Wistar-Kyoto rats serving as normotensive controls. 2 Adult hypertensive animals
      were treated with quinapril (10 mg kg-1 day-1) for 15 weeks, which reduced their
      blood pressure and the concentrations of atrial natriuretic peptide in plasma and
      ventricular tissue to a level comparable with that in normotensive rats. 3
      Responses of mesenteric arterial rings in vitro were examined at the end of the
      study. Compared with normotensive and untreated hypertensive rats, responses to
      noradrenaline were attenuated in hypertensive animals on quinapril, both force of
      contraction and sensitivity being reduced. Quinapril also attenuated maximal
      contractions but not sensitivity to potassium chloride. Nifedipine less
      effectively inhibited vascular contractions in normotensive and quinapril-treated
      than in untreated hypertensive rats. 4 Arterial relaxation responses by
      endothelium-dependent (acetylcholine) and endothelium-independent (sodium
      nitrite, isoprenaline) mechanisms were similar in normotensive and quinapril
      treated rats and more pronounced than in untreated hypertensive rats. 5 Cell
      membrane permeability to ions was evaluated by means of potassium-free solution
      induced contractions of endothelium-denuded denervated arterial rings. These
      responses were comparable in normotensive and quinapril-treated rats and less
      marked than in untreated hypertensive rats. 6 Intracellular free calcium
      concentrations in platelets and lymphocytes, measured by the fluorescent
      indicator quin-2, were similar in normotensive and quinapril-treated rats and
      lower than in untreated hypertensive rats. 7 In conclusion, quinapril treatment
      improved relaxation responses and attenuated contractions in arterial smooth
      muscle of hypertensive rats. These changes may be explained by diminished
      cytosolic free calcium concentration, reduced cell membrane permeability, and
      alterations in dihydropyridine-sensitive calcium channels following long-term
      angiotensin-converting enzyme inhibition.

PMID- 8485638
TI  - Anthelmintic resistance--can science win?

PMID- 8485637
TI  - Effects of P1060 and aprikalim on whole-cell currents in rat portal vein;
      inhibition by glibenclamide and phentolamine.
AB  - 1 Smooth muscle cells of the rat portal vein were dispersed by enzymatic
      treatment and recordings of whole-cell currents were made by the voltage-clamp
      technique. The effects of the potassium (K) channel openers, P1060 (0.3-10
      microM) and aprikalim (3-30 microM) on these currents were investigated.
      Antagonism of these agents by glibenclamide and phentolamine was also studied. 2
      When cells were clamped at -10 mV, P1060 (1 microM) and aprikalim (3 microM) each
      induced a slowly-developing K-current (IKCO), the noise of which gradually
      increased. The rate of onset of IKCO was greater for P1060 than for aprikalim.
      Current-voltage plots showed that P1060 and aprikalim each caused an
      approximately 25 mV negative shift of the reversal potential at zero current. 3
      P1060 (1 microM) and aprikalim (3 microM) each inhibited the slowly activating,
      slowly inactivating delayed rectifier current, ITO. 4 Addition of MgATP (5 mM) to
      the recording pipette inhibited the generation of IKCO by P1060 (1 microM) and
      reduced the accompanying inhibition of ITO. 5 Stationary fluctuation analysis of
      the current noise associated with IKCO induced by P1060 (1 microM) or aprikalim
      (3 microM) at a holding potential of -10 mV indicated that the unitary
      conductance of the underlying K-channels was 10.5 pS at 0 mV under the quasi
      physiological conditions of the experiment. 6 In the absence of K-channel
      openers, neither phentolamine (30-100 microM) nor glibenclamide (1 microM)
      affected the magnitude of control non-inactivating currents. However,
      phentolamine (30-100 microM), but not glibenclamide (1 microM) inhibited the
      control delayed rectifier current ITO. 7. After induction of IKCO by P1060 (1
      microM) or aprikalim (3 microM), subsequent exposure to glibenclamide(1 microM)
      or phentolamine (30 microM) inhibited this current. After aprikalim-induced
      reduction of ITO had developed, subsequent exposure to glibenclamide was able
      partially to reverse the inhibition of ITO whereas phentolamine was without
      effect. Pre-exposure to glibenclamide (1 microM) prevented both the generation of
      IKCO by aprikalim (3 microM) and the inhibitory effect of this agent on ITO.8. It
      is concluded that P1060 and aprikalim each induce the current IKCO by opening the
      same small conductance, ATP-sensitive K-channel (KATP), an effect which can be
      inhibited by glibenclamide orphentolamine. The opening of KATP by both P1060 and
      aprikalim probably involves competition between these agents and ATP for the ATP
      control site associated with the channel. Inhibition of the delayed rectifier
      current, ITO, by P1060 and aprikalim was glibenclamide-sensitive and may be
      caused by the induction of a state of run-down in the channel which underlies
      this current.

PMID- 8485639
TI  - Anthelmintic resistance--the state of play.
AB  - There is evidence that the incidence of anthelmintic resistance is increasing in
      livestock in countries throughout the world including the United Kingdom. Early
      detection of emerging drug resistance is important since reversion to
      susceptibility appears not to occur in highly selected homozygous strains.
      Because the current in vivo and in vitro assays, which generally determine the
      degree of disruption of normal physiological function of different parasite
      stages, are relatively insensitive, effort is being made to develop more direct
      genetic and biochemical diagnostic assays. Studies on the selection and genetics
      of resistance suggest that resistance is normally polygenic and arises from
      within the normal phenotypic range and that there are three phases in the
      selection process. An initial susceptible phase is followed by an intermediate
      one in which heterozygous resistant individuals are common within the population
      and finally homozygous resistant individuals predominate within the population.
      For these reasons low efficacy treatments, which enable the survival of
      heterozygous resistant individuals, and suppressive regimes, which only allow
      homozygous resistant individuals to survive, increase the rate of development of
      drug resistance. Strategies to delay the onset of resistance and control
      resistant strains usually incorporate minimal chemoprophylaxis, seek to maximize
      drug efficacy, and if possible include a 'slow' drug rotation and seek to limit
      host parasite contact by manipulation of the grazing environment. Although multi
      species mathematical models of anthelmintic resistance appear to offer a means of
      assessing the long term impact of these and other control strategies, current
      models are limited by a lack of detailed biological knowledge. In particular,
      more information on the status and numbers of alleles associated with resistance
      to specific drugs, their frequencies within populations of different species and
      the fitness of resistant and susceptible populations is required. Anthelmintic
      resistance provides an example of the adaptability of metazoan parasites under
      intensive selection and suggests that sustainable control strategies will require
      an integrated approach in which both chemotherapy and immunotherapy, together
      with environmental management are used to control nematodoses.

PMID- 8485640
TI  - Equine Cushing's disease.
AB  - In the horse, adenomata of the pairs intermedia of the pituitary gland have been
      associated with the distinct clinical entity of Cushing's disease which arises
      largely as a result of excessive secretion of adrenocorticotropin (ACTH) or other
      proopiomelanocortin (POMC) peptides. Pars intermedia peptide secretion is under
      dopaminergic control and compounds such as pergolide or bromocriptine, which are
      dopamine agonists, can palliate the clinical signs. A variety of endocrinological
      abnormalities, relevant to both pathogenesis and diagnosis, may be demonstrated
      in equine Cushing's disease, including hyperadrenocorticism, peripheral insulin
      resistance and excessive POMC-peptide secretion from the pituitary gland.
      Preliminary studies on carbohydrate metabolism suggest that quantification of
      insulin activity may be a useful prognostic index in cases of equine Cushing's
      disease, and that insulin therapy of secondary diabetes mellitus may be indicated
      in some cases.

PMID- 8485641
TI  - A field study of ovine listerial meningo-encephalitis with particular reference
      to cerebrospinal fluid analysis as an aid to diagnosis and prognosis.
AB  - In a field study of listerial meningo-encephalitis involving 21 sheep from six
      silage-fed flocks, the neurological signs included profound depression, circling,
      involvement of the trigeminal and facial cranial nerves and lateral recumbency
      with propulsive limb movements. Within the six flocks the incidence of listerial
      meningo-encephalitis did not exceed 1% of the adult sheep at risk. Eleven of 18
      (61%) adult animals were 2 years old. Evidence of an intrathecal inflammatory
      response in suspected listerial meningo-encephalitis cases was indicated by an
      increased cerebrospinal fluid (CSF) protein concentration greater than 0.4 g/l in
      18 of 21 cases (86%), increased white cell count above 0.012 x 10(9)/l in 17
      cases (81%) and lymphocyte percentage below 50% in all animals. None of the CSF
      parameters proved to be a reliable prognostic indicator because of the range of
      CSF values obtained and the small number of sheep which recovered.

PMID- 8485642
TI  - Oestrus in the British white goat: timing of plasma luteinizing hormone surge and
      changes in behavioural and vaginal traits in relationship to onset of oestrus.
AB  - Length of oestrus and timing of the LH surge was measured in six British White
      does, housed with a vasectomized buck (experiment 1). The following breeding
      season, pulsatile LH release during the cycle was measured in eight does and the
      pattern of behavioural and vaginal traits in relation to onset of oestrus (time
      0) determined (experiment 2). In experiment 1, the interval to first oestrus
      after introduction of the buck on 1st October was 10.3 +/- 3.0 days (n = 6) but
      in experiment 2, when the buck was put in on 1st September, first oestrus
      occurred after 39.3 +/- 3.4 days in 7/8 does and 7 days in 1/8 does indicating
      that adequate exposure to short days is needed before the buck can initiate
      ovarian activity. LH pulse frequency increased from 0-1 pulses/8 h to 3 pulses/8
      h after luteolysis, with no change in pulse amplitude, suggesting that
      progesterone regulates LH pulse frequency. Mean LH values rose from basal to
      102.1 +/- 7.8 ng/ml, 12 +/- 1.5 h after the onset of oestrus, which was 16.3 +/-
      1.7 h in length. Does sought out the buck and displayed tail wagging, bleating
      and restlessness from -60 h to +36 h relative to the onset of oestrus (time 0).
      The incidence of these activities rose at -12 h and peaked at 0 h. Tail wagging,
      but not bleating or restlessness, also increased in intensity at 0 h, as did the
      intensity with which the doe actively sought out the buck. Vulval redness and
      swelling and onset of a clear thin vaginal discharge were first observed 1-2 days
      before oestrus, becoming maximal on day 0. It was concluded that onset of
      frequent tail wagging was the most useful trait for detecting onset of oestrus.

PMID- 8485643
TI  - The role of induced virulence factors produced by Pasteurella haemolytica in the
      pathogenesis of bovine pneumonic pasteurellosis: review and hypotheses.
AB  - In the pathogenesis of pneumonic pasteurellosis, there is an abrupt commensal to
      pathogen shift from a predominance of P. haemolytica serotype 2 (ST2) to serotype
      1 (ST1) in the bovine upper respiratory tract (URT) microfloral population. This
      occurs following periods of stress associated with development of this disease.
      Data are reviewed from recent publications supporting the contention that surface
      expressed ST1-specific factor(s) could be critical in mediating URT adhesion and
      colonization. Such factors may promote an increase in the number of ST1 organisms
      deposited through infective droplets into the lungs, beyond that efficiently
      cleared by normal lung defences. The seeding of these organisms into the lungs
      may provide numerous foci of infection that eventually progress into
      characteristic pneumonic lesions seen in the disease.

PMID- 8485644
TI  - An outbreak of cameline filariasis in the Sudan.
AB  - Sheathed microfilariae (mean length 278 +/- 10 microns SEM; mean width 7.2 +/-
      0.8 microns) were detected in the blood of 7/14 housed camels (Camelus
      dromedarius). Microfilaraemic camels of either sex were inappetent, lethargic,
      reluctant to move and exhibited weakness in the hind limbs; some remained in
      sternal recumbency. Cardiac disorders, orchitis and skin nodules were
      conspicuously absent. The microfilariae showed a biphasic pattern in the blood
      that peaked at 20:00 and plateaued between 04:00 and 06:00. Adult filarial worms
      were recovered from the mesenteric and femoral arteries. Marked clinical
      improvement within 1-2 weeks was seen in three camels treated at 10:00 with a
      single subcutaneous injection of 0.2 mg/kg of ivermectin. These camels became
      amicrofilaraemic 2-5 days after treatment and remained so for the length of the
      observation period (133 days). Treatment of two camels at the time of high
      microfilaraemia (06:30) resulted in adverse reaction and death.

PMID- 8485645
TI  - Combined modality therapy increasing local control of pancreatic cancer.
AB  - Twenty patients with inoperable locally advanced Stage II and III pancreatic
      cancer were treated with combined modality therapy. Radiotherapy consisted of
      split courses of 2000 cGy each and, as needed, an additional 1400 cGy, separated
      by 2-week intervals. Simultaneous multidrug regimen chemotherapy consisted of 5
      fluorouracil, continuous infusion, 1 g/m2 days 1-5; streptozotocin, 300-500 mg/m2
      days 1, 2, 3; and cisplatin, 100 mg/m2 day 3 of every 4-week radiotherapy course
      (RT-FSP). Primary tumors decreased more than 50% in volume in 11 of 20 patients.
      Computed tomography scans demonstrated apparent complete disappearance of the
      primary tumor in 7 patients. Only 3 patients had tumor regrowth within the
      radiotherapy field, all after the end of radiotherapy. Local control improved as
      measured by increased frequency of tumor shrinkage and decreased frequency of
      primary tumor growth, recognizing the limitations of a pilot study and
      comparisons to best historical results achieved with standard short 5
      fluorouracil schedules and radiotherapy. Successful local control largely
      eliminates the most common cause of refractory pain and may decrease the need for
      some forms of early palliative surgical intervention. Tumor shrinkage sometimes
      downstages tumors, creating frequent investigational opportunities for either
      elective extirpative surgery or intraoperative radiotherapy. This pilot
      experience also supports testing of expanded eligibility staging criteria for
      combined modality treatment and testing of new drugs as part of 5-fluorouracil
      radiotherapy-based regimens.

PMID- 8485646
TI  - A phase I trial of protracted 5-fluorouracil infusion and oral calcium
      leucovorin.
AB  - This phase I study of 36 patients was performed to identify the maximal tolerated
      dose of oral calcium leucovorin (CLV) that could be concomitantly administered
      with protracted 5-fluorouracil (5-FU) infusion (greater than 30 days).
      Administration of CLV in very small doses (5 mg p.o. q8h) with 5-FU, 200-300
      mg/m2/day, resulted in excessive toxicity requiring treatment interruption in all
      patients. Subsequent reduction in the dose of 5-FU to 100 mg/m2/day with
      simultaneous administration of CLV, 5 mg p.o. q8h, decreased the toxicity and
      allowed for protracted administration of the combination. In subsequent patients
      the dose of oral CLV was increased to 22.5 mg p.o. q8h, which resulted in
      treatment-limiting toxicity in the majority of patients. Toxicity consisted
      almost exclusively of mucositis. No myelosuppression or significant organ
      toxicity was observed. We conclude that even low doses of oral CLV potentiate the
      biological effect of infusion 5-FU. If the combination is to be given on a
      protracted basis, 5-FU must be administered at a much smaller dosage than has
      been traditionally utilized.

PMID- 8485647
TI  - Depletion of patients' plasma tryptophan using tryptophan side-chain oxidase
      columns.
AB  - The use of the enzyme tryptophan side-chain oxidase, isolated from Pseudomonas
      XA, was explored in 3 patients with refractory acute lymphocytic leukemia.
      Patients were given either a low-tryptophan diet or tryptophan-free
      hyperalimentation, prior to and during therapy. Their plasma, separated by
      pheresis, was continuously passed through a tryptophan depletion column
      containing the immobilized tryptophan side-chain oxidase. Up to 4 plasma volumes
      were passed through the column daily, 5 days per week for 2-3 weeks, and plasma
      tryptophan levels, both free and total, were measured by high-performance liquid
      chromatography. Pre- and postcolumn plasma samples were collected throughout the
      pheresis procedure. All postcolumn plasma samples had unmeasurable tryptophan
      levels throughout the treatment period, whereas precolumn samples were always
      measurable. Generally, tryptophan levels of plasma isolated from peripheral blood
      decreased after therapy, but rebounded by the next day. The enzyme depletion
      column reduces circulating plasma tryptophan levels, and its use is well
      tolerated by patients. However, further development of this method will require
      study of the effects of diet and of the duration, interval, and frequency of use
      of this column on therapeutic efficacy. Problems include difficulties with
      extended diet compliance and apparently intensive mobilization of tryptophan from
      body stores, which may preclude the clinical application of this enzyme depletion
      column.

PMID- 8485648
TI  - O6-methylguanine-DNA methyltransferase in human normal and malignant lung
      tissues.

PMID- 8485649
TI  - Cell cycle perturbations of platinum derivatives on two ovarian cancer cell
      lines.
AB  - Cisplatin continues to be one of the most commonly used cytotoxic agent. Problems
      of drug resistance and nephrotoxicity have generated interest in new platinum
      derivatives. In this study, we used flow cytometry to study their effects on cell
      kinetics and to see if the extent of cell cycle perturbations can be used to
      determine relative potency. The following four platinum derivatives were tested:
      cisplatin, carboplatin, 254S, and NK121 on two human ovarian cancer cell lines:
      BG1 and CAOV3. Flow cytometric analysis revealed a dynamic spectrum of cell
      kinetic perturbations, which included sequential S-G2 block, concomitant S-G2
      block, and a dominant S block with abolition of G2 block. Platinum derivatives
      NK121, 254S, and CARBO induced an average of 54.5 +/- 5.6, 21.2 +/- 5.5, and 2.5
      +/- 2.8% more S-G2 blocks than cisplatin, respectively. When comparing the
      severity of S-G2 blocks and requiring a p-value of 0.05, the order of increasing
      potency was: cisplatin, carboplatin, 254S, and NK121.

PMID- 8485650
TI  - In vitro evaluation of the novel chemotherapeutic agents U-73,975, U-77,779, and
      U-80,244 in gynecologic cancer cell lines.
AB  - U-73,975 (U-73), U-77,779 (U-77), and U-80,244 (U-80) are analogs of the potent
      antitumor compound CC-1065. This class of drugs act as alkylating agents binding
      to DNA preferentially. Using the ATP-chemosensitivity assay, this study was
      designed to compare the potencies of U-73, U-77, and U-80 with cisplatin (DDP) or
      adriamycin (DXR) in 10 gynecologic cancer cell lines. The mean IC50s were: U-73,
      0.173 +/- 0.115 ng/ml; U-77, 0.650 +/- 0.209 ng/ml; U-80, 3.0 +/- 3.0 ng/ml; DDP,
      4.40 +/- 2.83 micrograms/ml; and DXR, 0.286 +/- 0.040 micrograms/ml. U-73 appears
      the most potent analog, being 10(3) to 10(4) times more cytotoxic than DDP and
      DXR. U-77 and U-80 were somewhat comparable, demonstrating approximately 10(2) to
      10(3) greater potency than DDP and DXR. All the cervical, endometrial, and
      ovarian cell lines were sensitive to U-73, with decreasing sensitivity to U-77, U
      80, DXR, and DDP in that order. U-73 as well as the other analogs appear
      promising chemotherapeutic agents.

PMID- 8485651
TI  - Response of primary colon cancer cells in hybrid spheroids to 5-fluorouracil.
AB  - We have measured the clonogenic survival of cells isolated directly from colon
      cancer surgical specimens and treated with 5-fluorouracil (5-FU). Enzymatically
      disassociated cells were incorporated into hybrid spheroids, consisting
      predominantly of nonproliferating HeLa feeder cells. Aliquots were exposed for
      1.5 hr to a range of concentrations of 5-FU. From the decrease in clonogenic
      survival, as deduced from the frequency of colony formers among hybrid spheroids
      after chemical treatment, we were able to construct survival curves in 50% of the
      surgical specimens tested. A striking revelation was the presence of a resistant
      plateau in the survival curves, reminiscent of the solid tumor response to
      treatment with 5-FU. This resistance was absent in monolayer cultures. Evidence
      is presented that this resistance is due to the absence of, or delay in, cell
      cycle progression of cells residing in hybrid spheroids.

PMID- 8485652
TI  - Analysis and distribution of etoposide in rat brain tumor model: intracarotid
      versus intracarotid with angiotensin II-induced hypertension.
AB  - The brain tissue distribution of etoposide has been investigated in 9L
      gliosarcoma-bearing rats with or without hypertension induced by angiotensin II
      (AT II). The rat brain tumor models were divided into the following two groups
      according to etoposide administration route: intracarotid injection (IC) group
      and intracarotid injection with hypertension induced by AT II (IHIC) group. Ten
      mg/kg of etoposide was given, and 30 min and 2, 4, 8, and 24 hr later the rats
      were sacrificed. The drug concentrations in the serum, tumor, and normal brain
      tissue were analyzed by high-pressure liquid chromatography. The etoposide
      concentration in the serum, tumor, and normal brain tissue peaked at 30 min in
      both groups. The serum concentration was similar between the two groups. The
      etoposide concentration in the tumor was at least 2.2 times higher in the IHIC
      group than in the IC group at 30 min and 2 hr. The area under drug concentration
      curve (AUC) in the tumor in the IHIC group was about 2.2 times higher than that
      in the IC group. The etoposide concentration in the normal brain on the drug
      injection side changed only slightly from 0.5 hr to 4 hr and was about 3 times
      higher in the IHIC group than in the IC group. The etoposide concentration in the
      contralateral normal brain was very low in both groups at 30 min and disappeared
      thereafter. Intracarotid injection of anticancer drugs with AT II-induced
      hypertension further increases the drug concentration and AUC in the tumor
      compared with intracarotid injection alone and can be useful in treatment of
      malignant brain tumors.

PMID- 8485653
TI  - Mechanisms by which interferon potentiates chemotherapy.
AB  - IFNs potentiate the activity of multiple chemotherapy drugs in vitro; improved
      activity has been noted with 5-FU and IFN-alpha against colon carcinoma and with
      IFN-alpha and DTIC against melanoma. The mechanisms whereby interferon
      potentiates the activity of chemotherapeutic drugs are complex, and different
      mechanisms may be operative with different drugs and against different tumors.
      Both indirect immunoaugmentative effects of interferon and direct biochemical
      modulation of the drugs (as documented in detail with 5-FU) may play a role;
      further elucidation of these mechanisms will enable us to optimally utilize the
      combination of interferon and antineoplastic agents.

PMID- 8485654
TI  - Fludarabine in the treatment of lymphoproliferative malignancies.

PMID- 8485655
TI  - Quality of life in cancer: definition, purpose, and method of measurement.
AB  - Over the past 20 years, changes within medicine and society have encouraged an
      expansion in conceptualizing and evaluating the goals and important outcomes of
      medical treatments. In evaluating the care of people with cancer and other
      chronic illnesses, a major part of the expansion has been the inclusion of means
      to assess the quality of life in addition to the quantity of life associated with
      various treatments. This paper presents a review of the current literature on
      quality-of-life assessment in oncology research and practice. The review is
      organized around current thinking about the definition of quality of life, the
      purpose of quality-of-life measurement, the method of assessment, and the
      competing advantages and disadvantages of disease-specific versus general health
      outcome measurement. Recommendations for proceeding with quality-of-life
      measurement in oncology are provided to encourage increased attention to the need
      to remain closely tied to a theoretical construct.

PMID- 8485656
TI  - Health technology and health reform.

PMID- 8485657
TI  - Retroviral vector-mediated cytokine-gene transfer into tumor cells.

PMID- 8485658
TI  - Withholding and/or withdrawing fluids and nutrition: an opposing view.

PMID- 8485659
TI  - Best papers on lymphoma.

PMID- 8485660
TI  - The death of Bill C-203.

PMID- 8485661
TI  - Success story.

PMID- 8485662
TI  - Applicants to medical school.

PMID- 8485663
TI  - The Canadian National Breast Screening Study: opportunity for a rethink.

PMID- 8485664
TI  - Why the GE boycott? Why indeed!

PMID- 8485665
TI  - Why the GE boycott? Why indeed!

PMID- 8485666
TI  - Childproof containers.

PMID- 8485667
TI  - Self-help movement.

PMID- 8485668
TI  - Self-help movement.

PMID- 8485669
TI  - Self-help movement.

PMID- 8485671
TI  - Hysteria, or "suffocation of the mother".

PMID- 8485670
TI  - TGIF.

PMID- 8485672
TI  - Ketorolac (Toradol): a marketing phenomenon.

PMID- 8485673
TI  - Ketorolac (Toradol): a new analgesic or an old NSAID?

PMID- 8485674
TI  - Canadian physicians and euthanasia: 3. Arguments and beliefs.

PMID- 8485675
TI  - International correlations between gun ownership and rates of homicide and
      suicide.
AB  - OBJECTIVE: To examine international correlations between reported rates of
      household gun ownership and rates of homicide and suicide with a gun. DESIGN:
      Survey. POPULATION: People who responded to a telephone survey conducted by the
      1989 International Crime Survey in 11 European countries, Australia, Canada and
      the United States. RESULTS: Positive correlations were obtained between the rates
      of household gun ownership and the national rates of homicide and suicide as well
      as the proportions of homicides and suicides committed with a gun. There was no
      negative correlation between the rates of ownership and the rates of homicide and
      suicide committed by other means; this indicated that the other means were not
      used to "compensate" for the absence of guns in countries with a lower rate of
      gun ownership. CONCLUSION: Larger studies are needed to examine more closely
      possible confounding factors such as the national tendency toward violent
      solutions, and more information on the type and availability of guns will be
      helpful in future studies. Nevertheless, the correlations detected in this study
      suggest that the presence of a gun in the home increases the likelihood of
      homicide or suicide.

PMID- 8485676
TI  - Variations in surgical rates in Quebec: does access to teaching hospitals make a
      difference?
AB  - OBJECTIVE: To document the geographic variations in the rates of 10 common
      surgical procedures in Quebec and to examine the relation between surgical rates
      and level of access to teaching hospitals. DESIGN: Population-based rates
      standardized for age and sex were calculated from 1985-88 data from MED-ECHO (the
      provincial hospital discharge database) for each of the 32 community health
      districts (departements de sante communautaire [DSCs]) in Quebec. Variation
      across DSCs was analysed with the use of the ratio of the highest to the lowest
      rate, the coefficient of variation and the systematic component of variation. On
      the basis of an urbanization index designed by Statistics Canada, DSCs were
      classified as having a low, medium, high or very high level of access to teaching
      hospitals. PATIENTS: All Quebec residents except those whose DSC of residence
      could not be traced (accounting for no more than 1.7% of patients for any study
      procedure) and aboriginal people from northern Quebec. SURGICAL PROCEDURES
      STUDIED: Appendectomy, cesarean section, cholecystectomy, coronary artery bypass
      grafting (CABG), hysterectomy, inguinal hernia repair, prostatectomy,
      tonsillectomy with or without adenoidectomy, total hip replacement and varicose
      vein stripping. RESULTS: There was considerable systematic variation in the
      surgical rates for all 10 procedures. Cesarean section, the rates of which varied
      the least, still exhibited almost a twofold variation between the highest and
      lowest rates. The rates of tonsillectomy varied the most, by a factor of more
      than five. With a few exceptions there was relatively little relation between the
      rates of the procedures within the DSCs. The rates of appendectomy,
      cholecystectomy, hysterectomy and tonsillectomy tended to be lower in the DSCs
      containing teaching hospitals, whereas the reverse was true for CABG. For the
      other procedures the relation between the rates and the level of access to
      teaching hospitals was nonsignificant. CONCLUSIONS: The overall consistency of
      the observed variations with those of previous studies invites a closer look at
      the practice patterns and the scientific basis of the clinical decisions
      associated with procedures showing high variations in rates. The lack of a
      systematic relation between the surgical rates and the level of access to
      teaching hospitals challenges the belief that remote regions are underserved with
      respect to the procedures studied.

PMID- 8485677
TI  - Electronic fetal monitoring: a Canadian survey.
AB  - OBJECTIVES: To determine the current status of electronic fetal monitoring (EFM)
      in Canadian teaching and nonteaching hospitals, to review the medical and nursing
      standards of practice for EFM and to determine the availability of EFM
      educational programs. DESIGN: National survey in 1989. PARTICIPANTS: The
      directors of nursing at the 737 hospitals providing obstetric care were sent a
      questionnaire and asked to have it completed by the most appropriate staff
      member. The response rate was 80.5% (593/737); 44 hospitals did not have
      deliveries in 1988 and were excluded. The remaining hospitals varied in size from
      8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8%
      were teaching hospitals. RESULTS: Of the 549 hospitals 419 (76.3%) reported
      having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors
      per hospital was higher in the teaching hospitals than in the nonteaching
      hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per
      hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with
      monitors almost all of the obstetric patients were monitored at some point during
      labour. However, 21.6% of the hospitals with monitors had no policy on EFM
      practice. The availability of EFM educational programs for physicians and nurses
      varied according to hospital size, type and region. CONCLUSIONS: Most Canadian
      hospitals providing obstetric services have electronic fetal monitors and use
      them frequently. Although substantial research has questioned the benefits of
      EFM, further definitive research is required. In the meantime, a national
      committee should be established to develop multidisciplinary guidelines for
      intrapartum fetal assessment.

PMID- 8485678
TI  - Bloodborne pathogens in the health care setting: risk for transmission.

PMID- 8485679
TI  - Incidence of HIV infection in donated blood has fallen considerably, MD reports.

PMID- 8485680
TI  - Article in Canadian physics journal put academic integrity on trial.

PMID- 8485681
TI  - Are children's hospitals an idea whose time has come and gone?

PMID- 8485682
TI  - Toronto hospital takes leadership role in providing care for inner-city
      residents.

PMID- 8485683
TI  - There is more to health care than access to a health care system, Montreal
      symposium told.

PMID- 8485684
TI  - Doctor-patient relationship put under microscope at CMA leadership conference.

PMID- 8485685
TI  - Museum a perfect memorial to the Lady of the Lamp.

PMID- 8485686
TI  - Sexual harassment a significant health care issue, Canadian Medical Association
      committee says.

PMID- 8485687
TI  - Manufacturers, plastic surgeons draw fire at US forum on breast-implant issue.

PMID- 8485688
TI  - Health care a major topic for Canadian public policy journal.

PMID- 8485689
TI  - Assessment of instruments.

PMID- 8485690
TI  - A comparison of four glucose monitors in a hospital medical surgical setting.
AB  - Four bedside glucose monitors were evaluated and compared for accuracy in
      correlation with concomitant laboratory glucose values. Of these four monitors-
      Diascan, Glucometer Q.A., Accucheck, and One Touch--two bedside glucose monitors
      were comparable with a correlation coefficient of 0.91 for Glucometer Q.A. and
      0.90 for One Touch. These two machines were then evaluated for precision and
      linearity. Although the Glucometer Q.A. was more precise for all three levels of
      glucose, the One Touch linearity was almost perfect. Lastly, in asking nursing
      staff for an evaluation of One Touch and Glucometer Q.A., 15 of 16 staff members
      preferred One Touch.

PMID- 8485691
TI  - The measurement of physical activity in bone density research.
AB  - Physical activity is often recommended as a method to prevent or treat
      osteoporosis. Nevertheless, it is difficult to interpret the research findings
      upon which this recommendation is made because of problems measuring physical
      activity. Studies investigating the bone density-physical activity association
      were reviewed. Physical activity was measured by participation in a specific form
      of exercise, questionnaire and interview, mechanical devices, and physiological
      markers of activity. In about half of the exercise participation studies,
      grouping criteria were problematic for the nonexercise or control group. Many
      discrepancies were found in the questionnaire and interview studies. Overall,
      little information was reported with respect to reliability or validity of
      measures, thereby hampering comparisons across studies. These measurement issues
      can provide nurses with a new perspective for evaluating studies that report the
      impact of physical activity on bone mass and other health outcomes as well.

PMID- 8485692
TI  - In theory and practice.

PMID- 8485693
TI  - Implementing cooperative care on an acute care medical unit.
AB  - Cooperative care is an approach to nursing care, based on Orem's self-care
      theory, that encourages patient self-care and family involvement in care giving.
      Patients and care partners (family members or friends) are taught by staff
      working on the unit. The model has been successfully implemented on acute care
      units at institutions across the nation. In March 1990, under the direction of
      our chief nurse, cooperative care was initiated at Dorn Veterans' Hospital as a
      part of a research project on a busy acute care medical unit. The model had
      already been piloted with success on the oncology unit of the institution. The
      purpose of this article is to describe patient, nursing, and pharmacy involvement
      during the implementation of cooperative care on a 40-bed acute care unit in a
      veteran population.

PMID- 8485694
TI  - The advanced practice nurse: is the time right for a singular title?

PMID- 8485695
TI  - Mrs. Hammond speaks.

PMID- 8485696
TI  - Time documentation: a question of worth.

PMID- 8485697
TI  - Evaluation and time documentation for the clinical nurse specialist.
AB  - This article introduces a time documentation tool designed to gather and record
      information on the many facets of the role of the CNS. A review of the literature
      provides background information on types of evaluation, time documentation, and
      the need for qualitative as well as quantitative accountability. Because existing
      tools did not meet the documentation needs of the authors, they designed a system
      that could accommodate six domains of the CNS role and provide a means to
      document quantitative and qualitative activities. Three CNSs pilot tested the
      tool for 2 months and provided a critique of the instrument for the authors. The
      evaluations have been summarized, and comments for individualization and
      frequency of use have been noted. Suggestions for future study include the need
      for measuring outcomes of care and documentation methods for qualitative
      interventions.

PMID- 8485698
TI  - Consultation: more than one dimension.

PMID- 8485699
TI  - Defining your role in ambulatory care: clinical nurse specialist or nurse
      practitioner?
AB  - A collaborative practice was established at the University of Southern
      California/Kenneth Norris Jr. Cancer Hospital utilizing combined roles of the CNS
      and nurse practitioner. The role was created out of a specific need of the
      physicians of the gastrointestinal malignancy service. Increased administrative
      and clinical responsibilities necessitated another clinical expert to be readily
      available for the management of the acute care private practice patients. As a
      CNS for both the departments of medicine and nursing, my primary responsibilities
      are focused within the ambulatory care area. This paper presents the concept for
      this position, the professional and personal benefits, advantages and
      disadvantages, and recommendations for nursing practice.

PMID- 8485700
TI  - Clinical nurse specialist subroles: foundations for entrepreneurship.
AB  - Entrepreneurship is a career option for nurses seeking autonomy in their
      practice. The six subroles of the CNS--researcher, consultant, advanced
      clinician, educator, leader/manager, and collaborator--provide the framework for
      discussion of the functional aspects of this new option. Examples demonstrate how
      these subroles have been used by various nurse entrepreneurs. Implications for
      practice and recommendations are provided.

PMID- 8485701
TI  - Federal action on prescriptive authority.

PMID- 8485702
TI  - The role of the female doctorally prepared nurse in caring for infertile women.
AB  - Today, in medical and nursing literature, infertility is described as a couple
      problem, with interventions aimed at treating the couple. While not dismissing
      the fact that the conception does involve both genders, the reality of
      infertility treatment is that the woman, not the couple, undergoes the majority
      of infertility testing and treatment. The numerous physical demands made of women
      during infertility investigation and therapy are associated with significant
      emotional and informational needs. As such, all infertility practices should
      offer supportive counseling to their clients. Incorporation of such services into
      general infertility treatment will ensure that the greatest number of female
      infertility clients receive the information and emotional support they need. The
      health care professional best qualified to provide these services is the female
      doctorally prepared nurse. By virtue of both her gender and training, she is more
      likely to be capable of intervening therapeutically, woman to woman, in a
      sensitive and empathic manner. Furthermore, she can anticipate extending her role
      to include the following services: (a) provision of basic gynecological care, (b)
      follow-up of patients on hormone therapy, (c) coordination of patient care, (d)
      provision of supportive counseling, and (e) participation in research. To secure
      a position, the female doctorally prepared nurse needs to recognize the
      importance of promoting herself in the infertility marketplace. Ultimately, both
      the establishment and survival of her role will depend on her professional
      uniqueness.

PMID- 8485703
TI  - Interstitial pressure of subcutaneous nodules in melanoma and lymphoma patients:
      changes during treatment.
AB  - Interstitial pressure (IP) is a physiological variable that may have its greatest
      influence on the transport of high-molecular-weight therapeutic agents. IP in
      tumor nodules was measured in patients with metastatic melanoma or non-Hodgkin's
      lymphoma to determine the influence of this physiological variable on treatment
      outcome. The wick-in-needle technique was used to measure IP at time points
      before and after treatment with a variety of immunotherapy and chemotherapy
      regimens. Selected patients had IP measurements during chemotherapy or
      immunotherapy infusions. Ultrasound or computed tomography was used to evaluate
      the size of the studied lesions and their relationship to normal structures. The
      mean baseline IP in melanoma nodules (n = 22) and lymphoma nodules (n = 7) was
      29.8 and 4.7 mm Hg, respectively (P = 0.013 for the difference between tumor
      types). In a subset of melanoma nodules for which IP had been measured before and
      after treatment, the IP increased significantly over time for nonresponding
      melanoma lesions from a baseline of 24.4 to 53.9 mm Hg after treatment (P =
      0.005) and decreased in melanoma lesions that responded to treatment where the
      mean baseline and post-treatment IPs were 12.2 and 0 mm Hg, respectively (P =
      0.001 for the difference in IP profiles between responding and nonresponding
      lesions). Six of seven lymphoma nodules responded completely to chemotherapy or
      radiation. The single nodule that did not respond had a baseline IP of 1 mm Hg
      that increased to 30 mm Hg after treatment. Tumor IP differs significantly
      between melanoma and non-Hodgkin's lymphoma. The changes in IP over time differ
      significantly between responding and nonresponding melanoma lesions. IP that
      increases during treatment appears to be associated with tumor progression in
      these tumor types.

PMID- 8485704
TI  - Elevated levels of M(r) 92,000 type IV collagenase in human brain tumors.
AB  - Local invasive growth is one of the key features of primary malignant brain
      tumors accompanied by remodeling of the vasculature and destruction of normal
      brain tissue. Tissue invasiveness is an essential biological function used by a
      tumor to overcome the various barriers to its progression. The expression of
      metalloproteases has been shown to play a critical role in the invasive process
      in a number of tumors; however, their expression in human brain tumors has not
      been previously reported. In this study we showed metalloprotease activities at
      M(r) 240,000, 123,000, 92,000, 72,000, and 67,000 in brain tumor extracts. These
      enzyme activities were inhibited by EDTA, an inhibitor of metalloproteases.
      Significant increases in levels of protease bands at M(r) 92,000, 123,000, and
      240,000 were observed in glioblastoma and metastatic lung tumors. Enzymatic
      inhibition and Western blotting with M(r) 92,000 type IV collagenase antibody
      confirmed the presence of M(r) 92,000 type IV collagenase in all samples.
      Quantitative analysis by densitometry showed 8-10-fold and 6-8-fold increases in
      M(r) 92,000 type IV collagenase activity in glioblastoma and metastatic lung
      carcinoma samples, respectively, when compared with normal brain, meningioma,
      astrocytoma, metastatic colon, and breast carcinoma samples. These findings
      provide evidence for elevated levels of metalloproteases in glioblastomas and
      suggest a therapeutic target for minimizing the invasive propensity of gliomas
      using protease inhibitors.

PMID- 8485706
TI  - 1 alpha,25-Dihydroxyvitamin D3 enhances 12-O-tetradecanoylphorbol-13-acetate-
      induced tumorigenic transformation and osteopontin expression in mouse JB6
      epidermal cells.
AB  - To study the role of 1 alpha,25-dihydroxyvitamin D3 (calcitriol) in tumor
      promotion, we used JB6 C141.5a cells, a mouse epidermal cell model of tumor
      promotion. The phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA)
      irreversibly induces anchorage-independent growth and tumorigenicity in these
      cells. Since we previously showed that calcitriol does not transform these cells
      but inhibits their proliferation, we hypothesized that calcitriol would inhibit
      TPA-induced transformation. Concurrent treatment of JB6 C141.5a cells with TPA
      and calcitriol revealed that calcitriol enhanced (1.7- to 10-fold, depending on
      dose) TPA-induced anchorage-independent growth without enhancing cell
      proliferation. Furthermore, a more than additive effect on osteopontin mRNA and
      protein levels was observed with concurrent drug treatment, which yielded a more
      highly phosphorylated form of osteopontin. These studies suggest coordinate
      regulation between the signaling pathways for calcitriol and TPA in JB6 C141.5a
      cells and further implicate expression of phosphorylated osteopontin in
      tumorigenesis.

PMID- 8485705
TI  - Increases in sequence specific DNA binding by p53 following treatment with
      chemotherapeutic and DNA damaging agents.
AB  - We have investigated the effect of chemotherapeutic and DNA damaging agents on
      binding of the tumor suppressor phosphoprotein p53 to its consensus DNA sequence.
      Activation of p53-DNA binding was seen for treatment with radiation, hydrogen
      peroxide, actinomycin D, Adriamycin, etoposide, camptothecin, 5-fluorouracil,
      mitomycin C, and cisplatin. These results showed that DNA strand breaks were
      sufficient to lead to increased levels of p53. The protein synthesis inhibitor
      cycloheximide blocks the increase in p53 following DNA damage. The increase in
      p53 activation in camptothecin treated cells may result, at least in part, from
      an increased half-life of the protein and consequent increases in intracellular
      protein concentration.

PMID- 8485707
TI  - High efficiency gene transfer into primary human tumor explants without cell
      selection.
AB  - Preclinical studies with murine tumor models have demonstrated that autologous
      tumor cell vaccines engineered to secrete certain cytokines in a paracrine
      fashion elicit systemic immune responses capable of eliminating small amounts of
      established tumor. These results have engendered much interest in developing this
      strategy for gene therapy of human cancer. The major limitation to creating
      genetically modified autologous human tumor vaccines is efficient gene transfer
      into primary tumor explants, since the majority of human tumors fail to
      proliferate in long-term culture. Using the retroviral vector MFG in conjunction
      with short-term culture techniques, we have achieved, in the absence of
      selection, a mean transduction efficiency of 60% in primary renal, ovarian, and
      pancreatic tumor explants, and we have developed an autologous granulocyte
      macrophage colony-stimulating factor secreting tumor vaccine for clinical trials.

PMID- 8485708
TI  - Overexpression of p53 is a late event in the development of malignant melanoma.
AB  - Overexpression of the p53 gene product has been observed in a high percentage of
      malignant melanomas. To evaluate the role of this protein in the development of
      melanoma, we examined p53 expression in benign, premalignant, and malignant
      melanocytic lesions. Using the antibodies DO-7 and 1801, which recognize both
      wild-type and most mutant forms of the p53 protein, we analyzed by
      immunohistochemical staining 26 benign nevi, 34 dysplastic nevi from patients at
      low risk for the development of melanoma, 22 dysplastic nevi from patients at
      high risk for the development of melanoma, 61 primary melanomas (including 15
      that arose from dysplastic nevi), and 10 metastatic melanomas. Expression of the
      p53 protein was not observed in any of the benign or dysplastic nevi. Of the
      primary melanomas only 3 (5%) demonstrated nuclear staining, whereas 70% of the
      metastatic melanomas showed a positive reaction for p53. These data suggest that
      overexpression of the p53 gene product is a late event in the progression of
      melanoma and consequently indicate that expression of this protein cannot be used
      as a marker to identify patients at high risk for the subsequent development of
      melanoma.

PMID- 8485709
TI  - Suramin: a novel antineoplastic agent with multiple potential mechanisms of
      action.

PMID- 8485710
TI  - Ultraviolet radiation-induced DNA damage and its photorepair in the skin of the
      platyfish Xiphophorus.
AB  - Fluence response relationships for the induction of DNA damage in the skin of UV
      irradiated Xiphophorus fish were obtained by quantitative gel electrophoresis of
      unlabeled DNA following extraction and treatment with an enzyme preparation that
      makes single strand breaks next to cyclobutane pyrimidine dimers. A buffer
      containing 7 M urea minimized the degradation of DNA during extraction and gave
      reproducible results. The shapes of fluence response curves for the production of
      dimers by sun lamp irradiation (lambda > 290 nm) or 302 nm in the dermis of grown
      fish were similar. Photoreversal of dimers was readily observed by black light
      exposure or from the longer wavelengths (> 304 nm) from sun lamps. As expected,
      the number of pyrimidine dimers/incident fluence in young fish skin was
      considerably higher on the irradiated side of immobilized fish than it was in
      swimming (randomly moving) fish, and the shape of the fluence response curves was
      linear for all wavelengths used lambda > 290, 302, and 313 nm. On the other hand,
      young fish irradiated from above with lambda > 290 nm showed a less than linear
      relationship between pyrimidine dimers in their skin and radiation fluence
      because most exposure occurred on the dorsal rim of fish skin; thus, some cells
      in that skin were exposed to high fluences while others were not, leading to a
      heterogenous population of cells. Values of dimers produced were also much less
      than in immobilized fish. The pigment melanin decreased the number of dimers in
      the epidermis of grown fish exposed to lambda > 290, 302, or 313 nm, or in the
      dermis of fish following 302 nm, thus conferring protection against this kind of
      damage. No dimers were detected in the epidermis of fish exposed to 365 nm. The
      dimers produced at 302 and 313 nm at tumoricidal exposures correspond to 1 dimer
      in 10(5) base pairs.

PMID- 8485711
TI  - Insulin-like growth factor 1 receptors are increased in estrogen-induced kidney
      tumors.
AB  - We have previously demonstrated that membrane receptor protein tyrosine kinase(s)
      activities are higher in estrogen-induced kidney tumors in comparison with such
      activities in the normal kidney. In the present work we have investigated the
      growth factor binding sites in estrogen-induced kidney tumor and in normal kidney
      membranes in an attempt to understand the mechanism of activation of membrane
      protein tyrosine kinase(s) and their possible relationship to the induction of
      estrogen-induced tumors. The characteristics of the normal hamster kidney
      membrane insulin-like growth factor 1 (IGF-1) receptor are similar to those
      reported for kidney and extrarenal tissues of other rodents. The binding of 125I
      IGF-1 to the normal kidney or tumor membranes was saturable and dependent on
      time, protein, pH, and temperature. The binding of 125I-IGF-1 to the tumor
      membranes was significantly higher when compared to the binding activity of the
      membranes obtained from age-matched normal kidney. The Scatchard analysis of the
      binding data of both tumor and normal kidney revealed a single class binding site
      for IGF-1 with Kd of 1.7 and 1.8 nM and maximum binding capacities of 4150 and
      2050 fmol/mg protein, respectively. Therefore, the difference observed in 125I
      IGF-1 binding between tumor and normal kidney membranes was due to an increase in
      the number of IGF-1 binding sites with no change in the affinity of receptors for
      IGF-1. An enhanced level of IGF-1 receptors in tumor membranes also was
      visualized by autoradiography following affinity labeling of membrane proteins
      subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Under
      reducing conditions of electrophoresis, two molecular bands of M(r) 240,000 and
      M(r) 130,000 were evident. The M(r) 130,000 band represents the alpha subunit of
      IGF-1 receptors, and the M(r) 240,000 band may represent the aggregates of the
      receptor subunits which were not reduced completely. IGF-1 stimulated normal
      kidney or tumor membrane protein tyrosine kinase(s) (wheat germ lectin agarose
      purified membrane proteins) in a dose-dependent fashion. Therefore, the
      alteration of IGF-1 binding activity of the tumor membrane receptors and
      stimulation of IGF-1-mediated membrane protein tyrosine kinase activity in tumor
      tissues suggest that events coupled to this membrane receptor may play a role in
      estrogen stimulation of renal carcinoma.

PMID- 8485712
TI  - Phosphorylation of elongation factor 2 in normal and malignant rat glial cells.
AB  - Certain calmodulin (CaM)-dependent protein kinases phosphorylate substrates have
      been implicated in regulating cellular proliferation. In this study, CaM
      dependent phosphorylation has been examined in normal and tumor tissue from rat
      brain to determine whether differences exist. Using in vitro phosphorylation
      reactions, we compared endogenous substrates for Ca2+/CaM-dependent protein
      kinases in rat brain white matter (RBWM), a tissue rich in normal glia, to those
      of C6 rat glioma cells. A major phosphoprotein having a M(r) of 100,000 was
      observed in proliferating C6 cells that was not present in RBWM or in
      nonproliferating cells. Phosphorylation was stimulated by Ca2+ and CaM and
      inhibited by trifluoperazine. An antibody to elongation factor 2 (EF-2)
      immunoprecipitated the M(r) 100,000 protein from C6 cells. EF-2 was present in
      RBWM but was not phosphorylated. Homogenates of RBWM did not phosphorylate
      exogenous EF-2, which suggested the absence of CaM kinase III activity in normal
      glial tissue. Furthermore, the addition of purified, exogenous CaM kinase III to
      homogenates of RBWM resulted in EF-2 phosphorylation. These data demonstrate that
      a basal level of EF-2 phosphorylation exists in proliferating glioma cells that
      is markedly diminished or absent in normal glial tissue and is due to the
      activity of CaM kinase III.

PMID- 8485713
TI  - Gene expression and cell proliferation in rat liver after 2,3,7,8
      tetrachlorodibenzo-p-dioxin exposure.
AB  - Recently 4 genes (plasminogen activator inhibitor 2, interleukin 1 beta, clone 1,
      and clone 141) that are transcriptionally or posttranscriptionally responsive to
      2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have been cloned from a human skin
      keratinocyte cell line. We determined whether these genes were expressed in the
      livers of Sprague-Dawley rats following exposure to TCDD and whether there was a
      relationship between expression and hepatic cell proliferation. TCDD was
      administered by using a dose loading/maintenance regimen to achieve rapid quasi
      steady-state TCDD liver concentrations of 0.03, 30, or 150 ng/g of liver. Gene
      expression was determined by Northern analysis using polyadenylated mRNA isolated
      from liver tissue of male and female animals exposed to TCDD for 1 or 14 days and
      hybridized with the human complementary DNA clone corresponding to one of the
      four human TCDD-responsive genes. Under low-stringency hybridization conditions,
      only the expression of clone 1 could be detected. A dose- and time-dependent
      expression of this gene was observed in the liver of both male and female rats.
      Expression of clone 1 was not detected in rats subjected to either a two-thirds
      partial hepatectomy or exposure to a single administration of the hepatic tumor
      promoters Wy-14643, carbon tetrachloride, or phenobarbital at doses that induce
      hepatic cell proliferation. Liver:body weight ratios were elevated in rats
      exposed to the middle and high TCDD doses. Histopathological observation and
      analysis of serum enzyme levels indicated no evidence of TCDD-induced liver
      necrosis. Cell proliferation was evaluated immunohistochemically after 7-day 5
      bromo-2'-deoxyuridine administration. No increase in total hepatic labeling index
      was observed for any of the TCDD-exposed treatment groups compared to controls at
      week 1 or week 2. An increase in the periportal hepatocyte proliferation labeling
      pattern was observed in TCDD-treated animals. While these results demonstrate
      that a human TCDD-responsive gene is expressed in the liver of TCDD-treated male
      and female Sprague-Dawley rats, the expression of this gene is not linked to
      hepatic cell proliferation or the sex-specific tumor-promoting activity of TCDD.

PMID- 8485714
TI  - Inactivation of plasmid reporter gene expression by one benzo(a)pyrene diol
      epoxide DNA adduct in adult rat hepatocytes.
AB  - Polycyclic aromatic hydrocarbons such as benzo(a)pyrene diol-epoxide (BPDE-I)
      cause hepatocellular carcinoma. To identify short-term carcinogen effects, we
      studied hepatocytes transfected with nonreplicating plasmids, adducted covalently
      with BPDE-I, varying in promoter structure and encoded reporter gene (beta
      galactosidase or luciferase). BPDE inactivated gene expression as a first-order
      function of BPDE concentration in adduction reactions. No evidence of
      cytotoxicity, diminished coprecipitation and availability, enhanced nicking of
      supercoiled forms and reduced cellular uptake, or instability of adducted
      plasmids was observed. At low BPDE:plasmid ratios, inactivation occurred with 1
      adduct/plasmid within a target 23-27% of plasmid bases. Using nuclear extracts
      and BPDE-adducted G-free cassette-encoding plasmids, the fraction of full-length
      RNA polymerase II-initiated transcripts also declined as a first-order function
      of BPDE concentration when approximately 3 adducts were distributed among 48% of
      plasmid bases. These observations suggest that carcinogens such as BPDE block
      mRNA transcription along DNA templates by forming limited numbers of persistent
      adducts at coding or noncoding sites.

PMID- 8485715
TI  - Local control of T2/3 transitional cell carcinoma of bladder is correlated to
      differences in DNA supercoiling: evidence for two discrete tumor populations.
AB  - Single cell tumor suspensions were prepared from biopsy and urine samples from 48
      patients with muscle invasive transitional cell carcinoma of the bladder. Prior
      to therapy, samples were irradiated in vitro with the condensation of DNA
      supercoils measured by the light scattered within a flow cytometer. Six months
      after completing a course of radiotherapy, the in vitro data were correlated with
      the presence or absence of local disease. After 12-Gy irradiation, nucleoid
      extraction and staining with 50 micrograms/ml ethidium bromide, 2 predominant
      forms of supercoiling behavior were seen. Nucleoids scattered either
      approximately 10% (Type I) or 35% (Type II) more light than unirradiated
      controls. Those patients with residual disease showed more Type I behavior (21 of
      25; 84%) than those patients clear of disease (9 of 23; 39%) (P = 0.02). It is
      proposed that the ability of these tumor samples to adopt positive supercoiling
      after irradiation is related to a stronger association between individual DNA
      loops and their attachment to the nuclear matrix. This difference in nucleoid
      response within these tumor samples may be related both to intrinsic cellular
      radiosensitivity and, subsequently, to clinical radiocurability.

PMID- 8485716
TI  - Phase I study of amonafide dosing based on acetylator phenotype.
AB  - Amonafide is extensively metabolized, including N-acetylation to an active
      metabolite. Prior studies have demonstrated that patients who are fast
      acetylators of amonafide (and other drugs) have increased toxicity at standard
      doses of amonafide. The primary objective of this study was to define the
      recommended phase II dose of amonafide separately for slow and fast acetylators.
      Twenty-six patients with advanced cancer underwent acetylator phenotyping with
      caffeine and were assigned to a dose level. Slow acetylators were treated at 375
      mg/m2 (daily for 5 days) and had a median WBC nadir of 1600/microliters. Fast
      acetylators were treated at both 200 and 250 mg/m2, resulting in median WBC
      nadirs of 5300 and 2000/microliter, respectively. Two patients were not typeable,
      and two patients appear to have been misphenotyped, one in each phenotype
      category. Pharmacodynamic analysis yielded a model for nadir WBC including
      acetylator phenotype, 24-h N-acetyl-amonafide plasma concentration, gender, and
      pretreatment WBC. We recommend doses of 250 and 375 mg/m2 (for 5 days) for
      further phase II testing of amonafide in fast and slow acetylators, respectively.

PMID- 8485717
TI  - Steroid production in different parts of malignant and benign ovarian tumors in
      vitro.
AB  - Pieces of ovaries and tumors from 45 patients (19 with malignant epithelial
      tumors, 14 with benign epithelial tumors, and 12 with normal postmenopausal
      ovaries) were incubated, and the release of steroid hormones from different parts
      of the tumors and from the contralateral ovaries was measured. Tumor tissue
      (mainly tumor cells with a small number of stromal cells), tumor base tissue
      (more stromal cells than tumor cells), and control ovaries were preincubated in
      oxygenated 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid-minimum essential
      medium buffer at 37 degrees C for 30 min followed by a 3-h incubation in fresh,
      oxygenated medium. Progesterone, androstenedione, testosterone, and estradiol
      were measured in the medium by radioimmunoassay at the end of the incubation
      period. Malignant tumors released more progesterone and androstenedione than
      benign tumors or postmenopausal control ovaries. In contrast, benign tumors
      released more testosterone than malignant tumors or control ovaries. Release of
      estradiol was low and not significantly different among control ovaries and
      malignant and benign tumor tissue. Different parts of the tumors differed in
      steroid hormone release. Tissue samples containing more tumor cells than stromal
      cells released more progesterone than those with predominantly stromal cells.
      Thus, malignant tumors had an active steroid secretion. Progesterone was the main
      steroid released.

PMID- 8485718
TI  - The glutathione S-transferase mu polymorphism as a marker for susceptibility to
      lung carcinoma.
AB  - Glutathione S-transferase (GST) enzymes detoxify carcinogens in tobacco smoke.
      Interindividual variation in GST function may be related to differences in risk
      for smoking-related cancer. Leukocytes from 50% of Caucasians lack GST activity
      toward trans-stilbene oxide (TSO), due to a deletion of the gene for the GST-mu
      enzyme. Presence of GST-TSO activity in leukocytes has been associated with low
      risk for lung cancer among cigarette smokers. We sought to determine whether GST
      activity in lung tissue is determined by the same gene polymorphism and whether
      it is associated with risk for lung cancer. Subjects were cigarette smokers,
      identified at the time of lung resection or autopsy in Seattle hospitals.
      Uninvolved lung tissue was obtained from 35 patients with lung carcinoma and 43
      control patients and assayed for GST-mu activity with TSO, for the presence of
      the GST-mu gene product with an immunological assay, and for the GST-mu gene with
      Southern blotting. Mailed questionnaires were used to collect information on
      subjects' smoking histories and exposures which might alter enzyme activity.
      Interindividual results from the three assays correlated well. Smokers with high
      GST-TSO enzyme activity present in their lung tissue had a lower risk for lung
      carcinoma than did smokers with no or low activity (relative risk = 0.30; 95%
      confidence interval, 0.11-0.79), as did smokers with GST-mu antigen identified in
      lung tissue versus those with no antigen (relative risk = 0.30; 95% confidence
      interval, 0.11-0.79). Smokers with both maternal and paternal copies of GST-mu
      DNA (n = 7) had a lower cancer risk than smokers lacking GST-mu DNA (n = 30;
      relative risk = 0.35; 95% confidence interval, 0.06-2.10). High GST-mu activity
      appeared to be associated with a greater decrease in lung cancer risk among 38
      heavy cigarette smokers (relative risk = 0.15; 95% confidence interval, 0.03
      0.64) than among 38 light smokers (relative risk = 0.61; 95% confidence interval,
      0.14-2.60). Presence or absence and number of copies of the GST-mu gene appear to
      determine activity of the GST-mu enzyme in lung. Smokers with the GST-mu enzyme
      have approximately one-third of the risk for lung carcinoma of smokers without
      the enzyme.

PMID- 8485719
TI  - Comparison of the therapeutic effects of a new arotinoid, Ro 40-8757, and all
      trans- and 13-cis-retinoic acids on rat breast cancer.
AB  - A novel arotinoid, 4-((2-(p-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl- 2
      naphthyl)propenyl]phenoxy))ethyl))-morpholine, was tested in rats bearing
      established chemically induced mammary tumors. At a dose of 0.35 mmol/kg/day of 4
      ((2-(p-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-
      naphthyl)propenyl]phenoxy)ethyl))-morpholine, decreased tumor growth was seen
      after 2 weeks. By weeks 4 and 5, tumor burdens were decreased to 10-30% of
      initial values and 50-70% of the animals became free of palpable tumors.
      Stabilization of tumor size through 15 weeks of treatment was seen in rats given
      0.23 mmol/kg/day of the arotinoid. The predominate adverse effects of this
      compound were dose-dependent weight loss during the first 1-3 weeks, attributed
      to poor palatability of the food admix as well as flaking of the skin and
      alopecia at later times. Bone toxicity, a characteristic side effect of retinoids
      in rodents, was rare with this arotinoid, mainly confined to young rats treated
      for more than 12 weeks with high doses. In a comparative study, neither all-trans
      retinoic acid nor 13-cis-retinoic acid had significant antitumor effects at doses
      that were tolerated by the animals. When all-trans-retinoic acid was administered
      at 0.08 mmol/kg/day, tumor reduction was seen during weeks 4-6, but treatment was
      terminated after week 6 due to severe skeletal toxicity and general deterioration
      in all the animals. Such marked toxicity was not evident with the arotinoid at
      doses having high antitumor activity. The high efficacy and relatively low
      toxicity of 4-((2-(p-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-
      naphthyl)propenyl]phenoxy)ethyl))-morpholine suggest that it may be a promising
      new anticancer agent.

PMID- 8485720
TI  - The role of active oxygen species and lipid peroxidation in the antitumor effect
      of hyperthermia.
AB  - The role of active oxygen species and lipid peroxidation in the antitumor effect
      of hyperthermia was studied in an experimental rabbit model. VX2 tumors were
      transplanted into rabbit hind legs, and the effect of hyperthermia on tumor
      growth was measured at 7 and 14 days after heating. As an index of lipid
      peroxidation, thiobarbituric acid-reactive substances in the tumor tissue were
      measured prior to hyperthermia and 3, 6, 12, and 24 h after hyperthermia. Tumor
      growth in rabbits treated with hyperthermia was significantly reduced, and
      thiobarbituric acid-reactive substances in the tumor tissue treated with
      hyperthermia were significantly increased until 6 h after hyperthermia. In
      addition, alpha-tocopherol in the tumor tissue was significantly decreased after
      hyperthermia. The antitumor effect of hyperthermia and the increase of
      thiobarbituric acid-reactive substances in the tumor tissue treated with
      hyperthermia were significantly inhibited by the administration of superoxide
      dismutase and catalase or dimethyl sulfoxide. These results suggest that lipid
      peroxidation mediated by active oxygen species plays an important role in the
      antitumor effect of hyperthermia.

PMID- 8485721
TI  - Intraarterial therapy of human glioma xenografts in athymic rats using 4
      hydroperoxycyclophosphamide.
AB  - The addition of chemotherapy, notably using nitrosoureas, in the treatment of
      patients with glioblastoma multiforme has resulted in only modest improvements in
      long-term patient survival over the use of surgical intervention and irradiation
      alone. Intraarterial (i.a.) chemotherapy offers the potential benefit of
      increasing tumor drug delivery because of first-pass drug uptake, while
      minimizing systemic drug levels and toxicity. We have now investigated the i.a.
      therapy of intracerebral human glioma xenografts in athymic rats with 4
      hydroperoxycyclophosphamide (4-HC), a preactivated derivative of
      cyclophosphamide. Athymic male rats were given intracerebral injections of the
      human glioma line D-54 MG. On Day 5 after injection, the rats were randomized (n
      = 8-10) by body weight (mean weight, approximately 300 g). In one set of
      experiments, each group received either i.v. saline, i.a. saline, 6 mg i.a. 4-HC,
      6 mg i.v. 4-HC (6 mg), or 12 mg i.v. 4-HC. Intraarterial 4-HC produced
      significant increases in median survival (Day 24) compared with i.a. saline
      controls (140% increase), equivalent doses given i.v. (71% increase), and twice
      the equivalent dose given i.v. (50% increase) (by Wilcoxon rank sum analysis, P <
      0.05 is statistically significant). The i.a. maximum tolerated dose was
      subsequently determined to be approximately 12.5 mg in non-tumor-bearing rats.
      Further experiments demonstrated a dose-response increase in survival for i.a.
      dosages of 6, 9, and 12.5 mg with significant improvement when compared with
      saline controls and 12.5 mg i.v. Pharmacokinetic experiments also demonstrated a
      significant first-pass uptake advantage for i.a. (versus i.v.) administered 4-HC.
      The short plasma half-life and marked antiglioma activity of 4-HC, without the
      need for hepatic activation, suggest a therapeutic application of this drug in
      the i.a. treatment of brain tumors.

PMID- 8485722
TI  - Mechanisms of adoptive immunotherapy: improved methods for in vivo tracking of
      tumor-infiltrating lymphocytes and lymphokine-activated killer cells.
AB  - Adoptive immunotherapy with tumor-infiltrating lymphocytes (TIL) and lymphokine
      activated killer cells has been demonstrated to mediate regression of tumors in
      murine models and in selected patients with advanced cancer. Improved methods for
      monitoring immune cell traffic, particularly to sites of tumor, are needed to
      elucidate mechanisms of antitumor activity and optimize treatment protocols.
      Traditional cell tracking methods such as fluorescent protein labeling and
      radiolabeling using 111In, 125I, or 51Cr are limited by isotope half-life,
      leakage or transfer of label from immune cells, and toxicity or altered cell
      function caused by the labeling process. Labeling with genetic markers allows
      long-term cell tracking but is laborious to perform and difficult to quantitate.
      We have used two recently described lipophilic cell tracking compounds (PKH26 and
      125I-PKH95) which stably partition into lipid regions of the cell membrane to
      track immune cells in vivo. Concentrations of each tracking compound which had no
      adverse effects were determined for a variety of murine TIL and lymphokine
      activated killer cell functions. Viability was unimpaired at labeling
      concentrations of up to 5 microM for PKH95 and 20 microM for PKH26. TIL
      proliferation was unaltered by labeling with up to 5 microM PKH95, 20 microM
      PKH26, or a combination of 15 microM PKH26 and 5 microM PKH95. In vivo cytotoxic
      effector function and in vivo therapeutic efficacy of lymphokine-activated killer
      cells and TIL were also unimpaired by labeling with 20 microM PKH26 or 1 microM
      125I-PKH95. Subsequent studies in an adoptive transfer immunotherapy model used
      125I-PKH95 to track the biodistribution of TIL in tumor and in non-tumor-bearing
      animals and PKH26 fluorescence to monitor microdistribution within tissues and
      distinguish TIL from host T-cells. The results suggest that differential
      accumulation, selective retention, or proliferation at the tumor site cannot
      account for the observed pattern of therapeutic efficacy. We hypothesize that a
      minimum number of TIL must reach the tumor site in order to achieve a
      demonstrable therapeutic effect.

PMID- 8485723
TI  - Delivery of radionuclides to pretargeted monoclonal antibodies using
      dihydrofolate reductase and methotrexate in an affinity system.
AB  - A novel affinity system for a two-phase delivery of radionuclides to tumor cells
      has been developed. In the first phase, a nontoxic bivalent monoclonal antibody
      conjugated to an enzyme is targeted to the tumor cells. In the second phase, a
      radionuclide-derivatized enzyme inhibitor, specific for the enzyme conjugated to
      the antibody, is administered. The model system selected for this study is the
      recombinant human enzyme dihydrofolate reductase (rhDHFR) and its high-affinity
      competitive inhibitor methotrexate (MTX). MTX was labeled with a radionuclide by
      covalent attachment of diethylenetriaminepentaacetic acid (DTPA) complexed with
      111In. Using the gamma-carboxyl residue of MTX for the attachment of DTPA,
      binding of the inhibitor to rhDHFR was not affected. The inhibitory activities of
      nonderivatized MTX and DTPA-MTX were indistinguishable. Human K562
      erythroleukemia cells were used to evaluate under in vitro conditions the DHFR
      MTX affinity system for the delivery of 111In-labeled DTPA-MTX to pretargeted
      alpha-transferrin receptor antibody-rhDHFR conjugates (alpha-TFR-DHFR). The data
      demonstrate that the delivery of 111In is dose dependent and highly specific.
      Under saturating conditions, binding of 111In-DTPA-MTX to alpha-TFR-DHFR-treated
      cells was 14-fold higher than to cells treated with nonconjugated alpha-TFR
      antibody. Further experiments indicated that the low level of nonspecific binding
      of 111In-DTPA-MTX was comparable to that of 111In-DTPA, known for its complete
      extracellular distribution and rapid clearance through the kidneys. Based on the
      data of this study, antibody-conjugated rhDHFR and radionuclide-labeled DTPA-MTX
      complexes provide components for an alternative radioimmunotherapeutic approach
      that can be expected to result in improved tumor tissue ratios of both the
      targeting moiety and the radionuclide-labeled derivative as compared to current
      approaches.

PMID- 8485724
TI  - Expression of HLA class I antigens in sporadic adenomas and histologically normal
      mucosa of the colon.
AB  - The loss of HLA antigens by neoplastic cells is considered important for tumor
      growth and metastasis, inasmuch as it may allow tumors to escape immune
      surveillance. We have observed reduced expression of HLA antigens in sporadic
      colon cancer and adenomas from familial adenomatous polyposis patients. We now
      studied the expression of HLA class I antigens in patients with sporadic
      adenomas, which are precursors of colorectal cancer. Expression of HLA class I
      antigens was studied by immunohistochemistry in (a) sporadic colon adenomas, (b)
      histologically normal mucosa distant from the adenomas, (c) histologically normal
      colonic mucosa from patients with history of sporadic colon adenomas, and (d)
      colonic mucosa from normal subjects. HLA class I antigen expression was
      moderately reduced in 56% and severely reduced in 44% of the adenomas; this
      reduction was significant when compared to controls (P < 0.0001). The reduction
      of HLA class I expression in adenomas was related to the grade of dysplasia of
      the adenomas. HLA class I expression of normal appearing mucosa was decreased in
      76% of patients with adenoma (P < 0.0001) and in 54% of patients with history of
      adenoma (P < 0.005) compared to normal controls. These changes were antigen
      specific, inasmuch as the expression of carcinoembryonic antigen, a surface
      antigen, was not affected. Our findings suggest that reduced HLA class I
      expression is an early event in the cell transformation process from normal to
      neoplastic state, preceding in many cases the onset of histological changes. HLA
      class I could be potentially used as a premalignant marker in the colon.

PMID- 8485725
TI  - Loss of heterozygosity for loci on chromosome 10 is associated with
      morphologically malignant meningioma progression.
AB  - Meningioma is a common tumor of the central nervous system which displays
      morphological heterogeneity. In order to determine whether this phenotypic
      variability is associated with distinct or overlapping genetic lesions, we
      compared genotypes at several loci defined by allele length polymorphism in tumor
      and normal tissues from patients with meningioma. In particular, we concentrated
      on loci on chromosomes 22 and 10 because these genomic regions have previously
      been shown to be altered in the former in sporadic and familial meningiomas and
      in the latter as a late stage event in progression of another common brain tumor,
      astrocytoma. We examined 38 tumors which were classified as benign, atypical, or
      malignant by morphological criteria, invasive characteristics, or both. We found
      that loss of heterozygosity (LOH) for loci on chromosome 22 occurred in 5 of 15
      benign, 2 of 2 atypical, and 5 of 10 malignant meningiomas. Similar alterations
      of chromosome 10 were found in 0 of 20 benign, 1 of 2 atypical, and 4 of 13
      malignant meningiomas. Among the malignant tumors, LOH for loci on chromosome 10
      occurred in 2 of 4 morphologically malignant tumors and in 2 of 4 morphologically
      and invasively malignant tumors. In contrast, LOH was not observed for any of the
      5 informative tumors classified as malignant by invasive characteristics only.
      LOH for loci on chromosome 22 accompanied (but was not restricted to) allelic
      loss of loci on chromosome 10. These data suggest that the progression of
      meningiomas from arachnoidal cells to the morphologically malignant phenotype
      may, in part, entail the loss of a tumor suppressor gene(s) on chromosome 22
      early in the process and that this may be compounded by alterations of chromosome
      10, the LOH of which is associated with morphological signs of malignancy.

PMID- 8485726
TI  - Human epithelial ovarian cancer allelotype.
AB  - To determine which chromosomes and chromosomal regions contain putative tumor
      suppressor genes important for human epithelial ovarian cancer, we performed loss
      of heterozygosity (LOH) studies on 37 primary epithelial ovarian tumors. Using 70
      polymorphic markers, we examined all chromosome arms (excluding acrocentric arms)
      on all specimens. Our findings show a high frequency of LOH for the following
      chromosome arms: 5q (43%); 6p (62%); 6q (57%); 7p (36%); 8p (40%); 9q (54%); 13q
      (56%); 14q (47%); 15q (36%); 17p (81%); 17q (76%); 18q (43%); 21q (36%); and 22q
      (71%). When separated into low and high grade tumors, there were statistically
      significant differences of LOH for the following chromosome arms: 6p (29% versus
      70%); 13q (0% versus 72%); 17p (33% versus 90%); and 17q (29% versus 87%). No
      statistically significant difference was found between different histological
      subtypes. The average fractional allelic loss for low grade tumors was 0.17
      versus 0.40 for high grade and 0.35 for all tumors. In an effort to more
      specifically localize common regions of molecular genetic deletion, we examined
      the following chromosomes in greater detail: chromosome 13 (5 markers);
      chromosome 17 (8 markers); and chromosome 6 (8 polymorphic markers). No tumor
      showed deletion of only a portion of chromosome 13. When any informative marker
      for chromosome 13 showed loss, all markers showed loss. Similarly, the tumors of
      most patients demonstrated LOH of all informative markers that map to chromosome
      17; however, regional deletion of 17p markers was observed in 3 tumors. Twelve
      tumors demonstrated regional deletions of portions of chromosome 6. These tumors
      suggest that at least 2 regions of chromosome 6 are important for ovarian
      epithelial carcinogenesis. One region appears to be on distal 6q and a second
      region is near the centromere of chromosome 6 proximal to the HLA locus.

PMID- 8485727
TI  - Concerted control of multiple histone promoter factors during cell density
      inhibition of proliferation in osteosarcoma cells: reciprocal regulation of cell
      cycle-controlled and bone-related genes.
AB  - Cell density-induced growth inhibition of osteosarcoma cells (ROS 17/2.8) results
      in the shutdown of proliferation-specific histone H4 and H2B genes and the
      concomitant up-regulation of several osteoblast-related genes. In several
      respects, this reciprocal regulatory relationship is analogous to the
      proliferation/differentiation transition stage during development of the bone
      cell phenotype in normal diploid osteoblasts. Here, we comprehensively analyzed
      the promoter binding activities interfacing with key regulatory elements in the
      cell cycle-dependent histone and bone-specific osteocalcin genes. Similarly, we
      examined factors interacting with a series of general transcription regulatory
      elements that are present in a broad spectrum of promoters. The results show that
      histone promoter binding activities HiNF-D, HiNF-P/H4TF-2, H4UA-1, and OCT-1, as
      well as AP-1 activity, are proliferation dependent. These factors decline
      coordinately during the cessation of proliferation in both ROS 17/2.8 bone tumor
      cells and normal diploid osteoblasts. Collective down-regulation of these trans
      activating factors occurs in both cell types within the physiological context of
      constitutive regulation of ubiquitous transcription factors (Sp1, ATF, and CCAAT
      binding proteins). In addition, during growth inhibition of ROS 17/2.8 cells we
      observe a complex series of modifications in protein/DNA interactions of the
      osteocalcin gene. These modifications include both increased and decreased
      representation of promoter factor complexes occurring at steroid hormone response
      elements as well as tissue-specific basal promoter sequences. These results
      demonstrate cell growth regulation of the promoter factors binding to the
      proliferation-specific histone and tissue-specific osteocalcin genes during the
      cessation of proliferation.

PMID- 8485728
TI  - Selectively down-regulated expression of major histocompatibility complex class I
      alleles in human solid tumors.
AB  - We studied the expression of major histocompatibility complex (MHC) class I
      molecule in 52 ex-vivo tumor samples comprising 29 ovarian, 15 lung, 1 breast,
      and 4 colon carcinomas; 1 midgut carcinoid; and 2 malignant mesenchymal tumors
      obtained from surgical specimens or from malignant effusions. The allelic
      products were visualized in untreated and interferon gamma + tumor necrosis
      factor alpha treated aliquots of tumor cells and in the patient's blood
      lymphocytes by the one-dimensional isoelectric focusing method. Generally, the
      tumor cells contained lower amounts of MHC class I molecules compared to the
      lymphocytes. In vitro exposure to interferon gamma and tumor necrosis factor
      alpha elevated the level of MHC class I expression in 24 of 52 tumors and
      corrected the assembly defect seen in 2 cases. In 20 tumors one or several human
      leukocyte antigen alleles were undetectable even after cytokine treatment.
      Correlation was seen with the grade of differentiation; the proportion of tumors
      with selective losses in poorly, moderately, or well differentiated tumors were
      16 of 30, 3 of 13, and 1 of 9, respectively. Selective losses occurred in ovarian
      carcinoma cells collected from malignant effusions (12 of 22, 54%) but not in 7
      primary tumors. In primary lung carcinomas the frequency was 36% (5 of 14 cases).
      Thirty-nine patients were serologically typed; thus the MHC alleles on the tumor
      cells could be identified. In this panel of tumors 30 human leukocyte antigen
      alleles were represented. Among these the expression of 15 was found to be down
      regulated in some but not all tumors of the same histology.

PMID- 8485729
TI  - Heterocyclic amines in cooked foods: possible human carcinogens.

PMID- 8485730
TI  - Introduction II: American Cancer Society Research Workshop on Cancer and
      Nutrition.

PMID- 8485731
TI  - Funding mechanisms for research through the National Cancer Institute.

PMID- 8485732
TI  - Funding mechanisms for research through the American Cancer Society.

PMID- 8485733
TI  - Can we really derive etiology from human-based studies?

PMID- 8485734
TI  - Diet, nutrition, and cancer: development of hypotheses and their evaluation in
      animal studies.
AB  - Research in diet, nutrition, and cancer is multidisciplinary. As a result there
      are many factors to consider in the conceptualization and design of experiments
      that may not be readily apparent to someone entering this field. In this article
      issues are identified that should be considered in the development of hypotheses
      about the effects of diet and nutrition on the carcinogenic process and the
      evaluation of these hypotheses using animal models. The questions considered are:
      what comprises an acceptable rationale for diet, nutrition, and cancer
      experiments in which animal models are used; what factors should be considered in
      the design of these experiments; and what constitutes a mechanistic component in
      such animal studies.

PMID- 8485735
TI  - Use of cell and organ cultures in the identification and characterization of
      agents that modify carcinogenesis.

PMID- 8485736
TI  - Report of group A of the American Cancer Society Research Workshop on Cancer and
      Nutrition: panel on human studies.

PMID- 8485737
TI  - Report of group B of the American Cancer Society Research Workshop on Cancer and
      Nutrition: panel on animal studies.

PMID- 8485738
TI  - Report of group C of the American Cancer Society Research Workshop on Cancer and
      Nutrition: panel on cell and organ culture studies.

PMID- 8485739
TI  - Treatment of a malignant stricture after esophagojejunostomy by a self-expanding
      metallic stent.
AB  - Gianturco self-expanding metallic stents (GSs) were placed across an
      esophagojejunostomy which had become strictured secondary to recurrent
      anastomotic gastric cancer. Placement of the GS enabled the patient to take
      liquid food and swallow saliva, though only for a short period of time. One month
      after placement, the stented lumen restrictured with a markedly irregular
      contour. The patient's clinical status deteriorated with eventual occlusion of
      the stented anastomosis. The patient died of renal insufficiency 80 days after
      placement of the stent. There are some questions concerning the stability of
      applying the Gianturco-type bare stent to the digestive tract. In the future,
      more suitable stents will have to be developed.

PMID- 8485740
TI  - Delayed fatal cardiac perforation by an indwelling long introducer sheath
      following transjugular intrahepatic portocaval stents (TIPS).
AB  - Iatrogenic cardiac perforation is a recognized complication of central venous
      catheterization. We report a fatal complication by a 10F introducer sheath which
      was left in place and resulted in perforation of the right atrial wall 8 h later.
      This case is reported to emphasize the increased risk of cardiac perforation from
      large caliber rigid sheaths which should be withdrawn immediately after
      completion of the procedure.

PMID- 8485741
TI  - A new curved peel-away sheath for central venous catheter placement.
AB  - A new 10F peel-away sheath with a preformed curve is now available. The procedure
      for insertion of central venous catheters remains the same, with the new curved
      sheath replacing the straight version. In our experience, this modification
      facilitates the placement of central venous catheters and decreases the incidence
      of catheter tip malposition and kinking.

PMID- 8485742
TI  - Bird's nest filter placement within an enlarged hemiazygos vein for prevention of
      pulmonary embolism.
AB  - Thrombosis of the inferior vena cava (IVC) may result in considerable enlargement
      of paravertebral, azygos, and hemiazygos collateral veins that may in turn serve
      as pathways for thromboemboli to the pulmonary circulation. Herein we describe
      the transfemoral placement of a Bird's Nest filter within an enlarged hemiazygos
      vein to provide prophylaxis against pulmonary embolism in a patient with right
      femoral venous thrombosis who could not tolerate systemic anticoagulation. There
      had been earlier transjugular placement of a Greenfield filter within the
      suprarenal IVC.

PMID- 8485743
TI  - Transosseous air contrast CT-guided needle biopsy of a cystic neoplasm.
AB  - CT-guided fine-needle aspiration biopsy of a metastasis from an ovarian
      cystadenocarcinoma was performed using air contrast and a transosseous approach.
      Air contrast allowed identification of a papillary projection within the cyst,
      and the transosseous approach permitted direct and easy access to the lesion.

PMID- 8485744
TI  - Re: Selecting the right technique to reform a reverse curve catheter (Simmons
      style): critical review.

PMID- 8485745
TI  - The interventional radiologist's training in The Netherlands.

PMID- 8485746
TI  - Percutaneous thrombectomy of the acutely thrombosed dialysis graft: in vitro
      evaluation of four devices.
AB  - Percutaneous recanalization of completely thrombosed hemodialysis grafts was
      simulated in a flow model. Thrombus removal was performed by 1) a Trac-Wright
      catheter; 2) an ultrasound-driven, oscillating probe aspiration thrombectomy (US
      OAT) device; 3) an electric motor-driven oscillating probe aspiration
      thrombectomy (EM-OAT) device; and 4) a rotating spiral aspiration thrombectomy
      (RAT) device. All devices were able to restore a continuous lumen of the shunt
      model within 1-5 min, but residual layers of wall-adherent thrombi remained
      attached, particularly to the inner curvature of the shunt loop. Clot removal
      rate was 95% for the Trac-Wright catheter, 73% for the US-OAT device, 68% for the
      EM-OAT device (straight tip catheter), 88% for the EM-OAT device (angulated tip
      catheter), and 51% for the RAT device. Effluent particle rates for particles >
      100 microns were 3.6% for the Trac-Wright catheter, 0.6% for US-OAT, and less
      than 0.1% for the other devices. Compared with the Trac-Wright catheter, the
      balance of clot-removing efficiency and creation of effluent particles favored
      the electric oscillating device with the angulated tip catheter, which had a
      slightly reduced, but still efficient, clot-removing capability and produced
      almost no effluent particles.

PMID- 8485747
TI  - Renal vein renin analysis: limitations of its use in predicting benefit from
      percutaneous angioplasty.
AB  - Two hundred forty-four consecutive patients (mean age 61 years), including 123
      who had technically valid renal vein renin (RVR) analysis and 121 without RVR
      data, underwent technically successful percutaneous renal artery angioplasty
      (PTRA). They were retrospectively examined to evaluate the utility of RVR
      analysis in identifying renal hypertension (RVH), predicting benefit from PTRA,
      and determining if the lack of knowledge of renin levels significantly affected
      clinical outcome after PTRA. Abnormal RVR values were associated wtih clinical
      benefit after PTRA in 62 of 93 patients (67% sensitivity, 20% specificity, 72%
      positive predictive value). Clinical improvement following PTRA occurred in 31 of
      37 patients with normal pre-PTRA RVR values (16% negative predictive value). RVR
      analysis correctly identified 86 of 117 patients with renovascular hypertension
      (74% sensitivity, 16% negative predictive value). Improved blood pressure (BP)
      control occurred in 72% with abnormal RVR analysis and 66% of the 121 patients
      without RVR data (p > 0.1). We conclude that the very low negative predictive
      value significantly limited the use of RVR analysis in this elderly (mean age 60
      years) patient population with a high incidence of mild renal functional
      impairment (mean serum creatinine 1.4 mg/dl) and bilateral renal artery stenosis
      (38%). The lack of pre-PTRA renin data did not significantly affect clinical
      outcome. If RVR data were relied upon as the exclusive selection criterion in
      patients of this type, many would be prevented from having the benefit of cure or
      improvement by PTRA.

PMID- 8485748
TI  - Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy.
AB  - We treated 35 patients who had hepatic cysts (30 congenital cysts, 5 hydatid
      cysts) with percutaneous puncture and sclerotherapy. After puncture and drainage
      of the cyst, a 95% alcohol solution was instilled as sclerosing agent into the
      cystic cavity. In all the patients, cyst puncture and drainage was successful.
      Follow-up in all cases was at least 12 months. In three uncooperative patients,
      cysts recurred due to incomplete sclerosis of the lining epithelium of the cyst
      wall. No major complications were encountered in all cases. All congenital cysts
      were treated on an outpatient basis. Patients with hydatid cyst were hospitalized
      for 48 h after puncture and aspiration. In our opinion, percutaneous drainage and
      sclerosis of congenital hepatic cysts can be considered an effective alternative
      to surgical treatment.

PMID- 8485749
TI  - Embolotherapy for persistent hemoptysis: the significance of pleural thickening.
AB  - Elective embolotherapy for recurrent hemoptysis was evaluated for its
      effectiveness. Forty embolotherapeutic procedures were performed in 30 patients.
      In the short term, complete hemostasis was achieved in 16 of 40 procedures (40%)
      and significant improvement in another 16 procedures (40%). Long-term, complete
      hemostasis was achieved in 14 of 34 procedures (41%) and significant improvement
      in 12 (35%). Embolotherapy was consistently more effective in patients who had no
      pleural abnormalities compared with those with pleural thickening. Long-term
      complete hemostasis was achieved in 7 of 10 procedures (70%) for the patients
      without pleural thickening and only 7 of 24 (29%) in patients with pleural
      thickening. Thus, pleural abnormalities negatively influence long-term
      effectiveness of embolotherapy.

PMID- 8485750
TI  - Ultrasound-monitored laser angioplasty: preliminary clinical results.
AB  - A novel coaxial catheter system for ultrasound (US)-guided, pulsed laser
      angioplasty was tested clinically in 4 patients with stenoses of the femoral and
      external iliac artery. The mean lesion length was 1.3 +/- 0.4 cm. The 9F
      multifiber laser catheter incorporated a 4.8F commercial intravascular US
      catheter and can be guided over a 0.014 inch wire. Laser angioplasty alone
      reduced the mean degree of stenoses from 84 +/- 8% to 47 +/- 10%. Though laser
      induced artifacts compromised detailed US monitoring during laser firing itself,
      the system proved to be clinically useful as assessment of laser effects and
      measurement of the severity of residual stenoses was possible immediately after
      laser irradiation.

PMID- 8485751
TI  - The mechanical properties of guidewires. Part III: Sliding friction.
AB  - Stiffness is always one of two factors that determine frictional resistance. The
      other factor, the coefficient of friction, depends on the surface
      characteristics. Teflon coating reduces the sliding friction to one-half, and a
      hydrophilic plastic coat to about one-sixth compared with steel.

PMID- 8485752
TI  - Application of a self-expanding metallic stent to a strictured
      esophagojejunostomy.
AB  - We placed a Gianturco self-expanding metallic stent across the recurrent
      stricture of an esophagojejunostomy in a patient with gastric cancer. Though
      excellent passage of food resulted, intractable reflux occurred. Two months later
      the patient succumbed to recurrent tumor. At autopsy, the stent was patent and
      was partially covered by esophageal mucosa. There were narrow but deep ulcers
      around the stent hooks. The Gianturco metallic stent may provide an additional
      option for treating recurrent enteric strictures after other methods fail.
      Further refinements of the technique appear necessary.

PMID- 8485753
TI  - [Intercellular communication and signal transduction mechanisms].
AB  - Cells in multicellular organisms coordinate their functions by signalling
      molecules serving as means of communication. Specific receptors enable
      transduction of chemical information from extracellular environment into a cell.
      Inside the cell the signal is multiplied and transduced further by intracellular
      signalling molecules and enzymatic cascades. Phosphorylation of proteins on
      tyrosine, serine or threonine residues, guanosine triphosphate binding by special
      G proteins and regulation of DNA transcription seem to be the most important
      biochemical mechanisms of signal transduction. Products of cellular
      protooncogenes are involved in all levels of signal transduction, the detailed
      knowledge of signal pathways is therefore important for our understanding of
      pathophysiology of malignant disease and strategies for the therapeutic use of
      growth factors in oncology and haematology.

PMID- 8485754
TI  - [The sleep apnea syndrome. Basic diagnostic and therapeutic possibilities].
AB  - The sleep apnoea syndrome (SAS) involves impaired regular breathing during sleep.
      It causes poor quality sleep and thus subsequent somnolence in daytime, it leads
      to periodic oxygen desaturation and has serious cardiovascular consequences. The
      authors describe methods used for the diagnosis and quantification of the
      intensity of SAS which they used (all-night extended polysomnography, ambulatory
      equipment MESAM 4 and afternoon polysomnography) and they list also the main
      therapeutic procedures used in SAS.

PMID- 8485755
TI  - [Lyme carditis].
AB  - Lyme borreliosis, a systemic disease, described as a new nosological unit as late
      as in 1976, has called for special attention in particular during the past few
      years. The author concentrated his attention on affection of the heart, and based
      on analysis of many publications in the world literature, he submits a review on
      Lyme carditis which comprises the clinical picture, diagnostic possibilities and
      treatment. In the conclusion he indicates possible ways how to investigate the
      disease the course and prognosis of which are the subject of open discussion.

PMID- 8485756
TI  - [Rapidly progressing glomerulonephritis with antibodies to glomerular capillary
      basement membrane].
AB  - Antiglomerular basement membrane glomerulonephritis was diagnosed in 14 patients
      (6 men and 8 women) aged 20 to 59 years. Five patients were found to have
      Goodpasture s syndrome. 5 rapidly progressive glomerulonephritis. 1 nephrotic
      syndrome, and 1 had mild glomerulonephritis. Blood pressure, proteinuria and
      haematuria were not severe in most patients. In 10 patients, the diagnosis was
      not established before end-stage renal failure had developed. Four patients died
      of lung haemorrhage, in 3 the haemorrhage was controlled by the treatment, in 3
      renal failure without lung haemorrhage occurred, and in 3 renal function improved
      or was stable. The prognosis improved significantly after plasma exchange
      together with immunosuppression had been introduced.

PMID- 8485757
TI  - [Fatty acid composition of plasma lipids in hyperlipidemia associated with
      ischemic heart disease].
AB  - The authors compared plasma lipid and lipoprotein values and the fatty acid
      composition in plasma lipids of a group of 38 men with primary
      hyperlipoproteinaemia (HLP) type II B and IV with a history of myocardial
      infarction (IM) and in a control group of 63 men with the same type of HLP
      without a history of ischaemic heart disease (IHD). Hyperlipidaemic subjects
      after IM differed from controls by the apolipoprotein (apo) B concentration in
      LDL lipoproteins and by the composition of fatty acids in plasma
      phosphatidylcholine (PC) and triglycerides (TG). In the discriminating function
      which makes it possible in the given group of patients to classify correctly
      hyperlipidaemic subjects after IM and without detectable IHD the independent
      variables are apo-B concentration in LDL, apo-A-I in plasma, eicosapentaenoic
      acid in TG, gamma-linolenic acid in cholesterol esters and stearic and oleic acid
      in PC. These findings confirm the practical value of assessment of
      apolipoproteins for detection of hyperlipidaemic subjects with a specially high
      risk of IHD and indicate also the role of essential FA in the pathogenesis of IM.

PMID- 8485758
TI  - [The importance of catecholamine determination in athletes].
AB  - During a physical as well as mental load as a rule sympathoadrenal activation
      occurs which leads to a rise of catecholamine plasma levels and their increased
      excretion. The author investigated changes of plasma catecholamines and their
      urinary excretion during different experimental conditions in the laboratory and
      in field work. These changes were assessed after different loads in trained and
      not trained subjects and the effect of different types of stress was
      investigated. As to stressing stimuli, the authors reports in the present work on
      the effect of hypoxia, dehydration, psychological stress, anticipation stress and
      the combined effect of stress and biorythms.

PMID- 8485759
TI  - [Sleep apnea syndrome--serious complications in a female patient treated with
      psychopharmaceutic agents].
AB  - The authors present the case-history of a patient treated in the past on account
      of depressive syndrome who suffered repeatedly from somnolence or even
      unconsciousness with dyspnoea which called for hospitalization in an
      anaesthesiological and resuscitation department. The repeatedly expressed
      suspicion of attempted suicide by drugs was always ruled out by toxicological
      examination. Based on the clinical picture a preliminary diagnosis of the sleep
      apnoea syndrome was established confirmed later by polysomnographic examination.
      The evoking factors of the mentioned serious complications were probably
      respiratory infections and psychiatric medication, in particular hypnotics-
      flunitrazepam and triazolam.

PMID- 8485760
TI  - [An acute care response to chronic care: the American perspective].
AB  - American medical care has been characterized by an acute care and surgical
      orientation. This acute care focus has been reinforced by advances in infectious
      diseases and cardiology in the years since World War II. The success in acute
      care medicine, however, has resulted in a larger number of Americans who are
      older and suffering from chronic disease. Despite these demographic developments,
      there is a general inattention to chronic and long term care in medical
      education. Such a focus is needed because unlike acute care medicine which is
      dependent upon diagnostic categories, the provision of long term care is
      dependent upon functional status. Ethical considerations in long term care are
      also different than acute care. While the autonomy ethic is predominant in acute
      care settings, the needs of the chronically ill might be better addressed with a
      communitarian ethic of care. The autonomy ethic distorts the doctor-patient
      relationship most notably in chronic care by isolating the dependent patient from
      a community of care. The current euthanasia debate in the United States is
      symptomatic of the health care system's inability to provide adequate chronic,
      long term and palliative care to patients in great need.

PMID- 8485761
TI  - [The physician and the anxious child].
AB  - The work is based on the conviction that anxiety and its control is a primary
      problem of man on Earth. Adults who are emotionally attached to a child feel the
      necessity to protect him. There exists also a syndrome of excessive anxiety and
      so-called untreatable children. The anxious child can easily succumb to panic:
      inducing moments are e.g. all medical practices which restrict free mobility or
      enforce an unusual position of the body. Anxiety is a permanent and to a
      considerable extent genetically conditioned character trait. Psychologists
      include it among so-called hard personality traits. The author mentions auxiliary
      provisions to help anxious children: 1. assurance, 2. training how to use
      economically his own forces and 3. building a system of safety measures. The
      author gives an account of principles for dealing with parents of anxious
      children.

PMID- 8485762
TI  - [Recent advances in clinical cytogenetics].
AB  - The development of cytogenetics in recent years revealed some new and even
      surprising findings some of which seem to be at variance with accepted rules of
      this discipline. The submitted paper gives a review of contemporary knowledge of
      the problem of imprinting, somatic mosaicism, micro-deletion syndromes,
      unbalanced aberrations without phenotypic manifestations and it mentions also
      some aspects of fragile X.

PMID- 8485763
TI  - [Recent advances in clinical aspects of infectious hepatitis].
AB  - A review of recent advances in the diagnosis, clinical course, complications and
      treatment of hitherto known types of viral hepatitis (VHA, VHB, VHC, VHD and
      VHE). The most serious complication of hepatitis is fulminant hepatic failure.
      The only effective drug in some types of viral hepatitis is interferon alpha 2a.

PMID- 8485764
TI  - [Endothelin--a vasoactive peptide of endothelial cells].
AB  - Endothelin is a recently discovered peptide which is formed in the endothelial
      layer of the vascular wall and is released, following different stimuli, into the
      neighbouring smooth muscle layer of blood vessels and into the vascular lumen. By
      its effects on the regulation of the vascular tonus endothelin could play a part
      in regulating the function of various organ systems. The submitted paper gives a
      brief account on contemporary knowledge regarding the formation, elimination and
      biological effects of endothelin. The authors discuss also the potential
      physiological and pathophysiological role of this peptide.

PMID- 8485765
TI  - [Initial experience with the transjugular renal biopsy].
AB  - Transjugular renal biopsy is a new diagnostic method used for collection of
      tissue specimens for morphological examination in some indicated cases where the
      use of the standard percutaneous technique involves risk. The method has not been
      used so far in Czechoslovakia.

PMID- 8485766
TI  - [Antigens for the ELISA test for serodiagnosis of Helicobacter pylori infection].
AB  - Semipurified urease and outer membranes of Helicobacter pylori were isolated and
      used as antigens for the construction of new ELISA tests for the serodiagnosis of
      infections caused by this microorganism. The highest discriminating capacity
      between infected and not infected subjects was obtained by the test detection of
      IgG antibodies against the urease antigen which reached a 100% sensitivity, 90%
      specificity, a 100% negative and 91% positive predictive value. Examination of
      sera of healthy children and blood donors revealed the possibility of
      asymptomatic infection and an increase of specific antibody levels with age.

PMID- 8485767
TI  - [IgG antibodies to Gastrospirillum hominis and Helicobacter pylori].
AB  - In conjunction with an investigation extending over several years, focused on the
      understanding of the importance of Helicobacter pylori in inflammatory gastric
      disease, the authors examined a group of 1242 patients. In fifteen they detected
      by microscopic examination the presence of helical bacteria described in the
      literature as Gastrospirillum hominis. The cultivation test was not positive. In
      three patients in addition to these bacteria also the presence of Helicobacter
      pylori was detected. Sera of eight patients with Gastrospirillum hominis were
      investigated by the ELISA test Helico-G f. Porton Cambridge; antibodies against
      Helicobacter pylori were found in three patients (incl. two with the concurrent
      presence of G.h. and H.p.). In sera of the remaining five patients antibodies
      were not detected.

PMID- 8485768
TI  - [Sorbitol-negative E. coli 016 in a 10-year-old child diagnosed with hemolytic
      uremic syndrome and in his asymptomatic father].
AB  - In Escherichia coli strains isolated from faeces and smears from the rectum in
      haemolytic-uraemic syndrome of a child and healthy relatives the authors assessed
      the biochemical activity, antigenic characteristic, sensitivity to twelve
      antimicrobial substances and factors of virulence. Sorbitol negative strains were
      isolated from the ill child and his father. The strains belonged into serogroup
      016. The remaining strains were sorbitol positive. They belonged into serogroups
      02, 012 and 019. Nineteen sorbitol negative strains of E. coli from the sick
      child caused mannose sensitive agglutination of chicken and guinea pig
      erythrocytes, they produced colicin V and aerobactin. Except for one strain they
      were serum resistant. Fourteen strains induced the oedema on the foot of mice and
      eleven produced a lethal effect in mice. Except for three ampicillin resistant
      strains the remaining were sensitive to the examined antibacterial substances.
      Two sorbitol negative strains of E. coli isolated from the asymptomatic father
      produced aerobactin and one strain was serum resistant.

PMID- 8485769
TI  - [Testing the sensitivity of opportunistic agents of mycoses to antimycotic drugs
      in vitro].
AB  - The authors tried to standardize the method of assessment of the minimal
      inhibitory concentration (MIC) of antimycotics for the evaluation of the
      sensitivity of opportunistic causal agents of mycoses. They paid attention to
      factors which cause deterioration of the reproducibility of tests and lead to
      intra- and interlaboratory variability of results. In conjunction with this the
      authors drew attention to the lack of uniformity of views on the application of
      these tests in clinical practice. In the author's view the reservation pertaining
      in particular to an inadequate correlation of results in vitro and in vivo do not
      cast doubts on the expedience of laboratory assessment of sensitivity. Testing of
      systemic antimycotics with a low pharmacotherapeutic index and a relatively high
      frequency of secondary resistance is particularly justified. In those instances
      assessment of MIC values is a significant component of monitoring of adequate
      antifungal chemotherapy, in particular when antimycotics are administered for
      prolonged periods to patients with altered immunity.

PMID- 8485770
TI  - [The epidemic process in infections before and after active immunization. I.
      Comparison of long-term monitoring of the disease with a simple mathematical
      model].
AB  - In the first part of this paper the authors used for demographic data and
      morbidity data concerning measles, parotitis, rubella and chickenpox in the
      Sokolov district a model of exponential distribution, in particular its
      distribution function. The authors introduced the concept of mean population
      year. They tested the theoretical assumption that in different infections in long
      term average the annual number of infected subjects is equal and equals the mean
      population year. They found that the delta parameter which determines the shape
      of the exponential regression curve and is the measure of the rate of spread of a
      given infection, expressed at the same time numerically by the number of mean
      population years the mean number of susceptibles which remain permanently in a
      given population.

PMID- 8485771
TI  - [Relation between the level of infection in Ixodes ricinus with Francisella
      tularensis and the level of bacteremia in the host].
AB  - The dynamics of bacteremia on white mice subcutaneously infected with an inoculum
      of 100 and 10 cells of F. tularensis (strain 273) was compared in two parallel
      experiments. The rise of bacteremia was relatively uniform, about 3 logarithms a
      day in both groups of animals, so that it reached values of 10(9)-10(10) cells
      per 1 ml of blood ante finem. Larvae of Ixodes ricinus were fed on white mice in
      different stages of bacteremia, so that groups of ticks with different degrees of
      infection were obtained. Our results of quantitative examination show an evident
      correlation between the degree of bacteremia of the host and the degree of
      infection of ticks. The highest values of positivity 10(6)-10(7) cells were
      recorded in larvae, which finished their feeding on the day of the host's death,
      during the time when bacteremia was reaching the highest degree 10(10) cells per
      ml of the blood. Persistence of the agent in the organism of infected larvae
      could be observed up to hatching, under given experimental conditions one month
      after infection. In nymphs developed from larvae with the highest degree of
      infection this ability was preserved in about one third of individuals still
      after 5 months of starvation. In ticks with low degrees of infection it
      disappeared during the experiments.

PMID- 8485772
TI  - [Are enteroviruses the causal agents of acute enteritis in humans?].
AB  - Based on assembled data from the literature and oral communications as well as
      findings in the laboratory, the author concludes that an enteroviral aetiology of
      diarrhoeal diseases can be taken for granted in many instances. Enteroviral
      gastritis is not frequent nor serious and is usually not encountered in winter
      but rather in summer under conditions with a higher standard of hygiene. The
      ratio of enteroviruses in epidemics of gastroenteritis and in the aetiology of
      enteritis within the framework of epidemics with other manifestations of
      enteroviral disease is very variable and there is no generally valid frequency
      which could serve for orientation. Virological and serological diagnosis of
      enteroviral diarrhoea would not be expedient in winter, it is, however, useful in
      summer and in epidemics affecting neonates and young children. In general, less
      attention is paid to an enteroviral aetiology or diarrhoea, as compared with
      thorough assessment of an enteroviral aetiology in severe forms of the disease.
      Attention is drawn to the usefulness of a more detailed investigation of
      properties of strains of polioviruses isolated from patients with diarrhoea.

PMID- 8485773
TI  - [Infectious diseases yesterday and today].
AB  - The authors present examples demonstrating that in the last decades we witnessed
      the discovery of new nosological units and their infectious agents, the detection
      of the infectious origin of "old" diseases the aetiology of which was still
      recently obscure, infectious attacks of people by diseases which were considered
      animal infectious only, as well as the more frequent incidence of opportune
      infections due to impairment of the immune state of the human organism. These
      changes have many reasons such as the development of properties of
      microorganisms, lifestyle changes of the human population, advances in medicine,
      and last but not least improving microbiological diagnosis. Attention is drawn to
      the fact that even in a time when so-called diseases of civilization are in the
      foreground of interest our awareness of infectious diseases must not slacken.
      Only all-round international surveillance can prove successful.

PMID- 8485774
TI  - [The epidemic process in infections before and after active immunization. II.
      Changes in the number of susceptible individuals in the population during a
      natural epidemic and its control by active immunization].
AB  - Based on the long-term follow-up of the incidence of some infectious diseases in
      the district and calculations of the actual number of infected subjects, the
      authors present an estimate of the ratio of susceptible and immune subjects
      during the unimpaired epidemic process. The epidemic process develops from the
      lowest range of immune subjects and stops at the highest range. The highest range
      thus gives the ratio of immune subjects which must be achieved or maintained by
      active immunization to achieve elimination of a given infection. The authors
      demonstrate on the model infection the mechanism by which after immunization the
      shift of infections to higher age groups occurs, and during introduction of the
      infection not only contact infections occur, but epidemic incidence develops. The
      restoration of some infections after years of elimination is to a restricted
      extent a natural phenomenon and does not imply failure of active immunization.

PMID- 8485776
TI  - [Neurilemmoma of the esophagus imitating carcinoma of the thyroid isthmus].
AB  - Fine needle aspiration cytology of a "stone hard" nodule in isthmic thyroid
      region of a 56-year old woman yielded unusual spindle and polyploid cells in a
      relatively monomorphic inflammatory background. Finding was suspicious of
      malignancy. Differential diagnosis of reparative inflammatory changes, anaplastic
      or medullary carcinoma was considered. During the operation a tight connection of
      the tumour with oesophageal wall as well as with thyroid was discovered. Biopsy
      proved the tumour to be a neurilemmoma originating in the oesophageal wall. Most
      of the tumour cells were S-100 protein positive. Comparison of the cytologic
      smears and biopsy slides proved the unusual cells to be of tumour origin.

PMID- 8485775
TI  - [Cytologic diagnosis of medullary carcinoma of the thyroid gland].
AB  - Over a five year period 50 malignant tumours (3.8% of investigations) has been
      histologically proved in a group of 1378 patients who underwent fine needle
      aspiration biopsy of thyroid. Five of these were medullary carcinomas (0.38% of
      investigation, 10% of malignancies). During revision and cytohistological
      correlation the most important cytologic diagnostic features for the sequential
      diagnosis of medullary carcinoma especially in cases without indicative clinical
      symptomatology have been checked. The following proved to be indicative
      especially if coinciding: a) background formed by blood with minimum or no
      colloid; b) clusters of epithelial cells with poor cohesion, sometimes
      multilayered, microfollicular, or stroma-like fusiform cells; c) striking
      anisocytosis, polygonal, plasmacytoid, fusiform, polyploid, and binucleated cells
      and naked nuclei in the background; d) striking anisokaryosis, at least part of
      the nuclei ovoid or elongated, chromatin rough, giant nuclei; e) amyloid
      identifiable in some tissue micro-fragments. If additional smears or cyto-block
      material are available it may be possible to establish the diagnosis at the
      cytology level using amyloid staining, argyrophilia test or immunohistochemistry.
      However if there is any cytological suspicion of medullary carcinoma, serum
      calcitonin should be investigated to confirm the preoperative diagnosis of
      medullary carcinoma enabling the patient to undergo one-step radical surgery.

PMID- 8485777
TI  - [Use of computer technology in a cytology center for screening of early forms of
      cervical carcinoma].
AB  - Programme setting using an actualized register of inhabitants was described. It
      has been serving in a cytocentre of the pathology department and for
      actualization of a district oncological register of patients suffering from
      cervical carcinoma.

PMID- 8485778
TI  - [Heterotopic ossification in endobronchial metastases of rectal adenocarcinoma].
AB  - An endobronchial metastasis of rectal carcinoma was found in a 62-year-old man
      three years after removal of the primary tumour. It imitated an aspirated foreign
      body and produced stromal foci of heterotopic ossification. Focal ossification
      was noticed in the revised primary tumour as well.

PMID- 8485779
TI  - [Mycoses of the heart].
AB  - There is an increasing frequency of heart mycoses. Authors identified 19 such
      cases between 1972 and 1991, 63% in the last 6 years (frequency was 0.1% in
      17.661 autopsies of patients over 7 days of life). Males prevailed (17:2). Yeasts
      of genus Candida dominated, unusual etiology represented Candida parapsilosis,
      Torulopsis candida and Aspergillus restrictus. Sampling from vegetations or
      abscesses was a prerequisite for positive autoptic cultivation. Probable source
      of infection was found in 12 patients and 5 of them had an infected thrombosis of
      venous catheter. Mycosepsis comprised nearly equal number of endocarditides
      (mostly left sided) and myocarditides. Spread of endocardial infection into
      myocardium was rare, most myocarditides resulted from disseminated infection in
      immunocompromised patients. Endocarditides mainly complicated surgical
      interventions.

PMID- 8485780
TI  - [Histological structure of the peniform clitoris in congenital adrenogenital
      syndrome].
AB  - Peniform clitoris in 50 girls suffering from congenital adrenogenital syndrome
      were subtotally removed at the age of 4-6 years and studied by biopsy. A corpus
      spongiosum more or less developed was found in all cases beneath the corpora
      cavernosa in the bottom part of corpus clitoridis, epithelial urethral rudiments
      represented by single or multiple short tubules with transitional epithelium and
      mucinous glands were found in 46 cases; they were localized in corpus spongiosum
      or close to it in loose connective tissue. Other urethral rudiments occurring in
      glans clitoridis were represented by long slight pegs of squamous epithelium
      extending into corpus spongiosum glandis. Control samples from 20 4-6-year-old
      girls who had deceased from tumours showed but once heterotopic epithelial
      urethral rudiments-tubules with transitional epithelium and mucinous glands.

PMID- 8485781
TI  - Diffuse sclerosing variant of papillary thyroid carcinoma.
AB  - Five cases of the diffuse sclerosing variant of papillary thyroid carcinoma
      (DSPC) were presented. The fifth case was discovered in a statistically not
      defined series of carcinomas of the thyroid gland. DSPC were found in 5.7% of 70
      cases of thyroid papillary carcinoma. All the cases described showed a similar
      histological picture. In the first case a "dominant nodule" was found.
      Immunohistologically B-cell markers were mostly proved on lymphocytes of the
      focal lymphocytic infiltration. Accumulation of Langerhans cells was present in
      the tumour foci. The finding of these cells is regarded as a sign of an enhanced
      immunological defense mechanism. The clinical follow-up interval of patients was
      3 to 9 years. Less favourable prognosis of DSPC as compared with classical
      papillary carcinomas could not be confirmed in this series.

PMID- 8485782
TI  - [Carcinoma of the thyroid with the so-called "tall cells"].
AB  - Two tall-cell tumours were found in a group of 70 papillary thyroid carcinomas.
      The tall cells were all over the first tumour whereas in the second case they
      represented more than 40% of tumour cells. Both patients were followed 8 and 7
      years respectively. Cervical lymph node metastases was mentioned in the clinical
      history of the first case. Biological behaviour of both tumours was not different
      at large from classical papillary carcinomas.

PMID- 8485783
TI  - Perturbation of the platelet plasma membrane is not sufficient for inhibition of
      thrombin-induced PKC-activity.
AB  - This work was carried out to decide whether a non-specific perturbation of the
      platelet membrane with exogenous amphiphiles affects protein phosphorylation in
      platelets, especially phosphorylation mediated by PKC. Effects of amphiphiles per
      se on protein phosphorylation were also recorded. (i) Sublytic concentrations of
      the differently charged model surfactants cetyltrimethylammonium bromide (CTAB),
      Zwittergent 3-16, sodium tetradecyl sulphate, and octaethyleneglycol hexadecyl
      ether, as well as chlorpromazine, and Triton X-100, did not affect the thrombin
      induced, PKC-mediated phosphorylation of pleckstrin, whereas sphingosine blocked
      this phosphorylation. (ii) The sphingosine-mediated phosphorylation blockade is
      not related to a non-specific perturbation of the membrane, but can instead be
      attributed to specific properties of sphingosine. (iii) The amphiphiles, per se,
      had differential effects on protein phosphorylation at sublytic concentrations: a
      treatment with CTAB, Zwittergent 3-16, and sodium tetradecyl sulphate for 1 min
      led to phosphorylation of a 49-kDa protein, while treatment with sphingosine for
      1 min led to a transient phosphorylation of the myosin light chain as well as a
      weak phosphorylation of pleckstrin.

PMID- 8485784
TI  - NO2-induced DNA single strand breaks are inhibited by antioxidative vitamins in
      V79 cells.
AB  - Recently, we were able to show that nitrogen dioxide (NO2), a strong oxidant,
      induced DNA single strand breaks (SSBs) in V79 cells. Possibly, special
      scavengers, e.g. antioxidative vitamins, may protect cells from NO2-induced
      damage. Therefore, the effect of various tocopherols, beta-carotene, retinol, and
      ascorbic acid on NO2-induced SSBs in V79 cells was investigated. Cells were
      preincubated with vitamins and treated for 10 min with 200 ppm NO2. The rate of
      SSBs was measured by the alkaline elution assay, the amount of DNA by a
      fluorimetric assay. Micromolar concentrations of d-gamma-tocopherol inhibited the
      rate of NO2-induced SSBs by 40%, beta-carotene and ascorbic acid by 25%. None of
      these vitamins had any effects on DNA or the viability of cells. When incubating
      the cells with retinol in a medium with pH 8.5, this vitamin inhibited NO2
      induced SSBs, reducing them by 35%. However, in high concentrations, retinol
      itself induced SSBs and influenced cell viability. The results are discussed with
      regard to many toxic effects of NO2.

PMID- 8485785
TI  - Differential phospholipid metabolism in rat aortic smooth muscle cells of varying
      proliferative potential upon long term exposure to phorbol 12-myristate 13
      acetate.
AB  - Subchronic exposure of rats to allylamine (AAM) modulates aortic smooth muscle
      cells (SMCs) from a quiescent to a proliferative phenotype. This response is
      associated with alterations in phospholipid metabolism and protein kinase C (PKC)
      activity. The present studies were conducted to evaluate the effects of long-term
      exposure to phorbol 12-myristate 13-acetate (PMA) on phospholipid metabolism in
      SMCs derived from control and AAM-treated animals, cells of varying proliferative
      potential. Measurements of 32P/[3H]myristic acid incorporation into parent
      phospholipids and phosphatidic acid (PA) and the extent of PKC-mediated histone
      phosphorylation were conducted following exposure of pre- and postconfluent
      subcultures of SMCs to PMA for 3 h. Increased 32P incorporation into
      phosphatidylcholine (PC) was observed in both pre- and postconfluent cultures of
      control and AAM cells treated with PMA relative to vehicle. This response was
      attenuated in pre- and postconfluent AAM cells relative to control counterparts.
      PMA enhanced 32P incorporation into phosphatidylinositol (PI) in preconfluent
      cultures of control cells, but decreased 32P incorporation in cultures of AAM
      cells relative to vehicle. A similar relationship was observed in the PI profile
      of postconfluent cultures. The alterations in primary phospholipid profiles
      induced by PMA correlated with the loss of PKC-mediated histone phosphorylation
      in the cytosolic and particulate fractions of both cell types. The pattern of 32P
      incorporation into PA, a phospholipid metabolite, paralleled that of PC in
      cultures of both cell types. In the presence of ethanol, vehicle-treated control
      and AAM cells exhibited a modest increase in phosphatidylethanol (PEt) formation,
      as measured by [3H]myristic acid incorporation. PMA enhanced PEt formation in
      control and AAM cultures, but selectively decreased [3H]myristic acid
      incorporation into PA in AAM cells. These data demonstrate that long-term PMA
      treatment differentially modulates phospholipid metabolism in aortic SMCs of
      varying proliferative potential. These alterations are associated with modulation
      of PLD-mediated hydrolysis of membrane phospholipids.

PMID- 8485786
TI  - Mechanism of genotoxicity and electron density distribution by NMR of 5-nitro-3
      thiophenecarboxamides, a novel group of direct-acting mutagens in Salmonella
      typhimurium.
AB  - The mutagenic activity of 23 5-nitro-3-thiophenecarboxanilides and of 5-nitro-3
      thiophenecarboxamide, the prototype, (NTCAs) have been evaluated in the Ames test
      on Salmonella typhimurium strains TA100 ad TA98 with and without metabolic
      activation. Effects of different substituents (electron-donating and electron
      withdrawing) were studied to evaluate structural features that affect the
      metabolism and the bacterial mutagenic potency. All the derivatives were direct
      acting mutagens, the mutagenic potency ranging from 0.7 to 142 revertants
      (rev.)/nmol in TA100 and from 0.09 to 68 rev./nmol in TA98 strain. Results
      obtained with strains TA98NR and TA98/1,8-DNP6 indicated that the mutagenic
      activity was largely dependent on bacterial nitroreductase, whereas the O
      acetylation step was not critical for mutagenic potency. Superoxide (O2-.) and
      hydroxyl (OH.) scavengers as well as other radical scavengers and enzymes
      inhibited NTCAs mutagenicity to different extents. In particular, O2-. seemed to
      be involved in NTCAs mutagenicity, showing a free radical pathway for NTCA
      metabolism. [1H]- and [13C]NMR data indicated that the effects of different
      substituents on genotoxicity are probably not exerted on the electron density
      distribution. The importance of factors such as extent of nitration, reduction
      potential, orientation of nitrosubstituent and planarity of the molecule are
      discussed.

PMID- 8485787
TI  - Monitoring the brain during cardiac surgery in children.

PMID- 8485788
TI  - Cerebral blood flow velocity patterns during cardiac surgery utilizing profound
      hypothermia with low-flow cardiopulmonary bypass or circulatory arrest in
      neonates and infants.
AB  - To examine the effects of low-flow cardiopulmonary bypass (CPB) and circulatory
      arrest (PHCA) on cerebral pressure-flow velocity relationships, we studied 32
      patients (< 9 mo of age) undergoing corrective cardiac procedures. Pressure-flow
      velocity relationships were studied during profound hypothermia (nasopharyngeal
      temperature < 20 degrees C). Cerebral blood-flow velocity (CBFV) was measured in
      the middle cerebral artery using transcranial Doppler sonography. The anterior
      fontanel pressure (AFP) was measured using an intracranial pressure monitor.
      Cerebral perfusion pressure (CPP) was calculated (mmHg) as mean arterial pressure
      (MAP) minus AFP. Nasopharyngeal temperature, PaCO2 and haematocrit were
      controlled during the study period. Alpha-stat acid-base management was employed.
      The CBFV measurements were made continuously over a range of CPP as pump flow (Q)
      was decreased to low-flow or to circulatory arrest and again during the
      subsequent increase in Q and CPP to normal. As Q and CPP were increased after a
      period of low-flow CPB during which period detectable CBFV was present, the CBFV
      was greater at any given CPP than prior to the low-flow state (P < 0.05).
      However, after PHCA a higher CPP (P < 0.05) was necessary to re-establish
      detectable CBFV and at any given CPP the CBFV was less than prior to PHCA (P <
      0.05). Seventeen patients underwent low-flow CPB during which CBFV became non
      detectable (7 +/- 1 cm.sec-1). In 12 of these patients the pattern of recovery of
      CBFV was the same as that observed after low-flow CPB whereas the remaining five
      (29%) demonstrated a pattern of recovery identical to the ones recorded after
      PHCA. We conclude that after PHCA a higher CPP is necessary to re-establish and
      maintain detectable CBFV. Furthermore, during low-flow CPB, patients where CBFV
      becomes non-detectable and show a pattern of CBFV recovery similar to PHCA,
      cessation of cerebral perfusion must be considered.

PMID- 8485789
TI  - A comparison of epidural tramadol and epidural morphine for postoperative
      analgesia.
AB  - The present study compared epidural tramadol with epidural morphine for
      postoperative analgesia in 20 patients undergoing major abdominal surgery.
      Intraoperatively, the patients were anaesthetized by a balanced technique of
      general anaesthesia combined with lumbar epidural lidocaine. In ten of the
      patients 100 mg tramadol diluted in 10 ml normal saline was also injected
      epidurally, while 4 mg epidural morphine was used in the other ten patients. In
      all patients, the visual analogue pain score, PaO2, PaCO2 and respiratory rate
      were monitored every hour for the first 24 hr postoperatively. In both the
      tramadol and morphine groups, the mean hourly pain scores ranged from 0.2 +/- 0.6
      to 1.4 +/- 2.5 throughout the period of observations. However, the mean PaO2 was
      decreased postoperatively in the epidural morphine group, while no change was
      observed in the epidural tramadol group. The maximal decrease of PaO2 in the
      epidural morphine group was observed at the tenth hour postoperatively, when it
      decreased to 72.8 +/- 10.3 mmHg. This was not associated with any increase in
      PaCO2 or a decrease of respiratory rate, suggesting that hypoxaemia rather than
      hypercarbia or decreased respiratory rate may be an earlier indicator of
      respiratory rate, suggesting that hypoxaemia rather than hypercarbia or decreased
      respiratory rate may be an earlier indicator of respiratory depression in
      patients breathing room air without oxygen supplementation. The absence of
      clinically relevant respiratory depression following epidural tramadol compared
      with epidural morphine may be attributed to the different mechanisms of their
      analgesic action. The results suggest that epidural tramadol can be used to
      provide prolonged postoperative analgesia without serious side effects.

PMID- 8485790
TI  - Epidural anaesthesia and analgesia do not affect energy expenditure after major
      abdominal surgery.
AB  - Our objective was to determine the effect of perioperative epidural anaesthesia
      and analgesia on the increase in energy expenditure which accompanies major
      elective abdominal surgery in a prospective, randomized study. Eight patients
      undergoing elective resections of the colon and/or rectum received general
      anaesthesia alone (nitrous oxide, oxygen, and isoflurane, supplemented with
      intravenous fentanyl to a maximum of 10 micrograms.kg-1), and 12 patients
      received perioperative epidural anaesthesia and analgesia using lidocaine
      (carbonated lidocaine 2% with epinephrine 1:200,000, 20 ml over 30 min) and
      morphine (preservative-free morphine 0.10 mg.kg-1 after catheter insertion and
      0.05 to 0.10 mg.kg-1 every 12 hr as needed until the morning following surgery)
      via a lower lumbar catheter in addition to general anaesthesia. Respiratory gas
      exchange was measured using a metabolic cart and canopy system early on the
      morning of surgery, six hours postoperatively, and on the first and second
      postoperative mornings. Parenteral analgesic administration (P < 0.001) and
      visual analogue pain scores (P < 0.05) were lower in the patients receiving
      epidural anaesthesia and time to first parenteral analgesia was longer (P <
      0.005). Oxygen consumption, carbon dioxide production, and energy expenditure
      increased after surgery (all P < 0.001) but were very similar in the two groups
      (all P > or = 0.8) before and after surgery. Despite substantial effects on
      postoperative pain, we conclude that oxygen consumption and energy expenditure
      following major abdominal surgery are not diminished by perioperative epidural
      anaesthesia and analgesia.

PMID- 8485791
TI  - Aortocaval compression in the sitting and lateral decubitus positions during
      extradural catheter placement in the parturient.
AB  - We prospectively studied the incidence of concealed aortocaval compression in
      parturients at term during identification of the extradural space. Forty ASA I or
      II parturients, at term and in active labour, who requested extradural analgesia
      were randomly allocated to one of two groups. Parturients in the first group (n =
      22) were positioned in the left lateral decubitus position and those in the
      second group (n = 18) were in the sitting position. Cardiac output (CO) was
      recorded at one-minute intervals for five minutes before extradural catheter
      placement (supine position with a 15 degrees wedge under the right side), and
      during and thereafter for five minutes (in the supine wedged position), using the
      BoMED NCCOM3-R7 thoracic electrical bioimpedance (TEB) monitor. The average of
      five COTEB recordings before positioning the patient were compared with the
      average of five COTEB measurements during and after extradural space
      identification. A change of > 25% COTEB was considered beyond machine
      variability. Upper limb arterial pressure was recorded at one-minute intervals.
      In the left lateral decubitus position, 17 of 22 patients demonstrated a > 25%
      reduction in COTEB compared with five of 18 patients in the sitting position (chi
      2, P < 0.01). The percentage change in COTEB in the lateral decubitus position (
      29.8%, 95% CI -17% to -44%) was greater than the sitting position (-9.8%, 95% CI
      +36% to -32%) (P < 0.01). A decreased incidence of aortocaval compression during
      identification of the extradural space was demonstrated in the sitting position
      when compared with the left lateral decubitus position.

PMID- 8485792
TI  - Perioperative gastric aspiration increases postoperative nausea and vomiting in
      outpatients.
AB  - The efficacy of aspiration of gastric contents to reduce postoperative nausea and
      vomiting was investigated in a controlled randomized, double-blind study of 265
      outpatients. Patients in the treated group had their stomachs aspirated with an
      orogastric tube. In the control group no tube was inserted. Data on the incidence
      of nausea and vomiting were collected in the recovery room, the day surgery unit
      and the day after surgery. The overall incidence of postoperative nausea and
      vomiting was comparable in the two groups. It was also comparable in the recovery
      room and the day surgery unit. However, treated patients had a higher incidence
      of both nausea (26.5% vs 12.0%, P < 0.005) and vomiting (16.7% vs 6.8%, P < 0.02)
      after their discharge from the day surgery unit. We conclude that aspiration of
      gastric contents with an orogastric tube does not decrease postoperative nausea
      and vomiting in outpatients and may increase it after discharge of the patient.

PMID- 8485793
TI  - Nifedipine attenuates the hypertensive response to tracheal intubation in
      pregnancy-induced hypertension.
AB  - Thirty women with pregnancy-induced hypertension (PIH) scheduled for Caesarean
      section under general anaesthesia were studied to evaluate the efficacy of
      sublingual nifedipine in attenuating the pressor response to laryngoscopy and
      tracheal intubation. The patients were randomly given either the contents of a
      nifedipine capsule 10 mg or placebo sublingually 20 min before induction of
      anaesthesia. Blood pressure and heart rate were recorded at various time
      intervals. There was a decrease in mean arterial blood pressure (MAP) after
      pretreatment with nifedipine (P < 0.01). The increase in MAP during laryngoscopy
      and intubation was higher in the control group compared with nifedipine
      pretreatment group (P < 0.01). During laryngoscopy and intubation, MAP decreased
      by 3 mmHg in the nifedipine pretreatment group, while there was an increase of 14
      mmHg in the control group. Heart rate increased in both the groups during the
      laryngoscopy and tracheal intubation (P < 0.01) but the increase was higher in
      the nifedipine group than in the control group (P < 0.05). Neonatal Apgar scores
      in both the groups were comparable. These results suggest that sublingual
      nifedipine is effective in attenuating the hypertensive response to laryngoscopy
      and intubation but not the tachycardiac response in parturients with PIH.

PMID- 8485794
TI  - Spinal subdural haematoma in a parturient after attempted epidural anaesthesia.
AB  - We report a case of spinal subdural haematoma with neurological deficit in a 36
      yr-old woman following Caesarean section for severe preeclampsia and placental
      abruption. She had been taking chronic trifluoperazine treatment for depression.
      Her activated partial thromboplastin time (aPTT) was 49 sec (normal = 26-36) but
      all other tests of coagulation were normal. Epidural anaesthesia was attempted
      but, despite a negative test dose, injection of local anaesthetic resulted in a
      generalized seizure and general anaesthesia was induced. Seventy-two hours after
      delivery, she was found to have bilateral leg weakness, urinary incontinence,
      absent rectal sphincter tone and asymmetrical leg reflexes. The diagnosis of
      spinal haematoma  was confirmed by magnetic resonance imaging. She underwent
      emergency laminectomy and made a full neurological recovery.

PMID- 8485795
TI  - The obstetrical anaesthesia assessment clinic: a review of six years experience.
AB  - We reviewed the out-patient consultation notes of 136 pregnant women seen at the
      Ottawa Civic Hospital from 1985 to 1991 to evaluate the efficacy of an Obstetric
      Anaesthesia Assessment Clinic (OAC). In addition, their anaesthetic records from
      labour and delivery were reviewed. For each patient the reason for referral was
      recorded according to the involved organ system. The anaesthetic management at
      delivery was compared with the proposed anaesthetic plan by the OAC consultant
      (obstetric anaesthetist). The majority of women 84 (62%) had complaints related
      to the musculo-skeletal system. In addition, 18 patients were referred because of
      previous anaesthetic problems, ten with a history of cardiac disease, and eight
      with neurological disease. Lumbar epidural analgesia (LEA) was a safe and
      effective choice for parturients with low back pain, history of lumbar fractures
      or single level discectomies without lumbar fusion. Parturients with posterior
      instrumentation experienced an increased incidence of inadequate pain relief from
      LEA. Individualized anaesthetic management plans were executed for parturients
      with spina bifida occulta, neurological, cardiac, and haematological disease as
      well as for women, with a history of adverse drug reactions and previous problems
      with regional or general anaesthesia. It is concluded that the OAC has provided a
      valuable service to obstetricians and anaesthetists for the anaesthetic
      management of pregnant women with co-existing disease. The OAC gave an
      opportunity for patient education regarding anaesthetic options for labour and
      delivery. The attending anaesthetist was provided with a risk assessment and
      anaesthetic management plan which was adhered to with only two exceptions.
      Finally, the obstetrician was given consistent advice regarding anaesthesia
      management that may affect obstetrical decisions.

PMID- 8485796
TI  - The laryngeal mask airway and prolonged balanced regional anaesthesia.
AB  - The purpose of this paper is to report an eight-hour operation in which
      anaesthesia was provided by a combination of continuous epidural analgesia and
      light general anaesthesia administered via a laryngeal mask. During the
      perioperative period, the respiratory system was monitored with arterial blood
      gas and thoraco-abdominal movement analyses. There was no deterioration in
      respiratory function nor evidence of respiratory fatigue. We suggest that this is
      a suitable technique in fasting healthy patients undergoing prolonged surgery to
      the extremities.

PMID- 8485797
TI  - Harold Griffith Memorial Lecture. The Griffith legacy.
AB  - 1992 was the anniversary of Crawford Long's use of ether in 1842, and Griffith
      and Johnson's introduction of Intocostrin into anaesthetic practice in 1942.
      Harold Randall Griffith was born in Montreal in 1894 and died in 1985. He
      interrupted his medical studies to serve in the first world war and was awarded
      the Military Medal for gallantry at the battle of Vimy Ridge. Griffith qualified
      from McGill University in 1922. After spending a year studying homoeopathic
      medicine, he joined his father's general practice and became the anaesthetist to
      the Homoeopathic Hospital in Montreal. He succeeded his father as Medical
      Director of the hospital (now renamed the Queen Elizabeth Hospital) in 1936 and
      retired in 1966. Griffith was a superb clinical anaesthetist. He was an early
      advocate of detailed anaesthetic records, and was responsible for the
      introduction of both ethylene and cyclopropane into Canadian practice, later
      teaching himself to intubate under these two agents. Griffith was one of the
      first to be concerned with standards of patient care. He introduced postoperative
      recovery and intensive care units into Canadian practice and played a major role
      in postgraduate teaching. He was unstinting in his support of organisations
      designed to further the progress of anaesthesia and was the first President of
      the Canadian Anaesthetist's Society. He was one of those responsible for
      inaugurating the World Federation of Societies of Anaesthesiology and was
      President of the First World Congress of Anaesthesiology in 1955. It is
      remarkable that the introduction of curare into anaesthetic practice was delayed
      until 1942, since curare had been used in anaesthesia some 30 years previously.
      However, it was probably Griffith's confidence in his own clinical abilities
      which enabled him to seize the opportunity when it was offered.

PMID- 8485798
TI  - Liquid crystal skin thermometry: an accurate reflection of core temperature?
AB  - Oesophageal, rectal, bladder, tympanic and pulmonary artery sites are used
      intraoperatively to measure body temperature. However, the temperatures measured
      at each site have different physiological and practical importance. The present
      two-part study sought to compare liquid crystal (CR) skin temperature with other
      temperature monitors which are used routinely during surgery. The first part
      compared CR with oesophageal (OS) temperature during general inhalational
      anaesthesia. The second part compared CR with OS, pulmonary artery (PA), and
      bladder (BL) temperatures during the periods of rapid temperature change
      associated with cardiopulmonary bypass (CPB). During the first part, the mean
      difference between OS and CR was -0.14 +/- 0.85 degrees C; this difference
      remained consistent over time (P < 0.05 by repeated measures analysis of
      variance). During the second part, the difference in temperature readings between
      CR and each of the other monitors remained consistent except for CR vs PA and CR
      vs OS during the cooling period of CPB, when the iced cardioplegia slush directly
      affected the PA and OS temperatures. This study suggests that CR, an inexpensive
      and noninvasive means of temperature monitoring, reflects trends in temperature
      changes in the clinical setting.

PMID- 8485799
TI  - Delivery of constant air-oxygen mixtures using a closed circle absorber system.
AB  - The aim of this study was to devise and validate a technique to deliver constant
      air-oxygen mixtures from a standard anaesthetic machine using only oxygen as the
      compressed gas source. The common gas outlet was modified to allow measured
      quantities of ambient air to be insufflated via a three-way attachment into a
      closed circle absorber system with a double-circuit collapsible bellows
      ventilator. During positive pressure ventilation, leakages of between 50-150
      ml.min-1 occur from the circuit and nomograms of the minimal air and oxygen flow
      rates needed to maintain constant oxygen concentrations in the presence of the
      leaks were then mathematically derived. The accuracy of the nomograms was tested
      on three different anaesthetic machines using test lung models. There were no
      differences observed among the mean oxygen concentrations using the three
      machines. Pooled mean values (SD) of 30.65% (0.77), 51.07% (1.04) and 70.4%
      (0.73) were obtained for predicted inspired concentrations of 30, 50 and 70%
      respectively. Next, the technique was studied on 18 patients who underwent
      isoflurane or propofol anaesthesia (duration 40-210 min) for various surgical
      procedures. Pooled mean values (SD) obtained were 29.3% (1.86), 40.95% (1.65) and
      50.06% (1.41) respectively for predicted oxygen concentrations of 30, 40 and 50%
      respectively. We conclude that this technique can be used to deliver constant air
      oxygen mixtures accurately during inhalational or total intravenous anaesthesia
      when N2O is contraindicated but a source of compressed air is not readily
      available.

PMID- 8485800
TI  - Assessment of the arterial tonometer (N-CAT) for the continuous blood pressure
      measurement in rapid atrial fibrillation.
AB  - The N-CAT is a newly developed arterial tonometer (TBP) able to determine
      systolic, diastolic and mean arterial blood pressures continuously and
      noninvasively. The aim of this study was to evaluate the accuracy and reliability
      of TBP relative to directly measured invasive blood pressure (IBP) in ten
      haemodynamically stable postoperative cardiac patients who were in rapid atrial
      fibrillation (HR > or = 100 bpm). There were differences between TBP and IBP for
      systolic (-1.7 mmHg) and diastolic (+0.9 mmHg) values but not for the mean
      arterial blood pressures. The N-CAT was able to follow blood pressure changes
      closely and demonstrated an average systolic, diastolic and mean bias (+/-SD) of 
      1.71 +/- 4.6, 0.99 +/- 4.6 and 0.33 +/- 4.2 mmHg, respectively. Although these
      biases are within the required standards for equivalency for noninvasive blood
      pressure to invasively determined blood pressure, approximately 20% of the
      readings were > +/- 10 mmHg while only 5% were > +/- 20 mmHg. Moreover, there
      were occasional discrepancies of sufficient magnitude and duration which may
      limit the clinical usefulness of the N-CAT in patients in whom continuous and
      accurate blood pressure measurement is required.

PMID- 8485801
TI  - LMA and respiratory arrest after anterior cervical fusion.

PMID- 8485802
TI  - Rubber and plastic endotracheal tube cuffs are highly vulnerable to the CO2
      laser.

PMID- 8485803
TI  - Exposure to N2O.

PMID- 8485804
TI  - Portex epidural catheters.

PMID- 8485805
TI  - Identification of serum components that inhibit the tumoricidal activity of
      amphiphilic alpha helical peptides.
AB  - Antimicrobial peptides that can form amphiphilic alpha helices were tested for
      their ability to lyse various human tumor cell lines in vitro. These peptides
      include C18G, whose sequence is a derivative of the carboxyl terminus of human
      platelet factor IV, and 399, an idealized amphiphilic alpha helix. Both peptides
      exhibited potent antitumor activity against all cell lines tested, unlike
      magainin 2, a naturally occurring antimicrobial peptide of similar structure,
      which was relatively inactive under the same conditions. Also, the lytic activity
      of C18G is specific for tumor cells versus human red blood cells. The effects of
      serum can be important when evaluating the potency of lytic peptides, since other
      tumoricidal peptides have been shown to be completely inactivated by low serum
      levels. Experiments with C18G and 399 revealed that their activity was indeed
      reduced in the presence of human serum, but that significant lytic activity
      remained even at relatively high serum concentrations. Various serum components
      were tested for their inhibitory activity. Whereas albumin and high-density
      lipoprotein had only slight inhibitory properties, low-density lipoprotein was
      found to be a potent inhibitor of peptide-mediated cell lysis. The peptide 399,
      which is more sensitive to serum inhibition than C18G, also binds more
      extensively to all serum components tested.

PMID- 8485806
TI  - The antitumor activity of the platinum complex D-17872 is associated with tumor
      cell differentiation.
AB  - The novel cisplatin analogue D-17872 was studied for its anticancer activity
      using in vivo and in vitro preclinical models. The compound at the sublethal dose
      of 215 mg/kg (ca. 50% of the approximate LD50) induced no nephrotoxic effect
      strong enough to increase the blood urea level in rats. It had good in vivo
      antitumor efficacy against murine P388 (max. ILS: D-17872 132%, cisplatin 55%)
      and L1210 leukemia (max. ILS: D-17872 43%, cisplatin 38%), L5222 leukemia of the
      rat (max. ILS: D-17872 163%, cisplatin 163%) and murine B16 melanoma. Activity
      against P388 leukemia substantially exceeded that of cisplatin. Moreover, the
      M5076 reticulum cell sarcoma implanted into the subrenal capsule and the DMBA
      induced mammary tumor of the rat were inhibited by D-17872 to a greater extent
      than by cisplatin (min. T/C: D-17872 -3%, cisplatin 11%). Using clonogenic
      microassays, D-17872 was active in vitro against a variety of human and rodent
      tumor cell lines, albeit at higher concentrations than cisplatin (IC50 values: D
      17872 2.6-12.7 mumol/l, cisplatin 0.13-0.42 mumol/l). Apart from its cytotoxic
      action it was able to induce in vitro differentiation of the human HL-60 and K562
      and of the murine M1-T22 cell lines, while cisplatin induced differentiation only
      in the HL-60 cell line. Thus D-17872 exhibited a pharmacological and
      toxicological profile different from that of the parent compound. The results
      suggest that induction of differentiation contributes to the antineoplastic
      efficacy of this novel cisplatin derivative.

PMID- 8485807
TI  - L-asparaginase kills lymphoma cells by apoptosis.
AB  - Microscopic examination of histological sections of lymph nodes from a canine
      case of malignant lymphoma at 4 h after treatment with L-asparaginase revealed
      massive destruction of neoplastic cells by what was consistent with apoptosis
      morphologically. Apoptosis as the mode of cell death after asparaginase treatment
      was confirmed in a mouse lymphoma cell line (LY-TH) by the characteristic
      fragmentation of DNA into oligonucleosome-sized pieces and by the morphological
      changes consistent with apoptosis following treatment in vitro. Applied to these
      cells, asparaginase was found to be most cytotoxic over the range of 1-10 IU/ml.
      Even after 4 h of asparaginase treatment at 100 IU/ml, protein synthesis was
      reduced by only one-half, yet DNA fragmentation reached 40%. Other agents that
      affect protein synthesis (cycloheximide and actinomycin D) caused apoptosis as
      well; however, agents (radiation, prednisolone, and VP-16) whose mechanisms are
      different from inhibition of protein synthesis also caused apoptosis. As such, it
      seems unlikely that protein depletion per se and/or the elimination of specific
      short-lived proteins is the triggering event that leads to cell death. It is more
      likely that the suspension of cellular proliferation commits cells to apoptosis
      after asparaginase treatment.

PMID- 8485808
TI  - Gas-chromatographic analysis of busulfan for therapeutic drug monitoring.
AB  - The development and validation of a gas chromatographic assay method for
      determination of total and free busulfan concentrations in human plasma for
      pharmacokinetic studies is reported. 1,6-Bis(methanesulfonyloxy)hexane, the
      internal standard, and a potential metabolite, 3-hydroxysulfolane, were
      synthesized. Plasma and plasma ultrafiltrate samples containing busulfan and
      internal standard were extracted with ethyl acetate and derivatized with 2,3,5,6
      tetrafluorothiophenol prior to gas chromatographic determination. The 63Ni
      electron-capture detector provided a limit of detection of 0.0600 microgram/ml
      with a limit of quantitation of 0.100 microgram/ml busulfan in biological
      samples. Calibration curves were linear from 0.100 to 3.00 micrograms/ml in
      plasma (500 microliters) and 0.100 to 2.00 micrograms/ml in plasma ultrafiltrate
      (100 microliters). Extraction and derivatization yields ranged from 78.4% to
      89.6% and 56.0% to 71.3%, respectively. Specificity of this assay for busulfan in
      the presence of its potential metabolites was demonstrated. Also, plasma samples
      containing co-administered drugs gave no response under these conditions.
      Clinical samples obtained following administration of a 1 mg/kg oral busulfan
      dose demonstrate the applicability of this method to analysis of total and free
      plasma concentrations.

PMID- 8485809
TI  - Disposition and metabolism of KW-2149, a novel anticancer agent.
AB  - KW-2149 is a new derivative of mitomycin C (MMC). The plasma concentrations,
      distribution, metabolism, and excretion of [3H]-KW-2149 in normal and tumor
      bearing mice after i.v. administration of 16.6 mg/kg were investigated. The
      plasma radioactivity decreased biexponentially after i.v. administration in
      normal mice. However, the unchanged drug disappeared rapidly, showing a half-life
      (t1/2) of 9.7 min, which was shorter than MMC's (18 min). The radioactivity was
      excreted in mouse urine (33%) and feces (58%) within 144 h. High radioactivity
      was distributed in the gallbladder, liver, kidney, pancreas, and lung at 1 h
      after i.v. administration to normal mice. The tumor concentration was lower than
      the plasma or blood concentration. The lowest radioactivity was observed in the
      brain. The metabolic rate of KW-2149 was very rapid. The methyl sulfide form (M
      16), the symmetrical disulfide dimer (M-18), and the albumin conjugate were
      detected in plasma, which possessed anticellular activity. The specific
      anticellular activity of these compounds against uterine carcinoma (HeLa S3) was
      1/100, 1, and 1/20 respectively, as compared with that of KW-2149.

PMID- 8485810
TI  - The comparative disposition of the pyrolloquinone GR63178A and its 9-hydroxy
      metabolite GR54374X in sensitive and resistant mouse colon adenocarcinoma.
AB  - The novel anticancer compound GR63178A is being evaluated in the clinic, having
      demonstrated activity against a wide range of experimental tumour systems in
      animals without significant toxic side-effects being apparent. In this work, we
      have demonstrated significant antitumour action of this compound against one
      murine colon cancer model (colon 38 tumour in BDF-1 mice, specific growth delay =
      1.2) when given at 10 mg/kg over 21 consecutive days and in contrast shown
      minimal sensitivity of another similar murine colon adenocarcinoma, MAC 26, in
      NMRI mice with the same dose regime. We investigated the disposition of both the
      parent drug and the 9-OH metabolite (GR54374X) in plasma, tissues and tumours,
      using solid phase extraction followed by reversed-phase high performance liquid
      chromatography. Although plasma clearance profiles of GR63178A were similar,
      significant differences were seen in the disposition of the drug to major organs
      in two mouse strains. Noteably, the liver and kidneys of the sensitive model had
      higher levels of parent drug and 9-OH metabolite at both 30 min and 4 h post
      injection. However, this was not apparent in the tumours themselves, and the
      levels of 9-OH metabolite were lower in the plasma and higher in the urine of the
      sensitive mice, indicating possible rapid renal clearance of this compound.
      Neither GR63178A nor GR54374X proved cytotoxic in in vitro experiments. The data
      presented here have revealed considerable variation in drug handling by these two
      mouse strains, but this did not produce different levels of either parent drug or
      GR54374X in the tumours, which are the presumed targets, suggesting that
      differences in disposition are probably not responsible for the different
      sensitivities of the two tumours. Other possible explanations include the
      production of a hitherto undetected ultimate cytotoxic metabolite in the
      sensitive, but not in the resistant, mouse/tumour combination, or differences in
      inherent tumour sensitivity, or in host-mediated effects. These possibilities are
      discussed.

PMID- 8485811
TI  - New drug design and development in cancer: present status and future
      perspectives.

PMID- 8485812
TI  - Role of DNA repair in the mechanisms of cell resistance to alkylating agents and
      cisplatin.

PMID- 8485813
TI  - Alkylphosphocholines: a new class of membrane-active anticancer agents.

PMID- 8485814
TI  - Use of pharmacokinetic-pharmacodynamic relationships in the development of new
      anthracyclines.

PMID- 8485815
TI  - Granulocytes of critically ill patients spontaneously express the 72 kD heat
      shock protein.
AB  - Polymorphonuclear neutrophils (PMN), through their ability to release oxygen-free
      radicals and other tissue-damaging molecules, play a major role in the
      pathogenesis of multiple organ failure syndrome (MOFS). There is evidence that
      heat shock proteins (stress proteins; HSPs) are involved in cellular repair
      mechanisms, and are protecting cells against oxidative injury. In this study, we
      analyzed the spontaneous expression of the 72 kD HSP (HSP72) in peripheral blood
      PMN of 20 critically ill patients (16 polytrauma victims, four patients after
      major surgery) admitted to an intensive care unit. The expression of HSP72 was
      investigated in PMN of patients and healthy donors by immunohistochemistry. We
      found spontaneous expression of HSP72 in PMN of 12 (60%) of 20 patients. No
      specific staining was detected in PMN of healthy donors (n = 10). In PMN of six
      of 12 patients expressing HSP72 without previous heat treatment, we found an
      impairment of respiratory burst activity (RBA) compared to the control
      population. These results demonstrate for the first time the in vivo expression
      of HSP72 in human leukocytes without previous heat treatment, and suggest a
      possible role of this protein in patients suffering from severe tissue injury.

PMID- 8485816
TI  - Vasodilating prostaglandin E1 decreases critical oxygen delivery by increasing
      critical oxygen extraction in anesthetized pigs.
AB  - The abnormal dependence of O2 uptake (VO2) on O2 delivery (QO2) during severe
      sepsis, and the adult respiratory distress syndrome (ARDS) may be caused by
      impaired vascular reactivity, following release of vasodilating prostaglandins.
      Infusion of these compounds, however, may improve tissue oxygenation. We studied
      the effect of vasodilating prostaglandin E1 (PGE1; 0.2 microgram/kg/min) on the
      critical O2 extraction ratio (ERO2c) and the critical QO2 (QO2c) in a saline
      controlled, crossover study in 12 barbiturate-anesthetized pigs. QO2, VO2
      (independently from QO2), and blood lactate concentrations were measured during
      graded cardiac output reductions by incremental positive end-expiratory pressure
      (0-20 cm H2O PEEP, raised by 5 cm H2O at 15 min intervals). At 0 cm H2O PEEP,
      PGE1 decreased arterial blood pressure, mainly due to a fall in systemic vascular
      resistance. From 0 to 20 cm H2O PEEP, the fall in QO2 was greater in the PGE1
      than in the saline series (P < 0.005), since ventricular filling and the rise in
      heart rate were less in the former. The decrease in VO2 (P < 0.005) did not
      differ between series. As estimated from bilinear regression on paired VO2/QO2
      data in individual pigs, the QO2c was 9.8 +/- 3.6 (mean +/- SD) during PGE1 and
      14.6 +/- 3.8 ml/kg/min during saline infusion (P = 0.008), with ERO2c 68% +/- 16%
      and 48% +/- 12%, respectively (P < 0.005). The QO2c, estimated from bilinear
      regression on paired lactate/QO2 data during the first treatment period, was 7.1
      +/- 1.2 for PGE1 and 12.8 +/- 4.5 ml/kg/min for saline (P < 0.05), at similar
      lactate concentrations (2.0 +/- 0.5 and 1.7 +/- 0.5 mmol/liter, respectively).
      PGE1-induced vasodilation thus decreases QO2c, because of increased ERO2c,
      probably resulting from capillary recruitment, an increased surface area
      available for O2 exchange, and decreased O2 diffusion distances. Hence, a reduced
      ERO2 and abnormal supply dependence of VO2 during severe sepsis and ARDS are not
      caused by release of vasodilating prostaglandins. In contrast, our results partly
      explain improved tissue oxygenation with these compounds during abnormal VO2
      supply dependence, following sepsis and ARDS.

PMID- 8485817
TI  - Gut bacterial translocation/dissemination explains the increased mortality
      produced by parenteral nutrition following methotrexate.
AB  - Mortality is reported to be higher in methotrexate (MTX)-treated animals
      receiving total parenteral nutrition (TPN), compared to animals receiving enteral
      nutrition. The increased mortality is felt to be related to gut atrophy and
      bacterial translocation. In this study, we examined the effect of MTX (30 mg/kg)
      on survival, body weight loss, gut mass, and gut bacterial translocation in rats
      randomized to TPN or enteral nutrition. Twenty-four male Sprague-Dawley rats (n =
      8 per group) were randomized to TPN, a peptide-based enteral diet (PEP), or CHOW.
      Animals were weighed daily and followed for survival (6 days). A separate group
      of rats (n = 6 per group) were similarly randomized and sacrificed at 3 days.
      Mesenteric lymph node complex, liver, spleen, lung, and blood were cultured for
      translocating bacteria. Body weight loss was similar in all groups (12.0-16.9
      g/day). Mortality was significantly (P < 0.05) higher in the TPN animals (100%),
      compared to PEP (50%) and CHOW (25%) fed animals. All tissues in the TPN animals
      contained large quantities of bacteria, while most tissues in the CHOW group were
      free of bacteria. Bacterial counts in the PEP tissues were intermediate between
      TPN and CHOW. There were no significant differences between groups for gut
      weights or mucosal protein content. This study supports a direct relationship
      between bacterial translocation and mortality in rats following MTX.

PMID- 8485818
TI  - Relative contribution of renal nerve and adrenal gland to renal vascular tone
      during prolonged canine hemorrhagic hypotension.
AB  - This study was designed to determine roles of renal sympathetic nerve activity
      (RNA) and adrenal catecholamines in the changes of renal vascular resistance
      during prolonged hemorrhagic shock in anesthetized dogs. In animals with intact
      baroreceptors, hemorrhagic hypotension (40 mm Hg) caused RNA to increase
      significantly within 1 min after bleeding, followed by a return to baseline
      within 10 min. Thereafter, a secondary increase in RNA occurred that was followed
      by a gradual decline towards the baseline level. The renal perfusion pressure
      (RPP) showed a progressive and significant increase until the end of the
      experiment. The initial increase in RNA was abolished by complete denervation of
      the systemic baroreceptors. The initial increase in RPP, which was observed
      within 10 min after bleeding in animals with intact baroreceptors, was attenuated
      by the denervation. In animals with bilateral adrenalectomy, RPP still showed an
      initial increase, but the progressive increase throughout the entire experimental
      period did not occur. In animals with baroreceptor denervation and bilateral
      adrenalectomy, RPP did not show any significant changes during the experiment.
      These results indicate that the initial renal vasoconstrictive response to
      hemorrhage is regulated by a reflex sympathetic mechanism. In contrast, a late
      renal vasoconstriction during hemorrhagic hypotension is predominantly evoked by
      humoral substances such as adrenal catecholamines.

PMID- 8485819
TI  - Tumor necrosis factor depresses gut absorptive function.
AB  - Although recent studies have shown that gut absorptive function is significantly
      depressed even in the early hyperdynamic phase of sepsis, the mechanism
      responsible for this is unknown. Tumor necrosis factor (TNF-alpha) is a potent
      mediator of shock resulting in a marked inflammatory response leading to mucosal
      erosions of the gut and multiple organ failure. Although TNF is elevated in early
      sepsis, it remains unknown whether TNF plays any role in the depression of gut
      absorptive function under these conditions. To study this, we used the 1 hr D
      xylose absorption test. C3H/HeN mice (n = 12) were lightly anesthetized, and a
      femoral artery and the portal vein were cannulated. After recovery from
      anesthesia, 125 micrograms recombinant murine TNF-alpha (rMuTNF-alpha)/kg body
      weight was given via the tail vein to one group of animals, while another group
      received an equivalent volume of saline (sham). One hour later, D-xylose was
      given orally. The systemic blood pressure was recorded 1 hr thereafter and D
      xylose concentration in a sample of portal blood was determined colorimetrically.
      Results show that, while the systemic pressure was elevated 2 hr after
      administration of rMuTNF-alpha, D-xylose absorption was severely depressed. Thus
      the depressed gut absorptive function seen in the early stage of sepsis may be
      mediated directly or indirectly by TNF-alpha.

PMID- 8485820
TI  - Analysis of endotoxin effects on pulmonary circulation in terms of pressure-flow
      characteristics.
AB  - The purpose of the present work was to explore the hypothesis that pulmonary
      vasoconstriction secondary to endotoxin insult results mainly from an increase in
      the critical closing pressure of the pulmonary vessels. Specifically, we reasoned
      that in the face of a Starling resistor located between pulmonary arteries and
      left atrium, upstream transmission of increased left atrial pressure (Pla) would
      be inversely related to the level of the pressure intercept (Pi) obtained by
      extrapolation from the linear pulmonary arterial pressure (Ppa)--flow (Q degrees)
      plot. Six dogs (group E) were infused with Escherichia coli endotoxin (0.25
      microgram/kg/min) for 2 hr, whereas six additional dogs (group C) served as
      control. During baseline conditions, Pi approximated LAP in both groups. In group
      C dogs, increasing LAP at constant Q degrees led to a proportional augmentation
      of Ppa. In group E dogs, endotoxin resulted in a shift of the Ppa-Q relationships
      to higher pressures due to both increases in Pi and slope. In addition, changes
      in Pla over the same range as in control dogs affected Ppa only at the highest
      levels of Pla. We conclude that endotoxin insult increases the critical closing
      pressure that exceeds Pla and induces the occurrence of a Starling resistor
      responsible for the production of an effective vascular waterfall.

PMID- 8485821
TI  - Potentiation of decreased pyruvate dehydrogenase activity by inflammatory stimuli
      in sepsis.
AB  - The effect of inflammation and chronic sepsis on the activity of pyruvate
      dehydrogenase complex (PDH) in skeletal muscle was investigated in rats.
      Inflammation was induced by the placement of a catheter in the carotid artery.
      Sepsis was induced by repeated (every 48 hr) injections of an inoculum composed
      of Staphylococcus aureus, Escherichia coli, and Bacteroides fragilis organisms
      into a preformed subcutaneous abscess. Hindlimb muscle was sampled 7 or 14 days
      following the initial injection of the inoculum into the abscess. Total PHD
      activity was not altered by any of the conditions examined. There were no
      differences in the proportion of active PDH complex after 7 days in any of the
      conditions examined. In contrast, 14 days after the initial bacterial injection,
      the concentration of active PDH complex in skeletal muscle was reduced by 50% in
      the septic rats. The combination of intravascular catheterization and infection
      resulted in a further decrease in the concentration of active PDH complex. The
      decreased concentration of active PDH complex was associated with increased
      plasma lactate concentrations in septic rats. Catheterization exacerbated the
      rise in plasma lactate in sepsis. In this model of chronic sepsis, the magnitude
      of the hyperlactatemia and the inhibition of the PDH complex in skeletal muscle
      appear dependent upon the length of time of the septic insult and are potentiated
      by addition of an intravascular focus of inflammation.

PMID- 8485822
TI  - Effects of pentoxifylline on tumor necrosis factor production and survival during
      lethal E. coli sepsis vs. disseminated candidiasis with fungal septic shock.
AB  - Lethal circulatory shock during microbial sepsis is thought to be initiated by
      early molecular events, including production of tumor necrosis factor (TNF) and
      cytokine-mediated upregulation of neutrophil (PMN) function, irrespective of the
      causative organism. The phosphodiesterase inhibitor pentoxifylline (PTX) inhibits
      TNF gene transcription and modulates PMN function, and has been shown to improve
      outcome in experimental sepsis. We hypothesized that PTX would attenuate gram
      negative and fungal septic shock by different mechanisms: reduced TNF production
      in Escherichia coli (EC) sepsis vs. enhanced PMN-mediated defense during Candida
      albicans (CA) fungemia. Conscious chronically catheterized rats received PTX (25
      mg/kg, i.v.) before i.v. challenge with 10(10) viable EC (serotype 055:B5), 10(9)
      viable serotype A yeast-phase CA (each the LD100 in < 24 hr in naive rats), or
      normal sterile saline (NSS), and then PTX posttreatment (6.5 mg/hr x 4.5 hr).
      Treatment controls received NSS before and after challenge. Serum TNF peaked 1.5
      hr after EC infection in NSS-treated animals (1654 +/- 390 U/ml, mean +/- SE),
      and was significantly reduced by PTX (120 +/- 32 U/ml, P < 0.01), but PTX did not
      improve 24 hr survival. PTX also aggravated systemic hypotension after EC, and
      did not modify neutropenia, thrombocytopenia, or microvascular permeability
      assessed by organ wet/dry weight (W/D) ratios. Peak serum TNF in CA + NSS animals
      (130 +/- 45 U/ml) was delayed 8 hr compared to EC animals, and were not reduced
      by PTX (67 +/- 25 U/ml, P = NS). Moreover, PTX did not alter CA-induced
      mortality, hypothermia, hypotension, neutropenia, increased lung W/D, or
      interstitial and alveolar hemorrhage. We conclude that PTX-induced suppression of
      endogenous TNF production does not prevent gram-negative shock in this model,
      possibly due to impaired TNF-mediated antibacterial host defense. Since fungal
      septic shock with acute disseminated candidiasis evolves prior to significant
      increases in circulating TNF, PTX also appears ineffective in its treatment.

PMID- 8485823
TI  - Responses to trauma: fifty years of ebb and flow.

PMID- 8485824
TI  - Development, early treatment, and prevention of heart failure. Introduction.

PMID- 8485825
TI  - Improvement of cardiac function by angiotensin converting enzyme inhibition.
      Sites of action.
AB  - BACKGROUND: The discovery of new properties of angiotensin converting enzyme
      (ACE) inhibitors in addition to their well-known ability to lower blood-pressure,
      such as antiproliferative actions and antiadrenergic and vagal-stimulating
      effects, has contributed to the usefulness of this class of agents in the
      prevention and treatment of cardiovascular diseases. METHODS AND RESULTS: The
      contribution of an activated endocrine and/or cardiac paracrine renin-angiotensin
      system to the progression of cardiovascular diseases with the exception of
      renovascular hypertension is not fully understood. In particular, the following
      questions were addressed: 1) Is the facilitation of noradrenaline release in the
      genesis of arrhythmias a target for ACE inhibition? 2) Is an impaired nutritional
      cardiac blood flow in heart failure a target for ACE inhibition? 3) Is the
      intimal hyperplasia that results from coronary angioplasty a target for ACE
      inhibition? 4) Is the diastolic dysfunction associated with left ventricular
      hypertrophy in essential hypertension a target for ACE inhibition? In an isolated
      rat heart preparation with ischemia-induced arrhythmias, none of the ACE
      inhibitors nor an angiotensin II antagonist was able to significantly suppress
      the incidence or severity of arrhythmias. In 12 patients with New York Heart
      Association functional class II-IV heart failure, a fall in cardiac filing
      pressures after ACE inhibition was associated with an immediate rise in cardiac
      output and an increase in coronary blood flow of almost 30%. In 24 patients with
      angina at rest, a preceding percutaneous transluminal coronary angioplasty, and a
      second angioplasty, control angiograms at 6 months revealed a high degree of
      restenosis in both ACE inhibitor-treated and placebo patients. Luminal narrowing
      amounted to 72% in the placebo group and 61% in the ACE inhibitor group. The
      differences between placebo and enalapril were statistically not significant. In
      12 patients with essential hypertension treated with 5 mg cilazapril, left
      ventricular mass was reduced by 30%, which was closely related to the change in
      mean arterial blood pressure. The concomitant normalization of the diastolic
      filling pattern by ACE inhibition, however, was not related to the respective
      changes in blood pressure. CONCLUSIONS: Promising experimental data regarding the
      antiproliferative effects of ACE inhibitors in preventing restenosis could not be
      transferred into clinical benefits for patients who underwent repeat coronary
      angioplasty. Possible antiarrhythmic effects of ACE inhibitors are not likely to
      be caused by their suppression of noradrenaline release during myocardial
      ischemia. ACE inhibition was effective in reducing coronary resistance in
      patients with severe heart failure, thereby augmenting nutritional cardiac blood
      flow. ACE inhibition also effectively induced a regression of left ventricular
      hypertrophy in essential hypertension. The associated normalization of diastolic
      filling pattern may represent an important goal in the treatment of hypertension.

PMID- 8485826
TI  - ACE inhibitors in early stages of heart failure.
AB  - BACKGROUND: Chronic blockade of the renin-angiotensin system by angiotensin
      converting enzyme (ACE) inhibitors in patients with mild to moderate heart
      failure as a second-line therapy has been shown to exert beneficial effects on
      exercise tolerance and symptomatology. METHODS AND RESULTS: Studies in
      experimental heart failure have shown that early inhibition of the renin
      angiotensin-aldosterone system leads to a retardation in the progression of
      cardiac failure and improves survival. Recently, published data from large
      controlled trials also indicate that ACE inhibitors prolong survival in patients
      with mild and moderate heart failure. The beneficial effects of ACE inhibition,
      even in early phases of the genesis of heart failure, are mainly due to a
      reduction of the progression of pump failure, whereas the incidence of sudden
      cardiac death remains unchanged. CONCLUSIONS: It can be concluded from these data
      that ACE inhibitors are no longer an add-on therapy in patients with mild to
      moderate heart failure but are clearly indicated for the treatment of symptomatic
      patients with mild heart failure as a first-line therapy.

PMID- 8485827
TI  - Development and prevention of congestive heart failure following myocardial
      infarction.
AB  - Ischemic heart disease is the major etiology for the development of congestive
      heart failure. Patients with acute myocardial infarction have a greatly increased
      risk for mortality and for manifesting symptomatic heart failure. This risk is
      not a uniform one but is greatly augmented in patients with a more extensive
      infarction and, consequently, a more depressed global ventricular function. An
      important concept that was derived from studies in rats with myocardial
      infarction and has been confirmed in patients is that ventricular enlargement,
      which has been shown to be a marker for an adverse outcome, can be a progressive
      process that leads to further deterioration of ventricular performance. Both
      experimental and early clinical studies have indicated that chronic therapy with
      an angiotensin converting enzyme inhibitor may attenuate this progressive
      ventricular enlargement. More definitive clinical trials are currently under way
      to determine whether this form of therapy, which may diminish the extent of
      ventricular enlargement over time, will result in an improvement in survival and
      in the prevention of the development of congestive heart failure. The addition of
      this pharmacological therapy to that of the primary prevention of atherosclerosis
      and that of the limitation of infarct size should make a substantial impact on
      the reduction of the incidence of congestive heart failure.

PMID- 8485828
TI  - Reduction in mortality by pharmacological therapy in congestive heart failure.
AB  - Mortality in congestive heart failure remains high. In analysis of heart failure
      in the perspective of pathophysiological mechanisms, some approaches to treatment
      to improve survival become particularly interesting. The concept of unloading
      myocardial performance by reducing systemic vascular resistance has received
      general acceptance. This approach was associated with improved survival with
      nitrates and hydralazine in the V-HeFT I study. Stimulation of the myocardium in
      excess of what is achieved by endogenous stimulation might be dangerous. Long
      term therapy with positive inotropic agents, therefore, is not an appropriate
      approach at present. However, addition of beta-blockers may protect the
      myocardium from the intense endogenous sympathetic stimulation in congestive
      heart failure. There are favorable trends with this approach in several small
      trials. An ongoing trial in idiopathic dilated cardiomyopathy may help to clarify
      this question. Counteraction of neuroendocrine activation may also be obtained by
      the addition of an angiotensin converting enzyme inhibitor. The CONSENSUS I study
      demonstrated a clear improvement in survival among very compromised patients by
      addition of enalapril. A positive effect was significantly associated with the
      degree of neuroendocrine activation at baseline. Two recent large-scale trials
      have emphasized the importance of adding an angiotensin converting enzyme
      inhibitor to other treatments in patients with mild to moderate symptoms and left
      ventricular dysfunction. These trials also support the importance of myocardial
      protection from neuroendocrine stimulation with symptomatic or asymptomatic
      myocardial failure. Antiarrhythmic agents have not been documented to improve
      survival. On the contrary, class I agents are deleterious in some patients with
      left ventricular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485829
TI  - Cardiac mechanics during development of heart failure. SOLVD Investigators.
AB  - BACKGROUND: The changes in myocardial performance responsible for the progression
      from a stage of asymptomatic left ventricular dysfunction toward overt congestive
      heart failure are still poorly understood. Accordingly, using invasive methods,
      we examined the differences in baseline left ventricular function between a
      subgroup of patients enrolled in the treatment arm (presence of congestive heart
      failure) and in the prevention arm (asymptomatic patients) of the Studies of Left
      Ventricular Dysfunction. METHODS AND RESULTS: High-fidelity left ventricular
      pressures and frame-by-frame angiographic volumes were simultaneously obtained
      under baseline conditions in 65 patients with left ventricular ejection fraction
      < or = 35%. Sixteen patients had New York Heart Association congestive heart
      failure (class II or III), whereas the remaining 49 patients had no clinical
      signs of heart failure and did not receive therapy for this syndrome. A second
      set of data was obtained an average of 12.4 months later in 42 patients. The
      group with heart failure had significantly greater end-diastolic and end-systolic
      volumes than the asymptomatic group (both p < 0.001), but the stroke index at
      rest was similar in both groups. Accordingly, ejection fraction was significantly
      lower in the heart failure group (19.6 +/- 7.0% versus 26.3 +/- 7.2%; p < 0.02).
      Left ventricular end-diastolic pressure was greater and peak +dP/dt was lower in
      heart failure patients, but the difference did not reach statistical significance
      after Bonferroni correction for multiple comparisons. Moreover, the individual
      end-systolic stress/end-systolic volume data of the heart failure patients fell
      within the 95% confidence interval of the relation observed in the patients
      without heart failure both at baseline and after 1 year of follow-up irrespective
      of their changes in functional status. It was also noted that during follow-up,
      the changes in end-diastolic and end-systolic volumes correlated linearly, as if
      both dimensions always shifted in parallel, whereas alterations in contractility
      primarily influence end-systolic volume. CONCLUSIONS: These observations are
      compatible with the hypothesis that a depression in the mechanical performance of
      the viable myocardial areas is not the major determinant for the progression from
      asymptomatic to symptomatic left ventricular dysfunction. Abnormalities in left
      ventricular diastolic distensibility, on the other hand, might underlie the
      progressive ventricular dilation and create a vicious cycle through the afterload
      mismatch.

PMID- 8485830
TI  - Cardiac hypertrophy and failure--a disease of adaptation. Modifications in
      membrane proteins provide a molecular basis for arrhythmogenicity.
AB  - Cardiac hypertrophy is the physiological adaptation of the heart to chronic
      mechanical overload. Cardiac failure indicates the limits of the process. Cardiac
      hypertrophy is only one example of biological adaptation and results from the
      induction of several changes in gene expression, mostly of the fetal type,
      including those coding for the myosin heavy chain or the alpha-subunit of the
      Na+,K(+)-ATPase. From a thermodynamic point of view, the decrease in Vmax allows
      the heart to produce a normal tension at a lower cost. This process results from
      changes both in the sarcomere and in the expression of certain membrane proteins.
      The decrease in calcium transient is determined by several changes in membrane
      proteins that result in a rather fragile equilibrium in terms of calcium
      homeostasis. Any abnormal input in calcium will have exaggerated detrimental
      consequences on a hypertrophied myocyte and may cause automaticity and
      arrhythmias or an exaggerated response to anoxia in terms of compliance.

PMID- 8485831
TI  - Modulation of adrenergic receptors and G-transduction proteins in failing human
      ventricular myocardium.
AB  - During times of physiological stress, the human heart is able to markedly
      increase contractility. This response is facilitated by the release of
      norepinephrine from postganglionic sympathetic nerves and epinephrine from the
      adrenal gland. These neurotransmitters effect a contractile response by
      interacting with a transmembrane signaling system within the myocyte sarcolemma
      consisting of beta 1- and beta 2-adrenergic receptors, the guanine nucleotide
      binding regulatory proteins Gs and Gi, and the effector enzyme adenylyl cyclase.
      Activation of this beta-receptor-G-protein-adenylyl cyclase signal transduction
      complex results in production of the second messenger, cAMP, activation of
      protein kinase A, and phosphorylation of a group of cellular proteins that are
      important in excitation-contraction coupling. In contrast to normal human
      myocardium, the failing human heart is insensitive to adrenergic stimulation.
      This insensitivity is a result of alterations in the function of this signal
      transduction pathway, including selective downregulation of the beta 1-adrenergic
      receptor, uncoupling of beta 2-adrenergic receptors from adenylyl cyclase, and an
      increase in the functional activity of the inhibitory G-protein. Subtle yet
      important differences exist between beta-adrenergic neuroeffector mechanisms in
      idiopathic dilated cardiomyopathy and cardiomyopathy secondary to ischemic heart
      disease. Most notably, beta-receptors are downregulated to a lesser degree in
      patients with ischemic heart disease. Therefore, various types of end-stage heart
      muscle disease may exhibit important pathophysiological differences despite
      common clinical features and an understanding of the regulatory mechanisms that
      modulate cardiac signal transduction may have therapeutic implications.

PMID- 8485832
TI  - Time course and mechanisms of contractile dysfunction during acute myocardial
      ischemia.
AB  - BACKGROUND: The purpose of the study was to characterize the functional and
      metabolic adjustments of a myocardial region subjected to low-flow ischemia. In
      addition, studies tested whether such myocardium retains an inotropic reserve.
      METHODS AND RESULTS: Anesthetized swine were studied in which the left anterior
      descending coronary artery was cannulated and perfused at a constant low level
      causing regional contractile dysfunction (sonomicrometry for wall thickness) and
      the appearance of metabolic indicators of ischemia (decrease in creatine
      phosphate and lactate production) with only slight loss of ATP and glycogen
      (transmural biopsies). After 85 minutes of low-flow ischemia, dobutamine was
      infused into the hypoperfused artery as an inotropic challenge. Coronary
      hypoperfusion for 5 minutes resulted in a 54% reduction of regional systolic wall
      thickening, reversal of lactate consumption to lactate production, and a
      significant decrease in creatine phosphate. Subendocardial blood flow was reduced
      from 0.62 +/- 0.11 (+/- SD) to 0.16 +/- 0.07 mL.min-1.g-1. Prolonged
      hypoperfusion for 85 minutes resulted in no further change in regional blood flow
      but a partial recovery of metabolic parameters. Dobutamine infusion after 85
      minutes of hypoperfusion increased regional myocardial work. However, again
      lactate production was significantly increase and creatine phosphate was
      decreased. Regional coronary hypoperfusion produces a downregulation of regional
      contractile function in proportion to the blood flow decrease. With prolonged
      hypoperfusion, after the initial adjustment phase, there is little further change
      in function, and metabolic markers of ischemia improve. Although the ischemic
      downregulated myocardium retains a significant inotropic reserve, primarily
      anaerobic energy production is utilized. CONCLUSIONS: These data are consistent
      with downregulation being a protective mechanism for the ischemic myocardium to
      restore an energy supply-demand balance in the face of reduced blood flow.
      Inotropic stimulation of the downregulated myocardium enhances regional function
      but at the cost of worsening its metabolic status. Thus, inotropic stimulation of
      the hypoperfused and downregulated myocardium is probably detrimental to long
      term viability.

PMID- 8485833
TI  - Disturbance of the myocardial energy metabolism in dilated cardiomyopathy due to
      autoimmunological mechanisms.
AB  - BACKGROUND: After the identification and immunochemical characterization of the
      ADP/ATP carrier of the inner mitochondrial membrane as an organ- and a
      conformation-specific autoantigen in myocarditis and dilated cardiomyopathy, we
      investigated whether an immunoreaction against the ADP/ATP carrier leads to a
      disturbance of cellular energy metabolism and consequently of myocardial
      function. METHODS AND RESULTS: Either immunization of guinea pigs with the
      isolated carrier protein or infection of A/J mice with coxsackievirus B3 induced
      heart reactive antibodies against the ADP/ATP carrier and led to a disturbance of
      the cellular energy metabolism: delta Gcyt-mit: 4.9 +/- 0.6 kJ/mol ATP (controls)
      to 2.3 +/- 1.1 kJ/mol ATP (immunized animals). In the isolated, perfused working
      heart preparation, the hemodynamic results of these hearts showed a > 50%
      reduction in external heart work. Because the amount of the decrease of external
      heart work and the magnitude of the reduction of delta Gcyt-mit showed a very
      close correlation, it must be suspected that the imbalance of the myocardial
      energy metabolism is responsible for the impairment of cardiac function.
      CONCLUSIONS: These data suggest that virus infection of the myocardium as shown
      for viral myocarditis and dilated cardiomyopathy may lead to a disturbed function
      of the ADP/ATP carrier and, thus, may be the cause of impaired myocardial
      function.

PMID- 8485835
TI  - Heart failure on the basis of hypertension.
AB  - Arterial hypertension leads to left ventricular hypertrophy. In proportion to
      increased left ventricular systolic pressure, left ventricular hypertrophy is
      considered to be of adaptive nature from the point of view of wall stress
      regulation. In the beginning, left ventricular function is normal, whereas
      diastolic filling is already compromised by the process of hypertrophy and
      altered ventricular geometry. In case of ventricular dilation and wall thinning,
      wall stress increases and leads to an increment in myocardial oxygen demand and a
      decrease of left ventricular ejection fraction. This is followed by a further
      decline in intrinsic myocardial contractility and a decrease in the elastic
      material properties of the myocardium. The structure of the myocardium is
      characterized by myocyte hypertrophy, a process of reactive and reparative
      fibrosis and alterations of the coronary microcirculation. Coronary vasodilator
      reserve is markedly impaired and is likely to initiate a process of malperfusion
      and malnutrition under increased metabolic demands. Particularly, the combined
      involvement of myocytes, interstitium, and intramyocardial vasculature appears to
      predispose to late heart failure after prolonged exposure to chronic pressure
      overload in arterial hypertension.

PMID- 8485834
TI  - Cytolytic cross-reactive antibodies directed against the cardiac membrane and
      viral proteins in coxsackievirus B3 and B4 myocarditis. Characterization and
      pathogenetic relevance.
AB  - BACKGROUND: Coxsackievirus B3 and B4 (CVB) myocarditis was assessed by a more
      than twofold change in titer of the microneutralization tests against
      enteroviruses within 3 weeks in all patients, by an endomyocardial biopsy
      indicative of active myocarditis in eight cases, and by pericardial effusion and
      acute cardiomegaly in two patients. In all endomyocardial biopsies,
      immunoglobulin binding to the sarcolemma and to the interstitial tissue was
      demonstrated irrespective of an infiltrate being at the same focus or not. IgG
      binding was found in nine, IgM and IgA in seven, C3 in C1q in three, and C5b9 in
      three of 10 patients. In addition, circulating antimyolemmal antibodies (AMLAs)
      were demonstrated regularly. METHODS AND RESULTS: In this study, for the first
      time adult human myocytes isolated from atrial appendages during open-heart
      surgery were used as antigen in the indirect immunofluorescence test: nine of 10
      sera of patients with CVB myocarditis demonstrated AMLAs of the homologous type
      in titers of 1:40-1:320, whereas eight of 10 reacted with rat myocytes
      (heterologous type) only. Circulating AMLAs fixed complement component C4 in the
      majority of cases. During the in vitro assay of antibody-mediated cytolysis with
      vital heart cells, fixation of components C3, C4 to the myolemma in all, of C1q
      in seven, and of the C3b9 complex in eight of 10 sera was demonstrated after
      addition of a fresh complement source, indicating the potential of a complement
      mediated cytolysis being operative. In vitro cardiocytolysis of isolated adult
      rat heart cells is present in the untreated sera of patients with enteroviral
      myocarditis and is abolished after adsorption of sera with CVB and with isolated
      rat heart cells. This indicates functional cross-reactivity of the antimembrane
      antibodies. To analyze further the cross-reactive epitopes, sodium dodecyl
      sulfate gel electrophoresis of human and rat sarcolemma and consecutive
      immunoblots were performed. Cross-reactivity between viral (CVB) and sarcolemmal
      epitopes could be demonstrated to bands of 220 kd in 10%, 110 kd in 50%, 48 kd in
      40%, 35 kd in 40%, and 31 and 28 kd in 30% each. Cardiospecific non-cross
      reactive epitopes for antisarcolemmal antibodies or AMLAs were membrane proteins
      of 90 kd and 78 kd in 50%, 72 kd in 90%, 67 kd in 40%, and 45 kd in 50%. Virus
      specific antibody binding sites for sera included proteins of 33 and 34 kd.
      CONCLUSIONS: Western blot analysis of sera incubated with cardiac membranes or
      enteroviral proteins demonstrated that the antibodies are directed to defined
      epitopes of the sarcolemma. Some antibodies were cross-reactive to enteroviral
      proteins, indicating that enteroviral infection may be the etiological trigger of
      an autoreactive myocarditis. The cytolytic property of the patients' sera in
      vitro suggests in addition that humoral autoreactivity and antigenic mimicry are
      major pathogenetic principles operative in human enteroviral myocarditis and its
      sequelae.

PMID- 8485836
TI  - Tissue renin-angiotensin systems. Their role in cardiovascular disease.
AB  - BACKGROUND: The identification of the components of the renin-angiotensin system
      (RAS) in various extrarenal tissues suggested the existence of local renin
      angiotensin systems with organ-specific functions that may act independently from
      the plasma RAS. These findings have led to the hypothesis of paracrine-autocrine
      functions of the RAS, which implies that locally generated angiotensin II
      mediates effects within one tissue or within one cell. Whereas the circulating
      endocrine RAS appears to be responsible for acute effects, the tissue RAS seems
      to participate in more chronic processes such as secondary structural changes and
      therefore may contribute to the pathogenesis of hypertension as well as other
      cardiovascular disorders such as cardiac hypertrophy, coronary artery disease,
      and atherosclerosis. METHODS AND RESULTS: The use of molecular biological
      techniques has demonstrated that all components of the RAS-renin,
      angiotensinogen, converting enzyme, and angiotensin receptors-are expressed in
      several tissues that participate in the regulation of cardiovascular homeostasis.
      CONCLUSIONS: The therapeutic importance of inhibitors of the RAS, such as
      converting enzyme inhibitors, is based on their cardioprotective as well as
      antiproliferative effects and points to a direct involvement of the RAS in the
      development and preservation of primary hypertension, a pathological condition in
      which normal or even low plasma renin activity is a common finding. Reversal of
      cardiovascular structural changes and enhancement of renal sodium excretion by
      converting enzyme inhibitors are important long-term antihypertensive actions
      possibly mediated by inhibition of the tissue RAS.

PMID- 8485837
TI  - Diastolic dysfunction in aortic stenosis.
AB  - Diastolic dysfunction is characterized by an increased resistance to filling with
      increased diastolic filling pressures. A variety of disorders are associated with
      diastolic dysfunction, such as hypertrophy, structural alterations of the
      myocardium with increased fibrosis, myocardial scarring, or infiltrative
      processes. In addition to these changes, physiological abnormalities of the left
      ventricle with impaired relaxation, decreased diastolic filling, and increased
      stiffness of the myocardium can be observed. In patients with aortic stenosis,
      the most common cause for diastolic dysfunction is left ventricular hypertrophy.
      Diastolic dysfunction is found in approximately 50% of the patients with normal
      systolic ejection performance and in 100% of the patients with depressed
      function. Diastolic function appears either to be more sensitive for detection of
      abnormal left ventricular function in patients with aortic stenosis or to precede
      systolic dysfunction or both. Treatment of diastolic dysfunction is usually
      achieved by aortic valve replacement with regression of left ventricular
      hypertrophy, but in patients with decompensated aortic stenosis, a reduction of
      circulating blood volume to reduce diastolic filling pressures, and thus dyspnea,
      is often indicated. Prognosis of patients with diastolic dysfunction is usually
      better than that of patients with systolic dysfunction but is clearly worse than
      that of normal patients.

PMID- 8485838
TI  - Adaptation to cardiac dysfunction after myocardial infarction.
AB  - Survival after myocardial infarction decreases with left ventricular dilatation,
      although dilatation at 4 weeks was found to be compensatory. To study this
      apparent discrepancy, prospective simultaneous volume and hemodynamic
      measurements at rest were extended in 39 patients with small and 37 with large
      myocardial infarctions from 4 days (range, 2-6 days) and 4 weeks (range, 3-5
      weeks) to 6 months (range, 5-8 months) after infarction and were repeated during
      supine bicycle exercise at 50 W. In patients with small infarction, end-diastolic
      volume (mL/m2) decreased from 4 days to 6 months; ejection fraction (%), stroke
      volume (mL/m2), and end-systolic volume (mL/m2) remained unchanged. Stroke index
      rose during exercise at 4 weeks and 6 months. In patients after large infarction
      (n = 37), left ventricular end-systolic volume index (4 days, 38 +/- 3; 4 weeks,
      47 +/- 3*; 6 months, 52 +/- 3*; *p < 0.05 versus 4 days) and end-diastolic volume
      indexes (4 days, 72 +/- 3; 4 weeks, 86 +/- 5*; 6 months, 92 +/- 5*; *p < 0.05
      versus 4 days, +p < 0.05 versus 4 weeks) increased at constant wedge pressure.
      Stroke index remained restored beyond 4 weeks after infarction (4 days, 35 +/- 2;
      4 weeks, 42 +/- 2*; 6 months, 42 +/- 2*; p < 0.05 versus 4 days) and rose during
      exercise at 4 weeks (rest, 45 +/- 2; exercise, 55 +/- 3; p < 0.05) but not at 6
      months (rest, 42 +/- 3; exercise, 45 +/- 3; p = NS).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8485839
TI  - Effect of insulin on GABAergic development in the embryonic chick retina.
AB  - We investigated the role of insulin in GABAergic differentiation in the embryonic
      chick retina at different embryonic ages using glutamate decarboxylase (GAD) and
      high-affinity GABA uptake as developmental markers. Both these GABAergic markers
      exhibit developmentally programmed increases in activity during retinogenesis
      that also occur in culture. Insulin stimulated GABA uptake in retina neurons at
      all embryonic ages in a dose-dependent manner and GAD activity by 30% in
      embryonic retina neurons after 11 days of development. The stimulation of GABA
      uptake by insulin was blocked by addition of ouabain suggesting a role for the
      Na+,K+ ATPase. The same concentration of insulin caused a 76% stimulation of
      protein synthesis in these retinal cells, and previous work demonstrated that
      insulin also stimulates cholinergic differentiation in the chick retina (Hausman
      et al., Dev. Brain. Res. 59, (1991) 31-37). Thus, there was no selective
      stimulation of GABAergic differentiation by insulin but likely a neurotrophic
      effect. The increase in GAD activity in neurons from post-11-day embryonic
      neurons contrasts with our previous findings at embryonic days 6-7 where there is
      little change in GAD activity after addition of insulin. It is possible that the
      failure of insulin to stimulate GAD activity during early retina development is
      due to the increased accumulation of GABA in the presence of insulin. GABA levels
      were increased more than two-fold by 100 ng/ml insulin.

PMID- 8485840
TI  - Isolation of sympathonectin; a substrate-bound protein which induces preferential
      growth of sympathetic fibers in vitro.
AB  - A protein named 'sympathonectin', was purified from chick heart cell-conditioned
      medium (HCM), on the basis of its ability to direct the neurite outgrowth of
      cultured sympathetic neurons. The most purified fraction showed a doublet band on
      SDS-PAGE with an apparent molecular weight of 370 kDa. The biological activity of
      sympathonectin was over 100 times higher than that of laminin. Immunoblotting
      with anti-sympathonectin of the 100,000 x g pellet (particulate) fraction of HCM
      identified a distinct 370 kDa band; this molecule did not react to the anti
      laminin serum. The immunohistochemical analysis showed that the antibody against
      sympathonectin stained heart tissue but not skeletal muscle tissue, whereas anti
      laminin serum stained both tissues. These results suggest that sympathonectin may
      play a role during sympathetic innervation of target organs.

PMID- 8485841
TI  - Estrogen receptor immunoreactive neurons in the fetal ferret forebrain.
AB  - The development of estrogen receptors was studied in the preoptic area/anterior
      hypothalamus (POA/AH) of fetal male and female ferrets. In males this region
      includes a nucleus (MN-POA/AH), delineated by Nissl stains, which is not
      discernible in females. The results reveal the distribution of estrogen receptor
      containing cells during the period when estrogen is known to induce the
      differentiation of the male ferret's MN-POA/AH. Brains were taken from ferret
      kits on days 30, 34, 37 and 40 of a 41-42 day gestation, and were processed
      utilizing the H222 monoclonal antibody to reveal estrogen receptors. At E30 there
      were numerous H222 immunoreactive (ir) cells in central regions of the POA/AH.
      From E30 to E40 there was a striking increase in the number of H222ir cells in
      the POA/AH. A broad sweep of H222ir cells extended from the ventral POA dorsally
      and laterally into the caudal POA and AH of both males and females. H222ir cells
      were not restricted to the region of the MN-POA/AH at any fetal age. H222
      immunoreaction product at E30 was restricted to nuclear compartments. By E40,
      H222ir processes extended from some cells with H222ir nuclei in the medial and
      lateral POA/AH in both males and females. At the older fetal ages immunopositive
      cell numbers increased in lateral positions. At E34 and E37 (but not E30)
      selective ventricular zones, and regions between the hypothalamus and amygdala
      contained H222ir cells, suggesting the presence of estrogen receptors in cells
      during migration. Although the amygdala contained a few H222ir cells as early as
      E34, the cortex lacked H222ir cells even as late as E40. The appearance of H222ir
      cells in positions suggestive of migration is consistent with the hypothesis that
      estrogen receptors play some role in determining cell positions in certain
      regions of the developing nervous system.

PMID- 8485842
TI  - Immunohistochemical localization of the S-100 beta protein in postnatal cat
      visual cortex: spatial and temporal patterns of expression in cortical and
      subcortical glia.
AB  - The ontogenic expression of the glial-specific protein S100 beta was examined in
      postnatal cat visual cortex using immunocytochemical methods. Astrocytes in
      visual cortex and oligodendrocytes in the subcortical white matter exhibited
      distinct spatio-temporal gradients in their expression of the S100 beta protein.
      In the visual cortex, S100 beta-immunoreactivity was detected in astroglial
      cytoplasm, as well as in the extracellular interstitium, in a lamina-specific
      manner throughout postnatal development. Using double labeling procedures, the
      S100 beta protein was found to be strictly colocalized with GFAP-immunoreactive
      astrocytes when GFAP was present. The glial fibrillary acidic protein (GFAP), a
      marker of mature astrocytes, was not present at high levels until the 4th
      postnatal week. From the 2nd through 5th postnatal weeks, the expression of S100
      beta was highest in the thalamocortical recipient, layer IV, of visual cortical
      areas 17 and 18. At ages beyond 6 postnatal weeks, S100 beta-immunoreactivity
      increased disproportionately in supra- and infragranular layers such that areas
      17 and 18 were demarcated from adjacent cortices by lower levels in layer IV. The
      S100 beta protein was also highly expressed in oligodendroglial somata and
      processes in the subcortical white matter between the 2nd and 6th postnatal
      weeks. The levels of S100 beta in the subcortical white matter progressively
      diminished to adult levels, where it was localized only to a few remaining
      oligodendroglial somata. The differential laminar expression of the S100 beta
      protein in astrocytes during the period within which the visual cortex exhibits
      input- and experience-dependent synaptic modifications suggests that astrocytes,
      possibly via their release of S100 beta, may play a special role in mediating
      plasticity in visual cortical development. A consistent feature of the appearance
      of the S100 beta protein was its expression in immature astroglia and
      oligodendroglia, well before they are considered morphologically mature. This
      characteristic underscores the potential of S100 beta as a marker of distinct
      populations of glial cells and of their role in normal and abnormal development.

PMID- 8485843
TI  - Differentiation of glial precursor cells from developing rat brain in vitro.
AB  - We have previously shown that enriched preparations of oligodendrocytes from
      mature bovine brain or 30d rat brain contain 4-10% ganglioside-GD3+ glial
      precursor cells, which differentiate into astrocytes in culture. These findings
      are in contrast to those described by others in cultures of neonatal rat brain,
      which contain precursors that differentiate into both astrocytes and
      oligodendrocytes. We have extended this study to determine whether the properties
      of glial precursor cells vary during development. Cells isolated by the same
      technique from 5-, 10- and 20-day-old rats, were placed in culture and double
      immunostained at 1,2,3,6 and 10 days in vitro (DIV) for GD3/glial fibrillary
      acidic protein (GFAP), galactosylceramide (GC)/GFAP, GD3/GC, GD3/antigen O4,
      GC/O4 and GFAP/O4. After 1 DIV the isolates from 5 day rats contained 30% GD3+
      cells, 1% oligodendrocytes (GC+) and 3.5% astrocytes (GFAP+). The corresponding
      percentages from 10 day rats were: 35% GD3+, 3% GC+ and 3% GFAP+; and from 20 day
      rats: 28% GD3+, 35% GC+ and 1% GFAP+. Thus the number of oligodendrocytes in the
      initial isolate increased dramatically between 10 and 20 days. At all 3 ages
      immature cells were a major component of the total isolate. GFAP+ cells increased
      rapidly in all cultures. In all cultures the numbers of GFAP+/GD3+ cells reached
      a maximum and then declined coincident with the increase of GFAP+/GD3- cells, but
      there were many more of these double-stained cells in cultures from 20 day rats.
      Moreover, all cultures at 1 DIV contained some GFAP+/GD3- cells. Thus astrocytes
      appeared to derive both from pre-existing GFAP+/GD3- cells and from GD3+ cells,
      the latter pathway being more significant in the older rats. GC+ cells increased
      in cultures prepared from 5 day and 10 day rats, but remained relatively constant
      in cultures from 20 day rats. The number of GD3+/O4+ cells decreased coincident
      with an increase of GC+/O4+ cells (all GC+ cells were O4+), but the number of
      GC+/GD3+ cells was insignificant in any culture from any age animal. These
      findings in developing animals support the scheme shown by others in neonates
      that oligodendrocytes derive from GD3+ cells via O4+/GC-intermediate cells. These
      data show that more GD3+ cells differentiate into oligodendrocytes in 5- and 10
      day-old animals than in 20-day-old animals, and a larger percentage differentiate
      into astrocytes in 20-day-old animals than in the younger animals. The most
      reasonable explanation of these results is that two committed populations of GD3+
      precursor cells exist in the brain, and that the ratio of these populations
      changes during development. The implication of this conclusion is that
      bipotential progenitor cells do not persist beyond the neonatal period, but
      become committed to separate lineages during development.

PMID- 8485844
TI  - Many spinal cord cells transiently express low molecular weight forms of glutamic
      acid decarboxylase during embryonic development.
AB  - At early developmental stages in the rat spinal cord (embryonic day 13), when
      neuronal progenitors are still proliferating, most differentiating neurons
      express truncated forms of glutamic acid decarboxylase (GAD) (approximately 25
      kDa) which are the products of alternative splicing of the GAD67 gene. These
      truncated proteins do not appear to synthesize gamma-aminobutyric acid (GABA).
      The amino acid is detected in cells only after alternative splicing of the GAD67
      gene generates a full-length, 67 kDa enzymatically active form of GAD. Both the
      67 kDa GAD and GABA colocalize and appear diffusely distributed in the cytoplasm
      of embryonic neurons. GABA does not appear associated with synaptic vesicles
      until after birth, when its intracellular distribution becomes punctate and it
      colocalizes with synaptophysin. At this time, it also colocalizes with an
      immunologically distinct 65 kDa GAD protein encoded by a second GAD gene (GAD65).
      Expression of different GAD-related proteins with distinct intracellular
      distributions during development suggests that GABA, the product of these
      enzymes, may have trophic or metabolic roles during spinal cord differentiation.

PMID- 8485845
TI  - Ontogeny of synaptophysin and synaptoporin in the central nervous system:
      differential expression in striatal neurons and their afferents during
      development.
AB  - The expression of the synaptic vesicle antigens synaptophysin (SY) and
      synaptoporin (SO) was studied in the rat striatum, which contains a nearly
      homogeneous population of GABAergic neurons. In situ hybridization revealed high
      levels of SY transcripts in the striatal anlage from embryonic day (E) 14 until
      birth. In contrast, SO hydridization signals were low, and no immunoreactive cell
      bodies were detected at these stages of development. At E 14, SY-immunoreactivity
      was restricted to perikarya. In later prenatal stages of development SY
      immunoreactivity appeared in puncta (identified as terminals containing
      immunostained synaptic vesicles), fibers, thick fiber bundles and 'patches'. In
      postnatal and adult animals, perikarya of striatal neurons exhibited
      immunoreaction for SO; ultrastructurally SO antigen was found in the Golgi
      apparatus and in multivesicular bodies. SO-positive boutons were rare in the
      striatum. In the neuropil, numerous presynaptic terminals positive for SY were
      observed. Our data indicate that the expression of synaptic vesicle proteins in
      GABAergic neurons of the striatum is developmentally regulated. Whereas SY is
      prevalent during embryonic development, SO is the major synaptic vesicle antigen
      expressed postnatally by striatal neurons which project to the globus pallidus
      and the substantia nigra. In contrast synapses of striatal afferents
      (predominantly from cortex, thalamus and substantia nigra) contain SY.

PMID- 8485846
TI  - Effects of perinatal hypo- and hyperthyroidism on the levels of nerve growth
      factor and its low-affinity receptor in cerebellum.
AB  - Deficits or excesses of thyroid hormones during critical periods of mammalian
      cerebellar development can lead to profound biochemical and morphological
      abnormalities in this system. The goal of this study was to investigate the
      effects of perinatal hypo- and hyperthyroidism on the ontogeny of nerve growth
      factor (NGF) and its low-affinity receptor (p75NGFR) in the rat cerebellum. The
      concentration of NGF and of p75NGFR immunoreactivity (IR) were measured, several
      days after birth, in cerebella of rats which had received propylthiouracil (PTU)
      or thyroxine. NGF concentration was markedly enhanced only on postnatal day 2
      (P2) in hyperthyroid rats, whereas in hypothyroid (PTU-treated) rats NGF values
      were similar to age-matched controls. These observations suggest that thyroid
      hormone affects NGF synthesis during early periods of cerebellar development. In
      Purkinje cells of control animals, p75NGFR IR peaked at P10. In hypothyroid rats,
      the expression of p75NGFR was retarded, peaking at P15, whereas in hyperthyroid
      rats it was advanced, peaking at P8. The increased p75NGFR IR found in Purkinje
      cell bodies and the delayed disappearance of p75NGFR IR from the external
      granular layer of hypothyroid rats suggest different roles for thyroid hormone in
      the developing cerebellum. We conclude that p75NGFR and NGF are independently
      regulated by thyroid hormone during critical periods of cerebellar development.
      The effect of thyroid hormone deficiency on p75NGFR content in Purkinje cells may
      involve complex mechanisms such as impaired efficiency of axonal transport.

PMID- 8485847
TI  - Asynaptic expression of the adult nicotinic acetylcholine receptor in long-term
      cultures of mammalian myotubes.
AB  - To determine whether synaptic contact is required to express adult-type nicotinic
      acetylcholine receptors (A-AChR) in developing mammalian muscle, we have examined
      single-channel AChR activity in primary muscle cultures maintained for up to 29
      days. A-AChRs were first expressed after day 12 in culture (CD12), during a
      period characterized by the accumulation of embryonic acetylcholine receptors (E
      AChR). The highest rate of A-AChR expression was observed between CD15 and 19,
      during a period of maximal E-AChR accumulation. Although the level of A-AChR
      expression between individual patches was quite variable during this period, A
      AChRs accounted for up to 40% of the events produced by receptors expressed over
      a 3-day interval. Between CD19 and 29, the density of E-AChRs diminished while
      the expression of A-AChRs per patch continued to increase but at a lower rate
      than that observed between CD15 and 19. In 25-29-day cultures, 70.6% of patches
      exhibited both E-AChR and A-AChR activity, and the percentage of A-AChR events
      per patch ranged between 0 and 47% with a mean of 11.7 +/- 3.2%. These results
      demonstrate that endogenous muscle mechanisms promote developmental increases in
      the expression of A-AChRs in myotubes that have no history of synaptic contact.
      This conclusion suggests that synaptic imprinting at developing junctions is
      mediated in part by endogenous muscle mechanisms, and does not require direct
      neurotrophic activation of epsilon mRNA transcription.

PMID- 8485848
TI  - The gustatory competence of the lingual epithelium requires neonatal innervation.
AB  - The rat vallate papilla is bilaterally innervated by the IXth nerve whose axons
      are required for the normal development of its several hundred taste buds.
      Temporary denervation during the developmental sensitive period for taste buds
      prevented most vallate taste buds from forming. Specifically, removing one IXth
      nerve and crushing the other in 3 day old neonates eliminated axons from the
      vallate papilla for about 10 days and by adulthood resulted in a mean +/- 1
      S.E.M. of 48 +/- 12 vallate taste buds. Two explanations for the shortfall of
      adult vallate taste buds were evaluated: either 10 days of neonatal denervation
      impaired the gustatory competence of the vallate papilla, or the IXth nerve's
      trophic support of taste buds failed to recover after nerve crush on day 3. In
      adults, it was found that a IXth nerve previously crushed on day 3 would support
      numerous vallate taste buds (183 +/- 27), provided that the vallate papilla had
      been continuously innervated by the contralateral IXth nerve during neonatal
      development. Consequently, taste neurons, whose axons had been crushed on day 3,
      seemed to survive and retain their trophic capacity to support taste buds in
      adults. To test for diminished competence of the gustatory epithelium, one IXth
      nerve was crushed on day 3 while the contralateral IXth nerve was removed.
      Beginning on day 75, the chorda tympani nerve was substituted for the re
      innervating axons of the crushed IXth nerve. The cross-innervating chorda tympani
      ultimately supported only 51 +/- 10 vallate taste buds. In contrast, in vallate
      papillae that developed without interruption of the contralateral IXth nerve
      during the sensitive period, the cross-innervating chorda tympani by itself
      supported more than four times as many vallate taste buds (214 +/- 22).
      Evidently, a neonatal period of denervation permanently restricts the gustatory
      competence of the vallate epithelium; nerve-dependent precursors of taste
      receptor cells probably died or permanently changed their fate.

PMID- 8485849
TI  - Quantitative analysis of transient GABA expression in embryonic and early
      postnatal rat spinal cord neurons.
AB  - GABA expression was investigated using biochemical analysis of spinal cord
      homogenates and immunocytochemical analysis of cells acutely dissociated from the
      embryonic and postnatal rat spinal cord. gamma-Aminobutyric acid (GABA) was
      detected by both methods as early as embryonic day 13 (E13). At E13, the
      percentage of neurons that were GABA+ was 0.5%. This value increased during
      embryogenesis, peaked during the first two postnatal weeks to just over 50%, and
      declined to approximately 20% by the third postnatal week emphasizing the
      transient nature of GABA expression. At E17 there was a pronounced, positive
      ventro-dorsal and rostro-caudal gradient of GABA+ cells that persisted until just
      before birth. At this time the gradients reversed in cervical and lumbosacral
      regions indicating that GABA immunoreactivity in discrete anatomical regions is
      also a transient phenomenon. During the embryonic period GABA immunoreactivity
      was diffusely distributed throughout cell bodies and proximal processes. At E21,
      both GABA and synaptophysin were present in the same cells. However the two
      antigens did not co-localize point for point. By postnatal day 21 GABA
      immunoreactivity appeared in puncta that co-localized entirely with puncta of
      synaptophysin immunoreactivity. The sizable percentage of neurons that
      transiently express GABA during development, and the fact that it can be detected
      prior to the synaptic form of glutamic acid decarboxylase (GAD65), suggest that
      the amino acid may play a significant role during differentiation before it
      functions as an inhibitory neurotransmitter.

PMID- 8485850
TI  - An immunohistochemical study of neuropeptide Y positive sites in the developing
      human hippocampal formation.
AB  - Neuropeptide Y (NPY)-positive sites were evaluated by immunohistochemistry in the
      hippocampal formation of human fetuses aged from 15 to 41 weeks of gestation.
      Immunopositive cells and fibers were identified in the hippocampus as early as 15
      weeks of gestation. These cells were localized in the polymorphic and pyramidal
      layers and their numbers increased with the age of the fetuses. NPY-positive
      cells were observed to be closely apposed to blood vessels and some NPY fibers,
      present mainly in the polymorphic layer, would infiltrate the alveus.

PMID- 8485851
TI  - Functional development of the neonatal rat retinotectal pathway.
AB  - Electrophysiological activity in the neonatal rat superior colliculus was
      recorded to measure neuronal and synaptic activity, and, therefore, functional
      development. Neonatal rat pups were studied from five days to two weeks of age.
      The earliest activity in the superior colliculus were spontaneous discharges at a
      frequency of one unit per animal on postnatal day 6 (P6). Spontaneously
      discharging units were more numerous at P8, and the number peaked on P10. The
      first clear response to optic nerve stimulation was seen on P10, with relatively
      long and variable latencies. By P14, electrically evoked responses had much
      shorter latencies. The results are in line with the first response to light flash
      in the superior colliculus at P12/13. The evidence suggests that functional
      development of the rat retinotectal pathway begins at the end of the first week
      after birth, and that much of the functional maturation occurs mainly during the
      second week after birth.

PMID- 8485852
TI  - Retinoic acid-induced differentiation of a human neuroblastoma cell line alters
      muscarinic receptor expression.
AB  - Muscarinic receptor density increased by approximately 36% after differentiation
      induced by retinoic acid (Bmax, control = 126 +/- 13 fmol/mg protein; Bmax,
      retinoic acid-treated = 170 +/- 17 fmol/mg protein; P < 0.05), corresponding to a
      170% increase in receptor content per cell. The affinity of [3H]NMS for the
      receptors was somewhat lower in the retinoic acid-treated cells (Kd, control =
      0.14 +/- 0.04 nM; Kd, retinoic acid-treated = 0.25 +/- 0.04 nM; P < 0.05).
      Reverse transcriptase/polymerase chain reaction analysis using subtype-specific
      primers revealed that undifferentiated Sk-N-SH cells transcribed mRNA for all 5
      receptor subtypes; this pattern was not affected by retinoic acid treatment.
      [3H]NMS displacement curves with subtype selective receptor ligands (pirenzepine,
      m1; AFDX-116, m2; 4-DAMP, m3) indicated the predominant expression of m3 and m1
      receptor subtypes, and differentiation did not affect the pharmacological profile
      of the expressed receptor populations. The present results indicate that
      differentiation induces selective changes in the expression and activity of
      muscarinic receptors in a neuronal cell line.

PMID- 8485853
TI  - Long-term alterations in brain function following cocaine administration during
      the preweanling period.
AB  - This report examines the long-term effects of cocaine exposure during postnatal
      days (P) 11-20 on the metabolic function of major central neuronal systems.
      Cocaine (50mg/kg) or vehicle was administered subcutaneously to rat pups during P
      11-20. At 60-64 days of age, the rats were examined for cerebral glucose
      metabolic patterns. In cocaine-treated females 18 of the 46 structures evaluated
      showed increased metabolic rates including 5 of 6 structures within the motor
      system and 7 of 17 limbic structures. No decreased rates were seen. In males,
      cocaine had no effects in the motor structures or hypothalamus while 2 of 17
      structures within the limbic system showed decreased rates of glucose utilization
      and 2 of 11 structures within the sensory systems showed increased rates. These
      results indicate that female rats show greater long-term metabolic effects than
      males and that cocaine exposure during P 11-20 produces different metabolic
      effects than cocaine exposure during P 1-10 which we previously reported.

PMID- 8485854
TI  - Developmental changes in seizure susceptibility in carbonic anhydrase II
      deficient mice and normal littermates.
AB  - Mice deficient in carbonic anhydrase II (CA II) were tested along with their
      normal littermates for susceptibility to seizures induced by flurothyl and loud
      sound at ages 10-180 days. In the flurothyl seizure model, CA II-deficient mice
      displayed increased resistance to clonic seizures from 32 to 90 days of age,
      whereas tonic-clonic seizures were suppressed at all ages. The mortality of CA II
      deficient mice was significantly decreased at ages 19-40 days. The incidence of
      sound-induced seizures was very low and no difference between CA II-deficient and
      normal mice was found. The anticonvulsant effect of CA II deficiency appears to
      be dependent on seizure model and seizure type and to have age-specific
      characteristics.

PMID- 8485855
TI  - Effects of probucol and pravastatin on plasma lipids, activities of postheparin
      lipoprotein lipase, and lecithin cholesterol acyltransferase and apo A-I
      containing lipoproteins with and without apo A-II in patients with moderate
      hypercholesterolemia.
AB  - In this study, plasma HDL fractions were separated by ultracentrifugation and apo
      A-I containing lipoproteins (A-I Lp) were then isolated using anti-apo A-I
      immunoaffinity chromatography. The A-I Lp were further separated into two
      fractions with the use of anti-apo A-II immunoaffinity chromatography. One
      fraction, Lp A-I, contained apo A-I without apo A-II, while the other, Lp A-I/A
      II, contained both apo A-I and apo A-II. These techniques were applied to
      investigate the changes in HDL apoprotein composition in hypercholesterolemic
      subjects treated with either probucol or pravastatin. Treatment with probucol
      (500 mg/day) or pravastatin (10 mg/day) reduced mean plasma total cholesterol
      concentrations by 24% (p < 0.01) and 16% (p < 0.05), respectively. Both drugs
      caused some reduction in lipoprotein lipase activity, but neither had any
      influence on the activity of hepatic triglyceride lipase or lecithin cholesterol
      acyltransferase. Their effects on HDL-cholesterol levels and apoprotein
      composition differed markedly. Probucol significantly decreased the HDL
      cholesterol concentration, the plasma apo A-I/apo A-II ratio, and the number of
      large particles of diameter greater than 10.4 nm. When the ratios of Lp A-I and
      Lp A-I/A-II for the probucol-treated subjects were compared with those in the
      normolipidemic controls, and with the ratios before and after administration of
      probucol, a remarkable decrease in the level of Lp A-I was apparent. It is
      presumed that the decrease in HLD-cholesterol by prolonged probucol
      administration reflects the decrease of Lp A-I more than the decrease of Lp A-I/A
      II.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485856
TI  - Human erythrocyte superoxide dismutase in adults, neonates, and normal,
      hypoxaemic, anaemic, and chromosomally abnormal fetuses.
AB  - An enzyme-linked immunosorbent method is described for the assay of human
      erythrocyte superoxide dismutase (SOD). The method was specific and precise as
      well as simple, economical, and reliable. The mean levels of adult SOD with SD
      were 652 +/- 122 mg/kg hemoglobin (Hb) for males and 635 +/- 100 mg/kg Hb for
      females. In neonates the levels were 528 +/- 92 mg/kg Hb. Normal fetal levels at
      20-36 weeks gestation were 421 +/- 90 mg/kg Hb. Mean SOD levels in hypoxemic
      growth-retarded fetuses and in anemic fetuses from red cell iso-immunised
      pregnancies (before their first intrauterine blood transfusion) were the same as
      those in normal fetuses. However, in a case of trisomy 21 the fetal level of SOD
      was significantly increased.

PMID- 8485857
TI  - Serum macro creatine kinase type 2 in asphyxiated newborn infants.
AB  - The presence of macro creatine kinase type 2 (MCK2) activity was noted in the
      serum of seven out of 32 newborn infants with perinatal asphyxia or birth trauma.
      MCK2 isoenzyme, when present, represented 15-35% of the total creatine kinase
      (CK) activity. The clinical and biochemical features of the seven MCK2-positive
      and 25 MCK2-negative newborns were compared. The infants with MCK2 activity were
      all males and clinically appeared to be more severely injured, requiring longer
      hospitalization. Total CK activity was similar in the two groups and CK-MB and CK
      BB isoenzyme fractions were present in a similar proportion of infants in both
      groups. Two infants in each group had long-term neurological disorders. Although
      the presence of MCK2 has been noted in adult patients with end-stage metastatic
      solid tumors, the presence of this isoenzyme has not previously been reported in
      newborn infants.

PMID- 8485858
TI  - HDL particle measurements: impact for diagnosis and therapy.

PMID- 8485859
TI  - Current controversies about galactosemia.

PMID- 8485860
TI  - Rheumatoid factors.
AB  - Rheumatoid factors (RFs) have been studied for over 50 years and are probably the
      most written about of any antibody. Nevertheless, the etiology of these RFs and
      the precise role they play in the pathogenesis of rheumatoid arthritis (RA) and
      juvenile rheumatoid arthritis (JRA) remain a major interest. When RFs participate
      in the generation of inflammation in RA and JRA, they probably do so by forming
      immune complexes (IC) or are themselves able to bring about the inflammatory
      response. Their presence has been associated with more severe disease,
      vasculitis, and systemic symptoms. The present review summarises the literature
      over the last few years on new and interesting findings on RF. This review covers
      an update on RF assays, RF cross-reactivity, specificity studies, immune complex
      formation, RF lymphocyte studies, and RF binding.

PMID- 8485861
TI  - Characterisation of human lung elastin-derived peptides.
AB  - The enzymatic breakdown of human lung elastin by leukocyte elastase precedes the
      development of pulmonary emphysema, and releases elastin-derived peptides (EDPs)
      into the circulation. While raised levels of EDPs measured by enzyme-linked
      immunosorbent assay (ELISA) have been proposed as a possible marker for early
      detection of emphysema, average normal values of EDPs measured by different
      investigators have differed by up to a factor of 1000. Standardisation of the
      methodology for elastin purification and EDP production in vitro is required to
      ensure the accuracy of EDP measurements in vivo, because antiserum used in the
      ELISA is raised against the EDPs produced in vitro. In the present study elastin
      was purified from human lung by sequential biochemical extraction, and
      solubilised by leukocyte elastase. Molecular weight distribution of EDPs produced
      by partial and complete elastin digestion were compared by gel exclusion
      chromatography. A method for successful separation of EDPs by SDS-polyacrylamide
      gel electrophoresis (SDS-PAGE) is reported. The implications of these results for
      further immunological characterisation of these peptides are discussed with a
      view to standardisation of the techniques employed for the measurement of EDPs in
      vivo.

PMID- 8485862
TI  - Comparative study of two commercial enzymatic kits for determining oxalate
      concentrations in urine.
AB  - We performed a comparative study of two commercial kits for determining oxalate
      in urine. These were: (a) an oxalate decarboxylase-based assay (Boehringer
      Mannheim); (b) an oxalate oxidase-based assay (Sigma). The within-run and between
      run imprecision were found to be similar in both methods. The recovery was 94%
      with the oxalate decarboxylase method. The pH of the specimen had a major effect
      on the recovery obtained by the oxalate oxidase method (66-86% at pH = 2.5 and 37
      68% at pH = 1.5). The decarboxylase method was linear up to at least 2224 mumol/L
      and the oxidase method was linear up to at least 890 mumol/L. We also studied the
      interference of ascorbic acid in both techniques and found a positive bias with
      the oxidase method and a negative bias using the decarboxylase method. The
      correlation coefficient was 0.592.

PMID- 8485863
TI  - Analysis of charge of kappa and lambda chain-containing serum immunoglobulin A by
      immunoblotting and densitometry.
AB  - A novel method for studying the charge distribution of different subclasses of
      serum immunoglobulin A (defined by the light chains) is described. Affinity
      chromatography purified immunoglobulins were focused in polyacrylamide gel and
      were then transferred electrophoretically onto nitrocellulose membranes. The
      transferred immunoglobulins were detected by rabbit antiserum to human kappa
      (kappa) or lambda (lambda) chain, swine antirabbit IgG, rabbit anti-peroxidase
      antibodies and peroxidase, together with a substrate solution comprising H2O2 and
      diaminobenzidine. Finally, the developed membranes were made transparent with
      Triton-x 114, scanned at 485 nm with a densitometer to obtain quantitation of
      charge distribution.

PMID- 8485864
TI  - Detecting the renal effects of cadmium toxicity.

PMID- 8485865
TI  - Lipase in serum--the elusive enzyme: an overview.
AB  - Lipase is a glycoprotein with 420-449 amino acid residues and a M(r) of 46,000
      56,000 for pancreatic lipase and 32,000-39,000 for serum lipase. Lipase is
      present in the pancreas, intestines, and a variety of other tissues. The
      concentration gradient between pancreatic tissue and serum lipase is
      approximately 20,000-fold. Serine, as part of an Asp-His-Ser triad, is the
      nucleophilic residue essential for catalysis. Lipase differs from other esterases
      by the presence of a hydrophobic recognition site. The optimal pH is between 7.5
      and 10.0, depending on the reaction condition; the pI for the various forms of
      the enzyme has been reported as 5.80 and 5.85; 6.4, 6.8, and 7.0; and 7.4 for a
      purified fraction. Several authors report the presence of two molecular forms in
      the pancreas and three electrophoretic bands with lipolytic activity. In normal
      serum two bands have been observed; in pancreatitis as many as four bands have
      been seen. Lipolytic activity may not always be due to lipase. Assays specific
      for lipase require a triglyceride as substrate as well as the presence of
      colipase (a water-soluble and heat-stable protein, essential for lipase action),
      a secondary bile salt, and Ca2+. The clinical sensitivity of all modern assays is
      high because of selection of a low decision limit; the clinical specificity
      varies greatly but can be improved by increasing the cutoff point. Lipase
      determinations in pancreatitis are superior to amylase determinations. The
      reasons for the great variability of reports regarding the clinical utility of
      lipase are discussed, and the clinical utility of lipase determinations is
      summarized.

PMID- 8485866
TI  - A quantitative measure of nonlinearity.
AB  - Quantitative measures of the nonlinearity of an analytical method are defined as
      follows: the "(dimensional) nonlinearity" of a method is the square root of the
      mean of the square of the deviation of the response curve from a straight line,
      where the straight line is chosen to minimize the nonlinearity. The "relative
      nonlinearity" is defined as the dimensional nonlinearity divided by the
      difference between the maximum and minimum assayed values. These definitions may
      be used to develop practical criteria for linearity that are still objective.
      Calculation of the nonlinearity requires a method of curve-fitting. In this
      article, we use polynomial regression to demonstrate calculations, but the
      definition of nonlinearity also accommodates alternative nonlinear regression
      procedures.

PMID- 8485867
TI  - International Federation of Clinical Chemistry standardization project for
      measurements of apolipoproteins A-I and B. III. Comparability of apolipoprotein A
      I values by use of international reference material.
AB  - In the third phase of the International Federation of Clinical Chemistry (IFCC)
      study for the standardization of apolipoprotein (apo) measurements, the
      preparation SP1-01, selected as the candidate international reference material
      for apo A-I, was investigated for its ability to transfer an accuracy-based value
      to the immunoassay calibrators and to produce comparability of the values for
      patients' samples. An apo A-I value of 1.50 g/L (SD 0.08 g/L) was assigned to SP1
      01 by a highly standardized RIA calibrated with purified apo A-I for which the
      mass value had been determined by amino acid analysis. According to a common
      detailed protocol, the participants transferred the mass value from SP1-01 to the
      calibrator of each method. To confirm that uniformity of calibration ensures
      comparability of the values over a wide range of apo A-I values, each laboratory
      analyzed 50 fresh-frozen samples from individual donors, using an approach
      similar to that adopted by the Cholesterol Reference Laboratory Network. The
      consensus mean value for each sample was in excellent agreement with the value
      assigned by the Northwest Lipid Research Laboratories, with the average absolute
      bias between assigned and consensus value being 0.01 g/L. The among-laboratory CV
      on each of the 50 samples ranged from 2.1% to 5.6% (mean 3.6%), demonstrating
      that comparable apo A-I results can be obtained by a variety of immunochemical
      methods through the use of certified reference material. Based on the results
      obtained in these studies, SP1-01 has been approved as Apolipoprotein A-I
      International Reference Material by the World Health Organization.

PMID- 8485868
TI  - Increased phospholipase A activities in sera of intensive-care patients show sn-2
      specificity but no acyl-chain selectivity.
AB  - Phospholipase A (PLA) activities were measured by high-performance liquid
      chromatography in two enzyme preparations purified from human duodenal juice and
      a serum pool as well as in 52 sera from 31 intensive-care patients with various
      diseases. On the basis of a position-specific fatty acid analysis of the natural
      substrate ("soybean lecithin") from a commercial PLA kit, serum activities of
      PLA1 could be clearly distinguished from those of PLA2, which is not possible in
      the usual measurements made with single-label radioactive substrates. Independent
      of the type of disease, all sera with highly increased PLA activities (40-200
      U/L) showed nearly pure PLA2 characteristics without any preference among oleic,
      linoleic, and linolenic acid in the sn-2 position of the glycerophospholipid
      substrate. Nevertheless, very low PLA1 activities (< or = 5 U/L, most likely due
      to heparin perfusion therapy) could also be detected by palmitic and stearic acid
      release from the sn-1 position, leading to small changes in fatty acid release
      patterns of sera with low PLA activities. Measurements with sera from heparin
      treated volunteers demonstrated that heparin therapy may initially contribute as
      much as 22 U/L to increased PLA1 activities but is not important under prolonged
      therapy. The absence of selectivity with respect to acyl-chain desaturation
      supports the concept of serum PLA2 as an acute-phase protein rather than a
      regulator of the arachidonic acid cascade.

PMID- 8485869
TI  - Lipid peroxidation and trace element status in diabetic ketotic patients:
      influence of insulin therapy.
AB  - Lipid peroxidation is known to accelerate aging and microvascular lesions in
      diabetic patients. We studied the acute influence of improved glycemic control on
      the concentrations of plasma lipid peroxidation intermediates [malondialdehydes
      (MDA), organic hydroperoxides (OHP)] in ketotic insulin-dependent diabetic
      patients, as well as the interplay of enzymes such as glutathione peroxidase
      (GPX) and CuZn superoxide dismutase (CuZn-SOD), and trace elements (Zn, Se, Cu)
      postulated to be involved in free radical protection. These plasma components
      were measured on the first day of hospitalization (T0) and when the patient had
      attained a stable glycemic state after continuous insulin treatment (T1). Plasma
      MDA and OHP concentrations were high at the beginning of the study but approached
      reference values after glycemic equilibration. Plasma zinc concentrations were
      significantly (P < 0.05) decreased during the ketotic state, but also approached
      reference values with glycemic equilibration. Plasma selenium concentrations and
      GPX activity were relatively unchanged between T0 and T1. Erythrocyte GPX
      activity measured at T1 in six patients was below the reference values, whereas
      CuZn-SOD activity was not affected. Our results show that enhanced lipid
      peroxidation is associated with decreased zinc plasma concentrations in ketotic
      patients and underline the beneficial effects of continuous insulin infusion. The
      mechanisms involved are still unclear but may indicate the importance of
      extracellular zinc transfer secondary to glycemic disorders.

PMID- 8485870
TI  - Analysis for bismuth in tissue by electrothermal atomic absorption spectrometry.
AB  - We developed a simple method for the analysis of bismuth (Bi) in biological
      tissue, using wet digestion for sample pretreatment. Bi was determined by
      electrothermal atomic absorption spectrometry with platinum as a matrix modifier
      to decrease the volatility of Bi. The furnace program included a gas stop for
      sensitivity enhancement. Analytical performance was established for Bi in kidney,
      liver, brain, and bone. As little as 25 ng/g wet weight can be detected in the
      most concentrated digests. Homogenization of bone was necessary before digestion,
      and its matrix showed the strongest interference. In rats exposed orally to
      colloidal bismuth subcitrate for 14 days, the metal could be detected in liver,
      kidney, and spleen but not in brain and bone. In the tissues of 12 patients who
      died from non-Bi-related causes, no Bi were present in kidney in the other 2.

PMID- 8485871
TI  - Separation of beta-carotene and lycopene geometrical isomers in biological
      samples.
AB  - The analysis of beta-carotene and lycopene, the two predominant carotenoids in
      human serum and tissues, was extended to the level of geometrical (cis-trans)
      isomers by using an improved reversed-phase HPLC methodology. We separated five
      geometrical isomers of beta-carotene and seven of lycopene in human serum and
      tissues. 13-cis-beta-Carotene was identified as the predominant cisisomer in
      human serum, contributing about 5% to total beta-carotene. In tissue, however,
      considerable amounts of 9-cis- and traces of 15-cis-beta-carotene were also
      detected. In contrast to beta-carotene, the lycopene isomer patterns in human
      serum and tissues are quite similar.

PMID- 8485872
TI  - Glycated calmodulin from platelets as an index of glycemic control.
AB  - In an effort to test whether a significant fraction of calmodulin would become
      glycated within the life span of the platelet (10-14 days), we monitored the
      kinetics of calmodulin glycation in vitro. Under the conditions we used, the
      fraction of glycated calmodulin reached a maximum (approximately 21%) within 10
      days. We then extended the studies to human subjects. The intraplatelet
      concentrations of calmodulin and glycated calmodulin from age-matched type I
      diabetic subjects were monitored by a combination of m-aminophenylboronate
      affinity chromatography and enzyme-linked immunosorbent assay. The results
      indicate that the concentrations of total intraplatelet calmodulin (nonglycated
      plus glycated) were not dependent on the glycemic state of the subjects. Data
      from control and diabetic subjects showed a poor correlation between the
      concentrations of glycohemoglobin and of glycated calmodulin. However, a better
      correlation was obtained when glycated calmodulin concentrations were compared
      with those of serum fructosamine. The fraction of glycated calmodulin in the
      control population (7.71% +/- 0.75%) was significantly (P < 0.05) different from
      that of the diabetic population (21.6% +/- 1.26%). Given that the clinical role
      of the fructosamine assay remains controversial, estimation of glycated
      calmodulin in platelets might be useful as a short time-window index of glycemic
      control.

PMID- 8485873
TI  - Fast HPLC determination of serum free fatty acids in the picomole range.
AB  - We developed a method for determining individual free fatty acids in serum by
      using a modified one-step Dole extraction, derivatization, and a new high
      performance liquid chromatographic (HPLC) separation. Sample handling is
      minimized to a single transfer of the fatty acids (upper layer of the Dole
      extract), which are readily derivatized at 85 degrees C with p-bromophenacyl
      bromide without significant hydrolysis of esterified fatty acids. The
      derivatization mixture is directly injected into the HPLC apparatus. The new
      method, which uses C6 (3-microns particle) column material and an isocratic
      acetonitrile-water eluent, separates nearly to baseline 12 of the physiologically
      most abundant long-chain fatty acids (C12-C22) in < 20 min with a detection limit
      of approximately 2 pmol. It is therefore suitable for routine analysis even with
      basic HPLC equipment and can easily analyze a series of 10-20 samples in about 2
      h including extraction until first results are available. The method is also
      applicable to other matrices than serum, e.g., for determination of precursor
      fatty acids such as arachidonic acid in platelets or of fatty acid patterns
      liberated by lipases or phospholipases A1/A2 in test systems.

PMID- 8485874
TI  - International cooperation in analytical chemistry: experience of antidoping
      control at the XI Pan American Games.
AB  - We describe the experience of the international cooperation carried out for
      antidoping control at the XI Pan American Games. A temporary accreditation was
      granted by the International Olympic Committee to the accredited laboratory of
      Barcelona (Spain) to set up a Doping Control Laboratory in Havana. Two other
      laboratories from Mexico and Cuba contributed personnel, materials, and
      instrumentation. The main issues associated with the preparation and organization
      of the project are described. During 16 days, 741 urine samples were tested for
      stimulants, narcotics, anabolic steroids, beta-blockers, diuretics, cannabinoids,
      local anesthetics, and human chorionic gonadotropin by gas-liquid chromatography,
      gas chromatography/mass spectrometry, high-performance liquid chromatography, and
      immunoassay techniques. Analytical methodologies, quality-control strategies, and
      the main results are reported.

PMID- 8485875
TI  - Intra- and interlaboratory sources of imprecision in drug measurements by
      different techniques.
AB  - We compared the intra- and interlaboratory precision of seven techniques used to
      measure eight antiepileptic drugs, digoxin, and theophylline by using data from
      the international Healthcontrol external quality-assessment scheme. Scheme
      participants were supplied blind with 6 or 12 sets of duplicate lyophilized serum
      samples. Each set contained different drug concentrations, and duplicates were
      analyzed separately, 1 to 6 months apart. The intra- and interlaboratory
      components of assay variance were isolated and compared by Bartlett's test for
      homogeneity of variance. Fluorescence polarization immunoassay (Abbott) showed
      the best overall intra- and interlaboratory performance for a range of analytes.
      The largest intralaboratory errors were produced by techniques using the Syva
      EMIT assays. Our analysis of the data shows that for most analyte/technique
      combinations, intralaboratory sources of variation were more important than
      interlaboratory sources. Gains in assay precision will therefore result from
      attention to internal laboratory procedures.

PMID- 8485876
TI  - Characterization procedure for ion-selective electrode assays of magnesium
      activity in aqueous solutions of physiological composition.
AB  - A magnesium ion-selective liquid membrane electrode based on a synthetic neutral
      carrier is presented. The selectivity for Mg2+ over Na+, K+, and H+ is sufficient
      for assays in the physiological range, but a chemometric correction of
      approximately 10% is still necessary for the Ca2+ interference. We optimized the
      membrane composition especially with respect to selectivity and accuracy by
      performing a new characterization procedure in which we simulated the variety of
      blood serum samples with 10 aqueous solutions. After a three-point calibration,
      these solutions were measured alternately with the middlerange calibrator for 3
      min. The magnesium activity was evaluated after correcting for the calcium
      interference according to the Nikolsky equation. The selectivity coefficient,
      KpotMgCa, was itself fitted to give the minimum deviations from the assigned
      magnesium activities. Electrodes with an optimized membrane composition show an
      average deviation from theoretical activity values of about 1.6% with logKpotMgCa
      = -0.8.

PMID- 8485877
TI  - Evaluation of seven Cholestech L.D.X analyzers for total cholesterol
      determinations.
AB  - We assessed the performance of seven Cholestech L.D.X lipid analyzers under
      tightly controlled laboratory conditions for accuracy and precision in accordance
      with analytical guidelines of the National Cholesterol Education Program (NCEP).
      Venous heparinized whole blood (VB) and plasma (VP), venous serum (VS), and
      capillary fingerstick whole blood (FB) were collected from 18 individuals. Total
      cholesterol (TC) concentration was measured in VB, VP, and VS on all seven
      instruments. Three instruments were used for TC measurements of FB. Reference
      cholesterol values for each individual were generated in the same laboratory with
      a standardized method. The within-run coefficients of variation (CVs) for all
      instruments with a Level I pool (1560 mg/L, n = 10) ranged from 1.3% to 1.8%
      (mean = 1.59%). The between-run CVs with the same pool ranged from 2.2% to 3.4%
      (mean = 2.84%, n = 10). Correlation coefficients derived from comparison of total
      cholesterol values generated by the instruments for each specimen type vs the
      reference cholesterol values were all > 0.97. The average bias for all
      instruments for each sample type was 1.9% (FB), 4.3% (VB), 6.6% (VP), and 7.0%
      (VS). Predicted cholesterol concentration for each sample type from regression
      curves for total cholesterol at the suggested NCEP clinical decision cutoff
      values of 2000 and 2400 mg/L, respectively, were 2049 and 2431 mg/L for FB, 2081
      and 2469 mg/L for VB, 2122 and 2522 mg/L for VP, and 2121 and 2521 mg/L for VS.

PMID- 8485878
TI  - Interference of lysophosphatidylcholine in hormone radioimmunoassays.
AB  - The interference of synthetic and naturally occurring detergents in immunoassays
      is well documented. In the present study, we evaluated the effect of
      lysophosphatidylcholine (LPC) and found that the lysophospholipid interfered with
      formation of the antigen-antibody complex in hormone immunoassays. In the
      presence of LPC (100 mumol/L), progesterone was overestimated by 29%.
      Furthermore, physiological concentrations of LPC (140 mumol/L) interfered with
      the assays of cortisol, progesterone, and aldosterone, resulting in
      overestimations of 35%, 30%, and 27%, respectively. The addition of albumin
      decreased the interference by LPC to 7% in the assay of cortisol and progesterone
      when the LPC:albumin ratio was unity. Adding cholesterol (100 mumol/L) also
      reduced by 50% the interference induced by LPC. Finally, treating plasma to
      increase the endogenous LPC concentration also resulted in interference in the
      cortisol assay. Thus, interpretation of the results of these assays should take
      into consideration the endogenous serum albumin:LPC ratio.

PMID- 8485879
TI  - Assay of complexed alpha 1-antichymotrypsin in plasma.
AB  - We introduce an assay to measure complexed alpha 1-antichymotrypsin in human
      plasma. The assay works on the principle that the target proteinase cathepsin G
      has a very high affinity to the surface of microtiter plates, even if these
      surfaces are blocked with albumin and Tween 20. alpha 1-Antichymotrypsin, when
      complexed to cathepsin G, is thus immobilized and can be detected with specific
      antibodies. The mean (SD) concentration of alpha 1-antichymotrypsin in 50 healthy
      individuals was 1.73 (0.58) nmol/L. The detection limit was 0.84 nmol/L. The
      results of the assay are linear to at least 14 nmol/L. We propose to use this
      assay for diseases in which increased turnover of alpha 1-antichymotrypsin or
      cathepsin G can be expected to clarify further the function of this enzyme
      inhibitor system.

PMID- 8485880
TI  - Reduced bovine hemoglobin solution evaluated for use as a blood gas quality
      control material.
AB  - We evaluated a new commercially available partially purified reduced bovine
      hemoglobin solution (RBHS) and a new tonometer for use in the quality control of
      blood gas analyzers. RBHS is manufactured in three different formulations, each
      corresponding to three different bicarbonate-buffering capacities and
      concentrations of total hemoglobin (ctHb). The P50 for each formulation of RBHS
      was determined to be as follows: 30.6 mmHg (4.08 kPa) for Level 1, 29.1 mmHg
      (3.88 kPa) for Level 2, and 28.2 mmHg (3.76 kPa) for Level 3. When RBHS and human
      blood samples were tonometered at three clinically significant values of PO2 and
      PCO2, the recovered values for PO2 and PCO2 in RBHS were comparable with those of
      the tonometered whole blood. Each level of RBHS also produced precise pH (SD < or
      = 0.006 pH units) and ctHb (SD = 1.0 g/L) values. In addition, when the
      temperature of a sample chamber was intentionally altered, the changes in RBHS
      blood gas values closely approximated the changes seen with human blood. RBHS
      shows more thermal sensitivity than either perfluorocarbon emulsions or aqueous
      buffers, which are currently being used as quality-control and proficiency
      testing materials.

PMID- 8485881
TI  - Role of antibody valency in hapten-heterologous immunoassays.
AB  - We studied the effects of hapten heterology on immunoassays of triiodothyronine
      (T3), digoxin, and cortisol, in a format involving labeled monoclonal antibodies
      and immobilized, protein-conjugated ligands. Replacing the homologous conjugated
      ligands T3, digoxin, and cortisol with their respective analogs diiodothyronine,
      digitoxin, and corticosterone led in each case to a decrease in the midpoint of
      displacement (ED50) for the same zero-dose signal. The mechanism of this
      phenomenon was studied by converting the bivalent anti-T3 to a monovalent whole
      antibody (bispecific monoclonal anti-T3 x anti-glucose-6-phosphate dehydrogenase)
      by cell fusion. The monovalent antibody was effective as a tracer in the
      homologous T3 assay, but generated a very low zero-dose signal with the
      heterologous solid phase, thus precluding sensitivity enhancement. On the basis
      of these results and additional kinetic and double-labeling experiments, we
      propose that the use of hapten heterology relies on bivalent binding of the
      antibody to the solid phase to compensate for a lower intrinsic affinity. This
      binding mechanism leads to lower assay concentrations of the ternary complex
      analyte-labeled antibody-immobilized hapten, thereby providing enhanced
      sensitivity.

PMID- 8485882
TI  - Measurement of urinary sugars by HPLC in the estimation of intestinal
      permeability: evaluation in pediatric clinical practice.
AB  - Determinations of the permeability of the intestine to various sugars have been
      used to assess intestinal mucosal abnormalities, but the widespread application
      of such tests has been prohibited by the complexity of most classically used
      techniques. In this study, we evaluated the sensitivity and practicability of
      using HPLC to estimate intestinal permeability, with mannitol and lactulose as
      mono- and disaccharides, respectively. The results of the permeability tests were
      compared with those of intestinal biopsy in 20 children. All patients with an
      abnormal intestinal biopsy showed a low mannitol recovery, and the patients with
      allergic symptoms showed a high lactulose recovery. Our preliminary data suggest
      that HPLC is reliable, gives results comparable with those of other methods, and
      is a practical way to determine intestinal permeability noninvasively.

PMID- 8485883
TI  - Monitoring cancer antigen 125 in serum of ovarian cancer patients after
      administration of 131I-labeled F(ab')2 fragments of OC125 antibody.
AB  - We evaluated the effect of repeated administration of OC125 F(ab')2 fragments on
      cancer antigen (CA) 125 determination in 210 serum samples from 30 patients. We
      found falsely high CA 125 concentrations in 142 (68%) samples, using a homologous
      CA 125 enzyme immunoassay (EIA) with OC125 antibodies. The Truquant OV2 method,
      which involves two other murine antibodies, and the IMx CA 125 method, which uses
      sheep antibodies as capture antibodies, resulted in only slightly increased
      (false-positive) values in some samples with exceptionally high CA 125 EIA
      values. We measured falsely low CA 125 values in 37 (18%) samples with the
      Truquant OV2 method. Interferences could be eliminated by removal of serum IgG.
      Our results suggest that interferences are to some extent caused by anti
      idiotypic IgG induced by OC125 administration. Assays involving nonmurine anti-CA
      125 antibodies as capture antibodies seem to be most suited for CA 125
      determination after OC125 treatment, but in every case an apparent increase of CA
      125 after OC125 infusion should be validated.

PMID- 8485884
TI  - 3-Hydroxydicarboxylic and 3-ketodicarboxylic aciduria in three patients: evidence
      for a new defect in fatty acid oxidation at the level of 3-ketoacyl-CoA thiolase.
AB  - Three patients presented with evidence of a fatty acid oxidation disorder.
      Analysis of urinary organic acids by gas chromatography/mass spectrometry
      demonstrated the presence of medium-chain (C6-C12) dicarboxylic, 3
      hydroxydicarboxylic, and 3-ketodicarboxylic acids in all three urines. 3
      Ketodicarboxylic aciduria is reported for the first time here, as are the mass
      spectra for 3-ketosuberic, 3-ketosebacic, and 3-ketododecanedioic acids and the
      oximated spectrum for 3-ketoadipic acid. The presence of 3-ketodicarboxylic acids
      suggests a defect at the level of a long-chain 3-ketoacyl-CoA thiolase, an enzyme
      for which a deficiency state has not previously been described. Our patients may
      represent the first cases of a long-chain thiolase defect.

PMID- 8485885
TI  - Sigma diagnostics: pioneer of kits for clinical chemistry.

PMID- 8485886
TI  - Calibration of automated thyrotropin assays.

PMID- 8485887
TI  - Within-subject variation of thyroxine and triiodothyronine concentrations in
      serum.

PMID- 8485888
TI  - Effect of parturition on serum alpha 1-antiprotease (alpha 1-antitrypsin)

PMID- 8485889
TI  - Interferences of bilirubin, ascorbic acid, dipyrone, and D-penicillamine in two
      assays of 5'-nucleotidase.

PMID- 8485890
TI  - Biological variation of lactate and pyruvate in blood.

PMID- 8485891
TI  - Incomplete separation of erythrocytes from serum causes significant error in the
      IMx free triiodothyronine assay.

PMID- 8485892
TI  - Growing use of nonisotopic CA 19-9 immunoassays increases between-laboratory
      variability.

PMID- 8485893
TI  - Interference in coupled-enzyme assay of urea nitrogen by excess endogenous
      enzyme.

PMID- 8485894
TI  - Mn- and Cu,Zn-superoxide dismutase activities during acute myocardial infarction.

PMID- 8485895
TI  - Effect of light on serum B12 and folate stability.

PMID- 8485896
TI  - Desirable performance criteria for quantitative measurements in medical
      laboratories based on biological analyte variation--hindrances to reaching some
      and reasons to surpass some.

PMID- 8485897
TI  - Detection of dystrophin with a modified western blot technique in muscle tissue
      extracts.

PMID- 8485898
TI  - False-positive ketone reactions in CAP surveys.

PMID- 8485899
TI  - IgA anti-lipoprotein antibodies in autoimmune dyslipidemia are restricted to IgA1
      subclass.

PMID- 8485900
TI  - Problems of C-reactive protein determination in patients with monoclonal
      immunoglobulins.

PMID- 8485901
TI  - Autoantibody specific for lactate dehydrogenase isoenzyme 4.

PMID- 8485902
TI  - High concentrations of eosinophil-derived neurotoxin in patients' urine mimic
      lysozyme far-cathodic bands in agarose gel electrophoresis.

PMID- 8485903
TI  - Stability of acetoacetate after venesection.

PMID- 8485904
TI  - Methemoglobin determinations in cerebrospinal fluid have low clinical utility.

PMID- 8485905
TI  - CR3 (CD11b, CD18): a phagocyte and NK cell membrane receptor with multiple ligand
      specificities and functions.
AB  - The C3 receptor CR3 is expressed on phagocytic cells, minor subsets of B and T
      cells, and natural killer (NK) cells. It has important functions both as an
      adhesion molecule and a membrane receptor mediating recognition of diverse
      ligands such as intercellular adhesion molecule-1 (ICAM-1) and fixed iC3b. The
      receptor is capable of undergoing an activation event that regulates both its
      specificity for various ligands and its ability to mediate phagocytosis or
      extracellular cytotoxicity. Certain bacteria express carbohydrates or
      lipopolysaccharides (LPS) that can bind to and activate CR3, allowing the
      receptor to assume its activated state. Soluble beta-glucan derived from the
      yeast Saccharomyces cerevisiae is a particularly potent stimulator of CR3, and
      produces an activated state of the receptor that permits neutrophil phagocytosis
      of iC3b-coated erythrocytes or NK, cell cytotoxicity of iC3b-coated tumour cells,
      that are normally resistant to NK cells.

PMID- 8485906
TI  - Activation of the immune system of cancer patients by continuous i.v. recombinant
      IL-2 (rIL-2) therapy is dependent on dose and schedule of rIL-2.
AB  - The effect of dose and schedule of continuous i.v. rIL-2 infusions on leucocyte
      subset counts, activation status of CD56+CD3- natural killer (NK) and CD3+ T
      lymphocytes, and cytolytic activities of peripheral blood mononuclear cells
      (PBMC) was studied. A single 4-day course of rIL-2 in escalating doses (0.9-11.5
      x 10(6) U/m2 per day) was given to 18 patients with various types of metastatic
      cancer. The serum IL-2 concentration during rIL-2 therapy ranged between 23 and
      64 U/ml and was proportional to the administered rIL-2 dose, as was the rebound
      lymphocytosis following therapy. Before therapy, the CD56+CD3- NK cells expressed
      low levels of the p75 chain of the IL-2 receptor (IL-2R) and virtually no IL
      2R(p55). Most CD3+ T cells were IL-2R(p55-,p75-). Between 2 and 4 days following
      therapy, i.e. at the time of lymphocytosis, the percentage of CD56+,CD3- NK cells
      among the lymphocytes had increased proportional to the administered rIL-2 dose.
      The levels of IL-2R(p75) expression by the CD56+,CD3- NK cells had increased. The
      percentages of CD3+ T cells expressing IL-2R(p55), HLA-DR and CD45RO had
      increased proportional to the administered rIL-2 dose. The level of lymphokine-
      activated killer (LAK) activity against Daudi cells was also positively
      correlated with rIL-2 dose. Subsequently, seven patients received 4-weekly cycles
      of rIL-2 (2.9-4.4 x 10(6) U/m2 per day) during 4 consecutive weeks. This schedule
      led to marked increments in lymphocyte and eosinophil counts, and to increased
      cytolytic activities compared with pretreatment. We conclude that CD56+,CD3- NK
      and CD3+ T cells are activated differentially by continuous i.v. rIL-2
      proportional to dose and duration of treatment.

PMID- 8485907
TI  - Isotype-specific cross-linking of select human Fc gamma R isoforms triggers
      release of IL-6.
AB  - Anti-CD3 MoAbs are widely used in T cell activation studies, and are effective in
      immunosuppressive therapy. We used a panel of mouse (m) anti-CD3 switch variant
      MoAbs of five different isotypes to study IL-6 release from accessory cells.
      Incubation of human (h) mononuclear cells with anti-CD3 MoAbs resulted in
      increased IL-6 levels with MoAbs of mIgG1 and mIgG2a isotypes, with no effect of
      mIgG2b or mIgA. This suggested involvement of IgG Fc receptors (Fc gamma R) in
      triggering IL-6 production. To evaluate the role of different Fc gamma R
      molecules individually we used a panel of hFc gamma R-transfected mouse
      fibroblasts, and Jurkat T cells as a model. IL-6 secretion by CD32 transfectants
      expressing the hFc gamma RIIa high-responder (HR) allelic form was triggered by
      mIgG1 anti-CD3 MoAb, with no effect of four other isotypes. None of the anti-CD3
      MoAbs induced IL-6 secretion by CD32 transfectants expressing either a variant of
      this receptor, containing only a single intracellular amino acid (CT-), the hFc
      gamma RIIa low-responder (LR) allelic form, or hFc gamma RIIb1. hFc gamma RI
      (CD64) transfectants exhibited IL-6 production after incubation with mIgG2a anti
      CD3 MoAb, and to a lesser extent with mIgG2b, and mIgG1 MoAb. Indirect
      involvement of T cells in triggering IL-6 secretion could be excluded by
      experiments in which transfectants were cultured with immobilized anti-CD3 MoAb.
      These data indicate that cross-linking of either hFc gamma RI, or hFc gamma
      RIIaHR by appropriate anti-CD3 MoAbs triggers IL-6 production of accessory cells,
      and not T cells. This may also take place in vivo during immunosuppressive
      therapy with anti-CD3 MoAbs, and related antibody-mediated immune responses.

PMID- 8485908
TI  - The anti-lipid A antibody HA-1A binds to rough gram-negative bacteria, fixes
      complement and facilitates binding to erythrocyte CR1 (CD35).
AB  - MoAbs to bacterial cell wall lipopolysaccharide are currently under evaluation
      for the treatment of Gram-negative sepsis. The mode of action of these reagents
      remains poorly understood. In this study we examined the ability of radiolabelled
      HA-1A (an IgM anti-lipid A MoAb) to bind in vitro to Salmonella minnesota (Re
      595), Escherichia coli, and Streptococcus pyogenes. HA-1A was able to bind
      specifically to the 'rough' mutant Salm. minnesota, but not to a 'smooth' E.
      coli, or Strep. pyogenes. Binding to Salm. minnesota led to complement fixation
      which resulted in bacterial adherence to erythrocyte CR1, suggesting a possible
      mechanism whereby the antibody might enhance clearance of bacteria by
      facilitating delivery to the fixed mononuclear phagocytic system. We were not
      able to demonstrate the formation of immune complexes between free
      lipopolysaccharide and HA-1A in the presence of serum, nor the enhancement of
      complement-mediated binding of HA-1A:Salm. minnesota immune complexes to
      erythrocytes by antibiotic treatment. Binding of HA-1A to small bacterial
      fragments was, however, demonstrable after in vitro treatment with a beta-lactam
      antibiotic, which disrupts the bacterial cell wall, but not with gentamicin, an
      aminoglycoside antibiotic which blocks protein synthesis.

PMID- 8485910
TI  - Synovial fluid antigen-presenting cell function in rheumatoid arthritis.
AB  - We have previously demonstrated enhanced synovial fluid (SF) antigen-presenting
      cell (APC) function in inflammatory arthritis patients selected on the basis of
      marked SF mononuclear cell (MNC) responsiveness to reactive arthritis-associated
      bacteria (Clin Exp Immunol 1990; 79:189-94). In this study we have assessed
      whether similarly enhanced synovial APC function is present in other inflammatory
      arthritis patients by using two assay systems to study 18 rheumatoid arthritis
      patients whose MNC responsiveness had not been determined in advance. We
      demonstrate that rheumatoid SF APC are much more potent than peripheral blood
      (PB) APC in stimulating the responses of autologous PB T cells to a range of
      recall antigens. In addition, SF APC are shown to be efficient stimulators of the
      antigen-specific responses of MHC-compatible, cloned T cells. Enhanced synovial
      APC function is thus likely to be a general feature of inflammatory arthritis and
      may play an important role in its pathogenesis.

PMID- 8485909
TI  - Increased IL-6 gene expression and production in patients with common variable
      immunodeficiency.
AB  - We have studied IL-6 gene expression and production by in vitro stimulated
      peripheral blood mononuclear cells (PBMC) isolated from common variable
      immunodeficiency (CVI) patients. A strong hybridization signal for the IL-6 probe
      was observed in mRNA extracted from phytohaemagglutinin (PHA)- and PHA/phorbol
      myristate acetate (PMA)-stimulated PBMC from most of 12 CVI patients analysed. IL
      6 production by PHA-stimulated PBMC from 28 CVI patients was evaluated in ELISA
      and found to be significantly (P < 0.0001) higher than in normal controls. IL-6
      production, however, did not correlate with the lymphocyte populations examined,
      nor with the absolute number of monocytes. We have also showed that IL-6 was able
      to increase IgM secretion by several Epstein-Barr virus (EBV)-transformed cell
      lines derived from both normal donors and CVI patients, but it failed to modify
      substantially the amounts of IgM and IgG produced in vitro by PBMC derived from
      CVI patients and activated with pokeweed mitogen (PWM) or anti-IgM. Our data
      indicate that IL-6 gene expression and production is increased in CVI, but CVI
      cells do not respond to IL-6 with increased production of immunoglobulin.

PMID- 8485911
TI  - Increased epithelial expression of HLA-DQ and HLA-DP molecules in salivary glands
      from patients with Sjogren's syndrome compared with obstructive sialadenitis.
AB  - Salivary gland specimens from 10 patients with primary Sjogren's syndrome (pSS)
      were examined by two-colour immunofluorescence with various combinations of
      monoclonal and polyclonal antibody reagents of the following specificities: human
      leucocyte antigen (HLA) class I and II (DR, DP and DQ), CD3, CD45 (leucocyte
      common antigen), various cytokeratins, and factor VIII-related antigen. Tissue
      specimens from 10 normal glands and 10 glands with obstructive sialadenitis (no
      known autoimmunity) served as controls. Only some intercalated ducts and
      scattered acini of the normal major glands expressed HLA class II determinants (<
      5% of total epithelial area); the relative proportion of positive elements
      indicated differential expression (DR > DP > DQ). SS glands contained substantial
      T cell infiltrates and increased numbers of activated (DR+) T cells; adjacent
      epithelium showed extensive differential expression of HLA class II determinants
      (DR > DP > DQ). Glands with obstructive sialadenitis showed similarly increased
      epithelial expression of HLA-DR but with surprisingly small amounts of
      concomitant HLA-DP and -DQ expression. Epithelial HLA class II expression
      probably depends on cytokines as an inductive event, which is not unique for SS
      but particularly prominent in this disorder. Our results suggest that epithelial
      expression of HLA-DP or -DQ, rather than -DR, might be a prerequisite for the
      autoimmune process of SS to develop in genetically susceptible individuals.

PMID- 8485912
TI  - C1 inhibitor functional deficiency in systemic lupus erythematosus (SLE).
AB  - C1 inhibitor (C1-inh) was assayed in eight SLE patients presenting with
      consistently low levels of intact C4. C1-inh antigenic levels were normal in all
      patients; however, the function of the C1-inh tested against C1s and C1r was
      variable and outside the normal functional range in seven of the eight patients.
      The molecular weight of patients' C1-inh protein was 105 kD, corresponding to the
      size of the intact molecule. The C1-inh gene was analysed in all patients.
      Restriction fragments generated with TaqI, PstI and HgiAI gave no indication of a
      major C1-inh gene rearrangement. Direct genomic sequencing of exon VIII revealed
      three polymorphic point mutations, but there were no changes from the normal gene
      in or around the reactive-centre residue of C1-inh. Furthermore, we found no
      evidence for a C1-inh autoantibody in patients which could affect normal C1-inh
      function in vitro. These results indicate that the etiology of C1-inh dysfunction
      in SLE is heterogeneous and distinct from that reported in either hereditary or
      acquired angioedema.

PMID- 8485913
TI  - Local and systemic activation of the whole complement cascade in human
      leukocytoclastic cutaneous vasculitis; C3d,g and terminal complement complex as
      sensitive markers.
AB  - We have studied complement activation both in plasma samples and in lesional skin
      from patients with leukocytoclastic cutaneous vasculitis (LCV). Enzyme
      immunoassay (EIA) quantification of the complement activation markers, C3d,g and
      the terminal complement complex (TCC) in plasma, showed that their levels were
      significantly increased in 66% and 55% of the patients, respectively (n = 29)
      compared with healthy controls, whereas the standard measurements of C3, factor
      B, C1q, C4 and C2 were generally within normal range. Elevations of C3d,g and TCC
      levels in plasma were significantly correlated. Importantly, a significant
      correlation was found between the severity of the vasculitis and both C3d,g and
      TCC plasma levels. Immunofluorescence studies of skin biopsy specimens
      demonstrated simultaneous presence of perivascular dermal deposits of C3d,g and
      TCC in lesional skin from 96% and 80% respectively of the patients (n = 25).
      There was a significant correlation between the intensity of the deposits of both
      markers. Clusterin, a TCC inhibitory protein, was always found at the same sites
      of perivascular TCC deposits. Immunofluorescence studies at the epidermal
      basement membrane zone (BMZ) revealed in each case deposits of C3d,g which were
      accompanied by TCC deposits in 52% of the biopsy specimens. These data
      demonstrate that there is a local and systemic activation of the whole complement
      cascade in human LCV. The presence of both C3d,g and clusterin-associated TCC
      perivascular deposits suggests an intervention of a regulatory mechanism of local
      complement activation in LCV. Finally, measurement of plasma C3d,g and TCC
      appears to be a sensitive indicator of systemic complement activation and disease
      severity in LCV.

PMID- 8485914
TI  - Association of C4B deficiency (C4B*Q0) with erythema nodosum in leprosy.
AB  - A considerable number of studies have postulated significant associations between
      susceptibility to the different clinical manifestations of leprosy and the MHC.
      In this investigation, the association between the MHC class III complement
      proteins C2, BF, C4A and C4B and leprosy in a patient population of Southern
      Brazil was studied. A total of 109 non-related leprosy patients was investigated;
      73 presented with lepromatous leprosy (LL), 46 of them had the immunopathological
      reaction of erythema nodosum (ENL), the remaining 36 were tuberculoid, borderline
      and indeterminate leprosy (TIBL) patients. The control group included 172 healthy
      individuals matched with the patients according to their ethnic and geographical
      origin. C2, BF, C4A and C4B allotypes were determined by standard technologies
      including Western blots for C2 and C4 variant alleles with monoclonal and
      polyclonal antibodies. Non-expressed ('silent') C4 alleles in hemizygously
      deficient individuals were estimated semiquantitatively on the basis of the C4A
      and C4B isotype ratio and by the MASC ('minimal chi-square') method. The results
      showed a significantly elevated presence of the non-expressed C4B allele (C4B*Q0)
      in the LL and ENL patient groups in comparison with the controls. The most
      significant difference was observed in the ENL group when compared with the
      controls. In addition, all patients who were homozygously C4B-deficient had ENL,
      and most of them had the BF*F1 allele. The comparison between LL patients with
      and without ENL also showed a statistically significant difference in the
      presence of C4B*Q0, indicating that C4B deficiency itself is associated with ENL.
      The relative risk of LL patients with the C4B*Q0 allele suffering from ENL was
      5.3 compared with LL patients without C4B*Q0. Since immune complexes (IC) are
      considered to be the pathogenic cause of ENL, our findings indicate that C4B
      deficiency may play an important role in the abnormal immune response against
      Mycobacterium leprae and in the lack of IC clearance, leading to ENL reactions.
      Individuals with this allele seem to be at a higher risk of developing
      pathological immune reactivity in lepromatous leprosy.

PMID- 8485915
TI  - Gamma delta lymphocytes in endocrine autoimmunity: evidence of expansion in
      Graves' disease but not in type 1 diabetes.
AB  - Endocrine autoimmune disorders are mediated by T cell-dependent responses to
      organ-specific antigens, but the mechanisms initiating the process remain
      unknown. Lymphocytes which use the gamma delta heterodimer as T cell receptor
      (TCR) for antigen constitute a distinct subset of T cells whose function remains
      elusive. In order to investigate their possible involvement in endocrine
      autoimmunity we have determined the proportion of gamma delta T cells in the
      peripheral blood of 23 patients with type 1 (insulin-dependent) diabetes mellitus
      (type-1 DM) and 30 patients with autoimmune thyrotoxicosis (Graves' disease). T
      lymphocyte TCR expression was assessed by fluorescence-activated flow cytometry
      on peripheral blood mononuclear cells using MoAbs UCHT1 (CD3), TCR delta 1 (gamma
      delta TCR), WT31 and beta F1 (alpha beta TCR) and both the percentage of T cells
      expressing gamma delta and the ratio gamma delta/alpha beta were calculated. In
      the diabetic patients gamma delta cells were not significantly different from the
      control group (7.7 +/- 54% versus 8.0 +/- 5.5% of T cells, P NS). There was no
      relation between the proportion of gamma delta lymphocytes and the presence of
      islet cell antibodies (ICA) in the sera. The Graves' patients showed a tendency
      towards a higher proportion of gamma delta T lymphocytes than the controls (gamma
      delta/alpha beta ratios: 0.095 +/- 0.047 versus 0.063 +/- 0.022, P = 0.03). In 14
      Graves' patients the number of gamma delta were measured in paired samples of
      peripheral and intrathyroidal lymphocytes, demonstrating an expansion of gamma
      delta within the thyroid glands (0.21 +/- 0.3 versus 0.095 +/- 0.047, P = 0.032).
      Immunohistochemical studies showed that gamma delta cells were scattered among
      the predominant alpha beta lymphocytes infiltrating the thyroid gland and that
      they account for 10% of intraepithelial lymphocytes. No relation was found
      between the increase of gamma delta lymphocytes and any clinical features.

PMID- 8485916
TI  - Lymphoid cells in afferent and efferent intestinal lymph: lymphocyte
      subpopulations and cell migration.
AB  - Gut wall emigrating cells have been characterized in the intestinal lymph. The
      intestinal lymph duct was cannulated in 6-month-old minipigs. Under non
      restraining conditions the efferent lymph from the mesenteric lymph nodes was
      collected in seven normal animals. Lymph coming directly from the gut (afferent
      lymph) was also collected in 18 pigs after resection of the mesenteric lymph node
      chains 3 months previously. The intestinal lymph flow was similar in both groups
      (around 18 ml/h). The lymphoid cell yield was 1.2 +/- 1.0 x 10(6)/h in control
      animals, while in mesenteric lymph node resected pigs it was around 20 times
      higher (26.2 +/- 17.6 x 10(6)/h). In the gut-derived lymph 76.5 +/- 8.8% T
      lymphocytes were observed (CD4+, 48.1 +/- 15.5%; CD8+, 53.6 +/- 12.7%). The
      percentage of immunoglobulin-positive cells was lower (IgM+, 10.1 +/- 4.5; IgA+,
      1.7 +/- 1.1). In 14 mesenteric lymph node resected pigs a mean of 5.6 +/- 3.1 x
      10(8) lymphocytes from the gut lymph were labelled in vitro with a fluorescent
      dye and retransfused. The labelling index of fluorescent cells in the intestinal
      lymph increased rapidly and remained at a high level until 44 h after cell
      transfusion. A four-to-ten times lower labelling index was found in the spleen,
      various lymph nodes and Peyer's patches. Most of the recovered lymphocytes were T
      cells. This model provides access to the cell pool leaving the gut wall, thus
      allowing an examination of its role in the gastrointestinal tract and other
      mucosal-lined organs.

PMID- 8485917
TI  - Increased limb involvement in murine collagen-induced arthritis following
      treatment with anti-interferon-gamma.
AB  - We have tested the effect of administering H22, a hamster neutralizing MoAb to
      murine interferon-gamma (IFN-gamma) in collagen-induced arthritis. Mice were
      immunized with human type II collagen in adjuvant on day 1 and boosted with
      soluble collagen on day 21. H22 was administered (250 micrograms,
      intraperitoneally) either during the induction of arthritis (on days 0, 6, 13 and
      20) or around the time of disease manifestation (on days 21, 28, 35 and 42).
      Control mice received either an isotype-matched non-neutralizing MoAb or saline.
      Both treatment regimes gave similar results. Treatment with H22 did not
      significantly affect the incidence of arthritis, time of onset, degree of oedema,
      histopathological severity, or level of anti-type II collagen IgG. However, a
      highly significant increase (P < 0.01) in the number of limbs affected by
      arthritis was observed in the H22-treated group, irrespective of whether the
      antibody was administered during the induction of arthritis, or during the time
      of clinical manifestation of disease. From these results it was concluded that
      anti-IFN-gamma treatment caused an increase in the number of arthritic lesions,
      but did not affect the severity of each individual lesion.

PMID- 8485918
TI  - Trafficking of inflammatory macrophages from the kidney to draining lymph nodes
      during experimental glomerulonephritis.
AB  - Macrophage accumulation within the glomerulus and renal interstitium is a
      prominent feature of most forms of glomerulonephritis, but the fate of these
      inflammatory cells is unknown. Macrophage trafficking to the draining kidney
      lymph nodes (KLN) was assessed in a detailed kinetic analysis of accelerated
      antiglomerular basement membrane (GBM) disease in the rat. Leucocytes draining to
      KLN via lymphatic vessels were identified within the marginal sinus by MoAb
      labelling of tissue sections. In anti-GBM disease, there was a significant
      increase in the weight of the KLN due to both lymphoproliferation within the
      nodes and increased lymphatic drainage from the inflamed kidney, as evidenced by
      prominent dilation of the marginal sinus and increased numbers of cells within
      the sinus. In non-inflamed lymph nodes, few ED1+ macrophages were present within
      the marginal sinus (3.0 +/- 0.6/100 nucleated cells). However, in anti-GBM
      disease, macrophages became the major cell type within the dilated marginal sinus
      of the KLN, as shown by labelling with ED1, ED2 and ED3 MoAbs, peaking at 74 +/-
      2.6 ED1+ cells/100 nucleated cells at day 14. These changes were not simply due
      to systemic antigen administration, since in the axillary lymph node (ALN) there
      was no obvious dilation of the marginal sinus and macrophages accounted for a
      maximum of only 15 +/- 4.6 ED1+ cells/100 nucleated cells. In conclusion, this
      study provides indirect evidence that there is significant trafficking of the
      renal macrophage infiltrate to the KLN during experimental glomerulonephritis.
      This may be a mechanism whereby nephritogenic antigens, released as a consequence
      of the local inflammatory response, may be presented to T and B lymphocytes
      within lymph nodes, resulting in the amplification of the immune response in
      glomerulonephritis.

PMID- 8485919
TI  - Quantitative study of mesangial injury with proteinuria induced by monoclonal
      antibody 1-22-3.
AB  - Murine MoAb 1-22-3 has already been reported to bind to the mesangial cell
      surface and to cause transient proteinuria and mesangial morphological changes
      characterized by mesangiolysis, subsequent mesangial cell proliferation and
      mesangial matrix increase by a single i.v. injection. In this study, MoAb-induced
      glomerulopathy was quantitatively analysed. No correlation between the severity
      of mesangial morphological changes and the degree of proteinuria was detected (r
      = 0.190). The minimum dose injected to induce abnormal proteinuria was 25
      micrograms. This dose corresponded to 1.79 micrograms/2 kidneys 30 min after MoAb
      injection. The highest average level of proteinuria was observed in rats injected
      with 500 micrograms of MoAb, and less proteinuria was observed in rats injected
      with 10.0, 5.0 and 2.0 mg. Although the amounts of kidney-fixing MoAb and the
      subsequent deposition of rat C3 in the high-dose-injected group were larger than
      in the 500 micrograms injected group, the numbers of infiltrating inflammatory
      cells were the same in both groups. No correlations between the degrees of such
      mediators and proteinuria were observed.

PMID- 8485920
TI  - Investigation of class I anti-arrhythmic drug actions on guinea-pig cardiac
      mitochondrial lactate dehydrogenase activity.
AB  - 1. The effects of the Class I anti-arrhythmic drugs quinidine, procainamide,
      lidocaine, phenytoin and tocainide on mitochondrial lactate dehydrogenase
      activity were compared in guinea-pig heart preparations. 2. All the tested drugs
      inhibited the enzyme activity in a concentration-dependent fashion, exhibiting
      varying profiles in their actions. Lidocaine exhibited inhibitory concentration
      20% (IC20) and IC50 values of 0.52 +/- 0.02 mmol/L and 25.6 +/- 0.5 mmol/L,
      procainamide 6.0 +/- 0.2 mmol/L and 108 +/- 7.2 mmol/L, phenytoin 3.4 +/- 0.06
      mumol/L and 0.34 +/- 0.02 mmol/L, quinidine 39.2 +/- 1.2 mumol/L and 9.8 +/- 0.8
      mmol/L and tocainide 2.7 +/- 0.3 mmol/L and 44.6 +/- 2.5 mmol/L. 3. According to
      the IC50 values, this is the order of their inhibitory potencies: phenytoin >
      quinidine > lidocaine > tocainide > procainamide. This trend is in general
      agreement with the lipophilicity rank of the drugs. 4. It is concluded,
      therefore, that inhibition of mitochondrial lactate dehydrogenase is a property
      shared by most Class I anti-arrhythmic drugs which may depend on their
      lipophilicity and possibly their membrane stabilizing effects.

PMID- 8485921
TI  - Effects of aldose reductase inhibition with epalrestat on diabetes-induced
      changes in rat isolated atria.
AB  - 1. Isoprenaline and cardiac responsiveness of isolated atria from 2 and 6 week
      streptozotocin-diabetic rats, and their age-matched controls, was examined. The
      effects of chronic administration of epalrestat (40 mg/kg orally, by gavage) on
      diabetes-induced changes were also investigated. 2. Spontaneously beating atria,
      bathed in either normal or high glucose (30 mmol/L) Krebs' solution, from both 2
      and 6 week diabetic rats beat more slowly and with greater force than atria from
      control rats. These changes in basal parameters were normalized by 2 weeks of
      insulin (5 U/day s.c.) treatment but not by 2 or 6 weeks of chronic treatment
      with epalrestat. 3. Isoprenaline (0.1 nmol-0.1 mumol/L) produced concentration
      dependent increases in inotropy and chronotropy in atria from both control and
      diabetic rats. 4. Atria from 2 week diabetic rats displayed decreased sensitivity
      to the positive inotropic effects of isoprenaline. This change was normalized by
      chronic insulin treatment but not by chronic epalrestat treatment. 5. Atria from
      6 week diabetic rats displayed increased sensitivity to the positive chronotropic
      effects of isoprenaline which was normalized by epalrestat. 6. These results
      suggest that changes observed in atria from 2 week diabetic rats may be due to
      hyperglycaemia per se whereas in atria from 6 week diabetic rats abnormal
      activity of the polyol pathway may be a contributing factor.

PMID- 8485922
TI  - The effect of cromakalim on the electrical properties of and [86Rb+] efflux from
      normal and hypertrophied rat bladder.
AB  - 1. The activity of smooth muscle strips from normal and hypertrophied rat
      bladders was compared. The hypertrophied bladders were produced by partially
      obstructing the urethra 8-13 weeks previously. 2. Spontaneous mechanical activity
      was more frequent and smaller in amplitude in strips from normal than
      hypertrophied bladders and was less sensitive to cromakalim, being reversibly
      abolished by cromakalim at 10(-6) mol/L compared with 10(-7) mol/lL for
      hypertrophied bladder. 3. The mean resting membrane potentials of smooth muscle
      cells from normal and hypertrophied rat bladders were -47.2 and -47.6 mV,
      respectively. Bursts of spontaneous action potentials, corresponding to the
      mechanical activity, were seen in some cells. 4. Nifedipine at 10(-6) mol/L had
      no significant effect on the resting membrane potential. Occasional single spikes
      occurred with increased duration and the after hyperpolarization was abolished.
      Cromakalim at 10(-5) mol/L produced hyperpolarization of 3-9 mV and, in the
      continued presence of the drug, occasional singe spikes could be recorded from
      both normal and hypertrophied bladders. 5. Nifedipine at 10(-6) mol/L abolished
      movement but did not significantly alter [86Rb+] efflux from strips from either
      normal or hypertrophied bladders. Addition of cromakalim at 5 x 10(-6) or 5 x 10(
      5) mol/L in the presence or absence of nifedipine increased efflux from the
      normal bladder by 30-40%. In the hypertrophied bladder the efflux increased by
      about 14% and 28% in the presence of 5 x 10(-6) and 5 x 10(-5) mol/L cromakalim,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485923
TI  - Identification and characterization of an amidating enzyme in ovine heart.
AB  - 1. Levels of peptidylglycine alpha-amidating mono-oxygenase (PAM) activity were
      examined in sheep and rat heart. This enzyme is responsible for alpha-amidation
      of a large number of peptide hormones, a modification essential for the
      bioactivity of these peptides. 2. PAM activity was measured in membrane and
      soluble fractions of atrial and ventricular homogenates by monitoring the
      amidation of iodinated synthetic substrate ([125I]-Ac-Tyr-Val-Gly). 3. PAM
      activity in both species resided almost exclusively in the atria rather than the
      ventricles, and similar levels of activity were found in left and right atria.
      Membrane-associated activity was 50-to 100-fold greater than soluble activity in
      the sheep, yet was only five- to 10-fold greater in the rat, indicating a larger
      proportion of soluble enzyme in the rat atrium. 4. Similar apparent Km values
      were found for atrial membrane-associated activity in both species (15.6 and 17.4
      mumol/L for rat right and left atria, 16.7 and 15.6 mumol/L for sheep right and
      left atria); however, the maximum velocity (Vmax) levels were higher in the rat
      (40.5 and 43.9 pmol/micrograms per h vs 12.8 and 15.1 pmol/micrograms per h). 5.
      Because expression of many peptides and processing enzymes can be regulated by
      steroid hormones, the possible effects of chronic glucocorticoid administration
      (1 mg dexamethasone i.m. twice daily for 10 days) on PAM levels were tested in
      four sheep, with four sheep receiving saline only as controls. There was no
      discernible effect of dexamethasone on either the distribution or the kinetics of
      PAM activity in the sheep heart.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485924
TI  - The effect of atrial natriuretic peptide infusion on renal haemodynamics and
      plasma lipoproteins in puromycin aminonucleoside nephrosis in rats.
AB  - 1. The effect of continuous intravenous administration of 1 microgram/h atrial
      natriuretic peptide (ANP) for 4 days was studied in normal male Sprague-Dawley
      rats and rats made nephrotic with puromycin aminonucleoside (PA). 2. ANP infusion
      significantly increased urinary sodium and potassium excretion by 3 days of
      infusion in control rats but not in PA-treated rats. ANP infusion significantly
      increased glomerular filtration rate in PA-treated rats, while effective renal
      plasma flow was similarly decreased compared with non-infused nephrotic rats. 3.
      Plasma high density lipoproteins (HDL) were significantly decreased and low
      density lipoproteins (LDL) were increased in PA-treated rats that received ANP;
      HDL were increased in normal rats infused with ANP. 4. Competitive binding
      studies demonstrated a lower density of specific ANP receptors in glomerular
      membranes from rats injected with PA, while binding affinity was unchanged. 5.
      Infusion with exogenous ANP did not promote natriuresis in PA nephrosis despite
      an enhancement of glomerular filtration rate (GFR), thus suggesting that sodium
      retention in this model is due to a post-glomerular defect. Plasma lipoprotein
      composition in both normal and nephrotic rats may be affected by ANP.

PMID- 8485925
TI  - Angiotensin converting enzyme inhibitor, captopril, inhibits cardiac hypertrophy
      without changing collagen types and concentration in spontaneously hypertensive
      rats.
AB  - 1. The effects of the ACE inhibitor, captopril, on collagen metabolism in
      spontaneously hypertensive rats (SHR) with cardiac hypertrophy was examined.
      Captopril (100 mg/kg per day) was administered in drinking water to 20 week old
      male SHR for 12 weeks. Collagen concentration was calculated from hydroxyproline
      content, and relative proportions of types I, III and V collagen were determined
      by non-interrupted SDS-polyacrylamide gel electrophoresis (SDS-PAGE). These
      parameters were examined in age and sex matched Wistar-Kyoto (WKY) rats, as well
      as in non-treated SHR, and compared with those of captopril-treated SHR. 2.
      Captopril significantly reduced both blood pressure (191 +/- 12.1 vs 146 +/- 11.2
      mmHg, P < 0.01), and the ratio of left ventricular (LV) weight to bodyweight (BW;
      2.38 +/- 0.17 vs 2.05 +/- 0.12 mg/g, P < 0.01). There were no significant
      differences in collagen concentration among WKY rats, captopril-treated SHR and
      non-treated 32 week old SHR. However, total collagen content in captopril-treated
      SHR reduced significantly compared with non-treated 32 week old SHR (16.8 +/- 2.0
      vs 21.3 +/- 0.8 mg, P < 0.01). The relative proportion of type V collagen was
      significantly higher in both captopril-treated (58.6 +/- 3.4 vs 46.8 +/- 1.3%, P
      < 0.01) and non-treated 32 week old SHR (59.9 +/- 3.1 vs 46.8 +/- 1.3%, P < 0.01)
      compared with WKY rats. However, there were no significant differences between
      captopril-treated SHR and non-treated 32 week old SHR.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8485926
TI  - Effects of reserpine on the content and uptake of dopamine and noradrenaline in
      rabbit arteries.
AB  - 1. Change with time of the content and uptake of dopamine (DA) and noradrenaline
      (NA) in the renal, superior mesenteric and femoral arteries and abdominal aorta
      of rabbit after reserpine administration was examined. Endogenous DA and NA were
      measured by high performance liquid chromatography coupled with electrochemical
      detector. 2. A single dose of reserpine (3 mg/kg, i.p.) maximally depleted the
      endogenous DA and NA contents in the four blood vessels 24 h after the
      administration; the ratios of reductions were 70-90% and approximately 90% of the
      normal levels, respectively. The DA contents in all four vessels recovered to the
      normal level within 4 days after reserpine. However, NA content did not recover
      to the normal levels within 30 days after reserpine except in the mesenteric
      artery. 3. The activity of dopamine beta-hydroxylase (DBH) significantly
      increased in all four blood vessels 1 h after reserpine. Although the DBH
      activity returned to the normal level after 3 days in the mesenteric artery, it
      returned within 24 h in the other three vessels. 4. [3H]-Dopamine and [3H]-NA
      uptake were almost completely depressed 1 h after reserpine. The [3H]-NA uptake
      in four vessels recovered to the normal level 2-14 days after reserpine, and [3H]
      DA uptake recovered after 30-45 days. Thus, the endogenous DA content in blood
      vessels was completely restored although DA uptake and NA content were still
      affected. 5. These results suggested that the recovery of stored DA after
      reserpine was faster than that of stored NA and the recovery of DA uptake after
      reserpine was slower than NA uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485927
TI  - Oxygen-haemoglobin dissociation curve in hypoxic rats of first or second
      generation.
AB  - 1. Albino Wistar rats were raised in a normobaric hypoxic environment (10% O2 in
      N2). Two generations of hypoxic rats were observed for changes in their
      haemoglobin-oxygen (Hb-O2) dissociation curves (ODC), 2,3-diphosphoglycerate (2,3
      DPG), haemoglobin (Hb), and Hill co-efficients at P50 (n50). The first generation
      were called (H1) and the second generation (H2). The control group (N) had a
      normoxic environment. 2. Thirty-five rats (13 N rats, 12 H1 rats and 10 H2 rats)
      were used. The 2,3-DPG was significantly higher in both hypoxic groups when
      compared with N rats (2.02 +/- 0.51 mmol/L) but 2,3-DPG of H2 rats was
      significantly lower than that of H1 rats (H1 = 3.48 +/- 0.58 mmol/L and H2 = 2.76
      +/- 0.54 mmol/L). The haemoglobin values were N = 2.00 +/- 0.26, H1 = 2.65 +/-
      0.32 and H2 = 2.36 +/- 0.30 mmol/L, respectively. 3. We observed considerable
      differences in Hb-O2 affinity between the three groups of rats. In standard
      conditions (pH = 7.400; pCO2 = 40 mmHg at 37 degrees C) the H1 rats showed a
      significantly decreased Hb-O2 affinity (P50,st = 37.0 +/- 1.3 mmHg) when compared
      with both H2 and N rats; the H2 rats showed a significantly increased Hb-O2
      affinity (P50,st = 31.1 +/- 1.5 mmHg) when compared with controls N (P50,st =
      34.7 +/- 2.1 mmHg). There were no significant differences in n50 values: N = 2.88
      +/- 0.44; H1 = 2.88 +/- 0.77; and H2 = 2.94 +/- 0.67.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8485928
TI  - Respiration and BP and HR variability.

PMID- 8485929
TI  - Upper blepharoplasty by eyelid invagination. Anchor blepharoplasty.
AB  - Anchor or lid invagination blepharoplasty is an operation giving neat, crisp, and
      youthful lids of a permanency unobtainable by traditional techniques. It allows
      the surgeon to preserve precious lid skin and give optimal results. Although
      there is more postoperative edema, long-term results verify the efficacy of the
      technique. This article represents the author's 25 years' experience with
      thousands of patients, both Caucasians and Orientals, undergoing invagination
      technique lid blepharoplasty procedures.

PMID- 8485930
TI  - Essential anatomy for contemporary upper lid blepharoplasty.
AB  - A clear understanding of upper eyelid anatomy is an absolute prerequisite for
      performing advanced invagination-type blepharoplasty. This article describes the
      author's simple, systematic approach to intraoperative identification of the
      levator aponeurosis as well as the other key layers of fascia in the upper lid.

PMID- 8485931
TI  - Preoperative evaluation of the blepharoplasty patient. Bypassing the pitfalls.
AB  - Patients predisposed to postoperative eyelid malposition can be identified by the
      careful preoperative analysis of the periorbital anatomy in conjunction with a
      good medical history. When necessary, ancillary procedures are performed at the
      time of the initial blepharoplasty to avoid undesirable deformities.

PMID- 8485932
TI  - Contemporary upper lid blepharoplasty--tissue invagination.
AB  - Blepharoplasty is the most commonly performed operation to enhance facial
      appearance. Controversy arises over the need for tissue invagination as opposed
      to simple tissue excision. This article focuses on advanced invagination-type
      blepharoplasty, discussing who, what, where, when, why, and how.

PMID- 8485933
TI  - The East Asian eyelid-open technique.
AB  - Creation of a dynamic levator aponeurosis fold or double eye adds to the beauty
      of the East Asian. The eyes are larger and less puffy, and the eyelashes appear
      longer and curve up and out instead of down. The distance from the ciliary border
      to the eyebrow is decreased and more in proportion. The Mongolian trait is
      preserved.

PMID- 8485934
TI  - The biomechanics of brow and frontalis function and its effect on blepharoplasty.
AB  - Understanding the biomechanics and dynamics of eyebrow and frontalis function is
      essential to controlling the outcome of blepharoplasty. Ignoring the forehead in
      the pursuit of blepharoplasty excellence dooms to failure any eventual outcome.
      If, however, the principles laid out in this article become the basis for
      planning and execution, the final result, measured in the quality of aesthetic
      repair, will surely improve immensely.

PMID- 8485935
TI  - Ptosis repair in aesthetic blepharoplasty.
AB  - It is important to recognize ptosis of the upper eyelids in patients who are
      contemplating aesthetic blepharoplasty. When ptosis is present, it should be
      corrected simultaneously with the blepharoplasty.

PMID- 8485936
TI  - Blepharoplasty in the patient with exophthalmos.
AB  - The plastic surgeon performing blepharoplasty should maintain a high degree of
      surveillance for the presence of exophthalmos. Exophthalmos may be masked by the
      presence of eyelid compensations and substantial amounts of eyelid fat. The
      surgeon should know how to detect the condition and measure its extent.

PMID- 8485937
TI  - Treatment of exophthalmos by orbital fat removal.
AB  - Decompression of the orbit by removal of fat is a safe method to obtain
      functional and aesthetic improvement in exophthalmos disease. In comparison with
      traditional orbital wall decompression, the complication rate is low.

PMID- 8485938
TI  - Periorbital appearance as a function of orbital volume.

PMID- 8485939
TI  - Surgical correction of the crow's feet deformity.
AB  - Improved methods and important adjuncts for rejuvenation of the aging face have
      evolved as surgeons have recognized the limitations of the techniques they
      employ. Presented here is a simple, safe, and straightforward technique for
      correction of the "crow's feet" deformity that has proven to produce a
      predictable and long-lasting improvement.

PMID- 8485940
TI  - Precision planning in blepharoplasty. The importance of preoperative mapping.
AB  - Routine standardized periorbital planning prior to blepharoplasty and brow
      lifting facilitates optimal outcome and minimizes the need for reoperation. It
      should be an essential companion to blepharoplasty in all instances.

PMID- 8485941
TI  - Updated muscle suspension and lower blepharoplasty.
AB  - The challenge of lower lid blepharoplasty surgery is to get the lid tight enough
      to smooth out wrinkles and not produce scleral show or round eye. The updated
      lower lid muscle suspension blepharoplasty can meet this challenge. The technique
      uses an easily placed muscle suspension suture to help support or elevate the
      lower lid.

PMID- 8485942
TI  - Minimizing deformity in lower blepharoplasty. The transconjunctival approach.
AB  - The transconjunctival approach offers many advantages for lower blepharoplasty.
      It addresses bulging fat directly, minimizes late lid retraction problems,
      permits skin resection if indicated, and retains the natural appearance of the
      palpebral fissure. The technique is straightforward and is easily mastered once
      the relevant anatomy is understood.

PMID- 8485943
TI  - Herniated fat and the orbital septum of the lower lid.
AB  - The bulging fat of aging eyelids has always been described as a hernia; yet, the
      treatment has not been that of a true hernia. Rather, the contents (orbital fat)
      have been excised and the hernia wall left unrepaired. It is possible to treat
      bulging lower eyelids as a hernia by replacing both the fat and the sac into the
      original location within the orbital cavity, and then repairing the retaining
      wall.

PMID- 8485944
TI  - Correction of weakness of the lower eyelid and lateral canthus. Personal
      techniques.
AB  - The author describes the approach to weakness of the lower eyelid and lateral
      canthus due to a decreased tension of the orbicularis muscle and canthal
      ligament. He describes several techniques such as blepharocanthoplasty, muscular
      suspension blepharoplasty, submusculoaponeurotic system rhytidectomy of the upper
      two thirds of the face, and a temporal fascia sling procedure indicated for major
      elevation of the lower eyelid and rim.

PMID- 8485945
TI  - Canthopexy as a routine blepharoplasty component.
AB  - Canthopexy should be a routine companion or alternative to lower lid
      blepharoplasty. It restores tone and youthful contour to the deteriorating eye,
      and it reduces or eliminates the need to resect skin that in truth is not
      excessive, but appears so owing to dropped lid posture from lid atonicity.
      Canthopexy with fat reduction and enhancement of the deficient suborbital portion
      of the malar complex should be the principal thrust of lower lid surgery. Skin
      removal accompanies this only when there is true excess and redundancy.
      Transconjunctival or stab wound fat removal are preferred procedures when there
      is no excess skin to remove. Canthopexies are possible through lower lid
      incisions, through upper lid incisions, or via coronal type access. They are an
      essential companion to aesthetic blepharoplasty if the surgeon wishes to prevent
      deformity.

PMID- 8485946
TI  - Festoons, mounds, and bags of the eyelids and cheek.
AB  - This article categorizes and defines periorbital soft tissue protrusions
      associated with aging. (Protrusions of intraorbital fat are excluded. Recent
      anatomic observations are described as well as surgical procedures based on these
      findings and on past experience. Complications are enumerated and their treatment
      is outlined.

PMID- 8485947
TI  - Diagnosing photographic distortion. Decoding true postoperative contour after
      eyelid surgery.
AB  - A method of "decoding" deceptive blepharoplasty photographs resulting from head
      postural changes (or changes in camera planes) between pre- and postoperative
      photographs is now available. One need only measure changes in the intercanthal
      axis relative to the horizontal plane of the face. Each degree of alteration of
      the axis represents 1 mm of true postural change in the margin of the lower lid-
      disguised by head tilt or downward gaze. This new "tool" can expose and help
      eliminate undesirable techniques that consistently deform the eye through lowered
      lid posture and increased scleral show, saddening the appearance of the orbital
      region and the entire face.

PMID- 8485948
TI  - Naso-jugal groove leveling with fat tissue.
AB  - One of the causes of a depressed naso-jugal groove is the fixation of the septum
      orbitale at the level of the inferior-medial portion of the arcus marginalis. To
      permit the leveling of the groove, it is necessary to liberate the subjacent
      orbital septum from its fixation to the arcus marginalis. To avoid recurrence of
      the depression, some fat tissue is properly placed in the undermined space
      subjacent to the groove. This can be done by free fat grafting or fat pad
      sliding.

PMID- 8485949
TI  - Tear trough implants for correction of tear trough deformity.
AB  - This essay describes the tear trough deformity and its extension into the cheek.
      It is an extremely common and consistently deforming characteristic of the lower
      orbital region. The article focuses on cause and correction. A suborbital malar
      implant designed to alleviate the deformity is now available from an implant
      manufacturer in a variety of sizes. The procedure provides in most instances a
      definitive correction of a significant disfigurement.

PMID- 8485950
TI  - Repair of lower lid deformities.
AB  - The most common complication of blepharoplasty is an unnatural distortion of the
      lower eyelid. Identification of the underlying anatomic deformities dictates the
      reconstructive procedures. Emphasis is placed on utilization of the dermal
      orbicular pennant lateral canthoplasty.

PMID- 8485951
TI  - Compiling a district diabetic register: theoretical and practical considerations.

PMID- 8485952
TI  - The skin in diabetes.

PMID- 8485953
TI  - Aldose reductase inhibitors and the complications of diabetes mellitus.

PMID- 8485954
TI  - Frequency and symptoms of hypoglycaemia experienced by patients with type 2
      diabetes treated with insulin.
AB  - This study ascertained the prevalence of severe hypoglycaemia and loss of
      awareness of hypoglycaemia in patients with Type 2 diabetes treated with insulin.
      One hundred and four sequentially selected Type 2 diabetic patients were compared
      with 104 patients with Type 1 diabetes who were matched for duration of insulin
      therapy. The patients were interviewed using a standardized questionnaire. During
      treatment with insulin, 18 Type 2 patients had experienced fewer than two
      episodes of hypoglycaemia, while 86 had experienced two or more episodes; 80
      (93%) reported normal awareness, six (7%) reported partial awareness, and none
      had absent awareness of hypoglycaemia. All 86 Type 1 diabetic patients matched to
      the 86 Type 2 patients had experienced multiple episodes of hypoglycaemia; 71
      (83%) had normal awareness, 14 (16%) had partial awareness and one patient (1%)
      reported absent awareness of hypoglycaemia. The Type 1 patients who had altered
      awareness of hypoglycaemia had longer duration of diabetes and insulin therapy
      (normal awareness: 5 (1-17) years (median (range)) vs partial awareness: 9 (3-18)
      years, p < 0.01). Similarly, Type 2 patients with altered awareness had longer
      duration of diabetes (normal awareness: 11 (2-25) years vs partial awareness: 19
      (8-24) years, p < 0.02) and had received insulin for longer (normal awareness: 3
      (1-18) years vs partial awareness: 12 (6-17) years, p < 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8485955
TI  - Frequency and morbidity of severe hypoglycaemia in insulin-treated diabetic
      patients.
AB  - To estimate the frequency and morbidity of insulin-induced hypoglycaemia, a
      retrospective survey was undertaken of the frequency of severe hypoglycaemia in
      600 randomly selected patients with insulin-treated diabetes who were attending a
      large diabetic outpatient clinic in a teaching hospital. The resulting morbidity
      (hypoglycaemia-related injuries, convulsions, and road traffic accidents) was
      ascertained in 302 patients. One hundred and seventy-five (29.2%) of the 600
      patients reported a total of 964 episodes of severe hypoglycaemia in the
      preceding year, giving an overall frequency for the group of 1.60 episodes
      patient-1year-1. The frequency of severe hypoglycaemia which was documented in
      544 Type 1 (ketosis prone) diabetic patients was double that observed in a
      subgroup of 56 Type 2 diabetic patients who were being treated with insulin (1.70
      vs 0.73 episodes patient-1year-1). In the subset of 302 patients, those who had
      experienced severe hypoglycaemia had greater morbidity associated with an
      estimated rate of injury of 0.04 injuries person-1year-1. Twenty (6.6%) patients
      reported a total of 37 convulsions associated with hypoglycaemia, 5 of which had
      occurred in the preceding year (0.02 convulsions person-1year-1). Five patients
      reported road traffic accidents in the preceding year which had been caused by
      hypoglycaemia. The only reliable predictors of severe hypoglycaemia were a
      history of previous severe hypoglycaemia (p < 0.001), a history of hypoglycaemia
      related injury (p < 0.001) or convulsion (p < 0.001), and the duration of insulin
      therapy (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485956
TI  - An analysis of the glucagon response to hypoglycaemia in patients with type 1
      diabetes and in healthy subjects.
AB  - The study aimed to analyse the glucagon response during hypoglycaemia in relation
      to gender, level of hypoglycaemia, and hyperinsulinaemia as well as its relation
      to other counterregulatory hormones in patients with Type 1 diabetes and in
      nondiabetic subjects. Mild hypoglycaemia was induced by an i.v. insulin infusion
      (244 pmol kg-1h-1) for 180 min in 43 Type 1 diabetic patients and 22 nondiabetic
      subjects. Venous blood glucose, plasma free insulin, glucagon, adrenaline,
      noradrenaline, growth hormone, and cortisol were measured every 15-30 min. The
      hormonal responses during hypoglycaemia were evaluated from the incremental areas
      under their respective curves. There was a linear correlation between the
      glucagon response and the decremental area of blood glucose (p < 0.005), but the
      slope of the regression line in the diabetic group was less steep than in the
      controls (p < 0.5), and, in spite of the deeper hypoglycaemia in the diabetic
      groups, their glucagon response was diminished (p < 0.05). Plasma, adrenaline,
      growth hormone and cortisol all increased during hypoglycaemia. The glucagon
      response correlated with the responses of growth hormone and cortisol in both
      groups, while it was positively correlated with the adrenaline response (p <
      0.001) and inversely with the plasma insulin (p < 0.001) only in the diabetic
      patients. Although the insulin infusion rate was identical, the female diabetic
      patients had a lower metabolic clearance rate of insulin as compared with the
      males (p < 0.05). There was no statistical difference in the counterregulatory
      hormone responses between males and females in neither of the groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8485957
TI  - Sudden death and human insulin: is there a link?
AB  - Case reports from the United Kingdom (UK) in 1989 have suggested that the
      introduction of human insulin in 1985 was associated with an increased risk of
      sudden death in insulin-treated diabetic patients. If human insulin increases the
      risk of sudden death, the number of these should have increased during the period
      where human insulin was introduced. We therefore identified all cases of sudden
      death in Denmark in younger insulin-treated diabetic patients, age at death below
      50 years. During this period the consumption of human insulin went from 0.2% to
      70% of the total consumption in Denmark. The total number of cases fulfilling the
      inclusion criteria was 226, and the annual number of sudden deaths did not change
      during the study period (p = 0.14). The number of deaths due to hypoglycaemia and
      cases with unexplained cause of death also remained constant (test for trend: p =
      0.44). Chronic alcohol abuse or acute alcohol intoxication was found in 50% of
      the 135 patients dying from hypoglycaemia, ketoacidosis or unknown cause of death
      (including found dead in bed), while this was the case in only 16% of the
      remaining 91 cases dying from other natural causes. We conclude that introduction
      of human insulin in Denmark was not followed by an increase in sudden deaths
      among younger insulin-treated diabetic patients.

PMID- 8485958
TI  - A novel device for the rapid in-clinic measurement of haemoglobin A1c.
AB  - In order to evaluate a novel technique for measuring haemoglobin A1c using a
      cassette-based immunoassay method we have undertaken a laboratory evaluation
      using 48 patient samples and a separate within-clinic prospective study of 59
      diabetic patients. Individuals were recruited from general (48 patients),
      paediatric (19 patients), obstetric (24 patients), and general practice (15
      patients) diabetic clinics. Agreement was evaluated between HbA1c results
      obtained using the new method (AMES DCA 2000) and an established laboratory assay
      (DIAMAT HPLC system). The mean differences between the two results (AMES DCA 2000
      DIAMAT) (95% confidence intervals) were: laboratory -0.69% (-1.42 to 0.04%);
      paediatric clinic -0.93% (-1.93 to 0.07%); obstetric clinic -0.29% (-1.09 to
      0.51%), and general practice clinic -0.77% (-1.3 to -0.24%). For the AMES DCA
      2000, the coefficient of variation for HbA1c of 5.2% was 1.6% and for HbA1c of
      13%, 2.4%. This instrument was used without difficulty by four different
      operators. Intra-assay coefficient of variation for each operator was < 3.4%. In
      9/18 patients where a specific assessment of clinical utility was made, knowledge
      of the HbA1c result at the time of consultation lead to a change in treatment.
      Methodology of this type may be used successfully within a diabetic clinic
      setting in both primary care and hospital environments.

PMID- 8485959
TI  - Diabetes in the elderly: an under-diagnosed condition.
AB  - The proportion of the population aged 65 years and over is increasing. The
      Coventry Diabetes Study was able to investigate the prevalence of diagnosed and
      undiagnosed diabetes among elderly (aged > or = 65 years) Europeans (n = 1600)
      and South Asians (n = 288) in Foleshill, Coventry. The total prevalence of
      diabetes was higher in South Asians than Europeans among males (30.7 (95% CI 24.0
      37.9)% vs 7.7 (95% CI 5.8-10.0)%, respectively) and females (24.0 (95% CI 17.5
      32.4)% vs 12.5 (95% CI 10.6-14.8)%, respectively). The proportion with diagnosed
      diabetes was higher among South Asians than Europeans (55% vs 33%, p < 0.001),
      possibly because of their earlier onset. These findings suggest that detection of
      diabetes in elderly Europeans in urban areas may be inadequate.

PMID- 8485960
TI  - Outpatient treatment of unilateral diabetic foot ulcers with 'half shoes'.
AB  - The impact of 'half shoes' in the treatment of neuropathic forefoot ulcers was
      studied in two groups of diabetic patients, who were treated either by standard
      treatment alone (retrospective controls, n = 22), or by standard treatment plus
      'half shoes' (cases, n = 26). The groups were matched for sex, age, type, and
      duration of diabetes and ulcer grading. The 'half-shoe' cases' vs controls'
      median overall healing time was 70 vs 118 days, the median difference being 48
      (95% CI: -5 to 82) days (NS). In the case group, hospitalization was required in
      1/26 (4%) of patients, vs 9/22 (41%) of the control patients (chi-square, p <
      0.01). The home nursing service was required in 23% of the cases vs 18% of the
      controls (NS). It is concluded that the use of half-shoes, in conjunction with
      standard treatment provided by a specialized diabetic foot clinic, may reduce the
      overall healing time and does reduce the hospitalization rate. This has
      implications for a rational strategy of treating unilateral diabetic neuropathic
      foot ulcers.

PMID- 8485961
TI  - Ethnic differences in the incidence of lower extremity amputation secondary to
      diabetes mellitus.
AB  - Patients of Asian ethnic origin with diabetes mellitus living in the United
      Kingdom (UK) have been shown to have a higher prevalence of coronary heart
      disease and renal disease. Little is known about the incidence of lower extremity
      amputation in this racial group. The incidence of lower extremity amputation was
      estimated for patients of Asian ethnic origin and White Caucasians with diabetes
      mellitus in the county of Leicestershire from 1980 to 1985. The age and sex
      adjusted incidence rate of lower extremity amputation for the estimated
      population of patients with diabetes mellitus in patients of Asian ethnic origin
      was 3.4 (95% CI, 1.1-10.7) cases per 10,000 patients year-1, compared to 14.2
      (12.6-15.9) in White Caucasians. Similarly, a lower incidence rate of lower
      extremity amputation was recorded in patients of Asian ethnic origin without
      diabetes mellitus (0.4 (0.2-0.6) vs 1.5 (1.4 to 1.6) cases per 10,000 persons
      year-1). These findings contrast markedly with the high rates of coronary heart
      disease and renal disease previously reported in patients of Asian ethnic origin
      residing in the UK.

PMID- 8485962
TI  - Smoking in diabetic teenagers.
AB  - The prevalence of smoking amongst a group of 77 diabetic teenagers aged 11-18
      years attending two paediatric clinics was determined using a questionnaire and
      urine cotinine assay. Five individuals were identified as definite smokers with
      two further individuals being probable smokers, all of whom were aged 15 years or
      more. This low prevalence (9%) is in contrast to a 48% prevalence in a young
      adult diabetic clinic. Many diabetic teenagers appear to acquire a regular
      smoking habit after leaving the paediatric clinic so it is important that health
      education is targeted at this group.

PMID- 8485963
TI  - Persisting mortality in diabetic ketoacidosis.
AB  - An overall hospital mortality rate of 3.9% was found in 929 episodes of diabetic
      ketoacidosis treated in single centre over a 21-year period. The mortality rate
      in the first half of the survey (4.4%) was not significantly different from that
      in the second half of the survey (3.4%). Six deaths in patients under 50 years of
      age occurred in the first half, but only one death under 50 years occurred in the
      second half of the survey. The number of deaths from a metabolic cause where no
      other illness was identified also fell from nine (43% of deaths) in the first
      half to five (33% of deaths) in the second half of the study (not significant).
      The remaining deaths were due to concurrent illness, mainly myocardial infarction
      and serious infections. Many of the residual deaths occurred in elderly patients
      with such medical illness in addition to the ketoacidosis. It may, therefore,
      prove difficult to reduce mortality further in diabetic ketoacidosis.

PMID- 8485964
TI  - Coming of age with diabetes: patients' views of a clinic for under-25 year olds.
AB  - This study is both an evaluation of patients' perceptions of a diabetes clinic
      for under-25 year olds, and an assessment of experiences in transferring from a
      paediatric clinic. Sixty-nine patients with Type 1 diabetes (74% of the total
      clinic), including 41 females, completed evaluations of the clinic and recall of
      experiences in transfer. Mean age on transferring clinic was 15.9 (range 12-20)
      years. Paediatricians were perceived to emphasise family and social life, school
      or work progress; adult physicians tended to stress the risk of long-term
      complications, importance of exercise and need to maintain strict levels of
      glycaemic control. Our data suggest that transition to adult care can generally
      be achieved non-traumatically, but patients may perceive some difficulty because
      of different emphases and treatment advice favoured by paediatricians and adult
      physicians.

PMID- 8485965
TI  - Outcome of pregnancy in diabetic women in Soweto, South Africa 1983-1992.
AB  - A specialized service for pregnant diabetic women of African ethnic origin from
      Soweto was introduced in May 1983 at Baragwanath Hospital. Modern methods of
      management were used, including home blood glucose monitoring. A total of 354
      pregnancies (147 gestational, 207 pregestational) were managed over an 8 1/2 year
      period. All but 12 women were treated with insulin. Mean capillary blood glucose
      (+/- SD) ranged from 5.8 +/- 0.8 mmol l-1 in the insulin-dependent group to 6.2
      mmol l-1 in the gestational group (p < 0.01). Although maternal hypoglycaemia was
      common (14.4%) in the insulin-dependent patients, no ill effects were noted. The
      highest Caesarean section rate was in the gestational group (56%), the lowest in
      the insulin-dependent group (39.8%) (p < 0.01). Mean (+/- SD) neonatal weights
      were similar in the insulin-dependent and non-insulin-dependent groups (3131 +/-
      627.9 g and 3236 +/- 674.3 g resp. p = NS); offspring of the gestational group
      were heavier than the insulin-dependent group (3384.4 +/- 657.5 g) (p < 0.01).
      Neonatal hypoglycaemia occurred in less than 5% of offspring overall. The
      combined perinatal mortality was 6.1%, stillbirths accounting for the majority
      (63.6%) of deaths. Major congenital abnormalities occurred in 6(1.7%) of the
      offspring. The perinatal mortality of the 'control' group of 146 women was 26.1%.
      Glucose intolerance persisted in at least 34.7% of gestational diabetic women
      postpartum. This study suggests that a specialized service for pregnant diabetic
      women from a Third World community can be implemented with good effect and
      limited expense. Late presentation of pregestational diabetic women is a problem.

PMID- 8485966
TI  - Continuing audit of diabetes service.

PMID- 8485967
TI  - The effect of a city-wide mass media campaign on the public awareness of
      diabetes.

PMID- 8485968
TI  - Caries experience of Native children of British Columbia, Canada, 1980-1988.
AB  - Surveys of the dental health of Native children in British Columbia, Canada, were
      conducted in 1980, 1984 and 1988 by Medical Services Branch, Health and Welfare
      Canada. Data were gathered on children turning 5, 7, 9, 11, 13, and 15 yr of age
      in each survey year. This paper analyzes the findings related to dental caries
      and the treatment of caries. Comparisons were made between the 1980 and 1988
      surveys using Student's t-tests; data from the 1984 survey were included for
      comparison. Results of these surveys demonstrate a continuous improvement in the
      dental health of Native children between the years 1980 and 1988, but the
      improvement was limited to the permanent dentition. The deft for 5-yr-olds
      remained constant over the time interval. In contrast, the DMFT for each group
      significantly decreased from 1980 to 1988 (P < 0.05). The percentage of 5-yr-old
      children who were caries-free in the primary dentition remained constant, and
      primary tooth mortality (tooth abscessed or with crown destroyed) in 5-yr-olds
      did not change. However, the percentage of children surveyed with caries-free
      permanent teeth improved significantly at each survey year and permanent tooth
      mortality significantly declined (P < 0.05). The proportion of filled, compared
      with carious, primary and permanent teeth increased from 1980 to 1988. In
      contrast, the number of extracted primary teeth stayed relatively constant for 5
      yr-olds, but the proportion of missing teeth declined significantly for all other
      age groups (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485969
TI  - Effects of non-response on estimates derived from an oral health survey of older
      adults.
AB  - A major source of bias in health surveys is non-response on the part of those
      selected to take part in a study. In a survey of the oral health of older adults
      in Ontario, Canada, we used an initial telephone survey based on random digit
      dialing with a personal interview and clinical examination follow-up. The
      telephone survey was completed by 3033 individuals (78.0%) of those sampled. The
      follow-up was completed by only 907 (30.0%) of these subjects. Nevertheless,
      there were no major differences in the characteristics of those completing the
      telephone survey and those subsequently participating in the follow-up. Non
      response bias analysis indicated that differences between crude and adjusted
      estimates of the prevalence of oral conditions were small and the effect of non
      response on estimates of the relationship between socioeconomic status and oral
      health in this population were also small. These results indicate that response
      rates lower than those conventionally regarded as acceptable do not necessarily
      compromise the results of epidemiological studies.

PMID- 8485970
TI  - Norwegian adults' perceived need for coping skills to adjust to dental and non
      dental life events.
AB  - Limited attention has been paid to the importance which adults attach to dental,
      as opposed to other, life events. Consequently, the purpose of the present study
      was to determine how Norwegian adults rate the need for adjustment to cope with
      losing teeth or getting dentures, relative to some other life events, and to
      study effects of age, gender, level of education, place of residence, smoking,
      drinking and exercise habits. A representative, simple random sample of 400
      residents of the County of Hordaland aged 20-69 yr received a mail questionnaire
      plus one reminder requesting demographic information and completion of a 48-item
      Social Readjustment Rating Questionnaire (SRRQ) in May 1990. The mean age of the
      284 who responded (71%) was 41.1 yr (SD = 13.5 yr). The replies to the SRRQ were
      given on a graphic rating scale with end points "not difficult at all" (0 cm) and
      "more difficult than anything" (20 cm). Mean values were calculated and used to
      rank the life events. "Losing one or more teeth" was ranked 30 (mean = 11.8; SD =
      5.6) and "getting dentures" 33 (mean = 13.8; SD = 5.5). "Losing one or more
      teeth" was on a par with life events like "trouble with other relatives" (mean =
      11.7). "Getting dentures" occupied a position between "trouble with wife/husband"
      (mean = 14.3) and "wife/husband stopping work" (mean = 13.8). Multiple
      Classification Analysis revealed significant effects of education on "losing one
      or more teeth"; and of age, sex and education on "getting dentures" (P < 0.05).
      Furthermore, it was found that these two dental life events required an above
      average degree of readjustment according to the Social Readjustment Rating
      Questionnaire.

PMID- 8485971
TI  - Longitudinal statistical models for loss of sound surfaces.
AB  - Longitudinal data of 50-yr-old men, followed for 10 yr, were analyzed to identify
      variables which may be associated with healthy tooth surface loss. Three types of
      longitudinal models were used, arriving at similar conclusions. Predictors of
      sound tooth surface loss with aging included pocket depth, mobility, and
      recession.

PMID- 8485972
TI  - Burning mouth in a Finnish adult population.
AB  - Burning mouth syndrome is an oral pain disorder with a prevalence of 5-18% in
      patient materials. The aim of this study was to determine the prevalence of
      Burning mouth syndrome in a representative sample of the general adult
      population. Altogether 431 subjects (237 females, 194 males) participated in the
      study. Subjects were questioned about the experience of prolonged burning
      sensation; the site, severity, pattern, duration and possible associations of the
      onset of the burning sensation, and a thorough clinical examination was
      performed. In all, 15% of the subjects had experienced prolonged oral burning but
      a half of them had some clinically observable oral mucosal lesion or oral
      candidosis. The prevalence of the complaint was significantly higher in females
      than in males.

PMID- 8485973
TI  - Reproducibility of examiner performance for muscle and joint palpation in the
      temporomandibular system following training and calibration.
AB  - The purpose of this investigation was to assess examiner ability to consistently
      perform specific tasks related to muscle and joint palpation. Four trained and
      calibrated examiners were asked 1) to deliver index finger pressures within a
      high (1.5-2.1 kg) and low (0.5-1.1 kg) target pressure range and 2) to precisely
      locate one joint palpation and four muscle sites. After passing a calibration
      test, the performance of the examiners was monitored during the course of a
      replicability study assessing the consistency of clinical findings during
      repeated exams for TM disorders. (1) Index finger pressure was regularly tested
      over a 3-month period with a hand held pressure algometer, and the reading of
      each trial was recorded. Data analysis showed a high proportion of trials within
      the pressure range (overall 89.5%). Examiner performance across target range of
      pressures was statistically different for success rate and mean pressure
      delivered. The differences in the mean finger pressure delivered by each examiner
      (intraexaminer variation) was low and varied from 0.12 to 0.22 kg/cm2 for the
      desired range of pressures. (2) Paired examiners were asked to independently and
      sequentially mark palpation sites over the forehead, superficial and deep
      masseter, anterior temporalis, and lateral capsule of the temporomandibular
      joint. Replicability of site locations was assessed by measuring, with a boley
      gauge, the distance between sites selected by the paired examiners. Except for
      the superficial masseter and the anterior temporalis, the paired examiners
      selected palpation sites within a distance of 7 mm more than 85% of the
      time.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8485974
TI  - Effects of cannabis smoking on oral soft tissues.
AB  - The oral effects of cigarette smoking have been well documented but the effects
      of cannabis smoke on the oral environment have been poorly documented. Three
      hundred cannabis/tobacco/methaqualone smokers were examined. Two control groups
      consisting of 152 tobacco- and 189 non-smokers respectively were examined
      similarly. Health of the oral tissues and oral dryness was recorded. Lesions
      present included leukoedema, leukoplakia and numerous others. The only
      significant differences between lesions and conditions noted in cannabis users
      and controls occurred with respect to leukoedema, dry mouth and traumatic ulcer.

PMID- 8485975
TI  - AIDS and infection control: Dutch dental hygienists surveyed.
AB  - A sample of all dental hygienists practicing in the Netherlands besides Amsterdam
      (n = 669) and all dental hygienists practicing in Amsterdam (n = 118) were sent a
      questionnaire to assess the extent of compliance with the Dutch Health Council's
      guidelines to prevent HIV transmission in dental practices. The response rate was
      64%, Gloves, masks and spectacles were widely used. Use of disposable parts of
      the three-way syringes, medical dishwasher, sterilizable handles and sterilizable
      three-way syringes was insufficient. Disinfection was too often preferred to
      sterilization. Compliance with the guidelines was not related to the size of the
      city of practice. Amsterdam hygienists did not comply better than hygienists not
      from Amsterdam. One third of the respondents asked questions to assess whether a
      patient was HIV seropositive. Evidently, the view of the Dutch Health Council
      that knowledge of seropositivity is not necessary, was not shared by a
      substantial part of the hygienists. Fear of infection appeared to be negatively
      related to experience in treating HIV-seropositive patients and, indirectly, to
      perceived knowledge about AIDS.

PMID- 8485976
TI  - Anxiety about dental hygienist treatment.
AB  - Although dental anxiety is a well investigated phenomenon in dental health care,
      remarkably little is known about anxiety reactions related to treatment carried
      out by the dental hygienist. In the present study anxiety reactions were measured
      among 101 patients attending the dental hygienist. General level of anxiety was
      assessed through the PAQ (Photo Anxiety Questionnaire; STOUTHARD, DE JONGH &
      HOOGSTRATEN, 1991), whereas an additional questionnaire was used to obtain
      information about specific stimuli and situations that might provoke anxiety in
      the dental hygienist situation. The results indicated that during dental
      hygienist treatment only 15% of the patients experienced no feelings of anxiety.
      Another 15% of the patients reported that a visit to the dental hygienist was
      more distressing than dental treatment. The level of anxiety appeared to be
      strongly related to a number of stimuli and situations, with actual pain (78%)
      and expected pain (67%) major anxiety provoking factors. The relation between
      pain and anxiety was highly significant, with highly anxious patients having more
      fear for pain than their low anxious counterparts. Also feelings and sounds of
      instruments, patient's helplessness and perceived lack of control over what
      happens were identified as important contributors to anxiety for the dental
      hygienist treatment. The results of this study suggests that treatment by the
      dental hygienist is a distressing event for many patients.

PMID- 8485977
TI  - Relationship between epidemiologic coronal caries assessments and practitioners'
      treatment recommendations in adults.
AB  - Caries incidence determinations in adults reflect dentists' treatment decisions
      as well as epidemiologists' caries assessments because many patients receive
      treatment between the two assessments that are required to determine incidence.
      Yet knowledge of the relationship between epidemiologically assessed caries and
      practitioners' treatment recommendations is poor. In this study, the proportions
      of practitioners recommending treatment for a tooth, and the reasons for those
      recommendations, were compared across teeth grouped by their caries status as
      determined from an epidemiologic assessment. On average, for a tooth deemed
      carious by epidemiologic assessment, a mean of almost 90% of examining
      practitioners recommended treatment. Most but not all of these recommendations
      for treatment of teeth with epidemiologically determined caries were for caries
      related reasons. Among teeth classified as sound by epidemiological assessment,
      the mean proportion of dentists recommending treatment was 11%. For restored, non
      carious teeth a mean of 35% of examining dentists recommended treatment. Across
      all noncarious teeth, 25% of all treatment recommendations were related to
      caries. The mean patient F increment (number of newly filled surfaces) that would
      result from treatment recommendations practitioners indicated as being associated
      with caries was slightly less than one-half of the total F increment. Thus, F
      increments may substantially overestimate caries incidence.

PMID- 8485978
TI  - Posttraumatic obsessive-compulsive disorder: a case study.
AB  - Recent epidemiologic evidence has pointed to a disproportionate rate of obsessive
      compulsive disorder (OCD) among high-combat-exposed Vietnam veterans. This case
      report describes an individual without previous overt psychopathology who under
      the stress of combat developed concurrent OCD and posttraumatic stress disorder
      (PTSD) persisting for more than 20 years. Phenomenologic, behavioral,
      psychodynamic, and biologic considerations all help to elucidate the potential
      role of emotional trauma in the pathogenesis of obsessions and compulsions.

PMID- 8485979
TI  - Should an axis for defense mechanisms be included in DSM-IV?
AB  - The purpose of this review is to address empirical evidence bearing on the
      desirability of including a Defense Mechanisms Axis in DSM-IV. The authors
      reviewed studies based on standardized clinical or self-report methods for
      assessing defense mechanisms. Information was sought pertinent to methods for
      assessment, relevance to clinicians with diverse theoretical perspectives,
      definitions, suitability for an axial format, complexity, reliability, clinical
      utility, and relationship to existing axes. Methods for reliably rating defense
      mechanisms have been developed, and data on the clinical utility of ratings have
      begun to accumulate. A consensus on definitions is emerging, and evidence
      supports a hierarchy of defenses based on their adaptiveness. Since training in
      psychodynamic theory and treatment approaches is required of residencies
      performed in the United States, all psychiatrists should be able to evaluate
      patient defenses. However, new methodologies have not been tested under usual
      clinical conditions with limited, "live" clinical data. A viable option for DSM
      IV is the inclusion of a defense mechanisms axis in an appendix of optional axes
      for use in special clinical and research settings. In addition to providing
      dynamically meaningful diagnostic data, this axis would facilitate expansion of
      the empirical data base on a standardized measure of defenses under conditions of
      routine clinical practice.

PMID- 8485980
TI  - Induced psychotic disorder: clinical aspects, theoretical considerations, and
      some guidelines for treatment.
AB  - We describe our experience with a case of folie a famille with role reversal,
      including the long-term course. In addition, the case reports published since
      1974 were reviewed and an overview is given of the psychoanalytic and system
      theory concepts on the pathogenesis of induced psychotic disorder. The inductor
      often appears to be suffering from schizophrenia. No further indications could be
      found in the literature for a hereditary predisposition in the recipient. It is
      sometimes difficult to distinguish between the inductor and the recipient, owing
      to the circular character of induced psychotic disorder and the role reversal
      that sometimes occurs. The DSM-III-R criteria for induced psychotic disorder were
      found to be lacking in practice because of their disregard for the circular
      causality and the strict exclusion criteria. In the short term, physical
      separation of the inductor and recipient leads to better treatment results than
      nonseparation, particularly in the case of recipient children. Long-term results
      are seldom mentioned. On the basis of theoretical considerations, interventions
      that aim at separation in psychological terms are necessary to achieve favorable
      long-term treatment results.

PMID- 8485981
TI  - Otoneurological functioning in panic disorder patients with prominent dizziness.
AB  - Fifteen panic disorder patients with prominent dizziness underwent audiologic,
      caloric, and vestibuloocular reflex activity testing and were compared with
      normal controls. There were no abnormalities detected on audiologic and caloric
      tests. Compared with normal controls, panickers with dizziness showed a greater
      discrepancy between eye and head movements on vestibulo-ocular reflex activity in
      the dark. Panickers with prominent dizziness did not differ from a second control
      group of panickers with severe heart palpitations on a number of psychological
      tests. The results did not support the hypothesis that organic dizziness is
      etiologically important in the causation of panic or agoraphobia, but do suggest
      that vestibuloocular reflex activity should be further studied in panic disorder.

PMID- 8485982
TI  - Subjective cognitive dysfunction in schizophrenic and depressed patients.
AB  - We examined the experience of subjective cognitive dysfunction in schizophrenic
      and depressive patients and in patient control and normal control subjects, using
      questionnaires for measuring components of everyday attentional functioning and
      subjective cognitive difficulties. These subjective ratings were stable over a
      period of 3 months. Irrespective of diagnosis, psychiatric patients reported
      higher levels of distractibility, cognitive overload, and cognitive failures. The
      psychopathological correlates of these experiences and of reduced processing
      capacity and attentional control consisted primarily of symptoms of anxiety and
      depression and the corresponding personality traits. However, cognitive overload
      experiences were specifically associated with psychotic and psychotic-like
      symptoms. No correlation was found between negative symptoms and subjective
      cognitive efficacy. The discussion focuses on the energetic aspects of cognition
      and on problems of cognitive self-evaluation. It is argued that subjective
      cognitive measures are worth studying in their own right, and that they may be of
      interest to clinicians involved in rehabilitation programs.

PMID- 8485983
TI  - Morbid risks for major disorders and frequencies of personality disorders among
      spouses of psychiatric inpatients and controls.
AB  - Three hundred fifty-three psychiatric inpatients and their 192 living spouses and
      98 control subjects and their 54 living spouses were examined and interviewed for
      affective, schizoaffective, schizophrenic (Research Diagnostic Criteria [RDC]),
      and personality disorders (DSM-III-R) using the Lifetime Version of the Schedule
      for Affective Disorders and Schizophrenia (SADS-L) and the Structured Clinical
      Interview for DSM-III-Personality Disorders (SCID). The morbid risks of spouses
      for unipolar depression were between .15 and .25, and those for other major
      disorders were below .03. The morbid risks of spouses of bipolar patients for
      unipolar depression exceeded those of other spouses by 50% without reaching
      statistical significance. Personality disorders were found in 44.6% of patients,
      in 8.4% of patients' spouses, and in 9.8% of healthy controls. There was only one
      couple in which the husband and wife had each had a major disorder before
      marriage. Only four husband-wife pairs suffered the same personality disorder.
      Spouses of patients do not have significantly more psychiatric disorders than
      healthy controls; therefore, assortative mating can only be of minor relevance in
      family studies.

PMID- 8485984
TI  - History and significance of childhood attention deficit disorder in treatment
      seeking cocaine abusers.
AB  - Thirty-five percent of 298 treatment-seeking cocaine abusers met DSM-III-R
      criteria for childhood attention deficit hyperactivity disorder (ADHD). Subjects
      with childhood ADHD were likely to be male (78%), meet Research Diagnostic
      Criteria (RDC) for conduct disorder (93%) and antisocial personality disorder
      (47%), and report a history of conduct disorder in first-degree relatives. With
      respect to those without the disorder and regardless of co-occurrence with
      sociopathy, cocaine abusers with childhood ADHD were younger at presentation for
      treatment and reported more severe substance use, earlier onset of cocaine abuse,
      more frequent and intense cocaine use, intranasal rather than freebase or
      intravenous use of cocaine, higher rates of alcoholism, and more previous
      treatment. This pattern of cocaine use is consistent with clinical descriptions
      of self-medication of residual symptoms of ADHD in cocaine abusers. Data from
      this study suggest that there may be more cocaine abusers with a history of ADHD
      than previously recognized in clinical samples of cocaine users, and that these
      individuals may differ in clinically meaningful ways from those without childhood
      ADHD. Moreover, the poorer outcome of subjects with ADHD in this sample
      underlines the importance of identifying and treating residual symptoms of ADHD
      in cocaine abusers.

PMID- 8485985
TI  - Primary depressives with secondary alcoholism compared with alcoholics and
      depressives.
AB  - While a subset of depressed patients are believed to "self-medicate" their
      depression with alcohol, there are no studies comparing the phenomenological and
      diagnostic characteristics of patients with primary depression and secondary
      alcoholism with those of patients with depression or alcoholism alone. In this
      study, we compared 11 patients from each of these three diagnostic groups in
      terms of past history and current clinical presentation. The patients were
      matched for age, sex, and level of function. Comorbid patients were most likely
      to meet criteria for sedative dependence and panic disorder, and had higher
      scores on the Hamilton Anxiety Scale. In addition, they scored higher on a
      hypomania scale and had more first-degree relatives with a history of drug abuse.

PMID- 8485986
TI  - Gender differences in psychiatric morbidity among alcohol misusers.
AB  - Sociodemographic characteristics, patterns and effects of alcohol abuse, and
      psychiatric morbidity were compared in 121 men and 121 women using structured
      interviews, and diagnostic criteria according to the DSM-III and Hamilton
      Depression Rating Scale were applied. Women were more likely to be binge
      drinkers, to have premorbid anxiety, and to be diagnosed with primary depression.
      Men cited social reasons for drinking, whereas women were more likely to drink to
      alleviate anxiety. Women also were more likely to have a family history of
      psychiatric disorder and/or alcohol misuse. More women were drinking at home
      alone than men, but almost as many were drinking openly with their spouses or
      friends.

PMID- 8485987
TI  - Biochemical basis of DNA replication fidelity.
AB  - DNA polymerase is the critical enzyme maintaining genetic integrity during DNA
      replication. Individual steps in the replication process that contribute to DNA
      synthesis fidelity include nucleotide insertion, exonucleolytic proofreading, and
      binding to and elongation of matched and mismatched primer termini. Each process
      has been investigated using polyacrylamide gel electrophoresis (PAGE) to resolve
      32P-labeled primer molecules extended by polymerase. We describe how integrated
      gel band intensities can be used to obtain site-specific velocities for addition
      of correct and incorrect nucleotides, extending mismatched compared to correctly
      matched primer termini and measuring polymerase dissociation rates and
      equilibrium DNA binding constants. The analysis is based on steady-state "single
      completed hit conditions", where polymerases encounter many DNA molecules but
      where each DNA encounters an enzyme at most once. Specific topics addressed
      include nucleotide misinsertion, mismatch extension, exonucleolytic proofreading,
      single nucleotide discrimination using PCR, promiscuous mismatch extension by HIV
      1 and AMV reverse transcriptases, sequence context effects on fidelity and
      polymerase dissociation, structural and kinetic properties of mispairs relating
      to fidelity, error avoidance mechanisms, kinetics of copying template lesions,
      the "A-rule" for insertion at abasic template lesions, an interesting exception
      to the "A-rule", thermodynamic and kinetic determinants of base pair
      discrimination by polymerases.

PMID- 8485988
TI  - Chromosomal assignments of genes for rat glutathione S-transferase Yb1 (GSTA3)
      and Yb2 (GSTA4) subunits.
AB  - Chromosomal assignments of genes for rat glutathione S-transferase Yb1 (GSTA3)
      and Yb2 (GSTA4) subunits were performed by Southern blot analyses of somatic cell
      hybrid DNAs. Both GSTA3 and GSTA4 were assigned to rat chromosome 2.

PMID- 8485989
TI  - A method for testing the nonrandomness of chromosomal breakpoints.
AB  - Testing the nonrandomness of breakage at a chromosome band is an essential step
      fo identifying a fragile site. In this paper, we propose a method derived by
      using the relationship between the binomial and F distributions for testing
      nonrandomness. The method is simple in calculation. It was applied to the
      detection of fragile sites for Chinese patients with colorectal carcinoma.

PMID- 8485990
TI  - The effect of 13;14 Robertsonian translocations on germ-cell differentiation in
      infertile males.
AB  - Two infertile men heterozygous for a 13;14 Robertsonian (Rb) translocation were
      investigated by means of synaptonemal complex studies, testicular histology, and
      semen analysis. In both individuals interaction between the Rb trivalent and the
      XY pair was observed. Twenty percent of pachytene cells analyzed in one patient
      showed XY-trivalent association which correlated with malformed spermatids; the
      higher rate of XY-trivalent association (approximately 47%) in the second proband
      corresponded with complete spermatogenic arrest. The data presented indicate a
      positive correlation between increased frequency of XY trivalent association and
      the degree of germ-cell impairment.

PMID- 8485991
TI  - Interstitial localization of telomeric DNA sequences in the Indian muntjac
      chromosomes: further evidence for tandem chromosome fusions in the karyotypic
      evolution of the Asian muntjacs.
AB  - The Indian muntjac is believed to have the lowest chromosome number in mammals
      (2n = 6 in females and 2n = 7 in males). It has been suggested that a series of
      tandem chromosome fusions from an ancestral Chinese muntjac-like species (2n =
      46) may have occurred during the karyotypic evolution of the Indian muntjac. In
      an earlier study, hybridization signals generated by the Chinese muntjac
      centromeric heterochromatin DNA probe (C5) were found to be distributed
      interstitially in the chromosomes of the Indian muntjac, providing supportive
      evidence for the tandem chromosome fusion theory. In this study, the highly
      conserved human telomeric DNA sequence (TTAGGG)n was localized by fluorescence in
      situ hybridization (FISH) on the metaphase chromosomes of three Cervidae species:
      the Indian muntjac, Chinese muntjac, and woodland caribou. As expected,
      hybridization signals were observed at the termini of almost every chromosome in
      all three species. In addition, interstitial hybridization signals were detected
      in chromosomes 1 and 2 of the Indian muntjac. The observed interstitial telomeric
      signals appeared to correspond to specific interstitial centromeric
      heterochromatin sites. These interstitial telomeric signals could represent
      remnant DNA sequences from the ancestral species telomeres, further supporting
      the tandem chromosome fusion theory. Furthermore, these observations permit the
      elucidation of the chromosome sites where breakage and fusion most likely
      occurred during the restructuring of the ancestral Chinese muntjac-like
      chromosomes to form the present day Indian muntjac karyotype.

PMID- 8485992
TI  - Co-dominance of radioresistant DNA synthesis in a group of AT-like Chinese
      hamster cell mutants.
AB  - The relation of radiosensitivity and radioresistant DNA synthesis (RDS) was
      studied in the AT-like Chinese hamster cell mutants V-C4, V-E5, and V-G8 of the
      same complementation group. Proliferating hybrid cell lines obtained after fusion
      of the AT-like hamster cell mutants with their parental V79 cells showed only
      very partial complementation of RDS, while radiosensitivity with respect to cell
      killing was fully complemented in these hybrid cells. Therefore, RDS behaves as a
      (co-)dominant feature in hybrids of AT-like mutants and wild-type V79 cells,
      indicating that RDS cannot be used for complementation analysis of X-ray
      sensitive Chinese hamster cells. In contrast to the intraspecies hybrids, a full
      complementation of RDS was observed in interspecies hybrids between the rodent AT
      like mutants and human (HeLa) cells, suggesting a species-specific regulation of
      DNA synthesis. These results indicate that radiosensitivity and RDS are
      pleiotropic effects of the same afflicted gene.

PMID- 8485993
TI  - A high-resolution banding pattern idiogram of Monodelphis domestica chromosomes
      (Marsupialia, Mammalia).

PMID- 8485994
TI  - Detailed characterization of a human 8q24.1 microdissection library and
      generation of "sequence-tagged sites".
AB  - A total of 533 clones from a human 8q24.1 microdissection library was analyzed by
      automatic DNA sequencing. Three hundred and thirty-seven different insert
      sequences were found. The insert size ranged from 45 to 376 bp (mean, 170 bp).
      Eighty-six percent (291/337) of these sequences were free of repetitive DNA. Each
      of 19 clones tested was successfully translated into a sequence-tagged site. We
      conclude that the microdissection library is a rich source of DNA markers for
      8q24.1.

PMID- 8485995
TI  - Cytogenetics of bisexual/unisexual species of Poecilia. V. Unisexual poeciliids
      with anomalous karyotypes from northeastern Mexico.
AB  - Unisexual poeciliid fishes collected from two localities in the Soto la Marina
      drainage have been analyzed. Unisexual diploid and triploid specimens with
      anomalous karyotypes were found among karyotypically normal specimens.
      Chromosomal data are discussed in light of the origin of clonal diversity in
      unisexual/bisexual breeding complexes and with regard to the role of triploids in
      these breeding complexes.

PMID- 8485996
TI  - Mapping of the human cardiac Na+/Ca2+ exchanger gene (NCX1) by fluorescent in
      situ hybridization to chromosome region 2p22-->p23.
AB  - The cDNA that encodes the human Na+/Ca2+ exchanger (NCX1) involved in regulation
      of intracellular calcium levels has been isolated from a cardiac cDNA library.
      Using fluorescent in situ hybridization, the human cDNA was mapped to chromosome
      region 2p23-->p22 by co-hybridization with fluorescinated alu517-PCR amplified
      total human DNA to obtain an R-banding pattern.

PMID- 8485997
TI  - Chromosomal evidence for a hybrid origin of diploid parthenogenetic females from
      the unisexual-bisexual Lepidodactylus lugubris complex (Reptilia, Gekkonidae).
AB  - Chromosome banding analysis of seven diploid parthenogenetic females from
      Polynesian and Southeast Asian populations of the unisexual-bisexual
      Lepidodactylus lugubris complex (Reptilia, Gekkonidae) showed that the unisexual
      karyotype consists of two different haploid sets. Similar analysis of an L.
      lugubris male from a bisexually reproducing population revealed two identical
      chromosome complements, the banding pattern generally matching that of the
      females, although many chromosomes were obviously different. These observations
      suggest that the gonochoristic males belong to a taxon related to the
      parthenogenetic female taxon but are not a direct ancestor of the latter. The
      data also offer strong evidence for a hybrid origin of diploid parthenogenetic
      females in L. lugubris and suggest that a high degree of chromosomal
      heterogeneity may be the leading reason for the evolutionary selection of a
      modified meiotic process in this species, allowing production of unreduced
      oocytes and, consequently, of a unisexual mode of reproduction.

PMID- 8485998
TI  - Is the MDI doomed to extinction?

PMID- 8485999
TI  - Ultrahigh frequency ventilation. Nouvelle ventilation or just old hash?

PMID- 8486000
TI  - Long-term ventilatory support in the community.

PMID- 8486001
TI  - Self-efficacy.

PMID- 8486003
TI  - Yes, there is life after ventilation.

PMID- 8486002
TI  - CEASE (Collaborative European Anti-Smoking Evaluation). A challenging multicenter
      trial organized by the European Respiratory Society.

PMID- 8486004
TI  - Natural history of left ventricular function in patients with uncomplicated acute
      myocardial infarction.
AB  - To investigate the serial changes of the infarcted and the noninfarcted areas,
      first-pass radionuclide angiocardiography was performed in 16 patients with
      uncomplicated anterior myocardial infarction (MI) at four weeks, one year, and
      two years after the onset of MI. Global ejection fraction (EF) and regional EF of
      the infarcted area improved significantly from four weeks to one year after MI
      (from 39 +/- 16 to 44 +/- 16 percent, 23 +/- 3 to 29 +/- 5 percent, both p <
      0.01), but did not change from one year to two years after MI. Regional EF of the
      noninfarcted area and left ventricular end-diastolic and end-systolic volume did
      not change during the study period. There was a significant relation in the
      direction of the changes of global EF and regional EF of the infarcted area
      during the first year after MI, whereas no relation was observed between the
      changes of global EF and regional EF of the noninfarcted area. A greater
      improvement in regional EF of the infarcted area was observed in seven patients
      who had spontaneous recanalization compared with nine patients with totally
      occluded coronary arteries. Thus, a significant improvement in cardiac function,
      mainly due to the increase in regional EF of the infarcted area, was observed
      during the first year after MI, which was related to patency of coronary artery.

PMID- 8486005
TI  - Pulmonary function and respiratory chemosensitivity in moderately obese patients
      with sleep apnea.
AB  - To determine whether moderately obese, normocapnic, sleep apnea patients are
      distinguished from normal obese individuals by differences in waking pulmonary
      function and respiratory chemosensitivity, we compared the waking pulmonary
      function, hypercapnic, and hypoxic ventilatory responses of 35 nonhypercapnic
      sleep apnea patients (32 men and 3 women) with those of 17 age-, sex-, weight-,
      and obesity-matched nonapneic control subjects (16 men and 1 woman). The waking
      ventilatory response to hypercapnia was lower among sleep apnea patients (mean +/
      SD, 2.05 +/- 1.29 L/min/mm Hg) than control subjects (3.02 +/- 2.05 L/min/mm Hg,
      p < 0.05). Patients with sleep apnea demonstrated a higher waking PaCO2 (40.4 +/-
      2.9 vs 37.0 +/- 2.7 mm Hg, p < 0.001), and a lower waking PaO2 (81.4 +/- 11.7 vs
      89.7 +/- 10.4 mm Hg, p < 0.03). The waking hypoxic ventilatory response, however,
      was not significantly different between the groups. Moreover, control subjects
      had a higher total lung capacity than sleep apnea patients (6.99 +/- 1.12 L and
      6.27 +/- 1.09 L, respectively, p < 0.05). The lower hypercapnic ventilatory
      response, higher waking PaCO2, and lower total lung capacity in the sleep apnea
      patients resemble the pattern observed in patients with pickwickian syndrome.
      This suggests that disturbances in pulmonary function and ventilatory control in
      moderately obese sleep apnea patients are intermediate along a continuum from
      normal obesity to the pickwickian syndrome.

PMID- 8486006
TI  - Sleep apnea syndrome and end-stage renal disease. Cure after renal
      transplantation.
AB  - We report two patients undergoing maintenance hemodialysis who presented with
      sleep apnea syndrome (SAS). The first patient is a 36-year-old man with a
      terminal Berger's glomerulopathy and associated obstructive sleep apnea syndrome
      (OSAS) (apnea-hypopnea index [AHI] = 80). He was receiving home hemodialysis and
      was treated by nasal continuous positive airway pressure (CPAP). After successful
      renal transplantation, his symptoms completely disappeared, and control
      polysomnography greatly improved (AHI = 9). The second patient had hypokalemic
      nephropathy with severe, uncontrolled hypertension and hypertensive
      myocardiopathy. He was receiving home dialysis and showed a central sleep apnea
      syndrome with an AHI of 51. He also was successfully treated by nasal CPAP. After
      renal transplantation, his sleep improved, insomnia disappeared, and
      polysomnography showed great improvement (AHI = 5). We discuss the role of
      periodic breathing related to end-stage renal disease associated metabolic
      abnormalities, as a pathogenetic factor of these SASs. Respiratory correction of
      chronic metabolic acidosis, "uremic toxins," "middle molecules," and hemodialysis
      are all evoked as etiologic factors and their own roles are discussed.

PMID- 8486007
TI  - Adiposity and cardiovascular risk factors in men with obstructive sleep apnea.
AB  - STUDY OBJECTIVE: To assess anthropometric characteristics of patients with
      obstructive sleep apnea (OSA) and their relationship to cardiovascular risk
      factors (dyslipidemia, hypertension, glucose intolerance) and severity of
      breathing abnormalities during sleep. DESIGN: Case series. SETTING: Referral
      based sleep disorder center serving Rhode Island and Southeastern Massachusetts.
      PATIENTS: Forty-five men, 26 to 65 years old, with OSA diagnosed by clinical and
      polysomnographic criteria. RESULTS: By national health survey criteria, 51
      percent of patients were in the upper fifth percentile for weight, whereas 91 to
      98 percent were in the upper fifth percentile for skinfold thicknesses (triceps,
      subscapular, triceps plus subscapular). Severe upper body obesity, as defined by
      a waist-hip ratio (WHR) greater than or equal to 1.00, was present in 51 percent
      of the patients. The WHR, however, did not correlate significantly with the
      severity of respiratory disturbances during sleep. The patients had higher
      prevalences of hypertension and impaired glucose tolerance than expected, but
      normal prevalences of hypercholesterolemia, low high-density lipoprotein
      cholesterol, and overt diabetes mellitus. Skinfold thicknesses correlated more
      closely with the severity of OSA than did body mass index (BMI) or neck
      circumference. CONCLUSION: Men with OSA have a marked excess of body fat that is
      not always reflected in measurements of body weight or BMI. Also, upper body
      obesity, hypertension, and impaired glucose tolerance occur more frequently than
      expected in this population. Severe adiposity may not only promote development of
      the respiratory abnormalities of OSA, but also may contribute directly to the
      increased cardiovascular risk associated with OSA.

PMID- 8486008
TI  - 24-hour ambulatory blood pressure variability in obstructive sleep apnea
      syndrome.
AB  - The 24-h ambulatory blood pressure (24h-ABP) was examined in 21 men, aged 38 to
      65 years (mean 50.6), with obstructive sleep apnea syndrome (OSAS) and in 123
      normal male control subjects, aged 40 to 60 years (mean 48.1) who did not have
      OSAS, obesity, autonomic nervous system abnormality, cardiac disease, or
      respiratory disease (group C), to assess the role of apneas in the circadian
      variation of blood pressure (BP). The 24h-ABP patterns in OSAS patients were
      classified into three types as follow: normotensive OSAS patients with normal BP
      throughout the 24-h period with nocturnal BP fall (type 1); hypertensive OSAS
      patients with progressive BP elevation from onset of sleep to early morning (type
      2); and hypertensive OSAS patients with elevated BP (systolic BP > or = 140 mm Hg
      or diastolic BP > or = 90 mm Hg) at any time during a 24-h period (type 3). It
      was concluded that the circadian BP variation in type 1 was almost identical to
      the level and pattern of group C; the circadian variations in types 2 and 3 were
      significantly different from that of group C; and the patients with types 2 and 3
      BP patterns had more severe OSAS than type 1 patients. The severity of OSAS was
      an important factor in nocturnal elevation of BP, hence affecting the circadian
      variation of BP. Noninvasive 24h-ABP monitoring is a useful procedure for
      understanding the clinical features of OSAS patients with or without
      hypertension.

PMID- 8486009
TI  - Validation of new pulsed Doppler echocardiographic techniques for assessment of
      pulmonary hemodynamics.
AB  - In preparation for a vasodilator study on chronic obstructive pulmonary disease
      (COPD), we investigated the reliability of recently described pulsed Doppler
      techniques for estimating pulmonary artery pressure (PAP) and cardiac output
      (CO). Our aims were to determine the following: (1) the imaging success rate for
      pulsed Doppler measurements; (2) the repeatability of the measurements, and
      interobserver and intraobserver variability; and (3) the accuracy of Doppler
      compared with catheter measurements. Doppler studies were attempted in 81
      patients (cardiac disease [23], COPD [22], sleep apnea [32], and normal subjects
      [4]). Suitable images were obtained in 68 subjects (84 percent) and in 76
      subjects (94 percent) for PAP and CO estimations, respectively. The lowest
      imaging success rates were in COPD patients (68 percent for PAP and 86 percent
      for CO estimation). Repeatability of the techniques was assessed in four cardiac
      patients and three healthy volunteers by performing four replicate studies in
      each subject over 1 h. Intrasubject coefficient of variation was < 10 percent for
      PAP and < 5 percent for CO. The intraobserver variability for Doppler estimation
      of systolic and mean PAP was 5.5 percent and 5.8 percent, respectively. The
      corresponding values for interobserver variability were 6.7 percent and 6.2
      percent. Intraobserver and interobserver variability for "nongeometric" method of
      estimating CO was 5.1 percent and 5.9 percent, respectively. Agreement was good
      between catheter-measured and Doppler-estimated PAP in the 27 patients tested
      (cardiac [19] and COPD [8]) for both mean and systolic pressures (r = 0.96 and r
      = 0.97, respectively). The correlations between thermodilution and Doppler
      estimations of CO in eight COPD patients were 0.77 ("geometric" technique) and
      0.97 ("nongeometric" technique). We conclude that pulsed Doppler techniques can
      be used to obtain accurate and reproducible quantitative information on pulmonary
      hemodynamics in a wide range of patients. Suitable Doppler images can be obtained
      in more than two thirds of COPD patients.

PMID- 8486010
TI  - Felodipine improves pulmonary hemodynamics in chronic obstructive pulmonary
      disease.
AB  - Pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is
      associated with a poor prognosis. Reduction of pulmonary artery pressure in COPD
      by prolonged oxygen treatment has been shown to be associated with increased
      survival. In an attempt to find a suitable pharmacologic method of reducing
      pulmonary artery pressure and pulmonary vascular resistance in COPD, we enrolled
      13 stable pulmonary-hypertensive, hypoxemic COPD patients in a study to test the
      effects of felodipine, a relatively new, vascular-selective calcium antagonist.
      Doppler echocardiography was used to estimate pulmonary artery pressure and
      cardiac output before treatment, 2, 7, and 12 weeks during felodipine treatment
      (10 to 20 mg/d), and after a 1-week placebo washout period. Measurements of lung
      function, arterial blood gases, and exercise capacity during an incremental
      bicycle ergometer test were also performed at intervals during the study period.
      Three patients withdrew from the study and of the remaining 10, 8 had some side
      effects of medication (peripheral edema or headache) that improved either
      spontaneously or following a reduction in drug dose. In the 10 patients who
      completed the study (8 male; mean age, 67 years), felodipine resulted in
      significant reductions in mean pulmonary artery pressure (22 percent) and total
      pulmonary (vascular) resistance (30 percent) and increases in cardiac output (15
      percent) and stroke volume (13 percent) compared with baseline measurements and
      those taken after placebo washout. These effects were sustained over the 12 weeks
      of felodipine treatment. There was no adverse effect of felodipine treatment on
      pulmonary gas exchange at rest or during exercise and no change in lung function
      or exercise capacity. We conclude that in pulmonary hypertensive, hypoxemic COPD
      patients, felodipine substantially improves pulmonary hemodynamics.

PMID- 8486011
TI  - Nutritional status of patients with chronic obstructive pulmonary disease and
      acute respiratory failure.
AB  - The prevalence and features of malnutrition in COPD patients have been studied
      extensively in stable conditions but are poorly defined in the presence of acute
      respiratory failure (ARF). Nutritional status was prospectively assessed, on
      hospital admission, in 50 consecutive COPD patients presenting with ARF, 27 of
      them requiring mechanical ventilation (MV). Malnutrition, defined on a
      multiparameter nutritional index, was observed in 60 percent (30/50) of all
      patients, and in 39 percent (13/33) of those whose body weight was equal to or
      above 90 percent ideal body weight (IBW). Malnutrition was more frequent in those
      patients who required MV than in those who did not (74 percent vs 43 percent, p <
      0.05). Subcutaneous fat stores were decreased (triceps skinfold thickness [TSF] <
      80 percent pred) in 68 percent of patients, and markedly depleted (TSF < 60
      percent pred) in 52 percent of them. The indices of lean body mass, ie, mid-arm
      muscle circumference (MAMC) and creatinine height index (CHI) were decreased in,
      respectively, 42 percent and 71 percent of patients, but MAMC was severely
      depressed (< 60 percent pred) in only 6 percent of them. A severe decrease of
      prealbumin (< 100 mg/L), retinol-binding-protein (< 20 mg/L), and albumin (< 20
      g/L) serum concentrations was observed in, respectively, 22 percent, 28 percent,
      and 4 percent of patients. These results suggest that an assessment of
      nutritional status using a multiparameter approach should be systematically
      performed in COPD patients with ARF, especially in those requiring MV, as
      malnutrition may have deleterious effects on weaning off MV.

PMID- 8486012
TI  - The influence of spring and summer New England meteorologic conditions on the
      respiratory status of patients with chronic lung disease.
AB  - To determine whether meteorologic conditions affect the respiratory status of
      individuals with chronic lung disease, we asked 14 patients who had completed
      outpatient pulmonary rehabilitation to record the following information daily
      during the spring and summer of 1991: (1) dyspnea on arising (morning dyspnea);
      (2) dyspnea throughout the day (daytime dyspnea); (3) peak expiratory flow rate
      (PEFR); (4) mood; and (5) the presence of lower respiratory tract infection
      (LRI). The effect of local meteorologic conditions and LRI frequency on morning
      and daytime dyspnea, PEFR, and mood were analyzed for spring and summer seasons
      using a linear regression technique that controlled for first-order
      autocorrelation. The LRI frequency and the preceding day's respiratory status
      were the most significant predictors of either season's daily variation in
      respiratory status. During spring, the only meteorologic condition associated
      with respiratory status was precipitation: rainfall was directly related to
      increased morning and daytime dyspnea. Meteorologic conditions were not related
      to changes in PEFR or mood. During summer, the combination of higher temperature,
      rise in barometric pressure, and increased LRI frequency best predicted increased
      morning dyspnea, while the combination of higher temperature and rise in
      barometric pressure best predicted reduced PEFR. Meteorologic conditions were not
      related to changes in daytime dyspnea or mood. Precipitation in spring and a
      combination of high temperature and rise in barometric pressure in summer best
      predicted deterioration in the respiratory status of this group of patients with
      chronic lung disease.

PMID- 8486013
TI  - Changes in transcutaneous oxygen partial pressure as an index of response to
      inhaled methacholine in asthmatic patients.
AB  - Bronchoconstriction and hypoxemia have been reported to occur during airway
      challenges, but the correlation between changes in forced expiratory volume in 1
      s (FEV1) and transcutaneous oxygen partial pressure (tcPO2) during methacholine
      provocation tests has not yet been established (to our knowledge). In 15 symptom
      free atopic asthmatic patients and 5 normal subjects, variations in tcPO2 and
      FEV1 were simultaneously measured during inhalation of doubling methacholine
      concentrations; the drug concentrations causing a 20 percent decrease in control
      FEV1 and tcPO2 (PC20FEV1 and PC20tcPO2, respectively) were subsequently
      calculated. In patients, geometric mean PC20FEV1 and PC20TcPO2 were 1.31 (range,
      0.16 to 5.19) and 1.26 (range, 0.29 to 5.82) mg/ml, respectively. In addition, in
      six patients, methacholine-induced fall in tcPO2 was accompanied by similar
      changes in arterial PO2. Methacholine inhalation caused no change in tcPO2 or
      FEV1 in normal subjects. The independent effects of deep breath tests and
      bronchoconstriction on PC20tcPO2 were studied in five patients challenged on two
      separate occasions, with and without FEV1 assessment; in these patients,
      PC20tcPO2 were similar on both the study days. The results indicate that, in
      asthmatic patients, methacholine-induced bronchoconstriction causes parallel
      decreases in FEV1 and tcPO2. The tcPO2 monitoring may serve as a tool in the
      assessment of airway hyperreactivity when active patient's cooperation is scarce.

PMID- 8486014
TI  - Acute effects of nifedipine on systolic and diastolic ventricular function in
      patients with chronic obstructive pulmonary disease.
AB  - To evaluate how nifedipine influences systolic and diastolic ventricular
      function, the effects of 20 mg sublingual nifedipine were studied in 13 stable
      COPD patients. Nifedipine induced no change in mean pulmonary arterial pressure,
      decreased mean arterial pressure, pulmonary and systemic vascular resistance
      index, and increased heart rate and cardiac index. It also caused an increase in
      right and left ventricular ejection fractions. The end-diastolic volume index of
      both ventricles remained unchanged, whereas the end-systolic volume index tended
      to decrease without reaching a significant level, and the right ventricular
      contractility increased. After nifedipine administration, right and left
      ventricular compliance increased. This study suggests that short-term
      administration of nifedipine improves the systolic function by a decrease in
      ventricular afterload and an increase in ventricular contractility and increases
      the ventricular compliance by a reflex sympathetic stimulation and an afterload
      reduction.

PMID- 8486015
TI  - Changing patterns of aerosol deposition during methacholine bronchoprovocation.
AB  - During bronchoprovocation testing with methacholine, induced changes in airway
      geometry are known to affect sites of drug deposition. However, it is not known
      if changes in these sites determine measured responsiveness. We assessed the
      importance of sites of deposition as determinants of reactivity by comparing
      particle behavior in two subject groups with and without hyperresponsiveness. By
      administering radiolabeled aerosols of similar aerodynamic characteristics to
      methacholine aerosol, we measured the deposition pattern in terms of the specific
      central to peripheral ratio (sC/P) before and after methacholine inhalation
      (sC/P1 and sC/P2, respectively) and thereby quantified the changes in deposition
      sites that occur during the course of a typical bronchoprovocation test. Subjects
      whose FEV1 decreased by 20 percent or greater were classified as methacholine
      responsive (MR; nine subjects), and the remainder were classified as non
      methacholine responsive (NMR; seven subjects). The two groups had similar
      baseline FEV1 percent predicted (FEV1 percent) and initial deposition patterns
      (sC/P1) with particles depositing primarily in peripheral airways (mean +/- SE;
      sC/P1 1.43 +/- 0.070 and 1.39 +/- 0.65, MR and NMR, respectively, p = NS).
      Following methacholine inhalation, the deposition pattern changes markedly for
      all subjects with particles depositing primarily in central airways (sC/P2 2.58
      +/- 0.24, p = 0.001, and 2.15 +/- 0.22, p = 0.001 from baseline, p = NS between
      groups) By definition, the MR subjects had a significantly greater change in FEV1
      than the NMR subjects. Preferential deposition in central airways occurs in all
      subjects during bronchoprovocation testing and does not significantly determine
      methacholine responsiveness.

PMID- 8486016
TI  - Regional impairment of mucociliary clearance in chronic obstructive pulmonary
      disease.
AB  - Asthmatic subjects with tidal expiratory flow limitation have mucociliary
      clearance (MC) impairment in central airways. Because tidal flow limitation
      develops in COPD, it is possible that regional MC in these patients also may be
      affected. We tested this hypothesis by measuring MC in the presence or absence of
      flow limitations. Patients with COPD and chronic flow limitation were compared
      with non-flow-limited normal volunteers. Deposition was normalized for regional
      lung volume and expressed as the specific central to peripheral (sC/P) ratio. In
      COPD subjects, clearance from the whole lung and central airways was
      significantly different from that of normal subjects after 20 min of observation.
      In the peripheral airways, there were no significant differences between COPD and
      normal subjects. An alternative analysis of regional MC indicated patients
      retained particles in central airways while normal subjects, with intact MC,
      emptied central airways. Thus, COPD subjects with tidal expiratory flow
      limitation have impaired MC in their central airways.

PMID- 8486017
TI  - Supported arm exercise vs unsupported arm exercise in the rehabilitation of
      patients with severe chronic airflow obstruction.
AB  - OBJECTIVE: Compare unsupported (UAEx) vs supported (SAEx) arm exercise in
      training of patients with severe chronic airflow obstruction (CAO). DESIGN:
      Randomized trial of UAEx vs SAEx training added to a 10-week outpatient program
      of lower extremity (LE) exercise training, respiratory muscle training, breathing
      retraining, psychological support, and teaching. SETTING: The Lahey Clinic
      Medical Center, a tertiary referral center. PATIENTS: Forty patients with CAO
      entered the rehabilitation program with 32 completing training and testing.
      INTERVENTIONS: All underwent progressive bicycle ergometer and treadmill training
      and respiratory muscle training using a threshold inspiratory pressure trainer.
      Patients were randomized to progressive SAEx training (arm cycle ergometer, n =
      17) or UAEx training (raising weighted dowel, n = 18). MAIN OUTCOME MEASURES AND
      RESULTS: There was no significant difference in disease severity or exercise
      capacity between the two groups. Twelve-min walk test, bicycle ergometer power
      output, and respiratory muscle function improved with no significant difference
      in improvement between the two groups. Both groups showed similar improvements in
      arm ergometer testing while those trained with UAEx showed greater improvement in
      dowel testing (UAEx > SAEx, p = 0.002). In 17 patients VO2isotime (time at which
      patient performed pre-training and post-training tests) was measured during dowel
      testing. Only those trained with UAEx showed decreases in VO2isotime (UAEx
      trained, p = 0.02; SAEx, p = 0.18). VO2 during the last minute of a 2-min period
      of simple arm elevation was also measured in 17 patients. Only those trained with
      UAEx showed decreases in VO2 (UAEx, p = 0.02; SAEx, p = 0.20). CONCLUSION: We
      confirm that a pulmonary rehabilitation program incorporating exercise training
      improves LE and respiratory muscle function. Arm exercise training improved arm
      activity with greater increases in unsupported arm activity seen in those trained
      with unsupported arm training. Metabolic cost of UAEx decreased only in those
      trained with UAEx. As UAEx is typical of activities of daily living in patients
      with CAO, the changes seen with UAEx training may be of greater clinical
      significance. Arm training should be incorporated in exercise training and a
      simple program of UAEx appears the optimal format.

PMID- 8486018
TI  - Ultrasonically guided aspiration biopsy in osteolytic bone lesions of the chest
      wall.
AB  - Sixteen consecutive patients with one or more osteolytic bone lesions of the
      chest wall radiologically confirmed underwent ultrasonically guided aspiration
      biopsy. Nine patients (56.2 percent) had bronchogenic carcinoma with a direct
      extension. Other diagnostic techniques had failed to diagnose disease in these
      patients. The lesion showed heterogeneous echogenicity (n = 16) caused by the
      hyperechoic signals of bone fragments. The interruption of the cortex bone was
      detected in all cases and extraosseous tumor portion in 14 of 16 patients (87.5
      percent). No respiratory motions of the lesion could be demonstrated (n = 16).
      Definitive histologic diagnosis was made in 14 of the 16 patients (87.5 percent).
      In malignancy, diagnosis was established in 13 of 14 patients (92.8 percent). Of
      two confirmed benign lesions, one diagnosis of tuberculosis was obtained. No
      complication occurred. Sonography and consequently ultrasonically guided
      aspiration biopsy are a useful, accurate, safe, and low-cost technique for
      osteolytic lesions in thoracic diseases.

PMID- 8486019
TI  - A comparison of manual to mechanical chest percussion for clearance of alveolar
      material in patients with pulmonary alveolar proteinosis (phospholipidosis).
AB  - To our knowledge, there are no studies that compare the effectiveness of manual
      chest percussion (MN), mechanical chest percussion (MC), and no percussion (NP)
      for removing the proteinaceous material found in the alveoli of patients with
      pulmonary alveolar proteinosis (PAP) while undergoing whole-lung bronchopulmonary
      lavage (BPL). We analyzed the optical densities (OD) of 27 bottles of effluent
      from three BPLs of a patient with PAP. One technique was used per bottle. The
      order of techniques was balanced within each nine-bottle series and among the
      three BPLs. The mean OD for MN (0.933 +/- 0.494) was significantly superior to MC
      (0.477 +/- 0.265) (p < 0.0005) and NP (0.318 +/- 0.242) (p < 0.0001). We conclude
      that MN is superior to MC and NP and increases the therapeutic results of BPL for
      PAP.

PMID- 8486020
TI  - Use of ultrahigh frequency ventilation in patients with ARDS. A preliminary
      report.
AB  - STUDY OBJECTIVE: Our objective was to compare the efficacy of ultrahigh frequency
      ventilation (UHFV) (frequencies > 3 Hz) with respect to oxygenation, airway
      pressures, and hemodynamic parameters in patients with adult respiratory distress
      syndrome (ARDS) who were not responding to conventional ventilation. DESIGN: We
      used a prospective, multicenter, nonrandomized study design in which each patient
      served as his own control. SETTING: Three university-affiliated, tertiary-care
      medical centers participated. PATIENTS: Persons aged 16 to 79 years old with ARDS
      and unresponsive to conventional ventilation, as defined by a Food and Drug
      Administration (FDA) approved protocol, were included. INTERVENTIONS: Ninety
      patients who were not responding to conventional ventilation were changed to UHFV
      using a microcomputer-controlled device. MEASUREMENTS AND RESULTS: The patient's
      blood gas, hemodynamic, and airway pressure variables were measured just before,
      and at 1 and 24 h after the switch to UHFV. We demonstrated clinically
      significant improvements in arterial oxygen tension (PaO2) and reductions in peak
      and mean inspiratory pressures. CONCLUSIONS: In a multicenter study, UHFV
      improved respiratory gas exchange and reduced airway pressure variables at both 1
      h and 24 h after the onset of UHFV when compared with conventional ventilation
      just prior to the change and without hemodynamic deterioration, in patients with
      severe ARDS.

PMID- 8486021
TI  - Topical treatment of pulmonary aspergilloma by antifungals. Relationship between
      duration of the disease and efficacy of therapy.
AB  - Twelve patients with aspergilloma were treated with intracavitary or
      endobronchial administration of antifungals. Patients with successful therapy had
      significantly shorter mean duration of the disease course (3.6 months) than the
      less effective group (44.4 months, p < 0.01). Minimal inhibitory concentrations
      of antifungal agents against isolated strains of aspergilli were considerably
      lower than estimated intracavitary concentrations of the antifungals. A
      pathologic examination suggested that the old mycetoma was for the most part
      comprised of dead mycelial cells, against which antifungal agents were not
      effective. However, clinical improvement was obtained, regardless of the
      roentgenographic improvement. Our study suggested that early diagnosis and
      therapy are recommended to achieve better therapeutic effect.

PMID- 8486022
TI  - Squamous metaplasia of the bronchial mucosa and its relationship to smoking.
AB  - We performed flexible fiberoptic bronchoscopy (FFB) on 106 heavy cigarette
      smokers. Six bronchial biopsy specimens, obtained from the carina and five major
      bronchi, were screened for squamous metaplasia. Individual biopsy specimens were
      sectioned into 4-microns sections, and a metaplasia index (MI), or percentage of
      sections containing squamous metaplasia, was determined. Metaplasia was noted at
      one or more biopsy sites in 66 of 99 subjects (seven were excluded from the
      analysis). Twenty-five percent of the subjects showed metaplasia at three or more
      biopsy sites, and one subject had metaplasia on all six biopsy specimens. The
      presence of squamous metaplasia varied from 40.4 percent in the right lower lobe
      to 15.3 percent in the left upper lobe. The subjects were grouped into simple
      categories based on the number of packs smoked per day and the pack-year history
      of smoking. Subjects who smoked more than two packs per day (n = 11) had the
      highest MI (37.4 +/- 4.9 percent, mean +/- SEM). Fifty-seven subjects smoked more
      than one pack per day but fewer than or equal to two packs per day, and they had
      a mean MI of 22.3 +/- 2.9 percent. Subjects who smoked one pack per day or less
      (n = 31) had a mean MI of only 12.9 +/- 2.8 percent. The MI of those who smoked
      more than two packs per day was significantly greater than the MI of those who
      smoked one pack per day or less (p < or = 0.003). While the MI varied from 12.9
      +/- 3.5 percent in subjects who had smoked less than 20 pack-years to a maximum
      of 29.1 +/- 4.5 percent in those who had smoked greater than 60 pack-years, no
      statistically significant difference was detected between these two groups. Thus,
      we conclude that heavy tobacco use is associated with important alterations of
      bronchial mucosa. Furthermore, the intensity of tobacco use (packs per day)
      rather than the number of pack-years appears to be the more important factor in
      promoting squamous metaplasia of the bronchial mucosa.

PMID- 8486023
TI  - Intrathoracic adenopathy associated with pulmonary tuberculosis in patients with
      human immunodeficiency virus infection.
AB  - The role of computed tomography (CT) in the diagnosis of mediastinal tuberculous
      lymphadenitis was evaluated retrospectively in 25 human immunodeficiency virus
      (HIV)-infected patients (19 had AIDS). In all cases, the diagnosis of
      tuberculosis was established by mycobacterial culture and/or histologic
      evaluation. The most characteristic CT finding was the presence of low-density
      mediastinal and hilar lymph nodes in 16 of 19 (84 percent) patients with AIDS and
      four of six (67 percent) HIV-seropositive patients without AIDS. Marked
      enhancement of the periphery of nodes was identified in five cases, all in
      patients with documented AIDS. In most cases, lymphadenopathy proved to be
      massive, presenting as extensive, heterogenous soft-tissue lesions, presumably
      the result of coalescence of groups of matted nodes. We conclude that low-density
      mediastinal and/or hilar lymph nodes on CT, while not pathognomonic, is
      sufficiently characteristic for tuberculosis to warrant empiric antituberculosis
      therapy pending results of cultures.

PMID- 8486024
TI  - The tidal volume response to incremental exercise in COPD.
AB  - Patients with severe COPD often exhibit a ventilatory limit to exercise. This is
      associated with a shallow breathing pattern when compared with normal control
      subjects. It is unclear, however, what factors affect differences in breathing
      patterns within this patient population. To further investigate the tidal volume
      (VT) response to exercise in severe COPD, nine patients were recruited to undergo
      a maximal incremental exercise test. Pulmonary function tests, collection of
      expired gases, and continuous pulse oximetry were performed. As a group, the
      results were as follows (mean +/- SD): The FEV1 was 31 +/- 7 percent of
      predicted, the FRC was 143 +/- 18 percent of predicted, and the DCO was 47 +/- 15
      percent of predicted. Exercise testing showed an oxygen consumption at peak
      exercise of only 44 +/- 9 percent predicted, a dyspnea index of 101 +/- 19
      percent predicted, a heart rate at peak exercise of 75 +/- 12 percent predicted,
      a tidal volume at peak exercise (PKVT) of 1.23 +/- .35, a respiratory rate at
      peak exercise (PKfb) of 26 +/- 6, and an oxygen saturation at peak exercise
      (PKO2sat) of 96 +/- 4 percent. An anaerobic threshold (AT) occurred in seven of
      the nine patients at a mean of 31 +/- 8 percent predicted maximal oxygen
      consumption. Regression analysis showed the PKVT to be inversely correlated with
      the FEV1 (r = -0.76; p = 0.01) and the PKfb (r = -0.85; p = 0.003), while
      positively correlating with the FRC (r = +0.80; p = 0.01) and the PKO2sat (r =
      +0.69; p = 0.04). Additionally, there was a trend for the PKVT to be inversely
      related with the AT (r = -0.72; p = 0.06). In COPD, the more severe the
      obstruction and hyperinflation, the larger the VT response to exercise. This may
      serve to avoid a deleterious increase in autoPEEP by promoting a lengthening of
      the expiratory time. Furthermore, given the association of an earlier AT and a
      higher PKO2sat with a larger PKVT, this would suggest that such a response may
      minimize the effects of dead space and/or autoPEEP on O2 delivery (early AT).

PMID- 8486025
TI  - Bronchodilator delivery from Gentlehaler, a new low-velocity pressurized aerosol
      inhaler.
AB  - We have compared radioaerosol deposition pattern and bronchodilator response
      following inhalation of 100 micrograms of albuterol from a correctly used
      conventional metered dose inhaler (MDI) to those from Gentlehaler, a new compact
      low-velocity pressurized aerosol device (Schering Corporation), in a group of ten
      asthmatic patients (mean baseline FEV1 52 percent; reversibility > 15 percent).
      Whole lung deposition (mean 18.8 percent of dose by conventional MDI, mean 19.9
      percent of dose by Gentlehaler), regional lung deposition, and bronchodilator
      response were similar for the two devices, but oropharyngeal deposition was
      halved by Gentlehaler. The spray velocity from Gentlehaler was less than 2 m s-1
      compared with a velocity of greater than 30 m s-1 commonly found in the
      conventional device. Gentlehaler may therefore play a valuable role in inhalation
      therapy, notably by reducing "cold Freon" problems (respiratory inhibition) in
      pressurized aerosol delivery, and by reducing oropharyngeal losses of inhaled
      corticosteroids.

PMID- 8486026
TI  - Diagnosis of right atrial mass lesions by transesophageal and transthoracic
      echocardiography.
AB  - The echocardiographic findings by transesophageal and transthoracic techniques
      were compared in 16 patients with right atrial mass lesions diagnosed by
      transesophageal echocardiography. In only 8 of the 16 patients were the masses
      imaged by transthoracic echocardiography. Masses in the main body of the right
      atrium (three of five), as well as those associated with indwelling catheters and
      pacer wires (three of four) were more likely to be imaged by transthoracic
      echocardiography than masses in the right atrial appendage (zero of three) or in
      the superior or inferior vena cava (one of three). Associated masses in other
      cardiac chambers were detected by transthoracic echocardiography in three of six
      patients. Other features such as size, mobility, and site of attachment of right
      atrial masses in general were better defined by transesophageal echocardiography.
      Thus, patients with suspected right atrial masses should be investigated with
      transesophageal echocardiography.

PMID- 8486027
TI  - Prognostic significance of posturally induced crackles. Long-term follow-up of
      patients after recovery from acute myocardial infarction.
AB  - We found that on pulmonary auscultation, fine crackles could be induced by
      changing the posture from sitting to supine and/or from supine to supine with
      passive leg elevation in patients without obvious congestive heart failure. We
      named these crackles "posturally induced crackles (PIC)." To investigate the
      relationship between PIC and long-term prognosis after myocardial infarction, we
      followed up 262 patients who recovered from acute myocardial infarction for a
      mean period of six years. Cardiac death occurred in three of 78 PIC-negative
      patients and in 28 of 143 PIC-positive patients. PIC-negative patients had a
      significantly better long-term prognosis than PIC-positive patients according to
      the Kaplan-Meier survival curves for cardiac death (p < 0.01). In a multilogistic
      model based on 70 appropriate cases, PIC was the third most important
      prognosticator after recovery from myocardial infarction and the number of
      diseased coronary vessels and the pulmonary capillary wedge pressure ranked first
      and second, respectively.

PMID- 8486028
TI  - Surveys of long-term ventilatory support in Minnesota: 1986 and 1992.
AB  - To determine the prevalence and some characteristics of persons in Minnesota
      receiving long-term ventilatory support (ventilator-assisted individuals [VAIs]),
      we conducted a survey of this population in Minnesota in 1986 and then again in
      1992 by canvassing long-term care units and home medical equipment providers. The
      number of VAIs in 1992 was 110 percent greater than in 1986 (216 vs 103). In
      1986, 81 percent of these patients received care at home; the remaining patients
      were supported in long-term care facilities. By 1992, the percentage had changed
      to 65 percent supported in the home and 35 percent in long-term care facilities.
      In both surveys, the largest number of VAIs were in the diagnostic categories of
      poliomyelitis, cervical trauma, amyotrophic lateral sclerosis (ALS), chronic
      obstructive pulmonary disease (COPD), and muscular dystrophy. The primary
      diagnoses with the greatest increase in number of patients were cervical trauma
      and ALS. When VAIs were categorized by age groups, there was a large increase in
      the proportion of patients younger than 10 years of age and older than 60 years
      of age. While the number of patients is small, the total resources required for
      care of these patients can be substantial. These data suggest that we need to
      monitor the number and demographic characteristics of VAIs in the United States
      so that appropriate policies and programs are developed to provide effective
      support services.

PMID- 8486029
TI  - Effects of obesity on respiratory resistance.
AB  - To assess the effects of obesity on pulmonary function, 46 healthy subjects
      exhibiting various degrees of obesity underwent lung function tests. Subjects
      were divided into three groups according to body mass index (BMI): 13 had minimal
      obesity (BMI, 25 to 29 kg/m2, group 1); 24 had a BMI in the 30 to 40 range (group
      2); and 9 displayed to morbid obesity (BMI > 40, group 3). Respiratory resistance
      was estimated by the forced random noise oscillation technique and airway
      resistance was determined by body plethysmography. Lung volumes and expiratory
      flows were also determined and significant negative correlations with BMI were
      found. Expiratory flows diminished in proportion to lung volumes, and the ratio
      of forced expiratory volume in 1 s to forced vital capacity was within normal
      limits. Although expiratory flows did not suggest bronchial obstruction, both
      respiratory resistance and airway resistance rose significantly with the level of
      obesity (p < 0.005 and p < 0.025, respectively), from 3.2 (+/- 0.02) and 3.2 (+/-
      0.02) cm H2O.s.L-1, respectively, in group 1, to 5.5 (+/- 0.06) and 5.0 (+/-
      0.05), respectively, in group 3. Evaluation of the factors responsible for this
      increased resistance disclosed a significant linear correlation between airway
      conductance and functional residual capacity (r = 0.70, p < 10(-4)), but specific
      airway conductance was found to be independent of the degree of obesity. The
      difference between respiratory resistance and airway resistance did not widen
      significantly according to the level of obesity, suggesting that chest wall
      resistance was not a factor enhancing these resistances. Taken together, these
      findings suggest that in addition to the elastic load, obese subjects have to
      overcome increased respiratory resistance resulting from the reduction in lung
      volumes related to being overweight.

PMID- 8486030
TI  - Bronchial hyperreactivity in patients with moderate pulmonary circulation
      overload.
AB  - The clinical course of congestive heart failure (CHF) and mitral valve stenosis
      (MVS) is accompanied by episodes of dyspnea, wheezing, and cough, symptoms also
      observed in patients with bronchial hyperreactivity. However, it is still
      controversial whether bronchial hyperreactivity is demonstrable in patients with
      chronic overload of the pulmonary circulation. In order to examine the effects of
      CHF on the respiratory function, we performed pulmonary function tests, titrated
      bronchial acetylcholine provocations, and left and right heart catheterization in
      21 patients with impaired left ventricular function (mean ejection fraction, 37
      percent, NYHA class 3), 5 patients with MVS, and 17 control patients with
      coronary artery disease (mean ejection fraction, 63 percent). Bronchial
      hyperresponsiveness was defined as an obstructive response to increased doses of
      inhaled acetylcholine. A 20 percent fall in forced expiratory volume in the first
      second (FEV1), a 100 percent increase in total airway resistance (Rtot), and a 60
      percent reduction of pulmonary conductance (SGtot) were considered positive.
      Patients with impaired left ventricular function showed significantly higher
      airway resistance, and lower airway conductance at the maximal tolerated
      acetylcholine dose compared with control patients. Patients with MVS had a
      significant lower airway conductance. The induced bronchial obstruction was
      completely reversible upon inhalation of a beta 2-mimetic. We conclude that
      chronic overload of the pulmonary circulation is accompanied by bronchial
      hyperreactivity that may augment the symptoms of dyspnea in patients with CHF and
      MVS.

PMID- 8486031
TI  - The bronchitis index. A semiquantitative visual scale for the assessment of
      airways inflammation.
AB  - Flexible fiberoptic bronchoscopy has been proven to be an effective tool for the
      assessment and characterization of airway inflammation. Visual inspection of
      airways affected by chronic bronchitis discloses an abnormal appearance
      characterized by erythema, edema, secretions, and friability. It was hypothesized
      that the visual appearance of airway inflammation could be assessed in a
      semiquantitative manner. A bronchitis index (BI) was developed that scores the
      visual appearance of airways according to the presence or absence of abnormal
      edema, erythema, secretions, and friability (0 = normal, 3 = remarkably
      abnormal). The BI was determined in three study groups: 86 subjects with chronic
      bronchitis, 15 subjects who smoked cigarettes, but did not have chronic
      bronchitis, and 25 normal, nonsmoking control subjects. The reproducibility of
      the BI was determined by comparing the results from pairs of two independent
      observers assessing 249 subjects undergoing fiberoptic bronchoscopy under various
      investigative protocols. In total, nine investigators scored the airways. For the
      three observer pairs with more than six observations, there were no differences
      noted in the BI (p = 0.43, 0.67, 0.82). To control for the effect of cough upon
      the BI, lidocaine usage was recorded. No correlation was found between lidocaine
      usage and BI. As previously noted for a smaller group of subjects, the BI was
      found to be elevated in those with chronic bronchitis (13.2 +/- 0.53) compared
      with both asymptomatic smokers (8.5 +/- 0.89, p < 0.0005) and normal volunteers
      (2.3 +/- 0.55, p < 0.0001); the latter two groups also differed significantly (p
      < 0.0001). The BI was also found to correlate significantly with bronchial sample
      lavage fluid neutrophil content in lavage fluid obtained after determination of
      the BI and with cigarette smoking as quantitated by pack years. Conversely, the
      BI correlated negatively with the spirometric measures of airway obstruction,
      FEV1, FEV1/FVC, FEV25-75, and FEFmax. Thus, the BI appears to be a reproducible,
      semiquantitative assessment of the visual appearance of airway inflammation. It
      may be a useful bronchoscopic adjunct for the assessment of airway inflammation
      in clinical investigations.

PMID- 8486032
TI  - "Pseudo auto-PEEP"? A new cause for discrepancy between the end-expiratory
      occlusion plateau pressure and airway opening pressure.
AB  - The purpose of this study is to describe an unexpected degree of differences
      between expiratory occlusion plateau pressure (EPO) and airway opening pressure
      (Pawo) measured level of intrinsic positive end-expiratory pressure above
      externally applied (auto-PEEP) that was found in six critically ill patients. In
      six patients (ten studies), the presence and degree of auto-PEEP found during the
      EPO maneuvers was not confirmed by Pawo measurements. In five studies, flow
      tracings showed prolonged near zero flow toward end expiration and a slow rise to
      plateau during the EPO maneuver. Because of the static nature of the EPO
      determination, a rise in pressure could conceivably be caused by the presence of
      subcutaneous or mediastinal emphysema and retrograde flow across the airway
      defect during exhalation. We suggest another cause for auto-PEEP-dynamic
      hyperinflation from extrapulmonary flow limitation.

PMID- 8486033
TI  - Aerobic and anaerobic microbiology of empyema. A retrospective review in two
      military hospitals.
AB  - The microbiology and clinical features of empyema were studied retrospectively in
      197 patients whose specimens yielded bacterial growth after inoculation for
      aerobic and anaerobic bacteria. Three hundred forty-three organisms (216 aerobic
      or facultative and 127 anaerobic organisms) were isolated. Aerobic bacteria were
      isolated in 127 (64 percent) patients, anaerobic bacteria in 25 (13 percent), and
      mixed aerobic and anaerobic bacteria in 45 (23 percent). The predominant aerobic
      or facultative organisms were Streptococcus pneumoniae (70 isolates),
      Staphylococcus aureus (58), Escherichia coli (17), Klebsiella pneumoniae (16),
      and Haemophilus influenzae (12). The predominant anaerobes were pigmented
      Prevotella and Porphyromonas species (24), Bacteroides fragilis group (22),
      anaerobic cocci (36), and Fusobacterium species (20). beta-Lactamase-producing
      organisms were recovered in 49 (38 percent) of 128 tested specimens. These
      included all 42 tested S aureus and 15 B fragilis group, 4 of 9 K pneumoniae, 3
      of 9 H influenzae, 3 of 8 pigmented Prevotella and Porphyromonas species, and 2
      of 6 E coli. Most patients from whom S pneumoniae and H influenzae were recovered
      had pneumonia, and most patients with S aureus had pneumonia, aspiration
      pneumonia, and lung abscesses. The recovery of anaerobic bacteria was mostly
      associated with the concomitant diagnosis of aspiration pneumonia, and lung,
      subdiaphragmatic, dental, and oropharyngeal abscesses. These data highlight the
      importance of anaerobic bacteria in selected cases of empyema.

PMID- 8486034
TI  - Early and rapid diagnosis of perioperative myocardial infarction in aortocoronary
      bypass surgery by immunoturbidimetric myoglobin measurements.
AB  - STUDY OBJECTIVES: To evaluate measurements of myoglobin in the diagnosis of
      perioperative myocardial tissue damage in aortocoronary bypass surgery. A new
      immunoturbidimetric myoglobin assay, which yields quantitative concentrations of
      myoglobin within approximately 1 min, was used. DESIGN: Prospective clinical
      study. PATIENTS: Thirty-two patients scheduled for elective aortocoronary bypass
      surgery. MEASUREMENTS AND RESULTS: Myoglobin concentrations in patients without
      perioperative myocardial infarction (n = 27) increased with aortic unclamping,
      peaked after 1 h, and decreased to almost baseline values within 4 h. By
      contrast, myoglobin concentrations in patients with perioperative myocardial
      infarction (n = 5) further increased after 1 h of aortic unclamping and were
      significantly higher (p < 0.05) than in patients without myocardial infarction as
      soon as 3 h after aortic unclamping. In all patients with myocardial infarction,
      myoglobin concentrations exceeded 400 micrograms/L over a minimum period of 4 h.
      Ten of 27 patients without perioperative myocardial infarction had episodes of
      minor perioperative myocardial ischemia (defined as ST-T segment changes in the
      ECG without a concomitant increase in the activity of creatine kinase isoenzyme
      MB). Myoglobin concentrations (but not creatine kinase isoenzyme MB activity)
      were significantly higher in these 10 patients when compared to the 17 completely
      uneventful cases. CONCLUSIONS: Plasma concentrations of myoglobin are a sensitive
      marker of perioperative myocardial tissue damage in aortocoronary bypass surgery.
      Myoglobin measurements with the immunoturbidimetric assay have an important
      contribution to make to the early and rapid diagnosis of perioperative myocardial
      infarction.

PMID- 8486035
TI  - Closure of the patent ductus arteriosus with a Ligaclip through a
      minithoracotomy.
AB  - This article describes a technique which allows the patent ductus arteriosus
      (PDA) to be closed through a minithoracotomy. It combines a simple method of
      inducing atelectasis with Ligaclip closure of the PDA through a subaxillary
      incision. It was used successfully in 11 children and adolescents.

PMID- 8486036
TI  - A clinical study of intravenous cibenzoline in selected patients with recent
      onset atrial tachyarrhythmia.
AB  - Twenty-five adult patients with sustained atrial tachyarrhythmia (ATA) and
      without heart failure were treated by intravenous cibenzoline, 1 mg/kg, as a slow
      bolus infusion, followed by a 8 mg/kg/24 h continuous infusion. Sinus rhythm
      conversion was observed in 18 patients (72 percent success rate). Severe adverse
      cardiac events were observed in only one patient (4 percent occurrence rate), as
      a wide QRS complex tachycardia finally requiring a semiemergency direct-current
      cardioversion. Two minor side effects were additionally observed. A similar
      population of 21 patients was conventionally treated with amiodarone, either
      given intravenously, 15 to 20 mg/kg/24 h, or orally, 30 mg/kg/24 h as a single
      dose. An identical success rate (15/21; 71 percent) was observed. Our results
      indicate that in selected patients with ATA, cibenzoline and amiodarone are
      highly effective for producing sinus rhythm conversion. We suggest that the
      former drug may be used as a first-line treatment. In case of failure, the latter
      may constitute an alternative to transthoracic electrical countershock.

PMID- 8486037
TI  - Differential lobe lavage for diagnosis of acute Pneumocystis carinii pneumonia in
      patients receiving prophylactic aerosolized pentamidine therapy.
AB  - The diagnostic yield of bronchoalveolar lavage (BAL) for Pneumocystis carinii
      pneumonia (PCP) in patients infected with human immunodeficiency virus has been
      reported to be 95 percent, but falls to 62 percent in patients receiving
      aerosolized pentamidine. Because aerosolized pentamidine appears to be
      preferentially deposited in the middle and lower lobes, we postulated that an
      upper lobe lavage would have a higher diagnostic yield than the standard
      middle/lower lobe lavage in patients receiving aerosolized pentamidine. Twenty
      five patients receiving aerosolized pentamidine suspected of having acute PCP
      underwent separate BAL of an upper lobe and lower lobe as well as transbronchial
      biopsy. Fifteen of the 25 (60 percent) were diagnosed as having PCP. Of the 15,
      one had the samples inadvertently combined. In the remaining 14, BAL was positive
      for P carinii organisms in 12 lavages of the lower lobe and 14 of the upper lobe.
      Upper lobe lavage had statistically significantly more P carinii organisms by
      semiquantitative technique than the lower lobe. In patients receiving aerosolized
      pentamidine, who develop acute PCP, an upper lobe lavage may have a higher
      diagnostic yield than the standard middle/lower lobe lavage. In addition, the
      transbronchial biopsy specimen offered no treatable diagnosis that was not made
      by lavage alone in the 25 patients. This raises the question of the utility of
      transbronchial biopsies in these patients.

PMID- 8486038
TI  - Measuring self-efficacy expectations for the self-management of cystic fibrosis.
AB  - This research developed and determined the psychometric characteristics of a
      measure of self-efficacy expectations (a social cognitive theory construct) for
      the self-management of cystic fibrosis (CF). Items for the original instrument
      were sampled from 150 self-management performance objectives for CF that
      represented behaviors in eight domains of CF care, including aspects of medical
      care, coping, and communication. The instrument was administered to 199 parents
      of children and adolescents with CF from two CF centers. The findings support a
      multidimensional structure for self-efficacy consistent with the multiple types
      of behavior required for the management of a chronic illness such as CF. An alpha
      factor analysis yielded solutions clearly reflecting five theorized aspects of
      self-management: medical judgment and communication, coping, family
      communication, compliance, and acceptance. The first factor of the caretaker's
      scale most closely represents the underlying conceptualization of self-management
      as requiring self-monitoring of health status and collaboration with the health
      care provider in making judgments about treatment. The unit weighted factors
      exhibited high internal consistencies (Cronbach's alpha-factors ranging from 0.73
      to 0.88).

PMID- 8486039
TI  - Angiosarcoma in the lung.
AB  - Angiosarcoma involving the lung is a rare disorder and its clinical features are
      not well known. We conducted a retrospective analysis of 15 patients seen at our
      institution from 1950 to 1990 in an attempt to better characterize the spectrum
      of clinical and radiographic findings of angiosarcoma in the lung. No documented
      case of primary angiosarcoma of the lung was seen. The diagnosis of metastatic
      angiosarcoma to the lung was made antemortem in 12 of 15 cases, either by lung
      biopsy specimen (5 patients), biopsy evidence of metastatic disease elsewhere
      with abnormal chest radiograph (4 patients), or a compatible clinical picture in
      a patient with previously documented angiosarcoma arising in an extrapulmonary
      site (3 patients). The median age at the time of diagnosis was 45 years with the
      most common presenting symptom being hemoptysis (7 of 15 patients). Other
      presenting complaints included weight loss (6 of 15), cough (4 of 15), and chest
      pain (4 of 15) occurring 6 weeks to 1 year prior to diagnosis. Chest radiographs
      frequently disclosed multiple pulmonary nodules (11 of 15). Primary origins of
      the angiosarcoma most commonly included the heart and breast. Metastatic sites
      other than the lung included the pericardium, liver, spleen, kidney, adrenal
      gland, bone, and brain. The prognosis is generally poor, with our study
      population surviving an average of 9 months after diagnosis.

PMID- 8486040
TI  - Time course of hemostatic abnormalities in sepsis and its relation to outcome.
AB  - OBJECTIVES: To investigate the time course and the relation to prognosis of
      coagulation and fibrinolytic abnormalities in patients with septic shock.
      PATIENTS AND METHODS: Forty-eight consecutive patients admitted to the medical
      ICU with the diagnosis of septic shock (diagnosed by defined criteria) were
      studied. Mortality was 25 of 48. Mean age was 57 +/- 7.3 years. Blood samples
      were obtained on days 1, 4, and 7 after hospital admission to measure tissue-type
      plasminogen activator antigen (t-PA), urokinase-type plasminogen activator (u
      PA), plasminogen activator inhibitor antigen (PAI-1), plasminogen, alpha 2
      antiplasmin, fibrinogen, antithrombin III, protein C, protein S, thrombin
      antithrombin complexes (TAT), D-dimer, and von Willebrand factor-related antigen
      (vWF:Ag). RESULTS: All patients showed marked abnormalities in both the
      coagulation and fibrinolytic systems. There were signs of coagulation activation
      and elevation of both activators and inhibitors of fibrinolysis. Nonsurvivors
      showed lower levels of protein C and antithrombin III and higher concentration of
      TAT than survivors. While both t-PA and PAI-1 concentrations were high in
      survivors and nonsurvivors, only survivors showed a progressive normalization of
      both parameters during the study period. Low plasminogen levels and
      plasminogen/alpha 2-antiplasmin ratio were found in both groups, presenting a
      trend toward normalization only in survivors. The differences reported were not
      apparent at the time of hospital admission. CONCLUSIONS: Septic shock is
      characterized by coagulation activation and fibrinolysis activation and
      inhibition. Nonsurvivors present a particular hemostatic profile characterized by
      a more marked activation of coagulation and a more intense inhibition of
      fibrinolysis. None of the abnormalities studied was significantly different
      between survivors and nonsurvivors at the time of hospital admission. In the
      presence of fibrin formation, nonsurvivors present a maintained imbalance in the
      fibrinolytic response determined by higher PAI-1 plasma concentration, probably
      contributing to their poor outcome.

PMID- 8486041
TI  - Effect of air-supported, continuous, postural oscillation on the risk of early
      ICU pneumonia in nontraumatic critical illness.
AB  - STUDY OBJECTIVES: We hypothesized that continuous, automatic turning utilizing a
      patient-friendly, low air loss surface would reduce the incidence of early ICU
      pneumonia in selected groups of critically ill medical patients. DESIGN:
      Prospective, randomized, controlled clinical trial. SETTING: Medical ICU of a
      large community teaching hospital. PATIENTS: One hundred twenty-four critically
      ill new admissions to the medical ICU at Charity Hospital in New Orleans.
      INTERVENTIONS: Patients were prospectively randomized within one of five
      diagnosis-related groups (DRG)--sepsis (SEPSIS), obstructive airways disease
      (OAD), metabolic coma, drug overdose, and stroke--to either routine turning on a
      standard ICU bed or to continuous turning on an oscillating air-flotation bed for
      a total of five days. MEASUREMENTS AND RESULTS: Patients were monitored daily
      during the treatment period for the development of pneumonia. The incidence of
      pneumonia during the first five ICU days was 22 percent in patients randomized to
      the standard ICU bed vs 9 percent for the oscillating bed (p = 0.05). This
      treatment effect was greatest in the SEPSIS DRG (23 percent vs 3 percent, p =
      0.04). Continuous automatic oscillation did not significantly change the number
      of days of required mechanical ventilation, ICU stay, hospital stay, or hospital
      mortality overall or within any of the DRGs. CONCLUSIONS: We conclude that air
      supported automated turning during the first five ICU days reduces the incidence
      of early ICU pneumonia in selected DRGs; however, this form of automated turning
      does not reduce other measured clinical outcome parameters.

PMID- 8486042
TI  - Critical illness in pregnancy. An analysis of 20 patients admitted to a medical
      intensive care unit.
AB  - There is a paucity of literature with regard to the need for intensive care
      treatment of critically ill obstetric patients. In this review, the findings from
      20 obstetric patients admitted to a medical ICU (MICU) over a 40-month period
      were analyzed. Demographics, preexistent medical problems, diagnoses, days in the
      hospital and the MICU, need for mechanical ventilation, maternal and fetal
      mortality, and invasive procedures were reviewed. (For comparison, a limited
      analysis of nonobstetric admissions to the MICU over the same time period were
      included.) Fifty percent (10) of the patients had preexisting medical problems.
      Maternal mortality was 20 percent (4 patients), with a fetal mortality of 35
      percent (7). In all of the maternal deaths, adult respiratory distress syndrome
      was present. Although mortality and the need for mechanical ventilation did not
      differ between the obstetric and nonobstetric patients, pulmonary artery and
      arterial catheters were placed at a higher rate in the obstetric patients.
      Critically ill obstetric patients, although younger than general MICU patients,
      appear to have as great a risk of dying of their critical illness and have a high
      infant mortality.

PMID- 8486043
TI  - Strategy for diagnosis of patients with suspected acute pulmonary embolism.
AB  - STUDY PROTOCOL: Two separate groups of clinical investigators have provided new
      information and divergent approaches to the management of acute pulmonary
      embolism (PE). In this position paper, investigators from both groups
      (Prospective Investigation of Pulmonary Embolism Diagnosis [PIOPED] and Canadian
      study groups) have utilized the combined scientific database in order to
      rationalize seemingly polarized diagnostic recommendations into a single
      practical algorithm. METHODS: An in-depth review established the relative risks
      of deep venous thrombosis (DVT) and the related accuracy of diagnostic tests. In
      PIOPED, 640 of 887 patients at risk for PE had either an intermediate probability
      ventilation/perfusion (V/Q) scan or a V/Q scan probability that was discordant
      with the prior estimate of probability by clinical assessment. The risk of PE in
      these patients was 16 to 88 percent (average, 34 percent). In this group, we
      calculated the probability of PE assuming that tests for DVT had been performed
      and that 50 percent of patients with PE have detectable proximal DVT. By
      calculation, 108 in 640 patients of whom the diagnosis of PE was uncertain, would
      have shown proximal DVT. In 239 of these 640 patients, tests for DVT would have
      been negative and the risks of PE in these patients is calculated to be less than
      10 percent. RESULTS: Therefore, we calculate that in 347 of 640 patients,
      confident recommendations for treatment or no treatment could have been given
      without pulmonary angiography. Accordingly, in the PIOPED study group of 887
      patients, the need for pulmonary angiography would have been reduced from 640 (72
      percent) to 293 patients (33 percent). CONCLUSION: In conclusion, a diagnostic
      strategy that includes the clinical evaluation, V/Q scan, and evaluation for DVT
      would decrease the number of patients who require pulmonary angiography from 72
      to 33 percent.

PMID- 8486044
TI  - Obstacles to discharge of ventilator-assisted children from the hospital to home.
AB  - Home care for ventilatory-assisted children improves psychosocial development and
      reduces medical costs compared with hospital care; yet, many ventilator-assisted
      children remain hospitalized for lengthy periods of time after they have achieved
      medical stability. To identify factors that contributed to a delay in hospital
      discharge from the time medical stability was achieved, we reviewed the records
      of 54 ventilator-assisted children (age 4.6 +/- 5.9 [SD] years at discharge) who
      were discharged from the hospital on a regimen of home mechanical ventilation.
      The length of the hospitalization from which the ventilator-assisted children
      were initially discharged on the ventilator was 172 +/- 161 days (range, 2 to
      756). The time from medical stability to discharge was 118 +/- 144 days (range, 2
      to 724), or 73 percent +/- 29 percent of the total hospitalization. Fifty-one
      ventilator-assisted children were discharged to their natural parents' homes, and
      three were discharged to foster care. Once ventilator-assisted children were
      medically stable, it took 99 +/- 141 days for third-party payers to approve home
      care funding, and only 48 +/- 87 days to be discharged once funding was approved.
      For the 27 ventilator-assisted children with public funding, it took 184 +/- 177
      days for home care funding approval, compared with 52 +/- 43 days for the 27
      ventilator-assisted children with private funding (p < 0.001). Parent training
      took only 52 +/- 65 days. It took 369 +/- 334 days (range, 44 to 711 days) to
      find placement for the three ventilator-assisted children who were placed in
      medical foster care. In summary, ventilator-assisted children often remained
      hospitalized for prolonged periods of time, after they were medically stable, for
      nonmedical reasons. The greatest obstacle to hospital discharge was seeking
      approval for home care funding and for arranging out-of-home placement. Public
      funding agencies took significantly longer to approve home care funding than
      private insurance agencies.

PMID- 8486045
TI  - Management of lung transplant rejection.
AB  - Using current immunosuppressive protocols, rejection is common after lung
      transplantation. Most recipients have at least one episode of acute rejection,
      and approximately 25 percent of recent long-term survivors have developed chronic
      rejection. Acute rejection has usually been reversible with treatment, but
      chronic rejection has responded poorly, relapsed frequently, and been one of the
      leading causes of late morbidity and mortality. Appropriate management of
      rejection is predicated on timely, accurate diagnosis. Clinical criteria for the
      diagnosis of acute rejection are useful but nonspecific, and TBB has emerged as
      the procedure of choice for diagnosing acute rejection and infection. Chronic
      rejection is manifested by OB and is characterized physiologically by the
      development of airflow obstruction. Although histologic confirmation is
      preferable, the sensitivity of TBB for the detection of OB has been inconsistent,
      and the specificity has been low. Lung transplantation has indeed come of age,
      but understanding the immunopathogenesis and improving the clinical management of
      rejection remain major challenges for the next decade.

PMID- 8486046
TI  - Anterior mediastinal mass.

PMID- 8486047
TI  - Weight loss, hemoptysis, diffuse alveolar infiltrates and hemorrhagic cerebral
      lesions in a 57-year-old man.

PMID- 8486048
TI  - Pathophysiology of ovine smoke inhalation injury treated with extracorporeal
      membrane oxygenation.
AB  - An ovine model was used to study the pathophysiology of smoke inhalation injury
      treated with extracorporeal membrane oxygenation (ECMO). Smoke inhalation is
      characterized by leukocyte-oxygen free-radical mediated acute lung injury.
      Treatment with ECMO was by extracorporeal venoarterial or venovenous perfusion
      using a venous drainage reservoir, roller pump, heat exchanger, and membrane lung
      oxygenator capable of oxygen delivery to and carbon dioxide removal from a
      patient. Blood-foreign surface interactions are known to occur during ECMO. We
      examined the effects of ECMO on circulating leukocytes, oxygen free-radical
      activity, thromboxane release, and gas exchange after smoke inhalation injury.
      Animals treated with smoke and ECMO had significantly increased circulating
      thromboxane B2 levels and oxygen free-radical activity compared with sham-treated
      animals and animals treated with smoke and mechanical ventilation (MV). Likewise,
      there was a significant increase in lung wet-to-dry weight ratios in animals
      treated with smoke and ECMO compared with those treated with smoke and MV. These
      data may account for the initial deterioration in native lung function after the
      initiation of ECMO and imply that ECMO may potentiate the pathophysiology of
      smoke inhalation injury.

PMID- 8486049
TI  - Ball-valve thrombus obstructing a bioprosthetic mitral valve.
AB  - We present a patient with a large, left atrial ball valve thrombus that was
      intermittently obstructing a bioprosthetic mitral valve. The diagnosis was
      confirmed by transesophageal two-dimensional echocardiogram. The transthoracic
      study initially had failed to demonstrate the true ball valve nature of the
      thrombus and instead, suggested two separate mass lesions, one in the left atrium
      and one in the bioprosthetic mitral valve.

PMID- 8486050
TI  - Spontaneous echo contrast in massive pericardial effusion with tamponade.
AB  - Spontaneous echo contrast is uncommon in pericardial effusion. We report the case
      of a patient with massive malignant pericardial effusion causing cardiac
      tamponade in which the intense spontaneous echo contrast was found in the
      effusion by echocardiography. It was suggested that both the heavy blood content
      and a large amount of pericardial effusion were needed to create the phenomenon
      of spontaneous echo contrast in the pericardial cavity.

PMID- 8486051
TI  - Right-sided pneumothorax as a result of a left-sided chest tube.
AB  - Chest tubes are inserted for a variety of reasons, and a number of complications
      have been associated with their use. We report a case of traumatic
      hemopneumothorax in which the chest tube crossed the mediastinum into the
      contralateral lung causing a pneumothorax. Its position was not apparent on
      portable chest radiographs.

PMID- 8486052
TI  - Traumatic aortic valve injury sustained despite the deployment of an automobile
      air bag.
AB  - Blunt chest trauma is a rare cause of aortic valve dysfunction. A case of the
      successful management of traumatic injury to the aortic valve is reported. The
      aortic valve injury was sustained in an automobile accident despite the use of a
      seat belt and the deployment of an air bag. The literature is briefly reviewed.
      Aortic valve injury remains a consideration in cases of automobile-associated
      chest trauma, even in automobiles equipped with seat belts and air bags.

PMID- 8486053
TI  - Tension pyopneumothorax. Rare presentation of ruptured Barrett's esophagus.
AB  - Tension pneumothorax following esophageal rupture is very rare. We report a case
      in which a perforated Barrett's esophagus rapidly developed a spontaneous tension
      pyopneumothorax. The mechanism for the tension remains obscure. Knowing that a
      tension pneumothorax can occur with esophageal rupture can help prevent
      misdiagnosis.

PMID- 8486054
TI  - Pneumomediastinum caused by subcutaneous emphysema in the shoulder. A rare
      complication of arthroscopy.
AB  - Severe subcutaneous emphysema following arthroscopy of the shoulder developed in
      a 62-year-old man. It subsequently evolved into pneumomediastinum with
      respiratory distress, but the patient recovered spontaneously. To our knowledge,
      this constitutes the first report of pneumomediastinum caused by subcutaneous
      emphysema in the shoulder.

PMID- 8486055
TI  - Myocarditis as a cause of primary right ventricular failure.
AB  - Patients with cardiomyopathy secondary to inflammatory myocarditis usually
      present with biventricular signs and symptoms. On occasion, the disease may
      progress focally, with left ventricular involvement predominating. This patient
      had elevated neck veins, edema, and a dilated right ventricle in the absence of
      left ventricular abnormalities. At autopsy, diffuse, transmural fibrosis of the
      right ventricle was found, consistent with end-stage myocarditis, with minimal
      disease of the left ventricle. This case emphasizes that the clinical
      manifestations of myocarditis can be limited to the right ventricle and should be
      considered in the differential diagnosis of right ventricular failure.

PMID- 8486056
TI  - Relationship of nasal continuous positive airway pressure to periodic limb
      movement disorder in a patient without sleep apnea.
AB  - The treatment of sleep apnea with nasal continuous positive airway pressure
      (CPAP) occasionally has been associated with the appearance of periodic limb
      movement (PLM) disorder, but it has not been clear whether CPAP induces PLM, or
      whether the PLM is simply disguised until apnea is treated. We report the
      emergence of PLM after the inadvertent application of CPAP in a patient without
      sleep apnea.

PMID- 8486057
TI  - Disappearing intracardiac thrombi in both atria after mumps in a patient with
      Turner syndrome.
AB  - A girl with Turner syndrome was admitted with an acute cerebrovascular occlusive
      disease 15 days after mumps infection. Imaging techniques such as Doppler
      echocardiography, computed tomography and angiography of the heart revealed the
      existence of masses in both atria. Eight days after the last radiologic study the
      patient had an operation, but no masses were found in either atrium. It was
      thought that atrial thrombi, probably formed after viral infection, had broken
      down to form emboli and disappeared. It is proposed that the patients with
      congenital cardiopathy should be regularly examined after viral infections for
      possible intracardiac thrombus formation. If such a mass is found and the
      decision is to operate, the existence of the mass must be confirmed even in the
      operating room just before intervention.

PMID- 8486058
TI  - Agenesis of the right upper lobe.
AB  - Bronchoscopy and bronchography revealed a very rare abnormality in the embryonal
      anatomy of the right bronchial tree in a 54-year-old woman with cough. There was
      a proximal migration of the apical branch of the right upper bronchus toward the
      trachea and a distal migration of the two other branches toward the middle lobe
      bronchus. The proximal migration was accompanied by a narrowing of the trachea.
      This case is considered an extremely rare embryonal variation in the development
      of the right bronchial tree.

PMID- 8486059
TI  - Usefulness of inhaled high-dose corticosteroids in allergic bronchopulmonary
      aspergillosis.
AB  - Two patients with allergic bronchopulmonary aspergillosis were seen on a regular
      basis, one since 1978 and the other since 1982. Throughout this period, both
      subjects required daily oral administration of corticosteroids (between 15 and 40
      mg of prednisolone daily) to control their symptoms and the lung infiltrates on
      the chest x-ray film. Attempts to further decrease the dosage of steroids or to
      discontinue their use were met with immediate recurrences of manifestations of
      the disease. With the introduction of high-dose inhaled beclomethasone
      dipropionate, both subjects could be weaned from their oral steroids and
      maintained with inhaled steroids alone for up to 11 months. We conclude that
      inhaled corticosteroids may be useful in the treatment of allergic
      bronchopulmonary aspergillosis.

PMID- 8486060
TI  - Transesophageal echocardiographic diagnosis of anomalous left coronary artery
      from the right aortic sinus.
AB  - Patients with anomalous left main coronary artery arising from the right sinus of
      Valsalva and coursing posteriorly between the aorta and the pulmonary artery are
      prone to sudden death. We present a patient with this entity in whom the
      diagnosis was made by transesophageal two-dimensional echocardiography and
      coronary angiography.

PMID- 8486061
TI  - Unusual complication of retrograde coronary sinus perfusion with pulmonary artery
      catheter.
AB  - A balloon-tipped catheter placed in the coronary sinus is used during cardiac
      surgery for retrograde cardioplegia and is secured by a purse string suture
      placed proximal to the atrioventricular groove in the lower right atrium. We
      report a complication of this procedure where a pulmonary artery catheter was
      sutured to the wall of the right atrium by the purse string suture in a patient
      scheduled for aortocoronary bypass grafting. Pulsatile resistance was noted when
      we attempted to withdraw the catheter indicating an attachment to the heart. The
      pulmonary artery catheter within the vascular space after atrial cannulation
      should be checked since the sheath-protected cannula will enable free mobility.

PMID- 8486062
TI  - Pleural effusion masquerading as myocardial infarction.
AB  - The effects of pleural effusions on the ECG have not been well studied. We report
      herein the case of a patient with extreme QRS axis deviation mimicking acute
      myocardial infarction. Thoracentesis caused the return of a more normal axis.

PMID- 8486063
TI  - Bronchiolitis obliterans organizing pneumonia. An unusual cause of solitary
      pulmonary nodule.
AB  - Bronchiolitis obliterans organizing pneumonia (BOOP) is a pulmonary disorder with
      a wide spectrum of radiologic features. Usually, these are bilateral, patchy,
      alveolar, or ground-glass infiltrates, but other presentations have also been
      described. We present a case in which the radiologic appearance was a cavitated
      pulmonary solitary nodule. We think that this finding may justify the inclusion
      of BOOP in the differential diagnosis of the pulmonary solitary nodule.

PMID- 8486064
TI  - Wegener's granulomatosis presenting as right middle lobe obstruction.
AB  - Wegener's granulomatosis may present with a variety of findings and be difficult
      to diagnose. We report a case of a 55-year-old woman presenting with right middle
      lobe obstruction who was found to have limited Wegener's granulomatosis.
      Extensive medical evaluation was nondiagnostic and open lung biopsy specimens
      were required to establish the diagnosis.

PMID- 8486065
TI  - Measles pneumonia. Treatment of a near-fatal case with corticosteroids and
      vitamin A.
AB  - A 29-year-old woman experienced overwhelming rubeola pneumonia requiring
      endotracheal intubation and mechanical ventilation. Treatment with high-dose
      corticosteroids and vitamin A was accompanied by a prompt clinical response.
      Further investigation of this novel therapy is needed.

PMID- 8486066
TI  - Mycetoma within an intralobar sequestration. Evidence supporting acquired origin
      for this pulmonary anomaly.
AB  - A rare example of an intralobar sequestration (ILS) containing a fungal mycetoma
      is reported. This finding indicates the presence of a communication between the
      ILS and the airways, thus supporting the theory that ILSs are acquired lesions,
      rather than congenital malformations.

PMID- 8486067
TI  - Adult respiratory distress syndrome as a complication of postanginal sepsis.
AB  - Adult respiratory distress syndrome (ARDS) was described in 1971 by Petty and
      Ashbaugh. Since that time it has been reported in association with many disease
      entities. We report a case in which a patient with postanginal sepsis, also known
      as Lemierre's syndrome, had development of ARDS.

PMID- 8486069
TI  - Pulmonary artery sarcoma mimicking pulmonary embolism.
AB  - Two cases of primary pulmonary sarcoma which were initially diagnosed as
      pulmonary thromboembolism are presented. The clinical and radiologic features of
      pulmonary sarcoma are reviewed, with special emphasis on the features which
      distinguish it from thromboembolism.

PMID- 8486068
TI  - Flow velocity paradoxus and pulsus paradoxus in obstructive sleep apnea syndrome.
AB  - Echo-Doppler monitoring was performed simultaneously with two-dimensional and M
      mode echocardiography, polysomnography and blood pressure recording in an
      obstructive sleep apnea patient. Increase in tricuspid flow and decrease of
      mitral flow velocity was demonstrated during each diastole prior to pulsus
      paradoxus, while aortic flow velocity decreased with pulsus paradoxus during
      obstructed breathing during sleep.

PMID- 8486070
TI  - Antithrombotic therapy for venous thromboembolism.

PMID- 8486071
TI  - Risk of aspiration pneumonia in the elderly.

PMID- 8486072
TI  - Community-acquired pneumonia in the Far East.

PMID- 8486073
TI  - Thrombolytic therapy for pulmonary embolism.

PMID- 8486074
TI  - Selective bronchial intubation for the treatment of bronchopleural fistula in a
      preterm newborn.

PMID- 8486076
TI  - Detection of minimal amounts of DNA by electron microscopy using simplified
      spreading procedures.
AB  - Electron microscopic examination of nucleic acids requires the use of special
      spreading techniques. The classical method was developed by Kleinschmidt and Zahn
      in 1959. Modifications of this method increased sensitivity to allow detection of
      a total amount of about 1 x 10(-3) micrograms of single-stranded DNA and 2 x 10(
      5) micrograms of double-stranded DNA. Here we describe two rapid and simple
      procedures increasing sensitivity by 1-2 orders of magnitude to visualize at
      least 1 x 10(-5) micrograms of single- and/or double-stranded DNA.

PMID- 8486075
TI  - Transcriptional regulation in Drosophila during heat shock: a nuclear run-on
      analysis.
AB  - We used a nuclear run-on assay as a novel approach to study the changes in
      transcriptional activity that take place in Drosophila melanogaster during heat
      shock. In response to a rapid temperature upshift, total transcriptional activity
      in cultured KC161 cells decreased proportionally to the severity of the shock.
      After extended stress at 37 degrees C (15 min or more), transcription was
      severely reduced, and at 39 degrees C most transcription was instantaneously
      arrested. However, strikingly different responses were observed for individual
      genes. Transcription of histone H1 genes was severely inhibited even under mild
      heat shock conditions. Transcription of the actin 5C gene decreased progressively
      with increasing temperature, while transcription of the core histone genes or of
      the heat shock cognate genes was repressed only under severe heat shock
      conditions. Transcriptional activation of the D. melanogaster heat shock genes
      was also investigated. In unshocked cells, hsp84 was moderately transcribed,
      while transcriptional activity at the other protein-coding heat shock genes was
      undetectable (less than 0.2 polymerases per gene). Engaged but paused RNA
      polymerase molecules were found at the hsp70 and hsp26 genes, but not at the
      other heat shock genes. The rates of transcription increased with increasing
      temperature with a peak of expression at around 35 degrees C. At 37 degrees C,
      induction was less efficient, and no induction was achieved after a rapid shift
      to 39 degrees C. Increased transcription of the heat shock genes was observed
      within 1-2 min of heat shock, and maximal rates were reached within 2-5 min.
      Despite very similar profiles of response, different heat shock genes were
      transcribed at strikingly different rates, which varied over a 20-fold range. The
      noncoding heat shock locus 93D was transcribed at a very high rate under non-heat
      shock conditions, and showed a transcriptional response to elevated temperatures
      different from that of protein-coding heat shock genes. An estimation of the
      absolute rates of transcription at different temperatures was obtained.

PMID- 8486077
TI  - A combined molecular and cytogenetic approach to genome evolution in Drosophila
      using large-fragment DNA cloning.
AB  - Methods of genome analysis, including the cloning and manipulation of large
      fragments of DNA, have opened new strategies for uniting molecular evolutionary
      genetics with chromosome evolution. We have begun the development of a physical
      map of the genome of Drosophila virilis based on large DNA fragments cloned in
      bacteriophage P1. A library of 10,080 P1 clones with average insert sizes of 65.8
      kb, containing approximately 3.7 copies of the haploid genome of D. virilis, has
      been constructed and characterized. Approximately 75% of the clones have inserts
      exceeding 50 kb, and approximately 25% have inserts exceeding 80 kb. A sample of
      186 randomly selected clones was mapped by in situ hybridization with the
      salivary gland chromosomes. A method for identifying D. virilis clones containing
      homologs of D. melanogaster genes has also been developed using hybridization
      with specific probes obtained from D. melanogaster by means of the polymerase
      chain reaction. This method proved successful for nine of ten genes and resulted
      in the recovery of 14 clones. The hybridization patterns of a sample of P1 clones
      containing repetitive DNA were also determined. A significant fraction of these
      clones hybridizes to multiple euchromatic sites but not to the chromocenter,
      which is a pattern of hybridization that is very rare among clones derived from
      D. melanogaster. The materials and methods described will make it possible to
      carry out a direct study of molecular evolution at the level of chromosome
      structure and organization as well as at the level of individual genes.

PMID- 8486078
TI  - Non-uniform distribution of methylatable CCGG sequences on human chromosomes as
      shown by in situ methylation.
AB  - We carried out in situ methylation of human chromosomes with the HpaII methylase
      using [3H]methyl-S-adenosyl-L-methionine as the methyl group carrier.
      Autoradiographs localising [3H]methyl groups show methylatable CCGG sequences in
      the R-bands as well as in the short arms of the acrocentric chromosomes that
      include ribosomal DNA. The strongest labelling was observed over a subset of R
      bands, including T-bands. Since methylatable CCGG sequences are representative of
      the unmethylated fraction of DNA, we suggest that differences in the degree of
      DNA methylation could be involved in the structure and function of chromosomal
      bands.

PMID- 8486079
TI  - Repetitive DNA sequence families in Crepis capillaris.
AB  - Three families of tandemly repetitive DNA from Crepis capillaris were cloned and
      characterized. Data obtained from in situ hybridization indicate that these
      families are located mainly in the heterochromatic C-bands. The pCcH32 family
      hybridizes at the paracentromeric C-band of the NOR (nucleolus-organized region)
      chromosome and along most of the long arm of the same chromosome. The pCcD29
      family is located in all the remaining C-bands of the karyotype, while the third
      family, pCcE9, is restricted to the more proximal C-bands. Nucleotide sequence
      comparisons between one cloned repeating unit from each DNA family showed some
      significant regions of homology between the families. We discuss the sequence
      relationships between the three DNA families and the significance of our data in
      relation to models of heterochromatin evolution, emphasizing the concepts of
      equilocality and the differentiation of the NOR-bearing chromosome. We also
      examine the possible role that chromosome disposition, in either mitotic or
      meiotic nuclei, plays in the distribution and homogenization of heterochromatic
      DNA sequences.

PMID- 8486080
TI  - Binding of sequences from the 5'- and 3'-nontranscribed spacers of the rat rDNA
      locus to the nucleolar matrix.
AB  - Nucleolar matrix structures were obtained under different extraction conditions
      from highly purified isolated nucleoli. Their ultrastructural appearance, protein
      composition and capacity to bind rDNA preferentially were studied in a model
      binding system. A region spanning approximately 25 kb in the rat ribosomal gene
      locus was screened for DNA sites capable of specifically interacting with the
      proteins of the nucleolar matrix (MARs). Two such sites were identified: one is
      located on an EcoRV-KpnI fragment in the 5'-nontranscribed spacer region, between
      two repetitive elements and close to the transcription initiation site; the other
      MAR is on a PvuII-BamHI fragment located in the 3'-nontranscribed region,
      encompassing an element 85% homologous to a B2-sequence. The two MARs are located
      in regions rich in polypyrimidine/polypurine tracks and contain a few elements
      homologous to the consensus sequence for topoisomerase II. This indicates that
      the "attachment sites" for the ribosomal genes belong to the same class of
      sequences as the MARs attaching the chromosomal DNA to the nuclear matrix.

PMID- 8486081
TI  - Preliminary note: dangerous use of anticholinergic drugs in Brazil.
AB  - To better evaluate the non-medical use of anticholinergic substances in Brazil, a
      review of the local literature was performed. Synthetic compounds such as
      triexyphenidyl (Artane), benactizine (Asmosterona), dicyclomine (Bentyl) as well
      as Datura sp. tea were reported as being used by first and second grade students
      and by street children of several Brazilian cities. In several cases the
      percentage of youngsters indulging in such use was higher than the percentage
      found for cocaine, barbiturates, cough syrups and amphetamine-related drugs.
      Several cases of patients seeking treatment for dependence or for acute psychotic
      symptoms were also described.

PMID- 8486082
TI  - Correlates of heavy drinking and alcohol related problems among men and women in
      drug treatment programs.
AB  - A series of analyses were conducted to explore if there were significant
      differences in heavy drinking and alcohol-related problems in clients admitted to
      different types of drug treatment programs and whether such differences, if
      found, could be attributed to variation in social characteristics, drug use
      behavior, drinking norms, drinking contexts, or in reasons for combining alcohol
      and drug use. Men and women (N = 246) in four types of publicly funded treatment
      programs were interviewed at intake regarding drinking and drug use patterns and
      related problems. The results of the study showed significant differences in
      drinking behavior and alcohol-related problems of clients in different treatment
      modalities. Men in a county jail substance abuse program exhibited the highest
      frequency of heavy drinking and highest rates of alcohol problems; clients of
      methadone programs reported the lowest rates and those in therapeutic communities
      described intermediate rates. A series of regression analyses showed that the
      only significant predictors of the frequency of heavier drinking and drunkenness
      were drinking context and reasons for combining alcohol and drug use. In
      addition, age (youthfulness) was associated with the frequency of getting drunk.
      The most powerful predictors of alcohol-related problems were the frequency of
      getting drunk and drinking to enhance the effects of other drugs. Heavy drinking
      and drinking to prevent getting sick from drugs were also significantly
      associated with drinking problems. The frequency of drug use (by specific type)
      and most social characteristics showed no direct association with drinking
      patterns or problems.

PMID- 8486083
TI  - Social support and anxiety in pregnant drug abusers and nonusers: unexpected
      findings of few differences.
AB  - Drug-abusing (n = 25) and nonusing (n = 55) pregnant women from a publicly
      supported prenatal clinic were tested for level of social support and of
      pregnancy anxiety during the last half of pregnancy. Differences found between
      the groups were fewer than expected. Drug abusers did not differ from nonusers in
      overall level of social support or in Appraisal, Belonging, or Tangible
      subscales. Abusers were found to report lower levels of self esteem; lower self
      esteem was predicted by drug abuse, having more children and lower socioeconomic
      status. Drug abusers did not differ from nonusers in their overall feelings of
      pregnancy anxiety, but they did indicate higher fears for themselves and for the
      baby, and there was a tendency for higher depression and withdrawal.

PMID- 8486084
TI  - Assessing the behavioral effects and abuse potential of propofol bolus injections
      in healthy volunteers.
AB  - Propofol is a recently introduced intravenous anesthetic agent, commonly
      administered to surgical patients because it induces anesthesia smoothly (i.e.,
      provides loss of consciousness rapidly and usually with no complications) and is
      associated with rapid recovery. Propofol has psychoactive effects that could be
      construed as pleasant, although little abuse liability testing has been done on
      this agent in humans. Accordingly, we examined various effects of this agent at
      different subanesthetic doses (0.2-0.6 mg/kg) in order to characterize this
      drug's abuse potential (for recreational use or potential for diversion). Using a
      double-blind, randomized, crossover design, healthy normal volunteers (N = 10)
      were injected intravenously with the drug or with placebo. Before the injection
      and for up to 1 h afterwards, mood (including drug liking), memory and
      psychomotor performance were assessed. Propofol impaired memory and psychomotor
      performance and produced changes in 10 of 20 VAS mood ratings. Although there was
      variability in self-reported drug liking, some subjects clearly liked the effects
      of propofol, especially at the two higher doses. At the debriefing interview held
      after completion of the study, five subjects said if they had to participate in
      one more session in which they were given a choice between being injected with
      the highest dose (0.6 mg/kg) or a placebo, they would choose propofol. These
      preliminary results suggest that this agent may have some potential for
      abuse/diversion and perhaps stricter accountability procedures should be
      established for this drug in settings where general anesthesia or conscious
      sedation procedures are done.

PMID- 8486085
TI  - Induction of antibodies to morphine during chronic morphine treatment in rodents
      and opiate addicts.
AB  - The phenomenon of induction of antibodies to morphine in morphine-treated animals
      and opiate addicts was shown by means of ELISA. The reaction of the immune system
      to injections of a morphine solution had the characteristics of a primary immune
      response. Opiate addicts differed from normal controls in the level of antibodies
      to morphine of IgM class. Elevated levels of such antibodies could be detected in
      about 70-80% of addicts with regular longterm opiate use when the time since the
      last drug intake did not exceed 60 days. Antibodies to morphine could serve as
      indicators of chronic opiate use especially in periods long after the last drug
      intake.

PMID- 8486086
TI  - GBR 12909 fails to antagonize cocaine-induced elevation of dopamine in striatal
      slices.
AB  - The effects of cocaine and 1-(2-bis (4-fluorophenyl)methoxy)-ethyl)-4-(3-phenyl
      propyl) piperazine (GBR 12909), alone and together, on [3H] dopamine efflux from
      superfused rat striatal slices was studied. Both drugs elicited a concentration
      dependent increase in spontaneous [3H]dopamine efflux. GBR 12909 when added
      together with cocaine, had no effect on cocaine-induced [3H] dopamine efflux. It
      was also determined that GBR 12909 was fully efficacious as an inhibitor of
      synaptosomal [3H] dopamine uptake and, whether administered in vitro or in vivo,
      acted in a manner consistent with competitive inhibition. These data are
      discussed in reference to the recent report that i.p. administration of GBR 12909
      antagonized the effect of cocaine on extracellular striatal dopamine levels when
      infused directly through the dialysis probe, perhaps by acting as a 'partial
      agonist' at the inhibitory site on the dopamine transporter (Rothman et al., 1991
      Pharmacol. Biochem. Behav. 40, 387-397).

PMID- 8486087
TI  - Prison experience of injecting drug users in Glasgow.
AB  - Five hundred three injecting drug users in Glasgow recruited by a multisite and
      citywide sampling strategy were questioned regarding their drug-taking behaviour
      during episodes of custody over the six months prior to interview. Fifty-two
      percent had been in custody during the past 6 months, 16% of these had injected
      while in custody. Of these 73% borrowed injecting equipment and 78% handed on
      used equipment to others. All those who shared, cleaned their injecting sets
      before use. Over half of those who injected had a source of new sets. While the
      potential exists for spread of HIV among drug users while in custody there is
      clear understanding among them of the route by which the virus is spread and also
      the will to prevent it.

PMID- 8486088
TI  - [Infusion therapy in newborn calves with diarrhea from the area of Ankara with
      special reference to acidosis (part 1)].
AB  - Characteristic changes (hyperkalemia, metabolic acidosis and azotemia) occurred
      in the blood of 54 calves 1 to 15 days old with diarrhoea. Clinical signs of
      dehydration were observed. Average values were: Potassium 6.37 mmol/l, pH 7.17,
      bicarbonate 18.76 mmol/l, base excess (BE)-10.01 mmol/l, urea % 78.2 mg. The
      amount of 1.3% sodium bicarbonate solution to be given to calves with patent
      metabolic acidosis was determined according to the following formula: HCO3-
      (mmol/l = body weight (kg) x 0.5 x BE. In most of the cases with severe metabolic
      acidosis (pH < 7.0), a good compensating effect was obtained. Infusion treatment
      brought blood pH and base excess values near to normal, and bicarbonate
      concentration to within the physiological range. Balanced solutions were used in
      the regulation of electrolyte-fluid balance. Hematocrit, potassium and urea
      values, which had been pathologically high, returned to normal following infusion
      treatment. Apart from this, patients were given symptomatic treatment according
      to the important clinical findings. Forty-two animals recovered completely after
      intravenous infusion of buffer and electrolyte solutions. Twelve out the total of
      54 animals died within 1-5 days despite infusion treatment.

PMID- 8486089
TI  - Studies on the teratogenic effects of deltamethrin in rats.
AB  - Deltamethrin is a pyrethroid insecticide used to eradicate external parasites on
      farm animals. Residues of this pesticide were shown to be present in food from
      animal origin which encouraged us to investigate the effects of deltamethrin on
      foetuses of pregnant rats. Literature search shows that previous research was
      focused on organochlorine and organophosphate pesticides whereas little attention
      was given to the newer pyrethroid insecticides. Four groups of pregnant rats (20
      rats each) were given either the vehicle (control) or doses of 1, 2.5 or 5 mg/kg
      b. w. of deltamethrin orally from day 6 to day 15 of pregnancy which was
      terminated by killing the animals on the 19th day for foetal examinations. The
      incidence of early embryonic deaths was higher in deltamethrin-treated rats than
      in control females. Deltamethrin caused retardation of growth, hypoplasia of the
      lungs, dilatation of the renal pelvis and increase in placental weight. No
      skeletal changes were observed in foetuses recovered from deltamethrin-treated
      females. Although deltamethrin is relatively safe, however its effects on the
      foetus should be considered when used on pregnant animals or in environments
      where pregnant animals and women live.

PMID- 8486090
TI  - [The reproductive performance of sows with different malignant hyperthermia
      syndrome status].
AB  - Based on 200 litters descending from 50 sows relations between MHS-genotype and
      reproductivity were investigated. Breeds used were "Deutsches Edelschwein",
      German Landrace and a crossbred line. Evaluation of MHS-status was done by
      Polymerase Chain Reaction. Reproductivity traits were piglet numbers at different
      ages and litter growth. The sows were not preselected in regard to the halothane
      gene. MHS-negative sows showed increased reproductivity towards MHS-positives and
      within the negatives, the homozygote sows were superior to the heterozygotes.

PMID- 8486091
TI  - Prophylactic application of Propionibacterium avidum KP-40 in swine with acute
      experimental infections. I. Viral infections--Aujeszky's disease and classical
      swine fever.
AB  - The usefulness of the prophylactic application of Propionibacterium avidum KP-40
      (PA), a potent stimulator of the macrophage-monocyte system and inducer of
      endogenous interferons, was demonstrated in swine infected experimentally with
      Aujeszky's disease or classical swine fever viruses. Some of the infected animals
      were preimmunized with respective vaccines containing live, attenuated viruses.
      In vaccinated and non-vaccinated swine infected with Aujeszky's disease virus,
      pretreatment with PA lowered the morbidity rate, shortened the period of fever
      and fastened the recovery. Infection with classical swine fever virus resulted in
      100% mortality of PA-pretreated non-vaccinated swine, but the length survival of
      the animals was significantly longer (p < 0.05).

PMID- 8486092
TI  - [Pharmacokinetics of sulfamerazine after a single intravenous dose in healthy
      calves and calves with diarrhea of different severity with consideration of the
      influence of an existing kidney function restriction].
AB  - Blood levels of Sulfamerazine were examined in 16 calves with different severity
      of diarrhoea in consideration of kidney function and compared with the values of
      5 clinically intact animals. Urea and creatinine levels in plasma as well as urea
      and creatine clearance were tested to check kidney function. A single dose of 60
      mg Sulfamerazine/kg body weight was administered to all animals via catheter into
      the vena jugularis. Blood samples were collected for 48 hours. The mean
      concentration of Sulfamerazine in calves with severe diarrhoea was significantly
      higher 24 hours post application than in the healthy control group and in animals
      with low and middle intensive diarrhoea (healthy animals: 37.61 +/- 7.18
      micrograms/ml; animals with severe diarrhoea: 57.3 +/- 7.5 micrograms/ml).
      Animals with severe diarrhoea showed significantly higher values of half life
      time of elimination t1/2 (healthy animals: 7.08 +/- 1.25 h; animals with severe
      diarrhoea: 11.39 +/- 2.11 h) and of area under the curve AUC (healthy animals:
      2023.4 +/- 397.21 micrograms*h/ml; animals with severe diarrhoea: 2990.6 +/-
      594.9 micrograms*h/ml) than the others. Low and middle intensive diarrhoea has no
      important influence on the pharmacokinetics of Sulfamerazine.

PMID- 8486093
TI  - [Hunting and animal protection].
AB  - In the Federal Republic of Germany the handling of animals during hunting is
      governed more by the animal protection law than by the corresponding hunting law.
      Points of the animal protection law which directly affect hunting are (1) the
      release of wild animals, (2) the training and examination of animals concerning
      attacking other animals, (3) the setting of animals on other animals, and (4) the
      killing of vertebrates. Guiding principles for killing wild animals during
      hunting according to the animal protection law are formulated and discussed in
      relation to the traditional German understanding of hunting ethics. It can be
      expected that hunting will increasingly become a topic of public discussion on
      animal protection, in which the ethics of hunting in relation to the wild animal
      will be dominant.

PMID- 8486094
TI  - [Ultrasound studies for the demarcation of the spatial extension of teat stenosis
      and other teat changes in cattle].
AB  - Under field conditions in 63 dairy cows a stenosis of the teat was diagnosed in
      60 cases and other teat anomalies were found in 5 animals. The results of a
      traditional clinical examination were compared with results obtained by
      diagnostic with a portable, 5 MHz linear scanner. The pictures found in unaltered
      teats were compared with pathological findings. As far as the localisation and
      extension of teat stenoses or lacerations of the mucosa in the teat is concerned,
      the accuracy of the diagnosis was improved by ultrasonography. Diagnostic
      ultrasound can be recommended as an additional diagnostic tool in certain cases
      of a stenosis or other anomalies of the teat in dairy cows.

PMID- 8486095
TI  - Effect of indomethacin, aspirin, nordihydroguairetic acid, and piperonyl butoxide
      on cyclophosphamide-induced bladder damage.
AB  - Cyclophosphamide (CP), a widely used antineoplastic and immunosuppressant drug,
      is a prototypical bladder toxin in humans and experimental animals. CP itself is
      biologically inert. However, following bioactivation, acrolein, a potent tissue
      alkylator is generated. It is currently accepted that CP activation occurs via
      oxidative metabolism by the mixed-function oxidase system (MFO). Previous
      evidence from this laboratory demonstrated that CP can be metabolized by pathways
      other than MFO. In the current study, it was demonstrated that two inhibitors of
      the prostaglandin hydroperoxide synthase enzyme system, indomethacin and
      nordihydroguairetic acid (NDGA), diminish CP-induced bladder toxicity. However,
      the ability of these inhibitors to provide protection did not appear to be due to
      interference with CP metabolism. Many of the biologic effects of acrolein have
      been attributed to interaction with cellular thiols. Indomethacin and NDGA
      protected against CP-induced losses of soluble thiols in liver and protein thiols
      in bladder. Additionally, animals pretreated with indomethacin prior to CP
      appeared to have more glutathione available for conjugation, providing a
      potential mechanism for its protective effects against CP-induced bladder damage.

PMID- 8486096
TI  - Characterization of protein phosphorylation by 2,3,7,8-tetrachlorodibenzo-p
      dioxin in murine lymphocytes: indirect evidence for a role in the suppression of
      humoral immunity.
AB  - Studies were undertaken to more thoroughly characterize 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD)-induced stimulation of kinase activity in
      murine lymphocytes. In female B6C3F1 mice, TCDD-induced phosphorylation of 29,
      45, 52 and 63 KDa proteins was selective for B cells, with little or no
      enhancement observed in T cells. When B cells were purified and separated by
      density on a percoll gradient, phosphorylation was only observed in the band
      composed of activated B cells, and was not enhanced in the band composed of
      resting B cells. TCDD-stimulated phosphorylation was associated with both the
      cytosol (45 and 52 KDa species) and membrane (52 KDa species) fractions. Purified
      B cells from both DBA/2 (Ahdd) and C57B16 (Ahbb) mice demonstrated equivalent
      enhancement of phosphorylation in response to TCDD. Administration of human gamma
      interferon (Hu-IFNg) at concentrations from 0.5 to 500 Units/ml produced a dose
      related reversal of TCDD-induced suppression of in vitro antibody responses to
      both the polyclonal B cell activator, LPS, and the T-dependent antigen, sRBC in
      whole splenocytes isolated from female B6C3F1 mice. These concentrations of Hu
      IFNg did not affect the magnitude of either response in the absence of TCDD, and
      did not reverse dexamethasone-induced suppression of either in vitro antibody
      response. TCDD-induced suppression of the T-dependent response was reversed only
      when Hu-IFNg was added to culture within the first 18 hours after treatment with
      TCDD and sRBC. These studies demonstrate that Hu-IFNg can reverse TCDD-induced in
      vitro Ab response suppression if it is administered during the period of
      susceptibility to TCDD. TCDD-induced phosphorylation in isolated B cells was also
      antagonized following co-incubation with Hu-IFNg. The profile of TCDD-induced
      increases in protein phosphorylation, including the selective effect on activated
      B cells, the general involvement of both cytosolic and membrane proteins, the
      lack of segregation with the Ah-dependent processes, and the ability of Hu-IFNg
      to reverse both the suppression of the Ab response and the increase in
      phosphorylation, supports the interpretation that such phosphorylation is
      involved in TCDD-induced suppression of the Ab response.

PMID- 8486097
TI  - Effect of cyclosporin A and its metabolites and analogs on lipid peroxidation in
      rabbit renal microsomes.
AB  - Rabbit renal microsomes were used to investigate the effect on lipid peroxidation
      (LPO) of cyclosporin A (CsA) and its first generation metabolites M1, M17 and
      M21, and of two natural CsA analogs: cyclosporins C and D (CsC & CsD
      respectively), at concentrations of 1 to 10 micrograms/ml. No induction of lipid
      peroxidation was observed with these substances except CsA at a high level (10
      microgram/ml); but at a concentration of CsA that would be reached in vivo, no
      inductive effect on LPO was noted. A moderate inhibitory effect upon LPO was
      observed with CsC and M21, but its biological significance is questionable.

PMID- 8486098
TI  - Inhalation studies in rats exposed to dimethylacetamide (DMAc) from 3 to 12 hours
      per day.
AB  - Male rats were exposed by inhalation from 10 to 300 ppm Dimethylacetamide (DMAc)
      for either 3, 6, or 12 hrs/day for a total of 10 exposures (5 exposures, 2 rest
      days, 5 exposures). Rats were observed daily for signs of DMAc-related effects,
      growth was monitored by body weights, clinical laboratory tests and microscopic
      examination of the liver, testes epididymides, and nasal passages were conducted.
      One half of the rats in each group was allowed a 14-day post-exposure period to
      evaluate the reversibility of DMAc-induced changes. No clinical signs of toxicity
      or DMAc-related gross changes at necropsy were seen in any of the rats although 1
      rat exposed to 300 ppm for 12 hours per day died following the seventh exposure.
      Slight (< 5%) decreases in body weight gain were seen in rats exposed to 300 ppm
      for 6 or 12 hrs/day. Serum cholesterol levels were elevated in rats exposed to
      either 100 or 300 ppm (all exposure durations) and in rats exposed to 30 ppm for
      12 hours. Total serum protein concentrations were increased in rats exposed for
      12 hours/day to either 30, 100, or 300 ppm. Hepatocellular hypertrophy together
      with margination of hepatocellular cytoplasmic contents and lipid-like
      cytoplasmic vacuolation in hepatocytes were seen microscopically only in rats
      exposed for 12 hours/day to 300 ppm. Recovery from these liver changes was not
      complete after 14-day post-exposure period. No evidence of either testicular
      damage or irritation to the upper respiratory tract was seen.

PMID- 8486099
TI  - Buflomedil: one-year oral safety evaluation in rats.
AB  - Buflomedil was given as a dietary mix to Sprague-Dawley Rats for one year at
      dosages of 0, 25, 75, and 400 mg/kg/day. Each group contained thirty rats of each
      sex, of which 10/sex/group were preassigned to a withdrawal period of 3 months
      following the 1-year drug administration period. There were no treatment-related
      deaths or clinical signs. Dosage-related decreases in body weight gain occurred
      during the 1-year treatment period. Food consumption was comparable to controls,
      except for a 10% decrease in high-dosage males during the first week of
      treatment. During the withdrawal period, body weight gain was higher than
      controls in all drug-treated groups. Hematocrit (PCV) and hemoglobin were
      slightly decreased during week 52 in high-dosage males; hematology values were
      comparable to controls during weeks 13 and 26 and at the end of the withdrawal
      period. There were no treatment-related changes in blood biochemistry. Urine pH
      was decreased in females at 75 mg/kg/day and in both sexes at 400 mg/kg/day.
      Discolored urine was observed in males at 75 mg/kg/day and in both sexes at 400
      mg/kg/day. Urine pH and color were comparable to controls after the 3-month
      withdrawal period. There were slight decreases compared to controls in urine
      volume at all dosages in females during week 52; these changes were still evident
      in the mid- and high-dosage groups at the end of the withdrawal period. The only
      possibly treatment-related observation at necropsy was dirty tails at the end of
      the treatment period in the high-dosage group which may have been related to the
      discolored urine. Liver and kidney weights were slightly increased in males at
      400 mg/kg/day at the end of the 1-year treatment period; these changes were not
      evident after the 3-month withdrawal period. There were no treatment-related
      histopathological changes. The changes observed were thought to result from
      either pharmacologic activity or physiological adaptation to compound
      administration or were marginal in severity. None were considered toxicologically
      significant. Therefore, the no-toxic-effect dosage was 400 mg/kg/day which is 40
      times the maximum clinical dosage.

PMID- 8486100
TI  - Captan metabolism in humans yields two biomarkers, tetrahydrophthalimide (THPI)
      and thiazolidine-2-thione-4-carboxylic acid (TTCA) in urine.
AB  - Captan fungicide (N-(trichloromethylthio)-4-cyclohexene-1,2-dicarboximide)
      metabolism in two human volunteers rapidly yields THPI (tetrahydrophthalimide)
      and TTCA (thiazolidine-2-thione-4-carboxylic acid). The work was done to evaluate
      usefulness of TTCA and THPI as biomarkers of occupational exposure and to compare
      human and rat dermal absorption and metabolism. THPI in 12h urine ranged from MDL
      (5 ppb) to 640 ppb and was stable for at least one year. TTCA was also a stable
      metabolite, but the MDL was 50 ppb. THPI was detectable in urine for 72 hours
      following oral dosages of 1 mg/kg, but most was eliminated 0-24 h. No THPI was
      detectable in urine following application of a chloroform solution to hands,
      forearms, or inguinal region. Dermal absorption and metabolism of captan are
      substantially different in humans and rats.

PMID- 8486101
TI  - Consequences of vocal cord hemorrhage.

PMID- 8486102
TI  - Secretory otitis media (glue ear).

PMID- 8486103
TI  - Endoscopic anatomy of the nasal cavity.

PMID- 8486104
TI  - Pediatric sinusitis and surgery revisited.

PMID- 8486105
TI  - Warthin's tumor-associated neoplasms: report of two cases and review of the
      literature.
AB  - The association of Warthin's tumor with another neoplasm of a different
      histological type in the same salivary gland is extremely rare. The literature
      includes 42 such cases to date. A case of malignant lymphoma developing within
      Warthin's tumor and another case of oncocytoma synchronous with Warthin's tumor
      in the same parotid gland are reported. The relation of Warthin's tumor to other
      neoplasms is discussed.

PMID- 8486106
TI  - Ewing's sarcoma of the nose.
AB  - Ewing's sarcoma is a bone tumor that rarely arises in the head and neck region.
      Head and neck tumors account for only 2% to 3% of all Ewing's sarcomas. There is
      an extremely rare subgroup of Ewing's tumors, that are histologically
      indistinguishable, which are not metastatic and arise in soft tissue rather than
      bone. Two Ewing's sarcomas of the nose are described. One case is the first
      reported nasal Ewing's soft tissue sarcoma. The other case is the more
      traditional type involving bone of the nose and extending into ethmoid sinuses
      and intracranially.

PMID- 8486107
TI  - Myxomas of the mandible and maxilla.
AB  - Myxomas of the mandible and maxillary sinus are rare but well described
      neoplasms. They appear to be odontogenic in origin related to malformations or
      missing teeth. Their local aggressiveness and ability to erode bone should not be
      underestimated. Based on our experience we feel that conservative surgical
      management including total excision and sparing of uninvolved structures allows
      for preservation of function. Long-term follow-up is necessary and in case of
      recurrence, a more radical procedure may have to be performed for this benign
      disease.

PMID- 8486108
TI  - Malignant melanoma of the nasal cavity and paranasal sinuses.

PMID- 8486109
TI  - Sinus histiocytosis--a rare tumor involving the paranasal sinuses.

PMID- 8486110
TI  - Adult rhabdomyoma of the larynx.
AB  - Rhabdomyomas of the larynx are rare lesions, with the "adult" type occurring more
      frequently than the "fetal" type. Treatment is complete surgical removal.
      Recurrences would suggest an incomplete surgical procedure and/or an incorrect
      pathological diagnosis.

PMID- 8486111
TI  - Intramuscular hemangiomas of the masseter and sternomastoid muscles.
AB  - Two cases of hemangiomas involving the masseter and sternomastoid muscle are
      added to the English literature. Our limited experience with these cases confirms
      that preoperative diagnosis and planning can be difficult. Recurrences of tumors
      are related to incomplete excisions although their further treatments in the
      final analysis depend on the adjacent structures affected. Careful
      individualization of treatment is therefore a necessity. Embolization is not
      sufficient therapy if not followed by surgery.

PMID- 8486112
TI  - Pediatric sinusitis is not a surgical disease.

PMID- 8486113
TI  - Spontaneous recovery after severe metabolic acidaemia at birth.
AB  - Twenty-two severely acidaemic babies (mean umbilical artery pH 7.00), born at
      term but not requiring resuscitation, were matched for gestational age, mode of
      delivery and birthweight with non-acidaemic infants. Skin-puncture pH, PCO2 and
      base deficit were measured at 1 h of age in the acidaemic group. Mean respiratory
      and heart rates at 30 and 60 min in the two groups were not significantly
      different. The improvement in pH and base deficit in the acidaemic group
      correlated with PCO2 at 1 h of age but not with respiratory rates, heart rates or
      birthweight. However, all four small-for-gestational age infants and one other
      showed a significantly smaller rise in pH (mean 0.09) compared with the others
      (mean 0.33). This was associated with a smaller fall in PCO2 and no change in
      base deficit and these babies were not identified by clinical observations at 1 h
      of age. Thus, clinical observations of respiratory and heart rates over the first
      hour of life did not distinguish babies born with severe metabolic acidaemia and
      did not identify babies who were less efficient at compensating for the
      acidaemia.

PMID- 8486114
TI  - Relative contribution of physical activity to neonatal oxygen consumption.
AB  - To explore the relevance of distinguishing between resting and global energy
      expenditure in newborn infants, oxygen consumption (VO2) was measured during
      extremes of physical activity in 17 parenterally fed newborn infants with a large
      range of body weights (1.0-3.4 kg) and gestational ages (28-41 weeks). Under
      constant nutrient intakes, each infant served as his/her own control when
      comparing VO2 during resting conditions and spontaneous intense physical
      activity, called exercise. VO2 was significantly correlated with body weight at
      rest (r = 0.96). But during intense activity, the better predictor of exercise
      induced VO2 was body weight in the smaller infants (< 2.0 kg) and gestational age
      in the larger infants (> 35 weeks). The difference in VO2 between both levels of
      activity represented the oxygen cost of exercise, which decreased (P < 0.01) with
      body weight. For clinical purposes, the physical activity of low-birth-weight
      infants does not contribute substantially to their energy balance.

PMID- 8486115
TI  - The effect of moderate maternal alcohol consumption on birth weight and
      gestational age in a low risk population.
AB  - We analyzed the relationship between moderate maternal alcohol consumption during
      pregnancy and both birth weight corrected for gestational age and preterm
      delivery in 3447 women. Information on alcohol consumption in the first and
      second trimester was obtained during mid pregnancy and information about third
      trimester drinking was obtained a few days after delivery. After adjustment for
      possible confounders we found that for most women alcohol consumption was
      unrelated to birth weight corrected for gestational age and preterm delivery.
      However, in the subgroup of women smoking 20 cigarettes or more a day, drinking
      more than 120 g alcohol a week in early pregnancy was associated with a 7.2% (95%
      CI 0.2% to 14.2%) decrease in birth weight. We conclude that the effect of
      alcohol use on birth weight corrected for gestational age and gestational age is
      limited. However, in women who smoke heavily, a reported consumption of about two
      drinks or more a day in early pregnancy may be an additional risk factor for
      impaired fetal growth.

PMID- 8486116
TI  - Cellular composition of the telencephalic wall in human embryos.
AB  - Cellular composition and lamination of the telencephalic wall (TW) was studied
      with Golgi impregnation in human embryos before and during the cortical plate
      formation (5, 6-7 and 7-8 gestational weeks (g.w.)). During this period, the
      telencephalic wall increased in width and lamination pattern became complex while
      cellular morphology reflected progressive differentiation. At 5 g.w. (Carnegie
      stage 16) TW was 140 microns wide and had two zones, marginal (MZ) and
      ventricular (VZ). It was built exclusively of bipolar ventricular cells and their
      upward directed processes. One week later, at 6 g.w. (stages 17 and 18) the
      telencephalic wall displayed three zones (VZ, intermediate-IZ, MZ) and increased
      to 220 microns. Sparse detached cells were found in the VZ while more of these
      cells were observed above VZ, in the incipient intermediate zone. These neurons
      were either simple or branched bipolar, and mainly oriented vertically in respect
      to the outer surface. However, horizontally oriented cells were also noticed
      either at the VZ/IZ border or immediately below the pia, where they probably
      represented Cajal-Retzius neurons. At 7-8 g.w. (stages 20-22), the cortical plate
      appeared between the IZ and the MZ at the ventrolateral level of the
      telencephalic wall. Intermediate zone could be further divided into a more
      superficial part or a presubplate layer (IZ1) and a deep part or a future white
      matter (IZ2). Thus, at this stage, TW consisted of five zones (VZ,
      subventricular, IZ with the presubplate, cortical plate-CP and MZ). The width of
      TW increased to 370-400 microns. Cortical plate cells were fusiform, with the
      apical dendrite branching into the MZ, and the axon directed in the opposite
      direction. Below it, differentiated neurons of the presubplate displayed a
      variety of morphological forms. The presence of horizontally oriented cells on
      the border of ventricular and subventricular zone was noteworthy. Impregnated
      bundles of horizontal fibres were encountered in the IZ and MZ of the
      telencephalic wall at 6 g.w. Their number increased in 7- to 8-g.w. embryos,
      especially in the lower (future white matter) and upper (future subplate)
      intermediate zone. Our results on the cellular development of the cortical
      anlage, as revealed by Golgi method, not only support results obtained on
      different experimental animals but also add new relevant evidence about human
      development. Data on transition of simple bipolar ventricular cells to different
      neuronal shapes as constituents of emerging new laminae were not available for
      human cortical anlage.

PMID- 8486117
TI  - The predictive value of Doppler flow velocity waveforms in the development of
      abnormal fetal heart rate traces in intrauterine growth retardation: a
      longitudinal study.
AB  - In a longitudinal, blinded study design the predictive value of Doppler
      velocimetry for the development of an abnormal fetal heart rate trace was
      assessed in 42 cases of intrauterine growth retardation. Doppler velocity
      waveform recordings were obtained at 2- to 3-day intervals and characterized by
      the standard deviation score of the pulsatility index in the umbilical artery and
      internal carotid artery, and the peak systolic and time-averaged velocity in the
      ascending aorta and pulmonary artery. Twenty-seven patients did not display an
      abnormal fetal heart rate trace on the day of entry into the study. During follow
      up of these patients, the pulsatility index in the umbilical artery and internal
      carotid artery were the most predictive parameters for the development of an
      abnormal fetal heart rate trace. The resulting prognostic index was found to have
      an acceptable discriminative power in the prediction of abnormal fetal heart rate
      traces as established in a second group of growth-retarded fetuses.

PMID- 8486118
TI  - The effect of intra-uterine breech position on postnatal motor functions of the
      lower limbs.
AB  - The effect of intra-uterine movement restriction on the development of motor
      functions was studied longitudinally by comparing infants born after
      uncomplicated breech position (n = 13) with control infants (vertex position, n =
      5-10). Before birth, fetal leg posture was studied at regular intervals by means
      of real time ultrasound observations, and classified as complete (n = 1),
      inconsistent (n = 6), or incomplete (n = 6) breech position. Limited extension of
      the hips, preference posture and joint position in percentage of time (each until
      12 weeks), withdrawal reflex and magnet response (until 26 weeks) and posture
      while sitting, standing and walking without support (up to 12-18 months) were
      assessed longitudinally. The results showed statistically significant, positive
      relationships between intra-uterine breech position and neonatal limited
      extension of the hip-joint, between limited extension of the hip-joint and the
      percentage of time that the hips are in flexion during the first 12 weeks,
      between this flexion of the hips (in percentage of time) and an abnormally
      'flexed' walking pattern at 12-18 months, and finally, between a positive magnet
      response at 6 months and an abnormal walking pattern at 12-18 months. These
      findings suggest that intra-uterine movement restriction of the legs can cause
      long term alterations in the development of motor functions (leg posture,
      reflexes and posture while walking), possibly mediated by alterations in
      proprioceptive feedback mechanisms.

PMID- 8486119
TI  - The intercostal-to-phrenic-inhibitory reflex (IPIR) in normal and intra-uterine
      growth-retarded (IUGR) human fetuses from 26 to 40 weeks of gestation.
AB  - The existence of an IPIR in the healthy fetus between 37 and 40 weeks of
      gestation has already been demonstrated: compression of the fetal thoracic wall
      during an epoch of fetal breathing movements (FBM) consistently caused a fetal
      apnea (> or = 4 s). The apnea durations were similar in fetal behavioural states
      1F and 2F, with a wide inter- and intrafetal variability. We therefore
      hypothesized that the duration of the IPIR-apnea would increase during gestation
      and would be increased in IUGR-fetuses as compared to healthy fetuses of the same
      age. Twenty-six healthy fetuses between 28 and 40 weeks (mean 34.3 weeks) and 14
      IUGR-fetuses between 26 and 38 weeks (mean 33.5 weeks) were studied. If FBM were
      present, the caudolateral part of the fetal thoracic wall was shortly compressed
      manually and the duration of the resulting apnea was measured. In a random order
      a sham-compression was also carried out on the fetal head. In normal fetuses
      21/28 real compressions were followed by an apnea in 1F, while this was only the
      case in 3/21 sham-compressions (P < 10(-4)). For 2F these results were 47/57 and
      7/51, respectively (P < 10(-4)). In IUGR-fetuses 43/51 real compressions (1F and
      2F together) and 7/46 sham-procedures provoked an apnea (P < 10(-4)). These
      results prove the existence of the IPIR in normal and IUGR-fetuses. The mean (+/-
      S.D.) duration of apnea in the IUGR-fetuses was 15.8 s (+/- 4.0) (range 4-80 s)
      and 15.2 s (+/- 4.3) (range 4-106 s) in the normal group.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8486120
TI  - Heart-rate variability in low-risk prematurely born infants reaching normal term:
      a comparison with full-term newborns.
AB  - To investigate the influence of prematurity and postnatal age on the maturation
      of the autonomic nervous system function, we analysed heart-rate and heart-rate
      variability in twelve prematurely born infants (< 37 weeks gestational age)
      reaching the conceptional age of 37-41 weeks. These neonates were compared with
      sixteen 37-41 week conceptional age newborns (< 10 days postnatal age). Heart
      rate variability was analysed by spectral analysis of interbeat intervals using
      Short-Time Fourier Transform. We found that during both active and quiet sleep,
      the durations of RR-intervals were shorter and the amplitude of heart-rate
      variability in different frequency bands was lower in prematures reaching term
      than in newborns of the same conceptional age (P < 0.001). Between-state
      comparison showed differences in both groups. In both groups, low-frequency heart
      rate variability was higher in active sleep than in quiet sleep. Between-state
      differences of RR-intervals and high-frequency heart-rate variability were
      present only in newborns (P < 0.01). Discrimination between newborns and
      prematures reaching term, based on RR-intervals and heart-rate variability, was
      correct in both sleep states with errors between 7 to 16%. However, in both
      newborns and prematures reaching term, between-state discrimination showed less
      reliable results, especially for quiet sleep discrimination with 24% (in PRT) and
      20% (in NB) of errors. Our results, especially information given by factor
      analysis, suggest that the differences between newborns and prematures reaching
      term, concerning RR-interval and heart-rate variability, may be related to a
      changed balance between the sympathetic and parasympathetic nervous systems with
      a diminished parasympathetic component of heart rate control in prematures
      reaching term, as compared to newborns.

PMID- 8486121
TI  - The incidence of obstructive apneas in preterm infants with and without
      bronchopulmonary dysplasia.
AB  - We tested the hypotheses that (1) preterm infants with bronchopulmonary dysplasia
      (BPD) have an increased incidence of obstructive apneas as compared to those
      without BPD (control) and (2) the respiratory pattern during obstructive apneas
      may be associated with more pronounced hypoventilation. Ventilation was measured
      with a flow-through system. We examined 2929 total apneas in 12 infants with BPD
      and 4366 apneas in 12 control infants matched for study weight (1.51 +/- 0.11 kg
      in the BPD group and 1.62 +/- 0.12 kg in the control group, P = 0.6) and for
      postconceptional age (33.3 +/- 0.8 weeks in the BPD group compared with 33.4 +/-
      0.7 weeks in the control group, P = 0.6). The incidence of central apneas
      predominated in the BPD group (2551/2929, 87%) and in the control group
      (4188/4366, 96%). Obstructive apneas were more frequent in the BPD group
      (378/2929, 13%) than in the control group (178/4366, 4%, P = 0.004). The
      increased incidence of obstructive apneas in infants with BPD was observed in
      Quiet sleep (9.1 vs. 1.6%, P = 0.03) and in REM sleep (14.2 vs. 3.6%, P = 0.009).
      This increased incidence of obstructive apneas was applicable to short apneas (<
      10 s, 10.9 vs. 2.7%, P = 0.003) and long apneas (> 10 s, 27.5 vs. 16.4%, P =
      0.01). There were no significant changes in ventilatory pattern that could be
      uniquely attributed to one type of apnea. The findings suggest: (1) the great
      variability in the incidence of obstructive apneas reported in the literature
      relates, at least in part, to the clinical status of the infants and (2)
      ventilatory pattern is not a useful predictor of either type of apnea.

PMID- 8486122
TI  - Indicators of long chain polyunsaturated fatty acid status of exclusively
      breastfed infants at delivery and after 20-22 days.
AB  - The fatty acid composition of plasma cholesterol esters (CE), erythrocytes (RBC)
      and mature milk from seven lactating/women and their exclusively breastfed
      newborns, living on Dominica, were studied. Blood samples were taken from
      umbilical cord and mother at birth. A sample of breastmilk was collected on day
      20-22 postpartum, together with a blood sample from the baby. At birth, cord
      blood plasma CE and RBC total long chain polyunsaturated fatty acid (LC-PUFA)
      contents were higher, and linoleic (18:2c, omega 6) and alpha-linolenic (18:3c,
      omega 3) acid contents lower, than in corresponding maternal compartments. Cord
      blood RBC LC-PUFA omega 3 content was lower and LC-PUFA omega 6 content higher
      than in maternal RBC. After birth, feeding with human milk led to a drop in LC
      PUFA content in the plasma CE fraction, whereas RBC LC-PUFA content remained
      virtually constant. Current understanding of the origin and relative affinity of
      fatty acids incorporated in plasma CE and RBC suggests that RBC LC-PUFA content
      is a more reliable parameter for LC-PUFA status than plasma CE LC-PUFA content.
      The RBC LC-PUFA data suggest therefore that at birth the newborn has a lower LC
      PUFA omega 3 status than the mother, and that this does not change during three
      weeks of exclusive breastfeeding.

PMID- 8486123
TI  - Fetal C-reactive protein.
AB  - C-reactive protein (CRP) was measured in fetal blood obtained by cordocentesis
      from 17 patients with preterm prelabour rupture of the membranes (PPROM). CRP was
      detected in the blood of eight of the 17 fetuses. Six fetuses, five of whom may
      have been infected had CRP > or = 0.8 mg dl-1. The remaining 11 fetuses as well
      as 25 healthy term infants who had cord blood taken immediately post delivery had
      CRP < 0.6 mg dl-1. These results suggest that elevation of fetal CRP levels may
      be a useful indicator of fetal infection in pregnancies complicated by PPROM.

PMID- 8486124
TI  - Respiratory status and diuresis following treatment with dexamethasone.
AB  - The effect of dexamethasone therapy on fluid balance, lung function and
      requirement for respiratory support has been assessed. Ten premature infants were
      studied, they had a median gestational age of 28 weeks. None of the infants had
      any improvement in the respiratory status for 48 h prior to commencing
      dexamethasone. Fluid balance, pulmonary function and requirement for respiratory
      support were measured 12 h prior to and for 36 h after receiving dexamethasone.
      There were no significant changes in fluid input over the study period, but urine
      output increased significantly after 12 h of dexamethasone therapy (P < 0.02).
      Compliance of the respiratory system only significantly improved after 36 h of
      dexamethasone therapy (P < 0.03), this was associated with a significant change
      in the inspired oxygen concentration (P < 0.05). We conclude that the improvement
      in respiratory status resulting from dexamethasone therapy is preceded by a
      diuresis.

PMID- 8486125
TI  - Morphometric development of the human auditory system: ventral cochlear nucleus.
AB  - The development of the human cochlear nucleus was studied in serial sections of
      the brain of 12 fetuses at 12-40 weeks of gestation, an infant at 2 months of age
      and an adult of 63 years using an electronic planimeter with a computer.
      Morphometric analysis of the development of the ventral cochlear nucleus showed
      that its development accelerates after 18 weeks of gestation in terms of columnar
      volume, columnar length, neuronal number and neuronal size.

PMID- 8486126
TI  - Typing of the 3' hypervariable region of the apolipoprotein B gene: approaches,
      pitfalls, and applications.
AB  - Apolipoprotein B-100 is the principal protein component of lipoproteins with very
      low, intermediate, and low density. The interaction of apoB-100 with low density
      lipoprotein (LDL) receptors is responsible for the uptake of LDL into cells. An
      AT-rich hypervariable region is located adjacent to the 3' end of the apoB gene.
      It consists of a variable number of tandemly repeated sequences (VNTR). Two
      approaches were used to analyze this polymorphism. In both, the region harboring
      the VNTR was amplified with the polymerase chain reaction (PCR). In the first
      method, fluorescently labeled primers were used in the PCR reactions and products
      were separated in agarose gels by means of an automated fluorescent fragment
      analyzer. In the second method, PCR products were analyzed in denaturing
      polyacrylamide gels and detected with silver staining. Even in the highly
      sophisticated automated system, agarose gel electrophoresis did not always enable
      unequivocal assignment of VNTR alleles. In contrast, denaturing polyacrylamide
      gel electrophoresis made it possible to distinguish the 15 bp differences between
      the VNTR alleles in a precise and simple manner. The VNTR polymorphism was typed
      in 234 individuals. Among these were 136 patients with coronary artery disease
      and 74 healthy controls. Thirteen alleles could be distinguished. The allele
      containing 49 repeats (VNTR-49) was found in 9.2% of the coronary artery disease
      patients and in 4.7% of the controls. Thus, the VNTR-49 allele increases relative
      coronary risk by about twofold. It is concluded that the apoB VNTR polymorphism
      is a potentially useful genetic marker. Since agarose gel electrophoresis may
      lead to ambiguous results, we prefer typing by denaturing polyacrylamide gel
      electrophoresis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486127
TI  - Amplification of a Y-chromosomal DNA sequence by the polymerase chain reaction
      for documentation of residual recipient cells in small samples from bone marrow,
      peripheral blood and cerebrospinal fluid after bone marrow transplantation.
AB  - The long arm of the human Y-chromosome contains about 800 to 5000 copies of the
      tandemly repeated DNA sequence DYZ1. A major part of the repeating unit (pHY10)
      has been cloned and sequenced. Primers were designed to match a part of this
      repeat sequence for the amplification of a 154 bp fragment spanning the EcoRI
      restriction site of the unit. Typical dilution experiments showed that this
      polymerase chain reaction (PCR) method allows the detection of 5 to 10 male cells
      among 100,000 female cells, or in 500 microL of cerebrospinal fluid containing
      only one cell per microL. In addition, the quality of the DNA used for the
      amplification reaction is less critical, thus allowing analysis of long-term
      stored samples such as bone marrow smears or dried blood stains spotted onto
      filter paper, which might contain partially degraded DNA. We applied this
      technique to detect residual host cells in the clinical setting of human sex
      mismatched bone marrow transplantation (BMT). Fourteen patients, receiving
      transplantations because of leukemias could be supervised so far. Throughout the
      whole period of monitoring (days +14 until +911 post BMT; median: 160 days),
      residual host cells were detected in all but three patients. Persistence of host
      cells in the early phase post-BMT was mostly transient and probably due to long
      term surviving host T-lymphocytes. Reappearance of host cells several months
      after BMT is highly suspicious of relapse from the underlying malignancy. Due to
      its high sensitivity, PCR is a valuable tool in monitoring the switch from
      recipient to donor cell population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486128
TI  - Agarose electrophoresis of DNA in discontinuous buffers, using a horizontal slab
      apparatus and a buffer system with improved properties.
AB  - Using a horizontal slab apparatus with a buffer in the reservoirs at the level of
      the gel ("sea-level electrophoresis"), the retrograde discontinuous buffer system
      reported by Wiltfang et al. for sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) of proteins was applied to DNA electrophoresis. This
      application yielded the advantages of an increased displacement rate of the
      moving boundary front and a decrease in the concentration of the counterion base
      in the resolving phase, which yielded reduced relative mobility values at
      equivalent gel concentrations and practicable low buffer concentrations. The
      change of relative mobilities (Rf) with a variation of field strength is
      decreased compared to that of the migration rate in the continuous Tris-boric
      acid-EDTA (TBE) buffer and thus the robustness of the system is improved, as well
      as the efficiency of separation. The system of Wiltfang et al. has in common with
      previously described discontinuous DNA system, that it is able to stack DNA from
      dilute samples and is insensitive to sample components with lower net mobilities
      than DNA, such as acetate. However, the variance of Rf at constant current
      density in the discontinuous buffer system is not improved over that of the
      migration rate at constant field strength in the continuous TBE buffer.

PMID- 8486129
TI  - DNA shape and separation efficiency in polymer media: a computerized method based
      on electrophoretic mobility data.
AB  - The computer program ELPHOFIT for evaluation of the nonlinear plots of log
      (mobility) vs. polymer concentration (Ferguson plots) in terms of molecular and
      polymer properties has been extended to yield a measure of the molecular sieving
      capacity of the polymer medium. The usefulness of the extended program, version
      2.2, was exemplified by the evaluation of DNA shape and separation efficiency in
      solutions and gels of agarose and polyacrylamide, using previous reports in the
      literature as a data base. That application of the extended program yields the
      following results:(i) The size of migrating DNA can be compared with an
      equivalent sphere having the same free mobility for a particular set of
      experimental conditions. The decrease in size of the equivalent sphere with
      polymer concentration previously demonstrated for agarose solutions applies to
      all of these polymer media; it reveals a steep, hyperbolic decline of that radius
      in uncrosslinked polyacrylamide solutions in contrast to the shallow decline in
      the other three media. (ii) The separation efficiency of polyacrylamide gels
      exceeds that of uncrosslinked polyacrylamide solutions; the separation efficiency
      of agarose solutions for DNA smaller than 1 kb in length is higher than that of
      polyacrylamide solutions. Program ELPHOFIT 2.2 is available on request from the
      first author.

PMID- 8486130
TI  - On the kinetics of photopolymerization: a theoretical study.
AB  - In dye-sensitized polymerization, some paradoxical phenomena have been found,
      such as an anomalous decrease of reaction rate with decrementing thicknesses of
      the gelling layers. By mathematical modelling, and experimental verification, it
      has been found that high incorporation efficiencies (> 95% conversion of monomers
      into the growing polymer) can only be obtained at the correct levels of dye in
      the gelling solution and by using the proper light intensity. Paradoxically, if
      levels of sensitizer or incident light intensities are too high, the rate of
      photosensitizer consumption is too high, as compared with the rate of monomer
      incorporation, so that dye depletion occurs prior to chain elongation, and the
      reaction suddenly comes to a stop. In methylene-blue catalysis, the curve
      correlating the monomer incorporation with the catalyst concentration exhibits a
      maximum, indicating poor conversions both below and above a critical catalyst
      level. When correctly used, photopolymerization still offers unique advantages
      over chemical (persulfate) polymerization, such as absence of oxidizing
      conditions and control at the onset of reaction, while guaranteeing high
      conversion efficiencies (> 95%).

PMID- 8486131
TI  - On the use of dimensionless parameters in acid-base theory. II. The molar buffer
      capacities of bivalent weak acids and bases.
AB  - It is shown that stoichiometric rather than thermodynamic dissociation constants
      can and should be used in the buffer capacity theory. The mean valence of
      bivalent weak acids and bases is deduced in a form with dimensionless parameters.
      The expressions for the molar buffer capacities of bivalent weak acids and bases
      are identical with that for a bivalent ampholyte, and the theory for the latter
      given earlier is thus valid in all details for bivalent weak acids and bases.

PMID- 8486132
TI  - Counterflow in isotachophoresis: computer simulation and experimental studies.
AB  - A computer model has been developed to predict the effects of co- and counter
      current flows on electrophoretic transport. Model predictions are compared with
      experimental data obtained with the large-scale recycling isotachophoresis
      apparatus, recently developed in our laboratory. There were no significant
      changes in the steady state properties or the transient development of the
      Kohlrausch-adjusted profiles with and without flow. The application of
      counterflow in free flow isotachophoresis in early stages, before a steady state
      is achieved, can result in selective wash-out of slower sample components. Thus,
      the magnitude of counterflow can be used as a variable in optimizing separations.
      The characteristic features of the model render it also suitable for the
      simulation of electroosmotic flow in capillary electrophoresis in open tubes,
      where plug-type flow prevails.

PMID- 8486133
TI  - Concanavalin A crossed affinoimmunoelectrophoretic analysis of the major pig
      serum proteins during fetal development.
AB  - The interaction between concanavalin A (Con A) and alpha-fetoprotein (AFP),
      transferrin (TF), fetuin, alpha 1-antitrypsin (AT) and alpha 1-acid glycoprotein
      (AGP) has been analyzed by crossed affinoimmunoelectrophoresis (CAIE) in fetal
      extracts or sera, from 26-day-old porcine fetuses to birth, and in adult pigs.
      Most of the TF and AFP (100 and 85-90%, respectively) reacted with Con A during
      the entire developmental period. AGP showed both two reactive and one nonreactive
      Con A isoforms, whose proportions change greatly during development. In younger
      fetuses 100% of the protein was Con A-nonreactive. This variant represented 64%
      in 50-day-old fetuses, 80% in newborn pigs and 20% in adult sera. Fetuin and AT
      showed a maximum of three Con A-reactive microforms and one Con A-nonreactive
      microform, which was always a minor form. These microforms were detected mainly
      in young fetuses. Although the proportion of Con A-reactive variants of fetuin
      and AT changes during fetal development, the predominant microform was always
      that with intermediate affinity against Con A. The same microform was also
      predominant in adult AT, whereas the more reactive microform in respect to Con A
      predominates in adult fetuin.

PMID- 8486134
TI  - Use of fluorogenic substrates to visualize trypsin and chymotrypsin inhibitors
      after electrophoresis.
AB  - Fluorogenic substrates were tested as a means of increasing both the sensitivity
      and the selectivity of trypsin and chymotrypsin inhibitor detection after
      electrophoretic separation. Out of six substrates applied to cellulose acetate
      membranes, N alpha-benzyloxycarbonyl-L-arginine-4-methylcoumarinyl-7-amide (Z-Arg
      MCA) and benzyloxycarbonyl-glycyl-glycyl-L-arginine-4-trifluoromethylcoumariny l
      7-amide (Z-Gly-Gly-Arg-TFMCA) were found to be suitable for trypsin, and L-alanyl
      L-alanyl-L-phenylalanine-4-methylcoumarinyl-7-amide (Ala-Ala-Phe-MCA) was
      suitable for chymotrypsin. A procedure to detect trypsin and chymotrypsin
      inhibitors, and to discriminate between them, was developed. After
      electrophoresis, slab gels were first incubated with the enzyme (bovine trypsin,
      bovine chymotrypsin, or human duodenal juice) at 37 degrees C, and then covered
      with the respective substrate membrane and incubated at room temperature while
      being observed under UV light. Dark blue inhibitor bands on a light-blue
      fluorescent background were obtained with Z-Arg-MCA/trypsin and Ala-Ala-Phe
      MCA/chymotrypsin, whereas Z-Gly-Gly-Arg-TFMCA/trypsin resulted in dark inhibitor
      bands on a fluorescent green background. The "inhibitor overlay membrane
      technique" (IOM technique) was used after polyacrylamide gel isoelectric focusing
      with carrier ampholytes and immobilized pH gradients, pore-gradient
      polyacrylamide gel electrophoresis, and sodium dodecyl sulfate pore-gradient
      polyacrylamide gel electrophoresis.

PMID- 8486135
TI  - Pattern variations of polyclonal and monoclonal immunoglobulins of different
      isotypes analyzed by high-resolution two-dimensional electrophoresis.
AB  - High-resolution two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) was
      used to analyze serum samples and purified immunoglobulins (Ig) obtained from
      "normal" individuals and from patients diagnosed with monoclonal gammopathies
      (MG) (n = 47; 5 IgA, 15 IgM, 15 IgG, 4 biclonal IgG, 1 IgD, 7 Bence Jones
      proteins). Polyclonal and monoclonal heavy (H) chains were located at different
      restricted gel positions according to their isotype. Monoclonal H chains appeared
      as sets of spots characterized by charge (pI) and size (M(r)) microheterogeneity.
      Most of the monoclonal gamma chains were not seen on the gels (12/15).
      Supplementary polypeptides of 45-48 kDa were detected in serum samples containing
      monoclonal IgM, but were not seen in MG of other isotypes. However, these
      polypeptides were not specifically associated with monoclonal IgM because they
      were also found on protein maps of purified polyclonal IgM. Polyclonal light (L)
      chains appeared as cloudy bands containing several zones of higher density,
      whereas monoclonal L chains were usually resolved as single sharp spots. In 6
      samples, monoclonal L chains were not seen, and in 9 samples, they appeared as
      two or more spots, characterized by different pI and/or M(r). In one sample
      obtained from a patient with a biclonal gammopathy, the L chains were resolved as
      4 different spots. Our results confirm that 2-D PAGE is an excellent tool to
      study Ig. Analysis of the L chain region of the gels was particularly
      informative. Several monoclonal L chains exhibited heterogeneous two-dimensional
      spot patterns, suggesting that "subtile" clonal mutations of B-cell lineage
      and/or posttranslational modifications were involved in their production.

PMID- 8486136
TI  - Subtyping of alkylated human orosomucoid: evidence for a duplicated gene,
      ORM1*F2S.
AB  - Isoelectric focusing of human orosomucoid (ORM) was studied following different
      sample treatment. It is shown that: (i) alkylation with iodoacetamide leads to a
      drastic change in the isoelectric point (pI) of both ORM1 F2 and ORM2 A gene
      products and greatly improves the discrimination between ORM1 F1 and ORM1 F2;
      (ii) previous reduction of the molecule with dithiothreitol partially inhibits
      the pI transitions with resultant artifactual ORM1 F1F2S patterns that correspond
      in most cases to F2S phenotypes. With the technique now described, the
      persistence of three ORM1 gene products was found in only one individual and the
      segregation analysis is consistent with the existence of a rare ORM1*F2S
      haplotype.

PMID- 8486137
TI  - Bronchoalveolar lavage fluid proteins in human lung disease: analysis by two
      dimensional electrophoresis.
AB  - Proteins of human bronchoalveolar lavage fluids, obtained by washing the
      epithelial lining fluid of the lungs with phosphate-buffered saline, were
      analyzed by two-dimensional electrophoresis under denaturating and reducing
      conditions. The two-dimensional pattern of bronchoalveolar lavage fluid proteins
      of healthy volunteers (controls) were compared with those of patients with
      idiopathic pulmonary fibrosis, sarcoidosis, and asbestosis. Particular interest
      was paid to the proteins present in minor amounts mainly in the low molecular
      weight region of the gels. Marked changes in single protein spots were observed.
      In idiopathic pulmonary fibrosis the spot intensity of the surfactant-associated
      protein, SP-A, showing isomeric forms both in charge and in molecular weight, was
      markedly decreased. In sarcoidosis, the immunoglobulins (IgG, IgA) and a group of
      protein spots at an isoelectric point of 4.5-5.0 and a molecular mass of 55 kDa
      were increased. An additional spot appeared at an isoelectric point of 4.5 and a
      molecular mass of 12 kDa. In particular in asbestosis, but also in some cases of
      idiopathic pulmonary fibrosis and sarcoidosis, the number and intensity of low
      molecular weight proteins were increased strongly.

PMID- 8486138
TI  - Clonal imbalances of plasma/serum immunoglobulin production in infants.
AB  - To study the clonal events occurring during ontogeny of the humoral immune
      system, we evaluated plasma immunoglobulin (Ig) production in term newborns and
      young children by high-resolution two-dimensional gel electrophoresis. The
      clonality pattern of Ig light (L) chains from healthy newborns (n = 19) was
      similar to that observed on protein maps of their mothers or of normal adults (n
      > 100), that is, rare distinguishable small spots in a cloud-like large band of
      indiscrete Ig L chain spots (polyclonal pattern; maternal Igs). Analysis of
      plasma samples obtained from infants between 1 month and 5 years of age (n = 55)
      revealed discrete but evident alterations of the clonality of Ig production.
      Between the 2nd and 4th months of life, transient attenuation of the "polyclonal
      background" was observed in association with the appearance of an increasing
      number of well-resolved Ig L chain spots (corresponding to plasma Ig
      concentrations between 0.5 and 1 g/L per spot). This "restricted" clonal pattern
      was progressively less apparent on protein maps of infants older than 2 year and
      evolved towards a "normal" adult polyclonal pattern at the age of 5. These
      results suggest that the development of the B-cell clones is heterogeneous,
      either through limited outgrowth of precursor cells or through selective
      antigenic pressures.

PMID- 8486139
TI  - Nephropharmacology.

PMID- 8486140
TI  - Factors influencing drug protein binding in patients with end stage renal
      failure.
AB  - Investigations were undertaken to evaluate which uraemic solutes decrease drug
      protein binding. This was done by performing HPLC-fractionation of uraemic
      biological fluids and studying the effect of addition of a lyophilisate of each
      fraction to normal plasma containing standard quantities of radiolabelled drugs.
      From a first study, based only on fractionation of uraemic ultrafiltrate with an
      HPLC-gradient mainly aimed at elution of hydrophilic compounds, hippuric acid
      appeared to be a major protein binding inhibitor for theophylline and phenytoin.
      The problem with this approach was that it did not include the compounds with the
      most substantial protein binding. Therefore, studies were planned to fractionate
      deproteinized uraemic sera, but first it was necessary to define which
      deproteinisation methods gave the highest yields of protein bound ligand. Heat
      denaturation was found to be one of the most effective deproteinisation methods.
      When a lyophilisate of uraemic serum, deproteinised by this method, was added to
      normal plasma, a higher capacity to displace theophylline from protein binding
      sites was found compared to the effect of an identical volume of an ultrafiltrate
      of the same samples. Fractionation of the deproteinised sample by HPLC revealed a
      larger number of fractions able to inhibit drug protein binding.

PMID- 8486141
TI  - Population kinetics of gentamicin in neonates.
AB  - A population kinetic analysis was carried out on sparse plasma gentamicin (GE)
      concentration data from 469 neonates obtained as part of a routine therapeutic
      drug monitoring (TDM) programme in the hospital neonatology unit. The best
      predictors of the kinetic parameters of the monoexponential model, volume of
      distribution (Vd) and clearance (CL), were the weight (WT) and gestational age
      (GA). Vd of the neonates was only related to WT, whereas the half-life was only
      related to the GA. The clinical implications of the findings are that the initial
      dose per WT administered to premature infants should be larger than that for term
      infants, because of a larger Vd per unit WT, and the intervals between
      maintenance doses should extended due to the prolonged half-life. Apart from
      these general guidelines, specific dose recommendations are also given.

PMID- 8486142
TI  - Nonlinear kinetics and the 1-exp function in nephropharmacology.
AB  - The basic law in nephropharmacology states that pharmacokinetic parameters depend
      linearly on renal function. Few exceptions to linear dependence have been
      reported, e.g. substances with saturable tubular reabsorption or secretion. A
      further example is cyclosporin, which was found to be eliminated according to log
      concave nonlinear kinetics in 3 patients with hepatotoxicity after kidney
      transplantation. The nonlinear cyclosporin kinetics were computer-fitted to the
      integrated forms of the 1-exp function and the Michaelis-Menten equation by
      nonlinear regression analysis. The same maximal velocity (Vmax = 23 ng ml-1 h-1)
      and Michaelis constant (Km = 686 ng ml-1) were calculated for cyclosporin when
      applying either the 1-exp function or the Michaelis-Menten equation. The
      nonlinear elimination of cyclosporin, however, was described even more closely by
      the 1-exp function than by the Michaelis-Menten equation.

PMID- 8486143
TI  - Diuretic action of potassium channel blockers.
AB  - The availability of specific potassium channel blockers has made it possible to
      examine their effects along the nephron on fluid and electrolyte excretion.
      Recent experiments indicate that they modulate transepithelial sodium and
      potassium transport. In the thick ascending limb, potassium channel blockers, by
      interfering with potassium recycling across the apical cell membrane, reduce the
      activity of the sodium-2chloride-potassium cotransporter. In the initial and
      cortical collecting duct their inhibitory action on ATP-sensitive potassium
      channels reduces potassium secretion. Accordingly, tissue-specific potassium
      channel blockers are promising diuretic agents that may induce diuresis by
      inhibiting tubular sodium transport with only minimal loss of potassium.

PMID- 8486144
TI  - Elimination of cefmenoxime during continuous haemofiltration.
AB  - The elimination of cefmenoxime after single and repeated i.v. dosing was studied
      in 12 patients with severe renal failure and sepsis during continuous
      haemofiltration. More than 30% of the drug was found in the filtrate. The sieving
      coefficient (S) was 0.54. Vss% was unchanged 0.31 l.kg-1 in comparison with
      patients with normal renal function, whereas the mean t1/2ss was prolonged to
      about 16 h, and total clearance was reduced 20.8 ml.min-1.1.73 m-2. Once daily
      administration of 1 g cefmenoxime is suggested as the appropriate dose under such
      circumstances.

PMID- 8486145
TI  - Shedding and repair of renal cell membranes following drug-induced nephrotoxicity
      in humans.
AB  - Nephrotoxic drugs may account for approximately at least 20% of clinically
      observed cases of acute renal failure in whom tubular lethal or sublethal damage
      is a predominant finding. Acute toxic tubular cell injury is characterized by
      loss of cellular polarization, intrinsic energy deficiency, calcium overload,
      release of toxic proteases and free oxygen radicals, derangement of the
      cytoskeleton, and vacuolar transformation of brush border microvilli. These
      events may finally lead to irreversible cell death. Shedding of membrane enzymes
      and cytoskeletal components in urine (kidney tissue proteinuria) may serve as a
      noninvasive early marker for assessing tubular cell injury. Successful recovery
      of renal function depends on early repair of lethally or sublethally damaged
      nephrons, in which intrinsic nephrogenic adaptive and proliferative responses
      cooperate in concert with auto/para/-juxtacrine growth promoting factors and
      cytokines. Exogenously administered growth factors may enhance renal cell
      recovery, as shown in animal models. Increased expression of immediate early
      genes in tubular cells after renal injury reflects the ongoing mitogenic activity
      necessary for reepithelialization and remodeling (new, polarized, differentiated
      cells). Further progress in understanding the molecular mechanisms of renal
      tubular injury will probably influence the diagnostic modalities and therapeutic
      approaches to acute drug induced renal failure.

PMID- 8486146
TI  - Evaluation of nephrotoxicity with renal antigens in children: role of Tamm
      Horsfall protein.
AB  - Renal antigens are proteins that originate from the kidney and are detectable in
      urine by immunological techniques. After renal injury cell fragments are shed and
      appear in urine. Thus, the appearance of cellular fragments represents acute
      damage to renal cells caused by various means. With this approach proximal
      tubular cell injury can be detected using the proteins intestinal alkaline
      phosphatase (IAP) a brush border enzyme, or villin, a protein of the
      cytoskeleton. Both proteins have been found in urine from children receiving
      immunosuppressive treatment, including ifosfamide and aminoglycosides. In
      contrast, Tamm-Horsfall protein (THP) is an actively secreted protein that has
      been found by mRNA-analysis to occur only in the kidney. Immuno-reactivity to THP
      is restricted to the ascending loop of Henle and the early distal tubule. In
      human fetal specimens, THP expression was consistently found in the 16th week of
      gestation. In amniotic fluid THP was detectable after the 20th week, rising to a
      median value of 1.3 mg.l-1 at birth. In disturbed pregnancies with the feto-fetal
      transfusion syndrome, THP was not detectable, indicating reduced tubular THP
      secretion and renal function. Postnatally, THP excretion increases steadily,
      reaching a maximum in early adulthood. THP-excretion is low immediately after
      renal transplantation, reflecting acute renal failure in the early phase of
      transplantation, and increases to a normal values two to three weeks later. In
      severe diabetic ketoacidosis THP excretion is extremely low, with partial
      recovery 12 days later. The combination of low THP excretion and high proximal
      tubular enzyme release indicates both proximal (renal cortical) and distal
      tubular (renal medullary) damage in diabetic ketoacidosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8486147
TI  - Partial and complete de Toni-Debre-Fanconi syndrome after ifosfamide chemotherapy
      of childhood malignancy.
AB  - Ten out of 79 patients treated with ifosfamide (IFO) developed a complete (n = 2)
      or partial (n = 8) de Toni-Debre-Fanconi syndrome (RFS). All but one of these
      patients had been treated in addition with cisplatinum (CPL) or had undergone
      radiotherapy to the abdomen or nephrectomy as part of the overall treatment for
      malignancy. A detailed nephrological work-up of proximal tubular function showed
      decreased fractional phosphate and percent aminoacid reabsorption in 37.1 and
      56.7% of cases, respectively, and the excretion of alpha 1-microglobulin and N
      acetyl-beta-D-glucosaminidase was elevated in 44.4 and 23.5%. Glomerular function
      was well preserved in the majority of patients. Tubular dysfunction was confirmed
      by silver-stained SDS PAGE of urine which showed mostly low molecular weight
      proteinuria. CPL has been shown to result in renal magnesium loss and reduced
      glomerular filtration rate, and its toxicity clearly differs from IFO-mediated
      tubulopathy. Our data suggest that subclinical impairment of proximal tubular
      function was significantly increased by additional CPL therapy. We conclude that
      CPL may enhance IFO-mediated nephrotoxicity and that a substantial number of
      patients is at risk of developing persistent tubular dysfunction leading to
      metabolic bone disease.

PMID- 8486148
TI  - Effect of antihypertensive drugs on glomerular hyperfiltration and renal
      haemodynamics. Comparison of captopril with nifedipine, metoprolol and
      celiprolol.
AB  - Glomerular hyperfiltration and hypertension may contribute to the progression of
      chronic renal insufficiency regardless of the underlying disease. Protein
      restriction and antihypertensive treatment are used to slow the decline in renal
      function. However, little is known about the interaction of protein loading and
      antihypertensive treatment on glomerular haemodynamics in humans. This paper
      compares the renal haemodynamic effects of beta-adrenoceptor blockers with those
      of the calcium channel antagonist nifedipine and the ACE inhibitor captopril on
      resting glomerular filtration and during glomerular hyperfiltration. In two
      separate studies the effects of nifedipine, captopril, metoprolol, and celiprolol
      on renal haemodynamics have been investigated. In two groups of healthy
      volunteers (n = 13) inulin and PAH clearances were measured, first under fasting
      conditions and afterwards during aminoacid infusion. In fasting subjects
      nifedipine and metoprolol induced glomerular hyperfiltration, while celiprolol
      and captopril did not significantly affect GFR. Without premedication, and also
      after nifedipine, metoprolol and celiprolol, the aminoacid infusion significantly
      increased the GFR. After premedication with captopril, however, aminoacid-induced
      hyperfiltration was prevented. In fasting subjects captopril, celiprolol and
      metoprolol elevated PAH clearance. With our without premedication aminoacid
      infusion increased renal plasma flow compared to baseline on the control day. We
      conclude that in healthy subjects, acute administration of antihypertensive drugs
      results in different renal haemodynamic responses. In contrast to captopril and
      celiprolol, nifedipine and metoprolol induce glomerular hyperfiltration like
      protein loading. Thus, they may counteract the renal haemodynamic effects of
      protein restriction. Celiprolol behaves similarly to captopril, since it
      increases renal perfusion without inducing glomerular hyperfiltration, a pattern
      which might reflect lower glomerular pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486149
TI  - Low-dose segmental blockade of the nephron rather than high-dose diuretic
      monotherapy.
AB  - The specific renal effect of diuretics is due to the fact that their
      concentrations is almost 100-fold greater in the renal tubule than in the plasma.
      The function of the different segments of the nephron may be altered following
      changes in the effective arterial blood volume (EABV) and the extracellular fluid
      volume (ECFV). In diseases with reduced EABV, e.g., congestive heart failure,
      decompensated cirrhosis of the liver, and the nephrotic syndrome, proximal
      tubular hyperreabsorption of sodium occurs, leaving only a low Na+ load in the
      distal segments of the nephron, the site of diuretic action. Clinically, the
      response to diuretics is reduced or resistance to diuretics may even ensue, which
      can be predicted by a FENa < 0.2%. Resistance to diuretics can be overcome by
      short-term comedication with acetazolamide, which increases Na+ delivery to the
      site of action of the other diuretics used concomitantly. In states with
      increased ECFV, e.g. in chronic renal failure, there is distal tubular Na+
      rejection, leading to a greater increase in FENa the more GFR is reduced. The
      remaining intact nephrons present a relatively increased response to diuretics.
      The efficacy of diuretic treatment in renal failure can be optimised by combining
      loop diuretics with thiazides. In conclusion, low-dose combination therapy,
      inducing "segmental blockade of the nephron", meets the functional changes along
      the nephron. It is therefore more effective and safer than high-dose monotherapy.

PMID- 8486150
TI  - Receptors for mammalian steroid hormones in microbes and plants.
AB  - Steroids are of universal occurrence, present variously as cell wall constituents
      and bioregulators. A number of bacteria, fungi, and photosynthetic vascular
      plants synthesize steroids that are hormonally active in the animal world. The
      cellular effect of such steroids in microbes and plants appears by and large to
      be comparable to that in mammals. Available evidence suggests that steroid action
      in botanical phyla is mediated via receptors organized in a manner similar to
      that seen in animals. Therefore, the ancestry of ligand induced transactivation
      via zinc finger proteins appears to date farther back than the early Cambrian
      burst of metazoan evolution 500 million years ago.

PMID- 8486151
TI  - N-peptidyl-O-carbamoyl amino acid hydroxamates: irreversible inhibitors for the
      study of the S2' specificity of cysteine proteinases.
AB  - A series of new inhibitors for cysteine proteinases with the general structure Z
      Phe-Gly-NHO-CO-Aa (Aa = amino acids) was synthesized and tested as inhibitors of
      papain-like enzymes (cathepsins S, L, B and papain). Like N-peptidyl-O-acyl
      hydroxamates the inhibitors inactivate cysteine proteinases by a sulfenamidation
      of the active site cysteine residue. The most effective inhibitors display second
      order-rate constants of inactivation in the range of 10(3)-10(4) M-1.s-1. Since
      the structure of the N-peptidyl-O-carbamoyl amino acid hydroxamates allows the
      variation of the leaving group this class of inhibitors was used as a new tool
      for evaluation of the S2' specificity of cysteine proteinases.

PMID- 8486152
TI  - Membrane interaction of Escherichia coli penicillin binding protein 5 is
      modulated by the ectomembranous domain.
AB  - E. coli penicillin binding protein (PBP) 5 is anchored to the periplasmic face of
      the inner membrane by a C-terminal domain which is predicted to form an
      amphiphilic alpha-helix. Here we show that the presence of a substrate analogue,
      benzyl penicillin, causes the protein to be converted from a membrane bound urea
      inaccessible form to a urea extractable form. If the anchor region is fused to
      the periplasmic protein, beta-lactamase, the fusion protein becomes membrane
      bound but is unable to exhibit the changes in urea extractability which are
      observed with PBP5. We therefore conclude that although the C-terminus of PBP5 is
      sufficient to anchor the protein to the membrane surface the ectomembranous
      domain can affect the state of the anchor and in vivo changes in the state of
      anchoring may be related to enzyme activity.

PMID- 8486153
TI  - Induction of GTP cyclohydrolase I by bacterial lipopolysaccharide in the rat.
AB  - A 2- to 3-fold increase of GTP cyclohydrolase I (E.C. 3.5.4.16), the key enzyme
      of tetrahydrobiopterin biosynthesis from GTP, was observed in cerebellum,
      remaining brain, liver, spleen, and adrenal gland of rats treated with a single
      dose of lipopolysaccharide (LPS). This led to increased biopterin levels in
      tissues but not in plasma. Parallel induction of nitric oxide (NO) synthase was
      indicated by a 10- to 100-fold increase of plasma nitrate levels 6 and 12 hours
      after injection of LPS. Furthermore, systolic blood pressure was reduced
      significantly by 23%. Our results demonstrate induction of tetrahydrobiopterin
      biosynthesis after LPS treatment in vivo.

PMID- 8486154
TI  - Prolyl oligopeptidase catalysis. Reactions with thiono substrates reveal
      substrate-induced conformational change to be the rate-limiting step.
AB  - Prolyl oligopeptidase, a member of the new family of serine proteases, exhibits
      significant mechanistic differences compared with the enzymes of the chymotrypsin
      and subtilisin families. Our kinetic study using the thiono substrate,
      benzyloxycarbonyl-Gly-Pro[CS-NH]-2-naphthylamide suggests that the putative
      oxyanion binding site is important in prolyl oligopeptidase catalysis, although
      to a lesser extent than in the chymotrypsin- and subtilisin-catalyzed reactions.
      By using another thiono substrate, benzyloxycarbonyl-Gly[CS-NH]Pro-2
      naphthylamide, it is demonstrated that the distant S2P2 hydrogen bond (formed
      between the S2 subsite and P2 peptide residue) makes a greater contribution to
      catalysis than does stabilization by the oxyanion binding site involved directly
      in the bond cleavage. In contrast to the reactions catalyzed by chymotrypsin and
      subtilisin, no kinetic deuterium isotope effect is apparent in the acylation of
      prolyl oligopeptidase measured either with the specific benzyloxycarbonyl-Gly-Pro
      2-naphthylamide, or with the very poor substrate, benzyloxycarbonyl-Gly-Pro[CS
      NH]-2-naphthylamide. This indicates that the rate-limiting conformational change
      is induced by the substrate.

PMID- 8486155
TI  - Pentoxifylline inhibits the expression of tissue factor mRNA in endotoxin
      activated human monocytes.
AB  - Tissue factor (TF) is a transmembrane glycoprotein which, in association with
      factor VII(a), is the main activator of coagulation. In illnesses such as Gram
      negative endotoxemia, circulating monocytes synthesize and express substantial TF
      activity, resulting in extensive disseminated intravascular coagulation. We
      investigated the way in which TF is suppressed by pentoxifylline (PTX), and found
      that PTX down-regulates immunologic TF expression and specific mRNA production in
      response to LPS. Since TF mRNA stability is not altered, this effect appears to
      take place at the transcriptional level.

PMID- 8486156
TI  - Zeta-crystallin versus other members of the alcohol dehydrogenase super-family.
      Variability as a functional characteristic.
AB  - Species variability of the lens protein zeta-crystallin was correlated with those
      of alcohol dehydrogenases of classes I and III and sorbitol dehydrogenase in the
      same protein family. The extent of overall variability, nature of residues
      conserved, and patterns of segment variability, all fall within the limits
      typical of the 'variable' group of medium-chain alcohol dehydrogenases. This
      shows that zeta-crystallin is subject to restrictions similar to those of
      classical liver alcohol dehydrogenase and therefore derived from a metabolically
      active enzyme like other enzyme crystallins. Special residues at the active site,
      however, differ substantially, including an apparent lack of a zinc-binding site.
      This is compatible with altered functional properties and makes the spread within
      this medium-chain dehydrogenase family resemble the wide spread within the short
      chain dehydrogenases. Schematic plotting is useful for illustrating the
      differences between 'variable' and 'constant' enzymes.

PMID- 8486157
TI  - Chemical modification of rat liver cytosolic NADP(+)-linked isocitrate
      dehydrogenase by N-ethylmaleimide. Evidence for essential sulphydryl groups.
AB  - Incubation of rat liver cytosolic isocitrate dehydrogenase with N-ethylmaleimide
      (NEM) resulted in the inactivation of the enzyme following pseudo-first order
      kinetics. Isocitrate affords considerable protection against inactivation whereas
      NADP+ enhances modification of the enzyme, suggesting localization of the
      modified group at the active site. Correlation of loss of activity with
      incorporation of [14C]NEM indicated that two sulphydryl residues/sub-unit are
      modified of which only one is shown to be involved in catalysis. pH dependence of
      the inactivation process implicates a reactive group of pKa 8.1 in catalysis. We
      conclude that a unique cysteine residue is essential for maximal catalytic
      activity of isocitrate dehydrogenase.

PMID- 8486158
TI  - Phase transitions of Acholeplasma laidlawii membranes. The involvement of Mg(2+)
      ATPase in the C transition.
AB  - Highly sensitive differential scanning calorimetry has been employed to study the
      phase transitions of A. laidlawii membrane. The DSC curves obtained show five
      distinct transitions between 20 and 80 degrees C which contain a reversible lipid
      thermotropic transition at about 37 degrees C and four irreversible denaturation
      transitions of the membrane proteins occurred at about 44 degrees C, 52 degrees
      C, 62 degrees C, and 67 degrees C, respectively. Total enthalpy of the thermal
      denaturation of membrane proteins is 3.4 +/- 0.5 cal/g. Further study of A.
      laidlawii membrane preparations by means of thermal gel analysis and enzyme
      activity measurements at various temperatures provided information that the third
      peak (C transition) of the DSC curve involved primarily with Mg(2+)-ATPase on A.
      laidlawii membranes.

PMID- 8486159
TI  - Metabolism of exogenous ganglioside GM1 in cultured cerebellar granule cells. The
      fatty acid and sphingosine moieties formed during degradation are re-used for
      lipid biosynthesis.
AB  - Cerebellar granule cells, differentiated in vitro, were parallelly fed with [Sph
      3H]GM1 and [stearoyl-14C]GM1, under identical conditions (10(-6) M ganglioside;
      pulse, from 1-4 h; chase, up to 24 h after 4 h pulse) and the salvage pathways of
      sphingosine and stearic acid were investigated. It was observed that both
      sphingosine and stearic acid, liberated during the intralysosomal degradation of
      ganglioside, are metabolically recycled, along distinct pathways. Sphingosine is
      used for the biosynthesis of a number of sphingolipids, particularly ceramide,
      glucosyl-ceramide, gangliosides and sphingomyelin; stearic acid is utilized for
      the biosynthesis of sphingolipids, and to a greater extent, glycero
      phospholipids, especially those endogenously richer in stearic acid (phosphatidyl
      ethanolamine and phosphatidyl-choline). No evidence was provided for a salvage
      pathway for ceramide.

PMID- 8486161
TI  - A 31P NMR study of the interaction of the antitumor active metallocene Cp2MoCl2
      with calf thymus DNA.
AB  - Treatment of sonicated calf thymus DNA with the antitumor active metallocene
      Cp2MoCl2 afforded a metallocene-DNA complex which was characterized by 31P NMR
      spectroscopy. In addition to the resonance for the phosphate backbone (delta
      1.6), the spectrum contained 2 signals assigned to a phosphate bound Mo-DNA
      complex(es) (delta 37.2, 36.5) and a broad signal at delta 6.2 ppm. This result
      suggests that covalent attachment of the metallocene Cp2MoCl2 occurs via
      phosphate(O) coordination and is accompanied by local distortion of the DNA
      backbone. This result supports recent ICP studies with Cp2TiCl2 that have DNA
      detected DNA-metallocene adducts.

PMID- 8486162
TI  - Beta-oxidation of unsaturated fatty acids in humans. Isoforms of delta 3, delta 2
      enoyl-CoA isomerase.
AB  - This investigation was undertaken in order to elucidate the human enzymes which
      participate in metabolism of the double bonds of unsaturated fatty acids during
      beta-oxidation. The results indicate that the human monofunctional delta 3, delta
      2-enoyl-CoA isomerase (EC 5.3.3.8) with the native M(r) of 70,000 differed
      significantly from its rat counterpart [Palosaari et al. (1990) J. Biol. Chem.
      265, 3347-3353]; the isoelectric point of the human isoform was over three pH
      units more acidic, it showed different chromatographic behaviour, the human
      enzyme did not show any clear-cut substrate chain-length specificity and only a
      weak immunological cross-reactivity was detected with the antibody to rat liver
      mitochondrial short-chain enzyme. This explains the failure of attempts to apply
      the rat data directly to human beings. Another isomerase activity from human
      liver was found to be a part of the isomerase-hydratase-dehydrogenase polypeptide
      showing immunological cross-reactivity with the previously characterized
      peroxisomal multifunctional enzyme (MFE) from rat liver.

PMID- 8486160
TI  - Autostimulation of the DnaK (HSP 70) ATPase of Escherichia coli.
AB  - The ATPase activity of DnaK, the 70-kDa chaperone of Escherichia coli, is
      stimulated by an unfolded protein. However, the stimulation of the DnaK ATPase by
      unfolded bovine pancreatic trypsin inhibitor can only be observed at low DnaK
      protein concentrations. At higher DnaK concentrations, the ATPase activity of
      DnaK cannot be stimulated by the addition of unfolded bovine pancreatic trypsin
      inhibitor. This is a consequence of the autostimulation of the DnaK ATPase at
      higher DnaK concentrations. The autostimulation of DnaK is reflected by a non
      linear dependence of ATP hydrolysis on DnaK concentration. Furthermore, DnaK
      exists as a mixture of monomers and dimers in equilibrium, and the dimers
      dissociate into monomers in the presence of ATP.

PMID- 8486163
TI  - Relative stability of AT and GC pairs in parallel DNA duplex formed by a natural
      sequence.
AB  - The low-cooperative melting of parallel DNA formed by a natural 40 bp long
      sequence from Drosophila: 5'-d(TGATTGATCGATTGTTTGCATGCACACGTTTTTGTGAGCG)-3' 5'
      d(ACTAACTAGCTAACAAACGTACGTGTGCAAAAACACTCGC)-3' that possesses a normal nucleotide
      content was studied by using the special method of measuring the fluorescence of
      its complex with acriflavine as well as by conventional thermal denaturation.
      Acriflavine allows discrimination of the melting of AT and GC pairs because its
      fluorescence is quenched by neighbouring G bases. We have observed that about 40%
      of AT pairs melt at 14 degrees C while the remainder melt at 42 degrees C. The GC
      pairs remain stable up to approximately 40 degrees C and melt at 54 degrees C.
      The higher stability of GC pairs suggests the formation of cis Watson-Crick pairs
      in parallel DNA.

PMID- 8486164
TI  - d-alpha-Tocopherol inhibits low density lipoprotein induced proliferation and
      protein kinase C activity in vascular smooth muscle cells.
AB  - Native and malondialdehyde modified low density lipoproteins have been shown to
      stimulate smooth muscle cell proliferation (A7r5) in vitro. The stimulation is
      associated with an increase of protein kinase C activity. d-alpha-Tocopherol, at
      physiological concentrations, has been found to inhibit both protein kinase C
      activity and cell proliferation.

PMID- 8486165
TI  - Electron microscopic study of compaction of individual DNA molecules with histone
      H1 in surface films.
AB  - Interaction of individual spread DNA molecules with histone H1 was studied by
      electron microscopy using the protein-free spreading technique. It was shown that
      in the presence of 0.2-5 micrograms/ml of histone H1 in hypophase there are three
      types of structures in electron-microscopic preparations: fibres of non-compacted
      DNA, compact fibres with twisted strands of duplex DNA and compacted rod-like and
      circular structures where the separate fibres of duplex DNA could not be
      distinguished. The study of compact structure morphology allows us to conclude
      that they are formed by side-by-side association of DNA fibres. At an increase of
      ionic strength there is a tendency for transition from the second to the third
      type structures. The latter can be explained by transition from non-cooperative
      to cooperative binding of histone H1 to DNA. Regularities established for
      interaction between DNA and histone H1 can be useful for understanding the role
      of histone H1 in the higher order structure organization of chromatin.

PMID- 8486166
TI  - Assessment of the implantation site by transvaginal ultrasonography.
AB  - OBJECTIVE: To investigate the implantation site in a singleton pregnancy. DESIGN:
      Transvaginal ultrasonography (US) was performed at the mid or late follicular
      phase and/or at very early gestation before 6 weeks. SETTING, PATIENTS:
      Ultrasound monitoring was performed on 21 women with spontaneous cycles or
      treated by administration of 2.5 mg/d bromocriptine mesylate (Parlodel; Sando
      Co., Tokyo, Japan) for occulted hyperprolactinemia at the Fertility Clinic of the
      Department of Obstetrics and Gynecology at Gunma University Hospital. MAIN
      OUTCOME MEASURES: The site of the ovary with a growing follicle and/or a corpus
      luteum of pregnancy, and the location of a gestational sac in longitudinal and
      transverse views were observed. RESULTS: When ovulation occurred in the right
      ovary, 12 of the 14 gestational sacs were located on the right wall, 1 on the
      midwall, and 1 on the left wall. Ovulation in the left ovary resulted in 5
      gestational sacs located in the left wall and 2 on the midwall. That is, of 21
      gestational sacs, 17 were located on the ipsilateral uterine wall to the
      ovulating ovary, 3 on the midwall, and only 1 on the contralateral. CONCLUSION:
      Implantation occurs on the ipsilateral uterine wall to the ovulating ovary.

PMID- 8486167
TI  - Chromosome errors as a cause of spontaneous abortion: the relative importance of
      maternal age and obstetric history.
AB  - OBJECTIVE: To evaluate the likelihood of obtaining a chromosome diagnosis in
      cases of spontaneous abortion (SAB) and of the relative importance of maternal
      age versus obstetric history in predicting the fetal karyotype. DESIGN: Obstetric
      history was obtained from all 100 cases of miscarriage in 1 year when products of
      conception were sent for chromosome studies. Multiple logistic regression
      analysis was used to calculate odds ratio and statistical significance for
      correlations between historical factors and the probability of any chromosomal
      abnormality or trisomy. RESULTS: A chromosome diagnosis was made in 84% of cases.
      Maternal age was a more important predictor of chromosome abnormality,
      specifically trisomy, than history of previous livebirths or miscarriages.
      CONCLUSION: Results from chromosome studies using chorionic villi from SABs are
      diagnostically useful, even when the patient has a history of repeated
      miscarriages.

PMID- 8486169
TI  - Tumor marker CA-125 in tissues of the female reproductive tract and in serum
      during the normal menstrual cycle.
AB  - OBJECTIVE: To further elucidate the origin of the physiological CA-125 amounts
      that lead to cyclic changes in CA-125 serum levels in normally menstruating
      women. DESIGN: Fifty-three normal endometria, 13 fallopian tubes, 25 ovaries, and
      nine isolated corpora lutea were prospectively investigated for their CA-125
      content in a sandwich solid-phase RIA and by immunohistochemistry. In addition,
      endometrial CA-125 tissue content was compared with the actual CA-125 serum
      levels of the study patients. RESULTS: Cytosolic CA-125 concentrations were 20
      fold and twofold higher in the endometrium than those measured in the ovary and
      the fallopian tube, respectively. Moreover, only in the endometrium did CA-125
      content show significant cyclic changes, with the highest concentrations during
      the early proliferative and middle secretory phase. The lowest tissue
      concentrations were measured during the early secretory phase. Furthermore,
      during the early and middle secretory phases cytosolic CA-125 was negatively
      associated with CA-125 serum levels. In immunohistochemistry, marked
      distributional changes in OC-125 reactivity were revealed in the basalis and the
      functionalis throughout the menstrual cycle and the postovulatory loss of CA-125
      expression was found to be strongly connected with early secretory transformation
      of glandular epithelium. CONCLUSION: Our findings indicate that the CA-125
      amounts responsible for cyclic changes in serum levels in normally menstruating
      women seem to be a product of normal endometrium.

PMID- 8486168
TI  - The reproducibility of the revised American Fertility Society classification of
      endometriosis.
AB  - OBJECTIVE: To assess the degree of intraobserver and interobserver variability in
      endometriosis staging using the revised American Fertility Society (AFS)
      classification of endometriosis. DESIGN: Videotapes of laparoscopies of 20
      patients with endometriosis were each scored twice by five observers. SETTING:
      The reproductive endocrine unit of a tertiary care, university-affiliated
      hospital. SUBJECTS: Five subspecialty-certified reproductive endocrinologists.
      INTERVENTIONS: None. MAIN OUTCOME MEASURES: Variability in assigned score was
      measured for each of the five components of the AFS classification, as well as
      total scores and stage of endometriosis. RESULTS: There was considerable
      variability in the scores assigned to each videotape, both by the same observer
      and by different observers. The grand total score, which ranged from 0 to 90,
      varied with an SD of 13.44 when a single patient was rated twice by the same
      observer and varied with an SD of 17.12 when a single patient was rated by two
      different observers. Among individual components of the score, the greatest
      variability occurred in endometriosis of the ovary and cul-de-sac obliteration,
      with less variability observed for peritoneum endometriosis and for ovarian and
      tubal adhesions. Comparison of intraobserver and interobserver scores resulted in
      a change in endometriosis stage in 38% and 52% of patients, respectively. There
      were statistically significant differences in mean endometriosis scores among the
      observers in four of the five anatomic categories examined. CONCLUSIONS:
      Intraobserver and interobserver variability was high for ovarian endometriosis
      and cul-de-sac subscores using the revised AFS classification of endometriosis.

PMID- 8486170
TI  - Human fetal ovaries and uteri: developmental expression of genes encoding the
      insulin, insulin-like growth factor I, and insulin-like growth factor II
      receptors.
AB  - OBJECTIVE: To study the messenger ribonucleic acid (mRNA) expression of receptors
      for insulin, insulin-like growth factor I (IGF-I), and insulin-like growth factor
      II (IGF-II) in human fetal ovaries and uteri at 10, 15, 19, and 22 weeks'
      gestation. Insulin, IGF-I, and IGF-II are postulated to have paracrine and
      autocrine functions in the development of fetal tissues, but receptors for these
      growth factors have never been studied in reproductive organs of the human female
      fetus. DESIGN: Ribonucleic acid extracted from human fetal reproductive tissues
      underwent reverse transcription and polymerase chain reaction (PCR)
      amplification. The amplified complementary deoxyribonucleic acid (cDNA) fragments
      were analyzed by gel electrophoresis and restriction enzyme mapping. RESULTS:
      Messenger RNA expression consistent with both known forms of the insulin
      receptor, the IGF-I receptor, and the IGF-II receptor was observed in human fetal
      ovaries and uteri at 10, 15, 19, and 22 weeks' gestation. The identity of the PCR
      amplified ovarian and uterine DNA fragments were confirmed by digestion with the
      restriction endonucleases AvaII, DdeI, and BamHI, respectively. CONCLUSIONS: This
      study demonstrates that mRNA for receptors for insulin, IGF-I, and IGF-II are
      expressed in the fetal human female genital tract. These receptors may have roles
      in fetal reproductive tract development.

PMID- 8486171
TI  - Relative infertility: modeling clinical paradoxes.
AB  - OBJECTIVES: To assume that a cause of relative infertility will decrease the
      monthly chance of conception (fecundability) in a dose-dependent manner and, by a
      mathematical model, to identify common clinical observations and paradoxes that
      are explainable within this hypothesis. DESIGN: An empirically based assumption
      of a population-mean fecundability of 0.2 and the accumulating probability of
      pregnancy equations and projections were used to examine over time the effects of
      diminishing such fecundability to one half, one fifth, and one twentieth of
      normal, and then reversing this effect with ideal treatment at points of 2 years
      and 5 years. RESULTS: [1] The duration of infertility is an important and
      powerful covariate in determining residual fecundability and the chance of
      pregnancy, with or without treatment. [2] The more substantial the pathology is,
      the greater should be the likelihood of pregnancy after its effective treatment.
      [3] Provided no harm is done by treatment, an increase in subsequent
      fecundability will result whatever the "dose" of the reproductive disturbance,
      but this will not always mean that pregnancy is probable. [4] The presence of a
      second infertility factor should compound dramatically the deleterious effects
      attributable to the first and make it more likely for either factor to be
      diagnosed. CONCLUSIONS: Duration of infertility is generally more important than
      the dose of an infertility factor as a covariate in clinical studies, and more
      emphasis should be placed on controlling for it. Discouraging clinical reports on
      the low success of treating certain conditions associated with infertility do not
      necessarily justify rejecting a hypothesis that such a condition decreases
      fertility in a dose-dependent manner.

PMID- 8486172
TI  - Why are couples satisfied with infertility treatment?
AB  - OBJECTIVE: To determine which factors relate to satisfaction with infertility
      treatment. DESIGN: A prospective structured interview research design was used.
      SETTING: In-person and telephone interviews were conducted. PARTICIPANTS: Wives
      and husbands from 185 couples in southeastern Michigan with primary infertility
      were studied. MAIN OUTCOME MEASURES: There were two main outcome measures: how
      satisfied people were with the infertility treatment they received and why they
      were satisfied. RESULTS: Both men and women were satisfied with the infertility
      treatment they had received. The most frequently mentioned reasons for
      satisfaction were the technical skills and the emotional support of infertility
      specialists. Both men and women advised infertility specialists to be
      compassionate and share information with their patients. Spouses' satisfaction
      with treatment was the greatest predictor for both men and women. For men, using
      escape as a coping skill was a negative predictor for treatment satisfaction. For
      women, personal control and the number of infertility treatments received were
      other predictors for treatment satisfaction. CONCLUSIONS: As hypothesized, a
      variety of psychosocial factors were related to treatment satisfaction. Contrary
      to expectation, treatment costs and how long respondents had been trying to have
      a child were not related to treatment satisfaction. This study's results suggest
      that physicians and their staff should pay particular attention to their
      patients' emotional needs, to their patients' understanding of procedures
      explained to them, to discussing adoption with their patients, to involving men
      more in the infertility treatment, and to assisting women to have more control
      over their course of treatment.

PMID- 8486173
TI  - The use of vaginal ultrasound for monitoring endometrial preparation in a donor
      oocyte program.
AB  - OBJECTIVE: To determine whether vaginal sonographic measurements can be used to
      monitor the endometrial preparation of recipients in a donor egg program. DESIGN:
      Prospective clinical trial. SETTING: University hospital-based IVF and donor egg
      program. PATIENTS: Twelve women without ovarian function. INTERVENTIONS: [1] In a
      control cycle, patients received 4 or 8 mg of oral E2 and vaginal ultrasound (US)
      daily until endometrial thickness > or = 6 mm with a triple-line pattern
      (favorable endometrium) was seen. Progesterone (P) in oil, 100 mg/d, was then
      added. [2] An endometrial biopsy was performed on day 7 of P therapy. [3] In a
      treatment cycle, US monitoring of endometrial development during estrogen (E)
      administration was used; and ET was performed on the 3rd day of P therapy.
      RESULTS: In the control cycle, 8 mg/d or 4 mg/d of micronized E2 resulted in
      favorable endometrium development in all patients in a mean time of 5 and 7 days,
      respectively. After P treatment, only 1 of 12 endometrial biopsies was in phase.
      In the treatment cycles, the overall clinical pregnancy rate (PR) was 42%. In
      those patients with a favorable endometrium in the E replacement phase, before
      addition of P, the PR was 62.5%. All of the pregnant patients but only 42.8% of
      the nonpregnant patients had a favorable endometrium on US before the addition of
      P. CONCLUSION: An endometrium that is favorable for implantation can result from
      the use of a simple fixed dose of E2, with higher doses achieving favorable
      endometrial development in shorter time. Vaginal sonography of endometrial
      development before P administration is more accurate than endometrial biopsy in
      predicting a successful donor egg cycle. Endometrial preparation in donor oocyte
      programs can be simplified by the use of vaginal US monitoring.

PMID- 8486174
TI  - The timing of placental competence in pregnancy after oocyte donation.
AB  - OBJECTIVE: To test the timing of placental support of pregnancy. DESIGN: Steroid
      levels in blood and urine were determined in pregnancy after ET into women with
      ovarian failure. SETTING: The study was carried out in a private IVF clinic and a
      university endocrine department. PATIENTS: Four patients with ovarian failure
      were treated by IVF using donor oocytes. INTERVENTIONS: Estrogen and P were
      given, up to the point of ET, to achieve the hormonal levels in the ranges for
      normal menstrual cycles. Pregnancy was supported in the first trimester by
      exogenous steroids. OUTCOME: The four pregnancies went to term, and each resulted
      in singleton livebirths. RESULTS: Increases in plasma P concentrations and in
      urinary pregnanediol excretion rates were indications for a placental
      contribution to the hormone pool. CONCLUSIONS: One hundred mg of P were probably
      a supraphysiological dose to support pregnancy 6 to 8 weeks after conception. The
      fetoplacental unit was competent from 10 to 12 weeks' gestation.

PMID- 8486175
TI  - The effect of gonadotropin-releasing hormone agonist on embryo quality and
      pregnancy rate following cryopreservation.
AB  - OBJECTIVE: To examine the effect of GnRH analogue (GnRH-a) on the quality of
      frozen-thawed embryos and the pregnancy rate (PR) resulting from transfer.
      DESIGN: A retrospective study of two groups of women undergoing transfers of
      frozen-thawed embryos. In group 1 ovulation induction with hMG was begun after
      hypophyseal desensitization with GnRH-a for 2 weeks. In group 2 ovulation was
      induced with hMG only. The freezing and thawing techniques were identical for
      both groups. SETTING: In vitro fertilization unit at a university hospital.
      PATIENTS: The study group (group 1) included 108 women who underwent 137 transfer
      cycles of frozen-thawed embryos, and the control group (group 2) included 44
      women in 51 cycles of thawed ETs. INTERVENTIONS: Ovum pick-up and ET techniques
      were the same for both groups. Methods of embryo freezing and thawing were
      identical, as were the morphological criteria for grading the embryos. RESULTS:
      The morphology of embryos was similar in both groups, as was the number of
      embryos that had at least 50% intact blastomeres (83% +/- 23% and 78% +/- 30% for
      group 1 and group 2, respectively). The PR (16 of 137 [11.7%] and 6 of 51
      [11.8%], respectively) as well as the abortion rate (30%) were similar for both
      groups. CONCLUSIONS: The use of GnRH-a does not affect the quality of embryos nor
      the pregnancy outcome. Because the yield of frozen embryos per ovum pick-up is
      higher in cycles stimulated by GnRH-a/hMG, the PR per pick-up cycle is thus
      anticipated to be higher.

PMID- 8486176
TI  - A multifactorial analysis of the pregnancy outcome in a successful embryo
      cryopreservation program.
AB  - OBJECTIVE: To determine which factor, or factors, may influence the success of an
      embryo-freezing program. DESIGN: Prospective. SETTING: An established, private
      IVF clinic. PATIENTS: This study comprises data from 185 consecutive thaw cycles
      (161 patients) that resulted in embryo replacement. The influence of the
      following factors, with regard to pregnancy outcome, was specifically addressed:
      embryo quality, day of the endogenous LH surge, number of thawed embryos
      replaced, length of time frozen, E2 level at the time of the hCG trigger in the
      stimulated cycle, and patient age at the time of freezing. RESULTS: An overall
      pregnancy rate (PR) of 27.6% per ET was achieved in this study. Regardless of the
      day of the LH surge, patients who had at least one good quality embryo (the
      "sponsoring embryo") conceived 35% of the time. Patients who lacked a sponsoring
      embryo frozen conceived 15% of the time. Patients who were 39 years of age or
      younger had a PR of 31% per transfer. None of the 22 patients who were 40 or
      older conceived. No other factor examined had any effect on pregnancy outcome.
      CONCLUSIONS: Good quality frozen/thawed embryos are a major factor in achieving a
      consistently high PR. Poorer quality embryos are capable of implantation but at a
      significantly reduced rate. Patient age was also found to be significant in
      predicting pregnancy. Neither the day of the LH surge, number of embryos
      transferred, length of time frozen, nor the E2 level appears to have any effect
      on the establishment of pregnancy.

PMID- 8486177
TI  - The hemizona assay: its role in identifying male factor infertility in assisted
      reproduction.
AB  - OBJECTIVES: To identify male factor infertility among a group of patients in an
      assisted reproductive program (phase 1) and to evaluate the hemizona assay (HZA)
      in the diagnosis and prognosis of such a program (phase 2). DESIGN: The IVF
      performance of normal gametes in the Tygerberg program were critically evaluated.
      Female patients were classified as pure tubal factor infertility, having a normal
      FSH:LH ratio on day 3 of the menstrual cycle. All participating women produced
      three or more preovulatory oocytes at retrieval and were inseminated with sperm
      considered normal by all present diagnostic criteria. The total and normal
      fertilization rate thresholds were defined in that group. Using those thresholds,
      couples tested for sperm binding in the HZA (n = 48) were used and divided into
      two groups according to their fertilization rates, namely group 1, low
      fertilization (< 55%) and group 2, normal fertilization (> 55%). SETTING:
      University-based tertiary care center. PATIENTS: Ninety-nine couples (589
      oocytes) with pure tubal factor infertility and normal male factor were used in
      phase 1. Forty-eight couples with normal and abnormal male factors that had both
      HZA performed and IVF treatment were included in phase 2. RESULTS: Investigation
      of the performance of normal gametes in 99 couples (589 oocytes) revealed the
      total fertilization rate (total number of oocytes fertilized/total number of
      oocytes inseminated) was (mean +/- SD) 88.6% +/- 16.8% and the normal
      fertilization rate (total number of oocytes with normal fertilization/total
      number of oocytes inseminated) was 81.3% +/- 22%. The minimum total fertilization
      rate that can be considered normal in the Tygerberg program using mean--2 SD is
      therefore 55% and for normal fertilization rate is 37%. The group with low
      fertilization rate (< 55%) showed a mean hemizona index (HZI) significantly
      lower; nevertheless, the distribution overlapping indicates a low discriminating
      power of the HZA. A sensitivity of 75% and a specificity of 75% were found; the
      positive and negative predictive values were 81% and 68%, respectively.
      CONCLUSIONS: The results indicated the HZA and HZI contribute important
      information and can serve in conjunction with other semen characteristics as
      useful tools during the diagnosis of the male factor in assisted reproduction.

PMID- 8486178
TI  - Serum immunoactive inhibin levels in early pregnancy after in vitro fertilization
      and embryo transfer.
AB  - OBJECTIVE: To determine the maternal serum concentrations of inhibin, E2, P, and
      hCG in early pregnancies arising from IVF and ET or GIFT and to assess the value
      of these hormone measurements in determining outcome of pregnancy. DESIGN: Serum
      immunoactive inhibin, E2, P, and hCG levels were measured in the first trimester
      of pregnancies after IVF-ET and GIFT procedures. SETTING: In vitro fertilization
      and ET or GIFT was undertaken at Monash IVF, Melbourne, Victoria, Australia.
      PATIENTS: At least two blood samples were collected from 117 women between 4 and
      11 weeks of gestation. MAIN OUTCOME MEASURES: The hormone concentrations in the
      IVF-ET and GIFT pregnancies were compared with those in pregnancies and related
      to outcome of pregnancy. RESULTS: Serum inhibin levels in singleton pregnancies
      were significantly higher than in comparable normal pregnancies. In contrast to
      normal conceptions in which inhibin concentrations rose to peak at 11 weeks, the
      levels found in IVF-ET and GIFT singleton pregnancies were high at 5 weeks'
      gestation and declined subsequently. In twin pregnancies, the inhibin levels were
      significantly greater than those in singleton pregnancies. In biochemical
      pregnancies diagnosed by increasing hCG concentrations in the absence of an
      embryonic sac, inhibin levels were significantly lower than those found in
      singleton pregnancy, as were E2, P, and hCG levels. In anembryonic pregnancies,
      diagnosed by the confirmation of an intrauterine gestation sac with no evidence
      of a fetal complex, inhibin concentrations were highest at week 4 and declined,
      being significantly lower at all stages of gestation. In ectopic pregnancy, serum
      inhibin levels were lower at all stages of gestation, whereas E2 concentrations
      were not lower until 6 weeks and P levels until week 5. Serum hCG levels were
      significantly lower at all stages of gestation. In women with spontaneous
      abortions, inhibin levels were lower than singleton pregnancies at 7 weeks.
      CONCLUSIONS: Serum inhibin concentrations are elevated in pregnancies arising
      from ovarian hyperstimulation in the first trimester when compared with those in
      normal pregnancy, probably as a result of the presence of multiple corpora lutea
      resulting from ovarian hyperstimulation. Serum inhibin, E2, P, and hCG are useful
      markers of abnormal pregnancy outcome.

PMID- 8486179
TI  - Premature elevation of plasma progesterone alters pregnancy rates of in vitro
      fertilization and embryo transfer.
AB  - OBJECTIVE: To determine if an increase in plasma P occurring before hCG
      administration might impair the outcome of IVF-ET. DESIGN: Five hundred eighty
      five IVF-ET cycles were prospectively studied for the occurrence of plasma P
      elevation before hCG administration. SETTING: Tertiary institution, IVF-ET
      program, Hopital A. Beclere. PATIENTS: Participating patients included IVF-ET
      candidates 23 to 42 years of age only, excluding the couples in whom a male
      factor was a primary or an accessory cause of infertility. MAIN OUTCOME MEASURES:
      To clarify the practical consequences on IVF-ET outcome of pre-hCG increases in
      plasma P, we studied 585 consecutive IVF-ET cycles. These were divided into two
      groups according to plasma P levels observed on the day of hCG administration;
      plasma P of 0.9 ng/mL (2.9 nmol/L) was taken as an arbitrary cutoff value. Group
      A included 485 IVF cycles in which plasma P was < or = 0.9 ng/mL (2.9 nmol/L);
      group B included the remaining 100 cycles in which plasma P was > 0.9 ng/mL (2.9
      nmol/L). RESULTS: The number of mature oocytes retrieved, the oocyte cleavage
      rate, and the number of embryos obtained were similar in groups A and B. In
      contrast to this apparent similarity in oocyte quality, a decrease in pregnancy
      rate (PR) and a trend for a decrease in embryo implantation rate were observed in
      group B in comparison with group A. CONCLUSIONS: The similar fertilization and
      cleavage rates obtained in groups A and B suggest that pre-hCG elevation in
      plasma P does not lead to decreased oocyte quality. Yet the lower PR observed
      when plasma P rises prematurely suggests that the prolonged but discrete
      elevation in plasma P occurring in these cases might alter endometrium
      receptivity to embryo implantation.

PMID- 8486180
TI  - Serum antisperm antibodies in men with vas deferens obstruction caused by
      childhood inguinal herniorrhaphy.
AB  - OBJECTIVE: To study the incidence of serum antisperm antibodies in patients with
      vas deferens obstruction caused by childhood inguinal herniorrhaphy. DESIGN:
      Retrospective. SETTING: Kansai Medical University and Kyoto University Hospital.
      PATIENTS: Thirteen patients with vas deferens obstruction caused by childhood
      inguinal herniorrhaphy. MAIN OUTCOME MEASURES: Indirect immunobead test for serum
      antisperm antibodies. RESULTS: Of 13 patients, 7 (54%) and 2 (15%) tested
      positive for immunoglobulin (Ig)G and IgA class antisperm antibodies,
      respectively; all patients tested negative for IgM class antibodies. The
      incidence of antisperm antibodies was not different between the patients with
      possible epididymal obstruction and those without epididymal obstruction.
      CONCLUSIONS: A significant percentage of patients with vasal obstruction caused
      by infant inguinal herniorrhaphy have serum antisperm antibodies despite the
      absence of sperm granulomas.

PMID- 8486181
TI  - Detection of Chlamydia trachomatis in semen of artificial insemination donors by
      the polymerase chain reaction.
AB  - OBJECTIVE: To assess the feasibility of detecting Chlamydia trachomatis in
      cryopreserved donor semen by a specific, direct polymerase chain reaction (PCR).
      DESIGN: Cryopreserved donor semen was tested for the presence of C. trachomatis
      by a specific PCR, directly applied to semen without prior DNA purification.
      SETTING: Tertiary care fertility center in a teaching hospital and university
      based laboratory for molecular pathology. PARTICIPANTS: Cryopreserved semen from
      30 donors was investigated. These semen samples had previously given negative
      results in cell culture for C. trachomatis. Two different ejaculates of each
      donor, cryopreserved with an interval of 2 years, were retrospectively analyzed.
      INTERVENTIONS: None. MAIN OUTCOME MEASURE: The presence of C. trachomatis as
      demonstrated by PCR. RESULTS: In 3 of 30 donors C. trachomatis was detected in
      both ejaculates, whereas in 2 additional donors only one of the two samples
      tested positive. Additional samples from 2 positive donors, together with samples
      from 3 negative donors, were studied more extensively, to test the
      reproducibility and reliability of PCR results. All ejaculates of the donors,
      previously positive for C. trachomatis by PCR, indeed appeared to be positive,
      whereas the samples of the negative donors remained negative. CONCLUSIONS: The
      direct PCR is a reliable, sensitive, and valuable method for detection of C.
      trachomatis in semen. The incidence of contamination of donor semen with C.
      trachomatis in the donor population in this study stresses the need for rigorous
      screening of donor semen before artificial insemination, preferably using a
      sensitive method such as the PCR.

PMID- 8486182
TI  - The effects of Vero (green monkey kidney) cell coculture on the motility patterns
      of cryopreserved human spermatozoa.
AB  - OBJECTIVE: To determine the effects of Vero (a primate, urogenital epithelium
      derived cell line) cell monolayer coculture on cryopreserved human sperm function
      in vitro. DESIGN: Prospective, controlled investigation in which cryopreserved
      semen specimens were thawed, processed, and then simultaneously exposed to
      control media (Dulbecco's modified Eagle's medium with either 10% heat
      inactivated fetal bovine serum [FBS] or 10% heat-inactivated pooled human sera
      [PHS]) or the same media with the addition of confluent Vero cell monolayers. A
      second series of investigations was also performed to study the effect of Vero
      cell conditioned media (CM). SETTING: In vitro fertilization/andrology service of
      tertiary center. PATIENTS: Donors with normal semen parameters. INTERVENTIONS:
      Coculture of human spermatozoa with Vero cell monolayers or Vero cell CM. MAIN
      OUTCOME MEASURES: General and hyperactivated (HA) motility patterns, multifactor,
      repeated measures ANOVA. RESULTS: General sperm motility parameters, including
      percentage motility, mean velocity, and mean amplitude of lateral head
      displacement were significantly greater than controls in the Vero cell monolayer
      FBS group at 6 hours and in both the Vero cell monolayer-FBS and Vero cell
      monolayer-PHS groups by 24 hours. Hyperactivated motility was increased after 3
      hours in the Vero cell monolayer-FBS coculture group. A significant decrease in
      the total sperm concentration over the time course of the study in the Vero cell
      monolayer, but not the control or Vero CM groups, was also noted. Vero CM did not
      exert significant effects on any sperm motility parameter, in spite of a sample
      size sufficient to detect relevant increases with a power of 0.80. CONCLUSIONS:
      Vero cell monolayers have a positive influence on cryopreserved sperm function as
      assessed by general and HA motility patterns. Epithelial cell to spermatozoon
      contact seems to be important in this process.

PMID- 8486183
TI  - The effect of the motility stimulants, caffeine, pentoxifylline, and 2
      deoxyadenosine on hyperactivation of cryopreserved human sperm.
AB  - OBJECTIVE: To determine if the motility stimulants, caffeine (7 mM),
      pentoxifylline (3 mM), 2-deoxyadenosine (3 mM), and a combination of the three
      would induce hyperactivated (HA) motility. DESIGN: Controlled laboratory study of
      stimulants using cryopreserved semen from 10 donors at three time points.
      SETTING: The study was performed in the Andrology Laboratory at Prince Henry's
      Institute of Medical Research Clayton, Victoria, Australia. INTERVENTIONS:
      Stimulants in doses maximally effective for stimulation of motility were
      incubated with suspensions of previously cryopreserved sperm. MAIN OUTCOME
      MEASURES: Motility characteristics (curvilinear velocity [VCL], linearity [LIN],
      and maximum amplitude of lateral head displacement [ALHmax]) were derived using
      the single cell track facility of the CellSoft computer-automated semen analyzer
      (Cryo Resources Ltd., Montgomery, NY). Videotapes were visually inspected, and
      125 sperm cell trajectories exhibiting characteristic HA behavior were
      identified. The HA motility thresholds (5th or 95th centiles) were as follows:
      VCL > 74 microns/s, LIN < 74%, and ALHmax > 4.7 microns. Cells with motility
      characteristics outside these limits were regarded as HA. The significance of the
      effect of the stimulants on the proportion of sperm exhibiting HA was examined by
      Poisson regression analysis. RESULTS: Sperm washing (removal of the cells from
      the cryoprotectant) and swim-up caused significant changes in the VCL and
      straight line velocity and a twofold (5.6% to 11.9%) increase in the proportion
      of HA cells. In the presence of motility stimulants, the proportion of HA cells
      was significantly increased threefold (11.9% to 32.5%) above that seen in the
      control washed sperm. Hyperactivated motility declined after 1 to 2 hours, but 2
      deoxyadenosine demonstrated a prolonged effect. CONCLUSION: These motility
      stimulants that affect adenosine 3':5' monophosphate in human sperm stimulate
      cyclic hyperactivation.

PMID- 8486184
TI  - Sexual function does not change when serum testosterone levels are
      pharmacologically varied within the normal male range.
AB  - OBJECTIVE: To examine the relationship between serum T levels and sexual function
      when T levels are varied in the normal male range by pharmacological means. Two
      groups of healthy men were treated with a depot form of GnRH agonist leuprolide
      acetate (Lupron depot; TAP Pharmaceuticals, Chicago, IL) on days 1 and 31 to
      suppress endogenous T production and either 4 (n = 6) or 8 (n = 5) mg/d T
      replacement by a sustained release, long-acting T microcapsule formulation on day
      1. OUTCOME MEASURES: Sexual function was evaluated by daily logs of sexual
      activity and electroencephalogram-coupled nocturnal penile tumescence recording
      before and after 9 weeks of treatment. RESULTS: Serum T levels in 4 and 8 mg/d
      groups were at low and high ends of the normal male range, respectively (10.5 +/-
      1.7 versus 26.5 +/- 3.4 nmol/L). The number and duration of rapid eye movement
      (REM) periods, latency to REM sleep, erections/REM period, magnitude, and
      duration of tumescence were not significantly different between the 4 and 8 mg
      groups. Sexual logs also did not show significant differences in overall scores
      or in subcategories of intensity of sexual feelings (libido) and sexual activity
      between the two doses. CONCLUSIONS: These data indicate that erectile function
      and sexual activity and feelings are restored by relatively low T levels. These
      data may help explain why some partially hypogonadal men continue to have normal
      sexual function and the absence of good correlation between serum T levels in the
      normal range and sexual function.

PMID- 8486185
TI  - Gonadotropin responsiveness to ultralow-dose leuprolide acetate administration in
      baboons.
AB  - OBJECTIVE: To evaluate the gonadotropin response to ultralow doses of a GnRH
      agonist, leuprolide acetate (LA). DESIGN: Prospective and cross-controlled.
      SETTING: Primate research center. SUBJECTS: Four reproductive age cycling baboons
      (Papio cyanocephalus). INTERVENTIONS: Three different doses of LA were given
      intravenously to each animal followed by serial sampling. MAIN OUTCOME MEASURES:
      Response patterns of circulating serum gonadotropin levels. RESULTS: All four
      animals responded to each of the three doses of LA in a dose-dependent fashion.
      Levels of LH and FSH peaked at 49.5 +/- 2.6 mIU/mL and 72.5 +/- 3.4 mIU/mL,
      respectively, for the highest dose studied (0.17 microgram/kg). Levels of LH
      peaked earlier but were lower than the FSH peak levels. CONCLUSIONS:
      Supraphysiological levels of gonadotropins are attained after the administration
      of ultralow doses of LA. The level of the response is dose-dependent and is in
      the range that is required to attain controlled ovarian hyperstimulation.

PMID- 8486186
TI  - Ultrasonically guided follicular aspiration during a pregnancy with massive
      ovarian cysts following ovulation induction by gonadotropins.
AB  - In this report, the treatment by follicular aspiration was evaluated in a
      pregnant patient with severe ovarian cysts subsequent to ovulation induction with
      CC and gonadotropins. The patient had dramatic and immediate improvement of the
      symptoms and general condition as well as a significant shorter hospital stay.
      The procedure was, under meticulous US guidance, safe and effective, providing
      additional improvement or increased therapeutic confidence in the severe
      complications after ovulation induction, as an assisted option during pregnancy.

PMID- 8486187
TI  - Use of particle filters for increased practicability in sperm processing:
      application to the indirect immunobead test.
AB  - The use of sterile particle filters is described for the washing and incubation
      of living sperm before the indirect IBT. The filters greatly simplify the
      technique, shorten its duration, and remove all centrifugation steps that have
      potentially detrimental effects on the sperm. The same filters have a variety of
      applications and can be used whenever sperm have to be washed or incubated before
      biochemical tests including acrosome binding studies and flow cytometry.

PMID- 8486188
TI  - Controversy about immunotherapy.

PMID- 8486189
TI  - Empty follicle syndrome in perimenopausal patients.

PMID- 8486190
TI  - Detection of human immunodeficiency virus in blood or semen by polymerase chain
      reaction--reliable?

PMID- 8486191
TI  - Detection of human immunodeficiency virus in blood or semen by polymerase chain
      reaction--reliable.

PMID- 8486192
TI  - Placebo effect--how powerful?

PMID- 8486193
TI  - Embryo biopsy strategies for preimplantation diagnosis.
AB  - OBJECTIVE: To analyze different biopsy methods, embryo stages, and cellular
      masses that can be removed for preimplantation diagnosis of genetic diseases to
      find optimal biopsy conditions compatible with the subsequent development of the
      conceptus, the acquisition of intact viable blastomeres, and the reliability of
      the genetic analysis. DATA IDENTIFICATION: The most important published studies
      have been identified through a computerized bibliographical search (MEDLINE;
      Dialog, Palo Alto, CA). STUDY SELECTION: Studies reporting different embryo
      biopsy methods practiced at different stages have been selected. RESULTS: The
      analysis carried out in the current review shows, at the present time, the
      following: [1] the displacement and push methods may be more suitable than the
      stitch and pull and aspiration (puncturing the zona pellucida) approaches at
      cleavages stages; [2] the aspiration and stitch and pull procedures may assure
      higher success rates than the herniation procedure at the blastocyst stage; [3]
      the mechanical division method and the use of acid Tyrode's solution would not be
      advisable before the eight-cell stage; [4] human embryos at the two-cell and
      blastocyst stages may not be suitable for preimplantation diagnosis because of an
      excessive reduction of cellular mass at the two-cell stage and a low or zero
      pregnancy rate after transfer at the blastocyst stage; and [5] biopsy of a
      quarter of the embryonic cellular mass on day 2 after insemination may increase
      biochemical pregnancies if the cleavage rate is not preserved. CONCLUSIONS: At
      the present time, biopsy of a quarter of the embryo on day 3 after insemination
      may be the most feasible approach for preimplantation diagnosis.

PMID- 8486194
TI  - Computer-aided sperm analysis: technology at a crossroads.

PMID- 8486195
TI  - Assisted reproductive technology in the United States and Canada: 1991 results
      from the Society for Assisted Reproductive Technology generated from the American
      Fertility Society Registry.
AB  - OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive
      technology (ART) initiated in the United States in 1991. DESIGN: Data were
      collected on an annual summary form and submitted to the Society for Assisted
      Reproductive Technology generated from The American Fertility Society central
      registry. PARTICIPANTS: Two hundred fifteen programs submitted data on procedures
      performed in 1991. Data were collected in October of 1992 so that outcome of all
      pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes
      measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth,
      delivery, and congenital abnormality. RESULTS: In 1991, programs reported
      initiation of 33,001 cycles of ART treatment, excluding frozen embryo and donor
      oocyte cycles. Of these, 24,671 cycles initiated were IVF with 15.2% deliveries
      per retrieval, 5,452 were cycles of GIFT with 26.6% deliveries per retrieval, and
      2,104 were cycles of zygote intrafallopian transfer with 19.7% deliveries per
      retrieval, and 714 were combination cycles, combining IVF and one of the tubal
      transfer techniques, resulting in 19.3% deliveries per retrieval. In addition to
      these cycles initiated in 1991, 4,838 frozen embryo procedures were reported,
      either as separate procedures or in combination with another ART procedure with
      11.1% deliveries per procedure, and 1,107 donor oocyte or surrogacy cycles were
      initiated with an overall success of 25.6% deliveries per retrieval. From all of
      these procedures, a total of 5,699 deliveries were reported. CONCLUSIONS: In
      1991, there were more programs offering more treatment cycles of ART. Average
      success rates for most ART procedures exhibited a small increase compared with
      previously reported summaries.

PMID- 8486196
TI  - A quantitative overview of controlled trials in endometriosis-associated
      infertility.
AB  - OBJECTIVE: To undertake quantitative overviews of the following commonly used
      treatments for endometriosis-associated infertility: ovulation suppression,
      laparoscopic ablation, and conservative laparotomy. DESIGN: A protocol was
      prospectively defined detailing the research question, mode of study
      identification, inclusion and exclusion, data extraction, and pooling methods.
      Studies were assessed for relevance and validity by independent reviewers and
      their findings compared. Data were extracted in a similar fashion. PATIENTS:
      Women with visually diagnosed endometriosis, complaining of infertility. MAIN
      OUTCOME MEASURE: Pregnancy as defined by positive pregnancy test. RESULTS: Twenty
      five relevant randomized controlled trials and cohort studies were identified
      with a total of 37 treatment comparisons. The common odds ratio (OR) from seven
      studies comparing ovulation suppression (danazol, medroxyprogesterone acetate
      [MPA], or gestrinone) versus placebo or no treatment was 0.85, suggesting no
      treatment benefit. The common OR for pregnancy after ovulation suppression (MPA,
      gestrinone, or GnRH agonist) versus danazol was also nonsignificant: 1.07.
      Although pooled data from trials of laparoscopic surgery suggested a treatment
      benefit, significant heterogeneity between studies undermines this conclusion.
      Laparoscopic data were similar to those from conservative laparotomy studies.
      Studies assessing conservative surgery plus danazol versus danazol alone showed
      no significant benefit from this adjunct. CONCLUSION: Ovulation suppression is an
      ineffective treatment for endometriosis-associated infertility. Well-designed
      trials of laparoscopic ablation deserve a high priority.

PMID- 8486197
TI  - Response to intermittent RU486 in women.
AB  - OBJECTIVE: To determine the effects of intermittent administration of the
      antiprogestin RU486 on ovarian function. DESIGN: Three different regimens of
      RU486 were tested. PARTICIPANTS: Nine healthy regularly menstruating volunteers
      protected by an intrauterine device or surgical sterilization. INTERVENTIONS: Two
      groups of three women each received 10 mg or 50 mg RU486 at weekly intervals for
      5 weeks. Another three women received 50 mg RU486 for 3 consecutive days at 10
      day intervals for 80 days. MAIN OUTCOME MEASURES: Serum E2, P and RU486 levels.
      Ovarian ultrasound (US) and serum LH and FSH in select subjects. RESULTS: The
      predominant effect was partial inhibition of E2 secretion and suppressed P
      levels. During a total aggregate of 16 treatment months, there were seven
      episodes of elevated P levels; however, US did not always indicate the occurrence
      of normal ovulation. CONCLUSION: Intermittent RU486 administration can interfere
      with normal follicular development and function, but its clinical application may
      require a more effective dose and/or timing of administration.

PMID- 8486198
TI  - A clomiphene citrate and tamoxifen citrate combination therapy: a novel therapy
      for ovulation induction.
AB  - OBJECTIVE: To assess the efficacy of a clomiphene citrate (CC) and tamoxifen
      citrate (CC/tamoxifen) combination therapy in ovulation induction by comparing
      with a CC alone therapy. DESIGN: A randomized cross-over study with CC alone and
      CC/tamoxifen combination therapies for 20 normoprolactinemic anovulatory women.
      Randomly selected 10 of the 20 women (group A) underwent a CC alone therapy (100
      mg CC during cycle days 5 to 9) for the initial three consecutive treatment
      cycles and a CC/tamoxifen combination therapy (50 mg CC and 20 mg tamoxifen
      during cycle days 5 to 9) for the subsequent three consecutive treatment cycles.
      The remaining 10 (group B) were treated similarly but with the inverse sequence.
      Ovulation was documented when a high BBT phase persisted for 11 days or more,
      when midluteal serum P levels exceeded 7 ng/mL (22.3 nmol/L), or when pregnancy
      ensued. RESULTS: The rates of ovulatory/treated, pregnant/treated, and
      pregnant/ovulatory cycles were 42 of 56 (75.0%), 3 of 47 (6.4%), and 3 of 35
      (8.6%) for CC/tamoxifen, respectively. Those were 25 of 57 (43.9%), 1 of 48
      (2.1%), and 1 of 21 (4.8%) for CC, respectively. Clomiphene citrate/tamoxifen was
      more effective in ovulation induction than CC. All the pregnancies were normal
      and single. None of the treatments was accompanied by any remarkable side
      effects. CONCLUSION: Clomiphene citrate/tamoxifen is a novel treatment modality
      of ovulation induction with high efficacy.

PMID- 8486199
TI  - Long-acting injectable bromocriptine (Parlodel LAR) in the chronic treatment of
      prolactin-secreting macroadenomas.
AB  - OBJECTIVE: To evaluate the efficacy and tolerability of Parlodel LAR (Sandoz,
      Basel, Switzerland), a long-acting injectable bromocriptine, in PRL-secreting
      macroadenomas. DESIGN: Eleven patients with macroprolactinomas were studied in an
      academic environment in an open and prospective protocol. Ten patients were
      followed for 6 months and 8 for 1 year. Fifty to 200 mg IM of Parlodel LAR were
      administered every 28 days. RESULTS: At the end of the 1st month, 64% of the
      patients had PRL suppression of > 75% of baseline values. After 1 year, 88% of
      the cases had PRL suppression of > 90%. Persistent PRL normalization was seen in
      three cases. Tumor shrinkage was seen in 64% of the patients on day 5, in 73% on
      day 28, and in 90% after 6 months of treatment. Early visual field improvement
      was seen in 83% of the cases. All patients had improvement of clinical symptoms.
      CONCLUSION: Parlodel LAR is well tolerated and very effective in the long-term
      treatment of patients with PRL-secreting macroadenomas.

PMID- 8486200
TI  - High-dose, short-term glucocorticoids for the treatment of infertility resulting
      from premature ovarian failure.
AB  - OBJECTIVE: To evaluate prospectively the effects of high-dose, short-term
      treatment with a glucocorticoid in an attempt to normalize ovarian failure and
      induce pregnancy in women presenting with infertility. DESIGN: Uncontrolled,
      nonrandomized prospective study. SETTING: Two university-based reproductive
      endocrinology clinics. PATIENTS: Eleven consecutive women with premature ovarian
      failure (POF) who were desirous of pregnancy. INTERVENTIONS: Prednisone 25 mg
      four times per day for 2 weeks. MAIN OUTCOME MEASURES: Two women demonstrated
      normalization of their serum gonadotropins, an increase of serum E2, and
      ultrasonographic visualization of follicular growth, with both conceiving. The
      other nine demonstrated no biochemical or clinical response. CONCLUSIONS:
      Premature ovarian failure may not be an irreversible process and may either
      spontaneously resolve or may respond to therapeutic modalities such as high-dose
      glucocorticoids in selected patients. In this uncontrolled study, the results
      were best with women with concomitant autoimmune thyroid disease and POF of < 2
      years' duration.

PMID- 8486201
TI  - Prevention of endometrial hyperplasia by progesterone during long-term estradiol
      replacement: influence of bleeding pattern and secretory changes.
AB  - OBJECTIVE: To determine the relative influences of induction of withdrawal
      bleedings secretory transformation, and reduction of mitosis in glands on
      prevention of endometrial hyperplasia during long-term hormonal replacement
      therapy. DESIGN: Observational expanded clinical case report. SETTING:
      Reproductive Endocrine Department of Hospital Necker, Paris, France, and
      Pathology Department of Women's Hospital, Los Angeles County and University of
      Southern California Medical Center, Los Angeles, California. PATIENTS:
      Postmenopausal women seeking treatment for symptomatic menopause. INTERVENTIONS:
      Endometrial biopsy and/or ambulatory hysteroscopy. MAIN OUTCOME MEASURE:
      Endometrial histology including progestational maturation patterns and glandular
      epithelial mitosis rates. Macroscopic endometrial appearance. RESULTS: The use of
      larger doses of E2 and P induced more marked secretory changes and more frequent
      withdrawal bleeding than the lower doses. There was no evidence of endometrial
      hyperplasia after 5 years of E2/P replacement therapy independently of bleeding
      pattern or progestational maturation. Consistent reduction of mitosis rates in
      glandular epithelium was found after 9 or more days of P administration in each
      cycle. CONCLUSIONS: Control of endometrial growth is mainly related to control of
      mitosis in glands by a relatively low doses of P. Induction of withdrawal
      bleeding and endometrial secretory transformation, which require larger doses of
      Progesterone, do not provide additional benefit for prevention of hyperplasia.
      Induction of amenorrhea with a relatively low dose of P may be offered to women
      seeking hormone replacement therapy with similar levels of safety.

PMID- 8486202
TI  - Sonographic assessment of ovarian and endometrial changes during long-term
      Norplant use and their correlation with hormonal levels.
AB  - OBJECTIVE: To study the probability of ovulation and subclinical abortion during
      long-term use of Norplant and to assess the concomitant endometrial development.
      DESIGN: This was a prospective nonrandomized comparative study. The ovaries and
      endometrium were assessed daily by ultrasonography during 59 menstrual cycles in
      50 women who were using Norplant for > 1 year. Serum concentrations of E2, P,
      FSH, LH, pregnancy specific beta 1 glycoprotein (Sp1), and hCG were also daily
      measured. The findings were compared with those in 35 ovulatory cycles in normal
      fertile women not using contraception. SETTING: Clients of the Family Planning
      Clinic of Assiut University Hospital (Norplant users) and the hospital women
      staff (controls). RESULTS: Sonographic and hormonal evidence of ovulation were
      observed in one third of Norplant users; two of them resulted in conception.
      However, the majority of these ovulatory cycles showed low midcycle peaks of E2,
      FSH, and LH and evidence of luteal phase defect (LPD). Excessive follicular
      enlargement was observed in 46% of the cycles. Norplant users had significantly
      thinner endometrium that did not exhibit the normal phasic changes in sonographic
      texture. Apart from conceptive cycles, no rise in Sp1 or hCG was observed.
      CONCLUSIONS: Norplant acts mainly by inhibiting ovulation, but when this occurs,
      it is associated with LPD and subnormal endometrial development. Subclinical
      abortion does not contribute to the contraceptive effect.

PMID- 8486203
TI  - [Gonadotrophin-releasing hormone agonist in the treatment of hypogonadotrophic
      secondary amenorrhoea].
AB  - In an attempt to induce ovulation in Clomiphene resistant secondary amenorrhoea
      patients, the gonadotrophin-releasing hormone agonist (Buserelin) (600-900
      micrograms/day) was administered in 13 cases aged 18 to 24 years for one week
      from day 5 of the menstrual cycle. Serum levels of luteinizing hormone increased
      in all patients, and estradiol levels increased in 10 of 13 patients in response
      to Buserelin. However, ovulation was observed in 6 cases, and the response to
      Clomiphene was recovered in all of these 6 cases in their subsequent menstrual
      cycles. These results imply the existence of a subgroup who respond to Buserelin
      in Clomiphene resistant secondary amenorrhoea patients and a possible new
      approach for the treatment of secondary amenorrhoea.

PMID- 8486204
TI  - [Metabolism, structure and biological activity of sex steroids].
AB  - Recently, the action of steroid hormones are interpreted as the results from the
      interaction with its proper receptors. However, every steroid hormones and
      steroid drugs have many biological effects, and if one steroid receptor is enough
      to result in these multiple effects or not is not well known. On the other hand,
      our experimental results showed that some steroid drugs are metabolized, in vivo,
      to form several biologically active compounds. Norethindrone, a representative
      progestational compound, has also some estrogenic and androgenic effects. It was
      demonstrated, in our laboratory, that the compound was converted, in vivo, to
      several androgens and to estrogen, ethynyl estradiol. Since it was demonstrated
      later that ethynyl estradiol but not norethindrone showed estrogenic activity in
      vitro, it can be concluded that the estrogenic activity of norethindrone was
      derived from the metabolite of norethindrone, ethynyl estradiol. Although the
      chemical structure of norethindrone is far different from that of progesterone,
      it was demonstrated that the progestational effect of norethindrone was derived
      from the interaction of norethindrone with progesterone receptor. The binding
      site of norethindrone with the receptor is identical with that of progesterone.
      Some steroid drugs, such as lynestrenol are inactive, per se, and the conversion
      of the compound into norethindrone in liver tissue well explained the
      progestational activity of the compound. In such cases, the studies on the
      interaction of original compound with receptor in target tissues will give us
      poor information on the mechanism of steroid action. Some progestational
      compounds such as medroxyprogesterone acetate has anticancer effect, but
      norethindrone and the related compounds have no such an effect. This indicates
      that the receptor for anticancer effect is different from the receptor for common
      progestational effect. This was confirmed by many ways and the receptor for
      anticancer effect was partially characterized. Although dydrogesterone is a
      potent progestational agent and the endometrial response to this compound is
      almost identical with that to progesterone, it results in neither the elevation
      of basal body temperature nor an inhibition of ovulation, which are commonly
      observed with other progestogens. This also raises a doubt on the identity of
      progesterone receptors in peripheral and central tissues.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8486205
TI  - [A case of bilateral aldosterone-producing adrenal adenomas].
AB  - A 43-year-old female was admitted to our hospital for high blood pressure
      control. She showed hypokalemia with increased urinary potassium excretion, high
      plasma aldosterone concentration (33.9ng/dl, normal range; 2-12ng/dl) and reduced
      plasma renin activity (trace, normal range; 0.83-5ng/ml/hr). Bilateral adrenal
      tumors were revealed by abdominal computed tomography, and left adrenalectomy and
      right partial adrenalectomy were performed. Cytochromes p-450 and other enzymes
      involved in aldosterone synthesis were found predominantly in the tumor portions
      but not in the zona glomerulosa of the attached adrenals, which
      histopathologically showed paradoxical hyperplasia. This was a rare case of
      bilateral aldosterone-producing adrenal adenomas, which we could differentiate
      from idiopathic hyperaldosteronism by employing immunohistochemical analysis of
      steroidogenic enzymes.

PMID- 8486206
TI  - Angiotensin II receptor subtypes: characterization, signalling mechanisms, and
      possible physiological implications.
AB  - Thanks to the recent discovery of angiotensin II (ANG II) receptor subtypes
      linked to different signalling pathways, research in the different areas related
      to this peptide has regained a strong interest. In the following review, we first
      describe the biochemistry and actions of angiotensin peptides formed both in the
      circulation and locally at the tissue and organ level. Evidence for the existence
      and distribution of ANG II receptor subtypes in mammalian as well as in
      nonmammalian species and lower organisms is presented. The changes in receptor
      subtype expression during development and disease are described. The signal
      transduction mechanisms and biological actions of ANG II mediated by the recently
      cloned AT1 receptor are reviewed and the recent data concerning the signalling
      pathways linked to the AT2 receptor are discussed. Finally, based upon their
      molecular pharmacology, we present evidence and also speculate upon the
      physiological function of the ANG II receptor subtypes.

PMID- 8486207
TI  - Involvement of the area postrema in the regulation of sympathetic outflow to the
      cardiovascular system.
AB  - The circumventricular organs of the brain have been implicated in the central
      regulation of the cardiovascular system. The area postrema, which is the only
      circumventricular organ in the hindbrain, has received less attention than the
      others, but recent studies suggest that it may play an important role in the
      regulation of the cardiovascular system. Studies in rats and rabbits indicate
      that angiotensin II (Ang II)-dependent hypertension is abolished by lesioning of
      the area postrema. Additional studies indicate that the hypertension associated
      with Ang II involves a resetting of the arterial baroreflex to a higher pressure.
      This upward resetting requires an interaction of neurons in the area postrema
      with barosensitive neurons terminating in the medial nucleus tractus solitarius
      (mNTS). Another peptide, arginine vasopressin (AVP), has been shown to enhance
      the sympathoinhibitory influence of the arterial baroreflex via an action at the
      area postrema. Studies in rabbits suggest that the sympathoinhibitory response is
      due to resetting of the baroreflex to a lower pressure. Electrophysiological
      studies, using an in vitro brain slice preparation, have shown that activation of
      area postrema neurons projecting to the mNTS alters the responsiveness of mNTS
      neurons to afferent inputs. It is postulated that alpha-adrenergic mechanisms are
      involved in these interactions.

PMID- 8486208
TI  - Esophageal cancer associated with multiple cancerous lesions: clinicopathologic
      comparisons between multiple primary and intramural metastatic lesions.
AB  - Detailed histopathological examination of serial blocks and subserial sections of
      the entire resected esophagus in 111 patients who underwent esophagectomy for
      esophageal squamous cell carcinoma revealed 38 associated cancerous lesions apart
      from the main tumors, in 33 patients (29.7%). These associated lesions were
      divided into multiple primary lesions (MPLs; 27 lesions in 23 patients) and
      intramural metastatic lesions (IMLs; 11 lesions in 10 patients). Thirteen and
      fourteen MPLs were distributed on the proximal and distal sides, respectively, of
      the main tumor with the same mean distance of 2.6 cm. Three and 8 IMLs were
      located on the proximal and distal sides, respectively, with mean distances of
      3.4 cm and 4.6 cm. With respect to the histological depth of cancer invasion,
      MPLs were all confined within the submucosal layer (superficial cancer) while
      IMLs varied from the submucosa to the adventitia. Histological findings indicate
      that MPLs may be associated with a possible increased multicentric carcinogenic
      potential in the non-cancerous epithelium of the esophagus of patients who have
      had an antecedent esophageal cancer, and that IMLs are developed by intramural
      lymphatic spread from the primary esophageal cancer. These results emphasize the
      need for careful attention to the choice of margins during the surgical resection
      of the esophagus.

PMID- 8486209
TI  - Endoscopic evaluation of the depth of invasion of the depressed type early
      gastric cancer and apparently early advanced cancer in cases of a peptic ulcer
      within the cancer lesion.
AB  - Depressed-type early and apparently early advanced cancers were divided into two
      groups according to whether or not an associated peptic ulcer was present within
      the cancer lesion, and the accuracy of preoperative endoscopic diagnosis was
      reviewed. As a result it was found that evaluation of depth of invasion was more
      difficult in the ulcer [UL(+)] group than in the group without an ulcer [UL(-)].
      In the UL(+) group it was difficult to identify endoscopic findings which
      indicate depth of invasion at the tip of the folds, the volume of cancer invasion
      of the deeper layers was small, and there many cases of invasion of deeper layers
      in a portion of the margins of the peptic ulcers.

PMID- 8486210
TI  - Small bowel transplantation in rats: endoscopic and histological evaluation of
      graft rejection.
AB  - Heterotopic small bowel transplantation was performed using the cuff technique in
      DA(RT1a) to PVG(RT1c) rat fully allogeneic combination. In this model, the
      rejection course of the grafted intestine was evaluated endoscopically via double
      stomata and was classified into four stages. Early changes appeared on
      postoperative day 3. Stage I: The mucosa of the grafted intestine showed patchy
      paleness and loss of the capillary fine network patterns, accompanied by
      microerosions. Closer examination revealed irregularity of the epithelial height
      and arrangement. Stage II: The damage spread progressively over the entire mucosa
      on day 4-5. Stage III: On day 6-7, the necrotic epithelium became detached,
      showing multiple ulcers which provoked hemorrhagic enteritis. Stage IV: Graft
      rejection was completed with total necrosis and white scar tissue formation by
      day 10-14. These endoscopic findings of the mucosa of the grafted intestine
      corresponded closely to the time course of pathological examinations. We conclude
      that endoscopic examination of grafted intestine may be an effective diagnostic
      tool to detect the rejection phenomenon at an early stage, as well as a simple
      tool to use for postoperative follow-up in combination with pathological
      examination.

PMID- 8486211
TI  - The effect and mechanism of the prokinetic action of cisapride on
      gastrointestinal smooth muscle.
AB  - Cisapride is a new prokinetic agent which can facilitate or restore motility
      throughout the entire gastrointestinal tract. Although facilitation of
      acetylcholine release has been suggested, the mechanism of action of cisapride is
      not clear. To investigate the effect and mechanism of action of cisapride, we
      used isolated muscle strips (with mucosa and submucosa removed) of guinea pig
      antrum, ileum and colon to study: (1) the dose response to cisapride, (2) the
      effect of antagonists (atropine and tetrodotoxin) on the stimulatory effect of
      cisapride. Besides these studies, we also used 3H-acetylcholine release method to
      investigate the acetylcholine release effect of cisapride. Cisapride elicited a
      dose-related enhancement of baseline activity (motility index) on the antrum and
      contraction on the ileum and colon at the dose of 4, 40 and 400 nM. At higher
      doses (4 microM) cisapride caused inhibition. This bell-shaped dose response
      curve suggested that cisapride might be autoinhibitory or that the receptors of
      cisapride might consist of high affinity stimulatory and low affinity inhibitory
      sites. The stimulatory responses elicited by cisapride (400 nM) were not
      significantly inhibited by atropine and tetrodotoxin in the antrum, ileum and
      colon. This suggested that cisapride might act directly on the smooth muscle.
      Cisapride (400 nM) evoked a rather small increase of 3H-acetylcholine release on
      the antrum, ileum and colon. Because the percentage of increase was small and we
      had demonstrated that the stimulatory effects of cisapride were not blocked by
      atropine and tetrodotoxin, the acetylcholine release effect of cisapride was
      considered unimportant.

PMID- 8486212
TI  - Studies on changes of colonic mucosal PGE2 levels and tissue localization in
      experimental colitis.
AB  - Experimental ulcerative colitis was produced in rats and the changes of PGE2
      levels in the colonic mucosa and the tissue localization of PGE2 were studied
      immunohistochemically during the process of onset and healing of the experimental
      lesions. Compared with that in controls, PGE2 levels in colonic mucosa were not
      significantly higher in the early stage of inflammation, but rose gradually with
      exacerbation of inflammation, and after reaching peak values at the peak stage of
      development of colitis, decreased as signs of inflammation receded.
      Immunohistochemical study of the normal rat colon showed that PGE2 was uniformly
      positive in the muscularis mucosa and in the tunica propria muscularis adjacent
      to the submucosal layer. Furthermore, as the inflammation progressed infiltrating
      inflammatory cells also became positive, especially macrophages. These changes
      decreased along with regeneration of the epithelium and resolution of the
      inflammation. Glandular epithelial cells did not show positivity. These results
      made it clear that the PGE2 level in colonic mucosa is an useful index of the
      activity of colitis and that changes in PGE2 levels are associated with
      infiltration by inflammatory cells, principally macrophages, of the interstitium.
      The results also suggested the possibility that the muscularis mucosa plays a
      role in the colonic mucosal protective system.

PMID- 8486213
TI  - Intermittent bursts of motor activity in the human rectum and absence of
      propagation.
AB  - Manometric recordings from multiple sites were performed to determine the
      propagating properties of intermittent bursts of motor activity in the human
      rectum. Pressure changes were recorded simultaneously at 12.5 cm, 10 cm and 7.5
      cm from the anal verge in nine healthy subjects for a total recording time of 32
      hours, each study lasting 2.7-4.8 hours. The burst motor activity was identified
      on 19 occasions in 7 of 9 subjects at 12.5 cm; 26 occasions in all subjects at 10
      cm; and 11 occasions in 3 of 9 subjects at 7.5 cm. In most cases, the burst motor
      activity was observed at a single recording site while other recording sites were
      quiescent. It did not appear to migrate in either an oral or aboral direction.
      The burst motor activity contained in part runs of pressure waves with a regular
      frequency: at 12.5 and 10 cm of the recording site, runs of regular pressure
      waves were dominated by a frequency of 2.5-5 cycle per minute, whereas those at
      7.5 cm occurred with a higher frequency and a lower amplitude as compared with
      the more proximal recording sites. No evidence of propagation of each pressure
      wave was seen even when the burst occurred simultaneously at more than two
      recording sites. These results suggest that the intermittent bursts of rectal
      motor activity occur locally and do not propagate in either on oral or aboral
      direction. They appear dissimilar to the interdigestive migrating motor complex
      observed in the more proximal part of the gut.

PMID- 8486214
TI  - A new surgical procedure consisting of ligation of the common hepatic artery and
      auto-transplantation of hepatocytes into the spleen for end stage liver cirrhosis
      accompanied by ascites.
AB  - The authors developed a new surgical procedure for end stage liver cirrhosis
      associated with ascites. This procedure consists of ligation of the common
      hepatic artery and hepatocyte inoculation into the spleen (method A) and in this
      study is compared with common hepatic artery ligation alone (method B). Six of
      the eleven dogs operated by method A survived for six months or more with a
      significant (P < 0.01) difference in the three month survival in comparison with
      method B. In the hemodynamic study of both methods, the portal vein pressure and
      portal resistance decreased as a result of operation, but in method B, they
      returned to preoperative levels and in method A the low levels persisted for more
      than one year. In our method, liver function improved remarkably after three
      months. The hepaplastin and the cholinesterase levels increased after three
      months in method A with a significant difference (P < 0.01) in comparison with
      method B. The labeling index (L.I.) of intrasplenic hepatocytes also increased
      three months later. We emphasize that our method is an ideal procedure not only
      to improve portal haemodynamics but also to improve liver function, in end stage
      cirrhosis.

PMID- 8486216
TI  - Hyperbaric oxygen therapy in the treatment of refractory peripancreatic abscess
      associated with severe acute pancreatitis.
AB  - Five patients with peripancreatic abscesses associated with severe acute
      pancreatitis were treated by hyperbaric oxygen therapy (HBO). In 3 patients, the
      course after surgical mobilization of the pancreas and drainage of the pancreas
      bed was complicated by peripancreatic abscesses. HBO was conducted under a
      pressure of 2.8 atmospheres for two hours daily. Four of the 5 patients showed a
      progressive improvement in their condition. In one patient who failed to respond
      despite seven sessions of HBO, Pseudomonas aeruginosa was isolated from the
      discharge, and resection of necrotic tissue and drainage were performed. The main
      effects of HBO were the alleviation of high spiking fever, the improvement of
      white blood cell count and serum amylase levels, and the reduction of the abscess
      size. We recognized HBO to be a successful treatment for peripancreatic abscess
      associated with severe acute pancreatitis and better results were obtained than
      in cases that did not receive HBO.

PMID- 8486215
TI  - Effect of a somatostatin analogue (SMS 201-995) on hemodynamics and glucagon
      secretion in cirrhotic rats.
AB  - The effects of somatostatin analogue, SMS 201-995, on systemic and splanchnic
      hemodynamics and glucagon secretion were investigated in control and cirrhotic
      rats induced by thioacetamide administration. Hemodynamics were measured using
      the radioactive microsphere method. Immunoreactive glucagon (IRG) was determined
      in the portal vein and femoral artery and the splanchnic output (OP) of IRG was
      calculated. In control rats, SMS 201-995 induced a decrease of 5.6% in portal
      venous inflow and a 25.8% decrease in OP of IRG. In cirrhotic rats, SMS 201-995
      produced a 14% decrease in portal pressure, a 13.6% decrease in portal venous
      inflow, and a 57.8% decrease in OP of IRG. In systemic hemodynamics no
      significant changes were noted following SMS 201-995 administration in the
      control or cirrhotic rats. The ratio of cirrhotic rats to the controls in the
      rate of decrease in portal venous inflow was similar to that in the percentage of
      decrease in OP of IRG. We conclude that SMS 201-995 is useful for the treatment
      of portal hypertension because of its effect of reducing portal pressure with
      mild changes in systemic hemodynamics. We suspect that the decrease in portal
      venous inflow by SMS 201-995 is mainly due to a reduction in the release of
      glucagon, a vasodilatory gastrointestinal hormone.

PMID- 8486218
TI  - Kimura's disease (angiolymphoid hyperplasia with eosinophilia) associated with
      ulcerative colitis.
AB  - We treated a 35-year-old Japanese woman who had Kimura's disease associated with
      ulcerative colitis. Kimura's disease is an uncommon chronic inflammatory disease
      considered to be of allergic origin based on the presence of eosinophilia and IgE
      hyperimmunoglobulinemia, and may be a manifestation of a systemic immunologic
      disturbance. Some immunological complications such as nephrotic syndrome have
      been reported in association with Kimura's disease, but the present case is the
      first associated with ulcerative colitis.

PMID- 8486217
TI  - Relationship between biliary excretion of bilirubin and glutathione disulfide.
AB  - The effects of two glutathione-oxidizing agents, t-butyl hydroperoxide and
      diamide, on biliary excretion of bilirubin and glutathione disulfide were
      investigated in anesthetized male Sprague-Dawley rats. Bilirubin (unconjugated)
      was infused at a constant rate of 100 nmol/kg/min through the jugular vein. When
      biliary excretion of bilirubin was stabilized, either of the glutathione
      oxidizing agents was administered via the mesenteric vein. Biliary excretion of
      glutathione disulfide increased temporarily after the administration and returned
      to its basal levels within 20 min. The biliary excretion of bilirubin decreased
      during the same period and returned to the former levels thereafter. Changes in
      bile flow rates remained within 20% of the basal levels. A linear correlation was
      found between the increments in the bile concentration of glutathione disulfide
      and the decrements in that of bilirubin. Furthermore, separate experiments
      revealed that reduction of hepatocellular glutathione per se had little effect on
      biliary excretion of bilirubin. The results thus indicate that the reduction of
      biliary excretion of bilirubin by glutathione-oxidizing agents was due to the
      increase in biliary excretion of glutathione disulfide, and suggest that a common
      biliary excretory mechanism is shared, at least partially, by bilirubin and
      glutathione disulfide in Sprague-Dawley rats.

PMID- 8486219
TI  - Fatal herpes simplex hepatitis type 2 in a post-thymectomized adult.
AB  - The authors report an unusual case of herpes simplex type 2 (HSV) hepatitis which
      presented as part of a systemic HSV infection accompanied by disseminated
      intravascular coagulation (DIC). The patient was a 49-year-old Japanese male who
      three months prior to admission underwent surgical resection of his thymus for an
      invasive thymoma. Postoperatively, he received a course of chemotherapy which
      included prednisone, cyclophosphamide, vincristine, and pinorubicin. After
      discharge from the hospital, he was put on a maintenance dosage of prednisone and
      cyclophosphamide. Two weeks prior to this admission, the patient developed
      rhinorrhea, chills and general fatigue. Routine follow-up laboratory tests
      revealed markedly elevated liver enzymes which led to his immediate
      hospitalization. The tentative diagnosis on admission was fulminant hepatitis
      with DIC. The patient's condition steadily worsened during his hospitalization
      and acyclovir was initiated on the 4th hospital day due to the possibility of HSV
      hepatitis. He died on the same day. Histopathology performed on the liver at
      autopsy revealed hepatic inclusion bodies of HSV with positive
      immunohistochemical detection of the HSV type 2 antigen. Our case is the first
      report of HSV hepatitis associated with the removal of the thymus secondary to
      thymoma. It supports previous observations of disseminated HSV infection being
      prevalent in those patients with disorders of cell mediated immunity.

PMID- 8486221
TI  - Changes of the extracellular matrix and cells producing it in acute liver injury.

PMID- 8486220
TI  - Role of hepatic sinusoidal cells in hepatic injury and fibrosis in the liver.

PMID- 8486222
TI  - Cytotoxic T lymphocyte activity and HB virus mutant in chronic HB virus carriers.

PMID- 8486223
TI  - Present status of fulminant hepatitis in Japan (1989-1991)
AB  - This paper describes the present status of fulminant hepatitis (FH) in Japan and
      focuses, in particular, on recent activities of the Research Subgroup of FH
      between 1989 and 1991. Both epidemiological and multi-institution surveys have
      demonstrated that the annual incidence of FH has decreased and that the survival
      rate is definitely improving, at least in the acute form of FH. Our goal,
      however, is to achieve a survival rate of greater than 50% overall for FH
      nationwide. To this end, a liaison across Japan of regional core hospitals with
      intensive care units has been organized to exchange opinions and experience in
      the clinical management of FH. Moreover, new specific and intelligent therapeutic
      modalities must be developed through basic research projects which focus on
      finding a means of inducing a necrotic liver to regenerate.

PMID- 8486224
TI  - Report of the research subgroup of autoimmune hepatitis/primary biliary
      cirrhosis.

PMID- 8486225
TI  - Interferon therapy in hepatitis C--refractory hepatitis--report of the research
      subgroup of treatment of chronic hepatitis.

PMID- 8486226
TI  - The role of cytotoxic T lymphocytes and inflammatory cytokines in the
      pathogenesis of acute viral hepatitis.

PMID- 8486227
TI  - Mechanisms and mediators in hepatic necrosis.
AB  - Necrotic processes may be restricted to individual cell types of the liver or
      afflict several liver cells sequentially. Noxious agents may induce necrobiosis
      by different mechanisms of injury. In many instances, however, similar or
      identical terminal processes are involved, e.g. accumulation of Ca2+ in cytosol
      or mitochondria, termination of nucleic acid and protein syntheses or membrane
      damage. Apoptosis may also be a relevant feature of hepatic necrosis. Inhibition
      of mRNA synthesis and post-translational glycosylations of proteins of the
      hepatocytes is instrumental in D-galactosamine-induced hepatocellular necrosis.
      An early event seen after administration of D-galactosamine plus endotoxin is an
      accumulation of neutrophilic granulocytes in the liver sinusoids. It results from
      the tumor necrosis factor (TNF)-alpha-induced adhesion of polymorphonuclear
      leukocytes to the sinusoidal endothelium and the vasoconstriction due to
      thromboxane A2 that is secreted by activated Kupffer cells. Temporal hypoxia and
      nutrient deprivation as well as the activation of the granulocytes with release
      of reactive oxygen species and proteinases appear to be severe consequences.
      Hypoxia followed by reperfusion (reoxygenation) must be considered as a mechanism
      of liver cell necrosis producing reactive oxygen species; oxygen radicals were
      reported to be signals for the activation of nuclear factor kappa B and thereby
      for the cytotoxicity of cytokines.

PMID- 8486228
TI  - Patterns and pathobiology of hepatic necrosis in chronic viral hepatitis.

PMID- 8486229
TI  - Network of cytokine and arachidonic acid cascade in acute hepatic failure.
AB  - When heat-killed Propionibacterium acnes (P. acnes) was intravenously injected
      into mice and 7 days later a small amount of lipopolysaccharide (LPS) endotoxin
      was administered, most of the mice died of massive liver necrosis. In this liver
      injury model, cytokines, immunomediators, and eicosanoids, inflammatory products,
      were produced by Kupffer cells and liver-infiltrated macrophages, which were
      thought to participate, directly or indirectly, in the induction of liver cell
      damage. Furthermore, these two networks seemed to regulate each other. Thus, this
      regulatory mechanism might play an important role in the induction of liver cell
      injury.

PMID- 8486230
TI  - Design of hepatocyte-specific extracellular matrices for hybrid artificial liver.
AB  - For the development of an artificial liver which can assist multiple metabolic
      functions of liver, the effective cultivation of hepatocytes on substrate as
      extracellular matrix analogs was examined. Adult rat hepatocytes attached on an
      asialoglycoprotein model polymer, poly-N-p-vinylbenzyl-D-lactonamide (PLVA),
      formed anchored multilayer aggregates which had a stable three-dimensional
      structure when epidermal growth factor (EGF) and insulin were added to the
      culture medium. The formation of multilayer aggregates was also dependent on the
      specific cellular attachment mediated by asialoglycoprotein receptor of
      hepatocyte surface. Cells in the aggregates expressed higher level of albumin
      secretion and lower proliferative ability than those in monolayer cultures on
      collagen. It seemed likely that the cells in multilayer aggregates experienced
      stable differentiated states resembling in vivo status through the forming
      multilayer aggregates. The culture system described here has useful potentiality
      for the development of hepatic module systems for a hybrid artificial liver.

PMID- 8486231
TI  - Immunogenetics of autoimmune chronic active hepatitis.

PMID- 8486232
TI  - Comparison of the clinical and immunogenetic features between patients with
      autoimmune hepatitis and patients with type C chronic active hepatitis.
AB  - We clarified the clinical and immunogenetical differences between patients with
      autoimmune hepatitis (AI-CAH), and patients with type C chronic active hepatitis
      (C-CAH) and type B chronic active hepatitis (B-CAH) who were positive for
      autoantibodies and hyperglobulinemia. While histories of blood transfusion,
      intravenous drug abuse and tattoo were seen frequently in patients with type C
      CAH, they were rare in patients with AI-CAH. The severe subjective symptoms
      including anorexia, lethargy, icterus, high fever and extrahepatic
      manifestations, and severe abnormality of biochemical data were seen in AI-CAH
      predominantly. Ongoing or past infection of HCV was seen in only 14% of patients
      with AI-CAH. HLA-DR4 was the most frequently associated with AI-CAH (89%) and 6
      DR4-negative patients were positive for DR2. HLA-DNA typing showed that there was
      no significant difference in the frequency of DR4-associated Dw-alleles between
      the patients and controls who were positive for DR4. These findings suggest that
      the basic amino acid at position 13, which is present only on the DR2 and DR4 B1
      molecules (Arg on DR2 and His on DR4), may contribute to the susceptibility to
      autoimmune hepatitis of Japanese. Thus, we conclude that AI-CAH is a genetically
      restricted, disease, and different from C-CAH which is a viral infectious
      disease.

PMID- 8486233
TI  - Immunogenetic background of hepatitis B virus infection and autoimmune hepatitis
      in Japan.
AB  - Human leucocyte antigen (HLA)-typing was studied in 82 hepatitis B carriers and
      15 cases of autoimmune hepatitis (AIH) to elucidate the genetic factors which may
      associated with the etio-pathogenesis of chronic hepatitis in Japan. There were
      two types of HLA phenotypes: HLA A2 was associated with the progression of the
      disease induced by HBV infection, and HLA A26 and DR5 were related to the
      retardation of the disease. A family study confirmed the strong association of
      these HLA phenotypes with the disease induced by HBV infection. In the analysis
      of AIH, HLA DR4 is a risk factor related to susceptibility of Japanese AIH which
      shows different clinical manifestations compared to HLA-DR3-positive AIH,
      dominantly observed in Western countries. These results suggest that genetic
      background as expressed by HLA, is an important factor in restricting the
      development of type B hepatitis and AIH, and can explain racial differences of
      disease susceptibility.

PMID- 8486234
TI  - Mutations of hepatitis B virus liver disease.
AB  - Individuals with chronic hepatitis B virus (HBV) infection are generally divided
      into asymptomatic healthy carriers and patients with chronic liver disease.
      Several studies have suggested that the core antigen (HBcAg) could be an
      immunological target of cytotoxic T lymphocytes (CTL). To investigate the
      possible pressure site from CTL, the entire core region of HBV DNA was sequenced
      in 30 subjects (10 asymptomatic healthy carriers and 20 patients with chronic
      liver disease). No significant changes in the nucleotide sequence and deduced
      amino acid residue were noted in the 10 healthy carriers. In contrast, a cluster
      of changes in small segment of 18 amino acids (codon 84 to 101 from the start of
      the core gene) was found in 15 of the 20 chronic liver disease patients. All
      these 15 patients had advanced liver diseases (chronic active hepatitis and
      cirrhosis), whereas only mild liver disease (chronic persistent hepatitis) was
      found in the 5 patients without mutation. These data suggest that this region
      with clustering mutations may play an important role in the pathogenesis of B
      viral liver disease, and the mutations in the region may be related to
      progressive liver disease.

PMID- 8486235
TI  - The biology and biochemistry of interferon-gamma and its receptor.
AB  - Interferon-gamma (IFN gamma) is an important immunomodulatory cytokine produced
      by activated T cells and NK cells that plays a pivotal role in promoting host
      defense. IFN gamma is distinguished from IFN alpha and IFN beta by its ability to
      regulate a number of immune functions. IFN gamma induces its biologic effects by
      interacting with a specific IFN gamma receptor expressed at the cell surface.
      Recently, IFN gamma receptors have been purified from human and murine cells and
      their cDNAs cloned and expressed. This work has revealed that IFN gamma receptors
      are 90 kDa, single chain glycoproteins that bind ligand with high affinity in a
      species specific manner. There appears to be only a single type of IFN gamma
      receptor that is expressed on nearly all cell types. Whereas this single
      polypeptide is sufficient to confer ligand binding and processing activity to
      transfected cells, a second, as yet undefined, component is required to form a
      functionally active IFN gamma receptor. The identity of this second component is
      currently being investigated. In addition, recent work has revealed novel
      structure-function relationships that exist within the IFN gamma receptor's
      intracellular domain. This work has shown that distinct portions of the
      intracellular domain are differentially responsible for mediating different
      biologic activities of the receptor.

PMID- 8486236
TI  - A role for cytokines as regulators of hepatic fibrogenesis.
AB  - It is evident that hepatic fibrogenesis is a complex process involving a cascade
      of cytokines which interact to enhance the expression of ECM. Cytokines involved
      early in this cascade may serve as proinflammatory agents or as stimulators of
      macrophage and Ito cell activation and proliferation, while those cytokines
      involved later in this process may be directly fibrogenic. Furthermore, we
      speculate that a balance between profibrogenic and antifibrogenic cytokines
      normally exists but in the presence of hepatic insults, a relative super
      abundance of the fibrogenic factors promotes the development of liver fibrosis.
      To date, most of the evidence supporting a role for cytokines in liver fibrosis
      has been obtained in in vitro systems or in animal models. We now need to extend
      these findings to man in order to determine whether a similar cascade of
      cytokines is important in the development of this pathologic process in man.
      Further delineation of these cytokines (as well as other profibrogenic soluble
      factors), and the mechanisms by which they act, are critical to our development
      of more rational forms of therapy for liver fibrosis.

PMID- 8486237
TI  - Conidial and mycelial-bound exo-pectinase of Aspergillus sp.
AB  - Intact conidia of Aspergillus sp. were able to degrade pectin 'in vitro' even
      when protein synthesis was inhibited, thus indicating the presence of cell bound
      pectinases. At least an exo-pectinase was found and this enzyme was also present
      in the mycelium of Aspergillus sp. Its presence was not dependent on the carbon
      source used for growth, suggesting its constitutive nature. This exo-pectinase
      could be released from conidia or mycelium by incubation at different pH values
      and the amount of enzyme released could be increased by treatments with chemical
      agents and hydrolytic enzymes.

PMID- 8486238
TI  - Correlation of cilofungin in vivo efficacy with its activity against Aspergillus
      fumigatus (1,3)-beta-D-glucan synthase.
AB  - (1,3)-beta-D-Glucan synthase is a cell wall synthesis enzyme that is the target
      of cilofungin, an antifungal agent of the lipopeptide class. Cilofungin's glucan
      synthase inhibitory activity, MIC, and effective dose 50% in a systemic infection
      mouse model tend to correlate for Candida albicans. This correlation is not seen
      in Aspergillus fumigatus. MICs for cilofungin against A. fumigatus were
      consistently > 125 micrograms/ml while the effective dose 50% in a systemic
      aspergillosis model was determined to be 20.6 mg/kg. To begin to understand this
      discrepancy, we examined the A. fumigatus glucan synthase. This cell wall enzyme
      was prepared and its activity was measured by [14C]-glucose incorporation from
      UDP-[U-14C]glucose into an acid insoluble polymer formed in the presence of alpha
      amylase. Enzyme activity in crude membrane preparations was measured in the
      presence of several antifungal agents. Enzyme inhibition results showed that 1
      microgram/ml of papulacandin B, echinochandin B, aculeacin A and cilofungin all
      inhibited A. fumigatus glucan synthase activity (40-71%) while 1 microgram/ml of
      amphotericin B, fluconazole, ketoconazole and nikkomycin did not affect enzyme
      activity. A correlation was therefore established between the inhibitory effect
      of cilofungin on the A. fumigatus glucan synthase and the effective dose 50%
      obtained in a systemic aspergillosis mouse model.

PMID- 8486239
TI  - Expression of bacteriophage PhiX174 lysis gene E in Staphylococcus carnosus
      TM300.
AB  - Expression of the cloned PhiX174 gene E causes lysis of the Gram-negative
      bacterium Escherichia coli, which led to the proposal that a two-membrane system
      is necessary for the protein E lysis function. Gene E was cloned in an E.
      coli/Bacillus subtilis shuttle vector and expressed in the Gram-positive
      bacterium Staphylococcus carnosus TM300. Regulated gene E expression had a lethal
      effect on S. carnosus; however, no lysis was detected, lending support to the
      hypothesis.

PMID- 8486240
TI  - MetJ-mediated regulation of the Salmonella typhimurium metE and metR genes occurs
      through a common operator region.
AB  - In Salmonella typhimurium the metE and metR promoters overlap and are divergently
      transcribed. Three tandem repeats of an 8 bp sequence defined previously as the
      metE operator site for MetJ-mediated repression also overlap the -35 region of
      the metR promoter. Starting with a metE-lacZ.metR-galK double gene fusion, site
      directed mutagenesis was used to change nucleotides in each of the repeat units
      from the consensus sequence. Each mutation, along with the wild-type metE
      lacZ.metR-galK gene fusion, was cloned into phage lambda gt2. Regulation of the
      metE and metR genes was examined by measuring beta-galactosidase and
      galactokinase levels in Escherichia coli strains lysogenized with phage carrying
      the wild-type and mutant fusions. Mutations in each of the 8 bp repeat units
      disrupt MetJ-mediated repression for both the metE-lacZ and metR-galK gene
      fusions, suggesting that the metE and metR genes share a common operator site for
      the MetJ repressor.

PMID- 8486241
TI  - Identification of Aeromonas schubertii and Aeromonas jandaei by using a
      polymerase chain reaction-probe test.
AB  - Two oligonucleotide primers were used in a polymerase chain reaction-protocol to
      amplify a region (approx. 850 bp) of the 16S rRNA gene of Aeromonas schubertii
      and Aeromonas jandaei. Hybridization of the polymerase chain reaction products to
      specific internal probes provided a highly specific method for the identification
      of these two species.

PMID- 8486242
TI  - Amino acid sequence of heat-labile enterotoxin from chicken enterotoxigenic
      Escherichia coli is identical to that of human strain H 10407.
AB  - The DNA sequence of heat-labile enterotoxin from the chicken enterotoxigenic
      Escherichia coli 21d strain was determined by direct dideoxy sequencing of
      polymerase chain reaction (PCR)-amplified DNA and was compared with those of heat
      labile enterotoxins from porcine and human enterotoxigenic E. coli strains EWD
      299 and H 10407. The structural genes of the A and B subunits of chicken heat
      labile enterotoxin were identical to those of human heat-labile enterotoxin from
      the human H 10407 strain. Moreover, 67 base pairs of the upstream and 60 base
      pairs of the downstream region of the chicken heat-labile enterotoxin gene were
      also identical to that of the human heat-labile enterotoxin from strain H 10407.
      However, the patterns of plasmids from the 21d and H 10407 strains were
      different. The 21d strain had no band corresponding to the 42-MDa plasmid of the
      H 10407 strain encoding the heat-labile enterotoxin gene but it had a smaller
      plasmid. These data suggest that although the DNA sequence of chicken heat-labile
      enterotoxin is identical to that of human heat-labile enterotoxin, the plasmid
      encoding the chicken heat-labile enterotoxin gene in the chicken might be
      different from that encoding the human heat-labile enterotoxin gene in the H
      10407 strain.

PMID- 8486243
TI  - Local and systemic immunity against Streptococcus pneumoniae: humoral responses
      against a non-capsulated temperature-sensitive mutant.
AB  - Temperature-sensitive mutants of Streptococcus pneumoniae were isolated after
      chemical mutagenesis. Intranasal immunization with temperature-sensitive mutant
      J/3 induced higher levels of circulating antibody than those obtained after
      immunization with the heat-killed parental wild type. Moreover, local
      immunization with mutant J/3 induced high levels of anti-S. pneumoniae IgG and
      IgA in the lower respiratory tract, whereas only moderate IgG (and no IgA)
      antibodies were detected in lung lavage fluids from mice immunized intranasally
      with the heat-killed strain.

PMID- 8486244
TI  - Interaction of a trypsin-like enzyme of Porphyromonas gingivalis W83 with
      antithrombin III.
AB  - We have previously observed that trypsin-like activity in Porphyromonas
      gingivalis culture supernatants is inhibitable by the plasma arg-serpin
      antithrombin III (ATIII). This report demonstrates that a partially purified P.
      gingivalis trypsin-like enzyme (M(r) 47,000) is inhibited by ATIII with an
      association rate constant (k(ass)) of 5.65 x 10(4) M-1 s-1 but does not form SDS
      stable complexes. Heparin enhances the k(ass) and stabilizes the complexes but in
      either case such inhibition is temporary and results in ATIII inactivation by
      reactive centre proteolysis between R393-S394. In the absence of heparin this is
      accompanied by N-terminal cleavage between K39-I40.

PMID- 8486245
TI  - Nucleotide sequence of the gene coding for Clostridium barati type F neurotoxin:
      comparison with other clostridial neurotoxins.
AB  - The neurotoxin gene from Clostridium barati ATCC43756 was cloned as a series of
      overlapping polymerase chain reaction (PCR) generated fragments using primers
      designed to conserve toxin sequences previously published. The toxin gene has an
      open reading frame (ORF) of 1268 amino acids giving a calculated molecular mass
      of 141,049 Da. The sequence identity between the C. barati ATCC43756 and non
      proteolytic C. botulinum 202F neurotoxins is 64.2% for the light chain and 73.6%
      for the heavy chain. This is much lower than reported identities for the type E
      neurotoxins from C. botulinum and C. butyricum (96% identity between light chains
      and 98.8% between the heavy chains). Previously identified conserved regions in
      other botulinal neurotoxins were also conserved in that of C. barati. An ORF
      upstream of the toxin coding region was revealed. This shows strong homology to
      the 3' end of the gene coding for the nontoxic-nonhemagglutinin (NTNH) component
      of the progenitor toxin from C. botulinum type C neurotoxin.

PMID- 8486246
TI  - Degradation of 2,4-dihydroxybenzoate by Pseudomonas sp. BN9.
AB  - The aerobic degradation of 2,4-dihydroxybenzoate by Pseudomonas sp. BN9 was
      studied. Intact cells of Pseudomonas sp. BN9 grown with 2,4-dihydroxybenzoate
      oxidized 2,4-dihydroxybenzoate but not salicylate. Cell-free extracts of
      Pseudomonas sp. BN9 converted 2,4-dihydroxybenzoate after the addition of
      NAD(P)H. A partially purified protein fraction converted 2,4-dihydroxybenzoate
      with NADH to 1,2,4-trihydroxybenzene. 1,2,4-Trihydroxybenzene was converted by a
      1,2-dioxygenase to maleylpyruvate, which was reduced by a NADH-dependent enzyme
      to 3-oxoadipate. 2,4-Dihydroxybenzoate 1-monooxygenase, 1,2,4-trihydroxybenzene
      1,2-dioxygenase and maleylpyruvate reductase were induced in Pseudomonas sp. BN9
      after growth with 2,4-dihydroxybenzoate.

PMID- 8486247
TI  - Expression of human alpha 1 interferon genes in vectors containing tandemly
      located promoters recognized by two different RNA polymerases (Escherichia coli
      and T7).
AB  - An expression vector containing two tandemly located promoters (T7 and P1) and
      two transcription terminators recognized by two different RNA polymerases (T7 RNA
      polymerase and Escherichia coli RNA polymerase) was constructed. Human alpha 1
      interferon gene variants were cloned in this vector and their expression was
      studied in E. coli strains containing [E. coli BL2I (DE3)] or devoid (E. coli
      BL21) of the gene for the T7 RNA polymerase. We report that simultaneous activity
      of the two promoters reduces the level of gene expression when compared with the
      levels of expression corresponding to either P1 or T7 promoter alone.

PMID- 8486248
TI  - Identification of the transcriptional start site of the cyd operon from
      Escherichia coli.
AB  - The cydAB operon encodes the two subunits of the cytochrome bd ubiquinol oxidase
      from Escherichia coli. This enzyme is one of two terminal oxidases in the aerobic
      respiratory chain of E. coli. It has been demonstrated that expression of the cyd
      operon is transcriptionally regulated by oxygen via both the fnr and arcA gene
      products. Whereas arcA clearly serves as a positive regulator at low oxygen
      tension, there is no consensus concerning the role of the fnr gene product (FNR).
      In this paper, the transcriptional start site of the cyd operon is identified at
      position -287 with respect to the translational start. This is located 53
      basepairs downstream from the center of dyad symmetry of the putative FNR
      recognition sequence.

PMID- 8486249
TI  - Ubiquinone systems of Coccidioides immitis, the causative agent of
      coccidioidomycosis.
AB  - The ubiquinone (coenzyme Q) systems of eleven strains of Coccidioides immitis
      were determined by high performance liquid chromatography (HPLC). The ubiquinone
      profile of the fungi was shown to be homogeneous: in all of the strains,
      ubiquinone-10 (Q-10) was demonstrated to be the major component, with Q-9 as a
      minor component. The results imply that the ubiquinone system may serve as an
      additional phenotypic criterion for identifying the fungus.

PMID- 8486250
TI  - [Genetic control of mitotic recombination in Saccharomyces cerevisiae yeast].
AB  - A review of research on genetic control of mitotic recombination in the yeast
      Saccharomyces cerevisiae is presented. The genes controlling different stages of
      mitotic recombination have been considered. Possible relationship of the
      recombination and repair functions of these genes is under discussion.

PMID- 8486251
TI  - [Existence of a negative correlation in the level of satellite DNA III and the
      number of rRNA gene repeats, localized on the short arms of human acrocentric
      chromosomes].
AB  - Relationship between the data on hybridization of the cloned sequences of the
      satellite DNA III located in the short arm of the acrocentric chromosomes and the
      hybridization data on the cloned fragments of 28S and 18S rRNA genes, as well as
      the transcriptional activity of human nucleolus organizer was studied. Negative
      correlation between the content of the satellite DNA III and the number or
      expression of rRNA genes was shown.

PMID- 8486252
TI  - [Specific proteolysis of Clostridium thermocellum endoglucanase upon heterologous
      expression in Escherichia coli cells].
AB  - The cel(1) gene of Clostridium thermocellum encoding endoglucanase cloned earlier
      in Escherichia coli was deleted at specific sites and fused with the E. coli gene
      lacZ'. Analysis of heterologous expression of the produced variants was
      performed. It was established that the post-translational modification of the
      clostridial endoglucanase in E. coli involves a membrane-linked N-terminal
      cleavage of 6 kDa polypeptide during secretion through the cytoplasmic membrane
      and a C-terminal cleavage of 4 kDa protein not related to the secretion. A
      comparative study of the authors' and literature data supports the suggestions
      that: (i) the cel(1) cloned in this laboratory is a deleted variant of the cloned
      cel(1) gene of C. thermocellum described previously by other authors, and (ii)
      the C-terminal proteolysis of the endoglucanase precursor takes place in a linker
      region connecting the catalytic and cellulose binding domains. An account of
      similar kind of proteolysis responsible for multiple forms of cellulolytic
      enzymes is given.

PMID- 8486253
TI  - [In vivo and in vitro study of plasmid fragments from Ca2+-dependent Yersinia
      pestis (Lehmann, Neumann)].
AB  - The bank of the HindIII, EcoRI and PstI fragments of Yersinia pestis Ca(2+)
      dependence plasmid (pCaD) was constructed and used as molecular probes, combined
      with the restriction analysis to map pCaD. Experiments on laboratory animals
      showed two subfragments of the fifth HindIII fragment to impart virulence,
      invasiveness to the plasmidless avirulent strains of Y. pestis, Y.
      pseudotuberculosis and Escherichia coli, and the protective activity to Y. pestis
      clones, while the original fifth HindIII fragment possessed no such property.

PMID- 8486254
TI  - [Rec41--a new gene, participating in the control of recombination in
      Saccharomyces cerevisiae yeast].
AB  - We isolated a collection of rec- mutants. The mutant rec41 from this collection
      was studied in detail. The mutant demonstrated a reduced level of interplasmid
      recombination, did not grow at the elevated temperature (36 degrees C) and was
      sensitive to gamma-rays but not to ultraviolet irradiation. The rec41-1 mutation
      behaved as a semidominant nuclear mutation. Our study on inter- and intraplasmid
      recombination suggested that the rec41-1 mutation decreased the level of crossing
      over events significantly and the frequency of gene conversion events at a lower
      degree. We postulate that rec41 mutation reduces the efficiency of double
      stranded break repair and this results in high sensitivity of mutant cells to
      methylenmethan-sulfonate and ionizing radiation. Using gamma-sensitivity of the
      mutant cells we isolated a rec41-1 complementing plasmid from a yeast genomic DNA
      library. The mapping of plasmid integration site allowed us to localize the REC41
      gene on the left arm of the VII chromosome nearby LYS4 and CDC43 genes.

PMID- 8486255
TI  - [Characteristics of the bacteriophage N15 lysogenic conversion gene and
      identification of its product].
AB  - The plasmids containing EcoRV fragments of N15 phage DNA and inhibiting the
      adsorption of T1, phi 80 and N15 phages were selected and characterized. The N15
      lysogenic conversion gene (cor) was mapped in the SalI-PstI fragment of 700 bp in
      length which is localized near SalI site with the coordinates 40.1 kb on the N15
      plasmid prophage DNA physical map. The cor gene was recloned on a multicopy
      vector in the both possible orientations and its expression was shown to occur
      most probably under control of its own promoter in the direction from SalI to the
      ClaI site of the SalI-PstI fragment. The molecular weight of the Cor protein (7-9
      kD) was determined by the analysis in the system of mini-cells. Initiation of
      transcription to wards the cor gene from the external promoter led to the
      bacteriostatic effect.

PMID- 8486256
TI  - [Mutagenesis of enzyme loci, induced in megaspores of Pinus sylvestris L. by
      ionizing radiation from the accident at the Chernobyl Atomic Power Plant].
AB  - Mutagenesis of alleles of 20-allozyme loci was studied using the electrophoresis
      methods in polyacrylamide gel in seeds of Pinus sylvestris within the 30 km zone
      of the Chernobyl NNP and the limits of contamination levels by Cs-137 from 5 up
      to 600 Cu/km (the absorbed doses being 0.5 to 10 Gy). The frequency of emergence
      of corresponding mutations which change the synthesis of enzymes in endosperms
      within the zone constituted on the average 2.7-10 per gene as compared with 0.6
      10 in control version. Linear dependence was observed between low doses absorbed
      and the frequency of gene mutations, while in case of high doses this decreased.
      Genetic effectivity was 0.001 mutations/locus/Gy. Various radiosensitivity levels
      were shown among the loci studied. Spontaneous level of mutations frequency in P.
      sylvestris populations was found to be within the limits of 0.5 to 1.5 Gy under
      conditions of the 30 km zone. The high rate of mutagenesis was revealed in seeds
      of the first two post-accident reproductions.

PMID- 8486257
TI  - [Effect of sperm genotype on the segregation of homologs in male mice,
      heterozygous for an aberrant chromosome 1].
AB  - The aberrant chromosome 1 with two large homogeneously staining insertions was
      isolated from wild populations of Mus musculus. Specific features of aberrant
      chromosome were described elsewhere. These include preferential entry of the
      chromosome into the oocyte of heterozygous females, increased mortality of
      homozygotes, decreased fertility of homozygous females. The data obtained
      indicated that segregation of homologues in heterozygous females depended on
      which spermatozoon entered the oocyte, prior to the second meiotic division:
      meiotic drive is powerful when the spermatozoon bore the normal chromosome 1, and
      homologue segregation got normalized during MII when the spermatozoon bore the
      chromosome 1 with insertions. Experimental data are adduced and explanations
      offered for the phenomenon observed.

PMID- 8486258
TI  - [Temperature modification of the mutation process and heat shock proteins].
AB  - Heat shock protein synthesis and mutagenesis (X-chromosome losses induced by
      radiation and high temperature) were studied in different. Drosophila
      melanogaster strains. Two models (strain l(1)ts403 with the defect in heat shock
      protein synthesis and the heat-resistant T strain with a specific reaction to the
      extreme temperature differing from the wild type strains) were used. The
      correlation between heat shock protein synthesis and the effect of synergism in
      the action of radiation and heat shock was revealed. It was concluded that HSPs
      are one of the components in mutagenic processes.

PMID- 8486259
TI  - [Cytogenetic analysis of recombination interactions].
AB  - Chiasma interference between separate regions of chromosomes was studied in three
      phylogenetically distant species. All these species displayed the similar
      patterns of chiasma interference. Chiasma completely suppressed recombination in
      the regions next to chiasma within a chromosome's arm. The level of crossing-over
      suppression decreased non-linearly with increase in a distance between the
      chiasma and the region under analysis. Some kind of the threshold effect was
      observed. In some cases, negative interference between the regions rather remote
      from each other was noted. Polarity of interference was revealed: interstitial
      chiasma suppressed recombination in the proximal (in relation to the centromere)
      direction more effectively than in the distal direction. Some regions belonging
      to the different arms of the same chromosome were shown to be able to interfere.

PMID- 8486260
TI  - [Molecular-genetic analysis of expression features of the evolutionary
      conservative neurogene Nc73EF of Drosophila melanogaster].
AB  - Molecular-genetic analysis of the Nc (neural conserved) genome sequence of
      Drosophila melanogaster located at the position 73EF of Drosophila melanogaster
      was performed. The Nc73EF sequence was shown to be expressed in the nervous
      system of Drosophila. We constructed the restriction map of this sequence and
      revealed the main RNA-coding fragment in the 5'-3' orientation. The RNA-dot
      analysis data demonstrated that expression of the Nc73EF transcripts took place
      mainly in the nervous system. Hybridization with the human brain poly(A)+RNA
      confirmed the basic RNA-coding fragment to be evolutionary conservative. Southern
      blot analysis showed this fragment to be unique in the Drosophila genome.
      Northern blots detected three transcripts of this DNA fragment.

PMID- 8486261
TI  - [Genetic disorders in laboratory mice, exposed in the region of the Chernobyl
      Atomic Power Plant four years after the accident].
AB  - Mice (CBA x C57BL)F1, of both sex and males C57BL were exposed within the 10 km
      zone of the Chernobyl Nuclear Power Station during 14, 22 and 34 days. Genetic
      damages of chronic radiation in the exposed adult mice, and in the course of
      embryogenesis, was studied. The gonadal absorbed radiation doses of the exposed
      mice varied from 0.5 to 1.5 Gy. The frequencies of dominant lethal mutations,
      abnormal sperm heads and reciprocal translocations linearly increase with
      increasing absorbed radiation doses. Among 49 males exposed at the embryonal
      stage one male heterozygote for reciprocal translocation was revealed. In other
      males of this group, reciprocal translocation yield was low. No uniform
      dependence of genetic effects from mice genotype was revealed.

PMID- 8486262
TI  - [Interrelation of genetic dimorphism of ear wax and the level of apolipoproteins
      with atherogenesis and longevity in the Lithuanian population].
AB  - Genetic dimorphism of the cerumen was studied in a random sample from the
      Lithuanian population (N = 253), among the patients with the most atherosclerotic
      risk, from different age groups (N = 276) and in a cohort of long-living (N =
      117). Simultaneously, the levels of apolipoprotein (apo- A-1, B, E) were
      determined in blood sera of the males-donors, long-living and elderly individuals
      depending on the phenotypes for ear wax consistency. The prevalence of frequency
      of the w gene for humid cerumen in children suffering from the insulin-dependent
      diabetes mellitus was found as compared with populational sample--0.8293 and
      0.6024, respectively (P < 0.002). On the contrary, essential increase in
      frequency of the d gene responsible for dry cerumen in long living was found as
      compared with the control--0.5311 and 0.3976, respectively (P < 0.01). An absence
      of differences in the concentrations of w and d alleles among the patients with
      coronary artery atherosclerosis and the populational control indicated that the
      genetic characters under study exerted no marked change in incidence of
      atherogenesis. However, the ratio apoB/apoA-1 proved higher in the donors with
      humid ear wax than in those with the dry variant under P < 0.06, which can
      stimulate this disease. The results of this study support the statement that low
      level of apoB and especially apoB/apoA-1 may be one of the longevity markers.

PMID- 8486263
TI  - [Repeating sequences, organizing the telomeric region of chromosomes from the
      eukaryotic genome].
AB  - The telomeric regions of the eukaryotic genome are composed of different types of
      the repeated DNA sequences. Extended subtelomeric repeats (STR) are located close
      to the terminating repeats (TR) at the extreme ends of the chromosomes. The first
      part of the review is devoted to the TR sequences. All of them are the simple
      satellite-similar tandem repeats (T/A)1-8 G1-8. TR, as a substrate of specific
      telomere elongating enzyme telomerase, controls the whole replication of the
      chromosomal DNAs. Information accumulated up to this time is sufficient to
      ascertain the principal uniformity of the structure, the functions and
      organization of TR in all eukaryotic genomes. The second part of the review is
      devoted to the STR sequences. The STRs are prolonged repetitive sequences
      localized between the TR cluster and non-repetitive genes. The STRs have been
      identified in rye, yeast, Trypanosoma, Drosophila, Chironomus, murine and human
      genomes. It can be seen from the analysis of experimental results that the STRs
      of different organisms may have general properties. The information about the
      functions of STRs is now being obtained for only the STR of Drosophila. The STR
      is the complex repetitive family located both in telomeres and in
      heterochromatin. The sequences from the family were recently shown to be capable
      of translocation and curing destroyed chromosomal ends. According to the latest
      information, the STR sequences are organized in two different types of clusters
      in the Drosophila genome. The types have different organization and different
      genome localization. Is the organization of both telomeric and heterochromatin
      regions of the Drosophila genome from the same structural elements common for
      higher eukaryotes or it is the characteristic feature of the Drosophila genome
      only, is to be cleared.

PMID- 8486264
TI  - [Drosophila beta-heterochromatin: molecular organization and function.
      Characteristics of the DNA sequences from proximal beta-heterochromatin,
      associated with the nuclear envelope of Drosophila melanogaster].
AB  - To study the nucleotide sequence from the pericentric heterochromatin associated
      with the nuclear envelope, a residual DNA was extracted from the DNAse-treated
      nuclear lamins of Drosophila melanogaster tissue culture cell line Kc. The
      isolated DNA was cloned in lambda vector. The DNA library obtained was screened
      for the clones homologous to the pericentric heterochromatin. The experiments on
      in situ hybridization to the polytene chromosome of the nurse cell nuclei of the
      strain fs(2) B assigned the reiterated sequence, homologous to the lamin DNA
      clone, to the nuclear envelope associated regions of the proximal beta
      heterochromatin which is known to undergo structural reorganization during cell
      differentiation. The nucleotide analysis of 300 bp from this sequence has
      established the presence of 21 bp and 300 bp d(GT/CA), 12 bp AT-box, the regions
      of recognition of the nuclear factor and the inverted repeats.

PMID- 8486265
TI  - [Drosophila beta-heterochromatin: molecular organization and function. Cloning
      and molecular biological analysis of the lambda 20 DNA fragment from Drosophila
      melanogaster beta-heterochromatin].
AB  - To isolate the DNA sequences specific for the pericentric heterochromatin of
      Drosophila we used two CREST-autoimmune sera which bind in the Western-blot
      analysis the nuclear antigens of 30 kDa, 43 kDa and 45 kDa molecular weight.
      Cloning of the DNA fragments associated with these CREST-specific proteins of
      Drosophila resulted in obtaining 8 clones. One of them, lambda 20, hybridized
      mainly to the chromomcenter of polytene chromosomes. The further analysis
      indicated that the lambda 20 DNA might belong to the proximal beta
      heterochromatin of the polytene chromosomes of D. melanogaster.

PMID- 8486266
TI  - [The nature of the emergence of His+-revertants in Salmonella typhimurium].
AB  - The His(-)-->His+ spontaneous reversion of the Salmonella typhimurium alleles
      hisD3052 and hisG46 was studied. The expected jackpot distribution of His+
      revertants was not observed in the fluctuation tests. The experimental
      distributions were close to Poisson. It was also shown that the mean number of
      His+ reversion events and the mean number of revertants per plate were similar.
      These data demonstrate that the His+ reversion occurred under the influence of
      histidine starvation. At the same time, kanamycin resistant mutants had the
      jackpot distribution. Selection for His+ revertants did not increase the Kans-
      >Kanr mutations.

PMID- 8486267
TI  - [Modification with ascorbic acid of the level of spontaneous and induced
      chromosome aberrations and sister chromatid exchanges in lymphocytes of workers
      in contact with molybdenum salts].
AB  - Five workers of molybdenum gilding at the metallurgical works were observed prior
      to and after administration of ascorbic acid. Tests for chromosomal aberrations
      (CA) and sister chromatid exchanges (SCE) were used as the criteria for
      estimation. Individual sensitivity to the chemicals was revealed in the workers.
      Administration of ascorbic acid caused reduction of the level of chromosomal
      structural rearrangements.

PMID- 8486268
TI  - [Formation of heat stability of gametes in Drosophila oogenesis and connection of
      this property with the mutation process].
AB  - It has been demonstrated that heat resistance (and radiosensitivity) of the germ
      cells at all stages of oogenesis in the females of heat resistant drosophila line
      (T) is being formed during ontogenesis and depends on the environmental
      temperature. These characteristics were retained at the stage of imago, even in
      the cases of temperature changes (from +32 to +25 degrees C, or from +25 to +32
      degrees C). The intensity of induced mutagenesis (by X-rays and high temperature)
      which was evaluated for the frequency of dominant lethal mutations and X
      chromosome loss depended on the temperature during development, but depends on no
      temperature at the time of treating imago with the mutagenic agents. It is
      suggested to be a result of the participation of heat shock proteins in repair of
      DNA damages.

PMID- 8486269
TI  - [Phylogenetic connection of aboriginal dogs of the Caucasus, Central Asia, and
      Siberia with species from Europe and Japan, detected by an analysis of
      polymorphism of blood proteins and enzymes].

PMID- 8486270
TI  - [Analysis of peripheral blood serotonin in domesticated silver foxes (Vulpes
      vulpes) as a major gene marker of domesticated behavior].
AB  - A segregation analysis of inheritance of the blood serotonin level in a
      domesticated silver fox population was performed (104 foxes from 4 pedigrees).
      The results of the analysis point to the effect of a major-gene in the control of
      this quantitative trait (dominance coefficient of lower level is 0.79), and
      suggest that breeding for domestic behavior is accompanied by selection against
      heterozygosity with respect to this major-gene. The lower blood serotonin level
      revealed in more domesticated foxes (p < 0.02) may be a consequence of this.

PMID- 8486271
TI  - [Interconnection of the functional activity of nucleolar organizer regions of
      chromosomes with human reproductive pathologies].
AB  - Comparative analysis of transcriptional activity of human nucleolus organizer
      regions (NOR) of the chromosomes in the group of the control phenotypically
      healthy individuals (I) and in the spouses with repeated spontaneous abortions
      (II) was conducted in an attempt to verify the hypothesis: whether elimination of
      zygotes having received a very large or very small number of the copies of active
      rRNA genes may serve as a factor decreasing the fecundity of some spouses? It has
      been shown that the groups I and II have no differences in total activity of 10
      NOR (Ag staining, rating estimation). At the same time, the II group is
      characterized by higher, in comparison with the I, heterogeneity of Ag-NOR
      variants in homologues of 5 nucleolus-organizing chromosomes. As a result, in the
      individuals of the group II the gametes are formed which are more heterogenous
      than in the group I for the Ag-NOR pattern variants. The imitation computer
      experiments revealed that in the group II elimination of zygotes as a consequence
      of inherited Ag-NOR variants combination should occur more frequently (in 22.2%
      cases) than in the group I (15.9%), p < 0.05. Thus, the hypothesis under test was
      substantiated in the present study.

PMID- 8486272
TI  - [Genetic HLA system in the Northern Khant population compared with other Ugro
      Finnish peoples].
AB  - The northern khants different from the east khants in frequencies of some genes
      from the HLA-A, B, Cw system and in the absence of the disequilibrium linkage.
      Population-genetic mechanisms underlying HLA polymorphism differences between the
      two groups of khants which may have resulted during the historical development of
      these groups or from the difference of climate conditions under which these
      ethnic groups had lived, are under discussion.

PMID- 8486273
TI  - [Differential fertility in the Kharkhov population].
AB  - The distribution of the number of pregnancies, births and abortions in the
      Kharkov population was analysed in the cohort of women with the completed
      fertility. The mean number of pregnancies per woman was 3.77 for the first
      generation and 4.30 for the second generation. The mean number of births in the
      first and second generations was 1.47 and 1.35. The Crow's Index of the
      opportunity for selection and its components connected with differential
      mortality was estimated. The value of the Crow's Index was decreased during one
      generation from 0.56 to 0.35. In the women of the second generations having high
      and secondary education, the number of pregnancies was 3.72 and 4.38,
      respectively, the Crow's Indexes being 0.33 and 0.35.

PMID- 8486274
TI  - [Molecular cloning of threonine biosynthesis genes from Propionibacterium
      shermanii in Escherichia coli cells].
AB  - Cloning the genes for threonine biosynthesis from Propionibacterium shermanii was
      performed in Escherichia coli cells using the plasmid vector pVZ361. The cloned
      genes were identified via complementation of thrB, thrC, thrA1 and thrA2
      mutations of E. coli. The gene complementing thrB of E. coli was located within a
      5.1 kb fragment of P. shermanii chromosomal DNA. The cloned DNA fragment
      hybridized with a chromosomal fragment of P. shermanii of the same size. The
      plasmid pSPt4 (with the thrB gene) was digested with Sau3A and ligated with the
      BamHI-restricted pUC19 vector. The 1.8 kb DNA fragment of P. shermanii was shown
      to complement the thrB gene function in E. coli cells.

PMID- 8486275
TI  - Lambda SK diphasmids: phage lambda vectors for genomic, jumping, linking and cDNA
      libraries.
AB  - Fifteen new phage lambda vectors are discussed: lambda SK4, lambda SK6, lambda
      SK10, lambda SK16, lambda SK17, lambda SK20, lambda SK21, lambda SK22, lambda
      SK23, lambda SK24, lambda SK25, lambda SK27, lambda SK28, lambda SK40 and lambda
      SK41. Their structural and functional features facilitate the implementation of a
      number of new strategies and cloning procedures which simplify, economize and
      vastly improve the utility and efficiency of library construction in lambda
      vectors. Such improved strategies and examples of their application, with
      particular reference to jumping and linking libraries, are presented.

PMID- 8486276
TI  - Cloning and sequence analysis of an Escherichia coli gene conferring bicyclomycin
      resistance.
AB  - We have cloned and sequenced DNA from Escherichia coli that, when present in a
      high-copy-number plasmid, confers resistance to the diketopiperazine antibiotic,
      bicyclomycin (Bc). The DNA includes a 378-amino-acid open reading frame (ORF),
      disruption of which results in the loss of Bc resistance. This ORF contains the
      BcR gene. Studies using the minicell expression system reveal that a polypeptide
      of 31 kDa is produced from this cloned region. The ORF maps at 47.1 min on the E.
      coli genome map. Sequence comparison between the translated ORF and a protein
      database reveal between 26.5 and 23.4% aa sequence homology to bacterial
      transmembrane (TM) proteins including those mediating chloramphenicol (Cm) and
      tetracycline (Tc) resistance and an arabinose-proton symport protein. Sequence
      analysis using the Diagon program showed the BcR gene product (BcR) had homology
      with the N-terminal regions of the CmR and TcR-encoded proteins and weak N
      terminal homology with the arabinose-proton symport protein. Hydropathy profiles
      of the BcR protein and CmR products show a striking similarity, both having
      twelve predicted TM domains.

PMID- 8486277
TI  - Cloning and sequencing of the Lactococcus lactis subsp. lactis groESL operon.
AB  - The operon (groESL) coding for the Lactococcus lactis subsp. lactis heat-shock
      proteins GroEL and GroES, has been isolated and its complete nucleotide (nt)
      sequence determined. A set of degenerate PCR primers, deduced from amino acids
      which are conserved in a number of prokaryotic GroELs, were synthesized and used
      to amplify a 957-bp fragment. This PCR fragment was used as a probe to isolate a
      5.0-kb EcoRI chromosomally derived fragment. A region of this 5.0-kb EcoRI
      fragment was sequenced and revealed that the groES gene was located 5' to groEL.
      This sequence was then used to design a set of inverse PCR primers and a 2.5-kb
      HindIII fragment was cloned which contained the region 5' to groEL. The complete
      nt sequence of the groESL operon was determined from overlapping fragments. It
      revealed that the groESL operon was preceded by a stem-loop structure and the
      promoter appears similar to most L. lactis subsp. lactis and other Gram+
      bacterial promoters. Northern analysis demonstrated that the groESL operon is
      under tight regulation and a dramatic induction of mRNA synthesis occurs within
      15 min after heat shock.

PMID- 8486278
TI  - Sequence and transcriptional analysis of the nourseothricin acetyltransferase
      encoding gene nat1 from Streptomyces noursei.
AB  - We have determined the nucleotide (nt) sequence of nat1, a gene encoding
      nourseothricin (Nc) acetyltransferase (AT) from Streptomyces noursei, and its
      transcriptional start point (tsp). The nt sequence upstream from the coding
      region is completely different from that of the stat gene (encoding
      streptothricin AT) from Streptomyces lavendulae [S. Horinouchi, K. Furuya, M.
      Nishiyama, H. Suzuki and T. Beppu, J. Bacteriol. 169 (1987) 1929-1937], even
      though the nt sequences of the two genes and the deduced amino acid (aa)
      sequences of the two enzymes show a high degree of similarity. Another stat gene,
      derived from a Gram-negative plasmid, showed only deduced aa similarity, but not
      nt sequence similarity, to the above two. A database search for related aa
      sequences did not reveal any clear-cut homologies to other types of protein. A
      multiple aa sequence alignment of several ATs is presented.

PMID- 8486279
TI  - Sequence of the Streptomyces thermoviolaceus CUB74 alpha-amylase-encoding gene
      and its transcription analysis in Streptomyces lividans.
AB  - The alpha-amylase (Amy)-encoding gene (amy) of Streptomyces thermoviolaceus
      CUB74, previously cloned in Escherichia coli and S. lividans and localised on a
      1.7-kb BamHI-SphI genomic DNA fragment, has been sequenced. A single open reading
      frame of 1380 bp, which could encode an Amy protein of 460 amino acids (aa), was
      identified. The deduced aa sequence of the thermophilic Amy is similar (up to
      69.5%) to the mesophilic Amy of S. griseus, S. limosus, S. venezuelae and S.
      hygroscopicus. A 40% sequence similarity was found between the extracellular
      forms of the S. thermoviolaceus and the pig pancreatic Amy. In addition, the
      activity of the S. thermoviolaceus Amy is strongly inhibited by tendamistat, a
      potent inhibitor of mammalian Amy. The nucleotide sequence at the 5' end of amy
      was able to initiate transcription in S. lividans and contains a promoter whose
      sequence is identical to the promoters of the S. limosus, S. venezuelae and S.
      griseus amy.

PMID- 8486280
TI  - A random mutagenesis procedure: application to the POL3 gene of Saccharomyces
      cerevisiae.
AB  - To obtain a broad spectrum of mutations in the POL3 gene, we have developed an
      efficient random mutagenesis procedure. Partially extended, primed, single
      stranded templates were used for forced misincorporation of non-complementary
      nucleotides, extended to completion and ligated. Linear fragments of the
      resulting amplified mutagenized library were then used to transform a
      Saccharomyces cerevisiae strain by the marker replacement technique. This
      procedure has proven to be very efficient when applied to the C-terminal moiety
      of POL3, yielding 24 temperature-sensitive mutants and six extragenic revertants.

PMID- 8486281
TI  - Analysis of 5' flanking sequences from the Schizosaccharomyces pombe cdc2 gene.
AB  - Previously, the sequence of the Schizosaccaromyces pombe cdc2 gene was reported
      to begin at a HindIII site, 141 nucleotides (nt) upstream from the ATG start
      codon [Hindley and Phear, Gene 31 (1984) 129-134]. We have extended the sequence
      of the 5' untranslated region of the gene to a PsI site at -822 nt. We
      demonstrate by primer extension analysis that transcription of the gene initiates
      at one major point 180 nt upstream from the ATG start codon. Since the 822-nt
      fragment extending from the PstI site to the start codon has been used in many
      studies as the promoter for cdc2 [Booher and Beach, Mol. Cell. Biol. 6 (1986)
      3523-3530; Carr et al., Mol. Gen. Genet 218 (1989) 41-49; Gould and Nurse, Nature
      342 (1989) 39-45], we investigated the strength of this promoter element relative
      to the SV40 early promoter, a promoter known to work very well in S. pombe [Jones
      et al., Cell 53 (1988) 659-667]. We confirm that the cdc2 gene fragment has
      significant promoting activity, albeit 20- to 60-fold less than the SV40 early
      promoter, when assayed in S. pombe.

PMID- 8486282
TI  - Sequence of the Candida albicans erg7 gene.
AB  - The nucleotide sequence of the Candida albicans erg7 gene, which complements erg7
      mutants of Saccharomyces cerevisiae and restores oxidosqualene cyclase activity,
      was determined. The gene encodes a 728-aa protein that displays homology with
      squalene-hopene cyclase, providing further evidence that erg7 is the gene
      encoding 2,3-oxidosqualene cyclase.

PMID- 8486283
TI  - Versatile suicide vectors which allow direct selection for gene replacement in
      gram-negative bacteria.
AB  - A set of vector plasmids which greatly facilitate gene replacement and reverse
      genetics in many Gram-negative bacteria was constructed. These vectors are based
      on the P15A origin of replication (ori) and incorporate sacB from Bacillus
      subtilis, which is inducible by sucrose and is lethal when expressed in Gram
      negative bacteria. The vectors also have a convenient antibiotic-resistance
      marker (gentamicin resistance) and the lacZ alpha system which allows blue/white
      selection of cloned fragments. Three different multiple cloning sites, allowing
      several distinct cloning and gene replacement strategies, are available in the 5'
      end of lacZ on different vectors. One of these cloning sites, which we
      synthesised, contains only a NotI-SmaI-NotI sequence; this allows access to most
      of the restriction sites within the cloned fragment for the purpose of insertion
      of various cassettes and interposons. The vectors carry the mob region from the
      broad-host-range plasmid RP4 and are thus mobilizable by conjugation into a wide
      range of Gram-negative bacteria; since they will not replicate in bacteria other
      than enterobacteria, they function as 'suicide' vectors. Variants of the vectors
      carrying the phage lambda cos site were also constructed. We have used these
      vectors to carry out gene replacement experiments in the fixN region of Rhizobium
      leguminosarum and have demonstrated that they are extremely useful in eliminating
      long and tedious screening procedures.

PMID- 8486284
TI  - A family of Ustilago maydis expression vectors: new selectable markers and
      promoters.
AB  - The cDNA expression system for Ustilago maydis has been expanded to include
      different selectable markers and promoters. These new elements allow the
      simultaneous expression of two genes in the same transformant.

PMID- 8486285
TI  - Sequences of genes encoding naphthalene dioxygenase in Pseudomonas putida strains
      G7 and NCIB 9816-4.
AB  - The multicomponent enzyme, naphthalene dioxygenase, initiates the metabolism of
      naphthalene by Pseudomonas putida strains G7 (PpG7) and NCIB 9816-4 (Pp9816-4).
      The genes involved (nahAaAbAcAd) are encoded by the NAH7 and pDTG1 plasmids,
      respectively, and form part of the nah operon. The locations of the structural
      genes were determined on previously cloned fragments of DNA. The nucleotide (nt)
      sequences were determined for nahAaAb from Pp9816-4 and for nahAaAbAcAd from
      PpG7. The appropriate open reading frames were identified using N-terminal amino
      acid sequences determined from the purified proteins. The two nt sequences showed
      93% homology, with the least homology seen upstream from the promoter region.

PMID- 8486286
TI  - Cloning and sequencing of the Serratia marcescens gene encoding a single-stranded
      DNA-binding protein (SSB) and its promoter region.
AB  - The gene (ssb) coding for a single-stranded DNA-binding protein (SSB) was
      identified on a 1.2-kb EcoRI-SalI fragment cloned from chromosomal DNA of
      Serratia marcescens. The cloned fragment conferred increased resistance against
      UV and mitomycin C (MC) to ssb- mutants of Escherichia coli. The nucleotide (nt)
      sequence revealed that SSB consists of 175 amino acids (aa) and has an M(r) of
      18,677. It shows 89% aa sequence homology with the SSB of E. coli. The nt
      sequence preceding the gene contains three promoters. Two of them overlap with a
      presumptive SOS box, and the distal one overlaps with a second SOS box that
      coincides with the promoter of the adjacent uvrA (gene encoding the UvrA
      protein). The uvrA is transcribed in a direction opposite to that of ssb. The
      sequence coding for the N terminus of the UvrA of S. marcescens indicates that
      the first 74 aa are identical to those of the E. coli protein. The results
      suggest that the two bacterial SSBs are members of a group which differs from the
      known SSBs of prokaryotic transmissible plasmids, because their aa sequence
      homology with these proteins is only about 60%.

PMID- 8486287
TI  - Cloning and sequencing the recA+ genes of Acetobacter polyoxogenes and
      Acetobacter aceti: construction of recA- mutants of by transformation-mediated
      gene replacement.
AB  - The recA+ gene of Acetobacter polyoxogenes was cloned as a gene that conferred
      methyl methanesulfonate resistance (MMSR) on the RecA- Escherichia coli HB101.
      The cloned recA+ gene also conferred (i) resistance to UV irradiation, (ii)
      enhanced intrachromosomal recombination, and (iii) permitted prophage phi 80
      induction in E. coli recA- lysogens. Nucleotide sequence determination revealed
      that the recA product consists of 348 amino acids (aa) corresponding to 38 kDa,
      and shows significant similarity to RecA proteins from other Gram- bacteria.
      Next, a portion of recA from Acetobacter aceti was cloned by using polymerase
      chain reaction with oligodeoxyribonucleotide primers design based on the A.
      polyoxogenes recA sequence. Due to availability of efficient host-vector and
      transformation systems in A. aceti, recA mutants of A. aceti were obtained by
      transformation-mediated gene replacement with the cloned A. aceti recA gene which
      was inactivated by insertion of the kanamycin-resistance-encoding gene from
      pACYC177. The recA mutants obtained in this way showed similar phenotypes to
      those of E. coli recA strains, such as increased sensitivity to MMS and to UV
      irradiation, and decreased homologous recombination.

PMID- 8486289
TI  - Analysis of the self-defense gene (fmrO) of a fortimicin A (astromicin) producer,
      Micromonospora olivasterospora: comparison with other aminoglycoside-resistance
      encoding genes.
AB  - The nucleotide (nt) sequence of a 3409-bp PvuII fragment carrying the self
      defense gene (fmrO) of a fortimicin A (FmA; astromicin) producer, Micromonospora
      olivasterospora, was determined; four open reading frames (ORFs) exist in this
      region. Expression analysis of fmrO using the lac promoter in Escherichia coli
      revealed that ORF-3 encodes fmrO. ORF-1 was considered to encode a FmKH epimerase
      (fms11). ORF-2, ORF-3 and ORF-4 seemed to form an operon. No homology was
      detected between fmrO and the resistance-encoding gene fmrT of Streptomyces
      tenjimariensis, a producer of the Fm-group antibiotic, istamycin. Gene
      organization around the fmr genes differed considerably between M.
      olivasterospora and S. tenjimariensis. The deduced amino acid sequence of fmrO
      showed an identity of 30.8% to grmA of M. purpurea and 35.8% to grmB of M. rosea,
      respectively, suggesting that fmrO encodes a 16S rRNA methyltransferase. We found
      in M. purpurea a novel resistance gene distinct from grmA and highly similar to
      fmrO which conferred a resistance phenotype similar to that of fmrO. These
      results suggest that fmrO of M. olivasterospora and the two resistance-encoding
      genes of M. purpurea were derived from a common ancestral gene.

PMID- 8486288
TI  - The Azotobacter chroococcum hydrogenase gene cluster: sequences and genetic
      analysis of four accessory genes, hupA, hupB, hupY and hupC.
AB  - The Azotobacter chroococcum chromosome contains a region spanning about 14 kb
      associated with hydrogen-uptake (Hup) activity. The small and large subunits of
      the hydrogenase are encoded by the structural genes hupS and hupL. Two other
      genes, hupD and hupE, are located 8.9 kb downstream from hupL and are required
      for the formation of a catalytically active hydrogenase. In this study, we
      determined the nucleotide sequence of a 3.8-kb region immediately upstream from
      hupD. This revealed four additional closely linked ORFs which we designated hupA,
      hupB, hupY and hupC; these genes potentially encode polypeptides with predicted
      masses of 12.6, 33.3, 80.4 and 9.0 kDa, respectively. This cluster of genes was
      shown to be essential for hydrogenase activity by insertion mutagenesis using
      antibiotic-resistance gene cassettes and a Tn5 derivative carrying a promoterless
      lacZ gene. A 10.5-kb fragment of DNA beginning 3.4 kb downstream from hupL, and
      including the sequenced region, was able to complement hupA and hupY mutants,
      supporting earlier evidence for a promoter downstream from hupSL. The deduced
      amino acid sequences of hupA, hupB and hupC are homologous to the Escherichia
      coli hypA, hypB and hypC gene products, respectively. Of particular interest is
      the fact that there is no homologue of the hupY gene product in the E. coli hyp
      operon. Mutations in hupY or hupB had little effect on beta-galactosidase
      activity in a strain also carrying a hupL::lacZ fusion, showing that hupY and
      hupB are not major factors in regulating the transcription of the hydrogenase
      structural genes.

PMID- 8486290
TI  - Genes encoding eleven subunits of photosystem I from the thermophilic
      cyanobacterium Synechococcus sp.
AB  - We have isolated the genes encoding 11 photosystem I (PSI) subunits from
      Synechococcus sp., from which this reaction center has been crystallized. The
      recombinant DNAs, including psaA, psaB, psaC, psaD, psaE, psaF, psaI, psaJ, psaK
      and psaL, were obtained by heterologous hybridization with probes from
      appropriate cDNAs or genes from spinach and Synechocystis sp. PCC 6803, or with
      synthetic oligodeoxyribonucleotides. Genes psaA/psaB, psaF/psaJ and psaL/psaI are
      each closely linked. The open reading frames predict polypeptides of 83 kDa
      (subunits Ia and Ib, encoded by genes psaA and psaB, respectively), 15.4 kDa (II,
      psaD), 17.7 kDa (III, psaF), 8.4 kDa (IV, psaE), 8.8 kDa (VII, psaC), 4.6 kDa
      (VIII, psaI), 4.8 kDa (IX, psaJ), 8.5 kDa (X, psaK) and 15.5 kDa (XI, psaL). A
      novel subunit (XII, psaM) was also identified. Subunits II, III, IV and VII seem
      to be peripheral, while the others seem to be intrinsic components of the
      reaction center. These data imply a striking similarity of cyanobacterial and
      eukaryotic PSI. All subunits studied are encoded by single-copy genes which seem
      to be transcribed into monocistronic (psaC, psaD, psaC, psaK) or dicistronic
      (psaA/psaB, psaF/psaJ, psaL/psaI) RNA species. Subunit III is translated as a
      17.7-kDa precursor, including a transit peptide of 23 amino acid residues. This
      is consistent with its location in the thylakoid lumen.

PMID- 8486291
TI  - Identification of a putative infC-rpmI-rplT operon flanked by long inverted
      repeats in Mycoplasma fermentans (incognitus strain).
AB  - A specific 1542-bp DNA fragment was amplified from Mycoplasma fermentans
      (incognitus strain) using a unique 23-nucleotide (nt) synthetic
      deoxyribonucleotide (oligo) (5'-TCCAAAAAGTCCGGAATTTGGGG) as the primer pair in
      the polymerase chain reaction (PCR). The 23-nt sequence is part of the 29-bp
      terminal inverted repeat (IR) which forms the left potential stem-and-loop (s&l)
      structure of the previously identified M. fermentans insertion-sequence(IS)-like
      genetic element [Hu et al., Gene 93 (1990) 67-72]. The amplified DNA was cloned
      and sequenced. A pair of 27-bp IR containing the 23-nt synthetic oligo was
      identified at both termini. Between the IR, there are four potential open reading
      frames (ORFs) which are arranged adjacent to each other in the order, ORF-1, ORF
      2, ORF-3 and ORF-4, with parts of ORF-1 and ORF-2 overlapping. The deduced amino
      acid (aa) sequences of ORF-2, ORF-3 and ORF-4 are 34 to 60% identical to the
      translation initiation factor IF3 (encoded by the infC gene), ribosomal proteins
      L35 (rpmI gene) and L20 (rplT gene) of Escherichia coli and Bacillus
      stearothermophilus, respectively. In bacteria, the infC-rpmI-rplT genes are
      organized to function as an operon. There are multiple sites with promoter-like
      sequences identified upstream from the putative infC gene in the mycoplasma
      closely resembling the gene arrangement in the bacterial operon. All three genes
      of ORF-2, ORF-3 and ORF-4 are preceded individually by a strong appropriately
      spaced (7 and 10 bp) putative Shine-Dalgarno sequence (5'-AAGGA).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8486292
TI  - A new cloning vector and expression strategy for genes encoding proteins toxic to
      Escherichia coli.
AB  - Here, we describe a modification of a plasmid, pT7-7 [Tabor and Richardson, Proc.
      Natl. Acad. Sci. USA 262 (1985) 1074-1078], that allows expression of inserted
      genes from the phage T7 RNA polymerase promoter. The modification is designed to
      suppress readthrough transcription from cryptic promoters and start points on the
      plasmid, in order to reduce expression in the absence of T7 RNA polymerase and
      thus improve the vector for use in the expression of highly toxic gene products.
      This vector (pT7SC) was used to stably clone the POL3 gene (encoding DNA
      polymerase delta) of Saccharomyces cerevisiae, which destabilizes all other
      cloning and expression vectors tested. Previously described expression strategies
      proved ineffective in overexpressing the POL3 gene. A new strategy was developed
      which relies on induction by infection with mutant T7 phage. This system
      efficiently overproduced the POL3 gene product.

PMID- 8486293
TI  - Final passages: physician-assisted dying.

PMID- 8486294
TI  - Assessing older drivers for physical and cognitive impairment.
AB  - For older drivers, the automobile is often a vital link in maintaining
      independence, acquiring goods, and socializing. However, physical or cognitive
      impairments linked to aging or disease may imperil the driver, passengers, and
      others on the road. For drivers with multiple medical conditions, physicians can
      reduce the risk for a crash by identifying and treating illnesses that can impair
      driving ability. If the conditions cannot be treated, consider modifying the
      driving environment to reduce the risk, rather than taking away driving
      privileges. If the risk is unacceptable, seek alternate modes of transportation.

PMID- 8486295
TI  - Seizure disorders of aging: differential diagnosis and patient management.
AB  - The incidence of seizures increases significantly after age 60, mainly because of
      an associated rise in the prevalence of such etiologies as stroke, brain tumors,
      and toxic-metabolic disturbances, including alcohol or drug misuse and diabetes.
      The differential diagnosis must rule out transient ischemic attacks, syncope, and
      psychiatric disorders, among other conditions. Treatment is based on the
      underlying cause. Seizures caused by toxic-metabolic disturbances are treated by
      correcting the underlying condition. Those with other etiologies require single
      drug therapy with an anticonvulsant, such as phenytoin, valproic acid, or
      carbamazepine.

PMID- 8486296
TI  - Exercise and aging: extending independence in older adults.
AB  - Exercise plays an important role in enhancing the quality of life of the older
      patient, although studies have shown that regular physical activity does not
      significantly lengthen life expectancy. Improved physiologic and psychological
      function helps to maintain personal independence and reduces demands for acute
      and chronic care services. This has significant economic benefits, as the
      resultant cost savings will likely cover the costs of a well-designed exercise
      program. Primary care physicians can help older patients to realize these
      benefits by encouraging them to increase their physical activity and by
      prescribing appropriate exercise regimens.

PMID- 8486297
TI  - Fernando Torres-Gil: Clinton's choice for top aging post.

PMID- 8486298
TI  - Enhancing independence in the older hip fracture patient.
AB  - No doubt all experienced clinicians have observed cases in which a hip fracture
      dramatically diminished the independence and quality of life of an elderly
      person. This difficult problem requires a concentrated, multidisciplinary effort.
      More than 800 patients have now been treated using our interdisciplinary
      approach. A recent review of the data shows that results in this larger group
      compare favorably with those in the followup group described in this article. We
      believe that our approach shows promise as a model for the future. Further,
      comparisons with current practices may lead in some situations to significant
      improvements in hip fracture rehabilitation. Primary care physicians play a key
      role in this process of review and modification and in contributing to the
      overall restorative effort.

PMID- 8486299
TI  - Laser scanning tomography and stereophotogrammetry in three-dimensional optic
      disc analysis.
AB  - Laser scanning tomography (LST) and computed stereophotogrammetry (CSP) are
      sophisticated diagnostic tools for the three-dimensional analysis of optic nerve
      head topography. The two methods are based on different physical principles. To
      compare the information about the shape of the cup of an optic nerve head
      obtained by LST and CSP, we evaluated the volume profile (VP; i.e., the cross
      sectional area of the cup from top to bottom) in 36 discs of 36 patients (20
      control group discs C, 16 glaucoma discs G). The Spearman correlation coefficient
      between the photogrammetric and the laser scanning VP-slope measurements was rs =
      0.931; P < 0.001 (rs = 0.935 G, P < 0.001; rs = 0.910 C, P < 0.001). The results
      suggest that confocal laser scanning provides readings of the shape of the optic
      disc cup that are similar to the measurements of computed stereophotogrammetry.

PMID- 8486300
TI  - Stereoscopic cooperation between the fovea of one eye and the periphery of the
      other eye at large disparities. Implications for anomalous retinal correspondence
      in strabismus.
AB  - In normal human observers we searched for the largest amount of visual disparity
      that can still provide depth information; we compared (1) crossed and uncrossed
      disparities and (2) symmetrical and asymmetrical locations of disparate stimuli.
      A pair of 3 degrees discs projected for 100 ms served as targets. Symmetrical
      stimuli were projected on temporal or nasal retinal loci in both eyes;
      asymmetrical stimuli were projected on the fovea of one eye and on the nasal or
      temporal periphery of the other eye. Thresholds were determined using a two
      alternative forced choice procedure. Subjects had to distinguish binocular
      disparate images from monocular double images of identical angular separation.
      Among six subjects, crossed disparities were recognized by one up to 6 degrees,
      by three up to 9 degrees, by one up to 18 degrees, and by one up to 21 degrees.
      Uncrossed disparities were recognized by two at 3 degrees, by two up to 6 degrees
      and by two up to 9 degrees. Hence, crossed disparities could be recognized up to
      higher angles than uncrossed. No consistent difference was found between
      symmetrical and asymmetrical stimuli. Stimuli with crossed disparity appeared
      smaller and with uncrossed disparity larger than monocular stimuli of the same
      objective size, suggesting that the size-constancy mechanism operates when
      disparity stimuli are presented as briefly as 100 ms, i.e., without simultaneous
      vergence eye movements. We speculate that the far-reaching interocular
      connections demonstrated in normal subjects might also be utilized in the case of
      strabismus: these interocular connections could form the basis for anomalous
      retinal correspondence.

PMID- 8486302
TI  - Survival prognosis of patients with retinal artery occlusion and associated
      carotid artery disease.
AB  - The records of 151 patients who developed retinal arterial obstruction were
      reviewed to evaluate the survival prognosis of these patients. Survival rates
      were calculated to expected rates of an age- and sex-matched control group of
      patients without retinal arterial obstruction. The presence of visible embolus
      and a branch retinal artery occlusion were found to be significant factors for
      worse survival prognosis (P = 0.0001 and P = 0.001, respectively). The survival
      rate of the entire group of 151 patients with retinal artery occlusion was not
      significantly different from that of the age- and sex-matched group (P = 0.29).
      Among the patients evaluated with continuous-wave Doppler sonography, the
      presence or the absence of the atheromatous carotid disease did not significantly
      affect the survival.

PMID- 8486301
TI  - Visibility of the normal retinal nerve fiber layer correlated with rim width and
      vessel caliber.
AB  - Since the distribution of the retinal nerve fiber layer (RNFL) is not regular,
      this study was performed to evaluate the normal regional variation in its
      ophthalmoscopic appearance. Wide-angle red-free photographs of the RNFL and color
      stereo optic disc slides of 195 normal eyes of 119 subjects were morphometrically
      examined. The RNFL was most visible in the temporal inferior sector, with the
      neuroretinal rim being correspondingly broadest (P < 0.001) and the diameter of
      the corresponding retinal artery the widest; these parameters were found to
      diminish appreciably in the temporal superior sector, the nasal superior sector,
      and the nasal inferior sector in this order. The visibility of the RNFL in a
      particular region therefore correlates positively with the rim width and retinal
      artery caliber in that region, the RNFL being most detectable in the temporal
      inferior part of the fundus. This may be important in the evaluation of eyes with
      optic nerve damage.

PMID- 8486303
TI  - Fetal development of the human orbit.
AB  - The development of the orbits in 70 human fetal skulls was investigated by
      measuring the width and height of the orbital entrance, as well as the volume and
      depth of the orbital cavity and the interorbital width. For determination of the
      orbital volume, we used the imprint method; the remaining parameters were
      estimated. Our measurements showed a linear growth rate for the orbital width,
      height, and depth. After transformation to the cubic root, the values of the
      orbital volume also demonstrated a linear increase. The orbital index
      (height/width x 100) expressed the change in the oval outline of the orbital
      entrance during fetal development from a flat, wide form to a nearly round form
      at birth. No statistically significant difference between the right and left
      orbit was found.

PMID- 8486304
TI  - Ascorbic acid phosphate ester and wound healing in rabbit corneal alkali burns:
      epithelial basement membrane and stroma.
AB  - We examined the effect of L-ascorbic acid 2-phosphate (P-Asc) on the healing of
      alkali-burned corneas in rabbits. Round filter paper containing 1 N NaOH was
      applied to the central cornea for 60 or 120 s to produce the alkali burn. Animals
      were treated with topical saline, 10% ascorbate, or 6.5% P-Asc applied on the
      cornea. The corneas were then examined histologically. Burned stroma showed no
      toluidine blue staining, indicating a loss of glycosaminoglycan. In the 60-s burn
      group, P-Asc reduced the size of the unstained area as compared with the control.
      Transmission electron microscopy showed basal lamina under new epithelia in the
      corneas treated with ascorbate or P-Asc, but not in controls. These observations
      support the theory that P-Asc may have a therapeutic role in the repair of
      corneal alkali burns.

PMID- 8486306
TI  - Retinal detachment and degeneration in response to subretinal perfluorodecalin in
      rabbit eyes.
AB  - Perfluorocarbon liquids, including perfluorodecalin (PFD), are useful
      intraoperative tools in complicated vitreoretinal surgery, such as for giant
      retinal tears, PVR and intraocular foreign bodies. Due to its high specific
      gravity (1.91 g/cm3) subretinal complications of PFD may occur. The consequences
      of subretinal PFD were studied in 23 albino rabbits (28 eyes). Using glass
      micropipettes (outer diameter of tip 100-120 microns), we injected 50-100
      microliters PFD subretinally via the vitreous space. The same volume of BSS was
      injected into 18 control eyes. Eyes were monitored by indirect ophthalmoscopy and
      examined by light and electron microscopy at 1, 2 and 3 days, and 1, 2, 4 and 12
      weeks. Progressive retinal detachments with newly formed retinal breaks in the
      inferior quadrants developed in 26 of 28 eyes. As early as 1 day postoperatively,
      subretinal PFD induced loss of outer and inner segments. Local retinal necrosis
      occurred in 4 eyes 5-7 days after surgery. A marked vacuole formation in retinal
      layers and PFD emulsification were regularly seen. The control eyes healed
      spontaneously. Toxic, mechanical and barrier effects may have caused the retinal
      damage. We advocate that all PFD be removed from the eye at surgery.

PMID- 8486305
TI  - Distribution of epidermal growth factor in rat ocular and periocular tissues.
AB  - Using a sensitive radioimmunoassay (RIA) specific for rat epidermal growth factor
      (rEGF), we investigated the presence of rEGF in a variety of rat ocular and
      periocular tissues. Immunoreactive rEGF (IR-rEGF) was present in tear fluids
      (25.5 +/- 5.8 ng/ml), exorbital lacrimal gland (6.73 ng/g wet weight),
      intraorbital lacrimal gland (2.80 ng/g wet weight), Harderian gland (1.90 ng/g
      wet weight), and conjunctiva (0.16 ng/g wet weight). EGF was not detectable in
      aqueous humor, cornea, iris and ciliary body, lens, or the posterior part of the
      globe (retina, choroid, and vitreous body). Gel exclusion chromatography and
      reverse-phase high-performance liquid chromatography revealed that IR-rEGF in the
      above ocular fluids and tissues was indistinguishable from standard rEGF. Using
      enzyme-linked immunohistochemistry, rEGF was demonstrated to be localized in the
      duct epithelial cells of lacrimal glands. These findings reveal that EGF is
      preferentially localized in the ocular surface and lacrimal apparatus.

PMID- 8486307
TI  - Immunological reactions against PMMA lens material?
AB  - We investigated the kind of reactions that occur after injection of a PMMA lens
      powder into the back skin of rabbit. The lens powder was suspended in NaCl and
      incomplete Freund's adjuvant to reinforce the immunological reaction. The ELISA
      test was carried out to detect antibodies against the lens material as a whole
      and against the UV absorber Tinuvin in particular. We also performed histological
      and immunohistochemical examinations of the back skin. We did not detect
      antibodies against either the lens material or against Tinuvin. Histological
      examination showed a foreign-body or delayed allergic reaction against the lens
      material. Lymphocytes surrounding the PMMA were found to be mainly of the T-type,
      which supports the results of the ELISA test.

PMID- 8486308
TI  - Senior-Loken syndrome with marbelized fundus and unusual skeletal abnormalities.
      A case report.

PMID- 8486309
TI  - Invasive squamous cell carcinoma of the palpebral conjunctiva.

PMID- 8486310
TI  - [A portrait of Dr. Enrique Gutierrez Murillo].

PMID- 8486311
TI  - [Hepatitis C during puerperium].
AB  - Screening of donor blood for hepatitis B led to recognition that most cases of
      post-transfusion hepatitis were due to an agent known as non-A, non-B. Until
      recently the causative agent for non-A, non-B hepatitis was identified, being
      denominated hepatitis C virus. It is estimated that one-half of patient with
      hepatitis C develop chronic liver disease, and 20% of this will develop
      cirrhosis. We describe a patient who due to obstetric complications received
      blood transfusion and during puerperium developed an icteric syndrome which was
      identified as C hepatitis. We review the diagnostic methodology, clinical
      characteristics, evolution and preventive measures of the C hepatitis.

PMID- 8486312
TI  - [The role of estradiol and progesterone receptors in the selection of endocrine
      therapy fo patients with fibrocystic mastopathy].
AB  - Estradiol and progesterone receptors were analyzed in breast tissue of 100 women
      with mastopathy fibrocystic. Four groups were found according to the receptors
      detected: (R-E+, R-Pg+); (R-E+, R-Pg-); (R-E-; R-Pg+); (R-E-, R-Pg-). Ten percent
      were positive for both receptors, while 75 percent were negative for both
      estradiol and progesterone receptors. Ten percent were estradiol receptor
      positive (R-E+). Eight percent were progesterone receptor positive (R-Pg+). In
      this pathology type were considered "receptor positive" when specific binding was
      higher than 6 fmol/mg. protein. These "receptor positive" had specific binding in
      the range of 6.1-80 fmol/mg. protein and was considered "receptor negative" when
      specific binding was less than 6 fmol/mg. protein. While there was no correlation
      between the two receptors and patient age. We discuss the presence, type of
      estradiol and progesterone receptors for the hormonal treatment of patients with
      mastopathy fibrocystic.

PMID- 8486313
TI  - [Radioactive antiestrogens: their clinical use].
AB  - Using antiestrogen labelled with iodine-131 we proved the useful as diagnostic
      and therapeutic tools to identified hormone dependent cancers in breast with very
      encorageous results in 7 cases of human cancer. The method was simple and safe
      and similar methods for scanning of prostate tumors dependent are in current
      research in our laboratory and will be object of other communications.

PMID- 8486314
TI  - [Index of cells obtainable from semen: indicator of fertility?].
AB  - It has been recognized that semen analysis is not a sensible nor a specific tool
      for detecting infertility in the male. Its predictive value is limited by the
      subjectivity of manual analysis, a high variability of semen parameters in
      fertile men and lack of correlation between sperm characteristics and fertility
      indexes. In this paper we present evidence supporting the concept that
      calculating an index of potentially fertile cells from data obtained in a regular
      semen analysis might be useful for predicting fertility in the male.

PMID- 8486315
TI  - [Obtaining zona-free ova from the golden hamster (Mesocricetus auratus
      Waterhouse)].
AB  - Our methodology for obtaining zona-free ova from golden hamster females
      (Mesocricetus Auratus Waterhouse) is described here. Five groups of 5 females
      were superovulated injecting intraperitoneally pregnant mare gonadothropins (PMG)
      at different dosages. The control group received 0.25 ml of distilled water. We
      harvested 653 ova from the stimulated females with an average of 32.65 per
      individual (range 16-52). The control group produced a total of 50 ova with an
      average of 10 (range 0-14). PMG optimum dose was 25 IU with an average of 39
      (S.D. +/- 10.93) (n = 195 ova). The best conditions for denuding the cumulus was
      a 0.01% hyaluronidase solution with an average time of 10 minutes (S.D. +/-
      03'56"). The optimum conditions for digesting the zona was 0.20% trypsin during
      03'20" (S.D. +/- 01'19"). The proof that the ova were not damaged by the
      procedure was by means of a supravital stain (Eosin Y). All mature ova (N = 681)
      were not affected by enzymes or manipulation. Final preparation used a 1% acetic
      acid fixation and staining with 0.01% methylene blue, both acting for 1-3
      minutes. Animal gametes give us the opportunity to substitute human ova in
      biology of reproduction studies and experiments, avoiding technical, ethical and
      moral problems.

PMID- 8486317
TI  - [Proceedings of the regional meetings of the Italian Society of Hematology].

PMID- 8486316
TI  - [Attitudes and behavior for reproductive health].
AB  - Educational interventions represent an alternative for the reproductive well
      being. The objective of this investigation was to identify in a mexican
      community, attitudes and behaviors related to reproductive health, with the goal
      of implementing a specific health education program. The study population
      consisted of women between 12 and 44 years old, living in non-residential areas
      of the Delegation Miguel Hidalgo, D.F. Variables of interest were analyzed only
      in women with parity (n = 300). Data were collected through interview. The mean
      age was 31 +/- 8 years. 93.3% were married or in consensual union. 63% had
      elementary, junior high or prevocational studies. 89% answered that would visit
      the doctor before considering a pregnancy (junior high+, p < .05), 99% would seek
      prenatal care if they were pregnant, and 92.7% would have a hospital delivery
      (parity < or = 3, p < .003). 69.5% had a preconceptional visit before their last
      pregnancy and 89.9% received prenatal care (junior high+, p < .008). 92.5% had
      only hospital deliveries (< or = 30 years, p < .05, junior high+, p < .0001,
      primigravida p < .002, with institutionalized medical services, p < .001), 1.7%
      had only out-of-hospital deliveries, and 5.8% both. Agreement between attitudes
      and behaviors are presented. An educational program consisting of confirmation
      and support to positive attitudes, values and beliefs, and reinforcement to
      decision making, will result in a final behavior: early assistance to medical
      care.

PMID- 8486318
TI  - [Isolation, configuration and contractile responses of single smooth muscle
      cells].
AB  - In studies on the intrinsic contraction mechanisms of smooth muscle, various
      factors such as cell-to-cell interaction, penetration of chemicals to the trigger
      regions, or extracellular spaces in the tissue may influence the results. The use
      of single smooth muscle cells in such investigations may help to eliminate these
      factors. Single smooth muscle cells can be isolated from guinea pig taenia coli
      by digesting the minced tissue with a combination of collagenase and soybean
      trypsin inhibitor. The cells are spindle shaped, 100-200 microns in length and 10
      microns in diameter. Three kinds of techniques for determination of contractile
      responses of single smooth muscle cells have been established: 1) fixation
      method, 2) perfusion method, and 3) capillary adhesion method. Using these
      techniques, the cells appeared to be contracted in a dose-dependent manner
      (graded response), while another mode of the contractile response, the "all-or
      none response", has also been proposed. Scanning and transmission electron
      micrographs of the single cells revealed several evaginations of various sizes
      and shapes on the surface and electron dense bodies at the neck of the
      evaginations. ED50 obtained with the single cells, prepared from taenia coli of
      guinea pigs with collagenase in the presence of trypsin inhibitor was similar to
      that obtained with the intact tissue. Digestion of the tissue with highly
      purified collagenase and papain yields a large number of single cells with higher
      sensitivity to agonists. Characteristics of cells isolated from ileal
      longitudinal muscle of guinea pig are similar to those of cells isolated from
      taenia coli. The magnitude of contraction and sensitivity to acetylcholine were
      different in each cell. Incubation of isolated tissues with various
      concentrations of agonists followed by measurement of cell length in the tissue
      showed that the heterogeneous responses of the cells were intrinsic
      characteristics of smooth muscle cells and not due to damage incurred during the
      isolation procedure. Since isolated smooth muscle cells possess contractility,
      these might preserve the characteristics of smooth muscle, so they can be used
      for smooth muscle research. It must be considered, however, that each cell in the
      smooth muscle tissue has different contractility.

PMID- 8486319
TI  - [All-or-none response of isolated smooth muscle cells from guinea pig taenia
      caecum to acetylcholine].
AB  - Most isolated smooth muscle cells from guinea pig taenia caecum responded
      repeatedly, showing an all-or-none response to acetylcholine (ACh). However, the
      average responses of all the cells were graded owing to the difference in the
      threshold concentration of ACh, like that of whole tissue. The sensitivity of the
      muscarinic receptor on individual cells was the same as that of whole tissue and
      ACh bound to the receptor concentration-dependently. The shortening of the cells
      in response to ACh depended upon the influx of extracellular Ca2+ through the Ca
      channel. 45Ca2+ influx stimulated by ACh was very sharp and highly correlated
      with the shortening of the cells. The shortening of alpha-toxin-permeabilized
      smooth muscle cells was induced by increasing free Ca2+. The concentration
      response relationship to free Ca2+ had a very steep slope, and the shortening
      appeared to be an all-or-none response rather than a graded response. In
      conclusion, it is suggested that isolated smooth muscle cells show an all-or-none
      response as a result of a slight increase in the intracellular free Ca2+ level
      over the threshold concentration when early signalling coupled to ACh-receptor
      stimulation reaches the threshold to evoke Ca2+ influx and Ca2+ release.

PMID- 8486320
TI  - [Ca2+ release mechanism studied in single isolated smooth muscle cells].
AB  - This paper briefly reviews our current effort to study the Ca2+ mobilization
      mechanism in enzymatically dispersed single smooth muscle cells. Each single cell
      obtained from guinea pig taenia caeci possesses two types of Ca2+ stores, one (S
      alpha) with both Ca(2+)-induced and IP3-induced Ca2+ release mechanisms and the
      other (S beta) with only IP3-induced Ca2+ release mechanism. After depletion of S
      alpha either with ryanodine treatment or with caffeine pretreatment, carbachol
      failed to induce Ca2+ release, while intracellular application of IP3 did induce
      Ca2+ release. Our results suggest that the difference between the agonist- and
      IP3-induced responses can be resolved by obligatory involvement of positive
      feedback control of IP3-induced Ca2+ release in the agonist-induced Ca2+ release.
      Furthermore, we were able to demonstrate that the dose-response relation in
      single cells shows an all-or-none feature, which seems at least partly due to the
      feedback control of Ca2+ release. We discuss the reasons why graded dose-response
      relation is obtained in bundles of smooth muscles, while the response of single
      cells is an all-or-none type.

PMID- 8486321
TI  - [Pharmacological studies on antidiarrheal effects of a preparation containing
      berberine and geranii herba].
AB  - We studied the effects of a preparation containing Berberine and Geranii Herba
      (BGH) on different diarrheal models of mice and the contractions of isolated
      guinea pig intestinal smooth muscle, comparing these effects with those of a
      preparation containing creosote (CSG) and loperamide (LP). BGH, as well as CSG
      and LP, significantly inhibited the diarrhea induced by castor oil or BaCl2, but
      not the diarrhea induced by pilocarpine or serotonin. BGH inhibited ACh-, Ba(2+)-
      or electrical stimulation (ES)-induced contraction of the ileum or colon at
      concentrations from 10(-6) to 10(-4) g/ml. On the other hand, the inhibitory
      effect of CSG on the ES-induced contraction was about one hundred times stronger
      than that on ACh- or Ba(2+)-induced contraction. The order of the inhibitory
      potency of LP on contractions of the ileum in this test was ES > Ba2+ > ACh, and
      LP showed stronger inhibition against the contraction of the ileum than that of
      the colon. These results suggest that BGH exerts its antidiarrheal action by
      inhibiting intestinal movement, and the mechanism of action of BGH may differ
      from those of CSG or LP.

PMID- 8486322
TI  - [Effects of NC-1100, a calcium channel blocker, on experimental cerebral
      ischemia/anoxia in rodents].
AB  - The anti-ischemic and anoxic effects of NC-1100, a piperazine type calcium
      channel blocker, were investigated in various cerebral ischemia and anoxia models
      in mice, gerbils and guinea pigs. Minimal effective doses of NC-1100 were 8
      mg/kg, i.p. and 30 mg/kg, p.o. for KCN-induced anoxia; 16 mg/kg, i.p. for
      decapitation-induced gasping; 30 mg/kg, i.p. for cerebral ischemia induced by
      occlusion of bilateral carotid arteries in gerbils; and 10 microM for the in
      vitro ischemic model in hippocampal slices. Moreover, NC-1100 attenuated the
      disturbance of cerebral energy metabolism induced by decapitation in mice. These
      results suggest that NC-1100 has a cerebral protective effect, and that
      attributable to its ability to improve the cerebral energy metabolism
      disturbance.

PMID- 8486323
TI  - [The role of the central monoaminergic nervous system relative to mechanisms of
      stress adaptation].
AB  - The difference of amine dynamics in central noradrenergic, dopaminergic and
      serotonergic systems of adaptive or non-adaptive rats to repeated restraint
      stress was investigated neurochemically. A single immobilization induced stress
      responses, such as reductions in growth rate, food intake, water intake and
      locomotor activity, and an increase in pain threshold. These responses
      disappeared after repeated immobilization 1 or 2 hr daily for 7 days, but not
      after 4 hr daily for 7 days. These results suggest that stress adaptation models
      should include the parameter of repeated exposure to restraint stress 1 or 2 hr
      daily for 7 days. In the frontal cortex, midbrain-thalamus, striatum,
      hypothalamus, medulla-pons, cerebellum, cervical cord, thoracic cord and lumbar
      cord of models with adaptability to repeated restraint stress, a marked increase
      in serotonin (5-HT) turnover was observed. This neurochemical change was seen in
      the hypothalamus and lumbar cord of non-adaptive models, but not in the other
      brain and spinal cord regions. Also, an increase in norepinephrine (NE) turnover
      in spinal cord regions was observed in adaptive models, but NE turnover was
      decreased in the frontal cortex, striatum or cervical cord of non-adaptive
      models. These findings suggest that enhancement of central 5-HT turnover and NE
      turnover in the spinal cord contribute to the formation of adaptation to repeated
      restraint stress.

PMID- 8486324
TI  - [Liver transplantation as a routine procedure? Indications and results in 270
      patients].
AB  - AIM: To represent the current state of the art of orthotopic liver
      transplantation (OLT). The constantly expanding spectrum of indications are
      discussed in detail, and the specific risks of the individual indications
      considered. Major points discussed: On the basis of the authors' own results
      obtained at the Rudolf Virchow Hospital, University of Berlin, the current
      survival rates following orthotopic liver transplantation are shown. In addition
      to established indications for liver transplantation (primary biliary cirrhosis,
      primary sclerosing cholangitis, acute hepatic failure, various metabolic
      diseases, small hepatocellular carcinomas and a number of posthepatic cirrhoses)
      the indication and results of liver transplantation in HbsAg-positive and
      alcoholic cirrhosis are presented in detail. In contrast to reports in the Anglo
      American literature, the incidence and severity of graft re-infections with the
      hepatitis virus was appreciably reduced through the use of anti-HBs
      hyperimmunoglobulin preparations in HBsAg-positive cirrhotics. The results
      obtained were comparable with those achieved for other indications.

PMID- 8486325
TI  - [Cytokine activity. On key substances of intercellular signal transduction].

PMID- 8486326
TI  - [Rational therapeutic strategies in onychomycoses. When topical, when systemic
      treatment?].

PMID- 8486327
TI  - [New guidelines for fracture treatment. Part 9: Ambulatory after-care--follow-up,
      complications].

PMID- 8486328
TI  - [Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a
      placebo controlled double-blind study].
AB  - BASIC REMARKS: Among travellers to distant countries with a low socioeconomic
      status and poor hygiene, traveller's diarrhea is a major problem. Once this
      epidemiological fact had been recognized, intensive efforts were made to reduce
      the incidence of this illness by prophylactic medication. Among non-antibiotic
      substances investigated, Saccharomyces boulardii (SB) appeared to show promising
      results in earlier studies. METHOD: In a placebo-controlled, double-blind study,
      various dosages (250 mg and 1,000 mg SB) were administered prophylactically to
      3,000 Austrian travellers to distant regions. RESULTS: A significant reduction in
      the incidence of diarrhea was observed, with success depending directly on the
      rigorous use of the preparation. A tendency was noted for SB to have a varying
      regional effect, which was particularly marked in North Africa and in the Near
      east (Turkey!); in addition, the effect also proved to be dose-dependent. The
      medication can be classified as low on side effects.

PMID- 8486329
TI  - A microcomputer program to determine the precision of elimination rate constant
      and half-life estimates when sampling time is short.
AB  - First-order elimination of drugs is often assumed in pharmacokinetics and
      elimination rate constant is then frequently determined by log-linear regression
      analysis from plasma concentration measurements. When the time which elapses
      between the first and the last plasma sample is short compared to the decay half
      life, the elimination rate constant may not be determined with satisfactory
      precision, in particular because of analytical error. Application of basic
      principles of linear regression analysis allowed us to quantify the theoretical
      effect of analytical error on the determination of the drug elimination rate
      constant in that situation. It was highlighted that the precision of that
      determination could be efficiently improved by measuring samples in replicate,
      which should be recommended in practice. A user-friendly program was developed
      which can be used prospectively to optimize sampling strategy, and
      retrospectively to estimate the precision of parameter estimates. The program
      works on IBM PC and compatible microcomputers and is available on request.

PMID- 8486330
TI  - Neurotensin modulates differently potassium, veratridine and 4-aminopyridine
      evoked release of dopamine in rat striatal slices.
AB  - We have studied the effects of neurotensin (NT) on the release of [3H]dopamine
      ([3H]DA) evoked by terminal depolarization with either K+, veratridine or 4
      aminopyridine (4-AP). NT (1-1000 nM) induced a net potentiation (up to 170%) of
      the K+ (25 mM)-evoked release of [3H]DA. The capacity of NT to potentiate the
      effect of K+ ions decreased as the K+ concentration rose from 25 to 50 mM and
      totally disappeared at this high K+ concentration. NT (100 nM; 1,000 nM) had no
      significant effect on the veratridine (1.5; 5 microM) or 4-AP (20 microM) -evoked
      release of [3H]DA. The relevance of these experimental models of DA release to
      physiological transmitter release remains to be established. Those data highlight
      the complexity of the modulation of evoked neurotransmitter release by
      pharmacological agents.

PMID- 8486331
TI  - Transient left bundle branch block following intravenous lisuride bolus.

PMID- 8486332
TI  - Identification of the human and animal hepatic cytochromes P450 involved in
      clonazepam metabolism.
AB  - This report characterizes the cytochrome P450 isozyme involved in clonazepam
      metabolism. This study was undertaken using a library of liver microsomal
      fractions prepared from untreated rabbits or those treated with drugs known to
      specifically induce various cytochrome P450 isozymes (ie P450 2B4 by
      phenobarbital, P450 1A1 and P450 1A2 by 3-methylcholanthrene and beta
      naphthoflavone, P450 2E1 by acetone and ethyl alcohol, and P450 3A6 by
      erythromycin). Only microsomes obtained from phenobarbital-treated rabbits
      exhibited a type II binding spectrum upon addition of clonazepam (Ks(app) = 31.4
      +/- 3.8 microM) and significantly metabolized clonazepam to 7-aminoclonazepam.
      Benzphetamine, which is a known substrate for P450 2B1 was also extensively
      metabolized by microsomes prepared from phenobarbital treated rabbits. This
      indicates that the same isozyme (P450 2B subfamily) was involved in the
      biotransformation of both substrates. Experiments performed on 14 human liver
      microsomal preparations showed a wide interindividual variability (from 1-4) and
      a good correlation (r = 0.70) between benzphetamine and clonazepam metabolism.
      Since P450 3A4 (nf25) was involved in benzphetamine metabolism, clonazepam was
      probably nitroreduced by the same isozyme. An oligonucleotide specific for the
      P450 3A4 gene subfamily was synthetized and used for hybridization on total RNA
      from human liver samples. Two transcripts of 2.2 and 3.0 kb were detected and the
      level of the 2.2 kb mRNA expression was significantly correlated (r = 0.61) with
      the intensity of clonazepam nitroreduction by the corresponding microsome
      batches.

PMID- 8486333
TI  - Comparative evaluation of ulcer prevention efficacy of orally, rectally and
      sublingually administered omeprazole in three acute gastric ulcer models in rats.
AB  - Ulcer prevention efficacy of orally, rectally and sublingually administered
      omeprazole was evaluated and compared using ulcer index and percentage inhibition
      of ulcerogenicity in three different acute gastric ulcer models viz,
      indomethacin, 0.6N HCl and aspirin (after pylorus ligation) induced ulcers in
      rats. The ulcer prevention efficacy after oral, rectal and sublingual
      administration were statistically significant (P < 0.01) in all the models. The
      differences in ulcer index and percentage inhibition of ulcerogenicity for rectal
      and sublingual administration were insignificant (P < 0.05) in indomethacin and
      HCl induced ulcers and were significant (P < 0.05) in aspirin induced ulcers. The
      ulcer prevention activity was significantly higher (P < 0.05) after rectal and
      sublingual routes when compared to oral administration in all three models
      evaluated. Results revealed a faster onset and higher extent of pharmacodynamic
      activity of omeprazole after rectal and sublingual administration.

PMID- 8486334
TI  - Effects of capsaicin on the endothelial permeability in isolated and perfused
      rabbit lungs.
AB  - Changes in pulmonary endothelial permeability and in microvascular hemodynamics
      in response to capsaicin (10(-4) M) were investigated in isolated, perfused
      rabbit lungs. Blood-free perfusate was recirculated through ventilated lungs in
      an isogravimetric state, under zone III conditions with a constant flow. Using
      the occlusions method, the total pressure gradient between the arterial and the
      venous levels (delta Pt) was partitioned into four components: arterial (delta
      Pa), pre-(delta Pa') and post-(delta Pv') capillary, and venous (delta Pv). The
      capillary filtration coefficient (Kf,c) was evaluated by measuring the amount of
      fluid filtering through the endothelium when arterial and venous pressures were
      suddenly increased. Capsaicin caused no changes in the vascular pressures at any
      level of the pulmonary circulation but induced a significant 3-fold increase in
      the Kf,c (P < 0.05). This reaction was accompanied by pulmonary oedema. The
      mechanisms involved in the permeability changes were investigated by testing the
      capacity of different drugs to block the response to capsaicin. Clonidine (10(-7)
      M to 10(-5) M), morphine (10(-6) M), aspirin (10(-3) M), ketanserin (10(-8) M)
      and (+/)- CP 96,345 (10(-6) M), an antagonist of neurokinin NK1 receptor,
      completely prevented the effects of capsaicin on the Kf,c. In contrast,
      terfenadine (10(-7)) together with cimetidine (10(-5) M) had no protective effect
      against capsaicin. It was concluded that capsaicin-induced pulmonary oedema was
      due to an increase in the capillary filtration coefficient and not to hemodynamic
      changes. This alteration in the endothelium permeability is mediated by the
      release of endogenous peptides from C-fibers upon the action of capsaicin and
      subsequent activation of NK1 receptors, probably by substance P. Moreover, 5
      hydroxytryptamine receptors and arachidonic acid derivates are also involved in
      this reaction.

PMID- 8486335
TI  - International Meeting on the Therapy of Hematological Malignancies in the
      Elderly. Proceedings. Turin, 15-16 April 1993.

PMID- 8486336
TI  - Aggressive chemotherapy of ALL in elderly patients.

PMID- 8486337
TI  - Prognostic factors in myelodysplastic syndromes.

PMID- 8486338
TI  - Recent advances in the management of myelodysplastic syndromes.

PMID- 8486339
TI  - When and how to treat elderly patients with chronic lymphocytic leukemia
      (C.L.L.)? The French Cooperative Group on C.L.L.

PMID- 8486340
TI  - The management of elderly patients with myeloproliferative disorders.

PMID- 8486341
TI  - Is intensive treatment beneficial to elderly patients with ANLL?

PMID- 8486342
TI  - The Italian experience in the treatment of HCL. Italian Cooperative Group for
      HCL.

PMID- 8486343
TI  - The treatment of low grade non-Hodgkin's lymphoma in elderly people.

PMID- 8486344
TI  - Multiple myeloma: a tailored therapy for elderly patients.

PMID- 8486345
TI  - Hodgkin's disease of the elderly. A different disease?

PMID- 8486346
TI  - Evolution of the vertebrate genome as reflected in paralogous chromosomal regions
      in man and the house mouse.
AB  - Gene constellations on several human chromosomes are interpreted as indications
      of large regional duplications that took place during evolution of the vertebrate
      genome. Four groups of paralogous chromosomal regions in man and the house mouse
      are suggested and are believed to be conserved remnants of the two or three
      rounds of tetraploidization that are likely to have occurred during evolution of
      the vertebrates. The phenomenon of differential silencing of genes is described.
      The importance of conservation of linkage of particular genes is discussed in
      relation to genetic regulation and cell differentiation.

PMID- 8486347
TI  - A chromosome 13-specific human satellite I DNA subfamily with minor presence on
      chromosome 21: further studies on Robertsonian translocations.
AB  - We describe a new human satellite I DNA subfamily (pTRI-6) which is composed of
      72 copies of monomeric repeating units of 42 basepairs (bp). These repeating
      units are tandemly organized into a higher order structure of 2.97 kilobases
      (kb). Sequencing of this DNA revealed base substitutions, deletions and
      insertions, and an overall conservation of 85% among the monomers. The sequence
      has a high AT content of 77%. Under low-stringency in situ hybridization
      conditions, satellite I is found on the pericentric regions of chromosomes 3 and
      4 and on all the acrocentric chromosomes. On the acrocentric chromosomes,
      satellite I is further detected on the distal p13 region. Analysis of somatic
      cell hybrids under high stringency indicates the presence of the pTRI-6 subfamily
      predominantly on chromosome 13. Chromosome 21 shows a 50- to 100-fold reduced
      amount of this subfamily and the presence of other sequences closely related to
      pTRI-6. Investigation of a group of 11 human t(14q21q) Robertsonian
      translocations revealed the retention of satellite I DNA around the breakpoints
      in all cases. These results extend our understanding of these translocations and
      of the general structural organization of the cen-pter regions of the acrocentric
      chromosomes.

PMID- 8486348
TI  - Organization of the human CD9 gene.
AB  - The CD9 antigen was originally described as a 24-kDa molecule present on B
      lineage-derived acute lymphoblastic leukemia cells and developing B lymphocytes.
      Platelets also express a large amount of CD9 antigen and can be activated by CD9
      antibodies. We report here the structure of the CD9 gene, which is composed of 8
      exons spanning more than 20 kb. There is no TATA or CAAT box in the 5'-flanking
      domain of the CD9 gene, but a 120-bp region extremely rich in C and G (88%)
      contains several Sp 1 binding sites and a consensus site for the binding of zinc
      finger proteins of the Krox/EGR family. The CD9 antigen belongs to a new cell
      surface protein family. The organization of its gene closely resembles the
      organization of the genes for two other members of this protein family, TAPA1 and
      CD63, which share with CD9 respectively 45 and 25% identity at the amino acid
      level.

PMID- 8486349
TI  - A B2 repeat insertion generates alternate structures of the mouse muscle gamma
      phosphorylase kinase gene.
AB  - A variety of cDNA and genomic clones for the gamma-subunit of mouse muscle
      phosphorylase kinase (Phk-gamma M) have been isolated and characterized. The
      murine gene for Phk-gamma M (Phkg) exhibits multiple transcription start sites
      that are identical in skeletal muscle, cardiac muscle, and brain. The gene is
      composed of 10 exons and includes a 4.9-kb intron located in the 5' untranslated
      region. Two mRNA species of 1.75 and 2.55 kb are produced from Phkg in ICR and
      C57BL/10 mice; these transcripts are colinear throughout the coding region and
      differ only in the length of the 3' untranslated region. We have mapped the
      polyadenylation site of the 1.75-kb mRNA to the middle of exon 10; the 2.55-kb
      mRNA terminates further 3' at the end of a mouse B2 repeat. In Balb/C mice an
      additional B2 insertion and related genomic rearrangements alter the sequence of
      Phkg exon 10 and are accompanied by an increase in the quantity of the 1.75-kb
      transcript and a decrease in the abundance and size of the longer transcript,
      from 2.55 to 2.35 kb. A PCR assay for sequences contained in exon 10 reveals that
      the Balb/C 3' gene structure is shared by Mus musculus castaneus and Mus musculus
      molossinus; the C57BL/10 gene structure is shared by Mus spretus, Mus domesticus,
      and several strains of laboratory mice. These results suggest that Phkg in Balb/C
      mice was derived from M. m. molossinus and that Phkg of the other examined
      laboratory strains was derived from M. domesticus.

PMID- 8486350
TI  - The human glutamate dehydrogenase gene family: gene organization and structural
      characterization.
AB  - Glutamate dehydrogenase is a mitochondrially located, key metabolic enzyme. In
      addition to its general metabolic role, GLUD is important in neurotransmission.
      Significant alterations in GLUD enzymatic activity have been associated with
      certain neurodegenerative human disorders. Although a single species of human
      GLUD cDNA molecule has been identified so far, both genomic DNA Southern and
      cytogenetic analyses have indicated the presence of a GLUD gene family. Screening
      of a human genomic lambda-phage library with the GLUD cDNA, led us to the
      isolation of several clones divided into five structurally distinct contigs. We
      have confirmed the presence of all GLUD-specific sequences in the human genome by
      detailed genomic Southern analysis. This study allowed the identification of the
      entire functional GLUD gene, named GLUD1. The GLUD1 gene is about 45 kb long and
      it is organized into 13 exons. Its nucleotide sequence, exon-intron boundaries,
      and transcription start sites were determined. Potential binding sites for
      various regulatory factors such as Sp1, AP-1, and AP-2 were recognized at the
      promoter region of the gene. The members of the other contigs showed an
      organization clearly different from GLUD1. Two distinct GLUD-specific gene loci,
      termed GLUDP2 and GLUDP3, possibly represent truncated pseudogenes. Their high
      degree of similarity to GLUD1 is limited to the region surrounding exons 2, 3,
      and 4. Finally, two additional GLUD-specific genomic sequences, termed GLUDP4 and
      GLUDP5, are structurally similar with the 3' part of the GLUD cDNA sequence.
      These loci probably represent truncated GLUD pseudogenes generated by
      retrotransposition. The data presented here suggest that all human GLUD
      pseudogenes have diverged recently in evolution.

PMID- 8486351
TI  - The short 3'-end region of complementary DNAs as PCR-based polymorphic markers
      for an expression map of the mouse genome.
AB  - Ideal markers for a complementary DNA (cDNA) map of the mouse genome should be
      amplifiable by the polymerase chain reaction (PCR) and they should be polymorphic
      for genetic mapping, as well as unique for physical mapping. In our search for
      such markers, we did comparative sequencing of PCR-amplified genomic DNAs derived
      from 15 inbred strains and found that about 250 bp of the 3'-end region (3'-ER)
      of cDNAs, which is the sequence immediately upstream from the poly(A) tail, was
      polymorphic enough to distinguish the allele of a laboratory strain from that of
      a wild strain (Mus spretus) in 14 of 22 cDNAs tested. Specifically, in 9 of these
      14 cDNAs, each allele was identified by the restriction fragment length
      polymorphism. This data indicates that about 65% of the 3'-ERs of cDNAs can be
      automatically transformed into PCR-based genetic markers named "biallelic
      polymorphic expressed sequence tags (bESTs)." These markers can be easily and
      precisely mapped by typing of the panels of interspecific backcrosses. Because a
      large number of bEST markers can be efficiently obtained by a single-run
      automated sequencing of randomly selected cDNAs, these markers will greatly
      facilitate the construction of high-resolution genetic and physical maps of
      expressed sequences of the mouse genome.

PMID- 8486352
TI  - Microdissection and microcloning of genomic DNA markers from human chromosomal
      region 11q23.
AB  - A human genomic DNA library was constructed by using a microdissection
      microcloning procedure with polymerase chain reaction (PCR) techniques on DNA
      from the chromosome 11q23 region. A total of 450 recombinant pUC clones were
      isolated from the library. Their insert sizes ranged from 150 to 850 bp with a
      mean of 320 bp. Fifty pUC clones were randomly selected and analyzed in detail.
      Southern blot analyses showed that 21 (42%) clones were unique DNA sequences, 20
      (40%) clones were repetitive sequences, and 9 (18%) clones had no detectable
      hybridization. The unique sequences were used further in a secondary screening of
      a partially digested human genomic DNA library constructed in phage vector, and 4
      clones were isolated. The chromosomal locations of these phage clones were
      confirmed to be in the q23 region of chromosome 11 by fluorescence in situ
      suppression hybridization. These pUC microclones isolated from the chromosomal
      region-specific genomic DNA library will be useful in the construction of
      physical contig maps with yeast artificial chromosome and/or cosmid clones and in
      the positional cloning of disease-associated genes localized to the q23 region of
      chromosome 11.

PMID- 8486353
TI  - Fluorescence in situ hybridization mapping of 25 markers on distal human
      chromosome 2q surrounding the human Waardenburg syndrome, type I (WS1) locus
      (PAX3 gene).
AB  - A total of 25 DNA markers located on the long arm of human chromosome 2 have been
      mapped by fluorescence in situ hybridization. This region includes the locus for
      Waardenburg syndrome, type I (WS1), recently found to result, at least in some
      cases, from mutations of the PAX3 gene. We have established that the chromosomal
      location of the PAX3 gene is within band 2q36. We also show that three markers in
      the distal 2q region, including the PAX3 gene, are deleted in a patient with
      phenotypic features of WS1 associated with a de novo deletion (2)(q35q36.2). The
      improved physical map of this region should facilitate linkage mapping and
      positional cloning of loci on distal 2q.

PMID- 8486354
TI  - Highly informative typing of the human TNF locus using six adjacent polymorphic
      markers.
AB  - The human tumor necrosis factor locus (TNF locus) is located within the major
      histocompatibility complex between the class III genes and HLA-B. We recently
      characterized and studied two closely linked highly informative dinucleotide
      repeats (AC/GT)n (designated TNFa) and (TC/GA)k (designated TNFb) in the upstream
      region of the human TNF-beta (lymphotoxin) gene. We also characterized two linked
      (TC/GA) and (TC/GA)-like repeats located downstream of the TNF-alpha gene,
      designated TNFe and TNFd, respectively. Here, we combine these four markers
      together with a biallelic TC/GA repeat in the first intron of the TNF-beta gene
      (TNFc) and a biallelic NcoI RFLP (TNFn) to type 105 cell lines from the American
      Society of Histocompatibility and Immunogenetics Workshop and the Center for
      Human Polymorphism Studies reference panels of HLA typing cell lines. These 6
      polymorphic markers define 35 distinct TNF haplotypes and together with the
      reference panel can be used for disease association and population genetics
      studies.

PMID- 8486355
TI  - Isolation and chromosomal mapping of the human immunoglobulin-associated B29 gene
      (IGB).
AB  - The B29 gene encodes a B-cell-specific membrane protein in the immunoglobulin
      antigen receptor complex. B29 is a crucial member of this receptor complex and is
      believed to function as an effector of signal transduction in a manner analogous
      to that of the CD3 components of the T cell antigen receptor. We have isolated a
      full-length human B29 cDNA clone by using a murine B29 cDNA probe. We show that
      there is an extremely high degree of evolutionary conservation between the human
      and mouse proteins, particularly in the transmembrane and intracytoplasmic
      regions, where the identity is 96%. In addition, the intracytoplasmic region in
      both proteins contains an identical peptide motif that is present in a number of
      molecules involved in lymphocyte activation. Genomic Southern blot analysis of
      human cell lines hybridized with both murine and human B29 cDNAs gives patterns
      consistent with a single-copy gene occupying a small region of the genomic
      sequence. Using human B29 cosmid DNA, we have localized the B29 gene to human
      chromosome 17q23 via fluorescence in situ hybridization. B29 is the first gene
      localized to this area of the genome. Interestingly, a subset of human B cell
      chronic lymphocytic leukemias (CLL) has translocations in this locus on
      chromosome 17.

PMID- 8486356
TI  - Chromosomal localization of five murine HSP70 gene family members: Hsp70-1, Hsp70
      2, Hsp70-3, Hsc70t, and Grp78.
AB  - The 70,000-D heat shock protein (HSP70) gene family includes both heat-inducible
      and constitutively expressed genes. We have mapped five murine HSP70 genes to
      specific sites on three separate chromosomes. Southern blot analysis of Chinese
      hamster x mouse somatic cell DNAs was used to assign the gene for the 78,000-D
      glucose-regulated protein (Grp78) to Chromosome (Chr) 2, the male germ cell
      specific Hsp70-2 and Hsc70t genes to Chr 12 and Chr 17, respectively, and the
      heat-inducible Hsp70-3 gene also to Chr 17. Southern blot analysis of DNA from
      the progeny of two multilocus crosses confirmed the Grp78 location on Chr 2 and
      suggested the order: centromere-Vim-Abl-Grp78-Hc. Similar analysis also confirmed
      the initial Hsp70-2 assignment to Chr 12 with the order: Hsp70-2-Aat-Igh. The
      Hsp70-3 and Hsc70t genes on Chr 17, along with the heat-inducible Hsp70-1 gene,
      were further localized by Southern blot analysis of genomic clones to the H-2
      histocompatibility region with the order: Hsp70-1-Hsp70-3-Hsc70t-Bat-6 (human
      G7a, valyl-tRNA synthetase).

PMID- 8486357
TI  - Molecular cloning, cDNA sequence, and chromosomal assignment of the human radixin
      gene and two dispersed pseudogenes.
AB  - Radixin is a cytoskeletal protein that may be important in linking actin to the
      plasma membrane. Recent cloning of the murine and porcine radixin cDNAs revealed
      a protein highly homologous to ezrin and moesin. We have cloned and sequenced the
      human radixin cDNA and found the predicted amino acid sequence for the human
      protein to be nearly identical to those predicted for radixin in the two other
      species. By Southern analyses of Chinese hamster x human somatic cell hybrid DNA
      and of PCR products derived from hybrids, the coding gene (RDX) was mapped to
      11q. Fluorescence chromosomal in situ hybridization with a cDNA plasmid further
      localized this gene to band 11q23. However, PCR amplification with "radixin
      specific" primers on the hybrid DNA panel yielded an additional, very similar DNA
      sequence that was further characterized by direct sequencing of PCR products.
      This sequence represents a truncated version and the respective locus (RDXP2) was
      assigned to Xp21.3. Furthermore, by employing a different set of primers, a third
      sequence was found that was 90% identical to the radixin sequence but contained
      termination codons and seemed to lack introns. This pseudogene (RDXP1) was mapped
      to 11p by Southern and PCR analyses.

PMID- 8486358
TI  - Severe hemophilia A in a female by cryptic translocation: order and orientation
      of factor VIII within Xq28.
AB  - We report studies of a female with severe hemophilia A resulting from a complex
      de novo translocation of chromosomes X and 17 (46,X,t(X;17)). Somatic cell
      hybrids containing the normal X, the der(X), or the der(17) were analyzed for
      coagulation factor VIII (F8C) sequences using Southern blots and polymerase chain
      reaction. The normal X, always late replicating, contains a normal F8C gene,
      whereas the der(X) has no F8C sequences. The der(17) chromosome containing Xq24
      Xq28 carries a functional G6PD locus and a deleted F8C allele that lacks exons 1
      15. Also, it lacks the DXYS64-X locus, situated between the F8C locus and the Xq
      telomere. These results indicate that a cryptic breakpoint within Xq28 deleted
      the 5' end of F8C, but left the more proximal G6PD locus intact on the der(17)
      chromosome. As the deleted segment includes the 5' half of F8C as well as the
      subtelomeric DXYS64 locus, F8C must be oriented on the chromosome with its 5'
      region closest to the telomere. Therefore, the order of these loci is Xcen-G6PD
      3'F8C-5'F8C-DXYS64-Xqtel. The analysis of somatic cell hybrids has elucidated the
      true nature of the F8C mutation in the proband, revealing a more complex
      rearrangement (three chromosomes involved) than that expected from cytogenetic
      analysis, chromosome painting, and Southern blots. A 900-kb segment within Xq28
      has been translocated to another autosome. Hemophilia A in this heterozygous
      female is due to the decapitation of the F8C gene on the der(17) and inactivation
      of the intact allele on the normal X.

PMID- 8486359
TI  - Identification and characterization of dinucleotide repeat (CA)n markers for
      genetic mapping in dog.
AB  - A large block of simple sequence repeat (SSR) polymorphisms for the dog genome
      has been isolated and characterized. Screening of primary libraries by
      conventional hybridization methods as well as by screening of enriched marker
      selected libraries led to the isolation of a large number of genomic clones that
      contained (CA)n repeats. The sequences of 101 clones showed that the size and
      complexity of (CA)n repeats in the dog genome were similar to those reported for
      these markers in the human genome. Detailed analysis of a representative subset
      of these markers revealed that most markers were moderately to highly
      polymorphic, with PIC values exceeding 0.70 for 33% of the markers tested. An
      association between higher PIC values and markers containing longer (CA)n repeats
      was observed in these studies, as previously noted for similar markers in the
      human genome. A list of primer sequences that tag each characterized marker is
      provided, and a comprehensive system of nomenclature for the dog genome is
      suggested.

PMID- 8486360
TI  - Construction and evaluation of a hncDNA library of human 12p transcribed
      sequences derived from a somatic cell hybrid.
AB  - An arrayed library of human heterogeneous nuclear complementary (hnc) DNA was
      constructed from a somatic cell hybrid (M28) containing an i(12p) marker as the
      sole human chromosome. Heterogeneous nuclear (hn) RNA of M28 was used to
      synthesize first-strand hncDNA with a primer (RT) containing a random
      hexanucleotide at its 3' end. Specific amplification of human sequences from this
      hncDNA was performed using Alu primers in combination with the RT primer. The
      products were directionally cloned and an arrayed library was constructed.
      Experiments indicated that all clones were derived from transcribed sequences. A
      number of randomly isolated clones were evaluated by Southern and Northern
      experiments, sequence analysis, and PCR. At least 80% of these clones were of
      human 12p origin. The number of independent clones in the library was estimated
      to be approximately 550. Using 60 hncDNA clones as probes, 6 showed positive
      signals on Northern blots. For 3 of these, the corresponding cDNAs were isolated:
      clone CD60A1 codes for the cation-dependent mannose 6-phosphate receptor, clone
      CC6 is a human homologue of the bovine 39-kDa nuclear-encoded NADH:ubiquinone
      oxidoreductase subunit, and CD18 belongs to the family of tumor necrosis factor
      receptor proteins. Southern experiments showed the 3 cDNAs to map to human
      chromosome 12p as expected. Taken together these results show that the generation
      of a hncDNA library is a useful tool for the isolation of unknown genes located
      on a human chromosome (fragment) present in a somatic cell hybrid.

PMID- 8486361
TI  - The genes encoding gonadal and nongonadal forms of 3 beta-hydroxysteroid
      dehydrogenase/delta 5-delta 4 isomerase are closely linked on mouse chromosome 3.
AB  - The biosynthesis of steroid hormones in the gonads and adrenal glands requires
      the activities of the enzyme 3 beta-hydroxysteroid dehydrogenase/isomerase (3
      beta HSD) which catalyzes the NAD(+)-dependent dehydrogenation and subsequent
      delta 5-->delta 4 isomerization of delta 5-3 beta-hydroxysteroids to delta 4-3
      ketosteroids. The mouse expresses four isoforms of 3 beta HSD. 3 beta HSD I is
      expressed in gonads and adrenal glands and appears to be the major steroidogenic
      form, 3 beta HSDs II and III are expressed in both liver and kidneys, and 3 beta
      HSD IV has been detected only in kidneys. To determine the genetic relationship
      between the 3 beta HSD isoforms, we have mapped the chromosomal locations of the
      four genes by linkage analysis using gene-specific probes derived from the 3'
      untranslated regions of 3 beta HSD cDNA clones. The four 3 beta HSD structural
      genes (Hsd3b) are closely linked within a segment of chromosome 3 that is
      conserved on human chromosome 1. The order of markers on Chr 3 surrounding Hsd3b
      is: centromere-Gba-(4.4 +/- 2.2)-Hsd3b-(3.3 +/- 1.9)-Tshb-(6.7 +/- 2.7)-Amy-1.

PMID- 8486362
TI  - Genetic map of the chicken Z chromosome using random amplified polymorphic DNA
      (RAPD) markers.
AB  - Commercially important traits of domestic animals have often been genetically
      linked to sex chromosomes, such as the Z chromosome of chickens. Using a
      backcross mapping population between two divergent, inbred lines and random
      amplified polymorphic DNA (RAPD)-PCR markers, a genetic map of the chicken Z
      chromosome has been generated. Thirteen Z-linked RAPD markers were identified,
      mapped, and linked to two RFLPs and one phenotypic marker. The protocol used also
      generated RAPD markers for the W chromosome. The linkage distances obtained
      suggest that the RAPD markers are widely distributed throughout the Z chromosome
      and are likely to be linked to most or all traits of interest on this chromosome.
      The map provides a preliminary estimate of genetic to physical distance of about
      0.5 Mb per centimorgan for the Z chromosome in chickens (male-specific
      recombination). A similar approach should be applicable to facilitate the mapping
      and analysis of sex-linked traits in other domestic animals.

PMID- 8486363
TI  - Identification of the mutation in murine histidinemia (his) and genetic mapping
      of the murine histidase locus (Hal) on chromosome 10.
AB  - We cloned a mouse histidase cDNA to identify the mutation in histidinemic mice
      (his/his) and to determine the relationship of the histidase locus (Hal) both to
      Chromosome 10 markers and to Hsd, the histidase activity variant locus. The his
      mutation, a G to A transition at nucleotide +965, changes Arg-322 to Gln (R322Q).
      Expression of the R322Q allele in COS cells resulted in proportionately reduced
      amounts of histidase protein and activity compared to the wildtype allele. Hal
      maps approximately 4 cM distal to the insulin-like growth factor-1 locus and
      approximately 10 cM proximal to steel. Hsd was found to be tightly linked to Hal,
      and the low-histidase-activity Hsd allele was associated with reduced histidase
      mRNA. These studies indicate that the R322Q allele reduces the stability of
      histidase, position Hal on the Chromosome 10 linkage map, and provide further
      evidence that Hsd is allelic to Hal.

PMID- 8486364
TI  - DUMPS cattle carry a point mutation in the uridine monophosphate synthase gene.
AB  - Deficiency of uridine monophosphate synthase (DUMPS) is a monogenic autosomal
      recessive disorder in cattle, resulting in early embryonic death of homozygous
      offspring. To identify the mutation responsible for DUMPS, liver RNA from
      identified, DUMPS heterozygous animals from the Holstein and Red Holstein breeds
      was reverse transcribed. Amplification of cDNA with sequence-specific primers and
      subsequent sequencing of the PCR products revealed a mutation (C-->T) with the
      loss of an AvaI site at codon 405, resulting in a premature stop codon with a
      truncated C-terminal catalytic subunit of the protein. A direct DNA test based on
      PCR was developed and subsequently tested on 102 animals. Complete concurrence of
      deficiency of UMPS and the presence of the described point mutation in
      heterozygous animals was observed, thus confirming this point mutation as the
      basic defect in DUMPS cattle.

PMID- 8486365
TI  - Application of denaturing gradient gel electrophoresis to detect DNA sequence
      differences encoding apolipoprotein E isoforms.
AB  - Apolipoprotein E (apoE) plays an important role in plasma lipid metabolism. Three
      common isoforms of this protein have been identified by the isoelectric focusing
      method. In this report we describe a new method for distinguishing these
      isoforms. Our method employs PCR amplification of the DNA sequence of exon 4 in
      the apoE gene followed by denaturing gradient gel electrophoresis (DGGE) to
      distinguish its different melting characteristics. Identification of the ApoE
      isoforms through DNA melting behavior rather than protein charge differences
      eliminates the problems associated with isoelectric focusing and facilitates
      screening for additional mutations at the apoE locus.

PMID- 8486366
TI  - The high-affinity interleukin 8 receptor gene (IL8RA) maps to the 2q33-q36 region
      of the human genome: cloning of a pseudogene (IL8RBP) for the low-affinity
      receptor.
AB  - The selective amplification by polymerase chain reaction (PCR) of gene fragments
      corresponding to new G-protein-coupled receptors resulted in the cloning of 18
      orphan members of this gene family. Of these, three human clones amplified from
      genomic DNA (HGMP03, HGMP04, and HGMP05) were shown to be structurally related.
      Genomic clones corresponding to HGMP03 and HGMP05 were isolated and their
      putative coding region sequenced. Following the characterization of two
      interleukin 8 (IL-8) receptors, HGMP03 appeared to encode the high-affinity IL-8
      receptor, whereas the partial clone HGMP04 encodes the low-affinity IL-8
      receptor. Comparison with the cDNA sequence suggests that the high-affinity
      receptor gene is split by an intron in the 5' untranslated region. The high
      affinity receptor gene was mapped by in situ hybridization to the 2q33-q36 region
      of the human genome. The HGMP05 locus turned out to be a pseudogene for the low
      affinity IL-8 receptor (87% identity), with multiple frameshifts and point
      mutations introducing stop codons. Southern blotting on genomic DNA did not allow
      the further detection of related loci in the human genome.

PMID- 8486367
TI  - Assignment of the human GTF2F1 gene to chromosome 19p13.3.
AB  - TFIIF (also termed FC) is a general transcription initiation factor that binds to
      RNA polymerase II and recruits it to a promoter. TFIIF is a heterodimer composed
      of 74-kDa (RAP74; gene symbol GTF2F1) and 30-kDa (RAP30; gene symbol GTF2F2)
      subunits. Here we report the mapping of the human GTF2F1 gene to band 19p13.3.
      Localization was performed by fluorescence in situ hybridization using the human
      RAP74 genomic cosmid clone as the probe.

PMID- 8486368
TI  - Genetic mapping of X-linked ocular albinism: linkage analysis in a large
      Newfoundland kindred.
AB  - Genetic linkage studies in a large Newfoundland family affected by X-linked
      ocular albinism (OA1) showed linkage to markers from Xp22.3. One recombinant
      mapped the disease proximal to DXS143 (dic56) and two recombinants mapped the
      disease distal to DXS85 (782). Combining the data with that from 16 British
      families previously published confirmed close linkage between OA1 and DXS143
      (dic56; Zmax = 21.96 at theta = 0.01, confidence interval (CI) 0.0005-0.05) and
      linkage to DXS85 (782; Zmax = 17.60 at theta = 0.07, CI = 0.03-0.13) and DXS237
      (GMGX9; Zmax = 15.20 at theta = 0.08, CI = 0.03-0.15). Multipoint analysis
      (LINKMAP) gave the most likely order as Xpter-XG-DXS237-DXS 143-OA1-DXS85, with
      odds of 48:1 over the order Xpter-XG-DXS237-OA1-DXS143-DXS85, and odds exceeding
      10(10):1 over other locations for the disease locus.

PMID- 8486369
TI  - A human pseudoautosomal gene encodes the ANT3 ADP/ATP translocase and escapes X
      inactivation.
AB  - We report that the human ANT3 ADP/ATP translocase gene is a pseudoautosomal gene
      located proximal to the GM-CSF receptor alpha chain gene (CSF2RA). An ANT3
      homologous locus, likely corresponding to a pseudogene, maps to chromosome 9. The
      ANT3 gene is transcribed from the centromere to the telomere and contains in its
      first intron a CpG island mapped 1300 kb from the telomere. This gene is
      transcribed from the Y chromosome and from the active and inactive X chromosomes.
      This gene thus escapes X-inactivation as predicted for genes belonging to the
      pseudoautosomal region.

PMID- 8486370
TI  - Localization of 14 functional J regions in the human T-cell receptor alpha-chain
      locus.
AB  - Nearly 60 unique J alpha regions have been identified in human T-cell receptor
      (TCR) alpha chains to date, yet fewer than one-third of these have been localized
      within the alpha-chain locus. We report a rapid method for the mapping of
      productively rearranged J alpha regions using oligonucleotide probes and
      overlapping phage clones spanning 80 kb of the TCR-alpha locus. Fourteen J alpha
      regions were mapped using this technique; the positions of five of these have
      been verified by genomic cloning.

PMID- 8486371
TI  - Localization of the gene-encoding upstream stimulatory factor (USF) to human
      chromosome 1q22-q23.
AB  - The upstream stimulatory factor, USF, is a ubiquitously expressed cellular
      transcription factor that binds to a symmetrical DNA sequence that is found in a
      variety of viral and cellular promoters. A full-length cDNA encoding the 43-kDa
      USF protein has previously been isolated. USF contains both helix-loop-helix and
      leucine repeats, which are involved in regulating its DNA binding and
      dimerization properties. We report the use of mouse-human somatic cell hybrids
      and in situ hybridization in localizing the gene-encoding USF to human chromosome
      1q22-q23.

PMID- 8486372
TI  - Characterization of a DNA sequence family in the Prader-Willi/Angelman syndrome
      chromosome region in 15q11-q13.
AB  - IR4-3R (D15S11) is an anonymous DNA sequence from human chromosome 15. Using YAC
      cloning and restriction enzyme analysis, we have found that IR4-3R detects five
      related DNA sequences, which are spread over 700 kb within the Prader
      Willi/Angelman syndrome chromosome region in 15q11-q13. The RsaI and StyI
      polymorphisms, which were described previously, are associated with the most
      proximal copy of IR4-3R and are in strong linkage disequilibrium. IR4-3R
      represents the third DNA sequence family that has been identified in 15q11-q13.

PMID- 8486373
TI  - Refinement of the localization of the X-linked ocular albinism gene.
AB  - Although physical and genetic mapping studies assigned the X-linked ocular
      albinism gene to Xp22.3, the exact gene order in this region is still unclear. We
      present additional genetic mapping data concerning X-linked ocular albinism that
      suggests the consensus order Xpter-STS-DXS237-KAL-(OA1, DXS143)-DXS85-DXS16-Xcen.

PMID- 8486374
TI  - S-laminin: mapping to mouse chromosome 9 and expression in the linked mutants
      tippy and ducky.
AB  - S-Laminin, a homologue of the laminin B1 chain, is present in a subset of basal
      laminae, including those of the skeletal neuromuscular junction and the renal
      glomerulus. Here, we show that the distribution and apparent size of murine S
      laminin are similar to those documented previously for rat and human. We then use
      interspecific backcross analysis to map the S-laminin (Lams) gene to mouse
      chromosome 9. Thus, it is unlinked to genes for the laminin A, B1, and B2 chains.
      Finally, because the Lams gene mapped near two mutations that affect
      neuromuscular function, ducky (du) and tippy (tip), we assayed S-laminin by
      Southern blotting, immunoblotting, and immunohistochemistry in these mutants. No
      abnormality of the S-laminin gene or protein was detectable in either mutant.

PMID- 8486375
TI  - A mutation in the amino-terminal end of the triple helix of type II collagen
      causing severe osteochondrodysplasia.
AB  - Type II collagen is coded by a large gene (COL2A1) consisting of 54 exons on
      chromosome 12. During the past few years several cartilage disorders have been
      linked to this gene, and some specific nucleotide changes have been identified in
      patients. In a spondyloepiphyseal form of chondrodysplasia, the three mutations
      found so far are all in exon 48 in the region coding for the carboxyl-terminal
      end of the triple helix. Since folding of the type II collagen polypeptides to
      the triple helix is initiated from the carboxyl-terminal end, it has been
      suggested that mutations in this region typically result in severe cartilage
      diseases. Here we report a novel mutation located in the area coding for the
      amino-terminal part of the triple helix in a sporadic patient with
      spondyloepiphyseal dysplasia (SED). The mutation, a substitution of G1063 to A,
      which results in the conversion of Gly154 to Arg, was identified using exon
      specific amplification of genomic DNA and subsequent analyses with denaturing
      gradient gel electrophoresis and single-strand conformation polymorphism. The
      substitution was not found in any other SED patient in Finland. This novel
      mutation demonstrates that amino acid substitutions in the amino-terminal part of
      the type II collagen triple helix can also result in SED.

PMID- 8486376
TI  - Artificially generated data sets for testing DNA sequence assembly algorithms.
AB  - We have developed a set of tools, genfrag, to fragment and optionally mutate a
      DNA sequence to generate benchmark data sets for testing DNA sequence assembly
      algorithms. Data parameters can be systematically and independently varied to
      explore the range of data--and corresponding performance of assembly tools-
      encountered on large-scale random, or "shot-gun," sequencing projects.

PMID- 8486377
TI  - The order and orientation of a cluster of metalloproteinase genes, stromelysin 2,
      collagenase, and stromelysin, together with D11S385, on chromosome 11q22-q23.
AB  - A cluster of metalloproteinase genes, stromelysin, fibroblast collagenase, and
      stromelysin 2 together with the anonymous DNA marker D11S385, was mapped using
      pulsed-field gel electrophoresis to a 135-kb region of chromosome 11q22-q23. The
      physical proximity of these markers was subsequently confirmed using two YAC
      clones, and their relative order was established as stromelysin 2-collagenase
      stromelysin-D11S385. The pattern of marker representation in a panel of radiation
      reduced chromosome 11 hybrids suggests that the metalloproteinase gene/D11S385
      cluster is orientated with STMY2 closest to the centromere.

PMID- 8486378
TI  - Genes for the dimerization cofactor of hepatocyte nuclear factor-1 alpha (DCOH)
      are on human and murine chromosomes 10.
AB  - Hepatocyte nuclear factor-1 alpha (HNF-1 alpha; gene symbol, TCF1) forms dimers
      with itself as well as with HNF-1 beta and regulates the expression of several
      liver-specific genes. Recently, a dimerization cofactor of hepatocyte nuclear
      factor-1 alpha, called DCOH, has been identified. Here, we report the chromosomal
      localization of the genes for this cofactor to chromosomes 10 in both humans and
      mice by Southern blot analyses of somatic cell hybrids.

PMID- 8486379
TI  - A recurrent deletion in the antithrombin gene, AT106-108(-6 bp), identified by
      DNA heteroduplex detection.

PMID- 8486380
TI  - The loss of a polymorphic glycosylation site caused by Thr-927-->Ile is linked to
      a second polymorphic Val-816-->Ile substitution in lysosomal alpha-glucosidase of
      American blacks.

PMID- 8486381
TI  - Human myosin-binding protein H (MyBP-H): complete primary sequence, genomic
      organization, and chromosomal localization.
AB  - Vertebrate striated muscle contains a set of myosin-associated proteins with
      discrete distributions in the A-band. Some of these proteins, including MyBP-H
      and MyBP-C, are characterized by a series of internal repeats (motifs) with
      homology to either the C2-set of the immunoglobulin superfamily or the
      fibronectin type III repeat. These repeats are predicted to be involved in
      protein-protein interactions within the myofibril. The cDNA sequence, the genomic
      organization, and the chromosomal localization of the human homologue of MyBP-H
      are presented. The 1.8-kb cDNA encodes a 52-kDa polypeptide containing two Ig-C2
      and two type III repeats. The mRNA is expressed in a skeletal muscle-specific
      pattern. A 28-kb region of genomic sequence has been isolated that encompasses
      the 5' and 3' ends of the cDNA. This region includes 4.2 kb of upstream sequence
      with a potential promoter and 14 kb of downstream sequence containing the
      polyadenylation site. The chromosomal assignment was made by high resolution
      chromosomal in situ hybridization. This method maps the gene to chromosome
      1q32.1. The repeat structure described previously in chicken MyBP-H and MyBP-C
      was also detected in human MyBP-H. The primary sequence of the C-terminal Ig-C2
      motif and its predicted secondary structure have been extensively conserved in
      MyBP-H homologues and other members of the MyBP family. This Ig-C2 motif has been
      implicated in myosin binding.

PMID- 8486382
TI  - A simple and powerful method for linkage analysis by amplification of DNA from
      single sperm cells.
AB  - Haplotypes of three bovine casein loci were analyzed as a way of determining
      genetic linkage. A total of 330 individual sperm cells from a triply heterozygous
      bull were selected by means of a new method involving fixing the sperm cells into
      low-melting-point agarose gels. The method is simple and very accurate with an
      efficiency close to 100% for picking sperm cells and producing amplifiable DNA
      templates, circumventing the complicated statistical analysis mandated by
      automated cell sorting. The DNA was amplified in a two-step polymerase chain
      reaction (PCR) to achieve the necessary high specificity of amplification. In the
      first reaction, primers flanking the polymorphic site at each locus were used.
      The PCR product from the first reaction was then reamplified in a second PCR
      using primers that create allele-specific restriction sites (ACRS) in the PCR
      products for two of the three loci, allowing the alleles to be determined by gel
      electrophoresis. No recombinants were found among the 330 single sperm cells
      analyzed, giving a lod score higher than 30 and proving a very strong linkage
      between bovine casein genes.

PMID- 8486383
TI  - New mouse primary retinal degeneration (rd-3).
AB  - A new mouse retinal degeneration that appears to be an excellent candidate for
      modeling human retinitis pigmentosa is reported. In this degeneration, called rd
      3, differentiation proceeds postnatally through 2 weeks, and photoreceptor
      degeneration starts by 3 weeks. The rod photoreceptor loss is essentially
      complete by 5 weeks, whereas remnant cone cells are seen through 7 weeks. This is
      the only mouse homozygous retinal degeneration reported to date in which
      photoreceptors are initially normal. Crosses with known mouse retinal
      degenerations rd, Rds, nr, and pcd are negative for retinal degeneration in
      offspring, and linkage analysis places rd-3 on mouse chromosome 1 at 10 +/- 2.5
      cM distal to Akp-1. Homology mapping suggests that the homologous human locus
      should be on chromosome 1q.

PMID- 8486384
TI  - Cystatin C (CST3), the candidate gene for hereditary cystatin C amyloid
      angiopathy (HCCAA), and other members of the cystatin gene family are clustered
      on chromosome 20p11.2.
AB  - The cystatin C gene (CST3) encodes a low-molecular-weight cysteine proteinase
      inhibitor belonging to family II of the cystatin superfamily and is mutated in
      cases of hereditary cystatin C amyloid angiopathy (HCCAA). CST3, which along with
      other family II cystatin genes is a member of the cystatin gene family, has been
      assigned to chromosome 20. To investigate the genomic organization on chromosome
      20, the CST3 gene and related sequences were regionally mapped by fluorescence in
      situ hybridization (FISH), Southern blot, and pulsed-field gel electrophoresis
      (PFGE) analysis using the cDNA cystatin C probe C6a and three genomic probes,
      C3E1, C3E2, and C3E2-2. Probe C3E2-2, which like probe C3E2 is specific for CST3,
      hybridized to only one HindIII and one XbaI fragment on Southern blots and to a
      300-kb BssHII PFGE fragment. FISH with probe C3E2 mapped this locus to chromosome
      20p11.2, with an FL-pter value of 0.37 +/- 0.07 on the physical map. Probe C3E1
      containing the most conserved cystatin gene exon (exon 1) and its flanking
      sequences hybridized with more fragments, e.g., to eight XbaI and nine HindIII
      fragments on conventional Southern blots and to eight SmaI, two BssHII (900 and
      300 kb), and two NotI fragments after PFGE. FISH with C3E1 revealed only one
      single site at 20p11.2 with an FL-pter value of 0.37 +/- 0.04, identical to that
      obtained with C3E2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486385
TI  - Polymorphic SSR (simple-sequence-repeat) markers for chromosome 20.
AB  - Chromosome 20-specific simple-sequence-repeat (SSR) markers were developed from a
      flow-sorted phage library (LL20NS01), subcloned in Bluescript, and screened with
      a tetranucleotide repeat, (AAAG)6, to identify potentially polymorphic loci. Of
      100 clones sequenced, 39 were selected to construct primers. Of these 39, 22 were
      polymorphic. Reference to the CEPH linkage database (version 5) permitted genetic
      mapping of 16 of the new markers to specific regions of chromosome 20. Ten of the
      SSRs showed heterozygosity indices (above 70%) that would qualify them as
      potential index markers.

PMID- 8486386
TI  - Subclustering of human immunoglobulin kappa light chain variable region genes.
AB  - The human immunoglobulin kappa light chain (IgK) locus includes multiple variable
      region gene segments (Vk) that can be divided into four subgroups.
      Oligonucleotide primers were designed to amplify specifically gene segments of
      the VkI, VkII, and VkIII subgroups using the polymerase chain reaction (PCR).
      Product sequences were subcloned, sequenced, and compared. Phylogenetic analyses
      of sequences within each subgroup indicate that some subgroups can be subdivided
      further into "sub-subgroups." The history of Vk segment duplications apparently
      includes at least two separate periods, the first giving rise to the subgroups
      and the second generating further complexity within each subgroup. Duplications
      of large pieces of DNA (demonstrated by others through pulsed-field gel
      electrophoresis) also played a role. Rates of synonymous and non-synonymous base
      changes between pairs of sequences suggest that natural selection has played a
      major role in the evolution of the Vk variable gene segments, leading to sequence
      conservation in some regions and to increased diversity in others.

PMID- 8486387
TI  - Characterization of the mouse thrombospondin 2 gene.
AB  - We have characterized the exon/intron organization, complete 3' untranslated
      region (3'-UTR), and approximately 2.5 kb of the promoter/5' flanking region of
      the mouse thrombospondin 2 (TSP2) gene. The sizes of exons and the pattern of
      interruption of the reading frame by introns are highly conserved in mouse TSP2
      in comparison with mouse or human TSP1, a finding that suggests a close
      evolutionary relationship between the two genes. The TSP2 and TSP1 genes are also
      similar in that the 3'-UTRs of both genes contain multiple TATT and ATTT(A)
      motifs that might function as mediators of mRNA stability. However, the sequences
      of the promoter regions in TSP1 and TSP2 are very different; in particular, the
      TSP2 gene lacks the serum response element and the NF-Y binding site that have
      been implicated in the serum response of the human TSP1 gene. The structure of
      the TSP2 gene is consistent with emerging evidence supporting the view that TSP1
      and TSP2 perform overlapping but distinct functions.

PMID- 8486388
TI  - Localization of genes encoding three distinct flavin-containing monooxygenases to
      human chromosome 1q.
AB  - We have used the polymerase chain reaction to map the gene encoding human flavin
      containing monooxygenase (FMO) form II (N. Lomri, Q. Gu, and J. R. Cashman, 1992,
      Proc. Natl. Acad. Sci. USA 89: 1685-1689) to chromosome 1. We propose the
      designation FMO3 for this gene as it is the third FMO gene to be mapped. The two
      other human FMO genes identified to date, FMO1 and FMO2, are also located on
      chromosome 1 (C. Dolphin, E. A. Shephard, S. Povey, C. N. A. Palmer, D. M.
      Ziegler, R. Ayesh, R. L. Smith, and I. R. Phillips, 1991, J. Biol. Chem. 266:
      12379-12385; C. Dolphin, E. A. Shephard, S. F. Povey, R. L. Smith, and I. R.
      Phillips, 1992, Biochem. J. 286: 261-267). The localization of FMO1, FMO2, and
      FMO3 has been refined to the long arm of chromosome 1. Analysis of human
      metaphase chromosomes by in situ hybridization confirmed the mapping of FMO1 and
      localized this gene more precisely to 1q23-q25.

PMID- 8486389
TI  - Isolation and FISH mapping of 80 cosmid clones on the short arm of human
      chromosome 3.
AB  - We have isolated and mapped by fluorescence in situ hybridization 80 new cosmids
      on the short arm of chromosome 3. These markers were isolated from a radiation
      reduced hybrid, DM1, made from a cell line that was monochromosomal for human
      chromosome 3. Selected cosmids were used in double-label cohybridization
      experiments in which polymerase chain reaction products, generated by an Alu
      oligonucleotide primer from genomic DNA, were used for chromosome banding. Fifty
      six of the cosmid probes map between 3p14.3 and 3p22 while 24 other probes
      cluster around bands 3p23-3p25. Three probes that appeared to map close to the
      chromosome 3 region bearing a t(3,8)p14.2; q24.1 translocation associated with
      renal cell carcinoma were analyzed by interphase mapping techniques and
      hybridized to metaphase spreads from the translocation cell line. These 80 probes
      will be useful in the elucidation of genetic alterations associated with diseases
      such as small cell lung carcinoma, renal cell carcinoma, and von Hippel-Lindau
      disease.

PMID- 8486391
TI  - Factors controlling the reactivity of immature and mature T cells to Mls antigens
      in vivo.

PMID- 8486390
TI  - Accurate characterization of porcine bivariate flow karyotype by PCR and
      fluorescence in situ hybridization.
AB  - The 19 chromosomal pairs of the swine karyotype are resolved into 18 peaks
      denoted A to Q and Y by dual-beam flow cytometry. The chromosomal content of six
      peaks has previously been determined by analyzing male/female differences,
      karyotypes of animals carrying translocations, and PCR studies of genes with
      known assignments. For the remaining chromosomes, putative assignments to flow
      peaks were deduced from comparison of DNA contents, determined by flow cytometry,
      and chromosomal size. We present here the complete characterization of the pig
      bivariate flow karyotype using the PARM-PCR technique combined with fluorescence
      in situ hybridization. Chromosome-specific probes were generated by PCR
      amplification of 300 sorted chromosomes with primers under nonspecific conditions
      and used to paint chromosomes by FISH. The chromosomal content of each peak was
      identified: peaks A (chromosome 1), B (13), C (6), D (2), E (14), F (3), G (7), H
      (9,4,X), H1 (9), I (15), J (8), K (5), L (10), M (12), N (16), O (11), P (17), Q
      (18), Y (Y). We were able to characterize perfectly the pig bivariate flow
      karyotype. Such techniques could be applied to any other species.

PMID- 8486392
TI  - Are there cellular superantigens?

PMID- 8486393
TI  - Immunoregulatory effects of superantigens: interactions of staphylococcal
      enterotoxins with host MHC and non-MHC products.
AB  - Staphylococcus aureus carries a highly conserved set of genes which encode a set
      of secreted enterotoxins. Although it is likely that these enterotoxins affect
      the host/parasite in favor of the bacterium, we do not understand the molecular
      basis of this interaction. We summarize recent evidence that defines two types of
      interaction between the bacterial toxin and host cellular receptors that may
      subvert the host immune response to S. aureus. An interaction between the toxin
      and class II products on APC can result in inhibition of costimulatory activity
      and thus impair clonal expansion of T cells specific for bacterial antigens.
      Studies using anti-class II antibodies suggest that this may reflect transmission
      of a negative signal to APC after ligation of class II products. A second
      interaction between a subset of toxins, including SEC, with non-MHC products
      stimulates both T-cell proliferation as well as toxin-specific cytotoxic T cells
      (CTL). We put forward the hypothesis that this interaction reflects binding of a
      VCAM-1-like subsequence of SEC to VLA-4 expressed by activated target cells. We
      suggest that this interaction may serve to inhibit the host response by
      subversion of lymphocyte homing to sites of infection by SEC-producing
      staphylococci and by local elimination of (VLA-4+) memory T cells.

PMID- 8486394
TI  - T-cell receptor beta-chain binding to enterotoxin superantigens.
AB  - The last few years have seen an enormous jump in our knowledge and understanding
      of T-cell activation by superantigens. Clearly, a great number of infectious and
      parasitic organisms utilize superantigens as part of a strategy to evade the
      immune response of their host. The ability to modulate superantigen effects will
      give us new means to fight infections, and the knowledge of T-cell activation
      that we have gained from study of superantigens will, in turn, allow us to
      modulate the immune system in new ways.

PMID- 8486395
TI  - Technetium-99 m labelling of DD-3B6/22 antifibrin monoclonal antibody fragment
      Fab' for thrombus imaging.
AB  - The antifibrin DD-3B6/22 monoclonal antibody Fab' fragment, a murine
      immunoglobulin, IgG3, has been labelled with technetium-99 m (99mTc) via a
      transchelation reaction, to specific activity in excess of 30 mCi/mg protein. The
      radiolabelling of Fab' was dependent on time, temperature, pH, antibody
      concentrations and nature of intermediary transchelation complex used. The
      resultant radioconjugate was stable in vitro and in vivo. Blood clearance of
      99mTc-Fab' in rat followed two compartment kinetics with the half time of the
      fast phase being 0.5 h. The main route of excretion was via the kidneys with
      little uptake indicated by other tissues. The results suggest that the inherent
      specificity of the antibody, small molecular size, rapid plasma clearance, high
      specific radioactivity, together with the physical properties of the 99mTc label,
      combine to make this labelled monoclonal antibody (MoAb), potentially suitable as
      a radiopharmaceutical for the scintigraphic detection of thrombi in humans.

PMID- 8486396
TI  - A re-examination of the molecular basis of cell movement.
AB  - A model for cell movement is presented. It is suggested that cells do not migrate
      on collagen using their VLA (very late antigen) integrins that bind this
      extracellular matrix protein. Rather, the cells utilize alpha v integrins to bind
      endogenously produced fibronectin, which binds to the underlying collagen. It is
      envisaged that cells proceed by a process of engagement and disengagement of
      alpha v integrins to the extracellular matrix, somewhat analogous to the motion
      of a monkey climbing a tree. Secretion of isoforms of the adhesion modulator,
      thrombospondin, regulates disengagement of the integrin from its ligand in
      migrating cells. The integrin disengagement signal is mediated by thrombospondin
      cross-linking the alpha v integrin to an integrin accessory molecule and thus
      activating protein kinases. The cross-linked receptor complex undergoes recycling
      back along actin stress fibres, guided by the integrin beta-subunit. After
      endocytosis and protein sorting the alpha v integrin is transported back to the
      leading edge off migrating cells in vesicles guided by the tubulin-binding
      capabilities of an integrin accessory molecule. Direct attachment to collagen
      required for processes, such as matrix contraction, is mediated by VLA integrins
      which displace alpha v integrins from points of attachment during integrin
      recycling, possibly through an alpha v beta 1 intermediary receptor.

PMID- 8486397
TI  - Selective modification and immune evasion: a hypothesis.
AB  - A hypothesis is proposed asking why enzyme neutralization is not an effective
      host-response to a parasite despite the fact that some parasite housekeeping
      enzymes are highly immunogenic. It is hypothesized that although the structural
      domain can be immunogenic, the active sites of the parasite enzyme molecules have
      converged evolutionarily to resemble the functional part (active sites) of host's
      enzyme molecules, by structural modification/rearrangement (amino acid
      substitution/polypeptide chain folding) with the effect: (i) of functional
      adaptation to the host environment; and (ii) to escape detection of active sites
      by the host as non-self, allowing the parasite to be exposed to antiparasite
      enzyme antibodies, without deleterious effects on the parasite.

PMID- 8486398
TI  - Alteration within a discrete region of the H-2Ld alpha 1 helix upon association
      with human beta 2 microglobulin.
AB  - The utilization of the beta 2-microglobulin (B2m) exchange assay allowed for the
      association of H-2Ld with human B2m. Upon association with H-2Ld, human B2m
      induces structural alterations in H-2Ld that appear dependent upon xenogeneic B2m
      amino acid sequence variability. In this regard, xenogeneic B2m exchange is used
      as a tool to induce structural alterations in class I as a means of analysing the
      structural-functional relationship of B2m/class I association. Incorporating H
      2Ld site-directed mutants into the experimental approach provided strong evidence
      that B2m makes indirect contact with discrete class I specific amino acid
      positions located in the helical region of the alpha 1 domain.

PMID- 8486399
TI  - Electroporation and DNA-dependent cell death in murine macrophages.
AB  - The difficulty of transfecting primary macrophages and macrophage cell lines has
      meant that relatively few studies on regulation of gene expression have been
      performed in these cells. This study has optimized an electroporation procedure
      for the macrophage cell line RAW 264, but shows that introduction of DNA into the
      cytoplasm of primary macrophages by electroporation is toxic to the cells. It is
      proposed that this cell death may have a physiological role in defence against
      certain viral infections which result in accumulation of cytoplasmic DNA. RAW 264
      cells were efficiently transfected by electroporation, but electroporated bone
      marrow derived macrophages (BMM) showed large scale cell death over a period of
      12 h. Electroporation without DNA was not toxic and DNase treatment of samples
      before transfection prevented cell death. The toxicity of DNA was concentration
      dependent and sequence-independent. Synthetic, genomic and plasmid DNA all caused
      cell death. This sensitivity to DNA seems to be distinct from the antiviral state
      induced by double-stranded RNA and may be part of an uncharacterized viral
      defence system.

PMID- 8486400
TI  - Human natural killer (NK) cells: requirements for cell proliferation and
      expansion of phenotypically novel subpopulations.
AB  - Previous studies established that the high density (resting) natural killer (NK)
      cell subset (R-NK) of peripheral blood NK cells is unresponsive to interleukin-2
      (IL-2) but can be induced to proliferate when cultured with gamma-irradiated
      malignant melanoma (MM-170) cells or mitomycin-C-treated activated T cells in the
      presence of an IL-2-conditioned medium (IL-2-CM). This study has examined
      additional requirements of this activation process. The induction of
      proliferation was dependent on cell to cell contact with metabolically active
      stimulator cells, although no evidence was obtained that stimulation was effected
      by soluble factors produced by the stimulator cells. Compared with IL-2-CM, rIL-2
      was an inefficient costimulator for the induction of NK cell proliferation,
      suggesting that factors in IL-2-CM were required in addition to IL-2, but rIL-2
      was as efficient as IL-2-CM in maintaining the proliferation of activated NK
      cells. Under optimum culture conditions, NK growth of up to 3200-fold occurred
      during a proliferation cycle of 18 days. Phenotypic analysis of the culture
      generated quiescent NK cells revealed novel heterogeneity in CD16 (Fc gamma RIII)
      and CD56 (N-CAM) expression. Some NK cells lacked expression of both CD16 and
      CD56 (as identified using currently available monoclonal antibodies), while other
      NK cells showed differential CD16 epitope expression. Since quiescent NK cells
      can be obtained in large numbers and high purity, they will be a convenient
      source of NK cells to study the molecular processes involved in initiating NK
      cell proliferation.

PMID- 8486401
TI  - Reduced secretion of IL-1 beta by peritoneal cells from patients on continuous
      ambulatory peritoneal dialysis.
AB  - The endogenous and lipopolysaccharide stimulated interleukin (IL)-1 beta
      production in vitro by peritoneal monocytes/macrophages from patients on
      continuous ambulatory peritoneal dialysis (CAPD) was examined during episodes of
      infection and inflammation. Measurement of immunoreactive IL-1 beta and bioactive
      IL-1 in both supernatants and cell lysates after culture for 18 h revealed that
      these cells secreted a significantly lower proportion of total IL-1 than that
      measured for elutriated blood monocytes. For the inflammatory peritoneal cells,
      the proportion of total IL-1 beta that was cell-associated resembled that
      reported for more differentiated pulmonary alveolar macrophages and for adherent
      monocytes cultured for 18 h prior to stimulation. A similar reduced ability to
      secrete IL-1 beta was detected for unfractionated peritoneal cells from CAPD
      patients without peritonitis upon direct comparison with the IL-1 beta production
      by blood mononuclear cells from the same patients. These results suggested that
      at a time when a pro-inflammatory response by extravasated host
      monocytes/macrophages was required by CAPD patients with peritonitis, only a
      minor proportion of total IL-1 beta would be available extracellularly. This
      study highlights the rapidity with which extravasated monocytes lose their
      ability to secrete IL-1 beta and raises the possibility that an important site of
      utilization of IL-1 beta in vivo may be intracellular in its location.

PMID- 8486402
TI  - Reduction of the cost of testing for antibody to human immunodeficiency virus,
      without losing sensitivity, by pooling sera.
AB  - The sensitivity of testing pooled sera instead of individual sera for antibody
      against human immunodeficiency virus (HIV) was evaluated using a non-competitive
      enzyme-linked immunosorbent assay (ELISA). For this purpose, 42 HIV antibody
      positive sera were titrated and introduced into 42 sets of pools of 2, 4, 8, 16,
      32 or 64 sera in such a manner that each pool had one positive sample and the
      rest, HIV antibody negative sera. When the pools were tested in ELISA, all pools
      with high titred antibody positive sera were reactive irrespective of pool size,
      while some of the pools containing medium or low titred sera were non-reactive
      when pool size exceeded 16. Subsequently the pool size was limited to 16. When
      208 previously unscreened samples were tested in 52 pools of 4, 26 pools of 8 or
      13 pools of 16 sera, or individually, 6 antibody positive sera were correctly
      identified. Thus, it was found that the pooling method did not reduce the
      sensitivity of ELISA test, whereas the cost was reduced to less than half of that
      of individual testing.

PMID- 8486403
TI  - T lymphocytes in pulmonary tuberculosis.
AB  - T cells and their sub-populations were evaluated with respect to reactive,
      intermediate and unreactive forms of tuberculosis as classified by Lenzini.
      Significant CD4 lymphopenia and a reduction of CD4/CD8 ratios were found in
      patients with reactive tuberculosis. It was observed that there was a B
      lymphocytosis, CD8 lymphocytosis and a reduction of CD4/CD8 ratio in patients
      with intermediate and unreactive forms of tuberculosis. The T lymphocytes and CD4
      subset were unchanged. There was no significant difference in the lymphocytes and
      sub-populations among the intermediate and unreactive groups.

PMID- 8486404
TI  - Antigenic similarity of a cultivable acid fast bacterium to Mycobacterium leprae.
AB  - A cultivable acid fast stainable bacterium obtained from leprosy nodule showed
      similarity to M. leprae in antigenicity to serum antibodies of lepromatous
      leprosy patients. The antigenic similarity has been seen more clearly in the
      delipidified cell components of both these bacteria. An antigen of 35-38 kDa has
      been seen as a common antigen between M. leprae and the cultivable bacilli with
      binding ability to sera from leprosy patients. This cultivable bacterial
      component could be used for serodiagnosis of lepromatous leprosy.

PMID- 8486405
TI  - Immunodiagnosis of group-A streptococci by latex agglutination assays with
      monoclonal or monospecific polyvalent antibodies.
AB  - Seven clones of murine monoclonal antibodies specific for group-A streptococci
      were generated. All of them were of IgM isotypes and recognized trypsinized as
      well as nontrypsinized group-A streptococci and polysaccharide. These were devoid
      of reactivity with streptococci-B, -C, -G and Staphylococcus aureus. Polyclonal
      antibodies against group-A polysaccharide (APS) were also raised in rabbits by
      linking APS to bovine serum albumin, and rendered monospecific by adsorption.
      Latex agglutination assays were developed employing both types of antibodies. The
      assay employing monospecific polyvalent antibodies had a sensitivity of 12.5 ng
      APS/ml as compared to 1 microgram APS/ml for latex sensitized with monoclonal
      antibodies. Both assays were specific, as no agglutination was observed with
      polysaccharides obtained from streptococci-B, -C, -G, Staph. aureus,
      Cornybacterium diptheriae, Candida albicans, Candida spp., Morexella catarrhalis,
      Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Streptococcus
      agalactiae, Strep. pneumoniae. Salmonella typhi and S. paratyphi A and B. Throat
      swabs from children obtained in duplicate, when tested for the presence of
      streptococci-A, showed a good correlation of the results obtained by latex
      agglutination assay with the microbial culture test and serogrouping.

PMID- 8486406
TI  - Evaluation of direct gas-liquid chromatography of CSF in rapid diagnosis of acute
      bacterial meningitis.
AB  - A comparison of culture and lactic acid level from 50 patients suffering from
      bacterial meningitis and 25 controls was done to evaluate the role of direct GLC
      analysis of CSF for early diagnosis of bacterial meningitis. The study revealed
      that the CSF lactic acid level was higher in 48 out of 50 cases. Only in 30
      patients the causative agent of the disease could be established by conventional
      techniques. Quantitative estimation of lactic acid was found to be useful.

PMID- 8486407
TI  - Coagglutination for rapid testing of toxin producing Corynebacterium diphtheriae.
AB  - Coagglutination test was standardised for rapid detection of diphtheria toxin
      after primary culture of C. diphtheriae isolates on conventional Loeffler's
      medium. The procedure was optimised with diphtheria toxoid (DT)-antidiphtheritic
      serum (ADS) system wherein Cowan-I strain of Staphylococcus aureus was sensitised
      with ADS. Toxoid in the range of 1.02 lf/ml to 4200 lf/ml could be detected by
      the present procedure. Toxin of C. diphtheriae could be demonstrated in five of
      eight clinical isolates, this correlated with the conventional guinea pig
      pathogenicity test. The coagglutination test thus needs further confirmation of
      its potential as a simple and satisfactory test for rapid detection of toxin
      producing C. diphtheriae.

PMID- 8486408
TI  - Insecticide susceptibility status & enzyme profile of Aedes albopictus
      populations from different localities of Maharashtra state.
AB  - Susceptibility status of five populations of Ae. albopictus mosquitoes from
      Maharashtra state, to DDT, malathion, fenitrothion, bromophos, propoxur and
      deltamethrin was studied and compared with the laboratory population. Four
      populations survived when adults were exposed to 4 per cent DDT impregnated paper
      for 2 h; though three of these populations had lower DDT-LC50 values at larval
      stages in comparison with the laboratory population. Results of topical
      application of DDT on these four populations supported these findings by showing
      comparatively higher LD50 values at adult stages in comparison with the
      laboratory population. All the populations were highly susceptible to other
      pesticides tested i.e., malathion, fenitrothion, bromophos, propoxur and
      deltamethrin. These populations were distinguished from each other by esterase
      isoenzyme patterns.

PMID- 8486409
TI  - Hepatitis E virus infection in pregnant rhesus monkeys.
AB  - Ten non-pregnant female monkeys and four pregnant monkeys (all Macaca mulatta) in
      the last third of their gestation period were infected intravenously with the
      stool sample of a patient with hepatitis E virus infection (immuno
      electronmicroscopy positive for hepatitis E virus). Four more non-pregnant
      monkeys were inoculated with a lower dose (less number of virus particles by IEM)
      of a stool sample collected on a different day from the same patient. The average
      incubation period as evidenced by the rise of serum alanine transferase in the
      non-pregnant monkeys, was 36.4 +/- 4.9 days. The dose of the virus did not affect
      the incubation period. Two of the pregnant monkeys had incubation periods of 9
      and 13 days respectively. They delivered healthy babies on 40th and 53rd day
      respectively after inoculation. At the age of 11 months, both babies were
      negative for anti-HEV antibodies. One monkey which delivered a healthy baby on
      the 2nd day after inoculation had incubation period of 36 days. The baby of this
      monkey was anti-HEV positive at the age of 11 months. The incubation period was
      41 days in the fourth monkey which delivered a macerated foetus on the 36th day
      after infection. No fatality was recorded in the infected monkeys. Bile samples
      collected from all monkeys showed strong signals in nested polymerase chain
      reaction (PCR). It seems that the incubation period in pregnant monkeys was
      determined by the state of pregnancy.

PMID- 8486410
TI  - Observations on the breeding habitats of Aedes aegypti in Calcutta following an
      episode of dengue haemorrhagic fever.
AB  - A year-long (Nov. 1990-Oct. 1991) search for Ae. aegypti larvae was made of all
      water containers in and around fixed 100 houses at Bowbazar area in Calcutta
      following an episode of DHF. Out of 10151 containers searched, 615 (6%) were
      positive. Masonry tanks were the major (64.2%) and preferred (17%) breeding sites
      of Ae. aegypti. Indoor containers (6.7%) were more conducive to breeding of the
      vector species than the outdoor ones (3%). Breteau index showing wide variation
      (25 in December '90 to '93 in August 1991) proved to be the best for measurement
      of density of larval population of Ae. aegypti and paralleled the fluctuation in
      both rainfall and humidity. Role of temperature was not pronounced. It was noted
      that cases of DHF occurred even with the lowest Breteau index in December.

PMID- 8486411
TI  - Hemolysis reduction in plasmapheresis by module design: operating with pulsed
      flow filtration enhancement.
AB  - This study is an investigation into the effects of module design on hemolysis
      levels during the filtration enhancement of plasmapheresis using pulsed blood
      flow. Two polypropylene hollow fiber modules (F1 and F2) were compared under
      steady and pulsed flow conditions. The fiber lengths and membrane areas of the
      respective filters were 136 mm, 0.1 m2 and 226 mm, 0.25 m2 and were used at wall
      shear rates of 400 and 600 s-1. Fresh citrated bovine blood was circulated at 90
      ml/min through their fibers with permate and retentate being recirculated. Plasma
      samples were analysed by the Cripps method to obtain the mean free hemoglobin
      concentration. A comparison of the average hemoglobin released with time per
      fiber, and per unit length allowed an assessment of the effects of fiber length
      and shear rate on hemolysis levels. It was concluded that a reduction in area and
      fiber length would reduce hemolysis levels and design equations are suggested to
      find the optimum length.

PMID- 8486412
TI  - A process for enhancing selectivity and limiting plugging in plasmafractionation
      for APOB removal.
AB  - A new process using pressure and flow pulsations was investigated in the second
      stage of cascade filtration for ApoB removal. Due to enhanced filtration by the
      pulsations, the retentate flow vanished naturally without clamping the line,
      which reduced albumin and ApoA1 losses. The performance of Eval 4A and cellulose
      PF100 filters in this case were compared with that of classical dead end mode at
      a plasma flux of 18 ml/(min m2). The apparent sieving coefficient for small
      proteins (albumin, ApoA1) under pulsed conditions increased with increasing
      pressure instead of dropping as in dead end mode. In both cases the ApoB sieving
      coefficients remained below 0.02. These encouraging results were accompanied by a
      slower rise of transmembrane pressure showing a decrease of membrane plugging.
      Thus, the recovery of albumin and ApoA1 is increased while ApoB removal remains
      constant, which improves the selectivity of the fractionation stage.

PMID- 8486413
TI  - Effect of recombinant erythropoietin on electrolytes and nutrition in end-stage
      renal disease patients.

PMID- 8486414
TI  - A technique for the laboratory determination of recirculation in single needle
      dialysis.
AB  - Recirculation is an important factor in single needle dialysis and, if high, can
      compromise treatment efficiency. To provide information regarding recirculation
      characteristics of access devices used in single needle dialysis, we have
      developed a new technique to characterise recirculation and have used this to
      measure the recirculation of a Terumo 15G fistula needle and a VasCath SC2300
      single lumen catheter. The experimentally obtained results agreed well with those
      established clinically (8.5 +/- 2.4% and 18.4 +/- 3.4%). The experimental results
      have also demonstrated a dependence on access type, pump speeds and fistula flow
      rate. A comparison of experimental data with theoretical predictions showed that
      the latter exceeded those measured with the largest contribution being due to the
      experimental fistula.

PMID- 8486415
TI  - The epidermo-peritoneal potential in patients treated with continuous ambulatory
      peritoneal dialysis.
AB  - At physiologic pH, S. epidermidis moves along an electrical potential gradient.
      We measured the epidermo-peritoneal electrical potential (EPP) in 23 end-stage
      renal failure patients treated with CAPD. There was a negative correlation
      between the mean EPP and the patient's age (r = 0.47, p = 0.016), but no
      correlation between the mean EPP and the duration of treatment (r = 0.003, p =
      0.5). The EPP was greater in those patients with a history of recurrent bacterial
      peritonitis due to S. epidermidis [median EPP 23 mv (95% confidence limits 16
      51)] compared to those with only one or no episodes of bacterial peritonitis due
      to S. epidermidis infection [11 mv (9-17), p < 0.05]. Thus electrical gradients
      caused by the presence of the CAPD catheter could contribute to colonisation and
      subsequent infection by skin commensals, by aiding bacterial migration.

PMID- 8486416
TI  - Reverse flux filtration: a new mode of therapy improving the efficacy of heparin
      induced extracorporeal LDL precipitation in hyperlipidemic hemodialysis patients.
AB  - In the steady state after a run-in phase of 3 months, the acute effects of 3
      modifications of weekly heparin-induced extracorporeal LDL precipitation (HELP)
      were studied in 5 ESRD and 2 non-uremic hypercholesterolemic coronary patients.
      In ESRD patients (n = 29 sessions), HELP reduced LDL-cholesterol (LDL-C) (56 +/-
      7%) and fibrinogen (FIB) (54 +/- 10%) by a similar percentage as compared to non
      uremic controls (60 +/- 4% and 61 +/- 3%, resp.; n = 5). In order to eliminate
      the need for extra HELP sessions in addition to the normal dialysis regimen,
      newly developed hardware was then used to perform combined synchronous HELP/HD (n
      = 12). However, premature precipitate filter plugging probably due to
      hyperfibrinogenemia in ESRD patients, accentuated by ultrafiltration (UF),
      decreased the corresponding reductions to 26 +/- 9% (LDL-C) and 34 +/- 11% (FIB).
      Therefore, the procedure was modified by reversing the filtrate flux through the
      precipitate filter membrane after 900 ml of treated plasma ("reverse flux
      filtration", RFF; n = 11). Thus, in RFF-HELP/HD the LDL/FIB/heparin coprecipitate
      was deposited on both filter membrane sides which caused a significant
      enhancement of the filter capacity and improved reductions to 46 +/- 14% for LDL
      C and 51 +/- 15% for FIB. Elution of the precipitate from the precipitate filter
      after the sessions showed that RFF-HELP/HD had trapped 1733 +/- 238 mg LDL-C and
      8108 +/- 1876 mg FIB in ESRD patients, while HELP eliminated 1890 +/- 333 mg LDL
      C and only 3663 +/- 369 mg FIB in non-uremics. Filter precipitate recoveries
      (relative to the mass removed from the patient plasma pool) amounted to 97 +/-
      18% for LDL-C and 158 +/- 67% for FIB in the ESRD group treated by RFF-HELP/HD
      vs. 70 and 76% in the non-uremic HELP group. Probably, passive transport of
      lipoproteins and FIB from the interstitium into the vascular space caused
      repletion of this compartment during HELP/HD where an UF induced solvent drag is
      effective. In summary, the new RFF-HELP/HD procedure effectively reduced LDL-C
      and FIB in ESRD patients who could not be adequately treated by the conventional
      HELP/HD system.

PMID- 8486417
TI  - Catecholamine infusion versus intraaortic counterpulsation at the initial phase
      of left intraventricular balloon pumping in the fibrillating animal heart.
AB  - This experimental study compares the effect of catecholamine infusion to the
      effect of intraaortic counterpulsation (IABP) while initiating intraventricular
      balloon pumping (IVBP) in the fibrillating heart. In 12 dogs IVBP started
      immediately after the induction of ventricular fibrillation. Intravenous
      adrenaline or noradrenaline (at a progressively increasing infusion rate until
      the systolic aortic blood pressure was 120 mm Hg) was interchanged with IABP. The
      systolic aortic pressure, the aortic flow and the mean left atrial pressure were,
      respectively, 120.4 +/- 0.5 mm Hg, 42 +/- 4 ml kg-1 min-1 and 18.7 +/- 1.2 mm Hg
      (x +/- SEM) ten min after initiating catecholamine infusion and 97 +/- 5 mm Hg
      (with a 131 +/- 4 mm Hg diastolic wave), 69.6 +/- 4 ml kg-1 min-1 and 16 +/- 1.5
      mm Hg ten min after initiating IABP. The difference in aortic flow was
      significant (p < 0.001). The results indicate that a better aortic flow may be
      obtained by combining IVBP and IABP than IVBP and vasoconstrictive agents in the
      fibrillating heart. If IVBP, IABP and catecholamines are combined, both AF and AP
      may increase.

PMID- 8486418
TI  - Chronic in vivo function of a new ventricular assist device: the extracorporeal
      pulsatile assist device (EPAD).
AB  - An extracorporeal pulsatile assist device (EPAD) is a valveless, single
      chambered, pneumatically-actuated blood pump composed of a graft conduit,
      connecting ring, bladder, and blowmolded housing. This allows a simple and quick
      surgical procedure and is easily actuated with a conventional intraaortic balloon
      pumping console if desired. To evaluate in vivo pump functions, the EPAD was
      tested in calves as a left ventricular assist device for 6-24 days. The EPAD was
      well synchronized to the natural heart beat up to 130 bpm in the counterpulsation
      mode with mild systemic heparinization (active clotting time: 200-250 seconds).
      Heart rate, coronary flow and cardiac output were not significantly changed by on
      off testing. However, the pump showed promising diastolic augmentation (10.8%
      increase in the diastolic pressure time index) in these chronic animal
      experiments.

PMID- 8486419
TI  - Transplantation of free and microencapsulated islets in rats: evidence for the
      requirement of an increased islet mass for transplantation into the peritoneal
      site.
AB  - Microencapsulation of islets of Langerhans may avoid the necessity of a permanent
      immunosuppressive drug therapy and opens up new perspectives for
      xenotransplantation in the treatment of insulin dependent diabetes. In a mouse
      model we recently showed long-term normoglycemia after microencapsulated
      xenotransplantation. Since the acceptance of mice to any kind of foreign material
      is quite high we assume that the rat model better reflects the situation of
      higher mammalians or even humans. Due to the volume of the transplanted material
      (i.e. islets+alginate-capsule) only the peritoneal cavity can be used up to now.
      The quantity of islets necessary to normalize the non-fasting blood glucose level
      was much higher than expected and free transplants needed even a higher amount of
      islets than encapsulated ones (3000 encapsulated vs. 2 x 3000 non-encapsulated).
      Transplantation beneath the kidney capsule was successful with only 1200-1500
      islets per rat proving the metabolic potency of the islets. Implantation of empty
      capsules did not alter the diabetic state. We conclude that the alginate matrix
      may act as a "spacer" creating a distance between the consuments of a lacking
      substrate esp. oxygen in an unfavourable environment and perhaps protect it from
      unspecific mediators released during the postoperative period. Our findings
      underline the necessity for smaller capsules that would enable us to use other
      transplantation sites.

PMID- 8486420
TI  - Tumor antigens recognized by cytolytic T lymphocytes: present perspectives for
      specific immunotherapy.

PMID- 8486421
TI  - Cytologic screening for esophageal cancer: results from 12,877 subjects from a
      high-risk population in China.
AB  - Linxian, China, has one of the highest esophageal-cancer mortality rates in the
      world. In 1983, esophageal balloon-cytology screening was performed to identify
      subjects eligible for 2 nutrition-intervention trials in Linxian; 12,877 subjects
      had cytology slides which were satisfactory for diagnosis. Of the 12,649 subjects
      with squamous-cell diagnoses, 31% were normal by Chinese cytologic criteria; 38%
      showed hyperplasia; 21% showed dysplasia 1; 6% showed dysplasia 2; 2% showed near
      cancer; and 2% showed cancer. Of the 1,471 subjects with columnar-cell diagnoses,
      31% were normal; 44% showed hyperplasia; 16% showed dysplasia 1; 4% showed
      dysplasia 2; 2% showed near-cancer; and 3% showed cancer. Squamous dysplasia and
      cancer were more common among females than males, while columnar dysplasia and
      cancer showed male predominance. The prevalence of dysplasia and cancer of both
      cell types increased with age. The prevalence of squamous dysplasia was
      significantly higher than in earlier balloon-cytology screenings in Linxian,
      probably reflecting changes in cytologic classification.

PMID- 8486422
TI  - In situ evaluation of the relationship between epidermal-growth-factor-receptor
      status and tumor-cell proliferation in colon carcinomas.
AB  - The association between the expression of the epidermal-growth-factor receptor
      (EGFR) and tumor proliferation was studied in 69 resected human adenocarcinomas
      of the colon. EGFR was detected immunohistochemically using the monoclonal
      antibody (MAb) EGFRI. Tumor-cell proliferation was assessed with the MAb Ki-67
      directed against a proliferation-associated nuclear antigen expressed only in
      proliferating cells. The percentage of Ki-67-positive tumor cells (Ki-67 index)
      was evaluated by the point-counting method. Forty-seven carcinomas contained
      detectable EGFR immunoreactivity. Statistical analysis failed to reveal
      correlations between the EGFR status and T, N and M stages or tumor
      differentiation. The mean Ki-67 index did not differ between EGFR-positive and 
      negative carcinomas. Seven tumors contained clearly distinguishable areas with
      different EGFR staining intensity. In these tumors with a locally heterogeneous
      EGFR expression, tumor proliferation also did not correlate with EGFR
      immunoreactivity. These in situ observations suggest that EGFR expression may not
      play an important role in the growth regulation of human colonic carcinomas.

PMID- 8486423
TI  - Histologic grading in soft-tissue sarcomas. An analysis of 194 cases including
      AgNOR count and mast-cell count.
AB  - In order to establish a new histologic grading system for STS, we evaluated
      histologic prognostic factors. For this purpose, we selected 194 patients with
      STS: 31 in the upper extremities, 63 in the trunk, and 100 in lower extremities.
      All the patients were treated by surgery, followed by chemotherapy in 74 cases,
      radiotherapy in 11, chemotherapy and radiotherapy in 30, or no adjuvant treatment
      in 79. Histologic factors evaluated were mitotic count, extent of necrosis,
      cellularity, cellular pleomorphism, extent of myxoid change, sclerosis, non
      specific histologic diagnosis, counting of reaction product in silver stain for
      nucleolar organizer regions (AgNOR) and mast-cell counts. Univariate analysis
      revealed mitotic count, necrosis, cellularity, cellular pleomorphism, non
      specific histologic classification, AgNOR count and mast-cell count to be
      significantly related to prognosis. Multivariate analysis revealed that AgNOR
      count, cellularity and necrosis were independent prognostic factors. A new
      grading system was introduced: low-grade, intermediate-grade and high-grade. The
      survival between each group were significantly different; the 5-year-survival
      rate in patients of the low-, intermediate- and high-grade groups was 87%, 74%
      and 35% respectively. Our findings suggest that this histologic grading system
      may be useful for making therapeutic decisions.

PMID- 8486424
TI  - Cell proliferation as a long-term prognostic factor in diffuse large-cell
      lymphomas.
AB  - The relevance of cell proliferation rate--defined as the 3H-thymidine labeling
      index (3H-dT LI)--in predicting response to treatment (complete remission, CR),
      freedom from progression (FFP) and overall survival (OS) was evaluated in 86
      patients with diffuse large-cell lymphoma (DLCL). The biologic variable was not
      associated with most of the established clinical factors, such as gender and age
      of the patient, performance status, B symptoms, tumor bulk, or extranodal
      disease, but was directly related to stage. 3H-dT LI significantly predicted
      short- and long-term clinical outcome. In fact, more patients with slowly
      proliferating DLCL reached CR and had longer median FFP and OS than patients with
      rapidly proliferating DLCL. Multiple-regression analysis to evaluate the relative
      contribution of the different biologic and clinical variables in predicting CR,
      FFP and OS showed that 3H-dT LI and Ann Arbor stage were the only 2 stable
      factors, which retained their prognostic significance even in the presence of
      other conventional factors, and that 3H-dT LI was the most powerful as an
      indicator of risk of death in DLCL patients.

PMID- 8486425
TI  - Appearance of amplified thymidylate synthase or dihydrofolate reductase genes in
      stage-IV breast-cancer patients receiving endocrine treatment.
AB  - We have examined the appearance of amplification of 2 genes involved in
      resistance to chemotherapy (thymidylate synthase, dihydrofolate reductase) in
      patients receiving endocrine treatment. Chronological tumor samples were obtained
      from breast-cancer patients with clinical stage-IV disease, using fine-needle
      biopsies. The presence of amplification of thymidylate synthase and dihydrofolate
      reductase was determined using PCR in 185 fine-needle biopsies from 37 patients.
      None of the initial samples of each patient showed amplification. However, in 7
      of the 37 patients (19%) we detected development of gene amplification: in 2
      cases of thymidylate synthase and in 5 cases of dihydrofolate reductase. Five of
      the 7 patients with amplification were receiving second-line endocrine treatment
      after failing to respond to tamoxifen.

PMID- 8486426
TI  - Oral contraceptives and endometrial cancer: do other risk factors modify the
      association?
AB  - The joint effect of use of combination-type oral contraceptives and other
      exposure factors on risk of endometrial cancer was examined in data from a
      multicenter case-control study conducted in 5 areas of the United States. Cases
      were 405 women with histologically confirmed invasive epithelial endometrial
      cancer first treated at one of 7 participating hospitals. A total of 297
      population-based controls of similar age, race, and geographic area were selected
      as a comparison group. Information on exposure factors was derived from in-person
      interviews. Combination-type oral contraceptive (COC) use was associated with a
      significant reduction in risk of endometrial cancer, with an adjusted odds ratio
      (OR) of 0.4 (95% confidence interval 0.3 to 0.7) for ever compared to never use.
      Long-term (> or = 10 years) users experienced a markedly lower risk (OR = 0.2).
      Women who discontinued COC use > or = 20 years earlier remained at reduced risk
      (OR = 0.7) compared with non-users. The negative association with COC use was
      apparent regardless of the presence or level of several other risk factors for
      endometrial cancer, including age, menopausal status, parity, obesity, ever-use
      of menopausal estrogens, smoking history, or history of infertility. The
      magnitude of the negative association observed in COC users, however, was
      considerably diminished in women with no full-term births and in women who
      subsequently used replacement estrogens for 3 or more years. These results
      provide new evidence that the protective effect of COC use lasts for 20 or more
      years after use is discontinued, and highlight several sub-groups of users in
      whom the level of protection is attenuated by the presence of other risk factors
      for this disease.

PMID- 8486427
TI  - Prevalence of G-to-T transversions among K-ras oncogene mutations in human
      colorectal tumors in Yugoslavia.
AB  - Human colorectal carcinoma tissue sampled from 37 patients, routinely graded into
      Dukes' stages A, B and C and histologically examined for the level of
      differentiation, were analyzed for the presence of point mutations in the K-ras
      oncogene. Seventeen cases out of the 37 analyzed were found to have a mutation in
      either the 12th or the 13th codon of the K-ras gene, giving an overall frequency
      of mutation of 46%. The incidence of mutations in Dukes' stages A, B and C was
      33, 46 and 58% respectively. Although the frequency of mutation appears to be
      similar to that reported for the USA population, the spectrum of point mutations
      in codons 12 and 13 of the K-ras gene in the Yugoslav population appears to
      differ significantly. G-to-T transversions make up 77% of all mutations present,
      with the distribution as follows: 18% at the first base and 59% at the second
      base of codons 12 and 13. G-to-A transitions at the second base is the only other
      mutation identified, occurring mainly in codon 13 in colorectal tumors of all 3
      stages.

PMID- 8486428
TI  - HTLV-I and HTLV-II world-wide distribution: reanalysis of 4,832 immunoblot
      results.
AB  - Mapping the geographic distribution of human T-lymphotrophic virus types 1 and 2
      (HTLV-I and -II) has been complicated because conventional serologic approaches
      cannot distinguish between these 2 viruses. To more precisely define the
      epidemiology of HTLV-I and HTLV-II, we evaluated a convenience sample of 4,832
      HTLV-I immunoblot results from over 140,000 samples screened for HTLV-I,
      collected in 16 countries for 35 separate studies. An algorithm that compares
      reactivity against p19 and p24, 2 gag (HTLV-I core) proteins, was employed to
      characterize the immunoblots: type I, p19 stronger than p24 (presumptive HTLV-I),
      type 2, p24 stronger than p19 (presumptive HTLV-II), or indeterminate (p19 and
      p24 weakly positive or p19 weakly positive in the presence of p21e). Geographic
      areas could be grouped into 4 patterns. Patterns A (> 75% type I) and B (> 75%
      type 2) were usually observed where the specific type of HTLV or its
      characteristic diseases had been found. Pattern C (mixed type 1 and 2 pattern)
      was observed predominantly in intravenous-drug-using and other populations in
      which both virus types have been reported. Pattern D (> 10% indeterminate),
      suggests the presence of non-specific reactivity, perhaps resulting from exposure
      to non-virus-related antigens or an HTLV-related virus. HTLV-I predominates in
      southern Japan, the South Pacific, parts of West Africa, and in Afro-populations
      of the Western hemisphere. HTLV-II clusters in Native American populations and
      among intravenous drug users. Pattern-D areas in Africa and Venezuela might prove
      to be fertile in the search for new and variant HTLV virus types.

PMID- 8486430
TI  - Expression of MaTu-MN protein in human tumor cultures and in clinical specimens.
AB  - MaTu is a novel agent which may be of relevance in human oncogenesis, and has 2
      components. One of them, the exogenous MX (coding for protein p58X), is
      transmissible to human fibroblasts, to HeLa and to HeLa x fibroblast (H/F)
      hybrids. The other component, MN, is a cellular gene. Its product, the protein
      p54/58N, is inducible by infecting HeLa cells with MX or by growing them in dense
      cultures. This p54/58N appears to be a tumor-associated antigen: it is expressed
      in HeLa and in tumorigenic cells (H/F-T), but not in fibroblasts or in
      nontumorigenic hybrid cells (H/F-N). Proteins related to p54/58N were also found
      on immunoblots prepared from human carcinomas of ovary, endometrium and uterine
      cervix, but not from normal tissues from corresponding organs or from placenta.
      Using genetically engineered MN protein, we developed a radioimmunoassay for MN
      specific antibodies, and for quantitative determination of MN proteins in cell
      extracts. In HeLa cells infected with MX we observed conspicuous ultrastructural
      alterations: formation of abundant filaments on the cell surface and
      amplification of mitochondria. Using immunogold-staining, we visualized the
      p54/58N on the surface microvilli and in the nucleus, particularly in nucleoli.

PMID- 8486429
TI  - Polarization of the alpha 6 beta 4 integrin in ovarian carcinomas.
AB  - By immunizing a BALB/c mouse with a human ovary-carcinoma cell line (IGROV1),
      grown intraperitoneally in nude mice, a monoclonal antibody (MAb), designated
      MAR6, was produced and characterized. Immunofluorescence on the immunizing cell
      line showed a specific labelling by MAR6 at the cell-to-cell contact points. In
      addition, MAR6 was found to immunoprecipitate the alpha 6 beta 4 integrin
      complex. Competition tests with MAbs anti-alpha 6, anti-beta 4, anti-beta 1 sub
      units demonstrated that the recognized sub-unit is alpha 6. Indirect
      immunofluorescence on various cell lines gave MAR6 as positive only on alpha 6
      positive lines (IGROV1, OVCAR3, SW626, SKOV3, ME4405, Calu3, N592, MDA468, A431
      and HT29). Moreover, on IGROV1 and OVCAR3 ovary-carcinoma cells, which normally
      grow either adhering to the culture flask or forming clumps in suspension in the
      medium, MAR6 selectively stained the connection points between the cells in
      clumps, where, in the same position, the presence of the beta 4 sub-unit, laminin
      and fibronectin was detected. On the contrary, the beta 1 sub-unit was
      distributed over the whole cell membrane. The same pattern of labelling by these
      MAbs was observed in 2 cases of ovarian-carcinoma cells present in ascitic fluids
      obtained from patients. Immunoperoxidase tests performed on cryosections of
      various normal tissues showed specific reactivity of MAR6 on basal or basolateral
      membranes of epithelial cells. On cryosections of ovarian tumors, MAR6 reactivity
      correlated with the degree of tumor differentiation. Indeed, in benign and well
      differentiated tumors, a strong basal or basolateral labelling only of cells
      surrounding the neoplastic nodules was found. On the contrary, on
      undifferentiated tumors the inner part of the tumor nodules was also
      progressively labelled, whereas the staining on the border was weak and
      discontinuous as a result of the alpha 6 sub-unit dispersion on the tumor cell
      surface.

PMID- 8486431
TI  - Uptake of the neuron-blocking agent meta-iodobenzylguanidine and serotonin by
      human platelets and neuro-adrenergic tumour cells.
AB  - The adrenomedulla-imaging agent meta-iodobenzylguanidine (MIBG) is concentrated
      by various tumours of neuroectodermal origin. Radio-iodinated [131I]MIBG is
      therefore increasingly used for diagnosis and therapy of these disorders. To
      study the cause of thrombocytopenia associated with [131I]MIBG therapy, we
      investigated the uptake of MIBG in human platelets in comparison with that of
      serotonin. Specific imipramine-sensitive uptake of [131I]MIBG was much slower
      than of [3H]serotonin, but after prolonged incubation high and serotonin
      equivalent uptake levels were observed. Accumulation of MIBG saturated at 10- to
      100-fold higher concentration than serotonin, and the affinity for uptake and
      intracellular storage in platelets was much higher for serotonin than for MIBG.
      Conversely, serotonin was not detectably concentrated by neuroadrenergic Uptake-I
      in SK-N-SH neuroblastoma and PC12 pheochromocytoma cells. Fluvoxamine inhibited
      the uptake of norepinephrine and MIBG in PC12 cells, similarly to that of
      serotonin in platelets. However, the drug was 100-fold more effective in
      inhibiting platelet transport of MIBG than of serotonin. The results indicate
      that MIBG uptake in platelets is not mediated by a neuro-adrenergic Uptake-I, but
      probably proceeds via the serotonin transport system. MIBG concentration by
      platelets was at least as efficient as in neuro-adrenergic tumour cells and has
      therefore (radio)biological potential for injuring these cells or precursor
      megakaryocytes. Platelet uptake of MIBG could be selectively blocked by
      fluvoxamine in concentrations which minimally affected its accumulation in neuro
      adrenergic target cells.

PMID- 8486432
TI  - Suppression of tumorigenicity in temperature-sensitive mutants of embryonal
      carcinoma cells by induction of cell differentiation at non-permissive
      temperature.
AB  - The temperature-sensitive (ts) mutants of cell differentiation derived from the
      mouse teratocarcinoma cell line F9, when exposed to non-permissive temperature,
      undergo stem-cell differentiation concomitant with a transient retardation of
      cell-cycle progression. By incubating these mutant strains at non-permissive
      temperature, we were able to study the relationship between cell differentiation
      and tumorigenicity. Upon exposure to non-permissive temperature, the mutant cells
      undergo extensive differentiation and lose their ability to initiate tumors in
      vivo, but retain their in vitro proliferative potential. Our data suggest that
      the loss of tumorigenicity is not caused by altered proliferative potential, but
      rather by cell differentiation. We therefore suggest that the loss of
      proliferative potential and the onset of cell differentiation in teratocarcinoma
      F9 cells are 2 independent events which can be genetically dissected, and that
      there is (a) crucial step(s) in the differentiation pathway at which these ts
      mutant cells lose their tumorigenicity.

PMID- 8486433
TI  - Predicting treatment retention among cocaine users.
AB  - Few studies have addressed treatment retention among cocaine-using samples. The
      current study develops and tests a model of treatment retention at the individual
      level, employing data from 110 cocaine users who initiated outpatient treatment.
      The model includes measures of extent of drug involvement, social isolation and
      support, motivation, and demographic characteristics. Logistic regression is used
      to fit a final model, which includes measures of the following: living alone, use
      of multiple substances prior to treatment, length of cocaine use, and external
      motivation. Treatment implications and directions for further research are
      discussed.

PMID- 8486434
TI  - Treating chemical dependency: the need for including the family.
AB  - Regression analysis was used to test Family Systems Therapy as a fruitful
      approach in chemical dependency treatment. Results indicate that the concerned
      person's perceptions of family life are critical in determining whether a family
      completes therapy or terminates early. Using both family and individual level
      variables, the significance and direction of the coefficients are consistent with
      the Family Systems Therapy model. Results support the importance of including the
      family in chemical dependency treatment.

PMID- 8486435
TI  - Misuse and legend in the "toad licking" phenomenon.
AB  - Between 1988 and 1992 a new illicit drug experience arrived on the cultural scene
      in the United States, Canada, South and Central America, and Australia. The media
      created a frenzy of misinformation in reporting on the latest drug craze which
      was termed "toad licking". The uses of bufo toad secretions have occurred
      throughout history in a variety of cultural milieus. These are explored as a
      backdrop to contemporary drug use/misuse issues. At the interpersonal and social
      level, media exposure helped create and maintain the use/misuse phenomenon,
      turning a fairly obscure activity into a potential epidemic.

PMID- 8486436
TI  - Ethnic and gender differences in drug users' perceived need for treatment.
AB  - Little is known about ethnic and gender variation in drug users' perceived need
      for treatment or about the predisposing factors that might account for such
      variation. Among 1,170 drug-using arrestees in Los Angeles, perceived need for
      treatment is positively related to these predisposing factors: self-reported drug
      dependence, attitude toward treatment for drug use, and occurrence of drug
      related problems other than dependence. Self-reported drug dependence is higher
      among women and accounts for the greater perceived need reported by women.
      Hispanics are less likely to perceive a need for treatment. Among daily drug
      users, both Hispanics and Africans Americans are less likely to do so. These
      ethnic differences are not explained by self-reported drug dependence or any
      other predisposing factor. Implications for treatment referral, intake, and
      counseling are discussed.

PMID- 8486437
TI  - Perceptions of the causes of drug use in a series of articles in The
      International Journal of the Addictions.
AB  - There is now considerable evidence of historical variation in the definition of
      problem drug use. Less well studied has been contemporary variations in the
      perception of drug use. To remedy this, an examination of a series titled "From
      Theory to Practice: The Planned Treatment of Drug Users," published in The
      International Journal of the Addictions, was undertaken. The analysis shows
      little agreement on the causes of drug usage. The implications of this
      disagreement for policy is illustrated by showing how different perceptions of
      the causes of drug use imply different ways of responding to that use.

PMID- 8486438
TI  - Social networks and support mechanisms for people with mild intellectual
      disability in competitive employment.
AB  - Participant observation techniques were used to examine the social networks and
      the social support mechanisms of nine subjects with a mild intellectual
      disability working in competitive employment settings. Results indicated that the
      social networks of this group of people lacked complexity with few
      interconnections among the network nodes. The major sources of social support
      emanated from the family and from organizations catering for people with
      disabilities. While subjects perceived considerable social support within the
      workplace, this support was restricted to the workplace and in general did not
      extend beyond it. Implications of the findings of the study for ensuring the
      adequacy of social support both within and beyond the workplace for this group of
      people are discussed. Additionally, the need for the development of a theory or
      model of social support as it pertains to people with a mild intellectual
      disability employed in competitive employment settings is advocated.

PMID- 8486439
TI  - Rehabilitation innovations in Central America.
AB  - In an extensive qualitative research project sponsored by the Partners of the
      Americas (32 professional and lay people from Panama, Costa Rica, Nicaragua,
      Honduras, El Salvador, Guatemala, Belize, the United States and the Dominican
      Republic) employment opportunities were examined for disabled youth in Central
      America. Despite economic and attitudinal barriers field researchers found
      innovations in financing, special education and rehabilitation programming, job
      development and job placement alternatives for those who live with disability in
      Central America.

PMID- 8486440
TI  - Early intervention for children with developmental disabilities: manifesto of the
      Eurlyaid working party.
AB  - Eurlyaid is a working party of the European Community (EC). It consists of
      experts and representatives of parents' associations from the various member
      states involved in early intervention for children who are disabled or at risk of
      developmental disabilities. Starting from the growing recognition of the
      importance of early identification and intervention Eurlyaid aims to contribute
      to the development of a common EC policy and legislation. Here we describe a
      comprehensive framework for early intervention, presented as a preliminary
      manifesto. First of all the Manifesto gives a definition of key concepts,
      delineates the target group and states the rationale behind, and the content, of
      early intervention. Secondly, we present the conditions and demands necessary to
      attain the best quality early intervention, and make a number of recommendations.
      With an EC grant, Eurlyaid is able to continue its activities as part of ALEFPA
      Europe, a so-called non-governmental organization (NGO).

PMID- 8486441
TI  - Labour market conditions and the rehabilitation process.

PMID- 8486442
TI  - New technology training for people with disabilities in Great Britain.

PMID- 8486443
TI  - Vocational rehabilitation of young adults with a disability of one arm or hand.

PMID- 8486444
TI  - Evaluating a rehabilitation co-ordinator service for personal injury claimants.

PMID- 8486445
TI  - Individuals with psychiatric disabilities in adult homes: monitoring changes over
      time.

PMID- 8486446
TI  - Self-awareness of people with mental handicap.

PMID- 8486447
TI  - Facilitating conversation for non-speaking people with multiple handicaps.

PMID- 8486448
TI  - A model for touch technique and computation of adequate cane length.

PMID- 8486449
TI  - Employers' attitudes toward employing people with mental handicap.

PMID- 8486450
TI  - Attitudes and words referring to mental handicap.

PMID- 8486451
TI  - Prior history of back pain in patients with compensable and non-compensable
      injuries.

PMID- 8486452
TI  - Current concepts in electron microscopy.

PMID- 8486453
TI  - Diagnostic high-resolution ultrasound in dermatology.

PMID- 8486454
TI  - Dermatoepidemiology. Part I: Epidemiologic methods.

PMID- 8486455
TI  - In vivo cutaneous surface microscopy: revised nomenclature.

PMID- 8486456
TI  - Vaccine therapy in the treatment of melanoma.

PMID- 8486457
TI  - Acute febrile neutrophilic dermatosis (Sweet's syndrome).
AB  - BACKGROUND: Sweet's syndrome is well recognized and not infrequently diagnosed in
      Spain; however, the range of clinical and pathologic expression may not have been
      fully realized. METHODS: We reviewed 30 consecutive Spanish cases of Sweet's
      syndrome diagnosed in our department from 1979 to 1990, with special attention to
      clinical and histopathologic findings. RESULTS: Distinctive clinical features in
      our series included oral mucosa lesions in four patients (13%), development of
      pathergy phenomenon in one case, concurrent nodular lesions resembling erythema
      nodosum on the limbs in nine cases (30%), and lung involvement in two patients.
      Infectious disease and drug treatment were recorded as possible triggering
      factors of Sweet's syndrome in eight and seven patients respectively. Associated
      underlying systemic disorders were present in 15 (50%) of our patients. The most
      frequent associations were hematologic neoplasia in four patients, solid
      neoplasia in two, and chronic idiopathic inflammatory bowel disease in three
      patients. Dressler's syndrome and sicca syndrome were found in one patient each.
      Histopathologic studies of skin biopsy specimens obtained at presentation
      disclosed typical features of Sweet's syndrome in all cases. Epidermal
      involvement, with variable degrees of spongiosis, exocytosis of polymorphonuclear
      leukocytes and keratinocyte necrosis, was a prominent feature in 83% of biopsy
      specimens. CONCLUSIONS: Further characterization of the clinicopathologic
      spectrum of Sweet's syndrome is necessary as the recognition of the full spectrum
      of this syndrome will improve our diagnostic abilities and provide a solid
      clinical basis for prospective studies that allow dissection of the intricate
      patho-mechanisms involved in this fascinating disorder.

PMID- 8486458
TI  - Ultrastructural study of vitiligo.
AB  - BACKGROUND: Vitiligo is a relatively common skin disease characterised by
      development of patchy depigmented macules. A comparative ultrastructural study
      was undertaken between early developing (2-6 months duration) and long standing
      (1-5 years duration) lesions of vitiligo in a series of ten patients. METHODS:
      Skin biopsy specimens from the ten patients were fixed, stained, and examined
      under an electron microscope. RESULTS: No melanocytes were found in the sections
      taken from long standing lesions. The sections from early lesions showed
      junctional melanocytes exhibiting various cellular abnormalities. The epidermal
      keratinocytes were normal in all sections; however, some sections from the
      periphery of early lesions exhibited minor degenerative changes. CONCLUSIONS: We
      can assume that because of the absence of melanocytes in long standing lesions,
      repigmentation may occur only from the melanocytic reservoir in the hair
      follicles. Repigmentation may also occur in lesions of short duration by
      reactivation of melanocytes present in the area, so an attempt should be made to
      treat vitiligo lesions in their early stage.

PMID- 8486459
TI  - Heparin-associated thrombocytopenia and thrombosis (HATT) presenting with livedo
      reticularis.
AB  - BACKGROUND: Heparin-associated thrombocytopenia and thrombosis (HATT) is an
      infrequently encountered syndrome characterized by ischemic necrosis of soft
      tissue and vital organs following anticoagulation with heparin. The syndrome is
      thought to be due to heparin-dependent platelet aggregation and thrombosis, which
      is mediated by pathologic immunoglobulins. CASE REPORT: A 60-year-old man
      developed truncal livedo reticularis and ischemic necrosis of the left foot
      associated with thrombocytopenia, disseminated intravascular coagulopathy (DIC),
      and microangiopathic hemolytic anemia during intravenous heparin therapy. Skin
      biopsy from an area of livedo reticularis revealed fibrin thrombi in dermal blood
      vessels, which is characteristic of HATT. The diagnosis of HATT promoted
      discontinuation of heparin and a resulting rapid resolution of the livedo
      reticularis and hematologic abnormalities. No other potential causes of DIC were
      identified, and, other than stopping heparin, no specific therapy was employed.
      CONCLUSIONS: Periodic monitoring of platelets should be performed on all patients
      receiving treatment with heparin, as early detection of heparin-induced
      thrombocytopenia followed by discontinuation of the drug may prevent life
      threatening thrombotic complications. HATT should be included in the differential
      diagnosis of patients with livedo reticularis that occurs during heparin therapy.

PMID- 8486460
TI  - Multiple agminated pigmented Spitz nevi (mimicking acral lentiginous malignant
      melanoma and dysplastic nevus) in an African-American girl.
AB  - BACKGROUND: Reed's nevi are distinguished from Sptiz tumors by their significant
      melanogenesis and growth pattern. They may be confused with melanoma on clinical
      and histologic grounds. CASE REPORT: An unusual case in which multiple agminated
      Reed's nevi mimicked acral lentiginous malignant melanoma in an African-American
      girl is presented. A critical review of the literature is presented to assist in
      the diagnosis. CONCLUSIONS: Awareness of this entity and of its possible clinical
      presentations and judicious application of conventional hematoxylin-eosin
      microscopic criteria remain the most useful methods to bring the correct
      diagnosis in most instances. Mutilating or excessive surgery may be avoided for
      most cases of pigmented spindle and epithelioid cell nevus.

PMID- 8486461
TI  - Peripheral blood lymphocyte imbalance in Koreans with active vitiligo.
AB  - BACKGROUND: An immune-mediated destruction of melanocytes is the most popular
      current theory of vitiligo. There have been a few published reports on the
      assessment of lymphocyte population in vitiligo, and they showed mixed results.
      The purpose of our investigation was to assess peripheral lymphocyte
      subpopulations in Koreans with actively spreading vitiligo. METHODS: Fifty
      patients with actively spreading vitiligo and 30 normal persons were studied for
      peripheral blood lymphocyte imbalance using flow cytometry. The percentages of
      total T-lymphocytes, B-lymphocytes, helper T cells, suppressor T cells, and
      natural killer cells were evaluated with the use of CD3, CD19, CD4, CD8, and CD16
      monoclonal antibodies, respectively. RESULTS: The mean value of helper T cells
      showed a significant difference between the two groups with the value being 38.2%
      in patients and 43.5% in control subjects. Seventeen of the 50 patients showed
      reversed helper/suppressor T cell ratio, whereas only 1 of 30 control subjects
      showed reversed ratio. There was a statistically significant difference in the
      mean percentage of helper T cells and suppressor T cells between generalized
      vitiligo patients and control subjects. The percentage of B cells in patients
      with recent onset less than 1 year was higher than control subjects and patients
      with late onset. The mean percentage of natural killer cells was increased
      significantly in patients with negative autoantibody test. CONCLUSIONS: The
      present data show that immunologic abnormalities, both cellular and humoral, are
      involved in the pathogenesis of vitiligo.

PMID- 8486462
TI  - Margin assessment of selected basal cell carcinomas utilizing laser Doppler
      velocimetry.
AB  - BACKGROUND: Basal cell carcinomas (BCC) have increased vasculature, therefore,
      blood flow within the tumor may be greater than normal surrounding skin. We
      attempted to detect the difference in blood flow between the tumor and uninvolved
      surrounding skin utilizing laser doppler velocimetry (LDV). METHODS: Ten patients
      with 14 BCC were studied. Using LDV, we calculated the size of the tumor based on
      margin assessment as predicted by the measured difference in blood flow and
      compared this size with the clinically predicted size and the size of the defect
      after Mohs micrographic surgery (MMS). RESULTS: Clinical evaluation of tumor size
      prior to MMS did not correlate with the size of the surgical defect after MMS;
      however, correlation was found between the predicted size of the tumor as
      determined by LDV and the defect after MMS. CONCLUSIONS: Tumor size of BCC as
      predicted by measured differences in blood flow using LDV correlated with the
      size of the surgical defect after MMS. This suggests that LDV was able to detect
      the difference in blood flow between the tumor and uninvolved surrounding skin.

PMID- 8486463
TI  - Natural history of a superficial spreading melanoma.

PMID- 8486464
TI  - Malignant melanoma in a tattoo.

PMID- 8486466
TI  - The dermatology society historian.

PMID- 8486465
TI  - Granulocytic sarcoma (chloroma) of chest wall at site of Hickman line.

PMID- 8486467
TI  - Fibrin cuff lysis in chronic venous ulcers treated with a hydrocolloid dressing.
AB  - BACKGROUND: Pericapillary fibrin cuffs (PFC) are a recognized part of the
      pathology of venous stasis ulcers. A hydrocolloid dressing capable of lysing
      wound surface fibrin was tested in venous ulcers for its capacity to lyse
      pericapillary fibrin below the wound surface. METHODS: Tissue biopsies from the
      rims of 19 venous ulcers were evaluated for thickness of shallow and deep dermal
      PFCs before and after treatment with DuoDERM covered by Unna's boot and a
      compression bandage (DD+UB; n = 9) versus the same treatment without the
      hydrocolloid dressing (UB; n = 10). Frozen sections of all biopsies were stained
      with an immunofluorescent antibody to fibrin for rating of PFC thickness.
      Separate sections were stained with hematoxylin and eosin to assess capillary
      frequency, histopathology, and inflammation. All ratings and pathology
      assessments were performed blinded to treatment conditions. RESULTS: Both deep
      and shallow PFCs were reduced in 89% of ulcers treated with DD+UB versus 40% of
      ulcers treated with UB (alpha < 0.04). No other significant differences in
      inflammation, histopathology, or capillary frequency were observed. CONCLUSIONS:
      Treatment with DD+UB reduced PCFs in twice the number of ulcers than UB alone in
      1 week. This is the first scientific documentation that a topical wound dressing
      could reduce the pathophysiology associated with venous ulcers, beyond the known
      beneficial effect of graduated compression. Not all hydrocolloid dressing are
      fibrinolytic, so this effect may not generalize to other dressings.

PMID- 8486468
TI  - Pemphigus vulgaris after electrosurgery (thermal-heat therapy) of a basal cell
      carcinoma.

PMID- 8486469
TI  - Amoxicillin cross reacts with penicillin on first exposure.

PMID- 8486470
TI  - The vacuolar H(+)-ATPases: versatile proton pumps participating in constitutive
      and specialized functions of eukaryotic cells.

PMID- 8486471
TI  - Molecular and kinetic aspects of sodium-calcium exchange.

PMID- 8486472
TI  - [The hypersensitive bronchial system. Significance for prognosis inhibition of
      progression of chronic obstructive respiratory tract diseases].

PMID- 8486473
TI  - [Inhibition of progression of decreasing bone mass and manifest osteoporosis].

PMID- 8486474
TI  - [Early chronic polyarthritis. Possibilities and limits of inhibition of joint
      destruction].

PMID- 8486475
TI  - [Inhibition of the progression of chronic liver diseases].

PMID- 8486476
TI  - [Crohn disease. How can short bowel syndrome be prevented?].

PMID- 8486477
TI  - [Inhibition of the progression of renal failure in glomerular diseases].

PMID- 8486478
TI  - [Systemic lupus erythematosus].

PMID- 8486479
TI  - [Young patient with hypotension, constipation and urinary retention].

PMID- 8486480
TI  - [Low platelet count without manifest disease].

PMID- 8486481
TI  - [How should serologic findings in borreliosis be evaluation (for example high
      antibody titer in remitted symptoms)?].

PMID- 8486482
TI  - [Hypercalcemia].

PMID- 8486483
TI  - The influence of clinical history on visual search with single and multiple
      abnormalities.
AB  - RATIONALE AND OBJECTIVES: Facilitation of detection by clinical history generally
      has been found with a single abnormality per image but not with multiple
      abnormalities. Multiple abnormalities per image can occasion a "satisfaction-of
      search" effect in which detection of one lesion is reduced in the presence of
      other distant lesions. Our experiment studied the combined effect of multiple
      abnormalities and clinical history on accuracy. METHODS: Detection of native
      lesions was measured 1) with histories suggestive of the native abnormality; 2)
      with these histories and added simulated pulmonary nodules; and 3) with the same
      added nodules and histories suggestive of metastatic disease. These conditions
      also were compared with those of a previous experiment that were similar but
      included no history. RESULTS: Detection was substantially improved for
      appropriately prompted abnormalities even in the presence of a pulmonary nodule.
      In fact, satisfaction of search was not found in the presence of an appropriate
      history. Detection of unprompted abnormalities was unchanged when prompts
      indicated other abnormalities actually present. Prompted abnormalities were
      detected earlier in search. CONCLUSIONS: History appears to direct perceptual
      resources to the prompted abnormalities, thereby alleviating satisfaction of
      search. The presence of nodules yielded a small but consistent reduction in total
      search time for searches involving false responses, suggesting that satisfaction
      of search may depend more on reduction in search time than had been indicated by
      previous research.

PMID- 8486484
TI  - Invasive lobular carcinoma. Imaging features and clinical detection.
AB  - RATIONALE AND OBJECTIVES: Mammographic findings and method of detection of 52
      cases of invasive lobular carcinoma (ILC), the second most common breast
      carcinoma, are reported. METHODS: Preoperative mammograms and clinical records of
      all patients with ILC not associated with a second mammary carcinoma (other than
      lobular carcinoma in situ) from 1979-1991 at the authors' institution were
      retrospectively reviewed. RESULTS: Abnormal mammographic findings were present in
      48/52 (92%) and included irregular spiculated masses (33/52, 63%), asymmetric
      densities (7/52, 13%), architectural distortion (5/52, 10%), microcalcifications
      (2/52, 4%), and well circumscribed masses (1/52, 2%). The mean mammographic
      diameter was 2.1 cm. The tumor was most often best visualized in the craniocaudal
      projection. At the time of diagnosis, 54% of women had coexistent suggestive
      breast physical findings and 35% had metastatic carcinoma in axillary lymph
      nodes. CONCLUSIONS: The infrequency of microcalcifications in pure ILC may hinder
      mammographic detection and contrasts markedly with ductal carcinoma. Mammography
      and breast physical examination play complementary roles in the detection of ILC.

PMID- 8486485
TI  - Susceptibility effects of bone trabeculae. Quantification in vivo using an
      asymmetric spin-echo technique.
AB  - RATIONALE AND OBJECTIVES: The authors assessed the capability of magnetic
      resonance imaging in measuring bone mineral density in vivo. METHODS: Using the
      in-phase asymmetric spin-echo technique, the susceptibility effect
      (T2*susceptibility) was measured in lumbar vertebrae in vivo. Calcium density was
      measured with single energy quantitative computed tomography scan. The values of
      the susceptibility effect were correlated with calcium density. RESULTS: A
      statistically significant positive correlation was observed between signal loss
      due to susceptibility-induced inhomogeneity and the calcium density in the region
      of interest. The change in 1/T2*susceptibility per unit change in density was
      0.114 seconds-1/mg/cm3. T2*susceptibility was 14.3 mseconds in volunteers and
      17.4 mseconds in postoophorectomy patients. CONCLUSIONS: To some extent,
      quantification of bone density is possible using magnetic resonance imaging;
      however, the relatively wide dispersion of the susceptibility effect, plotted
      against the calcium density in the axial skeleton, indicates that other factors,
      such as the three-dimensional structure of bone trabeculae, may play important
      roles in determining magnetic resonance parameters.

PMID- 8486486
TI  - Effect of clinical history on the interpretation of chest radiographs in
      childhood bronchiolitis.
AB  - RATIONALE AND OBJECTIVES: This study assesses the effect of a clinical history of
      "bronchiolitis" versus "well child" on the interpretation of pediatric chest
      radiographs. METHODS: Radiologists reviewed radiographs previously identified as
      "definite bronchiolitis," "equivocal bronchiolitis," "definite normal," and
      "equivocal normal." They were asked to identify features of bronchiolitis and
      give a confidence level for their diagnosis. A correct clinical history of
      "bronchiolitis" or a "well child" was provided for all definite and half the
      equivocal radiographs. The other half of the equivocal radiographs were matched
      with incorrect histories. RESULTS: Given normal radiographs with a history of
      bronchiolitis, radiologists reported more features of bronchiolitis with
      increased confidence and also more features. CONCLUSIONS: The results suggest
      that the effect of history is not simply to provide additional confirmatory
      information, thereby increasing the diagnosis rating, but rather to change the
      interpretation of features, to the extent that features apparently are seen even
      on normal radiographs.

PMID- 8486487
TI  - Detection of experimental rat liver tumors by contrast-assisted ultrasonography.
AB  - RATIONALE AND OBJECTIVES: The authors characterized the effect of intravenous
      lipid-coated microbubbles (LCMs) on the echogenicity of malignant liver tumors.
      METHODS: Novikoff hepatoma cells were inoculated into the livers of 16
      anesthetized Sprague-Dawley rats. Sonograms were obtained weekly after tail-vein
      injection with either 0.2 mL/kg LCMs or saline control. RESULTS: A statistically
      significant difference in the signal-to-noise ratio (SNR) was observed between
      the group that received LCMs (10 rats) and the group that received saline (6
      rats) (P < .01). The effect persisted for 30 minutes after contrast injection.
      Selective leakage and accumulation of LCMs into the tumor tissue itself was
      confirmed histologically using lipid-specific counterstains. CONCLUSIONS:
      Intravenous injection of the LCM contrast agent produces a rapid increase in the
      echogenicity of the experimental Novikoff tumor in the rat liver.

PMID- 8486488
TI  - Sodium-calcium balance in nonionic contrast media. Effects on the risk of
      ventricular fibrillation in the isolated rabbit heart.
AB  - RATIONALE AND OBJECTIVES: During coronary arteriography the blood is replaced for
      a short period of time with a contrast medium (CM) solution. The CM may cause a
      risk of arrhythmias and ventricular fibrillation (VF). Previous investigations
      have shown that the addition of small amounts of sodium (10-30 mmol/L) to
      nonionic CM may decrease the risk of VF from these media. Calcium addition to
      nonionic CM may reduce a negative inotropic effect. In the current investigation,
      the changed risk of VF from nonionic CM with 19 to 30 mmol/L NaCl was studied
      when the media also contained calcium or calcium and magnesium. METHODS: An
      isolated rabbit heart model was used. The risk of arrhythmias and VF from the
      nonionic monomer iohexol and the nonionic dimer iodixanol containing 19 to 30
      mmol/L NaCl with 0 to 2.5 mmol/L calcium as CaCl2 was studied. In the series with
      iodixanol, 0 to 0.95 mmol/L MgCl2 also was added to the solutions with sodium and
      calcium, but the role of magnesium was not especially evaluated in the
      investigation. RESULTS: Nonionic CM with small amounts of NaCl (19-30 mmol/L),
      without calcium or with calcium at the level of 0.05 to 0.3 mmol/L, caused the
      lowest risk of VF. When relatively higher additions of calcium reached the
      physiologic concentration of 2.5 mmol/L, the CM caused a greater risk of
      arrhythmias and VF. CONCLUSIONS: When calcium is added to a nonionic CM, the
      concentration of calcium must be balanced against the NaCl concentration to
      minimize the risk of VF. Excessive calcium concentration will increase the risk
      of VF.

PMID- 8486489
TI  - Electrocautery of the tract after needle biopsy of the liver to reduce blood
      loss. Experience in the canine model.
AB  - RATIONALE AND OBJECTIVES: Bleeding is the most common complication of needle
      biopsy of the liver. This study was designed to assess the feasibility of using
      unipolar electrocautery to decrease bleeding. METHODS: Under general anesthesia,
      the livers of eight dogs were surgically exposed. A mean of 15 biopsies was
      obtained with 18-gauge needles from each liver by alternating biopsies without
      and with electrocautery. Cautery was performed by applying radiofrequency energy
      at 25 watts (6 animals) or 125 watts (2 animals) to the needle as the needle was
      withdrawn from the liver. Blood loss was measured by applying preweighed sponges
      to the biopsy site, then reweighing them after use. Biopsy specimens were
      examined by light microscopy. RESULTS: The mean (+/- SD) blood loss was 0.44 g
      (+/- 1.36 g) with electrocautery and 1.47 g (+/- 2.23 g) without electrocautery
      (P < .01). No thermal injury was noted in the biopsy specimens when cautery was
      applied at 25 watts. CONCLUSIONS: The application of radiofrequency current to
      the biopsy needle after liver biopsy is a feasible and effective method to reduce
      blood loss in our canine model.

PMID- 8486490
TI  - Digital radiography versus conventional radiography for the detection of a skull
      fracture under varying exposure parameters.
AB  - RATIONALE AND OBJECTIVES: The effect of varying exposure parameters on the
      detectability of a fracture with digital and conventional radiography were
      examined. METHODS: A macerated fractured skull was imaged by film-screen
      radiography (FSR) and digital storage phosphor radiography (DR) with various
      exposure values. Five radiologists traced the course of a fracture line. The
      length of the fracture was reported and the results were analyzed by Student's t
      test for paired samples. RESULTS: At 35% of the conventional radiation dose, the
      standard DR screen displayed an average of 48% of the fracture length. The
      difference from the conventional image (45%) was not significant in this case. An
      increase of the dose to ten times the conventional dose (250 mAs) yielded no
      significant improvement in the detectability of the length of the fracture (51%).
      CONCLUSIONS: This experiment shows that with use of the DR with the standard
      screen, a dose reduction of approximately 35% appears to be possible without any
      resulting loss of image quality compared to FSR. Use of the high resolution
      screens should be avoided, since they require a higher incident image dose than
      standard screens without offering any diagnostic advantages. The image dose of
      digital radiographs can be roughly estimated based on the digital device
      sensitivity value. As a rule, the sensitivity value should range between 100 and
      200.

PMID- 8486491
TI  - Whole lung sections for computed tomographic-pathologic correlations. Modified
      Gough-Wentworth technique.
AB  - RATIONALE AND OBJECTIVES: High-resolution computed tomography of the lung has
      been advocated in the evaluation of interstitial lung diseases and emphysema. To
      provide material for correlations with gross pathology and macroscopic
      quantitation of emphysema, the authors have shortened and simplified the Gough
      Wentworth technique. METHODS: The method permits more precise correlation of
      cross-sectional images and pathologic specimens and is less time-consuming.
      RESULTS AND CONCLUSIONS: This modified method can be routinely performed in a
      clinical laboratory of pathology and provides paper-mounted whole lung sections
      within four days. The sections are protected by a transparency film.

PMID- 8486493
TI  - Five-year combined diagnostic radiology/nuclear medicine residency.

PMID- 8486492
TI  - Evaluation of the postsurgical esophagus after partial esophagogastrectomy for
      esophageal cancer. Normal postoperative appearance and complications.

PMID- 8486494
TI  - Abdominal wall mass in a pregnant woman.
AB  - Abdominal fibromatosis should be considered in female patients of childbearing
      age who present with a mass arising from the abdominal musculature, particularly
      if the mass becomes evident during or immediately after gestation. Magnetic
      resonance imaging, with its multiplanar imaging capabilities, is useful in
      characterizing soft tissue tumors and in defining the extent of tumor involvement
      of adjacent structures.

PMID- 8486496
TI  - A report from the American Board of Radiology.

PMID- 8486495
TI  - Apples and oranges.

PMID- 8486497
TI  - Remedial program for diagnostic radiology residents.
AB  - OBJECTIVES: We describe a 1-year remedial program for radiology residents with
      deficiencies in basic medical sciences that cause difficulty in the understanding
      and application of basic radiologic principles. METHODS: Six of 107 residents
      participated in the remedial program at separate times during an 8-year period.
      The design of the remedial program was based on the following: 1) reassignment to
      first year basic radiology rotations with 1-year delayed advancement to the
      subspecialty rotations; 2) comprehensive radiology texts that contain a detailed
      review of related embryology, anatomy, physiology and pathology; 3) instruction
      in the study of the texts; and 4) repetitive learning accomplished by
      intermittent reassignment of rotations in which difficulty was demonstrated.
      Resident performance was evaluated by correlation of monthly written faculty
      evaluations, the results of the American College of Radiology Intraining
      Examination, and the American Board of Radiology (ABR) written and oral
      examinations. RESULTS: During the period of remediation, faculty evaluation
      revealed improved performance in all six residents from below-average ratings
      (mean = 2.3) to above-average and superior ratings (mean = 8.3). These results
      were correlated with the American College of Radiology Intraining Examination
      scores, which improved from the lowest quartile (range 0% to 28%) to the highest
      (range 78% to 99%). Each resident successfully passed the ABR written and oral
      boards on the first attempt. Two additional residents who were offered but did
      not accept remediation eventually dropped out of the program or repeatedly failed
      the written ABR examination. CONCLUSIONS: Ultimately, strengthening basic medical
      science knowledge facilitated interpretation of radiographs by enabling the
      integration of basic radiologic and scientific principles and understanding the
      underlying basic medical, radiologic, and clinical significance.

PMID- 8486498
TI  - Evaluation of resident applicants by letters of recommendation: a comparison of
      traditional and behavior-based formats.
AB  - RATIONALE AND OBJECTIVES: Traditional, narrative letters of recommendation
      solicited by medical students applying for radiology residency are widely used as
      a selection tool. Letters of recommendation are considered a source of reliable
      information about the attitudes and behaviors (non-cognitive variables) of the
      resident applicant. However, in many instances, this information is not present
      or is highly encoded and cannot be extracted. This study attempted to document
      the deficiencies of traditional letters of recommendation and determine the
      effectiveness of a structured letter of recommendation in obtaining information
      regarding noncognitive variables. METHODS: One hundred thirteen randomly selected
      letters of recommendation were analyzed by two radiologists with experience in
      residency selection. Deficiencies in inclusion of information or the ability to
      extract information about noncognitive variables were documented. A standard
      behavioral assessment was sent to the writers of these letters of recommendation
      and these results tabulated. RESULTS: The traditional letters of recommendation
      were frequently deficient in data regarding the noncognitive variables. In
      letters that contained such data, two experienced reviewers could not reliably
      extract the information. The structured form produced clearly identifiable
      information about the letter writer's assessment of noncognitive variables.
      CONCLUSIONS: Traditional letters of information are frequently deficient in data
      regarding noncognitive variables. A standardized statement is effective in
      eliciting information on noncognitive variables related to applicant performance.

PMID- 8486499
TI  - Late bloomers.

PMID- 8486500
TI  - Magnetic resonance imaging contrast agents. Design and physicochemical properties
      of gadodiamide.

PMID- 8486501
TI  - Preclinical safety assessment and pharmacokinetics of gadodiamide injection, a
      new magnetic resonance imaging contrast agent.
AB  - In a wide range of preclinical studies of gadodiamide injection (Omniscan, Sanofi
      Winthrop, New York, NY, and Nycomed AS, Oslo, Norway), the pharmacokinetics of
      the compound have been delineated and its safety demonstrated. The
      pharmacokinetic behavior of gadodiamide was consistent with its extracellular
      distribution. Its half-life in rats, rabbits, and monkeys was short, 18, 38, and
      75 minutes, respectively. Gadodiamide was shown to be excreted rapidly, primarily
      through the kidneys. In rats, 94% of the administered dose was excreted in the
      urine within the first 24 hours after administration. Approximately 1% to 4%
      appeared in the feces during the same period. Gadodiamide injection has been
      shown to have a remarkably low acute lethal toxicity, superior to that of
      gadopentetate dimeglumine injection (Magnevist, Berlex Laboratories, Wayne, NJ,
      and Schering AG, Berlin, Germany) or gadoterate meglumine (Dotarem, Laboratoire
      Guerbet, Aulnay-Sous-Bois, France). In comparison with gadopentetate dimeglumine
      injection, gadodiamide injection had fewer effects on cardiovascular and
      hemodynamic function after rapid intravenous injection in anesthetized dogs and,
      in vitro at high concentrations, on erythrocyte fragility and arterial wall
      tension. The lesser effects might be attributable, at least in part, to the lower
      osmolality of gadodiamide injection, although it remains to be seen whether this
      will translate into any advantage for gadodiamide injection at the lower doses
      used for imaging procedures in patients. Similar to all known intravenously
      administered diagnostic imaging agents, gadodiamide injection produces
      vacuolization of the proximal tubular cells in the kidney, without any change in
      renal function. However, the single-dose threshold for this effect is greater
      than 0.5 mmol/kg in the rat; even after a dose of 10 mmol/kg, the vacuolization
      was only "moderate" in degree and was shown to have regressed partially during
      the 7 days after administration. In monkeys, administration of 0.25 mmol/kg daily
      for 28 days had no effect on the kidney, thus providing reassurance of the wide
      margin of safety for any effect of this compound on the kidney. Although intended
      for single administration in patients, gadodiamide injection has been studied
      extensively in a range of subchronic studies in rats and monkeys. The compound
      was well tolerated in monkeys even when administered at doses up to 1.25 mmol/kg
      daily for 28 consecutive days. In rats, significant toxicity occurred only at
      high doses, particularly in male animals, and the pattern of toxicity (involving
      the stomach, testes, and skin) suggested a disturbance of zinc metabolism.
      Gadodiamide injection produced no significant irritation when administered by a
      variety of intravascular and extravascular routes.

PMID- 8486502
TI  - Current status of enhanced magnetic resonance imaging in neuroradiology.

PMID- 8486503
TI  - Gadodiamide injection. First human experience with the nonionic magnetic
      resonance imaging enhancement agent.
AB  - The safety, tolerance, and pharmacokinetics of gadodiamide injection (Omniscan,
      Sanofi Winthrop Pharmaceuticals, New York, NY) were evaluated in an open,
      ascending-dose study in 20 healthy male volunteers. Gadodiamide injection was
      administered intravenously at doses of 0.05, 0.1, 0.2, and 0.3 mmol/kg. Mild
      adverse events were experienced by nine subjects. These events included, but were
      not limited to, light-headedness, dizziness, and perversion of taste or smell.
      There was one occurrence of injection-associated discomfort that resolved within
      seconds. Vital sign and electrocardiogram measurements did not show any
      clinically relevant changes. There were no clinically significant changes in
      laboratory parameters, but minor transient elevations in serum iron were
      detected. These elevations typically occurred 8 and 48 hours after administration
      of gadodiamide injection and were not dose related. The pharmacokinetics of
      gadodiamide injection were evaluated in the 0.1-mmol/kg and 0.3-mmol/kg dose
      groups with the serum time-concentration data fitted to an open two-compartment
      model and the urine time-concentration data fitted to a one-compartment model.
      The serum elimination half-life was approximately 70 minutes, and urinary
      recovery was greater than 95% by 72 hours after administration.

PMID- 8486505
TI  - Common problems and cooperative solutions. Organizational activity in
      evolutionary studies, 1936-1947.

PMID- 8486504
TI  - Use of the magnetic resonance contrast agent gadodiamide in the central nervous
      system. Results of a multicenter trial.
AB  - To investigate the safety and efficacy of the low-osmolar, nonionic contrast
      agent, gadodiamide injection (Omniscan, Sanofi Winthrop Pharmaceuticals, New
      York, NY), for magnetic resonance imaging (MRI) of the head and spine, a
      multicenter study involving 439 patients was done at 15 centers as part of a
      Phase II/III clinical trial. Unenhanced MRI scans were obtained after which the
      patients were injected with 0.1 mmol/kg gadodiamide, and the MRI was repeated.
      The patients' vital signs were monitored, and laboratory studies were conducted.
      Neurologic status was examined before and after the study. The images were
      evaluated for contrast enhancement. No patient had any significant adverse event
      or serious change in clinical status. Abnormalities were found in 80% (351) of
      all patients studied, and it was found that, in 75% (266) of these, the
      postgadodiamide injection images were improved or facilitated visualization of
      lesions compared with preinjection images. The investigators believe that, based
      on the results of this study, gadodiamide injection is safe and effective for
      imaging the head and spine. They suggest that future studies further assess and
      compare the safety parameters of gadodiamide injection with those of other
      nonionic and ionic gadolinium ligands.

PMID- 8486506
TI  - Exteroceptive silent periods of temporalis muscle activity: correlation with
      neuropsychological findings.
AB  - The latency and duration of the early (ES 1) and late (ES 2) exteroceptive silent
      period of temporalis muscle activity were determined in 51 neurological patients.
      We investigated whether these electrophysiological parameters correlated with
      neuropsychological variables of the patients using standardized scores for
      personality index, state of well-being and physical symptoms. There were no
      correlations between personality traits and the electrophysiological parameters,
      while we found significant correlations between the duration of ES 2 and
      momentary psychological and physical well-being variables. Moreover, the score of
      the momentary well-being item 'general feeling of well-being' was demonstrated to
      moderate significantly the ES 2 duration (P = 0.018). Therefore,
      neuropsychological factors prove to be of great relevance to the exteroceptive
      silent periods of temporalis muscle activity.

PMID- 8486507
TI  - Migraine: an alternative in the diagnosis of unclassified vertigo.
AB  - Vertigo and unsteadiness are frequent reasons for medical consultation. In some
      cases, these symptoms remain unclassified. The association of equilibrium
      disorders with migraine is often mentioned in literature. Seventy-two cases of
      unclassified vertigo were studied in order to ascertain the prevalence of
      migraine in patients affected by recurring episodes of vertigo from undetermined
      causes, and attempting to establish a possible relationship with migraine.
      Characteristics of the vertigo and the headache, were evaluated by clinical
      history and examination, electronystagmogram (ENG), electroencephalogram (EEG),
      computerized tomography scanning (CT) and/or magnetic resonance imaging (MRI). In
      the group of patients studied 50% suffered from headache, and 32.8% fulfilled the
      diagnostic criteria of migraine. Results suggest that only a thorough clinical
      history would be able to give enough information to establish the diagnosis of
      migraine in these patients. These observations imply an alternative diagnosis to
      be taken into account when a case of unclassified vertigo is evaluated.

PMID- 8486508
TI  - Vestibulo-ocular reflex in migraine patients: the effect of sodium valproate.
AB  - We studied vestibulo-ocular reflex measurements in a group of 12 patients
      suffering from migraine without aura and evaluated the effect of sodium valproate
      given as prophylactic migraine therapy. The study was randomized, double blind
      and placebo controlled, with a crossover design. The horizontal vestibulo-ocular
      reflex was evaluated by the Sinusoidal Harmonic Acceleration test at 0.01, 0.02,
      0.04, 0.08 and 0.16 Hz using a computerized rotatory chair system. No
      abnormalities were found for the vestibulo-ocular reflex gain, phase and
      asymmetry at each of the frequencies examined during the placebo treatment. These
      normal vestibulo-ocular reflex measurements contrasted with the repeated
      complaints of dizziness, vertigo and unsteadiness reported by 7 patients (58%).
      Sodium valproate affected neither vestibulo-ocular responses nor vestibular
      complaints but was effective in reducing migraine attacks in 8 of the 12
      patients. These results demonstrate that the low frequency vestibulo-ocular
      reflex measurements are normal in patients suffering from migraine without aura.

PMID- 8486509
TI  - Posttraumatic headache: determining chronicity.
AB  - In the headache literature, there exists a great deal of discrepancy regarding
      when posttraumatic headache (PTH) may be classified as chronic. Although chronic
      pain is usually described as pain persisting for longer than six months, many
      view chronic posttraumatic headache as persisting for more than two months,
      including the International Headache Society criteria. Observations made by
      Brenner and Friedman in 1944 have been repeatedly cited for this determination.
      Surprisingly, a review of this original source revealed that the term "chronic"
      was never used when discussing posttraumatic headache over two months duration.
      The authors, in fact, suggested two months as an "arbitrary" dividing line.
      Recent studies suggest that many patients with PTH continue to improve or change
      over the first six months but start to plateau after that time. We feel six
      months serves as a better time indicator for defining chronicity in cases of
      posttraumatic headache. This would be more consistent with the current literature
      concerning chronic pain and the international Headache Society criteria for
      chronic tension headache.

PMID- 8486510
TI  - Deficiency in serum ionized magnesium but not total magnesium in patients with
      migraines. Possible role of ICa2+/IMg2+ ratio.
AB  - It has been suggested that magnesium (Mg) may play a role in the pathogenesis of
      headaches. Serum and intracellular measurements of Mg in headache patients have
      produced inconsistent results. The recent development of an ion-selective
      electrode for Mg2+ allowed precise measurement of serum ionized magnesium (IMg2+)
      in patients with various headache syndromes. Low serum IMg2+ and a high
      ICa2+/IMg2+ ratio were found in 42% of patients having an attack of migraine, but
      only in 23% of patients with a severe continuous headache. Total serum Mg was
      normal in both groups of patients. However, in patients with low serum IMg2+
      total serum Mg was lower than in patients with normal serum IMg2+. These results
      are compatible with the serotonin and vascular concepts of migraine pathogenesis.
      Low IMg2+ and a high ICa2+/IMg2+ would result in cerebral vasospasm and reduced
      blood flow in the brain. The activity of serotonin receptors can also be affected
      by changes in IMg2+ levels. The finding of a difference in IMg2+ levels in two
      different headache types suggests a possible novel classification of headaches
      and that migraine patients with a low serum IMg2+ or a high ICa2+/IMg2+ ratio may
      benefit from Mg supplementation.

PMID- 8486511
TI  - Relation between headaches and neuropsychological functioning among head injury
      patients.
AB  - The Luria-Nebraska Neuropsychological Battery (LNNB) and the Minnesota
      Multiphasic Personality Inventory (MMPI) were administered to 184 head injury
      patients with varying degrees of headache activity. A multiple regression
      analysis, controlling for neurological status, compared the 11 LNNB scores of
      patients with Daily Headaches, Frequent Headaches, Infrequent Headaches, and No
      Headaches and found that the Arithmetic Scale was the only significant predictor,
      with the Daily Headache patients performing more poorly than the Infrequent
      Headache patients. A similar analysis of the 13 MMPI scores indicated that the K,
      Hs, and Pt Scales were significant predictors. However, post hoc Tukey tests
      revealed that K and Pt scores did not vary significantly among the four headache
      groups and only showed that Daily Headaches and Frequent Headaches patients had
      significantly higher Hs scores than the No headaches group. Subsequent
      comparisons of patients with and without headaches at the time of testing
      revealed no differences between the two groups on the LNNB and MMPI, after
      controlling for age, duration of symptoms, and neurological status. Overall, the
      results suggested that the relation between headache symptoms and
      neuropsychological functioning was insignificant.

PMID- 8486512
TI  - Value of MRI in pediatric migraine.
AB  - Twenty four pediatric migraineurs were prospectively evaluated to determine if
      white matter hyperintensities were present on magnetic resonance imaging (MRI).
      None had white matter findings or brain abnormalities. Five had mucoperiosteal
      thickening of the paranasal sinuses, which were unrelated to the patients'
      clinical course. MRI white matter findings are probably not a common occurrence
      in pediatric migraineurs. In addition, MRI sinus findings are not necessarily
      related to a child's headache complaints.

PMID- 8486513
TI  - An association between migrainous aura and hereditary haemorrhagic
      telangiectasia.
AB  - Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant
      disorder characterized by a variety of abnormalities of the vasculature. This
      study investigated by questionnaire an unselected group of 58 patients suffering
      from HHT to identify and diagnose any headache history. These were compared with
      a control group comprising 40 patients with an unrelated autosomal dominant
      disorder, familial adenomatous polyposis. Fifty percent of the HHT patients
      reported attacks of headache which fulfilled current diagnostic criteria for
      migraine with aura. This was over four times the figure for the control group and
      at least 10 times the expected level for a normal population. The auras described
      by all the affected patients were classic visual disturbances preceding the
      headaches. Two patients also described typical visual auras unassociated with
      headache symptoms. The reason for such a clear association between migraine with
      aura and HHT is uncertain but cerebral arteriovenous malformations seem to be the
      likely link. A greater understanding of the reasons for the relationship may
      provide an insight into the pathophysiology of both conditions.

PMID- 8486514
TI  - Psychophysiological and MMPI personality assessment of headaches: an integrative
      approach.
AB  - Multiple psychophysiological measures and personality assessment techniques were
      combined to facilitate the diagnosis of headache type and improve upon existing
      methodology. Twenty-four migraine, 24 chronic tension headache patients, and 24
      normal age- and gender-matched controls were assessed with bilateral measures of
      frontalis and occipitalis EMG and blood volume pulse. All subjects completed the
      MMPI. Results suggest that headache subjects could be differentiated on baseline
      heart rates and MMPI scales 1,2,3, and 7. Only one physiological measure served
      as an index of psychological distress, suggesting issues of an interaction
      between psychophysiological and personality variables, as well as the chronicity
      of the headache.

PMID- 8486516
TI  - Orbital phlebography.

PMID- 8486515
TI  - The effects of streptomycin/lidocaine block on trigeminal neuralgia: a double
      blind crossover placebo controlled study.
AB  - This study investigated the long term effect of a peripheral sensory block using
      streptomycin sulphate on trigeminal neuralgia. A total of twenty subjects,
      thirteen with idiopathic trigeminal neuralgia (ITN) and seven with traumatic
      trigeminal neuralgia (TTN) were studied. A double-blind placebo controlled
      randomized design was used. After the clinical assessment subjects were randomly
      assigned to receive either 1 g of streptomycin with 3 ml 2% lidocaine, or 3 ml
      lidocaine alone. The injections were performed adjacent to the branches that
      served the painful site. These were intraoral injections, more specifically
      infraorbital and inferior alveolar blocks. Patients received five blocks of
      either streptomycin/lidocaine or lidocaine alone for a period of five consecutive
      weeks. On the sixth week they were crossed over. Measures of pain intensity and
      pain frequency were used to assess treatment outcome. Patients also recorded
      their side-effects. Repeated measures analysis of variance was used to compare
      the treatment outcomes between the active and placebo groups. There was no
      statistically significant differences in the treatment outcomes regarding
      frequency and intensity of pain attacks. The sensory function of the treated
      nerves was also not affected. Side effects including facial swelling and pain
      were a common finding in the patients receiving streptomycin. This study
      demonstrated no beneficial effects of streptomycin blockade for idiopathic and
      traumatic trigeminal neuralgia.

PMID- 8486517
TI  - The link between migraine and dizziness.

PMID- 8486518
TI  - 38th annual meeting of the Health Physics Society. Atlanta, Georgia, 11-15 July
      1993. Abstracts.

PMID- 8486519
TI  - Inhibitory effects of dopamine on noradrenaline-induced constriction of
      arterioles in vivo in the striated cremaster muscle.
AB  - The effect of dopamine on the arterioles (50.8-95.2 microns) in the cremaster
      muscle was examined to determine its effect on microcirculation. Anesthetized
      rats were used under a light microscope connected to a videocamera. Drugs were
      applied using small round filter paper (370 microns in diameter) containing the
      drug and placed in the immediate vicinity of the arteriole on the cremaster with
      a micromanipulator. The dose of the drug applied was represented by concentration
      of the drug solution in which the filter paper was immersed. Dopamine (10(-6)-10(
      4)M) induced neither constriction nor dilation of the arteriole in the cremaster.
      Papaverine (10(-2)M) did not dilate the arteriole. However, the arterioles were
      constricted by noradrenaline (10(-6)-10(-4)M) and vasopressin (10(-7)M) in a dose
      dependent manner. Noradrenaline (10(-4)M)-induced constriction was blocked by
      concomitant application of dopamine (10(-4)M). This effect of dopamine was
      antagonized by SCH23390 (10(-3)M). However, isoproterenol (10(-3)M) did not
      affect the arteriole, nor inhibit noradrenaline (10(-4)M)-induced constriction of
      the arterioles. While forskolin (10(-2)M) alone did not produce constriction or
      dilation of the arterioles, it inhibited noradrenaline (10(-4)M)-induced
      constriction of the arteriole. These results suggest that dopamine prevents the
      constriction of the arteriole induced by noradrenaline, by activation of DA1
      receptors, which activates adenylate cyclase.

PMID- 8486520
TI  - A study on the lung function in alpha 1-antitrypsin-deficient (PiMZ) patients.
AB  - Laurel and Eriksson published the first report indicating that alpha 1
      antitrypsin deficiency predisposed patients to the development of Chronic
      Obstructive Pulmonary Disease (COPD). For the purpose of early detection,
      disturbances of pulmonary function in alpha 1-antitrypsin mild deficiency cases
      (PiMZ) were compared with those of normal cases (PiMM) in caucasian Americans.
      The marked results are as follows. 1) Parameters of flow-volume curves were more
      disturbed in PiMZ cases than in PiMM cases. 2) Volumes of isoflow are specially
      different between PiMZ and PiMM cases. 3) Mechanical properties, like lung work
      of breathing, were larger in PiMZ cases than in PiMM cases.

PMID- 8486521
TI  - Nucleotide sequence of the 5' region of the human platelet-derived growth factor
      A-chain gene.
AB  - We have isolated and characterized genomic clones of the 5' region of the human
      PDGF A-chain gene. The putative "TATAA" box was identified 876 bp upstream of the
      translation initiation site. A significant number of potential regulatory
      elements were identified in DNA sequences upstream of the "TATAA" box and were
      also found within the introns sequenced. The DNA sequence results differ
      significantly from those reported for the PDGF B-chain gene, suggesting a basis
      for the expression of the PDGF A-chain gene and the B-chain gene under very
      different conditions.

PMID- 8486522
TI  - The effect of occupational type of household on mortality in Japan.
AB  - The mortality of the Japanese population was examined focusing on the effect of
      household head occupation rather than individual occupations. The 'healthy worker
      effect' (HWE) which implies lower mortality observed in a working than in a non
      working populations has been successively observed in comparative studies on
      mortality in different occupation populations. In this study we report quite
      similar results analysing the effect of household head occupation. We point out
      the possibility that HWE should have a component which is shared with the
      household members if the worker is a household head. We call this component the
      'indirect effect'. The results obtained in this study are as follows. The
      employee household had the lowest mortality followed by self-employed,
      agriculture and 'others' households. The self-employed household also had a low
      standardized mortality ratio (SMR) except for diabetes in male. The SMR of the
      agriculture household was significantly high especially for those above 65 years
      of age and for suicide in both male and female of age 45 years old and over but
      low for cirrhosis of liver in male and tuberculosis in both male and female. The
      SMR of 'Others' household was the highest among the occupational type of
      households especially between 20-64 years. The similarity in SMR trend among male
      and female rather than in occupational type of household, despite the fact that
      males are more likely to be working than females, suggests the presence of
      indirect effect. Though it is difficult to distinguish direct and the indirect
      effects completely, we also discuss a method that enables us to distinguish the
      two effects more effectively.

PMID- 8486523
TI  - Milk-borne transmission of HTLV-1.

PMID- 8486524
TI  - Differential expression of a human sperm-specific isozyme in seminoma cells
      transplanted in Scid-nu(str) mice.
AB  - An isozyme of human sperm-specific lactate dehydrogenase, LDH-X (C4) (EC
      1.1.1.27), which is expressed only in differentiated germ cells (spermatozoa,
      spermatids and primary spermatocytes after midpachytene), appeared in the
      xenografted tumor cells of human seminoma and its metastatic lesions (lymph node
      and kidney) in scid (severe combined immunodeficiency)-nude(streaker) double
      mutant mice, though it was not expressed in the original tumor of the patient.
      The morphological pattern of seminoma cells also changed in the xenografts and
      metastatic lesions as in normal spermatogenesis. Thus, the human seminoma cells
      showed differential expression of the sperm-specific isozyme in parallel with
      their morphological changes. However, the sperm-specific isozyme disappeared in
      the mitotically dividing seminoma cells which were newly established from the LDH
      X positive xenograft.

PMID- 8486525
TI  - Possible tumor-initiating and -promoting activity of p-methylcatechol and
      methylhydroquinone in the pyloric mucosa of rat stomach.
AB  - The possible tumor-promoting and tumor-initiating activities of p-methylcatechol
      and methylhydroquinone in the pyloric mucosa of male F344 rats were studied.
      Ornithine decarboxylase (ODC) and replicative DNA synthesis (RDS) were used as
      markers of tumor promotion and DNA single strand scission and unscheduled DNA
      synthesis (UDS) as markers of tumor initiation. The compounds were administered
      by gastric intubation and results were compared with those after administration
      of catechol. p-Methylcatechol at doses of 60 to 180 mg/kg body weight dose
      dependently induced up to 20-fold increase in ODC activity and 9-fold increase in
      RDS with maxima 24 h after its administration, but it did not induce significant
      DNA single strand scission or UDS. Methylhydroquinone at a dose of 200 mg/kg body
      weight induced up to 6-fold increase in ODC activity 24 h, and 5-fold increase in
      RDS 16 h after its administration, but the induction was not dose-dependent. At a
      dose of 200 mg/kg body weight it induced DNA single strand scission, but not UDS.
      These results and previous findings show that the possible tumor-promoting
      activities of catechol are several times higher than those of p-methylcatechol
      and 10 times higher than those of methylhydroquinone.

PMID- 8486526
TI  - Correlation between medium-term multi-organ carcinogenesis bioassay data and long
      term observation results in rats.
AB  - The effects of four test chemicals [2-acetylaminofluorene (2-AAF), D,L-ethionine
      (ethionine), butylated hydroxyanisole (BHA), and catechol] were compared in
      medium- and long-term in vivo systems. In the medium-term assay, animals were
      sequentially treated with N-diethylnitrosamine (100 mg/kg body weight, i.p.,
      single injection), N-methylnitrosourea (20 mg/kg body weight, i.p., 4 times
      during weeks 1 and 2), N-butyl-N-(4-hydroxybutyl)nitrosamine (0.05% in the
      drinking water during weeks 1 and 2), 1,2-dimethylhydrazine (40 mg/kg body
      weight, s.c., 4 times during weeks 3 and 4) and dihydroxy-di-N-propylnitrosamine
      (0.1% in the drinking water during weeks 3 and 4) for multi-organ initiation, and
      then treated with one of the four test chemicals for 24 weeks, and killed at week
      28 (group 1). In the long-term assay, animals were treated in the same manner and
      then given basal diet and tap water (group 3) or test chemical continuously
      (group 4) for the remainder of the lifespan. Animals receiving multi-organ
      initiation and then maintained on basal diet for 24 weeks (group 2) or their
      lifespan (group 5) served as controls. Detailed histopathological examinations
      were performed on all rats. Hepatocellular carcinoma incidences in the long-term
      assay were found to reflect closely the respective medium-term results. Induction
      of proliferative forestomach or glandular stomach lesions by BHA and/or catechol,
      and bladder lesions by 2-AAF and BHA in the medium-term assay also correlated
      with tumor development in the long-term. Furthermore, inhibition of thyroid
      proliferative lesions by all test chemicals corresponded with low thyroid tumor
      incidences in the long-term assay. The observed strong correlation between medium
      and long-term results confirms the applicability of our medium-term multi-organ
      carcinogenesis bioassay system for detection of modifying effects of test
      chemicals in different organs.

PMID- 8486527
TI  - Cell-density-dependent expression of Cyp1a2 gene in monolayer-cultured adult
      mouse hepatocytes.
AB  - Expression of Cyp1a1 and Cyp1a2 genes was investigated in adult C57BL/6NCrj mouse
      hepatocytes for up to 5 days after transfer to monolayer culture. CYP1A1 mRNA was
      substantially induced by treatment with 3-methylcholanthrene during the
      observation period, independently of the seeded cell density. However, expression
      of CYP1A2 mRNA was dependent on cell density and was higher in cells cultivated
      at lower density. With increasing culture period the expression was decreased, so
      that only negligible levels were evident by day 5, and reduced expression of
      constitutive and induced CYP-1A2 mRNA became apparent earlier in more densely
      seeded cells. This was not related to differences in numbers of inducer molecules
      per cell. While mouse hepatocytes incorporated tritium-labeled thymidine under
      the given culture conditions, induction of expression of the two Cyp1a genes did
      not show any direct relationship with DNA synthesizing activity. These
      observations suggest some role for Cyp1a2 during changes in physiological state.

PMID- 8486528
TI  - Activation of Cyp1a1 and Cyp1a2 genes in adult mouse hepatocytes in primary
      culture.
AB  - Expression of Cyp1a1 and Cyp1a2 genes was investigated in adult C57BL/6NCrj mouse
      hepatocytes in primary culture for up to 5 days. When the cells were cultivated
      as monolayers on collagen-coated dishes, CYP1A1 mRNA species were prominently
      induced after treatment with 3-methylcholanthrene (MCA) throughout the
      observation period. Substantial induction of CYP1A2 mRNA by MCA was also observed
      at day 1 of cultivation, followed by a decrease to very low levels thereafter. In
      contrast, when cultivated on non-coated dishes, the hepatocytes formed
      multicellular aggregates (spheroids) and prominent induction of both mRNA species
      was found for up to 5 days. Constitutive expression of CYP1A2 mRNA in spheroid
      culture was maintained throughout the observation period, whereas that in
      monolayer culture decreased rapidly. The time-course of the induced CYP1A2 mRNA
      amounts after the treatment with MCA or 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD) followed the same pattern as that of CYP1A1 mRNA. Expressed amounts of
      CYP1A1 or CYP1A2 mRNA in spheroid culture were higher than or similar to the
      levels in the case of in vivo production, respectively. Induction of both mRNA
      species was also observed in hepatocytes from nonresponsive DBA/2NCrj mouse in
      spheroid culture, but the expressed amount after MCA treatment was far smaller
      than for C57BL/6NCrj cells, despite equivalent expression in the two strains
      after TCDD. Activities of aryl hydrocarbon hydroxylase (AHH) and acetanilide 4
      hydroxylase (AAH) were elevated with either type of cultivation after treatment
      with MCA or TCDD. Ratios of AAH to AHH were not changed between the two cultures
      after 24 h treatment. However, the ratios in spheroid culture after 48 h
      treatment increased, whereas they did not change in monolayer culture. The
      present observations indicate that the spheroid culture is more suitable than the
      monolayer system for studying the mechanism of Cyp1a2 gene expression in adult
      mouse hepatocytes.

PMID- 8486529
TI  - Use of serum gamma-enolase and aldolase A in combination as markers for renal
      cell carcinoma.
AB  - To clarify whether measurement of serum gamma-enolase and aldolase A in
      combination is useful for diagnosis and prediction of prognosis in cases of renal
      cell carcinoma (RCC), levels of both markers were evaluated by enzyme immunoassay
      in 132 patients with RCC. Serum gamma-enolase was elevated in 53 of the cases
      (40%) whereas serum aldolase A was elevated in 45 (34%). At least one of the two
      markers was elevated in 54% of the patients (71/132), this value being
      significantly higher than the positive rates for either gamma-enolase (40%) or
      aldolase A (34%) evaluated singly. Expression of the two markers assessed in
      combination became more positive with stage progression, values being 37% in
      stage I, 59% in stage II, 72% in stage III, and 74% in stage IV. In contrast,
      patients with benign urological diseases demonstrated positive rates for gamma
      enolase and aldolase A as low as 3% and 6%, respectively. Increase in serum gamma
      enolase was correlated with stage, tumor size, and histological grade, whereas
      elevated levels of serum aldolase A were associated only with advancing stage. In
      15 patients with recurrent diseases, 11 (73%) had elevated levels of gamma
      enolase and 5 (33%) had elevated levels of aldolase A, indicating that gamma
      enolase is the more sensitive of the two for detection of recurrence. Patients
      with elevated levels of both gamma-enolase and aldolase A had less favorable
      survival than those expressing no or only one of the markers, indicating that
      simultaneous measurement of the two markers provides information directly
      relevant to prognosis in cases of RCC.

PMID- 8486530
TI  - Morphometric analysis of colonic adenomatous polyps.
AB  - Morphometric evaluation of adenomas of the colon to determine their degree of
      dysplasia is still controversial, since subjective factors influence the decision
      concerning benignancy or malignancy. Some indices have been proposed to assist in
      categorizing intermediate lesions into benign or malignant. However, these
      indices show a wide range of distribution. To evaluate the reliability of one
      such index, the index of structural atypism (ISA, area of glands/area of stroma),
      we studied polyps as a whole, and found great variability of index values within
      a single polyp.

PMID- 8486531
TI  - Antimetastatic effect by anti-adhesion therapy with cell-adhesive peptide of
      fibronectin in combination with anticancer drugs.
AB  - We have investigated the therapeutic effect of CH-271 fusion polypeptide
      containing both cell-binding domain (C-274) and heparin-binding domain (H-271) of
      fibronectin in combination with anticancer drugs such as doxorubicin (DOX) or
      mitomycin C (MMC) on tumor metastasis of different types of tumors. CH-271 fusion
      polypeptide alone significantly inhibited both liver and lung metastasis when it
      was co-injected with L5178Y-ML25 T-lymphoma, RAW117-H10 B-lymphoma or B16-BL6
      melanoma cells, and spontaneous lung metastasis of B16-BL6 melanoma cells when
      administered i.v. seven times before or after surgical excision of the primary
      tumors. Combined treatments with CH-271 and either DOX or MMC significantly
      inhibited liver and lung metastasis of lymphoma or melanoma cells respectively,
      as compared with either treatment alone or the untreated control. Administrations
      of CH-271 and DOX in combination substantially prolonged the survival time of
      mice injected i.v. with L5178Y-ML25 cells. CH-271 or DOX was effective for
      inhibiting the invasion of L5178Y-ML25 cells into Matrigel in a concentration
      dependent manner. Our previous study has shown that CH-271-mediated inhibition of
      tumor invasion may be due in part to the anti-cell adhesive property without
      affecting the cell growth, whereas the anti-invasive effect of DOX was
      established to have resulted from the growth inhibition of tumor cells. Moreover,
      the combination of CH-271 with DOX provided a more effective inhibition of tumor
      invasion into Matrigel than did either alone. Thus, we have demonstrated that the
      combination of anti-cell adhesive CH-271 and anticancer drugs such as DOX or MMC,
      i.e. anti-adhesion therapy and chemotherapy, is a new approach that offers
      enhanced (additive) inhibitory effects on tumor metastasis and invasion.

PMID- 8486532
TI  - Hyperthermic enhancement of cytotoxicity and increased uptake of cis
      diamminedichloroplatinum(II) in cultured human esophageal cancer cells.
AB  - Thermal enhancement of cytotoxicity of cis-diamminedichloroplatinum(II) (CDDP)
      has been well recognized and applied clinically to chemotherapy of various
      malignancies, but its fundamental mechanism remains to be elucidated. In order to
      obtain a clue to this mechanism, we analyzed the effect of hyperthermia on the
      uptake and subsequent distribution of [195mPt]CDDP in two lines of esophageal
      cancer cells (KYSE-150 and KYSE-170) established from clinical patients. First,
      we observed a significant increase in [195mPt]CDDP uptake by both types of cells
      at increasingly higher temperatures. The incorporated CDDP was distributed
      between the nucleus and the cytosol at a ratio of approximately 3:1, and the
      ratio remained the same at various temperatures. The CDDP was found in all four
      molecular fractions, i.e., DNA, RNA, protein, and TCA-soluble, with a slight
      preference for DNA at higher temperatures. Enhancement of cytotoxicity required
      simultaneous, and not sequential, treatments with CDDP and hyperthermia;
      hyperthermia after CDDP treatment increased the efflux of CDDP from the cells,
      and rather reduced the cytotoxicity of CDDP. These results suggest that thermal
      enhancement of the cytotoxicity of CDDP is caused mainly by acceleration of the
      drug entry into the cell, probably due to increased permeability, and a
      consequent increase in the amount of CDDP binding to DNA. This mechanism gives
      support for clinical trial of simultaneous treatment with CDDP and hyperthermia.

PMID- 8486533
TI  - Cytokines induce uridine phosphorylase in mouse colon 26 carcinoma cells and make
      the cells more susceptible to 5'-deoxy-5-fluorouridine.
AB  - The antiproliferative activity of 5-fluorouracil (5-FUra) and 5'-deoxy-5
      fluorouridine (5'-dFUrd), used in combination with typical cytokines and growth
      factors, was investigated in mouse colon 26 carcinoma cells. Tumor necrosis
      factor alpha (TNF alpha), interleukin-1 alpha (IL-1 alpha), and interferon gamma
      (IFN gamma) at low doses showing < 50% inhibition of cell growth by themselves
      enhanced the susceptibility of the cells to the activity of 5'-dFUrd. In
      particular, a mixture of these cytokines greatly enhanced the activity of 5'
      dFUrd and 5-FUra by up to 12.4- and 2.7-fold, respectively, whereas the activity
      of other cytostatics was only slightly changed (< 1.5-fold). Basic fibroblast
      growth factor also increased the susceptibility, but only to 5'-dFUrd. This
      preferential enhancement of the activity of 5'-dFUrd would be due to induction by
      the cytokines of uridine phosphorylase (Urd Pase), by which 5'-dFUrd is converted
      to 5-FUra. TNF alpha, IL-1 alpha, IFN gamma, and a mixture of these factors
      increased the enzyme activity by up to 3.7-fold in colon 26 cells. Consequently,
      the anabolism of 5'-dFUrd to fluoronucleotides and the incorporation of 5-FUra
      into RNA in colon 26 cells were increased by TNF alpha treatment. In addition,
      the increase by the cytokine mixture in the susceptibility to 5'-dFUrd was
      abolished by an inhibitor of Urd Pase, 2,2'-anhydro-5-ethyluridine. These results
      indicate that induction of Urd Pase activity by cytokines is a critical event
      that increases the susceptibility to 5'-dFUrd.

PMID- 8486534
TI  - Caffeine modulates the antitumor activity and toxic side effects of adriamycin.
AB  - To improve both the survival and the response rate of patients, it is necessary
      to find modifiers which enhance the effects of known anticancer agents. In this
      study, we examined the effects of caffeine on the antitumor activity and side
      effects of antitumor agents, using CDF1 male mice. The combination of caffeine
      with adriamycin significantly enhanced the antitumor activity of adriamycin, by
      1.5-fold and 1.9-fold in single- and multi-administration schedules,
      respectively, compared to the activity of adriamycin only. However, the
      combination of caffeine with cisplatin had no effect on the antitumor activity of
      cisplatin in either administration schedule. We examined two biochemical
      parameters, lipid peroxide level and glutathione peroxidase activity, as indices
      of adriamycin-induced side effects. The caffeine combination did not enhance the
      adriamycin-induced changes in these two parameters. Regarding the lethal effect
      of adriamycin, the caffeine combination had no effect in the single
      administration schedule, but in the multi-administration schedule, it tended to
      reduce this acute toxicity. These results suggest that the combination of
      caffeine with adriamycin can significantly increase the in vivo antitumor
      activity of this agent without increasing its side effects.

PMID- 8486535
TI  - On not knowing beforehand.
AB  - This paper starts from recommendations of Freud and Jung on the desirable
      attitudes of analysts to their patients, and especially open-mindedness which I
      have named 'not knowing beforehand'. I use the metaphor of a filing cabinet to
      illustrate how to empty one's mind and, so to speak, lock up one's knowledge,
      memory, and desires in that filing cabinet. That gives space for the patient to
      structure his interview. I illustrate how knowing beforehand can disrupt an
      interview and how 'filing-cabinet material' will get used when tailored to the
      interview structure. The metaphor is used for the sake of simplicity. It does not
      include the complexity of the analytical dialectic.

PMID- 8486536
TI  - 'In a dark time, the eye begins to see'.
AB  - In this paper I discuss a patient whose shadow became his rival, or as Jung put
      it, 'The shadow is lived'. I describe the beginning of a process of the
      assimilation of shadow contents, whereby the rupture between ego and shadow can
      no longer be maintained. I also discuss how it is primarily through the mutual
      experience and analysis of archetypal images that the unconscious contents become
      more integrated. In my clinical illustrations I also explore the relationship
      between my patient's fight with his shadow and his experiences of childhood
      shame. I consider how fear expressed through a panic attack may open a royal door
      to the unconscious, and the way in which its mediation through empathy and
      analysis can lead to unconscious infantile contents becoming more accessible. In
      addition, I show how, once some of the fear had subsided, it became possible for
      play to enter into the analysis.

PMID- 8486537
TI  - Electra: the dark side of the moon.

PMID- 8486538
TI  - When the meaning gets lost in the body: psychosomatic disturbances as a failure
      of the transcendent function.

PMID- 8486539
TI  - The microbiology of bottled natural mineral waters.

PMID- 8486540
TI  - Isolation and attempted introduction of sugar alcohol-utilizing bacteria in the
      sheep rumen.
AB  - Bacteria that use sorbitol, xylitol, maltitol and dulcitol (galactitol) were
      isolated from the sheep rumen following enrichments in which bacteria were grown
      in rumen fluid medium where the sugar alcohol was the only added energy source.
      Only isolates obtained with sorbitol and maltitol grew sufficiently rapidly to be
      considered for enrichment by the sugar alcohol in vivo. Isolate SS2, a strain of
      Selenomonas ruminantium var. lactilytica which grew on sorbitol at 0.87 h-1, was
      selected for further study and a rifampicin-resistant mutant, SS2/R5, was
      isolated to facilitate tracking in the mixed population. Despite an initial
      transient increase in numbers, a significant population of S. ruminantium SS2/R5
      failed to establish in sheep which were dosed twice daily with 10 g of sorbitol.
      Continuous infusion of sorbitol increased numbers only slightly compared with
      twice-daily dosing. In vitro experiments indicated that strain SS2/R5 grew less
      well in the presence of other rumen organisms, particularly ciliate protozoa,
      than in pure culture. Furthermore, the concentration of sorbitol in vivo was
      lower than predicted from in vitro experiments, indicating that sorbitol was
      absorbed rapidly from the rumen. Similar observations were made with xylitol,
      dulcitol and maltitol. Proposed enrichment strategies that use sugar alcohols or
      other materials to support the growth of introduced bacteria will thus have to
      take account of the combined problems of microbe-microbe interactions and the
      loss of the compounds by absorption from the rumen.

PMID- 8486541
TI  - Culture media for the differentiation of isolates of Yersinia ruckeri, based on
      detection of a virulence factor.
AB  - Strains of the bacterial fish pathogen Yersinia ruckeri were identified with the
      API 20E system and distinguished on the basis of whole cell agglutination with
      antisera, sorbitol fermentation and polymyxin B sensitivity. Strains which were
      shown to possess the virulence-associated heat-sensitive factor (HSF) were shown
      to grow preferentially on culture media containing sodium dodecyl sulphate (SDS)
      and to produce a creamy deposit around the colonies. By contrast, strains lacking
      this factor (HSF-) grew poorly and without forming a deposit. Enhancement of the
      differentiation between the two types was shown by the incorporation of Coomassie
      brilliant blue dye into agar containing 1% SDS, and the uptake of Coomassie blue
      and Congo red was shown to be temperature-dependent. Most strains tested were
      shown to belong to serotype I, and were sensitive to polymyxin and did not
      ferment sorbitol. With the medium developed most serotype I strains but not those
      of other serotypes were shown to possess HSF. It is suggested that the medium is
      used in epidemiological studies of Y. ruckeri.

PMID- 8486542
TI  - Mesenterocin 52, a bacteriocin produced by Leuconostoc mesenteroides ssp.
      mesenteroides FR 52.
AB  - One hundred and sixty-five isolates of Leuconostoc spp. were tested for
      bacteriocin production. Only one strain, Leuc. mesenteroides ssp. mesenteroides
      FR 52, isolated from a raw milk, produced a bacteriocin which was named
      Mesenterocin 52. This bacteriocin inhibited other Leuconostoc strains and several
      strains of Enterococcus and Listeria spp. No activity was found against
      lactococci and lactobacilli. The antibacterial spectrum differed from that of
      previously described Leuconostoc bacteriocins. Mesenterocin 52 was secreted into
      the medium during the growth phase. It was inactivated with protease treatments.
      At pH 7.0 it had a relative stability after heating at 100 degrees C (15 min),
      but it had a greater stability at pH 4.5 than at pH 7.0 after 6 h at 80 degrees
      C. The apparent molecular mass was estimated to be less than 10 kDa by
      ultrafiltration. Mesenterocin 52 showed a bactericidal effect on Leuconostoc
      paramesenteroides DSM 20288.

PMID- 8486543
TI  - Enterocin 226NWC, a bacteriocin produced by Enterococcus faecalis 226, active
      against Listeria monocytogenes.
AB  - Enterococcus faecalis 226, isolated from natural whey cultures utilized as
      starters in the manufacture of mozzarella cheese from water-buffalo milk,
      produces a bacteriocin designated enterocin 226NWC. The bacteriocin was isolated
      from culture supernatant fluids of the producer strain and was active against
      strains of the same species and Listeria monocytogenes, but not against useful
      lactic acid bacteria. Enterocin 226NWC is a protein with an apparent molecular
      weight of about 5800; it is relatively heat-stable and has a bactericidal mode of
      action. Listeria monocytogenes, growing in the presence of the enterocin 226NWC
      producer strain in broth and in reconstituted skim milk, was inhibited.

PMID- 8486544
TI  - A laboratory apparatus for the generation and biocide efficacy testing of
      Legionella biofilms.
AB  - The construction and operation of a laboratory biofilm generator designed to grow
      sessile populations of legionellas for biocide efficacy testing is described.
      Some examples of static biocide testing on both sessile and planktonic
      populations of Legionella bozemanii are discussed along with other potential
      applications of the apparatus.

PMID- 8486545
TI  - A sandwich enzyme-linked immunosorbent assay (ELISA) for detection of Pseudomonas
      fluorescens and related psychrotrophic bacteria in refrigerated milk.
AB  - A sandwich ELISA (enzyme-linked immunosorbent assay) was developed for detection
      of Pseudomonas fluorescens and related psychrotrophic bacteria in refrigerated
      milk. Polyclonal antibodies were raised in rabbits against protein F from the
      cell envelope of Pseudomonas fluorescens AH-70. The anti-protein F antibodies
      (anti-PF) bound to the wells of a microtitre plate were used to capture this
      protein from the micro-organisms on milk samples. Further immunorecognition of
      the captured antigen was attained with the same anti-PF antibodies conjugated to
      biotin. ExtrAvidin-peroxidase was used to detect the biotinylated antibodies
      bound to their specific antigens. Subsequent enzymic conversion of substrate gave
      clear absorbance differences when assaying milk samples containing Ps.
      fluorescens strains of different origin as well as related psychrotropic micro
      organisms.

PMID- 8486546
TI  - Enumeration of Escherichia coli in cooked and raw meats by ion mobility
      spectrometry.
AB  - A novel method for enumerating Escherichia coli in foods is described. It is
      based on the production of o-nitrophenol (ONP) from o-nitrophenyl-beta-D
      glucuronide as detected by an ion mobility spectrometer. The time taken for the
      detection of ONP in a food sample was inversely proportional to the logarithm of
      the initial E. coli population. Escherichia coli could be detected at a level of
      10 g-1 within 9 h.

PMID- 8486547
TI  - Characterization of bacteriocin produced by Pediococcus pentosaceus from wine.
AB  - Twenty strains of Pediococcus pentosaceus isolated from wine were examined for
      production of bacteriocins. Only two of them showed inhibitory activity, Ped.
      pentosaceus N4p against the indicator strains of the same species and N5p against
      19 strains of the three genera of lactic acid bacteria from wine. The
      antimicrobial substance from N5p strains was removed by membrane (0.2 micron)
      filtration, destroyed by organic solvents and proteolytic enzymes. It was stable
      for 60 min at 100 degrees C. The bacteriocin was produced early in the growth
      cycle and its production was maximum after 48 h of culture in tomato juice medium
      at an initial pH of 6.5. The bactericidal effect was observed.

PMID- 8486548
TI  - Fibronectin and proteolytic fragments of fibronectin interfere with the adhesion
      of Staphylococcus epidermidis to plastic.
AB  - The adhesion of five strains of slime-positive Staphylococcus epidermidis to
      plastic microwells was significantly diminished (P < 0.005) in a concentration
      dependent fashion when wells were previously coated with increasing
      concentrations (1.6-13.1 micrograms cm-2) of human fibronectin (FN). The adhesion
      of four of five strains was significantly reduced when wells were coated with 3.2
      micrograms cm-2 of FN and at concentrations > or = 6.5 micrograms cm-2 the
      adhesion of all slime-positive strains was significantly reduced. The coating of
      microwells with chymotryptic fragments of FN containing the heparin-binding,
      gelatin-binding, or cell-binding domains also reduced bacterial adhesion but none
      of the fragments exceeded the anti-adhesive activity of intact FN. A comparison
      of FN-coated or albumin-coated microwells showed that both proteins caused a
      significant reduction in the adhesion of test strains to plastic but that the
      anti-adhesive activity of FN was greater than albumin at all concentrations
      tested. The adhesion of the slime-negative phase variant of one of the test
      strains to plastic was neither enhanced nor reduced by FN coating indicating that
      the production of an exopolysaccharide by Staph. epidermidis influences
      interactions with protein-coated surfaces. These results support the contention
      that FN does not mediate the adhesion of all strains of Staph. epidermidis to
      plastic surfaces.

PMID- 8486549
TI  - Comparison of Signal and Bactec NR-660 blood culture systems.
AB  - The Signal blood culture system was compared with the Bactec NR-660. A total of
      1617 blood culture sets yielded 143 (8.8%) significant isolates; 113 (79.0%) were
      from positive bottles in both the Bactec and Signal systems. Twelve organisms
      (8.4%) were detected and isolated from the Signal system only and another 18
      (12.6%) from the Bactec system only. Of these 18, five were Signal-positive but
      the organism was not recovered and four organisms were isolated from negative
      Signal bottles on terminal subculture. The time taken to detection for each
      system was similar; the Signal system detected 68% and the Bactec 63% of
      significant positives within 24 h. At 48 h Bactec detected 91% and the Signal
      85%. A significantly-reduced number of bottles which gave a positive signal but
      were negative by microscopical and cultural methods was found, compared with
      previous reports. The 1 h incubation period prior to the insertion of the Signal
      growth indicator device was considered to be the cause of this reduction in the
      proportion of false positives. Fifty-five percent (42/77) of the Bactec false
      positives were due to delta growth value. This is when there is an increase in
      the growth index of > or = 15 without the positive threshold level of 30 being
      attained. This occurred in the anaerobic bottle on day 2 with 42 bottles. Another
      40% (31/77) of the false positives had a growth value between the positive
      threshold of 30 and a value of 35. Eighty (4.9%) of Bactec and 65 (4.0%) of
      Signal sets yielded clinically non-significant isolates.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8486551
TI  - Heat resistance of Listeria monocytogenes by two recovery media used with and
      without cold preincubation.
AB  - Three strains of Listeria monocytogenes were heat-treated at three temperatures
      in physiological saline by a capillary tube method. Recovery of heat-treated
      bacteria was performed on blood agar and on tryptose phosphate agar with ferric
      citrate and aesculin (TPA-FE). Both media were used in two ways: (1) incubation
      at 37 degrees C for 7 d, and (2) preincubation at 4 degrees C for 5 d in order to
      obtain repair of heat-injured bacteria, followed by incubation at 37 degrees C
      for 7 d. D and z values were determined. In both incubation procedures, better
      average recovery was obtained on blood agar than on TPA-FE. Thus, higher D values
      were recorded when blood agar was used. In most cases the differences were
      statistically significant. Repair at 4 degrees C of heat-injured bacteria
      occurred on both media but the proportions of repaired bacteria were higher on
      blood agar. The repair on this medium was generally reflected in higher D values
      for preincubated samples. Some significant differences in heat resistance were
      noted between the strains.

PMID- 8486550
TI  - Viable but non-culturable salmonellas in soil.
AB  - An enzyme-linked immunosorbent assay (ELISA) and a microwell fluorescent antibody
      (FA) direct count method have been developed for the monitoring of salmonellas in
      soil. Both methods have a minimum detection level of ca 10(6) cells per gram of
      soil. The FA direct count method gave a linear recovery for the inoculum range
      10(6)-10(9) cells per gram of soil. When monitored by plate counts the survival
      of salmonellas was greater in a sterile than in a non-sterile soil. Evidence was
      found for the production of viable but non-culturable salmonellas in non-sterile
      soil; plate counts dropped rapidly with time, but FA direct counts and ELISA
      remained level. The salmonella cells became progressively smaller and rounder
      with time. Dead salmonella cells introduced into soil rapidly disappeared.

PMID- 8486552
TI  - Production and specificity of poly- and monoclonal antibodies raised against
      Shewanella putrefaciens.
AB  - Polyclonal antibodies were raised in rabbits and mice against Shewanella
      putrefaciens. Murine monoclonal antibodies were produced against the type strain
      (ATCC 8071) as well as wild type strains isolated from fish products. The
      specificities of four polyclonal and 12 monoclonal antibodies were tested by dot
      blotting, an indirect and a competitive ELISA against 16 Gram-negative strains;
      including six strains of S. putrefaciens and one strain of Pseudomonas rubescens
      (NC 10695). All polyclonal antibodies reacted strongly with S. putrefaciens and
      with Ps. rubescens and cross-reacted with the nine other bacteria (Pseudomonas
      spp., Aeromonas spp. and Vibrio anguillarum). The monoclonal antibodies could be
      divided into three groups with different patterns of specificity. The largest
      group (8 monoclonal antibodies) reacted strongly with S. putrefaciens and with
      Ps. rubescens and showed only weak reactions with the other strains. The results
      confirm that Ps. rubescens should be classified as S. putrefaciens.

PMID- 8486553
TI  - Isolation and characterization of a Bacillus strain capable of degrading the
      extracellular glucan from Cellulomonas flavigena strain KU.
AB  - Bacteria capable of utilizing the water-insoluble purified extracellular (1-->3)
      beta-D-glucan (curdlan) from Cellulomonas flavigena strain KU by extracellular
      enzymes, were isolated and characterized. Enrichment cultures from a Winogradsky
      column were incubated anaerobically at 55 degrees C with curdlan as the sole
      source of carbon. Colonies surrounded by zones of clearing were selected from
      subcultures on solid curdlan media. One of the isolates was chosen for further
      study and identified by conventional methods, API-tests with calculation of
      similarity coefficients and ID-scores, estimation of mol% (G+C) and DNA-DNA
      liquid hybridization. The isolate is a facultatively anaerobic, facultatively
      thermophilic Bacillus sp. Identification at the species-level was not achieved.
      The isolate was characterized by some rare traits among bacilli, but it remains
      unresolved whether it defines a new taxon.

PMID- 8486554
TI  - Purification and properties of the endocellular beta-glucosidase of Candida
      cacaoi Buckley and Van Uden CBS 2020.
AB  - The endocellular enzyme beta-glucosidase of Candida cacaoi was purified by ion
      exchange chromatography and gel filtration. The molecular weight was 220 +/- 10
      kDa; its optimum pH was between 4 and 5.5 and its optimum temperature was 60
      degrees C. This enzyme was active against soluble glucosides tested with beta(1
      2), beta(1-3), beta(1-4) and even alpha(1-4) and alpha(1-6) and was inhibited by
      D-glucono-delta-lactone. The enzyme was constitutive but its synthesis was
      repressed by glucose.

PMID- 8486555
TI  - Bactericidal activity of disinfectants on Listeria.
AB  - The bactericidal activity on Listeria spp. of nine disinfectants used in the food
      industry was studied by previously published methods. The disinfectants were
      diluted to the test concentration in sterile standard hard water. Various types
      of chemical agents were evaluated, including phenolic compounds, alcohols,
      quaternary ammonium compounds, surface-active agents, aldehydes and disochlorine
      tablets. The following strains isolated from cheese were studied: Listeria
      innocua, L. welshimeri, L. monocytogenes 1/2a, 1/2b, 1/2c and 4b. The results
      show that the listerias are not particularly resistant to disinfectants but the
      efficacy of some agents is affected by organic matter.

PMID- 8486556
TI  - A simple, rapid and sensitive presence/absence detection test for bacteriophage
      in drinking water.
AB  - A rapid, simple and sensitive direct bacteriophage presence detection method for
      500 ml drinking water samples has been developed. The method includes a glass
      device consisting of a jar containing the water sample and an immersible probe
      filled with solidified soft agar containing bacterial host cells. Host bacteria
      in logarithmic phase were added to the experimental volume and the probe was
      submerged. The entire device was incubated in a water bath at 36 degrees C.
      Plaques of somatic bacteriophage infecting Escherichia coli strain CN13, could be
      detected within 3 h. Male-specific bacteriophages infecting E. coli F+ amp were
      detected within 6 h. Bacteriophage infecting the anaerobe Bacteroides fragilis
      subsp. fragilis HSP40 were detected after 8 h. Application of this device and the
      associated technique, enabled a one-step detection of 1 pfu of E. coli or Bact.
      fragilis specific bacteriophage in 500 ml drinking water samples.

PMID- 8486557
TI  - External quality assessment in water microbiology: statistical analysis of
      performance.
AB  - A UK-based scheme of water microbiology assessment requires participants to
      record counts of relevant organisms. Not every sample will contain the target
      number of organisms because of natural variation and therefore a range of results
      is acceptable. Results which are tail-end (i.e. at the extreme low or high end of
      this range) could occasionally be reported by any individual laboratory by
      chance. Several tail-end results might imply a laboratory problem. Statistical
      assessment is done in two stages. A non-parametric test of the distribution of
      tail-end counts amongst laboratories is performed (Cochran's Q) and, if they are
      not random, then observed and expected frequencies of tail-end counts are
      compared to identify participants who may have reported excessive numbers of low
      or high results. Analyses so far have shown that laboratories find high counts no
      more frequently than would be expected by chance, but that significant clusters
      of low counts can be detected among participants. These findings have been
      observed both in short-term and in long-term assessments, thus allowing detection
      of new episodes of poor performance and intermittent problems. The analysis
      relies on an objective definition of tail-end results. Working definitions are
      presented which should identify poor performance in terms of microbiological
      significance, and which allow fair comparison between membrane-filtration and
      multiple-tube techniques. Smaller differences between laboratories, which may be
      statistically significant, will not be detected. Different definitions of poor
      performance could be incorporated into future assessments.

PMID- 8486558
TI  - Acetic, lactic and citric acids and pH inhibition of Listeria monocytogenes Scott
      A and the effect on intracellular pH.
AB  - The effects of acetic, lactic and citric acids and pH on the growth and
      intracellular pH (pHin) of Listeria monocytogenes Scott A were documented and
      compared for total acid concentrations ranging from 50 mmol ml-1 to 250 mmol ml-1
      for acetic and lactic acids and from 25 mmol ml-1 to 100 mmol ml-1 for citric
      acid. Initial pH values ranged from 4.7 to 6.0. Although the growth rate of L.
      monocytogenes Scott A was slower when incubated at 25 degrees C than at 37
      degrees C, the relative acid and pH inhibition was identical at both
      temperatures. As the initial pH values decreased and/or the total acid
      concentrations increased, the growth rates of L. monocytogenes Scott A decreased.
      Compared at equal initial pH values and on an equimolar total acid basis, the
      relative inhibition effect was generally acetic > lactic > citric. When based on
      initial undissociated acid concentrations, the inhibition effect was citric >
      lactic > acetic. The effect of differing acid and pH environments on pHin was
      determined. At equimolar total acid concentrations, the pHin of the cell was
      changed the least by citric acid and the most by acetic acid. Growth rates were
      influenced by the pHin and the acid used to adjust the system.

PMID- 8486559
TI  - Factors affecting spoilage microflora succession on lamb carcasses at
      refrigeration temperatures.
AB  - Three bacterial groups were detected during the shelf-life of lamb carcasses
      stored at refrigeration temperatures: coryneforms (mostly Brochothrix
      thermosphacta), Gram-positive cocci (staphylococci) and Gram-negative bacilli
      (Pseudomonas spp. and Moraxella spp.). Influence of categorical variables such as
      sampling day, sampling area and sampling method on their recovery was analysed by
      a chi-square test of independence and loglinear analysis. Hierarchical loglinear
      modelling proved to be very useful as several three-way interactions of factors
      were observed.

PMID- 8486560
TI  - Transfer of hybrid plasmids based on the replicon pRRI7 from Escherichia coli to
      Bacteroides and Prevotella strains.
AB  - New shuttle vectors based on a Prevotella ruminicola 9.5 kb cryptic plasmid
      (pRRI7) inserted within the Escherichia coli vector pKC71, carrying the Ccr/Emr
      Bacteroides marker, were constructed. These constructs (pKBR23-1 and pKBR23-2)
      were transferred into Bacteriodes distasonis, Bacteroides thetaiotaomicron,
      Bacteroides uniformis and into P. ruminicola NCFB 2202 either by conjugal
      mobilization or by electroporation. Another pRRI7 derivative based on pKC72,
      pKBR23-3, was smaller (13.1 kb) and non-mobilizable. By electroporation, it was
      transferred to Bact. distasonis and P. ruminicola. Being derived from pRRI7 which
      is compatible with the shuttle plasmid pRRI207, the host/vector combination
      involving P. ruminicola NCFB 2202 and pKBR23-3 offers new possibilities for
      genetic investigations in rumen anaerobic bacteria after further introduction of
      a second readily selectable marker within pRRI207 or pKBR23-3.

PMID- 8486561
TI  - Intestinal colonization of young chicks with Escherichia coli O157:H7 and other
      verotoxin-producing serotypes.
AB  - The susceptibility of chicks to colonization with Escherichia coli O157:H7 and
      other verotoxin-producing serotypes was studied. The E. coli colonized the caeca
      of both broilers and layers after oral administration of the challenge. The
      extent of colonization was dependent on challenge dose, age of chicks at the time
      of challenge, breed of chicks and length of time after exposure. A rapid increase
      in caecal colonization and a decrease in crop colonization was evident during the
      first few hours after challenge, with a maximum in the caeca at 6 h. Escherichia
      coli persisted in caecal contents as well as on caecal walls throughout the
      course of the experiments (14 d), but at much lower levels compared with the 6 h
      post-challenge.

PMID- 8486562
TI  - Production of hyperimmune bovine colostrum against Campylobacter jejuni.
AB  - Serial immunization of dairy cows with Campylobacter jejuni resulted in an
      enhanced serum antibody response and production of hyperimmune colostrum in all
      vaccinated animals. An approximate 10-fold decrease in the Camp. jejuni-specific
      antibody titres in colostrum was observed within 2 d post-partum. The lyophilized
      colostral concentrate fed to newborn calves resulted in a rapid increase in serum
      antibody response. Specific Camp. jejuni immunoglobulins could be detected in
      these animals for a further 10 weeks. The lyophilized hyperimmunized colostrum
      was very stable in vitro at different storage temperatures. It could be used for
      passive immunization to campylobacteriosis.

PMID- 8486563
TI  - Resistance to the antimicrobial agents of bacteria isolated from non-sterile
      pharmaceuticals.
AB  - The in vitro antimicrobial resistance of 391 bacterial strains isolated from 389
      samples of oral and topical medicaments was examined. The numbers of strains
      isolated (and percentage of samples that present them) were: 234 Bacillus
      (32.1%), 79 Staphylococcus (13.6%), 46 Micrococcus (11.3%), nine Pseudomonas
      (1.5%), eight Acinetobacter (1.5%), five Enterococcus (1.2%), three Alcaligenes
      (0.8%), two Escherichia and Enterobacter (0.5%), one each Providencia, Serratia
      and Streptococcus (0.2%). Gram-positive bacteria were isolated from topical and
      oral medicaments and Gram-negative rods were detected only in topical
      medicaments. The 97.4% of Bacillus strains were resistant to lincomycin and B.
      cereus was resistant to beta-lactam and trimethoprim-sulphamethoxazole.
      Staphylococcus spp. showed a high percentage of resistant strains to ampicillin
      (51.8%), tetracycline (40.5%) and trimethoprim-sulphamethoxazole (48.1%).
      Staphylococcus epidermidis had the highest number of multiresistant strains. The
      23.9% of Micrococcus strains were resistant to colistin. Enterococcus and
      Streptococcus strains showed multiresistance to penicillin G, aminoglycosides and
      erythromycin. The 61.5% of Gram-negative rod strains showed multiresistance to
      beta-lactam antibiotics and erythromycin; Pseudomonas spp. were the most
      resistant.

PMID- 8486564
TI  - The application of laser diffractometry to study the water content of spores of
      Bacillus sphaericus with different heat resistances.
AB  - The distribution of water in the protoplast and integument of three populations
      of Bacillus sphaericus spores was determined by laser diffractometry together
      with the sizes of their integuments and protoplasts. The spores were produced at
      15, 20 and 30 degrees C. Spores grown at 15 degrees C had protoplast and
      integument water contents similar to those produced at 20 degrees C, while those
      grown at 30 degrees C had significantly lower water contents than the other two
      populations. The inner (or protoplast) radii of the spores produced at 15, 20 and
      30 degrees C were 0.41 +/- 0.02 microns, 0.42 +/- 0.01 microns and 0.38 +/- 0.02
      microns whilst the outer (or whole spore) radii were 0.56 +/- 0.01 microns, 0.58
      +/- 0.01 microns and 0.52 +/- 0.02 microns respectively. The ratios of integument
      to protoplast radius were 0.40 +/- 0.02, 0.43 +/- 0.07 and 0.41 +/- 0.03
      respectively.

PMID- 8486565
TI  - Growth and physiological characteristics of Bacillus subtilis L-forms.
AB  - The specific growth rate of stable Bacillus subtilis L-forms was slower (mu =
      0.127) than the cell-walled form (mu = 0.219) when measured by optical density
      (O.D.). However, the L-form growth rate increased (mu = 0.288) when determined by
      viable cell counts. L-forms of B. subtilis appear to enter a phase of rapid cell
      division, followed by a period of cell enlargement which is associated with an
      increase in the number of cells with vacuoles and granules. Thus, maximum viable
      L-form numbers and DNA content were attained at approx. 30h, before maximum
      protein content was achieved (46h) and before maximum O.D. was observed at 71 h.
      Measurements showed that L-form cell size increased even after cell division had
      stopped. O.D. was therefore inaccurate for assessment of L-form growth. L-forms
      were sensitive to osmotic shock and unlike the cell-walled organisms from which
      they were derived, were resistant to penicillin, indicating a loss of
      peptidoglycan. The L-forms were similar to cell-walled forms in that
      antibiotic(s) and proteases were produced.

PMID- 8486566
TI  - Studies on the ecology of aquatic bacteria of the lower Niger Delta: multiple
      antibiotic resistance among the standard plate count organisms.
AB  - The ecology of multiple antibiotic resistant (MAR) bacteria in the fresh-waters
      of the lower Niger Delta was studied in the Port Harcourt area, Rivers State. On
      the basis of decreasing pollution levels three zones, A, B, C, were recognized.
      Cell recovery by two viable count media, casein-peptone-starch (CPS) and plate
      count (PC) agar containing chloramphenicol, tetracycline, penicillin,
      streptomycin or ampicillin were compared in an initial study. Higher numbers of
      antibiotic resistant (AR) bacteria were recovered on CPS containing tetracycline,
      penicillin, streptomycin and ampicillin from the faecally-polluted New Calabar
      River (zone A) than on SPC agar containing similar antibiotics but the reverse
      was observed for forest stream (zone B) samples. Differences between the two
      media were also observed at individual sample sites. The proportions of strains
      of AR bacteria resistant to their primary isolation antibiotic varied from 55%
      (zone B) to 72% in the least polluted Isiokpo and Elele-Alimini streams (zone C),
      for ampicillin, and mostly < 50% for the other drugs in each zone. Thirty
      bacterial strains purified from the prevent colonial types on the count media
      without antibiotics included mainly species of Bacillus (12) and enterobacteria
      (18). Between five and 10 strains were resistant to > or = three antibiotics;
      seven were resistant to all five. The antibiograms of most strains were variable
      and depended on the method of drug application (discs or incorporation into
      agar), media and temperature of incubation (25 degrees, 37 degrees or 44.5
      degrees C). Twenty-one strains were consistently resistant to ampicillin by the
      two methods; 10 to 19 were consistent for chloramphenicol, tetracycline and
      penicillin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486567
TI  - Leishmaniasis: some recent developments in chemotherapy.

PMID- 8486568
TI  - Pharmacokinetics of quinolones with special reference to the respiratory tree.
AB  - Successful treatment of respiratory tract infections with the fluoroquinolones
      requires knowledge about whether the prescribed antibiotic will reach the site of
      infection at clinically active concentrations. The difficulty in extrapolating
      pharmacokinetic information from animal models to man has resulted in new
      approaches to determine the distribution of antibiotic within the human lung.
      Bronchoalveolar-lavage (BAL) allows the collection of epithelial-lining-fluid,
      alveolar macrophages, bronchial mucosal samples and sputum, thereby permitting
      measurement of the cellular and extracellular concentrations of an antibiotic.
      All fluoroquinolones show similar patterns of penetration into the lung
      parenchyma, bronchial mucosa or bronchial secretions. The main differences
      between these agents concern antibacterial potency and the nature, frequency and
      severity of adverse reactions. Many respiratory infections are caused by obligate
      or faculative intracellular pathogens, which are likely to be eradicated by the
      intracellular and extracellular concentrations of quinolones achieved and is
      supported by models of phagocytic cell function.

PMID- 8486569
TI  - The activity of cefpirome and ten other antibacterial agents against 2858
      clinical isolates collected from 20 centres.
AB  - Two thousand eight hundred and fifty-eight aerobic clinical isolates of
      Enterobacteriaceae, Pseudomonas species, staphylococci, streptococci and
      Haemophilus species were collected in 19 geographically separated centres in the
      UK and one in Ireland. The identity of each isolate was confirmed at Southmead
      Hospital and the MIC of cefpirome, cefotaxime, ceftazidime, cefuroxime,
      cephradine, amoxycillin, piperacillin, imipenem, gentamicin, ciprofloxacin and
      trimethoprim was determined by an agar dilution method. Against species of
      Enterobacteriaceae not associated with producing an inducible cephalosporinase,
      cefpirome had a similar degree of activity to cefotaxime and was more active than
      ceftazidime and earlier cephalosporins. Against species with a high prevalence of
      inducible beta-lactamase production, cefpirome was superior to other
      cephalosporins; imipenem was also active against these isolates. Cefpirome was
      active against Pseudomonas aeruginosa, methicillin-sensitive staphylococci, non
      enterococcal streptococci and Haemophilus spp. When the isolates were exposed to
      0.1 mg/L of imipenem in agar plus the test agent, cefpirome had superior activity
      compared with the other cephalosporins tested for the Enterobacteriaceae, except
      Proteus vulgaris and Proteus penneri. 8.7% of Enterobacter spp., 7% of
      Citrobacter spp. and 6.7% of Morganella morganii had susceptibilities to beta
      lactams suggesting constitutive hyperproduction of chromosomal cephalosporinase;
      cefpirome, unlike the other cephalosporins tested, was active against these
      isolates, although to a lesser degree than against the wild-type inducible
      isolates. No isolates were thought to produce an extended-spectrum beta
      lactamase.

PMID- 8486570
TI  - Comparative susceptibility of the Bacteroides fragilis group species and other
      anaerobic bacteria to meropenem, imipenem, piperacillin, cefoxitin,
      ampicillin/sulbactam, clindamycin and metronidazole.
AB  - The in-vitro activity of meropenem, imipenem, piperacillin, cefoxitin,
      ampicillin/sulbactam, clindamycin and metronidazole was determined against 395
      strains of strict and facultative anaerobes, including Gardnerella vaginalis,
      Lactobacillus spp. and Mobiluncus spp. The activities of meropenem and imipenem
      were within one dilution of their MIC50 and MIC90 values. One isolate of
      Bacteroides fragilis, two of Bacteroides distasonis, and two of Bacteroides
      ovatus showed resistance or diminished susceptibility to meropenem and imipenem.
      Metronidazole was active against almost all obligate anaerobic isolates. Some non
      spore-forming Gram-positive bacilli and lactobacilli were resistant.
      Ampicillin/sulbactam inhibited almost all isolates at < or = 16/8 mg/L. The
      activity of clindamycin and cefoxitin was relatively good, but some strains of
      non-fragilis B. fragilis group species were resistant. Piperacillin was the least
      active agent tested.

PMID- 8486571
TI  - The release of endotoxin from antibiotic-treated Escherichia coli and the
      production of tumour necrosis factor by human monocytes.
AB  - The influence of antibiotic-induced release of endotoxin from in-vitro grown
      Escherichia coli on the production of tumour necrosis factor-alpha (TNF) by human
      monocytes was studied. Antibiotics tested were: cefuroxime (7.5 and 75 mg/L);
      ceftazidime (10 and 100 mg/L); aztreonam (10 and 100 mg/L); imipenem (10 and 100
      mg/L); and tobramycin (8 mg/L). The effect of the combination of cefuroxime plus
      tobramycin, and the effect of taurolidine, an endotoxin-binding agent, on TNF
      production was also tested. After incubation for 4 h, all antibiotic-treated
      cultures (high-dose) induced a similar rise in extracellular TNF production when
      compared to the controls. However, after incubation for 24 h, a significant rise
      in TNF production was noticed in the cefuroxime and aztreonam-treated cultures
      (6440 and 5969 ng/L, respectively) compared to the ceftazidime and imipenem
      treated cultures (846 and 381 ng/L, respectively). The cefuroxime-induced release
      of TNF could be reduced by addition of tobramycin (from 6440 to 1615 ng/L).
      Similar differences in TNF production were noticed in cell-associated TNF. Dose
      response curves did not demonstrate differences in TNF production in aztreonam or
      imipenem-treated cultures. However, for both cefuroxime and ceftazidime-treated
      cultures, low-dose treatment resulted in significantly higher production of TNF.
      The differences in TNF production between these antibiotics could be explained by
      the production of filaments following treatment with cefuroxime, aztreonam and
      low-dose ceftazidime, resulting in late bacterial lysis with high levels of
      endotoxin, whereas treatment with imipenem or high-dose ceftazidime resulted in
      the formation of spheroplasts, resulting in early lysis of the bacteria and much
      lower levels of endotoxin. The addition of taurolidine to either imipenem or
      aztreonam-treated cultures prevented a rise in TNF production as a result of
      nearly complete neutralization of the released endotoxin. It was concluded that
      the observed differences in TNF production by human monocytes in vitro were
      related to differences in the mechanisms and amount of antibiotic-induced release
      of endotoxin.

PMID- 8486572
TI  - Interference by antimalarial drugs with the in-vitro production of reactive
      nitrogen intermediates by murine macrophages.
AB  - The production of reactive oxygen intermediates (ROI) by host macrophages has
      long been recognized as an important defense mechanism against microorganisms.
      More recently, reactive nitrogen intermediates (RNI), also produced by activated
      macrophages, have been shown to be part of the host's first line of defense
      against malaria. In the present in-vitro study we have investigated the effects
      of antimalarial drugs on RNI production by murine macrophages stimulated by
      interferon-gamma (IFN-gamma) and/or malaria antigen, and on ROI production
      induced by phorbol myristate acetate. At concentrations exceeding the peak serum
      levels achieved with therapeutic dosages, chloroquine, in a dose-dependent
      manner, inhibited IFN-gamma- and malaria antigen-induced RNI production. Quinine,
      at a concentration of 10 mg/L also caused a significant reduction in IFN-gamma
      and malaria antigen-induced RNI synthesis; this concentration was well within the
      therapeutic range. High concentrations of artelinate significantly inhibited IFN
      gamma-induced RNI production but clindamycin had no effect on RNI synthesis. In
      contrast, halofantrine, in concentrations attainable with therapeutic dosages,
      significantly enhanced IFN-gamma-induced RNI production. ROI production by murine
      macrophages was unaffected by the antimalarial drugs over the same concentration
      ranges. It remains to be determined whether these in-vitro effects of
      antimalarial drugs on RNI production also influence the clinical and
      parasitological response in patients with malaria.

PMID- 8486573
TI  - In-vitro susceptibility and in-vivo efficacy of antimicrobials in the treatment
      of intraabdominal sepsis in mice.
AB  - Cefoxitin, cefotetan, cefmetazole, ceftizoxime, imipenem plus cilastatin,
      ampicillin plus sulbactam and clindamycin alone or combined with gentamicin,
      ciprofloxacin, ofloxacin or aztreonam were compared in the therapy of
      intraabdominal infection in mice caused by Escherichia coli in combination with
      either Bacteroides fragilis or Bacteroides thetaiotaomicron. Mortality in the
      control group was 45%, and no animal receiving either imipenem, gentamicin,
      ciprofloxacin, ofloxacin or aztreonam died. Mortality in mice receiving
      cefoxitin, cefotetan, cefmetazole, or ceftizoxime was below 7% (P < 0.05%) and
      mortality following treatment with ampicillin-sulbactam was 23-27% (P > 0.05).
      The abscesses were examined ten days after inoculation. No abscesses were
      observed in mice treated with clindamycin or imipenem. Therapy with gentamicin,
      ciprofloxacin, ofloxacin, aztreonam or ceftizoxime alone did not prevent abscess
      formation by both Bacteroides sp. A significant reduction in abscess formation
      and number of E. coli and B. fragilis was observed with combination therapy of
      clindamycin with either ciprofloxacin, ofloxacin, aztreonam, or gentamicin and
      single agent therapy with either imipenem, cefoxitin, cefotetan, cefmetazole and
      ampicillin-sulbactam alone. However, cefotetan and cefmetazole did not reduce
      abscess formation or the number of B. thetaiotaomicron. These in-vivo data
      confirm the in-vitro activity of these antimicrobials.

PMID- 8486574
TI  - Effectiveness of netilmicin and tobramycin against Pseudomonas aeruginosa in
      vitro and in an experimental tissue infection in mice.
AB  - The activity of netilmicin and tobramycin against Pseudomonas aeruginosa was
      assessed in vitro in the presence of constant and exponentially declining
      concentrations, and in mice in an experimental thigh infection. The activity in
      vitro at constant concentrations was expressed as the maximal killing rate (ER)
      during 3 h of exposure. On the basis of the quantitative relation between E(R)
      and the drug concentration, the numbers of cfu expected at consecutive times, at
      constant as well as at declining concentrations, were predicted. The relationship
      between observed numbers and predicted values of ERt were similar under both
      conditions for both drugs. On the same basis the numbers of cfu expected in the
      experimental thigh infection were predicted. There was indeed a significant
      linear relationship between observed numbers of cfu in homogenized muscle and the
      values predicted on the basis of the pharmacokinetics of the aminoglycosides, but
      the slope of this relationship was only 0.22. There was no difference in this
      respect between the two antibiotics. It is concluded that the efficacy of
      netilmicin and tobramycin against P. aeruginosa is considerably less in vivo than
      in vitro, but the relation is about the same for the two drugs; therefore the
      slightly higher activity of tobramycin in vitro is relevant in the in-vivo
      situation.

PMID- 8486575
TI  - Pharmacokinetics of cefuroxime axetil in patients with normal and impaired renal
      function.
AB  - The pharmacokinetics of cefuroxime axetil were studied by a model-independent
      method after a single oral dose corresponding to 500 mg of cefuroxime in 28
      subjects grouped according to renal functions. Creatinine clearance (Clcr) was >
      85, 50 to 84, 15 to 49, and < 15 mL/min in groups 1, 2, 3, and 4 respectively.
      The V(area)/F (distribution volume/bioavailability) was independent of renal
      function, the average being 0.82 +/- 0.27 L/kg. Both Cls/F (systemic
      clearance/bioavailability) and Clr (renal clearance) decreased linearly with the
      decrease in Clcr. The T1/2 (serum half-life) was 1.4 +/- 0.33 h, 2.4 +/- 0.65 h,
      4.6 +/- 2.32 h, and 16.8 +/- 10.2 h in groups 1, 2, 3, and 4 respectively. A
      significant correlation existed between kel (elimination rate constant) and Clcr
      (r = 0.88, P < 0.01). kel of cefuroxime can be predicted by: kel (h-1) = 0.0046 x
      Clcr + 0.0108. Based on these data, modification of dosing schedule is not deemed
      necessary when Clcr is above 50 mL/min/1.73 m2, while the standard individual
      dose should be given every 12 h when Clcr is 49-30 mL/min/1.73 m2, every 24 h
      when it is 29-10 mL/min/1.73 m2, and every 48 h when it is below 10 mL/min/1.73
      m2.

PMID- 8486576
TI  - Assessment of potential ototoxicity following high-dose nebulized tobramycin in
      patients with cystic fibrosis.
AB  - A deterioration in pulmonary function is a common problem in patients with cystic
      fibrosis. One strategy which might help to arrest this process is the
      administration of aminoglycosides by nebulizer in dosages which greatly exceed
      those which are normally given parenterally. Ten patients (4-19 years of age)
      with cystic fibrosis underwent evoked response audiometry at regular intervals
      following a 400 mg dose of nebulized tobramycin; the concentrations of tobramycin
      in samples of blood taken at the same time intervals were also determined. No
      significant abnormalities in the audiometric investigations were detected. The
      relationship between shifts in vestibulocochlear potentials and long-term
      ototoxic sequelae in patients receiving aminoglycosides via a nebulizer requires
      further evaluation.

PMID- 8486577
TI  - Recommendations for endocarditis prophylaxis. The Endocarditis Working Party for
      Antimicrobial Chemotherapy.

PMID- 8486578
TI  - Coagulase-negative staphylococcal bacteraemia treated with teicoplanin.

PMID- 8486579
TI  - High rates of erythromycin-resistant Streptococcus pneumoniae among penicillin
      resistant strains.

PMID- 8486580
TI  - beta-Lactamase parameters of heterogeneously and homogeneously methicillin
      resistant Staphylococcus aureus.

PMID- 8486581
TI  - Problems associated with susceptibility testing of co-amoxiclav.

PMID- 8486582
TI  - Newer glycopeptide antibiotics tested against nosocomial bloodstream isolates.

PMID- 8486583
TI  - Activity of four fluoroquinolones against 346 strains of enteric pathogens.

PMID- 8486584
TI  - HPLC assay of cefixime in serum and CSF.

PMID- 8486585
TI  - New hazard of meningococcal chemoprophylaxis.

PMID- 8486587
TI  - Better compliance and medicine use: making it happen.

PMID- 8486586
TI  - Efficacy of topical ciprofloxacin in the treatment of ear infections in adults.

PMID- 8486588
TI  - The reemergence of tuberculosis in Arkansas.

PMID- 8486589
TI  - Patient allegedly abandoned by physicians and hospital.

PMID- 8486590
TI  - Medical qualification of sport scuba divers.

PMID- 8486591
TI  - Radiological case of the month. Asbestosis-related round atelectasis.

PMID- 8486592
TI  - The abrupt discontinuation of fluvoxamine in patients with panic disorder.
AB  - BACKGROUND: We evaluated patients abruptly withdrawn from fluvoxamine, a
      serotonin selective reuptake inhibitor, for evidence of a discontinuation
      syndrome. METHOD: In an open-label study, 14 subjects were abruptly withdrawn
      from fluvoxamine after treatment lasting 8 months (7 months for 1 patient).
      Psychological, somatic, and perceptual symptoms were assessed at Day 5, Day 10,
      and Day 14 postdiscontinuation. Anxiety and depression were assessed using
      clinician and self-rated scales. RESULTS: Twelve (86%) of 14 subjects developed
      new symptoms. The most frequent symptoms reported were dizziness/incoordination,
      headaches, nausea, and irritability. Symptoms peaked on Day 5
      postdiscontinuation. Only 1 subject had a recurrence of panic, but another
      developed anxiety and depression; both were remedicated. CONCLUSION: Abrupt
      fluvoxamine discontinuation is associated with a characteristic syndrome in many
      patients.

PMID- 8486593
TI  - The clinical characteristics of panic disorder in the elderly: a retrospective
      study.
AB  - BACKGROUND: Community-based studies of the elderly have observed pathologic
      levels of anxiety to be common but find low rates of DSM-III-R anxiety disorders.
      Our clinical experience was that panic disorder may be more common than
      previously acknowledged. Our goals were to determine the prevalence, clinical
      characteristics, and possible factors that may facilitate a late-onset of panic
      disorder. METHOD: The clinical records of 540 patients aged 60 years or more were
      reviewed. DSM-III-R panic disorder was identified in 51 subjects. Demographic
      information, current medical illness, and family history were extracted from
      their records. Rating scale measures of anxiety, depression, phobias, and
      cognition were available. For comparison, subjects were divided into an early
      group who experienced onset of panic disorder at age 59 years or earlier and a
      late group who experienced onset at age 60 years or later. RESULTS: The overall
      prevalence of panic disorder was 9.4% and late-onset panic was 5.7%. The late
      onset group experienced more shortness of breath (p = .05) during panic attacks
      and were more likely to have medical disorders like chronic obstructive pulmonary
      disease, vertigo, and Parkinson's disease. The early-onset subjects were more
      socially phobic (p = .008) and more depressed. CONCLUSION: Panic disorder can
      have onset in late life. Its phenomenology is similar in most respects to that
      described in young adults. Factors contributing to onset include stress, medical
      illness, and central nervous system disease.

PMID- 8486594
TI  - Postpartum obsessive compulsive disorder: a case series.
AB  - BACKGROUND: The puerperium has typically been a period of risk for the
      development of psychiatric illness. Although postpartum depressive illness has
      been discussed extensively in the literature, obsessive compulsive disorder
      during pregnancy and puerperium has received little attention. METHOD: Fifteen
      women with new-onset obsessive compulsive symptoms during the puerperium were
      retrospectively evaluated by chart review; all met DSM-III-R criteria for
      obsessive compulsive disorder. Distinctive features of their clinical
      presentation, pharmacotherapy received, and status at 1-year follow-up were
      recorded. RESULTS: Patients were noted to have a characteristic constellation of
      symptoms comprised of disabling intrusive obsessional thoughts to harm their
      babies. Obsessive rituals were not observed in any of the patients described.
      Patients frequently developed secondary depression and appeared to be exquisitely
      responsive to serotonin selective reuptake inhibitors. CONCLUSION: The puerperium
      may be a period of risk for development of new-onset obsessive compulsive
      disorder. Clinicians caring for puerperal women need to be aware of the impact of
      these symptoms on maternal and fetal well-being.

PMID- 8486595
TI  - Rib fractures as an unusual complication of severe tardive dystonia.

PMID- 8486596
TI  - Molindone and weight loss.

PMID- 8486597
TI  - Fluoxetine-induced sexual dysfunction and yohimbine.

PMID- 8486598
TI  - A seizure following bupropion overdose.

PMID- 8486599
TI  - Role of tyrosine-5 in the cytoplasmic tail of the macrophage asialoglycoprotein
      receptor in the rapid internalization of ligands.
AB  - A macrophage asialoglycoprotein binding protein (M-ASGP-BP), which is an
      endocytic receptor specific for Gal/GalNAc-terminated glycoproteins, was shown to
      be functionally active as a homooligomer (hexamer or octamer) of a single
      polypeptide chain of 42 kDa [Ozaki, K., Ii, M., Itoh, N., & Kawasaki, T. (1992)
      J. Biol. Chem. 267, 9229-9235]. In various endocytic receptors, a four-amino-acid
      sequence, Tyr-X-Y-Phe, in the cytoplasmic domain has been identified as an
      internalization signal [Pearse, B.M.F. & Robinson, M.S. (1990) Annu. Rev. Cell
      Biol. 265, 151-171]. The amino-terminus of the M-ASGP-BP deduced from its cDNA
      sequence was found to contain the sequence, Tyr5-Glu6-Asn7-Phe8, in its
      cytoplasmic tail. This was confirmed by the fact that the recombinant M-ASGP-BP
      isolated from transfected COS-1 cells was found to have the amino-terminal
      sequence, Thr2-Met3-Ala4-Tyr5-Glu6-Asn7-Phe8. The role of this presumptive
      internalization signal in the cytoplasmic tail was studied by measuring the
      endocytic activity of the wild-type and mutant M-ASGP-BPs expressed on COS-1
      cells through transfection with the wild-type and mutant cDNAs prepared by
      oligonucleotide-directed mutagenesis, respectively. On the deletion of Tyr5 or
      replacement of it with alanine, the internalization of asialoorosomucoid (ASOR)
      decreased to approximately one-fourth that in the case of the wild-type molecule.
      On replacement of Tyr5 with phenylalanine, the internalization proceeded at a
      rate similar to that in the case of the wild-type molecule.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8486600
TI  - Structure, expression, and evolution of guinea pig serum amyloid P component and
      C-reactive protein.
AB  - The structure and expression of the pentraxins, serum amyloid P component (SAP),
      and C-reactive protein (CRP), have been investigated in the guinea pig. Northern
      blot analysis of hepatic RNA from animals in which acute inflammation had been
      induced by intraperitoneal injection of thioglycollate established that neither
      SAP or CRP is a major acute phase reactant in the guinea pig. Genomic clones of
      SAP and CRP were isolated and sequenced, and the gene and the derived protein
      sequences were compared with other mammalian homologues. Both genes have
      organizations typical of the pentraxin genes of other species, but some
      differences were defined in the regions that potentially determine the capacity
      of the pentraxin gene to be induced during acute inflammation. Nucleotide
      substitutions in coding regions have occurred at similar rates in the two
      pentraxin genes. Nonsynonymous substitution rates indicate that SAP and CRP are
      subject to similar, relatively low levels of constraint; at the amino acid
      sequence level the rate of evolution is approximately two replacements per site
      per 10(9) years. An estimate of the phylogenetic relationship among the pentraxin
      genes suggests that SAP and CRP arose as the result of a gene duplication event
      that occurred very early in mammalian evolution, but subsequent to the divergence
      of the reptilian ancestors of the mammalian and avian lineages. This raises
      doubts about the identity of proteins from fish, which have been previously
      characterized as CRP and SAP.

PMID- 8486601
TI  - Purification and characterization of prophenoloxidases from pupae of Drosophila
      melanogaster.
AB  - Two isoforms of prophenoloxidase were isolated from pupae of Oregon-R strain of
      Drosophila melanogaster. The purification procedure included ammonium sulfate
      fractionation, Sephacryl S-200 gel chromatography, DEAE-cellulose, and
      hydroxylapatite column chromatography. The two isoforms, A1 and A3, could be
      separated by ammonium sulfate fractionation. The isoelectric points of A1 and A3
      were determined to be pH 5.8 and 6.7, respectively. The molecular weights of the
      monomers of A1 and A3 were estimated by SDS-PAGE to be 78 and 77 kDa,
      respectively. The native states of A1 and A3 are considered to be homodimeric, as
      judged by gel-filtration chromatography.

PMID- 8486602
TI  - A membrane-bound metallo-endopeptidase from rat kidney: its immunological
      characterization.
AB  - The structure and location of a membrane-bound metallo-endopeptidase, previously
      purified from rat kidney [Yamaguchi et al. (1991) Eur. J. Biochem. 200, 563-571],
      were examined by immunochemical and immunohistochemical methods with a rabbit
      polyclonal antibody against the purified enzyme. On treatment with
      endoglycosidase F, the subunit of the purified enzyme (molecular mass = 88 kDa)
      was converted to a smaller form (78.5 kDa), indicating that the enzyme contained
      at least 11% N-linked carbohydrate. Treatment of kidney membranes with papain
      resulted in release of the enzyme, as shown by Western blotting analysis of the
      solubilized fraction. Immunoassays of rat tissues showed that only the kidney,
      and small and large intestine expressed significant amounts of the antigen.
      Moreover, immunohistochemical studies showed that the antigen was confined to the
      luminal surfaces of the proximal renal tubules and the intestinal villi. Thus,
      like another kidney membrane metallo-endopeptidase, meprin [Kounnas et al. (1991)
      J. Biol. Chem. 266, 17350-17357], the purified enzyme is shown to be a
      glycoprotein that is probably anchored in the plasma membrane, and located in the
      luminal surface of microvillar membranes of the kidney and intestine. These
      results indicate that our enzyme and meprin have clear structural and topological
      similarities.

PMID- 8486603
TI  - Drift of the sialyl-linkage specific recognition of the sialidase of influenza B
      virus isolates.
AB  - Sialyl-linkage specificity of the sialidase of influenza B viruses isolated in
      different years from 1940 through 1990
      (B/Lee/40,B/Setagaya/3/56,B/Tokyo/7/66,B/Kagoshima/1/68, B/Gifu/2/73,
      B/Kanagawa/3/76, B/Ibaraki/2/85, B/Yamagata/16/88, and B/Bangkok/163/90) was
      studied with N-acetylneuraminyl (alpha 2-3)- and (alpha 2-6)-lactoses, GM3
      gangliosides containing the same sialyl-oligosaccharide sequences as
      sialyllactose, and also with type I and type II lacto-series gangliosides
      carrying Neu5Ac alpha 2-3Gal and NeuAc alpha 2-6Gal linkages as substrates. From
      an examination of up to nine strains, the sialidases of all viruses
      preferentially hydrolyze substrates with Neu5Ac alpha 2-3Gal linkage rather than
      the Neu5Ac alpha 2-6Gal linkage. It was found that the sialidase activity toward
      Neu5Ac alpha 2-6Gal linkage relative to Neu5Ac alpha 2-3Gal linkage is increased
      in later strains, whether sialyllactose or ganglioside is used as the substrate.
      These results suggested that the sialidase of influenza B virus isolates has
      shown a drift in linkage specificity which correlates with the year of isolation.

PMID- 8486604
TI  - Purification of a 60 kDa nuclear localization signal binding protein in rat liver
      nuclear envelopes and characterization of its properties.
AB  - A nuclear localization signal binding protein in nuclear envelope was studied as
      the first step to determine the mechanism of nuclear protein recognition by
      nuclear envelope. The rat liver nuclear envelope extract was resolved by SDS-PAGE
      and ligand blotted with 125I-labeled nucleoplasmin bearing a strong nuclear
      localization signal. A nuclear localization signal binding protein with molecular
      mass of 60 kDa (NBP60) was detected in the extract. NBP60 could be extracted with
      2% Triton X-100-1 M KCl but not with 1 M KCl, 2 M urea, or 2% Triton X-100. The
      protein was partitioned to the lower layer in a two phase system using Triton X
      114. These results suggested that the protein is an intrinsic membrane protein
      and has a hydrophobic surface. This protein was bound to not only nucleoplasmin
      but also the nuclear localization signal peptide of SV 40 large T-antigen (T
      peptide) conjugated to human serum albumin. The binding of NBP60 to nucleoplasmin
      Sepharose was inhibited by 50% in the presence of 0.12 mM T-peptide. However, a
      high concentration of 2.1 mM was necessary, when mutant T-peptide in which the
      essential amino acid lysine was substituted with threonine was used. These
      results suggested that NBP60 binds specifically to nuclear localization signals.
      NBP60 extracted from the nuclear envelope was purified by nucleoplasmin-Sepharose
      affinity chromatography following hydroxyapatite high performance liquid
      chromatography.

PMID- 8486605
TI  - Structure of 29-kDa protein from ascidian (Halocynthia roretzi) body wall muscle.
AB  - Preparations of thin filament from ascidian (Halocynthia roretzi) body wall
      muscle were found to be contaminated with large amounts of an unknown protein
      which, when purified, migrated to 29 kDa on SDS-PAGE and was thus named HR-29. To
      elucidate its physiological function, we have determined the primary structure of
      HR-29 by peptide and cDNA sequence analysis. Genomic sequence analysis showed
      that HR-29 is divided to four exons by three introns. It is composed of 251 amino
      acid residues and the N-terminal Ser is blocked by an acetyl group. The N
      terminal domain of 150 residues is hydrophilic, and from residue 36 to 92 there
      are three similar repeated sequences of 19 residues. The N-terminal domain showed
      no significant sequence homology with other proteins. On the other hand, the C
      terminal domain of 100 residues has homology with those of small heat-shock
      proteins and alpha-crystallin of lens protein. HR-29 is thought to be a fusion
      protein of two different origins. Recently alpha B-crystallin was identified in
      skeletal muscle and suggested to be a myofibril-stabilizing protein [Atomi, T. et
      al. (1991) J. Biochem. 110, 2360-2364]. Thus, HR-29 may also be a myofibril
      stabilizing protein, as suggested by the sequence similarity of the C-terminal
      domain with alpha-crystallin, although the origin and role of the N-terminal
      domain are not clear.

PMID- 8486606
TI  - Characterization of casein kinase II, and of p98 as one of its effective
      phosphate acceptors in sea urchin eggs.
AB  - CK-II has been partially purified from a 1.5 M KCl extract of unfertilized sea
      urchin eggs by means of DEAE-cellulose column chromatography, gel filtration on
      Sephacryl S300, and heparin-agarose column chromatography, successively. This
      partially purified CK-II was associated with a 98 kDa polypeptide (designated as
      p98), which was then separated from the kinase by Mono Q column chromatography
      (HPLC). The biochemical characteristics of CK-II purified from unfertilized eggs
      were similar to those of CK-IIs from various mammalian cells: requirements of
      divalent cations (Mg2+ and Mn2+) and phosphate acceptors (casein and p98),
      response to basic polypeptides and heparin, subunit structure and molecular size.
      Moreover, it was found that: (i) p98 (apparent pI 10.0) has DNA-binding ability
      and functions as an effective phosphate acceptor for CK-II in vitro; (ii)
      phosphorylation of p98 by the kinase was highly stimulated by histone-like sperm
      protein from sea urchin sperm, protamine (salmon sperm), and poly Arg; and (iii)
      selective phosphorylation of p98 by CK-II was detected when the DEAE-cellulose
      fraction from unfertilized eggs was incubated with [gamma-32P]ATP in the presence
      of protamine. Some biochemical characteristics of p98 from the eggs were similar
      to those of transcriptional factor Sp1. The evidence obtained suggests that (i)
      arginine-rich sperm proteins function as potent activators for CK-II in
      unfertilized eggs and (ii) specific phosphorylation of p98 by the activated
      kinase may play an important role in the transcriptional regulation in the eggs
      accompanying fertilization.

PMID- 8486607
TI  - Thermostable farnesyl diphosphate synthase of Bacillus stearothermophilus:
      molecular cloning, sequence determination, overproduction, and purification.
AB  - The structural gene for thermostable farnesyl diphosphate synthase from Bacillus
      stearothermophilus was cloned, sequenced, and overexpressed in Escherichia coli
      cells. A 1,260-nucleotide sequence of the cloned fragment was determined. This
      sequence specifies an open reading frame of 891 nucleotides for farnesyl
      diphosphate synthase. The deduced amino acid sequence shows a 42% similarity with
      that of E. coli FPP synthase [Fujisaki et al. (1990) J. Biochem. 108, 995-1000].
      Comparison with prenyltransferases from a wide range of organisms, from bacteria
      to human, revealed the presence of seven highly conserved regions. In contrast to
      thermolabile prenyltransferases, which have four to six cysteine residues, the
      thermostable farnesyl diphosphate synthase carries only two cysteine residues.
      This enzyme is also unique in that some of the amino acids that are fully
      conserved in equivalents from other sources are replaced by functionally
      different amino acids. Construction of an overproducing strain provided a
      sufficient supply of this enzyme and it was purified to homogeneity. The purified
      recombinant enzyme is immunochemically identical with the native B.
      stearothermophilus enzyme, and it is not inactivated even after treatment at 65
      degrees C for 70 min.

PMID- 8486608
TI  - Structure and expression of the gene encoding rat nonspecific form delta
      aminolevulinate synthase.
AB  - To understand the regulatory mechanisms controlling the heme biosynthetic pathway
      in animal liver, RNA blot hybridization analysis was used to examine the
      developmental stage-specific transcription of the gene encoding nonspecific form
      delta-aminolevulinate synthase (ALAS-N). The expression of the erythroid-specific
      delta-aminolevulinate synthase (ALAS-E) mRNA was also studied. The results
      demonstrated that, while ALAS-E is the key enzyme which supplies large quantities
      of heme for hemoglobin synthesis in fetal rat liver, ALAS-N functions to supply
      heme for the cytochrome P-450 system in fetal, newborn, and adult rat liver. ALAS
      N was also suggested to work as a housekeeper gene to supply heme for respiratory
      cytochromes and other hemoproteins in various tissues. The structure and
      organization of the rat ALAS-N gene were next analyzed to study the molecular
      mechanisms regulating ALAS-N gene transcription. The ALAS-N gene was found to
      span more than 14 kb in the rat genome, encompassing eleven exons. The promoter
      region of the gene was found to contain several potential cis-acting regulatory
      elements, including motifs matching the TATA box sequence and the nuclear
      respiratory factor 1 binding sequence. The organization of the rat ALAS-N gene
      was determined to be quite similar to that of the ALAS-E gene in mouse; the mouse
      ALAS-E gene consists of eleven exons. This observation suggested that the
      ancestral gene for ALA synthase in animals was probably composed of eleven exons,
      and both the ALAS-N and ALAS-E genes were derived from this ancestral gene.

PMID- 8486609
TI  - Low-density lipoprotein receptor mutation that deletes exons 2 and 3 by Alu-Alu
      recombination.
AB  - A deletion mutant in the low density lipoprotein receptor gene of a Japanese
      patient with heterozygous familial hypercholesterolemia was analyzed. Genomic
      Southern blotting showed abnormal size restriction fragments with BamHI (7.8 kb),
      EcoRI (3.8 kb), BglII (17 kb), KpnI (> 23 kb), EcoRV (13 kb), and XbaI (14 kb).
      The abnormal EcoRI fragment, 3.8 kb, was cloned into lambda phage vector, and the
      deleted region of 10 kb including exons 2 and 3 was identified. The nucleotide
      sequence around the deletion joint was determined. The sequence of the eight
      nucleotides in the deletion-joint region of the mutant gene was identical to the
      corresponding sequences of both introns 1 and 3 of the normal gene. The deletion
      seemed to occur by an unequal recombination between the Alu-like sequences in the
      same direction in introns 1 and 3.

PMID- 8486610
TI  - Purification and characterization of a nuclear pore glycoprotein complex
      containing p62.
AB  - It is known that nucleoporins, a family of glycoproteins with N-acetylglucosamine
      that are found in nuclear pore complexes, are essential for nuclear import and
      export. A major component of the family, p62, was purified from a salt extract of
      rat liver nuclear envelopes by wheat germ agglutinin-Sepharose affinity
      chromatography and DEAE-anion exchange HPLC. p62 was purified as a complex with
      two glycoproteins of 60 and 54 kDa. The presence of the complex was confirmed by
      gel filtration, glycerol density gradient centrifugation, and cross-linking
      experiments. The molecular ratio of the 62-, 60-, and 54-kDa components of the
      complex was estimated to be 1: 1.1 +/- 0.2: 1.7 +/- 0.3 from the intensity of
      Coomassie Blue staining of SDS-PAGE gels. The complex was stable against 1 M
      NaCl, 1% Triton X-100, and 2 M urea. The Stokes' radius and sedimentation
      coefficient of the complex are 8.0 nm and 6.7 S. The molecular mass and
      frictional ratio of the complex were estimated to be about 231 kDa and 2.0,
      respectively. p62 and p54 were acidic and neutral proteins, respectively,
      exhibiting charge heterogeneities, and p60 was assumed to be a basic protein. p60
      tended to undergo proteolytic degradation to a 47-kDa fragment.

PMID- 8486611
TI  - Structural changes in Z-disks of skeletal muscle myofibrils during growth of
      chicken.
AB  - Postnatal structural changes in Z-disks of skeletal muscles of chicken from 2 to
      35 wk after hatching were examined to elucidate how Z-disks develop from the
      embryonic to the mature stage. The mechanical strength of Z-disks of breast
      muscle (i.e. the ratio of the number of myofibrils to the total number of
      myofibrils and myofibrillar fragments composed of 1-4 sarcomeres, which were
      formed under the mechanical forces exerted during homogenization) increased from
      66% at 2 wk of age to 75% at 10 wk, and leveled off at 76% at 25 wk. The Z-disks
      of leg muscle were stronger than those of breast muscle throughout growth.
      Measurements by electron microscope showed that the width of Z-disks increased
      during growth from 26 to 33 nm, 48 to 53 nm, and 89 to 101 nm, in white,
      intermediate, and red muscle fibers, respectively. It was proved that the
      configuration of Z-filaments, the structural backbone of Z-disks, takes its final
      shape within 2 wk after hatching; the immature Z-disks are then reinforced by the
      accumulation of amorphous matrix materials. These results confirm that the
      maturation of Z-disks is brought about by physical motion in muscle tissue and
      the accompanying development of tension.

PMID- 8486612
TI  - Purification and processing of rat liver procathepsin B.
AB  - In order to characterize the intracellular processing event of lysosomal
      cathepsin B, the proenzyme was purified from the rat liver microsomal contents
      using a Con A-Sepharose column, a Sepharose-Gly-Phe-GlySc column, and an anti
      cathepsin B IgG column. The purified proenzyme gave a single protein band of 39
      kDa on SDS/polyacrylamide gel electrophoresis. The proenzyme showed no
      appreciable enzymatic activity. When the purified proenzyme was incubated with
      the cathepsin B-free tritosomal contents, prepared by treatment of the tritosomal
      contents with anti-cathepsin B IgG Sepharose, at pH 3.0, 30 degrees C, a
      remarkable increase of enzymatic activity was observed. Immunoblot analysis
      showed that the proenzyme was completely converted to the active intermediate
      form of 31 kDa after 1 h incubation. These processing and activation events were
      blocked in the presence of pepstatin. When the proenzyme was incubated with the
      cathepsins B- and D-free tritosomal contents, prepared by treatment of the
      cathepsin B-free tritosomal contents with anti-cathepsin D IgG Sepharose, the
      processing and activation did not occur. These results indicate that cathepsin D
      is involved in the processing and activation of procathepsin B in rat liver
      lysosome. In the NH2-terminal sequence analysis of the 31 kDa form, the terminal
      was assigned as proline (66th residue). Since the NH2-terminus of the mature
      single-chain form of cathepsin B (29 kDa) ends at leucine (80th residue), the NH2
      terminus of the 31 kDa form is 14 amino acid residues longer than that of the
      single-chain form.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486613
TI  - Erythropoietin 5'-flanking sequence-binding protein induced during hypoxia and
      cobalt exposure.
AB  - The 5'-flanking region of the human erythropoietin (Epo) gene contains a 0.14-kb
      sequence that is conserved in the Epo gene from mouse and located within a
      promoter that is activated under hypoxic conditions such as anemia. Using a
      fragment containing this sequence in DNA mobility shift assays, we found that
      specific DNA-binding proteins were induced in mouse kidney nuclei under anemic
      hypoxia. Using synthetic double-stranded oligonucleotides that contain this
      sequence, the essential binding site was defined to be the -40 to -20 region
      upstream of the transcription initiation site in the human Epo gene. By DNA
      affinity chromatography using a column with the immobilized 5'-flanking sequence,
      two inducible binding proteins with apparent molecular masses of 55 and 45 kDa
      were identified in the nuclei of mouse kidney and liver under anemic hypoxia.
      These binding proteins were also induced during cobalt exposure.

PMID- 8486614
TI  - Cloning of the DNA polymerase gene of Bacillus caldotenax and characterization of
      the gene product.
AB  - The pol gene of the thermophilic eubacterium Bacillus caldotenax was cloned in a
      plasmid and expressed in Escherichia coli. The PCR method was used to clone the
      gene with no previous knowledge of the gene or protein sequence. The 3,329-bp DNA
      fragment containing the structural gene for DNA polymerase was sequenced. DNA
      polymerase, as deduced from the DNA sequence, consisted of 877 amino acids, had a
      molecular weight of 99,452, and was structurally homologous to the DNA
      polymerases of the Pol I family (family A), which includes E. coli DNA polymerase
      I and T7 DNA polymerase. B. caldotenax DNA polymerase (Bca polymerase) purified
      from the recombinant E. coli strain was characterized. Like E. coli Pol I, Bca
      polymerase had 5'-->3' exonuclease activity. The degraded product with the
      molecular weight of 65,000 was also purified and found to have polymerase
      activity. To overproduce this Klenow-type fragment of Bca polymerase, a
      recombinant expression plasmid pUI205 with a deletion in the 5'-region of the pol
      structural gene was constructed. The DNA polymerase produced by pUI205 is more
      suitable for use in the dideoxy sequencing method than the other DNA polymerases
      that have been used for sequencing.

PMID- 8486615
TI  - Structural requirements for the interaction of p21ras with GAP, exchange factors,
      and its biological effector target.
AB  - From the multitude of mutations that have been tested in p21ras, a common theme
      emerges regarding its interaction with the effector target, GAPs, and the newly
      discovered exchange factors. Many of the mutations that result in dysfunction for
      all three types of interactions are localized to the switch 1 and switch 2
      regions of the p21ras three-dimensional structure (Fig. 2). These two regions
      change conformation on GTP binding by p21ras and, accordingly, both GAP binding
      and Ras biological activity are GTP-dependent processes. In addition, certain
      mutations in the switch 1 and 2 regions alter the affinity of GAP for p21ras,
      again implicating this region in the binding interaction. On the other hand, the
      SDC25 exchange factor appears to promote dissociation of both GTP and GDP from
      p21ras, suggesting that the overall conformation of the switch 1 and 2 regions
      may not be important for recognition by SDC25. Moreover, none of the switch 1 or
      2 mutations that impaired stimulation by SDC25 affected its binding to p21ras.
      This suggests that these residues are essential for the mechanism of activation
      by SDC25 but not for its binding to p21ras. Amino acids at positions 73, 75, and
      possibly 102 and 103 appear also to be involved in the activation of p21ras by
      exchange factors. Whether these are required for binding to the exchanger has not
      been reported.

PMID- 8486616
TI  - The Wilms' tumor gene product WT1 activates or suppresses transcription through
      separate functional domains.
AB  - We recently reported that the putative tumor suppressor gene product WT1
      interacts with a 5'-flanking DNA sequence 5'-GCGGGGGCG-3' within the platelet
      derived growth factor A-chain gene and abolishes its promoter activity,
      suggesting that WT1 functions as a transcriptional suppressor of the platelet
      derived growth factor A-chain gene. We now show that WT1 functions also as a
      transcriptional activator. Using chimeric reporter plasmids, we demonstrated that
      WT1 requires both 5' and 3' binding sites relative to transcription start site
      for transcriptional repression; however, when WT1 binds to either the 5' or the
      3' site alone, WT1 functions to activate transcription. We truncated the wt1 gene
      and established that amino acid residues 84-179 are required for transcriptional
      suppression, whereas amino acid residues 180-294 contain a domain that mediates
      transcriptional activation. These results establish that WT1 has regulatory
      domains that function either to activate or suppress transcription and suggest
      the possibility that WT1 functions as an activator and not as a suppressor of
      selected gene transcription.

PMID- 8486617
TI  - The coated vesicle vacuolar (H+)-ATPase associates with and is phosphorylated by
      the 50-kDa polypeptide of the clathrin assembly protein AP-2.
AB  - We have previously noted a 50-kDa polypeptide (p50) co-purifying with
      preparations of the bovine brain clathrin-coated vesicle vacuolar (H+)-ATPase (V
      ATPase) (Zhang, J., Myers, M., and Forgac, M. (1992) J. Biol. Chem. 267, 9773
      9778). We show that p50 is also immunoprecipitated with the V-ATPase, further
      suggesting its specific association with the proton pump. To determine the
      identity of this 50-kDa polypeptide and the stoichiometry of its association with
      the V-ATPase, we performed N-terminal amino acid sequencing and quantitative
      amino acid analysis of the gel-purified protein. These results revealed the
      unknown polypeptide to be the 50-kDa subunit of the clathrin assembly protein AP
      2 (AP50); we estimate the stoichiometry of association is one AP50 per V-ATPase
      complex. AP50 is an N-ethylmaleimide (NEM)-inhibitable autokinase and incubation
      of purified V-ATPase with [gamma-32P]ATP resulted in the NEM-sensitive
      phosphorylation of AP50 and the B subunit of the V-ATPase. The same
      phosphorylation pattern is seen if the labeling reaction is done with intact
      clathrin-coated vesicles and the V-ATPase subsequently immunoprecipitated from
      the solubilized vesicles. This represents the first report of phosphorylation of
      one of the V-ATPase subunits. The functional significance of this phosphorylation
      for regulation or targeting of the V-ATPase in vivo remains to be determined.

PMID- 8486618
TI  - Insulin action on the internalization of the GLUT4 glucose transporter in
      isolated rat adipocytes.
AB  - A novel method was developed to measure relative amounts of the GLUT4 glucose
      transporter on the surface of intact fat cells and to monitor the action of
      insulin on cell surface glucose transporters as they internalize into
      intracellular membranes. The method takes advantage of two predicted trypsin
      cleavage sites in the major exofacial loop of this transporter protein. Treatment
      of cyanide-poisoned rat adipocytes with 1 mg/ml trypsin at 37 degrees C for 30
      min produced an immunoreactive GLUT4 protein species in subsequently isolated
      plasma membranes that migrated with higher mobility (apparent M(r) = 35,000) than
      native GLUT4 (apparent M(r) = 46,000) on SDS-polyacrylamide gel electrophoresis.
      This proteolyzed GLUT4 protein was absent in the intracellular low density
      microsomes. Insulin treatment of adipocytes for 20 min prior to sequential
      additions of cyanide and trypsin caused a 16-fold increase in the proteolytically
      cleaved GLUT4 species. Incubation of fresh fat cells with trypsin caused a rapid
      and progressive appearance of the proteolyzed GLUT4 species in the intracellular
      low density membranes as well as plasma membranes. After 5 min of trypsinization,
      66% of the total cleaved GLUT4 in these cells had moved into the low density
      membranes. Insulin treatment markedly decreased the internalized cleaved GLUT4 to
      20% of the total. These data indicate the following: 1) trypsinization of the
      GLUT4 transporter protein on intact fat cells is a convenient means to monitor
      the extent of transporter recruitment to the plasma membrane by insulin, as well
      as to estimate GLUT4 internalization rates; and 2) the action of insulin on
      glucose transporter redistribution to the cell surface is associated with a
      marked inhibition of the fraction of cell surface GLUT4 transporters internalized
      per unit time.

PMID- 8486619
TI  - Presteady state kinetics of an S-adenosylmethionine-dependent enzyme. Evidence
      for a unique binding orientation requirement for EcoRI DNA methyltransferase.
AB  - We present the first presteady state kinetic analysis of an S-adenosylmethionine
      dependent enzyme. The target enzyme is the bacterial EcoRI DNA methyl
      transferase, which transfers the methyl group to the second adenine in the DNA
      sequence GAATTC. The rate constant for conversion of the central complex (enzyme
      DNA-S-adenosylmethionine) to products (enzyme-methylated DNA-S
      adenosylhomocysteine) (41 +/- 7 s-1) is over 300-fold faster than kcat,
      consistent with our demonstration that steps after methyl transfer are rate
      limiting (Reich, N. O., and Mashhoon, N. (1991) Biochemistry 30, 2933-2939).
      Methyl transfer at the N6 amino moiety of adenine on each strand requires a
      single binding orientation.

PMID- 8486620
TI  - Selective inhibition of protein kinase C isozymes by the indolocarbazole Go 6976.
AB  - Indolocarbazoles have been identified as novel inhibitors of protein kinase C
      (PKC), with Go 6976 as one of its most potent and selective representatives.
      Recombinant PKC isozymes alpha, beta 1, delta, epsilon, and zeta were used in in
      vitro kinase assays to investigate Go 6976 with respect to isozyme-specific PKC
      inhibition. Go 6850, identical with GF 109203X, another PKC-specific kinase
      inhibitor, was included in this study as a reference compound. Nanomolar
      concentrations of the indolocarbazole Go 6976 inhibited the Ca(2+)-dependent
      isozymes alpha and beta 1, whereas even micromolar concentration of Go 6976 had
      no effect on the kinase activity of the Ca(2+)-independent PKC subtypes delta,
      epsilon, and zeta. In contrast, the bisindolymaleimide Go 6850 inhibited all PKC
      isozymes, however, with a ranked order of potency (alpha > beta 1 > epsilon >
      delta > zeta). Kinetic analysis revealed that PKC inhibition by Go 6976 was
      competitive with respect to ATP, non-competitive with respect to the protein
      substrate, and mixed type with respect to phosphatidylserine. Further experiments
      in the presence of different amounts of free Ca2+ indicated that interference
      with Ca2+ or its binding site is not responsible for the differential inhibition
      of PKC isozymes by Go 6976.

PMID- 8486621
TI  - Characterization of retinol metabolism in cultured human epidermal keratinocytes.
AB  - Retinoids present in cultured human epidermal keratinocytes maintained in medium
      containing 25 nM retinol were identified and quantitated utilizing reverse-phase
      gradient high performance liquid chromatography. Total cell retinoid mass and
      composition averaged 12.59 pmol/mg cell protein +/- 1.86, (mean +/- S.D., n = 5)
      between strains and was constant with culture age. Long chain fatty acid esters
      of retinol and 3,4-didehydroretinol comprised greater than 95% of total retinoid,
      each contributing 77 and 23% of total esters, respectively. In mature stratified
      cultures, less abundant retinoids included unesterified retinol, 1%, and 3,4
      didehydroretinol, 0.5%, retinoic acid, 0.5%, and a retinoid not previously
      reported in mammalian cells, 3,4-didehydroretinoic acid, 0.3%. This absolute and
      relative retinoid composition was essentially constant with culture age except
      that 3,4-didehydroretinoic acid was not detected in 3-4-day-old cultures (16-32
      cell colonies), suggesting that keratinocyte differentiation may be related to
      endogenous changes in production of "active" retinoids. Separate pools of retinyl
      and 3,4-didehydroretinyl esters served as predominant sources of substrate for
      production of retinoic and 3,4-didehydroretinoic acids, respectively, suggesting
      that their production may be regulated independently.

PMID- 8486622
TI  - Trypanosome metabolism of myristate, the fatty acid required for the variant
      surface glycoprotein membrane anchor.
AB  - The trypanosome variant surface glycoprotein (VSG) is anchored to the outer
      leaflet of the parasite plasma membrane by a glycosyl phosphatidylinositol (GPI).
      The VSG anchor is unique among GPIs in containing exclusively dimyristoylglycerol
      as its lipid moiety. Myristate is incorporated into the anchor precursor by
      sequential deacylation and specific reacylation with myristate. Although
      myristate is required for the VSG anchor, trypanosomes cannot synthesize this
      fatty acid and must import their entire supply from the host bloodstream, where
      it exists in low abundance. Chemical analysis of these parasites reveals that
      most of their myristate is in VSG protein, with no major lipid storage form.
      Unexpectedly, when these cells are radiolabeled with [3H]myristate in culture,
      most of the label is incorporated into phospholipids, with little into VSG. This
      apparent contradiction is explained by the fact that trypanosomes in culture
      medium elongate much of the [3H]myristate into palmitate and stearate, probably
      because the medium (with only 5% serum) contains limiting amounts of these fatty
      acids. In contrast, trypanosomes radiolabeled in whole blood (with higher
      concentrations of palmitate and stearate) do not modify most of the
      [3H]myristate, and instead utilize the major portion of it for GPI synthesis. Our
      studies suggest that bloodstream trypanosomes have evolved highly efficient means
      of directing myristate into the GPI biosynthetic pathway.

PMID- 8486623
TI  - Effect of low molecular weight aliphatic alcohols and related compounds on
      platelet factor 4 subunit association.
AB  - Titration of platelet factor 4 (PF4) with increasing concentrations of various
      low molecular weight aliphatic alcohols disrupts dimer and tetramer quaternary
      structure while preserving tertiary structural integrity. Normally observed slow
      subunit exchange (1H NMR time scale) is shifted into the fast chemical exchange
      regime. The order of effectiveness is butanol > 2-propanol > propanol > ethanol >
      methanol. Fluorination of ethanol (trifluoroethanol) and 2-propanol (hexafluoro-2
      propanol) increases effectiveness by approximately 2 orders of magnitude.
      Oxidation to 2-propanone or trifluoro-2-propanone produces a less effective
      compound, suggesting a mechanistic role for the hydroxyl group. Increasing the
      number of hydroxyls to three, as in glycerol, however, is relatively ineffective
      in disrupting aggregate states or modifying subunit exchange rates. While 19F NMR
      studies indicate that these alcohols specifically interact with PF4, binding
      alone can not explain their mechanism of action. Dimethyl sulfoxide, structurally
      similar to 2-propanol, disrupts PF4 aggregation by direct binding, but does not
      shift subunit exchange kinetics into the NMR fast-exchange regime. Although not
      fully understood, the effectiveness of these compounds appears to be related to
      the colligative properties of the solution.

PMID- 8486624
TI  - Isolation and primary structure of the three major forms of granulin-like
      peptides from hematopoietic tissues of a teleost fish (Cyprinus carpio).
AB  - Granulins are cysteine-rich polypeptides purified from human and rat
      hematopoietic cells and structurally related to the epithelin family of growth
      modulatory factors. A prototypic form of granulin was isolated from the
      hematopoietic organs of teleost fish (Belcourt, D., and Bennett, H.P.J. (1988) J.
      Cell Biol. 107, 629 (abstr.)). This study reports the structure of three
      granulins purified from the spleen and head kidney of the carp (Cyprinus carpio).
      Ion-spray mass spectrometric analysis of granulin-1, -2, and -3 corroborated the
      observed primary structures and demonstrated that each 57-residue-peptide was
      monomeric in nature with all cysteines linked via intramolecular disulfide
      bridges. A comparison of the carp granulin sequences demonstrates that granulins
      2 and 3 are most closely related with sequence variations occurring primarily
      toward the amino terminus. A rabbit polyclonal antibody was raised against carp
      granulin-1 to develop a radioimmunoassay for this peptide, which showed no
      significant cross-reactivity with granulin-2 and -3. The distribution of carp
      granulin-1 was studied by screening purified tissue extracts for immunoreactivity
      using reversed-phase high performance liquid chromatography. A single form of
      immunoreactive granulin-1 was identified in all carp tissues studied including
      spleen, head kidney, heart, skin, gills, and gut. These studies have established
      that members of the granulin/epithelin family are found in a lower vertebrate and
      may serve important growth modulatory functions throughout the vertebrate
      kingdom.

PMID- 8486625
TI  - Two different, overlapping pathways of transcription initiation are active on the
      TATA-less human androgen receptor promoter. The role of Sp1.
AB  - In this study, the minimal promoter requirements of the TATA-less human androgen
      receptor (hAR) gene promoter are described. The hAR promoter is characterized by
      a short GC-box (-59/-32) and a long homopurine stretch (-117/-60). Two major
      transcription initiation sites, AR transcription initiation site I (AR-TIS I,
      (+1/2/3)) and AR transcription initiation site II (AR-TIS II, (+12/13)) are
      located in a 13-base pair region (Faber, P. W., van Rooij, H. C. J., van der
      Korput, J. A. G. M., Baarends, W. M., Brinkmann, A. O., Grootegoed, J. A., and
      Trapman, J. (1991) J. Biol. Chem. 266, 10743-10749). Transient transfection of
      COS cells with hAR promoter deletion and mutant constructs, followed by RNA
      isolation and S1 nuclease protection analysis showed that the process of
      transcription initiation through AR-TIS I and AR-TIS II is regulated by different
      promoter sequences. The GC-box directed initiation from AR-TIS II but did not
      affect AR-TIS I utilization, which is dependent upon sequences between positions 
      5 and +57. Band shift analysis identified the transcription factor Sp1 as the
      protein interacting with the GC-box. A single Sp1 binding sequence was found to
      be present in the GC-box. Footprint analysis confirmed the interaction of Sp1
      with this sequence. The differential initiation through AR-TIS I and AR-TIS II
      was substantiated by the introduction of point mutations in the Sp1 binding
      sequence: only mutations that specifically abolished Sp1 binding interfered with
      AR-TIS II utilization, but all mutations left AR-TIS I initiation intact.

PMID- 8486626
TI  - Glycoprotein recycling to the galactosyltransferase compartment of the Golgi
      complex.
AB  - The recycling of plasma membrane glycoproteins to the Golgi complex is well
      established, but it is not clear which Golgi subcompartments receive this
      traffic. To date, recycling into the trans-Golgi compartment that contains
      sialyltransferase and the early Golgi region that contains alpha-mannosidase I
      has been demonstrated. However, transport into other Golgi compartments has not
      been reported. In this study we tested the return of cell surface glycoproteins
      to the Golgi galactosyltransferase compartment using the ldlD mutant of Chinese
      hamster ovary cells. The cation-independent mannose 6-phosphate/insulin-like
      growth factor-II receptor recycled through this Golgi region with a half-time of
      4 h and was transported to the sialyltransferase compartment as well. Because
      galactosyltransferase and sialyltransferases are probably located in different
      trans-Golgi regions in Chinese hamster ovary cells, these results suggest that
      the two compartments each receive recycling traffic or that recycling
      glycoproteins enter one region and are then transported to the other. The extent
      of cell surface protein recycling through the galactosyltransferase compartment
      was also studied. At least 10 different glycoproteins were transported from the
      cell surface to this Golgi region. Moreover, our results suggest that recycling
      glycoproteins make up 12-25% of the flux of cell surface glycoproteins through
      the Golgi galactosyltransferase compartment; the balance is comprised of newly
      made glycoproteins.

PMID- 8486627
TI  - Identity elements of tRNA(Trp). Identification and evolutionary conservation.
AB  - In this study, the varying reactivities of Bacillus subtilis tryptophanyl-tRNA
      synthetase toward prokaryotic, eukaryotic, and halophile tRNAs were employed to
      define the potential identity elements on tRNA(Trp). On this basis mutagenesis
      was performed to obtain, through in vivo heterologous expression in Escherichia
      coli and in vitro transcription with T7 RNA polymerase, mutant B. subtilis
      tRNA(Trp) for comparison with the wild-type. These comparisons served to
      establish G73 and the anticodon as major identity elements, and A1-U72, G5-C68,
      and A9 as minor identity elements. While the tryptophanyl-tRNA synthetase from B.
      subtilis and E. coli require G73 to function, replacement of G73 by A73 favors
      the enzyme from yeast. This change points to the variation of the identity
      elements for the same amino acid among different organisms. The similarity in
      these elements between B. subtilis and E. coli tryptophanyl-tRNA synthetase,
      however, suggests that identity elements on tRNA, like the active centers on
      enzymes, undergo evolutionary change at slower rates than less essential portions
      of the macromolecule.

PMID- 8486628
TI  - Kinetic characterization of a beta-glucosidase from a yeast, Candida wickerhamii.
AB  - The extracytoplasmic, cell-bound beta-1,4-glucosidase of Candida wickerhamii was
      characterized kinetically. The enzyme was found to produce glucose from
      cellobiose and cellodextrins (degree of polymerization from three to six) by
      catalyzing the removal of the terminal glucose moiety from the nonreducing end of
      these beta-glucans. The Km values for the series, cellobiose through
      cellohexaose, were 210.7, 106.6, 106.3, 105.9, and 79.8 mM, respectively, whereas
      the kcat values were 14.79, 13.24, 13.78, 15.13, and 7.66 mumol of glucose.min
      1.mg-1 of protein, respectively. A computer program was developed to estimate the
      integrated rate equation. When the above kinetic constants were used in the
      computer model, the predicted rates of glucose formation agreed well with the
      experimental data. Saccharomyces cerevisiae, which is unable to ferment
      cellobiose or cellodextrins, ferments glucose about twice as fast as C.
      wickerhamii. If S. cerevisiae is cultured on cellobiose or cellodextrins and the
      purified C. wickerhamii beta-glucosidase is added to the S. cerevisiae culture at
      levels that mimic the production of beta-glucosidase by a C. wickerhamii culture
      with time, the two cultures produce ethanol at equivalent rates. This suggests
      that the rate-limiting step in the fermentation of cellobiose/cellodextrins by C.
      wickerhamii is the production of beta-glucosidase.

PMID- 8486629
TI  - Phosphate affects the distribution of flux control among the enzymes of oxidative
      phosphorylation in rat skeletal muscle mitochondria.
AB  - The flux control coefficients of adenine nucleotide translocase, the phosphate
      transporter, and H(+)-ATPase were determined in rat skeletal muscle mitochondria
      using glutamate plus malate as substrates and soluble F1-ATPase as load enzyme.
      It was observed that the flux control coefficients of adenine nucleotide
      translocase, H(+)-ATPase, and the load enzyme F1-ATPase, at comparable rates of
      respiration, strongly depend on the phosphate concentration in the incubation
      medium. So, the flux control exerted by adenine nucleotide translocase, in the
      intermediate states of mitochondrial respiration (approximately 120 nmol of
      O2/min/mg) at 10 mM phosphate, was found to be about 0.37. At a phosphate
      concentration of 1 mM and comparable rates of respiration the flux control
      coefficient of the translocase decreased to about 0.20. Under these conditions, a
      sharp increase in the controlling influence of H(+)-ATPase from 0.10 to 0.74 was
      detected. Furthermore, at this flux rate, the sum of flux control coefficients of
      adenine nucleotide translocase, H(+)-ATPase, phosphate transporter, and the load
      enzyme F1-ATPase was noted to be very close to unity. This indicates that under
      the conditions of intermediate state respiration, all of the other reactions have
      a negligible controlling influence on oxidative phosphorylation in skeletal
      muscle mitochondria.

PMID- 8486630
TI  - Temperature-sensitive mutations in the phage P22 coat protein which interfere
      with polypeptide chain folding.
AB  - Temperature-sensitive mutations in the coat protein of phage P22 severely
      restrict formation of infectious particles at restrictive temperature. A set of
      25 temperature-sensitive strains, which had been localized to regions of the coat
      gene (Casjens, S., Eppler, K., Sampson, L., Parr, R., and Wyckoff, E. (1991)
      Genetics 127, 637-647), define 17 sites of single amino acid substitutions by DNA
      sequencing. Particles assembled from the mutant proteins at permissive
      temperature were not thermolabile at restrictive temperature, nor defective in
      the infectious process. At restrictive temperature, ts mutant polypeptide chains
      were synthesized at near wild-type rates. These inactive chains were not degraded
      within the cells. The ts chains failed to interact with scaffolding proteins to
      form the procapsid precursor shell, and they did not polymerize with each to form
      aberrant shells. Rather, the mutant coat protein accumulated as insoluble
      aggregates, with the amorphous morphology of inclusion bodies. The results
      indicate that the chains fail to reach the conformation needed for subunit
      subunit or subunit-scaffolding interaction. These mutations appear to be of the
      class of temperature-sensitive folding mutations, which destabilize an
      intermediate in the intracellular folding pathway.

PMID- 8486631
TI  - A novel form of cytochrome P-450 family 4 in human polymorphonuclear leukocytes.
      cDNA cloning and expression of leukotriene B4 omega-hydroxylase.
AB  - Isolation of cDNA clones for human leukotriene B4 (LTB4) omega-hydroxylase
      clearly demonstrates that the hydroxylase is a member of the cytochrome P-450
      (CYP) superfamily. cDNA clones isolated from a human leukocyte cDNA library with
      CYP4A4 cDNA as a probe encode a protein of 520 amino acids with a molecular
      weight of 59,805. The deduced amino acid sequence contains an invariant cysteine
      in the conserved heme-binding domain near the C terminus, characteristic of the P
      450 superfamily. The microsomes from yeast cells transfected with an expression
      vector pAAH5 carrying isolated cDNA catalyzed the omega-hydroxylation of LTB4
      with a Km value of 0.71 microM, and its activity was significantly inhibited by
      carbon monoxide and by antisera against CYP4A4, consistent with the properties
      previously reported with LTB4 omega-hydroxylase in human polymorphonuclear
      leukocytes. The amino acid sequence of LTB4 omega-hydroxylase (P-450LTB omega)
      shows 31-44% similarity to those of CYP4A, CYP4B, and CYP4C, whereas less than
      25% similarity was observed with any of the other P-450 families. According to
      the systematic classification of the P-450 superfamily, P-450LTB omega is
      classified into the CYP4 family but does not belong to any of the known CYP4
      subfamilies. This P-450 composes a new subfamily of CYP4. RNA blot analysis
      indicated that mRNA hybridized to the cDNA was expressed in the polymorphonuclear
      leukocytes as well as leukocytes from four individuals. Isolation of the cDNA
      opens the way to investigate the physiological role and to regulation of the
      omega-hydroxylase in the inflammation process.

PMID- 8486632
TI  - Isolation and characterization of the chains of type V/type XI collagen present
      in bovine vitreous.
AB  - Previous studies show that the collagen fibrils of the mammalian vitreous humor
      are assembled largely from type II collagen with smaller amounts of type IX
      collagen and either type V or type XI collagen. In this paper, we report the
      separation of two chains of type V/type XI collagen from type II collagen by
      heparin-Sepharose chromatography. These chains were characterized by sequencing
      of selected cyanogen bromide or tryptic peptides with subsequent comparison of
      these sequences with cDNA-derived amino acid sequences of the alpha 1(V), alpha
      1(XI), alpha 2(V), and alpha 2(XI) chains. The results show that vitreous fibrils
      are assembled from molecules containing the alpha 1(XI) and alpha 2(V) chains.
      These results, together with recent results from other laboratories, indicate
      that type V and type XI collagens are not separate collagen types but are part of
      a larger collagen family in which chains of both type V and type XI collagens
      participate in the formation of a variety of native molecules.

PMID- 8486633
TI  - Spermidine-induced destabilization of ornithine decarboxylase (ODC) is mediated
      by accumulation of antizyme in ODC-overproducing variant cells.
AB  - The mechanism of spermidine-induced destabilization of ornithine decarboxylase
      (ODC) was examined in newly isolated ODC-overproducing variant cells by use of an
      in vitro ODC degrading system. The cells accumulated ODC protein in the presence
      of alpha-difluoromethylornithine. Addition of spermidine to the medium
      accelerated degradation of ODC protein concomitantly with induction of antizyme,
      a regulatory protein that binds to ODC, inhibiting its activity. Both the
      acceleration of ODC degradation and the induction of antizyme were inhibited by
      cycloheximide, but not by actinomycin D. ODC was degraded rapidly in extracts
      from spermidine-treated cells. The rate of ODC degradation correlated with the
      amount of antizyme in the extracts, and the degradation activity was abolished by
      treatment of the extracts with anti-antizyme antibody. Thus, antizyme induced by
      spermidine was essential for the accelerated degradation of ODC in the cells. ODC
      was phosphorylated in the cells, probably at serine residue 303 in the first
      internal PEST region. ODC phosphorylation occurred even when its new synthesis
      was inhibited by cycloheximide. Antizyme accelerated the degradations of both
      dephosphorylated ODC and native ODC.

PMID- 8486634
TI  - Characterization of mutant rhodopsins responsible for autosomal dominant
      retinitis pigmentosa. Mutations on the cytoplasmic surface affect transducin
      activation.
AB  - Rhodopsin mutants responsible for autosomal dominant retinitis pigmentosa (ADRP)
      were prepared by site-directed mutagenesis and characterized. The aim was to
      evaluate ADRP mutations that occur at three locations on the cytoplasmic surface
      of rhodopsin: Thr-58 near the cytoplasmic border of helix A, the tetrapeptide Leu
      68 to Pro-71 in the first cytoplasmic loop, and Arg-135 at the cytoplasmic border
      of helix C. It was hypothesized that amino acid changes at these sites would
      result in mutant rhodopsins with normal spectral properties but defects in their
      ability to interact with the rod outer segment G protein, transducin. A set of 12
      mutant opsin genes was prepared. Four of the mutants were known to cause ADRP:
      Thr-58 replaced by Arg, a four-amino acid deletion (Leu-68/Arg-69/Thr-70/Pro-71),
      Arg-135 replaced by Leu, and Arg-135 replaced by Trp. Eight additional mutants
      were prepared to provide complementary structure-function information. The four
      amino acid deletion mutant failed to bind 11-cis-retinal. However, each of the
      Thr-58 and Arg-135 mutants bound 11-cis-retinal to form a pigment with a visible
      absorbance maximum (lambda max) of 500 nm. Upon illumination, each pigment was
      converted to a metarhodopsin II-like spectral form (lambda max = 380 nm).
      However, each of these spectrally normal ADRP mutants was defective in activating
      guanine nucleotide exchange by transducin. These results identify a defect in the
      signal transduction pathway in spectrally normal mutant rhodopsins that cause
      ADRP.

PMID- 8486635
TI  - Chemotaxis of the marine bacterium Vibrio furnissii to sugars. A potential
      mechanism for initiating the chitin catabolic cascade.
AB  - Immense quantities of chitin are catabolized by marine bacteria, and this process
      involves at least three signal transduction systems in Vibrio furnissii. One
      system, chemotaxis to chitin oligosaccharides, is probably used to colonize
      chitin particles. But how do the first few cells find this highly insoluble
      polysaccharide? The following hypothesis is proposed to answer this question: the
      bacteria respond to soluble chemo-attractants in exudates from injured organisms.
      Virtually all chitin-producing organisms also contain glucose and/or trehalose,
      often at high concentrations such as trehalose in insect hemolymph. Chemotaxis of
      V. furnissii was therefore studied with a variety of sugars. Fructose, ribose,
      and glycerol are catabolites but not attractants. The cells exhibit weak
      constitutive taxis to Glc and GlcNAc. After induction, they show a weak response
      to galactose but are strongly attracted to the following substrates of the
      phosphoenolpyruvate:glycose phosphotransferase system (PTS): GlcNAc, trehalose,
      glucose, sucrose, mannose, and mannitol. There is a rough qualitative but no
      quantitative correlation between the rate of phosphorylation and the chemotactic
      response to PTS sugars. Trehalose is especially noteworthy because it is
      phosphorylated at a very rapid rate by uninduced cells but is not an attractant
      until the cells are induced. We suggest that unidentified inducible factors link
      the PTS to chemotaxis.

PMID- 8486636
TI  - A variant of exotoxin A that forms potent and specific chemically conjugated
      immunotoxins.
AB  - To introduce a free sulfhydryl into Pseudomonas aeruginosa exotoxin A (ETA),
      methionine 161 in domain I of the toxin was changed to cysteine by site-directed
      mutagenesis. The free sulfhydryl provides a convenient site for covalent
      attachment of ETA to other proteins in the production of chimeric toxins. The
      mutation was then introduced into a variant of ETA that is impaired in receptor
      binding, termed ETA-60EF61, that has the dipeptide Glu-Phe inserted between
      residues 60 and 61. The resulting double mutant, ETA-60EF61 Cys161, was
      conjugated to three different monoclonal antibodies via a thioether linkage, and
      the immunotoxins were tested for cytotoxicity with cells in culture. Each
      immunotoxin was extremely potent against cells that expressed surface
      determinants for the monoclonal antibodies but had little cytotoxicity for cells
      that did not bind the antibodies. For comparison, we also conjugated ricin A
      chain to each of the three monoclonal antibodies and found that the resulting
      immunotoxins were at least two-orders of magnitude less potent than the
      corresponding immunotoxins made with ETA-60EF61Cys161. This study demonstrates
      that ETA-60EF61Cys161 makes potent and specific immunotoxins and may potentially
      be useful in selectively eliminating subpopulations of cells in vitro and in
      vivo.

PMID- 8486637
TI  - Charged residues render pro-OmpA potential dependent for initiation of membrane
      translocation.
AB  - We have examined the effects of positively and negatively charged residues on the
      translocation of outer membrane protein A precursor (pro-OmpA) across the
      bacterial inner membrane. Pro-OmpA does not translocate across the membrane when
      2 positively charged residues are inserted immediately after the leader peptide,
      whereas it does insert when 2 neutral or negatively charged residues are
      introduced. Using a cell-free translocation system, we show that the membrane
      potential stimulated the rate of initial insertion of pro-OmpA with negatively
      charged residues, inhibited pro-OmpA with positively charged residues, and had no
      effect on neutral pro-OmpA. Thus, acidic residues render pro-OmpA potential
      dependent for loop formation, which then initiates the translocation process.

PMID- 8486638
TI  - Purification and properties of 2'-hydroxybenzalpyruvate aldolase from a bacterium
      that degrades naphthalenesulfonates.
AB  - 2'-Hydroxybenzalpyruvate aldolase catalyzes the cleavage of 2'
      hydroxybenzalpyruvate to salicylaldehyde and pyruvate. This reaction is part of
      the degradative pathways for naphthalene and naphthalenesulfonates by bacteria.
      2'-Hydroxybenzalpyruvate aldolase has been purified to homogeneity from a
      bacterium that degrades naphthalenesulfonates (strain BN6). The enzyme has a
      molecular weight of about 120,000 and is composed of identical subunits with a
      molecular weight of about 38,500. Thus the enzyme appears to exist as a trimeric
      oligomer. The NH2-terminal amino acid sequence did not show significant homology
      to other published amino acid sequences. Extensive loss of enzyme activity
      occurred when the enzyme was incubated with 2'-hydroxybenzalpyruvate in the
      presence of sodium borhydride. This suggested the intermediate formation of a
      stable Schiff base between enzyme and substrate. 2'-Hydroxybenzalpyruvate
      aldolase was inhibited by p-chloromercuribenzoate and by the reaction product
      salicylaldehyde. The enzyme converted 2'-hydroxybenzalpyruvate, 2',4'- and 2',6'
      dihydroxybenzalpyruvate.

PMID- 8486639
TI  - Expression of dopamine beta-hydroxylase in Drosophila Schneider 2 cells. Evidence
      for a mechanism of membrane binding other than uncleaved signal peptide.
AB  - To characterize the mechanism of membrane attachment of dopamine beta
      hydroxylase, an expression system producing the processed form of this enzyme has
      been developed. We have replaced the endogenous signal peptide of bovine dopamine
      beta-hydroxylase with a heterologous signal peptide which is efficiently
      recognized and cleaved in Drosophila Schneider 2 cells. A cDNA encoding this
      chimeric recombinant bovine enzyme has been stably transfected into Schneider 2
      cells. The inducible expression of active dopamine beta-hydroxylase in these
      cells has been verified by Western blotting and enzyme activity assays. N
      terminal sequence analysis of purified recombinant enzyme demonstrates complete
      removal of the signal peptide. Subcellular analysis shows that the recombinant
      enzyme exists as both a soluble and a membrane-bound form in these cells. These
      data demonstrate that the endogenous signal peptide is not required for the
      formation of the membranous dopamine beta-hydroxylase and further that the enzyme
      can be bound to membranes via a mechanism other than uncleaved signal sequence.

PMID- 8486640
TI  - The 5' and 3' untranslated regions of satellite tobacco necrosis virus RNA affect
      translational efficiency and dependence on a 5' cap structure.
AB  - Satellite tobacco necrosis virus RNA (STNV RNA) is a naturally uncapped viral RNA
      that contains 1239 nucleotides: 29 in the 5' untranslated region (UTR), 591 in
      the coding region and 619 in the 3' UTR. Mutations were made in the 5' and 3'
      UTRs, and the effects of these mutations on translational efficiency and cap
      independence were measured in an in vitro translation system from wheat germ.
      Removal of the first 12 nucleotides or 10 changes in the nucleotide sequence of
      the 5' UTR reduced translational efficiency approximately 3-fold; capping of
      these 5' mutant mRNAs restored their translational efficiencies. Truncation of
      the 3' UTR to nucleotide 627 or 700, or deletion of nucleotides 627-737, reduced
      translational efficiency more than 20-fold; capping of these 3' mutant mRNAs
      restored their translational efficiencies. These modifications in the 3' UTR
      increased the concentration of initiation factor 4F required for translation.
      Chimeric mRNAs were constructed which contained the coding region of rabbit alpha
      globin mRNA and either the 5' UTR, 3' UTR, or both the 5' and 3' UTRs of STNV
      RNA. Both the 5' and 3' UTRs of STNV RNA were necessary to obtain cap-independent
      translation. These findings indicate that interaction between 5' UTR and the
      region between nucleotides 627 and 737 in the 3' UTR are required for cap
      independent translation.

PMID- 8486641
TI  - Effects of truncation of human pro-tumor necrosis factor transmembrane domain on
      cellular targeting.
AB  - Human tumor necrosis factor is initially synthesized as a transmembrane
      prohormone anchored by a hydrophobic region of the leader sequence. This
      hydrophobic domain has been previously localized to extend from Leu-46 to Ile-21
      based on hydropathy calculations. To functionally determine the nature of this
      domain, we have generated a series of pro-TNF mutant cDNAs in which either half
      or both halves of this encoding domain is deleted. These cDNAs were analyzed both
      by the ability of their mRNAs to direct translation in a microsomal system and by
      cellular localization of their encoded TNFs following transfection of NIH/3T3
      cells. We determined that the mutant protein with deletion of the periluminal
      region of the transmembrane domain (Thr-32 to Ile-21) was translocated into
      microsomes and localized on the inner surface of the microsomal membrane in a
      fashion identical to that of the parental TNF. In contrast, the mutants with
      deletion of either the pericytoplasmic aspect (Leu-46 to Gly-34) or of virtually
      the entire transmembrane domain were not localized in the microsomes.
      Transfection experiments indicated that only the cDNAs whose peptide products
      were translocated across microsomal membranes gave rise to transmembrane
      prohormones and matured TNFs. Thus, the functions of membrane targeting and
      orientation prior to proteolytic processing can be fulfilled by the sequence Leu
      46 to Ala-33 of the transmembrane domain, but not by the sequence Ala-33 to Ile
      21.

PMID- 8486642
TI  - Tumor necrosis factor-alpha induces expression of monocyte chemoattractant JE via
      fos and jun genes in clonal osteoblastic MC3T3-E1 cells.
AB  - The mechanism by which circulating monocytes are attracted to sites of bone
      remodeling is unknown. We now report that tumor necrosis factor-alpha (TNF
      alpha), a potent osteotrophic cytokine, was stimulatory for expression of the
      monocyte chemoattractant JE gene in osteoblastic MC3T3-E1 cells. TNF-alpha
      stimulated this JE gene expression transcriptionally. The presence of JE gene
      product in conditioned medium of the cytokine-treated cells was evidenced by an
      immunoprecipitation assay with antiserum specific for JE/MCP-1. The stimulated JE
      gene expression was markedly inhibited by H-7, a potent inhibitor of protein
      kinase C. Phorbol 12-myristate 13-acetate induced the JE gene expression, and the
      cytokine-induced JE gene expression was down-regulated by the phorbol ester
      pretreatment. TNF-alpha induced expression of both early protooncogenes, c-fos
      and c-jun, in the cells. Antisense oligonucleotides to these oncogenes
      significantly inhibited the cytokine-induced monocyte chemotactic activity.
      Furthermore, curcumin, a specific inhibitor of c-jun/AP-1, markedly inhibited JE
      gene expression and monocyte chemotactic activity induced by the cytokine. These
      results suggest that TNF-alpha may contribute to the regulation of remodeling and
      inflammation of bone tissues through the JE gene product.

PMID- 8486643
TI  - Complex patterns of sequence variation and multiple 5' and 3' ends are found
      among transcripts of the erythroid ankyrin gene.
AB  - The structural protein ankyrin functions in red blood cells to link the spectrin
      based membrane skeleton to the plasma membrane. Ankyrin proteins are now known to
      occur in most cell types, and two distinct ankyrin genes have been identified
      (erythroid (Ank-1) and brain (Ank-2)). We have characterized transcripts of the
      mouse erythroid ankyrin gene by cDNA cloning and DNA sequencing. Ank-1
      transcripts of 7.5 and 9.0 kilobases are found in erythroid tissues, and a 9.0
      kilobase transcript is found in cerebellum. RNA hybridization blot analysis of 13
      additional mouse tissues has detected four novel Ank-1 transcripts (5.0, 3.5,
      2.0, and 1.6 kilobases in size). Sequencing of Ank-1 cDNA clones isolated from
      mouse reticulocyte, spleen, and cerebellar libraries has identified (i) multiple
      5' ends that indicate possible multiple promoters; (ii) alternative
      polyadenylation sites that probably account for the 7.5- and 9.0-kilobase size
      difference; (iii) a variety of small insertions and deletions that could produce
      transcripts (and ultimately proteins) of nearly identical size, but different
      functions; and (iv) clones with large deletions of coding sequence that account
      for the smaller transcripts seen in spleen, skeletal muscle, and heart.

PMID- 8486644
TI  - Identification and purification of a novel serine proteinase inhibitor.
AB  - We report the identification, purification, and partial amino acid sequence of a
      novel serine proteinase inhibitor which is present in extracts from human
      placentas and in the cytosolic fraction of the leukemic cell line K562. Extracts
      from these tissues exhibited time-dependent inhibition of the serine proteinase
      thrombin. This activity was not accelerated by heparin and corresponded to a
      protein which formed a 67-kDa complex with 125I-thrombin. The complex was stable
      on reduced sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A cleaved
      and functionally inactive form of the protein was purified from placental tissue
      by chromatography on DEAE-Sepharose, followed by affinity chromatography on
      thrombin-Sepharose. Antibodies raised against the placental protein recognized
      the inhibitor from K562 cells and placental extract. Western blotting experiments
      using the antibody showed that the uncleaved inhibitor has a molecular mass of 38
      kDa. Amino acid sequencing was performed on the purified protein. Sequences of
      peptides resulting from digestion with cyanogen bromide followed by
      Endoproteinase Lys-c confirmed that this is a novel inhibitor with significant
      homology to the serpin family.

PMID- 8486645
TI  - Activation of ADP-ribosylation factor by Golgi membranes. Evidence for a
      brefeldin A- and protease-sensitive activating factor on Golgi membranes.
AB  - Recent evidence has implicated ADP-ribosylation factor (ARF) proteins as critical
      regulators of the protein secretory pathway, particularly in the endoplasmic
      reticulum-Golgi pathway. We have examined whether Golgi membranes contain
      activators of ARF and the consequences of ARF activation and acylation on its
      membrane association. Two means were used to assess ARF activation. First,
      guanosine 5'-3-O-(thio)triphosphate (GTP gamma S) binding to protein was found to
      be greater when ARF and Golgi were incubated together than when either was
      incubated alone. These data suggested that ARF GTP gamma S was formed. This was
      confirmed by showing that the GTP gamma S-bound protein functioned as a cofactor
      for cholera toxin-stimulated ADP-ribosylation of Gs alpha, a reaction for which
      activated ARF is a necessary cofactor. Trypsin treatment of Golgi, an inhibitory
      ARF peptide, and brefeldin A each inhibited Golgi-mediated activation by
      approximately 70%, demonstrating that a specific protein interaction is required
      for the majority of the ARF activation. This ARF-activating protein is a strong
      candidate for the molecular target for brefeldin A. The ubiquitous nature of ARF
      proteins and their importance in both the exocytic and endocytic pathways may
      explain the effects of brefeldin A on both exocytic and endocytic membrane
      traffic in animal cells. A protease-insensitive activation of ARF by Golgi could
      also be demonstrated and was the dominant activity observed in submicromolar
      concentrations of magnesium. We believe this to be the lipid-mediated process
      described previously for purified ARF proteins. ARF activation resulted in tight
      association of ARF with phospholipid vesicles. Vesicle association required amino
      terminal myristoylation of ARF whereas activation did not. These studies indicate
      that the brefeldin A-sensitive ARF-activating protein and other factors that
      determine the level of activation of ARF in animal cells are fundamental
      regulators of membrane traffic in animal cells.

PMID- 8486646
TI  - Interaction with newly synthesized and retained proteins in the endoplasmic
      reticulum suggests a chaperone function for human integral membrane protein IP90
      (calnexin).
AB  - A cDNA clone encoding the human endoplasmic reticulum (ER) resident protein IP90
      was isolated and sequenced. It predicts a transmembrane protein with a large ER
      luminal region showing sequence similarity to calreticulin and a short
      cytoplasmic domain containing a COOH-terminal RKPRRE sequence that may be
      relevant to its retention in the ER. It is 95% homologous to the canine ER
      membrane phosphorprotein called pp90 or calnexin (Wada, I., Rindress, D.,
      Cameron, P. H., Ou, W.-J., Doherty, J. J., II, Louvard, D., Bell, A. W., Dignard,
      D., Thomas, D. Y., and Bergeron, J. J. M. (1991) J. Biol. Chem. 266, 19599
      19610). Previously, in lymphocytes, we have characterized IP90 as a protein
      associated with partially assembled multichain proteins including the T cell
      receptor, the membrane immunoglobulin, and the heavy chain of the major
      histocompatibility complex class I molecules (Hochstenbach, F., David, V.,
      Watkins, S., and Brenner, M. B. (1992) Proc. Natl. Acad. Sci. U.S.A. 89, 4734
      4738). Here, we show that within a short metabolic labeling period, IP90
      associates transiently with many different newly synthesized proteins. However,
      in a T cell line that cannot assemble a complete T cell receptor because it lacks
      the alpha subunit, the unassembled T cell receptor beta chains, which are
      retained in the ER, remain associated with IP90 throughout a prolonged chase time
      period. Together, these data offer further evidence suggesting that IP90 may act
      in assisting protein assembly and/or in the retention within the ER of
      unassembled protein subunits.

PMID- 8486647
TI  - Induction of peroxisomal fatty acid beta-oxidation and liver fatty acid-binding
      protein by peroxisome proliferators. Mediation via the cytochrome P-450IVA1 omega
      hydroxylase pathway.
AB  - Both the enzymes of peroxisomal fatty acid beta-oxidation and the liver fatty
      acid-binding protein (L-FABP) are induced in the liver by peroxisome
      proliferators, such as clofibrate (CF), as well as high fat diets. One proposed
      mechanism for this induction is that it represents an adaptive response to
      altered intracellular fatty acid fluxes, mediated by dicarboxylic fatty acids
      formed via the cytochrome P-450IVA1 omega-oxidation pathway. The studies
      presented in this paper were designed to investigate the role of the products of
      P-450IVA1 omega-oxidation in the regulation of peroxisomal beta-oxidation and L
      FABP. In primary hepatocyte cultures exposed to CF, the increase in P-450IVA1
      activity preceded the induction of peroxisomal beta-oxidation and L-FABP. The CF
      mediated increases in peroxisomal beta-oxidation and L-FABP, but not P-450IVA1,
      could be significantly inhibited pretranslationally by concurrent exposure of
      cultured hepatocytes to inactivators of cytochromes P-450, such as 1
      aminobenzotriazole and 10-undecynoic acid. Hexadecanedioic acid, a 16-carbon
      dicarboxylic fatty acid, that is poorly metabolized in hepatocytes, induced
      peroxisomal beta-oxidation and L-FABP, but not P-450IVA1, via a pretranslational
      mechanism that was not inhibited by 1-aminobenzotriazole. Long-chain
      monocarboxylic acids were without such inducing effect. In further studies, non
      beta-oxidizable dicarboxylic acid analogs were found to display greater potency
      as inducers of peroxisomal beta-oxidation when compared to hexadecanedioic acid.
      The inducing effects of the dicarboxylic acid analogs were also independent of
      the P-450 omega-oxidation pathway. The results of these studies suggest that the
      regulation of peroxisomal beta-oxidation enzymes and L-FABP is mediated, to a
      significant extent, by poorly metabolized long-chain dicarboxylic acids formed
      via the P-450IVA1 pathway.

PMID- 8486648
TI  - The calmodulin-binding domain of the mouse 90-kDa heat shock protein.
AB  - The mouse 90-kDa heat shock protein (HSP90) and Ca(2+)-calmodulin were cross
      linked at an equimolar ratio using a carbodiimide zero-length cross-linker. To
      identify the calmodulin-binding domain(s) of HSP90, CNBr-cleaved peptide
      fragments of HSP90 were mixed with Ca(2+)-calmodulin and cross-linked. Amino acid
      sequence determination revealed that an HSP90 alpha-derived peptide starting at
      the 486th amino acid residue was contained in the cross-linked products, which
      contains a calmodulin-binding motif (from Lys500 to Ile520). A similar motif is
      present also in HSP90 beta (from Lys491 to Val511). The synthetic peptides
      corresponding to these putative calmodulin-binding sequences were found to be
      cross-linked with Ca(2+)-calmodulin and to prevent the cross-linking of HSP90 and
      Ca(2+)-calmodulin. Both HSP90 alpha and HSP90 beta bind Ca2+. The HSP90 peptides
      bind HSP90 and thereby inhibit the binding of Ca2+. In addition, the HSP90
      peptides augment the self-oligomerization of HSP90 induced at elevated
      temperatures. These results suggest that the calmodulin-binding domain of HSP90
      might interact with another part of the same molecule and that Ca(2+)-calmodulin
      might modulate the structure and function of HSP90 through abolishing the
      intramolecular interaction.

PMID- 8486649
TI  - Identification of a soluble receptor for platelet-derived growth factor in cell
      conditioned medium and human plasma.
AB  - We have discovered a soluble form of the platelet-derived growth factor (PDGF)
      alpha receptor, designated sPDGF-R alpha, that is produced by and secreted into
      the conditioned medium of the human osteosarcoma cell line, MG-63. Additionally,
      sPDGF-R alpha activity has been detected in normal human blood plasma and serum.
      We have achieved partial purification of this protein by column chromatography
      using three different affinity matrices: anti-PDGF-R alpha monoclonal antibody
      (mAb) 292.15-Sepharose, PDGF-BB-Sepharose, and wheat germ agglutinin-agarose. All
      three matrices have been shown to purify a 90-kDa protein that is recognized by
      mAbs specific for the PDGF-R alpha extracellular domain. sPDGF-R alpha is capable
      of binding PDGF ligand in solution and can compete with cell-associated PDGF
      receptors for ligand binding. We provide three pieces of data suggesting that the
      sPDGF-R alpha is generated by proteolytic clipping of the full-length PDGF-R
      alpha protein. First, the conditioned medium of an expression cell line
      transfected with a cDNA construct designed to produce only full-length PDGF-R
      alpha exhibits sPDGF-R alpha activity. Second, a truncated intracellular fragment
      of the PDGF-R alpha, presumably representing the intracellular counterpart of the
      clipped sPDGF-R alpha, can be immunoprecipitated from the MG-63 osteosarcoma cell
      extracts using antiserum raised against an intracellular portion of PDGF-R alpha.
      Finally, we have been unable to detect alternative splicing in the PDGF-R alpha
      transcript using reverse transcription-polymerase chain reaction.

PMID- 8486650
TI  - Wild type GAL4 binds cooperatively to the GAL1-10 UASG in vitro.
AB  - Transcription of the genes required for utilization of galactose in Saccharomyces
      cerevisiae is controlled primarily by the transcriptional activator protein GAL4.
      The upstream activating sequences for galactose (UASG) of most GAL genes have
      multiple sites to which GAL4 can bind. In this report we compare the binding
      properties of wild type GAL4 and derivatives of GAL4 bearing the N-terminal DNA
      binding domain to multiple DNA-binding sites in vitro. To produce wild type GAL4,
      we constructed a recombinant baculovirus for expression in insect cells.
      Recombinant wild type GAL4 was found to bind efficiently to an oligonucleotide
      containing a near-consensus 17-mer GAL4 DNA-binding site in electrophoretic
      mobility shift assays. Footprinting experiments revealed that wild type GAL4
      binds cooperatively to the four GAL4 DNA-binding sites of the GAL1-10 UASG;
      however, in contrast an N-terminal fragment of GAL4 containing only the DNA
      binding/dimerization domains binds to each of these sites with slightly different
      affinity. With increasing concentrations of GAL4(1-147), the four sites become
      filled in the following order: site II, site IV, site I, and site III. In
      experiments with wild type GAL4, these four sites become fully occupied at
      approximately the same concentration of protein. In footprints of wild type GAL4
      on the USAG, enhancements and protections of DNase I-sensitive cleavages are
      detectable between sites III and IV, indicative of formation of a loop between
      these distantly spaced sites. Binding of wild type GAL4 to a strong near
      consensus binding site assists binding to an adjacent mutant site in both
      electrophoretic mobility shift and footprinting assays. GAL4(1-147) and GAL4(1
      147) fused to portions of GAL4's activating region II were incapable of
      cooperative DNA binding in our assays. We conclude from these observations that
      wild type GAL4 has a cooperative DNA-binding function that is distinct from the
      DNA binding and dimerization or transcriptional activation functions, and likely
      plays and important role in precise regulation of GAL gene transcription.

PMID- 8486651
TI  - Locations and immunoreactivities of phosphorylation sites on bovine and porcine
      tau proteins and a PHF-tau fragment.
AB  - Tau protein is a phosphorylated neuronal microtubule-associated protein. Tau
      protein is also present in the major pathological lesions of Alzheimer's disease
      in an insoluble hyperphosphorylated state as paired helical filaments (PHFs). We
      have investigated the phosphorylation state of control taus and a fragment of PHF
      tau. Tau samples were digested with protease, separated by reversed-phase high
      performance liquid chromatography, and analyzed by mass spectrometry and Edman
      microsequencing. The serine homologous with S404 of human tau 441 was
      phosphorylated on bovine and porcine tau and up to two phosphates were present on
      a peptide of amino acids 182-240 of bovine tau (193-251 of human tau 441). The
      serine within the KSPV motif was not phosphorylated on bovine or porcine tau. PHF
      tau fragments, isolated from pronase-treated PHFs encompassed a 93-amino acid
      region within the microtubule binding domain. Enzymatic digestion and mass
      spectrometric analysis showed no phosphate was present and a second carboxyl
      terminus was identified at E380. Antibodies T3P and SMI34, which recognize PHF
      tau and peptides phosphorylated at the sequence KSPV, both reacted with bovine
      and porcine tau even though the KSPV sequence was not phosphorylated. These data
      indicate that the 93-amino acid sequence of F5.5 tau from PHFs is not
      phosphorylated, and the serine equivalent to S404 of human tau is phosphorylated
      in bovine and porcine tau. Antibodies T3P and SMI34 react with phosphorylated
      epitopes that are not unique to PHF-tau and that are not necessarily at the KSPV
      site.

PMID- 8486652
TI  - Expression and role of c-myc in chondrocytes undergoing endochondral
      ossification.
AB  - To analyze the relationship between c-myc gene expression and chondrocyte
      proliferation and maturation during endochondral ossification, Day 18-19 chick
      embryo sterna were pulse-labeled with [3H]thymidine, and serial sections were
      processed for autoradiography and in situ hybridization. Proliferating
      chondrocytes, located in four distinct areas of the developing sternum, all
      contained high levels of c-myc transcripts, whereas postmitotic chondrocytes
      (such as hypertrophic chondrocytes) contained undetectable amounts. These
      findings were confirmed by Northern blot analysis and by the observation that
      antisense c-myc oligomer treatment inhibited proliferation in cultured
      chondrocytes. Constitutive overexpression of c-myc by retroviral vectors in
      immature chondrocyte cultures (c-myc cultures) maintained the cells in a
      proliferative state and blocked their maturation into hypertrophic chondrocytes.
      The lack of maturation in the c-myc cultures was corroborated by analysis of type
      X collagen gene regulation. Control immature cultures contained strong repressor
      activity for the type X collagen gene promoter, as revealed by transfection
      assays; repressor activity was lost upon maturation and activation of type X
      collagen synthesis. In the c-myc cultures, however, repressor activity persisted.
      Thus, c-myc participates in the normal changes in proliferation accompanying
      chondrocyte maturation in vivo and in culture. The decreases in c-myc expression
      and cell proliferation appear to be required for completion of maturation.

PMID- 8486653
TI  - Lysosomal accumulation of unesterified cholesterol in model macrophage foam
      cells.
AB  - Lysosomal accumulation of unesterified (free) cholesterol, following the
      phagocytic incorporation of cholesteryl oleate lipid droplets, was quantitatively
      characterized in a murine J774 macrophage foam cell model. The induction of
      phagocytic incorporation by the macrophages, using an inverted culture technique,
      allowed the rapid delivery of large amounts of cholesteryl ester droplets to the
      lysosomes, leading to the subsequent generation of free cholesterol. The
      lysosomally generated free cholesterol was differentiated from the membrane
      cholesterol by a double radiolabeling procedure. Free cholesterol accumulation
      was quantitated in a population of low density lipid-filled lysosomes prepared by
      ultracentrifugal isolation of a floating lipid fraction from a homogenate of the
      cholesteryl ester-loaded cells. About 10% of the total N-acetyl-beta
      glucosaminidase activity, a lysosomal marker, was recovered in the lipid
      fraction. Negligible amounts of alkaline phosphodiesterase-1, a plasma membrane
      marker, or membrane cholesterol were present in this fraction. Electron
      microscopic and cytochemical analysis of the isolated lipid fraction revealed the
      presence of lysosomes in the fraction with a diameter ranging from 1.5 to 4
      microns. Continued hydrolysis of incorporated cholesteryl ester over a 24-h
      incubation resulted in approximately 30% of the generated free cholesterol in
      lipid-filled lysosomes. The accumulation of free cholesterol occurred whether or
      not the cholesterol esterifying enzyme, acyl-CoA: cholesterol acyltransferase,
      was inhibited. In addition, substantial amounts of free cholesterol accumulated
      even in the presence of efficient cholesterol acceptor particles, apolipoprotein
      high density lipoprotein-phosphatidylcholine complexes which stimulate
      cholesterol efflux. Also, increased accumulation of free cholesterol in the lipid
      fraction was observed when cholesteryl ester-loaded cells were treated with the
      compound U-18666A which blocks the movement of lysosomal cholesterol. The data
      demonstrate that the phagocytic incorporation and hydrolysis of cholesteryl ester
      lipid droplets by macrophage foam cells lead to a substantial accumulation of
      free cholesterol in the lipid-filled lysosomes. This process could result in a
      build-up of lysosomal free cholesterol in macrophage foam cells during the
      progression of atherosclerotic plaque.

PMID- 8486654
TI  - Macrosialin, a mouse macrophage-restricted glycoprotein, is a member of the
      lamp/lgp family.
AB  - Macrosialin is a heavily glycosylated transmembrane protein of 87-115 kDa, highly
      and specifically expressed by mouse tissue macrophages, and to a lesser extent by
      dendritic cells. We have isolated cDNA clones encoding macrosialin from a
      thioglycollate-elicited peritoneal macrophage cDNA library by transient
      expression in COS cells and panning with the anti-macrosialin monoclonal antibody
      FA/11. A single 1.3-kilobase macrosialin transcript was detected in both
      untreated and phorbol 12-myristate 13-acetate-stimulated RAW cells. The cDNA
      sequence predicts a type I integral membrane protein of 326 residues with a
      heavily glycosylated extracellular domain of 306 residues containing nine
      potential N-linked glycosylation sites and numerous potential O-linked
      glycosylation sites. The extracellular domain consists of two distinct regions,
      separated by an extended 12 residue proline-rich hinge; a membrane-distal mucin
      like domain of 89 residues containing short peptide repeats and consisting of 44%
      serine and threonine residues; and a membrane proximal domain of 170 residues,
      which has significant sequence homology to a family of lysosomal associated
      glycoproteins known as the lamp-1 group. Macrosialin is the murine homologue of
      the human macrophage glycoprotein CD68 (72% identity, 80% similarity). Both
      proteins are preferentially expressed by macrophages and share the same bipartite
      structure having a mucin-like domain and a domain common to the lamp family.
      Macrosialin and CD68 are the first examples of a lamp family protein with a
      restricted cell-type-specific expression. They may have evolved from the lamps to
      carry out specialized functions in dedicated phagocytic cells.

PMID- 8486655
TI  - High level expression of mammalian protein farnesyltransferase in a baculovirus
      system. The purified protein contains zinc.
AB  - The mammalian enzyme protein farnesyltransferase is a heterodimeric protein that
      catalyzes the addition of a farnesyl isoprenoid to a cysteine in ras proteins.
      Since oncogenic forms of ras proteins require the farnesyl group for transforming
      activity, the structure and mechanism of this enzyme are important to define.
      However, such studies have been difficult to approach because of the low
      abundance of the enzyme in mammalian tissues and hence the problems of obtaining
      large quantities of the protein. We report here the co-expression of the two
      subunits of protein farnesyltransferase by Sf9 cells infected with a recombinant
      baculovirus containing the coding sequences of both polypeptides. This results in
      the production of milligram quantities of enzyme which can be readily purified by
      conventional chromatographic methods. The individual subunits of the enzyme can
      also be expressed in the Sf9 cells, but the ability to reconstitute active enzyme
      from extracts containing individual subunits is quite low. In contrast, the
      enzyme produced by co-expression of the two subunits is fully active and retains
      the properties of the mammalian form, including the specificity for the COOH
      terminal amino acid of substrate proteins and the ability to bind short peptides
      encompassing the prenylation site of a ras protein. Furthermore, through atomic
      absorption analysis of the purified protein, we have confirmed the previous
      tentative assignment of protein farnesyltransferase as a zinc metalloenzyme by
      demonstrating that it contains an essentially stoichiometric amount of zinc. The
      ability to produce and purify milligram quantities of protein farnesyltransferase
      readily will allow detailed mechanistic and structural studies on this enzyme.

PMID- 8486656
TI  - Cloning, sequencing, distribution, and expression in Escherichia coli of flavin
      containing monooxygenase 1C1. Evidence for a third gene subfamily in rabbits.
AB  - Two full-length cDNA clones (2.2 kilobases) encoding a newly recognized form of
      mammalian flavin-containing monooxygenase (FMO) have been isolated from
      independent libraries constructed with mRNA from different rabbits. The cDNAs
      encode a polypeptide of 533 amino acids which contains two putative pyrophosphate
      binding domains and a hydrophobic carboxyl terminus characteristic of FMOs. This
      sequence is 52 and 57% identical to sequences of the rabbit "hepatic" and
      "pulmonary" FMOs, respectively, and 55% identical to the sequence of "liver form
      2" published recently by Ozols (Ozols, J. (1991) Arch. Biochem. Biophys. 290, 103
      115). cDNA for the new FMO (FMO 1C1) hybridizes with two species of mRNA, one of
      2.6 kilobases and one of about 5.4 kilobases, from liver or kidney, but not lung.
      Guinea pig, hamster, rat, and mouse all express this form of FMO in liver,
      kidney, and lung. FMO 1C1 has been tentatively characterized following expression
      in Escherichia coli. It is inactive with methimazole as substrate but highly
      active with n-octylamine. The temperature lability, responses to ions and
      detergent, and pH optimum of FMO 1C1 are similar to values reported for hepatic
      FMO. Sequence comparisons and analysis of rabbit and human genomic DNA indicate
      that FMO 1C1, as well as the pulmonary and hepatic FMOs, comprise a single gene
      family made up of distinct gene subfamilies (A, B,C,D, ... N), each appearing to
      contain a single gene. A nomenclature, based on these interrelationships and
      following the same designations used for classifying cytochromes P-450, is
      proposed.

PMID- 8486657
TI  - Multiple endoglycosidase F activities expressed by Flavobacterium meningosepticum
      endoglycosidases F2 and F3. Molecular cloning, primary sequence, and enzyme
      expression.
AB  - The genes for Flavobacterium meningosepticum Endo (endoglycosidase) F2 and Endo
      F3 were cloned, and their nucleotide sequences were determined. The deduced amino
      acid sequences were verified independently to a large extent by direct peptide
      microsequencing of 66 and 84% of native Endo F2 and Endo F3, respectively.
      Structurally, the Endo F2 and Endo F3 genes code for a typically long leader
      sequence of 45 and 39 amino acids, respectively, and, in both cases, a mature
      protein of 290 amino acids. Comparative structural analysis demonstrated minimum
      overall homology (15-30%) between Endo F1, Endo F2, and Endo F3, but revealed
      distinct clusters of identical residues distributed throughout the entire
      sequence, which represent motifs for binding and hydrolysis of beta 1,4-di-N
      acetylchitobiosyl linkages in complex carbohydrates. The mobility of native Endo
      F2 and Endo F3 on SDS-polyacrylamide gel electrophoresis, unlike Endo F1, did not
      correlate with the molecular weights determined from the coding region of the
      corresponding genes. Mass spectrometry confirmed that Endo F2 and Endo F3 were
      heterogeneous and contained approximately 4000 and 1200 daltons of mass not
      accounted for in the gene structure. We presume that Endo F2 and Endo F3 are
      variably post-translationally modified during secretion by possible linkage to
      the hydroxyl of serine.

PMID- 8486658
TI  - Use of endoproteases to identify catalytic domains, linker regions, and
      functional interactions in soluble peptidylglycine alpha-amidating monooxygenase.
AB  - The production of alpha-amidated peptides is accomplished through the sequential
      action of two enzymes, peptidylglycine alpha-hydroxylating monooxygenase (PHM)
      and peptidyl-alpha-hydroxyglycine alpha-amidating lyase (PAL), that are contained
      within the bifunctional peptidylglycine alpha-amidating monooxygenase (PAM)
      protein. Tissue-specific alternative splicing and endoproteolysis are known to
      generate both soluble and integral membrane mono- and bifunctional PAM proteins.
      In order to investigate the functional consequences of these differences we
      purified PAM-3, a soluble 95-kDa bifunctional form of the enzyme, from the spent
      medium of stably transfected hEK-293 cells. Using NH2-terminal sequence analysis
      of products of limited endoproteolysis and antibody cross-reactivity we
      identified protease-sensitive regions at the NH2 terminus, between the 35-kDa PHM
      and 42-kDa PAL domains and at the COOH terminus of the protein. Endoproteolytic
      removal of the COOH-terminal region from the bifunctional PAM-3 protein shifted
      the pH optimum of PHM to a more alkaline pH, increased the turnover number
      (kappa(cat)) of PHM and decreased its KM for alpha-N-acetyl-Tyr-Val-Gly; the
      catalytic properties of PAL were not altered. Since peptide amidation can be a
      rate-limiting step in the biosynthesis of neuropeptides, similar increases in PHM
      activity in vivo may play an important role in regulating the extent of peptide
      alpha-amidation.

PMID- 8486659
TI  - Molecular analysis of human beta-arrestin-1: cloning, tissue distribution, and
      regulation of expression. Identification of two isoforms generated by alternative
      splicing.
AB  - The cDNA for human beta-arrestin-1 was cloned by polymerase chain reaction (PCR)
      and identified based on its remarkably high amino acid identity (98.6%) with the
      bovine sequence. Two alternatively spliced isoforms of human beta-arrestin-1,
      differing only in the presence or absence of 24 base pairs/8 amino acids within
      the sequence, were identified and called beta-arrestin-1A and beta-arrestin-1B,
      respectively. Both isoforms were found in all tissues tested. Southern blot
      analysis revealed the existence of a single gene for beta-arrestin-1, suggesting
      that the two isoforms are generated by alternative mRNA splicing. The possible
      presence of similar isoforms was investigated for the other members of the
      arrestin/beta-arrestin gene family by PCR. Two isoforms of arrestin were revealed
      in bovine peripheral blood leukocytes. The expression of beta-arrestin-1 was
      studied in several human tissues and cell types. High levels of beta-arrestin-1
      mRNA and immunoreactivity were found in peripheral blood leukocytes. The possible
      regulation of the expression of beta-arrestin-1 was also investigated. Our work
      documents for the first time that the expression of beta-arrestin-1 is modulated
      by intracellular cAMP. Using two cell types, human endothelial cells and smooth
      muscle cells, we found that 6-8-h treatments with the cAMP-inducing agents
      cholera toxin, forskolin, iloprost, and isoproterenol raised beta-arrestin-1 mRNA
      by 2-4-fold. Forskolin preferentially increased beta-arrestin-1A expression in
      smooth muscle cells, as assessed by PCR. beta-Arrestin-1 immunoreactivity was 2-3
      fold higher in smooth muscle cells exposed to forskolin for 8 h, compared with
      untreated controls. We conclude that (i) the finding of alternatively spliced
      isoforms of beta-arrestin-1 and arrestin documents a novel mechanism to generate
      diversity within the arrestin/beta-arrestin gene family; (ii) the abundant
      expression of beta-arrestin-1 in peripheral blood leukocytes further supports our
      previous suggestion of a major role for the beta ARK/beta-arrestin system in
      regulating receptor-mediated immune functions; (iii) the increased expression of
      beta-arrestin-1 by cAMP suggests a new mechanism for the regulation of receptor
      mediated responses.

PMID- 8486660
TI  - A transgenic mouse model for studying the lineage relationships and
      differentiation program of type II pneumocytes at various stages of lung
      development.
AB  - A pedigree of transgenic mice has been characterized that contains a H2-Kb/LacZ
      fusion gene that exhibits integration site-dependent expression from the earliest
      stages of lung development through adulthood. Histochemical and
      immunocytochemical studies indicate that the LacZ reporter appears throughout the
      pulmonary endoderm by embryonic day 11 (E11). A proximal-to-distal wave of
      extinction of transgene expression occurs during E13-14 that parallels the wave
      of cytodifferentiation of the pulmonary endoderm. By E16, the LacZ reporter is
      restricted to the distal portion of epithelial tubules and by birth to scattered
      cells located in alveoli. Crude epithelial cell suspensions were prepared from
      lungs harvested from E16 and 14 day postnatal transgenic mice, labeled with the
      fluorescent LacZ substrate fluorescein di-(beta-galactopyranoside), and the LacZ
      expressing population isolated by fluorescence-activated cell sorting. Electron
      microscopic, immunocytochemical and histochemical studies of this purified cell
      population establish that type II pneumocytes are the only cell lineage that
      support H2-Kb/LacZ expression in the mature postnatal lung. Fluorescence
      activated cell sorting of E16 lung suspensions yielded a homogeneous population
      of cells that produced surfactant protein A, that could be maintained in cell
      culture, and that are likely precursors of adult type II pneumocytes. Together
      these studies indicate that (i) expression of the transgene in this pedigree of
      mice provides a marker for describing early differentiation of the pulmonary
      epithelium; (ii) the transgene may be useful as an enhancer trap to isolate cis
      acting sequences that regulate gene transcription within this lineage; (iii) the
      LacZ reporter expression can be used to purify specific embryonic pulmonary
      epithelial cell populations; and (iv) primary cultures of these embryonic
      populations represent a potentially useful model system for analyzing the
      cellular components and signaling pathways necessary to support and complete
      passage through the type II pneumocyte differentiation program.

PMID- 8486661
TI  - The three-dimensional structure of the ligand-binding domain of a wild-type
      bacterial chemotaxis receptor. Structural comparison to the cross-linked mutant
      forms and conformational changes upon ligand binding.
AB  - The three-dimensional structures of the ligand-binding domain of the wild-type
      Salmonella typhimurium aspartate receptor have been determined in the absence
      (apo) and presence of bound aspartate (complex) and compared to a cross-linked
      mutant containing a cysteine at position 36 which does not change signaling
      behavior of the intact receptor. The structures of the wild-type forms were
      determined in order to assess the effects of cross-linking on the structure and
      its influence on conformational changes upon ligand binding. As in the case of
      the cross-linked mutant receptor, the non-cross-linked ligand-binding domain is
      dimeric and is composed of 4-alpha-helical bundle monomer subunits related by a
      crystallographic 2-fold axis in the unbound form and by a non-crystallographic
      axis in the aspartate-bound form. A comparative study between the non-cross
      linked and cross-linked structures has led to the following observations: 1) The
      long N-terminal helices of the individual subunits in the cross-linked structures
      are bent toward each other to accommodate the disulfide bond. 2) The rest of the
      subunit conformation is very similar to that of the wild-type. 3) The
      intersubunit angle of the cross-linked apo structure is larger by about 13
      degrees when compared to the wild-type apo structure. 4) The nature and magnitude
      of the aspartate-induced conformational changes in the non-cross-linked wild-type
      structures are very similar to those of the cross-linked structures.

PMID- 8486662
TI  - Rapid agonist-mediated phosphorylation of m3-muscarinic receptors revealed by
      immunoprecipitation.
AB  - A specific antiserum against the human m3-muscarinic receptor subtype was made by
      subcloning a variant region of the third intracellular loop of the m3-receptor
      (Ser345-Leu463) into a bacterial expression plasmid that produced a fusion
      protein with glutathione S-transferase. In immunoblot studies this anti-serum
      identified the human m3-receptor expressed in transfected Chinese hamster ovary
      (CHO) cells (CHO-m3 cells, 1343 fmol/mg protein) as a diffuse band at
      approximately 97-110 kDa. In vivo labeling of the ATP pool in CHO-m3 cells with
      [32P]orthophosphate followed by immunoprecipitation of solubilized m3-receptors
      revealed that the unstimulated receptor existed in a phosphorylated form.
      Incubation of CHO-m3 cells with the cholinergic agonist carbachol (1 mM)
      increased the phosphorylated state of the receptor dramatically, primarily at
      serine. The time course for agonist-dependent phosphorylation was very rapid
      occurring within seconds of agonist addition and was maintained for at least 30
      min. The muscarinic antagonist atropine (10 microM) inhibited agonist-stimulated
      phosphorylation. Neither forskolin (10 microM) nor the calcium ionophore,
      ionomycin (1 microM), had any effect on the state of phosphorylation of the m3
      receptor, eliminating a role for cAMP-dependent protein kinase and
      Ca2+/calmodulin-dependent protein kinase in the agonist-dependent phosphorylation
      of m3-receptors. 4 beta-Phorbol 12 beta-myristate 13 alpha-acetate (100 nM) did
      increase m3-receptor phosphorylation, an effect that was inhibited by the
      selective protein kinase C inhibitor RO-318220 (10 microM). However, agonist
      stimulated m3-receptor phosphorylation was not inhibited by RO-318220 indicating
      that protein kinase C was not involved in agonist-induced m3-receptor
      phosphorylation. In conclusion the phosphorylation of m3-receptors, in vivo, was
      increased following the application of muscarinic agonist or PMA. The response to
      agonist was mediated via a kinase distinct from protein kinase C, protein kinase
      A and Ca2+/calmodulin dependent protein kinase, whereas the effect of 4 beta
      phorbol 12 beta-myristate 13 alpha-acetate was mediated by protein kinase C.

PMID- 8486663
TI  - Hormonal/metabolic regulation of the human GLUT4/muscle-fat facilitative glucose
      transporter gene in transgenic mice.
AB  - To examine the hormonal/metabolic as well as tissue-specific expression of the
      GLUT4/muscle-fat facilitative glucose transporter gene, we have generated several
      transgenic mouse lines expressing a human GLUT4 mini-gene which extends 5.3
      kilobases (kb) upstream of transcription start and terminates within exon 10.
      This construct (hGLUT4-11.5) was expressed in a tissue-specific pattern identical
      to the endogenous mouse GLUT4 gene. The transcription initiation sites of the
      transgenic construct were similar to the GLUT4 gene expressed in human tissues.
      To investigate the hormonal/metabolic-dependent regulation of GLUT4, the
      transgenic animals were made insulin-deficient by streptozotocin (STZ) treatment.
      In these animals, STZ-induced diabetes resulted in a parallel decrease in
      endogenous mouse GLUT4 mRNA and the transgenic human GLUT4 mRNA in white adipose
      tissue, brown adipose tissue, and cardiac muscle. Similarly, insulin treatment of
      the STZ-diabetic animals restored both the endogenous mouse and transgenic human
      GLUT4 mRNA levels. To further define cis-regulatory regions responsible for this
      hormonal/metabolic regulation, the same analysis was performed on transgenic
      animals which carry 2.4 kb of the human GLUT4 5'-flanking region fused to a CAT
      reporter gene (hGLUT4[2.4]-CAT). This reporter construct responded similarly to
      the human GLUT4 mini-gene demonstrating that the element(s) controlling
      hormonal/metabolic regulation and tissue specificity all reside exclusively
      within 2.4 kb of the transcriptional initiation site.

PMID- 8486664
TI  - Microtubule-associated protein 2 alters the dynamic properties of microtubule
      assembly and disassembly.
AB  - The influence of microtubule-associated protein 2 (MAP2) on the dynamics of
      microtubule assembly and disassembly from axonemal fragments was characterized in
      vitro in solutions of pure tubulin and varying concentrations of MAP2. A
      mechanistic description of interactions between MAP2 and individual microtubules
      was developed from analysis of recorded images obtained by video-enhanced
      differential-interference-contrast light microscopy. MAP2 decreased the rates and
      lengths of shortening events and decreased the frequency of transitions between
      growth and shortening over a wide range of concentrations, thereby producing the
      increases in net microtubule growth previously described by light-scattering
      techniques. Increases in rates and lengths of elongation phases, as well as
      rescue frequencies (i.e. transition from shortening to growth), were observed
      under conditions in which microtubules are expected to be saturated with MAP2.
      During early stages of nucleated assembly, MAP2 greatly increased the number of
      microtubules growing from a given axoneme and caused elongation of "curved"
      structures which may be sheet-like microtubules.

PMID- 8486665
TI  - Deficient expression of decorin in infantile progeroid patients.
AB  - Fibroblasts from young patients exhibiting clinical features of progeroidal
      syndromes showed decreased biosynthesis of the small proteoglycan decorin. Cells
      in culture were metabolically labeled, and proteoglycans secreted into the medium
      were analyzed electrophoretically after immunoprecipitation with antibodies
      raised against decorin and biglycan. Fluorograms showed regularly a reduction to
      15-30% of the normal amount of mature decorin and its core protein after
      chondroitin ABC lyase treatment. The size of the glycosaminoglycan chains was
      increased, but there was no obvious anomaly in the secretion kinetics of the
      mature proteoglycan. In addition, the patients' fibroblasts synthesized an
      increased amount of biglycan compared to control cells from healthy donors.
      Northern blot analysis clearly demonstrated a reduction by 85-94% in decorin
      mRNA, but biglycan mRNA was concomitantly increased, indicating that these
      alterations occur at the transcriptional level of protein expression.
      Transcription of decorin in fibroblasts from one of the patients was stimulated
      up to 3-fold by treatment with interleukin-1 beta. No response to interleukin-1
      beta and transforming growth factor-beta was observed in the cells from another
      patient. In situ hybridization of cultured cells with an antisense decorin probe
      showed that decorin levels were reduced throughout the cell population.
      Surprisingly, subsequent examination of cells from one of the patients, now in
      mid-teenage, revealed a return to normal levels of decorin expression compared to
      age-matched controls. These studies suggest that, as in Marfan's syndrome where
      the primary defect concerns the fibrillin gene, reduced decorin expression
      contributes to the formation of an abnormal matrix and the pathogenesis of these
      disorders. They also indicate that this abnormality is likely to represent a
      secondary phenomenon which leads to a fault in the regulation of decorin gene
      transcription.

PMID- 8486666
TI  - A high affinity conformational state on VLA integrin heterodimers induced by an
      anti-beta 1 chain monoclonal antibody.
AB  - The VLA integrin subfamily includes receptors for extracellular matrix proteins
      as well as receptors involved in cell-cell adhesive interactions. We have
      previously described the up-regulation of VLA integrin-mediated cell attachment
      to different ligands by the anti-beta 1 TS2/16 monoclonal antibody (mAb) (Arroyo,
      A. G., Sanchez-Mateos, P., Campanero, M. R., Martin-Padura, I., Dejana, E., and
      Sanchez-Madrid, F. (1992) J. Cell Biol. 117, 659-670). In this report, we have
      investigated the mechanism involved in this regulatory effect. The anti-beta 1
      mediated regulatory effect on cell adhesion did not require "de novo" protein
      synthesis, since it was not affected by pretreatment with either cycloheximide or
      actinomycin D. To quantitate the effect of the regulatory anti-beta 1 TS2/16 mAb
      on the affinity of VLA-5 for its ligand, an RGD-containing fragment of
      fibronectin (FN80), we performed binding studies of radiolabeled soluble FN80 to
      U-937 cells. The affinity of VLA-5 for FN80 was enhanced about 4-fold in the
      presence of TS2/16 mAb (Kd = 0.98 +/- 0.07 microM) compared to the functionally
      irrelevant anti-beta 1 Alex 1/4 mAb (Kd = 4.23 +/- 0.92 microM), whereas no
      alteration in the number of binding sites was observed. Indeed, the anti-beta 1
      TS2/16 mAb is inducing this high affinity state on VLA heterodimers by a direct
      change on the conformation of these receptors as demonstrated by affinity
      chromatography analysis using extracellular matrix proteins covalently bound to
      Sepharose. The yield of VLA-5 fibronectin receptor bound to FN80-Sepharose
      columns was strongly increased upon treatment of U-937 cell lysates with mAb
      TS2/16. Moreover, higher concentrations of EDTA were required for eluting the VLA
      5 integrin from this matrix. This up-regulatory effect was also observed with
      F(ab')2 and Fab fragments of the anti-beta 1 TS2/16 mAb, and was also exerted on
      the purified VLA-5 receptor. Similarly, the yield of VLA-2 retained on a collagen
      I-Sepharose column was dramatically increased by pretreatment of A375 melanoma
      cell lysates with the mAb TS2/16. Altogether, these results indicate that the
      interaction of VLA beta 1 heterodimers with their ligands can be regulated by
      switching between differently active conformations inherent to the alpha beta 1
      receptors.

PMID- 8486668
TI  - Enzymatic characterization of beta-D-galactoside alpha 2,3-trans-sialidase from
      Trypanosoma cruzi.
AB  - The substrate specificity, physico-chemical, and kinetic properties of the trans
      sialidase from Trypanosoma cruzi have been investigated. The enzyme demonstrates
      activity towards a wide range of saccharide, glycolipid, and glycoprotein
      acceptors which terminate with a beta-linked galactose residue, and synthesizes
      exclusively an alpha 2-3 sialosidic linkage. Oligosaccharides which terminate in
      Gal beta 1-4(Fuc alpha 1-3)GlcNAc, Gal beta 1-3(Fuc alpha 1-4)GlcNAc, or Gal
      alpha 1- are not acceptor-substrates. The enzyme utilizes alpha 2,3-linked sialic
      acid when the donor species is an oligosaccharide and can also transfer, at a low
      rate, sialic acid from synthetic alpha-sialosides such as p-nitrophenyl-alpha-N
      acetylneuraminic acid, but NeuAc alpha 2-3Gal beta 1-4(Fuc alpha 1-3)Glc is not a
      donor-substrate. The trans-sialidase has an apparent pH optimum of 7.9 and a
      temperature optimum of 13 degrees C. The kinetic properties of the enzyme suggest
      that the trans-sialylation reaction may occur via a rapid equilibrium random or
      steady-state ordered mechanism. A method for immobilizing the enzyme is described
      together with examples of its use for the synthesis of oligosaccharide and
      glycoprotein precursors of sialyl-Lewis and sialyl-Lewis.

PMID- 8486667
TI  - Neural expression of a novel alternatively spliced and polyadenylated Gs alpha
      transcript.
AB  - We have isolated an alternative transcript of the rat Gs alpha signal
      transduction protein gene, referred to as Gs alpha N1. Gs alpha N1 was isolated
      by differential hybridization screening of genes induced upon dexamethasone
      treatment of the neuronal-like CA77 rat thyroid C-cell line. The 1-kilobase Gs
      alpha N1 transcript is generated by alternative splicing and polyadenylation of a
      novel terminal exon. This exon lies 800 base pairs downstream of exon 3 in the Gs
      alpha gene. Dexamethasone differentially induced Gs alpha N1 severalfold relative
      to Gs alpha mRNA in the CA77 cells, similar to the bias seen with alternative
      processing of the calcitonin/calcitonin gene-related peptide transcript. In
      addition to the differential regulation by dexamethasone, the expression pattern
      of Gs alpha N1 in rat tissues differed markedly from Gs alpha. Gs alpha N1 mRNA
      was much more abundant in the brain, with intermediate levels in skeletal muscle
      and very low levels in other tissues. This was in contrast to the more
      ubiquitously expressed Gs alpha mRNA. Within the brain, Gs alpha N1 was
      particularly abundant in discrete regions of the brainstem and hypothalamus that
      modulate autonomic functions. Examination of rat embryos demonstrated that Gs
      alpha is expressed in both brain and nonneural tissue at least 1 day before Gs
      alpha N1 mRNA could be detected in the embryonic brain. Based on the regulated
      expression of the Gs alpha N1 transcript and previous studies on G alpha
      proteins, the predicted Gs alpha N1 protein may potentially modulate several
      heterotrimeric G protein functions in the nervous system.

PMID- 8486669
TI  - The specific association of a phosphofructokinase isoform with myocardial calcium
      independent phospholipase A2. Implications for the coordinated regulation of
      phospholipolysis and glycolysis.
AB  - We have demonstrated previously that myocardial cytosolic calcium-independent
      phospholipase A2 is a 40-kDa polypeptide regulated by ligand-modulated protein
      protein interactions (Hazen, S.L., and Gross, R.W. (1991) J. Biol. Chem. 266,
      14526-14534). We now demonstrate that an 85-kDa polypeptide which possesses
      sequence homology to and chemical, physical, immunological, and chromatographic
      similarities with phosphofructokinase (PFK) specifically interacts with the 40
      kDa phospholipase A2 catalytic subunit and represents the putative protein
      regulatory element identified in previous work. Multiple independent lines of
      evidence document the association between the 85-kDa phosphofructokinase isoform
      and the 40-kDa myocardial cytosolic calcium-independent phospholipase A2
      catalytic polypeptide, including 1) the coelution of the 85- and 40-kDa
      polypeptides which migrate as a 400-kDa complex during gel filtration
      chromatography, 2) the stoichiometry between the 85- and 40-kDa polypeptides
      which corresponds to a complex comprised of a tetrameric PFK isoform and a 40-kDa
      phospholipase A2 catalytic polypeptide, 3) the demonstration that the 85-kDa
      phosphofructokinase isoform acts as a specific and reversible affinity adsorbent
      for myocardial cytosolic phospholipase A2 catalytic activity, 4) the
      immunoprecipitation of myocardial cytosolic phospholipase A2 activity utilizing
      chicken anti-rabbit skeletal muscle PFK IgG, 5) the specific release of
      phospholipase A2 from ATP-agarose after formation of a ternary complex comprised
      of allosteric modifiers of phosphofructokinase, and 6) the selective attenuation
      of the denaturation of purified homogeneous calcium-independent cytosolic
      phospholipase A2 with PFK. Collectively, these results demonstrate the highly
      specific association of a phosphofructokinase isoform with myocardial cytosolic
      calcium-independent phospholipase A2 and suggest a novel biochemical mechanism
      underlying the coordinated regulation of phospholipolysis and glycolysis
      previously observed in myocardium and in other mammalian tissues.

PMID- 8486670
TI  - Interactions between the bone matrix proteins osteopontin and bone sialoprotein
      and the osteoclast integrin alpha v beta 3 potentiate bone resorption.
AB  - We have investigated the mechanism by which osteoclasts adhere to and resorb
      bone. We show that these cells express beta 1 and beta 3 integrins which are
      involved in attachment to purified bone matrix proteins. Binding to osteopontin
      and bone sialoprotein is mediated by alpha v beta 3, while a beta 1 integrin is
      responsible for attachment to fibronectin. Both the rapid attachment by
      osteoclasts to intact bone particles and their subsequent resorption are blocked
      by a monoclonal antibody directed to the alpha v beta 3 complex but not by an
      antibody against beta 1 integrins. Attachment of osteoclasts to bone is also
      inhibited with soluble osteopontin, Arg-Gly-Asp-containing peptides derived from
      both osteopontin and bone sialoprotein, or a monospecific polyclonal antibody
      against osteopontin. We conclude that both osteoclast adherence to bone and
      subsequent resorption of its matrix are dependent on interactions between the
      bone matrix proteins osteopontin and/or bone sialoprotein and the integrin alpha
      v beta 3. Moreover, collagen, which constitutes 90% of its organic matrix, is
      minimally involved in binding of chicken osteoclasts to bone.

PMID- 8486671
TI  - Characterization of endomannosidase inhibitors and evaluation of their effect on
      N-linked oligosaccharide processing during glycoprotein biosynthesis.
AB  - Endo-alpha-D-mannosidase is a Golgi-located processing enzyme that achieves
      deglucosylation of N-linked carbohydrate units through its unique property of
      cleaving the oligosaccharide chain internally with the release of glucose
      substituted mannose (Glc1-3Man). By chemically modifying the characteristic
      disaccharide product, Glc alpha 1-->3Man, a number of potent inhibitors of the
      endomannosidase were obtained, foremost among which were Glc alpha 1-->3(1
      deoxy)mannojirimycin (Glc alpha 1-->3DMJ) and Glc alpha 1-->3(1,2-dideoxy)mannose
      (IC50 = 1.7 and 3.8 microM, respectively), which, while blocking the in vitro
      action of the enzyme, had negligible effect on other endoplasmic reticulum- and
      Golgi-processing glycosidases. Although preparation of a large number of Glc
      alpha 1-->3DMJ derivatives did not yield a more effective endomannosidase
      inhibitor it provided valuable information relating to the structural
      requirements for the enzyme-substrate interaction. Glc alpha 1-->3DMJ was found
      to be active not only on rat liver endomannosidase but also on the enzyme from a
      number of other sources including mouse lymphoma (BW5147.3), HepG2, baby hamster
      kidney, and Madin-Darby canine kidney cell lines. When tested in vivo in lymphoma
      and Madin-Darby canine kidney cells during a castanospermine-imposed glucosidase
      blockade, Glc alpha 1-->3DMJ interrupted the endomannosidase processing pathway
      as evident from a concomitant inhibition of complex oligosaccharide formation and
      Glc3Man release; similarly the capacity of the glucosidase II-deficient mouse
      lymphoma cell line (PHAR2.7) to synthesize complex oligosaccharides was blocked
      by Glc alpha 1-->3DMJ. Endomannosidase could not be detected in Chinese hamster
      ovary cells by in vitro assay and consistent with this these cells produced only
      glucosylated polymannose N-linked oligosaccharides during glucosidase blockade.
      It would appear that by acting in conjunction with a glucosidase inhibitor, Glc
      alpha 1-->3DMJ and related endomannosidase-blocking agents could have the
      potential of influencing the exit of glycoproteins from the endoplasmic reticulum
      and interfering with viral replication.

PMID- 8486672
TI  - Role of calcium entry and protein kinase C in the progression activity of insulin
      like growth factor-I in Balb/c 3T3 cells.
AB  - We previously reported that insulin-like growth factor-I (IGF-I) stimulated
      calcium entry (Kojima, I., Matsunaga, H., Kurokawa, K., Ogata, E., and Nishimoto,
      I. (1988) J. Biol. Chem. 263, 16561-16567) and production of 1,2-diacylglycerol
      in IGF-responsive "primed competent" Balb/c 3T3 cells (Kojima, I., Kitaoka, M.,
      and Ogata, E. (1990) J. Biol. Chem. 265, 16846-16850). The present study was
      conducted to determine a role of protein kinase C (PKC) in the progression
      activity of IGF-I. To monitor the activity of PKC in intact cells, we measured
      phosphorylation of a synthetic KRTLRR peptide, a substrate of PKC, immediately
      after the permeabilization of the cells with digitonin. When 1 nM IGF-I was added
      to primed competent cells, KRTLRR peptide phosphorylation was augmented. IGF-I
      induced more than 2-fold increase in KRTLRR peptide phosphorylation that was
      blocked by PKC19-36, a pseudosubstrate of PKC, which blocks the activity of the
      kinase, and Ro31-8220, an inhibitor of PKC. The phosphorylation remained elevated
      for up to 6 h. To assess the role of PKC in cell cycle progression, IGF-I-induced
      nuclear labeling was measured in the presence of Ro31-8220. Ro31-8220 reduced the
      rate of entrance into S phase when added in the first quarter of the G1 phase,
      but did not affect cell cycle progression when added at the second quarter or
      later. In contrast, reduction of extracellular calcium completely blocked cell
      cycle progression when done in the first, second, and third quarter but had no
      effect in the last quarter. These results indicate that IGF-I persistently
      activates PKC in primed competent cells, but the activation is required only for
      the initiation of progression. We conclude that IGF-I promotes cell cycle
      progression by calcium-dependent mechanisms that are largely independent of PKC.

PMID- 8486673
TI  - Studies on the carbohydrate moiety and on the biosynthesis of rat C-reactive
      protein.
AB  - Rat C-reactive protein (CRP) is a pentameric glycoprotein composed of five
      apparently identical monomers, two of which form a disulfide-linked dimer
      (Rasosouli, M., Sambasivam, H., Azadi, P., Dell, A., Morris, H. R., Nagpurkar,
      A., Mookerjea, S., and Murray, R. K. (1992) J. Biol. Chem. 267, 2947-2954). In
      this study, the nature of the oligosaccharide chain of rat CRP was investigated
      by fast atom bombardment-mass spectrometry (FAB-MS), and general features of its
      biosynthetic pathway were also analyzed. FAB-MS, electrospray-mass spectrometry,
      and linkage analysis demonstrated that each monomer of rat CRP contained one
      oligosaccharide chain, predominantly a disialylated biantennary structure,
      attached to Asn-128. The biosynthesis of rat CRP was studied by
      immunoprecipitation of CRP synthesized in vitro and by cultured hepatocytes. The
      results revealed that each monomer of rat CRP was synthesized individually as a
      single-chain precursor with a cleavable signal sequence. The translocated species
      was sensitive to digestion by endoglycosidase H (endo H), indicating that it
      possessed a high mannose oligosaccharide. Rat CRP acquired the ability to bind to
      phosphorylcholine-Sepharose and to form the dimeric and oligomeric species prior
      to acquiring resistance to endo H. Studies using tunicamycin revealed that the N
      linked oligosaccharide present in rat CRP was not required for formation of its
      dimeric component, oligomerization, ability to bind to phosphorylcholine, or
      secretion. The non-glycosylated rat CRP, however, was still able to bind to
      phosphorylcholine-Sepharose and to be secreted by hepatocytes.

PMID- 8486674
TI  - The specificity of UDP-GalNAc:polypeptide N-acetylgalactosaminyltransferase as
      inferred from a database of in vivo substrates and from the in vitro
      glycosylation of proteins and peptides.
AB  - The acceptor substrate specificity of UDP-GalNAc:polypeptide N
      acetylgalactosaminyltransferase (GalNAc-transferase) was inferred from the amino
      acid sequences surrounding 196 O-glycosylation sites extracted from the National
      Biomedical Research Foundation Protein Database. When analyzed according to the
      cumulative enzyme specificity model (Poorman, R.A., Tomasselli, A.G., Heinrikson,
      R.L., and Kezdy, F.J. (1991) J. Biol. Chem. 266, 14554-14561) these data were
      found to be consistent with an enzymatic active site which interacts with an 8
      amino-acid long segment of the substrate, spanning 3 amino acid residues
      preceding and 4 amino acid residues following the reactive serine or threonine.
      The model postulates independent interactions of the 8 amino acid moieties with
      their respective binding sites, designated as subsites P3 through P0 and P1' to
      P4'. High selectivity is expressed at all subsites toward serine, threonine, and
      proline. The inferred specificity was confirmed by in vitro bovine colostrum
      GalNAc-transferase-catalyzed glycosylation of unglycosylated proteins containing
      predicted sites for O-glycosylation and synthetic peptides designed to be GalNAc
      acceptors. In synthetic peptides the bovine colostrum GalNAc-transferase
      glycosylates threonine about 35 times faster than serine. Our results suggest
      that the specificity of the enzyme is not dependent on any particular secondary
      structure of the substrate but, rather, it is determined by the amino acids in
      the acceptor peptide segment as well as by the accessibility of this segment. It
      also appears likely that bovine colostrum GalNAc-transferase is able to catalyze
      in vivo the glycosylation of both threonine and serine residues.

PMID- 8486675
TI  - Kinetics of binding and hydrolysis of a series of nucleoside triphosphates by
      actomyosin-S1. Relationship between solution rate constants and properties of
      muscle fibers.
AB  - We have measured the steady state kinetics of hydrolysis and presteady state
      kinetics of binding of the nucleoside triphosphate GTP, CTP, aza-ATP (1-N6-etheno
      2-aza-ATP), and ATP by rabbit skeletal actomyosin-S1. The maximum rates of steady
      state hydrolysis at 10 degrees C at low ionic strength are: CTP, 1.9 s-1 > ATP,
      1.3 s-1 > aza-ATP, 0.19 s-1 > GTP, 0.03 s-1. A similar dependence of the rate of
      steady state hydrolysis upon nucleotide structure has been observed in
      isometrically contracting muscle fibers in the accompanying paper (Pate, E.,
      Franks-Skiba, K., White, H., and Cooke, R. (1993) J. Biol. Chem. 268, 10046
      10053) which strongly suggests that the same biochemical step that limits the
      maximum rate of hydrolysis of nucleoside triphosphates by actomyosin-S1 in
      solution also limits the rate of hydrolysis by isometrically contracting muscle
      fibers. The apparent second order rate constants for the dissociation of
      actomyosin-S1 by nucleoside triphosphates at 10 degrees C are: ATP, 2.7 x 10(6) M
      1 s-1 > aza-ATP, 3.4 x 10(5) M-1 s-1 > GTP, 2.5 x 10(5) M-1 s-1 > CTP, 1.4 x
      10(5) M-1 s-1. There is an excellent correlation between the second order rate
      constant for the dissociation of actomyosin-S1 in solution and the dependence of
      shortening velocity in glycerinated muscle fibers upon the concentration for ATP,
      aza-ATP, and CTP (as per accompanying article; Pate et al., 1993). We have used
      the second order rate constants obtained in solution for the dissociation of
      actomyosin-S1 by these nucleotides and shortening velocity data obtained with the
      same nucleoside triphosphates in glycerinated psoas fibers in the accompanying
      article (Pate et al., 1993) to determine the average distance over which cross
      bridges remain attached during unloaded shortening to be 5-12 nm.

PMID- 8486676
TI  - The use of differing nucleotides to investigate cross-bridge kinetics.
AB  - We have investigated the ability of the nucleotides GTP, CTP, and 1-N6-etheno-2
      aza-ATP (aza-ATP) to support contraction of chemically skinned rabbit psoas
      fibers. Working at 10 degrees C, millimolar concentrations of all nucleotides
      relaxed fibers in the absence of calcium. In active fibers, GTP served as a very
      poor substrate with isometric tension, isometric GTPase rate, and maximum
      shortening velocity (Vmax) all less than 10% of those obtained with ATP. Aza-ATP
      was only a slightly better substrate. CTP, on the other hand, was an effective
      substrate with mechanical parameters which were 65-100% those obtained with ATP,
      and with a hydrolysis rate that exceeded that of ATP. For all three ligands, Vmax
      followed Michaelis-Menten saturation behavior with values for Km which were from
      2.5 to 12 times greater than that for ATP, showing that the analogs bound slowly
      to myosin in the fibers. Increasing concentrations of orthophosphate inhibited
      tension with CTP, to a lesser extent with aza-ATP, but not all with GTP. A
      combination of the mechanical data obtained in fibers with the kinetic data
      obtained in solution (White, H.D., Belknap, B., and Jiang, W. (1993) J. Biol.
      Chem. 268, 10039-10045) is used to better define the actomyosin interaction in
      fibers.

PMID- 8486677
TI  - 5-Lipoxygenase metabolites of arachidonic acid stimulate isolated osteoclasts to
      resorb calcified matrices.
AB  - Bone resorption requires cooperation between osteoclasts and mononuclear
      accessory cells by mechanisms which have not been elucidated. Since
      multinucleated cells in giant cell tumors of bone have many phenotypic and
      functional characteristics of normal osteoclasts, we have examined the
      interaction between the bone-resorbing multinucleated cells and the distinct
      mononuclear stromal cells from these tumors. We have found that these mononuclear
      cells produce an activity which stimulates both giant cells from giant cell
      tumors and rodent osteoclasts to resorb bone in vitro. We have identified the
      activity and found that it represents several products of the 5-lipoxygenase
      pathway of arachidonic acid metabolism, namely 5-hydroxyeicosatetraenoic acid and
      the leukotrienes. These data indicate that 5-lipoxygenase metabolites stimulate
      isolated osteoclasts to resorb bone in vitro and may represent a mechanism by
      which mononuclear stromal cells in human giant cell tumors communicate with the
      giant cells. In addition, these results may explain a possible mechanism for
      communication between accessory cells and osteoclasts involved in normal bone
      resorption.

PMID- 8486678
TI  - Simultaneous incorporations of two anticancer drugs into DNA. The structures of
      formaldehyde-cross-linked adducts of daunorubicin-d(CG(araC)GCG) and doxorubicin
      d(CA(araC)GTG) complexes at high resolution.
AB  - Anthracycline antibiotics (notably daunorubicin (DAU) and doxorubicin (DOX)) and
      nucleoside analog arabinosylcytosine (araC or aC) are important anticancer drugs.
      They are sometimes used together in the treatment of certain cancers. Both
      classes of compounds act by blocking DNA replication and transcription. To probe
      whether both drugs can be incorporated simultaneously into DNA and the possible
      structural consequences, we carried out x-ray diffraction analyses of the
      complexes between DAU/DOX and araC-containing DNA hexamers cross-linked with
      formaldehyde. The crystal structures were determined to high resolution (DAU
      CGaCGCG, 1.2 A, space group P4(1)2(1)2, R = 0.182, 3275 reflections; DOX-CAaCGTG,
      1.5 A, space group C2, R = 0.175, 3359 reflections), and they are similar to
      those of the previously studied DAU- and DOX-DNA complexes, despite different
      crystal packings. Two DAU/DOX molecules intercalate at both ends of the helix
      with their amino sugars in the minor groove. As in the structure of DAU-CGCGCG
      (Wang, A.H.-J., Gao, Y.-G., Liaw, Y.-C., and Li, Y.K. (1991) Biochemistry 30,
      3812-3815), a covalent methylene bridge (from formaldehyde) between the N3' of
      daunosamine and the N2 of the guanine is formed in both adducts. In DOX-CAaCGTG,
      the two halves are slightly different with a root-mean-square deviation of 0.322
      A between them. The O14 hydroxyls of the intercalated DOXs are within hydrogen
      bond distances to the O2P atoms of the A2p(aC3) and A8p(AC9) steps. The O2'
      hydroxyl group from araC does not affect the binding of DAU-DOX or the
      conformation of the drug-DNA complexes. The results suggest that three major drug
      modifications on DNA, i.e., intercalation, covalent bond formation, and
      nucleoside analog incorporation, can coexist in the same DNA molecule without
      difficulty. When they occur in close proximity in DNA, they may provide an
      additive inhibitory effect for the target enzymes.

PMID- 8486679
TI  - Studies of 5-fluorodeoxyuridine 5'-monophosphate binding to carboxypeptidase A
      inactivated thymidylate synthase from Lactobacillus casei.
AB  - The binding of 5-fluorodeoxyuridylate (FdUMP) to carboxypeptidase-inactivated
      thymidylate synthase obtained from methotrexate-resistant Lactobacillus casei was
      investigated using [3H]FdUMP in a trichloroacetic acid precipitation assay and by
      19F nuclear magnetic resonance spectroscopy. The cleavage of 1 valine residue
      from the carboxyl terminus of one of the identical subunits of the enzyme dimer
      correlates with complete loss of thymidylate synthesis (Aull, J. L., Loeble, R.
      B., and Dunlap, R. B. (1974) J. Biol. Chem. 249, 1167-1172). We have further
      investigated the phenomenon of carboxypeptidase A-dependent inactivation of
      thymidylate synthase by employing immobilized carboxypeptidase A in order to
      facilitate the isolation and characterization of the inactivated enzyme. The time
      course of carboxypeptidase treatment of thymidylate synthase has been profiled by
      the spectrophotometric assay, tritium release assay, trichloroacetic acid
      precipitation assay (covalent adduct analysis), 19F nuclear magnetic resonance
      spectroscopy, and amino acid analysis. The techniques utilized in this study
      yielded results which showed that the completely inactivated enzyme (failure to
      catalyze thymidylate formation) continued to catalyze both covalent FdUMP-enzyme
      interactions and the formation of the covalent inhibitory ternary complex with
      the cofactor, 5,1O-methylenetetrahydrofolate, although to a reduced extent, thus
      effectively uncoupling these processes from thymidylate synthesis activity.

PMID- 8486680
TI  - Formation of dolichol from dehydrodolichol is catalyzed by NADPH-dependent
      reductase localized in microsomes of rat liver.
AB  - The alpha-saturation reaction involved in the biosynthesis of dolichol has been
      investigated with rat liver preparations. Under improved in vitro conditions with
      10,000 x g supernatant of rat liver homogenates in the presence of NADPH at pH
      8.0, dolichol was synthesized from isopentenyl diphosphate and Z,E,E
      geranylgeranyl diphosphate. Neither dolichyl diphosphate nor dolichyl phosphate
      was detected. The chain length distribution of the dolicohol was the same as that
      of dehydrodolichyl products. In an assay system containing dehydrodolichol,
      dehydrodolichyl phosphate, or dehydrodolichyl diphosphate as a substrate,
      dehydrodolichol was predominantly converted into dolichol. The enzyme that
      catalyzes the conversion of dehydrodolichol to dolichol was localized in
      microsomes. The reductase activity was stimulated 9-fold by the addition of a
      100,000 x g soluble fraction. The reductase had an opimal pH at 8.0. These
      results indicate that dolichol is formed from dehydrodolichol in rat liver
      microsomes. The formation of dolichol from dehydrodolichol was also catalyzed by
      10,000 x g supernatant of rat or pig testis homogenates.

PMID- 8486681
TI  - The functional importance of hydrophobicity of the tyrosine at position 13 of
      human epidermal growth factor in receptor binding.
AB  - The tyrosine at position 13 of epidermal growth factor (EGF) has been implicated
      as playing a role in receptor binding due to its close proximity to the critical
      arginine 41 residue as well as its high degree of conservation in EGF and EGF
      like proteins that can bind to the EGF receptor. Site-directed mutagenesis of
      tyrosine 13 in human EGF (hEGF) was employed to examine the role of this residue
      in ligand-receptor interaction. The removal of the hydroxyl moiety of the
      tyrosine by substitution with phenylalanine had little effect on the binding,
      indicating that it is not involved in any crucial hydrogen bonds with either the
      receptor or with other regions of the EGF molecule. The substitution of the
      aromatic tyrosine side-chain with the nonpolar leucine side-chain caused the
      receptor affinity to decrease only slightly, indicating that aromaticity of the
      amino acid at this site is also not critical. Substitutions with other
      hydrophobic residues, isoleucine, valine, and alanine, resulted in a significant
      decrease in receptor affinity as a function of decreasing hydrophobicity.
      Substitution of tyrosine 13 with the polar residues histidine and arginine
      markedly decreased receptor binding affinity, and complete removal of the side
      chain by substitution with glycine dramatically lowered the binding affinity to
      0.3% as compared to wild type. Analysis of three hEGF mutants, Tyr13-->Leu, Tyr13
      ->Arg, and Tyr13-->Gly, by circular dichroism showed that the major structural
      features of hEGF were not significantly altered. The results demonstrate that the
      decreased receptor affinities of these hEGF mutants are due to disruption of the
      functional contribution(s) of the tyrosine 13 residue rather than alteration(s)
      in the overall structural integrity. Overall, the results suggest that the
      tyrosine 13 side-chain plays a critical role in receptor binding by contributing
      to hydrophobic receptor-ligand interactions.

PMID- 8486682
TI  - Purification and characterization of a bovine serum lectin (CL-43) with
      structural homology to conglutinin and SP-D and carbohydrate specificity similar
      to mannan-binding protein.
AB  - A previously undescribed bovine serum lectin (designated CL-43) was identified by
      its Ca(2+)-dependent binding to mannan and by its molecular mass of 43 kDa under
      reducing conditions on SDS-PAGE. The lectin was isolated by polyethylene glycol
      precipitation, affinity chromatography on mannan-Sepharose (followed by elution
      with EDTA), and absorption on Sepharose-4B-coupled rabbit anti-bovine Ig (to
      remove anti-mannan antibodies). Fractions containing the lectin were reapplied to
      mannan-Sepharose. Bound conglutinin was eluted with GlcNAc, and then the 43-kDa
      lectin, together with mannan-binding protein (MBP), was eluted with mannose. The
      43-kDa lectin was separated from MBP by ion exchange chromatography on Mono-Q. On
      SDS-PAGE under nonreducing conditions the lectin showed a molecular mass of 120
      kDa. On gel chromatography under nondissociating conditions the protein was
      eluted at a volume corresponding to a molecular mass of approximately 750 kDa.
      Amino acid analysis showed the presence of hydroxyproline and hydroxylysine and a
      high content of glycine (24.3%) indicating the presence of a collagen-like
      structure. This was supported by the susceptibility of the protein to collagenase
      digestion. The designation CL-43 was chosen since this molecule appears to belong
      to the collectins, i.e. proteins with collagen structure and lectin activity. The
      N-terminal sequence (27 amino acids) showed 56% identity with bovine SP-D and 44%
      identity to bovine conglutinin. An inhibition assay with biotinylated CL-43,
      using solid-phase mannan as ligand, revealed the following carbohydrate
      inhibition pattern: mannose and ManNAc > fucose > GlcNAc > glucose and maltose >
      galactose > lactose >> GalNAc. We conclude that CL-43 is a circulating lectin,
      with structural similarities to bovine conglutinin and SP-D, and a ligand binding
      profile resembling that of MBP.

PMID- 8486683
TI  - X-ray crystal structure of a pea lectin-trimannoside complex at 2.6 A resolution.
AB  - The x-ray crystal structure of pea lectin, in complex with a methyl glycoside of
      the N-linked-type oligosaccharide trimannosyl core, methyl 3,6-di-O-(alpha-D
      mannopyranosyl)-alpha-D-mannopyranoside, has been solved by molecular replacement
      and refined at 2.6-A resolution. The R factor is 0.183 for all data in the 8.0 to
      2.6 A resolution range with an average atomic temperature factor of 26.1 A2.
      Strong electron density for a single mannose residue is found in the
      monosaccharide-binding site suggesting that the trisaccharide binds primarily
      through one of the terminal alpha-linked mannose residues. The complex is
      stabilized by hydrogen bonds involving the protein residues Asp-81, Gly-99, Asn
      125, Ala-217, and Glu-218, and the carbohydrate oxygen atoms O3, O4, O5, and O6.
      In addition, the carbohydrate makes van der Waals contacts with the protein,
      involving Phe-123 in particular. These interactions are very similar to those
      found in the monosaccharide complexes with concanavalin A and isolectin 1 of
      Lathyrus ochrus, confirming the structural relatedness of this family of
      proteins. Comparison of the pea lectin complex with the unliganded pea lectin and
      concanavalin A structures indicates differences in the conformation and water
      structure of the unliganded binding sites of these two proteins. Furthermore, a
      correlation between the position of the carbohydrate oxygen atoms in the complex
      and the bound water molecules in the unliganded binding sites is found. Binding
      of the trimannose core through a single terminal monosaccharide residue strongly
      argues that an additional fucose-binding site is responsible for the high
      affinity pea lectin-oligosaccharide interactions.

PMID- 8486684
TI  - Specific interactions of chemoattractant factor receptors with G-proteins.
AB  - Stimulation of leukocytes with chemoattractant ligands activates phospholipid
      turnover and calcium release, ultimately leading to chemotaxis, degranulation,
      and the inflammatory response. The leukocyte response to these ligands is
      transduced by the interaction of transmembrane receptors with GTP-binding
      regulatory proteins (G-proteins). To examine the mechanisms of signal
      transduction by these receptors, we transfected cDNA clones encoding the
      receptors for the active cleavage product of the fifth component of complement
      (C5a) and platelet-activating factor (PAF) into COS-7 cells, then measured the
      production of inositol phosphates (IP) in response to stimulation with these
      chemoattractant ligands. Cells transfected with the C5a receptor showed no
      increase in IP production when stimulated with ligand (5-120 nM). However, in
      cells co-transfected with these receptors and with the cDNA for G alpha 16, a G
      protein alpha subunit that is specific to cells of hematopoietic lineage,
      addition of ligand caused up to a 5-fold increase in IP production. This
      interaction was specific, as co-transfection of receptors with the G-proteins G
      alpha q or G alpha 11 did not allow ligand-dependent increase in IP production.
      In contrast, ligand-dependent activation of IP production was seen in COS cells
      transfected solely with the PAF receptor. These results indicate that the C5a
      receptor utilizes signaling pathways distinct from the PAF receptor and suggest
      that a pertussis toxin-resistant G-protein, G alpha 16, may play a role in the
      leukocyte response to inflammatory ligands.

PMID- 8486685
TI  - Granulocyte-macrophage colony-stimulating factor receptors alter their binding
      characteristics during myeloid maturation through up-regulation of the affinity
      converting beta subunit (KH97).
AB  - Acute myeloid leukemia blasts express dual affinity (high and low) granulocyte
      macrophage colony-stimulating factor (GM-CSF) binding, and the high affinity GM
      CSF binding is counteracted by excess interleukin-3 (IL-3). Neutrophils express a
      single class of GM-CSF-R with intermediate affinity that lack IL-3 cross
      reactivity. Here we demonstrate the differentiation associated changes of GM-CSF
      binding characteristics in three models representative of different stages of
      myeloid maturation. We find that high affinity GM-CSF binding is converted into
      intermediate affinity binding, which still cross-reacts with IL-3, beyond the
      stage of promyelocytes. During terminal maturation towards neutrophils, IL-3
      cross-reactivity is gradually lost. We sought to determine the mechanism
      underlying the affinity conversion of the GM-CSF-R. Northern and reverse
      transcriptase-polymerase chain reaction analysis of GM-CSF-R alpha and -beta c
      (KH97) transcripts did not provide indications for the involvement of GM-CSF-R
      splice variants in the formation of the intermediate affinity GM-CSFR complex. In
      COS-cell transfectants with increasing amounts of beta c in the presence of a
      fixed number of GM-CSF-R alpha chains, the high affinity GM-CSF binding converted
      into intermediate affinity GM-CSF binding. These results are discussed in view of
      the concept that increasing expression of beta c subunits may cause alternative
      oligomerization of the GM-CSF-R alpha and -beta c subunits resulting in the
      formation of intermediate rather than high affinity GM-CSFR alpha.beta c
      complexes.

PMID- 8486686
TI  - Kinetic and spatial interrelationships between ganglioside glycosyltransferases
      and O-acetyltransferase(s) in human melanoma cells.
AB  - The melanoma-associated disialogangliosides 9(7)-O-acetyl-GD3 and 9(7)-O-acetyl
      GD2 have been structurally well characterized. However, the compartmentalization
      and sequence of action of the biosynthetic activities responsible for
      synthesizing these molecules remain obscure. Here, we have studied the spatial
      and temporal interrelationships among the activities responsible for the later
      stages of ganglioside biosynthesis and those for O-acetylation in cultured human
      melanoma cells. First, brefeldin A treatment was used to separate biosynthetic
      steps into compartments distal or proximal to the transport block imposed by the
      drug. In keeping with prior reports, GM2/GD2 synthase was consistently rendered
      inaccessible to its acceptors GM3 and GD3. In contrast, the effect on GD3
      biosynthesis was cell line-specific. Synthesis of GD3 was nearly abrogated in two
      lines, while it accumulated in a third line. This indicates that the spatial
      organization of ganglioside processing activities can vary even between similar
      cell lines. However, in all cell lines studied, the ratio of 9(7)-O-acetyl-GD3 to
      GD3 was not changed by brefeldin A, indicating that the majority of ganglioside O
      acetyltransferase activity is co-localized with GD3 biosynthetic activity in the
      same Golgi subcompartment(s). As an alternative approach, Golgi-enriched
      fractions from melanoma cells were incubated with radiolabeled and nonlabeled
      nucleotide sugars or acetyl-CoA. In these preparations, biosynthesis is dependent
      upon the co-localization of appropriate sugar nucleotide transporters,
      glycosyltransferases, and acceptors that are endogenously present within intact
      topologically correct compartments. Incubations with CMP-Neu5Ac and acetyl-CoA
      corroborated the results with brefeldin A, co-localizing ganglioside O
      acetyltransferase activity in compartments where GD3 biosynthesis takes place.
      Analyses with CMP-Neu5Ac and UDP-GalNAc showed that GD2 and GD3 synthesis occur
      in partially overlapping compartments. Labeling with acetyl-CoA and UDP-GalNAc
      indicated that although labeled acetate can be transferred from acetyl-CoA
      directly to GD2, ganglioside O-acetyltransferase activity does not substantially
      overlap with the biosynthetic compartment(s) for GD2. Instead, O-acetyl-GD3
      appears to be co-localized with the compartment of GD2 biosynthesis and serves as
      an acceptor for GD2 synthase. Thus, both 9-O-acetyl-GD3 and GD2 can be precursors
      of 9-O-acetyl-GD2, but apparently in distinct compartments.

PMID- 8486687
TI  - High level O-acetylation of sialic acids on N-linked oligosaccharides of rat
      liver membranes. Differential subcellular distribution of 7- and 9-O-acetyl
      groups and of enzymes involved in their regulation.
AB  - O-Acetylation of sialic acids has previously been considered an uncommon
      modification found on certain salivary mucins and neural gangliosides. We show
      here that glycosidically bound sialic acids from total membranes of rat liver
      have surprisingly high levels (approximately 20%) of O-acetylation at the 7- or 9
      position. This O-acetylation is further enriched in N-linked oligosaccharides but
      is barely detectable in ganglioside fractions from the same tissue. The position
      of O-acetylation on the sialic acid side chain varies between different
      subcellular fractions. In particular, 7-O-acetylation was enriched in lysosomal
      membranes and 9-O-acetylation in plasma membranes, whereas Golgi membranes
      contained both types. This distribution fits with the ability of the rat liver
      sialate: O-acetyltransferase(s) to synthesize both 7- and 9-O-acetyl esters
      (Diaz, S., Higa, H. H., Hayes, B. K., and Varki, A. (1989) J. Biol. Chem. 264,
      19416-19426) and the fact that 7-O-acetyl esters can migrate to the 9-position at
      physiological temperature but only under neutral or mildly alkaline conditions.
      Subcellular fractionation shows that sialate:O-acetyltransferase activity
      directed toward endogenous acceptors is enriched in Golgi fractions, whereas an
      intralumenal sialic acid-specific O-acetylesterase activity is not. The O
      acetyltransferase is labile and difficult to solubilize in the intact state and
      cannot be assayed with exogenous acceptors. However, a prelabeled [3H]acetyl
      intermediate can be solubilized from Golgi membranes with Triton X-100 and is
      stable for a prolonged time in the cold. In contrast to the transferase, the
      lumenal esterase is easily released in a stable and water-soluble form from
      membrane fractions by saponin permeabilization or repeated freeze-thaw. In
      keeping with this finding, differential subcellular fractionation and continuous
      sucrose gradients indicate that this enzyme is enriched in lysosomal fractions
      (see also the accompanying paper (Butor, C., Higa, H. H., and Varki, A. (1993) J.
      Biol. Chem. 268, 10207-10213). Based upon findings reported in this and previous
      studies, a model is proposed for the biosynthesis, maturation, and turnover of 7-
      and 9-O-acetyl esters on the sialic acids of N-linked oligosaccharides that are
      attached to membrane-bound proteins in the rat liver.

PMID- 8486688
TI  - Structural, immunological, and biosynthetic studies of a sialic acid-specific O
      acetylesterase from rat liver.
AB  - We have previously described a membrane-associated intralumenal sialic acid
      specific 9-O-acetylesterase (LSE) from rat liver (Higa, H. H., Manzi, A., and
      Varki, A. (1989) J. Biol. Chem. 264, 19435-19442). Unlike a cytosolic sialate: O
      acetylesterase (CSE) with similar specificity, the LSE carries N-linked
      oligosaccharides. A polyclonal monospecific antibody against homogenous LSE does
      not cross-react with the CSE. Monoclonal antibodies distinguish between the LSE
      and another N-glycosylated esterase that tends to partially co-purify with it.
      Amino-terminal sequencing of the LSE subunits indicates that it is distinct from
      previously described esterases and shows no homology to any other known proteins.
      In contrast, the esterase that partially co-purifies is similar but not identical
      to previously described "microsomal" esterases from rat liver. The LSE is also
      expressed in several hepatoma cell lines. Pulse-chase studies indicate that the
      two LSE subunits arise from a single precursor of approximately 65 kDa which
      yields a core polypeptide of apparent molecular mass approximately 53 kDa upon
      deglycosylation with peptide: N-glycosidase F. The protein quickly becomes partly
      resistant to endo-beta-N-acetylglucosaminidase H but remains sensitive to
      peptide: N-glycosidase F, indicating N-linked oligosaccharide processing during
      passage through the Golgi. After several hours, the precursor undergoes
      proteolysis, generating the mature heterodimeric protein of approximately 58 kDa,
      with subunits of approximately 38 and approximately 28 kDa. A portion of newly
      synthesized LSE is secreted into the medium intact, indicating that the cleavage
      normally takes place after diversion from the secretory pathway. These temporal
      changes and precursor-product distribution are reminiscent of some lysosomal acid
      hydrolases. In fact, immunofluorescence studies and Triton WR-1339 shift
      experiments suggest a lysosomal localization for this enzyme. Additional evidence
      for this, and the role of the LSE in O-acetylated sialic acid turnover are
      discussed in the accompanying paper (Butor, C., Diaz, S., and Varki, A. (1993) J.
      Biol. Chem. 268, 10197-10206).

PMID- 8486689
TI  - Molecular cloning of the cDNA for the catalytic subunit of human DNA polymerase
      epsilon.
AB  - The cDNA encoding the catalytic polypeptide of human DNA polymerase epsilon was
      cloned. The deduced amino acid sequence reveals that the catalytic polypeptide is
      2257 amino acids in length and its calculated molecular mass is 258 kDa. A single
      RNA message of 7.5 kilobases was recognized by isolated cDNA clones. The identity
      of the cDNA was verified by direct amino acid sequencing of tryptic fragments
      derived from the catalytic polypeptide of the HeLa DNA polymerase epsilon. The
      primary structure comparison with multiple DNA polymerases indicates that human
      DNA polymerase epsilon catalytic polypeptide is a homolog of the yeast
      Saccharomyces cerevisiae DNA polymerase II catalytic polypeptide. The proteins
      are 39% identical. In the region containing known DNA polymerase consensus
      motifs, the identity is 63%. The expression of the mRNA encoding DNA polymerase
      epsilon is strongly dependent on cell proliferation.

PMID- 8486690
TI  - A novel negative element in the promoter of the mouse alcohol dehydrogenase gene
      Adh-1.
AB  - The mouse alcohol dehydrogenase gene, Adh-1, is expressed in a tissue-specific
      manner. We examined the promoter activity of a series of 5' deletions extending
      from bp -473 to -47 and demonstrated that there are positive regulatory elements
      between bp -229 and +54 and a negative regulatory element between bp -323 and 
      229. To identify the sequence of the negative regulatory element, gel retardation
      and DNase I footprint assays were performed using nuclear proteins from mouse
      liver and from a hepatoma cell line, H4IIE-C3. A specific protein-binding site
      covered bp -324 and -297. Within this region, we identified sites of close
      protein-DNA contact by methylation interference assays, located in the sequence
      TGGAAGTTTCAGGTT (nt -316 to -302). Site-directed mutagenesis of four protein-DNA
      contact sites within this sequence eliminated the specific protein-DNA binding,
      assayed by gel retardation, and restored expression of Adh-1 in transient
      transfection assays to the levels seen when the entire region containing the
      negative element was deleted. Thus, we have identified a negative regulatory
      element within the Adh-1 promoter. No homology was found between this negative
      element and other regulatory elements, suggesting that this is a novel negative
      element.

PMID- 8486691
TI  - LESP, an androgen-regulated lizard epididymal secretory protein family identified
      as a new member of the lipocalin superfamily.
AB  - The sperm coating lizard epididymal secretory protein (LESP) family forms a
      complex of nine elements that are specifically synthesized under androgenic
      control and secreted by the epididymal epithelial cells of the lizard Lacerta
      vivipara. We report here the cloning and sequencing of an 806-base pair full
      length cDNA (C731) encoding one of the elements of the LESP family. Southern blot
      hybridization analysis of lizard total genomic DNA revealed a complex band
      pattern, suggesting that LESPs are encoded by a multigenic family. The cDNA open
      reading frame of 516 nucleotides, starting at an ATG codon, encodes a protein
      precursor of 172 amino acids with a calculated M(r) = 19,500. The corresponding
      mature form of M(r) = 17,200 and pI = 5.2 has been identified as the element LESP
      IV, and presents significant similarities to the different members of the large
      lipocalin protein superfamily, and especially to mouse epididymal protein ESP I.
      Lipocalins are extracellular proteins that share a common basic framework for the
      transport of small hydrophobic molecules like retinoids, thus suggesting that
      LESPs could be such transporters into the epididymal fluid during the sperm
      maturation.

PMID- 8486692
TI  - Characterization of the DNA-binding domain of the mouse uterine estrogen receptor
      using site-specific polyclonal antibodies.
AB  - The DNA-binding domain of the mouse uterine estrogen receptor (ER) was
      characterized using site-specific polyclonal antibodies. The peptides used as
      antigens have sequences corresponding to amino acids 185-199 and 227-245, the two
      zinc finger regions of the DNA-binding domain of the human ER, and produced anti
      sera designated A-1542 and A-1554, respectively. Mouse uterine nuclear ER and
      salt-activated 4 S cytosol receptor, as well as 8 S untransformed cytosol
      receptor, were observed to react with the antisera by Western blot and sucrose
      density gradient centrifugation analyses indicating that the DNA-binding domain
      of the 8 S cytosol receptor is not completely masked by heat shock protein 90 or
      other proteins. Only A-1554 detected a nuclear-specific doublet form of the ER on
      Western blot analysis. In a gel shift assay, neither antisera altered the pattern
      of the nuclear ER interaction with the vitellogenin A2 estrogen response element
      (VRE). In contrast, antiserum A-1554 partially shifted the 8 S cytosol receptor
      VRE complex. This concurs with mutational analysis and x-ray crystallography
      studies with the human ER that have shown that the second finger is not in
      contact with the DNA. The results of the gel shift assay were confirmed by
      sucrose density gradient analysis using the same buffer conditions. The nuclear
      receptor-VRE complex did not react with either antisera, suggesting that when the
      dimeric nuclear receptor form binds the VRE, the specific receptor epitopes
      involved with the DNA binding may be blocked and unable to bind the antisera. The
      cytosol receptor-VRE complex reacted only partially with the second finger
      antisera A-1554, suggesting that on receptor monomers the second finger epitope
      is not completely blocked by DNA binding or dimer formation.

PMID- 8486693
TI  - Identification and cloning of GP-3 from rat pancreatic acinar zymogen granules as
      a glycosylated membrane-associated lipase.
AB  - The protein components of highly purified secretory granule membranes and the
      granule contents from rat exocrine pancreas were characterized by two-dimensional
      polyacrylamide gel electrophoresis, protein staining, lectin absorption, and
      Western blotting with anti-secretory protein antibodies. NH2-terminal amino acid
      sequence was obtained for a approximately 53-kDa glycoprotein denoted GP-3,
      present only in granule membrane preparations where it was resistant to washing
      with Na2CO3 and KBr. The sequence of this protein showed homology to pancreatic
      lipase but was distinct from the NH2-terminal sequence of a 50-kDa content
      protein presumed to be secretory lipase. Polymerase chain reaction amplification
      with degenerate oligonucleotide primers to GP-3 and secretory lipase gave partial
      length subclones that were used to isolate clones from a rat pancreas cDNA
      library. Dideoxy sequencing of full-length subclones of GP-3 revealed the
      predicted amino acid sequence for a mature protein of 452 amino acids with a
      potential N-linked glycosylation site and a deglycosylated molecular weight of
      50,860. The GP-3 sequence possesses the serine esterase consensus sequence G-X-S
      X-G centered around Ser154 and the catalytic state triad Asp178-His265-Ser154
      characteristic of pancreatic lipases. Northern blot analysis of various rat
      tissues showed GP-3 expression solely in pancreas. Comparison of GP-3 nucleotide
      and amino acid sequence, along with pancreatic lipases of various species
      including rat, shows extensive homologies to both proteins and reveals an
      underlying diversity in the pancreatic lipase family. Close homology is observed
      between GP-3 and a lipase molecule previously isolated from mouse cytotoxic T
      cells.

PMID- 8486694
TI  - Processing of the carboxyl 15-amino acid extension in the alpha-chain of
      fibrinogen.
AB  - The cDNA for the alpha-chain of human fibrinogen codes for 15 amino acids at the
      carboxyl terminus that are not found in the native protein circulating in plasma.
      In the present studies, experiments were designed to test whether the carboxyl
      extension was required for fibrinogen assembly or was simply the result of
      limited proteolysis and maturation of the protein during or following secretion.
      Baby hamster kidney cells were transfected with cDNAs coding for the alpha-, beta
      , and gamma-chains, and the recombinant fibrinogen secreted into the cell culture
      medium was identified either with an antibody against the mature molecule or with
      an antibody directed toward the carboxyl extension of the alpha-chain. The
      secreted protein contained primarily two species of alpha-chains, including one
      with the carboxyl extension and one that was the same as that in plasma
      fibrinogen. A mutant fibrinogen, in which Arg-611 at the putative cleavage site
      in the alpha-chain was converted to Gly, was also readily assembled, and, in this
      case, the protein was secreted with the alpha-chain carboxyl extension.
      Similarly, a mutant fibrinogen that completely lacked the carboxyl extension of
      the alpha-chain was assembled and secreted from the transfected baby hamster
      kidney cells. These two mutants with modified alpha-chains were readily clotted
      by thrombin and cross-linked by factor XIIIa. These results indicate that the
      alpha-chain carboxyl extension in fibrinogen is not required for assembly or
      secretion of the molecule. Accordingly, it was concluded that the cleavage of the
      alpha-chain removing the carboxyl-terminal 15 amino acids is a normal and
      specific processing event occurring during the maturation of the protein.

PMID- 8486695
TI  - Detection and processing of peripheral myelin protein PMP22 in cultured Schwann
      cells.
AB  - Peripheral myelin protein, 22 kDa (PMP22), is a myelin molecule associated with
      Schwann cells in peripheral nerves (Snipes, G. J., Suter, U., Welcher, A. A., and
      Shooter, E. M. (1992) J. Cell Biol. 117, 225-238). Mutations affecting the PMP22
      gene have been implicated in the trembler mutation in mice (Suter, U., Welcher,
      A. A., Ozcelik, T., Snipes, G. J., Kosaras, B., Francke, U., Billings-Gagliardi,
      S., Sidman, R. L., and Shooter, E. M. (1992) Nature 356, 241-244; Suter, U.,
      Moskow, J. J., Welcher, A. A., Snipes, G. J., Kosaras, B., Sidman, R. L.,
      Buchberg, A. M., and Shooter, E. M. (1992) Proc. Natl. Acad. Sci. U. S. A. 89,
      4382-4386) and Charcot-Marie-Tooth Disease in humans (Patel, P. I., Roa, B. B.,
      Welcher, A. A., Schoener-Scott, R., Trask, B. J., Pentao, L., Snipes, G. J.,
      Garcia, C. A., Francke, U., Shooter, E. M., Lupski, J. R., and Suter, U. (1992)
      Nature genet. 1, 159-165). In this report, we have studied PMP22 production in
      cultured rat Schwann cells. Schwann cells contain a 1.8-kilobase mRNA transcript
      coding for PMP22, and its production is up-regulated in vitro by forskolin.
      Metabolic labeling combined with immunoprecipitation methods using antibodies
      raised against synthetic peptides of PMP22 reveal that Schwann cells generate the
      protein from an 18-kDa precursor form which is post-translationally modified by N
      linked glycosylation. A second molecule (molecular mass, 48 kDa) that reacted
      with PMP22 antibodies was also detected in Schwann cells but is not related
      chemically to PMP22 as determined by pulse-chase labeling. Metabolic labeling of
      rat sciatic nerve and Western blot analyses of purified rat sciatic nerve myelin
      reveal that deglycosylation of PMP22 gives rise to an 18-kDa protein similar in
      size to that in Schwann cells. These results indicate that cultured Schwann cells
      may provide a good model in which to investigate the production and function of
      PMP22 and to establish the cellular basis for the protein's involvement in
      inherited peripheral neuropathies.

PMID- 8486696
TI  - Arginine residues of the globular regions of human C1q involved in the
      interaction with immunoglobulin G.
AB  - The immunoglobulin G binding site in the globular regions of human complement
      subcomponent C1q has been investigated by chemical modification of histidine
      residues with diethylpyrocarbonate and arginine residues with phenylglyoxal and
      cyclohexane-1,2-dione (CHD). Only the modification of arginine residues with CHD
      fulfills the requirements of a specific modification without unwanted side
      reactions. Specific modification of arginine residues with CHD results in loss of
      immune complex recognition without affecting the binding of C1r2S2 to form C1.
      The gross structure of C1q is not changed by CHD treatment, and immune complex
      binding is restored to 82% of the control upon NH2OH treatment. Enzymic digestion
      and isolation of the modified peptides indicate that the modification by CHD of 4
      to 5 arginine residues (A162, B114, B129, C156, and possibly B163) per C1q
      globular "head" abolishes the ability of C1q to interact with immune complexes.
      These residues define two areas (and possible binding sites for IgG) on the
      globular region of C1q: B114-B129 (site 1) and A162-(B163)-C156 (site 2).
      Sequence comparison and solvent exposure predictive studies favor site 2 as the
      immunoglobulin G binding site on the globular regions of C1q, although the
      participation of site 1 cannot be ruled out.

PMID- 8486697
TI  - RNA polymerase II is a glycoprotein. Modification of the COOH-terminal domain by
      O-GlcNAc.
AB  - The largest subunit of mammalian RNA polymerase II (RNAP II) contains at its
      carboxyl terminus an unusual domain consisting of 52 tandem repeats of the
      consensus sequence Tyr-Ser-Pro-Thr-Ser-Pro-Ser. This domain, designated the COOH
      terminal domain (CTD), is essential for viability and is extensively
      phosphorylated during the transition from preinitiation complex assembly to
      elongation (1). Indeed, phosphorylation of the CTD may play an important
      regulatory role in this transition. We show here that the CTD is also modified by
      a novel form of protein glycosylation, O-GlcNAc. This modification has been found
      on numerous transcription factors and other nuclear and cytosolic proteins (2).
      Glycopeptides obtained by proteolytic digestion of the CTD were purified by
      reverse-phase high performance liquid chromatography and sequenced. Results from
      such experiments suggest that glycosylation occurs at multiple sites throughout
      the CTD, similar to the phosphorylation of this domain. The carbohydrate,
      however, is not detectable on the phosphorylated form of the enzyme. This
      observation is consistent with the idea that phosphorylation and glycosylation
      are mutually exclusive modifications. The CTD of RNAP II, therefore, appears to
      exist in three distinct conformational states: unmodified, phosphorylated, and
      glycosylated. The differential modification of the CTD may play an important role
      in the regulated expression of genes transcribed by RNA polymerase II.

PMID- 8486698
TI  - Purification and characterization of a template-associated protein kinase that
      phosphorylates RNA polymerase II.
AB  - We have recently shown that a template-associated protein kinase, which
      phosphorylates the carboxyl-terminal domain (CTD) of RNA polymerase II, is a two
      component system. We describe here the purification of these two components to
      apparent homogeneity from human (HeLa) cell nuclear extract. Kinase component A
      has a 340-kDa native molecular mass, consists of a single large polypeptide, and
      contains the kinase active site. Kinase component B, which is identical to the Ku
      autoantigen, has a 180-kDa native molecular mass, and consists of apparently
      equimolar 67- and 83-kDa polypeptides. Component B stimulates the activity of
      component A, and under some conditions, confers DNA dependence on the reaction.
      The purified kinase converts the CTD to the multiply phosphorylated CTD0 form.
      Conversion occurs processively, and this processivity is an inherent property of
      component A. The in vitro phosphorylated CTD0 form contains approximately
      equimolar phosphoserine and phosphothreonine, but no detectable phosphotyrosine.

PMID- 8486699
TI  - cDNA cloning and expression of the human hepatic bile acid-binding protein. A
      member of the monomeric reductase gene family.
AB  - In human liver, we previously identified one isoform of dihydrodiol dehydrogenase
      activity that expresses high affinity bile acid binding (HBAB) with minimal 3
      alpha-hydroxysteroid dehydrogenase (3 alpha-HSD) activity for bile acids. This
      protein may assist in the rapid intracellular transport of bile acids from the
      sinusoidal to the canalicular pole of the cell. We now report the cDNA cloning
      and bacterial expression of this novel, multifunctional protein. A 1252-base pair
      HBAB cDNA was cloned from a HepG2 lambda GT11 library using a rat hepatic bile
      acid binder cDNA probe. Bacterial expressed recombinant HBAB oxidized racemic
      trans dihydrodiol benzene (0.455 mumol NADPH/mg/min) with minimal 3 alpha-HSD
      activity for bile acids (< 0.003 mumol NADPH/mg/min). Lithocholic acid and
      chenodeoxycholic acid dissociation constants as determined by displacement of the
      fluorescent probe, bis-1-anilino-8 sulfonate, were higher than those previously
      reported for the native protein (1 microM versus 10 nM). Significant amino acid
      sequence homology was found with the human chlordecone reductase, bovine
      prostaglandin F synthetase, and rat hepatic-3 alpha-HSD suggesting, that HBAB is
      also a member of the recently identified, monomeric oxidoreductase gene family.
      Future studies will define the physiologic significance of this novel,
      multifunctional protein in bile acid transport and xenobiotic metabolism.

PMID- 8486700
TI  - Uptake and degradation of glyceraldehyde-3-phosphate dehydrogenase by rat liver
      lysosomes.
AB  - The molecular mechanisms involved in the degradation of individual cellular
      proteins are probably unique and characteristic. We have investigated in rat
      liver the degradation of glyceraldehyde-3-phosphate dehydrogenase, an abundant
      cytosolic enzyme of the glycolytic pathway. Immunoblot analysis of isolated liver
      lysosomes from rats treated with lysosomal inhibitors show that this protein is
      degraded, at least in part, by a lysosomal pathway. This pathway was further
      investigated by incubating the enzyme with lysosomes in a cell-free system,
      followed by proteolysis measurements, sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis of lysosomes, and electron microscopic immunocytochemistry. We
      postulate that the degradative mechanism of glyceraldehyde-3-phosphate
      dehydrogenase includes a temperature-dependent lysosomal pathway, different from
      classical nonspecific macroautophagy. The postulated pathway involves: binding of
      the enzyme to the lysosomal membrane, entry into the lysosomal matrix, and
      degradation. This cell-free system, which can also incorporate in vitro
      synthesized proteins, should allow further advances toward clarifying the complex
      signals that regulate protein degradation as well as its close interrelationship
      with protein synthesis.

PMID- 8486701
TI  - A cationic region of the platelet-derived growth factor (PDGF) A-chain (Arg159
      Lys160-Lys161) is required for receptor binding and mitogenic activity of the
      PDGF-AA homodimer.
AB  - Platelet-derived growth factor-AA and -BB homodimers and -AB heterodimers bind
      with high affinity to the platelet-derived growth factor (PDGF) alpha-receptor.
      Basic polypeptides such as polylysine and protamine sulfate compete with PDGF for
      receptor binding, suggesting a role for ligand positive charge in the binding
      interaction. A pentapeptide amino acid sequence with a cationic tripeptide core
      is perfectly conserved between the A- and B-chains (Val158-Arg159-Lys160-Lys161
      Pro162) and was therefore considered as a possible alpha-receptor-binding domain.
      We have investigated the functional importance of positive charge within this
      region of the PDGF A-chain by using site-directed mutagenesis to convert the
      cationic core amino acids to the acidic sequence triglutamic acid. cDNAs encoding
      wild-type (PDGF-AAwt) and charge mutant (PDGF-AAcm) proteins were expressed
      following stable transfection of Chinese hamster ovary cells. Proper assembly and
      secretion of PDGF-AAcm was verified by metabolic labeling with [35S]cysteine,
      immunoprecipitation, and SDS-polyacrylamide gel electrophoresis analysis under
      nonreducing and reducing conditions. PDGF-AAcm was secreted as two major species
      of disulfide-linked A-chain homodimers identical in molecular mass to those
      observed for PDGF-AAwt (32 and 35 kDa). Secreted PDGF-AAwt and PDGF-AAcm proteins
      were purified to homogeneity and subjected to structural and functional analyses.
      Compared to purified PDGF-AAwt, PDGF-AAcm displayed a marked reduction in both
      binding affinity for PDGF alpha-receptors and mitogenic activity in Swiss 3T3
      cells. Large reductions were also observed in the ability of semipurified PDGF
      AAcm to stimulate calcium influx and the production of inositol phosphates.
      Measurement of circular dichroism spectra of highly purified PDGF-AAcm and PDGF
      AAwt revealed no significant difference in secondary structure. Collectively,
      these results indicate that the cationic Arg159-Lys160-Lys161 region plays a
      critical role in the biological activity of PDGF-AA by direct participation in
      ligand binding to the PDGF alpha-receptor.

PMID- 8486702
TI  - Interleukin-6 signal communication to the alpha 1-acid glycoprotein gene, but not
      junB gene, is impaired in HTC cells.
AB  - In the rat hepatoma (HTC) cell line, transcription of the alpha 1-acid
      glycoprotein (AGP) gene is prominently stimulated by dexamethasone. Although
      interleukin (IL)-1 and IL-6 synergistically enhance expression of the AGP gene in
      liver, they have no detectable effect on this gene in HTC cells. Nevertheless,
      HTC cells have mRNA encoding the IL-6 receptor subunits and respond to IL-6 by
      increasing expression of the junB gene. The mRNA for the 80-kDa IL-6 receptors is
      increased severalfold following dexamethasone treatment. Even with elevated IL-6
      receptor expression, no IL-6 regulation of the AGP gene is observed. The lack of
      response to IL-6 is also found with the transfected AGP gene sequence, suggesting
      the absence of specific trans-acting factors. Since IL-6 promotes only a minimal
      stimulation of the CCAAT/enhancer-binding protein beta, HTC cells lack the
      indirect IL-6 signaling pathway to acute phase plasma protein genes that has been
      found to be crucial in other hepatoma cell lines. Considering that a similar IL-6
      regulation of the junB gene is manifested in HTC cells and normal liver, a
      separate IL-6 signal-transducing pathway controlling the AGP gene is assumed to
      be missing in HTC cells.

PMID- 8486703
TI  - Expression of the core lipopeptide of the glycopeptidolipid surface antigens in
      rough mutants of Mycobacterium avium.
AB  - Toward studying the genetics, biosynthesis, and roles in the pathogenesis of the
      dominant surface glycopeptidolipid antigens of Mycobacterium avium, rough colony
      variants of M. avium serovar 2 were picked, cultured in quantity, and their lipid
      composition examined. Two of the rough (Rg) variants, Rg-3 and Rg-4, were devoid
      of glycopeptidolipids or any more elemental structures and thus were similar to
      those described previously. Two others, Rg-0 and Rg-1, each contained two novel
      lipopeptides, devoid of any of the carbohydrate substituents that confer
      serotypic activity on the glycopeptidolipids. The application of gas
      chromatography, fast atom bombardment-mass spectrometry and 1H NMR to lipopeptide
      I established the structure C32:2-beta-OH-fatty acyl-D-Phe-D-allo-Thr-D-Ala-L
      alaninol. Lipopeptide II represented a minor variation of this structure: C32:1
      beta-OH-fatty acyl-D-Phe-D-allo-Thr-D-Ala-L-alaninol. These newly discovered
      lipopeptides are identical to the fatty acyl-tripeptide-amino alcohol "core"
      component of the glycopeptidolipids of the M. avium complex, and thus the Rg-0
      and Rg-1 variants represent a form of "deep rough" mutation in M. avium.
      Separately, we report that these rough variants of M. avium differ genetically
      from the smooth, virulent form by major deletions of portions of the genes
      responsible for glycopeptidolipid synthesis (Belisle, J. T., Klaczkiewicz, K.,
      Brennan, P. J., Jacobs, W. R., Jr., and Inamine, J. M. (1993) J. Biol. Chem. 268,
      10517-10523). The isolation of different sets of spontaneous mutants of M. avium
      differentially defective in the capacity to synthesize glycopeptidolipids
      provides the means to explore their biosynthesis and roles in opportunistic
      pathogenesis.

PMID- 8486704
TI  - Rough morphological variants of Mycobacterium avium. Characterization of genomic
      deletions resulting in the loss of glycopeptidolipid expression.
AB  - Previously, a gene cluster, termed ser2, which encodes for the synthesis of the
      specific oligosaccharide of the glycopeptidolipid antigen of Mycobacterium avium
      serovar 2 strain TMC 724, was defined. DNA probes from this cloned ser2 gene
      cluster have now been used to clone and characterize the ser2 region from a
      strain of M. avium which produces rough and smooth colony forms and to identify
      the genetic differences between these morphotypes. Interstrain differences were
      seen to exist between the ser2 gene cluster of M. avium strains TMC 724 and 2151.
      In addition, two distinct rough (Rg) genotypes of strain 2151 were defined by
      this analysis. The first of these, present in the M. avium Rg-0 and Rg-1
      variants, was attributed to a deletion of approximately 28 kilobases from smooth
      variants, including the entire ser2 gene cluster. This particular deletion is
      thought to be mediated by recombination between repetitive sequences that flank
      both sides of the 28-kilobase excised region. The second genotype, seen in M.
      avium Rg-3 and Rg-4 variants, results from the deletion of an undefined amount of
      DNA from the right of the ser2 gene cluster. Reported separately (Belisle, J. T.,
      McNeil, M. R., Chaterjee, D., Inamine, J. M., and Brennan, P. J. (1993) J. Biol.
      Chem. 268, 10510-10516) are the results of biochemical analyses of the
      glycopeptidolipid/lipopeptide population of the Rg genotypes which revealed that
      Rg-0 and Rg-1 possess lipopeptides devoid of all of the sugars of the
      glycopeptidolipids and are obviously biosynthetic precursors of the
      glycopeptidolipids. These studies help formulate a definition of the
      physiological effects of glycolipid expression, the biosynthetic and genetic
      mechanisms involved in their formation, and toward an understanding of the role
      of M. avium as a serious opportunistic pathogen.

PMID- 8486705
TI  - Eukaryotic translation initiation factor 5 from Saccharomyces cerevisiae.
      Cloning, characterization, and expression of the gene encoding the 45,346-Da
      protein.
AB  - Eukaryotic translation initiation factor 5 (eIF-5) catalyzes hydrolysis of GTP
      bound to a 40 S ribosomal initiation complex with the subsequent joining of a 60
      S ribosomal subunit to form an 80 S initiation complex. The yeast gene that
      encodes eIF-5, designated TIF5, has been isolated and expressed in Escherichia
      coli to yield a catalytically active eIF-5 protein. TIF5 is a single-copy gene
      that maps on yeast chromosome XVI and is essential for cell viability. The gene
      contains an intron-free open reading frame that encodes a protein of calculated
      M(r) 45,346 in close agreement with the apparent molecular weight of eIF-5
      isolated from yeast cells. Sequence analysis of the gene reveals several
      interesting features. First, the presence of two in-frame translational start
      sites located 51 base pairs apart suggests the possibility that two proteins,
      differing by an amino-terminal extension of 17 amino acids, could be generated
      from the TIF5 gene via differential translational starts. This would explain the
      presence, in yeast cell lysates, of two forms of eIF-5 differing in molecular
      weight by about 2,000. Second, the predicted amino acid sequence of eIF-5
      contains sequence motifs characteristic of proteins of the GTPase superfamily.

PMID- 8486706
TI  - Differential translocation of protein kinase C isozymes by thrombin and platelet
      derived growth factor. A possible function for phosphatidylcholine-derived
      diacylglycerol.
AB  - The translocation of protein kinase C (PKC) from the cytosolic to the particulate
      fraction in IIC9 fibroblasts has been studied to define the functions of 1,2
      diacylglycerol (DAG) derived from the hydrolysis of phosphatidylinositol 4,5
      bisphosphate (PIP2) and phosphatidylcholine (PC). alpha-Thrombin caused a
      biphasic change in DAG, with two peaks at 15-60 s and 5-15 min, derived from PIP2
      and PC, respectively, while platelet-derived growth factor (PDGF) induced a
      monophasic DAG increase from PC at 5-15 min. alpha-Thrombin also induced a rapid,
      but transient, increase of inositol 1,4,5-trisphosphate and cytosolic Ca2+,
      whereas PDGF did not. Three PKC isozymes, alpha, epsilon, and zeta, were
      identified by Western blotting in IIC9 cells and were mainly localized in the
      cytosol. A fraction of cytosolic PKC alpha was rapidly translocated by alpha
      thrombin at 15 s, but its membrane association was lost within 1 min. PKC epsilon
      was also rapidly translocated; however, its membrane association was sustained
      for almost 60 min. PKC zeta was not translocated by alpha-thrombin or phorbol 12
      myristate 13-acetate. PDGF translocated PKC epsilon at 5 min but had little
      effect at 15 s and did not translocate PKC alpha or zeta. Incubation with
      Bacillus cereus PC- or phosphatidylinositol-specific phospholipase C, which
      increased DAG but not phosphatidic acid, stimulated translocation of PKC epsilon,
      but not PKC alpha or zeta. Addition of chelators to inhibit the rise in
      intracellular Ca2+ largely blocked PKC alpha translocation induced by alpha
      thrombin but had no effect on PKC epsilon translocation. Addition of ionomycin
      allowed alpha-thrombin to induce PKC alpha translocation at 5 min. PKC alpha
      translocation was mimicked by 1,2-dioctanoylglycerol plus ionomycin, but not by
      either alone. On the other hand, PKC epsilon was translocated by the DAG alone.
      These results support the conclusion that PIP2 hydrolysis activates both PKC
      alpha and epsilon at 15 s, whereas PC hydrolysis activates only PKC epsilon at 5
      min. The differential activation at 5 min can be attributed to the failure of PC
      hydrolysis to increase Ca2+ and not to a difference in the molecular species of
      DAG derived from the phospholipids.

PMID- 8486707
TI  - EBP-80, a transcription factor closely resembling the human autoantigen Ku,
      recognizes single- to double-strand transitions in DNA.
AB  - We have previously reported the purification and characterization of the
      transcription factor EBP-80 (Falzon, M., and Kuff, E. L. (1989) J. Biol. Chem.
      264, 21915-21922). EBP-80 mediates the DNA methylation effect on transcription
      from an endogenous proviral long terminal repeat. Here we show that EBP-80 is
      very similar if not identical to the Ku autoantigen, a heterodimeric nuclear
      protein first detected by antibodies from autoimmune patients (Mimori, T.,
      Akizuki, M., Yamagata, H., Inada, S., Yoshida, S., and Homma, M. (1981) J. Clin.
      Invest. 68, 611-620). A number of laboratories have shown that the Ku protein
      complex binds to free double-stranded DNA ends. In this study, we have examined
      the binding properties of EBP-80. EBP-80 binds single-stranded DNA with low
      affinity. Binding to random sequence double-stranded DNA depends on the length of
      the duplex and is optimal with oligomers of 30 and 32 base pairs; the protein
      complexes formed with these oligomers have Kd values of 15-20 pM. It binds with
      comparable high affinities to blunt-ended duplex DNA, to duplex DNA ending in
      hairpin loops, and to constructs in which an internal segment of duplex DNA is
      flanked by single-strand extensions. EBP-80 also interacts effectively with
      circular duplex molecules containing a 30-nucleotide single-stranded region (gap)
      or a double-stranded segment of nonhomology (bubble), but only weakly with the
      corresponding closed circular construct made up entirely of duplex DNA. EBP-80
      prefers A/T to G/C ends. The binding properties of EBP-80 are consistent with the
      hypothesis that is recognizes single- to double-strand transitions in DNA. A
      model is presented for the interaction of EBP-80 with its target sequence in the
      proviral long terminal repeat.

PMID- 8486708
TI  - Complete selective absence of protamine P2 in humans.
AB  - Male sterility due to abnormal sperm morphology or motion has been widely
      reported, although relatively little has been published on the sperm nuclear
      protein abnormalities. We report the first cases worldwide of infertile patients
      having a complete selective absence of protamine P2 in the sperm nucleus. This
      provides a selective phenotype that will aid understanding of the mechanisms of
      synthesis, processing, or function of the P2 protamines. In addition, it is of
      marked immediate relevance to medicine as it allows the diagnosis of this type of
      human male sterility and the opportunity to understand the basis of this defect.

PMID- 8486709
TI  - Analysis of the sequence requirements for glycosylphosphatidylinositol anchoring
      of Saccharomyces cerevisiae Gas1 protein.
AB  - The Saccharomyces cerevisiae Gas1 protein is synthesized as a precursor with a
      hydrophobic extension at the carboxyl terminus which is removed and replaced with
      an inositol containing glycolipid that anchors the protein to the plasma
      membrane. We performed saturation mutagenesis on the anchor attachment site
      (Asn506) and showed that only a subset of amino acids with small side chains
      could act as substrates for peptide cleavage and glycolipid addition. After Asn,
      which is the most efficient anchor attachment site, Ser, Gly, Ala, Asp, and Cys
      function with decreasing effectiveness. Mutational analysis also revealed that
      the 2 adjacent amino acids to the carboxyl side of the anchor attachment site are
      important for efficient anchoring. These two amino acids should have relatively
      short side chains with the second position being more critical. Analysis of the
      region between the anchor attachment site and the carboxyl-terminal hydrophobic
      region indicated that this region may not simply perform a spacer function.

PMID- 8486710
TI  - Vacuolar ATPase mutants accumulate precursor proteins in a pre-vacuolar
      compartment.
AB  - The vacuole of the yeast Saccharomyces cerevisiae contains a proton-translocating
      ATPase that acidifies the vacuolar lumen and generates an electrochemical
      potential across the vacuole membrane. Strains with chromosomal disruptions of
      the genes encoding the A, B, and c subunits of the vacuolar ATPase accumulate
      precursor forms of the vacuolar membrane protein alkaline phosphatase, and the
      soluble vacuolar hydrolases carboxypeptidase Y and proteinase A. We have found
      that the intracellular precursors in delta vat strains accumulate within the
      secretory pathway at some point before delivery to the vacuole but after transit
      to the Golgi complex. Purified vacuoles from delta vat cells do not contain the
      precursor forms of carboxypeptidase Y or alkaline phosphatase. In addition,
      vacuolar hydrolase-invertase hybrid proteins are inefficiently delivered to the
      vacuole in delta vat strains as demonstrated by vacuole isolation. Further
      subcellular fractionation to separate organelles indicate that significant
      amounts of the carboxypeptidase Y-invertase and alkaline phosphatase-invertase
      hybrid proteins are located in the late Golgi complex and/or post Golgi
      compartments.

PMID- 8486711
TI  - Template activating factor I, a novel host factor required to stimulate the
      adenovirus core DNA replication.
AB  - The adenovirus (Ad) genome in virion exists in the form of the Ad core, which is
      a complex of Ad DNA and viral basic proteins. The Ad core supported only
      initiation and limited elongation in DNA replication in a cell-free system which
      was developed for DNA replication of naked Ad DNA. We found that addition of a
      cytoplasmic fraction from uninfected HeLa cells on the top of the system
      stimulated Ad core DNA replication, although it had no effect on DNA replication
      of naked Ad DNA. The factor stimulating Ad core DNA replication, designated as
      template activating factor I (TAF-I), was purified by successive steps of
      ammonium sulfate precipitation, column chromatographies on phosphocellulose and Q
      Sepharose, and glycerol density gradient centrifugation. SDS-polyacrylamide gel
      electrophoresis of the purified fraction revealed the presence of proteins with
      molecular masses of 41 and 39 kDa. TAF-I stimulated both initiation and
      elongation in Ad core DNA replication. Judging from its behavior in purification
      steps, TAF-I could be acidic. These findings suggest that TAF-I stimulates Ad
      core DNA replication by interaction with viral basic core proteins.

PMID- 8486712
TI  - Structural and functional analyses of the Arg-Gly-Asp sequence introduced into
      human lysozyme.
AB  - To determine the functional conformation of the Arg-Gly-Asp (RGD) sequence, we
      have constructed mutant proteins by inserting 4-12 amino acid residues from the
      RGD region of human fibronectin between Val74 and Asn75 of human lysozyme. RGDS-,
      GRGDSP-, TGRGDSPA-, VTGRGDSPAS-, and AVTGRGDS-PASS-introduced mutant lysozymes
      were expressed in yeast, purified, and designated as RGD4, -6, -8, -10, and -12,
      respectively. Using baby hamster kidney cells, RGD8, RGD10, and RGD12 were shown
      to possess high cell adhesion activity nearly equal to 10% of human vitronectin
      activity. RGD4 and RGD6 exhibited somewhat lower cell adhesion activity. The
      activities of these mutant proteins were inhibited by the addition of either
      GRGDSP peptide or polyclonal antibody against vitronectin receptor, as was the
      case for the vitronectin activity. The results suggest that the cell adhesion
      signals are transduced to cells through the interaction with the vitronectin
      receptor. The three-dimensional structures of RGD4 and RGD8 were determined at
      1.8-A resolution by x-ray crystallography. A model of the inserted region in RGD4
      could be built in the electron density map, but the positions of the preceding
      residues, Ala73-Val74, were uncertain. The inserted region in RGD8 did not
      demonstrate continuous electron densities. The results suggest that these RGD
      sequence-containing regions are highly flexible and that such flexibility could
      allow the conformation of the RGD regions to be induced to fit into the binding
      pocket of the integrin receptor.

PMID- 8486713
TI  - Muscle-specific calpain, p94, is degraded by autolysis immediately after
      translation, resulting in disappearance from muscle.
AB  - We previously identified a third type of the calpain large subunit named p94 as a
      cDNA whose mRNA is expressed exclusively in skeletal muscle at levels
      approximately 10-fold more abundant than those of the conventional calpain
      subunit. Rat skeletal muscle fractions were screened by two anti-peptide
      antibodies raised against two specific sequences in p94, but the p94 protein
      could not be found. To examine this apparent discrepancy between the amounts of
      mRNA and protein, wild-type p94 was expressed in COS cells. Although p94 mRNA was
      expressed normally in COS cells, only very small amounts of the protein and its
      presumed degradation products were detected by the antibodies described above. A
      series of COOH-terminal deletion mutants was constructed and expressed in COS
      cells and L8 cells, a rat myoblast cell line. When IS2, one of the specific
      regions of p94, was completely eliminated, the truncated p94 proteins were
      expressed normally, and the amount of the expressed proteins was at least 100
      fold higher than with wild-type p94. Moreover, when site-directed mutagenesis was
      introduced to change the presumed active-site cysteine of p94 to serine or
      alanine, the mutated p94 proteins were highly expressed like the IS2-deleted
      mutants. These results indicate the following. 1) The mRNA for p94 is normally
      transcribed in COS, L8, and muscle cells; 2) the p94 protein becomes active in
      the cytosol immediately after translation; 3) the p94 protein virtually
      disappears from cells by autocatalytic degradation; and 4) the p94-specific IS2
      region plays an important role in this degradation. In vitro translation
      experiments support this idea. Furthermore, p94 shows nuclear localization when
      expressed in COS cells. The physiological function of p94 in muscle is discussed
      on the basis of the analysis of these transfectants.

PMID- 8486714
TI  - Methyl jasmonate-regulated translation of nuclear-encoded chloroplast proteins in
      barley (Hordeum vulgare L. cv. salome).
AB  - The naturally occurring plant growth regulator (-)-jasmonic acid methyl ester
      (JaMe) induces the formation of novel abundant proteins in excised barley leaf
      segments. Concomitantly, this substance depresses the translation of most
      preexisting ("control") leaf mRNAs, including those for nuclear-encoded
      chloroplast proteins such as the small subunit of ribulose-1,5-bisphosphate
      carboxylase/oxygenase (SSU, rbcS gene product) and several light harvesting
      chlorophyll protein complex apoproteins (LHCPs, cab gene products). The changes
      in protein synthesis observed for SSU and LHCPs did not correspond to equivalent
      alterations in the rbcS and cab transcript levels. Analysis of polysome
      associated in vitro translatable and hybridizable mRNAs, however, demonstrated a
      restriction of rbcS and cab transcripts to smaller polysomes in JaMe-exposed leaf
      tissues, in comparison to water-treated tissues. Since treatment of JaMe
      incubated leaf segments with cycloheximide prior to harvest led to a shift of
      both transcripts toward larger polysomes, a hormone-induced impairment of chain
      initiation is assumed to lower translation of SSU and LHCP in situ. In contrast,
      the mRNA for plastid leucyl-tRNA synthetase (LRS1, lrs1 gene product) neither
      changed its abundance nor its association with polysomes in JaMe-treated leaves
      and was translated into the corresponding polypeptide. Together, our results
      highlight a remarkable variability of nuclear gene expression in response to
      plant growth regulators of the methyl jasmonate type.

PMID- 8486715
TI  - Oligomeric structure of bacteriophage T7 DNA primase/helicase proteins.
AB  - The oligomeric structure of bacteriophage T7 gene 4 helicase/primase proteins was
      investigated using protein cross-linking and high pressure gel-filtration
      chromatography. Studies were carried out with both 4A' and 4B proteins. 4A' is a
      M64L mutant of 4A which has similar helicase and primase activities as the wild
      type mixture of 4A and 4B proteins (Patel, S. S., Rosenberg, A. H., Studier, F.
      W., and Johnson, K. A. (1992) J. Biol. Chem. 267, 15013-15021), and 4B is the
      smaller protein which has only helicase activity. Chemical cross-linking of 4A'
      and 4B proteins with dimethyl suberimidate resulted in cross-linked species
      ranging from dimers to hexamers and beyond. The cross-linking time course,
      however, indicated that hexamers were the predominant species to accumulate in
      both 4A' and 4B proteins. The effect of MgNTP and DNA binding on oligomerization
      of the gene 4 proteins was investigated using high pressure gel-filtration
      chromatography at increasing protein concentrations. In the absence of added
      ligands, close to 100 microM protein concentrations were required to form stable
      oligomers beyond dimers. However, in the presence of Mg-beta, gamma-methylene
      deoxythymidine triphosphate (nonhydrolyzable analog of dTTP), 4A' and 4B protein
      assembled into stable hexamers at protein concentrations less than 8 microM.
      Addition of single-stranded DNA further stabilized the hexamer structure.
      Therefore, in the presence of a 60-nucleotide-long single-stranded DNA, hexamers
      were observed at protein concentrations as low as 0.2 microM. Nuclease protection
      experiments indicated that the 4A' and 4B hexamers protect about 60-65 bases of
      single-stranded DNA.

PMID- 8486716
TI  - Molecular characterization of the band 3 protein from Southeast Asian ovalocytes.
AB  - Southeast Asian ovalocytosis (SAO) is a hereditary form of elliptocytosis
      resulting in rigid, oval-shaped erythrocytes resistant to invasion by malaria
      parasites. The molecular defect is due to deletion of codons 400-408, encoding a
      9-amino-acid sequence located at the boundary between the cytosol and the first
      transmembrane segment in Band 3, the erythrocyte anion transport protein. We have
      carried out an extensive characterization of Band 3 isolated from SAO
      erythrocytes which contain about 50% mutant Band 3. A slightly higher proportion
      of Band 3 in SAO erythrocytes was left associated with the cytoskeleton after
      extraction of ghost membranes with non-ionic detergents. Size exclusion high
      performance liquid chromatography analysis showed that SAO Band 3 contained a
      higher proportion of tetramers relative to dimers (50% tetramer) than normal Band
      3 (33% tetramer). The circular dichroism spectrum of Band 3 from SAO erythrocytes
      was very similar to the spectrum for normal Band 3. Enzymatic deglycosylation and
      tomato lectin binding showed that SAO Band 3 lacked the polylactosaminyl
      oligosaccharide found on normal Band 3. SAO Band 3 was unable to bind the anion
      transport inhibitor 4-benzamido-4'-aminostilbene-2,2'-disulfonate, suggesting a
      dramatic alteration in the inhibitor binding site. In conclusion, deletion of 9
      amino acids from Band 3 on the cytosolic side of the membrane affects the
      properties (glycosylation and inhibitor binding) of Band 3 on the opposite side
      of the membrane without dramatic changes in the secondary and quaternary
      structure of the protein.

PMID- 8486717
TI  - Identification of a single-stranded DNA-binding protein that interacts with an S1
      nuclease-sensitive region in the platelet-derived growth factor A-chain gene
      promoter.
AB  - We previously observed that transcription of the platelet-derived growth factor
      (PDGF) A-chain gene is enhanced in cells stimulated by PDGF through a serum
      response element (SRE) in its 5'-flanking sequence. We now show that the region
      of the SRE is sensitive to S1 nuclease in vitro. We also identify a single
      stranded DNA-binding protein in HeLa cell nuclear extracts that binds to the
      noncoding strand of the PDGF A-chain SRE but not to its double-stranded
      counterpart or to the single-stranded coding sequence. Competition assays using
      oligonucleotides with sequence-specific mutations that diminished or eliminated
      detectable complex formation were used to establish the specificity of this
      protein/DNA interaction. Remarkably, the sequence-specific single-stranded
      binding protein binds to this region only when it is highly supercoiled. The data
      suggest that the single-stranded DNA-binding protein specifically interacts with
      a highly supercoiled region of the PDGF A-chain promoter and that this
      interaction may have a role in the transcriptional regulation of this gene.

PMID- 8486718
TI  - A cytotoxic ribonuclease. Study of the mechanism of onconase cytotoxicity.
AB  - Onconase, or P-30, is a protein initially purified from extracts of Rana pipiens
      oocytes and early embryos based upon its anticancer activity both in vitro and in
      vivo. It is a basic single-chain protein with an apparent molecular mass of
      12,000 daltons and is homologous to RNase A. In cultured 9L glioma cells,
      onconase inhibits protein synthesis with an IC50 of about 10(-7) M. The
      inhibition of protein synthesis correlates with cell death determined by
      clonogenic assays. 125I-Labeled onconase binds to specific sites on cultured 9L
      glioma cells. Scatchard analysis of the binding data shows that onconase appears
      to bind to cells with two different affinities, one with a Kd of 6.2 x 10(-8) and
      another of 2.5 x 10(-7) M. Each cell could bind about 3 x 10(5) molecules of
      onconase at each of the two affinity sites. The low affinity Kd is similar to the
      IC50 for onconase toxicity. Onconase also demonstrates a saturability of
      cytotoxicity at a concentration that would saturate the low affinity binding
      site. Incubation at 4 degrees C increased the binding of onconase to cells
      relative to 37 degrees C binding and also increased the sensitivity of cells to
      onconase toxicity, indicating that receptor binding may be an initial step in
      cell toxicity. Onconase cytotoxicity can be blocked by metabolic inhibitors, NaN3
      and 2-deoxyglucose, and cytotoxicity is potentiated 10-fold by monensin.
      Ribonuclease activity appears necessary for onconase toxicity because alkylated
      onconase, which only retains 2% of the ribonuclease activity, was at least 100
      fold less potent in inhibiting protein synthesis in cells. Onconase inhibition of
      protein synthesis in 9L cells coincides with the degradation of cellular 28 S and
      18 S rRNA. In contrast to RNase A, onconase is resistant to two RNase inhibitors,
      placental ribonuclease inhibitor and Inhibit-Ace. Northern hybridization with
      placental ribonuclease inhibitor cDNA probe indicates that 9L glioma cells
      contain endogenous placental ribonuclease inhibitor mRNA. Based on these results,
      we propose that onconase toxicity results from onconase binding to cell surface
      receptors, internalization to the cell cytosol where it degrades ribosomal RNA,
      inhibiting protein synthesis and causing cell death.

PMID- 8486719
TI  - Effect of sequence, adduct type, and opposing lesions on the binding and repair
      of ultraviolet photodamage by DNA photolyase and (A)BC excinuclease.
AB  - The cis,syn and (6-4) products of dipyrimidine sites are the major mutagenic and
      lethal UV photoproducts in DNA. To investigate their relative susceptibilities to
      repair and other factors such as sequence context and lesions in the
      complementary strand that might influence repair efficiencies, we constructed 49
      mer duplexes containing site-specific photoproducts of thymidylyl(3',5')thymidine
      sites at central locations. Using these substrates, we measured the binding of
      Escherichia coli DNA photolyase to cis,syn dimers in four sequence contexts and
      to two cis,syn dimers in close proximity and on opposing strands. We found that
      the sequence within a 10-base pair region had little effect on binding and that
      two enzyme molecules bound to substrate containing two dimers in the 5'-staggered
      orientation, but not in the 3'-staggered one. Similarly, the excision of a
      cis,syn dimer by (A)BC excinuclease was not influenced by the sequence in the
      immediate vicinity of the dimer, and the enzyme was active on 5'-staggered
      cis,syn dimers, but not on 3'-staggered ones. Of special significance, we found
      that (A)BC excinuclease removed the cis,syn, trans,syn-I, (6-4), and Dewar
      photoproducts at vastly differing relative rates of 1:6:9:9, respectively.

PMID- 8486720
TI  - ATP synthases. Structure, reaction center, mechanism, and regulation of one of
      nature's most unique machines.

PMID- 8486721
TI  - A pentapeptide from type I procollagen promotes extracellular matrix production.
AB  - The NH2 and COOH propieces of fibril-forming collagens are cleaved off
      extracellularly and have been implicated in feedback regulation of their own
      synthesis. Recently, we showed that a subfragment of the carboxyl-terminal
      propeptide of type I collagen (residues 197-241) dramatically augments
      extracellular matrix production in subconfluent fibroblasts. This stimulation of
      type I collagen, type III collagen, and fibronectin production occurred in a dose
      and time-dependent manner with no effect on total protein synthesis or on the
      ratio of secreted proteins to cell-associated proteins (Katayama, K., Seyer,
      J.M., Raghow, R., and Kang, A.H. (1991) Biochemistry 30, 7097-7104). In the
      present report, we have extensively dissected this subfragment of the propeptide
      and found that the pentapeptide Lys-Thr-Thr-Lys-Ser (residues 212-216) is the
      minimum sequence necessary for potent stimulation of collagen and fibronectin
      production in a variety of mesenchymal cells. We postulate that the extracellular
      matrix production in fibroblasts may be subject to either positive or negative
      feedback regulation depending on the repertoire of specific proteases during
      postinflammatory tissue regeneration and fibrosis.

PMID- 8486722
TI  - Interaction of myristoylated alanine-rich protein kinase C substrate (MARCKS)
      with membrane phospholipids.
AB  - A major in vivo substrate of Ca(2+)-phospholipid-dependent protein kinase
      (MARCKS) shows phosphorylation-dependent translocation between the cytoplasmic
      and the membrane fractions. The mechanism of the translocation was studied with
      purified MARCKS and various membranes. MARCKS was found to bind to pure
      phospholipid membranes as well as to the synaptic vesicle membranes. Although the
      interaction of MARCKS with the latter was phosphorylation-dependent,
      phosphorylation by protein kinase C showed no significant effect on the binding
      to the phosphatidylcholine liposomes. However, when phosphatidylserine was
      included in the membranes, the association became phosphorylation-dependent. A
      synthetic phosphorylation domain peptide showed a similar phosphorylation
      dependent interaction with the negatively charged liposomes. Phosphatidylserine
      but not phosphatidylcholine inhibited phosphorylation of MARCKS by protein kinase
      C. MARCKS seems to bind to the biomembranes through two binding sites: the N
      terminal myristoyl moiety and the basic phosphorylation domain of amphiphilic
      nature. Phosphorylation of this domain lowers its affinity to phosphatidylserine
      and makes the whole molecule strongly negatively charged, which causes its
      dissociation from the membranes.

PMID- 8486723
TI  - A comparative analysis of the kinetic mechanism and peptide substrate specificity
      of human and Saccharomyces cerevisiae myristoyl-CoA:protein N
      myristoyltransferase.
AB  - Human myristoyl-CoA:protein N-myristoyltransferase (hNmt) catalyzes the transfer
      of myristate from CoA to the amino-terminal Gly residue of a number of cellular
      proteins involved in signal transduction pathways, to structural and
      nonstructural proteins encoded by retroviruses, hepadnaviruses, picornaviruses,
      and reoviruses, as well as to several transforming tyrosine kinases. hNmt has
      been purified 230-fold from an erythroleukemia cell line. The monomeric enzyme
      has no associated methionyl aminopeptidase activity. To determine the enzyme's
      kinetic mechanism, we examined the effect of covariation of subsaturating
      concentrations of myristoyl-CoA and peptide substrate on initial velocity. Double
      reciprocal plots excluded a double displacement (ping-pong) mechanism. Product
      inhibition studies indicated that CoA was a noncompetitive inhibitor against
      myristoyl-CoA and a mixed-type inhibitor against peptide substrates. Together
      these results are consistent with a sequential ordered mechanism where, in a
      typical catalytic cycle, myristoyl-CoA binds to apoenzyme before peptide followed
      by release of the CoA and then myristoylpeptide products. This kinetic mechanism
      is identical to that described for Saccharomyces cerevisiae N-myristoyl
      transferase (Nmt1p) and emphasizes the impact that regulation of myristoyl-CoA
      pool size and accessibility may have in modulating protein N-myristoylation in
      these two species. Comparative studies of the peptide substrate specificities of
      hNmt and Nmt1p using a panel of 12 octapeptides revealed distinct differences in
      their tolerance for amino acid substitutions at positions 3, 4, 7, and 8 of
      parental peptides derived from the amino-terminal sequences of known N-myristoyl
      proteins. This finding contrasts with our recent observation that the acyl-CoA
      substrate specificities of hNmt and Nmt1p are highly conserved and suggests that
      these differences in peptide recognition provide an opportunity to develop
      species-specific enzyme inhibitors.

PMID- 8486725
TI  - Partitioning between N-dealkylation and N-oxygenation in the oxidation of N,N
      dialkylarylamines catalyzed by cytochrome P450 2B1.
AB  - Aminium radicals have been proposed as intermediates in amine N-dealkylations and
      N-oxygenations catalyzed by cytochrome P450 (P450) and some other enzymes. P450s
      can form some N-oxides and hydroxylamines but these are not favored whenever N
      dealkylation is possible. However, if a paradigm involving 1-electron oxidation
      is valid, then some finite level of partitioning of aminium radicals between N
      oxygenation and N-dealkylation might be expected in all cases. Methods were
      developed for the selective and sensitive measurement of N,N-dialkylaniline N
      oxides using high performance liquid chromatography, radiochromatography, and
      TiCl3 reduction. These N-oxides were relatively stable in the presence of P450
      2B1. In the presence of NADPH and NADPH-P450 reductase some reduction to N,N
      dialkylamines occurred, along with N-dealkylation (to monoalkylanilines); there
      was also slow N-dealkylation in the absence of NADPH, which is interpreted in
      terms of homolytic scission of the N-O bond; N,N-dialkylanilines were not formed
      nor did the N-oxides support other oxygenation reactions. P450 2B1 (with its
      reductase and NADPH) formed N-oxides at low rates from several N,N-dialkylaniline
      derivatives, including N,N-dimethylaniline, N,N-diethylaniline, N-ethyl-N
      methylaniline, 4-methyl-N,N-dimethylaniline, 4-cyano-N,N-dimethylaniline, N
      phenylpyrrolidine, and N,N-dimethyl-2-aminofluorene. The ratio of N
      dealkylation:N-oxygenation varied from 1020 to 6 in this series. These results
      are consistent with the view that aminium radicals are a branch point in N
      oxygenation and N-dealkylation reactions catalyzed by metalloproteins, although
      some alternate explanations cannot be ruled out. While N-dealkylation is the
      dominant process in all of the P450-catalyzed amine oxidations, there should be a
      finite partition ratio between these reactions depending upon the particular
      enzyme and substrate. The N-oxygenation reaction is probably more complex than a
      direct radical recombination event and is postulated to involve one or more
      intermediates.

PMID- 8486724
TI  - Phytanic acid alpha-oxidation. Differential subcellular localization in rat and
      human tissues and its inhibition by nycodenz.
AB  - The subcellular site of oxidation of [1-14C]phytanic acid to pristanic acid and
      CO2 was examined by measurement of the release of 14CO2 in different organelles
      from human and rat tissues prepared by isopycnic density gradient centrifugation
      in Nycodenz. The activity of phytanic acid oxidation in human tissues (liver and
      cultured skin fibroblasts) paralleled that of the peroxisomal marker catalase. We
      also observed that Nycodenz (commonly used gradient material for isolation of
      subcellular organelles) has a strong inhibitory effect on the alpha-oxidation of
      phytanic acid. This inhibition is reversible and can be decreased or eliminated
      by dialysis of isolated organelles against isotonic solution. The dialysis of
      endoplasmic reticulum, mitochondrial, and peroxisomal fractions from human liver
      and cultured skin fibroblasts for 2 h against isotonic solution increased the
      specific activity of phytanic acid oxidation by 1.3-, 1.3-, and 5-21-fold,
      respectively, after removal of Nycodenz as compared with nondialyzed samples.
      After dialysis, the rate of oxidation of phytanic acid in peroxisomes from human
      liver and cultured skin fibroblasts was 4-26 times higher than that in
      mitochondria and 43-130 times than that in the endoplasmic reticulum, suggesting
      that, in human tissues, phytanic acid is oxidized to pristanic acid in
      peroxisomes. On the other hand, the oxidation of phytanic acid in rat liver
      paralleled the distribution of the mitochondrial marker cytochrome-c oxidase. The
      18-fold higher rate of oxidation in dialyzed mitochondria (198.6 +/- 4.20
      pmol/h/mg of protein) than in peroxisomes (11.0 +/- 0.5 pmol/h/mg of protein)
      demonstrates that, in rodents, phytanic acid is oxidized in mitochondria. 2-[5-(4
      Chlorophenyl)pentyl]oxiran-2-carboxylic acid, an inhibitor of carnitine
      palmitoyltransferase I and mitochondrial fatty acid oxidation, inhibits the
      oxidation of phytanic acid in rat tissues (liver and cultured skin fibroblasts),
      whereas it has no effect on the oxidation of phytanic acid in human tissues
      (liver and cultured skin fibroblasts). The higher specific activity of phytanic
      acid oxidation in peroxisomes compared with that in mitochondria and the
      endoplasmic reticulum from human tissues and the inhibition of phytanic acid
      oxidation by 2-[5-(4-chlorophenyl)pentyl]oxiran-2-carboxylic acid in rat tissues
      (but not human tissues) demonstrate clearly that, in human tissues, phytanic acid
      is predominantly oxidized in peroxisomes.

PMID- 8486726
TI  - Role of endothelium in the responses to noradrenaline in normal and sensitized
      guinea-pig aorta.
AB  - 1. The pharmacological reactivity of sensitized blood vessels has been less
      studied than that of the airways. Aorta rings were obtained from normal (non
      sensitized) and actively sensitized guinea-pigs, and prepared for isometric
      recording of tension changes. 2. Noradrenaline (10 nM-0.1 mM), histamine (0.1
      microM-0.1 mM) and KCl (10-100 mM) produced concentration-related contractions of
      normal tissues. Removal of endothelium resulted in a marked leftward and upward
      shift of the concentration-response curve for noradrenaline but it did not alter
      histamine- or KCl-induced responses. Pretreatment with L-NG-nitroarginine (L
      NOARG, 30 microM), haemoglobin (5 microM) or ibuprofen (10 microM) enhanced
      noradrenaline-induced responses without affecting those to histamine or KCl. 3.
      Removal of endothelium or pretreatment with L-NOARG or ibuprofen did not alter
      agonist-induced responses in sensitized tissues. Acetylcholine (1 microM)-induced
      relaxation of the contraction produced by noradrenaline (1 microM) in intact
      rings was diminished in sensitized compared to normal tissues. 4. Neuronal uptake
      and release of [3H]-noradrenaline did not differ in normal and sensitized
      tissues. 5. Loss of the modulatory role of endothelium and other mechanisms may
      be involved in the hyperreactivity of sensitized guinea-pig aorta.

PMID- 8486727
TI  - Mechanisms involved in the increased vascular resistance in hypertension.

PMID- 8486728
TI  - Relationship between local myocardial adenylyl cyclase activity and local
      coronary blood flow in the dog heart.
AB  - 1. This study tested the hypothesis that heterogeneity of myocardial adenylyl
      cyclase activity exists and contributes to the heterogeneity of blood flow in
      canine myocardium, in which flow varies in different areas at any one moment or
      in a single area at different times. 2. Tissue adenylyl cyclase activity was
      measured simultaneously with coronary blood flow in the left ventricle of eight
      anaesthetized open-chest dogs. Coronary flow was measured using radioactive
      microspheres under control conditions and after sympathetic stimulation. The
      ventricle was cut into 15 subepicardial and 15 subendocardial sections in which
      both flow and adenylyl cyclase (basal and forskolin-stimulated) activity were
      assayed. 3. Control coronary flow was 73.1 +/- 19.9 ml min-1 100 g-1 and ansa
      subclavia nerve stimulation increased flow to 93.2 +/- 26.1. Baseline adenylyl
      cyclase activity averaged 51.9 +/- 38.8 pmol min-1 mg protein-1, while forskolin
      stimulated activity was 588.2 +/- 393.6. Method variability was approximately 10%
      of the mean, much less than the biological variability of 70%. 4. Regression
      analysis of control flow vs baseline adenylyl cyclase activity produced the
      equation: flow = 0.25 (Adenylyl Cyclase)+60.6, (r = 0.47, P < 0.0001). The
      equation for stimulated flow vs stimulated adenylyl cyclase was: flow = 0.03
      (Adenylyl Cyclase)+73.1, (r = 0.51, P < 0.0001). 5. Thus, significant
      heterogeneity of tissue adenylyl cyclase activity existed in the heart. There was
      also a direct linear relationship between adenylyl cyclase activity and coronary
      flow heterogeneity in canine left ventricle.

PMID- 8486729
TI  - Nomenclature of the desmosomal cadherins.

PMID- 8486730
TI  - The molecular organization of tight junctions.

PMID- 8486731
TI  - The 220-kD protein colocalizing with cadherins in non-epithelial cells is
      identical to ZO-1, a tight junction-associated protein in epithelial cells: cDNA
      cloning and immunoelectron microscopy.
AB  - We previously identified a 220-kD constitutive protein of the plasma membrane
      undercoat which colocalizes at the immunofluorescence microscopic level with
      cadherins and occurs not only in epithelial M., S. Yonemura, A. Nagafuchi, Sa.
      Tsukita, and Sh. Tsukita. 1991. J. Cell Biol. 115:1449-1462). To clarify the
      nature and possible functions of this protein, we cloned its full-length cDNA and
      sequenced it. Unexpectedly, we found mouse 220-kD protein to be highly homologous
      to rat protein ZO-1, only a part of which had been already sequenced. This
      relationship was confirmed by immunoblotting with anti-ZO-1 antibody. As protein
      ZO-1 was originally identified as a component exclusively underlying tight
      junctions in epithelial cells, where cadherins are not believed to be localized,
      we analyzed the distribution of cadherins and the 220-kD protein by ultrathin
      cryosection immunoelectron microscopy. We found that in non-epithelial cells
      lacking tight junctions cadherins and the 220-kD protein colocalize, whereas in
      epithelial cells (e.g., intestinal epithelial cells) bearing well-developed tight
      junctions cadherins and the 220-kD protein are clearly segregated into adherens
      and tight junctions, respectively. Interestingly, in epithelial cells such as
      hepatocytes, which tight junctions are not so well developed, the 220-kD protein
      is detected not only in the tight junction zone but also at adherens junctions.
      Furthermore, we show in mouse L cells transfected with cDNAs encoding N-, P-, E
      cadherins that cadherins interact directly or indirectly with the 220-kD protein.
      Possible functions of the 220-kD protein (ZO-1) are discussed with special
      reference to the molecular mechanism for adherens and tight junction formation.

PMID- 8486732
TI  - NDC10: a gene involved in chromosome segregation in Saccharomyces cerevisiae.
AB  - A mutant, ndc10-1, was isolated by anti-tubulin staining of temperature-sensitive
      mutant banks of budding yeast. ndc10-1 has a defect chromosome segregation since
      chromosomes remains at one pole of the anaphase spindle. This produces one
      polyploid cell and one aploid cell, each containing a spindle pole body (SPD.
      NDC10 was cloned and sequenced and is identical to CBF2 (Jiang, W., J. Lechnermn
      and J. Carbon. 1993. J. Cell Biol. 121:513) which is the 110-kD component of a
      centromere DNA binding complex (Lechner, J., and J. Carbon. 1991. Cell. 61:717
      725). NDC10 is an essential gene. Antibodies to Ndc10p labeled the SPB region in
      nearly all the cells examined including nonmitotic cells. In some cells with
      short spindles which may be in metaphase, staining was also observed along the
      spindle. The staining pattern and the phenotype of ndc10-1 are consistent with
      Cbf2p/Ndc10p being a kinetochore protein, and provide in vivo evidence for its
      role in the attachment of chromosomes to the spindle.

PMID- 8486733
TI  - Isolation and characterization of a gene (CBF2) specifying a protein component of
      the budding yeast kinetochore.
AB  - We have cloned and determined the nucleotide sequence of the gene (CBF2)
      specifying the large (110 kD) subunit of the 240-kD multisubunit yeast centromere
      binding factor CBF3, which binds selectively in vitro to yeast centromere DNA and
      contains a minus end-directed microtubule motor activity. The deduced amino acid
      sequence of CBF2p shows no sequence homologies with known molecular motors,
      although a consensus nucleotide binding site is present. The CBF2 gene is
      essential for viability of yeast and is identical to NDC10, in which a
      conditional mutation leads to a defect in chromosome segregation (Goh, P.-Y., and
      J. V. Kilmartin, in this issue of The Journal of Cell Biology). The combined in
      vitro and in vivo evidence indicate that CBF2p is a key component of the budding
      yeast kinetochore.

PMID- 8486734
TI  - Assembly of vaccinia virus: role of the intermediate compartment between the
      endoplasmic reticulum and the Golgi stacks.
AB  - Vaccinia virus, the prototype of the Poxviridae, is a large DNA virus which
      replicates in the cytoplasm of the host cell. The assembly pathway of vaccinia
      virus displays several unique features, such as the production of two
      structurally distinct, infectious forms. One of these, termed intracellular naked
      virus (INV), remains cells associated while the other, termed extracellular
      enveloped virus (EEV), is released from the cell. In addition, it has long been
      believed that INVs acquire their lipid envelopes by a unique example of de novo
      membrane biogenesis. To examine the structure and assembly of vaccinia virus we
      have used immunoelectron microscopy using antibodies to proteins of different
      subcellular compartments as well as a phospholipid analysis of purified INV and
      EEV. Our data are not consistent with the de novo model of viral membrane
      synthesis but rather argue that the vaccinia virus DNA becomes enwrapped by a
      membrane cisterna derived from the intermediate compartment between the ER and
      the Golgi stacks, thus acquiring two membranes in one step. Phospholipid analysis
      of purified INV supports its derivation from an early biosynthetic compartment.
      This unique assembly process is repeated once more when the INV becomes enwrapped
      by an additional membrane cisterna, in agreement with earlier reports. The
      available data suggest that after fusion between the outer envelope and the
      plasma membrane, mature EEV is released from the cell.

PMID- 8486735
TI  - Membrane flux through the pore formed by a fusogenic viral envelope protein
      during cell fusion.
AB  - We have investigated the mechanism of cell fusion mediated by HA, the fusogenic
      hemagglutinin of the Influenza viral envelope. Single erythrocytes (RBCs) were
      attached to fibroblasts expressing the HA on their cell surface, and fusion of
      the paired cells was triggered by rapid acidification. The RBC membrane was
      stained with fluorescent lipid, and the fusion-induced escape of lipid into the
      fibroblast was observed by quantitative image analysis. At the same time, the
      formation of an aqueous connection (i.e., the fusion pore) between the two cells
      was monitored electrically. Within minutes after acidification, an electrical
      conductance between the two cells appeared abruptly as the fusion pore opened,
      and then increased gradually as the pore dilated. Later, fluorescent lipid
      diffused into the fibroblast, approaching equilibrium over the next 5-20 min. No
      lipid flux was seen while the pore conductance remained 0.5 nS or less. Evidently
      lipid flux requires a threshold pore size. Our finding suggests that the smallest
      and earliest fusion pores are surrounded by a ring of protein. A fusion pore
      expands by breaking this ring and recruiting lipid into its circumference.

PMID- 8486737
TI  - A novel cytoskeletal structure involved in purse string wound closure and cell
      polarity maintenance.
AB  - The process of wound repair in monolayers of the intestinal epithelial cell line,
      Caco-2BBe, was analyzed by a combination of time-lapse differential interference
      contrast (DIC) video and immunofluorescence microscopy, and laser scanning
      confocal immunofluorescence microscopy (LSCIM). DIC video analysis revealed that
      stab wounds made in Caco-2BBe monolayers healed by two distinct processes: (a)
      Extension of lamellipodia into the wounds; and (b) Purse string closure of the
      wound by distinct arcs or rings formed by cells bordering the wound. The arcs and
      rings which effected purse string closure appeared sharp and sheer in DIC,
      spanned between two and eight individual cells along the wound border, and
      contracted in a concerted fashion. Immunofluorescence analysis of the wounds
      demonstrated that the arcs and rings contained striking accumulations of actin
      filaments, myosin-II, villin, and tropomyosin. In contrast, arcs and rings
      contained no apparent enrichment of microtubules, brush border myosin-I
      immunogens, or myosin-V. LSCIM analysis confirmed the localization of actin
      filaments, myosin-II, villin, and tropomyosin in arcs and rings at wound borders.
      ZO-1 (a tight junction protein), also accumulated in arcs and rings around
      wounds, despite the fact that cell-cell contacts are absent at wound borders.
      Sucrase-isomaltase, an apically-localized integral membrane protein, maintained
      an apical localization in cells where arcs or rings were formed, but was found in
      lamellipodia extending into wounds in cells where arcs failed to form. Time
      course, LSCIM quantification of actin, myosin II, and ZO-1 revealed that
      accumulation of these proteins within arcs and rings at the wound edge began
      within 5 minutes and peaked within 30-60 minutes of wounding. Actin filaments,
      myosin-II, and ZO-1 achieved 10-, 3-, and 4-fold enrichments, respectively,
      relative to cell edges which did not border wounds. The results demonstrate that
      wounded Caco-2BBe monolayers assemble a novel cytoskeletal structure at the
      borders of wounds. The results further suggest that this structure plays at least
      two roles in wound repair; first, mediation of concerted, purse string movement
      of cells into the area of the wound and second, maintenance of apical/basolateral
      polarity in cells which border the wound.

PMID- 8486736
TI  - Rab17, a novel small GTPase, is specific for epithelial cells and is induced
      during cell polarization.
AB  - The rab subfamily of small GTPases has been demonstrated to play an important
      role in the regulation of membrane traffic in eukaryotic cells. Compared with
      nonpolarized cells, epithelial cells have distinct apical and basolateral
      transport pathways which need to be separately regulated. This raises the
      question whether epithelial cells require specific rab proteins. However, all rab
      proteins identified so far were found to be equally expressed in polarized and
      nonpolarized cells. Here we report the identification of rab17, the first
      epithelial cell-specific small GTPase. Northern blot analysis on various mouse
      organs, revealed that the rab17 mRNA is present in kidney, liver, and intestine
      but not in organs lacking epithelial cells nor in fibroblasts. To determine
      whether rab17 is specific for epithelial cells we studied its expression in the
      developing kidney. We found that rab17 is absent from the mesenchymal precursors
      but is induced upon their differentiation into epithelial cells. In situ
      hybridization studies on the embryonic kidney and intestine revealed that rab17
      is restricted to epithelial cells. By immunofluorescence and immunoelectron
      microscopy on kidney sections, rab17 was localized to the basolateral plasma
      membrane and to apical tubules. Rab proteins associated with two distinct
      compartments have been found to regulate transport between them. Therefore, our
      data suggest that rab17 might be involved in transcellular transport.

PMID- 8486738
TI  - Flightin, a novel myofibrillar protein of Drosophila stretch-activated muscles.
AB  - The indirect flight muscles of Drosophila are adapted for rapid oscillatory
      movements which depend on properties of the contractile apparatus itself. Flight
      muscles are stretch activated and the frequency of contraction in these muscles
      is independent of the rate of nerve impulses. Little is known about the molecular
      basis of these adaptations. We now report a novel protein that is found only in
      flight muscles and has, therefore, been named flightin. Although we detect only
      one gene (in polytene region 76D) for flightin, this protein has several isoforms
      (relative gel mobilities, 27-30 kD; pIs, 4.6-6.0). These isoforms appear to be
      created by posttranslational modifications. A subset of these isoforms is absent
      in newly emerged adults but appears when the adult develops the ability to fly.
      In intact muscles flightin is associated with the A band of the sarcomere, where
      evidence suggests it interacts with the myosin filaments. Computer database
      searches do not reveal extensive similarity to any known protein. However, the
      NH2-terminal 12 residues show similarity to the NH2-terminal sequence of actin, a
      region that interacts with myosin. These features suggest a role for flightin in
      the regulation of contraction, possibly by modulating actin-myosin interaction.

PMID- 8486739
TI  - The Ca(2+)-binding domains in non-muscle type alpha-actinin: biochemical and
      genetic analysis.
AB  - Dictyostelium alpha-actinin is a Ca(2+)-regulated F-actin cross-linking protein.
      To test the inhibitory function of the two EF hands, point mutations were
      introduced into either one or both Ca(2+)-binding sites. After mutations, the two
      EF hands were distinguishable with respect to their regulatory activities.
      Inactivation of EF hand I abolished completely the F-actin cross-linking activity
      of Dictyostelium discoideum alpha-actinin but Ca2+ binding by EF hand II was
      still observed in a 45Ca2+ overlay assay. In contrast, after mutation of EF hand
      II the molecule was still active and inhibited by Ca2+; however, approximately
      500-fold more Ca2+ was necessary for inhibition and 45Ca2+ binding could not be
      detected in the overlay assay. These data indicate that EF hand I has a low
      affinity for Ca2+ and EF hand II a high affinity, implying a regulatory function
      of EF hand I in the inhibition of F-actin cross-linking activity. Biochemical
      data is presented which allows us to distinguish two functions of the EF hand
      domains in D. discoideum alpha-actinin: (a) at the level of the EF-hands, the
      Ca(2+)-binding affinity of EF hand I was increased by EF hand II in a cooperative
      manner, and (b) at the level of the two subunits, the EF hands acted as an on/off
      switch for actin-binding in the neighboring subunit. To corroborate in vitro
      observations in an in vivo system we tried to rescue the abnormal phenotype of a
      mutant (Witke, W., M. Schleicher, A. A. Noegel. 1992. Cell. 68:53-62) by
      introducing the mutated alpha-actinin cDNAs. In agreement with the biochemical
      data, only the molecule modified in EF hand II could rescue the abnormal
      phenotype. Considering the fact that the active construct is "always on" because
      it requires nonphysiological, high Ca2+ concentrations for inactivation, it is
      interesting to note that an unregulated alpha-actinin was able to rescue the
      mutant phenotype.

PMID- 8486740
TI  - Expression of plectin mutant cDNA in cultured cells indicates a role of COOH
      terminal domain in intermediate filament association.
AB  - Plectin is an intermediate filament (IF) binding protein of exceptionally large
      size. Its molecular structure, revealed by EM and predicted by its sequence,
      indicates an NH2-terminal globular domain, a long rodlike central domain, and a
      globular COOH-terminal domain containing six highly homologous repeat regions. To
      examine the role of the various domains in mediating plectin's interaction with
      IFs, we have constructed rat cDNAs encoding truncated plectin mutants under the
      control of the SV-40 promoter. Mutant proteins expressed in mammalian COS and
      PtK2 cells could be distinguished from endogenous wild type plectin by virtue of
      a short carboxy-terminal antigenic peptide (P tag). As shown by conventional and
      confocal immunofluorescence microscopy, the transient expression of plectin
      mutants containing all six or the last four of the repeat regions of the COOH
      terminus, or the COOH-terminus and the rod, associated with IF networks of both
      the vimentin and the cytokeratin type and eventually caused their collapse into
      perinuclear aggregates. Similar effects were observed upon expression of a
      protein encoded by a full length cDNA construct. Microtubules and microfilaments
      were unaffected. Unexpectedly, mutants containing the rod without any of the COOH
      terminal repeats, accumulated almost exclusively within the nuclei of cells. When
      the rod was extended by the first one and a half of the COOH-terminal repeats,
      mutant proteins showed a partial cytoplasmic distribution, although association
      with intermediate filaments was not observed. Nuclear and diffuse cytoplasmic
      distribution was also observed upon expression of the NH2-terminal domain without
      rod. These results indicate that sequences located roughly within the last two
      thirds of the globular COOH-terminus are indispensable for association of plectin
      with intermediate filaments in living cells.

PMID- 8486742
TI  - Mouse notch: expression in hair follicles correlates with cell fate
      determination.
AB  - Many vertebrate tissues, including skin, are known to develop as a consequence of
      epithelial-mesenchymal interactions. Much less is known about the role of cell
      cell interaction within the epithelial or the mesenchymal compartments in
      morphogenesis. To investigate cell-cell interactions during skin development, and
      the potential role of the Notch homolog in this process, we cloned the mouse
      homolog of Notch (mNotch) and studied its expression pattern, starting as early
      as mesoderm formation. The novel application of double-labeled in situ
      hybridization in vertebrates allowed high resolution analysis to follow the fate
      of mNotch expressing cells directly. In comparison with the distribution of Id
      mRNA, analysis confirmed that in the hair follicle high levels of mNotch are
      expressed exclusively in the epithelial compartment. Hair follicle matrix cells
      start expressing mNotch as different cell types become distinguishable in the
      developing follicle. mNotch mRNA expression persists throughout the growth phase
      of the follicle and maintains the same expression profile in the second hair
      cycle. The cells in the follicle that undergo a phase of high level mNotch
      expression are in transition from mitotic precursors to several discreet,
      differentiating cell types. Our observations point out that both in time (during
      development) and in space (by being removed one cell layer from the dermal
      papilla) mNotch expression is clearly separated from the inductive interactions.
      This is a novel finding and suggests that mNotch is important for follicular
      differentiation and possibly cell fate selection within the follicle.

PMID- 8486741
TI  - Essential roles for calcium and calmodulin in G2/M progression in Aspergillus
      nidulans.
AB  - nimT encodes a protein in Aspergillus nidulans that is required for tyrosine
      dephosphorylation of p34cdc2 and has a strong homology to cdc25-type proteins.
      Conditional mutation of nimT (nimT23 mutation) arrests cells in G2 at the
      restrictive temperature. After release of the temperature-sensitive nimT23 block,
      p34cdc2 undergoes tyrosine dephosphorylation and we showed that as cells entered
      mitosis, a rapid increase in calmodulin was observed. The increase in calmodulin
      and progression into mitosis were prevented by reducing extracellular Ca2+ levels
      to 2 nM. The calmodulin gene of a nimT23-containing strain was replaced with a
      hybrid gene in which calmodulin transcription was regulated by the alcA promoter
      (AlcCaM/T23). This allowed experimental manipulation of the level of
      intracellular calmodulin by the carbon source in the medium. When either
      extracellular Ca2+ or intracellular calmodulin levels were reduced at the nimT23
      G2 arrest point, p34cdc2 remained tyrosine phosphorylated but the mitotic NIMA
      kinase encoded by nimA was not activated. Release of the temperature sensitive
      nimT23 arrest when either extracellular Ca2+ or calmodulin concentrations were
      low blocked tyrosine dephosphorylation of p34cdc2, activation of NIMA and
      progression of cells into mitosis. However, reduced levels of either Ca2+ or
      calmodulin had no effect on the increase in histone H1 kinase activity associated
      with p13 beads or the degree of phosphorylation of the majority of MPM-2-reacting
      proteins following release of the nimT23 mutation. These results demonstrate that
      both Ca2+ and calmodulin are important for progression into mitosis from the
      nimT23 arrest point in a pathway involving activation of both NIMA and p34cdc2
      protein kinases.

PMID- 8486744
TI  - Column liquid chromatographic determination of flavanone glycosides in Citrus.
      Application to grapefruit and sour orange juice adulterations.
AB  - Six flavone glycosides were separated by HPLC using RP-18 with a quaternary
      mobile phase mixture [water-acetonitrile-tetrahydrofuran-acetic acid (80:16:3:1,
      v/v)]. This procedure was applied to the separation and determination of the most
      important flavanone glycosides contained in pure grapefruit and sour orange
      juices and mixtures. This method can be used for quality control of industrial
      concentrates and juices.

PMID- 8486743
TI  - Involvement of ras p21 in neurotrophin-induced response of sensory, but not
      sympathetic neurons.
AB  - Little is known about the signal transduction mechanisms involved in the response
      to neurotrophins and other neurotrophic factors in neurons, beyond the activation
      of the tyrosine kinase activity of the neurotrophin receptors belonging to the
      trk family. We have previously shown that the introduction of the oncogene
      product ras p21 into the cytoplasm of chick embryonic neurons can reproduce the
      survival and neurite-outgrowth promoting effects of the neurotrophins nerve
      growth factor (NGF) and brain-derived neurotrophic factor (BDNF), and of ciliary
      neurotrophic factor (CNTF). To assess the potential signal-transducing role of
      endogenous ras p21, we introduced function-blocking anti-ras antibodies or their
      Fab fragments into cultured chick embryonic neurons. The BDNF-induced neurite
      outgrowth in E12 nodose ganglion neurons was reduced to below control levels, and
      the NGF-induced survival of E9 dorsal root ganglion (DRG) neurons was inhibited
      in a specific and dose-dependent fashion. Both effects could be reversed by
      saturating the epitope-binding sites with biologically inactive ras p21 before
      microinjection. Surprisingly, ras p21 did not promote the survival of NGF
      dependent E12 chick sympathetic neurons, and the NGF-induced survival in these
      cells was not inhibited by the Fab-fragments. The survival effect of CNTF on ras
      responsive ciliary neurons could not be blocked by anti-ras Fab fragments. These
      results indicate an involvement of ras p21 in the signal transduction of
      neurotrophic factors in sensory, but not sympathetic or ciliary neurons, pointing
      to the existence of different signaling pathways not only in CNTF-responsive, but
      also in neurotrophin-responsive neuronal populations.

PMID- 8486745
TI  - Recognition of enantiomers by Chirasil-Val and oligopeptide analogues as studied
      by gas-phase calorimetry and 1H NMR spectroscopy in solution.
AB  - A series of oligopeptides, L-Valn-NHtBu (n = 1-4), were linked to poly(beta
      methyl)siloxy-alpha-methylpropanoic acid copolymer; the resulting chirally
      modified polydimethylsiloxanes were used for the resolution of enantiomers by gas
      chromatography. Chiral recognition proved most effective for n = 1 (known as
      Chirasil-Val), as judged from the resolution factors (alpha) and the
      thermodynamic parameters delta delta H, delta delta S and chi = delta delta
      H/delta H', where delta H' = delta HChir -delta HSE30. Likewise, 1H NMR
      spectroscopy in carbon tetrachloride solution revealed a maximum chemical shift
      non-equivalence of the amide N-H signal of racemic N-TFA-amino acid methyl esters
      on addition of the chiral polymer, for n = 1. From circular dichroism
      spectroscopy of L-Valn-NH'Bu (n = 2, 3, 4 and 6) and polyoxyethylene-bound
      pivaloyl-L-Valn-Gly-NH-POE3000 (n = 2-8), it is concluded that the peptide moiety
      of the stationary phase mostly adopts the unfavourable random coil conformation,
      whereas the beta-sheet structure was only partially found and only for n > or =
      6.

PMID- 8486746
TI  - Effect of stationary phase solvation on shape selectivity in reversed-phase high
      performance liquid chromatography.
AB  - The effect of stationary phase solvation on reversed-phase chromatographic shape
      selectivity has been investigated using n-hexanol as an additive to methanol
      water mobile phases. A wide range of mobile phase compositions was evaluated to
      normalize for solvent strength selectivity differences. Monomeric C18 stationary
      phases of both high and low bonding density were synthesized and used to
      correlate selectivity changes caused by stationary phase ordering with those seen
      by the addition of n-hexanol. The temperature dependence of retention and
      selectivity was also investigated using Van 't Hoff plots, which provided insight
      into the nature of selectivity behavior for estrogens and polyaromatic
      hydrocarbons. The results showed that using n-hexanol as a mobile phase additive
      did not provide higher shape selectivity, suggesting that changes in the
      solvation of the stationary phase did not impart a significant change in the
      level of surface ordering or morphology. However, n-hexanol did impart solvent
      selectivity changes in the separation of estrogen diastereomers that could prove
      useful in future methods development schemes.

PMID- 8486747
TI  - Characterization of N-ethoxycarbonyl ethyl esters of amino acids by mass
      spectrometry.
AB  - Derivatization of amino acids by using ethyl chloroformate-ethanol-pyridine
      provides volatile products, N-ethoxycarbonyl amino acid ethyl esters (ECEEs),
      which are easily amenable to GC or GC-MS analysis. MS behavior of these compounds
      under electron-impact has been studied. The fragments observed in the spectra
      facilitate recognition of commonly occurring protein amino acids and
      characterization of unknown analogues.

PMID- 8486748
TI  - Separation of cardiac glycosides by micellar electrokinetic capillary
      electrophoresis.
AB  - The separation of mixtures of primary and secondary cardiac glycosides by
      micellar electrokinetic capillary electrophoresis modified by cyclodextrins, urea
      and sodium cholate proved to be suitable for the determination of these
      hydrophobic compounds. It was possible to distinguish the two anomeric
      cardenolides glucodigifucoside and glucodigiglucomethyloside with all three
      buffer systems. Electropherograms of crude plant cell extracts from Digitalis
      lanata were obtained with this method.

PMID- 8486749
TI  - The 1990 Montana initiative to increase cigarette taxes: lessons for other states
      and localities.
AB  - In November 1990, voters in Montana defeated an initiative that would have
      increased the state's excise tax on a pack of cigarettes by 25 cents. The
      increased revenues were intended for tobacco education and research. Opponents of
      the measure, primarily tobacco companies, outspent proponents by more than 35 to
      1. Their primary themes were opposition to new taxes and to a larger state
      bureaucracy. Based on the results of initiative campaigns in Montana and
      California, taxation initiatives are more likely to succeed if guidance is sought
      from leaders of similar campaigns in other states, tobacco control coalitions are
      built and funding secured early, and polling conducted before initiative measures
      are finalized. Other requirements for success include careful wording of the
      initiative, strong leadership, consideration of a paid petition drive, effective
      use of the news media, anticipating opposition arguments, and emphasizing the
      benefits of the tax increase in the campaign.

PMID- 8486750
TI  - Longitudinal observations on a selected group of local health departments: a
      preliminary report.
AB  - A study is in progress to document changes in selected public health departments
      over the past decade and to use those observations for proposing an assessment
      protocol that may be helpful in measuring progress toward achieving one of the
      Health Objectives for the Nation for the Year 2000. Objective no. 8.14 reads:
      "Increase to at least 90 percent the proportion of people served by a local
      health department that is effectively carrying out the core functions of public
      health." The study re-surveys a group of 14 departments that were the subjects of
      intensive case studies between 1979 and 1981. Some preliminary observations from
      follow-up study of these departments in 1992 include: growth in budget and staff
      and even larger growth in pressure for services, especially for personal health
      care; reorganization that splits away some programs of comprehensive ambulatory
      care and responsibility for public hospitals, while increasing the aggregation of
      human service agencies, including public health, under locally organized umbrella
      agencies; increase in preventive, screening, and categorical programs under
      public health sponsorship; drastic change in patterns of financing, featuring
      nearly total loss of direct federal grants, and increase in fee income; increase
      in the number of community and migrant health centers in the public health
      jurisdictions under study; diminished collaborative interaction with private
      practitioners; and continued close collaboration between health departments and
      community health centers in several communities. The implications of these
      changes are discussed. Subsequent reports will be based on efforts to measure the
      impact of specific events of the 1980s on public health performance, and will
      describe experience with a community-based surveillance approach for assessing
      public health performance.

PMID- 8486751
TI  - The evolution, impact and significance of the healthy cities/healthy communities
      movement.
AB  - The Healthy Cities movement, or Healthy Communities as it is known in some parts
      of the world, has grown rapidly since it was launched in 1986. In addition to the
      35 cities formally associated with the WHO Europe project, there are now 18
      national networks and hundreds of towns and cities actively involved in Europe,
      North America, and, increasingly, the developing world. This article reviews the
      concept, its evolution and current practice, considers some of the problems in
      applying the concept, and speculates on its potential future development.

PMID- 8486752
TI  - Exporting asbestos: disease and policy in the developing world.
AB  - The health effects of asbestos are well known, with lung cancer, mesothelioma and
      asbestosis recognized as the most common causes of mortality and morbidity among
      exposed populations. Recognition of these hazards coupled with an explosion of
      litigation against asbestos manufacturers brought by injured workers has resulted
      in declining markets for this commodity in the U.S. and other Western
      democracies. With Western markets for asbestos decreasing, the developing world
      has become the target of asbestos exporters in an attempt to revitalize an
      industry in decline. This paper discusses the trends in worldwide asbestos
      markets over the last two decades and the serious health implications of policies
      directed at establishing viable markets for this commodity in developing nations.

PMID- 8486753
TI  - Persisting health inequalities: social class differentials in illness in the
      Scandinavian countries.
AB  - Finland, Norway and Sweden are highly developed welfare states with a long
      tradition of egalitarian health and welfare policies. This article analyzes
      social class differentials in self-reported limiting long-standing illness among
      men and women in these countries. The data consisted of nation-wide Level of
      Living Surveys made in 1986-87 in Finland (N = 11,783), Norway (N = 4,211) and
      Sweden (N = 4,699). Women reported both long-standing illness and limiting long
      standing illness slightly more often than men. The prevalence of limiting long
      standing illness was lower in Sweden than in Finland and Norway. In all countries
      blue-collar workers reported ill-health more often than white-collar employees.
      The prevalence of self-reported limiting long-standing illness among Swedish
      upper white-collar workers was very low and that among Finnish farmers very high.
      Skilled female workers showed the worst health whereas Swedish upper class men
      showed the best health. The reasons for these social inequalities, and their
      implications for social policy, are discussed.

PMID- 8486754
TI  - Socioeconomic differences in fetal and infant mortality in Scandinavia.
AB  - This study demonstrates that socioeconomic differences do exist in all three
      Scandinavian countries, and these differences have implications for perinatal and
      infant survival. Using parental education as a proxy for socioeconomic
      conditions, the association with perinatal survival seems to be stronger in
      Denmark and Norway than in Sweden. For postneonatal mortality the association is
      equally strong in the three countries. Data from one of the countries (Norway)
      demonstrates the joint importance of parental education, and the association with
      paternal education is equally strong as that with maternal education. If father
      and mother have the lowest level of education, their offspring has 50 to 80%
      higher perinatal and infant mortality risks. These observations call for further
      research into the association between social variables and health in order to
      tease out causal relationships which might lead to future preventive actions.

PMID- 8486755
TI  - Free exchange of medical supplies, information, and personnel with Cuba. American
      Public Health Association.

PMID- 8486756
TI  - Regional conflicts and their threat to world peace. Coordinating Committee, World
      Council of Health Worker Organizations for Social Well-Being, Health and Peace.

PMID- 8486757
TI  - AMP and microamps: neutrophil-derived chloride secretagogue identified.

PMID- 8486758
TI  - Pulmonary neuroendocrine cells and lung development: dim outlines emerge.

PMID- 8486759
TI  - Importance of factor Xa in determining the procoagulant activity of whole-blood
      clots.
AB  - The binding of thrombin to fibrin is thought to be an important mechanism by
      which thrombi exhibit procoagulant activity; however, the extent to which other
      procoagulants are associated with thrombi has not been previously defined. This
      study was designed to determine whether clotting factors other than thrombin are
      bound to whole-blood clots and can thereby contribute to significant procoagulant
      activity. Clots formed in vitro from human blood exhibited minimal thrombin
      activity when incubated in plasma depleted of vitamin K-dependent factors by
      barium-citrate adsorption, as indicated by increases in the concentration of
      fibrinopeptide A (FPA), a marker of fibrin formation, to 72 nM after 30 min.
      Incubation of clots in barium-absorbed plasma repleted with 0.9 microM human
      prothrombin under the same conditions resulted in marked increases in the
      concentration of FPA (> 1,000 nM) and clotting by 30 min. The increases in FPA
      were attributable to activation of the added prothrombin by clot-associated
      Factor Xa, judging from concomitant increases in the concentration of prothrombin
      fragment 1.2. Similar results were obtained with thrombi induced in the axillary
      arteries of dogs by vascular injury and incubated with plasma in vitro.
      Activation of prothrombin was inhibited in a dose-dependent manner by tick
      anticoagulant peptide, a direct inhibitor of Factor Xa, at concentrations of 0.5
      5.0 microM. Clot-associated Factor Xa activity was resistant to inhibition by
      anti-thrombin III, judging from the lack of inhibition of prothrombin activation
      during incubation of clots in plasma containing heparin pentasaccharide, an anti
      thrombin III-mediated inhibitor of Factor Xa. Thus, the activity of Factor Xa
      appears to be an important determinant of the procoagulant activity of whole
      blood clots and arterial thrombi, and is resistant to inhibition by anti-thrombin
      III-dependent inhibitors.

PMID- 8486760
TI  - Carbamyl phosphate synthetase I deficiency. One base substitution in an exon of
      the CPS I gene causes a 9-basepair deletion due to aberrant splicing.
AB  - Carbamyl phosphate synthetase I (CPS I; EC6,3,4,16) is an autosomal recessive
      disorder characterized by hyperammonemia. We studied the molecular bases of CPS I
      deficiency in a newborn Japanese girl with consanguineous parents. Northern and
      Western blots revealed a marked decrease in CPS I mRNA and enzyme protein but
      with a size similar to that of the control, respectively. Sequencing of the
      patient's cDNA revealed a nine-nucleotide deletion at position 832-840.
      Sequencing analysis of the genomic DNA revealed a G to C transversion at position
      840, the last nucleotide of an exon in the splice donor site. This substitution
      altered the consensus sequence of the splice donor site and the newly cryptical
      donor site in the exon caused the 9-bp in-frame deletion. This report seems to be
      the first complete definition of CPS I deficiency, at the molecular level.

PMID- 8486761
TI  - Insulin resistance in liver cirrhosis. Positron-emission tomography scan analysis
      of skeletal muscle glucose metabolism.
AB  - BACKGROUND: Insulin resistance and glucose intolerance are a major feature of
      patients with liver cirrhosis. However, site and mechanism of insulin resistance
      in cirrhosis are unknown. We investigated insulin-induced glucose metabolism of
      skeletal muscle by positron-emission tomography to identify possible defects of
      muscle glucose metabolism in these patients. METHODS: Whole body glucose disposal
      and oxidation were determined by the combined use of the euglycemic
      hyperinsulinemic clamp technique (insulin infusion rate: 1 mU/kg body wt per min)
      and indirect calorimetry in seven patients with biopsy-proven liver cirrhosis
      (Child: 1A, 5B, and 1C) and five healthy volunteers. Muscle glucose uptake of the
      thighs was measured simultaneously by dynamic [18F]fluorodeoxyglucose positron
      emission tomography scan. RESULTS: Both whole body and nonoxidative glucose
      disposal were significantly reduced in patients with liver cirrhosis (by 48%, P <
      0.001, and 79%, P < 0.0001, respectively), whereas glucose oxidation and the
      increase in plasma lactate were normal. Concomitantly, skeletal muscle glucose
      uptake was reduced by 69% in liver cirrhosis (P < 0.003) and explained 55 or 92%
      of whole body glucose disposal in cirrhotics and controls, respectively. Analysis
      of kinetic constants using a three-compartment model further indicated reduced
      glucose transport (P < 0.05) but unchanged phosphorylation of glucose in patients
      with liver cirrhosis. CONCLUSIONS: Patients with liver cirrhosis show significant
      insulin resistance that is characterized by both decreased glucose transport and
      decreased nonoxidative glucose metabolism in skeletal muscle.

PMID- 8486762
TI  - Binding, internalization, and degradation of mannose-terminated
      glucocerebrosidase by macrophages.
AB  - Mannose-terminated glucocerebrosidase (alglucerase; Ceredase) was designed for
      enzyme replacement therapy in Gaucher disease to take advantage of mannose
      receptor-mediated endocytosis by macrophages. To provide a rational basis for
      designing enzyme replacement therapy protocols, we examined the in vitro binding,
      uptake, and degradation of alglucerase by murine and human macrophages. Both were
      found to have approximately 500,000 mannose-dependent receptors for alglucerase
      per cell with a Kd of 10(-7) M at 0 degrees C. In contrast, the number of binding
      sites for mannose-bovine serum albumin (mannose-BSA), the classical ligand for
      the mannose receptor, was only approximately 20,000 with a Kd of 10(-8) M.
      Alglucerase was also bound in a mannose-dependent manner by cells that lack the
      capacity to bind mannose-BSA, such as Cos-1 cells, endothelial cells, and
      peripheral blood monocytes. The fact that the binding of alglucerase by
      macrophages was mediated principally by a receptor distinct from the classical
      mannose receptor that binds mannose-BSA was confirmed by differential inhibitors,
      viz., alpha-methyl-glucoside, fucose, and mannose-BSA, and by its independence on
      Ca2+. Uptake of alglucerase by macrophages at 37 degrees C was concentration
      dependent and half maximal at 10(-6) M. However, at a concentration of 10(-7) M,
      only 0.5% of the added alglucerase was incorporated into macrophages and
      approximately 50% of the alglucerase taken up was quickly released into the
      medium. Endothelial cells also manifest mannose-dependent binding and uptake of
      alglucerase and may therefore account for a large proportion of the infused
      alglucerase. Our data suggest that only a small amount of the alglucerase
      administered is effectively delivered to macrophages and that a more efficiently
      targeted enzyme might have a marked therapeutic advantage over mannose-terminated
      glucocerebrosidase.

PMID- 8486763
TI  - Cell-cell signaling between adult rat ventricular myocytes and cardiac
      microvascular endothelial cells in heterotypic primary culture.
AB  - It is unclear whether signaling between endothelial cells and muscle cells within
      ventricular myocardium, known to be important during cardiac development, remains
      physiologically relevant in the adult heart. Also, the mechanisms regulating the
      synthesis and activation of locally acting autacoids such as endothelins,
      cytokines known to have potent effects on contractile function and gene
      expression in cardiac myocytes, are unknown, as their cells of origin within
      ventricular muscle. Microvascular endothelial cells isolated from ventricular
      tissue of adult rats do not express endothelins constitutively. However, the
      appearance of preproendothelin mRNA can be increased in cardiac microvascular
      endothelial cells by heterotypic primary culture with adult rat ventricular
      myocytes. Cell-cell contact, or at least close apposition, appears to be
      necessary to increase preproendothelin mRNA, as medium conditioned by ventricular
      myocytes alone was ineffective when applied to monocultures of microvascular
      endothelial cells. The level of TGF beta precursor mRNA is also markedly
      increased in microvascular endothelial cells in coculture and precedes the
      appearance of endothelin precursor transcripts. In coculture, TGF beta acts as an
      autocrine cytokine, increasing endothelin precursor mRNA and inhibiting the rate
      of microvascular endothelial cell proliferation. This regulation of endothelial
      cell phenotype in heterotypic primary cultures suggests that dynamic, reciprocal
      cell-cell signaling may also be occurring between microvascular endothelium and
      ventricular myocytes in vivo.

PMID- 8486764
TI  - Phospholipase D-modified low density lipoprotein is taken up by macrophages at
      increased rate. A possible role for phosphatidic acid.
AB  - Macrophage uptake of modified forms of LDL leads to cellular cholesterol
      accumulation. Upon incubation of LDL with phospholipase D (PLase D), a time- and
      enzyme dose-dependent production of phosphatidic acid (PA), paralleled by a rapid
      reduction in LDL phosphatidyl choline content (up to 65% within 15 min of
      incubation) was noted. No lipid peroxidation could be found in PLase D-modified
      LDL. Upon in vitro incubation of PLase D-LDL with copper ions, however, this
      modified LDL was substantially oxidized. The addition of 100 micrograms PA/ml to
      native LDL for the period of its in vitro oxidation resulted in a 63% elevation
      in the lipoprotein peroxides content. Incubation of PLase D-LDL with J-774A.1
      macrophage-like cell line resulted in an increase in its cellular binding and
      degradation (up to 91 and 110%, respectively) in comparison with native LDL (via
      the LDL receptor). When PA was added to LDL before its incubation with the
      macrophages, a PA dose-dependent elevation in the cellular uptake of LDL (by up
      to twofold) was noted in comparison with LDL that was incubated without PA,
      suggesting that PA production in PLase D-LDL may be involved in the increased
      cellular uptake of PLase D-LDL. PLase D activity towards LDL was demonstrated in
      J-774A.1 macrophages. Human plasma was also shown to possess PLase D activity.
      Thus, PLase D modification of LDL may take place under certain pathological
      conditions and PLase D-LDL interaction with arterial wall macrophages can
      potentially lead to foam cell formation.

PMID- 8486765
TI  - Gene-environment interaction in the conversion of a mild-to-severe phenotype in a
      patient homozygous for a Ser172-->Cys mutation in the lipoprotein lipase gene.
AB  - Normal pregnancy is associated with a two- to threefold increase in plasma
      triglyceride levels, particularly in the third trimester, due both to the
      overproduction of VLDLs and to the possible suppression of lipoprotein lipase
      (LPL) activity. Numerous mutations in the human LPL gene causing complete LPL
      deficiency have been described, but naturally occurring mutations that result in
      defective LPL with partial activity have not yet been reported. Here we describe
      a 30-yr-old woman who was first diagnosed with LPL deficiency during pregnancy
      after she developed pancreatitis. Her plasma triglyceride levels remained mildly
      elevated at approximately 300 mg/dl (3.4 mmol/liter) after the first pregnancy
      but rose significantly after she became pregnant again (1800 to 2000 mg/dl) (20.2
      to 22.5 mmol/liter). DNA sequence analysis of the LPL gene showed that the
      patient is homozygous for a Ser172-->Cys missense mutation in exon 5. In vitro
      mutagenesis revealed that the Ser172-->Cys mutation caused a mutant LPL protein
      that had residual activity higher than that seen in all eight other missense
      mutations in patients with LPL deficiency identified in our laboratory. We
      propose that some mutations in the LPL gene produce a defective LPL with partial
      activity, which usually leads to mild hypertriglyceridemia.

PMID- 8486766
TI  - Cloning and chromosomal localization of a human kidney cDNA involved in cystine,
      dibasic, and neutral amino acid transport.
AB  - We have recently cloned, sequenced, and characterized a rat kidney cDNA (D2) that
      stimulates cystine as well as dibasic and neutral amino acid transport. In order
      to evaluate the role of this protein in human inherited diseases such as
      cystinuria, we have isolated a human D2 clone (D2H) by low stringency screening
      of a human kidney cDNA library using the radiolabeled D2 insert as a probe. The
      D2H cDNA is 2284 nucleotides long and encodes a 663 amino acid protein that is
      80% identical to the rat D2 amino acid sequence and 86% to that of the rabbit
      homologue rBAT. Microinjection of in vitro transcribed D2H cRNA into Xenopus
      oocytes induced uptake of cystine as well as dibasic and neutral amino acids in a
      pattern similar to that of rat D2 and rabbit rBAT. Both neutral and dibasic amino
      acids inhibited the D2H-induced uptake of cystine. Northern blot analysis
      demonstrated that D2H, like D2 and rBAT, is expressed strongly in the kidney and
      intestine. Southern blot analysis of genomic DNA from a panel of mouse-human
      somatic cell hybrids showed that the human gene for D2H resides on chromosome 2.

PMID- 8486767
TI  - CD10/neutral endopeptidase 24.11 regulates fetal lung growth and maturation in
      utero by potentiating endogenous bombesin-like peptides.
AB  - Bombesin-like peptides (BLPs) are mitogens for bronchial epithelial cells and
      small cell lung carcinomas, and increase fetal lung growth and maturation in
      utero and in organ cultures. BLPs are hydrolyzed by the enzyme CD10/neutral
      endopeptidase 24.11 (CD10/NEP) which is expressed in bronchial epithelium and
      functions to inhibit BLP-mediated growth of small cell lung carcinomas. To
      determine whether CD10/NEP regulates peptide-mediated lung development, we
      administered a specific CD10/NEP inhibitor, SCH32615, to fetal mice in utero from
      gestational days e15-17. Fetal lung tissues were evaluated on e18 for: (a) growth
      using [3H]thymidine incorporation into nuclear DNA; and (b) maturation using:
      [3H]-choline incorporation into surfactant phospholipids, electron microscopy for
      type II pneumocytes, and Northern blot analyses for surfactant apoproteins A, B,
      and C. Inhibition of CD10/NEP stimulated [3H]thymidine incorporation into DNA
      (70% above baseline, P < 0.005), [3H]choline incorporation into surfactant
      phospholipids (38% above baseline, P < 0.005), increased numbers of type II
      pneumocytes (36% above baseline, P = 0.07), and fivefold higher surfactant
      protein A transcripts (P < 0.05). CD10/NEP-mediated effects were completely
      blocked by the specific bombesin receptor antagonist, [D-Phe12, Leu14]bombesin.
      These observations suggest that CD10/NEP regulates fetal lung growth and
      maturation mediated by endogenous BLPs.

PMID- 8486768
TI  - Terminal complement complex C5b-9 stimulates mitogenesis in 3T3 cells.
AB  - The membrane attack complex of complement (MAC) can induce reversible changes in
      cell membrane permeability resulting in significant but transient intracellular
      ionic changes in the absence of cell lysis. Because ion fluxes and cytosolic
      ionic changes are integral steps in the signaling cascade initiated when growth
      factors bind to their receptors, we hypothesized that the MAC-induced reversible
      changes in membrane permeability could stimulate cell proliferation. Using
      purified terminal complement components we have documented a mitogenic effect of
      the MAC for quiescent murine 3T3 cells. The MAC enhances the mitogenic effects of
      serum and PDGF, and also stimulates cell proliferation in the absence of other
      exogenous growth factors. MAC-induced mitogenesis represents a novel effect of
      the terminal complement complex that could contribute to focal tissue repair or
      pathological cell proliferation locally at sites of complement activation.

PMID- 8486769
TI  - Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In
      vitro and in vivo animal studies.
AB  - This study investigates the pathophysiology of mucormycosis caused by Rhizopus,
      which has been reported in 46 dialysis patients, while treated with deferoxamine
      (DFO). This drug aggravates mucormycosis, which we experimentally induced in
      guinea pigs and which lead to a shortened animal survival (P < or = 0.01). The
      drug's effect on Rhizopus is not mediated through the polymorphonuclear cells.
      Fe.DFO, the iron chelate of DFO, abolishes the fungistatic effect of serum on
      Rhizopus and increases the in vitro growth of the fungus (P < or = 0.0001). This
      effect is present at Fe.DFO concentrations > or = 0.01 microM, at which fungal
      uptake of radioiron from 55Fe.DFO is observed. A 1,000-fold higher concentration
      of iron citrate is required to achieve a similar rate of radioiron uptake and of
      in vitro growth stimulation as observed with Fe.DFO. These in vitro effects of
      Fe.DFO (1 microM) in serum on radioiron uptake and on growth stimulation are more
      striking for Rhizopus than for Aspergillus fumigatus and are practically absent
      for Candida albicans. For these three fungal species, the rates of radioiron
      uptake from 55Fe.DFO and of growth stimulation in the presence of Fe.DFO in serum
      are directly related (r = 0.886). These results underscore the major role of
      Fe.DFO in the pathogenesis of DFO-related mucormycosis. Pharmacokinetic changes
      in uremia lead to a prolonged accumulation of Fe.DFO after DFO administration,
      which helps explain the increased sensitivity of dialysis patients to DFO-related
      mucormycosis.

PMID- 8486770
TI  - Bisphosphonates act on rat bone resorption through the mediation of osteoblasts.
AB  - Bisphosphonates are generally considered to act on bone resorption by binding to
      bone mineral and subsequently inhibiting the activity of the osteoclasts which
      ingest them. This has been supported by the fact that bisphosphonates adsorbed on
      mineralized tissue inhibit the resorbing activity of isolated osteoclasts in
      vitro. However, the effectiveness of different bisphosphonates determined in this
      system does not reflect their relative potencies in vivo. Employing the well
      described isolated osteoclast resorption pit assay, with ivory as the resorption
      substrate, we show here that this lack of correlation prevails only when the
      bisphosphonates are added to the mineral before addition of osteoclasts, but not
      when the cells are treated for a short time (5 min) before allowing them to
      adhere onto ivory. By using this approach with five different bisphosphonates, a
      stringent correlation of relative potencies was obtained with those found, both
      in the rat and in the human, in vivo. Furthermore, by using an osteoblastic cell
      line (CRP 10/30) which is a powerful promoter of osteoclastic resorption in
      vitro, we obtained evidence that the inhibitory effect of bisphosphonates was the
      result of an action on osteoblasts rather than on osteoclasts. Thus, in
      experiments in which the osteoblastic cells were pretreated for 5 min with
      bisphosphonates and then cocultured with osteoclasts, inhibition of osteoclastic
      resorbing activity was obtained. Moreover, it was found that this treatment
      resulted in a decrease of the stimulatory effect found in CRP 10/30-conditioned
      medium. In conclusion the present study shows that part of the osteoclast
      inhibiting action of the bisphosphonates is mediated through an action on
      osteoblasts.

PMID- 8486771
TI  - Endothelium-derived relaxing factor/nitric oxide modulates angiotensin II action
      in the isolated microperfused rabbit afferent but not efferent arteriole.
AB  - It has been reported that sensitivity to angiotensin II (Ang II) is higher in
      efferent (Ef) than afferent (Af) arterioles (Arts). We tested the hypothesis that
      this is due to arteriolar differences in the interaction between Ang II and
      endothelium-derived relaxing factor/nitric oxide (EDNO). Rabbit Af-Arts with
      glomerulus intact were microperfused in vitro at a constant pressure. Ef-Arts
      were perfused from the distal end of either the Af-Art (orthograde perfusion) or
      the Ef-Art (retrograde perfusion) to eliminate influences of the Af-Art or
      glomerulus, respectively. Ang II did not alter Af-Art luminal diameter until the
      concentration reached 10(-9) M, which decreased the diameter by 11 +/- 2.6% (n =
      11; P < 0.002). In contrast, Ef-Arts became significantly constricted at
      concentrations as low as 10(-11) M with either perfusion. Surprisingly, the
      decrease in Ef-Art diameter at 10(-10), 10(-9), and 10(-8) M was significantly
      greater with retrograde perfusion (44 +/- 6.9%, 70 +/- 5.6%, and 74 +/- 4.1%,
      respectively; n = 5) than with orthograde perfusion (16 +/- 4.2%, 25 +/- 2.9%,
      and 35 +/- 3.5%; n = 9). ENDO synthesis inhibition with 10(-4) M nitro-L-arginine
      methyl ester (L-NAME) decreased the diameter to a greater extent in Af-Arts (22
      +/- 3.0%; n = 11) compared to Ef-Arts with either orthograde (9.5 +/- 2.3%; n =
      8) or retrograde perfusion (1.2 +/- 2.1%; n = 6). With L-NAME pretreatment, Af
      Art constriction induced by 10(-10) M (14 +/- 4.0%, n = 9) and 10(-9) M Ang II
      (38 +/- 3.9%) was significantly greater compared to nontreated Af-Arts. In
      contrast, L-NAME pretreatment had no effect on Ang II-induced constriction in Ef
      Arts with either perfusion. In conclusion, this study demonstrates higher
      sensitivity of Ef-Arts to Ang II, particularly with retrograde perfusion. Our
      results suggest that EDNO significantly modulates the vasoconstrictor action of
      Ang II in Af-Arts II but not Ef-Arts, contributing to the differential
      sensitivity to Ang II.

PMID- 8486772
TI  - Interferon-gamma inhibits macrophage apolipoprotein E production by
      posttranslational mechanisms.
AB  - Macrophage-derived apolipoprotein (apo) E and multimers of a synthetic apo E
      peptide display monokine-like functions by inhibiting mitogen- or antigen-driven
      lymphocyte proliferation. This study demonstrated how the target lymphocyte
      itself can modulate macrophage apo E production. The lymphokine interferon-gamma
      (IFN) dramatically inhibited the accumulation of apo E in the supernatant of
      human monocytic THP-1 cells when present during phorbol myristate acetate-induced
      differentiation. A similar effect was observed when IFN was added to
      differentiated THP-1 cells. Treatment with IFN did not change the steady-state
      levels of apo E mRNA. Furthermore, in the presence of IFN no increased
      degradation or increased uptake of extracellular apo E was detected. Pulse-chase
      experiments indicated that IFN reduced the accumulation of extracellular apo E
      and increased the degradation of intracellular apo E. The inhibitory effect of
      IFN on apo E production also was observed in human monocyte-derived macrophages.
      Thus, our data demonstrated that IFN inhibited macrophage apo E production by
      posttranslational mechanisms. This represents a previously uncharacterized
      immunoregulatory interaction and lends further support to a relationship between
      lipid metabolism and the immune system.

PMID- 8486773
TI  - High stimulatory activity of dendritic cells from diabetes-prone
      BioBreeding/Worcester rats exposed to macrophage-derived factors.
AB  - Dendritic cells (DC) present antigen and initiate T cell-mediated immune
      responses. To investigate the possible association of autoimmunity with DC
      function, we compared the accessory activity of splenic DC from Wistar/Furth (WF)
      and diabetes-prone (DP) BioBreeding (BB) rats. The latter develop autoimmune
      diabetes and thyroiditis. DC function was quantified in vitro by measuring T cell
      proliferation in mitogen-stimulated and mixed lymphocyte reactions. When purified
      without macrophage coculture, WF and DP DC displayed similar levels of accessory
      activity. In contrast, when purified by a method involving coculture with
      macrophages, DC from DP rats consistently displayed greater accessory activity.
      This finding could not be explained by morphological or phenotypic differences
      between DP and WF DC. In accessory activity assays performed after reciprocal DC
      cocultures with DP and WF macrophages, DP DC exhibited higher accessory activity
      irrespective of macrophage donor strain. We also compared the accessory activity
      of WF and DP DC cultured in the presence of conditioned medium and a mixture of
      IL-1 and GM-CSF. In all assays, DP DC exhibited higher accessory activity. In
      studies of (WF x DP) F1 hybrids, the high accessory activity of DP DC was
      observed to be heritable, and studies of WF and DP radiation chimeras indicated
      that the effect was an intrinsic property of the DP hematopoietic system. We
      conclude: (a) splenic DC from DP and WF rats possess similar basal levels of
      accessory potency; (b) after interaction with macrophages, DC of DP origin are
      capable of greater stimulatory activity than are WF DC; and (c) the mechanism
      responsible for this phenomenon involves differential responsiveness of DP and WF
      DC to macrophage-derived factors such as IL-1 and GM-CSF.

PMID- 8486774
TI  - Tissue localization of beta receptors for platelet-derived growth factor and
      platelet-derived growth factor B chain during wound repair in humans.
AB  - The expression and localization of PDGF beta receptors and PDGF-AB/BB in human
      healing wounds was evaluated by immunohistochemical techniques and in situ
      hybridization. Expression of PDGF beta receptor protein and PDGF-AB/BB were
      analyzed in wound margin biopsies using the PDGFR-B2 and PDGF 007 antibodies.
      PDGF beta receptor expression was minor in normal skin. An increased expression
      of PDGF beta receptor protein was prominent in vessels in the proliferating
      tissue zone in wounds as early as 1 d after surgery and was apparent < or = 4 wk
      after surgery. There was also a concordant increase in PDGF beta receptor mRNA
      detected by in situ hybridization. PDGF-AB/BB was present in healing wounds as
      well as in normal skin. In normal skin, expression of PDGF-AB/BB was confined to
      peripheral nerve fibers and to solitary cells of the epidermis and of the
      superficial dermis. In wounds, infiltrating mononuclear cells also stained for
      PDGF-AB/BB. To identify cell types expressing PDGF AB/BB and PDGF beta receptors,
      respectively, we performed double immunofluorescence stainings. PDGF beta
      receptors were expressed by vascular smooth muscle cells and cells in capillary
      walls; the receptor protein could not be detected in neurofilament containing
      structures, T lymphocytes, or CD68 expressing macrophages. PDGF-AB/BB colocalized
      with neurofilaments, it was present in Langerhans cells of the epidermis and in
      HLA-DR positive cells located in the epidermal/dermal junction area. Of the
      macrophages infiltrating the wound, 43 +/- 18% stained positively for PDGF AB/BB.
      Since PDGF-AB/BB and PDGF beta receptors are expressed in the healing wound, two
      essential prerequisites for a role of PDGF in wound healing are fulfilled.

PMID- 8486775
TI  - Demonstration of GAD-65 as the main immunogenic isoform of glutamate
      decarboxylase in type 1 diabetes and determination of autoantibodies using a
      radioligand produced by eukaryotic expression.
AB  - Plasmids containing cDNA for the rat 67- and 65-kD isoforms of glutamate
      decarboxylase (GAD-67 and GAD-65) were expressed in COS-cells, and lysates of
      [35S]methionine-labeled cells were used for immunoprecipitations. Sera from 38
      patients with type 1 (insulin-dependent) diabetes mellitus, which precipitated a
      64-kD antigen from rat islets, reacted with recombinant GAD-65 in relation to
      their anti-64-kD titers. The eight strongest sera also precipitated recombinant
      GAD-67, suggesting that certain epitopes are common to both isoforms.
      Subsequently, [35S]methionine-labeled GAD-65 was purified from COS cell lysates
      and employed in a binding assay with 50 sera of patients with recent onset of
      type 1 diabetes mellitus. 38 sera (76%) precipitated labeled GAD-65 with titers
      that correlated with islet cell antibodies (ICA), determined in a standard
      immunofluorescence assay. 2 sera were GAD positive but ICA negative, 4 were
      positive only for ICA, and 6 were negative for both GAD and ICA, as were the sera
      of 20 controls. The data illustrate that antibodies against GAD-65 are present in
      a majority of patients with type 1 diabetes mellitus and that autoantibodies
      against other islet cell antigens also exist. The radioligand-binding assay,
      which is convenient and sensitive for detecting GAD antibodies, will facilitate
      the screening of individuals with autoimmune islet cell disease.

PMID- 8486776
TI  - Low expression allele alpha LELY of red cell spectrin is associated with
      mutations in exon 40 (alpha V/41 polymorphism) and intron 45 and with partial
      skipping of exon 46.
AB  - The alpha V/41 polymorphism of erythroid alpha-spectrin has been characterized
      initially by an increased susceptibility to proteolysis of the alpha IV-alpha V
      domain junction (Alloisio N., L. Morle, J. Marechal, A.-F. Roux, M.-T. Ducluzeau,
      D. Guetarni, B. Pothier, F. Baklouti, A. Ghanem, R. Kastally, et al. 1991. J.
      Clin. Invest. 87:2169-2177). Until now, it has been found associated invariably
      with a low expression level of the corresponding alpha chain. Among 61
      chromosomes investigated in French and North African individuals or kindreds, we
      observed 19 chromosomes with the alpha V/41 polymorphism. With no single
      exception, the latter displayed a point mutation in exon 40 (Leu-->Val; CTA-
      >GTA) at position alpha 1857. According to the triple helical model of spectrin
      structure, this change accounts for the peptide maps' abnormalities. Sequencing
      the entire alpha V domain cDNA disclosed, in addition, a partial skipping of exon
      46. At the gene level, a substitution (C-->T) was evidenced at nucleotide -12 of
      intron 45. This mutation appeared linked to the exon 40 mutation in 17
      chromosomes, again with no single exception, among 53 examined chromosomes. We
      hypothesized that the lack of exon 46 would hamper the nucleation process and
      eventually account for the low expression feature. The present doubly mutated
      allele was renamed allele alpha LELY (low expression, Lyon).

PMID- 8486777
TI  - Identification of the human NHE-1 form of Na(+)-H+ exchanger in rabbit renal
      brush border membranes.
AB  - To study the relation between the human Na(+)-H+ exchanger (NHE-1) and the renal
      brush border membrane (BBM) Na(+)-H+ exchanger, polyclonal antibodies to
      synthetic peptides representing a putative external (Ab-E) and an internal
      cytosolic domain (Ab-I) of human NHE-1 were generated in rabbits. Western
      immunoblot analyses indicated that both antibodies recognized a 97-kD protein in
      rabbit renal BBM but not basolateral membranes (BLM). Octyl glucoside-extracted
      rabbit renal BBM proteins also contained the 97-kD polypeptide as did a fraction
      eluted from an anion-exchange column with 0.2 M NaCl (fraction A). A fraction
      eluting between 0.2 and 0.4 M NaCl (fraction B) did not contain this protein.
      Prior reconstitution studies have indicated that Na(+)-H+ exchange activity is
      higher significantly in fraction B than fraction A. Administration of NH4Cl for 3
      7 d to rabbits, a stimulus known to increase renal BBM Na(+)-H+ exchange
      activity, did not result in a change in expression of the 97-kD protein in either
      renal BBM or BLM. The results indicate that affinity-purified polyclonal
      antibodies to two separate domains of the human Na(+)-H+ exchanger recognize a 97
      kD protein in rabbit renal BBM but not BLM. The dissociation between recognition
      of the 97-kD protein using antibodies and the majority of functional Na(+)-H+
      exchange activity after chromatographic fractionation of solubilized BBM proteins
      and in native BBM after administration of NH4Cl suggest that rabbit renal BBM
      contains more than one form of Na(+)-H+ exchanger.

PMID- 8486778
TI  - P53 mutation in acute T cell lymphoblastic leukemia is of somatic origin and is
      stable during establishment of T cell acute lymphoblastic leukemia cell lines.
AB  - Samples donated by patients with T cell acute lymphoblastic leukemia (T-ALL) were
      screened for mutations of the p53 tumor suppressor gene. Peripheral blood cells
      of T-ALL relapse patient H.A. were found to possess a heterozygous point mutation
      at codon 175 of the p53 gene. To determine whether this was an inherited
      mutation, a B cell line (HABL) was established. Leukemic T cell lines (HATL) were
      concurrently established by growing peripheral blood leukemic T cells at low
      oxygen tension in medium supplemented with IGF-I. Previously we had shown that >
      60% of leukemic T cell lines possessed mutations in the p53 gene (Cheng, J., and
      M. Hass. 1990. Mol. Cell. Biol. 10:5502), mutations that might have originated
      with the donor's leukemic cells, or might have been induced during establishment
      of the cell lines. To answer whether establishment of the HATL lines was
      associated with the induction of p53 mutations, cDNAs of the HATL and HABL lines
      were sequenced. The HATL lines retained the same heterozygous p53 mutation that
      was present in the patient's leukemic cells. The HABL line lacked p53 mutations.
      Immunoprecipitation with specific anti-p53 antibodies showed that HATL cells
      produced p53 proteins of mutant and wild type immunophenotype, while the HABL
      line synthesized only wild-type p53 protein. The HATL cells had an abnormal
      karyotype, while the HABL cells possessed a normal diploid karyotype. These
      experiments suggest that (a) p53 mutation occurred in the leukemic cells of
      relapse T-ALL patient HA; (b) the mutation was of somatic rather than hereditary
      origin; (c) the mutation was leukemia associated; and (d) establishment of human
      leukemia cell lines needs not be associated with in vitro induction of p53
      mutations. It may be significant that patient HA belonged to a category of
      relapse T-ALL patients in whom a second remission could not be induced.

PMID- 8486779
TI  - Effects of low dose oral contraceptives on very low density and low density
      lipoprotein metabolism.
AB  - Oral contraceptives (OC) raise plasma triglyceride and VLDL levels, which may be
      of concern, since some conditions characterized by elevated triglycerides are
      associated with atherosclerosis. To identify the responsible mechanism, we
      studied 11 healthy premenopausal women, 5 of whom were taking OC containing 0.035
      mg ethinyl estradiol, and 6 of whom were not. Their rates of VLDL and LDL
      metabolism were measured by endogenously labeling apoB, the protein component of
      VLDL and LDL, by an intravenous infusion of deuterated leucine. OC use had the
      greatest effect on the large, triglyceride-rich VLDL subfraction (Sf 60-400),
      increasing plasma levels threefold and production rates fivefold (P < 0.05).
      Among OC users, small VLDL (Sf 20-60) levels were 2.2 times higher, and
      production rates were 3.4-fold higher (P < 0.05). The fractional catabolic rates
      of large and small VLDL were similar among OC users and nonusers. LDL levels and
      metabolic rates were not significantly different between the two groups. Thus,
      contemporary low dose OC substantially raise VLDL levels by increasing the
      production rate of large, triglyceride-rich VLDL, and not by slowing VLDL
      catabolism. Since VLDL catabolism is not impaired, we speculate that the
      hypertriglyceridemia induced by OC may be less atherogenic than that of
      hypertriglyceridemia resulting from impaired lipolysis. This may explain why long
      term OC use does not appear to promote atherosclerosis.

PMID- 8486780
TI  - Expression of the phenotypic abnormality of platelet-type von Willebrand disease
      in a recombinant glycoprotein Ib alpha fragment.
AB  - The platelet GP Ib-IX receptor supports platelet adhesion and activation by
      binding to vWf in the exposed subendothelial matrix. An abnormal GP Ib-IX complex
      exists in platelet-type or pseudo-von Willebrand disease and has a characteristic
      increased affinity for soluble vWf resulting in impaired hemostatic function due
      to the removal of larger vWf multimers from the circulation. Genetic studies
      within an afflicted family have demonstrated that the disease is linked to a
      Gly233-->Val amino acid substitution within the alpha-subunit of the oligomeric
      GP Ib-IX complex (Miller, J.L., D. Cunningham, V.A. Lyle, and C. L. Finch. 1991.
      Proc. Natl. Acad. Sci. USA. 88:4761-4765). To evaluate the functional
      consequences of this mutation, we constructed a recombinant analogue of the alpha
      subunit of GP Ib containing Val233. Experiments comparing molecules with either
      Gly233 or Val233 revealed that the Val substitution generates a molecule with
      increased affinity for vWf. The recombinant fragment reproduces the functional
      abnormality of the GP Ib-IX complex in platelet-type von Willebrand disease, thus
      establishing the molecular basis of the bleeding disorder within this family.
      Moreover, it becomes apparent that structural elements responsible for the
      regulation of hemostasis through modulation of vWf affinity for platelets reside
      within the alpha-subunit of the GP Ib-IX complex.

PMID- 8486781
TI  - Effects of endothelin receptor antagonist on cyclosporine-induced
      vasoconstriction in isolated rat renal arterioles.
AB  - Recent evidence suggests that the potent constrictor peptide, endothelin (ET) has
      a mediating role in cyclosporine A (CsA)-related renal vasoconstriction. However,
      the nature of the CsA-ET interaction and effect on the renal vasculature is
      uncertain. The purpose of the present study was twofold: (a) to determine if CsA
      exposure caused direct local release of ET from the endothelium of the renal
      microvasculature and (b) to determine if locally generated ET has paracrine
      effects on the underlying vascular smooth muscle to induce vasoconstriction.
      Experiments were performed in isolated rat renal arterioles. First it was
      determined that both afferent arteriole (AA) and efferent arteriole (EA)
      exhibited concentration-dependent decreases in lumen diameter to increasing molar
      concentrations of CsA. The AA was more sensitive to the vasoconstrictive effects
      of CsA than the EA. Next, the blocking effect of a recently synthesized putative
      ETA receptor antagonist was verified in both the AA and EA, where it was found
      that the cyclic peptide cyclo D-Asp-L-Pro-D-Val-L-Leu-D-Trp totally inhibited the
      vasoconstriction observed with ET addition. Finally, the role of locally
      stimulated ET in CsA-induced vasoconstriction was tested by determining the
      effect of the ETA receptor antagonist on CsA-induced AA and EA constriction. In
      the AA the vasoconstrictor effect of 10(-11) M CsA was completely blocked by the
      ETA receptor antagonist. However, in contrast to AA, 10(-11) M CsA in EA in the
      presence of the ETA receptor antagonist decreased EA lumen diameter by a mean of
      41% from baseline (4.80 +/- 0.75 microns vs 7.80 +/- 0.84 microns, P < 0.05).
      This change in lumen diameter was similar to that induced by CsA alone. These
      data suggest that CsA directly constricts renal microvessels. This effect is
      mediated by ET in the AA but not the EA.

PMID- 8486782
TI  - von Willebrand factor mutation enhancing interaction with platelets in patients
      with normal multimeric structure.
AB  - Variant von Willebrand disease designated as type I New York or type Malmo is
      characterized by enhanced ristocetin-induced platelet agglutination with normal
      von Willebrand factor multimeric distribution in plasma. We have studied four
      such patients belonging to three unrelated families and found in all of them a
      unique cytosine-to-thymine transition changing the codon for Pro503 (CCG) to Leu
      (CTG). In three patients the mutant allele also had a silent mutation in the
      codon for Ser500 (TCG-->TCA). Both nucleotide changes are present in the von
      Willebrand factor pseudogene; however, the characterization of distinctive
      markers where the gene and pseudogene differ, as well as the examination of
      amplified cDNA derived from platelet mRNA, confirmed that the abnormality occurs
      in the von Willebrand factor gene of the patients. Moreover, recombinant
      expression of the isolated glycoprotein Ib-binding domain of von Willebrand
      factor provided direct evidence that the Pro503-->Leu mutation is responsible for
      enhanced platelet reactivity to lower ristocetin concentrations. These results
      define a new structural element affecting the affinity of von Willebrand factor
      for glycoprotein Ib and establish the molecular basis of a variant form of von
      Willebrand disease.

PMID- 8486783
TI  - Renal acid excretion and intracellular pH in salt-sensitive genetic hypertension.
AB  - Acid-base status and renal acid excretion were studied in the Dahl/Rapp salt
      sensitive (S) rat and its genetically salt-resistant counterpart (R). S rats
      developed hypertension while on a very high salt diet (8%) and while on a more
      physiological salt diet (1%) and remained normotensive while on a very low salt
      diet (0.08%). Under the high salt diet, intracellular pH measured in freshly
      isolated thymic lymphocytes using 2',7'-bis (carboxyethyl)-5 (6)
      carboxyfluorescein acetomethyl ester, a pH-sensitive dye, was lower in S than in
      R rats both when measured in the presence of HCO3/CO2 (7.32 +/- 0.02 vs. 7.38 +/-
      0.02, respectively, P < 0.05) and in its absence (7.18 +/- 0.04 vs. 7.27 +/-
      0.02, respectively, P < 0.05). Under the high salt diet, net acid excretion was
      higher in S than R rats (1,777 +/- 111 vs. 1,017 +/- 73 muEq/24 h per 100 g body
      wt, respectively, P < 0.001), and this difference was due to higher rates of both
      titratable acid and ammonium excretion. Directionally similar differences in
      intracellular pH and net acid excretion between S and R rats were also observed
      in salt-restricted animals. In S and R rats placed on a normal salt intake (1%)
      and strictly pair-fed to control food intake as a determinant of dietary acid,
      net acid excretion was also higher in S than in R rats (562 +/- 27 vs. 329 +/- 21
      muEq/24 h per 100 g, respectively, P < 0.01). No significant difference in either
      blood pH or bicarbonate levels were found between S and R rats on either the
      0.08%, 1%, or 8% salt diets. We conclude that renal acid excretion is augmented
      in the salt-sensitive Dahl/Rapp rat. Enhanced renal acid excretion may be a
      marker of increased acid production by cells from subjects with salt-sensitive
      hypertension.

PMID- 8486784
TI  - Tissue infiltration in a CD8 lymphocytosis syndrome associated with human
      immunodeficiency virus-1 infection has the phenotypic appearance of an
      antigenically driven response.
AB  - HIV-1 infection may initiate to an HLA-associated response designated diffuse
      infiltrative lymphocytosis syndrome, characterized by increased numbers of
      circulating CD8 T cells that infiltrate salivary glands, lungs, gastrointestinal
      tract, and kidneys. Since this response could either be an antigenically driven
      process induced by HIV-1 or a lymphoproliferation of cells with neoplastic or
      unusual features, we sought to define the phenotype of the cellular populations,
      the nature of tissue derangement, and the tissue localization of virus in diffuse
      infiltrative lymphocytosis syndrome. Circulating CD8 T cells were greatly
      increased while CD4 T cell numbers remained in the range found in asymptomatic
      seropositive persons. The majority of CD8 and CD4 T cells in both blood and
      tissues had the memory phenotype of CD29+ (beta 1 integrin) and CD11a+/CD18 (beta
      2 integrin) expression, but lacked markers of recent activation. A proportion of
      the circulating CD8 T cells also expressed CD57 (Leu 7) but not other markers of
      natural killer cells. HIV-encoded proteins were identified in tissue macrophages
      located in periacinar areas of the salivary glands. CD54 (intercellular adhesion
      molecule-1), a ligand for the CD11a integrin, was strongly expressed on
      postcapillary venule endothelium within lymphoid foci, and HLA-DR molecules were
      found on limited regions of ductular epithelium adjacent to lymphoid aggregates.
      These findings suggest that (a) the visceral lymphocytic infiltration in diffuse
      infiltrative lymphocytosis syndrome is an antigen-driven, and MHC-determined,
      host immune response to an element associated with HIV-1 infection, and (b) that
      the specific adhesive molecule interactions mediating the cellular influx, as
      well as the subsequent tissue damage, reflect altered patterns of gene expression
      in tissues undergoing an immune response.

PMID- 8486785
TI  - Multiple autocrine growth factors modulate vascular smooth muscle cell growth
      response to angiotensin II.
AB  - Angiotensin (Ang) II stimulates hypertrophic growth of vascular smooth muscle
      cells (VSMC). Accompanying this growth is the induction of the expression of
      growth-related protooncogenes (c-fos, c-jun, and c-myc), as well as the synthesis
      of the autocrine growth factors, such as PDGF-A and TGF-beta 1. In this study, we
      demonstrate further that Ang II also induces the synthesis of basic fibroblast
      growth factor (bFGF), a potent mitogen for VSMC. To examine how these factors
      interact to modulate the growth response of VSMC to Ang II, we used antisense
      oligomers to determine the relative contribution of these three factors.
      Treatment of confluent, quiescent smooth muscle cells with specific antisense
      oligomers complementary to bFGF, PDGF-A, and TGF-beta 1 efficiently inhibited the
      syntheses of these factors. Our results demonstrate that in these VSMC, TGF-beta
      1 affects a key antiproliferative action, modulating the mitogenic properties of
      bFGF. Autocrine PDGF exerts only a minimal effect on DNA synthesis. An imbalance
      in these signals activated by Ang II may result in abnormal VSMC growth leading
      to the development of vascular disease.

PMID- 8486786
TI  - Alternative splicing: a mechanism for phenotypic rescue of a common inherited
      defect.
AB  - Approximately 2% of Caucasians and African-Americans are homozygous for a
      nonsense mutation in exon 2 of the AMPD1 (AMP deaminase) gene. These individuals
      have a high grade deficiency of AMPD activity in their skeletal muscle. More than
      100 patients with AMPD1 deficiency have been reported to have symptoms of a
      metabolic myopathy, but it is apparent many individuals with this inherited
      defect are asymptomatic given the prevalence of this mutant. Results of the
      present study provide a potential molecular explanation for "correction" of this
      genetic defect. Alternative splicing eliminates exon 2 in 0.6-2% of AMPD1 mRNA
      transcripts in adult skeletal muscle. Expression studies document that AMPD1
      mRNA, which has exon 2 deleted, encodes a functional AMPD peptide. A much higher
      percentage of alternatively spliced transcripts are found during differentiation
      of human myocytes in vitro. Transfection studies with human minigene constructs
      demonstrate that alternative splicing of the primary transcript of human AMPD1 is
      controlled by tissue-specific and stage-specific signals. Alternative splicing of
      exon 2 in individuals who have inherited this defect provides a mechanism for
      phenotypic rescue and variations in splicing patterns may contribute to the
      variability in clinical symptoms.

PMID- 8486787
TI  - Recombinant human insulin-like growth factor-I accelerates recovery and reduces
      catabolism in rats with ischemic acute renal failure.
AB  - This study evaluated whether recombinant human insulin-like growth factor-I
      (rhIGF-I) enhances recovery of renal function and reduces catabolism in rats with
      ischemic acute renal failure (ARF). ARF and sham rats received subcutaneous
      injections of either rhIGF-I or vehicle three times daily starting 5 h after
      surgery. Serum creatinine and urea, which initially rose similarly in the
      ARF+vehicle and ARF+rhIGF-I rats, increased more slowly after commencing the
      rhIGF-I injections. 72 h after surgery, the ARF+rhIGF-I rats, in comparison with
      ARF+vehicle animals, showed significantly greater renal plasma flow and
      filtration fraction, a fivefold higher glomerular filtration rate, greater renal
      cortical IGF-I levels, increased proliferating cell nuclear antigen expression in
      proximal tubule nuclei and enhanced DNA synthesis in the renal cortex,
      corticomedullary junction, glomeruli, and tubules as demonstrated by
      [3H]thymidine incorporation and in corticomedullary junction tubules as
      determined by autoradiography. Estimated total nitrogen output (ETNO) was greater
      in ARF+vehicle than in ARF+rhIGF-I or sham rats throughout the study. ETNO in
      ARF+rhIGF-I rats returned to sham values by the second day after surgery. 72 h
      after surgery, protein degradation was increased and protein synthesis reduced in
      the epitrochlearis muscle of ARF+vehicle as compared with ARF+rhIGF-I or
      sham+vehicle rats. Thus, treatment with rhIGF-I starting 5 h after inducing
      ischemic ARF in rats increases recovery of renal function, enhances formation of
      new renal tubular cells, lowers protein degradation, and increases protein
      synthesis in skeletal muscle and reduces net catabolism.

PMID- 8486788
TI  - Selective growth arrest and phenotypic reversion of prostate cancer cells in
      vitro by nontoxic pharmacological concentrations of phenylacetate.
AB  - Differentiation therapy may provide an alternative for treatment of cancers that
      do not respond to cytotoxic chemotherapy or hormonal manipulations. This
      hypothesis led us to evaluate the effect of a nontoxic differentiation inducer,
      sodium phenylacetate (NaPA), on hormone-refractory prostate cancer, the second
      most common cause of cancer deaths in men. NaPA treatment of androgen-independent
      PC3 and DU145 prostate cell lines, like that of hormone-responsive LNCaP
      cultures, resulted in dose-dependent inhibition of cell proliferation. Similar
      treatments were not significantly inhibitory to replicating normal endothelial
      cells and skin fibroblasts. In addition to the selective cytostatic effect, NaPA
      induced reversion of the prostatic cells to a nonmalignant phenotype, evidenced
      by their reduced invasiveness and loss of tumorigenicity in athymic mice.
      Phenotypic reversion was accompanied by alterations in gene expression, including
      selective reduction in tumor growth factor-beta 2 mRNA levels and increased
      amounts of class I major histocompatibility complex HLA transcripts. Furthermore,
      there was a decrease in tumor-associated proteolysis mediated by urokinase
      plasminogen activator, a molecular marker of disease progression in humans. When
      tumor cells were treated with NaPA together with suramin, a drug with
      demonstrable activity in patients, there was complete abrogation of cell growth
      under conditions in which each treatment alone produced only a partial effect.
      The in vitro antineoplastic activity was observed with drug concentrations that
      have been achieved in humans with no significant toxicities, suggesting that PA,
      used alone or in combination with other antitumor agents, warrants evaluation in
      the treatment of advanced prostatic cancer.

PMID- 8486789
TI  - Differential expression of mutant and normal beta T3 receptor alleles in kindreds
      with generalized resistance to thyroid hormone.
AB  - Thyroid hormone resistance (THR) is primarily an autosomal dominant inherited
      disease characterized by resistance of pituitary and peripheral tissues to the
      action of thyroid hormone. We investigated whether the heterogeneous phenotypic
      features that occur not only among kindreds but also within the same kindred
      might be due to the expression of differing ratios of mutant and normal receptors
      in tissues. Using an allele-specific primer extension method, we determined the
      relative expression of normal and mutant mRNAs from the fibroblasts of affected
      and unaffected members of two kindreds with TRH: A-H and N-N. While two affected
      members of A-H, as expected, had nearly equal amounts of normal and mutant hTR
      beta mRNA, two other members had mutant mRNA levels that accounted for at least
      70% of the hTR beta mRNA. Phenotypic variability within and between kindreds with
      generalized resistance to thyroid hormone GRTH may be due to this differential
      expression of the mutant and wild type mRNA. Furthermore, when several clinical
      parameters of THR were compared in several affected members from two kindreds
      with GRTH, we found that two cases in one kindred exhibited a high mutant-to
      normal hTR beta ratio and had considerably more bone resistance during their
      development. In certain kindreds with THR, differing ratios of normal and mutant
      hTR receptors may be age and growth related and may account for the reported
      attenuation of phenotypic symptoms with age.

PMID- 8486790
TI  - Defective major histocompatibility complex class I expression on lymphoid cells
      in autoimmunity.
AB  - Lymphocytes from patients with insulin-dependent diabetes mellitus (IDDM), a
      chronic autoimmune disease, have recently been shown to have decreased surface
      expression of MHC class I antigens. Since IDDM and other autoimmune diseases
      share a strong genetic association with MHC class II genes, which may in turn be
      linked to genes that affect MHC class I expression, we studied other autoimmune
      diseases to determine whether MHC class I expression is abnormal. Fresh PBLs were
      isolated from patients with IDDM, Hashimoto's thyroiditis, Graves' disease,
      systemic lupus erythematosis, rheumatoid arthritis, and Sjogren's syndrome.
      Nondiabetic and non-insulin-dependent diabetes mellitus patients served as
      controls. MHC class I expression was measured with a conformationally dependent
      monoclonal antibody, W6/32. Freshly prepared PBLs from the autoimmune diseases
      studied and the corresponding fresh EBV-transformed B cell lines had decreased
      MHC class I expression compared with PBLs from normal volunteers and non-insulin
      dependent (nonautoimmune) diabetic patients. Only 3 of more than 180 donors
      without IDDM or other clinically recognized autoimmune disease had persistently
      decreased MHC class I expression; one patient was treated with immunosuppressive
      drugs, and subsequent screening of the other two patients revealed high titers of
      autoantibodies, revealing clinically occult autoimmunity. Patients with
      nonautoimmune inflammation (osteomyelitis or tuberculosis) had normal MHC class I
      expression. Autoimmune diseases are characterized by decreased expression of MHC
      class I on lymphocytes. MHC class I expression may be necessary for self
      tolerance, and abnormalities in such expression may lead to autoimmunity.

PMID- 8486791
TI  - Protamine and protamine-insulins exacerbate the vascular response to injury.
AB  - Endothelial cells and smooth muscle cells produce heparinlike compounds that are
      growth inhibitory for vascular smooth muscle cells, and it has been suggested
      that these compounds play a regulatory role that is perturbed with vascular
      injury. Indeed, exogenous heparin preparations effectively suppress smooth muscle
      cell proliferation following injury imposed on vascular endothelium. We now
      report that protamine, an agent that binds heparin and negates its anticoagulant
      properties, has potent stimulatory effects on vascular smooth muscle cell
      proliferation. The administration of protamine, alone or as part of commonly used
      insulin preparations, stimulated the proliferation of cultured smooth muscle
      cells, exacerbated vascular smooth muscle cell proliferative lesions in
      laboratory rats, and interfered with the growth-inhibitory effects of heparin in
      culture and in vivo. These results confirm the importance of endogenous
      heparinlike compounds in arterial homeostasis and may require reconsideration of
      protamine use following vascular reparative procedures and in diabetics.

PMID- 8486792
TI  - Abnormal contractile function due to induction of nitric oxide synthesis in rat
      cardiac myocytes follows exposure to activated macrophage-conditioned medium.
AB  - The mechanism by which soluble mediators of immune cell origin depress myocardial
      contractility, either globally as in systemic sepsis, or regionally in areas of
      inflammatory myocardial infiltrates, remains unclear. When freshly isolated
      ventricular myocytes from adult rat hearts were preincubated for at least 24 h in
      medium conditioned by endotoxin (LPS)-activated rat alveolar macrophages, their
      subsequent inotropic response to the beta-adrenergic agonist isoproterenol was
      reduced from 225 +/- 19% to 155 +/- 10% of the baseline amplitude of shortening
      (mean +/- SEM, P < 0.05). Neither baseline contractile function nor the
      contractile response to high extracellular calcium were affected. To determine
      whether an endogenous nitric-oxide (NO)-signaling pathway within ventricular
      myocytes was responsible for their decreased responsiveness to isoproterenol, the
      L-arginine analogue L-NMMA was added to the preincubation medium. While L-NMMA
      did not affect baseline contractile function or the response of control myocytes
      to isoproterenol, it completely restored the positive inotropic response to
      isoproterenol in myocytes preincubated in LPS-activated macrophage medium.
      Release of NO by ventricular myocytes following exposure to activated macrophage
      medium was detected as an increase in cGMP content in a reporter-cell (RFL-6)
      bioassay and also as increased nitrite content in myocyte-conditioned medium.
      Thus, the depressed contractile response of adult rat ventricular myocytes to
      beta-adrenergic agonists by a 24-h exposure to soluble inflammatory mediators is
      mediated at least in party by induction of an autocrine NO signaling pathway.

PMID- 8486794
TI  - Victims of traffic accidents: incidence and prevention of post-traumatic stress
      disorder.
AB  - The psychological consequences of traffic accidents have been rarely the subject
      of research. Responses of serious traffic accidents and the effects of an
      outreach program for victims were studied in a research project. Subjects
      selected from police registers participated in a preventive counseling program or
      in a monitoring group. Foci of this study were the way in which the subjects
      coped with the event and the symptoms that might develop. Measurements were
      carried out 1 month and 6 months after the accident. The results indicate that an
      average of about 10% of the victims suffer from post-traumatic stress disorders
      and that although counseling is appreciated by victims, it could not be proven
      that it was effective in preventing disorders.

PMID- 8486793
TI  - 5'-adenosine monophosphate is the neutrophil-derived paracrine factor that
      elicits chloride secretion from T84 intestinal epithelial cell monolayers.
AB  - Neutrophil transmigration across intestinal epithelia is thought to contribute to
      epithelial dysfunction and characterizes many inflammatory intestinal diseases.
      Neutrophils activated by factors, normally present in the lumen, release a
      neutrophil-derived secretagogue activity to which intestinal epithelia respond
      with an electrogenic chloride secretion, the transport event which underlies
      secretory diarrhea. Using sequential ultrafiltration, column chromatographic, and
      mass and Raman spectroscopic techniques, neutrophil-derived secretagogue was
      identified as 5'-AMP. Additional studies suggested that neutrophil-derived 5'-AMP
      is subsequently converted to adenosine at the epithelial cell surface by ecto-5'
      nucleotidase and that adenosine subsequently activates intestinal secretion
      through adenosine receptors on the apical membrane of target intestinal
      epithelial cells. These findings suggest that this ATP metabolite may serve as a
      neutrophil-derived paracrine mediator that contributes to secretory diarrhea in
      states of intestinal inflammation.

PMID- 8486795
TI  - The measurement and mismeasurement of ophidiophobia in analogue research: a
      procedural review.
AB  - The adequacy of current paper-and-pencil measures of ophidiophobia (fear of
      snakes) was analyzed by reviewing the subject selection procedures in 24
      published articles with the restriction that the procedures involve some form of
      self-report. The sample characteristics and selection procedures of these studies
      were reviewed in detail. We conclude that the recommendations and conclusions of
      these studies should not be accepted due to limited generalizability. Paper-and
      pencil measures are excellent initial selection devices, but cannot stand alone
      in selecting ophidiophobics from the general population.

PMID- 8486796
TI  - Factors associated with the psychological well-being of adults with acute
      leukemia in remission.
AB  - The relationships among coping responses, social support, personality factors,
      and psychological well-being in adults with acute leukemia in remission were
      studied. The psychological well-being measure was related to quality of life.
      Forty persons (21 male, 19 female), average age 47 years and average time since
      diagnosis of 24 months, completed demographic questions, the PRF-E, the Symptom
      Distress Scale, a Coping Responses inventory, the modified Social Support
      Questionnaire, and the General Behavior Inventory. An R of .80 was obtained
      between psychological well-being and Endurance, Affiliation, Cognitive Structure,
      Autonomy, and Nurturance. Findings were related to fighting spirit and
      confronting coping style, concepts associated with psychological well-being and
      longevity in cancer patients.

PMID- 8486798
TI  - Cognitive distortions and irrational beliefs in post-traumatic stress, anxiety,
      and depressive disorders.
AB  - This study examined the validity of PTSD by comparing the dysfunctional
      cognitions found in a PTSD group, a clinical group (anxiety or depression), and a
      nonclinical group. Subjects completed the Millon Clinical Multiaxial Inventory
      II, the Impact of Event Scale, the Beck Depression Inventory, the State-Trait
      Anxiety Inventory, the Cognitive Error Questionnaire, and the Survey of Personal
      Beliefs. Results revealed that PTSD and clinical groups were significantly more
      depressed and anxious than nonclinical subjects. Unlike the PTSD group, only the
      clinical group endorsed more dysfunctional cognitions than the nonclinical group,
      which supports the uniqueness of the PTSD group as differing cognitively from
      clinical groups.

PMID- 8486797
TI  - Sexually and physically abused adolescents: an empirical search for PTSD.
AB  - Recently, clinical manifestations of post-traumatic stress disorder (PTSD) in
      children and adolescents have been investigated, yet little is known about its
      assessment or diagnosis. Few empirically based studies appear in the PTSD
      literature on non-adult populations. Data were collected from 19 physically and
      sexually abused adolescents (aged 13-18 years) who were living in a group home
      setting. Subjects were administered the MMPI, Beck Depression Inventory (BDI),
      and Spielberger State Trait Anxiety Inventory (STAI). Results suggest that the
      subjects were moderately depressed and anxious, but that these adolescents did
      not manifest significant symptomatology of PTSD similar to that seen in adult,
      civilian PTSD populations using comparable MMPI measures. Implications of these
      findings for assessment purposes are discussed.

PMID- 8486799
TI  - Male perceptions of female attractiveness: the effects of targets' personal
      attributes and subjects' degree of masculinity.
AB  - This study examined the relationship between the degree of sexist beliefs held
      toward women by male subjects and their perceptions of attractiveness of females
      described as possessing either masculine or feminine personality characteristics.
      One hundred twenty-two undergraduate males were given the Macho Scale, the Auburn
      University Personal Behavior Summary, a biodata sheet, and were asked to judge
      previously rated photographs of women along a dimension of attractiveness.
      Results demonstrated that males perceived physically unattractive and average
      females described as affectionate and compassionate as more attractive than
      similarly rated females described as independent and assertive. High Macho
      subjects viewed females as less attractive than low Macho subjects. Physical
      attractiveness of the male subjects was largely unrelated to their ratings of the
      females.

PMID- 8486800
TI  - A self-rating scale for the assessment of posttraumatic stress disorder in Dutch
      Resistance veterans of World War II.
AB  - The present study reports on the development of a Dutch PTSD scale based on the
      DSM-III criteria for PTSD. Test-retest reliability was .91. The scale showed an
      internal consistency with a coefficient alpha of .88. Factor analysis on a large
      sample of Resistance veterans (N = 967) yielded six factors, which represent
      intrusive thoughts, physiological reactions, detachment, rage, active
      confrontation, and guilt.

PMID- 8486801
TI  - The differential responding of college students to subtle and obvious MCMI
      subscales.
AB  - This study investigated the differential responding of 49 male and 92 female
      college students to subtle and obvious MCMI scale items. It had been predicted
      that item subtlety would be correlated positively with item endorsement. This
      prediction was supported across all 175 MCMI items (r = .34). In addition,
      subjects endorsed a greater percentage of subtle than obvious subscale items for
      eight Basic Personality scales and two of three Pathological Personality scales.
      However, this pattern was not consistent for the nine Symptom Disorder scales. It
      also had been predicted that gender would moderate subjects' differential
      responding to subtle and obvious items, whereby males would show a greater
      tendency than females to endorse relatively more subtle than obvious items. This
      prediction was not supported.

PMID- 8486802
TI  - Reading level of the Dissociative Experiences Scale.
AB  - Reading difficulty values based upon the Flesch reading grade level and reading
      ease score (Flesch, 1949) were calculated for the 28 items of the Dissociative
      Experiences Scale (DES; Bernstein & Putnam, 1986). Item reading levels ranged
      from the sixth to more than the thirteenth grade. According to the reading level
      formula, 43% of the items required at least a high school education. The reading
      ease estimate suggested that only 1 item required at least 12 years of schooling.
      Overall, a tenth- to eleventh-grade reading level was required for the entire
      DES. For persons with confirmed or suspected reading difficulties, interpretation
      of the DES should be made cautiously.

PMID- 8486803
TI  - Unidimensionality of SCL-90-R scales in adult and adolescent crisis samples.
AB  - The factorial structure and consistency of the SCL-90-R dimensions were
      investigated in adult (90 male, 94 female) and adolescent (93 male, 120 female)
      admissions to a crisis intervention unit by means of principal components
      analysis. All four samples of subjects demonstrated one large factor, which
      accounted for 66 to 70% of the variance. Second factors in each sample
      contributed insignificant variance. Factorial invariance across male, female, and
      adult, adolescent samples was observed. Results suggest the SCL-90-R to be a
      unidimensional measure in a crisis context. Appropriateness of profile scores
      within such a context is discussed.

PMID- 8486804
TI  - Psychometric evaluation of post-traumatic stress disorder: the Multidimensional
      Personality Questionnaire as an adjunct to the MMPI.
AB  - Two groups of Vietnam veterans--Post-traumatic stress disorder (PTSD, n = 17) and
      non-PTSD (n = 80)--were developed from a sample of treatment-seeking alcohol
      abusers. The subjects completed a Combat Experiences Questionnaire, a PTSD
      Symptom Scale, the MMPI, and the Multidimensional Personality Questionnaire
      (MPQ). The MPQ proved to be a useful adjunct to the MMPI in describing the major
      manifestations of PTSD among alcohol-abusing veterans.

PMID- 8486805
TI  - Predicting Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ scores from the
      Luria-Nebraska Neuropsychological Battery (Form I).
AB  - The study examined a modification of two sets of previously published LNNB
      derived WAIS IQ estimates in order to estimate WAIS-R IQs in a sample of
      neuropsychiatric patients. Findings suggested that the modification will allow
      practicing clinicians to estimate WAIS-R IQs with a level of accuracy similar to
      that found in previous research. The level of predictive accuracy for WAIS-R FSIQ
      and VIQ was somewhat higher than would be expected on the basis of previous
      research, which suggests that the modified McKay, Golden, Moses, Fishburne, and
      Wisniewski (1981) formulae for estimating IQ may be more accurate than previously
      thought. The correlation matrix of WAIS-R subtests and LNNB Form I clinical and
      summary scales also is described.

PMID- 8486806
TI  - Factor structure of emotional and cognitive behaviors for normals and
      neurologically impaired patients.
AB  - This study examined the factor structure of 68 affective, cognitive, and
      behavioral symptoms often reported with neurological impairment. The responses of
      199 subjects to a behavioral inventory were submitted to an exploratory factor
      analysis. The results demonstrated that the instrument could be reduced to 16
      homogeneous factors, which were able to explain 67% of the instrument's total
      variability. These factors were entered into a discriminant analysis that
      examined neurologically impaired patients and normal controls. Eleven of the 16
      factors formed a linear composite that discriminated between these two groups
      with approximately 94% accuracy.

PMID- 8486807
TI  - Left temporal lobe brain damage pattern on the WAIS, addendum.
AB  - This study added Digit Span to an index investigated in a previous study. An
      index score, in which the WAIS Vocabulary and Information were more impaired than
      Similarities and Digit Span, indicated left temporal lobe damage. Using subjects
      with damage restricted to a single lobe of the brain, the index was found to be
      significantly more related to the left temporal lobe than to any other part of
      the brain.

PMID- 8486808
TI  - Wechsler Memory Scale-Revised in closed head injury.
AB  - This study was undertaken to determine the ability of the Wechsler Memory Scale
      Revised (WMS-R) to differentiate a group of closed head injury patients from a
      group of controls and determine how injury severity and attentional deficits are
      associated with WMS-R performance. The relationship of WMS-R performance to
      everyday memory also was assessed. The head injured group performed more poorly
      than controls on all five WMS-R indices and exhibited greater impairments on
      tasks that measure retention. In the original sample only the Visual Memory Index
      correlated with injury severity; in a larger sample, all four memory indices
      correlated modestly with injury severity. Patients who performed more poorly on
      the WMS-R also received poorer ratings on an independent assessment of everyday
      memory.

PMID- 8486809
TI  - Factor structure of the WISC-R in children with traumatic brain injury.
AB  - The factor structure of the WISC-R was examined in a sample of 108 children with
      traumatic brain injury. Principal factor analysis of 11 WISC-R subtests yielded
      three factors, which were subjected to varimax rotation. The rotated factor
      pattern suggested the existence of a Verbal Comprehension factor, a Perceptual
      Organization factor, and a somewhat weaker third factor. The meaning and
      implications of this third factor are discussed.

PMID- 8486810
TI  - Previewing: a developmental principle that promotes the therapeutic use of
      metaphor.
AB  - When one is treating mother-infant dyads psychotherapeutically, the infant's
      inchoate language skills render the traditional use of metaphor ineffective. This
      paper discusses how a developmental principle, labeled previewing, may function
      like a metaphor and be used to address the therapeutic needs of the dyad.
      Previewing and metaphor also may complement each other in the treatment of adults
      in individual therapy. Previewing--like metaphors--may provide a means of
      addressing interpersonal issues, may function as a shared language that promotes
      intersubjectivity, and may help the patient deal with conflict in a non
      threatening manner that may circumvent defensive operations.

PMID- 8486811
TI  - Features of borderline personality and violence.
AB  - This study tested the hypothesis that borderline personality characterizes
      extreme violence by assessing features of borderline and schizotypal personality
      in three groups: Murderers, Violent, and Nonviolent adult offenders. Murderers
      had higher borderline personality scores than nonviolent offenders (p < .04). A
      test for linear trend indicated a linear increase in borderline scores with
      increasing degree of violence across the three groups (p < .02). No group
      differences were observed for schizotypal personality. Borderline traits
      associated with extreme violence consisted of unstable, intense relationships and
      affective instability. Group differences were not an artifact of group
      differences in age, social class, IQ, or number of previous custodies. It is
      concluded that borderline personality may predispose toward extreme forms of
      violence.

PMID- 8486812
TI  - Academic achievement in Substance-Abusing and Conduct-Disordered adolescents.
AB  - This study determined the influence of adolescent alcohol abuse on academic
      achievement. Substance Abusing (SA), Conduct Disordered (CD), and Normal Student
      Control (NSC) adolescents, stratified on Family History (FH) of alcoholism and
      gender, were tested on the Peabody Individual Achievement Test (PIAT). While SAs
      and CDs did not differ on the PIAT, both had lower subtest and total test
      standard scores than NSCs. FH + SAs did not differ from FH + CDs on the Spelling
      subtest, but both groups had significantly lower scores than FH - NSCs. For SAs
      and NSCs there were no significant correlations between measures of alcohol
      intake and PIAT subtest scores.

PMID- 8486813
TI  - Gender effects in diagnosing alcohol abuse and dependence.
AB  - Using a national population sample of 43,809 adults, male and female responses
      were compared for 41 indicators of alcohol abuse and dependence. While men
      reported all indicators more often than did women, the male to female ratio of
      positive responses varied according to both the construct represented by the item
      and its underlying prevalence. Items that might be construed as signs of weakness
      physical effects, psychological effects, and loss of control or powerlessness-
      had lower male/female ratios than other items. Excess male prevalence was
      greatest for the least prevalent indicators. The paper presents alternative
      interpretations of these findings and discusses their implications for diagnostic
      classification.

PMID- 8486814
TI  - Antidepressants and cancer: cause for concern?

PMID- 8486816
TI  - Acutely psychotic patients receiving high-dose haloperidol therapy.
AB  - Despite the trend towards lower neuroleptic dosing in the treatment of psychosis,
      there continue to be patients who are administered doses that are higher than
      recommended. Thirty-six acutely psychotic patients receiving parenteral
      haloperidol were evaluated by the Brief Psychiatric Rating Scale, the Schedule
      for Affective Disorders and Schizophrenia-Change Version, and the Nurses'
      Observation Scale for Inpatient Evaluation, as well as by drug levels in plasma.
      Patients were compared on the basis of total haloperidol dose in the first 24
      hours: regular dose (RD: 10-30 mg) and high dose (HD: 40-80 mg). At baseline,
      patients in the HD group scored significantly higher on the Brief Psychiatric
      Rating Scale factor Hostile-Suspiciousness and the Nurses' Observation Scale for
      Inpatient Evaluation factor Irritability. Assignment to regular-dose and HD
      groups could not be accounted for on the basis of age, gender, weight, or
      duration of illness. Moreover, drug levels in plasma indicated that the HD
      patients did not require higher doses on the basis of differences in haloperidol
      levels.

PMID- 8486815
TI  - Differential effects of triazolam and ethanol on awareness, memory, and
      psychomotor performance.
AB  - Eight normal, healthy, male volunteers each received four triazolam doses (0, 2,
      4, and 8 micrograms/kg) and four ethanol doses (0, 0.25, 0.5 and 1.0 g/kg) in a
      double-blind, double-dummy experiment in which within-subject dose sequence was
      determined by a balanced Latin square design. Triazolam and ethanol produced dose
      related and time-related effects on subject ratings of mood and perceived drug
      effects and objective measures of memory and psychomotor performance. Dose
      response curves for the two drugs were not parallel, and therefore, comparisons
      of the two drugs were based upon comparisons of the high dose of each drug.
      Although the two high-dose conditions generally were not different from one
      another, there were differences in their relative effect sizes, which were
      important. The high dose of each drug produced comparable degrees of impairment
      on two different psychomotor tasks. Triazolam, but not ethanol, produced
      significant impairment on two different memory tasks. The relative effects of
      each drug on subject ratings of mood and perceived drug effects varied across
      different subject-rated measures. Only ethanol significantly increased subject
      ratings of alcohol strength and feeling drunk. In comparison to ethanol,
      triazolam tended to produce less-pronounced subject ratings of drug effect
      magnitude, drug liking, and estimated performance impairment. However, less
      pronounced subjective effects of triazolam were not universally observed on all
      subject ratings. Triazolam produced greater effects on several sedative symptoms
      and produced comparable effects on several mood factor scales.

PMID- 8486817
TI  - Haloperidol dosing requirements: the contribution of smoking and nonlinear
      pharmacokinetics.
AB  - Previous data suggest the possibility that haloperidol daily dosing requirements
      may be confounded by smoking and, at higher doses, capacity-limited metabolism.
      Forty hospitalized patients suffering from an acute exacerbation of schizophrenia
      were treated for 2 weeks with fixed oral doses of haloperidol ranging from 10 to
      70 mg/day (0.13 to 0.95 mg/kg/day) that produced mean steady-state concentrations
      between 4.5 and 55.4 ng/ml. No significant differences between the smoking and
      nonsmoking groups were obvious for the factors of weight, age, sex, daily doses,
      steady-state clearance, and steady-state haloperidol concentrations in plasma at
      week 1, week 2, and their mean. The hypothesis that the relationship between
      haloperidol dose and steady-state haloperidol concentration in plasma was
      affected by patients' smoking status and metabolic capacity was tested by
      multiple linear regression analysis and initially rejected. The relationship of
      dose to haloperidol concentration was fitted as a linear function. To improve the
      curve fit, the haloperidol concentrations and doses were transformed to their
      natural logs and then the regression line was refitted. The multiple regression
      analysis was repeated with the data in their transformed state. It was found
      that, although smoking status and dose of the drug did not independently affect
      the average haloperidol concentration, together they interacted in such a way
      that individual haloperidol concentrations were dependent on the smoking status
      at specific doses. Thus, two haloperidol dosing equations were generated, one for
      smokers and one for nonsmokers.

PMID- 8486818
TI  - Antidepressant-induced rapid cycling: six case reports.
AB  - We report six cases of rapid mood cycling induced by antidepressant treatment.
      The key to effective treatment involved the recognition of the pattern of
      apparent remission, relapse, antidepressant and/or stimulant adjustment,
      remission, relapse, etc. Hypomanic episodes were frequently mild and could be
      mistaken for remission. The destabilizing effects of antidepressant drugs were
      not corrected by the addition of mood stabilizers, necessitating the withdrawal
      of the antidepressant agent. All but one case responded to such withdrawal. Two
      cases required the addition of high-dose L-thyroxine for stabilization.
      Implications for an effective treatment protocol are discussed.

PMID- 8486819
TI  - This prescription may be hazardous to your health: who is accountable to the
      patient?

PMID- 8486820
TI  - Pimozide-induced depression?

PMID- 8486821
TI  - Neuroleptic malignant syndrome in communicating hydrocephaly and microcephaly.

PMID- 8486822
TI  - Effects of fluvoxamine on whole-blood serotonin and platelet number.

PMID- 8486823
TI  - Monoamine oxidase inhibitor hypertensive crisis headache and orthostatic
      hypotension.

PMID- 8486824
TI  - Response to "Monoamine oxidase inhibitors and hypertension".

PMID- 8486825
TI  - Rationale and clinical indications for contrast agents in MR imaging of the brain
      and spine.
AB  - This presentation explores clinical indications, limitations, and the scientific
      rationale for use of gadolinium contrast agents in MR imaging of the brain and
      spine. Enhancement of abnormal CNS tissues is related to structure and function
      of the blood-brain barrier under pathologic conditions, the prototype of which is
      tumor angiogenesis. Gadolinium administration can improve the diagnostic
      sensitivity of intracranial MR imaging, facilitating detection of leptomeningeal
      or ependymal disease spread and metastases. Moreover, use of contrast often
      provides greater diagnostic specificity by virtue of the presence and, in many
      cases, the absence of enhancement. This is particularly helpful in distinguishing
      metastases from other potential causes of high signal intensity on unenhanced
      spin-echo (SE) images. In addition to improving diagnosis of neoplasia,
      gadolinium use is often necessary to demonstrate most cranial neuropathies and to
      differentiate herniated disc from epidural fibrosis in the failed-back surgery
      syndrome. Advanced techniques that exploit gadolinium's properties (e.g., MR
      angiography, perfusion MR imaging) or increase its diagnostic effectiveness
      (e.g., fat suppression in the postoperative spine) are treated.

PMID- 8486826
TI  - Introduction to the gadolinium class.
AB  - Among the many paramagnetic substances, gadolinium ions [Gd(III)] exhibit one of
      the strongest degrees of proton-relaxation enhancement, which can be applied
      advantageously to selectively enhance diseases tissues on MR images. Such
      enhancement often proves the difference between suggestive and conclusive MR
      diagnostic studies. Chelation of the metal to organic ligands enhances safety and
      facilitates diagnostically useful tissue distribution and renal clearance.
      Chelates confer the further advantage of enabling gadolinium to be joined with
      carrier molecules, which can, in turn, foster tissue- or even antigen-specific
      targeting of contrast agents. Cost and relative biologic-tolerance profiles may
      prove to be key factors for distinguishing agents with similar distributions in
      clinical practice.

PMID- 8486827
TI  - Stability of gadolinium complexes in vitro and in vivo.
AB  - Gd(III) toxicity is such that, for in vivo use, the ion must be incorporated into
      stable, ionically bound complexes with organic chelating agents. Although metal
      chelate-based contrast agents have been demonstrated safe in phase I-III studies,
      their potential toxicities must be considered, particularly in the development of
      new contrast media. The potential for adverse effects is thought to arise from in
      vivo dissociation into constituent metal ion and ligand. Release of Gd(III) from
      ligand may also be facilitated by endogenous metals [e.g., Zn(II)] that compete
      with Gd(III) for ligand-binding sites. In vivo complex stability toward
      dissociation depends on several closely balanced characteristics of the metal and
      ligand that maintain metal-chelate integrity during residence in the body. Among
      design strategies explored to minimize the potential for in vivo Gd(III) release
      are the use of ligands that: form Gd(III) complexes with high thermodynamic
      stabilities; have binding selectivity for Gd(III) over endogenous metal ions;
      incorporate rigid cyclic structures and form Gd(III) complexes with greater
      kinetic stabilities than their open-chain homologs; or incorporate slight excess
      ligand to "scavenge" loosely bound or free endogenous metal ions that might
      otherwise compete with Gd(III) for ligand binding.

PMID- 8486828
TI  - MR imaging advances in practice.
AB  - Efficacy and safety of gadolinium contrast agents in MR imaging of the brain and
      spine are examined first in the context of clinical experience at the Barrow
      Neurological Institute. The role played by the absence and the presence of
      contrast enhancement in confirming or ruling out diagnostic suspicions is
      emphasized. Findings from multicenter phase I-III efficacy and safety studies of
      gadopentetate dimeglumine, gadodiamide, and gadoteridol in head and back imaging
      are reviewed. All three agents add diagnostic information, increase diagnostic
      confidence, and are extremely safe, readily tolerated compounds exhibiting
      generally mild side-effect profiles. Gadolinium-enhanced MR scanning is placed in
      the longer perspective of diagnostic imaging strategies, to consider the
      assignment of priorities to various modalities according to the suspected disease
      at hand.

PMID- 8486829
TI  - Future uses of MR imaging agents.
AB  - Existing paramagnetic agents and novel superparamagnetic pharmaceuticals under
      development promise to advance substantially the frontiers of MR imaging. Used in
      conjunction with ultrafast MR techniques, such as echoplanar imaging and
      turboFLASH (fast low-angle shot), relaxivity agents (e.g., dysprosium,
      gadolinium), which alter T1 characteristics of tissue protons they act on, can be
      used to generate quantitative maps of dynamic blood-brain barrier permeability as
      well as regional hemodynamic profiles of diseased heart and other organs. In
      addition, the magnetic susceptibility (T2*)-altering effects of gadolinium can be
      exploited to map regional cerebral blood volume during task-activated and
      pathologic brain states. Magnetic susceptibility agents, such as monocrystalline
      iron oxide nanoparticles (MIONs), allow the advantages of scintigraphy to be
      joined with the high spatial resolution of MR imaging. Not only can these
      magnetopharmaceutical preparations serve as hemodynamic markers, they have
      already enabled function-specific imaging at the cellular level under diverse
      pathologic conditions.

PMID- 8486830
TI  - Economic/reimbursement issues in MR imaging with gadolinium contrast agents.
AB  - Implementation of an accurate, reliable index of cost effectiveness would help to
      advance technology assessment and reimbursement of MR imaging procedures,
      including gadolinium enhancement. To this end, an objective, consensual measure
      that satisfies the need for "gold-standard" confirmation of diagnostic
      impressions in routine clinical practice and limits interpreter bias has been
      developed. Eponymously termed Diagnostic Merit, this barometer is expressed as
      the percentage of independent judges confirming diagnostic impressions entered by
      case-blinded radiologists assigned unenhanced and enhanced image sets for
      interpretation. The judges, who are informed of clinical indications, clinical
      follow-up, and unblinded diagnostic interpretation of the MR scans, confirm only
      those case-blind interpretations deemed "close enough for diagnostic utility" to
      actual clinical profiles. According to this method, gadopentetate dimeglumine has
      been shown to be cost effective by promoting optimal diagnostic performance. This
      improvement in utility offsets the cost of the gadolinium contrast agent.
      Efficacies of gadodiamide and gadoteridol, two other contrast agents in
      development, have been demonstrated by other measures but are probably also
      evaluable through the Diagnostic Merit method. CPT-4 codes for contrast-enhanced
      MR imaging are reviewed.

PMID- 8486831
TI  - Clinical experience with gadolinium contrast agents in spinal MR imaging.
AB  - Gadolinium contrast agents represent one of the most important advances in MR
      imaging of spinal disease. Many abnormalities that affect the epidural,
      intradural extramedullary, and intramedullary compartments demonstrate contrast
      enhancement, the pattern of which often provides specific diagnostic information.
      This is particularly true of neoplastic diseases such as primary glioma and
      leptomeningeal tumor spread. Gadolinium contrast also finds vital application in
      differentiating herniated disc from epidural fibrosis in the failed-back surgery
      syndrome, as well as hypointense disc from enhancing tumor in select cases.
      Certain demyelinating and inflammatory processes also have predictable MR
      manifestations that facilitate accurate diagnosis.

PMID- 8486832
TI  - Effects of recombinant bovine somatotropin (sometribove) on ovarian function in
      lactating and nonlactating dairy cows.
AB  - Metabolic and ovarian responses of lactating and nonlactating cows to recombinant
      bST (sometribove) were measured. Eighteen lactating cows (60 to 100 d postpartum)
      and 6 nonlactating cows (> 400 d postpartum) were injected daily with bST or
      saline during one of two periods. Concentrations of hormones and metabolites were
      measured in plasma, and ultrasonography was used to quantify ovarian follicular
      growth. Concentrations of glucose, insulin, IGF-I, progesterone, and estradiol in
      plasma were greater in nonlactating cows than in lactating cows. Lactating cows
      had fewer class 2 (6- to 9-mm) and class 3 (10- to 15-mm) follicles and more
      class 4 (> 15-mm) follicles than nonlactating cows. Bovine somatotropin increased
      the numbers of follicles in lactating cows so that the numbers of class 2 and of
      class 3 follicles were equivalent to those for non-lactating cows. Sizes of the
      largest follicles were similar for bST-and saline-treated cows. The second
      largest ovarian follicles, however, were larger in bST-treated cows. Ovarian
      follicular dynamics were altered by bST and lactation. Bovine somatotropin
      increased the numbers of follicles (6 to 15 mm) in lactating cows and size of
      second largest ovarian follicles in both lactating and nonlactating cows.
      Lactating cows developed dominant follicles that were larger and less estrogenic
      than those of nonlactating cows.

PMID- 8486834
TI  - Survival of bull spermatozoa seeded and frozen at different rates in egg yolk
      tris and whole milk extenders.
AB  - Six factorially arranged experiments were designed to study effects of seeding,
      freezing, and thawing rates in whole milk and egg yolk-Tris extenders commonly
      used for commercial cryopreservation of bull sperm. In these extenders, semen
      normally is supercooled to -13 or -14 degrees C unless the sperm are seeded. When
      sperm were supercooled or seeded, either mechanically or with immobilized silver
      iodide, and frozen to -196 degrees C, the postthaw percentages of motile sperm
      were 59, 57, and 64%, respectively. Freezing rates of -15, -25, and -35 degrees
      C/min gave similar sperm survival rates and were superior to -5 degrees C/min.
      For milk, the critical freezing temperature extended to -75 degrees C before
      transfer to liquid nitrogen gave good results. For egg yolk-Tris extender,
      transfer to liquid nitrogen was less critical once -50 degrees C had been
      attained. Thawing of sperm in water baths at 25 and 45 degrees C gave similar
      results, and both temperatures were superior to 5 degrees C. The postthaw
      percentage of motile sperm in egg yolk-Tris was equal or superior to that of
      sperm frozen in milk. A freezing rate of -15 degrees C/min to -100 degrees C and
      thawing at 25 degrees C consistently gave good results.

PMID- 8486833
TI  - Ovarian follicular populations in lactating dairy cows treated with recombinant
      bovine somatotropin (sometribove) or saline and fed diets differing in fat
      content and energy.
AB  - Interactions of dietary energy and fat with recombinant bST (sometribove)
      injections were tested for their effects on ovarian function. Lactating dairy
      cows were fed one of three diets differing in energy concentration (NEL) and
      percentage of DM of calcium salts of long-chain fatty acids: diet 1, 1.68 Mcal/kg
      and 0%; diet 2, 1.68 Mcal/kg and 2.2%; and diet 3, 1.78 Mcal/kg and 2.2%. Cows
      were injected daily with bST or saline during one of two 19-d interestrous
      periods (crossover design) in which ovarian follicles were measured by
      ultrasonography. The bST-treated cows produced more FCM and were in lower energy
      balance than saline-treated cows. Before d 12 (first follicular wave, estrus = d
      0), bST-treated cows had more ovarian follicles in classes 1 (3 to 5 mm; cows on
      diet 3) or 2 (6 to 9 mm; cows on diets 1 and 2) than saline-treated cows. After d
      12 (preovulatory follicular wave), numbers of follicles in different size classes
      were similar for bST-treated and saline-treated cows, but cows fed diet 2 had
      larger preovulatory follicles. Lower dietary energy and bST treatment were both
      associated with larger subordinate follicles. Ovarian follicles less than 10 mm
      were stimulated by bST, and calcium salts of long-chain fatty acids increased
      diameters of preovulatory follicles.

PMID- 8486835
TI  - Prevalence of high somatic cell counts in bulk tank goat milk.
AB  - Higher SCC have been observed in goat milk than in cow milk. This study evaluated
      the prevalence of high SCC and determined whether increased neutrophils were a
      factor in high SCC. Bulk tank goat milk samples were collected from commercial
      dairy goat herds in California, Arkansas, Michigan, and Wisconsin. Total SCC were
      determined using a Fossomatic Electronic Cell Counter and microscopically using
      pyronin Y-methyl green stain. Differential counts were determined using Wright's
      stained cytospin centrifuge preparations. Average SCC were high (6.12 log10
      cells/ml; geometric mean, 1.32 x 10(6) cells/ml). The average of the Fossomatic
      and direct microscopic SCC indicated that 8.6% of the producers had SCC < .75 x
      10(6) cells/ml and that 34.5% were < 1 x 10(6) cells/ml. The current goat milk
      SCC standard is 1 x 10(6) cells/ml; the cow milk SCC standard will be .75 x 10(6)
      cells/ml in 1993. Milk samples contained 9.9% macrophages, 2.8% lymphocytes, and
      87% neutrophils. These data indicate that high SCC were prevalent and that
      increased neutrophils contributed to high SCC in the bulk tank goat milk.

PMID- 8486836
TI  - Teat tissue reactions to milking: effects of vacuum level.
AB  - Machine-induced changes in diameter, thickness, and compressibility of the teat
      apex and teat barrel were measured on all teats of four cows milked at vacuums of
      25, 30, 40, and 50 kPa. Measurements were made with an electronic caliper
      instrument immediately before milking and then at .5, 15, and 30 min after
      milking. Teat length was also measured at these times. Immediately after milking,
      for the two higher levels, teats were significantly thicker (7 to 10% thicker at
      40 kPa, 17 to 25% at 50 kPa), shorter (by 3 to 6 mm), smaller in diameter (by 2
      to 4 mm for the apex, 3 to 6 mm for the barrel), and less compressible for all
      milking treatments compared with the premilking status for individual teats.
      Although teat thickness recovered to the premilking mean values 30 min after
      milking at 40 or 50 kPa, the barrel still was significantly thicker after 30 min
      compared with those at the lower vacuum treatments. We suggest that changes in
      teat length, diameter, thickness, and compressibility after milking at low vacuum
      levels mainly reflect tissue responses to udder evacuation. In contrast,
      increased teat wall thickness and reduced compressibility of teat tissue at
      higher vacuum levels likely result mainly from machine-induced edema.

PMID- 8486837
TI  - Use of bovine rib bone in serial sampling for mineral analysis.
AB  - A total of 2160 samples of rib bone were used in a split-plot design analysis of
      variance to show that, on an ash weight basis, P content is not different among
      the right and left 9th, 10th, 11th, and 12th ribs of cattle above 6 mo of age.
      Results were similar for Ca on a fresh or dry weight basis. Some differences
      existed in Mg content among some of the ribs. Location on the rib from which
      samples were taken was responsible for significant differences in mineral
      concentrations. Based on results reported herein, ribs 9, 10, 11, and 12 of the
      right and left side may be used in the serial sampling of bone tissue in the
      bovine for the purpose of comparing the content of P, Ca, and--to some extent-
      Mg. Serial sampling makes possible comparison of bovine mineral status based on
      bone tissue over an extended experimental period that includes eight sampling
      dates.

PMID- 8486838
TI  - Computerized monitoring of gas production to measure forage digestion in vitro.
AB  - The techniques reported in this paper were developed to facilitate the study of
      the kinetics of forage digestion in vitro by measuring gas production. Fiber
      disappearance as a measure of the reaction rate has been replaced by the use of
      computerized pressure sensors to monitor the gaseous products (CO2, CH4) of
      microbial metabolism. The recording system described requires a computer,
      pressure sensors, an interface card, and appropriate software to monitor gas
      production continuously. Several variables, including sample size, inoculum size,
      vessel size, and type of pressure sensor, have been investigated to determine
      ranges within which gas production can be measured accurately, and the
      reproducibility of the results has been established. Because this technique uses
      small (100-mg) samples, a modified NDF method has been introduced that allows
      determination of extent of digestion at the end of an incubation in which gas
      production has been monitored. A strong linear relationship existed between NDF
      disappearance and gas production.

PMID- 8486839
TI  - In vitro effects of a thiopeptide and monensin on ruminal fermentation of soluble
      carbohydrates.
AB  - Using a purified diet and a mixed culture of ruminal microorganisms, we studied
      the in vitro effects of a sulfur-containing peptide (A10255) and monensin on
      ruminal VFA and lactic acid concentrations. After 22 h of fermentation, total VFA
      concentration was greater in cultures with A10255 and monensin (2.5 ppm each)
      than in untreated controls (84.1, 91.9, and 65.2 mM for cultures with A10255,
      monensin, and control, respectively). The molar proportions of propionate were
      more than 40% greater, and the molar proportions of acetate were about 15% less,
      in treated than in untreated cultures. The molar proportions of the remaining VFA
      were lowest in monensin-treated cultures, intermediate in A10255-treated
      cultures, and greatest in untreated cultures. Addition of A10255 or monensin also
      prevented the accumulation of lactate and maintained higher pH than in untreated
      cultures. In pure culture, growth of Streptococcus bovis was slowed by A10255 at
      pH 5.5 and 6.5. Growth of S. bovis was reduced markedly with addition of monensin
      at pH 6.5 and inhibited at pH 5.5. Growth of Lactobacillus acidophilus was
      inhibited more at pH 5.5 than 6.5 with monensin but was unaffected by A10255. The
      thiopeptide A10255 and monensin inhibited ruminal lactate production, but
      sensitivities of lactate-producing bacteria differed between compounds.

PMID- 8486840
TI  - Effect of increasing ruminal butyrate on milk yield and blood constituents in
      dairy cows fed a grass silage-based diet.
AB  - The effects of increased ruminal supply of butyrate on milk yield, milk
      composition, and blood metabolites were studied in four lactating cows in a 4 x 4
      Latin square design. The basal diet comprised grass silage, hay, and concentrate
      (34:22:42, DM basis) and was supplemented with isoenergetic VFA infusions (3.58
      Mcal/d). A 3:1 molar mixture of acetate and propionate was replaced gradually
      with butyrate at the rates of 0, 200, 400, or 600 g/d. When the amount of infused
      butyrate increased, isobutyrate, butyrate, and isovalerate in plasma and
      acetoacetate and beta-hydroxybutyrate in whole blood increased linearly, but
      plasma glucose concentration decreased. The latter was associated with a trend
      toward higher plasma urea concentration, suggesting that more AA were used for
      gluconeogenesis as the supply of propionate decreased and that of butyrate
      increased. Milk yield was not changed. The concentrations of milk fat and protein
      increased, and that of lactose decreased linearly, with the rate of butyrate
      infusion. Milk fat yield increased, and lactose yield tended to decrease, with
      increased butyrate infusion. These results indicate that changes in the supply of
      butyrate do not affect markedly milk yield in cows yielding less than 20 kg/d but
      cause marked changes in milk composition. The increase in ruminal butyrate supply
      increased ketogenesis and decreased gluconeogenesis in the liver of lactating
      dairy cows.

PMID- 8486841
TI  - Dose titration of sustained-release recombinant bovine somatotropin in lactating
      dairy cows.
AB  - Lactating dairy cows (n = 264) were used in seven dose titration experiments at
      four geographic locations in the United States. A sustained-release formulation
      of recombinant bST was evaluated for a 30-wk treatment period that began 14 wk
      postpartum. The first series of four experiments evaluated doses of 0, 140, 350,
      or 700 mg of bST/14 d (series A); the second series evaluated doses of 0, 56,
      140, or 350 mg of bST/14 d (series B). Milk yield, DMI, milk composition, body
      condition, health, and reproductive parameters were measured. Multiparous cows in
      series A that were administered 700 mg of bST/14 d yielded 3.0 kg/d more milk and
      3.5% FCM than control cows. When all seven experiments were combined, multiparous
      cows that were administered 350 mg of bST/14 d yielded 2.7 and 2.6 kg/d more milk
      and 3.5% FCM than control cows. Dry matter intake was not significantly affected
      by bST administration. In series A, an increase in milk yield with no increase in
      DMI resulted in lower adequacy of dietary NEL and CP to meet maintenance and
      yield requirements among multiparous cows administered 700 mg of bST/14 d.
      Primiparous cows that were administered bST in series A and both parity groups in
      the combined seven experiments were not different from control cows in the
      adequacy of dietary NEL or CP to meet maintenance and yield requirements. No
      adverse effects of bST on health parameters were significant, and doses of 350 mg
      of bST/14 d or less caused no changes in reproductive parameters. Conception rate
      was decreased by administration of 700 mg of bST/14 d. These data suggest that
      350 mg of bST/14 d increased yields of milk and FCM with no adverse effects on
      DMI, health, or reproduction in dairy cows.

PMID- 8486842
TI  - Individual variation in the composition of colostrum and absorption of colostral
      antibodies by the precolostral buffalo calf.
AB  - The total protein and Ig content in the first colostrum was higher in buffalo
      cows than in dairy crossbred cows. Individual variation in Ig content of first
      colostrum may be responsible for differences in susceptibility of calves to
      infections. The decline in Ig content during subsequent milkings was faster in
      dairy crossbred cows. The major class was IgG in both species. Absorption of
      colostral proteins and Ig was 14.0 g (68%) and 4.6 g (75.4%), respectively,
      within 1 h of feeding colostrum to a 7-h-old female buffalo calf. Absorption was
      decreased to 2.1 and .83 g/h after the first feeding, suggesting that the
      intestinal absorption of macromolecules declined 1 h after the first feeding.
      Marginal placental transfer of maternal Ig also was demonstrated in buffalo. An
      albuminlike protein was predominant in blood plasma of the precolostral buffalo
      calf. This protein decreased, and IgG in blood plasma increased, after colostrum
      was fed, indicating that albuminlike protein may be involved in the transfer of
      maternal nutrients to the fetus.

PMID- 8486843
TI  - The goals and status of the bovine gene map.
AB  - The bovine genome map has developed rapidly in recent years. The synteny and
      chromosomal maps are sufficiently developed to identify chromosomal conservation
      with other mammals, which is especially useful for the extrapolation of data to
      cattle from the better developed maps of mouse and human. The rapid development
      of microsatellite and other hypervariable markers in several laboratories around
      the world and the availability of a common set of reference families for linkage
      analysis will produce a 20-cM map in 2 yr. Immediate needs for development are 1)
      markers to anchor physical maps to linkage maps, 2) resource families segregating
      economic trait loci, and 3) chromosome-specific libraries to develop densely
      saturated linkage maps over genomic regions shown to contain economic trait loci.

PMID- 8486844
TI  - Three-dimensional molecular modeling of bovine caseins: an energy-minimized beta
      casein structure.
AB  - To obtain a molecular basis for the similarities and dissimilarities in the
      functional, chemical, and biochemical properties between beta-casein and the
      other caseins, a predicted three-dimensional model is presented. The predicted
      structure was assembled using molecular modeling techniques, as well as secondary
      structural prediction algorithms, in conjunction with global secondary structural
      information from Raman spectroscopy. To add validity to this model, the structure
      was refined using energy minimization techniques to diminish the likelihood of
      structural overlaps and energetically unfavorable van der Waals contacts arising
      from the large number of proline residues present in the beta-casein sequence.
      The refined model overall showed a loosely packed, asymmetrical structure with an
      axial ratio of 2:1. Hydrophobic side chains were uniformly dispersed over one end
      (C terminal) and the center surface of the structure; the other end (N terminal)
      was hydrophilic. The hydrophobic section also possessed a large loop through
      which water could easily travel. Such a suprasurfactant structure could account
      for the micellar type of hydrophobically driven self-association exhibited by
      beta-casein. Other chemical and biochemical data are in good agreement with the
      refined structure.

PMID- 8486845
TI  - Separation and characterization of the C-terminal half molecule of bovine
      lactoferrin.
AB  - The C-terminal half molecule (C lobe) of bovine lactoferrin was isolated by mild
      tryptic hydrolysis of lactoferrin followed by gel filtration and ion-exchange
      chromatography. The identity of the fragment was established by determining its N
      terminal and C-terminal amino acid sequences and comparing them with the amino
      acid sequence of intact lactoferrin. The isoelectric point of the C lobe ranged
      between pH 6.2 and 6.5 as measured by isoelectric focusing on polyacrylamide
      gels. The circular dichroic spectrum in the range of 250 to 350 nm of the C lobe
      differed slightly from that of intact lactoferrin. The pattern of lectin
      reactivity was similar for both the C lobe and intact lactoferrin. The C lobe
      showed partial antigenic identity with intact lactoferrin as demonstrated by the
      double immunodiffusion method, and pH dependence of iron binding of C lobe is the
      same as that of intact lactoferrin molecule.

PMID- 8486846
TI  - Relationship among bile tolerance, bile salt deconjugation, and assimilation of
      cholesterol by Lactobacillus acidophilus.
AB  - The relationships among growth in the presence of bile, deconjugation of sodium
      taurocholate, and assimilation of cholesterol by 19 cultures of Lactobacillus
      acidophilus were examined. Cultures of L. acidophilus were grown at 37 degrees C
      in lactobacilli MRS broth supplemented with sodium thioglycollate, sodium
      taurocholate, and cholesterol (cholesterol phosphatidyl choline micelles).
      Deconjugation activity was maximum in the late exponential phase of growth, which
      also coincided with maximum assimilation of cholesterol. Considerable variation
      existed among cultures in their ability to grow in the presence of bile, to
      deconjugate sodium taurocholate, and to assimilate cholesterol. However,
      statistical analyses revealed no significant correlations.

PMID- 8486847
TI  - Growth characteristics of bifidobacteria in ultrafiltered milk.
AB  - Five replicates of raw skim milk were ultrafiltered at 54 degrees C to total
      protein concentration ratios of 2:1, 3:1, 4:1, and 5:1. Bifidobacterium bifidum
      and Bifidobacterium longum were inoculated at 5% into skim milk that was not
      ultrafiltered (1:1) and into ultrafiltered skim milks followed by incubation at
      37 degrees C. The mean maximum bacterial count (colony-forming units per
      milliliter) range and protein concentration ratio were from 6.25 x 10(8) to 1.69
      x 10(9), skim milk; 4.42 x 10(8) to 3.56 x 10(9), 2:1; 2.62 x 10(8) to 3.94 x
      10(9), 3:1; 6.67 x 10(8) to 1.88 x 10(9), 4:1; and 2.90 x 10(9) to 3.59 x 10(9),
      5:1. The mean developed acidity at maximum B. bifidum population in skim milk was
      .16%, and pH was 5.55. The 5:1 concentrate had a higher mean developed acidity of
      .57% at pH 5.35, which was similar to that of the skim milk. Trends were similar
      for B. longum. Because of the increased buffering capacity of highly concentrated
      ultrafiltered milks, pH 5.5 or higher was maintained longer, along with high
      developed acidity. Scanning electron micrographs showed distinct morphological
      variations between bifidobacteria grown in broth versus those grown in the milks.

PMID- 8486848
TI  - Growth of Listeria monocytogenes and Clostridium sporogenes in cottage cheese in
      modified atmosphere packaging.
AB  - Low fat cottage cheese (pH 5.14) was inoculated with three strains of Listeria
      monocytogenes, serotypes 1a and 4b, an isolate from a dairy processing plant, and
      Clostridium sporogenes ATCC 3584. The cheese was packaged with or without added
      dissolved CO2 in polystyrene tubs overwrapped with or without high barrier heat
      shrink film and stored at 4, 7, and 21 degrees C for up to 63 d. The
      concentration of CO2 in the container headspace was 35% (vol/vol). The CO2
      concentration in that headspace declined by one-third over the 63 d of storage at
      4 degrees C. Clostridium sporogenes failed to grow under any condition applied in
      this study. In the conventionally packaged cottage cheese, L. monocytogenes
      increased from 10(4) to 10(7) cfu/g after lag phases of 28 and 7 d at 4 and 7
      degrees C, respectively. In contrast, L. monocytogenes failed to grow in cottage
      cheese packaged with CO2 and stored at 4 degrees C up to 63 d and increased from
      10(4) to 10(5) cfu/g in products packaged with CO2 at 7 degrees C. These data
      suggest that the addition of CO2 to cottage cheese to extend shelf-life does not
      represent an increased Listeria or botulism hazard but that cottage cheese could
      be a vehicle for listeriosis.

PMID- 8486849
TI  - Growth responses of coliform bacteria to recombinant bovine cytokines.
AB  - Growth responses of 10 coliform isolates to recombinant bovine cytokines were
      measured in vitro. Six Escherichia coli and four Klebsiella pneumoniae isolates
      obtained from bovine IMI were tested for growth responses to recombinant bovine
      interleukin-1 beta, interleukin-2, and interferon-gamma. Cytokines were tested at
      10(4), 10(3), 10(2), and 10 U/ml of media. Media used were a synthetic tissue
      culture medium, a chemically defined synthetic bacterial growth medium, and UHT
      sterilized milk. Bacterial counts in the synthetic tissue culture medium and UHT
      milk increased slightly as concentration of interferon-gamma in the media
      increased. Recombinant bovine interferon-gamma increased bacterial populations
      during the log growth phase but did not affect the number of bacteria in
      stationary growth phase. Bacterial growth responses were not related to either
      interleukin-2 or interleukin-1 beta concentrations in any of the three media.
      Bacterial growth responses to cytokines were not related to differences in either
      serum susceptibility, growth of isolates in dry cow secretion, duration of IMI
      from which isolates were obtained, or bacterial species.

PMID- 8486850
TI  - Influence of recombinant bovine somatotropin (sometribove) on mononuclear cells
      during the nonlactating period.
AB  - Recombinant bST was evaluated as a potential immunoenhancer of bovine peripheral
      blood and mammary gland mononuclear cells during the nonlactating period. Cows (n
      = 4 per group) were assigned to one of four treatments: 1) untreated, 2) treated
      with recombinant bST during lactation only, 3) treated with recombinant bST
      during the nonlactating period only, and 4) treated with recombinant bST during
      lactation and the nonlactating period. Recombinant bST treatment during the
      nonlactating period had no effect on proliferation of bovine blood or mammary
      gland mononuclear cells in response to stimulation by mitogens or allogeneic
      cells. Recombinant bST treatment during the nonlactating period enhanced
      interleukin-2 secretion by mononuclear cells isolated from cows treated also with
      recombinant bST during lactation. However, recombinant bST treatment during the
      nonlactating period had little effect on interleukin-2 secretion by mononuclear
      cells from cows not treated with recombinant bST during lactation. Results of
      this study suggest that recombinant bST alters effector functions rather than
      proliferation of bovine mononuclear cells.

PMID- 8486851
TI  - Effect of prepartum bovine somatotropin in primigravid ewes on mammogenesis, milk
      production, and hormone concentrations.
AB  - Twenty-five primigravid ewes were used to investigate the effect of bST, between
      97 and 124 d of gestation, on mammogenesis and subsequent milk production. Five
      ewes (reference group) were slaughtered at 96 d of gestation, and the remaining
      ewes were injected daily with saline (control group: n = 10) or .1 mg/kg of BW of
      bST (bST group: n = 10). Following bST treatment, 5 control and 5 bST group ewes
      were slaughtered (slaughter group). The remaining ewes were slaughtered after
      lambing and being milked for 8 wk (production group). Weekly blood samples were
      obtained from both slaughter and production group ewes. Slaughter group ewes were
      also subjected to 8-h serial blood sampling at 98 d (period 1) and 123 d (period
      2) of gestation. Milk production was 42% higher in ewes treated prepartum with
      bST than in those treated with saline. Results suggest that the increase in milk
      was due to an increase in mammary parenchymal cell number rather than to an
      increase in cellular activity. The high rate of [3H]thymidine incorporation into
      parenchymal tissue in reference group ewes suggests that the increase in
      parenchyma during the second trimester of gestation is due to cellular
      hyperplasia but that cellular hypertrophy may be more important during the last
      trimester. Plasma IGF-I concentrations were significantly higher during bST
      treatment and remained elevated between daily injections; the increase was
      greatest in period 2.

PMID- 8486852
TI  - Evaluation of mandibular infiltration versus block anesthesia in pediatric
      dentistry.
AB  - The authors consider mandibular infiltration as a possible alternative to
      mandibular block anesthesia in young children. The study sample comprised
      eighteen children ages six to nine years old who required bilateral identical
      treatment on primary mandibular molars. A random number table was used to
      determine which side of the mouth was to receive the block or the infiltration
      technique and a coin toss determined which would be administered first: A short
      27 gauge needle was used to inject a 2 percent lidocaine solution with 1:100,000
      epinephrine, in both techniques. The paired t-test indicated no significant
      difference between the two techniques for any of the factors evaluated.

PMID- 8486853
TI  - Electrosurgical pulpotomy: a retrospective human study.
AB  - While the formocresol pulpotomy has enjoyed long-term clinical use and success,
      concerns over its toxicity and mutagenicity have prompted research into other
      pulpotomy techniques. The purpose of this study was to observe retrospectively
      the results of the electrosurgical pulpotomy technique used on primary molar
      teeth requiring pulp therapy, secondary to carious involvement. The mean age at
      the time of treatment was 5 years, 11 months and the mean postoperative
      observation time was 2 years, 3 months. Of the 164 teeth studied, 127 were normal
      at the last observation visit; 32 had undergone exfoliation; 4 had an abnormality
      associated with the pulpotomized tooth, but were not considered failures; and 1
      was considered a failure. This is a 99.4 percent success rate. Compared to a
      formocresol pulpotomy study of similar design, the success rate for the
      electrosurgical pulpotomy procedure in this study is higher at the statistically
      significant level of p < 0.01.

PMID- 8486854
TI  - A review of fluoride intake from fluoride dentifrice.
AB  - Ingestion of fluoride dentifrice by preschool children recently has been
      identified as a risk factor for dental fluorosis. There are relatively few
      published studies concerning patterns of fluoride dentifrice use and ingestion
      among preschool children at greatest risk for dental fluorosis. This paper
      reviews the literature on dentifrice use and ingestion in an attempt to emphasize
      to the practitioner the potential importance of this fluoride exposure in
      fluorosis etiology.

PMID- 8486855
TI  - Dental management of the child and adolescent with major depression.
AB  - Major depression is a psychiatric disorder in which mood, thought content, and
      behavioral patterns are impaired, often for an extended period of time. This
      condition appears to have an increasing prevalence among young children and
      adolescents. It may be associated with a disinterest in performing appropriate
      preventive oral hygiene techniques, a cariogenic diet, rampant dental decay, and
      advanced periodontal disease. Appropriate dental management necessitates a
      vigorous preventive dental education program and special precautions when
      administering local anesthetics and prescribing sedative and analgesic
      medications.

PMID- 8486856
TI  - The poisoning of our children.
AB  - In the second half of the 1980s, almost four million exposures to poison were
      reported for children less than six years of age. The causes, types of poisoning
      and treatment are reviewed.

PMID- 8486857
TI  - Is your next pediatric patient an addict?
AB  - There have been decreases in the use of illicit drugs by youngsters in our
      country. However, the reality is that great numbers of children continue to use
      these substances. A review is provided of the use of illicit drugs by children.
      In addition, the consumption of alcohol and cigarettes by youngsters also is
      considered.

PMID- 8486858
TI  - Gender trends among specialists in pediatric dentistry.
AB  - The number of women entering the dental profession has increased over the past
      few years and the percentage of females enrolling in pediatric postdoctoral
      studies surpassed 50 percent in 1990. The impact of the shift in the gender of
      practicing pediatric dentists was examined in this study. A survey was designed
      to evaluate the relationship between the age and gender of the pediatric dentist,
      location of principle practice site, and the number of hours dedicated to direct
      patient care. Twenty-seven hundred and sixty surveys were mailed to pediatric
      dentists in the United States and 1246 were returned (46 percent). Significantly
      more males were in private practice than females, although the difference in
      percentages was small (85 percent versus 80 percent). Women identified
      universities, hospitals, and institutions as their principle site of practice
      significantly more often than males (20 percent versus 15 percent). On average,
      females in private practice work only slightly fewer hours per week providing
      patient care than do males (32 versus 35 hours/week). In university, hospital,
      and institution, settings the reverse is true: women spend more time in direct
      patient care than men (27 versus 23 hours/week).

PMID- 8486859
TI  - Adverse reaction to a fissure sealant: report of case.
AB  - A six-year-old girl with a known allergy to mites had her first permanent molars
      sealed with Delton. On the night of the treatment day, she began to have
      asthmatic trouble. Urticaria appeared a few days later. Treatment with cortisone
      gave no relief. When the fissure sealant material was taken away, the asthma and
      urticaria disappeared. Possible explanations to the reaction are discussed in the
      report.

PMID- 8486860
TI  - Adolescent rebellion.

PMID- 8486861
TI  - A restorative dentistry renaissance for children: light-hardened glass
      ionomer/resin cement.
AB  - The light-hardened glass ionomer/resin dental restorative material was introduced
      in 1992. Its formula includes 80 percent glass ionomer material combined with a
      20 percent visible light polymerized resin component. The authors have completed
      over 1300 class I, class III, and class V restorations in primary teeth, using
      the new material. The new material is considered by the authors to be a great
      improvement over the self-hardening glass ionomers. The addition of the 20
      percent light-hardened resin component to the glass ionomer formula gives the
      material an initial setting time under sixty seconds, and improves resistance to
      wear and fracture.

PMID- 8486862
TI  - Prevalence of postoperative sensitivity with indirect Class II resin composite
      inlays.
AB  - In this clinical trial, the prevalence of postoperative sensitivity is studied in
      a comparison of standard size indirect class II resin composite inlays with class
      II amalgam restorations. Fifteen percent of the 240 restored teeth (resin
      composite and amalgam restorations) showed some form of sensitivity, the majority
      of them of a passing nature. No difference was found between amalgam and
      composite restorations. Molars appear to show more complaints than premolars and,
      rather than the restorative material applied, the patient seems to determine the
      results. Differences in prevalence of sensitivity between direct resin composite
      restorations in a previous study and the indirect restorations are discussed,
      using among others the differences in sensitivity that were found between the
      amalgam-control restorations of both studies.

PMID- 8486863
TI  - The relationship between alveolar bone loss and proximal caries in children:
      prevalence and microbiology.
AB  - The present study describes the prevalence of alveolar bone loss (ABL) in
      children in relation to caries, contact and space loss. In addition, the
      microbial composition of the subgingival plaque of 20 sites, from 5 children, is
      presented. Bite-wing radiographs from 500 children were examined. ABL was evident
      in: 99 sites from 60 children; > 1 site in 27 children; the maxilla only in 34
      children; the mandible only in 17 children; both arches in 9 children; 37 sites
      with no caries; 4.9 percent of all sites with proximal caries; 15.8 percent of
      all sites with contact loss; and 20.5 percent of all sites with mesial drift.
      Anaerobic bacteria were cultured from all 20 sites. No significant differences in
      the percentages of colony forming units of Actinobacillus actinomycetemcomitans
      and black pigmented Bacteroides were found among sites with/without bone loss,
      with/without caries or probing depths smaller/equal or larger than 2.5 mm.

PMID- 8486864
TI  - Oxygen consumption after cardiopulmonary bypass--implications of different
      measuring methods.
AB  - OBJECTIVE: To determine whether intra-pulmonary oxygen consumption or whole body
      oxygen consumption is the main determinant of the hypermetabolic response after
      cardiopulmonary bypass. Secondly, which method of measuring oxygen consumption
      best quantifies this hyperdynamic response. DESIGN: We measured oxygen
      consumption by analysing respiratory gas (VO2-gas), carbon dioxide excretion
      (VCO2), and respiratory exchange ratio (RER = VCO2/VO2), and calculated oxygen
      consumption using the Fick-method (VO2-Fick) and intra-pulmonary oxygen
      consumption (VO2-gas - VO2-Fick) in patients at fixed times before and after
      elective cardiac surgery. Next, comparisons were made between methods and also
      between measurements at different times before and after bypass. SETTING:
      University hospital. PATIENTS: 10 elective cardiac surgical patients.
      INTERVENTIONS: None. MEASUREMENTS AND RESULTS: VO2-gas, VCO2 and RER were
      measured with an open circuit indirect calorimeter. VO2-Fick was calculated: VO2
      Fick = cardiac index x (arterial - mixed venous oxygen content). Intrapulmonary
      oxygen consumption was calculated as the difference between VO2-gas and VO2-Fick.
      Both VO2-gas and VO2-Fick were about 20% higher after bypass than after induction
      of anaesthesia. Absolute values of VO2-gas were about 30% higher than VO2-Fick.
      Intra-pulmonary oxygen consumption accounted for 32% of whole body oxygen
      consumption after induction of anaesthesia and did not increase after bypass.
      CONCLUSION: Whole body oxygen consumption and not intra-pulmonary oxygen
      consumption is the main determinant of the hypermetabolic response after bypass.
      Increased intra-pulmonary oxygen consumption is not related to bypass. VO2-gas
      best quantifies this hypermetabolic response directly after bypass, and not VO2
      Fick, VCO2 or intra-pulmonary oxygen consumption, since VO2-Fick excludes intra
      pulmonary oxygen consumption and VCO2 does not reflect metabolism directly after
      bypass.

PMID- 8486865
TI  - Rapid recovery of acquired purpura fulminans in a patient with familial C4bBP
      deficiency.
AB  - A 32-year-old pregnant woman developed meningococcemia associated purpura
      fulminans and quickly improved with therapy. After this disease C4b-Binding
      Protein (C4bBP) plasma levels remained very low while protein S activity was in
      the normal range. Familial investigation proved a hereditary C4bBP deficiency.
      This observation points out the role of the protein C-protein S system during
      acquired purpura fulminans.

PMID- 8486866
TI  - Basic concepts and fundamental issues in technology assessment.

PMID- 8486867
TI  - Theophylline intoxication: toxicokinetic evaluation of hemodialysis.

PMID- 8486868
TI  - Low pulmonary compliance and/or tachycardia may reduce arterial pressure
      variations despite hypovolemia.

PMID- 8486869
TI  - Inhalation of a minitracheostomy tube.

PMID- 8486870
TI  - Neonatal and pediatric intensive care--a new section in Intensive Care Medicine.

PMID- 8486871
TI  - Newborn extracorporeal lung assist using a novel double lumen catheter and a
      heparin-bonded membrane lung.
AB  - We report the clinical application of a novel double lumen catheter for veno
      venous extracorporeal lung assist (ECLA) and the use of a heparin-bonded hollow
      fiber membrane lung, in the treatment of newborn respiratory failure. The outer
      lumen of the double lumen catheter was 14 Fr and was used for blood drainage;
      while the inner 8 Fr catheter was used for blood return. The double lumen
      catheter was made of spiral wire reinforced polyurethane, with a wall thickness
      of 0.25 mm. The hollow fiber membrane was made of non-microporous polyolefin, and
      was not permeable to water or plasma. We used this system to treat a newborn
      patient with meconium aspiration syndrome. Heparin was infused continuously at a
      rate of 18-25 units/kg/h, equal to 1/3 of the usual amount when a non-heparin
      bonded ECLA system was used and maintaining the activated clotting time near 120
      s. Bleeding from cutdown sites was negligible. Only the right internal jugular
      vein was sacrificed. The patient was successfully weaned from ECLA and appears
      normal one year following discharge.

PMID- 8486872
TI  - Sudden death revealing Chiari type 1 malformation in two children.
AB  - We report the first two fatal cases of sudden unprovoked cardiorespiratory arrest
      in children with previously undiagnosed Arnold-Chiari type 1 malformation. This
      diagnosis should be considered in children with unexplained cardiorespiratory
      arrest. The risk of sudden death in Arnold-Chiari type 1 malformation reinforces
      the indication for early neurosurgical procedure.

PMID- 8486873
TI  - Relief of severe pulmonary hypertension after closure of a large ventricular
      septal defect using low dose inhaled nitric oxide.
AB  - A 16-month-old girl developed severe pulmonary hypertension after closure of a
      large ventricular septal defect. All conventional therapeutic measures failed; an
      attempt to add nitric oxide at a continuous low dose to the inspired gas allowed
      resolution of pulmonary hypertension and low cardiac output. This report
      documents that continuous inhalation of low dose nitric oxide is capable of
      selective resolution of pulmonary hypertension following cardiac surgery for a
      large septal defect in a child. This suggests that a transient dysfunction in the
      release of nitric oxide by the pulmonary endothelial cell is responsible for the
      vasoconstriction.

PMID- 8486874
TI  - Hydrogen peroxide in expired breath condensate of patients with acute respiratory
      failure and with ARDS.
AB  - OBJECTIVE: Measurement of hydrogen peroxide concentrations in breath condensate
      of mechanically ventilated patients with ARDS and with risk factors for
      developing ARDS. DESIGN: Open study in intensive care patients. SETTING:
      Intensive care units of the Clinics of the University of Gottingen, a primary
      care center. PATIENTS: 10 post-operatively ventilated patients as a control group
      and 26 patients with acute respiratory failure, 7 of them with ARDS, 12 with
      polytrauma, 4 with pneumonia, 3 with cardiogenic or nephrogenic pulmonary edema.
      INTERVENTIONS: None. MEASUREMENTS: Breath condensate was collected by a special
      cold trap and was analysed for H2O2 by a chemiluminescence method. Daily
      measurements were performed for 4.2 +/- 2.6 days (mean +/- SD) as soon as
      possible after manifestation of respiratory failure. RESULTS: Patients with acute
      respiratory failure exhibited higher H2O2 concentrations than control patients
      (median 95 nmol/l, range 76-144 nmol/l), with the highest median value found in
      the ARDS group (552 nmol/l, range 154-893). After clinical improvement, H2O2
      concentrations decreased to the range of the control group. CONCLUSION: Since
      high concentrations of H2O2 in breath condensate were only found in patients with
      ARDS or with risk factors for ARDS, the results add to the existing evidence that
      reactive oxygen species are associated with some acute lung diseases.

PMID- 8486875
TI  - Brain resuscitation by extracorporeal circulation after prolonged cardiac arrest
      in cats.
AB  - OBJECTIVE: Brain reanimation after prolonged ischemia is limited by post-ischemic
      reperfusion deficits (no-reflow phenomenon). The present study was undertaken to
      establish whether after 30 min cardiac arrest extracorporeal circulation is able
      to restore brain reperfusion and to promote functional and metabolic recovery.
      DESIGN: Adult normothermic cats were submitted to 30 min cardiac arrest by KCl
      induced cardioplegia. Resuscitation was carried out by extracorporeal circulation
      (ECC) until spontaneous heart function returned. The quality of brain recovery
      was assessed 3 h later by electrophysiological recording and by imaging of the
      regional distribution of brain energy metabolites. RESULTS: In 6 of 10 cats
      cardiac sinus rhythm returned after 32 +/- 15 min. In the other 4 cats cardiac
      function did not return or only intermittently returned during the 3 h
      observation period. Cerebral blood flow measured by laser Doppler flowmetry
      returned to 102% +/- 40% of control immediately after the beginning of
      resuscitation but then gradually declined to 43% +/- 32% after 3 h despite
      normotensive perfusion. In all cats pupils started to constrict within less than
      5 min of recirculation but in 2 animals they secondarily dilated 1.5 and 2 h
      later, respectively. Spontaneous EEG activity reappeared in 4 of the 6
      successfully resuscitated cats after 111 +/- 40 min but failed to recover in the
      others. Bioluminescent imaging of ATP after 3 h recirculation revealed near
      complete depletion throughout the brain in all 4 cats without cardiac recovery.
      Of the 6 successfully resuscitated cats 5 exhibited patchy areas of low ATP,
      glucose and pH in 22%-92% of the cross sectional area of brain; in one cat
      recovery of energy metabolism and acid-base homoeostasis was homogeneous without
      any focal deficits. The cross sectional area of ATP recovery correlated directly
      with CBF and hematocrit and inversely with the plasma lactate level. CONCLUSIONS:
      This study demonstrates for the first time that ECC is able to restore
      electrophysiological and metabolic brain function after cardiac arrest of as long
      as 30 min, but recovery is heavily restricted by delayed post-ischemic
      disturbances of recirculation. Progress in cardiac resuscitation by ECC requires
      substantial improvement in the efficiency of cerebrovascular reperfusion.

PMID- 8486877
TI  - Bronchial electrocardiography to determine left or right main bronchial placement
      of an endotracheal suction catheter tip.
AB  - OBJECTIVE: To assess the utility of a blue lined angle tipped and electrode
      tipped catheter, to guide left and right main bronchus cannulation. DESIGN: A
      prospective study. SETTING: An 11-bed general intensive care unit in a 900-bed
      teaching hospital. PATIENTS: 50 intubated intensive care patients, in sinus
      rhythm with normal P and QRS mean frontal axis, who required endobronchial
      suctioning for routine respiratory management. INTERVENTIONS: Endobronchial
      electrocardiography was used to position a blue lined angle tipped and electrode
      tipped suction catheter into the right and left main bronchi. RESULTS: Selective
      cannulation of the left main bronchi was determined by observing a biphasic or
      inverted P wave in 42 patients, or biphasic or inverted QRS complex in 31
      patients. In 8 patients in whom no changes in the ECG were found, bronchoscopic
      placement of an ECG electrode into the left main bronchus demonstrated a biphasic
      or inverted P wave in 8 patients and a biphasic QRS complex in 3 patients,
      confirming the failure to cannulate the left main bronchus in these 8 patients.
      CONCLUSIONS: Using a blue lined, angle tipped and electrode tipped catheter for
      endotracheal suctioning, endobronchial electrocardiography may be a simple method
      to signal left or right main bronchus cannulation.

PMID- 8486876
TI  - Parenteral nutrition in the critically ill: use of a medium chain triglyceride
      emulsion.
AB  - OBJECTIVES: The study investigated the use of an intravenous lipid emulsion
      containing medium chain triglycerides (MCTs) in critically ill patients, and
      compared the effects with those of a conventional long chain triglyceride (LCT)
      preparation. DESIGN: Patients received a parenteral nutrition regime including
      either 500 ml 20% Lipofundin MCT/LCT (1/1) per day, or 500 ml 20% Lipofundin S
      (LCT) infused over 8 h each evening. SETTING: The patients were receiving
      treatment, including assisted ventilation, in the Intensive Care Unit of a large
      teaching hospital. All patients on this unit for at least 3 days and who were
      likely to receive parenteral nutrition for at least a week were considered,
      unless they had severe renal or liver disease, or trauma/major surgery in the
      previous 3 days. Because ICU patients are a heterogenous group, subjects were
      randomised within clinical groups to receive either lipid. There were 24 patients
      entered into the study and the data on 20 matched patients is reported.
      MEASUREMENTS AND RESULTS: Blood specimens were collected pre-TPN, daily at 0800
      and after 5 h lipid infusion on days 1 and 6. Urine collections (24 h) were also
      performed. There were no apparent adverse effects due to the new MCT/LCT
      emulsion. Plasma ketone and glycerol concentrations were higher during MCT/LCT
      infusion, but 8 h post infusion plasma levels of ketones, triglycerides, non
      esterified fatty acids and glucose were similar. Urinary carnitine excretion was
      high in all patients and was not significantly different between the groups.
      Nitrogen balance was less negative in patients receiving MCT/LCT on days 6 and 9.
      CONCLUSION: MCTs are rapidly hydrolysed and oxidised to fatty acids and ketones
      which can be readily utilised. This study indicates that intravenous lipid
      emulsion containing MCT are safe in critically ill patients and may have
      advantages over LCT. The number and range of patients studied was, however, small
      and larger studies are needed.

PMID- 8486878
TI  - Are activity-based assessments of balance and gait in the elderly predictive of
      risk of falling and/or type of fall?
AB  - OBJECTIVE: To determine whether an activity-based test of balance and gait is
      predictive of the risk of: (1) falling in situations that are related to specific
      tasks evaluated as part of the test, (2) experiencing falls precipitated by
      different classes of biomechanical events, or (3) falling in general; and to
      compare the predictive ability of the activity-based test for the falls described
      in (2) and (3) to that of a posturography test that has been found previously to
      be predictive of falling risk. DESIGN: Cohort study. SETTING: Baseline tests
      performed in balance laboratory; subsequent history of falling monitored
      prospectively for 1 year in two residential-care facilities. PARTICIPANTS:
      Seventeen male and 83 female consecutive volunteers (mean age = 83, SD = 6) who
      were independent in activities of daily living and able to stand unaided.
      MEASUREMENTS: Independent variables were derived from an activity-based balance
      and-gait test and a posturography test. Dependent variables were the numbers of
      subjects with one or more: (1) falls in specific situations related to activity
      based test items, (2) falls related to general classes of biomechanical
      precipitant, and (3) falls in general. MAIN RESULTS: Subjects who were rated as
      "abnormal" in activity-based test items related to transfers, turning or reaching
      were more likely to experience one or more falls in related situations in
      everyday life. Activity-based scores were predictive of risk of experiencing
      falls with no obvious biomechanical precipitant and falls precipitated by center
      of-mass perturbation, but not falls precipitated by base-of-support perturbation.
      In comparison, a posturographic measure of spontaneous medial-lateral postural
      sway (blindfolded conditions) failed to predict falls having no biomechanical
      precipitant, but provided the best predictions of both center-of-mass and base-of
      support falls, as well as risk of falling in general. CONCLUSIONS: Activity-based
      testing of certain tasks (transfer, turning, reaching) may be useful in
      indicating a specific need for intervention to reduce the risk of falling during
      related everyday activities. In terms of predicting falling risk, a static
      posturography test may provide better prediction overall of the different classes
      of falls and may be useful as a quick and simple screening tool to help identify
      high-risk individuals.

PMID- 8486879
TI  - An audit of cardiac pacing in the elderly: effect of myocardial infarction on
      outcome.
AB  - OBJECTIVE: To audit the outcome of temporary endocardial pacing in an elderly
      population. DESIGN: Retrospective case-series analysis. SETTING: The Department
      of Medicine for the Elderly at the Wrexham Maelor Hospital, a District General
      Hospital with 612 beds serving a catchment population of 220,000. SUBJECTS: A
      sample of 50 consecutive elderly patients, with an age range of 65 to 99 years,
      undergoing transvenous cardiac pacing. MAIN OUTCOME MEASURES: Length of stay in
      hospital, complications of the pacing procedure, whether a permanent pacemaker
      was installed, and whether the patient died within 1 month of admission. RESULTS:
      There was no difference in length of stay between those with a myocardial
      infarction and those without. Minor complications occurred in three patients (one
      local infection and two "failures to pace"). Major complications occurred in two
      patients (septicemia and pneumonia). More patients without a myocardial
      infarction (86.9%) went on to implantation of a permanent pacemaker than those
      with an infarction (11.1%, P = 0.001), and fewer of them died (8.7% compared with
      48.1%, P = 0.0025). In those patients with a myocardial infarction who died,
      there was no difference between the proportions who had inferior (7/18) and
      anterior (5/9) infarctions. CONCLUSION: Cardiac pacing seems to be a safe and
      reliable procedure in the elderly, although long term morbidity and mortality may
      be dependent on the presence or absence of myocardial ischaemic disease.
      Myocardial infarction in the elderly is an event of major significance, carrying
      with it a high mortality rate, particularly if accompanied by cardiogenic shock
      and the need for cardiac pacing.

PMID- 8486880
TI  - Correlates of cognitive function scores in elderly outpatients.
AB  - OBJECTIVE: To determine medical, ophthalmologic, and demographic predictors of
      cognitive function scores as measured by the Telephone Interview for Cognitive
      Status (TICS), an adaptation of the Folstein Mini-Mental Status Exam. A secondary
      objective was to perform an item-by-item analysis of the TICS scores to determine
      which items correlated most highly with the overall scores. DESIGN: Cross
      sectional cohort study. SETTING: The Glaucoma Consultation Service of the
      Massachusetts Eye and Ear Infirmary. SUBJECTS: 472 of 565 consecutive patients
      age 65 and older who were seen at the Glaucoma Consultation Service between
      November 1, 1987 and October 31, 1988. MEASUREMENTS: Each subject had a standard
      visual examination and review of medical history at entry, followed by a
      telephone interview that collected information on demographic characteristics,
      cognitive status, health status, accidents, falls, symptoms of depression, and
      alcohol intake. RESULTS: A multivariate linear regression model of correlates of
      TICS score found the strongest correlates to be education, age, occupation, and
      the presence of depressive symptoms. The only significant ocular condition that
      correlated with lower TICS score was the presence of surgical aphakia (model R2 =
      .46). Forty-six percent (216/472) of patients fell below the established
      definition of normal on the mental status scale. In a logistic regression
      analysis, the strongest correlates of an abnormal cognitive function score were
      age, diabetes, educational status, and occupational status. An item analysis
      using step-wise linear regression showed that 85 percent of the variance in the
      TICS score was explained by the ability to perform serial sevens and to repeat 10
      items immediately after hearing them. Educational status correlated most highly
      with both of these items (Kendall Tau R = .43 and Kendall Tau R = .30,
      respectively). CONCLUSION: Education, occupation, depression, and age were the
      strongest correlates of the score on this new screening test for assessing
      cognitive status. These factors were stronger correlates of the TICS score than
      chronic medical conditions, visual loss, or medications. The Telephone Interview
      for Cognitive Status is a useful instrument, but it may overestimate the
      prevalence of dementia in studies with a high prevalence of persons with less
      than a high school education.

PMID- 8486881
TI  - Quinine sulfate for leg cramps: does it work?
AB  - OBJECTIVE: To study the efficacy of quinine in the prevention of nocturnal leg
      muscle cramps. DESIGN: Double-blind, randomized, crossover trial with four
      periods of observation, each lasting 2 weeks. SETTING: General internal medicine
      outpatient clinic. PARTICIPANTS: Ambulatory outpatients who experienced an
      estimated two or more typical nocturnal leg cramps per week. INTERVENTION: 200 mg
      of quinine taken at bedtime. MAIN OUTCOME MEASURES: Self-reported ratings of leg
      cramp frequency, duration, and intensity. RESULTS: Sixteen patients completed the
      trial. During the 2 weeks patients used quinine, there was no statistically
      significant reduction in mean leg cramp number (quinine 3.5 vs placebo 4.2, P =
      0.48), mean leg cramp duration (quinine 152 seconds vs placebo 163 seconds, P =
      0.89), or patient ratings of severity using a 1 (low) to 10 (high) scale (quinine
      = 4.2 vs placebo = 4.0, P = 0.83). CONCLUSION: No significant reduction in
      nocturnal leg cramp frequency, intensity, or duration could be found using
      nightly quinine in this study. Since quinine is not without the potential for
      side effects and drug interactions, clinicians need to carefully consider the
      likelihood of modest benefit associated with quinine against the potential for
      side effects and drug-drug interactions.

PMID- 8486883
TI  - Dementia, agitation, and care in the nursing home.
AB  - OBJECTIVE: To examine the behavioral and functional problems of the cognitively
      impaired. DESIGN: A survey of a cohort of residents from six nursing homes.
      PARTICIPANTS: Subjects were randomly selected based on a minimum age of 70 years
      and a Resource Utilization Group (RUG) classification of the Physical or
      Behavioral type. Of those eligible, 44% (n = 366) agreed to participate. The
      participants and non-participants had similar demographics except for a higher
      incidence of mental illness in the non-participant group, which did not have a
      significant impact on agitation. SETTING: Six nursing homes in New York City,
      three voluntary non-profit and three proprietary. MEASUREMENT: The study used
      chart review, assessment of residents' cognitive and functional abilities,
      nursing assistants' ratings of residents' functional abilities, behavioral
      problems, and the amount of effort required in care, and time-motion observations
      of staff-resident interactions. RESULTS: Residents' level of cognitive impairment
      had a significant impact on problem behaviors during ADL tasks, along with
      supervision required in patient care (P < 0.05). These results were validated by
      time-motion analysis. Regression analysis revealed that for non-demented
      subjects, the best indicator of care needs was health status, while for demented
      residents the best indicator was cognitive status (P < 0.0001). CONCLUSIONS: The
      care needs of residents with dementia are better estimated by a mental status
      test for cognitive impairment then by ADL assessment alone. Greater agitation is
      associated with increasing cognitive impairment. Further, agitation and
      behavioral problems associated with care result in a need for increased staff
      supervision.

PMID- 8486882
TI  - Hypouricemia, abnormal renal tubular urate transport, and plasma natriuretic
      factor(s) in patients with Alzheimer's disease.
AB  - OBJECTIVE: To study tubular urate transport in Alzheimer's disease (AD) and
      measure sodium and lithium transport rates in rats exposed to AD plasma. DESIGN:
      Cross-sectional study in three comparison groups. SETTING: Referral private
      institution involving outpatient and hospitalized patients. PATIENTS: AD, multi
      infarct dementia (MID) and non-demented controls (C) were selected and evaluated
      by a geriatrician and a psychiatrist according to availability and willingness to
      participate in the study. Demented patients had brain imaging, categorized
      according to NINCDS-DSM III criteria, and had Mini-mental status examination
      (MMSE) scores determined. INTERVENTIONS: Injection of 0.5 mL of plasma I.P.
      followed 120 minutes later by an IV plasma injection of 0.2 mL priming dose and
      infusion of 1.8 mL of plasma at 0.01 mL/min in Sprague Dawley rats. MEASUREMENTS:
      Renal clearance studies were performed in subjects and in rats exposed to the
      plasma of study subjects. We measured serum urate concentration and fractional
      excretion (FE) of urate in subjects and FE sodium and FE lithium in rats.
      RESULTS: Serum urate was lower and FE urate higher in 18 AD patients compared
      with six patients with MID, P < 0.05 and P < 0.005, and 11 C, P < 0.02 and P <
      0.005, respectively. Higher FE sodium and FE lithium were noted in rats given
      plasma from 19 AD patients compared with 12 with MID, P < 0.005 and P < 0.0025,
      and 14 C, P < 0.0025 and P < 0.0005, respectively. FE sodium and FE lithium
      decreased progressively after serial dilutions of three AD plasmas and FE lithium
      was negatively correlated with MMSE scores only in AD, r = -0.71 and P < 0.0005.
      CONCLUSIONS: In AD there is defective tubular urate transport and a plasma
      natriuretic factor(s). FE sodium and/or FE lithium in rats exposed to plasma of
      demented patients may differentiate AD from MID and estimate the severity of AD.

PMID- 8486884
TI  - The effect of chlorothiazide on bone-related biochemical variables in normal post
      menopausal women.
AB  - OBJECTIVE: To evaluate the effects of short-term administration of chlorothiazide
      on fasting urinary hydroxyproline, an index of bone resorption, and other bone
      related biochemical parameters in normal post-menopausal women. DESIGN: Subjects
      served as their own control before and after chlorothiazide treatment. SETTING:
      Subjects were recruited by advertisement. PARTICIPANTS: Thirteen healthy post
      menopausal women with a mean age of 65 years. INTERVENTION: Each subject was
      given chlorothiazide 500 mg bd po for 7 days. Fasting blood and urine samples
      were obtained immediately before the commencement of chlorothiazide (day 1) and 2
      and 7 days after starting chlorothiazide. RESULTS: Chlorothiazide decreased the
      urinary calcium/creatinine (mean value day 1, 0.267; day 2, 0.143; day 7, 0.135;
      P < 0.001) and hydroxyproline/creatinine (day 1, 0.0192; day 2, 0.0145; day 7,
      0.0139; P < 0.02) molar ratios. CONCLUSION: Chlorothiazide decreases fasting
      urinary hydroxyproline, a marker of bone resorption in post-menopausal women.
      This observation supports a potential role for thiazide diuretics in the
      prevention of osteoporosis. The observed fall in urinary hydroxyproline is of the
      same order as that seen after treatment with estrogen or calcium supplements.

PMID- 8486885
TI  - Pain complaints and cognitive status among elderly institution residents.
AB  - OBJECTIVE: To examine the association between self-reported pain and cognitive
      impairment among frail elderly institution residents. DESIGN: A cross-sectional
      correlational study. SETTING: A large urban nursing home and congregate apartment
      complex housing predominantly Jewish elderly. PARTICIPANTS: Seven hundred fifty
      eight elderly institution residents (30% in the nursing home, 70% in congregate
      apartments). The sample was 70% female and averaged 83.3 years of age.
      MEASUREMENTS: Respondent self-reports tapped pain intensity, number of localized
      pain complaints, cognitive status, and disability in performance of activities of
      daily living. Attending physicians or physician assistants rated respondents'
      health status. MAIN RESULTS: Pain intensity and number of localized pain
      complaints bore small but significant negative relationships to cognitive
      impairment. Pain was positively associated with physician-rated ill health and
      functional disability. The association between pain and cognitive status remained
      significant even when controlled statistically for effects of physical health and
      functional disability. Item-by-item examination of localized pain complaints
      indicated that markedly cognitively impaired individuals were less likely to
      report pain in the back and joints. However, examination of possible physical
      causes of reported pain revealed no differences between pain reports of
      cognitively impaired versus intact individuals in either the presence or the
      absence of a likely physical cause. CONCLUSIONS: These data provide no evidence
      for the "masking" of pain complaints by cognitive impairment. They suggest
      instead that, although cognitively impaired elderly may slightly underreport
      experienced pain, their self-reports are generally no less valid that those of
      cognitively intact individuals. Limitations of the research are acknowledged and
      implications for treatment of cognitively impaired institution residents are
      discussed.

PMID- 8486886
TI  - The relationship between ankle-arm index and mortality in older men and women.
AB  - OBJECTIVE: To determine whether the ankle-arm blood pressure index is a useful
      predictor of mortality in a large group of patients aged 50 or older. DESIGN:
      Cohort study over a 13-year period. SETTING: Peripheral vascular laboratory in a
      hospital affiliated with an academic health center. PARTICIPANTS: 1,027 male and
      903 female patients referred for arterial evaluation. OUTCOME MEASURES: All-cause
      and cause-specific mortality. RESULTS: A decrease in ankle-arm index was a strong
      independent predictor of all-cause mortality [relative risk (RR) for men =
      1.8(95% CI 1.5, 1.9); for women = 1.5, (1.2, 2.0)] and atherosclerotic heart
      disease mortality [RR for men = 2.0 (1.4, 2.9); for women = 2.1 (1.4, 3.1)]. The
      risk of mortality was inversely proportional to the ankle-arm index. No
      relationship was found between the index and mortality due to stroke or cancer.
      CONCLUSIONS: These results suggest that a decreased ankle-arm index has important
      prognostic significance for mortality due to atherosclerotic heart disease in
      older men and women. Measurement of this index may be useful in identifying those
      at high risk who may benefit from aggressive therapeutic intervention.

PMID- 8486887
TI  - Acute exercise facilitates semantically cued memory in nursing home residents.
AB  - OBJECTIVE: To study the acute effects of non-strenuous physical exercise on
      memory retrieval and visuo-motor performance in old-old nursing home residents.
      DESIGN: A randomized control trial. SETTING: A nursing home. PARTICIPANTS:
      Ambulatory volunteers from the nursing home, with all 20 shown to be normal on
      mental status. Three were male and 17 female, with a means of 84.5 years for age
      and 9.3 years for education. They were divided at random into an exercise and a
      control group. INTERVENTION: A single 15-minute standardized bout of non
      strenuous exercise administered independently to each participant in the exercise
      group. Control group participants watched a video of similar exercises for 15
      minutes. MEASUREMENTS: Two measures requiring the retrieval of category instances
      with semantic or initial consonant cues. Retrieval time was 60 seconds for each
      of four categories per measure. Visuo-motor performance was measured by Symbol
      Digit coding. Testing sessions were held before exercise, immediately post
      exercise and 30 minutes post-exercise. RESULTS: The group-by-time interaction was
      significant only for semantically cued memory (P < 0.01), with higher retrieval
      at post-testing only in the exercised group. The higher retrieval was mainly
      attributable to more new items retrieved by the exercise group at the immediate
      post-test (P < 0.05). CONCLUSIONS: This study provides preliminary support for
      the hypothesis that non-strenuous physical exercise has positive acute effects on
      meaningfully cued memory.

PMID- 8486888
TI  - Predicting short-term survival for patients with advanced Alzheimer's disease.
AB  - OBJECTIVE: The purpose of this study was to develop a statistical model for
      predicting short term survival in patients with dementia of the Alzheimer type
      (DAT). DESIGN: A prospective cohort study. SETTING: Three 25-bed intermediate
      medical care units using a structured approach to patient care management
      including palliative care options and patients from a second, traditional long
      term care setting. PARTICIPANTS: Of 104 patients with advanced DAT monitored for
      34 months, 68 patients (97% white male) who had at least one fever episode were
      included in the model development phase. Data from 71 additional DAT patients
      with at least one fever episode were used to test the statistical model. MAIN
      OUTCOME MEASURES: Six-month survival following a fever episode. RESULTS: Older
      age and higher severity of DAT at the time of the fever episode, palliative care,
      and hospital admission for long-term care within 6 months prior to the fever were
      found to be positively associated with likelihood of mortality within 6 months of
      the fever onset. Adjusted odds ratios for each of these variables were
      statistically significant. The model performed well in subsequent testing on an
      independent sample of patients. CONCLUSION: Results provide a formula which can
      be used to predict likelihood of dying within 6 months following onset of a fever
      in DAT patients. This statistical prediction is recommended for use in
      combination with clinical judgment to certify DAT patients for Medicare hospice
      coverage.

PMID- 8486889
TI  - The problems of pain and its detection among geriatric nursing home residents.
AB  - OBJECTIVE: To assess physicians' detection of pain among geriatric nursing home
      residents and to determine if there are factors that may interfere with their
      ability to do this. DESIGN: Chart review and patient interview. SETTING:
      Geriatric nursing home. PARTICIPANTS: One hundred nursing home residents age 65
      or older. Seventy-six were communicative. MEASUREMENTS: Demographic information,
      diagnoses, and medication use were compared for several groups of residents to
      determine their effects on the detection of pain. RESULTS: Sixty-six percent of
      the communicative residents were identified as having chronic pain. Treating
      physicians did not detect this problem in 34% of these residents. Those whose
      pain was not so identified were more likely to have a neurologic disorder other
      than dementia. When non-communicative residents were compared with those who were
      communicative, the physicians were found to have identified pain less frequently
      in the former cohort. CONCLUSIONS: Chronic pain is a common problem among
      geriatric nursing home residents and is frequently undetected. Identification of
      this problem among communicative residents may be markedly improved by direct
      questioning about this problem at frequent intervals. New methods of assessing
      pain need to be created to assist in its detection among the non-communicative
      population.

PMID- 8486890
TI  - Serum albumin and prealbumin as predictors of clinical outcomes of hospitalized
      elderly nursing home residents.
AB  - OBJECTIVE: To investigate the prevalence of hypoalbuminemia and
      hypoprealbuminemia in hospitalized, elderly, skilled nursing facility residents
      and to correlate these findings with clinical outcomes. DESIGN: Prospective
      cohort study. SETTING: A 300-bed community hospital. PARTICIPANTS: Eighty-one
      hospitalized, skilled nursing facility patients, average age 83.1 years.
      INTERVENTIONS: None. OUTCOME MEASURES: Serum albumin and prealbumin
      (transthyretin) were measured at admission, mid-week, 1 week, and 1 month.
      Patients were followed for 90 days for the outcomes of length of hospitalization
      and mortality. RESULTS: The prevalence of hypoalbuminemia was 99% and of
      hypoprealbuminemia, 79%. Both means dropped significantly from admission to
      midweek nadirs of 25 g/L for albumin and 14 mg/L for prealbumin. Severe
      hypoalbuminemia at mid-week predicted mortality (RR = 4.1 95%, CI 2.0-8.5) and
      extended length of hospitalization (RR = 5.2 95%, CI 2.8-9.8). Severe
      hypoprealbuminemia predicted extended hospitalization (RR = 3.2, CI 1.5-6.7) but
      not mortality. CONCLUSIONS: Hypoalbuminemia and hypoprealbuminemia are very
      common in this clinical setting and vary in parallel fashion over time. Severe
      hypoalbuminemia was a stronger predictor than hypoprealbuminemia of 90-day
      mortality and extended length of stay. Serum albumin on admission was not as
      strong a predictor of outcomes as serum albumin at mid-week.

PMID- 8486891
TI  - Dopamine B hydroxylase deficiency responsible for severe dysautonomic orthostatic
      hypotension in an elderly patient.
AB  - We report the case of an elderly woman with severe dysautonomic orthostatic
      hypotension in whom a deficit in dopamine B hydroxylase has been established. In
      the literature, such a deficit has been described in six young adults with long
      standing symptoms of postural hypotension. This enzyme catalyses the conversion
      of dopamine to noradrenaline. In our elderly patient, noradrenaline and
      adrenaline were undetectable in the plasma, but plasma dopamine was detectable.
      Treatment with the synthetic amino acid, DL-threo-dihydroxyphenylserine, which is
      converted to noradrenaline by dopa-decarboxylase, resulted in a significant
      increase in blood pressure. The mechanism of this acquired deficit is not
      elucidated.

PMID- 8486892
TI  - The critical shortage of geriatrics faculty.
AB  - To estimate the adequacy of current and future supply of geriatrics faculty, we
      conducted a national survey to determine the current supply of geriatrics faculty
      in five specialties and compared these estimates to standards for optimal faculty
      supply in geriatrics. Finally, we generated a model to project future faculty
      supply based on both current training capacity and differing assumptions
      regarding future training capacity. Our findings indicate that the current supply
      of geriatrics physician faculty is less than half the number needed in each
      specialty. (Existing numbers range from a high of 909 faculty in internal
      medicine to a low of 86 in physical medicine.) Moreover, given the current
      capacity for training, there will be a net loss of such faculty each year in each
      specialty. We conclude that the number of geriatrics faculty currently available
      is insufficient to provide an appropriate "core" level of geriatrics training for
      all undergraduate medical students and residents in relevant residency programs.
      In addition, the current training capacity for geriatrics faculty cannot even
      sustain the current level of faculty over the next 10 years. To correct the
      current and future deficit, substantial increases in both geriatrics fellowship
      positions and mid-career training positions will be necessary.

PMID- 8486893
TI  - Mid-career faculty development awards in geriatrics: does retraining work?
AB  - OBJECTIVE: To evaluate the success of a mid-career physicians faculty retraining
      in geriatric medicine. DESIGN: Written survey of participants in the John
      Hartford Foundation's Mid-Career Faculty Development Program (1984-1988).
      SETTING: Four well established geriatric fellowship training programs.
      PARTICIPANTS: The 29 physicians who received John Hartford Foundation awards.
      RESULTS: Twenty-one (87%) of 24 respondents felt that the fellowship year had
      either a "major" or "significant" impact on their careers, and 87% also spend a
      significant portion of their time training others in geriatrics. CONCLUSION: This
      4-year experiment in mid-career faculty retraining in geriatrics suggests that
      this approach is a viable alternative to traditional 2-year fellowships for
      helping to reduce the shortage of faculty in geriatric medicine.

PMID- 8486894
TI  - Psychoneuroimmunology and aging.

PMID- 8486895
TI  - The Medicare fee schedule in long-term care.

PMID- 8486896
TI  - Clock drawing as a screening tool.

PMID- 8486897
TI  - Geriatric fellowship training.

PMID- 8486898
TI  - Geriatric fellowship training.

PMID- 8486899
TI  - Geriatric fellowship training.

PMID- 8486900
TI  - Geriatric fellowship training.

PMID- 8486901
TI  - Geriatric fellowship training.

PMID- 8486902
TI  - Geriatric fellowship training.

PMID- 8486903
TI  - Geriatric fellowship training.

PMID- 8486904
TI  - VAE versus assisted suicide.

PMID- 8486905
TI  - VAE versus assisted suicide.

PMID- 8486906
TI  - Connecticut partnership for long-term care.

PMID- 8486907
TI  - Iatrogenesis: no advance directive.

PMID- 8486908
TI  - Cell proliferation in the respiratory tract of the rat after acute inhalation of
      formaldehyde or acrolein.
AB  - Male Sprague Dawley rats were exposed by inhalation for 6 h per day on one or
      three successive days to 0, 2, 6 or 20 ppm formaldehyde or 0, 0.2 or 0.6 ppm
      acrolein. Nasal and tracheal epithelial and free lung cells were then analyzed
      for proliferative responses. The proliferative response was expressed as the
      proportion of DNA synthesizing cells determined by the 5-bromodeoxyuridine (BrdU)
      labeling technique. Single exposure to both irritants increased the DNA
      synthesizing (proliferating) cells by a factor of 3. After three exposures the
      increase was distinctly lower. All sites analyzed showed approximately the same
      concentration/response pattern. Significant changes in cell proliferation could
      be detected at 2 ppm formaldehyde and 0.2 ppm acrolein.

PMID- 8486909
TI  - Oral toxicity in weanling and adult rats and in vitro genotoxicity of the
      veterinary anthelmintic rafoxanide.
AB  - The oral toxicity of the veterinary anthelmintic Rafoxanide was evaluated in
      newborn rats exposed in utero and during lactation. In another group, 3 months of
      oral treatment started after weaning. Rafoxanide administration to dams (10 mg kg
      1) decreased the number of pups per litter, induced high mortality (42%) and
      delayed the growth of offsprings before weaning. Histopathological examination of
      the central nervous system revealed vacuolation of the white matter. Vacuolation
      was particularly severe in the cerebellum of the 14-21-day-old rats. Rafoxanide
      induced, in some pups (35%), the formation of cataracts. These toxic effects
      seemed to be reversible and were no longer detectable after a further 3-month
      administration of Rafoxanide (10 mg kg-1) to rats born of treated dams. In adult
      rats treated orally for 3 months with 1, 5 or 25 mg kg-1 Rafoxanide, biochemical
      and haematological tests did not reveal dose-related effects. Rafoxanide had no
      mutagenic activity in the Ames and CHO/HGPRT tests.

PMID- 8486910
TI  - Triethylbenzene-induced sensorimotor neuropathy in rats.
AB  - 1,2,4-Triethylbenzene (1,2,4-TEB) and 1,3,5-triethylbenzene (1,3,5-TEB) were
      administered orally to male Sprague-Dawley rats. Experimental and appropriate
      control rats were examined electrophysiologically for motor and sensory
      conduction velocities (MCV and SCV), and the amplitudes of the sensory (ASAP) and
      muscular action potentials (AMAP), at bi-weekly intervals. Oral administration of
      1,2,4-TEB (200 or 400 mg kg-1, once daily, 4 days per week for 8 weeks) produced
      a time- and dose-dependent decrease in MCV, SCV, AMAP and ASAP. Rats treated with
      1,2,4-TEB exhibited a bluish discoloration of the skin and the urine was greyish
      greenish. No changes in MCV, SCV, AMAP and ASAP developed in rats given 1,3,5-TEB
      orally (200 or 400 mg kg-1, daily, 4 days per week for 8 weeks). The results
      indicate that 1,2,4-TEB is a neurotoxic isomer of TEB and that the presence of
      two ethyl radicals in the ortho-position on an aromatic ring could be a critical
      molecular arrangement resulting in chromogenic and neurotoxic properties.

PMID- 8486911
TI  - Sensory and pulmonary irritation of aliphatic amines in mice: a structure
      activity relationship study.
AB  - The expiratory bradypnea indicative of upper airway irritation in mice was
      evaluated during a 15-min oronasal exposure to increasing concentrations of
      sixteen aliphatic amines. The airborne concentration resulting in a 50% decrease
      in the respiratory rate of mice (RD50) was calculated for each test compound.
      Moreover, the sixteen amines were tested for pulmonary irritation by measuring
      the decrease in respiratory rate of (non-anaesthetized) tracheally cannulated
      mice (RD50 TC). The RD50 and RD50 TC values and their ratios were related to n
      octanol/water partition coefficients (log P). The RD50 values associated with
      exposure to saturated amines ranged from 17 to 300 ppm. The RD50TC values for
      these saturated amines ranged from 35 to 489 ppm. The RD50 and RD50TC values of
      saturated amines were closely related to the n-octanol/water partition
      coefficient, indicating that the more lipophilic amines are more irritant for the
      upper and lower respiratory tracts. The RD50TC/RD50 values were much less closely
      related to the n-octanol/water partition coefficient. Based on the results,
      tentative standards are suggested for the studied amines.

PMID- 8486912
TI  - Induction of mast cell sensitization by chemical allergens: a comparative study.
AB  - In previous investigations we have shown that chemical allergens of different
      classes induce in mice qualitatively divergent immune responses. Respiratory
      allergens provoke substantial increases in total serum concentration of IgE. In
      contrast, contact allergens which are known or suspected not to cause respiratory
      sensitization or which at most have only a very limited potential to do so, have
      little or no effect on total serum IgE. Such differences, we propose, provide a
      novel approach for the prospective identification of chemicals with potential to
      cause respiratory allergy. In the absence of a robust method for the direct
      measurement of respiratory hypersensitivity reactions in mice we have sought in
      the present study to determine whether the IgE responses induced in mice by
      respiratory allergens are specific and of sufficient magnitude to cause the
      active sensitization of mast cells in vivo, a prerequisite for immediate
      hypersensitivity, including acute-onset respiratory hypersensitivity. Topical
      exposure of BALB/c mice to concentrations of > or = 10% of the human respiratory
      allergen trimellitic anhydride (TMA) caused the specific sensitization of
      peritoneal mast cells in situ as measured by the conjugate-induced release of
      [3H]-5-hydroxytryptamine in vitro. Experiments were performed also with 2,4
      dinitrochlorobenzene (DNCB), a contact allergen that fails to induce respiratory
      hypersensitivity. Treatment of mice with concentrations of DNCB of comparable
      immunogenicity failed to cause mast cell sensitization. These data demonstrate
      that a known human chemical respiratory allergen induces in mice specific mast
      cell-sensitizing IgE antibody and reinforce the value of the mouse as a model for
      the evaluation of respiratory sensitization potential.

PMID- 8486913
TI  - Delayed neurotoxic effect of sarin in mice after repeated inhalation exposure.
AB  - Delayed neurotoxicity of sarin in mice after repeated inhalation exposure has
      been studied. Female mice exposed to atmospheric sarin (5 mg m-3 for 20 min)
      daily for 10 days developed muscular weakness of the limbs and slight ataxia on
      the 14th day after the start of the exposure. These changes were accompanied by
      significant inhibition of neurotoxic esterase (NTE) activity in the brain, spinal
      cord and platelets. Histopathology of the spinal cord of exposed animals showed
      focal axonal degeneration. These changes were comparatively less than in animals
      treated with the neurotoxic organophosphate, mipafox. Results from this study
      indicate that sarin may induce delayed neurotoxic effects in mice following
      repeated inhalation exposure.

PMID- 8486914
TI  - Dibromomethane and carbon monoxide in the rat: comparison of the cardiovascular
      and metabolic effects.
AB  - The goals of this study were to examine the cardiovascular and metabolic
      responses to a dihalogenated methane and to compare them to inhaled CO. One group
      of male Sprague-Dawley rats received an i.p. injection of either 3 or 6 mmol kg-1
      dibromomethane (DBM) diluted 1:3 with sesame oil. Measurements of
      carboxyhemoglobin (COHb), rectal body temperature (BT), heart rate, systolic
      blood pressure (BP) and blood glucose and lactate concentrations were made at
      times 0, 30, 60, 120, 240, 360, 480, 600, 720, 840, 1020, 1440 and 1680 min. A
      second group of rats received only sesame oil and was tested in the same manner.
      A third group of rats breathed 225 ppm CO for 120 min before being tested. Peak
      COHb levels were 16% 8 h after 3 mmol kg-1 DBM, 18% 12 h after 6 mmol kg-1 DBM
      and 17% in the CO-exposed group. The sesame oil controls exhibited no elevation
      in COHb. The BT dropped by ca. 1 degree C in both the DBM- and CO-exposed rats,
      while there was no BT change in the sesame oil controls. The BT dropped by 1.0
      degree C and 1.2 degree C after 6 h in the 3 and 6 mmol kg-1 DBM groups,
      respectively, and by 0.9 degree C after 120 min in the CO-exposed group. The CO
      exposed rats displayed a 12 mmHg decrease in systolic BP, while both doses of DBM
      failed to produce any significant BP change. The BP in the sesame oil controls
      remained constant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8486915
TI  - Body distribution and endocrine toxicity of hexachlorobenzene (HCB) in the female
      rat.
AB  - Hexachlorobenzene (HCB) residue levels in dosed rats (50.0 mg kg-1 body wt.day-1,
      n = 9) were significantly (P < 0.05) greater in the periovarian fat compared to
      the thyroid gland. Hexachlorobenzene residue levels were significantly (P < 0.05)
      greater in the thyroid versus the adrenal and ovary. Ovarian HCB residue levels
      were greater than those found in the thymus, liver and lung. Serum thyroxin (T4)
      and the free T4 index (FTI) were significantly (P < 0.05) suppressed in HCB
      treated rats compared to the control group (n = 8). In contrast, no significant
      differences in serum concentrations of oestradiol (E2), progesterone (P4) or
      percentage triiodothyronine uptake (%T3) were observed, thus suggesting an HCB
      induced hypothyroid-like state. In a second experiment, adult female Sprague
      Dawley rats (n = 16) were dosed as above and superovulated with pregnant mare
      serum gonadotrophin (PMSG, 10 IU s.c.) and human chorionic gonadotrophin (hCG, 20
      IU s.c.). Circulating levels of P4 were significantly (P < 0.05) elevated
      compared to the control group (n = 8). The %T3 uptake and serum T4 levels were
      significantly (P = 0.05) suppressed compared to controls. Hexachlorobenzene
      treatment had no effect on circulating levels of E2 or on the FTI. These results
      suggest that HCB-induced changes found in the spontaneously cycling rat are
      augmented by ovulation induction strategies. We also conclude that HCB
      concentrates in the endocrine tissues in addition to the fat.

PMID- 8486916
TI  - Genetic toxicology studies with a tumor promoter.
AB  - A diuretic antihypertensive agent, SC-33643 (8-[2-ethoxyethyl]-7-phenyl
      [1,2,4]triazolo[4,3-c]pyrimidine-5- amine, also known as bemitradine), was tested
      in the Ames test, in the mouse lymphoma TK +/- mutation assay, in the Chinese
      hamster ovary cell hypoxanthine guanine phosphoribosyl transferase (CHO/HGPRT)
      mutation test and in the CHO chromosome aberration assay with and without
      metabolic activation. Additionally, the compound was tested in the rat primary
      hepatocyte unscheduled DNA synthesis (UDS) assay and in the mouse bone marrow
      micronucleus assay. The results were uniformly negative. Contrary to expectations
      based on the results of the battery of genetic toxicology tests, the compound
      produced liver, thyroid and mammary tumors in the rat (reported separately).
      Subsequently, SC-36741 (5-amino-7-phenyl-[1,2,4]triazolo-[1,5-c] pyrimidine-8
      ethanol, also known as desethylbemitradine), a major metabolite of SC-33643, was
      tested in the Ames test, in the CHO/HGPRT mutation test and in the CHO chromosome
      aberration assay with and without metabolic activation, and was also tested in
      the rat primary hepatocyte/UDS assay and in the mouse bone marrow micronucleus
      assay. This metabolite also produced negative results in these tests. Therefore,
      SC-33643 is a non-genotoxic carcinogen producing tumors in rats without altering
      DNA or chromosomes.

PMID- 8486917
TI  - Sailors' physicians: medical guides for merchant ships and whalers, 1774-1864.

PMID- 8486918
TI  - A Greek progymnasma on the physician-poisoner.

PMID- 8486919
TI  - When the doctors disagree: scientific temperance and scientific authority, 1891
      1906.

PMID- 8486920
TI  - Western biology and medicine in modern China: the career and legacy of Alice M.
      Boring (1883-1955).

PMID- 8486921
TI  - Europium-labelled recombinant protein G. A fast and sensitive universal
      immunoreagent for time-resolved immunofluorometry.
AB  - Recombinant protein G was labelled with europium by conjugating the protein with
      Eu3+ chelate of a p-isothiocyanatobenzyl derivative of
      diethylenetriaminetetraacetic acid, a bifunctional chelating agent specifically
      optimized for labelling of immunoreagents with lanthanide ions. The labelling
      produced a universal reagent for time-resolved fluorometric immunoassays based on
      the principle of dissociative fluorescence enhancement (DELFIA). The optimum
      labelling level of about eight chelates per protein yielded a highly sensitive
      and stable reagent which retained its affinity for IgG and exhibited low non
      specific binding to coated solid surfaces. The reagent was evaluated in an
      immunoassay of anti-tetanus antibodies in human serum samples and the results
      were compared to those obtained with Eu-labelled polyclonal and Eu-labelled
      monoclonal anti-human IgG antibodies. The detection limit of the assay was 0.003
      mU/ml (0.3 microU per assay well). After a 100-fold dilution of the samples, the
      assay range extended from 0.3 mU/ml to 100,000 mU/ml with a linear range of five
      log orders. The incubation with Eu-labelled protein G reached equilibrium after a
      15 min incubation. The rapid kinetics, the low non-specific background and the
      high specific binding suggest that Eu-protein G can serve as a universal label
      for immunoassays based on IgG binding to solid surfaces.

PMID- 8486922
TI  - Antibodies to brain integral membrane proteins in systemic lupus erythematosus.
AB  - Wheat germ lectin affinity chromatography and temperature-induced phase
      separation with Triton X-114 were evaluated for the isolation of surface neuronal
      antigens from rat and human brain and from human neuroblastoma cell lines IMR-6
      and SK-N-SH. Both techniques yielded surface proteins which were free of
      contamination by intracellular proteins but temperature-induced phase separation
      was technically less demanding and less expensive, required a shorter assay time
      and resulted in a superior quantity and quality of isolated proteins. Rat brain
      surface proteins were used for characterization of antineuronal antibody
      reactivity in sera from patients with systemic lupus erythematosus (SLE). Western
      blotting identified reactivity in 15 of 75 (20%) SLE sera compared to five of 95
      (5%) normal controls (P 0.006). In rat brain the molecular weight of the
      individual proteins identified ranged from 59 kDa to 22 kDa. Six of these were
      also present in human brain and two were present in neuroblastoma cell lines.
      Absorption studies indicated that some of the antigenic proteins were either
      restricted to brain tissue or shared with other non-neuronal tissues. These
      techniques should facilitate the characterization of antineuronal antibody
      reactivities and lead to a clearer understanding of their role in the
      pathogenesis of autoimmune neurologic disease.

PMID- 8486923
TI  - A flow cytometric study of the membrane potential of natural killer and K562
      cells during the cytotoxic process.
AB  - This study demonstrates that it is possible to investigate the membrane potential
      of interacting cells during the cytotoxic process using flow cytometry. Changes
      in the membrane potential of NK and K562 cells, involved in a cell-mediated
      cytotoxic process, were studied by standard and slit-scan flow cytometry, using
      the membrane potential sensitive fluorescent probe DiBAC4(3). The NK cells were
      labeled with a membrane marker (TR-18 or DiI) prior to incubation with K562 cells
      and the conjugates that were formed could be identified on the basis of the
      membrane marker fluorescence and light scattering signals. With a slit-scan
      technique we measured the membrane potential of each cell in a conjugate
      separately. The results show that depolarization of the K562 cell occurs as a
      consequence of the cytotoxic activity of the NK cell. This depolarization appears
      to be an early sign of cell damage because the cell membrane still remains
      impermeable to propidium iodide. Our data also indicate that depolarization of
      the NK cell occurs as a result of its cytotoxic activity.

PMID- 8486924
TI  - Preservation of phenotype and function of positively selected virus-specific CD8+
      T lymphocytes following anti-Fab detachment from immunomagnetic beads.

PMID- 8486925
TI  - Modified procedure for labelling target cells in a europium release assay of
      natural killer cell activity.
AB  - Lanthanide europium chelated to diethylenetriaminopentaacetate (EuDTPA) can be
      used to label target cells such as tumor cells and lymphocytes (Blomberg et al.,
      1986a,b; Granberg et al., 1988). This procedure has permitted the development of
      new non-radioactive methods for the detection of target cell cytolysis by natural
      killer (NK) cells (Blomberg et al., 1986a,b), cytotoxic T lymphocytes (CTL)
      (Granberg et al., 1988) or complement-mediated cytolysis (Cui et al., 1992).
      However, we had no success with this method because of a lack of comparability
      between human NK cell activity simultaneously measured by a classical 51Cr
      release assay (Seaman et al., 1981) and EuDTPA release assay (Blomberg et al.,
      1986a). Furthermore, cell division and cell viability were significantly impaired
      by the suggested concentrations of EuCl3. In this paper, we present a modified
      non-cytotoxic method for target cell labelling with EuDTPA while cells are
      growing in culture medium.

PMID- 8486926
TI  - A quantitative ELISA for dystrophin.
AB  - A novel approach to the quantitation of the muscular dystrophy protein,
      dystrophin, in muscle extracts is described. The two-site ELISA uses two
      monoclonal antibodies against dystrophin epitopes which lie close together in the
      rod domain of the dystrophin molecule in order to minimize the effects of
      dystrophin degradation. Dystrophin is assayed in its native form by extracting
      with non-ionic detergents and avoiding the use of SDS.

PMID- 8486927
TI  - Simultaneous electroelution of whole SDS-polyacrylamide gels for the direct
      cellular analysis of complex protein mixtures.
AB  - A novel procedure which allow the rapid screening of complex protein mixtures in
      cellular assays is described. A device has been developed which allows a
      convenient, simultaneous electroelution of separated proteins from whole SDS
      polyacrylamide gels into narrow chambers each containing single or a few protein
      bands. We have optimized the conditions of the procedure and have obtained an
      efficient removal of SDS, leading to non-toxic protein fractions in a
      physiological buffer suited for direct testing in cell cultures. The responses
      generated by stimulating lymphocytes with the purified products have been
      compared to the native protein and a corresponding preparation of protein
      transferred to nitrocellulose particles. The method was used to investigate
      murine T cell responses to secreted mycobacterial antigens during infection with
      M. tuberculosis. A immunodominant secreted protein fraction was purified in a
      semipreparative scale by the procedure and used to immunize mice. The specificity
      of and lymphokine production by T cells generated in these animals were
      investigated. The device developed has various applications and provides a tool
      for the possible identification of new T cell antigens of importance for
      protective immunity.

PMID- 8486928
TI  - Detection of distinct sets of newly synthesized polypeptides in supernatants of
      TCR-triggered T cell clones. Implication for the search for new lymphokines.
AB  - Using metabolic radiolabelling of proteins, which are newly synthesized during
      TCR-triggered T cell activation we were able to visualize distinct patterns of
      secreted polypeptides (with molecular weights ranging from 6 to 44 kDa) in
      supernatants of different T helper-1, T helper-2 and cytotoxic T cell clones.
      Most of these detected proteins are secreted in response to TCR-crosslinking (or
      to combined action of PMA and A231287), in an extracellular Ca(2+)-dependent
      manner and their appearance in supernatants was completely blocked by the
      addition of RNA synthesis or protein synthesis inhibitors or EGTA. Cyclosporin A
      (CsA) blocks secretion of several detected polypeptides, but does not affect TCR
      triggered synthesis and secretion of others reflecting the existence of TCR
      triggered, CsA-insensitive protein synthesis and secretion pathway. The
      insensitivity of secretion of several easily detectable polypeptides to
      inhibition by CsA offers a promising approach to further define the CsA-resistant
      and calcineurin-independent molecular pathways of TCR-triggered T cell
      activation. Several lymphokines (e.g., interferon-gamma, tumor necrosis factor,
      interleukin-4 and interleukin-10) are identified among the visualized set of
      secreted polypeptides. Since other, yet unidentified, secreted polypeptides in
      the same set of secreted proteins share important properties with known
      lymphokines it seems promising to use described approach in search for new
      lymphokines.

PMID- 8486929
TI  - Quantitation of IL-4 expression in small numbers of cells from mice.
AB  - Interleukin-4 (IL-4) is an important T cell and mast cell product that
      participates in allergic and cytotoxic responses, as well as functions as a
      growth factor for B, T, and inflammatory cells. Studies of the expression of IL-4
      by T cells present in inflammatory reactions would be facilitated by using
      polymerase chain reaction (PCR) coupled to reverse transcription of mRNA to
      amplify the small quantity of mRNA present in these cells. In order to use this
      method in a quantitative manner, a plasmid was constructed that contained a
      modified form of mouse IL-4 cDNA. This plasmid was transcribed to produce cRNA
      for this modified sequence. The cRNA was used as an internal standard for the
      reverse transcription and amplification of IL-4 transcripts in RNA samples from
      mouse thymocytes. Amplification of reverse-transcribed native IL-4 mRNA produced
      a 286 bp PCR product. Amplification of the reverse-transcribed standard RNA
      produced a 155 bp product, which reflected a deletion introduced into the
      original IL-4 cDNA sequence. Comparison of the amount of the 286 bp native
      product to the amount of 155 bp standard product enabled the quantitative
      determination of IL-4 expression in each sample. This method was used to
      demonstrate that platelet activating factor increases the expression of IL-4 in
      mouse thymocytes and in a mouse T cell line. The expression of IL-4 by thymocytes
      exposed to platelet-activating factor (PAF) may reveal an important link between
      inflammation and the maturation of T cells in the thymus.

PMID- 8486930
TI  - Detection of human T cell receptor cDNAs (alpha, beta, gamma and delta) by
      ligation of a universal adaptor to variable region.
AB  - The study of T cell receptor (TCR) genes has been hampered by their large
      repertoires and elusive methods for gene amplification. We have developed a new
      method for amplification of all human TCR genes (alpha, beta, gamma, and delta)
      with the ligation of a universal adaptor to the leader sequence of variable (V)
      regions, which permitted effective and reproducible amplification of all four
      types of TCR genes. cDNA sequencing of TCR-gamma, -delta, -alpha, -beta was
      carried out in respectively 15, 13, 28, and 26 T cell clones from human
      peripheral blood T cells using a newly developed universal adaptor and these
      methods. TCR-gamma V-II (V gamma 9) was a major population, and V-I (V gamma 2
      and 3) and V-III (V gamma 10) were next major populations among TCR-gamma
      subfamilies, and confirmed the previous observations determined using mAbs
      specific to TCR-gamma. All five clones of TCR-gamma V-II and three of five clones
      of TCR-gamma V-I subfamilies had in-frame V-N-J junctions. In contrast, sequences
      from both TCR-gamma V-III (4/4 clones) and V-IV (1/1 clones) subfamilies had
      intron-like regions that caused out-of-frame cDNA, suggesting that most of TCR
      gamma V-III and V-IV in PBL are not functional. V delta 2 was a major population
      and V delta 1 was a next predominant population among TCR-delta subfamilies, also
      confirming the previous observations determined using mAbs to TCR-delta. With
      regards to TCR-alpha and -beta, this new method randomly amplified TCR cDNAs. In
      addition, the sequences of 5' portions of three TCR-V-alpha and one TCR-V beta
      were extended. Two new TCR-alpha subfamilies and one new TCR-beta family were
      also identified. In summary, this new method will provide a scientific tool for
      understanding structures of the human TCR genes involved in specific immune
      responses.

PMID- 8486931
TI  - Characterization of human tumor cell lines transduced with the cDNA encoding
      either tumor necrosis factor alpha (TNF-a) or interleukin-2 (IL-2).
AB  - Tumor cell lines were generated from cancer patients, 17 with metastatic melanoma
      and one with colon adenocarcinoma. The lines were characterized as tumor cells by
      the presence of tumor associated antigens demonstrated by indirect
      immunofluorescence and analysing using a fluorescence activated cell sorter
      (FACS). The tumor cell lines were transduced using retroviruses encoding neomycin
      phosphotransferase and either human tumor necrosis factor alpha (TNF-alpha) or
      interleukin-2 (IL-2). Following transduction, cells were selected and grown in
      the neomycin analogue G418. Fibroblasts overgrew tumor cells in 6/18 cases
      following selection in G418 and 1/18 lines did not grow at all after selection.
      In the remaining 11 lines the expression of tumor associated antigens, growth,
      and susceptibility to lysis by LAK cells was similar between the selected
      transduced tumor cell lines and the nontransduced controls. Of the lines tested,
      all were positive for the presence of the cytokine gene by Southern blot or PCR
      analysis. In addition, no replication competent retrovirus was detected in the
      cell lines following transduction using an extended mink S+L- focus assay. The
      amount of specific cytokine produced per 10(5) transduced tumor cells in 24 h
      ranged from 0.2 ng to 5.8 ng of TNF-alpha for the TNF transduced lines and from
      0.1 ng to 3.6 ng of IL-2 for the IL-2 transduced tumor cell lines. One transduced
      tumor cell line examined maintained consistent levels of cytokine production when
      studied at 15 different time intervals over a period of 198 days. Additionally,
      40,000 rads of gamma irradiation did not stop cytokine production from two
      transduced tumor cell lines when studied over 6 days. This study demonstrates the
      feasibility of growing human tumor cell lines from surgical biopsies and
      genetically modifying those lines to produce a cytokine of choice for possible
      use as a tumor cell vaccine.

PMID- 8486932
TI  - Monoclonal antibody-specific immobilisation of erythrocyte antigens (MAIEA). A
      new technique to selectively determine antigenic sites on red cell membranes.
AB  - A new assay, the monoclonal antibody-immobilization of erythrocyte antigens
      (MAIEA) is described for the assignment of red cell antigens recognised by human
      allo-antisera, to particular membrane components of the red cell membrane. This
      technique detects tri-molecular complexes formed by the reaction of a human
      antibody and a mouse antibody with a particular red cell protein. A positive
      reaction, in an ELISA-type detection procedure, occurs if the epitopes recognised
      by the human and mouse antibodies are present on the same membrane component but
      different regions. The MAIEA assay has been developed to investigate blood group
      antigens and in this report its application to the study of the Lutheran, Yt and
      Kell blood group systems is described. The technique has been used to show that
      the Lu(a) and Lu3 antigens are carried on the Lutheran glycoprotein, Yta and Ytb
      on the enzyme acetylcholinesterase and K, k, Kpa and Kpb on the Kell
      glycoprotein.

PMID- 8486933
TI  - Optimization of a time-resolved immunofluorometric assay for tumor-associated
      trypsin inhibitor (TATI) using the streptavidin-biotin system.
AB  - We have developed two 'sandwich'-type time-resolved immunofluorometric assays
      (IFMA) for tumor-associated trypsin inhibitor (TATI) using monoclonal and
      polyclonal antibodies. In the standard assay the monoclonal antibody was
      immobilized onto the walls of polystyrene microstrip wells and the polyclonal
      reagent was labeled with a europium chelate. We tested various assay conditions
      in order to optimize the assay for sensitivity and measuring range. Purification
      of the labeled antibody by hydrophobic interaction chromatography was found to be
      the most important single factor affecting sensitivity. Assay sensitivity and
      range were also improved by acid treatment of the solid phase antibody. To
      improve the sensitivity further the streptavidin/biotin (SAB) system was
      incorporated into the IFMA technique. In this simple and fast streptavidin/biotin
      IFMA (SAB-IFMA) we used streptavidin-coated wells to which we added biotinylated
      monoclonal antibody and a serum or urine sample. After incubation for 1.5 h and
      washing, the polyclonal europium-labeled tracer antibody was added. After
      incubation for 1 h the wells were washed and the Eu fluorescence measured. The
      assay performance of the SAB-IFMA was compared to the standard IFMA and
      radioimmunoassay (RIA). The detection limit was 0.05 microgram/l and the
      analytical range 3000-fold. The mean analytical recovery was 101%. Other
      advantages of the SAB-IFMA were high sensitivity and the low amounts of
      monoclonal antibody required, only 1/50 of that used in the standard IFMA.

PMID- 8486934
TI  - Vitamin A, infectious disease, and childhood mortality: a 2 solution?
AB  - Vitamin A was first discovered in 1913. Its deficiency was soon associated in
      animal models and case reports with stunting, infection, and ocular changes
      (xerophthalmia) resulting in blindness. The ocular consequences dominated
      clinical interest through the early 1980s. A longitudinal prospective study of
      risk factors contributing to vitamin A deficiency and xerophthalmia revealed a
      close, dose-response relationship between the severity of mild preexisting
      vitamin A deficiency and the subsequent incidence of respiratory and diarrheal
      infection (relative risk [RR], 2.0-3.0) and, most dramatically, death (RR, 3.0
      10.0). Subsequent community-based prophylaxis trials of varying design confirmed
      that vitamin A supplementation of deficient populations could reduce childhood (1
      5 years old) mortality by an average of 35%. Concurrent hospital-based treatment
      trials with vitamin A in children with measles revealed a consistent reduction in
      measles-associated mortality in Africa of at least 50%. It is now estimated that
      improving the vitamin A status of all deficient children worldwide would prevent
      1-3 million childhood deaths annually.

PMID- 8486935
TI  - Early viremia and immune responses in vertical human immunodeficiency virus type
      1 infection.
AB  - Thirty-three infants born to human immunodeficiency virus type 1 (HIV-1)
      seropositive women were evaluated from birth using plasma and peripheral blood
      mononuclear cell (PBMC) cultures, polymerase chain reaction, and serum p24
      antigen assays. Five children were identified as infected. Evidence of infection
      was found in cord blood and subsequent samples from 2 infected children,
      suggesting in utero infection. Virologic studies on cord blood and early neonatal
      specimens from the 3 other infected children were negative but became positive by
      8 weeks of age, suggesting either intrapartum transmission or sequestration of
      virus with subsequent detection. An increase in blood (plasma and PBMC) virus
      titers consistent with primary viremia was observed in 4 infants between 3 and 16
      weeks of age. Blood virus titers subsequently declined in the absence of
      antiretroviral therapy and in the absence of activated HIV-1-specific cytotoxic T
      lymphocyte responses or broadly neutralizing antibodies. Confirmation of these
      results in larger studies may be helpful in the design of clinical trials to
      interrupt vertical transmission or to modify the course of infection.

PMID- 8486936
TI  - Identification of a type-specific protein that differentiates serologically
      between human T cell lymphotropic virus types I and II.
AB  - The 24-kDa band formed when sera of humans infected with human T cell
      lymphotropic virus type I (HTLV-1) were reacted with HTLV-I lysates in
      conventional Western blot (WB) assays was found to be composed of two
      immunologically unrelated proteins of 24- and 23-kDa. p24, but not p23, carries
      epitopes shared by the major core proteins of the other known transactivating C
      type retroviruses. p23 is unrelated immunologically to the env and tax HTLV-I
      products but partly cross-reacts with HTLV-I p19. All HTLV-I and simian T cell
      leukemia virus type I sera tested reacted with p23. Reactivity with p23 was seen
      with some HTLV-I sera that did not react or reacted weakly with HTLV-I p24. No
      reactivity with p23 was seen among the 51 human HTLV-II sera tested nor among a
      large panel of control sera. Because of its type-specificity and strong
      immunogenicity, p23 provides a reliable serologic marker for the diagnosis of
      HTLV-I infection and for distinguishing between HTLV-I and -II.

PMID- 8486937
TI  - Candidate recombinant vaccine for human B19 parvovirus.
AB  - Recombinant baculoviruses were used to produce human B19 parvovirus empty capsids
      composed of only VP2 and VP2 capsids containing 4%, 25%, 35%, or 41% VP1 protein.
      Immunogenicity of the purified capsids, formulated with or without adjuvant, was
      evaluated in mice, guinea pigs, and rabbits. Sera were analyzed for total anti
      B19 parvovirus antibodies, antibodies specific to the region unique to the VP1
      capsid protein, and virus neutralizing antibodies. A relationship was observed
      between the development of antibodies specific to sequences unique to the VP1
      protein and virus neutralization. The polypeptide composition of the empty capsid
      immunogens appeared to be important for elicitation of potent virus neutralizing
      activity. VP2 capsid immunogens devoid of VP1 protein, or consisting of only 4%
      VP1, the composition of naturally occurring virions, were generally poor at
      eliciting high levels of virus neutralizing activity. Capsids consisting of > or
      = 25% VP1 protein efficiently and consistently provoked vigorous B19 virus
      neutralizing responses. Recombinant empty capsids enriched for the VP1 protein
      should serve as the basis for a human B19 parvovirus vaccine.

PMID- 8486938
TI  - The 5C protein of Neisseria meningitidis is highly immunogenic in humans and
      induces bactericidal antibodies.
AB  - The 5C protein is expressed by the strain of Neisseria meningitidis (44/76) used
      for production of the Norwegian meningococcal group B outer membrane vesicle
      vaccine and is included in the final formulation of this vaccine. The
      immunoglobulin G antibody response to 5C stimulated by vaccination, systemic
      meningococcal disease, and carriage was measured using ELISAs with synthetic
      liposomes as antigen and by immunoblotting. Increased levels of IgG were found in
      paired sera from all three groups. The antibodies were bactericidal to
      meningococci of serogroups A and B that expressed large amounts of 5C but not to
      meningococci expressing smaller amounts. There was a linear correlation between
      bactericidal titer and units of IgG to 5C.

PMID- 8486939
TI  - Invasion of human skin fibroblasts by the Lyme disease spirochete, Borrelia
      burgdorferi.
AB  - The ability of Borrelia burgdorferi to attach to and invade human fibroblasts was
      investigated by scanning electron and confocal microscopy. By scanning electron
      microscopy, B. burgdorferi were tightly adherent to fibroblast monolayers after
      24-48 h but were eliminated from the cell surface by treatment with ceftriaxone
      (1 microgram/mL) for 5 days. Despite the absence of visible spirochetes on the
      cell surface after antibiotic treatment, viable B. burgdorferi were isolated from
      lysates of the fibroblast monolayers. B. burgdorferi were observed in the
      perinuclear region within human fibroblasts by laser scanning confocal
      microscopy. Intracellular spirochetes specifically labeled with monoclonal anti
      flagellin antibody were also identified by fluorescent laser scanning confocal
      microscopy. These observations suggest that B. burgdorferi can adhere to,
      penetrate, and invade human fibroblasts in organisms that remain viable.

PMID- 8486940
TI  - Dynamics of Borrelia burgdorferi transmission by nymphal Ixodes dammini ticks.
AB  - Groups of 25-30 nymphal Ixodes dammini infected with Borrelia burgdorferi fed on
      mice for 36, 42, or 48 h. Only 1 (7%) of 14 mice exposed for 36 h became infected
      as did 3 (25%) of 12 mice exposed for 42 h and 6 (75%) of 8 mice exposed for 48
      h. The minimum transmission rate calculation for ticks attached for 36 h was
      0.5%; for 42 h, 1.5%; and for 48 h, 5.8%. Homogenates derived from nonfed "flat"
      nymphs or nymphs fed for 12 h were not infectious to mice. Homogenates derived
      from nymphs attached for 24 h, however, infected 20% of inoculated mice;
      homogenates derived from ticks attached for > or = 36 h infected > or = 80% of
      inoculated mice. Incubation of nonfed ticks at 37 degrees C did not produce
      infectious homogenates. The ID50 for low-passage JD1 strain spirochetes in 3-week
      old mice was 2.69 x 10(3) spirochetes.

PMID- 8486941
TI  - Induction of interleukin-1 release by high- and low-passage isolates of Borrelia
      burgdorferi.
AB  - Low-passage isolates of Borrelia burgdorferi induced arthritis when injected into
      the hind paws of irradiated hamsters, while high-passage isolates did not. To
      examine a possible mechanism for induction of arthritis, peritoneal exudate cells
      were coincubated with high- and low-passage isolates of B. burgdorferi, and the
      resultant conditioned medium was assayed for interleukin-1 (IL-1) activity.
      Comparable amounts of IL-1 activity were detected in culture supernatants
      generated by high- and low-passage spirochetes and were dependent on the number
      of spirochetes added. Live B. burgdorferi stimulated greater release of IL-1
      activity than did heat-killed organisms. No evidence of release of IL-1 due to
      shedding of soluble components from spirochetes was obtained. A recombinant human
      IL-1 receptor antagonist blocked the proliferative activity of conditioned medium
      in a murine thymocyte assay for IL-1 activity. The greater ability of low-passage
      spirochetes to survive in vivo may be more important than the ability to induce
      IL-1 production in the pathogenesis of Lyme arthritis.

PMID- 8486942
TI  - Clinical and serologic evaluation of neonates for congenital syphilis: a
      continuing diagnostic dilemma.
AB  - Neonates born to women with reactive serologic tests for syphilis were studied;
      the total of 116 included 18 who were symptomatic, 60 asymptomatic but possibly
      infected, and 38 asymptomatic and probably uninfected. The fluorescent treponemal
      antibody-absorption (FTA-ABS) 19S IgM test and an IgM capture ELISA for Treponema
      pallidum, both treponema-specific assays, and the reverse enzyme-linked
      immunospot (RELISPOT), which detects immunoglobulin-secreting cells and is a
      nonspecific indicator of infection, were evaluated. Sensitivities among
      symptomatic neonates were 88% (IgM ELISA), 73% (FTA-ABS), and 78% (RELISPOT).
      Specificities ranged from 97% to 100%. A major problem has been the inability to
      identify which asymptomatic but possibly infected neonate is really uninfected.
      Among 41 such babies who had all three tests done, 93% were negative by all
      assays, suggesting they were uninfected or recently infected. Strategies to
      accurately identify the truly uninfected asymptomatic newborn would prevent the
      unnecessary hospitalization of all at-risk infants, resulting in improved quality
      of care and reduced costs.

PMID- 8486943
TI  - VDRL antibodies enhance phagocytosis of Treponema pallidum by macrophages.
AB  - Although reactivity in nontreponemal tests develops in patients with untreated
      syphilis, no immunologic function has been ascribed to these antibodies. This
      study demonstrates that rabbit antibodies induced by immunization with VDRL
      antigen and VDRL antibodies affinity-purified from syphilitic rabbit serum
      enhance phagocytosis of Treponema pallidum. The proportion of macrophages
      ingesting treponemes in the presence of these antisera was 45% +/- 5% and 27% +/-
      4%, respectively, versus 14% +/- 3% for normal serum (P < .001 and P < .01). Both
      IgG and IgM fractions contained opsonic activity. Absorption of VDRL antibodies
      from syphilitic serum diminished but did not eliminate opsonization, suggesting
      at least two classes of target molecules. Despite opsonic capacity, VDRL
      antibodies fail to facilitate macrophage-mediated killing of T. pallidum.
      Nevertheless, VDRL-immunized rabbits are partially protected against T. pallidum
      infection, developing fewer lesions (delayed and smaller) than do unimmunized
      controls. These results suggest a heretofore unrecognized functional role for
      VDRL antibodies in syphilis infection.

PMID- 8486944
TI  - Prevention of group B streptococcal colonization and bacteremia in neonatal mice
      with topical vaginal inhibitors.
AB  - Pregnant Swiss-Webster mice were vaginally inoculated with 10(5) virulent and
      avirulent serotype III Streptococcus agalactiae and treated 4 days later with
      topical vaginal inhibitor solutions. Preparations containing lipoteichoic acid
      (LTA) or glycerophosphate (GP), the repeating linear backbone of LTA,
      significantly reduced neonatal colonization and bacteremia by the virulent
      isolate and colonization by the avirulent strain. Similar results were obtained
      if bacteria were preincubated with LTA or GP at 37 degrees C for 30 min before
      vaginal inoculation. Human serum albumin (HSA), a known inhibitor of binding of
      LTA to human fetal epithelial cells, also resulted in reduction in colonization
      and bacteremia of neonatal mice. However, maternal treatment with a combination
      of HSA (2%) and GP (1%) completely prevented neonatal colonization and bacteremia
      without altering the normal aerobic bacterial vaginal flora. These results
      provide impetus to the development of an alternative means of preventing neonatal
      group B streptococcal infections in humans without requiring maternal
      immunization or chemoprophylaxis.

PMID- 8486945
TI  - Inhibition of platelet binding and aggregation by streptococcal
      exopolysaccharide.
AB  - Streptococcal exopolysaccharides are major virulence factors in the pathogenesis
      of endocarditis. They promote bacterial adherence to valves and subsequent
      vegetation formation. Since platelet binding and aggregation by streptococci are
      postulated mechanisms for endocardial colonization and vegetation production, the
      effect of exopolysaccharide on binding and aggregation was evaluated by flow
      cytometry and aggregometry. Streptococcus salivarius D1, a minimal
      exopolysaccharide producer, bound human platelets extensively (86.8% of bacteria
      bound by 1 min). S. Salivarius M13 and M15 and Streptococcus mitis M4 produced
      larger amounts of exopolysaccharide and bound platelets significantly less
      (52.6%, 51.2%, 52.8%, respectively). Exopolysaccharide also inhibited platelet
      aggregation: Strains with minimal exopolysaccharide aggregated platelets
      maximally, while strains with extensive exopolysaccharide failed to induce
      aggregation. Removal of exopolysaccharide by shearing restored aggregation by
      these latter strains. Thus, exopolysaccharides can inhibit the binding and
      aggregation of platelets by streptococci. The virulence associated with
      exopolysaccharide may result from the inhibition of platelet-mediated
      interactions that limit disease progression.

PMID- 8486946
TI  - Legionella pneumophila replicates within rat alveolar epithelial cells.
AB  - Legionella pneumophila replicates in the distal pulmonary airspace, causing
      legionnaires' pneumonia. Legionella organisms replicate within alveolar
      macrophages and recruited blood monocytes; however, when these cells are
      activated, they become potent inhibitors of L. pneumophila proliferation. L.
      pneumophila may replicate in other cells and thereby avoid the host defenses of
      macrophages. Experiments demonstrated that L. pneumophila replicate within
      primary cultures of rat pulmonary alveolar epithelial cells. Double-label
      immunofluorescent and electron microscopy demonstrated L. pneumophila within
      epithelial cells. Replication of L. pneumophila required similar numbers of
      alveolar epithelial cells or alveolar macrophages, required viable epithelial
      cells, and took place intracellularly. While replication of L. pneumophila
      occurred in both serum-free and serum-containing media, it was enhanced in the
      presence of serum. Pulmonary alveolar epithelial cells may represent an
      alternative site for replication of Legionella species in the terminal airspace
      and thus clarify some previously unexplained aspects of the pathogenesis of
      legionnaires' disease.

PMID- 8486947
TI  - Attachment and entry of Legionella pneumophila in Hartmannella vermiformis.
AB  - Legionella pneumophila is an intracellular parasite of Hartmannella vermiformis.
      Attachment to the amebae and entry of L. pneumophila were studied by two
      quantitative assays: One used plate counts to measure the number of bacteria
      attaching to amebae at 4 degrees C; the other determined the number of
      intracellular bacteria by use of transmission electron microscopy (TEM). The
      attachment assay showed that L. pneumophila are inefficient in attachment to
      amebae. About 0.05% of the bacteria were bound after 1 h with a 10- to 40-fold
      increase over the next 11 h. Attachment of both virulent and avirulent strains of
      L. pneumophila occurred at a similar rate. Uptake of L. pneumophila was measured
      by counting intracellular bacteria using TEM. Limited numbers of virulent L.
      pneumophila were found intracellularly before 4 h, but the numbers increased
      logarithmically after this time. The number of amebae containing virulent L.
      pneumophila increased linearly during the 12-h co-incubation. Avirulent L.
      pneumophila were rarely detected within amebae throughout the 12-h incubation.
      Results indicate that entry, not attachment, of virulent L. pneumophila is the
      limiting step in infection of axenically grown H. vermiformis.

PMID- 8486948
TI  - Inhibition of lipid A- and lipopolysaccharide-induced cytokine secretion, B cell
      mitogenesis, and lethal shock by lipid A-specific murine monoclonal antibodies.
AB  - Three murine hybridomas secreting IgM monoclonal antibodies (MAbs) to lipid A
      (LA) of Salmonella minnesota R595 were generated. These MAbs serologically cross
      reacted with LA and lipopolysaccharide (LPS) of unrelated gram-negative bacterial
      species. All three MAbs significantly suppressed the ability of LA and LPS from
      various gram-negative bacteria to induce tumor necrosis factor (TNF)-alpha (36%
      67%) and interleukin-1 (30%-98%) in murine peritoneal macrophages and to
      stimulate B lymphocytes (37%-78%). Lipid A-induced TNF alpha production was also
      suppressed in mice (86%-88%). All three antibodies protected adrenalectomized
      mice against lethal shock induced by LA of S. minnesota R595. Optimal protection
      was achieved with one of the antibodies (MLA-1), if it was administered 2 h
      before injection of lipid A, and full protection persisted < or = 24 h. Moreover,
      MLA-1 was able to protect adrenalized or D(+)-galactosamine-sensitized mice
      against lethal shock induced by LPS derived from various gram-negative bacteria.
      This cross-protection could be predicted on the basis of serologic cross
      reactivity and cross-neutralization by MLA-1 of the bioactivity of the
      heterologous LA or LPS in vitro.

PMID- 8486949
TI  - The major secreted antigen complex (Ag 85) from Mycobacterium bovis bacille
      Calmette-Guerin is associated with protective T cells in leprosy: a follow-up
      study of 45 household contacts.
AB  - T cell proliferation and interferon (IFN)-gamma secretion were analyzed in 45
      leprosy contacts stimulated with antigen 85 (Ag85), the major culture filtrate
      antigen from Mycobacterium bovis bacille Calmette-Guerin. All 14 Mitsuda reaction
      positive contacts reacted to Mycobacterium leprae and Ag85. Three Mitsuda
      reaction-negative contacts reacted weakly to M. leprae and Ag85. The other 28
      Mitsuda reaction-negative contacts did not react to M. leprae, but 9 reacted to
      Ag85. Thirty-four contacts were retested 16 months later. Eleven contacts
      initially positive by the Mitsuda test remained lepromin positive and reactive to
      M. leprae and Ag85. Fourteen contacts initially negative by the Mitsuda test
      converted, and all reacted in vitro to M. leprae and Ag85. Finally, 9 contacts
      remained Mitsuda test-negative, and 7 were unreactive to Ag85. In vitro
      reactivity to Ag85 at baseline in Mitsuda test-negative contacts was associated
      with subsequent conversion to lepromin reactivity in 7 of 9 subjects. These data
      suggest that reactive T cells against Ag85 develop very early during M. leprae
      infection and that Ag85 is a potentially protective T cell immunogen.

PMID- 8486950
TI  - Induction of tumor necrosis factor-alpha in murine Candida albicans infection.
AB  - Candidemia in humans is often associated with an endotoxic shock-like syndrome,
      comparable to gram-negative sepsis. Tumor necrosis factor-alpha (TNF alpha) has
      been implicated as a mediator in the endotoxic shock syndrome. The possible role
      of TNF alpha causing early deaths was explored in a murine model of acute
      infection with Candida albicans. In vitro data from three mouse strains (BALB/c,
      C3H/HeJ, and C3H/HeN) and in vivo data from BALB/c mice were obtained. Peritoneal
      macrophages from all three strains produced TNF alpha in vitro when stimulated
      with C. albicans. After intravenous infection with 10(8) cfu of C. albicans, mice
      died within 12 h. TNF concentrations in sera from these mice were significantly
      greater than in controls. Pretreatment of BALB/c mice with anti-murine TNF alpha
      did not alter mortality of C. albicans-infected mice, but pretreatment with
      murine TNF alpha reduced mortality. Therefore, in contrast to what was
      anticipated, TNF alpha may serve a protective role in murine candidiasis.

PMID- 8486951
TI  - Response to treatment for an intracellular infection in a T cell-deficient host:
      toxoplasmosis in nude mice.
AB  - To examine the experimental basis of treatment failures in T cell-deficient
      patients with intracellular infections, euthymic and athymic (nude) BALB/c mice
      were infected with Toxoplasma gondii and treated with sulfadiazine. All euthymic
      and nude mice survived during 2 weeks of sulfadiazine therapy. Once treatment was
      discontinued, 100% of euthymic mice survived while all nude mice died. Post
      sulfadiazine treatment survival was enhanced in nude mice by reconstitution with
      either L3T4+ or Lyt-2+ cells and was reduced in euthymic mice by monoclonal
      antibody treatment directed at depleting either L3T4+ or Lyt-2+ cells or
      interleukin-2 (IL-2) or interferon-gamma (IFN-gamma). These results suggest that
      although T cells and their products are not required for an initial response
      (survival) to treatment in acute experimental toxoplasmosis, survival off drug is
      strictly T cell-dependent. Optimal posttreatment survival appears to involve both
      L3T4+ helper and Lyt-2+ cytotoxic cells, probably acting in concert, as well as
      the endogenous secretion of at least two T cell-derived lymphokines, IL-2 and IFN
      gamma.

PMID- 8486952
TI  - Heterogeneity in filarial-specific immune responsiveness among patients with
      lymphatic obstruction.
AB  - The relationship between chronic obstructive disease and antifilarial immune
      responsiveness was studied in the Haitian community of Leogane, where Wuchereria
      bancrofti is endemic. Differences in sex ratios and in the prevalence of
      microfilaremia were observed between patients with hydrocele and those with
      lymphedema or elephantiasis of the lower limb. Only 2 of 84 patients with limb
      involvement (74 women, 10 men) were microfilaremic compared with 25 of 42 men
      with hydrocele. Microfilaria-positive men with hydrocele had significantly lower
      IgG2 and proliferative responses to filarial antigen than did amicrofilaremic men
      with hydrocele or individuals with lymphedema or elephantiasis. Parasite-specific
      cellular responses of amicrofilaremic individuals with obstructive disease were
      greater, although not significantly so, than those of amicrofilaremic
      asymptomatic members of the community. These results are compatible with the
      hypothesis that development of obstructive disease of the lymphatics has an
      immune component in amicrofilaremic persons.

PMID- 8486953
TI  - Anti-gp160 IgG and IgA antibodies associated with a large increase in total IgG
      in cervicovaginal secretions from human immunodeficiency virus type 1-infected
      women.
AB  - To study the specific local immune response in vaginal fluids, 19 women infected
      with human immunodeficiency virus (HIV) type 1 and 23 seronegative controls were
      selected. Vaginal fluids were tested by ELISA for total IgG, IgA, and IgM levels
      and for specific IgG, IgA, and IgM antibodies to gp160. Total IgG, IgA, and IgM
      concentrations were 6.8-, 5.0-, and 2.5-fold higher, respectively, in HIV-1
      infected women than in controls, with a positive correlation between IgG and IgA
      levels. IgG or IgA antibodies or both to gp160 were detected in 12 subjects
      (63%), whereas no IgM antibodies to gp160 were found. Anti-gp160 IgG strongly
      predominated. Serum samples were available for 11 women whose total IgG vaginal
      levels strongly correlated with total IgG in sera. These results suggest that
      transudation of serumborne antibodies is the main source of gp160-specific
      antibodies in the vaginal fluid of HIV-1-infected women.

PMID- 8486954
TI  - Acid dissociation of immune complexes improves diagnostic utility of p24 antigen
      detection in perinatally acquired human immunodeficiency virus infection.
AB  - Since acid treatment of serum is known to disrupt immune complexes, the
      diagnostic utility of the p24 antigen assay was examined after acid treatment of
      345 serum samples from 158 children born to women infected with human
      immunodeficiency virus (HIV). Although the p24 antigen assay after acid treatment
      was negative in 9 HIV-1-infected children < 1 week old, antigen was detectable at
      high levels in all 30 samples obtained from infected children 1-9 months old.
      Overall, antigen was positive in 145 (sensitivity 89.5%) of 162 samples from 47
      HIV-1-infected children > or = 1 month old. In contrast, the sensitivity of the
      p24 antigen assay without acid dissociation was only 18% (P < .001). Among the 76
      uninfected children, 132 (specificity 99.2%) of 133 specimens were p24 antigen
      negative after acid dissociation. These results demonstrate that acid treatment
      of serum markedly improves the sensitivity and predictive value of the p24
      antigen assay for diagnosis of perinatally acquired HIV-1 infection in children 1
      month of age or older.

PMID- 8486955
TI  - Humoral immune response of humans to lipooligosaccharide and outer membrane
      proteins of Haemophilus ducreyi.
AB  - The humoral immune response to purified lipooligosaccharide (LOS) and outer
      membrane proteins (OMP) of Haemophilus ducreyi was evaluated. Sera from chancroid
      endemic (Uganda, Kenya) and -nonendemic (Canada) countries were tested by an
      ELISA. The response to OMPs was cross-reactive with other Haemophilus species,
      and elevated levels of antibody were detected in patients that did not have
      chancroid. The LOS component stimulated an H. ducreyi-specific immune response
      that was detected only in patients with chancroid. The sensitivity of the LOS
      ELISA was 96% (95% confidence interval, 89.9%-100%) and the specificity was 97%
      (95% confidence interval, 95.8%-98.2%). Thus, the anti-H. ducreyi LOS immune
      response is a significant diagnostic and epidemiologic indicator.

PMID- 8486956
TI  - Immunogenicity of Haemophilus influenzae type b conjugate vaccine in children
      with congenital asplenia.
AB  - The immunogenicity of Haemophilus influenzae type b polysaccharide-protein
      conjugate vaccines in congenitally asplenic children is unknown. The short-term
      immunogenicity of the H. influenzae type b polysaccharide-diphtheria toxoid
      conjugate vaccine was therefore assessed in 10 children with congenital asplenia
      by measuring antipolyribosyl-ribitol phosphate antibody titers. An excellent
      antibody response was seen in 9 children (mean geometric titer in responders
      after immunization 44.7 micrograms/mL; range, 2.59-402). The remaining child
      responded to a booster dose. Further studies are required to assess whether H.
      influenzae type b conjugate vaccines are immunogenic in infancy in the presence
      of congenital asplenia.

PMID- 8486957
TI  - Decline in meningococcal antibody levels in African children 5 years after
      vaccination and the lack of an effect of booster immunization.
AB  - Antibodies to group A meningococcal polysaccharide were measured by
      hemagglutination (HA) and by ELISA in sera obtained from Gambian children before
      vaccination and 3 weeks, 2 years, and 5 years after vaccination with a group A +
      group C meningococcal capsular polysaccharide vaccine. Children were 1-4 years
      old at the time of vaccination. Most showed a good initial response to
      vaccination, including those aged 1-2 years. However, antibody titers declined
      progressively during follow-up, and 5 years after vaccination, antibody titers
      measured by both HA and ELISA had returned to prevaccination levels. This decline
      was not influenced significantly by a booster dose of vaccine given 2 years after
      initial immunization. Administration of malaria chemoprophylaxis reduced the rate
      at which antibody levels fell after initial immunization. Sustained protection of
      children against group A meningococcal disease will require the development of
      vaccines that are immunogenic in infants and that can induce T cell memory.

PMID- 8486958
TI  - The vanB gene confers various levels of self-transferable resistance to
      vancomycin in enterococci.
AB  - Thirty-nine strains of Enterococcus faecium and Enterococcus faecalis resistant
      to vancomycin and susceptible to teicoplanin on disk susceptibility testing
      (phenotypic class B) were isolated in 15 hospitals in Europe and the United
      States. The MICs of vancomycin for these strains ranged from 4 to 1024
      micrograms/mL. Part of the vancomycin resistance gene vanB from E. faecalis V583
      hybridized with a single but variably sized HindIII-KpnI fragment of total DNA
      from all 39 strains. This indicates that a single class of resistance
      determinants accounts for the VanB phenotype. No hybridization was detected with
      DNA from intrinsically resistant Enterococcus gallinarum or Enterococcus
      casseliflavus. Hybridization with DNA from enterococcal strains susceptible to or
      with acquired resistance to vancomycin and teicoplanin was not observed. The
      genes conferring resistance to vancomycin were self-transferable to other
      Enterococcus strains in 14 of the 39 strains. It thus appears that vanB confers
      various levels of conjugative vancomycin resistance in enterococci.

PMID- 8486959
TI  - In vivo development of teicoplanin resistance in a VanB Enterococcus faecium
      isolate.
AB  - Acquired vancomycin resistance in enterococci may be associated with teicoplanin
      susceptibility (VanB) or teicoplanin resistance (VanA). This paper characterizes
      the first instance of in vivo emergence of teicoplanin resistance in an
      Enterococcus faecium strain of VanB phenotype. Vancomycin-resistant (MIC, 256/512
      micrograms/mL) E. faecium was isolated intermittently from a patient's blood over
      4 months. The MIC of teicoplanin for the first 5 isolates was 1.0 micrograms/mL;
      it was 64 micrograms/mL for the final 2. Analysis of plasmid and chromosomal DNA
      revealed the isolates to be of clonal origin. Conjugal transfer of vancomycin
      resistance was not obtained. A vanB DNA probe hybridized with both teicoplanin
      susceptible and resistant isolates, but a vanA probe failed to hybridize with any
      isolate. SDS-PAGE of membrane proteins from a teicoplanin-resistant isolate
      revealed constitutive production of a normally inducible 41-kDa protein. These
      findings challenge the ultimate utility of teicoplanin for treatment of
      infections caused by vancomycin-resistant enterococci.

PMID- 8486960
TI  - Typhoid fever at a resort hotel in New York: a large outbreak with an unusual
      vehicle.
AB  - The largest outbreak of typhoid fever in the United States since 1981 occurred in
      1989 among guests and staff at a New York hotel. There were 43 culture-confirmed
      and 24 probable cases among guests, 1 culture-confirmed case and 1 asymptomatic
      culture-positive case among hotel employees, and 1 culture-confirmed secondary
      case. Twenty-one persons were hospitalized and 2 had bowel perforation. Breakfast
      on 13 June was the only meal consumed by all ill persons (relative risk,
      infinite; P = .004). In a case-control study, case-patients were more likely than
      controls to have consumed orange juice (odds ratio, 5.6; 95% confidence interval,
      1.1-54.7), which had been prepared in a 208-L container with ample opportunity
      for hand contact. No other food was associated with illness. S. typhi was
      isolated from the stool of an asymptomatic food worker who handled orange juice
      but who was not known to be a typhoid carrier. S. typhi is a foodborne pathogen
      with continuing potential to cause large outbreaks in the United States.

PMID- 8486961
TI  - Direct inoculation of food as the cause of an outbreak of group A streptococcal
      pharyngitis.
AB  - An investigation was conducted of a food-related outbreak of group A
      streptococcal pharyngitis following an elementary school banquet. Of 166 surveyed
      banquet attendees, 71 (43%) reported outbreak-associated pharyngitis, and 21
      (88%) of 24 tested attendees had evidence of group A streptococcus (GAS) in the
      throat. Attendees who ate macaroni and cheese were three times more likely to
      develop pharyngitis than those who did not (66/132 [50%] vs. 5/30 [17%], P =
      .002). None of the food handlers had GAS recovered by throat culture. However,
      the cook who prepared the macaroni and cheese had a hand wound; a wound culture
      grew GAS with the same T agglutination pattern and M- and/or opacity factor type
      as that of all available GAS strains from ill attendees. Under laboratory
      conditions, macaroni and cheese supported rapid growth of the outbreak-associated
      strain of GAS. To the authors' knowledge, this is the first documented foodborne
      outbreak of GAS pharyngitis in which the only apparent source of contamination
      was a food handler's skin lesion.

PMID- 8486962
TI  - Disparity of Borrelia burgdorferi infection rates of adult Ixodes dammini on deer
      and vegetation.
AB  - Rates of infection with Borrelia burgdorferi were compared in adult Ixodes
      dammini ticks collected from deer at one coastal and two island sites with those
      collected from vegetation at the same sites. Ticks were examined using polyclonal
      direct fluorescent antibody. Spirochetes were observed in 47% of 288 ticks from
      vegetation as opposed to 13% of 276 ticks from deer (chi 2, P < .001). This
      disparity was increased when only male ticks were compared. Among female ticks
      from deer, the infection rate was higher in flat than in engorged ticks. These
      findings may reflect spirochete loss from ingestion of borreliacidal antibodies
      in deer blood or may result from factors related to the sensitivity of direct
      fluorescent antibody methods. They indicate that erroneously low estimates of
      regional risk for Lyme disease may be obtained if ticks removed from deer are
      included in the determination of tick infection rates.

PMID- 8486963
TI  - Postexposure prophylaxis against experimental inhalation anthrax.
AB  - Inhalation anthrax is a rare disease that is almost invariably fatal. This study
      determined whether a prolonged course of postexposure antibiotics with or without
      vaccination would protect monkeys exposed to a lethal aerosol dose of Bacillus
      anthracis when the antibiotic was discontinued. Beginning 1 day after exposure,
      groups of 10 animals were given penicillin, ciprofloxacin, doxycycline,
      doxycycline plus vaccination, vaccination alone, or saline. Antibiotics were
      administered for 30 days and then discontinued. Vaccine was given on days 1 and
      15. Two animals died of causes other than anthrax and were not included in the
      statistical analysis. Nine of 10 controls and 8 of 10 animals given only vaccine
      died. Each antibiotic regimen completely protected animals while on therapy and
      provided significant long-term protection upon discontinuance of the drug
      (penicillin, 7 of 10 survived, P < .02; ciprofloxacin, 8 of 9 survived, P < .002;
      doxycycline, 9 of 10 survived, P < .002; doxycycline plus vaccination, 9 of 9
      survived, P < .0002). Protection against rechallenge was provided by combining
      postexposure antibiotic treatment with vaccination.

PMID- 8486964
TI  - Geographic variation in the humoral response to Pneumocystis carinii.
AB  - The reported incidence of Pneumocystis carinii pneumonia varies in different
      areas of the world, but little is known about geographic variation in the
      antibody response to specific antigens. The frequency of anti-P. carinii
      antibodies in the serum of normal and human immunodeficiency virus (HIV)-infected
      individuals from five different regions was compared. Serum specimens from 948
      subjects were assayed for IgG antibodies to human-derived P. carinii by Western
      blot. The overall prevalence of anti-P. carinii antibodies was 72.9%. Among HIV
      seronegative individuals, the rate of seropositivity was similar in all regions
      (70.5%-82.4%). Antibodies to the 30- to 40-kDa antigen were most commonly
      detected. The frequency of antibodies to high-molecular-mass antigens (95, 120,
      and > 120 kDa) demonstrated significant geographic variation. This study
      demonstrates that antibody responses to P. carinii are common in all areas
      studied but vary in frequency and pattern.

PMID- 8486965
TI  - Secular trends in the epidemiology of nosocomial fungal infections in the United
      States, 1980-1990. National Nosocomial Infections Surveillance System.
AB  - To identify pathogens causing nosocomial fungal infections and the secular trend
      in their incidence in US hospitals, data from the National Nosocomial Infections
      Surveillance System, 1980-1990, were analyzed. During that period, 30,477 fungal
      infections were reported. The rate rose from 2.0 to 3.8 infections/1000
      discharges. The highest number of nosocomial fungal infections/1000 discharges
      was reported from the burn/trauma service (16.1). Candida albicans was the most
      frequently isolated fungal pathogen (59.7%), followed by other Candida species
      (18.6%). The rate increased at all four major anatomic sites of infection.
      Patients with bloodstream infections who had a central intravascular catheter
      were more likely to have a fungal pathogen isolated than were other patients with
      bloodstream infection (relative risk = 3.2; P < .001): 29% of fungemia patients
      and 17% of patients with bloodstream infection due to other pathogens died during
      hospitalization (P < .001). Fungi are emerging as important nosocomial pathogens
      and control efforts should target fungal infections, especially fungemia.

PMID- 8486966
TI  - Increased exposure to cryptosporidia among dairy farmers in Wisconsin.
AB  - Cryptosporidium infection is an important cause of diarrhea in humans and
      livestock; no effective therapy is known. A self-administered questionnaire and
      an ELISA were used to assess the risk of exposure to cryptosporidia among 70
      dairy farmers and 50 who were not dairy farmers in Wisconsin. Dairy farmers
      (44.3%) were more likely to be seropositive for cryptosporidia than were other
      persons (24.0%; relative risk = 1.9). Among dairy farmers, age > or = 50 and use
      of a canister method of milking were associated with seropositive status. Among
      persons who were not dairy farmers, feeding or milking cows was associated with
      being seropositive. These findings suggest that dairy farmers and other persons
      who have contact with cattle are at greater risk of Cryptosporidium infection
      than are persons who do not have such contact. Identification and avoidance of
      farming practices associated with Cryptosporidium infection may reduce the risk
      of infection among dairy farmers.

PMID- 8486967
TI  - Human immunodeficiency virus transmission and oral contraceptives.

PMID- 8486968
TI  - Fever and infection in the age since Wunderlich.

PMID- 8486969
TI  - Racial differences in serum beta 2-microglobulin in persons with human
      immunodeficiency virus infection.

PMID- 8486970
TI  - Gastrointestinal carriage of Listeria monocytogenes in household contacts of
      patients with listeriosis.

PMID- 8486971
TI  - Bactericidal activity of human sera against a Brazilian purpuric fever (BPF)
      strain of Haemophilus influenzae biogroup aegyptius correlates with age-related
      occurrence of BPF.

PMID- 8486972
TI  - Role of superantigens in human disease.
AB  - Superantigens include bacterial products (mainly of streptococci and
      staphylococci) that stimulate T cells to proliferate nonspecifically through
      interaction with class II major histocompatibility complex products on antigen
      presenting cells and then with variable regions on the beta chain of the T cell
      receptor complex. They include pyrogenic toxins (streptococcal scarlet fever
      toxins of serotypes A, B, and C, toxic shock syndrome toxin 1, and staphylococcal
      enterotoxin serotypes A, B, Cn, D, E, and G), streptococcal M protein,
      staphylococcal exfoliative toxin, and recently identified pyrogenic toxins made
      by groups B, C, F, and G streptococci and Streptococcus sanguis. Pyrogenic toxin
      superantigens cause acute toxic shock syndrome and are associated with toxic
      shock-like syndromes. Superantigens cause symptoms via release of immune
      cytokines. These proteins should be considered potential causes of illnesses such
      as rheumatic fever, arthritis, Kawasaki syndrome, atopic dermatitis, and guttate
      psoriasis because of their potent immune system-altering capacity.

PMID- 8486974
TI  - [Epidemiology of Tsutsugamushi disease and typing of isolated Rickettsia in Chiba
      Prefecture].
AB  - In Chiba Prefecture, the first patient of Tsutsugamushi disease was found in the
      southern part in the 1950's, but after that no patient was detected until 1982.
      After 1982, patients have been noticed again, the number of patients has been
      increasing year by year. The number of serologically confirmed cases was 152 and
      157 in 1989 and 1990, respectively with indirect immunofluorescence assay. About
      90 percent of the patients were found in November and December, prevalently in
      the southern part of the prefecture. On the other hand, a few patients were found
      yearly in a harf of towns and villages in this prefecture. The number of isolated
      strains of Rickettsia tsutsugamushi from patients was 4, i.e., TR6030, TR6310,
      TR6311, and TR6324 in 1986 and 3, TR1811, TR1827 and TR1829, in 1991. Six
      isolates except TR6303 reacted with anti-Kawasaki monoclonal antibody but not
      with other strain specific monoclonal antibodies. Therefore, these 6 isolates
      were determined as Kawasaki type strain. An isolate. TR6303, reacted with anti
      Kuroki monoclonal antibody at a titer of 1:2560 and anti-Karp monoclonal antibody
      at a titer of 1:320. This result suggested that the recent Tsutsugamushi disease
      is mostly caused by Kawasaki types in this prefecture.

PMID- 8486973
TI  - [Investigation on immunological factors of non- and low-responders to hepatitis B
      vaccine].
AB  - We investigated the immunological factors concerning the backgrounds of non- and
      low-responders who could not respond well to the hepatitis B (HB) vaccine. We
      injected 10 micrograms of the recombinant HB vaccine to the medical staffs of our
      hospital intramuscularly three times, 199 subjects of whom could receive the full
      course of immunization with the HB surface (HBs) antigen. We found that 14
      subjects were non-responders whose titer of HBs antibody was under the 1.9 cut
      off index (C.I.) examined by radioimmunoassay (RIA) and 47 ones were low
      responders whose titers were between 2.0 to 9.9 C.I. and the frequency of non-
      and low-responders was higher in males after the full course of HB vaccination.
      We chose 46 subjects and divided them into 4 groups according to the titer of HBs
      antibody at 8 and 28 weeks. We compared those groups to each other according to
      the amounts of total protein, gamma-globulin, IgG, IgA and IgM, numbers of
      peripheral white blood cells and lymphocytes, and percentages of peripheral
      lymphocyte and subsets of T cell including the examination by two-color flow
      cytometry using monoclonal antibodies. However we could not get any significant
      difference in any of those immunological factors by T assay. From these findings
      we suggest that the response to the HB vaccine does not depend on the quantity of
      the immunological factors before vaccination but on specific reactivity to HBs
      antigen after vaccination.

PMID- 8486975
TI  - [In vitro induction of chlorhexidine- and benzalkonium-resistance in clinically
      isolated Pseudomonas aeruginosa].
AB  - A study was made on the MIC distributions of chlorhexidine and benzalkonium
      chloride against clinically isolated 178 strains of Pseudomonas aeruginosa to
      find out the existence of strains resistant to those disinfectants and also on
      the in vitro induction of resistance to both drugs. The MIC of chlorhexidine
      gluconate was found to be distributed from 78 to 625 micrograms/ml with a single
      peak at 312 micrograms/ml. All 178 strains of clinical isolates were sensitive to
      chlorhexidine and none could be induced to become chlorhexidine resistant in
      vitro, suggesting that P. aeruginosa can not easily acquire chlorhexidine
      resistance. On the other hand, the MIC of benzalkonium chloride was distributed
      in two peaks; one peak was benzalkonium sensitive at 625 micrograms/ml (150
      strains/178 strains: 84.3%) and the another peak was benzalkonium resistant at
      5,000 micrograms/ml (28 strains/178 strains; 15.7%). Six (4.0%) of the 150
      benzalkonium sensitive strains acquired benzalkonium resistance by in vitro
      induction of resistance; the MIC of 5 strains increased from 625 micrograms/ml to
      2,500 micrograms/ml and that of the residual 1 strain increased from 312
      micrograms/ml to 1,250 micrograms/ml. However, no change of MIC was observed in
      28 benzalkonium-resistant strains of clinically isolated P. aeruginosa by in
      vitro resistance induction. Strains with MIC more than 5,000 micrograms/ml could
      not be obtained at all. The results suggest that the benzalkonium resistance can
      be introduced in P. aeruginosa whereas the resistance-acquiring rate is low.
      These results suggest that chlorhexidine gluconate is the first choice for
      prevention of Pseudomonas infection in the hospital and benzalkonium is also
      useful in 0.5% solution is used.

PMID- 8486976
TI  - [A study on acid resistance of Helicobacter pylori].
AB  - Physiological saline solutions, each adjusted to pH 1.0, pH 2.0 and pH 7.2, and
      added urea and urease inhibitor (Acetohydroxamic acid), were inoculated with a
      culture solution of Helicobacter pylori NCTC11637 strain derived from man, and
      allowed to react for 10, 30, 60 and 120 minutes. After five days of incubation on
      a blood agar medium, remaining viable H. pylori was counted. Survival of H.
      pylori was inadequate under the conditions of pH 1.0 and pH 2.0, but survival up
      to 120 min was observed on addition of urea. Further, on addition of urease
      inhibitor the survival time was reduced. H. pylori survived under the condition
      of pH 7.2 independent of addition of urea and urease inhibitor. Urea is essential
      for survival of H. pylori under strongly acidic conditions, and utility of urease
      inhibitor was observed for inhibition of survival of H. pylori.

PMID- 8486977
TI  - [Clinical efficacy of flomoxef in neonatal bacterial infection].
AB  - One hundred and seventy one neonates were treated with flomoxef (FMOX) and the
      clinical efficacy and safety were evaluated. The ages of the patients ranged from
      0 to 28 days, and their body weights from 450 to 4300 g. Dose levels were 12.4 to
      24.9 mg/kg every 8 or 12 hours for 1 to 10 days. Fifty two patients who responded
      to the FMOX treatment included 5 neonates with sepsis, 17 with suspected sepsis,
      9 with urinary tract infections, 12 with pneumonia, 8 with intrauterine
      infections, and 1 with omphalitis. The other neonates could not be
      retrospectively diagnosed as bacterial infections. Of 52 patients, clinical
      results were excellent in 15, good in 34, fair in 1, and poor in 2. And the FMOX
      treatment was effective in 13 out of 14 patients in which causative bacteria were
      identified. The drug was well tolerated, but 6 neonates out of 33 over 5 days old
      had diarrhea. From these results, empiric treatment with FMOX against neonatal
      bacterial infection was as clinically useful as that of combination with
      ampicillin and gentamicin or cefotaxime and ampicillin in our neonatal intensive
      care unit. But, as this study did not include neonate with meningitis, efficacy
      to meningitis was not evaluated.

PMID- 8486978
TI  - [Pleural washing with povidone-iodine for treatment of empyema].
AB  - In this paper, we report two successful cases of empyema treated by pleural
      washing with povidone-iodine solution. In these two cases, empyema was caused by
      secondary infection of multi-drug resistant Pseudomonas aeruginosa. First, we
      replaced intrathoracic drainage tube and washed intrathoracic space with 500-1000
      ml saline containing antibiotics (tobramycin, aztreonam) every 8 hours for 10-14
      days. But, cultural studies of pleural effusion were positive even after this
      treatment. So, we tried pleural washing with warm povidone-iodine solution 1:20
      diluted with saline every 8 hours. Surprisingly, after 3 days treatment, cultural
      studies of the pleural effusion became negative. This pleural washing method with
      povidone-iodine was very effective for treatment of empyema patients.

PMID- 8486979
TI  - [Relationship between coagulase toxin-type and drug susceptibility in
      Staphylococcus aureus strains isolated in all the Japanese National University
      Hospitals].
AB  - Drug susceptibility of 430 Staphylococcus aureus strains isolated in 1991 from
      clinical specimens at all of the Japanese national university hospitals was
      evaluated in relationship with the epidemiological markers, namely, coagulase
      typing, and staphylococcal enterotoxins (SE) and toxic shock syndrome toxin 1
      (TSST-1) production. There were five major methicillin-resistant Staphylococcus
      aureus (MRSA) groups in all the 252 MRSA strains: coagulase-type II-SEC + TSST-1-
      producing strains (II-SEC + TSST-1): 34.5%; coagulase-type II-no toxin-producing
      strains (II-): 15.4%; coagulase-type IV-SEA-producing strains (IV-SEA): 10.3%;
      coagulase-type II-SEA + SEC + TSST-1- producing strains (II-SEA + SEC + TSST-1):
      8.7%; and coagulase-type III-no toxin-producing strains (III-): 7.1%. II-SEA +
      SEC + TSST-1 group was highly resistant to OFLX, whereas half of the other strain
      groups were sensitive to OFLX. Seventy-eight percent of the IV-SEA group was
      sensitive to FMOX, but there was no sensitive strain to FMOX in the II-SEA + SEC
      + TSST-1 group. More than 50% of the IV-SEA, III- and II-groups were sensitive to
      IPM, while the II-SEC + TSST-1 and II-SEA + SEC + TSST-1 groups were highly
      resistant to IPM. The III- and II-groups showed very good sensitivity to MINO,
      but the sensitivity to it of the II-SEA + SEC + TSST-1 group was very low. All of
      the strain groups were sensitive to ST except for the IV-SEA group. These results
      may provide useful information in the choice of antibacterial agents for MRSA
      infection.

PMID- 8486980
TI  - Successful antifungal treatment of disseminated candidiasis associated with ARDS.

PMID- 8486981
TI  - [Case report of toxic shock-like syndrome due to group A streptococcal
      infection].
AB  - A case of streptococcal toxic shock like syndrome occurring in a 44-year-old
      previously healthy Japanese male is reported. He initially had a sore throat, low
      grade fever, diarrhea and mild pains in a lower extremities. Shortly thereafter,
      he rapidly developed a high fever, profound hypotension, multifocal epidermal
      necrosis, and sever purulent fasciitis and myositis in both lower extremities,
      which required above knee amputation of both legs. He later developed
      disseminated intravascular coagulopathy, adult respiratory distress syndrome,
      acute renal failure, coma and necrotizing inflammation of both arms and external
      genitalia despite treatment. He died on the 13th hospital day. Streptococcus
      pyogenes was isolated from the necrotic muscles and right knee joint. The
      organism was typed as M3, T3, was sensitive to penicillins, and was found to be
      producing streptococcal pyogenic exotoxin A in vitro. This is the first case
      report of streptococcal toxic shock like syndrome in Japan.

PMID- 8486982
TI  - ECG of the month. One shot, two birds. Narrow QRS tachycardia.

PMID- 8486983
TI  - Caustic ingestion and esophageal injury.
AB  - This article reviews esophageal anatomy and the physiology of swallowing. A
      discussion of the epidemiology, pathology, evaluation, and management of patients
      with esophageal injury secondary to caustic ingestion is presented.

PMID- 8486984
TI  - Passive smoking and lung cancer.
AB  - The findings of a multicenter national study of lung cancer in lifetime-never
      smokers are reported. An increased lung cancer risk of approximately 30% was
      found among women whose husbands smoked. Elevated risks of 40% to 60% were also
      found associated with workplace exposures and other exposures outside the home.
      The findings of this study have been included in the recent Environmental
      Protection Agency assessment of the health effects of passive smoking, and have
      implications for regulation of environmental tobacco smoke exposure in Louisiana.

PMID- 8486985
TI  - Cancer awareness and attitudes toward preventive health behavior.
AB  - Elevated rates of morbidity and mortality among ethnic minorities have been
      linked to alterable patterns of behavior, including preventive health practices.
      African Americans in Louisiana are not only at increased risk for cancer, they
      also have poorer prognosis. This investigation describes beliefs, knowledge, and
      attitudes relevant to general and cancer-specific preventive health practices in
      a sample of African Americans (n = 48). Findings suggest a number of important
      differences exist between males and females in their attitude toward health
      issues. Females valued and expressed greater concern over their health status.
      Females also expressed greater confidence in their doctor's ability to diagnose
      cancer before it is too serious, while males appear to hold a more pessimistic
      view of the effectiveness of early detection. Although the use of a convenience
      sample limits the generalizations that can be made, present findings identify
      issues germane to the development of effective intervention strategies for this
      population.

PMID- 8486986
TI  - Breast Cancer Prevention Trial update.
AB  - In April 1992, the National Surgical Adjuvant Breast and Bowel Project and the
      National Cancer Institute launched the Breast Cancer Prevention Trial. This is
      the largest cancer prevention trial ever attempted. The Breast Cancer Prevention
      Trial will involve 16,000 high-risk women in the United States and Canada. Half
      will receive tamoxifen and half placebo. Currently, over 5,000 women have been
      enrolled in the Breast Cancer Prevention Trial. The Ochsner Community Clinical
      Oncology Program in New Orleans is coordinating the trial in Louisiana and
      Mississippi. Other participating centers in this area are located in Baton Rouge,
      Houma, and New Orleans East in Louisiana, and Biloxi, Gulfport, Hattiesburg, and
      Jackson in Mississippi.

PMID- 8486987
TI  - Childhood nasopharyngeal carcinoma.
AB  - A retrospective analysis identified 40 children and adolescents with
      nasopharyngeal carcinoma who were evaluated and treated at the Medical Center of
      Louisiana from 1948 through 1992. The male to female ratio was 1.8:1. Thirty-two
      patients had lymphoepithelioma and 8 had squamous cell carcinoma. Twenty-three
      children had primary lesions confined to the nasopharynx. In 8 patients, the
      tumor extended into the nasal cavity or oropharynx, and 7 patients had tumor
      invasion of skull or cranial nerve. Thirty-one had palpable cervical
      lymphadenopathy. There were no documented distant metastasis at presentation. All
      patients were treated with primary radiotherapy, and 9 patients also had
      chemotherapy containing cisplatin, fluorouracil, bleomycin, cyclophosphamide, and
      doxorubicin. Ten are alive 5 to 30 years from time of diagnosis (median 10
      years). Distant metastasis was the initial cause of failure. Though not a
      controlled study, bias in the data insinuate an improved prognosis for male
      patients, age > 10 years, tumor limited to the nasopharynx without extension (T1
      2), absence or single positive homolateral node (N0-1), and patients who received
      chemotherapy.

PMID- 8486988
TI  - Evidence for a major gene effect in early-onset lung cancer.
AB  - Genetic segregation analyses that allowed for variable age of onset of lung
      cancer and smoking history were performed on 337 families, each ascertained
      through a lung cancer patient. Results indicated compatibility of the data with
      Mendelian codominant inheritance of a rare major autosomal gene that acts in
      concert with smoking to predispose carriers to lung cancer, by producing earlier
      onset of the cancer when controlling for equivalent smoking levels. Segregation
      at this locus could account for 69% and 47% of the cumulative incidence of lung
      cancer in individuals up to ages 50 and 60 respectively, but only 22% of all lung
      cancers in persons up to age 70. This decrease in the importance of the gene's
      contribution to overall lung cancer rates at later ages is most likely a
      reflection of an increasing proportion of noncarriers succumbing to the effects
      of long-term exposure to tobacco. A significant cohort effect was found, most
      likely due to differing smoking patterns before and after World War I, but in
      both cohorts the effect of a major locus could not be rejected.

PMID- 8486989
TI  - Is breast preservation possible in women with large, locally advanced breast
      cancers?
AB  - Breast conservation therapy is an accepted treatment option for early stage
      breast carcinoma, but is rarely considered appropriate for locally advanced
      nonmetastatic lesions. Mastectomy specimens of 46/50 patients treated at the
      Ochsner Clinic and the Mallinckrodt Institute of Radiology with neoadjuvant
      chemotherapy prior to mastectomy +/- irradiation were evaluated by a single
      pathologist to assess tumor response to chemotherapy. Forty percent of this group
      would potentially have been eligible for breast conservation therapy, using a
      residual tumor size of < or = 4 cm with negative surgical margins as the
      criteria. Patients most likely to qualify for breast conservation therapy were
      those with T3N0-1 lesions (67%). Least likely were patients with skin involvement
      at diagnosis 4/33 (12%). Tumors with an extensive intraductal component at biopsy
      often had residual islands of intraductal carcinoma occupying the original tumor
      volume, even when the invasive component was absent or much reduced. A
      prospective trial will be required to determine whether or not acceptable local
      control rates can be obtained after breast conservation therapy for that subset
      of patients with a favorable response to induction chemotherapy.

PMID- 8486990
TI  - New agents for controlling emesis with cancer chemotherapy.
AB  - Over the past decade, marked progress in support techniques has been made in
      patients with cancer. In addition to improvement in pain and infection control,
      the ability to control chemotherapy-induced nausea and vomiting has improved
      greatly. Studies have demonstrated that serotonin type 3 receptors play an
      important role in mediating this side-effect. Several new agents, with excellent
      efficacy and few side effects have now been developed and are available
      clinically. Results of trials with these agents, and with newer investigative
      approaches are discussed.

PMID- 8486991
TI  - Cancer chemotherapy in historical perspective.
AB  - Effective systemic cancer therapy has evolved during the past 50 years. Prior to
      that time a variety of treatments were attempted, many of which seemed to have
      had their origins in sorcery rather than science. The 1950s and 1960s produced an
      explosion of knowledge and many of the chemotherapeutic agents in use today were
      synthesized during that time frame. Currently we are exploring a variety of new
      therapeutic approaches to cancer, and the future promises to be increasingly
      productive.

PMID- 8486992
TI  - Social skills in the context of learning disability definitions: a reply to
      Gresham and Elliott and directions for the future.
AB  - In this article we review the evidence on the status of a social skills deficit
      as a learning disability (LD) by examining social skills deficits in the context
      of learning disability definitions. For the most part, social skills deficits
      fall within the terms that are specified in the definitions; that is, when there
      is evidence of neurological involvement, social skills deficit as a learning
      disability is consistent with the focus on listening and speaking that is
      characteristic of most definitions of learning disabilities. We also conclude
      that the absence of limiting conditions in extant definitions of learning
      disabilities makes it difficult to exclude any particular skill or type of
      knowledge from falling within the bounds of the definitions. Furthermore, we
      argue that the critical issue centers on the reformulation of the definition of
      learning disabilities. We suggest two directions in future work: First, the term
      "learning disability" should be limited to intentional learning contexts.
      Acceptance of this limitation would clarify at least some of the confusion
      regarding the domain of learning disabilities. Second, learning disability
      definitions should become more responsive to recent research on the nature of
      learning.

PMID- 8486993
TI  - Adolescents with learning disabilities at risk? Emotional well-being, depression,
      suicide.
AB  - As recently as 5 years ago, very little information on the emotional well-being
      of adolescents with learning disabilities (LD) was available. However, a great
      deal of research has been conducted recently and some of the implications are
      unnerving. Research on self-concept, attributions, anxiety, depression, and
      suicide among adolescents with LD is examined for the purpose of detecting
      consistency of indicators concerning these emotional and developmental variables.
      The research indicates that the emotional development of many adolescents with LD
      is not notably positive, and these students appear to be at increased risk for
      severe depression and suicide. The discussion highlights methodological pitfalls
      and developmental issues. Practical implications are suggested.

PMID- 8486994
TI  - An examination of phonemic processing abilities in children during their first
      grade year.
AB  - The present study examined the development of reading and phonological processing
      abilities of 209 first graders (118 males, 91 females; mean age = 86.7 months)
      assessed during the first and last quarters of their first-grade year. The
      children were arranged into three different groups based on their Time 2 reading
      and intelligence data (children with and without reading disabilities, and
      "garden-variety" poor readers). Analyses indicated that the children with reading
      disabilities and the garden-variety poor readers did not differ significantly on
      many of the tasks, but both performed differently than the children without
      reading disabilities. Developmental analyses indicated that all three groups
      increased their reading and phonological skills; however, the gap between the
      performance of the children without reading disabilities and the other two groups
      widened from Time 1 to Time 2. The most important finding of the present study
      concerned the classification results of the discriminant analysis, which
      correctly identified the group membership of 207 of the 209 children (99.04%
      correct).

PMID- 8486995
TI  - The social misperception syndrome in children with learning disabilities: social
      causes versus neurological variables.
AB  - Family shortcomings or other intrinsic psychological deficits are frequently
      viewed as contributing factors to the social misperceptiveness frequently seen in
      children with learning disabilities. This article attempts to synthesize research
      defining the social problems of some children with learning disabilities.
      Particularly emphasized is the role of communication skills deficits.
      Breakthroughs in neurophysiology negate, to a large extent, traditional emphases
      on family dysfunction, school failure, or personality distrubances as primary
      causes of the social problems of some children with LD. Advances in vision and
      language research allow departure from the social paradigm of the "misperceptive
      syndrome" to consider constitutionally based hypotheses of neural dysfunction.
      Neural aberrations are viewed as triggering deficient language processing, which
      in turn may lead to unsatisfactory social interactions. Several correlates and
      characteristics of family, school, and environmental systems are discussed in the
      context of their impact on personality development and on changes in the life
      adjustments of both children and adults with learning disabilities.

PMID- 8486996
TI  - Which motoric condition is most effective for teaching spelling to students with
      and without learning disabilities?
AB  - The purpose of this study was to determine the efficacy of three motoric
      conditions (writing, tracing, and computer keyboarding) on the spelling
      performance of 24 third- and fourth-grade students without learning disabilities
      (NLD) (15 males, 9 females) and 24 third- and fourth-grade students with learning
      disabilities (LD) (16 males, 8 females). This study applied empirically based
      procedures for teaching spelling, examined student performance over time, and
      incorporated student interviews concerning their preference for motoric
      condition. For number of words spelled and proportion of bi-grams (correct letter
      sequences) used correctly, significant differences were found between the LD and
      NLD groups, both at posttest and follow-up, with the NLD students learning to
      spell more words and apply more correct bi-grams than the students with LD. There
      was no significant effect for condition for either words spelled or bi-grams,
      indicating that students did not learn significantly more words in the writing,
      tracing, or computer condition. There was also a significant time effect
      indicating that the accuracy of both groups decreased over time from posttest to
      follow-up for both words and bi-grams. Interviews revealed that students in both
      groups preferred the computer condition; however, they believed that they learned
      best in the writing and tracing conditions.

PMID- 8486997
TI  - Supervision of employees with moderate special needs.
AB  - A study was conducted to identify issues that confront workplace supervisors of
      people with learning disabilities (LD): problem behaviors, supervisory
      techniques, and the supervisor's needs. Conclusions are based on questionnaire
      responses from 65 supervisors in human service agencies and 27 interviews
      conducted with employers and supervisors in business and industry. Findings
      indicate that this special needs population surpasses the general population in
      exhibiting several positive work habits. Problem behaviors are most commonly
      addressed by establishing realistic performance standards, being flexible, and
      modifying tasks. Training supervisors who provide specific information concerning
      the individual are a major source of support to the on-site supervisor.
      Supervisors felt that personal commitment to this population and availability of
      specific information concerning LD were the most important influences on the
      quality of their work with the trainee. Findings from this study hold hope for
      the successful employment of people with LD.

PMID- 8486998
TI  - Giant fiber activation of an intrinsic muscle in the mesothoracic leg of
      Drosophila melanogaster.
AB  - Cinematographic analysis reveals that an important component of the light
      elicited escape response of Drosophila melanogaster is the extension of the femur
      tibia joint of the mesothoracic leg. During the jumping phase of the response,
      this extension works synergistically with extension of the femur. Femur extension
      is generated by contraction of the tergotrochanteral muscle (TTM), one of four
      previously described escape response muscles. Femur-tibia joint extension in the
      mesothoracic leg has been thought to be controlled by contraction of the tibial
      levator (TLM), an intrinsic leg muscle. We investigated the activation of the TLM
      during the escape response. Electrical stimulation of the giant fiber interneuron
      that mediates the escape response results in activation of the TLM with a latency
      of 1.46 +/- 0.02 ms. The TLM is innervated by a motor neuron (TLMn) with a large
      cell body in the mesothoracic ganglion. The TLMn has extensive arborizations in
      the lateral mesothoracic leg neuromere and has a prominent medially directed
      neurite. To investigate possible presynaptic inputs activating the TLMn during
      the escape response, we analyzed the muscle responses of two mutants, giant fiber
      A1 and bendless. Our analysis suggests that the TLMn is activated by a novel
      pathway.

PMID- 8486999
TI  - The regulation of haemolymph potassium activity during initiation and maintenance
      of diuresis in fed Rhodnius prolixus.
AB  - The blood-sucking insect Rhodnius prolixus rapidly eliminates a Na(+)-rich K(+)
      poor urine after its large meals. K(+)-rich fluid is first secreted by the upper
      Malpighian tubules and passes to the lower tubules where most of the potassium is
      reabsorbed. During the initial stimulation of the tubules, the lower tubules must
      be activated first to avoid loss of potassium. The major element in this is that
      they respond more rapidly than do the upper tubules to particular hormonal
      concentrations rather than that they react to lower hormonal concentrations than
      do the upper tubules. During subsequent diuresis, regulation of the haemolymph
      potassium concentration depends on three cooperative homoeostatic mechanisms in
      the tubules. A fall in potassium concentration of the medium bathing the tubules
      causes (i) a decrease in the rate of fluid secretion by the upper tubules, (ii) a
      decrease in potassium concentration in the fluid secreted by the upper tubules
      and (iii) an increase in the rate of potassium absorption by the lower tubules.
      The tubules respond in the opposite direction to an increase in potassium
      concentration of the medium. As a result, the potassium concentration of the
      urine can be adjusted to match the potassium concentration of the fluids absorbed
      from the gut, so that the potassium concentration of the insect's haemolymph
      remains unaltered.

PMID- 8487000
TI  - Effect of adenosine on glucose metabolism of Rana ridibunda erythrocytes.
AB  - The effects of adenosine and inosine on Rana ridibunda erythrocyte metabolism
      were studied. Adenosine can be metabolized by Rana ridibunda erythrocytes as a
      carbon source for glycolysis to maintain ATP levels, whereas neither inosine nor
      glucose could maintain ATP levels. The rate of lactate production was maximal
      (2.89 mumol ml-1 red cell h-1) in the presence of adenosine together with glucose
      compared with that in the presence of glucose or adenosine alone. Inosine
      sustained a similar rate of lactate production as did glucose. The concentrations
      of phosphorylated hexoses increased during 4 h of incubation in the presence of
      adenosine either with or without glucose. The presence of sodium iodoacetate
      accelerated the loss of ATP; furthermore, levels of lactate and pyruvate were
      significantly reduced in the presence of either adenosine or inosine. Ouabain
      strongly inhibited ATP and lactate formation in the presence of adenosine,
      whereas the levels of ATP and lactate were almost unchanged in the presence of
      inosine. An inhibitor of adenosine transport, dipyridamole, impeded the increases
      in erythrocyte lactate and ATP concentration in the presence of adenosine but did
      not modify the effects of inosine.

PMID- 8487001
TI  - Animal versus vegetable protein diet in hepatic encephalopathy.

PMID- 8487002
TI  - Fibrillating atria--a sizeable problem, or rather atrial fibrillation--a striking
      problem.

PMID- 8487003
TI  - Haemostatic factors in coronary heart disease.

PMID- 8487004
TI  - Prognostic significance of type and location of a first myocardial infarction.
AB  - The prognostic significance of type (Q-wave versus non-Q-wave) and location of
      infarction (anterior versus infero-posterior) was assessed in 350 patients with a
      first myocardial infarction followed for 3 years. A baseline multivariate Cox
      model was constructed from variables assessable at entry of the index infarction.
      The prognostic significance of site and type of infarction was evaluated when
      added to this model. Both Q-wave infarction and anterior location were
      significant with a risk ratio of 1.91 (95% confidence interval 1.14-3.18) and
      1.70 (95% confidence interval 1.11-2.61) respectively. However, when the model
      also included the size of infarction. Q-wave infarction was no longer formally
      significant, while anterior location still was associated with adverse outcome
      (risk ratio 1.56, 95% confidence interval 1.02-2.39). It is inferred from the
      results that this effect of anterior infarction is due to a larger damage to the
      left ventricle for identical infarct sizes compared to infero-posterior
      infarctions.

PMID- 8487005
TI  - Monitoring of hearing during treatment of leukaemia with special reference to the
      use of amikacin.
AB  - Thirty-nine patients with leukaemia were followed audiometrically during
      treatment with broad-spectrum antibiotics. Amikacin was given during neutropenic
      febrile episodes. Five patients reported a deterioration of the hearing function
      after termination of amikacin treatment. Significant hearing threshold loss
      occurred in 20 patients (51%). The hearing threshold changes were small in
      general, except for two patients who exhibited bilateral hearing threshold
      changes in the frequency range 0.5-8 kHz. Using multiple linear regression
      analysis 22% of the changes in hearing thresholds was estimated to be related to
      old age, an increased trough concentration of amikacin and an impaired
      pretreatment hearing state. Factors found not to influence the hearing thresholds
      were maximum peak concentration of amikacin, cumulative duration of therapy,
      pretreatment renal dysfunction and concomitant use of vancomycin. It is concluded
      that administration of amikacin for repeated treatment courses is associated with
      a low incidence of serious changes in hearing function.

PMID- 8487006
TI  - Metabolic effects of strict salt restriction in essential hypertensive patients.
AB  - OBJECTIVE: Some observations suggest that a strict low-salt diet may induce
      unfavourable metabolic side-effects. The main aim of this study was to analyse
      the possible consequences of severe salt restriction in mildly hypertensive
      patients. DESIGN: The study was carried out through a randomized double-blind
      protocol. SUBJECTS: Forty-seven ambulatory patients proceeding from the
      hypertension unit were initially admitted: 17 were lost, and 30 non-diabetic
      mildly hypertensives (DBP 90-104 mmHg) with normal renal function completed the
      protocol. INTERVENTION: After a wash-out period, patients were maintained on a
      low-salt intake (2.8 +/- 1.0 g day-1 of NaCl) and placebo for 2 weeks, and the
      same diet and salt supplements (11.7 +/- 2.5 g day-1 of NaCl) for another 2
      weeks, separated by a second wash-out period. MEASURES: At the end of each
      dietary period, blood pressure (BP) and body weight were measured, and a blood
      sample was taken for determination of routine serum chemistries, plasma lipid and
      apolipoprotein concentrations, immunoreactive insulin (IRI), and plasma renin
      activity (PRA). Urinary 24 h excretion of sodium and potassium were measured.
      RESULTS: During the salt restriction period BP did not change, weight lowered,
      and PRA raised. There was a significant increase in serum level of creatinine,
      uric acid, IRI, total cholesterol and apo B, and a decrease in HDL cholesterol
      and apo A-I. CONCLUSION: As previously suggested, these observations seem to
      indicate that strict salt restriction may cause, at least in the short-term,
      adverse metabolic changes in hypertensive patients.

PMID- 8487007
TI  - Supraventricular tachycardia, right atrial pressure, atrial natriuretic peptide
      and polyuria--a necessary sequence?
AB  - The release of atrial natriuretic peptide (ANP) may be stimulated by tachycardia
      and the evidence from human studies suggests that this is mediated by a rise in
      atrial pressure. However, animal experiments suggest that tachycardia can by
      itself increase ANP levels without increasing right atrial pressure (RAP). We
      report here the case of a healthy volunteer who had supraventricular tachycardia
      (SVT) whilst participating in a study evaluating the relationship between changes
      in RAP and changes in ANP. The ANP levels rose following the SVT but there was no
      rise in RAP, suggesting that heart rate can modulate ANP levels without changes
      in RAP as has been shown in animal experiments.

PMID- 8487008
TI  - Pyomyositis in a patient with myeloma responding to antibiotics alone.
AB  - Pyomyositis is a rare purulent infection of skeletal muscle with striking
      clinical features. It usually occurs in patients living in the tropics but is
      increasingly being reported in immunosuppressed patients. The traditional
      approach to management has been surgical with drainage and debridement of the
      multiple muscle abscesses. We report a patient with myeloma who developed
      multiple muscle and lung abscesses associated with a Staphylococcus aureus
      septicaemia. The case was successfully managed with intravenous antibiotics alone
      with no recurrence of the abscesses during a later episode of neutropenia. The
      advantages of avoiding surgical intervention in immunosuppressed and
      thrombocytopenic patients are obvious.

PMID- 8487009
TI  - Past and present problems in editing medical journals.

PMID- 8487010
TI  - von Willebrand factor antigen, atherothrombotic mechanisms and smoking.

PMID- 8487011
TI  - Global myocardial ischaemia unmasked following a bomb attack.

PMID- 8487012
TI  - The interaction between allopurinol and azathioprine.

PMID- 8487013
TI  - Sjogren's syndrome, primary biliary cirrhosis and overlap with scleroderma
      symptoms.

PMID- 8487014
TI  - Maintenance of high extracellular pH does not influence cell pH or metabolism in
      submerged anoxic bullfrogs.
AB  - We compared extracellular and intracellular acid-base states in paralyzed
      bullfrogs subjected to 4 h of anoxic submergence at 15 degrees C with or without
      maintenance of extracellular pH at preanoxic levels by bicarbonate infusion. We
      also assessed anaerobic metabolism under these conditions by measuring tissue
      lactate and glycogen concentrations in liver, heart, and skeletal muscle.
      Although bicarbonate infusion resulted in a significantly higher arterial blood
      pH (pHe) than saline infusion, intracellular pH (pHi) of heart and skeletal
      muscle, as determined by the DMO equilibration technique, were not significantly
      different after 4 h of anoxia. We were also unable to demonstrate any differences
      in anaerobic metabolic rate, since both tissue lactate accumulation and glycogen
      depletion were identical in bicarbonate- and saline-infused frogs in the tissues
      studied. We conclude that (1) alterations in the extracellular acid-base state by
      bicarbonate infusion are not necessarily reflected in the intracellular
      compartment, perhaps due to powerful intracellular buffering processes, and (2)
      maintenance of an alkaline extracellular pH during anoxia in bullfrogs does not
      influence the anaerobic metabolic rate. We could not, however, rule out a
      possible role for intracellular pH in regulating anaerobic metabolism during
      anoxia in frogs.

PMID- 8487015
TI  - In vitro exposure of frog (Rana pipiens) pituitaries to gonadotropin-releasing
      hormone results in a persistent stimulation of gonadotropin biosynthesis.
AB  - To further investigate the action of gonadotropin-releasing hormone (GnRH) on
      gonadotropin (Gth) secretion and synthesis, pituitaries from frogs, Rana pipiens,
      were incubated in the presence or absence of 100 ng/ml GnRH for 12 h. GnRH was
      then removed from the medium and glands were labeled with 35S-methionine either
      12, 24, or 36 h after the conclusion of GnRH exposure. Immunoassayable LH and FSH
      (iLH and iFSH; both labeled and nonlabeled hormone) were determined by separate
      radioimmunoassays. Newly synthesized (radiolabeled) Gth was quantified by
      immunoprecipitation. When GnRH was present in the medium, it stimulated the
      secretion of both iLH and iFSH (compared to unexposed glands). Following
      withdrawal of the secretagogue, iLH and iFSH secretion diminished until they
      returned to control levels (within ca. 12 h). Previous exposure to GnRH enhanced
      the biosynthesis of Gth; this elevation was detectable up to 36 h after removal
      of the secretagogue. The magnitude of the elevation in Gth synthesis did not
      diminish with time, as secretion had, but remained constant. Gth synthesis was
      comparable in glands that had been exposed to GnRH 12 h and those exposed to the
      secretagogue 36 h prior. Thus, the GnRH-induced elevation in Gth secretion and
      synthesis can be dissociated; the elevation in synthesis is more chronic than the
      elevation in secretion.

PMID- 8487016
TI  - Cloning and chromosomal mapping of mouse seminal vesicle protein F.
AB  - Seminal vesicle proteins (SVPs) are made by male rodents, and form the copulatory
      plug following mating. Here we report a partial nucleotide sequence of a mouse
      clone homologous to rat SVP F. Unexpectedly, we found that SVP F-related
      transcripts are expressed at high levels in mouse skeletal muscle. We mapped
      mouse SVP F to mouse chromosome 15 using somatic cell hybrid lines.

PMID- 8487017
TI  - Distribution of lectin binding sites in the oviducts of cycling and hormone
      treated pigs.
AB  - Gamete transport, fertilization, and early embryonic development take place in
      different regions of the oviduct and under different hormonal conditions. The
      objective of this study was to use lectins to detect variation in the
      distribution of glycosylated molecules on the surface of the epithelia that
      influence these events. Oviducts were collected from gilts on day 1 (estrus) and
      day 16 (diestrus) of the estrous cycle, and from gilts that were bilaterally
      ovariectomized on day 4 of the estrous cycle, and were subsequently treated with
      estradiol valerate (100 micrograms/day), progesterone (200 mg/day), or corn oil
      vehicle for 11 days. Six biotinylated lectins, Triticum vulgaris (WGA), Arachis
      hypogaea (PNA), Ulex europeus (UEA-I), Dolichos biflorus (DBA), Ricinus communis
      (RCA-I), and Canavalia ensiformis (Con A), were used to probe tissue from the
      isthmus and ampulla using peroxidase-conjugated avidin as the marker. In cyclic
      gilts, WGA and DBA stained more strongly in the isthmus than the ampulla on both
      cycle days. Staining with PNA was patchy, but greater on the apical surface of
      isthmic epithelium on day 16 than day 1. With UEA-I, staining was more intense in
      the ampulla on day 16 than day 1. Staining by PNA and UEA-I was suppressed in
      both the ampulla and isthmus with estradiol treatment. DBA staining was
      suppressed in the isthmus with both estradiol and progesterone treatments. Cilia
      were labelled by all lectins except WGA and PNA. Thus glycosylation patterns vary
      in the porcine oviduct with region and hormonal state, reflecting the variety of
      events that may be influenced.

PMID- 8487018
TI  - Temperature-dependent sex determination in the leopard gecko, Eublepharis
      macularius.
AB  - The leopard gecko, Eublepharis macularius, has temperature-dependent sex
      determination (TSD). Previous reports have shown that females are produced
      predominantly at cool incubation temperatures and males are produced
      predominantly at warm incubation temperatures (Pattern Ib). We report here that
      incubation at even higher temperatures (34 and 35 degrees C) produces mostly
      females (Pattern II). The lethal maximum constant incubation temperature for this
      species appears to be just above 35 degrees C. Although a previous study
      indicated that females from a warm incubation temperature (32 degrees C) failed
      to lay eggs, we found that 12 of 14 mature females incubated at 32.5 degrees C,
      and 5 of 6 mature females incubated at 34 degrees C produced fertile eggs and
      viable hatchlings.

PMID- 8487019
TI  - Stand united together.

PMID- 8487020
TI  - Potent ammunition.

PMID- 8487021
TI  - Like people, schools face new challenges at 40.

PMID- 8487023
TI  - The physician as dog.

PMID- 8487022
TI  - Social change in medical practice in the 1990s. The "US" health care plan.

PMID- 8487024
TI  - Effect of undocumented and excluded vaccinations on measles immunity in a
      university population.
AB  - Epidemic measles has occurred even in highly vaccinated university and college
      populations because vaccine efficacy is only 90-95% and some student bodies do
      not have 100% vaccine coverage. Some institutions have not adopted or enforced a
      one-dose, preregistration immunization requirement because of the increased
      administrative burden, although in 1990 a documented two-dose schedule was
      recommended to increase herd immunity to a critical 93.5-96.0%. Perhaps one
      documented immunization for all students coupled with an undocumented or excluded
      pre-1968 one that some students are reporting will result in adequate herd
      immunity. At the University of South Florida 149 students (group I), after
      documenting receipt of one immunization, attempted to prove immunity by having an
      antibody test. They were compared with 181 students who documented two doses
      (group II) for factors which might influence differences of immunity between the
      groups after one dose. Undocumented immunizations were estimated by determining
      the percent of students reporting recent immunizations after allowing for the
      expected unimmunized percent. Excluded vaccinations were calculated for students
      born before 1967. Group I had a 98% (95% C.I. 94.2-99.6) immunity. One-third to
      one-half of both groups had undocumented and excluded immunizations. Some
      differences identified were not important enough to prevent extrapolation of this
      high immunity from group I to group II students. One documented live measles
      vaccination for all students combined with an undocumented or excluded one for
      some of them may provide adequate herd immunity to prevent measles epidemics on
      university and college campuses.

PMID- 8487025
TI  - Breast cancer screening in Florida. Opportunities for prevention.
AB  - Records of 705 women age 40 years and over interviewed by the Florida Behavioral
      Risk Factor Surveillance System in 1990 were used to identify gaps in mammography
      utilization in Florida. Data were weighted to the 1990 age and race composition
      of the population. Of the women 55.8% received a mammogram in the last two years
      and 33.4% reported they had never had one. The percentage reporting a mammogram
      in the last two years was 61.9% for those who had a check-up in the last year and
      68.7% for those who had a breast examination in the last year. The reason 34%
      gave for not having a mammogram was "not recommended by doctor." Cost or lack of
      insurance was the reason for 10.6% of all women and 15.2% of women from
      households below $15,000 annual income. Data were further stratified by age and
      race/ethnicity. Significant missed opportunities for mammography are occurring
      among women in the health-care system. Interventions to increase mammography need
      to address providers' attitudes and behaviors as well as potential patients.

PMID- 8487026
TI  - Don't throw mama from the train.

PMID- 8487027
TI  - Regulating spermatogenesis. Mechanisms of reproductive hormones.

PMID- 8487028
TI  - Oral assessment in the elderly.
AB  - This review of common oral problems and oral assessment of the older adult is by
      no means exhaustive. There are a number of other oral manifestations of disease
      states that the physician can only assess by thorough examination of all
      structures and tissues in the mouth. By applying the simple principles of oral
      assessment and appropriate treatment and referral for common oral conditions,
      physicians can deliver optimum health-care services to the older adult patient.

PMID- 8487030
TI  - Breeder industry.

PMID- 8487029
TI  - Biomedical waste.

PMID- 8487031
TI  - First reported case.

PMID- 8487032
TI  - Future of health care in Florida.

PMID- 8487033
TI  - Blood groups and enzyme types from human teeth.
AB  - Paired human teeth and fresh blood samples were analysed for the genetic markers
      ABO, PGM1, GLO-I, EsD, EAP, AK, ADA, 6-PGD, G-6-PD and CA-II. ABO blood groups
      were successfully determined from dentine, pulp and cement samples whereas only
      dental pulp could be typed for different isozymes. Studies on the persistence of
      these genetic markers in teeth stored at room temperature showed that ABO blood
      groups were the most stable, followed by PGM1 and ADA isozymes, whereas CA-II
      isozymes were the least stable.

PMID- 8487034
TI  - Cases of fatal triazolam poisoning.
AB  - Benzodiazepines have been regarded as relatively safe drugs but since triazolam
      was introduced into Denmark in 1978, six fatal cases of poisoning by triazolam
      alone or in combination with ethanol, have occurred in East Denmark. In one case
      where no ethanol was detected, a blood triazolam concentration of 0.11 mg/l was
      found. In another case in which blood was unavailable because of putrefaction,
      muscle was analyzed. In the four cases in which the ethanol concentration was in
      the range 110-202 mg/100 ml, the triazolam concentration range was 0.04-0.22
      mg/l. Blood concentrations from these five cases were compared to those from
      living persons who had also ingested the drug, and these were in the range 0.002
      0.03 mg/l (n = 28), with an average concentration of 0.01 mg/l.

PMID- 8487035
TI  - Competitive EIA for anti-HIV-2 detection in The Gambia: use as a screening assay
      and to identify possible dual infections.
AB  - The performance of a competitive EIA for the detection of HIV-2-specific antibody
      utilising a viral lysate antigen was assessed over a 3 year period in The Gambia,
      West Africa, and compared with a commercially available assay, ELAVIA-2, using
      three panels of sera. An immunodominant region of the transmembrane glycoprotein
      of an HIV-2 isolate (ANT 53) was also cloned and expressed in E. coli as a beta
      galactosidase fusion protein and the resulting recombinant protein substituted in
      place of the existing viral lysate antigen. Competitive EIAs were found to be
      both a specific and sensitive means of reliably determining the HIV-2 status of
      an individual with a high predictive value, particularly when a strategy of
      concordant positive results in the two EIAs was used. When either anti-HIV-2
      competitive EIAs were used in conjunction with a competitive EIA for anti-HIV-1
      detection it was possible in the vast majority of cases to identify the virus
      type infecting an individual and speciate HIV-1 and HIV-2 infections. A few sera
      which showed similar regression profiles when diluted over a serial tenfold
      dilution steps were identified as possible dual infections.

PMID- 8487036
TI  - Assessment of the antibody response to the immunosuppressive/immunodominant
      region of HIV gp41 in a 5-year longitudinal study.
AB  - The antibody response of HIV-infected individuals to the 581-609 amino acid (aa)
      region of HIV-1 gp41 containing the putative immunosuppressive and immunodominant
      sequences was examined. Sera collected every 5 to 6 months over a period of 5
      years from 50 HIV-1-infected homosexual and bisexual men, 25 of whom progressed
      to AIDS during the collection period, were monitored for changes in ELISA
      reactivity against synthetic peptides encompassing aa581-609 of gp41. The data
      obtained in this blinded, historical prospective study were analyzed with respect
      to changes in mean ELISA absorbance over time and differences in absorbance
      between patient groups (those who progressed to AIDS and those who did not). No
      correlation was found between time or disease state and the presence of
      antibodies to the aa581-597 immunosuppressive sequence. In contrast, ELISA
      absorbance against the aa598-609 immunodominant sequence continued to increase
      over time in both the AIDS and non-AIDS groups. The rate of increase in
      absorbance was similar for both groups; however, the AIDS group had a
      significantly higher mean absorbance level at the outset of the study and
      maintained this difference throughout the study. This region of gp41 has been
      proposed to play a role in complement-mediated antibody-dependent enhancement of
      infection.

PMID- 8487037
TI  - Dobrava virus as a new Hantavirus: evidenced by comparative sequence analysis.
AB  - Dobrava virus, recently isolated from a yellow-neck mouse (Apodemus flavicollis),
      captured in a northern Slovenian village where severe cases of hemorrhagic fever
      with renal syndrome were recognized, was shown by serology and restriction enzyme
      digestion of PCR-amplified gene segments to be related to previously recognized
      hantaviruses. To investigate further the relationship of this new isolate to
      other hantaviruses, a portion of the medium (M) genome segment of Dobrava virus
      was amplified by PCR and the nucleotide sequence determined. Comparing the
      nucleotide sequence with the same gene region of other hantaviruses revealed an
      overall homology of 41.7%. A phylogenetic tree based on pairwise sequence
      similarity clearly showed that Dobrava virus is genetically distinct, and
      probably represents a new virus in the genus Hantavirus of the family
      Bunyaviridae.

PMID- 8487038
TI  - Hepatitis A causing a second episode of virus-associated haemophagocytic
      lymphohistiocytosis in a patient with Still's disease.
AB  - A 20-year-old female with Still's disease who had contracted hepatitis A became
      critically ill 2 weeks after the onset of jaundice with pancytopenia,
      coagulopathy, deteriorating liver function tests, and hepatomegaly. The diagnosis
      of virus-associated haemophagocytic lymphohistiocytosis was made, and she
      improved slowly after supportive treatment with parenteral steroids and
      immunoglobulin. Twelve years earlier, at the onset of her arthritis, she had
      suffered a similar episode of haemophagocytic lymphohistiocytosis in association
      with Epstein-Barr virus infection.

PMID- 8487039
TI  - Identification and use of a neutralising epitope of parvovirus B19 for the rapid
      detection of virus infection.
AB  - A conserved neutralising epitope was confirmed as the site of specific activity
      for the monoclonal antibody R92F6. This monoclonal antibody was used to detect
      B19 viral antigen in serum samples after SDS-PAGE and Western blotting. Twenty
      samples from the United Kingdom, Ireland, Japan, and the United States were
      positive with this technique. Serum samples from various control groups were
      negative.

PMID- 8487040
TI  - Preparation, characterization, and antitumor activity of new ethylenediamine
      platinum(IV) complexes containing mixed carboxylate ligands.
AB  - A series of ethylenediamine platinum(IV) complexes of the type PtIV(en)XA2 and
      PtIV(en)X'2A2, where X = 1,1-cyclobutanedicarboxylato or malonato, X' = chloro,
      cyclobutanecarboxylato, cyclopentanecarboxylato, or cyclohexanecarboxylato, and A
      = acetato or trifluoroacetato were synthesized and characterized by elemental
      analysis, infrared, and NMR (13C and 195Pt) spectroscopic techniques. These
      compounds had good to excellent antitumor activity against murine leukemia L1210
      cells. Complexes with axial trifluoroacetate groups were superior to those with
      acetate ligands. Those possessing both axial trifluoroacetate groups and
      monodentate bis-carboxylate ligands in the equatorial positions were the most
      active in the series investigated.

PMID- 8487041
TI  - Nursing in Europe towards the 3rd millennium. Report of the CICIAMS European
      Seminar, Edinburgh, Scotland.

PMID- 8487042
TI  - Relationship between tumor area, tumor volume, and criteria of response in
      clinical trials.

PMID- 8487043
TI  - A cry from the fringe.

PMID- 8487044
TI  - Regional hepatic arterial chemotherapy for colorectal cancer metastatic to the
      liver: the controversy continues.

PMID- 8487045
TI  - Back to the basics: the importance of concentration x time in oncology.

PMID- 8487046
TI  - Randomized comparison of 36-hour intermediate-dose versus 4-hour high-dose
      methotrexate infusions for remission induction in relapsed childhood acute
      lymphoblastic leukemia.
AB  - PURPOSE: Pharmacokinetics, toxicity, and therapeutic efficacy of two different
      methotrexate (MTX) infusions for remission induction of relapsed childhood acute
      lymphoblastic leukemia (ALL) were investigated in a randomized multicenter trial.
      PATIENTS AND METHODS: Sixty patients with early bone marrow relapse received a
      polychemotherapy induction protocol starting with either 12 g/m2 MTX as a 4-hour
      infusion (high-dose [HDM]) or 1 g/m2 as a 36-hour infusion (intermediate-dose
      [IDM]). In HDM, leucovorin (LCV) was administered orally (12 times, 15 mg/m2
      every 6 hours), beginning at hour 24. In IDM, only two doses were administered at
      hours 48 and 54. RESULTS: Median serum MTX concentrations during infusion were
      716 mumol/L in HDM and 7.2 mumol/L in IDM. In HDM, MTX serum levels at hour 24
      (median, 2.8 mumol/L) were significantly less than steady-state levels of IDM.
      Concentrations greater than 1 mumol/L were maintained for 36 hours with HDM and
      45 hours with IDM. General tolerance to treatment was better in the HDM group.
      Mucosal lesions occurred significantly more often and were more severe after IDM
      treatment. A median treatment delay of 3 days was required in the IDM group but
      not in the HDM group. At day 15, complete remission (CR) was documented in 45% of
      IDM- and 48% of HDM-treated patients. Persistent blasts (> 5%) appeared more
      frequently in HDM than in IDM (35% v 19% of patients; P = NS). After completion
      of induction therapy, 28 of 30 patients in each group achieved CR. CONCLUSION:
      Both regimens produced the same remission rates. The tendency to better
      antileukemic activity of IDM was accompanied by more severe side effects as a
      consequence of long-lasting cytotoxic MTX levels. Hence, long-term infusion of
      IDM followed by low-dose LCV is an effective treatment for recurrent ALL.

PMID- 8487047
TI  - Unrelated-donor bone marrow transplantation for Philadelphia chromosome-positive
      chronic myelogenous leukemia in children.
AB  - PURPOSE: Bone marrow transplantation (BMT) for Philadelphia chromosome-positive
      (Ph1) chronic myelogenous leukemia (CML) results in a 55% to 64% disease-free
      survival (DFS) rate in 20% to 30% of cases with a matched-sibling donor (MSD).
      Studies that include primarily adults with CML, using unrelated-donor (URD) BMT,
      have expanded this option to those without an MSD. We review and compare the
      efficacy of URD and MSD BMT in children with Ph1 CML. PATIENTS AND METHODS:
      Eleven children with URD BMTs were reviewed and compared with 11 children with
      MSD BMTs for Ph1 CML. Among the URD BMT recipients, there were three with fully
      matched marrows and 10 with advanced CML. The median time from diagnosis to
      transplant was 2.6 years. Among the MSD BMT recipients, 11 had fully matched
      marrows and five had advanced CML. The median time from diagnosis to BMT was 0.7
      years. All received non-T-depleted marrows after cyclophosphamide and
      fractionated total-body irradiation. RESULTS: Both groups had similar engraftment
      times. Late graft failure occurred in two URD patients. Graft-versus-host disease
      (GVHD), > or = grade II, was similar in both groups (77% for URD BMT, 45% for MSD
      BMT), although more severe acute disease and more persistent chronic disease was
      seen in the URD group. The Kaplan-Meier estimate of DFS was 45% +/- 15% (SE) and
      78% +/- 14% (SE) in the URD and MSD groups, respectively, at 3 years. All had
      Karnofsky scores of more than 70%, except one URD patient debilitated from GVHD.
      CONCLUSION: CML is eventually fatal to all patients without BMT. The high
      survival rate seen among children who receive a URD BMT, despite several adverse
      factors, opens this important therapeutic option to those without an MSD.

PMID- 8487049
TI  - Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas
      of childhood.
AB  - PURPOSE: This study investigates the response rate to and toxicity of carboplatin
      and vincristine in children with recurrent low-grade gliomas (LGGs) or patients
      younger than 60 months with newly diagnosed LGGs. PATIENTS AND METHODS: Twenty
      three children with recurrent and 37 children with newly diagnosed LGGs were
      treated with a 10-week induction cycle of carboplatin and vincristine, followed
      by maintenance treatment with the same drugs. Patients were evaluated for
      response to treatment and toxicity. RESULTS: Twelve of 23 (52% +/- 10%; 95%
      confidence interval [CI], 0.32 to 0.72) assessable children with recurrent
      disease had an objective response to treatment, which included a greater than 50%
      reduction in tumor size in seven of 23 (30% +/- 10%; 95% CI, 0.10 to 0.50).
      Twenty-three of 37 (62% +/- .08; 95% CI, 0.46 to 0.78) of newly diagnosed
      patients had an objective response, 16 of 37 (43% +/- 0.08%; 95% CI, 0.27 to
      0.59) with greater than 50% reduction in tumor size. The majority of those with
      an objective response had diencephalic tumors (n = 29), but children with
      thalamic (n = 2), cortical (n = 1), and brain stem (n = 2) LGGs also responded to
      treatment. Of the 35 patients with objective response to treatment, the maximum
      response was seen in 25 after completion of induction and in the remaining 10
      after two to six cycles of maintenance treatment. Forty-nine of 53 (92% +/- .04%)
      patients who were stable or improved after induction remain without progressive
      disease (PD). Hematologic toxicity was common, but resulted in cessation of
      therapy in only one patient. Six children have been removed from the study
      because of allergic reactions, which were considered to be carboplatin
      associated. CONCLUSION: Carboplatin and vincristine have activity in children
      with recurrent and newly diagnosed progressive LGGs. Objective responses to
      treatment after chemotherapy can be seen. This drug regimen is relatively well
      tolerated, and further studies are indicated to define the role of this
      combination of drugs in children with newly diagnosed LGGs.

PMID- 8487048
TI  - Extended triple intrathecal chemotherapy trial for prevention of CNS relapse in
      good-risk and poor-risk patients with B-progenitor acute lymphoblastic leukemia:
      a Pediatric Oncology Group study.
AB  - PURPOSE: The Pediatric Oncology Group (POG) acute leukemia in childhood (ALinC)
      13 study tested two treatment regimens that used different CNS chemoprophylaxis
      for children older than 12 months with non-T, non-B acute lymphoblastic leukemia
      (ALL) and with no demonstrable CNS disease at diagnosis. PATIENTS AND METHODS:
      With the first regimen, standard (S), six injections of triple intrathecal
      chemotherapy (TIC), consisting of methotrexate (MTX), hydrocortisone (HC), and
      cytarabine (ara-C), were administered during intensification treatment and at
      every-8-week intervals throughout the maintenance phase for 17 additional doses.
      The second regimen, standard and MTX pulses (SAM), also specified six TICs during
      intensification, but substituted every-8-week pulses of intermediate-dose
      parenteral methotrexate (IDM; 1 g/m2) for the 17 maintenance TIC injections, with
      a low-dose intrathecal (IT) MTX boost administered with the first four
      maintenance IDM pulses. Otherwise, systemic therapy on regimen SAM was identical
      to regimen S. There were 1,152 patients randomized to the S and SAM regimens
      after stratification by risk group (age/leukocyte count) and immunophenotype.
      RESULTS: The 5-year probabilities (+/- SE) of an isolated CNS relapse were
      regimen S: good risk (n = 381), 2.8% +/- 1.3%; poor risk (n = 196), 7.7% +/-
      3.2%; good + poor risk (n = 577), 4.7% +/- 1.5%; regimen SAM: good risk (n =
      388), 9.6% +/- 2.2%; poor risk (n = 187), 12.7% +/- 4.2%; good + poor risk (n =
      575), 10.9% +/- 2.2%. In poor-risk patients, approximately one third of the
      isolated CNS relapses occurred before preventive CNS therapy was begun at week 9.
      Hence, regimen S has provided better CNS preventive therapy for both good- and
      poor-risk patients (P < .001 overall). The difference is statistically
      significant for good-risk patients (P < .001), but not for poor-risk patients (P
      = .20). Neither treatment has shown a significant advantage in terms of general
      outcome. CONCLUSION: TIC injections extended throughout the intensification and
      maintenance periods are superior to IDM pulses for prevention of CNS leukemia.
      Our results with TIC seem comparable with those achieved with other contemporary
      methods of CNS preventative therapy. Thus, extended TIC affords a reasonable
      alternative to CNS irradiation plus upfront IT MTX for patients with B-progenitor
      ALL.

PMID- 8487050
TI  - Survival comparison of radiosurgery-eligible and -ineligible malignant glioma
      patients treated with hyperfractionated radiation therapy and carmustine: a
      report of Radiation Therapy Oncology Group 83-02.
AB  - PURPOSE: The purpose is twofold: (1) to identify the malignant glioma patients
      treated in a trial of hyperfractionated radiotherapy (RT) and carmustine (BCNU)
      who may have been eligible for a stereotactic radiosurgery (SRS) boost; and (2)
      to compare survival of such patients with that of those considered SRS
      ineligible. PATIENTS AND METHODS: From January 1983 to July 1989, 778 malignant
      glioma patients were enrolled on Radiation Therapy Oncology Group (RTOG) 83-02, a
      randomized phase I/II hyperfractionated RT dose-escalation trial with BCNU
      chemotherapy. The SRS criteria used in a single-institution trial were applied to
      these patients; they are: Karnofsky performance status (KPS) of greater than 60;
      well-circumscribed tumor less than 4.0 cm; no subependymal spread; and a location
      not adjacent to brainstem or optic chiasm. RESULTS: Eighty-nine patients (11.9%)
      were identified as potentially SRS-eligible. The median survival times (MST) and
      18-month survival rates of the 89 eligible and 643 ineligible patients were 14.4
      versus 11.7 months and 40% versus 27%, respectively (P = .047). The MST and 18
      month survival rate of the 544 SRS-ineligible patients with KPS greater than 60
      were 12.1 months and 29%, respectively, and were not statistically inferior to
      the survival of the SRS-eligible group (P = .21). Multivariate analysis revealed
      age, KPS, and histopathology to be strongly predictive of survival, and SRS
      eligibility was also significantly predictive (P = .047). CONCLUSION: SRS
      eligible patients enrolled on RTOG 83-02 had survival superior to that of the SRS
      ineligible group, and this advantage is mainly due to the selection of a subgroup
      with a high minimum KPS.

PMID- 8487051
TI  - The Head and Neck Radiotherapy Questionnaire: a morbidity/quality-of-life
      instrument for clinical trials of radiation therapy in locally advanced head and
      neck cancer.
AB  - PURPOSE: The purpose of this study was to develop and validate an instrument for
      clinical trials to measure radiation-related acute morbidity and quality of life
      from the perspective of patients with head and neck cancer (HNC) treated with
      radiotherapy. METHODS: The Head and Neck Radiotherapy Questionnaire (HNRQ) was
      developed by a panel of health care workers and patients, was pretested in a
      pilot study of HNC patients, and was validated in a randomized double-blind trial
      of concomitant fluorouracil (FUra) infusional therapy (1.2 g/m2 per 24 hours) or
      saline placebo administered for 72 hours in the first and third weeks of a 6 1/2
      week course of radiation therapy. The HNRQ was validated against existing
      toxicity and performance status indices, all of which were measured weekly for
      the 6 1/2 weeks of treatment and for 4 weeks posttreatment. RESULTS: There were
      three a priori constructs: (1) that the HNRQ scores would conform to a shallow U
      shaped pattern to reflect declining quality of life (increasing morbidity) during
      radiation and recovery posttreatment; (2) that the HNRQ would correlate with
      existing toxicity indices (World Health Organization [WHO] stomatitis, Byfield
      stomatitis, WHO skin toxicity, Eastern Cooperative Oncology Group [ECOG] and
      Karnofsky performance status); and (3) that the HNRQ would discriminate between
      FUra and placebo groups. The HNRQ and its domain scores all showed a change from
      baseline reflecting increased morbidity during radiation (analysis of variance
      [ANOVA], P < .00001). The HNRQ correlated well with all other indices (r > or =
      .60), and domain scores correlated best with other indices that assess the same
      symptom complex (eg, HNRQ skin domain and WHO skin toxicity index, r = .77).
      There was a significant difference in HNRQ scores between the FUra and placebo
      groups during radiation (ANOVA, P = .0007), and all HNRQ domains also
      discriminated between the treatment groups. CONCLUSION: The HNRQ is a valid
      measure of acute morbidity due to radiation therapy in patients with locally
      advanced HNC, and may be useful as an outcome measure for future clinical trials
      of radiation treatment strategies.

PMID- 8487052
TI  - Prognostic value of PS2 and cathepsin D in 710 human primary breast tumors:
      multivariate analysis.
AB  - PURPOSE: Evaluation of the prognostic value of cytosolic PS2 (pS2 protein) and
      cathepsin D in a large series of breast cancer patients by multivariate analysis
      taking into account steroid receptors and conventional prognostic factors.
      PATIENTS AND METHODS: Prognostic factors were analyzed in 710 primary breast
      cancers (median follow-up, 4 years). PS2 and cathepsin D were measured by
      radiometric immunoassays. Estrogen receptor (ER) and progesterone receptor (PgR)
      status were assessed by radioligand binding assays and multiple-point Scatchard
      analysis. RESULTS: The best cutoff point for PS2 to discriminate between positive
      (61% of the tumors) and negative was 2 ng/mg protein (univariate P value in 5
      year relapse-free survival = .003). For cathepsin D, no sensible cutoff point
      could be chosen, since there was a continuous association between the level of
      cathepsin D and relapse rate (P = .001). In Cox multivariate analysis, relapse
      rate decreased with age of premenopausal/perimenopausal patients and with PS2 or
      steroid receptor positivity, and increased with the size of the tumor, the number
      of positive lymph nodes, and increasing levels of cathepsin D. In analysis for
      overall survival, age of both premenopausal/perimenopausal and postmenopausal
      patients, tumor size, the number of positive lymph nodes, ER/PgR, and PS2 were
      all independently associated with the rate of death. The level of cathepsin D was
      positively correlated with the rate of death, but this trend was not
      statistically significant. Separate Cox multivariate analyses for relapse-free
      survival in subgroups of patients as defined by nodal status showed that the
      contribution of PS2 and cathepsin D was the strongest in the node-negative
      subgroup. Node-negative patients with tumors containing PS2 values < or = 2 ng/mg
      protein and cathepsin D values more than 70 pmol/mg protein experienced a 4.5
      fold increase in relapse rate as compared with those with PS2 levels greater than
      2 ng/mg protein and cathepsin D levels < or = 30 pmol/mg protein. CONCLUSION: PS2
      and cathepsin D are independent prognostic factors in primary breast cancer and
      lymph node-negative patients.

PMID- 8487053
TI  - Phase II study of CPT-11, a new camptothecin derivative, in metastatic colorectal
      cancer. CPT-11 Gastrointestinal Cancer Study Group.
AB  - PURPOSE: A phase II study was conducted to evaluate the antitumor effect and
      toxicity of CPT-11 in patients with metastatic colorectal cancer. PATIENTS AND
      METHODS: From December 1989 to March 1991, 67 patients with metastatic colorectal
      cancer were enrolled in this study. Sixty-three patients were assessable for
      toxicity and response. Their median age was 57 years (range, 24 to 72). Forty-six
      patients (73%) had a good performance status of 0 or 1. Fifty-one patients (81%)
      had received prior chemotherapy. The major sites of metastasis were liver (63%)
      and lung (44%). CPT-11 was administered as a 100 mg/m2 weekly intravenous
      infusion, or as 150 mg/m2 every 2 weeks. The dose was reduced based on the grade
      of leukopenia and diarrhea, if necessary. RESULTS: A partial response was
      obtained in 17 of 63 assessable patients (27%; 95% confidence interval, 16% to
      38%). The response rate in patients with prior radiotherapy or chemotherapy was
      25% (13 of 52). Liver metastases showed a 15% (six of 40) response and lung
      metastases showed a 39% (11 of 28) response. The median duration of partial
      response was 127 days (range, 49 to 353) and the median overall duration of
      response was 208 days (range, 99 to 381). The major toxicities (> or = grade 3)
      were leukopenia (16%), diarrhea (13%), nausea and vomiting (13%), and alopecia
      (11%). Adverse effects were generally well tolerated and reversible. Treatment
      could be continued on an outpatient basis for patients without severe toxicity.
      Hemorrhagic cystitis was not encountered in this study. CONCLUSION: CPT-11 showed
      promising antitumor activity against metastatic colorectal cancer that was
      resistant to prior therapy. Further clinical trials of combination chemotherapy
      using CPT-11 are justified.

PMID- 8487054
TI  - Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal
      gammopathies and Waldenstrom's macroglobulinemia.
AB  - PURPOSE: To determine the natural history of amyloidosis associated with
      Waldenstrom's macroglobulinemia and immunoglobulin M (IgM) monoclonal gammopathy.
      PATIENTS AND METHODS: From January 1968 to September 1990, 50 patients with a
      serum IgM monoclonal protein and biopsy-proven amyloidosis were evaluated at the
      Mayo Clinic. There were 32 men and 18 women (age range, 43 to 93 years). RESULTS:
      Percentages of patients presenting with cardiac, renal, hepatic, and pulmonary
      amyloid were 44%, 32%, 14%, and 10%, respectively. Forty-two percent of the
      patients had an M protein value greater than 1.5 g/dL, and 12% had an M component
      greater than 3 g/dL. Subcutaneous fat, rectum, and bone marrow showed amyloid in
      84%, 72%, and 50%, respectively, providing a simple technique for diagnosing
      amyloidosis. The bone marrow biopsy was consistent with Waldenstrom's
      macroglobulinemia in 10, a plasma-cell proliferative disorder in 10, and lymphoma
      or a lymphoproliferative disorder in 11; results were normal, nondiagnostic, or
      hypercellular in 17. Forty-three of 50 patients died. The median survival of the
      entire group was 24.6 months. Fifty-three percent of deaths were due to cardiac
      amyloid, 12% to respiratory failure, 7% to macroglobulinemia, 7% to liver
      failure, and 7% to kidney failure. CONCLUSION: The presence of amyloid
      cardiomyopathy and an increased creatinine concentration at diagnosis had an
      adverse impact on survival. Of the 22 patients who presented with cardiomyopathy,
      the median survival was 11.1 months, with only two surviving longer than 5 years.
      The median survival of the 28 patients without cardiomyopathy at diagnosis was 27
      months, with eight 5-year survivors (P = .013). All eight amyloid deposits
      studied stained for Ig light chain, indicating that this amyloidosis is of the
      primary (AL) type.

PMID- 8487055
TI  - Interleukin-2-induced thyroid dysfunction is correlated with treatment duration
      but not with tumor response.
AB  - PURPOSE: To analyze the putative relationship between immunotherapy-associated
      dysthyroidism and the probability of a tumor response. PATIENTS AND METHODS: A
      total of 89 consecutive patients with advanced cancer were treated with
      interleukin-2 (IL2)-based immunotherapy in a prospective study. RESULTS: Twenty
      patients developed thyroid dysfunction. Repeatedly positive tests for thyroid
      antibodies developed in 28% of the patients. Twenty-two patients achieved a
      response. There was no relationship between the formation of antibodies and the
      probability of response. There appeared to be a trend toward a relationship
      between thyroid dysfunction and response (P = .23). A strong relationship was
      found between response on the one hand and cumulative dose of IL2 (P = .01) and
      treatment duration with IL2 (P = .025) on the other. The frequency of thyroid
      dysfunction was also significantly correlated with treatment duration (P = .001).
      After adjustment for cumulative dose of IL2 and treatment duration, no
      relationship between thyroid dysfunction and response remained (P = .99).
      CONCLUSION: There is no relationship between thyroid dysfunction and the
      probability of tumor response. Thyroid dysfunction is merely a function of
      treatment duration and cumulative dose of IL2.

PMID- 8487056
TI  - Splenectomy and the increasing risk of secondary acute leukemia in Hodgkin's
      disease.
AB  - PURPOSE: Following irradiation alone, secondary acute nonlymphocytic leukemia
      (ANLL) is uncommon; following chemotherapy alone, the risk is increased, but not
      as much as when combined modality treatments are used. Because ANLL seems more
      likely to occur in splenectomized patients, attention is focused on an unexpected
      association between splenectomy and the risk of secondary leukemia. PATIENTS AND
      METHODS: The risk of ANLL was assessed in 503 patients with Hodgkin's disease
      (HD) homogeneously treated with combined modality therapy (mechlorethamine,
      vincristine, procarbazine, and prednisone [MOPP] plus radiotherapy). These
      patients were diagnosed from 1970 through 1984 and monitored until June 1991.
      RESULTS: ANLL was observed in one of 145 (0.69%) patients not splenectomized and
      in 21 of 358 (5.86%) splenectomized patients, demonstrating a significantly
      higher frequency of ANLL in the group of patients who underwent splenectomy. The
      group of patients who developed ANLL received a statistically greater number of
      MOPP courses than did the group not developing ANLL. ANLL was statistically more
      frequent in those patients who received more than four cycles of MOPP. Sex,
      symptoms, extent of radiotherapy, splenectomy, age, and number of MOPP courses
      were assessed for their impact on ANLL incidence by multivariate analysis.
      CONCLUSION: Cox's proportional hazards regression showed that splenectomy and, as
      previously described by others, the number of courses of MOPP are prognostic
      factors that increase the risk of secondary ANLL in HD patients treated with
      combined modality therapy. These data raise interesting questions regarding the
      possible role of the spleen in leukemia development.

PMID- 8487057
TI  - Autologous bone marrow transplantation in poor-prognosis intermediate-grade and
      high-grade B-cell non-Hodgkin's lymphoma in first remission: a pilot study.
AB  - PURPOSE: Using high-dose therapy and autologous bone marrow transplantation
      (ABMT) to overcome cellular resistance and eradicate minimal disease, we
      initiated a pilot study during first remission in patients with non-Hodgkin's
      lymphoma (NHL) to examine whether the long-term disease-free survival (DFS) rate
      can be improved for patients with poor-prognosis intermediate/high-grade NHL.
      PATIENTS AND METHODS: Twenty-six patients with advanced-stage diffuse
      intermediate/high-grade B-cell NHL (including 16 patients with diffuse small
      cleaved-cell [DSC]) were selected at presentation by histologic and clinical
      characteristics to have less than a 25% probability of long-term DFS with
      conventional treatment. After induction chemotherapy, 16 patients were in
      complete remission (CR) and 10 were in a minimal disease state. Patients were
      then treated with high-dose cyclophosphamide, total-body irradiation (TBI), and
      anti-B-cell monoclonal antibody-purged ABMT. RESULTS: Following ABMT, no acute in
      hospital treatment deaths occurred, and engraftment of granulocytes and platelets
      was significantly faster than for patients undergoing ABMT who were in second or
      subsequent remission. Of 26 patients, 21 remain in CR maintained without
      continued therapy, three relapsed in sites of prior nodal disease (4.8, 5.4, and
      28 months post-ABMT), and two died in remission. The DFS rate is estimated to be
      85% at 28 months and thereafter. The median follow-up period for the 21 patients
      who are alive and disease-free is 32 months. CONCLUSION: This pilot study
      suggests that consolidation of first remission with ABMT may improve the long
      term DFS rate for diffuse intermediate/high-grade NHL patients at high risk for
      relapse.

PMID- 8487058
TI  - Phase I evaluation of all-trans-retinoic acid in adults with solid tumors.
AB  - PURPOSE: Prompted by recent demonstrations that all-trans-retinoic acid (all
      trans-RA) had efficacy in acute promyelocytic leukemia, a phase I trial of all
      trans-RA was conducted to establish the maximum-tolerated dose (MTD) before phase
      II testing. PATIENTS AND METHODS: Forty patients with a histologic or cytologic
      diagnosis of malignancy other than leukemia were treated with single daily oral
      doses of all-trans-RA ranging from 45 mg/m2 to 200 mg/m2. Doses of all-trans-RA
      were escalated in the next cohort of patients until the MTD was determined if the
      preceding dose level was not associated with significant toxicity. RESULTS: Lung
      cancer was the most common type of tumor included in the study (26 cases)
      followed by head and neck squamous cell carcinomas (three cases), and squamous
      cell carcinoma of the skin (two cases); other miscellaneous solid tumors were
      also represented. Toxicities included cheilitis, skin reactions, headache, and
      nausea and vomiting, as well as transient elevations of liver enzymes and
      triglyceride levels. Skin toxicities, consisting of erythema with desquamation
      and paronychia, were considered to be the dose-limiting toxicity, and were
      observed in two of six patients who received 175 mg/m2/d, and in two of five
      patients who received 200 mg/m2/d. Of the 30 patients with assessable lesions,
      response was evaluated in 26 patients and no major objective tumor response was
      observed. Two patients were able to receive the drug for longer than 1 year
      without significant toxicities. There was considerable variation in individual
      patients' peak plasma all-trans-RA levels, and a decrease in the area under the
      curve of all-trans-RA plasma concentration was observed in all four patients
      evaluated. CONCLUSION: For phase II study of adult patients, we recommend 150
      mg/m2 of all-trans-RA administered orally once a day. However, for better
      optimization of drug administration schedules, further studies are needed.

PMID- 8487059
TI  - Placebo-blinded study of morphine sulfate sustained-release tablets and immediate
      release morphine sulfate solution in outpatients with chronic pain due to
      advanced cancer.
AB  - PURPOSE: This study was conducted to compare the relative analgesic efficacy and
      safety of an every-4-hour immediate-release oral morphine (IRM) solution with
      that of an every-12-hour sustained-release oral morphine (SRM) formulation.
      PATIENTS AND METHODS: This was a double-blind, placebo-blinded, crossover study
      in 34 adult male and female outpatients with pain due to advanced cancer.
      Baseline data were collected on day 1. On days 2 and 3, randomly assigned
      patients received either placebo plus IRM (Roxanol; Roxane Laboratories, Inc,
      Columbus, OH; 20 mg/mL) at 2, 6, and 10 am, and 2, 6, and 10 pm, or alternatively
      SRM (Oramorph SR; Roxane Laboratories, Inc; 30 mg) at 10 AM and 10 PM. Patients
      were then crossed over to the alternate treatment for days 4 through 6. Pain
      relief was measured using a conventional 100-mm visual analog scale (VAS) and by
      recording the incidence of breakthrough pain. Information on side effects was
      obtained from VAS scores for sedation, nausea, anxiety, and depression; by
      directly questioning the patient as to mental confusion, bowel movements, and
      laxative use; and from Karnofsky performance status scores. VAS data were
      analyzed using a linear statistical model. Breakthrough pain data were analyzed
      using analysis of variance (ANOVA). RESULTS: There were no statistically
      significant differences between IRM and SRM treatments with respect to VAS pain
      scores, side effect scores, or incidence of breakthrough pain data. Karnofsky
      performance scores remained stable for all patients throughout the study.
      CONCLUSION: It was concluded that every-12-hour administration of SRM and every-4
      hour administration of IRM provide similar analgesic effectiveness and side
      effect profiles in the treatment of chronic pain in cancer patients.

PMID- 8487060
TI  - Dose-ranging study of oxycodone for chronic pain in advanced cancer.
AB  - PURPOSE AND METHODS: We assessed the analgesic efficacy and safety of single
      entity oxycodone solution at doses greater than 10 mg orally every 4 hours in 24
      patients with chronic cancer pain not controlled by weaker analgesics. RESULTS:
      Twenty of 24 patients completed the study. Pain relief was obtained with doses up
      to 60 mg every 4 hours. When oxycodone was taken for long periods, further dose
      increments could be made safely. The side effects of oxycodone are mild, and
      common to all opioids, with sedation and constipation most frequent. Nausea was
      more common in females in all age groups and in patients of either sex less than
      50 years of age. Episodes of serious toxicity were rare, and responded to dose
      reduction. Patients older than 65 years required lower doses, suggesting
      pharmacokinetic similarities between oxycodone and morphine. Patients changed
      from oral oxycodone to morphine remained pain-free when relative milligram
      potency ratios of 1:1 to oral morphine and 3:1 to intravenous morphine were used.
      CONCLUSION: Oxycodone has been shown for the first time to be as versatile and
      flexible as oral morphine in the management of chronic pain in patients with
      advanced cancer.

PMID- 8487061
TI  - Psychosocial outcomes of cancer: a comparative analysis of Hodgkin's disease and
      testicular cancer.
AB  - PURPOSE: The psychosocial outcomes of testicular cancer and Hodgkin's disease
      were compared to test our hypotheses that more specific dysfunction and less
      hiding of symptoms would be found in the former group, as cancer visibly affects
      a sexual organ. Since those with Hodgkin's disease could more easily deny the
      disease, poorer psychosocial adjustment was predicted. PATIENTS AND METHODS: The
      sample consists of 85 men with Hodgkin's disease and 88 men with testicular
      cancer (seminomatous, n = 39; or nonseminomatous, n = 49). They were interviewed
      once, at least 1 year following the end of treatment. Measures of
      sociodemographic characteristics, physical functioning, psychologic distress, and
      social outcomes were collected. Treatment data were collected from medical
      records. RESULTS: Men with testicular cancer report more focused symptoms: less
      sexual enjoyment and poor health habits. Men with Hodgkin's disease report more
      generalized symptoms: fatigue, energy loss, and work impairment. Multivariate
      analysis indicates that most of these differences are site-related; independent
      effects of treatment on outcomes were found for more generalized symptoms.
      Contrary to expectations, both groups reported similar levels of infertility and
      erectile dysfunction. CONCLUSION: The response to testicular cancer is site
      specific, while the response to Hodgkin's disease is related to both site and
      treatment (stage-related).

PMID- 8487062
TI  - Cancer by another name: a randomized trial of the effects of euphemism and
      uncertainty in communicating with cancer patients.
AB  - PURPOSE: In this study we tested some assumptions about the use of euphemism in
      communicating with cancer patients. Does an explicit statement about the
      diagnosis of cancer cause patients to respond with greater anxiety than when
      uncertainty or ambiguity is allowed to persist? Do patients believe they cope
      better with cancer when the diagnosis is explicit? METHODS: A heterogeneous
      sample of 165 cancer patients completed a new measure of emotional adjustment to
      cancer using random assignment among four testing variables: agent (self-report v
      interview), terminology (the words cancer v illness), identification (patient
      identified v anonymous), and supervision (clinic v home). Internal consistency
      (Cronbach's alpha) for the 39-item set was 0.74 and face and content validity
      were determined using the focus-group technique and preliminary factor analysis.
      After answering the adjustment measures, subjects completed the Spielberger State
      Trait Anxiety Inventory (STAI). RESULTS: Overall anxiety levels were
      significantly lower in the sample than published norms for general medical and
      surgical patients. Exposure to the word cancer as distinct from illness increased
      anxiety, but did not alter adjustment scores. Supervision and agent conditions
      did not affect anxiety, but reported adjustment was poorer in the interview
      condition compared with the self-report condition. Ambiguous instructions, such
      as asking patients to complete the questionnaire anonymously but return it in
      person to staff in the clinic, resulted in poorer adjustment, which was reversed
      by the consistent instruction to complete the questionnaire anonymously at home
      and return it by mail. CONCLUSION: Use of the word cancer generated anxiety to
      levels similar to those reported in general medical and surgical patients, but
      did not produce any distortion in reported adjustment. However, any ambiguity
      associated with the conditions under which adjustment is assessed may lead to
      distortion and an increase in the patient's reported psychologic distress.

PMID- 8487063
TI  - Assessment of sleep in patients with lung cancer and breast cancer.
AB  - PURPOSE AND METHODS: We studied the sleep architecture and psychologic state of
      32 patients with breast or lung cancer compared with 32 age- and sex-matched,
      normal-sleeping volunteers and 32 otherwise healthy insomniacs. RESULTS: Research
      findings indicate that lung cancer patients slept as poorly as did insomniacs,
      but underreported their sleep difficulties. Breast cancer patients slept
      similarly to normal-sleeping volunteers. No psychiatric disorders were detected
      in the cancer patients, and there were no significant differences in mood between
      lung and breast cancer patients. CONCLUSION: Lung cancer patients appear to be
      unique in underestimating an objectively verified sleep difficulty. The adaptive
      mechanism of denial in these patients is discussed.

PMID- 8487064
TI  - Direct thrombosis of aneurysms.

PMID- 8487065
TI  - The myth of eloquent cortex, or what is non-eloquent cortex?

PMID- 8487066
TI  - The long-term outcome after surgical treatment of dorsally exophytic brain-stem
      gliomas.
AB  - Dorsally exophytic brain-stem gliomas represent a distinctive subgroup of
      pediatric brain-stem neoplasms that are amenable to radical excision because of
      their benign histology and growth characteristics. However, their attachment to
      the floor of the fourth ventricle invariably precludes complete tumor excision.
      The long-term behavior of the residual tumor remains a subject of concern. To
      address this issue, the authors reviewed their experience with 18 dorsally
      exophytic brain-stem gliomas treated between 1974 and 1990. At operation, the
      tumors filled the fourth ventricle, fungating out of a broad-based area of the
      dorsal brain stem. The exophytic tumor was resected, but no attempt was made to
      remove tumor from the brain stem. Histological examination showed that 16 of the
      tumors were grade I or II astrocytomas, one was a ganglioglioma, and one was an
      otherwise benign-appearing glioma with several foci of anaplasia that was
      classified as a grade III astrocytoma. The latter patient was one of only two in
      the series to receive postoperative radiation therapy; both cases so treated have
      no evidence of disease on follow-up imaging studies 61 and 135 months
      postoperatively. One other child who had stable disease postoperatively died of
      shunt malfunction 18 months after tumor excision. Serial radiographic studies in
      the other 15 patients have shown no evidence of disease in three, stable residual
      disease in eight, and tumor enlargement 12, 28, 40, and 84 months postoperatively
      in four (median follow-up period 113 months). Each of the four patients with
      tumor regrowth underwent repeat tumor excision. Two of these children received
      perioperative radiation therapy at the time of disease progression and both
      showed reduction in tumor volume 28 and 65 months after their second operation.
      In contrast, both patients who did not receive radiotherapy at the time of
      disease progression had further tumor enlargement 48 and 84 months after their
      second operation and underwent a third tumor resection; one received
      postoperative radiation therapy and has no evidence of disease 58 months after
      his third operation and the other child has stable disease 27 months
      postoperatively. Histological examination of tumor specimens obtained at second
      and third operations showed no change from the appearance of the tumor on the
      initial resection. The authors conclude that the majority of dorsally exophytic
      brain-stem gliomas can be managed successfully with subtotal excision and, if
      necessary, cerebrospinal fluid diversion. The small percentage of tumors in this
      series that showed recurrent growth remained benign histologically.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8487067
TI  - Preservation of hearing in surgery for acoustic neuromas.
AB  - Preservation of hearing was attempted in 161 cases of histologically confirmed
      acoustic neuroma removed by the senior author between January 1, 1970, and
      September 30, 1991. There were 136 patients with unilateral tumors; 22 patients
      had bilateral tumors (neurofibromatosis 2) and underwent a total of 25
      procedures. Hearing was initially preserved in 35% of patients with unilateral
      tumors and in 44% of those with bilateral tumors. Results are reported in terms
      of pre- and postoperative pure tone average and speech discrimination scores.
      Surgical access to the tumor was obtained via middle cranial fossa and
      suboccipital approaches. The latter has been used more often over the past 5
      years because of a lower associated incidence of transient facial paresis.
      Persistent postoperative headaches have been the most common complication
      following the suboccipital approach. The results of preoperative brain-stem
      auditory evoked response (BAER) studies were useful in predicting the outcome of
      hearing preservation attempts. Patients with intact BAER waveform morphology and
      normal or delayed latencies had a higher probability of hearing preservation in
      comparison to those with abnormal preoperative BAER morphology.

PMID- 8487068
TI  - Neurological complications of ankylosing spondylitis.
AB  - Thirty-three patients with ankylosing spondylitis with or without spinal
      neurological symptoms requiring surgical intervention were identified in a
      retrospective review of all cases of spinal disorders treated at the Mayo Clinic
      during the period from 1984 to 1989. Spinal fractures (traumatic or
      pseudoarthroses), progressive spinal deformity, rotary instability secondary to
      atlanto-occipital or atlantoaxial subluxation, and spinal stenosis with
      associated neurological deficit, pain, or spinal instability were the most common
      indications for surgery. Of the 41 operations performed, there were 17 cervical,
      14 thoracic, and 10 lumbar procedures. Eight patients had two or more disorders
      at separate spinal levels that required surgery. Preoperative neurological
      deficits were recorded in 13 patients; these improved following surgery in nine
      and stabilized in four. This review emphasizes the fragility of the ankylosed
      spinal column and its inherent susceptibility to fracture with attendant
      neurological compromise. It also identifies the variety of spinal disorders
      observed in these patients and discusses their surgical management. The
      experience with this series suggests that thorough radiological evaluation,
      extreme caution with endotracheal intubation and with halo-vest applications,
      early surgical spinal immobilization, and aggressive postoperative mobilization
      of patients are necessary for a successful outcome. It is concluded that outcomes
      in these patients can be favorable when managed appropriately.

PMID- 8487069
TI  - Pulsatile increases in aneurysm size determined by cine phase-contrast MR
      angiography.
AB  - The internal flow dynamics were assessed in 16 cerebral aneurysms by cine phase
      contrast magnetic resonance (MR) angiography. Six of the aneurysms were
      associated with subarachnoid hemorrhage and 10 were unruptured. The ruptured
      aneurysms demonstrated a 51% +/- 10% increase in volume between systole and
      diastole, while the increase in volume of the unruptured aneurysms was 17.6% +/-
      8.9% (p < 0.005). The ruptured aneurysms demonstrated an approximate 1.0- to 1.5
      mm increase in diameter in at least one dimension during systole. There was no
      relationship between aneurysm size and volumetric increases. These findings
      suggest that cine phase-contrast MR angiography can detect structural weakness in
      the aneurysmal wall. Imaging techniques that can evaluate aneurysmal wall
      dynamics may be useful in therapeutic planning.

PMID- 8487070
TI  - Computer-derived density spectral array in detection of mild analog
      electroencephalographic ischemic pattern changes during carotid endarterectomy.
AB  - The purpose of this prospective study was twofold: 1) to determine the
      sensitivity and specificity of computer-derived density spectral array in
      detecting analog electroencephalographic (EEG) ischemic pattern changes during
      carotid artery cross-clamping in patients undergoing carotid endarterectomy; and
      2) to assess the ability of density spectral array to identify such changes in
      comparison with the degree and type of change seen in the analog EEG ischemic
      pattern. Sixteen channels of anteroposterior bipolar and two to four channels of
      referential electroencephalography with four channels of density spectral array
      were monitored simultaneously during carotid endarterectomy in 103 patients under
      general anesthesia. Two "observers" interpreted the density spectral array and
      the analog electroencephalograms, one during and immediately after the operations
      and the other 6 months after completion of all surgery. Analyses were conducted
      to establish both the number of patients with analog EEG ischemic changes and the
      number of ischemia events during carotid artery cross-clamping. Observer A
      indicated that the density spectral array identified analog EEG ischemic changes
      in 21 of 29 patients, for a sensitivity of 72% (specificity 99%), whereas
      Observer B's results showed that the density spectral array identified analog EEG
      ischemic changes in 16 of 27 patients, for a sensitivity of 59% (specificity
      96%). Density spectral array detection of analog EEG ischemic changes based on
      severity classifications were 61% and 18% in the mild group, 70% and 71% in the
      moderate group, and 95% in the severe group, indicating a relationship between
      density spectral array sensitivity and severity of analog EEG ischemic change,
      with p = 0.02 and p = 0.004 for the two observers. The kappa statistics for
      observer reproducibility were highly significant, with k = 0.95 for analog EEG
      ischemic changes and 0.85 for density spectral array changes. It is concluded
      that density spectral array does not reliably detect mild analog EEG pattern
      changes of cerebral ischemia and is not a reliable substitute for 16-channel
      analog EEG monitoring of cerebral ischemia during carotid endarterectomy.

PMID- 8487071
TI  - Intraoperative electrocorticography during tumor resection: impact on seizure
      outcome in patients with gangliogliomas.
AB  - Gangliogliomas are indolent neoplasms that are often associated with long
      standing intractable seizures. The seizure-free outcome following ganglioglioma
      resection alone (or "lesionectomy") has been generally favorable, ranging in most
      series from 50% to 65%. Thus, the value of resection of epileptogenic cortex in
      addition to tumor with regard to seizure outcome has been the subject of
      controversy. The authors describe a series of 12 patients with frontal or
      temporal lobe gangliogliomas associated with long-standing intractable seizures.
      In these patients, intraoperative electrocorticography was used to guide the
      resection of epileptogenic cortex along with tumor. Functional brain mapping,
      interictal and ictal monitoring of seizures, as well as thorough
      neuropsychological assessments were performed prior to resection in all cases.
      Outcome with regard to seizures, tumor recurrence, and neurological deficits was
      assessed with a mean follow-up period of 3.1 years. There was universal freedom
      from seizures postoperatively in 11 patients in whom complete or near-complete
      resection of epileptogenic cortex was achieved. In one patient in whom complete
      tumor resection and subtotal removal of epileptogenic cortex was achieved, a 95%
      reduction in seizure frequency was identified. No tumor recurrence or
      neurological deficits were observed. In a subset of four patients,
      neuropsychological and cognitive function were evaluated pre- and
      postoperatively. In these four, a clear trend toward improvement was noted in
      most functions. Thus, resection of epileptogenic cortex along with tumor may
      improve seizure outcome in selected patients with tumor-associated epilepsy
      without engendering identifiable neurological or cognitive deficits attributable
      to the incremental resection.

PMID- 8487072
TI  - Radiosurgical treatment of recurrent hemangiopericytomas of the meninges:
      preliminary results.
AB  - Hemangiopericytomas of the meninges, classified previously as angioblastic
      meningiomas, have a propensity to recur either locally or at distant sites within
      the nervous system after surgical resection. Visceral metastases also develop
      much more commonly in these lesions than in other types of histologically benign
      meningiomas. The radiosurgical gamma knife was used to treat five patients with
      11 meningeal hemangiopericytomas (seven new, two recurrent, and two residual
      tumors) after surgical resection of an initially solitary intracranial lesion.
      Three patients had undergone multiple craniotomies and radiation therapy before
      referral, and two patients underwent a second radiosurgical procedure for lesions
      that appeared between 5 and 13 months after the first treatment session. Dramatic
      tumor shrinkage occurred in most patients within 6 to 10 months after treatment.
      The only treatment-related morbidity in this series was a partial visual-field
      defect in one patient with a large falx-tentorial junction hemangiopericytoma who
      had previously undergone radiation therapy. Radiosurgery appears to cause
      dramatic early shrinkage of small and medium-sized intracranial
      hemangiopericytomas that have recurred or developed after previous surgery and/or
      radiation therapy.

PMID- 8487073
TI  - A randomized trial of radiotherapy versus radiotherapy plus CCNU for incompletely
      resected low-grade gliomas: a Southwest Oncology Group study.
AB  - Sixty adult patients with incompletely excised low-grade gliomas were randomly
      assigned to receive radiotherapy (55 Gy over a total of 6 1/2 to 7 weeks) either
      alone or with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU; 100 mg/sq m
      every 6 weeks). Pathological review showed that six patients were ineligible for
      the study. Evaluation of patient age, extent of surgery, tumor grade, and
      performance status showed no significant differences between the treatment arms.
      The response rate, as judged by the disappearance or reduction in size of the
      tumor on computerized tomography scans, was 79% for radiation therapy alone
      versus 54% for irradiation plus CCNU. The median survival time was 4.45 years for
      all patients, with no significant difference between treatment arms (p = 0.7).
      For the group as a whole, patient age and performance status were the most
      important prognostic parameters. The majority of patients receiving chemotherapy
      experienced moderate hematological toxicity. This study demonstrates that CCNU
      chemotherapy does not improve the results of radiation therapy in the treatment
      of incompletely excised low-grade gliomas.

PMID- 8487074
TI  - Altered cerebrovascular CO2 reactivity following subarachnoid hemorrhage in cats.
AB  - The authors tested the hypothesis that cerebral blood flow (CBF) reactivity to
      CO2 was blunted following subarachnoid hemorrhage (SAH). Subarachnoid hemorrhage
      was produced in five cats by performing four cisterna magna injections of blood
      in each (SAH Group). A second group of six cats was treated with an
      antifibrinolytic agent (AF) in addition to four cisterna magna blood injections
      (SAH+AF Group). Four cats received AF and four cisterna magna injections of
      saline (Control Group). The presence or absence of basilar artery vasospasm was
      determined by comparing baseline and follow-up selective angiograms. Cerebral
      blood flow reactivity was determined by randomly varying the concentration of
      inspired CO2 to alter PaCO2 from 20 to 75 mm Hg. Regional CBF was measured with
      radiolabeled microspheres. Basilar artery vasospasm was seen following
      subarachnoid injection of blood but not of saline. Normocapnic CBF was similar in
      all three groups in the brain stem (mean +/- standard error of the mean: SAH
      Group 46 +/- 6, SAH+AF Group 46 +/- 6, and Control Group 44 +/- 9 ml/min/100 gm)
      and in the supratentorial compartment (SAH Group 53 +/- 8, SAH+AF Group 61 +/- 9,
      and Control Group 51 +/- 13 ml/min/100 gm). At intermediate levels of hypercarbia
      (PaCO2 50 +/- 3 mm Hg), CBF increased similarly in all three groups (SAH Group
      161% +/- 32%, SAH+AF Group 118% +/- 33%, and Control Group 174% +/- 19% compared
      to baseline); at higher levels of PaCO2 (60 +/- 3 mm Hg), CBF values were SAH
      Group 265% +/- 50%, SAH+AF Group 205% +/- 47%, and Control Group 159% +/- 30% of
      baseline. At the highest level of PaCO2 (75 +/- 6 mm Hg), supratentorial CBF did
      not increase as much in the SAH+AF Group as in the Control Group (179% +/- 59%
      vs. 463% +/- 58% of baseline, respectively). The authors conclude that, in this
      model of SAH, there is no change in normocapnic CBF; however, blood flow
      reactivity to hypercarbia is blunted. It is possible that this may result from a
      combination of narrowing of proximal large vessels and globally impaired
      reactivity of small vessels.

PMID- 8487075
TI  - Cardiovascular responses to global cerebral ischemia: role of excitatory amino
      acids in the ventrolateral medullary pressor area.
AB  - The object of this study was to investigate the role of the ventrolateral
      medullary pressor area in mediating the cardiovascular responses to
      experimentally induced global cerebral ischemia, and to test if excitatory amino
      acids or acetylcholine are the transmitters released in this brain region during
      these responses. The cerebral ischemic response was elicited in pentobarbital
      anesthetized, artificially ventilated male Wistar rats by bilateral ligation of
      vertebral arteries followed by temporary clamping of the common carotid arteries.
      The pressor area was identified by microinjections of L-glutamate. Inhibition of
      neurons in this area by microinjections of muscimol, a gamma-aminobutyric acid
      receptor agonist, abolished the ischemic response, which demonstrated that this
      area is important in mediating these responses. Microinjections of a broad
      spectrum excitatory amino acid receptor blocker (kynurenate), of specific
      antagonists for N-methyl-D-aspartic acid (NMDA) and non-NMDA receptors (injected
      alone or in combination), and of atropine failed to block the ischemic responses.
      These results indicate that: 1) the ventrolateral medullary pressor area mediates
      pressor responses to cerebral ischemia, and 2) excitatory amino acids or
      acetylcholine in this area do not mediate the cardiovascular responses to
      cerebral ischemia.

PMID- 8487076
TI  - Epileptogenic effect of antibiotic drugs.
AB  - The epileptogenicity of antibiotic drugs represents a clinical problem, and it is
      well known that the use of penicillin and certain other preparations can induce
      seizures. In the present study, the authors investigated the epileptogenic
      properties of different concentrations of 12 commonly used antibiotic medications
      belonging to seven separate groups. The drugs were tested in the hippocampus,
      which has a low threshold for the development of epileptiform activity. The
      hippocampal slice technique, using rat tissue, was employed since absence of the
      blood-brain barrier allows administration of the drugs in known concentrations.
      The preparation was exposed to antibiotics in known concentrations and the
      amplitude and number of population spikes were recorded. Penicillin G was used as
      a reference substance. Cloxacillin (> or = 1 gm/liter), cephalothin (> or = 1
      gm/liter), gentamicin (> or = 80 mg/liter), chloramphenicol (> or = 1 gm/liter),
      ciprofloxacin (> or = 50 mg/liter), erythromycin (> or = 1 gm/liter), and
      ampicillin (> or = 1 gm/liter) showed moderate to marked epileptogenic effects,
      whereas cefuroxime, clindamycin, cefotaxime, vancomycin, and tobramycin had no
      epileptogenic effects.

PMID- 8487077
TI  - The effect of transforming growth factor-beta 2-specific phosphorothioate-anti
      sense oligodeoxynucleotides in reversing cellular immunosuppression in malignant
      glioma.
AB  - This in vitro study was aimed at restitution of transforming growth factor (TGF)
      beta 2-mediated suppression of T-lymphocyte activation within malignant gliomas.
      In early-passage tumor cell cultures of two glioblastomas (HTZ-153 and HTZ-209)
      and one malignant astrocytoma classified as World Health Organization Grade III
      (HTZ-243), autologous peripheral blood mononuclear cells were activated by
      interleukin-1 alpha and interleukin-2 in vitro (lymphokine-activated killer
      cells) and tested for cytotoxic and proliferative activity. In expression studies
      (Western blot and Northern hybridization) of all three tumors, TGF-beta could be
      detected at the protein and messenger ribonucleic acid (mRNA) levels. A
      polyclonal anti-TGF-beta neutralizing antibody did not enhance lymphocyte
      proliferation upon stimulation with tumor targets (3H-thymidine incorporation)
      and slightly stimulated lymphocyte cytotoxicity against autologous target cells.
      Preincubation of target cells for 12 hours with TGF-beta 2-specific
      phosphorothioate-anti-sense oligodeoxynucleotides (S-ODN's) did, however, enhance
      lymphocyte proliferation up to 2.5-fold and autologous tumor cytotoxicity up to
      60%, compared to controls not treated with S-ODN's. Incubation of tumor cells
      with TGF-beta 2-specific S-ODN's resulted in decreased TGF-beta-specific
      immunoreactivity in cultured glioma cells, in reduced TGF-beta 2 protein
      concentration (Western blot), and in a change in the expression pattern of TGF
      beta 2 mRNA's. These observations may have implications for in vivo and in vitro
      activation of a cellular immune response against autologous malignant glioma
      cells.

PMID- 8487078
TI  - Effect of recombinant tumor necrosis factor-alpha on three-dimensional growth,
      morphology, and invasiveness of human glioblastoma cells in vitro.
AB  - In order to investigate the antiproliferative and anti-invasive effects of tumor
      necrosis factor (TNF)-alpha on human glioblastoma cells, an in vitro three
      dimensional (anchorage-independent) assay was performed using Matrigel, a mixture
      of extracellular matrix proteins. Four glioblastoma-derived cell lines, including
      one cloned line, were cultured in Matrigel with or without TNF-alpha. In the
      Matrigel containing TNF-alpha, three of the four cell lines, including the cloned
      line, showed significant growth inhibition in a dose-dependent manner. Dramatic
      three-dimensional morphological differences were observed between TNF-treated and
      untreated glioblastoma cells cultured in Matrigel. Untreated cells formed large
      and highly branched colonies throughout the gel. In contrast, the majority of TNF
      treated cells demonstrated truncated branching processes and, at a high TNF-alpha
      dose, an increasing number of cells remained in relatively small spherical
      aggregates, their cell processes being significantly reduced. Quantitative
      invasion assay using a micro-Boyden chamber system confirmed that TNF-treated
      cells lost invasiveness in a dose-dependent manner. These results suggest that
      TNF-alpha exerts not only antiproliferative but also anti-invasive effects on
      human glioblastoma cells in vitro. It is believed that this is the first report
      showing the anti-invasive effect of TNF-alpha on tumor cells.

PMID- 8487079
TI  - A brain-tumor model utilizing stereotactic implantation of a permanent cannula.
AB  - A tumor model involving stereotactically implanted culture-reared tumor cells is
      presented. Stainless steel cannulas were stereotactically and permanently
      implanted into the caudate nucleus of 30 rats. The animals were separated into
      two groups. In Group I, 15 animals received a 10-microliters injection containing
      10(6) C6 glioblastoma cells (five rats), 10(6) Walker 256 breast carcinoma cells
      (five rats), or cell medium (five rats). The coordinates were A(+1.5), L(+3.0),
      and DV(-5.0). In Group II, the coordinates were changed to A(+1.0), L(+3.0), and
      DV(-5.0) and the same number of rats received a 1-microliter injection containing
      10(5) cells of each tumor in an attempt to produce more focal tumors. Two weeks
      after implantation, brain sections were stained with cresyl violet and a subset
      was stained for glial fibrillary acid protein (GFAP). A computerized morphometric
      analysis system was used to quantify tumor size. In Group I, the mean C6 tumor
      areas (+/- standard error of the mean) at specific coordinates were (in sq mm):
      A(+4.7) 0.4 +/- 0.2; A(+3.7) 3.5 +/- 1.1; A(+2.7) 5.7 +/- 1.7; A(+1.7) 9.5 +/-
      2.3; A(+0.7) 7.5 +/- 3.2; A(-0.3) 3.7 +/- 2.9; and A(-1.3) 0.3 +/- 0.3. A nearly
      identical tumor mass and extension into the brain was produced in rats injected
      with Walker 256 cells. Similar C6 tumor areas were indicated in adjacent sections
      stained with cresyl violet and GFAP. Tumor was found in the caudate nucleus in
      all 10 rats, but not in the nucleus accumbens, fornix, or hippocampus. In Group
      II animals, tumor magnitude and extension into the brain were greatly reduced.
      The 10(6) cells in the 10-microliters volume was the most reliable tumor load for
      obtaining uniform tumors in different animals. The similarity of tumor
      distribution across different animals was indicated by the low variance of tumor
      area at specific anteroposterior coordinates. Reproducible and well-circumscribed
      caudate nucleus tumors were produced using this stereotactic procedure.

PMID- 8487080
TI  - Myelomeningocele and thick filum terminale with tethered cord appearing as a
      human tail. Case report.
AB  - Tail-like caudal appendages may be associated with spinal dysraphism,
      particularly with spinal lipomas or lipomyelomeningoceles. An unusual case is
      presented of a patient with a myelomeningocele and a thick filum terminale with
      tethered spinal cord, which presented with the external appearance of a human
      tail. A review of the literature reveals that human tails may be associated with
      dysraphic conditions. Extensive neuroradiological examinations should be
      performed for all such cases of apparent tails.

PMID- 8487081
TI  - Transcallosal interforniceal approach for a posteriorly projecting high basilar
      bifurcation aneurysm. Case report.
AB  - A transcallosal interforniceal approach was used for treatment of a posteriorly
      projecting high basilar bifurcation aneurysm with a neck located 30 mm above the
      posterior clinoid process. The aneurysm was successfully clipped via the third
      ventricle with minimal neurological deficits. This approach appears to be
      appropriate for basilar bifurcation aneurysms located more than 20 mm above the
      posterior clinoid process when the fundus projects posteriorly, and permits
      direct visualization of the aneurysmal neck and vital perforators with minimal
      brain retraction.

PMID- 8487082
TI  - Giant serpentine middle cerebral artery aneurysm treated by extracranial
      intracranial bypass. Case report.
AB  - Giant intracranial aneurysms often pose difficult management issues. Such
      aneurysms may not be amenable to direct surgical attack because of their size,
      location, or lack of a clear aneurysmal neck. In such cases, a combination of
      strategies may provide a means of proximal aneurysm occlusion and distal cerebral
      revascularization. The authors report the successful treatment of a giant (186.8
      ml) serpentine aneurysm of the left middle cerebral artery (MCA) in a 14-year-old
      boy. The aneurysm was managed in a two-stage procedure in which the MCA branches
      distal to the aneurysm were anastomosed first with branches of the left
      superficial temporal artery. After the bypass procedure, direct occlusion of the
      MCA was performed at the proximal base of the aneurysm at its site of dilatation.
      The patient had no intraoperative or postoperative complications and was intact
      neurologically 6 months following the procedures.

PMID- 8487083
TI  - Optic nerve ganglioglioma. Case report.
AB  - Gangliogliomas of the optic nerve are extremely rare. The case is reported of a
      38-year-old man who presented with a visual field deficit and was discovered to
      have an optic nerve ganglioglioma. The possible embryological origins of this
      neoplasm, its histological and immunohistochemical features, and its appearance
      on magnetic resonance imaging are examined. The prognoses of optic nerve glioma
      and of gangliogliomas occurring elsewhere in the nervous system are compared.

PMID- 8487084
TI  - Superficial temporal artery interposition graft after resection of bilateral
      anterior cerebral arteries. Case report.
AB  - A patient with an olfactory neuroblastoma in the frontal skull base was treated
      with primary tumor excision and partial resection of the A2 segment of both
      anterior cerebral arteries (ACA's). Revascularization was carried out using a
      superficial temporal artery (STA) interposition graft between the proximal and
      distal stumps with A3 segment-to-A3 segment end-to-side anastomosis. This
      technique established flow to the peripheral territories of the ACA's through the
      interposed STA graft. The technical aspects and possible role of this procedure
      are presented.

PMID- 8487085
TI  - A study of safe entry zones via the floor of the fourth ventricle for brain-stem
      lesions. Report of three cases.
AB  - Direct surgery for intra-axial lesions of the brain stem is considered a
      hazardous procedure, and morbidity of varying degrees cannot be avoided even with
      partial removal or biopsy. The main causes of morbidity relate to direct damage
      during removal of the lesion, selection of an entry route into the brain stem,
      and the direction of brain stem retraction. The authors examined the possibility
      of making a medullary incision and retracting the brain stem, taking into account
      the symptomatology and surgical anatomy, and found two safe entry zones into the
      brain stem through a suboccipital approach via the floor of the fourth ventricle.
      These safe entry zones are areas where important neural structures are less
      prominent. One is the "suprafacial triangle," which is bordered medially by the
      medial longitudinal fascicle, caudally by the facial nerve (which runs in the
      brain-stem parenchyma), and laterally by the cerebellar peduncle. The second is
      the "infrafacial triangle," which is bordered medially by the medial longitudinal
      fascicle, caudally by the striae medullares, and laterally by the facial nerve.
      In order to minimize the retraction-related damage to important brain-stem
      structures, the brain stem should be retracted either laterally or rostrally in
      the suprafacial triangle approach and only laterally in the infrafacial triangle
      approach. Three localized intra-axial brain-stem lesions were treated surgically
      via the safe entry zones using the suprafacial approach in two and the
      infrafacial approach in one. The cases are described and the approaches
      delineated. Both approaches are indicated for focal intra-axial lesions located
      unilaterally and dorsal to the medial lemniscus in the lower midbrain to the
      pons. Magnetic resonance imaging is useful in selecting these approaches, and
      intraoperative ultrasonography is helpful to confirm the exact location of a
      lesion before a medullary incision is made. These approaches can also be used as
      routes for aspiration of brain-stem hemorrhage as well as for tumor biopsy.

PMID- 8487086
TI  - Biopsy-proven isolated sarcoid meningitis. Case report.
AB  - Neurosarcoidosis without systemic involvement is rare and difficult to diagnose.
      The case of a 27-year-old man with a 6-week history of headache, mental status
      changes, and polyradiculopathy attributable to hypoglycorrheic lymphocytic
      meningitis is presented. Extensive testing for occult systemic sarcoidosis was
      negative. The presence of noncaseating granulomatous inflammation was established
      by open brain biopsy, and the patient improved clinically with oral steroid
      therapy. In individuals with undiagnosed chronic meningitis, brain biopsy may be
      necessary to rule out isolated neurosarcoidosis.

PMID- 8487087
TI  - Systemic T-cell lymphoma presenting with isolated neurological dysfunction and
      intraparenchymal brain lesions. Case report.
AB  - Secondary non-Hodgkin's lymphoma of the central nervous system is typically a
      late manifestation of systemic T-cell lymphoma, with a 2-month median survival
      time after the development of neurological disease. Of the reported patients with
      this late complication, only 1% manifest spread of the disease to the brain
      parenchyma. The authors report a patient with an unusual initial neurological
      presentation of systemic T-cell lymphoproliferative disorder and associated space
      occupying lesions of the brain parenchyma. The diagnosis was supported by
      extensive molecular, immunological, and histopathological analysis. Neurological
      symptoms appeared early in the course of systemic disease and were characterized
      by spontaneous exacerbations and remissions. The patient has survived for more
      than 5 years since the onset of his neurological symptoms. Histopathological
      characterization including immunoperoxidase staining for T-cell markers, DNA
      content, and cell-cycle analysis of brain tissue obtained at stereotactic biopsy
      were compared to those of atypical lymphoid cells of peripheral blood, bone
      marrow, and liver. The neurological manifestations and possible etiologies of T
      cell lymphoma are discussed.

PMID- 8487088
TI  - Mary Shaw Shorb (1907-1990)

PMID- 8487089
TI  - Nutrient bioavailability, with special reference to calcium.
AB  - The term "bioavailability" attempts to include in a single concept the effect of
      a sequence of metabolic events, i.e., digestibility, solubilization, absorption,
      organ uptake and release, enzymatic transformation, secretion and excretion. Each
      of these events is difficult to measure experimentally, and, with the possible
      exception of digestibility and solubilization, all are age-dependent and subject
      to nutritional and hormonal controls. In the case of calcium, the body's demand
      increases and then decreases with age; it also increases with pregnancy and
      lactation. Age, pregnancy and lactation each affect the regulatable component of
      the intestinal absorption of calcium. The passive component of calcium absorption
      is a function of the amount of calcium solubilized and of intestinal transit
      time. Inasmuch as digestibility and solubilization of calcium are very difficult
      to determine separately, even a reliable measure of calcium absorption includes a
      measure of uncertainty. If one wishes to include in the term "calcium
      bioavailability" rates of net deposition in bone, as well as rates of excretion
      from the body, quantitative information on calcium pool size, turnover and the
      effects thereon of age, sex, endocrine and nutritional status are needed. In the
      case of other nutrients, rates of enzymatic transformation and organ utilization
      need also to be taken into account. It will therefore require major research
      programs before the term "bioavailability" of a nutrient can become a
      quantitative concept useful for clinical, nutritional or managerial evaluation
      and counseling.

PMID- 8487090
TI  - Degree of protein deficiency affects the extent of the depression of the
      antioxidative enzyme activities and the enhancement of tissue lipid peroxidation
      in rats.
AB  - To investigate the effects of various dietary protein levels on tissue lipid
      peroxidation and antioxidative enzyme activities, four groups of Long-Evans male
      weanling rats were fed a 6, 8, 12 or 20% lactalbumin diet for 6 wk. The red blood
      cell in vitro spontaneous hemolysis values were 28.6, 24.9, 18.9 and 14.1% for
      the rats fed the 6, 8, 12 and 20% lactalbumin diets, respectively. The
      thiobarbituric acid-reactive substances (TBARS) in plasma, RBC, liver, kidney,
      muscle, lung, spleen and heart were lowest in the group fed the 20% lactalbumin
      diet. Rats fed the diet containing 12% lactalbumin had significantly greater
      TBARS in plasma, spleen, kidney and muscle compared with rats fed the 20%
      lactalbumin diet. Rats fed the 8% lactalbumin diet had markedly higher TBARS
      levels (P < 0.05) in all tissues examined than did those fed the 12% lactalbumin
      diet. The TBARS in all eight tissues of the rats fed the 6% lactalbumin diet were
      even higher than those of rats fed the 8% lactalbumin diet (P < 0.05). The
      activities of glutathione peroxidase, superoxide dismutase and glucose-6
      phosphate dehydrogenase in RBC were gradually lowered (P < 0.05) when the dietary
      protein level was decreased stepwise. The activities of these antioxidative
      enzymes in liver also were reduced significantly when dietary protein level
      decreased from 20 to 12% and then to 8%. These enzyme activities in the rats fed
      the diet containing 6% lactalbumin generally were not different from those of the
      rats fed 8% lactalbumin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487091
TI  - Perinatal food restriction in rats reduces the content but not concentration of
      liver extracellular matrix proteins.
AB  - Fibrosis of the liver has been reported to be associated with malnutrition, based
      on qualitative histological and histochemical approaches. The aim of this study
      was to quantitatively examine the effect of perinatal food-restriction on the
      expression of extracellular matrix components of the liver, using rats fed 50% of
      ad libitum intake, determined by the food consumption of the control group on the
      previous day. Levels of extracellular matrix proteins were measured by dot blot
      analysis using monospecific antibodies against collagen types I, III and IV,
      laminin and fibronectin. The body weights of 4, 8 and 13-wk-old malnourished
      groups were 25, 35 and 48% of the control group body weights, respectively, and
      the liver weights were 22, 32 and 60% of the controls. The total contents of the
      extracellular matrix components were significantly reduced to 30, 34 and 58% of
      the controls, but when expressed per tissue or per milligram protein there were
      no significant differences. Indirect immunofluorescence revealed no major changes
      in extracellular matrix localization. The major histological change in the food
      restricted rats was fatty infiltration. Our observations suggest that the effect
      of perinatal food restriction is mainly liver steatosis, and that the liver of
      food-restricted animals during the perinatal period has the capacity to preserve
      its main extracellular matrix components.

PMID- 8487092
TI  - Metallothionein gene is expressed in developing rat intestine and is induced by
      zinc but not by corticosteroids.
AB  - The expression of metallothionein (MT) mRNA during perinatal development of rat
      intestine and its induction by zinc and corticosteroids were studied. Pregnant
      rats from d 17 to 22 of gestation and rats at 2, 4, 13 and 21 d of postnatal life
      were injected with saline solution (control) or with zinc (10 mg/kg body wt) or
      corticosteroids (1 mg/kg body wt). After 6 h, tissues were removed for analysis.
      Northern hybridization of polyA + RNA to 32P-MT-cDNA revealed that MT was
      expressed already at d 17 of fetal life, increased afterwards (reaching the
      maximal expression around birth) and decreased soon after until weaning.
      Metallothionein mRNA was markedly induced by zinc at d 18 of fetal life to a
      level that remained constant throughout postnatal life. Corticosteroids were
      ineffective in inducing MT gene expression during prenatal and postnatal
      development. In 21-d-old adrenalectomized rats the level of MT mRNA was similar
      to that of control rats of the same age and was not changed by hormone treatment.
      The results indicate that MT gene expression can be induced by zinc during fetal
      life and that its expression without exogenous inducers cannot be ascribed to
      circulating corticosteroids.

PMID- 8487093
TI  - Vitamin A deficiency impairs some aspects of the host response to influenza A
      virus infection in BALB/c mice.
AB  - We examined the impact of vitamin A deficiency on the host response to an acute,
      viral infection of the respiratory tract by infecting BALB/c mice with a mouse
      adapted strain of influenza A virus. Several indicators of the severity of
      infection were examined, including the rate of virus clearance from the lungs,
      the extent of inflammatory lesions, and percentage of survival. None of these was
      affected by vitamin A deficiency. Following the acute phase of infection,
      however, the regeneration of normal, respiratory epithelium was impaired and
      adenomatoid, metaplastic lesions developed within inflammatory foci in the lungs
      of deficient animals. The antibody response to infection was also characterized:
      the influenza A-specific immunoglobulin A (IgA) response in the respiratory tract
      was markedly decreased by vitamin A deficiency, but tracheal and lung lavage IgG
      titers were not affected. The serum IgM and IgG responses, and the serum
      hemagglutination-inhibition response, were also diminished by vitamin A
      deficiency. Decreased mucosal IgA titers and impaired regeneration of normal
      respiratory epithelium could impair recovery from a primary infection and
      increase susceptibility to opportunistic secondary infections.

PMID- 8487094
TI  - Vitamin E status does not affect the responses to exercise training and acute
      exercise in female rats.
AB  - Responses of vitamin E-depleted female rats to acute exercise and chronic
      exercise training were tested. Rats were fed either a control diet (+E rats) or a
      vitamin E-depleted diet (-E rats). After 8 wk, subgroups of the +E and -E rats
      performed treadmill exercise for 45 min at 28 m/min, 15% grade, and were
      immediately killed. Vitamin E concentrations were 80-90% lower in liver, heart
      and muscles in -E rats as determined by HPLC. There was no difference between +E
      and -E rats in blood lactate concentration, creatine kinase, lipid peroxidation
      indices, hematocrit or hemoglobin concentration following acute exercise.
      Remaining rats were either trained for a further 8 wk at 40 m/min, 15% incline
      for up to 60 min/d or served as untrained controls. No differences in training
      tolerance were seen between diet groups, with 64% of +E rats and 71% of -E rats
      consistently completing 60 min of daily training. The training induced similar
      adaptive elevations in succinate dehydrogenase activity (31-107%) in various hind
      limb muscles of both +E and -E rats. Trained +E rats had lower vitamin E
      concentrations in some but not all tissues when compared with untrained +E
      controls. These results suggest that consumption of a vitamin E-free diet for 8
      wk did not result in differences in blood indices associated with exercise stress
      or in the ability to perform a submaximal acute exercise test when compared with
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487095
TI  - Household and preschooler vitamin A consumption in southwestern Kenya.
AB  - This study examined the effects of an income-generating policy to expand the
      commercialization of subsistence agriculture in southwestern Kenya on household
      and preschooler macro- and micronutrient consumption. A representative sample of
      617 household was included, and all preschoolers under the age of 6 y (1677)
      residing in these households were included in the study. Results of this analysis
      indicate that although increases in household income do result in improved
      household level vitamin A consumption, increases in household income are not
      significantly associated with the intake of dietary vitamin A by preschoolers.
      The analysis suggests that although increases in household income have some very
      positive effects on household food security and household micronutrient
      consumption, other community-based health, sanitation and nutrition interventions
      are needed to address the dietary needs of individuals within the household.

PMID- 8487096
TI  - Human serum concentrations of all-trans beta- and alpha-carotene but not 9-cis
      beta-carotene increase upon ingestion of a natural isomer mixture obtained from
      Dunaliella salina (Betatene).
AB  - The uptake of all-trans and 9-cis beta-carotene and of alpha-carotene from a
      natural carotene preparation from Dunaliella salina, Betatene, was studied in
      humans. All-trans beta-carotene and alpha-carotene were absorbed well and showed
      the expected biokinetics with serum peak concentrations between 24 and 48 h. The
      mean increase in serum concentrations of alpha-carotene was 5.6% of the increase
      of all-trans beta-carotene, reflecting the composition of these carotenoids in
      Betatene. 9-cis beta-Carotene, however, was not detected in human serum, even
      after repeated doses. This could be due to preferential absorption of all-trans
      beta-carotene, rapid distribution of 9-cis beta-carotene into the tissue, or the
      presence of isomerase activity processing 9-cis to all-trans beta-carotene.

PMID- 8487097
TI  - Rat liver is not damaged by high dose tryptophan treatment.
AB  - Adult male Sprague-Dawley rats were treated with USP-grade L-tryptophan at a
      level of 250 mg/kg seven times over 14 d or three times over 3 d by gastric
      gavage. At autopsy liver specimens were prepared for histological study by stains
      specific for lipids, for glycoprotein and glycogen, and for fine structure by
      electron microscopy. Liver lipid did not accumulate as a result of tryptophan
      treatment. In a series of unfed animals, however, liver lipid had accumulated
      within 24 h of food withdrawal. Tryptophan has been implicated in fatty liver
      development by several reports that cite each other, but, in all cases but one,
      unfed animals were used, and the data show that liver lipid was already present
      in the unfed animals at the beginning of the experiment. Tryptophan has also been
      cited as causing abnormal liver morphology, but our evidence suggests that such
      observations are the result of artifact induced by frozen section preparation and
      not the result of tryptophan treatment. Our experiments indicate that tryptophan
      administered to rats at dosages in excess of those recommended for humans does
      not induce fatty liver or other morphological changes detectable by the methods
      described.

PMID- 8487098
TI  - Biological efficacy of copper in chicken bile.
AB  - Newly hatched chicks were fed a Cu-deficient casein-soybean concentrate diet
      (0.56 mg Cu/kg) during an 8-d pretest period, after which they were fed
      experimental diets containing graded levels of added Cu from CuSO4.5H2O during a
      15-d assay period. Following the Cu-depletion period, gall bladder Cu
      concentration decreased from 645 nmol/g dry matter at hatching to 60 nmol/g dry
      matter at d 8 posthatching; liver Cu concentration decreased during the same
      period from 255 to 225 nmol/g dry matter. During the subsequent 15-d repletion
      period, a sevenfold linear increase in gall bladder Cu occurred as Cu was
      supplemented up to 2 mg Cu/kg, after which it declined gradually in birds fed
      graded doses between 2 and 16 mg Cu/kg. Liver Cu also increased linearly as Cu
      was supplemented up to 2 mg/kg; when chicks were fed between 2 and 16 mg/kg of
      supplemental Cu, liver Cu concentration remained constant. Bile obtained from
      chicks fed 800 mg Cu/kg diet for 22 d was freeze-dried, analyzed and found to
      contain 3.05 mumol Cu/g dry matter. When 8-d-old Cu-depleted chicks were fed
      graded levels of supplemental Cu (0, 0.5 and 1.0 mg Cu/kg) from CuSO4.5H2O, bile
      Cu concentration increased linearly from 10.5 to 102.7 mumol/L. Bile Cu did not
      increase when freeze-dried bile (1.0 mg Cu/kg diet) was supplemented. When 0.5 mg
      Cu/kg from CuSO4.5H2O was supplemented in combination with 0.5 mg Cu/kg from
      freeze-dried bile, bile Cu concentration was less than one-half the level present
      in chicks fed 0.5 mg Cu/kg from CuSO4.5H2O alone.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8487099
TI  - Nutrient oxidation by rat intestinal epithelial cells is concentration dependent.
AB  - The kinetics of oxidative metabolism of glucose, glutamine, acetate and butyrate
      were determined in cells isolated from the jejunum and colon of young, fed rats.
      Jejunal and colonic cells were isolated from the same animal and incubated with a
      single radiolabeled substrate at concentrations ranging from 0.005 to 25 mmol/L,
      and 14CO2 production was determined. Carbon dioxide production was concentration
      dependent and saturable for all substrates. Data points within the range of the
      apparent half-maximal oxidation rate were transformed by use of a Lineweaver-Burk
      plot to calculate K(ox), the concentration at which there was half-maximal
      oxidation, and Vmax, the calculated maximal rate of oxidation. In jejunal cells,
      the K(ox) for glucose and glutamine were 0.40 and 0.45 mmol/L, respectively. The
      K(ox) for glucose, glutamine and acetate ranged from 0.80 to 0.88 mmol/L in
      colonocytes, whereas the K(ox) for butyrate was 0.33 mmol/L. Except for butyrate
      in colonocytes, the observed maximal rate of oxidation was comparable to the
      calculated maximal rate. The substrate concentration required to ensure that
      substrate was not limiting for its oxidation was estimated at 5 mmol/L for
      glucose and glutamine in enterocytes and colonocytes, 5 mmol/L for acetate in
      colonocytes, and 0.50 mmol/L for butyrate in colonocytes. This study showed that
      attention needs to be given to the concentration of substrate used for in vitro
      studies.

PMID- 8487100
TI  - Total parenteral nutrition containing medium- vs. long-chain triglyceride
      emulsions elevates plasma cholesterol concentrations in rats.
AB  - Male Fischer 344 rats (235-246 g) were fed for 6-14 d by intravenous or
      intragastric infusion with total parenteral nutrition (TPN) solutions providing
      40 or 65% of nonprotein energy as fat from long-chain triglyceride (LCT) or a 3:1
      admixture of medium-chain triglyceride (MCT) and LCT emulsions. In three separate
      experiments, plasma cholesterol concentrations were significantly greater (24
      32%) with intravenous infusion of TPN solutions containing MCT-LCT rather than
      LCT. Plasma cholesterol concentrations in rats were not significantly different
      with intragastric infusion of TPN solutions containing MCT-LCT rather than LCT.
      Hepatic total lipid and triglyceride concentrations were not significantly
      different. Hepatic total cholesterol and esterified cholesterol concentrations
      were significantly lower in animals given 65% of energy from MCT-LCT rather than
      LCT emulsions (main effects, two-way ANOVA). The concentration of individual
      hepatic acyl-CoA esters reflected the fatty acid profiles of the lipid emulsions
      infused. Total hepatic acyl-CoA concentrations suggested differences in
      utilization of acyl-CoA esters with intravenous infusion of MCT-LCT rather than
      LCT and were consistent with rapid oxidation of MCT. These data demonstrate that
      MCT-LCT elevates plasma cholesterol concentrations compared with LCT emulsions
      with intravenous, but not with intragastric, infusion of TPN solutions in rats.

PMID- 8487101
TI  - Growth is compromised in rats fed ozone-treated casein.
AB  - Modified casein containing few phenylalanine residues and no other aromatic amino
      acid residues was obtained by ozonolysis of casein. Although 68% of phenylalanine
      was decomposed by ozonolysis of casein, ozonolysis caused alterations beyond the
      destruction of aromatic amino acid residues. Nearly the same degree of
      decomposition of amino acid residues was observed in casein ozonated after
      predigestion by pepsin. Rats were fed diets containing 8% casein supplemented
      with methionine and aspartic acid (8C-AA), 8% ozonated casein supplemented with
      methionine and free amino acids lost by ozonolysis (8OC-AA), 8% casein ozonated
      after predigestion by pepsin supplemented with methionine and free amino acids
      lost during preparation (8POC-AA) or 7.6% amino acid mixture. The growth of rats
      fed the 8OC-AA diet was significantly lower than that of those fed 8C-AA or 7.6AA
      diets. The growth of rats fed the 8POC-AA diet was comparable to growth of those
      fed 8OC-AA. The biological values of the 8OC-AA and 8POC-AA were comparable to
      that of 8C-AA, but true digestibility of 8OC-AA was significantly lower than that
      of 8C-AA. True digestibility 8POC-AA was significantly improved relative to 8OC
      AA, but the growth of rats fed 8POC-AA was not improved relative to that of those
      fed 8OC-AA. Kidney and cecum weights of rats fed 8OC-AA and 8POC-AA were
      significantly heavier than those of the 8C-AA-fed group, although
      histopathological examination of kidneys showed no deterioration compared to that
      of the 8C-AA-fed group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487102
TI  - Hydrolysis of proline dipeptides completely fulfills the proline requirement in a
      proline-auxotrophic Chinese hamster ovary cell line.
AB  - Proline- and hydroxyproline-containing oligopeptides may be important in protein
      nutrition because intestinal hydrolases are incapable of recognizing their imido
      bonds. Peripheral tissues have a cytosolic enzyme prolidase that cleaves
      dipeptides containing C-terminal proline (X-Pro) or hydroxyproline. The role of
      dipeptides in intracellular metabolism is uncertain. This study examined the
      ability of X-Pro to provide proline to the proline-auxotrophic cell line, CHO-K1.
      The action of prolidase on exogenously supplied Gly-Pro, the most abundant
      dipeptide product of digestion, provided adequate proline to support normal cell
      growth of CHO-K1 cells in a dose-dependent manner. The growth curve generated by
      addition of Gly-Pro to CHO-K1 cells was similar to that due to proline. Two other
      structurally unrelated X-Pro also supported growth indistinguishably from Gly
      Pro. Gly-Hyp was completely ineffective for growth. The ability of X-Pro to
      sustain cultures of a proline-auxotrophic cell line may be important in
      elucidating intracellular nutritional and physiological functions for those
      dipeptides.

PMID- 8487103
TI  - Riboflavin requirement of healthy elderly humans and its relationship to
      macronutrient composition of the diet.
AB  - The riboflavin requirements of two groups of riboflavin-deficient, but otherwise
      healthy, Guatemalan elderly persons over the age of 60 y were studied by varying
      the fat:carbohydrate ratio in two diets. The first group consumed a diet similar
      in macronutrient content to a Western-type diet with low carbohydrate and high
      fat; the second group consumed a typical Guatemalan diet with high carbohydrate
      and low fat. Energy and protein intakes of both groups were similar. Riboflavin
      status was monitored by weekly measurements of erythrocyte glutathione reductase
      activity coefficient (EGRAC) and urinary riboflavin excretion. Increasing
      increments of riboflavin were added to the subjects' diets until their status was
      normalized, as indicated by EGRAC of < 1.34 and a sharp increase in urinary
      riboflavin excretion. Using the EGRAC method, the mean value of riboflavin intake
      at which the subjects' EGRAC reached the limit of normality was 1.37 +/- 0.03
      mg/d in the first phase and 1.29 +/- 0.03 mg/d in the second phase. The sharp
      increase in urinary excretion occurred at riboflavin intakes of 1.13 and 1.03
      mg/d for Groups 1 and 2, respectively. Thus, the differences between the two
      groups suggest that diets with a lower fat:carbohydrate ratio can decrease the
      dietary need for riboflavin. The dietary requirement of riboflavin, as estimated
      by the more reliable urinary excretion method, was 1.1-1.3 mg/d for those
      consuming the Western-type diet, which is similar to values found over 40 y ago
      in young adults. We conclude that the dietary requirements of riboflavin in the
      elderly do not differ from those of young adults.

PMID- 8487104
TI  - Liver vitamin A levels in rats are predicted by a modified isotope dilution
      technique.
AB  - We tested the hypothesis that the fraction of an injected dose (FDp) of
      [3H]retinol remaining in plasma could be used to predict liver vitamin A mass.
      Rats (n = 36) with liver vitamin A ranging from 1.4 to 23,000 nmol received an
      intravenous dose of [3H]retinol-labeled plasma. Plasma samples obtained at 4,
      4.4, 5, 5.4, 6, 7 and 8 d were analyzed for radioactivity; liver vitamin A levels
      were determined at 8 d. Using a regression equation developed previously [liver
      vitamin A (nmol) = 7493.exp(-148.FDp)], there was a log linear relationship
      between FDp and liver vitamin A mass from 1.4 to 5200 nmol retinol; the equation
      did not predict levels > or = 7500 nmol. By expanding the regression equation
      [liver vitamin A (nmol) = 88,928.exp(-1347.FDp) + 5606.exp(-120.FDp)] and using
      the FDp at 4.4 d, liver vitamin A levels ranging from < 4 to 23,000 nmol were
      well predicted. Satisfactory equations were also developed for data obtained at
      4, 5 and 5.4 d. We conclude that this modified isotope dilution technique is a
      sensitive and reliable method for assessing vitamin A status in rats over a wide
      range of vitamin A nutriture. It is likely that this method could be modified for
      use in humans.

PMID- 8487105
TI  - Gastric acid production, iron status and dietary phytate alter enhancement by
      meat of iron absorption in rats.
AB  - This study was designed to determine whether gastric acidity, added phytate or
      iron status significantly influenced the effects that dietary proteins have on
      iron absorption. Rats were fed test meals of wheat cereal, with and without an
      added dietary protein (beef, pork, chicken, fish or egg white), by gavage. The
      influences of phytate and gastric acid were investigated by adding sodium phytate
      to the test meals and by treating the rats with cimetidine to inhibit gastric
      acid production. Iron status was altered by dietary regimens. Significant (P <
      0.05) effects of the proteins were determined by comparison of the various
      protein-containing meals to control meals of cereal or cereal + phytate, as
      appropriate. Gastric acidity, phytate and iron status were all confirmed as
      factors significantly affecting iron absorption. Beef, pork and chicken enhanced
      iron absorption, but only when phytate had been added to the meals and only in
      iron-deficient rats. Enhancement by meat was sufficient to overcome the
      inhibition by phytate. Fish was an inhibitor or enhancer in cimetidine-treated,
      iron-deficient rats, depending on the absence or presence of phytate,
      respectively. Egg white inhibited absorption from cereal meals in cimetidine
      treated, iron-deficient rats.

PMID- 8487106
TI  - Amino acid compositions of body and milk protein change during the suckling
      period in rats.
AB  - The amino acid concentrations of rat body protein and rat milk protein were
      measured at 1, 6, 10 and 16 d of age to determine whether the concentration of
      each amino acid in proportion to the concentration of total recovered amino acids
      (amino acid composition) in the body changes during early growth and development
      and whether parallel changes occur in the amino acid composition of milk. The
      ratio of essential to nonessential amino acids in bodies decreased 10% during the
      suckling period (P < 0.05). The ratio of essential to nonessential amino acids in
      milk proteins decreased by 6% (P < 0.05). With the exception of threonine, the
      body to milk ratio for each essential amino acid seemed similar to that for the
      other essential amino acids, implying that most essential amino acids are equally
      limiting for the synthesis of body protein in exclusively milk-fed pups.
      Measurements of milk intake and milk composition were used to determine amino
      acid intakes and hence the efficiency with which milk amino acids were used for
      body protein deposition. The efficiency of essential amino acid utilization was
      75% between 1 and 6 d, 86% between 6 and 10 d, and 62% between 10 and 16 d of
      age. Although the overall efficiency of nonessential amino acid utilization
      showed a similar pattern, the results suggested the need for a high degree of
      glycine and arginine synthesis.

PMID- 8487107
TI  - The form of response of body protein accretion to dietary amino acid supply.
AB  - The mean response of body protein accretion in growing animals to their amino
      acid intake is sometimes described by a rectilinear ("broken-line") model and
      sometimes by a curvilinear model. The response of a population may be curvilinear
      as a result of averaging individual rectilinear responses or because individual
      responses are themselves curvilinear. This experiment was undertaken to
      distinguish these possibilities by examining the responses of individual animals.
      Eighteen pigs with a mean initial weight of 35 kg and a mean final weight of 73
      kg were each fed, in a different sequence, six diets providing a daily nitrogen
      intake of 0.5, 1.5, 1.83, 2.17, 2.5 or 3.5 g/kg body wt0.75. Each diet was given
      for 10 d, with complete collections of feces over the last 6 d and of urine over
      the last 4 d. Rates of nitrogen retention (expressed per kg0.75 per day) were
      related to rates of nitrogen intake (in the same units) using a rectilinear
      (broken line), an exponential or a saturation kinetics model. Mean square errors
      were significantly larger for the rectilinear model than for either of the
      curvilinear models and were slightly but not significantly less for the
      saturation kinetics model than for the exponential model.

PMID- 8487108
TI  - Determination of nutritional requirements in rats: variation with time of weight
      gain responses to indispensable amino acids.
AB  - The Saturation Kinetics Model (SKM) can be used to describe physiological
      responses as functions of a limiting dietary nutrient. Physiological responses
      also vary with time, and, by graphing each parameter of the SKM as a function of
      time, the model equation can be used to produce a three-dimensional response
      surface, allowing the investigator to predict requirement as a function of both
      dietary nutrient concentration and time. To test this hypothesis, rats were fed
      diets containing graded levels of indispensable amino acids (0-10 g/100 g). The
      inhibition form of the SKM was able to predict the complete response range of
      weight gain, food intake, weight-specific weight gain and weight-specific food
      intake for each amino acid on a day-by-day basis. With a complete response range
      established, nutrient requirements (defined as maximum responses) could be
      determined explicitly by the equation: Requirement = (K0.5.KS)0.5, where K0.5 and
      KS are parameters of the SKM. No arbitrary decisions (such as break points,
      slopes, percentages of maximum, etc.) were necessary to accomplish this. This
      approach allows one to set nutritional requirements and optimize responses in a
      dynamic system without causing inhibiting and/or toxic responses. In each case
      (valine, methionine, threonine and histidine), the dietary amino acid
      concentration required for maximal weight gain exceeded current NRC
      recommendations, which may be low because they fall in the more time-dependent
      portion of the response curve whereas maximum responses do not.

PMID- 8487109
TI  - Colon and stomach cancer mortality among automotive wood model makers.

PMID- 8487110
TI  - Board-certified occupational physicians.

PMID- 8487111
TI  - What is the current treatment of asphalt skin burns?

PMID- 8487112
TI  - Walking by circular saws used to cut aluminum caused increasing pain at a
      previous laceration site. Is there a connection between sound energy and
      increasing wound pain?

PMID- 8487113
TI  - Laser hazards in research laboratories.
AB  - Laser use is expanding rapidly in laboratories, where multiple use strategies of
      research are not often amenable to laser engineering safeguards employed in
      industry. We report on five cases of laser-associated incidents requiring medical
      follow-up from a single research institution, and present exposure circumstances
      from four other incidents. Eye injuries from direct and reflected beams resulted
      from open alignment procedures in the absence of appropriate eye protection.
      Nd:YAG lasers operated with doubling crystals appear to create a considerable
      risk. For several reasons, we believe the importance of laser-associated injuries
      are underestimated and the incidence underreported in the research setting.
      Although knowledge personnel are shown to suffer lapses in standard operating
      procedures, most incidents and all injuries involved relatively inexperienced
      personnel. We propose that research laser users be registered and required to
      undergo formal training in laser safety. Student researchers are a key target
      population. Collaborative implementation between the equipment supplier and
      research user will be required to achieve this widespread implementation of
      effective training.

PMID- 8487114
TI  - N-of-one clinical trials. The practice of environmental and occupational
      medicine.
AB  - The randomized clinical trial is the paradigm of causal documentation in clinical
      medicine. It spawned an extension, the "N-of-one clinical trial," used as
      diagnostic instrument in the clinical practice of internal medicine to
      demonstrate the presence or absence of truly beneficial treatment. The author
      presents an extension of the method to environmental and occupational medicine,
      provides an example, and discusses the limitations of the approach. A guideline
      and justification for the provision of such services is suggested.

PMID- 8487115
TI  - Employment in electronics manufacturing and risk of spontaneous abortion.
AB  - A large case-control study of environmental risk factors for spontaneous abortion
      was conducted among women living in Santa Clara County, California. Because of
      the prevalence of electronics production work within this population, a
      specialized questionnaire was administered to women who self-identified as
      electronics production workers. Spontaneous abortions were identified from
      pathology records, and controls were identified from birth certificates. The odds
      ratio for spontaneous abortion and any electronics production work was 0.94 (95%
      confidence interval = 0.58, 1.5). Odds ratios for the three main branches of
      electronics production (semiconductor fabrication, printed circuit board
      manufacturing, and assembly) were likewise near or below unity. Specific
      production activities with elevated odds ratios included semiconductor diffusion,
      parts encapsulation, soldering, and flux removal, although the numbers were small
      and none of the confidence intervals excluded unity. Limitations of this study
      included modest statistical power and a potential for nondifferential
      misclassification of exposures, both of which could bias findings toward the
      null.

PMID- 8487116
TI  - Healthy worker effect in a cross-sectional study of lead workers.
AB  - To study the role lead may play in the development of renal disease, we performed
      a cross-sectional study of workers at a lead smelting plant. Renal function was
      defined based on calculated creatinine clearance using the prevalence of values
      under the 3rd percentile to compare groups. The prevalence of calculated
      creatinine clearance values under the 3rd percentile in these workers (n = 1782)
      as a whole was 2.81%, a result comparable to that which has to be expected for
      the general population. Closer analysis, however, showed significantly lower
      prevalence of calculated creatinine clearance under the 3rd percentile in certain
      subgroups of workers. These subgroups were workers between the ages of 30 and 39,
      workers over the age of 50, and Belgian workers who had worked in the plant for
      longer than 10 years. We conclude that these observations once more clearly
      demonstrate a "healthy worker effect" on the measurement of renal function in
      this work force, a major problem in epidemiologic cross-sectional studies.

PMID- 8487117
TI  - Dermatitis in workers exposed to antimony in a melting process.
AB  - An employee at a brazing rod manufacturing plant developed a generalized eruption
      of follicular papules and pustules. His job tasks included breaking up antimony
      ingots and melting the pieces in a crucible; he was exposed to antimony metal
      dust and to antimony trioxide fumes. Two fellow employees who later performed the
      same job tasks developed similar eruptions. The clinical and workplace
      evaluations suggested that the fumes from melting antimony were the cause of the
      dermatoses, and that the current Occupational Safety and Health Administration
      permissible exposure limit is not adequate to prevent cutaneous effects of
      antimony exposure.

PMID- 8487118
TI  - Multidisciplinary rehabilitation of chronic work-related upper extremity
      disorders. Long-term effects.
AB  - The prevalence of work-related upper extremity disorders has significantly
      increased in the past decade. Persistent pain, loss of function, and associated
      work disability in patients with work-related upper extremity disorders appears
      to be affected by multiple factors including physical capabilities in relation to
      work demands, ergonomic risk factors on the job, and psychological factors
      related to worker traits, psychological readiness to return to work, and ability
      to manage symptoms. The complex nature of these disorders suggests the utility of
      a multidisciplinary program targeted at these factors. The present study is an
      investigation of the long-term vocational outcome of a multicomponent
      rehabilitation program that includes physical conditioning, work conditioning,
      work-related pain and stress management, ergonomic consultation, and vocational
      counseling/placement. Two groups equivalent on measures of duration of work
      disability, pain severity, fear of reinjury, psychological distress, perceived
      work environment, age, and education level were exposed to either the
      comprehensive work rehabilitation intervention (n = 19) or usual care (n = 15).
      Return-to-work status was determined at an average of 17 months posttreatment
      (range, 3 to 35 months) for the treatment group and an average of 18 months
      postevaluation (range, 5 to 30 months) for the usual care group. Findings
      indicated that 74% of the treatment group returned to work or were involved in
      state-supported vocational training in contrast to 40% of the control group (P <
      .05). For those who returned to work, 91% of the treatment group were working
      full-time in contrast to 50% of the control group (P < .05). Although the
      treatment group demonstrated a higher return-to-work rate than controls, the work
      reentry rate was not as high as similar approaches with work-related low back
      pain (80% to 88% return-to-work rate). These findings suggest the need to modify
      treatment components to facilitate an increased return-to-work rate. Areas that
      may prove useful include a greater emphasis ergonomic modifications at the
      workplace to reduce the risks of repetitiveness, force, awkward posture, and
      insufficient work/rest cycles, as well as efforts to modify work style directly
      in order to reduce the impact of ergonomic stressors on the ability to perform
      essential job tasks. In combination with traditional work hardening efforts
      directed at improving strength and flexibility of the upper extremities and work
      related pain and stress management training, these ergonomic and work-style
      modification efforts may contribute to increases in the percentage of work
      disabled cases who successfully return to competitive work.

PMID- 8487119
TI  - Biochemical indicators of hazardous shoulder-neck loads in light industry.
AB  - Prolonged, repetitive handling of light material is known to increase the risk of
      shoulder-neck disorders. Biological risk indicators related to musculoskeletal
      exposure, applicable by the general practitioner in the workplace, could provide
      an instrument for early intervention and rehabilitation. Eight women were
      studied, all full-time workers performing assembly tasks associated with a high
      prevalence of shoulder-neck complaints. All subjects were more tender in the
      shoulder region than young women in low-risk occupations. Heart rate recordings
      indicated a low general metabolic load during work. Concentrations in antecubital
      venous blood of several markers for metabolic stress and cellular damage
      (lactate, ammonia, hypoxanthine, urate, malondialdehyde, potassium, creatine
      kinase) were normal for all subjects, and showed no increase during 3 consecutive
      working days. Thus, the blood markers did not reflect hazardous shoulder-neck
      exposure.

PMID- 8487121
TI  - A cohort mortality study of two California refinery and petrochemical plants.
AB  - This study examined the 1973 to 1989 mortality experience of Shell's two
      California manufacturing locations' employees who worked more than 6 months
      before December 31, 1989 and pensioners who were alive as of January 1, 1973.
      Vital status of each employee as of December 31, 1989 was determined from various
      sources including company records, the National Death Index, and the Social
      Security Administration's Master Beneficiary Record file. The study included many
      long-term employees, with more than half (57%) of the total population working 20
      years or longer. The total population exhibited 11% lower all causes mortality
      and 20% lower cancer mortality, as compared with the California general
      population. There were no significant excesses of any cause-specific mortality
      including cancer. Among total employees, mortality for several cancer sites
      showed a statistically nonsignificant increase, for example, cancer of the kidney
      (8 observed deaths and 6.02 expected), cancer of the bladder (11 observed deaths
      and 9.17 expected), and Hodgkin's disease (2 observed deaths and 1.01 expected).
      A review of these work histories revealed no predominant work area or job
      assignment. In contrast to the ecologic studies based on local county rates, lung
      cancer mortality in this study was significantly lower (Standardized Mortality
      ratio [SMR] = 0.73). In addition, statistically significant deficits in mortality
      were found for cirrhosis of the liver (SMR = 0.63) and all external causes of
      death (SMR = 0.74). This study also failed to show an increased mortality rate
      for cancers of the brain, stomach, and prostate--causes which have been reported
      to be elevated in other refinery and petrochemical employee studies.

PMID- 8487120
TI  - The Canadian Labour Force Ten Percent Sample Study. Cancer mortality among men,
      1965-1979.
AB  - The mortality experience of 415,309 men enrolled in the Canadian Labour Force 10%
      Sample Study has been updated to the end of 1979. The occupation and industry in
      which these men were employed between 1965 and 1969 were available, and these
      records were matched to the Canadian National Mortality Data Base by computerized
      record linkage. A total of 9,739 deaths from cancer between 1965 and 1979 were
      identified. Analyses were conducted with respect to men employed in 274
      occupations and 294 industries with respect to mortality from 33 different types
      of cancer resulting in 243 associations in which the 90% lower confidence bound
      for the relative risk compared to the whole cohort had a value of 1.0 or greater.
      Based on the criteria of strength of association, dose-response, and consistency,
      23 associations were identified as being of particular interest. Of these
      associations, four (waiters, bartenders and breweries with cancer of the buccal
      cavity and pharynx, and bartenders with lung cancer) seem most likely to be
      caused by excess smoking and/or alcohol consumption, and could provide a useful
      guide for intervention strategies focused on those employed in these occupations.
      A further seven (carpenters and stomach cancer, clerical occupations and colon
      cancer, truck drivers, plumbers and pipefitters, sheet metal workers,
      shipbuilding and repair, and asbestos products manufacturers with lung cancer)
      have support in terms of biological plausibility and/or other studies in the
      literature and appear to warrant more intensive study. The third group of
      associations, although demonstrating strength of association, a dose-response
      effect, and/or consistency, may well have arisen by chance given the many
      comparisons made in this study.

PMID- 8487122
TI  - The effect of self-care brochures on use of medical services.
AB  - A random sample of 14,917 new enrollees in a state-wide health maintenance
      organization was selected as part of a study of the effectiveness of medical self
      care brochures. Medical ICD-9 codes related to each of the conditions described
      in the brochures were examined for the intervention group (N = 7439) and controls
      (N = 7478). Significantly less utilization was found for visits due to colds in
      the month following brochure distribution (P < .01). While not statistically
      significant, trends in the expected direction of less utilization for earaches
      and less total medical charges for the intervention group were also found. No
      significant differences were found related to headache and backache symptoms,
      although a greater proportion of the intervention group reported backache
      symptoms. Utilization related to sore throats and fever was significantly (P <
      .001) higher in the intervention group. These findings suggest that a minimal
      intervention such as brochure distribution can have a favorable, albeit minimal,
      impact on medical services utilization. Self-care education may also play a role
      in increasing utilization for certain types of health conditions.

PMID- 8487123
TI  - Immunological probing of induction and repair of 8-methoxypsoralen photoadducts
      in DNA from Fanconi anemia and normal human fibroblasts: quantitative analysis by
      electron microscopy.
AB  - A direct method of immuno-electron microscopy has been employed to simultaneously
      determine 8-methoxypsoralen (8-MOP) photoinduced monoadducts (MA) and interstrand
      cross-links (CL), their relative localization along the DNA molecule, and their
      removal. It has been applied to DNA from cultures of Fanconi anemia (FA)
      fibroblasts (complementation groups A and D), and of normal human fibroblasts,
      following treatment by 8-MOP and 365 nm radiation. The immuno-reaction with
      monoclonal antibody 8G1 was performed on DNA extracted from the cells just after
      photoreaction, or after a 24 h repair period, and then denatured. Furan-side MA
      and also a significant proportion of pyrone-side MA were very efficiently immuno
      detected. Only 1-2% CL were IgG-labeled. This is why CL were directly visualized
      and quantified on denatured DNA from the same cellular samples as used for immuno
      detection. Results demonstrate that FA group A cells are not only impaired in the
      incision of CL, but also of MA. The response of FA group D cells is intermediate
      between normal and FA group A cells.

PMID- 8487124
TI  - Protein dynamics and fluorescence quenching.
AB  - There are both theoretical and experimental data which strongly suggest that the
      intramolecular dynamics of the protein matrix play an important role in protein
      functions. The interrelationship between theory and experiments is rather weak
      mainly because of the lack of relevant experimental methods and (model-dependent)
      misinterpretation of experimental data. We give a short account of a few
      fluorescence-quenching techniques that can provide adequate information
      concerning protein dynamics provided that the experimental data sets are
      correctly processed.

PMID- 8487125
TI  - Structure-activity relationships for DNA photocleavage by cationic porphyrins.
AB  - The influence of molecular structure and DNA binding mode on the ability of
      cationic porphyrins to photosensitize DNA strand break formation has been studied
      for a series of meso-substituted pyridinium porphyrins using electrophoretic and
      DNA sequencing techniques. Porphyrins substituted with pyridyl groups in which
      the heterocyclic nitrogen is in the para or meta position vis-a-vis the
      substitution point are capable of intercalative binding and are considerably more
      efficient DNA photosensitizers than the corresponding non-intercalating ortho
      compounds. Within each group of porphyrins the photosensitizer efficiency
      increases with the number of positive charges. Using DNA sequencing experiments,
      we have demonstrated that photomodification occurs primarily at the guanine and
      thymine bases, and that alkali-labile sites produced by photo-oxidation are as
      important as direct cleavage events. The kinetics of strand degradation in
      aerated and degassed solution suggest that type II reactions (probably mediated
      by singlet oxygen) occur with significantly higher yield than type I reactions
      and are responsible for the formation of alkali-labile sites in aerated systems.
      These observations seem to confirm the hypothesis that those structural features
      which influence the strength and mode of binding also serve to establish
      favourable porphyrin-DNA interactions for photosensitization.

PMID- 8487126
TI  - Light-induced photon emission by mammalian cells.
AB  - In this work, the light-induced photon emission (IPE) by suspensions of mammalian
      cells was examined. IPE is extremely low and for detection in a single photon
      counting device with a cooled EMI 9558QB photomultiplier tube was used. The
      mammalian cells in this study were from different tissues and different mammalian
      species including cat, Chinese hamster, cow, dog, human, monkey, mouse and rat.
      The IPE was detected in all mammalian cells tested, but was different for the
      various cell types, ranging from 4 to 100 photons per 10(4) cells. Although our
      data agree with previous studies in that the IPE of non-fibroblastic normal cells
      is distinct from that of malignant cells our results reveal that cells of
      fibroblastic origin show the highest IPE values.

PMID- 8487127
TI  - Inactivation and mutation induction to 6-thioguanine resistance in V79 Chinese
      hamster fibroblasts by 313 nm radiation: some problems of action spectroscopy.

PMID- 8487128
TI  - Photoreactivation of DNA synthetic activity in human embryo fibroblasts.

PMID- 8487129
TI  - Flow cytometric analysis of DNA sensitivity to nuclease S1 in UVC-irradiated
      human fibroblasts.
AB  - The sensitivity of human fibroblast DNA towards the activity of nuclease S1 was
      investigated in situ after irradiation of the cells with UVC light. DNA digestion
      was assessed using flow cytometry by staining the nuclease-resistant DNA fraction
      with the specific fluorochrome propidium iodide (PI). The results showed a non
      linear dependence of DNA digestion on the UVC irradiation dose between 0 and 20 J
      m-2. About 70% of the UVC-induced DNA sensitivity to nuclease S1 was lost after
      30 min of repair. These results suggest that flow cytometry may be useful for
      assessing the heterogeneity of cell response to UV damage.

PMID- 8487130
TI  - The use of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT).

PMID- 8487131
TI  - Toxicity of local anesthetics in infants and children.
AB  - Local anesthetics are extremely useful for providing anesthesia and analgesia for
      infants and children of all ages. Despite the toxicity issues raised here, the
      overall safety record of local anesthetic use in pediatrics has been very good,
      and local anesthetic administration within safe guidelines should be encouraged.
      In the great majority of cases, toxic reactions have been associated with either
      inadvertent intravascular injection or unintentional overdosage by physicians who
      did not adequately consider issues related to systemic drug uptake, distribution,
      or clearance. Unlike opioids, which can be titrated according to clinical signs
      to a wide range of doses, local anesthetic administration must be strictly
      limited "by the numbers." Pediatricians, surgeons, emergency room physicians, and
      anesthesiologists need to be informed regarding limits for the administration of
      local anesthetics and management of toxic reactions.

PMID- 8487132
TI  - Psychologic perspectives on pediatric pain.
AB  - Pain has always been a salient feature for children because it occurs frequently
      in their everyday lives. We are only beginning to understand childhood pain. Yet,
      it is this understanding that influences our assessment and treatment of their
      pain. As with adults, pain in children is a complex matrix of biologic,
      psychologic, and sociologic phenomena. This article reviews what we know today
      about childhood pain and focuses on the psychologic perspectives that affect that
      pain experience. It outlines the psychologic elements that include: cognition,
      coping strategies, ability to communicate pain, fear, temperament, and
      personality as well as the sociologic factors, such as the family, culture, and
      economics, that influence children's perceptions and reactions to pain. The
      article concludes with a review of psychologic treatments of pain and an
      exploration of the effects of the psychology of adults, including professional
      anxiety and beliefs about pain and medication, on how pain is experienced by
      children.

PMID- 8487133
TI  - Eutectic mixture of local anesthetics (EMLA): what is it? What does it do?

PMID- 8487134
TI  - Topical anesthesia and pain management before venipuncture.

PMID- 8487135
TI  - Use of the eutectic mixture of local anesthetics in young children for procedure
      related pain.

PMID- 8487136
TI  - The use of topical anesthesia in removal of port-wine stains in children.
AB  - The control of pain associated with laser treatment of port-wine stains in
      children has been problematic. Using EMLA, a topical anesthetic, children can be
      treated with a significant reduction in laser-induced pain. In this prospective,
      double-blind, placebo-controlled, randomized trial of EMLA, 73 children (35 boys
      and 38 girls) ranging in age from 5 to 16 years with port-wine stains were
      treated. EMLA reduced mean pain scores 66% when compared with control subjects (p
      < 0.0001 for all three assessments of pain). Concordance between evaluators' and
      patients' assessment of pain scores correlated strongly (p < 0.001). Treatment
      with EMLA abolished pain in 40% of patients and the percentage of pain-free
      treatments increased from 10% to 52% (p < 0.001). EMLA is clearly effective in
      reducing or eliminating pain associated with laser treatment of port-wine stains
      in children.

PMID- 8487137
TI  - Needle phobia: an anesthesiologist's perspective.

PMID- 8487138
TI  - Identifying the best scenario for using schematic organizers as integration tools
      for alcohol-related information.
AB  - The goal of the present study was to examine scenarios for using two schematic
      organizers--schematic knowledge maps and conceptual matrices--in integrating
      episodic and semantic knowledge about alcohol. Seventy students from
      undergraduate general psychology classes participated for course credit.
      Participants were assigned to either a schematic organizer group or an essay
      writing group. These groups were subdivided further into two treatment sequences:
      episodic/semantic and semantic/episodic. The episodic activity required
      participants to complete materials using their own alcohol-related experiences,
      whereas the semantic activity required participants to annotate expert materials.
      Assessment measures used were consumer-satisfaction questionnaires and free
      recall tests. While no preferences were established for any one scenario, the
      episodic activities were rated higher than the semantic activities regardless of
      integration sequence. The semantic/episodic integration scenario did produce
      higher recall scores for the expert information.

PMID- 8487139
TI  - Gender differences and similarities in patterns of drug use and attitudes of high
      school students.
AB  - The purpose of this research was to study the results of a large scale drug
      survey of high school students in the context of the baseline data provided by
      four previous surveys. These surveys were conducted at three-year intervals
      beginning in 1977. The most recent survey contained self report data from 2,000
      students representing fifteen schools in northeast Ohio. The instrument yields
      information on fourteen categories of drugs. Gender differences in drug use,
      perceived harmfulness of drugs, and age of first experimentation are reported. No
      gender differences were found in the reasons students give for turning to drugs.
      Baseline data from the four previous surveys comprised approximately 8,000
      respondents.

PMID- 8487140
TI  - The relationship of cigarette smoking and other substance use among college
      students.
AB  - A questionnaire relating to cigarette smoking behavior and use of other
      substances was administered to 863 college students in the state of Oregon.
      Results indicated that there was not a significant difference between cigarette
      smokers and non-smokers with regard to use of smokeless tobacco, alcohol
      consumption, or marijuana use. There was, however, a significant difference in
      the use of other illicit substances when comparing cigarette smokers and non
      smokers. Cigarette smokers were much more likely to use illicit substances on an
      occasional or regular basis than were non-smokers. Smokeless tobacco users who
      indicated that they consumed alcohol and used marijuana and other illicit
      substances were more likely to consume more alcohol on a weekly basis than non
      users. They were also more likely to use marijuana and other illicit substances
      on an occasional and regular basis.

PMID- 8487141
TI  - Drug involvement among potential dropouts and "typical" youth.
AB  - Drug involvement, conceptualized as drug use frequency, drug access, drug use
      control, and adverse use consequences, is described and compared among two
      randomly selected groups of students aged fourteen to nineteen years: 203 low
      risk typical high-school students and 160 youths at high-risk of school problems
      and dropout. High-risk youth, compared to low-risk youth and national statistics,
      endorsed a much greater breadth and depth of drug use, greater access to drugs,
      less drug use control, and greater adverse consequences due to use. A secondary
      analysis showed low-risk users (experimenters) were similar to high-risk youth in
      their access to drugs and eroding drug use control, but showed low frequencies of
      drug use and negligible adverse use consequences. Measuring and exploring these
      four facets of drug involvement provided a robust picture of the adolescents'
      drug milieu and revealed differences in patterns of drug involvement that would
      not have been evident by looking purely at drug use frequency. Implications for
      prevention programming are suggested.

PMID- 8487142
TI  - HIV risk factors among pregnant and non-pregnant high-risk women in New York
      City.
AB  - A comparison of high-risk pregnant (n = 55) and non-pregnant (n = 598) women from
      Harlem, New York City on HIV-related drug and sexual risk behaviors was
      undertaken to identify appropriate prevention and intervention policy
      recommendations. Clients were recruited for an AIDS risk reduction research
      demonstration project and were either intravenous drug users (IVDUs) or sexual
      partners of IVDUs. There was a higher percentage of IVDUs among the non-pregnant
      women, and no significant differences were found between pregnant and non
      pregnant IVDUs in terms of needle risk behaviors. The two groups were also
      similar in non-injected drug use behaviors. Pregnant women were significantly
      less likely to use condoms. Recommendations focused on the need for increased HIV
      risk reduction among high-risk women in general, and increased education efforts
      among pregnant high-risk women regarding condom use as protection from HIV and
      the potential consequences of maternal substance use for their children.

PMID- 8487143
TI  - An outcome evaluation of Here's Looking At You 2000.
AB  - This study reports outcome evaluation results from a segment of one of the most
      widely used drug education/prevention programs entitled "Here's Looking At You
      2000." HLAY 2000 was offered to the seventh and eighth grade students (n = 463)
      by regular classroom teachers of Yadkin County Schools located in one of the
      rural areas in North Carolina. Six schools served as the experimental group while
      two randomly selected schools served as a control group. The program was
      implemented during the 1990-91 school year.

PMID- 8487144
TI  - Teacher ratings of student risk for substance use as a function of specialized
      training.
AB  - The purpose of this study was to determine if teachers' abilities to identify
      accurately students who are at risk for substance abuse can be improved through
      attendance at a specialized training program. Sixty-three eighth-grade teachers
      participated in the study. Of these, thirty-six teachers participated in the
      training sequence (intervention group), while the remaining twenty-seven teachers
      served as a comparison group. All eighth-grade students in the school district
      were surveyed regarding their substance usage. Teachers rated the students
      regarding their risk for substance usage. Teachers' ratings and students'
      reported substance usage were compared to assess the percentage of matching
      responses. After training, the intervention teachers provided more accurate
      ratings among usage categories than did the comparison teachers. The trained
      teachers were better at correctly identifying the students who were at risk for
      substance use.

PMID- 8487145
TI  - Extracurricular activities: are they an effective strategy against drug
      consumption?
AB  - This work describes data obtained among 16,117 high-school students in fifteen
      Brazilian cities, involving participation in a number of extracurricular
      activities and consumption of drugs and alcohol. In the great majority of cases,
      no association was found between attendance of artistic-, community-, or sports
      related activities and the use of these substances. On the other hand, a weak but
      constant negative association was found involving alcohol/drug consumption and
      attendance of religious activities. The authors discuss these findings in the
      light of some current preconceptions prevailing in Brazilian society: namely,
      that such activities constitute effective strategies for drug use prevention and
      the "idle" young persons tend to be potential drug users. They also discuss the
      implications that among students involved in religious activities drug and
      alcohol consumption was shown to become slightly lower.

PMID- 8487146
TI  - Hypertension during pregnancy in Africa and infants' health. A cohort study in an
      urban setting.
AB  - The objective of the study was to assess the prevalence of unclassified
      hypertension during pregnancy and its consequences on infant's health in an
      African urban setting: Pikine, a suburb of Dakar, Senegal. A cross-sectional
      study of a random sample of pregnant women and a prospective study, from the
      inclusion to seven days after delivery, were performed. 886 women attending the
      prenatal centers were included in the cross-sectional study. 471 pregnant women
      were included in the follow-up study. The prevalence of DBP > or = 120 mmHg was
      0.7%; 5.7% of the women had DBP > or = 95 mmHg. Longitudinal data were available
      for 425 deliveries. Two spontaneous abortions, 25 stillbirths, and 12 deaths
      during the early neonatal period were recorded. Among babies living at birth, the
      percentage of LBW (> or = 2500 g) was 8.5%. The percentages of adverse outcome of
      pregnancy (death and/or low birth weight) was associated with mothers' diastolic
      BP: < 85 mmHg: 13%; 85 to 89: 16%; 90 to 94: 9%; DBP > or = 95: 32%, (p < 0.01).
      Using 95 mmHg as a cutpoint, the relative risk of adverse outcome associated with
      a DBP > or = 95 mmHg was 2.5 (CI 95%: 1.4-4.3). This risk was significantly
      increased among women who reported difficult living conditions. Eight percent of
      the adverse outcomes of pregnancy, 10% of the low birth weights and 8% of the
      perinatal mortality were found to be associated with DBP > or 95 mmHg.

PMID- 8487147
TI  - Transvaginal color Doppler in the assessment of the uteroplacental circulation in
      normal early pregnancy.
AB  - Transvaginal color Doppler investigation of the uteroplacental circulation was
      performed on 108 pregnant women with normal intrauterine pregnancy. Decline of
      resistance index (RI) and pulsatility index (PI) and increase of peak systolic
      velocity (Ps velocity) were found in all segments of the uteroplacental
      circulation with advancing gestational age. There was a decrease of RI and PI
      from the uterine artery through its branches: arcuate, radial and spiral
      arteries. Ps velocities decreased from the uterine, through the arcuate, to the
      radial arteries, but Ps velocities in the spiral arteries were higher than those
      in the radial arteries. According to our results RI seems to be more precise in
      the assessment of the uteroplacental than the PI.

PMID- 8487148
TI  - Uterine activity in spontaneous labour and maternal peripheral plasma
      prostaglandin E2 and F2 alpha metabolites.
AB  - The relationship between maternal peripheral plasma concentrations of
      prostaglandin E2 and prostaglandin F2 alpha metabolites (bicyclo-PGEM and PGFM
      respectively) and the level of uterine activity in spontaneous labour was studied
      in 10 nulliparous and 10 multiparous women. Plasma prostaglandin metabolites were
      measured by radioimmunoassay. Uterine activity was quantified by computer
      analysis of changes in intrauterine pressure and expressed as mean active
      pressure (MAP). As labour progressed, both parity groups showed a significant
      rise in MAP which was associated with a significant increase in the levels of
      PGFM. However, the percentage rise in PGFM did not significantly correlate with
      the percentage rise in MAP. At all stages in labour PGFM and MAP levels were
      higher in the nulliparous group compared with the multiparous group. Bicyclo-PGEM
      levels showed no significant change in the nulliparous group but rose in late
      first stage/second stage in the multiparous group. Our observations support a
      role for prostaglandin F2 alpha in the generation of uterine activity in
      spontaneous labour. However, further study is required to elucidate the
      mechanisms controlling prostaglandin production by the fetal membranes and
      decidua in vivo, and how this relates to maternal peripheral plasma prostaglandin
      metabolite concentrations and the level of uterine activity.

PMID- 8487149
TI  - Staff views on parental visiting of very low birthweight infants in neonatal
      intensive care units--results of a staff enquiry across eleven countries of the
      European Community. EC-Study Group on Parental Involvement in Neonatal Intensive
      Care.
AB  - As part of a larger European study of parental visiting and involvement in the
      care of very low birth weight infants in neonatal intensive care units, the
      results of a self-completed anonymous enquiry of 1008 medical/nursing staff of 35
      units in 11 European countries are presented. The study demonstrates a general
      agreement with parental visiting and involvement, with sometimes striking
      differences in views of staff of different countries, but with little or no
      differences between medical and nursing staff. Staff with more than seven years
      experience in neonatal care have a less positive attitude towards parent's
      presence in the unit. The same holds true for staff of units that have a
      restricted policy toward parents' visiting, i.e. units which do not have a 24
      hours visiting policy for parents.

PMID- 8487150
TI  - Water birth--is it safe?
AB  - Water births have gradually become more popular in industrialized countries
      during the last decade. People advocating this form of delivery argue that the
      buoyancy in water helps the mother to relax and that the warmth helps reduce
      pain, meaning that the whole labor process and experience is positively
      influenced and even accelerated. Due to the sitting position and lower pressure
      gradient, there are supposedly fewer injuries to the birth canal, and delivery is
      also claimed to be easier on the child. However there is a great lack of
      scientific data. We have found only one publication in a peer reviewed journal
      with some 100 water births described. In a case controlled study not published
      the authors found fewer birth canal injuries and less use of analgesics but the
      difference was only slight. There was no difference in the length of labor.
      Several neonatal deaths are reported during uncontrolled water births. Based on
      the knowledge available to date, physiologic and general considerations (e.g.
      risk of infections, risk of hypoxia, risk of aspiration), water births must be
      classified as a type of obstetrical management, whereby the risks are still too
      undetermined to be said to be a safe form of birth. Water births should, thus, be
      restricted to centers with adequate medical assistance, and only in randomized,
      controlled studies who fulfill the Declaration of Helsinki. In any other setting
      water births should be rejected, since too little is known about the safety of
      this method.

PMID- 8487151
TI  - Influence of perinatal risk factors on the involution of the irido-pupillary
      membrane.
AB  - The aim of this study was to assess the influence of common perinatal risk
      factors on the disappearance of the anterior vascular capsule of the lens (AVCL).
      Direct ophthalmologic examinations were performed on 75 neonates (27 to 35 weeks
      gestational age) in the first 24 hours after birth, using the degree of
      involution of the AVCL to estimate gestational age in high risk pregnancy. Our
      results show that the gradual disappearance of the AVCL is not influenced by
      perinatal risk factors, such as maternal preeclampsia, prenatal administration of
      steroids, neonatal infection and low birth weight, confirming the clinical value
      of this test in the assessment of gestational age in high risk babies.

PMID- 8487152
TI  - Vitamin A status in preterm and term infants at birth.
AB  - Vitamin A status was determined in infants born at term or prematurely to assess
      if vitamin A levels at birth were related to gestational age. Vitamin A levels
      were measured in cord blood samples from 13 infants born at term and in blood
      samples obtained within two hours of birth in 26 preterm infants (median
      gestational age 31 weeks, range 27-35). None of the preterm infants developed
      chronic lung disease. The vitamin A levels of the term infants (median 0.71
      mumol/l, range 0.34 to 1.27) were significantly higher than those of infants born
      preterm (median 0.35 mumol/l, range 0.12 to 1.22), p < 0.01. Vitamin A levels
      correlated significantly with gestational age (vitamin A level = 0.024
      gestational age (weeks) -0.23, r = 0.39, p < 0.02. We thus conclude that
      gestational age must be taken into account when interpreting vitamin A levels.

PMID- 8487153
TI  - Antenatal diagnosis and outcome in hydrops fetalis.
AB  - The records of 15 cases of hydrops fetalis consecutively delivered at our
      institution were reviewed to determine the accuracy of antenatal diagnosis and
      whether antenatal diagnostic techniques yielded information useful in predicting
      outcome. All 15 cases were detected antenatally, five were due to rhesus
      haemolytic disease and 10 were non-immune hydrops. All the infants required
      active resuscitation. Ten infants eventually died, two had immune hydrops fetalis
      and 8 non-immune hydrops. Seven infants had pleural effusions, all had been
      detected antenatally. The presence of pleural effusions did not influence
      mortality. All structural abnormalities were accurately detected in those
      patients seen prior to labour and there were no survivors in the group of infants
      so affected. We conclude that the mortality of non-immune hydrops fetalis remains
      high and that antenatal diagnosis of this condition is accurate and provides
      useful prognostic information.

PMID- 8487154
TI  - Neonatal adaptation in hypertensive pregnancy--a study of labetalol vs
      hydralazine treatment.
AB  - Twenty mothers with moderate to severe preeclampsia were allocated to labetalol
      (Trandate) or hydralazine (Apresolin) antihypertensive treatment. Arterial blood
      gas analysis was performed at delivery from the clamped cord. Neonatal blood
      pressure, heart rate and axillary temperature were registered 0.5, 2, 6, 12, 24,
      36, 48 hours and 3, 4 and 7 days after birth. Respiratory rate was registered at
      the same intervals until 36 hours after birth. Blood glucose levels were measured
      2, 6, 12 and 24 hours after birth. Peripheral blood flow in the calf was measured
      at 24 hours of age. Gestational age did not differ between the two groups; 36 (27
      40) in the labetalol, and 35 (29-37) weeks in the hydralazine group (median and
      range). Median cord pH was lower, and the number of infants with a cord pH < 7.20
      was higher in the hydralazine group. Blood glucose levels were lower in the
      labetalol group at 6 hours of age (p < 0.05). No other differences were found
      between the two groups. The conclusion is that no clinical signs of adrenergic
      blockade have been found at 24 hours of age, and no negative effect of labetalol
      on the neonatal adaptation compared to hydralazine antihypertensive treatment was
      found.

PMID- 8487155
TI  - Characteristics of the spontaneous milk ejecting activity occurring during human
      lactation.
AB  - Continuous recordings of intramammary pressure performed in 158 normal lactating
      women, and 22 women during spontaneous labor were retrospectively analyzed in
      order to characterize spontaneous milk ejecting activity (SA). SA appeared as
      spurts of contraction waves as early as the first post-partum day and throughout
      the first two months of lactation. The spurts of SA differed from reflex milk
      ejection evoked by baby's suckling. It showed two different patterns: a) single
      contraction waves with a rapid rise time, a slow decay time, high amplitude and a
      short duration; b) multiple contraction waves with a longer rise and decay times,
      progressively decreasing intensity and a large duration depending on the number
      of contractions per spurt. The multiple pattern occurred in 34.2% (41/120) of
      patients at 2.7 +/- 0.1 days of post-partum and increased to 84.3% (59/70) at
      34.5 +/- 1.2 days. Accordingly, duration and the area under contraction curves
      increased throughout lactation. Mammary gland sensitivity to exogenous oxytocin
      (OT) did not change during the 2 months studies. SA was significantly greater in
      full nursing mothers than in the partially nursing ones. The existence of a
      system for milk-ejection different from baby's suckling was further described. A
      neuroendocrine mechanism and the release of increasing amounts of OT are
      suggested as important factors in the control of this phenomenon.

PMID- 8487156
TI  - [Structure-activity relationship of flavonoids in suppressing rat liver lipid
      peroxidation].
AB  - 145 flavonoids were studied for their inhibitory effects on the iron-induced
      lipid peroxidation in mitochondria obtained from rat livers. Of these compounds
      tested, 30, 57, 59, 67, 70, 72, 77, 102 and 110 (ED50 < or = 0.5 nmol/mg prot)
      showed distinctly more potent inhibitory activity than baicalein (ED50 < or = 5
      nmol/mg prot) and 59 and 72 (ED50 < or = 0.05 nmol/mg prot) exhibited the most
      potent activity. In order to elucidate the relationships between substituents on
      the flavonoid skeleton and the biological activity, the quantitative structure
      activity relationships (QSAR) were analyzed by the adaptive least-squares (ALS)
      method for 142 flavonoids. The analysis has shown that the presence of the 1,4-
      and 1,2-hydroquinone in A-ring and/or B-ring of flavonoids and hydrophobicity of
      the molecule are responsible for the in vitro inhibitory activity.

PMID- 8487157
TI  - [A simultaneous determination of honokiol and magnolol in oriental pharmaceutical
      decoctions containing magnolia bark by ion-pair high-performance liquid
      chromatography].
AB  - A simple method using ion-pair high-performance liquid chromatography was
      established for the rapid and precise simultaneous determination of honokiol (3',
      5-di-2-propenyl-1, 1'-biphenyl-2,4'-diol) and magnolol (5,5'-di-2-propenyl-1,1'
      biphenyl-2,2'-diol) in oriental pharmaceutical decoctions containing Magnolia
      bark. An ODS column and a mixture of water involving 10 mM tetra-n-amylammonium
      bromide (TAA) and acetonitrile (4:6) as a mobile phase were used for the
      separation. Honokiol and magnolol were eluted without interference of other co
      existing components within 12 min.

PMID- 8487158
TI  - [Crystal morphological and habit investigations of crystalline drugs. II.
      Amobarbital, barbital and ephedrine hydrochloride].
AB  - Crystal morphology, habit and refractive indices necessary for the analyses of
      amobarbital, barbital, phase III and ephedrine hydrochloride were studied using a
      polarizing microscope and partly using a reflexing goniometer. These substances,
      market products of Japanese Pharmacopoeia XII, were measured for optical
      properties including key refractive indices to confirm their modifications, and
      their possible facial angles along the zone of which axis is parallel to the
      elongated direction was also measured using a goniometer. Stereographic
      projections were drawn and the crystal habits of market products were shown by
      orthographic projections. It was also found that one of the key refractive
      indices of each modification was specially usable for the analyses of crystal
      habits including their crushed powders.

PMID- 8487159
TI  - [Interaction of camptothecin derivatives with human plasma proteins in vitro].
AB  - The interactions of camptothecin (CPT) and its derivatives (CPT-11 and SN-38)
      with human plasma proteins (serum albumin (HSA) and alpha 1-acid glycoprotein
      (alpha 1-AGP)) were studied mainly by means of ultraviolet and fluorescence
      spectroscopy. The binding constants of lactone ring-opened forms (A form) of CPT
      and CPT-11 with HSA were larger than those of the intact lactone forms (L form).
      In the case of SN-38, there was no difference in the constants between A form and
      L form. The binding constant of CPT (A form) with HSA was larger than those of
      CPT-11 and SN-38. The presence of cisplatin, which is presumed to be
      coadministered with CPT derivatives, did not affect the interaction of CPT
      derivatives with HSA. Only L form of CPT-11 among the CPT derivatives examined
      interacted with alpha 1-AGP, followed by quenching the fluorescence of alpha 1
      AGP.

PMID- 8487160
TI  - [Vicia graminea lectin or Vicia unijuga lectin-binding (Vgu) glycoproteins as new
      tumor-associated substances].
AB  - The purification and serological and chemical properties of Vicia graminea lectin
      (VGA) and Vicia unijuga lectin (VUA) were described, and then the binding
      specificity of anti-M and -N antibodies and both the lectins was discussed in
      this review. On the basis of the facts that Vgu glycoproteins which react with
      either VGA or VUA but not with anti-M and -N antibodies and were not detected in
      human normal organ tissues and sera, were separated and identified as mucin-type
      glycoproteins with very high molecular weights from human cancerous organ
      tissues, ascitic fluids of cancer patients and cyst fluids of human ovarian
      cystadenoma in malignant, it was concluded that Vgu glycoproteins are new tumor
      associated substances.

PMID- 8487161
TI  - Strength of the lens capsule during hydroexpression of the nucleus.
AB  - In planned extracapsular cataract extraction, hydroexpression of the nucleus has
      been introduced to facilitate nucleus delivery when performing capsulorhexis. The
      hydroexpression technique induces a fluid pressure in the capsular bag, which may
      rupture the posterior capsule. In a human cadaver eye model the pressure at the
      capsule's rupture point was determined in 16 cadaver eyes and compared to the
      fluid pressure in the capsular bag during hydroexpression of the nucleus in 32
      eyes. The posterior capsule was able to withstand a pressure of 59 +/- 10 mm Hg
      (mean +/- SD) without rupturing. During hydroexpression of the nucleus the
      pressure was less than 12 mm Hg (3 mm Hg to 12 mm Hg) when the diameter of the
      capsulorhexis opening was 5.5 mm or more (measurement in the anterior chamber).
      Thus hydroexpression of the nucleus seems to be a safe technique when the
      diameter of the capsulorhexis is 5.5 mm or more.

PMID- 8487162
TI  - Hydroexpression and viscoexpression of the nucleus through a continuous circular
      capsulorhexis.
AB  - When a continuous circular capsulorhexis (CCC) is performed, conventional nucleus
      expression may be impossible because of the strong capsular rim. Hydroexpression
      of the nucleus seems to overcome the problem if the capsulorhexis opening is
      large enough. Because a viscoelastic material may be an even more gentle tool
      than balanced salt solution (BSS), hydroexpression and viscoexpression were
      evaluated in 16 pairs of human cadaver eyes. The diameter of the capsulorhexis
      opening ranged from 4 mm to 6 mm; it was the same in each pair of eyes.
      Hydroexpression was performed in one eye using BSS and viscoexpression was
      performed in the fellow eye using sodium hyaluronate (Healon Yellow). The fluid
      pressure in the capsular bag was measured during both procedures. The pressure
      was higher during hydroexpression than during viscoexpression. The pressure
      difference between fellow eyes ranged from 0 to 32 mm Hg and was most marked when
      the CCC opening was small. This correlation was significant (P < .05).
      Viscoexpression may enhance the safety in cases with a small CCC opening or in
      those that are otherwise difficult.

PMID- 8487163
TI  - Assessment of the long-term corneal response to hydrogel intrastromal lenses
      implanted in monkey eyes for up to five years.
AB  - The biocompatibility of hydrogel intracorneal lenses (ICLs) implanted in monkey
      eyes was evaluated for periods ranging up to five years. Seventy-three plus or
      minus powered ICLs made of Lidofilcon A (68% water) or Lidofilcon B (79% water)
      were implanted following lamellar dissection with a microkeratome. Ten sham
      surgical procedures were performed without ICL implantation as controls. Eyes
      were followed for up to five years by slitlamp biomicroscopy and specular
      microscopy. Light and transmission electron microscopic evaluations of enucleated
      eyes were performed at various intervals. Minimal tissue reaction was noted; both
      hydrogel materials appeared to be equally well tolerated. Failures usually
      occurred as a result of microkeratome problems encountered during surgery.
      Histopathological changes to the cornea included epithelial thinning anterior to
      the thickest portion of the ICL, fibroblastic activity along the ICL-stromal
      interface, and deposition of an amorphous extracellular material adjacent to the
      ICL. These observations did not appear to be clinically significant as the eyes
      were quiet by slitlamp examination. Removal of three ICLs eight to ten months
      prior to enucleation restored the normal histological characteristics of the
      cornea. The endothelial cell density of ICL-implanted eyes decreased by 4.3% (n =
      17) six months after surgery but remained stable thereafter. The variation in
      endothelial cell area and percentage of hexagonal cells did not change over 50
      months. The results appear to demonstrate that high water content synthetic ICLs
      can be well tolerated in the monkey cornea for up to five years.

PMID- 8487164
TI  - Evaluation of intraocular pressure fluctuations with differing
      phacoemulsification approaches.
AB  - Simultaneous two-camera video tracings of phacoemulsification surgery and
      intraocular pressure fluctuations were made. The fluctuations were transmitted to
      a quartz pressure transducer through a chamber maintainer that was plugged into
      the anterior chamber. The transducer was connected to a monitor and recorder
      calibrated to measure pressure variations between -8.6 and +60 mm Hg. Using
      common audio for synchronization, the pressure tracings were keyed over the
      surgical videos and combined in a single film. High, medium, and low inflow
      volume techniques used by many surgeons exhibiting commensurately higher or lower
      intraocular pressure fluctuations were scrutinized. Methods to increase inflow
      volume without a proportionate pressure increase were devised.

PMID- 8487165
TI  - Corneal endothelial cell transplantation using Descemet's membrane as a carrier.
AB  - Rabbit corneal endothelial cells were transplanted into the right eyes of four
      New Zealand white rabbits using bovine Descemet's membrane as a cell carrier.
      Descemet's membranes were dissected from cow eyes, flattened on 36 mm culture
      dishes, and cut into discs with a 6 mm trephine. Rabbit corneal endothelial cells
      were seeded onto the discs and maintained in tissue culture conditions for seven
      days until a complete monolayer with a cell density of 3,000 cells/mm2 was
      formed. Before transplantation, corneal edema was induced in the host animals by
      an endothelial scrape wound, which removed the corneal endothelium. Five weeks
      later, the animals were prepared for transplantation. A corneal button was cut
      and placed on a dissection table so the host Descemet's membrane could be
      removed. The donor Descemet's membrane with a complete monolayer of rabbit
      corneal endothelial cells was placed on the stroma of the corneal button. To keep
      the donor membrane in place, the button was cauterized at three peripheral points
      and sutured back into the host eye. Prednisolone sodium phosphate eyedrops and
      dexamethasone eyedrops and ointment were applied twice daily during the post
      operative period. All grafts stayed clear for a period of 12 to 17 weeks. This
      study shows the potential for using Descemet's membrane as a carrier for corneal
      endothelial cell transplantation.

PMID- 8487166
TI  - Changes in corneal shape after suture cutting using the argon laser for
      postoperative astigmatism following cataract extraction.
AB  - We studied the changes in corneal shape after suture cutting with an argon laser
      to reduce corneal astigmatism following cataract extraction. Sixty-two patients
      who exhibited high with-the-rule astigmatism (> 3 diopters [D]) following
      extracapsular lens extraction had argon laser suture cutting. The patients were
      classified into three groups: Group A comprised 30 patients whose sutures were
      cut two to three months after planned extracapsular cataract extraction (p-ECCE);
      Group B consisted of eight patients who had the same treatment five to nine
      months after p-ECCE; Group C comprised 24 patients who had the treatment one to
      two months after phacoemulsification (PE). The dioptric reduction of corneal
      astigmatism (the percent reduction of astigmatism) was 1.83 +/- 0.98 D (37.4 +/-
      18.3%) in Group A, 3.20 +/- 2.35 D (55.6 +/- 34.4%) in Group B, and 2.08 +/- 1.20
      D (41.4 +/- 20.4%) in Group C. There was no statistical significance in the
      dioptric reduction and the percent reduction among Groups A, B, and C. This
      suggests that the wound size and time of cutting are not directly correlated to
      the effect of argon laser suture cutting. To examine the relationship between the
      effect and changes in corneal shape from suture cutting, we divided the patients
      into two subgroups; one was Subgroup (+) in which the percent reduction of
      astigmatism was above 25%; the other was Subgroup (-) in which the percent
      reduction was below 25%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487167
TI  - Enhancement of the ocular bioavailability of topical tobramycin with use of a
      collagen shield.
AB  - We compared the ocular bioavailability in rabbits of 0.3% tobramycin applied with
      a collagen shield with eyedrop tobramycin application. Groups of rabbits received
      either (1) a collagen shield presoaked in tobramycin with a tobramycin drop
      before and after shield application (Shield) or (2) three drops of tobramycin
      (Drops). Postmortem samples of the cornea, conjunctiva, and aqueous humor were
      obtained at various intervals after shield application or drop instillation. The
      corneas in a second set of rabbits were anesthetized and then chemically abraded
      with n-heptanol before receiving the same two dosing regimens as in the groups
      with intact corneas. At nearly all times in all three tissues, the Shield groups
      had higher mean concentrations of tobramycin than the Drops groups. The area
      under the concentration-time curve for the Shield group relative to the Drops
      group was 5.0- to 16.1-fold greater for rabbits with intact corneas (P < .05),
      and 1.8- to 3.7-fold greater for rabbits with abraded corneas (P < .05). The use
      of collagen shields together with standard ophthalmic concentrations of
      tobramycin may be useful in achieving higher concentrations of topically
      delivered drugs into the anterior segment of the eye.

PMID- 8487168
TI  - Conversion to small-incision phacoemulsification: experience with the first 50
      eyes.
AB  - Conversion from extracapsular cataract surgery to small-incision
      phacoemulsification is inevitably associated with a learning curve. Retrospective
      analysis of one surgeon's learning curve was carried out on the first 50
      consecutive operations using small-incision phacoemulsification. Parameters were
      evaluated, including postoperative acuity and astigmatism at eight days, three
      weeks, three months, and six months. A comparison of the results of the first 25
      operations and the subsequent 25 showed statistically significant differences
      only in acuity at eight days and cylinder at three months. The most frequent
      complication was corneal edema lasting at least one week. With careful
      preparation, proper patient selection, and meticulous technique, the learning
      curve for converting from extracapsular surgery to small-incision
      phacoemulsification does not necessarily increase the complication rate.

PMID- 8487169
TI  - Distance visual acuity with diffractive multifocal and monofocal intraocular
      lenses.
AB  - A series comprising 166 eyes implanted with monofocal intraocular lenses and 143
      eyes with diffractive multifocal lenses was examined. The implantations were
      performed intermittently and consecutively during 18 months by one surgeon using
      the same technique. The mean postoperative visual acuity was 0.5 line higher in
      the monofocal than in the multifocal group, a significant difference (P < .01).
      The better performance of the monofocal lens was almost constant in all six age
      groups (range: < or = 65 years to > or = 86 years).

PMID- 8487170
TI  - Contrast sensitivity and glare in patients with a diffractive multifocal
      intraocular lens.
AB  - Contrast sensitivity was measured in 25 patients who had a multifocal diffractive
      intraocular lens and in 23 control patients with a monofocal lens in four
      simulated light conditions: (1) daylight, (2) daylight with peripheral glare, (3)
      twilight, (4) twilight with central glare. In normal daylight and twilight,
      contrast sensitivity of the multifocal group was significantly lower than the
      control group's (P < .05). The difference was 0.13 log units for the multifocal
      group and 0.17 log units for the control group (mean value across the tested
      frequency from 1.5 to 18 cycles/deg). Peripheral glare reduced contrast
      sensitivity under daylight conditions in both groups (P < .05), but the loss did
      not differ significantly between the two (P > .05). Central glare reduced
      contrast sensitivity under twilight conditions in both groups (P < .05), with the
      greatest loss in the multifocal patients (P < .001). We conclude that the most
      significant loss of contrast sensitivity in patients with the diffractive
      multifocal intraocular lens is found with central glare under twilight
      conditions.

PMID- 8487171
TI  - Long-term results and biocompatibility of heparin-surface-modified intraocular
      lenses.
AB  - A prospective in vivo study of 50 intraocular lenses was done to document the
      long-term results and biocompatibility of heparin-surface-modified poly(methyl
      methacrylate) posterior chamber lenses. Continuous curvilinear capsulorhexis and
      phacoemulsification were performed throughout and examinations were by slit-lamp
      and specular microscopy. Decentrations of more than 1 mm were seen in 4% of eyes.
      Stress folds from the haptic traction forces were detected in 16%. A posterior
      capsulotomy was performed in 10% because of fibrosis or Elschnig pearl formation.
      Fine fibers were found on the lens surface in 76%. During the first postoperative
      days only a moderate number of fibroblast-like cells was observed. Foreign-body
      giant cells were seen in 8%. All cases with foreign-body giant cells had
      posterior synechias. Visual performance and clinical results were comparable to
      those of other well-approved intraocular lenses. The low percentage of cellular
      reaction on the lens surface suggests good biocompatibility.

PMID- 8487172
TI  - Postoperative complications and uncorrected acuities after implantation of plate
      haptic silicone and three-piece silicone intraocular lenses.
AB  - Complications after implantation of 503 plate haptic silicone intraocular lenses
      were compared with those after implantation of 253 silicone three-piece
      polypropylene loop lenses. The uncorrected visual acuities were also compared.
      Capsulorhexis and endocapsular phacoemulsification were used in all cases. The
      incidence of cystoid macular edema and posterior capsule opacification requiring
      a YAG capsulotomy were significantly higher in the cases with polypropylene three
      piece loop lenses. Pigment dispersion and decentration also occurred more
      frequently in this group. This is probably because the 10.5 mm plate haptic lens
      is more rigid than the polypropylene loop lens. It also fixates more posteriorly
      within the capsular bag than the anteriorly located polypropylene lens. Patients
      implanted with a plate haptic silicone intraocular lens through a 3.5 mm scleral
      incision had significantly better uncorrected visual acuity at five to six weeks
      postoperatively than those with a three-piece silicone lens that required a 4.5
      mm incision for insertion.

PMID- 8487173
TI  - Surgical complications and visual acuity results in 536 cases of plate haptic
      silicone lens implantation.
AB  - Implantation of a plate haptic intraocular lens was planned in 536 cases. This
      paper reports the uncorrected and corrected visual acuities and complications in
      33 patients in whom there were surgical complications that prevented implantation
      of the plate haptic lens. Excluding five patients (15%) who had pre-existing
      pathology, 21 (75%) had uncorrected acuity of 20/40 or better and 27 (96%) had
      corrected acuity of 20/40 or better five to six weeks postoperatively. The plate
      haptic lens can only be used with capsulorhexis and an intact anterior capsular
      rim and posterior capsule. Two alternative backup lens styles--a loop lens for
      placement in the torn bag or the sulcus and an anterior chamber lens--have to be
      in the operating room for each surgery.

PMID- 8487175
TI  - Features of a modern retrobulbar anesthetic injection for cataract surgery.
AB  - No significant complications including retrobulbar orbital hemorrhage after
      retrobulbar anesthetic block were identified in a retrospective review of 3,415
      consecutive cataract surgical cases blocked and performed by one surgeon. The
      technique for retrobulbar injections using a disposable retrobulbar needle is
      described in detail. All injections were deliberately retrobulbar, directed
      toward the inferior temporal muscle cone, and were given immediately prior to
      cataract surgery by the surgeon.

PMID- 8487176
TI  - Topical anesthesia for small incision self-sealing cataract surgery. A
      prospective evaluation of the first 100 patients.
AB  - Small incision self-sealing cataract surgery has created the opportunity to use
      less invasive anesthesia. One hundred patients were evaluated in a prospective
      study using a new technique of topical anesthesia to allow small incision
      construction, intercapsular phacoemulsification, and small incision intraocular
      lens implantation without a peribulbar or retrobulbar injection. This study
      demonstrated that topical anesthesia avoids the risk of globe perforation,
      retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye and is
      effective for intraoperative anesthesia for cataract surgery.

PMID- 8487174
TI  - Suture to limbus distances in eyes with a posterior chamber intraocular lens
      implanted by scleral fixation.
AB  - This study used linear regression to analyze the correlation between the location
      of transscleral sutures and the postoperative visual acuity, refraction, and
      anterior chamber depth in eyes with posterior chamber intraocular lenses
      implanted by scleral fixation. The suture-to-limbus distance at the 12 o'clock
      and 6 o'clock positions averaged 2.4 mm and 1.7 mm, respectively. Suture location
      had no statistically significant relationship with postoperative acuity,
      spherical equivalent, astigmatism, or anterior chamber depth.

PMID- 8487177
TI  - New theoretical matrix formula for intraocular lens calculation using the optimal
      bending factor.
AB  - By applying Gaussian optics we propose a new matrix formula model for intraocular
      lens (IOL) calculation that yields not only IOL optical power for a particular
      eye but also an evaluation of the bending factor of different IOL optical
      designs. This option improves IOL selection and results in the best possible
      optical image, a function dependent on the IOL's bending factor. This formula is
      a new approach to IOL calculation and may be useful in designing IOLs for
      abnormally hyperopic or myopic eyes. Optimal IOL power and design should both be
      considered in IOL calculation, which may improve the optical and clinical results
      of IOL implantation in the aphakic patient. The radius of the cornea is assumed
      to be spherical, and aspherical curves of the cornea may influence the optimal
      "bending" or shape factor of a lens.

PMID- 8487178
TI  - Ultraviolet radiation and cataract development in the U.S. Virgin Islands.
AB  - Ultraviolet (UV) radiation is one of several factors thought to cause cataracts.
      This retrospective study of a population in the West Indies who had had voluntary
      cataract surgery sought to determine the effect of a relatively high level of UV
      exposure and the type of exposure. This population had a high incidence of
      nuclear/brunescent cataracts, which correlates with the type of radiation
      present. Yet the results indicate that although chronic exposure to UV radiation
      may play a role in the type and location of cataracts, other factors (e.g., age,
      diabetes) are more important in their formation.

PMID- 8487179
TI  - Treatment of anterior chamber fibrin following cataract surgery with tissue
      plasminogen activator.
AB  - Three patients who developed anterior chamber fibrinous exudates after cataract
      surgery were treated with tissue plasminogen activator injected into the anterior
      chamber. There was prompt dissolution of the fibrinous exudates and no observed
      complications. When fibrinous exudates occur in high-risk patients after cataract
      surgery, tissue plasminogen activator provides an excellent means of clearing the
      fibrin.

PMID- 8487180
TI  - Oil-drop cataracts.
AB  - The oil-drop cataract is a common yet often overlooked cause of progressive
      vision loss. Although the nuclear change can be subtle on slitlamp biomicroscopic
      examination, retinoscopy reveals the classic oil droplet silhouetted against the
      red reflex. We present seven patients with oil-drop cataracts referred for neuro
      ophthalmologic evaluation because of unexplained vision loss. All had been
      evaluated by multiple physicians and had had extensive diagnostic testing. The
      patients were between 36 and 69 years old with visual acuities from 20/20 to
      20/400. The neuro-ophthalmologic evaluation in all patients was normal except for
      lenticular nuclear changes, best appreciated with retinoscopy.

PMID- 8487181
TI  - Excimer laser ablation of conjunctival epithelial melanosis.
AB  - Two patients with conjunctival epithelial melanosis received a 193 nm argon
      fluoride excimer laser treatment. In both patients the melanosis was easily
      removed with a smoothing technique using the excimer laser. The ablated area
      showed normal appearing conjunctiva. The lesion did not recur during the eight
      month follow-up. Therapeutically, the excimer laser can be used to treat benign
      conjunctival lesions as well as superficial corneal diseases.

PMID- 8487183
TI  - Blade designed for improved safety and accuracy in radial keratotomy.

PMID- 8487184
TI  - Consultation section. Loss of the lens nucleus.

PMID- 8487182
TI  - Visual disability resulting from a dislocated intraocular lens.
AB  - Complications may arise from the failure to remove a dislocated intraocular lens,
      even when it appears to rest in a benign position and pose no problems. We
      examined a patient with a second intraocular lens left in the inferior vitreous
      cavity. Shifting the loose lens resulted in eventual complications and visual
      disability; removing the dislocated lens and replacing the functional intraocular
      lens yielded good results.

PMID- 8487185
TI  - Simple method to calculate the surgically induced refractive change.

PMID- 8487186
TI  - More on calculating the surgically induced refractive change: two easy solutions.

PMID- 8487187
TI  - Capsular tears with irrigation/aspiration system.

PMID- 8487188
TI  - Glare and other optical considerations with ovoid implant designs.

PMID- 8487189
TI  - The spring phenomenon with dual placement lenses.

PMID- 8487190
TI  - Ca2+ levels in myotubes grown from the skeletal muscle of dystrophic (mdx) and
      normal mice.
AB  - 1. Myotubes were grown in culture from normal (C57BL/ScSn) and mdx mice and the
      cytosolic [Ca2+] was monitored through development (5-21 days in culture) using
      fura-2 loaded via ionophoresis. Simultaneous measurements of the membrane
      potential and cytosolic [Ca2+] were made in normal and mdx myotubes before,
      during and after stimulation by action potentials elicited following anode break
      excitation. All experiments were undertaken at 22 degrees C. All data are
      expressed as means +/- S.E.M. 2. A new method was developed which enabled
      accurate determination of the fluorescence characteristics of fura-2 in murine
      skeletal muscle fibres. In the under in vitro conditions by 14.60 +/- 0.05, 9.40
      +/- 0.15 and 6.90 +/- 0.43% respectively. 3. The resting cytosolic [Ca2+] in the
      mdx myotubes was consistently higher than in the normal myotubes throughout the
      developmental period measured. Overall, the resting cytosolic [Ca2+] in mdx
      myotubes (134 +/- 9 nM, n = 22) was twofold higher than in normal myotubes (66 +/
      6 nM, n = 26). After stimulation (one to three action potentials) the cytosolic
      [Ca2+] of both mdx and normal myotubes remained elevated. The mdx myotubes (236
      +/- 55 nM, n = 5) again had approximately double the cytosolic [Ca2+] of normal
      myotubes (109 +/- 19 nM, n = 9). 4. The time course and amplitude of the Ca2+
      responses measured in the mdx and normal myotubes after action potential
      stimulation were variable. Two categories of Ca2+ response were observed in mdx
      and normal myotubes, the first consisted of a small, slow rise in [Ca2+] that
      remained elevated and the second consisted of a rapid (time to peak 7.4 +/- 1.5
      ms) (n = 8) rise in [Ca2+] with amplitudes in the range 61-773 nM and a [Ca2+]
      decay rate constant of 4.35 +/- 1.57 s-1 (n = 8) (range 0.96-15 s-1). 5. In
      conclusion, the elevated cytosolic [Ca2+] reported here through development of
      cultured mdx myotubes suggests that this genetic disorder results in a defect
      which compromises the ability of the myotubes to strictly regulate cytosolic
      [Ca2+]. The results are consistent with the presence of functionally abnormal
      Ca2+ channels recently reported in mdx myotubes.

PMID- 8487191
TI  - The cutaneous vascular axon reflex in humans characterized by laser Doppler
      perfusion imaging.
AB  - 1. Laser Doppler perfusion imaging was used to map the cutaneous vascular axon
      response induced by trains of electrical skin stimuli (1 ms, 2 Hz) on the dorsum
      of the hand, finger and foot in twenty-four healthy subjects. Conduction
      anaesthesia was applied to nerves supplying the stimulated skin areas.
      Subtraction of images recorded before and after stimulation was used for data
      analysis of the intensity and area of the response. 2. The stimulation evoked a
      localized perfusion increase around the stimulating electrode which lasted
      approximately 30 min and increased in intensity and area with increasing
      stimulation strength to a maximum at 20 pulses and 20 mA. The intensity and area
      of the response was greater on the hand than on the foot. 3. Approximating the
      response area as a circle, the maximal perfusion increase in the hand extended 9
      +/- 3 mm (mean +/- S.D.) outside the perimeter of the stimulating electrode. When
      stimulating within skin which had been subjected to surface anaesthesia, no
      response occurred, but when stimulating at the border of surface-anaesthetized
      skin, the perfusion increase extended 2 +/- 1 mm (mean +/- S.D.) into
      anaesthetized skin. 4. The results show that the perfusion increase must have
      been due in part to impulse conduction to, and release of transmitters from, axon
      endings terminating in skin outside the contact area of the probe. It is
      concluded that the area of perfusion increase corresponds to the size of the
      receptive fields of afferent polymodal C fibres.

PMID- 8487192
TI  - Magnetic coil stimulation of straight and bent amphibian and mammalian peripheral
      nerve in vitro: locus of excitation.
AB  - 1. According to classical cable theory, a magnetic coil (MC) should excite a
      linear nerve fibre in a homogeneous medium at the negative-going first spatial
      derivative of the induced electric field. This prediction was tested by MC
      stimulation of mammalian phrenic and amphibian sciatic nerve and branches in
      vitro, immersed in Ringer solution within a trough, and identifying the sites of
      excitation by recording responses of similar latency to local electrical
      stimulation. Subsequently, the identified sites of excitation were compared with
      measurements of the induced electric field and its calculated first spatial
      derivative. A special hardware device was used to selectively reverse MC current
      direction and to generate predominantly monophasic- or polyphasic-induced pulse
      profiles whose initial phases were identical in polarity, shape and amplitude.
      When using the amphibian nerve preparation, a complication was excitation at low
      threshold points related to cut branches. 2. Reversal of monophasic current
      resulted in latency shifts corresponding approximately to the distance between
      induced cathode and anode. The location of each site of excitation was at, or
      very near, the negative-going first spatial derivative peaks of the induced
      electric field measured parallel to the straight nerve. Significantly, excitation
      of the nerve did not occur at the peak of the induced electric field above the
      centre of the 'figure of eight' MC junction. 3. A polyphasic pulse excited the
      nerve at both sites, by the negative-going first phase at one location, and
      approximately 150 microseconds later, by the reversed negative-going second phase
      at the other location. Polyphasic and monophasic pulses elicited responses with
      similar latency when the induced current flowed towards the recording electrode.
      4. Straddling a nerve with non-coding solid lucite cylinders created a localized
      spatial narrowing and increase in the induced electric field, resulting in a
      lowered threshold of excitation. The corresponding closer spacing between first
      spatial derivative peaks was exhibited by a significant reduction in latency
      shift when MC current direction was reversed. 5. When a nerve is bent and the
      induced current is directed along the nerve towards the bend, the threshold of
      excitation is reduced there. Increasing the angle of the bend from 0 deg to more
      than 90 deg graded the decrease in threshold. 6. In a straight nerve the
      threshold was lowest when current was directed towards the cut end.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8487193
TI  - The central role of corticotrophin-releasing factor (CRF-41) in psychological
      stress in rats.
AB  - 1. We investigated the central role of corticotrophin-releasing factor (CRF-41)
      in psychological stress-induced responses, including cardiovascular,
      thermoregulatory and locomotive activity in free-moving rats. 2. Psychological
      stress was induced by cage-switch stress. After rats were placed in the novel
      environment, blood pressure, heart rate, body temperature and locomotive activity
      significantly increased. The intracerebroventricular (I.C.V.) injection of alpha
      helical CRF(9-41), a CRF-41 receptor antagonist, significantly attenuated the
      stress-induced hypertension, tachycardia, hyperthermia and increase in locomotive
      activity. However, in unstressed rats, the I.C.V. injection of alpha-helical
      CRF(9-41) had no effect on physiological parameters measured in this study. 3. In
      unstressed rats, the I.C.V. injection of CRF-41 (1 microgram and 10 micrograms)
      increased blood pressure, heart rate, body temperature and locomotive activity in
      a dose-dependent manner. The changes in these responses were quite similar to
      those observed during cage-switch stress. 4. The results suggest that central CRF
      41 plays an important role in psychological stress-induced hypertension,
      hyperthermia, tachycardia and increase in locomotive activity. However, it is
      likely that central CRF-41 does not contribute to normal cardiovascular and body
      temperature regulation when rats are free from stress.

PMID- 8487194
TI  - Effects of inorganic phosphate analogues on stiffness and unloaded shortening of
      skinned muscle fibres from rabbit.
AB  - 1. We examined the effects of aluminofluoride (AlFx) and orthovanadate (Vi),
      tightly binding analogues of orthophosphate (Pi), on the mechanical properties of
      glycerinated fibres from rabbit psoas muscle. Maximum Ca(2+)-activated force,
      stiffness, and unloaded shortening velocity (Vus) were measured under conditions
      of steady-state inhibition (up to 1 mM of inhibitor) and during the recovery from
      inhibition. 2. Stiffness was measured using either step or sinusoidal (1 kHz)
      changes in fibre length. Sarcomere length was monitored continuously by helium
      neon laser diffraction during maximum Ca2+ activation. Stiffness was determined
      from the changes in sarcomere length and the corresponding changes in force. Vus
      was measured using the slack test method. 3. AlF chi and Vi each reversibly
      inhibited force, stiffness and Vus. Actively cycling cross-bridges were required
      for reversal of these inhibitory effects. Recovery from inhibition by AlF chi was
      3- to 4-fold slower than that following removal of V1. 4. At various degrees of
      inhibition, AlF chi and Vi both inhibited steady-state isometric force more than
      either Vus or stiffness. For both AlF chi and Vi, the relatively greater
      inhibition of force over stiffness persisted during recovery from steady-state
      inhibition. We interpret these results to indicate that the cross-bridges with
      AlF chi or Vi bound are analogous to those which occur early in the cross-bridge
      cycle.

PMID- 8487195
TI  - The effects of MgADP on cross-bridge kinetics: a laser flash photolysis study of
      guinea-pig smooth muscle.
AB  - 1. The effects of MgADP on cross-bridge kinetics were investigated using laser
      flash photolysis of caged ATP (P3-1(2-nitrophenyl) ethyladenosine 5'
      triphosphate), in guinea-pig portal vein smooth muscle permeabilized with
      Staphylococcus aureus alpha-toxin. Isometric tension and in-phase stiffness
      transitions from rigor state were monitored upon photolysis of caged ATP. The
      estimated concentration of ATP released from caged ATP by high-pressure liquid
      chromatography (HPLC) was 1.3 mM. 2. The time course of relaxation initiated by
      photolysis of caged ATP in the absence of Ca2+ was well fitted during the initial
      200 ms by two exponential functions with time constants of, respectively, tau 1 =
      34 ms and tau 2 = 1.2 s and relative amplitudes of 0.14 and 0.86. Multiple
      exponential functions were needed to fit longer intervals; the half-time of the
      overall relaxation was 0.8 s. The second order rate constant for cross-bridge
      detachment by ATP, estimated from the rate of initial relaxation, was 0.4-2.3 x
      10(4) M-1 s-1. 3. MgADP dose dependently reduced both the relative amplitude of
      the first component and the rate constant of the second component of relaxation.
      Conversely, treatment of muscles with apyrase, to deplete endogenous ADP,
      increased the relative amplitude of the first component. In the presence of
      MgADP, in-phase stiffness decreased during force maintenance, suggesting that the
      force per cross-bridge increased. The apparent dissociation constant (Kd) of
      MgADP for the cross-bridge binding site, estimated from its concentration
      dependent effect on the relative amplitude of the first component, was 1.3
      microM. This affinity is much higher than the previously reported values (50-300
      microM for smooth muscle; 18-400 microM for skeletal muscle; 7-10 microM for
      cardiac muscle). It is possible that the high affinity reflects the properties of
      a state generated during the co-operative reattachment cycle, rather than that of
      the rigor bridge. 4. The rate constant of MgADP release from cross-bridges,
      estimated from its concentration-dependent effect on the rate constant of the
      second (tau 2) component, was 0.35-7.7 s-1. To the extent that reattachment of
      cross-bridges could slow relaxation even during the initial 200 ms, this rate
      constant may be an underestimate. 5. Inorganic phosphate (Pi, 30 mM) did not
      affect the rate of relaxation during the initial approximately 50 ms, but
      accelerated the slower phase of relaxation, consistent with a cyclic cross-bridge
      model in which Pi increases the proportion of cross-bridges in detached ('weakly
      bound') states.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487196
TI  - 31P nuclear magnetic resonance studies on the glycogenolysis regulation in
      resting and contracting frog skeletal muscle.
AB  - 1. Regulation of glycogenolysis in frog skeletal muscle at rest and following
      contraction was studied by measuring the concentration of phosphate-containing
      metabolites and the intracellular pH (pHi) in CN-treated muscles, in which
      oxidative phosphorylation was inhibited by NaCN, using the 31P nuclear magnetic
      resonance (NMR) technique. 2. When CN-treated muscles were kept at rest, the
      phosphocreatine (PCr) concentration very slowly decreased with time with a
      corresponding increase of the inorganic phosphate (Pi) concentration, while the
      ATP concentration remained unchanged. The pHi changed in the alkaline direction
      for the first 3 h, and then started to change in the acidic direction. 3. When CN
      treated muscles were tetanized for 10 s, the PCr concentration decreased with a
      corresponding increase of the Pi concentration and acidification of pHi, while
      the ATP concentration remained unchanged. 4. When CN-treated muscles were
      tetanized repeatedly (each for 2 s) at constant intervals, the pHi changed in the
      alkaline direction following the first and the second tetani, and then changed in
      the acidic direction following the subsequent tetani, indicating that the
      consumed ATP is first replenished by the Lohmann reaction, while glycogenolysis
      starts only when the total amount of contractile activity exceeds a critical
      value. 5. Irrespective of whether CN-treated muscles were kept at rest or
      tetanized repeatedly, the Pi concentration increased to about 8 mM (mmol/kg wet
      muscle) when glycogenolysis started, suggesting that the onset of glycogenolysis
      in CN-treated muscles is regulated by the Pi concentration. 6. The 'internal'
      buffering power of muscle cytosol was estimated to be 35 mM H+/pH unit in
      anaerobic muscles and 25 mM H+/pH unit in CN- and iodoacetic acid (IAA)-treated
      muscles. The 'internal' buffering power contains a contribution due to flux of
      carbon dioxide and lactic acid across the cell membrane. Evidence indicated that
      lactic acid flux is small.

PMID- 8487197
TI  - Effects of internal and external Na+ ions on inwardly rectifying K+ channels in
      guinea-pig ventricular cells.
AB  - 1. The effects of internal and external Na+ ions on the inwardly rectifying K+
      channel were studied in guinea-pig ventricular cells. 2. Single-channel currents
      through the inwardly rectifying K+ channel were recorded in the open cell
      attached or inside-out configuration at 150 mM internal K+ and either 150 or 25
      mM external K+. Internal Na+, at a concentration of 5-40 mM, reduced the unitary
      amplitude of the outward current. No increase in open-channel current noise was
      detected with the filter cut-off frequency of 3 kHz. Substate behaviour seen with
      internal Mg2+ at a micromolar level was not observed. The inward currents were
      little affected by internal Na+. 3. The unitary current-voltage relation
      rectified inwardly in the presence of internal Na+ in a concentration-dependent
      manner. 4. Outward unitary currents were normalized to those measured in the
      absence of Na+. The normalized current-voltage relation was shifted in the
      negative direction by 20-25 mV by decreasing external K+ from 150 to 25 mM,
      indicating that the blocking effect increases with low external K+ when compared
      at a fixed voltage. 5. The normalized current-Na+ concentration curve was fitted
      by a one-to-one binding curve at each voltage. In a semi-logarithmic plot of
      dissociation constant versus membrane potential, data points for 150 and 25 mM
      external K+ were fitted by straight lines with nearly the same slope. The
      dissociation constant at 0 mV is 154 mM in 150 mM external K+ and 89 mM in 25 mM
      external K+. The voltage dependence of dissociation constants gives a value for
      the effective valency of the Na+ ion of around 0.5. 6. To study effects of
      external Na+, single-channel currents were recorded with pipette solutions
      containing 125 mM Na+, 125 mM choline or 125 mM N-methyl-D-glucamine (NMDG) in
      addition to 25 mM K+. Current amplitude was smaller with choline than with Na+ or
      NMDG. The reduction in current amplitude with choline was more evident in the
      inward current, resulting in a stronger outward rectification of the current
      voltage relation. This finding and prolonged mean open time (see Summary point 7)
      was interpreted by assuming that choline is an open-channel blocker. 7. The
      lifetimes of the openings in the inward currents were distributed according to a
      single exponential. The mean open time with Na+ was similar to that with NMDG,
      which decreased with hyperpolarization. The mean open time with choline was much
      longer and less voltage dependent.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487198
TI  - Electrical and integrative properties of rabbit sympathetic neurones re-evaluated
      by patch clamping non-dissociated cells.
AB  - 1. Voltage recordings were performed on non-dissociated sympathetic neurones from
      rabbit coeliac ganglia using the whole-cell configuration of the patch clamp
      technique. 2. Cells were classified depending on their firing pattern as silent
      cells (63%) producing either phasic (24%) or tonic (76%) spike discharge in
      response to depolarizing currents, and pacemaker cells (37%). 3. All the cells
      produced large overshooting spikes and prolonged postspike after
      hyperpolarization. The peak-to-peak spike amplitude was 113.8 +/- 1 mV. Spikes
      were shortened and the after-hyperpolarization was suppressed when calcium
      channel blockers (Cd2+ and La3+) were added. 4. Silent cells have a resting
      potential of -58.8 +/- 1.5 mV. At potentials ranging from -50 to -90 mV, the
      input impedance was 490 +/- 27 M omega at 22-24 degrees C and 426 +/- 47 M omega
      at 35-36 degrees C. The time constant at voltages corresponding to the high input
      impedance region was 126 +/- 7 ms at 22-24 degrees C and 86 +/- 7 ms at 35-36
      degrees C. 5. The firing frequency of the pacemaker cells was 3.2 +/- 0.5 Hz at
      35-36 degrees C in the presence of nicotinic blockers. Evidence is given that the
      firing did not result from cell injury but was induced by an intrinsic pacemaker
      mechanism. Input impedance of pacemaker neurones was 580 +/- 47 M omega at 22-24
      degrees C and 473 +/- 56 M omega at 35-36 degrees C. 6. Most of the pacemaker
      cells (63%) were motoneurones, since they were antidromically fired by
      stimulating post-ganglionic nerves. In addition, they received synaptic inputs
      from both preganglionic fibres (splanchnic nerves) and the periphery
      (postganglionic nerves). Long-lasting depolarizations were induced in either
      silent or pacemaker cells by single shocks applied to pre- and postganglionic
      nerves. 7. Slowly rising voltage ramps revealed the presence of an N-shaped
      current-voltage relationship in voltage clamped pacemaker cells. The negative
      slope was located in a subthreshold voltage range, between -83.4 +/- 1.4 and 
      59.0 +/- 1.8 mV. It was induced by the activation of a low threshold persistent
      inward current. Although it was tiny (22 +/- 3 pA at its peak level) this current
      brought the null-current voltage up to -41.0 +/- 1.4 mV, which resulted in
      continuous firing. 8. Due to the instability introduced by the N-shaped I-V
      relationship, pacemaker cells can display bistable behaviour characterized by
      hyperpolarizing responses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487199
TI  - Correlations between myosin heavy chain isoforms and mechanical parameters in rat
      myometrium.
AB  - 1. The relations between mechanical parameters and myosin heavy chain isoforms
      were studied in myometrial smooth muscle from ovariectomized rats (O) and
      oestrogen-treated, ovariectomized rats (E). 2. Treatment of the rats for three
      days with beta-oestradiol (2 micrograms kg-1 day-1) 2-4 weeks postsurgery,
      produced maximal changes in uterine mass and myosin content of approximately
      threefold. 3. Myosin heavy chain isoform SM1 (204 kDa) was increased from 65.5 +/
      0.8% to 72.9 +/- 0.6% of the total isoform species (P < 0.001, n = 24, O and E
      respectively) after oestrogen treatment. 4. To avoid complications associated
      with activation processes, mechanical parameters were measured in permeabilized
      myometrial fibre bundles activated at a calcium concentration of 12.6 microM.
      After oestrogen treatment the maximum velocity of shortening (Vmax) measured by
      the slack test increased from 0.044 +/- 0.006 of the reference length (Lo) s-1 to
      0.101 +/- 0.006 Lo s-1, and maximal isometric force (Pmax) increased from 23.3 +/
      4.4 mN mm-2 to 74.1 +/- 13.9 mN mm-2 (P < 0.001, n = 24, respectively). Series
      elasticity and the half-time to peak force were not significantly altered. 5.
      Both Vmax and Pmax correlated significantly with percentage SM1 in O and E fibre
      bundles (r = 0.61 and 0.56, n = 48 fibres; or r = 0.87 and 0.89, n = 8 grouped
      data per rat). Vmax, however, was only weakly correlated with Pmax (r = 0.39, n =
      48). 6. To assess the relative significance of the correlation between Vmax and
      the percentage of SM1 and that between Vmax and Pmax, we used a multiple
      regression analysis with the model Vmax = intercept + beta 1 x % SM1 + beta 2 x
      Pmax, where intercept, beta 1 and beta 2 are regression parameters. This analysis
      (n = 48) indicated that Vmax was significantly dependent on the percentage of SM1
      (P < 0.0002) but not on Pmax (P < 0.61). 7. There were no significant differences
      in the levels of myosin light chain phosphorylation between O and E fibre
      bundles, indicating that light chain phosphorylation is unlikely to be the basis
      for the differences in mechanical parameters demonstrated by these fibres.

PMID- 8487200
TI  - Effect of external cation concentration and metabolic inhibitors on membrane
      potential of human glial cells.
AB  - 1. The effect on membrane potential (Em) of low external [K+]o, [Na+]o and
      [Ca2+]o and of metabolic inhibitors was studied in cultured human glial cells (U
      787CG) and human glioma cells (Tp-483MG and U-251MG). Whole cells were voltage or
      current clamped with the tight-seal recording technique. 2. Em was -76 and -80 mV
      in glial and glioma cells (mean values in U-787CG and U-251MG, respectively) in a
      reference external solution with 3.0 mM K+. K(+)-free external solution caused a
      rapid and reversible depolarization of these cells by about 26 and 42 mV
      (respectively). 3. Block of K+ channels with 1 mM Ba2+ in external solution
      rapidly depolarized the cells (U-251MG) by about 35 mV. 4. Na(+)-free solutions
      caused a delayed depolarization by 40-50 mV, which was slowly reversible (in 2
      min). 5. Ouabain (1 mM) depolarized the cells by about 4 mV. It did not prevent
      the effect of K(+)-free solution. 6. Ca(2+)-free external solution rapidly
      depolarized the cells to Em about -17 mV. The combination of either Na(+)-K(+)
      free or Na(+)-Ca(2+)-free solution transiently repolarized the cell, which
      indicated that the K+ selectivity of the membrane was decreased in both K(+)- and
      Ca(2+)-free solutions. 7. Metabolic inhibitors (carbonyl cyanide p
      trifluoromethoxy-phenylhydrazone (FCCP) and 2,4-dinitrophenol (DNP)) rapidly and
      reversibly depolarized the cells. This effect was not prevented by intracellular
      perfusion of a strong Ca(2+)-buffering solution. 8. Voltage clamp revealed only
      minor changes (< 20%) in the leak conductance (g) of cells that were depolarized
      by the above-mentioned solutions. 9. Positive polarizing current elicited (in
      some cells) a regenerative depolarization. The threshold for depolarization was
      less in low external [K+]o. 10. It is concluded (a) that the resting potential of
      these glial cells depends on ion channels that are K+ selective only in the
      presence of external Ca2+ and K+ and (b) that this K+ selectivity may require
      that Em is near the reversal potential for potassium (EK), and (c) that the
      action of metabolic inhibitors (DNP and FCCP) is different from that in neurones.

PMID- 8487201
TI  - Exercise-induced diaphragmatic fatigue in healthy humans.
AB  - 1. Twelve healthy subjects (33 +/- 3 years) with a variety of fitness levels
      (maximal oxygen uptake (VO2, max) = 61 +/- 4 ml kg-1 min-1, range 40-80),
      exercised at 95 and 85% VO2, max to exhaustion (mean time = 14 +/- 3 and 31 +/- 8
      min, expired ventilation (VE) over final minute of exercise = 149 +/- 9 and 126
      +/- 10 l min-1). 2. Bilateral transcutaneous supramaximal phrenic nerve
      stimulation (BPNS) was performed before and immediately after exercise at four
      lung volumes, and 400 ms tetanic stimulations were performed at 10 and 20 Hz. The
      coefficients of variation of repeated measurements for the twitch transdiaphragm
      pressures (Pdi) were +/- 7-10% and for compound muscle action potentials (M wave)
      +/- 10-15%. 3. Following exercise at 95% of VO2, max, group mean Pdi twitch
      values were reduced at all lung volumes (range -8 +/- 3 to -32 +/- 5%) and
      tetanically stimulated Pdi values were reduced at both 10 and 20 Hz (-21 +/- 3
      and -13 +/- 2%, respectively) (P = 0.001-0.047). Following exercise at 85% VO2,
      max, stimulated Pdi values were reduced at all lung volumes and stimulating
      frequencies, but only significantly so with the twitch at functional residual
      capacity (-15 +/- 5%). Stimulated Pdi values recovered partially by 30 min post
      exercise and almost completely by an average time of 70 min. 4. The fall in
      stimulated Pdi values post-exercise was significantly correlated with the
      percentage increase in diaphragmatic work (integral of Pdi min-1) from rest to
      end-exercise and the relative intensity of the exercise. 5. The integral of Pdi
      min-1 and the integral of Po min-1 (Po, esophageal pressure) rose together from
      rest through the fifth to tenth minute of exercise, after which integral of Pdi
      min-1 plateaued even though integral of Po min-1, VE and inspiratory flow rate
      all continued to rise substantially until exercise terminated. Thus, the relative
      contribution of the diaphragm to total respiratory motor output was progressively
      reduced with exercise duration. 6. We conclude that significant diaphragmatic
      fatigue is caused by the ventilatory requirements imposed by heavy endurance
      exercise in healthy persons with a variety of fitness levels. The magnitude of
      the fatigue and the likelihood of its occurrence increases as the relative
      intensity of the exercise exceeds 85% of VO2, max.

PMID- 8487202
TI  - Electrophysiology of guinea-pig supraoptic neurones: role of a hyperpolarization
      activated cation current in phasic firing.
AB  - 1. Immunocytochemically identified magnocellular neurosecretory cells (MNCs) in
      the guinea-pig supraoptic nucleus (SON) were studied using the in vitro
      intracellular recording technique. Cells were identified as containing arginine
      vasopressin (AVP) or oxytocin (OT) following recordings made with biocytin-filled
      electrodes. Both AVP and OT MNCs demonstrated a fusiform or pyramidal shape (15
      20 microns by 26-39 microns), with two to three processes. There were no
      significant differences in the proportion of AVP and OT cells in the
      retrochiasmatic (caudal) versus the rostral slices. 2. No significant differences
      in passive membrane properties were observed between AVP and OT cells, except
      that AVP cells exhibited a significantly broader action potential width (1.51 +/-
      0.1 ms, n = 11) than did OT cells (1.01 +/- 0.08 ms, n = 7). 3. Firing patterns
      were recorded for 100 MNCs, 41% of which fired in a phasic manner (repeated
      clustering of action potentials into bursts). Of the seventy-seven cells which
      were immunocytochemically identified, only AVP-containing MNCs displayed phasic
      firing. Phasic firing occurred only in MNCs demonstrating a depolarizing
      potential which followed hyperpolarizing after-potentials (HAPs). The presence of
      the depolarizing potential was not always associated with phasic firing, however,
      as both OT cells and non-phasic AVP cells sometimes exhibited a depolarizing
      potential. 4. In 160 MNCs examined for the presence of the time-dependent inward
      rectification (TDR in current clamp, or Ih in voltage clamp), a significant
      difference in the proportion of cells expressing the Ih was observed in the two
      cell types. The Ih was expressed in forty-five of fifty-four AVP MNCs (83%) and
      in six of fifteen OT MNCs (40%). No significant association was found with firing
      pattern. 5. The Ih exhibited properties similar to those found in other CNS and
      peripheral tissues. It appeared on steps to potentials more hyperpolarized than 
      65 mV. It was augmented by raising the extracellular potassium concentration,
      blocked by 2 mM CsCl, and insensitive to 100-500 microM BaCl2. Activation
      followed a single exponential, and the time constant of activation was voltage
      dependent. 6. The adenylate cyclase activator forskolin increased the Ih and
      shifted its activation curve to more depolarized levels. In cells recorded for
      several hours, the Ih varied in amplitude, suggesting intrinsic modulation,
      possibly by intracellular second messenger systems. The Ih in guinea-pig SON MNCs
      appears to serve an excitatory role, bringing cells closer to firing threshold.

PMID- 8487203
TI  - Energy metabolism in single human muscle fibres during intermittent contraction
      with occluded circulation.
AB  - 1. Glycogenolysis in type I and II muscle fibres was investigated in five healthy
      volunteers during electrical stimulation of the quadriceps muscle group with
      blood flow occluded. 2. The quadriceps femoris muscles were stimulated
      intermittently (1.6 s stimulation, 1.6 s rest) at a frequency of 50 Hz for 64 s
      and isometric contraction force was recorded. Muscle biopsies were obtained at
      rest prior to and immediately after stimulation. Single muscle fibres were
      dissected free and were identified as type I and II fibres. ATP, phosphocreatine
      (PCr) and glycogen contents were measured luminometrically and enzymatically in
      single fibres and mixed fibre muscle. 3. Electrical stimulation resulted in a
      marked decline in contraction force and near total depletion of PCr in both fibre
      types. The ATP turnover rate (P < 0.05) and the magnitude of the decline in ATP
      (P < 0.05) were greater in type II fibres. Prior to stimulation the muscle
      glycogen content was 32% higher in type II fibres compared with type I fibres (P
      < 0.01). During stimulation the rate of glycogenolysis in type II fibres (4.32 +/
      0.54 mmol (kg dry matter (DM)-1 s-1 was twofold greater than the rate in type I
      fibres (2.05 +/- 0.70 mmol (kg DM)-1 s-1, P < 0.05). 4. The data suggest that the
      relatively higher rate of glycogenolysis observed in type I fibres during
      intermittent electrical stimulation with occluded circulation (2.05 +/- 0.70 mmol
      (kg DM)-1 s-1), when compared with the corresponding rate recorded during intense
      contraction with circulation intact (0.18 +/- 0.14 mmol (kg DM)-1 s-1, P < 0.05),
      may result from an accelerated ATP turnover rate in this fibre type increasing
      the cellular concentrations of free AMP and inosine 5'-monophosphate (IMP), which
      are known activators of glycogen phosphorylase. 5. The similarity in the rate of
      type II fibre glycogenolysis during contraction with circulatory occlusion (4.32
      +/- 0.54 mmol (kg DM)-1 s-1), when compared with the corresponding rate recorded
      during non-occluded circulation (3.54 +/- 0.53 mmol (kg DM)-1 s-1, P > 0.05), is
      in agreement with the suggestion that glycogenolysis in this fibre type is
      already occurring at a near-maximal rate with circulation intact.

PMID- 8487204
TI  - Human circulatory and thermoregulatory adaptations with heat acclimation and
      exercise in a hot, dry environment.
AB  - 1. Heat acclimation was induced in eight subjects by asking them to exercise
      until exhaustion at 60% of maximum oxygen consumption rate (VO2) for 9-12
      consecutive days at an ambient temperature of 40 degrees C, with 10% relative
      humidity (RH). Five control subjects exercised similarly in a cool environment,
      20 degrees C, for 90 min for 9-12 days; of these, three were exposed to exercise
      at 40 degrees C on the first and last day. 2. Acclimation had occurred as seen by
      the increased average endurance from 48 min to 80 min, the lower rate of rise in
      the heart rate (HR) and core temperature and the increased sweating. 3. Cardiac
      output increased significantly from the first to the final heat exposure from
      19.6 to 21.4 l min-1; this was possibly due to an increased plasma volume and
      stroke volume. 4. The mechanism for the increased plasma volume may be an
      isosmotic volume expansion caused by influx of protein to the vascular
      compartment, and a sodium retention induced by a significant increase in
      aldosterone. 5. The exhaustion coincided with, or was elicited when, core
      temperature reached 39.7 +/- 0.15 degrees C; with progressing acclimation
      processes it took progressively longer to reach this level. However, at this
      point we found no reduction in cardiac output, muscle (leg) blood flow, no
      changes in substrate utilization or availability, and no recognized accumulated
      'fatigue' substances. 6. It is concluded that the high core temperature per se,
      and not circulatory failure, is the critical factor for the exhaustion during
      exercise in heat stress.

PMID- 8487205
TI  - Within-breath modulation of left ventricular function during normal breathing and
      positive-pressure ventilation in man.
AB  - 1. To investigate how intrathoracic pressure affects left ventricular function
      during normal breathing and positive-pressure ventilation, beat-by-beat
      measurements of left ventricular stroke volume (LVSV; pulsed Doppler ultrasound),
      heart rate and blood pressure were made in five normal subjects breathing
      actively and then undergoing passive positive-pressure ventilation. 2. To assess
      the within-breath effects of positive-pressure ventilation on left ventricular
      function in the clinical setting, further measurements were made in six patients
      sedated, paralysed and ventilated because of brain injuries, who had no disease
      of the heart or lungs. 3. In the normal subjects, there were minimal phasic
      variation in LVSV during positive-pressure ventilation with the subject passive.
      Heart rate and blood pressure also stayed relatively constant throughout the
      ventilator cycle. During active breathing at the same depth and rate, there were
      large phasic respiratory variations in LVSV, with the lowest values occurring
      during inspiration. 4. In the paralysed and unconscious patients, an increase in
      LVSV was associated with the increase in airway pressure which occurred during
      lung inflation; however, the phase lag between the rise in airway pressure and
      the rise in LVSV varied widely between patients. These changes occurred whether
      or not sinus arrhythmia was present. 5. Addition of 4.6 +/- 1 cmH2O of positive
      end-expiratory pressure (PEEP) did not increase the within-breath LVSV
      variations, but resulted in a mean depression of LVSV of 5.4% (paired t test, P =
      0.035). 6. The smaller variations in LVSV during positive-pressure ventilation
      compared to normal breathing in the conscious subjects may reflect (a) the
      smaller magnitude of positive, compared to negative, pleural pressure excursions
      which accompany a given tidal volume, and (b) an asymmetry between the effects of
      positive and negative pleural pressure on the heart. 7. The prominent effects of
      positive-pressure ventilation on LVSV in unconscious patients, compared to the
      minimal effects seen in ventilated normal subjects, may result from reduced lung
      compliance and a degree of pulmonary vascular congestion in the patients which
      was undetectable clinically or radiologically.

PMID- 8487206
TI  - Contractile properties of skinned muscle fibres from young and adult normal and
      dystrophic (mdx) mice.
AB  - 1. Single muscle fibres were enzymatically isolated from the soleus and extensor
      digitorum longus (EDL) muscles of genetically dystrophic mdx and normal
      (C57BL/10) mice aged 3-6 or 17-23 weeks. 2. Fibres of both muscles were
      chemically skinned with the non-ionic detergent Triton X-100 (2% v/v). Ca(2+)-
      and Sr(2+)-activated contractile responses were recorded and comparisons were
      made between several contractile parameters of various fibre types of normal and
      dystrophic mice of similar age. 3. There were no significant differences in the
      following contractile parameters of skinned fibres of normal and mdx mice of the
      same age: sensitivity to activating Ca2+ (pCa50) or Sr2+ (pSr50) and differential
      sensitivity to the activating ions (pCa50-pSr50). However the maximum isometric
      tension (Po) and the frequency of myofibrillar force oscillations in EDL fast
      twitch fibres of young mdx mice were significantly lower than those of soleus
      fast-twitch fibres of the same animals, or fast-twitch fibres (EDL or soleus) of
      normal mice. 4. Age-related differences were apparent in some contractile
      parameters of both normal and mdx mice. In particular the steepness of force-pCa
      and force-pSr curves increased with age in normal mice, yet decreased with age in
      fibres of mdx mice. 5. A fluorescent probe, ethidium bromide, which interchelates
      with DNA, was used with laser-scanning confocal microscopy to determine the
      distribution of myonuclei in fibres. Fibres isolated from either muscle type of
      normal animals displayed a characteristic peripheral spiral of myonuclei. Fibres
      from muscles of mdx mice displayed three major patterns of nuclear distribution;
      the normal peripheral spiral, long central strands of nuclei, and a mixture of
      these two patterns. 6. The contractile characteristics of mdx fibres were not
      markedly influenced by the nuclear distribution pattern in that there were no
      discernible differences in the major contractile parameters (the Hill
      coefficients nCa and nSr, which are associated with the steepness of the Ca2+ and
      Sr2+ activation curves, pCa50, pSr50, pCa50-pSr50) of skinned fibres possessing
      peripheral or central nuclei. However, except for nSr, these values were all
      lower in individual fibres which displayed similar proportions of central and
      peripheral nuclei. The presence of mixed nucleation and absence of fibres with
      embryonic contractile characteristics in mdx mice suggest that the dystrophin
      negative fibres can repair locally occurring muscle damage.

PMID- 8487207
TI  - Evidence from fluorescence microscopy and comparative studies that rat, ovine and
      bovine colonic crypts are absorptive.
AB  - 1. To test whether colonic crypts are secretory or absorptive interstitial [Na+]
      in rat descending colonic mucosa is determined using video-enhanced imaging of
      the impermeant acid form of the fluorescent Na+ probe SBFI (Molecular Probes) and
      intracellular [Na+] is monitored with SBFI (AM form). In rat descending colonic
      mucosa perifused with isotonic Tyrode solution interstitial [Na+] = 500-650 mM.
      Following exposure to Tyrode solution containing theophylline (10 mM)
      interstitial [Na+] falls by 300-450 mM within 1 min. Exposure to amiloride (0.2
      mM) reduces the intracellular [Na+] from ca 25 to 12 mM within 15 min and
      concurrently decreases [Na+] in the interstitial fluid surrounding the crypts at
      the mucosal surface by approximately 200 mM. 2. The route of fluid inflow across
      the rat colonic mucosa is directly traced by perifusing with Tyrode solution
      containing the impermeant fluorescent dye, fluorescein disulphonate (FS). FS
      accumulates rapidly within crypt lumens of control tissues to a 2-fold higher
      concentration than in the external bathing solution, but FS does not accumulate
      in crypts of tissues treated with azide (2 mM). The increment in FS accumulation
      within the crypt lumen above the bulk solution decreases by 80% within 1 min
      following exposure to theophylline (10 mM), indicating that fluid absorption into
      crypts is reduced. Estimates of the total fluid influx from the rate and extent
      of FS concentration polarization within crypts indicate that it is sufficient to
      account for the entire transcolonic fluid absorption. 3. Comparative studies of
      isolated bovine and ovine colon were also undertaken to investigate the failure
      of bovine colon to generate a hypertonic absorbate and hence its incapacity to
      produce hard faeces. The interstitial fluid surrounding ovine colonic crypts is
      hypertonic to the bulk solution, whereas the interstitial fluid surrounding
      bovine colonic crypts is nearly isotonic with the bathing solution. Additionally,
      fluorescein disulphonate accumulates within ovine colonic crypt lumens by
      concentration polarization, whereas no concentration of FS occurs within bovine
      colonic crypt lumens. This corroborates the view that a hypertonic interstitial
      fluid is absent from bovine colon mainly because of a high rate of
      transepithelial leakage of low molecular weight solutes via paracellular routes.

PMID- 8487208
TI  - Asynchronous increases in oxidative capacity and resistance to fatigue of
      electrostimulated muscles of rat and rabbit.
AB  - 1. The present study investigates to what extent increases in resistance to
      fatigue and aerobic oxidative capacity of energy metabolism are correlated in
      fast-twitch tibialis anterior muscles of rat and rabbit subjected to chronic low
      frequency stimulation. 2. Changes in the aerobic oxidative capacity of the
      stimulated muscles were judged from increases in citrate synthase activity,
      representing the constant-proportion enzyme group of the citric acid cycle. 3.
      Resistance to fatigue reached maximal values in both rat and rabbit tibialis
      anterior muscles after stimulation periods of 14 days, whereas citrate synthase
      activity continued to increase with longer stimulation periods. 4. Different time
      courses of the changes in resistance to fatigue and citrate synthase activity
      were observed not only with prolonged stimulation periods but also during the
      first week, when pronounced increases in resistance to fatigue were accompanied
      by only moderate elevations in citrate synthase activity. 5. The dissociation
      between the changes of the two parameters studied suggests that factors other
      than elevated aerobic oxidative capacity contribute to enhanced resistance to
      fatigue.

PMID- 8487209
TI  - Tetrodotoxin-sensitive dendritic spiking and control of axonal firing in a
      lobster mechanoreceptor neurone.
AB  - 1. A primary mechanosensory neurone, the anterior gastric receptor (AGR)
      associated with gastric mill muscle in the lobster foregut was examined in vitro
      with extra- and intra-cellular recording techniques to understand processes of
      dendritic integration and dendro-axonal communication. 2. AGR has a 'T'-shaped
      geometry; its two long (> 3 mm) primary dendrites project distally to spatially
      separate, stretch sensitive terminals and converge centrally onto a common apical
      neurite that leads to a bipolar soma and single axon. 3. The receptor's bilateral
      dendrites are independently capable of generating action potentials. These appear
      to be Na+ dependent since they are blocked by tetrodotoxin, but not by Co2+ or a
      lack of Ca2+ in the bath saline. 4. Both dendrites are autogenically active,
      although impulses in the dendrite with the higher intrinsic excitability may
      cross over and activate the trigger zone on the contralateral side. Moreover,
      spikes arising on either dendrite do not actively invade the soma, but are
      conveyed as decremented potentials to a third trigger zone on the initial axon
      segment. 5. Focal applications of TTX (tetrodotoxin) demonstrated the existence
      and allowed precise definition of a central membrane compartment of AGR that
      appears to lack in functional Na+ channels. This inexcitable region includes the
      soma, the apical neurite and the central branch point of the two dendrites. A
      failure to observe collision block of bilateral dendritic potentials as they
      traverse the neurite supported this conclusion. 6. Horseradish peroxidase
      injections and staining revealed two morphological features of the apical neurite
      that differed markedly from other regions of the cell. In addition to a
      relatively large diameter, the neurite's plasma membrane is heavily convoluted
      and coiled to form a lamellar transverse profile. This latter feature may itself
      contribute to membrane inexcitability while the former is consistent with an
      elevated space constant for electrotonic conduction. 7. It is concluded that the
      inhomogeneous distribution of membrane excitability in AGR enhances the
      integrative capability of the receptor's dendrites, permitting mechanical input
      at diverse loci to be encoded and processed prior to transformation into axonal
      discharge.

PMID- 8487210
TI  - Effects of specific carotid body and brain hypoxia on respiratory muscle control
      in the awake goat.
AB  - 1. We assessed the effects of specific brain hypoxia on the control of
      inspiratory and expiratory muscle electromyographic (EMG) activities in response
      to specific carotid body hypoxia in seven awake goats. We used an isolated
      carotid body perfusion technique that permitted specific, physiological, steady
      state stimulation of the carotid bodies or maintenance of normoxia and
      normocapnia at the carotid bodies while varying the level of systemic, and
      therefore, brain oxygenation. 2. Isolated brain normocapnic hypoxia of up to 1.5
      h duration increased inspired minute ventilation (VI) by means of increases in
      both tidal volume (VT) and respiratory frequency (fR). Electromyographic
      activities of both inspiratory and expiratory muscles were augmented as well.
      These responses were similar to those produced by low levels of whole-body
      normoxic hypercapnia. We conclude that moderate levels of brain hypoxia (Pa,O2
      approximately 40 mmHg) in awake goats caused a net stimulation of ventilatory
      motor output. 3. Hypoxic stimulation of the carotid bodies alone caused
      comparable increases in VT and fR, and EMG augmentation of both inspiratory and
      expiratory muscles whether the brain was hypoxic or normoxic. These responses
      were quite similar to those obtained over a wide range of whole-body normoxic
      hypercapnia. We conclude that the integration of carotid body afferent
      information is not affected by moderate brain hypoxia in awake goats. 4. We found
      no evidence for an asymmetrical recruitment pattern of inspiratory vs. expiratory
      muscles in response to carotid body hypoxia or in response to brain hypoxia
      alone. 5. Our data support the concept that moderate brain hypoxia results in a
      net stimulation of respiratory motor output. These findings question the
      significance of 'central hypoxic depression' to the regulation of breathing under
      physiological levels of hypoxaemia in the awake animal.

PMID- 8487211
TI  - Fluctuations in blood flow to acral skin in humans: connection with heart rate
      and blood pressure variability.
AB  - 1. Spontaneous fluctuations in blood flow in arteries supplying acral skin were
      investigated with Doppler ultrasound in human subjects. Finger blood pressure,
      heart rate (HR) and cardiac output were measured simultaneously and
      noninvasively. 2. Synchronous fluctuations in flow were found in arteries
      supplying the hands and feet. The fluctuations were larger and more rapid than
      the flow variations which have been demonstrated with other methods. The
      magnitude of the total flow fluctuations in the hands and feet was estimated to
      be 5-10% of cardiac output in resting subjects. This range of flow fluctuations
      is made possible by spontaneous opening and closing of skin arteriovenous
      anastomoses (AVAs). 3. The fluctuations in skin blood flow were accompanied by
      inverse fluctuations in mean blood pressure (MAP). The power spectra of skin
      vascular conductance and MAP both contained maximum intensity at low frequencies,
      below 0.15 Hz, with high coherence. 4. The central circulatory events connected
      with the skin blood flow fluctuations were calculated from the experimental data
      with the use of transfer function analysis. There was a rise in HR, cardiac
      output and MAP starting 1-4 s before a cutaneous vasoconstriction. This indicates
      that the HR and MAP responses are not only passive effects of changes in
      peripheral resistance, but are the result of a simultaneous activation of the
      peripheral vascular and cardiac efferent branches of the autonomic nervous
      system. The HR and MAP responses are then modified, probably by baroreceptor
      activation.

PMID- 8487212
TI  - Incidence of non-driving excitation of Ia afferents during ramp frequency
      stimulation of static gamma-axons in cat hindlimbs.
AB  - 1. The aim of this investigation was to identify static gamma-axons which do not
      drive any Ia afferents at any stimulus frequency in any spindle which they
      supply, and to determine their occurrence in various hindlimb muscles (peroneus
      tertius, brevis, longus and tenuissimus). 2. Ia responses to static gamma
      stimulation were classified as 'non-driven' when the discharge did not follow the
      stimulation frequency, or its subharmonics, at any time during a linear increase
      in stimulus frequency up to 150 Hz lasting 2-3 s, and when tested at two muscle
      lengths--except in the tenuissimus muscle. In almost all experiments, cross
      correlograms were used in addition to evaluate the percentage of these 'non
      driven' responses in which a time-locking of discharge to stimulus pulses was
      obscured by irregularity of the Ia discharge. 3. In 104 spindles, out of 347
      responses to stimulation of single static gamma-axons 332 (93%) could be
      characterized, and of these, 57% (183) were of the non-driven type. The mean
      number of static gamma effects characterized per spindle was 4.1 (fourteen
      experiments). In the large majority of spindles (79%, 82 out of 104) at least one
      response was of the non-driven type. 4. Of the static gamma-axons studied 16%
      were called 'non driving' ('ndr' gamma s-axons) because they elicited non-driven
      effects, and since they had the same qualitative effect consistently in all
      spindles whose discharge was modulated by stimulating them they were called
      specific 'ndr' axons. If axons with non-driven effects, but acting on one spindle
      were included in the 'non-driving' category the proportion was 23%. Of spindles
      tested 63% were innervated by at least one 'ndr' axon. 5. Absence of Ia driving
      during ramp frequency stimulation of gamma s-axons has been equated with
      selective bag2 contraction. All the non-driven responses identified in this study
      cannot be attributed to exclusive bag2 involvement because the total number of
      'ndr' responses was too high. In fact, in the isolated spindle preparation bag2
      and chain co-contraction were shown to elicit non-driven responses, so chain
      contraction is not detected reliably in all experimental conditions. Possibly
      chain fibre contraction is sometimes too weak to dominate the response, or can be
      of a non-driving character.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487213
TI  - Involvement of intrahepatic innervation in caesium-induced haemodynamic
      oscillations in the rat liver.
AB  - 1. Cs+ was used to study the mechanisms involved in the induction of haemodynamic
      and metabolic oscillations in the isolated rat liver perfused by the portal vein.
      2. Cs+ (2.25 mM) in K(+)-free perfusate causes the appearance of periodic
      increases in portal pressure (3.87 +/- 0.6 mmHg, n = 24) and decreases in O2
      uptake (111 +/- 26 microM) at a frequency of 0.013 +/- 0.002 Hz. A 19.8 +/- 1.2
      min induction time occurs prior to the generation of periodicity. The
      oscillations are interspersed with low amplitude shoulders and peaks indicating
      multiple non-phasic components. 3. Cs+ concentrations higher or lower than 2.25
      mM decrease oscillation amplitude and render them aperiodic. No oscillations are
      observed with 0.5 or 12.5 mM Cs+. 4. The oscillations are reversibly blocked by 1
      mM K+, 1 mM EGTA, 5 microM verapamil or 0.17 microM tetrodotoxin. One micromolar
      chlorpheniramine, 10 microM propranolol, 12 microM phentolamine or 35 microM
      atropine also maximally inhibit the Cs(+)-induced vasoactivity. 5. The results
      show that the liver perfused by the portal vein has all of the components
      required to activate vascular synchrony including intrinsic neural input and
      responsive vasoactive cells.

PMID- 8487214
TI  - The time course of phosphate metabolites and intracellular pH using 31P NMR
      compared to recovery heat in rat soleus muscle.
AB  - 1. The recovery time course of changes in phosphate metabolites and pH, after
      tetanic contractions of 6 and 9 s were studied using 31P NMR with 4 and 16 s
      resolution, in rat soleus muscles at 20 degrees C. Muscles were at a sarcomere
      length of 3.15 microns (active), being greater than optimum for force which was
      2.88 microns (active). 2. The post-contraction recovery of chemical changes was
      compared with the heat production in parallel experiments. Initial and recovery
      heat production were measured in tetanically stimulated muscles. 3. During
      recovery from tetanic contractions the changes in phosphocreatine (PCr) matched
      the changes in inorganic phosphate (Pi). The change in intracellular pH (pHi) was
      biphasic. The pHi first became more alkaline after contraction and then decreased
      until it reached a point below the baseline value. There was then a final
      recovery. 4. The initial heat and recovery heat production were greater than that
      expected from the PCr hydrolysis estimated during the tetanus and the PCr
      resynthesis that follows. 5. These data support the presence of 'unexplained
      heat' during a contraction and its related recovery processes in rat soleus
      muscle.

PMID- 8487215
TI  - Membrane properties and synaptic potentials of three types of neurone in rat
      lateral amygdala.
AB  - 1. Intracellular recordings were made from the lateral nucleus of the amygdala in
      tissue slices cut from rat brain and maintained in vitro. 2. Three types of
      neurones were distinguished according to the after-potential that followed an
      action potential. Type 1 cells (44%, n = 225) had depolarizing after-potentials,
      resulting from a calcium-dependent chloride conductance. Type 2 cells (48%) had
      long-lasting (> 250 ms) hyperpolarizing after-potentials and type 3 cells (8%)
      had shorter hyperpolarizing after-potentials. The average resting potentials of
      the three cell types were -78, -69 and -62 mV respectively. Intracellular
      labelling with biocytin showed that type 1 cells were pyramidal neurones; type 2
      and type 3 cells were non-pyramidal. 3. Experiments with receptor antagonists
      identified synaptic potentials mediated by excitatory amino acids and by GABA
      (acting at GABAA receptors) in all three cell types. A longer duration inhibitory
      synaptic potential resulting from activation of GABAB receptors was present in
      type 1 (pyramidal) and type 2 cells. 4. Cholecystokinin (100 nM to 1 microM)
      depolarized type 2 and type 3 cells but had no effect on type 1 (pyramidal)
      cells. Baclofen (1-3 microM) hyperpolarized type 1 and type 2, but not type 3
      cells. [Met5]enkephalin (1-10 microM) hyperpolarized only type 2 cells. 5. It is
      concluded that the lateral nucleus of the amygdala contains pyramidal neurones
      and two types of non-pyramidal neurone; these can be differentiated by membrane
      properties, synaptic inputs and sensitivities to transmitters.

PMID- 8487216
TI  - Relaxant innervation of the guinea-pig trachealis: demonstration of capsaicin
      sensitive and -insensitive vagal pathways.
AB  - 1. The guinea-pig trachea was isolated with its extrinsic innervation intact and
      placed in a water-jacketed dissecting dish containing warmed, oxygenated Krebs
      solution. The trachea was not separated from the oesophagus. Two adjacent
      cartilage rings of the rostral portion of the trachea were cut open opposite the
      trachealis and prepared for isometric tension measurements. 2. Following the
      addition of atropine and contraction of the trachealis with prostaglandin F2
      alpha (PGF2 alpha), stimulation of the cervical sympathetic trunks elicited
      relaxations that were abolished by propranolol or hexamethonium. Stimulation of
      the vagus nerves caudal to the nodose ganglia also elicited relaxations. These
      vagally mediated relaxations were unaffected by propranolol but were abolished by
      hexamethonium or by cutting the recurrent laryngeal nerves. 3. After cutting the
      vagi caudal to the nodose ganglia, stimulation of the vagi rostral to the nodose
      ganglia elicited relaxations of the trachealis that were not significantly
      affected by either propranolol or hexamethonium but were abolished by cutting the
      superior laryngeal nerves. Stimulation of right vagi which had undergone
      supranodose vagotomy 14 days prior to experimentation was without effect on the
      smooth muscle of the guinea-pig trachea while the response to stimulation of the
      left vagus was unchanged. 4. Acute capsaicin desensitization abolished
      relaxations of the guinea-pig trachealis elicited by stimulation of the vagal
      fibres carried by the superior laryngeal nerves. In contrast, capsaicin
      desensitization only modestly inhibited relaxations elicited by stimulation of
      the preganglionic parasympathetic fibres carried by the recurrent laryngeal
      nerves and had no effect on sympathetic nerve-induced relaxations. 5. Removing
      the oesophagus selectively abolished relaxations elicited by stimulation of both
      vagal pathways of non-adrenergic relaxant innervation. Non-adrenergic relaxations
      of the trachealis elicited by electrical field stimulation were unaffected by
      removing the oesophagus. Oesophagus removal also had no effect on the
      parasympathetic-cholinergic contractile innervation or the sympathetic relaxant
      innervation of the trachealis. 6. The results indicate that the guinea-pig
      trachealis receives non-adrenergic relaxant innervation from both parasympathetic
      and capsaicin-sensitive vagal pathways. The results also suggest that the
      neurones mediating non-adrenergic relaxations of the trachea are sensitive to
      oesophagus removal. The observation that oesophagus removal abolishes
      parasympathetic relaxations of the trachealis while having no effect on
      parasympathetic contractions supports the hypothesis that the guinea-pig
      trachealis receives excitatory and inhibitory innervation from distinct vagal
      parasympathetic pathways.

PMID- 8487217
TI  - Orofacial manifestations in primary immunodeficiencies involving IgA deficiency.
AB  - The orofacial manifestations of 39 patients with primary IgA deficiency are
      reported. Aphthous-like oral ulceration was observed in 61% while candidosis and
      recurrent herpes labialis were each present in 25%. Only 4 (9%) patients had no
      orofacial lesions.

PMID- 8487218
TI  - Clonal expansion of lymphocytes from oral lichen planus lesions.
AB  - Lymphocytes were extracted from 11 biopsy specimens of oral lichen planus (OLP)
      by collagenase digestion, and cell lines were expanded with repetitive cycles of
      stimulation (with phytohaemagglutinin) and rest in media supplemented with
      interleukin 2. Four OLP lines contained a majority of CD3+CD4-CD8+ cells, in six
      lines the CD4:CD8 ratio was between 1 and 2, and in one line the CD4:CD8 ratio
      was 5:1. Limiting dilution of nine lines at 0.3 and 1.0 cells/well resulted in
      viable wells (putative clones) with plating efficiencies ranging from 0.0 to 18.1
      percent and 0.0 to 22.2 percent respectively. The majority of clones were CD3+CD4
      CD8+alpha beta+gamma delta-, although three clones were CD3+CD4+CD8-alpha
      beta+gamma delta- and one clone was CD3+CD4-CD8- and expressed the gamma delta T
      cell receptor. T cell clones derived from lymphocytes extracted from OLP lesions
      may be generated and maintained in culture providing opportunity for their
      further phenotypic and functional characterisation. This strategy may facilitate
      the identification of a putative oral lichen planus-specific antigen and indicate
      the frequency of lichen planus-specific T cells within lesions of OLP.

PMID- 8487219
TI  - Role of thermal trauma in experimental oral mucosal Candida infections in rats.
AB  - A model of candidosis in experimental rats was used to study the role of trauma
      in the aetiology of oral mucosal infections caused by Candida albicans.
      Standardised thermal trauma was delivered to the dorsum of the tongue of Sprague
      Dawley rats and experimental candidosis was induced. Histologically, the site of
      trauma was invaded by hyphae earlier and more extensively than in control
      animals, leading to the conclusion that trauma facilitated the establishment of
      the C. albicans infections.

PMID- 8487220
TI  - Effect of sialoadenectomy on the carriage of Candida albicans in the mouths of
      rats.
AB  - Xerostomia provoked in rats by surgical removal of the major salivary glands
      significantly increased oral carriage of Candida albicans. Five weeks after 3
      oral inoculations of 10(8) CFU, C. albicans were found in the mouths in 50% of
      normal animals but after 8 weeks in none. In xerostomic rats, 100% had oral C.
      albicans after 5 weeks and after 18 weeks, 66.6% still harboured yeasts. Over the
      whole experimental period the amount of C. albicans was greater in the mouths of
      sialoadenectomized than in normal rats.

PMID- 8487221
TI  - Legume-associated residual cyst.
AB  - This report describes three unique cases of residual cyst (RC) which were
      characterized by large legume implants. To determine whether these represented a
      distinctive RC subset or if implanted materials have general importance in RC
      pathogenesis, a retrospective comparison of these cases and 37 further RCs with
      40 control periapical cysts was performed. The frequency of foreign material
      implantation and the associated histopathologic features were assessed. No
      significant differences were noted suggesting that foreign implantations do not
      have an etiologically significant association with RCs and that the legume
      associated RCs represent a unique subgroup. The relationship of the legume
      associated RCs to the category of lesions variously termed giant cell hyaline
      angiopathy, oral pulse granuloma or hyaline ring granuloma is discussed.

PMID- 8487222
TI  - Hospital psychiatric units. Nonsmoking policies.
AB  - Establishing nonsmoking policies in hospitals--even on acute psychiatric units-
      requires patience, planning, and a bit of nerve. The benefits of such a move,
      however, can be significant for patients and staff. When Vancouver General
      Hospital implemented a complete indoor nonsmoking policy on its psychiatric
      assessment and inpatient psychiatry units, workplace conditions noticeably
      improved, and some long-standing beliefs about psychiatric patients were
      disproved. Several conditions provided the impetus to change to a nonsmoking
      policy. With a few exceptions (palliative care, the burn unit) the indoor areas
      were nonsmoking; nevertheless, the hospital environmental committee considered a
      site-wide (indoor and outdoor) ban on smoking. One reason was that the community
      funding that had provided psychiatric patients with cigarettes would soon be cut
      off. Another reason was that all psychiatry units were anticipating moving into
      the new hospital tower--a facility slated to be smoke-free--on its completion.

PMID- 8487223
TI  - Lesbian self-disclosure. Strategies for success.
AB  - 1. Lesbian nurses must decide whether to share information about lesbian culture
      with their nursing colleagues. 2. Making calm rejoinders to homophobic remarks,
      using policies on minority status and affirmative action, promoting competitive
      liberalism between institutions, and using marketing techniques can aid lesbian
      self-disclosure to individuals and institutions. 3. Nurses who are open about
      being lesbian can provide healthy role models for their colleagues and patients.

PMID- 8487224
TI  - Partnership to prevent chemical dependency in nursing using Neuman's systems
      model.
AB  - 1. Neuman's theory of optimal client system, which has the goal to maintain or to
      bring about the system's stability by the process of reconstitution, is used as
      the basis for the prevention efforts of the West Tennessee Nurses' Peer
      Assistance Program. Efforts are directed at bringing the client system to a state
      of stability or wellness that is higher than the previous state of chemical
      dependency. 2. The program has grown in both number of clients and in
      comprehensiveness of its prevention activities. Prevention in three specific
      areas--primary, secondary, and tertiary--is needed to combat the chemical
      dependency problem in nursing. 3. A continued partnership between the university,
      the school of nursing, the TNF, the TBN, and the various health care providers
      and nurse practitioners is needed to address the problem of chemical dependency
      in nursing.

PMID- 8487225
TI  - Focus on dementia.

PMID- 8487226
TI  - Relationships between cognitively impaired elders.

PMID- 8487227
TI  - What goals and interventions are important for psychiatric nurses to use when
      working with homeless chronically mentally ill?

PMID- 8487228
TI  - Clozapine: how it changed my life.

PMID- 8487229
TI  - More violence, more need for change.

PMID- 8487230
TI  - Recovering our sense of value after being labeled mentally ill.
AB  - 1. People with mental illness must know that mental illness does not mean they
      can no longer lead full lives. Role models--successful people who have mental
      illness--are needed. 2. There is a great danger in labeling a person as an
      illness. Once people believe they are an illness, there is no one left inside to
      take a stand toward the illness; they give up control and others take
      responsibility for them. 3. "High functioning" and "low functioning" are not
      attributes that exist inside a person. They are value judgments that are put on a
      person. There are no high-functioning or low-functioning people. There are people
      whose contribution we are able to see and value and there are those whose gifts
      we have failed to see and have failed to value.

PMID- 8487231
TI  - Local anesthesia for cryosurgery on the cervix.
AB  - Forty-five patients were evaluated in a prospective, randomized study to
      determine the effectiveness of a local injection of lidocaine in reducing pain
      during cervical cryosurgery. Study patients received a submucosal cervical
      injection of 1% lidocaine with a 1:100,000 dilution of epinephrine. Control
      patients did not receive an injection. Both groups received a single dose of
      naproxen sodium or ketoprofen prior to the procedure. The patient and the
      observing nurse recorded the pain experienced with a visual analog scale (VAS).
      Nurse and patient response for the control and study groups showed a high
      correlation (r = .573 and P < .01, r = .673 and P < .001, respectively). The mean
      VAS score recorded for the 26 control patients was 4.27, significantly greater
      than the mean score for the 19 study patients, 1.16 (P < .001). These findings
      indicate that a submucosal local injection of lidocaine with epinephrine is
      effective in reducing pain during cervical cryosurgery.

PMID- 8487232
TI  - LA-1 oncogene. A possible new prognostic index for evaluating cervical squamous
      intraepithelial lesions.
AB  - Cervical biopsies from 96 patients referred to the Union Memorial Hospital
      Colposcopy Clinic were analyzed for the expression of the LA-1 oncogene by using
      an antibody directed against a 13 amino acid epitope of the oncogene product. The
      expression of the oncogene was found to correlate with the grade of the cervical
      intraepithelial lesion. A trend was suggested even though chi 2 analysis was not
      significant (P = .08). Further studies are warranted to determine whether the LA
      1 test predicts persistence or progression of the disease.

PMID- 8487233
TI  - Estrogen replacement therapy and breast cancer.
AB  - The safety of estrogen use in breast cancer patients is discussed. Most reports
      indicate there is no risk.

PMID- 8487234
TI  - Elective cesarean hysterectomy for treatment of cervical neoplasia. An update.
AB  - From January 1, 1979, to March 31, 1991, 37 patients underwent elective cesarean
      hysterectomy for early cervical neoplasia. Thirty-four patients had cervical
      intraepithelial neoplasia III, and three patients had stage IA-1 squamous cell
      carcinoma of the cervix. Twenty-eight were primary cesarean sections; nine had
      obstetric indications. The mean operative time was 128 minutes; mean estimated
      blood loss was 1,400 mL. One patient experienced an intraoperative hemorrhage
      (3,500 mL). There were no other recognized intraoperative complications. Four
      significant postoperative complications included a vaginal cuff abscess, a wound
      dehiscence and pelvic abscess, one patient with febrile morbidity and an ileus
      and ligation with partial transection of a ureter. Patients were discharged on a
      mean of postoperative day 5.7. Although significant complications occurred, we
      believe that the noncompliant nature of our patient population justifies elective
      cesarean hysterectomy for treatment of cervical neoplasia.

PMID- 8487235
TI  - Maternal renal artery Doppler flow-velocity waveform in preeclampsia. A
      preliminary report.
AB  - By use of duplex Doppler ultrasonography, we preliminarily studied 30 normal
      pregnancies (control group) and 30 patients with preeclampsia (study group)
      before treatment. The peak systolic flow height to end diastolic flow height
      (S/D) ratio of the maternal right and left renal arteries of both groups were
      compared and analyzed. The results showed that there were no significant
      differences between the right and left renal arteries in either group, but
      unexpectedly the S/D ratio of the renal artery on both sides in preeclamptic
      patients was significantly lower than in normal pregnant women (mean +/- SD, 2.07
      +/- .12 vs. 2.41 +/- .12, respectively, P < .001). The lower S/D ratio of the
      renal artery may reflect a decrease in renovascular resistance and an increase in
      renal perfusion. These findings were the reverse of what might be expected from
      an elevated vascular resistance and hypoperfusion model.

PMID- 8487236
TI  - Breech presentation and fetal growth retardation.
AB  - Although it has been consistently demonstrated that breech presentation is
      associated with fetal growth retardation, this relationship has not been
      clarified. This study intends to elucidate this association by use of live births
      recorded in North Carolina in 1988 and 1989. A remarkable difference in birth
      weight between breech and vertex infants existed only in the preterm births.
      Although the breech infants had a higher proportion of small for gestational age
      than the vertex infants, the difference in the proportions decreased with
      advancing gestational age. Our analysis indicated that breech presentation is
      unlikely to be a cause of fetal growth retardation. Results of the study also
      implied that the significant association between breech presentation and
      increased perinatal mortality may be due in part to the common correlation with
      premature delivery and fetal growth retardation.

PMID- 8487237
TI  - Tuboovarian abscesses after operative hysteroscopy.
AB  - Postoperative infection after operative hysteroscopy is uncommon. However,
      patients who have a past history of pelvic inflammatory disease appear to be at
      risk of developing such infections, including tuboovarian abscesses. Prophylactic
      antibiotics during operative hysteroscopy appear to be effective in preventing
      this problem.

PMID- 8487238
TI  - Fetal biparietal diameter, head circumference, abdominal circumference and femur
      length. A comparison by race and sex.
AB  - Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC)
      and femur length (FL) were compared by race and sex in 5,405 ultrasound
      examinations done on 2,831 women. Black fetuses had significantly longer FL than
      white fetuses; male fetuses had larger BPD, HC and AC than females. The
      differences in BPD, HC and AC correlated with the different birth weights
      observed between male and female infants, 3,253 vs. 3,153 g. The difference in
      birth weight between black and white infants, 3,152 vs. 3,331 g, did not
      correlate with differences in their respective BPD, HC and AC. Earlier delivery
      accounted for some but not all of the birth weight difference between black and
      white infants. Our data suggest that there may be differences in body length
      proportions (longer legs and shorter trunks in black infants) that are important
      factors in understanding the birth weight difference between black and white
      infants. Furthermore, fetal race and sex differences could account for some
      degree of error in the ultrasound estimation of gestational age.

PMID- 8487239
TI  - Evaluation of low-dose estrogen and progestin therapy in postmenopausal women. A
      double-blind, prospective study of sequential versus continuous therapy.
AB  - In this prospective, double-blind study, we evaluated the efficacy and safety of
      low-dose estrogen and progestin replacement therapy in 36 postmenopausal women
      who were administered oral medroxyprogesterone acetate (MPA) cyclically or
      continuously in combination with conjugated equine estrogen (CEE) 0.625 mg daily.
      In the sequential group, MPA (5.0 mg) was administered daily for 12 days of each
      25-day treatment cycle. In the two continuous groups, MPA was administered
      without interruption at a daily dose of either 2.5 mg or 5.0 mg for 12 treatment
      cycles. Of the 36 women in the study, 29 women completed the one-year protocol.
      The clinical and metabolic responses were assessed before and every three cycles
      during the 12 cycles of treatment. Endometrial biopsies and lumbar bone density
      scans were performed before and during the last week of the 12th treatment cycle.
      Vasomotor and urogenital symptoms improved in all women. Cyclic menstrual
      bleeding occurred in all patients on sequential therapy, and proliferative
      endometrium was noted in two of these women. All patients in both continuous
      treatment groups experienced amenorrhea after the fifth cycle of therapy, and all
      endometrial biopsies were atrophic or inactive. From the 3rd through the 12th
      month of cycle, favorable lipid and lipoprotein changes occurred in all treatment
      groups. Lumbar bone mineral density improved significantly (P < .05) by an
      average of 6.41% in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487240
TI  - Weight, length, head and chest circumference at birth in Phoenix, Arizona.
AB  - Standard percentile curves are presented for weight, length, head circumference
      and chest circumference at birth for a population of 27,963 singleton infants
      born between the gestational ages of 26 and 42 weeks at a large, private hospital
      in Phoenix, Arizona. At term, all four growth parameters were significantly
      greater in male than in female infants. These parameters were significantly
      reduced in infants born to mothers who smoked and increased in infants born to
      mothers with diabetes. Percentiles in all parameters were higher than in those of
      previous studies, suggesting that continued use of growth curves based on older
      data may result in misclassification of infants with respect to appropriateness
      of growth-for-gestational age.

PMID- 8487241
TI  - Subtle ultrasound signs of appendicitis in a pregnant patient. A case report.
AB  - An abnormal, 1 cm in diameter appendix in a pregnant patient was demonstrated
      using graded compression sonography. Prior to the use of this technique, the
      suggestion of appendicitis on ultrasound examination was made only after
      observation of an abscess or peritoneal fluid.

PMID- 8487242
TI  - Prenatal diagnosis of fetal pelvic kidney. A case report.
AB  - Published experience on prenatal diagnosis of pelvic kidney is limited. We
      present the ultrasonographic characteristics of a case of ectopic pelvic kidney
      and discuss the significance of prenatal diagnosis.

PMID- 8487243
TI  - Management of osteogenesis imperfecta in pregnancy. A case report.
AB  - Osteogenesis imperfecta (OI) is a metabolic disorder of connective tissue; it is
      typically characterized by blue sclera, bone fragility and deformity secondary to
      repetitive fractures. The severity of the disease in the infant cannot be
      predicted by the phenotypic presentation of the mother. We present a case report
      and review literature and discuss the prenatal diagnosis, evaluation criteria and
      guidelines for delivery.

PMID- 8487244
TI  - Spontaneous uterine rupture after hysteroscopic metroplasty with uterine
      perforation. A case report.
AB  - This is the first documented case of spontaneous uterine rupture during pregnancy
      following hysteroscopic metroplasty complicated by uterine perforation. This case
      emphasizes the importance of treating these patients as high risk throughout
      pregnancy.

PMID- 8487245
TI  - Preclinical and clinical pharmacology of carvedilol.
AB  - Carvedilol is a novel multiple-action cardiovascular drug that has recently been
      introduced to the market for the treatment of mild to moderate hypertension.
      Clinical studies have demonstrated that once daily therapy with carvedilol is
      efficacious and has a favourable side-effect profile. Clinical studies are in
      progress to establish the utility of carvedilol in angina and congestive heart
      failure. Carvedilol is a beta-adrenoceptor antagonist and a vasodilator, with the
      vasodilating activity resulting primarily from alpha 1-adrenoceptor blockade and
      possibly also from calcium channel blockade. The reduction in BP produced by
      carvedilol results from the vasodilating activity of the drug because peripheral
      vascular resistance is significantly reduced. The reduction in BP produced by
      carvedilol is not associated with reflex tachycardia owing to the beta
      adrenoceptor blocking activity of the compound. Throughout its antihypertensive
      dose range, carvedilol has been a renal-sparing antihypertensive agent in animals
      and also in humans, inasmuch as renal blood flow, glomerular filtration rate and
      sodium excretion are all maintained. In preclinical experimental models of acute
      myocardial infarction, carvedilol has produced marked reductions in infarct size
      in the pig, rat and dog. The cardioprotection observed with carvedilol is greater
      than that provided by beta-adrenoceptor antagonists alone, suggesting that the
      additional activities of carvedilol may provide benefit in the setting of
      myocardial ischaemia.

PMID- 8487246
TI  - Relationship between cardiovascular haemodynamics and goals of antihypertensive
      therapy.
AB  - Hypertension is a haemodynamic disorder, reflecting a disturbance in the ratio
      between cardiac output and total peripheral resistance. In nearly all forms of
      established hypertension, total peripheral resistance is increased and cardiac
      output is abnormally low, particularly during exercise. When left untreated,
      total peripheral resistance increases, cardiac output falls and BP increases over
      time. The coronary reserve is reduced. Antihypertensive agents affect central
      haemodynamics differently. Vasodilators like alpha-blockers, calcium channel
      blockers and angiotensin-converting enzyme inhibitors all reduce total peripheral
      resistance and maintain cardiac output unchanged at rest as well as during
      exercise. In contrast, beta-blockers do not usually reduce total peripheral
      resistance much below the pretreatment level, and cardiac output is chronically
      depressed, particularly during exercise. However, the beta-blockers greatly
      reduce the workload in the heart by decreasing the rate-pressure product.
      Recently-developed beta-blockers with vasodilating activity, such as carvedilol,
      are based on a combination of beta-blockade and vasodilatation. Such beta
      blockers also induce marked reduction in pressure-rate product and some reduction
      in total peripheral resistance. They induce less reduction in cardiac output
      during exercise than ordinary beta-blockers. From a theoretical point of view,
      this type of antihypertensive treatment should maintain good BP control, reduce
      cardiac workload and be associated with fewer side-effects than ordinary beta
      blockers.

PMID- 8487247
TI  - Altered coronary flow reserve in the hypertrophied heart: implications for
      therapy.
AB  - Coronary flow reserve has been shown to be abnormally low in several models of
      left ventricular hypertrophy induced by long-standing pressure overload. Because
      the presence of hypertrophy is a risk factor for the development of
      subendocardial ischaemia and sudden death, efforts to restore alterations in flow
      reserve may prove beneficial. In the following review, we discuss potential
      mechanisms which might contribute to this abnormal vasodilator capacity in the
      hypertrophied heart, with particular emphasis on how chronic therapy may
      potentially reverse such abnormalities. In addition, we report how the acute
      administration of various classes of pharmacological agents can alter
      measurements of coronary flow reserve, as observed in our anaesthetised swine
      model. Such factors must be considered before interpreting any changes in
      coronary flow reserve in models of hypertrophy following chronic administration
      of drugs.

PMID- 8487248
TI  - Kidney and aetiology, pathology and management of essential hypertension.
AB  - The existence of a relationship between the kidney and arterial hypertension has
      long been known. Renal participation in the development of arterial hypertension
      has been clearly shown in different animal models that mimic human essential
      hypertension. Some data obtained in hypertensive humans also seem to support the
      prevalence of the kidney in the initiation of this particular type of arterial
      hypertension. On the other hand, renal vasculature can also suffer the
      consequences of essential hypertension and, as a result, chronic renal failure
      can develop. The role of antihypertensive therapy in preventing renal damage has
      been sufficiently addressed. However, investigation of the potential for
      facilitating the antihypertensive capacity of drugs through their renal effects
      and investigation of the differing abilities of particular groups of
      antihypertensive agents to prevent or slow the progression of renal damage
      constitutes a challenge for future research.

PMID- 8487249
TI  - Renal haemodynamics in hypertension: effects of antihypertensive drugs.
AB  - Sustained essential hypertension is characterised by a progressive decline in
      renal blood flow and a progressive increase in renal vascular resistance, while
      glomerular filtration rate remains normal or is reduced to a lesser extent. Renal
      blood flow is not only decreased per unit square metre of body surface area but
      also as a fraction of cardiac output. Although the precise mechanism of this
      renal haemodynamic abnormality remains speculative, the possibility that the
      renal vasculature plays a role in the pathogenesis of essential hypertension is
      receiving major attention. Different antihypertensive drugs have different renal
      haemodynamic effects. Nonselective beta-blockers generally tend to cause a modest
      decrease in renal blood flow but certain beta-blockers (including those with
      cardio-selectivity or intrinsic sympathomimetic activity) appear to cause less of
      a reduction in renal haemodynamics than others. Adrenergic blocking agents and
      diuretics do not produce clinically relevant renal haemodynamic changes, and data
      obtained with vasodilators are conflicting. Most studies with calcium antagonists
      show a renal vasodilator response. Angiotensin-converting enzyme inhibitors
      increase renal blood flow and decrease renovascular resistance in essential
      hypertension.

PMID- 8487250
TI  - The issue of quality of life in antihypertensive therapy.
AB  - The treatment of hypertension is based on an assessment of the balance between
      the effects of therapy on survival on the one hand and effects of the patient's
      symptoms and well-being on the other. The concept of quality of life is used to
      summarise the latter effects. Preservation of quality of life involves both the
      prevention of hypertensive complications and detrimental effects on well-being
      induced by drugs. However, scientific accumulation of data in this area has been
      severely hampered by the lack of consensus as to how quality of life should be
      defined and measured. The scientific power of the quality of life concept has
      also yet to be proven. Although recent studies indicate that specific aspects of
      quality of life could be adequately assessed the relative importance of minor
      shifts in questionnaire or test scores remains an unresolved scientific and
      clinical issue. Despite these shortcomings a series of studies now available
      suggests that there are only minor differences between the first-line
      antihypertensive drugs (e.g. beta-blockers and ACE inhibitors) regarding their
      effect on quality of life.

PMID- 8487251
TI  - Clinical significance of the metabolic effects of antihypertensive drugs.
AB  - Data from the Hypertension Treatment Trials do not indicate that the metabolic
      effects of the medications used, namely diuretics in all and beta-blockers in
      some, are of great clinical significance. Effects on lipids are mainly short-term
      (about one year) and the increased incidence of significant hyperglycaemia and/or
      diabetes in treated compared with control or placebo subjects is < 1% in most
      trials. The use of these drugs has improved the prognosis of subjects with both
      severe and less severe hypertension. Despite these findings, it is possible that
      medications such as the calcium blockers, ACE inhibitors, or multiple-action
      drugs, e.g. the alpha-beta-blockers which have no negative and possibly have some
      positive effects on lipids and glucose metabolism, will improve outcome still
      further. We must await additional long-term trials to determine this. It is
      possible that combinations of small doses of two different agents from different
      classes of drugs will prove to be the ideal approach to hypertension management
      in the future: efficacy is improved and any adverse metabolic effects are
      minimised.

PMID- 8487252
TI  - Treating hypertension in the elderly.
AB  - Hypertension is a common problem in the elderly, with a prevalence of about 50%.
      The risk of cardiovascular disease and death is increased in hypertensive
      patients aged 60-79 years, whereas this increased risk seems to be diminished or
      even non-existent in those aged > or = 80 years. Antihypertensive drug treatment
      has been shown to be beneficial for most elderly patients but whether this is
      also true for the oldest patients is less clear. Treatment is more difficult in
      the elderly than in the middle aged or young because of the structural and
      functional alterations of the cardiovascular system associated with ageing (in
      particular the impairment of BP homeostasis), which contraindicate some drugs and
      impose a cautious use of the remaining ones. Isolated systolic hypertension
      increases the cardiovascular risk but we lack data on the efficacy of treatment
      in this group.

PMID- 8487253
TI  - Fluorine-18-labeled progestin ketals: synthesis and target tissue uptake
      selectivity of potential imaging agents for receptor-positive breast tumors.
AB  - We have studied two new fluorine-substituted progestins as potential imaging
      agents for progesterone-receptor-positive human breast tumors. The steroids are
      16 alpha, 17 alpha-fluoroacetophenone ketals of 16 alpha, 17 alpha
      dihydroxyprogesterone and 16 alpha, 17 alpha, 21-trihydroxy-19-norprogesterone.
      Synthesis of the latter compound in seven steps from 19-norandrost-4-ene-3,17
      dione is reported. Both compounds demonstrate high affinity for the progesterone
      receptor (PgR) (52.5 and 240%, respectively, relative to R5020 = 100). The
      syntheses were adapted to 18F-labeling with 4'-[18F]-fluoroacetophenone, prepared
      from 4'-nitroacetophenone by nucleophilic substitution with K18F/Kryptofix.
      Considerable adjustment of reaction conditions was required to effect
      ketalization using tracer quantities of the ketone. In tissue distribution
      studies in estrogen-primed immature female rats, both ketals showed selective
      uterine uptake, which was blocked by coinjection of a saturating dose of the
      unlabeled progestin ORG 2058. Additionally, metabolic stability of the radiolabel
      was indicated by the low radioactivity levels seen in bone. Both compounds showed
      relatively high uptake in fat, in accord with their relative lipophilicities
      demonstrated by HPLC-derived octanol-water partition coefficients. The selective
      uterine uptake and metabolic stability of these compounds suggests that this
      class of PgR ligands might be promising for the selective imaging of receptor
      positive tumors if derivatives of reduced lipophilicity can be prepared.

PMID- 8487254
TI  - Development of a pharmacophore for inhibition of human liver cytochrome P-450
      2D6: molecular modeling and inhibition studies.
AB  - To gain insight into the specificity of cytochrome P-450 2D6 toward inhibitors, a
      preliminary pharmacophore model was built up using strong competitive inhibitors.
      Ajmalicine (1), the strongest inhibitor known (Ki = 3 nM) was selected as
      template because of its rigid structure. The preliminary pharmacophore model was
      validated by performing inhibition studies with derivatives of ajmalicine (1) and
      quinidine (9). Bufuralol (18) was chosen as substrate and the metabolite 1'
      hydroxybufuralol (19) was separated by high performance liquid chromatography.
      All incubations were carried out using human liver microsomes after demonstration
      that the Ki values obtained with microsomes were in accordance with those
      obtained with a reconstituted monooxygenase system containing purified cytochrome
      P-450 2D6. Large differences of Ki values ranging between 0.005 and 100 microM
      were observed. Low-energy conformers of tested compounds were fit within the
      preliminary pharmacophore model. The analysis of steric and electronic properties
      of these compounds led to the definition of a final pharmacophore model.
      Characteristic properties are a positive charge on a nitrogen atom and a flat
      hydrophobic region, the plane of which is almost perpendicular to the N-H axis
      and maximally extends up to a distance of 7.5 A from the nitrogen atom. Compounds
      with high inhibitory potency had additional functional groups with negative
      molecular electrostatic potential and hydrogen bond acceptor properties on the
      opposite side at respective distances of 4.8-5.5 A and 6.6-7.5 A from the
      nitrogen atom. The superposition of strong and weak inhibitors led to the
      definition of an excluded volume map. Compounds that required additional space
      were not inhibitors. This is apparently the first pharmacophore model for
      inhibitors of a cytochrome P-450 enzyme and offers the opportunity to classify
      compounds according to their potency of inhibition. Adverse drug interactions
      which occur when both substrates and inhibitors of cytochrome P-450 2D6 are
      applied may be predicted.

PMID- 8487255
TI  - 5-[4-(benzyloxy)phenyl]-1,3,4-oxadiazol-2(3H)-one derivatives and related
      analogues: new reversible, highly potent, and selective monamine oxidase type B
      inhibitors.
AB  - Thirty-three new 5-[4-(benzyloxy)phenyl]-1,3,4-oxadiazol-2(3H)-one derivatives
      including related analogues, designed as inhibitors of monoamine oxidase type B
      (MAO B), were synthesized and investigated both in vitro and ex vivo for their
      abilities to inhibit selectively rat brain MAO B over MAO A. Three inhibitors
      were found to act as reversible, highly potent, and selective MAO B inhibitors,
      namely the nitrile derivative 5-[4-(benzyloxy)phenyl]-3-(2-cyanoethyl)-1,3,4
      oxadiazol-2(3H)-one (12a) and two closely related homologues, the corresponding
      oxadiazolethione 13a and the alcohol 14b. Their IC50 (MAO B) values are in the
      low nanomolar range of 1.4-4.6 nM and their selectivities, estimated by the ratio
      of IC50 values (A/B), are from 3200 to > 71,400. Compound 12a exhibited the
      highest activity against MAO B. Its IC50 was evaluated to be 1.4 nM with a
      quasitotal selectivity (> 71,400) toward this enzyme. In ex vivo studies, 12a
      showed a reversible and short duration of action. MAO B was markedly inhibited
      with the oral dose of 1 mg/kg without any alteration of MAO A, and the inhibition
      almost did not exceed 24 h. Its ED50 (1 h after oral administration) was
      evaluated to be 0.56 mg (1.7 mumol)/kg. Remarkably, MAO A was not affected at
      doses as high as 1500 mg/kg, po. In addition, no apparent toxicity or behavioral
      anomaly was observed during the treatment even at the maximum administrated dose.
      SAR studies emphasize the existence of three binding sites to the enzyme with a
      special importance of the terminal phenyl. Analysis of the inhibition kinetics
      indicated that 12a acts in a two-step mechanism as a competitive, slow, and tight
      binding inhibitor of MAO B with a Ki value of 0.22 microM and an overall Ki*
      value at equilibrium of 0.7 nM.

PMID- 8487256
TI  - Synthesis and structure-activity relationships of novel benzimidazole and
      imidazo[4,5-b]pyridine acid derivatives as thromboxane A2 receptor antagonists.
AB  - A series of 1-benzylbenzimidazole and 3-benzylimidazo[4,5-b]pyridine substituted
      in the 2-position by an alkanoic or mercaptoalkanoic acid chain was synthesized
      for evaluation as potential thromboxane A2/prostaglandin H2 (TXA2/PGH2) receptor
      antagonists. The affinity of each compound for washed human platelet TXA2/PGH2
      receptors was determined by radioligand binding studies using [125I]PTA-OH.
      Structure-activity relationships led to the conclusions that 2-alkanoic acid
      derivatives were slightly more potent than 2-mercaptoalkanoic acids and that
      compounds possessing a 3,3-dimethylbutanoic acid in the 2-position were
      definitely the most potent with Ki values of 4-39 nM (11a, 11g-x, 37a, 37f-o, 23a
      c). The replacement of this 3,3-dimethylbutanoic acid side chain by a shorter one
      led to a marked decrease of affinity (11b and 11c; Ki = 5600 and 1700 nM,
      respectively). Compounds of benzimidazole and imidazo[4,5-b]pyridine series
      displayed similar potencies (11q and 23c have Ki values of 6 and 7 nM,
      respectively). The interesting pharmacological profile of compound 23a (UP 116
      77: 4-[3-[(4-chlorophenyl)methyl]-6-chloroimidazo[4,5-b]pyridin-2-yl]- 3,3
      dimethylbutanoic acid) and its excellent tolerance led us to select this
      derivative for further development.

PMID- 8487257
TI  - New indole derivatives as potent and selective serotonin uptake inhibitors.
AB  - A series of new indole derivatives (2-28) has been prepared in the search for
      novel 5-HT uptake inhibitors. These compounds were obtained by the condensation
      of N-(chloroalkyl) naphthalenesultam derivatives with the appropriate amine in
      presence of a base, at reflux of DMF or THF. The yields were moderate (12-56%),
      except for the piperazine derivative 20 (85%). The affinity of the compounds for
      uptake site and 5-HT2, alpha 1, and D2 receptors was measured. Some compounds
      were studied in vivo by their potentiating effect of 5-HTP-induced
      symptomatology. The most potent and selective (uptake, 5-HT2 versus alpha 1, D2
      sites) compounds contain a 3-[(4-piperidinyl)methyl]indole moiety. 5-Fluoro-3-[(4
      piperidinyl)methyl]indole itself (compound 1) displayed a high affinity for the
      uptake site but was devoided of in vivo activity. N-Methylation of this compound
      abolished the affinity. In contrast N-substitution by a two-carbon chain linked
      to a naphthalenesultam or related heterocycle led to compounds exhibiting high
      affinity for the uptake site. One of them, 1-[2-[4-((5-fluoro-1H-indol-3
      yl)methyl-1- piperidinyl]ethyl]-5,6-dihydro-1H,4H-1,2,5-thiadiazolo[4,3,2-
      ij]quinoline 2,2-dioxide (compound 24), was found as active as fluoxetine in
      vivo.

PMID- 8487258
TI  - Structure-function studies of amphiphilic antibacterial peptides.
AB  - The synthesis of 11 peptides, ranging in composition from 9 to 17 amino acid
      residues, by solid-phase methodology was accomplished with the purpose of
      studying how the amphiphilic and hydrophobic character, the size of the molecule,
      and the charge distribution modulate the antibacterial activity. It was found
      that peptides composed of 16 and 17 amino acid residues, with high hydrophobic
      (mainly due to Trp or Phe) and hydrophilic (due to Lys) character distributed
      along opposite amphiphilic faces, showed considerable antibacterial activity
      against clinically isolated bacteria together with Gram positive and Gram
      negative ATCC bacterial strains. However, the hemolytic capacity of the peptides
      was also significant. Decreasing the hydrophobic character of the molecule by
      replacing Trp or Phe with Leu residues while maintaining the basic contribution
      of Lys drastically reduced the hemolytic activity and only slightly decreased the
      bioactivity. Peptides composed of 9-10 amino acid residues with high hydrophobic
      and basic nature possess antibacterial activity but, in general, are less active
      than the larger counterpart peptides. By replacing all Trp residues of a short
      peptide by Leu residues, the activity was considerably reduced. Circular
      dichroism studies and antibacterial assays showed that shorter peptides with very
      low helical content, and thus deprived of amphiphilic character, still have
      appreciable bioactivity. This observation, coupled with the fact that due to
      their small size they cannot span the bacterial outer lipid bilayer, may suggest
      different mechanisms of action for long-chain vis-a-vis short-chain peptides.

PMID- 8487259
TI  - Molecular shape comparison of angiotensin II receptor antagonists.
AB  - A new and powerful analytical method for comparing molecular shapes by optimizing
      the overlap of molecular volumes has been developed. This shape comparison method
      provides both a quantitative measure of the shape similarity of molecules and a
      means to align molecules such that shape similarity if maximized. Our MSC method
      has been enhanced with an option to allow discrimination between groups with
      different chemical properties. Atoms or groups of atoms may be assigned to
      different classes based on specific properties such as electrostatic potential,
      hydrogen bonding ability, or hydrophobicity. This enables matches based on
      criteria such as alignment of hydrophobic groups or hydrogen bond acceptor
      groups. In this study, we report shape comparisons of angiotensin II (AII)
      receptor antagonists from two structural classes, 4-(biphenyl-4-ylmethoxy)
      quinoline derivatives such as ICI D8731 and N-(biphenyl-4-ylmethyl)imidazole
      derivatives, such as DuP753. Starting with a list of low-energy conformations for
      the two molecules, each conformation of the first molecule is paired with each of
      the conformations of the second molecule. For each of these conformational pairs,
      an MSC comparison, which generates multiple MSC maxima, is initiated. Eight high
      scoring conformational pairings were found with shape matching based on the
      intersection of the total molecular volume, while nine high-scoring pairs were
      identified with matching by atom type. MSC identifies conformational pairs with
      high shape similarity, as measured by the intersection volume, and thus generates
      and prioritizes several alternative models for the AII antagonist pharmacophore.

PMID- 8487260
TI  - Hybrids of antibiotics inhibiting protein synthesis. Synthesis and biological
      activity.
AB  - Four hybrid antibiotics combining structural features of chloramphenicol (1a),
      sparsomycin (2b), lincomycin (5c), and puromycin (6d)--lincophenicol (1c),
      chloramlincomycin (5a), sparsolincomycin (5b), and sparsopuromycin (6b)--were
      synthesized. They were investigated as inhibitors of several partial reactions of
      procaryotic and eucaryotic protein synthesis as well as potential antimicrobial
      agents. Lincophenicol (1c) was active as inhibitor of Escherichia coli ribosomal
      peptidyltransferase-catalyzed puromycin reaction. Both lincophenicol (1c) and
      sparsophenicol (1b) inhibited the binding of the iodophenol analogue of
      sparsomycin to E. coli ribosomes. The results are discussed in terms of a retro
      inverso hypothesis advanced earlier for interpretation of biological activity of
      chloramphenicol (1a) and sparsophenicol (1b). Chloramlincomycin (5a) suppressed
      the growth of Streptococcus pyogenes with MIC 6.25 micrograms/mL.

PMID- 8487261
TI  - New nonpeptide angiotensin II receptor antagonists. 3. Synthesis, biological
      properties, and structure-activity relationships of 2-alkyl-4
      (biphenylylmethoxy)pyridine derivatives.
AB  - A novel series of nonpeptide angiotensin II (AII) receptor antagonists is
      reported, derived from linkage of the biphenylyltetrazole moiety found in
      previously described antagonists via a methyleneoxy chain to the 4-position of a
      3-substituted 2,6-dialkylpyridine. When evaluated in an in vitro binding assay
      using a guinea pig adrenal membrane preparation, compounds in this series
      generally gave IC50 values in the range 0.005-0.5 microM. A variety of
      substituents was found to be effective at the 3-position of the pyridine ring. On
      intravenous administration in a normotensive rat model, the more potent compounds
      inhibited the AII-induced pressor response with ED50 values in the range 0.1-1.0
      mg/kg. One of the compounds, 2-ethyl-5,6,7,8-tetrahydro-4-([2'-(1H-tetrazol-5
      yl)biphenyl-4y l] methoxy)quinoline (26), demonstrated good oral activity in two
      rat models. At doses in the range 1-10 mg/kg po in AII-infused, conscious,
      normotensive rats, the compound exhibited a dose-related inhibition of the
      pressor response with a good duration of action at the higher doses. In a renal
      hypertensive rat model compound 26 showed a rapid and sustained lowering of blood
      pressure at a dose of 5 mg/kg po. Based on its profile, this compound, designated
      ICI D6888, has been selected for evaluation in volunteers.

PMID- 8487262
TI  - Site-specific conjugation of a radioiodinated phenethylamine derivative to a
      monoclonal antibody results in increased radioactivity localization in tumor.
AB  - The preparation of a novel radioiodination reagent, the (aminooxy)acetyl
      derivative of (p-[125]-iodophenyl)ethylamine, is described. Conventional
      radioiodination of proteins involves the formation of iodotyrosine residues, but
      for in vivo applications such as thyroid or stomach immunoscintigraphy, the
      susceptibility of these residues to tissue dehalogenases constitutes a serious
      disadvantage. Using our new compound, which has a particularly nonreactive
      aromatic ring, we confirm and extend studies published by other workers
      indicating the much greater in vivo stability of iodophenyl compounds compared to
      the more conventional iodophenolic ones. In addition, the aminooxy group of our
      reagent gives a stable and specific linkage to aldehyde groups formed by
      periodate oxidation on the sugar moiety of antibody molecules. In vitro,
      favorable binding activity and high stability was obtained with a
      (([125I]iodoaryl)amino)oxy labeled monoclonal antibody directed against
      carcinoembryonic antigen. In vivo, using paired labeling experiments in nude mice
      bearing colon carcinoma xenografts, the (([125I]iodoaryl)amino)oxy-MAb (MAb =
      monoclonal antibody) was compared with the same MAb 131I-labeled by conventional
      chloramine-T method. Tumor 125I concentration of (arylamino)oxy MAb (measured as
      percent injected dose per gram) was significantly higher as compared to values
      obtained with a conventionally labeled 131I antibody. Additionally, thyroid
      uptake, an indicator of iodine release from the antibody, was up to 25 times
      lower after injection of 125I-MAb obtained by the new method as compared to the
      conventionally iodinated 131I-MAb.

PMID- 8487263
TI  - Benzylamine antioxidants: relationship between structure, peroxyl radical
      scavenging, lipid peroxidation inhibition, and cytoprotection.
AB  - Three homologous series of 3,5-dialkoxy-4-hydroxybenzylamines were prepared and
      tested (1) as peroxyl radical scavengers in homogeneous aqueous solution, (2) as
      inhibitors of iron-dependent peroxidation of rabbit brain vesicular membrane
      lipids, and (3) as cytoprotective agents using primary cultures of rat
      hippocampal neurons exposed to hydrogen peroxide. The structural requirements for
      efficient radical trapping in homogeneous solution differed from those for
      effective lipid peroxidation inhibition: In homogeneous solution a kinetic
      preference existed for smaller, less sterically encumbered substituents flanking
      the reactive phenolic hydroxyl group. Lipid peroxidation inhibition, on the other
      hand, required longer more lipophilic substituents. Consequently, a lipophilic
      alkoxyl substituent at C3 and a small substituent at C5 appeared optimal for
      efficient radical scavenging activity in both lipid and homogeneous solution.
      Maximal cytoprotection of rat hippocampal neurons exposed to hydrogen peroxide
      was also associated with more lipophilic derivatives although substituent length
      and substituent bulk may represent independent parameters for relating structure
      and efficacy in this system.

PMID- 8487264
TI  - Thyroid hormone uptake by hepatocytes: structure-activity relationships of
      phenylanthranilic acids with inhibitory activity.
AB  - The synthesis of a series of mono- and disubstituted N-phenylanthranilic acids is
      described. Substituents on the phenyl ring include Cl, CN, OH, CF3, Br, I, CH3,
      OCH3, and OCF2CF2H. These compounds have been tested for their inhibitory effect
      on triiodothyronine (T3) uptake by H4 hepatocytes. The nonsteroidal
      antiinflammatory drugs flufenamic acid, mefenamic acid, and meclofenamic acid and
      the structurally related compounds 2,3-dimethyldiphenylamine and diclofenac were
      also tested. The most potent compounds were found to be, in order of decreasing
      activity, meclofenamic acid (2,6-Cl2,3-CH3), flufenamic acid (3-CF3), mefenamic
      acid (2,3-(CH3)2), and the compounds with 3,5-Cl2 and 3-OCF2CF2H substituents.
      The least potent compounds had 3-CN and 3-OH substituents. An analysis of
      quantitative structure-activity relationships (QSAR) for the series of
      phenylanthranilic acids showed that the inhibition of T3 uptake is highly
      dependent on the hydrophobicity of the compound. The relationship between uptake
      inhibition and the calculated octanol-water partition coefficient (clogP) was
      found to be parabolic, with optimum inhibitory activity found when the clogP of
      the phenylanthranilic acid was 5.7. It was also found that the 1-carboxylic acid
      group of the phenylanthranilic acids was not a prerequisite for uptake inhibition
      to occur, but its removal or alteration resulted in reduced inhibition.

PMID- 8487265
TI  - Molecular size and flexibility as determinants of selectivity in the oxidation of
      N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine analogs by monoamine oxidase A and
      B.
AB  - The introduction of a methylene bridge between the phenyl and tetrahydropyridyl
      moieties of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) results in
      increased selectivity for monoamine oxidase B (MAO B) over monoamine oxidase A
      (MAO A). However, lengthening of this bridge results in a total loss of
      selectivity. In the present study, a number of isomeric 4-naphthyl-, 4
      (naphthylalkyl)-, 4-thienyl-, and 4-(thienylalkyl)tetrahydropyridines,
      conformationally restrained and flexible analogs of MPTP, were synthesized and
      evaluated as potential selective substrates of MAO A and B. In terms of the
      parameter (turnover number)/Km, the bulky naphthyl analogs were invariably better
      substrates of MAO A than kynuramine, the reference substrate for this enzyme. In
      addition, all naphthyl analogs, regardless of conformational mobility, were more
      effective substrates of MAO A than MAO B. Similarly, all thienyl analogs were
      found to be more effective substrates of MAO B. In contrast to the naphthalenes,
      the conformationally restrained thiophenes 9a and 10a were found to be poor
      substrates of MAO B, relative to benzylamine, the reference substrate. These
      results suggest that the selectivity of these compounds for either MAO A or B is
      determined by the complex interplay of molecular size and flexibility. In this
      interplay, either one of these two factors may predominate.

PMID- 8487266
TI  - Design and synthesis of 18F-labeled neurotoxic analogs of MPTP.
AB  - We report on the synthesis of two fluorine-18 labeled analogs of 1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine (MPTP). A piperidyl triazene was fluorinated to
      produce [18F]-1-methyl-4-(2-fluorophenyl)-1,2,3,6-tetrahydropyridine (2'-F-MPTP,
      12) in very low yield, and 1-methyl-4-[2-(fluoromethyl)phenyl]-1,2,3,6
      tetrahydropyridine (2'-FCH2-MPTP, 11) was labeled with 18F by nucleophilic
      displacement of the corresponding chloride in 60% yield. The biodistribution in
      mice of the latter radiotracer and its oxidation to 1-methyl-4-[2
      (fluoromethyl)phenyl]pyridinium (2'-FCH2-MPP+, 6) is also reported. The kinetics
      of oxidation of 2'-FCH2-MPTP and its solvolysis products (the corresponding 2'
      hydroxymethyl and 2'-chloromethyl analogs) by rat liver monoamine oxidase were
      investigated. 2'-FCH2-MPTP accumulated to a useful degree in the brain, was
      oxidized by monoamine oxidase in vitro, was converted to the oxidation product in
      brain in vivo, and had a neurotoxic potency similar to that of MPTP. We feel it
      may be useful as an 18F-labeled radiopharmaceutical for positron tomographic
      studies of the mechanisms of MPTP toxicity.

PMID- 8487267
TI  - Statistics using neural networks: chance effects.

PMID- 8487268
TI  - Prenatal diagnosis of diastrophic dysplasia with polymorphic DNA markers.
AB  - Ultrasonography is a non-invasive method for prenatal detection of diastrophic
      dysplasia (DTD) in the second trimester of pregnancy. As there is a need for
      genetic counselling as early as possible we wished to develop a method based on
      molecular analysis. Five fetuses in families with a previous history of DTD were
      studied by typing them and their relevant family members for DNA markers closely
      linked to the DTD gene. The DNA analyses predicted that three of the fetuses were
      unaffected and two affected. These results were concordant with those obtained by
      ultrasonography, and the phenotype of the fetus was correctly predicted in all
      cases. DNA analysis provides a reliable means of prenatal diagnosis in the first
      trimester of pregnancy.

PMID- 8487269
TI  - Possible X linked congenital mitochondrial cardiomyopathy in three families.
AB  - Familial cases of childhood congestive cardiomyopathy with X linked recessive
      inheritance and abnormalities of heart muscle mitochondria have been previously
      reported. We report here three families with possible X linked congestive
      cardiomyopathy and specific mitochondrial abnormalities. The heart disorder
      presented as endocardial fibroelastosis with neonatal death in two brothers in
      one family, and as heart failure and death in infancy in two brothers in the
      other two families. In one family a maternal uncle may also have been affected.
      Pyodermia and neutropenia was reported in one of the boys. Electron microscopy of
      heart muscle after necropsy showed increased numbers of mitochondria and abnormal
      mitochondrial crystal condensations and paracrystalline inclusions in all
      sibships. Barth's syndrome has been mapped to Xq28 and includes cardiomyopathy,
      skeletal muscle myopathy, neutropenia, and mitochondrial abnormalities similar to
      those found in the three families reported here. Since the clinical picture
      differed in the three families, they may represent more than one entity.

PMID- 8487270
TI  - Gaucher's disease in the United Kingdom: screening non-Jewish patients for the
      two common mutations.
AB  - Twenty-six patients with Gaucher's disease diagnosed in the United Kingdom and
      two obligate carriers, all of non-Jewish origin, were screened for the two common
      disease causing mutations and two rarer mutations in the glucocerebrosidase gene.
      These mutations are referred to as N370S, L444P, Ins84G, and 1066 + 1G-->A,
      respectively. The results showed that out of 54 alleles screened, 26% were N370S,
      35% were L444P, and the remaining 39% were rare or undefined. The results also
      showed a clear correlation between the presence of at least one N370S allele and
      mild disease.

PMID- 8487271
TI  - Phenylketonuria: variable phenotypic outcomes of the R261Q mutation and maternal
      PKU in the offspring of a healthy homozygote.
AB  - Phenylketonuria (PKU) and benign hyperphenylalaninaemia (HPA) result from a
      variety of mutations in the gene for the hepatic enzyme phenylalanine
      hydroxylase. PKU has been found in the Israeli population in two variants,
      classical and atypical. The two are clinically indistinguishable and require
      treatment with low phenylalanine diet to prevent mental retardation, but show
      differences in serum phenylalanine levels and in tolerance to this amino acid.
      Maternal PKU is a syndrome of congenital anomalies and mental retardation that
      appears in offspring of PKU mothers as a result of fetal exposure to the high
      phenylalanine level in the maternal blood. We studied a family in which two
      children with severe, classical PKU and their unaffected brother showed mild
      signs of maternal PKU. Their mother had no clinical signs of PKU, but the
      phenylalanine concentration in her serum reached a level that usually
      characterises PKU patients. This woman represents a rare phenotype, benign
      atypical PKU. Such 'hidden' PKU in women may lead to maternal PKU in the
      offspring, similar to overt PKU. Special attention should therefore be paid to
      women having children with any of the clinical hallmarks of maternal PKU, and to
      children born to women known to have benign HPA. The mother was also found to be
      homozygous for a missense mutation at the phenylalanine hydroxylase locus, R261Q,
      which does not abolish enzymatic activity completely. In two other families,
      homozygosity for this mutation resulted in atypical PKU in four children. This
      observation suggests that mutations that do not completely destroy phenylalanine
      hydroxylase activity may exhibit variable phenotypic expression which is
      unpredictable. Compound heterozygosity for R261Q and other mutations led in other
      patients either to classical PKU or to mild benign HPA.

PMID- 8487272
TI  - Onset symptoms in 510 patients with Huntington's disease.
AB  - The onset of Huntington's disease (HD) is preceded or accompanied by events and
      symptoms which contribute to the natural history of the disease. Data obtained
      from the first 510 completed 'Questionnaires for Affected Individuals', recorded
      by the National Huntington's Disease Research Roster (NHDRR) were analysed. The
      following features were evaluated: (1) neurological and psychiatric onset
      symptoms; (2) the precipitating effect of stressful events and drugs; (3) the
      modification after onset of smoking and alcohol consumption. The most frequent
      psychiatric onset symptom was depression. Stressful events in the year before
      onset occurred in 43% of patients. However, onset age was the same in patients
      with and without previous stressful events. Smoking and especially alcohol
      consumption showed a decreasing trend after onset.

PMID- 8487273
TI  - Suicide risk in Huntington's disease.
AB  - In order to evaluate the relevance of suicide risk in families affected by
      Huntington's disease (HD), 2793 subjects registered with the National
      Huntington's Disease Research Roster were studied. Suicide was the reported cause
      of death in 205 subjects (7.3%). This group included affected and possibly
      affected subjects, subjects at 50% and 25% risk, possibly at risk subjects, and
      normal relatives. In all categories suicide was more frequent than in the general
      US population. The data suggest that suicide is quite frequent in some families
      with HD. This increased suicide risk must be carefully considered in planning
      genetic counselling for predictive testing in HD.

PMID- 8487274
TI  - Polydactyly: a study of a five generation Indian family.
AB  - Preaxial polydactyly was observed in up to five generations of an Indian family
      living in a village in the Rajkot district (Gujarat). Among the 71 affected
      members, 45 were males and 26 were females. All these affected members showed
      preaxial polydactyly manifesting as a well formed, articulated extra digit of the
      hand or foot. Twenty other cases were also identified with polydactyly involving
      triphalangeal digits replacing the thumbs or duplication of the big toe(s). To
      the best of our knowledge, the present family is the largest in which several
      members have preaxial polydactyly of different types. No other abnormalities were
      apparent. The present study strongly suggests that preaxial polydactyly with a
      well formed extra digit, triphalangeal thumbs, and duplication of the big toe can
      be manifestations of the same autosomal dominant gene. It is likely that other
      factors are modifying the expression of this gene.

PMID- 8487275
TI  - Characterisation of a highly polymorphic microsatellite at the DXS207 locus:
      confirmation of very close linkage to the retinoschisis disease gene.
AB  - Juvenile retinoschisis (RS) is an X linked recessive vitreoretinal disorder for
      which the basic molecular defect is unknown. The gene for RS has been previously
      localised by linkage analysis to Xp22.1-p22.2 and the locus order Xpter-DXS16
      (DXS43, DXS207)-RS-DXS274-DXS41-Xcen established. To improve the resolution of
      the genetic map in the RS region, we have isolated a highly polymorphic
      microsatellite at DXS207, which displays at least nine alleles with a
      heterozygosity of 0.83. Using this microsatellite and four other Xp22.1-p22.2
      marker loci, DXS16, DXS43, DXS274, and DXS41, we performed pairwise and
      multilocus linkage analysis in 14 kindreds with RS. The microsatellite was also
      typed in the CEPH (Centre d'Etude du Polymorphisme Humain) reference families.
      Tight linkage was found between RS and DXS207 (Z(theta) = 14.32 at theta = 0.0),
      RS and DXS43 (Z(theta) = 8.10 at theta = 0.0), and DXS207 and DXS43 (Z(theta) =
      40.31 at theta = 0.0). Our linkage results combined with data previously reported
      suggest that the DXS207-DXS43 cluster is located less than 2 cM telomeric to the
      RS locus. The microsatellite reported here will be a very useful marker for
      further linkage studies with retinoschisis as well as with other diseases in this
      region of the X chromosome.

PMID- 8487276
TI  - An improved, non-isotopic method of screening cells from patients with
      abnormalities of sexual differentiation for Y chromosomal DNA content.
AB  - The detection of 45,X/46,XY mosaicism in patients with abnormalities of sexual
      differentiation is of crucial diagnostic importance. Here we present application
      of a PCR based method of detection of alphoid repeats of Y chromosomal origin.
      The method detects 0.01% of male DNA on a female DNA background. Out of 28
      patients studied, in all cases where the Y chromosome or a part of it containing
      centromeric sequences was present, a positive amplification signal of Y
      chromosomal alphoid repeats was detected. In five cases the Y origin of marker
      chromosomes was diagnosed. The pattern of amplification signal distribution of
      the SRY gene was identical to that of Y specific alphoid primers, which confirms
      applicability of this method in the molecular diagnostic laboratory. The other
      diagnostic advantage is the ability to use dried blood specimens as an easy to
      handle and efficient source of DNA.

PMID- 8487277
TI  - Otopalatodigital syndrome type II.

PMID- 8487278
TI  - A cytogenetic survey in Menkes disease: implications for the detection of
      chromosomal rearrangements in X linked disorders.

PMID- 8487279
TI  - Prevalence of cystic fibrosis mutations in the Grampian region of Scotland.
AB  - We have identified all known sufferers of cystic fibrosis (CF) alive in the
      Grampian region, north east Scotland, on 1 January 1989. DNA samples were
      obtained for a prevalence study of the common mutations with near to complete
      ascertainment. A relatively high prevalence of the delta F508 mutation was found
      (82%), with one of four mutations being present on 92% of CF chromosomes. The
      high prevalence of these four easily detectable mutations in Grampian has local
      implications for genetic counselling, the efficacy of population carrier
      screening, and the usefulness of mutation analysis in cases where the diagnosis
      of CF is in doubt.

PMID- 8487280
TI  - Absence of linkage between chromosome 21 loci and familial amyotrophic lateral
      sclerosis.
AB  - Familial amyotrophic lateral sclerosis (FALS) has recently been shown to be
      linked to chromosome 21 markers in a subset of families. However, we were unable
      to show linkage between FALS and chromosome 21 markers which flank the putative
      FALS locus in UK families.

PMID- 8487281
TI  - Profound mental retardation, characteristic facies with midfacial hypoplasia and
      premature frontotemporal balding, muscular hypotrophy, and small patellae in two
      unrelated male patients.
AB  - Two profoundly mentally retarded, unrelated males are reported with an
      unidentified multiple congenital anomaly/mental retardation syndrome, including
      early balding, patella luxations, small hands and feet, and hypogonadism, similar
      to a previous publication in this journal of a severely mentally retarded male
      patient with dysmorphic features.

PMID- 8487282
TI  - Short limbed dwarfism, genital hypoplasia, sparse hair, and vertebral anomalies:
      a variant of Ellis-van Creveld syndrome?
AB  - A male newborn with acromesomelic short limbed dwarfism, genital hypoplasia, and
      vertebral anomalies is reported. As the child had an important number of clinical
      and radiological symptoms seen in patients with Ellis-van Creveld syndrome, we
      raise the question of whether he may represent a variant example of this syndrome
      despite the absence of cardinal symptoms such as postaxial polydactyly and
      ectodermal changes (nail hypoplasia).

PMID- 8487283
TI  - Consanguinity, cardiac arrest, hearing impairment, and ECG abnormalities:
      counselling pitfalls in the Romano-Ward syndrome.
AB  - Genetic counselling in the autosomal dominant condition of the Romano-Ward
      syndrome might be assumed to be relatively straightforward. The problems posed by
      consanguinity, deafness, and subclinical gene carriers in a pedigree with this
      condition have caused us to reevaluate this view. The diagnostic and management
      difficulties which may attend this potentially fatal condition are highlighted by
      our experience with this family.

PMID- 8487284
TI  - Coarctation of the aorta, interrupted aortic arch, and hypoplastic left heart
      syndrome in three generations.
AB  - Five members in three generations of a family were affected by a congenital heart
      disease. Four of them had mild or severe coarctation of the aorta (CoA), either
      isolated or in association with other cardiac defects. Fetal echocardiography
      allowed prenatal diagnosis in one pregnancy at risk. This family suggests that a
      rare form of CoA could be the result of an autosomal dominant mutation with high
      penetrance and variable expressivity rather than polygenic inheritance.

PMID- 8487285
TI  - Simultaneous de novo interstitial deletion of 16q21 and intercalary duplication
      of 19q in a retarded infant with minor dysmorphic features.
AB  - We report on a retarded infant with minor dysmorphic features in whom deletion 16
      and duplication 19q were discovered. The karyotype is 46,XX,del(16) (q13.08
      21.05),dup(19)(q13.13-13.2). The origin and significance of the aberrant
      chromosomes are unknown.

PMID- 8487286
TI  - MRSA: major problem or minor threat?

PMID- 8487287
TI  - A review of the correlation of T-agglutination patterns and M-protein typing and
      opacity factor production in the identification of group A streptococci.
AB  - The classical techniques of M protein and opacity factor (OF) typing and T
      agglutination typing remain the "gold standard" in identifying group A
      streptococci, although newer techniques have been proposed to assist laboratory
      scientists, microbiologists, epidemiologists and clinicians in the precise
      identification and characterisation of these organisms. Because of the current
      scarcity of M-typing sera and the increased use by many laboratories of T typing
      as the sole method of group A identification, a table is presented to indicate
      specific correlation between the T-agglutination pattern and the M serotype. The
      use of this table will enable not only more selective use of typing sera but
      also, perhaps, result in improved understanding and ultimately in correlating
      these defined patterns with newer and more sensitive techniques.

PMID- 8487288
TI  - Pathological changes in the rabbit ileal loop model caused by Campylobacter
      jejuni from human colitis.
AB  - Four strains of Campylobacter jejuni isolated from children with inflammatory
      diarrhoea were assayed in the rabbit ileal loop model of infectious diarrhoea.
      All caused inflammatory reactions with severe macroscopic and microscopic damage
      in infected rabbit ileal tissue similar to that observed in the patients by
      endoscopy and histological analysis of colonic biopsies. Haemoglobin and other
      proteins were observed in loop fluids, consistent with leakage of serum from
      damaged mucosa. Loop fluids also contained significant bicarbonate
      concentrations, indicative of an active secretory component similar to that in
      control loops inoculated with cholera toxin. However, although three of the four
      clinical strains produced small amounts of a protein immunologically related to
      cholera toxin in vitro, none such was detected in either tissues or fluids of
      infected ileal loops. We propose instead that host-derived mediators of secretion
      may be important in pathogenesis. A mutant strain of C. jejuni with impaired
      motility, obtained from the National Collection of Type Cultures, did not induce
      tissue damage or fluid secretion in rabbit ileal loops.

PMID- 8487289
TI  - Typing of Listeria spp. by random amplified polymorphic DNA (RAPD) analysis.
AB  - Random amplified polymorphic DNA (RAPD) analysis, a variation of the polymerase
      chain reaction (PCR) in which a single primer is used, was evaluated for use as a
      simple and reliable method with which to type Listeria spp. Representatives of
      six species of Listeria were studied. Five isolates of L. innocua and four
      isolates of L. seeligeri were all distinguishable from one another, but the four
      isolates of L. ivanovii tested, although distinguishable from other Listeria
      spp., were not differentiated. Among L. monocytogenes serovars 1/2a (eight
      isolates), 1/2b (eight isolates) and 4b (10 isolates), at least six, three and
      six RAPD patterns were observed, respectively. Fourteen neonatal cross-infection
      sets of L. monocytogenes isolates, shown to be indistinguishable by serotyping
      and phage typing, were examined with three different primers. With one primer,
      three of the sets were shown to consist of closely related, but distinguishable,
      strains. In the other 11 cases, each set of strains was indistinguishable with
      all three primers. These preliminary data indicate that RAPD analysis has promise
      as a method for typing Listeria spp.

PMID- 8487290
TI  - Effect of clearance of bacteria from the blood on the development of systemic
      bacteraemia in mice.
AB  - Clearance of various bacteria isolated from portal and systemic blood of mice was
      evaluated and compared. All portal blood strains, including Escherichia coli and
      enterococci were eliminated more rapidly from the circulation than were strains
      isolated from systemic blood, including Pseudomonas aeruginosa. With mannose-type
      lectin, mannose or fucose residues that mediated lectinophagocytosis were
      detected on the surfaces of most portal strains by agglutination tests. Blood
      clearance of Esch. coli H21 was inhibited by prior injection of mannose into
      mice, suggesting that the clearance of this strain was mediated by mannose-type
      lectin on the surface of tissue macrophages. However, no inhibition of clearance
      of any other strains was observed by the injection of mannose, galactose, or
      fucose into mice, nor by pre-incubation of bacteria with mannose. Blood clearance
      of some portal strains was significantly faster in CBA/J mice than in CBA/N mice
      with B cell immune deficiency, indicating that immunoglobulin was involved in
      their clearance. Among portal strains only enterococci showed high cell-surface
      hydrophobicity. These data suggest that initial bacteria blood clearance may be
      critical in determining whether latent portal bacteraemia progresses to systemic
      bacteraemia and that the rapid clearance of most strains is multifactorial.

PMID- 8487291
TI  - Oral infectivity and bacterial interactions with mononuclear phagocytes.
AB  - The purpose of this study was to clarify the association between the oral
      infectivity of a bacterial strain and its susceptibility to ingestion by
      mononuclear phagocytes or ability to survive within them. Ten bacterial strains
      tested--all of known oral infectivity--comprised Salmonella typhimurium, Listeria
      monocytogenes (three strains), Escherichia coli (two strains), Proteus mirabilis,
      Enterococcus faecalis, Bacteroides fragilis, and a Bacteroides sp. The phagocytic
      uptake of each strain was measured as the bacteria to phagocyte ratio after
      mononuclear phagocytes in mouse peritoneal exudate were permitted to ingest
      bacteria in vivo for 3 min. The three Listeria strains were the most susceptible
      to phagocytic uptake and the Salmonella strain was relatively resistant. The
      intracellular survival of each strain was studied during a subsequent 2 h in
      vitro incubation of the mononuclear phagocytes that had been permitted to ingest
      bacteria in vivo. The strains with the best intracellular survival were Ent.
      faecalis and two of the three Listeria strains. The ability of S. typhimurium to
      survive intracellularly was intermediate but better than that of the two E. coli
      strains. Oral infectivity was not consistently correlated with susceptibility to
      ingestion by mononuclear phagocytes or ability to survive within them.

PMID- 8487292
TI  - Clearance and tissue distribution of staphylococcal enterotoxin A in the rat and
      potential use of adsorbents for removal from plasma.
AB  - Many of the profound effects of staphylococcal septicaemia are thought to be the
      result of entry of enterotoxins into the systemic circulation. The aim of this
      study was to investigate the disposition of staphylococcal enterotoxin A (SEA) in
      the rat and its possible removal from blood. SEA labelled with 125I was
      administered intravenously (250 micrograms/kg) to rats. The blood clearance of
      SEA showed a biphasic pattern; an initial fast disappearance (half-life c. 3 min)
      was followed by a slower one (half-life c. 2 h). Thirty minutes after injection
      of 125I-labelled SEA, most of the radioactivity was concentrated in the kidneys,
      indicating that renal excretion was the main route of elimination of SEA. The
      adsorption capacities of polymer-coated activated charcoal (DHP-1 and Adsorba
      150C), uncharged resin (Amberlite XAD-7), anion exchange resin (Dowex-1) and
      polymyxin B matrix were assessed by measurement of the equilibrium adsorption
      isotherms for SEA. DHP-1 charcoal, Amberlite XAD-7 resin and Dowex-1 resin
      adsorbed similar amounts of SEA in human plasma. Plasma perfusion experiments
      were performed in vitro with small columns containing either charcoal or resin
      adsorbents. Over 4 h perfusion, DHP-1 charcoal removed 50% of the initial amount
      of 125I-SEA, Adsorba 150C charcoal 8.1% of SEA and Amberlite XAD-7 resin 32.5% of
      SEA. These results suggest that it may be feasible to develop the adsorbent
      columns for direct removal of SEA from the plasma of patients with staphylococcal
      septicaemia.

PMID- 8487293
TI  - Comparison of two gene amplification methods for the detection of Toxoplasma
      gondii in experimentally infected sheep.
AB  - Efferent lymph and peripheral blood collected from sheep experimentally infected
      with Toxoplasma gondii strain S48 were analysed for parasite DNA by amplification
      of the B1 and P30 T. gondii genes by the polymerase chain reaction (PCR). The
      relative sensitivity of these two gene amplification methods was assessed and
      compared with parasite detection by mouse injection (MI). B1 PCR was consistently
      more sensitive than P30 PCR and the results agreed closely with those from MI. By
      contrast, P30 PCR gave more than twice as many false negatives results than B1
      PCR. The few apparent false positive results given by either PCR method were
      probably due to the inability of MI to detect non-viable parasites. All specimens
      collected before infection with T. gondii gave negative results by PCR and MI.
      Parasite DNA was detected by both B1 and P30 PCR in the lymph node of a sheep 12
      days after infection but not in other tissues. The results permit a direct
      comparison between T. gondii detection by P30 and B1 PCR. Moreover, they further
      confirm the value of PCR detection of toxoplasma as a sensitive, specific and
      reliable diagnostic and research tool.

PMID- 8487294
TI  - Ultrastructure and biochemical studies of the flagellar sheath of Helicobacter
      pylori.
AB  - Helicobacter pylori flagellar sheaths were isolated by sucrose density-gradient
      centrifugation and analysed by electronmicroscopy, SDS-PAGE and gas-liquid
      chromatography. Electronmicroscopy of thin sections of flagella showed an
      internal electron-dense filament and a surrounding flagellar sheath with the
      typical bilayer structure of a membrane. The flagellar filaments could be
      disintegrated by acid treatment and the resulting isolated flagellar sheaths
      formed vesicles, sometimes with characteristic structures. Centrifugation of
      flagellar preparations after acid treatment resulted in the enrichment of
      flagellar sheaths in the pellet. SDS-PAGE analysis of the pellet showed a
      reduction of the flagellin band and a number of protein bands of 150, 76, 67, 65,
      53, 51, 49, 29.5, 18, 17 and 16 kDa. However, there were no major protein bands
      characteristic for the sheath. Differences between the protein profiles of
      Sarkosyl-insoluble membranes and flagellar sheaths appeared in the lower M(r)
      range of 30-14 kDa. Major fatty acids of isolated flagellar sheaths were C 14:0,
      C 19:0 cyc, C 18:0, and the LPS-specific fatty acids 3-OH C 16:0 and 3-OH C 18:0.
      The results demonstrate that the flagellar sheaths of H. pylori are membranes and
      contain LPS and proteins.

PMID- 8487295
TI  - Outer-membrane protein and immunoblot analysis of Australian isolates of
      Haemophilus influenzae.
AB  - Strains of Haemophilus influenzae isolated from children in South Australia and
      the Northern Territory with systemic infections (mostly meningitis or
      epiglottitis) were subjected to serotyping, biotyping, outer-membrane protein
      (OMP) analysis and immunoblot subtyping. All 65 isolates examined were from blood
      or cerebrospinal fluid; 59 (91%) of the strains were identified as type b and the
      remainder as either type a (two strains) or non-typable (four strains). Of the 59
      type b strains, 45 (76%) belonged to a single OMP subtype (equivalent to subtype
      3L in the Barenkamp scheme); the remaining type b strains belonged to five other
      OMP subtypes. No correlation was apparent between OMP subtype and geographical
      region, clinical diagnosis or antimicrobial drug susceptibility pattern.
      Immunoblot subtyping enabled nine (18%) of 41 strains belonging to the principal
      OMP subtype to be distinguished from the remainder.

PMID- 8487296
TI  - Detection of Clostridium difficile enterotoxin gene in clinical specimens by the
      polymerase chain reaction.
AB  - A rapid assay was developed for detection of the Clostridium difficile
      enterotoxin gene in stool specimens by means of the polymerase chain reaction
      (PCR). The PCR primers amplified a 63-bp repetitive sequence of the enterotoxin
      gene, thereby generating a distinctive ladder pattern of DNA bands following
      electrophoresis. Crude DNA extracts from stools containing C. difficile produced
      one (63-bp) or more bands of the characteristic ladder. Of 172 stool specimens
      from 58 patients, 37 gave positive results by culture (15 specimens) or cytotoxin
      assay (36 specimens). When 36 available "positive" specimens were tested by the
      PCR assay, 34 (94%) gave positive results--24 by direct testing, and 10 after
      extraction of DNA by the Qiagen procedure. Insufficient material of the remaining
      two specimens was available for DNA extraction. Of 21 stools "negative" for C.
      difficile by culture or cytotoxin assay, one gave a positive result by PCR and
      seven produced atypical bands. The rapid PCR detection technique for C. difficile
      was more sensitive than standard culture, and of a sensitivity similar to
      cytotoxin testing. The method has the potential for adoption in routine
      laboratory practice.

PMID- 8487297
TI  - Highly cooperative DNA binding by the coliphage HK022 repressor.
AB  - The CI repressor protein from the temperate lambdoid phage HK022 was purified to
      near homogeneity and used in DNase I footprinting analyses to identify six
      binding sites in this phage. All these sites contained homologous 15 bp inverted
      repeats. Three of these 15 bp inverted repeats were located between the cI and
      cro (OR1 to OR3), and the other three were 3' to the cI gene (OL1 to OL3). Two of
      these sites were identified as operator sites for the repressor by DNA sequence
      analyses of virulent phage mutants. Almost all these mutations identified lay
      within the 15 bp inverted repeats comprising OR1 and OR2, and almost all were in
      the most highly conserved positions in the operators. The majority of virulent
      mutants contained mutations in both OR1 and OR2. Intrinsic affinities for
      individual operators were measured by DNase I footprinting analyses using DNA
      fragments which contained a single wild-type operator adjacent to two mutant
      operators. Comparison of these values with the affinity observed with these sites
      in the wild-type operator indicated that HK022 CI repressor bound cooperativity
      to OR1 and OR2 with a cooperativity parameter, omega, of almost 2000. Cooperative
      binding occurred in an alternative pairwise fashion, as previously seen with
      lambda CI repressor. In addition to cooperative binding between two adjacent
      operators, the repressor also increased the affinity for adjacent non-specific
      DNA sites, resulting in a periodic pattern of binding termed "phasing". This
      phasing pattern extended beyond regions predicted for pair-wise interaction, but
      was significantly decreased on a template with two adjacent operators, suggesting
      that pairwise cooperativity interfered with phasing.

PMID- 8487298
TI  - Plant bZIP protein DNA binding specificity.
AB  - Plant bZIP proteins exhibit a relaxed DNA-binding specificity for DNA sequence
      motifs containing an ACGT core. Gel mobility shift experiments employing ten
      different recombinant plant bZIP proteins demonstrated that nucleotides flanking
      the ACGT core affected binding specificity and identified three different types
      of ACGT elements: G-box, CACGTG; C-box, GACGTC; and A-box, TACGTA, motifs. These
      ten different bZIP proteins could be categorized into three groups according to
      their qualitative and quantitative specificity for G-box and C-box elements.
      Dissociation constant values (Kd values) of these bZIP proteins for high affinity
      G-box and C-box elements and reciprocal competition gel mobility shift assays
      confirmed our classification scheme. Group 1 proteins exhibit a stronger binding
      affinity for G-box elements, group 2 proteins bind both G-box and C-box motifs
      with comparable binding affinity, whereas the group 3 proteins display a stronger
      binding affinity for C-box oligonucleotides. Studies using a panel of G-box and C
      box oligonucleotides differing in their flanking sequences identified high
      affinity binding sites. All ten plant bZIP proteins examined, except TGA1a,
      exhibited type A G-box binding activity preferring class I G-box elements. In
      contrast to the situation observed for G-box elements, C-box motifs displayed a
      very much more stringent flanking nucleotide requirement for binding activity.
      Protein/DNA binding experiments using scanning mutants of a high affinity G-box
      element and G-box/C-box hybrid elements demonstrated that bZIP protein binding
      activity depends upon the affinity of protein dimer subunits for ACGT half-sites.
      Information provided by our systematic analysis of plant bZIP DNA binding
      specificity can be used to identify high affinity binding sites for the plant
      bZIP proteins studied here. Assuming that only high affinity bZIP binding sites
      are likely to function in vivo, identification of these sites will allow us to
      predict which genes are activated by a particular bZIP protein.

PMID- 8487299
TI  - Site-directed mutagenesis of the yeast mitochondrial ADP/ATP translocator. Six
      arginines and one lysine are essential.
AB  - The ADP/ATP translocator mediates adenine nucleotide exchange across the inner
      mitochondrial membrane. ADP/ATP exchange is essential when yeast are grown on a
      non-fermentable carbon source such as glycerol, but it is not required for growth
      on glucose. Failure to grow on glycerol is therefore a phenotypic indicator of
      protein function, and it has been used here to screen site-directed mutants to
      identify functionally important amino acids in the yeast adenine nucleotide
      translocator (AAC2). Single mutations of all four charged amino acids in the
      transmembrane segments of AAC2 (K38A, R96D, R96H, R96L, R96P, R204L, R294A)
      resulted in loss of function, as did mutations in the matrix arginine cluster
      (R252I, R253I, R254I). Seven other residues were mutated without affecting growth
      on glycerol (C73S, C244S, C271S, K179M, K182I, P247G, W235F). The non-functional
      mutants have been used to select intragenic suppressors to gain further insight
      into the structure of this membrane transport protein.

PMID- 8487300
TI  - Refined crystal structure of the catalytic domain of dihydrolipoyl transacetylase
      (E2p) from Azotobacter vinelandii at 2.6 A resolution.
AB  - Dihydrolipoyl transacetylase (E2p) is both structurally and functionally the
      central enzyme of the pyruvate dehydrogenase multienzyme complex. The crystal
      structure of the catalytic domain, i.e. residues 382 to 637, of Azotobacter
      vinelandii E2p (E2pCD) was solved by multiple isomorphous replacement and refined
      by energy minimization procedures. The final model contains 2182 protein atoms
      and 37 ordered water molecules. The R-factor is 18.7% for 10,344 reflections
      between 10.0 and 2.6 A resolution. The root-mean-square shift deviation from the
      ideal values is 0.017 A for bond lengths and 3.3 degrees for bond angles. The N
      terminal residues 382 to 394 are disordered and not visible in the electron
      density map, otherwise all residues have well-defined density. The catalytic
      domain forms an oligomer of 24 subunits, having octahedral 432 symmetry. In the
      E2pCD crystals, the 24 subunits are related by the crystallographic symmetry. The
      cubic arrangement of subunits gives rise to a large hollow cube with edges of 120
      A. The faces of the cube have pores of diameter of 30 A. The true building block
      of the cube is the E2p trimer, eight of which occupy the corners of the cube. Two
      levels of intermolecular contacts can be distinguished: (1) the extensive
      interactions between 3-fold related subunits leading to a tightly associated
      trimer; and (2) the interactions along the 2-fold axis leading to the assembly of
      the trimers into the cubic 24-mer. Each subunit has a topology similar to
      chloramphenicol acetyltransferase (CAT) and comprises a central beta-sheet
      surrounded by five alpha-helices. The comparison of the two proteins indicates a
      large rotation of the N-terminal residues 395 to 426 of E2pCD, which reshapes the
      substrate binding site and extends the interaction between threefold related
      subunits. The catalytic centre consists of a 30 A long channel extending from the
      "inner" side of the trimer to the "outer" side, where inner and outer refer to
      the position in the 24-meric cubic core of the pyruvate dehydrogenase complex and
      correspond with CoA and lipoamide binding sites, respectively. The active site is
      formed by the residues with the lowest mobility as indicated by the atomic B
      factors. Five proline residues surround the active site.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8487301
TI  - Three-dimensional structure of lipoamide dehydrogenase from Pseudomonas
      fluorescens at 2.8 A resolution. Analysis of redox and thermostability
      properties.
AB  - The structure of Pseudomonas fluorescens lipoamide dehydrogenase, a dimeric
      flavoenzyme with a molecular mass of 106,000 daltons, was solved by the molecular
      replacement method and refined to an R-factor of 19.4% at 2.8 A resolution. The
      root-mean-square difference from ideal values for bonds and angles is 0.019 A and
      3.8 degrees, respectively. The structure is closely related to that of the same
      flavoprotein from Azotobacter vinelandii. The root-mean-square difference for 932
      C alpha atoms is 0.64 A, with 84% sequence identity. The residues in the active
      site are identical, while 89% of the interface residues are the same in the two
      enzymes. A few structural variations provide the basis for the differences in
      thermostability and redox properties between the two homologous proteins.
      Particularly, in the A. vinelandii molecule a threonine to alanine (T452A)
      mutation leaves a buried carbonyl oxygen, located at the subunit interface and in
      proximity of the flavin ring, unpaired to any H-bond donor, probably providing an
      explanation for the lower stability of the A. vinelandii enzyme with respect to
      the P. fluorescens enzyme. Six surface loops, which previously could not be
      accurately positioned in the A. vinelandii structure, are well defined in P.
      fluorescens lipoamide dehydrogenase. On the basis of the P. fluorescens
      structure, the six loops could be correctly defined also in the A. vinelandii
      enzyme. This is an unusual case where similar refinement methodologies applied to
      two crystal forms of closely related proteins led to electron density maps of
      substantially different quality. The correct definition of these surface residues
      is likely to be an essential step for revealing the structural basis of the
      interactions between lipoamide dehydrogenase and the other members of the
      pyruvate dehydrogenase multienzyme complex.

PMID- 8487302
TI  - Refinement of recombinant oncomodulin at 1.30 A resolution.
AB  - A refinement of the oncomodulin crystal structure at 1.30 A resolution has been
      carried out with X-ray data from the recombinant protein. The crystallographic R
      factor values are 0.169 for 19,995 reflections in the range 6.0 to 1.30 A, which
      were used for the restrained least-squares refinement, and 0.176 for 20,186
      observed reflections in the range 10.0 to 1.30 A. This high resolution refinement
      has enabled us to make more definitive statements about the molecular structure
      than was possible heretofore. The present model includes residues 1 to 108, the
      two Ca2+ of the CD and EF loops, two intermolecular Ca2+, and 103 water molecules
      per oncomodulin molecule. The electron density maps indicate disordered
      orientations for ten residues on the hydrophilic surface of the molecule. The
      pattern of molecular aggregation via intermolecular Ca2+, which occurs in the
      native rat oncomodulin structure, is also present in the recombinant oncomodulin
      structure. The Cys18 side-chain is not in a position that would be easily
      accessible for molecular dimerization via a disulphide bond. The substitution of
      Glu59, which is preserved in all the determined species of parvalbumin, by Asp59
      in oncomodulin seems to break a stabilizing hydrogen bond in the CD loop and
      render the main-chain in positions 59 to 60 somewhat unstable. This instability
      in the CD loop, and the strong tendency of oncomodulin for molecular aggregation
      via intermolecular Ca2+, appear to be the two outstanding features that may
      account for oncomodulin's biological peculiarities.

PMID- 8487303
TI  - Crystal structures of holo and apo-cellular retinol-binding protein II.
AB  - Apo and holo-cellular retinol-binding protein II have been crystallized, and
      their crystal structures have been determined to 2.1 A and 1.9 A respectively.
      The apo and holo-crystals have different but related triclinic space groups. The
      X-ray phases for both structures were determined using the molecular replacement
      method. The crystal co-ordinates were refined to an R-factor of 0.200 for apo,
      and 0.173 for holo-cellular retinol-binding protein II. The holo and apo-models
      have nearly the same tertiary structures. Cellular retinol-binding protein II
      consists of a ten-stranded anti-parallel beta-barrel with the ligand binding
      cavity within the barrel. Two alpha-helices cover the open end of the beta-barrel
      making it almost solvent inaccessible. A single portal large enough to admit a
      water molecule was observed opening into the binding cavity. Exogenously added
      retinol was found within the cavity of each holo-cellular retinol-binding protein
      II molecule. Each retinol was surrounded by both polar and non-polar residues.
      The hydroxyl group of the bound retinol hydrogen bonds to the amide group of
      glutamine 108. The overall conformation of the bound retinol was derived from the
      four different molecules of holo-cellular retinol-binding protein II present in
      the triclinic form. The four copies of bound retinol had essentially the same
      conformation as found in crystalline retinaldehyde.

PMID- 8487304
TI  - Energetics of a stable intramolecular DNA triple helix formation.
AB  - We have designed and synthesized by conventional chemical techniques a 38mer
      oligonucleotide consisting of a 5'd(Pu)10d(C)4d(Py)10d(T)4d(Py)10(3') sequence.
      This oligonucleotide assumes a randomly coiled conformation at pH 12. At pH 8.0 a
      hairpin helix forms between its 5' purine decamer sequence and the consecutive
      pyrimidine decamer leaving the second pyrimidine decamer as a dangling disordered
      3' extension. On reducing the pH to 4.5 this second pyrimidine decamer folds back
      onto the major groove of the hairpin helix resulting in an intramolecular triple
      stranded stem-loop structure. We have used a variety of biochemical (gel
      mobility, P1 nuclease digestion) and biophysical (ultraviolet light and circular
      dichroism spectroscopy, fluorimetry, microcalorimetry) techniques to characterize
      the different conformers, their stability and the folding pathway into an
      intramolecular triple helix. The thermodynamic properties of this intramolecular
      triple strand in 100 mM-Na+ are: tm, 71 degrees C; delta HvH, 119.4(+/- 11.9)
      kcal mol-1; delta Hcal, 121.9 (+/- 6.1) kcal mol-1 at pH 4.5; those of the
      hairpin are: tm, 63 degrees C; delta HvH, 71.7(+/- 4.0) kcal mol-1; delta Hcal,
      69.9(+/- 3.5) kcal mol-1 at pH 8.0. At intermediate pH values, the triplex to
      coil transition breaks up into its component triplex to hairpin and hairpin to
      coil transitions with thermodynamic properties: tm, 41 degrees C; delta HvH,
      58.7(+/- 4.2) kcal mol-1; delta Hcal, 39.8(+/- 2.0) kcal mol-1; and tm, 63
      degrees C; delta HvH, 71.7(+/- 4.0) kcal mol-1; delta Hcal, 69.6(+/- 3.5) kcal
      mol-1 at pH 6.7.

PMID- 8487305
TI  - A mutagenic study of the allosteric linkage of His(HC3)146 beta in haemoglobin.
AB  - We have examined the contribution of His(HC3)146 beta to the alkaline Bohr effect
      of human haemoglobin (HbA) by replacing it with Gln, using site-directed
      mutagenesis, and studying the structural and functional consequences. Oxygen
      equilibrium curves of the mutant show that the effect of pH on the oxygen
      affinity, the alkaline Bohr effect, is half that of HbA in the presence of
      chloride ion and less than 10% in its absence. Crystallographic analysis shows
      that the mutation introduced only small structural changes localized to the site
      of substitution, proving that the replacement of the hydrogen bond between the
      ionizable side-chain of His146 beta and Asp94 beta by a hydrogen bond between the
      unionizable side-chain of Gln146 beta and the same aspartate is solely
      responsible for the reduction of the alkaline Bohr effect. Our data confirm that
      His(HC3)146 beta is predominantly responsible for the chloride-independent
      component of the alkaline Bohr effect which results from the breaking of the
      hydrogen bond between His(HC3)146 beta and Asp(FG1)94 beta accompanying the
      transition from the quaternary deoxy to oxy-structure.

PMID- 8487306
TI  - The in vivo glycation of diabetic tendon collagen studied by neutron diffraction.
AB  - Glycation (non-enzymatic glycosylation) sites in the axial unit cell of diabetic
      tendon collagen were investigated by neutron diffraction. Samples of diabetic and
      control tendon were reacted with sodium borodeuteride and sodium
      cyanoborodeuteride. This facilitated deuteration at aldimine, aldol or ketoimine
      groups in the molecule. These are natural collagen cross-links and sites where
      non-enzymatic glycation had occurred. The introduction of a deuteron at specific
      locations allowed the diabetic glycation collagen to be treated as multiple
      isomorphous derivatives for neutron fibre diffraction. Neutron diffraction was
      conducted at the Institut Laue Langevin, Grenoble. Standard crystallographic
      refinement techniques (modified for axial projections) were used to determine the
      structure of the control (non-diabetic) and diabetic samples. The results are
      shown as difference maps, these indicate that glycation takes place at different
      rates within the collagen axial unit cell. The position of glycation correlates
      well with the position of hydroxylysine residues. The reactions of periodate with
      enzymatically attached sugars, proteoglycan, natural cross-links and glycation
      products lead to complications in map interpretation.

PMID- 8487307
TI  - Primary structure and crystallization of orotate phosphoribosyltransferase from
      Salmonella typhimurium.
AB  - Orotate phosphoribosyltransferase (OPRTase; EC 2.4.2.10) catalyzes phosphoribosyl
      group transfer between alpha-D-5-phosphoribosyl-1-pyrophosphate and orotate to
      form orotidine-5'-monophosphate and pyrophosphate, the nucleotide-forming step in
      pyrimidine biosynthesis. It is one of ten PRTases that perform vital roles in de
      novo and salvage pathways for purine, pyrimidine and pyridine nucleotides.
      Although the PRTases are important drug targets, they are poorly understood
      mechanistically, and no three-dimensional structures exist. Here, we report the
      complete sequence of the Salmonella typhimurium pyrE gene and the deduced
      sequence of the OPRTase gene product. OPRTase forms tetragonal crystals from
      polyethylene glycol solutions; these crystals diffract to better than 2 A
      resolution, and are stable to radiation damage. The space group is P4(1)2(1)2 (or
      P4(3)2(1)2) with unit cell dimensions of a = b = 48.5 A, c = 210.5 A, and alpha =
      beta = gamma = 90 degrees. A crystalline form of the selenomethionine derivative
      of the protein is also reported.

PMID- 8487308
TI  - Crystals of protein L30 from the 50 S ribosomal subunit of Thermus thermophilus.
      Preliminary crystallographic data.
AB  - Crystals have been obtained of protein L30 from the large ribosomal subunit of an
      extreme thermophile, Thermus thermophilus, using ammonium sulphate as a
      precipitant. The crystals belong to space group P3(1)12 with cell parameters a =
      b = 64.2 A, c = 78.3 A. They diffract X-rays to at least 2.3 A resolution.

PMID- 8487309
TI  - New crystal form of the photosynthetic reaction centre from Rhodobacter
      sphaeroides of improved diffraction quality.
AB  - Trigonal crystals of photosynthetic reaction centres from the wild-type purple
      bacterium, Rhodobacter sphaeroides (ATCC 17023), have been grown from potassium
      phosphate solutions at 18 degrees C. They belong to the space group P3(1/2)21 and
      have unit cell dimensions of a = b = 141.4 A and c = 187.2 A. The crystals
      diffract to at least 2.65 A resolution and are suitable for detailed structural
      studies.

PMID- 8487310
TI  - Crystallization and preliminary X-ray studies of a protease from Pseudomonas
      aeruginosa.
AB  - A protease produced by Pseudomonas aeruginosa has been crystallized by the vapor
      diffusion method using polyethylene glycol 4000 as a precipitant. The crystals
      belong to the hexagonal space group P6(1) (P6(5) with unit cell dimensions; a = b
      = 106.9 A, c = 96.9 A. There are two molecules per asymmetric unit. The crystals
      diffract X-rays to at least 3.0 A and are suitable for X-ray crystallographic
      studies.

PMID- 8487311
TI  - Purification and crystallization of human cyclin-dependent kinase 2.
AB  - The major transitions of the eukaryotic cell cycle are triggered by cyclin
      dependent protein kinases. We report the purification and crystallization of the
      catalytic subunit of human cyclin-dependent kinase 2 (CDK2), which has been
      implicated in the control of the G1/S transition. CDK2 was purified in large
      quantities from insect cells infected with a recombinant baculovirus, and
      crystals of the protein were prepared and subjected to preliminary X-ray
      diffraction analysis.

PMID- 8487312
TI  - Cataract surgery.
AB  - 1. The eye is made up of three layers: the retina, uveal tract, and sclera, which
      is continuous with the cornea. 2. Drugs are used during surgery to achieve
      specific effects. Nonsteroidal anti-inflammatory drugs reduce irritation and
      maintain the dilation effect of cycloplegics and mydriatics. Viscoelastic
      substances protect the nonregenerative endothelial cells. 3. The risks involved
      with cataract surgery include hemorrhage in the anterior chamber, a tear in the
      posterior capsule, and damage to the endothelial cells and retina.

PMID- 8487313
TI  - Mobile eye units in the fight against eye disease in East Africa.
AB  - 1. Trachoma is one of the leading causes of blindness in Kenya, but it may be
      prevented in the early stages by tetracycline ointment. Mobile eye units (MEUs)
      provide the means by which technicians travel to remote villages. 2. Ophthalmic
      clinical officers travel to remote areas, providing examinations, diagnoses,
      ointments, eye medications, and lectures on eye care. In addition, villagers are
      trained in basic health and hygiene to help prevent many eye disorders. 3. Once
      the MEUs are purchased, continuing funds are needed to keep them running and to
      supply them with gasoline.

PMID- 8487314
TI  - Use of cold spray for relieving pain from local anesthetic injections in ocular
      surgery.
AB  - To relieve pain from local anesthetic injections, the authors tried lowering the
      skin surface temperature by spraying a commercially available cold spray
      immediately before the injections. A noncontact thermometer was used to measure
      the thermal change of the skin surface. An esthesiometer was applied to determine
      the surface perception of the skin. Our basic experiments indicated that there
      was a relationship between the thermal change and the perception. When the
      surface temperature dropped to 10 degrees C, there was a definite decrease in the
      perception. Based on these findings, the authors applied the spray to 100
      patients undergoing cataract surgery prior to both akinesia and retrobulbar
      anesthesia at a distance of 10 cm from the skin surface for 2 seconds, to be
      immediately followed by the injections. We found the spray to be effective in
      decreasing the pain due to these injections. Furthermore, there has been no major
      complications of the spray.

PMID- 8487316
TI  - Managing contact lens noncompliance.

PMID- 8487315
TI  - A 5-month-old black boy presented with leukocoria and a "glassy look" in his
      right eye: Coats' disease.

PMID- 8487317
TI  - OSHA regulations on universal precautions: a sample training curriculum.
AB  - 1. Training must be provided to each newly hired employee before that employee
      can work in a risk environment. Current staff must be trained annually, and
      additional training must be provided when infection control or universal
      precaution techniques are revised. 2. Training should include written material,
      oral presentations, films, videos, computer programs, and audio tapes at the
      employee's educational, literacy, and language level. Interactive discussion
      between the trainer and employees is required. 3. Employee evaluation should
      consist of written pretraining and posttraining tests and a practical
      demonstration of steps to protect against infectious diseases in the workplace.

PMID- 8487318
TI  - Dietary fat and breast cancer: where are we?

PMID- 8487319
TI  - Sex after chemo: a neglected issue.

PMID- 8487320
TI  - Evidence emerges: colorectal screening reduces deaths.

PMID- 8487321
TI  - Studies link familial breast, prostate cancers.

PMID- 8487322
TI  - Cancer rehabilitation.
AB  - An important trend in cancer treatment is an increasing emphasis on the overall
      outcome, not just on survival or disease-free interval, but also on the
      functional status and the quality of life of the survivor. Measuring the quality
      of life as a part of a clinical protocol is not enough. Measures must be aimed at
      facilitating optimal function and life satisfaction for the patient treated for
      cancer. The rehabilitation techniques used to enhance the life of the survivor
      need to be subjected to the same sort of scientific rigor required for other
      kinds of treatment. To develop data on rehabilitation parameters, we must create
      and utilize standardized and reliable evaluation techniques and instruments.
      These evaluation practices can then be utilized in clinical trials, both to
      assess the effectiveness of the rehabilitation techniques themselves and also to
      determine the effect of specific antitumor treatments on the patient's physical
      and psychosocial function. An organized multidisciplinary cancer rehabilitation
      program as a part of clinical and research facilities may be helpful. The
      important concept for all of us involved with the care of cancer patients is that
      of conveying our concern, not only for their survival, but for their function-
      physical, emotional, social, and vocational.

PMID- 8487323
TI  - Fatty acid composition of the subcutaneous adipose tissue and risk of
      proliferative benign breast disease and breast cancer.
AB  - BACKGROUND: Studies in animals and geographic correlations across populations
      suggest that fatty acid intake may have a positive relationship with breast
      cancer risk, but analytic epidemiologic studies of fat intake have been less
      supportive. Adipose tissue analysis provides a more objective assessment of
      intakes of fatty acids that are not endogenously synthesized than do the
      questionnaire survey methods used in many epidemiologic studies. PURPOSE: This
      case-control study of postmenopausal women was designed to examine the
      relationship between fatty acid composition of subcutaneous adipose tissue and
      risk of breast cancer and proliferative benign breast disease. In addition, we
      examined specific hypotheses that breast cancer risk is negatively associated
      with long-chain N-3 fatty acid intake, positively associated with trans fatty
      acid intake, and positively associated with increased intake of polyunsaturated
      fat together with low intake of antioxidants. METHODS: Aspirates of subcutaneous
      fat from the buttocks were obtained from 380 women with newly diagnosed stage I
      or II breast cancer and 176 with proliferative benign breast disease. A total of
      397 women who were evaluated for breast abnormalities at the same institutions
      but did not require breast biopsy or whose biopsy revealed nonproliferative
      benign breast disease served as the control group. We examined associations
      between saturated, monounsaturated, polyunsaturated, trans, or long-chain N-3
      fatty acids and breast cancer, atypical hyperplasia, or proliferative benign
      breast disease without atypia. RESULTS: We observed no consistent patterns of
      association between breast cancer risk and any of the categories of fatty acids
      or the individual constituent fatty acids in the adipose tissue. Saturated fatty
      acids were inversely associated with risk of proliferative benign breast disease
      without atypia but not with atypical hyperplasia or breast cancer. This
      association was not observed, however, when total fat intake was taken into
      account. Women with high levels of polyunsaturated fatty acids in adipose tissue
      and low serum or dietary levels of antioxidants were not observed to be at higher
      risk of breast cancer. CONCLUSIONS: Using an objective measure of intake, we
      observed no major associations between polyunsaturated fatty acids, including
      long-chain N-3 fatty acids and trans fatty acids, and risk of breast cancer or
      proliferative benign breast disease. IMPLICATIONS: These data do not support the
      hypothesis that intake of specific fatty acids, particularly polyunsaturated and
      trans fatty acids, is an important risk factor for malignant or benign breast
      disease.

PMID- 8487324
TI  - Recombinant human erythropoietin therapy for anemic cancer patients on
      combination chemotherapy.
AB  - BACKGROUND: Patients with advanced cancer frequently experience clinically
      significant anemia, which is often exacerbated by myelosuppressive chemotherapy.
      Consistent with the anemia of chronic disease, studies have documented serum
      erythropoietin levels that are inappropriately low for the degree of anemia in
      cancer patients. Myelosuppressive chemotherapy impairs erythropoiesis, which may
      not fully recover between treatment cycles. Recombinant human erythropoietin
      (rHuEPO) has been used safely and effectively to treat anemia in AIDS patients
      receiving zidovudine (AZT) and in patients with chronic renal failure. PURPOSE:
      This study was designed to evaluate the clinical role of rHuEPO in reducing
      symptomatic anemia in patients with advanced cancer who were receiving
      myelosuppressive chemotherapy (excluding cisplatin). METHODS: We studied 153
      anemic cancer patients receiving cyclic combination chemotherapy in a prospective
      multicenter, double-blind, placebo-controlled trial. The patients were randomly
      assigned to receive either rHuEPO (150 U/kg) or placebo subcutaneously three
      times a week for a maximum of 12 weeks or until the hematocrit level increased to
      38%-40%. If the hematocrit reached this target level before 12 weeks, the rHuEPO
      dose could be reduced to maintain the hematocrit at that level for the duration
      of the study. Response to rHuEPO therapy was assessed by measuring changes in
      hematocrit level, transfusion requirements, and quality of life. Quality-of-life
      assessment was based on patients' responses to questionnaires before and after
      the courses of therapy. RESULTS: The increase in hematocrit in the rHuEPO-treated
      group compared with hematocrit in the placebo-treated group was statistically
      significant (P = .0001) as measured by percentage point of change from baseline
      to final evaluation, by an increase in hematocrit level of six percentage points
      or more unrelated to transfusion, and by a rise in hematocrit level to 38% or
      more unrelated to transfusion. There was a trend toward the reduction in mean
      units of blood transfused per patient during months 2 and 3 of therapy combined
      in rHuEPO-treated patients compared with placebo-treated patients (0.91 U versus
      1.65 U; P = .056). In addition, rHuEPO-treated patients experienced a
      statistically significant improvement in energy level and ability to perform
      daily activities (P < or = .05). The two treatment groups showed no statistically
      significant differences in toxic effects except for increased incidence of
      diaphoresis (P < .05) and diarrhea (P = .05) in the rHuEPO-treated group.
      CONCLUSIONS: We conclude that rHuEPO is safe and effective for reversing anemia
      related to advanced cancer or to chemotherapy for cancer.

PMID- 8487325
TI  - Investigation of the mechanism of tamoxifen-stimulated breast tumor growth with
      nonisomerizable analogues of tamoxifen and metabolites.
AB  - BACKGROUND: The nonsteroidal anti-estrogen tamoxifen (TAM) is the front-line
      endocrine treatment for breast cancer, but disease recurrence is common.
      Treatment failure may occur because tumors become insensitive to TAM.
      Alternatively, resistance may occur because tumors become stimulated rather than
      inhibited by TAM. TAM-stimulated growth of MCF-7 human breast tumors has been
      observed in athymic mice after prolonged treatment with TAM. PURPOSE: Our purpose
      was to examine the mechanism of treatment failure by determining whether TAM
      stimulated tumors acquire the ability to excrete TAM and its anti-estrogenic
      metabolites or to convert them to estrogenic compounds with weakened
      antiestrogenic activity. METHODS: We used high-pressure liquid chromatography to
      quantitate TAM and its metabolites in serum and tumors from ovariectomized
      athymic mice and in MCF-7 cells grown in vitro. We treated tumor-bearing mice
      with subcutaneous sustained-release preparations of estradiol, TAM, or a
      nonisomerizable (fixed-ring) analogue and then assessed the activity of these
      compounds on TAM-inhibited parental MCF-7 tumors and on TAM-stimulated MCF-7 TAM
      tumors. RESULTS: We found negligible differences in intratumoral TAM levels
      between TAM-inhibited parental MCF-7 tumors and TAM-stimulated MCF-7 TAM
      variants. We did not detect metabolite E (Met E), an estrogenic TAM metabolite,
      in serum or tumors. Using MCF-7 cells in vitro, we determined that the (Z) isomer
      of Met E, the form directly produced by TAM metabolism, must be present in the
      cell at a concentration of over 1000 ng/g to overcome growth inhibition by
      physiological levels of TAM and antiestrogenic metabolites, but the (E) isomer of
      Met E was effective at 10 ng/g. We reasoned that conversion of Met E from the (Z)
      (a weak estrogen) to (E) isomer (a potent estrogen) would be required if
      formation of Met E were responsible for TAM-stimulated growth. However, fixed
      ring TAM, which can only form (Z) Met E, was shown to be as capable as TAM of
      initiating and maintaining anti-estrogen-stimulated growth of MCF-7 tumors in
      athymic mice. CONCLUSION: Metabolism and isomerization of TAM to estrogenic
      compounds is not the mechanism of TAM-stimulated growth in our model.
      IMPLICATION: Other potential mechanisms for TAM-stimulated growth, such as
      estrogen receptor mutation, must be investigated so that effective strategies can
      be devised to control breast cancer once therapy fails.

PMID- 8487327
TI  - Assessment of the carcinogenic potential of chlorinated water: experimental
      studies of chlorine, chloramine, and trihalomethanes.
AB  - BACKGROUND: Water chlorination has been one of the major disease prevention
      treatments of this century. While epidemiologic studies suggest an association
      between cancer in humans and consumption of chlorination byproducts in drinking
      water, these studies have not been adequate to draw definite conclusions about
      the carcinogenic potential of the individual byproducts. PURPOSE: The purpose of
      this study was to investigate the carcinogenic potential of chlorinated or
      chloraminated drinking water and of four organic trihalomethane byproducts of
      chlorination (chloroform, bromodichloromethane, chlorodibromomethane, and
      bromoform) in rats and mice. METHODS: Bromodichloromethane, chlorodibromomethane,
      bromoform, chlorine, or chloramine was administered to both sexes of F344/N rats
      and (C57BL/6 x C3H)F1 mice (hereafter called B6C3F1 mice). Chloroform was given
      to both sexes of Osborne-Mendel rats and B6C3F1 mice. Chlorine or chloramine was
      administered daily in the drinking water for 2 years at doses ranging from 0.05
      to 0.3 mmol/kg per day. The trihalomethanes were administered by gavage in corn
      oil at doses ranging from 0.15 to 4.0 mmol/kg per day for 2 years, with the
      exception of chloroform, which was given for 78 weeks. RESULTS: The
      trihalomethanes were carcinogenic in the liver, kidney, and/or intestine of
      rodents. There was equivocal evidence for carcinogenicity in female rats that
      received chlorinated or chloraminated drinking water; this evidence was based on
      a marginal increase in the incidence of mononuclear cell leukemia. Rodents were
      generally exposed to lower doses of chlorine and chloramine than to the
      trihalomethanes, but the doses in these studies were the maximum that the animals
      would consume in the drinking water. The highest doses used in the chlorine and
      chloramine studies were equivalent to a daily gavage dose of bromodichloromethane
      that induced neoplasms of the large intestine in rats. In contrast to the results
      with the trihalomethanes, administration of chlorine or chloramine did not cause
      a clear carcinogenic response in rats or mice after long-term exposure.
      CONCLUSION: These results suggest that organic byproducts of chlorination are the
      chemicals of greatest concern in assessment of the carcinogenic potential of
      chlorinated drinking water.

PMID- 8487326
TI  - Comparison of adjuvant chemotherapy with methotrexate and fluorouracil with and
      without cyclophosphamide in breast cancer patients with one to three positive
      axillary lymph nodes.
AB  - BACKGROUND: Alkylating agents administered as single agents or in combination
      with antimetabolites or anthracyclines delay the appearance of metastases and
      prolong the survival of breast cancer patients after surgery. PURPOSE: This phase
      III clinical trial was designed to evaluate the therapeutic efficacy and toxicity
      of the alkylating agent cyclophosphamide in combination with the antimetabolites
      methotrexate and fluorouracil adjuvant to breast cancer surgery. METHODS: This
      study consisted of 255 breast cancer patients (a) with one to three
      histologically positive axillary lymph nodes and either no detectable primary
      tumor or operable primary tumors 5 cm or less (T0-T2) (95% of the patients) or
      (b) with tumors larger than 5 cm (T3) and with negative axillary nodes. Patients
      were randomly allocated to receive either methotrexate (60 mg/m2) and
      fluorouracil (600 mg/m2) (MF) intravenously on days 1 and 8 every 28 days for
      eight cycles or cyclophosphamide (100 mg/m2) orally on days 1-14 plus MF (CMF)
      every 28 days for the same duration. Median follow-up was 7.8 years, and maximum
      follow-up was 13 years. RESULTS: There were no statistically significant
      differences in time to treatment failure or overall survival for patients treated
      with MF or CMF. At 8 years after completion of treatment, time to treatment
      failure was 55% (95% confidence interval [CI] = 50%-60%) and 59% (95% CI = 54%
      64%) and overall survival was 69% (95% CI = 65%-73%) and 67% (95% CI = 62%-72%)
      for MF- and CMF-treated patients, respectively. The hazard ratios (MF to CMF) for
      time to treatment failure and for survival, estimated with a proportional hazards
      model, were 1.02 (95% CI = 0.69-1.50) and 0.87 (95% CI = 0.56-1.34),
      respectively. Myelosuppression was significantly greater (P < .0001) in CMF
      treated patients during cycles 1-6. Median white blood cell count nadirs were
      between 4.4 x 10(3)/microL and 3.5 x 10(3)/microL in patients receiving MF and
      between 3.0 x 10(3)/microL and 2.4 x 10(3)/microL in those receiving CMF. Dose
      reductions were more frequent in CMF-treated patients, which led to statistically
      significant differences (P < .0001) in amounts of methotrexate and fluorouracil
      administered. Primary cancers at other sites occurred in 14 patients (5.5%)--six
      treated with MF and eight treated with CMF. CONCLUSIONS: Our findings suggest
      that the addition of cyclophosphamide to adjuvant chemotherapy with MF offers no
      therapeutic advantage but results in increased myelosuppression. IMPLICATIONS:
      Future trials will define the possible advantages of antimetabolites in adjuvant
      therapy. Further information will also become available when results of the
      ongoing National Surgical Adjuvant Breast and Bowel Project trial comparing
      adjuvant MF to CMF in node-negative breast cancer patients are presented.

PMID- 8487328
TI  - Phase I clinical trial of recombinant human interleukin-3 combined with
      carboplatin in the treatment of patients with recurrent ovarian carcinoma.

PMID- 8487329
TI  - Re: Chemoprevention studies in the community clinical oncology program.

PMID- 8487330
TI  - Autoregulation of hepatic macrophage activation in sepsis.
AB  - Endotoxin (LPS)-stimulated macrophages release mediators, such as tumor necrosis
      factor (TNF) and prostaglandin E2 (PGE2), which modulate the function of many
      different cells. We hypothesize that macrophage regulation is altered in sepsis
      and that mediators from LPS-stimulated macrophages "autoregulate" their
      activation state. Alterations in the LPS dose response relationships for
      inhibition of hepatocyte protein synthesis by hepatic macrophages (hMos) were
      examined to investigate factors that regulate hMo activation. In vitro
      pretreatment was compared using TNF alpha, PGE2, subactivating concentrations of
      LPS, or LPS plus indomethacin. Pre-exposure to LPS resulted in a dose-dependent
      loss of subsequent LPS-triggered activation of hMos in co-culture. Pretreatment
      with LPS and 1 mumol/L indomethacin partially restored hMo responsiveness. Pre
      exposure to PGE2 significantly decreased LPS responsiveness of co-cultured hMos,
      suggesting that PGE2 produced by LPS-stimulated hMos may mediate this effect.
      Pretreatment of hMos with TNF alpha, but not IL-1 beta, significantly lowered the
      LPS concentration required for maximal hMo activation. We conclude that both
      macrophage mediators and LPS pretreatment alter macrophage activation state.
      These data suggest an "autoregulatory" role for mediators of LPS-stimulated
      macrophages in sepsis.

PMID- 8487331
TI  - Blood component supplementation during massive transfusion of AS-1 red cells in
      trauma patients.
AB  - Coagulation component transfusions in trauma patients given more than 10 units of
      AS-1 red cells during the first 24 hours after injury were studied. Serial
      coagulation tests were obtained to direct component therapy. Coagulopathy
      developed in more than 70% of patients. Patients with blunt or penetrating trauma
      had similar coagulation abnormalities during massive transfusions. More than 40%
      of patients with either exsanguinating hemorrhage from penetrating trauma or
      blunt trauma with associated brain injuries had abnormal coagulation tests on
      admission. In contrast, patients with blunt trauma, but without brain injury, did
      not have coagulopathy on admission. Patients received an average of 25 units
      (range, 10-77) of AS-1 red cells and were exposed to an average of 80 (range, 11
      252) donors. Exsanguination and brain injuries primarily caused death in 57%.
      Abnormal coagulation tests will be frequent and profound during a massive
      transfusion with AS-1 red cells. Serial coagulation testing is recommended.

PMID- 8487332
TI  - Ultrasound in blunt abdominal and thoracic trauma.
AB  - Between July 1989 and June 1991, 312 patients with blunt thoracic or abdominal
      injuries were examined prospectively. Sonographic examination was performed by
      surgeons in the emergency room using a mobile ultrasound unit. In 113 (36.2%)
      cases pathologic findings were demonstrated sonographically. These included 47
      cases of hemothorax, 11 pericardial effusions, 52 cases of intra-abdominal fluid,
      24 lesions of intra-abdominal organs, and 10 cases of retroperitoneal hematoma.
      Physical examination findings were positive in 96 (30.8%), negative in 63
      (20.2%), and equivocal in 153 (49.0%). Two hundred thirty-nine patients had
      between one and eight injuries in addition to the blunt abdominal or thoracic
      trauma. These patients had an average Injury Severity Score (ISS) of 19.9 (range,
      1 to 75). The 73 patients with isolated blunt trauma of the thorax or abdomen had
      an ISS of 4.9 (range, 0-25). None of the 66 patients (21.2%) with positive
      clinical findings and negative sonographic examination results had to be operated
      on later in the course of treatment, while 5 (36%) of 14 patients (4.5%) with
      negative physical examination findings and positive sonographic findings had to
      undergo surgery. The sensitivity for the demonstration of intra-abdominal fluid
      and organ lesions was 98.1% and 41.4%, respectively. The overall sensitivity and
      specificity of the ultrasonic examination were 90.0% and 99.5%, respectively.

PMID- 8487333
TI  - Selective exclusion of the injured lung.
AB  - Intratracheal bleeding and intrapleural air leakage that are uncontrollable by
      conventional therapy are life-threatening in patients with blunt pulmonary
      trauma. Selective exclusion of the injured lung is the most effective treatment
      in such cases. Two hundred six consecutive patients over a 5-year period with
      blunt pulmonary trauma who survived 5 hours or more after arriving at the
      hospital were divided into three categories based on mode of treatment. In 190
      (92%), intratracheal bleeding, intrapleural air leakage, and intrapleural
      bleeding were controllable by conventional treatment (class 1). In six (3%),
      intratracheal bleeding and intrapleural air leakage were controllable by
      selective pulmonary exclusion, and intrapleural bleeding was controllable by tube
      thoracostomy (class 2). In ten (5%), thoracotomy was required because of
      uncontrollable intratracheal bleeding or intrapleural air leakage, despite
      selective pulmonary exclusion, or intrapleural hemorrhage was not controllable by
      tube thoracostomy (class 3). Among the 16 patients with class 2 or 3 trauma, 14
      survived.

PMID- 8487334
TI  - Supracondylar fracture of the femur: closed or open reduction?
AB  - Fifty-one cases of supracondylar fracture of the femur with a mean follow-up of
      29 months were retrospectively studied. Thirty-one fractures were open; most had
      major soft tissue damage. Open management was used for 32 of the fractures with
      good to excellent results in 81%, while a good or excellent outcome was attained
      in only 42% of the 19 fractures treated nonsurgically. Malunion was observed in
      seven cases treated by closed methods and in only one case treated by open
      reduction. The patients treated surgically also had shorter average hospital
      stays and a better range of motion in the knee, while the rates of deep infection
      (three cases) and nonunion (two cases) were similarly distributed between the
      surgically and nonsurgically managed groups. Twelve patients required closed knee
      manipulation to improve knee motion, five in the group treated by closed
      reduction and seven in the group treated surgically with an average gain in
      motion of 52 degrees in the former and 42 degrees in the latter group.

PMID- 8487335
TI  - Emergency cricothyroidotomy in trauma victims.
AB  - The first dictum of trauma care is to establish an airway. Infrequently
      endotracheal intubation is unsuccessful or contraindicated, and a surgical airway
      is required. We reviewed 30 emergency cricothyroidotomies among 8320 admissions
      over a 36-month period at a level I trauma center. Twenty cricothyroidotomies
      were performed in the emergency room by Trauma Service personnel and 10 during
      prehospital care by flight nurses. Cricothyroidotomy was the first airway control
      maneuver performed in 7 patients and 23 cricothyroidotomies were performed after
      attempts at oral intubation failed. No major complications were identified. Minor
      complications identified in the hospital included minimal subglottic stenosis
      (2), local wound infection (1), and nonthreatening hemorrhage (1). Fifteen
      patients were long-term survivors. We conclude that emergency cricothyroidotomy
      is a safe and rapid means of obtaining an airway when endotracheal intubation
      fails or is contraindicated.

PMID- 8487336
TI  - The role of diagnostic laparoscopy in the management of trauma patients: a
      preliminary assessment.
AB  - This study evaluated the role and advantages of diagnostic laparoscopy (DL)
      compared with diagnostic peritoneal lavage (DPL) in 75 trauma patients who were
      prospectively studied with DL followed by DPL. Of these, 59 patients had blunt
      injuries and 16 stab wounds. Seventy patients (93%) had the procedures performed
      in the emergency department (ED); 41 (59%) of these were awake and under local
      anesthesia. Forty-two patients had negative DPL and DL results with no subsequent
      sequelae. Twenty-three patients had negative DPL results and abnormal DL results.
      Of these, 20 were managed nonsurgically, and three (DPL < 10,000 RBC) underwent
      surgery based solely on DL findings of diaphragmatic lacerations from stab
      wounds. These were repaired. All 23 had an uneventful course. Three patients had
      positive DPL and insignificant DL findings. Laparotomy and DL findings
      correlated. A splenectomy for iatrogenic injury unrelated to DL and two
      nontherapeutic laparotomies were performed. Seven patients demonstrated both
      positive DPL and significant DL findings, and all had therapeutic laparotomies.
      Management based on DL rather than DPL would potentially have improved care in 8%
      of cases (6 of 75). Reliance on DL improved care in 19% (3 of 16) of patients
      with stab wounds and possibly could have in 3% (2 of 59) of those with blunt
      injuries. Management using DL would have potentially improved care in 30% (3 of
      10) of patients with positive DPL findings and 5% (3 of 65) with negative DPL
      findings. Diagnostic laparoscopy can be performed safely in stable patients under
      local anesthesia in the ED. It offers no advantage over DPL as a primary
      assessment tool in blunt trauma. It does have advantages in the management of
      stab wounds. Diagnostic laparoscopy has a role in redefining DPL criteria for
      laparotomy and, in selected patients, as an adjunct to DPL, allowing further
      diagnosis and potentially the treatment of injuries without laparotomy.

PMID- 8487337
TI  - Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma
      patients.
AB  - Ultrasound diagnostic imaging has been demonstrated to be a valuable
      investigative tool in the evaluation of trauma patients in Europe and Japan. In
      the United States, however, ultrasound has not been widely used by trauma
      surgeons because of its lack of availability in the trauma resuscitation area and
      the associated cost and lack of full-time availability of a technician. In this
      prospective study, four attending trauma surgeons, four trauma fellows (PGY 6 and
      7), and 25 surgical residents (PGY 4) at a level I trauma center were trained in
      specific ultrasound techniques to identify fluid in trauma patients with
      thoracoabdominal injuries. Their ultrasound evaluations of 476 patients
      demonstrated that in 90 patients with clinically significant injuries, ultrasound
      imaging successfully detected injury in 71, for a 79% sensitivity. Specificity
      was 95.6%. We conclude that (1) surgeons can rapidly and accurately perform and
      interpret ultrasound examinations; and (2) ultrasound is a rapid, sensitive,
      specific diagnostic modality for detecting intraabdominal fluid and pericardial
      effusion.

PMID- 8487338
TI  - Physical impairment and functional outcomes six months after severe lower
      extremity fractures.
AB  - To determine functional outcomes after lower extremity fracture (LEF), a
      prospective follow-up study of patients admitted to three level I trauma centers
      for treatment of unilateral LEFs was conducted. In this paper we describe
      outcomes at 6 months after discharge from the initial hospitalization and examine
      the relationship between impairment and disability. A total of 444 patients met
      the entry criteria for the study. Of these 376 (85%) were successfully located
      and interviewed at 6 months; 302 (68%) returned to the trauma center at 6 months
      for a clinical assessment by a physical therapist. Study patients were
      predominantly young (mean age = 32.4), white (72%) men (70%) who were working
      before the injury (77%). The fractures resulted primarily from motor vehicle
      crashes (71%); mean hospital LOS was 12 days. Disability was measured using the
      Sickness Impact Profile (SIP), a well validated patient assessment of health
      status. The overall SIP score averaged for all patients was 10.2, denoting a
      moderate level of dysfunction or disability. Analysis of the 12 subscores that
      constitute the SIP indicate particularly high scores for ambulation (16.7
      postdischarge vs. 1.2 preinjury), sleep and rest (14.0 vs. 5.1), emotional
      behavior (10.5 vs. 2.2), home management (15.1 vs. 2.6), recreation and pastimes
      (19.0 vs. 4.4), and most notably, work (33.2 vs. 8.3). Further analysis of the
      subgroup of patients working before the injury shows that 48% had returned to
      work at 6 months. Correlations between lower extremity impairment (range of
      motion, muscle strength, and pain) and the ambulation subscore of the SIP were
      high. However, correlations between impairment and more global areas of activity
      such as home management, work, and recreation were considerably lower. These
      results suggest that other factors, over and above the extent of physical
      impairment, significantly influence broader disability outcomes such as return to
      work. Further research is needed to define these factors so that effective
      interventions after acute care can be identified and appropriately targeted.

PMID- 8487339
TI  - Primary intramedullary femur fixation in multiple trauma patients with associated
      lung contusion--a cause of posttraumatic ARDS?
AB  - We investigated whether primary (< 24 hours) intramedullary stabilization of
      femoral shaft fractures in multiple trauma patients with severe thoracic injury
      might be associated with an increased incidence of adult respiratory distress
      syndrome (ARDS). A total of 766 patients with multiple trauma admitted to
      Hannover Medical School between January 1, 1982, and December 31, 1991, were
      investigated retrospectively. Of these, 106 patients met the inclusion criteria:
      Injury Severity Score > 18, femoral midshaft fracture treated by intramedullary
      nailing, primary admission or referral within 8 hours after injury, and no death
      from head injury or hemorrhagic shock. Two groups were differentiated according
      to the presence or absence of chest trauma (severe chest trauma = AIS thorax > or
      =, group T; no severe chest trauma = AIS thorax < 2, group N). Selection of
      subgroups according to the time of femur stabilization was group I < 24 hours
      after trauma, group II > 24 hours after trauma. Injury Severity Scores in the
      four groups were TI: 29.4 (n = 24); TII 31.4 (n = 26); NI 20.1 (n = 33); NII 25.4
      (n = 23). In patients without thoracic trauma the ICU time (NI: 7.3 days; NII:
      18.0 days) and intubation time (NI: 5.5 days; NII: 11.0 days) were lower in the
      patients treated primarily (p < 0.05). In patients with severe chest trauma there
      was a higher incidence of posttraumatic ARDS (33% versus 7.7%) and mortality (21%
      versus 4%) when early intramedullary femoral nailing was done. In the absence of
      severe chest trauma primary intramedullary femoral nailing is
      beneficial.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487340
TI  - Head injury and facial injury: is there an increased risk of cervical spine
      injury?
AB  - A series of 8285 blunt trauma victims from one hospital were analyzed to
      establish the possible association of cervical spine injuries with craniocerebral
      and facial injuries. Patients with clinically significant head injuries were at
      greater risk of cervical spine injuries than those without head trauma (4.5% vs.
      1.1%, significant by Chi-squared analysis). Patients with Glasgow Coma Scale
      scores of 8 or less were at even greater risk of cervical spine injuries (7.8%).
      Facial injuries were not associated with cervical spine injuries. Procedures to
      achieve airway control in patients with serious head injuries must reflect these
      findings so that protection is afforded to the cervical spine during trauma
      resuscitation.

PMID- 8487341
TI  - Long-term consequences of minimal brain injury: loss of consciousness does not
      predict memory impairment.
AB  - This study evaluated the memory and intellectual function of 32 adults following
      minimal brain injury. All patients had a Glasgow Coma Scale score of 15 upon
      evaluation in the Emergency Room, negative findings on radiographic examination,
      and negative history of prior neurologic disease or injury. Seventeen of these
      had experienced a loss of consciousness. Patients suffering a loss of
      consciousness postinjury obtained significantly lower mean verbal intelligence
      quotients than those obtained by patients who remained conscious following their
      accidents. Both groups exhibited memory impairments. This could indicate that
      loss of consciousness predicts intellectual impairment, but not degree of memory
      dysfunction. An alternative interpretation of these data is that patients
      referred for examination after a head injury that did not involve a loss of
      consciousness included a disproportionate number of patients from upper
      socioeconomic levels who have greater access to medical delivery systems or
      greater sophistication regarding cognitive function.

PMID- 8487342
TI  - The effect of education and safety devices on scald burn prevention.
AB  - A prospective study was designed to evaluate the effects of education on the
      incidence of pediatric scald burns. Demographic data from our Trauma Registry
      identified the Zip code area of greatest risk. Eighty of 121 families with
      children in a large rental property were chosen randomly for the education
      program. Twenty of these families also had an anti-scald device installed in the
      bathtub faucet; all had two or more children under age 5 years. Families were
      surveyed before and after intervention. Safety knowledge improved post-education
      as judged by correct survey responses. Although 90% of the families had water
      heaters set at "warm" (< or = 120 degrees F), the actual temperature at the tap
      was above 130 degrees F in 71%. The anti-scald devices did work, but at 9 months
      all but one had been removed because of sediment buildup, which prevented water
      flow. In the year of the study, the number of scald burns from the target Zip
      code area decreased from 15 to 12. This was a pilot project for programs that can
      test public response to general safety education. An anti-scald device in
      conjunction with education works well in theory, but a better device needs to be
      engineered. In view of discrepancies between water heater settings and tap water
      temperature, housing authorities could play a vital role in implementing safety
      measures.

PMID- 8487343
TI  - Arterial intimal flaps: a comparison of primary repair, aspirin, and endovascular
      excision in an experimental model.
AB  - The optimal management for traumatic arterial intimal injuries is unresolved.
      Three therapeutic options were compared in an experimental model employing a
      standard intimal flap created in 51 canine superficial femoral arteries. Group 1
      (14 arteries) underwent resection with end-to-end repair. Group 2 (19 arteries)
      received acetylsalicylic acid (ASA) and observation only. Group 3 (21 arteries)
      underwent endovascular excision of the flap with angioscopic guidance. Control
      intimal flaps (18 arteries) were created and observed without further
      intervention. Patency in group 1 (primary repair) and group 2 (ASA) was 100%; the
      patency in both was significantly (p < 0.05) greater than in the controls, which
      was 67%. Patency in group 3 (endovascular excision) was 79%. Residual luminal
      defects were observed in only 8% of the arteries repaired primarily, but in 76%
      of the aspirin-treated arteries. Residual luminal defects following endovascular
      excision were present in 53% of the arteries remaining patent. Although resection
      and primary repair (group 1) provided better results than observation alone
      (control), addition of ASA (group 2) also sustained patency. However, a high
      incidence of residual intimal defects occurred, the natural history of which is
      unknown. While endovascular excision (group 3) may become a feasible alternative,
      current technology provided inferior patency with frequent residual intimal
      defects. These results suggest that observation alone supplemented with
      antiplatelet medication (ASA) may be adequate treatment, but longer follow-up is
      necessary for confirmation.

PMID- 8487344
TI  - Abdominal surgical wound infection is lowered with improved perioperative
      enterococcus and bacteroides therapy.
AB  - Perioperative antibiotics decrease surgical wound infection (SWI) in trauma
      patients requiring abdominal exploration. This investigation evaluated 24 hours
      of cefoxitin or ampicillin/sulbactam used for early therapy in such patients.
      Patients were randomly assigned to one of two treatment groups. The primary
      endpoint evaluated was SWI, which was defined as purulent drainage or active
      wound treatment. Five hundred ninety-two patients were evaluated: 283 received
      ampicillin/sulbactam and 309 received cefoxitin. The incidence of wound infection
      among the ampicillin/sulbactam patients was 2% and among cefoxitin patients it
      was 7% (p < 0.004). The cefoxitin patients with colon injuries were analyzed (p <
      0.007). The major difference between the two groups was an increased incidence of
      enterococcal infections in the cefoxitin-treated patients. A single broad
      spectrum antibiotic given for 24 hour perioperatively effectively controls SWI.
      Use of ampicillin/sulbactam results in a significantly lower SWI rate than use of
      cefoxitin, which may be a result of improved enterococcal and Bacteroides
      coverage.

PMID- 8487345
TI  - Bacterial translocation occurs in humans after traumatic injury: evidence using
      immunofluorescence.
AB  - We evaluated the occurrence of bacterial translocation (BT) in humans after
      traumatic injury. Twenty trauma patients (18 with blunt trauma) requiring
      celiotomy and without hollow viscus injury were studied. After surgical
      hemostasis and repair, portal venous blood (PVB) was sampled for culture.
      Additionally, a mesenteric lymph node (MLN) was harvested for culture and
      indirect immunofluorescence analysis using, first, mouse monoclonal antibody to
      E. coli beta-galactosidase, then goat anti-mouse immunoglobulin G (IgG). Injury
      Severity Score (ISS), Trauma Score (TS), and period of hemorrhagic shock (HS;
      systolic BP < 90 mm Hg with blood loss > 500 mL) were recorded before specimens
      were obtained. RESULTS: Fifteen patients initially had HS (mean period of 60
      minutes). Mean TS and ISS were 10 and 29, respectively. Seven patients did not
      have HS (mean TS and ISS, 10 and 13). Three patients received antibiotics
      preoperatively. Portal venous blood culture produced positive results in only
      three patients (two with HS) and culture of the MLN specimen was positive in one.
      However E. coli beta-galactosidase was detected within the cytoplasm of
      macrophages in all MLNs. One patient developed multiple organ failure.
      CONCLUSION: Bacterial translocation occurs in humans following traumatic injury
      and may be independent of HS. Culture techniques may not detect BT since
      organisms may have been phagocytized by macrophages. The clinical significance of
      BT in trauma patients remains unclear.

PMID- 8487346
TI  - A circulating protein that depolarizes cells increases after hemorrhage in dogs.
AB  - Recent evidence suggests that a circulating factor or factors may mediate cell
      membrane depolarization after hemorrhage in rats. To test for the presence of a
      similar factor in dogs, conscious adult splenectomized dogs with chronic arterial
      cannulae were either (1) bled 30% of measured blood volume over 3 minutes (HEM, n
      = 8); (2) bled 30% of measured blood volume over 3 minutes and reinfused with the
      shed blood 10 minutes later (HEM + REINF, n = 6); or (3) observed without
      hemorrhage (CONTROL, n = 5). Treatments were applied in random order, 72 hours
      apart. Arterial blood was sampled at rest and for 1 hour. Depolarizing activity
      of the plasma was measured in an in vitro bioassay using resting dog RBCs and a
      membrane potential-sensitive oxonol dye (DIBAC). Fluorescence was measured by
      spectrofluorometry and the percentage of change from resting values was
      calculated. Fluorescence intensity increased after hemorrhage in the HEM and the
      HEM + REINF groups. Fluorescence intensity decreased to CONTROL values in the HEM
      + REINF group by 10 minutes after reinfusion of shed blood, but remained greater
      than CONTROL values in the HEM group. The magnitude of early cell membrane
      depolarization was approximately 20 mV. Similar depolarization was observed in
      cultured canine skeletal myocytes and pre-adipocytes. Changes in fluorescence
      intensity correlated with changes in mean arterial pressure at all times after
      hemorrhage except at 15 minutes (5 minutes after reinfusion in the HEM + REINF
      group). The depolarizing activity in dog plasma after hemorrhage shares several
      physical chemical properties with a similar substance identified in rats after
      hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487347
TI  - Isolated fracture-dislocation of the sacrum: case report.
AB  - An unusual case of isolated fracture-dislocation of the sacrum is reported. A 19
      year-old woman had a fracture-dislocation of S-1-2 combined with two longitudinal
      fractures of the sacrum, but no other pelvic fractures were identified. The
      possible mechanisms of fracture-dislocation of the sacrum are discussed. The
      fracture site was identified accurately on a CT scan. Pain relief was obtained by
      application of an external fixator. A mild neurologic deficit in the S-1 root
      distribution disappeared uneventfully.

PMID- 8487348
TI  - Acute epidural hematoma appearing as a side-by-side isodensity and hyperdensity
      on computed tomographic scan: case report.
AB  - A case of acute epidural hematoma appearing as a side-by-side isodensity and
      hyperdensity on a computed tomographic (CT) scan is presented. This uncommon CT
      finding is discussed and the pathophysiology is reviewed.

PMID- 8487349
TI  - Vascular surgery: "a running commentary".

PMID- 8487350
TI  - Routine surveillance after carotid endarterectomy: does it affect clinical
      management?
AB  - PURPOSE: Although routine noninvasive surveillance is recommended after carotid
      endarterectomy (CEA), there are little data to show that identification and
      eradication of recurrent carotid artery stenosis are necessary to avoid the risk
      of subsequent neurologic complications. METHODS: We reviewed our experience over
      a 16-year period in 380 consecutive patients undergoing 409 CEAs who underwent
      serial postoperative ultrasonic scanning at 6 weeks, 6 months, and 1 year after
      CEA and then yearly thereafter. RESULTS: Recurrent stenoses (> or = 50% diameter
      reduction) were detected in 44 arteries (10.8%) during follow-up from 1 to 177
      months (mean 42.0 months). Most (70.5%) occurred within 2 years of CEA.
      Cumulative recurrence rates were 5.8%, 9.9%, 13.9%, and 23.4% at 1, 3, 5, and 10
      years, respectively. Recurrent stenoses were more frequent in female (p = 0.02)
      and younger patients (p = 0.01) and less frequent in those having a vein patch
      repair (p = 0.02). Most recurrences (84%) were in the 50% to 79% stenosis range.
      In four patients 80% to 99% stenoses developed and in three patients total
      occlusions developed, for a severe recurrence rate of 2.1%. Only 10 (22.7%) of
      the recurrent stenoses were initially symptomatic, and only one (2.9%) of the
      asymptomatic restenoses later became symptomatic. One patient with recurrent
      stenosis suffered a stroke (0.3%). Cumulative 5-year ipsilateral stroke-free
      rates in patients with recurrent stenosis (94.4%) were practically identical (p =
      0.76) to those in patients without recurrent stenosis (94.2%). Life-table
      ipsilateral stroke-free survival rates at 5 years were 94.2% in patients with
      recurrent stenosis and 78.4% in patients without recurrent stenosis (p = 0.16).
      Four (9%) recurrent stenoses and 12 lesions (27%) in the contralateral artery
      progressed. Only seven patients (1.7%) underwent repeat operation for ipsilateral
      disease, four for symptoms and three for recurrent stenosis. CONCLUSIONS:
      Recurrent carotid artery stenosis occurs early after CEA, is typically benign,
      and remains stable over a prolonged follow-up period. Our results question the
      importance of routine noninvasive surveillance after CEA and suggest that a more
      conservative approach would be equally beneficial in terms of clinical relevance
      and cost-effectiveness.

PMID- 8487351
TI  - Combined use of duplex imaging and magnetic resonance angiography for evaluation
      of patients with symptomatic ipsilateral high-grade carotid stenosis.
AB  - PURPOSE: Advances in cerebral vascular imaging suggest that patients with
      critical levels of carotid artery stenosis (> 70%) who have symptoms can be
      identified accurately and necessary information about the intracranial and
      extracranial circulation obtained before surgery without conventional
      angiography. We have used carotid duplex imaging in combination with magnetic
      resonance angiography (MRA) to evaluate 20 patients with symptomatic ipsilateral
      high-grade carotid stenosis. METHODS: All patients underwent CT and magnetic
      resonance imaging brain scans, as well as MRA and conventional arteriography of
      the cerebral circulation. Magnetic resonance angiograms were obtained with two
      dimensional phase contrast and time-of-flight techniques. Phase contrast was used
      for intracranial vascular imaging and for determining qualitative flow velocities
      and the direction of blood flow in the circle of Willis. Two-dimensional time of
      flight was used to assess the carotid bifurcations. RESULTS: Twenty patients with
      symptoms (six with strokes, 11 with transient ischemic attacks, and three with
      amaurosis fugax) had duplex evidence of high-grade carotid stenoses. Computed
      tomographic and magnetic resonance brain scans were positive for cerebral
      infarction in six patients with clinical strokes. Comparison of MRA with
      conventional angiography was 91% accurate for high-grade stenoses and occlusions
      (sensitivity 100% and specificity 90% for stenosis; sensitivity/specificity was
      100% for complete occlusion). Comparison of duplex imaging with conventional
      angiography demonstrated 86% accuracy for detection of severe stenosis or
      occlusion (sensitivity 94% and specificity 89% for stenosis; sensitivity and
      specificity were 100% for complete occlusion). CONCLUSIONS: This study suggests
      that combined use of MRA and duplex imaging is accurate for detection and
      evaluation of high-grade carotid stenoses in patients with symptoms.

PMID- 8487352
TI  - The effect of nifedipine on lipid and monocyte infiltration of the subendothelial
      space.
AB  - PURPOSE: Calcium channel blockade has been shown to inhibit experimental
      atherosclerosis in cholesterol-fed animals, and early clinical trials suggest its
      benefit in human subjects as well. METHODS: To determine the effect of the
      calcium channel blocker nifedipine on lipid and monocyte infiltration of the
      subendothelial space, an endothelial cell (EC)-smooth muscle cell (SMC) bilayer
      model of the arterial wall was incubated for 18 hours with nifedipine (0.1
      micrograms/ml). Iodine 125-labeled low-density lipoprotein (125I-LDL) (10
      micrograms protein/ml) was then added to the upper-well medium. RESULTS: After a
      3-hour incubation period, nifedipine-treated bilayers showed an increased
      permeability to LDL (p < 10(-7). Nifedipine had no effect on the membrane binding
      or cellular uptake of LDL by the EC but did increase SMC binding and uptake (p <
      0.0005). U937 monocytes were found to incorporate 125I-LDL in a concentration
      dependent fashion, without saturation to 25 micrograms/ml, the highest
      concentration studied. Nifedipine increased monocyte uptake of LDL (10
      micrograms/ml; p < 0.003 but reduced monocyte movement through the EC barrier (p
      < 10(-7). A study of the selective preincubation of each cell type (EC, SMC, and
      monocyte) with nifedipine indicated that this reduction was likely the result of
      a direct effect on the monocyte. CONCLUSIONS: Given the potential cytotoxic
      effects of the monocyte within the subendothelial space, nifedipine-induced
      inhibition of monocyte infiltration and enhancement of lipoprotein uptake by the
      SMC may be protective.

PMID- 8487353
TI  - Optimizing technical success of renal revascularization: the impact of
      intraoperative color-flow duplex ultrasonography.
AB  - PURPOSE: Technical problems with renal revascularization can be difficult to
      detect, especially with end points of transaortic renal endarterectomies or
      anastomosis of bypass grafts to small distal renal arteries. If missed, such
      technical mishaps may not be recognized until after operation, when the chance
      for timely renal salvage has often been lost. METHODS: To evaluate the value of
      newer color-flow duplex imaging, we performed intraoperative ultrasonography on
      35 patients undergoing revascularization of 64 renal arteries, 29 patients
      undergoing transaortic endarterectomy, and 6 undergoing bypass grafting. Most
      patients (24/35; 69%) underwent concomitant aortic reconstruction. Ninety-four
      percent had hypertension, whereas 66% had associated chronic renal insufficiency.
      RESULTS: Technical abnormalities prompting operative revision were identified
      during surgery in 10.9% of reconstructed main renal arteries (7/64). These
      included two occlusions, three intimal defects, and one extrinsic tissue band
      after endarterectomy plus one graft anastomotic stenosis. Color-flow imaging
      revealed all of them. Technical defects were also associated with higher peak
      systolic flow velocities (mean 2.62 m/sec; range 2.00 to 3.50 m/sec) than normal
      appearing arteries (mean 1.34 m/sec; range 0.40 to 2.50 m/sec) (p = 0.004).
      Eighty-six percent of the defects (6/7) were immediately correctable. One patient
      required nephrectomy. Postoperative angiograms revealed two asymptomatic small
      branch-vessel occlusions (3%). Compared with preoperative levels (p < 0.01), both
      hypertension and renal insufficiency improved initially. The clinical outcome of
      patients requiring intraoperative revision did not differ from that of patients
      undergoing normal intraoperative studies. CONCLUSION: Intraoperative color-flow
      duplex detection and surgical correction of technical problems with renal
      revascularization have enhanced our technical success and been associated with
      long-term results comparable to those of patients undergoing normal
      intraoperative studies.

PMID- 8487354
TI  - Increased platelet-derived growth factor production and intimal thickening during
      healing of Dacron grafts in a canine model.
AB  - PURPOSE: Growth factor production by endothelial cells on grafts may play a role
      in the development of intimal hyperplasia and subsequent graft failure. METHODS:
      To study the relationship between platelet-derived growth factor production and
      graft healing, 26 beagles underwent placement of 20 cm long, 6 mm internal
      diameter, knitted Dacron thoracoabdominal grafts, either seeded with autologous
      endothelial cells (n = 14) or unseeded controls (n = 12). The grafts and adjacent
      arteries were removed 4 or 20 weeks after implantation for measurement of
      platelet-derived growth factor production in organ culture, endothelial cell
      coverage, and intimal thickness. RESULTS: Midgraft platelet-derived growth factor
      production by seeded graft segments increased from 41 +/- 6 to 148 +/- 27
      pg/cm2/72 hr (p < 0.002) between 4 and 20 weeks. This was accompanied by a
      significant increase in inner-capsule thickness. Platelet-derived growth factor
      production by control graft segments also increased from 58 +/- 21 to 163 +/- 42
      pg (p < 0.05) and was similar to that of seeded grafts despite more rapid
      endothelialization of seeded grafts. The increase in growth factor production by
      Dacron grafts was greater than that of the expanded polytetrafluoroethylene
      grafts studied previously despite similar endothelial cell coverage. CONCLUSION:
      This increase corresponded with the rapid appearance of smooth muscle cells in
      the pseudointima of Dacron grafts, suggesting that these cells may be responsible
      for the observed increase in platelet-derived growth factor production.

PMID- 8487355
TI  - Supraceliac aortic cross-clamping: determinants of outcome in elective abdominal
      aortic reconstruction.
AB  - PURPOSE: A 7-year experience in which 43 patients underwent supraceliac aortic
      cross-clamping (SC-AXC) during elective abdominal aortic reconstruction was
      reviewed. METHODS: Operation was performed for abdominal aortic aneurysm (AAA) in
      29 (68%) patients, aortoiliac occlusive disease in seven (16%), proximal
      anastomotic AAA in three (7%), "shaggy" aorta syndrome in three (7%), and in situ
      grafting of a previously ligated aorta in one (2%) patient. The indications for
      supraceliac control included pararenal AAA origin (25), pararenal aortic
      atherosclerosis (18), inflammatory AAA (2), and a short infrarenal aortic stump
      (1). Vital organ ischemic complications (VOICs) were defined as any major
      ischemic complication involving the liver, kidneys, bowel, or spinal cord.
      RESULTS: The incidence of VOICs was significantly increased when concomitant
      renal or visceral revascularization (CRVR) was required (p = 0.002) and
      correlated with an increasing SC-AXC time (p = 0.015). In patients undergoing
      CRVR (n = 16) the perioperative mortality rate was 25%; VOICs developed in six
      patients and included renal failure (3), mesenteric/colonic ischemia (3), hepatic
      ischemia with coagulopathy (2), and spinal cord ischemia (1). In contrast, in
      those not requiring CRVR (n = 27), SC-AXC was well tolerated. There were no VOICs
      and no deaths; morbidity rate was 33%. CONCLUSIONS: The incidence of VOICs
      associated with the use of SC-AXC is primarily related to the level of
      preoperative renal or mesenteric insufficiency, the severity of pararenal aortic
      atherosclerosis, the extent of the operative procedure, and the duration of
      proximal aortic cross-clamping. In complex abdominal aortic reconstruction in
      which infrarenal aortic control is either not possible or deemed hazardous, SC
      AXC is a safe and valuable technique for achieving proximal control.

PMID- 8487356
TI  - Pharmacologic modulation of intimal hyperplasia in canine vein interposition
      grafts.
AB  - PURPOSE: The purpose of this study was to evaluate the efficacy of three drugs
      (cilazapril, cyclosporine, and aspirin) in modulating the progression of intimal
      hyperplasia during short postoperative times in short-segment, autogenous vein
      bypass grafts in a canine model. The relative effects of the drugs on the
      progression of intimal hyperplasia were compared with the Gilman parameter, a
      measure used extensively as a wound healing descriptor. To our knowledge this is
      the first use of the Gilman parameter in assessing vascular disease. METHODS:
      Seventy-two conditioned mongrel dogs were randomly and equally divided according
      to a three-factor analysis of variance. The factors included (1) drug treatments
      (cilazapril [10 mg/kg/day], cyclosporine [4 mg/kg/day], aspirin [325 mg/day], and
      control [nonmedicated]), (2) implantation sites (femoral and carotid arteries),
      and (3) postoperative times of graft harvest (1, 3, and 6 weeks). Each dog had 2
      cm segments of autogenous jugular vein interpositioned bilaterally into each of
      the paired carotid and femoral arteries. Quantitative data on luminal narrowing
      over time from intimal hyperplasia were compared from calculated Gilman
      parameters after image analysis of retrieved, histologically processed graft
      sections. RESULTS: The observed variability in the data was attributed to drug
      treatments and time. At 1 week after operation the mean Gilman parameters did not
      differ significantly among the treatment groups in either midgraft or distal
      graft segments. At 3 weeks the mean Gilman parameters of midgraft and distal
      graft sections of cyclosporine-treated dogs differed significantly (p < 0.05)
      from those of the control group and the cilazapril and aspirin-treated groups,
      which did not differ from each other. At 6 weeks after operation, mean Gilman
      parameters from aspirin- and cyclosporine-treated dogs differed statistically
      from control and cilazapril-medicated dogs and from each other (p < 0.001).
      CONCLUSIONS: These data support the efficacy of aspirin and cyclosporine in
      reducing intimal hyperplasia in short-segment arterialized vein grafts during
      short postoperative periods. Additional studies are required to ascertain whether
      the beneficial effects of aspirin and cyclosporine persist long-term.

PMID- 8487357
TI  - A reevaluation of intraarterial thrombolytic therapy for acute lower extremity
      ischemia.
AB  - PURPOSE: This study was performed to clarify the role of intraarterial
      thrombolytic therapy (IATT) in the management of acute lower extremity ischemia.
      METHODS: A retrospective review of 77 patients undergoing 84 courses of high-dose
      regional urokinase IATT from July 1981 to June 1991 was performed. The group
      included patients with acute thrombosis of lower extremity bypass grafts (n = 48)
      or native arteries (n = 36), presenting with ischemic but viable limbs, minimal
      or no motor dysfunction, and an absence of muscle rigor or compartment syndrome.
      The data were then examined individually by site of thrombosis to evaluate
      patient selection for IATT. RESULTS: Complete lysis, complications (either distal
      thromboembolism or bleeding), and early limb loss occurred in 59.5%, 11%, and 6%
      of infusions, respectively. IATT precluded the need for operative intervention in
      49% of acutely ischemic limbs. When surgery was required, successful IATT
      precisely localized responsible lesions and reduced the magnitude of operation. A
      subset of 13 patients were identified in whom either no intrinsic abnormality or
      poor runoff were evident after lysis and were treated with anticoagulation alone.
      CONCLUSIONS: These data show IATT to be especially suitable for thrombosis of
      native iliac or femoropopliteal arteries and infrainguinal vein grafts. IATT
      serves primarily as an adjunct in management of acute lower extremity ischemia.
      After successful IATT, subsequent therapy can be tailored to the anatomic cause
      of thrombosis.

PMID- 8487358
TI  - The effect of inguinal lymphatic manipulation on regional lymph flow patterns.
AB  - PURPOSE: Because of the proximity of the inguinal lymphatics and the femoral
      vessels, lymph vessel manipulation during inguinal dissection is unavoidable, and
      this project was undertaken to evaluate the consequences. METHODS: Thirty-five
      greyhound dogs underwent popliteal lymph node dissection, cannulation with
      microvascular silastic tubing, and infusion of 2.5% Patent blue violet (Sigma
      Chemical Co., St. Louis, Mo.) (visual enhancement) and technetium 99m-labeled
      human serum albumin (HSA). Animals underwent inguinal exploration with no
      manipulation (group 1; n = 9), local lymphatic ligation (group 2; n = 11), or
      radical excision and ligation (group 3; n = 15) of the inguinal lymph vessels.
      Lymphatic flow was calculated by 99mTc-HSA clearance (counts per minute) at the
      popliteal, inguinal, and iliac regions, before and after lymph vessel
      manipulation and was converted into percent change between the regions. RESULTS:
      There was statistically reduced intralymphatic radioactivity in groups 2 and 3
      compared with group 1 (p < 0.001; Student t test), whereas there was no
      significant difference between groups 2 and 3. CONCLUSIONS: This demonstrates
      that lymphatic flow in this experimental model is significantly reduced when
      major channels are identified and ligated, although radical obliteration does not
      reduce flow more significantly than local ligation, implying that there is an
      alternate pathway for lymph flow.

PMID- 8487359
TI  - The influence of carotid siphon stenosis on short- and long-term outcome after
      carotid endarterectomy.
AB  - PURPOSE: This study was designed to determine whether the presence of ipsilateral
      carotid siphon stenosis influenced the risk of early and late stroke and death
      after carotid endarterectomy (CEA). METHODS: The outcomes of patients with
      moderate (20% to 49%), severe (> 50%), and no siphon stenosis were compared over
      a 16-year period from April 1976 to February 1992. Complete angiographic data
      were available in 393 carotid arteries. RESULTS: Siphon stenosis was found
      ipsilateral to the CEA in 84 (21.4%) of the arteries. Most lesions were in the
      20% to 49% diameter-reducing range (77.4%), with the remainder in the greater
      than 50% range (22.6%). There were no occlusions. The perioperative mortality
      rate was nearly identical for the groups with and without siphon stenosis, 0.0%
      versus 0.6%, respectively (p = 0.99). Perioperative stroke morbidity rates (no
      stenosis, 2.3%; moderate stenosis, 3.1%; > 50% stenosis, 5.3%) were acceptable
      and were not statistically different (p > 0.38). Late ipsilateral stroke-free
      rates were similar in the groups with and without siphon stenosis. The 5- and 7
      year stroke-free incidences were 88.5% and 83.4% versus 94.9% and 94.9%,
      respectively (p > 0.20) for the two groups. Long-term ipsilateral stroke-free
      rates were not significantly different in the subgroups with moderate (20% to
      49%) and hemodynamically significant (> 50%) siphon stenosis. The 3- and 5-year
      ipsilateral stroke-free rates were 96.7% and 87.9% versus 94.6% and 94.6%,
      respectively (p = 0.69). Late death was more common in the group with siphon
      stenosis than it was in the group without siphon stenosis, 23.8% versus 12.5% (p
      = 0.02). Heart disease was responsible for most late deaths, 47% in both groups.
      Late stroke-related deaths were infrequent: 1.3% in patients with and 0.0% in
      patients without siphon stenosis. CONCLUSIONS: Although carotid siphon stenosis
      seemed to be associated with a higher risk of late death, it did not alter the
      short- and long-term stroke morbidity rates after carotid endarterectomy
      significantly. We conclude that the presence of carotid siphon stenosis should
      not influence the decision to perform carotid endarterectomy in patients with the
      appropriate indications.

PMID- 8487360
TI  - The importance of intraoperative detection of residual flow abnormalities after
      carotid artery endarterectomy.
AB  - PURPOSE: The efficacy of carotid endarterectomy in the prevention of strokes
      mandates low perioperative morbidity, as well as a low incidence of late
      ipsilateral stroke. This prospective study involving 430 patients (461 carotid
      endarterectomies) correlated the results of intraoperative assessment with end
      points of stroke and residual/recurrent internal carotid artery (ICA) stenosis.
      METHODS: Adequacy of the repair was assessed by ultrasound studies (duplex scan
      and pulsed Doppler spectral analysis) alone (n = 142), ultrasound studies and
      arteriography (n = 268), or clinical inspection (n = 51). After operation, duplex
      ultrasonography was used to confirm patency and categorize severity of ICA
      stenosis. At operation 26 carotid endarterectomy sites (5.6%), were revised based
      on intraoperative studies. RESULTS: Perioperative (30-day) morbidity rates were
      similar in patients with normal, mildly abnormal, or no ultrasound completion
      studies. There were six permanent (1.3%) and 12 temporary (2.6%) neurologic
      deficits and six deaths, including four fatal strokes and two fatal myocardial
      infarctions. By life-table analysis, the incidence of greater than 50% diameter
      reducing ICA stenosis or occlusion was increased (p < 0.007, log-rank test) in
      patients with residual flow abnormality or no study. More important, patients
      with normal intraoperative flow studies had a significantly lower rate of late
      ipsilateral stroke compared with the remaining patient cohort (p = 0.04, log-rank
      test). During the mean 30-month follow-up interval, the incidence of late stroke
      was increased (p = 0.00016) in patients with ICA restenosis or occlusion (3/35)
      compared with patients without recurrent stenosis (3/426). CONCLUSION:
      Confirmation of a normal repair at operation affords the best opportunity to
      minimize ischemic neurologic events and anatomic restenosis after carotid
      endarterectomy.

PMID- 8487361
TI  - Arteriovenous reversal for limb salvage in unreconstructible upper extremity
      arterial occlusive disease.
AB  - PURPOSE: Peripheral vascular disease of the upper extremity as a result of
      atherosclerotic disease or systemic vascular disorders presents a difficult
      management problem to the vascular surgeon. When extensive distal disease is
      present bypass procedures with standard arterial reconstruction techniques may
      not be possible. The use of retrograde perfusion to deliver oxygenated blood to
      the capillary bed by means of a normal venous system is not new. Flow reversal
      has been attempted in the myocardial, cerebral, and distal extremity
      circulations. Arteriovenous reversal (AVR) has been described for limb salvage in
      patients with upper extremity ischemia, with variable results. METHODS: We
      performed six AVR procedures on five patients with diffuse distal arterial
      disease and limb-threatening upper extremity ischemia. Two patients had insulin
      dependent diabetes, one had systemic lupus erythematosus (two extremities), one
      had rheumatoid arthritis with vasculitis, and the remaining patient had CRST
      (calcinosis, Raynaud's disease, sclerodactyly, telangiectasia) syndrome. The two
      patients with diabetes had systemic manifestations of atherosclerotic vascular
      disease and lower extremity ischemia; the remaining three patients had no
      evidence of atherosclerosis. In all patients the AVR was performed at the most
      distal site of nondiseased artery. RESULTS: Limb salvage was obtained in all
      cases; one patient had a healed minor digital amputation, and another patient had
      a healed major amputation. Clinical improvement with resolution of pain was
      achieved in five of six cases. The remaining patient had a significant diabetic
      neuropathy that was believed to contribute to her persistent pain. CONCLUSIONS:
      In patients with severe upper extremity ischemia not amenable to standard
      revascularization techniques, AVR should be considered to provide limb salvage
      and maximize hand function.

PMID- 8487362
TI  - Value of lower extremity venous duplex examination in the diagnosis of pulmonary
      embolism.
AB  - PURPOSE: This study tests the hypothesis that the absence of deep venous
      thrombosis (DVT) on lower extremity color-flow venous duplex examination (LECFD)
      combined with a non-high-probability ventilation/perfusion (V/Q) scanning results
      rules out pulmonary embolus (PE). The use of LECFD as a diagnostic aid for PE is
      based on data that show that 90% of PE originate from lower extremity DVT, and
      therefore on the assumption that PE cannot be present if DVT is not present as
      the source. METHODS: Over a 3-year period 51 patients with clinically suspected
      PE underwent LECFD and pulmonary angiography (PA) within 72 hours of each other.
      Forty-one patients also underwent V/Q scanning during the same time period. The
      results of LECFD and V/Q scans were compared with the results of PA, the gold
      standard for the diagnosis of pulmonary emboli. RESULTS: Results of LECFD were
      positive for DVT in seven of 16 cases of angiographically documented PE. Thus the
      "sensitivity" of LECFD as a diagnostic aid in cases of suspected PE is 44%. The
      results of LECFD and V/Q scans were combined and compared with the results of PA.
      A high-probability V/Q scanning result was considered positive for PE.
      Intermediate- and low-probability scanning results were considered negative,
      because in the literature the decision to begin heparin therapy is not made on
      the basis of this result. The combination of test results was considered positive
      if either test result was positive and negative only if results of both were
      negative. With these criteria the combination of test results was positive in
      only 62% of cases of angiographically documented PE. CONCLUSIONS: If treatment of
      suspected PE were based on LECFD alone or on duplex combined with V/Q scanning,
      40% to 50% of patients with PE would remain untreated. In cases of suspected PE
      where these noninvasive tests do not confirm its presence, PA should be
      performed.

PMID- 8487363
TI  - Surgical management of aortic aneurysm and coexistent horseshoe kidney: review of
      a 31-year experience.
AB  - PURPOSE: The coexistence of horseshoe kidney and aortic aneurysm poses a
      technical challenge to the vascular surgeon at the time of aneurysm repair.
      Clinical experience with this problem was reviewed to assess the results of
      treatment and to develop guidelines for the treatment of patients with horseshoe
      kidney and aortic aneurysm. METHODS: From 1960 through 1991, 19 patients with
      associated horseshoe kidney (HSK) required repair of abdominal aortic aneurysm at
      the Cleveland Clinic. Seventeen men and two women, with a mean age of 67 years,
      underwent 16 elective and three urgent operations. The HSK was found before
      operation in 16 patients (84%), whereas the remaining three were discovered at
      operation. Computed tomography and intravenous pyelography were the most reliable
      means of preoperative diagnosis, whereas ultrasonography and aortography were
      less dependable. Mean size of abdominal aortic aneurysm was 6.1 cm. The mean
      preoperative creatinine level was 1.5 mg/dl. The surgical approach was
      transperitoneal in 16 patients and retroperitoneal in three. Division of the
      renal isthmus was avoided in all patients. RESULTS: Renal artery anomalies were
      encountered in 14 patients (74%). Renal arterial continuity was established by a
      variety of techniques, including branch grafts or reimplantation into the aortic
      graft. Abnormal preoperative renal function was associated with a significantly
      increased risk for early postoperative hemodialysis (p = 0.02). There were three
      postoperative deaths, and the mortality rate for patients who required dialysis
      (67%) was significantly higher (p = 0.05) than that for patients who did not
      (6.3%). There were six late deaths at a mean follow-up interval of 57 months.
      CONCLUSIONS: The most important aspect of HSK, therefore, is the appropriate
      surgical management of frequent renal artery anomalies. We currently believe this
      is best achieved with retroperitoneal exposure.

PMID- 8487364
TI  - Preservation of renal function in juxtarenal and suprarenal abdominal aortic
      aneurysm repair.
AB  - PURPOSE: Deterioration in renal function is a common cause of morbidity in
      patients treated surgically for juxtarenal and suprarenal abdominal aortic
      aneurysms. We reviewed our experience over the last 8 years with 65 consecutive
      patients undergoing juxtarenal (n = 31) or suprarenal (n = 34) abdominal aortic
      aneurysm repair. METHODS: The aneurysms were repaired with a transabdominal (n =
      8), thoracoabdominal (n = 4), retroperitoneal (n = 22), or thoracoretroperitoneal
      (n = 31) approach. Proximal aortic clamps were placed at the suprarenal, supra
      superior mesenteric artery, or supraceliac level. Renal hypothermia with cold
      heparinized saline solution renal artery perfusion was used to protect renal
      function in 38 patients with either preoperative renal insufficiency or with
      anticipated prolonged renal ischemia (> 30 minutes). Concomitant renal artery
      reconstruction was required in 30 patients. RESULTS: Significant operative
      morbidity developed in 23 (35.3%) patients. There was one (1.53%) perioperative
      death (0 to 90 days). Temporary dialysis was necessary in two patients.
      Preoperative renal insufficiency was a significant risk factor on multivariate
      analysis for a decline in renal function during the first postoperative week.
      However, serum creatinine concentration had returned to baseline or improved in
      all patients but two (3.1%) at the time of discharge. In spite of significantly
      longer renal ischemia, discharge creatinine levels were, on univariate analysis,
      statistically less than baseline creatinine levels in patients with suprarenal
      aneurysms, patients requiring renal reconstruction, and patients treated with
      renal hypothermia. The location of the proximal aortic clamp was not a factor in
      postoperative morbidity. There was no significant difference between juxtarenal
      and suprarenal aneurysms with respect to operating room time, transfusion
      requirements, days intubated, resumption of oral diet, or the length of
      hospitalization. CONCLUSIONS: Careful consideration of the route of exposure,
      location of the proximal aortic clamp, and the preservation of renal function
      with renal hypothermia and with the repair of significant renal artery lesions
      will result in minimal morbidity and mortality in patients requiring surgery for
      juxtarenal or suprarenal abdominal aortic aneurysms.

PMID- 8487365
TI  - Angiographic follow-up after laser-assisted balloon angioplasty.
AB  - PURPOSE: The purpose of this study was to obtain angiographic documentation of
      patency and recurrence rates after laser-assisted balloon angioplasty. METHODS: A
      prospective assessment of laser-assisted balloon angioplasty (LABA) was performed
      in 35 limbs of 33 patients with femoral popliteal atherosclerotic disease. There
      were 21 male and 12 female patients with a mean age of 60.6 years. Indications
      were intermittent claudication in 19, rest pain in nine, and ischemic
      ulcer/gangrene in seven limbs. There were 23 totally occluded (mean length 6 +/-
      3.8 cm) and 12 stenotic arteries. LABA was achieved with a pulsed Nd:YAG laser
      with 10 to 25 W and a 2.2/3 mm sapphire probe, followed by balloon dilatation in
      all but four limbs. RESULTS: Immediate technical success (< or = 50% residual
      stenosis) was achieved in 27 (77%) of 35 limbs. Mean ankle/brachial index
      improved from 0.49 to 0.80 (p < 0.05). Major complications included three
      perforations, three dissections, and two emboli. Two additional limbs required
      operation at less than 30 days for a 30-day patency rate of 71.4%. Long-term
      clinical and noninvasive follow-up ranged from 1 to 55 months (mean 17.68
      months). Twenty-nine angiograms were obtained from 3 to 49 months after LABA.
      Nineteen limbs underwent at least one angiogram, seven underwent two, and three
      limbs underwent three angiograms. Eleven of the 19 limbs showed evidence of
      restenosis greater than 50%, all within 12 months. The cumulative patency rate
      was 71.5% at 1 month, 39.7% at 6 months, and 31.3% at 12, 24, and 36 months.
      CONCLUSIONS: LABA with the Nd:YAG laser has a 30-day success rate of 71.4%.
      Angiographic follow-up demonstrates a high incidence of restenosis (> 50%),
      usually within 12 months. Approximately 50% of limbs eventually required
      reintervention within 1 year. In view of the disappointing early results, the use
      of LABA must remain strictly investigational.

PMID- 8487366
TI  - Training of vascular surgeons: the two-class system.

PMID- 8487367
TI  - The Residency Review Committee for Surgery and the training of vascular surgeons.
AB  - PURPOSE: This article reviews the activities and actions of the Residency Review
      Committee (RRC) for Surgery in the accreditation process of of vascular surgery
      training programs since 1983. METHODS: The substantial changes of the Special
      Requirements for Graduate Education in General Vascular Surgery are discussed for
      1983, 1987, 1989, and 1992. The rank-ordered list of RRC citations is reviewed.
      The national resident operative statistics for the past 4 years are reported for
      both general and vascular surgery residents. RESULTS: Changes in the Special
      Requirements have included deletion of two of the four types of programs,
      elimination of the need for institutional programs in specialties other than core
      general or thoracic surgery, and relaxation of the restriction against concurrent
      resident assignment. The most common citation continues to be the negative impact
      on general surgery residents. Nevertheless national operative statistics show a
      favorable increase in case load for both general and vascular surgery residents.
      CONCLUSIONS: Future challenges to surgical education and practice are summarized;
      the solutions to these challenges will require cooperative efforts of the RRC,
      the American Board of Surgery, and a number of specialty societies and
      credentialing or regulatory bodies.

PMID- 8487368
TI  - Class and conflict in vascular surgery.

PMID- 8487369
TI  - Differentiation of two rabies strains in Estonia with reference to recent Finnish
      isolates.
AB  - We compared 24 rabies samples collected in Estonia in 1989 to 1992, to identify
      the kinds of rabies strains circulating in this country. Eleven of the strains
      came from the islands of Saaremaa, Hiiumaa and Muhu, off the Baltic coast; 13
      came from the mainland. The mainland strains, like those from the 1988 to 1989
      epizootic in Finland, were antigenically different from the 11 island isolates.
      The island isolates reacted negatively with monoclonal antibody W-187.5 as does
      the SAD B19 rabies vaccine strain, currently spread as baits to wildlife in
      Finland and other parts of Europe. In order to unambiguously distinguish the
      island isolates from the SAD B19 vaccine, we developed a polymerase chain
      reaction (PCR) protocol for rabies, followed by a single restriction enzyme
      digestion. This method enabled the island isolates to be differentiated with ease
      from the vaccine strain SAD B19 at the level of the nucleoprotein-coding region.
      Additionally, this method had the ability to distinguish other polar field
      isolates examined, as well as the laboratory challenge virus strain CVS, from SAD
      B19 vaccine. Modifications of the above PCR method may be used for
      epidemiological investigations of new outbreaks or of outbreaks involving
      different species.

PMID- 8487370
TI  - Experimental Borrelia burgdorferi infections in the white-footed mouse, deer
      mouse, and fulvous harvest mouse detected by needle aspiration of spirochetes.
AB  - Three methods were tested for recovering Borrelia burgdorferi from live mice onto
      BSK II culture medium. Four laboratory-reared Peromyscus leucopus were inoculated
      intraperitoneally with the JD-1 isolate of Borrelia burgdorferi. Borrelia
      burgdorferi spirochetes were recovered from 13 of 20 (65%) samples taken by
      needle aspiration between days 7 and 40 post-inoculation (PI) and from 1 of 16
      samples of skin obtained by ear punch biopsy during the same sampling period.
      Spirochetes were not recovered from culture media inoculated with mouse blood.
      The use of needle aspirates for recovering spirochetes was compared among three
      species of mice: P. leucopus, P. maniculatus, and Reithrodontomys fulvescens.
      Spirochetes were isolated from 14 of 15 aspiration samples from four P.
      maniculatus, 12 of 20 from three P. leucopus, and 15 of 20 from four R.
      fulvescens taken between days 7 and 48 PI. Spirochetes were isolated from only
      one aspiration sample between days 80 and 95 PI from any of the mice tested.
      Needle aspiration was an efficient method for repeated recovery of B. burgdorferi
      from live, experimentally infected mice. We also document R. fulvescens as an
      experimental host for B. burgdorferi. Based on their susceptibility to infection,
      all species of mice tested herein may play a role in the epidemiology of Lyme
      disease where their distribution is compatible with endemic transmission.

PMID- 8487371
TI  - A serologic survey for viruses and Mycoplasma pulmonis among wild house mice (Mus
      domesticus) in southeastern Australia.
AB  - Plasma samples from 267 wild house mice (Mus domesticus) trapped at 14 sites in
      southeastern Australia were screened for antibody to 14 viruses normally
      associated with laboratory-reared rodents and to Mycoplasma pulmonis. Serologic
      prevalence was high for murine cytomegalovirus (99%, n = 94), murine coronavirus
      (95%), and murine rotavirus (74%). Samples from mice collected at all sites
      contained antibody to these viruses. The serologic prevalence was lower for mouse
      adenovirus, strain K87 (37%), parvovirus (33%), and reovirus type 3 (28%), with
      substantial site-to-site variation. Plasma from mice collected at 12 sites
      contained mouse adenovirus or reovirus antibody, and samples from mice at eight
      sites contained parvovirus antibody. Parvovirus-antibody positive mice were
      typically from high density populations or from low density populations that had
      recently declined from high density. Antibody to lymphocytic choriomeningitis
      virus (LCMV) and Sendai virus occurred at only three sites, and the serologic
      prevalence was very low (9.6% and 1.8%, respectively). All of the LCMV-positive
      mice were from northeastern New South Wales. The presence of this zoonotic virus
      in a mouse plague-prone region raises questions about human health risks
      resulting from cohabitation with large numbers of mice. It appeared that mouse
      populations at high density or declining from high density had higher prevalence
      of viral antibody than populations that had been at low or moderate density for
      some time. Thus, viral epizootics may occur among high-density populations and
      may be responsible for or precipitate declines in mouse density. These data raise
      the possibility of rodent viruses having potential as biological control agents.

PMID- 8487372
TI  - Serologic survey for antibodies to Borrelia burgdorferi in white-tailed deer in
      Georgia.
AB  - A serologic survey for antibodies to Borrelia burgdorferi utilizing an enzyme
      linked immunosorbent assay (ELISA) was conducted on white-tailed deer (Odocoileus
      virginianus) serum samples collected in Georgia (USA) from 1979 to 1990.
      Serologic results from four regions (Barrier Islands, Coastal Plain, Piedmont,
      and Mountain) and three age classes (0.5, 1.5, and > or = 2.5 yr) were compared.
      Antibody prevalence, as determined by positive results at a 1:64 dilution or
      higher, was 36% in the Barrier Islands, 14% in the Coastal Plain, 8% in the
      Piedmont, and 4% in the Mountain regions. Statewide antibody prevalence was 19%.
      Antibody titers generally were low, and if a more conservative cutoff titer of
      1:128 were used, the statewide prevalence estimate would have been reduced to 5%.
      Antibody prevalence as determined at this higher cutoff value, however, still
      remained highest in the Barrier Islands and lowest in the Mountains. Prevalence
      estimates were lower in the 0.5-yr age class than in the 1.5-yr or > or = 2.5-yr
      age class (P < 0.05). A more in-depth retrospective study of the Barrier Islands
      region from 1971 to 1985 revealed a 50% overall antibody prevalence; positive
      results were found in every year represented except 1990. Based on these results,
      we propose that B. burgdorferi has been present in Georgia since at least 1971.

PMID- 8487373
TI  - The epizootiology of eustrongylidosis in wading birds (Ciconiiformes) in Florida.
AB  - A total of 2,167 individuals representing 15 species of wading birds was examined
      for infection with the nematode Eustrongylides ignotus in Florida (USA). Ten of
      the species were infected with the greatest prevalences occurring in great blue
      herons (Ardea herodius) (33%), great egrets (Casmerodius albus) (22%), and snowy
      egrets (Egretta thula) (19%). Among nestlings, prevalences increased with age.
      This parasite was estimated to cause at least 80% mortality among nestling
      ciconiiforms at one colony in Everglades National Park, and was found in 15% of
      nestling ardeids throughout the state. Despite wide sampling efforts, infected
      fish (second intermediate hosts) were only found at six sites in Florida, all of
      which had been physically altered, such as with canals and ditches, and had an
      anthropogenic (human-caused) source of nutrient pollution. Colonies near sources
      of infected fish experienced significantly higher prevalences of eustrongylidosis
      that did colonies for which no source of infected fish could be found within 20
      km. Higher prevalences were found at freshwater and estuarine mainland colonies
      than at marine colonies. Densities of aquatic oligochaetes, which may act as
      first intermediate hosts, were highest at sites containing infected fish and at
      sites with a source of nutrient pollution. Conservation and management of wading
      bird species should include consideration of this disease, epizootics of which
      seem to be linked to nutrient pollution.

PMID- 8487374
TI  - Pathogenesis of Eustrongylides ignotus (Nematoda: Dioctophymatoidea) in
      Ciconiiformes.
AB  - Natural (n = 157) and experimental (n = 5) infections with the nematode
      Eustrongylides ignotus are described for ciconiforms collected in Florida (USA).
      Larvae perforated the ventriculus in 3 to 5 hr and caused hemorrhage and
      bacterial peritonitis that sometimes progressed to a fibrous peritonitis with
      extensive adhesions. Severity of the disease was related inversely to the age of
      the bird and directly to the number of parasites involved. Some infections in
      adult birds were resolved. As a consequence of eustrongylidosis, anorexia and
      behavioral abnormalities resulted in emaciation and may have predisposed birds to
      traumatic death. Host-parasite adaptations apparently were not adequate for
      nestling ciconiforms as death of nestlings usually occurred before infections
      become patent (longer than 14 days, less than 23 days). Patent infections were
      found in both color morphs of the great blue heron (Ardea herodius), and in great
      egrets (Casmerodius albus) and snowy egrets (Egretta thula). We propose that
      birds of the family Ardeidae are the primary definitive hosts.

PMID- 8487375
TI  - Evidence for arrested development of abomasal nematodes in white-tailed deer.
AB  - White-tailed deer (Odocoileus virginianus) obtained from Noxubee National
      Wildlife Refuge, Noxubee County, Mississippi (USA) during April (n = 3), June (n
      = 5), September (n = 5), and November (n = 5) 1989, were necropsied for counting
      and identification of adult and larval stages of abomasal nematodes. Fourth-stage
      larvae (L4) (n < or = 25) from each deer were randomly selected for measurement
      of total worm length and width. Adults of four worm species were found:
      Mazamastrongylus odocoilei, M. pursglovei, Ostertagia mossi, and O. dikmansi.
      There were no differences between months in adult male worm burdens for all
      species except O. dikmansi for which the April worm burden was greatest (P < or =
      0.05). Overall, the length of L4 ranged from 929 to 4,361 microns. There were no
      significant differences (P > 0.05) between months in the mean length (1,334 to
      1,532 microns) of L4. Except for low numbers of developing fourth-stage larvae
      (length > 1,650 microns) in April (2.6%), June (7.4%), September (11.3%), and
      November (3.7%), worms were early fourth-stage larvae (EL4) or fully developed
      adults. Overall, the proportion of EL4 in individual deer ranged from 19 to 97%;
      in male (n = 3) and female (n = 15) deer the proportions of EL4 were 22.5% and
      67%, respectively. The mean proportions of EL4 in female deer were 51.4% (April),
      63.2% (June), 78.1% (September), and 74.7% (November), but there was no
      difference (P > 0.05) among the 4 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487376
TI  - Factors affecting Parelaphostrongylus tenuis in white-tailed deer (Odocoileus
      virginianus) from Maine.
AB  - White-tailed deer (Odocoileus virginianus) collected in Maine (USA) from November
      1988 to December 1989 were examined for Parelaphostrongylus tenuis. Relationships
      of deer age class, sex, collection year, and deer density to prevalence and
      intensity of P. tenuis infections were analyzed. Prevalence increased with deer
      age (P < 0.001) and interaction of deer age class and collection year (P <
      0.001). Prevalence did not vary by year in deer > or = 1 yr old (85%, n = 519),
      but was higher in fawns in 1988 (66%, n = 87) than 1989 (23%, n = 73, P < 0.001).
      Based on such yearly variations, prevalence in fawns during late autumn could
      provide an index of annual transmission of P. tenuis. Intensity of P. tenuis
      averaged 2.5 worms per infected fawn (SD = 2.8, n = 72) versus 3.9 (SD = 3.1, n =
      375) in deer > or = 1 yr old (P = 0.032). Neither prevalence (P > 0.50) nor
      intensity (P > 0.50) of infection was associated with deer density over a range
      of 1.4 to 5.8 deer per km2. Heads and fecal samples from the same individuals (n
      = 42) provided prevalence estimates of 73% and 44%, respectively. No differences
      in prevalence, intensity, or geographic distribution of P. tenuis in adult deer
      collected in Maine during fall were evident between the late 1980's (this study)
      and the late 1960's (Gilbert, 1973).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487377
TI  - Pneumocystis carinii and helminth parasitism in shrews Sorex araneus and Sorex
      caecutiens.
AB  - The prevalence of Pneumocystis carinii was compared in two species of shrews,
      Sorex araneus and Sorex caecutiens in Finnish Lapland. The overall prevalence of
      P. carinii in S. araneus was 70% and in S. caecutiens was 17%. The prevalence for
      S. araneus is the highest reported for wild animals. The interspecific
      differences in prevalence were significant for all sex and age groups except for
      adult males. Based on multiway contingency tables (log-linear models), there was
      no dependence between sex or age of S. araneus and occurrence of P. carinii. In
      individual S. araneus the intensity of P. carinii was not related to the total
      number of helminths or the number of helminth species, and no dependence was
      observed between the presence of P. carinii and various helminth species.

PMID- 8487378
TI  - Infestation of northern spotted owls by hippoboscid (Diptera) flies in
      northwestern California.
AB  - Hippoboscid flies were found on 62 (17%) of 382 northern spotted owls (Strix
      occidentalis caurina) captured between April and September, 1986 through 1990.
      Two species of hippoboscids were identified: Icosta americana and Ornithomya
      anchineuria. Male and female adult spotted owls had similar prevalences and
      relative densities of hippoboscid flies. Juvenile owls had lower prevalence and
      relative densities than adults. There were no significant differences in mean
      intensity of hippoboscids on adult male, adult female and juvenile spotted owls.
      Relative densities of flies infesting adult owls were significantly greater
      during years of increased fall temperatures, decreased winter precipitation, and
      decreased summer temperatures.

PMID- 8487379
TI  - Counting dead birds: examination of methods.
AB  - We studied three methods (line transect, circular quadrat, complete count) for
      estimating density of dead birds, using models of sparrows and meadowlarks placed
      at a density of 50 birds of each type/ha. Line transects with a 500-m search line
      were used in cultivated pasture and native prairie habitats. The number of birds
      found by individual searchers in line transects varied markedly, particularly, in
      pasture habitat. More birds were found, and birds were detected at a greater
      distance, in prairie than in pasture. More meadowlarks than sparrows were found
      in both habitats but the mean estimated density of meadowlarks was greater than
      that of sparrows only in prairie. The number of birds found during most searches
      was less than that suggested for estimating density accurately and longer search
      lines were required. Density estimates obtained using circular plots to sample
      10% of the prairie area ranged from 20 to 80 birds/ha for meadowlarks and from 10
      to 60 birds/ha for sparrows in prairie habitat. A complete search by 25
      volunteers spaced at 4 m intervals detected 90% of meadowlarks but only 62% of
      sparrows in pasture habitat. Mean (SD) time for a single search, including
      searchers and recorders, was 3.0 (0.8), 1.5 (0.3), and 7.5 person-hours, for line
      transect, circular plot and complete search, respectively.

PMID- 8487380
TI  - Evaluation of baits for oral rabies vaccination of mongooses: pilot field trials
      in Antigua, West Indies.
AB  - A field study was conducted on the island of Antigua, West Indies, to evaluate
      baits for delivering an oral rabies vaccine to the small Indian mongoose
      (Herpestes auropunctatus). Tracking tiles were used to determine that mongooses
      were nonselective and took both egg-flavored polyurethane baits and fish-flavored
      polymer baits containing several different food materials. A high proportion of
      baits were taken the day of placement with minimal disturbance by nontarget
      species. DuPont Oil Blue A dye was an effective short-term biomarker for use in
      baits; based on its subsequent detection in mongooses, some of the population had
      consumed and not cached or discarded baits. Central point baiting stations showed
      promise as an alternative delivery technique.

PMID- 8487381
TI  - Serum enzymes as indicators of capture myopathy in mallards (Anas platyrhynchos).
AB  - Serum concentrations of the enzymes creatine kinase (CK) and aspartate
      aminotransferase (AST) were measured in captive and wild mallards (Anas
      platyrhynchos) as indicators of muscle damage. Baseline values for both enzymes
      were determined from six captive male mallards. During winter 1990 to 1991, six
      diets (including controls) representative of food available in the Mississippi
      alluvial valley were fed to captive female mallards housed in an outdoor aviary
      at the White River National Wildlife Refuge, Arkansas County, Arkansas (USA).
      Controlled handling of penned mallards resulted in elevated serum CK (means =
      1,352 IU/liter; SD = 1,212) and AST (means = 101 IU/liter; SD = 95)
      concentrations consistent with myopathies. These serum enzyme elevations were not
      affected (P > 0.3) by dietary selenium concentrations in the six diets or by
      energy malnutrition suffered by birds fed soybeans. Capture of wild mallards with
      an entanglement type rocket net resulted in serum CK and AST concentrations
      (means = 12,035 and 330 IU/liter; SD = 8,125 and 171, respectively) that were
      higher (P < 0.001) than those reported after capture with an enveloping type
      rocket net. Baseline values, controlled handling values, and entanglement rocket
      net values for serum CK and AST all differed (P < 0.0001).

PMID- 8487382
TI  - Evaluation of the Bionic trap to quickly kill fisher (Martes pennanti) in
      simulated natural environments.
AB  - The Bionic trap equipped with a 10 cm aperture bait cone and cocked to eight
      notches quickly killed nine of nine fishers (Martes pennanti) in simulated
      natural conditions. Mean (+/- SE) estimated times to loss of consciousness and
      heartbeat were < or = 55 sec and 305 (+/- 8) sec, respectively after firing the
      trap. This study confirmed that the Bionic trap can be expected to render > or =
      70% of captured fishers irreversibly unconscious in < or = 3 min (P < 0.05).

PMID- 8487383
TI  - Evaluation of mechanically improved Conibear 220 traps to quickly kill fisher
      (Martes pennanti) in simulated natural environments.
AB  - Mechanically improved Conibear 220 traps failed to render irreversibly
      unconscious in < or = 3 min fishers single-struck in the head-neck region, or
      double-struck in the neck and thorax regions. Although the Conibear 220 trap is
      often recommended as an alternative to the steel leghold trap, it is unlikely
      that it has the potential to humanely kill fisher.

PMID- 8487384
TI  - Assessment of the Kania trap to humanely kill red squirrels (Tamiasciurus
      hudsonicus) in enclosures.
AB  - The Kania trap equipped with side wings and baited with a pine cone quickly
      killed nine of nine red squirrels (Tamiasciurus hudsonicus) in enclosures. Mean
      times to loss of consciousness and heartbeat were estimated at < or = 65 sec and
      < or = 91 sec, respectively, after firing the trap. Thus the Kania can be
      expected to render > or = 70% of captured red squirrels irreversibly unconscious
      in < or = 3 min (P < 0.05).

PMID- 8487385
TI  - An epizootic of Edwardsiella tarda in largemouth bass (Micropterus salmoides).
AB  - Edwardsiella tarda, an opportunistic bacterial pathogen, was isolated from dying
      largemouth bass (Micropterus salmoides) during an epizootic in a eutrophic lake
      system, Lochloosa Lake, Florida, USA. Approximately 1,500 adult fish died over a
      6-wk period during the late summer and early fall of 1991. A mixed population of
      aerobic bacteria (E. tarda, Aeromonas hydrophila, and Pseudomonas sp.) was
      isolated from deep cutaneous ulcers and intestines of moribund bass. However, E.
      tarda in pure culture was the only bacterium isolated from several viscera of
      several fish; E. tarda may be the etiologic agent responsible for some episodes
      of seasonal mortality in largemouth bass.

PMID- 8487386
TI  - The prevalence of Trichinella sp. in Arctic foxes (Alopex lagopus) in Svalbard.
AB  - The prevalence of Trichinella sp. in arctic foxes (Alopex lagopus) from Svalbard
      was studied from 1983 to 1989. Diaphragms of 697 foxes were examined for larvae;
      59 foxes (8.5%) were infected. The prevalence of Trichinella sp. increased from
      4% in juveniles to 36% in foxes aged more than 6 years of age. There were no
      significant correlations when condition and body weight each were correlated to
      the occurrence and number of larvae of Trichinella sp. More foxes were infected
      in the northern than in the central part of Svalbard. There were only minor
      differences in prevalence among years.

PMID- 8487387
TI  - Prevalence of Encephalitozoon cuniculi antibodies in terrestrial mammals in
      Iceland, 1986 to 1989.
AB  - Antibodies to Encephalitozoon cuniculi were found in wild arctic foxes (Alopex
      lagopus), feral mink (Mustela vison), wood mice (Apodemus sylvaticus) and house
      mice (Mus musculus) in Iceland. Animals with antibodies were found throughout the
      country. No lesions attributable to encephalitozoonosis were found in adult
      animals necropsied. However, one arctic fox cub with a neurological disorder had
      pathological and serological evidence of encephalitozoonosis.

PMID- 8487388
TI  - A fibrosarcoma in the skeletal muscle of a capybara (Hydrochoerus hydrochaeris).
AB  - An 8-yr-old male capybara (Hydrochoerus hydrochaeris), a resident of an urban
      zoological collection in upstate New York (USA), had a mass posteroventral to its
      left stifle; it was of unknown duration. The mass was a fibrosarcoma based on
      invasive sheets of interwoven spindle-shaped neoplastic cells with moderate
      associated extracellular matrix composed of collagen fibers. Supportive
      immunohistochemical staining was positive for vimentin but negative for
      cytokeratins, desmin, and myoglobin. The animal subsequently died of unknown
      causes. This is the first known report of a neoplasm in a capybara.

PMID- 8487389
TI  - A survey of lead poisoning in wild waterfowl in Japan.
AB  - Ingested shotgun pellets were found in 13 of 56 hunter-killed wild waterfowl
      between October and December 1991 from two hunting grounds in Japan. Four of 33
      other waterfowl found dead in lightly hunted areas between January 1991 and March
      1992 were diagnosed as having lead poisoning. We propose that lead poisoning
      maybe a threat to waterfowl in Japan.

PMID- 8487390
TI  - Differences in blood haptoglobin and length-mass relationships in river otters
      (Lutra canadensis) from oiled and nonoiled areas of Prince William Sound, Alaska.
AB  - Significant differences in levels of blood haptoglobin occurred between river
      otters (Lutra canadensis) inhabiting oiled (mean = 361 mg/100 ml, SD = 38, n = 6)
      and nonoiled (mean = 306 mg/100 ml, SD = 87, n = 8) areas of Prince William
      Sound, Alaska (USA) following the Exxon Valdez oil spill in 1989. Additionally,
      male river otters from oiled areas had significantly lower body mass (1.13 kg)
      than male otters from nonoiled areas. We propose oil-related causes for these
      differences.

PMID- 8487391
TI  - Physical and behavioral findings in a pseudohermaphrodite American bison.
AB  - A pseudohermaphrodite American bison (Bison bison) behaved like an adult male
      when interacting with adult females, but like an adult female when interacting
      with adult males. Its chromosomes were a normal 60, XX and it had a uterus; but
      it had bilateral testes rather than ovaries. Skull measurements were intermediate
      between a bull and a cow. Gonadotrophin levels were typical of ovariectomized
      domestic cows or steers.

PMID- 8487392
TI  - Hiatal hernia in a harbor porpoise (Phocoena phocoena).
AB  - We observed the displacement of the first compartment of the stomach through the
      diaphragmatic hiatus into the thoracic cavity in an immature harbor porpoise
      (Phocoena phocoena). This hiatal hernia, coupled with a severe pneumonia,
      contributed to the emaciation and death of the animal.

PMID- 8487393
TI  - Notes on the first known avian cholera epizootic in wildfowl in North America.

PMID- 8487394
TI  - US-based world medical relief group finds charity begins at home.

PMID- 8487395
TI  - What can Tillery tell Hillary? Tiny town reforms its own health care.

PMID- 8487396
TI  - Spouses of the chronically ill help each other cope.

PMID- 8487397
TI  - 'Health of nation at stake' says Elders.

PMID- 8487398
TI  - From the Food and Drug Administration.

PMID- 8487399
TI  - From the Centers for Disease Control and Prevention. Impact of the expanded AIDS
      surveillance case definition on AIDS case reporting--United States, first
      quarter, 1993.

PMID- 8487400
TI  - From the Centers for Disease Control and Prevention. Populations at risk from air
      pollution--United States, 1991.

PMID- 8487401
TI  - The biggest roadblock to reform--this Congress is independent of Clinton.

PMID- 8487402
TI  - Health insurance reform and the physician-patient relationship.

PMID- 8487403
TI  - Health insurance reform and the physician-patient relationship.

PMID- 8487404
TI  - Medical care is not health care.

PMID- 8487405
TI  - Incorporating prevention in managed care.

PMID- 8487407
TI  - Trauma surgeons: primary care practitioners by default.

PMID- 8487406
TI  - Rehabilitating the medical specialist.

PMID- 8487408
TI  - Uninsured children and national health care reform.

PMID- 8487409
TI  - Health care access and birth outcome.

PMID- 8487410
TI  - Health care access and birth outcome.

PMID- 8487411
TI  - Prisoners' access to medications.

PMID- 8487412
TI  - 'Cat': methcathinone--a new drug of abuse.

PMID- 8487413
TI  - The foreskin.

PMID- 8487414
TI  - Effects of lower surgical fees on the use of physician services under Medicare.
AB  - BACKGROUND AND OBJECTIVE: The changes in physician fees that will occur under the
      resource-based Medicare Fee Schedule (MFS) are similar to those that took place
      under the Omnibus Budget Reconciliation Act of 1987 (OBRA 87), when Medicare fees
      for selected "overpriced" procedures and diagnostic tests were reduced. To gain
      insight regarding the changes in utilization that may occur under the MFS, this
      study examines the effects of the OBRA 87 fee reductions on the use of physician
      services by Medicare patients. DATA AND METHODS: The five specialties that were
      most affected by the OBRA 87 fee reductions were studied: ophthalmology, thoracic
      surgery, urology, orthopedic surgery, and gastroenterology. Medicare physician
      claims files for 1987 and 1989 were used to obtain data on utilization and fees.
      Multivariate regression analysis was used to assess the effect of changes in fees
      on changes in utilization. RESULTS: The best estimate of the effect of the OBRA
      87 fee reductions on overall physician-services utilization, obtained by pooling
      the five study specialties, was that every 1% decrease in fees led to a 0.09%
      decrease in the volume and complexity of services (95% confidence interval, 0.49%
      decrease to 0.31% increase). This result was not sensitive to minor changes in
      the covariates included in the regression model. CONCLUSION: To calculate payment
      levels during the transition to the MFS, the Health Care Financing Administration
      assumed that physicians whose Medicare revenue declines under the MFS will
      increase service volume and complexity enough to make up one half of the lost
      revenue. The findings of this study suggest that the Health Care Financing
      Administration's assumption was, at best, extreme.

PMID- 8487415
TI  - Medical students' attitudes toward providing care for the underserved. Are we
      training socially responsible physicians?
AB  - OBJECTIVE: To investigate the association between attitudes toward caring for the
      medically indigent and years of medical training. DESIGN: Questionnaire comparing
      attitudes of first-year medical students (MS-Is) and fourth-year medical students
      (MS-IVs). SETTING: Southwest medical school. PARTICIPANTS: A total of 83 (67%)
      male and 41 (33%) female MS-I and 65 (73%) male and 24 (27%) female MS-IV
      volunteers. MAIN OUTCOME MEASURE: Self-report, attitudinal scale developed for
      this study that provided a measure of overall attitudes, perceived societal
      expectations, physician/student responsibility, personal efficacy, and provision
      of basic services and expensive procedures. RESULTS: Overall attitudes were
      significantly less favorable for MS-IVs (95% confidence interval [CI], 99.6 to
      106.2) than MS-Is (95% CI, 109.5 to 114.3, P < .0001). Except for basic services
      (P = .46), MS-IVs had worse attitudes on all attitudes subscales. Male MS-IVs
      reported significantly less favorable attitudes than male MS-Is in the areas of
      general attitudes (P = .03) and physician/student responsibility (P = .01).
      Female medical students showed no significant differences across classes (P >
      .05). Except for physician/student responsibility, female medical students'
      attitudes were more favorable than those of males, regardless of class.
      CONCLUSIONS: The MS-IVs are less favorably inclined toward caring for the
      medically indigent than MS-Is, though these differences are apparent only for
      males. Further research is needed to explore why females appear to be more
      resistant to attitude changes, and what educational interventions are necessary
      to better train physicians to respond to national health care issues.

PMID- 8487416
TI  - Managed competition that works.
AB  - President Clinton has advocated managed competition within a global budget as a
      long-term strategy for simultaneously controlling health care costs and expanding
      access to medical care to all Americans. This proposal is intended to show how
      these two seemingly conflicting goals can be simultaneously accomplished. Managed
      competition, as it has been conceptualized to date, is primarily a strategy for
      reforming the system of providing health services. To work, it must be joined
      with a strategy for reforming our system of financing and paying for those
      services and of limiting overall system capacity. "Managed Competition That
      Works" is a proposal that would create a single trust-funded national system of
      health insurance, implemented through a system of vouchers to individuals. Global
      budgeting would be accomplished through establishment of the voucher's value each
      year. The trust fund would pay health plans for all medical care by capitation,
      but health plans would be free to negotiate a variety of payment arrangements
      with physicians, hospitals, and other providers. All plans would be required to
      offer a standard package of benefits, but would have great flexibility in
      offering benefits beyond the scope of the standard package, if those benefits
      replace high-cost with lower-cost services or permit the plan to compete more
      effectively for market share. This proposal would establish firm but acceptable
      national budget limits; provide universal, comprehensive, and uniform insurance
      coverage; eliminate cost shifting; encourage competition; reward efficiency
      improving innovation; greatly reduce the need for centralized micromanagement of
      medical care; and retain local determination and a somewhat reduced level of
      consumer choice. Although this proposal is written as a national plan, trust
      funds could be implemented at the state level, if problems associated with
      portability of benefits among states could be solved.

PMID- 8487417
TI  - What's wrong with the ERISA vacuum? Employers' freedom to limit health care
      coverage provided by risk retention plans.

PMID- 8487418
TI  - Caring for the poor. Council on Ethical and Judicial Affairs, American Medical
      Association.

PMID- 8487419
TI  - Hawaii's employer mandate and its contribution to universal access.
AB  - Much national debate centers around national models in which an employer mandate
      plays an important role in providing for health care coverage for all Americans.
      Hawaii has had the nation's only health insurance employer mandate for almost 20
      years, yet little is known nationally about the mandate itself or Hawaii's
      experience with it. This article describes the long-term effects of Hawaii's
      employer mandate on health care access and costs, and offers reflections on the
      potentials of national health care reform based on Hawaii's experience.

PMID- 8487420
TI  - Community-oriented primary care. The cornerstone of health care reform.
AB  - The current high-cost health care delivery system, which places greater emphasis
      on acute hospital care than on community-based primary and preventive care, is no
      longer viewed by policymakers, politicians, and the American public as the ideal
      model for organizing and providing health care services. Americans want change;
      however, politicians are responding with a barrage of disjointed finance and cost
      containment proposals that fail to address the organization and provision of
      health care services. Nevertheless, to adequately address problems of cost,
      access, and quality, reform proposals will need to consider delivery models that
      create a balance between medical care and health care, between public health and
      personal health services, and between curative and preventive care. The community
      oriented primary care model and the discipline of community and socially
      responsive medicine is a process for making a health care system more rational,
      accountable, appropriate, and socially relevant to the public. Consequently, this
      model, which is now at a pivotal point in its evolution, may serve as a paradigm
      for reforming the organization and provision of health care services in America.

PMID- 8487421
TI  - Using academic health centers to help avoid health care's next crisis.

PMID- 8487422
TI  - Physician response to fee changes. A contrary view.

PMID- 8487423
TI  - Grading President Clinton's health proposal.

PMID- 8487424
TI  - American health care system management objectives. The aura of inevitability
      becomes incarnate.

PMID- 8487425
TI  - Attempting to reduce hospital costs by strengthening primary care institutions.
      The Dutch Health Care Demonstration Project in the new town of Almere.

PMID- 8487426
TI  - Bridging the gap between expert and public views on health care reform.

PMID- 8487427
TI  - A piece of my mind. The bottom line.

PMID- 8487428
TI  - A piece of my mind. Cognocardiology.

PMID- 8487429
TI  - Imaging methods for sinusitis.

PMID- 8487430
TI  - Prophylactic mastectomy for familial breast cancer.

PMID- 8487431
TI  - Stool analysis for asthma.

PMID- 8487432
TI  - Gay, lesbian physicians meet, march, tell Shalala bigotry is health hazard.

PMID- 8487433
TI  - 'Window to tobacco-free world' clouded slightly.

PMID- 8487434
TI  - Childhood immunization initiative goes forward.

PMID- 8487435
TI  - Varied mammogram readings worry researchers.

PMID- 8487436
TI  - From the National Institutes of Health.

PMID- 8487437
TI  - From the Centers for Disease Control and Prevention. Update: investigations of
      persons treated by HIV-infected health-care workers--United States.

PMID- 8487438
TI  - Cardiopulmonary resuscitation.

PMID- 8487439
TI  - Cardiopulmonary resuscitation.

PMID- 8487440
TI  - Cardiopulmonary resuscitation.

PMID- 8487441
TI  - Cardiopulmonary resuscitation.

PMID- 8487442
TI  - Cardiopulmonary resuscitation.

PMID- 8487443
TI  - Renal disease in hypertensive blacks: MRFIT.

PMID- 8487444
TI  - Renal disease in hypertensive blacks: MRFIT.

PMID- 8487445
TI  - An assessment of radical prostatectomy. Time trends, geographic variation, and
      outcomes. The Prostate Patient Outcomes Research Team.
AB  - OBJECTIVES: To examine temporal trends and geographic variation in radical
      prostatectomy rates and short-term outcomes. DESIGN: Population-based study of
      radical prostatectomy for the years 1984 through 1990. Poisson regression was
      used to estimate temporal and regional effects. SETTING: The 50 states and the
      District of Columbia. PARTICIPANTS: A 20% national sample of male Medicare
      beneficiaries aged 65 years or older. MAIN OUTCOME MEASURES: Rate of radical
      prostatectomy; 30-day mortality; and major cardiopulmonary complications,
      vascular complications, or surgical repairs within 30 days of radical
      prostatectomy. RESULTS: A total of 10,598 radical prostatectomies were
      identified. The adjusted rate of radical prostatectomy in 1990 was 5.75 times
      that in 1984. The relative increase was similar in all age groups. Substantial
      geographic variation existed in rates from 1988 through 1990: all states in the
      New England and Mid-Atlantic regions had rates equal to or below 60 per 100,000
      male Medicare beneficiaries, while all states in the Pacific and Mountain regions
      had rates equal to or above 130 per 100,000. The mortality and morbidity after
      radical prostatectomy are not trivial for older men (aged 75 years and older)-
      almost 2% died and nearly 8% suffered major cardiopulmonary complications within
      30 days of the operation. CONCLUSION: The sharp increase and wide geographic
      variation in radical prostatectomy rates make the evaluation of this surgical
      procedure a pressing issue. The rising rate of radical prostatectomy among men
      aged 75 years and older merits special attention.

PMID- 8487446
TI  - Estrogen replacement therapy and cognitive function in older women.
AB  - OBJECTIVE: To determine whether replacement estrogen delays or prevents loss of
      cognitive function in elderly women. DESIGN: A 15-year prospective and cross
      sectional study. SETTING: Rancho Bernardo, a geographically defined community in
      Southern California. PARTICIPANTS: Eight hundred women (80% of local surviving
      women from the original Rancho Bernardo cohort) aged 65 to 95 years. Estrogen use
      was evaluated at baseline between 1972 and 1974 and at follow-up between 1988 and
      1991. MAIN OUTCOME MEASURES: Twelve tests of cognitive function from eight
      standard instruments administered at follow-up between 1988 and 1991. RESULTS:
      Almost half of this older, educated cohort had used estrogen at some time after
      menopause, and one third were current users. The age-related decrement in
      cognitive function was similar for women who were current, past, or never users
      of estrogen. Age- and education-adjusted comparisons also failed to show any
      consistent association between performance on tests of cognitive function and
      baseline, past, current, or never estrogen use; estrogen dose; or duration of
      use. Among 132 statistical comparisons, only five statistically significant
      differences were observed, less than the number expected by chance alone.
      Furthermore, these significant differences occurred with different tests of
      cognitive function, and in only one instance was the better test score associated
      with current estrogen use. No biases were identified that could explain these
      negative results. CONCLUSIONS: No compelling or internally consistent evidence
      for an effect of estrogen on cognitive function was found in these older women.
      These data do not support the hypothesis that estrogen use after the menopause
      preserves cognitive function in old age.

PMID- 8487447
TI  - Racial differences in the use of revascularization procedures after coronary
      angiography.
AB  - OBJECTIVE: To assess whether rates of coronary revascularization procedures
      differ between blacks and whites after coronary angiography is performed and to
      assess the relationship of these rates to hospital characteristics. DESIGN: A
      retrospective cohort study using 1987 and 1988 data on hospital claims and
      characteristics from the Health Care Financing Administration. SETTING: One
      thousand four hundred twenty-nine acute care hospitals that provide coronary
      angiography in the United States. PATIENTS: A national sample of 27,485 Medicare
      Part A enrollees, aged 65 to 74 years, who underwent inpatient angiography for
      coronary heart disease in 1987. MAIN OUTCOME MEASURE: The adjusted odds of
      revascularization with either coronary angioplasty or bypass graft surgery within
      90 days of angiography for whites relative to blacks, controlling for age, sex,
      region, Medicaid eligibility, principal diagnosis, comorbid diagnoses, and
      hospital characteristics of ownership, teaching status, urban/suburban or rural
      location, and availability of revascularization procedures. RESULTS: White men
      and women were significantly more likely than black men and women, respectively,
      to receive a revascularization procedure after coronary angiography (57% and 50%
      vs 40% and 34%, both P < .001). The adjusted odds of receiving a
      revascularization procedure after coronary angiography were 78% higher for whites
      than blacks (95% confidence interval for odds ratio, 1.56 to 2.03). Statistically
      significant racial differences in the adjusted odds of receiving a
      revascularization procedure were present in all types of hospitals except rural
      hospitals, and these differences did not vary significantly by any of the four
      hospital characteristics (all P > .20 for interaction terms). CONCLUSIONS: Among
      Medicare enrollees, whites are more likely than blacks to receive
      revascularization procedures after coronary angiography. Racial differences of
      similar magnitude occur in all types of hospitals. These differences may reflect
      overuse in whites or underuse in blacks, but they are unlikely to reflect access
      to cardiologists or hospitals that perform revascularization procedures.
      Potential explanations include unmeasured clinical or socioeconomic factors,
      differing patient preferences, and racial bias at the hospitals performing
      angiography.

PMID- 8487448
TI  - Case-by-case assessment of recoverable materials for overseas donation from 1318
      surgical procedures.
AB  - OBJECTIVE: To provide a mechanism for addressing the need for consistency and
      projection in overseas donation of surgical supplies, we conducted a case-by-case
      inventory of unused materials recovered from all surgical procedures in our
      facility over a 2.5-month period. DESIGN: Unused surgical supplies were recovered
      in coded bags from individual cases and inventoried. SETTING: Inpatient operating
      rooms at Yale-New Haven Hospital. MAIN OUTCOME MEASURE: The weight and dollar
      value of recovered materials were tallied for each case type; these were then
      extrapolated according to the frequency with which each procedure is performed in
      the United States to provide an estimate of the impact of a nationwide recovery
      program. RESULTS: The value of supplies recovered ranged from $1 (bone marrow
      transplant) to greater than $40 (liver and vulva/perineum procedures). By
      extrapolation to case-specific data from the National Hospital Discharge Survey
      (1990), we estimate that a nationwide recovery program could yield more than $193
      million in charitable material and reduce operating room waste by more than 1.7
      million kilograms (1948 tons). CONCLUSIONS: Consistency and organization would
      contribute greatly to efforts to alleviate existing medical supply needs in the
      developing world. This case-by-case assessment should enable participating
      centers to project more effectively the outcome of such collections and allow the
      coordination of efforts. Though unlikely to be adopted by all operating theaters
      in the United States, the potential charitable contributions from a nationwide
      recovery program are significant.

PMID- 8487449
TI  - A decision analysis of alternative treatment strategies for clinically localized
      prostate cancer. Prostate Patient Outcomes Research Team.
AB  - OBJECTIVE: To model the impact of initial therapy on outcomes for men with
      localized (clinical stage A or B) prostatic carcinoma. DESIGN: A decision
      analysis modeling three strategies: radical prostatectomy, external-beam
      radiation therapy, and watchful waiting, with delayed hormonal therapy if
      metastatic disease develops. We modeled the main benefit of treatment as a
      reduction in the chance of death or disutility from metastatic disease. These
      benefits were offset in the model by the risks of treatment-related morbidity and
      mortality. The model was used to analyze expected outcomes by tumor grade (well,
      moderately, and poorly differentiated) for men 60 to 75 years of age. DATA:
      Probabilities and rates for important clinical events, obtained through review of
      the literature for prostatic carcinoma and analysis of Medicare claims data. MAIN
      RESULTS: Several patterns emerged within the range of uncertainty about the risks
      and benefits of treatment for prostatic carcinoma. In patients with well
      differentiated tumor grades, based on clinical staging, treatment at best offers
      limited benefit in terms of quality-adjusted life expectancy and may result in
      harm to the patient. Among patients with moderately or poorly differentiated
      tumors, if we use the most optimistic assumptions about treatment efficacy, then
      patients aged 60 to 65 years would benefit from either radical prostatectomy or
      external-beam radiation therapy, compared with watchful waiting. However, in most
      other cases, treatment offers less than a 1-year improvement in quality-adjusted
      life expectancy or decreases the quality-adjusted life expectancy compared with
      watchful waiting. Invasive treatment generally appears to be harmful for patients
      older than 70 years. CONCLUSIONS: Radical prostatectomy and radiation therapy may
      benefit selected groups of patients with localized prostate cancer, particularly
      younger patients with higher-grade tumors. However, our model shows that in most
      cases the potential benefits of therapy are small enough that the choice of
      therapy is sensitive to the patient's preferences for various outcomes and
      discounting. The choice of watchful waiting is a reasonable alternative to
      invasive treatment for many men with localized prostatic carcinoma.

PMID- 8487450
TI  - Why estimates of physician supply and requirements disagree.
AB  - OBJECTIVE: To review the major forecasts of physician supply and physician
      requirements. DATA SOURCES: English-language medical literature on physician
      manpower published between 1980 and 1990, identified from journal articles
      selected through searches of the MEDLINE and Health Planning and Administration
      databases using the search formulations physician supply, health manpower-
      physicians, and physician manpower. STUDY SELECTION: Sources were selected if
      they were repeatedly cited and provided quantitative projections. DATA
      EXTRACTION: Each study was reviewed for its quantitative projections and to
      identify its methodological assumptions. DATA SYNTHESIS: All forecasts point to a
      steadily increasing physician supply and, with one exception, suggest that supply
      will exceed requirements in the year 2000. The estimates of physician supply
      across studies varied primarily because of differing assumptions about entrance
      rates into the profession and the size and clinical work load of specific
      categories of physicians: researchers, teachers, administrators, residents, and
      women. The estimates of physician requirements were more volatile because of
      differences in the basic approach and assumptions about future growth and market
      structure. CONCLUSIONS: Even though the measurement of entrance and exit rates
      from the profession is a generally accepted approach to forecasting supply,
      apparently minor disagreements on assumptions create large discrepancies between
      forecasts over time. There is no accepted approach to forecasting physician
      requirements.

PMID- 8487451
TI  - Screening for adolescent idiopathic scoliosis. Policy statement. US Preventive
      Services Task Force.

PMID- 8487452
TI  - Screening for adolescent idiopathic scoliosis. Review article. US Preventive
      Services Task Force.

PMID- 8487453
TI  - The safety of tricyclic antidepressants in cardiac patients. Risk-benefit
      reconsidered.

PMID- 8487454
TI  - Evidence-based practice guidelines from the US Preventive Services Task Force.

PMID- 8487455
TI  - Hypertension in pregnancy: preeclampsia-eclampsia.
AB  - Diagnosis of preeclampsia involves consideration of many different factors. It is
      desirable to make the diagnosis early in the disease course for the best possible
      outcome for mother and fetus. Overdiagnosis may occur in some cases; however,
      given the severe maternal and fetal morbidity in cases of untreated disease, it
      is best to monitor and treat symptoms before they become severe. Overall goals of
      treatment include prolonging the pregnancy as long as possible without compromise
      of maternal health, while monitoring the fetus for signs of distress. Treatment
      for the mother is symptomatic, with seizure prophylaxis and hypertension control.
      In gestations less than 32 weeks, it is desirable to expose the fetal lungs to at
      least 48 hours of corticosteroids before delivery to enhance lung maturity.
      Studies of preeclampsia have demonstrated high fetal morbidity/mortality for
      gestations less than 24 weeks. With expectant management, decreased fetal
      morbidity and mortality are shown for both 24- to 27- and 28- to 34-week
      gestations. Secondary to excellent fetal survival, immediate delivery is
      indicated for severe disease at gestation greater than 34 weeks.

PMID- 8487456
TI  - Norplant: a welcome new contraceptive.

PMID- 8487457
TI  - Declining incidence of Haemophilus meningitis in Kansas.

PMID- 8487458
TI  - Does 'front-loading' with rt-PA improve treatment of acute myocardial infarction?

PMID- 8487459
TI  - Without a clout.

PMID- 8487461
TI  - Fiduciary duties.

PMID- 8487460
TI  - What a year this has been!

PMID- 8487462
TI  - [Tarsoconjunctival advancement--a surgical procedure in cicatricial entropion
      with marginal tarsus deformation].
AB  - BACKGROUND: After severe chemical and thermal burns, and in chronic inflammatory
      conditions of the conjunctiva frequently scarring of the tarsal plate with
      distortion of the eyelid margin and keratinization of the tarsal conjunctiva
      could be found. This condition is accompanied with chronic inflammation and
      malposition of the eyelids resulting in entropion and trichiasis. PATIENTS AND
      METHODS: A surgical procedure is introduced separating the scarred and shortened
      tarsal plate from the cutis-muscle sheet. After excision of tarsal scar tissue
      and of the marginal metaplastic tarsus a new eyelid margin is formed by tarso
      conjunctival advancement, correcting trichiasis and cicatricial entropion. During
      the time from August 1984 to December 1991 this surgical procedure was conducted
      on 16 patients, correcting 18 upper and 4 lower eyelids. 11 patients suffered
      from severe chemical and thermal burns, 2 patients from Stevens-Johnson-syndrome,
      2 patients from ocular pemphigoid and 1 patient from herpes zoster infection.
      RESULTS: All patients were examined at least once in the first 6 postoperative
      months, 11 patients are still under continuing outpatient review. The mean follow
      up time is 27 months, the minimum follow-up period is 7 months. In 7 patients the
      surgical procedure prepared conditions for a successful keratoplasty and in 5
      other cases the keratopathy healed. In 4 cases a recurrence of the entropion
      occurred (18% recurrence rate). CONCLUSIONS: The presented surgical procedure is
      a promising alternative to more complicated procedures for correcting cicatricial
      entropion with keratinization of the marginal tarsus.

PMID- 8487463
TI  - [Ocular complications of long-term survival of bone marrow transplantation. A
      prospective study with 21 patients].
AB  - BACKGROUND: Survival time after bone marrow transplantation is getting
      increasingly longer and secondary ocular complications need to be identified and
      deserve more attention as so far. PATIENTS AND METHODS: We evaluated the ocular
      complications of 21 not selected, long-term survivors after bone marrow
      transplantation in a prospective study. The ophthalmological examination
      consisted of visual acuity, slit lamp examination, tonometry and ophthalmoscopy.
      It included also determination of tears break-up-time, Jones-test, rose bengal
      staining and impression cytology of the conjunctiva. RESULTS: The major ocular
      complication was the development of a keratoconjunctivitis sicca syndrome in 14
      of the 21 patients. This complication is probably due to the total-body
      irradiation in the preparative before and to the development of a chronic Graft
      versus-Host-Disease after transplantation. 13 of the 21 patients developed a
      cataract. This might be a result of the total-body irradiation and a prolonged
      high steroid intake. CONCLUSION: The frequency and severity of ocular
      complications suggest that detailed ocular examinations should be performed
      routinely in patients after bone marrow transplantation.

PMID- 8487464
TI  - [Visual compromise of automobile drivers by frontal photo-flash in mesoptic
      conditions].
AB  - The time for recovery of recognition of an optotype presented at a distance of 40
      m subsequent to exposure to a flash gun (Eso company, Tettnang; flash energy 200
      Ws, duration 1/1000 s; distance 10 m) was studied on 97 subjects aged 20 to 83
      years. A Landolt-ring (contrast 1:5, diameter 29 cm), mounted on a disk (diameter
      58 cm) which could be rotated in steps of 45 degrees served as a test target. The
      flash gun could be dimmed down by a red filter (Schott RG 665). The tests were
      performed at night without additional illumination except the low beam of the
      car. The flash gun was foveally fixated. After a white flash, a period of 93.1 s
      +/- 48.6 s (MEAN +/- SD) passed before the optotype could be recognized correctly
      again. By adding the red filter in front of the flash gun the recovery time could
      be shortened significantly (p < 0.0001; Wilcoxon signed-rank test) to 4.9 s +/-
      1.7 s. "Time for re-adaptation" after dazzling by red flash is comparatively
      short and therefore strongly influenced by many variables (e.g. time for
      recognition and for verbalization). Because of that a final evaluation of
      dazzling by red flash seems to be impossible with this method. Subjects of
      advanced age and opacities of the ocular media showed an increase in the "time
      for re-adaptation" for the white as well as the red flash. In conclusion, a speed
      control using white flash guns at night can be considered as critical.

PMID- 8487465
TI  - [Clinical use of the excimer laser in treatment of surface corneal opacities-
      therapeutic strategy and case reports].
AB  - BACKGROUND: The authors report on the Phototherapeutic 193nm-Excimer Laser
      Keratectomy (PTK) for the treatment of superficial corneal opacities. MATERIAL
      AND METHOD: In two cases with corneal opacities after contact lens wearing and
      after therapy resistant keratoconjunctivitis epidemica respectively the treatment
      strategy is presented. The epithelium and the corneal opacities are removed
      mechanically as far as possible. Then the Excimer laser smoothing with masking
      fluids of different viscosity is performed. RESULTS: In both patients the visual
      acuity improved from 1/50 and 0.16 respectively to 0.7. Both eyes had an
      hyperopic shift. The patients were without pain within a follow-up period of 8
      months after treatment. CONCLUSION: The phototherapeutical use of the 193nm
      Excimer laser to treat superficial corneal opacities can be regarded as a real
      alternative to conventional surgical techniques.

PMID- 8487466
TI  - [Development of endocrine orbitopathy in pregnancy].
AB  - A report is given on an endocrine orbitopathy in a 24-year-old female in which
      the disease deteriorated from the 3rd month of pregnancy, with a severe
      restriction of motility, exophthalmia (Hertel exophthalmometer both eyes 28 mm),
      severe visual field defects and a decrease of visual acuity to 20/200 both eyes.
      Therefore--despite of certain restraints of the pharmacologic therapy during
      pregnancy--glucocorticoid-treatment was started. After delivery, the condition
      deteriorated, despite of a higher steroid dose. Therefore, a retrobulbar
      irradiation was begun on the 12th day post partum (telecobalt 10 Gy). From that
      time on all signs improved over the next months (visual acuity 20/25;
      exophthalmometer both eyes 20 mm, normal visual field). In the literature,
      endocrine orbitopathy (Graves' ophthalmopathy) during pregnancy has been
      mentioned sporadically, but to our knowledge such a severe case, as reported
      here, has not been described before.

PMID- 8487467
TI  - [Spontaneous dislocation of a silicone disk lens 4 months postoperative into the
      vitreous body].
AB  - We report on a patient who experienced an acute deterioration in visual acuity at
      night four months after implantation of a silicon-disc lens into the capsular
      bag. On examination, the artificial lens was localized preretinally. The capsular
      equator was fibrous, but had retained its circular shape. The posterior capsule
      was ruptured. The rupture may be explained by tension in the posterior capsule,
      which is only 1-4 microns thick, within the shrunken capsular bag, and by an
      acute increase of intraocular pressure caused by rubbing of the eyes during
      sleep.

PMID- 8487468
TI  - [3 cases of vertical accommodative vergence].
AB  - Three cases of vertical accommodative vergence have been observed. One patient is
      described in detail. His right eye had become blind after a trauma. He showed a
      vertical vergence triggered by accommodation that had not been seen before his
      loss of sight. The strabismic eye deviated upwards during desaccommodation and
      downwards during accommodation. This unusual phenomenon could be due to a
      congenital supranuclear abnormality which became apparent only after the loss of
      binocular vision.

PMID- 8487469
TI  - [An illuminated orbital spatula--possibilities for use in ophthalmology].
AB  - Illumination sometimes becomes a problem during ophthalmic surgery, especially in
      retroequatorial myopexia (Fadenoperation). The common headlights use to reduce
      the mobility of the surgeon. We present a modified SAUTTER's orbita spatula,
      which is armed with a fibre-optic. It can be connected with a commonly available
      cold-light-source. The prototype can been used in the following surgical
      procedures, retroequatorial myopexia (Fadenoperation) demonstrated by photograph:
      tendon tucking of the superior oblique, retinal detachment surgery, orbital
      tumors. Several surgeons regarded the optimal illumination of a difficult
      surgical situs as an improvement. With some modifications of the prototype which
      are prepared now the illuminated orbital spatula should become a useful
      instrument for the ophthalmic surgeon.

PMID- 8487470
TI  - [Developments in ophthalmologic electrophysiology].
AB  - During the last years electrophysiology in ophthalmology has been facilitated to
      a big extent by computerized methods. Thus it has become a suitable method for an
      increasing number of relevant diagnostic problems. To make comparisons between
      test results of different diagnostic places easier an international standard
      concerning the methodology of the electroretinogram (ERG) has been elaborated by
      the "International Society of Clinical Electrophysiology in Vision" (ISCEV). Aim
      of the present article is to give a short description of the ERG-standard and to
      review recent developments in clinical electrophysiology in ophthalmology (ca.
      since 1989).

PMID- 8487471
TI  - [Teratoma of the orbit].

PMID- 8487472
TI  - [Recollections of Hans Goldmann, 1899-1991].
AB  - Professor Hans Goldmann died in Bern on November 19th, 1991 at the age of 91
      years. His outstanding intellectual capacity was discovered at an early age and
      demonstrated throughout his life. He was appointed as teaching assistant of the
      famous A. Cermak von Seysenegg, Chairman of the Institute of Physiology of the
      German Charles University in Prague. During his stay at the University of Prague,
      he was influenced by the famous people of his time, such as Einstein (physicist),
      Mach (physicist and psychophysicist), Lorenz (behavioral scientist), Popper
      (philosopher), Schlick (physicist and philosopher), Hering (physiologist), and
      others. Goldmann absorbed the essence of these disciplines to a very large
      extent. This, together with his remarkable intellect, enabled him to produce
      outstanding research work within a large spectrum of sciences more or less
      directly related to ophthalmology. Goldmann became known in particular for his
      exceptional and fundamental work on perimetry and glaucoma and he managed to cast
      his basic insight into practical, easy-to-operate, high-precision diagnostic
      instruments which, several decades after their invention, are still used by every
      ophthalmologist. He will enter history as one of the very great pioneers in
      ophthalmology.

PMID- 8487473
TI  - [Treatable diseases of the nervous system with cataract formation].
AB  - The detection of a cataract in combination with a neurological deficit may
      provide the physician with important diagnostic help. But a minority of
      underlying diseases (angiokeratoma corporis diffusum, cerebrotendinous
      xanthomatosis, diabetes mellitus, galactosemia, hypocalcemia, Refsum's disease,
      Wilson's disease; Charles Bonnet syndrome; relapsing Perichondritis; adverse
      effects of medication and intoxications) can be treated causally. Therefore they
      are summed up and discussed in this paper.

PMID- 8487474
TI  - [Do pilots need stereopsis ?].
AB  - Pilots so far are required to have a good quality of stereopsis. Many people do
      not meet this requirement. But is this requirement justified by research in
      aviation medicine and psychology of perception? This question is discussed on the
      basis of the theoretical and empirical literature. The answer is: No.

PMID- 8487475
TI  - [Tongue ultrasound and pressure measurement in infantile sucking. Initial
      results].
AB  - The sucking procedure was examined in 10 healthy, term infants and in one newborn
      with disturbed sucking actions suffering from recurrent aspiration pneumonia. We
      applied ultrasonography of the tongue and simultaneous intraoral pressure
      measurements in the examinations. Observations were made with a bottle feeding
      system (NUK). Sonography and intraoral measurements both gave reliable
      informations. Parallel recordings of tongue dorsum movements by pseudo-3
      dimensional imaging and simultaneously obtained pressure curves show, that
      increasing suction is maintained by withdrawing the tongue dorso-cranially.
      Computer-aided evaluation of ultrasound images and pressure data demonstrate the
      possibility to distinguish between coordinated and uncoordinated sucking
      movements. Simultaneous use of both examination techniques can be helpful in
      diagnosis and documentation of disturbed sucking actions.

PMID- 8487476
TI  - [Accuracy of measurements of Kontrol 7840, Nellcor N200 and Radiometer OX13 pulse
      oximeters in infants and young children].
AB  - Comparative validation studies of pulse oximeters from different manufacturers
      have predominantly been performed in adult patients. However, due to differences
      in the patient-sensor interface, the results from those studies may not be
      transferable to the paediatric population. We therefore performed 123
      simultaneous measurements (37 patients) of transcutaneous O2-saturation (StcO2)
      from 3 pulse oximeters and compared these with the arterial O2-saturation (SaO2)
      from a co-oximeter (Radiometer OSM 3). The median age of the 37 patients at the
      time of study was 2.0 months (range 1 day-5 years), their weight 4.7 kg (0.8-15.0
      kg). The mean difference between StcO2 and SaO2 was -0.6% (SD 5.2%) for the
      Kontron 7840 pulse oximeter, -0.9% (SD 2.3%) for the Nellcor N200, and -1.2% (SD
      3.5%) for the Radiometer OXI3 pulse oximeter. The corresponding 95% intervals
      were -7.4(-) + 9.6%, -5.7(-) + 4.3% and -7.0(-) + 6.3% for the Kontron, Nellcor
      and Radiometer instrument, respectively. These results demonstrate that neither
      of the 3 instruments systematically under- or overestimated SaO2. However, there
      were differences in precision, particularly in the low range of SaO2.

PMID- 8487477
TI  - [Is reliable blood glucose determination in the newborn infant possible with the
      small reflectance meter Reflolux S?].
AB  - With the reflectance meter Reflolux S (Accucheck III) high as well as low blood
      glucose levels can be determined with excellent precision irrespective of the
      sample's hematocrit value. Within the range from 20-50 mg/dl we found an average
      deviation from the expected value of less than 2 mg/dl; in selected samples,
      however, a difference of up to 10 mg/dl was recorded. The scatter can be
      explained by the influence of hematocrit values on the results. An increase of
      10% in hematocrit lowered the measured glucose value by approximately 10%. At
      glucose concentrations below 40 mg/dl and in the presence of high resp. low
      hematocrit values any results obtained with this glucose meter will only have
      screening character; they should be re-run using an established method.

PMID- 8487478
TI  - [Epiphysiolysis capitis femoris as a possible complication of hypoparathyroidism
      in partial Di George syndrome].
AB  - We report on a 2-year old boy with the characteristic features of Di George
      syndrome. The diagnosis was confirmed by history, biochemical, immunologic and
      radiologic findings. After physical exercise he developed an unilateral
      epiphysiolysis capitis femoris, rarely seen in this age and not known to be a
      complication of hypoparathyroidism.

PMID- 8487479
TI  - [Congenital lipoid hyperplasia of the adrenal gland and male
      pseudohermaphroditism: clinical aspects of two siblings].
AB  - Two siblings of consanguinous parents, one male and one female, presented with
      symptoms of adrenal insufficiency related to respiratory infection at the age of
      two and three months, respectively. Besides a reduction of the synthesis of gluco
      and mineralocorticoids, the sexual hormones were found to be reduced as well.
      Therefore, the boy showed a female sexual phenotype (male pseudohermaphroditism).
      Additionally, minor malformations including epicanthal folds, anti-mongoloid
      palpebral fissures, low-set ears were noticed, which have not been reported in
      children with the suspected diagnosis previously. The female sibling had typical
      Addison's crisis twice during the following years. Endocrinological tests yielded
      evidence for Cholesterol-20,22-desmolase deficiency.

PMID- 8487480
TI  - [Glutaric acidemia/glutaric aciduria I as differential chorea minor diagnosis].
AB  - Glutaracidemia/glutaraciduria type I is an acute or subacute neuropathic disorder
      of infancy or early childhood. The following symptoms characterize the clinical
      course: macrocephalus present at birth, cerebral atrophy revealed by CT or MRI
      scans, most striking in the frontal and temporal lobes, choreoathetosis and
      dystonia as neurological handicaps. The deficiency of glutaryl-CoA-dehydrogenase
      leads to glutaracidemia and glutaraciduria. It is reported on a three year old
      girl. The glutaraciduria is an important differential diagnosis to chorea minor.

PMID- 8487481
TI  - [Tetra-X syndrome with epilepsy, mental retardation and multiple dysmorphias].
AB  - It is reported on a 21-year-old female with super-female syndrome in association
      with an early childhood brain damage exhibiting idiopathic epilepsy, severe
      oligophrenia, emotional instability, Little syndrome, areflexia of the legs,
      strabismus, telecanthus, broad nose, epicanthic fold, clinodactyly of little
      fingers, radio-ulnar-synostosis, retardation of ossification, aortic
      insufficiency, erythro-cyanosis, one-side clubfoot and nephrosclerosis, also
      menstrual cycle dysfunction.

PMID- 8487482
TI  - "Changing concepts in the treatment of congenital diaphragmatic hernia".

PMID- 8487483
TI  - [Surfactant therapy in severe neonatal respiratory failure--multicenter study--I.
      Surfactant therapy in 264 premature infants of < 34 weeks with IRDS with special
      reference to "non-responders"].
AB  - As a part of a west german multicenter study (16 hospitals) 264 preterm neonates
      < 34 gestational weeks were treated with bovine surfactant (Alveofact, 50-200
      mg/kgBW). Entry criterion was need of mechanical ventilation and FiO2 of > 0.5.
      Compared with a previous prophylactic study with the same surfactant product
      these patients were slightly more mature (median: 29 gestational weeks, 1260 g)
      but had a higher oxygen demand at the time of treatment (median FiO2: 0.82).
      Survival rate (28. d) was 82%. At this time 38% showed spontaneous respiration
      without, 16% with additional oxygen. The incidence of pulmonary interstitial
      emphysema was 22%, of pneumothorax 13%, and of PDA 33%. Severe intracranial
      hemorrhage (grade III or IV according to Papile) had 25%, ROP (any grade) 27%.
      Nonresponder showed a higher initial FiO2 of 0.94. With regard to umbilical
      artery pH, mode of delivery, birth weight, and maturity) they were similar to the
      responders. We did not find a parameter, by which we could predict the response
      to surfactant.

PMID- 8487484
TI  - [Surfactant therapy in severe neonatal respiratory failure--multicenter study-
      II. Surfactant therapy in 10 newborn infants with meconium aspiration syndrome].
AB  - As a part of a west german multicenter study (424 patients, 16 hospitals) 10 term
      neonates ventilated because of severe meconium aspiration syndrome were treated
      with 1-4 doses of 50 mg/kg/BW of a bovine surfactant (Alveofact). Before
      treatment respiratory distress was severe (median FiO2: 1.0, median MAD 9.9 mmHg,
      median OI: 20). Acute improvement ("responders") was shown in 4 patients. All
      patients survived. Time of mechanical ventilation was 6-26 d. High frequency
      ventilation was applied in two nonresponders, ECMO in one.

PMID- 8487485
TI  - [Surfactant therapy in severe neonatal respiratory failure--multicenter study-
      III. Surfactant therapy in 41 premature infants < 34 weeks with suspected
      congenital infection (case-control analysis)].
AB  - As a part of a multicenter study (424 patients, 16 hospitals) 41 ventilated very
      low birth weight infants (24-33 gestational weeks, 640-1560 g), who were
      suspected to have connatal pneumonia, were treated with a bovine surfactant
      (Alveofact, 50-200 mg/kgBW). Using a case control design they were compared with
      41 patients having IRDS. There were no differences between the collectives with
      regard to the acute response to surfactant, the clinical course, and the outcome
      at the 28. d of life. Accidental treatment with natural surfactant in very
      immature neonates suffering from severe respiratory distress due to connatal
      pneumonia resp. connatal pneumonia accompanying IRDS seems not to harm these
      patients.

PMID- 8487486
TI  - [Effect of organized general preventive administration of iodized salt on struma
      incidence and ioduria in 11-16-year-old children in the Jena endemic area].
AB  - In 1988 and in 1991, i.e. two and five years after the introduction of a general
      iod salt supply (32 mg KJO2/kg salt) in our region, we investigated the frequency
      of goiters and the level of iodine excretion in urine in 504 and 336 school
      children of 11 to 16 years of age. In 1988 the assessment of goiter size was made
      by inspection and palpation according to the recommendation of WHO. 36% of the
      school children were found to have goiters of type I b or II. The average urine
      excretion of iodine amounted to 46.2 +/- 37.2 micrograms Iod/g creatinine (n =
      353). In 1991 we selected school children with goiters by the same criteria and
      found frequency (34%) to be nearly unchanged compared to 1988. Furthermore we
      investigated these goiters with ultrasound and confirmed the diagnosis in 100
      from 107 children. The average daily urine excretion of iodine was significantly
      higher in 1991 (57.7 +/- 24.8 micrograms/Iod/g creatinine, n = 328) than in 1988.
      However this value is below the level recommended by the WHO (minimum 75
      micrograms Iod/g creatinine). Despite the increase of the iodine intake over the
      last years, the frequency of goiters in pubertal school children in the Jena
      region is endemic. This fact supports the demand for a general and sufficient
      iodine supply.

PMID- 8487487
TI  - [Secretory immunoglobulin A in childhood: does the saliva value reflect the
      bronchial value?].
AB  - Immunoglobulin A (IgA) can be found in different body secretions and plays a
      major role in the local immune response. It inhibits bacterial adherence,
      neutralizes toxins and protects the mucosa from penetrating antigens and
      allergens. Whereas measurement of IgA in saliva mostly does not show any
      problems, difficulties in assessing IgA in bronchial fluids often occur mainly
      due to variable dilutional effects. Aim of the present study was to find out
      whether saliva IgA predicts bronchial IgA. In 15 children aged 4 months to 14
      years (mean 53.5 months; SEM 12.3) with chronic cough (n = 10), mediastinal mass
      (n = 1), recurrent airways obstructions (n = 2) and inspiratory stridor (n = 2)
      we performed a diagnostic rigid bronchoscopy and assessed IgA by means of
      bronchial lavage (BL). We attempted to control for uncertain dilution by the use
      of albumin as a denominator and to present our data as ratios of IgA to albumin.
      As various disease states alter the integrity of the alveolar-capillary membrane
      and influence the concentration of albumin in the epithelial lining fluid we
      developed an optical score to describe the state of the bronchial mucosa.
      Measurement of saliva IgA is easy and can be done without dilutional effects. The
      mean value of IgA in saliva was 65.49 mg/l (SEM 14.75; range 3.5-227), the one of
      IgA in bronchial lavage fluid 30.75 mg/l (SEM 7.11; range 3.5-100). IgA-albumin
      ratio ranged from 0.006 to 1.46 (mean 0.36, SEM 0.12). Saliva IgA did neither
      significantly correlate with bronchial IgA nor with bronchial IgA-albumin
      ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487488
TI  - [The protective effect of theophylline in exercise-induced asthma in childhood].
AB  - In order to study the protective effect of theophylline on exercise-induced
      asthma in children, we investigated the lung function of 16 children with
      documented bronchial asthma. Exercise provocation was performed by running on a
      treadmill for 6 minutes before and after two dose regimens of theophylline (10
      and 20 mg/kg body weight). While for FEV1 the low dose regimen only showed a
      trend (p < 0.1), there was a slight but significant improvement in the high dose
      regimen (p < 0.05). Concerning sRaw both groups showed a small but significant
      improvement compared with the baseline values (p < 0.05). We conclude that in
      addition to its bronchodilatory effect theophylline may modulate exercise induced
      bronchospasm in asthmatic children.

PMID- 8487489
TI  - Controlled diet in phenylketonuria may cause serum carnitine deficiency.
AB  - Serum carnitine levels may be reduced in patients with phenylketonuria (PKU)
      owing to low carnitine intake, deficient carnitine synthesis and acylcarnitine
      production from phenylalanine metabolites. In order to investigate the possible
      carnitine deficiency we determined serum carnitine in its different forms and the
      precursors and cofactors involved in its synthesis in a group of patients with
      PKU or hyperphenylalaninaemia. Free, total and acylcarnitine values were
      significatively reduced only in PKU patients with Phe-restricted diet which had
      not been supplemented with carnitine. Acylcarnitine/free carnitine ratio and all
      the other parameters studied were normal in all patients. We conclude that the
      low serum carnitine levels in PKU patients with a strict diet are a consequence
      of the low carnitine intake.

PMID- 8487490
TI  - Plasma phenylalanine and tyrosine levels revisited in heterozygotes for
      hyperphenylalaninaemia.
AB  - We examined the value of the fasting plasma phenylalanine/tyrosine ratio obtained
      in an ordinary clinical setting for assessing the probability of being a
      heterozygote for hyperphenylalaninaemia. This biochemical test was found to be of
      little value in those with a high (66%) prior risk of heterozygosity, because it
      could not reduce the risk below 12%. However, in a population with a prior risk
      of only 2%, it discriminates the 3% with a 19% risk from the 97% with a risk of
      1.5% or less. This simple method could usefully be applied to such a population,
      in order to select those at higher risk for further investigation using molecular
      genetics.

PMID- 8487491
TI  - The use of gelatin capsules for ingestion of formula in dietary treatment of
      maternal phenylketonuria.
AB  - Maternal phenylketonuria (PKU) represents a high risk for birth defects,
      including mental retardation, in offspring. Thus, it could cancel gains
      represented by the prevention of PKU-induced mental retardation in the current
      generation. Effective dietary treatment of maternal PKU pregnancies could avoid
      this potentially tragic occurrence. However, dietary compliance is often
      difficult because a necessary component of the diet, medical nutritional
      formulas, often have an unpleasant taste and odour. We treated the second
      pregnancy of a phenylketonuric women who had required extended hospitalization
      during her first pregnancy because of poor formula tolerance, and who had similar
      difficulty in the second pregnancy. To alleviate this problem, we developed a
      system whereby she could pack the formula into gelatin capsules for ingestion.
      Packing and ingestion of 20 capsules required less than 30 minutes three times a
      day. With capsules her blood phenylalanine level was almost always within the
      recommended range of 120-360 mumol/L (2-6 mg/dl) and hospitalization was not
      required. The phenylalanine content of the capsules was easily accommodated by a
      small reduction in allowable food. Other amino acid levels, including tyrosine
      and other essential nutrient levels, were normal. We believe that using gelatin
      capsules for formula ingestion can be very beneficial in the management of
      maternal PKU pregnancies and could be extended to the dietary treatment of other
      inborn errors of metabolism.

PMID- 8487492
TI  - Identification of N-acetyl-alpha-aminoadipic acid in the urine of a patient with
      alpha-aminoadipic and alpha-ketoadipic aciduria.
AB  - A 3.5-year-old Japanese boy with a mild speech disturbance excreted a large
      amount of alpha-aminoadipic acid into the urine. The amino acid analysis using an
      amino acid analyser confirmed the presence of alpha-aminoadipic acid in both
      urine and plasma. We detected alpha-aminoadipic acid in the hydrolysate of the
      effluent and washwater fraction through cation exchange resin. This suggested the
      presence of acetylated derivatives and we identified N-acetyl-alpha-aminoadipic
      acid using liquid chromatography-atmospheric pressure ionization mass
      spectrometry (LC-API-MS). The concentrations of alpha-aminoadipic acid and N
      acetyl-alpha-aminoadipic acid in the urine of a patient with alpha-aminoadipic
      aciduria were 376.9 nmol/mg creatinine and 18.1 nmol/mg creatinine, respectively.
      We also detected alpha-ketoadipic acid in the urine of this patient using LC-API
      MS.

PMID- 8487493
TI  - The effect of lovastatin on very low-density lipoprotein apolipoprotein B
      production by the liver in familial combined hyperlipidaemia.
AB  - Overproduction of very low-density lipoprotein apolipoprotein B by the liver is a
      metabolic marker for familial combined hyperlipidaemia, a common inherited
      disorder of lipoprotein metabolism. Four subjects with familial combined
      hyperlipidaemia had rates of apolipoprotein B production which were 2-7 times
      normal, using a protocol in which [15N]glycine was used to label newly
      synthesized hepatic proteins. Following 4-6 months of therapy with lovastatin,
      very low-density lipoprotein apolipoprotein B production in all four subjects had
      returned to the normal range. This demonstrates that lovastatin, an inhibitor of
      cholesterol biosynthesis, acts also to reduce the apparent production rate of
      apolipoprotein B by the liver.

PMID- 8487494
TI  - Inhibition of succinate dehydrogenase and beta-hydroxybutyrate dehydrogenase
      activities by methylmalonate in brain and liver of developing rats.
AB  - The effects of methylmalonate (MMA) on succinate dehydrogenase (SDH) and beta
      hydroxybutyrate dehydrogenase (HBDH) activities in brain and liver of 15-day-old
      rats were studied. The apparent Km of SDH for succinate was 0.45 mmol/L in brain
      and 0.34 mmol/L in liver. MMA inhibited the enzyme activity in both tissues with
      Ki values of 4.5 mmol/L and 2.3 mmol/L in brain and liver, respectively, and the
      inhibition was of the reversible competitive type. The calculated Km for HBDH
      with beta-hydroxybutyrate as substrate was 1.26 mmol/L in brain and 0.36 mmol/L
      in liver. MMA inhibited the enzyme with a Ki value of 0.015 mmol/L in brain and
      0.275 mmol/L in liver. These results are probably relevant to our understanding
      of cerebral metabolism in methylmalonic acidaemic children, especially during
      ketoacidotic and hypoglycaemic crises, and may be related to the pathogenesis of
      cerebral dysfunction of methylmalonic acidaemia.

PMID- 8487495
TI  - Formiminoglutamic/hydantoinpropionic aciduria in two siblings.

PMID- 8487496
TI  - Alcaptonuria in a Brazilian baby.

PMID- 8487497
TI  - Relation between phenotype and genotype in phenylketonuric patients from
      Bulgaria.

PMID- 8487498
TI  - Biochemical and immunological characterization of X-linked ichthyosis.
AB  - An immunoquantification protocol based on an enzyme-linked immunosorbent assay
      was developed to measure the abundance of the microsomal enzyme steroid
      sulphatase (STS). The two-step sandwich immunoassay is sufficiently sensitive to
      detect 100-200 pg purified steroid sulphatase in a 50-microliters sample. The
      steroid sulphatase content in fibroblast, leukocyte and placental extracts
      correlates with the steroid sulphatase activity in these extracts. No steroid
      sulphatase protein was found in approximately 350 micrograms plasma proteins from
      a normal person. In three of four X-linked ichthyosis patients a complete gene
      deletion was found by Southern hybridization with the full-length STS cDNA as
      probe. Neither steroid sulphatase protein nor enzymatic activity was found in
      fibroblast extracts of these three patients. In a fibroblast extract of another X
      linked ichthyosis patient, which had a normal Southern blotting pattern, no
      immunoreactive protein was detected. Residual activity of steroid sulphatase was
      also not found after prolonged incubation of this fibroblast extract with the
      natural substrate oestrone sulphate.

PMID- 8487499
TI  - Tissue distribution of mutant mitochondrial DNA in mitochondrial myopathy,
      encephalopathy, lactic acidosis and stroke-like episodes (MELAS).
AB  - We analysed the distribution of mutant mitochondrial DNA (mtDNA) with A-to-G
      substitution mutation of tRNA(Leu)(UUR) in various autopsied tissues from a
      patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke
      like episodes (MELAS). There was no significant difference in the proportion (76
      86%) of mutant mtDNA in many tissues, except in the lung and spleen. Unequal
      partitioning of mtDNA in somatic cells appears less prominent than that in germ
      cells.

PMID- 8487500
TI  - Review: the immunochemical analysis of enzyme from mucopolysaccharidoses
      patients.
AB  - The immunochemical analysis of enzyme from mucopolysaccharidoses (MPS) patients
      is aimed at defining the level and nature of the enzymically deficient protein
      produced by specific gene mutations. Immunochemical techniques allow purification
      of enzyme, characterization of the composite molecular species, measurement of
      cellular protein content, investigation of protein biosynthesis, determination of
      subcellular distribution, as well as information on protein structure and
      folding. This review focuses on the application of immunochemical techniques to
      the study of the aberrant protein produced in skin fibroblast cells derived from
      MPS patients. The analysis of enzyme protein has been applied to phenotype
      expression within single enzyme deficiency disorders. It is proposed that
      reliable prediction of MPS patient phenotype may require a combined approach
      utilizing immunochemical, biochemical, cell biological and gene analysis.
      However, this review will address the structure and nature of the protein
      produced in cells from MPS patients, the biological activity of this protein, and
      the incorporation of the protein into, and location within, subcellular
      fractions.

PMID- 8487501
TI  - Prenatal monitoring of ornithine transcarbamoylase deficiency in two families by
      DNA analysis.
AB  - We examined the DNA in two families with ornithine transcarbamoylase (OTC)
      deficiency. Two point mutations of the OTC gene, a C-to-T (codon 141) and a G-to
      A (codon 141), were identified. This allowed prenatal monitoring to be made for
      two fetuses in each family, using polymerase chain reaction (PCR), followed by
      allele-specific oligonucleotide hybridization or TaqI digestion of amplified
      sequence. The diagnoses showed heterozygotes of a wild type gene and the
      corresponding mutant gene in these fetuses; each was confirmed postnatally.

PMID- 8487502
TI  - Carbamoylphosphate synthetase deficiency in an adult: deterioration due to
      administration of valproic acid.
AB  - A 24-year-old patient had symptoms of lethargy, convulsions and hyperammonaemia
      during valproic acid therapy. Cessation of valproic acid treatment brought about
      an improvement both of the symptoms and of the hyperammonaemia. However,
      enzymatic analysis after the cessation of valproic acid therapy revealed a
      complete absence of carbamoylphosphate synthetase (CPS) activity in liver biopsy.
      A unique polypeptide band, corresponding to the control CPS protein in molecular
      weight ('CPS-like' protein), was found in normal amounts in the patient's liver
      on sodium dodecyl sulphate-polyacrylamide gel electrophoresis. This CPS-like
      protein seemed to be more labile than the control, because the polypeptide band
      became faint after freeze-thawing. Intravenous administration of L-alanine
      resulted in a significant increase of serum urea and a transient increase of
      blood ammonia concentrations. These results strongly suggest that the patient has
      a labile CPS protein with no activity in vitro but some activity in vivo. We
      consider that valproic acid may have disrupted some metabolic adaptation by
      reducing N-acetylglutamate in the liver, which in combination with CPS deficiency
      induced severe hyperammonaemia.

PMID- 8487503
TI  - Mitochondrial 2-methylacetoacetyl-CoA thiolase deficiency: an inborn error of
      isoleucine and ketone body metabolism.
AB  - A review is presented of 22 published cases of verified or probable mitochondrial
      2-methylacetoacetyl-CoA thiolase deficiency, a disorder of isoleucine and ketone
      body metabolism. The clinical expression, characterized by ketoacidosis, vomiting
      and lethargy, is highly variable. Typical age of onset is between 6 and 24
      months. The disorder, which has been observed in several ethnic groups, is
      apparently inherited as an autosomal, recessive trait. The prognosis is
      relatively good if acute episodes of ketoacidosis and dehydration are adequately
      treated. There is abnormal urinary excretion of 2-methyl-3-hydroxybutyric acid,
      tiglylglycine, and in some instances also 2-methyl-acetoacetic acid. However,
      such a pattern of organic aciduria has also been found in cases with normal
      thiolase activity. Genetic complementation analyses have demonstrated
      considerable heterogeneity. The cDNA for human methyl-acetoacetyl-CoA thiolase
      has been cloned and sequenced. Studies in one patient showed a G-to-A
      substitution at position 1138 of the mRNA, causing 347Ala to Thr change in the
      mature enzyme. Studies in other patients have shown variable enzyme amount and/or
      stability.

PMID- 8487504
TI  - Diagnosis of Zellweger syndrome by analysis of very long-chain fatty acids in
      stored blood spots collected at neonatal screening.

PMID- 8487505
TI  - Membrane-bound sorbitol dehydrogenase in human red blood cells. Studies in normal
      subjects and in enzyme-deficient subjects with congenital cataracts.
AB  - Membrane-bound and soluble forms of erythrocyte sorbitol dehydrogenase (SORD)
      activity are compared in normal individuals. Both isoenzymes showed similar
      properties. In a family with red cell SORD deficiency and congenital cataracts,
      Km values for sorbitol and NAD+ as well as the effect of the enzymatic deficiency
      on sorbitol accumulation in red cells incubated in high-glucose or high-fructose
      media were determined. In SORD-deficient patients, the enzymatic deficiency was
      observed in both crude haemolysate and SORD-M preparations with sorbitol,
      galactitol, xylitol or ribitol as substrates. The mutation responsible for SORD
      deficiency did not modify the Km for sorbitol and NAD+. Finally, SORD deficiency
      produced a significant increase of sorbitol accumulation in red cells incubated
      in high-concentration glucose media and a significant decrease when the cells
      were incubated in high-concentration fructose media.

PMID- 8487506
TI  - A possible case of transient hereditary fructose intolerance.
AB  - A patient is described who presented with the signs and symptoms of hereditary
      fructose intolerance a few hours after her first fructose challenge. The
      diagnosis was confirmed by the demonstration of reduced activity of hepatic
      aldolase B towards fructose-1-phosphate. A second liver biopsy 10 months later
      had normal aldolase B activity towards fructose-1-phosphate and a fructose
      tolerance test was also normal. A possible explanation for these findings is
      proposed.

PMID- 8487507
TI  - The effect of dietary fruits and vegetables on urinary galactitol excretion in
      galactose-1-phosphate uridyltransferase deficiency.
AB  - Even on a lactose-restricted diet, urinary galactitol excretion and erythrocyte
      galactose-1-phosphate levels are persistently elevated in patients with galactose
      1-phosphate uridyltransferase deficiency. In order to determine the contribution
      of galactose in dietary fruits and vegetables to this phenomenon, (1) the content
      of galactose in a lactose-free diet was directly measured when a galactosaemic
      patient's diet was specifically enriched in those fruits and vegetables which
      contain relatively large amounts of free galactose and (2) galactitol excretion
      was determined during ingestion of this diet for 3 weeks and while on a synthetic
      diet for 1 week that provided < 8 mg galactose/day. For comparison the effect of
      a 3-week supplementation of 200 mg galactose/day was determined. The measured
      intake in total foodstuffs matched the theoretical content of galactose in the
      patient's diet based on amounts in fruits and vegetables alone, thus supporting
      the concept that fruits and vegetables are primarily responsible for galactose
      intake in a lactose-free diet. All of the dietary manipulations, however, had
      relatively little effect on metabolite levels, suggesting that endogenous
      galactose production is primarily responsible for the elevated levels of
      galactose metabolites routinely detected in patients on lactose-restricted diets.

PMID- 8487508
TI  - Investigating children's knowledge and understanding of AIDS.
AB  - Though AIDS education in schools reaches many adolescents, the incidence of
      adolescent HIV infection has risen dramatically. Reasons for failure to properly
      educate adolescents include not educating children prior to adolescence and
      neglecting to assess and address children's varying levels of cognitive
      development when designing AIDS education programs. Citing examples from a study
      of more than 600 elementary-age schoolchildren, this paper focuses on the
      importance of assessing children's understanding of disease processes rather than
      accepting their use of key phrases in appropriate contexts as reflecting
      knowledge, and using the level at which they understand disease processes rather
      than age as the primary determinant of students' readiness for comprehending AIDS
      related concepts. Guidelines for assessing how well children understand disease
      processes, including use of nonleading probes, are presented.

PMID- 8487509
TI  - Chief State School Officers rank barriers to implementing comprehensive school
      health education.
AB  - Council of Chief State School Officers (CCSSO) members were surveyed to determine
      their perception of barriers to implementing comprehensive school health
      education. CCSSO members were asked to prioritize the barriers and offer
      recommendations to overcome the barriers. A structured response, paired
      comparison survey instrument was developed and mailed to 56 of 57 CCSSO members.
      Eighty-two percent of the members responded. CCSSO members perceived lack of
      administrative commitment as the number one barrier. Lack of adequately prepared
      teachers and insufficient time in the school day ranked second and third,
      respectively. While CCSSO members offered no recommendations for overcoming the
      number one barrier, recommendations to overcome other barriers included high
      quality and more available preservice and inservice programs for teachers.

PMID- 8487510
TI  - School health education in the European Community.
AB  - The School Health Education Commission of the European Community is making
      efforts to improve school health education in the European Community countries.
      While past efforts have involved single issue causes, current activities
      emphasize a holistic perception of school health education. Radical education
      reforms throughout the European Community advocate improved health education. The
      movement toward quality health education in the European Community countries uses
      a model called the Health Promoting School, a cooperative effort involving
      schools, families, and communities. The model is being promoted through three
      stages: 1) national conferences held in each European Community country, 2)
      summer schools to provide teacher training, and 3) national projects, supported
      by the World Health Organization, agreement conducted to determine the efficacy
      of the Health Promoting School Model.

PMID- 8487511
TI  - School heart health promotion: the National Heart Foundation (Western Australian)
      approach.
AB  - The National Heart Foundation of Australia's commitment to school health
      promotion expanded progressively since 1983. Following establishment of health
      education curriculum documents by the state Ministries of Education, the
      Foundation targeted schoolchildren with primary prevention programs and
      resources. The Foundation looked beyond instructional settings to examine the
      influence of the school environment on the health of students and school
      personnel. This paper describes a school heart health promotion model implemented
      by the Western Australian Division of the National Heart Foundation, serving one
      of Australia's eight states and territories. The model incorporates elements of
      policy, curriculum, environment, health services, and community interaction.
      Though similar to comprehensive models of school health education, this model
      limits its application to heart health. The program operates in a nongovernment
      agency with unmatched potential for national reach.

PMID- 8487512
TI  - Incorporating health-fitness concepts in secondary physical education curricula.
AB  - This investigation ascertained effects of exposing high school students to
      classroom health-related fitness instruction involving a curriculum focused on
      the relationship of exercise to cardiorespiratory fitness, body composition,
      flexibility, strength (particularly as it relates to abdominal and lower-back
      muscoskeletal function), and muscular endurance. The curriculum included
      lectures, labs, and readings as part of the physical education course work.
      Ninety ninth and 10th grade students were assigned randomly to one of three
      physical education classes, which met daily for one, 12-week semester. Each class
      received the same skill-related instruction; however, the two experimental
      classes, in lieu of skill activities, were exposed to classroom instruction and
      readings dealing with health fitness topics on a one or two day per week basis.
      The third class of students, the control group, was engaged strictly in skill
      activities daily. Students exposed to health-related fitness classroom
      instruction displayed significantly more positive attitudes toward physical
      activity and a better understanding of health-related fitness than students who
      did not receive such information.

PMID- 8487513
TI  - An evaluation of a substance abuse education program for Mississippi delta
      pregnant adolescents.
AB  - A non-equivalent control group design was used to examine effectiveness of a drug
      and alcohol abuse prenatal care health education program for pregnant teens (N =
      212) in the Mississippi delta region of southern Illinois. Experimental group
      posttest knowledge scores were significantly higher than control group scores;
      however, no significant differences occurred in attitudes between the two groups
      at posttest. Frequency of drug use decreased substantially for both experimental
      and control groups at posttest; however, significantly more experimentals than
      controls indicated they reduced or quit using drugs. The experimental group had a
      significantly lower rate of diabetes, anemia, and sexually transmitted diseases,
      and possibly a lower rate of spontaneous abortion depending on the statistical
      test used. Data suggest prenatal care health education programs may be effective
      methods for increasing patient awareness about the dangers of drug and alcohol
      abuse and may have an effect on infant and maternal outcomes.

PMID- 8487514
TI  - The impact of training on school professionals' knowledge, beliefs, and behaviors
      regarding HIV/AIDS and adolescent homosexuality.
AB  - The impact of training on secondary school professionals' knowledge, beliefs, and
      behaviors regarding HIV/AIDS and adolescent homosexuality was examined. Subjects
      (79 introductory and 50 advanced trainees) and 58 controls (no prior training)
      were systematically sampled from professionals in a statewide demonstration
      program to prevent HIV transmission among gay and bisexual youth. Subjects
      completed mailed, self-administered surveys based on the curriculum. The overall
      response rate was 79%. Trainees scored significantly higher than controls on
      knowledge pertaining to HIV and adolescent homosexuality. They also reported
      using greater numbers of strategies to teach students about homosexuality and to
      improve the mileu for homosexual students. Training at any level was
      independently associated with constructive behaviors, while controlling for
      demographic characteristics. Advanced learners were most knowledgeable and least
      reliant on informal sources of information. They were more likely than others to
      teach about homosexuality and to refer homosexual students to community services.
      Findings supported the hypothesized benefits of the intervention. Schools that
      mandate AIDS education should help staff confront the difficult issue of
      adolescent homosexuality.

PMID- 8487515
TI  - Using a student-constructed baby model to teach health subjects to learning
      disabled children.

PMID- 8487516
TI  - Hearing loss, speech, and hearing aids.
AB  - Modern hearing aids permit adjustment of a number of electroacoustic parameters,
      among them frequency response, saturation sound pressure level, and various
      aspects of compression. Relatively little is known, however, about how the
      electroacoustic characteristics of hearing aids affect the information-bearing
      properties of speech. Even less is known about how hearing aids might alleviate
      or exacerbate the effects of impaired hearing. This article reviews current
      knowledge in three areas: (a) characteristics of mild/moderate hearing loss, (b)
      information-bearing aspects of speech, and (c) the relation between
      electroacoustic characteristics of hearing aids and the speech signal. Concluding
      suggestions are made regarding the implications of the current data for selecting
      hearing-aid characteristics.

PMID- 8487517
TI  - Speech production changes under fluency-evoking conditions in nonstuttering
      speakers.
AB  - Changes in airflow and intraoral pressure between baseline and four fluency
      evoking conditions--choral reading (CR), metronome pacing (MET), delayed auditory
      feedback (DAF), and masking noise (NOISE)--were studied in 12 American English
      nonstuttering speakers. The duration, amplitude, and velocity of airflow and
      intraoral pressure development during the initial plosive and the duration and
      intensity of the following vowel were measured in eight target CVC words. Speech
      rate was computed for each sentence. Comparisons between baseline and the
      corresponding production in each condition revealed significant changes in peak
      flow, pressure rise time, peak instantaneous pressure velocity, speech rate,
      intensity, and vowel duration. Vowel duration increased under DAF, MET, and NOISE
      conditions. Peak pressure and pressure velocity decreased during CR and MET and
      increased during NOISE, but did not change during DAF. Subjects were consistent
      in the variables they modified across conditions. Changes in the aerodynamic
      variables were not related to intensity or rate changes. Thus, nonstuttering
      speakers modify intraoral pressure and flow under fluency-evoking conditions.

PMID- 8487518
TI  - A cepstrum-based technique for determining a harmonics-to-noise ratio in speech
      signals.
AB  - A new method to calculate a spectral harmonics-to-noise ratio (HNR) in speech
      signals is presented. The method involves discrimination between harmonic and
      noise energy in the magnitude spectrum by means of a comb-liftering operation in
      the cepstrum domain. Sensitivity of HNR to (a) additive noise and (b) jitter was
      tested with synthetic vowel-like signals, generated at 10 fundamental
      frequencies. All jitter and noise signals were analyzed at three window lengths
      in order to investigate the effect of the length of the analysis frame on the
      estimated HNR values. Results of a multiple linear regression analysis with noise
      or jitter, F0, and window length as predictors for HNR indicate a major effect of
      both noise and jitter on HNR, in that HNR decreases almost linearly with
      increasing noise levels or increasing jitter. The influence of F0 and window
      length on HNR is small for the jittered signals, but HNR increases considerably
      with increasing F0 or window length for the noise signals. We conclude that the
      method seems to be a valid technique for determining the amount of spectral
      noise, because it is almost linearly sensitive to both noise and jitter for a
      large part of the noise or jitter continuum. The strong negative relation between
      HNR and jitter illustrates that spectral noise measures cannot simply be taken as
      indicators of the actual amount of noise in the time signal. Instead, HNR
      integrates several aspects of the acoustic stability of the signal. As such, HNR
      may be a useful parameter in the analysis of voice quality, although it cannot be
      directly interpreted in terms of underlying glottal events or perceptual
      characteristics.

PMID- 8487519
TI  - Speech and swallowing function after anterior tongue and floor of mouth resection
      with distal flap reconstruction.
AB  - The purpose of this study was to assess the postoperative functioning of oral
      cancer patients with resections of the anterior tongue and floor of mouth,
      reconstructed with distal flap closure. Speech and swallowing performance was
      assessed for 11 men and 5 women preoperatively and at 1 and 3 months
      postoperatively following a standardized protocol. Speech tasks included an audio
      recording of a brief conversation and of a standard articulation test; swallowing
      function was examined using videofluoroscopy. Data were also collected on the
      number and duration of speech/swallowing treatment sessions, as well as the
      amount and duration of radiation therapy. Statistical analyses revealed that
      patients demonstrated a significant and severe impairment in speech and swallow
      functioning after surgery, with no recovery of function by 3 months post-healing.
      The degree of impairment in these patients may be related to the adynamic
      character of the distal flap used for reconstruction. Lack of improvement at the
      3-month evaluation may be related to either the timing of postoperative radiation
      therapy or the low rate (44%) and amount of speech/swallowing treatment provided
      to these patients.

PMID- 8487520
TI  - Role of visual feedback treatment for defective /s/ sounds in patients with cleft
      palate.
AB  - The role of visual feedback in the treatment of defective /s/ sounds in patients
      with cleft palate is described. Six patients with cleft palate who were similar
      in age, velopharyngeal function, and type of misarticulation were selected for
      this study. Treatment was provided using either visual feedback or no visual
      feedback. Visual feedback for tongue placement was provided by the Rion
      Electropalatograph (EPG). Visual feedback for frication was provided by a multi
      function speech training aid (MFSTA). Improvement in /s/ sound production was
      assessed objectively using a method described previously (Michi et al., 1986).
      The results indicated that visual feedback for tongue placement and frication was
      especially useful in the treatment of defective /s/ sounds in patients with cleft
      palate who exhibited abnormal posterior tongue posturing during the production of
      dental or alveolar sounds.

PMID- 8487521
TI  - Differences between stutterers' and nonstutterers' short-term recall and
      recognition performance.
AB  - Longer rehearsal times presumably reduce the efficiency of rehearsal and, hence,
      of short-term recall. The present experiment examined the question as to whether
      the slower subvocalization rate of people who stutter is correlated with inferior
      short-term serial recall and recognition performance. Rate of overt articulation
      was taken as a measure of rehearsal time. Lists of four nonlexical CVC syllables
      were presented for short-term serial recall and for short-term recognition.
      Nineteen adults who stutter and 30 nonstutterers participated in the experiment.
      In the serial reproduction task the subjects who stuttered reproduced
      significantly fewer items correctly than did nonstutterers. Recognition
      performance was measured by nonparametric measures of sensitivity and bias as
      defined in signal detection theory. The stuttering subjects had a significantly
      lower sensitivity resulting primarily from a higher false alarm rate. Rate of
      overt articulation was significantly related to one measure of short-term recall
      but not to the sensitivity of recognition. These results were interpreted as
      suggesting that people who stutter have slower phonological encoding and
      rehearsal times, that they make less use of nonphonological forms of coding than
      do nonstutterers, and that within their phonological system, activation more
      easily spills over to similar items.

PMID- 8487522
TI  - Speech breathing in Parkinson's disease.
AB  - Breathing was investigated in 14 male subjects with Parkinson's disease and 14
      healthy male control subjects. Kinematic, spirometric, acoustic, and pressure
      data were used to assess function during resting tidal breathing, reading aloud,
      and monologue production. Data were collected at two times during the drug cycle
      for subjects with Parkinson's disease. During resting tidal breathing, subjects
      with Parkinson's disease, on average, had a faster breathing rate, greater minute
      ventilation, and smaller relative contribution of the rib cage to lung volume
      change than did healthy control subjects. During speech breathing, rib cage
      volume was smaller and abdominal volume was larger at initiation of the breath
      groups for subjects with Parkinson's disease than for healthy control subjects.
      Subjects with Parkinson's disease produced fewer words and spent less time
      producing speech per breath group and tended to have a faster interpause speech
      rate than did healthy control subjects. There was no difference between groups
      for duration of inspirations between speech breath groups. Oral pressure was
      lower for subjects with Parkinson's disease but estimated tracheal pressure did
      not differ between the two subject groups. Few differences were found between the
      two times in the drug cycle for resting and speech breathing. Results provide
      indirect evidence for reduced relative compliance of the rib cage to the abdomen
      for subjects with Parkinson's disease as compared to healthy control subjects. In
      addition, the results support the possibility of inadequate valving of the air
      stream for subjects with Parkinson's disease.

PMID- 8487523
TI  - Communication behaviors of infants with hearing loss and their hearing mothers.
AB  - This study documented communication behaviors of hearing mothers and infants with
      a hearing loss that had been identified before 9 months of age (Group HL). Their
      behaviors were compared with those of mothers and infants without hearing loss
      (Group H). Each group was composed of 18 dyads videotaped during mother-infant
      play with toys at 12- and 18-months. Group HL mothers produced more gestural and
      tactile communications (but similar numbers of vocal communications) compared to
      H mothers. In contrast with earlier reports, infants with and without hearing
      loss were similar in quantity of gestural and vocal expressive prelinguistic
      communication behaviors. Despite group similarities in quantity of prelinguistic
      communications, H infants as a group surpassed HL infants in expression of formal
      language by 18 months. There was considerable variation within each group in
      formal language expression, however, with performance of some HL infants matching
      that of H infants.

PMID- 8487524
TI  - Access behaviors of children with specific language impairment.
AB  - The verbal and nonverbal behaviors used by 5 children with specific language
      impairment (SLI) to attempt to gain access into established interactions were
      described and compared with those of chronological-age-mates and language-similar
      control subjects. Three of the children with SLI were unsuccessful. Two of the
      children with SLI achieved access but did so without using linguistic forms like
      those most normal-language children use. All of the children with normal language
      accessed, and most did so quickly and easily using an orderly and sequential set
      of indirect behaviors. The findings contribute to social-linguistic
      characterizations of SLI and clarify specific aspects of access described in the
      normal-language literature.

PMID- 8487525
TI  - A system for quantifying the informativeness and efficiency of the connected
      speech of adults with aphasia.
AB  - A standardized rule-based scoring system, the Correct Information Unit (CIU)
      analysis, was used to evaluate the informativeness and efficiency of the
      connected speech of 20 non-brain-damaged adults and 20 adults with aphasia in
      response to 10 elicitation stimuli. The interjudge reliability of the scoring
      system proved to be high, as did the session-to-session stability of performance
      on measures. There was a significant difference between the non-brain-damaged and
      aphasic speakers on each of the five measures derived from CIU and word counts.
      However, the three calculated measures (words per minute, percent CIUs, and CIUs
      per minute) more dependably separated aphasic from non-brain-damaged speakers on
      an individual basis than the two counts (number of words and number of CIUs).

PMID- 8487526
TI  - Temporal analysis in children.
AB  - This study investigated the development of temporal resolution as a function of
      frequency region using a modified masking period pattern paradigm. This paradigm
      also allowed age-dependent comparisons of within-channel (temporal resolution)
      versus across-channel (comodulation masking release [CMR]) processing of temporal
      information to be made in the same listeners. The results indicated that temporal
      resolution improves with age. At low frequencies, this improvement continues
      beyond 10 years of age, whereas at high frequencies performance approaches adult
      levels by about age 6. Although it is reasonable to expect an association between
      CMR and temporal acuity, the measure of CMR did not show a significant age
      effect. The possibility was raised that the poorer temporal resolution of
      children may not reflect simply a deficiency in peripheral processing of temporal
      information.

PMID- 8487527
TI  - Loudness matching of signals spectrally shaped by a simulated hearing aid.
AB  - A hearing aid with multiple frequency responses was simulated by programming an
      equalizer to produce spectral tilt factors of -6, 0, and +6 dB/octave over the
      frequency range from 0.25 kHz to 4 kHz. Listeners with normal hearing matched the
      loudness of signals (speech and white noise) that were shaped by these different
      equalizer settings and delivered via an insert earphone. All signals with spectra
      that were tilted, either negatively or positively, were perceived as louder than
      untilted signals. The general pattern of loudness matching was similar across
      subjects, and intrasubject judgments were found to be highly transitive. A
      measure of signal power was found to account only moderately well for the
      individual data. Preliminary evidence from a follow-up study using tilt factors
      less severe than those used in the main experiment suggests that loudness
      differences are roughly proportional to the degree of spectral tilt. The
      incorporation of level corrections approximating those necessary to achieve equal
      loudness is recommended in the fitting of programmable hearing aids.

PMID- 8487528
TI  - Temporary threshold shift caused by hearing aid use.
AB  - Temporary threshold shift (TTS) over a wide range of frequencies was found after
      4 hours of hearing aid use by a 15-year-old student with severe sensorineural
      hearing loss who was using real-ear insertion gains 10 to 20 dB greater than
      those recommended by the current National Acoustic Laboratories (NAL) procedure
      for selecting the gain and frequency response of hearing aids. Measurements were
      made of her noise exposure during hearing aid use with a noise dosimeter. The
      real-ear insertion response and input-output function of her hearing aid were
      measured with a real-ear gain analyzer and were used to calculate in-ear noise
      levels from the noise levels measured by the dosimeter. The amount of TTS could
      be predicted from the in-ear noise levels and the student's hearing levels (HLs)
      by means of a mathematical model consisting of the Modified Power Law (MPL) of
      Humes and Jesteadt (1991) combined with equations for predicting TTS in listeners
      with normal hearing published by Mills, Gilbert, and Adkins (1979). The mean of
      the instantaneous A-weighted in-ear noise levels proved to be the appropriate
      equivalent continuous level (ECL) for use in the predictions. The MPL was also
      used to determine safety limits for TTS due to hearing aid use. The observed TTS
      exceeded the safety limits at all frequencies up to and including 2000 Hz. It was
      therefore considered desirable for the girl to use less gain at frequencies from
      500 to 1500 Hz.

PMID- 8487529
TI  - Importance of patient and processor variables in determining outcomes with
      cochlear implants.
AB  - Within-subjects comparisons of processing strategies for cochlear implants are
      reviewed. Compressed analog strategies were compared to interleaved pulses
      strategies in tests with one group of 8 subjects, and to continuous interleaved
      sampling strategies in tests with another group of 11 subjects. The tests
      included open-set recognition of words and sentences. The results show that,
      while different strategies may produce quite different outcomes across subjects,
      individual performances with one processing strategy are significantly correlated
      with those of alternative strategies. These findings emphasize the importance of
      patient variables in determining outcomes across a variety of prosthesis designs.

PMID- 8487530
TI  - Auditory processing in children's speech perception: results of selective
      adaptation and discrimination tasks.
AB  - Five- to six-year-old children and adults participated in discrimination and
      selective adaptation speech perception tasks using a synthetic consonant-vowel
      continuum ranging from [ba] to [da]. In one condition of selective adaptation,
      attention was focused on the adapting stimulus, the continuum-endpoint [ba], with
      a whispering task. In another condition, attention was focused away from the
      continuum-endpoint [da] adaptor to contralaterally presented syllables "SHE" and
      "SEE." Results, compared with two more typical adaptation conditions, indicated
      that focused attention did not augment selective adaptation effects, particularly
      for children who showed smaller effects with focused attention on the adaptor. In
      contrast to adults, children did not significantly change labeling responses
      after exposure to endpoint-[ba] adaptors, results matching those of Sussman and
      Carney (1989). However, children did significantly change labeling following
      exposure to endpoint-[da] adaptors. Discrimination findings with five-formant
      consonant-vowel and single-formant stimuli supported the importance of acoustic
      processing for the selective adaptation tasks performed. Together, results
      support hypotheses of sensory processing differences in younger, normally
      developing children compared with adults and show that such abilities appear to
      be related to speech perception skills.

PMID- 8487531
TI  - Influence of frequency selectivity on comodulation masking release in normal
      hearing listeners.
AB  - Experiments 1 and 2 investigated the effect of frequency selectivity on
      comodulation masking release (CMR) in normal-hearing subjects, examining
      conditions where frequency selectivity was relatively good (low masker level at
      both low [500-Hz] and high [2500-Hz] signal frequency, and high masker level at
      low signal frequency) and where frequency selectivity was somewhat degraded (high
      masker level and high signal frequency). The first experiment investigated CMR in
      conditions where a narrow modulated noise band was centered on the signal
      frequency, and a wider comodulated noise band was located below the band centered
      on the signal frequency. Signal frequencies were 500 and 2000 Hz. The masker
      level and the frequency separation between the on-signal and comodulated flanking
      band were varied. In addition to conditions where the flanking band and on-signal
      band were presented at the same spectrum level, conditions were included where
      the spectrum level of the flanking band was 10-dB higher than that of the on
      signal band, in order to accentuate effects of reduced frequency selectivity.
      Results indicated that CMR was reduced at the 2000-Hz region when masker level
      was high, when the frequency separation between on-signal and flanking band was
      small, and when a 10-dB level disparity existed between the on-signal and
      flanking band. In the second experiment, CMR was investigated for narrow
      comodulated noise bands, presented either without any additional sound or in the
      presence of a random noise background. CMR increased slightly as the masker level
      increased, except at 2500 Hz when the noise background was present. The decrease
      in CMR at 2500 Hz with the high masker level and with a noise background present
      could be explained in terms of reduced frequency selectivity. In a third
      experiment, we compared performance for equal absolute bandwidth maskers at a low
      (500-Hz) and a high (2000-Hz) stimulus frequency. Results here suggested that
      detection in modulated noise may be reduced due to a reduction in the number of
      quasi-independent auditory filters contributing temporal envelope information.
      The effects found in the present study using normal-hearing listeners under
      conditions of degraded frequency selectivity may be useful in understanding part
      of the reduction of CMR that occurs in cochlear-impaired listeners having reduced
      frequency selectivity.

PMID- 8487532
TI  - Tracking of "moving" fused auditory images by children.
AB  - Recent investigations (Cranford, Boose, & Moore, 1990a,b; Moore, Cranford, &
      Rahn, 1990) studied the ability of normal adult subjects to localize sounds under
      conditions that elicit the Precedence Effect. In different tests, subjects were
      required either to report the perceived location of a stationary fused auditory
      image (FAI) or track the apparent motion of a "moving" FAI. Movement of the FAI
      was simulated by incrementally varying the delay between pairs of clicks
      presented, one each, from two matched loudspeakers placed on opposite sides of
      the listener. In the present study, groups of normally developing children,
      ranging in age from 6 to 12 years of age, were tested with these two procedures.
      Although subjects performed at normal adult levels with the stationary FAI test,
      a significant age-related trend was observed with the moving FAI test. The
      younger children exhibited poorer tracking performances than did the older
      children. These results provide evidence that significant changes in binaural
      temporal processing abilities may occur in the early childhood years.

PMID- 8487533
TI  - Benefit from visual cues in auditory-visual speech recognition by middle-aged and
      elderly persons.
AB  - The benefit derived from visual cues in auditory-visual speech recognition and
      patterns of auditory and visual consonant confusions were compared for 20 middle
      aged and 20 elderly men who were moderately to severely hearing impaired.
      Consonant-vowel nonsense syllables and CID sentences were presented to the
      subjects under auditory-only, visual-only, and auditory-visual test conditions.
      Benefit was defined as the difference between the scores in the auditory-only and
      auditory-visual conditions. The results revealed that the middle-aged and elderly
      subjects obtained similar benefit from visual cues in auditory-visual speech
      recognition. Further, patterns of consonant confusions were similar for the two
      groups.

PMID- 8487534
TI  - Influences of age and hearing loss on the precedence effect in sound
      localization.
AB  - Cranford, Boose, & Moore (1990a) reported that many elderly persons exhibit
      problems in perceiving the apparent location of fused auditory images in a sound
      localization task involving the Precedence Effect (PE). In the earlier study,
      differences in peripheral hearing sensitivity between young and elderly subjects
      were not controlled. In the present study, four groups of young and elderly
      subjects, matched with respect to age and the presence or absence of
      sensorineural hearing loss, were examined to determine the effects of these two
      factors on performance with the PE task. Although significantly poorer
      performances on the PE task were found to be associated with both increased age
      and hearing loss, additional tentative evidence was obtained that the presence of
      hearing loss may have a relatively greater detrimental effect on the performance
      of at least some elderly subjects than it does on younger persons.

PMID- 8487535
TI  - Auditory detection of the human brainstem auditory evoked response.
AB  - The human brainstem auditory evoked response (BAER) is a far-field electrical
      potential recorded from the scalp in response to transient acoustic stimuli.
      Typically, voltage measurements are obtained for a period of about 10 msec
      following the acoustic stimulus, which is repeated and summed several hundred or
      thousand times to permit extraction of the response from ongoing nonauditory
      neural activity. The judgment about whether a response has been obtained is
      normally based on the pattern observed in a visual display of the waveform. In
      this study, we investigated whether listeners can distinguish BAERs elicited by
      acoustic clicks from control waveforms obtained with no acoustic stimulus when
      the waveforms were presented auditorily. For this purpose, BAER and control
      waveforms were transduced by an earphone and used in an auditory detection task.
      Several presentation strategies were examined, including lengthening the waveform
      by playing it at a lower sampling rate, playing the waveform repetitively, and
      using the waveform to frequency modulate a pure-tone carrier. The results
      indicated that the BAER, when extended in duration and used to frequency modulate
      a 1000-Hz pure tone, was highly detectable in a YES-NO paradigm for BAERs
      elicited with high-level (e.g., 70 dB re. behavioral detection threshold)
      acoustic clicks. Performance declined to near chance as the level of the BAER
      eliciting stimulus was lowered to 10 dB. In general, detection performance for
      stimuli presented visually was slightly, but consistently, superior to that which
      occurred for stimuli presented auditorily.

PMID- 8487536
TI  - The prevention of prenatal alcohol use: a critical analysis of intervention
      studies.
AB  - Alcohol is a major cause of birth defects and mental retardation in the U.S. The
      yearly cost to care for those affected has been estimated to be over $300
      million. Prenatal education and counseling have been advocated as techniques to
      reduce alcohol use in pregnancy. The purpose of this study was to critically
      review investigations that used these methods in order to determine their
      effectiveness. Reports of relevant studies were found by searching Medline, the
      ETOH database and bibliographies of primary sources. Only five studies were
      identified that met predetermined selection criteria. As judged by usual
      methodologic standards for intervention programs, only one was of acceptable
      quality. None employed a randomized design, and only two compared the treatment
      group to a control group. Both these studies found no difference in alcohol use
      between control and intervention groups. An ethical argument was used by several
      authors to justify performing inadequately controlled studies. Since no
      intervention has proven to be superior to the usual care delivered to pregnant
      women, this problem can be overcome through the use of controls who receive this
      level of care. Despite the public health importance of prenatal alcohol use,
      interventions to alter this behavior have not been rigorously evaluated, and the
      benefits of any specific approach are unclear. Randomized trials are ethically
      justified and guidelines for undertaking such studies are proposed.

PMID- 8487537
TI  - Spirituality and purpose in life in alcoholism recovery.
AB  - This study examines the relationship between spirituality and recovery from
      alcoholism. Spirituality was defined as the extent of practice of Alcoholics
      Anonymous Steps 11 and 12 and was measured by a Step Questionnaire developed by
      the researcher. Step 11 suggests prayer and meditation and Step 12 suggests
      assistance of other alcoholics. Expressed degree of purpose  in life was also
      seen as a reflection of spirituality. It was postulated that the extent to which
      Steps 11 and 12 were practiced would be positively correlated with the extent of
      purpose in life reported by 100 Alcoholics Anonymous members. The major findings
      of this study are significant positive correlations between practice of Step 11
      and purpose in life scores (r = .59, p < .001) and between Step 11 and length of
      sobriety (r = .25, p < .01). Number of Alcoholics Anonymous meetings attended was
      significantly correlated with purpose in life scores (r = .24, p < .01) and
      length of sobriety (r = .25, p < .01). These findings suggest that a sense of
      purpose in life increases with continuing sobriety and practice of the spiritual
      principles of Alcoholics Anonymous.

PMID- 8487538
TI  - The external costs of alcohol abuse.
AB  - This study reviews the economic concepts of external and private costs and
      interprets them in the context of alcohol abuse. Previous economic cost studies
      by NIAAA are found inadequate in that they fail to differentiate between external
      and private costs. This study differentiates between external and private costs.
      This study finds that the external costs of alcohol abuse in 1985 were $9.5
      billion with an additional $4.5 billion in government incurred costs. Policy
      implications of this finding are discussed.

PMID- 8487539
TI  - Prediction of alcohol-related casualties in the emergency room: a U.S.-Spain
      comparison.
AB  - Alcohol consumption variables predictive of casualties are compared in
      probability samples of emergency room (ER) patients in two countries with
      different drinking patterns; (1) Spain, where frequent light drinking is the
      typical pattern (N = 2,072), and (2) the U.S. (i.e., California), where less
      frequent heavier drinking is more typical (N = 1,756). Logistic regression was
      used to evaluate the predictive value of breath-analyzer readings, drinking
      patterns and problems, time and place of injury, and demographic characteristics
      on ER admission for injuries vs noninjuries and for alcohol-related injuries vs
      non-alcohol-related injuries. Quantity and frequency of drinking, time and place
      of injury, and feeling drunk at the time of the event were predictive of
      casualties in California. Drinking patterns were less predictive of injury
      occurrence and of alcohol-related injury in Spain. One possible explanation for
      this difference may be that drinking is integrated into society as part of the
      wine drinking culture in Spain, while in the U.S. drinking occasions are more
      circumscribed by appropriateness of time and place.

PMID- 8487540
TI  - Perception of male drinkers as a function of their alcoholic beverage preference.
AB  - The present study examined perception of a man's likelihood of driving after
      drinking and his ability to do so as a function of his choice of beverage.
      Perceptions of his social characteristics were also examined. The sample was
      composed of 200 volunteer undergraduate psychology students. Equal numbers of
      male and female subjects read one of four vignettes which varied only in the male
      protagonist's choice of beverage: beer, wine, shots of distilled spirits, or
      cola. After reading the story, subjects answered multiple-choice questions about
      the character, tapping social judgments, situational judgments and drinking and
      driving judgments. Subject drinking habits were also assessed. The most notable
      result was the consistently positive perception of the protagonist portrayed as
      an abstainer. The lack of a consistent alcoholic beverage distinction implies
      that the beer-spirits double standard is far from a clear-cut discrimination.
      Possible explanations for results are discussed. This study questions the
      robustness of the alcoholic beverage type bias and reflects the need for future
      research.

PMID- 8487541
TI  - Alcohol availability, drinking contexts and drinking problems: the Iowa
      experience.
AB  - Before/after survey data were used to investigate the effects that a wine and
      spirits privatization-induced increase in alcohol availability might have had on
      drinking contexts and, in turn, what effect any context changes might have had on
      specific drinking-related troubles. State surveys representing the aged 18+
      noninstitutionalized population of Iowa were conducted in 1985, prior to the wine
      privatization; in 1986, after the wine privatization but before the spirits
      privatization; and in 1989, after both wine and spirits sales had been
      privatized. Despite substantial increases in the number of off-premise outlets
      for bottled wine and spirits following their privatizations, there was little or
      no change in the frequency of drinking in several different contexts or in the
      specific kinds of drinking-related problems studied.

PMID- 8487542
TI  - The stress and negative affect model of adolescent alcohol use and the moderating
      effects of behavioral undercontrol.
AB  - Empirical evidence for the stress and negative affect model of adolescent alcohol
      use has been inconsistent. We hypothesized that this inconsistent support was
      partially due to a third variable that moderates the model's effects. The current
      study assessed behavioral undercontrol as a moderator of the stress and negative
      affect model of adolescent alcohol use. Using a community-based sample of
      adolescent children of alcoholics (COAs) and a demographically matched comparison
      group (non-COAs), life stress, negative affect, behavioral undercontrol and
      alcohol use were assessed. Results showed that the stress and negative affect
      model predicted alcohol use. Consistent with theoretical predictions and previous
      research, negative affect partially mediated the relation between stress and
      alcohol use. However, behavioral undercontrol did not moderate the effects of
      stress and negative affect for COAs and non-COAs. Theoretical and methodological
      implications of the findings are discussed.

PMID- 8487543
TI  - Validity and reliability of self-reported drinking behavior: dealing with the
      problem of response bias.
AB  - This work assesses the validity and reliability of self-reported survey data on
      drinking behavior. There is evidence to suggest that data are adversely affected
      by bias from underreporting. This bias affects the validity of measures of
      consumption of alcohol and can have deleterious effects on the results of some
      forms of statistical estimation. Data for this study were collected at an
      isolated military base. The remoteness of this site and the fact that it is a
      military station made it possible to estimate the actual level of consumption of
      alcohol for the population by assessing apparent consumption through officially
      recorded sales of alcohol. The results of eight measures of consumption of
      alcohol were compared with apparent consumption, as established by documented
      sales, and the validity and reliability of the various measures were determined
      using the classical correlational approach. The validity and reliability of the
      data generated by the self-report survey were also analyzed using LISREL, the
      measurement model in particular. The results indicate that various instruments
      used to assess the consumption of alcohol produce very different outcomes in
      terms of their validity and reliability, some questions being considerably more
      valid and reliable than others. Two of the more salient characteristics of
      questions that affect validity and reliability were isolated, namely a question's
      ability to aid recall and its ability to mitigate the effects of persons
      providing socially desirable responses. The LISREL results show that these are
      two underlying factors for the measurement of the consumption of alcohol. It is
      concluded that questions that produce valid and reliable responses do so for
      identifiable reasons, and measurement instruments can be improved by
      incorporating particular features.

PMID- 8487544
TI  - Assessment of prepubertal and postpubertal boys and girls at risk for developing
      alcoholism with P300 from a visual discrimination task.
AB  - A total of 86 children (45 male) between the ages of 8-18 who were from families
      that were either at high- or low-risk for developing alcoholism were evaluated in
      a visual event-related potential paradigm. The children responded to two target
      conditions (hard and easy) and a blank condition by pressing an appropriate
      button. P300 amplitude was reduced in prepubescent boys who were at high-risk for
      developing alcoholism. Reaction time data for type of target indicated that,
      while latency was longer for the hard condition compared to the easy one, no
      significant differences by risk status were found. Performance accuracy did not
      differ by group status. These behavioral findings suggest that P300 amplitude is
      an electrophysiological marker of alcoholism risk in young boys.

PMID- 8487545
TI  - Reactivity to alcohol-related cues in heavy and light drinkers.
AB  - Physiological responses and self-reported desire for alcohol were compared in
      heavy (n = 21) and light (n = 29) drinkers under each of two cue conditions. The
      cues were presented in a counterbalanced order and consisted of the sight, smell
      and taste of the subject's preferred alcoholic beverage (alcohol cue) and of a
      nonalcoholic lemon-flavored drink (neutral cue). Heavy drinkers showed a
      significant linear increase in reported desire for alcohol over time in the
      presence of the alcohol cue. This persistent increase in desire for alcohol seen
      in heavy drinkers contrasted with the initial increase shown by light drinkers
      which dissipated over time. Neither group showed any significant change in desire
      for alcohol when presented with the neutral cue. Heavy drinkers showed lower
      levels of skin conductance than light drinkers and all subjects showed changes in
      heart rate during exposure to both cues. Heart rate was affected differentially
      in the two groups of drinkers but only when the alcohol cue was presented first.
      Neither blood pressure nor stress and arousal levels changed significantly from
      pre- to post-cue presentations. The findings of this study have implications for
      understanding the nature and time course of cue-elicited desire for alcohol and
      its potential role in the development and treatment of alcohol dependence.

PMID- 8487546
TI  - Acute effects of alcohol on regional cerebral blood flow in man.
AB  - Acute effects of alcohol in a low (0.7 g/kg) and a high dose (1.5 g/kg) on
      regional cerebral blood flow (rCBF) were measured with 133Xe inhalation technique
      at resting conditions in 13 normals. Mean hemisphere CBF increased globally by
      12% at the lower dose and 16% at the higher dose. A normal hyperfrontal flow
      pattern was seen in both alcohol conditions. There were, however, significant
      regional differences in response to alcohol. The largest rCBF increase was
      observed in prefrontal regions at the lower dose, and in temporal regions at the
      higher. Expressed in relative values (% of the whole brain CBF), the temporal
      rCBF increased linearly with increasing alcohol dosage, while the prefrontal rCBF
      showed a increase at the lower dose followed by a decrease at the higher dose. It
      is concluded that alcohol has two types of acute effects on rCBF, a global
      vasodilatory effect and some regional effects, most clearly seen in prefrontal
      and temporal regions. The prefrontal flow augmentation following acute alcohol
      intake may be related to a transient arousal reaction, which has been reported by
      others. The temporal flow increase may be related to effects of alcohol on
      emotions and mood.

PMID- 8487547
TI  - Frontiers in HIV pathogenesis. March 29-April 4, 1993, Albuquerque, New Mexico.
      22nd annual Keystone symposia. Abstracts.

PMID- 8487548
TI  - Progress in basic research of wound repair and its application to clinical
      management of problematic wounds. 22nd annual Keystone symposia. March 29-April
      4, 1993, Breckenridge, Colorado. Abstracts.

PMID- 8487549
TI  - Extracellular matrix in development and disease. 22nd annual Keystone symposia.
      March 29-April 4, 1993. Breckenridge, Colorado. Abstracts.

PMID- 8487550
TI  - Genetically targeted research and therapeutics: antisense and gene therapy. 22nd
      annual Keystone symposia. April 12-18, 1993, Keystone, Colorado. Abstracts.

PMID- 8487551
TI  - Gene therapy. 22nd annual Keystone symposia. April 12-18, 1993, Keystone,
      Colorado. Abstracts.

PMID- 8487552
TI  - B and T cell lymphomas. 22nd annual Keystone symposia. April 17-23, 1993, Copper
      Mountain, Colorado. Abstracts.

PMID- 8487553
TI  - Bacterial chromosomes. 22nd annual Keystone symposia. April 18-25, 1993,
      Keystone, Colorado. Abstracts.

PMID- 8487554
TI  - HIV pathogenesis in infants and children. 22nd annual Keystone symposia. March 29
      April 2, 1993, Albuquerque, New Mexico. Abstracts.

PMID- 8487555
TI  - In memoriam Nina S. Braunwald (1928-1992).

PMID- 8487556
TI  - Time course of dimension and function of the autologous pulmonary root in the
      aortic position.
AB  - Although the autologous, fully vital, and compatible pulmonary root theoretically
      offers the prospect of an ideal aortic valve substitute, this type of replacement
      is performed in only a few centers. Major concern relates to the fate of root
      dimension and function in the systemic circulation and is largely unknown. To
      investigate the fate of the aortic root, we conducted echocardiographic
      examinations of eight freestanding pulmonary roots used for aortic valve
      replacement in adults. The studies were performed at discharge from the hospital
      and up to 21 months (mean 12.5 +/- 6.6 months) after the operation, as well as in
      26 matched control subjects. There were no significant differences between the
      first and second postoperative studies regarding the root diameter (mean 26.6 +/-
      2.1 mm and 27.6 +/- 2.6 mm, respectively), which was within control limits, the
      maximum transvalvular pressure gradient (mean 4.6 +/- 1.2 mm Hg and 6.6 +/- 2.1
      mm Hg, respectively), the maximum leaflet separation (mean 22.1 +/- 1.4 mm and
      22.1 +/- 1.8 mm, respectively), and the degree of insufficiency. At the first
      study, grade I aortic regurgitation was found in four patients and grade I-II in
      one patient. Regurgitation increased slightly in one patient with an abnormal
      leaflet. In three patients primary grade I regurgitation disappeared. These data
      suggest that the pulmonary root in the aortic position can withstand systemic
      circulation without changes in dimension and function for up to 21 months.
      Furthermore, some evidence is provided to indicate that in certain cases the
      viable autograft may adapt to systemic pressure, as indicated by the
      disappearance of primary regurgitation.

PMID- 8487557
TI  - Surgical repair of type A aortic dissection by the circulatory arrest-graft
      inclusion technique in sixty-six patients.
AB  - During an 8-year period (1984 to 1991) 66 patients (mean age 59 years, range 26
      to 84 years) with type A aortic dissection (60 ascending aorta tears, 6 arch
      tears; 35 acute, 31 chronic) had surgical repair by a continuous suture-graft
      inclusion technique. Hypothermic circulatory arrest (16 degrees C) was used in 58
      patients (35/35 acute, 23/31 chronic; mean arrest time 26 minutes, range 10 to 55
      minutes). Fifty-two patients had hemiarch repair and 6 had total arch
      replacement. Aortic valve disease necessitated treatment in 38 patients (1 valved
      conduit, 20 valve replacements, 17 valve repairs). Recently 11 patients had valve
      repair by reconstruction of the native aortic root, by means of techniques
      similar to those used for homograft valve insertion. Operative mortality was 9%
      (14% acute, 3% chronic). Stroke occurred in 2 patients (3%) and was fatal in
      both. Variables suggestive of increased operative risk by univariate analysis
      were acuteness (p = 0.12), visceral ischemia (p = 0.12), and preoperative shock
      (p = 0.13). No variable was significant by multivariate analysis. Overall
      actuarial survival at 48 months was 77%, with 3 late deaths from a ruptured
      distal aneurysm. Late computed tomography or magnetic resonance imaging scan was
      done in 28 patients at a mean interval of 33 months. These studies identified 1
      patient with a pseudoaneurysm requiring reoperation and 3 patients with contained
      flow between the graft and the wrap. Three patients required late operation: 1
      for pseudoaneurysm, 1 for arch dissection, and 1 for repair of a distal aneurysm.

PMID- 8487558
TI  - Very small-diameter polyurethane vascular prostheses with rapid
      endothelialization for coronary artery bypass grafting.
AB  - Two types of spongy polyurethane-polydimethylsiloxane blend (Cardiothane 51,
      Kontron Instruments, Inc., Everett, Mass.) vascular grafts with an internal
      diameter of 1.5 mm were fabricated by a spray, phase-inversion technique. Low
      porosity grafts with hydraulic permeability of 2.7 +/- 0.4 ml/min per square
      centimeter and medium-porosity grafts with hydraulic permeability of 39 +/- 8
      ml/min per square centimeter displayed good handling properties and suturability.
      Twelve straight low-porosity grafts, 17 straight medium-porosity grafts (1.5 to
      2.0 cm in length), and one loop medium-porosity graft (10 cm in length) were
      implanted by the same surgeon end to end in the infrarenal aorta of 30 male
      Sprague-Dawley rats. Three months after implantation, patency was 8% for low
      porosity grafts (1/12) and 76% for straight medium-porosity grafts (13/17). The
      loop medium-porosity graft was also patent. The sole patent low-porosity graft
      showed neointimal hyperplasia and incomplete endothelialization. All but one of
      the patent straight medium-porosity grafts showed a glistening and transparent
      neointima with complete endothelialization and no anastomotic hyperplasia. The
      loop medium-porosity graft displayed endothelialization from each anastomosis and
      in many islands in the middle portion of the graft, totalling 47% of the luminal
      surface by morphometric analysis. Thick mural thrombus, anastomotic hyperplasia,
      or aneurysm formation were not observed in any patent medium-porosity graft.
      These data indicate that in the rat aortic replacement model it is possible to
      achieve patency and a high degree of endothelialization in very small-diameter
      prostheses of appropriate porosity.

PMID- 8487559
TI  - Acceleration of neointima formation in vascular prostheses by transplantation of
      autologous venous tissue fragments. Application to small-diameter grafts.
AB  - We have previously demonstrated rapid and complete endothelialization in
      synthetic fabric vascular prostheses that have been pretreated with autologous
      venous tissue fragments. However, significant thrombogenicity has been a major
      problem when this method has been applied to small-diameter grafts. By masking
      the positively charged collagen fibrils in the tissue fragments with negatively
      charged heparin, we were able to overcome this problem. A canine jugular vein was
      resected, minced into tissue fragments, and suspended. This mixture was sieved
      through the wall of a highly porous vascular prosthesis with a water porosity
      value of 4,000 ml/cm2 per minute by pressurized injection, which caused the
      tissue fragments to be trapped in the graft wall. Tissue-fragmented grafts (7 mm
      inside diameter, 5.7 cm long) were implanted into the thoracic aorta of 35 dogs.
      In addition, tissue-fragmented grafts of small diameter (4 mm inside diameter,
      3.5 cm long) were pretreated with heparin and implanted into the carotid arteries
      of 16 dogs (32 grafts). Preclotted grafts without tissue fragmentation were
      implanted into the thoracic aorta (25 dogs) and carotid arteries (6 dogs, 12
      grafts) as controls. Grafts were explanted from 1 to 495 days after implantation.
      New arterial wall formation was complete throughout the tissue-fragmented grafts
      within 2 weeks; however, in the control grafts, neointima formation was limited
      to the anastomotic sites even after 2 months. Twenty small-caliber tissue
      fragmented grafts that were pretreated with heparin in the carotid position were
      patent, but all the control grafts were occluded within 1 week. These results
      demonstrate that neointima formation can be enhanced in synthetic fabric
      prostheses; furthermore, long-term patency of vascular grafts of small caliber is
      possible in dogs with this tissue-fragmentation technique.

PMID- 8487560
TI  - Bless the babies: one hundred fifteen late survivors of heart transplantation
      during the first year of life. The Loma Linda University Pediatric Heart
      Transplant Group.
AB  - There is a rapid growth of interest in heart transplantation therapy during early
      infancy. From 10% to 25% of the infants who are listed for transplantation
      annually have died while awaiting a donor heart. There has been no significant
      trend in this variable. Since November 1985, 140 consecutive orthotopic
      transplantation procedures were performed in 139 infants who were from 3 hours to
      12 months of age. Indications for transplantation included hypoplastic left heart
      syndrome (63%), other complex structural anomalies (29%), myopathy (6.5%), and
      tumors (1.5%). Most recipients had ductus-dependent circulation and received
      continuous infusion of prostaglandin E1. Heart donors were usually victims of
      trauma, sudden infant death, or birth asphyxia. A donor-recipient weight ratio of
      4.0 or less was found to be acceptable. The amount of time the graft underwent
      cold ischemia, ranged from 64 to 576 minutes. The procurement process was
      facilitated by a single dose of cold crystalloid cardioplegic solution and cold
      immersion transport. Profound hypothermic circulatory arrest was used for graft
      implantation. One hundred twenty-four (89%) recipients survived transplantation
      and were discharged from the hospital. There were 9 late deaths, which resulted
      in an 83% overall survival. The 5-year actuarial survival is 80%. The survival
      among newborn recipients (n = 60) at 5 years is 84%. Chronic immunomodulation was
      cyclosporine-based and steroid-free. Surveillance was noninvasive and relied
      heavily on echocardiography, electrocardiography, and clinical intuition. There
      was one documented late lethal infection, tumor was not encountered, and coronary
      occlusive disease was known to exist in only one long-term survivor. We concluded
      that transplantation results in excellent life quality and is a highly effective
      and durable therapy when applied during early infancy.

PMID- 8487561
TI  - Inhibition of platelet function by heparin. An etiologic factor in postbypass
      hemorrhage.
AB  - The effect of heparin (5 U/ml) on platelet function was examined by
      hemostatometry in vitro. A wide individual variation of this effect was found in
      290 patients who underwent cardiac operations: 8.6% (25) experienced a
      proaggregatory effect, 58.6% (170) experienced a mild to moderate inhibition of
      platelet function, and 32.8% (95) experienced a severe inhibition. No significant
      difference was found among patient characteristics, including antiplatelet
      medication, in these three subgroups. In vitro measurements correlated
      significantly with ex vivo measurements, that is, from blood taken after
      heparinization (p < 0.0001; r = 0.97, n = 15). In 111 patients who underwent
      cardiac surgical intervention, a significant correlation (p < 0.0001; 0.4 < r <
      0.52) was found between preoperative measurements of the degree of inhibition of
      platelet function by heparin and the total postoperative blood loss after 4, 12,
      and 18 hours. Similarly, there was a significant difference (p < 0.0001) in the
      total blood loss at 4, 12, and 18 hours between the subgroups that showed, in
      vitro, a mild to moderate inhibition of platelet function preoperatively compared
      with a severe inhibition (713 +/- 43 ml versus 1172 +/- 76 ml at 18 hours). It is
      concluded that platelet inhibition as a result of heparin varies among patients
      and appears to be a previously unrecognized etiologic factor in bleeding after
      cardiopulmonary bypass.

PMID- 8487562
TI  - Ventricular function after normothermic versus hypothermic cardioplegia.
AB  - Warm cardioplegia produced by essentially continuous infusion has been used as an
      alternative to traditional cold intermittent infusion techniques during cardiac
      surgery, but its effects on postoperative left ventricular function have not been
      defined. We performed a randomized clinical trial to assess the effects of warm
      and cold blood cardioplegia on load-independent indices of ventricular function.
      Fifty-three patients were randomized to warm (n = 27) or cold (n = 26)
      cardioplegia. Myocardial oxygen consumption, lactate production, adenine
      nucleotides, and adenine nucleotide degradation products were measured during
      cardioplegia and reperfusion. In 13 patients per group, pressure-volume loops
      were constructed and ventricular function was assessed 3 hours after the
      operation. Warm cardioplegia resulted in greater myocardial lactate production
      but improved recovery of oxygen consumption during reperfusion. Depletion of
      adenosine triphosphate was similar between groups, but total adenine nucleotides
      (adenosine triphosphate + adenosine diphosphate + adenosine monophosphate) fell
      further during warm cardioplegia. Cold cardioplegia was associated with an
      accumulation of adenosine diphosphate and adenosine monophosphate. Creatine
      kinase MB isoenzyme release was reduced in the warm group. Three hours after the
      operation, end-systolic elastance and preload-recruitable stroke work index were
      increased after warm cardioplegia, and early diastolic relaxation was also
      increased. Increased systolic function after warm cardioplegia may have been
      related to improved myocardial protection, elevated arterial lactate
      concentrations, or increased circulating catecholamine levels. Altered diastolic
      compliance in the warm group may reflect greater active relaxation during early
      diastolic filling.

PMID- 8487563
TI  - The microvascular distribution of cardioplegic solution in the piglet heart.
      Retrograde versus antegrade delivery.
AB  - The uniform distribution of cardioplegic solution to all areas of the
      microvasculature is considered critical for myocardial protection. Despite this,
      little information exists regarding the ability of retrogradely infused
      cardioplegic solution to perfuse the microvasculature of the heart. In this
      report, the microvascular distribution of retrogradely delivered cardioplegic
      solution was studied by means of a technique to quantitatively demonstrate
      capillary perfusion. Duroc piglet hearts were subjected to either antegrade (n =
      4) or retrograde (n = 8) perfusion fixation with 2.5% glutaraldehyde and
      subsequently perfused with NTB-2 (an intracapillary marker). The results indicate
      that retrogradely delivered NTB-2 consistently perfused the anterior half of the
      intraventricular septum and the anterior and lateral free walls of the left
      ventricle but inconsistently perfused the posterior half of the intraventricular
      septum, the posterior wall of the left ventricle, and a small paraseptal region
      of the right ventricle. The remainder of the right ventricle was not perfused. In
      contradistinction, all regions of the heart were consistently perfused by the
      antegrade technique. In regions of the heart in which retrograde microvascular
      perfusion occurred, no statistical difference was found in the quantitative
      degree of capillary perfusion achieved by either the antegrade or retrograde
      technique. These results have important implications for planning strategies of
      myocardial protection and suggest that further investigation concerning the
      microvascular distribution of retrogradely delivered cardioplegic solution in
      human beings is merited.

PMID- 8487564
TI  - Retrograde versus antegrade delivery of cardioplegic solution in myocardial
      revascularization. A clinical trial in patients with three-vessel coronary artery
      disease who underwent myocardial revascularization with extensive use of the
      internal mammary artery.
AB  - The effects of retrograde and antegrade delivery of cardioplegic solution on
      myocardial function were evaluated and compared in 60 patients who underwent
      myocardial revascularization. All patients had three-vessel coronary artery
      disease, and the revascularization was done with extensive use of the internal
      mammary artery. Seventy-five percent of the distal anastomoses were performed
      with the internal mammary artery. Myocardial protection consisted of St. Thomas'
      Hospital cardioplegic solution, topical slushed ice, and systemic hypothermia (28
      degrees C). The patients were randomly separated into two groups: group A (n =
      30), who received antegrade cardioplegia, and group B (n = 30), who received
      retrograde cardioplegia. With the exception of the total dose of cardioplegic
      solution (p = 0.02), there was no significant difference between the two groups
      that concerned septal myocardial temperature at the moment of asystole and after
      infusion of the total dose of cardioplegic solution. Cardiac function was
      assessed before and after the patient was weaned from cardiopulmonary bypass. In
      the immediate postoperative period there was a significant increase in right
      atrial pressure of the patients who underwent antegrade cardioplegia. For the
      other registered parameters there was no significant difference either in the
      immediate postoperative period or 6 hours later. Release of creatine kinase MB
      isoenzyme was the same in the two groups. Clinical outcome in terms of mortality,
      prevalence of perioperative infarction, prevalence of low cardiac output, and
      rhythm and conduction disturbances was similar in both groups. Technical problems
      related to cannulation and decannulation of the coronary sinus were not
      encountered. Multivariate analysis showed that occlusion of the left anterior
      descending coronary artery (p = 0.012) is an essential contraindication of
      antegrade delivery of cardioplegic solution. Analysis of the patients with an
      occlusion of the left anterior descending coronary artery who underwent antegrade
      (n = 9) and retrograde (n = 10) cardioplegia showed a significant difference in
      the total dose of cardioplegic solution (p = 0.02) and septal myocardial
      temperature at the moment of asystole (p = 0.008) and after infusion of the total
      dose of cardioplegic solution (p = 0.015). The mean arterial systolic blood
      pressure in the antegrade group was significantly lower than in the retrograde
      group (p = 0.003). Preservation of the left ventricular stroke work index was
      significantly better in the retrograde group (namely, 85% of its initial value
      versus 71% in the antegrade group, p = 0.0116).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487565
TI  - Superiority of controlled surgical reperfusion versus percutaneous transluminal
      coronary angioplasty in acute coronary occlusion.
AB  - Although percutaneous transluminal coronary angioplasty is successful in more
      than 90% of patients after acute coronary occlusion, overall mortality remains
      approximately 10% with higher subgroup mortality (i.e., occlusion of the left
      anterior descending coronary artery, multivessel disease, age older than 70
      years, cardiogenic shock) and early recovery of regional wall motion is marginal.
      This multicenter report shows that controlled surgical reperfusion in patients
      with acute coronary occlusion reduces overall and subgroup mortality and restores
      substantial early contractility. In a survey from six institutions, 156
      consecutive patients with acute coronary occlusion documented by angiography
      underwent surgical revascularization with controlled reperfusion using amino acid
      enriched blood cardioplegic solution on total vented bypass. Ventricular wall
      motion was studied by echocardiography or multiple gated acquisition scan on
      postoperative days 5 to 7 and scored independently (0 = normal, 1 = mild
      hypokinesia, 2 = severe hypokinesia, 3 = akinesia, 4 = dyskinesia). Results are
      compared with results in 1203 patients with acute coronary occlusion treated by
      angioplasty in five reported medical series. Surgically treated patients were
      revascularized at longer ischemic intervals (6.3 versus 3.9 hours, p < 0.05) and
      had a greater incidence of left anterior descending occlusion (61% versus 43%, p
      < 0.05), multivessel disease (42% versus 22%, p < 0.05), and cardiogenic shock
      (41% versus 10%, p < 0.05), with 12 patients undergoing cardiopulmonary
      resuscitation en route to the operating room. Surgical results were superior in
      all categories, with overall mortality reduced from 8.7% after angioplasty to
      3.9% after coronary bypass (p < 0.05). All surgical deaths occurred in patients
      with preoperative cardiogenic shock. Regional wall motion recovered significantly
      (score < 2) in 131 of 150 (87%) surgically treated patients with an average score
      of 0.9 +/- 0.8 (normal to mild hypokinesia) despite longer ischemic times.

PMID- 8487566
TI  - Plasma fentanyl levels in infants undergoing extracorporeal membrane oxygenation.
AB  - Plasma levels of fentanyl were analyzed in 12 infants undergoing extracorporeal
      membrane oxygenation who received a fentanyl bolus (5 to 10 micrograms/kg)
      followed by infusion at 1 to 6.3 micrograms/kg/hr. Fentanyl levels, averaging 11
      samples/infant, were measured by radioimmunoassay (mean 19.7 +/- 35.7 ng/ml; n =
      140). Eight of the infants, all with a primary diagnosis other than congenital
      diaphragmatic hernia, survived with relatively short (< 7 days) courses on
      extracorporeal membrane oxygenation; this group of infants did not develop
      tolerance to fentanyl and could be maintained on infusion rates of < 5
      micrograms/kg/hr throughout. The four infants with congenital diaphragmatic
      hernia had longer extracorporeal membrane oxygenation runs and three did not
      survive; their plasma fentanyl levels were consistently higher and while the
      infusion rates were higher early on extracorporeal membrane oxygenation, they did
      not exceed 7 micrograms/kg/hr and actually decreased after 5 days on
      extracorporeal membrane oxygenation. Five infants (42%) received lorazepam in
      addition to fentanyl for at least one sampling time. The fentanyl infusion dose
      and plasma level were higher in the congenital diaphragmatic hernia nonsurvivors
      who did not receive lorazepam (p < 0.001). A decrease in fentanyl clearance
      correlated with renal dysfunction (p < 0.01). A bolus of fentanyl followed by
      infusion of relatively low doses (1 to 5 micrograms/kg/hr) provides adequate
      analgesia for infants on extracorporeal membrane oxygenation, particularly when
      it is supplemented with intravenous lorazepam whenever needed to control infant
      movement.

PMID- 8487567
TI  - Immunization by bovine thrombin used with fibrin glue during cardiovascular
      operations. Development of thrombin and factor V inhibitors.
AB  - Brief case histories of three patients aged 58, 38, and 44 years are reported.
      All underwent cardiovascular operations. Subsequently hemostasis test
      abnormalities developed between the seventh and eighth postoperative days after
      exposure to bovine thrombin used with fibrin glue. These were characterized by an
      increased activated partial thromboplastin time (64 to 147 seconds), prothrombin
      time (19 to 24 seconds), bovine thrombin time (> 120 seconds) and a markedly
      reduced factor V level (< 10% in two patients and 16% in the third patient). A
      patient plasma dilution of 1 in 200 with a normal plasma pool was necessary to
      correct bovine thrombin time. No fast-acting or progressive inhibitor against
      factor V could be detected by coagulation tests, and fresh frozen plasma
      perfusion had no effect. Plasmapheresis was performed preventatively to avoid
      bleeding, and factor V levels stabilized at around 50% after two to four
      exchanges. Immunologic studies showed that the inhibitors were directed not only
      against bovine factors but also against human ones. Therefore factor V decrease
      could have been the result of rapid clearance from the circulation of complexes
      formed with a nonneutralizing inhibitor that is not detected by clotting tests.
      These antibodies were purified by standard methods and immunoaffinity. Fast
      immunization could be explained by a prior sensitization to bovine thrombin
      exposure during previous operations. It is suggested that bovine thrombin used
      with fibrin glue contains small amounts of factor V and may be responsible for
      these abnormalities. This is in agreement with previous literature reports.
      However, these described neutralizing factor V inhibitors, which were easily
      detected.

PMID- 8487568
TI  - Esophagectomy with or without thoracotomy. Is there any difference?
AB  - Two operative approaches for esophageal carcinoma were compared with respect to
      operative morbidity and mortality by means of multivariable analysis. From 1980
      to 1986, 152 patients underwent resection by laparotomy and right-sided
      anterolateral thoracotomy with an intrathoracic anastomosis. From 1986 to 1989,
      141 patients underwent resection by transhiatal blunt dissection with a cervical
      anastomosis. The stomach was the preferred organ for reconstruction. Paresis of
      the recurrent laryngeal nerve and leakage of the cervical anastomosis occurred
      significantly more often in the transhiatal group. Pulmonary complications
      occurred less frequently in the transhiatal group. In-hospital mortality (9% in
      the thoracotomy group and 5% in the transhiatal group) increased significantly
      with advanced age of the patients. Furthermore, it was significantly higher in
      case of colonic interposition as compared with reconstruction with the stomach.
      Long-term survival did not differ between the two groups. Especially for
      carcinomas in the distal part of the esophagus, transhiatal esophageal resection
      without thoracotomy seems to be an oncologically justifiable operation with a
      reduced morbidity and mortality.

PMID- 8487569
TI  - N2 lung cancer: outcome in patients with false-negative computed tomographic
      scans of the chest.
AB  - Over the past 13 years 681 consecutive patients have undergone computed
      tomographic staging and surgical staging of the mediastinum. Five hundred one
      tested negative for mediastinal lymph node enlargement by computed tomographic
      staging, and 37 of these patients had cancerous mediastinal lymph nodes at
      thoracotomy (n = 36) or mediastinoscopy (n = 1). The survival in this group of
      patients was analyzed according to T status, central or peripheral location of
      tumor, cell type, areas of mediastinum that are involved, and extent of nodal
      involvement with tumor. Twelve patients had central tumors, and 25 had peripheral
      tumors. Two of the patients in the central tumor group died postoperatively and
      only 2 others survived, whereas 12 of the 25 patients in the peripheral tumor
      group survived. Four of the 37 patients, 2 in each group, did not undergo
      resection, and all died. All but 2 of the 31 survivors who underwent resection
      received postoperative adjuvant x-ray therapy (23 patients), chemotherapy (1
      patient), or x-ray therapy and chemotherapy (5 patients). The projected 2-year
      and 5-year survivals (Kaplan-Meier) were 40% and 28% for patients overall, 46%
      and 31% for those whose tumors were resected, 40% and 20% for those with resected
      central tumors, and 52% and 45% for those with resected peripheral tumors. None
      of these differences was significant. Cell type, location or number of locations
      of involved nodes, and the average percentage or maximum percentage of
      mediastinal node that was involved with tumor did not influence survival. The
      high negative predictive index for computed tomographic staging of the
      mediastinal lymph nodes and the observed 2-year and 5-year survivals in patients
      with false-negative computed tomographic scans of the chest justifies definitive
      thoracotomy without mediastinoscopy in most patients with a normal mediastinum on
      computed tomographic scan.

PMID- 8487570
TI  - Indications, risks, and results of completion pneumonectomy.
AB  - Completion pneumonectomy refers to an operation intended to remove what is left
      of a lung partially resected during a previous operation. The procedure is seldom
      indicated and, according to current medical literature, it carries a higher risk
      of operative mortality and morbidity than does standard pneumonectomy, especially
      when done for benign disease. Over the past 20 years, 60 consecutive patients
      aged 17 to 70 years and having a diagnosis of recurrent lung cancer (n = 28), new
      primary lung cancer (n = 13), or benign pleuropulmonary disease (n = 19)
      underwent completion pneumonectomy. The mean interval between the first operation
      and completion pneumonectomy was 30 months for patients with carcinoma and 215
      months for patients with benign disease. For all patients, the previous
      thoracotomy incision was reopened and maneuvers such as rib resection,
      intrapericardial blood vessel ligation, division of the bronchus first, local
      application of glues and hemostatic agents, and bronchial reinforcement were
      routinely used. Six patients died during (n = 2) or after (n = 4) the operation,
      for an overall operative mortality of 10%. The rate was higher for patients with
      carcinoma (11.6%) than for patients with benign disease (5.9%). Actuarial 5-year
      survivals from the time of completion pneumonectomy were 48% for the entire
      population, 33% for patients with cancer, and 88% for patients with benign
      disease. These results suggest that completion pneumonectomy can be done with an
      operative risk similar to the one reported for standard pneumonectomy (6% to
      10%). In addition, patients undergoing completion pneumonectomy have a reasonable
      prospect for long-term survival.

PMID- 8487571
TI  - Anatomic repair of transposition of great arteries with ventricular septal defect
      and aortic arch obstruction. One-stage versus two-stage procedure.
AB  - Between September 1, 1982, and March 1, 1992, 40 patients underwent anatomic
      repair of transposition of the great arteries, ventricular septal defect, and
      aortic arch obstruction. In group I, 26 patients (65%) underwent repair in a two
      stage procedure, phases A and B. Phase A included repair of the aortic arch
      obstruction with (16 patients) or without (10 patients) pulmonary artery banding
      through a left thoracotomy (mean age 18.7 +/- 23.4 days). There were three deaths
      and three reoperations. Phase B included an arterial switch operation with
      closure of the ventricular septal defect (mean age 95.5 +/- 122 days). There were
      five early deaths and two late deaths. Eight patients required reoperation. Mean
      delay between phase A and phase B was 77.5 +/- 109 days. In group I, there were
      eight early and two late deaths, and 11 patients required reoperation. The mean
      stay in the intensive care unit was 24.7 +/- 20 days. Mean follow-up of 59.6 +/-
      21.4 months was completed in all survivors. All but one were in New York Heart
      Association class I without medication. Actuarial survival rate and rate of
      freedom from reoperation at 5 years were 57.5% and 49.9%, respectively. In group
      II, 14 patients (35%) had a one-stage procedure through midsternotomy: an
      arterial switch operation with closure of the ventricular septal defect and
      repair of the aortic arch obstruction (mean age 10.2 +/- 5.5 days). There were
      two early deaths (14.2%) and one late death after reoperation for overlooked
      multiple ventricular septal defects. Two patients required reoperation. The mean
      stay in the intensive care unit was 11.7 +/- 2.5 days. Mean follow-up of 22.4 +/-
      16.7 months was achieved in all survivors. They were all in New York Heart
      Association class I without medication. Actuarial survival rate and rate of
      freedom from reoperation at 3 years were 78.5% and 81.5%, respectively. The one
      stage procedure allowed complete repair in neonates without the need for multiple
      operations. We believe that it may decrease early mortality rates (14.2% versus
      30.7%), reduce the reoperation rate and cumulative stay in the intensive care
      unit (11.7 days versus 24.7 days, p = Not significant), and significantly
      decrease the overall rate of morbidity (p < 0.01). However, requirements for
      surgical intervention with a one-stage or a two-stage procedure must include
      accurate assessments of intracardiac and aortic arch anatomy.

PMID- 8487573
TI  - Mesothelioma: an incurable, nonsurgically treatable disease.

PMID- 8487572
TI  - Degeneration of aortic valve allografts in young recipients.
AB  - Aortic allograft fibrocalcification and valvular insufficiency have been observed
      in patients less than 3 years of age at initial replacement of the left
      ventricular outflow tract. From June 1985 through May 1992, 47 children have
      undergone aortic root replacement with cryopreserved aortic valve allografts.
      Thirty-three children were 3 years of age or older and 14 were less than 3 years
      of age at operation. In the older patient group, there were three (9%) hospital
      deaths and one child underwent cardiac transplantation 30 hours after aortic root
      replacement because of left ventricular failure. Clinical follow-up of the 29
      surviving older children is from 4 months to 6.6 years (mean 3.0 years). One
      patient was lost to follow-up. Two children (7%) have required reoperation, but
      primary allograft degeneration was not observed. In the younger patient group,
      there were three (21%) hospital deaths. Follow-up ranged from 2.5 months to 4.7
      years (mean 2.3 years). Among 11 operative survivors, one late death resulted
      from a pulmonary embolus. Seven of 10 (70%) remaining allograft recipients had
      progressive allograft calcification or insufficiency. Six of them have required
      reoperation to explant the allograft, and one child is currently receiving
      cyclosporine therapy with the original valve allograft. The cause of allograft
      failure is possibly immunologic. The prevalence of early aortic valve allograft
      degeneration has prompted the consideration of nonviable allografts or
      xenografts, pulmonary autografts, or minimal immunosuppression as alternatives
      when left ventricular outflow tract reconstruction is necessary in children less
      than 3 years of age.

PMID- 8487574
TI  - Solitary bone plasmacytoma of rib presenting as a superior sulcus tumor.

PMID- 8487575
TI  - Transesophageal echography as an emergency diagnostic tool for acute aortic
      dissection.

PMID- 8487576
TI  - Surgical correction of a recurrent aneurysm of the ascending aorta simulating
      pulmonary stenosis.

PMID- 8487577
TI  - Aneurysm of saphenous vein graft used for aorta-coronary bypass, resembling an
      anterior mediastinal mass.

PMID- 8487578
TI  - Aortic aneurysm after subclavian arterial flap angioplasty for coarctation of the
      aorta.

PMID- 8487579
TI  - A variant course of posterior descending artery.

PMID- 8487580
TI  - Characteristics of the inhibition of human promyelocytic leukaemia HL60 cell
      growth by S-D-lactoylglutathione in vitro.
AB  - The mechanism of the inhibition of proliferation of human leukaemia 60 (HL60)
      cells by S-D-lactoylglutathione in vitro was investigated. The median inhibitory
      concentration IC50 value was 66 microM (95% C.I. 50-87 microM; n = 18). The
      inhibition of leukaemia cell growth required exposure of HL60 cells to S-D
      lactoylglutathione (and metabolites) for 12 h, with maximum growth inhibition
      achieved after 24 h. Removal and replacement of culture medium within the initial
      12 h of culture prevented inhibition of growth and toxicity. S-D
      lactoylglutathione was consumed within the initial 3 h of culture. Pretreatment
      of culture medium containing 10% foetal calf serum for 3 h produced no subsequent
      inhibition of HL60 cell growth. Incubation of HL60 cells in culture medium with
      low serum content (5% v/v) produced a decreased rate of cell proliferation and a
      decreased response to S-D-lactoylglutathione. S-D-lactoylglutathione inhibited
      uptake of 3H-thymidine into DNA in the third hour of culture where the median
      inhibitory concentration IC50 value was 74 microM (95% C.I. 51-102; n = 10). The
      mechanism of inhibition of HL60 cell growth by S-D-lactoylglutathione is unknown
      but may be cell cycle related, mediated by inhibition of DNA synthesis and
      involve an active metabolite which may be removed and/or inactivated by a change
      in culture medium.

PMID- 8487581
TI  - Effects of dolastatins on human B-lymphocytic leukemia cell lines.
AB  - Dolastatins are naturally occurring peptides isolated from marine animals and are
      known to be potent anti-neoplastic agents. Here, the three compounds dolastatin
      10 (Dola 10), dolastatin 15 (Dola 15) and deo-dolastatin 10 (Deo-Dola 10) were
      added to cultures of two human chronic B-leukemia cell lines, JVM-2 and EHEB. The
      three dolastatins (Dola 10 > Dola 15 > Deo-Dola 10) inhibited cell proliferation
      and immunoglobulin production. Decreased cell growth and lack of accumulation of
      immunoglobulin was not caused by cytotoxicity as cell viability in the cultures
      remained high. The unchanged surface marker immunoprofiles during treatment and a
      predominance of treated cells in S and G2/M phase suggested cytostatic rather
      than directly cytotoxic effects. Exposure to these reagents increased quickly,
      albeit only short c-myc and bcl-2 mRNA expression. These results indicate that
      the three dolastatins are potent inhibitors of leukemic B-cell proliferation.

PMID- 8487582
TI  - Detection of circulating monoclonal lymphocytes in multiple myeloma patients by
      analysis of gene rearrangements: correlation with progressive disease.
AB  - Multiple myeloma is characterized by the proliferation of a monoclonal plasma
      cell population that essentially spreads in the bone marrow. However,
      immunological data and studies on clonal gene rearrangements have provided
      evidence for circulating malignant B-lymphocytes. Herein, we report on the
      detection and clinical significance of monoclonal lymphocytes in the peripheral
      blood of multiple myeloma patients. Applying the analysis of immunoglobulin gene
      rearrangements, clonal circulating lymphocytes were found in 8 out of 37
      patients. In three of these eight patients, DNA from the bone marrow could be
      examined as well, and the same gene rearrangement as in peripheral blood was
      detected. This observation indicates that the monoclonal lymphocytes in the
      peripheral blood are part of the malignant plasma cell clone in the bone marrow.
      There was a strong correlation between progressive stage III disease and the
      detection of circulating tumour cells, whereas neither in stable stage III nor
      stage I disease could clonal gene rearrangements be detected. Our findings
      indicate the high incidence of monoclonal lymphocytes in the peripheral blood
      from patients with progressive multiple myeloma. This may be of importance with
      respect to cell harvesting strategies for autologous peripheral stem cell
      transplantation in multiple myeloma.

PMID- 8487583
TI  - Intracellular concentrations of mitoxantrone in leukemic cells in vitro vs in
      vivo.
AB  - The aim of this study was to determine the intracellular pharmacokinetics of
      mitoxantrone in vivo and to use these results to establish how leukemic cells
      should be incubated to perform clinically relevant in vitro studies of this drug.
      Blood samples were obtained from 11 patients with acute nonlymphoblastic leukemia
      at certain intervals up to 20 h after the infusion of mitoxantrone 12 mg/m2.
      Plasma and leukemic cells were separated and the drug concentrations were
      determined with HPLC. Before treatment, leukemic cells from 12 patients were
      incubated with 0.02, 0.05, 0.1, 0.2 and 1.0 microM mitoxantrone for 1-4 h and
      thereafter cultured in suspension culture for 20 h; during this time cell samples
      were taken at certain intervals for drug determination. In cells incubated with
      0.05 and 0.2 microM mitoxantrone the cytotoxic effect was measured with the DiSC
      assay after cultivation for 4-5 days. In vivo, the intracellular levels exceeded
      the plasma concentrations already at the end of infusion and after 2 h the
      intracellular concentrations were 200-300 times higher than in plasma. In vitro,
      the intracellular steady state level of mitoxantrone was reached after 1-2 h and
      there was a pronounced intracellular retention even after 20 h culture in drug
      free medium. Incubation with 0.05 microM during 1 h gave intracellular
      concentrations of mitoxantrone similar to those achieved in vivo. This incubation
      concentration gave a mean cytotoxic effect of 53% living cells measured with the
      DiSC assay, which gives good possibilities to discriminate between mitoxantrone
      sensitive and unsensitive cells. We believe that exposing leukemic cells in vitro
      for in vivo mimicking mitoxantrone concentrations could increase the clinical
      relevance of predictive assays.

PMID- 8487584
TI  - Effect of verapamil on daunorubicin accumulation in human leukemic cells with
      different levels of MDR1 gene expression.
AB  - The purpose of the present study was to evaluate the distribution of the multiple
      drug resistance phenotype in leukemic cells with different levels of mdr1 gene
      expression. Peripheral leukemic cells from 8 patients (5 with detectable and 3
      with undetectable mdr1 RNA levels) were incubated with daunorubicin (1 microM) in
      the absence and presence of verapamil (6.6 microM). Daunorubicin accumulation in
      individual cells was analysed by flow cytometry. Verapamil increased (16-45%) the
      mean daunorubicin accumulation in 7 of the 8 cell samples. In cells from 4 of
      these 7 patients, the fluorescence histograms showed a general increase of
      daunorubicin accumulation. The increase was limited to a small subpopulation of
      cells in one patient. In the remaining two patients an increase of daunorubicin
      accumulation was seen in the majority of cells, while cells with the highest
      accumulation were unaffected. In conclusion, verapamil can increase daunorubicin
      accumulation in leukemic cells with and without detectable mdr1 gene expression
      and the increase seems to affect the majority of the cell population.

PMID- 8487585
TI  - Delineation of translocation t(15; 17) in acute promyelocytic leukemia by
      chromosomal in situ suppression hybridization.
AB  - In this study we demonstrate the feasibility of chromosomal in situ suppression
      (CISS) hybridization to detect the translocation t(15; 17) in metaphase spreads
      of patients with acute promyelocytic leukemia. Using DNA libraries from sorted
      human chromosomes 15 and 17 the translocation t(15; 17) can be unequivocally
      identified even if the spread and the morphology of the chromosomes are poor. The
      sensitivity of CISS hybridization is compared with the sensitivity of
      conventional G-banded karyotypes.

PMID- 8487586
TI  - Combination of classical and interphase cytogenetics to investigate the biology
      of myeloid disorders: detection of masked monosomy 7 in AML.
AB  - Numerical abnormalities of chromosome 7 were detected by using fluorescence
      labeled in situ hybridization (FISH) procedure with a centromere-specific probe
      in four cases of acute myeloid leukemia (AML) and three cases of myelodysplastic
      syndromes (MDS). Comparison of these results with classical cytogenetic (CC) data
      demonstrated a good correlation between the two methods. FISH confirmed the
      finding of monosomy 7 in all patients who demonstrated this abnormality by CC.
      Two AML patients who did not show monosomy 7 by CC were unexpectedly found to
      contain this abnormality in 39.8% and 17% cells when examined by FISH. Given that
      our modified FISH method consistently yielded > 96% hybridization efficiency,
      these findings constitute an unexpected but real presence of monosomy 7 in a
      substantial number of interphase cells that had remained undetected by classical
      karyotyping. Finally, a number of maturing myeloid cells including granulocytes
      also demonstrated monosomy 7 by FISH, thereby confirming the ability of malignant
      cells to undergo differentiation. We conclude that FISH constitutes a highly
      sophisticated molecular technique which can be extremely useful in select cases
      for detecting 'masked monosomy 7' as well as helping to determine the lineage of
      terminally mature cells in AML, thereby providing a handle on the effects of
      cytokines or chemotherapy on normal vs leukemic clones.

PMID- 8487587
TI  - Acute myeloblastic leukemia (ANLL-M2) with t(8;21)(q22;q22) variant expressing
      lymphoid but not myeloid surface antigens with a high number of G-CSF receptors.
AB  - Leukemic cells from an 8-year-old girl with ANLL-M2 expressed precursor B-cell
      antigen CD19, but none of the myeloid antigens CD11b, CD13, CD14 and CD33. After
      culture, the cells expressed CD11b and CD13. The cells carried a high number of
      granulocyte colony-stimulating factor (G-CSF) receptors. In chromosome analysis,
      metaphase cells were obtained only in the case of culture with G-CSF. The
      karyotype was a variant of t(8;21)(q22;q22). Southern blot analysis revealed
      rearrangement of the AMLI gene located on chromosome 21. These observations may
      suggest that even without myeloid surface antigens and with precursor B-cell
      antigen, ANLL-M2 with t(8;21)(q22;q22) has apparent myeloid characteristics.

PMID- 8487588
TI  - The history of HTLV-I.

PMID- 8487589
TI  - HTLV-I and adult T-cell leukemia.

PMID- 8487590
TI  - Discovery of HTLV-1.

PMID- 8487591
TI  - Expression of sialyl-Lewis(x) on CD10-positive normal bone marrow cells.

PMID- 8487592
TI  - Comparison of in vitro effects of two thiol-containing drugs on human neutrophils
      hydrogen peroxide production.
AB  - During inflammatory disorders, potentially destructive reactive oxygen species,
      especially hydrogen peroxide, are produced by activated phagocytic cells. It was
      demonstrated in vitro that mesna and N-acetylcysteine (NAC), mucolytic thiols,
      have antioxidant properties. An estimation was made of the 50% inhibitory
      concentration (IC50) of mesna and NAC for PMA-induced H2O2 production by human
      neutrophils, the results being 70 mcM and 77 mcM, respectively. The mechanism
      which governs mesna and NAC reactions results from a scavenging effect of H2O2:
      the calculated IC50s of this effect were 30 mcM and 42 mcM, respectively, in free
      cellular experimentation. The results suggest that mesna and NAC might be used as
      antioxidants in aerosols to prevent tissue damage inflicted by this reactive
      oxygen species, especially in the lungs.

PMID- 8487593
TI  - Studies on the tissue distribution of liposome-associated clofazimine, an
      antileprosy drug.
AB  - Clofazimine, a potent antimycobacterial drug, being highly lipophilic accumulates
      in fatty tissue and in the reticuloendothelial system causing dose-dependent side
      effects. In this study, the distribution of the free drug and liposome-associated
      drug was compared after intravenous administration in mice. Differences in the
      distribution of the drug were observed in the liver, spleen, kidney and lung
      tissues when injected as free drug and as liposome-associated drug. Following
      intravenous challenge with the free drug, the drug accumulated quickly and high
      concentrations of the drug were seen in the spleen, liver, kidney and lung even
      after 24 h, indicating poor clearance. However, with liposome-associated drug,
      increased levels were seen in liver, spleen and lung at 1 h with levels falling
      considerably at 24 h, with no accumulation in the kidney either at 1 h or 24 h
      after challenge. Clofazimine associated with neutral liposomes was preferentially
      targetted to spleen and lung, positively charged liposome-associated drug
      accumulated more in the lungs than in other tissues, while negatively charged
      liposome-associated drug was directed to liver and spleen. The results suggest
      that inclusion of clofazimine into liposome not only targets the drug to the
      organs concerned but also facilitates clearance of the drug, resulting in little
      accumulation. Also, renal accumulation is much lower as compared to the free
      drug. This suggests the potential usefulness of liposome as a carrier for
      clofazimine, thereby reducing the harmful side effects due to excessive
      accumulation of the drug.

PMID- 8487594
TI  - The application of computerized analysis of nuclear images and multivariate
      analysis to the understanding of the effects of antineoplastic agents and their
      mechanism of action.
AB  - The present work involves the creation of a model that makes the rapid study of
      anticancer drugs possible. In order to make possible the multilevel study of
      antineoplastic derivatives (their effects on cell proliferation, their cell
      kinetics, their chromatin texture and the study of their potential operating
      mechanisms), the computerized analysis of nuclear images linked to multivariate
      analysis was chosen, and, in so doing, took into account 15 computer-calculated
      morphonuclear parameters for Feulgen-stained cell nuclei. In order to validate
      the method it was subjected to a series of well-known cancer drugs. The present
      results are in agreement with those obtained by conventional methods similar to
      those used for the study of the cytotoxicity of anticancer molecules or their
      effect on cell kinetics. Multivariate analysis applied to the parameters
      described by image analysis should make possible the rapid study of new
      anticancer drugs together with the rapid orientation of studies undertaken to
      ascertain their operating mechanisms.

PMID- 8487595
TI  - Liver damage and plasma concentrations of paracetamol and its metabolites after
      paracetamol overdosage in mice.
AB  - The effects of single oral and intraperitoneal (i.p.) overdoses of paracetamol
      (500 mg/kg) were studied in mice. The correlation between hepatocellular damage
      and plasma levels of paracetamol metabolites derived from the oxidative pathway
      were also investigated. Animals were killed at different intervals (1, 2.5 and 6
      h) after drug administration. Plasma concentrations of paracetamol and its
      sulphate, glucuronide, cysteine and mercapturate conjugates were determined by
      HPLC. Paracetamol plasma levels were significantly higher at 1 and 2.5 h after
      i.p. administration as compared to oral administration (p = 0.01 and p = 0.02,
      respectively). Plasma levels of mercapturic acid conjugate were significantly
      higher at 6 h after i.p. administration (p = 0.04). After 6 h, animals given oral
      paracetamol showed significantly less necrosis than animals given i.p.
      paracetamol (p = 0.03). Plasma levels of mercapturate conjugate at 6 h showed a
      significant correlation with the severity of liver necrosis (r = 0.64; p = 0.02).
      The results suggest that i.p. paracetamol seems to be more adequate for
      hepatotoxicity studies in mice.

PMID- 8487596
TI  - A new method of blood sampling and determination of the local anesthetic agent
      lidocaine in dentistry.
AB  - Blood levels of local anesthetic agents after application in dentistry have been
      determined only in peripheral venous blood. A method of withdrawing blood from
      the alveolus after extraction of a tooth was developed. With a new simple gas
      chromatographic method with a low detection limit, concentration of lidocaine was
      determined. A correlation between the blood levels of lidocaine and the type of
      anesthesia and the localization of the extracted teeth was found.

PMID- 8487597
TI  - Effects of pinacidil and acetylcholine on early afterdepolarization of atrial
      fibers in mouse heart.
AB  - The effects of pinacidil and acetylcholine (Ach) on action potential (AP) and
      early afterdepolarization (EAD) were investigated in mouse atrial fibers. Under
      treatment with pinacidil the AP and EAD were affected only with the concentration
      of 8 x 10(-5) M, which inhibited EAD but did not affect AP except for only a
      minor reduction of action potential duration (APD). After withdrawal of
      pinacidil, the inhibitory effect of EAD was enhanced. Under treatment with Ach (2
      x 10(-7) M), AP was not changed except the APD, which was significantly reduced,
      and the EAD was completely abolished. Withdrawal of Ach produced a rebound
      increase in APD and led to induction of EAD or promoted EAD to more extensive
      level such as appearance of long second plateau. Atropine (1 x 10(-7) M)
      abolished the rebound effect caused by withdrawal of Ach. The mechanism of EAD
      generation induced by removing Ach is discussed.

PMID- 8487598
TI  - The increase in erythrocyte deformability in patients treated with nicardipine or
      nimodipine.
AB  - A study was made of a total of 50 patients, 36 females and 14 males, with an
      average age of 51.3 +/- 11.71 years (range 19-71). The group consisted of
      outpatients who came to the neurology clinic suffering from vascular headache or
      other symptomatic complaint of vascular type. In all cases, the existence of an
      organic neurological pathology had been considered and rejected. All patients who
      were smokers or suffering from hypertension were excluded, as well as those who
      had abnormal lipid or glucose values or who were on drug treatment for other
      reasons. The basal erythrocyte deformability value was determined and the
      patients divided into two random homogeneous groups. One of the groups was
      treated with nimodipine (90 mg/d) and the other with nicardipine (60 mg/d) for a
      period of two months. After this treatment period a further determination of the
      erythrocyte deformability was carried out. In the group treated with nimodipine,
      the erythrocyte deformability varied from 45.5 +/- 7.4 mcl/s to 50.35 +/- 12.02
      mcl/s (p = 0.07123). In the group treated with nicardipine, these values varied
      from 45.96 +/- 7.35 mcl/s to 56.21 +/- 12.72 mcl/s (p = 0.00079). It was
      concluded that in both groups of patients, after two months treatment with these
      calcium antagonists, there was an improvement in erythrocyte deformability and,
      therefore, in blood fluidity, although only the nicardipine-treated group reached
      statistically significant levels.

PMID- 8487599
TI  - [Does olsalazine influence spermatogenesis?].

PMID- 8487600
TI  - [Investigations of drugs from regional centers].

PMID- 8487601
TI  - [Scopolamine against hypersalivation].

PMID- 8487602
TI  - [Adjusting for studied districts can be useful].

PMID- 8487603
TI  - [A highly unethical and distasteful advertising campaign].

PMID- 8487604
TI  - [Can time trends for results after vascular surgery be misunderstood?].

PMID- 8487605
TI  - [It is too easy to get exemption from military service].

PMID- 8487606
TI  - [Simple payment by results in hospital care].

PMID- 8487607
TI  - [Egg donation. A desirable therapeutic method?].

PMID- 8487608
TI  - [The topic of WHO for the World Health Day: try to prevent violence].

PMID- 8487609
TI  - [10 years with HIV and AIDS. Clinical experiences].

PMID- 8487610
TI  - [Polyamines in health and disease].

PMID- 8487611
TI  - [Removal of urinary tract calculi. How invasive should the treatment be?].

PMID- 8487612
TI  - [A case report. Erythropoietin replaced blood transfusion].

PMID- 8487613
TI  - [Is problem-based learning good? A research review].

PMID- 8487614
TI  - [Benzodiazepines. Physicians in the public service and industry: time to take
      responsibility for abuse of the drug].

PMID- 8487615
TI  - [The Institute for Medical Education. The special teaching function of the
      Karolinska Institute].

PMID- 8487616
TI  - [Mentally disturbed juvenile delinquents. Immigrants are more often sentenced to
      imprisonment].

PMID- 8487617
TI  - Elongation predominates over desaturation in the metabolism of 18:3n-3 and 20:5n
      3 in turbot (Scophthalmus maximus) brain astroglial cells in primary culture.
AB  - The origin of docosahexaenoic acid (DHA, 22:6n-3) that accumulates in turbot
      brain during development was investigated by studying the incorporation and
      metabolism via the desaturase/elongase pathways of [1-14C]-labelled
      polyunsaturated fatty acids (PUFA) in primary cultures of brain astrocytic glial
      cells. There was little specificity evident in the total incorporation of PUFAs
      into the turbot astrocytes. However, specificity was apparent in the distribution
      of the various PUFAs among the individual lipid classes. In particular, there was
      very specific incorporation of [14C]arachidonic acid (AA, 20:4n-6) into
      phosphatidylinositol balanced by a lower incorporation of this acid into total
      diradyl glycerophosphocholines. [14C]-Linolenic acid (LNA, 18:3n-3) and
      [14C]eicosapentaenoic acid (EPA, 20:5n-3) were metabolized via the
      desaturase/elongase pathways to a significantly greater extent than [14C]linoleic
      acid (18:2n-6) and [14C]AA. The turbot astrocytes expressed very little delta 5
      desaturase activity and only low levels of delta 4 desaturation activity.
      Although the percentages were small, approximately 4-5 times as much labelled DHA
      was produced from [14C]EPA compared with [14C]LNA. However, it was concluded that
      very little DHA in the turbot brain could result from the metabolism of LNA and
      EPA in astrocytic glial cells.

PMID- 8487618
TI  - Detection of [U-13C]eicosapentaenoic acid in rat liver lipids using 13C nuclear
      magnetic resonance spectroscopy.
AB  - Fatty acid carbons are well-resolved in 13C nuclear magnetic resonance (NMR)
      spectra of lipid extracts, but application of this methodology to the metabolism
      of 13C-labelled fatty acids has not yet been reported. In the present study, 13C
      NMR was used to monitor the presence of 98% [U-13C]eicosapentaenoic acid (EPA) in
      liver and carcass lipids 24 h after it had been injected into the stomach of a
      rat. Natural abundance 13C NMR spectra of liver total fatty acid extracts were
      obtained from four control rats for comparison. At 24 h post-injection,
      quantitative high resolution 13C NMR showed 13C enrichment in liver fatty acid
      extracts was present mainly at olefinic and at the n-1 to n-4 carbons, but 13C
      signal intensities for C-1 to C-4 of [U-13C]EPA were markedly reduced or absent.
      Small 13C resonances, possibly indicative of some 13C incorporation into
      docosahexaenoic acid and saturated or monounsaturated fatty acids, were present
      in spectra of liver fatty acids. Liver and carcass fatty acid composition was
      similar in both the controls and the EPA-injected rat, suggesting little
      accumulation of the injected [U-13C]EPA after 24 h. We conclude that the carbon
      specific data provided by 13C NMR of lipid extracts may be useful in monitoring
      the fate of individual carbons during tracer studies using 13C-labelled fatty
      acids.

PMID- 8487619
TI  - Positional distribution of n-3 fatty acids in triacylglycerols from rat adipose
      tissue during fish oil feeding.
AB  - The present study was designed to investigate the metabolism of the n-3
      polyunsaturated fatty acids (PUFA) in adipose tissue and its dependence upon
      dietary factors. Changes in the positional distribution of the fatty acids in
      triacylglycerols from retroperitoneal adipose tissue were studied as a function
      of time on rats fed for 4 wk a diet enriched with fish oil. The stereospecific
      analysis of triacylglycerols by Grignard degradation. This was followed by
      synthesis of rac-phosphatidic acids and treatment with phospholipase A2. In the
      triacylglycerols of the fish oil diet, 57% of the total n-3 fatty acids were in
      position 3, i.e., two-thirds of 20:5n-3 and 22:5n-3 were esterified in sn-3
      position, whereas 22:6n-3 was equally distributed in positions 2 and 3. After 4
      wk of feeding fish oil, the fatty acid composition of adipose tissue
      triacylglycerols reached a steady state. Half of the n-3 fatty acids were found
      in position 3, namely 75% of 22:5n-3, 50% of 20:5n-3 and 18:4n-3 and 45% of 22:6n
      3, the latter being equally distributed in positions 2 and 3. This pattern of
      distribution resembled that found in triacylglycerols of the fish oil diet,
      except for a higher proportion of 20:5n-3 in adipose tissue in position 1 at the
      expense of position 3. Throughout the 4-wk period of fish oil feeding, the
      distribution pattern of minor n-3 fatty acids (18:4n-3 and 22:5n-3) in adipose
      tissue triacylglycerols remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487620
TI  - Relationship between mouse liver delta 9 desaturase activity and plasma lipids.
AB  - This study was undertaken to investigate the total plasma fatty acid composition
      and the relationship between plasma triacylglycerol (TG) levels and liver delta 9
      desaturase activity in mice fed n-3 and/or n-6 fatty acid or hydrogenated coconut
      oil (HCO) (maximum 25 mg/g) supplemented diets. Generally, plasma TG levels and
      delta 9 desaturase activity were inversely correlated with the ratio of the sum
      of long chain n-6 fatty acids to 18:2n-6 and to the ratio of the sum of long
      chain n-3 fatty acids to 18:n-3, but they were positively correlated with the
      ratio of products and substrates (18:1/18:0) of the enzyme in plasma total
      lipids. The n-3 fatty acid (mainly 20:5n-3) enriched diet, when compared to the
      HCO diet at 21 d, caused a significant reduction in plasma TG levels but not in
      delta 9 desaturase activity. However, a marked reduction in plasma TG content (50
      60%) and delta 9 desaturase activity (55-70%) was observed when both 20:5n-3 and
      18:3n-6 were supplemented in the diet. The plasma TG levels and delta 9
      desaturase activity rose again when the animals were fed the HCO diet or chow.
      The results suggest that low dose supplementation of a mixture of n-3 (mainly
      20:5n-3) and n-6 (18:3n-6) fatty acids modified both plasma TG content and liver
      delta 9 desaturase activity, in parallel.

PMID- 8487621
TI  - Age-related changes in delta 6 and delta 5 desaturase activities in rat liver
      microsomes.
AB  - Age-related changes in delta 6 desaturation of [1-14C]alpha-linolenic acid and [1
      14C]linoleic acid and in delta 5 desaturation of [2-14C]dihomo-gamma-linolenic
      acid were studied in liver microsomes from Wistar male rats at various ages
      ranging from 1.5 to 24 mon. Desaturase activities were expressed both as specific
      activity of liver microsomes and as the capacity of whole liver to desaturate by
      taking into account the total amount of liver microsomal protein. delta 6
      Desaturation of alpha-linolenic acid increased from 1.5 to 3 mon and then
      decreased linearly up to 24 mon to reach the same desaturation capacity of liver
      measured at 1.5 mon. The capacity of liver to desaturate linoleic acid increased
      up to 6 mon and then remained constant, whereas microsomal specific activity was
      equal at 1.5 and 24 mon of age. The capacity of liver to convert dihomo-gamma
      linolenic acid to arachidonic acid by delta 5 desaturation decreased markedly
      from 1.5 to 3 mon. It then increased to reach, at 24 mon, the same level as that
      observed at 1.5 mon. Age-related changes in the fatty acid composition of liver
      microsomal phospholipids at the seven time points studied and of erythrocyte
      lipids at 1.5 and 24 mon were consistent with the variations in desaturation
      capacity of liver. In particular, arachidonic acid content in old rats was
      slightly higher than in young rats whereas contents in linoleic and
      docosahexaenoic acids varied little throughout the life span.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8487622
TI  - Cholesterol gallstone induction in hamsters reflects strain differences in plasma
      lipoproteins and bile acid profiles.
AB  - Because different strains of hamsters vary in their susceptibility to gallstones,
      the relationship between plasma lipoproteins, hepatic cholesterol, bile lipids
      and bile acid profile was examined during gallstone induction in strains of male
      Syrian hamsters from Charles River Lakeview (CHR), Biobreeder F1B (BIO) and
      Harlan Sprague-Dawley (HAR). Gallstones were induced by feeding a purified diet
      containing 0.4 or 0.8% cholesterol for 5 wk. Basal plasma total cholesterol was
      similar, but the hypercholesterolemia induced by dietary challenge was
      significantly lower in CHR than in HAR and BIO hamsters. Cholesterol-fed CHR
      hamsters transported cholesterol mainly in HDL (47%), whereas VLDL-C + IDL-C
      predominated in BIO and HAR hamsters, and their HDL transported only 28 and 38%,
      respectively. HAR hamsters accumulated the most hepatic cholesterol, revealed the
      highest cholate/cheno ratio, the lowest glycine/taurine ratio and hydrophobicity
      index. HAR also developed the fewest cholesterol gallstones (23%), while 64% of
      CHR and 58% of BIO hamsters had cholesterol gallstones and 34% of BIO hamsters
      developed pigment stones. Doubling dietary cholesterol from 0.4 to 0.8% doubled
      the incidence of cholesterol gallstones but exerted minimal impact on other
      parameters compared to strain differences. Thus, different strains of hamsters
      vary considerably with respect to biliary cholesterol, bile acid profile and
      formation of cholesterol gallstones associated with differences in plasma
      lipoprotein profiles.

PMID- 8487623
TI  - Hydrolysis of fish oils containing polymers of triacylglycerols by pancreatic
      lipase in vitro.
AB  - Fish oils containing different levels of polymers of triacylglycerols formed
      during autoxidation were incubated with pancreatic lipase to establish whether
      these polymers are substrates for lipase hydrolysis. With oils containing low
      amounts (less than 4%) of triacylglycerol polymers as substrates, both
      triacylglycerols and polymers of triacylglycerols were almost completely
      hydrolyzed, and fatty acid monomers and monoacylglycerols were the major lipid
      products. Under the same incubation conditions, some triacylglycerols remained
      intact when highly oxidized oils containing 20 or 30% triacylglycerol polymers
      were the substrate. The fatty acid composition of these residual triacylglycerols
      was almost identical to that of triacylglycerols present at the start of the
      assay. When fish oil containing 30% triacylglycerol polymers was incubated with
      the lipase, the component triacylglycerols and polymers of triacylglycerols were
      hydrolyzed at similar rates, and fatty acid dimers were detected as a product. It
      is concluded that the high molecular weight polymers of triacylglycerols present
      in oxidized fish oils can be hydrolyzed by pancreatic lipase in vitro.

PMID- 8487624
TI  - Stearidonic acid, an inhibitor of the 5-lipoxygenase pathway. A comparison with
      timnodonic and dihomogammalinolenic acid.
AB  - Leukotrienes have been shown to play an important role as mediators in various
      disease processes, including asthma and inflammation; thus, their synthesis is
      tightly regulated. The major precursor of leukotrienes is arachidonic acid (20:4n
      6). Fatty acids which are structurally similar to 20:4n-6, such as eicosatrienoic
      acid (20:3n-6; dihomogammalinolenic acid) and eicosapentaenoic acid (20:5n-3;
      timnodonic acid) have been found to inhibit leukotriene biosynthesis. Because of
      the structural similarity of octadecatetraenoic acid (18:4n-3; stearidonic acid)
      with 20:4n-6, the present study was undertaken to determine whether stearidonic
      acid also exerts an inhibitory effect on the 5-lipoxygenase pathway. Human
      leukocytes were incubated with 18:4n-3 (20 microM or 10 microM), 20:5n-3 (20
      microM) or 20:3n-6 (20 microM) and subsequently stimulated with 1 microM
      ionophore A23187 and 20:4n-6 (20 microM or 10 microM). The 5-lipoxygenase
      products were then measured by high-performance liquid chromatography.
      Leukotriene synthesis was reduced by 50% with 20 microM 18:4n-3 and by 35% with
      10 microM 18:4n-3. Formation of 5S,12S-di-hydroxy-eicosatetraenoic acid and of 5
      hydroxy-eicosatetraenoic acid was decreased by 25% with 20 microM 18:4n-3 and by
      3% with 10 microM 18:4n-3. The inhibition observed with 20 microM 18:4n-3
      appeared to be of the same order as that observed with 20 microM 20:5n-3; the
      inhibition observed with 18:4n-3 was shown to be dose-dependent. The inhibition
      produced by 20 microM 20:3n-6 was greater than that observed with either 20
      microM 18:4n-3 or with 20 microM 20:5n-3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487625
TI  - Identification of core aldehydes among in vitro peroxidation products of
      cholesteryl esters.
AB  - Synthetic cholesteryl 5-oxovalerate and 9-oxononanoate were used as reference
      standards for the isolation and identification of cholesteryl ester core
      aldehydes from tert-butyl hydroperoxide/Fe++ oxidation of synthetic and natural
      cholesteryl esters. The core aldehydes were recovered from the peroxidation
      products by thin-layer chromatography as the free aldehydes or the 2,4
      dinitrophenylhydrazones and were identified, respectively, by gas-liquid
      chromatography (GLC) and by GLC combined with mass spectrometry (GC/MS) or by
      reverse-phase high-performance liquid chromatography (HPLC) and by HPLC with MS
      (LC/MS). The core aldehydes produced by peroxidation of cholesteryl linoleate
      were identified as mainly 9-oxononanoates of cholesterol and oxycholesterols,
      with smaller amounts of the 8-oxooctenoates, 10-oxodecenoates, 11-oxoundecenoates
      and 12-oxododecenoates. Peroxidation of cholesteryl arachidonate yielded 5
      oxovalerates of cholesterol and the oxycholesterols as the main products with
      smaller amounts of the 4-oxobutyrates, 6-oxohexenoates, 7-oxoheptenoates, 8
      oxooctenoates, 9-oxononenoates, 9-oxononadienoates and 10-oxodecadienotes. The
      oxycholesterols resulting from the peroxidation of the steroid ring were
      identified as mainly 7-keto-, 7 alpha-hydroxy- and 7 beta-hydroxy-cholesterols
      and 5 alpha,6 alpha- and 5 beta,6 beta-epoxy-cholestanols. Cholesteryl palmitate
      and oleate did not yield core aldehydes in the present peroxidation system. In
      these esters, the sterol and linoleic acid moieties appeared to be oxygenated at
      about the same rate, while the arachidonic acid moiety reacted more rapidly than
      did the sterol moiety.

PMID- 8487626
TI  - Characteristics of the thiobarbituric acid reactivity of human urine as a
      possible consequence of lipid peroxidation.
AB  - A 532 nm red pigment formed in the thiobarbituric acid (TBA) assay of human urine
      was characterized after separation of the pigment by high-performance liquid
      chromatography. The yield of the red pigment was somewhat higher at pH 2 than at
      pH 5; its development was not inhibited by ethylenediaminetetraacetic acid. The
      characteristics of the pigment were similar to those of the pigment derived from
      standard malonaldehyde. The amount of the pigment formed was roughly equal to the
      content of malonaldehyde derivatives estimated as 1-(2,4-dinitrophenyl)pyrazole.
      Pigment formation was significantly enhanced by t-butyl hydroperoxide (t-BuOOH)
      and ferric ions, which may be due to pigment formed from aldehydes other than
      malonaldehyde; the presence of these aldehydes was confirmed by the formation of
      the corresponding 2,4-dinitrophenylhydrazones. The amount of pigment produced
      from 24-h urine samples of 12 healthy subjects was estimated to be 26-95 nmol/kg,
      and 65-182 nmol/kg in the presence of t-BuOOH. These values are lower than those
      for urine of rabbit or rat. The TBA reactivity in the absence and presence of t
      BuOOH of human urine was not related to age or sex. The TBA reactivity of human
      urine collected in the afternoon and in the evening was higher than that of urine
      collected in the morning.

PMID- 8487627
TI  - Fatty acids in the lipids of Drosophila heads: effects of visual mutants,
      carotenoid deprivation and dietary fatty acids.
AB  - Lipids of Drosophila heads were extracted and separated by high-performance thin
      layer chromatography. Fatty acid compositions of major phospholipids as well as
      of triglycerides were analyzed by gas-liquid chromatography. Proportions of the
      major fatty acids (14:0, 16:0, 16:1, 18:0, 18:1, 18:2, 18:3) varied depending on
      the lipid analyzed. Docosahexaenoic acid (22:6), common in vertebrate
      photoreceptors and brain, and arachidonic acid (20:4), a precursor of
      eicosanoids, were lacking. A comparison of the fatty acid composition of the diet
      vs. the head suggested that Drosophila can desaturate but may not be able to
      elongate fatty acid carbon chains. Fatty acid analyses were carried out after the
      following visual system alterations: i) the transduction mutant where no receptor
      potential results from a deficit in phospholipase C; ii) an allele of eyes
      absent; iii) the mutant outer rhabdomeres absent which lacks visual pigment and
      rhabdomeres in the predominant type of compound eye receptor, rhabdomeres 1
      through 6; and iv) carotenoid deprivation which reduces opsin and rhabdomere
      size. We also evaluated aging by comparing newly-emerged vs. aged wild-type
      flies. Alterations in fatty acid composition based on some of these manipulations
      were found. Based on comparisons between flies reared on media differing in C16
      and C18, there is an indication that diet readily affects tissue fatty acid
      composition.

PMID- 8487628
TI  - Use of acetyl chloride/methanol for assumed selective methylation of plasma
      nonesterified fatty acids results in significant methylation of esterified fatty
      acids.
AB  - The albumin-bound nonesterified fatty acid pool in plasma, which represents a
      very small percentage of total plasma fatty acids, has previously been
      quantitated by a variety of methods. In the present study we determined that the
      nonesterified fatty acid concentrations in the plasma, quantitated by a popular
      method using acetyl chloride and methanol which is reported to be specific for
      methylation of nonesterified fatty acids in the presence of esterified fatty
      acids (i.e., without prior isolation of the plasma nonesterified fatty acids),
      were significantly overestimated due to cleavage and methylation of esterified
      fatty acids. Quantitation of the contaminating fatty acid from the esterified
      pool demonstrated that the amount of fatty acid cleaved from the esterified pool
      was enough to exceed the entire mass of nonesterified fatty acids. As an
      established method for comparison, we isolated nonesterified fatty acids from the
      plasma by thin-layer chromatography prior to methylation, using a number of
      simple precautions to limit oxidation. By performing all thin-layer
      chromatography steps in an atmosphere of nitrogen and by including fatty acid
      standards in the plasma with 0, 1, 2 or 4 double bonds, we were able to
      accurately and reproducibly determine the concentration of nonesterified fatty
      acids in the plasma, including arachidonate. We demonstrated that no oxidation
      occurred in the thin-layer chromatographic isolation of nonesterified fatty acids
      and that the coefficients of variation for repeat measurements of the same sample
      were < 11% using our reference method. Our data indicate that the use of acetyl
      chloride and methanol for assumed selective methylation of plasma nonesterified
      fatty acids results in significant methylation of esterified fatty acids.

PMID- 8487629
TI  - Profiling of arachidonic acid metabolites in rabbit platelets by radio gas
      chromatography.
AB  - A method for profiling arachidonic acid metabolites by radio gas chromatography
      (GC) is described. The incubation mixture of rabbit platelets with
      [14C]arachidonic acid was purified on a Sep-Pak C18 cartridge and derivatized
      with diazomethane, O-methylhydroxylamine and dimethyl-isopropylsilylimidazole.
      The recovery of total 14C-radioactivity was 93.1 +/- 7.2%. Loss of radioactivity
      during derivatization was negligible. Baseline separations for [14C]arachidonic
      acid and its metabolites were obtained in a single run within 45 min by GC using
      a synchronized accumulating radioisotope detector (GC/SARD). The recovery of
      radioactivity from the GC column was virtually 100%. The chemical structures of
      the metabolites were confirmed by GC/mass spectrometry; peaks of arachidonic acid
      metabolites were assigned by comparison of the methylene unit values with those
      of radioactive peaks in GC/SARD analyses. The intra-assay coefficients of
      variation in GC/SARD analyses were less than 10%. The method was used to map the
      profile of arachidonic acid metabolites formed by rabbit platelets in the
      presence of indomethacin, baicalein or glutathione.

PMID- 8487630
TI  - Evolution of the Zfx and Zfy genes: rates and interdependence between the genes.
AB  - A phylogenetic analysis of sex-chromosomal zinc-finger genes (Zfx and Zfy)
      indicates that the genes have not evolved completely independently since their
      initial separation. The sequence similarities suggest gene conversion in the last
      exon between the duplicated Y-chromosomal genes Zfy-1 and Zfy-2 in the mouse.
      There are also indications of conversion (or recombination) between the X- and Y
      chromosomal genes in the crab-eating fox and in the mouse. The method for
      estimating synonymous and nonsynonymous substitutions is modified by
      incorporating the substitutions in the twofold-degenerate sites in a novel way.
      The estimates of synonymous substitutions support the generation-time hypothesis
      in that the obtained rates are higher in mice (by a factor of 4.7) than in humans
      and higher in the Y-chromosomal genes (by a factor of 1.9) than in the X
      chromosomal genes.

PMID- 8487631
TI  - mtDNA diversity in rhesus monkeys reveals overestimates of divergence time and
      paraphyly with neighboring species.
AB  - Reconstructions of the human-African great ape phylogeny by using mitochondrial
      DNA (mtDNA) have been subject to considerable debate. One confounding factor may
      be the lack of data on intraspecific variation. To test this hypothesis, we
      examined the effect of intraspecific mtDNA diversity on the phylogenetic
      reconstruction of another Plio-Pleistocene radiation of higher primates, the
      fascicularis group of macaque (Macaca) monkey species. Fifteen endonucleases were
      used to identify 10 haplotypes of 40-47 restriction sites in M. mulatta, which
      were compared with similar data for the other members of this species group.
      Interpopulational, intraspecific mtDNA diversity was large (0.5%-4.5%), and
      estimates of divergence time and branching order incorporating this variation
      were substantially different from those based on single representatives of each
      species. We conclude that intraspecific mtDNA diversity is substantial in at
      least some primate species. Consequently, without prior information on the extent
      of genetic diversity within a particular species, intraspecific variation must be
      assessed and accounted for when reconstructing primate phylogenies. Further, we
      question the reliability of hominoid mtDNA phylogenies, based as they are on one
      or a few representatives of each species, in an already depauperate superfamily
      of primates.

PMID- 8487632
TI  - Nucleotide sequence of the D-loop region of the sperm whale (Physeter
      macrocephalus) mitochondrial genome.
AB  - We have amplified, by the polymerase chain reaction, and have sequenced the D
      loop region of the mitochondrial DNA from the sperm whale (Physeter
      macrocephalus). The sperm whale D-loop was aligned with D-loop sequences from
      four other cetaceans (Commerson's dolphin, orca, fin whale, and minke whale) and
      an out-group (cow). This alignment showed the sperm whale sequence to be larger
      than that of other cetaceans. In addition, some sequence blocks were highly
      conserved among all six species, suggesting roles in the functioning of
      mitochondrial DNA. Other blocks that were previously reported to be well
      conserved among cetaceans showed little sequence conservation with the sperm
      whale D-loop, which argues against the functional importance of these sequence
      blocks in cetaceans.

PMID- 8487633
TI  - Molecular studies on two variant repeat types of the common cetacean DNA
      satellite of the sperm whale, and the relationship between Physeteridae (sperm
      whales) and Ziphiidae (beaked whales).
AB  - In the sperm whale (Physeter macrocephalus) two different repeat types (A and B)
      of the common cetacean DNA satellite were identified. The evolution of each group
      of repeats appears to be independent from that of the other. The sequence
      similarity between the two groups is less than the similarity between group A and
      repeats of the satellite in related whale species. The systematic relationship
      within and between the families Physeteridae (sperm whales) and Ziphiidae (beaked
      whales) was addressed by both sequence analysis of the satellite and comparisons
      with the families Delphinidae and Phocoenidae. The mysticete blue whale
      (Balaenoptera musculus) was used as an outgroup in the comparisons. The molecular
      phylogeny, when maximum-parsimony analysis and the neighbor-joining method were
      used, grouped together species of each family. At the family level the ziphiids
      grouped closet to the families Phocoenidae and Delphinidae. The similarities
      between the common cetacean satellite of the blue whale and the sperm whale were
      greater than those between the blue whale and the other odontocetes included,
      suggesting that the evolution of the satellite is slower in the sperm whale than
      in the other odontocetes.

PMID- 8487634
TI  - Intraspecific DNA sequence variation of the mitochondrial control region of white
      sturgeon (Acipenser transmontanus).
AB  - Intraspecific sequence variation in the D-loop region of mtDNA in white sturgeon
      (Acipenser transmontanus), a relict North American fish species, was examined in
      27 individuals from populations of the Columbia and Fraser rivers. Thirty-three
      varied nucleotide positions were present in a 462-nucleotide D-loop sequence,
      amplified using the polymerase chain reaction. Bootstrapped neighbor-joining and
      maximum-parsimony trees of sequences from 19 haplotypes suggest that the two
      populations have recently diverged. This is consistent with the hypothesis that
      the Columbia River, a Pleistocene refugium habitat, was the source of founders
      for the Fraser River after the last glacial recession. On the basis of a
      divergence time of 10-12 thousand years ago, the estimated substitution rate of
      the white sturgeon D-loop region is 1.1-1.3 x 10(-7) nucleotides/site/year, which
      is comparable to rates for hypervariable sequences in the human D-loop region.
      Furthermore, the ratio of mean percent nucleotide differences in the D-loop
      (2.27%) to that in whole mtDNA (0.54%, as estimated from restriction-enzyme data)
      is 4.3, which is similar to the fourfold-to-fivefold-higher substitution rate
      estimated for the human D-loop. The high nucleotide substitution rate of the
      hypervariable region indicates that the vertebrate D-loop has potential as a
      genetic marker in molecular population studies.

PMID- 8487635
TI  - Phylogenetic relationships in Drosophila: a conflict between molecular and
      morphological data.
AB  - Grimaldi's recent cladistic classification of genera in the family Drosophilidae,
      based on adult morphological characters, is evaluated for those taxa for which
      alcohol dehydrogenase DNA sequences are also available. These data allow us to
      look at relationships of the Drosophila subgenera Sophophora and Drosophila with
      the Hawaiian Drosophila (Idiomyia) and with Scaptomyza, when Scaptodrosophila is
      used as an outgroup. The molecular data give strong support for the broad
      relationships hypothesized by Throckmorton, who contended that the subgenus
      Sophophora is a sister group to the remaining ingroup taxa. The Drosophila
      subgenus Engiscaptomyza, which Throckmorton regarded as intermediate between the
      Idiomyia (Hawaiian Drosophila) and Scaptomyza, is shown to be much more closely
      allied with Scaptomyza, in agreement with Grimaldi's results from adult
      morphology. The Hawaiian taxa, both Idiomyia and Scaptomyza, are firmly located
      as a sister group to the subgenus Drosophila, and these in turn all form a sister
      group to the subgenus Sophophora. Grimaldi's classification of these taxa is
      quite different and places the Hawaiian Drosophila (Idiomyia) as sister group to
      the remaining ingroup taxa (Scaptomyza and the subgenera Sophophora and
      Drosophila). Our results show that Grimaldi's new classification of these taxa
      results in paraphyletic groups, just as does the traditional classification under
      Throckmorton's interpretation of relationships. Additional data are required to
      produce a robust classification of this huge paraphyletic genus.

PMID- 8487636
TI  - Mitochondrial DNA evolution in the Montium-species subgroup of Drosophila.
AB  - Mitochondrial DNA (mtDNA) restriction-site maps for six species (10 strains) of
      the Drosophila montium subgroup were established. A total of 50 restriction sites
      were mapped, corresponding to 1.67% of the mtDNA genome. On the basis of
      differences in the restriction sites, nucleotide divergence (delta) was
      calculated for each pair of species (strains), and phylogenetic trees were
      constructed by using distance-matrix and parsimony methods. Comparison of the
      resultant phylogenetic trees shows that the sibling species D. auraria and D.
      quadraria are closely related. At the other extreme, considerable divergence was
      observed between the two strains of D. serrata and between D. serrata and D.
      birchii, a finding that contrasts with their grouping within the same species
      complex. Nevertheless, our data indicate that these six oriental montium species
      are rather closely related.

PMID- 8487637
TI  - DNA insertions as a component of the evolution of unique satellite DNA families
      in two genera of parasitoid wasps: Diadromus and Eupelmus (Hymenoptera).
AB  - In the two parasitoid wasps, Diadromus collaris and Eupelmus orientalis, the
      satellite DNAs were each found to consist wholly or largely of a single family
      (5%-7% of the genome). Several clones of each family were obtained and sequenced.
      The repeat unit in each species is characterized by both the repetition of a
      basic motif and the presence of an inserted sequence. Sequence comparisons with
      satellite DNA from D. pulchellus and E. vuilleti provide plausible scenarios for
      the evolution of the satellite DNA in each genus. Palindromes and A-rich tracts
      in each consensus sequence suggest the formation, in vivo, of hairpin structures
      and bend centers that may play a role in heterochromatin condensation in insects.
      The insertions in the repeat units of each species also contain these structural
      features, suggesting that maintenance of these insertions requires constraints
      similar to those pertaining to the rest of the satellite-DNA unit.

PMID- 8487638
TI  - Low codon bias and high rates of synonymous substitution in Drosophila hydei and
      D. melanogaster histone genes.
AB  - We have evaluated codon usage bias in Drosophila histone genes and have obtained
      the nucleotide sequence of a 5,161-bp D. hydei histone gene repeat unit. This
      repeat contains genes for all five histone proteins (H1, H2a, H2b, H3, and H4)
      and differs from the previously reported one by a second EcoRI site. These D.
      hydei repeats have been aligned to each other and to the 5.0-kb (i.e., long) and
      4.8-kb (i.e., short) histone repeat types from D. melanogaster. In each species,
      base composition at synonymous sites is similar to the average genomic
      composition and approaches that in the small intergenic spacers of the histone
      gene repeats. Accumulation of synonymous changes at synonymous sites after the
      species diverged is quite high. Both of these features are consistent with the
      relatively low codon usage bias observed in these genes when compared with other
      Drosophila genes. Thus, the generalization that abundantly expressed genes in
      Drosophila have high codon bias and low rates of silent substitution does not
      hold for the histone genes.

PMID- 8487639
TI  - Phylogenetic relationships among Taphrina, Saitoella, and other higher fungi.
AB  - To determine the phylogenetic placement of the major groups of higher fungi, we
      sequenced the DNA sequences from the small-subunit ribosomal RNA (18S rRNA)
      coding regions from Taphrina wiesneri (synonym: T. cerasi) and Saitoella
      complicata and compared them to 18S rRNA sequences from the oomycetes,
      chytridiomycetes, zygomycetes, ascomycetes, and basidiomycetes. Here we
      demonstrate that the ascomycetes have at least two major evolutionary lineages.
      Taphrina wiesneri and Saitoella complicata form a monophyletic branch that
      diverged prior to the separation of other ascomycetes. The same treatment could
      be accorded to Schizosaccharomyces pombe.

PMID- 8487640
TI  - The variability of the hepatitis B virus genome: statistical analysis and
      biological implications.
AB  - A statistical analysis of the nucleotide sequence variability in 14 published
      hepatitis B virus (HBV) genomes was carried out using parametric and
      nonparametric methods. A parametric statistical model revealed that the different
      regions of the genome differed significantly in their variability. The conclusion
      was supported by a nonparametric kernel-density model of the HBV genome. Genes S,
      C, and P, region X, the precore region, and the pre-S2/pre-S1 regions were ranked
      in order of increasing variability. In many instances, conserved regions of the
      genome identified with sequences of known function in HBV biology. However, other
      characterized regions (such as pre-S) showed much variability despite the
      involvement of their encoded peptides in specific functions. Point mutations that
      may result in the formation of stop codons and amino acid changes may affect the
      clinical picture of HBV infection and may be reflected in atypical serological
      patterns.

PMID- 8487641
TI  - Lack of mitochondrial DNA variation in Australian Drosophila buzzatii.

PMID- 8487642
TI  - The evolution of the cytochrome b protein: How many regions are conserved?

PMID- 8487643
TI  - Aldose reductase expression and prostaglandin E2 production are coordinately
      regulated in cultured rat mesangial cells.
AB  - There is increasing evidence that a link between the polyol pathway and
      prostaglandins is important in the pathogenesis of diabetic nephropathy. The
      presence of the polyol pathway in the kidneys of normal animals, the galactose
      fed rat, and animals with experimental diabetes has been established. While
      aldose reductase (AR) immunoreactive protein (AR-IRP) and AR mRNA are expressed
      at high levels in renal medulla, the sites of AR synthesis and regulation and
      metabolic consequences of AR activity in renal cortex are uncertain. The present
      study was conducted to test the hypothesis that AR expression and PGE2 production
      are coordinately regulated in glomerular mesangial cells. To test this
      hypothesis, we measured AR-IRP, AR mRNA, and PGE2 production in mesangial cells
      isolated from rats maintained on diets containing normal chow (MC-N), 50%
      galactose (MC-G), and 50% dextrin (MC-D). The rank order for each parameter
      studied (AR-IRP, AR mRNA, PGE2) was MC-N > MC-G > MC-D. Western blot analysis
      demonstrated that MC-N (optical density [OD] 1.0), MC-G (OD 0.59), and MC-D (OD
      0.25) express AR-IRP. Slot-blot analyses demonstrated that levels of AR mRNA were
      greatest in MC-N (1.0), intermediate in MC-G (0.49), and lowest in MC-D (0.31).
      Ribonuclease (RNase) protection analyses demonstrated a similar pattern of AR
      mRNA expression, with MC-N at 1.0, MC-G at 0.60, and MC-D at 0.33. PGE2
      production (pg/5 x 10(4) cells/30 min) was highest in MC-N (278 +/- 29),
      intermediate in MC-G (110 +/- 9), and lowest in MC-D (37 +/- 4).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8487644
TI  - Impaired glucose tolerance after endurance exercise is associated with reduced
      insulin secretion rather than altered insulin sensitivity.
AB  - Paired frequently sampled intravenous glucose tolerance tests (FSIGT) were
      performed on five highly trained athletes within 2 hours of completing a 6-day
      ultramarathon run (E) and after 2 weeks of complete rest (R). Severe exercise
      increased free fatty acid (FFA) levels (E 1.2 +/- 0.16 v 0.42 +/- 0.07 mmol/L, P
      < .01) and norepinephrine levels (E 573 +/- 141 v 224 +/- 33 pg/mL, P < .01),
      with only moderate reductions in glucose tolerance (glucose disappearance [Kg] E
      1.06 +/- 0.2 v R 1.7 +/- 0.3 min-1 x 10(2), P < .05). The minimal model analysis
      of FSIGT data using the method of Bergman et al (Endocr Rev 6:45-86, 1985) showed
      a reduced second-phase insulin secretion ([phi 2] E 5.2 +/- 1.3 v 13 +/- 2.2
      microU/mL.min-2 per mg/dL, P < .05) and glucose disposition index ([SI x phi 2] E
      33.8 +/- 10 v 73.9 +/- 11 mg-1.dL.min-3 x 10(4), P < .02). Insulin sensitivity
      (SI) and glucose-mediated glucose disposal (SG) were unchanged (SI E 6.9 +/- 1.0
      v 6.0 +/- 0.6 min-1 per microU/mL x 10(4); SG E 1.8 +/- 0.6 v 1.4 +/- 0.3 min-1 x
      10(2)). Reduced glucose tolerance after prolonged extreme physical exercise was
      accompanied by reduced phi 2 and not by alterations of SI or SG, despite the
      marked increase of FFA levels. Elevated norepinephrine levels, reflecting
      activation of the sympathetic noradrenergic system, was also associated with the
      reduction in Kg. The reduction in phi 2 would promote mobilization of FFA, the
      predominant metabolic substrate in these endurance events.

PMID- 8487645
TI  - Hepatic insulin action in adolescents with insulin-dependent diabetes mellitus:
      relationship with long-term glycemic control.
AB  - The relationship between hepatic insulin action and long-term glycemic control
      was assessed in 20 adolescents with insulin-dependent diabetes mellitus (IDDM)
      and five healthy matched controls using a two-step (0.8 and 1.6 mU/kg/min)
      hyperinsulinemic-euglycemic clamp and [6,6-2H2]glucose. The night before the
      study, diabetic patients received variable-rate intravenous insulin in an attempt
      to normalize fasting plasma glucose concentrations. In the postabsorptive state,
      hepatic glucose production (HGP) was similar in IDDM patients and controls (593
      +/- 40 v 518 +/- 27 mumol/m2/min); however, plasma glucose and free insulin
      concentrations were higher in IDDM patients than in controls (6.5 +/- 0.4 v 5.4
      +/- 0.1 mmol/L [P = .01], and 207 +/- 21 v 104 +/- 10 pmol/L [P < .001],
      respectively). There was a positive correlation (r = .62 P = .002) between basal
      HGP and glycohemoglobin level (HbA1). Separation of the patients at the median
      HbA1 (group no. 1 < and group no. 2. > 11.4% HbA1) revealed two distinct patient
      populations with regard to hepatic and peripheral insulin action and plasma free
      fatty acid (FFA) suppression. During hyperinsulinemia, the percent suppression of
      HGP was lower in group no. 2 compared with group no. 1 (65.7% +/- 9.8% v 94.4% +/
      3.8%; P = .018). Rates of glucose disposal were lower in group no. 2 compared
      with controls and with group no. 1. Postabsorptive FFA levels were similar
      between group no. 2 and group no. 1 (0.45 +/- 0.03 and 0.43 +/- 0.04 mmol/L)
      despite higher free-insulin concentrations in group no. 2 (260 +/- 30 v 171 +/-
      25 pmol/L; P = .04).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487646
TI  - Protein turnover in advanced lung cancer patients.
AB  - Understanding the extent to which changes in whole-body protein kinetics
      contribute to the commonly observed weight loss and decrease in lean body mass
      (LBM) in patients with cancer is currently obscured by conflicting reports in the
      literature. While several studies have reported significant increases in whole
      body protein turnover (WBPT), synthesis (WBPS), and catabolism (WBPC) in patients
      with cancer, others have failed to confirm these observations. We have measured
      whole-body protein kinetics using a primed constant infusion of 15N-glycine in a
      homogenous group of 32 newly diagnosed advanced lung cancer patients with
      comparable staging and before any antineoplastic treatment, and in 19 normal
      healthy volunteer controls. Urinary urea and ammonia 15N enrichment was
      determined in individually collected urine samples obtained during the 24-hour
      study period and averaged for the determination of protein kinetics. During the
      last 6 hours of urine collection, samples were obtained hourly for determination
      of 15N plateau enrichment. Twenty-four-hour urinary nitrogen and creatinine
      excretion was determined from 24-hour pooled urine samples. Resting metabolic
      expenditure (RME) was determined by indirect calorimetry and LBM was estimated
      from deuterium oxide dilution. Age body weight, LBM, RME, and 24-hour urinary
      nitrogen excretion did not differ between cancer and control subjects. WBPT,
      WBPC, and WBPS (g/kg/d) were significantly increased in lung cancer patients.
      However, when the same results were expressed either per kilogram LBM or per gram
      24-hour urinary creatinine excretion, WBPT, WBPC, and WBPS rates were not
      statistically different from those of the controls.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8487647
TI  - Effects of tumor necrosis factor on the hypothalamic-pituitary-testicular axis in
      healthy men.
AB  - Tumor necrosis factor (TNF) has been implicated as a mediator of many diseases
      associated with alterations in hypothalamic-pituitary-testicular (HPT) function.
      To assess the effects of TNF on the HPT axis, we performed a saline-controlled
      cross-over study in six healthy men, sequentially measuring serum concentrations
      of gonadotropins, testosterone, and sex hormone-binding globulin (SHBG) after a
      bolus intravenous injection of recombinant human TNF (50 micrograms/m2). TNF
      induced an early and transient increase in serum luteinizing hormone (LH) levels
      from 6.0 +/- 1.0 to a maximum of 8.0 +/- 1.0 U/L after 30 minutes (P < .005),
      whereas the concentrations of follicle-stimulating hormone (FSH) remained
      unchanged. The increase in LH concentrations was followed by a transient decrease
      in serum testosterone levels from 18.2 +/- 0.3 to 9.1 +/- 1.2 nmol/L after 4
      hours (P < .0001). Remarkably, LH levels had returned to control values when the
      testosterone level reached its nadir. SHBG levels were not affected by TNF. Our
      results suggest that TNF affects the HPT axis at multiple levels and may be
      involved either directly or indirectly in the decrease in circulating
      testosterone concentrations in systemic illnesses.

PMID- 8487648
TI  - Acipimox increases glucose disposal in normal man independent of changes in
      plasma nonesterified fatty acid concentration and whole-body lipid oxidation
      rate.
AB  - The short-term administration of a nicotinic acid analogue (acipimox) increases
      insulin sensitivity and consequently glucose disposal, both in patients with non
      insulin-dependent diabetes mellitus (NIDDM) and in patients with cirrhosis. This
      effect has been attributed to a decrease in plasma nonesterified fatty acid
      (NEFA) levels and fatty acid oxidation rates, and a corresponding increase in
      carbohydrate oxidation. The aim of the present study was to determine whether
      acipimox influenced glucose disposal independent of changes in lipid metabolism.
      Seven normal men (age, 31 +/- 4 years; body mass index, 23.2 +/- 1.8 kg.m-2; fat
      free mass [FFM], 66.8 +/- 4.2 kg) were studied on two separate occasions with
      hyperinsulinemic (0.06 U.kg FFM-1.h-1) euglycemic clamps (duration, 150 minutes).
      A primed (150 U), continuous (0.4 U.kg-1.min-1) infusion of heparin together with
      10% intralipid (25 mL.h-1) was infused in both studies from -90 to 150 minutes to
      maintain comparable levels of plasma NEFA and lipid oxidation rates. Acipimox
      (500-mg capsules) or placebo were administered orally in a double-blind random
      fashion at t = -90 and t = 0 minutes. Whole-body lipid and carbohydrate oxidation
      were measured in the last 30 minutes of both the basal (preclamp) period (-30 to
      0 minutes) and the clamp period (120 to 150 minutes).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8487649
TI  - The methylcobalamin metabolism of cultured human fibroblasts.
AB  - The effect of supplying exogenous methylcobalamin (MeCbl), a methyl donor to
      methionine synthase (MS), on the cellular metabolism of MeCbl was tested in
      cultured fibroblasts from healthy persons and from a subject with an inherited
      defect in the synthesis of MeCbl. MeCbl bound to transcobalamin II (TCII) was
      taken up in larger amounts than cyanocobalamin (CN-Cbl), but was equal to the
      uptake of hydroxocobalamin (OH-Cbl). The form of Cbl in the lysosomes persisted
      as the same form, bound to TCII, to which the cells were exposed in the medium.
      Once released from the lysosomes, both MeCbl and OH-Cbl were converted in the
      same proportions to coenzyme forms, suggesting equivalent entry into common
      cellular pools of Cbl from which active forms are synthesized. Exogenous MeCbl
      enjoyed no advantage in binding to MS, in synthesis of MeCbl, and in supporting
      cell division in the absence of methionine. All evidence supported the concept
      that in human cells the active MeCbl on MS forms de novo on the enzyme. It
      appeared unlikely that therapeutic MeCbl would have any advantage over OH-Cbl in
      the treatment of MeCbl deficiency or Cbl deficiency in general.

PMID- 8487650
TI  - Influence of omega-3 fatty acid treatment on cardiac phospholipid composition and
      coronary flow of streptozocin-diabetic rats.
AB  - Cardiac effects of omega-3 fatty acid treatment were studied in streptozocin
      (STZ)-induced (55 mg/kg intravenously [IV]) diabetic male Wistar rats.
      Nondiabetic control and STZ-diabetic animals were treated with Promega (0.5
      mL/kg/d; Warner-Lambert, Morris Plains, NJ) for a period of 4 weeks beginning 2
      weeks after either vehicle or STZ injection. Plasma glucose, triglyceride, and
      cholesterol concentrations were significantly (P < .05) elevated in diabetic
      animals; omega-3 fatty acid treatment did not significantly affect these
      parameters. An isolated working heart preparation was used to determine aortic
      and coronary flow rates in control, diabetic, treated control, and treated
      diabetic animals. Aortic and coronary flow rates of untreated STZ-diabetic rats
      were significantly (P < .05) lower than those of controls over a range of left
      atrial filling pressures (7.5 to 20 cm water). Both aortic and coronary flow
      rates of omega-3 fatty acid-treated diabetic animals were significantly (P < .05)
      increased above those of untreated diabetic rats. Aortic and coronary flow rates
      of treated diabetic rats paralleled those of control animals; omega-3 fatty acid
      treatment did not affect aortic or coronary flow rates of control animals.
      Cardiac phosphatidylcholine (PC) and phosphatidylethanolamine (PE) and
      sarcoplasmic reticulum (SR) total phospholipid were isolated and the acyl
      composition was determined. Stearic acid and C22:4, n-6 were significantly
      reduced in cardiac PE of diabetic animals. Relative to PE acyl species of
      untreated nondiabetic controls, treated diabetic PE had increased
      eicosapentaenoic acid (EPA) and decosahexaenoic acid (DHA) and reduced C22:4, n-6
      levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487651
TI  - Treatment of E2E2 homozygous familial dysbetalipoproteinemic subjects with
      gemfibrozil does not enhance the binding of their d < 1.019 lipoprotein fraction
      to the low-density lipoprotein receptor.
AB  - Six E2E2 homozygous familial dysbetalipoproteinemic (FD) patients were treated
      with gemfibrozil (2 x 600 mg/d) for a period of 4 weeks. For all subjects,
      normalization of serum cholesterol concentrations with treatment did not result
      in a significant change in the cholesterol/triglyceride ratio of the d < 1.019
      lipoprotein fraction. In addition, the binding efficiency of this lipoprotein
      fraction to the low-density lipoprotein (LDL) receptor on HepG2 cells did not
      change consistently with treatment. We conclude that normalization of serum
      cholesterol concentrations in FD patients by treatment with gemfibrozil is the
      result of an effect of gemfibrozil on the synthesis of d < 1.019 lipoproteins
      rather than an effect on the receptor-mediated clearance of these particles.

PMID- 8487652
TI  - Glucose turnover in severe falciparum malaria.
AB  - To investigate glucose metabolism in acute falciparum malaria, [3-3H]glucose
      turnover was measured in 18 normoglycemic adult Thais (eight males, 10 females;
      median age, 28 years) with severe infections. Eleven patients were studied before
      quinine treatment, 15 while receiving quinine, and 10 during convalescence. In
      paired studies conducted before and after initial intravenous quinine, plasma
      glucose level decreased from a median (95% confidence limits) of 5.5 (3.0 to 6.6)
      to 4.6 (2.5 to 6.1) mmol/L (P < or = .027, n = 8), and plasma insulin level
      increased 9.3 (-3.2 to 30.0) mU/L (P = .02). Glucose turnover decreased during
      the 4-hour quinine infusion from 3.04 (2.12 to 4.23) to 1.89 (1.20 to 2.54)
      mg/kg.min-1 (P < .004), as did the metabolic clearance rate for glucose (2.87
      [1.88 to 7.83] to 2.50 [1.43 to 4.55) mL/kg.min-1; P = .008). Glucose turnover
      and clearance measured both after initial quinine treatment and in convalescence
      were similar (P = .234 and .344, respectively; n = 7). In the series as a whole,
      there was an inverse association between pretreatment turnover and the
      simultaneous plasma glucose level (rs = -.76, P < .01; n = 11), a stronger
      inverse relationship between glucose clearance and plasma glucose level (rs = 
      .88, P < .001), and a positive association between pretreatment turnover and oral
      temperature (rs = .65, P < .025; n = 10). These data suggest that, as in other
      severe illnesses, glucose turnover is high in untreated patients, but that
      glycolysis by mature parasite forms may accelerate glucose disposal.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8487653
TI  - Effects of colonic fermentation on respiratory gas exchanges following a glucose
      load in man.
AB  - Colonic fermentation produces short-chain fatty acids (SCFA). In humans, the
      amount of energy produced from the oxidation of these compounds is unknown and
      could modify the metabolic utilization of energetic fuels (eg, carbohydrates and
      lipids). If it were so, the equations used to evaluate the oxidation of nutrients
      from indirect calorimetry data should include the contribution of SCFA, which is
      not usually the case. Indeed, this fermentation process is usually considered as
      a minor and neglected energetic pathway. In this study, we have addressed the
      reliability of this assumption. Six normal subjects received orally either 50 g
      glucose or 50 g glucose plus 20 g lactulose. Their respiratory gas exchanges,
      breath hydrogen, methane, and 13CO2 concentrations, and plasma glucose, insulin,
      and free fatty acid (FFA) concentrations were monitored for 8 hours. CO2
      production and breath hydrogen concentration were significantly greater with
      lactulose. No differences in oxygen consumption, breath 13CO2 production, or
      plasma concentrations of blood glucose, FFA, and insulin could be found between
      the two experiments. This suggests that the fermentation process induced by
      lactulose generates extra fuels going through an oxidation pathway. Therefore,
      the classic equations used to calculate carbohydrate and lipid oxidation and
      energy expenditure (EE) from indirect calorimetry data are probably not valid
      when fermentation is taking place. Indeed, in this experiment we could have
      overestimated glucose oxidation (12.5%) if the fermentation process were not
      considered. In conclusion, colonic fermentation in humans of nondigestible
      carbohydrates produces energetic substrates that could be used and oxidized as
      energetic fuels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487654
TI  - Effect of heparin on insulin-glucose interactions measured by the minimal model
      technique: implications for reproducibility using this method.
AB  - The minimal model technique permits investigation of glucose and insulin
      interactions during a frequently sampled intravenous glucose tolerance test
      (FSIGT). The model allows measurement of several important variables including
      insulin sensitivity (SI), glucose effectiveness at basal insulin (SG), and
      glucose effectiveness at zero insulin (GEZI). In addition, from the FSIGT, first
      phase insulin secretion (AIRglucose) and the glucose disappearance constant (Kg)
      can be estimated. The estimates obtained using the minimal model technique could
      be of importance in understanding potential relationships between carbohydrate
      and lipid metabolism. In studying lipoprotein lipase (LPL) activity and mass as
      one of the elements of lipid metabolism, heparin administration is necessary.
      However, the effect of administration of this agent on factors important in
      carbohydrate metabolism has not been fully elucidated. Therefore, to assess the
      effect of heparin on insulin-glucose interactions, we performed paired studies in
      which subjects randomly underwent FSIGT studies 20 minutes following bolus
      injections of heparin or saline. None of the measured parameters was influenced
      by heparin administration just before the FSIGT. Since these estimates were not
      affected by heparin administration, these studies also permitted assessment of
      the coefficient of variation of replicate analysis for all values generated using
      the minimal model technique. The coefficients of variation of replicate analysis
      calculated from these two studies were 16.9% for SI, 16.6% for SG, 18.3% for
      GEZI, 20.6% for AIRglucose, and 14.5% for Kg. These results suggest that heparin
      can be administered as part of a procedure that would allow concurrent assessment
      of various aspects of both carbohydrate and lipid metabolism.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8487655
TI  - Glutamine is a potentially limiting amino acid for milk production in dairy cows:
      a hypothesis.
AB  - Recently, extensive research has been focused on glutamine because of its key
      position between energy and protein metabolism. Evidence is growing that
      glutamine is essential in situations of metabolic stress; practical application
      of this knowledge can already be found in parenteral nutrition of severely ill
      patients. Furthermore, glutamine is claimed to increase muscle protein synthesis.
      Glutamine and its counterpart, glutamic acid, are the most abundant amino acids
      in milk protein. Nevertheless, the role of nonessential amino acids (NEAA) in
      milk protein synthesis in high-yielding dairy cows has been practically neglected
      during the past 20 years. Evaluating current literature on glutamine metabolism
      in ruminants with emphasis on data related to milk protein production, we
      conclude the following: (1) Ruminants have a relatively low glutamine synthetase
      capacity compared with monogastric species, reflected in relatively low plasma
      glutamine levels; (2) The uptake of glutamine by the mammary gland is effectively
      100% of the arterial supply; (3) Milk production in high-yielding dairy cows
      represents a metabolic stress comparable to fasting or acidosis; and (4)
      Responses of plasma and tissue glutamine pools in conditions of "metabolic
      stress," including high milk production, resemble those of most essential amino
      acids (EAA). Therefore we hypothesize that glutamine, although regarded as a
      NEAA, limits milk protein synthesis in high-yielding dairy cows.

PMID- 8487656
TI  - No change in glucose tolerance and substrate oxidation after a high-carbohydrate,
      low-fat diet.
AB  - Possible changes in glucose tolerance and substrate oxidation after a high
      carbohydrate, low-fat diet were studied in seven healthy volunteers. Each subject
      consumed two experimental diets for 1 week after 1 week on a stabilization diet;
      diet no. 1 11% fat and 64% carbohydrates, and diet no. 2 30% fat and 45%
      carbohydrates. At the end of each experimental week, plasma levels of glucose,
      insulin, and free fatty acids were measured before and every 30 minutes for 6
      hours after a 75-g oral glucose challenge. At the same time, energy expenditure
      and substrate oxidation were measured by indirect calorimetry. Plasma lipid and
      lipoprotein levels were measured at the end of one stabilization period and at
      the end of each diet. Plasma glucose concentrations and areas under the curve of
      glucose concentrations were identical after the two experimental periods; the
      means +/- standard deviation for the values at 120 minutes were 6.4 +/- 0.3 and
      6.4 +/- 0.6 mmol/L after diets no. 1 and 2, respectively, and areas under the
      curve were 1,853 +/- 115 and 1,862 +/- 211 mmol.min/L after diets no. 1 and 2,
      respectively. Similarly, plasma concentrations of insulin and free fatty acids
      after glucose ingestion were unaffected by the dietary changes. Energy
      expenditure increased after glucose administration, and this thermic effect of
      glucose was identical after the two experimental diets at 4.2% +/- 1.4%, and 3.9%
      +/- 1.4% of ingested energy for diets no. 1 and 2, respectively. Substrate
      oxidation rates were also identical for both the fasted and post-glucose periods
      after the two diets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487657
TI  - Lack of insulin feedback inhibition in non-obese and obese men.
AB  - The existence of insulin feedback inhibition is a controversial issue. The
      present study adopted a novel approach to determine whether insulin feedback
      inhibition exists in vivo during physiologic hyperinsulinemia and if it could
      contribute to enhanced insulin secretion in obesity. Serial plasma insulin and C
      peptide levels were determined during a basal state and a hyperinsulinemic clamp
      (287 pmol/min/m2) and following discontinuation of the insulin infusion under
      euglycemic conditions. Insulin secretion rates were derived from plasma C-peptide
      levels and individual C-peptide kinetics using a two-compartment model. Eight non
      obese and nine obese men were recruited for the studies, which were performed in
      random order. Men with significant variations in glucose levels during
      hyperinsulinemia were excluded from the analysis. Plasma glucose levels were
      similar between the non-obese and obese groups during all phases of the study,
      and similar plasma insulin levels were achieved in both groups during euglycemic
      hyperinsulinemia. In obese men, C-peptide levels were significantly greater
      compared with non-obese men during euglycemic hyperinsulinemia (P < .05).
      However, neither the non-obese nor the obese group demonstrated significant
      suppression of insulin secretion rates during euglycemic hyperinsulinemia.
      Expressing the data in absolute terms or as a percent of basal did not alter the
      results. Moreover, there was no significant change between the non-obese and the
      obese group during the rapid onset and cessation of hyperinsulinemia. Under
      euglycemic conditions, physiologic hyperinsulinemia does not induce suppression
      of endogenous insulin secretion in non-obese or obese men.

PMID- 8487658
TI  - Influence of calmodulin antagonists and calcium channel blockers on
      triiodothyronine uptake by rat hepatoma and myoblast cell lines.
AB  - The influence of calcium-related mechanisms on cellular uptake of
      triiodothyronine (T3) has not yet been defined, although it is known that T3 can
      stimulate cellular entry of calcium. We therefore investigated the saturable
      uptake of [125I]-T3 (10(-11) mol/L) from serum-free medium in vitro by hepatoma
      (H4) cells and skeletal myoblast (L6) cells to establish the calcium-dependency
      of this process. We studied the effects of the following three structurally
      distinct types of calmodulin antagonists in H4 cells: the naphthalene
      sulfonamides W7, W12, and W13, calmidazolium, and trifluoperazine. Uptake of
      [125I]-T3 as a percentage of control values (n = 4, 10(-4) mol/L antagonist) was
      as follows: W7, 42.0% +/- 3.3% (P < .001); W12, 87.5% +/- 4.5% (NS); W13, 79.5%
      +/- 2.5% (P < .05); calmidazolium (10(-6) mol/L, n = 8), 55.1% +/- 2.2% (P <
      .001); and trifluoperazine (10(-5) mol/L, n = 6), 65.7% +/- 4.1% (P < .001). To
      investigate whether the calmodulin sensitivity of uptake was mediated via
      transmembrane calcium flux, we also studied the effects of three structurally
      distinct types of organic calcium channel blockers in both H4 and L6 cells.
      [125I]-T3 uptake as a percent of control values (10(-4) mol/L blocker, n = 4) was
      as follows: nifedipine, 8.6% +/- 0.9% (H4) and 16.7% +/- 7.2% (L6); verapamil,
      24.6% +/- 3.2% (H4) and 61.9% +/- 4.2% (L6); diltiazem, 62.7% +/- 3.6% (H4) and
      36.1% +/- 5.4% (L6); all P < .001. Eadie-Hofstee analysis indicated competitive
      inhibition of T3 uptake for both calmidazolium and nifedipine.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8487659
TI  - Apolipoprotein E polymorphism and its association with serum lipoprotein
      concentrations in black versus white children: the Bogalusa Heart Study.
AB  - The structural gene locus for apolipoprotein E (apo E) is polymorphic. The
      relative apo E allele frequencies and the influence of this polymorphism on serum
      lipoprotein concentrations were studied in 8- to 17-year-old black (n = 444) and
      white (n = 446) children from the community of Bogalusa, LA. The frequencies of
      the e2, e3, and e4 alleles for white males/females were 0.027/0.024, 0.849/0.823,
      and 0.124/0.153, respectively; corresponding values for black males/females were
      0.087/0.074, 0.713/0.721, and 0.20/0.205, respectively. Apo E phenotype
      distributions and allele frequencies showed a significant race difference, but no
      sex difference. Significant differences among apo E phenotypes were noted for
      total cholesterol, low-density lipoprotein cholesterol (LDL-C), and apo B in both
      races; significant effects were noted for high-density lipoprotein cholesterol
      (HDL-C) and apo A-I in black children, but not in white children. Among white
      children, the average excess of the apo e2 allele showed lower LDL-C (-12.5
      mg/dL) and apo B (-15.8 mg/dL) concentrations, while the average excess of the
      apo e4 allele showed higher LDL-C (7.0 mg/dL) and apo B (7.5 mg/dL)
      concentrations. Black children showed a similar trend for these variables, but to
      a lesser degree; in addition, the average excess of apo e2 allele showed higher
      HDL-C (12.8 mg/dL) and apo A-I (8.3 mg/dL) concentrations in this racial group.
      It is noteworthy that the association of apo E polymorphism with serum
      lipoprotein concentrations noted in adults can be seen already in children.

PMID- 8487660
TI  - Effect of prolonged hyperglycemia on growth hormone levels and insulin
      sensitivity in insulin-dependent diabetes mellitus.
AB  - The aim of the present study was to characterize the effect of a hyperglycemic
      period (44 hours) on the levels of insulin-antagonistic hormones and insulin
      sensitivity in seven subjects with well-controlled insulin-dependent diabetes
      mellitus (IDDM). Hyperglycemia (approximately 15 mmol.L-1) was induced by a
      glucose infusion while the degree of insulinization was similar to that of the
      period with near normoglycemia (approximately 6.9 mmol.L-1). Insulin sensitivity
      was measured with hyperinsulinemic euglycemic clamps performed 4 hours before and
      after the periods of normoglycemia (control) and hyperglycemia. D-[3-3H]glucose
      was infused in the second clamp in each study to evaluate glucose production and
      utilization. Since growth hormone (GH) levels frequently are elevated during poor
      diabetic control, diurnal GH secretion was measured in blood samples continuously
      drawn for 24 hours during the euglycemic and hyperglycemic periods. Levels of
      epinephrine, norepinephrine, cortisol, and nonesterified free fatty acids (NEFA)
      were similar during the control and hyperglycemic periods and during the clamps.
      GH levels were also similar, but an abnormal diurnal secretion pattern was
      present with increased numbers of daytime peaks. Hyperglycemia did not reduce GH
      secretion in IDDM. Hyperglycemia for 44 hours induced insulin resistance (32%
      reduction of glucose infusion rate, P < .02). In the control study, a 21%
      reduction (P = .064, NS) of the glucose disposal rate (Rd) was seen, suggesting
      that the hospitalization period per se may also reduce insulin sensitivity. In
      conclusion, a period of hyperglycemia leads to insulin resistance in IDDM
      patients. This insulin resistance cannot be attributable to increased levels of
      insulin-antagonistic hormones, although an abnormal secretion pattern for GH was
      found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487661
TI  - Sodium ipodate and methimazole in the long-term treatment of hyperthyroid Graves'
      disease.
AB  - A prospective study was conducted to evaluate the effect of prolonged treatment
      of hyperthryoid Graves' disease with methimazole (MMI) for 12 months or Na
      ipodate for only 6.6 +/- 1.1 months, since the drug had to be discontinued
      because of persistent or recurrent hyperthyroidism during treatment. The eight
      patients who were treated with MMI alone for 12 months became euthyroid, and
      seven remained in remission for at least 6 months after MMI was discontinued. In
      contrast, only two of 10 patients treated with Na ipodate alone became euthyroid
      and remained so during therapy. No ipodate was discontinued in the eight patients
      who did not respond, and they were then treated with MMI. One patient had
      recurrent hyperthyrodism after NA ipodate was discontinued, and she was then
      treated with MMI. MMI was efficacious in treating these nine patients, and all
      patients were euthyroid by the third month of MMI administration. Five of these
      nine patients remained euthyroid for at least 6 months after MMI was
      discontinued, a remission rate that was not significantly different from that
      observed in the eight patients treated only and initially with MMI (Fisher's
      Exact Test). There was no significant change in serum thyroid peroxidase
      antibodies during treatment with MMI alone, Na ipodate alone, or Na ipodate
      followed by MMI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487662
TI  - Effects of chloroquine on the dyslipidemia of non-insulin-dependent diabetes
      mellitus.
AB  - The effects of 3-day oral chloroquine phosphate treatment administered at a
      dosage of 250 mg four times daily on fasting serum levels of lipids,
      lipoproteins, and apolipoproteins were studied in 20 patients with non-insulin
      dependent diabetes mellitus (NIDDM). Chloroquine reduced the fasting serum
      concentrations of total cholesterol (6.16 +/- 0.31 to 5.67 +/- 0.31 mmol/L, P <
      .05), low-density lipoprotein (LDL) cholesterol (4.38 +/- 0.35 to 3.93 +/- 0.32
      mmol/L, P < .05), and apolipoprotein (apo) B (1.46 +/- 0.08 to 1.24 +/- 0.06 g/L,
      P < .01), and the ratio of apo B to apo A-I (0.81 +/- 0.05 to 0.71 +/- 0.03, P <
      .05). Chloroquine also caused a decrease in fasting plasma glucose levels (11.1
      +/- 0.5 to 9.2 +/- 0.4 mmol/L, P < .01) and an increase in fasting plasma insulin
      levels (0.12 +/- 0.01 to 0.14 +/- 0.01 nmol/L, P < .01). The decrease in total
      cholesterol and apo B levels correlated with the increase in fasting plasma
      insulin levels (r = .35, P = .04 and r = .33, P = .03, respectively), but not
      with changes in plasma levels of glucose or nonesterified fatty acids (NEFA).
      This study demonstrates that 3 days of oral chloroquine treatment improves
      abnormalities of lipoprotein metabolism in patients with NIDDM. This may be due
      to an increase in insulin levels, but there also appears to be a more direct
      effect of the drug on apo B metabolism.

PMID- 8487663
TI  - Differential effect of aging on protein kinase C activity in rat adipocytes and
      soleus muscle.
AB  - Protein kinase C (PKC) has been postulated to play an important role in glucose
      transport in insulin-sensitive tissues such as rat adipocytes and skeletal
      muscle. Since glucose transport decreases in old rats, we examined age-related
      changes in PKC. Cytosolic PKC-dependent histone-phosphorylating enzyme activity
      and PKC-beta immunoreactivity of both adipocytes and soleus muscles increased
      progressively with age (or weight) in rats weighing less than 400 g. In comparing
      PKC enzyme activity and PKC-beta immunoreactivity in young rats (180 +/- 32 g;
      mean +/- SE, body weight) versus old rats (658 +/- 108 g), both cytosolic and
      membrane-associated PKC were greater in adipocytes of old rats (relative to
      adipocytes of young rats), whereas in the soleus muscle of old rats cytosolic PKC
      activity was diminished and membrane-associated PKC was increased (relative to
      solei of young rats). The latter redistribution of soleus PKC may be due to
      endogenous hyperinsulinemia, which is known to occur in old rats and which may
      have stimulated the translocation of PKC from cytosol to membrane in the soleus.
      Whatever the cause, decreases in cytosolic PKC in the soleus muscle may limit
      acute PKC translocation responses to insulin or other agents in old rats.

PMID- 8487664
TI  - The effects of changes in plasma nonesterified fatty acid levels on oxidative
      metabolism during moderate exercise in patients with non-insulin-dependent
      diabetes mellitus.
AB  - Blood levels of intermediary metabolites were measured and indirect calorimetry
      was performed in 10 otherwise healthy, non-insulin-dependent diabetic (NIDDM)
      patients before, during, and after 30 minutes of moderate exercise on three
      occasions in random order at weekly intervals with (1) heparin treatment to
      increase preexercise plasma nonesterified fatty acid (NEFA) levels (HEPARIN); (2)
      acipimox, a nicotinic acid analogue, to reduce preexercise plasma NEFA levels
      (ACIPIMOX); and (3) no manipulation of preexercise plasma NEFA levels (NIL). With
      ACIPIMOX, preexercise blood levels were significantly reduced for NEFAs and
      glycerol (P < .01) and marginally reduced for acetoacetate and 3-hydroxybutyrate
      (NS) compared with preexercise levels for the other two treatments; these low
      levels seen with acipimox treatment increased only slightly during exercise and
      the postexercise period. Plasma NEFA levels increased by approximately 150% (P <
      .001) with HEPARIN at the same times. The levels of ketone bodies during either
      NIL or HEPARIN increased rapidly postexercise by approximately 90% to 110% for
      both acetoacetate and 3-hydroxybutyrate (both P < .01). Plasma insulin levels
      tended to be lowest (despite similar plasma glucose levels during the three
      treatments) with ACIPIMOX, while growth hormone (hGH) and, perhaps, noradrenaline
      levels were highest both during and after exercise. The respiratory quotient (RQ)
      was highest with ACIPIMOX (P < .05 for exercise and postexercise periods compared
      with the other two treatments), which, compared with NIL, reduced fat oxidation
      by 27% and 60% and increased carbohydrate oxidation by 29% and 74% during and
      after exercise, respectively (all P < .05). These changes in substrate oxidation
      due to ACIPIMOX were almost opposite to those observed with HEPARIN.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8487665
TI  - Regulation of contraction-stimulated system A amino acid uptake in skeletal
      muscle: role of vicinal sulfhydryls.
AB  - Functional vicinal sulfhydryls are essential for insulin-stimulated system A
      neutral amino acid uptake in the rat epitrochlearis muscle. In skeletal muscle,
      system A uptake is also activated by contractile activity. Therefore, the
      purposes of this study were to characterize the stimulation of system A activity
      by contractions induced by electrical stimulation in vitro, and to assess the
      role of vicinal sulfhydryls in this process. System A activity in the isolated
      epitrochlearis muscle was measured using the nonmetabolizable analogue alpha
      (methylamino)isobutyric acid (MeAIB). Contractions increased MeAIB uptake by
      increasing the apparent maximal velocity (Vmax), with no alteration in the
      apparent Km. The maximal stimulatory effects of insulin and contractions on MeAIB
      uptake were completely additive, demonstrating that these two stimuli exert their
      effects via different mechanisms. Phenylarsine oxide (PAO), a vicinal sulfhydryl
      antagonist, at greater than 20 mumol/L inhibited basal and contraction-stimulated
      MeAIB uptake by approximately 50% and 70%, respectively, by decreasing Vmax, with
      no change in Km. Both inhibitory effects were completely prevented by cotreatment
      with the vicinal dithiol dimercaptopropanol (DMP), indicating the effects were
      mediated by interactions with vicinal sulfhydryls. Contraction-stimulated MeAIB
      uptake was rapidly (half-time, approximately 7 minutes) reversed by the addition
      of PAO. These results (1) define conditions under which contraction-stimulated
      system A amino acid uptake can be studied in an isolated mammalian skeletal
      muscle preparation, and (2) indicate that vicinal sulfhydryls are essential for
      stimulation of system A activity by muscle contractions.

PMID- 8487666
TI  - The effect of testosterone aromatization on high-density lipoprotein cholesterol
      level and postheparin lipolytic activity.
AB  - Stanozolol, an oral 17 alpha-alkylated androgen, increases hepatic triglyceride
      lipase activity (HTGLA) and decreases high-density lipoprotein cholesterol (HDL
      C) levels, whereas intramuscular testosterone has comparatively little effect. In
      the present study, we tested the hypothesis that aromatization of androgen to
      estrogen blunts the lipid and lipase effects of exogenous testosterone. Fourteen
      male weightlifters received testosterone enanthate (200 mg/wk intramuscularly),
      the aromatase inhibitor testolactone (250 mg four times per day), or both drugs
      together in a randomized cross-over design. Serum testosterone level increased
      during all three drug treatments, whereas estradiol level increased only with
      testosterone alone (+47%, P < .05), demonstrating that testolactone effectively
      inhibited testosterone aromatization. Testosterone decreased HDL-C(-16%, P <
      .05), HDL2-C(-23%, NS), and apoprotein (apo) A-I (-12%, P < .05) levels, effects
      that were consistently but not significantly greater with simultaneous
      testosterone and testolactone administration (HDL-C, -20%; HDL2-C, -30%; apo A-I,
      -15%; P < .05 for all). In contrast, both testosterone regimens decreased HDL3-C
      levels by 13% (P < .05 for both). HTGLA increased 21% during testosterone
      treatment and 38% during combined testosterone and testolactone treatment (P <
      .01 for both). Lipoprotein lipase activity (LPLA) increased only during combined
      testosterone and testolactone treatment (+31%, P < .01), suggesting that estrogen
      production may counteract the effects of testosterone on LPLA. Testolactone alone
      had little effect on any lipid, lipoprotein, apoprotein, or lipase
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487667
TI  - Skeletal muscle lipids and glycogen mask substrate competition (Randle cycle).
AB  - The glucose-free fatty acid (FFA) cycle (Randle) was examined in soleus muscle, a
      red muscle with a high lipid oxidation rate, and extensor digitorum longus (EDL)
      muscle, a white muscle with a low lipid oxidation rate, using a carnitine
      palmethyltransferase (CPT-I) inhibitor as a probe. Exogenous palmitate by itself
      had little if any effect on glycolysis or glycogen accumulation in the two muscle
      types. The CPT-I inhibitor markedly decreased glycogen accumulation in both
      muscles (from fed rats), but increased glycolysis (lactate formation) and glucose
      oxidation to carbon dioxide only in the red muscle. When the muscles were made
      more dependent on FFA oxidation by prior fasting or exercise, the CPT-I
      stimulatory effect on glycolysis and glucose oxidation in white muscle was
      unmasked. In conclusion, the competition between lipid and carbohydrate
      utilization (Randle cycle) is easily demonstrated in both red and white muscle
      using a CPT-I inhibitor as a probe. The difficulties encountered in showing this
      competition in other studies using exogenous FFA may be explained by a
      combination of factors, including (1) low tissue lipid oxidation rates, (2)
      competition between exogenous and endogenous lipids such that provision of
      exogenous lipids fails to increase overall lipid oxidation, and (3) preferential
      utilization of exogenous glucose with glycogen sparing in the presence of FFA.

PMID- 8487668
TI  - Measuring glucose and fructose-6-phosphate cycling in liver in vivo.
AB  - Approaches measuring futile cycling of glucose and fructose-6-phosphate (fructose
      6-P) in liver in vivo depend on assumptions about the fates of hydrogens bound to
      specific carbons of glucose. Thus, 3H of [2-3H]glucose has been assumed to be
      completely removed after its conversion to glucose-6-P, [3-3H]glucose after its
      conversion to fructose-1,6-bisP, and [6-3H]glucose not at all. Previous
      measurements have shown that these assumptions are incompletely fulfilled.
      Corrections to estimates of cycling can be made when detritiations of [2
      3H]glucose and [3-3H]glucose are not complete, and detritiation of [6-3H]glucose
      occurs. How the corrections can be made is presented using data previously
      reported on giving labeled glucoses to humans after an overnight fast and on
      infusing a glucose load. Estimates of glucose cycling nearly double, and that of
      fructose-6-P cycling almost triples. Estimates of hepatic glucose production as
      measured with [6-3H]glucose decrease. Correction of estimates of cycling under
      other conditions may very well be similarly affected. Thus, rates of glucose and
      fructose-6-P cycling appear to be substantially more than previously estimated.
      Quantitation under a given condition requires measurements to be made of the
      extent to which assumptions as to the fate of labeled hydrogen of the glucoses
      are fulfilled. The uncertain extent of exchange of label catalyzed by
      transaldolase and detritiation in the pentose cycle, the failure of fructose-6-P
      cycling to be expressed through detritiation of 3H from [3-3H]glucose, and
      possible isotope effects still limit the confidence that can be placed in such
      estimates.

PMID- 8487669
TI  - Comparison of the effects of diets rich in stearic acid versus myristic acid and
      lauric acid on platelet fatty acids and excretion of thromboxane A2 and PGI2
      metabolites in healthy young men.
AB  - The present study compared the effects of diets rich in stearic acid (C18:0)
      versus one high in lauric and myristic acid (C12:0, C14:0) on platelet
      phospholipid fatty acid levels and concentrations of urinary thromboxane B2
      (TXB2) and 6-keto-PGF1 alpha, which are stable metabolites of thromboxane A2
      (TXA2) and PGI2 and indicators of cardiovascular hemostasis. A diet high in dairy
      butter (B) was the source of C12:0 and C14:0; C18:0 was provided by diets high in
      cocoa butter (CB), milk chocolate (CHOC) or CB+B in a 4:1 ratio (MIX). A
      randomized, crossover double-blind experimental design was used. Experimental
      subjects (n = 15) consumed each diet for 26 days, with a 1-month washout period
      between each experimental period. Urine and blood were collected from each
      subject at the beginning and end of each dietary period. Urinary TXB2 and 6-keto
      PGF1 alpha were analyzed by radioimmunoassay (RIA). There were no effects of diet
      on the 24-hour excretion of either metabolite or on the ratio of 6-keto-PGF1
      alpha/TXB2, even though there were significant changes in the eicosanoid
      precursor, arachidonic acid (C20:4n-6), in platelet phospholipids. C20:4n-6
      levels increased (44.8% +/- 1.0% to 47.1% +/- 1.3%; P < .05) in the
      phosphatidylethanolamine phospholipid subclass in subjects on the B diet and
      decreased in the phosphatidylcholine subclass on the CB diet (16.5% +/- 1.0% to
      14.2% +/- 1.1%; P < .05) compared with baseline values.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8487670
TI  - Effect of uremia on aldosterone metabolism in the isolated perfused rat liver.
AB  - The effect of uremia on hepatic metabolism of aldosterone was studied in the
      isolated perfused liver of female Wistar rats. Uremia was induced by five-sixths
      partial nephrectomy 4 weeks before experiments. Isolated livers of normal and
      uremic rats were perfused at a constant flow rate with a hemoglobin-free medium,
      to which 4-14C-D-aldosterone was added at 3 nmol/L. Aldosterone was analyzed by
      radioimmunoassay (RIA) and 4-14C-D-aldosterone radiometabolites in perfusate and
      bile were assayed by high-performance liquid chromatography (HPLC). Uremic rats
      had a 10% lower body weight (P < .01) and increased plasma urea, creatinine, and
      parathyroid hormone (PTH) levels (258%, 200%, and 208%, respectively; P < .01
      .001). Blood pressure and plasma K+, Na+, and aldosterone levels were similar.
      Plasma renin activity was suppressed by 68% in uremic rats (P < .001). Liver wet
      weight and hepatic function were similar in livers of both groups of rats.
      Hepatic elimination of aldosterone was compatible with a first-order kinetics.
      Hepatic clearance of aldosterone per liver and per gram liver was similar;
      however, when expressed per 100 g rat body weight, a 21% higher value was
      observed in uremic rats (11.6 +/- 1.8 mL/min) compared with normal rats (9.6 +/-
      1.5 mL/min, P < .01). Polar aldosterone radiometabolites accumulated in the
      perfusate to approximately 40% of the initial 14C added at 15 minutes, and were
      eliminated in bile at a similar rate in both groups. No qualitative difference
      was found in the pattern of radiometabolites of aldosterone in perfusate and
      bile.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487671
TI  - Insulin binding and degradation by rat liver Kupffer and endothelial cells.
AB  - The liver is the major site of insulin metabolism. Previous studies have
      suggested that hepatocytes were chiefly responsible for this activity, while
      contributions of Kupffer and other nonparenchymal liver cells remained
      controversial. In this study, we compared 125I-insulin binding and degradation by
      rat hepatocytes with insulin binding and degradation by sinusoidal Kupffer and
      endothelial cells. Kupffer cells were separated from endothelial cells by
      centrifugal elutriation. Hepatocytes had approximately 3.5 times more insulin
      binding sites than Kupffer cells and approximately eight times more binding sites
      than endothelial cells. In addition, wheat germ agglutinin (WGA)-purified
      solubilized receptors from all three cell types bound insulin in proportions
      similar to whole cells. Moreover, all three cell types were shown with a
      ribonuclease (RNase) protection assay to express insulin receptor mRNA.
      Hepatocytes degraded approximately four times more insulin than Kupffer cells,
      while endothelial cells degraded only negligible amounts of insulin. Based on
      morphometric data available in the literature, we estimated that nonparenchymal
      cells could account for approximately 10% to 15% of hepatic insulin degradation.
      We concluded that rat hepatocytes, Kupffer cells, and endothelial cells all have
      specific insulin receptors, and that nonparenchymal cells play a small but
      significant role in insulin degradation.

PMID- 8487672
TI  - Prospective evaluation of beta-cell function in insulin autoantibody-positive
      relatives of insulin-dependent diabetic patients.
AB  - During the preclinical period of insulin-dependent diabetes mellitus (IDDM),
      progression to clinical IDDM is characterized by declining beta-cell function.
      Although the presence of insulin autoantibodies (IAA) improves the ability of
      islet cell antibodies (ICA) to predict subsequent clinical IDDM, few studies have
      examined the risk of developing IDDM in subjects positive for IAA but negative
      for both ICA and antibodies to glutamic acid decarboxylase (64kA). To investigate
      this question, detailed beta-cell function tests (acute insulin response to
      glucose [AIRgluc] and slope of glucose potentiation) were performed on eight IAA
      positive first-degree relatives of insulin-dependent diabetics. All eight
      subjects were negative for ICA, and seven were tested for 64kA and were negative.
      Five subjects were studied prospectively for 22.4 +/- 9.4 months, while three
      subjects had only initial studies. Initial beta-cell function tests were normal
      in each subject. AIRgluc was 122.2% +/- 19.0% of the expected normal response,
      while slope was 168.6% +/- 20.6% of expected normal response. beta-cell function
      remained normal and remarkably stable in the five subjects followed
      prospectively. AIRgluc did not significantly change from an initial value of
      147.9% +/- 23.1% of expected to 153.2% +/- 22.4% (NS). The slope of glucose
      potentiation varied little from 165.5% +/- 39.4% initially to 159.5% +/- 27.3%
      (NS) at the most recent determination. We conclude that among nondiabetic first
      degree relatives of IDDM subjects, the presence of IAA in the absence of ICA and
      64kA is not usually associated with and therefore does not reliably predict beta
      cell dysfunction or progressive deterioration in beta-cell function.

PMID- 8487673
TI  - Variation in total energy expenditure in young healthy free-living men.
AB  - Interindividual and intraindividual variation in total energy expenditure (TEE)
      were examined in 17 healthy, free-living men (weight, 56.4 to 82.4 kg; age, 18 to
      30 years). TEE over 14 days, resting metabolic rate (RMR), and body composition
      were measured two or three times during 77 days of fixed caloric intake using
      doubly labeled water, respiratory gas analysis, and isotope dilution,
      respectively. When individual data were averaged, TEE was most significantly
      related to fat-free mass ([FFM] r = .73, P = .001), body mass (r = .70, P =
      .002), and RMR (r = .63, P = .006). After adjusting TEE for BM, a significant
      inverse relation with age was found (partial r = -.52, P = .032). Stepwise
      regression analysis showed that 69% of individual variation in TEE was explained
      by BM, age, and fasting respiratory exchange ratio (RER). TEE/RMR averaged 1.73
      +/- 0.25 (range, 1.38 to 2.32), and was independent of age and body composition.
      In 10 subjects in whom triplicate observations of TEE were performed, the average
      experimental variation for TEE was +/- 11.9% (range, 6.1% to 19.6%) compared with
      a theoretical estimate of precision of +/- 5.9% based on the reported isotope
      dose and analytical uncertainty. The difference between theoretical estimates of
      precision and observed experimental variation suggests that inherent random
      variation in free-living TEE is +/- 10% (ie, square root of 12(2)-6(2)) in
      subjects maintained on fixed caloric intake. We conclude that in young free
      living men (1) BM, age, and RER are important determinants of TEE; and (2)
      intraindividual variation in TEE is approximately +/- 10% due to fluctuations in
      physical activity levels within individuals over time.

PMID- 8487674
TI  - Simvastatin improves chylomicron remnant removal in familial combined
      hyperlipidemia without changing chylomicron conversion.
AB  - It is unknown whether the clearance of atherogenic chylomicron remnants and the
      postprandial lipoprotein metabolism in general can be improved by 3-hydroxy-3
      methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors in subjects with
      familial combined hyperlipidemia (FCH). Therefore, the postprandial chylomicron
      remnant clearance was studied in nine normolipidemic untreated controls and seven
      FCH patients before and after treatment with simvastatin using an oral vitamin A
      fat load (24 hours, 50 g/m2). Treatment with simvastatin reduced plasma
      cholesterol level by 16% (mean +/- SEM, 8.1 +/- 0.8 v 6.8 +/- 0.8 mmol/L; P <
      .05) and plasma apolipoprotein (apo) B level by 19% (1.6 +/- 0.2 v 1.3 +/- 0.2
      g/L; P < .05). Plasma apo E level (89.6 +/- 21.0 mg/L) was reduced by 29% (63.5
      +/- 14.1 mg/L; P < .05). High-density lipoprotein cholesterol (HDL-C) and low
      density lipoprotein cholesterol (LDL-C) levels did not change; consequently, the
      reductions seen had been due to a decrease in very-low-density lipoprotein (VLDL)
      levels. Fasting plasma triglyceride (30% reduction) and plasma apo C-II (31%
      reduction) levels did not change significantly. Mean postheparin plasma
      lipoprotein lipase (LPL) activity increased by 13% after treatment (90.4 +/- 19.8
      v 102.6 +/- 20.3 mU/mL; P < .05), but hepatic lipase (HL) activity was not
      altered. The clearance of chylomicrons (Sf > 1,000), expressed as the area under
      the 24-hour retinyl palmitate curve, did not change with simvastatin (52.8 +/-
      12.9 v 51.8 +/- 13.4 h.mg-1/L).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487675
TI  - Periprandial regulation of lipid metabolism in insulin-treated diabetes mellitus.
AB  - We have examined the regulation of lipid and glucose metabolism in the
      postabsorptive and postprandial states in six subjects with insulin-treated
      diabetes mellitus, and compared them with eight nondiabetic subjects. Blood or
      plasma concentrations of metabolites and fluxes across forearm and subcutaneous
      adipose tissue were studied after an overnight fast and for 6 hours after a mixed
      meal (3.1 MJ, 41% from fat). In the postabsorptive state, regulation of lipid
      metabolism in the two groups appeared basically similar except that a wider
      spread of plasma (free) insulin concentrations in the diabetic group led to a
      wider range of values of plasma nonesterified fatty acid (NEFA) release from
      adipose tissue, plasma NEFA concentrations, and blood ketone body concentrations.
      Extraction of ketone bodies across adipose tissue was positively correlated with
      arterial concentration in both groups (as it was in the forearm), confirming the
      ability of human adipose tissue to utilize ketone bodies. A single subcutaneous
      injection of insulin before the meal in the diabetic group produced a plasma free
      insulin profile that was blunted and prolonged compared with the postprandial
      response in the control group. Postprandial forearm glucose uptake followed very
      closely the plasma (free) insulin concentration. Postprandial suppression of NEFA
      release from adipose tissue was essentially normal in the diabetic group, and the
      normal postprandial decrease in plasma NEFA concentrations was reproduced
      extremely closely. Forearm and adipose tissue blood flow did not differ between
      the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487676
TI  - Pituitary-testicular and pituitary-thyroid axes in spinal cord-injured males.
AB  - Thirty spinal cord-injured (SCI) males were studied for evaluation of their
      pituitary-testicular and pituitary-thyroid axes using combined luteinizing
      hormone-releasing hormone (LHRH) and thyrotropin-releasing hormone (TRH) tests
      and electroejaculated semen analyses. Thirty age-matched normal male volunteers
      served as controls. There were four subjects with low serum triiodothyronine (T3)
      levels, one with elevated serum follicle-stimulating hormone (FSH) level, eight
      with elevated serum testosterone levels, and 11 with elevated serum prolactin
      levels. There were significantly elevated luteinizing hormone (LH) responses to
      LHRH in SCI subjects when compared with normal controls. There were 16 (53.3%)
      SCI subjects who had exaggerated and/or prolonged LH responses. Among them, six
      subjects also had elevated FSH responses. There were eight and four subjects
      whose thyrotropin (TSH) and prolactin responses to TRH were exaggerated,
      respectively. Marked impaired motility was observed in 56 electroejaculated semen
      samples from 16 SCI subjects. There was a significant correlation between LH and
      total sperm count. Our data suggest that there is a reduced central dopaminergic
      tone in SCI subjects.

PMID- 8487677
TI  - Glucose fluxes and oxidation after an oral glucose load in patients with non
      insulin-dependent diabetes mellitus of variable severity.
AB  - The relative contribution of liver and peripheral tissues to the postprandial
      glucose response has been examined in 19 obese non-insulin-dependent diabetes
      mellitus (NIDDM) patients and 11 matched nondiabetic control subjects during a 5
      hour oral glucose tolerance test (OGTT) performed with a load of 75 g,
      corresponding to approximately 67 g/1.73 m2. A dual-tracer technique was used to
      measure exogenous and endogenous glucose fluxes separately. Glucose oxidation was
      measured by indirect calorimetry. Diabetic patients were subdivided into two
      subgroups designated as "mild" (n = 7) and "severe" (n = 12) NIDDM according to
      postabsorptive glucose concentration with a cut-off point of 140 mg/dL. In the
      basal state, glucose concentrations averaged 99, 117, and 194 mg/dL,
      respectively, in control subjects and in the two diabetic subgroups, but insulin
      concentrations were not significantly different between groups. In comparison to
      control subjects, the basal hyperglycemia of mildly diabetic patients was
      entirely caused by a reduced metabolic clearance rate (118 v 144 mL/min; P <
      .05), whereas in severely diabetic patients basal hyperglycemia resulted from a
      combination of increased hepatic glucose output (187 v 139 mg/min; P < .001) and
      decreased metabolic clearance rate (97 v 144 mL/min; P < .001). A similar
      situation prevailed during the initial 2 hours after glucose ingestion. In
      patients with mild NIDDM, glucose concentration increased by 121 +/- 10 mg/dL as
      compared with 36 +/- 7 mg/dL in control subjects (P < .001).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8487678
TI  - Partial correction of impaired creatinine kinase activity in diabetic rat heart
      by physical training.

PMID- 8487679
TI  - Hypertension in pregnancy.

PMID- 8487680
TI  - Randomised controlled trials: the challenge of Archie Cochrane.

PMID- 8487681
TI  - The changing face of clinical trials in Australia.

PMID- 8487682
TI  - Triplets and quadruplets born in Victoria between 1982 and 1990. The impact of
      IVF and GIFT on rising birthrates.
AB  - OBJECTIVES: To examine the perinatal characteristics of all higher order multiple
      births (133 sets of triplets and six sets of quadruplets) in the State of
      Victoria between 1982 and 1990. To compare the rising higher order multiple birth
      rates in Victoria with those in the other States of Australia, and to assess the
      impact of in-vitro fertilisation (IVF) and gamete intrafallopian transfer (GIFT)
      on these rising birth rates. DESIGN: Retrospective review of all higher order
      multiple births registered in Victoria and other States of Australia between 1982
      and 1990, and in particular those resulting from IVF and GIFT. DATA SOURCES:
      Victorian Perinatal Data Collection Unit, Australian Bureau of Statistics,
      National Perinatal Statistics Unit, data from Victorian IVF and GIFT units. MAIN
      OUTCOME MEASURES: Higher order multiple birth rates and perinatal mortality
      rates. RESULTS: The higher order multiple birth rates in Victoria rose from 3.5
      per 10,000 in 1982 to 10.9 per 10,000 in 1990. The average perinatal mortality
      rates for the Victorian triplets and quadruplets born during this period were
      10.8% and 25.0%, respectively. The rates of caesarean section were 70% and 83%;
      the proportions of deliveries in level III hospitals, 75% and 100%; and the mean
      maternal lengths of stay in hospital, 32 and 57 days, respectively. Endotracheal
      intubation was performed at birth in 18.5% of all infants. The proportions of
      triplet and quadruplet pregnancies in Victoria owing to IVF and GIFT rose during
      this period, reaching a peak of 42% in 1990. In the other States, the birth rates
      for higher order multiples increased at 1.8 times the rate observed for Victoria,
      with IVF and GIFT contributing to an estimated 43% of these conceptions between
      1985 and 1989. CONCLUSION: Restrictions on the numbers of embryos/oocytes
      transferred during IVF and GIFT should reduce the frequency of higher order
      multiple births.

PMID- 8487683
TI  - Birthweight-specific trends in perinatal mortality by hospital category in South
      Australia, 1985-1990.
AB  - OBJECTIVE: To investigate differences by birthweight in risk of perinatal death
      between level 3 hospitals (which provide care for high risk pregnancies and
      neonatal intensive care) and other hospitals in South Australia, using perinatal
      data for the 1985-1990 period. DESIGN: Analysis of birthweight-specific trends in
      risk of perinatal death by hospital category for singleton births, adjusting for
      risk factors. SUBJECTS: 114 725 singleton births of at least 400 g birthweight
      (or at least 20 weeks' gestation) born in hospitals in the 1985-1990 period and
      notified to the perinatal data collection. MAIN OUTCOME MEASURE: The relative
      odds of a perinatal death, as opposed to a live birth which survived the neonatal
      period. RESULTS: Births at level 3 hospitals had a higher crude risk of perinatal
      death than those at other hospitals, but this was due to the higher frequency of
      low birthweights at level 3 hospitals. For birthweights under 2000 g, and
      especially for the very low birth-weights, there was a higher risk at non-level-3
      than level 3 hospitals. There was also the unexpected finding that births at
      level 3 hospitals in the 2500-2999 g range had a comparatively high risk of
      perinatal death. There was little difference in risk for births of higher
      birthweight. CONCLUSIONS: The greatly reduced risk of perinatal death in level 3
      hospitals for babies with birthweights under 2000 g seems likely to be due to the
      specialist services in these hospitals. Further investigation is required to
      determine why babies in the 2500-2999 g range of birthweights had a comparatively
      high risk of perinatal death at these hospitals. This appears to be due, at least
      in part, to an excess contribution of deaths from congenital abnormalities. Also,
      it seems that the higher prevalence of complications in pregnancy in level 3
      hospitals, and the transfers for induction of labour after intrauterine fetal
      death, would have made a contribution. These same factors may also have affected
      the risk in level 3 hospitals for higher birthweight births.

PMID- 8487684
TI  - Role of percutaneous cervical cordotomy for pain of malignant origin.
AB  - OBJECTIVE: To discuss the place of, and indications for, percutaneous cervical
      cordotomy in the relief of cancer pain and to report a series of patients on whom
      the operation was performed at the Royal Brisbane Hospital. SETTING AND PATIENTS:
      Two hundred and seventy-three patients underwent percutaneous cervical cordotomy
      of approximately 4000 cancer patients referred to the Pain Clinic, Royal Brisbane
      Hospital, a tertiary referral centre, in the years 1979 to 1991. Both public and
      private patients were included. All received the same level of clinical care from
      the authors, all operations being performed by the first author. The major
      indication for the procedure was unilateral cancer pain below the head and neck,
      but other factors influencing the decision for operation were respiratory
      function, age, general condition and expectation of life. MAJOR OUTCOME MEASURES:
      Effectiveness of pain relief, first-week mortality, quality of life. RESULTS:
      Satisfactory pain relief was achieved in 89% of patients. First-week mortality
      was 3.3%. Long-term survivors (eight and five years) have remained free of their
      original pain. Particular emphasis is placed on the successful pain relief in 114
      patients suffering from primary lung cancer, including mesothelioma. Side effects
      and complications have been few. CONCLUSION: Unilateral percutaneous cervical
      cordotomy is a valuable method of treatment of cancer pain in selected patients.
      The procedure has a special place in the treatment of the large group of patients
      suffering pain associated with primary lung cancer including mesothelioma. We
      support the view of overseas workers that percutaneous cervical cordotomy is the
      only effective method of achieving stable pain control in these patients, many of
      whom are referred late.

PMID- 8487685
TI  - Bacteraemia and fungaemia in an Australian general hospital--associations and
      outcomes.
AB  - OBJECTIVE: To obtain a comprehensive overview of bacteraemia and fungaemia in a
      general hospital and thus to determine the incidence, primary sites of sepsis,
      organisms involved and associated mortality. DESIGN: A prospective laboratory and
      clinical evaluation of all episodes where microorganisms were cultured from blood
      over one year. SETTING: The two major hospitals in the Australian Capital
      Territory which have both community and referral functions. These hospitals
      provide obstetric and paediatric services along with adult medicine and surgery.
      PATIENTS: All those who acquired bacteraemia in hospital or presented with a
      blood-stream infection documented by a positive blood culture. RESULTS: During
      1990, 474 clinical episodes of bacteraemia or fungaemia were detected in 446
      patients. Significant isolates were identified in 317 of these episodes. The
      incidence of significant sepsis was 8.1 episodes per 1000 admissions. The most
      common organisms isolated were Staphylococcus aureus (75 episodes) and
      Escherichia coli (70 episodes). One hundred and twenty-eight episodes were
      hospital acquired. Intravenous catheters were the primary sites of sepsis in 68
      episodes. Fifty patients died. Higher mortality rates were associated with
      patients over 60 years of age, respiratory tract sepsis, endocarditis and the
      presence of an underlying malignancy. CONCLUSION: Bacteraemia and fungaemia are
      common problems. Nosocomial bacteraemia accounted for 40% of episodes. Half of
      these nosocomial infections were iatrogenic. Many of the episodes of intravenous
      catheter sepsis were potentially preventable. Ongoing programs of surveillance of
      bacteraemia, with the evaluation of primary site, associated features and
      mortality, are essential to monitor the dimensions of this problem and aid in
      implementing effective preventive strategies.

PMID- 8487686
TI  - ACE-inhibitors, calcium antagonists and low systemic vascular resistance
      following cardiopulmonary bypass. A case-control study.
AB  - OBJECTIVE: To investigate whether the syndrome of low systemic vascular
      resistance (SVR) following cardiac surgery and cardiopulmonary bypass (CPB) is
      more common in patients taking angiotensin-converting enzyme inhibitors (ACE
      inhibitors) or calcium antagonists. DESIGN: A case-control study, with cases
      ("low SVR syndrome") identified from intensive care unit observation charts.
      These cases were each matched to two controls identified from the same group of
      charts during the same time period. Exposure (ACE-inhibitors or calcium
      antagonists) was determined in a blinded fashion from the patient's medical
      record. SETTING: Cardiothoracic surgical unit in a teaching hospital.
      PARTICIPANTS: We identified 42 cases of low SVR syndrome; these were matched to
      84 controls. RESULTS: There was no association between therapy with ACE
      inhibitors and the low SVR syndrome following CPB (odds ratio [OR], 1.33; 95%
      confidence interval [CI], 0.53-3.34), nor with calcium antagonists (OR, 0.49; 95%
      CI, 0.21-1.13). The incidence of the low SVR syndrome was 7.4%. Patients who
      develop the low SVR syndrome are more likely to be treated with noradrenaline,
      adrenaline and dopamine, and spend more time in the cardiothoracic intensive care
      unit. CONCLUSION: The "low SVR syndrome" following CPB is not associated with
      preoperative therapy with ACE-inhibitors or calcium antagonists.

PMID- 8487687
TI  - Genetics of connective tissue disease.

PMID- 8487688
TI  - Vector-borne diseases and their control.
AB  - Control of the vector is usually a crucial factor in control programs for
      tropical diseases spread by insect vectors. Successful control programs aim at
      vulnerable points in the interactions between the vector, the reservoir host, the
      pathogen, the human host, and the environment. The objective is to prevent
      potential transmission, or interrupt actual transmission, by reducing the
      abundance, longevity, or host contact of the vector--whichever is most
      appropriate to the particular pathogen or disease and the local situation. The
      importance of individual assessment in the light of local conditions and a
      knowledge of the biology of the local vector is stressed. The vector-borne
      diseases discussed here are malaria, filariasis, arbovirus diseases,
      trypanosomiasis, leishmaniasis, plague and rickettsiosis.

PMID- 8487689
TI  - Antibiotics in acute respiratory infections.
AB  - In the absence of clear research-based guidelines, this paper gives practical
      empirical directions for deciding when to prescribe antibiotics in acute
      respiratory infections, and how not to prescribe them when their use is
      inappropriate. Antibiotics probably have no effect on the outcome of most
      respiratory infections, viral or bacterial. When even the small chance of benefit
      seems to outweigh the risks and disadvantages, penicillin remains the best first
      line agent for most respiratory infections, owing to the range of pathogenic
      bacteria likely to be encountered and its low side effect profile. Convincing
      some patients that antibiotics are not necessary is a sometimes difficult, but
      worthwhile task.

PMID- 8487690
TI  - Management of hypertension in pregnancy: executive summary. Australasian Society
      for the Study of Hypertension in Pregnancy.

PMID- 8487691
TI  - Effect of ambient temperature on SIDS rate.
AB  - OBJECTIVE: To examine the relationship between ambient temperature and rate of
      sudden infant death syndrome (SIDS). SUBJECTS AND SETTING: All infants with SIDS
      occurring during 1980-1989 in the Sydney metropolitan area. RESULTS: The SIDS
      rate varied more than threefold over the months of the year and peaked at the
      minimum daily temperature in July. The rate was negatively linearly related to
      both the monthly mean minimum and maximum daily temperatures. Both relationships
      were highly significant (P < 0.001). CONCLUSION: The significant relationship
      between daily temperature and SIDS rate means either that daily temperature is an
      excellent indicator of the cold weather conditions that have a profound effect on
      the rate of SIDS or that temperature itself plays a direct role in the cause of
      SIDS.

PMID- 8487693
TI  - Fatal brown snake (Pseudonaja textilis) envenomation despite the use of
      antivenom.
AB  - OBJECTIVE: To report two cases of fatal brown snake envenomation in adults
      despite the use of appropriate antivenom. CLINICAL FEATURES: Two men, aged 42 and
      39, one with a history of hypertension, suffered fatal brown snake envenomation
      in Queensland. One believed he had been stung by a wasp. Both developed
      cardiorespiratory failure within one hour of the bite, followed by coagulopathy
      and pulmonary oedema. One patient developed fulminant multiorgan failure.
      INTERVENTION: Both patients died despite the administration of large doses of
      appropriate antivenom and full supportive care. CONCLUSION: Brown snake bites
      remain extremely dangerous despite the availability of specific antivenom. In
      severe cases associated with myocardial depression and gross coagulopathy, death
      may occur rapidly despite the use of conventional doses of antivenom. In such
      patients the antivenom requirement may be much greater than is currently
      recommended.

PMID- 8487692
TI  - D-dimer in the early diagnosis of thromboembolic disease in acute spinal
      injuries.
AB  - The role of monitoring plasma levels of D-dimer (XDP) as a diagnostic aid for
      thromboembolic disease was investigated in 267 patients admitted for acute care
      to the Prince Henry Hospital Spinal Unit. Elevated plasma XDP levels were found
      in 103 patients (39%) and a diagnosis of thromboembolic disease was made in 33.
      Thromboembolic disease was not found in patients whose XDP levels remained
      normal.

PMID- 8487694
TI  - Henri Parinaud and his syndrome.

PMID- 8487695
TI  - New horizons in the treatment of multiple sclerosis.
AB  - OBJECTIVE: To review and discuss novel therapeutic approaches to multiple
      sclerosis (MS), particularly strategies designed to modulate immunopathogenetic
      mechanisms. DATA SOURCES: Recent medical and scientific publications and the
      proceedings of recent conferences in Australia and the United States.
      CONCLUSIONS: Clearer understanding of the pathogenetic mechanisms leading to
      inflammation and demyelination in MS is suggesting new strategies for
      intervention. Both antigen-specific and non-antigen-specific immunomodulation can
      be achieved in animal models, and human clinical trials of several new agents can
      be expected shortly.

PMID- 8487696
TI  - Knowledge of Hib disease and vaccine in long day care centres.

PMID- 8487697
TI  - Massive disc sequestration after spinal manipulation.

PMID- 8487698
TI  - Ipratropium bromide nasal spray.

PMID- 8487699
TI  - Protocols for vegetative patients.

PMID- 8487700
TI  - Oliguria and haemorrhage after intramuscular injection of ketorolac trometamol.

PMID- 8487701
TI  - Ketorolac.

PMID- 8487702
TI  - Munchausen syndrome by proxy.

PMID- 8487703
TI  - Treatment of psoriasis with topical auranofin.

PMID- 8487704
TI  - Reduction in cervical "whiplash" after new motor vehicle accident legislation in
      Victoria.

PMID- 8487705
TI  - The hand diagram.

PMID- 8487706
TI  - Obesity--a major health problem.

PMID- 8487707
TI  - Geriatric medicine--spanning the generations.

PMID- 8487708
TI  - Importance of resistant Klebsiella spp. in Victoria.

PMID- 8487709
TI  - Fluoxetine--delayed half-life and an adverse event.

PMID- 8487710
TI  - Sudden infant death syndrome (SIDS) in South Australia related to sleeping
      conditions.

PMID- 8487711
TI  - Evaluation of a hospital-based education program for aboriginal people with
      diabetes.

PMID- 8487712
TI  - Drug utilisation.

PMID- 8487713
TI  - Traveller's diarrhoea associated with a cyanobacterium-like body.

PMID- 8487714
TI  - Sports medicine in Australia.

PMID- 8487715
TI  - Lipoprotein(a): important risk factor or passing fashion?

PMID- 8487716
TI  - Diabetes and impaired glucose tolerance: using the new criteria.

PMID- 8487717
TI  - Planned sexual behaviour of young Australian visitors to Thailand.
AB  - OBJECTIVE: To research the knowledge of AIDS and other sexually transmitted
      diseases among young Australian tourists to Thailand, and their intended sexual
      behaviour. DESIGN AND SETTING: A cross-sectional survey by anonymous, self
      administered questionnaire, of persons seeking pre-travel medical advice in
      private clinics in five Australian cities. PARTICIPANTS: 213 consecutive patients
      travelling to Thailand without a spouse or partner. RESULTS: Only 34% of the
      sample reported a definite intention not to have sex in Thailand. Regarding
      choice of potential partners: 24.5% more men than women said they would have sex
      with a Thai national; 13.7% of men said they would have sex with a "bar girl";
      and 21.7% more women than men said they would choose a fellow Australian
      traveller. Eighty-two per cent of the sample reported that they would use condoms
      100% of the time, and there was no significant difference between the number of
      men and women who expressed this intention. CONCLUSIONS: Although not obviously
      "sex tourists", many young Australian travellers are likely to have sex while
      visiting Thailand. These data have important implications for education and
      prevention programs to control the spread of human immunodeficiency virus (HIV)
      and other sexually transmitted diseases.

PMID- 8487718
TI  - Diabetes mellitus.
AB  - Elderly diabetic patients require education in dietary therapy, physical
      activity, and self-monitoring of glycaemic control. However, rather than tight
      control, treatment should aim for a simple regimen which will relieve symptoms
      without introducing complications of its own. It is important to be aware of
      possible interactions between hypoglycaemic agents and drugs given for other
      diseases.

PMID- 8487719
TI  - Otitis media in general practice.

PMID- 8487720
TI  - FISH and the technicolour revolution. Molecular cytogenetics and its application
      in chromosome analysis today.

PMID- 8487721
TI  - Australia's contribution to tropical health: past and present.
AB  - Australian research workers have made important contributions to tropical
      medicine and tropical public health. Recognised high points of international
      significance (for example, Joseph Bancroft and filariasis, 1876; Thomas Bancroft
      and dengue fever, 1906; Burnet and Australian X disease, 1934; Derrick and Q
      fever, 1937; and Fairley and malaria, 1947) must be seen in the context of much
      detailed work of national relevance by institutions and individuals. The
      directions of Australian research can be related to several major themes: the
      large extent of Australia that is tropical or subtropical; interactions with
      neighbouring countries, especially Papua New Guinea; and concern for the health
      of Australian Aborigines.

PMID- 8487722
TI  - The natural history of aortic dilatation in Marfan syndrome.
AB  - OBJECTIVES: To determine the relationship between age and aortic dilatation in
      patients with Marfan syndrome and to define the rate of progression of aortic
      dilatation in these patients. DESIGN: All patients were evaluated in a
      multidisciplinary clinic to establish a firm diagnosis of Marfan syndrome. Aortic
      dimensions were measured by echocardiography and patients with Marfan syndrome
      were followed up with annual physical and echocardiographic examinations to
      detect any change in aortic diameter over the subsequent four years. PATIENTS:
      One hundred and fifty-seven patients were referred to the clinic for assessment,
      of whom 40 exhibited diagnostic features of Marfan syndrome. Only 24 of these
      patients had previously been diagnosed with Marfan syndrome, while 17 other
      patients, previously diagnosed with Marfan syndrome, had insufficient clinical
      features to justify the diagnosis. RESULTS: Among the 40 patients (19 male, 21
      female) with Marfan syndrome (mean age, 28 +/- 15 years), the prevalence of
      cardiovascular abnormalities was 90%. Aortic root dilatation was present in 78%
      of patients, aortic regurgitation in 28%, mitral valve prolapse in 65% and mitral
      regurgitation in 35%. Mean aortic root diameter in the Marfan patients (21.4 +/-
      4.0 mm/m2 body surface area) markedly exceeded that of age and sex matched
      controls without Marfan syndrome (14.9 +/- 2.2 mm/m2) and that of first-degree
      relatives without Marfan syndrome (15.3 +/- 2.9 mm/m2). The occurrence of aortic
      dilatation in Marfan syndrome was variable, with patients as young as 20 years
      exhibiting severe dilatation. All patients with Marfan syndrome exhibiting aortic
      dilatation were advised to take beta-adrenergic blocking drugs, unless
      contraindicated, in an effort to retard the rate of aortic dilatation. Among 33
      patients followed up for at least one year, 14 (42%) exhibited an increase in
      aortic diameter of at least 2 mm, while 16 of 23 patients (70%) followed up for
      at least three years exhibited similar progression of aortic dilatation. The
      overall mean rate of dilatation in the Marfan patients was 1.9 mm per year. Nine
      patients developed aortic dilatation of more than 50 mm diameter during four
      years' follow-up and required surgical repair of the aorta. Each of these
      patients is well at between three months' and four years' follow-up. CONCLUSIONS:
      Aneurysmal dilatation of the aorta is a common complication of Marfan syndrome
      and may become manifest at an early age. Furthermore, aortic dilatation can
      progress rapidly, even in the absence of symptoms. Individuals with Marfan
      syndrome should have annual echocardiographic examinations to monitor aortic root
      dimensions, and those exhibiting rapid progression of aortic dilatation or an
      aortic root diameter in excess of 50 mm, should be considered for elective
      composite graft repair of the aorta.

PMID- 8487723
TI  - Revised criteria for diagnosis of diabetes. Working Party of the Australian
      Diabetes Society, Australian Association of Clinical Biochemists and the Royal
      College of Pathologists of Australasia.

PMID- 8487724
TI  - The 18 to 20 week obstetrical scan. A joint statement from the Australasian
      Society for Ultrasound in Medicine, the Royal Australian College of Obstetricians
      and Gynaecologists and the Royal Australasian College of Radiologists.
AB  - The Australasian Society for Ultrasound in Medicine, The Royal Australian College
      of Obstetricians and Gynaecologists and the Royal Australasian College of
      Radiologists have produced jointly the accompanying document on the 18-20 week
      obstetrical scan. It is an important document not only for the sonologists and
      sonographers but also for clinicians who request ultrasound examinations for
      pregnant women, so that they may have a better idea of what the examination
      should cover and its limitations.

PMID- 8487725
TI  - Planning bedside teaching--5. Debriefing after clinical interaction.

PMID- 8487726
TI  - The poisoned tap.

PMID- 8487727
TI  - HIV in the suburbs.

PMID- 8487728
TI  - HIV infection in drug and alcohol practice.

PMID- 8487729
TI  - The effects of danazol on vocal parameters--is an objective prospective study
      needed?

PMID- 8487730
TI  - Condoms and HIV.

PMID- 8487731
TI  - Sexually active or sexually mobile.

PMID- 8487732
TI  - The National Heart Foundation of Australia Pick the Tick program.

PMID- 8487733
TI  - An aid to laparoscopic hernioplasty--balloon dissection.

PMID- 8487734
TI  - Carcinoma of the breast.

PMID- 8487735
TI  - Laparoscopic cholecystectomy.

PMID- 8487736
TI  - Re-entry syndrome.

PMID- 8487737
TI  - Carpet cleaning.

PMID- 8487738
TI  - Medicolegal assessment.

PMID- 8487739
TI  - "Confidence buster".

PMID- 8487740
TI  - Lowering cholesterol.

PMID- 8487741
TI  - The potential for teratogenicity of vitamin A and its congeners.

PMID- 8487742
TI  - The potential organ donor.

PMID- 8487743
TI  - Drugs of choice for cancer chemotherapy.

PMID- 8487744
TI  - Smoking control among health-care workers--World No-Tobacco Day, 1993.

PMID- 8487745
TI  - Influence of religious leaders on smoking cessation in a rural population-
      Thailand, 1991.
AB  - Despite substantial increases in smoking and intensified marketing of tobacco
      products in developing countries (1), efforts to prevent tobacco use through
      community-based approaches have been limited (2,3). In Thailand, an estimated 9
      million children will become smokers, and more than 2 million will die
      prematurely as adults from smoking-related illnesses (1,4). Because of these
      risks, the Department of Community and Social Medicine, Mae Sot General Hospital
      (MSGH), and the Field Epidemiology Training Program (FETP) of the Thai Ministry
      of Public Health recently assessed the impact of community-based smoking
      prevention efforts initiated by religious leaders. This report describes this
      program and summarizes the assessment.

PMID- 8487746
TI  - School-based tobacco-use prevention--People's Republic of China, May 1989-January
      1990.
AB  - Tobacco consumption has increased markedly in the People's Republic of China
      (PRC) since the 1960s (1,2). In 1984, when the prevalence of cigarette smoking
      was 61% among men and 7% among women, approximately 250 million persons in PRC
      smoked tobacco products (1). In 1988, among junior high school students in PRC,
      34% of boys and 4% of girls reported smoking at least occasionally (3). To
      increase public knowledge of the health consequences of cigarette smoking,
      promote healthier attitudes among elementary school students, and motivate
      fathers who smoke to quit, the Zhejiang Center for Health Education developed and
      implemented a school-based smoking-intervention program in the Jiangan district
      of Hangzhou from May 1989 through January 1990. This report summarizes an
      assessment of this program.

PMID- 8487747
TI  - Measles--United States, 1992.
AB  - As of January 2, 1993 (week 53), local and state health departments reported a
      provisional total of 2200 measles cases for 1992 (1)--a 77% decrease from the
      9643 cases reported for 1991 (2), and a 92% decrease from the 27,786 cases
      reported for 1990 (3). Cases were reported from 36 states and the District of
      Columbia. This provisional total is one of the lowest annual totals reported in
      the United States; fewer cases were reported only in 1982 (1714 cases) and 1983
      (1497 cases) (4). This report summarizes epidemiologic characteristics of measles
      cases reported for 1992 and compares them with cases reported during 1989-1991.

PMID- 8487748
TI  - NIOSH alert: request for assistance in preventing falls and electrocutions during
      tree trimming.

PMID- 8487749
TI  - NIOSH alert: request for assistance in preventing worker injuries and deaths
      caused by falls from suspension scaffolds.

PMID- 8487750
TI  - Identification of an autoinhibitory domain in the insulin receptor tyrosine
      kinase.
AB  - We have tested the hypothesis that activation of the insulin receptor tyrosine
      kinase is due to autophosphorylation of tyrosines 1146, 1150 and 1151 within a
      putative autoinhibitory domain. A synthetic peptide corresponding to residues
      1134-1162, with tyrosines substituted by alanine or phenylalanine, of the insulin
      receptor beta subunit was tested for its inhibitory potency and specificity
      towards the tyrosine kinase activity. This synthetic peptide gave inhibition of
      the insulin receptor tyrosine kinase autophosphorylation and phosphorylation of
      the exogenous substrate poly(Glu, Tyr) with an approximate IC50 of 100 microM.
      Inhibition appeared to be independent of the concentrations of insulin or the
      substrate poly(Glu, Tyr) but was decreased by increasing concentrations of ATP.
      This same peptide also inhibited the EGF receptor tyrosine kinase but not a
      serine/threonine protein kinase. These results are consistent with the hypothesis
      that this autophosphorylation domain contains an autoinhibitory sequence.

PMID- 8487751
TI  - A novel plant membrane proteoglycan which causes anorexia in animals.
AB  - Hunger and satiety are complex interplay of several factors in human and animal
      species. Reduced food intake has also been observed under various pathological
      conditions. Earlier, we have been able to isolate an endogenous glycoprotein from
      erythrocyte membranes, which causes anorexia in rats. In the present study, a
      similar anorexigenic proteoglycan from Mung bean sprout membranes has been
      isolated and purified. The proteoglycan (50 kDa) consisted of 70-85% carbohydrate
      with galactose, glucose galactosamine and mannose as the main sugars. Protein
      part on analysis showed higher glutamic acid and serine content. This
      proteoglycan reduces food intake when injected in rats deprived of food for 96 hr
      as well as normally fed rats, mice and rabbits without any rebound. The TCA
      soluble proteoglycan from different plant sources have also been compared for
      their anorexigenic activity. The similarities observed among plant and animal
      cell membrane proteoglycans with satietins isolated from human blood plasma could
      be due to membrane origin of satietins.

PMID- 8487752
TI  - Influence of liposome charge and composition on their interaction with human
      blood serum proteins.
AB  - Lipid composition and specially their electrostatic properties, were found to
      greatly influence the stability of liposomes in human blood serum. The amount and
      type of serum proteins bound to the liposomes were also clearly influenced by
      lipid composition and charge of liposomes. A good correlation was found between
      the amount of serum proteins adsorbed to a given type of liposome and its
      instability as measured by the release of an encapsulated fluorescent probe.
      Liposomes that bind the highest amount of protein were the least stable, except
      for the case of liposomes containing gangliosides, which were fairly stable even
      at a high amount of bound protein. Liposomes with neutral charge containing
      phosphatidylcholine were the most stable and bound the lowest amount of protein.
      Liposomes with positive charge behaved similarly to those with neutral charge.
      However, the stability of negatively charged liposomes was very dependent on
      their composition. Those liposomes containing only one class of negatively
      charged phospholipids bound a great amount of protein and were very unstable.
      However, those liposomes containing also phosphatidylcholine bound less protein
      and were more stable. The examination of the electrophoresis patterns of serum
      proteins bound to the different types of liposomes indicated the presence of
      specific proteins which correlated with liposome instability.

PMID- 8487753
TI  - Effect of streptozotocin and nicotinamide upon FAD-glycerophosphate dehydrogenase
      activity and insulin release in purified pancreatic B-cells.
AB  - Purified rat pancreatic insulin-producing B-cells, which display a 12-fold higher
      activity of FAD-linked glycerophosphate dehydrogenase than other islet endocrine
      cells, were exposed for 30 min to 2 mM streptozotocin and subsequently cultured
      for 2 days in the absence or presence of 2 mM nicotinamide. Streptozotocin
      decreased by 54% the number of B-cells and, in surviving cells, lowered by 75%
      the activity of FAD-linked glycerophosphate dehydrogenase, whilst failing to
      affect that of glutamate dehydrogenase. This coincided with a 42-51% reduction of
      insulin secretion, when expressed relative to either the DNA or hormonal content
      of surviving cells. After exposure to streptozotocin, the presence of
      nicotinamide in the culture medium reduced cell death by 44% and also reduced the
      deleterious effects of streptozotocin upon both the enzymic and secretory
      activities of surviving cells. These findings indicate that the decreased
      activity of FAD-linked glycerophosphate dehydrogenase previously documented in
      pancreatic islets from streptozotocin-injected rats, as well as the protective
      effect of nicotinamide thereupon, are not attributable solely to changes in the
      number of B-cells but also to an altered enzymic activity in surviving B-cells.
      The latter anomaly may account, in part at least, for an impaired B-cell
      secretory response to D-glucose.

PMID- 8487754
TI  - Ferrous-iron induces lipid peroxidation with little damage to energy transduction
      in mitochondria.
AB  - Addition of ferrous sulfate, but not ferric chloride, in micromolar
      concentrations to rat liver mitochondria induced high rates of consumption of
      oxygen. The oxygen consumed was several times in excess of the reducing capacity
      of ferrous-iron (O:Fe ratios 5-8). This occurred in the absence of NADPH or any
      exogenous oxidizable substrate. The reaction terminated on oxidation of ferrous
      ions. Malondialdehyde (MDA), measured as thiobarbituric acid-reacting material,
      was produced indicating peroxidation of lipids. The ratio of O2:MDA was about
      4:1. Pretreatment of mitochondria with ferrous sulfate decreased the rate of
      oxidation (state 3) with glutamate (+ malate) as the substrate by about 40% but
      caused little damage to energy transduction process as represented by ratios of
      ADP:O and respiratory control, as well as calcium-stimulated oxygen uptake and
      energy-dependent uptake of [45Ca]-calcium. Addition of succinate or ubiquinone
      decreased ferrous iron-induced lipid peroxidation in intact mitochondria. In
      frozen-thawed mitochondria, addition of succinate enhanced lipid peroxidation
      whereas ubiquinone had little effect. These results suggest that ferrous-iron can
      cause peroxidation of mitochondrial lipids without affecting the energy
      transduction systems, and that succinate and ubiquinone can offer protection from
      damage due to such ferrous-iron released from the stores within the cells.

PMID- 8487755
TI  - Triiodo-L-thyronine stimulates glycogen synthesis in rat hepatocyte cultures.
AB  - The hyperthyroid state is associated with low hepatic glycogen levels, but
      paradoxically with a high activity of glycogen synthase and low activity of
      glycogen phosphorylase. We determined the effects of triiodo-L-thyronine (T3) on
      glycogen synthesis and glycogen synthase activity in rat hepatocytes in vitro.
      Culture of rat hepatocytes with T3 (100 nM-1 microM) for 16 h-40 h increases
      glycogen synthesis from glucose and gluconeogenic precursors. The stimulation of
      glycogen synthesis by T3 was associated with an increase in the activity of
      glycogen synthase and was additive with the long-term effects of insulin but not
      with the short-term stimulation of glycogen synthesis by insulin. Culture of
      hepatocytes with T3 (at concentrations up to 1 microM) did not affect the
      responsiveness of glycogen synthesis to short-term stimulation by insulin but
      culture with 10 microM-T3 decreased the responsiveness to insulin without
      affecting the basal rate. It is suggested that the high activity of glycogen
      synthase in the hyperthyroid state is due to a direct effect of T3 on the
      hepatocyte, but the low hepatic glycogen content is probably due to either
      secondary metabolite and/or endocrine changes or to impaired responsiveness to
      insulin. T3 may have an anabolic role in the control of hepatic glycogen storage
      in the euthyroid postprandial state.

PMID- 8487756
TI  - Pregnancy specific beta 1-glycoprotein in human intestine.
AB  - Pregnancy-specific beta 1-glycoprotein (PSG) transcripts have been identified in
      a number of placental and non-placental tissues. Using a placental PSG cDNA probe
      to screen a normal human intestinal cDNA library we have isolated 22 hybridizing
      clones. These clones could be divided into four groups. Nucleotide sequence
      analysis showed that one group of clones correspond to functional and another
      group correspond to non-functional PSG cDNAs. The other two groups are homologous
      to the nonspecific cross-reacting antigen (NCA) and biliary glycoprotein (BGP),
      both of which are members of the carcinoembryonic antigen (CEA) family. Thus,
      PSG, NCA and BGP are co-expressed in normal human intestine. RNA and immunoblot
      analysis, along with polymerase chain reaction amplification further confirm the
      expression of PSG in human intestinal tissue.

PMID- 8487757
TI  - Expression analysis of the mixed function oxidase system in rat brain by the
      polymerase chain reaction.
AB  - Metabolism of therapeutic drugs in the body by the mixed function oxidase system
      is an important consideration in the analysis of a drug's effectiveness. P450
      dependent metabolism within the brain of a neuro-specific drug may affect the
      drug's course of action. To determine whether cytochrome P450 was expressed in
      brain, RNA was isolated from the whole brains of rats treated with a variety of
      known hepatic P450 inducers, including amitriptyline, imipramine, isosafrole,
      phenobarbital, and beta-naphthoflavone. The RNA was analyzed for the presence of
      P450 isozymes by the PCR technique. Differential expression of P450IA1, P450IIB1,
      P450IIB2, P450IID, and P450IIE1 was detected in the brain samples, depending on
      the treatment. Cytochrome P450 reductase expression was also detected in the
      brain samples, giving strong evidence that the brain contains a competent mixed
      function oxidase system under all conditions studied.

PMID- 8487758
TI  - [Mapping vaccinia virus genes].
AB  - This is a critical review of the modern methods of gene mapping in the vaccinia
      virus genome. Experimental data are given on the localization of the vaccinia
      virus genes. Major attention is paid to the functions of the proteins encoded by
      the mapped genes.

PMID- 8487759
TI  - [The role of oligophosphate and nucleoside fragments upon the interaction of a
      nucleotide with RecA protein].
AB  - Pyrophosphate and 1-pyrophospho-5-phosphoribose displace the nucleotide from the
      complex with RecA protein (in the absence of DNA). Adenosine, AMP, inorganic
      phosphate riboso-5-phosphate have no effect. Pyrophosphate causes the
      dissociation of RecA-ssDNA-complex in the same manner as ADP, circular
      hexaphosphate has no effect. In the complex with RecA protein the dissociation
      constant for pyrophosphate is 1.6 mM and 710 mM for adenosine. It is proposed
      that the oligophosphate is the main binding group in the RecA-nucleotide
      interaction. Two vicinal "closed" -O and one terminal "open" oxygenous =O-groups
      of oligophosphate take part in the binding. The nucleoside fragment alone cannot
      provide the firm binding of the nucleotide with the protein, but probably is
      responsible for the specificity of the nucleotide to protein binding.

PMID- 8487760
TI  - [Immunochemical analysis of Escherichia coli expression products of I3 and A2
      genes of vaccinia virus strain L-IVL genome].
AB  - Genes I3 and A2 of the vaccinia virus strain L-IVP DNA were cloned into bacterial
      expressing vectors. The monospecific antisera to the expression products of these
      genes in E. coli were obtained. By means of immunochemical cross-analysis two
      polypeptides of equal electrophoretic mobility were found in the virion
      preparations in the band of the major envelope protein p35. The major of them is
      the product of gene I3, and the minor is encoded by gene A2.

PMID- 8487761
TI  - [Nuclear peptides, specifically binding oligonucleotides].
AB  - Interaction of alkylating derivatives of oligonucleotides with nuclear extracts
      from mammalian cells has been investigated. Three modified 1.5-, 3.0-, and 6.0
      kDa proteins were detected in nuclear extracts from human and murine cells. The
      1.5-kDa and 3.0-kDa proteins were also detected in insect, plant, yeast, and
      bacterial cells. The ubiquity of the proteins suggests their important role in
      cellular metabolism.

PMID- 8487762
TI  - [Quantitative determination of the accessible surface of globular proteins by
      tritium planigraphy].
AB  - At the last time the term "accessible surface" is used for a description of
      protein structure. The tritium planigraphy was used for quantitative detection of
      the accessible surface. The experimental dependence of an interaction probability
      of the tritium atoms with globular proteins with calculated accessible surface
      areas was obtained. The method was proposed on the basis of the information about
      the reactivity of amino acids residues and was used for the determination of an
      accessible surface of parvalbumin III of pike.

PMID- 8487763
TI  - [Ionization energy and glycoside bond rupture energy of nucleosides, suppressing
      the reproduction of the human immunodeficiency virus (HIV)].
AB  - By photoionization mass spectrometry the energy characteristics were investigated
      for a series of nucleosides whose triphosphates possess anti-HIV activity. The
      electron-donor ability (a value reciprocal to ionization energy) does not
      correlate with the biological activity of corresponding nucleotides. The energy
      of glycoside bond rupture depended on modification in deoxyribose.

PMID- 8487764
TI  - [Characteristics for determining nonpolar amino acid residues in amino acid
      sequences of certain globular proteins].
AB  - A method of quantitative characterization of nonpolar residue distribution in
      amino acid sequences of globular proteins is proposed. It consists in
      determination of ratios of residues belonging to two selected amino acid
      subgroups: leucine, phenylalanine, tyrosine, tryptophan; and alanine, valine,
      isoleucine. It was found that the values of the proposed index of analyzed
      proteins are in the range 0.51-1.27, the mean value being 0.90 +/- 0.10.

PMID- 8487765
TI  - [In vitro suppression of translation of tick-borne encephalitis virus RNA using
      antisense nucleotides].
AB  - Effect of antisense oligodeoxyribonucleotides on in vitro translation of RNAs
      corresponding to fragments of the tick-borne encephalitis virus genome has been
      investigated. Sequences optimal for oligonucleotide binding and translation
      arrest have been identified. The most efficient oligonucleotide (17-mer) at a
      concentration of 2.5 microM completely arrests translation of the RNA coding for
      the NS3 protein.

PMID- 8487766
TI  - [Interaction of mRNA analogs--oligoribonucleotides AUGU3, AUGU6 and (pU)6 with
      80S ribosomes from human placenta in the presence of related tRNA and a protein
      synthesizing system].
AB  - Binding of oligoribonucleotides AUGUn (n-3 and 6) and (pU) to 80S ribosomes from
      human placenta in the presence of cognate tRNAs and a "ribosome-free" protein
      synthesizing system from rabbit reticulocytes has been studied. The binding of
      the mRNA analogues resulted in formation of stable post-translocational complexes
      (which may be easily isolated by centrifugation in sucrose density gradient):
      80S.AUGU3.MetPhe-tRNA(Phe); 80S.AUGU6.Met(Phe)2.tRNA(Phe); 80S.(pU)6.(Phe)2
      tRNA(Phe). In these complexes the ratios of the bound ligands are close to the
      theoretically expected values. Comparison of the results obtained with the
      previously reported data on nonenzymatic binding of oligouridylates and Phe
      tRNA(Phe) to 80S ribosomes lead one to the conclusion that translation factors
      significantly stabilize the complexes of tRNA with 80S ribosomes and
      oligoribonucleotide templates.

PMID- 8487767
TI  - [Heat capacity of hydrated and dehydrated globular proteins. The denaturing
      increment of heat capacity].
AB  - Absolute values of heat capacity for some hydrated globular proteins (11S
      globulin, ovalbumin, ribonuclease A, and lysozyme) have been studied by
      differential scanning calorimetry. It has been found that for proteins with bound
      water, as in the case of protein solutions, the heat capacity of denatured
      proteins is higher then prior to denaturation. Depending on temperature and
      humidity, the denatured proteins can be either in high-elastic or glass state.
      Specific heat capacities for these two states have the same values for all
      proteins and depend only on temperature with a characteristic increment of 0.55
      J.g-1.K-1 at glass transition. The glass transitions were observed not only in
      denatured but also in native proteins. Our results indicate that the main
      contribution to the heat capacity increment at denaturation is connected with the
      thermal motion in the protein globule, which is contrast with the commonly
      accepted ideas.

PMID- 8487768
TI  - [Analysis of the spatial structure of proteins in terms of residue-residue
      contacts. II. Contact affinity].
AB  - The possibility of detecting the mutual amino acid residue affinity when protein
      three-dimensional structures are described in terms of residue-residue contact
      matrices is discussed. The hypothesis of the lack of affinity between amino acid
      residues is examined; the values of the pertinent elements of the overall residue
      residue contact matrices prove not to be statistically different from random
      estimates in 91%; the chance hypothesis is rejected in 9% of cases, represented
      as a rule by residues with charged side groups, especially oppositely charged
      ones.

PMID- 8487769
TI  - [Gene 26 of bacteriophage T4 baseplate. II. Synthesis of a smaller peptide of
      gene 26 is initiated at an unusual AUU-codon].
AB  - The sequence of gene 26 consisting of 624 nucleotides codes for two peptides
      whereby the smaller peptide (gp26*) is encoded by the 3'-end of the same open
      reading frame. Expression of gene 26 from plasmids, containing various fragments
      from the terminal part of this gene, allowed us to determine the gene 26 internal
      segment responsible for the initiation of gp26* synthesis. By site-directed
      mutagenesis the nucleotide sequence of this DNA segment has been changed, and in
      further expression experiments of the mutagenized gene 26 it was determined that
      an unusual AUU codon, triplet 114 of gene 26, is used to initiate the synthesis
      of the smaller peptide. Thus gene 26 encodes two peptides of M(r) 23,880 and M(r)
      10,873. The regulation of the expression of gene 26 in T4-infected cells is
      discussed.

PMID- 8487770
TI  - [Analysis of reporter gene expression at different segments of the vaccinia virus
      genome].
AB  - Two reporter genes: the firefly Photinus pyralis luciferase gene and the
      Escherichia coli beta-galactosidase gene were used for construction and
      characterization of the five unique recombinant vaccinia strain LIVP viruses
      expressing these genes in three nonessential regions of the virus genome. We give
      comparative characteristics of beta-galactosidase and luciferase activities in
      experiments of transient expression and expression dynamics of reporter genes by
      different stable recombinant viruses. Both genes are expressed with high
      efficiency independent on the sites of virus genome localization. It is shown
      that the TK-, HA- and N-regions of vaccinia virus DNA may be used for inserting
      foreign genes.

PMID- 8487772
TI  - [Three mutant forms of ribosomal protein L7/L12].
AB  - Three mutant forms of the ribosomal protein L7/L12 with Ser1, Met14, and Met26
      replacements with Tyr were constructed for studying the N-terminal domain of the
      protein. Three point mutations in the gene L7/L12 on the phage M13mp18 were
      generated. Recombinant plasmids containing the mutant genes were constructed on
      the base of expression vector pKK223-3 and plasmid pUC19. The mutant proteins
      were expressed in Escherichia coli cells, and methods of their purification were
      developed. It was found that the mutant proteins L7/L12 do not differ from the
      wild-type protein L7/L12 and represent a suitable object for 1H-NMR study of the
      L7/L12 protein. The three mutant proteins bind with the E. coli ribosome.

PMID- 8487771
TI  - [Comparison of the heat stability and structure close homologs--Bacillus
      amyloliquefaciens ribonuclease and Bacillus intermedius 7P ribonuclease].
AB  - Parameters of heat denaturation and intrinsic fluorescence of barnase and its
      close homologue, binase, in the pH region 2-6 have been determined. 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 the 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 Trp-94 by the His-18 residue,
      which is absent in binase. Secondary structures of both native and denaturated
      proteins also do not differ. Some differences have been found in the barnase and
      binase electrostatic characteristics, revealed in the character of the dipole
      moment distribution.

PMID- 8487773
TI  - [Preparation of single-chained antibodies to human ferritin in Escherichia coli].
AB  - We have cloned cDNA copies of the immunoglobulin heavy and light chain genes from
      hybridoma cells able to produce antibody against human ferritin. Variable
      segments of these genes were obtained using the polymerase chain reaction (PCR).
      The specific amplifications of ligase reaction products were carried out to
      combine the variable segments with DNA fragments coding for a peptide-linker and
      for a signal peptide of the cloned pelB gene of Erwinia carotovora. During the
      antiferritin single-chain antibody gene expression under the T7 RNA polymerase
      control in E. coli the processed molecules of recombinant proteins formed
      aggregates in periplasm. The reversible denaturation in the absence of reducing
      agents had allowed us to obtain single-chain antibodies with the original binding
      specificity toward human ferritin.

PMID- 8487774
TI  - New DNA sequences for the human complement gene C4.

PMID- 8487775
TI  - Mouse monoclonal anti-idiotypic antibodies to HIV p24: immunochemical properties
      and internal imagery.
AB  - Two mouse monoclonal antibodies (VIC5 and VIC6; referred to as Ab1) reacting with
      the p24 core antigen of HIV-1 were used to produce mouse monoclonal anti
      idiotypic antibodies (Ab2). Six anti-idiotypic antibodies were characterized. The
      five anti-idiotypic antibodies directed against VIC6 partly competed which each
      other and thus defined a set of overlapping idiotypes on Ab1. All 6 Ab2s
      inhibited the binding of the corresponding anti-p24 antibody to antigen, although
      four (W1, Y16, Y6, X14) were markedly more inhibitory than the remaining two (G6,
      Y11). All six Ab2s were antigen-inhibitable; however the interaction of G6 and
      Y11 with Ab1 was blocked with considerably less soluble p24 antigen than the
      remaining four. Correspondingly, G6 and Y11 had lower affinities for Ab1 than did
      W1, Y6 and X14; the affinity index of Y16 was equivalent to that of Y11. None of
      the Ab2s reacted with H or L chains of Ab1 after reduction on SDS-gels.
      Similarly, both Ab1s failed to react with the H or L chains of Ab2. These
      criteria appeared to define at least four of these Ab2s as internal image
      antibodies whose image is composed of both H and L chains. The anti-idiotypic
      antibodies were injected either individually or as a combined preparation of all
      6 into syngeneic mice and Porton rats. Despite the presence of anti-anti
      idiotypic antibodies (Ab3) in these animals, when used individually no antigen
      specific antibodies were found. A small response to p24 antigen was induced in 3
      of 6 mice using preparations containing all 6 anti-idiotypes.

PMID- 8487776
TI  - Induction of immune response against a short synthetic peptide antigen coupled to
      small neutral liposomes containing monophosphoryl lipid A.
AB  - We have investigated the parameters affecting the immunogenicity of a short
      synthetic hexapeptide associated with liposomes. The model peptide used had the
      sequence IRGERA which corresponds to the C-terminal hexapeptide region of histone
      H3. Immunogenicity was measured by the ability of anti-peptide antibodies to
      cross-react with the parent protein. By itself, the peptide was not able to
      induce significant antibody production. However, liposomes were shown to be able
      to render the peptide immunogenic, nevertheless a number of parameters were
      important: to be immunogenic the peptide had to be surface bound, rather than
      entrapped within the liposomes, and an adjuvant, monophosphoryl lipid A (MPLA),
      had to be present in the same population of liposomes. Additionally, the
      intensity and duration of the immune response were found to be dependent both on
      the charge of the liposomes; neutral liposomes yielding a longer lasting response
      than negatively charged liposomes, and on the immunisation schedule where a long
      time period between immunisation and boosting yielded a better result than a
      short time period. To account for these phenomena we propose a model in which
      surface-bound antigen targets liposomal MPLA to B lymphocytes specific for the
      antigen. These results demonstrate that liposomes containing the non-toxic
      adjuvant MPLA can act as carriers to induce a long-lasting IgG response against
      peptides, eliminating the need of protein carriers and conventional adjuvants.
      Such an approach may be useful for designing synthetic vaccines.

PMID- 8487777
TI  - Recombinant Fel d.I: Expression, purification, IgE binding and reaction with cat
      allergic human T cells.
AB  - This study describes the properties of the two recombinantly expressed
      polypeptide chains of Fel d I, the major allergen produced by the domestic cat
      (Felis domesticus). An inframe linker encoding polyhistidine has been added to
      the 5' ends of the Fel d I chains 1 and 2 cDNAs to facilitate purification using
      Ni2+ ion affinity chromatography. This method provides high yields in a single
      step of rchain 1 and rchain 2 of Fel d I with a > 90% level of purity. Polymerase
      chain reaction (PCR) methods were used to introduce a thrombin cleavage site
      (LVPR decreases GS) at the N-terminus of both chains. Thrombin cleavage of rchain
      1 and rchain 2 followed by HPLC purification of the cleavage products allowed the
      isolation of each recombinant chain with only two additional residuals (GS) at
      the N-terminus of the native sequence. Amino acid sequencing analysis of the N
      terminus and mass spectrometry of these polypeptides demonstrated that they are
      highly pure and full-length. Direct ELISA assays showed that IgE from cat
      allergic patients binds to both rchain 1 and rchain 2 of Fel d I, demonstrating
      that both these chains contribute to the allergenicity of this heterodimeric
      protein. An examination of the reactivity of T cells derived from cat-allergic
      patients revealed that both polypeptide chains contribute to the T cell response
      to this allergen. Consequently, it is concluded that the immunological response
      to Fel d I is composed of a reaction at both the B and T cell level to each of
      the two chains that constitute the native allergen.

PMID- 8487778
TI  - Extensive somatic mutation in the Ig heavy chain V genes in a late primary anti
      hapten immune response.
AB  - Somatic mutations and cell lineage relationships were examined in a large panel
      of hybridomas derived from a single mouse 21 days after a primary immunization
      with NP-CGG. Among 21 lambda-bearing anti-NP hybridomas 18 distinct cell lineages
      were observed. Ten of the hybridomas used the V186-2 gene which is the most
      frequently utilized VH gene in the anti-NP response. Analysis of DNA sequence of
      the entire VH region of these antibodies revealed extensive somatic mutations.
      The selection for certain codon changes and the level of mutation observed is
      comparable to that observed in an early secondary anti-NP response. An unexpected
      observation was that one-third of the hybridomas produced IgM antibodies. Two IgM
      antibodies expressing the V186-2 gene contained extensive mutations in the VH
      region. These results indicate that once the somatic mutation process is
      initiated, it progresses rapidly and continues for at least two weeks during the
      development of the response. A highly mutated repertoire of memory B cells is
      formed by three weeks post-immunization that can be rapidly utilized to generate
      the secondary immune response.

PMID- 8487779
TI  - A genetically engineered human IgG with limited flexibility fully initiates
      cytolysis via complement.
AB  - A causal link between antigen induced conformational change and functional
      activity has been previously suggested for the triggering of immunoglobulin
      effector functions. To test this hypothesis an immunoglobulin with greatly
      restricted Fab flexibility has been created by site-directed mutagenesis.
      Serine119, a residue at the elbow in the first heavy chain constant domain of a
      mouse-human chimeric immunoglobulin, was replaced by cysteine119. The resulting
      mutant immunoglobulin had an additional intramolecular disulfide bond connecting
      the two heavy chains. This newly introduced covalent bond between antigen binding
      arms gave rise to a compact 'tethered' conformation which displayed lowered
      segmental flexibility as determined by nanosecond fluorescence depolarization
      anisotropy. However, the ability of this tethered immunoglobulin to initiate
      lysis of target cells via the complement cascade was unimpaired. Therefore, it is
      likely that allosteric or distortive mechanisms of conformational change induced
      complement activation which require unhindered 'twist' and/or 'waggle' motions of
      Fab are untenable.

PMID- 8487780
TI  - A light-scattering method for measuring the sizes of insoluble immune complexes.
AB  - A turbidimetric method for measuring the diameters of insoluble immune complexes,
      based on the wavelength dependence of their ability to scatter light, was
      developed. The method was validated by demonstrating that it gave experimental
      values for the diameters of polystyrene microspheres which were in good agreement
      with independently known values of these. The method was used to measure the
      diameters of ovalbumin:anti-ovalbumin IgG immune complexes, giving values
      consistent with literature measurements of the sizes of other IgG-containing
      immune complexes.

PMID- 8487781
TI  - Characterisation of rainbow trout cDNAs encoding a secreted and membrane-bound Ig
      heavy chain and the genomic intron upstream of the first constant exon.
AB  - Two different rainbow trout cDNA sequences encoding a heavy chain secreted Ig
      (Hs) and a part of a membrane-bound heavy chain Ig (Hm) are reported. The
      sequences were most similar to those encoding the Ig heavy chains (IgH) of other
      teleost fish. As in the Hm of the other teleost fish the rainbow trout Hm results
      from the splicing of the 3' end of the third constant exon (CH3) to the sequence
      encoding the membrane-bound domain. Analysis of a rainbow trout IgH genomic clone
      revealed that a joining heavy chain (JH) segment, different to the one observed
      in the cDNA, is located 825 bp 5' of the CH1 exon. The sequence also contains
      possible enhancer-like and octamer-like motifs.

PMID- 8487782
TI  - Cytokine gene expression in mice undergoing chronic graft-versus-host disease.
AB  - Chronic graft-versus-host disease (GVHD) can be induced in B6D2F1 mice by
      injection of parental DBA/2 lymphoid cells. Stimulation of donor T cells by host
      MHC antigens leads to the stimulation of host B cells. Little is known of the
      lymphokines produced during such a reaction. This study was designed to directly
      measure the levels of mRNA for interferon-gamma (IFN-gamma), interleukin 2 (IL
      2), IL-4, IL-5, and IL-10, as well as several other genes, using semiquantitative
      polymerase chain reaction (PCR). Semiquantitative PCR was reproducible and
      signals generated were dependent on the amount of specific RNA or cDNA in each
      reaction. Early during the progression of GVHD (2 days after the first injection
      of parental cells) there was little increase in IL-10 mRNA, a slight increase in
      IL-4 mRNA, and a dramatic increase in IL-2 mRNA. In addition, IL-2 bioactivity
      was demonstrated in supernatants from GVH splenocytes cultured in vitro for 24 h.
      Later in the response (1 week after the second and final injection of parental
      cells) IL-4 mRNA levels were elevated as they were earlier while IL-10 mRNA
      levels were dramatically increased. IL-2 mRNA levels were no different in mice
      undergoing GVHD than in normal mice at this time. IFN-gamma mRNA was detectable
      both early and late, although at similar levels in normal mice and mice
      undergoing GVHD. At both times examined, IL-4 was below the limits of detection
      by bioassay and IFN-gamma, IL-4, IL-5 and IL-10 were below the limits of
      detection by ELISA. Further studies showed that a majority of the IL-4 and IL-10
      mRNA found elevated in GVH mice were produced by Thy1.2+ T cells, with small
      amounts from B220+ B cells. In addition, the detectable IFN-gamma mRNA found in
      GVH mice at this later time also was produced by Thy1.2+ T cells, with small
      amounts from B220+ B cells.

PMID- 8487783
TI  - Identification of multiple sites of interaction between heparin and the
      complement system.
AB  - Many diverse effects of heparin on the complement system have been reported. In
      only a few cases have the sites or the mechanisms of these effects been
      identified. In order to understand these results we sought to comprehensively
      analyze which complement proteins interact with heparin and which do not.
      Purified components of the classical, alternative and terminal pathways of
      complement were radiolabeled and their affinity for heparin determined. Affinity
      chromatography of normal human serum on heparin-agarose allowed a complete
      analysis of complement proteins and confirmed the results obtained with
      radiolabeled purified components. Of the 22 complement proteins examined, 13
      bound heparin (C1q, C2, C4, C4bp, C1INH, B, D, H, P, C6, C8, C9, and vitronectin)
      while 9 did not bind heparin (C1r, C1s, C3, Factor I, C5, C7, C3b, Ba and Bb).
      These observations help explain the many effects heparin has on the complement
      system and they identify the proteins which need to be examined in order to
      explain these effects.

PMID- 8487784
TI  - Regeneration of antidigoxin binding activity in an antibody by changes
      surrounding the original binding defect.
AB  - A panel of antibodies which differ in their L chain structures and which bind to
      structurally defined haptens, would be useful in investigating L chain structure
      and function. In a previous study, chain recombinant antibody CR24 (26-10 H, 45
      20 lambda) was produced by hybridoma-hybridoma fusion. Although both parental
      antibodies bound digoxin with high affinity, CR24 lacked detectable digoxin
      binding activity. Hybridoma CR24 was subsequently fused with H chain-loss
      hybridomas in order to produce a panel of antibodies composed of 26-10 H chains
      and 26-10 "like" L chains. Two antibodies produced were CR260 which demonstrated
      digoxin-binding activity and CR256 which did not. CR260 and CR256 expressed only
      one amino acid difference (Pro to Leu at L-96). This difference resulted in the
      CR256 binding defect. In this report, two new antidigoxin antibodies are
      described. One, SR2E7, contained the Pro to Leu (L-96) defect, but still bound
      digoxin. Binding affinities and binding specificity patterns, as well as complete
      VL DNA sequence and corresponding protein sequence of the new digoxin binding
      antibody L chains (SR2E7 and SR1C7) are presented. Both kappa L chains are highly
      homologous to the 26-10 kappa L chain as well as the BALB/c germline gene K5.1.
      These results suggest that antibodies which are initially defective in binding
      activity can be cured by changing specific amino acids involved in determining
      the binding-site structure. Molecular modelling studies of the binding-site
      region were completed to address L chain structural changes induced by specific
      amino acid substitutions.

PMID- 8487785
TI  - Analysis of oligosaccharides involved in the asymmetrical glycosylation of IgG
      monoclonal antibodies.
AB  - The aim of this study is to identify the oligosaccharide residues involved in the
      asymmetric glycosylation of immunoglobulins. We have studied two anti-DNP
      monoclonal antibodies of the IgG1 isotype. Results show both qualitative and
      quantitative differences in the carbohydrates of both monoclonal antibodies and
      their fragments F(ab')2, Fab' and Fd. One of the antibodies -112D5-, which
      appears to be homogeneous in the Scatchard plot, has oligosaccharide residues in
      the L chain and in the Fd of one of the Fab'. On the other hand, 112B2 mAb, which
      also appears to be asymmetrically glycosylated, shows the bimodal curve
      characteristic of antibodies with different combining site affinities.

PMID- 8487786
TI  - [Comment on the contribution by H. Gotze and A. Mahdi. Fructose malabsorption and
      dysfunctional abdominal complaints].

PMID- 8487787
TI  - [Aspects of psychosocial management of children with kidney failure and their
      relatives].
AB  - Being confronted with chronic illness in childhood and adolescence implicates a
      high degree of physical and emotional burden hardly coped with without external
      support. For this reason psychosocial services to support children with chronic
      renal failure recently have been initiated at several pediatric nephrology
      centres during recent years. The spectrum of psychosocial burdens accompanying
      chronic renal failure in childhood is revealed. Tasks and interventions of
      psychosocial services corresponding to these burdens are described. The presented
      data concerning educational and vocational rehabilitation of young renal patients
      demonstrate the continuous need of qualified psychosocial staff, although the
      basic equipment of pediatric nephrology with psychosocial services has increased
      during the last years. In conclusion a concept of integrative patient care is
      illustrated by giving practical suggestions increasing the patient's compliance.

PMID- 8487788
TI  - [Allergy and psyche].

PMID- 8487789
TI  - ["Tropical" pyomyositis in childhood].
AB  - We report on a 14 year old boy, who developed bacterial pyomyositis
      (Staphylococcus aureus) in his left thigh. Ultrasound and magnetic resonance
      imaging were very helpful for the differential diagnosis and follow-up of this
      infection which in large skeletal muscles frequently is associated with abscess
      formation. Treatment consisted of antibiotics and surgical drainage.

PMID- 8487790
TI  - [Interaction of tolazoline and cimetidine in persistent fetal circulation of the
      newborn infant].
AB  - A newborn was treated with tolazoline for persistent pulmonary hypertension.
      Oxygenation improved during continuous infusion of the drug, but gastrointestinal
      bleeding occurred. Therefore, cimetidine was given. After this there was a rapid
      deterioration with decrease of oxygen saturation and arterial pO2 values.
      Tolazoline induces a dilatation of the pulmonary vascular system by stimulating
      H1 and H2 receptors. Blocking of H2 receptors by cimetidine abolishes the effect
      of tolazoline at least partially. Our case shows that the interaction between
      tolazoline and cimetidine is of clinical significance. The recommendation to use
      cimetidine as prophylaxis against gastrointestinal side-effects induced by
      tolazoline can no longer be maintained.

PMID- 8487791
TI  - [Hemimegalencephaly. Therapy with hemispherectomy].
AB  - Hemimegalencephaly is associated with a poor clinical course characterized by
      intractable seizures and severe encephalopathy. We present a case report of a
      girl with hemimegalencephaly. At the age of 9 month hemispherectomy was
      undertaken to preserve function of the other hemisphere. MRI and histologic
      examinations showed characteristic dysplastic malformations. Follow-up and the
      complications are described.

PMID- 8487792
TI  - [Secondary rhabdomyolysis and acute renal failure in gastroenteritis with
      hypernatremic dehydration].
AB  - A child with severe gastroenteritis developed acute rhabdomyolysis combined with
      acute renal failure. The pathophysiological mechanisms of this clinical syndrome
      are not completely understood. Rhabdomyolysis is mainly due to osmotic changes on
      both sides of the cell membrane. The preventive and therapeutic measures consist
      of adequate fluid substitution, correction of electrolyte and acid-base
      imbalances, administration of diuretics and alkalization of the urine. Dialysis
      treatment may be necessary. In this particular case renal failure resolved but
      the child died of other organ failure.

PMID- 8487794
TI  - [Sexual abuse of children. A regional study of the prevalence and
      characteristics].
AB  - BACKGROUND: In contrast to angloamerican countries there are no national figures
      for the incidence and prevalence of sexual abuse in Germany. Reports based on
      criminal statistics are inappropriate and are often misinterpreted. METHODS: In
      this report we present the main results of a regional study of the prevalence of
      sexual abuse in childhood and compare them with angloamerican studies. RESULTS:
      Based on replies from 1009 students and apprentices (age > 18y) the prevalence
      for criminal sexual abuse was found to be 25.2% for females and 6.2% for males. A
      breakdown of these figures showed that females reported having to experience
      anal, oral or sexual intercourse (2.3%), physical contact (11.7%), exhibitionism
      (4.6%) and other sexual behaviour without physical contact (6.6%). For males the
      prevalence rates for these categories of sexual abuse were 1.5%, 2.4%, 0.9% and
      1.5% respectively. All these figures, especially those for males, should be
      evaluated critically as actual prevalence rates are probably higher. Girls,
      particularly those aged 6-10 years, are more often involved than boys. Ninety
      percent of physical abuse happens with persons known to the victim (60% within
      the family, only 8% with strangers. In general 95% of abusers are male, however
      in 25% of cases of hands-on-contact with boys the abusers are female. From the
      relative frequency of reported abuse we estimate the potential incidence to be
      1:30 within the family, 1:23 with other acquaintances and 1:6 with strangers.
      CONCLUSIONS: The importance of regional differences should not be underestimated.
      These results cannot be generalized for the whole of Germany. Only prevalence
      studies appropriately reflect the scale of the problem; they are necessary for a
      broad, a rational and a sufficient planning of strategies designed for
      prevention, intervention and rehabilitation. More scientifically based
      epidemiological studies on the extend of sexual abuse are required in Germany.

PMID- 8487793
TI  - [Aspects of long-term management of children with myelomeningocele. Analysis of
      the last 10 years from the neuropediatric-neurosurgical viewpoint].
AB  - BACKGROUND: Both the use of a selective policy of treatment of newborns with
      myelomeningocele and the right time of back closure are still controversially
      discussed. We report our experiences in the long-term care of children with
      myelomeningocele. METHODS: 103 newborns with myelomeningocele (n = 94) and
      meningocele (n = 9) born 1980 to 1990 and cared for regularly at the
      Olgahospital's pediatric clinic were followed up from the neuropediatric
      neurosurgical point of view. Postpartum we predominantly practised a selective
      policy of treatment. RESULTS: 15 of 21 children (71.4%) not operated on died
      during the first days or months of life, 6 (28.6%) survived. 70 were operated
      selectively, of which 9 (12.9%) died, 61 (87.1%) survived with mainly good
      result. There were no differences in the survival rate and frequency/type of
      postoperative complications with respect to the time of the back closure. 31
      children with myelomeningocele (33%) had CNS anomalies other than the Arnold
      Chiari-Malformation, mostly being a dys- or aplasia of the corpus callosum and a
      deformed ventricle system. These were diagnosed almost exclusively by CT or MRT
      scan. CONCLUSIONS: We still predominantly practised a selective policy of
      treatment of newborns with myelomeningocele with mainly good results.

PMID- 8487795
TI  - [Bronchial asthma in childhood and adolescence. Burden of illness and coping with
      the disease].
AB  - We report an empirical study in which the subjective complaints and stress
      experiences of children with bronchial asthma (outpatient, short- and long-term
      rehabilitation) are analyzed. The data were taken from a specifically developed
      questionnaire. The results should contribute to the conceptualization of programs
      for patient education and asthma training in order to meet the exact requirements
      and needs of the children to be instructed. The role of emotional asthma triggers
      is specified. Hierarchical cluster analysis is applied in order to analyze,
      first, the perception patterns of attack precursors and, second, the array of
      stressors that a child has to face as a consequence of suffering chronic asthma.
      Based on the social learning theory approach, the child's various expectations
      about the controllability of an asthma attack are differentiated. A factor
      analysis reveals that the coping process can be described by two basic coping
      dimensions.

PMID- 8487797
TI  - [Pneumologic aspects of mucoviscidosis].

PMID- 8487796
TI  - [Reduction of pain perception of chronically ill children by intermittent
      infusion therapy].
AB  - Chronically ill children who require life-long i.v. infusions in regular
      intervals (i.e. Agammaglobulinemia, HIV-infection) can be traumatized by such
      painful procedures. Some children gradually accept such infusions, whereas other
      children become sensitized and react with increasing fear and resistance. We
      report on our experience with a combined method of local anaesthesia and active
      role-plays enacting the i.v. infusion on a puppet. In more than 230 applications
      (approximately 11 per child) in our outpatient clinic, 19/20 children reported
      significantly less pain sensations after the 2nd or 3rd application. The children
      learned to handle actively the threatening situation. The method of local
      anaesthesia with Lidocaine/Prilocaine and role playing is suitable to relieve
      pain and reduces distress of such invasive events as regular i.v. infusions are.

PMID- 8487798
TI  - [The child and the environment. Position of the Academy of Pediatrics and
      Adolescent Medicine at the Klausurtagung 5-7 February 1993].

PMID- 8487799
TI  - [Responsibilities, structure and organization of metabolic centers and special
      diagnostic laboratories. Position of the Professional Society of Pediatric
      Metabolic Disorders e. V].

PMID- 8487800
TI  - [Declaration of Saint Vincent: management of diabetes and research in Europe].

PMID- 8487801
TI  - Transforming growth factor beta as a predictor of liver and lung fibrosis after
      autologous bone marrow transplantation for advanced breast cancer.
AB  - BACKGROUND: Hepatic veno-occlusive disease and idiopathic interstitial
      pneumonitis are major causes of morbidity and mortality after bone marrow
      transplantation. Fibrosis is a characteristic of both conditions, and
      transforming growth factor beta (TGF beta) has been implicated in the
      pathogenesis of fibrosis. METHODS: Using acid-ethanol extraction to remove TGF
      beta from human plasma and a mink-lung epithelial-cell growth-inhibition assay to
      measure TGF beta activity, we quantified plasma TGF beta in 10 normal subjects
      and 41 patients before and after they underwent high-dose chemotherapy and
      autologous bone marrow transplantation for advanced breast cancer. RESULTS: There
      was no difference in pretransplantation TGF beta levels between the controls and
      the patients who did not have hepatic veno-occlusive disease or idiopathic
      interstitial pneumonitis after transplantation. In contrast, pretransplantation
      TGF beta levels were significantly higher in patients in whom hepatic veno
      occlusive disease or idiopathic interstitial pneumonitis developed than in the
      controls or the patients without these conditions. The predictive value for the
      development of either condition was 90 percent or more when pretransplantation
      plasma TGF beta levels were more than 2 SD above the mean established in the
      controls. CONCLUSIONS: The plasma TGF beta concentration measured after induction
      chemotherapy but before high-dose chemotherapy and autologous bone marrow
      transplantation strongly correlates with the risk of hepatic veno-occlusive
      disease and idiopathic interstitial pneumonitis after these treatments.

PMID- 8487802
TI  - Brief report: stenting of the ductus arteriosus as a bridge to cardiac
      transplantation in infants with the hypoplastic left-heart syndrome.

PMID- 8487803
TI  - Shattuck Lecture--misconduct in medical research.

PMID- 8487804
TI  - Hunting for the cause: how far to go?

PMID- 8487805
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 22-1993. A 22-year-old man with 20 months of progressive swelling
      of the face.

PMID- 8487806
TI  - The diagnosis of thoracic aortic dissection by noninvasive imaging procedures.

PMID- 8487807
TI  - The diagnosis of thoracic aortic dissection by noninvasive imaging procedures.

PMID- 8487808
TI  - Cardiopulmonary resuscitation.

PMID- 8487809
TI  - Cardiopulmonary resuscitation.

PMID- 8487810
TI  - Cardiopulmonary resuscitation.

PMID- 8487811
TI  - Asthma.

PMID- 8487812
TI  - Asthma.

PMID- 8487813
TI  - Asthma.

PMID- 8487814
TI  - Felbamate therapy in the Lennox-Gastaut syndrome.

PMID- 8487815
TI  - Vitamins to prevent neural-tube defects.

PMID- 8487816
TI  - Case 46-1992: correction.

PMID- 8487817
TI  - Case 46-1992: correction.

PMID- 8487818
TI  - National Leadership Coalition's Plan for Health Care Reform.

PMID- 8487819
TI  - National Leadership Coalition's Plan for Health Care Reform.

PMID- 8487820
TI  - National Leadership Coalition's Plan for Health Care Reform.

PMID- 8487821
TI  - Reuse of a transplanted kidney.

PMID- 8487822
TI  - The spring meetings-- are they dying?

PMID- 8487823
TI  - A controlled trial of bismuth subsalicylate in infants with acute watery
      diarrheal disease.
AB  - BACKGROUND: Bismuth subsalicylate is a common constituent of over-the-counter
      medications for diarrhea. However, it is uncertain whether bismuth offers any
      more benefit than standard oral rehydration therapy with early feeding. METHODS:
      We conducted a placebo-controlled, randomized trial to evaluate the effect of
      bismuth subsalicylate (100 or 150 mg per kilogram of body weight per day for up
      to 5 days) on the duration and volume of acute watery diarrhea in 275 male
      infants and young boys (mean age, 13.5 months). Serum salicylate and bismuth
      levels were monitored throughout the study and were also measured two weeks after
      discharge. All the patients received fluid replacement by the oral route and
      early feeding of easily digestible foods with high caloric density. RESULTS:
      Diarrhea stopped within 120 hours of admission in 74 percent of the patients
      given placebo, 89 percent of those given 100 mg of bismuth per kilogram (P =
      0.009 vs. the placebo group), and 88 percent of those given 150 mg of bismuth per
      kilogram (P = 0.019 vs. the placebo group). As compared with the patients given
      placebo, those given bismuth had significant reductions in their total stool
      output (P = 0.015), total intake of oral rehydration solution (P = 0.013), and
      duration of hospitalization (P = 0.005); there was no significant difference
      between the two groups given bismuth in these clinical outcomes. All measurements
      of bismuth and salicylate concentrations in blood were well below concentrations
      considered toxic. No adverse reactions were seen. CONCLUSIONS: Treatment with
      bismuth subsalicylate decreases the duration of diarrhea and is a safe and
      effective adjunct to oral rehydration therapy for infants and young children with
      acute watery diarrhea.

PMID- 8487824
TI  - Evidence of impaired endothelium-dependent coronary vasodilatation in patients
      with angina pectoris and normal coronary angiograms.
AB  - BACKGROUND: A group of patients has been described who have chest pain resembling
      angina and positive exercise tests, but normal coronary angiograms and no
      coronary-artery spasm. This constellation of features has sometimes been called
      syndrome X or microvascular angina. We attempted to determine whether endothelium
      dependent vasodilatation of the coronary vasculature was impaired in patients
      with this syndrome. METHODS: We infused the endothelium-dependent vasodilator
      acetylcholine and the endothelium-independent vasodilators papaverine and
      isosorbide dinitrate into the left coronary artery of 9 patients and 10 control
      subjects. The diameter of the left anterior descending coronary artery was
      assessed by quantitative angiography, and changes in coronary blood flow were
      estimated with the use of an intracoronary Doppler catheter. RESULTS:
      Acetylcholine, given in doses of 1, 3, 10, and 30 micrograms per minute,
      increased coronary blood flow in a dose-dependent manner in both groups. However,
      the mean (+/- SD) acetylcholine-induced increases in coronary blood flow were
      significantly less (P < 0.001) in the patient (8 +/- 14, 37 +/- 37, 59 +/- 67,
      and 103 +/- 77 percent, respectively) than in the controls (62 +/- 52, 186 +/-
      93, 341 +/- 128, and 345 +/- 78 percent, respectively). The changes in coronary
      blood flow in response to 2 mg of isosorbide dinitrate (236 +/- 66 percent vs.
      280 +/- 56 percent) and 10 mg of papaverine (366 +/- 168 percent vs. 411 +/- 92
      percent) did not differ significantly between the patients and controls. The
      administration of papaverine resulted in myocardial lactate production in the
      patients but not in the controls. The three lower doses of acetylcholine caused a
      similar degree of dilatation of the left anterior descending coronary artery in
      the two groups, and the highest dose caused a similar degree of constriction in
      the two groups. Isosorbide dinitrate and papaverine caused a similar degree of
      dilatation in both groups. CONCLUSIONS: These findings suggest that endothelium
      dependent dilatation of the resistance coronary arteries is defective in patients
      with anginal chest pain and normal coronary arteries, which may contribute to the
      altered regulation of myocardial perfusion in these patients.

PMID- 8487825
TI  - Association between exposure to environmental tobacco smoke and exacerbations of
      asthma in children.
AB  - BACKGROUND: Exposure to environmental tobacco smoke, as reported by parents, has
      been linked to diminished pulmonary function and more frequent exacerbations of
      asthma in children with the disease. Further insight into this association might
      be gained by using urine cotinine levels to measure actual exposure. METHODS: We
      measured urine cotinine levels in 199 children with asthma; 145 also underwent
      pulmonary-function studies. A parent answered questions about each child's
      exposure to environmental tobacco smoke. Acute exacerbations of asthma during the
      preceding year were documented through blinded review of medical records.
      Possible confounding factors were accounted for by the use of multivariate
      analysis and by comparisons of serum theophylline levels in exposed and unexposed
      children. RESULTS: The median urine cotinine levels were 5.6 ng per milliliter in
      the 116 children reported not to have been exposed to tobacco smoke, 13.1 ng per
      milliliter in the 53 children exposed to cigarette smoking by the mother or other
      persons, and 55.8 ng per milliliter in the 30 children exposed to cigarette
      smoking by the mother and other persons. Acute exacerbations of asthma increased
      with exposure, whether such exposure was reported by a parent or identified on
      the basis of the cotinine level; the relative risks for the highest as compared
      with the lowest exposure category were 1.8 (95 percent confidence interval, 1.4
      to 2.2) for reported exposure and 1.7 (95 percent confidence interval, 1.4 to
      2.1) for exposure indicated by cotinine levels. The forced expiratory volume in
      one second (FEV1), the forced expiratory flow between 25 and 75 percent of vital
      capacity, and the ratio of FEV1 to forced vital capacity also decreased with
      increases in both measures of exposure. CONCLUSIONS: Measurement of urine
      cotinine levels provides further evidence of an association between exposure to
      environmental tobacco smoke and pulmonary morbidity in children with asthma.
      These data emphasize the need for systematic, persistent efforts to stop the
      exposure of children with asthma to environmental tobacco smoke.

PMID- 8487826
TI  - Cutaneous disease and drug reactions in HIV infection.
AB  - BACKGROUND: Skin diseases, including adverse reactions to drugs, are thought to
      be more common among patients with human immunodeficiency virus (HIV) infection
      and the acquired immunodeficiency syndrome (AIDS) than among other persons. These
      skin conditions can be disabling or disfiguring and may require discontinuation
      of essential drugs. METHODS: We identified 684 HIV-infected members of a 265,000
      member health maintenance organization and reviewed their medical records to
      determine the frequency of dermatologic diagnoses from April 1, 1988, through
      January 15, 1991. We compared the rates of visits per year for skin conditions by
      HIV-infected men, 20 to 49 years of age, with those by non-HIV-infected men. We
      used an automated prescription data base to quantify exposures to drugs. RESULTS:
      Of the 684 HIV-infected patients, 540 (79 percent) were given one or more
      dermatologic diagnoses, for a total of 2281 diagnoses, including 188 cutaneous
      reactions to drugs. There were 43 hospitalizations for cellulitis (n = 15),
      cutaneous drug reactions (n = 13), or other skin problems. As compared with non
      HIV-infected men, the men with AIDS had visit rates that were at least 5 times
      higher for 18 of the 20 most common infectious and inflammatory skin conditions
      and at least 15 times higher for 9 conditions. Drugs with the highest rate of
      cutaneous reactions (per 1000 courses) included trimethoprim-sulfamethoxazole
      (149), sulfadiazine (200), trimethoprim-dapsone (156), and aminopenicillins (93).
      The number of diagnoses of skin conditions increased according to the stage of
      disease: it was lowest in patients immediately before the documentation of HIV
      infection and highest in patients with a diagnosis of AIDS. CONCLUSIONS:
      Cutaneous diseases, including drug reactions, are extremely common in patients
      with HIV infection, and their incidence increases as immune function
      deteriorates.

PMID- 8487827
TI  - Long-term complications of diabetes mellitus.

PMID- 8487828
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 23-1993. A 30-year-old man with a dry cough, dyspnea, and nodular
      pulmonary lesions.

PMID- 8487829
TI  - Can bismuth improve the simple solution for diarrhea?

PMID- 8487830
TI  - Chest pain with normal coronary angiograms.

PMID- 8487831
TI  - The hazards of passive- and active-smoking.

PMID- 8487832
TI  - Prenatal diagnosis.

PMID- 8487833
TI  - Prenatal diagnosis.

PMID- 8487834
TI  - Prenatal diagnosis.

PMID- 8487835
TI  - Prenatal diagnosis.

PMID- 8487836
TI  - Acute bacterial meningitis in adults.

PMID- 8487837
TI  - Chronic idiopathic diarrhea.

PMID- 8487838
TI  - Acute myocarditis masquerading as acute myocardial infarction.

PMID- 8487840
TI  - More on routine HIV screening.

PMID- 8487839
TI  - Protective effect or symptomatic effect of deprenyl?

PMID- 8487841
TI  - More on routine HIV screening.

PMID- 8487842
TI  - More on office-based testing for HIV.

PMID- 8487843
TI  - Management of the nursing function.

PMID- 8487845
TI  - Psychiatric nursing. Amaudo--the village of peace.

PMID- 8487844
TI  - Psychiatric nursing. The Cuba experience.

PMID- 8487846
TI  - The development of professional nursing education 1860-1988. Part IV: South
      Africa.

PMID- 8487847
TI  - Equipment-related infection risks--the fibrescope.

PMID- 8487848
TI  - NPPHC/SAHSSO National Health Policy Conference.

PMID- 8487849
TI  - Supporting the care-givers in oncology.

PMID- 8487850
TI  - Respect and reverence for life.

PMID- 8487851
TI  - AIDS and the cycle of poverty.

PMID- 8487852
TI  - US Army to use peer review in breast cancer programme.

PMID- 8487853
TI  - US companies settle EPO patent suit.

PMID- 8487855
TI  - Differential salary scales.

PMID- 8487854
TI  - Beating fraud.

PMID- 8487856
TI  - Differential salary scales.

PMID- 8487857
TI  - Stifling the media.

PMID- 8487858
TI  - How and why of vesicle formation.

PMID- 8487859
TI  - Immunology. The power of clonal selection.

PMID- 8487860
TI  - Neurobiology. Motor neurons find their factors.

PMID- 8487861
TI  - World population forecasts.

PMID- 8487862
TI  - Primate origins: plugging the gaps.
AB  - Recent discoveries of fossil primate specimens have produced several surprises
      and challenged prevailing views of early primate evolution. Plesiadapiformes,
      long regarded as 'archaic primates', may perhaps be linked to the peculiar
      colugos instead. Inferred relationships of the earliest known undoubted primates
      (adapids and omomyids) are in turmoil. Both groups have been proposed as sources
      for the simian primates. Although the origin of the simian primates is obscure,
      new fossil evidence could push it further back by at least 10 million years. Such
      uncertainties reflect the low sampling level of the primate fossil record, which
      can potentially also lead to underestimation of times of origin within the
      primate tree.

PMID- 8487863
TI  - Antisense oligodeoxynucleotides to NMDA-R1 receptor channel protect cortical
      neurons from excitotoxicity and reduce focal ischaemic infarctions.
AB  - The excitatory amino acid, L-glutamate, acting through its N-methyl-D-aspartate
      (NMDA) receptor, may contribute to neuronal death following cerebral vascular
      occlusion. In support of this hypothesis, NMDA receptor antagonists reduce the
      volume of infarction produced by occlusion of the middle cerebral artery in vivo
      and attenuate Ca2+ influx and neuronal death elicited by L-glutamate or NMDA in
      vitro. A complementary DNA coding for a major component of the NMDA receptor
      channel complex, a single protein of M(r) 105.5K (NMDA-R1), has been isolated
      from rat brain. Here we demonstrate that inhibition of the synthesis of NMDA-R1
      by treatment with antisense oligodeoxynucleotides selectively reduces the
      expression of NMDA receptors, prevents the neurotoxicity elicited by NMDA in
      vitro and reduces the volume of the focal ischaemic infarction produced by
      occlusion of the middle cerebral artery in the rat.

PMID- 8487864
TI  - Neurotrophins promote motor neuron survival and are present in embryonic limb
      bud.
AB  - Embryonic spinal motor neurons are thought to depend for survival on unidentified
      factors secreted both by their peripheral targets and by cells within the central
      nervous system. The neurotrophins are a family of polypeptides required for
      survival of discrete central and peripheral neuronal populations in vivo and in
      vitro. In spite of their ability to reduce motor neuron death in vivo, the known
      neurotrophins have been thought to be without direct effect on motor neurons.
      Here we show that picomolar concentrations of three of them, brain-derived
      neurotrophic factor, neurotrophin-3 and neurotrophin-5, can prevent the death of
      cultured embryonic rat spinal motor neurons. Furthermore, messenger RNA coding
      for neurotrophins is present at appropriate stages in spinal cord and limb bud,
      and mRNA for their receptors is found in motor neurons. These neurotrophins may
      therefore be physiological motor neuron growth factors.

PMID- 8487865
TI  - Affinity maturation leads to differential expression of multiple copies of a
      kappa light-chain transgene.
AB  - Transgenic animals containing rearranged heavy or light chains are used to study
      the process of hypermutation, which characterizes the maturation of the antibody
      response. LK6 mice contain five copies of a transgene coding for a light chain
      produced in response to the hapten 2-phenyloxazolone. We have selected hybridomas
      from secondary responses that express the transgene as the only light chain. Some
      of these hybridomas contain transgene copies carrying mutations known to improve
      antibody affinity. We have analysed the expression of the five transgene copies
      in those hybridomas. We report here that the somatic hypermutation process can
      affect the successful expression of antibody light-chain transgenes. When
      mutations that improve the antibody affinity appear in one transgene copy,
      antigenic selection favours cells that downregulate the other copies at multiple
      levels of gene expression, including examples where nonsense mutations correlate
      with a drop in messenger RNA level.

PMID- 8487866
TI  - NMR structure of a receptor-bound G-protein peptide.
AB  - Heterotrimeric GTP-binding proteins (G proteins) regulate cellular activity by
      coupling to hormone or sensory receptors. Stimulated receptors catalyse the
      release of GDP from G protein alpha-subunits and GTP bound to the empty alpha
      subunits provides signals that control effectors such as adenylyl cyclases,
      phosphodiesterases, phospholipases and ion channels. Three cytoplasmic loops of
      the activated receptor are thought to interact with three sites on the
      heterotrimeric G protein to provide high-affinity interaction and catalyse G
      protein activation. The carboxyl terminus of the alpha-subunit is particularly
      important for interaction with the receptor. Here we study the structure of part
      of the active interface between the photon receptor rhodopsin and the G protein
      transducin, or Gt, using nuclear magnetic resonance. An 11-amino-acid peptide
      from the C terminus of the alpha-subunit of Gt (alpha t (340-350)) binds to
      rhodopsin and mimics the G protein in stabilizing its active form, metarhodopsin
      II. The peptide alpha t (340-350) binds to both excited and unexcited rhodopsin
      and conformational differences between the two bound forms suggest a mechanism
      for activation of G proteins by agonist-stimulated receptors. Insight into
      receptor-catalysed GDP release will have broad application because the GTP/GDP
      exchange and the intrinsic GTPase activity of GTP-binding proteins constitute a
      widespread regulatory mechanism.

PMID- 8487867
TI  - Spruce pollen as a source of increased radiocesium concentrations in air.

PMID- 8487868
TI  - There is no mitotic nor meiotic recombination in the Drosophila Y-chromosome.

PMID- 8487869
TI  - GT dinucleotide repeat polymorphisms in a polygynous ant, Leptothorax spinosior
      and their use for measurement of relatedness.

PMID- 8487870
TI  - This could be good.

PMID- 8487871
TI  - Preceptors' perceptions of a baccalaureate preceptorial experience.
AB  - A preceptor's perception of a baccalaureate preceptorial experience has
      implications for faculty, nursing service administrators, and clinical agency
      personnel as they select nurses to serve as preceptors. This article describes a
      specific preceptorial experience and presents data collected from 137 preceptors
      who participated. Data include descriptive information about the preceptors and
      an analysis of their responses to six questions about the experience.

PMID- 8487872
TI  - Ethical and policy implications for the allocation of health care services to
      elderly persons in rural America.

PMID- 8487873
TI  - Patients', nurses', and physicians' perceptions of nurses' caring behaviors.
AB  - The purpose of this study was to identify how patients, nurses and physicians in
      a coronary care setting rank the importance of different nurse behaviors related
      to caring. The study was descriptive and used Q Methodology characterized by a
      forced choice format and priority rankings. Analysis of the mean scores for each
      subset of subjects revealed two items within the top five for all three
      subgroups. Comparison of this studies findings with previous studies showed
      similarities among patient rankings but little agreement among nurses regarding
      what constitutes caring behavior. Implications for practice, administration,
      research and education are identified.

PMID- 8487874
TI  - Nurses on hospital IRBs: a critical voice in protecting human subjects.
AB  - The nature and extent of nurses' participation on hospital institutional review
      boards (IRBs) has not previously been investigated. This descriptive study
      provides some insights into the characteristics of nurses serving on IRBs and
      describes the IRBs on which they serve. The nurses are typically master's
      prepared nurse managers who have served as volunteer or appointed members of the
      IRB for an average of 2.67 years. The IRBs have an interdisciplinary membership,
      and differ widely in structure and procedure, but generally, they conform to the
      requirements specified in the National Research Act for IRBs. The findings of
      this study have implications for nursing administration, practice, research, and
      education.

PMID- 8487875
TI  - Situational supports and job stress: a correlational study.
AB  - This correlational study provides information for creating a nursing work
      environment that supports coping with stress. Questionnaire-generated data were
      collected from registered staff nurses (N = 538) in two urban, acute care
      hospitals. Results of multiple regression analysis indicated that situational
      support variables (autonomy, control over practice, group cohesion, substantive
      exchange, manager consideration) correlated inversely with job stress. Predictor
      variables and demographics explained 37% of the variance in situational job
      stress [F(13, 442) = 19.74, P < .001] and 28% of the variance in personal job
      stress [F(13, 442) = 13.03, P < .001]. The variables may serve as situational
      supports for nurses coping with job stress.

PMID- 8487876
TI  - An unsafe or unprofessional colleague: what's a nurse to do?

PMID- 8487877
TI  - Cherry Ames and the future of nursing in children's literature.

PMID- 8487878
TI  - Synergy in nursing: partners-in-practice.
AB  - Diminished numbers of bedside care providers and support personnel for registered
      nurses have contributed to declining self-fulfillment and an exodus from the
      profession. RNs are expected to provide knowledge-based, competent care, yet they
      may not have the support staff to achieve this outcome. Nurse extender systems
      have been introduced in hope of changing this situation. One such nurse extender
      program is founded on the belief that the development of a voluntary relationship
      between the RN and a support person will result in a productive, synergistic
      partnership. The development of this relationship and the impact of the
      partnership concept as it relates to clinical application are explored here.

PMID- 8487879
TI  - [Lumbar puncture and incarceration].

PMID- 8487880
TI  - [Current therapy of acute promyelocytic leukemia using vitamin A derivatives].

PMID- 8487881
TI  - [Vitamin A derivatives: potential prevention and therapy of solid tumors].

PMID- 8487882
TI  - [Indications for lumbar puncture; shifts in diagnosis].

PMID- 8487883
TI  - [Routine urodynamic studies is not indicated in children with enuresis].
AB  - From January 1980 to January 1992, urodynamic examinations were performed in 339
      enuretic children without constipation or anatomical or neurogenic causes of
      incontinence. Nocturnal enuresis was seen in 178 patients, 130 children suffered
      from nocturnal and diurnal enuresis, and 31 had only diurnal enuresis. M.
      detrusor instability was found in 44% of the children and 73% showed more than
      15% reduction in functional bladder capacity. In 5% an infravesical obstruction
      was suspected on pressure-flowmetry and in 12% dysfunctional voiding was seen.
      Routine urodynamic studies are not indicated in children with enuresis.

PMID- 8487884
TI  - [Usefulness of a physical examination upon return from the tropics].
AB  - This study was undertaken to determine the usefulness of medical check-ups after
      return from the tropics by retrospective analysis of the data of the outpatient
      clinic for tropical medicine and imported diseases of the University Hospital of
      Nijmegen. During the years 1986-1990, 379 persons who had returned from the
      tropics and who were asymptomatic were subjected to a medical check-up (this
      group comprised 32% of the total of 1190 patients seen in the clinic during this
      period). In 230 persons (61%) no abnormality was detected. In 101 persons (27%)
      one or more diagnoses were made which were related to their stay in the tropics.
      For three-quarters of them treatment was indicated (77 patients). In the
      remaining 48 persons (13%) diagnoses were made which were neither related to the
      tropics nor required treatment (e.g. mild varices or minor kyphoscoliosis). Such
      diagnoses did not contribute to the usefulness of a medical check-up. In 200
      persons a chest X-ray was made, either because they had stayed in the tropics for
      more than 3 years, or had had close contacts with the local population or because
      abnormalities were suspected on the basis of history or physical examination.
      While four X-rays revealed significant pathology, in only one of these did the
      patient benefit from its detection (early pulmonary tuberculosis). We conclude
      from our study that a medical check-up after return from the tropics is
      justifiable. The duration of the stay in the tropics by itself is no indication
      for a chest X-ray.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487885
TI  - [Prognostic significance of the histological classification and staging for
      patients with a malignant non-Hodgkin lymphoma].
AB  - OBJECTIVE: To assess the prognostic significance of histological classification,
      grade and stage with regard to overall survival in patients with non-Hodgkin's
      lymphoma (NHL). DESIGN: Retrospective analysis. SETTING: University Hospital St
      Radboud, Nijmegen. METHOD: All consecutive 346 patients with NHL diagnosed in the
      period January 1978-December 1990 were included in this one-centre study.
      Recorded data included histological type according to the Kiel classification,
      histological grading according to the International Working Formulation (IWF),
      Ann Arbor stage, age, sex, tumour mass, number of extranodal sites, serum LDH and
      ESR. Grading according to the IWF was assessed retrospectively for those patients
      whose primary disease had been diagnosed before 1982. The observation period
      ended September 1st, 1991. Overall survival was calculated according to Kaplan
      Meier. The significance of the prognostic parameters was studied using both
      univariate and multivariate stepwise regression analysis. RESULTS: There were 209
      men and 137 women with a median age of 56 years (range 15-85). No initial
      treatment was given to 8% of the patients. After a median follow-up of 52 months,
      179 patients (52%) had died; the calculated median survival time was 49 months.
      Patients with low-grade NHL had a significantly better short-term prognosis than
      the remaining patients. Related to clinical stage, only patients with stage I
      disease had distinctly longer survival times than those with more advanced
      disease. Multivariate analysis revealed serum LDH, age, stage and histological
      classification to be the most important independent prognostic variables.
      CONCLUSION: Even in multivariate analysis, histological classification and Ann
      Arbor stage have prognostic significance with regard to overall survival in
      patients with NHL. However, serum LDH levels proved to be the most important
      prognostic parameter.

PMID- 8487886
TI  - [Primary treatment of acute promyelocytic leukemia using all-trans-retinoic
      acid].
AB  - We describe the medical history of a 68-year-old woman with acute promyelocytic
      leukaemia. As primary treatment she received all-trans retinoic acid. For the
      major part this treatment could be given on an outpatient basis. After 60 days
      there was a complete remission of the leukaemia with disappearance of the
      characteristic cytogenetic abnormality t(15;17)(q22;q21).

PMID- 8487887
TI  - [Eye injuries in 'paintball'; a modern 'war injury'].
AB  - Paintball shooting is played with increasing frequency in the Netherlands. A
      bullet, filled with paint, shot at 60 m/sec can cause serious damage to the eye.
      All five patients seen in two years showed a hyphaema. Four out of five patients
      showed damage of the posterior pole, including vitreous haemorrhage, choroidal
      rupture, retinal detachment, and sub- or intraretinal haemorrhage. Three out of
      five patients incurred permanent visual loss, varying from 3/60 to 25/100.
      Adequate instruction of the participants in the game and proper use of the eye
      protector will be of help in preventing eye injuries.

PMID- 8487888
TI  - [Financing of health research. The National Rheuma Foundation].

PMID- 8487889
TI  - [Pregnant and in specialist education].

PMID- 8487890
TI  - [Favorable effect of hematopoietic stem cells isolated from blood on hematologic
      recovery following high-dose chemotherapy].

PMID- 8487891
TI  - [The dynamic hip screw in medial femoral neck fractures: results in 51 patients].

PMID- 8487892
TI  - [The dynamic hip screw in medial femoral neck fractures: results in 51 patients].

PMID- 8487893
TI  - [The dynamic hip screw in medial femoral neck fractures: results in 51 patients].

PMID- 8487894
TI  - [The dynamic hip screw in medial femoral neck fractures: results in 51 patients].

PMID- 8487895
TI  - [Oral rehydration therapy].

PMID- 8487896
TI  - [Controversies in preventive health care. IV. Primary health care].

PMID- 8487897
TI  - [A patient's complaints due to inadequacies in communication].

PMID- 8487898
TI  - [Prevention of vitamin D deficiency in adults; at what age should it start and
      with what dosage?].

PMID- 8487899
TI  - [Late intestinal radiation injuries; diagnosis and treatment].

PMID- 8487900
TI  - [Good results of 100% oxygen treatment for acute carbon monoxide poisoning;
      temporarily no indication for hyperbaric oxygenation].
AB  - OBJECTIVE: To describe the complications in patients with acute carbon monoxide
      intoxication, if treated with 100% instead of hyperbaric oxygen. DESIGN:
      Retrospective chart review. PATIENTS: Thirty-three patients with acute-carbon
      monoxide intoxication admitted to the medical Intensive Care Unit of Leiden
      University Hospital. RESULTS: The mean carbon monoxide level of all patients was
      29.4%. Ten patients had a carbon monoxide level above 40%. Seven patients (21%)
      were in coma on admission. Most complications occurred in the latter group. All
      patients were treated with normobaric 100% oxygen. Recovery was usually rapid. No
      patient showed neurological deficits at discharge. CONCLUSION: The short-term
      prognosis of patients with acute carbon monoxide intoxication is good, even if
      they are not treated with hyperbaric oxygen. There is still inconclusive evidence
      from the literature that hyperbaric oxygen improves the prognosis in these
      patients.

PMID- 8487901
TI  - [The significance of endometrial cells in the cervical smear].
AB  - Presence of atypical endometrial cells in a cervical smear is quite unusual; but
      if they are found the woman needs extra attention because of the risk of
      adenocarcinoma of the uterus. Postmenopausal women sometimes also have
      endometrial cells without atypia in the cervical smear, as a sign of endometrial
      pathology. We conducted a retrospective follow-up study of these women. From 1978
      to 1989, 52 smears from a total of about 50,000 postmenopausal women were
      classified as Pap IIIA, due to the presence of normal endometrial cells.
      Histological follow-up was performed in 25 cases and 3 times an adenocarcinoma of
      the endometrium was diagnosed (6%). The smears from 142 women (pre- and
      postmenopausal) contained atypical endometrial cells and therefore were
      classified as Pap IIIA or higher. Histological follow-up was performed in 104
      cases. In 48% (n = 68) an adenocarcinoma was diagnosed. In 75% of these cases (n
      = 51) the atypical cells were graded as severe or worse (> or = Pap IIIB).
      Cervical smears are not taken to detect pathology of the endometrium, but
      whenever atypical cells are found in the smear there is a strong indication for
      further (gynaecological) examination.

PMID- 8487902
TI  - [Parametrial coitus].
AB  - We saw an 18-year-old female patient with a practically imperforated and
      thickened hymen who, during an attempt at intercourse, suffered traumatic
      penetration in the right parametrium, parallel to the vagina. The hymen was
      opened further. The girl recovered completely.

PMID- 8487903
TI  - [Are extensions of the Dutch vaccination program to be expected?].

PMID- 8487904
TI  - [Hemodilution to measure in acute brain infarct using a 20% albumin solution and
      physiological saline].

PMID- 8487905
TI  - [Continuation or discontinuation of life-support measures in newborn infants].

PMID- 8487906
TI  - [Continuation or discontinuation of life support measures in newborn infants].

PMID- 8487907
TI  - [Where are laboratory studies in clinical-pharmaceutical research conducted?
      Medical-ethical considerations].

PMID- 8487908
TI  - [Vasectomy and prostate cancer; education and practical advice].

PMID- 8487909
TI  - [A patient with hypocalcemia: an experiment of nature and culture].

PMID- 8487910
TI  - "Doctors unchecked"--the apology of a physician.

PMID- 8487911
TI  - "Parvovirus B-19 infection in pregnancy: two case reports and discussion".

PMID- 8487912
TI  - Open tibia fractures.
AB  - Open tibia fractures can be very challenging fractures to care for. Good results
      should be expected, however, if a thorough irrigation and debridement is
      performed, repeated as necessary, and appropriate antibiotics utilized. Soft
      tissue coverage is extremely important in open tibia fractures to decrease the
      rate of infection and to facilitate fracture healing. Bony stabilization can be
      achieved in a variety of ways. In the past, the gold standard has been external
      fixation. In the future, however, small, unreamed, locked intramedullary nails
      may be utilized more frequently, especially with Types I, II and IIIA open tibia
      fractures.

PMID- 8487913
TI  - Necrotizing enterocolitis.
AB  - In summary, NEC is the most common gastrointestinal emergency in the newborn.
      Premature infants are the most likely affected. Although progress has been made
      in elucidating some of the factors responsible for NEC, the exact etiology is
      still unclear. Aggressive medical management is required, but indications for
      surgical intervention differ from institution to institution. Overall mortality
      remains about 20% to 40%. About one half of survivors seem to have no sequelae,
      but the remaining infants may have significant ones which require additional
      surgical intervention or produce life long problems. Efforts at prevention have
      not been very successful. The single most important prophylactic measure would be
      to prevent prematurity. Until the exact pathogenesis of NEC is better understood,
      effective preventive measures are unlikely to be developed.

PMID- 8487914
TI  - BDNF and trkB mRNA expression in the hippocampal formation of aging rats.
AB  - Quantitative in situ hybridization and northern blot analysis techniques were
      used to determine the topographical distribution and levels of mRNA coding for
      brain-derived neurotrophic factor (BDNF) and the tyrosine receptor kinase (trkB)
      mRNA in the hippocampal formation of two strains of male rat during aging. Age
      did not change the prevalence or regional distribution patterns of BDNF or trkB
      mRNA in the hippocampal formation throughout the lifespan of male Sprague-Dawley
      rats. There also were no significant differences in the prevalence or
      topographical distribution patterns of trkB mRNA transcripts during aging.
      Northern blot analysis of hippocampal RNA from male Fischer 344 confirmed that
      neither BDNF mRNA nor trkB mRNA levels changed with age. These findings suggest
      that age-related neurodegenerative changes, including the atrophy of the
      cholinergic septo-hippocampal pathway, are not the result of changes in
      hippocampal BDNF or trkB mRNA expression. Moreover, the prevalence and
      distribution of synaptosomal-associated protein 25 (SNAP-25), a neuron-specific
      protein located in synaptic terminals and a putative marker of synaptic
      integrity, did not change with age. These findings indicate that altered
      hippocampal synaptic plasticity which occurs in the aged rat brain is not a
      reflection of changes in the expression of BDNF or trkB receptor mRNA.

PMID- 8487915
TI  - Response properties in young and old Fischer-344 rat lateral superior olive
      neurons: a quantitative approach.
AB  - Significant age-related functional deficits may result from a selective loss of
      inhibitory processing in the lateral superior olivary (LSO) nucleus. To test this
      hypothesis, methods were developed for quantitative comparisons of the excitation
      evoked by ipsilateral acoustic stimuli and the inhibition evoked by contralateral
      acoustic stimuli in neurons recorded from this binaural structure. Data were
      obtained from 103 LSO neurons from 22 young adult (3-6 month) and 70 LSO neurons
      from 14 old (20-23 month) Fischer-344 (F-344) rats. Age-related increases in the
      thresholds of auditory brainstem responses as well as in the inhibitory and
      excitatory responses of LSO neurons were observed. Spike-discharge rates were
      analyzed using multiple regression analysis for interaural intensity data and by
      calculating correlation coefficients between excitatory and inhibitory
      isointensity curves. Most LSO principal cells exhibited ipsilateral excitation
      and contralateral inhibition of similar strength for similar stimuli. Inhibitory
      and excitatory response areas of these neurons were similar based on visual
      inspection and correlation coefficients. No statistically significant age-related
      changes were observed for (a) rate-level functions generated by ipsilateral or
      contralateral stimuli; (b) maximal discharge rate; (c) conduction latencies; or
      (d) measures of binaural function. However, a small percentage of LSO neurons
      both in young and old rats displayed "unmatched" inhibitory and excitatory
      response areas. Quantitative methods developed in this study are used to examine
      age-related changes in binaural function in the inferior colliculus of F-344 rats
      and in the LSO of the Sprague-Dawley rat. Although no asymmetrical aging changes
      were observed for the F-344 rat LSO, there appear to be significant differences
      between the aging auditory system in the F-344 and Sprague-Dawley rats. Age
      related changes have been previously described for the F-344 in other brainstem
      auditory structures.

PMID- 8487916
TI  - Regional spectral analysis of the REM sleep EEG in mild to moderate Alzheimer's
      disease.
AB  - Regional spectral analyses of the EEG during wakefulness and REM sleep was
      performed in eight patients with mild to moderate Alzheimer's disease and
      compared to that of healthy age-matched controls. Alzheimer patients presented
      some EEG slowing in frontal, parieto-occipital and temporal regions in the waking
      state. However, this EEG slowing was much better revealed in REM sleep, whether
      expressed by the ratio of slow to fast frequencies or by changes in each of the
      frequency bands. Moreover, regional differences in EEG slowing, relatively
      nonexistent in the awake EEG, were a prominent feature of the REM sleep EEG.
      Importance of cholinergic basal forebrain in the desynchronization of the REM
      sleep EEG might explain these results because this structure is affected in early
      Alzheimer's disease.

PMID- 8487917
TI  - Continuous ICV infusion of scopolamine impairs sustained attention of rhesus
      monkeys.
AB  - Systemic administration of anticholinergic agents impairs cognitive performance
      in animals and man. The anticholinergic, scopolamine, has profound effects on
      peripheral and central cholinergic function, making interpretation of its effects
      on cognitive performance difficult. To circumvent this problem, scopolamine was
      administered directly to the central nervous system of rhesus monkeys using a
      subcutaneously implanted infusion pump connected to a cannulae directed toward
      the right lateral ventricle. Intracerebroventricular (ICV) infusion of
      scopolamine (0.004, 0.012, 12.5, and 40.0 micrograms/kg/h) produced a dose
      dependent decrease in the number of responses on a continuous performance task.
      Response decrements produced by scopolamine were seen mainly during the last half
      of the test session and at short stimulus durations. These data suggest that
      scopolamine produces a deficit in sustained attention or slowing of information
      processing that is mediated through direct central cholinergic blockade in the
      rhesus monkey.

PMID- 8487918
TI  - Age-related changes in footshock avoidance acquisition and retention in
      senescence accelerated mouse (SAM).
AB  - An inbred strain has been developed which exhibits some characteristics of aging
      in mice as young 6 months of age. The strain was designated "Senescence
      Accelerated Mouse" (SAM). A subline of the SAM strain, P/8, has an early onset of
      impaired learning in appetitive and aversive training tasks. Simple aversive and
      appetitive tasks were learned normally up to 12 months of age, whereas more
      difficult tasks detected impairment as early as 6 months of age while the mice
      still had good general health. Comparable impairment of learning and memory in
      C57BL/6Nnia mice was not detected until about 24 months of age which is near the
      end of the strain's lifespan when general health declines. In the present study,
      we report age-dependent impairment of acquisition and retention for footshock
      avoidance conditioning. Long-term (1 week) but not short-term (1 h) retention was
      adversely effected by aging. In 12-month-old P/8 mice, practicing the avoidance
      response (overtraining) did not alleviate the impairment of long-term memory
      processing.

PMID- 8487919
TI  - Age-related changes in the pharmacological improvement of retention in senescence
      accelerated mouse (SAM).
AB  - The P/8 line of the senescence accelerated mouse (SAM) model exhibits
      characteristics of aging early in its lifespan including an early onset of
      impaired learning and memory which becomes progressively worse with age. Age
      matched controls of the R/1 line do not show impaired learning and memory. We
      report age-related changes in the drug dosage needed to improve 1 week retention
      in the P/8 but not R/1 line. The results indicate that 8-month-old P/8 mice show
      a reduced sensitivity to memory enhancing doses of cholinomimetics and an
      increased sensitivity to a serotonin antagonist compared to 4-month-old mice. By
      12 months of age, improvement of retention required still higher doses of
      cholinomimetics and even lower doses of the serotonin antagonist. Higher doses of
      an opioid antagonist and a dopamine agonist were needed to improve retention in
      12-month-old mice. A GABA antagonist and an alpha noradrenergic agonist improved
      retention at the same dose in mice 4, 8, and 12 months of age.

PMID- 8487920
TI  - Geometric response to nerve growth factor is preserved in aged rat sensory
      neurons: a single-neuron culture study.
AB  - We previously established a single-neuron culture system to analyze the primary
      effects of neurotrophic factors and reported that NGF promoted neurite extension
      in young adult (4- to 6-month-old) rat dorsal root ganglion (DRG) neurons by
      promoting neurite arborization. In this study, we demonstrated that the effects
      of NGF on neurite regeneration in DRG neurons was well preserved in aged rats (20
      to 24-month-old and 33-month-old). NGF did not increase the percent process
      bearing neurons in aged rats, which indicated that neuronal survival was not
      promoted by NGF, but it significantly enhanced the number of branching points,
      total neurite length, and soma size in aged neurons. These effects of NGF on
      neurite geometry tended to be reduced to some extent in aged neurons and the
      initiation of neurite-outgrowth in aged neurons was also delayed as compared with
      young adult neurons. NGF-responsive subpopulation of neurons, found in the entire
      range of neuronal size, were preserved in aged rats. These findings indicate that
      NGF could play an important role in regeneration of injured DRG neurons of aged
      animals.

PMID- 8487921
TI  - Beta A4 deposits are constant in the brain of the oldest old: an
      immunocytochemical study of 20 French centenarians.
AB  - beta A4 deposits occur in the brain of some individuals over 50 years of age. It
      could be a part of the aging process or indicate a disease found frequently in
      the elderly. To address this question, beta A4 immunocytochemistry was performed
      on the brain of 15 nondemented and 5 demented centenarians, some of whom were
      affected by Alzheimer's disease. We found beta A4 deposits in the parahippocampal
      and the superior temporal gyri of all the cases, whatever the clinical state. The
      hippocampus was frequently spared. The lesion density was not correlated with the
      severity of the mental deterioration. The constant deposition of beta A4 protein
      in the brain of very old people indicates that this process does not spare a
      large proportion of this population. This result favors beta A4 accumulation in
      the brain being an ineluctable age-related process.

PMID- 8487922
TI  - [Measurement of cerebral blood flow by stable xenon-enhanced computed tomography
      (series 3)].

PMID- 8487923
TI  - [Continuous intracarotid infusion of mannitol in severe head injury].
AB  - The clinical significance of continuous intracarotid infusion of a small dose of
      mannitol (ICI of mannitol) was discussed. Eighteen patients suffering from severe
      head injury with Glasgow coma scale (GCS) less than 6 were treated by ICI of
      mannitol for the improvement of raised intracranial pressure (ICP). In all of
      these 18 cases, conventional venous administration of mannitol could not be
      carried out, because of the unstable vital signs due to hypovolemic shock such as
      multiple trauma or disturbance of serum sodium and potassium levels. This method
      requires that a 20% mannitol solution be directly and continuously administered
      to the bilateral common carotid artery. The ICP 6 hours after the beginning of
      ICI of mannitol was significantly lower than the ICP just before the treatment.
      The total amount of excretion of the sodium and potassium through the urine every
      hour decreased significantly after this method was used. It was also noticed that
      this method was very suitable for stabilizing the vital signs in cases which had
      unstable vital signs such as hypovolemic shock. These findings suggested that ICI
      of mannitol has an advantage over the conventional venous administration of
      mannitol in cases which had to have correction of serum electrolyte or which had
      unstable vital signs.

PMID- 8487924
TI  - [Clinical assessment of meningeal carcinomatosis; from the viewpoint of the
      analysis of intracranial pressure].
AB  - Meningeal carcinomatoses (MC) have been mainly studied from the viewpoint of the
      analysis of intracranial pressure (ICP). From the CT findings, ten patients were
      divided into two groups: group I, six patients showed characteristics of MC;
      group II, four showed normal characteristics. Ventricular fluid pressure (VFP)
      was continuously measured by a controlled ventricular drainage tube using a
      Spectramed P-10EZ at 3.1 +/- 2.1 months after the onset of the neurological
      symptoms. At the same time as VFP monitoring, the CBF by 133Xe method was
      measured in 5 cases and RI cisternography was performed in 9 cases. "A" wave was
      observed in 5 cases of group I and in 3 cases of group II. "B" wave was observed
      in all cases of both groups. In all 10 cases, the occurrence rate of both A and B
      waves (ORA, ORB) were high, averaging 2.34 +/- 0.54 times/hour, 74.0 +/- 16.6%
      time, respectively. Mean resting pressure(R) and mean peak pressure(P) tended to
      be high, averaging 28.8 +/- 12.2mmHg, 58.9 +/- 13.7mmHg, respectively. Mean
      cerebral perfusion pressure corresponding with R and P (CPPR, CPPP) was markedly
      reduced, averaging 79.1 +/- 15.9mmHg, 50.9 +/- 12.7mmHg, respectively. Both ORA
      and ORB in group I were higher, and both CPPR and CPPP in group 1 were lower,
      than in group II. Statistically, this is significant. Both R and P in Group I
      tended to be higher than in group II. This has no statistical significance. CBF
      in all 5 cases averaged 34.8 +/- 8.4ml/100g/min. No significant difference in the
      impairment of CBF was found between both groups. RI cisternography showed delayed
      clearance in all 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487925
TI  - [Vasospasm and its outcome after early surgery for ruptured cerebral aneurysms:
      relationship with the clinical grade based on the Glasgow Coma Scale].
AB  - Over a 9 year period, 270 patients who had early aneurysm surgery within 7 days
      after subarachnoid hemorrhage were analyzed regarding occurrence of vasospasm
      (VS) and its outcome. Occurrence of VS was recognized by ischemic neurological
      deterioration, with or without CT evidence of infarcts. Surgical outcome was
      assessed by the Glasgow Outcome Scale 6 months postoperatively. The results were
      correlated with age, aneurysm site, day of surgery, and preoperative clinical
      grade evaluated by the Glasgow Coma Scale (GCS). Thirty patients with the GCS sum
      score of less than 6 were excluded from the analysis of VS. Eighty two patients
      (34%) developed VS, of which 36 patients (15%) showed ischemic symptoms only, and
      46 (19%) had infarct on CT. The incidence of symptomatic VS was 12% in GCS 15
      group (117 patients), 23% in GCS 14-13 group (70 patients), and 11% in GCS 12-7
      group (53 patients). That of VS with infarct was 14%, 23%, and 26% in GCS 15, GCS
      14-13, and GCS 12-7 groups, respectively. Thus, there was a close correlation
      between the clinical grade based on the GCS and the incidence of VS, especially
      with infarct. The grade was also useful in predicting the surgical outcome. VS
      was more common in the older age group. The site of aneurysm or the day of
      surgery had no apparent influences on the incidence of VS or its outcome.
      Overall, the incidence of poor outcome due to VS proved to be 12%, which
      accounted for one-third of the cases in which there was poor outcome due to
      various causes.

PMID- 8487926
TI  - [The evaluation of tumor blood flow measured by single photon emission CT].
AB  - The blood flow was measured in brain tumors (tumor blood flow: TBF). A total of
      83 patients were studied. These included cases of 29 gliomas, 25 meningiomas, 10
      metastatic brain tumors and others. Measurements of TBF were performed using the
      133Xe gas inhalation technique, the N-isopropyl-p-[123I] iodoamphetamine
      intravenous injection method, and SPECT. The results showed that TBF was
      variable, and was higher in meningioma. There was a significant correlation
      between TBF and the number of vessels in the operative specimen. Higher TBF
      tumors had a tendency to bleed profusely during operation. IMP E1 images were
      closely similar to Xe-SPECT images in TBF value. In cases with glioma, moderate
      correlation was noted between Xe-SPECT and IMP E2 image. A discrepancy in TBF
      values between IMP E2 image and Xe-SPECT image was observed. There was low
      activity on IMP E2 image and high TBF value in Xe-SPECT image. This was true
      especially in cases with angioblastic meningioma. In conclusion, TBF was
      considered to be helpful not only for preoperative diagnosis, but also for
      estimation of bleeding from tumors during operation and treatment.

PMID- 8487927
TI  - [How to preserve the facial nerve in acoustic neurinoma excision: development of
      a microneurostimulator].
AB  - We developed a Micro-neurostimulator that is suitable for intracranial electrical
      stimulation of the facial nerve in excision of acoustic neurinomas. The tips of
      our Micro-neurostimulator were thinner and finer than those of commercially
      available bipolar forceps and therefore it was possible to stimulate tumor tissue
      and the facial nerve selectively. This facilitated precise excision of tumor
      tissue from the facial nerve without residual tumor tissue around it. It was
      emphasized that the shape of the tips of stimulating electrodes and the stimulus
      intensity were the most important factors in obtaining reliable responses in
      preserving the facial nerve using intracranial electrical stimulation and evoked
      electromyographic responses.

PMID- 8487928
TI  - [Experimental study of acute spinal cord injury: a study of spinal blood flow].
AB  - It is well known that the worsening of neurological findings after spinal cord
      injury is due to the secondary progression of pathological changes which may be
      caused by spinal cord blood flow disturbance. We measured spinal blood flow of
      5mm rostrally and caudally distant portions from the injured point, using the
      laser Doppler flowmeter experimentally. Forty rats were used. Ten of these were
      used as a control group. And thirty animals were injured at the level of the
      tenth thoracic cord with a 50g epidural one minute compression method and
      measured continuously from 30 minutes before the injury to 6 hours after the
      injury. Twenty two surviving animals were evaluated. In the control group, spinal
      blood flow was stable. But in the injured group, spinal blood flow dropped by
      30.6 + 9.8% on the rostral side and 37.3 + 17.6% on the caudal side in comparison
      with the resting value soon after the injury. Although the flow improved to 89.3
      + 11.1 and 71.3 + 17.8% respectively 15 minutes later, it dropped again gradually
      and reached 42.8 + 14.1 and 66.2 + 16.4% respectively 6 hours after the injury
      had been inflicted. Lastly, in the animals, carbon perfusion was performed
      through the left ventricle. The normal figured vasculature in the preparation of
      the injured and measured portion was calculated with a microcomputer imaging
      analyzer and compared with control groups. The number of the normal vessels was
      significantly more abundant on the caudal side than on the rostral side (p <
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487929
TI  - [Percutaneous transluminal angioplasty for cervical internal carotid artery
      stenosis: case report].
AB  - We encountered one case of right cervical internal carotid artery (ICA) stenosis
      with ulcerative plaque. The patient was treated using percutaneous transluminal
      angioplasty (PTA). A 70 year-old man complained of left motor weakness and left
      hemidysesthesia. CT scan on the day of admission showed no abnormal findings.
      Angiographical findings revealed a severe right ICA stenosis with ulcerative
      plaque. We first treated the patient conservatively because of high-positioned
      carotid bifurcation, bronchial asthma and hypertension. 20 hours after the
      stroke, left motor weakness gradually worsened and CT scan revealed multiple low
      density areas in the right fronto-parieto-occipital watershed region. Because of
      this, we treated the stenosed ICA by PTCA balloon dilatation catheter, and
      successfully obtained adequate dilatation with no complications. We propose that
      PTA of ICA stenosis, as well as PTA of the vertebral region, is a useful method
      for patients who have conditions which would make surgical operations risky.

PMID- 8487930
TI  - [Dumbbell cervical neurinomas with subcutaneous extension: report of two cases].
AB  - Two cases of dumbbell cervical neurinomas with massive subcutaneous extension
      were reported. The first case was A 30-year-old woman who was admitted to our
      hospital because she had been aware of a left lateral cervical subcutaneous mass
      and was suffering from shoulder dullness. On admission, neurological examination
      revealed hypesthesia to touch and pain in the segmental area of C4, and
      hyperreflexia in the left biceps and patellar tendon reflexes. Plain X-ray showed
      enlargement of the left C3/4 intervertebral foramen. CT scan, post-myelogram CT
      and MRI demonstrated a dumbbell shaped tumor at the level of C3-4. Angiogram
      showed an anterior shift of the left vertebral artery (VA) and tumor stain.
      Temporary occlusion of the left VA by a balloon catheter was performed leaving no
      neurological deficits. The second case was a 36-year-old woman who had been aware
      of a left lateral cervical subcutaneous mass. She complained of shoulder pain and
      finger clumsiness. On admission, neurological examination revealed weakness of
      the left deltoid muscle, hypesthesia in the segmental area of C3-4 and
      exaggeration of all deep tendon reflexes in the left-side extremities. Plain X
      ray showed enlargement of the C2/3, C3/4 and C4/5 intervertebral foramina. CT
      scan, post myelogram CT and MRI demonstrated a dumbbell shaped tumor at the level
      of C2-5. Angiogram showed an anteromedial shift of the left VA and tumor stain.
      Temporary occlusion test of the left VA by a balloon catheter was performed with
      negative results. In each case two-stage operations were undertaken with
      excellent results.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487931
TI  - [Surgical excision of a huge olfactory groove meningioma by extensive
      transfrontal approach].
AB  - A case with a huge olfactory groove meningioma was cured surgically by extensive
      transfrontal approach. A 46-year-old female was admitted with complains of left
      visual disturbance. CT revealed a large high-density mass in the base of the
      frontal fossa which was enhanced homogenously. Hyperostosis was seen in the
      planum sphenoidale. MRI showed a relatively low intensity with a peritumoral low
      intensity rim on T1WI and high intensity on T2WI. The brain stem had shifted
      dorsally. Rich feeding to the lesion from the ethmoidal artery was seen on
      angiography. An operation was performed using an extensive transfrontal approach.
      After bifrontal craniotomy, orbitofrontal osteotomy was performed. This approach
      enabled us to minimize frontal lobe retraction, to interrupt the blood supply to
      the tumor early, and to remove the tumor completely from the frontal base and to
      present invasion of the sinuses. The postoperative course was uneventful without
      cosmetic problems.

PMID- 8487932
TI  - [A case of cortical deafness with bilateral putaminal hemorrhage].
AB  - A 56 years old right-handed female, a housewife, had suffered from right
      putaminal hemorrhage which had been treated surgically in July, 1985. Since it
      was difficult to approach the trans-sylvian fissure, evacuation of the hematoma
      was performed transcortically through the superior temporal gyrus. She was
      neurologically free and lived normally until she suddenly became completely deaf
      in April, 1991. On admission, she was alert, well oriented and spontaneously
      stated that she was deaf. She showed no response to verbal commands or loud
      noises but followed complex written commands. No other neurological deficit was
      observed. In addition to an irregular low-density area in the right temporal
      lobe, CT scan revealed a left putaminal hemorrhage. Audiological testing
      disclosed pure tone thresholds to be below 90db on both sides. Auditory brain
      stem response (ABR) showed waves I to VI in normal latency ranges, but wave VII
      was not observed. She was treated conservatively. Although her hearing loss had
      been gradually improving for 1 month, she suffered from word deafness, an
      inability to comprehend speech, for the following 2 months. Clinical features, CT
      findings as well as results of ABR suggest that hearing loss observed in this
      case, cortical deafness, was presumably due to bilateral damage of acoustic
      radiation of the temporal lobe. It was also suggested that, although she was
      asymptomatic, cortical and subcortical damage to the right temporal lobe
      following evacuation of the putaminal hematoma may have been extensive. During
      surgical procedures for evacuation of the putaminal hematoma, it has to be always
      kept in mind not to damage the auditory cortex and its radiations.

PMID- 8487933
TI  - The heightened sensitivity of hypophyseal cells of neonatal rats to
      corticosteroids.

PMID- 8487934
TI  - The morphofunctional state of the supraopticoneurohypophyseal system of rats in
      hypoparathyroidism.

PMID- 8487935
TI  - Structural changes of the human embryonal cortex during explantation.

PMID- 8487936
TI  - The serotoninergic innervation of the area postrema.

PMID- 8487937
TI  - The projections of the amygdaloid body and the dopaminergic mesencephalic
      formations to the dorsal and ventral pallidum of the cat brain.

PMID- 8487938
TI  - An hypothesis regarding the cortical mechanisms of operative memory.
AB  - Investigations of the neuronal activity of the cerebral cortex of monkeys during
      the performance of a delayed spatial choice made it possible to formulate an
      hypothesis regarding the neuronal systems providing for operative memory. One
      system functions on the principle of relay race-reverberation transmission of
      information. During the action of a sensory signal a population of spatially
      selective "sensory" neurons is excited. By the delay period (operative memory)
      this information is transmitted to a population of "memory" neurons. The delay
      period is quantized in time segments in the course of which individual
      populations of cells are involved in relays in the reverberation activity. Each
      of these populations comprises a "neuronal trap" in which the excitation
      circulates for 1.5-2 sec. At the end of the delay period switching of the
      excitation to a different population of cells takes place, which are associated
      with the preparation of a goal-directed movement (the "neurons of the motor
      programs"). Another system of neurons assures the reliability of the transitional
      phases of the above-named processes, specifically: 1) of the switchings of
      information from the "sensory" neurons to the "memory" neurons and subsequently
      to the neurons of the "motor programs"; 2) the reflection of the entire period of
      operative memory without relay race-reverberation; and 3) the preservation of the
      signal information in the activity of a unified neuronal population right up to
      the moment of the performance of the goal-directed movement. The above-designated
      systems are represented variously in the associative (frontal and parietal) zones
      of the neocortex.

PMID- 8487939
TI  - The participation of cortical areas of the brain in processes of the perception
      and reproduction of emotional states of man.
AB  - The participation of the cortical zones of the brain in the processes of the
      perception and reproduction of the emotional states of man was investigated by
      means of a new method of mapping intracortical interaction. During the
      recognition of emotions the focus of activity was in the left temporal area of
      the cortex. If the emotions were not recognized, a focus of activity was not
      observed in the temporal area of the cortex, but was found in the frontal
      divisions of both hemispheres. Foci of activity were observed primarily in the
      frontal areas of the cortex during the mental reproduction of emotional states.

PMID- 8487940
TI  - A computer analysis of EEG-intersignal reactions during the development of
      motoric alimentary conditioned reflexes in dogs.
AB  - The background electrical activity of the neocortex in the interstimulus periods
      at the stage of generalization during the development of alimentary motor
      conditioned reflexes (CR) in dogs was the investigational object. It was
      characterized by the appearance of brief (0.1-0.3 sec) trains of high frequencies
      (HF), significantly exceeding the adjacent initial baseline in frequency and
      amplitude. The relative variance index which we had developed made it possible to
      distinguish this EEG phenomenon in the initial realizations of the background
      activity when they were inputted into a digital computer. It was not possible to
      evaluate the parameters of the HF chains by means of a spectral correlation
      analysis. Nonstandard techniques of computer analysis directed toward the
      decomposition of the EEG tracing into a system of oscillations and toward the
      obtaining of the corresponding amplitude-frequency distributions (maps) were
      developed by us for the purpose of accomplishing this objective. It was
      demonstrated that HF trains were localized in these maps in specific, quite
      compact regions.

PMID- 8487941
TI  - The influence of high-frequency stimulation of the midbrain reticular formation
      on the interaction of neurons of the neocortex.
AB  - The influence of the stimulation of the midbrain reticular formation (NRT) at a
      frequency of 75-100 Hz, current strength 33-400 microA, on the interaction of
      neurons of the visual and sensorimotor areas of the neocortex of rabbits was
      investigated. Cross- and autocorrelation histograms of the impulse sequences were
      plotted. Stimulation of the NRT led to an increase in the number of pairs of
      neurons functioning in correlation and an increase in the probability of
      discharges of neurons one after the other with delays from 100 to 400 msec as
      compared with resting wakefulness. The mechanisms of the interaction of the cells
      were not altered in the process. Comparison with previously obtained data made it
      possible to conclude that activation of the NRT may lead to specific changes in
      the interaction of neurons which are observable during pseudoconditioning and at
      the beginning of the development of a conditioned reflex.

PMID- 8487942
TI  - The intercentral relationships of rabbit brain biopotentials during the creation
      of a blink dominant.
AB  - The intercentral relationships of the biopotentials of the sensorimotor area of
      the cerebral cortex, the ventroposteromedial nucleus of the thalamus, and the
      motor nucleus of the oculomotor nerve during the formation of a blink dominant,
      created by means of serial stimulation of one eye by an airstream, were
      investigated in chronic experiments on rabbits by the spectral correlation
      analysis method. An increase in the power of the spectrum and an increase in the
      COH of the potentials of the delta range were identified in structures associated
      with the function of the blinking of the stimulated eye. Analogous
      reorganizations of biopotentials were identified in a dominant focus arising by
      induction of the symmetrical center of the other eye.

PMID- 8487943
TI  - Cholinosensitivity as an indicator of functional differences of neurons of the
      cortex of young and old rabbits.
AB  - The cholinosensitivity of neurons of the motor cortex of young and old rabbits
      was studied. It was shown that muscarinic activation in the cells of old animals
      is encountered half as often than in young animals. The age-related decrease in
      cholinosensitivity is explained by an insufficiency of the overall activation of
      neurons in old animals. The change in the functional state of the cells of the
      motor cortex leads to the fact that the frequency of impulse activity of neurons
      associated with movement proves to be insufficient for the achievement of
      effective cortical control of motor functions.

PMID- 8487944
TI  - The reactions of neurons of the sensorimotor cortex of rabbits to stimulations of
      various sensory modalities against the background of the action of actinomycin D,
      a protein synthesis blocker.

PMID- 8487945
TI  - The influence of antibodies to brain-specific nonhistone chromatin proteins on
      the development and reproduction of a passive avoidance conditioned reflex in
      rats.

PMID- 8487946
TI  - NADPH-diaphorase histochemistry identifies isolated endothelial cells at sites of
      traumatic injury in the adult rat brain.
AB  - In addition to labelling endothelium, some ependymal cells (including tanycytes),
      and a subpopulation of neurons, nicotinamide adenine dinucleotide phosphate
      (NADPH)-diaphorase histochemistry of stab lesion sites in the neocortex revealed
      a large population of cells concentrated within several hundred micrometers of
      the lesion site. To determine the identity of these cells, NADPH-diaphorase
      reactivity was compared to binding with either the I-B4 isolectin from Bandeiraea
      simplicifolia (which has previously been shown to identify endothelial cells and
      activated mononuclear phagocytes), or a monoclonal antibody (OX-42) that
      recognizes activated mononuclear phagocytes. Many I-B4 lectin-labelled cells were
      also NADPH-diaphorase reactive, and other I-B4 lectin-labelled cells were also OX
      42 immunoreactive, but co-existence of OX-42 immunoreactivity and NADPH
      diaphorase reactivity was not observed. Only a small minority of NADPH-diaphorase
      reactive cells did not exhibit I-B4 lectin binding. In contrast to the simple
      somatic morphology of the majority of NADPH-diaphorase-reactive cells, the I-B4
      lectin-negative cells had a ramified appearance, and while readily observed at
      two days postlesion, they were only rarely seen at three days postlesion. Primary
      cultures of bovine aortic endothelial cells also exhibited NADPH-diaphorase
      reactivity which occupied most of the cytoplasm in a filamentous web pattern.
      Endothelial cells possess a constitutive form of nitric oxide synthase which, as
      demonstrated in NADPH-diaphorase-reactive neurons, may be the basis of their
      NADPH-diaphorase reactivity. These findings indicate that NADPH-diaphorase
      reactive cells observed at lesion sites are probably angiogenic endothelial cells
      not associated with extant blood vessels. Thus, NADPH-diaphorase histochemistry
      offers an effective method of visualizing neovascularization in the brain and
      other tissues.

PMID- 8487947
TI  - Long-term protective effects of human recombinant nerve growth factor and
      monosialoganglioside GM1 treatment on primate nucleus basalis cholinergic neurons
      after neocortical infarction.
AB  - Neocortical infarction induces biochemical and morphological retrograde
      degenerative changes in cholinergic neurons of the rat nucleus basalis
      magnocellularis [Sofroniew et al. (1983) Brain Res. 289, 370-374]. In the present
      study, this lesion model has been reproduced in the non-human primate
      (Cercopithecus aethiops) to investigate whether degenerative changes affecting
      the cortex surrounding the lesioned area and the ipsilateral basal forebrain are
      prevented by the early administration of recombinant human nerve growth factor
      alone or in combination with the monosialoganglioside GM1. Six months after
      surgery and treatment, the monkeys were processed either for biochemistry
      (choline acetyltransferase assay) or immunocytochemistry. In lesioned vehicle
      treated animals, choline acetyltransferase activity significantly decreased by
      28% in the cortex surrounding the injured area and by 31% in the ipsilateral
      nucleus basalis of Meynert when compared with values of sham-operated monkeys.
      These biochemical changes were fully prevented with the administration of nerve
      growth factor alone or in combination with the monosialoganglioside GM1. The
      morphometrical analysis revealed a significant shrinkage of cholinergic neurons
      (61 +/- 1.4% of sham-operated cell size) and loss of neuritic processes (59 +/-
      10% of sham-operated values) within the intermediate nucleus basalis region of
      lesioned vehicle-treated animals. Although a protection of the cholinergic cell
      bodies within the nucleus basalis was found with both treatments, a significant
      recovery of the neuritic processes (84 +/- 7.2% of sham-operated values) was
      assessed only in the double-treated monkeys. These results indicate that the
      early administration of nerve growth factor alone or in combination with the
      monosialoganglioside GM1 induces a long-term protective effect on the nucleus
      basalis cholinergic neurons in cortical injured non-human primates.

PMID- 8487948
TI  - Cholecystokinin-dependent regulation of host dopamine inputs to striatal grafts.
AB  - Intrastriatal infusions of cholecystokinin-8-sulphate in the rat exerts a dose
      dependent inhibition of dopamine-release from nigrostriatal terminals in the
      neostriatum, as measured by push-pull perfusion. This effect is abolished by
      excitotoxic lesions of the neostriatum, which, along with behavioural,
      electrophysiological and receptor binding studies, suggests that cholecystokinin
      exerts its action indirectly on dopamine release via receptors located on
      intrinsic striatal neurons. Grafts of embryonic striatum implanted in the
      lesioned striatum become innervated by host-derived dopamine axons and restore
      the response of those host neurons to cholecystokinin infusion. This suggests
      that the innervation of the grafts by dopaminergic axons of the host brain does
      not simply provide a tonic input to the grafts, but rather represents a phasic
      input that is under dynamic local regulation by graft-host feedback influences
      from the transplanted neurons themselves.

PMID- 8487949
TI  - Dopamine decreases striatal enkephalin turnover and proenkephalin messenger RNA
      abundance via D2 receptor activation in primary striatal cell cultures.
AB  - Dopaminergic regulation of striatal enkephalin biosynthesis and secretion was
      studied in primary neuronal cultures from fetal rat striatum. To allow
      pharmacological treatment, striatal primary cell cultures were seeded in
      chemically defined medium onto extracellular matrix. In these conditions,
      pharmacological treatment of the striatal neurons on the 10th day in vitro for 48
      h with 10(-6) M dopamine induced a 50% decrease in preproenkephalin mRNA level
      concomitant with a 50% decrease in methionine enkephalin neuronal content. These
      effects of dopamine were mimicked by the D2 agonist bromocriptine (10(-6) M). The
      decrease in methionine enkephalin neuronal content induced by dopamine or
      bromocriptine was reversed by the simultaneous application of sulpiride (10(-6)
      M), a selective D2 antagonist. Interestingly, the D1 agonist SKF 38393 (10(-6) M)
      application for 24 or 48 h was found to have no significant effect on methionine
      enkephalin neuronal content. To ensure dopamine regulation of enkephalin
      secretion, shorter dopaminergic treatments were performed. Dopamine application
      (10(-6) M) for 2 h had no significant effect on basal methionine enkephalin
      secretion but significantly decreased (50%) methionine enkephalin secretion
      induced by KCl 56 mM. This effect of dopamine on the KCl-induced methionine
      enkephalin secretion was mimicked by bromocriptine (10(-6) M), reversed by
      sulpiride (10(-6) M) and unaffected by the D1 antagonist SCH 23390 (10(-6) M)
      application onto striatal neurons. Our data provide direct evidence for a
      dopaminergic inhibitory control on enkephalin biosynthesis and secretion from
      striatal cell cultures, mediated through the dopaminergic D2 receptor activation.

PMID- 8487950
TI  - Organotypic slice cultures of the rat striatum--I. A histochemical and
      immunocytochemical study of acetylcholinesterase, choline acetyltransferase,
      glutamate decarboxylase and GABA.
AB  - Slices of striatal tissue from newborn to eight-day-old rats were cultured for
      six to 47 days. Cholinergic neurons and fibres were then visualized by
      histochemical staining for acetylcholinesterase or immunocytochemical staining
      for choline acetyltransferase. GABA-containing neurons and fibres were visualized
      by immunocytochemical staining for glutamate decarboxylase or GABA. Corresponding
      to the normal postnatal development in vivo, acetylcholinesterase staining of the
      striatal tissue progressed from a "patchy" distribution in the six to 14 days old
      cultures to an almost even distribution of high acetylcholinesterase activity
      after 18-27 days. Extrinsic afferents were accordingly not necessary for the
      maintenance of a patch-matrix-like, acetylcholinesterase distribution during the
      first one to two weeks in culture, just as a subsequent, normal developmental
      change of the acetylcholinesterase staining pattern into a more homogeneous
      distribution also occurred without such afferents. Cholinergic, choline
      acetyltransferase-immunoreactive neurons were evenly distributed within the
      cultured striatal tissue, like in vivo, but the density of the neurons appeared
      to be higher in the cultures. The neurons had a morphology corresponding to the
      "classical", large-sized, aspiny, cholinergic interneurons in the adult rat
      striatum. Glutamate decarboxylase-immunoreactive and GABA-immunoreactive neurons
      were either lightly or darkly stained and of medium size, but some large, lightly
      stained glutamate decarboxylase-immunoreactive and GABA-immunoreactive neurons
      were also found. The difference in staining density among the medium-sized cells
      was observed with both antisera and hence provide evidence for the existence of
      two populations of medium-sized GABAergic neurons, which in vivo are intensely
      stained interneurons and more weakly stained, spiny projection neurons. Fibres
      stained better for glutamate decarboxylase than for GABA and outgrowth of
      glutamate decarboxylase-immunoreactive nerve fibres from the striatal slice
      cultures onto the coverslip was often observed. The presence at all culture
      periods of "protospines" on cell bodies and proximal dendrites of some glutamate
      decarboxylase-immunoreactive, and in particular some GABA-immunoreactive neurons,
      suggested that at least some developmental characteristics might be maintained
      for extended periods in culture. In several cultures, groups of small GABA
      immunoreactive cells were observed. Similar groups were also found by staining
      for glutamate decarboxylase, but a smaller proportion of the cells were then
      positively stained. In view of their immature appearance with few or no
      processes, the known presence of GABA in neuroblast-like cells, and the recent
      demonstration of neuronal and glial progenitor cells in the adult mouse striatum,
      the small cells might belong to a population of undifferentiated cells surviving
      in the slice cultures.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8487951
TI  - Response of locus coeruleus neurons to footshock stimulation is mediated by
      neurons in the rostral ventral medulla.
AB  - While it is well documented that locus coeruleus neurons are potently activated
      by foot-pinch or sciatic nerve stimulation, little is known about the circuit
      producing this sensory response. Previous work in our laboratory has identified
      the medullary nucleus paragigantocellularis as a major excitatory afferent to the
      locus coeruleus. Here, we use local microinjections into the
      paragigantocellularis to test whether this nucleus is a link in the pathway
      mediating the activation of locus coeruleus neurons by subcutaneous footpad
      stimulation, or footshock, in anesthetized rats. Lidocaine HCl microinjected into
      the paragigantocellularis reversibly attenuated footshock-evoked activation of 50
      out of 56 locus coeruleus cells, with responses in 20 cells completely blocked.
      Microinjections of GABA into the paragigantocellularis reduced the footshock
      evoked responses of 17 out of 27 locus coeruleus cells (seven complete blocks);
      microinjections of the GABAB agonist baclofen had no effect (0 out of 11 cells
      blocked). Microinjections of a synaptic decoupling cocktail of manganese and
      cadmium also attenuated locus coeruleus activation in eight out of nine cells
      with two complete blocks. With each agent, the most effective injection placement
      for complete blockade of responses was the ventromedial paragigantocellularis;
      injections bordering this region attenuated responses, while those outside of the
      paragigantocellularis (dorsal medullary reticular formation, nucleus tractus
      solitarius, or facial nucleus), or vehicle injections, were ineffective. These
      results are consistent with previous findings that pharmacologic blockade of
      paragigantocellularis-evoked locus coeruleus activity also blocks footshock
      evoked responses of locus coeruleus neurons [Ennis and Aston-Jones (1988) J.
      Neurosci. 8, 3644-3657], and support the view that this somatosensory response,
      and perhaps other sensory-evoked responses of locus coeruleus neurons, involve
      the nucleus paragigantocellularis.

PMID- 8487952
TI  - Expression of c-fos in restricted areas of the basal forebrain and brainstem
      following single or combined intraventricular infusions of vasopressin and
      corticotropin-releasing factor.
AB  - Vasopressin has been shown to be localized in specific central nervous system
      (CNS) sites. There is considerable evidence that it can act as a central
      neurotransmitter and it has been ascribed a variety of putative roles in the CNS.
      To identify those regions of the brain capable of responding to this peptide, 250
      pmol vasopressin were infused into the lateral ventricle intracerebroventricular
      of conscious, handled male rats, and their brains processed for fos
      immunohistochemistry 60 min later. Increases in fos-immunoreactivity, compared
      with cerebrospinal fluid-infused controls, were found in specific regions of the
      basal forebrain and brainstem: the central nucleus of the amygdala, ventrolateral
      septum, parvocellular divisions of the paraventricular nucleus of the
      hypothalamus, dorsal tuberal nucleus and locus coeruleus. Pre-infusion of 2500
      pmol of a V1a antagonist prevented or reduced the expression of c-fos by
      intracerebroventricular vasopressin in all areas except the dorsal parvocellular
      paraventricular nucleus, implying that in most (but not all) areas the actions of
      vasopressin are mediated by the V1a receptor. Central administration of
      vasopressin had no effect on plasma corticosterone levels. Vasopressin and
      corticotropin-releasing factor act synergistically on the anterior pituitary to
      cause release of adrenocorticotropic releasing hormone and have corresponding
      synergistic interactions on behaviour. Infusion of 250 pmol corticotropin
      releasing factor produced a similar but not identical pattern of fos-like
      immunoreactivity to that of vasopressin. Activation of the parabrachial nucleus
      was observed, but there was no significant effect on the lateral septum and
      apparent increases in the medial parvocellular division of the paraventricular
      nucleus and locus coeruleus were not significant. Corticotropin releasing factor
      also caused a marked rise in plasma corticosterone. When the two peptides were
      infused together (125 pmol each) no evidence for synergy was found, in terms of
      the number of neurons activated to express c-fos. The induction of differential
      patterns of fos-like immunoreactivity by vasopressin and corticotropin-releasing
      factor in specific regions of the limbic forebrain and brainstem has implications
      for the individual roles they play in the CNS.

PMID- 8487954
TI  - Regressive modifications of climbing fibres following Purkinje cell degeneration
      in the cerebellar cortex of the adult rat.
AB  - The role of postsynaptic neurons in the maintenance of adult terminal axon
      arbours was investigated in the rat olivocerebellar system. The degeneration of
      Purkinje cells, the main target of olivary axons in the cerebellar cortex, was
      obtained by intraparenchymal application of kainate. The structural features of
      target-deprived climbing fibres, visualized by Phaseolus vulgaris leucoagglutinin
      tracing, were examined from two days to six months after the lesion. Following
      the degeneration of its Purkinje cell, the climbing fibre underwent remarkable
      regressive modifications involving the disappearance of most of the terminal
      arborization. Never the less, atrophic arbours still spanned through the
      molecular layer six months after the lesion. Morphometric evaluations showed
      that, one week after kainate application, total arbour length was already reduced
      to 52% of control, whereas the number of branches and of varicosities had both
      dropped around 40%. This retraction process progressed in the following stages to
      reach its maximum at about one month after the lesion, when total length was 30%
      of control and only 10% of branches and varicosities were still present. Only a
      slight tendency to a further decrease of the values could be detected at longer
      survival times. Branching pattern analysis revealed that such regressive
      phenomena mainly involved the distal compartment of the climbing fibres, the one
      made of fine varicose branchlets, while sparing the proximal thick branches. In
      addition, the whole process appeared to follow some rather strict guiding
      principles leading to an ordered branch retraction, from the periphery of the
      arbour inwards. Finally, in order to rule out the possibility that the observed
      changes could be due to a direct action of kainate on climbing fibres, we
      designed an alternative method of killing Purkinje cells by intraparenchymal
      injection of propidium iodide. The structural features of climbing fibres
      deprived of their target by such a procedure were very similar to those shown by
      arbours from time-matched kainate-lesioned animals at both qualitative and
      quantitative levels. Our results show that target deprivation induces remarkable
      structural modifications in the climbing fibre, leading to the retraction of most
      of the arbour. Never the less, the integrity of the Purkinje cell is not
      necessary for the maintenance of the whole arborization since its proximal
      compartment is maintained in the molecular layer for several months after target
      degeneration. It is proposed that the Purkinje cell, most likely by acting
      through a contact factor, directly controls the formation and the maintenance of
      the distal climbing fibre branches with their varicosities, which represent the
      presynaptic compartment of the axonal arbour.

PMID- 8487953
TI  - Induction and suppression of immediate early genes in specific rat brain regions
      by the non-competitive N-methyl-D-aspartate receptor antagonist MK-801.
AB  - The expression pattern of six different immediate early gene-encoded proteins was
      examined in the rat forebrain after intraperitoneal administration of MK-801, a
      non-competitive N-methyl-D-aspartate receptor antagonist, at doses of 3 mg/kg and
      0.3 mg/kg, respectively. Following MK-801 treatment, the presence of c-FOS, FOS
      B, KROX-24, c-JUN, JUN B, and JUN D were investigated by immunocytochemistry with
      specific antisera at different time intervals up to 48 h. Selective induction of
      all six immediate early genes was found in layer III neurons of the posterior
      cingulate and retrosplenial cortex. More complex effects were observed in the
      neocortex: MK-801 did not influence constitutive expression of different FOS and
      JUN proteins, but caused marked induction of c-FOS, FOS B, JUN B and JUN D,
      mainly in layer IV, but also in layers V and VI. In contrast, strong neocortical
      constitutive expression of KROX-24 was almost abolished by MK-801 administration,
      and replaced by an expression pattern similar to that of FOS and JUN proteins.
      Subcortical areas such as the hypothalamus and thalamus demonstrated an induction
      of a subset of immediate early genes (c-fos, fos B, Krox-24, jun B). Injection of
      MK-801 caused the same distributional pattern of immediate early gene expression
      irrespective of the dose given, but the extent of changes was stronger after 3
      mg/kg, and altered levels of immunoreactivity persisted longer. In many
      experimental paradigms, immediate early genes are induced by N-methyl-D-aspartate
      receptor-mediated mechanisms. This induction can readily be blocked by N-methyl-D
      aspartate receptor antagonists like MK-801. Our data, however, indicate that MK
      801 itself causes immediate early gene expression in specific neuronal
      populations. In the present study MK-801-elicited expression of immediate early
      gene-encoded proteins seems to identify reversibly injured neurons, mainly in
      layer III of the posterior cingulate and retrosplenial cortex. These neurons have
      previously been shown to be the principal target of N-methyl-D-aspartate receptor
      antagonist toxicity. Since immediate early gene induction precedes heat-shock
      protein expression as well as pathomorphological changes, and is induced in
      additional cortical cell populations, it seems to be a more rapid and more
      sensitive indicator of non-lethal neuronal injury.

PMID- 8487955
TI  - Physiological influence of lateral proisocortex on the midbrain periaqueductal
      gray: evidence for a role of an excitatory amino acid in synaptic activation.
AB  - Recent anatomical studies in this laboratory have demonstrated that the
      proisocortex cortex adjacent and dorsal to the rhinal sulcus is one of the major
      forebrain afferent inputs to the midbrain periaqueductal gray matter in the rat.
      The physiological influence(s) of this projection has not been examined. The
      present studies investigated the responses of periaqueductal gray neurons to
      chemical and electrical stimulation of proisocortex in chloral hydrate
      anesthetized rats. In addition, the role of glutamate as a possible transmitter
      in excitatory proisocortex-periaqueductal gray synaptic responses was tested.
      Microinjection of D,L-homocysteate into proisocortex excited 44% (19/43),
      inhibited 37% (16/43) and had no effect on 19% of periaqueductal gray cells. The
      onset of D,L-homocystic acid-evoked responses ranged from 2 to 60 s; the duration
      of responses ranged from 1 to 18 min. Low-frequency, single-pulse electrical
      stimulation of proisocortex robustly altered neuronal discharge in 25% of
      periaqueductal gray neurons sampled; 10% (74/724) of neurons were excited and 15%
      (107/724) were inhibited. Insular cortex-evoked excitatory responses had a mean
      onset latency of 19.5 +/- 4.2 ms and a mean duration of 38.5 +/- 26.9 ms.
      Inhibitory responses had a mean onset latency of 26.2 +/- 15.6 ms and mean
      duration of 108.0 +/- 84.9 ms. Trains of high-frequency electrical stimulation of
      proisocortex excited 22% (13/59) and inhibited 25% (15/59) of periaqueductal gray
      cells tested. In separate experiments, stimulation electrodes were placed in
      periaqueductal gray to antidromically activate proisocortex neurons that project
      to periaqueductal gray.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8487957
TI  - Identification of a novel neuron-specific surface antigen in the developing
      nervous system, by monoclonal antibody 4C5.
AB  - Monoclonal antibody 4C5 was obtained after immunization of Balb/c mice with a
      crude membrane preparation derived from the brains of 15-day-old rat embryos. As
      revealed by immunocytochemistry on primary cell cultures from embryonic rat
      brain, it was shown that the antigen recognized by monoclonal antibody 4C5 (4C5
      antigen) is localized on the cell surface of the neurons. Preliminary biochemical
      characterization showed that it is a peripheral protein with a molecular weight
      of 94,000. The 4C5 antigen does not appear to be linked with other polypeptides
      by S--S bonds and contains few or no disulphide intramolecular bridges. N
      Glycanase digestion indicated that the protein is probably not glycosylated.
      Monoclonal antibody 4C5 crossreacts with membrane fractions from rat, rabbit, pig
      and human developing brain. It was shown by immunohistochemistry that the 4C5
      antigen is widely distributed in the embryonic and adult rat brain. In the
      peripheral nervous system 4C5 immunoreactivity was present in dorsal root
      ganglion neurons. Immunoblotting and immunohistochemistry on dissociated cells
      from rat brain and on tissue sections of brain and dorsal root ganglia revealed
      an age-dependent decline in the expression of the epitope recognized by
      monoclonal antibody 4C5, in the central and peripheral nervous system. In
      particular, intense 4C5 immunoreactivity was observed during the embryonic and
      early postnatal ages. By the second postnatal week, expression of the protein was
      greatly reduced, becoming very weak at later stages of development and in the
      adult animal. In PC12 cell cultures, expression of the 4C5 antigen was intense in
      proliferating cells while being greatly reduced after nerve growth factor induced
      differentiation of these cells. The increased expression of the 4C5 antigen in
      proliferating PC12 cells and the prominent presence of this molecule during a
      time of neuronal migration suggest that it is involved in these developmental
      events.

PMID- 8487956
TI  - Expression patterns of the cell adhesion molecule Nr-CAM during histogenesis of
      the chick nervous system.
AB  - Neuron-glia-related cell adhesion molecule (Nr-CAM) is a recently characterized
      cell adhesion molecule in the family of immunoglobulin-related molecules of which
      the neural cell adhesion molecule, N-CAM, is the prototype. Nr-CAM shares
      structural properties with another member of this family (neuron-glia CAM, Ng
      CAM) and both molecules exhibit homophilic and heterophilic binding properties.
      To understand better the role of such molecules in development, we have examined
      the sites of synthesis and expression of Nr-CAM by means of in situ hybridization
      and immunohistochemistry. Both methods indicated that Nr-CAM is expressed only in
      the nervous system. The molecule was observed on neurons in both the peripheral
      and central nervous systems and on epithelial floor plate cells in the spinal
      cord, but it was absent in the germinal zones. The protein was present on
      perikarya, but was found preferentially on axonal tracts. As observed for
      messenger RNAs specifying other cell adhesion molecules, messenger RNA for Nr-CAM
      was localized in the perikarya. The temporal expression of Nr-CAM was correlated
      with various neural morphoregulatory events, including cell proliferation and
      migration, axonal outgrowth and myelination. The molecule was expressed during
      the onset of neurogenesis at embryonic day 3 in the floor plate epithelium, and
      then on postmitotic ventral horn motor neurons of the spinal cord. At later
      stages, it was expressed throughout the spinal cord but disappeared from the
      floor plate. In the cerebellum, Nr-CAM was found on granule and Purkinje neurons
      and afferent fibers. Both local and projection neurons in the optic tectum, as
      well as axonal pathways throughout the telencephalon, expressed Nr-CAM. In the
      peripheral nervous system, Nr-CAM was expressed strongly in sensory and autonomic
      ganglia and in the enteric nervous system. At the onset of myelination, there was
      a general decrease in staining for Nr-CAM protein in the central nervous system
      but not in the periphery. Comparison of the expression of Nr-CAM to that of the
      structurally related Ng-CAM showed considerable overlap in their distributions,
      although there were differences in the levels at which each CAM was observed in
      particular structures. For example, sympathetic ganglia stained more intensely
      for Nr-CAM protein than for Ng-CAM. This differential but co-distributed pattern
      is consistent with the idea that although similar cell adhesion molecules have
      independent binding specificities, they may have related functions that act
      synergistically in the development of the nervous system.

PMID- 8487958
TI  - The effects of chlormethiazole and nimodipine on cortical infarct area after
      focal cerebral ischaemia in the rat.
AB  - Focal ischaemia in the rat cerebral cortex was produced by means of a
      photochemically induced thrombosis of cerebral arteries. This was achieved by
      intravenous infusion of the photosensitive dye Rose Bengal and illumination of
      the skull with focused green light. Initial experiments justified the use of
      tetrazolium staining as an index of infarct damage. Using this technique it was
      demonstrated that chlormethiazole (200 mg/kg, i.p.) given 5 min post ischaemia
      markedly reduced the area of infarcted cortical tissue. A second experiment
      replicated this observation and showed that, in contrast, nimodipine (0.5 mg/kg,
      i.p.) given 5 min post infarct was without effect on infarct size. The pattern of
      Evans Blue extravasation indicated that the infarct developed over a 24-h period
      with the major damage occurring in the first 4.5 h. The spread of the infarct
      beyond the initial core of damage was decreased by an estimated value of almost
      50% by injection of chlormethiazole (200 mg/kg, i.p.) 5 min after the light
      exposure. These data indicate that chlormethiazole is an effective drug in
      protecting against the effects of focal ischaemia in the rat and, taken with
      earlier observations that chlormethiazole protects against the effects of global
      ischaemia in the gerbil, suggest that the drug may be an effective treatment
      against the ischaemic cell death that can occur following a stroke or cardiac
      arrest.

PMID- 8487959
TI  - Hypothalamic melanin-concentrating hormone and alpha-neoendorphin-immunoreactive
      neurons project to the medial part of the rat parabrachial area.
AB  - Neurons in the middle and posterior parts of the lateral hypothalamus project to
      the parabrachial area, and in particular to the gustatory relay-station located
      in the medial part of this area. In the present study we have examined some of
      the neuropeptide immunoreactivities of the lateral hypothalamus neurons that
      project to the gustatory region of the parabrachial area. By coupling retrograde
      transport and immunohistochemistry, we found that 50-60% of medial parabrachial
      area-projecting cells located in the juxta-capsular region of the posterior
      lateral hypothalamus are labeled by rat melanin-concentrating hormone antiserum,
      while 28% of the retrogradely labeled neurons located in the perifornical lateral
      hypothalamus are visualized with alpha-neoendorphin antiserum. Moreover, a large
      number of terminals distributed throughout the parabrachial nucleus are
      immunoreactive to melanin-concentrating hormone or alpha-neoendorphin antisera.
      These immunoreactivities are not co-localized within the same lateral
      hypothalamic neurons. The potential role of these peptidergic projections in the
      reward mechanisms elicited in the medial parabrachial area and in the control of
      palatability is discussed.

PMID- 8487960
TI  - Gulf War veterans with PTSD.

PMID- 8487961
TI  - Evaluation of gender differences in urine specific gravity and serum electrolytes
      in response to varied fluid intake and ibuprofen use.
AB  - Heat casualties and other conditions related to suboptimal fluid intake (FI) are
      common in the military. Current methods to assess FI do not address gender
      differences or medication use, specifically non-steroidal anti-inflammatory drugs
      (NSAIDs), which are commonly used in the field. Nine men and six women were
      prospectively studied while stationed in Saudi Arabia. Urine specific gravity and
      serum electrolytes were monitored as FI was varied before and after daily
      ibuprofen (IBP) ingestion. IBP impaired urinary dilution in both men and women,
      but differences were not statistically significant pre- and post-IBP or between
      genders. Use of IBP or other NSAIDs may confound usual methods to ensure adequate
      FI, and soldiers should be specifically questioned about their use before such
      assessments.

PMID- 8487962
TI  - Deployment of an Air Transportable Hospital in support of Allied Forces during
      Operation Provide Comfort: April 29 to July 17, 1991.
AB  - The deployment, setup, and operation of an Air Transportable Hospital (ATH) as a
      primary field hospital for 25,000 Allied Forces during Operation Provide Comfort
      is presented with a description of the performance and experiences of this unit.
      More than 3,300 outpatients were seen and treated, and more than 50 patients were
      operated on at the ATH. In addition, assigned personnel participated as medical
      augmentees to Kurdish refugees camps, screening and treating more than 13,000
      individuals. The success of this deployment validates and expands the concept of
      the ATH and of Air Force training doctrine.

PMID- 8487963
TI  - A prophylactic program to prevent traveler's diarrhea in United States Naval
      personnel comparing doxycycline and trimethoprim-sulfamethoxazole.
AB  - A prophylactic program was designed to prevent traveler's diarrhea comparing the
      efficacy of doxycycline and trimethoprim-sulfamethoxazole. A total of 99
      volunteers received either medication. No cases of traveler's diarrhea were
      reported in either group or in a control group not taking prophylactic
      antibiotics. The 42 volunteers taking doxycycline showed neither of its main two
      side effects, photosensitivity or gastrointestinal discomfort. Three of 57
      volunteers taking trimethoprim-sulfamethoxazole had side affects from it--two
      with some gastric discomfort and one with a skin rash. Another common side
      effect, which did not occur, is diarrhea. This paper makes suggestions on
      managing a shipboard traveler's diarrhea prevention program and anticipating
      potential problems.

PMID- 8487964
TI  - Support systems at the U.S. government's only medical school, the Uniformed
      Services University of the Health Sciences.
AB  - A brief history and a discussion of general support management employed at the
      Uniformed Services University of the Health Sciences are given. This includes the
      "place" of support, leadership philosophy, and guiding principles. Guiding
      principles advocated by H. Edwards Deming were adopted. Some of the specific
      management techniques employed in instituting his 14-point plan are emphasized
      when making personnel selections, "immersing" them in the "culture," and
      maintaining the environment established.

PMID- 8487965
TI  - How psychiatric symptoms varied in World War I and II.
AB  - Psychiatric syndromes may be differentially expressed according to cultural
      expectation. An examination of the literature reveals a predominance of
      conversion symptoms in World War I and a relative decrease among World War II
      neuropsychiatric casualties. In the latter conflict, by contrast, "combat
      exhaustion" and psychosomatic disorders comprised the majority of non-psychotic
      psychiatric casualties. Determinants of this changing "vocabulary of distress"
      are discussed.

PMID- 8487966
TI  - A TQM involvement plan.
AB  - We present the plan used to change our 35-bed medical treatment facility to a
      Deming Total Quality Improvement environment. This was successfully intermeshed
      with the military hierarchical chain of command and has resulted in a paradigm
      shift in the least amount of time within the facility. We present this plan, its
      steps for implementation, and our Quality Council organization so that similar
      military medical units may learn from our experience.

PMID- 8487967
TI  - Impact of nutritional care upon return-to-duty rates.
AB  - Returning soldiers to duty is a primary goal of the medical department. One of
      the most critical factors in achieving this goal is the soldier's nutritional
      status--both prior to the trauma and during treatment. This article reviews the
      role of nutrition in healthy lifestyles, the effect of stress and the role of
      nutrition in wound healing, and the role of the registered dietitian in providing
      nutritional care. Implications for maximizing the return-to-duty rate through
      inclusion of a registered dietitian on the treatment team are identified.

PMID- 8487968
TI  - A major outbreak of foodborne gastroenteritis among Air Force personnel during
      Operation Desert Storm.
AB  - An outbreak of foodborne gastroenteritis affected 648 United States Air Force
      personnel stationed in Jeddah, Saudi Arabia during Operation Desert Storm. The
      implicated food source was a locally catered meal. Despite the presence of an
      aggressive Air Force public health program, foodborne illness had a major impact
      on manpower and medical resources during a critical phase of military operations.
      It is the recommendation of the authors that the Air Force not rely on local
      caterers during future deployments.

PMID- 8487969
TI  - Intraarticular autogenous bone grafting in recurrent shoulder dislocations.
AB  - In a reexamination, 24 young soldiers who had been operated on using a new method
      of screwing an autogenous bone graft into the glenoid rim in cases of recurrent
      dislocation of the shoulder joint were investigated. A major functional problem
      is the reduced lateral rotation, even by using other procedures for operative
      treatment like Eden-Hybinette or Putti-Platt. This reduction of shoulder movement
      results in problems using the affected arm during sporting activities or military
      duties. There has been an excellent result without any redislocation in a follow
      through of 6 to 42 months and more than 90% satisfied patients, with only a very
      low rate of reduction of lateral rotations about 10 degrees using this procedure.
      The X-rays of all the patients, reinvestigated, showed a complete healing of the
      bone grafts into the glenoid rim and correct position of AO-screws.

PMID- 8487970
TI  - An examination of narcissistic personality traits as seen in a military
      population.
AB  - Various studies examining the prevalence of personality disorders in civilian
      inpatient and outpatient populations have consistently found narcissistic
      personality disorder to be one of the least common. In striking contrast to this,
      a recently published study showed narcissistic personality features to be among
      the most common personality features in a military outpatient clinic population.
      This paper examines several possible explanations for this finding. This
      surprisingly high relative incidence of narcissistic personality features may be
      related to a self-selection bias on the part of persons choosing a military
      career. Narcissistic personality traits may confer adaptive advantage in certain
      military professional roles. Kohut's theory of specific transference requirements
      in individuals with narcissistic character structure serves as a useful
      explanatory model for these findings.

PMID- 8487971
TI  - A review of sternal wound complications in a military hospital.
AB  - A retrospective review of sternal wound complications was conducted during a
      recent 13-month period at the Naval Hospital, San Diego. These complications
      developed in 5 (3.0%) of 168 patients after they underwent coronary artery bypass
      with saphenous vein grafts. Three or more of these patients were male, obese, and
      hypertensive, with a significant smoking history. All these factors have been
      previously reported to be associated with an increase in the incidence of sternal
      wound complications. All patients had prolonged postoperative intensive care
      treatment, and ultimately all patients recovered and were discharged from the
      hospital. Interestingly, as opposed to other reviews, we were unable to show an
      association of sternal wound complications with the use of internal mammary
      artery harvesting.

PMID- 8487972
TI  - Physical fitness and cardiovascular disease risk factors of female senior U.S.
      military officers and federal employees.
AB  - This study compared physical fitness and cardiovascular risk factors between
      military officers (N = 23) and civilians (N = 17). Subjects were women (average
      age 43 years) who attended the U.S. Army War College from 1986-1991. Officers had
      less body fat, higher aerobic capacity, lower resting heart rates, lower resting
      diastolic blood pressure, higher HDL, and marginally lower triglycerides. Female
      military officers appear to be more fit and have lower cardiovascular risk
      factors than their civilian counterparts.

PMID- 8487973
TI  - The history of the military medical service in Poland.

PMID- 8487974
TI  - The clinical assessment of femoral stress fractures: a comparison of two methods.
AB  - In a prospective study among 667 recruits, the incidence of asymptomatic femoral
      stress fractures was compared using a new expanded stress fracture clinical
      examination (SFCA) versus an older stress fracture examination. There was a
      statistically significant difference (p = 0.0001) between the percentage of
      femoral stress fractures that were asymptomatic in the group evaluated by SFCA
      (26%) and those evaluated by the older stress fracture examination (80%). By
      using the SFCA, many of the femoral stress fractures previously classified as
      asymptomatic are in fact recognized as symptomatic.

PMID- 8487975
TI  - The use of computed tomography to assess and treat complex pneumothorax.
AB  - A complex pneumothorax is a loculated pneumothorax due to adhesions. Chest
      roentgenograms are usually inadequate to assess a complex pneumothorax. A
      computed tomography (CT) scan can be used to accurately assess the extent of the
      pneumothorax, and to determine its exact location in order to make placement of a
      tube thoracostomy easier and safer. In addition, if there is a persistent or
      recurrent pneumothorax after tube thoracostomy, a CT scan can be used to
      determine the relationship of the chest tube to the pneumothorax. Three cases are
      discussed to illustrate the use of the CT scan in evaluating patients who have a
      complex pneumothorax.

PMID- 8487976
TI  - Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen
      therapy.
AB  - Radiation necrosis is a major complication of surgery or trauma in a previously
      irradiated field. Although it may occur in any location, the most common region
      affected is the head and neck. Osteoradionecrosis (ORN), the involvement of bone
      with radiation necrosis, occurs most frequently in the mandible, and has been
      well described. Involvement of the temporal bone, although less frequent, is
      nonetheless a difficult problem in management. Described herein is a case of ORN
      of the temporal bone treated with adjunctive hyperbaric oxygen therapy with
      complete resolution. This is followed by a discussion of the pathophysiology,
      presentation, and management of osteoradionecrosis of the temporal bone,
      including the role of adjunctive hyperbaric oxygen in the treatment regimen.

PMID- 8487977
TI  - A one-year experience in the antenatal evaluation of suspected abdominal wall and
      bowel defects at a military tertiary referral center.
AB  - A variety of fetal abdominal wall defects and bowel anomalies are detected or
      suspected antenatally at institutions providing primary, secondary, and tertiary
      level care. Presented is a summary of a 1-year experience at a tertiary care
      center demonstrating a working referral network and its advantages. Of the 10
      cases presented, 8 were referred and 2 originated from within our institution.
      The initial diagnosis was uncertain or differed from the final diagnosis in half
      of referred cases. Within the military, a reliable route for referral enhances
      prenatal evaluation and provides intensive neonatal support at delivery if needed
      and more immediately available surgery if indicated.

PMID- 8487978
TI  - Promoting the use of program evaluation findings.
AB  - Although program evaluations promote organizational hygiene by early detection of
      problems, many faculty experience evaluation phobia. To overcome this phenomenon,
      the author discusses four major strategies for faculty and administrators.

PMID- 8487979
TI  - The multifocused faculty selection model: a design for hiring the best faculty.
AB  - The multifocused faculty selection model is designed to assist the faculty search
      committee in two ways. First, this model organizes the stages for obtaining
      information about the applicant's abilities related to faculty performance.
      Second, the model provides a consistent method for faculty selection as the
      membership of the department's search committee changes. The applicant selection
      techniques used in this model include descriptive interviewing, computer assisted
      data, and the teaching demonstration.

PMID- 8487980
TI  - Eliminating sexism in the classroom.
AB  - Sexism exists in many nursing classrooms without the teacher or students being
      aware of it. Speech patterns, written-communication, and pedagogical styles may
      contribute to sexism. Nurse educators need to take measures to identify and
      eliminate sexism from the classroom, because it subordinates and limits students.
      The classroom should promote gender-free situations that enhance and contribute
      to learning and advancement of all students.

PMID- 8487981
TI  - Have program, will travel!
AB  - A lack of nurses with masters degree preparation on Guam resulted in a contract
      with Washington State University to deliver its graduate program to Guam. Faculty
      who taught the first of four consecutive summer sessions identified many issues
      in transporting themselves and a total program 6,000 miles away from the home
      campus. The authors provide suggestions for dealing with administrative,
      curricular, faculty, and student concerns that may help others plan international
      education endeavors.

PMID- 8487982
TI  - Transformation: nursing education and cultural diversity.
AB  - Teaching is the transformation of ideas and content into representations that are
      appropriate for particular students. The teacher moves from a personal
      understanding of an idea to its being comprehended by the students. Teachers
      change knowing into telling, and students change that telling into doing and
      caring.

PMID- 8487983
TI  - The use of group process in developing articulation models.
AB  - This article explores the use of group process for developing articulation models
      to enable movement of graduates between levels of nursing education with minimal
      barriers and repetition of content. Potential roadblocks to success include
      differing philosophical positions, lack of recognition of core content and end
      competencies of the different levels, and time commitments required. However,
      with careful planning and flexibility, group dynamics can be used proactively to
      achieve success.

PMID- 8487984
TI  - Learning style as a predictor of drug dosage calculation ability.
AB  - This study measured the learning style in mathematics of nursing students to
      determine if there was a correlation with their ability to calculate drug
      dosages. The results seem to indicate that instructors can improve the ability of
      their students to calculate drug dosages by integrating instructional methods
      that 1) reinforce the student's preferred learning style; and 2) require the
      student to use both sequential, step-by-step, paper and pencil processing and
      global, all-at-once mental processing.

PMID- 8487985
TI  - Reducing the sea of paper in nursing education.

PMID- 8487986
TI  - Assessing the effectiveness of oral presentations.

PMID- 8487987
TI  - The confidence scale: development and psychometric characteristics.
AB  - Developing confidence is an important component of clinical nursing practice, yet
      nurse educators do not have a valid and reliable instrument to measure confidence
      for tracking the development of this phenomenon or studying the factors that
      influence the level of confidence. The author discusses the C-Scale as a valid
      and reliable instrument to measure confidence.

PMID- 8487988
TI  - Your nursing image--tending the flame.

PMID- 8487989
TI  - Finding the magic words.

PMID- 8487990
TI  - Chloral hydrate overdoses implicated in deaths.

PMID- 8487991
TI  - Evaluating serum triglyceride levels.

PMID- 8487992
TI  - Pediatric near drowning.

PMID- 8487993
TI  - Jenni, RN.

PMID- 8487994
TI  - Critical incidents: pulling together to cope with the stress.

PMID- 8487996
TI  - Using blood glucose meters--what you and your patient need to know. Part III.

PMID- 8487995
TI  - T.B. the second time around ... and how you can help to control it.

PMID- 8487997
TI  - Predicting future trends in oncology nursing.

PMID- 8487998
TI  - New drugs.

PMID- 8487999
TI  - Nurses' guide to good nutrition and sensible weight control. Part 1.

PMID- 8488000
TI  - Weight loss programs. Is one right for you?

PMID- 8488001
TI  - Remembering Rose.

PMID- 8488002
TI  - Managing delirious patients.

PMID- 8488003
TI  - Exposure to H.I.V.--common sense precautions.

PMID- 8488004
TI  - [Studying at Sherbrooke. An experience of hope].

PMID- 8488005
TI  - [Pregnant, we latch on to life].

PMID- 8488006
TI  - [Liaison nurses in demand].

PMID- 8488007
TI  - [Open window on the department of community health].

PMID- 8488008
TI  - The emergence of new professional dynamics.

PMID- 8488009
TI  - [Alternative mechanisms of the "2(k) rule" for cellularity].

PMID- 8488010
TI  - [The embryonic brain-derived neuralizing factor (EBDNF): its partial purification
      by ion-exchange and affinity chromatography].
AB  - The data are presented about isolation from the brain of 7.5-day chick embryos of
      a factor capable of neuralizing effect on the early gastrula ectoderm of the
      grass frog Rana temporaria L. Earlier this factor was defined as embryonic brain
      derived neuralizing factor (EBDNF) (Mikhailov, Gorgoliuk, 1989). The isolation
      procedure includes (1) extraction with deionized water at pH 9.0; (2) ion
      exchange chromatography on a column with DEAE-adsorbent at pII 8.0; (3) affinity
      chromatography on Heparin-Ultragel column. EBDNF-containing fraction is eluted
      from the Heparin-Ultragel column with 250 mM NaCl as a separate peak. Four bands
      are observed on SDS-electrophoregrams of this fraction, two more prominent ones
      having the molecular weight of 43 and 63 kDa. The yield of EBDNF-containing
      fraction is about 0.01-0.02% of the wet weight of the initial brain tissue.

PMID- 8488011
TI  - [The tissue localization of "chitinoprotein", detectable by using specific
      antibodies, in the development of Drosophila melanogaster].
AB  - The biosynthesis of cognate glycoproteins with chitinase-sensitive carbohydrate
      moiety ("chitinoproteins") was detected after incubation of cultured cells of
      different insect species with 3H-glucosamine (Kramerov et al., Insect Biochem. v.
      20; 769-775, 1990). It was also demonstrated that production of the specific
      chitinoprotein takes place during the development of D. melanogaster as revealed
      by immunoblotting and autoradiographic analysis of crude tissue extracts. An
      investigation of the developmental pattern of tissue localization of Drosophila
      chitinoprotein was performed using antibodies raised in rabbit after immunization
      with a purified preparation of the chitinoprotein (ChiP) from Drosophila
      embryonic cultured cells. The paraffin-embedded thin (5 microns) sections of
      organisms fixed in Bouin fixative were stained immunohistochemically with primary
      antibodies and peroxidase-conjugated secondary antibodies followed by enhancement
      of the precipitated DAB product with osmium tetroxide. Preimmune serum and
      antiserum preadsorbed with the purified ChiP preparation were used as negative
      controls yielding no specific staining of tissue sections. Negative staining with
      specific anti-ChiP antibodies was demonstrated for salivary glands, gut, muscles,
      central and peripheral nerve system and some other tissues. A complex pattern of
      tissue-specific ChiP localization in a variety of tissues of ectodermal,
      mesodermal and germ line origin was revealed. The mesodermal derivatives-
      hemocytes and oenocytes capable of producing the components of cuticle as well as
      epidermal cells of larvae and imago clearly demonstrated staining of cytoplasmic
      vesicles, which in the latter case were exocytosed and included into the newly
      formed endocuticle. Another cell type known to produce cuticle--epithelial cells
      of imaginal discs (primordia of adult organs)--were also stained with antibodies.
      One can suppose that ChiP is involved in biogenesis of insect cuticle, probably,
      as a protein precursor of chitin formation. It was quite surprising to observe a
      rather strong staining of fat body cells and follicle cells of adult ovaries. The
      follicular epithelium secreted the stained granules into a growing oocyte that
      accumulated large amounts of this immunopositive material until transformation
      into a mature egg. In an early embryo ChiP is localized in blastodermal and pole
      cells, but not in yolk. This is, probably, the result of segregation of ChiP to
      the periphery of an egg during the final stage of its maturation and subsequent
      cellularization in the beginning of embryogenesis. Later ChiP can be found in
      ectodermal cells and hemocyte-like cells. It should be noted that not all amounts
      of ChiP detected in embryos are maternally inherited, for an active ChiP
      biosynthesis takes place in dissociated embryonic cells after incubation with
      labelled sugar precursor.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488012
TI  - [Melanotropic activity in the hypophysis and blood of Wistar rats in early
      postnatal development].
AB  - The activity of melanotropins in pituitary homogenates and blood of Wistar rats
      obtained from the nursery Stolbovaia (Russian Academy of Medical Sciences) was
      studied using the method of biological testing (Hogben, Slome, 1931; Golichenkov,
      1980). In order to elucidate, to what extent the normal status of melanotropic
      activity is retained in albino rats, two experimental series were performed.
      Melanotropic activity was determined in (1) intact rats and (2) in rats receiving
      subcutaneous injections of parachlorophenylalanine, a specific inhibitor of
      serotonin synthesis. Melanotropic activity of Wistar rats hypophysis during the
      studied period of development was similar to that of normal pigmented rats.
      However, the peak of melanotropic activity of blood which is characteristically
      observed in pigmented rats on day 3 of postnatal development is absent in the
      case of Wistar rats. The experimentally induced decrease in the serotonin level
      did not result in the increased melanotropic activity of blood. These data
      suggest that certain structures of hypophysis responsible for MSH secretion can
      be disturbed in Wistar rats. A short-term peak of blood MSH in rats during the
      first week after birth is known to provide for maturation of dopaminergic neurons
      located in the arcuate nucleus of the hypothalamus. Consequently, the absence of
      such peak in Wistar rats should result in neuroendocrine disturbances such as
      inadequate functioning of dopaminergic neurons responsible for melanotropin
      secretion by hypophysis beginning from the second week after birth
      (Lichtensteiger, Schlumpf, 1986).

PMID- 8488013
TI  - [The effect of methylazoxymethanol on neuronal differentiation in the murine
      cerebellum].
AB  - The effect of methylazoxymethanol (MAM), an antimitotic drug, on granule and
      Purkinje cells of the rat cerebellum was studied. MAM was injected subcutaneously
      into ICR mice on day 5 after birth. The number of nucleoli and DNA content in
      nuclei of cerebellar neurons were determined 2 and 12 days after the injection.
      The number of nucleoli served as a criterion of maturity of neurons. On day 2
      after MAM administration the proportion of Purkinje cells containing a smaller
      number of nucleoli increased suggesting a direct effect of MAM on maturation of
      Purkinje neurons. On day 12 no difference in the number of nucleoli was found
      between experimental and control animals but the number of granule cells
      containing multiple nucleoli increased significantly. The latter suggests that
      the studied cell population was supplemented with less mature cells. As a result,
      development of Purkinje and granule cells is desynchronized and that appears to
      determine the secondary effect of MAM on Purkinje cell differentiation.

PMID- 8488014
TI  - [An androgenic program of expression of the particular estrogen-binding protein
      is present in male rats in all hepatocytes].
AB  - Radioligand and immunohistochemical analysis was used for studying the expression
      of an unusual estrogen-binding protein (UEBP) in the regenerated liver of male
      rats poisoned with CCl4. As a result of CCl4 poisoning, most hepatocytes
      intensely producing UEBP and located in the central part of the liver lobules are
      destroyed (40 to 90% of the liver parenchymal cells). Dead cells are substituted
      by new hepatocytes formed due to proliferation of periportal hepatocytes in which
      UEBP is expressed at a low level. In regenerated liver, however, a high level of
      UEBP expression characteristic of the control animals is restored, as well as a
      gradient mode of distribution of UEBP-containing cells with the maximum UEBP
      concentration in hepatocytes surrounding the central vein. The results obtained
      with animals with either intact or removed testes were similar, except that the
      dynamics of liver regeneration was slower in the castrated rats. These data
      suggest the existence in all hepatocytes of the complete androgen-related program
      for UEBP expression. This program is inherited by daughter cells in the absence
      of an inducing hormone and is similar in all cells, independently of the extent
      of its phenotypic expression in hepatocytes with different localization within
      the liver lobule.

PMID- 8488015
TI  - [The formation of T-suppressors that suppress the activity of alloreactive T
      cells after lymphocyte interaction with 2 different thymus-derived mediators].
AB  - The data are presented on simultaneous interaction of thymocytes and T-cells from
      lymph nodes with two humoral factors produced by macrophages and epithelial
      cells, main stromal elements of the thymus. Such contact of T-cells with two
      mediators resulted in the formation of T-suppressors capable of inhibiting the
      activity of syngeneic allospecific T-lymphocytes. These T-suppressors did not
      alter the response to another antigen but inhibited proliferation of donor cells.
      Involvement of such mechanism of T-suppressor formation in regulation of the
      immune status is discussed.

PMID- 8488016
TI  - [Phenogenetic analysis of independent and dependent differentiation].

PMID- 8488017
TI  - Thrombolytic therapy for acute myocardial infarction after oral surgery.
AB  - Two cases of mild-to-moderate bleeding after thrombolytic streptokinase therapy
      are presented, and the treatment modalities are discussed. To the best of our
      knowledge, these are the first two cases reported in the medical and dental
      literature.

PMID- 8488018
TI  - A simple method to enable feeding during maxillomandibular fixation of the jaws.
AB  - The use of maxillomandibular fixation after surgery on the jaw bone invariably
      affects the dietary intake and the oral hygiene of patients. When the upper and
      lower jaws are kept in occlusion, the patient has to take bland food that has to
      sieve through the crevices between teeth to enter the oral cavity. This results
      in food accumulation around teeth, orthodontic appliances, and surgical wound.
      Feeding in this manner can also be very trying on some patients. A simple method
      is devised in which finely minced food can be introduced by a catheter directly
      into the oral cavity.

PMID- 8488019
TI  - Third molars confusing the diagnosis of carcinoma.
AB  - The purpose of this study was to describe cases of oral cancer in which the
      initial presenting symptoms were considered to be due to third molars and in
      which the underlying carcinoma therefore escaped early diagnosis. Between 1986
      and 1990 a total of five cases with squamous cell carcinoma associated with a
      third molar (impacted, partially or totally erupted, or recently extracted) were
      treated at our unit. Because of acute or chronic symptoms related to disturbed
      eruption of third molars, the detection of a simultaneous malignant change and
      referral were delayed. In conclusion, all third molars, especially impacted,
      partially erupted, or overerupted ones, should be examined critically, especially
      if the patient has symptoms.

PMID- 8488020
TI  - Dermoid cyst of the floor of the mouth.
AB  - Sublingual dermoid cysts are uncommon in the head and neck region. They are most
      often seen in young adults and can become unusually large with few symptoms. A
      case is presented to demonstrate the slow, expansive growth pattern and
      relatively painless swelling in the floor of the mouth that occurred over a 9
      year period.

PMID- 8488021
TI  - Osteochondroma of the coronoid process of the mandible. Report of a case and
      review of the literature.
AB  - A review of the literature and the addition of one case have revealed that, on
      the basis of strict histologic criteria, there are presently 30 published cases
      of osteochondroma of the coronoid process of the mandible. Twenty-one cases (70%)
      were men. Most osteochondromas developed before the age of 40 years. The lesions
      were mushroomlike in more than two thirds of the cases. Deformity of surrounding
      structures and facial deformity was found in most cases. The surgical approach
      was intraoral in the majority of cases. None of the reported cases showed a
      recurrence.

PMID- 8488022
TI  - Central hemangioma of the mandible.
AB  - Central hemangioma of the mandible is a relatively rare condition; when it
      occurs, the clinical and radiographic presentation are often nonspecific. A
      proper diagnosis can be made with a high level of clinical suspicion, and imaging
      studies such as angiography can confirm the suspicion that a vascular lesion
      exists and can contribute valuable information to the preoperative data base. We
      report three cases of central hemangioma of the mandible demonstrating the
      variability of signs and symptoms and review the various treatment alternatives
      in the literature. We suggest that the treatment of choice for this entity is
      surgery, including reconstruction as necessary.

PMID- 8488023
TI  - McCune-Albright syndrome. Report of a case.
AB  - The McCune Albright syndrome is seldom encountered and rarely reported in dental
      literature. It represents a special category of polyostic fibrous displasia
      associated with skin pigmentation and endocrine disturbances. We describe the
      case of a 9-year-old boy with the McCune Albright syndrome, who was treated for a
      mandibular osteolytic lesion.

PMID- 8488024
TI  - Lobular adenocarcinoma of breast metastatic to the mandibular condyle. Report of
      a case and review of the literature.
AB  - A case of metastatic breast adenocarcinoma to the condyle in a 55-year-old white
      woman is reported. Highlights of this case presentation include the rarity of
      reported metastatic lesions to the condyle, a negative bone scan 2 months before
      the bone biopsy, the existence of a pathologic fracture as the only persistent
      symptom of the lesion, initial symptoms suggestive of temporomandibular joint
      disorder, and the uncommon type of breast carcinoma.

PMID- 8488025
TI  - A case of acromegaly identified after patient complaint of apertognathia.
AB  - Acromegaly results from the over production of growth hormone after the age at
      which the epiphyses of the bones have fused. The most common cause is an adenoma
      of the anterior pituitary gland. Early signs and symptoms are subtle and delayed
      diagnosis is common. The health consequences of untreated acromegaly are
      considerable. A brief description of the condition is given and a case report is
      included. The condition of the patient was first diagnosed after a dental
      examination at which he voiced a complaint of the inability to incise and a
      progressive open bite that he attributed to prosthetic treatment. On the basis of
      his intraoral radiograph history, it is probable that he developed the disease
      more than 5 years before its diagnosis.

PMID- 8488026
TI  - Perineural spread of squamous cell carcinoma involving trigeminal and facial
      nerves.
AB  - Perineural spread of squamous cell carcinomas in the orofacial region
      predominantly involves the trigeminal and facial nerves. Central spread,
      particularly along the trigeminal nerve, produces sensory impairment and
      involvement of other divisions through invasion of the gasserian ganglion, as
      illustrated in these case reports. Early diagnosis and medical referral is
      important because central invasion has a poor prognosis.

PMID- 8488027
TI  - Verruciform xanthoma in a bone marrow transplant recipient.
AB  - The verruciform xanthoma is an uncommon benign condition of uncertain cause that
      affects either mucosa or, less commonly, skin. Most lesions are solitary, and
      most have been reported to involve the oral mucosa. In some instances, chronic
      damage to the lesional site has been identified. This report describes a
      verruciform xanthoma that developed on the lower vermillion zone of the lip of a
      young person who had undergone allogeneic bone marrow transplantation for acute
      lymphoblastic leukemia. To our knowledge, this is the first reported case of this
      lesion occurring in a bone marrow transplantation patient. We speculate that
      immunologically mediated damage to the patient's epithelium in this area may be
      related to the pathogenesis of the lesion.

PMID- 8488028
TI  - Effects of dietary gluten elimination in patients with recurrent minor aphthous
      stomatitis and no detectable gluten enteropathy.
AB  - Fifty patients with a history of minor recurrent aphthous stomatitis were entered
      into a 6-month double-blind controlled trial of a gluten-free diet. After
      hematologic and biochemical investigations and jejunal biopsy, one half of the
      group was given a gluten-free diet; the other half served as controls and
      received a gluten-free diet supplemented by gluten given blind (control diet).
      Twenty-three patients completed the trial, 11 patients on a gluten-free diet, 12
      on the control diet. Four of the 11 on the gluten-free diet and 7 of the 12 on
      the control diet reported significant benefit in terms of minor recurrent
      aphthous stomatitis, but there was no statistical difference between the
      responses. The results fail to support studies that report widespread benefit in
      aphthae of gluten withdrawal and suggest simply a marked placebo response in the
      condition.

PMID- 8488029
TI  - Tooth enamel dust as an asthma stimulus. A case report.
AB  - A case report of a first-year dental student with asthma, who experienced
      exacerbation of symptoms and a severe asthmatic crisis in the course of her
      preclinical dental training, is presented. Dust generated as a result of
      preparing natural teeth triggered the bronchoconstrictive response. Her
      subsequent medical and preventive measures are cited. This case identifies, for
      the first time, enamel dust as an asthma stimulus, thus serving as a precaution
      to prospective dental students and personnel afflicted with the disease and
      emphasizing the importance of effective face masks in dental laboratories during
      dust-generating procedures.

PMID- 8488030
TI  - Embryogenesis of enterocystomas-enteric duplication cysts of the tongue.
AB  - Enteric duplication cysts of the tongue are unusual lesions that may be confused
      with dermoid cysts, hemangiomas, lingual thyroid remnants, ranulas, and cystic
      hygromas. Two cases of lingual enteric duplications are reported in a 5-year-old
      boy and a 4-month-old boy. In the first case the cyst was lined by gastric-type
      epithelium, and in the second by colonic-type epithelium. Theories of
      pathogenesis of enteric duplications include development from small epithelial
      inclusions trapped during fusion of primordial tissues, from incomplete
      coalescence of lacunas that form between epithelial cells of the solid core of
      the developing gut, from persistence of epithelial buds within the wall of the
      bowel, or from nests of trapped entodermal cells. However, each of these theories
      presents problems with respect to lingual enteric cysts, as possible trapping of
      epithelium by fusing primordia does not explain the presence of heterotopic
      mucosa, and the tongue does not develop in the same manner as the hollow viscera.
      It becomes apparent therefore that enteric duplication cysts are a heterogeneous
      group of lesions that share some morphologic features, but perhaps not the same
      pathogenesis.

PMID- 8488031
TI  - Radiation-induced cancer risk in radiographic cephalometry.
AB  - The carcinogenic risks associated with the cephalometric x-ray techniques
      customarily used in orthodontics and oral surgery have been estimated. Lateral,
      posteroanterior, 45 degrees oblique, lateral temporomandibular joint tomography,
      basilar techniques, and commonly-used combinations were examined. Data reported
      in a previous article on doses absorbed by pituitary (brain), salivary, and
      thyroid glands were used to calculate increased risk over normal incidence using
      the BEIR V model. The findings are expressed in a number of graphs. Tables list
      the estimated percentage increase in carcinomas for several of the most often
      used cephalometric procedures, and compare these with the more common complete
      mouth (periapical) and panoramic surveys. The overall conclusion is that
      responsible use of cephalometric radiology adds very little to the person's
      carcinogenic burden.

PMID- 8488032
TI  - Effects of region of interest outline variations on gray-scale frequency
      distributions for alveolar bone.
AB  - Normalized cumulative percentage gray-scale distributions from digitized
      radiographs of dry skulls can be used to evaluate alveolar bone health. With this
      method, manually defined regions of interest are used to identify the area of the
      image to be analyzed. The purpose of this study was to determine if variations in
      the dimensions of the regions of interest affect the gray-scale distributions.
      Two approaches were used. The effect of region of interest outline variations on
      (1) the ability to differentiate between various sized bone chips and (2) the
      ability to distinguish between two groups of skulls with the alveolar bone
      subjectively rates as normal or diseased were investigated. Four different
      regions of interest, which consisted of outline and area variations to a basic
      region, were used. Ninety-one percent of the cumulative histograms that
      represented chips were sufficiently separated from nonchip plots to be
      distinguished. Bone health was correctly assessed with a numeric classifier for
      37 of 44 quadrants, for an accuracy of 84%, a specificity of 79%, and a
      sensitivity of 90%. Although ROI size and shape consistency in longitudinal
      studies are important in radiometric analyses, small variations had minimal
      impact in this study.

PMID- 8488033
TI  - Maxillary alveolar bone imaging. Wiener filter design.
AB  - Optimal digital filter design is essential for noise suppression in the detection
      of subtle radiographic bony changes. The purpose of this study was to determine
      the signal (Ps) and noise (Pn) power spectra of sampled maxillary alveolar bone,
      to derive the optimal Wiener filter transfer function, H, from sets of Ps and Pn,
      and to quantify noise suppression through application of this filter. Sixteen
      standardized radiographs were made of five interproximal bony areas, each area
      from a separate dry human maxilla. The radiographs were digitized (0.02 mm/pixel
      resolution) and identical profiles (scan lines) generated between lead markers
      for each set of films. Ps was calculated from the averaged scan line of each set,
      Pn was calculated from the difference between the noisy images and the averaged
      scan line for each set, and an average maxillary H was calculated from the sets
      of Ps and Pn. Filtering of the 80 noisy sample radiographic profiles with H
      resulted in a 39% reduction in noise. Application of this digital filter should
      significantly improve detection of radiographic bony changes in the maxilla.

PMID- 8488034
TI  - Diagnostic value of bone scintigraphy in osteomyelitis of the mandible.
AB  - Thirty-five patients each with a tentative diagnosis of osteomyelitis of the
      mandible were examined with 99Tcm-labeled phosphorus compounds. The scintigraphic
      findings were compared with the radiographic features and related to disease
      stages to evaluate the diagnostic potential of bone scintigraphy in different
      disease stages. The scintigraphy was valuable to exclude bone tissue involvement
      in some patients with clinical signs and symptoms similar to those of
      osteomyelitis and with equivocal radiographic findings. In 13 patients with
      chronic osteomyelitis, scintigraphy revealed a larger extent of the lesion than
      the radiography. In lesions with permeated bone destructions with penetration of
      the cortex, the uptake of 99Tcm was higher than in lesions with a motheaten or
      sclerotic appearance. This study supports the view that 99Tcm-bone scintigraphy
      is a useful tool at various stages of osteomyelitis, that is, in its early
      detection, in the treatment or biopsy planning, and in the evaluation of the
      efficacy of treatment.

PMID- 8488035
TI  - Pathologic deviation of the parotid duct.

PMID- 8488036
TI  - Bilateral hypoplasia of mandibular condyles in Hurler's syndrome.

PMID- 8488037
TI  - Bullet discovered on a panoramic radiograph.

PMID- 8488038
TI  - Swallowed hypodermic needle in the stomach.

PMID- 8488039
TI  - Quality measurement, management, and reimbursement in today's health care
      environment.

PMID- 8488040
TI  - Quality, cost, and the public's right to know: what is needed to make informed
      decisions?

PMID- 8488041
TI  - Outcomes are in the eye of the "health seeker".

PMID- 8488042
TI  - The leader's role in implementing quality improvement: walking the talk.

PMID- 8488043
TI  - Overcoming the barriers to implementation of TQM/CQI in hospitals: myths and
      realities.
AB  - Many health care organizations are attempting to rapidly implement total quality
      management (TQM) and continuous quality improvement (CQI) philosophies and
      concepts. In the case of hospitals, a number of issues resulting from traditional
      organizational design and management practices as well as the characteristics of
      health care professionals pose significant challenges to rapid implementation.
      Recognizing and developing strategies to address these challenges, along with
      realizing that TQM and CQI represent viable processes for conducting
      organizational "preventive maintenance," may help in changing the focus of
      quality assessment and enhancement initiatives from processes that are "broken"
      to processes that should be "fixed" before they "break." This article discusses
      strategies for overcoming some of the major barriers and challenges to successful
      TQM and CQI implementation to the hospital setting.

PMID- 8488044
TI  - Patients' good and bad surprises: how do they relate to overall patient
      satisfaction?
AB  - The literature documents little research regarding patients' good and bad
      surprises in the hospital. Such experiences may inform a patient's future
      decisions about recommending or returning to the hospital. Utilizing a database
      of survey respondents, the authors conducted qualitative and quantitative
      analyses of patients' self-reported surprises about their hospital stay and the
      relationship between those surprise experiences and their overall feelings of
      satisfaction. Analysis of these data shows that patients do experience surprises
      during their hospital stays, that specific events are associated with these
      surprises, and that these surprises influence patient satisfaction. These results
      suggest that in order for health care providers to continuously improve and meet
      patients' needs and expectations, providers must determine steps to take to
      delight their patients, to avoid patient disappointments, and to meet patients'
      basic expectations.

PMID- 8488045
TI  - Too many managers: major threat to CQI in hospitals.
AB  - Some hospitals are rushing into continuous quality improvement (CQI) without
      understanding the pitfalls, one of which is the issue of empowerment. To prevent
      middle managers from inappropriately reinvolving themselves in the activities of
      empowered front-line workers, empowerment of employees must be accompanied by a
      substantial decrease in the number of middle managers. Despite its importance,
      however, this move is rarely undertaken for two reasons: first, a failure to
      analyze management "spans of control" in the context of empowerment; second, the
      fear that staff reductions will imperil the CQI implementation. This article
      presents case studies of effective and ineffective management to demonstrate that
      without span of control adjustments, empowerment will fail, whereas appropriate
      adjustments will allow it to succeed even beyond expectations.

PMID- 8488046
TI  - Debating Medicare participation.

PMID- 8488047
TI  - Questioning KePRO's methods.

PMID- 8488048
TI  - What physicians need to know: new state CON law.
AB  - In past years, Pennsylvania's certificate of need law applied mostly to hospitals
      and other health care institutions. But the commonwealth's new law also targets
      physicians--especially those planning to establish MRI or ambulatory surgical
      facilities.

PMID- 8488049
TI  - A matter of cost control: comparing priorities for Pennsylvania.

PMID- 8488050
TI  - Physicians speak out on reform concerns.
AB  - Physicians have taken an aggressive role testifying at hearings on a health care
      reform plan proposed late last year by the governor's Economic Development
      Partnership (EDP). The State Society has offered substantial support to those
      physicians and closely monitored each event. This article briefly overviews the
      proposed plan and includes excerpted testimonies submitted to the EDP by four
      concerned physicians.

PMID- 8488051
TI  - Society endorses AIDS guidelines.

PMID- 8488052
TI  - Building blocks of the public health system. Interview by Juli C. McGreevy.

PMID- 8488053
TI  - Protecting your practice from insurance defaults.

PMID- 8488054
TI  - Self-referral: a matter of ethics?

PMID- 8488055
TI  - [Species of the genus Koellikeria--parasites of Pacific Ocean sea breams].
AB  - Rediscriptions and original figures of the trematodes Koellikeria filicollis and
      K. shimai, parasites of sae breams (Brama brama, B. japonica) from the Pacific
      with the data on localization and distribution of these species, have been given.
      K. filicollis is a very polymorphic form, which changes during its development.
      Didymozoon shimai Pozdnyakov, 1985 is transferred to the genus Koellikeria.

PMID- 8488056
TI  - [The effect of temperature and lighting on the biology of Philophthalmus rhionica
      (Trematoda) miracidia].
AB  - The influence of temperature and illumination on the process of mature eggs
      production from the uterus of adults of Philophthalmus rhionica and on the
      hatching of miracidia has been investigated. Illumination in contrast to the
      temperature does not play a great role. The temperature factor also defines the
      larvae duration life and the velocity of their swimming and has some influence on
      the invasiability of miracidia, which is enhanced with heating. The data received
      does not confirm the position of Semenov (1977) that in the presence of
      simultaneous influence of light and temperature the influence of the former
      factor upon the infection of the fresh-water mollusk Melanopsis praemorsa is more
      significant.

PMID- 8488057
TI  - [The population level and distribution of ectoparasites in carp].
AB  - The abundance and the distribution of Dactylogyrus extensus and Ichthyophthirius
      multifiliis on gills of two-years old carps have been investigated. It has been
      established that at least there are five groups, which differs from each other on
      the asymmetry of infection.

PMID- 8488058
TI  - [Specialization, progress and regress in endoparasites].

PMID- 8488059
TI  - Microtubular organization visualized by immunofluorescence microscopy during
      erythrocytic schizogony in Plasmodium falciparum and investigation of post
      translational modifications of parasite tubulin.
AB  - We describe a novel procedure for the immunofluorescent investigation of
      Plasmodium falciparum. This has allowed us to visualize clearly microtubular
      structures and their changing conformation through the erythrocytic cell-cycle,
      to the stage of cytodifferentiation leading to merozoite release. The images of
      spindle development we observed, together with an analysis of nuclear body
      numbers in large numbers of parasites, indicate that there is an apparent
      asynchrony in chromosomal multiplication within a single parasite. Using
      antibodies specific for post-translational modification of alpha-tubulin, we also
      demonstrate that the C-terminal tyrosine-containing epitope of P. falciparum
      alpha-tubulin I is similar to that of other organisms. Lysine-40 in the same
      molecule, a target for highly specific in vivo acetylation in some organisms, is
      unmodified in the blood stages we examined here. After in vitro acetylation of
      this residue, however, the epitope to which it contributes was recognized by
      antibody, showing that the conformation of this part of the molecule is also
      conserved, despite a lack of primary sequence homology immediately downstream of
      the target lysine residue.

PMID- 8488060
TI  - The effect of Giardia lamblia trophozoites on trypsin, chymotrypsin and amylase
      in vitro.
AB  - Giardia lamblia localize and multiply in the small intestine and may cause acute
      or chronic diarrhoea with malabsorption of fat, protein and other nutrients.
      Abnormal pancreatic function has been documented in giardiasis and trophozoites
      directly inhibit pancreatic lipase activity in vitro. The aim of this study was
      to examine the effect of Giardia trophozoites on pancreatic trypsin, chymotrypsin
      and amylase activity in vitro. Axenically cultured Giardia trophozoites (Portland
      1 stock) were incubated with a range of concentrations of trypsin, chymotrypsin
      and amylase and enzyme activity assayed over time. Tryptic activity was decreased
      after incubation with Giardia trophozoites. This reduction was time dependent and
      linear over the incubation period of 2 h. At a trypsin concentration of 18 BAEE
      units/ml, there was a 35.5 +/- 4% reduction in enzyme activity after 2 h compared
      to controls. The total amount of activity lost was proportional to the initial
      trypsin concentration up to 185 BAEE units/ml. At this initial concentration, the
      activity was reduced by 46.5 +/- 3 units/ml after 2 h. Above this concentration,
      little further loss of enzyme activity was seen. To investigate the nature and
      specificity of this effect, similar experiments were conducted using killed
      trophozoites and with a related protozoan, Trichomonas vaginalis. No loss of
      enzyme activity was evident. Media previously incubated for 2 h with trophozoites
      did not diminish tryptic activity. Trophozoites had no effect on chymotrypsin or
      amylase activities over the range of concentrations tested.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8488061
TI  - In vitro isolation and characterization of a Neospora sp. from aborted bovine
      foetuses.
AB  - A Neospora sp. was isolated from the brains of two aborted bovine foetuses and
      grown continuously in vitro in bovine cell cultures. A comparison of the
      antigenic reactivity of in vitro cultivated tachyzoites with polyclonal antisera
      to Neospora caninum, Hammondia hammondi or Toxoplasma gondii revealed that the
      bovine protozoal isolates were similar to N. caninum and antigenically distinct
      from T. gondii. Tachyzoites of both bovine isolates had similar ultrastructural
      features, including an apical polar ring, conoid, electron-dense rhoptries and
      micronemes. The orientation of the micronemes, presence of micropores and a large
      number of electron-dense granules in the posterior portion of the bovine isolate
      tachyzoites differed from previous descriptions of N. caninum in vivo.
      Tachyzoites of the bovine isolates were ultrastructurally more similar to in
      vitro cultivated N. caninum tachyzoites than to tachyzoites of T. gondii or H.
      hammondi. The antigenic and ultrastructural similarities between N. caninum and
      the protozoal parasites isolated from aborted bovine foetuses in this study
      support the proposition that these parasites belong to the genus Neospora.

PMID- 8488062
TI  - Preliminary analysis of the transmission dynamics of Theileria parva in eastern
      Africa.
AB  - Two mathematical models are developed that investigate the transmission dynamics
      of Theileria parva by the ixodid tick Rhipicephalus appendiculatus to cattle in
      endemically stable areas. A method of estimating the rate of infection to cattle
      of T. parva at the endemically stable state is given. Empirical estimates of all
      the parameters in the model are available. The degree to which animals that have
      recovered from theileriosis (the 'carrier' state) are able to transmit the
      infection to tick nymphs or larvae is a crucial determinant of the dynamics of
      infection in a herd. Two control methods influencing the transmission of
      infection are considered--infection and treatment immunization and the reduction
      in tick feeding by acaricide application. The impact of each method on the
      transmission of infection is evaluated. Future developments and the data required
      to predict the dynamics of T. parva infections in cattle and ticks are discussed.

PMID- 8488063
TI  - Decoy effect and host infection by miracidia within snail communities.
AB  - The effect of experimental non-host snail (NHS) communities on the infection of
      Lymnaea truncatula with Paramphistomum daubneyi and Fasciola hepatica miracidia
      was studied. The results obtained indicated that NHS had variable effects on
      basic population parameters of host infection. Specifically, NHS were able to
      produce aggregation of sporocyst number/snail in the experimental host
      populations. Proposed hypotheses for decoy effect mechanisms failed to explain
      completely the experimental results. A new mechanism is suggested, based on a
      distance response of miracidia to snail chemo-attractants, to explain effects of
      NHS on miracidial host finding behaviour. It is assumed that miracidia have
      evolved the ability to discriminate among individual snail chemical attractants
      in a community already at a distance. This attribute of miracidial behaviour
      allows NHS to induce variations in the effectiveness of individual host
      localization by miracidia. The resulting aggregation of successful
      infections/host is assumed to be the specific component of snail decoy effect at
      the community level. It was also established that NHS affected trematode
      reproduction in the host inducing a compensatory increase in the intramolluscan
      population. Intraspecific competition among developmental stages is suggested to
      be the mechanism of this compensatory reaction.

PMID- 8488064
TI  - Field trials in the control of Opisthorchis viverrini with an integrated
      programme in endemic areas of northeast Thailand.
AB  - A control programme of opisthorchiasis was carried out for three years in three
      villages of northeast Thailand in order to compare the effectiveness of two
      intervention measures. The intervention measures employed were to give
      praziquantel treatment to all infected people either once (village I) or twice
      (village II) per year with the integration of regular health education and
      sanitation improvement. A control village (village III) received no intervention
      during the study. Sampling of the population in these villages to estimate
      prevalence, intensity, reinfection and incidence of infection as well as
      knowledge of opisthorchiasis and number of latrines was performed at 6 monthly
      intervals throughout the duration of the study. At the initial assessment, there
      were no significant differences in the prevalence and intensity of infection of
      villages I and II. Both values were greatly reduced when assessed 6 months after
      the initiation of treatment, and the decrease in prevalence and intensity of
      infection did not differ between village I and II. The control village (village
      III), during the first 2 years, exhibited slight variation in the prevalence and
      intensity, and these decreased considerably in the third year of the study. The
      reinfection rate per 6 months in villages I and II was nearly equal. The
      incidence rate per 6 months in the two treated villages was lower than that of
      the control village. Marked improvement in knowledge of opisthorchiasis,
      behavioural changes of eating raw fish and increased numbers of latrines was
      evident in all of the villages during this study.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8488065
TI  - An IgG (Fc gamma)-binding protein of Taenia crassiceps (Cestoda) exhibits
      sequence homology and antigenic similarity with schistosome paramyosin.
AB  - Previous studies from this laboratory have suggested the presence of antibody
      binding molecules on the surface of Taenia crassiceps metacestodes. We now report
      the purification of a T. crassiceps Fc gamma-binding protein which has an
      equivalent molecular size (96 kDa), is antigenically similar and exhibits
      significant amino acid sequence homology to schistosome paramyosin. The
      similarities in molecular weight of the T. crassiceps protein, Schistosoma
      mansoni paramyosin and antigen B of T. solium, the close amino acid sequence
      homologies between the T. crassiceps protein and S. mansoni paramyosin and
      between S. mansoni paramyosin and antigen B of T. solium, and the antigenic
      similarity of the T. crassiceps protein with paramyosin indicates that this
      family of platyhelminth proteins are closely related. The known characteristics
      of T. solium antigen B (collagen binding affinity; disruption of complement
      function) and the Fc gamma-binding activity of the T. crassiceps molecule
      suggests that this class of proteins may be multifunctional, fulfilling not only
      a structural role but also as components interacting with the host immune system
      to increase parasite survival.

PMID- 8488066
TI  - The expulsion of Echinostoma trivolvis: worm kinetics and intestinal
      cytopathology in conventional and congenitally athymic BALB/c mice.
AB  - The infectivity and distribution of Echinostoma trivolvis were studied in male,
      conventional and congenitally athymic nude mice, each infected with 30
      metacercarial cysts. In conventional mice, worm recoveries at 6 and 8 days post
      exposure were 58.3 and 54.0%, respectively. Worm recovery declined to 44.0% by
      day 10, to 4.3% by day 13, and 0% by day 17. In athymic mice, worm recoveries at
      6 and 8 days post-exposure were 61.7 and 36.3%, respectively. Worm recovery
      declined to 27.7% by day 10, to 0.7% by day 13, and 0% by day 17. The
      distribution of worms demonstrated a posteriad migration over time in both
      groups. Kinetic changes in the number of goblet and mucosal mast cells in the
      upper ileum of mice infected with E. trivolvis were examined. In conventional
      mice, the number of goblet cells increased rapidly to reach a peak at day 13 and
      then declined gradually. The number of goblet cells in athymic mice also
      increased to reach a peak at day 13, and then declined rapidly. However, the
      number of goblet cells in athymic mice was always less than that in conventional
      mice. The mast cell number in infected conventional mice increased rapidly to
      reach a peak at day 17 and then declined. There was no increase in the mast cell
      number of infected athymic mice throughout the experiment. Whereas common
      pathological changes occurred in the intestines of both mice groups infected with
      echinostomes some ultrastructural differences were observed in the gut epithelial
      cells of conventional versus athymic mice.

PMID- 8488067
TI  - Temporal changes in glucose and carbohydrate metabolism in the oncospheres of the
      cyclophyllidean tapeworm, Hymenolepis diminuta.
AB  - When incubated in vitro for 24 h, oncospheres of Hymenolepis diminuta absorb and
      metabolize radioactive glucose. Between 0 and 12 h post-activation, oncospheres
      absorb glucose, but glucose is neither metabolized into other carbohydrates nor
      incorporated into the ethanol-precipitable fraction (which would contain
      glycogen). Between 12 and 24 h post-activation glucose is incorporated into a
      number of higher molecular weight carbohydrates that are demonstrable in ethanol
      extracts of the larvae, as well as the incubation media. Furthermore, measurable
      amounts of radioactivity are incorporated into the ethanol-precipitable
      carbohydrate fraction of oncospheres. To determine if these temporal changes in
      carbohydrate metabolism occurred spontaneously following activation, oncospheres
      were pre-incubated for 12 h (0-12 h post-activation) in the absence or presence
      of glucose, and then transferred to media containing radioactive glucose for an
      additional 12 h (12-24 h post-activation). In these latter experiments, glucose
      absorption and metabolism between 12 and 24 h post-activation were virtually
      identical to glucose metabolism in oncospheres that were incubated in radioactive
      glucose for 0-12 h immediately following activation. Thus, these data do not
      support the hypothesis that the temporal shift in carbohydrate metabolism occurs
      spontaneously.

PMID- 8488068
TI  - Intestinal helminth communities of the long-finned pilot whale (Globicephala
      melas) off the Faroe Islands.
AB  - The intestines of 170 long-finned pilot whales, Globicephala melas, caught off
      the Faroe Islands (N.E. Atlantic) were examined for helminth parasites. Eight
      species were detected but only 4 occurred in at least 10% of the sample. No core
      or recurrent group of species were identified and no correlations between
      abundances of species were significant. Diversity values were far below those
      reported for other endotherms. Colonization by helminths was random, whales not
      being readily colonized. These features point to largely unpredictable,
      isolationist infracommunities, there being little potential for inter-specific
      interactions. Older hosts tended to harbour more diverse infracommunities,
      offering more opportunities for such interactions. Two hypotheses, which might
      also apply to other cetaceans, are proposed to account for the depauperate
      helminth communities of the pilot whale: (i) some ancestral helminth species
      failed to adapt their cycles to the marine habitat and (ii) the hosts' isolation
      from land prohibited new infections with helminths of mammals.

PMID- 8488069
TI  - Aquatic pollution: effects on the health of fish and shellfish.
AB  - As there is little evidence of pollution affecting the health of fish and
      shellfish on a global scale, this paper attempts to put into perspective the
      pollution/fish disease relationship by reviewing examples of studies and reports
      in the historic and current literature. Although there is no dispute that
      pollution can affect the aquatic organisms under laboratory conditions and may be
      responsible for the decline of populations of such animals in some inland waters
      and some estuaries, most of the evidence for pollution causing or increasing
      disease in fish in open waters is circumstantial. Historical data proves that
      almost all fish and shellfish diseases known today have been described since the
      end of the last century. However, it is also known that water pollution,
      especially in inland waters, has for the past 400-500 years been the result of
      urbanization and industrialization. This has resulted in some major rivers
      becoming devoid of or deficient in fish stocks. The concern that pollution may
      influence the health status of fish and shellfish stocks has increased over the
      past 20 years. Initial attention was paid to epidermal diseases, including fin
      rot in demersal fish, and protozoan diseases in molluscs in the heavily polluted
      bays and estuaries in North America. As the interest in this subject spread, it
      became political, and often controversial, especially amongst the North Sea
      countries. The disagreements have largely been settled amongst scientists because
      international bodies, such as the International Council for Exploration of the
      Sea (ICES), established workshops to investigate sampling methods and disease
      reporting techniques. Recommendations from those workshops have contributed to
      some form of standardization for field work and the subject, although largely
      subjective, has some objective approaches which are described. As there are
      variable, interacting biological and physical influences in the aquatic
      environment, it is difficult to establish the background prevalences of diseases
      in populations of fish and shellfish. Examples of the influences of climatic
      changes are presented, and these show that short-term catastrophes can be
      directly related. However, a more long-term problem is water acidification
      resulting largely from anthropogenic activities. In parts of Scandinavia this
      has, and is, leading to decimation of fish stocks in inland waters. In general,
      diseases in fish and shellfish are very localized, but there is concern amongst
      scientists that certain cancers, especially liver tumours, occurring in demersal
      fish inhabiting polluted estuarine and coastal waters, are related to the release
      of chemicals, e.g. hydrocarbons, pesticides and heavy metals.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8488070
TI  - Depletion of the ozone layer: consequences for non-infectious human diseases.
AB  - Stratospheric ozone depletion threatens to increase exposure to ultraviolet (UV)
      radiation which is known to be a factor in a number of diseases. There is little
      doubt that cumulative exposure to UV radiation is important in the aetiology of
      non-melanoma skin cancers. Evidence is also strong for a link with cutaneous
      malignant melanoma, although here it appears to be intermittent intense exposure
      that is most damaging. More controversial is the view that exposure to solar
      radiation is a significant factor in ocular damage, particularly in the formation
      of cataracts. Earlier studies pointing to such an effect have been criticized and
      alternative aetiological hypotheses have been proposed. However, other studies do
      show an effect of UV exposure on cortical cataract. Concern is also growing that
      UV may be capable of activating viruses and have immunological effects that might
      exacerbate infectious disease. Very worrying is the possibility that UV exposure
      can activate the human immunodeficiency virus which might accelerate the onset
      AIDS. Any such health effects that have been observed in human populations are
      the result of exposure to existing, naturally occurring levels of UV radiation.
      There is, therefore, great concern about the possible exacerbation of these
      impacts as a result of increased exposure to UV radiation associated with
      stratospheric ozone depletion. However, any assessment of the nature and scale of
      such impacts on human health has to deal with several major problems and these
      are the focus of this paper. There are uncertainties about recent trends in
      stratospheric ozone and problems in the prediction of future changes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488071
TI  - Mankind and plants: the need to conserve biodiversity.
AB  - Only green plants can convert the single carbon units of atmospheric carbon
      dioxide into the multi-carbon organic molecules on which all forms of life
      depend. Only green plants can provide the oxygen required by man and other
      aerobic organisms. In addition to his basic need for preformed organic molecules
      and oxygen, man also depends on plants to provide him, directly or indirectly,
      with an array of specific compounds such as vitamins and essential amino acids.
      Inadequate supplies of these may hinder growth and development or give rise to
      well defined deficiency diseases. At the present time information concerning the
      distribution and concentrations of such essential nutrients in plants is largely
      restricted to those plants that are already used as human foods. Nothing or
      virtually nothing is known about the chemical composition of approximately 250
      000 wild and little-used species. Amongst these there may be many that could
      provide us with cheap and plentiful new sources of essential nutrients that could
      be of enormous benefit to those suffering not only from full-blown deficiency
      diseases but also suffering sub-normal health due to partial deficiencies. The
      destruction of much of the world's wilderness areas has already deprived us of
      the opportunity to evaluate the contributions that a great many plant species
      might have made towards the elimination of deficiency diseases. Many plants used
      as human foods contain compounds that are toxic to man. If intake is sufficiently
      high, these toxins may cause disease. Breeding programmes designed to eliminate
      toxins from crops species or reduce their concentrations to acceptable levels
      depend on genetic variability within the species or the possibility of producing
      hybrids with the desired characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488072
TI  - Global warming: trends and effects.
AB  - As animals we have been a remarkably successful species; but also as animals we
      are vulnerable to environmental, in particular climate change. Such change is
      accelerating as a result of human activity, and global warming may already be
      taking place. Although we can foresee the trends, we cannot yet be specific about
      the results. Change usually proceeds by steps rather than gradients. But warming
      would probably include new risks to human health and contribute to an increase in
      human displacement. Of course climate change is only one among other complex
      problems facing human society, but it is closely related to them all, including
      population increase, environmental degradation and loss of biodiversity. We
      cannot prevent global warming but we can anticipate and mitigate some of its
      worst effects. Peoples and governments still need persuading of the need for
      action and of the magnitude of the issue at stake.

PMID- 8488073
TI  - Deforestation: effects on vector-borne disease.
AB  - This review addresses changes in the ecology of vectors and epidemiology of
      vector-borne diseases which result from deforestation. Selected examples are
      considered from viral and parasitic infections (arboviruses, malaria, the
      leishmaniases, filariases, Chagas Disease and schistosomiasis) where disease
      patterns have been directly or indirectly influenced by loss of natural tropical
      forests. A wide range of activities have resulted in deforestation. These include
      colonisation and settlement, transmigrant programmes, logging, agricultural
      activities to provide for cash crops, mining, hydropower development and fuelwood
      collection. Each activity influences the prevalence, incidence and distribution
      of vector-borne disease. Three main regions are considered--South America, West &
      Central Africa and South-East Asia. In each, documented changes in vector ecology
      and behaviour and disease pattern have occurred. Such changes result from human
      activity at the forest interface and within the forest. They include both
      deforestation and reafforestation programmes. Deforestation, or activities
      associated with it, have produced new habitats for Anopheles darlingi mosquitoes
      and have caused malaria epidemics in South America. The different species
      complexes in South-East Asia (A. dirus, A. minimus, A. balabacensis) have been
      affected in different ways by forest clearance with different impacts on malaria
      incidence. The ability of zoophilic vectors to adapt to human blood as an
      alternative source of food and to become associated with human dwellings
      (peridomestic behaviour) have influenced the distribution of the leishmaniases in
      South America. Certain species of sandflies (Lutzomyia intermedia, Lu.
      longipalpis, Lu. whitmani), which were originally zoophilic and sylvatic, have
      adapted to feeding on humans in peridomestic and even periurban situations. The
      changes in behaviour of reservoir hosts and the ability of pathogens to adapt to
      new reservoir hosts in the newly-created habitats also influence the patterns of
      disease. In anthroponotic infections, such as Plasmodium, Onchocerca and
      Wuchereria, changes in disease patterns and vector ecology may be more difficult
      to detect. Detailed knowledge of vector species and species complexes is needed
      in relation to changing climate associated with deforestation. The distributions
      of the Anopheles gambiae and Simulium damnosum species complexes in West Africa
      are examples. There have been detailed longitudinal studies of Anopheles gambiae
      populations in different ecological zones of West Africa. Studies on Simulium
      damnosum cytoforms (using chromosome identification methods) in the
      Onchocerciasis Control Programme were necessary to detect changes in distribution
      of species in relation to changed habitats. These examples underline the need for
      studies on the taxonomy of medically-important insects in parallel with long-term
      observations on changing habitats.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488074
TI  - Monitoring trypanosomiasis in space and time.
AB  - The paper examines the possible contributions to be made by Geographic
      Information Systems (GIS) to studies on human and animal trypanosomiasis in
      Africa. The epidemiological characteristics of trypanosomiasis are reviewed in
      the light of the formula for the basic reproductive rate or number of vector
      borne diseases. The paper then describes how important biological characteristics
      of the vectors of trypanosomiasis in West Africa may be monitored using data from
      the NOAA series of meteorological satellites. This will lead to an understanding
      of the spatial distribution of both vectors and disease. An alternative,
      statistical approach to understanding the spatial distribution of tsetse, based
      on linear discriminant analysis, is illustrated with the example of Glossina
      morsitans in Zimbabwe, Kenya and Tanzania. In the case of Zimbabwe, a single
      climatic variable, the maximum of the mean monthly temperature, correctly
      predicts the pre-rinderpest distribution of tsetse over 82% of the country;
      additional climatic and vegetation variables do not improve considerably on this
      figure. In the cases of Kenya and Tanzania, however, another variable, the
      maximum of the mean monthly Normalized Difference Vegetation Index, is the single
      most important variable, giving correct predictions over 69% of the area; the
      other climatic and vegetation variables improve this to 82% overall. Such
      statistical analyses can guide field work towards the correct biological
      interpretation of the distributional limits of vectors and may also be used to
      make predictions about the impact of global change on vector ranges. Examples are
      given of the areas of Zimbabwe which would become climatically suitable for
      tsetse given mean temperature increases of 1, 2 and 3 degrees Centigrade. Five
      possible causes for sleeping sickness outbreaks are given, illustrated by the
      analysis of field data or from the output of mathematical models. One cause is
      abiotic (variation in rainfall), three are biotic (variation in vectorial
      potential, host immunity, or parasite virulence) and one is historical (the
      impact of explorers, colonizers and dictators). The implications for disease
      monitoring, in order to anticipate sleeping sickness outbreaks, are briefly
      discussed. It is concluded that present data are inadequate to distinguish
      between these hypotheses. The idea that sleeping sickness outbreaks are periodic
      (i.e. cyclical) is only barely supported by hard data. Hence it is even difficult
      to conclude whether the major cause of sleeping sickness outbreaks is biotic
      (which, in model situations, tends to produce cyclical epidemics) or
      abiotic.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488075
TI  - Urbanization and human health.
AB  - Urbanization involves a physical change in which increasing proportions of
      populations live in urban settings, however defined. It also implies considerable
      changes in the ways in which these people live, how they earn their livelihoods,
      the food which they eat, and the wide range of environmental factors to which
      they are exposed. There is another underlying assumption that, increasingly,
      urban populations will be more healthy than their rural counterparts and that
      higher levels of urbanization will equate with better health status. This paper
      discusses some of the assumptions underlying this contention. It takes issue with
      certain of them, particularly the assumption that urbanization affects the health
      of all residents equally. It is manifestly evident that in many cities,
      particularly in the developing world, the poor are exposed to greater risks and
      have much lower health status than their richer neighbours. In addition, whilst
      urban residents may theoretically have a better access to health care and
      services than do residents in many rural areas, and whilst many indicators of
      health do appear better in more highly urbanized societies than ones less so,
      there are caveats. The paper introduces the concept of epidemiological
      transition, which suggests that, whilst life expectancy might be higher in many
      urbanized countries and in certain cities, the inhabitants are often merely
      suffering from different forms of ill-health, often chronic or degenerative,
      rather than infective. In certain cities in middle-income countries, residents,
      particularly the poor, are exposed to a double risk of both infection and chronic
      degenerative ailments. The paper concludes with a consideration of more general
      recent statements from the World Health Organization among others, on the impact
      of urbanization on health. The 'Healthy Cities' project is also discussed. WHO
      identifies a range of general determinants of urban health: physical, social,
      cultural and environmental. Many represent the by-products of modernization and
      especially industrialization. It is emphasized that urbanization, and the
      concentration of human beings into new areas in particular, can bring exposure to
      new risk factors for large numbers of people. The growth of infectious and
      parasitic disease in some urban settings must therefore be recognized, as must
      the emergence of chronic diseases, with the concomitant need for investment in
      new types of health and social care. However, a number of constraints militate
      against the achievement of improved urban health, especially in developing
      countries.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488076
TI  - Tumor-like intravascular proliferations of the stroma in adenomyosis.
AB  - Two hundred cases of adenomyosis have been studied in order to clarify the origin
      and significance of intravascular endometrial tissue in adenomyosis. A tumor-like
      intravascular proliferation of the adenomyotic stroma (IVSP) has been found in
      17.5% of the cases. An endolymphatic proliferation (35 cases) was occasionally
      accompanied by an intravenous proliferation (3 cases). IVSP originated from a
      perivascular stromal proliferation (PVSP) and occurred only in deep adenomyosis.
      IVSP was focal and showed no atypia. It was significantly most frequent in
      patients 50-53 years of age and more frequent in patients up to 53 years than in
      those over 53. The frequency of occurrence of PVSP and IVSP was related to the
      histologic features of adenomyosis and the endometrium and was highest in
      hyperplastic adenomyosis and in adenomyosis accompanied by hyperplasia of the
      endometrium. The study suggests that PVSP and IVSP develop in the areas of
      adenomyotic stroma stimulated by estrogen and nonresponsive to progesterone. The
      differential diagnosis of tumor-like and sarcomatous IVSP, and histogenesis of
      adenomyosis are discussed.

PMID- 8488077
TI  - Porphobilinogen deaminase activity in malignant proliferative disorders of the
      lymphatic system and bone marrow.
AB  - Porphobilinogen deaminase activity was studied in the erythrocytes of 73 women
      and 35 men with various malignant proliferative disorders of the lymphatic system
      and bone marrow, and, for comparison, in the erythrocytes of 34 women and 14 men
      with non malignant diseases of the haemopoietic system, and in those of 20
      healthy women and 20 healthy men. The activity of the enzyme was determined by
      the Hsiao et al. method, using porphobilinogen as a substrate. Statistical
      analysis showed a significant decrease of porphobilinogen deaminase activity in
      the erythrocytes of men with Hodgkin's disease and women with plasmocytoma and
      with myeloblastic leukemia; an increased activity of the studied enzyme was found
      only in men with lymphocytic leukemia.

PMID- 8488078
TI  - [Transmissible and non-transmissible brain amyloidoses: neurodegenerative
      disorders of different etiologies and the same pathogenesis].
AB  - I report here the molecular, ultrastructural and immunohistochemical similarities
      between transmissible (scrapie, Creutzfeldt-Jakob disease and Gerstmann
      Straussler-Scheinker syndrome) and non-transmissible (Alzheimer's disease,
      hereditary cerebral hemorrhage with amyloidosis--Dutch (HCHWA-D) and Icelandic
      (HCHWA-I) types) brain amyloidoses. The central pathogenic event in both types of
      amyloidoses is a synthesis and a processing of amyloid precursor followed by an
      accumulation of a final deposit. PrPc and APP are amyloid precursors and PrPsc
      and beta-A4 are final deposits in transmissible and nontransmissible cerebral
      amyloidoses of Alzheimer's disease type, respectively. In HCHWA-I, cystatin C
      serves the role of the amyloid precursor protein. The amyloid plaque composed of
      a different proportions of amyloid fibers, dystrophic neurites and astrocytes and
      microglia cells is the crucial neuropathological entity. The role of microglial
      cell as amyloid producer/processor cell seems to be analogous in both types of
      amyloidoses. The impairment of slow axoplasmic transport which leads to the
      accumulation of neurofilament triplet protein in the transmissible and tau
      protein in the non-transmissible cerebral amyloidoses causes the development of
      dystrophic neurites and neuropil threads. The other elements of neuropathology
      like Hirano bodies and granulovacuolar degeneration may be only secondary and non
      specific phenomena.

PMID- 8488079
TI  - [PATHOLOGIST --software package for database management systems in pathology].
AB  - This article summed up 4 years experiences in the creation and working with
      software package for collection, processing and storage of data in the form of
      standard database. Software package--PATHOLOGIST--can be implemented on
      microcomputer compatible with IBM PC. This package manages 92 relative databases
      in the order to gather all possible information about performed histological,
      cytological, immunological examinations as well as autopsy.

PMID- 8488080
TI  - Cytodiagnosis of Hodgkin's disease in bronchial brush smears.
AB  - A case of 65 years of old female in which Reed-Sternberg cells were found in
      brush specimens from bronchial mucosa is reported. Histopathologic specimens from
      bronchial mucosa and lymph nodes were estimated too. We would like to direct
      attention to the necessity differential diagnosis Reed-Sternberg cells with
      adenocarcinoma cells in brush specimens from bronchial mucosa.

PMID- 8488081
TI  - The malignant form of calcifying odontogenic cyst. A case report.
AB  - A rare case of the malignant form of Gorlin's cyst is reported in a 42-year-old
      woman. The neoplasm developed in the right maxilla, infiltrated the anterior wall
      and roof of the sinus and grew into the nasal cavity. Based upon literature data
      we characterized various clinical and histological forms of Gorlin's cyst
      (calcifying odontogenic cyst).

PMID- 8488082
TI  - Inflammatory pseudotumor of spleen.
AB  - A case of inflammatory pseudotumor of the spleen in a 78-years-old woman is
      presented. The diagnosis was established histologically. This is the ninth case
      of this rare entity described in the literature. The differential diagnosis of
      inflammatory pseudotumor especially with primary lymphoma of the spleen is
      discussed.

PMID- 8488083
TI  - Relation between cardiovascular pathologic conditions and malignant tumours as
      seen by pathologist. II. Myocardial infarct and coronary atherosclerosis in the
      population suffering from malignant neoplasm as seen by pathologist.
AB  - In the autopsy material of 2932 men and 3051 women the frequency of fresh
      myocardial infarct and the severity of coronary atherosclerosis were highly
      significantly lower in the population suffering from malignancies than in that
      free of cancer. Lower frequency of myocardial infarct seems to result from lower
      severity of coronary atherosclerosis. The incidence rate of myocardial infarct
      was also significantly lower in the cancer--bearing group when both compared
      populations showed identical, severe (grade 4) coronary atherosclerosis. This
      observation seems to indicate lesser contribution of coronary spasm in cancerous
      population and justifies the discussion of possible significance of EDRF
      (endothelium-derived relaxing factor) and catecholamines.

PMID- 8488084
TI  - Water handling in Caco-2 cells: effects of acidification of the medium.
AB  - Caco-2 cells were cultured on permeable supports. At confluence the minute-by
      minute net water movement (Jw) was automatically recorded. Simultaneously,
      unidirectional [14C]mannitol, 22Na+, and/or 36Cl- fluxes and transepithelial
      resistances were measured. The water and mannitol permeabilities went
      progressively down between 9 and 16 days after seeding and then stabilized. In
      this last condition the hydrostatic permeability coefficient (Phydr) was 2.67 +/-
      0.31 cm s-1 while the osmotic permeability coefficient (Posm) was 0.0017 +/-
      0.0004 cm s-1. Phydr but not Posm was dependent on the temperature and on the
      presence of Na+ in the medium. A net secretory Jw was observed 16 days after
      seeding, in the absence of any osmotic, hydrostatic or chemical gradient. This
      secretory Jw was associated with net Cl- (1.43 +/- 0.43 muequiv h-1 cm-2) and Na+
      (1.05 +/- 0.35 muequiv h-1 cm-2) secretions. Amiloride reduced, in open-circuit
      conditions, both Na+ and Cl- apical to basal fluxes, thus enhancing the net Na+
      and Cl- exit. Acidification of the medium (pH 6.2) reversibly increased water and
      mannitol permeabilities in 10-day-old cultures. In 16-day-old cultures the same
      shift in medium pH did not change mannitol permeability, while stimulating water
      secretion. These results, obtained in the absence of supracellular structures
      (villae, crypts) and subepithelial components (muscular, vascular and conjunctive
      tissues) indicate that paracellular and transport-associated water pathways are
      sensitive to changes in the pH of the medium in Caco-2 cell layers.

PMID- 8488085
TI  - A force transducer and a length-ramp generator for mechanical investigations of
      frog-heart myocytes.
AB  - An apparatus for studying the mechanics of isolated frog heart myocytes is
      described. The cells are held horizontal in a through of Ringer solution by means
      of two suction micropipettes. Myocyte force is measured with an opto-electronic
      system recording the deflection of the tip of one micropipette, which acts as a
      cantilever force probe. The force probes are selected for compliance according to
      the force a myocyte is expected to develop in a given condition, so as to limit
      myocyte shortening during force development to no more than 1% of the slack
      cellular length (l0). The other micropipette, which is stiff relative to the
      forces measured, is mounted on an electromagnetic-loudspeaker motor by which
      controlled-velocity length changes, of preset size and in either direction, are
      imposed on myocytes. The force transducer has a sensitivity of 5-10 mV/nN, with a
      frequency response of 700-900 Hz in Ringer solution and a resolution of 0.5-1 nN.
      The motor with a suction micropipette can complete controlled-velocity length
      ramps within 1.5-2.0 ms, across a range of +/- 100 microns at a resolution of 8.0
      nm. These values correspond, for frog-heart myocytes 200 microns and 400 microns
      long, to 25%-50% l0 and 0.002%-0.004% l0 respectively.

PMID- 8488086
TI  - Temporal response properties of lumbar-projecting vestibulospinal neurons to roll
      tilt in decerebrate cats.
AB  - In decerebrate cats, rotation about the longitudinal axis of the animal, leading
      to sinusoidal stimulation of labyrinth receptors, produces a tonic contraction of
      limb extensors during side-down tilt (alpha responses) and of dorsal neck
      extensors during side-up tilt (beta responses). These changes in posture are
      mediated, at least in part, by lateral vestibular nucleus (LVN) neurons, with
      response characteristics to stimulation of macular and/or canal receptors that
      have so far been evaluated at the level of either unidentified vestibulospinal
      (VS) neurons or vestibulo-collic neurons projecting to the upper cervical cord.
      In the present study we investigated the dynamics of the responses of VS neurons
      projecting to the lumbosacral segments of the spinal cord to increasing
      frequencies of tilt (from 0.026 to 0.32 Hz, +/- 10 degrees). All the recorded
      units showed an average phase lead with respect to position of +25.6 +/- 5.5
      degrees (SE) at the tilt frequency of 0.026 Hz. Most of these neurons (n = 32)
      were particularly activated during side-down tilt (alpha responses) and showed
      either a stable phase or an increase in phase lead of the responses with
      increasing frequency of tilt. At the tilt frequency of 0.026 Hz, the smaller the
      phase lead of the responses, the larger was the response gain. Moreover, the
      smaller the phase lead of the responses at that frequency of tilt, the smaller
      the increase in gain but the larger was the increase in lead of the responses
      obtained by increasing the stimulation frequency up to 0.32 Hz. Through this set
      of finely organized changes in unit response characteristics, the overall output
      of this population of neurons increased, while the phase angle of the responses
      reached the mean value of +64.9 +/- 2.6 degrees (SE), thus becoming more related
      to the velocity than to the positional signal. The remaining units (n = 7), which
      were mainly activated during side-up tilt (beta responses), displayed an increase
      in phase lag of the responses to increasing frequency of stimulation, which
      reached the mean value of -118.9 +/- 14.5 degrees (SE) at 0.32 Hz. The
      differences in the dynamic properties of these VS neurons projecting to the
      lumbosacral cord, with respect to those of previously recorded populations of VS
      neurons, are discussed.

PMID- 8488087
TI  - Intracellular ADP activates ATP-sensitive K+ channels in vascular smooth muscle
      cells of the guinea pig portal vein.
AB  - Vasodilatation following tissue ischemia is assumed to partially result from
      activation of ATP-dependent K+ channels (KATP). To assess the effect of cytosolic
      adenosine nucleotides, the balance of which depends on tissue pO2, on KATP, we
      have measured steady state outward currents (SSC) by the whole-cell clamp
      technique in smooth muscle cells of the guinea pig portal vein at different
      concentrations of ATP and ADP in the pipette solution. Glibenclamide, a selective
      inhibitor of KATP, was used as a pharmacological tool. With no nucleotides in the
      pipette solution (Ca(2+)-free), the SSC determined at +20 mV was unaffected by
      glibenclamide, while with 0.1 mM ATP or with 0.1 mM ADP, the SSC exhibited a
      glibenclamide-sensitive component indicating activation of KATP. At 5 mM ATP and
      no ADP, hardly any effect of glibenclamide on the SSC was detected, suggesting
      inhibition of KATP by this high concentration of ATP. With 0.1 mM ADP at 5 mM ATP
      however, activation of KATP was achieved. At 10(-7) M Ca2+ in the pipette
      solution, an increased SSC was measured, but the responses to the nucleotides
      and/or glibenclamide were not modified. These findings suggest that in vivo, ADP
      may be involved in the regulation of vascular KATP, linking tissue pO2 with
      vascular tone and tissue perfusion.

PMID- 8488088
TI  - An estimate of the calcium content of the sarcoplasmic reticulum in rat
      ventricular myocytes.
AB  - The aim of this paper was to estimate the Ca content of the sarcoplasmic
      reticulum (s.r.) and to compare this with the amount of Ca which enters the cell
      via the calcium current in systole. The s.r. Ca content was measured
      electrophysiologically in voltage-clamped rat ventricular myocytes. Rapid
      application of caffeine produced a transient increase of [Ca2+]i which was
      accompanied by a transient inward Na-Ca exchange current. The integral of this
      current gives a measure of the Ca2+ pumped out of the cell by Na-Ca exchange.
      Ni2+ (5 mM) inhibited the current and decreased the rate of fall of [Ca2+]i to
      32% of the control suggesting that Na-Ca exchange is responsible for 68% of Ca
      removal from the cytoplasm following the addition of caffeine. Correcting for the
      Na-Ca independent Ca removal suggests that the s.r. Ca content is equivalent to
      about 120 mumol per litre cell. Furthermore we estimate that, during systole, Ca
      entry into the cell via the sarcolemmal calcium current is equal to about 6% of
      the Ca content of the s.r.

PMID- 8488089
TI  - Contractile response of normotensive rat aorta to serum from salt-loaded Sprague
      Dawley rats.
AB  - Sprague-Dawley rats were made hypertensive by 6-week dietary salt loading with 8%
      NaCl in the diet and compared with control rats which had normal feed and water.
      At the end of this period, the salt-loaded group developed hypertension but the
      heart rate did not differ significantly from control. Serum taken from salt
      loaded rats showed enhanced vasoconstrictor effect on normal rat's aorta when
      compared with controls. This enhanced vasoconstrictor effect was attenuated by
      adrenergic receptor blockers but not by serotoninergic blockers. Thus salt
      loading may induce accumulation of vasoactive agents in the blood of rats.

PMID- 8488090
TI  - Inactivity induces muscle hypertrophy and redistribution of myosin isozymes in
      chicken anterior latissimus dorsi muscle.
AB  - Denervation of the anterior latissimus dorsi (ALD) muscle causes transient muscle
      fibre hypertrophy and leads to an increase of the SM1 myosin isoform. We tested
      whether the changes that take place after denervation can be attributed to loss
      of muscle activity which follows denervation. Neuromuscular activity was
      prevented by blocking the acetylcholine receptors with alpha-bungarotoxin and
      thereby paralysing the muscle. Following this treatment, we found increased
      muscle weight and pronounced hypertrophy of muscle fibres. Also, the proportion
      of SM1 isomyosin was decreased. Due to the multiple innervation of ALD muscle
      fibres it is possible to paralyze only part of the muscle. When only a region of
      the muscle was paralysed a local hypertrophy of fibres was detected, and the
      change from SM1 to SM2 was most pronounced in the area where activity was
      blocked. Removal of muscle activity resulted in changes similar to those that
      occurred after denervation.

PMID- 8488091
TI  - Simultaneous measurements of cytosolic pH and calcium interactions in bovine
      lactotrophs using optical probes and four-wavelength quantitative video
      microscopy.
AB  - The properties of pH and calcium homeostasis have been investigated in single
      bovine lactotrophs by the use of the fluorescent indicators 2',7'
      bis(carboxyethyl)-carboxyfluorescein (BCECF) and fura-2 respectively. A method of
      simultaneous recording from both dyes loaded in the same cell was used. Despite
      slight crosstalk between the two dyes, physiologically relevant information about
      the interrelationship between pH and calcium homeostasis was obtained. Three
      types of interactions were recorded. First, an increase in calcium due to the
      discharge of intracellular stores by thyrotropin-releasing hormone resulted in no
      change in cytosolic pH. Secondly, alkalinization by the addition of a weak base,
      NH4Cl, induced a large transient (around 1000 nM) and a small (a few tens of
      nanomoles per liter) sustained increase in cytosolic calcium. The former is
      partly due to release from agonist-sensitive stores. Thirdly, upon the removal of
      NH4Cl the cytoplasm became acidic, which induced a release of calcium from
      intracellular stores in some cells. In addition we demonstrate that the recovery
      from acid load is sensitive to extracellular Na+, suggesting the presence of
      Na+/H+ exchange mechanisms in bovine lactotrophs. Interestingly we have also
      found that, at rest, removal of Na+ from the bathing medium results in a decrease
      in resting [Ca2+]i, paralleled by a reduction in pHi. This suggests a role for
      Na+/H+ exchange in determining resting [Ca2+]i.

PMID- 8488092
TI  - Urea derivatives as tools for studying the urea-facilitated transport system.
AB  - The effects of urea structural analogues on the urea-facilitated diffusion system
      were examined in human red cell membranes (pink ghosts) and in antidiuretic
      hormone(ADH)-stimulated frog urinary bladder epithelia. In both tissues, urea
      permeability (P(urea)) was dramatically but reversibly inhibited by a number of
      urea analogues, such as 1-(3,4-dichlorophenyl)-2-thiourea (DCPTU). This urea
      derivative reduced the urea flux in a dose-dependent manner (90% inhibition of
      P(urea) at 0.5 mM concentration of DCPTU). With the aim of obtaining irreversible
      markers of red cell and urinary bladder urea transport systems, urea derivatives
      were modified by addition of an azido residue (N3) and preliminary experiments of
      photoaffinity labelling were carried out. Two synthetic urea derivatives: 1-(3
      azido-4-chlorophenyl)-2-thiourea (ACPTU) and 1-(3-azido-4-chlorophenyl)-3-methyl
      2-thiourea (Me-ACPTU) were shown to be very potent inhibitors of P(urea) when
      used in the absence of light, with IC50 values 60.3 microM and 31.6 microM
      respectively, as measured in frog urinary bladder. Both these molecules appeared
      to bind covalently to the urea carrier in both frog urinary bladder and human
      pink red cell ghosts, when illuminated in the presence of the tissue: the urea
      flux, which fell to 30-70% of the value obtained in the presence of ADH after
      inhibitor addition, remained low after the preparation had been illuminated for
      30 min and the inhibitor removed. These results provide an interesting approach
      to the urea carrier analysis, particularly to the urea or urea analogue binding
      site on the transport protein.

PMID- 8488093
TI  - Effect of starvation on neutral amino acid transport in isolated small-intestinal
      cells from guinea pigs.
AB  - The effects of starvation on neutral amino acid transport were examined in
      isolated enterocytes. Starvation stimulated L-alanine transport by the Na(+)
      dependent system A and the Na(+)-independent system L without producing any
      changes in either the Na(+)-dependent systems ASC or the passive non-mediated
      uptake. Starvation produces a twofold increase in Vmax of system A without any
      change in Kt. Starvation produces an increase in Vmax of system L of 1.7 times
      without any change in Kt. Activation of systems A and L by starvation was
      reversible with subsequent refeeding. The effects of a series of amino acids on
      systems A and L were evaluated. A different inhibition pattern was found in
      starved animals as compared to controls. Starvation increases Na(+)-dependent L
      alanine uptake and Na(+)-independent cycloleucine uptake by small-intestinal
      brush-border membrane vesicles. These results suggest that starvation stimulates
      amino acid transport across the apical plasma membrane of the enterocytes by
      inducing specific carrier units.

PMID- 8488094
TI  - Regulatory volume increase after hypertonicity- or vasoactive-intestinal-peptide
      induced cell-volume decrease in small-intestinal crypts is dependent on Na(+)
      K(+)-2Cl- cotransport.
AB  - The volume of intact crypts isolated from guinea-pig small intestine has been
      measured to assess the capacity of the cells to regulate their volume after
      hypertonic shock or vasoactive-intestinal-peptide (VIP)-induced shrinkage. Crypts
      exposed to anisotonic medium initially behave as perfect osmometers. Continued
      exposure to a hypertonic (400 mosmol/l) medium was followed by regulatory volume
      increase (RVI), which led to complete volume recovery in about 20 min. VIP
      produced a volume reduction, attributed to KCl loss through channels activated by
      the secretagogue, without any recovery during exposure to the polypeptide.
      Removal of VIP led to an increase of cellular volume towards control levels. This
      volume recovery after secretagogue-induced shrinkage is termed SVI. Both RVI and
      SVI were abolished by removal of Na+ or Cl- from the bathing solution, by
      addition of the loop diuretic bumetanide (1 microM), but not by addition of
      ethylisopropylamiloride (10 microM) or amiloride (1 mM). Cell shrinkage was also
      observed when tonicity was increased by addition of 100 mM NaCl or 200 mM D
      mannitol, but RVI was seen only when NaCl was the added osmolyte. The ion
      dependence, pharmacological sensitivity and thermodynamic considerations of these
      effects are consistent with the operation of a Na(+)-K(+)-2Cl- cotransport
      mechanism activated by cell shrinkage and the secretagogue action of VIP.

PMID- 8488095
TI  - Relation between regional electrical activation time and subepicardial fiber
      strain in the canine left ventricle.
AB  - To determine the relation between regional electrical activation time and fiber
      strain, epicardial electrical activation and deformation were measured in six
      open-chest dogs at the left ventricular anterior free wall after 15 min of right
      atrial, left ventricular free wall, left ventricular apex, or right ventricular
      outflow tract pacing, when end-diastolic pressure was normal or elevated (volume
      loading). Regional electrical activation was measured using a 192-electrode
      brush. Regional subepicardial fiber strain (ef) was measured simultaneously in 16
      regions, using optical markers which were attached to the epicardial surface and
      recorded on video. When relating regional ef during the ejection phase to
      regional activation time, the best correlation was found when a hemodynamic time
      reference rather than an electrophysiological one is used. Using the moment of
      the maximum rate of change of left ventricular pressure as the time reference for
      electrical activation, regional electrical activation time (t(ea)) and the degree
      of ef during the ejection phase could be fitted by a linear regression equation
      ef = a t(ea) + b, in which a = -3.46 +/- 0.73 s-1 an b = -0.28 +/- 0.05. For
      electrical activation times ranging from -40 to -80 ms, fiber strain was
      estimated with an accuracy of +/- 0.026 (+/- SE) with this relation. During right
      atrial pacing, t(ea) and ef were on the average -48 ms and -0.10 respectively. On
      further investigation, the relation between ef and t(ea) appeared to be
      influenced by end-diastolic pressure. For normal (1.1 kPa) and elevated end
      diastolic pressure (1.8 kPa), the slope of the linear regression line was -3.96
      and -2.86 s-1, respectively. Three conclusions may be drawn. Firstly, the time
      interval between the moment of regional electrical activation and the moment of
      the maximum rate of change of left ventricular pressure is an index of regional
      fiber strain. Secondly, it can be concluded from the above equations that
      electrical asynchrony of more than 30 ms causes non-uniformities in the degree of
      ef of the order of mean ef during pacing from the right atrium. Finally,
      differences in fiber strain during asynchronous electrical activation are less
      pronounced at larger filling pressures.

PMID- 8488097
TI  - [Cerebral MR imaging in patients with primary biliary cirrhosis].
AB  - Five patients with primary biliary cirrhosis (PBC) underwent cerebral magnetic
      resonance (MR) imaging to evaluate subclinical hepatocerebral degeneration. All
      patients were neurologically asymptomatic, but three of the five patients had
      symptoms such as jaundice and itching. Symmetrically hyperintense globus pallidi
      were observed on T1-weighted images in four of the five patients. One remaining
      patient who had normal MR images was an asymptomatic fresh case. Patients with
      markedly hyperintense globus pallidi also had mildly increased signal intensities
      in the surrounding structures. On proton-density- and T2-weighted images, there
      were no abnormal signals in the globus pallidi any of the patients. Portal
      systemic collateral vessels were demonstrated in three of the four patients with
      abnormal MR images. The mechanisms by which T1-shortening of the globus pallidi
      occurs remains obscure. We believe that both portal-systemic collaterals and
      cholestasis play a prominent role in the cause of cerebral abnormalities on T1
      weighted images.

PMID- 8488096
TI  - Small-conductance Ca(2+)-activated K+ channels in bovine chromaffin cells.
AB  - Simultaneous whole-cell patch-clamp and fura-2 fluorescence [Ca2+]i measurements
      were used to characterize Ca(2+)-activated K+ currents in cultured bovine
      chromaffin cells. Extracellular application of histamine (10 microM) induced a
      rise of [Ca2+]i concomitantly with an outward current at holding potentials
      positive to -80 mV. The activation of the current reflected an increase in
      conductance, which did not depend on membrane potential in the range -80 mV to 
      40 mV. Increasing the extracellular K+ concentration to 20 mM at the holding
      potential of -78 mV was associated with inwardly directed currents during the
      [Ca2+]i elevations induced either by histamine (10 microM) or short voltage-clamp
      depolarizations. The current reversal potential was close to the K+ equilibrium
      potential, being a function of external K+ concentration. Current fluctuation
      analysis suggested a unit conductance of 3-5 pS for the channel that underlies
      this K+ current. The current could be blocked by apamin (1 microM). Whole-cell
      current-clamp recordings showed that histamine (10 microM) application caused a
      transient hyperpolarization, which evolved in parallel with the [Ca2+]i changes.
      It is proposed that a small-conductance Ca(2+)-activated K+ channel is present in
      the membrane of bovine chromaffin cells and may be involved in regulating
      catecholamine secretion by the adrenal glands of various species.

PMID- 8488098
TI  - [CT finding of right diaphragmatic rupture due to blunt trauma--subhepatic
      hemothorax].
AB  - Owing to the poor detectability of the anatomic location of diaphragm on the
      parallel plane of computed tomography (CT), capability of CT to predict traumatic
      ruptured diaphragm has been debated in several reports. A specific hematoma
      (subhepatic hemothorax) adjacent to the posterior attachment of the right
      diaphragm was identified on CT. The finding originated from herniated liver that
      migrated to the posterior thoracic wall as a result of gravity, to separate the
      hemothorax in the supine position. This was surgically proven in two patients
      after blunt traumatic accident. The finding is useful in predicting right
      diaphragmatic rupture on CT study. The formation of subhepatic hemothorax, its
      differential diagnosis and a brief review of diaphragmatic rupture are discussed.

PMID- 8488099
TI  - [Clinical utility of Gd-DTPA subtraction MR imaging for spinal bone metastasis].
AB  - Based on reports that Gd-DTPA contributes to the detection of tumors, we used it
      in 31 cases (97 lesions) of spinal bone metastases. The result was that Gd-DTPA
      increased the intensity of tumors and the surrounding bone marrow to almost the
      same level in 53%. To show the metastases clearly, an existing subtraction
      command system was utilized. The technique included the pixel-by-pixel method, to
      obtain a Gd-DTPA T1-weighted image (T1WI) subtracted by the original T1WI. The
      detectability of the subtraction image was improved up to 96%, but was less than
      the original T1WI (99%). Because of the different imaging rationale between two
      methods, a means to assess the quality of diagnosis must be proposed. To check
      the normal background, the same kind of postprocessing was performed in 21
      patients without malignancy. Gd-DTPA perfusion was highest in the paravertebral
      veins, moderate in muscles and epidural fat, and lowest in the spinal cord,
      intervertebral disk and bone cortex. Gd-DTPA enhanced subtraction MR imaging
      provides a new diagnostic tool to detect and to assess bone metastasis.

PMID- 8488100
TI  - [MR tractography--visualization of structure of nerve fiber system from diffusion
      weighted images with maximum intensity projection method].
AB  - We developed a new noninvasive technique to visualize the anatomical structure of
      the nerve fiber system in vivo, and named this technique magnetic resonance (MR)
      tractography and the acquired image an MR tractogram. MR tractography has two
      steps. One is to obtain diffusion-weighted images sensitized along axes
      appropriate for depicting the intended nerve fibers with anisotropic water
      diffusion MR imaging. The other is to extract the anatomical structure of the
      nerve fiber system from a series of diffusion-weighted images by the maximum
      intensity projection method. To examine the clinical usefulness of the proposed
      technique, many contiguous, thin (3 mm) coronal two-dimensional sections of the
      brain were acquired sequentially in normal volunteers and selected patients with
      paralyses, on a 1.5 Tesla MR system (Signa, GE) with an ECG-gated Stejskal-Tanner
      pulse sequence. The structure of the nerve fiber system of normal volunteers was
      almost the same as the anatomy. The tractograms of patients with paralyses
      clearly showed the degeneration of nerve fibers and were correlated with clinical
      symptoms. MR tractography showed great promise for the study of neuroanatomy and
      neuroradiology.

PMID- 8488101
TI  - [Clinical usefulness of helical scanning CT (HES-CT) for orbital lesion].
AB  - Helical scanning CT (HES-CT) was applied to multiplanar reconstruction (MPR) and
      3-D imaging for the diagnosis of 65 patients with orbital lesions. We employed
      the the Toshiba TCT-900S, a fourth-generation high-speed CT scanner equipped with
      a slip-ring system. In HES-CT, scanning was performed with continuous rotation of
      the X-ray tube for 30 s, while the couch top was simultaneously moved at a
      constant speed of 1 to 2 mm/s. Images were reconstructed from continuous raw data
      to obtain a slice pitch of 1 mm in the longitudinal direction. HES-CT was found
      to have some advantages over conventional thin slice CT: 1) a wide area could be
      scanned in a short time (30 s) without motion artifact, 2) small lesions could be
      easily detected because slice images could be generated with a fine pitch at
      arbitrary positions from continuous raw data, 3) MPR images had good continuity
      in the longitudinal direction, and 4) high contrast of structures was obtained in
      the orbital region. HES-CT was considered to be useful for the detection of
      orbital lesions.

PMID- 8488102
TI  - [MR imaging of pituitary dwarfism].
AB  - Pituitary MR imaging was performed in 32 patients with clinically diagnosed
      pituitary dwarfism and 12 normal controls. The patients were divided into two
      groups according to the severity of pituitary dwarfism based on endocrinological
      data. The two patients with severe dwarfism showed transection of the pituitary
      stalk, ectopic posterior lobe and atrophy of the anterior lobe on MR imaging,
      while the 27 patients with mild dwarfism showed no abnormal MR findings of the
      pituitary gland. The former group corresponds to typical pituitary dwarfism and
      the latter to partial GH deficiency, which was recently proposed as another type
      of pituitary dwarfism. In conclusion, pituitary MR imaging may differentiate
      partial GH deficiency from typical (stalk-transected) pituitary dwarfism.

PMID- 8488103
TI  - [Efficacy of ultrasound detection of the oro- and hypopharyngeal carcinoma].
AB  - Sixteen histologically confirmed carcinomas of oro- and hypopharynx were examined
      by ultrasonography (US) from submental, submandibular, sub-auricular, and
      laterally cervical skin surface. Well-circumscribed hypoechoic tumors were
      demonstrated in twelve cases (75%). Nine of them had partial hypoechoic areas,
      such as "bull's eye pattern" or "pseudokidney sign". The remainder were one
      homogeneous hypoechoic mass and two inhomogeneous bulky tumors. In four negative
      studies, two were suspected too thin to be detected by US, and the other two
      could not be visualized by percutaneous scan because of their anatomical sites.
      The dimensions of demonstrated twelve tumors were measured three-dimensionally.
      The US information should be valuable for a prediction or an evaluation of the
      radiotherapy efficacy.

PMID- 8488104
TI  - [Radiation stenosis and fistula formation developed after iridium-192 high-dose
      rate intracavitary radiation boost therapy for carcinoma of the esophagus].
AB  - Intracavitary irradiation using a high-dose-rate Ir-192 remote after-loading
      system was applied to 14 advanced or inoperable patients with esophageal
      carcinoma as a boost therapy. The total dose of external irradiation was 45-70
      Gy/15-35 fractions and that of intracavitary irradiation was 11.6-34.0 Gy/2-4
      fractions at a point 5 mm deep from the inner surface of the esophageal mucosa.
      The time-dose-fractionation factor (TDF) of the whole treatment was 116-186
      (mean, 146). Six patients (43%) had complete response (CR), three (21%) had
      partial response and five (36%) had no response. Esophageal carcinoma that showed
      exophytic growth, was less than 5 cm ling, and showed favorable response to
      external irradiation was likely to be a good candidate for intracavitary
      radiation boost therapy. Fistula formation was produced in five patients (36%),
      four of whom were irradiated at more than 140 TDF. All six CR patients were free
      from esophageal tumors, but severe esophageal stenosis due to radiation injury
      developed in five (83%) of them. They were irradiated at more than 135 TDF. One-
      and two-year survival rates were 28.6% and 14.3%, respectively. The poor
      prognosis was ascribed to the frequent occurrence of fatal radiation stenosis and
      fistula formation. An appropriate therapeutic dose for esophageal carcinoma that
      does not cause severe radiation stenosis was estimated to be under 120 TDF.

PMID- 8488105
TI  - [A case of alcoholic liver cirrhosis associated with portal vein thrombosis which
      was successfully treated by TIPS].
AB  - We reported a case of 51-year-old man with repeated bleeding from
      gastroesophageal varices and portal vein thrombosis which were successfully
      treated by transjugular intrahepatic portosystemic shunt (TIPS) and thrombolysis.
      We used a flexible tip puncture needle (.038") which was thought to be safer than
      Colapinto needle (16G).

PMID- 8488106
TI  - [Magnetization transfer contrast imaging of the skeletal muscle in gradient
      recalled echo sequence].
AB  - The human midcalf muscle images were obtained using gradient recalled echo (GRE)
      sequence with and without magnetization transfer contrast (MTC) sequence. A
      significant decrease of relative signal intensity was observed in muscle with off
      resonance irradiation. The percentage increase of signal intensity after
      dorsiflexion exercises was 55.6% and 29.0% for MTC-GRE and GRE sequence,
      respectively. MTC technique might be useful in improving contrast between many
      tissues as well as muscles.

PMID- 8488107
TI  - [Evaluation of early MR imaging of the liver in rabbits after ethanol injection].
AB  - Seven days after ethanol injection, MR images of the liver in 5 rabbits were
      evaluated by T1, T2-weighted SE and TURBO-FLASH dynamic images. Necrotic area was
      visualized as low-intensity on T1-weighted images and high-intensity on T2
      weighted images. These findings were similar to the tumor that was not treated,
      so it is necessary to be careful for evaluation of therapeutic efficacy. Necrotic
      area was not meanwhile enhanced on TURBO-FLASH dynamic images, therefore, dynamic
      study seemed to be useful for therapeutic efficacy after ethanol injection.

PMID- 8488108
TI  - [Embolization of the internal maxillary artery for severe epistaxis--including an
      experience of the approach from the superficial temporal artery].
AB  - Six cases of severe epistaxis were treated with the super-selective intraarterial
      embolization of the internal maxillary artery. Tens of fragments of Gelfoam were
      delivered into the distal internal maxillary artery and, additionally, embolized
      by several pieces of the coils. In a case with cerebral infraction, catheter was
      inserted via the superficial temporal artery. There were no complications due to
      these procedures in all cases of this study. It is considered that therapeutic
      intraarterial embolization of the internal maxillary artery is an effective
      therapy for severe epistaxis and the superficial temporal artery approach is
      useful for selected cases.

PMID- 8488109
TI  - Risk: a concept worthy of attention.
AB  - Clients often engage in behavior that involves risk. Consequences of this
      behavior are sometimes harmful, but not always. Many times clients' views of the
      risks they are taking are often based on personal decisions they have made about
      their own health. People who take risks are frequently quite knowledgeable. The
      author uses case studies to examine the concept of risk. The author posits that
      teaching plans must account for the risks that clients take. Teaching plans
      should reflect that risks/benefits need to be discussed. Teaching should reflect
      respect for patient choices. An open discussion with the client that reflects
      what is really happening in the client's everyday life is of far more value than
      scanty, often glossed-over reports clients are accustomed to giving health
      professionals.

PMID- 8488110
TI  - Are there employment risks to ethical decisions?
AB  - A 1991 Washington State Supreme Court decision revisited the issue of job
      protection for a nurse who criticizes her employer for a treatment policy or
      practice that, while apparently legal, she believes to be unethical. In a case
      involving artificial nutrition and hydration, the court held that a nurse who
      tried to change her nursing home employer's policy of permitting withdrawal was
      acting to promote her own values, not the public good, and therefore was not
      entitled to protection by the public policy exception to the employment-at-will
      doctrine.

PMID- 8488111
TI  - Counseling implications in a client's choice of anesthesia during a first or
      repeat abortion.
AB  - Deciding to have an abortion is a process that causes most women a great deal of
      distress. This study addresses the question of whether a difference exists in
      psychological distress between women having abortions under local and general
      anesthesia. A two-factor analysis of variance design was utilized. The level of
      psychological distress among four groups of women was measured: Those
      experiencing a first-time and a repeat abortion under local anesthesia and those
      experiencing a first-time and repeat abortion under general anesthesia. A main
      effect for anesthesia was found for the variables of somatization, depression,
      hostility, psychotocism, global severity index, and positive symptom total.
      Specifically, women experiencing abortions under general anesthesia experienced
      more psychological distress in the above variables. Data suggest an association
      between psychological distress concerning the procedure and choice of anesthetic
      method may provide clues to the women's counseling needs.

PMID- 8488113
TI  - Seeking one's sacred space.

PMID- 8488112
TI  - Nursing: a scientific discipline? 1972.

PMID- 8488114
TI  - The challenge of accountability in nursing.
AB  - The authors examine the literature on accountability in nursing and analyze the
      following questions: What is meant by accountability in nursing? To whom are
      nurses accountable? For what should nurses be held accountable? Finally, the
      implications of accountability for the nursing profession are explored. In order
      for nursing to grow and develop as a profession based on sound theoretical
      foundations, nurses need to examine what it means to be truly accountable. The
      authors point out that accountability is a complex issue that requires nurses to
      examine their practice relative to the needs of healthcare consumers, their
      relationships with other healthcare professional, and the increasingly critical
      role of nursing in the healthcare system.

PMID- 8488115
TI  - Failure of one conductor in a nonthoracotomy implantable defibrillator lead
      causing inappropriate sensing and potentially ineffective shock delivery.
AB  - We describe how a single defect in a new model transvenous lead for an
      implantable cardioverter defibrillator can result in malfunction of the sensing
      and defibrillation circuits. The patient had received shocks during atrial
      fibrillation without premonitory symptoms. At least one shock was delivered and
      not felt by the patient. In addition, late in the course, a shock was delivered
      during atrial fibrillation documented to be with a slow ventricular response. In
      the transvenous lead, a distal spring functions as the anode for rate sensing and
      the cathode for defibrillation. The wire from this spring bifurcates near the
      proximal end of the catheter. One wire from the bifurcation leads to the positive
      (anode) rate-sensing socket of the pulse generator, and the other wire leads to
      the negative (cathode) high voltage output socket of the defibrillator for
      defibrillation and cardioversion. After the inappropriate and unperceived shocks
      were documented, intraoperative and postoperative electrical testing indicated
      that intermittent discontinuity of the distal spring system within the proximal
      yoke of the catheter caused faulty sensing and potentially unreliable
      defibrillation. This dual malfunction was possible because the distal spring of
      the lead functions in the high-voltage output and the rate-sensing low-voltage
      input circuits of the implantable defibrillator.

PMID- 8488116
TI  - [Reduced natural killer function in children with recurrent respiratory tract
      infections].
AB  - Respiratory infections are the major cause of disease in childhood in the
      industrialized areas of the world. This essentially depends on two factors:
      immunological immaturity and immunological naivety. In most cases a virus has
      been considered the causative agent in respiratory infection. A defect in immune
      responses has been described in children with recurrent respiratory infections
      and in particular a decrease in CD4/CD8 T lymphocyte ratio or in IL-2 and IFN
      gamma production. Our results show that Natural Killer (NK) cell activity is
      defective in children with recurrent respiratory infections. That is particularly
      noteworthy since NK cells play an important role in host defense against viral
      infections. At present it is difficult to understand whether the NK defect is a
      primary defect or it is secondary to viral infections. Further studies will help
      to clarify whether NK decreased activity depends on a cell damage directly caused
      by virus or it depends on the decreased levels of cytokines.

PMID- 8488117
TI  - [Hemangiopericytoma in childhood: presentation of an unusual clinical case].
AB  - A case of retroperitoneal Hemangiopericytoma in a 9 year old boy is presented.
      Hemangiopericytoma is a rare soft tissue tumor with unpredictable biological
      behaviour and a high local recurrency rate. Its ubiquity, the different grades of
      malignancy, the lack of correlation between clinical and histological feature are
      discussed. It is emphasized the hard preoperative diagnosis of the painless
      "mass", that can be reached only by histology. Increased cellularity, prominent
      mitotic activity, and foci of necrosis or hemorrhage suggest a malignant form
      rather than a benign one. Classifying Hemangiopericytoma among mesenchymal
      tumors, radical surgery is the treatment of choice whenever possible, associated
      with pre or post operative chemotherapy according to National Protocol RMS 88.

PMID- 8488118
TI  - [Gastroesophageal reflux and respiratory pathology].
AB  - The prevalence of gastroesophageal reflux (GER) in 86 children with respiratory
      disease (recurrent pneumonia, chronic cough, bronchial asthma) has been evaluated
      by mean of prolonged (22-24 hours) esophageal pH-monitoring. The following
      parameters were evaluated: the total percentage of time pH < 4 and the percent
      time the esophageal pH was < 4 while sleeping. None of the children had
      gastrointestinal symptoms suggesting GER and no neurological disorder was noted
      in any of the studied patients. The mean age was 68.98 +/- 46.46 months (range 14
      189); 53 (61.6%) males and 33 (38.4%) females were considered in the study. Atopy
      was evidenced in 42/86 (48.8%) children (total IgE > 2SD in 42/86 and prick tests
      positiveness in 32/86. A pH-metry indicating pathological GER was present in
      52/86 (60.5%) children: 39/62 (62.9%) patients with bronchial asthma, 5/10 (50%)
      subjects with chronic cough and 8/14 (57.2%) children with recurrent pneumonia.
      No significant difference in the diagnosis of GER was recorded between atopic or
      non-atopic patients. The children with abnormal pH-metric recording were also
      evaluated by upper gastrointestinal series and/or endoscopy. A conventional
      barium radiology was performed in 44/52 patients and confirmed GER in 19/44
      (43.2%). Esophagitis was evidenced in 21/46 (45.7%) studied patients. The
      presence of esophagitis was significantly (p = 0.032) related to the total
      percentage of time pH < 4, but the most significant (p = 0.002) association was
      with the percent time the esophageal pH was < 4 during sleep.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8488119
TI  - [Multiple pterygium syndrome: description of a new clinical case].
AB  - Multiple Pterygium Syndrome is a rare autosomal recessive disorder characterized
      by short stature, multiple pterygium, joint contractures, vertebral fusions and
      minor facial anomalies. Due to the extreme phenotypic variability of this
      syndrome many mild cases may be misdiagnosed or not recognized. The importance of
      an early diagnosis is to provide an adequate follow-up of these children in order
      to try to prevent many of the clinical problems they may encounter in their life
      time.

PMID- 8488120
TI  - [IgG subclasses against bovine alpha-lactalbumin and beta-lactoglobulin in
      infants fed with a seroprotein hydrolysate].
AB  - Prevention of food allergy in infancy has been the aim of important researches in
      the last years but many studies have produced conflicting conclusions. The use of
      hydrolysate formulas seems to be an helpful tool in prevention of cow milk
      protein allergy but confusion often remains about capability of small hydrolysate
      molecules to be "allergens" or "antigens". In order to clarify this point IgE,
      IgG and IgM as well as IgG subclasses against alfa-lactoalbumin (ALA) and beta
      lactoglobulin (BLG) have been evaluated in 41 infants at risk for allergy and in
      30 controls at the fourth month. The same evaluation has been done on their
      mothers. The 41 "at risk" children were fed with breast milk or with an
      hypoallergenic formula (Nidina HA, Nestle) or both. The control children received
      an adapted formula. No difference between the two groups of children was found
      regarding IgM or IgG against ALA while antibodies against BLG were more
      frequently found in controls than in "at risk" children. Only one child in the
      group fed with Nidina HA developed specific IgE against whole milk. Therefore
      hydrolysate formula seems to be as antigenic (not allergenic) as adapted formula
      in respect of ALA while BLG contained in adapted formula seems to be a stronger
      immunogen. The pattern of specific IgG subclasses against ALA and BLG is
      different between the two groups of children because of the absence in "at risk"
      group of specific IgG2 and IgG3. As for the mothers, the presence in their sera
      of IgG against ALA or BLG seems to induce in infants a reduced response to the
      same antigen.

PMID- 8488121
TI  - [Screening of urologic pathology in newborns with prenatal and postnatal
      echography].
AB  - We compared the results, by prenatal ultrasonography, effected on 2592 foetus at
      the 15th-25th-35th weeks of gestation with the ones, made by postnatal
      ultrasonography, effected the 5th day of life on 2539 infants born from
      pregnancies previously monitored. We considered the obstructive and not
      obstructive malformations. The prenatal ultrasonography put in evidence 19 cases
      of urological pathology, which is 0.75%. The postnatal research established the
      truth of 14 cases, which is 0.55%; 7 cases underwent a precocious surgical
      operation. Percentage of positive false is 0.2%. The postnatal ultrasonography
      made evident 30 cases which can be considered pathological: 25 uropathy
      obstructive cases and 5 uropathy not-obstructive cases; 3 of them underwent
      precocious surgical operation. The result is 44 pathological cases (1.74% of
      infants). We also considered an heterogeneous group of non-nephro-urological
      anomalies (0.47%), a casual medical report of this research; in particular, 10
      cases of surrenal hematoma and 1 case of neuroblastoma. The Authors remark that
      it's useful to complete the prenatal ultrasonographic research with another
      postnatal ultrasonographic research, particularly in the nephro-urological
      pathology; and they hope this system can be much more diffuse.

PMID- 8488122
TI  - [Urinary tract infections in newborns: sensitivity, specificity, and predictive
      value of urinary screening with the reagent strip test].
AB  - Important considerations in evaluating newborn urine examinations by dip-stick
      method are: ease of performance, the volume of the specimen required for test,
      the time required to perform the test and the cost. In considering the dip-stick
      test for the early diagnosis of Urinary Tract Infections (U.T.I.), it has never
      been tested with later follow-up to evaluate its sensitivity and specificity,
      also in regard to reduce the risk of further complications for urinary tract and
      kidney.

PMID- 8488123
TI  - [Epidemiologic correlation between microhematuria in children and hypertension in
      their parents].
AB  - The significance of asymptomatic microhematuria in children is unknown. In 1976
      Dodge et al. found a "surprising" high prevalence of proteinuria and haematuria
      in 12,000 healthy schoolchildren and, in the absence of knowledge of the natural
      history, this finding prompted them to postpone urinary mass screening.
      Nonetheless, the progressive course of most chronic renal disease in adulthood
      argues for investigation of microhematuria in children to uncover any sub-groups
      "at risk" of kidney diseases. The sensitivity of screening for microhematuria
      could be increased by a questionnaire on family medical history? We have
      investigated 1554 boys and 1484 girls aged 3-12 years, from the school population
      of a rural district near Rome. A self-administered questionnaire on renal disease
      and related symptoms in families was distributed to the parents. Urinalyses were
      done on all the children except for those with diseases or symptoms related to
      the urinary apparatus and girls who were menstruating. Haematuria was tested for
      by dipstick ("Combur 7"; Boehringer), children with microhematuria were retested
      10 day and 1 year later. On the initial 3038 dipstick tests 175 (5.76%) were
      positive, and 52 children (1.71%) had haematuria in all three specimens. The
      questionnaires were used only if they had been filled in properly (1821/3038). Of
      the 1821 valid questionnaires 121 (6.64%) revealed a family history of
      hypertension, but the frequency of such a family history was significantly higher
      for the 128 children with haematuria (14.8%, p < 0.005) and the 52 with
      persistent haematuria (23.0%; p < 0.001).

PMID- 8488124
TI  - [Echo-Doppler, exercise test, NMR in the follow-up of surgically treated aortic
      coarctation].
AB  - Persistent hypertension is one of the causes of sudden death which sometimes
      happens in patients operated on for coarctation of the aorta. Seven patients
      operated on for coarctation of the aorta were examined using exercise testing
      (Treadmill-Bruce), Echo-Doppler and NMR. Pressure gradients between the right
      upper and lower limbs were compared with those of normal young people and
      evaluated using NMR. The authors conclude that the patients operated on have
      resting blood pressure and pressure gradients, both resting and during exercise,
      greater than normal. Some patients operated on, with normal resting blood
      pressure and a slight gradient, can develop hypertension during exercise and a
      significant pressure gradient. Significant gradients during exercise are
      correlated to isthmic obstruction which is visible on the NMR. Follow-up after
      surgical repair of coarctation of the aorta cannot exclude measurement of
      exercise pressure gradients. This gives more physiological information compared
      with pressure gradients measured at rest.

PMID- 8488125
TI  - [Antibodies against milk and soy proteins in specific intolerances and celiac
      disease].
AB  - It has been suggested that high serum level of food proteins antibodies
      (especially cow's milk protein antibodies) may have a specific meaning in the
      diagnosis of food allergy, especially presenting with gastrointestinal
      complaints. In our study we tested with enzyme-linked immunoabsorbent assay test
      (ELISA) the antibody serum level to cow's milk and soy proteins in 123 children.
      The following patients were included in the study: 30 children with cow's milk
      enteropathy (CME), 27 children with soy proteins intolerance (SI), 19 coeliac
      children on gluten containing diet (CD), 9 coeliac children on gluten free diet
      (GFD) and 50 healthy sex and age matched control children. All coeliac patients
      had assumed cow's milk and soy proteins at the moment of the test or a few days
      before. Higher antibody serum level was found in coeliac disease to both cow's
      milk and soy proteins and in cases with cow's and soy allergy, than in control
      cases. The highest mean value of cow's milk and soy proteins antibodies have been
      found in the untreated coeliac children (CD), also higher than in the two groups
      of specific allergy. In treated coeliac children (GFD) with normalized jejunal
      mucosa cow's milk and soy proteins antibodies was normal. None of the 19 CD with
      high cow's milk and soy proteins antibodies level showed clinical intolerance to
      cow's milk and soy proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488127
TI  - [Cholestasis associated with sepsis in newborns].
AB  - Cholestatic jaundice is a well-known complication of gram-negative bacterial
      infections in the neonates. Newborn and premature infants are particularly
      vulnerable to cholestasis because of immaturities in bile forming mechanisms. The
      Authors describe two premature infants who developed cholestasis in the course of
      a proved bacterial infection by Klebsiella pneumoniae. The main clinical aspects
      of this association are illustrated and the recent concepts of pathogenetic
      mechanism of intrahepatic cholestasis is discussed.

PMID- 8488126
TI  - [Hepatitis B virus: new markers and their immunology].
AB  - Hepatitis B virus (HBV) is one of the most important causes of chronic liver
      disease. HBV is a DNA virus with an external glycoprotein surface and an internal
      nucleocapsid which contains the viral genome. HBV infection is revealed by the
      appearance of specific markers. Some of these markers are well known and their
      presence in serum is important to understand the behaviour of the disease. Among
      them HBsAg, HBeAg, anti-HBs and anti-HBe are found in serum, so as anti-Core; the
      HBcAg may be found in hepatic tissue and marks infectivity and virus replication.
      In the few last years some new antigens and antibodies have been studied and
      their importance in diagnosis and follow-up of hepatitis has been recognized.
      HBxAg, Pre-S and DNA-Polymerase (Pol) seem to be specific and early signals of
      viral replication. More studies showed the trans-activating properties of HBxAg;
      actually the X protein seems to be involved in replicative cycle of HBV. Many
      Authors also demonstrated a relationship between the presence of X in serum
      and/or liver and the progression of disease to cirrhosis and hepatocellular
      carcinoma. The Pol antigen and its antibody seem to be very common markers of HBV
      infection in serum of patients with hepatitis. Moreover their presence is the
      only signal of viral infection in some patients which have no other marker of
      HBV. More studies are of course needed to exactly establish the significance of
      these new markers and their importance for diagnosis and prognosis of HBV
      infection.

PMID- 8488128
TI  - [Migraine and food intolerance: a controlled study in pediatric patients].
AB  - The possible correlation between migraine and food intolerance has been found to
      be of great interest in the recent literature. We have studied 43 patients aged
      from 7 to 18 years suffering from migraine without aura according to the
      classification of International Headache Society (IHS): they had at least 2
      attacks monthly and they were pharmacological free of any prophylactic treatment
      for the latest three months. Each patient was given an allergologic anamnesis.
      Half of them (group A) were first in oligoantigenic regimen (including 8 simple
      foods) for 4 weeks. Afterward each patient has been challenged weekly in an open
      trial, introducing in the diet the different foods and additives previously
      eliminated; then they have been controlled in a simple double blind study. We
      have taken skin tests (PRICK method) for the most important allergens (foods and
      main inhalants), plasma levels of total and specific IgE (PRIST and RAST method),
      and moreover we have taken histamine plasma levels at the beginning and at the
      end of the oligoantigenic diet, and during challenge test, only in case of
      headache attacks. The second half of the patients (group B) were not following
      any diet nor a pharmacological prophylaxis, but they have been followed up with a
      clinical diary. Among the patients on oligoantigenic diet 12 only concluded the
      trial: 6/12 presented a completed remission of headache, 5/12 had a significant
      improvement of the migrainous pattern, 1/12 patients did not get any improvement
      after the dietetic treatment. The food recognized responsible of the attacks
      were: cacao, banana, egg, hazelnuts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488129
TI  - [Non-ketotic hypoglycemia caused by carnitine palmitoyl transferase 1
      deficiency].
AB  - A 9-year-old girl was referred to our hospital after recurrent episodes of
      hypoglycemia, altered consciousness and persistent vomiting without acetonemia or
      myopathic symptoms. Other pertinent laboratory data included elevated BUN,
      hyperammonemia and very low levels of triglycerides with elevated free fatty
      acids. The patient was born from unaffected but related parents (second cousins)
      and the illness was previously diagnosed as Reye encephalopathy. Recurrence of
      similar attacks suggested an underlying metabolic disorder. Several syndromes of
      impaired FFA beta oxidation were taken into account and discarded successively
      after laboratory investigations: systemic carnitine deficiency, Medium and Long
      Chain Acyl-CoA Dehydrogenase deficiency and Multiple Acyl CoA Dehydrogenation
      deficiency (Glutaric aciduria, Ethylmalonic-adipic aciduria and riboflavin
      responsive multiple acyl CoA dehydrogenation deficiency). Urinary and hematic gas
      chromatography and Mass-Spectrometry show no abnormality in Medium Chain fatty
      acids and in C6-C10 dicarboxylic acids. Carnitine plasma concentrations (both
      total and free) were above normal levels while in urine acetyl carnitine was low
      in respect to longer acyclic radicals. Among metabolic defects located at the
      level of hepatic fatty acid oxidation, only Carnitine Transferase deficiency can
      explain this peculiar mosaic of data (precursors of the blocked reaction are
      elevated in blood whereas lack of the metabolites derived uniquely from this
      reaction explains all the clinical manifestations).

PMID- 8488130
TI  - [Acute scrotum in childhood: considerations on 457 cases].
AB  - The Authors present their experience about 457 consecutive cases of acute
      scrotum, occurring from 1980 to 1990, at their Pediatric Surgery Unit. The
      condition is caused by torsion of the appendage of the testis (78.1%), torsion of
      the funicle (9.6%), acute idiopathic oedema of the scrotum (2.87%), and also
      tumours (1.17%). Also in their experience, the surgical approach is the correct
      treatment for the acute scrotum in order to prevent the irreversible damage of
      the testis. The surgical treatment present no problem and all the post-operatives
      were uneventful. In children under 2 years, the interventions were performed by
      inguinal incision, above 2 years by scrotal incision. The contralateral
      orchiopexy, in case of torsion of the funicle, was performed in the same session,
      or performed later, because of the anesthetic consideration.

PMID- 8488131
TI  - [Primary Toni-Debre-Fanconi syndrome].
AB  - A case of primary de Toni-Debre-Fanconi syndrome with hypercalciuria and urinary
      calculosis was reported and the relationships between congenital and acquired de
      Toni-Debre-Fanconi syndrome are discussed. The dysmorphic, facial features of
      primary de Toni-Debre-Fanconi are particularly outlined and common, genetic basis
      supposed. The new studies about the tubular defect for aminoaciduria,
      phosphaturia and glycosuria are reported and discussed. For the de Toni-Debre
      Fanconi syndrome primary and on genetic basis, the name "de Toni-Debre-Fanconi
      disease" is appropriate.

PMID- 8488132
TI  - [Xanthogranulomatous pyelonephritis in childhood: considerations on 2 new cases].
AB  - The Authors report their experience about two cases of xanthogranulomatous
      pyelonephritis in childhood. The clinical history, diagnostic procedures and
      surgical treatment are described. The xanthogranulomatous pyelonephritis is a
      rare form of chronic inflammatory disease of the kidney, in which pre-operative
      differential diagnosis with renal cancer or with extra renal neoplastic and
      inflammatory diseases is very difficult. The signs and symptoms are not
      characteristic, such as renal tumour, recurrent UTI, abdominal pain, fever. Also
      non characteristic are the findings, performed with diagnostic ultra sound and
      computed tomography. The surgical treatment is always effective in the
      xanthogranulomatous pyelonephritis. About 500 cases are described in adults and
      about 80 cases in children, from the first description in 1963. The first of our
      cases, occurring in a boy 6 years old, was treated with nephrectomy, because of
      the pre-operatory aspect was like tumour. In the second of the cases described,
      occurring in a girl 11 years old, the nephrectomy was performed because the
      chronic purulent inflammatory process had involved all the kidney. In the post
      operative, in the first case was performed a relaparotomy for intestinal
      occlusion in 12th day, in the second case the post-operative was uneventful. The
      Authors emphasize the importance of the xanthogranulomatous pyelonephritis in the
      differential diagnosis in children with recurrent UTI, renal masses, fever, in
      the clinical history.

PMID- 8488133
TI  - [Kawasaki disease in Sicily: description of the first case with giant coronary
      aneurysm].
AB  - A case of Kawasaki disease with early development of giant coronary artery
      aneurysm is reported. The delay in the diagnosis and consequently in the use of
      correct therapy has conditioned the outcome of the illness. We don't know the
      predictive factors of cardiac complications, but steroid treatment in our patient
      probably had an important role in the cardiac damage. The use of echocardiography
      in the evaluation of coronary aneurysm has confirmed the sensitivity, specificity
      and predictive value of this technique in detecting cardiac lesions.

PMID- 8488134
TI  - [Respiratory function involvement in intestinal chronic inflammatory disease:
      description of a case].
AB  - In the process of chronic intestinal inflammatory diseases the involvement of
      other organs and apparatuses is frequent. The respiratory apparatus, however, is
      not so frequently concerned as other organs, especially with regard to the
      paediatric age. The rarity of clinical evidences concerning the respiratory
      apparatus contrasts with the anomalies of the lung functionality tests described
      in literature. A fifteen year old boy is taken into consideration. He was first
      examined at the age of nine, when his symptomatology (slight fever and abdominal
      pain) was regarded as a chronic intestine inflammatory disease and it was treated
      with salazopyrina and cortisone. Compilations supervened later on, such as ilium
      arthritis, psoriasis-like dermatitis, perineal abscess. Five years after the
      beginning of the intestine disease the lungs were also involved and there was
      evidence of dyspnoea, especially when the patient was under stress. The clinical
      picture was confirmed by the reduction of the parameters of the respiratory
      functionality in the sense of an insufficiency of obstructive and restrictive
      kind. The pulmonary compilation was treated with disodium cromoglycate; such
      treatment was stopped, after the appearance of headache. After more than a year
      since the supervening of the lung complication the patient is being kept under
      periodic control to evaluate his pulmonary functionality. The indexes are
      constantly altered in the sense of a reduction of FEV 1, of FVC, of FEF 25-75 and
      of PEF, while the ventilatory and perfusional pulmonary scintigraphy has not
      shown relevant anomalies.

PMID- 8488135
TI  - [Juvenile fibromyalgia syndrome: 2 clinical cases].
AB  - We report two cases (F. 11 years, M. 7 years) with juvenile fibro-myalgic
      syndrome, diagnosed because of the presence of musculo-skeletal pain, tender
      points and associated symptoms, and after exclusion of any other known etiology.
      Both patients improved after treatment with antidepressant serotoninergic
      (amitriptyline, trazodone).

PMID- 8488136
TI  - Missed appendicitis in a pediatric emergency department.
AB  - Appendicitis is the most common cause of abdominal pain requiring surgery in
      children. Missed appendicitis is also a frequent cause of professional liability
      in an emergency department (ED). A retrospective review of all patients with
      appendicitis diagnosed in the ED was undertaken to identify: 1) how many patients
      required more than one visit to diagnose appendicitis and 2) the clinical
      characteristics that distinguished the patients who visited twice from patients
      who were diagnosed on the first visit. A total of 87 patients with appendicitis
      were seen by pediatricians in the ED from 1987 to 1989. The patients included 43
      girls and 44 boys (mean age, 8.9 years). Six patients (7%) were seen twice before
      the diagnosis of appendicitis was made. They returned to the ED on average 29
      hours after the first visit. The ED discharge diagnosis of the six "missed"
      patients included: probable Campylobacter (n = 1), viral urinary tract infection
      (n = 1), gastroenteritis (n = 2), and abdominal pain (n = 2). The six missed
      patients were different from the other patients with appendicitis. They were more
      likely to have a normal appetite, to have diarrhea, and to be afebrile. All the
      patients had at least two of the four following signs and symptoms: vomiting,
      tenderness, guarding, and right lower quadrant (RLQ) pain. At the time of
      surgery, 23/81 (28%) of the one-visit group had a ruptured appendix, whereas 3/6
      (50%) of the missed patients had a ruptured appendix. CONCLUSIONS: 1) Seven
      percent of the patients were seen twice in our ED before the diagnosis of
      appendicitis was made.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488137
TI  - Pain, punctures, and pediatricians.

PMID- 8488138
TI  - Central nervous system findings and intussusception: how are they related?

PMID- 8488139
TI  - Bacterial peritonitis and sepsis presenting as acute gastrointestinal bleeding in
      patients with portal hypertension.
AB  - Four children with portal hypertension and ascites developed hematemesis,
      abdominal pain, and fever as the acute manifestations of bacterial peritonitis.
      Initial management in the emergency department was directed toward controlling
      the upper gastrointestinal hemorrhage, and antibiotic therapy was delayed in four
      of six episodes until ascitic fluid cultures grew Streptococcus pneumoniae.
      Gastrointestinal bleeding has not been previously reported as a presenting
      symptom of peritoneal infection. Our clinical experience emphasizes the need for
      antibiotic therapy during the initial management of children with ascites and
      hematemesis.

PMID- 8488140
TI  - Torsade de pointes associated with Astemizole overdose treated with magnesium
      sulfate.
AB  - Astemizole (Hismanal-Janssen, New Brunswick, NJ) is a nonsedating antihistamine
      that has the advantage of a once-daily dosage schedule. This article reports the
      case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and
      developed torsade de pointes, a form of polymorphic ventricular tachycardia that
      is associated with prolongation of the QTc interval. She was successfully treated
      with magnesium sulfate infusion and had an uneventful recovery over a period of
      36 hours. This case illustrates that Astemizole overdose is not benign and should
      be considered in the differential diagnosis of ventricular tachyarrhythmias. Use
      of high-dose Astemizole may not be advisable for patients who are at risk for
      prolongation of the QTc interval.

PMID- 8488141
TI  - Magnetic resonance imaging for early diagnosis of necrotizing fasciitis.
AB  - One of the most serious complications of chickenpox is varicella gangrenosa, a
      form of necrotizing fasciitis. A confounding factor is the frequency of more
      superficial skin infections during chickenpox, often caused by group A beta
      hemolytic streptococcus. Because the progression from cellulitis to fasciitis is
      so insidious, severe tissue necrosis often has occurred before the correct
      diagnosis is made on the basis of clinical examination. Even today, limb
      amputation is occasionally required for treatment of gangrenous varicella. In
      this report, we demonstrate that magnetic resonance imaging can delineate the
      degree and depth of inflammation within an extremity and, thereby, indicate when
      the infection is progressing despite antibiotic therapy. Thus, the earlier use of
      magnetic resonance imaging may facilitate the diagnosis of necrotizing fasciitis.

PMID- 8488142
TI  - Cervicofacial and thoracic barotrauma following a minor dental procedure.
AB  - A case of cervicofacial subcutaneous emphysema and pneumomediastinum following a
      seemingly minor dental procedure is described. This dramatic but usually benign
      complication of dental work is rare and has not been reported in the pediatric
      emergency medicine literature. A brief review of this entity and an overview of
      diagnostic considerations and management are presented.

PMID- 8488143
TI  - Pediatric herpes zoster with mild cutaneous dissemination.
AB  - The textbook division of herpes zoster into segmental or disseminated is too
      simple and limited. Like all diseases, herpes zoster presents as a spectrum of
      disease. Mild cutaneous dissemination represents a "transition zone" in this
      spectrum and appears to be a benign clinical variant. This case of pediatric
      herpes zoster with mild cutaneous dissemination did not need aggressive inpatient
      treatment with IV agents; appropriate treatment included close follow-up.
      Optional treatment with high-dose oral acyclovir was also instituted.

PMID- 8488144
TI  - What dose of epinephrine is being used in pediatric resuscitation? Results of a
      survey.
AB  - Standard-dose epinephrine (SDE) currently recommended by the American Heart
      Association for pediatric resuscitation is 0.01 mg/kg (0.1 ml/kg of 1:10,000
      solution). SDE has come under increasing scrutiny; many authors suggest that this
      dose is too small. We sought to determine current epinephrine dosing practices
      among physicians practicing pediatric emergency medicine. Half of the members of
      the American Academy of Pediatrics Emergency Medicine section, selected randomly,
      were surveyed by a mailed questionnaire. After two mailings, 105 of 162 surveys
      (65%) were completed by members in practice. Of the 105 responders, 59% described
      their practice as "pediatric emergency medicine"; 17% as "emergency medicine
      (children and adults)"; 10% as "general pediatric practice or clinic"; 10% as
      "critical care"; and 5% as "other." Fifty-one (49%) had completed fellowship
      training, and 81 (77%) were either PALS or APLS instructors (referred to as
      "instructors" below). Overall, 72% (76/105) indicated that they use doses larger
      than SDE. Sixty-five of these (86%) described their dosing practice as
      "recommended dose initially, then larger dose." Twenty-one percent use SDE less
      than half of the time, and 16% use a dose 10 to 20 times larger at least half of
      the time. No responder used doses smaller than SDE. Instructors were more likely
      to use larger doses than were noninstructors (83% compared with 38%; P < 0.001).
      In the instructor group, a significantly larger dose was being taught
      "informally" than "formally" (P < 0.001). This survey was undertaken to determine
      current dosing practices by a group of physicians who are knowledgeable and
      experienced in pediatric resuscitation, not to resolve the question of the
      optimal dose of epinephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488145
TI  - Prehospital curriculum development: a learning objective approach.
AB  - Prehospital curriculum development is a time-consuming, yet essential, component
      of emergency medical technician and paramedic education. Over the past several
      years, much has changed within the EMS system and with the approach to educating
      the prehospital care provider. Learning is defined as a permanent change in
      behavior that comes about as a result of a planned experience. This planned
      experience must include learning objectives that incorporate assessment of
      presenting signs and symptoms and demonstrate the prehospital care providers'
      psychomotor skills in providing prehospital care based on that assessment.

PMID- 8488146
TI  - Intussusception: don't miss the diagnosis!

PMID- 8488147
TI  - ECG monitors.

PMID- 8488148
TI  - Leg pain with activity.

PMID- 8488149
TI  - A 13 year old with seizures and deafness.

PMID- 8488150
TI  - Use of acyclovir in varicella.

PMID- 8488151
TI  - Pediatric Emergency Medicine (PEM) Fellowship Curriculum Statement. Curriculum
      Subcommittee, Section of Emergency Medicine, American Academy of Pediatrics.

PMID- 8488152
TI  - Epidemiology of ocular complications of childhood head trauma.

PMID- 8488153
TI  - Analysis of pediatric emergency department telephone calls.
AB  - This study analyzed incoming telephone calls to an urban county pediatric
      emergency department (PED). Data were collected by reviewing recorded incoming
      calls and written logs for two separate months, six months apart. Eight hundred
      seventeen calls were reviewed. The largest number of calls for both months (15%)
      was for upper respiratory infection symptoms. Information, fever, and diarrhea
      were in the next three ranks for both months. Fifty-three percent were about
      children under one year of age. Over 50% of the calls were received from 4:00 PM
      to 12:00 AM during both months. The average length of calls was 4.0 minutes. A
      review of the logs identified 221 (27%) calls to be emergent or urgent; 197 (89%)
      of these callers were advised to bring the child to the PED. These data suggest
      that content for a curriculum should be directed toward common pediatric problems
      regarding young children, focusing on children under one year of age.

PMID- 8488154
TI  - Modified apical dissection for early continence after radical prostatectomy.
AB  - A prospective evaluation of urinary continence in 83 consecutive patients
      undergoing radical prostatectomy using a modified apical urethral dissection is
      described. Using this technique, complete continence has been achieved in 88%,
      with stress incontinence in 11% and total incontinence in 1%. Continence was
      achieved in less than 1 week to a maximum of 16 weeks, with 17% dry during the
      first week, 53% dry by 6 weeks, and 81% by 3 months. Median time to continence
      was 5 weeks. Median age of the continent patients was significantly lower than
      that of incontinent patients. Neither the number of neurovascular bundles
      resected, the need to reconstruct the vesical neck, nor the number of anastomotic
      sutures used affected the rate of continence. The described technique, which
      incorporates the fascia posterior to the urethra into the vesicourethral
      anastomosis, results in earlier continence after radical prostatectomy, and
      thereby lessens the morbidity of this procedure.

PMID- 8488155
TI  - Effect of prostatic inhibin peptide (PIP) on prostate cancer cell growth in vitro
      and in vivo.
AB  - Prostatic inhibin peptide (PIP), is a 94 amino acid protein which is secreted by
      the prostate gland in an androgen-independent manner. Previously, it has been
      demonstrated that PIP appears to inhibit follicle-stimulating-hormone (FSH)
      secretion by the pituitary and prostate glands. In vitro, the Dunning R3327 rat
      prostate cancer cell line MAT-LyLu (MLL) cells and the human prostate cancer cell
      line PC-3, are stimulated to grow in response to exogenous FSH and these effects
      are blocked by PIP. In vivo, PIP inhibits the growth of the highly metastatic MLL
      prostate cancer cell line. A comparison of hormone levels in control and PIP
      treated rats demonstrates a significant inhibition of FSH in treated animals. It
      appears that, in vivo, PIP may inhibit prostate cancer growth by inhibiting FSH.
      PIP may represent a novel hormonal treatment for prostate cancer.

PMID- 8488156
TI  - Ultrasonic diagnosis of 3,2'-dimethyl-4-aminobiphenyl induced tumors in the
      urogenital organs of F344 rats.
AB  - The usefulness of transabdominal ultrasonography in the diagnosis of 3,2'
      dimethyl-4-aminobiphenyl- and testosterone propionate-induced tumors of the
      urogenital organs was evaluated in F344 rats. Seven mass lesions (1 ventral
      prostate, 1 dorsolateral prostate, 3 seminal vesicles, and 1 kidney) in the
      urogenital organs could easily be diagnosed concerning size and localization by
      ultrasound. Histological examination revealed a lesion in the ventral prostate to
      be an abscess and the other tumors to be malignant. Three hydronephroses by tumor
      invasion to the ureter, and six tumors in organs other than the urogenital organs
      could be detected by ultrasound. The threshold of malignant tumor detection by
      ultrasound was 7 mm in actual length. The size of the mass lesion estimated by
      ultrasound correlated well with the direct measurement (r = 0.96). Transabdominal
      ultrasonography is useful for diagnosing the localization of experimental tumors
      and accurately measuring their size in the urogenital organs of rats.

PMID- 8488157
TI  - Insulin-like growth factor I: action and receptor characterization in human
      prostate cancer cell lines.
AB  - The role of insulin-like growth factor I (IGF-I) in the growth and development of
      prostate cancer was studied using established human prostate cancer cell lines.
      Under steroid and growth factor-free culture conditions, IGF-I significantly
      stimulated the androgen-independent cell lines PC-3 and DU-145 to incorporate
      [3H]thymidine into DNA, while the androgen-dependent cell line, LNCaP, was not
      affected. However, in the presence of dihydrotestosterone (DHT), DNA synthesis of
      LNCaP cells was stimulated by IGF-I in a dose-dependent manner. None of the cell
      lines tested secreted an immunoreactive level of IGF-I into their conditioned
      medium. Characterization of receptors by ligand binding assays revealed that all
      prostate cancer cell lines tested express specific binding sites for IGF-I with
      similar dissociation constants (0.23-0.39 nM). Crosslinking studies supported the
      suggestion that 125I-IGF-I was bound to a receptor on these cells. The IGF-I
      receptor concentrations of androgen-independent cell lines were significantly
      higher than those of the androgen-dependent cell line. Androgen appeared to
      affect neither the expression of IGF-I receptors nor the secretion of IGF-I. The
      results suggest that IGF-I may play an important role in stimulating the growth
      and progression of prostate cancer.

PMID- 8488158
TI  - Immunohistochemical study of phospholipase A2 in bovine prostate.
AB  - Approximately 1,100-fold purified phospholipase A2 (PLA2) from bovine prostate
      was injected into rabbit to prepare polyclonal antibodies. Antibodies produced
      showed specific immunoprecipitation only with the purified enzyme, as well as
      with homogenate of bovine prostatic tissue. By Western blot analysis or by
      immunodiffusion test, no cross-reactivity with PLA2 purified from human seminal
      plasma, bovine pancreas, Crotalus adamanteus venom, or with partially purified
      PLA2 from bovine seminal vesicle fluid or Cowper's glands was observed. Using the
      indirect peroxidase technique, PLA2 was localized in the cytoplasm of bovine
      prostatic epithelial cells. By immunogold microscopy, this enzyme was directly
      visualized inside the lysosomes, as well as in the endoplasmic reticulum of the
      glandular epithelial cells. Enzyme activity was localized in two principal
      subcellular sites: the mitochondria and lysosome-enriched fraction, and in the
      microsomal fraction.

PMID- 8488159
TI  - [The bioanalytical uses of the luciferase from fireflies (a review)].
AB  - Main principles of the bioluminescent microassay with the use of firefly
      luciferase are considered. Literature data and own experimental results of the
      author on application of luciferase in microbiology, clinical biochemistry, and
      express assays for antibiotic sensitivity and resistance to biocorrosion are
      generalized. New approaches to the use of luciferase for the detection of enzyme
      labels in EIA and for the nonradioactive detection of DNA probes are discussed.

PMID- 8488160
TI  - [The characteristics of the regulation of lysine biosynthesis in Streptococcus
      bovis].
AB  - The effect of threonine and methionine on the growth of and lysine synthesis in
      Streptococcus bovis st. A024/85 was studied. The character and the degree of
      manifestation of growth and regulation effects of these amino acids depend on
      their contents in the fermentation medium. The target in the regulation of lysine
      biosynthesis is aspartate kinase, whose synthesis is controlled by threonine and
      methionine. Lysine excretion was stimulated by the addition of a low
      concentration of dimethylsulfoxide in the medium during fermentation.

PMID- 8488161
TI  - [The action of exogenous RNAse on the cells of lower eukaryotes].
AB  - We studied the mechanism of growth-stimulating effect of various compounds using
      an exogenous RNase-micromycete model and found that the treatment with microdoses
      of RNase intensified the reproduction of the yeast Candida valida and growth of
      Aspergillus fumigatus. At the same time the respiration activity of yeast cells
      and fungal mitochondria as well as succinate dehydrogenase activity increased.
      The secretion of total protein, cellulase and cellobiase changed in the presence
      of RNase in the growth medium. Electrophoretic mobility of Candida valida cells
      enhanced by 20%. The RNase stimulating effect on microbial cells seems to result
      from changes in characteristics of the cell surface.

PMID- 8488162
TI  - [The stimulation and inhibition of the secondary growth of microorganisms by
      metals].
AB  - A selective (inhibitory and stimulatory) effect of metal salts on secondary
      growth of representatives of 5 genera of actinomycetes and 5 genera of fungi was
      established. The effect of metal salts on the growth of procaryotes and
      eucaryotes have both common and specific features. Differences in the biosorption
      of metals (Mo, Mn, Cu, Zn) by cells of primary and secondary growth were
      revealed. The possibility of enhancing the sorption capacities of cells in
      secondary colonies of mycelial microorganisms should be taken into account as
      selecting cultures for the purification of environment from heavy metals.

PMID- 8488163
TI  - [Associationism: the force of consensus].

PMID- 8488165
TI  - [The ICN: a social force].

PMID- 8488166
TI  - [Associationism for the defense of civil rights].

PMID- 8488164
TI  - [Who is safeguarding the profession?].

PMID- 8488167
TI  - [Law 421 of 23 October 1992 on the Reorganization of Teaching in Health Matters].

PMID- 8488168
TI  - [Unity in plurality--associationism: force and progress in the nursing
      profession].

PMID- 8488169
TI  - Antihypertensive activity of the novel, nonpeptide angiotensin II receptor
      antagonists BIBS 39 and BIBS 222 in conscious renal hypertensive rats.
AB  - BIBS 39 and BIBS 222 are novel, nonpeptide angiotensin II receptor antagonists
      with a benzimidazole structure. These compounds, in contrast to the angiotensin
      II receptor subtype 1 (AT1) selective drug DuP 753, also display affinity for the
      angiotensin II receptor subtype 2. Their antihypertensive activity was
      established in conscious renal hypertensive rats. BIBS 39, BIBS 222 and DuP 753,
      when administered intravenously, caused a substantial dose-dependent
      antihypertensive effect with very similar ED30 values of approximately 2 mg/kg.
      The antihypertensive effect was accompanied by mild and transient reflex
      tachycardia. Captopril, when administered directly after the maximally effective
      dose of the three angiotensin II receptor antagonists, caused no further fall in
      blood pressure. This finding indicates that these angiotensin II receptor
      antagonists had caused a functionally effective suppression of the activity of
      the renin-angiotensin-aldosterone system. BIBS 222 had a longer duration of
      antihypertensive action than its congener BIBS 39. The hemodynamic pattern of DuP
      753 was somewhat more complex; after a rapid fall and recovery blood pressure was
      maintained for a long time at a level somewhat below the control value. BIBS 39
      and BIBS 222 appear to be effective antihypertensives in the model of the renal
      hypertensive rat. Their activity is likely to be associated with AT1 receptor
      blockade.

PMID- 8488170
TI  - Fluid resuscitation improves survival of endotoxemic or septicemic rats: possible
      contribution of tumor necrosis factor.
AB  - The present study was designed to investigate the effects of fluid administration
      on survival in endotoxemic or septicemic male Sprague-Dawley rats. Endotoxemia
      was induced by intravenous injection of Escherichia coli lipopolysaccharide
      (LPS), and septicemia produced by cecal ligation and puncture (CLP). In
      endotoxemic animals deprived of fluid resuscitation, 7-day survival following
      injection of LPS at doses of 1, 3, or 10 mg/kg LPS were 70% (n = 10), 30% (n =
      10), and 0% (n = 10), respectively. In rats resuscitated with 3.3 ml/kg/h of 0.9%
      NaCl, the dose-response curve for survival was shifted 5-fold rightward in a
      parallel manner (p < 0.001, between the fluid-resuscitated and nonfluid
      resuscitated LPS groups), indicating a reduced sensitivity to the effects of LPS
      following fluid resuscitation. LPS increased serum tumor necrosis factor (TNF
      alpha) concentrations in fluid-resuscitated endotoxemic animals from a baseline
      value of 20 U/ml to 2,350 U/ml at 1 h, which returned to 200 U/ml at 2 h. In
      endotoxemic animals not receiving fluid resuscitation, serum TNF alpha levels at
      1 and 2 h were 5-fold and 27-fold higher, respectively, than in fluid
      resuscitated animals. There were no differences in arterial blood pressure or
      heart rate between the two groups of endotoxemic animals; total peripheral
      resistance was significantly lower at 1 h, and cardiac index was significantly
      greater at 3 h in the fluid-resuscitated LPS group; otherwise there were no
      further differences in hemodynamic parameters between the two groups. The
      survival rate at 4 days following CLP without fluid resuscitation was 14%,
      whereas CLP with fluid resuscitation improved survival to 74% (p < 0.01). TNF
      alpha was undetectable (i.e., < 20 U/ml) in the serum of animals subjected to
      CLP. The improvement in survival with fluid infusion in the LPS and CLP models
      cannot be attributed to catheter implantation, or to improved hemodynamic
      parameters in the LPS model. The improvement in survival in the LPS model with
      fluid infusion was associated with attenuated increases in TNF alpha levels.
      Furthermore, these studies illustrate that fluid-resuscitated and nonfluid
      resuscitated experimental animal models should not be considered equivalent.

PMID- 8488171
TI  - Microsomal acyl glucuronidation: enzyme-kinetic studies with labile glucuronides.
AB  - Because of the labile nature of acyl glucuronides under physiologic conditions,
      metabolic rates of formation calculated using traditional methods may be
      confounded by concomitant rates of degradation. True metabolic formation rates
      may be approximated by stabilization of the metabolic product or by purifying the
      metabolite and calculating its degradation rate under similar conditions to that
      utilized in the formation experiments. This latter degradation rate is used to
      correct the apparent formation parameter in the absence of inhibitors. The
      advantages and limitations of each approach are reviewed employing studies to
      characterize rates of acyl glucuronidation for nonsteroidal antiinflammatory
      drugs.

PMID- 8488172
TI  - Sulphydryl-containing agents and the prevention of duodenal ulcer relapse.
AB  - This prospective randomized double-blind controlled study investigated whether
      sulphydryl-containing agents protect against the recurrence of duodenal
      ulceration. To this end, DL-cysteine (200 mg 4 times daily) and DL-methionine
      methyl sulphonium chloride (MMSC, 500 mg 4 times daily) were administered orally.
      Three hundred and six consecutive smokers with previous symptomatic endoscopy
      proven duodenal ulceration which had been shown endoscopically to have healed
      were randomized to receive for 1 year either placebo, cimetidine 400 mg at
      bedtime, cysteine, or MMSC. In 221 patients evaluable for efficacy, the
      cumulative relapse rate at 1 year was: placebo 64%, cimetidine 30%, cysteine 11%
      and MMSC 12%. Cimetidine was significantly effective in preventing ulcer relapse
      (p < 0.01), however cysteine and MMSC were more effective in this respect (p <
      0.05). In the patients who relapsed, ulcer recurrence tended to occur early on
      placebo but to be evenly distributed over the year on active therapy. In all the
      study groups, the relative frequency of symptomatic to silent relapse was similar
      in the first and second halves of the year and was comparable among these groups.
      These results show that sulphydryl-containing agents significantly reduce the
      recurrence rate of duodenal ulceration.

PMID- 8488173
TI  - Effect of naloxone on the antipyretic action of acupuncture.
AB  - The effect of the opioid antagonist naloxone on the antipyretic action of
      acupuncture was studied in rabbits. Naloxone (0.1-0.2 mg/kg) when administered
      intravenously prior to acupuncture reduced the intensity and duration of the
      antipyretic action of acupuncture only in the initial stage. The data suggest
      participation of an endogenous opioid system in initiation of a number of
      responses mediating the antipyretic effect of acupuncture.

PMID- 8488174
TI  - Norcocaine and N-hydroxynorcocaine formation in human liver microsomes: role of
      cytochrome P-450 3A4.
AB  - Cocaine was metabolized to norcocaine by microsomes prepared from lymphoblastoid
      cells expressing transfected human P-450 3A4. The specific activities of
      norcocaine formation by microsomes prepared from three human liver samples
      correlated with the amount of P-450 3A immunoreactive protein detected by
      immunoblot. Triacetyloleandomycin, a specific inhibitor of P-450 3A isoforms,
      inhibited formation of norcocaine from cocaine, but not formation of N
      hydroxynorcocaine from norcocaine. The chemical identity of the norcocaine and N
      hydroxynorcocaine produced by human liver microsomes was established by
      combination of gas chromatography and mass spectrometry. Thus, human P-450 3A4 is
      a cocaine demethylase, and P-450 isoforms of the 3A family are responsible for
      the majority of norcocaine production by human hepatic microsomes.

PMID- 8488175
TI  - A transputer based three-dimensional dynamic cardiac imaging system.
AB  - In Aberdeen, a single-section transverse emission scanner has been adapted to
      trigger off patient ECG signals, allowing for the acquisition of gated blood pool
      tomograms at a number of slice levels through the patient's heart. This paper
      describes a system for the routine generation and display of surface rendered
      images derived from this data using a transputer based hardware system. Surface
      rendering algorithms have been implemented to provide an indication of the
      distribution of the cardiac blood pool in three dimensions, whilst the additional
      use of colour and/or cine sequences provide a succinct method of representing the
      extra information provided by gated acquisition. The transputer provides
      sufficient computing power to produce rendered views at a rate of about 1 frame
      per second, thus putting view selection fully under operator control. The success
      of the system described is reflected in its routine use in a busy clinical
      department.

PMID- 8488176
TI  - Measurement of the optical properties of the skull in the wavelength range 650
      950 nm.
AB  - The optical properties of samples of bone from pig skull have been measured over
      the wavelength range 650-950 nm. The scattering phase function was measured on
      thin samples of the bone using a goniometer, and a value for the mean cosine g,
      of the scattering angle, was calculated. The scattering and absorption
      coefficients, mu s and mu a were then determined from measurements of diffuse
      reflectance and transmittance made with a pair of integrating spheres, by a step
      wise search through a table of diffuse reflectance and transmittance versus mu a
      and mu s generated by a Monte Carlo model incorporating the measured scattering
      phase function. Values for g measured on six samples varied from 0.925 +/- 0.014
      at 650 nm to 0.945 +/- 0.013 at 950 nm. Corresponding values for mu a and mu s
      measured on 18 samples were mu a = 0.04 +/- 0.002 mm-1, mu s = 35 +/- 0.7 mm-1 at
      650 nm to mu a = 0.05 +/- 0.002 mm-1, mu s = 24 +/- 0.6 mm-1 at 950 nm.

PMID- 8488177
TI  - Time-domain dielectric spectroscopy applied to cell suspensions.
AB  - A precision difference time-domain reflectometry (TDR) technique is described for
      the investigation of the dielectric properties of cell suspensions. The
      dielectric spectra obtained for erythrocytes using TDR are comparable with those
      reported in previous dielectric studies employing frequency-domain technique.

PMID- 8488178
TI  - Nursing case management for children undergoing craniofacial reconstruction.
AB  - With consumers and providers alike expressing dissatisfaction with today's health
      care delivery system, case management has helped to achieve an effective balance
      among expected outcomes, the process of care delivery, and cost. This article
      describes nursing case management for children undergoing craniofacial
      reconstruction and how case management plans can be implemented.

PMID- 8488179
TI  - Nutrition and wound healing.
AB  - As many as 50% of medical-surgical patients in major metropolitan medical centers
      have some degree of protein-calorie malnutrition, which is associated with
      increased morbidity and mortality. Malnutrition affects wound healing in these
      patients, and nurses must assess and help these patients meet their nutritional
      needs.

PMID- 8488180
TI  - Fibrocystic breast disease: every woman is at risk.
AB  - Fibrocystic breast disease refers to a constellation of breast changes observed
      in premenopausal women, and 90% of all women experience evidence of
      pathophysiologic changes in the breast during their lifetime. Although most
      breast changes are harmless, women need to be concerned with the increased risk
      of breast cancer, one of the leading causes of death in women in the United
      States.

PMID- 8488181
TI  - American Nurses Association philosophical statement on ethics and human rights.
AB  - The purpose of this statement is to describe some of the features of human rights
      and to indicate how human rights and ethics are related. Human rights are
      assertions that call for treating human beings as ends in themselves, rather than
      as means to the goals and purposes of others. The principle of justice is one
      point at which issues of ethics and human rights intersect.

PMID- 8488183
TI  - Sterilization in the O.R.

PMID- 8488182
TI  - Development of the certification examination for plastic surgical nursing.

PMID- 8488184
TI  - Who's the boss?

PMID- 8488185
TI  - Nursing research: a vital resource to the profession.

PMID- 8488186
TI  - A team approach in the treatment of craniofacial deformities.
AB  - The treatment of the child with craniofacial deformities is multifaceted. Health
      care professionals must take a "team approach" in providing care, and address the
      physical, psychological, and sociological needs of the child and family.

PMID- 8488187
TI  - Activity on the central nervous system of Himanthalia elongata; Part II.
AB  - We report the effects on the central nervous system (CNS) and on analgesic
      activity of a fraction (F2) obtained from a Himanthalia elongata extract. The
      fraction was assayed for effects on spontaneous locomotor activity, d-amphetamine
      induced hypermotility, motor coordination, muscular relaxation, rectal
      temperature, sodium pentobarbital-induced hypnosis, and pentylenetetrazole
      induced convulsions. Analgesic activity was evaluated using the hot plate test
      and the Randall-Selitto test (1). The fraction caused significant reductions in
      spontaneous locomotor activity, hypermotility, rectal temperature, and motor
      coordination and postponed pentylenetetrazole-induced death, but no effect was
      noted on muscle relaxation or the duration of sodium pentobarbital-induced sleep.
      The fraction exhibited central analgesic effects in the hot plate and Randall
      Selitto tests.

PMID- 8488188
TI  - Memory effects of standardized extracts of Panax ginseng (G115), Ginkgo biloba
      (GK 501) and their combination Gincosan (PHL-00701).
AB  - In experiments on young (aged 3 months) and old (aged 26 months) rats, using some
      conditioned-reflex methods with punishment or positive reinforcement for active
      and passive avoidance (shuttle-box, step-down, step-through, and water maze), we
      studied the effects of the standardized extracts of Panax ginseng (G115), Ginkgo
      biloba (GK501) and their combination Gincosan (PHL-00701). The extracts were
      administered orally for 7 days before training at three increasing doses: 17, 50,
      and 150 mg/kg for G115; 10, 30, and 90 mg/kg for GK501; and 27, 80, and 240 mg/kg
      for PHL-00701. The two extracts and their combination improved the retention of
      learned behavior. This effect varied considerably with the extracts, with the
      dose and with the behavioral method used. The results suggest that the Panax
      ginseng G115 and the Ginkgo biloba GK501 extracts possess properties similar in
      every respect to those of nootropic drugs. The favorable effects on learning and
      memory of the combination of G115 plus GK501 and the other pharmacological
      activities inherent in the extracts characterize this combination, offered as
      Gincosan as a particularly promising drug in geriatric practice.

PMID- 8488189
TI  - alpha-Asarone toxicity in long-term cultures of adult rat hepatocytes.
AB  - In this work we studied the toxic effects of alpha-asarone, a hypolipidemic
      active principle of Guatteria gaumeri Greenman, on long-term cultures of adult
      rat hepatocytes cultivated on a feeder layer of 3T3 cells. The exposure for one
      and two weeks to alpha-asarone (1-50 micrograms/ml) produced intracytoplasmic
      lipid droplets and at higher concentrations (25-50 micrograms/ml) retraction of
      the hepatocyte cords and cell detachment. Ultrastructurally, the treated cultures
      (10 micrograms/ml) showed enlargement and vacuolization of the mitochondria in
      addition to lipid droplets. The triacylglycerol content increased up to 2.3-fold
      in the cultures treated for one week with 50 micrograms/ml, whereas the protein
      content per culture, a rough estimate of cell number and viability, decreased by
      up to 53% in the cultures treated for two weeks with 50 micrograms/ml. The
      synthesis and secretion of proteins, measured by the incorporation of [3H]
      leucine into cellular and secreted macromolecules, decreased also in the cultures
      exposed. After one and two week exposure to 50 micrograms/ml of alpha-asarone,
      the secretion of labeled proteins decreased by 53 and 67%, respectively, whereas
      the synthesis of cellular and total proteins decreased by 48-67%, respectively.
      The secretion of proteins was the most sensitive parameter of alpha-asarone
      toxicity. The mean inhibitory dose (ID50), i.e, that producing 50% inhibition in
      the incorporation of the labeled precursor, was 22.12 and 5.04 micrograms/ml
      after one and two weeks exposure, respectively. Our results show that long-term
      exposure to micromolar concentrations of alpha-asarone produces morphologic and
      ultrastructural alterations, triacylglycerol accumulation (fatty liver), and
      inhibition of protein synthesis and secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488190
TI  - Inhibition of lipid synthesis and secretion in long-term cultures of adult rat
      hepatocytes by alpha-asarone.
AB  - In this work we studied the effect of alpha-asarone, a hypolipidemic active
      principle of Guatteria gaumeri Greenman, on hepatic lipid metabolism using adult
      rat hepatocytes cultured on a feeder layer of 3T3 cells. These cultures
      synthesize and secrete for at least two weeks various lipids from [14C]-acetic
      and [14C]-oleic acid. Exposure for one or two weeks to 10 micrograms/ml of alpha
      asarone decreased the secretion of various lipids to the culture medium;
      triacylglycerol secretion was inhibited by 80-97%, phospholipid secretion by 70
      87%, cholesterol by 64-70%, and cholesterol esters by 50-92%. The incorporation
      of [14C]-acetic acid into cellular lipids decreased by 30-81% and that of [14C]
      oleic acid into phospholipids by 25-47% whereas the incorporation of [14C]-oleic
      acid into triglycerides and cholesterol esters increased 3.2 fold and by 28-36%,
      respectively. Similarly, the activities of glycerol-3-phosphate dehydrogenase and
      malic enzyme, marker enzymes of glycerolipid and fatty acid synthesis, decreased
      by 22-50% and 30-76%, respectively. Our results show that the exposure of the 3T3
      hepatocyte cultures to micromolar concentrations of alpha-asarone significantly
      inhibits lipid secretion and probably lipid synthesis. They also suggest that at
      least part of the hypolipidemic effect could be due to a decrease in the
      secretion of lipids (i.e., lipoproteins) by the hepatocytes.

PMID- 8488191
TI  - Effects of Chlorella stigmatophora extract on the central nervous system.
AB  - At the level of the central nervous system an aqueous extract of the marine
      microalga Chlorella stigmatophora (Butcher) (Chlorophyceae) showed anti
      dopaminergic-type activity in assays of its effects on spontaneous motor
      response, rectal temperature, motor coordination, amphetamine-induced
      hypermotility, exploratory conduct, muscle relaxation, catalepsy, conditioned
      avoidance responses, oxotremorine-induced cholinergic syndrome, and
      pentylenetetrazole-induced convulsions.

PMID- 8488192
TI  - Crude extracts and two linear diterpenes from Cystoseira balearica and their
      activity.
AB  - Crude extracts of Cystoseira balearica were submitted to pharmacological
      investigations. The chloroform-methanol residue caused relaxation of the rat
      aortic musculature and an inhibitory action on the guinea pig atria. The
      fractionation of this crude extract gave two active diterpenoids, eleganolone (1)
      and elegandiol (2), the latter has not previously been isolated from this alga.
      These pure components, never before tested, showed a higher activity when
      compared with the crude residue.

PMID- 8488193
TI  - Inhibition of cytochrome P-450(11)beta by some naturally occurring acetophenones
      and plant extracts from the shrub Salsola tuberculatiformis.
AB  - Ingestion of the Namibian shrub Salsola tuberculatiformis Botsch. by virgin
      female rats extends the dioestrus period of their oestrous cycles. Methanol
      extracts of the plant also inhibit adrenal steroidogenesis in the rat. With the
      aid of a bioassay, in which vaginal smears were used to follow the oestrous
      cycles of virgin rats, active fractions could be obtained which indicated that
      the plant contains a number of active compounds. The most active of these are
      highly unstable compounds which could not be isolated in pure form. However, two
      stable but less active compounds were identified as 4-hydroxyacetophenone and 4
      hydroxy-3-methoxyacetophenone. This study investigated the influence of these
      acetophenones, their glucosides, and that of ethanol extracts of S.
      tuberculatiformis on adrenal steroidogenesis. Acetovanillon, a structurally
      related natural product also known as compound Z, was included in this study.
      Results show that the shrub contains active substances which interfere with
      adrenal 11 beta-hydroxylase, the terminal enzyme in glucocorticoid biosynthesis.
      This interaction with the cytochrome P-450(11)beta-dependent hydroxylase, as well
      as the inhibition of the conversion of deoxycorticosterone to corticosterone, was
      used to develop two sensitive and reliable assays for the rapid identification of
      small amounts of active compounds from S. tuberculatiformis.

PMID- 8488194
TI  - Effects of kampo (Japanese herbal) medicine "sho-saiko-to" on DNA-synthesizing
      enzyme activity in 1,2-dimethylhydrazine-induced colonic carcinomas in rats.
AB  - Sho-Saiko-To (SST) is a modified Japanese traditional Chinese herbal medicine
      containing seven medical plants: Bupleuri radix, Pinelliae tuber, Suxtallariae
      radix, Zizyphi fructus, Ginseng radix, Glycyrrhizae radix, and Zingiberis recens
      rhizoma. This preparation has been used in the treatment of some inflammatory
      diseases of the respiratory system and chronic hepatitis. In the present study,
      the effects of SST were investigated on the activities of DNA-synthesizing
      enzymes in 1,2-dimethylhydrazine (DMH)-induced colonic carcinomas in rats. Six
      week administration of SST prevented nearly 100% of the body weight loss and the
      final number of the colonic carcinomas compared to those in the rats treated with
      DMH alone, and suppressed the enhanced activities of thymidylate synthetase (TS)
      and thymidine kinase (TK) which were involved in the de novo and salvage pathways
      of pyrimidine synthesis, respectively, in DMH-induced colonic carcinomas. These
      results indicate that SST may show directly and/or indirectly inhibitory effects
      on the development of colonic carcinomas.

PMID- 8488195
TI  - [Biological standardization of Ginkgo extracts].
AB  - The determination of the inhibition of PAF (platelet-activating factor)-induced
      platelet aggregation has been proposed as a biological standardization method for
      commercially available Ginkgo biloba extracts by measuring the characteristic
      pharmacological effect of ginkgolides in vitro. The determination is specific for
      ginkgolides A, B, C, and J and is not influenced by other constituents present in
      Ginkgo biloba extracts. IC50 values of ginkgolide B can be used to standardize
      various Ginkgo extracts produced by special extraction methods with respect to
      equi-effective ginkgolide B contents. In order to compare values obtained by a
      chemical-analytical procedure with those obtained by the biological assay, the
      equi-effective total ginkgolide content of each Ginkgo extract had to be
      calculated. Accordingly, the concentrations of the individual ginkgolides in the
      various Ginkgo extracts were determined chromatographically by assaying
      ginkgolides as trime-thylsilyl derivatives. Their individual contributions
      towards the measured in vitro effects were derived from their respective IC50
      values. The calculated equi-effective total ginkgolide contents of the Ginkgo
      extracts were in good agreement with those obtained by gas chromatography. The
      results demonstrate that, in addition to a chemical standardization, the
      biological standardization of Ginkgo extract preparations is also feasible.

PMID- 8488196
TI  - Tetragalloylquinic acid, the major antiasthmatic principle of Galphimia glauca.
AB  - In the search for antiasthmatic principles in plant drugs, a bioguided
      fractionation of an alcoholic extract of Galphimia glauca was performed using a
      plethysmographic in vivo model. Tetragalloylquinic acid (G1), which was found
      together with other compounds (gallic acid, methyl gallate, ellagic acid, and
      flavonoid acylglycosides), showed the highest activity against bronchial
      hyperreactivity and allergic reactions. Using mass and NMR spectroscopy in
      combination with energy calculations, the structure G1 was elucidated as tetra-O
      galloylquinic acid. Depending on the solvent used, the quinic acid skeleton can
      occupy a fixed conformation or several interconverting ones on the NMR time
      scale.

PMID- 8488197
TI  - Isodunnianin: a new sesquiterpene enhancing neurite outgrowth in primary culture
      of fetal rat cerebral hemisphere from Illicium tashiroi.

PMID- 8488199
TI  - [The psychosociological assessment of suicidal behavior among soldiers].

PMID- 8488198
TI  - [Psychological, neuroendocrinological and ethnological aspects of sexual
      variation, deviations and clinical observations].

PMID- 8488200
TI  - [Life stress events and individual reactions to stress in relation to illness].
AB  - Data was collected from 90 persons in relation to the level of their emotional
      reactions to life's difficulties as well as to the number of somatic symptoms. It
      was concluded that falling ill with certain infectious diseases and some
      psychosomatic states are related to the increased level of emotional processes
      and the number of psychosomatic symptoms to stress.

PMID- 8488201
TI  - [Psychopathological characteristics of the consequences of obstructive sleep
      apnea prior to and 3 months after therapy].
AB  - The aim of the research was to discover the level of change observed in cognitive
      functions and personality variables in patients ill with obstructive sleep apnea
      prior to and after CPAP treatment. Data was collected from 20 male patients ill
      with a severe form of obstructive sleep apnea whose physiological symptoms were
      correlated with the results of cognitive functions and personality variables. It
      was concluded that obstructive sleep apnea patients have lowered; attention,
      concentration, speed of learning verbal and visual stimuli and speed of learning
      visual-motor tasks. An increased level of depression was noted together with
      increased anxiety and psychological tension. In half of the group irregular EEG
      recordings and a pathological result on the Benton Test suggests organic damage
      to the CNS. These changes were negatively correlated with amounts of REM and 3 +
      4 NREM sleep, but were positively correlated with the level of sleep hypoxemia.
      The results suggest that after 3 months of CPAP treatment affect improved
      significantly. The observed tendency for cognitive functions to improved was not
      statistically significant.

PMID- 8488202
TI  - [The role of anxiety as motivation in the genesis of manslaughter].
AB  - Presented below are the results of comparative analysis of the motivational role
      of anxiety in man-slaughter based on six subgroups of perpetrators isolated with
      the help of cluster analysis according to the types and kinds of leading themes
      of their action. The statistical analysis of the data of a 105 cases of
      perpetrators of man-slaughter revealed that anxiety played a differentiating role
      in the psychological mechanisms which are supposed to lay at the bottom of the
      crime of man-slaughter. This was especially true of those actions governed by
      psychological processes which are concerned with the relationship between anxiety
      and the type and level of interpersonal aggression. It may be concluded that
      aggression, as well as the anxiety at its base, differ as to their genesis,
      motivation and course. The results do not support a single universal concept
      about the actions of perpetrators of man-slaughter, but support the heterogeneity
      of personality factors of such people, the criminogenic factors of situations and
      the motivational mechanisms which lead to such action.

PMID- 8488203
TI  - [The influence of information on the diagnosis of short-term prognosis in
      schizophrenia].
AB  - Data was collected from 60 patients ill for the first time with schizophrenia. In
      30 cases a nosological diagnosis was given while in the rest of the patients a
      syndrome diagnosis was placed. In the follow-up conducted 3 years later it was
      revealed that the groups basically do not differ from each other in the course of
      the illness or the clinical picture but they do differ from each other in their
      job adjustment.

PMID- 8488204
TI  - [Altered states of consciousness: theoretical models and concepts].
AB  - The main contemporary theoretical models and concepts of altered states of
      consciousness are reviewed. Analysis of the literature indicates that nowadays,
      psychology recognizes the existence of different levels of consciousness. The
      achievements of the psychology of consciousness are helpful in research, but they
      have a very limited application in psychiatric practice.

PMID- 8488205
TI  - [Applications of computer database in prospective studies on the mortality of
      patients with diagnosis of schizophrenia].
AB  - The efficacy of epistemological research including the analysis of mortality
      rates depends to some extent on the ability to make use of registration systems
      and the processing of data. In the paper presented below the author outlines the
      application of a programme-dBase III plus, created for computer data bases and
      its use in the assessment of a prospective study of mortality of patients with a
      schizophrenic diagnosis. Three data bases (S295.DBF, SB295.DBF, GUS1982.DBF) of
      varying sizes were created, each of which possessed specific categories of
      information.

PMID- 8488206
TI  - The horror! The horror! Reflections on our culture of violence and its
      implications for early development and morality.
AB  - This commentary draws on two dimensions of chronic community violence, with
      thoughts that have been mobilized by the foregoing contributions. One concerns
      the importance of culture and the other concerns the importance of thinking about
      early development. Culture permeates all of our actions, and we are in a culture
      of violence. In other papers in this issue, Richters and Martinez point out that
      the United States is the most violent country in the industrialized world, and
      Ciccheti and Lynch state that violence "is becoming a defining characteristic of
      American society." We are fascinated by violence and in an implicit way we love
      violence-a fact that we need to acknowledge. Our fascination with violence in
      American culture is permeating and deep, and, as horrible as it is, I believe we
      need to face it in order to try to counter it.

PMID- 8488207
TI  - Impact of violence on children and adolescents: report from a community-based
      child psychiatry clinic.
AB  - The Children's National Medical Center is located in the inner-city area of
      Washington, DC. As is nationally now well publicized, the drug-related violence
      in Washington has earned the area the dubious title of "murder capital of the
      world." Our outpatient child and adolescent psychiatry clinic at Children's
      Hospital provides walk-in services during daytime hours, Monday through Friday.
      Access to services is available at other times through the emergency room.

PMID- 8488208
TI  - Children in poverty: resilience despite risk.
AB  - Two objectives provided the focus for the Conference on Community Violence and
      Children's Development that was jointly sponsored by the National Institute of
      Mental Health and the John D. and Catherine T. MacArthur Foundation. One was to
      examine the evidence for deficit behaviors that characterized children reared in
      poverty; the second was to identify the characteristics of children who sustained
      their competencies despite being reared in comparable environments. These dual
      objectives took this form: "What can we conclude from studies of children, their
      families, and environments about characteristics that predispose children to
      maladjustment following exposure to violence, and about characteristics that
      protect children from such adjustment problems following, or in the midst of,
      violence exposure?"

PMID- 8488209
TI  - The NIMH community violence project: II. Children's distress symptoms associated
      with violence exposure.
AB  - The rising tide of violence in American cities has placed the causes and
      consequences of violence squarely on the public health agenda. The U.S.
      Government's Year 2000 National Health Promotion and Disease Prevention
      Objectives includes a full chapter devoted to violence issues and delineates a
      number of goals and programs aimed at reducing the number of deaths and injuries
      associated with violence (Public Health Service 1990). Notably absent from these
      objectives, however, is attention to the possible adverse psychological
      consequences of exposure to acute or chronic violence. Nonetheless, in light of
      numerous media reports of children's exposure to community violence and recent
      reports documenting high levels of exposure even among very young children
      (Richters and Martinez 1993), it is reasonable to question whether the risks of
      exposure extend beyond death and physical injury to psychological well-being.

PMID- 8488210
TI  - Community violence and children's development: toward a research agenda for the
      1990s.
AB  - The United States is the most violent country in the industrialized world
      particularly for young people. Homicide in the United States ranks as the second
      leading cause of death among those between 15 and 24 years of age (Earls et al.
      1991). Males, especially, are at high risk. As indicated in Figure 1, those
      between 15 and 24 years of age were more likely to be murdered than their
      counterparts in all 22 other developed countries for which comparable homicide
      statistics were available during 1986-1987 (Fingerhut and Kleinman 1990). Young
      males were 4 times more likely to be murdered than their counterparts in the next
      highest country, Scotland; 7 times more likely than young males in Canada; 21
      times more likely than those in West Germany; and 40 times more likely than same
      age males in Japan. Moreover, the U.S. homicide rate for Black males (15 and 24
      years) was more than 7 times the homicide rate for White males in this age range.
      These figures are all the more alarming in light of the fact that homicide rates
      in major U.S. cities have increased steadily since these data were recorded.

PMID- 8488211
TI  - Chronic community violence: what is happening to our children?
AB  - Chronic violence is a growing problem in our society today as evidenced, among
      other factors, by the ever-increasing murder rate in many of our large urban
      centers in the United States. Emphasis has begun to be placed on chronic
      violence, causes that may contribute to it, and the impact of this violence on
      cities and the country at large. While concern has been expressed, we still have
      not addressed adequately, nor do we fully understand, the effects on the children
      who must grow up in environments where they are repeatedly being exposed to
      significant levels of violence.

PMID- 8488212
TI  - Community violence and children on Chicago's southside.
AB  - This report summarizes a program of study on African-American children and
      violence conducted by a comprehensive community mental health center on the
      southside of Chicago. The research, which looked at exposure to violence, self
      reports of aggression, and possible interventions, grew out of: (1) an awareness
      of the enormous amount of familial and extrafamilial violence in the black
      community; (2) clinical experiences that indicated that victimization and
      covictimization (i.e., victimization of close others) were often significant
      factors in the lives of the mentally ill; (3) a growing uneasiness, and indeed
      curiosity, over the extent to which children were witnessing these events and the
      impact of this witnessing, particularly on their own levels of aggression; and
      (4) a belief that the integrity of the black community was being threatened by
      the violence and that solutions must be sought.

PMID- 8488213
TI  - Children's exposure to community violence: following a path from concern to
      research to action.
AB  - This paper discusses the antecedents and current progress of an ongoing program
      of research on the nature, extent, and consequences of children's direct and
      indirect exposure to violent events and settings. Involvement in such research
      has sensitized the authors to difficult ethical and methodological challenges
      that, we believe, merit consideration by mental health scientists and policy
      markers. Resolution of those challenges has substantive implications for both
      subsequent research and the application of resultant findings.

PMID- 8488214
TI  - Community violence, children's development, and mass media: in pursuit of new
      insights, new goals, and new strategies.
AB  - Community violence that victimizes children is an unmitigated evil that is
      exacerbated by vast economic and social forces that leave people in central
      cities and the rural countryside adrift on seas of rolelessness, hopelessness,
      group disintegration, and alienation. The contemporary drug scene and the easy
      availability of guns greatly intensify violence on a local scale, while crimes of
      violence, especially with guns, appear to be level or declining in the nation as
      a whole. Claims that the persistently high levels of violence in mass media,
      mostly television, are largely responsible for violence in society represent
      narrow views of very large issues. These narrow views overlook essential elements
      of both phenomena--violence and media. Direct models of interpersonal violence in
      families and in the community probably give rise to more violent behavior than
      indirect models in media. Disinhibitory and provocative aspects of media probably
      do as much or more to trigger violent behavior than violent narratives and
      violent actions. Comprehensive meta-analysis indicates that prosocial messages on
      television can have greater effects on behavior than antisocial messages. These
      data support the contention that mass media can play a strong and positive role
      in alleviating some of the distress of victims of community violence, and in
      redirecting the behavior of some of its perpetrators so as to protect the
      children.

PMID- 8488215
TI  - The NIMH community violence project: I. Children as victims of and witnesses to
      violence.
AB  - The 1980s witnessed an extraordinary increase in community violence in most major
      cities across the United States. In 1990 the homicide rate in Boston increased by
      45% over the previous year; in Denver, by 29%; in Chicago, Dallas, and New
      Orleans, by more than 20%; in Los Angeles, by 16%; in New York, by 11%. In
      Washington, DC, which has the highest per capita homicide rate in the country,
      the 1990 murder rate set an all time record in the District's history (Escobar
      1991). Across the country, 1 out of 5 teenage and young adult deaths was gun
      related in 1988 - the first year in which firearm death rates for both Black and
      White teenagers exceeded the total for all natural causes of death combined. Also
      in 1988, the firearm homicide rate for young Black males increased by 35%, and
      Black male teens were 11 times more likely than their White counterparts to be
      killed by guns (Christofel 1990).

PMID- 8488216
TI  - Child sexual abuse: a model of chronic trauma.
AB  - Although there is a general consensus among concerned professionals that exposure
      to community violence is likely to be stressful and may contribute significantly
      to immediate and long-term mental health problems, there is virtually no
      empirical research on either its acute or enduring effects. In the absence of
      data, investigators planning research in this area must look to other studies of
      the impact of chronic environmental trauma on children, including the effects of
      war and child maltreatment. Research on child abuse provides an important source
      of information on the effects of trauma on children because it draws on both
      prospective and retrospective studies crossing a variety of theoretical
      perspectives and disciplines. The existence of data on both the acute impact of
      abuse on children and its chronic effects and outcomes in adults informs the
      generation of developmentally based psychological and biological hypotheses. This
      paper utilizes data from research on the acute and chronic effects of sexual
      abuse to discuss three broad hypotheses that may be relevant to the study of the
      effects of community violence on children.

PMID- 8488217
TI  - Toward an ecological/transactional model of community violence and child
      maltreatment: consequences for children's development.
AB  - In recent decades it has become increasingly apparent that violence affects a
      significant proportion of families in the United States (Bureau of Justice
      Statistics 1983). Violence, in fact, is becoming a defining characteristic of
      American society. A recent comparison of the rates of homicide among 21 developed
      nations indicates that the United States has the highest homicide rate in the
      world, and its rate is more than four times higher than the next highest rate
      (Fingerhut and Kleinman 1990). What is even more alarming is the high incidence
      of violent death and injury for children and adolescents in the United States.
      Acts of violence are the cause of death for over 2000 children between the ages
      of 0 and 19 years each year, and more than 1.5 million children and adolescents
      are abused by their adult caretakers each year (Christoffel 1990).

PMID- 8488218
TI  - An investigation into the internal structure of DSM-III antisocial personality
      disorder.
AB  - The present study examined the DSM-III antisocial personality disorder by
      examining endorsements of each of the DSM-III criteria to obtain various indices,
      including interrater reliability, sensitivity, specificity, positive and negative
      predictive power, alpha levels, and item (criterion)-total correlations. 112
      psychiatric inpatients were rated on the Structured Interview for DSM-III
      Personality. 11 patients were accorded a diagnosis of antisocial personality
      disorder, 65 had other forms of personality disorders, and 36 received no
      personality disorder diagnosis. The antisocial criteria successfully
      discriminated patients with antisocial personality disorder from those without
      the diagnosis. Strong interrater reliability and reasonable alpha levels were
      achieved. Although some criteria were successful in identifying patients with and
      without a diagnosis of antisocial personality disorder, the criteria were
      generally better at predicting the absence of antisocial personality disorder.

PMID- 8488219
TI  - Utility of the Hobby WISC-R Split-half Short Form for children and adolescents
      with severe head injury.
AB  - This study investigated the utility of the Hobby WISC-R Split-half Short Form in
      a sample of children and adolescents with severe head injury. Subjects included
      30 patients with severe closed-head injuries who were referred for
      neuropsychological testing as part of their hospitalization in a pediatric
      rehabilitation center. Subjects ranged in age from 7.5 to 16.2 years and were of
      the low to middle socioeconomic range. Analyses yielded significant correlations
      between scores on the standard WISC-R and the Split-half Short Form. Except for
      the WISC-R Split-half Short Form slightly overestimating scores on Object
      Assembly, no other score differences were obtained between the two forms.
      Patterns of strengths and weaknesses were variable for the two forms, with over
      all agreements ranging from 46% on the Performance subtests to 53.7% on the
      Verbal subtests. The rate of classification agreement between the standard and
      short-form formats in assigning a child to one of five traditional IQ categories
      was 76.7%, with nearly all scores on the short form falling within one standard
      error of measurement of the standard WISC-R scores. There was a tendency for
      younger children to show more stability in their classification categories across
      the two WISC-R forms than older children. Issues related to the use of the WISC-R
      Split-half Short Form for a severely head-injured pediatric population are
      discussed.

PMID- 8488220
TI  - Evaluation of a brief measure of depressive mood for use in a university
      counseling center.
AB  - To study the reliability of Set 1 (A, B, C, D) and Set 2 (E, F, G) of the state
      and trait forms of the Depression Adjective Check Lists in university counseling
      centers, four independent studies were conducted. Reliability (internal
      consistency, split-half, and alternate form) and validity (convergent and
      discriminant) for both sets and both forms were sufficiently high to warrant use
      for research and clinical purposes. Additional research needs were mentioned.

PMID- 8488221
TI  - Job stress and satisfaction: international police officers.
AB  - Scores of 30 police officers on the Occupational Stress Indicator differed from
      British norms on organisational structure and climate, home and work interface,
      and relations with others. Officers showed internal control and individual
      influence. Through managed time and home support, officers coped with stress.
      Scale scores were intercorrelated.

PMID- 8488222
TI  - The Patient Satisfaction Interview for partial hospitalization programs.
AB  - The Patient Satisfaction Interview was developed to assess consumers'
      satisfaction with four dimensions of partial hospitalization programs: the
      physical environment, the therapists, the treatment strategies, and the
      preparation for community autonomy. Content validity of the measure was examined
      and cross-validated by independent samples of expert raters and patients. The
      measure was then administered to 30 patients participating in a six-month partial
      hospitalization program. Analyses showed test dimensions had good internal
      consistency and test-retest reliability. Six-month stability was good for three
      of the four scales as well as the over-all test score. Research using the test
      must examine its utility for description of satisfaction with community-based
      programs.

PMID- 8488223
TI  - Motivation of disabled athletes to participate in triathlons.
AB  - 25 competitors in the Fifth National Triathlon for the Physically Challenged
      responded to a questionnaire regarding their previous and current exercise and
      participation in sports. Analysis showed that the majority had been active before
      the onset of disability and that the encouragement and motivation provided by
      other physically disabled individuals was the consistent factor in their own
      initial rehabilitation and subsequent participation in sports.

PMID- 8488224
TI  - Denigration of a victim in group psychotherapy by violent vs seductive sex
      offenders.
AB  - Two psychotherapy groups were set up in a prison treatment program, one for
      violent sex offenders, the other for sex offenders who were less violent and
      primarily used seduction to obtain sex. Most of the patients were child
      molesters. Observations showed that over the course of 10 group psychotherapy
      sessions, 8 out of 10 violent offenders said denigrating things about their
      victims vs 2 out of 10 seductive offenders. The significant comparison if
      supported by cross-validation suggests the value of the distinction of violence
      vs seduction for sex offenders.

PMID- 8488225
TI  - A videotape as introduction for cognitive behavioral therapy with depressed
      inpatients.
AB  - This paper reports on the development of a videotape "Depression ... the answers"
      for use in cognitive behavioral therapy with depressed inpatients. 17 patients
      evaluated the videotape. The described psychoeducational video program was
      constructed as an introduction for, an opening to, and as a facilitation and
      clarification of the psychotherapeutic and pharmacological treatments.

PMID- 8488226
TI  - Effects of explicit time-limits on the initial therapeutic alliance.
AB  - This study investigated the hypothesis that the setting of explicit time-limits
      in individual counseling enhances the formation of the therapeutic alliance.
      Students at a university-based counseling center were randomly assigned to a 5
      session, time-limited therapy condition (n = 16) or a time-unlimited therapy
      condition (n = 15). Contrary to the hypothesis, statistical analyses showed no
      differences between audiotaped segments from the second and third therapy
      sessions rated on the Vanderbilt Therapeutic Alliance Scale.

PMID- 8488227
TI  - Neuroethics vs neurophysiologically and neuropsychologically uninformed
      influences in child-rearing, education, emerging hunter-gatherers, and artificial
      intelligence models of the brain.
AB  - Potentially negative long-term consequences in four areas are emphasized, if
      specific neuromaturational, neurophysiological, and neuropsychological facts
      within a neurodevelopmental and ecological context are neglected in normal
      functional levels of child development and maturational lag of the frontal lobe
      system in "Attention Deficit Disorder," in education (reading/writing and
      arithmetic), in assessment of cognitive functioning in hunter-gatherer
      populations, specifically modified in the service of their survival, and in
      constructing computer models of the brain, neglecting consciousness and
      intentionality as criticized recently by Searle.

PMID- 8488228
TI  - Speaking anxiety, achievement, and crime: a rejoinder to the response by
      Witherspoon, Long, and Nickell.

PMID- 8488229
TI  - Fears of normal and retarded children.
AB  - The developmental features of the fears of 112 nonretarded and 42 retarded
      children were examined. With development, the fears of nonretarded children
      became more closely aligned with real sources of threat that involve human agency
      and less fearful of imaginary things. The retarded children displayed patterns of
      fears similar to their mental-age peers rather than chronological peers and were
      more likely to deny being fearful than their nonretarded peers.

PMID- 8488230
TI  - Locus of control, depression, and anger among African-Americans.
AB  - Subjects, 98 African-American college students, were given a measure of belief in
      locus of control, a self-report measure of depression, and three scales from the
      Buss and Durkee Hostility Inventory. Depression and belief in control by powerful
      others correlated only for subjects with low scores on Assaultive, Verbal, and
      Indirect Hostility. The findings, using nonwhite subjects, replicate a previous
      study in which the racial composition was not indicated.

PMID- 8488231
TI  - Human response to traumatic events: an integration of counterfactual thinking,
      hindsight bias, and attribution theory.
AB  - In documenting cognitive processes underlying persons' reactions to negative
      events, counterfactual thinking, hindsight bias, and attribution theory focus on
      distinct, although not unrelated, aspects of human information processing.
      Counterfactual thinking highlights the cognitive processing undertaken when
      persons imagine different courses of action that lead to alternative outcomes.
      Hindsight bias describes the inflated retrospective estimates individuals make
      regarding event probabilities that come with the advantage of knowledge about
      outcomes. And attribution theory concerns the affective and behavioral
      consequences that result from the perceived causes of events. This essay argues
      that a more comprehensive understanding of the processes underlying human
      response to traumatic events results from the integration of counterfactual
      thinking, hindsight bias, and attribution theory into a single model.

PMID- 8488232
TI  - Prediction of cancer and coronary heart disease mortality by means of a
      personality inventory: results of a 15-year follow-up study.
AB  - This paper reports on the 1982-1986 follow-up of two samples of healthy persons
      first studied in 1972 and followed up in 1982 when mortality and cause of death
      were established (N = 2,146). Both were related to stress and personality type
      according to clearly elaborated theories, and results were very much in
      accordance with theory. The second follow-up was instigated to answer criticisms
      of the first study and to test whether results would still support the theories
      involved. The data support the previous results strongly and show that
      psychosocial data can predict with considerable accuracy mortality and cause of
      death over 14 years ahead.

PMID- 8488233
TI  - On the validity of hypotheses derived from the Rorschach: the relationship
      between shading and anxiety, update 1992.
AB  - Research on the hypothesis that shading responses on the Rorschach reflect how
      people deal with their anxiety was reviewed. The research does not lend support
      to the hypothesis, but serious methodological and conceptual problems with this
      research make it difficult to assess the meaning of the results of these studies.
      The nature of needed research is discussed.

PMID- 8488234
TI  - Anger and sports participation.
AB  - This study investigated differences between 19 varsity and 20 intramural male
      football players in trait anger, anger expression, and sports orientation. While
      varsity athletes reported comparable levels of trait anger, they described
      significantly less internalized (anger in) and externalized anger (anger out)
      than intramural athletes. Also, the varsity athletes reported significantly less
      anger control. Significant differences were also found for competitiveness and
      goal orientation, but not win orientation, such that the varsity athletes were
      more competitive and goal-oriented than the intramural athletes. The implications
      of these findings are discussed in terms of several alternative hypotheses.

PMID- 8488235
TI  - Hopelessness in adolescent psychiatric inpatients.
AB  - To study hopelessness in adolescent inpatients, we administered the Beck
      Hopelessness Scale to 108 inpatients between 12 and 17 years old who were
      diagnosed with mixed psychiatric disorders. Moderate to severe pessimism about
      the future was described by 42.6%. A principal components analysis of the
      correlations among the scale's 20 items was conducted, and three components
      reflecting rejection of the possibility of a hopeful future, acceptance of the
      inevitability of a hopeless future, and resignation to the futility of changing
      the future were identified. These dimensions were comparable to those previously
      reported for adults, and the usefulness of the scale for evaluating hopelessness
      in adolescent inpatients was discussed.

PMID- 8488236
TI  - Adolescent and adult female leaders: comparisons on measures of valued leadership
      traits and irrational thinking.
AB  - This study compared the responses of 45 adolescent and 45 adult female leaders on
      measures of valued leadership traits and irrational thinking. Adolescent leaders
      value Creativity, while adult leaders view Sense of Purpose an important
      leadership trait. Adolescent leaders possess significantly more irrational
      beliefs than adult leaders and tend to endorse those beliefs which reflect high
      self-expectations, blame proneness, and anxious overconcern about the future.

PMID- 8488237
TI  - Anxiety, anger, and depression in elderly women.
AB  - Few epidemiological data are available on affect, such as anxiety, anger, and
      depression, among elderly persons. Given the increase in the number of relatively
      older people, epidemiological studies of aging are critically important. The
      present study was undertaken to elucidate the relationship between age and these
      affects. Data obtained from 4,302 women participating in a breast cancer
      screening program, aged over 43 and up to 89 years, showed that correlations for
      age and anxiety, anger, and depression are generally low, respectively, -.02, 
      .05, and .05. Mean scores for anxiety, anger, and depression over the various age
      groups are comparatively similar, with some slight age-related trends for anger
      and depression. The changes in depression (an increase in mean depression scores
      with increasing age) appeared to be related to the positive association of the
      self-reported "somatic-depression" with age.

PMID- 8488238
TI  - Just world beliefs, self-esteem, and attitudes towards homosexuals with AIDS.

PMID- 8488239
TI  - Anxiety during pregnancy at the time of the Gulf War: comparison of anxiety of
      Israeli women with normal pregnancies and those with "at-risk" pregnancies.
AB  - 81 pregnant women were interviewed at the time of the Gulf War. One group was
      interviewed before the missile attacks began in Israel, and the second group
      during the period of the attacks. Of the women interviewed, 53 women had "high
      risk" pregnancies and 28 had normal pregnancies. Despite the hypothesis that
      women with "at-risk" pregnancies would report a greater rise in anxiety during
      the missile attacks, it was found that the women with normal pregnancies reported
      a significantly greater rise in anxiety during missile attacks. It is suggested
      that the already-stressed "high-risk" group "shut out" the additional anxiety
      generated by the dangers from the missile attacks.

PMID- 8488240
TI  - Source of sex education in relation to self-esteem and attitudes towards AIDS
      precautions among college students.
AB  - 84 college students responded to Coopersmith's self-esteem scale, Moore and
      Barling's AIDS Questionnaire, and a background survey querying them as to their
      sex, race, religion, frequency of church attendance, marital status, college
      classification, and sources of their sex education. The results indicated that
      self-esteem scores correlated positively with having received sex education from
      the parents and negatively with not having received sex education from any of the
      listed sources. More frequent church attenders were more likely to have received
      sex education from their parents and to score higher in foreclosure status with
      regard to attitudes towards AIDS. Persons who scored higher on moratorium status
      for attitudes towards AIDS were less likely to have received sex education in
      high school, were more likely not to have received sex education from formal
      sources, and reported being less likely to use condoms.

PMID- 8488241
TI  - Pleasure from activities and self-defeating personality.
AB  - As predicted, people who scored higher on a measure of Self-defeating Personality
      reported experiencing less pleasure and enjoyment from individual and social
      activities as well as from personal accomplishments. The results were consistent
      with the idea that these people maintain a self-image of "loser" by minimizing or
      discounting positives in their lives. Results were also consistent with prior
      research showing a positive relationship between self-defeating personality and
      depressive affect.

PMID- 8488242
TI  - Mini-Mental State Examination scores: gender and lifetime psychiatric disorders.
AB  - The Mini-Mental State Examination was taken by 862 subjects from the general
      population, all born in 1931 and 55 to 57 years of age at the time of the study.
      These responses were analyzed in detail to obtain normative data for the test,
      and comparisons were made between the members of the group who had lifetime
      histories of psychiatric disorder and those who did not. Comprehensive
      comparisons were also made of the geometric diagram included in the test with the
      aim of finding nonpathological variations within correct geometric drawings.
      Apart from providing normative data, findings show a difference in the final
      score for the sexes, depending on whether Serial 7s are chosen or a word is
      spelled backwards. The men received a higher score on Serial 7s and the women a
      higher score on spelling a word backwards. A pretest choice is recommended in
      that the Serial 7s be selected for men, but omitted for women. Both gender
      differences and a psychiatric diagnosis correlate with the naming of two digits
      in a MMS subscore category.

PMID- 8488243
TI  - Cyclical variations in psychiatric patient-to-staff assaults: preliminary
      inquiry.
AB  - This study examined possible cyclical variations in psychiatric patient assaults
      against staff. A statistically significant greater number of assaults occurred
      during hotter months. Possible explanations are presented.

PMID- 8488244
TI  - The evaluation and understanding of pain: clinical and legal/forensic
      perspectives.
AB  - The evaluation and proper clinical and legal management of pain clients defy
      simple remedies. Historically, human pain has challenged the most sophisticated
      of philosophical, theological, and biomedical explanations. Following an
      historical overview of pain concepts and treatment, this paper discusses the
      prevalence in and influence of pain on the modern world. One perspective for
      viewing multifaceted pain issues is a model developed by John Loeser. This four
      level model addresses not only tissue damage (Nociception), but also the
      patient's perception of such damage (Pain), the negative emotional reactions to
      such perceptions (Suffering), as well as the pain activity stemming from such
      damage (Pain Behavior)--all issues critical in medical management as well as in
      personal injury litigation. Several methods for classifying pain are discussed,
      including acute vs chronic pain, benign vs cancer pain, "real" vs psychogenic
      pain, and a multiaxial coding schema for pain which encompasses a number of
      professional disciplines. Clinical pain assessment is then reframed and
      translated into a legal format more relevant to forensic discovery and case
      development.

PMID- 8488245
TI  - Personality subgroups in an inpatient Vietnam veteran treatment program.
AB  - Millon Clinical Multiaxial Inventory personality profiles of 250 male inpatient
      Vietnam veterans were examined to locate subgroups within that population. Using
      a hierarchical cluster analysis to form relatively homogeneous groups, four
      clusters were identified which accounted for 98% of the population. Three
      clusters had Millon profiles suggestive of a stress reaction and one cluster had
      a profile indicative of an antisocial adjustment. As measured by a PTSD subscale
      of the Minnesota Multiphasic Personality Inventory two clusters are high stress
      groups and two clusters are lower stress groups. The two Millon personality
      profiles in the high stress category were an 8-2-1/6 group and a 2-8-1-3 group.
      The lower stress groups had profiles of /8-2 and 6/8-5. The high stress groups
      are considered Posttraumatic Stress Disorder groups and the lower stress groups
      are considered nonPosttraumatic Stress Disorder groups.

PMID- 8488246
TI  - Psychology of computer use: XVII. Relating self-rated computer experience to
      computer stress.
AB  - College students were surveyed using Hudiburg's Computer Technology Hassles Scale
      and their computer experience. Students with low, moderate, and high computer
      experience (ns = 67, 77, and 37) appeared to perceive the same interactions as
      unpleasant. The students selected unpleasant interactions in the same numbers and
      with the same intensity.

PMID- 8488247
TI  - Tendency toward controlling behavior in adult children of problem drinkers: an
      experimental study.
AB  - Several clinicians have remarked on an obsessive need to control among adult
      children of alcoholics. In an experimental test of this hypothesis 30 adult
      children of problem drinkers and 31 control subjects performed a computer
      simulated coin-tossing task. On half of the trials the outcome of the coin toss
      was open to control; the outcome was random on the remainder of the trials. The
      children of problem drinkers and the control group did not differ in their
      success on the task, but in comparison to control subjects the children of
      problem drinkers tended to perceive a greater difference between controllable and
      random trials in the coin-tossing task's openness to control. Of the two groups,
      the control subjects proved to be more realistic in their assessment of the
      control they had exercised during the task. These findings are discussed in terms
      of the theme of control in the lives of the adult children of alcoholics.

PMID- 8488248
TI  - Joint analysis of site-specific cancer risks for the atomic bomb survivors.
AB  - Statistical methods are presented for joint analysis of site-specific cancer
      risks for the atomic bomb survivors. Previous analyses of these data have been
      made either without regard to cancer type, excluding leukemia, or separately for
      types or classes of cancers. Clearly, analyses without regard to cancer type are
      less than satisfactory. The primary advantages of joint, rather than separate,
      analyses are that: (1) models can be fitted with some parameters common to cancer
      types and others type-specific; (2) significance tests can be used to compare
      type-specific risks; and (3) through consideration of more comprehensive models,
      a clearer understanding may be obtained of the modifying effects of sex, age at
      exposure, and time since exposure. Joint analysis is straightforward, entailing
      primarily the incorporation of another factor, cancer type, in the usual cross
      tabulation of the data for analysis. The use of these methods is illustrated in
      an analysis of three classes of cancer studied by the National Research Council's
      BEIR V Committee: digestive, respiratory, and other solid tumors. Based on this
      analysis, some criticism is made of the BEIR V preferred models. The proposed
      methods are applicable to models for either relative or absolute risks, and
      results using both types of models are given. Although some of the gains from
      joint analysis are apparent from the results here, it will be important to use
      these methods with a more suitable choice of cancer classes and for cancer
      incidence data where the diagnoses are more accurate.

PMID- 8488249
TI  - A model of cell inactivation by alpha-particle internal emitters.
AB  - Tumor-associated antibodies labeled with 131I and 90Y have been used in the
      treatment of malignant disease with some success. The use of alpha-particle
      emitting radionuclides as radiolabels offers potential advantages over beta
      particle sources. The short range in tissue (< 100 microns) and the high linear
      energy transfer associated with alpha-particle emitters will result in a more
      concentrated deposition of energy at the site of radionuclide decay. Thus, if
      radiolabeled antibodies can be bound to malignant cells specifically, a high
      differential cell killing can be achieved between the malignant and the normal
      cells. However, the energy deposition pattern will be strongly dependent upon the
      configuration of alpha-particle sources relative to the cells, and will
      consequently impact upon the dose-response characteristics. The purpose of this
      paper is to study distributions of energy deposition from alpha-particle-emitting
      radioimmunoconjugates distributed uniformly and nonuniformly around cells through
      theoretical modeling. Energy deposition spectra for cell nuclei are calculated
      and used to estimate the survival fraction by a simple biological model. We show
      that survival curves resulting from nonuniform distributions of alpha-particle
      emitting radiolabeled antibodies can depart significantly from the classical
      exponential survival model applied to external alpha-particle beams. The survival
      curves may have initial slopes much steeper than those produced by a uniform
      distribution of sources, and they may also depart from linearity. Furthermore,
      the results of the modelling indicate how survival curves are dependent on the
      cell and radiolabel spacing. The results from our model compare reasonably well
      with published experimental data and can be used to facilitate the design and
      interpretation of radiobiological experiments.

PMID- 8488250
TI  - Lung hyperpermeability and changes in biochemical constituents in bronchoalveolar
      lavage fluids following X irradiation of the thorax.
AB  - Groups of rats were administered different doses of X rays (7.5 and 15 Gy), and
      the effect on the permeability of their lungs was evaluated during a time frame
      within which radiation pneumonitis develops. Sham-exposed animals served as
      controls. End points surveyed included lung weight and increases in the total
      protein in the lavage fluid. To obtain more detailed information about
      hyperpermeability and to examine some specific protein changes that occur in the
      lung's fluid in response to X irradiation, the lavage fluids were subjected to a
      reverse-phase HPLC technique that resolves 11 fractions quantitatively, including
      transferrin, albumin, and immunoglobulins derived from blood, as well as eight
      other protein and nonprotein constituents that appear to be derived from the lung
      (fractions 1, 2, 6-11). The earliest change following the 7.5-Gy dose was a
      decrease in fraction 6 at 1 week after exposure. As of Week 5, the lung weight
      and total protein in the lavage fluid were all normal, while the HPLC analyses
      revealed significant and equivalent increases in the amount of transferrin,
      albumin, and immunoglobulins in the lavage fluid; fraction 6 was no longer
      diminished. At 9 and 13 weeks, hyperpermeability could no longer be detected,
      while fraction 6 was again decreased at week 13. Fraction 6 was also decreased 1
      week after the 15-Gy dose. At 5 weeks, when the weight of the lungs and the total
      protein in the lavage fluid were elevated, lavage fractions 1, 2, 10, and 11 were
      all increased, and transferrin, albumin, and immunoglobulins were increased
      approximately 1500, 1000, and 500%, respectively, and fractions 6 and 9 were
      decreased. By Week 7, the weight of the lungs returned to control limits, while
      total protein in the lavage fluid remained elevated. The hyperpermeability was
      characterized by increases in transferrin and albumin in the lavage fluid, but
      not immunoglobulins. Fractions 1, 2, 10, and 11 returned to within normal limits,
      whereas fraction 9 decreased further. Increases in transferrin and albumin were
      components of a persisting hyperpermeability observed at the last 9-week time
      point. All other fractions were normal, with the exception of fraction 6, which
      remained decreased.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488251
TI  - Radiosensitivity of atomic bomb survivors as determined with a micronucleus
      assay.
AB  - If A-bomb survivors include a disproportionately large number of either
      radioresistant or radiosensitive persons, the surviving population would provide
      a biased estimate of the true risk of radiogenic cancer. To test this hypothesis,
      the in vitro X-ray sensitivities of peripheral blood lymphocytes obtained from
      937 A-bomb survivors were measured with a cytokinesis-blocking micronucleus
      assay. Background frequencies (no irradiation in vitro) of micronuclei show a
      wide distribution. Frequencies in both males and females tend to increase with
      increasing donor age. Frequencies in females are significantly higher than those
      in males. Donor age decreases the sensitivity of lymphocytes to in vitro X-ray
      exposure at a rate of about 0.001 micronuclei per cell per year per gray. There
      is no effect of donors' sex on in vitro radiation sensitivity. Atomic bomb
      radiation and cigarette smoking had no significant effect on background and X-ray
      induced micronuclei frequencies. Thus there is no difference in radiosensitivity
      of peripheral blood lymphocytes between proximally and distally exposed
      survivors.

PMID- 8488252
TI  - Effect of adrenalectomy on the latency of radiation myelopathy in rats.
AB  - The effect of adrenalectomy on the development of radiation myelopathy was
      studied. A 1-cm section of cervical cord of adrenalectomized and intact animals
      was exposed to graded doses (18 to 30 Gy) of gamma rays. The radiation tolerance,
      the latent period from exposure to paralysis, plasma corticosterone levels at the
      time of paralysis, and histopathology of the cord were evaluated. Adrenalectomy
      essentially eliminated endogenous production of corticosterone and significantly
      shortened the mean latent period between irradiation (24 to 30 Gy) and paralysis
      by more than 10 weeks. This reduced latent period was not reversed by the
      administration of the exogenous glucocorticoid, dexamethasone, and
      corticosterone, although prolonged administration of dexamethasone resulted in
      the development of Cushingoid features, indicating hypercorticoidism.
      Histopathological examinations indicated that adrenalectomized paretic animals
      had multiple hemorrhages in both the gray and the white matter, but less white
      matter necrosis than normally observed in intact paretic animals irradiated
      similarly. Possible mechanisms for the shortened latent period in
      adrenalectomized animals are discussed.

PMID- 8488253
TI  - Sequence analysis of X-ray-induced mutations occurring in a cDNA of the human
      hprt gene integrated into mammalian chromosomal DNA.
AB  - Sequences of 38 independent X-ray-induced mutations in a cDNA of the human
      hypoxanthine phosphoribosyltransferase (hprt) gene were analyzed after it was
      integrated into mammalian chromosomes as part of a shuttle vector. There were 15
      base substitutions (39%), 9 frameshifts (24%), 11 deletions (29%), and 3 other
      mutations (8%) of two kinds. Radiation-induced mutations were found throughout
      the coding region of the gene. Base substitution mutations occurred more often at
      A:T sites than at G:C sites, and there were more transversions than transitions.
      Most of the frameshifts and deletions had short direct repeats or a run of
      several identical bases at the site of the mutation. A slippage misalignment
      mechanism, suggested previously, can account for the generation of these classes
      of mutations. The kinds, distribution, and possible mechanism of X-ray-induced
      mutations were similar to those of spontaneous mutations.

PMID- 8488254
TI  - Delayed heritable damage and epigenetics in radiation-induced neoplastic
      transformation of human hybrid cells.
AB  - The HeLa x skin fibroblast human hybrid cell system has proven to be an excellent
      model system for quantitative studies of radiation-induced neoplastic
      transformation in vitro. A unique aspect of this system is the reexpression of a
      cell surface protein p75/150 with tumorigenicity. The identification of p75/150
      as intestinal alkaline phosphatase (IAP) allowed for the recent development of a
      more simplified, rapid, and sensitive screening method than the previous p75/150
      antibody-based staining procedure. The new method directly detects neoplastically
      transformed, IAP-expressing cells by staining with the alkaline phosphatase
      chromogenic substrate, Western Blue (WB). Earlier studies with the antibody-based
      immunoperoxidase assay indicated that, while no foci with tumor-associated
      antigen (p75-positive) were evident 15 days after irradiation, the number of foci
      rose quickly and leveled off between Day 19 and Day 23. This late appearance of
      the IAP-positive foci suggested that the neoplastic transformation process was
      not an immediate consequence of radiation damage. The mechanism underlying this
      observation was unknown. The possibility existed that very small foci and/or foci
      expressing a low level of IAP were being missed at earlier expression times. The
      increased sensitivity of the WB staining technique has allowed for the
      reinvestigation of the kinetics of induction of radiation-induced foci in this
      system. Experiments were performed where parallel groups of transformation flasks
      were stained at Days 7, 9, 11, 13, 15, 17, 19, and 21 days after irradiation. The
      data clearly indicate that the radiation induction of IAP-positive foci is indeed
      delayed in this system with the vast majority of the foci beginning to appear
      after Day 9 after irradiation. The delay is not the result of a lack of ability
      to detect small IAP-positive foci since foci with as few as 15 IAP-positive cells
      were discernible. We have reported previously that under identical experimental
      conditions both the establishment of plateau phase and the onset of the
      expression of lethal mutations also occur after Day 9. We therefore propose that
      radiation-induced neoplastic transformation of HeLa x skin fibroblast hybrid
      cells is a consequence of the delayed expression of heritable damage under
      epigenetic control with a resultant loss of tumor-suppressor function.

PMID- 8488255
TI  - Benign thyroid adenomas among persons X-irradiated in infancy for enlarged thymus
      glands.
AB  - Thyroid adenoma incidence in a cohort of 2657 infants given X-ray treatment for a
      supposedly enlarged thymus gland, along with 4833 unirradiated siblings, has been
      ascertained for an average of 37 years since irradiation. Estimated thyroid doses
      ranged from 0.03 to > 8 Gy, with 62% receiving < 0.5 Gy. After excluding 4
      adenoma cases with concurrent or previous thyroid cancer, there were 86 cases
      with pathologically diagnosed thyroid adenomas in the irradiated group and 11 in
      the sibling controls. The estimated excess relative risk (ERR) was 6.3 per gray
      (90% CI = 3.7, 11.2). Once the dose group with > or = 6 Gy, which was producing
      downward curvature in the dose-response function, was removed, the curve was
      compatible with linearity and the ERR was 7.8 per gray. Thyroid adenoma rates
      were elevated even at low doses: the lowest dose group (< 0.25 Gy) showed a
      significant elevation in risk. The relative risk appeared to be constant over
      time and was comparable for both sexes. Excess adenoma risk was observed in the
      irradiated group to the maximum follow-up interval of about 50 years. A number of
      potential risk factors for thyroid adenoma were examined both as risk factors in
      their own right and as modifiers of the radiogenic risk. Parity and use of
      hormones in relation to menopause were significantly associated with thyroid
      adenoma risk in women, while education, Jewish origin, history of hyperthyroidism
      or hypothyroidism, and family history of cancer were also adenoma risk factors in
      both sexes. An examination of interactions between possible risk factors and
      radiation suggested that women with a history of oral contraceptive use or
      hysterectomy and persons with a family history of cancer may have greater risk
      (per unit dose) of radiogenic thyroid adenomas than their counterparts.

PMID- 8488256
TI  - Leukemia and other related hematological disorders among Danish patients exposed
      to Thorotrast.
AB  - At least 60 case studies of leukemia among people exposed to chronic low-dose
      alpha-particle radiation from injections with the radiographic contrast medium
      Thorotrast and 115 cases from follow-up studies have been described in the
      literature. In the present study, malignant hematological diseases among 1003
      Danish patients injected during 1935-1947 and followed to 1992 accruing 20,433
      person-years were assessed and available histopathological specimens revised. The
      mean cumulative bone marrow alpha-particle radiation dose (1.34 Gy) was estimated
      from records of the amount of Thorotrast injected (mean 18.7 ml). Sixteen cases
      of acute myelogenous leukemia (AML) and seven cases of myelodysplastic syndrome
      (MDS) were diagnosed 8-40 years after injection, the cumulative frequency
      reaching 7.6%. No significant relationship was seen between the cumulative
      frequency of AML + MDS and the age at injection, gender, or amount of Thorotrast
      injected, but a multivariate analysis described data best by a model with the
      bone marrow dose and the power of the attained age. The risk estimate for AML +
      MDS was 173 cases/10(4) persons per Gy. If also considering cases of acute
      lymphocytic leukemia (1), chronic myelogenous leukemia (3), non-Hodgkins lymphoma
      (4), and multiple myeloma (2), the risk estimate became 248 cases/10(4) persons
      per Gy. It is suggested that RBE of alpha particles from thorium may be lower
      than 20.

PMID- 8488257
TI  - Zero tumor incidence in mice after repeated lifetime exposures to 0.5 Gy of beta
      radiation.
AB  - A final series of experiments on tumor induction by repeating 90Sr-90Y beta
      irradiation of the back of ICR mice three times weekly throughout the life span
      showed no tumor incidence with repeated doses of 0.5 Gy per exposure. The whole
      dose-response relationship for repeated irradiation with 0.5 to 11.8 Gy per
      exposure, summarized along with data obtained previously, showed a unique
      nonlinear dose response with saturation of tumor incidence at doses of over 2.5
      Gy per exposure and a threshold-like value around 1.5 Gy per exposure.

PMID- 8488258
TI  - Radiation-induced proliferation in contralateral unirradiated kidneys.
AB  - Following irradiation of a single kidney in mice, the weights and labeling
      indices in the irradiated and contralateral unirradiated kidneys were measured.
      Three to 12 months after irradiation we found that the proliferation of proximal
      tubule cells was increased not only in the irradiated kidney but also in the
      contralateral unirradiated kidney. The labeling index in the contralateral
      unirradiated kidney did not increase in the first month after irradiation but it
      did in the irradiated kidney. Contralateral kidney weight increased as the weight
      of the irradiated kidney decreased. We suggest that cell proliferation in the
      contralateral kidney was probably induced through a humoral growth factor
      beginning 3 months after irradiation. We postulate that induced cell
      proliferation in the irradiated kidney is a result of a local factor at 1 month
      and of local and humoral factors at later times.

PMID- 8488259
TI  - Low-dose-rate irradiation of rat embryo cells containing the Ha-ras oncogene.
AB  - Rat embryo cells and derived transfectants containing the Ha-ras oncogenes were
      irradiated with 60Co gamma rays at dose rates of 0.72, 0.066, 0.035, and 0.018
      Gy/min. The measured dose response of cell survival shows that the oncogene
      containing cells exhibit higher survival levels at all doses than the parental
      cells at every dose rate. The response of the cells containing the ras oncogene
      also became dose-rate independent at a higher dose rate, perhaps indicative of a
      greater repair capability relative to that of the primary cells.

PMID- 8488260
TI  - [Genome mapping of human chromosome 11--construction of cytogenetic map].

PMID- 8488261
TI  - [Physical mapping of human chromosome 21--construction of a NotI restriction map
      by linking clone mapping].

PMID- 8488262
TI  - [Analysis of chromosome 21--construction of STS map and its application for
      contig map construction].

PMID- 8488263
TI  - [Human genome analysis using chromosome sorting].

PMID- 8488264
TI  - [Mapping the human Y chromosome].

PMID- 8488265
TI  - [Analysis of oncogenes and tumor suppressor genes].

PMID- 8488266
TI  - [Abnormal gene in Huntington's disease].

PMID- 8488267
TI  - [Genetic studies in the neuropsychiatric disorders].

PMID- 8488268
TI  - [Cloning of the genes underlying neurological diseases--chromosome dissection and
      SUP-PCR].

PMID- 8488269
TI  - [Molecular genetic approach for positional cloning of X-chromosome-linked
      diseases].

PMID- 8488270
TI  - [Genetic analysis of hypertrophic cardiomyopathy].

PMID- 8488271
TI  - [Organization of the human T-cell receptor genes and its involvement in
      chromosome translocations in T-cell malignancy].

PMID- 8488272
TI  - [Gene organization of HLA region].

PMID- 8488273
TI  - [The centromere of human chromosome].

PMID- 8488274
TI  - [Organization of the human immunoglobulin heavy chain variable regions genes].

PMID- 8488275
TI  - [An equalized cDNA library and its application].

PMID- 8488276
TI  - [Fission yeast cDNA project].

PMID- 8488277
TI  - [Human genome analysis by large scale DNA sequencing].

PMID- 8488278
TI  - [The large scale cDNA database and the analysis system--cDNA binder].

PMID- 8488279
TI  - [Homo.protein cDNA bank--from molecular taxonomy to molecular ecology].

PMID- 8488280
TI  - [cDNA project of embryonal carcinoma cells].

PMID- 8488281
TI  - [Toward the construction of a full length cDNA library].

PMID- 8488282
TI  - [cDNA subtraction].

PMID- 8488283
TI  - [Exploration of new genes in the nervous system].

PMID- 8488284
TI  - [Approach to protein catalog].

PMID- 8488285
TI  - [Chemical cleavage of long chain DNA--molecular design for artificial restriction
      enzyme].

PMID- 8488286
TI  - [Separation of large DNAs--inhomogeneous field gel electrophoresis].

PMID- 8488287
TI  - [Separation of large DNAs--large DNA dynamics in gel].

PMID- 8488288
TI  - [Triple helix DNA and genome analysis].

PMID- 8488289
TI  - [Human genome mapping by direct R-banding fluorescence in situ hybridization].

PMID- 8488290
TI  - [Methodology of gene mapping].

PMID- 8488291
TI  - [Use of microcell-hybrid for genomic analyses].

PMID- 8488292
TI  - [Collection and analysis of polymorphic repetitive sequences].

PMID- 8488293
TI  - [Dual-laser chromosome sorting].

PMID- 8488294
TI  - [Screening of YAC library].

PMID- 8488295
TI  - [Stabilization of the YAC clone].

PMID- 8488296
TI  - [P1 phage vector].

PMID- 8488297
TI  - [Structural analysis of giant DNA by a defined in vitro DNA packaging system of
      T3 phage].

PMID- 8488298
TI  - [Exon trapping and its application].

PMID- 8488299
TI  - [Automated DNA sequencer in genome analysis].

PMID- 8488300
TI  - [Construction of an automated system of human genome analysis (HUGA-I)].

PMID- 8488301
TI  - [Sequencing by oligonucleotide hybridization].

PMID- 8488302
TI  - [Genomic analysis of Escherichia coli K-12].

PMID- 8488303
TI  - [Sequencing project of Bacillus subtilis genome].

PMID- 8488304
TI  - [Genome mapping of Schizosaccharomyces pombe].

PMID- 8488305
TI  - [Genome analysis of the nematode C. elegans].

PMID- 8488306
TI  - [Genome analysis of mice].

PMID- 8488307
TI  - Holism, holes, and wholes.

PMID- 8488309
TI  - Health consequences of loneliness in adolescents.
AB  - The purpose of this study was to test a causal model developed from a theoretical
      formulation of the health consequences of loneliness in adolescents. The sample
      consisted of 325 adolescents, ages 12 to 21. Data were obtained in classroom
      settings on the variables of age, gender, and loneliness on one testing date; and
      on the variables of introspectiveness, symptom patterns, and perceived health
      status on another testing date 1 week later. The causal model was tested via the
      LISREL 7 program. By all indicators used in this study, there was a very good fit
      of the overidentified model with the data, the causal relationships predicted in
      the model were correctly specified, and modification of the model was not
      indicated. The results indicated that loneliness contributed to
      introspectiveness, that both loneliness and introspectiveness contributed to the
      reporting of symptom patterns, and that all of the aforementioned variables
      contributed directly and/or indirectly to a less positive perception of health
      status among adolescents. A vast majority of the direct and indirect effects of
      age and gender predicted on other variables in the model were supported.

PMID- 8488308
TI  - Outcomes of specialized and traditional AIDS counseling programs for impoverished
      women of color.
AB  - The efficacy and differential effects of specialized (S) and traditional (T) AIDS
      education programs on cognitive, behavioral, and psychological outcomes were
      investigated. The sample consisted of 858 impoverished African-American and
      Latina women (S = 448, T = 410). At baseline, women in the traditional group
      reported significantly higher distress, greater knowledge of AIDS, and less
      problem-focused coping. Significant improvements over the 2-week intervention
      interval were found for participants of both AIDS education programs for
      appraisal of threat, concerns, knowledge, and attitudes about AIDS, emotion
      focused coping, number of sexual partners, IV and non-IV drug use, depression,
      and distress. However, multivariate analysis indicated that the traditional group
      had slightly better posttest scores on concerns, emotion-focused coping,
      knowledge of AIDS, and number of partners than the specialized group. The
      specialized group reported greater use of problem-focused coping. These
      differences do not detract from the substantial improvement found for both
      groups, but they do reinforce the conclusion that the specialized program was not
      more effective than its standard counterpart.

PMID- 8488310
TI  - Integration of biological and nursing sciences: a 10-year plan to enhance
      research and training.
AB  - A proposed multiyear plan of funding mechanisms by the National Center for
      Nursing Research (NCNR) to increase the use of biological theory and measurements
      in nursing research has been developed for both research training and research
      programs. The objectives of the research training programs are (a) to develop a
      cadre of nurse scientists with solid research training in the biological
      sciences, (b) to upgrade to state-of-the-art biological research for mid-career
      nurse scientists, and (c) to ensure adequate highly trained biological-nurse
      manpower will be available to accomplish the nation's nursing research agenda.
      The objectives of the research programs are (a) to stimulate nurse scientists to
      undertake novel, innovative research using state-of-the-art biological
      technology, (b) to link the behavioral and biological underpinnings of nursing
      science in specified areas of biomedical clinical research, and (c) to ensure
      that, in the coming decade, nursing science and behavioral research will be
      inextricably interwoven with biological research. The research training programs
      include: targeted predoctoral-postdoctoral transitional training, targeted
      predoctoral or postdoctoral fellowships, training awards for existing
      institutional training grants in other disciplines, mid-career awards, the Nurse
      Scientist award, and institutional training grants for biological nursing. The
      research programs include: small grants programs, augmentation of existing
      projects in other Institutes, Requests For Applications (RFA) in biobehavioral
      nursing, cluster studies, and clinical trials.

PMID- 8488312
TI  - Predictors of partner relationships during pregnancy and infancy.
AB  - The partner relationship of 153 women hospitalized for a high-risk pregnancy, 75
      of their partners, 218 women who experienced a low-risk pregnancy and 147 of
      their partners was studied to determine risk-status or gender differences at
      pregnancy, the postpartal hospitalization, 1, 4, and 8 months following birth. A
      theoretical causal model predicting partner relationships was tested, followed by
      model respecification to derive the best explanatory model for each group. No
      differences were observed between low- and high-risk mothers' partner
      relationship; however, high-risk fathers scored lower than low-risk fathers.
      Partner relationships for all groups were significantly higher during pregnancy
      and at birth than at 4 and 8 months after birth. Respecified models explained
      from 26% to 63% of the variance in partner relationship during pregnancy, and
      from 31% to 52% at 8 months after birth.

PMID- 8488311
TI  - Maternal employment, family functioning, and preterm infant development at 9 and
      12 months.
AB  - The purpose of this study was to investigate the effects of maternal employment
      on child development and family functioning for families with preterm infants.
      Data were collected in the family's home (N = 67) when the infant was 3, 9, and
      12 months of age. Maternal employment at 3 months had little effect on 9- and 12
      month child mental or psychomotor development or on family cohesion,
      adaptability, or satisfaction. Maternal employment attitude/behavior consistency
      was a significant predictor of psychomotor development. Choice in the employment
      decision at 3 months was positively related to both mental and psychomotor
      development at 9 and 12 months for nonemployed mothers.

PMID- 8488313
TI  - Everyday indicators of impaired cognition: development of a new screening scale.
AB  - Development of the Everyday Indicators of Impaired Cognition (EIIC) Scale to
      assess nursing home residents for performance errors in four domains of cognitive
      functioning is reported. The EIIC had strong content validity, with indices
      ranging from .7 to 1.0. Factor analyses of data from two independent samples (N =
      198, N = 107) confirmed four factors: abstract thinking, judgement, language, and
      spatial skills. Cronbach's alpha for subscales ranged from .67 to .92; test
      retest reliabilities ranged from .49 to .80 with higher reliabilities occurring
      when time of retest matched time of original testing. Overall EIIC scores
      correlated to the short Memory-Orientation-Concentration (MOC) test and the Mini
      Mental Status Examination (MMSE) at values supporting convergent validity (r =
      .67 and -.74, respectively). Evidence for divergent validity is a small,
      negative, nonsignificant correlations (r = -.15, -.18) of the EIIC at Times 1 and
      2 to the Bradburn Affect Balance Scale.

PMID- 8488314
TI  - The erosion of nursing resources: employee withdrawal behaviors.
AB  - A 5-year retrospective cohort study of 404 nurses hired during a 2-year period in
      five hospitals was conducted in order to explore withdrawal behavior exhibited by
      76% of them. Three withdrawal behaviors were examined and compared: turnover,
      absenteeism, and systematic reduction in participation (reduced work schedules).
      In two separate regressions, systematic reduction in participation (SRP) and
      turnover were each regressed on absenteeism, after controlling for six
      organizational and demographic variables. The relationship between absenteeism
      and each of the other two behaviors was significant, but opposite in effect.
      Systematic reduction in participation was found to be an important source of
      nursing resource loss in some, but not all, hospitals.

PMID- 8488315
TI  - Nursing intervention studies require outcome measures that are sensitive to
      change: Part Two.
AB  - Ohis article is the second and concluding part of a discussion of the importance
      of sensitivity to change in selecting an outcome measure for a study evaluating a
      nursing intervention. In Part One of the discussion, (Stewart & Archbold, 1992)
      the relative lack of attention to measurement sensitivity in the nursing and
      measurement literature was described. Three factors to consider in selecting an
      outcome measure for an intervention study were reviewed: the conceptual link
      between the intervention and the outcome variable, the extent to which the
      outcome variable is amenable to change, and content validity. In Part Two, four
      additional factors are discussed: construct validity, distribution of scores on
      the outcome measure, reliability, and correlational stability over time.

PMID- 8488316
TI  - [Angiotensin-converting enzyme inhibitors in the treatment of heart failure:
      toward a change in the natural history of the disease].

PMID- 8488317
TI  - [The incidence of arrhythmias in young persons without demonstrable heart
      disease: a 24-hour Holter study in 100 medical students].
AB  - A Holter monitorization study was performed in 100 voluntary university students
      (64 men and 36 women). The mean age was 23.6 years and organic heart disease was
      ruled out in all cases. Data were analysed in different subgroups including the
      practice of physical activity and subjects smokers or alcohol consumers. The
      maximum heart rate (HR) achieved during the wake period was 138.3 +/- 20.43
      beat/m. Minimum daytime heart rate was 61.42 +/- 10.32 beat/m and it was below 60
      beat/m in 41 subjects. During the nighttime period, the maximum heart rate
      achieved by the group was 89.34 +/- 11.31 beat/m. Minimum nighttime heart rate
      was 45.82 +/- 6.35 beat/m. Maximum heart rate in men was 134.3 +/- 21.35 beat/m,
      while in women was 145.42 +/- 16.36 beat/m. Eighty students presented one or more
      arrhythmias, among them 28 women and 52 men (p = NS): 92% in sportsmen and women
      groups as compared with 79% in the non sports practicers, 90% of alcohol
      consumers and 82% between subjects who smoked and drank, compared with 63% in the
      non drinkers (p < 0.006). 48% of the subjects presented one or more
      supraventricular arrhythmias during the daytime or during the nighttime (p = NS).
      Ventricular rhythm disturbances were found in 20 subjects. There was only one
      case who had a non sustained ventricular tachycardia of 4 complexes. These
      disturbances were not increased by practising sport nor by toxic habits. In 15
      cases we found sinoatrial block, with a male predominance. Five subjects
      presented some type of atrioventricular block, 4 of which were alcohol and
      tobacco consumers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488318
TI  - [The detection of acute myocardial infarct without a Q wave; indium-111-labelled
      antimyosin antibodies versus technetium-99m-labelled radiophosphates].
AB  - In order to ascertain whether antimyosin myocardial imaging is superior to the
      more conventional cardiac radiophosphate scanning for the diagnosis of non Q wave
      acute myocardial infarction (AMI), we conducted a comparative study with the
      contemporary use of both tracers. Forty eight patients admitted to the coronary
      care unit of our centre because of non Q AMI, were included. Between two and
      seven days after onset, cardiac scintigraphy was performed both using 99mTc
      labelled diphosphonic-propane-dicarboxylic acid (99mTc-DPD) and 111indium
      labelled antimyosin (111In-AAM). In addition to planar imaging, tomoscintigraphy
      (SPECT) with 99mTc-DPD was obtained in 12 patients. 99mTc-DPD imaging was
      positive for AMI in 44% of the cases, while 111In-AAM in 52% (NS). In most
      positive cases (more than 85%) myocardial necrosis was localised in the
      posterolateral wall. In the subgroup of SPECT imaged patients, the percentage of
      positive findings was the same as the percentage using planar 111In-AAM imaging
      (58%). We conclude that the apparent efficacy of antimyosin for the diagnosis of
      non Q AMI is similar to that of 99mTc-DPD imaging. We feel that owing to its
      higher cost, such procedure should be saved for those cases were standard 99mTc
      DPD imaging fails to detect the infarcted myocardium.

PMID- 8488319
TI  - [The role of Doppler of effort in the indications for percutaneous valvuloplasty
      and/or mitral surgery in patients with a preserved functional class].
AB  - We have evaluated in this study the role of exercise Doppler echocardiography to
      establish the clinical indication of invasive procedures in patients with mitral
      stenosis and preserved functional class. Thirty-tree patients, mean age 45 +/- 9
      years, underwent 35 exercise Doppler studies by supine bicycle ergometry with a 2
      MHz nonimaging continuous wave Doppler probe. Sixteen patients were in N.Y.H.A.
      class I and 19 in class II. Peak and mean mitral gradient were obtained at rest,
      during, at maximal exercise and at recovery period, averaging at least 5 cardiac
      cycles. The data of 16 patients with mitral area at rest < 1.2 cm2 (group I) were
      compared with the data of 19 patients with mitral area at rest > 1.1 cm2 (group
      II). The mean gradient (mmHg) in the group I compared with respect group II was
      significantly higher at rest (9.5 +/- 3 vs 6 +/- 3, p < 0.01), step 1 (21 +/- 5
      vs 14 +/- 6, p < 0.001), step 2 (26.4 +/- 5 vs 17.9 +/- 6, p < 0.001), step 3
      (26.5 +/- 4 vs 20.7 +/- 6, p < 0.01), step 4 (29.8 +/- 5 vs 23.8 +/- 4, p < 0.05)
      and peak exercise (31.4 +/- 4 vs 21.9 +/- 6, p < 0.001). The functional capacity
      in mets was similar in both groups (6.7 +/- 1 vs 7.2 +/- 2, p = NS). Three
      patients of group I (15.7%) showed the same increase of gradient as group I. We
      conclude that exercise Doppler echocardiography allow identification of the
      haemodynamic severity of patients with mitral stenosis and preserved functional
      class. This technique could be a good tool in clinical indication of invasive
      procedures in these patients.

PMID- 8488320
TI  - [The transmitral gradient of effort: old concepts, new technologies].

PMID- 8488321
TI  - [The nonpharmacological treatment of tachyarrhythmias in 23 children and
      adolescents].
AB  - We comment the results with non pharmacological treatment in 23 patients (mean
      age 11 +/- 4 years) with multiple episodes of palpitations, most of them required
      intravenous drugs for interrupting it. Twenty-eight procedures were performed, 17
      catheter ablation and 11 surgical interventions. The energy source employed for
      fulguration until 1990 was DC and since 1991 radiofrequency. The best results
      with catheter ablation were obtained with accessory pathways. Interruption was
      achieved in all patients after a mean of 1.2 sessions per patient, but it was
      definitive in only 72%. Most of the patients (81%) remained asymptomatic without
      antiarrhythmic drugs. Nine patients with accessory pathways underwent surgery
      interruption, it was achieved in all; only one patient had arrhythmia recurrence,
      due to a second pathway in a different localization. We could not ablate a
      ectopic atrial tachycardia, that underwent surgery. There was only one indication
      for surgery in a patient with ventricular tachycardia. Catheter ablation does not
      present technical problem in children and teenagers, different from adults. The
      presented results lead us to suppose that the indications for non pharmacological
      treatment in the young will become more common.

PMID- 8488322
TI  - [Peripheral vascular reflexes during ventricular overdriving and cardiac
      ischemia. An experimental study].
AB  - The aim of this paper is to analyze the behaviour of the muscular arteries during
      ventricular tachycardia in normal and in ischemic hearts. In 19/30 anaesthetized
      dogs in which a resistance vessel (gracilis muscle artery) was isolated (while
      innervation and venous backflow remained intact), we performed transient (20 min)
      coronary artery occlusions and ventricular overdriving (30 sec). A systolic left
      ventricular pressure decrease (144.2 +/- 18.2 mmHg vs 114 +/- 16.1) (p < 0.001)
      was produced with the coronary circumflex obstruction. Changes in the end
      diastolic left ventricular pressure and muscular artery pressure were not
      significant. A new systolic left ventricular pressure decrease (114 +/- 16.1 mmHg
      vs 64.8 +/- 27) (p < 0.001) was induced when the ventricular overdriving (272.2
      +/- 46.1 bpm) was added to the coronary circumflex obstruction. The end-diastolic
      left ventricular pressure increased (6.8 +/- 10.1 mmHg vs 18.3 +/- 4.8) (p <
      0.001) and the muscular artery pressure increased (121 +/- 27.3 mmHg vs 158.1 +/-
      21.3) (p < 0.01) in these circumstances. When the ventricular overdriving (275 +/
      70.7 bpm) was added to the left descendent anterior coronary occlusion a
      significative decrease of left systolic ventricular pressure (141 +/- 23 mmHg vs
      84.4 +/- 28.4) (p < 0.01) and an increase of the muscular artery pressure (124.3
      +/- 25 mmHg vs 149 +/- 25.1) (p < 0.01) was produced. Ventricular overdriving
      induced hypotension produced an isolated muscular artery response with clear
      vasoconstrictor predominance, which indicates that there is a natural
      compensatory capacity with predominance of efferent sympathetic
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488323
TI  - [Myocardial contusion with and without coronary artery involvement].
AB  - We present the first case of myocardial contusion secondary to blunt chest trauma
      with injury in two different areas, with and without coronary lesions. The
      akinesis of the anterolateral wall was secondary to the obstruction of the left
      anterior descending coronary artery and the severe hypokinesis of the posterior
      wall, without lesion of the right coronary artery, was probably related with the
      compression between the sternum and vertebral column.

PMID- 8488324
TI  - [Biventricular rhabdomyoma or a case of spontaneous regression. A two-dimensional
      echocardiographic study].
AB  - We present the case of an infant diagnosed by prenatal echocardiography as having
      a biventricular rhabdomyoma which was confirmed after birth. In the series of two
      dimensional echocardiographies this tumor was seen to decrease in size until its
      complete disappearance.

PMID- 8488325
TI  - [Exercise-induced atrioventricular block].
AB  - Exercise-induced atrioventricular block in patients with normal atrioventricular
      conduction at rest is uncommon. Electrophysiologic studies have documented block
      distal to the atrioventricular node in these patients. Implantation of a
      permanent pacemaker is recommended because of a high incidence of subsequent
      symptomatic block. We report three symptomatic patients with exercise-induced
      atrioventricular block. Two patients showed a bundle branch block in the baseline
      electrocardiogram, suggesting a distal location of the block. In the remainder,
      with a normal QRS, the electrophysiologic study revealed AV block within the His
      bundle in response to atrial pacing.

PMID- 8488326
TI  - [Embolism due to cholesterol crystals].
AB  - We present a case of cholesterol crystal embolization confirmed histologically by
      skin biopsy and by the presence of a yellowish microemboli with a refringent look
      lodged inside a retinal arterioles. The presence of a typical clinic case
      history, together concurrent risk factor (coronarography, implantation of stent
      and anticoagulation) supported the diagnostic suspicion. Although it is a serious
      illness, often with a fatal evolution, the patient has followed a favourable
      clinic course.

PMID- 8488327
TI  - [The possible damages from cosmetic abuse].

PMID- 8488328
TI  - [The new education of the physician in the Italian university. A low percentage
      of students abandoning their medical studies who attend the degree course in
      medicine and surgery under the new regulations].

PMID- 8488329
TI  - [Angiotensin II stimulates endothelin-1 release from human endothelial cells].
AB  - Endothelin-1 (ET-1) is an endothelium-derived vasoconstrictor peptide isolated
      from the culture supernatant of porcine aortic endothelial cells. This 21 amino
      acid residue peptide has potent vasoconstrictive properties in vitro and in vivo.
      ET-1 action involves phosphatidylinositol turnover, calcium mobilization and
      protein kinase C activation. Endothelial cells have distinct receptors for
      different operating through hydrosoluble hormones. The aim of this study was to
      investigate on a possible role of angiotensin II (ANG II) to modulate the release
      ET-1 from human endothelial cells in vitro. These data revealed a time- and a
      dose-dependent increase of ET-1 production in response to ANG II. This mechanism
      may have important pathophysiological implications in vivo. In fact, a double
      mechanism of secretion of ET-1 from endothelial cells could exist: one active in
      a physiological condition and an other in response to a vasoconstrictor stimuli
      (as well as ANG II). Furthermore, these results may suggest an additional
      favourable effect of ACE-inhibition in human hypertension therapy.

PMID- 8488330
TI  - [Ischemic stroke and transient ischemic attacks: a case-control study of the risk
      factors in elderly hospitalized patients].
AB  - We have evaluated in a case-control study the association of the main risk
      factors with cerebrovascular ischemic accidents in elderly patients. Two hundred
      and twenty patients aged 65 year or more (average age 77.3 +/- 7.3 yr, 93 males
      and 127 females) admitted to our Division for stroke (122) or transient ischemic
      attacks (TIA) (98) were enrolled: 220 hospitalized patients, age and sex-matched,
      without actual or previous cardiovascular clinical manifestations were the
      control group. Advanced senile decay, hepatic or renale failure and malignancies
      were considered exclusion criteria for both groups. The following risk factors
      have been considered: family history, obesity, cigarette smoking, diabetes,
      hypercholesterolemia, hypertriglyceridemia, atrial fibrillation, left ventricular
      hypertrophy, and related continuous variables. After logistic multiple regression
      analysis, atrial fibrillation, hypertension and blood cholesterol concentration
      above 240 mg/dl were significantly and independently associated with stroke,
      while only hypertension and hypercholesterolemia were associated with TIA. The
      unexpected finding of a significant association between hypercholesterolemia and
      cerebrovascular ischemia seems attributable to the choice of hospitalized
      patients as control group. These results indicate that hypertension and atrial
      fibrillation are independently associated with ischemic stroke even in advanced
      age.

PMID- 8488331
TI  - [Community-acquired bronchopneumonias in the elderly. The cost-benefit ratio in
      some plans of antibiotic therapy].
AB  - Community-acquired pneumonias represent the first cause of mortality due to a
      infectious disease, and determine more than 500,000 hospitalizations per year in
      the USA: moreover, they are the terminal event in many geriatric patients.
      Although the etiological microbial agents responsible for the majority of such
      pneumonias, Haemophilus influenzae and Streptococcus pneumoniae, are still
      sensitive to traditional antibiotics, as ampicillin, many doctors treat community
      acquired pneumonias with more recent and expensive antibiotics, as the third
      generation cephalosporins or other beta-lactamines, so enhancing the cost of the
      treatments, without a known, real advantage with respect to the older therapies.
      In this study, to evaluate whether the use of the latter antibiotics improves the
      outcome of community acquired pneumonias of the elderly with respect to the
      traditional therapy with ampicillin, we studied 123 hospitalized patients older
      than 65 years, affected by community-acquired pneumonia, simple or complicated.
      We also evaluated the cost/benefit ratio of every single treatment. Our data
      demonstrate that the recent antibiotics do not influence the outcome of the
      disease of the elderly: in particular, they do not affect the duration of the
      hospitalization, do not have a lower incidence of side effects, do not show a
      better efficacy versus ampicillin. The cost of the treatment with ampicillin is
      about one third of the cost of a third-generation cephalosporin treatment. We
      conclude that the treatment of choice for community acquired pneumonias of the
      elderly is ampicillin; only in few cases, as in nosocomial or in nursing homes
      pneumonias, third-generation cephalosporins or other antibiotics are necessary.

PMID- 8488332
TI  - [Rectal neoplasms].

PMID- 8488333
TI  - [New horizons in medicine. Chaos and its laws].
AB  - We have synthesized the fundamentals that modern technology offers in all areas
      of research, especially in the field of biomedicine. The theory of systems,
      cybernetics, synergetics, boolean algebra, communication science (according to
      modern laws of signal transmission and translation), the solution of non-linear
      equations by computer science, applied principles of reduction in biological
      survey, fractal analysis as a representation of dynamic, chaotic, non-linear
      systems, defined attractors as conditioning elements of biologic function, are
      just a few of the many instruments that modern science offers as a revolutionary
      approach to research programming. Borrowing the laws of mathematics, we have
      defined the fundamental characteristics of linear and non-linear homeostatic
      systems along with the concept of predictable behavior of a system as a function
      of its complex structure. Lastly, we have documented, based on personal research
      and recent findings in biomathematics, and despite current and strong opposition,
      how the functional death of any dynamic system is identified by the system's
      absolute state of equilibrium. The operative errors at times caused by different
      stimuli acting on specific organs and apparatus, are interpreted not as an index
      of altered function but as an expression of a chaotic response of the
      deterministic type and therefore an indication of the system's adaptability to
      the specific functional requirements in that precise moment.

PMID- 8488334
TI  - [The medical treatment of primary hyperparathyroidism].
AB  - The first-choice treatment of primary hyperparathyroidism is surgical removal of
      abnormal parathyroid gland(s) and the medical management is usually reserved only
      to control severe hypercalcemia. However, asymptomatic primary
      hyperparathyroidism with mild hypercalcemia and renal and bone status close to
      normal is now the more common picture of the disease and in this situation
      conservative management can be considered, because many of those patients may
      have a prolonged benign course. Management guidelines are therefore devised to
      minimize the risk for deterioration of renal, skeletal or gastrointestinal
      complications of hyperparathyroidism. General medical management includes
      recommendation to avoid dehydration, immobilization or excessive dietary calcium
      intake and therapy with thiazides; intravenous infusion with isotonic saline
      combined to furosemide or etacrinic acid are recommended to treat acute or
      threatening hypercalcemia. Many other drugs as phosphate, mithramycin, gallium
      nitrate and calcitonin have been reported to be useful in reversing hypercalcemia
      but their transient effects, toxicity and side effects limit their clinical use.
      The bisphosphonates, a new class of bone resorption inhibitors, have been shown
      to be particularly safe so they result especially effective on controlling acute
      hypercalcemia and on preventing "hungry bone" disease. However, their effect is
      not sustained because the serum calcium tends to return toward pretreatment
      levels despite continued therapy; therefore their consistent beneficial effect on
      long-term treatment seems unlike.

PMID- 8488335
TI  - [The diagnosis and therapy of hyperprolactinemia].
AB  - Hyperprolactinaemia is the most common result of pituitary dysfunction and is
      characterized by alteration on the reproductive function. After a review of the
      hypothalamic control mechanisms and of the local paracrine and autocrine factors
      regulating prolactin secretion, the most common physiological, pharmacological
      and pathological causes of hyperprolactinaemia are described. The clinical
      pictures of hyperprolactinaemia in man and woman are then summarized. The
      diagnostic protocol used in this Institute is then described: confirmation of the
      existence and entity of hyperprolactinaemia by means of a prolactin profile;
      exclusion of pharmacological or extra pituitary causes (cirrhosis, primitive
      hypothyroidism, chronic renal failure, etc.); neuro-radiological evaluation of
      the sella region, by means of standard X-ray, computer tomography scan, nuclear
      magnetic resonance. The drugs commonly used in medical treatment of
      hyperprolactinaemia such as a bromocriptine, other-derived compounds and then
      recent CV 205-502, and the surgical approaches (trans-sphenoidal and transcranial
      routes) are reported. The indication of medical or surgical treatment and the
      relevance of radiotherapy are finally considered.

PMID- 8488336
TI  - [Technological innovations in a medical library].

PMID- 8488337
TI  - The role of lipid peroxidation and calcium in galactosamine induced toxicity in
      the rat liver.
AB  - Liver homogenate and subcellular fractional levels of lipid peroxides, homogenate
      glutathione (GSH) and calcium contents and hepatic plasma membrane Ca(2+)-ATPase
      activity were determined in rats, 12, 18, 24 and 48 hours after treatment with a
      single dose of 1 g/kg galactosamine. Lipid peroxides and calcium levels in liver
      homogenate and subcellular fractions were found to increase, but hepatic GSH
      content and Ca(2+)-ATPase activity were observed to decrease reversibly.

PMID- 8488338
TI  - Effects of procainamide, tocainide and phenytoin on guinea pig cardiac
      mitochondrial ATPase activity.
AB  - The effects of three class I antiarrhythmic drugs procainamide, tocainide and
      phenytoin on undamaged myocardial mitochondrial ATPase [ATP: phosphohydrolase EC
      3.6.1.3] activity were evaluated in guinea pig heart preparations. Tocainide
      inhibited the ATPase activity in the range of 1.0 nM-500 mM, exhibiting IC20 and
      IC50 values of 9.4 +/- 0.7 microM and 5.2 +/- 0.4 mM, while procainamide
      exhibited significant (p < 0.05) inhibitory effect only at concentrations above
      1.0 mM with IC20 and IC50 values of 35.4 +/- 2.7 mM and 90.8 +/- 3.7 mM,
      respectively. On the other hand, phenytoin inhibited the enzyme by 17% and 8% at
      1.0 nM and 1.0 microM respectively, while it stimulated it at higher
      concentrations, thereby increasing its activity by 10%, 57% and 227% at 10, 100,
      1000 microM, respectively. The inhibitory actions of these drugs are probably
      related to their lipophilicity and membrane stabilizing activity, while the
      stimulatory effect of phenytoin suggests some specific interaction with some
      component(s) of the oxidative phosphorylation or respiratory chain.

PMID- 8488339
TI  - Anti-Candida activity of the anti-cancer drug tamoxifen.
AB  - Earlier workers found that tamoxifen, a drug widely used to treat breast cancer,
      can exert a marked antifungal action against the non-pathogenic yeast
      Saccharomyces cerevisiae. In this report, the earlier observation has been
      extended to Candida albicans, the most important of the opportunistic fungal
      pathogens. Experiments in which antifungal effect against logarithmic phase cells
      was monitored by viable count as a function of drug exposure time clearly showed
      that tamoxifen is highly fungicidal at 2.0 x 10(-5) M, moderately and transiently
      fungicidal at 1.0 x 10(-5) M, but only very weakly fungistatic at 5.0 x 10(-6) M.

PMID- 8488340
TI  - Interaction between beta blockers and epinephrine on hemodynamics of
      spontaneously hypertensive rats.
AB  - Hypertensive patients treated with nonselective beta adrenergic blocking agents
      may show remarkable hemodynamic changes with administration of epinephrine
      clinically. We have attempted to investigate the effects of the interaction
      between beta blockers (a nonselective beta blocker, pindolol, and a
      cardioselective beta blocker, acebutolol) and a solution of 2% lidocaine
      containing 1:80,000 epinephrine on the hemodynamics of conscious spontaneously
      hypertensive rats (SHR) and Wistar-Kyoto rats (WKY), as compared with the
      normotensive rats. The blood pressures (systolic and diastolic) and heart rate
      were measured indirectly by the photoplethysmographic tail cuff method. All drugs
      were administered intraperitoneally. We found that: (1) epinephrine with pindolol
      or acebutolol pretreatment did not cause significant hemodynamic changes in WKY;
      (2) in SHR, epinephrine in combination with pindolol induced remarkable
      hemodynamic changes (in particular, increase in diastolic blood pressure), which
      were prevented by phentolamine pretreatment, whereas epinephrine with acebutolol
      pretreatment induced no significant hemodynamic changes in these animals; (3)
      epinephrine in combination with pindolol caused pulmonary congestion or edema in
      SHR; this was confirmed by both quantitative analysis and histological
      investigations. These results suggest that pindolol blocked both beta 1 and beta
      2 receptors, and therefore, this resulted in exaggerated alpha effects of
      epinephrine, a remarkable systemic vasoconstriction, and pulmonary congestion. In
      a clinical setting, great caution should be paid to the hypertensive patients,
      who are being treated with nonselective beta blockers, if epinephrine-containing
      local anesthetics are administered.

PMID- 8488341
TI  - Recovery of decreased antibody production by ceruloplasmin in the macular mutant
      mouse.
AB  - The macular mutant mouse is a murine model of Menkes' kinky hair disease,
      characterized by a serum copper and ceruloplasmin deficiency. The hemizygote
      (ml/y) had a decreased antibody response to sheep red blood cells (SRBC). 1) In
      vivo; the administration of ceruloplasmin recovered antibody production in ml/y
      mice, but, had no effect on that of normal mice (+/y). The administration of heat
      treated ceruloplasmin did not increase antibody production in ml/y mice, whereas
      the administration of various concentrations of copper suppressed the anti-SRBC
      plaque-forming response in both ml/y and +/y mice. 2) in vitro; ceruloplasmin had
      no effect upon antibody production against SRBC in both ml/y and +/y mouse spleen
      cells. In contrast to ceruloplasmin, 1 microgram/ml of copper inhibited the
      antibody production in spleen cells from both +/y and ml/y mice as well as in
      vivo. These findings suggested that the decreased antibody production in ml/y
      mice was considered to be due the decreased ceruloplasmin.

PMID- 8488342
TI  - Halothane anesthesia is neuroprotective in experimental spinal cord injury: early
      hemodynamic mechanisms of action.
AB  - The neuroprotective potential of halothane anesthesia was explored in a weight
      drop model of spinal trauma in the rat (N = 252). In initial experiments, animals
      were subjected to 25, 50 or 100 g cm impact injuries at T10 during pentobarbital
      or halothane anesthesia and their outcomes determined using somatosensory-evoked
      potentials, blinded neurologic evaluations for two weeks, and post-mortem
      analysis of spinal serotonin levels. Subsequently, halothane anesthesia was
      combined with either pentobarbital or nitrous oxide or given as a late treatment
      to pentobarbital anesthetized rats subjected to 50 g cm injuries. A series of
      acute studies were then performed in order to assess the hemodynamic and
      respiratory concomitants of halothane vs. pentobarbital, as well as the effect of
      mechanical ventilation and bicarbonate treatment upon halothane neuroprotection.
      Finally, the effect of a 50 g cm impact upon local white matter spinal cord blood
      flow was measured during halothane or pentobarbital anesthesia using laser
      Doppler flowmetry. Results demonstrate an active neuroprotective action for
      halothane anesthesia that is not altered by the presence of other anesthetics and
      is most prominent at severe injury levels. The data suggest the importance of
      immediate injury responses in this action. Late halothane treatment was
      ineffective when given as early as 10 minutes postinjury while both the
      electrophysiological and hemodynamic effects of halothane vs. pentobarbital were
      apparent during this 10 minute period. Thus, halothane was associated with the
      prevention of spinal ischemia during the first 10 minutes after trauma in
      comparison to pentobarbital.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488343
TI  - Influence of inorganic and organic arsenicals on intestinal transfer of
      nutrients.
AB  - The effects of organic (oxophenylarsine, PhAsO 2.5-50 mumol/l) and inorganic
      arsenicals (As2O3 2.5-250 mumol/l; As2O5 2.5-2500 mumol/l) on intestinal transfer
      of water, sodium, glucose and leucine was investigated in vitro using isolated
      jejunal segments of male Sprague Dawley rats. All three arsenicals decreased in a
      dose-dependent manner the transfer of water, sodium, glucose and leucine. At the
      highest concentrations investigated the amount absorbed was reduced to some 10
      20% of the respective control values. For both glucose and leucine the
      concentration ratio between absorbate and perfusate was about 3.5-4 in controls.
      It decreased to about 2 for leucine and to near unity for glucose. As assessed
      from the concentration ratio between intestinal tissue and perfusate the arsenic
      compounds inhibited the uptake of glucose and leucine into the tissue. There was
      a marked difference with respect to the potency of arsenicals, PhAsO being about
      10 times more potent than As2O3 which in turn was about 5 times more potent than
      As2O5.

PMID- 8488344
TI  - Influence of low luminal cadmium-concentrations on transfer of water and cadmium
      in the rat small intestine in vitro.
AB  - The sensitivity of the small intestinal water transfer for cadmium (Cd) exposure
      and its longitudinal gradient were investigated in luminally perfused intestinal
      segments in vitro and in vivo. Proximal segments accumulated Cd to a higher
      extent and, in addition, were more sensitive to Cd exposure than distal segments.
      In the proximal small intestine Cd impairs the intestinal water transfer at
      concentrations between 0.1 and 1.0 mumol/l in vitro and 4 mumol Cd/l in vivo. In
      vitro the Cd transfer from the intestinal tissue into the serosal absorbate
      declined in parallel to the reduction of the water transfer. In proximal but not
      in distal segments the declining water transfer corresponded to the decreases in
      glucose transfer in response to Cd exposure. According to literature the Cd
      effect on intestinal water transfer may be mediated by interaction of Cd with the
      Na-glucose co-carrier or by inhibition of the oxidative phosphorylation. The
      involvement of both mechanisms may differ along the small intestine.

PMID- 8488345
TI  - Coping amid uncertainty: an illness trajectory perspective.
AB  - This paper offers an alternative to the conventional social/psychological
      definition of "coping." Using a theoretical framework of "illness trajectory,"
      the authors examine the uncertainty of temporality, body, and identity inherent
      in coping with cancer. Analysis then turns to the interaction among these
      uncertain conditions and the complex work processes described by people with
      cancer, as they tolerate, i.e., "cope with," the disease. Although presented
      separately for purposes of clarity, these processes and their related activities
      are experienced in varying combinations and with varying and fluctuating
      importance by each individual. Viewed comprehensively, however, they constitute
      the larger process of coping with cancer, with implications for other diseases as
      well.

PMID- 8488346
TI  - Praxis: a case study in the depoliticization of methods in nursing research.
AB  - This paper offers a case study in the depoliticization of the concept of praxis
      as it enters the nursing literature through Margaret Newman's (1990) paper Theory
      of Health as Praxis, which draws on Lather's (1986) description of 'research as
      praxis.' Newman's view of the relationship between consciousness and matter is
      contrasted with that of Marxism and her concept of health-illness is discussed.
      These considerations yield some examples of the liberal-democratic ideological
      position which underwrites her theory, and it is suggested that in drawing on the
      notion of praxis, Newman borrows from an ideology which is ultimately at odds
      with her theoretical construction of nursing.

PMID- 8488347
TI  - Toward a practice theory of caring for patients with chronic skin disease.
AB  - The purpose of this study was to provide a description and interpretation of the
      practical knowledge embedded in the practice of a group of experienced nurses
      caring for patients suffering from chronic skin disease. A practice theory was
      uncovered encompassing the nurses' underlying "model" of persons living with
      chronic skin disease, the values/goals for their care, action strategies utilized
      to realize the values, and the context framing their understanding and practice.
      The practice theory is proposed as a useful tool to systematize, communicate,
      reflect upon, refine, and extend the clinical practice of experienced nurses
      caring for this group of patients. The theory is also proposed as an example of
      how practical knowledge in other specialty areas may be systematized in order to
      communicate that knowledge efficiently. A scholarly discussion is needed about
      how best to communicate the invaluable resource of knowledge embedded in the
      practice of experienced nurses.

PMID- 8488348
TI  - The meaning of being homeless.
AB  - In this study, the meaning of the experience of being homeless as lived by 15
      homeless women with dependent children is explored. The significance of being
      homeless is approached from what is known about the concept of home. Following a
      review of the literature, an identification of the sample, and an explanation of
      how data were collected, a three-level phenomenological method was utilized:
      description, reduction, and interpretation. The descriptive level generates seven
      themes: boundaries, connections, fatigue/despair, self-respect, self
      determination, privacy, and mobility. The reduction level reveals three ways of
      being homeless: physical, social, and symbolic. The interpretation of the meaning
      of being homeless employs the metaphor of homelessness as a whirlpool.
      Implications for nursing and social policy are discussed.

PMID- 8488349
TI  - [What is your diagnosis? Adenoid hyperplasia with narrowing of the nasopharynx].

PMID- 8488350
TI  - [Diagnosis and therapy of colonic diseases].

PMID- 8488351
TI  - [Irritable colon and constipation].
AB  - Irritable bowel syndrome is a very common clinical problem with a broad spectrum
      of severity. The management includes a combination of positive diagnosis of
      typical symptoms with limited investigations to exclude underlying structural or
      biochemical disorders. Therapeutic trials focus on the relief of predominant
      symptoms. Identification and modification of factors exacerbating symptoms,
      behavioural techniques and pharmacologic agents directed to the presumed
      gastrointestinal motor dysfunction are required. Psychological support by the
      physician is the most important part of treatment. Chronic constipation may be
      the predominant symptom of irritable bowel syndrome. Underlying organic disorders
      must be excluded by clinical examination and endoscopy. Severe chronic
      constipation requires further investigation of colonic motility and defecation.
      High fibre diet, osmotic laxatives and procinetic agents may lead to an
      improvement. In rare cases surgery may be indicated.

PMID- 8488352
TI  - [Chronic diarrhea with special reference to ulcerative colitis and Crohn
      disease].
AB  - There is a wide range of possible causes in chronic diarrhea. An attempt to
      correlate the symptoms with some clinically defined main categories facilitates a
      straight forward diagnostic approach. First and most important is a careful
      patient history. Very useful is a stratification regarding presence or absence of
      macroscopic lesions in the distal intestinal tract, usually done by coloscopy.
      Considering these principles, an overview of the most important causes for
      chronic diarrhea is given. Some relevant aspects of inflammatory bowel disease
      are discussed with special emphasis on the medical treatment. The major advantage
      of the newer 5-ASA compounds compared with sulfasalazine is the lower rate of
      side effects. 5-ASA enemas are very effective in the treatment of distal
      ulcerative colitis. Systemic treatment with corticosteroids is mandatory in
      severe case of ulcerative colitis and Crohn's disease.

PMID- 8488353
TI  - [Diverticulosis].
AB  - Diverticula of the colon are very common in developed countries. In most of those
      affected diverticulosis is an asymptomatic condition. Only 20% complain of
      recurrent symptoms. Symptomatic diverticulosis is common only after the age of
      50. Dietary treatment combined with antispasmodics is generally sufficient.
      Diverticular disease is complicated by bleeding or by diverticulitis in 20% of
      symptomatic patients. Diverticulitis itself can be complicated by intra-abdominal
      abscess, fistulas, perforation with generalized peritonitis or bowel obstruction.
      Each clinical appearance is described and treatment is discussed.

PMID- 8488354
TI  - [Acute diarrhea--current assessment and therapy in clinical practice].
AB  - Acute diarrhea is most commonly caused by infectious agents. The first step in
      the evaluation is based on the medical history, clinical presentation and simple
      stool examinations (fecal leukocytes and occult blood). Thereby it can be
      decided, whether a microbial identification or an antibiotic therapy are
      indicated. In case of viral or noninvasive, enterotoxinogenic diarrhea oral
      rehydration is sufficient, whereas enteroinvasive diarrhea or enteric syndromes
      need further evaluation by stool and blood cultures. Depending on the clinical
      situation and the result of cultures, an appropriate or empiric therapy with
      antibiotics is indicated in acute febrile dysentery, shigellosis, cholera,
      typhoid fever, severe salmonellosis and Cl. difficile colitis.

PMID- 8488355
TI  - Resection for second and third primary lung cancer.
AB  - The continued increasing incidence of bronchogenic carcinoma increases the
      likelihood that a patient may develop a second or third primary tumor. We have
      carried out a second thoracotomy for 114 patients who met our criteria of having
      a new primary lung cancer. These criteria were a different histologic cell type,
      a tumor-free interval of 24 mo, the second primary in the contralateral lung, or
      the new tumor in a separate and distinct ipsilateral lobe if the tumor was on the
      same side. There were 18 patients who had a thoracotomy for a third primary lung
      cancer and they met the same criteria. There were 73 segmental resections in the
      132 thoracotomies, and a conservative resection is important to minimize
      postoperative complications. Operative mortality for the second resection group
      of patients was 8.8% (10/114). There was one operative death in the 18 patients
      undergoing a third resection. The cumulative survival rate following a second
      resection in 114 patients with metachronous tumors was 33% at 5 yr and 20% at 10
      yr. Early detection of a second and third primary lung cancer and surgical
      resection offers the greatest chance for long-term survival in this group of
      patients.

PMID- 8488356
TI  - Initial and reoperative pulmonary metastasectomy: indications, technique, and
      results.
AB  - The ability to predict which patients will derive a survival benefit from
      pulmonary metastasectomy is limited. Most patients remain asymptomatic until the
      disease becomes advanced, and therefore computerized tomography (CT) of the chest
      has become the standard of care for follow-up of patients at risk for pulmonary
      metastases. The most important predictor of post-thoracotomy survival in patients
      at the National Cancer Institute with soft tissue, osteogenic, and pediatric
      sarcomas as well as melanoma and renal cell carcinoma has been the ability to
      render the patient disease-free. Tumor histology, disease-free interval, and
      possibly number of nodules are also determinants of survival. Median sternotomy
      is the preferred approach for initial and repeat metastasectomies and every
      effort should be made to preserve pulmonary parenchyma. Resection of pulmonary
      metastases has become an accepted therapeutic modality, but selection of surgical
      candidates, and operative planning needs to be individualized.

PMID- 8488357
TI  - Primary tumors of the thoracic skeleton.
AB  - From 1975 to 1990, eighty-nine primary tumors of the thoracic skeleton; ribs,
      sternum, scapula, clavicle, and thoracic spine, were treated. Forty-four tumors
      (49%) were benign lesions. Forty-five tumors were malignant and were
      proportionately distributed amongst the five sites. The most common malignancies
      were Ewing's sarcomas, chondrosarcomas, plasmacytomas, osteogenic sarcomas, and
      lymphomas. All patients with Ewing's sarcomas were treated with combination
      chemotherapy, surgical resection, and radiation therapy for those with residual
      disease after surgery. Only one patient has died of disease. Patients with
      primary chondrosarcomas were treated by surgery alone and all are free of disease
      or have died without disease. Patients with solitary plasmacytomas or primary
      lymphomas of bone were treated with radiation therapy initially. Half the
      patients developed systemic disease. The patients with osteogenic sarcomas
      included several with radiation induced lesions and Paget's osteosarcoma and all
      but one died of disease.

PMID- 8488358
TI  - Superior results with complete resection of Askin's tumor.
AB  - A malignant small round cell tumor of the thoracopulmonary region arising in
      childhood has been described by Askin and colleagues. Subsequent descriptions
      have emphasized refinements (or disagreements) regarding pathology and emphasized
      the usual poor outcome. Complete excision has not been uniformly attempted in
      previous series. Our purpose is to describe superior results possible in a
      multidisciplinary setting emphasizing complete surgical excision.

PMID- 8488359
TI  - Recent developments in the epidemiology of lung cancer.
AB  - Lung cancer is currently the leading cause of cancer death in the United States
      and also the most common tumor worldwide. Changes in the distribution of
      histologic types over the past two decades in the United States, as well as high
      rates of lung cancer in certain subpopulations, require explanation. While
      cigarette smoking and specific occupational exposures are firmly established as
      important risk factors for lung cancer, recent work provides evidence that other
      factors may play a role either as independent risk factors or as modifiers of the
      effect of smoking. This paper reviews the epidemiology of lung cancer, with an
      emphasis on developments in the past decade.

PMID- 8488360
TI  - Comparative study of survival of screen-detected compared with symptom-detected
      lung cancer cases. Japanese Lung Cancer Screening Research Group.
AB  - Survival rates were studied in 1,297 screen-detected and 1297 symptom-detected
      patients with lung cancer. Resections took place in 20 hospitals and institutions
      in the Japanese Lung Cancer Screening Research Group. 60.6% of the screen
      detected lung cancer patients were from stage 0 to 11 and 39.4% were from stage
      III and IV. On the other hand, 27.1% of symptom-detected patients were from stage
      0 to 11 and 72.9% were stage III to IV. In the screen-detected group, the tumor
      was peripheral in 83%, adenocarcinoma in 52.4% and the resectability rate was
      66.5%. Five- and 10-year survival rates were 32.4% and 22.5% respectively in the
      screen-detected patients and 13.7% and 9.9% in symptom-detected patients.

PMID- 8488361
TI  - Diagnostic imaging and staging of primary lung cancer.
AB  - Improved diagnostic imaging has the potential to guide the surgeon in choice of
      invasive procedures required for staging and treatment of lung cancer. In the
      evaluation of a solitary pulmonary nodule, absence of growth for 2 years or
      certain typical calcifications are strong evidence of benignity, but we do not
      advocate following indeterminate nodules without a diagnosis because even small
      nodules may be carcinomas. In assessing chest wall invasion, computed tomography
      has no greater predictive value than a history of localized pain. The absence of
      nodes greater than 1.0 cm in short axis diameter on computed tomograms of the
      thorax is associated with low risk of tumor in mediastinal nodes, but tissue
      diagnosis is required for certainty. The finding of nodes larger than 1.0 cm may
      be useful in guiding the surgeon during staging procedures. Currently, there is
      no advantage of magnetic resonance imaging over computed tomography in evaluation
      of mediastinal nodes. Complete history and physical examination with routine
      serum chemistries will identify patients at high risk for metastases and will
      guide selection of appropriate special studies. It is emphasized that accurate
      staging requires histologic diagnosis and that CT and thorough surgical
      evaluation of the mediastinum are complementary procedures in staging of lung
      cancer.

PMID- 8488362
TI  - What controls should be used in studies of acute effects of alcohol and alcoholic
      beverages on the stomach and the pancreas?

PMID- 8488363
TI  - Gastrectomy causes bone loss in the rat: is lack of gastric acid responsible?
AB  - Total gastrectomy or resection of the acid-producing part of the stomach
      (fundectomy) in the rat induced a marked and rapid reduction in bone wet weight,
      ash weight, and density (expressed as ash weight in mg/mm3 bone). Bone volumes
      were also affected but not as much. The radius, sternum, tibia, and femur were
      studied. Three weeks after gastrectomy the bone ash weight was reduced by almost
      30% and the density by more than 25%. Maximum bone loss (approximately 40%)
      occurred about 6 weeks after the operation. The bone loss after gastrectomy was
      somewhat greater than that after fundectomy, whereas antrectomy had a marginal
      effect only. The percentage trabecular bone volume, calculated from morphometric
      analysis of histologic sections of the tibia, was greatly reduced by gastrectomy
      (approximately 50%), somewhat less so by fundectomy, whereas antrectomy had
      little effect. We set out to study whether calcium malabsorption could explain
      the bone loss after gastrectomy. Gastric acid is thought to facilitate the
      intestinal absorption of ingested calcium by mobilizing calcium from insoluble
      complexes in the diet. The possibility that lack of acid might contribute to the
      bone loss after gastrectomy was examined in experiments in which the proton pump
      inhibitor omeprazole was given for 4-8 weeks at such a dose (400 mumol/kg/day)
      that acid secretion was blocked almost completely during the period of study.
      This treatment was without effect on bone. However, the possibility could not be
      excluded that gastrectomized rats develop calcium deficiency for some reason
      other than lack of acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488364
TI  - Non-Hodgkin's lymphoma and AIDS: frequency of gastrointestinal involvement in a
      large Italian series.
AB  - Even though the close association between AIDS and non-Hodgkin's lymphoma (NHL)
      is widely known, few studies have evaluated the frequency of gastrointestinal
      involvement in a large series of AIDS patients with heterogeneous risk factors.
      We therefore reviewed the demographic and clinical features of patients with AIDS
      and NHL seen at our institution over a period of 5 years. NHLs complicated AIDS
      in 70 of 786 (9%) cases in our study. All but one of the tumours were of high- or
      intermediate-grade histologic subtype, and 80% of 56 patients with diagnosis made
      during lifetime had disease stages III or IV, most with extranodal localization.
      The gastrointestinal tract was involved in 23 cases (33%), 13 of whom had an
      antemortem diagnosis. All these patients complained of significant symptoms, the
      most frequent being GI bleeding followed by recurrent abdominal pain with or
      without masses. Three patients had evidence of lymphomatous disease along both
      the upper and lower GI tract, but more often a single localization was present.
      Prognosis of patients with NHLs was very poor, and there was no significant
      difference in survival between patients with and without GI localization at the
      time of initial diagnosis.

PMID- 8488365
TI  - Effects of sedation and supplemental oxygen during upper alimentary tract
      endoscopy.
AB  - The effects of supplemental oxygen therapy on arterial oxygen saturation (SaO2)
      in unsedated and sedated patients have been studied using pulse oximetry. Hypoxia
      (minimum SaO2 92% or less) occurred in 41% of unsedated patients breathing room
      air but in only 11% (p < 0.01) of those receiving supplemental oxygen (41/min) by
      nasal cannulae. Comparable effects were seen in sedated patients (60% versus 16%,
      respectively, p < 0.01). Hypoxia during upper alimentary tract endoscopy is
      common with or without sedation and can be reduced by supplemental oxygen.

PMID- 8488366
TI  - Tumor necrosis factor-alpha potentiates phospholipase A2-stimulated release and
      metabolism of arachidonic acid in cultured intestinal epithelial cells (INT 407).
AB  - Tumor necrosis factor-alpha (TNF-alpha), a known pro-inflammatory cytokine, has
      been suggested to play a role in the pathogenesis of inflammatory bowel disease
      (IBD) by mediating damage to the intestinal epithelial cells. The present study
      demonstrates that TNF-alpha potentiates release and metabolism of 14C-labeled
      arachidonic acid (14C-AA) in cultured intestinal epithelial cells (INT 407).
      Although TNF-alpha on its own was but a weak stimulator of cellular 14C-AA
      turnover, it significantly potentiated the release of 14C-AA and 14C-labeled
      prostaglandin E2(14C-PGE2) after stimulation with three known phospholipase A2
      activators: phospholipase. C from Clostridium perfringens, the calcium ionophore
      A23187, and the phorbol ester 4-beta-phorbol-12-myristate-13-acetate (PMA). The
      phospholipase A2 inhibitor quinacrine significantly reduced both AA and PGE2
      release after combined stimulation with phospholipase C and TNF-alpha. In
      contrast to its effect on the AA turnover, TNF-alpha did not affect the
      phospholipase C-stimulated production of platelet-activating factor (PAF
      acether). Taken together, these findings indicate that a) TNF-alpha potentiates
      phospholipase A2-stimulated AA release from cultured intestinal epithelial cells;
      b) TNF-alpha may stimulate phospholipase A2-dependent AA release without
      affecting the formation of PAF-acether and c) pretreatment with TNF-alpha
      potentiates the formation of PGE2 after stimulation with phospholipase A2
      activators. In summary, the present investigation points to the possibility that
      TNF-alpha may stimulate intestinal epithelial cells to produce biologically
      active AA metabolites and that this stimulation may be modulated by components of
      the intestinal luminal content, like bacterial toxins.

PMID- 8488367
TI  - Purification of lipase and other lipolytic enzymes from the human pancreas.
AB  - A pure lipase has been isolated from extracts of the human pancreas. The
      purification process includes centrifugation, two ion-exchange chromatography
      steps, and one gel filtration step. Compared with other reports, a high recovery,
      large amounts, and a high specific activity were obtained. Lipase is present at 1
      2 mg/g in the pancreatic gland. In the absence of colipase and bile salts with
      tributyrine as substrate, the specific activity at room temperature and at pH 7.0
      is 4000 mumol/min/mg. It increases to 8000-10,000 in the presence of colipase and
      bile salts at a temperature of 37 degrees C. The fate of the other human
      lipolytic proteins during the different purification steps is also indicated.
      Lipase purified by this method has been used for crystallization.

PMID- 8488368
TI  - The enkephalinase inhibitor, acetorphan, in acute diarrhoea. A double-blind,
      controlled clinical trial versus loperamide.
AB  - The antidiarrhoeal properties of acetorphan, an inhibitor of enkephalinase (EC
      3.4.24.11) that prevents endogenous enkephalin degradation, and loperamide, a mu
      opiate receptor agonist, were compared. The double-blind study included 69
      patients with acute diarrhoea of presumed infectious origin, allocated at random
      to two parallel groups. Acetorphan and loperamide were both rapidly and similarly
      effective, diarrhoea resolving in both cases in nearly 2 days. With acetorphan,
      however, abdominal distension vanished significantly more rapidly, and reactive
      constipation was less frequent (8% versus 31% with loperamide). These differences
      can be accounted for by the distinct mechanisms of antidiarrhoeal activity of the
      two drugs--that is, primary antitransit effect for loperamide and antisecretory
      activity for acetorphan.

PMID- 8488369
TI  - A study of gastric emptying in non-ulcer dyspepsia using a new ultrasonographic
      method.
AB  - To ascertain the effect of gastric emptying on the symptoms of non-ulcer
      dyspepsia (NUD) patients, we randomly selected 60 NUD patients and, as control,
      26 dyspepsia-free volunteers. We measured the gastric emptying time of mixed food
      (270 kcal), using real-time ultrasonography in two ways. NUD patients were
      divided randomly into two groups and given domperidone or placebo in a double
      blind trial. Of the NUD patients 48% had delayed gastric emptying times and
      associated epigastric pain, bloating, early satiety, and regurgitation. A
      prokinetic agent not only improved emptying time but also relieved some of the
      symptoms of the NUD patients. Real-time ultrasonography proved a useful method
      for evaluating gastric emptying.

PMID- 8488370
TI  - Adaptive protection related to clearance of ethanol in gastric mucosa of cats.
AB  - This study was designed to test the hypothesis that hyperemia after exposure to 2
      M NaCl protects the gastric mucosa against damage caused by absolute ethanol by
      removing ethanol diffusing from the gastric lumen into the mucosa. The stomach of
      anesthetized cats was perfused with saline at pH 1.0. Gastric mucosal blood flow
      was determined by radioactive microspheres, and portal vein blood flow was
      measured by Doppler ultrasound flowmetry. The concentration of ethanol in the
      corpus mucosa and the amount of ethanol transported away from the stomach in
      portal blood were measured by using absolute ethanol containing trace amounts of
      14C-labeled ethanol. Pretreatment with 2 M NaCl for 10 min increased mucosal
      blood flow and prevented the development of deep mucosal lesions after subsequent
      application of absolute ethanol. An inverse correlation was found between mucosal
      blood flow and the degree of ethanol-induced damage. The mucosal content of
      ethanol was low in animals pretreated with hyperosmolar NaCl, and the degree of
      mucosal damage was related to the tissue concentration of ethanol. The amount of
      ethanol transported by blood from the stomach increased with increasing mucosal
      blood flow. We conclude that the mild irritant, 2 M NaCl, increases mucosal blood
      flow, which protects the mucosa by removing ethanol diffusing from the lumen.
      Thus, the mucosal ethanol concentration remains below a level that causes damage.

PMID- 8488371
TI  - [Persistent vomiting].
AB  - Vomiting is a physiological reflex to protect the body from harmful influences,
      whereas "pathological vomiting" occurs irrespective of its primary purpose or
      causes secondary disturbances. Artificially induced vomiting and enemas were
      prophylactic and therapeutic procedures to purge the body that were employed in
      ancient times and reached their zenith by the end of the 18th century. The act of
      vomiting is regulated by the vomiting centre, where neural afferents from the
      chemoreceptor trigger zone, vagal and sympathetic nerve system, and from other
      trigger areas, are coordinated. Differential diagnosis of vomiting, emphasizing
      metabolic/endocrine and psychogenic vomiting--including anorexia nervosa and
      bulimia--are briefly discussed. Symptomatic treatment of vomiting primarily
      consists of the use of receptor antagonists, e.g. dopamine, histamine and 5
      hydroxytryptamine-3 antagonists. Acupuncture/-pressure are also discussed as an
      alternative treatment method.

PMID- 8488372
TI  - [Hematemesis. Extramural emergency].
AB  - Hematemesis is the cardinal sign of upper gastrointestinal bleeding. It is a sign
      related to numerous affections, with a prognosis depending on the underlying
      lesion, the degree of bleeding, the accompanying disease and other risk factors.
      Mortality rates are generally close to 10%, although if hematemesis is secondary
      to variceal bleeding, as high as 30%. 65% of hemorrhages subside spontaneously,
      but 25% bleed recurrently (after initial cessation) and in 10% bleeding persists.
      Three quarters of all renewed bleeding occurs within two days after the initial
      hemorrhage. If hematemesis occurs outside a hospital, rapid evaluation is
      required to assess the necessity of emergency transport and treatment. In the
      case of severe to moderate bleeding, life-support measures and rapid transport to
      the nearest hospital are of primary importance and all measures complicating
      diagnosis and treatment in the hospital should be avoided. Patients with mild
      hematemesis, stable cardiovascular parameters and no risk factors can be
      investigated and, if appropriate, treated, on an out-patient basis. If the cause
      of hematemesis cannot be found, aggressive, inpatient investigations are required
      at the first sign of second bleed. Endoscopy is the primary investigative
      procedure for hematemesis. The success rate is highest if endoscopy is performed
      within the first 36 hours of the onset of bleeding. There are indications that
      aggressive diagnosis and therapy, including endoscopic hemostatic interventions,
      can reduce hematemesis mortality.

PMID- 8488373
TI  - [Internal bleeding in patients on oral anticoagulants].
AB  - Five selected case reports of patients suffering from rather unusual bleeding
      complications during oral anticoagulant therapy are presented. The reported
      frequency of bleeding during oral anticoagulation varies greatly. An unacceptably
      high incidence of hemorrhages has been reported in North American studies of the
      early 1980ies. The therapeutic target INR of 2.5-4.9 in these series is
      comparable to that in European studies where bleeding occurred much less
      frequently. We suggest that the insensitive thromboplastin reagents used in North
      America are unsuited to guide coumarin dosage, because too many prothrombin time
      values were outside the INR target range. In contrast, most prothrombin time
      values in European studies where a sensitive thromboplastin reagent was used,
      were within the target range. A recent prospective investigation by 25 Swiss
      practitioners showed an acceptably low bleeding complication rate (2.1
      hemorrhagic complications severe enough to necessitate hospitalization per 100
      patient years). Observation of contraindications, regular control of the
      prothrombin time using a sensitive and correctly calibrated thromboplastin,
      participation of practitioners and hospital laboratories at quality control
      exercises and consideration of drug interferences with coumarins help to reduce
      the incidence of hemorrhagic side effects. In case of either a PT value outside
      the target range or manifest bleeding, the necessary measures have to be tailored
      to the individual situation considering the Quick value as well as the severity
      and localization of hemorrhage.

PMID- 8488374
TI  - [Emergency blood picture].
AB  - Assessment of peripheral blood counts and blood film analysis are frequently
      performed as diagnostic procedures in emergency medicine. Far fewer situations
      exist, however, in which these analyses are the main clue in establishing an
      emergency diagnosis. Artifacts can lead to wrong diagnosis, e.g. pseudo
      thrombocytopenia, which is defined as a low platelet count resulting from a
      laboratory artifact. Severe neutropenia (agranulocytosis) and extreme
      hyperleukocytosis, as well as suspicion of acute leukemia, require a rapid
      diagnostic work-up. A newly detected anemia should not necessarily be treated by
      packed red cell transfusions. The decision whether an anemic patient ought to
      receive transfusions should be based on the speed with which the anemia has
      developed, as well as on clinical judgement. As a rule a chronic anemia patient
      with hemoglobin above 70 g/l does not need transfusions. An uncritical
      transfusion policy can even cause emergencies, e.g. in patients with
      megaloblastic anemia or in anemic multiple myeloma patients with a hyperviscosity
      syndrome. An elevated hematocrit requires prompt further investigations. This is
      of utmost importance if one considers the diagnosis of polycythemia vera rubra, a
      disease in which patients are particularly prone to thrombotic complications.
      Fragmented red cells (schistocytes) on peripheral blood smears constitute a
      cardinal diagnostic clue for the detection of microangiopathic hemolytic anemias
      (MAHA), in particular for the diagnosis of the life-threatening thrombotic
      thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). Malaria is
      another example for a chief role of blood smears examination in achieving a rapid
      diagnosis. If one encounters an unexpected severe thrombocytopenia, a marrow
      examination reveals whether it is due to rapid peripheral destruction, or due to
      a marrow failure. Furthermore, in any patients with an unanticipated
      thrombocytopenia, a disseminated intravascular coagulation and a MAHA should be
      ruled out. Heparin-induced thrombocytopenia is a rare, but possibly fatal
      complication of therapy with heparins.

PMID- 8488375
TI  - [Emergencies in patients with tumors].
AB  - Oncological emergencies are frequent, particularly in advanced cancer stages.
      Many situations can only be tackled successfully with the cooperation of a well
      organized team of specialists. Spinal cord compression caused by cancer requires
      particularly swift action. The diagnosis should include a careful neurological
      examination. Myelography, once a classical approach in this setting, is
      increasingly being replaced by nuclear magnetic imaging techniques. Steroids
      should be given immediately after a diagnosis has been made and further treatment
      includes surgery, radiotherapy and/or chemotherapy, depending on the type of
      tumour involved. Febrile patients with severe neutropenia due to myelosuppression
      by cytostatic drugs often require treatment with intravenous antibiotics.
      Although hematopoietic growth factors are now available to hasten neutrophil
      recovery, these drugs should not be given on a routine basis. Another relatively
      frequent emergency is the superior vena cava syndrome, which is almost always due
      to a malignant tumour. Any treatment plan prepared to deal with an oncological
      emergency in a particular patient should take into account the prognosis of the
      underlying disease, the prospects for further therapy, and the patient's
      attitude.

PMID- 8488376
TI  - [Endocrine crises].
AB  - Endocrine crises can occur in diabetes mellitus, in pituitary failure when there
      is a lack of ACTH, TSH or ADH secretion, in severe hyper- or hypothyroidism
      (thyroid storm and myxedema coma), severe hyper- or hypoparathyroidism
      (parathyroid crisis and tetany), in adrenal failure and in patients with
      pheochromocytoma or carcinoid tumors. Cushing's syndrome can be associated with
      psychotic crises. This review describes the most important clinical features and
      the basic diagnostic and therapeutic aspects of the non diabetic endocrine
      crises.

PMID- 8488377
TI  - [Hypercalcemia as an emergency].
AB  - The hypercalcemic syndrome and the relation of serum calcium with the
      concentration of ionic calcium and albumin are shortly described. The
      pathogenetic significance of local, cytokine-induced bone destruction and of the
      osteoclast-stimulating effect by "parathyroid hormone related peptide" leading to
      "humoral hypercalcemia of malignancy" is underscored. In a hypercalcemic
      emergency the therapeutic strategy should combine adequate rehydration and
      induction of calciuresis by furosemide and the intravenous application of a rapid
      onset, calcium lowering substance such as calcitonin and, simultaneously, of a
      slow-onset, long-acting bisphosphonate such as pamidromate, which may be infused
      as a single dose.

PMID- 8488378
TI  - [3 dangerous electrolyte disturbances: hyponatremia, hyperkalemia and
      hypomagnesemia].
AB  - Three cases of acute and potentially dangerous electrolyte disturbances provide a
      basis for discussion of selected aspects of pathogenesis, clinical manifestation
      and correction of certain electrolyte disorders (hyponatremia, hyperkalemia,
      hypomagnesemia). A case of diuretic-induced hyponatremia illustrates the
      controversy surrounding correction of this disorder. The regulatory mechanisms of
      transcellular potassium equilibrium are discussed with the help of a case of
      exercise-induced hyperkalemia. A separate case is dedicated to the discussion of
      the multiple causes and symptoms of magnesium depletion.

PMID- 8488379
TI  - [Urological emergencies].
AB  - Every general practitioner has to deal with urologic emergencies. The most
      frequent illnesses are urinary retention, acute scrotum, priapism,
      macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis.
      Whereas urinary retention, as well as acute ureteric stone colic must generally
      be treated by the practitioner, the urologist must often be consulted in case of
      an acute scrotum or for priapism. Testicular torsion is one situation, where
      surgical treatment needs to be performed within 6 hours. Of utmost importance is
      his timely assistance with the obstructive pyelonephritis and pyonephrosis. These
      are initially often not recognized, especially because the first ultrasound
      examination of the intrarenal pyelone may not show a dilatation of the collecting
      system despite obstruction. If the adequate treatment with drainage and
      antibiotics is applied too late, this can result in serious and potentially
      lethal consequences.

PMID- 8488380
TI  - [Suffocation attack].
AB  - An acute attack of suffocation is a life threatening event which may be fatal
      within minutes. Since the oxygen stores of the body are small, any interruption
      of oxygen uptake by the lungs results in immediate anoxia of tissue and in
      particular in perilous cerebral anoxia. The primary aims in the management of
      this emergency situation are: (1.) opening of the airways, clearing any
      obstruction, and keeping airways open; (2.) administration of oxygen and, if
      possible, assisted ventilation. This "reflex management" will gain time for
      diagnostic evaluation, for the decision about further management and, in most
      cases, for safe transport to the nearest emergency hospital. Further emergency
      measures are required in the case of upper airway obstruction due either to a
      foreign body or to laryngeal edema caused by local insect stings or anaphylaxis.
      Occasionally a foreign body obstructing the upper airways can be cleared using
      the Heimlich maneuver, i.e. rapid inward and upward pressure on the victim's
      epigastrium. Mild forms of laryngeal edema can be relieved by inhalation of
      epinephrine. If these methods fail, cricothyroidotomy or transtracheal
      ventilation must be performed. Patients with acute severe asthma must be
      immediately treated with inhalations of a beta-agonist, parenteral prednisolone
      and administration of oxygen, while emergency transport to the nearest hospital
      must be organized. To ensure first aid the emergency physician must be equipped
      with the necessary instruments such as a small oxygen cylinder, appropriate
      cannula with connectors and tubings for transtracheal ventilation, and a suitable
      bag-valve-mask device.

PMID- 8488381
TI  - [Stroke].
AB  - Stroke is an ischemic event in 80% and hemorrhagic in 20%, which can be
      distinguished by computed tomography of the brain. Unfortunately, no routinely
      applicable therapy is available for stroke. Several thrombolysis studies are
      underway and their results will become available in the next few years.
      Hemodilution has been abandoned except for hematocrits above 50%. Calcium
      antagonists such as nimodipine reduce vascular spasms after subarachnoidal
      hemorrhage, but their administration after ischemic stroke is unsuccessful. A new
      experimental approach is offered by glutamate receptor antagonists, which may
      prevent cell damage induced by the excitatory amino acid glutamate. In the case
      of cardio-embolic stroke, heparin should be started after 48 hours. Hypertension
      should only be treated above values of 200/120 mm Hg, with short-acting
      intravenous drugs. Because of the limited therapeutic options for completed
      stroke, primary prevention (treatment of hypertension, anticoagulation for atrial
      fibrillation) and secondary prevention after transitory ischemic attacks
      (endarterectomy for carotid stenosis > 70%, aspirin) should be intensified.

PMID- 8488382
TI  - [Acute loss of vision due to ocular perfusion disorders].
AB  - Particularly in patients over 40 years of age, disturbances of perfusion at the
      optic nerve head and retina are a frequent cause of acute visual acuity loss. As
      the most important disease entities, we must distinguish between ischemic optic
      neuropathy and arterial and venous perfusion disturbances. The prognosis with
      regard to visual acuity is, at any rate, serious: a considerable, persistent loss
      of vision must be expected. Unfortunately, at present there is no therapy
      available which could normalize perfusion quickly enough. In individual cases of
      ocular venous thrombosis, isovolumetric hemodilution can be effective. Use of
      argon-laser coagulation may markedly reduce the occurrence of severe
      complications (hemorrhagic glaucoma, vitreous bleeding). As an emergency measure,
      brief massage of the globe as well as administration of 100 mg prednisone and 250
      mg acetazolamide are recommended. Disturbances in ocular perfusion call
      investigation with regard to hematological and vascular risk factors. It is
      always important to rule out giant-cell arteritis (Horton's disease).

PMID- 8488383
TI  - [Acute headache].
AB  - Sudden, explosive headache is rather rare. Though dramatic for the patient and
      the physician, it does not necessarily herald an intracranial catastrophe. Benign
      and dangerous thunderclap headaches cannot be distinguished from the features of
      headache itself, but rather on the basis of the situation, the additional
      symptoms and the findings. This means that every sudden headache should be
      considered potentially dangerous and be investigated immediately. The dangerous
      forms comprise intermittent hydrocephalus, acute bacterial meningitis and above
      all vascular complications. Subarachnoid hemorrhage frequently must be ruled out
      by computed tomography and lumbar puncture. Intracerebral, especially cerebellar
      hemorrhage, as well as hypertensive crisis require immediate treatment. Fatal
      cerebral embolism complicating spontaneous dissection of craniocervical arteries
      (carotid or vertebral arteries) can be prevented by early anticoagulant therapy.
      To confirm diagnosis, additional investigations such as CT, lumbar puncture or
      cerebrovascular ultrasound, and in rare cases MRI, should be performed early as
      the available time for effective therapy in many situations is short. Many of the
      benign forms of sudden headache can be diagnosed with a focused interview (cold
      or drug induced and food dependent headaches, sinusitis, glaucoma). Others, such
      as neuralgia, cough and coital headache, can be diagnosed as benign only when
      additional investigations have ruled out symptomatic forms.

PMID- 8488384
TI  - [Emergency: the internist as psychiatrist].
AB  - Aspects of psychiatric emergencies of special interest to the general physician
      are discussed. The perception that a problem constitutes an emergency is often
      subjective and sometimes reflects the anxieties of others rather than a real need
      for urgent treatment. Keeping calm and unhurried in front of an agitated patient
      might be as important as the use of a neuroleptic. The rather unusual
      psychopathological phenomena catalepsy and psychogenic twilight state
      (psychogenic trance) are mentioned in view of their importance for urgent
      assessment of mental status. The scope of the problem of suicide is outlined as
      far as the general physician is involved. Special attention is paid to panic
      disorder and attacks, a relatively new concept in medicine. Since the symptoms
      mimic those of cardiac, endocrine and convulsive disorders, patients with such
      symptoms often come to the attention of general physicians and frequently use the
      services of emergency departments. Early identification and treatment of panic
      disorder might help to avoid unnecessary repeated emergency department visits,
      and at the same time reduce the associated high risk of suicide and other
      psychiatric disorders such as depression as well as drug and alcohol abuse.

PMID- 8488385
TI  - ["Needlestick" accidents--procedures following potentially infectious exposure in
      medical personnel].
AB  - Accidental exposure to blood carries with it a definite risk for the health care
      worker of infection by various bloodborne pathogens, especially the hepatitis B,
      hepatitis C, and human immunodeficiency virus. The risk of transmission from
      exposure to HIV is lower than that associated with exposure to HBV and HCV.
      Should HIV infection occur, however, the outcome is likely to be fatal. Although
      general infection control precautions, safer use of needles, gloves, and other
      procedures may substantially reduce the incidence of occupational exposures, they
      cannot eliminate the risk completely. The post-exposure management is discussed.
      Neither the efficacy nor the safety of AZT (zidovudine) for use as a
      chemoprophylactic agent following occupational exposures to HIV has been
      established. Nevertheless in selected cases it can be proposed to health care
      workers.

PMID- 8488386
TI  - [Fever with chills].
AB  - Abrupt onset of fever with chills represents a body response to various stimuli
      called exogenous pyrogens. These substances interact with monocytes and
      macrophages, thus releasing various cytokines including interleukin-1 and tumor
      necrosis factor (endogenous pyrogens). Endogenous pyrogens act centrally on the
      thermosensitive neurons in the hypothalamus to increase the core body temperature
      by increasing heat production and decreasing heat loss. In addition, endogenous
      pyrogens trigger a non-specific inflammatory response and amplify the specific
      immune response through activating the T- and B-cell system. Pyogenic infections
      are the most frequent and most important cause of abrupt onset of fever with
      chill, but a similar pattern of fever may occur in many other situations. In many
      instances, a thorough history and a complete physical examination will produce a
      presumptive diagnosis. Further management decisions depend on the clinical
      conditions and on the localization of the infection. Patients with compromised
      vital functions, with involvement of the central nervous system, with chills
      associated with prolonged fever without localizing symptoms or physical findings,
      or with symptoms of intraabdominal sepsis, must be promptly hospitalized. The
      most important aspects of treatment should be directed at the cause of fever, and
      antipyretic drugs should be used after evaluation of relative risks in the
      individual case.

PMID- 8488387
TI  - [Give credit where credit is due?].

PMID- 8488388
TI  - [Meetings of the Swiss Societies of Internal Medicine, Rheumatology, and
      Rehabilitation and Physical Medicine. Lausanne, 13-15 May 1993. Abstracts].

PMID- 8488389
TI  - [The immunohistochemical picture in transfusion of incompatible blood].
AB  - To provide evidence of transfusion of incompatible blood in the ABO system in
      forensic medicine also antigens A and B of the donor must be detected in the body
      of the recipient. The author presents his own experience with evidence of
      incompatible red blood cells with group properties A, B or AB by the indirect
      immunoperoxidase method in paraffin section of the recipient's tissues. A
      positive reaction makes it possible to detect also occasional incompatible
      erythrocytes in particular in the periphery. An advantage is in particular the
      high sensitivity of the method, and as paraffin tissue blocks are used, also the
      possibility of retrospective evaluation.

PMID- 8488390
TI  - [Complications of thermal injuries leading to death].
AB  - The authors analyzed a group of 194 decreased subjects, 119 men and 75 women aged
      15.96 years who suffered thermic damage in the years 1981-1989. As compared with
      the source of burns in 1966-1974, there was a striking increase of subjects who
      suffered burns during propane-butane explosions. In the foreground of
      thanatological findings was pneumonia in 49%, shock in 28.3%, sepsis in 26.8%
      damage of the upper gastrointestinal tract in 23.7% and thrombotic embolism in
      18% of the subjects who died. More than half of them died with normothermia, 25%
      with hyperpyrexia and more than 20% with hypothermia. As compared with values of
      LA50 in 1966-1974 an increase occurred which implies a more favourable prognosis
      of burns. The values of LA50 were higher in particular in in the age group from
      15-50 years.

PMID- 8488391
TI  - [Forensic evaluation of drowning].
AB  - The authors discuss the basic types of the mechanism of drowning and different
      findings on necropsy. They draw attention to some endogenous and exogenous
      factors which participate in the development and course of drowning and changes
      which occur when the corpse is in water for prolonged periods. On examples from
      practice they demonstrate difficulties which may influence the diagnosis, in
      particular uncommon interferences with the organism.

PMID- 8488392
TI  - Chemotherapy-induced alopecia: new developments.
AB  - Alopecia (hair loss) is one of the most physically and psychologically
      distressing side effects of cancer chemotherapeutic drugs. Since its first
      recognition as a common outcome to most chemotherapeutic agents, only a few
      trials have been reported, using either a method to temporarily reduce the scalp
      blood flow (scalp tourniquet or hypothermia) or vitamin E, with undocumented and
      variable efficacy. The lack of progress in the treatment and prevention of
      chemotherapy-induced alopecia is in part due to the lack of a reproducible animal
      model. In the past 2 years, we reported on the following observations: (1)
      treatment of 8-day-old rats with vidarabine (ara-C), doxorubicin, and
      cyclophosphamide consistently produced either total body alopecia (ara-C and
      cyclophosphamide) or alopecia confined to the head and proximal part of the back
      (doxorubicin); (2) Imuvert, a biologic response modifier derived from the
      bacterium Serratia marcescens, uniformly produced complete protection against
      alopecia induced by ara-C and doxorubicin but not that produced by
      cyclophosphamide; (3) the protective effect of Imuvert against chemotherapy
      induced alopecia is mediated by a monocyte-mediated cytokine; and (4) this
      monocyte-derived cytokine is, possibly, interleukin-1. These observations
      constitute important progress in the understanding and prevention of chemotherapy
      induced alopecia.

PMID- 8488393
TI  - Ondansetron: a novel antiemetic agent.
AB  - Ondansetron hydrochloride is a new serotonin receptor antagonist that is
      effective in preventing emesis associated with cancer chemotherapy. The
      antiemetic effect appears to be exerted through a peripheral vagal blocking
      within the gastrointestinal tract, as well as an inhibitory effect within the
      chemoreceptor trigger zone (CTZ). Plasma concentrations of ondansetron peak 1
      hour after an oral dose, and the tablet has an absolute bioavailability of 59%.
      Ondansetron undergoes extensive hepatic oxidative metabolism in the liver. The
      half-life of ondansetron is 3.5 hours in healthy volunteers; elderly patients
      have a slightly reduced clearance, and pediatric patients have increased
      clearance. Although less than 10% of ondansetron is recovered unchanged in the
      urine, most metabolites are eliminated by this route. The recommended dose of
      ondansetron is 0.15 mg/kg for three doses on the day of chemotherapy (30 minutes
      before chemotherapy and 4 and 8 hours afterward). An alternative regimen includes
      a single-day dose of 32 mg IV in adult patients before chemotherapy. The efficacy
      of ondansetron therapy for delayed emesis has not been determined. Ondansetron
      has proven to be appropriate as a single agent or as an addition to standard
      antiemetic therapy (ie, corticosteroids, benzodiazepines, neurotransmitter
      blockers) in preventing and treating acute chemotherapy-induced emesis (CIE).
      Initial results of clinical trials in prevention of radiotherapy-induced emesis
      and anesthesia-induced emesis appear positive. Ondansetron is well tolerated,
      with few adverse events (eg, headache, sedation).

PMID- 8488394
TI  - Open trial of fluoxetine therapy for premenstrual syndrome.
AB  - To assess the possible efficacy of fluoxetine hydrochloride in severe PMS
      (premenstrual syndrome, luteal phase dysphoric disorder), an open trial of this
      medication was undertaken on women with severe PMS. Of 38 patients seeking
      evaluation of PMS, 35 met the criteria for diagnosis, and 21 had mild symptoms
      and were treated symptomatically. Fourteen had more severe symptoms persisting
      for more than 5 to 6 days of the month, and 11 elected to participate in an open
      trial of low-dose (20 mg) fluoxetine, an antidepressant. Ten continued treatment
      for 3 to 20 months, with moderate to marked relief of symptoms during treatment
      and without problematic side effects (one patient was given 40 mg daily; the
      remainder received 20 mg daily). On discontinuing therapy, seven have had
      persisting remissions, and two have returned for another cycle of fluoxetine
      therapy, with relief. It is unclear whether such a strong positive response to
      fluoxetine, an antidepressant with particularly good effects in "atypical
      depression," indicates that the women affected by severe PMS have a cyclic,
      hormonally induced change in brain chemistry causing a depressive type of
      condition, or whether they have a true (atypical) mild depression with brief
      remission due to "perifollicular euphoria" in the estrogenic follicular phase.

PMID- 8488395
TI  - Emphasis on high-density lipoprotein cholesterol in patients with coronary artery
      disease.
AB  - Although numerous epidemiologic and lipid intervention studies clearly
      demonstrate the pivotal role of high-density lipoprotein cholesterol (HDL-C) on
      risk of coronary artery disease (CAD), the National Cholesterol Education Program
      (NCEP) has emphasized only total cholesterol and low-density lipoprotein
      cholesterol (LDL-C), and has underemphasized the role of HDL-C in their lipid
      assessment and treatment recommendations. In a review of 113 consecutive patients
      in our cardiac rehabilitation program, lipid levels improved modestly with
      cardiac rehabilitation. "Ideal" lipids (LDL-C < 130 mg/dL according to the NCEP)
      were present in 49% before the rehabilitation program and in 46% afterward. In
      fact, 60 (53%) of our patients had total cholesterol levels < 200 mg/dL and would
      require no further lipid assessment or treatment according to the NCEP. Of these
      60 patients, 40 (67%) had low HDL-C (< or = 35 mg/dL). In our total study group,
      56% (63/113) had HDL-C < or = 35 mg/dL and 33% (37/113) had HDL-C < or = 30 mg/dL
      before rehabilitation (compared to 42% and 21%, respectively, after
      rehabilitation. On the other hand, a "high-risk" LDL-C value (> or = 160 mg/dL)
      was found in only 17% of patients at baseline and in only 13% after the cardiac
      rehabilitation program. Using an approach that incorporates the pivotal role of
      both LDL-C and HDL-C (LDL-C > or = 160 mg/dL or HDL-C < or = 35 mg/dL) for our
      patients with known CAD, 65% would require drug treatment before rehabilitation
      and 53% after rehabilitation. We conclude that: (1) lipids improve only modestly
      (though the change is significant statistically) with cardiac rehabilitation; (2)
      low levels of HDL-C are prevalent in cardiac rehabilitation patients and are much
      more prevalent than elevated LDL-C, both before and after rehabilitation; and (3)
      the NCEP should reevaluate the pivotal role of HDL-C in its assessment and
      treatment guidelines, particularly in patients with known CAD, since emphasis on
      both LDL-C and HDL-C is needed for optimal primary and secondary prevention of
      CAD.

PMID- 8488396
TI  - Conservative surgery and radiation therapy in early breast cancer: ten-year
      experience at the West Florida Cancer Institute.
AB  - Between July 1981 and December 1989, 143 patients received conservative surgery
      and radiation for 147 primary breast tumors. Ten lesions were staged as Tis, 122
      as T1, and 15 as T2. N stages were NX in 15 cases, N0 in 93, and N1 in 39. All
      patients had lumpectomy, and 132 (89%) had axillary lymph node dissection. All
      had irradiation (45 to 50 Gy) to the entire breast. All received an electron
      boost to the primary site to a total dose of 60 Gy. Minimal follow-up was 18
      months, and median follow-up was 56 months; 123 patients had at least 3 years of
      follow-up, and 59 patients had at least 5 years. The local control rates at 3 and
      5 years were 96% and 97%, respectively. Tumor-free states at 3 and 5 years were
      93% and 86%, respectively. Minor complications occurred in four patients.
      Approximately 90% of patients had good to excellent cosmetic results.

PMID- 8488397
TI  - Treatment of acute intestinal ischemia with hyperbaric oxygen.
AB  - Hyperbaric oxygen has been shown to improve oxygen tension and promote wound
      healing. We did a pilot study in which we created ischemic jejunal segments
      measuring 3, 6, and 9 cm, 10 of each length, in 30 rats. Half of the rats were
      given hyperbaric oxygen at 100%, 30 psi, for 90 minutes twice daily for 7 days to
      determine whether hyperbaric oxygen therapy could overcome the ischemic
      intestinal injury and prevent ischemic necrosis. In the rats with 6- and 9-cm
      ischemic segments, no difference was seen between the hyperbaric oxygen and
      control groups. Of the rats with 3-cm ischemic segments, ischemic infarction of
      the bowel developed in 40% of the hyperbaric oxygen group and 100% of the
      controls (P = 0.167, Fisher's Exact Test). We then created 3-cm ischemic
      intestinal segments in 30 additional rats. Again, half were treated with
      hyperbaric oxygen as previously described for 7 days. There was no difference
      between the controls and the hyperbaric oxygen group in the rate of perforation
      (4 of 15 [27%] versus 1 of 15 [7%]) or stricture rate (8 of 15 [53%] versus 9 of
      15 [60%]). We concluded that hyperbaric oxygen therapy is of limited value for
      the treatment of intestinal ischemias.

PMID- 8488399
TI  - Factors predicting reluctance to seek treatment in patients with eating
      disorders.
AB  - Eating disorders, including anorexia nervosa and bulimia nervosa, are common
      problems in young women, yet many delay or never seek treatment for them. A
      semistructured telephone interview that addressed various eating problems was
      conducted with 78 consecutive patients referred to a university hospital eating
      disorders clinic. It was hypothesized that individuals who subsequently followed
      through with treatment would differ in some easily recognizable characteristics
      from those who did not. No significant differences were found in variables,
      including duration of eating problems, frequency of binge eating or vomiting,
      history of previous treatment, or presence of associated physical problems.
      However, individuals who abused laxatives, those with depression, and those who
      were least satisfied with their current weight tended to avoid coming to the
      clinic for treatment. These findings suggest that individuals with more severe
      eating problems may be the most reluctant to seek treatment.

PMID- 8488398
TI  - STAR complexes: febrile illnesses associated with sore throat, arthritis, and
      rash.
AB  - Between January 1990 and February 1991 we evaluated the cases of 20 patients for
      a symptom complex consisting of Sore throat, elevated Temperature, migratory
      Arthritis, and a pruritic urticarial Rash (STAR). The patients ranged in age from
      3 1/2 to 48 years; most were from central Texas. Duration of illness varied from
      2 weeks to longer than 1 year. Results of laboratory studies included the
      following abnormal findings: elevated erythrocyte sedimentation rate,
      leukocytosis, anemia, and thrombocytosis. Eleven of 18 (61%) patients had low
      antinuclear antibody titers. HLA-A2 was noted in 8 of 10 (80%) of those tested.
      Test results were positive in eight cases for IgM antibodies to parvovirus and in
      six cases for IgM antibodies to rubella, suggesting that these entities may
      represent an underdiagnosed cause of STAR complex. In six cases no specific cause
      of disease was found; these cases may be attributable to other infectious
      agent(s) yet to be identified. Here we present a description of the cases, a
      discussion of the differential diagnosis, and an evaluation of STAR complex.

PMID- 8488400
TI  - Cerebral monitoring during implantation of automatic internal cardiac
      defibrillators.
AB  - Implantation of automatic internal cardiac defibrillators (AICD) for management
      of arrhythmias necessitates the induction of ventricular fibrillation (VF) to
      test the device adequately. The profound hypotension associated with induced
      arrhythmia and subsequent circulatory arrest may result in cerebral ischemia. To
      characterize cerebral ischemia, we used a five-lead Lifescan brain activity
      monitor to examine changes in cerebral activity in 10 patients having AICD
      placement. The duration of hypotension, as defined by a mean arterial pressure
      (MAP) < 50 mm Hg, was recorded, and the corresponding changes in brain activity
      were evaluated during 51 episodes of circulatory arrest. The number of episodes
      for each patient ranged from 2 to 14. The average duration of hypotension per
      episode was 26.2 seconds, with a range of 8 to 67 seconds. Brain activity changes
      characteristic of cerebral ischemia occurred in 46 of the 51 events (90%).
      Cerebral ischemia did not occur when the duration of hypotension was less than 16
      seconds (5 episodes). The duration of cerebral ischemia ranged from 50 to 279
      seconds (average 84.9 seconds) and did not correlate with the duration of
      hypotension or the order of the episodes in the testing sequence. These findings
      suggest that reevaluation of standard monitoring practice for AICD implantation
      may be warranted.

PMID- 8488401
TI  - Human immunodeficiency virus infection: knowledge of the disease and attitudes
      toward related issues and policies among health care workers in a low-incidence
      nonurban hospital.
AB  - We compared the knowledge and attitudes regarding human immunodeficiency virus
      (HIV) infection among employees in a tertiary care teaching hospital in a
      nonurban southeastern city with a relatively low incidence of acquired
      immunodeficiency syndrome (AIDS). All 260 physicians and a random sample of 240
      other employees were asked to complete a 59-item anonymous mail survey. All
      groups of respondents, including physicians, showed a lack of understanding of
      critical aspects of AIDS, particularly transmission. Negative attitudes such as
      victim blaming and not liking to care for persons with HIV infection were common,
      especially among house staff and respondents who do not give hands-on care.
      Misinformation, aversion, fear, and lack of compassion were evidenced by a
      substantial proportion of the respondents, particularly house staff. The
      attitudes expressed suggest that there is more focus on the rights of the
      caregiver than on the welfare of patients. These findings show that there is a
      need for medical education that focuses on both knowledge and affective issues of
      HIV infection.

PMID- 8488402
TI  - Effect of hemodialysis on left ventricular contractility in pediatric patients
      with end-stage renal disease.
AB  - Assessment of the effect of hemodialysis on myocardial contractility is
      complicated by variations in loading conditions that can occur during
      hemodialysis and by the prevalence of coronary artery disease among patients with
      chronic renal failure. Therefore, we used a load-independent index of left
      ventricular contractility, derived from analyses of the rate corrected velocity
      of circumferential fiber shortening (Vcfc)-end systolic wall stress (ESWS)
      relationship, to study the acute effects of hemodialysis on left ventricular
      function in the cases of 15 pediatric patients with end-stage renal disease.
      Prior to dialysis, Vcfc was appropriate for ESWS (102% +/- 16% of predicted) and
      did not differ significantly from values obtained from a group of nine normal
      control subjects of similar ages (103% +/- 9% of predicted), indicating that the
      patients' left ventricles were functioning in a normal inotropic state. After
      dialysis, Vcfc increased to levels beyond those expected for ESWS (118% +/- 20%
      of predicted, P < .05 versus control; P < .001 versus predialysis levels),
      indicating that dialysis was associated with enhancement of the left ventricle's
      inotropic state. A statistically significant increase in plasma norepinephrine
      levels was also observed. However, the increase in the percentage of the
      predicted Vcfc did not correlate with observed changes in this inotropic agent or
      with dialysis-induced variations in body weight or levels of electrolytes, urea
      nitrogen, or creatinine, and firm conclusions regarding the identity of the
      factors responsible for the positive inotropic effect of hemodialysis could not
      be drawn.

PMID- 8488403
TI  - More short-term volunteer staffing for public health: an independent policy
      statement.
AB  - This paper is an independent policy statement recommending more short-term
      volunteer staffing for the US Public Health Service. I propose a Public Health
      survey of all physicians to determine their willingness to serve short-term, so
      that those available can be mobilized. Public Health should redirect its
      recruitment efforts, eliminate bureaucratic hindrances, develop a cadre of
      generalists and specialists, and designate appropriate organizations that can
      incorporate existing medical personnel.

PMID- 8488404
TI  - Trauma surgery during the Civil War.

PMID- 8488405
TI  - Spontaneous migration of an intracranial bullet into the cervical canal.
AB  - We have reported a case of intracranial to intraspinal migration of a retained
      bullet fragment over a course of approximately 4 years. The patient remained
      asymptomatic. The bullet was removed via a posterior cervical laminectomy.
      Migration of bullet fragments, though rare, should be included as one of the
      delayed complications of gunshot wound to the head.

PMID- 8488406
TI  - Respiratory insufficiency in adult-type acid maltase deficiency.
AB  - AMD is a glycogen storage disease that affects all age groups. In both childhood
      and adult forms, the classic clinical picture is that of a progressive myopathy
      that may resemble polymyositis or limb girdle muscular dystrophy. Respiratory
      muscle involvement is common, may occur early in the course of the disease, and
      is the most frequent cause of mortality from AMD. These findings underscore the
      need to consider AMD in the differential diagnosis of unexplained respiratory
      insufficiency. We have described the case of one patient in whom respiratory
      failure was the initial symptom and two other cases in which the patient had
      progressive muscular weakness and subsequent respiratory failure. A review of the
      literature revealed that respiratory muscle weakness has been reported in 21 of
      43 cases of AMD in adults. In 10 cases respiratory insufficiency was preceded by
      only mild or moderate weakness.

PMID- 8488407
TI  - Multiple myeloma and AL amyloidosis mimicking Sjogren's syndrome.
AB  - A 49-year-old white man had xerostomia, orthostatic hypotension, salivary gland
      enlargement, and a monoclonal gammopathy. Salivary gland biopsy revealed AL
      amyloidosis without histopathologic evidence of Sjogren's syndrome; serologic
      evidence of Sjogren's syndrome was also absent. Bone marrow biopsy revealed more
      than 30% plasma cells, and a diagnosis of multiple myeloma was made. The
      association of myeloma amyloidosis with salivary gland infiltration and
      xerostomia is rare. Unusual causes of xerostomia, such as myeloma amyloidosis,
      should be considered when histopathologic and serologic evidence of Sjogren's
      syndrome are absent.

PMID- 8488408
TI  - Silicone pleural effusion due to iatrogenic breast implant rupture.

PMID- 8488409
TI  - External iliac artery occlusion due to pelvic fracture: management with a cross
      femoral bypass graft.
AB  - Vascular injury is not uncommon in cases of major pelvic trauma. Venous injury is
      by far the most common associated problem and may lead to exsanguinating
      hemorrhage. Arterial injury is less common, but certainly not without associated
      morbidity and mortality. It can lead to persistent bleeding after fixation and
      stabilization of the pelvic girdle, and occlusion of major pelvic arteries can
      cause limb ischemia and limb loss. The potential problems with revascularizing
      the ischemic extremity are (1) other life-threatening injuries that may be
      present and (2) a retroperitoneal hematoma that can interfere with an anatomic
      approach. Our solution to the latter problem, as presented here, is placement of
      a cross-femoral bypass graft, which rapidly and safely restores blood flow in the
      presence of pelvic fracture and an occluded external iliac artery. The pelvic
      hematoma is avoided, thereby restoring circulation more quickly, with less blood
      loss and greater ease.

PMID- 8488410
TI  - Acute Page kidney phenomenon: a cause of reversible renal allograft failure.
AB  - We have reported a case of reversible acute renal transplant failure due to the
      Page kidney phenomenon, which followed routine diagnostic needle biopsy. Duplex
      Doppler ultrasonography differentiated between allograft rejection and graft
      failure due to perirenal and mechanical abnormalities. Renal transplant failure
      may result from intrinsic or extrinsic allograft compression. If this is detected
      and treated rapidly, renal deterioration may be reversed and the transplant
      salvaged.

PMID- 8488411
TI  - Pylephlebitis associated with diverticulitis.
AB  - We have reported the cases of two patients who had acute pylephlebitis associated
      with portal vein thrombosis and septic hepatic emboli as a result of right
      colonic diverticulitis. Although rare, pylephlebitis is a treatable but often
      lethal complication of intra-abdominal sepsis. Several bacterial pathogens,
      especially Escherichia coli are associated with pylephlebitis. Early suspicion
      and prompt antibiotic therapy can lead to resolution of portal vein thrombosis
      and hepatic abscess formation, resulting in full recovery for the patient.
      Surgery may not be required. Our two patients received ampicillin--the best first
      line drug--until specific antibiotic therapy could be given. Early administration
      of a broad spectrum antibiotic is essential.

PMID- 8488412
TI  - Pyoderma gangrenosum as a cutaneous manifestation of diverticular disease.
AB  - We have described a case of pyoderma gangrenosum due to diverticular disease. The
      patient was an elderly woman with a 3-month history of cutaneous disease without
      associated gastrointestinal complaints. There was no history of inflammatory
      bowel disease, malignancy, or seropositive arthritis. Evaluation revealed a
      retroperitoneal abscess due to a ruptured diverticulum. Surgical resection of the
      affected colon led to rapid and complete resolution of all symptoms. Pathologic
      examination of resected tissue showed diverticulitis without evidence of chronic
      inflammatory bowel disease.

PMID- 8488413
TI  - Symptomatic pleural effusion after coronary artery revascularization: unsuspected
      pleural injury from internal mammary artery resection.
AB  - A patient with a large left pleural effusion returned to her physician 4 weeks
      after CABG with saphenous vein grafts. After repeated investigations the cause of
      the effusion still could not be ascertained. Upon subsequent review it was noted
      that the patient had had an aborted attempt at coronary artery revascularization
      using the left IMA. Nonsurgeons frequently fail to recognize the association of
      significant pleuropulmonary complications with harvesting of the IMA conduit as a
      coronary bypass graft. The delay in presentation of these complications after
      CABG, along with a lack of physician familiarity with them, can lead to problems
      in diagnosis and management. Although serious pleuropulmonary complications are
      an uncommon problem, physicians must become familiar with these complications
      because of the widespread use of the IMA graft.

PMID- 8488414
TI  - Peritonitis due to Moraxella (Branhamella) catarrhalis in a diabetic patient
      receiving peritoneal dialysis.

PMID- 8488416
TI  - Minimalism in surgery.

PMID- 8488415
TI  - Tetanus, pseudotetanus, or conversion disorder: a diagnostic dilemma?
AB  - Failure to consider conversion disorder in a patient with acute, tetanus-like
      symptoms led to unnecessary medical expenditures and delayed appropriate
      psychiatric intervention. Patients presenting these clinical symptoms need a
      comprehensive evaluation, with careful attention to details in the psychosocial
      history. While tetanus is rarely encountered now in the United States, conversion
      disorder is commonly encountered in both medical and psychiatric populations.

PMID- 8488417
TI  - "Mister Christopher Columbus".

PMID- 8488418
TI  - "Mister Christopher Columbus".

PMID- 8488419
TI  - Use of ketorolac (Toradol) to inhibit perioperative platelet aggregation.

PMID- 8488420
TI  - [The significance of the ultrasound examination in surgery of the thyroid gland].
AB  - The authors emphasize the importance of ultrasonographic examination of the
      thyroid gland for the diagnosis of disease as well as for planning and
      implementation of the operation. They evaluate the importance of 154 sonographic
      examinations which were made during the last three years in 545 operations of the
      thyroid. For the surgeon anatomical parameters of the pathological tissue are
      important with special emphasis on the relation with surrounding tissues and
      affection of the lymphatic system. The examination is irreplaceable, in
      particular in reoperations of the thyroid gland and nodular syndrome.

PMID- 8488421
TI  - [The importance of annulo-ventricular integrity in replacement of the mitral
      valve. Experience with the double-disc low profile Carbo Medics mechanical
      valve].
AB  - In the submitted paper the authors compare the results of the conventional
      replacement of the mitral valve with total excision of the subvalvular apparatus
      and the results of mitral replacement with a completely or partly preserved or
      reconstructed integrity of the annulopapillary structures. During the last five
      years the authors operated by the former method 115 patients (group A) and the
      second surgical method was used in 93 patients (group B). In both groups the
      authors compared 33 demographic, clinical, peroperative, postoperative and
      echocardiographic indicators. Group B comprised substantial more patients with
      severe myocardial disorders. In the latter group significantly more frequently a
      mechanical double-disc valve Carbo Medics was implanted than other types of
      synthetic valves which were used mostly in patients of group A. In patients of
      group B the operation took longer and after operation they needed more frequently
      intense inotropic support. Despite that their mortality on hospitalization was
      lower -3.2% than in group A where it was 6.9%. The late echocardiographic results
      were also in favour of group B where, contrary to group A, after operation the
      left ventricular function improved. The authors' experience support the view that
      preserving the integrity of the annulopapillary apparatus is nowadays one of the
      demands in surgical correlation of a mitral defect and is of decisive importance
      for the subsequent fate of the thus treated patients.

PMID- 8488422
TI  - [Use of the right gastroepiploic artery graft in revascularization of the
      myocardium].
AB  - The right gastroepiploic artery (rGEA) was used as a graft for revascularization
      of the heart muscle in 239 patients along with other arterial grafts obtained
      from the internal mammary arteries (IMA). The mean follow-up of patients after
      operation was 17 months, the longest period being 38 months with a total follow
      up period of 4,063 months. The authors recorded a high percentage of patency of
      the graft during check-up catheterization after a 6-month interval (94.7%), a low
      incidence of early complications of minor importance (2.5%), a low percentage of
      anginose complaints (7.9%) and reoperations (5%), while the lethality was not
      higher than in the control group (2.51%). The use of a graft from the rGEA is
      very suited for surgical treatment of IHD, in particular in patients of younger
      age groups and in reoperations. The authors discuss contraindications, the
      majority being only relative contraindications. The authors deal also with the
      preparatory surgical technique and the use of the graft.

PMID- 8488424
TI  - [The role and tasks of surgery within the transformation of the health care
      system].

PMID- 8488423
TI  - [Autotransplantation of the spleen].
AB  - The authors present a report on the autotransplantation of the damaged spleen by
      successful use of a tissue fibrin glue to fix thin lienal slices to the greater
      omentum. The new method was used in 8 men and 2 women, with the exception of one
      man in all patients after multiple injuries. From the total number two women died
      from sequelae of the injuries. Complications caused by replantation of the tissue
      were not observed. All the other patients survive and have no complaints
      associated with the loss of the spleen. The function of the transplant can be
      tested only by scintigraphy and laboratory examination. Other examinations by
      means of sonography, CT, X-ray of the stomach and irrigoscopy are not conclusive.
      The described method of replantation is suitable as it is simple and safe. In
      children orthotopic replantation is more suitable.

PMID- 8488425
TI  - [Functional reconstruction of urinary bladder exstrophy: long-term follow-up of
      urinary continence].
AB  - The author followed up a group of seven patients 5 to 29 years after functional
      reconstruction without augmentation on account of classical exstrophy of the
      urinary bladder. The plastic operation to ensure continence was performed in 5
      boys and 2 girls at the age of two and a half to 23 months, in six cases by the
      Young-Dees' method and in one patient by Leadbetter's method. Posterior iliac
      osteotomy was performed in two and an antireflux plastic operation was performed
      in four patients. In one patient a disruption of the plastic operation of the
      abdominal wall occurred on the fourth day after reconstruction. Continence was
      excellent in five patients and satisfactory in two. Among the many factors for
      urinary continence a plastic operation of the posterior urethra and neck of the
      bladder is most important as it creates the appropriate length of the continence
      zone and the adequate pressure on closure. In the discussion the author
      emphasizes the advantage to start with the reconstruction of the abdominal wall
      and bladder during the neonatal period and to proceed in stages. The functional
      closure of the bladder and its neck with the posterior urethra should be
      implemented after a minimal capacity of 60 ml has been attained. Augmentation
      enterocystoplasty is indicated on account of urinary incontinence as a secondary
      operation if the function of the urethra and neck of the bladder is satisfactory
      and achieved capacity is less than 100 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488426
TI  - [Breast carcinoma in women].

PMID- 8488427
TI  - [Retrograde myocardial revascularization using a bypass into the cardiac vein].
AB  - The authors submit a review of the surgical treatment of ischaemic heart disease,
      and based on data from the literature and their own experience, they evaluate the
      asset of so-called indirect revascularization operations under conditions when an
      aortocoronary bypass is impossible or has only a short-term effect due to the
      diffuse sclerotic affection of the coronary circulation. Special attention is
      paid to attempts of retrograde revascularization of the heart muscle by bypasses
      into the coronary veins. Because at present the possibility of indirect
      revascularization of the myocardium by a retrograde approach via the cardiac
      veins still remains a by far not yet resolved problem, the authors recommend for
      situations where the aortocoronary bypass is out of question a procedure making
      use of the advantages of a direct aortocoronary bypass and Vineberg's operation
      performed so as to relieve the blood flow through the sclerotic coronary artery
      beneath the anastomosis. In special situations also a sequential bypass could be
      considered with a side-to-side anastomosis into the artery and end-to-side into
      the appropriate vein.

PMID- 8488428
TI  - [Laparoscopic cholecystectomy: early results in the initial non-selected group of
      50 surgical patients].
AB  - Early results of an initial non-selected group of 50 laparoscopic
      cholecystectomies (mean hospitalization 3.5 days, 6% conversions, no serious
      complications, no revisions, morbidity due to minor complications 6.3% and saved
      costs of postoperative hospital treatment 44.6%) confirm that this operation is
      feasible, safe, preferred by patients and well tolerated economical definitive
      treatment of cholecystolithiasis. On these grounds it is becoming a method of
      first choice. The safety of patients is ensured by steady care of the surgeon and
      his adequate training according to generally accepted principles.

PMID- 8488429
TI  - Clinical anatomy: a new challenge.

PMID- 8488430
TI  - Anatomic basis of the physiopathology of the epicondylalgias: a study of the deep
      branch of the radial nerve.
AB  - Compression of the deep branch of the radial n. during its passage through
      Frohse's arcade in the supinator m. is one of the classical explanations advanced
      for epicondylalgia. The object of this study was to define the anatomy of the
      deep branch of the radial n. from its origin up to the origin of the branches to
      the lateral epicondylar mm. 34 upper limbs were dissected and three segments of
      the deep branch of the radial n. were distinguished: segment I, from its origin
      to its entry into the supinator m.; segment II, corresponding to its passage
      through the supinator m.; and segment III, extending from its exit from the
      supinator m. to the origin of the nn. to the lateral epicondylar mm. The lengths
      of these three segments were defined, as well as the level of division of the
      radial n. in relation to the joint-line, the thickness of the arcade of the
      supinator m., and the number of nerve branches to the supinator m. It was found
      that segment III is closely related to the radial head, around which it winds in
      supination and extension. The three nerve segments thus defined were studied
      separately microscopically for evidence of lesions. The results were as follows.
      Segment I: absence of any marked histologic lesions; segment II: marked fibrous
      thickening of the perineurium and the interstitial connective tissue, replacing
      certain nerve fibers; segment III: persistence of moderate interstitial fibrosis.
      These findings appeared constant in all the specimens examined. These results
      indicate that the deep branch of the radial n. is most affected during its
      passage through the supinator m.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488431
TI  - Large inferior right hepatic vein. Clinical implications.
AB  - The right middle and inferior hepatic vv. are very frequent, indeed constant, but
      usually of small caliber. The presence of an extra-wide right inferior hepatic
      v., usually solitary, produces a variation in the venous drainage of the right
      lobe of the liver. The right inferior hepatic vv. reaching or exceeding a caliber
      of 0.5 cm were investigated in 125 anatomic liver specimens: 70 injection
      corrosion specimens, 32 formolised livers and frontal or frontal-oblique sections
      of the trunk made in 23 cadavers. The incidence of such vv. was estimated at 9%
      in the injection-corrosion specimens, 13% in the sections and 16% in the
      formolised livers. The incidence of these vv. in the literature varies from 10%
      to 24% according to the method used to demonstrate them. Usually, there is a
      balance between the right superior and inferior hepatic vv. Rarely, the right
      inferior hepatic v. predominates compared with the right superior hepatic v. The
      position of an extra-wide right inferior hepatic v. is constant, close to the
      visceral aspect of the liver. Its appropriate territory is segment VI, but it may
      encroach somewhat on adjacent segments. Clinically, the existence of an extrawide
      right inferior hepatic v. as detected by MRI and, especially, located by
      intraoperative ultrasonography, allows performance of a subtotal hepatectomy
      leaving only segment VI. In certain pathologic conditions, thanks to the
      development of anastomoses between the hepatic vv., an extra-wide right inferior
      hepatic v. may contribute to a compensatory circulation towards the right atrium.

PMID- 8488432
TI  - Origin of the internal thoracic artery and its relationship to the phrenic
      nerves.
AB  - The internal thoracic artery was studied because of its recent use in the
      revascularization of the myocardium in patients with coronary artery disease. The
      artery of 50 cadavers of adult individuals of either sex, whose age ranged from
      20 to 84 years, was studied after neoprene latex injection. Its origin, relation
      to the phrenic nerve and origin of the pericardiacophrenic artery were
      investigated. The left and right phrenic nerves cross the artery anteriorly in
      54% of the cases and posteriorly in 14%. The right nerve crosses the artery
      anteriorly and the left posteriorly in 22%, and the reverse occurs in 10%. The
      origin of the internal thoracic artery is much more frequent from the subclavian
      artery (80%) than from a common trunk with other arteries (20%). The
      pericardiacophrenic artery is a branch of the internal thoracic artery in 99% of
      the cases and the average distance between the origins of these two arteries is
      3.9 +/- 1.3 cm.

PMID- 8488433
TI  - Anatomical study of five prenataly diagnosed sternopagus twins.
AB  - Among conjoined twins (1 out 50000 births), thoracopagus occurs most frequently
      and is generally lethal. Our anatomical study of five sets of sternopagus twins
      (3 female, 2 male) was performed to determine the ability of prenatal sonography
      to detect these anomalies. Autopsy in four cases revealed identical
      malformations: common sternum, single malformed heart, joined hepatic parenchyma,
      and a common small bowel leading to a cystic dilatation situated on the ileal
      segment at the end of the superior mesenteric artery. The diagnosis of conjoined
      twins was made in all cases by prenatal sonography at the mean time of 24.6
      gestation weeks (range 19-34). The malformations detected by prenatal sonography
      were a single cardiac mass (all cases), joined hepatic parenchymas (3 cases), and
      an ileal cystic dilatation (1 case). Pregnancy was terminated in four cases. In
      one case cesarean delivery was performed, and the infants died 48 hours later.
      Prenatal sonography currently seems to be the best examination for diagnosis of
      sternopagus twins and the detection of lethal malformations thus allowing
      interruption of pregnancy.

PMID- 8488434
TI  - Relations between Meckel's cartilage and the morphogenesis of the mandible in the
      human embryo.
AB  - Based on a series of human embryos classified in stages, the authors studied the
      evolution of Meckel's cartilage in its ventral portion and its relations to the
      morphogenesis of the mandible. Three stages appeared particularly important:
      stage 16, appearance of Meckel's cartilage; stage 20, beginning of membranous
      ossification; and stage 23, end of the embryonic period (8th week). The primitive
      bony nodule which develops from the embryonic mesenchyme appears as a double bony
      layer forming a groove containing the neurovascular bundle, into which the dental
      lamina is also invaginated.

PMID- 8488435
TI  - A survey of different high resolution visualization modes of a volumetric object
      with applications.
AB  - In view of the variety of 3D representation techniques, a clinical study was
      carried out in order to evaluate their respective usefulness. It appears that a
      single technique cannot be claimed to be valid for all clinical situations and
      that a combination of representations brings more relevant information. Among the
      different techniques a clear delineation must be established between those which
      allow the accurate definition of landmarks (multiplanar reformation, surface
      representation), and those which do not (integral shading, reconstructed
      radiology). The main point is the possibility to recognize anatomical landmarks
      on these latter modes and to choose oblique cut planes in relation to them.
      Visualization quality is strongly dependent upon the acquisition protocol which
      must provide a spatial resolution as isotropic as possible.

PMID- 8488436
TI  - Ultrasonic assessment of the anatomy and function of the tongue.
AB  - The tongue is a complex muscular structure. Apart from its intrinsic strength, it
      has a major influence on the adjacent bony structures. Real time ultrasound
      appears to be the method of choice for assessing the topographic and functional
      anatomy. The examination was performed using an Acuson 128 scanner, with a 5 MHz
      probe, either a sector scanner (sagittal plane) or linear array probe (coronal
      plane). The scans were performed using the sub-hyoid approach, between the rami
      of the mandible. The images were stored on U-matic videotape. Thirty adult
      patients were included in the study population. The scan protocol consisted of an
      examination of the tongue at rest, a scan of the swallowing mechanism with and
      without a liquid bolus and a study of the posterior lingual positions (which show
      some anatomical variation). The intrinsic muscles of the tongue and the floor of
      the mouth could be identified on the "at rest" images. The lingual mass is the
      most important parameter and is opposed against the palate in order to propel a
      bolus during the swallowing mechanism. The mobility, shape and supporting
      structures of the tongue are variable depending on the nature of the bolus, the
      patient and the two imaging planes. Ultrasound is a simple and non-invasive
      method for the examination of the buccal cavity. The function of the posterior
      portion of the tongue must be taken into consideration prior to any treatment
      concerning the oral cavity.

PMID- 8488437
TI  - Anatomy of the acromial arch: correlation of anatomy and magnetic resonance
      imaging.
AB  - Based on a retrospective study of 179 MRI records covering four populations
      (patients presenting with impingement without known injury (n = 90), post
      traumatic shoulder pain (n = 28), instability or dislocation (n = 36) and
      controls (n = 25)), morphologic criteria are suggested to define presumedly
      normal arches and arches compatible with subacromial impingement. The subacromial
      arch is presumed normal or without impingement if the sagittal and frontal views
      show it to be parallel to the humeral head, and/or if there is a fatty layer
      interposed between the arch and the supraspinatus m. The arch is presumed
      "aggressive" or actually capable of giving rise to impingement if, in either the
      sagittal or frontal view, there is a zone of narrowing of the subacromial passage
      with an impression of the arch on the supraspinatus tendon or tendinous thinning
      at this level or just lateral to this narrowed zone. Based on these criteria,
      study of the 179 MRI records demonstrated a significant difference of
      distribution of the arches in the four populations. "Aggressive" arches were
      found in 45.5% of patients with impingement, 25% of patients with posttraumatic
      pain, 8.9% of patients with an acute or recurrent dislocation and 12% of
      controls. Conversely, a presumedly normal arch was found in 56% of the controls,
      55% of patients with dislocation, 25% of posttraumatic painful shoulders and only
      5.5% of patients with clinical impingement. Subacromial impingement may be due to
      the type 3 acromial dysplasia described by Bigliani or to a thickening of the
      coracoacromial ligament at its acromial attachment. This study was supplemented
      by 15 anatomic dissections which confirmed the regularity of attachment of the
      coracoacromial ligament at the inferior aspect of the acromion along its lateral
      border.

PMID- 8488438
TI  - Anomalous origin of the brachiocephalic vessels with right aortic arch and
      contralateral subclavian steal syndrome.
AB  - Anomalies of origin of the brachiocephalic vessels are uncommon. The authors
      report a new case of such an abnormality revealed by a subclavian steal syndrome.
      The angiographic study showed a right aortic arch with hypoplasia of the origin
      of the left subclavian a., which arose from the descending aorta, and a
      collateral cervical circulation derived from the left vertebral a. and the right
      subclavian a.

PMID- 8488439
TI  - Adaptation of facial architecture in the Toulouse deformity (23.10.92).

PMID- 8488440
TI  - Microsurgical anatomy of the ethmoid.
AB  - A description of the constant landmarks of the ethmoidal labyrinth is proposed,
      based on data from micro-dissection, endoscopy, computed tomography and histology
      in 12 subjects. In accord with surgical procedure, the identification of these
      landmarks follows the lateral orbital and superior cranio-frontal aspects. The
      uncinate process, ethmoidal bulla, middle nasal concha and their septal roots,
      and the upper wall of the ethmoidal labyrinth in continuity with that of the
      sphenoidal sinus, form the definitive landmarks for endonasal ethmoidectomy under
      endoscopic monitoring.

PMID- 8488441
TI  - Fertility following excision of a symptomatic craniopharyngioma during pregnancy:
      case report.
AB  - A 27-year-old woman in the second trimester of pregnancy presented with
      bitemporal hemianopsia. Total resection of a craniopharyngioma restored normal
      vision, and she delivered a normal infant at term. Permanent hormonal replacement
      therapy was not needed. Subsequent spontaneous pregnancy and delivery indicate
      that fertility was preserved. Literature review shows this case to be unique.
      Even with new developments in stereotactic radiotherapy, total excision remains a
      potentially achievable surgical goal.

PMID- 8488442
TI  - Recurrence of symptomatic Rathke's cleft cyst: a case report.
AB  - A 65-year-old man presented with bitemporal hemianopsia. He had undergone frontal
      craniotomy for a Rathke's cleft cyst associated with narrowed visual field 8
      years earlier. His vision had returned to normal soon after surgery and he
      remained asymptomatic until the present complaint. Neurodiagnostic imaging
      revealed a recurrence of the intrasellar cyst extending into the suprasellar
      cistern. His vision improved rapidly after a second surgery. The histological
      findings were the same as those of the previous operation; the cyst wall was
      composed of a single layer of ciliated columnar epithelium resting on a
      collagenous connective tissue stroma.

PMID- 8488443
TI  - Management of low-risk head injuries in an entire area: results of an 18-month
      survey.
AB  - All patients admitted following a minor head injury (GCS is without neurological
      deficits) during an 18 month period in an entire area were submitted to the same
      diagnostic and therapeutic protocol. Adult patients were x rayed and in the cases
      with skull fracture (even asymptomatic), a computed tomographic (CT) scan was
      performed. Children (below the age of 14) did not routinely receive skull X-rays
      but were admitted to one of the five regional hospitals where a CT scanner was
      available 24 hours per day. Neuroradiologic investigations (carried out in over
      600 patients) showed posttraumatic lesions in 201 cases; 113 of these patients
      were transferred to the neurosurgical center. There were 49 patients with
      extradural hematomas, 41 with brain contusions, 17 with depressed skull
      fractures, and six with subdural hematomas. Of these 113, 40 patients were
      operated on (mainly extradural hematomas); surgical indications were based on
      appearance of clinical deterioration, lesion volume, presence of midline shift,
      and/or compressed third ventricle and basal cisterns. In eight cases there was a
      clinical deterioration to a GCS of 13 or less; in all of these patients, the CT
      diagnosis (and transfer to a neurosurgical center, preceded the onset of
      deterioration. All patients admitted to such a center had a good outcome, but a
      survey of deaths related to head injury in the area revealed two fatalities
      following minor head injury. The only avoidable death was a patient with multiple
      brain contusions who developed sudden brain swelling on day 12 post-trauma. We
      conclude that, even if management mortality is not zero, our protocol is
      sufficiently safe for the treatment of minor head injury.

PMID- 8488444
TI  - Severe subarachnoid hemorrhage during transsphenoidal surgery for pituitary
      adenoma.
AB  - There are many reports about complications of transphenoidal surgery for
      pituitary adenomas. We report a patient who suffered severe subarachnoid
      hemorrhage due to an indirect injury of the intradural internal carotid artery
      during or immediately after transsphenoidal surgery for pituitary adenoma. An
      autopsy suggested that a small branch of the intradural internal carotid artery
      was strongly adherent to the suprasellar portion of the tumor capsule and its
      avulsion from the internal carotid artery might have been caused as the capsule
      fell down during the intracapsular removal of the tumor. In a case of pituitary
      adenoma operated by the transsphenoidal approach the possibility of subarachnoid
      hemorrhage due to this type of arterial injury, though rare, should be kept in
      mind.

PMID- 8488445
TI  - Bilateral synovial cysts of the thoracic spine: a case report.
AB  - We report a case of bilateral synovial cysts of the thoracic spine. The patient
      presented with progressive, lower-extremity weakness and hypesthesia, culminating
      in complete paraplegia. This rare lesion should be considered when confronted
      with a patient with thoracic cord compression.

PMID- 8488446
TI  - Villaret's syndrome: a report of two cases.
AB  - The syndrome resulting from lesions of the lower four cranial nerves (CN) and the
      cervical sympathetic chain is known as Villaret's syndrome. We report two cases
      of the syndrome and emphasize the localizing value of this constellation of
      signs. The second case is unusual because involvement of the cervical sympathetic
      chain produced sympathetic overactivity, instead of the usual sympathectomy
      effect. Increased sympathetic outflow expressed as pupillary dilation, widened
      palpebral fissure, and facial sweating (the Claude Bernard syndrome) usually
      occurs as an early manifestation of apical thoracic tumors and has not been
      previously associated with Villaret's syndrome.

PMID- 8488447
TI  - Primary malignant non-Hodgkin's lymphoma of cranial vault: a case report.
AB  - Primary cranial vault non-Hodgkin's lymphomas are rare and only four such cases
      are described in the literature. A 65-year-old woman presented with focal
      neurological deficits and a subcutaneous scalp lump. Computed tomography (CT)
      scan showed a left parietal cranial vault lesion with soft tissue scalp swelling
      and underlying intracranial extra axial mass mimicking a meningioma. Histology
      showed features of a typical B-cell non-Hodgkin's lymphoma, there was no systemic
      involvement. The characteristic CT findings of this lesion are described and
      relevant literature is reviewed. We are reporting this case because of its rare
      occurrence. A diagnosis of primary lymphoma of the skull vault should always be
      considered in the differential diagnosis when such a lesion is encountered.

PMID- 8488448
TI  - Review of 140 patients with brain abscess.
AB  - There were 140 cases of brain abscess treated between 1980 (when CT scanning
      became available) and June 1991. These arose by spread of a contiguous area of
      infection in 37%, and from another identified cause in 22%; the origin was
      undetermined in 41%. There were multiple abscesses in 11%. The abscess was < 2 cm
      in diameter in 21%. In two-thirds of the patients, the intracranial pressure was
      raised, there were localizing neurologic signs in 33%, and in 28% there were
      epileptic seizures. The computed tomographic (CT) feature of an abscess in the
      capsular stage was a thin, regular, and uniform, ring-like enhancement. In the
      cerebritis stage, nine out of 17 patients showed a uniform enhancement throughout
      the lesion. Since 1989, 14 cases have been investigated with magnetic resonance
      imaging (MRI). In 11, the abscess was in the capsular stage. In both T1- and T2
      weighted images, the abscess and the surrounding inflammatory area were well
      demonstrated, and with T2-weighting, the capsule showed a low-intensity signal
      clearly. In the three abscesses in the cerebritis stage, there was a uniform
      abnormality with indistinct margins between the abscess, inflammatory edema, and
      surrounding grey and white matter. All cases received a combination of wide
      spectrum antibiotics before the organism was identified; and later the medication
      was administered according to bacteriologic indication of the organism of 112
      cases, organisms were identified in 71%, with anaerobic organisms occurring in
      30% of these. In 127 cases, surgical treatment was used: either repeated
      aspiration, excision or both. We treated 13 cases that had small, early, or
      multiple abscesses with antibiotics only. The mortality with surgical treatment
      was 7.9%, and no case treated conservatively died.

PMID- 8488450
TI  - Isolated fourth ventricle in neurocysticercosis: pathophysiology, diagnosis, and
      treatment.
AB  - Four cases of isolated fourth ventricle in neurocysticerocosis are reported
      (three after ventriculoperitoneal shunting, and one after hydrocephalus without
      shunting). Diagnosis was made based on computed tomography (CT) and/or CT
      cisternogram/ventriculogram. Three patients underwent fourth ventricle drainage
      (two died and the third remains well). The fourth patient refused surgical
      treatment and continues to have severe ataxia. Diagnosis, pathophysiology, and
      treatment of this entity in neurocysticercosis are discussed.

PMID- 8488449
TI  - Time course of energy perturbation after compression trauma to the spinal cord:
      an experimental study in the rat using microdialysis.
AB  - Changes occurring in the extracellular fluid (ECF) concentration of energy
      related metabolites were investigated in a well-characterized model of
      compression trauma to the spinal cord. Microdialysis probes were inserted into
      exposed grey matter of the dorsal horn at the level of Th 7-8, and perfused with
      mock cerebrospinal fluid. The trauma was produced 2 hours later by compression of
      the cord with a 9-, 35-, or 50-g load for 5 min. Microdialysis samples (10-minute
      fractions) were collected for another 2 hours following decompression. The trauma
      was associated with an accumulation of lactate, inosine, and hypoxanthine, and an
      increase in the lactate/pyruvate ratio in the ECF, indicating a profound
      disturbance in energy metabolism. These changes were related to the severity of
      spinal cord injury as well as to the spinal cord blood flow (SCBF) reductions and
      neurological deteriorations previously determined. Following decompression, all
      ECF metabolites normalized within 20-40 min after mild (9 g) to moderate (35 g)
      trauma. After severe trauma (50 g), resulting in complete ischemia during
      compression, followed by irreversible paraplegia, there was a partial recovery of
      ECF inosine and hypoxanthine, whereas the increase in lactate and the
      lactate/pyruvate ratio persisted. The results suggest that penumbra conditions
      prevail during the early posttraumatic period when the degree of trauma results
      in severe neurological deterioration and that ECF lactate levels in the spinal
      cord is a sensitive indicator of secondary ischemia after compression injury.

PMID- 8488451
TI  - Comments on specialty site visits by the Residency Review Committee for
      Neurological Surgery.

PMID- 8488452
TI  - Extravasation of contrast medium from the lenticulostriate artery following local
      intracarotid fibrinolysis.
AB  - Two patients with acute embolic occlusion of the intracranial internal carotid
      artery and the lenticulostriate arteries were treated by local intraarterial
      fibrinolysis using tissue plasminogen activator. Although fibrinolysis started
      within 2.5 hours from the ictus, extravasation of the contrast medium from the
      lenticulostriate arteries occurred in the region of the basal ganglia. Local
      intraarterial fibrinolysis for acute embolic occlusion of the internal carotid
      artery may be a high-risk therapeutic intervention even within the ultra-acute
      stage, especially when the lenticulostriate arteries are occluded by an embolus.

PMID- 8488453
TI  - Nonaneurysmal subarachnoid hemorrhage: prevalence of perimesencephalic hemorrhage
      in a consecutive series.
AB  - The perimesencephalic type of nonaneurysmal subarachnoid hemorrhage (SAH) is a
      recently described clinical and radiological entity, with a good outcome. We
      carried out a retrospective analysis of 294 patients with subarachnoid
      hemorrhage, of whom 62 had a negative four-vessel angiography. We identified 20
      cases with the typical computed tomographic (CT) pattern of perimesencephalic
      hemorrhage, in whom the prognosis was invariably good. However, five cases of
      aneurysmal subarachnoid hemorrhage had a more or less similar CT appearance: the
      diagnosis cannot be made on the CT image only and angiography remains mandatory.
      The use of bed rest, antifibrinolytics, and calcium antagonists is discussed.

PMID- 8488454
TI  - Traumatic atlanto-occipital dislocation with survival: a case report and review
      of the literature.
AB  - The number of patients who have survived traumatic atlanto-occipital dislocation,
      the usual outcome of which is death from brain stem transection, has increased in
      the past two decades due to improvements in on-scene resuscitation and
      transportation. This case of survival after traumatic atlanto-occipital
      dislocation is of interest because the patient had a complete neurologic recovery
      and a magnetic resonance imaging (MRI) study was obtained to confirm the
      diagnosis and rule out associated injuries.

PMID- 8488455
TI  - Intracranial cryosurgery in a canine model: a pilot study.

PMID- 8488456
TI  - Cranial fasciitis of childhood: a case report.

PMID- 8488457
TI  - [Simultaneous radiochemotherapy].
AB  - Simultaneous radiochemotherapy (RCT) means the simultaneous application of
      radiotherapy and chemotherapy. The major objective of this approach is the
      improvement of local control. On the cellular level, three types of interactions
      may be distinguished: additivity, synergism, and sensibilization. The main type
      of interaction seems to be a simple additive effect. The clinical effect of a
      simultaneous chemotherapy depends mainly on the cytotoxic action of the drug
      itself and not on radiosensibilization. Therefore, effective chemotherapeutic
      drugs are to be delivered in cytotoxic dosages in RCT protocols. Compromises in
      radiotherapy as the main modality should be avoided. Recent clinical data have
      shown that simultaneous radiochemotherapy may yield high remission rates in a
      number of tumor entities (e. g. anal cancer, bladder cancer, head and neck
      cancer). This seems to improve local control as compared to radiotherapy alone.
      In some tumors (e. g. head and neck, esophagus), survival may be improved also.
      However, several questions require future detailed clinical trials. These
      questions include the value of simultaneous radiochemotherapy compared to optimal
      fractionation schemes, the clear definition of subgroups of patients with benefit
      by radiochemotherapy and the optimal dose intensity of cytotoxic drugs.

PMID- 8488458
TI  - [Medulloblastomas--the results after postoperative radiotherapy with and without
      adjuvant chemotherapy].
AB  - Between 1975 and 1991, 40 patients with newly diagnosed medulloblastoma were
      treated at the authors' institutions. After aggressive surgical resection 39/40
      (98%) received craniospinal radiation therapy with a local boost to the posterior
      fossa and other macroscopically involved areas. A group of 29 patients was
      treated with adjuvant chemotherapy. The five-year actuarial survival and event
      free survival were 75% and 65%, respectively. Survival was significantly better
      for patients treated after 1981 as compared to those treated between 1975 and
      1980 (p = .02). Younger age (two to four years) was associated with a better
      prognosis (p = .02). The extend of resection, Chang-stage, radiation dose to
      posterior fossa and the use of chemotherapy did not significantly impact on
      survival and relapse-free survival.

PMID- 8488459
TI  - [The clinical picture and therapy of aggressive fibromatosis (desmoids)].
AB  - Desmoid tumors are accounted among histologically benign soft tissue tumors.
      Though metastases do not occur the clinical course of the disease with their
      tendency to grow locally aggressive and to relapse after curative intended
      surgery is similar to sarcomas. After surgical excision adjuvant therapy of
      desmoid tumors is necessary in such cases, where a radical excision with a wide
      margin is not possible, or must be doubted or after the surgical excision of a
      locally recurrent tumor. Radiation doses of 50 to 60 Gy reduce the risk of local
      recurrence of desmoid tumors to 18%. In such cases, where surgery and
      radiotherapy have been leading to incomplete responses, systemic therapy with
      hormones (tamoxifen or progesterone), with alkylating agents (e. g. ifosfamide)
      or with prostaglandin antagonists (indomethacin) is possible. The published data
      on therapeutic responses to the treatment of desmoid tumors are scarce. We are
      reporting on seven of our own cases, treated with surgery and radiotherapy (four)
      or with a combination of surgery, radiotherapy, hormones and chemotherapy
      (three).

PMID- 8488460
TI  - [Is lymphography still relevant in seminoma?].
AB  - In the radiotherapist's point of view lymphography and computed tomography scan
      compete for staging and therapy planning of testicular seminoma. We investigated
      whether lymphogram can be replaced by computed tomography scan. 114 patients with
      histologically confirmed seminoma of the testis were treated by radiotherapy at
      the Nurnberg Community Hospital (n = 65) and the University of Erlangen (n = 49)
      from 1978 through 1991. Radiological staging included both computed tomography
      scan and lymphography in all cases. The results of both methods were similar in
      79%. Computed tomography scan led to an upstaging in 4% while lymphography was
      negative. 17% of the patients showed negative results considering computed
      tomography scan while lymphogram was positive. In accordance with these data
      treatment portals or doses were altered in 21%. Using the M.D. Anderson Hospital
      clinical staging system a stage IIa (micrometastasis < 2 cm) is not safely
      identified by computed tomography scan. Just lymphography can safely identify a
      stage IIa patient. On the other hand, lymphography shows a very high amount of
      false positive interpretations. However, two conclusions are made: 1. Using a
      conventional technic (radiation of para-aortal and ipsilateral iliac region, dose
      about 30 Gy HD) lymphogram can be superseded by computed tomography scan. 2. In
      the case of reducing treatment volume and/or dose lymphogram should be added to
      computed tomography scan.

PMID- 8488461
TI  - Role of total body irradiation as based on the comparison of preparation regimens
      for allogeneic bone marrow transplantation for acute leukemia in first complete
      remission.
AB  - The role of total body irradiation (TBI) for allogeneic bone marrow
      transplantation (BMT) for acute leukemia in first complete remission was
      reevaluated in this study. From Japanese BMT Registry, data of 123 acute leukemia
      patients in first complete remission who underwent allogeneic bone marrow
      transplantation in 22 hospitals between 1988 and 1990 were available for the
      present comparative study of preparation regimens with or without total body
      irradiation. Two-year survivals were 77% and 51% in the TBI containing regimen
      group and in the non-TBI regimen group, respectively (p = 0.0010). Corresponding
      two-year relapse rates were 16% and 37%, respectively (p = 0.0197). Corresponding
      probabilities of developing interstitial pneumonitis were 21% and 24%,
      respectively (p = 0.8127). The analysis of causes of death indicated that non-TBI
      regimen increased the incidence of septicemia and lethal organ failures, such as
      liver, heart, lung and other multiple sites. It was emphasized that an additional
      role of total body irradiation was to disperse the treatment-related toxicity in
      allogeneic bone marrow transplantation for acute leukemia.

PMID- 8488462
TI  - Influence of blood storage after in vitro exposure on the yield of micronuclei
      observed in human lymphocytes.
AB  - In a cooperative study, four laboratories evaluated the micronucleus test in
      irradiated and non-irradiated lymphocytes with respect to time of storage, the
      difference between X-ray and gamma exposure and inter-observer variance. The
      results were compared with parallel studies on dicentric aberrations. No
      significant differences between laboratories, with respect to storage time or
      between gamma and X-irradiation were observed for micronuclei and dicentrics
      using analysis of variance. However, micronuclei are not suitable for an
      assessment of exposure inhomogeneity because of a significant overdispersion
      already in controls and homogeneously irradiated samples.

PMID- 8488463
TI  - Free radicals and other reactive oxygen metabolites: clinical relevance and the
      therapeutic efficacy of antioxidant therapy.
AB  - As in any new field, justifiable enthusiasm for the potential for antioxidant
      therapy has led to hyperbole, hastily designed, poorly conceived clinical trials,
      and premature reporting of uncontrolled, anecdotal indicators of efficacy that
      have not held up when subjected to close scrutiny or more careful, controlled
      trial design. This tendency has been augmented by strong pressure for early
      positive results from a few, but not most, members of the pharmaceutical industry
      and by a few clinicians in highly competitive fields who were anxious not to be
      left behind. The sobering reality of negative or, even worse, indeterminate
      clinical trials has culled the field and educated those that remain. As a result,
      we are beginning to see the publication of quite promising results from large,
      well-controlled, carefully designed clinical studies, many, but not all, of which
      are quite promising. This has been associated with a much better understanding of
      the basic mechanism of free radical-mediated human disease, without which further
      substantial progress would be quite limited. Because the manipulation of oxidant
      mediated tissue injury represents treating disease at its most basic level, the
      therapeutic potential of this approach remains not only promising but exciting.

PMID- 8488464
TI  - Healing of the stapled stomach in bariatric operations.
AB  - Breakdown of the in-continuity gastric staple line after gastroplasty and gastric
      bypass is frequently associated with either complications or unsatisfactory
      weight loss. Although there is wide variation in the reported incidence of stale
      line disruption after gastric bariatric operations, this complication is most
      frequently recognized by surgeons who routinely examine the integrity of the
      staple line at 12 months or more after operation. Upper gastrointestinal contrast
      studies are more sensitive than upper endoscopy in detecting small defects in the
      stapled gastric partition. The stomach should be routinely divided in patients
      who require reoperation for late staple-line disruption. This complication could
      be prevented by routine transection of the stomach at the initial gastric
      restrictive operation.

PMID- 8488465
TI  - Rationing surgery: rules or constraints?
AB  - BACKGROUND: As U.S. health care expenditures climb, the need to set limits on
      surgery is becoming more generally accepted. If limits are necessary, how should
      they be established and by whom? This article considers two fundamental
      approaches, rules and constraints. RESULTS: With rules, payers or policymakers
      ration care by prioritizing and then restricting specific procedures. Although
      they have the advantage of explicitness, rules based on treatment prioritization
      are limited by patient heterogeneity and the lack of outcomes data necessary to
      rank many procedures. Rules are unambiguous and free the surgeon from the
      obligation to set limits, but they do not accommodate clinical judgment or
      patient preferences. With constraints, limits are set on surgical resources
      (e.g., the number and distribution of surgeons), but individual surgeons
      determine which procedures are provided to which patients. Although constraints
      are more feasible than rules, it is difficult to establish an "adequate" supply
      of surgical resources and to ensure that limits set by the individual surgeon are
      based on treatment efficacy. While preserving clinical autonomy, constraints
      require the surgeon to assume the responsibility of rationing care. CONCLUSIONS:
      Surgeons should consider carefully the approach to rationing that best serves
      their professional interests, their patients, and society.

PMID- 8488466
TI  - Submucosal tumors of the stomach: a study of 100 operative cases.
AB  - BACKGROUND: Mass screening for gastric cancer has been established in Japan, and
      asymptomatic submucosal tumors are often detected. This retrospective study was
      made to evaluate the proper surgical management of malignant submucosal tumors of
      the stomach. METHODS: One hundred submucosal tumors of the stomach were
      surgically resected, irrespective of symptoms and size. Up to 45% of these
      tumors, including 44 myogenic lesions, 23 non-Hodgkin's lymphomas, and 11
      schwannomas, proved malignant. Myogenic sarcomas were classified in low and high
      grades according to mitotic rates, cellularity, and pleomorphism. RESULTS: Thirty
      five of 55 benign tumors and four of nine low-grade sarcomas underwent
      enucleation only, without recurrence. The remaining five low-grade and 11 high
      grade sarcomas were treated by radical gastrectomy; the 5-year survival was 100%
      for the former and 80% for the latter. Eighteen patients with lymphomas underwent
      total or subtotal gastrectomy, and three patients underwent noncurative
      resection; the 5-year survival rates were 54.2% and 0%, respectively, with a
      clear significant difference (p < 0.001). Adjuvant chemotherapy was significantly
      superior to surgery alone (p < 0.05). Other factors did not affect survival of
      lymphoma. CONCLUSIONS: With these observations, we believe that following the
      patients with submucosal tumor without surgery is not reasonable. Enucleation
      will suffice for low-grade sarcomas and benign tumors; high-grade sarcomas can be
      well treated by gastrectomy. Total or subtotal gastrectomy with systematic lymph
      node dissection when performed for cure can provide good results for resectable
      lymphomas.

PMID- 8488467
TI  - Patterns of lung involvement by malignant lymphoma.
AB  - BACKGROUND: Recent evidence has suggested that the anatomic distribution of
      malignant lymphomas may reflect important differences in biologic behavior. To
      determine if the anatomic distribution of malignant lymphomas in the lung
      correlated with the disease course, we examined the pattern of lung involvement
      in patients with Hodgkin's and non-Hodgkin's lymphomas. METHODS: We reviewed the
      medical records of 651 patients with a diagnosis of malignant lymphoma and
      identified 54 patients with histologically documented lung involvement. Based on
      radiologic and surgical findings, these patients had lung involvement
      characterized as either (1) bronchovascular-lymphangitic, (2) nodular, or (3)
      alveolar. The pattern of lung involvement was correlated with clinical
      manifestations and disease course. RESULTS: Distinct clinical courses were
      associated with these three patterns of lung involvement. In contrast,
      traditional histopathologic classification did not correlated with the pattern of
      lung involvement was a poor prognostic factor and was associated with a median
      survival of 12 1/2 months. Pleural effusions eventually developed in 24 patients
      and were associated with a median survival of only 3 months. CONCLUSIONS: These
      findings suggest that the anatomic pattern of lung involvement is a measure of
      biologic behavior and may be a useful variable in the staging of patients with
      malignant lymphoma.

PMID- 8488468
TI  - Reconstruction of the thoracic esophagus, with extended jejunum used as a
      substitute, with the aid of microvascular anastomosis.
AB  - BACKGROUND: After radical ablation of tumors, colon or jejunum is pulled up for
      reconstruction of the thoracic esophagus when stomach is unusable. However,
      esophagocolonic or esophagojejunal anastomotic leak is relatively frequent
      because of the potential for vascular insufficiency of conduit extended upward.
      METHODS: To overcome this disadvantage, 14 consecutive patients with esophageal
      or gastric carcinomas whose stomachs were unusable were subjected to
      thoracoesophageal reconstruction through upward extension of the jejunum with
      microvascular anastomosis. Jejunal vessels were used as graft vessels, and
      internal thoracic vessels were used as recipient vessels. If needed, arcade
      vessels were severed to ease extension. RESULTS: All extended jejunums survived,
      and there were no operative deaths. Two of four initial series of patients, whose
      arcade vessels were not severed despite undue tension at the anastomotic site,
      had esophagojejunal anastomotic leaks that healed spontaneously. CONCLUSIONS:
      Some clinical functional problems still exist, but we believe this a safe and
      useful method for reconstruction of the esophagus where stomach cannot be used.

PMID- 8488469
TI  - Gastric intramucosal acidosis in patients with chronic kidney failure.
AB  - BACKGROUND: Patients with chronic kidney failure have an increased incidence of
      gastrointestinal complications, particularly bleeding from the stomach.
      Diminished mucosal blood flow is thought to be an important etiologic factor for
      such bleeding. METHODS: Eleven patients with kidney failure on maintenance
      dialysis underwent placement of a gastric tonometer for the determination of
      gastric intramucosal pH (pHi) before and during dialysis. The arterial pH (pHa),
      calculated pHi, and pHa-pHi differences were compared with the results in a
      control group of seven normal volunteers. RESULTS: The patients with chronic
      kidney failure had a mean (+/- SD) pHa (7.36 +/- 0.04) similar to that found in
      seven control subjects (7.37 +/- 0.04). However, the gastric mucosal pH in the
      patients on dialysis (7.20 +/- 0.17) was lower than in the seven control subjects
      (7.38 +/- 0.06) (p < 0.01). A gastric mucosal pH thought to be predictive of
      either bleeding from stress ulceration (pHi < 7.32) or mucosal ischemia (pHi-pHa
      difference > 0.13) was found in nine (82%) of the patients with kidney failure
      and in only one (14%) of the control subjects (p < 0.001). CONCLUSIONS: This new
      preliminary finding suggests that the high incidence of gastric bleeding in
      chronic kidney failure may be related to mucosal ischemia.

PMID- 8488470
TI  - Comparative cardiopulmonary effects of carbon dioxide versus helium
      pneumoperitoneum.
AB  - The recent surge in enthusiasm for laparoscopic surgery has created concern that
      abdominal insufflation with carbon dioxide produces a respiratory acidosis. This
      may be because of both transperitoneal gas absorption and impaired ventilation
      with increased dead space from elevated intraabdominal pressure. To examine the
      relative contributions of these factors, we developed an animal model of surgical
      pneumoperitoneum that evaluated the cardiorespiratory effects of abdominal
      insufflation. Helium was chosen as an alternative to CO2 because it is both
      chemically and biologically inert. Carbon dioxide absorption during CO2
      pneumoperitoneum caused arterial PCO2 to increase from 41.3 +/- 3.0 to a maximum
      of 58.3 +/- 4.0 mm Hg, with pH descending from 7.46 +/- 0.02 to a nadir of 7.31
      +/- 0.02 (p < 0.05). Pulmonary artery pressure increased to twice baseline levels
      during CO2 insufflation (p < 0.05). Helium did not cause hypercarbia, acidemia,
      or pulmonary hypertension despite insufflation under identical conditions. These
      results indicate that transperitoneal absorption of CO2, not increased dead
      space, is responsible for the respiratory acidosis observed. Helium merits
      further study as an agent to induce pneumoperitoneum, especially when concerns of
      underlying acidosis or impaired gas exchange are present.

PMID- 8488471
TI  - Medial pancreatectomy for tumors of the neck of the pancreas.
AB  - BACKGROUND: The surgical treatment of benign tumors of the pancreas usually
      consists of enucleation or formal pancreatectomy. Nonetheless, enucleation is not
      always feasible, and extended pancreatectomies may result in impaired endocrine
      and exocrine function. METHODS: For these reasons we proposed a limited resection
      centered on the neck of the pancreas with complete excision of the tumor. The
      cephalic section was sutured, and a Roux-en-Y jejunal loop was anastomosed to the
      distal section of the pancreas. Fourteen patients were operated on by this
      technique. The tumors were mainly cystadenomas (n = 6) and endocrine tumors (n =
      4). The other lesions were one epithelial cyst, one necrotic pseudocyst, one
      Castleman disease, and one cystadenocarcinoma diagnosed after surgery on
      histologic examination. RESULTS: No patients died. Two patients underwent
      reoperation: one for a postoperative acute pancreatitis and one for a pancreatic
      fistula. All patients were followed up from 4 months to 8 years. No patients had
      exocrine insufficiency or diabetes mellitus. CONCLUSIONS: Medial pancreatectomy
      does not carry a higher operative risk than formal pancreatectomy and avoids
      extensive pancreatic resection when enucleation is not feasible.

PMID- 8488472
TI  - Generation of cytotoxic T lymphocytes from peripheral blood.
AB  - BACKGROUND: Cytotoxic T lymphocytes (CTL) have been shown to be useful for
      adoptive immunotherapy in malignancy. Traditional sources for CTL, such as tumor
      infiltrating lymphocytes, have limitations. It would therefore be useful to
      develop a method of generating antitumor CTL from a renewable source such as
      peripheral blood. METHODS: DBA/2 mice were injected intradermally in the
      abdominal wall with the murine tumor PHS-5 and killed 14 days later. Peripheral
      blood lymphocytes were harvested and cultured with 20 units/ml interleukin-2 and
      autologous tumor-stimulator cells treated with mitomycin C. Cultures were split
      when greater than 2 x 10(6) cells/well, fed every 3 days and stimulated weekly.
      RESULTS: Lymphocytes expanded greater than 130,000-fold during 8 weeks. Specific
      cytotoxicity was shown with 51Cr release assay. Withdrawal of repeated
      stimulation with autologous tumor resulted in failure of cells to expand in
      culture and loss of cytotoxicity. In vivo administration showed marked reduction
      of 10-day liver metastases, indicating therapeutic efficacy. CONCLUSIONS: These
      data demonstrate a successful animal model of adoptive immunotherapy with CTL
      generated from peripheral blood lymphocytes.

PMID- 8488473
TI  - Clinical evaluation of upper mediastinal dissection for differentiated thyroid
      carcinoma.
AB  - BACKGROUND: An extensive upper mediastinal dissection in advanced differentiated
      thyroid carcinoma is occasionally required. This investigation was undertaken to
      clarify the indications for mediastinal lymph node dissection and the route of
      upper mediastinal metastases. METHODS: Twenty-one patients with differentiated
      thyroid cancer, who underwent their first radical operations with mediastinal
      dissection through a partial midline sternotomy, were enrolled in this study. Of
      21 patients, 10 (48%) were found to have mediastinal lymph node metastases.
      RESULTS: The tumor size in the group with metastatic disease was much bigger than
      that in the group without metastatic disease. Histologic type and age were
      similar between the two groups. The extent of cervical lymph node metastases was
      more significant in the group with metastatic disease; in particular, all 10
      patients showed more than two metastatic nodes along the internal jugular vein of
      the tumor-free side. CONCLUSIONS: This study indicates that metastases to the
      internal jugular chain on the side contralateral to the primary tumor would be an
      extremely important factor for indication of extensive upper mediastinal lymph
      node dissection after median partial sternotomy in patients with differentiated
      thyroid carcinoma.

PMID- 8488474
TI  - Intestinal fatty acid binding protein in serum and urine reflects early ischemic
      injury to the small bowel.
AB  - BACKGROUND: Intestinal fatty acid binding protein (I-FABP) is a 15 kd protein
      that constitutes 2% to 3% of enterocyte protein. Normally I-FABP is undetectable
      in serum. The purpose of this study was to determine whether I-FABP could be
      detected in peripheral serum and/or urine early in the evolution of intestinal
      ischemic injury. METHODS: I-FABP and two putative biochemical markers of
      mesenteric ischemia, hexosaminidase and lactate dehydrogenase, were quantitated
      in the serum of rats subjected to mesenteric ischemia produced by: (1) 0.5 hours,
      1 hour, or 3 hours of superior mesenteric artery (SMA) occlusion followed by
      reperfusion; (2) 1 hour of mesenteric occlusion to a 10 cm segment of jejunum
      followed by reperfusion; and (3) arterial ligation to a 10 cm segment of jejunum
      without reperfusion. I-FABP was also quantitated in the urine and intestinal
      mucosa of these animals. RESULTS: The baseline serum I-FABP level was < or = 4.0
      ng/ml in all animals. In control animals, I-FABP remained unchanged throughout
      the experiment. In the ischemia/reperfusion groups, I-FABP immediately appeared
      in the serum on reperfusion. With segmental arterial ligation, I-FABP was
      detected in the serum within 15 minutes. Urinary content of I-FABP rose 60
      minutes after its initial appearance in the serum, and its elimination paralleled
      serum I-FABP levels. Serum hexosaminidase and lactate dehydrogenase levels only
      rose after 3 hours of SMA occlusion with reperfusion. One hour of SMA occlusion
      and reperfusion resulted in only mild to moderate mucosal injury, whereas 3 hours
      of SMA ischemia with reperfusion produced areas of transmural necrosis.
      CONCLUSIONS: I-FABP is released into the peripheral circulation after reversible
      intestinal ischemic injury and has potential as a biochemical marker to
      facilitate the early detection of mesenteric ischemia.

PMID- 8488475
TI  - Regulation of small intestinal glutamine transport by epidermal growth factor.
AB  - BACKGROUND: Epidermal growth factor (EGF) stimulates cell replication and
      increases DNA content of the small intestine, but its effects on mucosal amino
      acid transport are unknown. METHODS: To investigate these effects, we treated
      adult rats with vehicle or EGF (10 micrograms/100 gm body weight subcutaneously
      every 8 hours for three doses). Jejunal brush border membrane vesicles (BBMVs)
      from each group were prepared by Mg++ aggregation/differential centrifugation.
      BBMVs were enriched fifteen-fold in alkaline phosphatase, indicating BBMV purity.
      Transport of 3H-glutamine and 3H-alanine was studied by a rapid mixing filtration
      technique. Uptakes were primarily Na+ dependent, occurred in an osmotically
      active space, exhibited classic overshoots, and had similar 2-hour equilibrium
      values. RESULTS: Glutamine transport by BBMVs more than doubled in rats treated
      with EGF (16.4 +/- 0.1 pmol glutamine/mg protein/10 sec in EGF vs 7.1 +/- 0.5
      pmol glutamine/mg protein/10 sec in controls; p < 0.001). Kinetic studies of the
      glutamine transporter showed that the increase in transport was the result of a
      70% increase in maximal transport velocity (total maximum glutamine uptake = 193
      +/- 8 pmol glutamine/mg protein/10 sec in EGF vs 114 +/- 7 pmol glutamine/mg
      protein/10 sec in controls; p < 0.0001 with no change in transporter affinity
      (transporter affinity = 224 +/- 6 mumol/L in EGF vs 242 +/- 37 mumol/L in
      controls; difference, not significant). Alanine uptake by BBMVs was also
      increased with EGF administration (10.2 +/- 2.0 pmol alanine/mg protein/10 sec in
      EGF vs 4.5 +/- 0.5 pmol alanine/mg protein/10 sec in controls; p < 0.005).
      Simultaneously, glucose transport was decreased by 50% in EGF-treated rats,
      indicating that the Na(+)-dependent glucose cotransporter is regulated
      independently from and opposite to amino acid transporters. CONCLUSIONS: We
      conclude that EGF up-regulates amino acid transport activity in jejunal BBMVs, an
      event that is most likely caused by an increase in de novo biosynthesis of
      transporter protein. The increase in amino acid uptake not only may support de
      novo protein synthesis but, in the case of glutamine, also may be required for
      energy production and nucleotide biosynthesis.

PMID- 8488476
TI  - Effects of sodium valproate on various intestinal motor functions after ileal J
      pouch-anal anastomosis.
AB  - BACKGROUND: We investigate the effects of sodium valproate, a gamma-aminobutyric
      acid transaminase inhibitor, on the clinico-physiologic state after ileoanal
      anastomosis. METHODS: Twelve patients (five with ulcerative colitis and seven
      with familial adenomatous polyposis coli) were studied in a placebo-controlled
      trial. RESULTS: Placebo had no effect, but valproate increased the resting anal
      pressure by 22.4% and the maximum tolerable pouch volume by 20.7%. It also
      prolonged pouch emptying by 47.3%, with an associated improvement in stool
      frequency and incontinence. These results suggested that valproate improved both
      reservoir continence and sphincter continence. CONCLUSIONS: Only minimal side
      effects were noted, so the administration of sodium valproate appears to be a
      safe and useful adjunct for patients with ileoanal anastomosis in the early
      postoperative period.

PMID- 8488477
TI  - Epidermal growth factor limits structural alterations in gastrointestinal tissues
      and decreases bacterial translocation in burned mice.
AB  - BACKGROUND: Burn injury produces acute gastrointestinal derangements that may
      predispose to bacterial translocation (BT). We studied effects of recombinant
      human epidermal growth factor (r-HuEGF), a gastrointestinal trophic hormone, on
      gastrointestinal alterations and BT after murine burn injury. METHODS: r-HuEGF
      was administered 1 and 12 hours after burn injury in a dose of 4 micrograms per
      animal subcutaneously after 25% and 32% total body surface area (TBSA) scald
      burn. Small bowel and gastric weight and histologic factors were studied, and BT
      was measured by culturing mesenteric lymph nodes. RESULTS: Mice treated with r
      HuEGF maintained gastric and small intestine weight measured 24 hours after burn
      injury, and ileal mucosal height was preserved, whereas burned-untreated mice
      lost organ weight and mucosal height. BT was decreased significantly in mice with
      32% TBSA burn injury treated with r-HuEGF after injury (burn, 64.2% of animals
      had BT; burn-r-HuEGF, 34.6% had BT; p < 0.05). After 25% TBSA burn injury, BT was
      also decreased in r-HuEGF-treated animals (burn, 31.4% of animals had BT; burn-r
      HuEGF, 14.3% had BT), but the difference was not statistically significant (p <
      0.1). CONCLUSIONS: r-HuEGF improves intestinal and gastric structure in mice 24
      hours after burn injury and decreases BT after 32% TBSA burn injury.

PMID- 8488478
TI  - Successful treatment by simultaneous hepatic venoplasty and cavoplasty for Budd
      Chiari syndrome with obstruction of retrohepatic inferior vena cava.
AB  - BACKGROUND: Various surgical procedures for treating chronic Budd-Chiari syndrome
      have been established, but none are adequate because of the variation in
      underlying pathologic vascular changes. METHODS: This article presents a 32-year
      old patient with a 5 cm long segment of obstruction of the retrohepatic inferior
      vena cava involving the main hepatic veins with severe portal hypertension.
      RESULTS: After five unsuccessful attempts at percutaneous transluminal
      angioplasty, simultaneous hepatic venoplasty was conducted with the saphenous
      vein patch and retrohepatic inferior venacavoplasty by the expanded
      polytetrafluoroethylene patch with a 3 cm long cuff interposition for
      suprahepatic reconstruction of the inferior vena cava. Hypothermic preserved
      liver perfusion after vascular isolation and femoroportoaxillary venovenous
      bypass with a centrifugal blood pump throughout the anhepatic stage ensured safe
      operation on the liver and maintained hemodynamics. Early postoperative
      anticoagulant is recommended. CONCLUSIONS: An uneventful postoperative course and
      a 10-month follow-up showing excellent condition indicated this one-stage
      simultaneous patch hepatic venoplasty and cavoplasty to be adequate for
      appropriate correction very of complex obstructive vascular lesions in Budd
      Chiari syndrome.

PMID- 8488479
TI  - Symptomatic recurrent carotid stenosis and aneurysmal degeneration after
      endarterectomy.
AB  - BACKGROUND: Aneurysmal degeneration of a carotid reconstruction was not
      recognized until the patient, who was known to have recurrent carotid artery
      stenosis, had a thromboembolic stroke. This sequelae of carotid endarterectomy is
      a serious complication, associated with a high morbidity and mortality rate. This
      review was conducted to establish the risk of transient ischemic attack and
      stroke for patients found to have recurrent carotid stenosis associated with
      aneurysmal degeneration of the carotid artery after endarterectomy. METHODS: A
      case is reported, and 100 literature references of aneurysmal degeneration of the
      carotid artery after endarterectomy were reviewed. RESULTS: False aneurysm from
      anastomotic disruption was the most common presentation identified in the cases
      reviewed. Nineteen of the patients had a significant neurologic event; however,
      three (50%) of six patients with aneurysm and recurrent carotid artery stenosis
      had a transient ischemic attack or stroke. CONCLUSIONS: The incidence of
      neurologic symptoms is markedly increased when recurrent carotid artery stenosis
      is associated with carotid aneurysm. During postoperative surveillance after
      endarterectomy, the identification of recurrent carotid artery stenosis requires
      evaluation for aneurysmal degeneration of the carotid artery with duplex
      scanning. These patients are at significant risk for transient ischemic attack
      and stroke. This rare complication merits operative repair.

PMID- 8488480
TI  - Hyperparathyroid crisis and posterior mediastinal parathyroid adenoma: a case for
      preoperative localization.
AB  - Hyperparathyroid crisis is a rare, life-threatening condition that requires
      prompt removal of the involved parathyroid gland(s). This report describes a
      patient with hyperparathyroid crisis caused by a mediastinal parathyroid adenoma,
      which was localized before operation and removed at the initial operation,
      without neck exploration. Surgical approaches to hyperparathyroid crisis and the
      importance of preoperative localization studies are discussed.

PMID- 8488481
TI  - Primary appendiceal malignancy.

PMID- 8488482
TI  - Use of biphosphonates in preoperative treatment of patients with
      hyperparathyroidism.

PMID- 8488483
TI  - Prognostic factors of carcinoid tumor of the appendix smaller than two
      centimeters.

PMID- 8488484
TI  - Genetic markers in thyroid tumors.

PMID- 8488485
TI  - Feeding jejunostomy techniques.

PMID- 8488486
TI  - The Teratology 33rd annual meeting June 28-July 1, 1993 and the Neurobehavioral
      Teratology Society 17th annual meeting June 26-29, 1993. Tucson, Arizona.
      Abstracts.

PMID- 8488487
TI  - [Rapid detection of antimicrobial residues in slaughter animals via ATP
      determination].
AB  - A rapid antibiotic test was developed, based on ATP/bioluminescence, to detect
      antimicrobial residues in slaughter animals as early as possible. Several aspects
      that influence the assay were studied. For many samples of renal fluid the
      results of the test agreed very well with the inhibition zones obtained with the
      new Dutch agar diffusion test. The ATP/antibiotic test offers the possibility of
      detecting a wide range of antibiotics in renal fluid within 3.5 to 4 hours after
      receipt of the kidney samples. The detection level is comparable to that of
      existing agar diffusion tests.

PMID- 8488488
TI  - [Consequences of a Salmonella typhimurium infection on a veal calf farm].
AB  - An outbreak of Salmonella typhimurium in veal calves is described. The pattern of
      resistance to antibiotics was unique in the Netherlands at the time of the
      outbreak. Other factors besides antibiotic resistance also played a role in the
      outbreak, resulting in a mortality exceeding 90%.

PMID- 8488489
TI  - [Toxocara species, unwelcome guests].

PMID- 8488490
TI  - [The annual incidence of salmonellosis in humans in The Netherlands].

PMID- 8488491
TI  - [Registration of veterinary drugs: order or chaos?].

PMID- 8488492
TI  - [Castration of male cats].

PMID- 8488493
TI  - [Food allergy in Westies].

PMID- 8488494
TI  - [A heifer with very difficult calving].

PMID- 8488495
TI  - [The clinical case. Warmblood foal, male, 3 days old].

PMID- 8488496
TI  - [Horses as trichinosis carriers].

PMID- 8488497
TI  - [Cauda equina syndrome in a Fleckvieh bull after a pathological fracture of the
      first sacral vertebra caused by a spindle cell sarcoma].
AB  - A 9 month old Simmental fattening bull was presented with signs of a cauda equina
      syndrome. An epidurographic examination was made after thorough clinical,
      neurological and routine radiographic examination. The cause of the cauda equina
      compression--a spindle cell sarcoma--was revealed by the pathologic-histologic
      examination. This tumor caused the compression of the cauda equina and pathologic
      transverse fracture of the body of the first sacral vertebra and cranial
      epiphyseal fracture of the 1st and the 3rd sacral vertebra as well as the
      separation of the arcus from the first and second sacral vertebral bodies. Some
      other diseases which can cause cauda equina syndrome are mentioned.

PMID- 8488498
TI  - [The effect of antepartum doses of selenium-vitamin E combinations on the
      incidence of puerperal disorders in cattle].
AB  - The effect of a single i.m. injection of 0, 5, 25 or 50 mg Se and 60, 300 or 600
      mg vitamin E (12 combinations) about ten days before delivery on the incidence of
      post partum disturbances was investigated using 288 cows with selenium deficiency
      from six farms. The higher dose of Se, the lower was the frequency of fetal
      membrane retention (0 mg Se = 23.6%, 5 mg Se = 11.1%, 25 mg Se = 12.5%, 50 mg Se
      = 6.9%, p < 0.0001). This was independent of vitamin E. A beneficial effect of
      the higher Se doses together with vitamin E was noted in reduction in incidence
      of metritis, ovarian dysfunction and cysts. There was no significant difference
      in conception rate, services per conception or calving interval between the
      groups.

PMID- 8488499
TI  - [Eperythrozoonosis in sheep].
AB  - In 1990/91 eperythrozoonosis in the sheep was seen in our clinic for the first
      time. In 10 animals out of 4 flocks infection with Eperythrozoon ovis was
      diagnosed. Most of the animals showed a transient parasitaemia with a temporary
      anaemia. A chronic high grade parasitaemia and anaemia were produced in one sheep
      by splenectomy. This animal showed haemoglobinuria following a haemolytic attack.
      In a lamb a high grade chronic parasitaemia occurred spontaneously. The
      parasitaemia lasted for over 7 months, and the lamb eventually died.

PMID- 8488500
TI  - [The content of hemoglobin in the blood and the abundant and trace elements in
      blood plasma and erythrocytes of sheep, fallow deer, dwarf goats and reindeer].
AB  - Of the 4 species, the blood of fallow deer had the highest concentration of Hb
      (10.9 +/- 0.7) and that of pygmy goats (6.5 +/- 1.4 mmol/l) the lowest. The
      highest concentration of protein in the plasma was found in the reindeer (81.2 +/
      2.1) and the lowest in the pygmy goats (59.1 +/- 4.3 g/l). High values of
      ascorbic acid were recorded in the reindeer (16.4 +/- 2.4) and in the Finnish
      sheep (16.3 +/- 2.5 micrograms/ml). There existed some differences in the
      concentrations of Na, K, Ca, Mg, Pa, Fe, Cu and Zn in the plasma of the sheep of
      7 different breeds under similar nutritional conditions. The erythrocytes of the
      sheep of 3 breeds and that of fallow deer, of pygmy goats and of reindeer
      uniformly had a low Na- and a high K-concentration. The Ca-concentration of the
      erythrocytes of the sheep of most breeds and that of the fallow deer and pygmy
      goats was very low, that of Mg and Zn was higher than in the plasma.

PMID- 8488501
TI  - [Spavin in horses--clinical, radiological and scintigraphic findings].
AB  - Both hock joints were examined clinically, radiologically and scintigraphically
      in 80 horses with special regard to bone spavin. The positive x-ray and bone scan
      results corresponded in most cases. It was evident that there was no correlation
      between degree of lameness and/or extent of radiological findings and increased
      radioactive uptake in the joint. Scintigraphic evaluation may demonstrate early
      changes at the onset of bone spavin as well as the frequent bilateral nature of
      the condition.

PMID- 8488502
TI  - [Clinico-toxicologic aspects of non-steroidal anti-inflammatory agents in the dog
      and cat].
AB  - The use of nonsteroidal anti-inflammatory drugs (NSAID) is increasing in small
      animal practice. This has resulted in a greater incidence of acute as well as
      chronic toxicosis. NSAID toxicoses are usually manifested by gastrointestinal
      upset, such as nausea, vomiting, gastrointestinal hemorrhage and ulceration. The
      mechanisms by which these drugs cause their toxic effects are mainly associated
      with the impaired prostaglandin synthesis and therefore the reduced physiological
      cytoprotection of the mucosa. In addition, local cellular damage due to the acid
      effects of NSAID contribute to the GI-toxicity. Treatment of acute intoxication
      involves maintenance of vital function as well as early decontamination of the
      gastrointestinal tract and symptomatic treatment (correction of bleeding tendency
      and local acidosis). Symptomatic care of gastrointestinal damage is the most
      important aspect of dealing with chronic intoxication. A reduction of acid
      production as well as a stimulation of the repair mechanism of the mucosa is the
      aim of the therapy.

PMID- 8488503
TI  - [The measurement of the sensory antidromic nerve conduction velocity in the dog].
AB  - Sensory neurography is a diagnostic aid in the evaluation of peripheral nerve
      function. Up to now, the measurement of the orthodromic nerve conduction velocity
      has been supposed to be the only valuable method in veterinary medicine. However,
      there is always a certain risk because the procedure requires immobilized
      animals. In this article, the measurement of the sensory antidromic nerve
      conduction velocity in the superficial radial and the superficial peroneal nerve
      of the dog is described as an alternative method. Usually, this procedure can be
      done without immobilisation or general anesthesia. Thus, the antidromic nerve
      conduction velocity represents a valuable screening method for evaluation of
      peripheral nerve function. In dogs without changes in laboratory values and
      without signs of neurologic disease, the nerve conduction velocity is 52.5 +/-
      6.6 m/s (mu +/- s) for the superficial radial nerve and 49.4 +/- 5.7 m/s (mu +/-
      s) for the superficial peroneal nerve.

PMID- 8488504
TI  - [BT-PABA/xylose test in the cat?].
AB  - The BT-PABA/Xylose test was used in 10 healthy cats and 49 cats with chronic
      diarrhea. In seven cats the test was performed three times in order to
      investigate individual variability. There was a statistically significant
      difference between the control group and the patients in the mean peak
      concentration of xylose, but no difference between groups of different diseases.
      The mean peaks of PABA were not significantly different between the control group
      and the patient group. Due to high individual variation in healthy cats the BT
      PABA/Xylose test cannot be considered to be a useful test in feline diagnosis.

PMID- 8488505
TI  - [Anatomic fundamentals and species-specific movements of the elbow joint and
      proximal radioulnar joint of domestic cats].
AB  - The elbow joint of the cat is more than a simple cylindrical joint and cannot be
      compared to that of the dog. The structure of the bone ends, arrangement of
      ligaments and the shapes of the joint surfaces, which are described individually,
      emphasize that the elbow joint, together with the proximal radioulnar joint, have
      an important role to play in feline-specific limb functions.

PMID- 8488506
TI  - [Pain prevention and pain treatment in small and large domestic animals].
AB  - The aim of this article is to emphasize the need for analgesic medication in
      animals in possibly painful situations, especially in the postoperative period.
      The two large groups of compounds used as analgesics--the opiates and the
      nonsteroidal antiinflammatory drugs (NSAIDs)--are described with special
      reference to their pharmacokinetics, side-effects and toxicity, their mechanism
      of action, their indications and contraindications. Recommended doses of the
      different drugs available are given for the dog, the cat, the horse, the swine
      and the small and large ruminants.

PMID- 8488507
TI  - [The raising and worship of monkeys in the late period of ancient Egypt].
AB  - New finds of pathologically altered skeletal remains of baboons originating from
      the galleries under the temple of the god Thot in Tuna el-Gebel/Middle Egypt
      enlarge the knowledge of diseases observed in these animals, which were kept in
      non-appropriate conditions during ancient Egyptian time. "Rickets" and chronic
      deformations of the joints ("arthrosis") were observed most frequently.
      Additional cases of bone tumors and osteomyelitis were noted.

PMID- 8488508
TI  - Financial analysis of medical staff development plans.

PMID- 8488509
TI  - Medical staff development: planning for a successful program.

PMID- 8488510
TI  - Developing a physician-hospital organization.

PMID- 8488511
TI  - Medical practice evaluation and analysis.

PMID- 8488512
TI  - Economic credentialing.

PMID- 8488513
TI  - The valuation of medical practices.

PMID- 8488514
TI  - Financial analysis of medical office buildings.

PMID- 8488515
TI  - Designing a physician ecosystem.

PMID- 8488516
TI  - Can carotid endarterectomy be improved by neurovascular monitoring?

PMID- 8488517
TI  - Cigarette smoking and alcohol consumption as risk factors for aneurysmal
      subarachnoid hemorrhage.
AB  - BACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage is a serious disease
      despite recent improvements in medical and surgical treatment. Hence,
      identification of modifiable risk factors for subarachnoid hemorrhage is
      important. METHODS: We compared the smoking and drinking habits of 278
      consecutive patients with aneurysmal subarachnoid hemorrhage, aged 15-60 years
      (145 men and 133 women) with those of 314 hospitalized control patients (164 men
      and 150 women) who did not differ in regard to age, day of onset of symptoms, and
      acuteness of disease onset. RESULTS: Multiple logistic regression analysis showed
      that recent alcohol intake and smoking, but not hypertension, were significant
      independent risk factors for hemorrhage. After adjustment for age, hypertension,
      and smoking status, men who had consumed 1-40, 41-120, or > 120 g of alcohol
      within the 24 hours preceding the onset of illness had a relative risk of
      hemorrhage of 0.3 (95% confidence interval [CI], 0.1-0.8), 2.5 (95% CI, 1.1-5.5),
      and 4.5 (95% CI, 1.5-12.9), respectively, compared with men who had consumed 0 g.
      Women who had consumed 1-40 or > 40 g of alcohol had a risk of hemorrhage of 0.4
      (95% CI, 0.2-0.8) and 6.4 (95% CI, 2.3-17.9), respectively, compared with women
      without use of alcohol. Heavily smoking (> 20 cigarettes per day) men and
      currently smoking women had adjusted relative risks of hemorrhage of 7.3 (95% CI,
      3.8-14.3) and 2.1 (95% CI, 1.2-3.6), respectively, compared with men who had
      never smoked and with women who were not current smokers. Higher levels of
      erythrocyte mean corpuscular volume in patients with subarachnoid hemorrhage than
      in control subjects supported the notion of different smoking and drinking
      habits. CONCLUSIONS: Recent heavy alcohol intake and current smoking seem to be
      independent risk factors for aneurysmal subarachnoid hemorrhage.

PMID- 8488518
TI  - Silent brain infarctions in patients with first-ever stroke. A community-based
      study in Umbria, Italy.
AB  - BACKGROUND AND PURPOSE: The relative frequency of computed tomographic evidence
      of old cerebral infarctions without prior history of stroke, and their effect on
      short- and long-term outcome of patients with first-ever ischemic stroke, are
      currently unknown. Silent infarctions may relate to specific risk factors and may
      influence the rate of survival free of handicap. METHODS: We studied the
      prevalence of such lesions in patients registered with SEPIVAC, a community-based
      survey of stroke incidence and outcome in the Sixth Local Health Unit of Umbria,
      Italy. Of 375 first-ever strokes, 209 patients with cerebral infarction (computed
      tomogram done within 30 days after the stroke) were included in this study.
      Computed tomograms were reviewed blindly, and cases were classified as having a
      single lesion or multiple lesions; in the latter case, it was assumed that at
      least one silent brain infarction was present. The two groups were compared in
      terms of risk factors and outcome. To avoid a selection bias, these patients were
      also compared with 68 patients who were not submitted to computed tomography but
      were judged on clinical grounds to have a > 90% probability of having suffered a
      cerebral infarction. RESULTS: Risk factors and outcome did not differ between
      patients without and with a computed tomogram. In the latter group, 80 patients
      (38.3%; 95% confidence interval, 31.7%-44.9%) had silent brain infarction. Male
      sex (odds ratio, 1.84; 95% confidence interval, 1-3.4), ischemic changes on an
      electrocardiogram (odds ratio, 2.5; 95% confidence interval, 1.3-4.9), and--in
      the multivariate analysis--hypertension (odds ratio, 1.46; 95% confidence
      interval, 1.1-2) were significantly more frequent in these patients. Outcome at
      1, 6, and 12 months was not influenced by the presence of silent infarctions.
      CONCLUSIONS: This community-based study shows that silent brain infarctions in
      patients with first-ever stroke are not significantly related to risk factors
      commonly described in hospital-based series (atrial fibrillation, transient
      ischemic attack, etc.); rather, silent infarctions seem to be a marker of
      widespread vascular disease.

PMID- 8488519
TI  - Two clinically distinct lacunar infarct entities? A hypothesis.
AB  - BACKGROUND AND PURPOSE: We investigated the hypothesis that patients with one or
      more asymptomatic lacunar infarcts and those with only one symptomatic lacunar
      infarct represent two clinically distinct lacunar infarct entities. METHODS: In a
      prospective series of 100 lacunar infarct patients, univariate and multivariate
      logistic regression analysis was performed on clinical features, vascular risk
      factors, and leukoaraiosis between patients with and without asymptomatic lacunar
      infarcts. RESULTS: Patients with asymptomatic lacunar infarcts had hypertension
      significantly more often (71% versus 43%; [crude] odds ratio, 3.31; 95%
      confidence intervals, 1.16-9.43; p < 0.05) and had leukoaraiosis significantly
      more often (71% versus 19%; [crude] odds ratio, 10.67; 95% confidence intervals,
      3.81-32.10; p < 0.001) than those with only a symptomatic lacunar infarct. After
      multivariate logistic regression analysis, only leukoaraiosis was significantly
      associated with the presence of asymptomatic lacunar infarcts. The asymptomatic
      lacunar infarcts differed in location, involved vascular territory, and volume
      from the symptomatic infarcts. CONCLUSIONS: Two distinct lacunar infarct entities
      might be broadly distinguished during life: lacunar infarct patients with a
      single, symptomatic lacunar infarct, and patients with multiple lacunar infarcts
      and a high frequency of hypertension and leukoaraiosis, in which the underlying
      small-vessel vasculopathy might be different.

PMID- 8488520
TI  - Prevalence of apolipoprotein E phenotypes in ischemic cerebrovascular disease. A
      case-control study.
AB  - BACKGROUND AND PURPOSE: Apolipoprotein E polymorphism may influence the early
      development of coronary artery disease. We investigated the putative role of
      apolipoprotein E phenotypes in cerebral infarction. METHODS: The apolipoprotein E
      phenotypes of 69 patients (mean +/- SD age, 72 +/- 11 years) who had suffered
      completed stroke or a transient ischemic attack and 68 sex- and age-matched
      control subjects free of cerebrovascular disease were determined by isoelectric
      focusing. The relative frequency of the apolipoprotein E phenotypes in the
      general population was estimated in 498 healthy blood donors (mean age, 37
      years). RESULTS: The prevalences of hypertension, diabetes mellitus, obesity, and
      intermittent claudication were significantly higher in patients than in control
      subjects. Serum lipid and apolipoprotein B concentrations and the composition of
      very low density lipoproteins were not significantly different between patients
      and control subjects. Apolipoprotein A-I and E levels were significantly lower in
      patients. Cholesterol levels were higher in male patients than in male control
      subjects (5.10 +/- 1.46 versus 4.41 +/- 0.80 mmol/L; p = 0.036), and the ratio of
      apolipoprotein A-I to B was lower (0.77 +/- 0.29 versus 1.03 +/- 0.37; p <
      0.001). The E3/E3 phenotype was more frequent in control subjects (85%) than in
      patients (72.5%; p < 0.05) and healthy blood donors (64%; p < 0.02). The E3/E2
      phenotype was more frequent in patients (10.1%) than in control subjects (1.4%; p
      < 0.05). A stepwise logistic regression showed that the presence of stroke was
      significantly related to high blood pressure (p < 0.0001), low apo E levels (p <
      0.008), obesity (p < 0.041), the apo E phenotype (p < 0.05), and diabetes
      mellitus (p < 0.05). CONCLUSIONS: The E3/E3 phenotype may protect against early
      vascular morbidity, and the epsilon 2 gene may be a risk factor for
      cerebrovascular morbidity, possibly related to diabetes, hypertension, and/or
      obesity.

PMID- 8488521
TI  - Reactivity of cerebral blood flow to carbon dioxide in various types of ischemic
      cerebrovascular disease: evaluation by the transcranial Doppler method.
AB  - BACKGROUND AND PURPOSE: The response of cerebral blood flow to changes in the
      arterial carbon dioxide partial pressure (i.e., carbon dioxide reactivity) has
      been evaluated as a parameter of cerebral perfusion reserve in patients with
      cerebrovascular disease. In this study, variations in this reactivity in various
      ischemic cerebrovascular diseases were evaluated by a newly established method, a
      transcranial Doppler technique. METHODS: Thirty-three patients with symptomatic
      cerebrovascular disease, 13 patients with asymptomatic cerebral infarction, and
      25 age-matched normal control subjects were investigated. The symptomatic
      patients were divided into three groups; those with unilateral carotid artery
      obstruction, those with cortical infarction, and those with lacunar infarction.
      The carbon dioxide reactivity of each subject was determined by simultaneously
      measuring the mean spatial Doppler frequency in the middle cerebral artery and
      the end-tidal carbon dioxide partial pressure under normocapnic, hypercapnic, and
      hypocapnic conditions. RESULTS: In the patients with carotid obstruction, the
      carbon dioxide reactivity of the hemisphere ipsilateral to the obstruction was
      more impaired than the reactivity of the symptomatic hemispheres in any other
      group, and was significantly less than in the contralateral asymptomatic
      hemisphere (p < 0.01). In patients with cortical infarction, the carbon dioxide
      reactivity of the symptomatic hemisphere was significantly less than in normal
      control subjects (p < 0.05) and was also less than that of the contralateral
      asymptomatic hemisphere (p < 0.05). In patients with lacunar infarction, the
      carbon dioxide reactivity of both hemispheres was significantly less than that in
      normal controls (p < 0.01), although there was no difference between the
      symptomatic and asymptomatic hemispheres. In patients with asymptomatic
      infarction, the carbon dioxide reactivity was also less than that in normal
      controls (p < 0.01). CONCLUSIONS: The carbon dioxide reactivity of cerebral blood
      flow measured by this transcranial Doppler technique may be useful for
      characterizing the hemodynamic changes that occur in various types of ischemic
      cerebrovascular disease.

PMID- 8488522
TI  - Contrast-enhanced transcranial color-coded real-time sonography. Results of a
      phase-two study.
AB  - BACKGROUND AND PURPOSE: Transcranial color-coded real-time sonography has been
      developed as a promising new bedside procedure to monitor central nervous system
      parenchymal and vascular pathology; the present study was designed to investigate
      the potential role of galactose microparticles (SH U 508 A) as a new ultrasound
      contrast-enhancing agent for transcranial sonography. METHODS: Ten patients (four
      women and six men, 24-63 years of age) with a broad spectrum of central nervous
      system pathology were investigated by transcranial color-coded real-time
      sonography in a phase-two clinical study. After conventional ultrasound
      examination, all patients received a maximum of six injections of 10 ml with 200,
      300, or 400 mg/mL SH U 508 A. The intracranial vessels were scanned by color flow
      imaging in the axial and coronal planes through a transtemporal acoustic bone
      window; in addition, the vertebrobasilar system was followed through the foramen
      magnum. RESULTS: SH U 508 A was well tolerated without side effects. In axial and
      coronal scans, the application of SH U 508 A resulted in detection of peripheral
      branches of the anterior, middle, and posterior cerebral arteries, as well as the
      posterior communicating and superior cerebellar arteries. In addition, the deep
      cerebral veins (i.e., inferior sagittal sinus, internal cerebral veins, great
      cerebral vein of Galen, straight sinus, and the confluence sinuum) were revealed.
      The transforaminal approach led to detection of the main infratentorial branches
      (anterior inferior, posterior inferior, and superior cerebellar arteries). One
      patient could not be insonated without contrast, but after SH U 508 A the trunks
      of the large intracranial arteries were detected. No obvious changes in the
      ultrasound pattern of the central nervous system parenchyma were observed.
      CONCLUSIONS: These preliminary data indicate that the use of a transpulmonary
      ultrasound contrast agent (SH U 508 A) may substantially broaden the spectrum and
      potential diagnostic utility of transcranial ultrasound by allowing detection of
      supratentorial peripheral central nervous system arteries, deep cerebral veins,
      and (through the foramen magnum) the entire vertebrobasilar system, including the
      cerebellar arteries.

PMID- 8488523
TI  - Sneddon's syndrome: diagnosis by skin biopsy and MRI in 17 patients.
AB  - BACKGROUND AND PURPOSE: Sneddon's syndrome, characterized by generalized livedo
      racemosa and cerebrovascular lesions, is an underdiagnosed disease. We evaluated
      clinical, laboratory, histological, and neuroradiological findings in a series of
      17 patients to improve diagnostic criteria for Sneddon's syndrome. METHODS:
      Patients with generalized livedo racemosa and cerebrovascular events were
      included in the study. All underwent neurological and dermatological examination,
      skin biopsy, computed tomographic scan, magnetic resonance imaging as well as
      magnetic resonance angiography, sonography of the extracranial arteries, and a
      comprehensive laboratory protocol. RESULTS: Completed stroke was present in eight
      patients, and 15 reported transient neurological deficits. Magnetic resonance
      imaging yielded cerebral abnormalities in 16 of 17, whereas computed tomographic
      scans were abnormal in only 12 of 16 patients. Magnetic resonance imaging
      revealed more lesions in individual patients than did computed tomography.
      Magnetic resonance angiography demonstrated patent intracranial vessels in 16 of
      17 patients. Skin biopsy showed distinct histopathological findings in all
      patients. The involved vessels were small to medium-sized arteries at the border
      between dermis and subcutis. Early inflammatory reactions were followed by
      subendothelial proliferation and a late fibrotic stage. Laboratory examinations
      showed impaired creatinine clearance in eight patients, whereas all other
      laboratory tests, including antiphospholipid antibodies, were normal.
      CONCLUSIONS: In this series, magnetic resonance imaging and skin biopsy were
      useful for confirmation of the diagnosis of Sneddon's syndrome. Magnetic
      resonance findings were not specific, but the high sensitivity for detection of
      asymptomatic brain lesions helped to confirm the diagnosis in patients with
      transient symptoms. Histological features of skin biopsies were characteristic if
      appropriate techniques were employed.

PMID- 8488524
TI  - Cardiovascular changes during focal cerebral ischemia in rats.
AB  - BACKGROUND AND PURPOSE: Recent studies have suggested that cerebral infarction
      influences autonomic activity and may contribute to sudden death. The goal of
      this study was to examine effects of focal cerebral infarction on mean arterial
      pressure and heart rate. METHODS: Halothane-anesthetized rats were assigned to
      two groups: stroke (n = 10), in which the middle cerebral artery or an adjacent
      vessel was embolized with a silicone cylinder, and sham (n = 8), in which rats
      were sham embolized (saline). Arterial pressure and heart rate were measured for
      90 minutes and again 24 hours after vascular occlusion. A change in
      electroencephalographic amplitude of -45% after embolization was used to
      determine if a significant degree of infarction was present. RESULTS: Vascular
      occlusion produced a significant increase in mean arterial pressure at 10, 60,
      and 90 minutes (p < 0.05). Changes in heart rate were significantly greater (p <
      0.05) than in sham-treated rats at 10 and 30 minutes after embolization. In
      contrast, mean arterial pressure and heart rate measured 24 hours after
      embolization were similar in both groups. Anatomic analysis of the infarcted
      areas demonstrated that either insular cortex or amygdala was affected in all
      embolized rats. CONCLUSIONS: This study indicates that cerebral infarction
      produces a transient elevation of mean arterial pressure and heart rate. However,
      within 24 hours both parameters returned to preinfarcted levels. Our findings are
      consistent with clinical reports that indicate that mean arterial pressure and
      heart rate of stroke patients are similar to those of other groups when they are
      admitted to the hospital, although other cardiovascular parameters are greatly
      altered.

PMID- 8488525
TI  - Intracellular pH during reperfusion influences evoked potential recovery after
      complete cerebral ischemia.
AB  - BACKGROUND AND PURPOSE: Increasing ischemic duration delays recovery of
      intracellular pH and depresses recovery of somatosensory evoked potentials. We
      tested whether manipulation of the rate of pH recovery influences evoked
      potential recovery after complete ischemia. METHODS: Four groups of eight
      anesthetized dogs underwent 12 minutes of complete ischemia followed by 4 hours
      of reperfusion with either 1) normocapnia, 2) normocapnia and acetazolamide (25
      mg/kg at reperfusion plus 12.5 mg/kg per hour, 3) hypocapnia, or 4) hypercapnia.
      Intracellular pH was measured by phosphorus magnetic resonance spectroscopy, and
      intracellular bicarbonate was calculated using sagittal sinus partial pressure of
      CO2 during reperfusion. RESULTS: In the normocapnic control group, intracellular
      pH decreased from 7.10 +/- 0.04 (+/- SEM) to 6.13 +/- 0.08 during ischemia and
      recovered to 6.90 +/- 0.08 by 30 minutes of reperfusion. Bicarbonate also largely
      recovered (9.9 +/- 1.6 mM). With acetazolamide pH (6.51 +/- 0.10) and estimated
      bicarbonate (4.8 +/- 1.3 mM) remained depressed at 30 minutes and did not fully
      recover until 60-75 minutes. However, percent recovery of somatosensory evoked
      potential amplitude at 4 hours of reperfusion was less with acetazolamide (23 +/-
      4%) than in the control group (52 +/- 5%). With hypercapnic reperfusion, which
      delayed pH recovery but not bicarbonate recovery, evoked potential recovery was
      also depressed (27 +/- 5%). With hypocapnic reperfusion, which delayed
      bicarbonate recovery but not pH recovery, evoked potential recovery (52 +/- 6%)
      was not depressed compared with controls. Recovery of adenosine triphosphate and
      oxygen consumption was similar among groups. CONCLUSIONS: Delayed recovery of
      intracellular pH with or without delayed recovery of bicarbonate during
      reperfusion further impairs somatosensory evoked potential recovery independent
      of recovery of high-energy phosphates. Persistence of acidosis during reperfusion
      can contribute to postischemic electrophysiological deficit.

PMID- 8488526
TI  - Risk area and infarct area relations in the hypertensive stroke-prone rat.
AB  - BACKGROUND AND PURPOSE: Our purpose was to characterize the surface area of the
      infarct and the surface area at risk of infarction as defined spatially by
      arterial anastomoses to determine whether position, size, or shape of the infarct
      and the area at risk were related in stroke-prone rats or hybrid rats. METHODS:
      Stroke-prone rats (n = 18; mean +/- SEM blood pressure, 182 +/- 8 mm Hg) and
      hybrid rats (n = 18; mean +/- SEM blood pressure, 147 +/- 6 mm Hg; p < 0.05) were
      anesthetized and the left middle cerebral artery was occluded with a ligature.
      The rats were killed 7 days later, arterial anastomoses were made visible with
      latex, the brains were fixed in formalin, and film recorded the infarct and
      anastomoses. Anastomoses and infarcts were digitized for measurements of risk
      area, luminal width, and infarct area. RESULTS: Mean risk area was similar in
      size, length, width, and variability in stroke-prone rats (area, 85 +/- 5 mm2)
      and hybrid rats (area, 84 +/- 7 mm2; p > 0.05), whereas mean infarct area was
      larger, longer, wider, and less variable in stroke-prone rats (area, 53 +/- 6
      mm2) than in hybrid rats (area, 15 +/- 11 mm2; p < 0.05). Infarct length was
      appreciably greater than infarct width in both groups, indicating that infarct
      shape was not amorphous. Spatial overlap maps indicated that the infarct area
      common to all stroke-prone rats was positioned centrally in the risk area and was
      surrounded by a variable infarct area, which indicated that the likelihood of
      infarction increased with distance from the anastomoses. Shape factors for both
      risk area and infarct area were significantly different within each rat group,
      which indicated that infarct shape did not uniformly parallel the anastomotic
      sites that determined risk area shape (p < 0.05). Risk area anastomoses and
      border zone width were linearly correlated in size and both were significantly
      wider in hybrid rats than in stroke-prone rats (p < 0.05), which suggests that
      the narrower border zone tissue was perfused by narrower anastomoses.
      CONCLUSIONS: We conclude that the position of the infarct within the risk area
      relates to luminal widths of conterminous anastomoses that define the risk area,
      but not to the size or shape of the area at risk of infarction defined spatially
      by the anastomoses.

PMID- 8488527
TI  - Protective efficacy of a hypothermic pharmacological agent in gerbil forebrain
      ischemia.
AB  - BACKGROUND AND PURPOSE: The novel muscarinic cholinergic partial agonist U-80816E
      was tested in the gerbil brief bilateral carotid occlusion ischemia model based
      on the rationale that the compound's hypothermic properties might afford
      effective protection of the selectively vulnerable hippocampal CA1 region.
      METHODS: Male gerbils were subjected to either 10 or 15 minutes of bilateral
      carotid occlusion, followed by histopathological assessment of the CA1 neuronal
      survival 7 days later. RESULTS: In saline-treated animals, 10 minutes of
      bilateral carotid occlusion resulted in a 30.5% loss of CA1 neurons, whereas a 15
      minute insult resulted in a 49.6% loss. Administration of U-80816E (6 mg/kg i.p.
      30 minutes before bilateral carotid occlusion and again 2 hours after
      reperfusion) resulted in a significant protective effect of the CA1 neuronal
      population with either duration of ischemia; neuronal loss was reduced to 12.6%
      in the milder model (p < 0.05 versus saline-treated) and 24.9% in the more severe
      model (p < 0.04 versus saline). However, the 6 mg/kg i.p. dose of U-80816E was
      found to produce a 1.0 degree C decrease in brain temperature (measured with a
      tympanic temperature probe) at 10 minutes of ischemia compared with that of
      saline-treated gerbils. At 10 minutes of reperfusion, after the 10-minute episode
      of ischemia, the brain temperature of the U-80816E-treated gerbils was 2.2
      degrees C lower than that of saline-treated animals. When the U-80816E-treated
      gerbils were subjected to either 10 or 15 minutes of ischemia but placed in a
      heated chamber that prevented the hypothermic effects, no cerebroprotection was
      observed. CONCLUSIONS: These results show that the anti-ischemic efficacy of U
      80816E is mediated through its hypothermic properties, thus suggesting the
      feasibility of pharmacologically induced hypothermia as a cerebroprotective
      approach.

PMID- 8488528
TI  - The antioxidant LY231617 reduces global ischemic neuronal injury in rats.
AB  - BACKGROUND AND PURPOSE: In the rat four-vessel occlusion model with 30 minutes of
      ischemia most agents have failed to be of benefit when given after ischemia.
      Because postischemia administration is more clinically relevant, we evaluated the
      antioxidant LY231617 (2,6-bis(1,1-dimethylethyl)-4-[[(1-ethyl)amino]methyl]phenol
      hydrochloride]) when administered after 30 minutes of four-vessel occlusion.
      METHODS: Male Wistar rats were subjected to 30 minutes of four-vessel occlusion.
      LY231617 was either given orally 30 minutes before ischemia or intravenously
      beginning at 30 minutes after the onset of ischemia. Hippocampal CA1 layer and
      striatal damage were rated on a scale of 0-3 (0, no damage; 3, > 90% cell loss).
      We also evaluated the ability of LY231617 to prevent iron-dependent lipid
      peroxidation and to prevent hydrogen peroxide-induced neuronal death of
      hippocampal neurons in primary culture by exposing cultures to a 50-microM
      concentration of hydrogen peroxide for 15 minutes in the presence of LY231617.
      RESULTS: Oral administration of LY231617 reduced both striatal and hippocampal
      CA1 damage by > 75% (p < 0.0001). In two separate experiments in which LY231617
      was given intravenously beginning 30 minutes after occlusion, hippocampal and
      striatal damage were reduced by approximately 50% (p < 0.03) in the first
      experiment and by approximately 41% (p < 0.02) in the second experiment. Addition
      of 5 microM of LY231617 to primary hippocampal neuronal cultures antagonized the
      lethal effect of hydrogen peroxide (p < 0.05). Iron-dependent lipid peroxidation
      was also inhibited in a dose-related fashion. CONCLUSIONS: The significant
      reduction of ischemia-induced or hydrogen peroxide-induced neuronal damage and
      inhibition of lipid peroxidation by LY231617 observed in this study suggest that
      reactive oxygen intermediates play an important role in the events leading to
      neuronal death after global ischemia/reperfusion.

PMID- 8488529
TI  - Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked
      potentials after incomplete ischemia.
AB  - BACKGROUND AND PURPOSE: Postischemic evoked potential recovery correlates with
      acidosis during ischemia and early reperfusion. Acidosis promotes lipid
      peroxidation in vitro. We tested the hypothesis that the 21-aminosteroid
      tirilazad mesylate (U74006F), an inhibitor of lipid peroxidation in vitro,
      ameliorates somatosensory evoked potential recovery and acidosis during
      reperfusion after severe incomplete cerebral ischemia. METHODS: Cerebral
      perfusion pressure was reduced to 11 +/- 1 mm Hg (+/- SEM) for 30 minutes by
      cerebral ventricular fluid infusion in anesthetized dogs. Cerebral intracellular
      pH and high-energy phosphates were measured by magnetic resonance spectroscopy.
      Dogs were randomized to receive vehicle (citrate buffer; n = 8) or tirilazad (1
      mg/kg; n = 8) before ischemia in a blinded study. RESULTS: Cerebral blood flow
      was reduced to 6 +/- 1 mL/min per 100 g during ischemia, resulting in nearly
      complete loss of high-energy phosphates and an intracellular pH of 6.0-6.1 in
      both groups. Initial postischemic hyperemia was similar between groups but lasted
      longer in the vehicle group. Tirilazad accelerated mean recovery time of
      intracellular pH from 31 +/- 5 to 15 +/- 3 minutes and of inorganic phosphate
      from 13 +/- 2 to 6 +/- 1 minutes. Recovery of somatosensory evoked potential
      amplitude was greater with tirilazad (49 +/- 3%) than vehicle (33 +/- 6%).
      Fractional cortical water content was less with tirilazad (0.819 +/- 0.003) than
      vehicle (0.831 +/- 0.002). CONCLUSIONS: Tirilazad attenuates cerebral edema and
      improves somatosensory evoked potential recovery after incomplete ischemia
      associated with severe acidosis. Accelerated pH and inorganic phosphate recovery
      indicates that this antioxidant acts during the early minutes of reperfusion.

PMID- 8488530
TI  - Acute ischemic stroke from fibrocartilaginous embolism to the middle cerebral
      artery.
AB  - BACKGROUND AND PURPOSE: Fibrocartilaginous embolism from the nucleus pulposus has
      been reported as a rare cause of spinal cord ischemia. We were unable to find
      previous reports of embolism from this source to cerebral arteries. CASE
      DESCRIPTION: A previously healthy 17-year-old girl fell during a basketball game.
      Left hemiparesis and unresponsiveness developed followed by signs of right uncal
      herniation and death over a 3-day period. There was no evidence of neck, head, or
      spine trauma, and cardiac evaluation was normal. Neuropathological examination
      showed extensive ischemic infarction of the right middle cerebral artery
      territory, brain edema, and herniation. Complete embolic occlusion of the right
      middle cerebral artery by fibrocartilaginous material, consistent with nucleus
      pulposus, was documented. Small, terminal coronary artery branches also showed
      embolism by the same material and limited areas of myocardial infarction.
      CONCLUSIONS: Acute cerebral embolism after minor trauma in a young patient may be
      rarely due to fibrocartilaginous embolism from the nucleus pulposus. The
      pathogenesis of this problem remains poorly understood, but systemic embolism
      appeared to have occurred in this case.

PMID- 8488531
TI  - Computed tomographic evidence of an extensive thrombosis and infarction of the
      deep venous system.
AB  - BACKGROUND: Massive bilateral infarcts due to deep venous system thrombosis are
      extremely rare and poorly documented. We present a case with computed tomographic
      evidence of both thrombosis and infarction of the whole deep venous system. CASE
      DESCRIPTION: A previously healthy 30-year-old woman who had taken oral
      contraceptives for 3 years complained of recurrent headaches and transient visual
      obscuration. Three months later, she suddenly became comatose and was found to
      have papilledema. She rapidly worsened, became decerebrate, and died within 48
      hours. Noncontrast computed tomographic scan showed the spontaneous hyperdensity
      of the thrombosed deep veins and a massive bilateral centrobasilar hypodensity
      suggestive of a deep venous system infarction. CONCLUSIONS: This case shows that
      cerebral venous thrombosis can masquerade during 3 months as benign intracranial
      hypertension and then make a dramatic extension to the deep cerebral veins. It
      illustrates extensive thrombosis of the deep venous system as a possible cause of
      rapid coma and decerebration and stresses the importance of computed tomographic
      scan to show both the thrombosed veins and the venous infarct, which allows
      delineation of the deep venous system territory.

PMID- 8488532
TI  - Suppression of protein synthesis in the reperfused brain.
AB  - BACKGROUND: Brain ischemia and reperfusion produce profound protein synthesis
      alterations, the extent and persistence of which are dependent on the nature of
      the ischemia, the brain region, the cell layer within a region, and the
      particular proteins studied. After transient ischemia, most brain regions recover
      their protein synthesis capability; however, recovery in the selectively
      vulnerable areas is poor. It is unknown whether this phenomenon itself provokes
      or is a consequence of the process of neuronal death. SUMMARY OF REVIEW: Protein
      synthesis suppression during ischemia is due to energy depletion, but this is
      quickly reversed upon recirculation. Reperfusion does not appear to damage DNA or
      transcription mechanisms, although there are changes in the profile of
      transcripts being made. Similarly, purified ribosomes isolated from reperfused
      brains can make the normal repertoire of proteins and heat-shock proteins.
      However, during early reperfusion, newly synthesized messenger RNAs appear to
      accumulate in the nucleus; this alteration in RNA handling could reflect
      disruption at any of several steps, including posttranscriptional processing,
      nuclear pore transport, cytoskeletal binding, or formation of the translation
      initiation complex. Another mechanism that may be responsible for protein
      synthesis suppression during late reperfusion is progressive membrane
      destruction, with consequent shifts in the concentration of ions crucial for
      ribosomal function. CONCLUSIONS: Protein synthesis suppression after ischemia
      likely involves a progression of multiple mechanisms during reperfusion. Although
      the recent work reviewed here offers new insight into the potential mechanisms
      disrupting protein synthesis, detailed understanding will require further
      investigation.

PMID- 8488533
TI  - Denial of illness in stroke.
AB  - BACKGROUND: The effects of stroke on classically nondominant hemisphere functions
      have received less attention than those on the dominant hemisphere, but
      visuospatial neglect and denial of illness both produce significant morbidity.
      SUMMARY OF COMMENT: The early literature on denial of illness is discussed and
      the etiological theories are examined. These are explanations based on deficits
      of higher mental function, impaired sensory input (especially proprioceptive), an
      abnormal representation of body image, psychodynamic defense mechanisms, and/or
      premorbid personality factors. CONCLUSIONS: Denial of illness is an important
      consequence of stroke. No explanation thus far proposed is entirely satisfactory.
      The consequences on rehabilitation and strategies for therapy have not been
      adequately investigated.

PMID- 8488534
TI  - Is aspirin effective in preventing strokes in diabetic patients?

PMID- 8488535
TI  - Blood viscosity and cerebral blood flow.

PMID- 8488536
TI  - Capsular warning syndrome preceding pontine infarction.

PMID- 8488537
TI  - Significance of antibody to hepatitis B core antigen in blood donors as
      determined by their serologic response to hepatitis B vaccine.
AB  - Because large numbers of volunteer blood donors may be disqualified for "false
      positive" results on tests for antibody to hepatitis B core antigen (anti-HBc), a
      more specific definition of anti-HBc enzyme immunoassay (EIA)-reactive was
      evaluated, including only those donor samples that were "strongly" reactive
      (sample-to-cutoff absorbance ratio, < 0.45). Results using this definition and
      other anti-HBc test methods were compared to the serologic response (antibody to
      hepatitis B surface antigen [anti-HBsAg]) to hepatitis B vaccination. Fifty-eight
      volunteer blood donors who had previously been deferred as donors, because of
      reactive anti-HBc tests (all other blood screening tests were negative, including
      those for HBsAg and anti-HBsAg) on two occasions, were vaccinated for hepatitis
      B. It was assumed that an anamnestic response to vaccine indicated past infection
      with hepatitis B, while a primary response to vaccine indicated lack of past
      infection. One (2%) of 43 donors with a historically "weak" anti-HBc (reactive
      absorbance ratio, > or = 0.45) had an anamnestic response to vaccine, compared to
      8 (53%) of 15 with historically "strong" anti-HBc (reactive absorbance ratio, <
      0.45) (p < 0.005). Anti-HBc testing using the microparticle EIA method also
      correlated well with hepatitis B vaccination results. The use of a narrower
      definition of "reactive" for anti-HBc EIA testing yielded much more specific, but
      slightly less sensitive, results.

PMID- 8488538
TI  - Blood donation leads to a decrease in natural killer cell activity: a study in
      normal blood donors and cancer patients.
AB  - Transfusion-induced immunosuppression has long been known to be beneficial for
      organ transplantation patients, but recent retrospective studies suggest that
      blood transfusions may be detrimental for patients with cancer. If autologous
      blood is used to avoid immunosuppression, the assumption is that the procedure,
      involving blood donation, is immunologically neutral. In the present study, this
      assumption was evaluated by monitoring 33 normal blood donors and 16 colorectal
      cancer patients before and after donation of 1 (500 mL) and 2 units of blood,
      respectively. The cancer patients belonged to the autologous arm of a randomized
      trial in which the effects of allogeneic versus autologous blood on cancer
      prognosis were studied. The patients donated 2 units of blood with an interval of
      3 to 4 days between donations. Flow cytometric analysis revealed that blood
      donation by normal donors and cancer patients had no effect on the proportion of
      B, T, and natural killer (NK) cells. Only the total number of lymphocytes was
      significantly decreased in the normal donors on Day 12 after donation. Blood
      donation had no significant effect on T-cell function assessed by
      phytohemagglutinin stimulation in normal donors or in cancer patients donating 2
      units of blood. A significant depression of NK cell function (88% and 74% of
      predonation levels) was observed in normal donors on Days 2 and 5 after donation;
      on Day 12, the activity was again normal. Colorectal cancer patients had a
      significantly depressed NK cell activity (54% of predonation activity) on Day 12
      after the first donation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488539
TI  - Storage of pools of six and eight platelet concentrates.
AB  - Platelet concentrates (PCs) prepared from units of whole blood are routinely
      stored singly at 20 to 24 degrees C and pooled prior to transfusion. Studies have
      been conducted to evaluate the in vitro properties of pools of six (n = 19) and
      eight (n = 17) ABO-identical PCs after storage, with comparative studies
      involving single units (n = 33). The pools were prepared using the sterile
      connecting device. One-day-old and 3-day-old PCs were pooled and stored for a
      total of 5 days in a container system consisting of two 1000-mL polyolefin
      containers. The pooled platelet suspension was divided approximately equally
      between the two containers. The platelet count was reduced by less than 5 percent
      during storage of the pools, which is similar to the reduction found with storage
      of control units of single PCs. The volume loss due to pooling was 9.6 +/- 1.9
      percent (mean +/- 1 SD). The pH of the PC pools was approximately 7.0 after 5
      days of storage, with no pool having a pH below 6.2. In vitro platelet
      properties, such as morphology score, extent of shape change induced by ADP,
      total ATP, aggregation response to ADP and collagen, response to hypotonic
      stress, lactate dehydrogenase discharge, and beta-thromboglobulin release, were
      similar for pools and control single PCs. In addition, comparable low levels of
      thymidine uptake were detected in the mononuclear leukocyte fraction of pooled
      and unpooled PCs that were stored for 5 days at 20 to 24 degrees C, which
      indicates that the mixing of lymphocytes in the pool did not stimulate in vitro
      immunologic reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488540
TI  - Effective use of a strategy using assigned red cell units to limit donor exposure
      for neonatal patients.
AB  - Critically ill neonatal infants receive frequent small-volume red cell (RBC)
      transfusions for replacement of blood drawn for laboratory analysis or for
      treatment of symptomatic anemia secondary to underlying medical conditions and/or
      a relative bleeding diathesis. Retrospective review of transfusion practice in a
      hospital revealed that the donor exposure-to-transfusion ratio was 1:1.3. In an
      effort to limit donor exposure and decrease the risk of transfusion-transmitted
      disease, a sterile connection device was used for multiple small-aliquot
      preparations. Three neonatal infants were given part of the same RBC unit, and
      the assigned RBC unit was used only until it reached 14 days of age. These
      criteria resulted in 49-percent reduction in donor exposure for neonatal infants
      weighting less than 1500 g and 27-percent reduction for those weighing more than
      1500 g. The donor exposure-to-transfusion ratio decreased to 1:2.5. RBC waste
      from syringe aliquot preparation and residual volume at Day 15 were a mean of 32
      percent of the total unit volume. Of 722 transfusion occurrences, there were no
      reported adverse effects due to elevated potassium subsequent to transfusion of
      14-day-old RBCs. This limited-donor-exposure strategy effectively meets the needs
      of a transfusion service and will reduce the donor exposures of neonatal infants
      in similar institutions.

PMID- 8488541
TI  - Characteristics of red cells irradiated and subsequently frozen for long-term
      storage.
AB  - Irradiation of blood components eliminates the risk of transfusion-associated
      graft-versus-host disease. Freezing directed or rare red cell units that are
      irradiated but not transfused would facilitate inventory management and would
      increase the transfusion options for the involved patients. However, no studies
      have been performed to evaluate whether prestorage irradiation damages
      subsequently frozen red cells. Ten normal volunteers donated a unit of whole
      blood on two separate occasions. One unit was irradiated with 15 Gy (1500 rad),
      stored at 4 degrees C for 6 days, and then frozen and stored at -75 degrees C for
      56 days. The other unit (control) was similarly stored but was not irradiated.
      Aliquots of the units were tested on Day 0 and Day 6 and, after
      deglycerolization, on Day 62. Comparison of means and changes in means showed no
      significant differences in red cell ATP, 2,3 DPG, or supernatant hemoglobin and
      glucose in control and irradiated units. The difference in the change in
      supernatant potassium from Day 0 to Day 6 in control and irradiated units was
      significant (1.5 to 28.6 mmol/L vs. 1.5 to 48.5 mmol/L: p < 0.0001). Irradiation
      did not cause significant differences in postdeglycerolization red cell recovery
      (control, 84.5% vs. irradiated, 81.2%) or in 24-hour posttransfusion autologous
      red cell survival (control, 91.1% vs. irradiated, 90.9%). Red cells can be
      irradiated, stored at 4 degrees C for 6 days, and subsequently frozen with no
      increase in detectable damage as compared to controls that were not irradiated.

PMID- 8488542
TI  - Plateletpheresis: comparison of platelet yields, processing time, and white cell
      content with two apheresis systems.
AB  - Two apheresis systems (COBE Spectra and Fenwal CS-3000 Plus with TNX-6 chamber
      [CS-3000 Plus]) were compared by using their yield predictors and maximum
      processing times in regard to platelet yields and processing times (n = 200
      each). Platelet yields (n = 50 each) and white cell (WBC) content (n = 20 each)
      from procedures using the current software revision (3.6) on the Spectra and
      various interface offset (IO) settings on the CS-3000 Plus were also compared.
      Significantly higher median platelet yields (4.88 [range, 1.84-9.97] vs. 4.57
      [range, 2.82-9.20] x 10(11) platelets) and frequency of components with > or =
      6.0 x 10(11) platelets (31.5 vs. 21.5%) were found with the Spectra. In the study
      with Spectra and the CS-3000 Plus IO settings, IO-10 and IO-13, overall, produced
      the most platelets, although the differences were not significant. All Spectra
      collections tested had < 5 x 10(8) WBCs, and, depending on the software revision,
      had either 85 percent (revision 3.6) or 100 percent (revision 2.5) of components
      with < 5 x 10(6) WBCs. To ensure that 100 percent of components contained < 5 x
      10(8) WBCs when the CS-3000 Plus was used, IO settings of 10 or less were
      required, and to ensure components with < 5 x 10(6) WBCs, only IO-6 could be
      used. Spectra and CS-3000 Plus were capable of collecting large doses of
      platelets (up to the equivalent of 18 units) in processing times of 67 to 100
      minutes with < 5 x 10(6) WBCs.

PMID- 8488543
TI  - Polyclonal antibodies against the NB1-bearing 58- to 64-kDa glycoprotein of human
      neutrophils do not identify an NB2-bearing molecule.
AB  - The neutrophil-specific NB antigen system has been serologically characterized
      with human alloantisera. Two alleles, NB1 and NB2, have been described; however,
      there may be important quantitative or qualitative variation in the expression of
      NB1 and NB2. Human alloantibodies have been used to identify the 58- to 64-kDa
      glycoprotein (GP) on which NB1 antigen is located, but an NB2 antigen-bearing
      molecule has not yet been identified. To identify the NB2 molecule, human
      alloantibody to NB1 was used to isolate the 58- to 64-kDa NB1 GP, and rabbits
      were immunized with this GP. Two rabbit antisera were produced. Both antisera
      immunoblotted and immunoprecipitated the 58- to 64-kDa GP on which NB1 is
      located, but neither identified the molecule on which NB2 is located. The
      inability of two rabbit polyclonal antibodies specific for the NB1 molecule to
      react with the NB2-bearing molecule suggests that considerable differences may
      exist between these two molecules or that NB2 as currently defined is not related
      to NB1.

PMID- 8488544
TI  - Lack of detection of human immunodeficiency virus type 1 DNA by polymerase chain
      reaction in the plasma and lymphocytes of seronegative exposed hemophiliacs.
AB  - Direct detection of human immunodeficiency virus type 1 (HIV-1) DNA in serum or
      plasma samples has been reported in seronegative as well as seropositive
      individuals. An alkaline lysis procedure was adapted for polymerase chain
      reaction (PCR) analysis of plasma specimens. Eighty-five seronegative
      hemophiliacs, 52 of whom had been exposed to HIV-contaminated blood components,
      and 19 seronegative at-risk individuals were studied. Each sample was extracted
      and amplified with SK38/39 gag primers at least three times. Seventy-six samples
      (72%) were consistently negative for HIV-1 DNA, 24 (22%) were positive only once,
      and 4 (3%) were positive twice. Genomic DNA from peripheral mononuclear cells was
      prepared from 12 of 76 negative samples, 18 of 24 samples that were positive
      once, and 2 of 4 samples that were positive twice and analyzed with both gag and
      long terminal repeat primers. None (0/32) of these cellular DNAs were positive
      for HIV-1, which suggests that these seronegative exposed hemophiliacs were not
      latently infected with HIV-1. In contrast, all (10/10) control cells from
      seropositive patients were positive with both primer pairs. The detection of HIV
      1 DNA in serum or plasma may be prone to a high level of false-positive PCR
      signals and should be interpreted with caution.

PMID- 8488545
TI  - Large-volume hemocytometer chamber for accurate counting of white cells (WBCs) in
      WBC-reduced platelets: validation and application for quality control of WBC
      reduced platelets prepared by apheresis and filtration.
AB  - A detailed description is provided of a method using a large-volume (50 microL)
      hemocytometer to count very low numbers of white cells (WBCs) in platelet
      components. A method employing a Nageotte hemocytometer uses crystal violet stain
      and a standard microscope with a reading time of 5 to 10 minutes. The method is
      validated by using serial dilutions of known concentrations of WBCs in platelets
      and by correlation with a flow cytometric technique. The interobserver
      coefficient of variation was 11.9 percent for WBC concentrations > 2 per microL.
      Use of the method for the evaluation of 203 WBC-reduced platelet components
      prepared by apheresis or by filtration revealed that over 94 percent of
      components had WBC content < 5 x 10(6). This method could easily be applied in
      the routine quality control of WBC-reduced platelet components and in clinical
      studies employing these components.

PMID- 8488546
TI  - A rapid molecular diagnosis of posttransfusion graft-versus-host disease by
      polymerase chain reaction.
AB  - A woman with recurrent Paget's disease of the vulva developed acute graft-versus
      host disease (GVHD) 12 days after radical surgery and massive blood transfusion.
      Molecular diagnosis of lymphocyte chimerism in the peripheral blood was made by
      polymerase chain reaction (PCR) directed against a Y chromosome-specific sex
      determining region Y (SRY) gene. PCR with skin biopsy after onset of GVHD also
      revealed infiltration of SRY-positive donor lymphocytes. The diagnosis was
      confirmed by HLA-DNA typing with PCR-sequence-specific oligonucleotide that
      revealed the presence of complex HLA-DR chimerism in the peripheral lymphocytes
      collected after onset of GVHD. The use of SRY-directed PCR is a rapid technique
      for the early diagnosis of acute posttransfusion GVHD in female patients.

PMID- 8488547
TI  - Pure red cell aplasia following ABO-incompatible bone marrow transplantation:
      response to erythropoietin.
AB  - Allogeneic bone marrow transplants with major ABO incompatibility may be
      associated with delayed erythroid engraftment. A case of a male patient with
      erythroleukemia (blood group O) who received a bone marrow transplant from an HLA
      identical sibling (blood group AB) is reported. The bone marrow transplantation
      was followed by normal myeloid and megakaryocytic engraftment, but pure red cell
      aplasia was present for more than 230 days after bone marrow transplant. Despite
      documentation of an elevated endogenous erythropoietin level (360 mU/mL; normal
      value, < 19 mU/mL) during the period of absent erythropoiesis, erythroid
      engraftment was observed soon after the initiation of human recombinant
      erythropoietin at a dose of 50 U per kg daily. This experience suggests that high
      dose erythropoietin may stimulate sufficient production of erythroid precursors
      to overcome circulating inhibitors resulting in the correction of pure red cell
      aplasia.

PMID- 8488548
TI  - Recent evolution of clotting factor concentrates for hemophilia A and B.
      Transfusion Practices Committee.

PMID- 8488549
TI  - Controversies in transfusion medicine. Blood banks should use good manufacturing
      practices and the pharmaceutical manufacturing approach [corrected].

PMID- 8488550
TI  - Controversies in transfusion medicine. The recent emphasis on good manufacturing
      practices and the pharmaceutical manufacturing approach damages blood banking and
      transfusion medicine as medical care activities [corrected].

PMID- 8488551
TI  - Continuous infusion of factor VIII concentrate to a patient with severe von
      Willebrand disease.

PMID- 8488552
TI  - On the incidence of Xga and anti-Xga in Hong Kong Chinese.

PMID- 8488553
TI  - Transfusion-induced anti-Ina following a single-unit transfusion.

PMID- 8488554
TI  - Transfusion-related acute lung injury.

PMID- 8488555
TI  - A putative fatty acid-binding domain of the NMDA receptor.

PMID- 8488556
TI  - A data-based reaction mechanism for type I fructose bisphosphate aldolase.
AB  - The structures of three type I fructose-1,6-bisphosphate aldolases have been
      determined and the common residues surrounding the Schiff base-forming Lys
      residue located. Armed with this information, it is now possible to propose a
      mechanism for this ubiquitous enzyme which is consistent with the recorded
      biochemical data. An interesting, but by no means mandatory, feature of the
      reaction mechanism is that catalysis can proceed without exchange with the
      solvent.

PMID- 8488557
TI  - The biochemical basis of the NADPH oxidase of phagocytes.
AB  - The NADPH oxidase is an electron transport chain found in lymphocytes and in the
      wall of the endocytic vacuole of 'professional' phagocytic cells. It is so called
      because NADPH is used as an electron donor to reduce oxygen to superoxide and
      hydrogen peroxide. The redox components are provided by a very unusual
      flavocytochrome b from the membrane, which is dependent upon cytosolic factors
      (including two specialized proteins, p47phox and p67phox) for activation. The
      small GTP-binding protein, p21rac, is also implicated in this system, possibly as
      the switch that triggers electron transport. This system provides a key to our
      understanding of the way in which these GTP-binding proteins function.

PMID- 8488559
TI  - Computers for molecular biologists.

PMID- 8488558
TI  - Nerve growth factor revisited.
AB  - Recent studies on nerve growth factor have revealed important new insights into
      the structure, function and evolution of this prototypical neurotrophic factor.
      Some of its features are (1) it has a unique three-dimensional fold that has
      since been found in two other growth factors, (2) it uses the trk proto-oncogene
      product, which has a tyrosine kinase, as a receptor and (3) it shares homology
      with at least three other factors, now collectively called neurotrophins, which
      have a spectrum of target cells.

PMID- 8488560
TI  - Numerical integration of rate equations by computer.
AB  - This article describes the availability of a package of free, user-friendly
      computer programs (VAX, PC or Mac) that allow investigators to obtain insights
      into reaction mechanisms. The programs provide an easy way to use the full time
      course of a reaction to evaluate kinetic mechanisms and determine rate constants
      for the transitions between the intermediates. While the programs can be used to
      examine any reaction mechanism, they are particularly useful for enzymatic
      reactions.

PMID- 8488561
TI  - William Arthur Johnson--a postgraduate's contribution to the Krebs cycle.
AB  - Anyone wishing to find out more about William Arthur Johnson will find little of
      relevance in the history of the Krebs cycle. Although Krebs makes fleeting
      reference to Johnson in his autobiography, no mention is made of Johnson's
      contribution in the Nobel Prize oration. Who was William Johnson and what role
      did he play in this crucially important work?

PMID- 8488562
TI  - UGA: a split personality in the universal genetic code.

PMID- 8488563
TI  - cDNA subtraction library construction using a magnet-assisted subtraction
      technique (MAST).

PMID- 8488564
TI  - Improved immunocytochemical detection of biotinylated probes with Neutralite
      avidin.

PMID- 8488565
TI  - Pulsed-field gel electrophoresis of Streptomyces lividans DNA.

PMID- 8488566
TI  - Ionizing radiation, genetic risk estimation and molecular biology: impact and
      inferences.
AB  - In recent years, a substantial amount of information has been obtained on the
      molecular nature of spontaneous mutations underlying human mendelian diseases,
      and on the mechanisms that give rise to these mutations. These data, when
      considered together with data on mutations induced by ionizing radiation in
      mammalian experimental systems, support the view that current radiation risk
      estimates for mendelian diseases (which are based on mouse data) are
      conservative.

PMID- 8488567
TI  - The role of host tyrosine phosphorylation in bacterial pathogenesis.
AB  - Recent studies on the pathogenic mechanisms of several bacterial genera,
      including the Yersinia, Salmonella and Escherichia, have revealed novel
      strategies of infection that involve the signal transduction processes of
      eukaryotic cells. These model systems are reviewed here, with emphasis on the
      role of tyrosine phosphorylation in these bacterial-host cell interactions.

PMID- 8488568
TI  - Turner syndrome: the case of the missing sex chromosome.
AB  - Turner syndrome is the phenotype associated with the absence of a second sex
      chromosome in humans. Recent observations support the hypothesis that the
      phenotype results from haploid dosage of genes that are common to the X and Y
      chromosomes and that escape X inactivation. A goal of current studies is the
      identification of these "Turner' genes.

PMID- 8488569
TI  - The Cheng-Prusoff relationship: something lost in the translation.
AB  - For a variety of reasons, pharmacologists often construct 'inhibition curves' to
      evaluate antagonists rather than employing the more comprehensive 'Schild
      analysis'. There is a widespread perception that it is only possible to derive
      antagonist Kb values from such experiments via application of the Cheng-Prusoff
      equation, requiring knowledge of the agonist affinity at the receptor. In this
      article, Douglas Craig presents a practical examination of 'inhibition curve'
      methodology and demonstrates that it is a related equation requiring no knowledge
      of agonist affinity, rather than the Cheng-Prusoff equation, that affords
      theoretically valid estimates of antagonist Kb values from this technique.

PMID- 8488571
TI  - The value of autopsies in hospital practice.

PMID- 8488572
TI  - The editors in tandem.

PMID- 8488570
TI  - Phospholipase A2 enzymes: regulation and inhibition.
AB  - The phospholipase A2 enzymes are important components of the cellular machinery
      that responds to inflammatory stimuli and maintains cell homeostasis by membrane
      remodelling. Their role as the rate-limiting step in the production of pro
      inflammatory lipid mediators makes these enzymes an important therapeutic target
      for the treatment of inflammatory disorders. Keith Glaser and colleagues explain
      how the two major groups of phospholipase A2, the secretory and cytosolic forms,
      are very different both structurally and enzymatically. Understanding the
      relative contributions of these different forms of phospholipase A2 to
      physiological and pathological conditions requires greater insight into their
      cellular regulation and the development of selective inhibitors.

PMID- 8488573
TI  - The value of the autopsy in a rural hospital of Haiti.
AB  - We conducted a retrospective study of the autopsies performed during a 28-month
      period in the Department of Medicine of the Hopital Albert Schweitzer in Haiti.
      We found that of 77 autopsies, the main clinical diagnosis was not confirmed at
      autopsy in 15 patients (19.5%). The results obtained at autopsy would have
      changed the treatment in 19 patients (24.7%) and the new therapeutical regimens
      could have had a significant impact on the outcome in six patients (7.8%).
      Important new information was also gained from the macroscopical examination
      only. The authors stress the value of the post-mortem examination in areas with
      limited resources.

PMID- 8488574
TI  - Rapid rural appraisal: its role in health planning in developing countries.
AB  - There is an urgent need for a quick inexpensive and reliable method for
      identifying groups and individuals most in need of primary health care. The Rapid
      Rural Appraisal (RRA) is the most appropriate approach. It is a method by which
      resources can be quickly deployed to alleviate the problems of the poor. If
      properly used it can play a major role in identifying community health needs
      thereby aiding the health planning process and improving the health of the
      people. Nevertheless, RRA techniques should not be regarded as separate and apart
      from other research methodologies but complementary to them.

PMID- 8488575
TI  - Prevention of transfusion-associated HIV transmission with the use of a
      transfusion protocol for under 5s.
AB  - Recently there has been an increasing realization that for the prevention of
      transfusion-associated HIV infection, HIV screening alone is insufficient. In
      1988, a treatment protocol for children under 5 years with severe anaemia, was
      introduced in Ekwendeni Hospital. Initial results showed that it was possible to
      reduce the number of blood transfusions without increasing the mortality rate. By
      January 1992 the protocol was being widely disregarded by ward staff, and
      transfusion rates had increased. Strict enforcement of the transfusion protocol
      from the 16 January produced a sharp drop in the percentage transfused from 44%
      to 11%. Mortality rates remained similar throughout the period of the study.
      Thus, it would appear to be possible, with the use of the transfusion protocol,
      to reduce the number of blood transfusions carried out, without affecting
      mortality rates, and hence to reduce the risk of transfusion-associated HIV.

PMID- 8488576
TI  - Bicycle injuries in a tropical city (Townsville)

PMID- 8488577
TI  - Reusable needles--a major risk factor for acute virus B hepatitis.
AB  - We conducted a case control study to find the extent to which acute virus B
      hepatitis was hospital acquired. One hundred and sixty consecutive cases of acute
      virus B hepatitis were compared with age (+/- 3 years) and sex matched healthy
      hospital visitors. Exposure to reusable needles, blood or blood products,
      therapeutic and diagnostic procedures, common razors and sexual practices were
      elicited by means of a questionnaire. Only exposures in the incubation period (6
      weeks to 6 months before the onset of symptoms) were included in the analysis.
      The odds ratio (OR) for injections for reusable needles was 6.3 [95% confidence
      interval (CI) = 3.8-10.6]. The OR for single injection (OR = 3.9; 95% CI = 2.0
      7.3) was less than that for multiple injections (OR = 9.8; 95% CI = 3.8-26.3),
      showing a dose response relationship. The proportion of cases of acute virus B
      hepatitis attributable to hospital related exposures was 67%. Proper aseptic
      techniques and sterilization practices can substantially reduce the incidence of
      acute hepatitis B in the population.

PMID- 8488578
TI  - Estimating maternal mortality by sisterhood method in rural Zimbabwe.

PMID- 8488579
TI  - Osmotic production of sterile oral rehydration solutions--an economic, low
      technology method.
AB  - A sterile oral rehydration solution can be produced by immersing in water a semi
      permeable cellulose tube containing glucose and salts. Osmotically-driven
      ultrafiltration excludes all microbes and particulate matter even when the
      immersion water contains 45 x 10(6) cfu/ml of Pseudomonas aeruginosa, 25 x 10(7)
      cfu/ml of Staphylococcus aureus or 20 x 10(7) cfu/ml of Escherichia coli.
      Solutions of consistent composition can be obtained by having a standard amount
      of glucose-electrolytes in a cellulose tube of appropriate dimensions and
      immersing this in a fixed volume of water for a minimum period of time. The
      method is simple, inexpensive, low-technology and requires no external source of
      power. It has potential for producing sterile solutions for injections and
      intravenous use in situations with very limited and simple resources, in
      emergencies and during natural disasters. Further studies are now needed to
      determine whether the method can be adapted to provide the large quantities of
      oral rehydration fluid needed in field conditions.

PMID- 8488580
TI  - External skeletal fixation: experience in a small rural hospital in northern
      Kenya.
AB  - The author describes the use of external skeletal fixation in the management of
      complicated septic limb fractures. Eight fractures in seven patients were treated
      at Sololo General Hospital using a low cost, simple external device, with good
      results. The report emphasizes how external fixation can solve difficult fracture
      cases in small up-country hospitals; a good example of appropriate technology at
      district level.

PMID- 8488581
TI  - Blast injuries of the eye.
AB  - Ninety-four cases of ocular blast injuries (122 eyes) were studied. Sixty-five
      per cent of the cases were between 15 and 25 years of age. The right and the left
      eyes were involved in 38% and 32% of the cases, respectively, while bilateral
      involvement was seen in 30%. Ninety of the eyes (74%) were blind. Twenty-one per
      cent of the patients with binocular injuries had bilateral blindness. Injuries of
      the iris, conjunctival and corneal foreign-bodies, and corneal and/or scleral
      lacerations were the most frequent types of injury seen.

PMID- 8488582
TI  - Paraprofessional women as health care facilitators in mother and child health.
AB  - The aim of the study was to compare the performance of midwives with that of lady
      home visitors (LHV; paraprofessionals). The project area was divided into six
      according to the population map. One midwife or one LHV was assigned to each
      visiting area. Home visits were carried out to identify and offer guidance on
      family planning (FP), antenatal care, well-child control, immunizations and other
      mother and child health related issues to those at high risk. Criteria taken for
      evaluation were the numbers of pregnant women identified in the last trimester;
      pregnant women receiving antenatal care; deliveries attended by a health care
      provider; modern FP users; continuation rate of the new users; pregnancy rate in
      new users; immunization status of children; well-child visits of the children. No
      significant differences were found in these health measurements between areas
      visited by LHV and areas visited by midwives. Response rates to the invitation
      was also similar in both areas. An important observation was the good performance
      of the LHV in communicating with the families. Women with limited school
      attainment from the community can be used effectively and efficiently in
      community health services.

PMID- 8488583
TI  - Another look at acute appendicitis in tropical Africa: and the value of
      laparoscopy in diagnosis.
AB  - Acute appendicitis is believed to be one of the commonest causes of the acute
      abdomen in tropical Africa. Negative appendicectomy rates are usually above 20%,
      which is now considered unacceptably high because of increased risk to patients
      and the availability of diagnostic facilities to aid clinical decision-making.
      Our negative appendicectomy rate over a 4-year retrospective period was 29.7% in
      males, and 47% in females. These reduced to 11% and 10%, respectively, after the
      introduction of laparoscopy for doubtful cases of acute abdominal pain.

PMID- 8488584
TI  - Leprosy in Botswana.

PMID- 8488585
TI  - Pancreatic pseudocysts in children: a Zimbabwean perspective.

PMID- 8488586
TI  - L'Institut Panafricain de Sante Communautaire: a new initiative in the training
      of health professionals in community health in French speaking Africa.

PMID- 8488587
TI  - Improving drug utilization: what about the 'KAP' gap?

PMID- 8488588
TI  - Inserting a Sengstaken-Blakemore (S-B) tube.

PMID- 8488589
TI  - Nasogastric tube knotting: spontaneous or induced?

PMID- 8488590
TI  - 0.1% lignocaine with 1:1000,000 adrenaline in general surgery.

PMID- 8488591
TI  - Ascariasis and post-operative recovery.

PMID- 8488592
TI  - Retroperitoneal sponge causing painless haematuria.

PMID- 8488593
TI  - Mycotic aneurysm of the brachial artery simulating soft tissue malignancy.

PMID- 8488594
TI  - Rabies vaccine: economical regimens.

PMID- 8488595
TI  - [Urinary incontinence--a problem neglected by physicians?].

PMID- 8488596
TI  - [Urinary incontinence after apoplexy].
AB  - In a retrospective study, based upon doctors' and nurses' case records, urinary
      incontinence (UI) and its relation to the severity of strokes was studied in 156
      stroke patients discharged from the department of neurology, Bispebjerg Hospital
      in 1988. A significant relationship was found between the presence of UI and
      stroke severity measured by length of hospital stay, circumstances of discharge
      and mobility (p < 0.0001). 44% of patients had some urinary incontinence on
      admission and on discharge 26% still had UI. Surprisingly, however, information
      about incontinence appeared in only 10% of doctors' records, whereas nurses,
      records had the relevant information concerning as many as 90% of patients. It
      appears that urinary incontinence in stroke patients has a low priority among
      doctors.

PMID- 8488597
TI  - [Measurement of stress and stressors in epidemiological studies].
AB  - There is considerable uncertainty and confusion with regard to definitions and
      measurements of stress and stressors in the medical literature. In the present
      article the concepts are defined, and three different methods for measuring
      stress and stressors respectively are presented. A matrix constructed against
      this background is used to classify a number of studies on stressors, stress, and
      disease. On the basis of examples from empirical studies, methodological problems
      are discussed. It is concluded that the methodological problems within this field
      of research are not fundamentally different from the wellknown methodological
      problems of medical epidemiology. It is recommended that independent measures of
      stressors as well as stress are used as widely as possible.

PMID- 8488598
TI  - [Invasive fibrous thyroiditis--Riedel's goiter. A review of the literature and a
      case report].
AB  - Invasive fibrous thyroiditis (Riedel's goitre) is a rare condition of an unknown
      aetiology. The condition was first described by Riedel in 1883. In 1904 Hashimoto
      described another condition of invasive fibrous thyroiditis. Since then it has
      been discussed if Hashimoto's thyroiditis and Riedel's goitre were one disease in
      different states or two different diseases. Hashimoto's thyroiditis is known to
      have an autoimmune aetiology and it can be seen together with pernicious anaemia.
      Co-existence of Riedel's goitre and pernicious anaemia has never been reported.
      The patient mentioned had both Riedel's goitre and pernicious anaemia, and was
      first treated with subtotal thyroidectomy, relapsed after one year and
      consequently received steroids. Such coexistence and the very good effect of
      steroids could be explained on the basis of Hashimoto's and Riedel's thyroiditis
      being one condition in different states and with an autoimmune aetiology. It is
      recommended that patients with Riedel's goitre are postoperatively treated with
      steroids.

PMID- 8488599
TI  - [Electron microscopy of needle biopsies from cancer patients with unknown primary
      tumors].
AB  - The aim of the present study was to evaluate the diagnostic value of electron
      microscopy (EM) performed on Surecut biopsies from patients without known primary
      tumour. The material consisted of 108 consecutive biopsies, obtained over a
      period of two years, from patients with tumour(s) in the liver or lymph nodes (on
      the neck, in the axilla or retroperitoneum). From each patient fine needle
      aspirations and Surecut biopsies for light microscopy and electron microscopy
      were taken. Only biopsies in which material for both electron microscopy and
      light microscopy was sufficient were included (60%). Immunohistochemical
      reactions were performed on paraffin sections when indicated. Final diagnoses
      were confirmed on surgically removed specimens and/or autopsies. Electron
      microscopy was necessary for obtaining the final histological diagnosis in 15% of
      the cases. It is therefore recommended to obtain additional ultrasound guided
      biopsies for EM from cancer patients with tumours in the liver or lymph nodes in
      cases where the primary origin of the tumour is unknown.

PMID- 8488600
TI  - [Assessment of sex life and psychological reactions after local excision of
      vulvar carcinoma in situ].

PMID- 8488601
TI  - [Evaluation of knemometry as a method for control of growth in short-stature
      children during a single-year treatment with growth hormone].

PMID- 8488602
TI  - [Toxic epidermal necrolysis].
AB  - A case of severe toxic epidermal necrolysis is described, stressing the
      importance of multiorgan system involvement of the disease. A possible
      pathogenetic mechanism involving tumor necrosis factor is discussed.

PMID- 8488603
TI  - [Physiology of growth hormone during pregnancy].

PMID- 8488604
TI  - [New targets for anti-ulcer agents?].

PMID- 8488605
TI  - [Sexual knowledge among physicians of women applying for abortion].

PMID- 8488606
TI  - [Quality assurance and legal position of physicians].

PMID- 8488607
TI  - [Can Q-10 be dangerous?].

PMID- 8488608
TI  - Staging of early prostate cancer: a proposed tumor volume-based prognostic index.
AB  - Current staging of early prostate cancer separates patients into two groups:
      those with palpable and non-palpable tumors. Such staging relies on digital
      rectal examination in making this separation, despite the low sensitivity, low
      specificity, and low positive predictive value of this method. As an alternative,
      tumor volume may be useful for staging because of its powerful prognostic ability
      and its potential to be assessed clinically due to recent advances in imaging
      techniques such as transrectal ultrasound. In this study, we evaluate the utility
      of tumor volume in predicting progression of early prostate cancer based on the
      composite published evidence from nine pathologic studies of serially-sectioned
      prostates. Logistic regression revealed that tumor volume was a good positive
      predictor of all measures of tumor progression. There was a 10 percent
      probability of capsular invasion in tumors measuring about 0.5 cm3; 10 percent
      probability of seminal vesicle invasion in tumors measuring about 4.0 cm3; and 10
      percent probability of metastases in tumors measuring about 5.0 cm3. These
      composite results suggest that tumor volume is a significant predictor of cancer
      progression. A volume-based prognostic index is proposed as an adjunct to staging
      for early prostate cancer.

PMID- 8488609
TI  - Use of tissue expanders in final reconstruction of infrapubic midline scar, mons
      pubis, and vulva after bladder exstrophy repair.
AB  - Two patients following bladder exstrophy repair presented for final cosmetic
      reconstruction with the characteristic lower abdominal midline scar, bisected
      mons pubis, and laterally displaced labia majora. Tissue expanders were used to
      obtain additional skin and subcutaneous tissue. After adequate serial expansion,
      the expanders were removed, scar tissue excised, and primary approximation of
      healthy tissues performed. A tension-free closure and esthetically pleasing
      midline incision, mons pubis, and vulva were obtained.

PMID- 8488610
TI  - Potentiation of drug-induced erection with audiovisual sexual stimulation.
AB  - Twenty-five patients underwent audiovisual sexual stimulation (AVSS) after
      pharmacologically-induced erection. Grade of erection and cavernosal blood flow
      were assessed after intracorporeal (IC) injection of TRI-MIX or prostaglandin E1,
      and then after AVSS, using pulsed Doppler ultrasonography (PDUS). After IC
      injection, 5 patients had a Grade II erection, 8 had Grade III, 10 had Grade IV,
      and 2 had Grade V. There was an increase in peak arterial flow and arterial
      diameter which corresponded with the grade of erection obtained. After addition
      of AVSS, 56.5 percent of patients experienced improved erection. The improvement
      from Grade III to IV in 13 percent is especially significant because it showed
      the attainment of adequate erection when IC injection alone failed. Penile blood
      flow improved among AVSS responders but not in nonresponders. AVSS may enhance
      pharmacologically-induced erection and may improve the diagnostic accuracy of
      PDUS.

PMID- 8488611
TI  - Pheochromocytoma of urinary bladder: contemporary methods of diagnosis and
      treatment options.
AB  - Two patients with vesical pheochromocytoma are presented with a review of the
      literature. Imaging modalities for localizing extra-adrenal pheochromocytomas are
      reviewed with an overview of the commonly accepted treatment options. Successful
      treatment of this lesion requires a high index of suspicion based upon the
      patient's symptom complex, allowing preoperative preparation prior to surgical
      manipulation.

PMID- 8488612
TI  - Renal angiomyolipoma in association with pulmonary lymphangioleiomyomatosis:
      forme fruste of tuberous sclerosis?
AB  - From 1976 to 1989, 27 patients with pulmonary lymphangioleiomyomatosis were seen
      at our institution. Twenty-five had no signs or symptoms of tuberous sclerosis;
      21 of these had abdominal imaging or surgical exploration to make the diagnosis
      of renal angiomyolipoma in seven patients, all female. Three presented with
      symptoms secondary to renal disease, three with pulmonary manifestations, and one
      with both. Renal disease was bilateral in four patients; four patients underwent
      nephrectomy and two tumors were embolized. All patients experienced spontaneous
      pneumothoraces during the course of their disease. There was one respiratory
      death. It is our belief that any patient presenting with angiomyolipoma and a
      history of pulmonary problems should be evaluated for pulmonary
      lymphangioleiomyomatosis with a limited computed tomography scan of the chest at
      the time of abdominal imaging. The surgical treatment of angiomyolipoma when
      associated with lymphangioleiomyomatosis is predicated on the ability to
      adequately manage the complicating lung disease perioperatively.

PMID- 8488614
TI  - Renal cell carcinoma with situs inversus totalis.
AB  - A case of renal cell carcinoma in a patient with situs inversus totalis is
      reported. Only 8 cases of malignant neoplasms have been reported in situs
      inversus totalis, and our case represents the second case report of renal cell
      carcinoma in a patient with situs inversus totalis. The frequency of situs
      inversus totalis is between 1 in 8,000 and 1 in 20,000. Cardiac and pulmonary
      anomalies are common in patients with situs inversus totalis. Renal anomalies,
      including agenesis, dysplasia, hypoplasia, ectopia, polycystic kidney, and
      horseshoe kidney, have been reported. Because of the association between situs
      inversus and cardiac, pulmonary, renal, and vascular anomalies, management of the
      patient with situs inversus and urologic disease requires careful preoperative
      evaluation.

PMID- 8488613
TI  - Evaluation of erectile dysfunction by dynamic infusion cavernosometry and
      cavernosography (DICC). Multi-institutional study.
AB  - In a cooperative, private practice, multi-institutional impotence study, dynamic
      infusion cavernosometry and cavernosography (DICC) was performed on 743 patients
      to make an accurate diagnosis and/or identify candidates for penile
      revascularization. Maximum equilibrium intracorporeal pressure achieved following
      papaverine and phentolamine injection (Phase I) averaged 29.42 +/- 0.76 mm Hg,
      approximately one third of normal erection pressure. Corporeal pressure fall from
      150 mm Hg over thirty seconds (cavernosometry) averaged 82.38 +/- 1.33 mm Hg
      (Phase II). The gradient between systolic and cavernosal artery pressure averaged
      42.84 +/- 1.12 mm Hg on the right and 43.33 +/- 1.13 mm Hg on the left (Phase
      III). Cavernosography at 90 mm Hg erection pressure was performed in Phase IV. Of
      the 124 patients from one center who were reviewed in greater detail, pure
      cavernosal artery insufficiency (CAI) was found in 25 (20.2%), corporeal veno
      occlusive dysfunction (CVOD) in 26 (21.0%), and 73 patients (58.9%) demonstrated
      combined CAI and CVOD. Diabetics (n = 69) achieved lower equilibrium
      intracorporeal pressures than nondiabetics, had similar CVOD, and worse CAI.
      Smokers (n = 365) and patients with Peyronie's disease (n = 32) had erectile
      dysfunction similar to those without these conditions. Patients impotent after
      trauma (n = 124) were younger, achieved higher intracorporeal pressures, and
      showed better corporeal veno-occlusive function than those without trauma.
      Complications of DICC were minimal and infrequent. After DICC, 169 patients
      underwent internal pudendal arteriography, 105 had arterial bypass surgery with
      or without penile venous ligation procedures, and 45 had venous surgery alone.
      Dynamic infusion cavernosometry and cavernosography is a useful erectile function
      study to evaluate impotence and can be performed easily in a private practice
      setting.

PMID- 8488615
TI  - Clostridium perfringens emphysematous cystitis.
AB  - Emphysematous cystitis is a rare disease and is usually caused by aerobic
      bacteria, most commonly Escherichia coli. Only rarely have anaerobic bacteria
      been associated with this condition. We report a case of emphysematous cystitis
      due to Clostridium perfringens with bacteremia in an elderly diabetic woman.

PMID- 8488616
TI  - Varicoceles: effect on testicular volume in prepubertal and pubertal males.
AB  - A total of 63 prepubertal and 17 pubertal males were examined to determine both
      testicular volumes and to correlate testicular volumes with the presence or
      absence of a varicocele. In the prepubertal group neither the left nor the right
      testicle predominated in size. In the pubertal group, the left testicle with an
      associated varicocele was smaller than the right.

PMID- 8488617
TI  - Malignant melanoma of penis and male urethra. Is it a difficult tumor to
      diagnose?
AB  - Two cases of malignant melanoma of the penis and male urethra are presented in
      which the diagnosis was difficult to make clinically and histopathologically. Our
      findings support the general opinion that melanomas at this site have a poor
      prognosis.

PMID- 8488618
TI  - Instrument for ligation of dorsal vein complex in radical prostatectomy.

PMID- 8488619
TI  - Comparison of vasovasostomy techniques in rats utilizing conventional
      microsurgical suture, carbon dioxide laser, and fibrin tissue adhesives.
AB  - An evaluation of vas reanastomoses in rats comparing suture only, carbon dioxide
      (CO2) laser-assisted, and fibrin-based tissue adhesive was performed in our
      laboratory. A cohort of 60 known fertile male Sprague Dawley rats initially
      underwent lower midline abdominal exploration and transection of their vas
      deferens bilaterally, followed by immediate microsurgical vasovasostomy by one of
      the three experimental methods. All groups initially had the severed vasa ends
      coapted by two or three transmural (mucosa through serosa) sutures of 10-0 nylon
      under an operating microscope. The conventionally sutured group had an additional
      four to six nylon 10-0 sutures placed externally in the serosa only to complete
      the anastomosis. The CO2 laser-assisted group underwent laser welding with
      denaturation of the serosa to seal the anastomosis. A fibrin-based tissue
      adhesive, produced by combining human cryoprecipitate and thrombin, was placed
      topically over the coapted vas ends to seal the anastomosis in the third group.
      Postoperative evaluation revealed similarities among the three surgical groups
      with the fibrin-based tissue adhesive group resulting in the highest patency rate
      (89%) and pregnancy rate (85%) as well as the lowest granulation rate (18%) and
      shortest operative time (27 minutes). The laser-assisted group resulted in the
      lowest pregnancy rate (68%), while the sewn anastomosis group had the lowest
      patency rate (76%). Both laser-assisted and conventionally sewn vasectomy
      reversals required significantly longer operative time (39 and 46 minutes,
      respectively) compared with the fibrin-based tissue adhesive-assisted procedures
      (p < 0.01). This study provides evidence that alternative microsurgical
      techniques may be utilized to perform uncomplicated, expeditious, and successful
      vasectomy reversals.

PMID- 8488620
TI  - Effect of nifedipine on kidney and ureteral function after experimental acute
      unilateral ureteral obstruction.
AB  - Nifedipine, a calcium channel blocker, was tested for its in vivo effect on the
      ureter and kidney during acute obstruction. There was no discernible effect on
      peristalsis but glomerular filtration rate was improved. Thus, nifedipine would
      not be expected to decrease renal colic from obstruction.

PMID- 8488621
TI  - Effect of lidocaine on ureteral motility and fluid transport in vitro.
AB  - We used a whole canine ureter, under constant inflow hydrostatic pressure, in a
      tissue bath, to investigate the effect of lidocaine on flow and contractility in
      the ureter, simultaneously. Lidocaine caused increased contractility and
      reduction of flow in 9 ureters tested. In 5/9 ureters exposed to lidocaine in
      concentration of 50 to 500 micrograms/mL in the bath, the contraction became
      continuous and the flow ceased. This could be reversed by irrigating the bath
      with fresh solution. We conclude that lidocaine causes increased contractility
      and reduction of flow in canine ureters in vitro.

PMID- 8488622
TI  - Isolated lymphoma of genitourinary tract and adrenals.
AB  - With the routine use of computed tomographic imaging, intrinsic involvement of
      the genitourinary tract in newly diagnosed non-Hodgkin's lymphoma is seen in as
      many as 10 percent of patients. Incidental discovery of an extranodal, extra
      lymphatic lesion in the genitourinary tract without clinical or radiographic
      evidence of disease elsewhere, however, is an uncommon occurrence. The clinical
      presentation and imaging findings in 4 patients with initial manifestation of
      lymphoma isolated to the kidney, ureter, bladder, and adrenals, respectively, are
      presented. These patients had no evidence of lymphoma elsewhere, and imaging
      studies mimicked the more common neoplasms affecting these organs.

PMID- 8488623
TI  - Magnetic resonance images of hematospermia.
AB  - Seminal vesicles and their adjacent structures were studied using magnetic
      resonance imaging (MRI) in 7 normal volunteers and 15 patients with
      hematospermia. Normal seminal vesicles are depicted on T2-weighted images either
      as a mixture of high- and low-signal granules or as a convolution of tubules with
      a diameter of less than 0.5 cm. Fourteen of the 15 patients with hematospermia
      exhibited abnormalities on MRI. Dilatation or cyst formation in the seminal
      vesicle was observed in 13 patients, and a dilatation of the midline structure
      was seen in 3 patients. Abnormal signal intensity of the seminal vesicles was
      seen in 11 patients and was thought to be due to subacute hemorrhage.

PMID- 8488624
TI  - [Functional level, care needs and family-based care for home-care recipients with
      extended care needs].
AB  - A study of home care and home health services was undertaken in three Swedish
      municipalities. Persons who received extended home care and home health care were
      interviewed. The interviews covered different themes such as impairments, care
      needs, functions and activities in the horizontal social network (the informal
      network), and opinions concerning how care is and should be provided. A modified
      ADL-index was used to assess the functional level of daily living. Care needs
      were measured by the judgement of the care recipient, and by the interviewer's
      judgement. The correspondence between these measures was high, with some
      exceptions. Lower correspondence between the measures was obtained for three
      categories of care recipients: individuals with communicative dysfunctions,
      younger individuals with reduced ability to move and, thirdly, individuals with
      psychosocial problems. Problems concerning measurement of care given by family
      members were also identified and discussed.

PMID- 8488625
TI  - Emotions, care and particularity.
AB  - The main intention of this article is to illuminate the normative foundation of
      caring in nursing. I will focus on the debate between an ethics of care and an
      ethics of universal principles which has evolved both in nursing ethics and moral
      philosophy during the last decade. In spite of what a number of people have
      claimed, I shall argue that a care-based ethics is compatible with judgment based
      on universal, impartial principles. However, an ethics of care articulates other
      important aspects of morality and moral behavior than the justificational ones
      that are central to prevailing impartialist ethics. The paper explains why and
      how moral perception, sensitivity and emotional capacities are important for a
      modern professional nursing ethics. It focuses on capacities and preconditions
      for principle-based reflection and action by arguing that moral perception and
      certain emotional qualities are prerequisites for moral judgment and action.
      Achieving perceptual awareness and emotional sensitivity in understanding the
      situation and its particulars are genuine moral tasks in nursing. These qualities
      are essential in discovering the morally salient features of the situation. This
      perspective on an ethics of care also recognizes an important place to central
      positions in traditional nursing ethics, where developing personal qualities and
      altruistic capabilities have always been a fundamental normative claim.

PMID- 8488626
TI  - [Why situational ethics in many cases can be right for clinical nurses and other
      health workers].

PMID- 8488627
TI  - Nursing home staff opinions of work with demented patients and effects of
      training in integrity-promoting care.
AB  - This study is part of a larger study of the effect of integrity-promoting care in
      a Swedish nursing home ward. Compared with assessments on a control ward,
      improvements were found in the patients' behaviour and in the quality of care
      after a three-month intervention period. This paper reports on parts of a
      questionnaire survey on the nursing staff's opinions of their working conditions
      and demented patients. Most staff members on both the intervention ward and the
      control ward found their jobs meaningful, engaging and stimulating, but they also
      felt that they had a heavy work-load. Most of the staff members experienced
      mental strain because of the patients' disturbed behaviour. Many did not think
      that the care on their ward would have been good enough for their own close
      relatives, if they had been suffering from dementia. Only slight changes were
      found in the staff members opinions after the intervention.

PMID- 8488628
TI  - [Properties of adherent staphylococci isolated from the rumen wall in lambs].
AB  - Six defined strains of adherent, coagulase-negative and catalase-positive
      staphylococci were isolated from the rumen wall of lambs. All the strains
      fermented maltose and had positive acetoin production. The strains were
      classified as follows on the basis of diagnostic tests, according to an
      identification key: three strains belonged to the species Staphylococcus warneri
      (SW34, SW64, SW6), two to the species S. epidermidis (SE30, SE49) and one to the
      species S. cohnii subsp. urealyticum (SCU32)--Tab. I. The adherence index of the
      different isolates ranged from 1.9 +/- 0.02 to 14.9 +/- 2.12 of bacteria adhering
      to one epithelial cell of the rumen wall. There were large differences in urease
      production (2.3 +/- 0.15 to 29.3 +/- 1.16 nkat/ml). But in general the isolated
      staphylococci can be taken as strains with low, medium or high adherence, and/or
      urease activity (Tab. II). In the group of facultative anaerobic bacteria the
      staphylococci are the first, lactic acid producing bacteria and the attained
      production (0.164 to 0.687 mol/l) is adequate to their portion in the rumen (Tab.
      II). The isolated strains produced bacteriocin-like substances which inhibited
      the growth of maximally four out of the six used indicator bacteria of the same
      species, and also of a related species (Tab. III) while they showed small but
      clear zones of inhibition of the size 2 to 5 mm. In general, the mentioned
      staphylococci can be considered as little active producers of bacteriocin-like
      substances. All the tested strains were resistant to the observed heavy metals.

PMID- 8488629
TI  - [Acute oral toxicity of bentazon, an herbicide developed in Czechoslovakia, in
      pheasants and rabbits and the clinical symptoms of poisoning].
AB  - Adult rabbits of the New Zealand White breed and pheasants were used to determine
      the rate of acute oral toxicity (LD50), clinical symptomatology of poisoning of
      organisms loaded with lethal doses, and the recovery of intoxicated individuals
      from the toxic effects of bentazon, Czechoslovak developmental herbicide
      (Research Institute of Chemical Technology, Bratislava), administered at
      sublethal doses within the framework of obligatory toxicological testing of this
      herbicide. The determined acute oral toxicity (LD50) was 1139 mg/kg in rabbits
      and 2918 mg/kg of live weight in pheasants. The table shows LD50 of the tested
      herbicide for various animal species. The LD50 values of bentazon produced abroad
      (Germany) are also shown for comparison in this table. If the LD50 values of both
      herbicides are compared, Czechoslovak developmental bentazon appears safer. The
      administration of lethal doses (1110 and 1170 mg/kg in rabbits, 2750 and 3100
      mg/kg of live weight in pheasants) resulted in clinical symptoms of poisoning
      detected predominantly in the respiratory system. Shallow accelerated breathing
      and dyspnoea, CNS suppression, pronounced increase in body temperature, rapid
      onset and high intensity of rigor mortis were observed. Animals which died as a
      result of asphyxia induced by the sublethal doses (1000 mg/kg in rabbits and 2200
      mg/kg in pheasants) were observed after 2-4 days. Difficult accelerated breathing
      and increased body temperature disappeared after 1-2 days while the remaining
      symptoms after 2-3 days. The loss of appetite persisted for 2-4 days.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488630
TI  - [Occurrence of Leptospira antibodies in the blood of game animals].
AB  - The blood serum of game was examined for the presence of antibodies to
      Leptospiras in 1987-1989. A total of 792 blood sera from animals belonging to 14
      zoo-species were examined (Tab. I). The blood serum of red deer (Cervus elephus)
      was examined the most often within the group of animals, in 398 cases, i.e.
      50.2%, followed by 165 blood sera of wild boar (Sus scrofa), representing 20.8%,
      and by 136 blood sera of roedeer (Capreolus capreolus), representing 18.6%. Small
      numbers of blood sera of the other animals were examined. A serological reaction
      of microagglutination-lysion revealed the antibodies to Leptospiras in fifty
      examined samples, i.e. 6.31%, of the six examined zoo-species: muskrat (Ondatra
      zibethica) 14.28%, wild boar (Sus scrofa) 13.93%, roedeer (Capreolus capreolus)
      6.76%, fox (Vulpes vulpes) 5.26%, red deer (Cervus elephus) 3.76%, mouflon (Ovis
      musimon) 2.50%. No antibodies to Leptospiras were found in the blood serum of the
      other animal species (Tab. I). Twelve strains of Leptospira were used for
      serological examination according to the standard method (Sebek, 1979). The
      examined blood sera of game reacted only with Leptospiras of the serotype L.
      grippotyphosa. No reaction with other Leptospira serotypes was observed. Our
      results have demonstrated, in comparison with the results of foreign authors,
      great susceptibility of the game to infection with different serotypes of
      Leptospira. But it is possible to say that with certain exceptions these game
      species do not play an important role in the epidemiology of Leptospirosis.

PMID- 8488631
TI  - [Occurrence of streptococci resistant to antibiotics in the rumen of calves].
AB  - The occurrence and antibiotic-resistance spectrum of some strains of rumen
      streptococci were investigated in calves of four age categories in the milk diet
      period at 1-3, 4-7, 8-14 days of age and 6-8 weeks of age. More than 75% of the
      strains isolated from the calves of all age categories were resistant to more
      than one tested antibiotic (tetracycline, neomycin, erythromycin, streptomycin,
      chloramphenicol). The average number of streptococci isolated from the ingesta of
      calves during the period of observation was 10(5) per ml. The per cent of
      resistant strains showed an increasing trend from birth to the age of 8-14 days
      (Tab. I). The occurrence of resistant strains in 6-8 week calves was even lower
      than in the calves of the youngest age category. A four-marker type of resistance
      (41.6-50%) prevailed within 14 days of age. Two-marker types of resistance
      (42.6%) occurred most frequently in the calves of the oldest age category. Tab.
      II shows the spectrum of resistant strains. Tetracycline-resistant amylolytic
      strains of Streptococcus bovis were selected from among the isolated strains to
      be used as donor strains in conjugation experiments. Successful resistance
      transmission was observed in solid-surface conjugation. The transmission
      frequency ranged within the transconjugate values of 10(-3) to 10(-5) per donor
      cell within the species (Tab. III). A chromosomally rifampicin-resistant strain
      of Streptococcus bovis BM114 was used as a recipient as it did not contain any
      plasmids and was sensitive to the tested antibiotics. Agarose-gel electrophoresis
      was used to visualize the presence of plasmid DNA in donor strains (Fig. 1).

PMID- 8488632
TI  - [A rapid method of detecting psychrotrophic bacteria in raw milk].
AB  - Determination of the counts of psychrotrophic bacteria offers an important
      indicator of the technological quality of purchased raw milk, and also an
      indicator of the hygienic level of its production in agricultural primary
      production, particularly with respect to the sanitation of milking machines. The
      applied and published methods of determination of the counts of psychrotrophic
      microbial contaminants have revealed large differences, multiplied by
      insufficient legislation in this country, by vague and even wrong definition of
      the given group of bacteria, and/or by the misuse of the concepts psychrotrophic
      and psychrophil bacteria. Since the level of the microbial quality of raw milk
      should be increased, we investigated and developed convenient methods of
      determination of psychrotrophic bacterium counts in the last years (Urbanova et
      al., 1988; Urbanova, in print): these methods should facilitate the reasonable
      control applying an expeditious procedure. A long incubation time of standard
      procedure is a disadvantage complicating the practical use of the previous
      procedure (10 days at a temperature of 7 degrees C). An accelerated procedure of
      psychotrophic bacterium cultivation to determine their counts in raw milk is
      described in this paper. After thorough stirring, a raw milk sample is diluted
      with sterile physiological solution (pH 7.2) pursuant to the standard CSN 57
      0101. The dilutions 10(-2), 10(-3), 10(-4) were the most convenient for
      inoculation when the counts of psychrotrophic contaminants were determined in raw
      milk. The dilutions 10(-3), 10(-4), 10(-5) were inoculated if higher milk
      contaminations were expected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488633
TI  - [Ethologic determinants of maternal behavior in swine].
AB  - Care giving behaviour was investigated in pigs as a form of maternal behaviour
      and its effects on the youngs. The objective of observation was to compare the
      identified phenomena in their biological, social and experience variables of the
      behaviour of the investigated animals. The observations included 40 sows and 280
      youngs of the Landrace x Large White breed, of the female sex. They took place in
      semi-natural conditions while the standard criteria of management were
      maintained. Two categories of sows and their youngs were investigated. The first
      group included 20 sows (first-litter gilts) and their youngs: A (1-20). A study
      unit comprised one sow and seven youngs. The other category, B (1-20), had
      analogical numbers of individuals but the sows were after their third
      parturitions. As an indicator of maternal behaviour the average index of
      sociability (IS) had the value mean = 1.7 for the first category and the value
      mean = 2.0 for the second category. Evaluation of these differences enables to
      determine a significant difference between the average IS for both groups (Fig.
      1). This fact, which spoke in favour of B (1-20) group, made us follow the
      different litters. That means we wanted to know how the maternal behaviour
      determined piglet sociogenesis. IS was calculated from the average values of IS
      determined in both categories within their adequate litters. The value mean A (a
      g) = 1.8 was determined for the first category (Tab. II) while for the second
      category B (1-20) the value mean B (a-g) made 2.0 (Tab. III).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8488634
TI  - Average testosterone levels in bulls after GnRH stimulation at breeder bull
      rearing stations and A. I. stations.
AB  - Base average testosterone levels and testosterone levels in 60 and 90 min after
      GnRH administration were determined in bulls at five breeder bull rearing
      stations at their age of 13 months and at nine A. I. stations at their age of 17
      34 months. Significant increases in testosterone levels in 60 and 90 min after
      GnRH administration were the responses of all groups of bulls. There were
      differences between the average testosterone levels typical of the various BRSs
      and AISs. Highly significant correlation coefficients 0.344 for base levels and
      0.583 for induced levels were calculated from a comparison of the testosterone
      levels determined at BRSs at the bull's age of 13 months and of those recorded
      after a six-month stay of the same bulls at AISs. A decrease in testosterone
      levels was also observed.

PMID- 8488635
TI  - [Mineral metabolism in calves during periods of milk feeding and weaning based on
      selected parameters in the blood].
AB  - Concentrations of calcium, inorganic phosphorus, magnesium, sodium and potassium
      (Tab. I) were followed in the blood serum of calves in the period of milk diet
      and weaning (at the age of nine weeks), and the results were evaluated with
      respect to their deviations from the reference values. The average concentrations
      of calcium and inorganic phosphorus did not show any significant variations and
      they were within the range of reference values. Magnesium concentrations in the
      blood serum of calves on all-vegetable diet (11 weeks of age) were significantly
      higher (p < 0.01) in comparison with the starting value (at the age of two weeks)
      while they approached the lower boundary of reference range as late as at the age
      of nine weeks (Fig. 1). The highest percentage of hypocalcaemia (33.3%) and
      hypophosphataemia (47.3%) in individual animals was determined at weaning. The
      highest level of hypomagnesaemia was observed at the age of two and five weeks
      (57.1% of the calves). The subnormal values of the mentioned parameters were
      markedly adjusted in the calves on all-vegetable diet (Fig. 2). The
      concentrations of serum sodium and potassium (Fig. 3) were decreasing in the
      calves on milk diet, but after weaning they were stabilized at the values which
      were recorded at the age of five weeks (Na 146.3 mmol/l and K 5.19 mmol/l). With
      the exception of weaning, the average sodium concentrations in the blood serum of
      calves were slightly above the upper boundary of the reference range, their
      significant drop was observed only at weaning (p < 0.05). The concentrations of
      serum potassium were within the range of reference values except the values at
      the age of two weeks and the potassium concentrations in the serum were
      significantly lower at the age of 5, 9 and 11 weeks in comparison with the
      starting value (p < 0.01). The highest percentage of hypernatraemia (81%) and
      hyperkalaemia (85.7%) was determined in individual animals at the age of two
      weeks (Fig. 4).

PMID- 8488636
TI  - [Use of selected parameters in the serum and blood of calves in the evaluation of
      nitrogen and energy metabolism].
AB  - Concentrations of total proteins, albumin, total serum immunoglobulins, urea and
      total lipids in the blood serum and glucose concentrations in the blood were
      investigated in the periods of milk nutrition and weaning, and the results were
      evaluated with respect to their differences from the range of reference values.
      Concentrations of total proteins (TP) in the blood serum significantly decreased
      if the starting values at the age of two weeks (65, 45 g/l) were compared with
      the values at the age of five weeks, and they began to increase to the age of 11
      weeks. The average TP values at the age of 11 weeks were significantly higher (p
      < 0.01) than the starting values (Fig. 1, Tab. I). TP concentrations were above
      the upper limit of the reference range since weaning (nine weeks of age).
      Subnormal TP values were recorded in individual animals at the age of two, five
      weeks, at weaning, at 11 weeks in the animals on all-vegetable diet in 4.8%,
      19.1%, 4.8% and 9.5% of the calves, respectively (Fig. 2). The albumin
      concentrations were increasing from the age of five weeks but the changes in the
      values were statistically insignificant and the average values remained in the
      reference range (Fig. 1). The reduced albumin concentrations were recorded in
      individual animals in 28.6% of the calves at the age of two weeks, in 19.1% of
      the calves at the age of five weeks, in 42.9% of the calves at weaning, and in
      38.1% at the age of 11 weeks. The concentrations of total serum immunoglobulins
      (TS-Ig) were increasing since the animal collection with their growing age (Fig.
      1) while in comparison with the starting values the increases were significant at
      the age of five weeks (p < 0.05), nine and eleven weeks (p < 0.01). The average
      TS-Ig values rose to the reference range at the age of five weeks. In individual
      animals, the reduced TS-Ig values were recorded in the serum at the age of two
      weeks in 71.4% of calves, at the age of five weeks in 42.9%, at weaning in 33.3%
      and at the age of 11 weeks it was only in 9.5% of the calves (Fig. 2). The urea
      concentration in the serum was decreasing from the age of five weeks to weaning.
      In comparison with the starting values, the differences in the average values
      were statistically insignificant and the average values remained within the
      reference range (Fig. 1).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488638
TI  - Dogs and human epilepsy.

PMID- 8488637
TI  - [Sampling of venous blood and fixation of lower abdominal vessels in dairy cows].

PMID- 8488639
TI  - Veterinary pathology and the Royal College of Pathologists.

PMID- 8488640
TI  - A comparison of lincomycin hydrochloride and clindamycin hydrochloride in the
      treatment of superficial pyoderma in dogs.
AB  - Thirty dogs with superficial pyoderma were randomly allocated to treatments with
      either lincomycin hydrochloride (22 mg/kg twice daily) or clindamycin
      hydrochloride (11 mg/kg once daily), initially for three weeks. Samples were
      taken from pustules, from adjacent apparently uninvolved skin, and from the
      nares. These were submitted for bacterial culture and sensitivity testing. The
      dogs were re-examined after three weeks treatment and samples for bacteriology
      were taken from the nares, from any pustules that were present or from skin in
      the area that was previously affected; the treatment was extended if necessary.
      Seventy-one per cent of the dogs given lincomycin hydrochloride responded within
      three weeks compared with 81 per cent of the dogs treated with clindamycin
      hydrochloride. The overall response rates, including those given longer courses
      of treatment were 93 per cent for those treated with lincomycin hydrochloride and
      94 per cent for those treated with clindamycin hydrochloride, and there was no
      statistically significant difference between the groups either after three weeks
      treatment or after extended treatment. The microbiological results demonstrated
      that Staphylococcus intermedius was present on the skin adjacent to pustules and
      suggested that the nasal carriage of S intermedius was a result of cutaneous
      colonisation.

PMID- 8488641
TI  - Hypereosinophilic syndrome in a cat.

PMID- 8488642
TI  - Identification of Cheyletiella eggs in dog faeces.

PMID- 8488643
TI  - Steroid responsive meningitis in three boxer dogs.

PMID- 8488644
TI  - An unexpected bacterial flora in the proximal small intestine of normal cats.

PMID- 8488645
TI  - Oiled birds from Shetland, January 1993.

PMID- 8488646
TI  - Porcine proliferative enteropathy.

PMID- 8488647
TI  - OVS survey refutes claims of high veterinary fees.

PMID- 8488648
TI  - Leporine dysautonomia: further evidence that hares suffer from grass sickness.
AB  - The recently described dysautonomia of hares has many similarities to equine
      grass sickness, particularly when the autonomic ganglia of affected hares and
      horses are compared by light microscopy. This study shows that the
      ultrastructural findings are also similar, with a loss of ribosomes from the
      rough endoplasmic reticulum and distension of its cisternae; the Golgi apparatus
      is not recognisable in affected neurons. Membranous stacks were identified in
      autonomic neurons of affected hares, a feature not characteristic of equine grass
      sickness but often found in feline dysautonomia. Staining with wheat germ
      agglutinin, a lectin recognising Golgi membranes, showed a lack of reactivity in
      affected neurons again suggesting a lack of a normal Golgi apparatus.

PMID- 8488649
TI  - Xylazine or medetomidine premedication before propofol anaesthesia.
AB  - The duration of action and cardiopulmonary effects of propofol (6.55 mg/kg
      intravenously), xylazine (0.8 mg/kg intramuscularly), medetomidine (30
      micrograms/kg intramuscularly), xylazine plus propofol (3 mg/kg intravenously)
      and medetomidine plus propofol (3 mg/kg intravenously) were compared in dogs. A
      cannula inserted into a raised carotid artery before the drugs were given allowed
      the continuous recording of blood pressure and heart rate and the measurement of
      arterial pH, PCO2, PO2, bicarbonate and base balance. Xylazine and medetomidine
      premedication prolonged propofol anaesthesia in dogs. Propofol alone reduced
      blood pressure and transiently raised heart rate. The apnoea and hypoxaemia
      induced by propofol alone also occurred in the premedicated groups with
      hypoxaemia being most evident in the medetomidine/propofol group. Bradycardia was
      a common feature in all the dogs given xylazine or medetomidine, but hypertension
      was consistently recorded in all the dogs given medetomidine.

PMID- 8488650
TI  - Microsporum canis infection in sheep.

PMID- 8488651
TI  - Chlamydia psittaci infection in sheep in Northern Ireland.

PMID- 8488652
TI  - Dirty cattle.

PMID- 8488653
TI  - Epileptiform seizure in ewes associated with sheep scab mite infestation.

PMID- 8488654
TI  - Future of veterinary education.

PMID- 8488655
TI  - Canine leishmaniasis.

PMID- 8488656
TI  - Casualty slaughter.

PMID- 8488657
TI  - Report backs central meat hygiene agency.

PMID- 8488658
TI  - Experimental transmission of BSE and scrapie to the common marmoset.
AB  - Two young male common marmosets (Callithrix jacchus) were injected
      intracerebrally and intraperitoneally with a crude brain homogenate prepared from
      a cow with bovine spongiform encephalopathy (BSE). Two other marmosets were
      similarly injected with brain homogenate from a sheep with natural scrapie. The
      two animals injected with scrapie material developed neurological signs 38 and 42
      months after injection and the two animals injected with BSE material developed
      neurological signs after 46 and 47 months. Post mortem examination of the brains
      revealed spongiform encephalopathy especially in the basal nuclei and
      diencephalon of all the animals and, in addition, involvement of the cerebral
      cortex of the marmosets injected with scrapie material. The experiment extends
      the host range of experimental BSE to include a primate species.

PMID- 8488659
TI  - Influence of feeding patterns on the artificial infection of laying hens with
      Salmonella enteritidis phage type 4.
AB  - Salmonella enteritidis phage type 4 was recovered significantly more frequently
      from the crops of birds which had been denied food for 24 hours than from birds
      allowed food ad libitum. There was, however, no difference in its isolation rate
      from tissues. Within one hour of infection, S enteritidis could be recovered from
      a variety of tissues, including the oviduct, of a small proportion of the
      infected birds.

PMID- 8488660
TI  - Treatment of ovine toxoplasmosis with a combination of sulphamezathine and
      pyrimethamine.
AB  - Experimentally induced toxoplasmosis in pregnant ewes was treated with a
      combination of sulphamezathine and pyrimethamine. Fifteen untreated ewes gave
      birth to 14 live and six dead lambs whereas all the 15 lambs born to the 12
      treated ewes were viable. The placental lesions were less severe, the gestation
      period was longer and the precolostral antibody titres to Toxoplasma gondii were
      lower, all significantly, for the lambs born to the treated ewes.

PMID- 8488661
TI  - Systemic aspergillosis in a dog.
AB  - Systemic aspergillosis was diagnosed in a two-and-a-half-year-old spayed German
      shepherd dog which had suffered an acute attack of paralysis of the pelvic limbs.
      The neurological deficits were attributed to the destruction of the seventh
      vertebral body and the intervertebral disc, with protrusion of necrotic material
      into the vertebral canal and compression of the spinal cord at this level.
      Microscopically, fungal invasion and destruction of the body of T-7 was observed
      and Aspergillus species were identified. Fungal granulomas were also found in the
      liver, lung, spleen and mesenteric lymph nodes.

PMID- 8488662
TI  - Congenital pure red blood cell aplasia (Diamond-Blackfan anaemia) in a dog.

PMID- 8488663
TI  - Efficacy of moxidectin against an ivermectin-resistant strain of Ostertagia
      circumcincta in young sheep.

PMID- 8488664
TI  - Bovine deaths associated with ammoniated straw.

PMID- 8488665
TI  - Encephalomalacia in first-week chicks.

PMID- 8488666
TI  - Bovine embryo transfer.

PMID- 8488667
TI  - Infected feline papilla.

PMID- 8488668
TI  - Magnetic resonance imaging in the diagnosis of degenerative lumbosacral stenosis
      in four dogs.
AB  - Magnetic resonance imaging was used to diagnose degenerative lumbosacral stenosis
      in four dogs that had physical and neurologic signs consistent with a cauda
      equina lesion. Nerve root displacement by protruding disc material and loss of
      epidural fat were identified. In all dogs, the diagnosis was confirmed by dorsal
      laminectomy of the lumbosacral area.

PMID- 8488669
TI  - Internal skeletal fixation using a Kirschner apparatus for stabilization of
      fracture/luxations of the lumbosacral joint in six dogs. A modification of the
      transilial pin technique.
AB  - A technique using a modification of the transilial pin technique for
      stabilization of fracture/luxations of the lumbosacral joint was performed in six
      dogs. This technique used an internal skeletal fixator composed of two transilial
      pins secured with two double fixator clamps. Collapse (shortening) of the seventh
      lumbar vertebra (L7) was observed in five dogs without compromise of the
      vertebral canal. Kirschner wires placed across the articular facets as
      supplemental fixation devices migrated to the subcutaneous tissues in two dogs
      and were easily removed. Migration of the internal fixators was not observed
      during healing; vertebral canal dimensions were maintained in all cases, and the
      internal fixators were not removed after resolution of fracture healing. All
      fractures were healed within 6 to 12 weeks of surgery without evidence of pain,
      neurologic impairment, or long-term complications.

PMID- 8488670
TI  - Vascular and morphologic changes in canine femora after uncemented hip
      arthroplasty.
AB  - The effects on femoral remodeling of medullary reaming and insertion of a porous
      endoprosthesis in uncemented hip arthroplasty (UHA) were measured. A unilateral
      hip hemiarthroplasty (HA) was performed in 12 dogs, with six dogs receiving full
      sized and six dogs receiving undersized femoral endoprostheses. A prosthetic head
      and neck, or acetabular cup, was not implanted. A control group of six dogs
      underwent femoral head and neck excision (FHNE) only. All dogs were killed 4
      weeks after the surgical procedure. Porosity, vascularity, and bone formation
      were quantified in each femur of the dogs that had been operated on and in each
      femur of two unoperated dogs. Full-sized did not differ from undersized HA bones
      in vascularity, porosity, or bone formation. Femurs in which hemiarthroplasties
      had been performed (full-sized and undersized) had a three-fold increase in
      porosity, vascularity, and bone formation compared to the contralateral and the
      FHNE femurs. Changes in porosity and vascularity were greatest (p < .05) at the
      metaphyseal level and in the medial and caudal quadrants. There was a strong
      correlation (R2 0.77 to 0.93, and p = .0001) between the increase in porosity and
      vascularity. These results support the hypothesis that medullary reaming followed
      by uncemented prosthetic stem implantation contribute to remodeling of the
      proximal portion of the femur after UHA.

PMID- 8488671
TI  - Bacterial isolates from blood cultures of dogs undergoing dentistry.
AB  - Bacteria in blood cultures in 30 dogs undergoing high-speed dental scaling and
      tooth extraction were examined. One or more positive blood cultures were
      identified in 9 of 30 (30%) dogs. Pasteurella spp. were most frequently (5 dogs)
      isolated and were sensitive to ampicillin, penicillin, cephalothin,
      chloramphenicol, tetracycline, amoxicillin with clavulanic acid, and
      sulfamethoxazole with trimethoprim. Two groups of 15 dogs each, anesthetized or
      sedated but not undergoing dental procedures, served as non-dentistry controls.
      There were no significant (p < .05) differences between the number of positive
      cultures in dentistry and non-dentistry groups. In healthy dogs undergoing high
      speed dental scaling and tooth extraction, the occurrence of bacteria in blood
      cultures was much lower than previously reported. The clinical significance of
      positive blood cultures was uncertain.

PMID- 8488672
TI  - The effect of hyperbaric oxygen treatment on a compromised axial pattern flap in
      the cat.
AB  - A pedicle skin flap based on the caudal superficial epigastric artery was created
      in 12 cats. The artery was ligated and the vein left intact. Six cats were
      treated with hyperbaric oxygen at 2 atm absolute for 90 minutes daily for 14
      days, starting the day after surgery. Skin flap color was significantly better in
      the treated cats on days 1, 2, and 3. The amount of exudate was significantly
      less in the treated cats on day 3. There was no difference in the amount of
      swelling between treated and nontreated control cats. Although five of six of the
      treated cats had 100% skin flap survival, there was no significant difference in
      total flap survival between treated and nontreated control cats.

PMID- 8488673
TI  - Evaluation of an omental pedicle extension technique in the dog.
AB  - A two-step omental pedicle extension technique was performed on 10 dogs. Step 1
      of the pedicle extension involved release of the dorsal leaf of the omentum from
      its pancreatic attachment, whereas step 2 consisted of an inverse L-shaped
      incision to double the length of the pedicle. The pedicle dimensions were
      measured and the distance reached when extended toward the hind limb, forelimb,
      and the muzzle recorded after each stage of the procedure. The vascular patency
      of the pedicle was determined by intravenous injection of fluorescein dye after
      the second stage of omental extension. Mean pedicle lengths were 44.5 cm with the
      first stage of extension and 82.0 cm after full extension. The mean width at the
      caudal extent of the pedicles after dorsal and full extension was 30.4 cm and
      17.2 cm, respectively. Eight of the 10 pedicles were patent after full extension.
      The fully extended omental pedicles reached and, in most cases, extended beyond
      the distal extremities and the muzzle. The findings in this study suggest that
      the canine omentum can be extended to any part of the body without being detached
      from its vascular supply.

PMID- 8488674
TI  - A retrospective study of inguinal hernia in 35 dogs.
AB  - Inguinal hernia was associated with trauma in five dogs and was considered
      nontraumatic in 30 dogs. There were 11 males, 13 intact females, and six spayed
      females with nontraumatic inguinal hernia. Six dogs had bilateral hernias. Five
      dogs were younger than 4 months at the time of diagnosis. In 11 older dogs with
      nontraumatic inguinal hernia, the hernias were identified less than 7 days before
      surgical repair; in 14 older dogs, the hernias had been recognized for 1 to 60
      months. Clinical signs in dogs without small intestinal incarceration were
      usually limited to a visible or palpable mass without pain or systemic illness.
      Herniorrhaphy approaches included inguinal, midline with contralateral ring
      evaluation, and celiotomy with or without inguinal exposure. Fat and omentum were
      the most common hernial contents. Small intestine was within the hernias of 12
      dogs. Six dogs had nonviable small intestine. Postoperative complications
      included two incisional infections, one incisional dehiscence, two cases of
      peritonitis and sepsis associated with bowel leakage after intestinal resection
      and anastomosis, and one hernia recurrence. The overall prevalence of
      postoperative complications was 17%, and the mortality rate was 3%. Vomiting for
      2 to 6 days was predictive of nonviable small intestine. Dogs younger than 2
      years were at 11 times greater risk for nonviable small intestine than dogs older
      than 2 years. Four of five dogs with nontraumatic inguinal hernia and nonviable
      small intestine were intact males, whereas none of 13 intact females were
      affected. Only one of 14 dogs with longstanding hernias had nonviable small
      intestine.

PMID- 8488675
TI  - Magnetic motor evoked potentials for assessing spinal cord integrity in dogs with
      intervertebral disc disease.
AB  - Magnetically elicited transcranial motor evoked potentials (MEPs) were studied in
      37 dogs with type 1 intervertebral disc (IVD) disease. The waveforms were
      recorded from both cranial tibial muscles before and after surgery. The latencies
      and amplitudes obtained were compared to those of a control population (n = 14).
      MEPs were recordable in all dogs with mild or no neurologic deficits, but they
      were recordable in only 50% of ambulatory dogs that were severely ataxic. MEPs
      could not be elicited from nonambulatory dogs. There was a significant
      attenuation of the amplitudes in all clinical cases, even if the dogs
      demonstrated back pain alone. Significantly prolonged latencies were associated
      with neurologic deficits. MEPs were not good predictors of neurologic recovery.
      The responses obtained from the side where the disc material was found were not
      different from those recorded from the opposite side. MEPs were very sensitive to
      lesions of the spinal cord, as indicated by the significant changes in the waves
      in patients with mild or no neurologic deficits and in the loss of response in
      dogs that still demonstrated purposeful movement. Neurologic exams provided more
      accurate diagnoses and prognoses than did MEPs in dogs with IVD disease.

PMID- 8488676
TI  - Partial arytenoidectomy in the horse using an extralaryngeal approach.
AB  - An extralaryngeal approach to partial arytenoidectomy in the horse was developed
      by in vitro experiments on isolated larynges and then on intact equine cadavers.
      The goals of the approach were to preserve the laryngeal mucosa, eliminate the
      need for a laryngotomy or tracheotomy, and minimize postoperative complications.
      The new approach was evaluated in seven horses with normal upper respiratory
      tracts. Left laryngeal hemiplegia was surgically created, and, after a 30-day
      convalescence, left partial arytenoidectomy was performed using an extralaryngeal
      approach. The left-to-right hemilaryngeal ratio was calculated before and after
      left recurrent laryngeal neurectomy and 60 days after partial arytenoidectomy.
      Left partial arytenoidectomy was successfully completed in all horses without
      performing a laryngotomy or tracheotomy. Preservation of the laryngeal mucosa
      (6/7 horses) and apparent stabilization of the adjacent soft tissue (6/7 horses)
      was achieved. In one horse, a 1-cm laryngeal mucosal tear healed without
      complication, and in another some collapse of adjacent soft tissue occurred when
      a retention suture failed. The mean left-to-right hemilaryngeal ratio was
      significantly increased compared to horses with left laryngeal hemiplegia, but it
      remained significantly less than the pre-recurrent laryngeal neurectomy ratio (p
      < .05). Coughing, aspiration, and airway narrowing were not observed. Partial
      arytenoidectomy could be reliably performed through an extralaryngeal approach in
      horses with a normal underlying arytenoid cartilage with preservation of the
      laryngeal mucosa.

PMID- 8488677
TI  - Incarceration of the small intestine in the epiploic foramen. Report of 19 cases
      (1983-1992).
AB  - The medical records of 19 horses referred for colic and subsequently found (18
      confirmed, 1 suspected) to have small intestinal incarceration through the
      epiploic foramen were reviewed. These horses were of various ages and breeds;
      they had clinical signs of colic for an average duration of 13.5 hours before
      examination. Seventeen horses had nasogastric reflux, and 15 had palpable small
      intestinal distention. Three horses were killed during surgery because of severe
      intestinal damage. Of the remaining 16 horses, 13 required intestinal resection
      and anastomosis. The length of incarcerated small intestine varied from 8 cm to
      17.6 m. The ileum was involved in 12 cases. In one horse, the mesoduodenum was
      disrupted before surgery, causing intra-abdominal bleeding; incarceration of
      bowel was not found during surgery. The short-term (1 month) survival rate was
      74% (14 of 19 cases), and the long-term survival rate was 63% (12 of 19 cases).
      The follow-up period was 3 months to 45 months (mean 17.2 +/- 7.2 months).

PMID- 8488678
TI  - Rectal and colonic injury in the llama. Anatomic considerations and surgical
      management in four llamas.
AB  - Transrectal palpation in llamas can result in iatrogenic rectal and colonic
      injury. The purpose of this report is to define the caudal extent of the
      peritoneal cavity in llamas and to describe the surgical management of rectal or
      colonic injuries in four llamas. Measurements were made of six adult llamas
      during necropsy. The mean distance from the peritoneal reflection to the anus was
      3.9 +/- 0.1 cm (3.4-4.3 cm). Four llamas were examined for rectal or colonic
      perforations. One laceration was of partial thickness and three lacerations were
      of full thickness. Two of the defects were repaired by a transanal approach and
      two by celiotomy to facilitate removal of fecal debris and abdominal lavage.
      Successful repair of the rectal or colonic tears was achieved in all four llamas.
      Wound infection and incisional hernia occurred in both llamas that underwent
      celiotomy. Two llamas died 3 and 18 months later, and two llamas have survived 2
      years. Rectal tears in llamas are accompanied by a high risk of peritoneal
      contamination, and primary closure is recommended. If fecal contamination of the
      abdomen has occurred, celiotomy is indicated to allow mechanical removal of fecal
      debris and peritoneal lavage.

PMID- 8488679
TI  - Thiamylal-sparing effect of midazolam for canine endotracheal intubation. A
      clinical study of 118 dogs.
AB  - One hundred eighteen dogs were studied at three veterinary teaching hospitals
      after the administration of midazolam (0.1 mg/kg, intravenously [IV]) or a
      placebo. Midazolam and placebo treatments were randomized and blinded to the
      investigators. The dose of thiamylal required for tracheal intubation 3 to 5
      minutes after midazolam or placebo was calculated. The dose of thiamylal at the
      three hospitals was 10.6, 9.8, and 10.1 mg/kg i.v. after midazolam, and 12.1,
      11.2, and 11.6 mg/kg i.v. after placebo. Pooled data from the three hospitals
      yielded a significant (p < .001) decrease in mean IV thiamylal dose after
      midazolam (10.2 mg/kg) compared with placebo (11.6 mg/kg). Overall, there was a
      12% decrease in the dose of thiamylal required for tracheal intubation after
      midazolam compared to that after the placebo. The thiamylal dose was
      significantly (p < .001) decreased after midazolam compared with placebo for dogs
      weighing more than 15 kg but not for dogs weighing less than 15 kg.

PMID- 8488680
TI  - Closed-circuit liquid injection isoflurane anesthesia in the horse.
AB  - Six horses were administered isoflurane anesthesia by liquid injection into a
      closed breathing circuit according to the square root of time model. The unit
      dose (UD) was calculated using Lowe's formula to provide an end-tidal
      concentration of 1.3%, or the minimum alveolar concentration of isoflurane. The
      mean UD was 4.2 +/- 0.2 mL. The mean end-tidal isoflurane concentration (ETiso)
      for each interval after injection, and the peak and minimum concentrations for
      each injection interval, did not change beginning with the second injection,
      indicating that the square root of time model accurately predicted isoflurane
      uptake in the horse. Mean ETiso measured for the interval after the first
      injection was 0.68 +/- 0.06%, which was significantly (p < .05) lower than the
      mean concentration after all subsequent injections (1.1 +/- 0.1%). Mean peak end
      tidal concentration was 1.1 +/- 0.25% after the first injection and 1.7 +/- 0.26%
      for all other injections. Mean minimum end-tidal concentration was 0.77 +/- 0.13%
      for all injection periods. This model proved to be an acceptable technique for
      administration of isoflurane anesthesia to horses.

PMID- 8488681
TI  - Pulsus alternans during halothane anesthesia in a dog.
AB  - An adult dog with pyloric obstruction was anesthetized with thiamylal and
      halothane for surgical revision. When an ECG was attached, the QRS-complex rate
      was noted to differ dramatically from the peripheral pulse rate. A dorsal pedal
      arterial catheter was introduced, and direct arterial pressure measurements
      revealed a blood pressure waveform that alternated in amplitude. Blood pressure
      and ECG traces were recorded, and the condition was diagnosed as pulsus
      alternans. The inhalation anesthetic was changed to isoflurane, and the condition
      was resolved.

PMID- 8488682
TI  - Radiofrequency catheter ablation for recurrent ventricular tachycardia.
AB  - Since 1989, six patients have presented to the Charleston Area Medical Center
      (CAMC) with ventricular tachycardia and no underlying structural heart disease.
      Three patients were managed with antiarrhythmic medications, and three others
      underwent a successful catheter ablation procedure. This article describes the
      case of one of these three patients who underwent catheter ablation.

PMID- 8488683
TI  - Choroidal metastasis from primary mucinous cystadenocarcinoma of the ovary.
AB  - Central nervous system metastases are uncommon in epithelial carcinoma of the
      ovary; and metastases to the eye are even more rare. This article describes what
      is believed to be only the third case reported of epithelial carcinoma of the
      ovary metastatic to the eye.

PMID- 8488684
TI  - A different perspective on obstetrical data.

PMID- 8488685
TI  - [Comparison of two long-acting theophylline preparations in daily evening
      administration].
AB  - The therapeutic value of a sustained-release theophylline preparation (Theospirex
      retard 300 mg) with administration of the daily dose once a day in the evening
      compared to the 2 x 1 dosage usual was investigated in 19 patients suffering from
      asthma symptoms manifested mainly at night. In this open randomized clinical
      trial, a sustained-release theophylline preparation (400 mg) which had already
      been used for administration once a day in the evening served as reference
      preparation. The single dose in the evening for both preparations was 600 mg pure
      theophylline. Target parameters were the level of theophylline in the blood, the
      pulmonary function, symptoms of asthma, and the tolerance of the two sustained
      release drugs. The theophylline serum levels after 13 respectively 22 hours were
      12.44 and 6.98 micrograms/ml for the reference drug and 11.72 and 7.11
      micrograms/ml for Theospirex retard. Equivalence of the two drugs was shown in
      the parameters pulmonary function, symptoms of asthma and tolerance. This study
      shows that 300 mg Theospirex retard film-coated tablets are suitable for a single
      administration of the entire daily dose in the evening.

PMID- 8488686
TI  - [Factor XII (Hageman factor) deficiency: a risk factor for development of
      thromboembolism. Incidence of factor XII deficiency in patients after recurrent
      venous or arterial thromboembolism and myocardial infarction].
AB  - 103 patients suffering from recurrent venous thrombosis, recurrent arterial
      thromboembolism and/or recurrent myocardial infarction and 50 healthy subjects
      were tested for Hageman factor (F XII) coagulant activity and antigen. Among the
      103 patients we identified 15 subjects with F XII deficiency (15%), 3 with
      protein C deficiency (3%) and 3 with protein S deficiency (3%). Combined F XII
      and protein C, protein S or antithrombin III deficiency was not observed. The 103
      patients were divided into subgroups according to the type of thrombotic
      complication. Among patients with exclusively recurrent venous thromboembolism 8%
      (p = 0.153) were deficient in F XII. Among patients suffering from recurrent
      arterial thromboembolism and/or myocardial infarction, the incidence of F XII
      deficiency was significantly higher (20%, p < 0.003). In 67% of the patients with
      F XII deficiency a positive family history of thrombosis could be established. In
      contrast, only 32% (p = 0.043) of all venous and 28% (p = 0.019) of all arterial
      thrombosis patients had a positive family history. We believe that reduced levels
      of F XII should be considered as a risk factor in the development of
      thromboembolism. Consequently, more attention should be payed to the measurement
      of F XII when evaluating thromboembolic risk factors especially in cases of
      recurrent arterial thromboembolism and/or myocardial infarction.

PMID- 8488687
TI  - [Animals--humans, the physician and ethics].
AB  - Ethics and humanitarianism are indivisible. They have to refer to the entire
      animated and inanimate environment likewise. This has moral as well as essential
      ecological consequences which are of special actuality at present, with mankind
      being on the verge of total ecological self-destruction. Key-word: eco-ethics.
      The worship of the Golden Calf by name of economic growth has to be replaced at
      last by an acceptance of "shrinking into recovery". Unfortunately, human cruelty
      is not to be confined to the historical past of the Third Reich, but becomes
      evident continuously before our very eyes. To shut one's eyes to it is a tendency
      as widespread as the habit of averting one's eyes from avoidable man-made
      suffering of animals. We need better education and enlightenment (in the sense of
      resistance at the very beginning), better control and better execution of better
      regulations. The health professions, together with educational, ecclesiastical
      and military professions are called upon to direct attention to this aspect of
      moral hygiene.

PMID- 8488688
TI  - [Gender-specific attitude and behavior in dealing with AIDS. Summary of important
      results].

PMID- 8488689
TI  - [Comment on A. Hecht: causality and illness].

PMID- 8488690
TI  - [Sense and possibilities of prevention in advanced age: psychosocial aspects].
AB  - Cardiovascular diseases have multifactorial causes, as has been shown, and as has
      been demonstrated via an interactional model. These multifactorial causes must be
      counteracted by means of multidimensional preventive or rehabilitation measures.
      Intervention in cardiovascular patients requires interdisciplinary cooperation.
      Studies conducted so far on rehabilitation of cardiovascular patients have rarely
      included persons over 60 years of age. This may be explained in part by a poor
      image of elderly people that exists in the minds of many, discouraging
      intervention as hardly promising and hence useless. However, persons of an
      advanced age in particular stand greatly in need of being factually informed at
      an early date by the physician; such information has a significant influence on
      the way they can experience and cope with the disease. They must be placed in a
      position to realise the existing possibilities and limitations to influence their
      status by means of their attitude, and to look to the future. Successful
      (secondary) preventive care of elderly persons must also include physical
      training (kinesitherapy) and psychological aspects when changing dietary habits.
      On the whole, we are still in need of more research on the problem of possible
      interventions in cardiovascular patients in general and aged patients in
      particular. The results of psychological fundamental research in gerontology and
      intervention supply only few pointers to combatting cardiovascular disease in the
      elderly. It is however emphasised that psychological measures can merely
      supplement the medical ones, such supplementation having become so important by
      now that one should practically not do without it any longer.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8488691
TI  - [Therapy of Wegener's granulomatosis. Experiences with conventional and stage
      adjusted treatment in 111 patients over 24 years].
AB  - Treatment and outcome of 111 patients who fell ill with Wegener's granulomatosis
      (WG) between 1966 and 1990 were analysed retrospectively. The mean observation
      time after diagnosis had been 47 (1-288) months. At the time of diagnosis 37
      patients suffered from locoregional symptoms only, whereas the disease was
      generalised in 74 patients. Two regimes of treatment were differentiated:
      "conventional" treatment, i.e. daily application of cyclophosphamide/prednisolone
      (FAUCI scheme) or azathioprine/prednisolone or prednisolone alone, and "stage
      adapted" treatment, characterised by change of different treatments (e.g.
      cyclophosphamide pulse therapy, cotrimoxazole) according to the extent and
      activity of disease. In patients who received stage-adapted treatment, relapses
      occurred significantly more frequently than in conventionally treated patients.
      On the other hand, lethal outcome was much more frequent in conventionally
      treated patients.

PMID- 8488692
TI  - [Gestosis, thrombophilia and pulmonary embolism in a primipara with twin
      pregnancy].
AB  - This is a case report on a course of gemini-pregnancy complicated by gestosis,
      recurrent submassive pulmonary embolism and discordant growth of the hypotrophic
      twins. It is concluded from this report that: 1. the AT-III-deficiency in
      gestosis can be caused by loss and consumption; 2. due to decrease below a
      critical AT-III-level the coagulation-fibrinolysis system tends to decompensate,
      reflected in a disseminated intravascular coagulation and/or a pulmonary
      embolism. The tendency consists particularly in immobilisation and stasis; 3. the
      daily determination of AT III, better of TAT-complex and D-dimer, the daily
      clinical examination regarding signs of thrombosis and in cases of heparinization
      the measurement of PTT several times daily, are necessary to avoid or recognise
      disorders, of the coagulation-fibrinolysis-system at an early stage. 4. The
      increased consumption in coagulation systems can be avoided by AT-III
      substitution and correct heparinisation. 5. In cases of risk of pulmonary
      embolisation in pregnancy a cava filter should be temporarily implanted. The
      filter must be changed every 3 days, if it is required for a longer period. 6. In
      high-risk pregnancy the check for factors of thrombophilia is a basic diagnostic
      procedure.

PMID- 8488693
TI  - [Osteomalacia caused by malabsorption].
AB  - Reports on sickness osteomalacia are relatively rare in Europe. Distinction from
      other painful illnesses of the locomotor system is difficult. A case of
      osteomalacia has been reported which was caused by a primarily biliary cirrhosis
      of the liver as well as by chronic cholecystitis and pancreatitis.

PMID- 8488694
TI  - [Autogenic training in hypertensive dysregulation after aortocoronary venous
      bypass operation of coronary heart disease].
AB  - The authors report on the influence of autogenous training on blood pressure at
      rest and under stress conditions in patients with coronary heart disease
      following coronary bypass operation. We investigated the influence of autogenous
      training on the microcirculation and the left ventricular ejection fraction
      (LVEF) as well. The results showed a significant decrease in blood pressure at
      rest and also an increase of muscle circulation F and of LVEF.

PMID- 8488695
TI  - [General practice-oriented curriculum of the 19th century].
AB  - Clinical teaching, partly based on the examination and treatment of outpatients,
      became more and more common at the universities of the end of the 18th century,
      thus prompting the setting up of so-called "teaching hospitals" forming part of
      the university concerned and specialising in the disciplines of internal
      medicine, surgery and obstetrics. This phase of practice-oriented teaching
      progressed only slowly because of locally different basic conditions and
      activities. Occasionally it took decades help of communal and private
      institutions when setting up such teaching facilities. This development is
      explained taking the University of Halle in the early 19th century as an example.

PMID- 8488696
TI  - [Vertigo as the main symptom. Diagnosis and therapy from the neurologic
      viewpoint].
AB  - Vertigo is very often an unspecific symptom. The author differentiates between
      vestibular or systematic vertigo and non-vestibular or unsystematic vertigo. The
      diseases of the central vestibular system are described. Not only the special
      diagnostic methods (e.g. electronystagmography) but also the anamnesis and simple
      clinical investigation are presented. The overview includes drug therapy and
      physical therapy of vertigo from a neurological point of view.

PMID- 8488697
TI  - Vaccines and the military.

PMID- 8488698
TI  - Space flight and the immune system.
AB  - Depression of lymphocyte response to mitogens in cosmonauts after space flight
      was reported for the first time in the early 1970s by Soviet immunologists. Today
      we know that depression of lymphocyte function affects at least 50% of space crew
      members. Investigations on the ground on subjects undergoing physical and
      psychological stress indicate that stress is a major factor in immune depression
      of astronauts. This is despite the fact that weightlessness per se has a strong
      inhibitory effect on lymphocyte activation in vitro. Although the changes
      observed never harmed the health of astronauts, immunological changes must be
      seriously investigated and understood in view of long-duration flight on space
      stations in an Earth orbit, to other planets such as Mars and to the Moon.

PMID- 8488699
TI  - Mechanisms of immune failure in burn injury.
AB  - The burden on military medical services in handling burn casualties is daunting
      as all physiological systems become affected. Severe burns in a battlefield
      setting have a very low salvage rate, to a great degree because of the immune
      failure which invariably develops. Evaluations of responses of lymphocytes taken
      from burn patients over several weeks following the burn (> 30% total burn
      surface area), have revealed that the immune failure which follows thermal injury
      involves T-cell activation events. Interleukin 2, which is normally produced by
      activated T lymphocytes, is very poorly produced by cells cultivated in vitro
      taken from non-surviving patients, whereas some production continues, although at
      below normal levels, in patients who ultimately survive their injury. IL2
      exogenously added to lymphocyte cultures enhances the proliferation of cells from
      surviving patients but gives no such help to cells from non-survivors. The TAC
      portion of the IL2 receptor (IL2R alpha), expressed on the T-cell surface,
      appears to be responsible for this difference, as the number of lymphocytes able
      to express IL2R alpha falls post-burn. A lipid protein complex (LPC) produced in
      skin by burning has been shown to inhibit the immune response in vivo and the
      growth of IL2-dependent lymphocytes in culture. Cerium nitrate, applied topically
      to the burn patient, is thought to fix the LPC in the burn eschar and prevent its
      entry into the circulation. In a study of ten patients, bathed in cerium nitrate,
      some T-lymphocyte activities were found to be in the normal range rather than
      suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488700
TI  - Clinical types of HBsAg-positive hepatitis.
AB  - Hepatitis B is a parenterally and sexually transmitted disease of global
      importance. It associates with hepatitis D in a consistent proportion of cases.
      The disease most frequently runs a subclinical and anicteric course, with a
      significant number of cases that become chronic. Chronic hepatitis may progress
      to cirrhosis or cancer. The strategies by which hepatitis B and hepatitis D can
      be diminished and eventually eliminated are: immunization, measures to prevent
      exposure to infective blood or blood derivatives and education (in particular
      awareness that hepatitis B is a sexually transmitted disease).

PMID- 8488701
TI  - Viral hepatitis in the US Air Force, 1980-1989.
AB  - Viral hepatitis and its acute and chronic complications continue to pose
      significant threats to the readiness of military personnel. Knowledge about the
      specific viral agents and their routes of transmission are important in
      developing prevention strategies. A recent analysis of hepatitis in the US Navy
      for the period 1975-1984 is reviewed. In order to better characterize the risk of
      viral hepatitis among US Air Force personnel, a comprehensive review of inpatient
      and quarters data for hepatitis A, B and 'non-A, non-B' were reviewed from Air
      Force medical treatment facilities worldwide for the period 1980-1989. Following
      a discussion of the study methodology, preliminary data and hepatitis type
      specific demographic risk variables are discussed. Preliminary results from a
      hepatitis serosurvey (A, B and C antibody with use of a supplemental validating
      assay) of the subset of the study cohort who are currently on active duty are
      briefly reviewed.

PMID- 8488702
TI  - Vaccination against hepatitis B: the Italian strategy.
AB  - Viral hepatitis B, which is a major health problem worldwide, is endemic in
      Italy. In response to this, vaccination became compulsory in 1991. Vaccine is
      administered to neonates and 12-year-old adolescents; in 12 years time, all
      Italians under the age of 24 will be immune to HBV.

PMID- 8488703
TI  - HIV infection in the nineties.
AB  - By the year 2000 a cumulative global total of 30-40 million men, women and
      children are projected to have been infected with HIV. This will represent a
      three to four times increase of the present total. Currently, it is estimated
      that about 5000 persons are newly infected daily. Worldwide, the predominant and
      increasing mode of transmission is by heterosexual intercourse. Therefore, the
      number of infected women will equal that of men. Consequently, more infants will
      be infected by their mothers and more infants will be orphaned as their parents
      die of AIDS. By the end of the 1990s, over one million adult AIDS cases and
      deaths per year are expected, most of them in developing countries. Although the
      majority of HIV infections are currently occurring in sub-Saharan Africa, the
      annual number of HIV infections in Asia is projected to exceed that in Africa
      during the 1990s. Also, in industrialized countries, the proportion of
      heterosexual transmission is increasing, and AIDS is becoming one of the
      predominant causes of death in young men and women. In spite of promising
      scientific progress, vaccines and therapeutic drugs are not expected to have any
      major impact on the global development of the pandemic during the 1990s. WHO is
      promoting behavioural changes, condom use and control of other sexually
      transmitted diseases as the most important preventive measures.

PMID- 8488704
TI  - AIDS/HIV in the US military.
AB  - HIV infection (AIDS) burst upon the scene a decade ago. Because it is a sexually
      transmitted disease that infects blood and kills its victim, it is military
      relevant and will impact on all aspects of the military. The US Army Medical
      Research and Development Command as 'Lead Agent for Infectious Disease Research'
      in the Department of Defense has developed a comprehensive approach to address
      military concerns: surveillance of infection rates (intelligence) around the
      world and in the military; behavioural research to develop more effective means
      of education to change behaviour; and biological research to develop a quick and
      easy field test, and a vaccine or drug to prevent the disease from occurring
      despite exposure. Its success will influence the success of the Army in the
      future.

PMID- 8488705
TI  - Estimates of human immunodeficiency virus (HIV) incidence and trends in the US
      Air Force.
AB  - The results of HIV screening between early 1986 and February 1991 in the United
      States Air Force are presented. In this period, two total-force screenings were
      conducted. HIV incidence estimates are presented by age, ethnicity/race, sex and
      occupational category.

PMID- 8488706
TI  - Silent HIV infection.
AB  - The period of latency between infection by the human immunodeficiency virus type
      1 (HIV-1) and the production of specific antibodies to viral antigens may be
      prolonged and, occasionally, may last for years. This condition of seronegative
      infection could represent a serious risk of viral transmission from subjects who
      are unaware of their status. However, whether these individuals are actually
      infectious, especially through body fluids, has not been clarified. We have
      performed a prospective study in 65 high-risk individuals seronegative for HIV-1
      antibodies for a prolonged period of time. Twelve of them (18%) were shown to be
      carriers of HIV-1 proviral sequences by the polymerase chain reaction (PCR). The
      virus was isolated from mitogen-stimulated peripheral blood lymphocytes in five
      out of ten subjects tested since the first positive PCR. In two of them, virus
      could also be isolated from cell-free plasma, subsequently they remained
      seronegative during 10 months of follow-up. These data indicate that delayed
      seroconversions may be associated with productive infection, suggesting that
      mechanism(s) other than viral latency may be responsible for the absence of
      antibody responses to HIV-1 proteins. Furthermore, our findings suggest that
      prolonged seronegative individuals can transmit HIV infection through their body
      fluids.

PMID- 8488707
TI  - HIV variability and perspectives for a vaccine.
AB  - An overview of efforts to induce neutralizing antibodies in order to develop an
      effective vaccine against AIDS is presented. The principal Neutralizing
      Determinant (PND) on the HIV-1 envelope is described. PND variability and the
      induction of neutralizing antibodies by synthetic peptides representing PND are
      discussed. The use of a cocktail of different peptides representing the PND
      sequences of the majority of HIV-1 isolates, as well as the construction of
      hybrid immunogens containing PND of several viral isolates, could overcome the
      problems related to PND variability. A different approach based on the
      possibility of inducing a type of intracellular immunity is also discussed: a
      cellular clone (F12) obtained in our laboratory from Hut-78 cells infected with
      supernatant of cultured lymphocytes from an HIV-infected patient, does not
      release viral particles despite the presence of a full-length HIV-1 provirus.
      Moreover, F12 cells are fully resistant against superinfection with any HIV-1 or
      HIV-2 isolates. We are now attempting to reproduce the homologous viral
      interference by transferring the F12/HIV genome of the clone into HIV-susceptible
      cells in order to render these cells resistant to HIV infection.

PMID- 8488708
TI  - Immunological parameters in current and former US Air Force personnel.
AB  - As part of a comprehensive study of current and former US Air Force personnel, an
      extensive assessment of the immune system of 497 normal male subjects was
      conducted in 1987. Cell surface marker studies for CD2 (total T cells), CD4
      (helper T cells), CD8 (suppressor T cells), CD25 (activated T cells), CD20 (total
      B cells), CD14 (monocytes), and HLA-DR positive cell populations were measured.
      The CD4/CD8 ratio was also calculated. Functional stimulation assays were also
      performed using phytohemagglutinin (PHA) and a culture of mixed lymphocytes.
      Assays of natural killer cells with and without interleukin-2 stimulation were
      done. In addition to the distribution and range of values for each assay,
      statistical analyses were performed to determine the effect of age, race,
      percentage body fat, tobacco use and alcohol consumption on each variable. Age
      and alcohol consumption had significant correlation with suppressed counts and
      functions on nearly all variables while tobacco use was associated with
      stimulation of both T-cell numbers and function. These findings highlight the
      importance of using age-specific ranges of normal values for these tests of
      immunity and the need to consider life-style factors in the interpretation of the
      laboratory assessment of immune status.

PMID- 8488709
TI  - Analysis of disease progression from clinical observations of US Air Force active
      duty members infected with the human immunodeficiency virus: distribution of AIDS
      survival time from interval-censored observations.
AB  - A non-parametric estimator of the AIDS survival time (after developing AIDS) is
      computed for the AIDS data set from the US Air Force (USAF). Survival times are
      unobservable. They are censored by the screening mechanism. The Armstrong
      Laboratory's Epidemiologic Research Division maintains data on over 954 active
      duty US Air Force (USAF) individuals who tested positive for human
      immunodeficiency virus (HIV) antibodies. Many have been clinically evaluated
      seven times since 1986. The HIV-positive individual is classified in seven stages
      of the disease complex as time progresses. Exact times of transition from one
      stage to the next are unknown. It is known that transition occurred between two
      consecutive evaluations. The aim of this study is to analyse distributions of the
      times that individuals spend in each stage of the HIV disease complex. We will
      discuss methods used to obtain non-parametric estimators of the distribution of
      times that individuals spend in stage 6. Finally, it is hoped to model the median
      time spent in each stage of the disease. This, along with incidence and
      separation data, will allow the prediction of the impact of HIV disease on USAF
      individuals and medical care systems.

PMID- 8488710
TI  - Relating cognitive function to military aviator performance in early HIV
      infection.
AB  - There has been controversy about whether cognitive changes occur in early human
      immunodeficiency virus (HIV) disease. In those studies reporting cognitive
      changes, these are typically subclinical, and their relationship to daily and/or
      occupational functioning has not been addressed. The potential effects of changes
      may vary as a function of occupational demands. This is germane to military
      performance, where occupational demands cover a wide spectrum of complexity. In
      particular, such effects are important to consider in the many cognitively
      demanding specialties associated with military aviation. This paper will explore
      ways in which possible HIV-related military performance decrements in aviators
      may be measured empirically. First, studies from Walter Reed Army Medical Center
      (WRAMC), which have shown cognitive changes in early HIV disease, will be
      described. This will be followed by a summary of presentations and discussions at
      a conference in November 1990, entitled 'HIV and Military Performance: Assessment
      Methodologies' held at WRAMC. The third section of the paper will describe a
      programme of research, which is developing measures to detect cognitive
      difficulties in civilian aviators. The application of measures from this research
      to research on HIV will be discussed. Finally, a research programme being
      developed to examine the possible impact of HIV-related cognitive changes on
      military aviator performance will be described.

PMID- 8488711
TI  - Neuropsychiatric morbidity in early HIV disease: implications for military
      occupational function.
AB  - The Military Medical Consortium for Applied Retroviral Research Program's
      (MMCARR) Behavioral Medicine Human Immunodeficiency Virus (HIV) Research
      component is conducting a tri-service, comprehensive, and longitudinal research
      study in military HIV-infected personnel at all stages of infection.
      Identification of neuropsychiatric and psychosocial outcomes and their
      determinants will help the military minimize the impact of the HIV epidemic on
      military readiness and function. Neuropsychiatric and psychosocial findings are
      among the most common complications seen in early HIV disease and among the most
      likely to have an adverse impact on military readiness and function. The study
      has demonstrated that the average HIV-infected service person experiences at
      least transient military occupational difficulty following notification of HIV
      status. More than 15% at any given time have levels of clinical or subclinical
      anxiety or depression that are referrable for mental health intervention. Ten per
      cent of study subjects have a current major mood disorder and 5% have a
      psychoactive substance use disorder. Finally, 17% of study subjects have
      experienced serious suicidal ideation or behaviours at least once since
      notification of seropositivity. Fortunately, however, data also indicate at least
      partial effectiveness of current primary, secondary and tertiary preventive
      efforts. Only about 1% of Air Force HIV-infected persons are discharged for
      psychiatric reasons prior to eventual medical discharge. Further, a large
      majority of active-duty patients demonstrate solid military occupational and
      social performance. Though military HIV neurobehavioural research is still in
      progress, preliminary data identify social support and pre-HIV psychiatric
      predisposition as important factors associated with current neuropsychiatric
      status.

PMID- 8488712
TI  - Communicable diseases: a major burden of morbidity and mortality.
AB  - A brief overview of the present situation regarding some of the world's most
      important diseases is given. Particular mention is made of dengue, yellow fever,
      malaria and parasitic diseases. Vaccination is concluded to have a major role in
      combating these diseases.

PMID- 8488713
TI  - Susceptibility in USAF recruits to vaccine-preventable diseases.
AB  - Because of increasing incidence of mumps in a cohort of underimmunized young
      adults and the concern about the impact of this disease on the USAF recruit
      population, two studies were undertaken. These studies took a retrospective look
      at mumps in the active duty population, a cost analysis of immunizing all or only
      susceptible individuals, the actual antibody response in a group of 276 recruits
      in basic training, the demographic patterns of susceptibility and the types of
      previous immunization documentation. The conclusions were that the numbers of new
      mumps cases per year did not justify immunizing all recruits or screening for
      mumps antibodies and only immunizing known susceptibles.

PMID- 8488714
TI  - Absence of protective immunity against diphtheria in a large proportion of young
      adults.
AB  - The schedule of vaccination recommended worldwide for diphtheria, tetanus and
      other diseases, provides good immunity during childhood. However, little
      attention has been paid to effective immunity in adults. We have collected sera
      from 334 Italian Army recruits and tested them for the presence of protective
      immunity against diphtheria and tetanus. In vivo neutralization assays were
      performed on rabbits and mice and values below 1/100 IU ml-1 were considered
      negative. Of the recruits, 22.9% were negative for diphtheria, while only 5.3%
      had no protective immunity against tetanus. This finding shows that a large
      proportion of Italian young adults are susceptible to diphtheria, and this could
      be dangerous if they travel to sites where this disease is still endemic, or if
      they come into contact with people coming from such areas. A booster vaccination
      of young adults against diphtheria should become common practice to avoid this
      risk. To reduce the side effects which are often associated with diphtheria
      vaccination in adults, we have developed a vaccine which contains a highly
      purified, non-toxic mutant of diphtheria toxin. This vaccine is combined with
      tetanus toxoid and can be routinely used as a booster in adults.

PMID- 8488715
TI  - Dramatic reduction of meningococcal meningitis among military recruits in Italy
      after introduction of specific vaccination.
AB  - Meningococcal meningitis is still a serious infectious disease with a mortality
      rate that can be as high as 10% even in developed countries. Military recruits
      are generally a high-risk group for meningococcal disease, with a reported
      incidence of four to ten times greater than that of the general population. In
      Italy the results of the National Meningitis Surveillance Programme showed a high
      attack rate of the disease among recruits in 1985 as well as in 1986, with 92 and
      95% of the cases, respectively, caused by serogroup C and thus preventable. These
      findings led to the authorities' decision to make vaccination against
      meningococcal disease mandatory for recruits starting from January 1987. After
      almost 5 years from the introduction of meningococcal vaccination, we here sum up
      the epidemiological and immunological effects of the vaccination. From the
      epidemiological point of view we have observed a dramatic reduction of the
      prevalence of the disease. In 1987, the year in which we had 150,000 unvaccinated
      and 150,000 vaccinated recruits, the protective efficacy was 91.2%. From the
      immunological point of view, vaccination is highly effective, as seroconversion
      against polysaccharide (PS) A and C is 84 and 91%, respectively. The spectrotypic
      analysis of the sera before and after vaccination shows that the type of response
      is mainly oligoclonal, like the majority of the responses to PSs, and the
      antibodies induced by a sole PS are not qualitatively different from the
      antibodies induced by natural immunization. In addition, the efficacy is not
      modified by environmental factors like hypoxia, as demonstrated during permanence
      at 16,174 feet for 20 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488716
TI  - Clinical and immunological response to typhoid vaccination with parenteral or
      oral vaccines in two groups of 30 recruits.
AB  - The clinical and immunological responses to typhoid vaccination with parenteral
      and oral vaccines in two groups of 30 adult male subjects were studied. Specific
      anti-Salmonella typhi cell-mediated immunity and total or specific anti
      lipopolysaccharide faecal immunoglobulin (Ig) A titres in vaccinated subjects
      were monitored. Cellular antibacterial activity was significantly increased only
      in orally vaccinated subjects. Serum arming activity and inhibition experiments
      suggested an IgA-dependent cellular cytotoxicity in those orally vaccinated. In
      these subjects, a total and anti-lipopolysaccharide faecal IgA increase was
      observed lasting up to 8 months after completion of the vaccination schedule. In
      parenteral vaccinated subjects, an early onset transitory increase of IgM
      rheumatoid factor was observed. Oral vaccine was well tolerated and free of side
      effects, whereas 65% of parenterally vaccinated subjects reported side effects
      such as fever, headache, malaise and local tenderness in the injection site.

PMID- 8488717
TI  - Studies of safety, infectivity and immunogenicity of a new temperature-sensitive
      (ts) 51-1 strain of Salmonella typhi as a new live oral typhoid fever vaccine
      candidate.
AB  - This report describes the results of a phase 1 study evaluating the safety,
      infectivity, and immunogenicity of a new live oral Salmonella typhi temperature
      sensitive (ts) 51-1 typhoid fever vaccine in the human. Three normal male
      subjects aged 23-32 years received three oral doses of S. typhi ts 51-1, each
      dose containing 10(9) organisms. Prior to and following immunization each subject
      was carefully monitored by clinical and laboratory parameters over a 2 week
      period during which serial specimens of blood and stool were analysed for the
      presence of the organism. Blood specimens were also obtained for the
      determination of serum antibody and cell-mediated immune responses and stool
      filtrates were analysed for the development of coproantibody. The results of
      these studies indicate that: (1) the vaccine is well tolerated with no clinical
      or laboratory evidence of adverse reactions; (2) ts 51-1 was detected in only one
      stool specimen from one volunteer; the organism recovered displayed
      characteristics of the ts 51-1 vaccine strain; and (3) although no significant
      humoral or cell-mediated lymphocytotoxic immune responses were detected in the
      blood, coproantibody was detected in stool specimens from all of the three
      immunized subjects and IgA-armed ADCC activity was detected in two of three
      subjects. These studies indicate that S. typhi ts 51-1 may be a suitable strain
      for the development of an improved oral typhoid fever vaccine. Studies are in
      progress to determine optimal methods of vaccine delivery preparatory to large
      phase 2 studies of efficacy.

PMID- 8488718
TI  - Use of novel adjuvants and delivery systems to improve the humoral and cellular
      immune response to malaria vaccine candidate antigens.
AB  - The immune effector mechanisms responsible for the solid protection against
      malaria, as demonstrated by immunization with radiation-attenuated sporozoites,
      are poorly understood. An effective malaria vaccine must induce a well
      orchestrated combination of humoral and cellular immune responses directed
      against critical parasite antigens/epitopes expressed during different stages of
      the parasite's complicated life cycle. Currently licensed human vaccine
      adjuvants, such as alum, may improve antibody production but are poor stimulators
      of cellular effector mechanisms, while potent cellular stimulants such as
      Freund's adjuvant are too reactogenic for human use. Over the last 5 years we
      have systematically evaluated several methods of antigen presentation to include
      chemical conjugation to bacterial carrier proteins, emulsification in 'Freund's
      like' preparations, and incorporation into liposomes. This work has resulted in
      the production of safe, potent vaccine delivery systems capable of targeting
      multiple antigenic determinants to the host's immune system. Further advances in
      malaria vaccine development now depend on the identification of appropriate
      parasite epitopes for inclusion in a multicomponent-multistage vaccine.

PMID- 8488719
TI  - Cytokines as vaccine adjuvants: interleukin 1 and its synthetic peptide 163-171.
AB  - The possibility of preventing infectious diseases by employing efficacious
      vaccine is rapidly growing as a consequence of the new technologies in
      recombinant DNA and protein chemistry. However, the increasing number of
      synthetic and recombinant antigens further stresses the role of appropriate
      adjuvants to ensure maximal vaccine activity and the protection of all vaccinees.
      Several approaches can be applied to develop safe and effective agents capable of
      enhancing specific immune responses which can then protect the host from the
      pathogen. Among others, the direct use as adjuvant of those cytokines which are
      induced in animals by the classical Freund's adjuvants has recently become a
      matter of investigation. In particular, interleukin 1 (IL-1) has been shown to
      possess adjuvant activity for a variety of infectious and tumour antigens.
      However, the numerous side effects associated with the proinflammatory action of
      IL-1 represent a serious disadvantage for its use as a vaccine adjuvant. It was
      therefore of great interest that a nonpeptide contained in the IL-1 beta sequence
      (residues 163-171 corresponding to the sequence VQGEESNDK) is devoid of all
      proinflammatory activities but maintains the immunostimulating activity of the
      whole IL-1 beta. Thus, peptide 163-171 was successfully employed in animals to
      potentiate the specific immune response against T-helper-dependent cellular
      antigens, T helper-independent polysaccharidic antigens and recombinant as well
      as synthetic antigenic preparations derived from human pathogens. Furthermore, IL
      1 and peptide 163-171 have been successfully used in tumour vaccines in
      experimental systems. It can therefore be concluded that peptide 163-171 is
      potentially a good candidate as vaccine adjuvant for human use.

PMID- 8488720
TI  - Future approaches to vaccine development: single-dose vaccines using controlled
      release delivery systems.
AB  - The development of single-dose vaccines, mainly those administered during
      childhood, which would effectively protect against certain diseases, would be a
      very important advance towards better immunization coverage and protection
      against the respective pathogens. Biodegradable polymeric microspheres which are
      'programmed' to deliver the antigen when a boost of the immune response is
      required, may be a possible way of achieving this goal.

PMID- 8488721
TI  - The amino terminal sequence of VP60 from rabbit hemorrhagic disease virus
      supports its putative subgenomic origin.
AB  - Direct determination of the amino acid sequence of VP60 from rabbit hemorrhagic
      disease virus is impeded by the presence of a blocked N-terminus. Chemical
      cleavage of VP60 using cyanogen bromide allowed the identification and
      purification of two oligopeptides showing identical amino acid composition, one
      of which had its amino terminus blocked. Automated sequential degradation of the
      unblocked CNBr- peptide yielded the amino acid sequence EGKARTAPQGEAA. This
      sequence is identical to the deduced amino acid sequence following the first AUG
      codon found at position +10 at the 5'-end of the 2.4 kb subgenomic mRNA. These
      data favor the hypothesis that this viral polypeptide is mainly produced from the
      subgenomic mRNA and not from the genomic RNA by processing of the putative
      polyprotein generated from the major open reading frame.

PMID- 8488722
TI  - Heterogeneity of the woodchuck hepatitis virus genome in a chronically infected
      woodchuck.
AB  - The nucleotide sequence of an isolate of woodchuck hepatitis virus (WHV) from the
      serum of a woodchuck trapped in New York state (WHVNY) was compared with the
      sequences of previously published isolates. The nucleotide sequence of WHVNY was
      closest to that of an isolate originating from New Jersey: the two genomes shared
      a 15 nucleotide in-frame deletion in the region where the presurface and
      polymerase genes overlap (nucleotides 3260-3274) and differed by 54 point
      mutations (1.6% of genome). Amino acid differences ranged from 0.4% in the
      surface gene to 5.7% in the X gene. Three isolates from woodchucks that
      originated in Pennsylvania and Maryland did not contain the deletion and differed
      from WHVNY by 102 to 106 point mutations (3.0% to 3.2% of nucleotides). Amino
      acid changes ranged from 0.5% in the core gene to 5.7% in the X-gene. Thus, WHVNY
      differed little from previous isolates. Next, the genomes from 102 independent
      clones of WHVNY were compared to ascertain the extent of sequence variation among
      WHV genomes in a chronically infected animal. A total of 98 clones had genomes of
      unit length while 2 clones had genomes shorter than unit length and 2 clones had
      genomes longer than unit length. The clones not of unit length possessed
      deletions or inverted duplications of sequence. The rate of mutation in the viral
      genes was 2.65 mutations per 10,000 nucleotides in the precore domain, 1.27 per
      10,000 in the X-gene, 0.98 per 10,000 in the presurface gene, and 3.77 per 10,000
      at the 5' end of the core gene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488723
TI  - Characterization of plasma membrane H(+)-ATPase from salt-tolerant yeast Candida
      versatilis.
AB  - Plasma membrane was isolated from the salt-tolerant yeast Candida versatilis and
      the ATPase in plasma membrane was characterized. The ATPase was a typical H(+)
      ATPase with similar properties to the Saccharomyces cerevisiae and
      Zygosaccharomyces rouxii enzymes. It was reacted with antibody (IgG) raised
      against S. cerevisiae plasma membrane H(+)-ATPase. The ATPase activity was not
      changed by adding NaCl and KCl to the assay solutions, but was increased by NH4+,
      especially by ammonium sulfate. In vivo stimulation of ATPase activity was
      observed by the addition of NaCl into the culture medium, as observed in Z.
      rouxii. No in vivo activation of H(+)-ATPase by glucose metabolism was observed
      in C. versatilis cells and the activity was independent of the growth phase, like
      Z. rouxii and unlike S. cerevisiae cells.

PMID- 8488724
TI  - Reduced efficiency in the glycosylation of the first sequon of Saccharomyces
      cerevisiae exoglucanase leads to the synthesis and secretion of a new glycoform
      of the molecule.
AB  - In addition to exoglucanases (EXGs) I and II, old cultures of Saccharomyces
      cerevisiae secreted into the culture medium a new immunologically-related
      material that exhibited exoglucanase activity. The new exoglucanase (EXGII1/2)
      was purified from stationary-phase cultures. It turned out to be a glycoprotein
      whose protein portion was identical to that of the other two isoenzymes in terms
      of ionic properties, size, amino acid composition and NH2-terminal sequence (25
      residues). Disruption of the structural gene encoding EXGs I and II resulted in a
      strain unable to secrete all three isoenzymes. EXGII1/2 was indistinguishable in
      terms of molecular weight from the single intermediate detected during the
      deglycosylation (mediated by endo H) of EXGII by sodium dodecyl sulphate
      polyacrylamide gel electrophoresis. Thus, the new isoenzyme contains only one of
      the two slightly elongated mannan inner cores present in enzyme II. Two
      intermediates were, however, detected when the deglycosylation of EXGII was
      monitored by ion-exchange chromatography (high-pressure liquid chromatography).
      Site-directed mutagenesis indicated that the major intermediate, which eluted at
      about the same position as enzyme II1/2, corresponded to protein molecules
      carrying the oligosaccharide attached to the Asn of the second sequon, whereas
      the minor one carried the oligosaccharide in the first potential glycosylation
      site. Several lines of evidence indicate that EXGII1/2 is a biosynthetic product
      resulting from an imbalance between the rate of protein synthesis and the
      glycosylation capabilities of the glycosylation machinery.

PMID- 8488725
TI  - Nuclear pore complex antigens delineate nuclear envelope dynamics in vegetative
      and conjugating Saccharomyces cerevisiae.
AB  - In the yeast Saccharomyces cerevisiae, the nucleus undergoes dramatic shape
      changes during mitosis and mating. We have studied nuclear envelope dynamics
      during the processes of mitosis and conjugation using nuclear pore complexes as a
      marker for the nuclear envelope in wild-type cells and several cell-division
      cycle (cdc) mutants. Three monoclonal antibodies are described that recognize
      nuclear pore complex-related antigens in S. cerevisiae. One of these antibodies,
      RL1, has been extensively characterized by Gerace and colleagues and recognizes
      nuclear pore complexes in mammalian and amphibian cells. By indirect
      immunofluorescence of yeast cells, all three antibodies yield a discontinuous
      nuclear rim stain. All three react with multiple nuclear-enriched proteins in
      immunoblots, including the nucleoporin protein encoded by the NSP1 gene. When the
      antibodies were used in immunofluorescence experiments on mating cells, the
      nuclear pore complex staining pattern proved to be a sensitive indicator of
      nuclear fusion. Nuclei with closely apposed spindle pole bodies and unfused
      nuclear envelopes could be readily distinguished. Marked shape changes were
      observed in nuclei during fusion and segregation of the diploid nucleus into the
      zygotic bud. In cdc14 and cdc15 mutants that arrest late in mitosis, the
      elongated nuclear envelope extension that stretches between daughter nuclei
      during telophase was preserved. In cytokinesis-defective mutants (cdc3, cdc10,
      cdc11 and cdc12), the elongated nuclear envelope was usually resolved into two
      daughter nuclei in the absence of cytokinesis. These results indicate that
      nuclear envelope division is mechanically distinguishable from chromosome
      segregation, nucleolar segregation and cytokinesis.

PMID- 8488726
TI  - Role of the gamma component of preprotoxin in expression of the yeast K1 killer
      phenotype.
AB  - K1 killer strains of Saccharomyces cerevisiae secrete a polypeptide toxin to
      which they are themselves immune. The alpha and beta components of toxin comprise
      residues 45-147 and 234-316 of the 316-residue K1 preprotoxin. The intervening 86
      residue segment is called gamma. A 26-residue signal peptide is removed on entry
      into the endoplasmic reticulum. The Kex2 protease excises the toxin components
      from the 290-residue glycosylated protoxin in a late Golgi compartment.
      Expression of a cDNA copy of the preprotoxin gene confers the complete K1 killer
      phenotype on sensitive cells. We now show that expression of immunity requires
      the alpha component and the N-terminal 31 residues of gamma. An additional C
      terminal extension, either eight residues of gamma or three of four unrelated
      peptides, is also required. Expression of preprotoxin terminating at the alpha C
      terminus, or lacking the gamma N-terminal half of gamma causes profound but
      reversible growth inhibition. Inhibition is suppressed in cis by the same 31
      residues of gamma required for immunity to exocellular toxin in trans, but not by
      the presence of beta. Both immunity and growth inhibition are alleviated by
      insertions in alpha that inactivate toxin. Inhibition is not suppressed by kex2,
      chc1 or kre1 mutations, by growth at higher pH or temperature, or by normal K1
      immunity. Inhibition, therefore, probably does not involve processing of the
      alpha toxin component at its N-terminus or release from the cell and binding to
      glucan receptors. Some insertion and substitution mutations in gamma severely
      reduce toxin secretion without affecting immunity. They are presumed to affect
      protoxin folding in the endoplasmic reticulum and translocation to the Golgi.

PMID- 8488727
TI  - Yeast mutants affected in viability upon starvation have a modified phospholipid
      composition.
AB  - Selection of mutations, based on the suppression of rvs161 delta defects, was
      performed. Ten mutants were obtained, ranged amongst four complementation groups,
      named SUR1, SUR2, SUR3 and SUR4. All sur mutations also suppress a mutation in
      another gene, RVS167, indicating that all six genes are involved in the same
      biological pathway. The sur mutant cells have abnormal morphologies in stationary
      phase, i.e. dumbbell-like in sur1, sur2 or sur3 strains and multi-budded in sur4
      strains. Several phenotypic characteristics of the physiological suppressors as
      well as the rvs161 delta strain itself led us to analyse the phospholipid
      composition of the mutants. The assays show an overall decrease of the
      phospholipid amounts and modifications in the relative contents of some
      phospholipid classes in sur mutant cells.

PMID- 8488728
TI  - Sequence of a 7.8 kb segment on the left arm of yeast chromosome XI reveals four
      open reading frames, including the CAP1 gene, an intron-containing gene and a
      gene encoding a homolog to the mammalian UOG-1 gene.
AB  - We report here the DNA sequence of a segment of chromosome XI of Saccharomyces
      cerevisiae extending over 7.8 kb. The segment contains four long open reading
      frames, YKL150, YKL153, YKL155 and YKL156, YKL155 corresponds to the CAP1 gene.
      YKL153 contains an intron and shows an extremely biased codon usage suggestive of
      a highly expressed protein. YKL156 is a homolog to UOG-1, an open reading frame
      associated with the cDNA clone of the mammalian growth/differentiation factor 1.
      YKL150 reveals common motifs to both the RNA polymerase II elongation factor of
      Drosophila melanogaster and to the yeast PPR2 gene product.

PMID- 8488729
TI  - Sequence of a 4.8 kb fragment of Saccharomyces cerevisiae chromosome II including
      three essential open reading frames.
AB  - The nucleotide sequence of a fragment of 4867 base pairs of Saccharomyces
      cerevisiae chromosome II has been determined. The sequence contains three
      complete open reading frames. In addition to the already known gene RPB5, coding
      for a subunit shared by all three DNA directed RNA polymerases, two new open
      reading frames could be identified. YBR12.03 codes for a protein of 183 amino
      acids with homology to one of the proteins of the Bacillus subtilis riboflavin
      biosynthesis operon (RibG). Deletion mutants of YBR12.03 can germinate but stop
      growing after five to seven cell divisions on YPD. Supplementation with high
      concentrations of riboflavin does promote growth. YBR12.05 codes for a protein of
      386 amino acids with homology to STI1, a stress-inducible protein of S.
      cerevisiae. Deletion mutants of YBR12.05 are not viable.

PMID- 8488730
TI  - RPB7, one of two dissociable subunits of yeast RNA polymerase II, is essential
      for cell viability.
AB  - The Saccharomyces cerevisiae RNA polymerase II subunit gene RPB7 was isolated and
      sequenced. RPB7 is a single copy gene whose sequence predicts a 19,000 Dalton
      protein of 171 amino acids. RPB7 is known to dissociate from RNA polymerase II as
      an RPB4/RPB7 subcomplex in vitro. RPB7 also appears to interact with RNA
      polymerase II in a manner dependent upon RPB4, since RNA polymerase II purified
      from cells lacking RPB4 also lacks RPB7. Previous results have demonstrated that
      deletion of the RPB4 results in slow growth and cold- and temperature
      sensitivity. In contrast, deletion of the RPB7 gene revealed that it is essential
      for cell growth and viability. Loss of both the RPB4 and the RPB7 genes causes
      lethality. These results suggest that RPB7 contributes to the function of RNA
      polymerase II in the absence of RPB4 either in a manner independent of its
      association with the enzyme or by directly binding to the enzyme in a manner
      independent of its association with RPB4.

PMID- 8488731
TI  - YMC1, a yeast gene encoding a new putative mitochondrial carrier protein.
AB  - We have cloned and sequenced a Saccharomyces cerevisiae gene coding for a protein
      with significant similarities to the mitochondrial carrier family. The gene we
      termed YMC1 (yeast mitochondrial carrier) is located on chromosome XVI, closely
      downstream of ARO7 encoding chorismate mutase.

PMID- 8488732
TI  - [Progress in biology and the treatment of acute promyelocytic leukemia].
AB  - Acute promyelocytic leukaemia (APL) is a distinct subtype of acute myeloid
      leukaemia distinguished by the presence of a balanced chromosomal translocation:
      t(15; 17). The most characteristic clinical manifestation of this disease is the
      presence of a haemorrhagic syndrome associated with an abnormal coagulation
      profile. In the last few years significant progress in the understanding of the
      biology of this leukaemia and its treatment has been done. In particular, the
      breakpoint on chromosome 17 has been localized within the retinoic acid receptor
      alpha locus while the breakpoint on chromosome 15 has been localized within a new
      gene named PML. In contrast to the other acute myeloid leukaemia subtypes APL
      shows high response rate to induction monochemotherapy with anthracycline drugs
      and with all-trans retinoic acid.

PMID- 8488733
TI  - [The origin of fibrinogen in megakaryocytes and blood platelets].
AB  - Fibrinogen is involved in platelet aggregation and clot formation. It is mainly
      synthesized by hepatocytes. The additional, small pool of this glycoprotein is
      known to exist in the alpha granules of bone marrow megakaryocytes and blood
      platelets. Up-date of the origin of fibrinogen in these cells has been discussed.

PMID- 8488734
TI  - [Comparison of computed tomography results and pathological findings after
      laparotomy with splenectomy in Hodgkin's disease].
AB  - In 69 patients (pts) with Hodgkin's disease (HD) in I-IIIA clinical stage results
      of abdominopelvic computed tomography (CT) were compared with pathological
      staging. Concordance (specificity) of CT scan with results of macroscopic
      evaluation of HD lesions in the abdomen during laparotomy with splenectomy was
      83%. Accuracy CT results and microscopic findings was 80%. False positive results
      of CT were found in 11.6% of patients and false negative in 8.6%. Specificity and
      sensitivity of CT versus to pathological staging were 84% and 63% respectively.
      The results presented here confirm, that pathological staging after laparotomy
      with splenectomy in HD was some advantage in precise prediction of some patients
      to radiotherapy and planning of irradiated fields.

PMID- 8488735
TI  - [Long-term (over 10-years) survival in Hodgkin's disease].
AB  - 61 patients with Hodgkin's disease, i.e., 40.9% of all HD pts hospitalized in the
      years 1970-1981 are more than 10 years survivors: 46 are alive and 15 died of
      underlying disease or its complications. The most important prognostic factor at
      diagnosis was clinical advancement and the form A or B of HD. Age and sex also
      influenced survival but to a lesser degree. Patients living in CCR were more
      likely to have MC histology than those with relapsing disease, who more often
      showed LD and LP type. Among 5 persons with second neoplasms four disclosed NS
      type of HD. No statistical differences in clinical prognostic factors were
      encountered between further alive and those who died after more than 10-yrs.
      Almost all patients were able to normally continue their familial and
      professional lives.

PMID- 8488736
TI  - [Use of microtest in gel for compatibility in serological testing before
      transfusion].
AB  - A gel technique for the detection of red blood cell antigen--antibody reaction
      was evaluated in pretransfusion compatibility tests. The evaluation was
      undertaken on 917 blood samples of recipients and 2450 samples of donors.
      Parallel study of microtest in gel and classical techniques revealed that gel
      technique was more sensitive than the classical one, because some antibodies of
      Rh, Kell and Kidd systems were found by this method exclusively. It is also more
      specific because a lot of unspecific reactions could be eliminated. Therefore, it
      was decided to use the microtest in gel for crossmatching of recipient serum
      against red cells from each intended donor--particularly when the patient had
      irregular erythrocyte antibodies. The results presented in this paper revealed
      that in gel is one of the most potent tests and it is the safest for routine use
      before transfusion.

PMID- 8488737
TI  - [Progress in the treatment of chronic lymphocytic leukemia].

PMID- 8488738
TI  - [Myelodysplastic syndrome associated with clonal proliferation of B lymphocytes].
AB  - We present an unusual case of the myelodysplastic syndrome (subtype refractory
      anemia with the excess of blasts in transformation--RAEB-t) associated with
      significant increase of IgG (4,700 mg/dl), lambda (160 U/dl) in blood serum and
      circulating clone of B lymphocytes SIgG, lambda, manifesting clonal rearrangement
      of JH domain. Peripheral blood cells of the patient showed two different
      chromosomal abnormalities: 47,XY, + del/8/p? and 47,XY, +22, +14, -19. We suppose
      that two independent neoplastic clones are developed in the described case, i.e.
      a population displaying markers of myeloblasts and monoblasts, and a clone of B
      lymphocytes.

PMID- 8488739
TI  - [Lymph node involvement as a primary localization of extramedullary blast crisis
      of chronic granulocytic leukemia (PBS)].
AB  - Among 28 patients with blastic crisis of chronic granulocytic leukemia (CGL) its
      primary symptom in four persons was lymph nodes enlargement. In two of them
      histopathologic examination confirmed myeloblastic infiltration. Lymph nodes
      involvement appeared 1-7 months before the onset of blastic transformation in
      peripheral blood and bone marrow: myeloblastic in two patients, promyelocytic in
      one and lymphoblastic myeloblastic (bi-phenotypic) in one. Survival time from
      nodal infiltration was 8-16 months and from the diagnosis of CGL 16-105 months.
      Remission of the disease after first blastic crisis was achieved in three
      patients. Cytogenetic examinations disclosed double Ph chromosome in three and
      single Ph chromosome in one patient.

PMID- 8488740
TI  - Tracheo- and bronchoesophageal fistulas in Hodgkin's disease.
AB  - Among 330 patients with Hodgkin's disease, in five development of fistula between
      the respiratory and alimentary tract was observed; tracheoesophageal in three and
      bronchoesophageal in two patients. Generalization of the disease was the cause of
      fistula in three patients; it appeared as a result of necrosis of the neoplastic
      infiltration during cytostatic treatment or radiotherapy. In the fourth patient
      the fistula was of iatrogenic origin (radiation induced damage), and in the fifth
      it was the result of secondary neoplasm (bronchial anaplastic cancer).

PMID- 8488741
TI  - Staging: a neglected dimension in psychiatric classification.
AB  - The staging method, whereby a disorder is characterized according to seriousness,
      extension and features, has achieved wide currency in medicine but is currently
      neglected in psychiatry. Studies addressing or related to the issue of staging in
      schizophrenia, unipolar depression, bipolar disorder and panic disorder are
      discussed. The phenomenological development of these mental disorders may be
      categorized according to stages.

PMID- 8488742
TI  - Compulsory admission of psychiatric patients--an international comparison.
AB  - The frequency of compulsory admissions to psychiatric hospitals varies
      considerably between countries and regions. However, the differences are partly
      artificial, as the figures available are not fully comparable; this is mainly
      owing to differing definitions of "compulsory" and the methodological
      shortcomings of most studies in this field. In addition, there are also clear
      real differences, most of which result from different legislation and
      administrative regulations. Characteristics of the patient that influence the
      risk of compulsory admission include diagnosis and certain sociodemographic and
      social factors. Most studies, however, are based on highly selected populations.
      Furthermore, the results depend heavily on the commitment frequency of a country
      and therefore eventually also on the restrictiveness of legislation. The lack of
      methodologically sound studies, internationally comparable data and
      internationally published information is regrettable, as international comparison
      and discussion would certainly be valuable, especially for countries that are in
      the process of re-evaluating their commitment criteria and mental health
      legislation.

PMID- 8488743
TI  - The prevalence of transsexualism in The Netherlands.
AB  - The prevalence of transsexualism in the Netherlands was estimated by counting all
      the subjects who were diagnosed as transsexuals by psychiatrists or psychologists
      and were subsequently hormonally treated and generally underwent sex-reassignment
      surgery. At the end of 1990, 713 Dutch-born transsexuals received treatment (507
      men, 206 women). This amounts to a prevalence of 1:11,900 for male-to-female
      transsexualism and 1:30,400 for female-to-male transsexualism (population age 15
      and above in both groups). The sex ratio was about 2.5 men to 1 woman. The most
      important reason for this relatively high prevalence seems to be the benevolent
      climate for the treatment of transsexualism in the Netherlands.

PMID- 8488744
TI  - Prevalence of mental disorders in young adults with chronic physical diseases
      since childhood as identified by the Present State Examination and the CATEGO
      program.
AB  - To find out whether long-term physical disorders in childhood increase the risk
      for mental disorder, we interviewed 407 young adults and compared their findings
      to a control group of 123 age-matched controls. The overall prevalence of mental
      disorders according to ICD-8 classification exceeded 20% in both groups.
      Depression and phobic disorders were the most common diagnostic syndromes, being
      most prevalent in women with motor handicaps or short stature. Only 7 patients
      had received psychotherapy, 5 for psychotic symptoms. In conclusion, only a
      severe physical disease, visible and disabling for years in everyday life, seems
      to increase the risk for mental problems. The results demonstrate the need to
      improve the approach towards psychological problems in the somatic clinics
      treating patients with long-term physical diseases.

PMID- 8488745
TI  - A prevalence survey of mental disorders among children in a rural Malaysian
      village.
AB  - This is the first epidemiological survey of mental disorders among children in a
      Malaysian village. The WHO Research Questionnaire for Children (RQC) was used for
      initial screening followed by a semistructured interview, the Follow-up Interview
      for Children (FIC) at its second stage. Diagnosis was obtained by using Rutter's
      multi-axial classification. The prevalence rates obtained for the diagnostic
      categories were described in 3 age groups, in accordance with the age of
      attending school in Malaysia. Of 507 children screened aged 1-15, 6.1% were
      classified as having a mental disorder.

PMID- 8488746
TI  - A nationwide survey of seasonal affective disorder at 53 outpatient university
      clinics in Japan.
AB  - A nationwide survey of seasonal affective disorder (SAD) was performed from
      autumn 1990 to spring 1991 with the cooperation of 53 outpatient university
      psychiatric clinics in Japan. Forty-six SAD patients were identified among 5265
      depressed outpatients. SAD was generally reported to occur in 1-3% of the
      depressed outpatients newly attending each facility. Hours of sunshine were found
      to be a more relevant variable influencing the prevalence of SAD than latitude or
      the mean temperature in December. The unexpectedly low percentage (20-30%) of SAD
      patients with atypical vegetative symptoms suggests that SAD patients who have no
      prior knowledge of SAD and those who are recruited via the media have different
      vegetative symptom profiles.

PMID- 8488747
TI  - Prevalence of tardive dyskinesia in samples of elderly people in Hong Kong.
AB  - The prevalence of dyskinesia was studied in 4 samples of elderly Chinese people
      in Hong Kong--a psychogeriatric clinic, a mental hospital, a geriatric day
      hospital and a senior citizen centre. Research Diagnostic Criteria were used to
      identify cases of tardive dyskinesia. The overall prevalence of spontaneous
      dyskinesia was 2.4% and tardive dyskinesia was 25.9%. The rate of spontaneous
      dyskinesia differs across the study samples and is related to nervous system
      conditions associated with increased age. On the other hand, the rate of
      dyskinesia associated with antidepressants may not be significantly different
      from that of spontaneous dyskinesia.

PMID- 8488748
TI  - A comparison of fluoxetine and imipramine in the treatment of outpatients with
      major depressive disorder.
AB  - A double-blind clinical trial was undertaken to evaluate the clinical efficacy
      and safety of fluoxetine compared with imipramine in the treatment of 59
      outpatients suffering from major depressive disorder. The mean scores of all
      depression rating scales showed that the drugs had comparable efficacy. The side
      effect profile of imipramine was found to be mainly anticholinergic, which was
      not the case for fluoxetine, where it was mainly found to be gastrointestinal,
      such as nausea and diarrhoea. In both groups the total number of adverse events
      reported were the same. Fluoxetine treatment resulted in weight loss, whereas
      imipramine treatment resulted in a slight but significant weight increase.

PMID- 8488749
TI  - The St. George's dementia bed investigation study: cardiovascular, neurological
      and neuropsychological correlates.
AB  - The results of the cardiovascular, neurological and neuropsychological
      examination of a series of patients admitted to the St. George's dementia
      investigation bed and who later came to postmortem are compared in relation to
      their pathological diagnosis. Individual clinical signs were not found to
      differentiate between cases of dementia with vascular versus those with
      Alzheimer's disease pathology, although multivariate analysis suggested that
      there was a pattern of signs associated with cerebrovascular disease. A
      vascularity index was constructed from these signs; it achieved a useful level of
      discrimination between vascular and nonvascular causes of dementia.

PMID- 8488750
TI  - The distinction of bipolar II disorder from bipolar I and recurrent unipolar
      depression: results of a controlled family study.
AB  - The aim of the study was to differentiate bipolar II, bipolar I and recurrent
      unipolar depression by their familial load for affective disorders. Eighty
      bipolar, 108 unipolar, 80 control subjects and interviewed first-degree relatives
      were diagnosed according to Research Diagnostic Criteria using the Schedule for
      Affective Disorders and Schizophrenia--lifetime version. The morbid risks for
      bipolar I disorder were equivalent in relatives of bipolar I (3.6%) and bipolar
      II (3.5%) subjects and lower in relatives of unipolar subjects (1.0%). The morbid
      risks of relatives for bipolar II disorder distinguished bipolar II subjects
      (6.1%) from bipolar I subjects (1.8%), from unipolar depressives (0.3%) and from
      controls (0.5%). To promote further evaluation, bipolar II disorder should be
      included in DSM-IV as a distinct diagnostic category.

PMID- 8488751
TI  - Clinical, endocrine and neurochemical effects of moclobemide in depressed
      patients.
AB  - The clinical efficacy of the monoamine oxidase A inhibitor moclobemide and its
      effect on the dexamethasone suppression test (DST) and plasma and urine
      methoxyhydroxyphenylglycol (MHPG) were investigated in 26 depressed patients
      during a 4-week clinical trial. Fourteen patients (54%) responded favourably to
      the treatment (50% or more reduction of the Hamilton Rating Scale for Depression
      score). All (8) patients with an abnormal DST responded to treatment; 11 of 16
      patients with a normal DST did not respond. Patients with low pretreatment MHPG
      excretion, according to the median value, were more frequently treatment
      responders. Plasma and urine MHPG were significantly decreased by treatment. The
      results indicate that low excretion of MHPG and cortisol nonsuppression may be
      considered as predictors of favourable clinical response to moclobemide
      treatment.

PMID- 8488752
TI  - Developmental changes of aminopeptidase activity in the cortex of the cat brain.
AB  - Aminopeptidase activity has been proposed as a candidate regulator of the
      degradation of several neuroactive peptides. In this paper, possible changes in
      Lys-, Arg-, Asp- and Tyr-aminopeptidase activities in the cat brain neocortex
      (frontal, parietal, area 17 and areas 18 and 19 as a whole) were examined during
      two of the first stages of the critical developmental period (15 and 30 days
      postbirth). Aminopeptidase activities were studied by measuring the rate of
      hydrolysis of the artificial substrates Lys-, Arg-, Asp- and Tyr-2-naphthylamides
      (fluorimetrically detected in triplicate). Lys- and Arg-aminopeptidase activities
      do not show significant changes between the first the second stage in any of the
      cortical regions assayed. On the contrary, in all the cortical structures,
      activity with Tyr-2-naphthylamide shows significant increase with age. In
      contrast, the activity of Asp-aminopeptidase shows significant decreases on the
      30th day (except in area 17). It is suggested that these activities play a part
      in the neurochemical changes that take place during cat brain maturation.

PMID- 8488753
TI  - Influence of tongue myoblasts on rat dissociated hypoglossal motoneurons in
      culture.
AB  - Hypoglossal motoneurons of 1-2 day-old newborn rats were retrogradely labelled
      following an injection of fluorescent latex microspheres and carbocyanines.
      Motoneurons were identified among the cell population of the hypoglossal nuclei
      during the dissociation and culture procedures. DiI labelled motoneurons could be
      maintained in culture on poly-L-lysine coating and Dulbecco Minimum Essential
      Medium with Ham F12 complement, supplemented with additives and 3% fetal calf
      serum. Neuronal survival as well as extension of neurites, identified by their
      content in DiI or by the presence of choline acetyltransferase immunoreactivity,
      was increased in the presence of myoblastic satellite cells originating from
      tongue muscular explants. Co-cultures of dissociated hypoglossal cells with
      tongue myoblasts revealed the presence, after 10-15 days in culture, of
      structures morphologically similar to neuromuscular junctions. Such re-innervated
      muscular fibres exhibited muscular contractions which were blocked by curare and
      augmented by glutamate applications, demonstrating the functionality of the
      observed re-innervations.

PMID- 8488754
TI  - Mesenteric neurons in the adult rat are responsive to ileal treatment with
      benzalkonium chloride.
AB  - The application of a 2 mM solution of the cationic surfactant benzalkonium
      chloride (BAC) to an ileal segment produced a selective and extensive myenteric
      denervation. The aim of the present study was to investigate whether such a
      selective unbalance of the enteric nervous system in the adult rat elicited any
      plastic response within the mesenteric nervous structures contacting it.
      Acetylcholinesterase (AChE) staining, beta-nicotinamide adenine dinucleotide
      (NADH) and beta-nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase
      histochemistry and glyoxylic acid-induced fluorescence were performed on whole
      mount preparations of myenteric plexus and mesenteric nerves. In both control and
      BAC-treated animals nervous elements were detected along the mesenteric nerves.
      Although rather similar in position, shape and size, these neurons displayed
      striking differences with regard to their arrangement and density per nerve. In
      the controls, few small aggregates of neurons could be detected; more commonly,
      isolated nerve cell bodies were scattered along the nerve trunks. In the BAC
      treated animals, numerous spherical or spindle-shaped clusters of neurons were
      located along the nerves; the mean neuronal density per nerve displayed a two
      five-fold increase over the control values. The observed changes within the
      mesenteric nerves might be involved in an attempt at reinnervation of the BAC
      treated intestinal segments from extra-enteric sources.

PMID- 8488755
TI  - Culture of rat brain preoptic area neurons: effects of sex steroids.
AB  - The aim of the present study was to investigate the direct effects of
      testosterone (T), estradiol-17 alpha (E2) and 5 alpha-dihydrotestosterone (5
      alpha-DHT) on the survival of neurons and the morphology of neuronal processes
      (the total process length, the number of processes and the number of process
      branchings) of the cells derived from neonatal rat preoptic area (POA) to analyze
      the bases of morphological sexual dimorphism of the POA. The POA cells were
      exposed to sex steroids during 2-14 days of culture in serum-free medium.
      Neuronal survival was significantly greater in cultures treated with 1.0 nM T
      than controls. Although T at any concentration tested (0.1, 1.0 or 10.0 nM)
      failed to affect the mean value of the process length, a significant difference
      was observed in the frequency distribution of total process length between 1.0 nM
      T-treated cultures and control cultures. By 1.0 nM T, the number of process
      branchings was also significantly increased. In contrast, the number of neurons
      and the total process length of neurons were not affected by 5 alpha-DHT.
      However, the number of process branchings was significantly increased by 0.1 nM 5
      alpha-DHT. E2 had no significant effect on any of these parameters. These results
      suggest that T directly enhances the survival of neurons and increases the
      dendritic and/or axonic field of the POA, which serves, at least partly, for the
      development of morphological sexual dimorphism in the rat.

PMID- 8488756
TI  - Expression of NCAM mRNA and polypeptides in aging rat brain.
AB  - In aging brain, degenerative as well as compensatory regenerative processes are
      believed to occur. The neural cell adhesion molecule NCAM is involved in
      developmental and regenerative processes in the brain. However, the role of NCAM
      in aging brain has not been characterized. In this study, the expression of NCAM
      mRNAs and polypeptides was investigated in aging rat brain. The 7.4 and 6.7 kb
      NCAM mRNAs were selectively downregulated during postnatal development, and the
      5.2 and 2.9 kb NCAM mRNAs were upregulated. However, from postnatal day 40 to old
      age no change in NCAM mRNA classes was observed. The fraction of NCAM mRNA
      containing the VASE exon increased postnatally but remained stable during adult
      life. VASE, which is believed to modulate the binding capacity, seemed to be
      relatively more abundant in the 7.4 and 6.7 kb NCAM mRNAs, encoding transmembrane
      NCAM forms, than in the 5.2 and 2.9 kb NCAM mRNAs, coding for glycosyl
      phosphatidylinositol (GPI) linked NCAM. Conversely, insertion of exons a and AAG
      between exons 12 and 13, a region containing two fibronectin type III repeats,
      seemed to be more pronounced in 5.2 and 2.9 kb NCAM mRNAs than in the 7.4 and 6.7
      kb mRNAs. During postnatal development an increase in the fraction of 6.7 kb NCAM
      mRNA containing the exons a and AAG was observed. However, during aging the
      fraction of NCAM mRNAs containing this exon combination seemed constant. At the
      protein level, NCAM-A was downregulated both during development and aging. No
      changes were observed during aging in the composition of soluble NCAM forms in
      the brain, cerebrospinal fluid or blood plasma. The amount of NCAM in rat brain
      decreased during postnatal development, but remained at a constant level from
      postnatal day 40 to old age. To conclude, several changes in NCAM expression
      occur during early postnatal development emphasizing the important role of this
      molecule in the morphogenetic processes. During aging, a significant selective
      downregulation of NCAM-A was observed indicating that in general only minor
      regenerative processes occur in the brain.

PMID- 8488757
TI  - Effect of CDP-choline treatment on mitochondrial and synaptosomal protein
      composition in different brain regions during aging.
AB  - Several age-dependent modifications of inner mitochondrial membrane and
      synaptosomal plasma membrane proteins from different brain regions of 4-, 12-, 18
      and 24-month-old male Wistar rats, were observed. Some proteins, identified by
      immunoblotting assay as various subunits of mitochondrial respiratory chain
      complexes and calmodulin, were particularly impaired. Chronic treatment with CDP
      choline at a dose of 20 mg/kg body weight per day for 28 days caused significant
      changes in the amounts of several of the above mentioned proteins. Most of the
      proteins, which decreased during aging, showed a significant increase after CDP
      choline treatment compared with the corresponding control values at the same age.
      The effect of CDP-choline might be due to: the increased availability of
      cytidylic nucleotides, which in the brain are present in limited amounts compared
      to the other nucleotides; the increased content of total adenine nucleotides; the
      improvement of brain energy metabolism.

PMID- 8488758
TI  - Laminin concentrations in serum and cerebrospinal fluid in aging and Alzheimer's
      disease.
AB  - Laminin, a basement membrane protein, and a potent promoter of neurite outgrowth,
      surrounds all peripheral nerves. It appears in the central nervous system during
      development and reappears in response to injury. In Alzheimer's disease (AD),
      there is a progressive loss of neurons in specific areas of the brain along with
      the presence of an increased number of senile plaques and neurofibrillary
      tangles. Laminin levels have been shown to be increased in injury, so we
      undertook to examine levels of laminin by radioimmunoassay (RIA), in
      cerebrospinal fluid and serum of patients with AD and age-matched controls. No
      difference in the CSF and serum laminin concentrations was found between
      Alzheimer's disease and age-matched controls. We found a lack of correlation
      between severity of clinical dementia and laminin concentrations. Finally, we
      show that the CSF and serum laminin concentrations increase with age.

PMID- 8488759
TI  - [Pulmonary sequestration. Report of a clinical case].
AB  - Concerning a clinical situation of intralobar pulmonary sequestration, in a
      seventeen year old young man, the authors review this nosological entity. They
      emphasize the importance of the complementary examens of diagnosis, namely of
      thoracic scan and aortography, for the establishment of the said diagnosis.

PMID- 8488760
TI  - [The adoption of heroin addicts++ as a strategy of ambulatory treatment].
AB  - The authors describe the ambulatory treatment of a young man, the son of a
      divorced mother, where they used a methodology called Combined Treatment of
      Heroin Addicts, which was done in stages. They used family sessions, with a
      concomitant hearing of the patient alone, combined with the use of an opioid
      antagonist, called naltrexone. The young man was adopted by an uncle, married to
      his mother's sister, because his mother was divorced, living alone, and was too
      old to support, contain and provide her son with the necessary basis for
      treatment. The uncle assumed the tutorage of the case completely and gave his
      nephew the basis for identification and psychic maturation. The young man has now
      a year of treatment with a satisfactory evolution: he has had good results in his
      studies, has achieved good family and social integration, and does not use
      heroin.

PMID- 8488761
TI  - [Letter concerning the article: Drug surveillance: concepts, objectives, and
      methods (1992; 11:595-602)].

PMID- 8488762
TI  - [Imaging methods in the study of urinary tract infections in children].
AB  - When studying a child with urinary tract infection it is important to detect and
      localize any renal (scar) or urologic anomaly. Here we study the information
      obtained using: renal and vesical ultrasound (US), DMSA scan and radiologic or
      isotopic cystogram. METHODS: We studied 148 children with more than one urinary
      tract infection and/or pyelonephritis; their mean age was 35.9 months (1-148
      months); 55% were girls. The three diagnostic examinations--US, DMSA scan and
      cystogram were made in the order; the DMSA scan or cystogram was never made
      sooner than one month after the UTI. RESULTS: In 42% of the children the three
      exams were normal; 4 of these children had another UTI and the urodynamic study
      revealed vesical disfunction. 11% had renal scars (DMSA scan) with normal US and
      cystogram; 30% had VUR, 50% of which had an altered US and 57% had renal scars on
      the DMSA scan. 12% of the children had an altered US with a cystogram showing no
      VUR; 66% of these had renal scars. 4% had vesical anomalies on the US and
      cystogram. CONCLUSION: The three exams chosen were able to direct the diagnostic
      approach of UTI, being sufficient in most of the cases. We would like to
      emphasize the importance of the DMSA scan in diagnosing unsuspected renal scars.

PMID- 8488763
TI  - [The role of radiotherapy in soft tissue sarcomas. Retrospective analysis of 115
      cases treated from 1979 to 1988].
AB  - In this study was analysed the results of a group of patients with soft tissue
      sarcomas treated at the IPOFG Center of Lisbon from January 1979 to December
      1988. All these cases were referred to the Radiotherapy Department for radiation
      treatment which was given in 84% of the patients as a complement to surgery and
      in 16% was either combined with chemotherapy or given as exclusive therapy. The
      immediate results showed complete remission in 79% and partial remission in 7% of
      the cases. Seventeen per cent of the patients developed relapses and 28% distant
      metastases after a free interval of 27.7 and 19.6 months respectively. The five
      year actuarial survival rates were 73.3% for the patients without recurrences,
      55.4% for the patients with relapses and 21.4% for disseminated disease. The long
      term results varied according to the localization of the tumor, the stage of the
      disease, the age of the patient, the extension of surgery, the histologic type
      and the radiation dose. Five year actuarial survival rates also varied with the
      type of treatment (63.8% for surgery followed by radiotherapy with or without
      chemotherapy and 50.8% for preoperative radiotherapy and surgery with or without
      adjuvant chemotherapy). Radiotherapy with or without chemotherapy, in inoperable
      patients, was generally useful because it improved the quality of life, saving
      about 25% of the inoperable cases. Treatment related complications were minimal.

PMID- 8488764
TI  - [Disodium pamidronate (APD) in the treatment of bone metastases].
AB  - Diphosphonates are potent inhibitors of bone resorption, they have been evaluated
      in several clinical trials for bone metastases. We performed a clinical study to
      evaluate the therapeutic effect of Disodium Pamidronate over pain and radiologic
      evolution in bone metastases (Breast Cancer and Multiple Myeloma patients). The
      results regarding the first 10 patients concluded that there is good drug
      tolerability and significant analgesic activity in 6 patients, with sclerosis of
      lytic skull lesions in one breast cancer patient.

PMID- 8488765
TI  - [Hepatitis C virus infection in chronic asymptomatic carriers of HBs antigen].
AB  - The objectives of the study were to evaluate the prevalence, the incidence and
      the clinical significance of antibodies to hepatitis C virus in HBsAg chronic
      carriers. The evaluation of Stored sera was combined with the follow-up of a
      cohort os cases observed in a referral-based university hospital. A total of 183
      HBsAg asymptomatic chronic carriers were identified during routine screening and
      followed for a mean period of 3.8 years. Stored sera and sera obtained during
      follow-up were tested for anti-HCV using ELISA. Second generation RIBA (Ortho)
      was used as a possible confirmatory test. Demographic data and risk factors were
      assessed using a standard questionnaire. The prevalence of HCV infection in HBsAg
      chronic carriers was 2.7% (95% CI: 1.2%-6.3%), higher in male than female (3.1%
      vs 1.8%, p = 0.52) and also higher than the one found in voluntary blood donors
      from the same region. Only 3 out of 5 ELISA-positive cases were RIBA-positive.
      Patients positive for both types of virus more frequently admitted drug abuse.
      The presence of anti-HCV was not significantly related to the histologic
      severity. During follow-up no new cases of infection were found. CONCLUSIONS: The
      prevalence of HCV infection in asymptomatic chronic carriers is higher than in
      blood donors but lower than previously reported for other populations of chronic
      hepatitis B cases. HCV infection was not found responsible for the frequency or
      the type of lesions observed im these HBsAg chronic carriers.

PMID- 8488766
TI  - [Bone marrow transplantation with major ABO incompatibility. Experience at the
      bone marrow transplantation unit of the Center of Lisbon at the IPOFG].
AB  - Thirteen patients submitted to major ABO incompatible, HLA A and B identical,
      mixed lymphocyte culture negative bone marrow transplantation (BMT) were
      retrospectively evaluated. Gravity sedimentation by hydroxyethyl starch was used
      in almost all cases to deplete erythrocytes from bone marrow (12/13): a removal
      rate or 90%--corresponding to an erythrocyte residual volume of 27.4 rate ml--and
      a nucleated cell recovery of 76% (mean values) were obtained. All patients
      underwent a hyperhydration regimen and received corticosteroid prophylaxis before
      bone marrow infusion. Considering the most important immunohematological problems
      associated to this type of transplant we verified that seven patients developed
      minor complications, and among them only one had long term consequences. In
      comparison with the control group, ABO identical and with minor incompatibility,
      the study group had delayed onset of erythropoiesis and needed greater
      erythrocyte transfusion support. We concluded that major ABO incompatibility does
      not constitute a drawback to BMT success in most patients.

PMID- 8488767
TI  - [Giant cell arteritis (Horton's disease): report of 18 cases].
AB  - The authors present and comment on 18 cases of Giant-cell arteritis observed in
      an Internal Medicine Department between 1984 and 1991 with emphasis on clinical
      aspects and diagnostic considerations, on the occult presentation forms and,
      finally, on two cases with peripheral neuropathy. The clinical manifestations
      were: headache (78%), general non-specific symptoms (78%), polymyalgia rheumatica
      (61%), sudden blindness (33%), local temporal signs (28%), jaw pain (24%),
      articular complaints (17%) and peripheral neuropathy (12%).

PMID- 8488768
TI  - [Prognostic systems in intensive care: general principles, development, and
      clinical applications].
AB  - In this review article, we present the need for prognostic scoring in clinical
      medicine, specially in Intensive Care Medicine (ICM). The general principles of
      prognostication in ICM are discussed, and three general scoring systems are
      presented: ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE) in its 3
      versions, SIMPLIFIED ACUTE PHYSIOLOGY SCORE (SAPS) and MORTALITY PREDICTION MODEL
      (MPM). The use of these prognostic systems is then evaluated not only as a
      support for medical decision-making, and resource allocation, but also as a tool
      for clinical studies in terms of patient randomization. Finally, the future
      developments and clinical application of these risk stratification systems are
      presented and discussed.

PMID- 8488769
TI  - [Biological rhythms in man. Particular aspects in medicine].
AB  - The concepts of chronobiology and chronopharmacology have become more and more
      important in medical practice nowadays. Today, the circadian variation in blood
      pressure and heart rate as well as in the occurrence of acute cardiovascular
      disease is quite obvious (ischemia, infarction, stroke and sudden death).
      However, biological rhythms are also present in episodes of dyspnoea in nocturnal
      asthma, in hormonal pulses, in the organization of the immunological system and
      in the processes of cellular proliferation. These acknowledgments have been
      leading to changes in our therapeutical approaches implying the definition of
      correct anti-hypertensive and anti-ischemic strategy was well as in the use of
      xanthins, corticosteroids, immunomodulators and cytostatics.

PMID- 8488770
TI  - Clinical applications of Doppler coronary flow reserve measurements.
AB  - The development of a subselective coronary Doppler catheter coupled with
      pharmacologic coronary resistance vessel vasodilation has enabled clinicians to
      assess coronary vasodilator reserve in humans. This technique has proven useful
      in the clinical management of patients with a variety of cardiologic problems.
      This review describes usefulness of Doppler measurements of coronary flow reserve
      for (1) functional assessment of coronary stenoses of intermediate severity; (2)
      determination of the need for lesion-specific interventional therapy; (3)
      assessment of the severity of saphenous vein bypass graft and graft-native vessel
      anastomotic lesions; (4) assessment of the coronary microcirculation.

PMID- 8488771
TI  - Applications of coronary flow velocity during angioplasty and other coronary
      interventional procedures.
AB  - Previous studies utilizing Doppler catheters to assess blood flow immediately
      following coronary artery interventions have failed to demonstrate significant
      improvement in proximal coronary artery velocities or vasodilator reserve.
      Measurement of blood flow velocity, flow reserve, and the phasic
      diastolic/systolic velocity ratio in the distal coronary artery has been
      performed following various interventional procedures utilizing a low profile
      (.018 in) Doppler angioplasty guidewire. Following balloon angioplasty in 38
      patients, average peak velocity increased significantly from 19 +/- 12 to 35 +/-
      16 cm/sec in the distal coronary artery. The diastolic/systolic flow ratio
      improved from 1.3 +/- 0.5 to 1.8 +/- 0.5 and coronary flow reserve remained
      unchanged. Similar improvement in distal mean velocities (200%) versus proximal
      mean velocities (90% increase), and improvement in phasic velocity patterns,
      total velocity integral, and peak diastolic velocity were also noted in a
      separate study of 29 patients, before and after balloon angioplasty. Following
      excimer laser angioplasty in 10 patients, average peak velocity in the distal
      coronary artery was noted to increase from 6.3 to 13.0 cm/sec following laser
      alone, with a further increase to 20.6 cm/sec following adjunctive balloon
      angioplasty. The diastolic/systolic flow ratio increased from a mean value of 1.1
      to 2.0 following laser recanalization, with a further increase to 2.9 following
      adjunctive balloon angioplasty. Following directional coronary atherectomy only
      modest improvement in distal average peak velocity was noted (24.7 to 31.2
      cm/sec), with no significant change in diastolic/systolic velocity ratio (1.78 vs
      2.04) immediately following the procedure. Measurement of distal flow velocity
      parameters performed immediately following coronary interventions may prove
      useful in assessing the hemodynamic result of these interventions and may prove
      useful in clinical decision making.

PMID- 8488772
TI  - Assessment of angiographically intermediate coronary artery stenosis using the
      Doppler flowire.
AB  - Determination of the clinical and hemodynamic significance of coronary stenoses
      is often difficult and inexact. Angiography and coronary vasodilator reserve have
      been shown to be imperfect tools to determine the physiologic significance of
      coronary stenoses. Spectral flow velocity data, both proximal and distal to
      coronary stenoses, using an 0.018-in intracoronary Doppler-tipped angioplasty
      guidewire, were compared to translesional pressure gradients and angiography
      during cardiac catheterization. Patients were divided into 2 groups based on
      resting translesional gradients: Group 1 had gradients < 20 mm Hg and group 2 had
      gradients > or = 20 mm Hg. Proximal average peak velocity, diastolic velocity
      integral, and total velocity integral were statistically significantly lower in
      Group 1. The distal average peak velocity, and diastolic and total velocity
      integrals were all significantly (p < 0.01) decreased in patients with gradients
      > 20 mm Hg (group 2). The ratio of proximal-to-distal total flow velocity
      integral was also higher in group 2 patients (2.3 +/- 0.9) compared with group 1
      (1.1 +/- 0.2; p < 0.001). There was a strong correlation between translesional
      pressure gradients and the ratios of the proximal-to-distal total flow velocity
      integrals (r = 0.8, p < 0.001) with a weaker relationship between quantitative
      angiography and pressure gradients (r = 0.6, p < 0.001). Angiography was a poor
      predictor of translesional gradients in angiographically intermediate stenoses
      (range 50-70%; r = 0.2, p = NS), while the flow velocity ratios continued to have
      a strong correlation (r = 0.8, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488773
TI  - Coronary flow velocity dynamics in normal and diseased arteries.
AB  - Distal coronary flow velocity measurements were previously limited to open heart
      or experimental procedures. Unlike previous Doppler catheter techniques, a
      Doppler angioplasty flow wire permits flow velocity measurements in both the
      proximal and distal segments of normal and diseased coronary arteries. In order
      to determine the potential clinical application of the Doppler flow wire, we
      performed baseline and hyperemia flow velocity measurements in proximal and
      distal segments of 20 angiographically normal arteries (right coronary = 8; left
      circumflex = 7; left anterior descending = 5) and 29 significantly stenosed
      arteries. All 3 normal coronary arteries had a diastolic-predominant pattern in
      both proximal and distal segments; the right coronary artery showed significantly
      less diastolic predominance. The coronary vasodilator reserve was similar in all
      three normal coronary arteries, and in the proximal and distal arterial segments.
      Abnormal arteries had significantly lower coronary vasodilator reserve (normal vs
      abnormal, 2.3 +/- 0.8/1.6 +/- 0.7; p < 0.02). Normal arteries had preservation of
      velocity parameters in the distal segments; abnormal arteries had a significant
      decrease in distal velocity parameters. The proximal-to-distal velocity ratio was
      thus significantly higher in abnormal arteries (2.4 +/- 0.7 vs 1.1 +/- 0.2; p <
      0.001). The coronary vasodilator reserve in proximal and distal arteries--in
      addition to the proximal to distal velocity ratio--may provide functional and
      hemodynamic data complementary to coronary angiography in the assessment of
      coronary artery stenosis.

PMID- 8488774
TI  - Quantitating coronary collateral flow velocity in patients during coronary
      angioplasty using a Doppler guidewire.
AB  - Quantitation of coronary collateral flow in patients has been limited to
      angiographic techniques, which are subject to well-known methodologic
      limitations. The use of a Doppler-tipped angioplasty guidewire permits
      measurement of both antegrade and retrograde flow distal to totally or subtotally
      occluded vessels that may be supplied with acutely recruitable or
      angiographically mature collateral conduits. Using coronary flow velocity as an
      indicator of collateral flow, retrograde flow velocity was quantitated in 17
      patients. Mean collateral flow velocity was approximately 30% of normal
      postangioplasty antegrade flow velocity. The phasic pattern of collateral flow
      was highly variable, but the retrograde diastolic and systolic flow velocity
      integrals were 20% and 40% (respectively) of post-procedure antegrade flow
      velocity. Preliminary studies with pharmacologic stimulation of the contralateral
      supply artery suggests that collateral flow is not increased by intracoronary
      nitroglycerin (200 micrograms) or adenosine (12 micrograms), but may be markedly
      augmented during mechanical stimulation of balloon occlusion. These data
      represent the first in a series of quantitative observations on control of the
      coronary collateral circulation in humans. Future investigations using the
      Doppler Flowire (Cardiometrics) will enhance understanding of factors modulating
      ischemia through collateral supply.

PMID- 8488775
TI  - Intracoronary pressure and flow velocity with sensor-tip guidewires: a new
      methodologic approach for assessment of coronary hemodynamics before and after
      coronary interventions.
AB  - The use of miniaturized pressure and velocity sensors mounted on angioplasty
      guidewires allows the simultaneous measurement of coronary blood flow velocity
      and transstenotic pressure gradient, 2 parameters that, combined, should
      perfectly characterize stenosis hemodynamics. The aim of this article is
      assessment of the changes in coronary blood flow velocity observed with a Doppler
      tipped angioplasty guidewire in 35 patients undergoing balloon angioplasty. We
      also report our initial experience in 16 patients with the combined use of sensor
      tip pressure and Doppler guidewires, and we discuss the application of new
      methodologic approaches for the study of the coronary circulation allowed by
      these techniques, such as the instantaneous assessment of the flow
      velocity/pressure and pressure gradient/flow velocity relations. Before and after
      angioplasty, flow velocity measurements were obtained distal to the stenosis,
      both in baseline conditions and after intracoronary injection of 8-12.5 mg of
      papaverine. The Doppler guidewire was left in place during the dilation procedure
      and the Doppler signal was continuously recorded during balloon inflation and
      after deflation to monitor the development of collateral flow, the restoration of
      flow after balloon deflation, the phase of postocclusive reactive hyperemia, and,
      incidently, the development of flow-limiting complications. Merits and pitfalls
      of several flow velocity parameters (average peak velocity, coronary flow
      velocity reserve, diastolic/systolic velocity ratio), as well as of parameters
      derived from the combination of pressure and velocity measurements (transstenotic
      pressure gradient/flow velocity relation and instantaneous diastolic hyperemic
      flow velocity/pressure relation) were evaluated in 35 patients with, and 37
      without, significant coronary stenoses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488776
TI  - Maximal blood flow velocity in severe coronary stenoses measured with a Doppler
      guidewire. Limitations for the application of the continuity equation in the
      assessment of stenosis severity.
AB  - In vitro and animal experiments have shown that the severity of coronary stenoses
      can be assessed using the continuity equation if the maximal blood flow velocity
      of the stenotic jet is measured. The large diameter and the low range of
      velocities measurable without frequency aliasing with the conventional
      intracoronary Doppler catheters precluded the clinical application of this method
      for hemodynamically significant coronary stenoses in humans. This article reports
      the results obtained using a 12 MHz steerable angioplasty guidewire in a
      consecutive series of 52 patients undergoing percutaneous coronary angioplasty
      (61 coronary stenoses). The ratio between coronary flow velocity in a reference
      segment and in the stenosis was used to estimate the percent cross-sectional area
      stenosis. A Doppler recording suitable for quantitation was obtained in the
      stenotic segment in only 10 of 61 arteries (16%). The time-averaged peak velocity
      increased from 15 +/- 5 to 115 +/- 26 cm/sec from the reference normal segment to
      the stenosis. Volumetric coronary flow calculated from the product of mean flow
      velocity and cross-sectional area was similar in the stenosis and in the
      reference segment (33.2 +/- 14.9 vs 33.5 +/- 17.0 mL/min, respectively,
      difference not significant). The percent cross-sectional area stenosis and
      minimal luminal cross-sectional area derived from the Doppler velocity
      measurements using the continuity equation and calculated with quantitative
      angiography were also similar (Doppler, 86.7 +/- 5.1% and 1.00 +/- 0.48 mm2;
      quantitative angiography, 85.9 +/- 7.9% and 1.02 +/- 0.50 mm2).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488777
TI  - Coronary artery flow monitoring following coronary interventions.
AB  - Technologic innovations have made it possible to measure coronary artery blood
      flow in awake patients. Both flow velocity as well as flow reserve can be
      assessed. In particular, the period of time immediately following coronary
      interventions offers a unique opportunity to study important features of coronary
      flow behavior. In 22 patients, coronary flow reserve was measured before and
      after an intervention, either angioplasty or atherectomy, using a 0.018-in
      Doppler guidewire (Flowire). The minimum lumen diameter (MLD) was increased from
      1.0 +/- 0.4 to 1.7 +/- 0.4 mm, while coronary flow velocity increased
      significantly, rising from 29 +/- 13 to 39 +/- 14 cm/sec (p < 0.025). The maximum
      hyperemic velocity also increased, from 44 +/- 16 to 69 +/- 21 cm/sec. Using only
      the preintervention or postintervention values, the flow reserve ratio was 1.53
      +/- 0.4 prior to intervention and 1.84 +/- 0.5 after intervention (p =
      nonsignificant). However, the post-intervention value may have been artifactually
      reduced by the fact that both resting as well as hyperemic velocities increased.
      When the post-intervention flow reserve ratio was recalculated, using the
      preintervention resting value, flow reserve ratio was seen in increase from 1.53
      +/- 0.4 to 2.73 +/- 1.2 (p < 0.001). Measurements of coronary flow in the
      postintervention period also revealed several interesting phenomena. Spasm of a
      coronary artery was documented, and its resolution in response to intracoronary
      nitroglycerin was observed. Elastic recoil following angioplasty was documented
      by gradual decline in coronary flow over 30 minutes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8488778
TI  - Combined physiologic and anatomic assessment of percutaneous revascularization
      using a Doppler guidewire and ultrasound catheter.
AB  - Previous investigations have established the utility of intravascular ultrasound
      (IVUS) examination for the evaluation of arterial dimensions and qualitative
      changes following percutaneous revascularization. More recently, the feasibility
      of obtaining intravascular physiology findings before and/or after percutaneous
      revascularization by use of an intravascular Doppler Flowire (Cardiometrics) has
      been demonstrated. Accordingly, we investigated the feasibility of using this
      combined physiologic/anatomic approach to evaluate individuals undergoing
      percutaneous revascularization of stenotic or occluded coronary and peripheral
      arteries. A total of 76 patients were evaluated using the Flowire to guide an
      IVUS catheter. Revascularization of coronary and peripheral vascular stenoses
      and/or occlusions was achieved in these patients by balloon angioplasty,
      directional atherectomy, excimer laser angioplasty, and thrombolytic therapy,
      alone or in combination. Physiologic findings obtained with the Flowire
      reinforced conclusions regarding morphologic severity of candidate stenoses and
      anatomic adequacy of revascularization following IVUS examination. In certain
      ambiguous cases, information gained by one modality clarified information
      obtained with the other. Finally, one modality may also serve as an alternative
      when logistics preclude the serial use of both. The preliminary experience
      obtained in this feasibility trial confirmed that IVUS and the Flowire may be
      combined to assess both candidate lesions as well as postprocedural patency in
      patients undergoing percutaneous revascularization. The combination of anatomic
      and physiologic data available from IVUS and Flowire provides a far more
      sensitive and possibly more accurate analysis of the adequacy of
      revascularization than has been possible by angiography alone. The extent to
      which such a detailed investigation is required to optimize interventional
      therapy on a routine basis is the subject of subsequent investigations.

PMID- 8488779
TI  - Poverty, health, and children: a second look.

PMID- 8488780
TI  - Youth alienation as an emerging pediatric health care issue. Update.

PMID- 8488781
TI  - Prevention and adolescent health. Commentary on progress of the past 2 years.

PMID- 8488782
TI  - Redoing the health care quilt. A progress report.

PMID- 8488783
TI  - Academic pediatrics and the health of medically underserved children in America.

PMID- 8488784
TI  - Improving health care provision to neonates in the United States.

PMID- 8488785
TI  - Child abuse and neglect. Follow-up.

PMID- 8488786
TI  - Homeless children. Two years later.

PMID- 8488787
TI  - Homeless children in America. Taking the next step.

PMID- 8488788
TI  - Pediatric human immunodeficiency virus revisited.

PMID- 8488789
TI  - Pediatric human immunodeficiency virus infection and the acquired
      immunodeficiency syndrome. A progress report.

PMID- 8488790
TI  - Update on the American Academy of Pediatrics activities to achieve universal
      access to health care for all children.

PMID- 8488791
TI  - Growing neglect of American children.

PMID- 8488792
TI  - Update on the research agenda and care for the poor child. Steps forward, steps
      backward.

PMID- 8488793
TI  - Progress in resident education on serving the underserved.

PMID- 8488794
TI  - Poverty and cardiac disease in children revisited.

PMID- 8488795
TI  - Caring for indigent children with rheumatologic diseases. The challenge
      continues.

PMID- 8488796
TI  - What will it take to fully protect all American children with vaccines? An
      update.

PMID- 8488797
TI  - Older adolescents, a group at special risk. What have 2 years achieved?

PMID- 8488798
TI  - Update on children's health care.

PMID- 8488799
TI  - Children's services in an era of budget deficits.

PMID- 8488800
TI  - Behavioral adaptation to human immunodeficiency virus-seropositive status in
      children and adolescents with hemophilia.
AB  - OBJECTIVE: To examine the behavioral adaptation to human immunodeficiency virus
      (HIV)-seropositive status, as defined by parental report, in children and
      adolescents with hemophilia. RESEARCH DESIGN: A clinical descriptive study of two
      groups of patients as part of a longitudinal design. SETTING: A university-based
      comprehensive hemophilia center and department of neurology acquired
      immunodeficiency syndrome dementia center. PATIENTS: Forty-six male children with
      hemophilia divided into two groups based on HIV-seropositive (n = 18) or 
      seronegative (n = 28) status. None of the patients were symptomatic for acquired
      immunodeficiency syndrome. SELECTION PROCEDURES: All pediatric patients with
      documented factor VII or IX deficiency aged between 4 and 19 years at study onset
      and their families were eligible to participate. All subjects were recruited
      without regard to human immunodeficiency virus status. INTERVENTIONS: None.
      MEASUREMENTS AND RESULTS: Profiles of behavioral adjustment were obtained from
      parents' reports on the Child Behavior Checklist for the HIV-seropositive and HIV
      seronegative groups. The two groups did not differ on any of the major indexes of
      the Child Behavior Checklist, even after adjusting for maternal education and
      severity of hemophilia. There also was no difference between the groups when
      individual cases were examined for the number of child behavior checklist scales
      falling within a clinically significant range. CONCLUSIONS: The current findings
      fail to confirm any clear evidence of behavioral problems in an asymptomatic
      group of HIV-seropositive children and adolescents with hemophilia.

PMID- 8488801
TI  - Health maintenance organizations and children with special health needs. A
      suitable match?
AB  - OBJECTIVE: To address how well health maintenance organizations (HMOs) meet the
      needs of almost 700,000 children with disabilities due to chronic conditions
      enrolled in these plans. DESIGN: A cross-sectional survey. MEASUREMENTS/MAIN
      RESULTS: Health maintenance organizations offered better protection than
      conventional plans against out-of-pocket expenses and were much more likely than
      fee-for-service plans to cover ancillary therapies, home care, outpatient mental
      health care, and medical case management. In addition, few HMOs maintained
      exclusions for preexisting conditions. Other aspects of HMO policies, however,
      were found to operate against the interest of families with chronically ill
      children. In particular, HMOs commonly made specialty services available only
      when significant improvement was expected within a short period. Also, HMOs
      typically placed limits on the amount and duration of mental health, ancillary
      services, and certain other services frequently needed by chronically ill
      children. Probably the most serious problems for chronically ill children
      enrolled in HMOs were the lack of choice among and access to appropriate
      specialty providers. PARTICIPANTS: Individual HMO plans. SELECTION PROCEDURE: A
      sample of 95 geographically representative HMOs were selected; 59 (62%)
      responded. INTERVENTIONS: None. CONCLUSIONS: Health maintenance organizations
      offer several advantages over traditional fee-for-service plans for families
      whose children have special health needs. However, the results also indicate that
      HMOs do not always operate effectively as service provision systems for these
      children. To a large extent, the availability and quality of services available
      to a child with special needs is likely to depend on the parents' ability to
      maneuver within the system.

PMID- 8488802
TI  - The value of urinary growth hormone determination for assessment of growth
      hormone deficiency and compliance with growth hormone therapy.
AB  - OBJECTIVE: To compare the 24-hour integrated concentrations of plasma growth
      hormone with growth hormone levels in a simultaneously collected sample of urine.
      SETTING: Pediatric endocrine diagnostic unit. PATIENTS: Forty-six children (41
      male and five female) aged 6 to 19 years underwent measurement of integrated
      concentrations of growth hormone and simultaneous urine collection. MEASUREMENTS
      AND RESULTS: Integrated concentration of plasma growth hormone was correlated
      with urinary growth hormone levels from both the 24-hour (r = .67; P < .0001) and
      12-hour overnight (r = .52; P < .001) measurements. Peak growth hormone response
      to paired stimulation was not correlated with either the 24-hour (r = .26; P <
      .23; n = 28) or 12-hour (r = .16; P < .48; n = 28) urinary growth hormone levels.
      The mean 24- and 12-hour urinary growth hormone levels for the patients with
      normal integrated concentrations of growth hormone were significantly higher than
      those in patient groups having subnormal integrated concentrations of growth
      hormone (P < .05). However, there was considerable overlap in the 12- and 24-hour
      urinary growth hormone levels between the patients with normal and those with
      subnormal integrated concentrations of growth hormone. Only one patient who had
      subnormal integrated concentrations of growth hormone had a 24-hour urinary
      growth hormone level higher than 9 ng, and none had a 12-hour urinary growth
      hormone level higher than 7 ng. The mean 12- and 24-hour urinary growth hormone
      levels were significantly higher in patients who received growth hormone
      injection than in those with normal spontaneous integrated concentrations of
      growth hormone and had no overlap with patients who had subnormal integrated
      concentrations of growth hormone. CONCLUSIONS: (1) Urinary and integrated
      concentrations of plasma growth hormone are correlated; (2) patient diagnoses
      based on integrated plasma growth hormone levels exhibit a high degree of overlap
      of urinary growth hormone; and (3) urinary growth hormone levels can serve to
      monitor compliance with growth hormone therapy.

PMID- 8488803
TI  - Measles, mumps, and rubella antibodies in vaccinated Baltimore children.
AB  - OBJECTIVE: To determine quantitative measles, mumps, and rubella serum antibody
      levels as a function of time since vaccination in a sample of vaccinated
      Baltimore children. DESIGN: Cross-sectional serologic survey. SETTING: Pediatric
      outpatient departments at the University of Maryland Medical Center, Baltimore.
      PARTICIPANTS: One hundred seventy children, ranging in age from 1.5 through 16
      years, who had measles, mumps, and rubella vaccination between ages 12 and 18
      months. RESULTS: Serum antibody levels to measles and rubella declined with
      increasing time since vaccination. However, no such decline in antibody levels to
      mumps was observed. Children who were vaccinated between ages 12 and 14 months
      did not have lower antibody levels than children who were vaccinated at age 15
      months or older. CONCLUSIONS: In areas free from natural disease, antibody levels
      resultant from measles, mumps, and rubella vaccine are likely to decline with
      advancing age. Revaccination with measles, mumps, and rubella vaccine may boost
      falling antibody titers.

PMID- 8488804
TI  - Taxicabs and child restraint.
AB  - For young urban families who may not own a car, taxicabs are a common mode of
      transportation. We surveyed the frequency of taxicab use involving children
      younger than age 4 years in a Baltimore, Md, clinic population and studied
      pediatric occupant safety issues, including taxicab child restraint law
      exemptions, taxicab occupant morbidity/mortality data, and taxicab child
      restraint device availability. In our inner-city clinic, 84 (78%) of 108 families
      reported that they did not own a car and 64 (76%) of those without cars rode with
      their small children in taxicabs at least monthly (n = 28), weekly (n = 27), or
      daily (n = 9), all without child restraints. Thirty-five of 50 states (70%) plus
      Washington, DC, exempt taxicabs from child restraint laws. Only 11 (27%) of 41
      states with safety belt laws exempt taxicabs. There were 106 reported taxicab
      occupant fatalities from 1986 to 1990 in the United States, including 11 children
      and adolescents. National and state data on motor vehicle occupant morbidity do
      not separately examine taxicabs. Individual taxicab fleets we contacted would not
      release injury data. Of 50 urban taxicab fleets in four states (Delaware,
      Maryland, New Jersey, and Pennsylvania), only three (6%) offered child restraint
      devices by advance telephone request. There was no difference in availability
      based on state taxicab exemptions from child restraint laws. We conclude that
      taxicab use involving young children is common in this inner-city population.
      Data on taxicab occupant injuries are needed. Child restraint law exemptions for
      taxicabs should be eliminated. Education about, and enforcement of, child
      restraint laws for taxicabs is needed. Recent local legislation linking child
      restraint device availability to taxicab licensure should be encouraged.

PMID- 8488805
TI  - Infrared eye injury not due to radiant warmer use in premature neonates.
AB  - OBJECTIVE: Exposure to far-wavelength infrared radiation (lambda > 2000 nm) may
      cause corneal opacity, miosis, and delayed cataracts (onset > 30 days). Near
      wavelength infrared exposure (lambda < 1000 nm) may focus on the retina, causing
      burns; however, early eye examinations in neonates nursed under radiant warmers
      have failed to reveal acute injuries. Our purpose is to report long-term
      ophthalmologic outcome in infants treated under radiant warmers from birth.
      PARTICIPANTS AND METHODS: We report findings from eye examinations in infants
      followed up to a median age of 2 years, 9 months (range, 1 to 75 months), for (1)
      33 infants nursed exclusively under radiant warmers for up to 5 days postnatally
      (mean [+/- SD] birth weight, 1.16 +/- 0.24 kg; mean gestation, 30 +/- 2 weeks)
      and (2) 14 convection-warmed incubator-nursed infants (1.26 +/- 0.22 kg, 31 +/- 2
      weeks), who were slightly more mature. MAIN RESULTS: A trend toward retinopathy
      of prematurity was noted as occurring more frequently in the radiant warmer
      nursed infant population, and one infant in that group was blind. However, no
      macular burns and no permanent corneal, lens, or other anterior segment injuries
      were observed. CONCLUSION: Preliminary findings do not support permanent eye
      damage attributable to near- or far-wavelength infrared injury in neonates nursed
      under radiant warmers.

PMID- 8488806
TI  - Developmental outcome of preterm infants with transient neuromotor abnormalities.
AB  - OBJECTIVE: To determine the relationship between transiently abnormal neurologic
      findings in preterm infants and subsequent cognitive outcome at 4 years of age.
      DESIGN: Prospective 4-year follow-up. SETTING: Regional perinatal center in
      Syracuse, NY. PARTICIPANTS: One hundred thirty-one of 135 consecutively born
      infants of no more than 32 weeks of gestational age; 98% followed up from birth
      to 4 years of age. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Based on
      neuromotor evaluations performed at 6 and 15 months of age, two groups of infants
      were identified. One group had abnormal neurologic findings at 6 months of age
      that had resolved by 15 months of age (transiently abnormal group). The other
      group had normal neuromotor findings at both 6 and 15 months of age (normal
      group). The transiently abnormal group had significantly poorer scores on the
      Bayley Mental scale at 6 months of age (90 +/- 15 vs 108 +/- 10; P < .001), 15
      months (91 +/- 21 vs 105 +/- 12; P < .001), and 24 months (91 +/- 19 vs 101 +/-
      17; P < .001). However, at 4 years of age, cognitive performance on the McCarthy
      Scales was similar for the transiently abnormal and normal groups (General
      Cognitive index, 93 +/- 13 and 95 +/- 14, respectively). The incidence of poor
      cognitive outcome (Cognitive index < 84) decreased from 39% at 2 years of age to
      18% at 4 years of age in the group with a history of transient neurologic
      abnormalities but remained unchanged (16% to 18%) in the normal group.
      CONCLUSION: Early neurologic abnormalities that are transient did not predict
      cognitive delays at 4 years of age in preterm infants.

PMID- 8488807
TI  - Unrecognized pertussis infection in adolescents.
AB  - Little information is available regarding the level of immunity to Bordetella
      pertussis among adolescents. We measured serum antibodies in 156 healthy
      adolescents to the following pertussis antigens: pertussis toxin, filamentous
      hemagglutinin, and 69-kd outer membrane protein. In an attempt to identify
      intercurrent pertussis infections, we also obtained a total of 43 repeated
      samples during the following 5 years. Using a 50% or greater rise in IgG enzyme
      linked immunosorbent assay titers to define seroconversion, we found an annual
      incidence of 6.1%; by alternative definitions of seropositivity, the predicted
      annual incidence of infection ranged from 1.2% to 8.2%. These data suggest that
      infection with B pertussis is common in the adolescent population.

PMID- 8488808
TI  - Black clouds. Work load, sleep, and resident reputation.
AB  - OBJECTIVE: Although it is assumed that residents in a specific training program
      will have comparable experiences, residents commonly perceive that some have
      consistently more difficult times on call. Such residents in our program are said
      to have "black clouds." We sought to determine if these perceptions were related
      to differences in real work load. METHODS: We collected data about the on-call
      experiences of our first-year pediatric residents (PL-1s) for 358 days (1355 on
      call experiences) during the 1984-1985 academic year. Every PL-1 (n = 19)
      reported the following data the morning after each night on call: hours of sleep,
      number of admissions, total number of patients, number of deaths, number of
      transfers to the pediatric intensive care unit, number of delivery room trips,
      and a subjective assessment of work load, using a three-point scale. The
      reputation of each house officer was determined by asking all residents in the
      program (PL-1s, PL-2s, and PL-3s) to rate each other three times during the year
      regarding how hard they worked on call. RESULTS: There were significant
      differences among PL-1s in how difficult they perceived their work load to be and
      in how much they slept (P < .001 using analysis of variance). However, actual
      work load (as measured by the number of either admissions or patients) did not
      vary significantly among the residents. There was a strong negative association
      between self-perception of work load and hours of sleep (r = -.75; 95% confidence
      interval, -0.73 to -0.76). Sleep was the major predictor of perceived work load
      (multiple R2 = .563 using multiple linear regression analysis). The absence of an
      association between perceived and actual work load is attributed to large
      differences in the residents' working styles. This is evidenced by a wide range
      of correlations among PL-1s between the number of admissions and hours of sleep
      (range of r values, -.66 to -.16). A reputation for difficult on-call experiences
      was strongly associated with few hours of sleep (r = -.77; 95% confidence
      interval, -0.49 to -0.91), but not with actual work load measured by the number
      of admissions, patients, deaths, or other variables. Sleep was the major
      predictor of reputation (multiple R2 = .567 using multiple linear regression
      analysis). CONCLUSIONS: Some residents did have a black cloud; they slept less,
      perceived that they worked harder than average, and had a reputation for having
      difficult on-call experiences. Residents with a black cloud function differently
      from their colleagues; for example, some may be inefficient, while others may
      create extra work for themselves. Residency program directors must recognize
      these functional differences to effectively evaluate and counsel house officers.

PMID- 8488809
TI  - Radiological case of the month. Amputated calcified ovary.

PMID- 8488810
TI  - Radiological case of the month. Pulmonary blastoma.

PMID- 8488811
TI  - Picture of the month. Anterior encephalocele.

PMID- 8488812
TI  - Pathological case of the month. Ovarian stromal hyperthecosis.

PMID- 8488813
TI  - Permanent vascular access: a nephrologist's view.
AB  - Vascular access complications are the greatest cause of morbidity in hemodialysis
      patients in the United States. Although arteriovenous fistulas have been
      recommended as the preferred mode of vascular access, recent data indicate that
      the majority of patients on hemodialysis in the United States have prosthetic
      graft fistulas. The most frequent complications of prosthetic graft fistulas are
      thrombosis and stenosis. Hospitalization rates for fistula complications are
      higher in patients with diabetes mellitus and of black race. Pathogenesis of
      intimal hyperplasia may include elaboration of platelet-derived growth factor and
      mechanical endothelial injury. Screening for stenosis and impaired blood flow in
      fistulas can be carried out with recirculation measurements, venous and intra
      access pressure measurements, and Doppler ultrasound. A combination of the
      techniques is probably the best current strategy for fistula screening and
      further evaluation. Surgical thrombectomy and fistula revision remain the
      standard for comparison of newer approaches to management of complications.
      Percutaneous angioplasty with or without stent placement, thrombolysis, and use
      of atherectomy devices may play an increasing role in the treatment of
      complications, although comparative trials of these modalities need to be
      performed. No satisfactory long-term pharmacologic means of preventing
      thrombosis, stenosis, or restenosis have been found for graft arteriovenous
      fistulas. It is hoped that future directions in the field of vascular access
      placement and management will include better strategies for allowing primary
      arteriovenous fistula development, advances in graft materials, improved
      understanding of the pathogenesis of thrombosis and stenosis, and development
      strategies to prevent complications.

PMID- 8488814
TI  - Angiotensin II modulates atrial natriuretic factor-induced natriuresis in
      cirrhosis with ascites.
AB  - Resistance to the natriuretic action of atrial natriuretic factor (ANF) in
      cirrhosis with ascites has been correlated with rising levels of antinatriuretic
      factors, such as renin, angiotensin II (AII), and aldosterone, as well as
      increased sympathetic nerve activity. To determine whether AII can serve as a
      mediator rather than only as a marker of the antinatriuresis, a nonpressor dose
      of AII (5 ng/kg/min) was given during an ANF infusion in eight patients with
      cirrhosis and ascites who responded to ANF infusion with a natriuresis. Patients
      were maintained in metabolic balance and measurements of para-aminohippuric acid,
      inulin, and lithium clearance were taken before and during infusion of ANF with
      or without AII. Atrial natriuretic factor infusion was associated with a
      natriuretic response accompanied by an increase in glomerular filtration rate,
      filtration fraction, and lithium clearance compared with baseline. The addition
      of AII was associated with a return of the glomerular filtration rate to
      baseline, with no change in filtration fraction. This was reversible on
      withdrawal of AII infusion. Natriuresis induced by ANF occurred despite baseline
      elevations of the renin angiotensin aldosterone system and was associated with an
      increase in distal delivery of sodium and a decrease in fractional reabsorption
      of distally delivered sodium as estimated by lithium clearance parameters.
      Angiotensin II infusion exerted effects on both proximal and distal nephron sites
      to abrogate ANF-induced natriuresis. These results suggest that AII may serve as
      a mediator as well as a marker of resistance to the natriuretic effect of ANF in
      patients with cirrhosis and ascites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488815
TI  - The role of macrophages in diabetic glomerulosclerosis.
AB  - To elucidate the role of macrophages in diabetic glomerulosclerosis (DGS), an
      immunohistologic study was performed using monoclonal antibodies to common
      leukocyte antigen (DAKO-LC), T cells (T3), B cells (CD22), and macrophages (MAC
      387, Leu-M5, and EBM-11). Kidney biopsy specimens were obtained from 28 patients
      with non-insulin-dependent diabetes mellitus. Cells were identified by a three
      layer immunoperoxidase technique applied to cold ethanol-fixed, paraffin-embedded
      sections and quantitated as the number of cells per glomerular cross-sections and
      number of cells per square millimeter of glomerulus. The severity of the diffuse
      lesions in each glomerulus was graded semiquantitatively. The average grades for
      all the glomeruli were calculated and registered as an index of DGS for a biopsy
      specimen. There was no relationship between the index of DGS and the number of T
      or B cells. However, the number of macrophages and common leukocyte-positive
      cells increased significantly in the moderate stage of glomerulosclerosis
      compared with the mild or advanced stage. The results suggest that macrophages
      may transiently infiltrate during the moderate stage of diffuse DGS, contributing
      to irreversible structural damage.

PMID- 8488816
TI  - Mesangial proliferative glomerulonephritis in southwestern American Indians.
AB  - A series of 166 American Indian renal biopsy specimens from 1971 to 1989 showed a
      very high proportion with mesangial proliferative glomerulonephritis with
      mesangial immunoglobulin deposition (Ig-pos mesGN). This disease comprised 68.7%
      of all the biopsies and 83.8% of all primary GN, proportions much greater than
      those (23.5% and 37.7%, respectively) of a local contemporaneous biopsy series
      from non-Indians (P < 0.001). These proportions and the extrapolated population
      based incidence rates of mesGN are the highest yet described in any population.
      Males and females were equally represented in the Indian Ig-pos mesGN series.
      Biopsy was most commonly performed in early adulthood, but duration of suspected
      disease prior to biopsy was often many years. Mesangial glomerulonephritis often
      occurred in family clusters. It was occasionally associated with rashes,
      arthralgias, and/or a history of alcohol abuse. Due to different surveillance and
      biopsy practices, the spectrum of severity was different in Zunis and Navajos,
      allowing examination of clinicopathologic correlations over a broad range of
      disease. Early disease was manifest by microscopic hematuria alone, but rates of
      severe disease, with hypertension, heavy proteinuria, and renal insufficiency,
      were very high. Clinical severity increased with age, with extension of pathology
      beyond the mesangium, and with scarring and vascular change. Changing patterns of
      deposition of mesangial immunoglobulin and of electron-dense deposits in
      sequential biopsy specimens, recurrence of disease in kidney transplants, and
      biopsy diagnosis of disease in asymptomatic relatives of afflicted subjects were
      all observed. Five-year renal failure rates were estimated at 41%, much higher
      than in most other series. This disease constituted most biopsied cases of GN-end
      stage renal disease in Navajos, and largely determined the young age of Navajo GN
      end stage renal disease subjects compared with their US-wide counterparts. To
      reconcile the diversity of clinical and morphologic findings in such homogeneous
      ethnic groups, and in individual families within such groups, we propose a
      unifying hypothesis for a broader spectrum of mesGN than traditionally defined by
      immunoglobulin subtype deposition. We also argue against a major role for IgA
      aggregates or immune complexes in initiating or propagating the mesangial
      inflammatory process, and propose that mesangial pathology of another,
      independent cause might be primary. Hyperinsulinemia, or insulin resistance,
      which is common in these populations and in other transitional populations with
      similar GN and ESRD patterns, might be one such mesangiopathic factor.

PMID- 8488817
TI  - Cyclophosphamide provides no additional benefit to steroid therapy in the
      treatment of idiopathic membranous nephropathy.
AB  - Thirty-six patients with idiopathic membranous nephropathy were retrospectively
      studied. The mean age was 47 years and the male to female ratio 25 to 11. Twenty
      eight patients (77.8%) had nephrotic syndrome at first investigation. Nineteen
      patients received corticosteroids alone (group A) and 17 received corticosteroids
      combined with cyclophosphamide (group B). The mean period of follow-up was 58.9
      months (range, 12 to 156 months). The two groups did not differ in clinical or
      laboratory features at the time of biopsy or at the start of treatment. In the
      entire series a complete remission of proteinuria occurred in 13 of 36 patients
      (36.1%) and a partial remission occurred in 13 (36.1%); 10 patients (27.8%) had
      no response. Optimal remission of proteinuria was usually recorded 6 to 12 months
      after the start of treatment. The two groups showed no statistical differences
      regarding the rate of complete (seven v six patients; P = not significant) or
      partial (six v seven patients; P = not significant) remissions. Two patients (one
      from each group) entered end stage renal failure during follow-up. At last
      assessment, the number of patients with complete remission (four v three
      patients; P = not significant), nonnephrotic proteinuria (nine v nine patients; P
      = not significant), or nephrotic syndrome (five v four patients; P = not
      significant) was similar in both groups. In addition, final plasma creatinine did
      not differ significantly between the two groups (1.8 +/- 2.3 mg/dL v 2.6 +/- 2.6
      mg/dL; P = not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488818
TI  - Successful treatment of cystinuria with captopril.
AB  - Cystinuria is an autosomal recessive hereditary disorder associated with
      nephrolithiasis and its attendant complications. Traditional management aimed at
      increasing urinary cystine solubility using oral alkali, D-penicillamine, or
      mercaptopropionyglycine is often unsuccessful due to intolerable side effects.
      Two cystinuric patients intolerant of traditional therapy were treated with
      captopril for 1 year, resulting in a marked decline in urinary cystine excretion.
      Neither patient experienced recurrent nephrolithiasis or adverse drug effects.
      Captopril should be considered an alternative to traditional drug management of
      cystinuria.

PMID- 8488819
TI  - Acute continuous hemodiafiltration: a prospective study of 110 patients and a
      review of the literature.
AB  - One hundred ten critically ill patients with acute renal failure receiving acute
      continuous hemodiafiltration (ACHD) in our intensive care unit were studied
      prospectively. Acute continuous hemodiafiltration consisted either of continuous
      arteriovenous hemodiafiltration or of continuous veno-venous hemodiafiltration,
      and was used for 17,817 hours (mean duration of patient treatment, 161.9 hours),
      resulting in a fall from a mean pre-ACHD urea of 35.7 mmol/L to a plateau value
      of 16.8 mmol/L at 72 hours of treatment. The mean urea clearance achieved was
      24.9 mL/min. Eighty of these patients (72.7%) were receiving artificial
      ventilation at the time of ACHD and 45 (40.9%) had more than four failing organs.
      The mean APACHE II score was 27.7. Despite the degree of illness severity, 42
      patients (32.2%) survived to discharge from hospital. The use of ACHD was
      associated with hemodynamic stability, rapid normalization of electrolytes, and
      the ability to freely administer drugs, blood, and/or blood products. It also
      allowed for maintenance of an aggressive, nitrogen-rich, nutritional regimen.
      Support of these critically ill patients with acute renal failure using ACHD was
      achieved safely and without the employment of additional dialysis-trained nursing
      staff. Our own experience and a review of the available literature strongly
      suggest that the advantages associated with the use of ACHD therapies are
      clinically significant and support the view that ACHD is a modality of renal
      replacement most suited to critically ill patients with acute renal failure.

PMID- 8488820
TI  - Beta 2-microglobulin generation and removal in long slow and short fast
      hemodialysis.
AB  - We studied the influence of different modes of hemodialysis (HD) on plasma levels
      of beta 2-microglobulin (P-beta 2-m) and its correlation to changes in leukocyte
      count, complement activation (C3a), and elastase generation. The influence of
      dialyzer membrane, membrane surface area, duration of treatment, and blood flow
      was analyzed with respect to post-HD levels of P-beta 2-m. Twenty patients
      underwent 12 modes of bicarbonate hemodialysis in random order (n = 252) using
      three different membranes (Cuprophan [CU], hemophan [HE], or polyamide [PA], two
      dialyzer areas, and fast (400 mL/min) or slow (200 mL/min) blood flow (Qb) for 2
      or 4 hours, respectively. All dialysate was collected and beta 2-m was analyzed
      (D-beta 2-m). After correction for hemoconcentration, P-beta 2-m concentrations
      were found to have decreased significantly during treatment with all three
      membranes (CU, 0.9 +/- 0.3 mg/L, P = 0.002; HE, 1.2 +/- 0.3 mg/L, P < 0.001; and
      PA, 8.3 +/- 0.3 mg/L, P < 0.001). Elimination of P-beta 2-m was influenced by
      type of membrane (P < 0.001) and ultrafiltration volume (P = 0.0019) but not by
      membrane area or Qb. The largest reduction in P-beta 2-m (-10.4 mg/L) was
      achieved by the following treatment combination: PA membrane, large dialyzer
      area, and low Qb for 4 hours. P-beta 2-m decreased more during PA dialysis at low
      Qb for 4 hours (-9.9 +/- 0.5 mg/L) than during high Qb for 2 hours (-6.8 +/- 0.5
      mg/L, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488821
TI  - The effects of recombinant human growth hormone and intradialytic parenteral
      nutrition in malnourished hemodialysis patients.
AB  - Malnutrition in hemodialysis patients is associated with increased morbidity and
      mortality. The use of intradialytic parenteral nutrition (IDPN) to improve
      nutritional parameters has been shown to be of limited benefit in most studies.
      We studied the use of recombinant human growth hormone (rHuGH) in potentiating
      the effects of IDPN in seven hemodialysis patients dialyzed with a Kt/V of 1.03
      +/- 0.11 (mean +/- SEM), but with evidence of malnutrition: albumin, 3.2 +/- 0.18
      g/dL; transferrin, 215 +/- 30 mg/dL; insulin-like growth factor-1 (IGF-1), 115 +/
      19 ng/mL, protein catabolic rate (PCR), 0.70 +/- 0.05 g/kg/d; and weight, 12.3%
      +/- 4.0% below ideal body weight. During 6 weeks of IDPN, resulting in an
      additional 18 +/- 4 kcal and 0.69 +/- 0.03 g of protein/kg body weight per
      dialysis session, albumin concentration increased to 3.5 +/- 0.14 g/dL (compared
      with baseline, P = NS), transferrin increased to 279 +/- 36 mg/dL (P < 0.002),
      IGF-1 increased to 152 +/- 32 ng/mL (P = NS), and PCR increased to 0.81 +/- 0.04
      g/kg/d (P = NS). During the next 6 weeks, IDPN administration was continued and
      rHuGH, at a dose of 5 mg subcutaneously during each dialysis, was added to the
      regimen. This resulted in an increase in albumin concentration to 3.8 +/- 0.08
      g/dL (P < or = 0.04 compared with end of IDPN phase), an increase in transferrin
      to 298 +/- 41 mg/dL (P = NS compared with end of IDPN phase), and an increase in
      IGF-1 to 212 +/- 45 ng/mL (P = 0.05 compared with end of IDPN phase).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488822
TI  - Disseminated histoplasmosis with glomerulonephritis mimicking Wegener's
      granulomatosis.
AB  - Renal complications of disseminated histoplasmosis include chronic recurrent
      abcesses of the interstitium and urogenital tract. To our knowledge,
      glomerulonephritis has never been reported in histoplasmosis. We describe a case
      of proven histoplasmosis presenting with oral granulomatous ulceration and
      segmental glomerulonephritis that mimicked Wegener's granulomatosis (WG). All
      symptoms and renal parameters remitted under itraconazole treatment alone. In
      conclusion, glomerulonephritis may complicate the course of chronic disseminated
      histoplasmosis. Since it can masquerade as WG, systematic tissue staining for
      intracellular microorganisms should be done when WG is suspected.

PMID- 8488823
TI  - Glomerular disease and urinary Sezary cells in cutaneous T-cell lymphomas.
AB  - We report three cases of biopsy-documented renal glomerular disease occurring in
      patients with cutaneous T-cell lymphomas. One patient had immunoglobulin A (IgA)
      nephropathy and another had membranous nephropathy. The remaining patient had an
      immune complex glomerulonephritis without immunofluorescent evidence of IgA, but
      with mesangial deposits and a clinical course notable for stable renal function,
      minimal proteinuria, and episodic gross hematuria of renal origin. These three
      cases, along with IgA nephropathy in two of the four previously reported cases,
      suggest a possible association between cutaneous T-cell lymphoma and this
      glomerular lesion. In addition, Sezary cells were observed in the urine of two
      patients, one without evidence of glomerular disease. The prognostic value of
      this new observation is unknown.

PMID- 8488824
TI  - Tubulointerstitial nephropathy persisting 20 months after discontinuation of
      chronic intake of germanium lactate citrate.
AB  - Two young human immunodeficiency virus (HIV)-infected patients, a 25-year-old
      woman and a 26-year-old man, consumed large amounts of germanium lactate citrate
      18% as an "immunostimulant" for 9 months. The woman, who had stage II HIV
      infection, developed severe renal dysfunction (creatinine clearance, 7
      mL/min/1.73 m2) and slight proteinuria (0.28 g/d) after ingesting 260 g germanium
      lactate citrate 18%. Hepatomegaly with liver dysfunction (SGOT, 102 U/L; gamma
      glutamyl transferase (GT), 159 U/L) and lactic acidosis (plasma lactate, 7.3
      mmol/L) developed simultaneously. Renal biopsy revealed tubulointerstitial
      nephropathy with vacuolar cell degeneration and periodic acid-Schiff-positive
      intracellular deposits mainly in distal tubules. Liver biopsy disclosed severe
      hepatic steatosis; liver function tests returned to normal within 5 weeks. Since
      renal failure persisted for 2 years after ingestion of germanium (creatinine
      clearance, 14 mL/min/1.73 m2; proteinuria, 0.84 g/d), a second renal biopsy was
      performed, which showed marked but focal distal tubular atrophy and slight
      interstitial fibrosis. The male patient, who had stage III HIV infection, had
      ingested the same compound; he presented with a creatinine clearance of 43
      mL/min/m2 and proteinuria of 0.36 g/d. Renal biopsy disclosed tubulointerstitial
      changes similar to those found in the female patient. After 9 months off
      germanium, creatinine clearance remained unchanged. Neutron activation analysis
      of all biopsy specimens in both cases documented germanium concentrations 10 to
      70 times normal in renal tissue and 140 times normal in liver tissue.

PMID- 8488825
TI  - Papillary renal cell carcinoma with numeric changes of chromosomes in a long-term
      hemodialysis patient: a karyotype analysis.
AB  - A patient with renal neoplasm was nephrectomized 5 months after successful renal
      transplantation. The tumor was clearly diagnosed after renal transplantation,
      although a computed tomography scan before renal transplantation had suggested
      its presence. The patient had been on hemodialysis for 11 years, with extensive
      acquired renal cystic disease before renal transplantation. Pathology revealed a
      renal cell tumor with granular cells and tubulopapillary structure, consistent
      with papillary renal cell carcinoma. Karyotype analysis revealed that this tumor,
      which was 1.7 cm in diameter, showed trisomy of chromosomes 5, 16, and 20 and
      deletion of chromosome Y. This preliminary study suggests that cytogenetic
      changes of papillary renal cell tumor associated with acquired cystic disease are
      similar to those in the general population.

PMID- 8488826
TI  - Amplification of the arachidonic acid cascade: implications for pharmacologic
      intervention.
AB  - The signal transduction pathway that results in prostaglandin production is
      thought to occur in a stepwise manner that involves agonist-stimulated action of
      a phospholipase that releases the second messenger arachidonic acid from membrane
      phospholipids. Prostaglandin endoperoxide synthase (PGH synthase) then converts
      arachidonic acid to the prostaglandin precursors. Further delineation of this
      cascade has recently occurred with the identification of two distinct
      prostaglandin endoperoxide synthases, PGH synthase-1 and PGH synthase-2. There is
      evidence that PGH synthase-1 may have broad cellular expression and may be
      constitutively expressed in most cells. In contrast, PGH synthase-2 expression
      may be more limited and has been shown to be stimulated by a variety of cytokines
      and growth factors. Dexamethasone inhibits the expression of an early response
      gene, TIS10, which is homologous to PGH synthase-2. The exact mechanism of PGH
      synthase-2 gene regulation in mesangial cells is unknown; however, it may be a
      potential site for pharmacologic intervention. Regulation of PGH synthase-2 could
      in turn modulate prostaglandin production and temper the production of
      extracellular matrix and thus scar formation that occurs in a wide variety of
      inflammatory renal diseases.

PMID- 8488827
TI  - Adequacy of hemodialysis.

PMID- 8488829
TI  - Outbreak of hemodialysis-associated non-A, non-B hepatitis.

PMID- 8488828
TI  - Short-term responsiveness of membranous glomerulopathy to cyclosporine.

PMID- 8488830
TI  - Nonsyndromic cleft lip with or without cleft palate in west Bengal, India:
      evidence for an autosomal major locus.
AB  - Ninety extended families having one or more individuals affected with
      nonsyndromic cleft lip (CL) with or without cleft palate (CL/P) were ascertained
      in rural West Bengal, India. These families included 138 affected people, 64% of
      whom had CL alone and 66% of whom were male. Multiple-affected-member
      ("multiplex") pedigrees were less common than single-affected-member ("simplex")
      pedigrees, composing 34% of all extended pedigrees. There was no difference
      between multiplex and simplex pedigrees in the frequency of affected persons with
      CL alone, but multiplex pedigrees had a lower frequency of affected males (58%)
      than did simplex pedigrees (76%; P = .02). Complex segregation analysis using the
      POINTER computer program rejected both the hypothesis of no familial transmission
      (P < .0001) and the hypothesis that familiarity could be explained solely by a
      multifactorial/threshold model (P < .05). The hypothesis of major-locus
      inheritance alone could not be rejected. Among major-locus models examined,
      strictly recessive inheritance was rejected (P < .0001), but codominant and
      dominant models were not. Neither the addition of a multifactorial component nor
      the addition of a proportion of sporadic cases to the major-locus model improved
      the fit of the data. In conclusion, the results of complex segregation analysis
      were consistent with a dominant or codominant major-locus mode of inheritance of
      CL/P in these families.

PMID- 8488831
TI  - Concerns about the genetics of pre-eclampsia.

PMID- 8488832
TI  - Is the presence of two different Tay-Sachs disease mutations in a Cajun
      population an unexpected observation?

PMID- 8488833
TI  - A postulated mechanism for deletions with inversions.

PMID- 8488834
TI  - Insurance commissioners and genetic discrimination.

PMID- 8488835
TI  - Efficacy and applicability of interphase fluorescence in situ hybridization for
      prenatal diagnosis.

PMID- 8488836
TI  - Rapid prenatal diagnosis of chromosomal aneuploidies by fluorescence in situ
      hybridization: clinical experience with 4,500 specimens.
AB  - Detection of chromosome aneuploidies in uncultured amniocytes is possible using
      fluorescence in situ hybridization (FISH). We herein describe the results of the
      first clinical program which utilized FISH for the rapid detection of chromosome
      aneuploidies in uncultured amniocytes. FISH was performed on physician request,
      as an adjunct to cytogenetics in 4,500 patients. Region-specific DNA probes to
      chromosomes 13, 18, 21, X, and Y were used to determine ploidy by analysis of
      signal number in hybridized nuclei. A sample was considered to be euploid when
      all autosomal probes generated two hybridization signals and when a normal sex
      chromosome pattern was observed in greater than or equal to 80% of hybridized
      nuclei. A sample was considered to be aneuploid when greater than or equal to 70%
      of hybridized nuclei displayed the same abnormal hybridization pattern for a
      specific probe. Of the attempted analyses, 90.2% met these criteria and were
      reported as informative to referring physicians within 2 d of receipt. Based on
      these reporting parameters, the overall detection rate for aneuploidies was 73.3%
      (107/146), with an accuracy of informative results for aneuploidies of 93.9%
      (107/114). Compared to cytogenetics, the accuracy of all informative FISH
      results, euploid and aneuploid, was 99.8%, and the specificity was 99.9%. In
      those pregnancies where fetal abnormalities had been observed by ultrasound,
      referring physicians requested FISH plus cytogenetics at a significantly higher
      rate than they requested cytogenetics alone. The current prenatal FISH protocol
      is not designed to detect all chromosome abnormalities and should only be
      utilized as an adjunctive test to cytogenetics. This experience demonstrates that
      FISH can provide a rapid and accurate clinical method for prenatal identification
      of chromosome aneuploidies.

PMID- 8488837
TI  - Two-hit model for sporadic congenital anomalies in mice with the disorganization
      mutation.
AB  - Congenital anomalies have complex etiologies involving both genetic and
      nongenetic components. Many are sporadic, without obvious evidence for
      heritability. An important model for these anomalies is a mutation in laboratory
      mice that is called "disorganization" (Ds), which functions as a variable
      autosomal dominant and leads to a wide variety of congenital anomalies involving
      many developmental processes and systems. Variable expressivity, asymmetrical
      manifestations, and low penetrance suggest that somatic events determine the
      location and nature of these anomalies. A statistical analysis suggests that
      occurrence of anomalies in mice with the Ds mutation follows a Poisson
      distribution. These results suggest that congenital anomalies in mice with the Ds
      mutation occur independently of each other. We propose that Ds causes a heritable
      predisposition to congenital anomalies and that Ds and appropriate somatic events
      combine to compromise normal development. We also propose that some sporadic,
      nonheritable congenital anomalies involve somatic mutations at Ds-like loci. Ds
      may therefore serve not only as a model for developmental anomalies in cell fate
      and pattern formation but also for complex developmental traits showing variable
      expressivity, low penetrance, and sporadic occurrence in mice and humans.

PMID- 8488838
TI  - Neurobehavioral effects of the fragile X premutation in adult women: a controlled
      study.
AB  - Although previous studies have suggested that the fragile X premutation (fra [X]
      pM) does not cause deleterious effects, methodological constraints have prevented
      more definitive conclusions from being reached. In this report, we describe the
      neuropsychiatric and cognitive-neuropsychological status of 34 adult women with
      the fra (X) pM, as compared with a well-matched control group of 41 mothers of
      fra (X)-negative children with developmental disability. The results indicate
      that there are no meaningful differences between adult women with the fra (X) pM
      and control subjects with respect to cognitive abilities or profile,
      neuropsychological function, psychiatric diagnoses or symptoms, and self-rated
      personality profile. No measure for either group showed evidence of functioning
      outside the normal range except for a high lifetime prevalence of major
      depression in both groups. Additional exploratory analyses within the fra (X)
      group showed no significant effect of either the size of the fra (X) insert or X
      chromosome inactivation pattern in leukocytes, on any measure of neurobehavioral
      function. These findings provide additional information to professionals
      providing genetic counseling to, and assessment of, fra (X) families.

PMID- 8488839
TI  - Molecular analysis of the 18q- syndrome--and correlation with phenotype.
AB  - Seven individuals with deletions of the distal long arm of chromosome 18 were
      evaluated at the clinical, cytogenetic, and molecular levels. The patients had
      varying degrees of typical clinical findings associated with the 18q- syndrome.
      Cytogenetic analysis revealed deletions from 18q21.3 or 18q22.2 to qter. Somatic
      cell hybrids derived from the patients were molecularly characterized using
      ordered groups of probes isolated from a chromosome 18-specific library. In
      general, the size of the deletion could be correlated with the severity of the
      phenotype. Based on the clinical pictures of these seven patients, a preliminary
      phenotypic map for the clinical features associated with deletions of the distal
      portion of the long arm has been generated. Furthermore, genes previously
      localized to 18q21 were mapped relative to the chromosome breakpoints present in
      these patients.

PMID- 8488840
TI  - Narrowing the position of the Treacher Collins syndrome locus to a small interval
      between three new microsatellite markers at 5q32-33.1.
AB  - Treacher Collins syndrome (TCOF1) is an autosomal dominant disorder of
      craniofacial development, the features of which include conductive hearing loss
      and cleft palate. The TCOF1 locus has been localized to chromosome 5q32-33.2. In
      the present study we have used the combined techniques of genetic linkage
      analysis and fluorescence in situ hybridization (FISH) to more accurately define
      the TCOF1 critical region. Cosmids IG90 and SPARC, which map to distal 5q,
      encompass two and one hypervariable microsatellite markers, respectively. The
      heterozygosity values of these three markers range from .72 to .81. Twenty-two
      unrelated TCOF1 families have been analyzed for linkage to these markers. There
      is strong evidence demonstrating linkage to all three markers, the strongest
      support for positive linkage being provided by haplotyping those markers at the
      locus encompassed by the cosmid IG90 (Zmax = 19.65; theta = .010). FISH to
      metaphase chromosomes and interphase nuclei established that IG90 lies
      centromeric to SPARC. This information combined with the data generated by
      genetic linkage analysis demonstrated that the TCOF1 locus is closely flanked
      proximally by IG90 and distally by SPARC.

PMID- 8488841
TI  - Incidence and origin of "null" alleles in the (AC)n microsatellite markers.
AB  - Twenty-three (AC)n repeat markers from chromosome 16 were typed in the parents of
      the 40 CEPH (Centre d'Etude du Polymorphisme Humain) families. Where parents were
      informative, the entire families were then typed. There were seven markers in
      which null alleles were demonstrated, as recognized by the apparent
      noninheritance, by a sib, of a parental allele. Four of these markers showed a
      null allele in a single sibship, while in the other three at least 30% of the
      CEPH sibships were shown to have a null allele segregating. One null allele was
      sequenced and shown to be the result of an 8-bp deletion occurring within the
      priming sequence for PCR amplification of the (AC)n repeats. In gene mapping or
      in application to diagnosis, the presence of a segregating null allele will not
      corrupt the linkage data but could result in loss of information. In isolated
      instances a segregating null allele may be interpreted as nonpaternity. The
      presence of a null allele may generate misleading data when individuals are
      haplotyped to determine the presence of linkage disequilibrium with a disease
      gene.

PMID- 8488842
TI  - Mutation at codon 322 in the human acetylcholinesterase (ACHE) gene accounts for
      YT blood group polymorphism.
AB  - Acetylcholinesterase is present in innervated tissues, where its function is to
      terminate nerve impulse transmission. It is also found in the red blood cell
      membrane, where its function is unknown. We report the first genetic variant of
      human acetylcholinesterase and support the identity of acetylcholinesterase as
      the YT blood group antigen. DNA sequencing shows that the wild-type sequence of
      acetylcholinesterase with His322 (CAC) is the YT1 blood group antigen and that
      the rare variant of acetylcholinesterase with Asn322 (AAC) is the YT2 blood group
      antigen. Two additional point mutations in the acetylcholinesterase gene do not
      affect the amino acid sequence of the mature enzyme.

PMID- 8488843
TI  - Characterization of five new mutants in the carboxyl-terminal domain of human
      apolipoprotein E: no cosegregation with severe hyperlipidemia.
AB  - Assessment of the apolipoprotein E (apoE) phenotype by isoelectric focusing of
      both hyperlipidemic and normolipidemic individuals identified five new variants.
      All mutations were confined to the downstream part of the APOE gene by using
      denaturing gradient gel electrophoresis (DGGE). Sequence analysis revealed five
      new mutations causing unique amino acid substitutions in the carboxyl-terminal
      part of the protein containing the putative lipid-binding domain. Three
      hyperlipoproteinemic probands were carriers of the APOE*2(Val236-->Glu) allele,
      the APOE*3(Cys112-->Arg; Arg251-->Gly) allele, or the APOE*1(Arg158-->Cys; Leu252
      ->Glu) allele. DGGE of the region encoding the receptor-binding domain was useful
      for haplotyping the mutations at codons 112 and 158. Family studies failed to
      demonstrate cosegregation between the new mutations and severe
      hyperlipoproteinemia, although a number of carriers for the APOE*3(Cys112-->Arg;
      Arg251-->Gly) allele and the APOE*1(Arg158-->Cys; Leu252-->Glu) allele expressed
      hypertriglyceridemia and/or hypercholesterolemia. Two other mutant alleles,
      APOE*4-(Cys112-->Arg; Arg274-->His) and APOE*4+(Ser296-->Arg), were found in
      normolipidemic probands. The lack of cosegregation of these new mutations with
      severe hyperlipoproteinemia suggests that these mutations do not exert a dominant
      effect on the functioning of apoE.

PMID- 8488844
TI  - Ordering genes: controlling the decision-error probabilities.
AB  - Determination of the relative gene order on chromosomes is of critical importance
      in the construction of human gene maps. In this paper we develop a sequential
      algorithm for gene ordering. We start by comparing three sequential procedures to
      order three genes on the basis of Bayesian posterior probabilities, maximum
      likelihood ratio, and minimal recombinant class. In the second part of the paper
      we extend sequential procedure based on the posterior probabilities to the
      general case of g genes. We present a theorem that states that the predicted
      average probability of committing a decision error, associated with a Bayesian
      sequential procedure that accepts the hypothesis of a gene-order configuration
      with posterior probability equal to or greater than pi *, is smaller than 1 - pi
      *. This theorem holds irrespective of the number of genes, the genetic model, and
      the source of genetic information. The theorem is an extension of a classical
      result of Wald, concerning the sum of the actual and the nominal error
      probabilities in the sequential probability ratio test of two hypotheses. A
      stepwise strategy for ordering a large number of genes, with control over the
      decision-error probabilities, is discussed. An asymptotic approximation is
      provided, which facilitates the calculations with existing computer software for
      gene mapping, of the posterior probabilities of an order and the error
      probabilities. We illustrate with some simulations that the stepwise ordering is
      an efficient procedure.

PMID- 8488845
TI  - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency: diagnosis by acylcarnitine
      analysis in blood.
AB  - Medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency is a disorder of
      fatty acid catabolism, with autosomal recessive inheritance. The disease is
      characterized by episodic illness associated with potentially fatal hypoglycemia
      and has a relatively high frequency. A rapid and reliable method for the
      diagnosis of MCAD deficiency is highly desirable. Analysis of specific
      acylcarnitines was performed by isotope-dilution tandem mass spectrometry on
      plasma or whole blood samples from 62 patients with MCAD deficiency.
      Acylcarnitines were also analyzed in 42 unaffected relatives of patients with
      MCAD deficiency and in other groups of patients having elevated plasma C8
      acylcarnitine, consisting of 32 receiving valproic acid, 9 receiving medium-chain
      triglyceride supplement, 4 having multiple acyl-coenzyme A dehydrogenase
      deficiency, and 8 others with various etiologies. Criteria for the unequivocal
      diagnosis of MCAD deficiency by acylcarnitine analysis are an elevated C8
      acylcarnitine concentration (> 0.3 microM), a ratio of C8/C10 acylcarnitines of >
      5, and lack of elevated species of chain length > C10. These criteria were not
      influenced by clinical state, carnitine treatment, or underlying genetic
      mutation, and no false-positive or false-negative results were obtained. The same
      criteria were also successfully applied to profiles from neonatal blood spots
      retrieved from the original Guthrie cards of eight patients. Diagnosis of MCAD
      deficiency can therefore be made reliably through the analysis of acylcarnitines
      in blood, including presymptomatic neonatal recognition. Tandem mass spectrometry
      is a convenient method for fast and accurate determination of all relevant
      acylcarnitine species.

PMID- 8488846
TI  - Segregation analysis of fat mass and other body composition measures derived from
      underwater weighing.
AB  - Segregation patterns of three body composition measures which were derived from
      underwater weighing were evaluated in a random sample of 176 French-Canadian
      families. Two of the variables can be considered as primary partitions of weight
      (fat mass [FM] and fat-free mass [FFM]), while the remaining variable (percent
      body fat [%BF]) is a derived index combining the measures of both fat and fat
      free weight. This study represents the first report investigating major gene
      effects for these measures. Segregation analyses revealed that a major locus
      hypothesis could not be rejected for two of the three phenotypes. The single
      exception was FFM, for which nearly 60% of the variance was accounted for by a
      non-Mendelian major effect, which may reflect environmentally based commingling
      or may be in part a function of gene-environment interactions or correlations. In
      contrast to the results for FFM, the results for each of FM and %BF were similar
      and suggested a major locus which accounted for 45% of the variance, with an
      additional 22%-26% due to a multifactorial component. Given the similarity of the
      major gene characteristics for these two phenotypes, the possibility that the
      same gene underlies both measures warrants investigation. A reasonable hypothesis
      is to consider genes that may influence nutrient partitioning, as the family of
      candidate genes to receive the major attention.

PMID- 8488847
TI  - Molecular topography of the secondary constriction region (qh) of human
      chromosome 9 with an unusual euchromatic band.
AB  - Heterochromatin confined to pericentromeric (c) and secondary constriction (qh)
      regions plays a major role in morphological variation of chromosome 9, because of
      its size and affinity for pericentric inversion. Consequently, pairing at
      pachytene may lead to some disturbances between homologous chromosomes having
      such extreme variations and may result in abnormalities involving bands adjacent
      to the qh region. We encountered such a case, where a G-positive band has
      originated de novo, suggesting a maternal origin from the chromosome 9 that has
      had a complete pericentric inversion. In previously reported cases, the presence
      of an extra G-positive band within the 9qh region has been familial, and in the
      majority of those cases it was not associated with any clinical consequences.
      Therefore, this anomaly has been referred to as a "rare" variant. The qh region
      consists of a mixture of various tandemly repeated DNA sequences, and routine
      banding techniques have failed to characterize the origin of this extra genetic
      material. By the chromosome in situ suppression hybridization technique using
      whole chromosome paint, the probe annealed with the extra G-band, suggesting a
      euchromatic origin from chromosome 9, presumably band p12. By the fluorescence in
      situ hybridization technique using alpha- and beta-satellite probes, the
      dicentric nature was further revealed, supporting the concept of unequal crossing
      over during maternal meiosis I, which could account for a duplication of the h
      region. The G-positive band most likely became genetically inert when it was
      sandwiched between two blocks of heterochromatin, resulting in a phenotypically
      normal child. Therefore, an earlier hypothesis, suggesting its origin from
      heterochromatin through so-called euchromatinization, is refuted here.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488848
TI  - Characterization of three de novo derivative chromosomes 16 by "reverse
      chromosome painting" and molecular analysis.
AB  - We have analyzed three de novo chromosome 16 rearrangements--two with a 16p+
      chromosome and one a 16q+--none of which could be fully characterized by
      conventional cytogenetics. In each case, flow karyotypes have been produced, and
      the aberrant chromosome has been isolated by flow sorting. The origin of the
      additional material has been ascertained by amplifying and labeling the DNA of
      the abnormal chromosome by degenerate-oligonucleotide-primer-PCR and hybridizing
      it in situ to normal metaphase spreads (reverse chromosome painting). Both 16p+
      chromosomes contain more than 30 Mb of DNA from the short arm of chromosome
      9(9p21.2-pter), while the 16q+ contains approximately 9 Mb of DNA from 2q37. The
      breakpoints on chromosome 16 have been localized in each case; the two
      breakpoints on the short arm are at different points within the terminal band,
      16p13.3. The breakpoint on the long arm of chromosome 16 is very close to (within
      230 kb of) the 16q telomere. Determination of the regions of monosomy and trisomy
      allowed the observed phenotypes to be compared with other reported cases
      involving aneuploidy for these regions.

PMID- 8488849
TI  - Diverse growth hormone receptor gene mutations in Laron syndrome.
AB  - To better understand the molecular genetic basis and genetic epidemiology of
      Laron syndrome (growth-hormone insensitivity syndrome), we analyzed the growth
      hormone receptor (GHR) genes of seven unrelated affected individuals from the
      United States, South America, Europe, and Africa. We amplified all nine GHR gene
      exons and splice junctions from these individuals by PCR and screened the
      products for mutations by using denaturing gradient gel electrophoresis (DGGE).
      We identified a single GHR gene fragment with abnormal DGGE results for each
      affected individual, sequenced this fragment, and, in each case, identified a
      mutation likely to cause Laron syndrome, including two nonsense mutations (R43X
      and R217X), two splice-junction mutations, (189-1 G to T and 71 + 1 G to A), and
      two frameshift mutations (46 del TT and 230 del TA or AT). Only one of these
      mutations, R43X, has been previously reported. Using haplotype analysis, we
      determined that this mutation, which involves a CpG dinucleotide hot spot, likely
      arose as a separate event in this case, relative to the two prior reports of
      R43X. Aside from R43X, the mutations we identified are unique to patients from
      particular geographic regions. Ten GHR gene mutations have now been described in
      this disorder. We conclude that Laron syndrome is caused by diverse GHR gene
      mutations, including deletions, RNA processing defects, translational stop
      codons, and missense codons. All the identified mutations involve the
      extracellular domain of the receptor, and most are unique to particular families
      or geographic areas.

PMID- 8488850
TI  - Cardiovascular remodeling and its correction: toward a comprehensive strategy.

PMID- 8488851
TI  - Effects of peptide vasoconstrictors on vessel structure.
AB  - The peptide vasoconstrictors angiotensin II and endothelin-1, originally
      described as being derived exclusively from the plasma renin-angiotensin system
      and vascular endothelium, respectively, have been demonstrated to be produced
      independently of these sources. Local tissue angiotensin-generating systems are
      well documented and endothelin production has been demonstrated for a variety of
      nonendothelial cells, including vascular smooth muscle cells. There is increasing
      evidence that these locally produced vasoconstrictor peptides may contribute to
      blood vessel homeostasis, as well as the development of vascular pathologic
      conditions. Results obtained from pharmaceutical intervention in humans and
      animals of these systems strongly support this hypothesis. In addition to their
      vasoconstrictor properties, angiotensin II and endothelin-1 act as potent
      biologic effectors. In vitro, both vasoconstrictor peptides appear to modulate
      the activity of autocrine feedback loops in vascular smooth muscle cells. The
      activity of these feedback loops in vivo may represent a central mechanism for
      regulation and phenotypic differentiation of this cell type. The most well
      established autocrine feedback loops of vascular smooth muscle cells are
      constituted by platelet-derived growth factor and transforming growth factor
      beta, both of which are influenced by the action of angiotensin II and endothelin
      1. The effects of the peptide vasoconstrictors on the (auto-) regulated feedback
      loops are of long-term structural importance, since both vasoconstrictors (via
      autocrine growth modulators) may influence the composition of the extracellular
      matrix of vascular smooth muscle cells. This includes effects on the synthesis
      and secretion of thrombospondin, fibronectin, tenascin, etc. The secretion of
      extracellular matrix glycoproteins themselves and incorporation into
      extracellular matrix in vitro appear to be linked to the activity of the
      autocrine feedback loops: e.g., stimulation of thrombospondin mRNA results in
      secretion of the glycoprotein only in the concomitant presence of exogenous
      platelet-derived growth factor, whereas the expression of fibronectin and
      tenascin may be directed by transforming growth factor-beta. The influence of
      angiotensin II and endothelin-1 on vascular smooth muscle cell surface receptor
      expression may represent a secondary mode of action of these vasoconstrictor
      peptides. Endothelin-1, for instance, can rapidly down-regulate platelet-derived
      growth factor-alpha receptor mRNA and both angiotensin II and endothelin-1, via
      induction of transforming growth factor-beta, may interrupt the platelet-derived
      growth factor based autocrine feedback loop. In vivo, the highly complex
      interactions between local and systemic vasoconstrictor production, autoregulated
      feedback loops, and extracellular matrix (which also serves as a reservoir for
      growth and differentiation modulators) are central to vessel
      homeostasis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8488852
TI  - Control of vascular structure.
AB  - The development of the vasculature is a complex process, the end result making it
      possible for the cardiovascular system to supply each tissue with the required
      amount of blood at the correct pressure. The mechanisms controlling this
      development are poorly understood, but in general the changes seen appear to be
      adaptive, so that the vessels perform their tasks more effectively. Increasing
      flow appears to be a powerful stimulus to growth, resulting in an increased
      lumen, whereas raised mean pressure and pulse pressure are associated with an
      increased media:lumen ratio. Thus, the physical environment (intravascular flow
      and pressure) plays an important role in determining vascular structure. This
      suggests that an important aspect of future research will be to understand more
      closely the mechanism by which the physical factors can stimulate growth, a
      process that must presumably be mediated by proto-oncogenes.

PMID- 8488853
TI  - Hypertension as a risk factor syndrome: therapeutic implications.
AB  - Reduction of blood pressure as the only therapeutic goal of antihypertensive
      treatment may no longer be appropriate. High blood pressure is associated with an
      increased risk of cardiovascular events, but clinical trials of antihypertensive
      therapy have shown an inconsistent reduction in major cardiovascular endpoints.
      Importantly, the incidence of coronary artery disease has been reduced to only a
      small extent, suggesting that factors beyond high blood pressure are important in
      the genesis of atherosclerotic disease in hypertensive patients. It is evident,
      for example, that patients with hypertension have an exaggerated vulnerability to
      the consequences of lipid abnormalities. Moreover, it has recently been
      established that hypertension is characterized by insulin resistance and altered
      glucose tolerance. As a result, high plasma concentrations of insulin produce
      proliferative effects on vascular smooth muscle and connective tissue, and they
      may adversely affect the lipid profile. The left ventricle is also involved in
      hypertension, independent of blood pressure. There is growing evidence that there
      are increases in the muscle mass of the left ventricle and changes in its
      diastolic filling characteristics at very early stages of hypertension. The
      arterial circulation is similarly involved, for alterations in structure or
      function (reflected by diminished arterial compliance) can be demonstrated prior
      to the appearance of clinical hypertension. New therapeutic strategies should be
      aimed at the full spectrum of hypertension-related changes. Because the renin
      angiotensin system can contribute to the structural and functional cardiovascular
      characteristics of this condition, such agents as angiotensin-converting enzyme
      inhibitors may be especially effective in preventing or reversing these
      abnormalities and are emerging as a treatment of choice for hypertension.

PMID- 8488854
TI  - Some metabolic aspects of essential hypertension and its treatment.
AB  - We tested whether patients with essential hypertension (EH) have metabolic
      evidence of increased adrenergic activity, and if a relationship exists between
      carbohydrate metabolism and the blood pressure (BP) response to angiotensin
      converting enzyme (ACE) inhibition. Study 1 included 59 subjects who underwent
      resting ambulatory BP, heart rate, and resting energy expenditure (REE)
      measurement (by indirect calorimetry). REE was directly related to lean body mass
      (LBM) (r = 0.56, p < 0.0001) and to fasting plasma insulin levels (p < 0.03),
      after adjusting for LBM and age) but not to BP. The 38 subjects with EH had
      significantly higher fasting plasma insulin levels (54 +/- 4 vs 42 +/- 4 pM; p <
      0.05) than the 21 normotensive subjects. When normalized by the LBM, the
      hypertensive patients had significantly higher REE values than the normotensive
      subjects (89 +/- 2 vs 78 +/- 3 J min-1.kg-1; p < 0.005). No differences in the
      other measured variables were found between the two groups. Thus, in this group
      of lean patients with stable EH, relative hyperinsulinemia is associated with a
      small increase in REE, the significance of which remains to be determined. In
      study 2, 20 patients with EH received an oral glucose tolerance test and a
      euglycemic insulin clamp before and after 3 months of treatment with cilazapril.
      Glucose-induced insulin response, but not insulin sensitivity, was improved by
      treatment in the whole group. Before therapy, the 12 responders (diastolic BP <
      95 mm Hg) had similar glucose tolerance and insulin sensitivity to the eight
      nonresponders. Responders, however, had lower fractional potassium excretion than
      nonresponders both during fasting (9.6 +/- 1 vs 16.0 +/- 2.4%; p < 0.02) and
      during the glucose load (9.1 +/- 1.4 vs 13.1 +/- 1.1%; p < 0.04). In the
      responders, fasting potassium levels at baseline were directly related to the
      decrease in BP (p < 0.01) and to the improvement of glucose-induced insulin
      response (p < 0.04) achieved after treatment. Thus, the therapeutic effect of ACE
      inhibition is in part related to fractional potassium excretion, which, in turn,
      affects glucose tolerance through the influence of potassium levels on glucose
      induced insulin release.

PMID- 8488855
TI  - Organ blood flow protection in hypertension and congestive heart failure.
AB  - The nutrients to the different organs of the body are provided through the blood
      supply to these organs. Since the nutrient requirements change considerably and
      abruptly according to the demands set by, for example, physical activity, organ
      blood flow has to be adjusted accordingly. This is achieved by a complex
      interplay between neural (parasympathetic and sympathetic nerves), humoral
      (vasopressin, angiotensin, etc.), and local (ions, pH, adenosine, etc.) factors.
      It is also well recognized that diseases, such as hypertension and heart failure,
      as well as the drugs to treat them, can substantially affect organ blood flow.
      Using tracer microspheres, several studies in animals have shown that, during the
      established phase of hypertension, there is some decrease in cardiac output,
      which is then redistributed, with the brain, small intestines, and heart
      receiving a higher proportion. Blood flow to and vascular conductance in the
      other organs, particularly the kidneys, is decreased. Similar findings have also
      been observed in human hypertension. During congestive heart failure, most organs
      show a decrease in blood flow and there is a conspicuous increase in the
      sympathetic nerve activity. The drug responses may differ in the disease state
      and, from a clinical viewpoint, changes in some circulatory beds (e.g., cerebral,
      cardiac, renal, skeletal muscles) as well as the partition of blood flow into
      nutrient (tissue) and non-nutrient (arteriovenous anastomoses or shunts) parts
      can be of great importance. For example, overzealous antihypertensive therapy or
      the use of cerebral vasodilators may adversely affect cerebral circulation in
      certain situations and increased arterial blood flow may only be in the
      arteriovenous anastomotic part of the circulation.

PMID- 8488856
TI  - Pathobiology of restenosis after angioplasty.
AB  - Restenosis is a consequence of a disturbed wound healing process after the
      vascular trauma of angioplasty or similar intervention. Mechanisms involve
      clotting, cell recruitment and activation (from the blood, the vascular wall, and
      the perivascular tissue), as well as cell proliferation, matrix synthesis, and
      tissue contraction. In more than half of the lesions, these events are
      coordinated and self-limited, leading to a remodeling of the vessel wall with
      more stable and viable tissue than the original necrotic and lipid-laden
      atherosclerotic plaque. This remodeling may be as important as the gain in lumen
      for long-term patency. However, this basically favorable healing process may be
      disturbed by predominantly local conditions such as poor resulting wound anatomy,
      necrotic debris, excessive old plaque material, continued movement and
      irritation, or poor flow, leading to repetitive activation of any of these
      mechanisms. It is this unpredictable chronic persistence of these essentially
      physiologic mechanisms rather than the mechanisms themselves that eventually lead
      to an exuberant proliferative and synthetic response, which builds up restenotic
      mass together with thrombotic material and the old plaque components.

PMID- 8488857
TI  - Coronary blood flow in renovascular hypertension.
AB  - We assessed the acute effects of 2.5 mg oral cilazapril on systemic and coronary
      hemodynamics in seven renovascular hypertensive patients with a chronically
      overactive renin-angiotensin system (RAS), but with no electrocardiographic or
      echocardiographic signs of left ventricular hypertrophy. Cilazapril resulted in a
      significant decrease in mean arterial pressure and coronary vascular resistance,
      together with a prolonged increase in coronary sinus blood flow (CSBF). Post
      cilazapril handgrip resulted in larger increases in CSBF in response to a given
      increase in myocardial oxygen requirements. It is concluded that the chronic
      activation of the RAS exerts an adverse influence on the control mechanisms of
      CSBF and that converting enzyme inhibition reverses the effects of angiotensin II
      on coronary hemodynamics. Converting enzyme inhibitors may have a
      cardioprotective role in renovascular hypertension.

PMID- 8488858
TI  - Effect of cilazapril on isomyosin pattern in the spontaneously hypertensive rat.

PMID- 8488859
TI  - Renal pressure-natriuresis relationship.

PMID- 8488860
TI  - Effect of cilazapril on lipids.

PMID- 8488861
TI  - Modulation of sympathetic vasomotor control with cilazapril in mild hypertension.

PMID- 8488862
TI  - Diabetic microalbuminuria and cilazapril.

PMID- 8488863
TI  - Antihypertensive efficacy of cilazapril in general practice: assessment by
      ambulatory blood pressure monitoring.

PMID- 8488864
TI  - Effects of cilazapril on Na+ retention and ANP resistance in IDDM hypertensives.

PMID- 8488865
TI  - Comparative effects of cilazapril and atenolol on maximal and prolonged
      submaximal exercise performance in hypertensive males.

PMID- 8488866
TI  - Comparison of casual ambulatory and self-measured blood pressure in a long-term
      study with cilazapril and atenolol.

PMID- 8488867
TI  - New findings in short rib syndrome.
AB  - This white infant, born at 37 weeks of gestation, had a large cranium, bilateral
      anophthalmia, a midline cleft lip and palate, hypoplastic chest with short ribs,
      slightly protuberant abdomen, short limbs, bilateral single transverse palmar
      creases, a single umbilical artery, normal female external genitalia, normal (46
      XY) chromosomes, and radiographic findings suggesting a short-rib (polydactyly)
      syndrome type IV (Beemer-Langer). Autopsy showed pulmonary hypoplasia, bilateral
      renal cystic dysplasia, intrahepatic bile duct cysts with periportal fibrosis,
      pancreatic cysts, absent internal genitalia, an atrophic optic chiasm, absent
      optic nerves, a single left anterior cerebral artery, polymicrogyria, and fusion
      of the frontal lobes, preoptic region, mammillary bodies, and thalami.

PMID- 8488868
TI  - Mixed gonadal dysgenesis: clinical, cytogenetic, endocrinological, and
      histopathological findings in 16 patients.
AB  - We describe clinical, cytogenetic, endocrine, and histopathological findings in
      16 patients with mixed gonadal dysgenesis (MGD). All patients except 1 presented
      genital ambiguity and 10 of them had Ullrich-Turner manifestations. The
      45,X/46,XY karyotype was the most frequent with a predominance of 45,X cells in
      both peripheral lymphocytes and gonads. In all cases Mullerian and Wolffian
      remnants and/or derivatives were found and in some patients both Wolffian- and
      Mullerian-derived structures were identified on the streak or testicular side.
      Postpubertal patients exhibited variable degrees of virilization and all of them
      had hypergonadotropism coexisting with low to normal baseline serum levels of
      testosterone; their testicular response to human chorionic gonadotropin (HCG) in
      terms of testosterone secretion was also variable, ranging from minimal to almost
      a normal response. All prepubertal patients but 1 had normal baseline levels of
      pituitary gonadotropins and testosterone and their gonadal response to the HCG
      challenge was highly variable. With the exception of 1 case, who had a
      45,X/46,XY(p-) karyotype, no correlation between the cytogenetic data and degree
      of external genital ambiguity and the hormonal findings was observed. Additional
      information on the specific structural abnormalities involving the testis
      determining gene of the Y chromosome in patients with MGD is needed in order to
      further understand the mechanisms responsible for the wide variability
      characteristic of this disorder.

PMID- 8488869
TI  - Detection of the cystic fibrosis delta-F508 mutation at autopsy by site-directed
      mutagenesis.
AB  - In Caucasian populations cystic fibrosis (CF) is the most common autosomal
      recessive disorder. CF was previously considered rare in Mexico; however, the
      reported frequency is about 1% in autopsies. This discrepancy appears to be due
      to the inability to diagnose the illness during life. It is now known that in
      developing countries a great number of affected children die without the benefit
      of CF diagnosis and appropriate treatment. In this study we have used the PCR
      mediated site-directed mutagenesis technique for the detection of the delta-F508
      mutation in a 6-month-old Mexican boy who died without definitive diagnosis. The
      tissue available from the child was a formaldehyde fixed paraffin-embedded liver.
      We identified the delta-F508 mutation in homozygous form in the propositus and in
      a heterozygous form in his parents. This represents the first report of CF
      molecular diagnosis in Mexico.

PMID- 8488870
TI  - Renal findings in 40 individuals with Williams syndrome.
AB  - We tabulated the frequency of renal abnormalities in 40 Williams syndrome
      individuals presenting for medical and/or developmental assessment to a multi
      disciplinary Williams syndrome program. The average age at time of assessment was
      7 2/12 years. Seven individuals (7/40 = 18%) had abnormalities detected,
      including nephrocalcinosis = 2; marked asymmetry in kidney size = 2; small
      kidneys = 1; solitary kidney = 1; and pelvic kidney = 1. Renal function was also
      assessed. Two individuals had evidence of renal dysfunction, one secondary to
      nephrocalcinosis and the second due to hypercalcemia and interstitial nephritis
      of unclear pathogenesis. We examined the frequency of renal artery stenosis in 9
      individuals who underwent abdominal angiography during cardiac catheterization.
      We found unilateral or bilateral mild renal artery narrowing in 4 individuals and
      normal renal arteries in the remaining 5. Persistent hypertension occurred in
      only 2 individuals and did not correlate with renal artery status. We conclude
      that intrinsic renal anomalies, as well as problems secondary to hypercalcemia,
      occur with sufficient frequency to warrant baseline renal screening in all
      individuals with Williams syndrome.

PMID- 8488871
TI  - Concordance and recessive inheritance of Leber congenital amaurosis.
AB  - Pedigrees were obtained on 43 patients with confirmed Leber congenital amaurosis,
      a rare form of blindness caused by congenital dysfunction of the retina. All of
      the pedigrees were consistent with autosomal recessive inheritance and the
      segregation frequency using classical segregation analysis was 0.24 +/- 0.07. Six
      of the 7 affected sib pairs were concordant in regards to systemic abnormalities.
      Despite previous reports that Leber congenital amaurosis can be inherited either
      as an autosomal dominant or recessive condition, our findings support only an
      autosomal recessive inheritance of this disorder.

PMID- 8488872
TI  - Apparent dominant transmission of the Rubinstein-Taybi syndrome.
AB  - The cause of the Rubinstein-Taybi syndrome (RTS), a multiple congenital
      anomalies/mental retardation (MCA/MR) syndrome first described in 1963, remains
      obscure. Recently, a deletion of chromosomal material at 16p13.3 has been found
      in some patients with the disorder, but no such deletion can be identified in the
      majority of affected individuals. Although the disorder has been well documented
      to be concordant in at least 7 monozygotic twin pairs and in one non-twin sib
      pair, only one clear-cut case of parent-to-child transmission has been reported
      previously. We present here a mother and daughter, both of whom appear to be
      affected with RTS, strongly suggesting either autosomal or X-linked dominant
      transmission. The paucity of previous cases of parent-to-child transmission may
      be related to either decreased fertility or decreased fitness in affected
      individuals.

PMID- 8488873
TI  - Molecular and cytogenetic characterization of 9p- abnormalities.
AB  - We report on 2 girls with terminal deletion of the short arm of chromosome 9 with
      concurrent duplication unrecognizable by routine chromosome studies. The
      phenotype of the patients was not specifically suggestive of the 9p-syndrome in
      the absence of trigonocephaly and long philtrum as cardinal manifestations. In
      addition to psychomotor retardation, their manifestations were mild and include
      upward slant of palpebral fissures and dolichomesophalangy which are
      characteristic of del(9p). Chromosome abnormalities were de novo in both cases.
      The two rearranged chromosomes 9 exhibit similar G-banding patterns and suggested
      the possible duplication of distal 7p. Fluorescence in situ hybridization (FISH)
      with a chromosome-7 specific library probe indeed identified that one derivative
      chromosome 9 was the result of a translocation between chromosomes 7 and 9
      [der(9)t(7;9)(p15.3;p24] but failed to detect a signal on the other derivative 9.
      In the second case, the concurrent abnormality was an inverted duplication of
      proximal 9p and deletion of distal 9p [inv dup(9)(p13-->p22::p22-->qter)]
      confirmed by FISH using a chromosome 9 specific library probe. FISH clearly
      identified the origin of these 2 abnormal chromosomes 9 and provided crucial
      information for clinical evaluation. We emphasize the importance of utilizing
      updated cytogenetic and molecular techniques in the precise delineation of subtle
      or complex abnormalities where there are no useful phenotypic clues.

PMID- 8488874
TI  - Rubinstein-Taybi Syndrome with thymic hypoplasia.
AB  - We report the autopsy findings in a 20-month-old boy with Rubinstein-Taybi
      syndrome and DiGeorge sequence. No visible thymus was demonstrated at the time of
      autopsy. With careful microscopic examination, a few pieces of thymic tissues
      found near the thyroid gland showed remarkable depletion of both thymocytes and
      cortical epithelial cells. Immunohistological staining with T-cell surface
      antigens resulted in a definite positive reaction. Repeated respiratory
      infections present in this patient may, in part, be attributable to thymic
      hypoplasia. Other major anomalies included broad thumbs and great toes,
      microphthalmia, arrhinencephaly, patent ductus arteriosus, stenosis of the
      ureterovesicular junction, bilateral cryptorchidism, and minor facial anomalies.

PMID- 8488875
TI  - Cognitive and behavioral profile of the oculocerebrorenal syndrome of Lowe.
AB  - BACKGROUND: The oculocerebrorenal syndrome of Lowe (OCRL) is an X-linked disorder
      characterized by congenital cataracts, cognitive impairment, and renal tubular
      dysfunction. Significant behavioral difficulties have been reported, but no
      formal study of intelligence or behavior has been described. METHODS: We surveyed
      IQ and behavior using archival data and standardized instruments in 47 affected
      males. RESULTS: Mean IQ was in the moderate mental retardation range (40 < or =
      IQ < or = 54), with 25% of tested individuals in the normal range (IQ > or = 70).
      The OCRL population was comparable to a normative population with mental
      retardation in language, communication, and socialization skills, but lower in
      independent living skills than means of either populations of individuals with
      mental retardation or visual impairment. Maladaptive behaviors, particularly
      stubbornness, temper tantrums, and stereotypic behaviors, were very frequent (>
      80%). CONCLUSIONS: The diagnosis of OCRL is compatible with normal intelligence.
      Maladaptive behaviors significantly interfere with adaptive functions. These
      behaviors appear to define a characteristic behavioral phenotype in OCRL.

PMID- 8488876
TI  - Recombinant chromosome 9 possibly derived from breakage and reunion of sister
      chromatids within a paracentric inversion loop.
AB  - Chromosomally unbalanced offspring resulting from the recombination of parental
      paracentric inversions are uncommon. We report on a 20-month-old boy with a
      partial duplication of 9p due to the recombination of a paternal paracentric
      inversion. The patient's recombinant chromosome was designated rec(9)(p13-
      >p24::p12-->p24::p12-->qter). The patient's father and paternal aunt have a
      paracentric inversion of chromosome 9:inv(9)(p13p24). Although several mechanisms
      have been proposed to explain the chromosome imbalance generated from paracentric
      inversions, none of the previously described mechanisms can account for the
      structure of the recombinant chromosome observed in the propositus. We propose an
      unusual mechanism of formation involving breakage and unequal reunion of sister
      chromatids within the inversion loop to explain the structure of the patient's
      recombinant chromosome.

PMID- 8488877
TI  - In utero fetal muscle biopsy for the diagnosis of Duchenne muscular dystrophy in
      a female fetus "suddenly at risk".
AB  - DNA methods to diagnose Duchenne muscular dystrophy (DMD) are not always
      informative, and we have published previously the first instance of in utero
      muscle biopsy to assess dystrophin in a male fetus having the same "X" as an
      affected sib. We present here a female fetus with a de novo X,1 translocation
      with breakpoint at Xp21, detected on amniocentesis for advanced maternal age. The
      translocation breakpoint placed her at high risk for DMD. In utero muscle biopsy
      at 20 weeks of gestation produced a specimen positive for dystrophin
      immunofluorescence indicating a likely normal fetus. The pregnancy was continued,
      and at term the baby girl was found to have normal serum creatine kinase levels,
      and was therefore unaffected with DMD. Our experiences add de novo Xp21
      translocation to the indications for in utero muscle biopsy for diagnosis of DMD.

PMID- 8488878
TI  - Possible second case of tricho-oculo-dermo-vertebral (Alves) syndrome.
AB  - We report on a 10-year-old girl with trichodysplasia, onychodysplasia,
      hyperpigmented ichthyoform lesions on her shins, mild enamel dysplasia, and
      hyperkeratosis involving the soles. This combination of ectodermal defects has
      only been described by Alves et al.

PMID- 8488879
TI  - Living history-biography: from oral pathology to craniofacial genetics.

PMID- 8488880
TI  - Oral-facial-digital syndrome type I in a newborn male.
AB  - We report on a newborn male, born at term with clinical manifestations of oral
      facial-digital (OFD) syndrome type I. This syndrome is generally assumed to be
      inherited in an X-linked dominant fashion with lethality in males. Therefore,
      liveborn males are exceptional. This liveborn male also had Dandy-Walker
      malformation and polycystic kidneys. From a general point of view, distinction
      between the 8 types of OFD syndromes described so far appears subtle and
      considerable overlap exists between them. In this regard, it should be noted that
      polycystic kidneys different from adult polycystic kidney disease both
      macroscopically and microscopically are a frequent manifestation of OFD I.

PMID- 8488881
TI  - Case of (Y;1) familial translocation.
AB  - A balanced reciprocal translocation t(1;Y) (q11;q11) was found in an infertile
      man with severe oligoasthenospermia. The same translocation was found in his
      father. The role of X-chromosome inactivation during meiosis in a male carrying a
      Y;autosome translocation is discussed.

PMID- 8488882
TI  - Inguinal hernia and atrial septal defect in Tel Hashomer camptodactyly syndrome:
      report of a new case expanding the phenotypic spectrum of the disease.
AB  - We report on a girl with Tel Hashomer camptodactyly syndrome (THCS) born to first
      cousin parents. In addition to the usual findings, the patient had bilateral
      inguinal hernia and atrial septal defect, not previously described as component
      manifestations of the syndrome. The present description expands the phenotypic
      spectrum of the syndrome and gives new support to the hypothesized pleiotropic
      effects of the THCS gene on connective tissue.

PMID- 8488883
TI  - Short rib (polydactyly) syndrome type IV: Beemer-Langer syndrome.

PMID- 8488884
TI  - Clustering of cri du chat syndrome among the Bedouins.

PMID- 8488885
TI  - Mucinous cystadenoma of ovary in a patient with Williams syndrome.

PMID- 8488886
TI  - Poland anomaly with a limb body wall disruption defect.

PMID- 8488887
TI  - Inverted duplication involving alpha satellite DNA resulting in a C-negative-band
      in the qh region of chromosome 16.

PMID- 8488888
TI  - Monozygotic twinning and Wiedemann-Beckwith syndrome.

PMID- 8488889
TI  - The good ending.

PMID- 8488890
TI  - Trial volunteers sought.

PMID- 8488891
TI  - Motivating ourselves.

PMID- 8488892
TI  - Back stress solution.

PMID- 8488893
TI  - Back stress solutions.

PMID- 8488894
TI  - Nurses as house staff.

PMID- 8488895
TI  - Nurses as house staff.

PMID- 8488896
TI  - Pollution confusion.

PMID- 8488897
TI  - Spotting and treating spinal cord compression.

PMID- 8488898
TI  - Terminal weaning: a loved one's vigil.

PMID- 8488899
TI  - Visions of tomorrow's ICU.

PMID- 8488900
TI  - Treating bladder cancer: new methods, new management.

PMID- 8488901
TI  - Exploring the mystery of near-death experiences.

PMID- 8488902
TI  - The right way to culture a wound.

PMID- 8488903
TI  - What kind of recognition do staff nurses want?

PMID- 8488904
TI  - My name is nurse.

PMID- 8488905
TI  - Probing the safety of central venous catheters.

PMID- 8488906
TI  - Oncology nurses: doing the unexpected.

PMID- 8488907
TI  - How to aspirate fluid from small-bore feeding tubes.

PMID- 8488908
TI  - Effect of insulin therapy on progression of retinopathy in noninsulin-dependent
      diabetes mellitus.
AB  - In a six-month prospective study involving 60 noninsulin-dependent diabetics, we
      evaluated the effect of change to conventional insulin therapy on the pre
      existing retinopathy. Ten of 15 patients in group 1 (background or
      preproliferative diabetic retinopathy treated with insulin) compared to one of 15
      patients in group 2 (background or preproliferative diabetic retinopathy treated
      with hypoglycemic agents) had progression of retinopathy. Worsening of
      retinopathy was related significantly only to the age of the patients (r = .752,
      P < .001). None of the 15 patients each in groups 3 and 4 (no retinopathy treated
      with insulin injections [group 3] or oral hypoglycemic agents [group 4])
      developed retinopathy.

PMID- 8488909
TI  - A masked, randomized, dose-response study between cyclosporine A and G in the
      treatment of sight-threatening uveitis of noninfectious origin.
AB  - Thirty-two patients with sight-threatening uveitis and a decrease in visual
      acuity requiring systemic therapy were randomly assigned to either cyclosporine A
      or G in a dose-escalation study. Groups received from 2.5 mg/kg of body
      weight/day to 10 mg/kg of body weight/day of either drug along with low-dose
      prednisone. More patients taking cyclosporine G had improved visual acuity and a
      decrease in macular edema, which occurred more rapidly than in the other group,
      even at the lower doses tested. No difference in renal function was noted between
      groups at any doses tested. Four patients receiving cyclosporine G had hepatic
      alterations, but only one required cessation of the drug. The study indicates the
      potential usefulness of cyclosporine G, particularly at lower doses (4 mg/kg of
      body weight/day), which could lower the potential for serious renal
      complications.

PMID- 8488910
TI  - The effect of corneal thickness on applanation tonometry.
AB  - Simultaneous manometry and Perkins tonometry were performed at 10.0, 20.0, and
      30.0 mm Hg on 15 eyes on which intraocular procedures were performed. There was a
      statistically significant relationship between corneal thickness and the error of
      Perkins tonometry. Thin corneas produced underestimations of the intraocular
      pressure by as much as 4.9 mm Hg, whereas thick corneas produced overestimations
      by as much as 6.8 mm Hg. Measuring the corneal thickness is necessary to
      interpret properly the results of Goldmann applanation tonometry, particularly in
      eyes with thin corneas.

PMID- 8488911
TI  - A clinicopathologic correlative study of noncontact transscleral Nd:YAG
      cyclophotocoagulation.
AB  - We studied the histopathologic changes of three eyes enucleated two weeks, eight
      weeks, and 17 months, respectively, after noncontact Nd:YAG
      cyclophotocoagulation. The histologic findings at two weeks were destruction of
      the nonpigmented and pigmented ciliary body epithelium, occlusion of the
      capillaries of the ciliary processes, and ciliary body stromal necrosis in the
      region of the processes. Hyperplasia of the pigmented and nonpigmented
      epithelium, fibrosis and near total atrophy of the ciliary processes, and partial
      atrophy of the ciliary muscles were present at eight weeks and 17 months. We
      concluded that application of treatment 1.0 to 1.5 mm posterior to the
      corneoscleral limbus selectively destroys the pars plicata, and that,
      histologically, the mechanism for reducing intraocular pressure appears to be
      destruction of ciliary processes with reduction of aqueous formation.

PMID- 8488912
TI  - Long-term visual outcome of ocular hypotension after thermosclerostomy.
AB  - Maximum intraocular pressure reduction is often the goal of glaucoma filtering
      procedures. To evaluate whether surgically induced ocular hypotension adversely
      affects visual acuity, we reviewed the visual outcome of 87 eyes of 67 patients
      who had undergone thermosclerostomy with follow-up of at least two years. Final
      visual acuity was compared in three groups on the basis of postoperative
      intraocular pressure level (< or = 10.0 mm Hg; > 10.0 mm Hg and < or = 21.0 mm
      Hg; and eyes that did not consistently fit solely in either group [mixed]).
      Average loss in visual acuity measured 1.8 +/- 3.0, 2.2 +/- 2.9, and 1.2 +/- 2.1
      Snellen lines, respectively (P = .542). These data suggest that hypotensive eyes
      are not at greater risk for visual loss after glaucoma filtering procedures
      compared to normotensive eyes.

PMID- 8488913
TI  - Calcium channel blockers in the management of low-tension and open-angle
      glaucoma.
AB  - Fifty-six patients with either open-angle or low-tension glaucoma who were
      concurrently taking calcium channel blockers were compared to similar groups not
      taking such medications for a mean follow-up period of 3.4 years. Serial
      stereoscopic optic nerve photographs and visual fields of all patients were
      evaluated for evidence of glaucomatous progression. In patients with low-tension
      glaucoma, there was a significant difference in the progression of visual field
      defects, with only two of 18 eyes (11%) of patients taking calcium channel
      blockers, compared to ten of 18 eyes (56%) of controls showing new visual field
      defects. Similarly, low-tension glaucoma patients taking calcium channel blocker
      therapy demonstrated no evidence of progressive optic nerve damage, compared to
      eight of 18 control eyes (44%). In contrast, patients with open-angle glaucoma
      taking calcium channel blockers showed no marked difference in the progression of
      glaucoma, compared to controls. These findings suggest that calcium channel
      blockers may be useful in the management of low-tension glaucoma.

PMID- 8488914
TI  - The influence of patient-related variables in the timing of cataract extraction.
AB  - Data from a prospective study of quality of life after cataract extraction with
      intraocular lens implantation were used to examine associations between patient
      factors and the timing of cataract extraction. The 495 patients were drawn from
      76 ophthalmologists' offices in three cities. Patients were categorized as
      waiting three months or less or four months or more to schedule their operations
      after their physicians' recommendations. Patients who delayed scheduling their
      operations were more likely to be younger, have higher incomes, be working full
      time, have higher life satisfaction, have lower levels of depression and higher
      levels of vigor, have had a less than perfect previous operation, have lower
      scores for mid-range vision and higher scores for cataract symptoms, be fearful
      of nighttime driving, and be heavy drinkers. Conversely, patients who delayed
      their operations were less likely to be covered by Medicare and to expect
      excellent postoperative vision and a short recovery time. A discriminant analysis
      correctly classified 68.9% of the patients according to timing group.

PMID- 8488915
TI  - The penetration of oral ciprofloxacin into the aqueous humor, vitreous, and
      subretinal fluid of humans.
AB  - We examined ciprofloxacin levels in the aqueous humor, vitreous, or subretinal
      fluid in 40 patients undergoing cataract extraction, vitrectomy, or scleral
      buckling. Ciprofloxacin, 750 mg, was administered orally an average of 17 1/2 and
      5 1/2 hours preoperatively. We obtained mean ciprofloxacin levels of 0.53
      microgram/ml in aqueous humor, 0.51 microgram/ml in vitreous, and 0.71
      microgram/ml in subretinal fluid. These vitreous levels exceed the minimum
      inhibitory concentration (MIC)90 of Staphylococcus epidermidis, Propionibacterium
      species, Pseudomonas aeruginosa, Proteus mirabilis, and Haemophilus influenzae,
      as well as the MIC70 of S. aureus and Bacillus cereus. Therefore, ciprofloxacin
      may have a role in the management and prevention of endophthalmitis.

PMID- 8488916
TI  - Effect of eye patching on ocular surface.
AB  - We studied the effect of pressure patching in 27 medical students. Fourteen
      students had pressure patching in one eye (group 1) and 13 (group 2) had light
      patching. The fellow eye of each volunteer remained unpatched (group 3). Clinical
      signs and symptoms were scored and evaluated at the first and the following
      (after overnight) examinations. Before patching no subject had any of the
      clinical signs or symptoms. After the patch was removed in groups 1 and 2, all
      except one volunteer in each group had clinical signs or symptoms, or both,
      whereas in group 3, none had clinical signs or symptoms. Group 1 had greater
      scores for clinical signs (P = .019) and for symptoms (P = .038) as compared to
      group 2. In group 1, two participants did not complete the study period (by
      removal of the patch) because of severe discomfort and three had temporary
      irregularities in corneal surface with temporary decrease of vision. We suggest
      that pressure patching may cause discomfort and changes in visual acuity that are
      usually attributed to other reasons.

PMID- 8488917
TI  - Excimer laser keratectomy after radial keratotomy.
AB  - Radial keratotomy to treat myopia has been characterized by a lack of
      predictability. Until recently, patients with undercorrected myopia who were
      unsatisfied with their visual outcome could only be offered secondary
      augmentation procedures, which were equally unpredictable. We performed excimer
      laser keratectomy in six eyes of five patients whose myopia was undercorrected
      after radial keratotomy. The average residual spherical equivalent refractive
      error after radial keratotomy was -2.40 diopters, and this was reduced to -0.48
      diopters after laser treatment. Final uncorrected visual acuity ranged from 20/80
      to 20/20, and visual acuity was corrected to within one line of the preoperative
      best-corrected value in all patients. Epithelialization of all eyes occurred
      within four to six days. There were no incidences of corneal neovascularization,
      including no vascularization of the radial keratotomy incisions. Our findings
      suggest excimer phototherapeutic keratectomy offers a safe and more controlled
      method of augmenting undercorrected myopia after radial keratotomy.

PMID- 8488918
TI  - Eosinophil granule major basic protein deposition in corneal ulcers associated
      with vernal keratoconjunctivitis.
AB  - An indirect immunofluorescence assay detected eosinophil granule major basic
      protein in the inflammatory debris covering deepithelialized cornea in two
      patients with vernal keratoconjunctivitis. A slight degree of non-specific
      fluorescence was present in the control autopsy corneas. High concentrations of
      the eosinophil granule major basic protein inhibit epithelial migration and
      protein synthesis, whereas low concentrations affect epithelial migration. The
      results suggest participation of eosinophil granule major basic protein in the
      ulcerative process.

PMID- 8488919
TI  - Transesophageal echocardiography in the diagnosis of branch retinal artery
      obstruction.
AB  - We examined a 28-year-old man and a 19-year-old woman with branch retinal artery
      obstruction. Both were examined exhaustively. In each patient, a patent foramen
      ovale was demonstrated by transesophageal echocardiography after a transthoracic
      study disclosed no abnormalities. These observations suggest that transesophageal
      echocardiography is valuable in examining young patients with retinal emboli in
      whom cardiac abnormalities are suspected.

PMID- 8488920
TI  - Longitudinal study of the early electroretinographic changes in Alstrom's
      syndrome.
AB  - We obtained serial electroretinograms in four patients aged between 6 months and
      5 years with Alstrom's syndrome and studied the early stages of the severe
      retinopathy that is characteristic of that disease. The weak electroretinographic
      signals found at age 6 months demonstrate a severe early cone dysfunction; one
      year later the cone activity is undetectable. The rod component of the
      electroretinogram is initially normal but can rapidly deteriorate to become
      undetectable as early as 5 years of age. These unusual electroretinographic
      findings are pathognomonic of Alstrom's syndrome and different from other cone
      rod dystrophies or other syndromes with similar phenotypes such as Bardet-Biedl,
      Laurence-Moon, and Cohen syndromes.

PMID- 8488922
TI  - Transpupillary continuous suture for intraoperative mydriasis.

PMID- 8488921
TI  - The outgrowth of lens epithelial cells onto the anterior capsule after
      intraocular lens implantation.

PMID- 8488923
TI  - Subcutaneous emphysema of the eyelids after dacryocystorhinostomy.

PMID- 8488924
TI  - Comparison of time required for strabismus correction by using the microscope or
      loupes.

PMID- 8488925
TI  - Ophthalmic manifestations of the chromosome 11q deletion syndrome.

PMID- 8488927
TI  - Massive spontaneous subretinal hemorrhage from a choroidal metastasis.

PMID- 8488926
TI  - Endophthalmitis caused by beta-lactamase-positive Moraxella nonliquefaciens.

PMID- 8488928
TI  - Echographic signs of perfluorodecalin.

PMID- 8488929
TI  - Determination of corneal image-forming properties from corneal topography.

PMID- 8488930
TI  - A biometric study of ocular changes during accommodation.

PMID- 8488931
TI  - Causes of reduced visual acuity on long-term follow-up after cataract extraction
      in patients with uveitis and juvenile rheumatoid arthritis.

PMID- 8488932
TI  - The influence of exposure duration in transscleral Nd:YAG laser
      cyclophotocoagulation.

PMID- 8488933
TI  - Recession of both horizontal recti muscles in Duane's retraction syndrome with
      elevation and depression of the adducted eye.

PMID- 8488934
TI  - Vogt-Koyanagi-Harada syndrome in patients with Cherokee Indian ancestry.

PMID- 8488935
TI  - The surgeon as gatekeeper.
AB  - The author pays tribute to three deceased members of the North Pacific Surgical
      Association who directed his own career. The gatekeeper function of surgical
      specialists is discussed, and surgeons are urged to become more active in this
      role. Increased involvement in managed care planning and cost control,
      particularly in smaller communities, is encouraged.

PMID- 8488936
TI  - Role of computed tomographic scans in the staging of esophageal and proximal
      gastric malignancies.
AB  - In order to determine the accuracy of computed tomographic (CT) scanning, CT scan
      results were compared with operative and pathologic findings in 45 patients with
      esophageal and proximal gastric malignancies. CT scans were evaluated with
      respect to nodal metastases, hepatic metastases, and adjacent spread. Eight
      patients did not undergo surgery because of advanced disease noted on the CT
      scan. Of the remaining 37 patients, sensitivity of CT for all 3 parameters was
      less than 60%, whereas the specificity was greater than 90%. The positive
      predictive value was greater than 90% for nodal metastases and adjacent spread
      and 67% for hepatic metastases. The negative predictive value was less than 40%
      for nodal metastases and adjacent spread and 90% for hepatic metastases. For
      esophageal and proximal gastric malignancies, CT is useful in identifying
      advanced disease and in predicting resectability. In less advanced cases, CT is
      not sensitive, and its negative predictive value is poor with regard to local and
      lymphatic spread. CT scanning is useful to stage the most advanced cases but
      because of limited accuracy should be combined with other diagnostic studies when
      accurate staging is required.

PMID- 8488937
TI  - Diagnosis and management of stage IE and stage IIE gastric lymphomas.
AB  - We performed a retrospective study involving 56 patients with stage IE or stage
      IIE gastric lymphomas treated between January 1980 and January 1990. Endoscopy
      had a sensitivity of 98% compared with 83% for radiographic contrast studies. The
      data were analyzed with respect to 10 prognostic factors. Age greater than 65
      years and an elevated lactate dehydrogenase level were associated with a
      significantly lower 5-year survival rate (each p = 0.001). Those patients having
      had gastric resection with grossly negative margins demonstrated improved
      survival compared with those patients who did not have complete resection (67%
      versus 29%). The use or omission of radiotherapy had no effect on survivorship
      (51% versus 55%). Neither tumor size, stage, sex, site of extragastric
      involvement, time from onset of symptoms to diagnosis, nor microscopic resection
      margins influenced survival. We conclude that endoscopy with biopsy is the
      diagnostic procedure of choice for gastric lymphoma. Gastric resection still
      plays an important role in the management of stage IE and stage IIE gastric
      lymphomas, whereas chemotherapy remains the mainstay of therapy. The role of
      radiotherapy remains undefined.

PMID- 8488938
TI  - Critical appraisal of the angiographic portacaval shunt (TIPS).
AB  - The transjugular intrahepatic portacaval shunt (TIPS) is a novel angiographic
      method for achieving portal decompression without operation. Fifty-nine
      consecutive patients underwent a total of 80 consecutive TIPS procedures. The
      procedure was unsuccessful in 4 patients (7%) and initially succeeded in 55
      (93%). Eighteen patients (30%) underwent 2 or more TIPS procedures during the
      same hospitalization due to technical difficulties, early rebleeding, shunt
      stenosis, or thrombosis. Early TIPS occlusion occurred in seven patients (12%)
      and led to recurrent variceal hemorrhage in five. Forty-two percent of the cases
      of persisting or recurrent bleeding were nonvariceal. Procedure-related
      complications occurred in 10% of TIPS procedures or 14% of patients. Twenty-three
      patients (39%) were actively bleeding at the time of the procedure, and, in 6 of
      these (26%), bleeding was never controlled. In-hospital mortality (25%) was
      related only to the presence of bleeding at the time of TIPS (56% for emergent
      versus 5.5% for non-emergent, p < 0.0001). Mortality was not related to the Child
      Pugh classification. Hemodynamic stabilization, vasoconstrictor therapy, balloon
      tamponade, and sclerotherapy were underutilized in 30% to 40% of patients prior
      to TIPS. Aggressive medical management should be used to stop variceal hemorrhage
      prior to TIPS in all patients, regardless of the Child-Pugh classification.
      Prospective trials comparing TIPS with sclerotherapy and surgical shunt are
      required to demonstrate the proper role of this procedure in the management of
      portal hypertension and variceal hemorrhage.

PMID- 8488939
TI  - Extending the limits of lung cancer resection.
AB  - Patients with locally advanced bronchogenic carcinoma are often considered to
      have unresectable disease because of invasion into vital structures, or they
      undergo resection with questionable or involved margins, which results in local
      recurrence later. Brachytherapy (direct application of radioactive sources to the
      tumor bed) offers the potential to provide tumoricidal doses of radiation to the
      target area with minimal toxicity to surrounding structures. In this study, one
      of two different techniques of brachytherapy was utilized to treat 15 highly
      selected patients with histologically positive (n = 8) or suspicious (n = 7)
      margins after resection. The techniques were easy to apply and were not
      associated with any complications directly related to their use. One
      postoperative death resulted from a perforated peptic ulcer. In the remaining 14
      patients, at a mean follow-up of 38 months, local control was complete in 12
      (86%) patients, and 8 patients are alive, with 7 free of disease. Thoracic
      brachytherapy may offer the potential for cure to patients whose disease would
      otherwise be considered inoperable.

PMID- 8488940
TI  - Effects of age and severity of illness on outcome and length of stay in geriatric
      surgical patients.
AB  - From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age
      and older underwent an anesthetic and surgical procedure in a 1,000-bed community
      hospital in Victoria, British Columbia, Canada. The hospital has been using a
      proprietary system called MedisGroups for assessing the severity of illness on
      admission and in-hospital morbidity. All patients were followed up until death or
      discharge from the hospital. Using the hospital database, we analyzed the patient
      sample to test the hypothesis that severity of illness was more important than
      age in predicting postoperative morbidity and mortality rates. Using correlation
      and multiple regression analysis, we found that the severity of illness was a
      much better predictor of outcome than age. The results were significant at the
      level of p < 0.001. Based on the results of this study, we recommend that age not
      be used in surgical decisions in the elderly.

PMID- 8488941
TI  - Endoscopic retrograde cholangiopancreatography after laparoscopic
      cholecystectomy.
AB  - We assessed the use of endoscopic retrograde cholangiopancreatography (ERCP)
      after laparoscopic cholecystectomy (LC) at our hepatobiliary referral center.
      This assessment included patients from outside institutions with post-LC
      problems. Between May 1990 and September 1992, we performed 522 LCs and 1,723
      ERCP examinations. There were 78 patients who underwent 143 ERCP examinations
      after LC, 65% of whom were referred. ERCP findings were categorized as follows:
      normal results (8%), problems inherent to stone disease (65%), and iatrogenic
      injury (27%). The types of inherent problems were common bile duct (CBD) stones,
      pancreatitis, and papillary stenosis/microlithiasis. Within the CBD stone group,
      5 of 26 patients also had papillary stenosis, and, within the pancreatitis group,
      9 of 11 patients also had papillary stenosis, making papillary stenosis the most
      frequent observation (55%). Almost all of these patients (96%) required
      endoscopic papillotomy for successful treatment. The iatrogenic injury group was
      comprised of 21 patients, 16% of whom had cystic duct leak and 84% of whom had
      CBD injury. These patients required a variety of endoscopic procedures including
      endoscopic papillotomy (67%), CBD endoscopic stenting (76%), percutaneous
      drainage of biloma (29%), and percutaneous transhepatic biliary drainage (24%).
      Open surgical procedures after endoscopic assessment or treatment were required
      in only three patients in the iatrogenic group and in none in the inherent group.
      At this time, long-term follow-up is not possible with regard to biliary
      stricture. We conclude that the majority of problems after LC are either due to
      papillary stenosis/microlithiasis with or without CBD stones or to biliary
      injury. Both can be successfully diagnosed and treated with endoscopic
      techniques.

PMID- 8488942
TI  - Clinical results of cryopreserved valved conduits in the pulmonary ventricle-to
      pulmonary artery position.
AB  - Aortic valved homograft conduits (AVHC) have become valuable in the pulmonary
      ventricle (PV)-to-main pulmonary artery (MPA) reconstruction in congenital heart
      defects. Since 1985, 45 patients, ranging in age from 12 days to 32 years,
      underwent PV-to-MPA reconstruction utilizing cryopreserved AVHC. Operative deaths
      included seven patients (16%), six of whom died as a result of the complexity of
      their underlying heart defects. One late death (2%) occurred as a result of
      infective endocarditis 48 months after conduit placement. The 38 patients who
      survived the operation remained in the intensive care unit for a mean of 5.7 +/-
      1.0 days (median: 4 days; range: 2 to 37 days). The mean hospital stay was 13.0
      +/- 1.8 days (median: 9 days; range: 6 to 63 days). The mean follow-up was 40.0
      +/- 3.6 months (median: 40 months; range: 10 months to 7.1 years). Only two
      patients (5%) required reoperation for conduit stenosis with systolic pressure
      gradients of 60 to 80 mm Hg at 10 and 14 months, respectively, after operation,
      and both reoperations were successful. During outpatient visits, 16 patients are
      totally asymptomatic, and 21 patients have minimal symptoms (New York Heart
      Association class II). Only 10 patients (26%) require digoxin, and 2 patients
      (5%) need diuretics as part of their medical regimen. Recent echocardiographic
      examinations show insignificant pressure gradients in all 37 currently surviving
      patients. Thus, barring operative mortality, which is almost always associated
      with the nature of the underlying heart defect, the use of cryopreserved AVHC is
      a safe and effective alternative for PV-to-MPA reconstruction.

PMID- 8488943
TI  - Use of thoracoscopy in clinical practice.
AB  - Endoscopic surgery and, in particular, thoracoscopy, have become useful clinical
      tools as both technique and instrumentation have evolved. Our experience with a
      series of 20 patients undergoing thoracoscopy, including the indications,
      results, and outcome, is presented. Indications for thoracoscopy and biopsy or
      resection include the diagnosis and, in some cases, treatment of idiopathic
      pulmonary infiltrates, mycetomas, lung masses, spontaneous pneumothorax, and
      empyema. Morbidity is limited, and there has been no mortality due to the
      procedure.

PMID- 8488944
TI  - Simplified preperitoneal Marlex hernia repair.
AB  - The routine use of mesh for repair of inguinal hernia has been popularized by
      Lichtenstein and others. Although preperitoneal placement is more appealing than
      the onlay technique, the classical approach by Nyhus and Condon is difficult
      under local anesthesia and denervates the inguinal muscles to some degree.
      Preperitoneal mesh may become the standard for inguinal hernia as the
      laparoscopic approach becomes more popular. This report describes the author's
      first 100 hernia repairs done using a simplified preperitoneal approach under
      local anesthesia. The preperitoneal space is entered directly through the
      posterior floor, but a complete covering of the direct, indirect, and femoral
      spaces is accomplished similar to an open technique. After placement of the mesh,
      a truly "tension-free" closure of the posterior floor can be accomplished.
      Patients are discharged home in 1 to 2 hours. Because a standard approach and
      block are used, the learning curve for this operation should be brief compared
      with that of the laparoscopic method. The follow-up of this series is short
      (average: 15 months), but there have been no recurrences or infections. One
      patient returned to the operating room within 4 hours due to an arterial bleeder
      in Scarpa's fascia but was discharged that day and had no subsequent problems.
      Another patient has a postoperative neuralgia probably unrelated to the mesh.
      Otherwise, there has no complications with the placement of the Marlex mesh.
      Patients are allowed to return to full activity and work at their discretion.

PMID- 8488945
TI  - Diagnosis and staging of pancreatic adenocarcinoma with dynamic computed
      tomography.
AB  - We assessed the accuracy of dynamic contrast-enhanced computed tomography (CT) in
      the diagnosis and staging of 213 patients with pancreatic carcinoma and compared
      it with the accuracy of angiography and surgery. A correct CT diagnosis of
      pancreatic carcinoma was made in 207 of 213 (97%) patients. Tumors were located
      in the pancreatic head in 64%, the body in 22%, and the tail in 10%, and enlarged
      the pancreas diffusely in 4%. CT staged 25 (12%) patients as having potentially
      resectable tumors and 188 (88%) as having unresectable tumors on the basis of
      local extension (72%), contiguous organ invasion (43%), vascular invasion (82%),
      and distant metastases (50%). Compared with angiography in 60 patients, CT
      detected vascular invasion missed on angiography in 20%, and angiography detected
      invasion missed by CT in 5%. In these latter cases, other CT criteria of
      unresectability were present, and angiography provided no significant staging
      information. Compared with surgery in 71 patients, CT accurately predicted
      unresectable tumors in 100% of patients and resectable tumors in 72% of patients.
      Eleven of the patients with CT-resectable tumors underwent resection. Median
      survival was 22.7 months, with four patients alive at a median of 15.5 months
      postoperatively. Palliative resections were performed in six patients, and median
      survival was 14.4 months.

PMID- 8488946
TI  - Surgical management of the post-phlebitic leg syndrome.
AB  - Twenty-five patients (32 limbs) with severe retrograde ejection venous syndrome
      (post-phlebitic leg syndrome) were surgically treated from 1971 to 1986 using a
      "very complete fasciotomy" with or without other individualized procedures.
      Clinical data, venographic findings, operative choices, and outcome were analyzed
      retrospectively. The theoretic benefit of adopting this new and conceptually
      accurate diagnostic label and the principle of "no incompetent perforators, no
      ulcers" is discussed. The patients generally had been managed for 10 to 20 years
      with conservative neglect or operative inadequacy. With correct conceptual
      understanding, anatomic stratification, defined indications for surgery, and
      individualization of procedures, an excellent result has been obtained with a low
      rate of serious complications. The very complete fasciotomy should be suitable
      for general use in treating this difficult and controversial syndrome.

PMID- 8488947
TI  - Review of the pathologic diagnoses of 2,216 appendectomy specimens.
AB  - A retrospective review of 2,216 patients surgically treated for a clinical
      diagnosis of acute appendicitis was performed. In 80% of cases, histologic acute
      appendicitis was found; 57% of these patients were male. The rate of normal
      appendectomy was 16%, and females comprised 68% of that group. The remaining 102
      cases (4%) were designated as the alternate diagnosis group. Apart from
      histologic diagnoses that could be considered variants of normal (57) or acute
      inflammation (20), the alternate diagnosis group included such entities as
      neoplasm, parasitic infection, mucocele, and diverticulitis.

PMID- 8488948
TI  - Evaluation of 50 consecutive segmental hepatic resections.
AB  - The development of increasingly sensitive imaging techniques along with improved
      follow-up and screening of high-risk patients has led to hepatic tumors, both
      primary and secondary, being detected while still at an early stage. Improved
      understanding of hepatic anatomy along with advances in surgical technique has
      led to the ability to undertake hepatic resections based on the segmental hepatic
      anatomy as described by Couinaud. The purpose of this paper is to assess the
      safety, technique, and oncologic efficacy of segmental hepatic resection. Fifty
      consecutive patients undergoing segmental hepatic resection during a 3-year time
      period ending in January 1992 were reviewed. Parametric statistical analysis was
      undertaken using Student's t-tests. Overall mortality was 2% with a morbidity
      rate of 8%. Transfusion requirements were 1 +/- 1.5 U; however, cirrhotic
      patients showed a significantly increased transfusion requirement of 2.0 +/- 1.3
      U versus 0.7 +/- 1.3 U (p = 0.03). Sixty percent of patients required no
      transfusion at all. The mean duration of inflow occlusion was 42 +/- 17 minutes.
      Resection margins were clear of tumor by greater than 1 cm in 48 of 50 patients.
      Segmental hepatic resection is a safe and effective technique that occasionally
      may offer advantages over formal resection. Some aspects of the technique are
      reviewed.

PMID- 8488949
TI  - Laparoscopic cholecystectomy in pregnancy.
AB  - It has been stated that pregnancy is an absolute contraindication to laparoscopic
      cholecystectomy. After failed medical management, five gravid patients underwent
      successful laparoscopic cholecystectomy with single-film intraoperative
      cholangiography. One patient was in the first trimester, three were in the second
      trimester, and one was in the third trimester. All carried the pregnancy to term
      and delivered normal children. Laparoscopic cholecystectomy can be safely
      performed during pregnancy and offers the potential of significant cost savings
      compared with traditional medical management of cholecystitis complicating
      pregnancy.

PMID- 8488950
TI  - Double aortic arch causing tracheoesophageal compression.
AB  - Since 1972, 17 patients have been surgically treated for double aortic arch at
      our institution. The procedure became necessary before 12 months of age in 11
      patients and before 24 months in 16 patients. The major symptoms were respiratory
      distress, noisy breathing, and respiratory infections; four patients also had
      dysphagia. A high degree of clinical suspicion should warrant further
      investigation. Barium swallow and bronchoscopy were diagnostic and revealed
      extrinsic compression of the esophagus and trachea, respectively. Division of the
      anterior arch was performed in 16 patients; the right (posterior) arch was
      divided in the remaining patient. Kommerell's diverticulum was found in four
      patients and was resected in order to avoid recurrence of dysphagia by
      compression. A vascular suspension procedure was necessary in 13 patients to
      further release the trachea and esophagus. There was no mortality in this series,
      and symptomatic improvement was achieved in all patients. A degree of
      tracheomalacia may be responsible for some residual symptoms in four patients.

PMID- 8488951
TI  - Fate of infected and eroded hemodialysis grafts and autogenous fistulas.
AB  - Between 1970 and 1991, we placed 1,090 grafts (bovine and
      polytetrafluoroethylene) in 1,041 patients and created 1,034 autogenous fistulas
      in 856 patients for hemodialysis. Subsequent revisions for complications resulted
      in a total of 3,944 operations performed in patients with grafts and 1,633
      operations in patients with autogenous fistulas. A total of 255 infections
      developed in 158 of the patients with grafts, whereas 8 infections developed in 7
      patients with autogenous fistulas. The puncture infection rate was 5%/yr (12%/yr
      for a second puncture infection). The clean wound infection rate was 3% for
      grafts and 0.4% for autogenous fistulas. We made an attempt to salvage the graft,
      usually with a segmental bypass, in 75% of patients with a graft infection.
      Grafts were salvaged in 80% of patients in whom salvage was attempted (60% of all
      patients with an infection). The results in the few patients with infected
      autogenous fistulas were relatively poor.

PMID- 8488952
TI  - Diagnosis and management of pericardial abscess in trauma patients.
AB  - Pericardial infection is an uncommon clinical entity after traumatic injury.
      Although invasive intervention is rarely necessary for mild pericardial
      inflammation, pericardial abscess can be life-threatening. The charts of 27
      patients with pericarditis requiring management in the intensive care unit and/or
      invasive intervention at Harborview Medical Center during a 10-year period were
      reviewed. Six cases of trauma-related pericarditis were identified, including
      three cases of pericardial abscess following torso trauma without initial cardiac
      or pericardial injury. Pericardial abscess following trauma was associated with
      the sepsis syndrome and multiple system organ failure (MSOF) in all patients.
      Computed tomography and pericardiocentesis were useful diagnostic adjuncts. All
      patients required thoracotomy for pericardial drainage and pericardiectomy.
      Successful surgical management of pericardial abscess contributed to the
      resolution of sepsis, multiple end-organ dysfunction and, ultimately, patient
      survival in all cases. We conclude that pericardial abscess, although rare,
      should be considered a potential occult site of sepsis capable of driving MSOF in
      trauma patients. Expedient diagnosis and surgical drainage are essential for
      successful patient outcome.

PMID- 8488953
TI  - Lethal nature of ischemic gastropathy.
AB  - Gastropathy on the basis of mesenteric arterial ischemia can be masked in
      presentation as the typically more benign entities of gastritis, gastric
      ulceration, or gastric atony. Gastritis and ulceration are commonly associated
      with stress, hyperacidity, Helicobacter pylori infection, or medication injury.
      Gastric atony is less commonly seen and usually attributable to diabetes
      mellitus, vagotomy, or mechanical gastric outlet obstruction. Gastric ischemia as
      a cause of gastropathy is an underappreciated phenomenon with a particularly poor
      prognosis in which early diagnosis is essential to potentially successful
      intervention. Seven patients with ischemic gastropathy are described; all are
      women, aged 41 to 71 years, smokers, with hypertension. Nausea, vomiting, weight
      loss, and gastrointestinal bleeding were the common presenting symptoms. All
      patients had endoscopic or autopsy-proven gastric ulcerations or necrosis, and
      two patients had proven gastroparesis. Four of five patients with ischemic
      gastritis died within 3 months of diagnosis despite vascular reconstruction. The
      two patients with gastroparesis underwent aorto-celiac bypass and are well 9 and
      20 months, respectively, after operation. Treatment results were distressingly
      unsatisfactory, especially in those patients in whom gastritis rather than
      gastroparesis was the presenting problem. Although the high mortality of
      mesenteric ischemia is well described, little documentation of gastric ischemia
      exists in the literature. This entity is generally not considered in the
      differential diagnosis of gastritis, ulceration, or gastroparesis. Empirically,
      an early diagnosis and treatment may improve the survival in this select patient
      group.

PMID- 8488954
TI  - Does the use of erythropoietin in hemodialysis patients increase dialysis graft
      thrombosis rates?
AB  - Erythropoietin (EPO) is highly efficacious in the treatment of the anemia of
      chronic renal failure. Evidence for a reported serious side effect, increased
      dialysis graft thrombosis, is equivocal. Sixty-four hemodialysis patients
      utilizing polytetrafluoroethylene (PTFE) grafts were treated with EPO. The
      patients served as their own historical controls. There were 1.188 thrombectomies
      and 0.222 mechanical problems per 1,000 patient-days prior to the initiation of
      EPO treatment. With EPO, the values were 0.656 and 0.222, respectively. Patients
      were separated into low-, medium-, and high-dose EPO groups and analyzed within
      groups for the effect of EPO and between groups for a dose-dependent response.
      According to an analysis of variance procedure, there was no statistically
      significant differences between the groups, which suggests that EPO is not
      thrombogenic to dialysis grafts.

PMID- 8488955
TI  - DRD2 dopamine receptor genotype, linkage disequilibrium, and alcoholism in
      American Indians and other populations.
AB  - We defined interpopulation differences in the frequency of the dopamine D2
      receptor DRD2/Taq1 A1 allele, which has previously been associated with
      alcoholism. Frequencies of the A1 allele in unrelated subjects were 0.18 to 0.20
      (se = 0.02 to 0.03) in several Caucasian populations previously assessed, 0.38
      (+/- 0.05) in American Blacks (n = 44), 0.63 (+/- 0.07) in Jemez Pueblo Indians
      (n = 23), and 0.80 (+/- 0.04) in Cheyenne Indians (n = 52). The existence of
      large interpopulation differences in the frequency of the Taq1 alleles suggests
      that associations to disease status could readily be generated or masked if
      disease and control groups were uneven in ethnic composition. To address the
      possibility that the 4-fold higher frequency of the A1 allele in Cheyenne Indians
      was related to an increased vulnerability to alcoholism in that population, 47
      Cheyenne Indians were psychiatrically interviewed and blind-rated. However, there
      was no significant difference between interviewed controls (0.73 +/- 0.06, n =
      24), subjects with alcoholism and/or drug abuse (0.74 +/- 0.06, n = 23) and
      noninterviewed population controls (0.87 +/- 0.05, n = 20). Legitimate
      association of the DRD2/Taq1 allele to alcoholism would presumably require it to
      be in linkage disequilibrium (nonrandom association) with a functional mutation
      at DRD2 or elsewhere. The level of disequilibrium would vary between populations
      and could place an upper bound on the strength of an association.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8488956
TI  - Neuropsychological deficits are correlated with frontal hypometabolism in
      positron emission tomography studies of older alcoholic patients.
AB  - In an extension of previous work, we studied the behavioral correlates of medial
      frontal lobe glucose hypometabolism in chronically alcohol-dependent patients.
      Thirty-one male patients who were detoxified, medically stable, and free of other
      central nervous system risk factors for neuropsychological impairment were
      examined with (1) anatomic imaging (CT or MR), (2) functional imaging with [18F]
      fluorodeoxyglucose (18F-FDG) and positron emission tomography (PET), and (3) a
      battery of neuropsychological tests, including two measures of abstraction known
      to be generally sensitive to frontal lobe disease or dysfunction [the Wisconsin
      Card Sorting Test (WCST) and the Halstead Category Test (HCT)]. 18F-FDG PET data
      from 18 age- and sex-matched normal control subjects were used for comparison.
      All patients met criteria for severe alcohol dependence and for at least a mild
      degree of alcoholic-induced cognitive impairment. Although the mean IQ level of
      the alcoholic patients was in the average range, the concepts attained and the
      error scores on the WCST and HCT were significantly impaired in comparison with
      established norms. Local cerebral metabolic rate for glucose (LCMRglc) was
      significantly decreased in a sagittal strip of the medial frontal cortex in the
      alcoholic patients as compared with the normal controls. Comparison of data from
      PET scans and anatomic images indicated that the reduced LCMRglc could not be
      attributed to reduced amounts of tissue alone. A statistically significant
      relationship was found between LCMRglc in the medial frontal region of the
      cerebral cortex and performance on the WCST, but not the HCT. These findings
      suggest that chronic alcohol intake results in impaired function of cerebral
      tissue in the medial frontal region.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488957
TI  - Measurement of acute tolerance to alcohol in human subjects.
AB  - Acute tolerance can be defined as a decrease in response to alcohol within a
      single exposure to the drug, which occurs independently of changes in blood
      alcohol concentrations (BACs). BACs change over time in most human alcohol
      administration studies, and computational techniques that account for these
      changes must be used to measure the rate of acute tolerance development. The most
      widely used acute tolerance measure in human research is often called the
      Mellanby effect, and involves the comparison of responses at the same BAC on the
      ascending and descending limbs of the blood alcohol curve. We compared the
      Mellanby measure with two other measures of acute tolerance: a conceptually
      similar area under the curve measure, and a slope function approach that used
      data only from the descending limb of the blood alcohol curve. The measures were
      intercorrelated and discussed with regard to empirical and conceptual issues.
      Exploratory comparisons of those with and without a family history of alcoholism
      are reported. Methodological recommendations for the computation of acute
      tolerance are made. The results suggest new methods for measuring the rate of
      acquisition of acute tolerance, and suggest areas for future research on
      tolerance-proneness and risk for alcoholism.

PMID- 8488958
TI  - What triggers the resolution of alcohol problems without treatment.
AB  - This study investigated natural recoveries (self-change) from alcohol problems,
      and overcame several methodological problems that affected the few previous
      studies of this phenomenon. Three groups of individuals who had resolved an
      alcohol problem without treatment were interviewed about their drinking history,
      life events that occurred during the year prior to their resolution, and factors
      that helped maintain their resolution. As a control for prevalence of life
      events, a control group of nonresolved, nontreated alcohol abusers were
      interviewed about events in a randomly selected year. Collaterals were
      interviewed for all subjects. No life event or constellation of events was
      differentially associated with the resolutions across the three resolved groups
      or differentiated the resolved and nonresolved groups. Interviews with resolved
      subjects were qualitatively analyzed-the majority (57%) of recoveries were
      characterized as involving a "cognitive evaluation" or appraisal of the pros and
      cons of drinking. Spousal support was reported by the greatest number of resolved
      subjects as having helped them maintain their resolution. Findings from this
      study may provide direction for developing new treatment strategies and for
      accelerating self-change among problem drinkers in the community. The study also
      demonstrates the importance of using a control group, without which very
      different conclusions might have been drawn.

PMID- 8488959
TI  - CDT by anion-exchange chromatography followed by RIA as a marker of heavy
      drinking among men.
AB  - Carbohydrate-deficient transferrin, CDT, had previously been reported to be an
      excellent marker for alcoholism. The present population-based study examined the
      diagnostic value of CDT among consecutive middle-aged males including 122 social
      drinkers (mean alcohol consumption 88 +/- 79 g per week) and 77 non-alcoholic
      heavy drinkers (301 +/- 195 g/wk). Ninety-six men with a well-documented history
      of chronic alcoholism (> or = 1000 g/wk) were used as a reference group. The CDT
      (containing mainly isotransferrin with pI = 5.8 and 5.9) was separated by anion
      exchange chromatography and assayed by RIA. The CDT values of social drinkers
      (mean +/- SD = 14 +/- 5 U/I) were significantly lower than those of heavy
      drinkers (19 +/- 13 U/I, p < 0.01) and alcoholics (34 +/- 18 U/I, p < 0.001). In
      the whole material CDT correlated positively with alcohol consumption (r = 0.53,
      p < 0.001). At a specificity of 91.8%, CDT found 28.6% of the heavy drinkers and
      79.2% of the alcoholics; the best traditional marker, GGT, with a specificity of
      86.9%, found 35.1% and 64.6%, respectively. In conclusion, CDT is a specific
      marker, which is superior to traditional markers for identifying alcoholics.
      Unfortunately, it does not seem to provide additional power for identifying the
      important group, non-alcoholic heavy drinkers.

PMID- 8488961
TI  - Alcoholic beverage licensing practices in California: a study of a regulatory
      agency.
AB  - A mail survey sent to all 25 State of California Alcoholic Beverage Control (ABC)
      offices and distributed to all 167 investigators assessed investigators'
      decisions to recommend issuance or denial of alcoholic beverage license
      applications. Investigators responded to three hypothetical vignettes that
      involved applications for liquor licenses. Findings show that although ABC
      investigators are influenced by public protests, illegal applications, and an
      applicant's moral character, they consistently favor licensing the applicant. The
      two formal rules that were designed specifically to respond to the community's
      welfare do not present serious barriers to obtaining an alcohol license. As a
      state regulatory organization, ABC is influenced greatly by the industry that it
      is supposed to regulate.

PMID- 8488960
TI  - Effect of haloperidol on measures of craving and impaired control in alcoholic
      subjects.
AB  - We recently proposed that alcoholics suffer from a functional defect within the
      basal ganglia/limbic striatum or its modulation by dopaminergic projections from
      the ventral tegmentum, and that inhibition of striatal output caused by the
      prodopaminergic effects of alcohol ingestion induces or exacerbates craving and
      impaired control over alcohol consumption in alcoholic individuals. To test this
      hypothesis, 16 subjects with a diagnosis of alcohol dependence or abuse were
      studied in a double-blind, placebo-controlled experiment in which the effects of
      the D-2 antagonist haloperidol on measures of craving and impaired control were
      assessed before and after administration of a priming dose of alcohol. Subjects
      were pretreated with 0.015-0.025 mg/kg haloperidol (experimental condition) or 2
      ml normal saline (control condition), and subsequently consumed 0.4-0.6 g/kg
      ethanol as their preferred alcohol-containing beverage. Significant increases in
      subjectively rated craving for alcohol and perceived difficulty resisting
      additional alcohol consumption occurred following the priming dose of alcohol
      when subjects were pretreated with saline. In contrast, no significant changes in
      reported ability to resist additional alcohol occurred when subjects were
      pretreated with haloperidol, and reported levels of craving decreased relative to
      baseline following haloperidol pretreatment. Subjects also consumed about 25%
      less optionally available alcohol when pretreated with haloperidol than when
      pretreated with saline. These findings support the hypothesis that craving and
      impaired control are induced or exacerbated by the prodopaminergic effects of
      alcohol consumption.

PMID- 8488962
TI  - Serum carbohydrate-deficient transferrin as a marker of alcohol consumption in
      patients with chronic liver diseases.
AB  - We measured serum levels of carbohydrate deficient transferrin (CDT) in 420
      subjects: 100 healthy blood donors, 82 healthy employees, 70 abstaining patients
      with different chronic nonalcoholic liver disease, 16 abstaining patients with
      alcoholic fatty liver, 50 abstaining patients with alcoholic liver cirrhosis, 25
      abusing patients with alcoholic fatty liver, 41 abusing patients with alcoholic
      liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily
      ethanol consumption of 173 +/- 120 g the last 4 weeks before blood was drawn. In
      controls the serum level of CDT was significantly higher in females compared with
      males (17.7 +/- 5.1 and 13.7 +/- 3.8 units/liter, respectively), and the upper
      normal limit was defined as 27 and 20 units/liter. Sixty-two of 102 (60.8%)
      abusing patients with alcoholic liver disease had increased levels of CDT
      compared with 1 of 66 abstaining (1.5%) patients with alcoholic liver disease,
      and 10 of 70 (14.3%) abstaining patients with nonalcoholic liver disease among
      them 3 with primary biliary cirrhosis and 2 with chronic autoimmune hepatitis. No
      correlation was found between serum CDT and gamma-glutamyltranspeptidase (GGT),
      AST, ALT, and mean red cell volume (MCV). The sensitivity and specificity for
      serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70
      and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our
      study confirms that CDT is a specific marker for chronic alcohol abuse, except in
      few patients with other chronic liver diseases. Serum CDT seems to be a better
      indicator of abstention than GGT; AST and MCV in patients with alcoholic liver
      disease. However, in our hands CDT is not so sensitive for alcohol abuse in
      patients with liver disease as reported earlier in unselected alcoholics.

PMID- 8488963
TI  - Alcohol-related mortality in Spain.
AB  - Alcohol-related mortality and years of potential life lost in Spain in 1986 have
      been studied according to the official statistics with regard to the population
      mortality in our country. 6.1% of the deaths in Spain in 1986 were related to
      alcohol consumption, mainly caused by malignant neoplasm (26.0%), digestive
      diseases (23.6%), and unintentional injuries (21.1%). Mean potential years of
      life lost for alcohol-related deaths until 65 was 7.3. Unintentional injuries
      were responsible for the greater part (61.2%) of alcohol-related years of
      potential life lost. The present study shows the high mortality rate associated
      with alcohol consumption in our country, as well as its importance in premature
      death.

PMID- 8488964
TI  - Effect of bedtime ethanol on total inspiratory resistance and respiratory drive
      in normal nonsnoring men.
AB  - We have previously reported that bedtime ethanol (2.0 ml/kg of 100 proof vodka)
      increases upper airway closing pressure in males who habitually snored but were
      otherwise healthy. We also observed that some of these snorers developed
      obstructive apneas. To explore this phenomenon in more detail, we measured the
      inspiratory resistance (RI) and respiratory drive after bedtime ethanol in 10
      nonobese men (ages 23 to 33) with no history of snoring. Subjects went to bed
      wearing a tightly fitting valved mask over the nose and mouth that allowed
      measurement of inspiratory and expiratory flow, pressure in the mask, and
      endtidal CO2. We measured RI by calculating the pressure difference between the
      mouth and a balloon positioned in the midesophagus. Respiratory drive was
      quantified by the inspiratory occlusion pressure (P0.1), the ventilatory response
      to hyperoxic hypercapnia (delta VE/delta PETCO2), and the ventilatory response to
      isocapnic hypoxia (delta VE/delta SaO2). Measurements were made during waking and
      during stage 2 NREM sleep on two nights: (1) when the subjects drank 1.5 ml/kg of
      100 proof vodka in orange juice over a 30-min period 15-45 min before lights out
      and (2) when the orange juice contained less than 0.1 ml of vodka floating on the
      top. Eight of the nine men in whom we had technically adequate measurements
      showed a rise in RI during NREM sleep above the waking level on both control and
      ethanol nights and the sleeping RI was greater on the ethanol than on the control
      night.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488965
TI  - A genetic familial study of monoamine oxidase B activity and concentration in
      alcoholics.
AB  - Platelet monoamine oxidase B (MAO B) activity and concentration were studied in a
      small sample of alcoholic families (n = 8) and in 20 unrelated, nonalcoholic
      controls. Complex segregation analyses of familial data indicated that both
      activity and concentration are controlled by a single major gene locus with a
      multifactorial background effect accounting for 0-50% of the variance. When the
      alcoholic family members (n = 24) were compared with the controls, all
      determinations of activity display significant differences, whereas MAO B
      concentration levels showed no difference. These results indicated that the
      lowered MAO B activities frequently reported among alcoholics do not reflect a
      change in the number of MAO B macromolecules expressed in platelets, but could be
      caused by the presence of an inhibitor or by a polymorphic or variant form of the
      enzyme.

PMID- 8488966
TI  - Urinary level of L-fucose as a marker of alcoholic liver disease.
AB  - The urinary levels of L-fucose were measured in 93 alcoholics; 20 of these were
      without liver disease, 57 with noncirrhotic alcoholic liver disease, and 16 with
      alcoholic liver cirrhosis. In addition, patients with cirrhosis due to viral
      infection, and healthy subjects were evaluated. The mean urinary L-fucose
      concentration showed significantly higher values in patients with alcoholic liver
      disease and alcoholic liver cirrhosis when compared with the healthy subjects or
      the chronic alcoholics without liver disease (p < 0.001). The urinary L-fucose
      level was also significantly higher (p < 0.001) in cases of alcoholic liver
      cirrhosis than in noncirrhotic alcoholic liver disease (384 +/- 97 vs. 240 +/- 95
      mumol/g of creatinine). No difference was observed between the healthy subjects
      and chronic alcoholics without liver disease (143 +/- 29 vs. 155 +/- 60 mumol/g
      of creatinine). The urinary level of L-fucose was significantly higher with
      alcoholic cirrhosis (384 +/- 97 mumol/g of creatinine) than with viral cirrhosis
      (265 +/- 42 mumol/g of creatinine) (p < 0.001). The measurement of urinary L
      fucose may be a useful marker of alcoholic liver disease.

PMID- 8488967
TI  - MAST scores, alcohol consumption, and gynecological symptoms in endometriosis
      patients.
AB  - Alcohol consumption (quantity, frequency, and pattern) and alcohol-related
      problems were determined in endometriosis patients (n = 137), patients with other
      gynecological disorders (n = 91), and normal control subjects (n = 98).
      Participants completed a self-administered questionnaire, including the Michigan
      Alcoholism Screening Test (MAST), questions to determine the quantity and
      frequency of alcohol use, and questions regarding the relationship between
      gynecological symptoms and alcohol intake. The percentage of endometriosis
      patients with MAST scores greater than five or seven was significantly greater
      than that of normal control subjects (p = 0.045 and p = 0.009, respectively), but
      did not differ from that for patients with other gynecological disorders.
      Endometriosis patients with high MAST scores (> or = 5) tended to consume more
      alcohol on a yearly basis than normal control subjects with high MAST scores (p =
      0.07). Among participants who experienced gynecological symptoms and were not
      abstainers, 31% of endometriosis patients, 9.5% of normal control subjects, and
      14.3% of patients with other gynecological disorders reported increasing their
      alcohol consumption when experiencing gynecological symptoms. Endometriosis
      patients tended to differ in this regard from normal control subjects (p = 0.058)
      and were significantly different from patients with other gynecological disorders
      (p = 0.039). The evidence suggests that the gynecological problems of
      endometriosis may be a major medical correlative of alcoholism in women.

PMID- 8488968
TI  - Immune function in alcoholism: a controlled study.
AB  - Several studies have shown an increased risk for infection and cancer in
      alcoholic patients. The mechanisms for such observations remain largely unknown.
      In an effort to investigate the possibility of immunological dysfunction in
      alcoholism, we studied three immune parameters in 47 hospitalized chronic
      alcoholic patients and 47 age- and sex-matched normal controls. The immune
      measures were: (1) lymphocyte phenotyping, with estimates of percentages of T
      cells, B cells, T helpers, T suppressors, natural killer (NK) cells, and cells
      carrying the activation markers IL2R1 and I2; (2) NK cell activity; and (3)
      lymphokine-activated killer cell activity. Results indicate a significant
      increase in the IL2R and I2 lymphocyte markers in alcoholic patients compared
      with matched controls. We also found a nonsignificant trend for a decrease in the
      percentage of suppressor T cells in the alcoholic group, as well as a trend for a
      negative correlation between the percentage of T suppressor cells and age. There
      were no significant differences in either NK or lymphokine-activated killer cell
      activities between the two groups. Furthermore, there were no significant
      associations between duration and intensity of alcohol consumption and any of the
      immune measures. These results suggest subtle alterations in immune regulation in
      alcoholic patients that cannot be explained solely on the basis of duration
      and/or amount of alcohol consumed.

PMID- 8488969
TI  - A time series analysis of the impact of the alcohol warning label on antenatal
      drinking.
AB  - In a sample of over 12,000 African-American gravidas, we tested the hypothesis
      that the Federal Beverage Labeling Act of 1988 has decreased antenatal drinking.
      Results of time series analysis indicated a 7-month lag in the impact of the
      alcohol warning label. Controlling for population changes, antenatal drinking
      began to fall as of June 1990. However, this decrease was small in size and did
      not impact on the heaviest drinkers. Seasonal trends in drinking were also
      detected, with peaks around the end of the year and the summer.

PMID- 8488970
TI  - Drinking patterns and correlates of drinking among pregnant teenagers.
AB  - Many adolescents drink, and the rate of teenage pregnancy is increasing, yet the
      effect of drinking among pregnant teenagers has received little attention. We
      present a description of the drinking patterns of 124 pregnant teenagers
      attending a prenatal clinic in Pittsburgh. Sixty-nine percent of the women were
      African-American, and the average age was 16 years (range 13-18 years). Eighty
      two percent drank the year before pregnancy, while 54%, 19%, and 15% drank during
      the first, second, and third trimesters, respectively. All substance use
      decreased between the first and third trimesters, with the exception of tobacco,
      which rose significantly. Binge drinking (5+ drinks/occasion) occurred in 31% of
      the sample before pregnancy, rose to 35% in the first trimester, and then fell
      precipitously. Binge drinkers during pregnancy were more likely to be white and
      heavier users of tobacco, marijuana, and cocaine. Binge drinkers experienced
      alcohol and tobacco use and sexual intercourse earlier than nonbinge drinkers.
      Binge drinking in the first trimester may be considered a risk factor for infants
      of adolescents.

PMID- 8488971
TI  - Secondary immune response to hepatitis B virus vaccine in alcoholics.
AB  - The efficacy of full vaccination against hepatitis B virus (i.e., including the 1
      year booster injection) was evaluated in 28 alcoholic patients with minimal liver
      disease. Although such patients are reportedly poor responders, the proportion of
      those protected (anti-HBs titer > = 10 mlU/ml) rose from 42.8% after primary
      immunization to 82% after the booster. The mean anti-HBs titer, which remained
      low in the overall group, was significantly lower in the subjects who resumed
      drinking during the follow-up period than in those who did not. This suggests a
      direct influence of alcohol itself on the response, because none of our patients
      had cirrhosis and none were clearly malnourished. Among the 17 patients for whom
      the 2-year post-booster anti-HBs titer could be determined, all those with a 1
      month postbooster titer above 1000 mlU/ml still had a high anti-HBs level (>
      100), whereas 80% of those with a 1-month postbooster titer < 1000 had 2 years
      later only a low (< 100) or even an unprotective anti-HBs level; this means that
      only the latter should be considered for a new booster injection. Our data
      indicate that protection against hepatitis B virus can be achieved in a good
      proportion of alcoholics with a full vaccination protocol. We suggest that
      efficacy should be evaluated 1 month after the booster, and that patients with
      low postbooster anti-HBs titers should be tested at regular intervals, because
      they can also be protected provided an adapted schedule of further injections is
      conducted.

PMID- 8488972
TI  - Similar effects of ethanol and tert-butanol on amino acid concentrations in rat
      serum and liver.
AB  - Both metabolic and nonmetabolic mechanisms have been proposed to the plasma amino
      acid decreasing effect of an acute ethanol load. We used tert-butanol, an alcohol
      that is only minimally metabolized, as a tool to explain the mechanism behind the
      amino acid decreasing effect of ethanol. Acute administration of tert-butanol was
      found to exert a decreasing effect on rat serum amino acid concentrations similar
      to that of ethanol, indicating that the mechanism of the amino acid decreasing
      effect of ethanol is primarily due to ethanol itself and not to its oxidation.
      Ethanol and tert-butanol also had similar effects on liver amino acid
      concentrations, including an increase in the glycine concentration and decrease
      in the concentrations of glutamate, alanine, leucine, and tyrosine.

PMID- 8488973
TI  - Migration of cortical neurons is altered by gestational exposure to ethanol.
AB  - Rats prenatally exposed to ethanol exhibit a variety of structural anomalies in
      the central nervous system. One of the key features of experimental fetal alcohol
      syndrome is microencephaly. Cerebral cortex is particularly susceptible to the
      effects of prenatal exposure to ethanol. Its total mass is reduced, it is
      thinner, and it contains fewer neurons and glia. Various studies in rats and
      humans suggest that chronic early exposure to ethanol leads to a massive
      reorganization of cortex characterized by heterotopic clusters of neurons. A
      pulse and chase study with [3H]thymidine autoradiography was used to determine if
      gestational exposure to ethanol leads to defects in neuronal migration. Rats were
      fed an ethanol-containing diet between gestational day (G) 6 and G21, pair-fed a
      liquid control diet, or fed chow. Ethanol delayed the migration of early
      generated neurons (those born on G13) to deep cortex by 2 days. Moreover, the
      migration of late-generated neurons (those born on G21) was delayed 4 to 6 days
      by ethanol, and often these neurons terminated their migration in ectopic
      locations. Ethanol significantly decreased the rate of migration and the time
      postmitotic cells remained in the proliferative zones. On the other hand, ethanol
      did not have a significant effect on the rate of cortical expansion and the
      fraction of cells that left the proliferating population in order to migrate to
      cortex. Thus, the migration of young neurons was profoundly altered by prenatal
      exposure to ethanol. Such delays may lead to a desynchronization of cortical
      development that makes it impossible for cortical neurons to establish a normal
      circuitry.

PMID- 8488974
TI  - Enhanced expression of the inhibitory protein Gi2 alpha and decreased activity of
      adenylyl cyclase in lymphocytes of abstinent alcoholics.
AB  - Ethanol exposure alters signal transduction through the adenylyl cyclase (AC)
      system. To elucidate the basis for this effect, we investigated the AC system in
      peripheral lymphocytes from abstinent alcoholic men (n = 22), actively drinking
      alcoholic men (n = 41), and nonalcoholic control men (n = 16). Immunoblot
      analysis of lymphocyte membranes from abstinent alcoholics demonstrated a 3.0
      fold increase in the level of Gi2 alpha protein (p < 0.05) compared with
      controls. However, levels of Gs alpha protein were similar in both groups.
      Abstinent alcoholics had a 2.9-fold increase in Gi2 alpha mRNA (p < 0.001) and a
      2.7-fold increase in Gs alpha mRNA (p < 0.03) compared with lymphocytes from
      control subjects. Actively drinking alcoholics, in contrast, had unaltered Gs
      alpha protein, Gi2 alpha protein, and Gi2 alpha mRNA levels compared with control
      subjects, but did have a 1.8-fold increase (p < 0.01) in Gs alpha mRNA.
      Consistent with enhanced Gi2 alpha expression, lymphocyte membranes from
      abstinent alcoholics had decreased basal, prostaglandin E1-, guanosine 5'-0-(3
      thiotriphosphate)-gamma S-, and forskolin-stimulated AC activity compared with
      both controls and actively drinking alcoholics (p < 0.05). We conclude that
      lymphocyte AC is reduced during abstinence from alcohol and enhanced expression
      of the inhibitory G-protein, Gi2 alpha, may account for this change.

PMID- 8488975
TI  - Role of gangliosides in behavioral and biochemical actions of alcohol: cell
      membrane structure and function.
AB  - Alcohol exerts its pharmacological effects in adult brain by altering the
      physicochemical properties of cellular plasma membranes. Although alcohol does
      induce changes in membrane lipid composition, studies to relate these alterations
      to the development of behavioral tolerance to alcohol and the withdrawal effects
      have been unsuccessful. Actions of alcohol on developing brain are even more
      complex. Some of the reported effects include inhibition of embryogenesis, cell
      migration, and differentiation, including synaptogenesis. Gangliosides have
      neuroprotective action against a variety of neural insults (e.g., mechanical
      injury, drug toxicity, or hypoxic insult). This review addresses the role and
      significance of gangliosides in the CNS pathophysiology of alcohol exposure, as
      well as the effect of changes in endogenous gangliosides on membrane structure
      and function. We also describe the role of exogenous gangliosides in prevention
      of alcohol (acute and/or chronic)-induced CNS (prenatal and postnatal)
      neurotoxicity through their action on cellular plasma membranes. We propose that
      ganglioside's neuroprotective effects against alcohol neurotoxicity involve
      protection and restoration of plasma membrane structure (proteins and lipids) and
      thereby its function (ionic homeostasis, neurotransmitter receptor-mediated
      signal transduction). Thus gangliosides may have potential therapeutic use in
      treatment of alcohol-related problems.

PMID- 8488976
TI  - Selective inhibition of luteinizing hormone action by ethanol in cultured human
      granulosa cells.
AB  - To extend further our previous observations on the inhibition of luteinizing
      hormone (LH)-induced increases in steroid secretion by ethanol (EtOH) (Alcohol.
      Clin. Exp. Res. 14:522-527, 1990), cultured human granulosa cells were pretreated
      with several EtOH concentrations (0-100 mM), and cells were stimulated with human
      LH (25 ng/ml) or human follicle stimulating hormone (FSH) (100 ng/ml) and the
      secretion of 17-beta-estradiol (E2) and progesterone (P) was measured. EtOH
      significantly increased basal E2 secretion in a dose-related manner (0-20 mM);
      however, in the same concentration range EtOH did not produce consistent changes
      in FSH-stimulated E2 secretion. In contrast, EtOH decreased LH-stimulated E2
      secretion between 0-20 mM such that at 20 mM EtOH, the positive effect of LH was
      abolished. EtOH increased P secretion by 40% at 20 mM and at 100 mM, there was a
      100% increase. The FSH-stimulated P secretion was not consistently changed by
      EtOH, whereas LH-stimulated P secretion was decreased in a dose-dependent manner.
      LH/human chorionic gonadotropin (hCG) receptors in cells exposed to EtOH showed a
      15% (p < 0.01) and a 47% decrease at 20 mM and 50 mM EtOH, respectively. At 50 mM
      EtOH, there was a decrease in LH/hCG receptor number from 2900/cell to 1670/cell,
      without a change in receptor affinity for hCG and 50 mM EtOH decreased LH/hCG
      receptors in intact granulosa cells in a time-dependent manner. These results
      indicate that the selective effects of EtOH on LH action in human granulosa cells
      may be mediated in part by an action on LH/hCG receptors.

PMID- 8488977
TI  - Cholesterol exchange and lateral cholesterol pools in synaptosomal membranes of
      pair-fed control and chronic ethanol-treated mice.
AB  - Most studies on effects of ethanol on membrane cholesterol have reported on
      changes in the total or bulk amount of cholesterol. Membrane cholesterol,
      however, can be described in terms of its kinetics and domains. The kinetics and
      size of lateral cholesterol exchangeable and nonexchangeable pools were examined
      in synaptosomes of pair-fed controls and chronic ethanol-treated mice. Effects of
      sphingomyelin, an exofacial leaflet phospholipid, that has been shown to affect
      cholesterol pools, were also examined. Radiolabeled small unilamellar vesicles
      were used to exchange cholesterol with synaptosomes. The total amounts of
      membrane cholesterol, phospholipid phosphorus, and the ratio of cholesterol to
      phospholipid did not differ between the pair-fed control and ethanol groups. In
      control mice, the rate constant (hr-1) and the t1/2 (hr) of cholesterol exchange
      were 0.065 +/- 0.001 and 10.7 +/- 0.25 (hr), respectively. The rate constant was
      significantly slower (0.053 +/- 0.001, p < 0.05) and the t1/2 significantly
      longer (13.33 +/- 0.58, p < 0.05) in synaptosomes of the ethanol group compared
      with the control group. The size of the exchangeable pool of cholesterol did not
      differ significantly between the two groups. Sphingomyelinase-induced hydrolysis
      of sphingomyelin significantly slowed cholesterol exchange with the largest
      effect in synaptosomes of the control group as compared with the ethanol group (p
      < 0.05). Hydrolysis of sphingomyelin had significantly (p < 0.05) less of an
      effect on cholesterol exchange in synaptosomes of the ethanol group. Membrane
      cholesterol can be described in terms of total content, transbilayer
      distribution, kinetics, and size of lateral pools.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8488978
TI  - Ethanol exposure increases total protein kinase C activity in human lymphocytes.
AB  - Human circulating lymphocytes were isolated and incubated with ethanol.
      Cytosolic, membrane-bound and total detergent extractable protein kinase C (PKC)
      activities were measured. Exposure to ethanol (100 mm) resulted in an increase in
      PKC activity, with membrane-associated PKC activity increasing with respect to
      cytosolic activity at 5 min of exposure. Higher concentrations of ethanol up to
      200 mm were associated with increases in total detergent extractable PKC
      activity. Ethanol was the most potent of a series of straight chain alcohols
      studied for their effects on detergent-extractable PKC activity.

PMID- 8488979
TI  - "Binge" versus steady drinking: effects on the liver in the ovariectomized rat.
AB  - Substantial interest exists as to whether or not differential effects in liver
      injury based on the pattern of alcohol intake exist; and further, if they do, are
      they simply a function of the total dose over time. A rat model in which ethanol
      (ETOH) at doses of 12%, 24%, or 36% of total calories was isocalorically
      administered for 4 months either daily or intermittently (4 days of ETOH, 3 days
      of control diet, repeatedly) was used to assess this question. There were
      significant differences in the two feeding pattern groups between 36% ETOH rats
      for the liver weight corrected for body weight, the fat infiltration score, the
      total amount of ETOH consumed/mg body weight, the proportion of animals with a
      fat infiltration score > 2, and albumin levels. There was a significant
      difference between 12% ETOH rats for the liver weight corrected for body weight.
      Of particular relevance is the comparison to be made between Daily 12% ETOH and
      Binge 24% ETOH animals, because these two groups consumed an identical total
      amount of ETOH/mg body weight (Daily: 445 +/- 5 vs. Binge: 468 +/- 15) and thus
      these animals are comparable in terms of ETOH dose over time but different in
      terms of the pattern of ETOH exposure. There were no differences in the
      liver/body ratio (Daily: 235 +/- 6 vs. Binge: 232 +/- 4), fat infiltration score
      (Daily: 2.5 +/- 4 vs. Binge: 2.4 +/- 0.3), the proportion of animals with a fat
      infiltration score > 2 (Daily: 5/10 vs. Binge: 4/8), or albumin levels (Daily:
      3.0 +/- 0.1 vs. Binge: 3.1 +/- 0.1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488980
TI  - Ethanol increases apoptotic cell death of thymocytes in vitro.
AB  - Exposure of animals to ethanol causes thymic atrophy in adults and fetuses.
      Whether direct effects of ethanol contribute to thymic atrophy or whether
      indirect effects are entirely responsible is at present unknown. In the normal
      animal, large numbers of thymocytes undergo a physiological form of cell death
      referred to as "apoptosis." To determine if ethanol affects the process of
      apoptosis, studies were undertaken in which mouse thymocytes were cultured
      overnight in the presence or absence of ethanol. Apoptotic cell death was
      analyzed by flow cytometric quantitation of apoptotic nuclei, by fluorometric
      measurement of DNA fragments, and by gel electrophoretic analysis of DNA
      fragments. Ethanol in concentrations of 0.2% to 0.8% produced significantly
      higher levels of apoptosis than were seen in control cultures. The DNA
      fragmentation was characterized as apoptotic on the basis of inhibition by
      aurintricarboxylic acid (an inhibitor of nucleases) and by the presence of
      characteristic oligonucleosomal-sized fragments of DNA. The effect of ethanol on
      apoptosis was additive to that induced by immobilized anti-CD3 monoclonal
      antibody. CD4+CD8+ cells underwent apoptosis as indicated by reduction in CD4 and
      CD8 surface antigen expression. An inhibitor of protein kinases (H-7) reduced the
      DNA degradation induced by ethanol and by anti-CD3. These results suggest that
      direct effects of ethanol contribute to thymic atrophy in alcohol-consuming
      animals.

PMID- 8488981
TI  - Saccharin intake predicts ethanol intake in genetically heterogeneous rats as
      well as different rat strains.
AB  - Saccharin and ethanol intakes were measured in seven strains of rats known to
      differ in their preferences for ethanol: The Fawn-Hooded (FH), alcohol-preferring
      (P) and Maudsley Reactive rats have been reported to drink ethanol voluntarily,
      whereas the alcohol-nonpreferring, Maudsley Nonreactive and Flinders Line (FSL
      and FRL) rats do not. Saccharin and ethanol intakes were highly correlated (r =
      +0.61) over all strains, with the FH rats drinking the most of both solutions.
      Correlation coefficients between pairs of drinking versus nondrinking rat strains
      were even higher. In a second experiment, genetically heterogeneous F2 progeny
      from cross-breeding the ethanol-preferring FH rats with the ethanol-nonpreferring
      Flinders Resistant Line (FRL) rats were studied. The results indicated a high
      positive correlation between saccharin and ethanol intakes (+0.65). These
      findings suggest that the association between saccharin and ethanol intakes
      previously reported in rat strains with different preferences for ethanol may
      have a similar genetic basis.

PMID- 8488982
TI  - Alcohol and aldehyde dehydrogenases in human esophagus: comparison with the
      stomach enzyme activities.
AB  - Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) isoenzymes from
      surgical esophageal and gastric mucosa were compared by agarose isoelectric
      focusing. Two prominent ADH forms, designated mu 1 (equivalent to the recently
      reported mu-form) and mu 2, were expressed in all the 15 esophagus specimens
      studied, whereas only four of seven examined gastric specimens exhibited a weak
      to moderately strong mu 1-ADH activity band on the isoelectric focusing gels. pI
      values of the esophageal mu 1-ADH and mu 2-ADH, and the liver pi-ADH were
      determined to be 8.61, 8.13, and 8.90, respectively. mu-ADHs exhibited high Km
      for ethanol (12 mM) and low sensitivity to 4-methylpyrazole inhibition. ALDH3 (BB
      form) and ALDH1 were the major high- and low-Km aldehyde dehydrogenase in the
      esophagus, respectively. The ADH and ALDH activities were determined at pH 7.5 to
      be 751 +/- 78 and 29.9 +/- 3.0 nmol/min/g tissue, respectively (measured at 500
      mM ethanol or at 200 microM acetaldehyde; mean +/- SEM; N = 15). The esophageal
      ADH activity was approximately 4-fold and the ALDH activity 20% that of the
      stomach enzyme. Because the presence of high activity and high Km mu-ADHs as well
      as low-activity ALDH1 were found in human esophageal mucosa, it is suggested that
      there may exist an accumulation of intracellular acetaldehyde during alcohol
      ingestion. This reactive and toxic metabolite may be involved in the pathogenesis
      of alcohol-induced esophageal disorders.

PMID- 8488983
TI  - The influence of age on blood alcohol levels and ethanol-associated
      immunosuppression in a murine model of ethanol consumption.
AB  - Several study findings indicate that with ethanol ingestion a number of changes
      occur in the immune system. We studied the effects of ethanol consumption on mice
      at various ages. We used a murine model in which young (age 6-8 weeks), middle
      aged (age 12 months), and old (age 24 months) male C57Bl/6 mice were pair-fed
      either a Leiber-DeCarli liquid diet containing 7% (v/v) ethanol or an isocaloric
      control diet. Consumption of ethanol diet for 8 days resulted in high blood
      alcohol levels in young and old mice; low levels were observed in middle-aged
      mice. Middle-aged mice consumed more ethanol than did either young or old mice
      and had the lowest percent body weight loss of all three age groups.
      Proliferation of spleen lymphocytes to T-cell stimuli (concanavalin A and
      alloantigens) in both young and old mice fed ethanol was diminished. T-cell
      function was unchanged in middle-aged mice consuming an ethanol diet when
      compared with that observed in age-matched mice pair-fed control diet. No effect
      of ethanol on proliferation to lipopolysaccharide was noted in any group.
      Proliferative response of T cells to soluble anti-CD3 monoclonal antibody was
      also decreased in middle-aged and old pair-fed control mice when compared with
      young control mice. The proliferative response to soluble anti-CD3 in all three
      age groups of mice fed ethanol, however, was not significantly affected by
      ethanol consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488984
TI  - Effect of chronic alcohol feeding on hepatic iron status and ferritin uptake by
      rat hepatocytes.
AB  - Alcohol abuse is known to cause disturbances to iron homeostasis in man and is
      associated with elevated serum ferritin levels. We have previously shown that
      ethanol metabolism in the rat hepatocyte is associated with an immediate
      reduction in ferritin uptake by this cell. In this study we have examined the
      effect of pair-feeding the Lieber-DeCarli liquid alcohol diet on ferritin uptake
      by rat hepatocytes. Rat liver ferritin was radiolabeled with 59Fe in vivo and
      isolated by conventional techniques. Rats were pair-fed the Lieber-DeCarli liquid
      alcoholic diet for 4-6 weeks. Hepatocytes, isolated from their livers by
      collagenase perfusion, were incubated with [59Fe]ferritin in L-15 medium at 37
      degrees C and 4 degrees to measure ferritin uptake and binding. The in vitro
      effect of ethanol on these hepatocytes was also studied. Ferritin and iron
      parameters were measured in the sera and hepatocytes of these animals and a
      comparable group of normal chow-fed rats. The rate of ferritin uptake by
      hepatocytes from alcohol-fed rats was significantly faster than that of their
      pair-fed controls (0.743 +/- 0.061 vs. 0.540 +/- 0.042 ng/min/10(6) cells, p <
      0.05). However, the rats on Lieber-DeCarli control diet exhibited a lower
      hepatocyte ferritin uptake rate than chow-fed animals (79.3 +/- 8.1% of the
      control values, p < 0.01). In vitro incubation of cells in 100 mM ethanol
      resulted in less inhibition of ferritin uptake by hepatocytes from alcoholic rats
      than from their pair-fed controls (11 +/- 7.1% inhibition vs. 43.6 +/- 10.7% for
      controls, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488985
TI  - Decreased synapse-to-neuron ratio in rat locus ceruleus following chronic ethanol
      feeding.
AB  - Effects of chronic ethanol exposure on the synapse-to-neuron ratio of rat locus
      ceruleus were investigated. Male Sprague-Dawley rats were given an ethanol
      containing liquid diet for 4 months starting at an age of 5 weeks. Littermates,
      given isocaloric amounts of an ethanol-free diet, served as control. The animals
      were perfusion fixed using a mixture of glutaraldehyde and paraformaldehyde.
      Synapse-to-neuron ratio was estimated by the double disector method and
      calculated from (Ns/A) x (Nsec -1) / (Nn/A) where Ns/A is the number of synapses
      per unit area estimated in a disector with a height of on section and Nsec -1 is
      height of the disector, i.e., the number of sections, used for estimating the
      number of neurons per area (Nn/A). The mean estimated synapse-to-neuron ratio was
      2046 +/- 544 (SD) in ethanol-fed rats and 4291 +/- 1171 (SD) in control rats. The
      difference is statistically significant (p < 0.05). The finding may be of
      relevance for understanding the development of abuse, tolerance, drug dependence,
      and abstinence reactions.

PMID- 8488986
TI  - Potential role of 5HT1C and/or 5HT2 receptors in the mianserin-induced prevention
      of anxiogenic behaviors occurring during ethanol withdrawal.
AB  - A single dose of mianserin (a 5HT1C/5HT2 antagonist), administered 1 hr, 48 hr,
      or 7 days before testing, was evaluated for its efficacy in alleviating or
      preventing the occurrence of anxiogenic behaviors observed during ethanol
      withdrawal. Other behavioral experiments using selected drug interactions were
      conducted to examine whether the effect of mianserin was related to a long-term
      modification of 5-hydroxy-tryptamine (5HT) receptor function. Rats were fed a
      liquid diet containing 4.5% ethanol for 4 days. They were tested on the elevated
      plus-maze (EPM) 12 hr (acute withdrawal) and 5 days (protracted withdrawal) after
      the last ethanol dose. Ethanol withdrawal induced a pattern of "anxiogenic"
      behavior that consisted of reduced activity (total entries) and a reduced
      proportion of open arm activity. Mianserin, injected as a single dose given
      either 1 hr (0.16-5 mg/kg, ip) before testing or given (20 mg/kg, ip) on the
      morning of the 3rd day of ethanol administration, i.e., 48 hr and 7 days before
      testing, dose-dependently prevented or reversed the ethanol withdrawal induced
      reduction in open-arm activity. In contrast, the 5HT1C/5HT2 receptor agonist (+/-
      )-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane HCl (DOl) did not affect
      behaviors in the EPM in ethanol-naive rats, nor in those undergoing ethanol
      withdrawal. However, although there was a marked tolerance to DOl-induced body
      shakes (a measure of 5HT2 function) during withdrawal, DOl reversed the action of
      mianserin in the EPM. The 5HT1 receptor agonist, 5HT2 receptor antagonist 1
      naphthyl-piperazine (1-NP) reduced open-arm activity in ethanol-naive rats and
      this action was enhanced during withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8488987
TI  - Chronic cadmium exposure attenuates ethanol-induced hypoalgesia in the adult rat.
AB  - Adult male rats were exposed to a diet containing either 100 ppm added cadmium
      (Cadmium-Diet), or a control diet containing no added chemicals (Control-Diet)
      for 67 days prior to pain reactivity testing using a tail-flick procedure. Rats
      were placed in restraining tubes for a 20-min acclimation period, then baseline
      tail-flick latencies in response to a radiant heat source were measured.
      Subsequently, half the animals from each group were serially injected
      intraperitoneally with either 0.5, 1.0, 1.5, or 2.0 g/kg body weight of a 20% v/v
      ethanol solution, and the other half of the animals were injected with an
      equivalent volume of saline. Tail-flick latencies were reassessed at 20-min
      intervals over the next 2 hr. Results indicated dose-dependent ethanol-induced
      hypoalgesia in the Control-Diet animals for the two highest doses, but ethanol
      induced hypoalgesia was evident only at the highest dose for the Cadmium-Diet
      animals. Further, the magnitude of this hypoalgesic effect was significantly
      lower for the Cadmium-Diet animals than the Control-Diet animals at the 2.0 g/kg
      dose. Results are discussed in terms of an attenuation of the pharmacological
      properties of ethanol by cadmium.

PMID- 8488988
TI  - The alcohol beverage warning label: when did knowledge increase?
AB  - This article presents data on the awareness of the alcohol beverage warning label
      among a sample of 5,169 inner city African-American gravidas seeking prenatal
      care. While the label law was implemented in November 1989, a significant
      increase in knowledge of the label did not occur until March 1990. Women who
      predominantly consumed wine coolers and beer, and those under age 30 were more
      likely to know about the label than their counterparts.

PMID- 8488989
TI  - Dietary carbohydrate accelerates ethanol elimination, but does not alter hepatic
      alcohol dehydrogenase.
AB  - In naive animals the rate of ethanol elimination is dependent on the hepatic
      alcohol dehydrogenase activity. Carbohydrates have been shown to modify ethanol
      metabolism by a mechanism that has not been determined. In this study, adult
      female rats, fed chow diets supplemented with fructose or glucose in their
      drinking water for 10 days demonstrated significantly greater ethanol elimination
      rates (4.85 +/- 0.28 and 4.92 +/- 1.56 microM ethanol/min/g liver, respectively)
      than rats receiving water (3.65 +/- 0.29). The hepatic alcohol dehydrogenase
      activity of the fructose (1687 +/- 101 nM ethanol/min/g liver) and the glucose
      (1832 +/- 15)-supplemented rats were not significantly different from that of
      control rats (1845 +/- 160). Dietary carbohydrate supplementation, therefore,
      enhanced ethanol elimination, but did not alter the activity of alcohol
      dehydrogenase. Thus the changes in the ethanol elimination rate following
      carbohydrate loading were not the consequence of an alteration in hepatic alcohol
      dehydrogenase.

PMID- 8488990
TI  - Bestatin, an aminopeptidase B inhibitor, selectively reduces alcohol intake in
      rats.
AB  - Extensive research has shown that manipulations that augment activity in the
      renin-angiotensin system can reduce alcohol intake. Inhibition of aminopeptidase
      B and M can prolong the action of angiotensin (ANG) II and ANG III by preventing
      their degradation. This study assessed the ability of bestatin, an aminopeptidase
      B and M inhibitor, to decrease alcohol intake. Bestatin produced a dose-dependent
      reduction in alcohol intake without altering water intake. The angiotensin
      antagonist Sar1Thr3-ANG II, however, did not attenuate the effect of bestatin,
      suggesting that the reduction in alcohol intake was mediated by a system other
      than the renin-angiotensin system. Bestatin (Ubenimex) is used extensively in
      Japan as an anticancer agent. It has a low toxicity and is readily absorbed after
      oral administration. Although further research is needed to uncover the mechanism
      of its effect, the potential of this drug as an adjunct for the treatment of
      alcohol abuse should be evaluated.

PMID- 8488991
TI  - [Anesthesia induction using etomidate in a lipid emulsion].
AB  - The use of etomidate as an anaesthetic induction agent has been hampered
      significantly by unwanted side effects such as pain on injection and
      thrombophlebitis. Investigations by Doenicke et al. have shown that the
      solubilizer propylene glycol is responsible for these side effects and that they
      can be avoided by the use of a lipid emulsion formulation. It was the goal of the
      present study to quantitate the reduction of thrombophlebitis and pain on
      injection following both formulations under double-blind study conditions.
      METHODS. In 100 patients anaesthesia was induced either with a new galenic
      formulation of etomidate--etomidate in lipid emulsion formulation (Lipofundin MCT
      20%; eto-lip)--or with etomidate in propylene glycol 35% (eto-pg). Both groups
      received 0.3 mg kg-1 etomidate in double-blind randomized fashion. After the
      injection of etomidate the venous cannula was removed. The observing anaesthetist
      was unaware of the study drug used, to guarantee blinded investigation
      conditions. Discomfort and pain during and following injection were recorded, as
      was local skin irritation. Venous sequelae were assessed for 7 days following
      injection to register the occurrence of thrombophlebitis. RESULTS. Demographic
      data were not different between the two groups. For induction of anaesthesia the
      same dose of both preparations was necessary, and no difference in heart rate and
      blood pressure before, during or after anaesthesia induction was observed. Pain
      on injection (78% vs 14%), myoclonus (24% vs 8%) and local skin reaction (50% vs
      6%) were present significantly more often in the eto-pg group (P < 0.01; P < 0.05
      respectively, chi-square test) than in the eto-lip group. On the 1st and 2nd
      postoperative days, examination of the injected vein revealed a significantly
      higher incidence of symptoms of thrombophlebitis in the group treated with eto-pg
      (25% vs 3%). CONCLUSION. From these results it is concluded that in terms of vein
      compatibility the new galenic formulation of etomidate with lipofundin MCT 20% is
      superior to the propylene glycol preparation while pharmacodynamic properties
      seem not to be affected.

PMID- 8488992
TI  - [Cardiopulmonary effects of CPPV (continuous positive pressure ventilation) and
      IRV (inverse ratio ventilation) in experimental myocardial ischemia].
AB  - Continuous positive pressure ventilation (CPPV) is an established therapy for
      treatment of acute respiratory failure (ARF). However, cardiac performance may be
      severely disturbed due to elevated intrathoracic pressure, inducing a decrease in
      cardiac output (CO) and oxygen delivery (DO2). Alternatively, mechanical
      ventilation with prolonged inspiratory to expiratory duration ratio (inversed
      ratio ventilation IRV) has been successfully used in ARF. No data are available
      about IRV in acute haemodynamic oedema. Thus, the cardiopulmonary effects of CPPV
      (positive end-expiratory pressure [PEEP] = 10 cm H2O) and IRV (inspiration to
      expiration duration ratio [I:E] = 3.0) were studied in nine dogs (body weight
      29.9 +/- 4.3 kg) before and after induction of myocardial ischaemia. METHODS.
      Continuous intravenous anaesthesia and muscle paralysis were provided by 1.2
      mg.kg-1 x h-1 piritramide and 0.08 mg.kg-1 x h-1 pancuronium, and the animals
      were ventilated with intermittent positive pressure ventilation (IPPV) as
      reference method. Cardiocirculatory performance was determined by means of heart
      rate (HR), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP),
      central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP) and
      left ventricular end-diastolic pressure (LVEDP). Cardiac output (CO) was
      determined by thermodilution method. Systemic vascular resistance (SVR) was
      calculated. Pulmonary function was assessed by arterial and mixed venous blood
      gas tension for oxygen (PaO2, PvO2) and carbon dioxide (PaCO2). Functional
      residual lung capacity (FRC) was measured by means of the foreign gas wash-in
      method using helium as inert gas, and determination of extravascular lung water
      (EVLW) using the thermal-dye indicator technique. CPPV and IRV were studied in
      random sequence in the control phase and 60 min after induction of acute left
      ventricular ischaemia, which was achieved by occlusion of the ramus
      interventricularis anterior. RESULTS. During the control phase CPPV induced an
      increase in MPAP (P < 0.05), CVP (P < 0.05) and PAOP (P < 0.05). HR and MAP
      remained unchanged, whereas CO decreased by 16% (P < 0.05). FRC was elevated by
      25 ml.kg-1 (P < 0.01), but not EVLW (9.1 +/- 3.5 ml.kg-1). There was no
      improvement in oxygenation; instead, oxygen delivery (DO2) decreased (P < 0.05).
      During inversed ratio ventilation MPAP, CVP, PAOP increased, but less than during
      CPPV. FRC was elevated mu 7.0 ml.kg-1 (P < 0.05), which was significantly less
      than during CPPV (P < 0.05). EVLW revealed no differences. During IPPV in the
      ischaemia phase cardiopulmonary performance deteriorated significantly. CO
      decreased by 19% (P < 0.05), whereas HR, MPAP, CVP and PAOP increased (P < 0.05).
      PaO2 was lower (P < 0.05) and alveolo-arterial PO2 gradient (PAaO2) increased (P
      < 0.05). All animals revealed moderate pulmonary oedema (EVLW = 15.1 +/- 8.4
      ml.kg-1) (P < 0.01) and a lower FRC. Mechanical ventilation with PEEP
      significantly improved oxygenation and FRC; however, DO2 was slightly lower than
      during IPPV (not significant). IRV elevated PaO2, FRC and DO2, since CO was not
      depressed when compared with IPPV. CONCLUSIONS. CPPV and IRV may induce a
      recruitment of collapsed or hypoventilated lung areas, which is more pronounced
      during CPPV. During both modes of ventilation, oxygenation was improved without
      apparent changes in EVLW. Haemodynamic performance was more impaired during CPPV,
      and no improvement of left ventricular function secondary to an elevated
      intrathoracic pressure was observed. Occlusion of the RIVA coronary artery
      typically induces an infarction of 35% of left ventricular muscle mass; however,
      non-ischaemic myocardium reveals an unchanged or increased contractility. Thus, a
      reduction of left ventricular preload secondary to CPPV mainly contributes to
      haemodynamic depression, which is less pronounced during IRV due to a lower peak
      inspiratory airway pressure and mean airway pressure. IRV may be useful for
      mechanical ventCntCo

PMID- 8488993
TI  - [Acupressure in the prevention of postoperative nausea and vomiting].
AB  - Despite modern anaesthetic procedures, postoperative nausea and vomiting are
      still the side-effects most often mentioned: acupressure is reported to be an
      additional method of preventing these effects in minor gynaecological surgery. We
      investigated the effectiveness of acupressure in patients undergoing
      gynaecological operations of longer duration (6-8 h) in a verum acupressure group
      compared to a placebo group. Before beginning the study we investigated a control
      group to find out the frequency of emesis. In the worst case of nausea that we
      encountered, 80% in the 0-6 h postoperative period, the number of random samples
      for the acupressure and placebo groups was calculated (30 patients in each
      group). The error for alpha was established at 5% and the reduction of nausea was
      50%. METHODS. The female patients were 18 to 65 years old (ASA group I and II).
      Acupressure was carried out by fastening small metal bullets at the point P 6 to
      each forearm by means of an elastic bandage. The bullets were left there for 24
      h. The premedication anaesthesia, postoperative analgesia, and antiemetic
      treatment were standardized. During a 24-h period we investigated the incidence
      of nausea and vomiting. RESULTS. The anthropometric data, the duration of surgery
      and the amount of postoperative analgesia were comparable between the three
      groups. Verum acupressure obtained a statistically significant and relevant
      reduction in nausea up to the 6th postoperative hour in comparison with the
      placebo group (P = 0.03). Nausea was reduced from 53% in the placebo group to 23%
      in the acupressure group. CONCLUSION. As demonstrated in this group of longer
      gynaecological surgery patients as well as in chemotherapy-induced nausea and
      vomiting, we were able to demonstrate that acupressure is an effective method of
      preventing nausea and vomiting without any side-effects. It is a valuable
      addition to the prevention of postoperative nausea and vomiting. Further studies
      should be conducted to investigate this possibility further.

PMID- 8488994
TI  - [Continuous monitoring of spontaneous postoperative respiration. 3. The effect of
      amiphenazole on cutaneous oxygen and carbon dioxide partial pressure following
      gynecologic surgery under halothane anesthesia].
AB  - METHODS: In an attempt to verify non-invasive respiratory monitoring for patients
      in the early postoperative period, cutaneous O2 and CO2 pressures were monitored
      in 30 female patients recovering from major gynaecologic surgery under halothane
      anaesthesia. In a double-blind and randomized fashion, in the recovery room the
      patients received a single intravenous bolus injection of placebo or 150 mg
      amiphenazole, a respiratory stimulant. The data were collected and stored in a
      personal computer, using the TCM3 system with a combination electrode for
      simultaneous measuring of cutaneous oxygen and carbon dioxide partial pressures
      (TINA, Radiometer) at 30-s intervals. The overall observation period was 240 min.
      Means and standard deviations were calculated for individual data and for data
      pooled at 15- or 60-min intervals. Groups were compared by means of the chi 2
      test, Student's t-test, Wilcoxon rank sum test or analysis of variance (level of
      significance P < or = 0.05). RESULTS: The study groups were comparable with
      respect to demographic and anaesthesiological data. The partial pressures for
      both O2 and CO2 were not statistically significant between groups. Electrode
      heating was slightly higher with amiphenazole (n.s.), indicating a trend for
      peripheral vasodilation without a true improvement of spontaneous ventilation.
      pctO2 and pctCO2 levels were decreased or elevated, respectively, in the first
      observation hours and slowly returned to normal within the 240-min observation
      period. Episodes of hypercapnia (pct-CO2 > 50 or > 55 mm Hg) were frequent in the
      first 2 h (10-30% of individual data for pctCO2 > 50, 2-7% for pctCO2 > 55,
      respectively), indicating the need for close monitoring of spontaneous
      respiration after general anaesthesia with halothane. DISCUSSION AND CONCLUSION:
      The present study confirmed that spontaneous respiration in the early
      postoperative period can be monitored non-invasively by measuring transcutaneous
      partial pressures of carbon dioxide and, less precisely due to large individual
      variations, oxygen. It showed that spontaneous respiration deteriorates after
      gynaecological surgery under halothane anaesthesia and recovers slowly during the
      next 4 h. The respiratory stimulant amiphenazole (150 mg i.v.) was of no
      significant value with respect to the improvement of ventilation.

PMID- 8488995
TI  - [A comparison of different endotracheal tubes. Tracheal cuff seal, peak centering
      and the incidence of postoperative sore throat].
AB  - The study objective was to evaluate cuff seal, tube tip position and incidence of
      postoperative sore throat in three different endotracheal tubes: the reusable
      Rusch "red rubber" tube (low-volume, high-pressure cuff) and the disposable Rusch
      "Super Safety Clear" and Mallinckrodt "lo-pro" tubes (both high-volume, low
      pressure cuffs). METHODS: In a prospective randomized trial, 150 consecutive
      patients scheduled for minor orthopaedic surgery under standardized general
      anaesthesia, including standardized cuff pressure control, were allocated to one
      of the three types of endotracheal tube. Leakage and intratracheal tube tip
      position were investigated by means of fiberoptic tracheoscopy via the
      endotracheal tube, preceded by pharyngeal instillation of indigocarmine. The semi
      standardized interviews for the recording of postoperative sore throat were
      performed once a day under double-blind conditions from the day of operation to
      postoperative day 3. Statistical independence testing was based on the chi 2
      test, significance was assumed at P < 0.05. MAIN RESULTS: A past-cuff leakage of
      the pharyngeally instilled dye was found in three patients with "red rubber"
      tubes. In all of these cases the tracheal cross section deviated markedly from
      circular. The tips of the "Super Safety Clear" tubes tended to be better centred
      (P = 0.099). Bad tip position, however, had little influence on postoperative
      throat complaints (P = 0.394). The differences in incidence of postoperative
      throat complaints between the "red rubber" (48.9%), "Super Safety Clear" (35.6%)
      and "lo-pro" tubes (34.1%) did not reach the 5% level (P = 0.288). Such
      complaints, however, were significantly more frequent in females and in obese
      patients who exceeded their Broca weights by more than 25%. By contrast,
      postoperative throat complaints did not vary statistically significantly by age
      group, tracheal cross-sectional shape, use of atropine or duration of intubation.
      CONCLUSION: Despite the economic (usable up to 100 times) and ecological (less
      PVC waste) advantages of the rubber tube, the disposable tubes with high-volume,
      low-pressure cuffs tended to be superior regarding cuff seal, tube tip position
      and incidence of postoperative throat complaints. Nevertheless, the continued use
      of "red rubber" type reusable tubes may be justified in cases where the tube has
      to stay in place for only a short time.

PMID- 8488996
TI  - [Ethics and research in emergency medicine].

PMID- 8488997
TI  - [Research in emergency medicine. Ethical requirements].
AB  - Having pointed out some curriculum goals in medical ethics, a plea is made for
      extensive animal experimentation, especially in emergency medicine in order to
      minimize necessary investigations in human beings. Although certain groups of
      patients (persons in custody, minors) are protected nowadays against unjustified
      research activities by legal restraints, well-designed therapeutic (even
      nontherapeutic) investigative projects can be facilitated under certain
      conditions. The same attitude might be adopted for "special" populations (e.g.,
      HIV patients), which are very often excluded for various reasons. Research
      protocols and statistical evaluation should not be permitted to differ in these
      groups in comparison to "normal" patients. The issue of "informed consent" in
      emergency research with the main emphasis on resuscitation cannot be considered
      as resolved since many patients are unconscious or at least incompetent.
      Irrespective of the number of legislative constructions proposed mainly in the
      USA ("proxy consent", "substitute decision making," "deferred consent"--the
      latter being already declared a misnomer by its "inventor", ethical standards
      might better be adapted to the respective situations guided by competent ethical
      committees. As for the particulars of research protocols, randomization combined
      with a blind or double-blind study design is now considered to be ethically
      desirable by a majority of authors, the same holding true for risk stratification
      and sequential test procedures in order to reduce the number of patients
      required. The "theory of intuitive thinking" is briefly touched upon as a
      futuristic investigative method and/or decision strategy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8488998
TI  - [The anterior sonographic-guided celiac plexus blockade. Review and personal
      observations].
AB  - The coeliac plexus block is an approved method for the relief of upper abdominal
      pain due to cancer of the upper intra-abdominal viscera or to chronic
      pancreatitis. While there are many reports concerning the posterior approach to
      the coeliac plexus block, little attention has been given the anterior approach.
      There are two ways of implementing the anterior approach to the coeliac plexus:
      CT-guided and the ultrasound guided approach. METHODS. The ultrasonic-guided
      anterior approach to the coeliac plexus block is used with the patient in the
      supine position. The aorta and discharge of the truncus coeliacus or the a.
      lienalis respectively, are ultrasonographically presented at two levels. After
      setting local cutaneous and subcutaneous anaesthesia, a 15-cm-long 25 G-needle is
      introduced into the epigastrium. The point of the needle is--ultrasonographically
      guided--inserted into the pre-aortic area near the discharge of the truncus
      coeliacus. The position of the needle point is ultrasonographically controlled on
      two levels. For the enforcement of a diagnostic coeliac plexus block after
      careful aspiration on two levels, 10 ml of bupivacaine 0.5% is injected. The
      spread of the solution is evaluated by ultrasound. If the needle position is
      correct; a few minutes later the patient has a feeling of warmth in the upper
      abdominal region. For the enforcement of a neurolytic coeliac plexus block 10 ml
      ethanol 96% and 10 ml prilocaine 1% can be administered. The two solutions are
      applied as small volumes in permanent succession. Thus the burning pain, which is
      often observed after the injection of alcohol, is avoided. RESULTS. In the
      literature there are only a few reports, about the results and side-effects after
      use of the anterior approach in the coeliac plexus block. The results of these
      investigations and our own show total pain relief or at least good pain reduction
      by at best 85%. The reduction in pain achieved continues in as many as 60% of the
      treated patients. There is the possibility to stop or at least reduce the
      analgesic premedication. These results are comparable with those after using the
      posterior approach to the coeliac plexus block. When carrying out the anterior
      approach in the coeliac plexus block, most of the patients showed increased
      intestinal motility. Therefore, about 60% of all patients had transitory
      diarrhoea. In 12-25% of the patients orthostatic hypotension was observed. This
      side-effect is avoided by an appropriate infusion before enforcement of the
      block. In a frequency of 4-100% the occurrence of burning pain was reported
      during injection of the alcohol. No serious side-effects were observed.
      CONCLUSIONS. The results concerning total pain relief or at least pain reduction
      are comparable to the posterior approach for the block. Nevertheless, there are
      some advantages to the ultrasound-guided anterior approach. There is less risk
      using this technique. No methodological complications have been observed so far.
      There is no risk of neurological complications such as paraplegia. Because the
      patients remain in the supine position, the anterior approach to the coeliac
      plexus block is suitable for terminally ill patients, who are not able to
      tolerate the prone position and need careful supervision and good ventilation.
      Also, no contrast medium is necessary. Only a small volume of local anaesthetics
      or alcohol is required. We prefer the anterior approach of the coeliac plexus
      block as a fast, safe and cost-effective method, which should receive increasing
      attention during the next few years.

PMID- 8488999
TI  - [Laterosubmental tracheal intubation. An alternative method to nasal-oral
      intubation or tracheostomy in single-step treatment of panfacial multiple
      fractures or osteotomies].
AB  - In single-step surgery of panfacial fractures or conversion osteotomies of the
      visceral cranium, nasal as well as oral intubation or tracheal intubation via
      tracheostomy is necessary. If complicated tracheostomy is not done,
      intraoperative nasal-oral repositioning of the tube is required. In order to
      avoid the risks of repositioning the endotracheal tube or tracheostomy, we
      suggest a new alternative method called laterosubmental tracheal intubation.
      After a laterosubmental fistula is created at the base of the mouth, directly
      behind the anterior mandibular dentition, the tube is guided through the oral
      floor, lateral to the muscles and the salivary duct, and fixed extraorally. The
      advantages of this method are: no more intraoperative repositioning of the
      endotracheal tube and no need for tracheostomy, thus eliminating the risks and
      side effects, as well as tracheal scarring, and free accessibility of the
      operative field.

PMID- 8489000
TI  - [The diagnosis of brain death. Guidelines in Germany, Austria and Switzerland].
AB  - Today's modern medicine with its nearly limitless possibilities requires a well
      founded diagnosis of brain death. After this diagnosis continuation of intensive
      medical care becomes meaningless, or an essential precondition for organ donation
      is fulfilled. In view of the delicate problems involved, it is essential that
      brain death be diagnosed uniformly and in well-founded fashion. Responsible
      institutions in Germany, Austria and Switzerland have issued guidelines, criteria
      and aids to decision making that vary only insignificantly.

PMID- 8489001
TI  - [Comments on the work by W. Tolksdorf et al. The effects of carbon dioxide
      pneumoperitoneum in laparoscopic cholecystectomy on postoperative spontaneous
      respiration].

PMID- 8489002
TI  - A study of sensitized lanthanide luminescence in an engineered calcium-binding
      protein.
AB  - In this study, the CD loop of the Ca(2+)-binding protein oncomodulin was replaced
      by a high-affinity, metal-binding sequence that was found to reverse the order of
      fill of the two sites in the protein. A cysteine was included at position 7 of
      this sequence, i.e., DKNADGCIEFEE. The cysteine allowed covalent attachment of
      chromophores to the loop that could subsequently be tested for their ability to
      sensitize the luminescence of Tb3+ or Eu3+ bound in the loop. 7-Diethylamino-3
      ((4'-iodoacetylamino)phenyl)-4-methylcoumarin was the most efficient Eu3+
      sensitizer studied, consistent with a mechanism of energy transfer that involves
      the triplet state of the donor. 4-Iodoacetamidosalicylic acid was the most
      efficient Tb3+ donor tested. Levels of lanthanide ion and labeled C3 as low as 5
      x 10(-10) mol/liter could be detected. This protein chelator system has potential
      to be a useful, flexible complement to the organic chelators currently used in
      lanthanide-based, time-resolved luminescence immunoassays.

PMID- 8489003
TI  - Catabolism of deoxycytidine in human peripheral blood mononuclear cells and its
      interference with the determination of in situ thymidylate synthase activity.
AB  - Resting and stimulated human peripheral blood lymphocytes and monocyte-derived
      macrophages were incubated with tritiated deoxycytidine labeled at the 5
      position. Release of tritiated water into the medium was thereupon detected
      utilizing its lack of binding to active charcoal, which is an established
      technique to measure in situ thymidylate synthase activity. It was found that
      tritiated dihydrouracil, a deoxycytidine catabolite, was formed during incubation
      with tritiated deoxycytidine. Like water, dihydrouracil does not bind to active
      charcoal, and its presence in the cell medium can result in an overestimation of
      the in situ thymidylate synthase activity. The catabolism of dCyd was highest in
      macrophages where 25% of the added dCyd (0.5 microM, 0.5 nmol/million cells) had
      been converted to dihydrouracil after 30 min, and 90% after 12 h. The in situ
      thymidylate synthase activity was found to be the highest in stimulated
      lymphocytes. If the interference of dihydrouracil had not been considered, the
      activity in macrophages would have been greatly overestimated and would have
      appeared to be higher than that of stimulated lymphocytes.

PMID- 8489004
TI  - Analysis of the neutral glycan fractions of glycosyl-phosphatidylinositols by
      thin-layer chromatography.
AB  - The radiolabeled neutral glycan fractions of both glycosyl-phosphatidylinositol
      (GPI) protein anchors and related glycolipids were analyzed by thin-layer
      chromatography on silica gel 60, using butanol:ethanol:water (4:3:3, v/v) or a
      combination of 1-propanol:acetone:water (9:6:5, v/v and 5:4:1, v/v) as solvents.
      Dextran acid hydrolysates were used as standards, and oligomers up to 11 glucose
      units could be resolved. A comparison of 18 GPI-glycan standards revealed that
      their migration was dependent mainly on the size of the oligosaccharide. Isomers
      were generally not resolved, with the exception of Man alpha 1-6Man alpha 1-4AHM
      and Man alpha 1-3Man alpha 1-4AHM. Structures containing galactofuranose or
      GalNAc were well resolved from structures containing only Galp and/or Manp. The
      utility of this method for the microsequencing of radiolabeled neutral glycans
      derived from two GPI glycolipids, using exoglycosidases and chemical treatments,
      is demonstrated. This method is a simple and useful complement to the existing
      chromatographic techniques.

PMID- 8489005
TI  - Determination of platinum in urine, ultrafiltrate, and whole plasma by isotope
      dilution gas chromatography-mass spectrometry compared to electrothermal atomic
      absorption spectrometry.
AB  - Isotope dilution gas chromatography-mass spectrometry (GC-MS) and electrothermal
      atomic absorption spectrometry (EAAS) are compared for platinum (Pt)
      determination in urine, plasma ultrafiltrate, and plasma samples from a patient
      undergoing cisplatin therapy. The isotope dilution GC-MS method is based on the
      use of lithium bis(trifluoroethyl)dithiocarbamate as a chelating agent and
      enriched 192Pt as an internal standard. Pt isotope ratios were measured using a
      Finnigan MAT 8230 organic mass spectrometer, and Pt concentrations were
      calculated from different sets of isotope ratios in the molecular ion of the Pt
      chelate. In the EAAS method, Pt concentrations were determined using three
      different approaches. These were: (i) calibration curve based on aqueous
      standards containing Pt in 10% HCl, (ii) standard addition, and (iii) matrix
      digestion followed by standard addition. Good agreement was obtained for Pt
      concentrations determined by GC-MS and EAAS in urine samples while there were
      significant differences in Pt concentrations of ultrafiltrate and whole plasma
      samples by the two methods. Discussion of possible reasons for these differences
      emphasizes the need for future critical evaluation of these methods.

PMID- 8489006
TI  - The ionophore ETH 129 as Ca2+ translocator in artificial and natural membranes.
AB  - We have investigated the ability of the neutral ionophore ETH 129 to translocate
      Ca2+ across artificial and biological membranes. ETH 129 induces Ca2+ transport
      across planar lipid bilayer. The zero-current membrane potential in a gradient of
      Ca2+ concentration exhibits Nernst behavior. The dependence of the membrane
      conductance on ionophore and Ca2+ concentration indicates that three ionophore
      molecules are needed to transfer one Ca2+ across the hydrophobic region of the
      membrane. In mitochondria the neutral Ca2+ ionophore can move Ca2+ inside in
      response to a negative membrane potential under conditions in which the
      endogenous uniporter is blocked by ruthenium red. This electrophoretic transport
      of Ca2+ by ETH 129 occurs at a concentration much lower than the one previously
      reported with the neutral Ca2+ ionophore ETH 1001. Using sea urchin eggs, we have
      also shown that the efficiency of ETH 129 in inducing egg activation, as revealed
      by cortical granules exocytosis, is four orders of magnitude higher than that of
      the commonly used Ca2+ ionophore A21387. ETH 129 is a very efficient and useful
      tool for use in the investigation of Ca(2+)-dependent biological processes.

PMID- 8489007
TI  - Use of in vivo 13C nuclear magnetic resonance spectroscopy to follow sugar uptake
      in Zymomonas mobilis.
AB  - A noninvasive, in situ, in vivo, and anomer-specific method for studying membrane
      transport of sugars in bacteria is presented. High-resolution 13C NMR was used to
      measure the distribution of alpha- and beta-xylose, maltose, Mes buffer, and
      ethanol in the extracellular and the cytoplasmic compartments in dense cell
      suspensions of Zymomonas mobilis, an aerotolerant bacterium that transports
      xylose but does not further metabolize it. The method relied on a difference in
      the magnetic susceptibility of the media inside and outside cells, induced with
      Dy-diethylenetriaminepentaacetic acid. The applicability of this method was
      demonstrated: (a) by showing that xylose and ethanol crossed the inner membrane
      of Z. mobilis while maltose and Mes buffer did not and (b) by a kinetic study of
      xylose uptake in this organism. After addition of xylose, both the extracellular
      decrease in the alpha- and beta-anomers in the medium and their intracellular
      accumulation could be followed.

PMID- 8489009
TI  - Micromethod for the determination of heparin in plasma after intravenous and
      subcutaneous administration.
AB  - A sensitive method has been developed for extracting and analyzing heparin from
      plasma after intravenous and subcutaneous administration in humans and rabbits.
      The glycosaminoglycans are precipitated from the biological fluid as
      cetylpyridinium salt, and heparin is cleaved with heparinase. The reaction
      products are analyzed by polyacrylamide gel electrophoresis and visualized by
      staining with Azure A/ammoniacal silver. With this method 12 ng of heparin can be
      detected.

PMID- 8489008
TI  - Stoichiometric labeling of peptides by iodination on tyrosyl or histidyl
      residues.
AB  - Radioiodination with 125I or 131I is a favored technique for labeling
      biologically active peptides or proteins because of high specific radioactivities
      and convenience in counting gamma-emissions. Previous studies used trace
      labeling, in which fewer than 1% of the molecules are iodinated. We describe
      procedures for obtaining stoichiometrically iodinated and therefore chemically
      homogeneous peptides with specific activities exceeding 10(7) cpm/micrograms
      (approximately 10 Ci/mmol). By analyzing the pH dependence of iodination on
      tyrosyl and histidyl residues, we show that the method described can be applied
      to many short peptides and optimized for labeling on tyrosine and/or histidine.
      The power of reverse-phase HPLC is exploited to resolve multiple products
      substituted with different molar equivalents of iodine from each other and from
      unlabeled peptide. Specific radioactivity ratios can be used to identify the
      products, as confirmed by Edman sequence analysis under conditions that separate
      iodinated tyrosine and histidine derivatives from all other amino acids. We also
      show that the biological activities of iodinated and uniodinated peptides can
      differ by several orders of magnitude in a T cell assay and demonstrate the
      usefulness of stoichiometric labeling to overcome ambiguities inherent in
      studying biological activities with trace-labeled peptides.

PMID- 8489010
TI  - Defined analyte-enzyme conjugates as signal generators in immunoassays.
AB  - We investigated the synthesis of progesterone-horseradish peroxidase (P-HRP)
      conjugates and products purified by affinity chromatography. The obtained
      preparations were characterized with an immobilized monoclonal antibody in solid
      phase immunoassays. Three homogeneous P-HRP conjugates were isolated. Two
      preparations were identified to contain a single progesterone ligand on the
      enzyme molecule. A third preparation contained two progesterone ligands. We
      postulate that conjugation can occur at two different positions on the enzyme,
      and that the different microenvironment of the protein structure surrounding the
      ligand contributes to different binding constants of the conjugates with
      immunoglobulin. By comparing the effective binding constants derived from
      affinity chromatography and from Scatchard analysis, we have demonstrated that
      the divalent conjugate binds to antibody immobilized on planar surfaces only by a
      single attachment due to steric restriction. Dose-response curves for
      progesterone using the isolated P-HRP conjugates have been investigated and
      compared.

PMID- 8489011
TI  - Protease activity and autodigestion (autolysis) assays using Coomassie blue dye
      binding.
AB  - A new proteolytic assay is described involving Coomassie blue. Under specified
      conditions, the amount of Coomassie-stained casein protein hydrolyzed by several
      proteases was proportional to the amount of protease. Coomassie dye reaction was
      used directly to determine the change in protein concentration of the substrate
      casein during proteolysis by three proteases: stem bromelain, papain, and
      trypsin. This method can be used with 0.1- to 0.5-micrograms quantities of
      protease. The dye reagent was used directly on the protease protein in order to
      obtain an assay of autodigestion. Autodigestion of bromelain at 50 and 25 degrees
      C was followed by measuring the amount of residual protease protein with time.

PMID- 8489012
TI  - Two methods for the introduction of amino groups into agarose-based matrices:
      their use in immunoaffinity chromatography.
AB  - In this study two methods of coupling antibody to Sepharose CL2B are described.
      They involve the introduction of amino groups either via an amino acid such as
      glycine or through polyethyleneimine. After introduction of amino groups into the
      matrices, their activation and simultaneous fixing were accomplished by treatment
      with glutaraldehyde. Monoclonal antibody raised against von Willebrand factor was
      used as a model ligand to demonstrate the stability and performance of the
      affinity supports. Both methods examined in this study resulted in good retention
      of the antibody's binding capabilities and excellent stability of the derivatized
      matrices. Leaching of the insolubilized protein was considerably less with the
      polyethyleneimine-glutaraldehyde than with cyanogen bromide.

PMID- 8489013
TI  - Large-scale sequencing library production: an adaptor-based strategy.
AB  - A significant bottleneck in large-scale DNA sequencing projects is the creation
      of high-quality random libraries suitable for sequencing. We have utilized an
      adaptor-based strategy and developed a simple protocol to reliably generate
      single-insert random subclone M13 libraries yielding uniform coverage and > 10(3)
      clones per microgram of DNA. Of the resulting white plaques, 95% contained
      inserts, < 0.5% were due to adaptors with no insert, and none of the clones were
      found to contain extraneous DNA (0/600) or multiple inserts (0/300).

PMID- 8489014
TI  - Activation of protein kinase C in vitro and in intact cells or synaptosomes
      determined by acetic acid extraction of MARCKS.
AB  - MARCKS is a widespread cellular phosphoprotein that migrates at 80-87 kDa on
      polyacrylamide gels. It is phosphorylated apparently exclusively by protein
      kinase C (PKC) and its phosphorylation in intact cells can be used as an index of
      intracellular PKC activation. Most methods for the determination of its
      phosphorylation state in vitro or in intact cells rely on two-dimensional gel
      electrophoresis to detect the protein with a pI of 4.6; however, this does not
      readily allow for multiple samples to be simultaneously and rapidly processed.
      Here we utilize the acid solubility of MARCKS to develop a novel extraction
      procedure. MARCKS was found to be soluble in 40% acetic acid and can be extracted
      quantitatively and rapidly from phosphorylation mixtures in vitro or from labeled
      intact cells. Acetic acid has the advantage that it is volatile and readily
      removed and precipitates protein in the presence of SDS, and the extracted
      protein is more readily resuspended in sodium dodecyl sulfate (SDS) sample
      buffer. Two extraction methods were developed, one for extraction of MARCKS from
      [gamma-32P]ATP-labeled subcellular fractions or intact synaptosomes labeled with
      32Pi and one for extraction from 32Pi-labeled cultured nucleated cells, the
      latter requiring an additional protein recovery and DNA removal step. With this
      procedure MARCKS phosphorylation in intact synaptosomes was shown to be
      reversibly stimulated upon depolarization and MARCKS phosphorylation was found to
      be an early event in the activation of cultured smooth muscle cells by
      angiotensin II.

PMID- 8489015
TI  - Solubilization and purification of enzymatically active glutathione S-transferase
      (pGEX) fusion proteins.
AB  - The pGEX glutathione S-transferase (GST) fusion protein system is used
      extensively for high level expression and rapid purification of fusion proteins
      from bacterial and eukaryotic cell lysates. Unfortunately, many GST fusion
      proteins are partially or completely insoluble, and thus cannot be purified
      efficiently from a crude lysate. We have adapted a protocol, previously used to
      solubilize actin, for the purification of otherwise insoluble GST fusion
      proteins. Using a GST fusion of the nontransmembrane protein tyrosine phosphatase
      1B, we demonstrate that tyrosine phosphatase enzymatic activity is maintained
      during the purification process. We provide methods for the purification of GST
      fusion proteins at analytical and preparative scales, and demonstrate that
      saturation of glutathione agarose is dependent on fusion protein molecular
      weight. Finally, we present strategies for eluting purified fusion proteins from
      glutathione agarose beads, for storing eluted protein, and for preparing
      covalently coupled affinity matrices.

PMID- 8489016
TI  - A polymerase chain reaction-based method for detection and quantification of
      reporter gene expression in transient transfection assays.
AB  - Transcription in higher eukaryotes is often studied by the use of transient
      transfection assays. These experiments are performed by cloning putative cis
      acting transcriptional elements (i.e., a promoter or enhancer) with a reporter
      gene that codes for a protein not expressed by the target cells. Although this
      approach is useful in many cases, the limited sensitivity of reporter assays can
      prevent studies in cases where few cells are obtainable or efficiency of
      transfection is low. We present an alternative approach. Cells are transfected
      with a plasmid containing a promoter with a human growth hormone (hGH) reporter
      gene. After an incubation period, RNA is isolated, and DNA complementary to the
      growth hormone mRNA is produced. The reporter cDNA concentration is measured by
      quantitative polymerase chain reaction (PCR). We have designed PCR primers that
      span the mRNA splice sites of the human growth hormone gene; these ensure
      exclusive amplification of the hGH cDNA and not the reporter plasmid. The assay
      is sensitive and simple to perform, requires no special equipment, and can
      quantify reporter cDNA concentration over a broad range.

PMID- 8489017
TI  - A rapid spectrophotometric estimation of individual phosphates and phosphonates:
      its application to chromatography of sugar phosphates and their phosphonate
      analogues.
AB  - A compound containing the -PO3H2 group (phosphoric acid, one of its monoesters,
      or an alkylphosphonic acid) may be rapidly assayed by the decrease it produces in
      the absorbance at 450 nm of a buffered acidic solution of Fe3+ and N(-3)
      [corrected]. The method has been used to follow chromatograms of sugar phosphates
      and their phosphonomethyl analogues.

PMID- 8489018
TI  - Coulometric electrochemical detection of hydroxyproline using 7-chloro-4
      nitrobenzo-2-oxa-1,3-diazole.
AB  - A new method for detection of hydroxyproline has been developed. Hydroxyproline
      was derivatized using 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole; separation and
      detection were accomplished using HPLC with coulometric electrochemical
      detection. Derivatized hydroxyproline was initially detected using a 16 channel
      coulometric electrochemical array system. The assay was slightly modified for use
      with a simpler 2-channel coulometric electrochemical detector. Both detectors are
      sensitive into the upper fmol range. Derivatization of hydroxyproline occurs in 5
      min and the derivative is stable for several hours at 0 degrees C. The techniques
      were used to quantitate hydroxyproline in purified type I collagen and other
      biological samples.

PMID- 8489019
TI  - On-line membrane blotting of peptides and proteins from a capillary column.

PMID- 8489020
TI  - Detection of strand-specific DNA-protein interactions using single-stranded PCR
      products.

PMID- 8489021
TI  - Electroporation of the HIV Tat trans-activator protein into cells.

PMID- 8489022
TI  - Flow-cytometric measurement of histone H1o in human cells.

PMID- 8489023
TI  - Identification of cysteine residues alkylated with 3-bromopropylamine by protein
      sequence analysis.
AB  - A new reagent for the routine identification of cysteine residues during protein
      sequencing is described. This method employs 3-bromopropylamine to alkylate
      cysteines in proteins after reduction with dithiothreitol. Upon sequencing of the
      protein on an Applied Biosystems 477A protein sequencer, the aminopropylcysteine
      residue yields a phenylthiohydantoin (PTH) derivative which elutes reproducibly
      at a unique position immediately after PTH-leucine; baseline resolution is
      achieved without modification of the PTH analyzer gradient. Unlike PTH
      pyridylethylcysteine, the relative elution position of the aminopropylcysteine
      PTH derivative is not affected by changes in the ionic strength of the analyzer
      solvents. In addition, the previewing of the next amino acid which is observed in
      proteins modified with 4-vinylpyridine does not occur in aminopropylated
      proteins. Preparation of alkylated proteins for electroblotting onto
      polyvinylidene difluoride (PVDF) membranes and methods for desalting alkylated
      proteins immobilized on precoated glass fiber filters or PVDF membranes are also
      described.

PMID- 8489024
TI  - Modification of a competitive protein binding assay for determination of inositol
      1,4,5-trisphosphate.
AB  - A modification of a competitive protein-binding method for the determination of
      inositol 1,4,5-triphosphate (Ins(1,4,5)P3), facilitated by the use of a cell
      harvester, is described. The method is based on the competition of
      [3H]Ins(1,4,5)P3 with Ins(1,4,5)P3 in the sample for binding to a binding protein
      prepared from bovine adrenal cortex. The assay is carried out in 96-well
      microtiter plates in a final volume of 100 microliters and free [3H]Ins(1,4,5)P3
      is separated from bound by filtration using a cell harvester. This allows the
      rapid measurement of large numbers of samples, with high reproducibility.
      Ins(1,4,5)P3 bound to a single class of high-affinity receptors with a KD of 2.3
      +/- 0.2 nM and a Bmax of 289 +/- 7 fmol/mg of protein. The binding was rapid,
      reaching equilibrium after 20 min, and reversible. The sensitivity of the assay
      allows the determination of amounts of Ins(1,4,5)P3 as small as 0.1 pmol, which
      corresponds to a concentration of 5 nM in the sample. The application of the
      method to measure the formation of Ins(1,4,5)P3 in DDT1 MF-2 smooth muscle cells
      activated with ATP or bradykinin is described. The modification is a rapid,
      sensitive, convenient, and relatively inexpensive method for the determination of
      Ins(1,4,5)P3 in large numbers of samples.

PMID- 8489025
TI  - Continuous spectrophotometric assay for ascorbate oxidase based on a novel
      chromophoric substrate, 2-aminoascorbic acid.
AB  - Recently, we reported the development of a sensitive continuous
      spectrophotometric assay for the ascorbate-dependent mammalian enzyme dopamine
      beta-monooxygenase based on the novel chromophoric electron donor 2-aminoascorbic
      acid [K. Wimalasena and D.S. Wimalasena (1991) Anal. Biochem. 197, 353-361]. We
      now report that ascorbate oxidase (EC 1.10.3.3, L-ascorbate:O2 oxidoreductase)
      also catalyzes the oxidation of 2-aminoascorbic acid to chromophoric 2,2'
      nitrilodi-2(2')-deoxy-L-ascorbic acid (red pigment). The reaction is kinetically
      well behaved, displaying the expected stoichiometry for an oxidase-catalyzed
      reaction with respect to oxygen and the oxidation product (red pigment),
      demonstrating that 2-aminoascorbic acid is a well-behaved alternative substrate
      for the enzyme. Ascorbate oxidase is a very efficient enzyme toward its natural
      substrate, ascorbic acid. Although 2-amino-ascorbic acid is a significantly weak
      substrate for the enzyme in comparison to ascorbic acid, as indicated by the
      apparent initial rate kinetic parameters, the high extinction coefficient of the
      red pigment under our assay conditions suggests that this novel reactivity of the
      enzyme could be used to design a sensitive, convenient, and continuous
      spectrophotometric assay for ascorbate oxidase. While this assay is more
      convenient than the existing oxygen monitor assay, its adaptability to measure
      the activity of the enzyme in the immobilized form may be helpful in the
      development of technologies for the automated detection of ascorbic acid in
      biological fluids for industrial or clinical applications. In addition, this
      novel reactivity of the enzyme may be used to examine the substrate specificity
      and the mechanism of action of the enzyme.

PMID- 8489026
TI  - Use of carboxyatractylate and tight-binding inhibitor theory to determine the
      concentration of functional mitochondrial adenine nucleotide translocators in a
      reconstituted system.
AB  - The adenine nucleotide translocator (AdNT) has been isolated from rat heart
      mitochondria and reconstituted into liposomes containing ATP. Translocator
      activity was determined using a coupled enzyme system to measure the ADP-induced
      efflux of ATP from the liposomes. In order to determine specific activity, the
      number of functional translocators must also be known. Carboxyatractylate (CAT)
      is a highly selective inhibitor of the AdNT, with Ki < 10 nM, a value
      sufficiently low relative to the concentration of protein in transport assays to
      suggest the use of tight-binding inhibitor theory to quantify functional
      translocators. Ackermann-Potter plots of velocity vs proteoliposome concentration
      at several different CAT concentrations were used both to demonstrate the
      occurrence of tight-binding inhibition and to determine the concentration of AdNT
      catalytic sites in the native orientation. The results obtained agreed well with
      earlier reports based on [14C]CAT binding; functionally reconstituted AdNT
      represented 5-10% of the protein added to the system. Specific activities were
      ca. 7-10 mumol/min mg depending on the lipid composition of the liposomes.
      Unincorporated protein did not appreciably affect the measurements. This
      methodology should be readily applicable to any reconstituted systems for which
      high-affinity inhibitors which bind only to active protein are known.

PMID- 8489027
TI  - Application of 13C-labeling and nuclear magnetic resonance spectroscopy to
      pharmacokinetic research: measurement of metabolic rate of benzoic acid to
      hippuric acid in the rat.
AB  - The use of 13C-labeling and nuclear magnetic resonance (NMR) spectroscopy to
      trace the biotransformation of benzoic acid (BA) to hippuric acid (HA) in the rat
      has been described. Novel [2,4,6,7-13C4]BA, which was labeled in the specific
      protonated carbons, was used in order to enhance the sensitivity of 13C NMR
      detection on the basis of the nuclear Overhauser enhancement and short spin
      lattice relaxation time. The urinary excretion of [2,4,6,7-13C4]HA formed from
      intravenously administered [2,4,6,7-13C4]BA was followed by proton-decoupled 13C
      NMR spectroscopy (only 10 min accumulation time) without any separation
      procedures such as extraction and chromatography, using [2-13C]sodium acetate as
      an internal standard for quantitation. The heights of resonances for C2,6 of
      [2,4,6,7-13C4]HA and C2 of the internal standard were used to calculate [2,4,6,7
      13C4]HA concentration. The lower limit of measurable amounts (ca. 40 nmol) was
      found to be improved about one order of magnitude over that of the method using
      commercially available [7-13C]BA. In general, this tracer technique has the
      potential for wide application to pharmacokinetic research since xenobiotic and
      endogenous metabolism can be followed by very simple and convenient procedures.

PMID- 8489028
TI  - Improvements in the numerical analysis of thermodynamic data from biomolecular
      complexes.
AB  - In this work, recent improvements in the capability of the numerical solver-based
      binding data global analysis program, BIOEQS, are presented. These improvements
      represent an expansion of the types of physical models which can be considered.
      The first realm of improvement concerns the modeling of systems which include
      several species of the same stoichiometry and differing chemical potentials, or
      site isomers. Such an option is generally used in the analysis of binding of
      multiple ligands to multiple protein sites. In addition to classical ligand
      binding problems, such a capability is useful in considering the binding of
      protein to different sites on the same DNA molecule and the effects of ligation
      upon these equilibria. It can also be employed for consideration of the
      equilibrium unfolding of oligomeric proteins with folded monomeric intermediates.
      The effect of dilution of the protein and ligation by up to two different types
      of ligands at multiple binding sites upon the dissociation and unfolding
      properties of the oligomers is now possible. The second advance which has been
      incorporated into the modeling capabilities of the BIOEQS program is the option
      of considering perturbations to the multiple binding or folding equilibria by
      chemical denaturants, temperature, or high hydrostatic pressure. Additional
      improvements to the BIOEQS program include direct mapping of individual species
      or sums of species to the numerical physical experimental observable. The values
      of the observable corresponding to particular species or to 0 and 100% completion
      of a titration can be either fixed or floating parameters in the fit.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8489029
TI  - [In memoriam Reinhold Sulzmann].

PMID- 8489030
TI  - A scanning electron microscopic and immunohistochemical study of spinal ligaments
      innervation.
AB  - Neural elements in the interspinous and longitudinal ligaments of the human
      lumbar spine were investigated by means of scanning electron microscopy (SEM) and
      immunohistochemistry for neurofilament protein (NFP). The SEM results agree with
      our previous findings of nerve fibers and localized them in the superficial
      layers of the ligaments as well as in the deeper ligamentous substance. The
      immunohistochemical staining for NFP has clearly confirmed the presence of
      sensory nerve endings. Most of the nerve fibers terminated as simple free endings
      which are thought to be nociceptors.

PMID- 8489031
TI  - An anatomical study of the laterotrigeminal venous system.
AB  - The middle cranial fossa of 100 cadavers were dissected under stereoscopic loupe
      in order to identify and systematize the venous vessels located along the lateral
      margin of the trigeminal cave. The author found that at the sensitive root and
      trigeminal ganglion level a dural venous canal was present in most individuals
      examined and that the upper side of this canal communicated with the superior
      petrosal sinus. However, at the level of the lateral border of the intracranial
      segment of the mandibular nerve, venous lacunae were found to prevail, and these
      lacunae communicated with several other venous formations in the peritrigeminal
      region. The author concludes that the venous vascularization of this area
      constitutes a major risk in surgical interventions made in the middle cranial
      fossa. In addition, it is a relevant factor in the hemodynamics of the
      intracranial circulation.

PMID- 8489032
TI  - Histomorphometric analysis of the abomasum of the sheep during development.
AB  - Histomorphometric analyses were carried out on 64 embryos and fetuses and on 20
      sheep (early postnatal to adult age). Histodifferentiation of the abomasum took
      place at 33 days of fetal life, with the appearance of abomasal villi at 53 days.
      By 64 fetal days, the epithelium had changed from pseudostratified to simple
      mucous cylindrical. Acidic glycoproteins appeared at 46 fetal days. Neutral
      glycoproteins did not appear until later stages of development, near birth. We
      believe that the configuration of a simple epithelium with acidic secretion is
      enhanced at birth by the secretion of neutral glycoproteins which act as a buffer
      against acidic substances, and particularly against the abomasal acidity during
      lactation. Growth curves and formulae were set out for each tissue layer.

PMID- 8489033
TI  - [The conjunctival epithelium of dogs. Light and electron microscopic
      investigations].
AB  - The conjunctiva of the dog has a smooth surface on the inside of the upper and
      lower lid and of the bulbus oculi. In these areas the conjunctiva is covered by a
      stratified squamous epithelium, the polygonal surface cells of which have
      microvilli and microplicae which are different in number and show a great variety
      of shapes. In the passage towards the fornix conjunctivae a stratified cuboidal
      epithelium is to be discerned. In the fornix itself, the conjunctiva is arranged
      in small folds which are protruded by goblet cells and the openings of lacrimal
      glands. Here a stratified cuboidal or columnar epithelium can be observed which
      at the electron microscopic level shows in all epithelial layers--mostly however
      in the stratum superficiale--morphological signs of enhanced metabolic
      activities. The bulbar surface of the third eyelid which is covered by a
      stratified squamous epithelium has a three-dimensional moulded pattern of pads
      and grooves. The structure of the conjunctival epithelium to some extend is age
      dependent.

PMID- 8489034
TI  - Morphology of the rat uterus after long-term treatment with progesterone
      antagonists.
AB  - The effects of long-term treatment with the progesterone antagonists ZK 98.299
      and ZK 112.993 on the uterus of intact mature rats were investigated with light
      and electron microscopy. After 3-4 weeks treatment with both progesterone
      antagonists, the uterine luminal epithelium showed ongoing mitotic activity,
      increased apoptosis and invasion by granulocytes. Many uteri showed metaplastic
      areas with stratified squamous epithelium. Basically, the same changes occurred,
      but to a lesser extent, in the glandular epithelium. At the ultrastructural
      level, the epithelial cells displayed the morphological features of a certain
      degree of differentiation. The dissociation of collagen fibres, infiltration by
      granulocytes and dilatation of small vessels were observed in the subepithelial
      connective tissue. The myometrium increased in thickness and electron microscopic
      examination revealed hypertrophic myocytes with a well developed granular
      endoplasmic reticulum. Most of the morphological reactions may be regarded as due
      to the direct inhibitory action of progesterone antagonists at the level of the
      different uterine tissues and the resulting unopposed action of estrogen. The
      metaplastic changes and the suppression of the anti-proliferative action of
      progesterone on uterine epithelial cells should be taken into account when
      treating women in their reproductive years with these drugs for long periods of
      time, as may be necessary for the endocrine treatment of mammary cancer and
      endometriosis.

PMID- 8489035
TI  - Histological examination of chick embryos with ocular hypoplasia.
AB  - From so-called "dead-in-pipped-eggs" provided by the Poultry Breeding Center of
      Gifu Prefecture, we obtained two chick embryos with hypoplastic eyes on external
      examination, and studied the visual system and cranial nerve nuclei innervating
      the extraocular muscles. The upper bills of both embryos deviated toward one side
      when observed with the naked eye. In histological sections from the most severely
      affected eyeball of each case primordial retinal tissue in the poorly developed
      orbit seemed to be at the stage of optic vesicle formation; it had not
      differentiated into individual layers. The optic nerve was absent from these
      eyeballs and the neural retina had multiple folds. The ciliary ganglion was
      smaller on the more severely affected side than on the contralateral side which
      had only mild hypoplasia. The optic nerve, which was present on the contralateral
      side, bifurcated at the level of the chiasma close to the diencephalic base; one
      branch ran toward the ipsilateral optic tectum and the other toward the
      contralateral brain region. The oculomotor and trochlear nerve nuclei could be
      identified bilaterally in one of the embryonic brains but not in the other. These
      findings suggest that hypoplasia of the neural retina and optic nerve in an orbit
      leads to bifurcation of the contralateral optic nerve which, under normal
      conditions, should completely cross at the chiasma. This may also suggest that
      retinal afferents from the brain are also affected in the hypoplastic eyeball.

PMID- 8489036
TI  - Morphological changes in thrombocytes during blood bank storage. An
      ultrastructural morphometric study.
AB  - Monitoring the storage lesion of platelet concentrates (PC) is commonly done by
      determining metabolic parameters, release of cytoplasmic markers and granules
      contents and watching the light microscopical appearance of platelets.
      Descriptions of ultrastructural changes are rare, and so we ascertained the
      changes in two important organelles, the alpha- and lysosomal granules and the
      open canalicular system (OCS), by morphometric analysis. Single donor PC's were
      prepared with a CS-3000 plus (Baxter) processor and stored under routine
      conditions. The volume fraction of the granules displayed a decrease to 43% after
      8 days of storage, and the OCS fraction increased to 143%. Moreover, changes in
      the morphology of granules and the development of OCS channels are described, and
      ballooning and even complete lysis of some platelets could be observed after only
      three days. Furthermore, the membrane flux in the formation of pseudopodia is
      discussed. Our results stress the need to establish better preparation and
      storage conditions for platelet concentrates.

PMID- 8489037
TI  - Pars tuberalis specific cells within the pars distalis of the adenohypophysis. An
      ontogenetic study.
AB  - Several types of secretory cells of the pars distalis (pd), especially
      gonadotrophs, are known to occur in the distal pars tuberalis (pt) of the rat.
      The distribution of the pt-specific cells, however, within the pd has not been
      investigated in detail and is the subject of this study. Pt and pd of the rat
      adenohypophysis were investigated at different stages of the peri- and postnatal
      development by light and electron microscopy using conventional and
      immunohistochemical staining. The distribution of pt-specific cells changes from
      a continuous strand of cells extending on the ventral surface to the centre of
      the pd perinatally to single clusters in the vicinity of the big portal vessels
      in adult rats. The secretory activity of pt-specific cells within the pd also
      varies with age. It is highest perinatally, declines in the young rat, and
      increases again in the adult animal. Functional implications of our observations
      are discussed especially in relation to the distribution of melatonin-binding
      pituitary cells.

PMID- 8489038
TI  - [Microstructure of fossil mammalian bones from the Rixdorfer Horizon of Weichsel
      Kaltzeit at Niederlehme near Konigs Wusterhausen (Brandengurg)].
AB  - The structure is reported of bones of glacial-period mammals, which were found in
      1973 to 1989 in gravel-sandy soil of the fossiliferous layer "Rixdorfer Horizont"
      at Niederlehme near Konigs Wusterhausen. The findings, probably, date from one of
      the interstages of the glacial period "Weichsel-Kaltzeit" before the stage
      "Brandenburger Stadium". Their embedding took place more than 20,000 years ago.
      Changes of the deposit of bones and teeth from older sediments are not to exclude
      in the finding place Niederlehme. In the collection of findings with 102 skeletal
      parts are to define following species: Mammuthus primigenius, Coelodonta
      antiquitatis, Equus sp., Bison priscus, Megalocerus giganteus, Cervus elaphus,
      Rangifer tarandus and Canis lupus. A trajectorial direction of the trabecula in
      the substantia spongiosa is evident. There are also specific channels of blood
      vessels with different diameters. This channels have completely closed bone-wall
      (with a central venous sinus of diameter 5 to 10 mm) or in little vessels
      (diameter 1 to 3 mm), we have found many apertures to the rooms of the substantia
      spongiosa. The microscopical investigation of bones of Mammuthus primigenius has
      shown Havers' channels and perforating channels, Havers' systems and lacunae
      osseae.

PMID- 8489039
TI  - Structure on the capsular ligaments of the facet joints.
AB  - Microscopic studies showed that the capsular ligaments were mostly composed of
      collagenous tissue. The collagen fiber bundles were found to be crimped at right
      angles to their long axis. The collagen fibrils were connected transversely by
      proteoglycan filaments which were regularly associated with their periodicity.
      Among the collagen fiber bundles were varying quantities of elastic fibers and
      numerous fibroblasts. The highest concentration of elastic fibers was found in
      the posterior and inferior aspects of the capsular ligaments. These findings are
      discussed in relation to the mechanical behavior of the capsular ligaments.

PMID- 8489040
TI  - The effect of ageing on the posterior medial and posterior lateral subnuclei of
      the bed nucleus of the stria terminalis in the mouse.
AB  - The posterior medial and posterior lateral subnuclei of the bed nucleus of the
      stria terminalis were examined in male ASH/TO mice aged 6, 15, 25, 28 and 31
      months using quantitative histological techniques. Neuron number in the posterior
      lateral subnucleus remained constant from 6 to 31 months (mean 1918 +/- 60)
      whereas in the posterior medial subnucleus neuron number fell from 5165 +/- 145
      at 25 months to 4197 +/- 172 at 28 months. There was no further decrease in
      neuron number at 31 months (4034 +/- 55).

PMID- 8489041
TI  - EMG study of the anterior, superior and posterior auricular muscles in man.
AB  - Anterior, superior and posterior auricular muscles were studied
      electromyographically by means of wire electrodes. During ear movement the three
      muscles acted as a group and the movement was always directed upwards and
      backwards. The highest electrical activities were observed during natural smiling
      and yawning. Mouth opening without the drawing backwards of the comissura
      labiorum and the displacement of galea aponeurotica also produced electrical
      activity by the auricular muscles, with however, less intensity and in only 50%
      of the cases studied.

PMID- 8489042
TI  - A variant of the floor of the carotid canal.
AB  - 325 skulls were investigated in the present study. The absence of the floor of
      the carotid canal was found in only one skull, a condition which makes the
      internal carotid artery vulnerable during a surgical approach to this region.

PMID- 8489043
TI  - [The laterocranial fascia structures in the upper and forearm and the differences
      in the insertion of the M. biceps brachii in domestic mammals].
AB  - The laterocranial fascia of the upper arm and forearm, as well as aponeurotic
      relationships of the Musculus biceps brachii were investigated on each of ten
      forelimbs from horses, cattle and swine. Ten canine biceps were also
      investigated. Equine and bovine fascia contain elastic components. An as-yet
      undescribed ligament-like aponeuroses of the laterocranial forearm fascia to the
      Fossa radialis humeri was seen in all three species studied. The laterocranial
      fascia of the upper and forearm form a common passage for the Musculi brachialis
      et extensor carpi radialis. In the case of the horse, the ulnar aponeurotic
      tendon of the biceps muscle crosses below the Ligamentum collaterale cubiti
      medialis. In cattle, on the other hand, it runs between the two branches of the
      collateral ligament, to attach on the olecranon. This portion of the equine
      tendon protrudes into the joint. It has connective tissue character in young
      animals, but becomes fibrocartilaginous in older horses. The radial aponeuroses
      of the canine biceps exhibits two branches. A situation similar to that seen for
      the ulnar aponeuroses of the equine Musculus biceps brachii is observed on the
      inside surface of the porcine Ligamentum cubiti mediale, in which a wedge of
      connective tissue protrudes into the joint, taking on fibrocartilaginous
      character in older animals.

PMID- 8489044
TI  - Radiographic study of postnatal development of the tarsus in west African dwarf
      goats.
AB  - Seven goats of the West African dwarf breeds, three females and four males, from
      the same farm were studied by serial radiography from the first week of life and
      at 3, 6, 9, 16, 23, 28, 37 and 46 weeks of age. The radiological appearance of
      the developing tarsus as evaluated from radiographs is described. During the
      first week postnatally, eight loci were observed to be partially ossified. The
      talus, tarsi centrale (Tc), first (T1), second (T2), third (T3) and fourth (T4)
      tarsal bones had each a single loci. The calcaneus bone had two loci, one for the
      tuber calcanei and another for the calcaneus himself. Fusion of the locus for T2
      and T3 was evident in radiographs taken at three weeks. The fused T2 + T3 also
      appeared fused with the Tc in one of the goats at 23 weeks. The Tc and T4 were
      observed to fuse in only three of the goats at 23 weeks while in others the bones
      remained separate throughout the study period. In those goats where the Tc and T4
      tarsal bones were not fused, the three tarsal joints were linked by a radiolucent
      line between these bones. While in the goat where Tc and T2 + T3 bone fusion has
      occurred the distal intertarsal joint was blocked and the proximal intertarsal
      was communicating with the tarsometatarsal joint between the separate Tc and T4.
      The tarsus of the goat is variable and differs from that of sheep and cattle.

PMID- 8489045
TI  - [Chronology of the postnatal ossification of the shoulder and elbow joints in the
      Siamese cat (Felis catus L.)].
AB  - A study was done by radiological techniques to show the chronology of
      ossification of the shoulder and cubit joints in the Siam cat, from birth up to
      the 25th week of postnatal development. For this experiment we used 40 little
      cats (19 males and 21 females) belonging to 11 litters subjected to different
      controls: pattern race, healthy, feeding, growing up and radioactivity. The time
      of the appearance and the evolution of the ossification centers is determined as
      well as the phenomenon of fusion during this time. The postnatal ossification
      from both joints of the Siam cat is compared with that of the common cat.

PMID- 8489046
TI  - [Chronology of the postnatal ossification of the thoracic limb in the Siamese cat
      (Felis catus L.)].
AB  - A study was done by radiological techniques to show the chronology of
      ossification of the thoracic autopodo of the Siam cat from birth up to the 25th
      week of postnatal development. For this experiment we used 40 little cats (19
      males and 21 females) belonging to 11 litters subjected to different controls:
      pattern race, healthy, feeding, grow up and radioactivity. The time of the
      appearance and evolution of the centres that form the basipodo, metapodo and
      acropodo of the thoracic limb is determined. Likewise it is analyzed the
      phenomenon of fusion during that time to define the main ossification sequence in
      the carpo. The aspects of the postnatal ossification of the thoracic autopodo in
      the Siam cat are compared with the literature of different authors about the
      common cat.

PMID- 8489047
TI  - Histology and histomorphometry of the tibial diaphyseal growth in two turkey
      strains during the first six weeks after hatching.
AB  - The comparative cortical growth of the tibio-tarsus was studied during the first
      six weeks after hatching in two turkey strains, a light and a heavy one. At one
      day post-hatching the cortical appeared to be constituted in both strains of an
      embryonic non-active fibrous bone tissue which had completely disappeared at one
      week. On and after one week the cortex was constituted of a fibrolamellar adult
      bone tissue elaborated on the periosteal part of the cortex. Its vascular pattern
      depended on the strain and on the thickness of the cortical faces. The
      histomorphometric studies showed that the growth in thickness was earlier and
      faster in the heavy strain with a Total Diaphyseal Surface twice larger at 6
      weeks but a Diaphyseal Cortical Ratio not significantly different since 3 weeks
      of age.

PMID- 8489048
TI  - [The innervation of the syrinx of the duck (Anas platyrhynchos)].
AB  - The innervation of the Syrinx was studied in 15 female Peking Ducks of 10 to 12
      months old by using L.M. and E.M. In this organ a nervous plexiform net is
      present located in the connective below the epithelium along the membrana
      tympaniformis medialis. This net-work is made of the nervous trunks which
      repeatedly anastomise among themselves and display during their course acapsulate
      ganglions. However, no specialized contact device were encountered at the
      periphery.

PMID- 8489049
TI  - Loads on muscles, tendons and bones in the hind extremities of sheep--a
      theoretical study.
AB  - Muscle forces and bending moments were calculated with a two-dimensional non
      linear force and moment analysis (according to the Finite Element Method) during
      the foot-lowering phase, stance phase and stem phase in the hind legs of sheep.
      During the foot-lowering phase, the largest production of force is detectable in
      the m. biceps femoris and the highest bending moment in the proximal third of the
      metatarsal bone. The lowest influence of force resulted during the stance phase.
      During the stance phase, high forces are detectable only in the patellar ligament
      and middle-high forces in the m. flexor digitalis profundus. In contrast, bending
      forces are almost equal in strength in the metatarsus and tibia. The strongest
      forces are detectable in the m. quadriceps femoris and extreme demands of the
      patellar ligament as well as of the flexors in the proximal ankle joint during
      the stem phase.

PMID- 8489050
TI  - Lectin histochemistry of glycoconjugates in horse salivary glands.
AB  - The glycoconjugate content of major horse salivary glands was investigated by
      means of horseradish peroxidase-conjugated lectins. Qualitative differences were
      observed in the terminal sugar residues of secretory glycoproteins and
      glycoconjugates linked to the apical surface of excretory duct epithelial cells.
      Mucous acinar cells in mandibular and sublingual glands contained
      oligosaccharides with D-galactose, alpha- and beta-N-acetylgalactosamine, N
      acetylglucosamine and fucose residues, whereas mandibular, sublingual and parotid
      serous cells contained only oligosaccharides with terminal alpha- and beta-N
      acetylgalactosamine residues. The apical portion of striated and interlobular
      duct lining cells of mandibular and sublingual glands stained for alpha- and beta
      N-acetylgalactosamine and for N-acetylglucosamine. In parotid gland the cytoplasm
      of intercalated duct cells and the apical surface of striated duct epithelial
      cells stained for alpha-N-acetylgalactosamine.

PMID- 8489051
TI  - [Radiological study of the sternum of the growing sheep].
AB  - A radiological investigation of the sternum of the sheep demonstrated distinct
      growth phases. Forty Merino sheep of mixed breeds were distributed into 4 age
      groups of 0, 45, 105 and 270 days. Each animal was radiographed in sternal and
      lateral recumbency. Measurements were made from the radiographs. The sternebrae
      are rectangular in newborn and become concave in adult. The curvature of the
      sternum is 16 to 17 degrees at day 0 and 27-28 degrees at day 270. The nucleus of
      ossification was seen in all sternebrae at 45 days of age, they were present only
      in the most caudal sternebrae at 105 days.

PMID- 8489052
TI  - American Association of Anatomists 106th annual meeting held jointly with the
      Japanese Association of Anatomists. San Diego, California, March 27-31, 1993.
      Abstracts.

PMID- 8489053
TI  - Neurologic changes during carotid endarterectomy under cervical block predict a
      high risk of postoperative stroke.
AB  - BACKGROUND: This study was undertaken to confirm a previous report that patients
      having neurologic changes with carotid artery clamping were at greater risk of
      developing permanent postoperative neurologic complications after carotid
      endarterectomy. METHODS: Superficial and deep cervical plexus blocks were
      performed in 389 patients undergoing carotid endarterectomy. The patients were
      premedicated and sedated to a level that allowed awake neurologic assessment.
      Intraoperative neurologic changes were recorded and all patients were examined
      postoperatively by an independent anesthesiologist to record postoperative
      neurologic outcome. RESULTS: Trial carotid artery cross clamping resulted in 24%
      of patients having neurologic changes that usually responded to declamping and
      shunt insertion. Postoperative permanent neurologic complications occurred in
      2.6% of patients, but were more common in patients who had neurologic changes
      associated with carotid artery cross clamping (6.6% compared to 1.1%, P < 0.01).
      Thrombosis of the carotid artery was the most common finding in patients who
      underwent reexploration of the carotid artery after developing postoperative
      neurologic changes. CONCLUSIONS: This study confirms that patients undergoing
      carotid endarterectomy under cervical plexus block who have intraoperative
      neurologic changes have a sixfold increase in the chance of developing a
      postoperative stroke. This high-risk group may benefit from antithrombotic
      therapies to improve their outcome.

PMID- 8489054
TI  - Effect of phenylephrine bolus administration on global left ventricular function
      in patients with coronary artery disease and patients with valvular aortic
      stenosis.
AB  - BACKGROUND: Although phenylephrine bolus administration is frequently used to
      increase coronary perfusion pressure in patients with coronary artery disease or
      valvular aortic stenosis, there are no data describing its effect on left
      ventricular function (LVF). METHODS: Twenty patients scheduled for elective
      coronary artery bypass grafting (group 1) and 18 patients scheduled for elective
      aortic valve replacement (group 2) entered the study. The effect of phenylephrine
      was compared with that of norepinephrine in those patients who developed a
      defined degree of arterial hypotension under general anesthesia. These patients
      were randomized to receive an initial bolus of either phenylephrine (1
      micrograms/kg) or norepinephrine (0.05 micrograms/kg) followed by a bolus of the
      other drug after arterial pressure and heart rate (HR) had returned to baseline.
      Transesophageal echocardiography was used to evaluate LVF. Arterial pressure, HR,
      ejection time, and LV diameter, area, and wall thickness were recorded
      immediately before and for 3 min after bolus administration. Fractional diameter
      shortening, fractional area change, mean heart rate corrected velocity of
      circumferential fiber shortening (mVcfc), and LV meridional end-systolic wall
      stress (ESWS) were calculated. RESULTS: Both substances effectively restored
      arterial pressure in both groups. However, in group 1, phenylephrine
      administration resulted in a reduction of fractional area change from 0.51
      (median) to 0.39 (P = 0.0007) and a reduction of mVcfc from 1.16 to 0.61 circ/s
      (P = 0.0001). End-systolic wall stress increased from 98 to 186 10(3) dyne-cm-2
      (P = 0.0001). Administration of norepinephrine to group 1 and administration of
      either substance to the group 2 patients did not cause any significant changes of
      LVF. CONCLUSIONS: The results indicate that phenylephrine given as an intravenous
      bolus to patients with CAD anesthetized with fentanyl causes a transient
      impairment of LV global function and that phenylephrine bolus administration is
      well tolerated in patients with valvular aortic stenosis.

PMID- 8489055
TI  - Plasma concentration of fentanyl, with 70% nitrous oxide, to prevent movement at
      skin incision.
AB  - BACKGROUND: The Cp50 (minimal steady state plasma concentration of an intravenous
      analgesic/anesthetic required to prevent a somatic response in 50% of patients
      following skin incision) and the Cp50-BAR (minimal plasma concentration of an
      analgesic/anesthetic required to prevent either a somatic, hemodynamic, or
      autonomic response in 50% of patients following skin incision) have been recently
      proposed as a measure, like minimum alveolar concentration (MAC; and MAC-BAR), to
      establish the relative potency of intravenous analgesics. This study was
      conducted to establish the Cp50 for fentanyl. METHODS: Unpremedicated patients
      were administered fentanyl (in the presence of 70% N2O) via computer-assisted
      continuous infusion, a pharmacokinetic model-driven infusion device. After
      induction of anesthesia with fentanyl, the randomized target fentanyl
      concentration was entered into computer-assisted continuous infusion. This target
      fentanyl concentration was maintained until skin incision. Before induction,
      prior to skin incision, and immediately after skin incision, arterial blood
      samples were obtained for measurement of fentanyl and norepinephrine
      concentrations. At skin incision, patients were observed for a somatic,
      hemodynamic, or autonomic response. Only patients in whom the pre- and
      postincision fentanyl concentrations were within +/- 30% were included in the
      calculation of the Cp50. The Cp50 was calculated using logistic regression.
      RESULTS: The Cp50 for fentanyl was 3.26 ng/ml, and the Cp50-BAR was 4.17 ng/ml.
      CONCLUSIONS: Comparing these results with the previously published Cp50 of
      alfentanil, the potency of fentanyl relative to alfentanil is 1:58. Establishing
      the Cp50, once effect site equilibration has occurred, will allow pharmacodynamic
      comparisons between the opioids at equipotent concentrations.

PMID- 8489056
TI  - Improved noninvasive diagnostic testing for malignant hyperthermia susceptibility
      from a combination of metabolites determined in vivo with 31P-magnetic resonance
      spectroscopy.
AB  - BACKGROUND: Phosphorus magnetic resonance spectroscopy (31P-MRS) in vivo has been
      suggested recently as a possible noninvasive diagnostic test in malignant
      hyperthermia (MH) susceptibility. However, differences between protocols and also
      within subjects may have led to inconsistent MRS abnormalities reported during
      and after exercise. The aim of the current study was to detect discriminant
      abnormalities in the leg muscles using in vivo 31P-MRS during the rest period.
      METHODS: Fourteen patients shown to be MH-susceptible and 22 patients MH-negative
      on the basis of in vitro caffeine/halothane contracture tests according to the
      European MH group protocol were compared to 36 control subjects using in vivo 31P
      MRS during the rest period. A score of MRS combined abnormalities was calculated
      from a stepwise discriminant function analysis. RESULTS: The MH-susceptible group
      had a significantly (P < 0.01) higher inorganic phosphate (Pi) to phosphocreatine
      (PCr) (Pi/PCr) value (0.134 +/- 0.022) than either the MH-negative (0.097 +/-
      0.016) or the control (0.101 +/- 0.017) group. The MH-susceptible group also
      exhibited a significantly (P < 0.01) higher phosphodiesters (PDE) to PCr
      (PDE/PCr) value (0.093 +/- 0.056) than either the MH-negative (0.034 +/- 0.021)
      or the control (0.029 +/- 0.019) group. Combining both MRS parameters, 13 of the
      14 MH-susceptible patients demonstrated abnormal MRS test results (score value <
      1.65). Conversely, 21 of the 22 MH-negative patients had normal MRS results
      (score value > or = 1.65). The sensitivity and specificity of this threshold
      value were 93 and 95%, respectively. CONCLUSIONS: This study confirms that 31P
      MRS could be useful for distinguishing noninvasively between MH-susceptible and
      MH-negative patients if several MRS parameter are combined. Moreover, the present
      MRS approach appears to be more reliable and easier than that used during
      exercise.

PMID- 8489057
TI  - Leg heat content continues to decrease during the core temperature plateau in
      humans anesthetized with isoflurane.
AB  - BACKGROUND: Sufficient hypothermia during anesthesia provokes thermoregulatory
      responses, but the clinical significance of these responses remains unknown.
      Nonshivering thermogenesis does not increase metabolic heat production in
      anesthetized adults. Vasoconstriction reduces cutaneous heat loss, but the
      initial decrease appears insufficient to cause a thermal steady state (heat
      production equaling heat loss). Accordingly, the authors tested the hypotheses
      that: 1) thermoregulatory vasoconstriction prevents further core hypothermia; and
      2) the resulting stable core temperature is not a thermal steady state, but,
      instead, is accompanied for several hours by a continued reduction in body heat
      content. METHODS: Six healthy volunteers were anesthetized with isoflurane (0.8%)
      and paralyzed with vecuronium. Core hypothermia was induced by fan cooling, and
      continued for 3 h after vasoconstriction in the legs was detected. Leg heat
      content was calculated from six needle thermocouples and skin temperature, by
      integrating the resulting parabolic regression over volume. RESULTS: Core
      temperature decreased 1.0 +/- 0.2 degrees C in the 1 h before vasoconstriction,
      but only 0.4 +/- 0.3 degrees C in the subsequent 3 h. This temperature decrease,
      evenly distributed throughout the body, would reduce leg heat content 10 kcal.
      However, measured leg heat content decreased 49 +/- 18 kcal in the 3 h after
      vasoconstriction. CONCLUSIONS: These data thus indicate that thermoregulatory
      vasoconstriction produces a clinically important reduction in the rate of core
      cooling. This core temperature plateau resulted, at least in part, from
      sequestration of metabolic heat to the core which allowed core temperature to
      remain nearly constant, despite a continually decreasing body heat content.

PMID- 8489058
TI  - Isoflurane minimum alveolar concentration reduction by fentanyl.
AB  - BACKGROUND: Isoflurane is commonly combined with fentanyl during anesthesia.
      Because of hysteresis between plasma and effect site, bolus administration of
      fentanyl does not accurately describe the interaction between these drugs. The
      purpose of this study was to determine the MAC reduction of isoflurane by
      fentanyl when both drugs had reached steady biophase concentrations. METHODS:
      Seventy-seven patients were randomly allocated to receive either no fentanyl or
      fentanyl at several predetermined plasma concentrations. Fentanyl was
      administered using a computer-assisted continuous infusion device. Patients were
      also randomly allocated to receive a predetermined steady state end-tidal
      concentration of isoflurane. Blood samples for fentanyl concentration were taken
      at 10 min after initiation of the infusion and before and immediately after skin
      incision. A minimum of 20 min was allowed between the start of the fentanyl
      infusion and skin incision. The reduction in the MAC of isoflurane by the
      measured fentanyl concentration was calculated using a maximum likelihood
      solution to a logistic regression model. RESULTS: There was an initial steep
      reduction in the MAC of isoflurane by fentanyl, with 3 ng/ml resulting in a 63%
      MAC reduction. A ceiling effect was observed with 10 ng/ml providing only a
      further 19% reduction in MAC. A 50% decrease in MAC was produced by a fentanyl
      concentration of 1.67 ng/ml. CONCLUSIONS: Defining the MAC reduction of
      isoflurane by all the opioids allows their more rational administration with
      inhalational anesthetics and provides a comparison of their relative anesthetic
      potencies.

PMID- 8489059
TI  - Intrathecal sufentanil for labor analgesia. Effects of added epinephrine.
AB  - BACKGROUND: Intrathecal sufentanil has been found to provide profound analgesia
      during labor. Epinephrine, when added to various local anesthetic agents or
      opioids, may modify the analgesic profile and incidence of side effects. The
      authors sought to determine the effect of adding 0.2 mg epinephrine to 10
      micrograms sufentanil when administered for analgesia during labor. METHODS:
      Forty women during active labor received 10 micrograms intrathecal sufentanil
      either with (n = 20) or without (n = 20) 0.2 mg epinephrine in a randomized,
      blinded fashion. A combined spinal-epidural technique was used in which a 25-G
      Whitacre spinal needle was passed through a standard 17-G epidural needle. After
      injection of the study drug, an epidural catheter was passed, but no local
      anesthetics were given. Analgesia was quantitated using visual analog scores, as
      well as time elapsed until first request for additional analgesia via the
      epidural catheter (0.25% bupivacaine). The incidence and severity of pruritus,
      nausea, and somnolence were assessed. RESULTS: The duration (median, range) of
      analgesia was 90 (40-310) min in the plain sufentanil group (SUF) and 90 (45-230)
      min in the sufentanil-epinephrine (SUF-EPI) group (P = NS). The onset of
      analgesia was rapid (within 5 min) in both groups and visual analog scores did
      not differ at any observation point between groups. The incidence of pruritus was
      80% (16/20) in the SUF group, and 45% (9/20) in the SUF-EPI group (P = 0.05).
      Four patients in the SUF group rated the pruritus as severe versus none in the
      SUF-EPI groups (P = 0.05). Seven patients (35%) in the SUF-EPI group experienced
      nausea, versus none in the SUF group (P = 0.004). No patient developed
      hypotension, motor blockade, fetal heart rate abnormalities, excessive sedation,
      or postdural puncture headache. CONCLUSIONS: Intrathecal sufentanil 10
      micrograms, both with and without epinephrine, provided rapid-onset, albeit short
      duration, analgesia during labor. Epinephrine did not prolong the duration of
      intrathecal sufentanil analgesia. The addition of epinephrine increased the
      incidence of nausea and decreased the incidence and severity of pruritus.

PMID- 8489060
TI  - Laparoscopy explosion hazards with nitrous oxide.
AB  - BACKGROUND: During laparoscopic surgery utilizing carbon dioxide as the
      insufflating agent, nitrous oxide will diffuse into the peritoneal cavity if it
      is used as part of the anesthetic. Bowel perforation and the subsequent release
      of volatile bowel gas could create a explosion hazard. METHODS: Two related
      studies were undertaken. The first quantified the transfer of nitrous oxide, over
      time, in 19 female patients undergoing laparoscopy. The second established the
      lower limits of flammability of a range of concentrations of methane and hydrogen
      diluted with nitrogen (simulated bowel gas) in a range of concentrations of
      nitrous oxide diluted with carbon dioxide (simulated peritoneal gas). RESULTS:
      The mean concentrations of N2O at 10, 20, and 30 min from the time of
      insufflation were 19.9 +/- 4.8%, 30.3 +/- 6.8%, and 36.1 +/- 6.9%, respectively.
      The maximum reported concentrations of methane and hydrogen in bowel gas are 56%
      and 69%, respectively. The concentration of nitrous oxide necessary to support
      combustion of 56% methane is approximately 47%. By contrast, the concentration of
      nitrous oxide needed to support combustion of 69% hydrogen is approximately 29%.
      CONCLUSIONS: The authors have shown that it is possible for nitrous oxide to
      reach concentrations in the peritoneal cavity that can support combustion of
      bowel gas.

PMID- 8489061
TI  - The effectiveness of pressure support ventilation for mechanical ventilatory
      support in children.
AB  - BACKGROUND: The rapid respiratory frequency of children may lead to patient
      ventilator asynchrony and increase the work of breathing during mechanical
      ventilation, and the use of a small endotracheal tube and a demand valve can
      further increase this work of breathing. Although pressure support ventilation
      (PSV) is well known to reduce the work of breathing in adults, there are no
      reports regarding clinical studies of PSV in children. Therefore, the effect of
      PSV on breathing patterns and the work of breathing in children was studied.
      METHODS: Six children (3-5 yr of age) were studied in the immediate postoperative
      period. Three levels of PSV, 0, 5, and 10 cmH2O, were employed. Airway pressure,
      flow, tidal volume, minute ventilation, and respiratory frequency were measured.
      To assess the work of breathing, the negative deflection of esophageal pressure
      (delta Pes) caused by inspiratory effort was measured. The inspiratory work of
      breathing was also estimated directly by measuring the esophageal pressure-volume
      loop using the Campbell technique. RESULTS: Although minute ventilation did not
      change with PSV, tidal volume increased and respiratory frequency decreased with
      increasing levels of PSV. The delta Pes decreased markedly from 8.9 cmH2O with
      PSV of 0 cmH2O to 5.7 cmH2O with PSV of 5 cmH2O and 2.7 cmH2O with PSV of 10
      cmH2O. The mechanical work of breathing also decreased from 0.743 Joules/l with
      PSV of 0 cmH2O to 0.463 Joules/l with PSV of 5 cmH2O and 0.196 Joules/l with PSV
      of 10 cmH2O. CONCLUSIONS: It was concluded that PSV can effectively augment
      spontaneous breathing and reduce the work of breathing in children.

PMID- 8489062
TI  - Transmucosal administration of midazolam for premedication of pediatric patients.
      Comparison of the nasal and sublingual routes.
AB  - BACKGROUND: Nasal transmucosal midazolam is effective for premedication of
      pediatric patients; however, 61-74% of these patients cry at nasal drug
      administration. Sublingual benzodiazepines, including midazolam, are effective in
      adults. The current blinded randomized study compared acceptance of and
      behavioral responses to transmucosal midazolam administered via the intranasal
      and sublingual routes. METHODS: Ninety-three patients aged 0.5-10 yr were
      stratified by age: 30 infants and toddlers, 0.5-2 yr; 39 preschoolers, 2.1-5 yr;
      and 24 school age, 5.1-10 yr. They were randomized to receive 0.2 mg/kg of
      midazolam in the nose or under the tongue without or with additional flavoring.
      For the group receiving sublingual flavored midazolam, the syringe tip was dipped
      in candy flavor and sugar. Duration of crying and compliance with instructions
      for sublingual drug administration were recorded. Hemoglobin oxygen saturation by
      pulse oximetry and sedation score were recorded by three observers before drug
      administration, at 2.5-min intervals for 10 min, at separation from parents, and
      during induction with halothane in O2. RESULTS: Children accepted midazolam
      administered via the sublingual route better than that given intranasally. In
      children not crying before drug administration, the frequency and duration of
      crying was greater following intranasal compared with sublingual administration
      (71% vs. 18% (P < 0.0001) and 48 +/- 56 vs. 25 +/- 49 s (P = 0.004),
      respectively). Lack of total compliance with instructions for sublingual
      administration did not alter drug effect, and there were no differences between
      the three study groups in maximum sedation, response to separation from parents,
      and behavior at induction of anesthesia; 80% displayed adequate or excellent
      behavior. Finally, the addition of candy flavor did not improve acceptance of or
      compliance with sublingual midazolam administration. CONCLUSIONS: Sublingual
      administration of midazolam is as effective as, and better accepted than,
      intranasal midazolam as a preanesthetic sedative in children.

PMID- 8489063
TI  - Inhibitory effects of bupivacaine and lidocaine on adrenergic neuroeffector
      junctions in rat tail artery.
AB  - BACKGROUND: Various local anesthetic agents have been shown to cause relaxation
      of isolated vascular segments contracted by catecholamines and other constrictor
      drugs. This report describes the actions of the amide-linked local anesthetic,
      bupivacaine, on adrenergic responsiveness of isolated arterial smooth muscle, and
      compares bupivacaine effects with those of lidocaine. METHODS: Helical strips of
      rat tail artery mounted in a muscle bath for measurement of isometric force
      generation were contracted in response to adrenergic nerve stimulation, increased
      potassium concentration, tyramine, or exogenous norepinephrine. RESULTS:
      Treatment with bupivacaine or lidocaine caused depression of contraction to all
      four stimuli. Contraction to adrenergic nerve stimulation was more sensitive to
      the inhibitory effects of local anesthetics than was contraction to elevated
      potassium, tyramine, or exogenous norepinephrine. Furthermore, bupivacaine was
      more effective in reducing contraction to adrenergic nerve stimulation than was
      lidocaine (EC50: bupivacaine = 4 x 10(-6) M; lidocaine = 61 x 10(-6) M). In
      arteries incubated in solutions containing [3H]-norepinephrine and mounted for
      superfusion and isometric force recording, both bupivacaine and lidocaine (10(-5)
      M) depressed the contractions and diminished the release of radioactivity evoked
      by nerve stimulation. At the concentration tested, bupivacaine was more effective
      than lidocaine in reducing both contraction and the efflux of radioactivity as
      indicated by the magnitude of depression compared with control activities.
      CONCLUSIONS: These findings suggest that lidocaine and bupivacaine depress
      adrenergic neurotransmission and inhibit smooth muscle contraction. Bupivacaine
      is a more potent inhibitor of adrenergic neurotransmission in the blood vessel
      wall than is lidocaine.

PMID- 8489064
TI  - Anesthetic cutoff in cycloalkanemethanols. A test of current theories.
AB  - BACKGROUND: N-alkanols containing up to 12 carbons are anesthetic; however, those
      with more than 12 carbons are not. This phenomenon has been termed cutoff. Lipid
      disordering theories of anesthesia suggest that cutoff occurs because the alkyl
      chains of long-chain alcohols approach the length and shape of the lipids of
      neuronal membranes and, therefore, intercalate into membranes without perturbing
      them. Protein theories suggest that cutoff occurs because the size of long-chain
      alcohols exceeds that of a protein binding site having finite dimensions. These
      theories were tested with a new series of alcohols, the cycloalkanemethanols,
      c(CnH2n-1).CH2.OH. METHODS: Anesthetic potency was measured in Rana pipiens
      tadpoles using the reversible loss of righting reflexes as the endpoint. The
      change in order parameter induced by cycloalkanemethanols and n-alkanols in lipid
      bilayers made of egg phosphatidylcholine and cholesterol was measured with
      electron paramagnetic resonance spectroscopy. RESULTS: On ascending the series
      from cyclopropanemethanol (EC50 = 54 +/- 3.2 mM) to cycloundecanemethanol (EC50 =
      7.0 +/- 0.12 microM) anesthetic potencies first increased exponentially but then
      decreased sharply at cyclododecanemethanol (EC50 = 13 +/- 0.2 microM).
      Cyclotetradecanemethanol was found not to cause anesthesia in tadpoles, even
      after 48 h of exposure, although saturated solutions shifted the dose-response
      curve of octanol from 66 +/- 2.6 to 47 +/- 2.8 microM. A linear loss in the
      ability to disorder lipid bilayers was observed on ascending both alcohol series
      such that cyclotetradecanemethanol and n-tridecanol actually increased bilayer
      order. CONCLUSIONS: Molecular length does not correlate with anesthetic cutoff in
      these two alcohol series. Cutoff is predicted by the ability of both series of
      alcohols to disorder lipid bilayers and correlates with their molecular volume.

PMID- 8489065
TI  - Inhibition by enflurane of baroreflex mediated mesenteric venoconstriction in the
      rabbit ileum.
AB  - BACKGROUND: Halothane and isoflurane are known to attenuate neurally mediated
      regulation of mesenteric vein diameter. The current study evaluated the effects
      of enflurane on baroreflex control of small mesenteric veins. METHODS: Changes in
      mesenteric vein diameter, intravenous pressure, mean arterial pressure, and heart
      rate in response to bilateral carotid occlusion, aortic nerve stimulation, and
      celiac ganglion stimulation were measured in 23 chloralose-anesthetized rabbits
      before, during, and after 1% and 2% inhaled enflurane administration. In six
      other rabbits, sympathetic efferent nerve activity was recorded directly from a
      postganglionic splanchnic nerve, also during bilateral carotid occlusion and
      aortic nerve stimulation, before, during, and after inhalation of 1% and 2%
      enflurane. RESULTS: Baseline mean arterial pressure and heart rate decreased, and
      mesenteric vein diameter increased, in response to inhaled enflurane. Reflex
      venoconstriction and the increases in mean arterial pressure, intravenous
      pressure, and heart rate, in response to bilateral carotid occlusion, were
      significantly inhibited at both levels of inhaled enflurane. Decreases in mean
      arterial pressure and heart rate, and reflex venodilation in response to aortic
      nerve stimulation, were attenuated by 2%, but not 1%, enflurane. Mesenteric
      venoconstriction, blood pressure increase, and bradycardia in response to celiac
      ganglion stimulation were unaffected by 2% inhaled and 5% superfused enflurane.
      Both 1% and 2% inhaled enflurane attenuated resting and carotid sinus-mediated
      increases in sympathetic efferent nerve activity. CONCLUSIONS: These results
      indicate that enflurane alters splanchnic venous reflexes in large part via the
      inhibition of sympathetic efferent activity.

PMID- 8489066
TI  - The influence of cryogenic brain injury on nociception in the rat.
AB  - BACKGROUND: Previous studies have suggested that focal cryogenic brain lesions
      that cause functional cerebral depression may increase anesthetic potency. To
      determine whether this effect was caused by changes in nociception, this study
      prospectively evaluated the influence of an experimental focal brain injury on
      the analgesic effects of the opioids, fentanyl and alfentanil, in rats. METHODS:
      The cortical freezing lesion was made with a brass probe cooled to -50 degrees C,
      applied through a craniotomy to the intact dura for 5 s. The analgesic effects of
      the opioids were quantified by tail-flick latency 3 days after the injury. The
      prolongation of tail-flick latency by infusions of each opioid in animals injured
      with a standardized cortical freezing lesion was compared with the results
      obtained from sham-operated control animals. RESULTS: At the endpoint of the
      experiment, prolongation of the tail-flick latency to 10 s, the mean serum
      concentrations (EC50) of both fentanyl and alfentanil were approximately 25% less
      in the brain-injured animals than in the controls (EC50 fentanyl; injured: 10.2
      +/- 2.6 ng/ml, controls: 13.6 +/- 5.2 ng/ml [P < 0.02]; EC50 alfentanil; injured:
      54.7 +/- 9.2 ng/ml, controls: 74.3 +/- 18.4 ng/ml [P < 0.02]). For alfentanil, no
      significant differences in pharmacokinetics between injured and control animals
      were observed. CONCLUSIONS: These results support the hypothesis that reductions
      in anesthetic requirements in this animal model of brain injury may be caused, in
      part, by alterations in nociception.

PMID- 8489067
TI  - The influence of intravascular volume expansion on cerebral blood flow and blood
      volume in normal rats.
AB  - BACKGROUND: Intravascular volume expansion can increase cerebral blood flow (CBF)
      in patients with cerebral ischemia. However, the changes in CBF produced by
      volume expansion in the normal brain remain the subject of debate, and the
      changes on cerebral blood volume (CBV; one determinant of intracranial pressure)
      have not been described. The effects of acute nondilutional volume expansion on
      cardiac output (CO), CBF, and CBV in normal rats were examined. METHODS:
      Normocarbic, normothermic halothane/N2O-anesthetized rats were given 0, 6, 12,
      24, or 36 ml of a blood-hetastarch mixture (n = 6 for each group). When volume
      loading was completed, 3H-nicotine was used to measure CBF, while 99mTc-labeled
      red cells and 14C-dextran were used to measure cerebral red cell and plasma
      volumes. Animals were killed by microwave irradiation (8KW x 770 msec). In
      different animals, cardiac output (CO) was measured by thermodilution during the
      infusion of 36 ml of blood-hetastarch. RESULTS: Central venous pressure (CVP)
      increased from 3.9 +/- 0.7 mmHg (mean +/- SD) in control animals to 13.0 +/- 2.0
      mmHg in rats given 36 ml of blood. Cardiac output increased to 138 +/- 11% of
      control. There were no changes in arterial Hct or mean arterial pressure. There
      were no significant changes in CBF (which varied from 127 +/- 22 ml.100 g-1.min-1
      in controls to 102 +/- 14 after the infusion of 36 ml). However, CBV increased in
      a linear fashion with increasing CVP, from 2.96 +/- 0.57 ml/100 g in control
      conditions to 4.47 +/- 0.83 ml/100 g after the infusion of 36 ml of
      blood/hetastarch. CONCLUSIONS: In normal brain, CBF does not change during volume
      expansion, in spite of an increase in CO. This contradicts earlier studies, the
      results of which indicate an independent role for cardiac output in CBF control.
      Cerebral blood volume increased in proportion to CVP, suggesting simple passive
      venous distention. Whether this could increase ICP and compromise cerebral
      perfusion remains unclear.

PMID- 8489068
TI  - Effects of lidocaine on intracellular Ca2+ and tension in airway smooth muscle.
AB  - BACKGROUND: Many studies have demonstrated that lidocaine directly relaxes airway
      smooth muscle. The underlying mechanisms, especially in relation to Ca2+
      mobilization, remain to be elucidated. METHODS: Using front-surface fluorometry
      and fura-2-loaded porcine tracheal smooth muscle strips, intracellular Ca2+
      concentration ([Ca2+]i) and isometric tension were simultaneously measured.
      RESULTS: In cases of 40 mM K(+)-induced contraction and 1 microM acetylcholine
      (ACh)-induced contraction, the cumulative application of lidocaine (10(-6)
      approximately 3 x 10(-3) M) caused a concentration-dependent decrease in [Ca2+]i
      and tension, and almost complete relaxation. To examine the effect of lidocaine
      on Ca2+ sensitivity of the contractile apparatus, the [Ca2+]i-tension
      relationship was determined by changing the extracellular Ca2+ concentration
      during 40 mM K+ induced depolarization, with and without treatment with
      lidocaine. Although treatment with 1 mM lidocaine inhibited increases in both
      [Ca2+]i and tension induced by extracellular Ca2+, it had little effect on the
      [Ca2+]i-tension relationship. In the presence of 1 microM ACh, the [Ca2+]i
      tension relationship shifted markedly to the left, thereby indicating an increase
      in Ca2+ sensitivity of the contractile apparatus; this shift was inhibited by 1
      mM lidocaine. In the absence of extracellular Ca2+, 1 mM lidocaine inhibited the
      release of stored Ca2+ induced by 1 microM ACh, but not that by 20 mM caffeine.
      CONCLUSIONS: Lidocaine directly relaxes airway smooth muscle by decreasing
      [Ca2+]i. In addition, lidocaine inhibits the ACh-induced increase of Ca2+
      sensitivity of the contractile apparatus, although it has little effect on Ca2+
      sensitivity during high K+ depolarization. The decrease in [Ca2+]i is attributed
      to inhibition of the influx of extracellular Ca2+, as induced by high K+
      depolarization and by ACh, and to the inhibition of the ACh-induced release of
      stored Ca2+.

PMID- 8489069
TI  - Evaluation of a new fluid warmer effective at low to moderate flow rates.
AB  - BACKGROUND: The tendency of intravenous fluid exiting the heat exchanger of a
      fluid warmer to cool to room temperature increases as the rate of infusion slows
      and the length of tubing between the heat exchanger and the patient increases.
      Thus, slow to moderate flow rates result in the delivery of fluid near room
      temperature despite the use of a fluid warmer. The volumes infused even at low
      flow rates may be large relative to the size of infants and children and may
      result in a significant decrease in patient temperature. METHODS: A new warmer
      (Hotline, Level 1 Technologies) that actively heats the fluid in the delivery
      tubing was evaluated and compared to two different conventional dry-wall warmers:
      the model DW1000A (Baxter Health Care) and the FloTem IIe (DataChem). Cold blood
      (4-10 degrees C) and room temperature saline (22 degrees C) were pumped through
      the warmers and the delivered temperature was measured as the flow rate was
      varied from 50 to 12,000 ml/h. RESULTS: The Hotline was more effective than the
      Baxter or the FloTem IIe at flow rates between 50 and 6,000 ml/h for saline and
      at flow rates between 50 and 3,000 ml/h for blood. Insulating the tubing beyond
      the heat exchangers of the conventional warmers improved their performance, but
      the delivered temperatures were still less than those of the Hotline at low flow
      rates. CONCLUSIONS: The Hotline is more effective than conventional warmers at
      slow flow rates, and may be useful for preventing hypothermia when large volumes
      of fluid relative to patient size are infused at slow rates.

PMID- 8489070
TI  - Motor paralysis of the lower extremities following lumbar sympathetic block.

PMID- 8489071
TI  - Digitally assisted tracheal intubation in a neonate with Pierre Robin syndrome.

PMID- 8489072
TI  - Safe nasogastric tube placement in a patient with a basal skull fracture.

PMID- 8489073
TI  - Epidural versus intravenous fentanyl.

PMID- 8489074
TI  - Is nitroglycerin a myocardial depressant?

PMID- 8489075
TI  - Regional anesthesia for arteriovenous fistula.

PMID- 8489076
TI  - Laryngeal mask airway and difficult intubation.

PMID- 8489077
TI  - Left bronchial intubation by the laryngectomy tube.

PMID- 8489078
TI  - Heart block after methylmethacrylate cementing.

PMID- 8489079
TI  - Electrocardiographic changes during cesarean section.

PMID- 8489080
TI  - The relationship between timing of repair of disruptions and subsequent aneurysm
      formation in laser-assisted microvascular anastomoses.
AB  - In this study we investigated the effects of duration of bleeding after laser
      assisted microvascular anastomoses and the amount of laser energy used to control
      bleeding on aneurysm formation. Eighty femoral arteries were exposed in 40
      Sprague-Dawley rats anesthetized with chloral hydrate. The arteries were
      transected and then anastomosed end-to-end with three nylon stay sutures followed
      by irradiation of the vessels with energy from a CO2 laser. The laser power was
      kept at 90 mW, and each of three segments between stay sutures was exposed for 6
      seconds to continuous laser energy. If anastomotic disruption (defined as
      bleeding after completion of the anastomosis) occurred, it was controlled with
      pressure over the disrupted site for 10, 25, or 40 seconds. Disruptions were
      required with exposure to additional laser energy for either 6 (group 1) or 12
      seconds (group 2). The anastomoses were inspected at 21 days postoperatively to
      assess patency and aneurysm formation. Twenty-six of 80 vessels (32%) were
      anastomosed without the occurrence of disruptions: these 26 vessels had a 100 per
      cent patency rate and did not develop aneurysms. In group 1, the incidence of
      redisruption following a primary disruption was the same irrespective of duration
      of bleeding (4/8, 3/6, and 3/6 for 10-, 25-, and 40-seconds bleeding time,
      respectively P = NS). Similarly, there was no difference in the incidence of
      aneurysm formation in this group (0/8, 2/6, and 2/6 for 10, 25, and 40",
      respectively, P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489081
TI  - Prevention of seroma formation after dissection of musculocutaneous flaps.
AB  - Dissection of musculocutaneous flaps is uniformly followed by the formation of
      seroma if drains are not used. Drains can be colonized and form deep tissue
      infection if left in place for a long time. In this study we investigated whether
      talc poudrage could prevent the formation of seroma following dissection of the
      latissimus dorsi muscle in a canine model. Twelve mongrel dogs were randomized
      into two groups. Group 1 (n = 6) underwent dissection of the left latissimus
      dorsi muscle which was rotated as a pedicle flap into the left chest through a
      second intercostal space thoracotomy. The wound was closed in layers without
      drains. Group 2 (n = 6) had the same procedure, but before closure of the wound,
      USP talc was applied to the tissues. All animals received cefazolin (500 mg) Q8h
      for 48 hours perioperatively. Animals were followed for 1-5 months. Wounds with
      fluctuation were aspirated as many times as necessary and the amount of fluid was
      recorded. All Group 1 animals developed seromas, in contrast, only one animal in
      group 2 had a seroma. There was a significant difference in the amount of fluid
      aspirated for each animal between the two groups (280 +/- 80 in group 1 vs 25 +/-
      25 ml in group 2, P < 0.05). The total amount of fluid drained in group 1 was
      1730 ml, whereas only 150 ml was aspirated in group 2. Group 1 animals required a
      total of 11 aspirations to control seromas, in contrast, only one aspiration was
      needed in group 2. No abscess was identified at postmortem in either group. Based
      on the results of this study we conclude that talc poudrage can be safely used to
      minimize seroma formation after dissection of musculocutaneous flaps.

PMID- 8489082
TI  - Pyogenic hepatic abscess: a case for open drainage.
AB  - A retrospective review of 24 patients treated at the University of Chicago for
      pyogenic liver abscess from 1979 to 1989 was performed to determine if there is a
      changing etiology in pyogenic liver abscess and if percutaneous drainage is a
      reliable treatment alternative to open drainage. Biliary tract disease was the
      most common cause and presented in 29 per cent of patients. Klebsiella and
      enterococcus were the most common bacterial organisms cultured in 33 and 29 per
      cent of patients, respectively. The overall mortality rate was 25 per cent,
      however, if open drainage, in addition to a definitive procedure such as
      cholecystectomy or bowel resection was performed, there were no deaths. We
      therefore recommend the use of percutaneous drainage alone only in selected
      patients.

PMID- 8489083
TI  - Atypical thyroglossal duct cyst: a rare cause for a solitary cold thyroid nodule
      in childhood.
AB  - A case of an atypical thyroglossal duct cyst is described in a 9-year-old boy who
      presented with a lateral neck mass that was hypofunctioning on thyroid scan and
      clinically indistinguishable from a thyroid nodule. Preoperative fine needle
      aspiration biopsy results demonstrating abundant, normal appearing squamous
      epithelial cells and keratinaceous material was suggestive of the diagnosis.
      Definitive diagnosis was made only after complete mobilization of the left lobe
      of the thyroid gland and cyst resection. A standard Sistrunk procedure was
      performed, and cyst excision was accomplished without resection of the left lobe
      of the thyroid gland. Microscopic examination disclosed a keratinizing
      pseudostratified squamous epithelium that has not been previously reported with
      thyroglossal duct cysts.

PMID- 8489084
TI  - Asymptomatic and normocalcemic parathyroid adenoma: detection by preoperative
      ultrasound.
AB  - Hyperparathyroidism is often detected in the asymptomatic stage at the present
      time with the advent of mass screening for hypercalcemia. There may be patients
      with parathyroid disease who are asymptomatic and who do not have detectable
      elevations of their serum calcium. Many patients who undergo surgery for thyroid
      conditions may have synchronous parathyroid disease which is asymptomatic and not
      detectable by routine laboratory screening. Preoperative ultrasound scans may be
      of utility in identifying coexistent disease in those patients scheduled for
      thyroid surgery so that both disease entities may be treated at the same
      operation.

PMID- 8489085
TI  - Laparoscopically guided cholecystectomy: a detailed report of the first 453 cases
      performed by one surgical team.
AB  - This study reports outcome data from a diverse population undergoing laparoscopic
      cholecystectomy. Our technique differs from other laparoscopic methods in its use
      of electrocautery, blunt hilar dissection, and routine intraoperative
      cholangiography. This study includes 453 consecutive surgeries performed between
      August 1989 and March 1991. Only the first 20 patients were screened to exclude
      those with common bile duct stones, prior upper abdominal surgery, pregnancy, or
      acute cholecystitis. Patients had the following conditions: current acute
      cholecystitis (9%), a history of acute cholecystitis (16%), jaundice (5%),
      pancreatitis (4%), and prior abdominal surgery (38%). Nine per cent had common
      bile duct stones which were treated with either laparoscopic transcystic common
      bile duct exploration (69%), laparoscopic choledochotomy (5%), open
      choledochotomy (10%), endoscopic retrograde cholangiopancreatography (10%), or
      observation (7%). Operative time averaged 78 minutes. One patient died, and 6%
      developed complications. Seventy-one per cent were discharged on the first
      postoperative day. Our experience demonstrates that LC can be performed safely,
      even in difficult cases, although considerable endoscopic experience and skill
      are required.

PMID- 8489086
TI  - Biliary complications of laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy has rapidly become the preferred treatment for
      symptomatic gallstones. Although this procedure has certain advantages over open
      cholecystectomy, concern has been expressed regarding the potential for bile duct
      injuries. In an effort to understand the scope of this problem, a retrospective
      review was performed of all patients referred to UCLA after having sustained
      biliary injuries during laparoscopic cholecystectomy. Over a 14-month period, 10
      patients were referred to UCLA with 12 major bile duct injuries. One patient had
      a false positive cholangiogram leading to an unnecessary biliary-enteric bypass
      and subsequent dehiscence, resulting in a biliary fistula. Six patients were
      referred on an acute basis, whereas four patients underwent attempted biliary
      reconstruction at outside facilities and were ultimately referred with either a
      biliary stricture or a fistula. Review of cholangiograms suggested that bile duct
      anomalies were present in five patients. There did not appear to be a
      relationship between the use of either electrocautery or laser and bile duct
      injuries. To date eight patients have been successfully managed via Roux-en-Y
      hepaticojejunostomies, with a mortality rate of 0%. Although the exact frequency
      cannot be ascertained from the current study, our data demonstrate that major
      biliary complications do occur during laparoscopic cholecystectomy. Most of these
      injuries, however, can be safely and successfully treated with surgical biliary
      reconstruction. Early diagnosis and treatment with liberal use of intraoperative
      cholangiography and a low threshold for conversion to open laparotomy appears to
      be associated with a more favorable outcome.

PMID- 8489087
TI  - Prospective randomized study of two different doses of clindamycin admixed with
      gentamicin in the management of perforated appendicitis.
AB  - Septic complications after surgery for enterogenous peritonitis are minimized by
      adjuvant antibiotics effective against aerobes and anaerobes. Historically, "gold
      standard" therapy included an aminoglycoside plus clindamycin, the latter given
      at 600 mg intravenous piggyback (IVPB), every 6 hours. Clindamycin
      pharmacokinetics suggests that it can be given q8h and admixed with gentamicin,
      thereby markedly reducing the cost of administration. Although this is now common
      practice, there is no prospective study comparing the efficacy of the two dose
      schedules in peritonitis. This study was designed to test the hypothesis
      regarding the clinical efficacy of the two regimens. One hundred twenty-six
      patients with gangrenous (n = 34) or perforated appendicitis (n = 91) were
      randomized (2:1) to receive gentamicin admixed with clindamycin 900 mg IVPB every
      8 hours (Group I n = 80) or gentamicin IVPB q8h plus clindamycin 600 mg IVPB
      every 6 hours (Group II n = 46). Appendectomy was performed, and aerobic and
      anaerobic cultures were obtained. Twenty-one patients had simultaneous
      determinations of clindamycin levels in plasma, peritoneal fluid, and appendix.
      Outcome analysis revealed no significant differences in postoperative days of
      fever, days non per os, antibiotic therapy, or hospitalization. There were 6
      failures (4 abscesses and 2 wound infections) in Group I and 4 failures (1
      abscess and 3 wound infections) in Group II. Both antibiotic regimens provided
      clinically equivalent results in mixed infections due to aerobic and anaerobic
      bacteria. The admixed clindamycin, administered every 8 hours, results in at
      least 20% reduction in costs. This is an important consideration.

PMID- 8489088
TI  - The enigma of leiomyoblastoma: spectrum of a rare gastric tumor.
AB  - Leiomyoblastoma is a rare, smooth muscle tumor of the stomach occurring chiefly
      in the antrum in patients between the fifth and seventh decades. The clinical
      spectrum, as illustrated in eight patients described in this report, ranges from
      an incidental finding to a highly malignant, metastasizing neoplasm. Although the
      large majority of leiomyoblastomas are benign, malignancy has been reported to
      occur in up to 12% of cases. Resection of the tumor with an appropriate full
      thickness segment of gastric wall is mandatory.

PMID- 8489089
TI  - Impact of anesthetic agents on patients with sickle cell disease.
AB  - Fifty-two surgical procedures were performed on 45 patients with sickle cell
      anemia. All patients were managed perioperatively with hydration and were kept
      warm and well oxygenated. Patients were anesthetized with either halothane (n =
      16), enflurane (n = 22), isoflurane (n = 6), or intravenous narcotics (n = 4).
      Four patients had epidural anesthesia. Perioperative morbidity was assessed using
      the criteria of atelectasis, urinary tract infection, wound infection,
      thrombophlebitis, drug reaction, hypotension, and vaso-occlusive crisis. The
      overall perioperative complication rate in this study was 45 per cent. Patients
      anesthetized with isoflurane and enflurane had postoperative morbidity rates of
      83 and 59 per cent, respectively, while the patients anesthetized with halothane
      had a complication rate of 25 per cent. In all three groups, atelectasis was the
      main cause. No complications occurred in the epidural group. In the intravenous
      anesthesia group, one patient developed sickle cell crisis. It appears that the
      types of anesthetic agents used do not impact on postoperative morbidity in
      patients with sickle cell anemia more than any other type of patient.

PMID- 8489090
TI  - Anterior resection for the treatment of rectal prolapse: a 20-year experience.
AB  - Between 1971 and 1991, 41 patients underwent anterior resection for the treatment
      of complete rectal prolapse. Anterior resection was performed after full rectal
      mobilization to the levator ani muscles with reanastomosis (39 hand-sewn and two
      stapled) carried out to peritonealized distal rectum. The 41 patients comprised
      35 women and six men with an average age of 56 years (range, 7-88 years).
      Postoperative follow-up averaged 6 years (range, 6 months to 18 years). Three
      patients (7%) suffered recurrent prolapse in 2, 2.5, and 5.5 years, respectively.
      Mortality was 0 per cent; morbidity was 15 per cent including three incisional
      herniae, two small bowel obstructions, and one stroke. No pelvic sepsis, abscess,
      or anastomotic dehiscence occurred. Anal incontinence was a preoperative finding
      in 21 patients (51%) with rectal prolapse. Nineteen of these patients (90%) noted
      either improvement or no change in postoperative continence. Anterior resection
      is a familiar, frequently performed operation that does not require a foreign
      body or rectal suspension. We believe this to be the procedure of choice for
      patients with complete rectal prolapse. Anterior resection withstands long-term
      scrutiny both in terms of recurrence rate and associated complications.

PMID- 8489091
TI  - Endoscopic resection of primary rectal teratoma.
AB  - A 76-year-old female was noted to have a rectal mass on evaluation for
      postmenopausal bleeding. There was no history of abdominal pain, constipation, or
      rectal bleeding. Flexible sigmoidoscopy revealed a 3-cm pedunculated rectal mass
      at 10 cm. Hair fibers were visible through the smooth glistening surface. At
      colonoscopy, the polyp was removed by snare polypectomy. Histology showed
      epidermal, mesodermal, and endodermal components diagnostic of benign cystic
      teratoma. Subsequent total abdominal hysterectomy and bilateral salpingo
      oophorectomy revealed endometrial carcinoma and postmenopausal ovaries. Primary
      rectal teratoma is a very rare rectal mass that may present endoscopically. Since
      1865, only 33 cases have been reported in the literature. Endoscopic photographs,
      histology, and a review of the literature are presented.

PMID- 8489092
TI  - Kinevac-assisted cholescintigraphy as an accurate predictor of chronic acalculus
      gallbladder disease and the likelihood of symptom relief with cholecystectomy.
AB  - Thirty patients with chronic upper abdominal pain and no evidence of
      cholelithiasis were entered into this study. All had negative ultrasonography of
      the gallbladder, and most had a host of other negative investigations. These
      patients were referred to a surgeon to evaluate the possibility of atypical
      biliary colic associated with chronic acalculous cholecystitis. All patients
      underwent cholecystokinin-stimulated cholescintigraphy and were offered
      cholecystectomy if the ejection fraction was less than 35 per cent. Of the 30
      patients, 27 (90%) had pathologically abnormal gallbladders. Follow-up averaged
      over 1 year (13.2 mo), and relief of symptoms occurred in 28 (94%). The authors
      conclude that in appropriately selected patients with symptoms of biliary colic
      (typical or atypical) and no evidence of cholelithiasis, a cholecystokinin
      stimulated cholescintigram is a significant help in predicting not only which
      patients have gallbladder disease, but also how likely cholecystectomy is to
      result in an improvement in their symptoms.

PMID- 8489093
TI  - Anatomic variance in the cholecystic blood supply: a case report.
AB  - The cystic artery is known to arise from many possible origins; with the right
      hepatic artery is the most common. Other origins of the cystic artery include the
      left hepatic artery, the common hepatic artery, and the superior mesenteric
      artery. In addition to the variability in origin of the cystic artery, its course
      can also follow diverse paths, often in close proximity to the common bile duct.
      This report presents a rare and, to our knowledge, previously unreported
      deviation of the cystic artery's origin and course that was encountered during
      cholecystectomy. This rare variant emphasizes the importance of a thorough
      knowledge of cystic arterial variations that often occur and may be encountered
      during both open and laparoscopic cholecystectomy.

PMID- 8489094
TI  - Pharmacologic hemostasis in laparoscopy: topical epinephrine facilitates
      cholecystectomy.
AB  - Bleeding may become a major impediment to accurate and safe dissection by
      laparoscopy. The traditional maneuvers of pressure, dumping, irrigation, and
      aspiration frequently applied during open procedures to maintain a clear field of
      dissection are cumbersome through laparoscopy. Several pharmacologic agents have
      been used topically or by local injection to stop bleeding or to prevent
      excessive blood loss during surgical procedures. They include calcium alginate,
      aluminum salts, silver nitrate, formalin, and coagulating agents like thrombin
      and collagens, all of which leave a layer of damaged tissue or foreign material
      on the surface. Epinephrine and vasopressin have been employed mostly by local
      injections. We report the use of topical epinephrine applied before and during
      the dissection of the cystic duct and artery area in the course of laparoscopic
      cholecystectomy. A 3/8-inch gauze sponge, impregnated with a 1:10,000 epinephrine
      solution, was used to blanch the tissues and to bluntly dissect the cystic duct
      and artery. It was also used to control minor bleeding in the gallbladder fossa.
      The prophylactic bleeding control with topical epinephrine proved to be an easy
      and safe maneuver, and greatly facilitated the dissection of the most critical
      areas during laparoscopic cholecystectomy. This technique may be applicable to
      laparoscopic dissection for other procedures.

PMID- 8489095
TI  - The role of endoscopic retrograde cholangio-pancreaticrogram in laparoscopic
      cholecystectomy.
AB  - Four hundred and fifty-nine patients were studied to evaluate the role of
      diagnostic and therapeutic endoscopic retrograde cholangio-pancreaticrogram
      (ERCP) in their management before laparoscopic cholecystectomy (LC) when
      choledocholithiasis is suspected. Using bilirubin, liver function tests (LFTs)
      (alkaline phosphatase, SGOT, SGPT) and findings on ultrasound of a dilated common
      bile duct (CBD), 37 patients (8.1%) were suspected of having concomitant common
      bile duct stones preoperatively. These patients were subjected to the following
      diagnostic and therapeutic procedures: 25 ERCPs, 20 laparoscopic cholangiograms,
      and three extracorporeal shock wave lithotripsies. Preoperative ERCP was done on
      19 patients, intraoperative ERCP-sphincterotomy was done on one patient, and
      postoperative ERCP-sphincterotomy was done on five patients. Fifteen laparoscopic
      cholangiograms were done as primary tests and five after preoperative ERCP.
      Sixteen patients (3.5%) had stones in their CBD. Four patients had their
      laparoscopic cholecystectomy cancelled, and one patient had laparoscopic common
      duct exploration that was converted to an open procedure. Three groups were
      identified: group I, patients with a high index of suspicion, included elevated
      bilirubin with elevation of all three LFTs, or normal bilirubin with elevation of
      all three LFTs with or without dilated CBD. Seventy-five per cent of this group
      had CBD stones. Group II, patients with a low index of suspicion, included normal
      bilirubin and normal CBD by ultrasound with elevation of the alkaline phosphatase
      alone or elevation of two of the three LFTs. Six per cent of this group had CBD
      stones. Group III, patients with no index of suspicion, were patients with normal
      preoperative laboratory test results and CBD. Two patients (0.47%) in this group
      had elevated LFTs postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489096
TI  - Two pitfalls of laparoscopic balloon cholangiography: recognition and correction.
AB  - The balloon cholangiocater has become popular for laparoscopic intraoperative
      cholangiography. Two pitfalls of this instrument include apparent common bile
      duct injury and pseudo-Mirizzi anatomy. These pitfalls are illustrated, and their
      correction is discussed.

PMID- 8489097
TI  - Gastric schwannoma. Clinical and pathologic considerations.
AB  - Solitary gastric schwannomas are rare clinical entities. Presented are three
      cases encountered in a single hospital in a 4.5-year period. Solitary gastric
      schwannomas represent a small percentage of schwannomas and a small percentage of
      gastric tumors. These tumors are usually asymptomatic and may present as upper
      gastrointestinal bleeding or as mass lesions. Upper endoscopy is important in the
      initial evaluation of these patients. Pathologic diagnosis is based on features
      of palisading nuclei, spindle-cell morphology, and hyalinized vessels.
      Immunohistochemical stains and electron microscopy may be helpful for diagnosis.
      Complete excision of the tumor is adequate treatment. The risks of coexistent
      malignancies have not been stressed, but this association may be important;
      therefore, we recommend a diligent search for other tumors. Prognosis following
      treatment is good.

PMID- 8489098
TI  - Irrigation of the abdominal cavity in the treatment of experimentally induced
      microbial peritonitis: efficacy of ozonated saline.
AB  - Ozone is an oxidizing agent possessing potent in vitro microbicidal capacity.
      This study was designed to address the extent to which irrigation of the
      contaminated abdominal cavity using a saline solution primed with ozone is
      effective in reducing morbidity and mortality. Gelatin capsules containing
      different quantities of a premixed slurry of filtered human fecal material were
      implanted in the peritoneal cavities of a preliminary series of rats. Three
      inocula concentrations were selected for later experiments, based upon their
      ability to produce morbid consequences: (1) high (100% 1-day mortality), (2)
      medium (70% 3-day mortality, 100% abscess rate in survivors), and (3) low (100%
      10-day survival, 100% abscess rate). Fecal and abscess bacteriology were similar
      in all rats. The peritoneal cavities of 240 rats then underwent fecal-capsule
      implantation (three groups of 80 rats/inoculum concentration). At celiotomy 4
      hours later, equal numbers of rats from each group were randomly assigned to one
      of four protocols: (1) no irrigation, (2) normal saline irrigation, (3) saline
      cephalothin irrigation, and (4) ozonated saline irrigation. Each treatment lasted
      5 minutes, using 100 ml of irrigation fluid. Mortality was significantly reduced
      when, in lieu of no irrigation, any of the irrigation solutions were used.
      Additionally, ozonated saline statistically proved the most effective irrigating
      solution for reducing abscess formation in survivors.

PMID- 8489099
TI  - Implications of risk factors in necrotizing fasciitis.
AB  - The following risk factors, previously associated with necrotizing fasciitis,
      were identified in 25 consecutive patients: diabetes mellitus, intravenous drug
      abuse, age greater than 50, hypertension, and malnutrition/obesity. Additional
      data recorded included the duration of illness to the time of the first operative
      procedure, the type of procedure performed, the anatomic location of the
      infection, the etiology, culture reports, and leukocyte counts. The goal of this
      study was to determine whether the number of risk factors present in a patient
      was predictive of mortality. Six patients (24%) died and 19 patients survived.
      The nonsurvivors exhibited a significantly higher percentage of diabetes
      mellitus, 83 per cent versus 37 per cent (P = 0.047). Fifteen of 19 survivors
      (79%) and only one of six nonsurvivors (17%) had fewer than three risk factors (P
      = 0.006). In conclusion, more than three previously identified risk factors
      present in patients with necrotizing fasciitis were found to be predictive of a
      mortality rate of 50 per cent. The mainstay of treatment remains aggressive
      surgical intervention, broad-spectrum antibiotics, and nutrition support.

PMID- 8489100
TI  - A critical analysis of adjuvant techniques used to assess bowel viability in
      acute mesenteric ischemia.
AB  - Delayed revascularization and inaccurate assessment of bowel viability in acute
      mesenteric ischemia can be catastrophic. We reviewed the outcome of three popular
      adjuvant techniques used to evaluate bowel viability in all 16 patients who had
      second-look abdominal explorations following revascularization for acute
      mesenteric ischemia from 1984 to 1989. Each adjuvant technique was reviewed
      separately and compared with the unequivocal end points of viable or nonviable
      bowel. The sensitivity (percentage of nonviable bowel correctly identified),
      specificity (percentage of viable bowel identified), predictive value (percentage
      of bowel identified as "nonviable" that proved to be so), and overall accuracy
      (percentage of correct evaluations) were determined for each method. The overall
      accuracy of clinical judgment, fluorescein fluorescence, and Doppler was 50 per
      cent, 56 per cent, and 0 per cent, respectively. Based on this critical review,
      we recommend routine second-look explorations in patients with acute mesenteric
      ischemia to reassess bowel that has been predicted to be viable or to resect
      bowel that has progressed to infarction.

PMID- 8489101
TI  - Risk of complication in perforated duodenal ulcer operations according to the
      surgical technique employed.
AB  - We prospectively analyzed a homogeneous group of 65 patients with perforated
      duodenal ulcer whose medical condition (no perioperative shock, no associated
      disease, underwent laparotomy within 12 hours after perforation, and an APACHE II
      score below 11) would have little effect on the outcome of surgery to study the
      influence of the surgical procedure (suture closure, vagotomy, or gastrectomy) on
      the morbidity and mortality rate. Thirty-three patients (51%) underwent vagotomy,
      25 (38%) simple suture closure, and seven (11%) gastrectomy. Five patients (8%)
      suffered postoperative complications, two (3%) required further operation, and
      one (1.5%) died of pulmonary sepsis. Statistical analyses revealed that
      "vagotomy" presented significantly better results than did "simple suture" and
      "gastrectomy" that had similar results. The type of surgery, however, was not a
      significant risk factor in predicting complications in this sample. This study
      points out the need to stratify the perforated duodenal ulcer patients for
      accurate investigations. It also shows that definitive operations (gastrectomy or
      vagotomy) do not increase surgical risk in this group of patients, and,
      considering the poorer results with simple suture closure compared to vagotomy,
      the latter is an attractive option because it also treats the underlying ulcer
      disease.

PMID- 8489102
TI  - Delayed presentation of an inflammatory polyp following colonic ischemia.
AB  - Inflammatory polyps are usually associated with inflammatory bowel disease. The
      majority of these lesions are asymptomatic, however, they may be a source of
      obstruction or hemorrhage. These polyps represent re-epithelialization of the
      damaged colonic mucosa. Although inflammatory polyps have been associated with
      the acute phase of ischemic colitis, there has been only one report of delayed
      presentation of a symptomatic inflammatory polyp following ischemic injury to the
      colon. We present the second such report and a review of the literature.

PMID- 8489103
TI  - Perforated gastric and duodenal ulcer: an analysis of prognostic factors.
AB  - A review of patients treated operatively for perforated ulcer was undertaken to
      determine factors that independently predict mortality and morbidity. From 1980
      to 1989 84 patients were treated with operative mortality and morbidity rates of
      18 and 37 per cent, respectively. Patients with gastric ulcer were significantly
      older and were more likely to have concomitant medical problems, to use steroids,
      and be hospitalized at time of their perforation. They also had a higher
      perioperative mortality rate when compared to patients with gastroduodenal ulcers
      (P < 0.05 for each). Patients treated with definitive operation (n = 51) had a
      significantly lower recurrent ulcer rate when compared to an equivalent group
      treated with simple closure (n = 33) (mean follow-up, 47 months). Multivariate
      analysis confirmed a patient's likelihood of complication or death could be
      predicted using three variables (P < 0.03); age greater than 42 years,
      hospitalization at time of perforation, concomitant medical illness. While the
      relative distribution of these three factors in patients with gastric versus
      peptic ulcers appears to account for the difference in outcome between these two
      groups, the distribution of these factors between patients treated with patch
      closure and definitive operation was not significantly different. Patient outcome
      from operation for perforated ulcer is dependent on preoperative conditions and
      appears to be independent of surgical procedure performed. There was no benefit
      to simple closure of a perforated ulcer. Definitive procedures of perforated
      ulcers are associated with lower ulcer recurrence and therefore are advocated to
      treat perforation.

PMID- 8489104
TI  - Laparoscopic reduction of acute gastric volvulus.
AB  - The traditional surgical treatment of gastric volvulus involves upper abdominal
      laparotomy with gastric detorsion, fixation, and, when present, repair of
      associated diaphragmatic hernia. We describe a case of organoaxial gastric
      volvulus associated with a paraesophageal hernia in a poor risk patient, which
      was successfully treated with laparoscopic detorsion and percutaneous endoscopic
      gastropexy. This approach avoided the morbidity of a laparotomy and allowed the
      rapid recovery of gastric function.

PMID- 8489105
TI  - Abusive scald burns in infants and children: a prospective study.
AB  - Between July 1, 1987 and June 30, 1990, 30 consecutive deliberately scalded
      children were studied prospectively. Purposes of the study were to characterize
      the scald-abused child and address the management problems specific to this
      group. Mean age was 22.5 months. Many had preburn growth retardation. Mean burn
      size was 18.1 per cent of the total body surface area and 37 per cent required a
      surgical procedure for their scald. All 30 children had burns on the buttocks.
      Four (13.3%) had other injuries. Eighty per cent of patients had at least one
      complication. In 30 per cent, diarrhea complicated nutrition support, wound, or
      autograft care. Four (13.3%) patients with a mean burn size of 32.3 per cent of
      the total body surface area, diarrhea, and burns involving the buttocks,
      perineum, and external genitalia died of burn wound sepsis; three of these had
      Gram-positive bacteremia (Staphylococcus aureus and enterococcus). Burn wounds
      exposed to the fecal stream (buttocks) should be examined carefully and
      frequently for signs of infection, particularly in those patients with diarrhea.

PMID- 8489106
TI  - A clinical and immunologic evaluation of women with silicone breast implants and
      symptoms of rheumatic disease.
AB  - OBJECTIVE: To describe the clinical and serologic features of women with silicone
      breast implants who were referred for symptoms of rheumatic disease. DESIGN: A
      case series. SETTING: University and private rheumatology practices. PATIENTS: A
      total of 156 women with silicone breast implants and rheumatic disease
      complaints. Controls for the serologic studies included women with silicone
      implants and no rheumatic symptoms (n = 12) and women with fibromyalgia without
      silicone implants (n = 174). MEASUREMENTS: Complete physical examination and
      testing for immunoglobulins; complement; C-reactive protein; rheumatoid factor;
      and autoantibodies by indirect immunofluorescence, immunodiffusion, and Western
      blot. RESULTS: Three subgroups of patients were defined based on clinical and
      laboratory findings: joint and muscle pain (n = 95), joint swelling (n = 32), and
      connective tissue disease (n = 29). Most women had normal immunologic studies.
      The patients with joint swelling had mild, asymmetric, rheumatoid-factor-negative
      synovitis that did not meet American College of Rheumatology criteria for
      rheumatoid arthritis. Fourteen patients had a scleroderma-like illness and anti
      centromere or anti-PM-Sci antibodies by Western blot. Ten patients had a positive
      Western blot for BB' polypeptide, a small nuclear ribonucleoprotein (snRNP), but
      did not meet criteria for systemic lupus erythematosus. No autoantibodies to
      known disease-related polypeptides were detected on Western blot in the control
      groups. CONCLUSION: Most women with silicone implants and rheumatic complaints
      had normal results of serologic tests and nonspecific symptoms, suggesting no
      serious connective tissue disease. However, a subset of women had clinical signs
      and serologic tests that were unusual even for referred patients. These
      observations suggest, but cannot establish, that some women with silicone breast
      implants may develop atypical immunologic reactions.

PMID- 8489107
TI  - High-dose weekly intravenous immunoglobulin to prevent infections in patients
      undergoing autologous bone marrow transplantation or severe myelosuppressive
      therapy. A study of the American Bone Marrow Transplant Group.
AB  - OBJECTIVE: To determine whether intravenous immunoglobulin (IVIG) prevents severe
      infections during autologous bone marrow transplantation or equivalent high-dose
      myelosuppressive therapy. DESIGN: Randomized, stratified, nonblinded study.
      SETTING: Three tertiary care university hospitals. PATIENTS: One hundred seventy
      patients entered the study; 82 received IVIG and 88 were untreated controls. The
      study groups were similar for parameters capable of influencing the likelihood of
      infection. INTERVENTIONS: Intravenous immunoglobulin was given weekly at a dose
      of 500 mg/kg body weight from the initiation of cytotoxic therapy to the
      resolution of neutropenia. MEASUREMENTS: The development of bloodstream or other
      clinically proven infection, platelet use, and the development of alloimmunity to
      platelet transfusion. RESULTS: Clinical infection, bacteremia, and fungemia
      occurred in 43%, 35%, and 6% of the IVIG-treated patients and in 44%, 34%, and 9%
      of the control patients. Gram-positive bacteremia and gram-negative bacteremia
      occurred in 28% and 11% of the IVIG group and in 23% and 13% of the control
      group. Death due to infection occurred in 4.9% of IVIG recipients and in 2.3% of
      controls. None of these observations was statistically significant (P > 0.2).
      Survival to hospital discharge was achieved in 86.6% of the IVIG group and in
      96.6% of the control group. The survival difference (10%; 95% CI, 1.7% to 18.3%;
      P = 0.02) was due to a higher incidence of regimen-related toxic death in the
      IVIG-treated group. CONCLUSIONS: The use of IVIG did not prevent infection. Fewer
      deaths occurred among controls due to a higher incidence of fatal hepatic veno
      occlusive disease in patients receiving IVIG.

PMID- 8489108
TI  - Vagal cardiovascular reflexes in young persons with syncope.
AB  - OBJECTIVE: To study the neurocardiologic reflexes in young persons who have
      fainted under conditions of emotional stress. DESIGN: Case-control study.
      SETTING: Clinical neurophysiology laboratory in Haifa, Israel. PATIENTS: Sixty
      persons (41 women and 19 men), 15 to 17 years old, who were referred for study
      because of syncope related to an emotionally distressing event. Forty aged
      matched, healthy volunteers drawn from the same population served as controls.
      MEASUREMENTS: Resting electrocardiogram, inspiratory-expiratory difference in
      heart rate during deep breathing, heart rate response to the Valsalva maneuver,
      and blood pressure during motionless standing for 5 minutes. RESULTS: Although
      individual results were within widely accepted limits of normal, patients with
      syncope as a group had higher vagal autonomic tone than did controls. This
      manifested as a slower heart rate at rest (mean, 67.8 beats/min compared with
      73.2 beats/min; P = 0.005), a higher inspiratory-expiratory difference in heart
      rate (mean, 44.1 beats/min compared with 37.9 beats/min; P = 0.001), and a higher
      Valsalva ratio (1.91 compared with 1.72; P < 0.0001). No significant difference
      was found in the PR and QTc (QT interval corrected for rate) intervals of the
      electrocardiogram or in the blood pressure response to standing. CONCLUSION: Many
      young persons who faint under conditions of emotional distress do so because a
      relatively high vagal tone predisposes them to the cardioinhibitory component of
      the syncope. Age-related physiologic reduction in vagal cardiac responses may
      explain the lower incidence of this type of syncope with increasing age.

PMID- 8489109
TI  - Serologic evidence of previous Campylobacter jejuni infection in patients with
      the Guillain-Barre syndrome.
AB  - OBJECTIVE: To determine if patients with the Guillain-Barre syndrome are likely
      to have had Campylobacter jejuni infection before onset of neurologic symptoms.
      DESIGN: A case-control study. SETTING: Several university medical centers.
      PATIENTS: Case patients met clinical criteria for the Guillain-Barre syndrome
      between 1983 and 1990 and had a serum sample collected and frozen within 3 weeks
      after onset of neurologic symptoms (n = 118). Disease controls were patients with
      other neurologic illnesses (n = 56); healthy controls were hospital employees or
      healthy family members of patients (n = 47). MEASUREMENTS: Serum IgA, IgG, and
      IgM antibodies to C. jejuni were determined by enzyme-linked immunosorbent
      assays. Assays were done in a blinded manner. RESULTS: Optical density ratios >
      or = 2 in two or more immunoglobulin classes were seen in 43 (36%) of patients
      with the Guillain-Barre syndrome and in 10 (10%) of controls (odds ratio, 5.3;
      95% CI, 2.4 to 12.5; P < 0.001). Increasing the optical density ratio or the
      number of immunoglobulin classes necessary to yield a positive result increased
      the strength of the association. The number of patients with the Guillain-Barre
      syndrome who had positive serologic responses was greatest from September to
      November (P = 0.02). Male patients were three times more likely to have serologic
      evidence of C. jejuni infection (P = 0.009); the proportion of patients with the
      syndrome who had a positive serologic response increased with age. CONCLUSIONS:
      Patients with the Guillain-Barre syndrome are more likely than controls to have
      serologic evidence of C. jejuni infection in the weeks before onset of neurologic
      symptoms. Campylobacter jejuni may play a role in the initiation of the Guillain
      Barre syndrome in many patients.

PMID- 8489110
TI  - Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the
      literature.
AB  - PURPOSE: To evaluate the possibility that fibrinogen represents a cardiovascular
      risk factor. DATA IDENTIFICATION: A computerized literature search (1980 to 1992)
      identified all published epidemiologic studies on fibrinogen and cardiovascular
      disease. Clinical and basic research data were found by separate searches.
      References of all papers thus obtained were studied and relevant papers included.
      STUDY SELECTION: Six prospective epidemiologic studies were included in a meta
      analysis (one study was excluded because the study population was non
      representative). Clinical papers were reviewed separately for other evidence of
      causation. DATA EXTRACTION: The correlation of fibrinogen levels on the
      subsequent incidence of myocardial infarction, stroke, and peripheral arterial
      occlusive disease was assessed and the causality of the association was analyzed.
      Calculations were made to examine fibrinogen level (in tertiles) versus
      cardiovascular risk. Odds ratios of high versus low tertile were computed.
      RESULTS OF DATA ANALYSIS: All prospective studies showed that fibrinogen was
      associated with subsequent myocardial infarction or stroke. A total of 92,147
      person-years was covered by these investigations. Odds ratios varied between 1.8
      (95% CI, 1.2 to 2.5) in the Framingham and 4.1 (CI, 2.3 to 6.9) in the GRIPS
      study, with a summary odds ratio of 2.3 (CI, 1.9 to 2.8). Associations existed
      between fibrinogen and other cardiovascular risk factors, but after multivariate
      analysis, only the association between fibrinogen and cardiovascular events
      remained. The majority of the preconditions for causality were fulfilled,
      indicating that fibrinogen is pathophysiologically related to cardiovascular
      events. CONCLUSIONS: Fibrinogen can be considered a major cardiovascular risk
      factor. Future studies of cardiovascular morbidity and death should include this
      variable.

PMID- 8489111
TI  - Cognitive behavioral techniques for hypertension: are they effective?
AB  - PURPOSE: To assess by analysis of published controlled trials the efficacy of
      cognitive behavioral therapies (such as biofeedback, relaxation, meditation) for
      essential hypertension. DATA IDENTIFICATION: Randomized controlled trials
      published in the English language between 1970 and 1991 identified from the
      MEDLINE database and bibliographic references from these articles. STUDY
      SELECTION: Limited to studies involving randomized assignment to a treatment
      group consisting of one or more cognitive behavioral interventions or a
      concurrent control group consisting of no therapy, a waiting list, regular
      monitoring, or placebo intervention. RESULTS OF DATA SYNTHESIS: Although we
      identified more than 800 published works, only 26 met entry criteria. We
      identified a number of methodologic short-comings, including small sample size,
      inconsistencies regarding baseline blood pressure determinations and types of
      control groups, and the possibility of confounding by multiple noncognitive
      cointerventions (diet, exercise) and expectancy (the placebo effect). In meta
      analyses involving 1264 patients, differences in mean blood pressure reduction
      varied according to the duration of baseline blood pressure measurements and type
      of control groups studied. In 16 comparisons involving baseline periods of more
      than 1 day, with patients (n = 368) assigned to either a cognitive therapy or a
      placebo intervention (sham biofeedback, "pseudo-meditation"), systolic and
      diastolic blood pressures decreased by 2.8 mm Hg (95% CI, -0.8 to 6.4) and 1.3 mm
      Hg (CI, -1.3 to 3.8), respectively. These changes were neither statistically nor
      clinically significant. CONCLUSION: Cognitive interventions for essential
      hypertension are superior to no therapy but not superior to credible sham
      techniques or to self-monitoring alone. The literature on this subject is limited
      by a variety of methodologic inadequacies. No single cognitive behavioral
      technique appears to be more effective than any other.

PMID- 8489113
TI  - The next patient.

PMID- 8489112
TI  - Making "connexions": enhancing the therapeutic potential of patient-clinician
      relationships.
AB  - Healers must try to understand what the illness means to the patient and create a
      therapeutic sense of connection in the patient-clinician relationship. A
      favorable climate for "connexional" experiences can be created through the use of
      various interviewing techniques. Attending to rapport, silencing internal talk,
      accessing unconscious processes, and communicating understanding can help
      clinicians enhance their sensitivity to the subtle clues on which issues of
      meaning and connection often depend. Several risks are associated with the
      establishment of closer patient-clinician relationships, including dependence and
      power issues, sexual attraction, and deeper exposure of the clinician to the
      patient's pain. Prepared with an awareness of these risks and techniques to
      address them, clinicians are encouraged to deepen their level of dialogue with
      patients, to compare their experiences with those of other clinicians, and to
      thereby develop a more systematic understanding of therapeutic relationships.

PMID- 8489115
TI  - Cosmetic surgical procedures and connective tissue disease: the Cleopatra
      syndrome revisited.

PMID- 8489114
TI  - Is antiretroviral treatment after percutaneous HIV exposure justified?

PMID- 8489116
TI  - Postoperative hyponatremia in menstruant women.

PMID- 8489117
TI  - Postoperative hyponatremia in menstruant women.

PMID- 8489118
TI  - Postoperative hyponatremia in menstruant women.

PMID- 8489119
TI  - Antibody response to Blastocystis hominis infections.

PMID- 8489120
TI  - Anticardiolipin antibodies and hypercoagulability.

PMID- 8489121
TI  - Cyclosporine for thrombotic thrombocytopenic purpura.

PMID- 8489122
TI  - Changing over-the-counter drugs while retaining the brand name.

PMID- 8489123
TI  - Call us principal physicians.

PMID- 8489124
TI  - Dietary cholesterol and plasma lipoproteins.

PMID- 8489125
TI  - Salt and hypertension: water-sodium handling in essential hypertension.
AB  - This paper describes sodium handling in the kidney and the significance and
      mechanisms of its effects upon essential hypertension. In patients with low renin
      essential hypertension, plasma and urinary norepinephrine levels, plasma renin
      activity and fractional excretion of sodium were significantly lower, while
      plasma volume, extracellular fluid volume and exchangeable sodium were higher
      than in normal renin essential hypertension. The suppression of some renal
      depressor-natriuretic systems, the dopaminergic, kallikrein-kinin and
      prostaglandin E2 systems may contribute to the retention of sodium-water in these
      patients, because these depressor systems were observed to be greatly suppressed
      in essential hypertension, especially in the low renin group. The reduction of
      conversion from L-dopa to dopamine by dopa-decarboxylase in the proximal tubules
      was suggested from our clearance studies as the mechanism of the suppression of
      renal dopaminergic activity. Moreover, renal dopaminergic activity was already
      suppressed at the prehypertensive stage, possibly through the inhibition of renal
      dopa-decarboxylase activity. Thus, it appears that the suppression of renal
      depressor-natriuretic systems play an important role in the pathogenesis of
      essential hypertension through the retention of sodium and body fluid volume.

PMID- 8489126
TI  - The interaction of dietary cholesterol and specific fatty acids in the regulation
      of LDL receptor activity and plasma LDL-cholesterol concentrations.
AB  - From these brief considerations, it is clear that the steady-state LDL
      cholesterol concentration is determined in a powerful way by the interaction of
      dietary cholesterol and specific fatty acids. There appear to be only a few
      saturated fatty acids and an even lesser number of unsaturated fatty acids that
      significantly interact with cholesterol in the liver cell to alter hepatic LDL
      receptor activity. These effects are uniformly seen in most experimental animals
      and in humans under circumstances where the experiments are properly designed.
      Future work is urgently needed to define the metabolic effects of the more
      unusual fatty acids (e.g., the trans fatty acid) and the more intimate details of
      how these substances regulate LDL receptor activity in the cell. It is also of
      considerable importance to extend these studies to the members of the same
      species that exhibit variable responses to these same dietary lipids. It is now
      clear that the magnitude of these specific responses to dietary cholesterol and
      specific fatty acids varies in different individuals with different genetic
      backgrounds from the same species. Elucidating the reasons for this variability
      is another area of research of considerable importance to human biology.

PMID- 8489127
TI  - Dietary salt and blood pressure.

PMID- 8489128
TI  - Metabolic determinants of low HDL-C levels.

PMID- 8489129
TI  - Hypo- and hyperresponse of serum cholesterol level and low density lipoprotein
      production and degradation to dietary cholesterol in man.
AB  - Serum cholesterol in man rises when cholesterol intake increases, but the extent
      of the elevation varies between subjects. Part of the variation between subjects
      is spurious and not reproducible; it is caused by random diet-independent
      fluctuations of serum lipid levels. Part is due to consistent metabolic
      differences between subjects. We have earlier found that responsiveness was
      associated with higher initial total and HDL cholesterol, lower habitual
      cholesterol consumption, and lower body mass index, and unrelated to gender, age,
      or apo E phenotype. We have now investigated the metabolic basis of variability
      by measuring turnover rates of low density lipoprotein (LDL) apolipoprotein B
      (apo B) on a low-cholesterol diet (140 mg/day) and a high-cholesterol diet (900
      mg/day) in 8 volunteers with well-defined differences in the responsiveness of
      their serum cholesterol to diet. Autologous 125I-LDL was injected on day 23 of
      each diet period. Its fractional catabolic rate (FCR) was estimated from the
      ratio of 125I in urine over that in plasma, seven days after injection. FCR (mean
      +/- SD) increased from 0.24 +/- 0.02 pools/day on the low- to 0.31 +/- 0.20 on
      the high-cholesterol diet. LDL-apo B concentration rose from 49 +/- 13 to 63 +/-
      12 mg/dl, and LDL-apo B production rate, calculated as FCR x concentration/body
      weight, from 4.8 +/- 1.2 to 8.0 +/- 1.4 mg/kg/day. The individual rise in
      production rate was significantly correlated with the rise in the serum
      concentration of LDL-apo B (r = 0.90) or LDL-cholesterol (r = 0.75), and also
      with the rise in total serum cholesterol measured in these same subjects in
      similar experiments 3-4 years earlier (r = 0.74). Degradation of LDL by freshly
      isolated blood mononuclear cells and by mononuclear cells incubated for 72 h in
      lipoprotein-deficient medium (derepressed cells) was measured on both diets in
      these and in additional volunteers. The rate of degradation (mean +/- SD) of
      standard human LDL by fresh cells was 336 +/- 166 ng LDL protein/mg cell protein
      per 8 h on the low-cholesterol diet, and decreased by 147 +/- 180 ng/mg per 8 h
      or 44% on the high-cholesterol diet (n = 23, p < 0.01). The catabolic activity of
      derepressed cells obtained when subjects were on the low-cholesterol diet was
      negatively related to the LDL cholesterol response (r = -0.57, n = 18, p < 0.05),
      and to the total cholesterol response in earlier experiments (r = -0.45, n = 18,
      p < 0.10).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8489130
TI  - Dietary protein and experimental atherosclerosis.

PMID- 8489131
TI  - Soybean protein diet and plasma cholesterol: from therapy to molecular
      mechanisms.

PMID- 8489132
TI  - Anti-atherogenicity of soybean protein.

PMID- 8489133
TI  - Dietary protein and lipid metabolism: a multifunctional effect.

PMID- 8489134
TI  - The nutrient balance hypothesis: peptides, sympathetic activity, and food intake.
AB  - Food intake can be increased or decreased after either central or peripheral
      administration of peptides. Galanin, neuropeptide Y, opioid peptides, growth
      hormone releasing hormone and desacetyl-MSH increase food intake whereas insulin,
      glucagon, cholecystokinin, anorectin, corticotropin releasing hormone,
      neurotensin, bombesin, enterostatin, cyclo-his-pro and thyrotropin-releasing
      hormone reduce food intake. A number of these peptides also affect the activity
      of the sympathetic nervous system. The peptides which have been tested have a
      reciprocal effect on food intake and sympathetic activity. Opioids, NPY and GHRH,
      which increase food intake, decrease sympathetic activity. Conversely, peptides
      which reduce food intake, increase sympathetic activity, with glucagon,
      cholecystokinin, corticotropin releasing hormone, calcitonin, neurotensin and
      bombesin being examples, Several of these peptides also affect the intake of
      specific nutrients. Insulin reduces food intake in animals fed a high
      carbohydrate diet, but not when fed a high fat diet. Neuropeptide Y increases
      carbohydrate intake. Galanin and opioid peptides increase fat intake.
      Enterostatin and cyclo-His-Pro, on the other hand reduce fat intake. Glucagon
      decreases protein intake. The effect of peptides on the intake of specific
      nutrients suggests that peptides may work in part by modulating basic feeding
      mechanisms to lead to the selection of specific nutrients from the diet. This
      hypothesis might be called a nutrient specific model of peptide-induced food
      intake.

PMID- 8489135
TI  - Androgens, the metabolic syndrome, and non-insulin-dependent diabetes mellitus.

PMID- 8489136
TI  - Genetic differences in adipose tissue metabolism and regulation.

PMID- 8489137
TI  - Lipid peroxides as the initiating factor of atherosclerosis.

PMID- 8489138
TI  - Pathophysiology and pathogenesis of visceral fat obesity.

PMID- 8489139
TI  - Changes of plasma lipids and biochemical markers for coronary artery disease in
      Korea.
AB  - The average Korean diet is low in total fat, cholesterol, animal protein, and
      sugar, and high in total carbohydrate, and adequate in total protein. More foods
      are derived from vegetables than in any comparable Western countries. The
      nutritional status of Korean is good without evidence of any gross nutritional
      deficiency. The leading causes of death, currently, form a unique ranking of
      malignancies, accidents, and cerebrovascular diseases. Korean diet may account
      for the strikingly low incidence of heart disease. Studying the relationship
      between diet and these diseases may greatly aid our understanding of their
      pathogenesis and lead to improved prevention and treatment. Current changes in
      the Korean diet are a decreasing proportion of carbohydrates with increasing
      proportions of fat and animal protein and an increased content of cholesterol.
      The ratio of polyunsaturated to saturated fatty acid of Korean diet seems to fall
      in desirable range. The changes in plasma cholesterol levels and CAD mortality
      among Korean in the past 20 years seem to be a reflection of changes in diet.
      Similar changes could be seen in the Japanese population. In Korea, the incidence
      of CAD is still low compared with that in western countries. Recently, a slightly
      increased incidence of CAD has been observed in Korea. Thus, establishment of
      reliable biochemical markers and their cut-off values are needed for the Korean
      population. Several methods including TC, TG, HDL-C, LDL-C, HDL-C/TC, LDL-C/TC,
      LDL-C/HDL-C, Apo A-I, Apo B and Apo A-I/B for CAD were examined and found that
      Apo A-I/B ratio was a good biochemical marker for CAD in Korea. In the future,
      the Korean diet will probably continue to change. The changes are being
      influenced by economic development that have been emerging and growing stronger
      since 1980 and that will probably continue to be potent. The effect of these
      changes upon CAD is not clear at the present time. To detect a changing incidence
      of CAD and to evaluate the significance of diet will require continued close
      observation and use of more specific and sensitive methods. The Korean experience
      with diet and plasma lipids will be potentially valuable in appraising CAD of
      both developing and technically developed countries.

PMID- 8489140
TI  - Complexities of national recommendations for the dietary prevention of coronary
      heart disease.

PMID- 8489141
TI  - Age-related loss of bone mass and aortic/aortic valve calcification--reevaluation
      of recommended dietary allowance of calcium in the elderly.

PMID- 8489142
TI  - Trace elements in cardio-cerebrovascular diseases.

PMID- 8489143
TI  - Hypotensive effect of soy protein and its hydrolysate.

PMID- 8489144
TI  - Serum lipids and nutritional intake in a Japanese general population: the
      Hisayama Study.

PMID- 8489145
TI  - The relationship between coronary artery diseases and magnesium deficiency, with
      regard to coronary artery spasms.

PMID- 8489146
TI  - Effects of sesamin on serum lipoprotein metabolism in normocholesterolemic and
      hypercholesterolemic stroke-prone SHR.

PMID- 8489147
TI  - Trace elements and ischemic cerebral vascular disease.

PMID- 8489148
TI  - Glucose tolerance, obesity, and hypertension: epidemiological study in Hokkaido,
      Japan.

PMID- 8489149
TI  - Insulin sensitivity and renal sodium-water metabolism in obese normotensive
      subjects.

PMID- 8489150
TI  - Discovery of a new diet for patients with acute myocardial infarction: an Indian
      experiment on infarct survival.

PMID- 8489151
TI  - A fat meal test is useful to recognize the background of hyperlipidemia.

PMID- 8489152
TI  - A simple method for measuring urinary sodium and potassium excretion in field
      surveys and its application to epidemiological studies.

PMID- 8489153
TI  - Effect of soy protein on the excretion amount of fecal sterols in Jcl:Wistar
      rats.

PMID- 8489154
TI  - Ultrastructural and biochemical evidence of cardiac lipofuscinosis after short
      term intake of fish oil in rats.

PMID- 8489155
TI  - Eicosanoids and health.

PMID- 8489156
TI  - The influence of dietary n-3 fatty acids on plasma lipids and lipoproteins.
AB  - The body of epidemiologic data indicates that the incidence of cardiovascular
      disease is lower in populations whose habitual diet is rich in fish. It is
      unclear however to what extent this apparent protection is due to the intake of n
      3 fatty acids in sea food or to the fact that these subjects have generally been
      consuming lower amounts of saturated fatty acids in their diets. It is clear,
      however, that when the dietary intake of n-3 fatty acids is increased to 4-8
      g/day distinct metabolic effects are observed, including reductions in plasma
      triglycerides, effects on platelet function and coagulation factors and blood
      pressure. Larger intakes exert a more profound hypotriglyceridemic effect, and in
      patients with primary hypercholesterolemia daily intakes exceeding 10-12 g/day
      are effective in reducing plasma concentrations of LDL cholesterol. However, from
      a practical point of view, the lipid-modifying effects of supplemental dietary n
      3 fatty acids are most clearly observed in patients with hypertriglyceridemia and
      the major usefulness of dietary n-3 fatty acids is in the treatment of this
      patient population, particularly patients with severe hypertriglyceridemia or
      potentially those with Type III hyperlipoproteinemia. Further studies are needed
      to better define the potential utility of dietary n-3 fatty acids when used in
      combination with lipid-lowering drugs to reduce lipoprotein concentrations in
      patients with combined hyperlipoproteinemia or severe hypertriglyceridemia.

PMID- 8489157
TI  - The influence of docosahexaenoic acid loading on stroke-prone spontaneously
      hypertensive rats.

PMID- 8489158
TI  - Vegetarian diets, alcohol consumption, and hypertension.

PMID- 8489159
TI  - Hypertensive cerebrovascular diseases: importance of nutrition in pathogenesis
      and prevention.

PMID- 8489160
TI  - Particle repositioning maneuver for benign paroxysmal positional vertigo.
AB  - Benign paroxysmal positional vertigo is a common, most often self-limited,
      vestibular end organ disorder that in some cases may be quite disabling. Recent
      evidence suggests that some, if not most, cases result from free-floating
      posterior semicircular canal endolymph particles. We postulate that the particle
      repositioning maneuver displaces these particles from the posterior canal through
      the common crus into the utricle, where they no longer induce pathologic
      responses. Our report focuses on 38 consecutive patients treated with this simple
      bedside technique during a 10-month period. On follow-up, 26 patients (68.4%)
      were free of disease, 4 (10.5%) were significantly improved, 4(10.5%) remained
      unchanged, and 4(10.5%) were lost to follow-up. Of the 4 patients who remained
      unchanged, 2 underwent successful posterior semicircular canal occlusions. The
      direction of the nystagmus during the second stage of the maneuver appears
      important in predicting the efficacy, with reversal of nystagmus denoting a poor
      response. These findings provide additional insight into the pathophysiology of
      this disorder.

PMID- 8489161
TI  - Esophageal stricture following esophageal atresia repair: endoscopic assessment
      and dilation.
AB  - A retrospective review from 1981 to 1986 was made of 51 neonates who were treated
      for congenital esophageal atresia at the Royal Alexandra Hospital for Children,
      Sydney, Australia. Thirty of the 51 had primary repair and 15 (50%) developed
      esophageal stricture requiring one or more dilations. Stricture dilations were
      performed with open-tube rigid esophagoscopes, rigid telescopes, and Jackson
      dilators. The number of dilations performed until the patient was asymptomatic
      ranged from 1 to 12 (mean 4.5). The minimal follow-up time was 4 years. There was
      one esophageal perforation with full recovery following conservative management.
      One child died of septicemia caused by continued aspiration of unknown cause. A
      surprising finding, contrary to other reports, was the stricture formation did
      not appear to be related to the size of the "gap" found at the time of esophageal
      repair. Gastroesophageal reflux, however, was an important factor. We conclude
      that esophageal stricture following repair of tracheoesophageal atresia can be
      satisfactorily and relatively safely managed by direct vision antegrade
      endoscopic dilation using graduated dilators, although treatment may be prolonged
      and repeated. New esophagoscopes and dilators, in graduated sizes and designed
      for pediatric use, are recommended. The technique of esophageal dilation in
      infants is described in detail. Pediatric laryngobronchoesophagologists will
      become more involved in the care of infants born with esophageal atresia with or
      without tracheoesophageal fistula.

PMID- 8489162
TI  - Early diagnosis of otologic Wegener's granulomatosis using the serologic marker C
      ANCA.
AB  - Wegener's granulomatosis is a systemic vasculitis that may involve any organ
      system. Otologic manifestations are common, and can be the presenting complaint.
      In the past, diagnosis often necessitated the development of characteristic
      pulmonary or renal disease. The identification of a new serologic marker,
      cytoplasmic pattern antineutrophil cytoplasmic autoantibody (C-ANCA), allows for
      the early diagnosis of Wegener's granulomatosis and gives the patient the best
      chance for remission with cytotoxic therapy. We report two patients with
      Wegener's granulomatosis who presented with refractory otitis media, one of whom
      subsequently developed facial nerve paralysis, in which an early diagnosis was
      facilitated by the use of the C-ANCA test. Otologic manifestations of Wegener's
      granulomatosis and the basis of the C-ANCA test are discussed.

PMID- 8489163
TI  - Conversion deafness.
AB  - Conversion deafness is very rarely encountered among adults. This report will
      illustrate two cases of this somatoform disorder following different traumatic
      experiences. It emphasizes the difficulties in establishing the diagnosis and
      reviews various aspects of treatment.

PMID- 8489164
TI  - Composition of the otosclerotic stapes: electron microprobe analyses.
AB  - For the first time, otosclerotic stapes have been distinguished from unafflicted
      controls at a high level of significance by using a spectrum of elements measured
      by energy-dispersive spectrometer-electron probe microanalyses (EDS/EPMA).
      Discriminant analyses of the maximum concentration of 13 elements measured at
      several sites within each of 32 stapes differentiated otosclerotic from
      unafflicted individuals well above the 95% confidence level. Eight of the 9
      control (unafflicted) and 21 of the 23 afflicted stapes were correctly
      classified. In descending order of contribution to the discriminant function, the
      elements are Zn > Cr > K > Ca > Si > Mn > Na > Al > Mg > P > Fe > S > Ti. Zinc
      and chromium account for much of the difference, but discriminant analyses
      excluding them still distinguish the two groups at the 95% confidence level.
      These results are consistent with previous reports of high levels of alkaline
      phosphatase, a zinc-containing enzyme, in afflicted stapes. But the broad
      spectrum of elements capable of distinguishing otosclerotic stapes warrants study
      of additional zinc-containing and other metal-containing or metal-activated
      moieties.

PMID- 8489165
TI  - Neuro-otologic abnormalities in myelopathy associated with human T-cell
      lymphotropic virus type 1.
AB  - Auditory testing (pure tone audiometry, auditory brain stem response), and
      vestibular tests (eye tracking test, optokinetic pattern test, and caloric test)
      were performed to define neuro-otologic abnormalities in myelopathy associated
      with human T-cell lymphotropic virus type 1. Of the eight patients tested, seven
      showed sensorineural hearing loss and one showed mixed hearing loss on pure tone
      audiometry. The auditory brain stem responses of five patients showed increases
      of the I-III and I-V interpeak latencies. Two patients showed fast superimposed
      saccadic movements on the smooth pursuit test, and one other patient showed canal
      paresis on the caloric test. These findings suggest both the presence of neuro
      otologic abnormality and involvement of the brain stem in myelopathy associated
      with human T-cell lymphotropic virus type 1.

PMID- 8489166
TI  - Comparison of half-band and full-band electrodes for intracochlear electrical
      stimulation.
AB  - It was hypothesized that intracochlear stimulating electrodes oriented toward the
      modiolus would require a lower stimulus current to elicit a threshold neural
      response than longitudinal band electrodes. Electrically evoked auditory brain
      stem responses (EABRs) and electrode impedances were recorded with full-band and
      oriented half-band scala tympani electrodes in anesthetized, deafened cats. To
      elicit a threshold EABR, the stimulus current required for stimulation through
      half-band electrodes oriented toward the modiolus was not significantly different
      from the current required for stimulation through full-band electrodes. The
      impedances of full-band electrodes were significantly lower than those of half
      band electrodes. Considering the significantly higher impedance and current
      density of half-band electrodes in comparison to full-band electrodes, as well as
      the critical orientation of half-band electrodes during implantation, we believe
      that full-band electrodes have advantages over half-band electrodes for scala
      tympani implantation.

PMID- 8489167
TI  - Immunohistochemical localization of a cytochrome P-450 isozyme in human nasal
      mucosa: age-related trends.
AB  - Immunoperoxidase staining with an antibody to cytochrome P-450 (NMa) was used to
      investigate the localization of this isozyme in the human nasal mucosa. Olfactory
      mucosa was identified by staining of olfactory receptor cells with an antibody to
      olfactory marker protein. Immunoreactivity to NMa was localized in sustentacular
      cells in the olfactory epithelium, and in Bowman's gland acinar cells and
      vascular endothelial cells in the lamina propria. In the respiratory mucosa,
      ciliated epithelial cells, as well as serous gland acinar cells and vascular
      endothelial cells in the lamina propria, were immunoreactive for this isozyme. An
      age-related decrement in the intensity and extent of immunoreactivity within
      these cells was noted in nasal tissue from patients 60 years of age and over when
      compared with that of patients under 60 years of age. These results identify
      sites of xenobiotic metabolism or activation in human nasal mucosa.

PMID- 8489168
TI  - Bilateral parotid duct fistula. Case report.
AB  - Parotid duct fistulas (PDFs) are rare and have various causes such as gunshot
      wounds and human and animal bites; they may also be congenital. We have not found
      previous publications on bilateral PDF. Our patient, although young, also had
      generalized pigmentation characteristic of aging and thick, dry, wrinkled skin,
      as well as pyoderma. Biochemical analysis was performed on discharge from the
      patient's face, and histopathologic and immunologic studies were done. The
      fistulas were treated by intraoral fistulization. Cephalosporins were given to
      the patient for 5 days postoperatively to treat the pyoderma.

PMID- 8489169
TI  - Effects of stellate ganglion stimulation on bilateral cochlear blood flow.
AB  - The effect of intraneural electrical stimulation of the stellate ganglion (SG) on
      bilateral cochlear blood flow (CBF) was investigated with laser-Doppler
      flowmetry. The SG of 15 anesthetized guinea pigs was exposed by a novel surgical
      approach and stimulated with a specially designed intraneural bipolar platinum
      iridium electrode. Bilateral CBF was continuously monitored. Stimulation of 0.25
      mA caused a detectable increase of the systemic blood pressure (BP) and a
      bilateral decrease of the cochlear vascular conductance (R, defined as the ratio
      CBF/BP). A stimulus of 0.5 mA elicited a statistically significant ipsilateral
      CBF (CBFi) decrease of 3.6% +/- 5.1% from the baseline and a contralateral CBF
      (CBFc) decrease of 3.1% +/- 5.5%. That no statistical difference was found
      between CBFi and CBFc indicates that a unilateral sympathetic stimulation of the
      SG can cause equal bilateral responses. These responses were accompanied by a
      significantly increased BP (8.7% +/- 5.2% of baseline) and consequently a greatly
      decreased R (12.2% +/- 6.5%) of the ipsilateral cochlea. Bilateral sections of
      the cervical sympathetic trunk below the level of the superior cervical ganglion
      did not alter the evoked changes in CBF, BP, and R. It is concluded that SG
      stimulation can decrease the conductivity of the cochlear vessels or the
      supplying vessels of the cochlea. Additionally, the SG nerve fibers that cause
      these effects do not pass through the superior cervical ganglion.

PMID- 8489170
TI  - Development of secretory elements in murine tubotympanum: lysozyme and
      lactoferrin immunohistochemistry.
AB  - Secretory activity, particularly of antibacterial agents such as lysozyme and
      lactoferrin, is an important aspect of the mucosal defense mechanism, and the
      development of these agents may have a direct bearing on the susceptibility of
      the ear to infection. In this study, the secretory cells of the murine tubal
      epithelium were first observed at gestational day 17. Although tubal glands began
      to develop on gestational day 18, their secretory activity was first shown on
      postnatal day 3. The number of secretory cells of the tubal epithelium increased
      rapidly immediately after birth, while that of the tubal glands showed a gradual
      increase from postnatal day 3. The epithelial secretory cells in the tubotympanum
      matured at birth, but the tubal glands matured gradually after birth. Lysozyme
      was first recognized in the epithelial secretory cells on postnatal day 1, while
      lactoferrin was first detected in the tubal glands on postnatal day 3. Both
      lysozyme and lactoferrin were co-localized in the serous cells of the tubal
      glands. The secretion of lysozyme and lactoferrin seemed to reflect the
      maturation of the secretory cells in the murine tubotympanum.

PMID- 8489171
TI  - Combined (external and internal) laryngopyocele.

PMID- 8489172
TI  - Osteoma arising from the stylohyoid chain and manifesting as a neck and
      oropharyngeal mass.

PMID- 8489173
TI  - Tall cell carcinoma of the thyroid gland.
AB  - Tall cell carcinoma of the thyroid gland is an aggressive variant of papillary
      carcinoma with a respectable 20% to 25% lethality. Its histologic features are
      characterized by a basal orientation of nuclei, abundant eosinophilic or
      oxyphilic cytoplasm, and a cellular height-width ratio greater than 2:1. These
      distinguish it from another aggressive variant, columnar cell carcinoma, which
      has a stratification of its nuclei and scant cellular cytoplasm.

PMID- 8489174
TI  - Superiority of the fasciocutaneous flap in reconstruction of sacral pressure
      sores.
AB  - The gluteal maximus muscle has been used in the treatment of sacral pressure
      sores since the 1970s. However, it is noted that the muscle portion of the
      transferred flap shows highly atrophic degeneration and the muscle itself is not
      suitable tissue for covering the pressure-bearing area. We have managed various
      fasciocutaneous flaps as the first choice for reconstruction of sacral pressure
      sores and obtained good results. The fasciocutaneous flap has an anatomical
      structure that resists physical stimulation or external pressure and an abundant
      blood supply via its fascial plexus. In addition, if we use a gluteal maximus
      myocutaneous flap at first, some fasciocutaneous flaps are compromised because of
      the design and blood supply. We suggest that the fasciocutaneous flap has the
      first priority and is superior to the gluteal maximus myocutaneous and muscle
      flaps in reconstruction of sacral pressure sores.

PMID- 8489175
TI  - A newly designed minigraft to achieve angularity and projection of the nasal tip:
      the asymmetrical bipyramidal graft.
AB  - A new systematization for onlay tip grafting is described, using a minigraft
      constructed from either irradiated, glutaraldehyde-processed bovine cartilage or
      soft-grade silicone blocks. The graft design consists of two pyramidal volumes
      amputated in the apex and carved with mild concave surfaces. The lateral profile
      of the graft is asymmetrical with an acute inclination in the front and a slight
      inclination in the back. The graft height ranges from 1.5 to 3.8 mm. With this
      type of implant, high tip projection with a natural appearance can be achieved
      easily. Since 1986, we have performed 39 tip implants (12 cartilage grafts and 27
      silicone grafts). Silicone graft fate has been excellent with no complications,
      whereas cartilage grafts underwent a 25% resorption rate. Thus, the current
      technique is now solely undertaken with silicone minigrafts. Main indications are
      primary tip plasty in normal-size noses with poor tip projection, and secondary
      noses. This technique is not recommended for simultaneous use with primary
      rhinoplasty. For more than 4 years, this technique has provided consistent
      results, being highly effective in achieving the objective of increasing tip
      projection.

PMID- 8489176
TI  - Futility of muscle flaps for self-inflicted wounds.
AB  - Unacceptable forms of self-mutilation usually are resistant to surgical
      intervention and have a basis in psychopathology. Establishing this diagnosis may
      be as difficult as is the treatment, frequently involving a prolonged process of
      exclusion of other known disease entities. Management of these chronic self
      inflicted wounds demands flexibility by the surgeon who must be aware of this
      possibility and willing to deviate from the normal approach to wound healing.
      Simplicity is of paramount importance. The use of vascularized tissues and, in
      particular, the sacrifice of scarce muscle flaps probably is unwarranted except
      as a last resort because these wounds nevertheless remain recalcitrant to
      permanent healing. Instead, a nonconfrontational approach with long-term
      psychotherapy should be a major part of the initial therapy with surgery
      considered only important in an adjunctive role.

PMID- 8489177
TI  - Surgical treatment of axillary osmidrosis.
AB  - Various types of surgical procedures have been developed for treatment of
      axillary hyperhidrosis and osmidrosis. However, Asian people tend to seek
      treatment for osmidrosis rather than hyperhidrosis. In this article, we report a
      new modified surgical method concerning axillary osmidrosis. At first we make
      four transverse parallel incisions; two incisions in the center are large
      (approximately 4 cm in length) and the lateral ones are small (approximately 1.5
      cm in length). Then, we do enough undermining from the four wound edges to make a
      wide subcutaneous tunnel, and the adipose tissue beneath the skin is removed with
      scissors through each incision. Finally, two pieces of Penrose drain are inserted
      through the small lateral incisions. With this method we have operated on 21
      patients in the past 3 years; 19 patients were female, and only 2 were male.
      Patients were followed for a minimum of 3 months and a maximum of 22 months, with
      an average follow-up of 7 months. In terms of results, 14 were good, 5 fair, and
      2 poor. Minor complications such as partial epidermal necrosis occurred in only 2
      patients, but healed with conservative treatment, and other complications such as
      hematoma formation or infection did not occur. In this article, we emphasize two
      merits of our procedure. One is that adding small incisions at both lateral
      margins makes it possible to perform the further excision of the apocrine glands.
      The other merit is that drainage from the small incisions is very effective. We
      believe this procedure is a viable option for treatment of axillary hyperhidrosis
      and osmidrosis.

PMID- 8489178
TI  - Immediate free tissue transfer for distal musculoskeletal neoplasms.
AB  - Sarcomas and other aggressive neoplasms of the extremities present particular
      challenges for limb salvage when the tumors are located distally in the arms or
      legs. These tumors require a large area of excision, yet there are no suitable
      options for local tissue coverage. In the past, amputation was often necessary
      due to the inability to adequately reconstruct the extremity. We performed
      immediate free tissue transfers on 10 patients with aggressive tumors in the
      forearm and lower leg. Eight patients had sarcomas, 1 had a melanoma, and 1 had a
      recurrent fibromatosis. Seven patients had rectus abdominis flaps, 1 had a
      latissimus dorsi flap, 1 had a groin flap, and 1 had an osteocutaneous flap from
      the iliac crest. Three patients had tendon transfers at the time of surgery. Four
      patients required radiation therapy after resection due to the high-grade nature
      of their neoplasms. The flaps tolerated the radiation well, with only 1 patient
      sustaining flap necrosis that required skin grafting. Average follow-up was 28
      months. All patients are alive and none had local recurrences of their tumors.
      All free flaps have survived and remained durable. There have been no late
      breakdowns of skin grafts, and all tendon transfers have functioned well.
      Immediate free tissue transfer provides an excellent method of reconstruction for
      distal tumors of the extremities.

PMID- 8489179
TI  - Walking track analysis: utilization of individual footprint parameters.
AB  - Functional assessment of rat sciatic, tibial, and peroneal nerve injuries was
      performed using walking track analysis. Individual walking print length (PL), toe
      spread (TS), and intermediate toe spread (ITS) values were measured up to 24
      weeks after specific nerve transection, with or without repair. Sciatic and
      tibial nerve manipulation initially affected all footprint measurements,
      consistent with loss of intrinsic and extrinsic motor function. After sciatic
      repair, TS demonstrated partial recovery without any substantial recovery in PL
      or ITS, compared with sciatic transection values. By contrast, after tibial
      repair, PL values recovered dramatically, between 16 and 24 weeks, to levels not
      significantly different from control subjects. This was not observed after tibial
      transection without repair. TS recovered partially, whereas ITS recovered to
      control levels by 20 weeks after tibial repair. Peroneal transection resulted in
      multiple contractures, rendering this group unmeasurable at 4 weeks. After
      peroneal repair, only the PL reflected significant loss of function at 2 weeks,
      recovering to control values by 8 weeks. Manual TS measurements in nonwalking
      rats did not reflect functional nerve regeneration. Thus, individual PL
      measurements alone can be used to characterize functional recovery after tibial
      and peroneal nerve injury, whereas TS reflected recovery after sciatic nerve
      injury.

PMID- 8489180
TI  - Augmentation of skin flap survival by selective intraarterial infusion of
      prostaglandin E1: experimental and clinical studies.
AB  - Prostaglandin E1 has been proven to be useful in the treatment of vascular
      diseases of the lower leg. Plastic surgeons have been aware of its usefulness in
      augmenting flap survival and have used it intraarterially or intravenously. We
      attempted to enhance the effect of prostaglandin E1 with heparin by local
      continuous intraarterial infusion of both drugs. First, we assessed the viability
      area of an experimental island flap model on rabbit abdomen, and confirmed the
      usefulness of this method. Next, we attempted to develop clinical cases using
      Seldinger's method. By this method, we were able to rescue the flaps with
      circulatory insufficiency and gain a larger survival area of an axial pattern
      flap.

PMID- 8489181
TI  - Reconstruction of a medial canthus defect with a myocutaneous flap.
AB  - Defects in the inner canthal area are generally repaired by full-thickness skin
      grafts, V-Y advancement flap, or frontal flap. Each of these techniques may give
      some problems in restoring the functional or aesthetic features of that region,
      or both. To avoid these inconveniences, we performed the reconstruction of the
      medial canthal area after tumor excision by using a myocutaneous rotation flap
      from the upper lid joined to a rotation flap from the lower lid and cheek. No
      scar resulted inside the aesthetic unit and a fine result was achieved from both
      the functional and the aesthetic point of view.

PMID- 8489182
TI  - Congenital bilateral intermaxillary bony fusion.
AB  - Congenital fusion of maxillary and mandibular alveolar margins is extremely rare.
      Bony fusion between the jaws is still more uncommon. Only eight patients with
      bony fusion have been described in the literature to date, of whom only three had
      bilateral bony fusion. We present here a patient with very extensive bilateral
      bony fusion of the jaws, who underwent surgery with excellent immediate
      postoperative results. Details of the surgical management of this rare and
      difficult problem in a neonate with poor general condition are described.

PMID- 8489183
TI  - Free lateral calcaneal flap.
AB  - Our cadaver dissection demonstrated that the lateral calcaneal artery is large
      enough for microsurgical anastomosis. Based on the finding, the lateral calcaneal
      flap was first successfully applied as a free flap that included the lesser
      saphenous vein and the sural nerve in the pedicle. This thin sensory flap,
      dispensing with main arterial damage, is indicated for the lesion of the
      posterior heel, plantar, and hand.

PMID- 8489184
TI  - Closure of myelomeningocele using skin from stillborn twin.
AB  - We report a case of homologous skin transplantation from a stillborn twin to the
      surviving twin for coverage of a myelomeningocele defect. Genetic studies were
      not available preoperatively, however, similar morphogenetic anomalies of the
      twins suggested monozygosity. Long-term follow-up revealed a well-healed graft.
      Cutaneous genetics and literature review of twin homologous skin transplantation
      are presented.

PMID- 8489185
TI  - A latissimus/scapula combined myo-osseous free flap based on the subscapular
      artery used for elbow reconstruction.
AB  - A myo-osseous free tissue transfer based on the subscapular artery provided elbow
      reconstruction after a shotgun injury. This reconstruction offers a durable and
      stable form of soft tissue and bone, preventing some arm function. The tailoring
      of the latissimus dorsi muscle and the modification of not dividing the teres
      major in the microvascular harvest offers donor site functional preservation.
      Although the dissection is more tedious, preservation of the teres major permits
      minimal donor morbidity, maintenance of function, and the ideal reconstruction of
      soft tissue and bony loss.

PMID- 8489186
TI  - Use of the temporal muscle flap in Barraquer-Simon's progressive lipodystrophy.

PMID- 8489188
TI  - The view from the bridge.

PMID- 8489187
TI  - A simple technique for harvesting standardized skin grafts in the rodent.
AB  - A simple technique for harvesting skin grafts of predetermined size, shape, and
      thickness in rodents is described. In this technique, the donor skin is
      immobilized and tensed by means of a tongue depressor, or similar template,
      inserted into the loose areolar tissue below the panniculus, stretching the
      overlying skin to permit easy dermatome harvesting of a skin graft.

PMID- 8489189
TI  - Re: Recombinant human platelet-derived growth factor-BB for the treatment of
      chronic pressure ulcers.

PMID- 8489190
TI  - Reconstruction of the lower extremity after grade III distal tibial injuries
      using combined microsurgical free tissue transfer and bone transport by
      distraction osteosynthesis.
AB  - Five patients each with grade IIIB or IIIC distal tibial injuries are presented.
      All patients were treated initially by multiple debridements and external
      fixation of the tibial fracture. After failure of the primary treatment, each
      patient underwent microsurgical free muscle transfer and bone transport of the
      proximal tibia to reconstruct the lower leg. Soft tissue loss ranged from 8 to 20
      cm. Segmental tibial loss ranged from 8 to 18 cm. Free flaps used included rectus
      abdominis, latissimus dorsi, and combined latissimus dorsi-serratus anterior
      muscles. Bone transport was accomplished by callus distraction after corticotomy.
      All patients are ambulatory, fully weight bearing, and without pain (range, 17-34
      mo). This treatment method has obviated the need for below-the-knee amputation in
      all of our patients.

PMID- 8489191
TI  - [Neuroma of the common bile duct].
AB  - After a surgical operation on the biliary tract, stenoses can occur, most of the
      time due to fibrotic lesions, and more rarely due to granulomas or traumatic
      neuromas. The latter generally develop on the cystic stump after a
      cholecystectomy. The occurrence of a traumatic neuroma on the common bile duct is
      much more rarely described. We report the case of a 64 year-old man presenting,
      four years after a surgical removal of the gallbladder, with a cholangitis, due
      to neuroma located on the choledochus. He was treated by surgical resection of
      the common bile-duct at the site of the stenotic zone, and choledocojejunal
      anastomosis; post-operative course was satisfactory.

PMID- 8489192
TI  - [The value and limitations of biofeedback in ano-rectal pathology].
AB  - Biofeedback, an instrumental training technique, enables the understanding and
      correction of a physiological mechanism, anorectal function in the present case.
      Correction of a functional abnormality seen as being responsible for a symptom
      involves the interplay of several factors within biofeedback, in particular the
      link between symptoms and functional abnormalities and the relationship existing
      between the trainer and trainee, the relative importance of which is difficult to
      identify. Initiation of such rehabilitation requires full clinical and functional
      evaluation in order to determine the indications and type of training programme
      required. Terminal constipation and incontinence are the chief indications
      providing useful results. This technique must be envisaged in the context of
      global management of perineal status as a whole, concomitantly with medical and
      surgical treatment.

PMID- 8489193
TI  - [Pharmacokinetics and therapeutic monitoring of cyclosporine in liver transplant
      patients].
AB  - Cyclosporine (CsA) has played a major role in the development of organ
      transplantation. However, its use in the prevention of liver graft rejection is
      somewhat delicate because the liver plays an essential role in the intestinal
      absorption, metabolism an excretion of CsA. Interindividual differences in CsA
      pharmacokinetics are large, and clearance can vary by a factor of 40 in liver
      transplant recipients. During CsA therapy, the intact molecule is assayed in
      whole blood by means of specific technique. The margin between immunosuppressive
      and nephrotoxic concentrations is poorly defined. The interpretation of blood
      concentrations must take into account the mode of administration, associated drug
      therapy, the time since grafting, and pathological episodes. The recommend
      through concentrations are 150-200 ng/ml during the first three months.

PMID- 8489194
TI  - [Endo-brachyesophagus, Jean-Louis Lortat-Jacob and the Barrett esophagus. The
      history of a modern disease].
AB  - The term endo-brachyoesophagus (EBO) became part of the specialised vocabulary of
      all those interested in the pathology of the esophagus at the beginning of the
      1950s, when J.L. Lortat-Jacob identified the existence, in certain patients
      suffering from reflux, of the endoesophageal ascent of a mucosa of gastric type,
      without any change in the gross topography of the gastro-esophageal junction. A
      similar lesion had been described at this same time in Great Britain by N.R.
      Barrett. Since then, numerous clinical and experimental arguments have been
      advanced in support of the acquired origin of this disorder, in the context of
      progressive gastro-esophageal reflux disease. However, the possibility of its
      regression after the treatment of reflux and its histologic presentation, though
      of major importance, remain unsettled. It is now generally acknowledged that EBO
      is one of the digestive lesions most prone to malignant degeneration, to the
      extent that it is now generally classified as precancerous, and all the most
      sophisticated procedures have been currently suggested and exploited in the
      attempt to detect EBO of potential malignancy. Within this field,
      ultramicroscopic study, enzyme assays and the techniques of flow cytometry are
      being used to better define this problem and to specify the point after which it
      is legitimate to abandon the medical treatment of reflux in favor of more
      aggressive methods, even surgical resection of the esophagus. The OESO Group,
      created in 1978, is currently conducting an international multidisciplinary and
      multicenter study to deal with the epidemiologic and therapeutic problems of this
      disorder.

PMID- 8489195
TI  - [Ethical and social problems posed by organ transplantation].
AB  - Organ transplantation more than a scientific fact is now a social fact. Since the
      first organ transplantations in France, forty years ago, medicine demonstrated
      its ability to perform the operation and to obtain (what was more difficult) the
      tolerance of the graft but medicine so far remains unable to give the material:
      organs. These organs are given by the donor's relatives when the kidney is
      concerned and when it is a donation from a living person. But such donation
      remain strictly limited in our country (less than 5 p. cent of the kidney
      transplantations) due to the risk of moral pressure and commercialization. More
      often and for the other organs (liver, heart, lung) the donation is obtained
      after death, a special and dramatic death: the brain death. The nowadays
      spectacular results of organ transplantation 70 to 80 p. cent survival rate at 10
      years with a complete rehabilitation gave a considerable increase on the demand.
      Unfortunately organ transplantation is the victim of its success, the number of
      donor's organ being insufficient to satisfy the needs. So in December 1990, 6,055
      patients were on the waiting list and only 3,772 (56 p. cent) were transplanted.
      In December 1991, 6,334 patients were on the waiting list and may be only 4,000
      could be transplanted. So the difference between the needs and the possibilities
      is increasing each year with for consequences, the death of 10 p. cent of the
      waiting patients and, for those who could be transplanted, a considerable
      increase in the waiting period responsible for slow deterioration of their status
      and less chances of success.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489196
TI  - [Adjuvant treatment of patients with neoplastic lesions using the combination of
      a vitamin complex and an amino acid. Apropos of a series of 17 cases of
      epidermoid carcinoma of the upper aerodigestive tract].
AB  - The aim of the work reported here was to evaluate the effects of an adjuvant
      treatment composed of an association of vitamins with an amino acid: beta
      alanine, in cancer patients. This adjuvant therapy has been given to 17 subjects
      with a squamous cell carcinoma of upper aerodigestive tract treated by
      radiotherapy most cases were T3 (according to the TNM-UICC). After a 63 months
      follow-up, 7 patients are alive and sterilized, 4 are alive but no sterilized, 2
      died, 4 were excluded from the study. Besides a physical comfort improved in all
      our patients, we note a restoration of the immune defenses, both humoral and
      cellular, disturbed by radiotherapy. At last, we note an increase of survival in
      the patients treated by the adjuvant therapy, compared to a reference population
      of patients with squamous cell carcinoma of upper aerodigestive tract. Despite
      the limits of the study, it was interesting to report the positive effects of the
      therapeutical association, vitamins and beta-alanine, after a combined radio
      surgical treatment of patients with squamous cell carcinoma of upper
      aerodigestive tract.

PMID- 8489197
TI  - Genetic structure of human populations in the British Isles.
AB  - Spatial patterns were studied for 36 allele frequencies representing 14 genetic
      systems (blood antigens, enzymes and serum proteins) in the United Kingdom and
      Irish Republic. The total number of data points over all systems and localities
      is 331. Patterns of genetic variation in space are graphically represented by one
      dimensional and directional correlograms, and by interpolated allele-frequency
      surfaces. The data surfaces were examined by the various techniques of spatial
      autocorrelation analysis. Zones of rapid change across allele surfaces were
      discovered by the wombling method. Six allele frequency surfaces from four
      genetic systems exhibit significant spatial patterns. Only one pattern (IO; in
      the ABO system) may be described as purely clinal in an east-west direction;
      another (IB; in ABO) approximates a cline or at least north-south
      differentiation. A method was developed for testing the direction of maximal
      genetic autocorrelation. Two previously unrecorded patterns for the British
      Isles, north-south gradients for Rhesus and P, were detected. Twelve zones of
      rapid genetic change were discovered; some of these seem to reflect maritime and
      montane physical barriers as well as long-held cultural and linguistic
      differences, particularly between early Germanic and Celtic speakers. Moreover,
      some appear to reflect past historic events such as the invasions of Anglo-Saxons
      and Anglo-Normans.

PMID- 8489198
TI  - Correlations of birth weight and gestational age across generations.
AB  - Maternal birth weight is known to be a predictor of offspring birth weight. Less
      is known about the recurrence of gestational age. In order to estimate the
      recurrence risk of low birth weight and preterm birth across generations in a
      population-based sample, 11,092 pairs of mother-firstborn offspring were obtained
      through an internal linkage in the Norwegian Birth Registry based on the years
      1967-1969 (mothers) and 1986-1989 (offspring). A low correlation coefficient of
      0.086 was found for gestational age across generations, whereas the correlation
      between maternal and offspring birth weight was 0.242. Mothers with birth weight
      below 2500 g had a significantly increased risk (odds ratio = 3.03, 95% conf.
      interval 1.79-5.11) of having a low birth weight child compared with mothers with
      birth weight above 4 kg. On the other hand, if the mother was born before the
      37th completed week of gestation, the risk of having a preterm child was not
      significantly increased (odds ratio = 1.46, conf. interval 0.96-2.21) compared
      with mothers who were born at term. Thus, in contrast to birth weight, human
      variation in gestational age does not appear to be influenced by genetic factors
      to any large degree.

PMID- 8489199
TI  - The dynamics of growth of weight, circumferences and skinfolds in distance,
      velocity and acceleration.
AB  - Based on structural average curves of distance, velocity and acceleration, an
      analysis of the longitudinally assessed growth of weight, arm and calf
      circumferences and skinfolds (biceps, triceps, suprailiac, subscapular) was
      undertaken. The data come from the first Zurich longitudinal growth study and
      represent a normal sample. In addition to a graphic analysis, timing, intensity
      and duration of the mid-growth spurt (MS) and of the pubertal spurt (PS) are
      quantified via descriptive parameters of growth. Mechanisms are different and
      more complex for these variables, in particular for skinfolds, compared to
      previously studied somatic variables, such as height. Skinfolds showed a rapid
      decline to a negative velocity minimum in the first year, recovering to a pre-PS
      fat spurt, earlier and more pronounced for central (suprailiac, subscapular) than
      for peripheral skinfolds (biceps, triceps). At age of peak height velocity a drop
      occurred, stronger for boys, followed by a post-PS spurt. A further analysis
      demonstrates that these ups and downs in skinfold velocity are mainly due to
      subjects with thick skinfolds. Weight and circumferences show a distinct MS, with
      sex-independent characteristics and a strong, sex-dependent PS. Weight and even
      more arm circumference are delayed compared to height in puberty.

PMID- 8489200
TI  - Microevolution in Perugia: isonymy 1890-1990.
AB  - The distribution of surnames in the population of the Comune of Perugia, as it
      existed in the memory banks of the Municipality Computer in autumn 1991, was
      studied by age and place of birth. Fisher's alpha and Karlin-McGregor's v were
      estimated in the total population, in persons born before 1901, and in persons
      born in the nine decades thereafter, ending with the period 1981-1991, for
      immigrants and for natives of Perugia, respectively. The wealth of surnames was
      significantly higher in immigrants than in natives of Perugia, as detected by
      alpha, v and by the log-log regression of the corresponding distributions. Among
      residents born in Perugia, Fisher's alpha shows a minimum value during 1921-1930,
      explained as a consequence of the First World War. The relationship between all
      possible combinations of cohorts born in the 10 different decades was studied
      through the Euclidean distance and through Lasker's coefficient of relationship,
      and a significant correlation between the former and time was revealed, both in
      immigrants and in natives of Perugia. When compared with the Province of Ferrara,
      Perugia was far richer in surnames, as measured by Fisher's alpha, for the total
      population and for each of the 10 decades analysed. Recent immigration, measured
      by Karlin-McGregor's v, was significantly higher in Perugia until the 1960s,
      equal in both Provinces during the 1970s, and higher in Ferrara during the 1980s.

PMID- 8489201
TI  - Body fat distribution in men and women of the Hispanic health and nutrition
      examination survey of the United States: associations with behavioural variables.
AB  - Body fat distribution is a biological risk factor for cardiovascular disease and
      diabetes. There are known genetic factors influencing body fat distribution, but
      variation in this characteristic is also attributable to human behavioural and
      socioeconomic variables such as social class. Bjorntorp has proposed that these
      associations may be due to a series of physiological responses to psychosocial
      stress, most prominently chronic stimulation of the adrenal-cortical system. This
      system is known to affect body fat distribution. Elsewhere we have shown that
      general socioeconomic status is related to body fat distribution in men and women
      of the Hispanic Health and Nutrition Examination Survey (HHANES) of the United
      States. In this paper we explore the relationship with those behavioural
      variables available from the HHANES which could hypothetically serve as
      indicators of psychosocial stress: smoking, drinking and depression. For both
      sexes in all Hispanic ethnic groups except Puerto Rican men, as socioeconomic
      status declined, subcutaneous fat became more centrally distributed. This
      relationship continued to be significant after controlling for the behavioural
      variables. A positive relationship was also found between smoking and central
      body fat distribution which was independent of socioeconomic status. This
      relationship was statistically significant for all subsamples except Cuban
      American women. No consistent relationships were found between body fat
      distribution, drinking and depression. The data support the hypothesis that body
      fat distribution may be linked to the social stress of low socioeconomic status,
      independent of the behavioural factors tested.

PMID- 8489202
TI  - Skin colour variability in Basque boys aged 8-19 years.
AB  - Skin colour variation with increasing age was analysed using a cross-sectional
      sample of 796 Basque boys aged from 8 to 19 years. Measurements were taken at the
      upper inner arm and forehead by means of an EEL DS29 Digital Unigalvo reflectance
      spectrophotometer with a nine-filter head. Ontogenic changes of skin pigmentation
      were found to be statistically significant. The influence of the month in which
      measurements were taken on reflectance values has been studied. Comparisons with
      another similar study (Pembrokeshire, Wales population) were carried out.

PMID- 8489203
TI  - Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in
      China.
AB  - In northern China, annual epidemics of acute-onset flaccid paralysis diagnosed
      clinically as Guillain-Barre syndrome have been recognized for at least 20 years.
      On the basis of an historical analysis of more than 3,200 patients, distinctive
      features include most cases occurring during the summer months among children and
      young adults, most of whom reside in rural areas. Of 90 patients with acute
      flaccid paralysis, 88 had a distinctive pattern that shares clinical and
      cerebrospinal fluid findings with demyelinating Guillain-Barre syndrome, but that
      differs from Guillain-Barre syndrome physiologically and pathologically. The
      clinical course is marked by rapidly progressive ascending tetraparesis, often
      with respiratory failure, but without fever, systemic illness, or sensory
      involvement. Cerebrospinal fluid is acellular, and elevations of protein content
      occur in the second or third week of illness. Electrodiagnostic studies show
      normal motor distal latencies and limb conduction velocities, but reduced
      compound muscle action potential amplitudes. Sensory nerve action potentials and,
      when elicitable, F waves are within the range of normal. Recovery is usually
      good. Autopsy studies have shown Wallerian-like degeneration of motor fibers.
      These studies establish that this is a distinctive syndrome, distinguishable from
      poliomyelitis and demyelinating Guillain-Barre syndrome.

PMID- 8489204
TI  - Zidovudine treatment of the AIDS dementia complex: results of a placebo
      controlled trial. AIDS Clinical Trials Group.
AB  - The efficacy of two doses of zidovudine was examined for the treatment of the
      acquired immunodeficiency syndrome (AIDS) dementia complex in a randomized,
      double-blinded, placebo-controlled trial conducted at nine study centers. For the
      initial 16 weeks, 40 subjects with mild to moderate AIDS dementia complex were
      randomized to one of three treatment arms: 400 mg of zidovudine five times daily,
      200 mg of zidovudine five times daily, or placebo five times daily. After week
      16, patients initially randomized to the placebo group were rerandomized to one
      of the two zidovudine treatment arms. The primary efficacy end point was
      improvement in performance on a battery of seven neuropsychological tests; the
      secondary end point was improvement on a protocol neurological evaluation
      directed at the cardinal features of the AIDS dementia complex. For the initial
      16-week period, average z scores based on the neuropsychological test battery
      revealed a significant improvement in the combined treatment groups compared to
      the placebo group; however, when the two treatment groups were compared
      separately to the placebo group, only the group receiving the higher zidovudine
      dose exhibited significant improvement. After rerandomization of the placebo
      patients to one of the two treatment arms at week 16, this group also showed
      significant improvement in the average neuropsychological z score by week 32.
      These results extend previous observations that indicate a therapeutic benefit of
      zidovudine for the treatment of AIDS dementia complex.

PMID- 8489205
TI  - A controlled trial of lazabemide (RO19-6327) in untreated Parkinson's disease.
      Parkinson Study Group.
AB  - The monoamine oxidase type B inhibitor deprenyl (selegiline) has been
      demonstrated to delay the emergence of disability in early untreated Parkinson's
      disease. Lazabemide (RO19-6327) is a short-acting, reversible, highly selective
      inhibitor of monoamine oxidase type B which, unlike deprenyl, is not metabolized
      to active compounds. We conducted a randomized, double-blinded clinical trial to
      assess the short-term tolerability of lazabemide in subjects who had early,
      untreated Parkinson's disease. Two hundred and one patients were enrolled at 14
      centers and randomized to receive 100 mg/day, 200 mg/day, or 400 mg/day of
      lazabemide or matching placebo. Subjects were followed for 8 weeks including a
      randomized, double-blinded withdrawal of lazabemide for 2 or 4 weeks. The primary
      measure of tolerability was the proportion of treated subjects who were able to
      complete the study on their originally assigned treatment. Clinical features were
      assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). Lazabemide
      treatment was as well tolerated as placebo and was not attended by serious
      adverse experiences. A significant improvement in the activities of daily living
      component of the rating scale was found after 4 weeks of lazabemide treatment,
      although other subscale scores did not change significantly. The overall safety
      and benefits of lazabemide observed in this short-term study justify further long
      term investigations to determine if this monoamine oxidase type B inhibitor can
      slow the clinical progression of Parkinson's disease.

PMID- 8489206
TI  - Loss of C1 and C3 epinephrine-synthesizing neurons in the medulla oblongata in
      Parkinson's disease.
AB  - We used immunohistochemical analysis to determine whether medulla oblongata
      neurons containing phenylethanolamine N-methyltransferase (PNMT) are affected in
      patients who died with idiopathic Parkinson's disease (n = 7) compared with age
      matched control subjects who died with nonneurological diseases (n = 8).
      Transverse sections (50 microns) of medulla were prepared either for conventional
      neuropathological examination or for the immunohistochemical demonstration of
      PNMT. Immunopositive neurons at approximately 30 rostrocaudal levels, evenly
      spaced throughout the whole medulla, were mapped and cells in each section were
      counted with a camera lucida system linked to a computer. In the ventrolateral
      medulla, from the level of the obex to 11 mm rostral to the obex where the C1
      group of neurons is located, there were 7,631 +/- 844 PNMT-positive neurons in
      control brains and 3,604 +/- 1,051 in brains affected by Parkinson's disease (47%
      of control). Many PNMT-positive neurons contained Lewy bodies. We observed a
      previously undescribed midline (C3) group of PNMT-positive neurons in normal
      brains, and this group was also severely affected (12% of control) in
      parkinsonian brains. Neither the C2 group nor the small PNMT-positive neurons in
      the nucleus tractus solitarii were significantly reduced in numbers but there was
      a reduction in the numbers of melanin-pigmented cells in both the ventrolateral
      (50% of control) and the dorsomedial (79% of control) region. Our results
      demonstrate a selective loss of C1 and C3 PNMT-positive neurons, providing the
      first quantitative evidence for damage to these presumed brainstem sympathetic
      premotor neurons in Parkinson's disease. These changes may underlie some of the
      autonomic symptoms occurring in this condition.

PMID- 8489207
TI  - Association of a monoamine oxidase B allele with Parkinson's disease.
AB  - Monoamine oxidase B (MAO-B) is implicated in the cause of Parkinson's disease
      (PD) because of its role in metabolizing the neurotoxin 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine, and forming H2O2 during dopamine metabolism. Altered MAO-B
      activity has been observed in PD platelets. Polymerase chain reaction was used to
      amplify a portion of the MAO-B gene. Polymerase chain reaction products were
      screened with restriction enzymes to identify fragments useful for single
      stranded conformational polymorphism analysis. A single-stranded conformational
      polymorphism was identified in an MAO-B polymerase chain reaction product after
      Hae III digestion. One hundred twenty-one control individuals were allelotyped
      with frequencies of 0.45 and 0.55 for alleles 1 and 2, respectively. Frequencies
      of 0.62 and 0.38 (1 and 2, respectively) were observed in a population of 46
      patients with PD. The presence of MAO-B allele 1 is associated with a relative
      risk for PD of 2.03-fold (confidence interval, 1.44-2.61; p < 0.02). For
      comparison, a monoamine oxidase A polymorphism was used to determine allelic
      frequencies in these same populations and no statistically significant
      differences were found. These results suggest that an inherited variant of MAO-B
      may be involved in a genetic predisposition for PD.

PMID- 8489208
TI  - Analysis of autoantibody binding to 52-kd paraneoplastic cerebellar degeneration
      associated antigen expressed in recombinant proteins.
AB  - A 52-kd neural antigen was reported to be recognized by anti-Purkinje cell
      antibodies in serum of a patient with paraneoplastic cerebellar degeneration
      associated with uterine carcinoma. In this study, we demonstrate that this neural
      antigen is recognized by antibodies known as anti-Purkinje cell antibody type I
      (PCAb Type I) and anti-YO. The latter's antigen is reported to be specific for
      the 62- to 64-kd antigen CDR62. Assuming that the 52-kd and 62- to 64-kd antigens
      share a common epitope(s) recognized by all of these antibodies, we examined the
      antigenic region on the 52-kd protein by immunoblots with deletion fragment
      proteins of the recombinant 52-kd protein. A major epitope was localized in the
      region of amino acid residues 94 to 133 of the 52-kd protein, which is the site
      of a leucine zipper motif. The potential pathogenicity of PCAb Type I is
      discussed.

PMID- 8489209
TI  - Persistent vegetative state: report of the American Neurological Association
      Committee on Ethical Affairs. ANA Committee on Ethical Affairs.

PMID- 8489210
TI  - Isolation of HTLV-II from a patient with chronic, progressive neurological
      disease clinically indistinguishable from HTLV-I-associated myelopathy/tropical
      spastic paraparesis.
AB  - An increasing spectrum of diseases has been shown to be associated with the human
      T-cell lymphotropic virus type I (HTLV-I), most notably a chronic, progressive
      myelopathy termed HTLV-I--associated myelopathy/tropical spastic paraparesis and
      adult T-cell leukemia. HTLV-II is a close relative of HTLV-I and is structurally
      similar but molecularly distinct. This virus is endemic in Amerindian populations
      and a high seroprevalence rate has been observed in intravenous drug abusers.
      Here, for the first time, we have identified a patient with a chronic,
      progressive neurological disease clinically indistinguishable from HTLV-I-
      associated myelopathy/tropical spastic paraparesis from whom we have isolated and
      characterized HTLV-II in the absence of any other detectable human retrovirus.
      Antibodies to HTLV were detected in both serum and cerebrospinal fluid, with
      typical HTLV-II banding patterns on Western blots. HTLV-II viral sequences were
      detected in high copy number from peripheral lymphocytes by polymerase chain
      reaction techniques, and cloning and sequencing of this virus revealed a 99.5%
      homology with prototype HTLV-II. These results serve to alert the medical
      community to the possibility that in addition to HTLV-I, HTLV-II may be
      associated with a neurological disorder.

PMID- 8489211
TI  - Maple syrup urine disease: metabolic decompensation monitored by proton magnetic
      resonance imaging and spectroscopy.
AB  - Metabolic decompensation of maple syrup urine disease in a 3.5-year-old boy was
      monitored by means of proton magnetic resonance imaging and spectroscopy. In the
      acute stage, imaging showed diffuse cerebral edema. Proton spectra showed an
      elevation of lactate and a previously unassigned resonance at 1 ppm. This peak
      disappeared with normalization of branched-chain amino acids and oxoacids in the
      plasma and cerebrospinal fluid. In vitro spectroscopy of these metabolites at 1.5
      T confirmed the chemical shift position of their methyl resonances at 1 ppm. The
      duration of lactate elevation correlated with the presence of brain edema and
      coma. These results demonstrate that magnetic resonance imaging can monitor
      therapeutic effects, and suggest that proton spectroscopy can detect cerebral
      accumulation of branched-chain amino acids and oxoacids in maple syrup urine
      disease.

PMID- 8489212
TI  - Callosal apraxia without agraphia.
AB  - We describe a patient with left unilateral ideomotor apraxia without left-sided
      agraphia caused by a callosal lesion that was demonstrated by magnetic resonance
      imaging. The clinical features, together with data in the literature, suggest
      that the callosal fibers for writing are concentrated in the posterior corpus
      callosum, while those for praxis cross in the more rostral part of the posterior
      half of the callosum.

PMID- 8489213
TI  - Spastic ataxia associated with human T-cell lymphotropic virus type II infection.
AB  - Human T-cell lymphotropic virus type one (HTLV-1) is associated with tropical
      spastic paraparesis or HTLV-I--associated myelopathy. We report 2 women with a
      spastic ataxic illness similar to HTLV-I--associated myelopathy infected solely
      with HTLV-II. Identification of HTLV-II infection was made serologically, by
      polymerase chain reaction, and by viral culture (in 1 woman). One woman, treated
      with 200 mg of danazol orally, three times daily, had pronounced improvement in
      ambulation, nocturnal spasticity, and nighttime urinary frequency. It appears
      that infection with HTLV-II may cause an illness similar to HTLV-I--associated
      myelopathy, but distinguished by the presence of ataxia.

PMID- 8489214
TI  - Nonepileptic seizures during apparent sleep.
AB  - We report 12 patients with nonepileptic seizures (NESs) documented with video
      electroencephalographic monitoring during apparent sleep. There were 7 females
      and 5 males, ages 11 to 67 years (mean, 33 yr). In all patients there was a well
      organized posterior alpha rhythm present immediately before onset of clinical
      changes despite the appearance of sleep. Patients later "confirmed" that these
      attacks occurred during sleep. Features of these episodes were typical of NESs
      and none were associated with ictal or postictal electroencephalographic changes
      other than muscle and movement artifact. Provocative testing with suggestion
      confirmed the nonepileptic nature of these episodes in 9 patients. Three patients
      had epileptiform discharges during prolonged interictal recordings and 1 had a
      documented complex partial seizure. Our findings indicate that reports of
      seizures during sleep are not uncommon among patients with NESs.

PMID- 8489215
TI  - Oscillopsia and horizontal nystagmus with accelerating slow phases following
      lumbar puncture in the Arnold-Chiari malformation.
AB  - Oscillopsia and nystagmus began in a woman 2 weeks after an inadvertent lumbar
      puncture during anesthesia for childbirth. Examination showed horizontal
      torsional jerk nystagmus in all positions of gaze. Magnetic-search-coil
      oculography revealed accelerating slow phases, with an increase in nystagmus
      amplitude in darkness. Magnetic resonance images showed type 1 Arnold-Chiari
      malformation. Three months after occipital decompressive surgery, nystagmus had
      almost disappeared. Accelerating slow phases should not be considered diagnostic
      of congenital nystagmus, especially with an onset of oscillopsia in adult life;
      imaging should be considered to exclude treatable hindbrain anomalies. Lumbar
      puncture in patients with the Arnold-Chiari malformation may accentuate
      craniospinal pressure dissociation and precipitate neurological signs.

PMID- 8489216
TI  - Reactive nitrogen intermediates: effector molecules of immune-mediated
      inflammatory nervous system disorders?

PMID- 8489217
TI  - New neuroimaging methods and the neurological examination.

PMID- 8489218
TI  - Skilled perioperative care is not enough--customer service is a must.

PMID- 8489219
TI  - Bloodborne pathogens.

PMID- 8489220
TI  - Perioperative nursing care quality. Patients' opinions.

PMID- 8489221
TI  - Children's drawings. A preoperative assessment tool.

PMID- 8489222
TI  - Anxiety of elective surgical patients' family members. Relationship between
      anxiety levels, family characteristics.
AB  - Technological advances in the OR create new practices and procedures; however,
      humanistic and holistic approaches to nursing care remain the foundation of
      clinical practice. Perioperative nurses recognize that family members experience
      anxiety during surgery, especially during the time the patient is in the OR.
      Ironically, it is during this time period that little or no meaningful
      communication occurs between family members and health professionals. Patients
      continue to be discharged sooner, and in sicker condition, to be cared for by
      their family members. Families require information about how to provide
      postoperative care. Anxiety levels need to be decreased sufficiently to allow
      family members to use the information they are taught and ask appropriate
      questions. Interventions that reduce family members' anxiety need to be developed
      and tested so that family members can help patients after surgery. Using research
      findings as a basis for perioperative nursing practice may mean changing
      traditions and attitudes about family members of surgical patients. In the
      consumer-oriented climate of current health care, doing the "new" may make a
      difference in the market share. This "new" may be independent nursing
      interventions designed to reduce family members' anxiety during the
      intraoperative waiting period.

PMID- 8489223
TI  - Perioperative nurse caring behaviors. Perceptions of surgical patients.

PMID- 8489224
TI  - Ambulatory surgery--hospital-based vs freestanding. A comparative study of
      patient satisfaction.

PMID- 8489225
TI  - Reoperative cardiac surgery. Challenges, perioperative nursing considerations.

PMID- 8489226
TI  - Comprehensive perioperative care: patient assessment, teaching, documentation.

PMID- 8489227
TI  - Patients deserve respectful surgical environment.

PMID- 8489228
TI  - New American Nurses Association lobbyist thrives on involvement in his native
      Washington, DC. Interview by Celeste Goldbaum.

PMID- 8489229
TI  - The assumed assimilation of cholesterol by Lactobacilli and Bifidobacterium
      bifidum is due to their bile salt-deconjugating activity.
AB  - To study the mechanism of the propsed assimilation of cholesterol, we cultured
      various strains of Lactobacillus acidophilus and a Bifidobacterium sp. in the
      presence of cholesterol and oxgall. During culturing, both cholesterol and bile
      salts were precipitated. Because of bacterial bile salt deconjugation, no
      conjugated bile salts were observed in either the culture fluids or the pellets.
      During incubation, the cell count and optical density decreased. The degree of
      precipitation of bile salts and of cholesterol was dependent on the culture
      conditions. If L. acidophilus RP32 was cultured under acidifying conditions, the
      degree of precipitation of deconjugated bile salts was higher than if the pH was
      maintained at 6.0. Under acidifying conditions, cholesterol was coprecipitated
      with the bile salts, whereas in pH-controlled cultures, no coprecipitation of
      cholesterol was observed. From control experiments with different mixtures of
      bile salts, it appeared that coprecipitation of cholesterol during culturing was
      a result of formation of deconjugated bile salts, which have a decreased
      solubility at pH values lower than 6.0. It is concluded that the removal of
      cholesterol from the culture medium by L. acidophilus RP32 and other species is
      not due to bacterial uptake of cholesterol, but results from bacterial bile salt
      deconjugating activity.

PMID- 8489230
TI  - Mycoplasmalike organisms (MLOs) and distinguish them from other MLOs.
AB  - DNA of 10 lines of rice yellow dwarf (RYD) mycoplasmalike organisms (MLOs) from
      Japan, the Phillippines, and Thailand hybridized with four probes containing
      chromosomal and six probes containing extrachromosomal DNA of a Tochigi (Japan)
      line of RYD MLO. One chromosomal probe (RYD9) and all six extrachromosomal probes
      hybridized with various other MLOs (sugarcane white leaf, onion yellows,
      cineraria witches'-broom, Japanese hornwort witches'-broom, water dropwort
      wiches'-broom, gentian witches'-broom, udo dwarf, tsuwabuki witches'-broom,
      pelargonium witches's-broom, peach western-X, and pear decline). DNA from the
      culturable mollicutes Spiroplasma kunkelii, Spiroplasma citri, Mycoplasma
      hominis, and Mycoplasma orale did not hybridize with RYD MLO probes. The
      extrachromosomal DNAs hybridizing with the probes showed variations in
      electrophoretic behavior.

PMID- 8489231
TI  - Impact of the ring-billed gull (Larus delawarensis) on the microbiological
      quality of recreational water.
AB  - We evaluated the impact of the ring-billed gull (Larus delawarensis) on the
      microbiological quality of water. We measured fecal coliforms, Salmonella spp.,
      and Aeromonas spp. in the gull droppings and the number of fecal coliforms in the
      water prior to and after attracting these birds to the beach with food. Gulls can
      contribute to the bacteriological degradation of recreational water.

PMID- 8489232
TI  - Use of autoradiography to assess viability of Helicobacter pylori in water.
AB  - Autoradiographic methods have been developed to detect metabolic activity of
      viable but nonculturable cells of Helicobacter pylori in water. Four strains of
      H. pylori were studied by using microcosms containing suspensions of 72-h
      cultures in water. The suspensions of aged, nonculturable cells of H. pylori were
      incubated with [3H]thymidine for 24 to 72 h, after which the cell suspensions
      were exposed to Kodak NTB2 emulsion for 3 to 28 days. Each sample was processed
      with three separate controls to rule out false-positive reactions. The organism
      remains viable and culturable under these conditions for up to 48 h and, in some
      cases, 20 to 30 days, depending on physical conditions of the environment. We
      found that temperature was a significant (P < or equal to 0.01) environmental
      factor associated with the viability of H. pylori cells in water. Autoradiographs
      of tritium-labeled cells of H. pylori revealed aggregations of silver grains
      associated with uptake by H. pylori of radiolabelled substrate. Findings based on
      the autoradiographic approach give strong evidence supporting the hypothesis that
      there is a waterborne route of infection for H. pylori. The possibility that H.
      pylori may persist in water in a metabolically active stage but not actively
      growing and dividing is intriguing and relevant to public health concerns.

PMID- 8489233
TI  - A proposed nonpathogenic biological indicator for thermal inactivation of
      Listeria monocytogenes.
AB  - Listeria innocua M1 was developed as a thermal processing indicator organism for
      L. monocytogenes by selection of a rifampin- and streptomycin-resistant mutant.
      zetaD values were 5.6 and 5.8 degrees C, and D (68 degrees C) values were 3.8 and
      4.9 s for L. monocytogenes and L. innocua, respectively, in skim milk. The
      advantages of easy selection, similar heat resistance, and nonpathogenicity make
      L. innocua M1 appropriate for challenge studies designed to evaluate process
      lethality with respect to L. monocytogenes.

PMID- 8489234
TI  - Inhibitory effect of oolong tea polyphenols on glycosyltransferases of mutans
      Streptococci.
AB  - Oolong tea extract (OTE) was found to inhibit the water-insoluble glucan
      synthesizing enzyme, glucosyltransferase I (GTase-I), of Streptococcus sobrinus
      6715. The GTase-inhibitory substance in the OTE was purified successive
      adsorption chromatography on Diaion HP-21 and HP-20 columns; this was followed by
      further purification by Sephadex LH-20 column chromatography. A major fraction
      that inhibited GTase activity (fraction OTF10) was obtained, and the chemical
      analysis of OTF10 indicated that it was a novel polymeric polyphenol compound
      that had a molecular weight of approximately 2,000 and differed from other tea
      polyphenols. Catechins and all other low-molecular-weight polyphenols except
      theaflavin derived from balck tea did not show significant GTase-inhibitory
      activities. It was found that OTE amd PTF10 markedly inhibit GTase-I and yeast
      alpha-glucosidase, but not salivary alpha-amylase. Various GTases purified from
      S. sobrinus and Streptococcus mutans were examined for inhibition by OTE and
      OTF10. It was determined that S. sobrinus GTase-I and S. mutans cell-free GTase
      synthesizing water-soluble glucan were most susceptible to the inhibitory action
      of OTF10, while S. sobrinus GTase-Sa and S. mutans cell-associated GTase were
      moderately inhibited; no inhibition of S. sobrinus GTase-Sb was observed.
      Inhibition of a specific GTase or specific GTases of mutants streptococci
      resulted in decreased adherence of the growing cells of these organisms. The
      inhibitory effect of OTF10 on cellular adherence was significantly stronger than
      that of OTE.

PMID- 8489235
TI  - The carnitine acyltransferases and their role in modulating acyl-CoA pools.
AB  - The role of carnitine via the action of carnitine acyltransferase in buffering
      CoA availability in the mitochondrial matrix is well known. There is now
      sufficient evidence to extend this to a general role. Carnitine can buffer the
      acylation state of the CoA pool for any type of acyl group that is a substrate
      for the carnitine acyltransferase family of enzymes. Specific carnitine
      acyltransferases in each organelle or membrane can modulate the reserves of free
      CoA and acyl-CoA in ways specific to the local metabolic demands. The use of
      inhibitors of carnitine acyltransferases in complex systems and in vivo now
      permits exploration of the consequences of this role.

PMID- 8489236
TI  - Characterization of superoxide dismutase-insensitive cytochrome c reductase
      activity in HL-60 cytosol as NADPH-cytochrome P450 reductase.
AB  - A flavoprotein dehydrogenase assayed for the activity of electron transfer from
      NADPH to cytochrome c was highly purified from the cytosolic fraction of
      differentiated human promyelocytic leukemia HL-60 cells. The purified enzyme had
      an apparent molecular mass of 68 kDa by sodium dodecyl sulfate gel
      electrophoresis and an equimolar amounts of flavin mononucleotide and flavin
      adenine dinucleotide. The purification factor of the enzyme with respect to the
      cytosolic fraction was close to 1100 and the recovery of activity was
      approximately 18%. Reduction of cytochrome c by NADPH indicated Michaelis-Menten
      kinetics with a Km value of 1.50 microM for NADPH. When cytochrome c was the
      varied substrate, a Km value of 4.10 microM was obtained. NADH was not an
      effective electron donor for cytochrome c reduction and NADPH-dependent reduction
      of nitroblue tetrazolium was negligibly small. The purified enzyme alone did not
      exhibit superoxide production, and NADPH oxidase activity was not markedly
      stimulated upon incubation of the reductase with cytochrome b558 purified from
      porcine neutrophils. The purified flavoprotein gave a positive cross-reactivity
      to polyclonal antibodies raised to microsomal NADPH-cytochrome P450 reductase,
      indicating structural homology between these enzymes. The catalytic properties of
      the purified NADPH-cytochrome c reductase have similarities to those of liver
      NADPH-cytochrome P450 reductase.

PMID- 8489237
TI  - Effects of heparin and other glycosaminoglycans on elastin production by cultured
      neonatal rat lung fibroblasts.
AB  - Proteoglycans are important structural elements of the extracellular matrix, and
      may contribute to the dynamic architecture of the lung and also influence
      pulmonary gas and solute exchange. The potential for proteoglycans and
      glycosaminoglycans to modulate the synthesis and deposition of elastin, another
      important extracellular matrix component of the lung, has not been established.
      Therefore the effects of glycosaminoglycans on the steady-state level of elastin
      mRNA, the incorporation of [3H]valine into tropoelastin, the distribution of
      soluble elastin in the medium and cell layer, and insoluble elastin deposition
      have been examined using cultured neonatal rat lung fibroblasts. Heparin
      decreases the soluble elastin content of the culture medium while increasing the
      soluble elastin content of the cell layer. This altered partitioning of soluble
      elastin is associated with an increase in steady-state elastin mRNA and an
      increase in the deposition of insoluble elastin in the extracellular matrix. Some
      of these effects may result from the binding of heparin to soluble elastin at
      physiological concentrations of NaCl. The galactosamine-containing
      glycosaminoglycans, chondroitin sulfate and dermatan sulfate, differ from heparin
      in that they increase the quantity of soluble elastin in the culture medium and
      decrease the deposition of insoluble elastin in the extracellular matrix.
      Proteoglycans, which are present in most elastic tissues, may participate in the
      regulation of elastin synthesis and deposition during periods of new elastin
      formation.

PMID- 8489239
TI  - Transcriptional activation of cytochrome P450 2B1/2 genes in rat liver by diallyl
      sulfide, a compound derived from garlic.
AB  - Previous work in our laboratory demonstrated that cytochrome P450 2B1 in rat
      liver was induced, but P450 2E1 was inhibited and inactivated, by diallyl sulfide
      (DAS), a compound derived from garlic. Such a selective effect on P450 enzymes is
      of considerable interest toward the understanding of dietary effects on
      xenobiotic metabolism. In the present study, the mechanism of P450 2B1 induction
      by DAS was investigated. Following a single dose of DAS (200 mg/kg body weight,
      ig), liver microsomal pentoxyresorufin dealkylase (PORd) activity, a
      representative activity of P450 2B1, was induced 3-, 16-, 26-, and 43-fold at 6,
      12, 18, and 24 h after the treatment, respectively. A corresponding increase in
      the level of P450 2B1/2 protein was observed by immunoblot analysis. The level of
      P450 2B1/2 mRNA in rat liver also increased markedly, reaching a maximum at 12 h
      after the DAS treatment. Hybridization with the isozyme-specific oligonucleotide
      probes revealed that the mRNA levels of both P450s 2B1 and 2B2 were induced. In
      contrast, the level of P450 2E1 mRNA in the liver of DAS-treated rats was not
      changed. The results of nuclear run-on assay revealed that the transcriptional
      rate of P450 2B1/2 genes in the rat liver increased 13-fold at 6 h after DAS
      administration and returned to the control value at 24 h. The transcription of
      P450 2B1/2 genes was blocked completely by alpha-amanitin, an inhibitor of RNA
      polymerase II. These results clearly demonstrate that the induction of P450 2B1/2
      in rat liver by DAS is mainly due to transcriptional activation. In the DAS
      treated rats, P450 2B1/2 mRNA was also markedly induced in the stomach and
      duodenum. The maximal induction was found at 12 h after the treatment while the
      levels of P450 2B1/2 mRNA increased 66-fold in the duodenum and 23-fold in the
      stomach. DAS treatment, however, did not change the levels of P450 2B1/2 mRNA in
      the lung and nasal mucosa.

PMID- 8489238
TI  - Induction of flavin-containing monooxygenase (FMO B) in rabbit lung and kidney by
      sex steroids and glucocorticoids.
AB  - Modulation of lung and kidney levels of flavin-containing monooxygenase (FMO)
      isoform B following sc administration of dexamethasone, progesterone, beta
      estradiol, aldosterone, or beta-estradiol plus progesterone was examined in male
      rabbits. Both dexamethasone and progesterone increased FMO B protein levels in
      lung. N-Oxygenation of N,N'-dimethylaniline (DMA) was significantly induced in
      lung microsomes from rabbits treated with progesterone. In kidney, only
      dexamethasone was effective in inducing FMO B protein levels and DMA N
      oxygenation. Surgical implantation of osmotic pumps containing beta-estradiol or
      progesterone into non-pregnant female rabbits resulted in elevated plasma levels
      of these steroids after 4-5 days at which point the lung levels of FMO B were
      induced by 35 and 82% for beta-estradiol and progesterone, respectively. The
      responsiveness of FMO B in lung to both progesterone and glucocorticoids and in
      kidney to only the latter is consistent with the developmental pattern of both
      maternal FMO B and peak plasma levels of these steroids during pregnancy.

PMID- 8489240
TI  - Purification and characterization of salicylhydroxamic acid reductase from rat
      liver.
AB  - Salicylhydroxamic acid reductase, which catalyzes the reduction of
      salicylhydroxamic acid to salicylamide, was purified from rat liver cytosol. The
      purification procedure consisted of fractionation with ammonium sulfate,
      chromatography with Phenyl-Toyopearl 650, DEAE-cellulose, hydroxyapatite, and
      Sephadex G-200, and chromatofocusing with PBE94. The molecular weight of the
      enzyme was estimated to be about 140,000 by Sephadex G-200 gel filtration and
      152,000 by polyacrylamide gel electrophoresis. The enzyme was dissociated into
      two different subunits with estimated molecular weights of 41,000 and 32,000,
      respectively, by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These
      facts suggested that the enzyme is a heterotetramer consisting of two pairs of
      two nonidentical polypeptide chains. The Km value of the enzyme for
      salicylhydroxamic acid was estimated to be 91.5 or 88.7 microM in the presence of
      NADH or NADPH, respectively. The isoelectric point of the enzyme is pH 5.4. The
      enzyme was highly specific for salicylhydroxamic acid, but it also showed some
      activity with other hydroxamic acids such as nicotinohydroxamic acid and N
      hydroxy-2-acetylaminofluorene. The enzyme activity was inhibited by allopurinol,
      oxipurinol, dicumarol, menadione, p-chloromercuribenzoic acid, sodium arsenite,
      potassium cyanide, cupric sulfate, and disulfiram, but little inhibition was
      observed with oxygen.

PMID- 8489241
TI  - Synthesis and turnover of ceruloplasmin in rats treated with 17 beta-estradiol.
AB  - The effects of estrogen on synthesis and turnover of ceruloplasmin were studied
      in adult female Fischer rats. Daily treatment with 140 microgram 17 beta
      estradiol resulted in a slow rise of ceruloplasmin concentrations, as measured by
      p-phenylenediamine oxidase activity, leading to a 70% increase by 7 days and a
      tripling by Day 14. Ceruloplasmin protein concentrations increased to the same
      degree, based on yields of the protein obtained during purification. Effects of
      estrogen on rates of synthesis (incorporation of [3H]leucine) were followed,
      using immunoprecipitation of total ceruloplasmin or isolation of its two major
      isoforms (Rfs 0.4 and 0.6 in native gel electrophoresis). Synthesis was increased
      by 7 days and was 2.5 times that of controls by Day 14. Both forms of
      ceruloplasmin showed the same specific activities and degree of increase in rate
      of synthesis. Rates of ceruloplasmin turnover were unaffected, based on double
      labeling with 3H- and 14C-leucine, but were three- to fourfold faster than for
      total plasma protein. The enzymatically more active 0.6 Rf form of ceruloplasmin
      had a faster turnover rate than the 0.4 Rf form. Estrogen treatment doubled
      ceruloplasmin mRNA levels by 7 days and almost tripled them by Day 14. Most of
      the ceruloplasmin mRNA was associated with the endoplasmic reticulum-bound
      polyribosomes. We conclude that estrogen increases the rate of synthesis of two
      forms of ceruloplasmin by indirectly increasing liver concentrations of its mRNA
      but has no effect on ceruloplasmin turnover.

PMID- 8489242
TI  - Isolation of a phospholipid inhibitor of platelet activating factor-induced
      activity from perfused rat liver: identification as phosphatidylglycerol.
AB  - An endogenous inhibitor of platelet activating factor action was isolated from
      perfused rat liver. It was purified by thin-layer chromatography and high
      performance liquid chromatography and subjected to chemical modifications in
      order to identify its structure. On the basis of its fast atom bombardment-mass
      spectrum it was characterized as phosphatidylglycerol composed mainly of
      16:0/18:1 and 16:0/20:2 fatty acyl chains ([M+H]+ at m/z 749 and 775,
      respectively) and very minor levels of 18:0/18:1 and 18:0/20:2. The purified
      compound exhibited inhibition on rabbit platelet aggregation induced by 5 x 10(
      10) M platelet activating factor (PAF) at an EC50 value near 2.5 x 10(-6) M and
      on the serotonin secretion at an EC50 7 x 10(-6) M. Other phospholipids isolated
      from the liver preparations, such as phosphatidylethanolamine,
      phosphatidylserine, phosphatidylinositol, sphingomyelin, cardiolipin
      (diphosphatidylglycerol), and phosphatidic acid, exhibited no inhibitory activity
      in the concentration range from 1 x 10(-4) to 1 x 10(-7) M nor did they induce
      any aggregation, or lysis, of the platelets. Of importance, phosphatidylglycerol
      could inhibit thrombin- and ADP-induced aggregation of rabbit platelets. These
      results suggested a possible site of inhibition common to the signal transduction
      pathway of these agonists. Preliminary binding experiments showed a
      noncompetitive type of inhibition on PAF binding to intact rabbit platelets.

PMID- 8489243
TI  - Archaebacterial adenylate kinase from the thermoacidophile Sulfolobus
      acidocaldarius: purification, characterization, and partial sequence.
AB  - For the first time an adenylate kinase of archaebacterial origin has been
      purified to homogeneity. The enzyme from the extreme thermoacidophile Sulfolobus
      acidocaldarius (DSM 639) has been found to consist of a 23- to 24-kDa polypeptide
      likely to form a dimer under in vitro conditions. Its temperature optimum is
      about 90 degrees C; the pH optimum is 5.3-6.0, depending on the observed
      direction of the reaction. The KM values for ATP, AMP, and ADP are almost equal
      (0.6-0.7 mM). The enzyme is absolutely specific for AMP as phosphate acceptor but
      has a broad specificity for nucleotide triphosphates as donors. It requires
      divalent metals for activity with Mg2+ > Mn2+ > Ca2+ > Zn2+ in the order of
      decreasing potency. Distinct from mammalian enzymes the sensitivity toward the
      typical inhibitor diadenosine-5,5'-pentaphosphate is extremely low; > 300 microM
      is required for 50% inhibition, suggesting an altered distance between the AMP
      /ATP-binding sites. The thermostability of the protein decreases sharply at room
      temperatures above 90 degrees C. It exhibits unusual stability, however, toward
      acidic pH. A 41-residue N-terminal sequence has been determined which allowed us
      to construct probes for the genetic approach. From residue 8-15 the protein
      contains the typical glycine rich P-loop as well as another conserved sequence
      stretch 21 residues further. Isolation of the gene is in progress.

PMID- 8489244
TI  - Domains of rat heme oxygenase-2: the amino terminus and histidine 151 are
      required for heme oxidation.
AB  - Cleavage of heme b (Fe-protoporphyrin IX) at the alpha-meso carbon bridge is
      catalyzed by heme oxygenase isozymes, HO-1 and HO-2, to form biliverdin IX alpha.
      Currently, we have examined the requirement for the amino terminus and the
      hydrophobic carboxy terminus of rat HO-2 expressed in Escherichia coli for heme
      degradation activity and have assessed the importance of His 151 for this
      activity. His 151 is in the longest span of amino acids (24 residues) which are
      present, with only a single conservative substitution, in seven cloned heme
      oxygenases including the apparent single isozyme in chicken. We show His 151 is
      essential for cleavage of heme, as substitution of alanine for this residue by
      site-directed mutagenesis resulted in expression of an inactive protein with
      immunoreactivity toward antibody to rat HO-2. A cDNA construct in which
      nucleotides encoding the 33 N-terminal amino acid residues were deleted, when
      expressed, produced a protein of predicted size and immunoreactivity with
      antibody to HO-2 but also devoid of heme degrading activity. The presence of
      additional residues at this terminus, for the most part, accounts for the larger
      size of HO-2 compared to HO-1. Conversely, the hydrophobic region at the carboxy
      terminus did not appear to be essential for heme degradation. A construct in
      which the sequence encoding the primarily hydrophobic amino acids of the carboxy
      terminus was replaced by a sequence encoding predominantly hydrophilic residues
      expressed a protein which retained full capability to convert heme to biliverdin.
      Further, the construct with a hydrophilic carboxy terminus was not appreciably
      associated with bacterial membranes, suggesting that the carboxy terminus in the
      wild-type protein serves as a membrane anchor for this enzyme.

PMID- 8489245
TI  - Possible roles of the 3'-flanking sequences of the human activin beta A subunit
      gene in its expression.
AB  - Tumor promoter 12-O-tetradecanoylphorbol-13-acetate stimulates an increase in
      erythroid differentiation activity in human fibrosarcoma HT1080 cells. Here, we
      demonstrate that this process involves a rapid accumulation of five species of
      activin beta A/erythroid differentiation factor mRNA, followed by protein kinase
      C activation, and that variation in size of the activin transcripts is due to
      multiple 3' ends, presumably reflecting an alternative polyadenylation. In
      transiently transfected HT1080 cells, a 97-bp DNA fragment containing an AP-1
      consensus sequence (TGAGTCA) located in the 3'-flanking region of the activin
      gene was capable of activating the heterologous herpes simplex virus thymidine
      kinase (tk) and SV40 early promoters, and a cotransfected c-Jun enhanced these
      fusion promoter activities. The deletion of TGAG sequences from the AP-1 element
      in the 97-bp DNA sequence context abolished its c-Jun-mediated activation from
      the tk promoter even in HT1080 cells overexpressing stably transfected c-Jun.
      Cotransfected adenovirus E1A products repressed the tk promoter activity enhanced
      by the activin AP-1 element itself or in concert with transiently transfected c
      Jun, indicating that the putative AP-1 sequence acts as an activator element,
      depending upon c-Jun activity. These results suggest that the 3'-flanking DNA
      sequences of the human activin beta A subunit gene play an important role in its
      expression.

PMID- 8489246
TI  - Crystallization and preliminary X-ray crystallographic analysis of
      carboxylesterase from pseudomonas fluorescens.
AB  - Large crystals of carboxylesterase from Pseudomonas fluorescens have been grown
      in the presence of dioxane using ammonium sulfate and lithium sulfate as
      precipitant. They belong to the tetragonal space group P4(1)2(1)2 (or
      P4(3)2(1)2), with unit cell dimensions of a = 82.01 (+/-0.06) A and c = 145.44
      (+/- 0.08) A. The presence of one carboxylesterase dimer in the asymmetric unit
      gives the crystal volume per protein mass (VM) of 2.56 A3/Da and solvent fraction
      of 52.0% by volume. The crystals diffract to at least 2.3 A Bragg spacing when
      exposed to CuK alpha X rays from a rotating anode generator. X-ray data (nearly
      complete to 2.6 A Bragg spacing) have been collected from a native crystal.

PMID- 8489247
TI  - Serum protein of 135-kDa molecular weight--a molecular signal for cardiac
      hypertrophy.
AB  - A serum protein, similar to the 135-kDa protein which appears during
      experimentally induced cardiac hypertrophy in rats, was identified in human serum
      by Western blot analysis using anti-rat 135-kDa protein antibody. The rat protein
      antibody gave a very strong positive signal when reacted with sera obtained from
      cardiac patients, suggesting an induced level of this protein in patients' sera
      when compared to normal sera from healthy individuals. Multiple injections of
      polyclonal anti-rat 135-kDa protein antibody to aorta-constricted animals
      completely inhibited the development of cardiac hypertrophy, suggesting that this
      protein could be hypertrophy specific. This was further substantiated by the
      decrease in the expression of a molecular marker such as the beta myosin heavy
      chain gene in aorta-constricted but antibody-injected animals. Further, the
      presence of high levels of this protein in first- and third-day neonatal animals
      is also suggestive of the hypertrophy-specific nature of this protein as the
      heart is subjected to high pressure overload immediately after birth.

PMID- 8489248
TI  - Proteoglycan metabolism is age related and modulated by isoforms of platelet
      derived growth factor in bovine articular cartilage explant cultures.
AB  - The influence of recombinant human platelet-derived growth factor (PDGF) on
      proteoglycan metabolism was examined in bovine articular cartilage explants under
      serum-free conditions. All three isoforms of PDGF (AB, AA, and BB) dose
      dependently increased proteoglycan biosynthesis and decreased the rate of
      proteoglycan catabolism in cartilage explants obtained from young (1-6 weeks),
      adolescent (2-6 months), and adult animals (2-3 years). The biosynthetic
      stimulative effect of PDGF-AA was significantly lower than that of PDGF-AB only
      in adult tissues. The decrease in catabolic rate was more pronounced in younger
      animals. For culture periods of up to 12 days, the three PDGF isoforms did not
      have an effect on DNA synthesis. The molecular size of both the proteoglycan
      monomers and the glycosaminoglycan chains and the chondroitinase ABC sensitive
      pool decreased with age of the animal, but were not altered by PDGF-AB treatment.
      These data show that the three recombinant human PDGF isoforms contributed to
      matrix homeostasis in the articular cartilage explant system, with no apparent
      mitogenic effect.

PMID- 8489249
TI  - The human platelet dense granule: serotonin uptake, tetrabenazine binding,
      phospholipid and ganglioside profiles.
AB  - The functioning and composition of human platelet dense granules were studied
      using granules purified by Percoll fractionation. Reserpine-blockable serotonin
      (5-HT) uptake by the dense granule fraction was characterized and also
      demonstrated in the crude membrane fraction. Tetrabenazine (TBZ)-displaceable
      [3H]ketanserin binding was used to label the granular 5-HT transporter. Scatchard
      analyses, Hill plots, displacement curves, and binding kinetics indicated that
      TBZ-displaceable [3H]ketanserin binding labeled a site similar to that previously
      reported for chromaffin granules and synaptic vesicles. Analysis of phospholipid
      profiles in platelet fractions revealed that most platelet lysolecithin was
      associated with the dense granule fraction. Ganglioside analysis indicated that
      the predominant platelet ganglioside, GM3, was highly enriched in the dense
      granule fraction. The data lend further support to the idea that the 5-HT
      transporter complex is similar in platelet dense granules, chromaffin granules,
      and synaptic vesicles. However, the ganglioside and phospholipid findings clearly
      distinguish the types of storage sites and raise questions concerning the
      functional roles of dense granule GM3 and lysolecithin.

PMID- 8489250
TI  - Glycosylation pattern and disulfide assignments of recombinant human
      differentiation-stimulating factor.
AB  - This report describes the post-translational modifications of recombinant human
      differentiation-stimulating factor, a 180-residue glycoprotein that is secreted
      from transfected Chinese hamster ovary cells. Peptide peptides containing six
      potential N-glycosylation sites were analyzed to determine that Asn residues 9,
      34, 63, 73, 96, and 116 were utilized. Additional peptides, generated by tryptic
      digestion of peptic fragments, allowed the assignments of three intrachain
      disulfide bonds (Cys-18 to Cys-131, Cys-12 to Cys-134, and Cys-60 to Cys-163).

PMID- 8489251
TI  - Chronic effects of glucose on insulin signaling in A-10 vascular smooth muscle
      cells.
AB  - To examine the effects of hyperglycemia on insulin signaling in A-10 vascular
      smooth muscle cells, cells were treated with extracellular D-glucose and effects
      of insulin were studied on the diacylglycerol-protein kinase C signaling system.
      A-10 cells specifically bound 125I-insulin, and insulin-like growth factor-I did
      not displace the label. 125I-insulin binding was unaltered under hyperglycemic
      conditions. To determine if insulin receptors were coupled to other insulin
      regulated processes, diacylglycerol, protein kinase C, and glucose transport were
      evaluated. Insulin increased cellular diacylglycerol (DAG) levels which were also
      increased following glucose treatment and not further stimulated by insulin. The
      uptake of 2-[3H]deoxy-D-glucose (2-DOG) was stimulated by insulin and 12-O
      tetradecanoyl phorbol 13-acetate (TPA). Insulin- and TPA-stimulated 2-[3H]DOG
      uptake was inhibited by a protein kinase inhibitor, staurosporine. Preincubation
      of cells with 500 nM TPA overnight resulted in the inhibition of insulin- and TPA
      stimulated 2-[3H]DOG uptake. Protein kinase C activity was translocated from
      cytosolic to membrane fractions following insulin treatment. Overnight glucose
      (25 mM) treatment resulted in a 50% decrease in protein kinase C enzyme activity
      and > 90% decrease in protein kinase C beta immunoreactive levels. Protein kinase
      C activity and levels were not affected by osmotic control media containing
      mannitol. A-10 cells express GLUT4-type glucose transporters. Neither insulin
      regulatable glucose transporter (GLUT4) mRNA nor GLUT4 protein levels were
      diminished by glucose. Significant decreases in insulin- and TPA-stimulated 2
      [3H]DOG uptake occurred, however, with glucose. The down-regulation of protein
      kinase C beta and resultant inhibition of 2-[3H]DOG uptake by chronic glucose
      suggests a biochemical link between hyperglycemia and DAG-protein kinase C
      signaling in vascular smooth muscle cells.

PMID- 8489252
TI  - Crystallization and preliminary X-ray analysis of subtilisin DY, a natural mutant
      of subtilisin Carlsberg.

PMID- 8489253
TI  - Spermidine-induced alteration in the gene-spacer discrimination of nucleases in
      protonated DNA.
AB  - The sequence preference of a Drosophila lysosomal DNase was studied on the
      Drosophila hsp 70 heat-shock and histone recombinants, which carry six different
      genes, and the surrounding spacer sequences. The distribution of cleavage sites
      was random in respect of the locations of gene and spacer sequences. However, in
      the presence of 10 mM spermidine, a major transition was observed: the coding
      sequences became more susceptible than the spacer regions to nuclease attack. A
      similar transition was induced in the sequence preference of DNase I if the
      digestion was performed in the presence of spermidine at pH 5.2. At pH 7.5,
      spermidine does not influence the sequence preference of DNase I, which indicates
      the involvement of DNA protonation in this transition. In the presence of
      spermidine, the distributions of preferred and protected sequences were almost
      indistinguishable for these nucleases, suggesting that the protonated DNA, and
      not the enzymes, is the target of spermidine. A Drosophila embryonal protein was
      detected and partially purified which induced the same transition as observed in
      the presence of spermidine. The purified protein preferentially protected the
      spacer DNA sequences against acid DNase or DNase I cleavage in the hsp 70 heat
      shock and histone gene recombinants. The protection was concentration dependent
      and occurred only at pH 5.2. The transition of nuclease specificity is probably
      due to a conformational change in the protonated DNA, induced by the binding of
      either the embryonal protein or spermidine.

PMID- 8489254
TI  - Mobility and molecular orientation of vitamin E in liposomal membranes as
      determined by 19F NMR and fluorescence polarization techniques.
AB  - To elucidate the molecular orientation and mobility of alpha-tocopherol (vitamin
      E) in membranes, 19F nuclear magnetic resonance (NMR) was applied. In bilayer
      phosphatidylcholine (PC) liposomes, 19F NMR spin-spin relaxation times (T2) of
      19F-labeled methyl groups on either the chromanol moiety or the isoprenoid side
      chain of alpha-tocopherol were significantly decreased compared to those for
      alpha-tocopherol in solution (CDCl3), suggesting that the vitamin E molecule
      exists in the lipid core of membranes and that its motional freedom is
      significantly restricted. The difference in T2 values between the solution state
      and PC liposomes was greatest for the 5a-CF3 on the chromanol moiety compared
      with other methyl groups on the isoprenoid side chain. Hence, it is thought that
      the chromanol moiety of alpha-tocopherol may fit tightly near the surface of the
      membrane because of its hydrophilicity. When Pr3+ was added to the liposomal
      suspension, the intensity of the NMR signal for 5a-CF3 changed faster than those
      of the other methyl groups. When the surface of the liposomal membranes was
      positively charged using stearyl amine, the mobility of the 5a-methyl group,
      expressed as the correlation time (tau c), was quite similar to that in
      negatively charged membranes. These results indicate that the chromanol moiety of
      alpha-tocopherol may orient near the membrane surface, and that the hydroxyl
      group may be hydrogen bonded to the ester carbonyl of PC. For further
      confirmation of this conclusion, time-dependent changes in the fluidity of
      liposomes caused by the addition of Pr3+ were measured at the surface and inner
      region of liposomal membranes using a fluorescence polarization technique. The
      fluidity increased in the surface region and decreased in the inner region of
      liposomes containing alpha-tocopherol. These results show that when praseodymium
      ions may pass through the liposomal membrane, the hydrogen bonds between alpha
      tocopherol and the ester carbonyl of PC may be broken, leading to the formation
      of an alpha-tocopherol-Pr3+ complex, thus causing the fluidity to increase. Based
      on the findings obtained, mobility and molecular orientation of vitamin E in
      membranes are proposed.

PMID- 8489255
TI  - Beta 1-3-N-acetylglucosaminyltransferase in human leukocytes: properties and role
      in regulating neolacto glycosphingolipid biosynthesis.
AB  - There are well-established differences in the expression of neolacto neutral
      glycosphingolipids among human leukocyte subclasses. Mature myeloid cells express
      several types of these compounds, whereas mature lymphoid cells are deficient in
      such compounds. The biochemical basis for this is unknown. Therefore, enzyme
      studies were done to determine whether different classes of leukocytes
      (represented by cell lines) contained beta 1-3-N-acetylglucosaminyltransferase
      activity (EC 2.4.1.149, beta 1-3GlcNAcT(i)). This enzyme participates in the
      synthesis of Type 2 chains in glycosphingolipids by catalyzing the following two
      reactions: (i) Gal beta 1-4Glc beta 1-1Cer (lactosylceramide, LacCer) + UDP
      GlcNAc-->GlcNAc beta 1-3Gal beta 1-4Glc beta 1- 1Cer (lactotriaosylceramide) and
      (ii) Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1Cer
      (neolactotetraosylceramide) + UDP-GlcNAc-->GlcNAc beta 1-3Gal beta 1-4GlcNAc beta
      1-3Gal beta 1-4Glc beta 1-1Cer. The first reaction may be the key step in the
      biosynthetic pathway of neolacto structures in human leukocytes. Therefore,
      extracts from several cell lines representative of both myeloid and lymphoid
      lineages, at varied stages of maturity, were assayed with LacCer for the presence
      of beta 1-3GlcNAcT(i) activity. Our results indicate that myeloid cells contain
      this initiating beta 1-3GlcNAcT(i) activity, whereas lymphoid cells do not. This
      is consistent with our thin-layer chromatography immunostain results which show
      that all myeloid cell lines express neutral neolacto glycosphingolipids and
      lymphoid cells do not. Our findings suggest that the presence of the initiating
      activity only in myeloid cells is a regulatory factor in the expression of
      neutral neolacto glycosphingolipids in human leukocytes. We also tested both
      myeloid and lymphoid cell lines for the presence of elongating beta 1-3GlcNAcT(i)
      activity (reaction (ii) above) by using neolactotetraosylceramide as an acceptor.
      Our results show that an elongating activity is expressed by all myeloid and
      lymphoid cell lines tested. Initiating (myeloid) and elongating (myeloid and
      lymphoid) activities were distinguished by several characteristics: metal ion
      activation, pH optimum, and kinetic constants. In conclusion, our results
      indicate the presence of two beta 1-3GlcNAcT(i) activities in human leukocytes:
      one that catalyzes the initial reaction and is found only in the myeloid lineage
      and one that catalyzes the elongating reaction and is found in both myeloid and
      lymphoid cells.

PMID- 8489256
TI  - The effects of castanospermine and swainsonine on the activity and synthesis of
      intestinal sucrase.
AB  - Castanospermine is an indolizidine alkaloid that is found in the seeds of the
      Australian tree Castanospermum australe. These seeds have been reported to be
      toxic to animals and to cause severe gastrointestinal upset. In order to
      determine whether castanospermine is responsible for this toxicity, the alkaloid
      was injected into young mice or rats, and its effects on various intestinal
      disaccharidases were determined. Another indolizidine alkaloid, the alpha
      mannosidase inhibitor swainsonine, was also tested to compare its effects to
      those of castanospermine. Castanospermine strongly and rapidly inhibited the
      activity of the disaccharidases, sucrase, maltase, and trehalase, with sucrase
      being the most sensitive to inhibition. The loss of activity of these enzymes,
      especially sucrase, in injected animals appeared to be due to a direct inhibition
      of enzyme activity, rather than to a change in the structure of the glycan chains
      of the enzyme, since only minor alterations in carbohydrates were observed. On
      the other hand, swainsonine, when injected into animals, also profoundly
      decreased the activity of the sucrase, but this alkaloid had no direct effect on
      sucrase activity although it did markedly alter the carbohydrate nature of this
      glycoprotein. This change in oligosaccharide structure may affect protein
      conformation, stability, or targeting, any or all of which may in turn affect
      activity. In in vitro studies with the purified enzyme, castanospermine was found
      to be a competitive inhibitor of intestinal sucrase, but it was a noncompetitive
      inhibitor of intestinal maltase. A number of other glucosidase inhibitors that
      inhibit sucrase activity in vitro are also described.

PMID- 8489257
TI  - Biosynthesis of vernoleate (cis-12-epoxyoctadeca-cis-9-enoate) in microsomal
      preparations from developing endosperm of Euphorbia lagascae.
AB  - Epoxidated fatty acids are the major constituents of the triacylglycerols in a
      few plant species. We have investigated the biosynthesis of vernolic acid (cis-12
      epoxyoctadeca-cis-9-enoic acid) in the seed oil of Euphorbia lagascae. Microsomes
      were isolated from developing endosperm. The membrane lipids were labeled in situ
      with [14C]oleate or [14C]linoleate, which mainly were recovered in
      phosphatidylcholine (PC), and the metabolization of the radioactive fatty acids
      was followed in incubations with or without NADPH. In the presence of NADPH,
      [14C]vernoleate was formed. After short incubations, most of the vernolic acid
      was found in PC, but with increasing incubation times, the free acid dominated.
      The synthesis of vernoleate was inhibited by carbon monoxide, but not by cyanide.
      The presence of anticytochrome b5 antibodies inhibited both the desaturation of
      [14C]oleate to [14C]linoleate and the epoxidation of [14C]linoleate to
      [14C]vernoleate. Free linoleic acid did not serve as substrate for epoxidation.
      The results indicate that, in the endosperm of E. lagascae, vernoleate is
      synthesized on PC from linoleate, and that the epoxidation is catalyzed by a
      cytochrome P450 and involves cytochrome b5.

PMID- 8489258
TI  - Induction of Schistosoma mansoni glutathione S-transferase by xenobiotics.
AB  - The effects of 3-methylcholanthrene, butylated hydroxyanisole, and phenobarbital
      on the expression of glutathione S-transferase (GST, EC 2.5.1.18) were examined
      in the human parasite Schistosoma mansoni. GST specific activity toward 1-chloro
      2,4-dinitrobenzene increased by 170% in parasites recovered from mice injected
      with 3-methylcholanthrene and 230% in parasites recovered from mice maintained on
      a diet containing butylated hydroxyanisole. These increases in specific enzyme
      activity were paralleled by accumulation of mRNA hybridizing to pGT16.4, a cDNA
      clone that encodes the most abundant GST subunit, SmGST-3. Northern hybridization
      analysis showed a 5-fold increase in mRNA hybridizing to pGT16.4 72 h after
      exposure to 3-methylcholanthrene, a 10-fold increase after 12 days exposure to
      butylated hydroxyanisole, and a 6-fold increase 16 h after treatment with
      phenobarbital. In contrast, no accumulation of mRNA hybridizing to either of two
      other cDNA clones that encode the SmGST-4 and SmGST-6 subunits was detected.
      Hybrid select translation using pGT16.4 combined with reverse-phase high-pressure
      liquid chromatographic analysis demonstrated that in addition to SmGST-3 mRNA,
      the clone also hybridized to mRNA species encoding the SmGST-1 subunit, a member
      of the same isoenzyme family. High-pressure liquid chromatographic analysis of
      GST affinity purified from butylated hydroxyanisole-exposed parasites revealed a
      2.5-fold increase in the concentration of SmGST-1 and SmGST-3 present compared
      with an equivalent amount of tissue from control organisms. There was no change,
      however, in the SmGST-1 to SmGST-3 ratio (1:6), indicating that both subunits
      were induced to the same extent by this agent. The results of these studies
      suggest that alterations in GST expression may influence the parasite's survival
      within the host environment.

PMID- 8489259
TI  - Inhibition of protein radical reactions of ferrylmyoglobin by the water-soluble
      analog of vitamin E, Trolox C.
AB  - The reactivity of Trolox C, a water-soluble analog of vitamin E, toward protein
      radicals formed during the oxidation of metmyoglobin and the therefrom derived
      molecular products was examined in terms of the ability of the phenolic
      antioxidant to prevent specific oxidative reactions involving tyrosyl radicals
      and to reduce the molecular products to functional hemoproteins. (i) Trolox
      prevented the oxidative reactions initiated upon oxidation of the hemoprotein by
      H2O2 and involving tyrosyl radicals: on one hand, it inhibited the covalent
      binding of protein to the heme group and, on the other hand, it inhibited
      dimerization of sperm whale myoglobin, the latter process entailing the
      intermolecular covalent binding of tyrosines. The inhibition of both processes
      required concentrations of Trolox 20- to 50-fold higher than those needed to
      reduce the hypervalent heme iron to its ferric form. Likewise, Trolox inhibited
      dimerization and polymerization of sperm whale myoglobin upon its treatment with
      chloroiridate, a process associated with formation of tyrosyl radicals and
      negligible oxidation of the heme iron. However, these results did not provide
      unambiguous evidence for the reactivity of the phenolic antioxidant toward amino
      acid radicals in myoglobin, for Trolox displayed a high reactivity toward the
      oxidant, chloroiridate. (ii) The stable oxidation product originating from sperm
      whale myoglobin oxidation, i.e., the dimeric hemoprotein, was redox active,
      inasmuch as it retained its capacity to form an oxy complex upon reduction and an
      oxoferryl complex upon oxidation by H2O2. The latter complex was reduced by
      Trolox to a compound which exhibited a 10- to 12-nm blue shift of the 632-nm
      absorption typical of the native metmyoglobin. Although this absorption shift was
      likely to express oxidative modifications of the porphyrin ring, the modified
      hemoprotein retained its capacity to react with peroxides and displayed a
      peroxidative activity.

PMID- 8489260
TI  - Interaction between the C-terminal peptides of tubulin and tubulin S detected
      with the fluorescent probe 4',6-diamidino-2-phenylindole.
AB  - The digestion of tubulin with subtilisin and the reassociation of the digestion
      products was followed by means of the fluorescent probe 4',6-diamidino-2
      phenylindole (DAPI). The fluorescence spectra of DAPI bound to chicken brain
      tubulin and to the main products of tubulin digested with subtilisin-agarose
      (tubulin S and C-terminal peptides) were analyzed. The corrected emission
      spectrum of DAPI in the presence of tubulin showed an enhancement of fluorescence
      intensity with a maximum at 452 nm. The digestion reaction was followed by the
      diminution of the area of DAPI-tubulin emission spectra, which showed biphasic
      pseudo-first-order kinetics. The values for the rate constants were 1.2 x 10(-2)
      min-1 and 3.5 x 10(-2) min-1 for the alpha and beta subunits, respectively, and
      were similar to those determined from the undigested subunits using
      polyacrylamide gel electrophoresis. Tubulin S and the C-terminal peptides were
      purified by means of a Bio-Gel P-60 column. The C-terminal peptides obtained from
      this column were analyzed by urea-sodium dodecyl sulfate polyacrylamide gel
      electrophoresis, and an apparent molecular weight around 3000 was determined. The
      corrected emission spectrum of DAPI in the presence of tubulin S showed a maximum
      shifted to 460 nm and a lower enhancement of fluorescence than the emission
      spectrum of the DAPI-tubulin complex. Titration of purified tubulin S with the C
      terminal peptides of tubulin showed, after the addition of DAPI, an increase in
      the fluorescence intensity at 460 nm with a saturation function dependent on the
      concentration of peptides added. On the other hand, the emission spectrum of DAPI
      in the presence of the C-terminal peptides was unchanged from that of free DAPI
      in the solution. From these results we propose that the DAPI binding site is
      located on tubulin S and that the C-terminal peptides interact with tubulin S
      after digestion with subtilisin.

PMID- 8489261
TI  - The hydroxylation of plant diterpene analogues by the fungus Syncephalastrum
      racemosum.
AB  - Triepoxide diterpenes isolated from the perennial herb, Tripterygium wilfordii,
      have shown promising antileukemic and anti-inflammatory activity in vitro and in
      vivo. However, the toxicity of these epoxides has limited their clinical
      usefulness and analogues are sought which possess the pharmacological actions but
      have a lower toxicity. In this study, we have generated oxidized analogues of
      these diterpenes from a synthetic lactone precursor (19-hydroxy-18 (4-3) abeo
      abieta-3,8,11,13-tetraen-18-oic acid lactone) by incubating the lactone with the
      Zygomycete fungus, Syncephalastrum racemosum. Incubation of lactone with S.
      racemosum in liquid media yielded four distinct polar metabolites as determined
      by thin-layer chromatography of ethyl acetate extracts. Column purification
      followed by structural analysis by 1H NMR and mass spectroscopy revealed these
      compounds to be 7-beta-hydroxylactone, 7-alpha-hydroxylactone, 15-hydroxylactone,
      and 7-ketolactone. When lactone was added to 48-h-old cultures, 7-beta
      hydroxylactone appeared after 30 min whereas there was a 4-h lag period before
      the 7-alpha-hydroxy and 15-hydroxy metabolites were detected suggesting that
      enzyme induction was necessary before metabolism occurred. The 7-ketolactone was
      not detected until 24 h of incubation and this may represent a nonenzymatic
      oxidation of 7-hydroxylactone. The addition of various cytochrome P450 inhibitors
      (ketoconazole, miconazole, alpha-naphthoflavone, aminobenzothiazole, and carbon
      monoxide) to liquid cultures prevented the 15-hydroxylation of lactone.
      Interestingly, in contrast to the other agents, ketoconazole and miconazole (20
      microM) were not able to inhibit 7-hydroxylation even though 15-hydroxylation was
      inhibited by these agents. With the exception of carbon monoxide, cell growth was
      unaffected by these agents. These data suggest that the biotransformation of
      diterpenes by S. racemosum was mediated by an inducible hydroxylase system which
      is sensitive to cytochrome P450 inhibitors and that more than one hydroxylase
      enzyme may be responsible for the observed products.

PMID- 8489262
TI  - Evidence that catalase is a major pathway of ethanol oxidation in vivo: dose
      response studies in deer mice using methanol as a selective substrate.
AB  - Recently, it was demonstrated that 4-methylpyrazole was not only an inhibitor of
      alcohol dehydrogenase but also caused competitive inhibition of fatty acyl-CoA
      synthetase, the enzyme which activates fatty acids (B. U. Bradford, D. T. Forman,
      and R. G. Thurman, 1993, Mol. Pharmacol. 43, 115-119). Rates of catalase
      dependent alcohol metabolism were decreased in alcohol dehydrogenase-negative
      (ADH-) deer mice because the H2O2 supply for catalase via peroxisomal fatty acid
      oxidation was inhibited due to substrate limitation. In light of these findings
      it became necessary to reevaluate the role of catalase and alcohol dehydrogenase
      in alcohol metabolism. In this study, methanol, a selective substrate for
      catalase in rodents, was compared with ethanol. Rates of ethanol and methanol
      metabolism were studied in vivo at blood alcohol levels ranging from 50 to 500
      mg/dl. In the ADH- deer mouse, rates of methanol and ethanol metabolism increased
      when alcohol was elevated from 0 to 100 mg/dl and were maximal at values around 6
      8 mmol/kg/h (half-maximal rates were observed at blood alcohol levels around 50
      mg/dl). In the ADH+ deer mouse, rates of ethanol metabolism increased to values
      around 9 mmol/kg/h at 100 mg/dl and remained constant at blood levels up to 500
      mg/dl. In contrast, rates of methanol metabolism increased to values of only 5
      mmol/kg/h at levels of 100 mg/dl (the half-maximal rate was about 2.5 mmol/kg/h
      at 50 mg/dl) followed by a steady increase to 9 mmol/kg/h as the blood level was
      increased from 100 to 500 mg/dl (the half-maximal rate for this second component
      was around 6 mmol/kg/h at 300 mg/dl). Rates of methanol uptake were 50 +/- 4
      nmol/min/mg protein in 10,000g pellets from ADH- deer mouse livers; however,
      methanol was not metabolized by isolated microsomes. The catalase inhibitor
      aminotriazole decreased ethanol and methanol metabolism 75% in ADH- deer mice.
      Further, olive oil, which is rich in oleate, increased methanol metabolism from 7
      to 11.5 mmol/kg/h. This stimulation was blocked by fructose, which diminishes ATP
      and decreases H2O2 supply. In the ADH+ deer mouse, fructose (2 g/kg) stimulated
      ethanol metabolism as expected; however, inhibition of both ethanol and methanol
      metabolism was observed with higher doses of fructose (10 g/kg). Taken together,
      these data support the hypothesis that catalase is the predominant pathway for
      alcohol metabolism in the ADH- deer mouse. The contribution of catalase was about
      50% in the ADH+ mutant at low doses of ethanol and approached 100% as the alcohol
      concentration was elevated.

PMID- 8489263
TI  - The amino acid sequence of Pseudomonas putida azurin.
AB  - The low molecular weight "blue" copper protein, azurin, has been purified from
      Pseudomonas putida (NCIB 9869) to homogeneity using various chromatographic
      techniques including reverse-phase HPLC. The amino acid sequence of the N
      terminus of the reduced and carboxymethylated protein yielded a single sequence
      corresponding to AECKV. The complete sequence, comprising 128 amino acid residues
      with a C-terminal sequence corresponding to TVTLK, was determined from the
      peptides obtained from a Staphylococcus aureus V8 digest of the protein and
      confirmed using peptides obtained following cyanogen bromide and endoprotease Asp
      N digests. The amino acid sequence contained three cysteine residues at positions
      3, 26, and 112, was devoid of tryptophan, and showed closest similarity (90%
      identical residues) to the previously determined sequence of azurin isolated from
      Pseudomonas fluorescens biotype B [Ambler, R.P. (1971) in Developpements Recents
      Dans L'Etude Chimique De La Structures Des proteins (Preverio, A., Pechere, J.
      F., and Coletti-Preverio, M.-A., Eds.), pp. 289-305, INSERM, Paris]. Examination
      of the complete sequence indicated P. putida azurin contained unique Asp and Ala
      residues at positions 19 and 21, respectively, that have not been found in any
      other azurin sequence.

PMID- 8489264
TI  - The skeletal muscle transverse tubular Mg-ATPase: identity with Mg-ATPases of
      smooth muscle and brain.
AB  - Purified chicken skeletal muscle transverse tubule (T-tubule, TT) membrane
      preparations contain a very active Ca- or Mg-ATPase (EC 3.6.1.3) previously
      thought to be a T-system-specific marker enzyme. The function of the Mg-ATPase
      has not yet been determined although its prominent activity and concentration in
      junctional complexes supports a possible role in the excitation-contraction
      cycle. An essential component of the Mg-ATPase has been identified as a M(r)
      85,000 glycoprotein (85k-GP). Polyclonal antibodies raised against the TT 85k-GP
      were specific and exhibited no cross-reactivity with other skeletal muscle
      proteins on immunoblots. Using this anti-85k-glycoprotein IgG, we have explored
      other chicken tissues to determine the tissue distribution of the 85k-GP.
      Antibody reactive polypeptides of M(r) 85,000 were found in gizzard smooth
      muscle, brain, heart, spleen, and lung tissue. The brain and smooth muscle
      membrane proteins were further purified and characterized for 85k-GP-associated
      Mg-ATPase activity. The brain and smooth muscle enzymes exhibited properties
      indistinguishable from the skeletal muscle TT-specific Mg-ATPase with regard to a
      series of activators and inhibitors, amino terminal amino acid sequences, and the
      effects of deglycosylation. The enzyme in all three tissues was inhibited by the
      diacylglycerol kinase inhibitor R 59022. Identification of the TT Mg-ATPase in
      gizzard smooth muscle has allowed the investigation of the Mg-ATPase membrane
      topology using isolated whole smooth muscle cells. The data support an ecto
      orientation for the smooth muscle cell enzyme. Although the orientations of the
      brain and skeletal muscle enzymes have not been conclusively determined, the
      nearly identical properties of all three enzymes argues for an ecto-orientation
      of the active sites of these enzymes as well. The responsiveness of the three
      enzymes to regulatory lipids suggests that the ecto-Mg-ATPase may serve as a
      master switch controlling extracellular ATP concentrations and ligand
      accessibility to P1- and P2-purinoceptors. It is also proposed that the ecto
      MgATPase may regulate ATP accessibility to ectoprotein kinases in a variety of
      tissues, and, in brain, the ecto-MgATPase may modulate the neurotransmitter role
      of ATP.

PMID- 8489265
TI  - Deoxyribonuclease of Syncephalastrum racemosum--enzymatic properties and
      molecular structure.
AB  - Among the isolated fungal species of soil, one filamentous fungus,
      Syncephalastrum racemosum, produces a relatively large amount of DNase. This
      enzyme has been purified to apparent homogeneity by column chromatography on DEAE
      cellulose, hydroxylapatite, phenyl-Sepharose CL-4B, and Sephadex G-100. The
      active enzyme requires divalent metal ions and has an optimum pH of 7.0 with Mg2+
      and 7.2 with Mn2+. This enzyme is an acidic glycoprotein with a pI 5.0 and is
      relatively unstable at low concentrations. The M(r) of the enzyme is 56,000
      during gel filtration under nondenaturing conditions but is 28,000 during
      polyacrylamide gel electrophoresis in sodium dodecyl sulfate. These results
      suggest a structure consisting of two subunits. The subunits of the holoenzyme
      can be cross-linked with glutaraldehyde. The yield of N-terminal
      phenylthiohydantoin-alanine from the holoenzyme is 140% and that of one peptide
      (D-Y-V-S-S-G-Y-D-R), obtained from the tryptic digest is 160%, indicating that
      the native enzyme is composed of two identical subunits and probably has two
      active domains. Fungal DNase can be inactivated by Cu(2+)-iodoacetate under
      conditions that inactivate bovine pancreatic DNase. The specific activity
      (units/mg of protein) of fungal DNase is 6.5 times that of bovine DNase. The
      amino acid content of fungal DNase, relative to bovine DNase, is higher in Gly
      and lower in Ser and Val. The fungal N-terminal 40-residue sequence shows a high
      degree of homology with a consensus sequence derived from DNase of three
      mammalian species.

PMID- 8489266
TI  - Participation of P450 3A enzymes in rat hepatic microsomal retinoic acid 4
      hydroxylation.
AB  - Cytochrome P450-mediated 4-hydroxylation is an important pathway in the
      termination of the biological action of retinoids. Several purified mammalian
      hepatic P450s have been shown to catalyze the 4-hydroxylation of all-trans
      retinoic acid (retinoic acid) in reconstituted enzyme systems, but the nature of
      the activity in untreated rat liver microsomes has not been defined. In the
      present study, microsomal retinoic acid 4-hydroxylation was characterized in
      untreated liver from rats of both sexes and after a series of induction
      treatments. Thus, dexamethasone and phenobarbital, but not beta-naphthoflavone or
      dimethyl sulfoxide, increased the activity in male and female rats. An
      immunoglobulin G (IgG) fraction raised against P450 3A1 decreased the rate of
      retinoic acid 4-hydroxylation in untreated rat hepatic microsomes, but IgG
      directed against the P450s 2C11, 2B1, and 2C6 were noninhibitory. In vivo
      administration of triacetyloleandomycin, which has been shown to form a
      metabolite intermediate complex with P450 3A, followed by potassium ferricyanide
      oxidation in vitro, reactivated retinoic acid 4-hydroxylation and androst-4-ene
      3,17-dione 6 beta-hydroxylation similarly (to 154 and 152% of the respective
      activities in the absence of potassium ferricyanide). Finally, exogenous retinoic
      acid (60 mg/kg ip for three days) markedly increased the rate of retinoic acid 4
      hydroxylation in hepatic microsomes from male and female rats (3.8- and 3.7-fold,
      respectively). This occurred without comparable increases in other P450
      activities. Despite these findings, the age- and sex-related profiles of
      microsomal retinoic acid 4-hydroxylation were clearly different from those
      measured for other P450 activities. Thus, on the basis of xenobiotic
      pretreatment, developmental, and immunochemical studies, the enzyme(s) involved
      in constitutive retinoic acid 4-hydroxylation appears distinct from a number of
      well-described P450s in untreated and induced rat liver. The data are consistent
      with the partial involvement of P450(s) from the 3A subfamily in retinoic acid 4
      hydroxylation, but it seems clear that P450s 3A1 and 3A2 do not participate in
      this activity.

PMID- 8489267
TI  - Localization of free and bound biotin in cells from green pea leaves.
AB  - Cytosol and vacuoles from protoplasts, chloroplasts, and mitochondria from green
      pea (Pisum sativum) leaves were purified and examined for their biotin content.
      The bulk of free biotin was shown to be exclusively associated with the cytosolic
      fraction at a concentration of about 4 pmol/mg protein and no bound biotin was
      detected. The bulk of bound biotin (biotin-containing carboxylases) was
      associated with the soluble fraction of chloroplasts and mitochondria at a
      concentration of about 1.2 and 13 microM, respectively. No free biotin was
      detected in these organelles. Western blot analysis of total, chloroplastic, and
      mitochondrial polypeptides, using horseradish peroxidase-labeled streptavidin,
      revealed three biotin-containing polypeptides with molecular mass of 220,000,
      76,000 and 34,000. All were detected in the total pea leaf extract, but the M(r)
      76,000 and the M(r) 34,000 biotinylated polypeptides were only detected in
      mitochondria and chloroplasts, respectively. 3-Methylcrotonyl-coenzyme A
      carboxylase and acetyl-coenzyme A carboxylase activities were measured in these
      two compartments, respectively. Previously, it has been shown that the M(r)
      76,000 polypeptide was the biotinylated subunit of the mitochondrial 3
      methylcrotonyl-coenzyme A carboxylase. In this paper, the origin and putative
      function of free biotin located in cytosol are discussed.

PMID- 8489268
TI  - Hormonal regulation of rat uterine collagenase.
AB  - Two different methods of study have been employed in the analysis of the hormonal
      regulation of rat uterine collagenases. The first is concerned with the enzyme
      activity and the second, its synthesis. The data presented in this report reveal
      that the rat uterine collagenase is under the regulatory influence of both
      estradiol and progesterone. This fact is first exemplified by the observation
      that on Day 2 post-ovriectomy, a wave of collagenase synthesis takes place which
      influences the enzyme activity in the uterus during the next 3-4 days. This peak
      in collagenase synthesis disappeared in the uteri of rats subjected to
      ovariectomy and adrenalectomy simultaneously. It indicated that a hormone of
      adrenal origin was responsible for the enhanced synthesis and activity of
      collagenase in the uteri of ovariectomized rats. That the hormone involved was
      progesterone was shown by the subsequent experimental data. The estradiol
      mediated enhancement in rat uterine collagenase activity has been shown to be
      inhibited by intraluminal exposure of the uteri to actinomycin D/cyclohexinmide,
      indicating the apparent influence of the hormone at the level of the collagenase
      gene.

PMID- 8489269
TI  - Vitamin D deficiency suppresses cell-mediated immunity in vivo.
AB  - Severe vitamin D deficiency has been produced in mice as evidenced by severe
      hypocalcemia and an absence of 25-hydroxyvitamin D in blood. Vitamin D deficiency
      was accompanied by a slight decrease in body weight and food consumption. Vitamin
      D-deficient and vitamin D-sufficient mice were sensitized with
      dinitrofluorobenzene (DNFB). Sensitivity to DNFB was determined by treatment of
      one ear with DNFB. The ratio of thickness of the treated ear to that of
      nontreated ear was used as an index of cell-mediated immune reaction. The
      incorporation of [3H]thymidine into the DNA of the ear was also used as an index
      of cell-mediated immunity as was the response of thymus lymphocytes to
      concanavalin A. Vitamin D deficiency markedly decreased the ear thickness ratio
      and the [3H]thymidine incorporation ratio in DNFB-sensitized mice. Similarly, the
      incorporation of [3H]thymidine into the DNA of concanavalin A-treated thymus
      lymphocytes from DNFB-sensitive mice was significantly reduced in vitamin D
      deficiency. These results show that in vivo vitamin D deficiency impairs cell
      mediated immunity. The provision of a vitamin D-sufficient diet for 8 weeks
      corrected the impaired response of the immune system, while vitamin D
      administration for 3 weeks did not.

PMID- 8489270
TI  - [Pathology of gastric precancerous lesions: with special reference to present
      study for genetic abnormality].

PMID- 8489271
TI  - [Fluorocytometric DNA analysis of intestinal metaplasia associated with gastric
      carcinoma].
AB  - Histopathologic studies and fluorocytometric DNA analysis were carried out in 39
      patients with intestinal metaplasia (IM) of the mucosa associated with gastric
      carcinoma, in order to determine possible relationships. According to the
      histological degree of IM, 39 cases were divided into 16 (41%) with slight-to
      moderate, and 23 (59%) with severe IM. The 39 tumors were histologically divided
      into 20 (51%) differentiated tumors and 19 (49%) undifferentiated tumors. The DNA
      patterns of tumors revealed 17 (43%) to be euploidy and 22 (57%) to be
      aneuploidy. The DNA content of the metaplastic epithelial cells was measured, and
      the percentage of the cells in S and G2 + M phases of the cell cycle was taken as
      the index of proliferative activity. DNA analysis of the non-metaplastic
      epithelium was performed in 10 as a control group. While the histological
      differentiation of the tumors and the degree of IM were not related to the
      proliferative activity of IM, the IM around the aneuploid tumors did have higher
      proliferative activity (14.01 +/- 6.16%) than that around euploid tumors (11.08
      +/- 7.13%) or of normal mucosa (9.95 +/- 9.92%). This approach will help to
      determine cell kinetics of IM around the gastric tumor. Our study indicated a
      relationship between DNA ploidy and the proliferative activity of IM around
      gastric cancer.

PMID- 8489272
TI  - [DNA flow cytometry in smooth muscle tumors of the gastrointestinal tract].
AB  - DNA ploidy of 45 smooth muscle tumors of the G.I. tract was determined by flow
      cytometry and correlated with clinical features and prognosis. The sites of the
      tumors were: esophagus (1), stomach (24), small intestine (12), large intestine
      (6), liver (1) and pancreas (1). The histologic type was leiomyoma in 14,
      leiomyosarcoma in 29, and leiomyoblastoma in 2. DNA aneuploidy was more frequent
      in leiomyosarcoma (17/29) than leiomyoma (5/14), but the difference was not
      statistically significant. One leiomyoblastoma was diploid and the other was
      aneuploid. No patients with leiomyoma died. In patients with leiomyosarcomas, 5
      year survival was significantly poorer in those with aneuploid tumors (38%) than
      in those with diploid tumors (83%). There was no correlation between DNA ploidy
      and clinico-pathological features of tumors. The present study disclosed that DNA
      ploidy is a prognostic variable, independent of other variables.

PMID- 8489273
TI  - [Fluorocytometric DNA analysis of borderline lesions in the large intestine].
AB  - A total of 9 surgically resected non-cancerous benign lesions (5 regenerative
      epithelium, 4 hyperplastic or metaplastic epithelium), 4 normal epithelium, 30
      carcinomas and 12 adenomas containing 7 moderate dysplastic epithelium and 5
      severe dysplastic epithelium in the large intestine, were used. Then 40 microns
      thick paraffin sections were made from each specimen, dewaxed, and the target
      portion was excised under microscopic visualization. Free cells isolated by 0.5%
      pepsin solution were smeared and followed by DNA staining by DAPI, and
      fluorocytometric DNA measurement was performed using a fluorocytometer (BH
      2.QRFL, Olympus). All specimens of non-cancerous benign epithelium and normal
      epithelium showed diploidy. The average mean DNA value was 2.03 +/- 0.04 c (1.95
      2.10), the percentage of cells above 4.1 c (4.1 c > or = %) averaged 0.26 +/-
      0.42% (0-1.25) and the coefficient of variation (CV) averaged 14.30 +/- 3.18%
      (10.19-19.58). Seven of 30 carcinomas showed diploidy. Among these diploid
      carcinomas, the mean DNA value averaged 2.30 +/- 1.98 c (2.01-2.71) (p < 0.05),
      4.1 c > or = % averaged 4.17 +/- 2.91% (2.0-10.5) (p < 0.05) and CV averaged 32.2
      +/- 5.8% (24.43-38.90) (p < 0.01). Based on these results, aneuploid cases were
      judged to be malignant. In the case of diploidy, if the percentage of cells above
      4.1 c was more than 2.0% and CV was more than 24.43%; when the former was less
      than 1.25% and the latter was less than 19.58%; and when one or both of the two
      was out of the range described in the above two categories, they were judged to
      be malignant, benign or borderline, respectively. From these criteria, 7 adenomas
      showing moderate dysplasia were analyzed as benign in 2, borderline in 4 and
      malignant in 1, while 5 adenomas evidencing severe dysplasia were analyzed as
      malignant in 4 and borderline in 1. In conclusion, fluorocytometric evaluation of
      the malignant or benign tumor of borderline lesions in the large intestine was
      found to be possible.

PMID- 8489274
TI  - [Immunohistochemical study of p53 in colorectal polyps].

PMID- 8489275
TI  - [Problems in DNA ploidy analysis using flow cytometry--influences from
      contaminant mononuclear cells].
AB  - The present study was undertaken to examine the influences of excessive
      contamination by lymphocytes on the flow cytometric analysis of DNA ploidy of
      head and neck cancers. Although lymphocytes which contaminate test cells can
      serve as an internal control (2C), an excess of these lymphocytes can mask the
      aneuploid peak of cancers. This tendency was particularly prevalent in well
      differentiated squamous cell carcinoma. In some cases, most of the cells isolated
      from tumor-positive HE-stained tissue samples were lymphocytes. This is probably
      because lymphocytes are likely to survive the cell-isolating procedure, whereas
      keratocytes are likely to be destroyed during it. If samples excessively
      contaminated by lymphocytes are subjected to flow cytometry, the aneuploid peak
      of cancer cells is low relative to the 2C peak, possibly causing an erroneous
      judgment of diploid. Cytofluorometry, in which a smear of test cells is observed
      directly to quantify the DNA of cancer cells alone, was useful in detecting
      lymphocyte-masked aneuploid cells.

PMID- 8489276
TI  - [Preoperative evaluation of malignant potential in esophageal carcinoma by
      nuclear DNA contents].
AB  - Employing surgically resected specimens from patients without preoperative
      radiation therapy, we measured the nuclear DNA contents in order to evaluate the
      malignant potential of esophageal carcinoma. The association of the DNA index
      (DI) > or = 1.7 and the intratumoral DNA heterogeneity of biopsy specimens from
      patients with or without preoperative radiotherapy was also analyzed in relation
      to problems related to preoperative evaluation of nuclear DNA contents using
      biopsy specimens and the influence of irradiation on nuclear DNA contents.
      Esophageal carcinomas in 128 cases were studied. Nuclear DNA content was measured
      for biopsy specimens as well as surgically resected tumors by flow cytometry
      according to the method of Hedley and colleagues. HET was found in 42% of
      surgically resected specimens, but in only 18% of biopsy specimens. In 90% of
      cases, dominant DI of the resected tumor was also found in the biopsy specimens.
      Cases of DI > or = 1.7 showed a poorer prognosis than those with DI < 1.7 in
      cases with preoperative radiotherapy (p < 0.05) as well as in those without it.
      These results indicated that DI can be an indicator for highly malignant
      potential of esophageal carcinoma when measuring nuclear DNA contents using not
      only biopsy specimens but also specimens from irradiated cases.

PMID- 8489277
TI  - [Adverse effect of prolonged formalin fixation on DNA ploidy in paraffin-embedded
      tissue].
AB  - From retrospective analysis of 174 formalin fixed, paraffin-embedded, HCC tissue
      samples, the possible correlation was investigated between the CV determined by
      FCM and the duration of formalin fixation. An adverse effect of prolonged
      formalin fixation on CV and fluorescence intensity in liver tissue was
      investigated prospectively in samples from 4 patients.

PMID- 8489278
TI  - [Image analysis on isolated colorectal tumor cells].
AB  - Image analysis of the nuclear morphology was performed on propidium iodide
      stained isolated cells from 9 adenomas and 9 cancers of the colorectum. We
      analyzed DNA content, seven nuclear geometric features and four shape factors of
      tumor cells using an image cytometry system that has been developed in our
      laboratory. Nuclear breadth and the degree of contour irregularity of cancer
      cells were found to be significantly different from those of adenoma cells. The
      coefficients of variation (CV) of some nuclear features and the degree of contour
      irregularity were increased in cancer cells, while CV of the degree of
      circularity was increased in adenoma cells. Moreover, nuclear in G2 phase were
      found to be larger and more round than those in G1 phase. These results suggest
      that cell-cycle-related analysis of nuclear features would be a valid means to
      assess the nuclear morphology of colorectal tumors.

PMID- 8489279
TI  - [Analysis of cell proliferation in endoscopically biopsied specimen of the stomal
      mucosa of the remnant stomach--with special reference to cell cycle and ODC
      activity].
AB  - An attempt was made to investigate the status of cell proliferation in the
      remnant stomach, using endoscopically biopsied specimens, with cell cycle
      analysis by flow cytometry (FCM) and ornithine decarboxylase (ODC) activity
      determination. Fifty-three partially gastrectomized patients (male 33, female 20)
      were examined. Their mean age was 60.5, and 22 underwent Billroth I (BI), and 30
      Billroth II (B II) operation. The mean time elapsing from the initial operation
      was 4.0 years. Almost all specimens showed DNA diploidy by FCM. The S phase cell
      percentage was higher in the stomal area, especially in the B II group.
      Significantly higher ODC activity was recognized in the stomal mucosa especially
      in the B II group. A significant positive relationship was noted between
      postoperative duration and ODC activity in the B II group. These results suggest
      activated cell proliferation in the stomal area of the remnant stomach.
      Especially in the B II group, cell proliferation increased with time after
      initial operation. This activated cell proliferation may play some role in the
      carcinogenesis of the remnant stomach.

PMID- 8489280
TI  - [Simultaneous measurement of kinetochore protein and DNA by flow cytometry].
AB  - We were successful in obtaining simultaneous measurements of kinetochore protein
      and DNA with flow cytometry using HeLa cells and KM cells; the latter originated
      with a squamous cell carcinoma of the oral cavity. Kinetochore protein was
      stained with the serum obtained from a patient with CREST syndrome and FITC
      conjugated goat antihuman IgG antibody; the DNA was stained with propidium
      iodide. The FITC fluorescence of cells with a large DNA index was stronger than
      in cells with a small DNA index. The FITC intensity increased from G1 phase to
      G2/M phase. The rate of FITC intensity increase representing the kinetochore
      protein amount was greater in the early and late S phases than in the other
      phases. The results suggest that kinetochore protein increases in the interphase
      as the cell cycle unfolds.

PMID- 8489281
TI  - [Detection of chromosomal aberration using fluorescence in situ hybridization in
      DNA diploid colorectal carcinomas].
AB  - Numerical aberrations of chromosomes can be detected by fluorescence in situ
      hybridization (FISH), using chromosome-specific probes. It is possible to observe
      this in solid tumors from which it is very difficult to obtain metaphase nuclei.
      The present study employed surgical specimens from 15 cases of colorectal
      carcinoma, all of which showed DNA diploidy. In the same samples, we analyzed
      chromosomal numerical aberration by FISH according to the method of Pinkel et al.
      Biotinylated DNA probes specific to chromosome #7, #11 and #17, were used. The
      hybridization spots were observed by fluorescent microscopy. As a result, the
      numerical aberrations of chromosomes detected by FISH were found in DNA diploid
      cases by FCM. They were trisomy and monosomy. These results indicate that FISH is
      useful to detect the chromosomal aberrations of DNA diploid cases.

PMID- 8489282
TI  - [The intensity of hst-1 gene amplification and malignant potential of esophageal
      carcinoma in relation to intratumoral heterogeneity].
AB  - Amplification of hst-1 gene is associated with poor prognosis in patients with
      esophageal carcinoma. Since there is a high frequency of DNA stem-line
      heterogeneity, we studied intratumoral heterogeneity of hst-1 amplification, and
      evaluated whether or not the intensity of hst-1 amplification is associated with
      the malignant potential of esophageal carcinoma. A total of 73 patients with
      esophageal carcinoma who had undergone esophagectomy were studied. Intratumoral
      heterogeneity of hst-1 amplification was examined in two to four sections of
      tumour specimens which showed mainly DNA heterogeneity in 27 of these patients.
      The judgement of hst-1 amplification in the same tumor was identical in all of
      the 27 patients, although its intensity was not identical in some cases. And in
      73 patients, postoperative recurrence in organs showed a high incidence (78%) in
      the hst-1 amplification group with a high intensity (over 7-fold). Therefore, hst
      1 amplification exceeding 7-fold can serve as an indicator to predict the high
      grade of malignant potential of esophageal carcinoma.

PMID- 8489283
TI  - [Flow cytometric analysis of DNA ploidy in colorectal adenoma].
AB  - Flow cytometric measurement of nuclear DNA content in 159 colorectal adenomas was
      carried out to investigate the relationship between DNA ploidy and the
      histological findings. DNA aneuploidy was detected in 18 lesions (12.8%). The
      incidence of DNA aneuploidy was significantly higher in tubulovillous adenomas
      than in tubular adenomas (30.4% vs. 8.1%; p < 0.01). DNA aneuploidy was not found
      in any adenoma with mild dysplasia, but was noted in 19.1% of those with moderate
      dysplasia and in 33.3% of those with severe dysplasia. The mean size of the
      lesions was significantly larger in adenomas with aneuploidy than in those
      without aneuploidy (14.0 mm vs. 7.7 mm; p < 0.01). The DNA index values of 18
      adenomas with aneuploidy were divided into two groups: one ranged from 1.07 to
      1.23 and the other from 1.66 to 1.85. DNA index values correlated with the size
      of the lesions (p < 0.05), but not with the histologic type and degree of
      dysplasia.

PMID- 8489284
TI  - [S-phase fraction and malignant potential in DNA diploid colorectal cancer].
AB  - Patients with DNA diploid tumor have a significantly longer survival than those
      with DNA aneuploid in colorectal cancer, but some patients with diploid tumor
      show poor survival. For assessing malignant potential in diploid colorectal
      cancer, flow cytometric analysis of S-phase fraction (SPF) was investigated using
      paraffin-embedded materials from 79 carcinoma patients who had been treated from
      1971 to 1989. There was no significant correlation between SPF and
      clinicopathological factors (such as sex, tumor size, tumor location,
      macroscopical type, depth of invasion, node metastasis, peritoneal dissemination,
      liver metastasis and clinical stage). Mean SPF was significantly higher in poorly
      differentiated type carcinomas than in well differentiated type carcinomas.
      Patients with higher SPF had a tendency to poorer survival than those with lower
      SPF. From these results, it was concluded that SPF represents histological
      differentiation and that SPF may be a prognostic indicator, in diploid colorectal
      cancer.

PMID- 8489285
TI  - [Clinical significance of flow cytometric DNA analysis in patients with rectal
      cancer].
AB  - DNA content was measured by flow cytometry using paraffin-embedded material from
      148 primary rectal cancers and 10 distant metastatic lesions. DNA ploidy pattern
      was classified into the following three groups in terms of the DNA index: 1.00
      was defined as the diploid group (DP), 1.00 < DNA index < 1.60 as the low
      aneuploid group (LAP) and > or = 1.60 as the high-aneuploid group (HAP). Primary
      carcinomas were DP in 26.4%, LAP in 36.5% and HAP in 37.1%. The DNA ploidy
      pattern of the primary tumor correlated well with clinicopathological findings
      such as depth of invasion, lymphatic invasion, pathological stage, metastasis to
      distant organs and curability of the tumor. In patients with HAP tumor after
      curative operation, the recurrence rate (21.6%) in distant organs was
      significantly higher than those with DP tumor (2.8%) and LAP tumor (6.4%) [p <
      0.05]. Two LAP patients and 8 HAP patients with distant metastatic disease had
      the same DNA ploidy pattern HAP in the metastatic lesions. These data indicate
      that tumor DNA ploidy patterns classified into three groups in rectal cancer may
      play an important role in predicting prognosis, including distant metastasis.

PMID- 8489286
TI  - [Analysis of p53 expression and DNA ploidy pattern in colorectal cancer].
AB  - An immunohistological staining for p53 conducted in 114 cases of colorectal
      cancer. The background risk factors such as pathological and DNA ploidy patterns
      were analized in all cases. p53 was found in 50.0% (57/114). There was a slight
      increase in p53 positive cases in the advanced cancers, but it was not
      statistically significant. Five-year survival rates of Dukes B and C were 42.2%
      for p53-positive cases and 67.2% for p53-negative cases. There was a statistical
      difference (p < 0.05), but none in the Dukes A group. Study of p53 in combination
      with DNA ploidy patterns revealed an even greater disparity in survival rates (p
      < 0.01) between p53-positive aneuploid cases and p53-negative diploid cases.
      These results indicate that the staining of p53 in conjunction DNA ploidy
      patterns may be a useful indicator of prognosis in the cases of colorectal
      cancer.

PMID- 8489287
TI  - [Preoperative prediction of gastric cancer development by in vitro labelling
      index of bromodeoxyuridine].
AB  - In vitro labelling index (L.I.) of bromodeoxyuridine (BrdU) was evaluated as a
      preoperative predictor of gastric cancer development. Biopsy specimens were
      obtained endoscopically from 187 gastric cancer patients preoperatively.
      Specimens were incubated in RPMI containing BrdU under carbogen gas at 3 times
      atmospheric pressure. They were fixed and embedded in paraffin. After slicing and
      dewaxing, they were denatured in 2N HCl. Then BrdU were stained by ABC method and
      labelling index was calculated. Patients with L.I. more than 10% had a
      significantly higher risk of lymph node involvement (p < 0.001) and venous
      invasion (p < 0.05). Those with L.I. more than 20% had a significantly higher
      risk of liver metastasis (p < 0.01), while patients with L.I. more than 25% had a
      significantly higher risk of submucosal invasion (p < 0.01). In conclusion in
      vitro BrdU labelling is a technique available as a preoperative predictor of node
      involvement, venous invasion, submucosal invasion and prognosis in gastric
      cancer.

PMID- 8489288
TI  - [Effect of neoadjuvant chemotherapy (CDDP.UFT therapy) upon cell DNA analysis by
      flow cytometry in gastric carcinoma].
AB  - Neoadjuvant chemotherapy with CDDP and UFT was performed on far advanced gastric
      carcinoma cases whose curative resection was impossible. These trials were
      carried out on 10 patients who had Borrmann 4 type carcinoma. PR was found in 6
      cases, for an efficacy rate of 60% (6/10). The DNA content in gastric carcinoma
      was determined before and after treatment by flow cytometry. The relationship
      between the change of DNA ploidy pattern and effects of chemotherapy was
      investigated. Aneuploidy was found in 6 of 10 patients (60.0%). DNA ploidy
      patterns showed no correlation with effectiveness. In aneuploid cases, the group
      of responders showed seemingly the change of ploidy pattern, from aneuploid to
      diploid. In non-responders the percentage of aneuploid cells increased. In
      diploid cases, an accumulation of S-phase fraction was observed in the group of
      responders. These results suggested that DNA ploidy analysis may provide
      additional diagnostic criteria for better assessment of chemotherapeutic effects.

PMID- 8489289
TI  - [Diagnostic value of DNA ploidy in epithelial elevated lesions of the stomach].
AB  - Using flow cytometry, we evaluated the diagnostic usefulness of DNA aneuploidy in
      epithelial elevated lesions of the stomach. Four biopsy specimens were obtained
      from each lesion in 14 elevated early cancers, 21 adenomas, 37 hyperplastic
      polyps and 11 cases of chronic gastritis with intestinal metaplasia. All samples
      obtained from benign lesions indicated diploidy. DNA aneuploidy was detected in
      12 lesions (85.7%) of early cancers. DNA indices ranged from 1.10 to 1.19 in six
      of 10 intramucosal cancers with DNA aneuploidy. Meanwhile, a total of two
      submucosally invasive cancers had stemlines with a DNA index of more than 2.00.
      Four early cancers, including two submucosally invasive ones, had multiple
      aneuploid stemlines. DNA aneuploidy is a useful marker of malignancy in
      epithelial elevated lesions of the stomach. A higher DNA index and multiple
      aneuploid stemlines may be possible markers of submucosal invasion in early
      cancer.

PMID- 8489290
TI  - [DNA-cytofluorometric, histopathological and immunohistochemical analyses of
      pancreatoduodenal cancers].
AB  - To study the cell characteristics of relatively small pancreatoduodenal cancers
      (less than 4 cm in the greatest dimension in histopathological examination), we
      analyzed the relation between the cell kinetics, and histopathological and
      immunohistochemical findings. Tumors were classified into t1 (0-2 cm in its
      greatest dimension) and t2 (2-4 cm). We analyzed DNA contents of five tumors of
      t1 and twelve of t2 by cytofluorometry. Histopathological and immunohistochemical
      (CA19-9 and CEA) examinations were also carried out. Nuclear DNA content
      histograms of the tumors in the t1 group showed all diploid pattern, while those
      in the t2 group exhibited 4 diploid, 7 euploid polyploid and 1 aneuploid
      patterns. Invasions to the lymphatic (ly), vein (v) and nerve (pn) were found in
      five cases of diploid tumors (3 of t1 and 2 of t2) and all (8 in t2) of non
      diploid tumors. A medullary pattern of tumor growth was only noted in three
      tumors of t1. This pattern was not found in t2 (4 diploid, 8 non-diploid). These
      results suggest that the cellular DNA content increased in association with the
      tumor growth in size. In the histopathological findings, both the invasions (ly,
      v, pn) and fibrosis of the stroma more often appeared as the tumor size and
      polyploid and aneuploid cells increased. However, other histopathological
      findings and the immunohistochemical examination for CA19-9 and CEA had no
      relation to the tumor growth and the DNA ploidy pattern.

PMID- 8489291
TI  - [Nuclear DNA ploidy pattern and cytological atypia in aspiration cytology of
      breast cancer].
AB  - The relationship between nuclear DNA ploidy pattern and cytological atypia in
      aspiration cytology of breast cancer was studied in 40 cases of primary breast
      cancers (T1: 14 cases; T2: 26 cases). They were divided into two groups,
      according to cytological specimens, high degree (H group) and low degree (L
      group). Twelve of 40 cases were classified into H group and 28 cases into L
      group. Fresh frozen materials were obtained from mastectomy specimens and nuclear
      DNA analysis was carried out by flow cytometry (FCM). Estrogen receptor (ER) and
      progesterone receptor were measured with the DCC method. Lymph node metastases
      were histologically seen in 17 cases; the ER positive rate was 55.0%, and the PgR
      positive rate was 42.5%. FCM revealed 21 cases (52.5%) with diploidy pattern and
      19 cases (47.5%) with aneuploidy pattern. S-phase fraction in 17 cases (48.6%)
      exceeded 20%. L group had more diploid cases and ER positive cases than H group
      (p < 0.05, p < 0.01). No differences in other factors were seen between the two
      groups. In diploid cases, L group had more ER positive cases than H group (p <
      0.02).

PMID- 8489292
TI  - [Influences of 5'-deoxy-5-fluorouridine (5'-DFUR) on cell cycle in patients with
      breast cancer].
AB  - Recently, the effectiveness of preoperative chemotherapy for cancer treatment has
      attracted much attention. The authors conducted a study to investigate the
      influence of 5'-DFUR administration on the cell cycle, based on DNA analysis
      using FCM in patients with breast cancer. A total of 53 patients with breast
      cancer (Stages I, II and III) were investigated concerning tumor PyNPase activity
      and cell cycle phase. Subjects were stratified according to tumor diameter,
      histologic type and ER in the group receiving preoperative 5'-DFUR administration
      (25 patients) and the group not receiving 5'-DFUR (28 patients). The subjects in
      the group on 5'-DFUR preoperative administration were classified into three sub
      groups according to total dosages of 400 mg (8 patients), under 4,800 mg (8
      patients) and 4,800 mg or over (9 patients). In terms of tumor diameter,
      significant increases (p = 0.027) of S-phase were observed in patients with the
      diameters of 5 cm or more in the sub-group of under 4,800 mg dosage. Similar
      tendencies were seen in all drug administration groups (p = 0.05). However, no
      influence was observed on S-phase in the group without 5'-DFUR administration. In
      terms of ER stratification, ER(-) patients in the dosing groups showed increasing
      tendencies in S-phase and significant differences of G1- as well as G2+M phases.
      No differences in PyNPase activity were noted in each stratified group.
      Preoperative administration of 5'-DFUR resulted in alterations of cell cycle in
      breast cancers. In patients with a total drug dosage of under 4,800 mg and with
      tumor diameters of 5 cm or more, increases of S-phase and decreases of G1-phase
      were observed. It was suggested that 5'-DFUR acted in DNA synthesizing stage to
      accumulate S-phase inhibiting cell cycles. Consequently, this drug is considered
      useful for neoadjuvant chemotherapy.

PMID- 8489293
TI  - [Evaluation of chemosensitivity test for cancer using the collagen gel embedded
      culture system--DNA ploidy pattern and chemosensitivity].
AB  - The authors previously reported the advantages of a collagen gel embedded culture
      system for chemosensitivity tests for cancer. In this report, the
      chemosensitivities of surgically resected specimens were evaluated by the
      collagen gel embedded culture system and compared with the DNA ploidy pattern,
      measured by flow cytometry. The chemosensitivity and DNA ploidy pattern were
      determined in 11 patients with lung cancer, 8 with gastric cancer and 46 with
      colorectal cancer. Anticancer agents were MMC and CDDP at Cmax for one hour of
      exposure, and 5-FU, VDS, VP-16 and ADM at one tenth the Cmax for 24 hours of
      exposure. Results were compared with those of DNA histogram. In eight lung
      cancers which were demonstrated to be sensitive by the collagen gel system, 5
      showed DNA aneuploidy (DA) and 3 DNA diploidy (DD). Seven cases (87.5%) of
      gastric cancer were demonstrated to be sensitive with the collagen gel system.
      Two of them showed DA and five DD. On the other hand, 19 cases (41.3%) of
      colorectal cancer were found to be sensitive, and 7 of them showed DA and twelve
      DD. Lung cancer and gastric cancer exhibiting aneuploidy demonstrated sensitivity
      with the collagen gel system, but the rate of sensitivity was only 28% in
      colorectal cancer, and even aneuploidy cases showed a low sensitivity.

PMID- 8489294
TI  - [Protooncogene c-myc amplification and cell cycle analysis in human malignant
      tumors].
AB  - As predictors of tumor response by radiotherapy, tumor with or without c-myc
      amplification and DNA histogram pattern were analyzed and evaluated for patients'
      prognosis. There was no relation between c-myc amplification and DNA ploidy
      pattern in this study. These factors also showed no relation to response rate and
      survival. But all of the tumors with c-myc amplification and aneuploid pattern
      exhibited a complete response by radiotherapy. The tumors with c-myc
      amplification and aneuploid pattern may be more radiosensitive than without
      amplification and diploid. These data suggested that c-myc amplification and
      ploidy pattern might be a predictive parameter before radiotherapy.

PMID- 8489295
TI  - [Estimation of proliferative activity of experimental tongue papillomas and
      carcinomas in rats--comparison with DNA cytofluorometric analysis and silver
      stained nucleolar organizer regions].
AB  - Eleven tongue papillomas and 25 tongue carcinomas were produced in rats by the
      oral administration of 0.001% 4-nitroquinoline 1-oxide (4 NQO) in drinking water,
      and tumor kinetics were investigated by both DNA cytofluorometry and Ag-nucleolar
      organizer regions (Ag-NORs) staining. The histopathologic characteristics, the
      mean Ag-NOR number per cell and DNA ploidy patterns were compared. The mean Ag
      NOR number was least in normal epithelium, more numerous in papillomas and
      highest in squamous cell carcinomas. The differences were statistically
      significant. All cases of normal epithelium and papilloma showed a diploid
      pattern. Eighteen cases of the squamous cell carcinomas (72%) showed a diploid
      pattern, and 7 cases (28%) exhibited a diploid plus tetraploid pattern. There was
      a significant difference in the mean Ag-NOR number between the two groups of
      squamous cell carcinomas. These results suggest that the mean Ag-NOR number may
      reflect the cell kinetics in the process of carcinogenesis and polyploidization
      of carcinomas.

PMID- 8489296
TI  - [Early phase II study of Idarubicin, a new anthracycline anticancer drug, in
      acute leukemia. Idarubicin Study Group].
AB  - An early phase II study of Idarubicin was performed in patients with acute
      leukemia. The dosages administered were 10 mg/m2, 12 mg/m2, or 15 mg/m2 by iv
      bolus, once daily for 3 consecutive days. The treatment was given to 47 patients
      who were in relapse or whose diseases had been refractory to remission induction
      therapy. Of the 47 patients, 35 were evaluable for response. The patients who
      showed a response (complete or partial remission) were 9 of 14 patients (64.3%)
      in the 10 mg/m2 group, 1 of 12 patients (8.3%) in the 12 mg/m2 group, and 3 of 9
      patients (33.3%) in the 15 mg/m2 group, respectively. Remissions were achieved in
      10 of 23 (43.5%) patients with acute myelogenous leukemia, and in 3 of 6 (50.0%)
      of those with chronic myelogenous leukemia in blast crisis. However, no remission
      was achieved in 6 patients with acute lymphocytic leukemia. As for patients who
      had received prior anthracycline therapy, remissions were achieved in 11 of 29
      patients (37.9%), and so clinical cross resistance between idarubicin and other
      anthracyclines was thought to be partial. The principal adverse effects were
      gastrointestinal symptoms, alopecia, fever and infection. In the 15 mg/m2 group,
      there was an increased number of adverse events of WHO's grade 3 or over. The
      result indicated that Idarubicin is a useful drug for the treatment of acute
      leukemia, and the clinical optimal dosage estimated was either 10 mg/m2 or 12
      mg/m2 once daily for 3 consecutive days.

PMID- 8489297
TI  - [Early phase II study of Idarubicin combined with cytarabine in acute myelogenous
      leukemia. Idarubicin Study Group].
AB  - An early phase II study of a combination regimen consisting of Idarubicin and
      Cytarabine was performed in patients with acute myelogenous leukemia. Idarubicin
      at a dose of 10 mg/m2 or 12 mg/m2 was given by 5-min. iv bolus, once daily for 3
      consecutive days and Cytarabine at a dose of 80 mg/m2 was given by 2-hour iv
      infusion, twice daily for 7 consecutive days. Of 19 patients treated, 17 were
      evaluable for responses. The patients who showed a response (complete or partial
      remission) were 4 of 10 (40.0%) in the 10 mg/m2 group, 6 of 7 (85.7%) in the 12
      mg/m2 group, and in total, 10 of 17 patients (58.8%), respectively. Analysing
      relationship between prior chemotherapy and responses, all of 3 patients without
      pretreatment, 6 of 10 patients (60.0%) in the first relapse, and 1 of 4 patients
      (25.0%) whose disease had been refractory to induction therapy after relapse
      responded. Seven of 14 patients (50%) who had received prior anthracycline
      therapy, showed a response. The principal adverse effects were gastrointestinal
      symptoms, alopecia, fever and infection, similarly to those observed in
      Idarubicin single therapy. When combined with Cytarabine, Idarubicin increased
      the incidence and severity of gastrointestinal symptoms. Considering
      effectiveness and safety, the clinical optimal dosage of Idarubicin when used
      concomitantly with Cytarabine was judged to be 12 mg/m2 once daily for 3
      consecutive days.

PMID- 8489298
TI  - [Usefulness of contact thermography for the evaluation of chemotherapeutic
      effectiveness in breast cancer].
AB  - We examined temperature differences between a cancerous breast and its
      counterpart normal one by contact thermography before and after preoperative
      chemotherapy, and evaluated the relationship between the changes in the
      thermograms and response to chemotherapy in six patients with breast cancer. We
      used the following definitions: 1) delta Tmean: temperature differences between a
      mean temperature of a cancerous breast and that of the contralateral healthy
      breast; 2) delta Tmax: temperature differences between a cancer-related
      hyperthermic area in a breast and the mirror area of contralateral breast; 3) and
      the thermal patterns in thermogram were estimated by the criteria of Tada et al.
      In responders the thermograms after chemotherapy indicated an improvement in the
      hyperthermic vascular pattern (HVP) or hyperthermic area and a decrease of delta
      Tmean and delta Tmax. In contrast, little or no changes were observed in the
      thermograms of non-responders. Degrees of changes in thermograms reflected the
      effectiveness of chemotherapy. Our study showed that chemotherapeutic
      effectiveness may be better evaluated by combining contact thermography with the
      present method measuring tumor sizes than by only the present one.

PMID- 8489299
TI  - [Experimental study on comparative efficacy of hepatic arterial injection of
      anticancer agent under temporary occlusion of portal vein].
AB  - To compare the efficacy of intra-hepatic arterial infusion of anti-cancer drug
      under temporary occlusion of portal vein, the following two experiments were
      performed. 1. VX2 tumor cells (about 1 x 10(5) cells) were transplanted through
      the superior mesenteric vein of the rabbits, after 2 weeks, 4'-0
      Tetrahydropyranyl doxorubicin (2 mg/kg, 2 ml) aqueous solution (THP) was
      administered into hepatic artery of rabbits with metastatic VX2 liver tumor. 2.
      THP was injected into hepatic artery under temporary occlusion of portal branch
      of median left lobe with metastatic liver. Then the THP levels of normal liver
      tissue and tumor of median left lobe and lateral right lobe. The THP levels of
      tumor under portal occlusion tended to be about 2.63-fold higher than without
      occlusion. These results suggest that hepatic arterial injection under portal
      occlusion is more useful to increase the levels of anticancer agents of
      metastatic liver tumor.

PMID- 8489300
TI  - [Effect of medroxyprogesterone acetate on antitumor efficacies and side effect of
      5-fluorouracil].
AB  - Effect of medroxyprogesterone acetate (MPA) on the lethal toxicity, bone marrow
      toxicity and antitumor efficacies of 5-fluorouracil (5-FU) was examined. The
      following results were obtained. In aged female ddY mice, the lethal toxicity and
      body weight loss caused by 5-FU were reduced by MPA. MPA also reduced the bone
      marrow toxicity of 5-FU in aged female ddY mice. These effects of MPA were not
      observed in young male ddY mice. Moreover, MPA did not affect the antitumor
      activity of 5-FU against MPA-insensitive mouse breast carcinoma FM3A, or rather
      augmented its antitumor activity against MPA-sensitive human breast carcinoma MCF
      7. These results indicate that MPA reduces the side effects of 5-FU and augments
      the antitumor activity of 5-FU in female mice.

PMID- 8489301
TI  - [Disease-free survival in a patient with squamous cell lung carcinoma following
      complete response with the combination chemotherapy of cisplatin and etoposide].
AB  - Disease-free survival is reported in a patient with non-small cell lung carcinoma
      successfully treated with the combination chemotherapy of cisplatin and etoposide
      (CDDP-ETOP). An 80-year-old woman was diagnosed as having squamous cell carcinoma
      of the lung with bone metastasis. Chest X-ray showed a tumor (64 x 68 mm in size)
      in the S1/4 segment of the right lobe, and CT scan revealed no apparent
      metastasis of hilar lymphnode. In March 1989, the patient achieved a complete
      response (CR) after two courses of CDDP-ETOP therapy, followed by ETOP(100mg)
      every two weeks and daily UFT (400 mg) for 10 months. Subsequently, a single
      course of CDDP-ETOP was administered as a consolidation therapy. The patient is
      alive with no evidence of recurrent disease for 3 years and half after achieving
      CR.

PMID- 8489302
TI  - [Effects of combined hormone therapy on the coagulation-fibrinolytic systems in
      patients with advanced breast cancer].

PMID- 8489303
TI  - [Establishment of continuous infusion system via hepatic artery or portal vein of
      the rat].

PMID- 8489304
TI  - [Effect of hepatic arterial injection of liposome-encapsulated cisplatin upon
      hepatic carcinoma in rats].

PMID- 8489305
TI  - [Clinical trial of the systemic chemotherapy for advanced prostatic cancer
      patients].

PMID- 8489306
TI  - [Clinical efficacy of YNK 01 (1-beta-D-arabinofuranosylcytosine-5'
      stearylphosphate) in patients with polycythemia vera].

PMID- 8489307
TI  - Organized medicine in the United States.

PMID- 8489308
TI  - Progressive loss of pancreatic function in chronic pancreatitis is delayed by
      main pancreatic duct decompression. A longitudinal prospective analysis of the
      modified puestow procedure.
AB  - OBJECTIVE: This study evaluated the effect of operative drainage of the main
      pancreatic duct (MPD) on functional derangements associated with chronic
      pancreatitis (CP). SUMMARY BACKGROUND DATA: The author previously reported
      delayed functional impairment in an evaluation of the impact of operative
      drainage in patients with CP. The author now reports on a prospective study of
      143 patients with this diagnosis. METHODS: Each patient underwent 1) ERCP, 2) the
      Bentiromide PABA, 3) 72-hour fecal fat test, 4) oral glucose tolerance test
      (OGTT) and 5) fat meal (LIPOMUL)--stimulated pancreatic polypeptide release (PP).
      All patients were stratified as mild/moderate (M/M) or severe CP on the basis of
      a 5-point system that was developed by the author. Patients were studied at 16
      month intervals. RESULTS: All 143 patients underwent initial and follow-up
      evaluations in a mean follow-up of 47.3 months; 83 of 143 patients had M/M grade
      at initial evaluation. Eighty-seven patients underwent (MPD) decompression to
      relieve abdominal pain. In a separate prospective 17 patients with a diagnosis of
      CP, a grade of M/M and non-disabling abdominal pain were randomized to operative
      or non-operative treatment; 9 of these randomized patients were operated upon and
      8 were not. No patient improved their grade during follow-up; 47 of 83 M/M
      patients had operative drainage and 36 did not. This grade was preserved in 41 of
      47 (87%) operated patients but in only 8 of the 36 non-operated patients (22%).
      In the randomized trial, seven of nine operated patients retained their
      functional status in follow-up, whereas only two of eight patients (25%)
      randomized to non-operation preserved their functional grade. CONCLUSIONS: These
      data in this large study as well as among a previous randomized sample, support a
      policy of early operative drainage before the development of irreversible
      functional impairment in patients with chronic pancreatitis and associated
      dilation of the main pancreatic duct.

PMID- 8489309
TI  - Acute pancreatitis of unknown etiology in the elderly.
AB  - OBJECTIVE: The incidence of acute pancreatitis in the elderly patient is
      increasing, and a significant number of such patients have no clearly defined
      etiology of their pancreatitis. To delineate the role of early organ failure
      versus progressive pancreatic disease in the morbidity and mortality, the
      authors' experience with patients older than 60 years with acute pancreatitis was
      reviewed. SUMMARY BACKGROUND DATA: As many as 30%-40% of elderly patients with
      acute pancreatitis have an unclear etiology and such patients have high rates of
      early organ failure and death. While some authorities have shown that pre
      existing disease in these elderly patients did not contribute to subsequent
      morbidity, others have demonstrated that poor outcome was related to co-existing
      medical illness. METHODS: Their review of acute pancreatitis in the elderly was
      grouped into known and unknown etiology patients. Various parameters such as
      morbidity, mortality and length of stay were then compared between the two
      groups. Severity of organ failure and acute pancreatitis on admission were both
      graded and attempts made to correlate this severity with subsequent outcome.
      RESULTS: Unknown etiology patients had a greater number of Ranson's criteria (3.5
      +/- .44 vs. 2.4 +/- .18) (p < 0.02), higher morbidity (48% vs. 22%) (p < 0.05),
      higher mortality (24% vs. 8.3%), and more SICU days (4.4 +/- 1.3 vs. 1.6 +/- .44)
      (p < 0.05) when compared with the known etiology group. Duration of symptoms,
      admission hypotension, and Ranson's criteria were unsuccessful in predicting
      mortality. Functional status of the various organ systems on admission did
      predict subsequent mortality. CONCLUSIONS: Elderly patients with acute
      pancreatitis of unknown etiology present with a more severe disease, have higher
      morbidity and longer SICU stays, and appear to have greater compromise of organ
      function. Organ function compromise correlates with mortality and appears more
      significant than severity of pancreatic disease. Aggressive support of such organ
      systems may be beneficial in the management of these patients.

PMID- 8489310
TI  - Experience with mycophenolate mofetil (RS61443) in renal transplantation at a
      single center.
AB  - OBJECTIVE: Mycophenolate mofetil (MM) is a new immunosuppressive agent that
      reversibly inhibits guanine nucleotide synthesis and DNA replication. Its
      activity is highly selective for T and B lymphocytes. Two open-label multicenter
      trials of MM in renal transplantation have been performed. This report summarizes
      the results from one center involved in these two trials. METHODS AND RESULTS:
      The initial trial of MM was an open-label dose-ranging trial in primary cadaveric
      renal transplantation. Mycophenolate mofetil was included in the maintenance
      immunosuppression regimen from the day after transplantation. Of the 21 patients
      enrolled in this trial, one (5%) was withdrawn for side effects. There was one
      graft loss due to recurrent renal disease and two patients were withdrawn for
      difficulty with follow-up. Mean follow-up is 26 months, and patient and graft
      survival at 2 years are 100 and 95% respectively. The second trial was designed
      to study the efficacy of mycophenolate in reversing refractory renal allograft
      rejection. Patients enrolled in the trial had biopsy-proven acute rejection and
      had previously received at least one course of high-dose corticosteroids and/or
      OKT3. Of the 26 patients enrolled in this trial, one (4%) was withdrawn for side
      effects. There were two deaths. Mean follow-up is 20 months, and patient and
      graft survival at 12 months was 91 and 54%. The incidence of infections in the
      two groups was 38% and there were no deaths in either group attributable to
      infection. CONCLUSIONS: The results of these two studies indicate that
      mycophenolate mofetil could be administered safely to renal allograft recipients
      for periods up to 2 years. It appears to be effective in reversing acute
      rejection in a high percentage of patients refractory to other forms of therapy.

PMID- 8489311
TI  - Soluble HLA class I in the serum of transplant recipients.
AB  - BACKGROUND: Soluble HLA, Class I (S-HLA-I) has been found in serum, plasma, body
      fluids, peritoneal dialysates, and urine. S-HLA-I may be a product of membrane
      shedding, proteolysis, and/or alternate gene splicing. Previous assays to
      quantitate S-HLA-I were cumbersome, required radioisotope labeling procedures, or
      the purification of Class I antigen preceding antigen quantitation. The authors
      developed a solid-phase, enzyme-linked immunoassay that can be used to quantitate
      S-HLA-I and to study its relevance in transplantation. METHODS: A solid-phase
      enzyme-linked immunoassay employing monoclonal anti-Class I to catch S-HLA-I
      present in plasma and peroxidase-labeled monoclonal anti-beta 2-microglobulin
      (B2M) to quantitate bound S-HLA-I was employed. Values were correlated with
      rejection and infection episodes. Pre and postoperative determinations were made
      from the sera of liver, heart, and kidney recipients. Size chromatography was
      used to compare the molecular weight of S-HLA-I from baseline and peak serum
      concentrations obtained during rejection episodes (2 liver, 1 heart, 1 kidney),
      and from 1 kidney recipient with a wound infection. RESULTS: All 9 liver
      recipients and 12 heart recipients demonstrated a fall in S-HLA-I, or very low
      initial values, for the first 10 days and then a progressive increase in values
      substantially above preoperative concentrations. Values from renal recipients
      were more variable. There were temporary increases in S-HLA-I preceding or during
      16 of 20 (80%) biopsy-proven rejections (all reversible), and in 9 of 11 (83%)
      episodes of infection (bacterial, viral, and fungal). In heart and liver
      rejection, as well as the wound infection, the sera contained increased S-HLA-I,
      which was almost all of the same molecular weight (approximately 52,000 daltons).
      In serum from the one patient with renal rejection, two additional S-HLA-I peaks
      occurred, one with a molecular weight near 1,000,000 daltons and the second at a
      molecular weight approximately 11,000 daltons suggesting cellular breakdown of
      the donor organ. CONCLUSION: In summary, different patterns of S-HLA-I
      concentrations occur after kidney transplantation. Most liver and heart
      recipients reached a steady state higher than preoperative levels. Transient
      increases in S-HLA-I occurred with rejection and infection. In one severe
      rejection episode, larger and smaller fractions of S-HLA-I were detected and may
      represent cell membrane breakdown.

PMID- 8489312
TI  - MHC class II presenting cells are necessary for the induction of intrathymic
      tolerance.
AB  - OBJECTIVE: This study determined the form of cellular donor MHC alloantigen
      necessary for the induction of intrathymic tolerance. BACKGROUND: The authors
      have achieved indefinite donor-specific tolerance, to a fully MHC-disparate rat
      heterotopic cardiac allograft, after the pretransplant intrathymic injection of
      unfractionated donor splenocytes and a single injection of rabbit anti-rat
      lymphocyte serum (ALS), without subsequent immunosuppression. METHODS: Male 4-12
      week-old Buffalo (RT1b) rats underwent an intrathymic injection of either
      fractionated Lewis (RT1(1)) red blood cells (purified by Ficoll gradient) or T
      lymphocytes (purified by nylon wool column and plastic adherence), both of which
      express only MHC class I alloantigens, or B lymphocytes, macrophages, and
      dendritic cells (purified by plastic adherence) which express both MHC class I
      and class II alloantigens. At the completion of alloantigen injection the Buffalo
      recipient rats were given 1 ml of ALS intraperitoneally. Twenty-one days later a
      heterotopic Lewis heart was transplanted. RESULTS: The intrathymic injection of
      the fractions of Lewis MHC class I and class II expressing B lymphocytes,
      macrophages, and dendritic cells induced a donor-specific tolerance that resulted
      in indefinite Lewis cardiac allograft survival (MST > 125 days) in all recipients
      without further immunosuppression, whereas groups receiving MHC class I
      expressing red blood cell or T lymphocyte injections plus ALS rejected Lewis
      cardiac allografts with a MST of 7.3 and 16.5 days, respectively, thus indicating
      that the MHC class II expressing cell is necessary for the induction of
      intrathymic tolerance. Buffalo recipients with a long-term surviving Lewis
      cardiac allograft, after Lewis MHC class II expressing cells were still able to
      reject a third-party heterotopic ACI (RT1a) cardiac allograft in normal time (MST
      = 7.0 days), but did not reject a second Lewis cardiac allograft (MST > 100
      days). Additionally, the intrathymic injection of MHC class II expressing cells
      resulted in decreased interleukin-2 (IL-2) production and an 80% decrease in in
      vitro donor-specific cell mediated cytotoxicity, whereas the cytolytic response
      to a third party was unaltered. CONCLUSION: Donor MHC class II, and not class I,
      expressing cells are the cells in donor splenocytes, injected intrathymically,
      responsible for the development of donor-specific allograft tolerance.

PMID- 8489313
TI  - Development of a hybrid bioartificial liver.
AB  - OBJECTIVE: The authors developed an extracorporeal liver support system and
      tested its efficacy in experimental animals with liver failure. The first
      clinical use of this system to treat a patient with liver failure is reported.
      SUMMARY BACKGROUND DATA: Multiple attempts have been made, ranging from plasma
      exchange to use of charcoal columns, to develop liver support systems for
      treating patients with acute severe liver failure. None of these systems has
      achieved wide clinical use. There is a need for providing liver support as a
      "bridge" to transplantation and for treating patients with potentially reversible
      liver dysfunction. METHODS: A hybrid liver support system has been developed
      consisting of plasma perfusion through a charcoal column and a porous hollow
      fiber module inoculated with 5 x 10(9) matrix-attached hepatocytes. The system
      was tested in dogs with ischemic liver failure (n = 7) who underwent
      plasmapheresis; a control group (n = 6) underwent charcoal perfusion alone. A
      patient with liver failure was treated with this hybrid system. RESULTS: After 6
      hours of hybrid liver support treatment, animals had significantly decreased
      serum ammonia and lactate levels, increased glucose level, normal prothrombin
      time, and increased systolic blood pressure compared with controls treated with
      charcoal perfusion alone. Use of the system to treat a patient was well tolerated
      with evidence of clinical improvement. CONCLUSIONS: Plasma perfusion through a
      system consisting of a charcoal column and matrix-attached porcine hepatocytes
      had significant beneficial effects in animals with liver failure and was well
      tolerated by a patient with liver failure.

PMID- 8489314
TI  - Successful transplantation of marginally acceptable thoracic organs.
AB  - OBJECTIVE: This study evaluates the efficacy of personally inspecting marginal
      thoracic organ donors to expand the donor pool. SUMMARY BACKGROUND DATA: The
      present donor criteria for heart and lung transplantation are very strict and
      result in exclusion of many potential thoracic organ donors. Due to a limited
      donor pool, 20-30% of patients die waiting for transplantation. METHODS: The
      authors have performed a prospective study of personally inspecting marginal
      donor organs that previously would have been rejected by standard donor criteria.
      RESULTS: Fourteen marginal hearts and eleven marginal lungs were inspected. All
      14 marginal hearts and 10 of the marginal lungs were transplanted. All cardiac
      transplant patients did well. The mean ejection fraction of the donor hearts
      preoperatively was 39 +/- 11% (range 15-50%). Postoperatively, the ejection
      fraction of the donor hearts improved significantly to 55 +/- 3% (p < 0.002).
      Nine of the ten lung transplant patients did well and were operative survivors.
      Our donor pool expanded by 36% over the study period. CONCLUSIONS: The present
      donor criteria for heart and lung transplantation are too strict. Personal
      inspection of marginal thoracic donor organs will help to maximize donor
      utilization.

PMID- 8489315
TI  - Infections caused by halophilic marine Vibrio bacteria.
AB  - OBJECTIVE: The authors reviewed patients who developed sepsis or soft tissue
      infections caused by marine Vibrio bacteria in Florida. SUMMARY BACKGROUND DATA:
      Marine Vibrio bacteria are the most common bacteria found in seawater. They are
      concentrated in marine animals that feed by filtration such as oysters and clams.
      These bacteria can cause gastroenteritis, sepsis, cellulitis leading to
      necrotizing soft tissue infection after exposure to seawater or consumption of
      raw seafood. METHODS: The authors received 182 systemic infections that occurred
      in Florida between January 1, 1979, and December 31, 1991, which were treated by
      the authors or were reported to the Florida Department of Health and
      Rehabilitative Services. Patients were divided into two groups depending on
      whether they presented with primary bacteremia or soft tissue infection. RESULTS:
      Seventy-one patients had been exposed to these bacteria by eating raw seafood, 94
      had direct exposure to seawater, and exposure was uncertain in 27 patients.
      Vibrio species were cultured from the blood of 103 patients and from wounds or
      soft tissues of 113. An additional 5 patients had cellulitis but bacteria were
      not cultured from these sites. In patients in whom it could be determined, 93 had
      primary soft tissue infections and 82 had primary bacteremia. Twenty-four
      patients had necrotizing soft tissue infections and required surgical
      debridement. Three of these 24 patients required amputation. Thirty-seven (20.3%)
      patients died. Severe liver disease occurred in 54 patients and 25 of these
      patients died. CONCLUSIONS: Marine Vibrio bacteria can cause sepsis and soft
      tissue infections, especially in individuals with severe liver disease and other
      chronic illnesses such as diabetes mellitus. The authors believe all individuals,
      especially those with systemic illness, should be warned against eating raw
      seafood.

PMID- 8489316
TI  - Management of major biliary complications after laparoscopic cholecystectomy.
AB  - OBJECTIVE: A total of 50 major bile duct injuries after laparoscopic
      cholecystectomy were managed by the Duke University Hepatobiliary Service from
      1990-1992. The management of these complex cases is reviewed. SUMMARY BACKGROUND
      DATA: Laparoscopic cholecystectomy is the preferred method for removing the
      gallbladder. Bile duct injury is the most feared complication of the new
      procedure. METHODS: Review of videotapes, pathology, and management of the
      original operations were reviewed retrospectively, and the injuries categorized.
      Major biliary injury was defined as a recognized disruption of any part of the
      major extrahepatic biliary system. Biliary leakage was defined as a clinically
      significant biliary fistula in the absence of major biliary injury, i.e., with an
      intact extrahepatic biliary system. RESULTS: Thirty-eight injuries were major
      biliary ductal injuries and 12 patients had simple biliary leakage. Twenty-four
      patients had the classic type injury or some variant of the classic injury. A
      standard treatment approach was developed which consisted of ERCP for diagnosis,
      preoperative PTC with the placement of stents, CT drainage immediately after the
      PTC for drainage of biliary ascites, and usually Roux-en-Y hepaticojejunostomy
      with placement of O-rings for future biliary access if necessary. Major ductal
      injuries were high in the biliary system involving multiple ducts in 31 of the 38
      patients. Re-operation was required in 5 of the 38 patients with particularly
      complex problems. CONCLUSIONS: Successful management of bile duct injury after
      laparoscopic cholecystectomy requires careful understanding of the mechanisms,
      considerable preoperative assessment by experts, and a multidisciplinary
      approach.

PMID- 8489317
TI  - Laparoscopically harvested omental free flap to cover a large soft tissue defect.
AB  - OBJECTIVE: The omentum has been a very important tool in the armamentarium of the
      reconstructive surgeon. It has lost much of its value because of the morbidity
      associated with laparotomy. Laparoscopic surgery has become a popular technique
      and allows operations to be performed with minimal morbidity. The possibility of
      harvesting the omental free flap with the laparoscope and its use in
      reconstructive surgery has been demonstrated. SUMMARY BACKGROUND DATA: Since the
      first laparoscopic cholecystectomy was performed, many surgeons have learned the
      procedure. Other surgical specialties have also benefited from this technique.
      The omentum provides a large amount of vascularized tissue and excellent wound
      coverage. It can be transferred as a pedicle flap, or as a free flap, using
      microvascular technique. METHODS: The procedure was developed and refined in an
      animal model. One team harvested the omentum with laparoscopic assistance, while
      the other team prepared the recipient vessels. After completion of the
      microvascular transfer, the dogs were observed for 14 days. At that time, the
      omental tissue was examined for gross and histologic changes. A clinical case is
      also presented. RESULTS: Gross and microscopic studies documented the viability
      of this approach. The patient tolerated the procedure well and had an
      unremarkable postoperative course. CONCLUSIONS: Experimental and clinical
      evidence shows that the omentum can be successfully harvested as a free flap
      using laparoscopic assistance. This technique may prove to be of clinical
      significance and very useful for reconstructive surgery with less morbidity.

PMID- 8489318
TI  - Endoscopic management of peptic ulcer disease.
AB  - OBJECTIVE: This article reviews the authors' experience with endoscopic
      management of duodenal ulcer and ulcers occurring after a previous drainage
      procedure. SUMMARY BACKGROUND DATA: Patients with complications of duodenal ulcer
      and ulcers occurring after a previous drainage procedure still require surgical
      management. Virtually all operations for duodenal ulcer include some form of
      vagotomy. American surgeons in academic centers prefer highly selective vagotomy
      in suitable candidates. Video-directed laparoscopic and thoracoscopic operations
      have been done for all complications of duodenal ulcer except for acute
      hemorrhage. METHODS: The authors have performed laparoscopic operation on eight
      patients with intractable chronic duodenal ulcer, seven patients with
      gastroesophageal reflux disease combined with duodenal ulcer, one patient with
      chronic duodenal ulcer and gastric outlet obstruction, and one patient with acute
      perforation. Operations performed included omentopexy, anterior seromyotomy plus
      post truncal vagotomy, and highly selective vagotomy. Seven patients had a
      simultaneous Nissen fundoplication; and the patient with obstruction underwent
      concomitant pyloroplasty and vagotomy. Six patients with intestinal ulcers
      occurring after a previous drainage procedure were treated with thoracoscopic
      vagotomy. Techniques used are shown. RESULTS: There has been one recurrent ulcer
      in the laparoscopic group after anterior seromyotomy plus posterior truncal
      vagotomy. The patient treated by omentopexy for duodenal perforation recovered
      gastrointestinal function promptly with no further difficulty, but eventually
      died of primary medical disease. Patients undergoing thoracoscopic vagotomy have
      all become asymptomatic. Postoperative hospital stay after highly selective
      vagotomy, anterior seromyotomy plus posterior truncal vagotomy, or thoracoscopic
      vagotomy was 1-5 days. CONCLUSIONS: Laparoscopic management of duodenal ulcers is
      feasible. Larger numbers of patients with longer follow-up are essential. Ulcers
      occurring after a drainage procedure deserve thoracoscopic vagotomy.

PMID- 8489319
TI  - A prospective analysis of diagnostic laparoscopy in trauma.
AB  - OBJECTIVE: This study was performed to assess current and potential future
      application for laparoscopy (DL) in the diagnosis of penetrating and blunt
      injuries. Efficacy, safety, and cost analyses were performed. SUMMARY BACKGROUND
      DATA: Diagnostic peritoneal lavage (DPL) and computed tomography (CT) have been
      the mainstays in recent years for diagnosis of equivocal nontherapeutic
      laparotomy, whereas CT is not helpful for the vast majority of penetrating
      wounds. DL may be a useful adjunct to fill in these gaps. METHODS:
      Hemodynamically stable patients with equivocal evidence of intraabdominal injury
      were prospectively entered into the protocol. DL was performed under general
      anesthesia; patients with wounds penetrating the peritoneum or blunt injury with
      significant organ injury underwent laparotomy. RESULTS: Over 19 months, 182
      patients (55% stab, 36% GSW, 9% blunt) were studied. No peritoneal penetration
      was found at DL in 55% of penetrating wounds with 66% of the remainder having
      therapeutic laparotomy, 17% nontherapeutic laparotomy, and 17% negative
      laparotomy. Therapeutic laparotomy was performed in 53% of blunt injuries after
      DL. Tension pneumothorax occurred in one patient and one had an iatrogenic small
      bowel injury. Charges for DL were $3,325 per patient compared with $3,320 for a
      similar group undergoing negative laparotomy before this protocol. CONCLUSIONS:
      DL is a safe modality for trauma. With current technology, DL is most efficacious
      for evaluation of equivocal penetrating wounds. Significant cost savings would be
      gained by performance under local anesthesia. Development of miniaturized optics,
      bowel clamps, retractors, and stapling devices will reduce overall costs and
      permit some therapeutic applications for laparoscopy in trauma management.

PMID- 8489320
TI  - Thoracoscopic surgery for diseases of the lung and pleura. Effectiveness,
      changing indications, and limitations.
AB  - OBJECTIVE: This study compared the results of video-assisted thoracic surgery
      (VATS) with thoracoscopic surgery (TS) for diseases of the lung and pleura.
      SUMMARY BACKGROUND DATA: No studies exist that compare the capabilities of VATS
      with advanced video systems and instrumentation to that of TS which has been done
      for 80 years. METHODS: A retrospective study was done comparing the
      effectiveness, indications, complications, and limitations of TS and VATS done
      for four categories of pleural disease: 1) pleural fluid problems, 2) diffuse
      lung disease, 3) lung masses, and 4) pneumothorax. The TS period was 1981-1990.
      The VATS period was 1991-1992. RESULTS: Eighty-nine consecutive TS cases and 64
      consecutive VATS cases were reviewed. TS for resolution of pleural fluid problem
      was successful in 29 of 34 patients (85%), and VATS was successful in 18 of 20
      (90%). Diffuse lung disease was diagnosed by TS using a cup biopsy on end-stage
      patients in respiratory failure. Since 1991 the diagnosis has been made with VATS
      using stapled wedge excisions on ambulatory patients. Surgical mortality
      decreased from 33% (10 of 30) to 9% (1 of 11) and the postoperative stay from
      16.6 +/- 2.4 days to 8.2 +/- 2.2 days. Lung masses were diagnosed entirely by
      incisional biopsies using TS. Diagnosis was made in 83% and postoperative stay
      was 5.3 +/- 1.0 day. VATS allowed excisional biopsies permitting diagnosis in
      100% with a postoperative stay of 3.0 +/- 0.2 days (p = 0.05). However, 20%
      required conversion to thoracotomy to locate the subpleural mass. TS was
      performed for spontaneous pneumothorax in only 26% (5 of 19) of the total
      pneumothorax cases, whereas, VATS was used for spontaneous pneumothorax in 67%
      (12 of 18). CONCLUSION: VATS has continued the effectiveness of TS for treating
      pleural fluid problems, has resulted in earlier surgical diagnostic intervention
      in diffuse lung disease and earlier therapeutic intervention in primary
      pneumothorax states, and has markedly expanded the safety, efficacy and
      indications for lung mass biopsy.

PMID- 8489321
TI  - The staged celiotomy for trauma. Issues in unpacking and reconstruction.
AB  - OBJECTIVE: This article describes the important clinical events and decisions
      surrounding the reconstruction/unpacking portion of the staged celiotomy for
      trauma. METHODS: Of 13,817 consecutive trauma admissions, 1175 received trauma
      celiotomies. Of these, 107 patients (9.1%) underwent staged celiotomy with
      abdominal packing. The authors examined medical records to identify and
      characterize: (1) indications and timing of reconstruction, (2) criteria for
      emergency return to the operating room, (3) complications after reconstruction,
      and (4) abdominal compartment syndrome (ACS). RESULTS: Fifty-eight patients
      (54.2%) survived to reconstruction, 43 (74.1%) survived to discharge; 9 patients
      (15.5%) were returned to the operating room for bleeding; 13 patients required
      multiple packing procedures. There were 117 complications; 8 patients had
      positive blood cultures, abdominal abscesses developed in 6 patients, and ACS
      developed in 16 patients. CONCLUSIONS: 1. Reconstruction should occur after
      temperature, coagulopathy, and acidosis are corrected, usually within 36 hours
      after the damage control procedure. 2. Emergent reoperation should occur in any
      normothermic patient with unabated bleeding (greater than 2 U packed cells/hr).
      3. ACS occurs in 15% of patients and is characterized by high peak inspiratory
      pressure, CO2 retention, and oliguria. Lethal reperfusion syndrome is common but
      preventable.

PMID- 8489322
TI  - Brain metabolism in teenagers with attention-deficit hyperactivity disorder.
AB  - OBJECTIVES: We sought to obtain and compare values of cerebral glucose metabolism
      in normal minors and minors with Attention Deficit Hyperactivity Disorder (ADHD).
      We also sought to confirm our earlier findings of reduced brain metabolism in
      adults with ADHD, and to examine whether these results might be diagnostically
      useful. DESIGN: Case-control study. SETTING: Adolescents were recruited to
      National Institutes of Health Clinical Center/Research Facility through
      advertisement at local high schools and ADHD organizations. PATIENTS: Subjects
      were 10 normal adolescents and 10 adolescents with ADHD diagnosed with structured
      interviews using DSM-III-R criteria. MAIN OUTCOME MEASURES: Positron emission
      tomography and fludeoxyglucose F18 were used to study cerebral glucose metabolism
      in minors while they performed an auditory-attention task. RESULTS: Global or
      absolute measures of metabolism did not statistically differ between groups,
      although hyperactive girls had a 17.6% lower absolute brain metabolism than
      normal girls. As compared with the values for the controls, normalized glucose
      metabolism was significantly reduced in six of 60 specific regions of the brain,
      including an area of the left anterior frontal lobe (P < .05). Lower metabolism
      in that specific region of the left anterior frontal lobe was significantly
      inversely correlated with measures of symptom severity (P < .001-.009, r = -.56
      to -.67). CONCLUSIONS: Global or absolute measures of metabolism using positron
      emission tomography and fludeoxyglucose F18 did not statistically differentiate
      between normal adolescents with ADHD. Positron emission tomography scans can be
      performed and are well tolerated by normal teenagers and teenagers with ADHD. The
      feasibility of normal minors participating in research involving radiation was
      established.

PMID- 8489323
TI  - An in vivo study of phosphorus and glucose metabolism in Alzheimer's disease
      using magnetic resonance spectroscopy and PET.
AB  - OBJECTIVES: To study phosphorus and glucose metabolism in whole-brain slices of
      otherwise healthy patients with dementia of the Alzheimer type (DAT) and healthy
      controls. DESIGN: We used proton nuclear magnetic resonance imaging phosphorus
      spectroscopy and positron emission tomography to study in vivo brain phosphorus
      and glucose metabolism. PATIENTS: Whole-brain slice phosphorus metabolism was
      studied in nine drug free patients with mild to moderately severe dementia of the
      Alzheimer type (DAT) and in eight age- and sex-matched healthy controls. Mean
      ages (+/- SD) of the patients and controls were 60 +/- 10 years and 64 +/- 16
      years, respectively. Positron emission tomography was used to study cerebral
      glucose metabolism in seven of the patients with DAT and seven of the healthy
      controls. RESULTS: Patients with DAT had significant brain glucose hypometabolism
      compared with controls, but there was no significant group difference in any
      phosphorus metabolite concentration or ratio in the same volume of brain tissue.
      Also, within patients with DAT there was no correlation between any phosphorus
      metabolite concentration or ratio and either severity of dementia or glucose
      metabolism. CONCLUSIONS: We suggest glucose metabolism is reduced early in DAT
      (reflecting decreased basal synaptic functioning) and is unrelated to a rate
      limitation in glucose delivery, abnormal glucose metabolism, or abnormal coupling
      between oxidation and phosphorylation. Normal or near-normal levels of phosphorus
      metabolites are maintained in mild, moderate, and severe DAT. Therefore, altered
      high-energy phosphate levels are not a consequence of reduced glucose metabolism
      in DAT, and do not play a major role in the pathophysiology of the disorder, at
      least in whole-brain sections.

PMID- 8489324
TI  - Evidence of subtypes of Alzheimer's disease and implications for etiology.
AB  - OBJECTIVE: Because age of onset does not reliably define two subtypes of
      Alzheimer's disease, classification based on the severity of neuronal
      degeneration was tested. DESIGN: Numbers of extracellular tangles and pyramidal
      neurons in the hippocampus were used to group patients. PATIENTS: The study
      population consisted of 46 elderly patients satisfying DSM-III criteria for
      dementia and NINCDS-ADRDA criteria for definite Alzheimer's disease after death.
      RESULTS: Univariate logistic regression analysis showed the numbers of
      neurofibrillary tangles and pyramidal neurons and the duration of dementia were
      significantly associated with grouping based on the presence of abundant
      extracellular tangles. Ninety-one percent of patients were correctly classified
      as compared with 85% correctly classified by age of onset data. Odds ratios
      showed that increasing numbers of neurofibrillary tangles predicted greater
      severity of neuronal loss. CONCLUSION: The results of the study indicate the
      importance of neurofibrillary degeneration, not the deposition of amyloid, in the
      pathogenesis of Alzheimer's disease. They support a classification of Alzheimer's
      disease related more closely to the severity of neurofibrillary degeneration than
      to age at onset.

PMID- 8489325
TI  - Brain morphology, dopamine, and eye-tracking abnormalities in first-episode
      schizophrenia. Prevalence and clinical correlates.
AB  - OBJECTIVE: To characterize the pathophysiology of schizophrenia and to identify
      biologic markers in first-episode patients with no or little prior treatment
      exposure. DESIGN: Prospective study of an inception cohort. SETTING: Psychiatric
      division of an academic medical center with a suburban metropolitan catchment
      area. PATIENTS: 70 patients in their first episode of schizophrenia (77%) or
      schizoaffective disorder (23%) with no (70%) or limited prior neuroleptic
      exposure (30%), and 50 healthy volunteer control subjects. ASSESSMENT MEASURES:
      Demographic and clinical evaluations of natural history and psychopathology;
      methylphenidate hydrochloride and apomorphine hydrochloride stimulation tests as
      measures of central nervous system dopamine activity; brain magnetic resonance
      imaging; eye-tracking examinations. RESULTS: Preliminary analyses demonstrate
      that pathobiologic features previously identified in heterogeneous and primarily
      chronically ill patients are also present in subgroups during their first
      episode. These include psychotogenic response to methylphenidate (59%), abnormal
      growth hormone (GH) secretion (50%), abnormal brain morphology (31%), and eye
      tracking dysfunction (51%). An association of pathobiologic variables with
      increased symptom severity and earlier age of onset was observed but not
      statistically significant. The strongest associations among biologic variables
      were for the following: GH secretion and psychotogenic response to
      methylphenidate, which may reflect increased dopamine agonist neural activity;
      decreased GH response to apomorphine and third-ventricle enlargement, which may
      represent a neuropathologic correlate of anterior pituitary abnormalities; and
      morphologic abnormalities of the medial temporal lobe and third ventricle were
      associated with normal eye tracking, suggesting that these pathobiologic features
      are mediated by distinct processes. CONCLUSIONS: These phenomena appear to be a
      consequence of the disease rather than the effects of chronicity, drug treatment,
      or institutionalization. It remains to be determined if these biologic phenomena
      will remain stable over time or change with disease progression. A companion
      article examines the clinical significance of these findings.

PMID- 8489326
TI  - Efficacy of phenelzine and haloperidol in borderline personality disorder.
AB  - OBJECTIVE: To compare the efficacy of a neuroleptic (haloperidol) to a monoamine
      oxidase inhibitor antidepressant (phenelzine sulfate) against the affective,
      cognitive, and impulsive-aggressive symptoms of criteria-defined borderline
      inpatients in an effort to dissect apart affective and schizotypal symptom
      patterns or subtypes using medication response. DESIGN: Randomized, double-blind,
      placebo-controlled trial. SETTING: Inpatient unit of a tertiary care university
      psychiatric hospital serving a large public catchment area. PATIENTS: One hundred
      eight consecutively admitted borderline inpatients defined by Gunderson's
      Diagnostic Interview for Borderline Patients and DSM-III-R criteria, randomly
      assigned to 38 phenelzine, 36 haloperidol, and 34 placebo trials. INTERVENTIONS:
      Following 1 week free of medication, haloperidol (average dose, 4 mg/d),
      phenelzine sulfate (average dose, 60 mg/d), or placebo were given for 5 weeks
      with weekly symptom ratings and plasma drug level determinations. MAIN OUTCOME
      MEASURES: Efficacy was measured on depression (Hamilton Rating Scale, Beck
      Depression Inventory), global severity (Global Assessment Scale, Symptom
      Checklist-90 items [SCL-90]), anxiety, anger-hostility (SCL-90, Inpatient
      Multidimensional Psychiatric Scale [IMPS], Buss-Durkee Hostility Inventory),
      psychoticism (Schizotypal Symptom Inventory, SCL-90, IMPS), impulsivity (Ward
      Scale, Barratt Impulsiveness Scale, Self-Report Test of Impulse Control), and
      borderline psychotherapy (Borderline Syndrome Index). RESULTS: Three-way
      comparisons between groups indicated superior efficacy for phenelzine, followed
      by placebo and haloperidol on measures of depression, borderline psychopathologic
      symptoms, and anxiety. Pairwise comparisons between medication and placebo
      revealed significant efficacy for phenelzine against anger and hostility but no
      efficacy against atypical depression or hysteroid dysphoria. We were unable to
      replicate prior reports of efficacy for the neuroleptic. CONCLUSIONS:
      Pharmacologic dissection of borderline personality disorder patients into
      affective and schizotypal subtypes could not be demonstrated.

PMID- 8489327
TI  - A placebo-controlled comparison of lithium and triiodothyronine augmentation of
      tricyclic antidepressants in unipolar refractory depression.
AB  - OBJECTIVE: To directly compare the efficacy of lithium carbonate and liothyronine
      sodium (triiodothyronine) in the augmentation of therapeutic response in
      antidepressant nonresponders. DESIGN: A randomized, double-blind, placebo
      controlled study of 2 weeks' duration. SETTING: The Mood Disorders Program,
      Clarke Institute of Psychiatry and the University of Toronto, Ontario. PATIENTS:
      Fifty outpatients, males and females, with unipolar, nonpsychotic major
      depression who had failed to respond to treatment with desipramine hydrochloride
      or imipramine hydrochloride. RESULTS: Both liothyronine and lithium were more
      effective than placebo in reducing scores on the Hamilton Rating Scale for
      Depression. However, the antidepressant augmenting effect of these two compounds
      did not differ from each other. When response was defined as a 50% or more
      reduction in the Hamilton Rating Scale for Depression scores and a final score
      less than 10, we found that 10 of 17 subjects responded to liothyronine, nine of
      17 responded to lithium and three of 16 responded to placebo. CONCLUSIONS: Our
      study suggests that both lithium and liothyronine may be considered as
      alternatives in augmenting antidepressant response in patients who do not respond
      to treatment with a tricyclic antidepressant.

PMID- 8489328
TI  - Dissociation between pituitary and adrenal suppression to dexamethasone in
      depression.
AB  - OBJECTIVE: To determine if corticotroph nonsuppression, as reflected by beta
      endorphin nonsuppression, occurs before cortisol nonsuppression (defined as a
      cortisol level of > 140 nmol/L) when examining multiple time points in a day.
      SETTING: The General Medical Clinical Research Center and Inpatient Depression
      Research Unit, Ann Arbor, Mich. DESIGN: Multiple blood samples were obtained
      through an intravenous catheter around the time points of 8 AM, noon, and 4 PM
      and assayed for beta-endorphin and cortisol. PATIENTS: Patients meeting Research
      Diagnostic Criteria for the diagnosis of major depressive disorder, primary and
      simple. A total of 73 subjects, both inpatients and outpatients, were studied.
      INTERVENTION: Samples were obtained both at baseline and 1 day after
      administration of 1 mg of dexamethasone at 11:30 PM. MEASUREMENTS AND RESULTS:
      Overall 39 patients (53%) demonstrated beta-endorphin nonsuppression after
      administration of dexamethasone at any of the three time points, while only eight
      patients (11%) demonstrated cortisol nonsuppression at any of these time points.
      Cortisol nonsuppression, but not beta-endorphin nonsuppression, was associated
      with lower concentrations of dexamethasone in plasma. Baseline cortisol and
      menopausal status were significantly associated with beta-endorphin
      nonsuppression in women.

PMID- 8489329
TI  - The definition of remission and its impact on the length of a depressive episode.

PMID- 8489330
TI  - Seasonal effects on platelet 5-HT content in patients with OCD and controls.

PMID- 8489331
TI  - The Human Genome Project. History, goals, and progress to date.
AB  - This article presents an overview of the Human Genome Project. The goals of the
      program are outlined; the genetic, physical, and DNA sequence maps that will be
      its products are defined; the brief origins of the project are traced; the
      management structure of the US Human Genome Project, in which the Department of
      Energy and the National Institutes of Health participate as partners, is
      outlined; international dimensions are discussed; the excellent progress to date
      with respect to each of the eight scientific goals is reported; and the projected
      impact of the project on biology and medicine is discussed.

PMID- 8489332
TI  - Ethics and the Human Genome Project.
AB  - This article provides an overview of ethical issues in genetic testing and
      screening as they are currently considered in relationship to the Human Genome
      Project. Previous landmark reports and policy recommendations on genetic testing
      and screening are briefly described. The goals and research interests of the
      joint National Institutes of Health/Department of Energy Ethical, Legal, and
      Social Working Group of the Human Genome Project are outlined. To provide an
      example of one method by which ethical issues in genetics may be addressed, the
      ethical framework and practical aspects of a clinical ethics research project at
      the University of Washington, Seattle, are described. Finally, future directions
      for the study of ethical and social issues related to genetic testing and
      screening programs are suggested.

PMID- 8489333
TI  - Molecular genetics. Introduction.
AB  - While sharing the same techniques as the field at large, diagnostic molecular
      genetics is unique among the subdisciplines of molecular pathology in many of its
      aspects, from sample collection to ethical implications of the test results
      obtained. Yet, despite its many challenges, this branch of DNA diagnostics has
      already pervaded the practice of medical genetics to an extent unmatched in any
      other clinical specialty. Genetic disease also presents the most immediately
      obvious opportunities for extension from DNA-based diagnosis to DNA-based
      therapy.

PMID- 8489334
TI  - Detection and quantitation of human immunodeficiency virus type 1 using molecular
      DNA/RNA technology.
AB  - The direct detection and quantitation of human immunodeficiency virus type 1 are
      becoming increasingly important for diagnosis and viral load determinations in
      human immunodeficiency virus type 1 infection. Traditional molecular-based assays
      such as Southern, Northern, and in situ hybridization have had limited
      application in this area due to the relatively low number of proviral copies per
      cell, the low percentage of infected cells, and transcriptional dormancy in many
      of the infected cells. Recent technological advances in polymerase chain reaction
      assays promise a number of useful applications in the clinical research and
      clinical laboratory setting.

PMID- 8489335
TI  - In situ hybridization. A research technique or routine diagnostic test?
AB  - In situ hybridization is the molecular method for localizing nucleic acid targets
      in the context of histomorphology. As such, it has tremendous potential
      application in research and diagnostic pathology. This essay attempts to briefly
      review the in situ method and to clarify its position as an emerging clinically
      useful technology.

PMID- 8489336
TI  - Analysis of HLA class II polymorphism using polymerase chain reaction.
AB  - A simple, rapid, and precise method of typing HLA class II polymorphism would be
      valuable in the areas of disease susceptibility, tissue transplantation,
      individual identification, and anthropological genetics. Herein, we describe a
      method of analyzing class II sequence polymorphism based on polymerase chain
      reaction (PCR) amplification and hybridization with oligonucleotide probes. Many
      more DNA-defined alleles at the class II loci have been identified than can be
      distinguished by conventional serologic typing. Consequently, matching transplant
      donors and recipients by PCR/oligonucleotide typing should reduce graft rejection
      and graft-vs-host disease. Also, the ability to identify alleles conferring
      genetic predisposition to specific diseases (eg, insulin-dependent diabetes
      mellitus) is significantly enhanced by distinguishing the many alleles or
      "subtypes" within a serologic type (eg, DR4). One valuable property of sequence
      based HLA typing strategies, like oligonucleotide probe hybridization, is that
      they reveal how and where two alleles differ, not simply that they can be
      operationally distinguished. The nature and location of HLA polymorphisms appears
      to be critical in disease association studies and are important in tissue typing
      for transplantation. New alleles at the DRB1, DPB1, and DQB1 loci are likely to
      be identified as this technology is applied to more and more samples,
      particularly in nonwhite ethnic groups. A new allele is uncovered as an unusual
      pattern of probe binding and then confirmed by sequencing. This pattern is
      observed because class II polymorphism is localized to specific regions and
      virtually all "new" alleles represent "shuffled" combinations of polymorphic
      sequences found in previously known alleles. Since these polymorphisms are in the
      region of probe binding, these new alleles can be detected without increasing the
      probe panel. Obviously, any new allele with a new polymorphic sequence in a
      region for which typing probes are not available would not be revealed by
      oligonucleotide typing. With the PCR primers and probes described here, 7 DQ
      alpha 1 alleles, 15 DQ beta 1 alleles, 18 DPB1 alleles, and 32 DRB1 alleles are
      distinguished. Additional primers and/or probes can, of course, increase the
      allelic discrimination of PCR/oligonucleotide probe typing. These horseradish
      peroxidase-labeled oligonucleotide probes are stable (> 2 years when stored at 4
      degrees C) and the typing system is simple and robust. Although this dot
      blot/oligonucleotide hybridization procedure is a powerful and precise method of
      HLA class II typing, the complexity of the procedure increases as the number of
      probes required for analysis increases.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8489337
TI  - Forensic DNA testing.
AB  - Forensic deoxyribonucleic acid (DNA) testing has revolutionized criminal
      investigations. Deoxyribonucleic acid testing is superseding traditional
      serologic testing due to its discriminatory power, universal application to
      biologic materials, and resistance to environmental insults, among other
      advantages. Its acceptance is becoming commonplace, and it is being put into
      widespread use. Forensic DNA testing technology and its application is continuing
      to evolve.

PMID- 8489338
TI  - Lack of effect of prophylactic aerosolized pentamidine on the detection of
      Pneumocystis carinii in induced sputum or bronchoalveolar lavage specimens.
AB  - Two independent studies were undertaken to determine the effect of prophylactic
      treatment with aerosolized pentamidine on the laboratory diagnosis of
      Pneumocystis carinii pneumonia in individuals at risk for or with the acquired
      immunodeficiency syndrome. The first study was a retrospective analysis to
      determine the effect of prophylactic treatment with aerosolized pentamidine on
      the diagnostic yield and sensitivity of detection of P carinii in induced sputum
      specimens. The results of examinations of 110 induced sputum specimens from
      patients who had not received aerosolized pentamidine were compared with the
      findings in 57 specimens from patients who had. There was no statistically
      significant difference between the two groups for the diagnostic yield in induced
      sputum specimens (48% vs 47%) or in bronchoalveolar lavage fluid specimens
      subsequently obtained from patients with nondiagnostic induced sputum
      examinations (33% vs 37%). The sensitivity of induced sputum specimens for
      identifying P carinii was 76% to 78% for patients who had not received
      aerosolized pentamidine and 71% to 75% for patients who had received the drug.
      The second study was a prospective comparison of 118 bronchoalveolar lavage fluid
      specimens to determine the effect of prophylactic treatment with aerosolized
      pentamidine on the number of organisms present. One hundred eighteen
      bronchoalveolar lavage fluid specimens were quantitatively examined and scored
      according to the number of clumps of P carinii present. No statistically
      significant difference was seen in the number of clumps of P carinii found in
      specimens from patients who had received aerosolized pentamidine vs the number of
      clumps found in specimens from patients who had not. In conclusion, prophylactic
      treatment with aerosolized pentamidine had no effect on (1) the diagnostic yield
      and sensitivity of detection of P carinii in induced sputum specimens or (2) the
      number of organisms detected in bronchoalveolar lavage fluid specimens obtained
      from individuals at risk for or with the acquired immunodeficiency syndrome.

PMID- 8489339
TI  - Plasma cell hyperplasia and monoclonal paraproteinemia in human immunodeficiency
      virus-infected patients.
AB  - Twenty-seven bone marrow aspirates and biopsy specimens from human
      immunodeficiency virus-positive patients with plasmacytosis were analyzed to
      identify the pathologic correlates of polyclonal and monoclonal
      hypergammaglobulinemia in these patients, to compare the results with another
      random group of similar human immunodeficiency virus patients with plasmacytosis
      who did not have serum protein electrophoresis, and to evaluate the significance
      of the presence of monoclonal proteins in a few patients. Serum protein
      electrophoresis and immunoelectrophoresis and/or immunofixation electrophoresis
      revealed monoclonal spikes in five of 18 patients tested. The remaining patients
      with an abnormal serum protein electrophoresis showed a polyclonal
      hypergammaglobulinemia. Immunohistochemical stains for kappa and lambda light
      chains were performed in the bone marrow specimens to determine the presence
      and/or absence of light-chain preponderance or monoclonality. The percentage of
      plasma cells varied from 5% to 30% and atypical plasma cells from 1% to 20%.
      Plasma cell aggregates were present in every case, but variable in number and
      generally small. In all these cases, including those with monoclonal spikes,
      plasma cells expressed lambda and kappa light chains with approximately equal
      intensity. There were no identifiable morphologic differences between the two
      groups of patients. The paraproteins observed in these patients are likely a
      reflection of B-cell overactivation. It is important to be aware of this peculiar
      subset of human immunodeficiency virus-infected patients to avoid an erroneous
      diagnosis of plasma cell dyscrasia.

PMID- 8489340
TI  - The use of a commercially available enzyme immunoassay for the detection of
      Clostridium difficile toxin A.
AB  - A commercially available enzyme immunoassay (EIA) for the detection of
      Clostridium difficile toxin A (Premier Toxin A EIA, Meridian Diagnostics,
      Cincinnati, Ohio) was compared with tissue culture cytotoxicity assay,
      enterotoxigenic culture, and latex agglutination test for the laboratory
      diagnosis of C difficile-associated disease. When evaluated for detection of C
      difficile-associated disease using clinical specimens, EIA was the most sensitive
      (83.1%) and tissue culture cytotoxicity assay was the most specific test with
      EIA, tissue culture cytotoxicity assay and enterotoxigenic culture having similar
      correlation values (96.6, 96.1, 94.0%, respectively). The latex agglutination
      test was not as accurate (89.7% correlation) as the other three tests due mainly
      to its poor sensitivity (47.9%). The EIA is a rapid, easy-to-use alternative to
      tissue culture cytotoxicity assay for detection of C difficile-associated
      disease.

PMID- 8489341
TI  - Detection and isolation of Mycoplasma fermentans from urine of human
      immunodeficiency virus type 1-infected patients.
AB  - Mycoplasma fermentans (incognitus strain) has been linked with acquired
      immunodeficiency syndrome-associated nephropathy. Ten (23%) of 43 urine sediment
      specimens from 40 human immunodeficiency virus (HIV)-positive patients at
      different stages of acquired immunodeficiency syndrome disease tested positive in
      the polymerase chain reaction using a primer pair found in the insertion
      sequences specific to M fermentans. Mycoplasma fermentans was isolated from two
      HIV-positive patients' urine sediment specimens and on a repeated basis from one.
      All three culture-positive urine sediment specimens tested positive in the
      polymerase chain reaction. Fifty urine sediment specimens from age-matched HIV
      negative healthy controls tested negative for M fermentans by polymerase chain
      reaction. Mycoplasma fermentans was not isolated from any of the control urine
      sediment specimens. Our results show a high prevalence of M fermentans in urine
      sediment specimens from HIV-positive patients but not from urine sediment
      specimens of HIV-negative healthy controls.

PMID- 8489342
TI  - Concurrent isolation of Candida krusei and Candida tropicalis from multiple blood
      cultures in a patient with acute leukemia.
AB  - Reports of the concurrent isolation of more than one non-albicans species of
      Candida from blood cultures of immunocompromised patients with disseminated
      candidiasis are extremely infrequent. We report on the isolation of Candida
      krusei and Candida tropicalis from 17 blood cultures that were taken from a 67
      year-old white man with a diagnosis of acute biphenotypic leukemia during a 2
      week period of hospitalization for induction chemotherapy. Despite receiving high
      dose amphotericin B throughout this period, the status of the patient worsened,
      and he experienced pancytopenia, hypernatremia, azotemia, and disseminated
      intravascular coagulation, which led to his death. Candida krusei and C
      tropicalis were isolated concurrently from 10 of the 17 blood cultures, while C
      krusei was the single isolate in three cultures and C tropicalis was isolated
      alone in four cultures. Each species manifested markedly different colonial
      morphological features. This case report serves to emphasize to microbiologists
      that they must exercise extreme suspicion when non-albicans species of Candida
      are isolated singly or concurrently from blood cultures in neutropenic patients,
      given the increasing clinical significance of these yeasts.

PMID- 8489343
TI  - Neutropenic enterocolitis. Two unusual cases with review of the literature.
AB  - Cases of neutropenic enterocolitis associated with Clostridium septicum infection
      have been reported with increasing frequency in the past decade. We report two
      such cases involving unusual hosts and briefly discuss possible pathogenetic
      mechanisms such as ischemia, mucosal damage related to chemotherapy and
      neutropenia, and immunosuppression. One case involved a young man with chronic
      Epstein-Barr infection who developed extensive gas gangrene of the right side of
      his trunk and thigh and who died within 12 hours of presentation to the emergency
      department. Diagnosis was only made at postmortem examination. The second, middle
      aged patient was admitted with an acute abdomen shortly after he completed
      chemotherapy for pleural mesothelioma. A right hemicolectomy was performed, but
      the patient developed antibiotic-associated pseudomembranous colitis and died.
      These cases indicate that neutropenic enterocolitis may arise in a variety of
      underlying conditions and that prompt diagnosis and therapy will be required to
      salvage more patients with this disorder.

PMID- 8489344
TI  - Granulocyte aggregation is edetic acid and temperature dependent.
AB  - Nineteen cases of leukocyte agglutination were observed in the last 6 years,
      while performing routine blood cell counts with an autoanalyzer (Technicon
      H6000). The phenomenon occurred only in edetic acid-anticoagulated samples and
      only at room temperature. Leukocyte aggregation could be reproduced by incubating
      patient serum samples or edetic acid-plasma with whole blood from ABO-compatible
      healthy control subjects. When patient serum samples or plasma samples were first
      preincubated with anti-IgM serum and then mixed with normal blood, leuko
      agglutinates were not observed, suggesting that a plasma factor, probably an IgM,
      was responsible for the phenomenon. Nonetheless, IgM presence could not be
      correlated with any particular disease or the use of specific drugs.

PMID- 8489345
TI  - An implementation plan for autopsy quality control and quality assurance.
AB  - The few guidelines that exist for performing autopsy quality assurance are vague.
      Much has been written about the use of the autopsy to monitor clinical services,
      but not how to monitor the quality of the autopsy and autopsy reports. We present
      the comprehensive quality assurance program that has been developed and
      implemented at Hahnemann University Hospital, Philadelphia, Pa, for the past 2
      years; this program has encompassed quality control of our diagnostic work. Key
      features have included in-depth peer review of completed reports, documentation
      of review at conferences, and careful monitoring of turnaround time. We have
      found that integrating quality assurance into departmental conferences is a
      useful supplement to in-depth peer review of randomly chosen autopsies. Our
      approach to quality assurance may serve as a model for other pathology
      departments, particularly those with pathology residency training programs.

PMID- 8489346
TI  - Periparotid lupus erythematosus panniculitis. Clinicopathologic correlation of
      two cases presenting as primary parotid disease.
AB  - Lupus erythematosus (LE) panniculitis, also called lupus profundus, is an
      uncommon but well-established manifestation of both chronic cutaneous (discoid)
      LE and systemic LE. Although LE panniculitis characteristically may involve the
      face, specific parotid and periparotid involvement has not, to the best of our
      knowledge, been previously reported. We describe the clinicopathologic
      correlation of two cases of LE panniculitis that presented as apparent primary
      parotid parenchymal disease; one as a neoplasm, the other as parotiditis. Failure
      to recognize LE panniculitis resulted in prolonged periods of inappropriate
      therapy and significant morbidity, including an unnecessary parotidectomy. Lupus
      erythematosus panniculitis has well-established histologic criteria that should
      be considered in the differential diagnosis of an unexplained parotid mass.

PMID- 8489347
TI  - Anergic disseminated toxoplasmosis in a patient with the acquired
      immunodeficiency syndrome.
AB  - Cerebral toxoplasmosis is the most common cause of focal brain disease in
      patients with the acquired immunodeficiency syndrome. A 24-year-old human
      immunodeficiency virus-infected woman with two previous episodes of Pneumocystis
      carinii pneumonia presented with diarrhea and fever. Despite antibiotic
      treatment, septic shock developed, and she died 3 weeks after the symptoms began.
      Histologic and histochemical studies revealed an anergic toxoplasmosis with
      dissemination in all examined organs. There were multiple foci of toxoplasmic
      cysts and free tachyzoites, sometimes with minute areas of necrosis, but no
      inflammatory reaction at all. Since effective treatment of toxoplasmosis is
      available, the occurrence of this rare form of toxoplasmosis should be kept in
      mind.

PMID- 8489348
TI  - Primary lymphoma of the kidney in the acquired immunodeficiency syndrome.
AB  - An increased incidence of lymphoma has been reported in patients with the
      acquired immunodeficiency syndrome. Malignant lymphomas that develop within this
      setting of impaired immune surveillance have distinctive clinical, histologic,
      and molecular biologic characteristics. Histologically, the majority of these
      lymphomas are small noncleaved cell or immunoblastic lymphomas, and are B-cell
      phenotype by immunophenotypic and immunoglobulin gene rearrangement studies. In
      contrast with malignant lymphoma occurring in the general population, extranodal
      origin is common in acquired immunodeficiency syndrome-related non-Hodgkin's
      lymphomas, with the central nervous system, bone marrow, gastrointestinal tract,
      and liver being the most common sites. To the best of our knowledge, there has
      been no description in the literature of primary renal lymphoma occurring in
      patients with the acquired immunodeficiency syndrome. We report an unusual case
      of primary non-Hodgkin's lymphoma (diffuse B-cell immunoblastic type) of the
      kidney in a patient with the acquired immunodeficiency syndrome.

PMID- 8489349
TI  - Mural bridging lesions in colonic Crohn's disease.
AB  - A case of Crohn's colitis with mural bridging lesions is described. The bridging
      lesions comprised colonic-type mucosa, smooth muscle, nerve fibers, with foci of
      adipose tissue and fibrous connective tissue. The lesions arose from the
      muscularis propria proximal to colonic strictures and possibly due to
      diverticular outpouching of the colonic wall associated with increased
      intraluminal pressure, although the exact mechanism of their formation appears
      unclear. This entity has not been previously described in inflammatory bowel
      disease, to our knowledge. Bridging pseudopolyps are seen in ulcerative colitis
      and rarely in Crohn's disease but do not contain substantial amounts of smooth
      muscle and/or nerve fibers. We believe that the mural bridges described in this
      article represent residual muscularis propria at the site of diverticular
      formation due to long-standing Crohn's colitis. We speculate that the stricture
      formation seen distal to the site of the mural bridging lesions may have been an
      important factor in formation of the colonic diverticula and, hence, these
      lesions that we interpret as representing residual muscularis propria adjacent to
      sites of diverticular formation in long-standing Crohn's colitis.

PMID- 8489350
TI  - An assessment of the contribution of electromyographic biofeedback as an adjunct
      therapy in the physical training of spinal cord injured persons.
AB  - This study tested the efficacy of biofeedback when administered in conjunction
      with physical rehabilitation therapy to chronic C5-7 quadriplegics. Triceps
      brachii, biceps brachii, wrist extensors, and wrist flexors were tested. The
      studied muscles were compromised by the injury to varying degrees, but were often
      still useful to these subjects. An exercise regimen was given to all subjects. In
      addition, subjects were separated into two groups: those who received biofeedback
      training and those who did not. Two measures of performance were tested: manual
      muscle scores and functional activities scores. Both groups scored significantly
      higher on both measures after 12 weeks of rehabilitation therapy. We found no
      evidence that biofeedback generally increased the amount of improvement seen.
      These results do not support the routine use of biofeedback in the treatment of
      chronic spinal cord injury, but rather further stress the importance of exercise
      therapy for such injuries.

PMID- 8489351
TI  - Determining residual urine volumes using a portable ultrasonographic device.
AB  - Residual urine volumes of 24 men with neurogenic bladder dysfunction were
      repetitively assessed 400 times with the BVI-2000 BladderScan portable
      ultrasonographic device prior to 100 episodes of intermittent catheterization. By
      comparing each examiner's first ultrasonographic measurement of urine volume with
      the catheterized urine volume, the mean error of the ultrasonographic
      measurements was -26mL (-11%) and the mean absolute error was 44mL (22%). The
      ultrasonographic measurements detected the presence of residual urine volumes of
      > or = 100mL with a sensitivity of 90% and a specificity of 81%. In the subset of
      catheterization episodes in which the catheterized urine volumes were < or =
      200mL, the mean error of the ultrasonographic measurements was -15mL (-9%), the
      mean absolute error was 37 mL (28%), and the sensitivity and specificity were 77%
      and 81%, respectively. There was no clear advantage in using the average or
      maximum of two repeated ultrasonographic measurements over using each examiner's
      first ultrasonographic measurement alone. Increased examiner experience did not
      significantly decrease the errors encountered.

PMID- 8489352
TI  - Hydrocortisone and exercise effects on articular cartilage in rats.
AB  - The combined effects of hydrocortisone and running exercise on articular
      cartilage were assessed in female Sprague-Dawley rats. Animals were divided into
      three groups: 12 control (C), 12 who received an injection of 0.1 mL
      hydrocortisone once a week for three weeks (HC), and 12 rats who received three
      weekly injections of hydrocortisone and ran twice daily for six weeks (HC + run).
      Previous study revealed that rats that ran on a treadmill for three to 12 months
      did not have articular cartilage that was different from controls and thus a
      fourth group of rats, runners only, was not included in this analysis. At
      sacrifice, both knees were examined, photographed, and subsequently decalcified,
      then sectioned at 6 mu and stained. HC + run rats had significant more surface
      degeneration on femoral cartilage than HC or C rats. Eight of 12 HC + run rats
      displayed fibrotic invasion and/or subchondral bone replacement of degenerated
      articular cartilage, a feature not seen in HC or C rats. Cross-sections from HC +
      run rats displayed areas of cell death, and loss of matrix staining. Results
      suggest that, in rats, running exercise combined with intraarticular injections
      of hydrocortisone is more detrimental to articular cartilage than hydrocortisone
      or running alone.

PMID- 8489353
TI  - Training of ambulatory individuals with cerebral palsy.
AB  - The effect of training on the physical work capacity (PWC) and the physiological
      response to simulated tasks of seven ambulatory individuals with cerebral palsy
      (CP) were studied. Energy demand for each work task was determined by percentage
      of PWC (%PWC). Results indicate that an eight week training program increased the
      PWC as evaluated by an exercise test on the Schwinn Air-Dyne Ergometer. The
      performance of the individuals for the simulated tasks measured in %PWC increased
      significantly, suggesting that individuals with CP could benefit from a training
      program and would be able to work eight hours before experiencing fatigue.

PMID- 8489354
TI  - A follow-up study on the effects of training on the fitness and habitual activity
      patterns of 60- to 70-year-old women.
AB  - This study investigated the aerobic fitness, body composition, spirometric
      variables, Human Activity Profile, and level of adherence to physical activity
      subsequent to completion of a progressive walking program of six month's duration
      (T1). Sixty-six women previously randomized to training (TG) and control (CG)
      groups were reassessed six months after finishing the six month walking program
      (T2). During the follow-up period, 77.8% of the TG subjects continued with
      exercise and maintained lower (p < 0.005) exercise heart rates compared to the
      CG. A Mann-Whitney U test on the difference scores (T2-T1) revealed no difference
      (p > 0.05) between the TG and CG for changes in Maximum Current Activity and
      Normative Impairment Index, which are both components of the Human Activity
      Profile, with the earlier increases (p < 0.05) in these parameters by the TG
      having been maintained. Participation in a previous low frequency training
      regimen therefore resulted in elderly women adopting and sustaining a higher
      level of habitual physical activity. This is important because a favorable
      modification of lifestyle factors is likely to be indicative of an enhanced
      outlook for independence.

PMID- 8489355
TI  - Movement energetics of individuals with a history of poliomyelitis.
AB  - Principles for evaluating the functional capacity of, and, therefore, exercise
      testing, chronically-disabled populations such as individuals with a history of
      poliomyelitis are considerably less well established than those for able-bodied
      persons. Therefore, we examined the use of indexes of movement economy and
      cardiorespiratory conditioning based on the results of a submaximal exercise test
      and oxygen consumption studies in individuals with a history of poliomyelitis.
      Subjects (n = 48) were categorized into four distinct groups, ie, having normal
      movement economy and either normal (n = 12) or reduced cardiorespiratory
      conditioning (n = 11), or having reduced movement economy and either normal (n =
      10) or reduced cardiorespiratory conditioning (n = 15). There was no relationship
      between the indexes of movement economy and cardiorespiratory conditioning (p >
      0.05) supporting that these indexes reflected physiologically-distinct entities.
      Irrespective of movement economy, deconditioned subjects had a reduced forced
      vital capacity (% predicted) (p < 0.05) and a higher resting heart rate (HR) (p <
      0.01) compared to conditioned subjects. The difference in resting HR was
      attributed to conditioning level rather than initial arousal because resting HR
      and VO2 were comparable on repeated tests (p > 0.05). Although there was no
      difference in steady-state HR (% predicted maximum) among the four groups (p >
      0.05), VO2 (% pred max) was significantly lower for the deconditioned than the
      conditioned subjects (p < 0.01). We concluded that determining movement economy
      and cardiorespiratory conditioning with a submaximal exercise test may enhance
      assessment and treatment outcome evaluation, hence provide a rational basis for
      rehabilitation interventions in individuals with a history of poliomyelitis.

PMID- 8489356
TI  - The hemodynamic responses to upright exercise after orthotopic cardiac
      transplant.
AB  - The study was undertaken to examine the heart rate (HR) and stroke volume (SV)
      responses to upright exercise in patients after orthotopic cardiac
      transplantation (Group A). The findings were compared to data obtained from post
      coronary artery bypass surgery patients (Group B) and from healthy subjects
      (Group C). All three groups (n = 12 in each group) were matched for age and
      gender. The preexercise HR and blood pressure were significantly higher in Group
      A (p < 0.05), whereas the SV was significantly lower (41 +/- 4mL.beat-1 vs 63 +/-
      3 and 65 +/- 2 mL.beat-1 in Group B and C respectively, p < 0.05). In Group A, at
      submaximal work loads, the SV was consistently lower than in Groups B and C.
      During the early phases of exercise, the HR was consistently higher in Group A
      also. Systemic vascular resistance remained significantly higher in Group A
      throughout exercise (p < 0.05).

PMID- 8489357
TI  - Health status and quality of life following cardiac transplantation.
AB  - There is little information regarding the functional status and quality of life
      of cardiac transplant patients. This investigation is the largest study
      describing outcome up to 10 years after cardiac transplantation. We conducted a
      cross-sectional survey of 200 cardiac transplant recipients using the Sickness
      Impact Profile and a supplementary questionnaire. The response rate was 48%. The
      median duration post-cardiac transplantation was 2.3 years (range, 0.5 to 9.7
      years). The median age was 53 years (range, 27.1 to 68.7). In comparison to
      previously published studies, our sample of cardiac transplant recipients had
      worse quality of life than normals, similar scores to cardiac arrest survivors
      and post-myocardial infarction patients, and better quality of life than patients
      with low back pain. We found that those not working (44%) reported a lower
      quality of life. Musculoskeletal-neurologic complaints were highly prevalent,
      with generalized weakness in 54% responding, fatigue in 42%, and low back pain in
      37%. Lower quality of life was found in patients reporting a higher number of
      musculoskeletal-neurological disorders. We conclude that there are specific areas
      for rehabilitation intervention in patients post-cardiac transplantation, and
      suggest areas for future research directed towards enhancing quality of life for
      cardiac transplant recipients.

PMID- 8489358
TI  - Physicians' practice patterns in pediatric electrodiagnosis.
AB  - The medical literature contains contradictory reports and recommendations
      regarding pediatric patients' pain and distress during electrodiagnosis. We
      surveyed 117 pediatric neurologists and physiatrists regarding their practice
      patterns in pediatric electrodiagnosis; 84 (72%) responded, of whom 44 (52%)
      regularly perform electrodiagnosis on children (mean = 85 per year, representing
      3,667 examinations per year). Respondents reported extreme behavioral distress
      (eg, screaming, flailing, requiring additional restraint, or attempting to leave
      the examination table) in 35% of examinations, most often among 2- to 6-year
      olds. Pain medications are never prescribed by 45%, occasionally by 48%, and
      always by 2%; general anesthesia is never administered by 75%, occasionally by
      21%. Only 32% reported that any psychological intervention is routinely offered
      to enhance child coping. Wide variability was found in physicians' preferences
      about parental presence, order of examinations, demonstration of procedures, and
      other aspects of electrodiagnosis.

PMID- 8489359
TI  - Medial paraspinal muscle electromyography: techniques of examination.
AB  - We describe two techniques, developed through cadaveric dissections, for the
      electromyographic examination of the lumbar interspinal muscles and medial lumbar
      multifidi. Previous anatomic studies have indicated that these medial paraspinal
      muscles share unisegmental innervation by a single nerve root. Electromyography
      of these muscles may therefore improve the localization of lumbosacral
      radiculopathy. The ability of the two techniques to achieve appropriate needle
      placement was confirmed using percutaneous injection of colored latex into
      cadavers. The safety and feasibility of the techniques were confirmed in healthy
      volunteers. Further studies are underway in subjects with lumbosacral
      radiculopathy to determine the clinical utility of these techniques.

PMID- 8489360
TI  - Effect of ankle joint position on electrically evoked surface myoelectric signals
      of the tibialis anterior muscle.
AB  - The relationship between surface myoelectric signal variables and ankle joint
      angle is studied in the tibialis anterior muscle of ten normal subjects during
      electrical stimulation of the main muscle motor point in isometric conditions.
      Rectangular current pulses of 0.1 ms width and 20Hz repetition rate were applied
      for 10s with a monopolar technique using a stimulation/detection system providing
      stimulation artifact suppression. Electrically evoked responses (M-waves) were
      detected with a four-bar electrode placed on the skin below the lowest motor
      point near the tendon end of the muscle. Average rectified value, root mean
      square value, mean and median spectral frequency, conduction velocity, and
      latency of the surface signal were computed for ankle angles of 15 degrees dorsal
      flexion (-15 degrees), 0 degrees, 15 degrees, 30 degrees and 45 degrees of
      plantar flexion. All variables were considerably affected by the joint angle.
      Spectral variables and latency showed a statistically significant decrement as
      angle increased from -15 degrees to 45 degrees whereas conduction velocity and
      amplitude variables had a less regular behavior. The evoked response showed a
      latency decrement and a change of shape (mostly a widening of the second phase),
      as ankle joint angle increased from -15 degrees to 45 degrees. In most subjects
      conduction velocity appeared to be over estimated at -15 degrees and 45 degrees,
      a fact attributed to the small distance between the electrodes and either the
      tendon or the innervation zone at these two angles.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8489361
TI  - Muscle damage progression in Duchenne muscular dystrophy evaluated by a new
      quantitative computed tomography method.
AB  - The progression of muscle damage was studied in the lower extremity and trunk
      muscles of patients with Duchenne muscular dystrophy (DMD) with a new
      quantitative computed tomography (CT) method. The degree of muscle fiber loss and
      fat tissue replacement was quantified using the indices of percent cross
      sectional area (%CSA) of muscle and fat, or the percentages of the area having
      the CT numbers of normal muscle and fat. A cross-sectional study in 71 patients
      showed that as the disability stage progressed, both CT number and %CSA of muscle
      decreased while %CSA of fat increased. The rate of progression was different for
      each muscle, and the order of involvement was clarified. The CT findings were
      also significantly correlated with muscle strength, indicating validity of our
      method. Our findings of the natural course of muscle involvement would be useful
      in providing appropriate rehabilitative care as well as assessing the efficacy of
      therapeutic interventions.

PMID- 8489362
TI  - Anaerobic threshold and maximal oxygen consumption during arm cranking exercise
      in paraplegia.
AB  - The major purpose of this investigation was to compare the anaerobic threshold
      (AT) and maximal cardiopulmonary responses to arm exercise between persons with
      paraplegia and the able-bodied. The locomotive stress on the heart in paraplegic
      subjects was also examined. Thirty-nine paraplegic subjects (T1-L4 lesions) and
      32 able-bodied subjects completed a continuous, progressive, resisted arm
      cranking exercise test. The AT was determined from the ventilatory parameters. At
      the AT, the mean values of Vo2/body weight (BW) for class II (T1-T5, N = 9), III
      (T6-T10, N = 11), and IV (T11-L4, n = 19) paraplegic subjects were 10.9, 13.2,
      and 13.5mL/kg/min, respectively, and only class II had significantly lower value
      than the able-bodied (14.4mL/kg/min). During maximal exercise, the mean values of
      maximal oxygen consumption per body weight (Vo2max/BW) for class II and III
      paraplegics were 17.4 and 17.7mL/kg/min, respectively, which were significantly
      lower (p < 0.05) than that of class IV (21.3mL/kg/min) and the able-bodied
      (28.2mL/kg/min). The heart rate (HR) during wheelchair-propelling (119bpm, n =
      37) was significantly less than that at the AT (134bpm), but the HR during crutch
      walking (151bpm, n = 17) was significantly higher. The results indicate that both
      submaximal and maximal cardiopulmonary functions in high-lesion paraplegics were
      less than that of the able bodied. Furthermore, the intensity of wheelchair
      propelling at comfortable speed is not enough for improving the cardiopulmonary
      functions.

PMID- 8489363
TI  - The relationship between comfortable and most metabolically efficient walking
      speed in persons with unilateral above-knee amputation.
AB  - Walking is most efficient when the least energy is spent over a certain distance.
      In six normal male subjects and 11 males with above-knee amputation the
      comfortable self-selected walking speeds and the most metabolically efficient
      walking speeds were determined. For that purpose energy expenditure was measured
      per second and per meter at six incremental walking speeds. Heart and step rate
      were registrated also at each walking speed. The results showed that in subjects
      who have not undergone amputation the comfortable walking speed is the same as
      the most efficient walking speed. However, in the above-knee amputee group, the
      comfortable walking speed is lower than the most efficient walking speed. When
      both groups walked at their own efficient walking speed they had the same energy
      expenditure per second.

PMID- 8489364
TI  - Electronic pressure algometry of deep pain in healthy volunteers.
AB  - Deep pressure pain threshold (PPT) and pressure pain tolerance (PPtol) were
      measured by pressure algometry at the mastoid processes, external malleoli, and
      sternum in 24 healthy volunteers. The algometer consisted of a force displacement
      transducer with a 0.25 cm2 pressure tip linked to a recorder. The rate of force
      application was approximately 1kg/sec/0.25cm2. High intersubject variation was
      noted at all sites for both PPT and PPtol. Mean PPT and PPtol values at the
      sternum were 5.2kg +/- 2.1 and 8.1kg +/- 2.4, respectively, and significantly
      higher than at the other sites. PTT did not differ significantly between the
      sexes or between dominant and nondominant sides. PPtol, on the other hand, was
      lower in the women, but significantly so only at the malleoli. On repeat
      examination, comparison between the mean values at each site showed no
      statistical differences in any instance. Pressure algometry, as used in this
      study in healthy subjects, proved a reliable technique for the estimation of deep
      PPT and PPtol values. It may possibly serve for screening the response to
      experimental pain in various groups of pain patients.

PMID- 8489365
TI  - A validation of the functional independence measurement and its performance among
      rehabilitation inpatients.
AB  - The Functional Independence Measurement (FIM) is a new functional status
      instrument for use among rehabilitation inpatients, but its validity and
      reliability have been only partially established. Because of its rapid
      dissemination, we sought further evidence concerning the FIM's internal
      consistency, responsiveness over time, and construct validity. We examined
      Uniform Data System (UDS) data on 11,102 general rehabilitation inpatients from
      the Pacific Northwest. Mean age was 65 and 51% were male. The most common
      diagnoses were stroke (52%), orthopedic conditions (10%), and brain injury (10%).
      Internal consistency of the FIM was calculated using Cronbach's alpha. To assess
      FIM responsiveness, we examined differences between admission and discharge FIM
      scores. For construct validation purposes, we hypothesized that the FIM would
      vary with age, comorbidity, discharge destination, and impairment severity.
      Comorbidity was quantified with the Charlson Comorbidity Index. The FIM had a
      high overall internal consistency (discharge FIM alpha = .93). The FIM registered
      significant functional gains during rehabilitation (33% FIM score improvement, p
      < .001), as do many other functional status indicators. The greatest and least
      functional improvements were observed for traumatic brain injury and low back
      pain (53% and 8% FIM score improvement, respectively). The FIM discriminates
      patients on the basis of age, comorbidity, and discharge destination. Severity
      differences could be distinguished among spinal cord injury and stroke patients.
      We conclude that the FIM has high internal consistency and adequate
      discriminative capabilities for rehabilitation patients. It is a good indicator
      of burden of care, and demonstrates some responsiveness, but its capacity to
      measure change over time needs further examination and comparison with competing
      scales.

PMID- 8489366
TI  - Progressive supranuclear palsy: clinical presentation and rehabilitation of two
      patients.
AB  - Progressive supranuclear palsy (PSP), is an infrequent movement disorder
      characterized by supranuclear ophthalmoplegia, pseudobulbar palsy, and axial
      dystonia with frequent and unpredictable falls, usually backward. Median survival
      from time of diagnosis is two years. When diagnosis is reached, the patients are
      usually disabled and unable to ambulate independently. No specific rehabilitation
      protocol has been described for PSP. This article examines our rehabilitation
      experience with two PSP patients and our management of their frequent and
      unpredictable falls. The rehabilitation program consisted of a thorough physical
      evaluation; cognitive and speech evaluation and training; exercises to improve
      strength and coordination; and static and dynamic balance training. In order to
      improve safety during ambulation, we provided the patients with a heavy shopping
      cart or wheelchair that they could grab when in danger of losing their balance.
      The patients were able to achieve independence in ambulation.

PMID- 8489367
TI  - Forearm pain secondary to compression of the medial antebrachial cutaneous nerve
      at the elbow.
AB  - We report the case of a 42-year-old man whose only symptom was pain in the medial
      aspect of the left forearm. There were no paresthesiae and the clinical
      examination was normal except for the presence of a small lipoma at the elbow.
      Electromyographic examination confirmed the normality of the main nerve trunks of
      the left upper limb and demonstrated abnormalities of the left medial
      antebrachial cutaneous nerve when compared with the right side. On the basis of
      this finding, a local corticosteroid injection was performed, which rapidly and
      lastingly relieved the pain (no recurrence after 18 months).

PMID- 8489368
TI  - Thalamic infarction secondary to cervical manipulation.
AB  - Vertebrobasilar infarction is a well documented complication of cervical
      manipulation. A commonly proposed pathogenesis is an intimal tear of the
      vertebral artery leading to cerebellar and other posterior fossa lesions.
      However, there have been no cases of thalamic infarct reported. This case
      demonstrates a thalamic infarction concurrent with brainstem and cerebellar
      infarction secondary to cervical manipulation and intimal tearing of the
      vertebral artery. Immediately following manipulation, the patient developed
      nystagmus, quadriparesis, and a speech deficit. After an aggressive course of in
      patient rehabilitation, the patient progressed to a community ambulator with
      deficits in speech and perception. This case demonstrates one of the inherent
      risks associated with repetitive forceful cervical manipulation.

PMID- 8489369
TI  - Coexistence of deep venous thrombosis and heterotopic ossification in the
      pediatric patient.
AB  - A 14-year-old girl and a 15-year-old boy with severe traumatic brain injuries
      were noted to have marked asymmetry in the lower extremities. Clinical and
      radiologic evaluation demonstrated the coexistence of deep venous thrombosis
      (DVT) and heterotopic ossification (HO). These cases demonstrate that although
      DVT are rare in children, they can be present and may coexist with the more
      common presentation of a swollen lower extremity secondary to HO.

PMID- 8489370
TI  - Posttraumatic osseous tunnel formation causing sciatic nerve entrapment.
AB  - Sciatic nerve entrapment in an osseous tunnel has only been reported twice
      previously. We describe a 19-year-old man evaluated for left lower limb pain and
      weakness that began one and one half years after sustaining stab wounds to the
      left buttock and midline back near the T11 vertebrae. The patient had sciatica
      and demonstrated motor and sensory deficits on physical exam. Electrodiagnostic
      studies demonstrated a localized injury to the sciatic nerve in the proximal
      thigh. Radiographic studies of the left pelvis and femur showed an 8 to 10cm
      linear opacification overshadowing the left femoral head and anatomic neck. An
      arteriogram of the left leg demonstrated a 3 x 4cm lobulated aneurysm arising
      from the distal portion of the inferior gluteal artery. Surgical exploration
      revealed the sciatic nerve to be encased in cylindrical bone. The ectopic bone
      was removed and the sciatic nerve released. The patient had gradual improvement
      with a nearly complete neurological recovery by three months after surgery.

PMID- 8489371
TI  - Geriatric rehabilitation. 1. Social, attitudinal, and economic factors.
AB  - This self-directed learning module highlights the social, attitudinal, and
      economic factors that are important in the rehabilitation of the older adult. It
      is part of the chapter on geriatric rehabilitation in the Self-Directed Medical
      Knowledge Program for practitioners and trainees in physical medicine and
      rehabilitation. This article contains information on the epidemiology of aging
      and disability, geriatric rehabilitation treatment environments, social support
      systems, reimbursement issues, and ageism.

PMID- 8489372
TI  - Geriatric rehabilitation. 2. Diagnosis and management of acquired disabling
      disorders.
AB  - This self-directed learning module highlights the diagnosis and rehabilitation
      management of acquired disabling disorders. It is part of the chapter on
      geriatric rehabilitation in the Self-Directed Medical Knowledge Program for
      practitioners and trainees in physical medicine and rehabilitation. This article
      contains information on the physiology of aging; rehabilitation management of
      pathologic conditions of the older adult affecting the cardiovascular, pulmonary,
      skeletal, connective tissue, and neurologic systems; rehabilitation issues
      relating to psychologic functioning of the older adult; pharmacologic concerns of
      the older adult; and response to illness with aging.

PMID- 8489373
TI  - Geriatric rehabilitation. 3. Mid- and late-life effects of early-life
      disabilities.
AB  - This self-directed learning module highlights mid- and late-life effects of early
      life disabilities. It is part of the chapter on geriatric rehabilitation in the
      Self-Directed Medical Knowledge Program for practitioners and trainees in
      physical medicine and rehabilitation. This article contains information on how to
      evaluate, prevent, and manage late complications seen in adults and older adults
      with cerebral palsy, spina bifida, spinal cord injury, multiple sclerosis,
      juvenile rheumatoid arthritis, and early-life amputations, including psychosocial
      and other quality-of-life issues. New advances in post-polio syndrome are also
      covered.

PMID- 8489374
TI  - Geriatric rehabilitation. 4. Assessment, preservation, and enhancement of fitness
      and function.
AB  - This self-directed learning module highlights the assessment, preservation, and
      enhancement of fitness and function in the older adult. It is part of the chapter
      on geriatric rehabilitation in the Self-Directed Medical Knowledge Program for
      practitioners and trainees in physical medicine and rehabilitation. This article
      contains information on functional assessment, deconditioning, exercise testing
      and physiology, gait disorders and falls, sports injuries, and industrial
      injuries in the older adult.

PMID- 8489375
TI  - Sports medicine. 1. The physiatric approach.
AB  - This self-directed learning module highlights key elements in this topic area. It
      is part of the chapter on sports medicine in the Self-Directed Medical Knowledge
      Program for practitioners and trainees in physical medicine and rehabilitation.
      This article covers the role of the physiatrist in sports medicine and presents
      an overview of the diagnosis, treatment, and prevention of sports-related
      injuries. We describe how the physiatrist relates to other sports medicine
      practitioners and detail the stepwise physical examination of an injured athlete
      by a physiatrist.

PMID- 8489376
TI  - Sports medicine. 2. Upper extremity injuries.
AB  - This self-directed learning module highlights recent advances in this topic area.
      It is part of the chapter on sports medicine in the Self-Directed Medical
      Knowledge Program for practitioners and trainees in physical medicine and
      rehabilitation. In this article, shoulder and elbow problems of the throwing
      athlete are emphasized. Common injuries involving the wrist and hand are also
      covered.

PMID- 8489377
TI  - Sports medicine. 3. Lower extremity injuries.
AB  - This self-directed learning module highlights new advances in sports-related
      injuries of the lower extremity. It is part of the chapter on sports medicine in
      the Self-Directed Medical Knowledge Program for practitioners and trainees in
      physical medicine and rehabilitation. This article contains sections on injuries
      of the hip and thigh, knee and leg, and ankle and foot. The most common injuries
      are primarily addressed, while less common injuries are more briefly discussed.
      New advances that are covered in this section include closed kinetic chain
      strengthening exercises and recent advances in rehabilitation after anterior
      cruciate ligament reconstruction.

PMID- 8489378
TI  - Sports medicine. 4. Spine and head injuries.
AB  - This self-directed learning module highlights important aspects of athletic spine
      and head injuries. It is part of the chapter on sports medicine in the Self
      Directed Medical Knowledge Program for practitioners and trainees in physical
      medicine and rehabilitation. This article covers the presentation,
      pathomechanics, and classification of common and important cervical and lumbar
      injuries. Sports participation criteria for children with spine deformities are
      discussed. In addition, a description of the degrees of concussion, the general
      guidelines for return to play after a sports-related head injury, and
      postconcussion sequelae are reviewed.

PMID- 8489379
TI  - Sports medicine. 5. The physiatrist as team physician.
AB  - This self-directed learning module highlights important aspects of the evaluation
      and care of the injured athlete by a team physician. It is part of the chapter on
      sports medicine in the Self-Directed Medical Knowledge Program for practitioners
      and trainees in physical medicine and rehabilitation. This article covers the
      components of a preparticipation examination, the on-field evaluation of head,
      spine, and limb injuries, and return-to-play criteria after specific injuries.
      Sports medicine for the physically challenged athlete, medicolegal considerations
      for the team physician, and anabolic steroids are also reviewed.

PMID- 8489380
TI  - Some thoughts of a trauma surgeon.

PMID- 8489381
TI  - Laparoscopic cholecystectomy. A statewide experience. The Connecticut
      Laparoscopic Cholecystectomy Registry.
AB  - The explosion in laparoscopic cholecystectomy has posed many questions about its
      safety compared with the "gold standard" of open cholecystectomy. A statewide
      database was established in Connecticut to study these issues. Thirty-three (97%)
      of 34 hospitals in Connecticut participated in the study, which began at the
      inception of the laparoscopic procedure. Four thousand six hundred forty
      laparoscopic cholecystectomies were performed between May 1, 1990, and September
      30, 1991. The overall conversion rate to open cholecystectomy was 6.9%.
      Conversions were more frequent with acute cholecystitis, in the elderly, and
      early in a surgeon's experience. The overall technical complication rate was
      4.7%; common bile duct injuries occurred in 15 patients (0.3%). Complications
      decreased with increasing experience, to 0.98% after a surgeon's 75th procedure.
      Six patients (0.13%) died following laparoscopic cholecystectomy. The overall
      mortality rate associated with cholecystectomy fell during the study period. The
      frequency of cholecystectomy in Connecticut increased 29% with the advent of the
      laparoscopic procedure. The introduction of laparoscopic cholecystectomy has
      resulted in an increased frequency of surgery without an increase in surgical
      mortality. The incidence of common bile duct injuries was low. The decreasing
      incidence of technical complications demonstrates the learning curve for the
      procedure.

PMID- 8489382
TI  - Long-term results of the ileoanal pouch procedure.
AB  - Many surgeons consider the ileoanal pouch procedure to be the procedure of choice
      for patients who require surgery for ulcerative colitis and familial adenomatous
      polyposis. To determine long-term results, 460 patients (mean +/- SD age, 31 +/-
      9 years) who underwent the ileoanal pouch procedure from 1980 through 1991 were
      prospectively observed by computerized registry. The leading indication for
      operation was ulcerative colitis (n = 382; 83%). A J-shaped reservoir was created
      in 434 patients (94%). More than 5 years after ileostomy closure, the mean number
      of bowel movements was 5.8 +/- 2.2, and 13% of patients had leakage. Most
      patients (94%) were satisfied with their results. Sixteen patients (3.5%)
      required recreation of a permanent stoma for pouch failure. Complications (major
      and minor) occurred in 266 patients (58%) and included obstruction (n = 94; 20%),
      pouch fistula (n = 26; 6%), anastomotic stricture (n = 40; 9%), anastomosis
      separation (n = 14; 3%), and pouchitis (n = 83; 18%). Modifications in technique
      and increased operative experience have significantly decreased the incidence of
      obstruction (P = .05) and pouch-related complications (P = .004). Despite
      complications, long-term results are acceptable, and patient satisfaction remains
      high.

PMID- 8489383
TI  - Continuing trends in the prevalence of right-sided lesions among colorectal
      carcinomas.
AB  - The shift of colorectal carcinoma location toward the proximal colon has been
      reported. This study documents that this statistically significant trend has
      continued through 1992. An increase in transverse and descending colon cancers is
      now apparent also. Only 59% of all large-bowel cancers occurred distal to the
      descending colon between 1978 and 1992. Both right-sided and distal large-bowel
      cancers have significantly decreased in size, yet the incidence and frequency of
      lymph node metastases have not changed over a 65-year interval (from 1928 to
      1992). This constant proportion of lymph node metastases may suggest distinct
      biological subsets of cancers (lymph node avid vs lymph node avoidance). The
      progression from small size with fewer metastases to large size with more lymph
      node metastases occurs only in some of the smallest distal colorectal cancers.

PMID- 8489384
TI  - Breast cancer and earlier detection efforts. Realized and unrealized impact on
      stage.
AB  - OBJECTIVE: To test our hypotheses that increased public and professional
      education in breast cancer detection (screening mammography, clinical breast
      examination, and breast self-examination) would lead to detection at earlier
      stages of disease with each of the three methods. DESIGN AND SETTING: A survey
      study of all pathologically diagnosed breast cancers in a defined geographic area
      (all nonfederal general hospitals in the state of Vermont) before (1975-1984, n =
      1652) and after (1989-1990, n = 683) screening mammography became more commonly
      used. MAIN OUTCOME MEASURES: Method of detection of breast cancer and stage at
      detection. RESULTS: The age-adjusted annual incidence rate of breast cancer among
      adult women was 99 per 100,000 during the years 1975 to 1984 compared with 169
      per 100,000 during 1989-1990 (P < .001). Mammography as the method of detection
      increased in use from 2% to 36% (P < .001). In the later era, invasive breast
      cancers were detected at more favorable TNM stage (P < .001); mean maximum tumor
      diameter was smaller (2.2 cm vs 2.7 cm; P < .001); percentage of histologically
      positive nodes was lower (37% vs 47%; P < .001). When mammographically detected
      cancers were excluded from the analysis of invasive cancers, the mean maximum
      tumor diameter and percentage of negative nodes in the two eras were similar even
      though there was an apparent shift to detection at an earlier clinical stage.
      CONCLUSION: The earlier stages of detection and the sudden increase in incidence
      could almost entirely be credited to screening mammography. Mammographic
      screening had a much greater impact on stage at detection in women aged 50 years
      and older than in those younger than 50 years.

PMID- 8489385
TI  - Laparoscopic appendectomy. A safety and cost analysis.
AB  - To assess the feasibility of laparoscopic appendectomy, we reviewed hospital
      records and charge data for all patients older than age 15 years who underwent
      appendectomy between November 1990 and July 1992. Fifty-eight patients underwent
      laparoscopic appendectomy and 206 patients underwent conventional appendectomy.
      Intraoperative (1.9%) and postoperative (5.8%) complication rates were low. The
      rate of conversion to conventional appendectomy was 7.7%. Hospital stay and
      charge analysis was performed on a cohort of 52 patients undergoing laparoscopic
      appendectomy and 180 patients undergoing conventional appendectomy. Total costs
      were similar. The most notable difference between the two groups was the
      operating room supply charge; this negated any cost savings achieved by the
      reduced length of stay following laparoscopic appendectomy. Laparoscopic
      appendectomy is a safe alternative to conventional appendectomy; it shortens
      hospital stay and allows patients to resume normal activity more quickly than
      conventional appendectomy.

PMID- 8489386
TI  - Determination of tumor aggressiveness in colorectal cancer by K-ras-2 analysis.
AB  - Markers that predict tumor aggressiveness on a case-by-case basis would enable
      individualization and optimization of oncologic therapy. To achieve this goal,
      the presence and specific type of K-ras-2 point mutation was determined from
      formalin-fixed, paraffin-embedded tissue sites in 247 primary and 166 metastatic
      recurrent colorectal adenocarcinomas, using a novel approach consisting of
      topographic tissue selection, DNA amplification, and direct sequencing applicable
      to large and needle-biopsy-sized specimens. The results provide the basis for a
      genotypic classification of colorectal cancer capable of predicting individual
      tumor aggressiveness, including the pattern and extent of metastasis.

PMID- 8489387
TI  - Surgical repair of esophageal perforation due to pneumatic dilatation for
      achalasia. Is myotomy really necessary?
AB  - Esophageal perforation is a rare complication of pneumatic dilatation for
      achalasia. The few clinical series reported in the literature recommend, under
      most circumstances, esophageal repair combined with esophagocardiomyotomy.
      However, the superiority of this technique over repair alone has never been
      proven. We reviewed our experience, since 1979, with six operative cases of
      esophageal perforation from pneumatic dilatation for achalasia. After
      debridement, the esophagus was repaired and, if possible, buttressed with a
      gastric fundal patch. There was only one late postoperative death due to sepsis
      and one upper gastrointestinal bleeding complication in our series. Follow-up (1
      to 12 years) revealed no dysphagia in any of the five surviving patients and mild
      gastroesophageal reflux in two. From a review of the literature we found no
      reports of similarly treated patients experiencing recurrent symptoms of
      achalasia. In these acutely ill patients, our operative strategy is more feasible
      than repair and esophagocardiomyotomy and equally effective.

PMID- 8489388
TI  - Sphincter-saving alternatives in the management of adenocarcinoma involving the
      distal rectum. 5-year follow-up results in 40 patients.
AB  - We reviewed the treatment outcome in 40 patients undergoing full-thickness local
      excision (seven patients) or electrocoagulation (33 patients) for adenocarcinoma
      of the rectum. Patients were followed up for a minimum of 5 years or until death
      (mean follow-up, 7.6 years). Twenty-two patients (55%) survived 5 years free of
      disease or were free of disease at the time of death due to other causes
      following local treatment. Eight (62%) of 13 patients with persistent or locally
      recurrent disease were successfully treated with additional local therapy, rectal
      resection, or combined radiation therapy and chemotherapy. Overall, 30 (75%) of
      40 patients embarking on a program of local treatment for carcinoma of the rectum
      survived 5 years free of disease or were free of disease at the time of death due
      to other causes.

PMID- 8489389
TI  - Routine cholangiography is not warranted during laparoscopic cholecystectomy.
AB  - The role of intraoperative cholangiography during laparoscopic cholecystectomy
      was prospectively evaluated in 514 patients undergoing laparoscopic
      cholecystectomy. Before surgery, all patients were assigned to one of three
      groups depending on the likelihood of their having common bile duct stones.
      Stratification was based on objective historical, laboratory, or radiologic
      criteria. In 453 patients deemed unlikely to have stones, laparoscopic
      cholecystectomy was performed without cholangiography. Of these patients, four
      had retained stones (0.9%). In 25 patients likely to have stones, preoperative
      endoscopic retrograde cholangiopancreatography identified stones in six patients
      (24%). In 36 patients whose likelihood of having stones was deemed indeterminate,
      intraoperative cholangiography was performed at laparoscopic cholecystectomy. A
      common bile duct stone was identified in one patient (2.8%). One common bile duct
      injury occurred in the group deemed unlikely to have stones, and this injury
      would not have been prevented by intraoperative cholangiography. We conclude that
      preoperative assessment will identify common bile duct stones and that routine
      cholangiography is not warranted. Meticulous dissection of the cystic duct at its
      origin at the infundibulum will prevent common bile duct injury.

PMID- 8489390
TI  - Portal vein thrombosis after elective splenectomy. An underappreciated,
      potentially lethal syndrome.
AB  - We describe seven cases of thrombosis of the portal and splenic vein after
      elective splenectomy. The diagnosis was initially unrecognized in all patients
      and was confused with biliary sepsis (three cases), postoperative pancreatitis
      (three cases), or pulmonary emboli (one case). Two patients in whom the diagnosis
      of portal vein thrombosis was not made within 3 days of disease onset died. In
      the five survivors, the diagnosis was based on clinical suspicion, confirmed with
      color flow Doppler ultrasonography or computed tomography with intravenous
      contrast material, and treated with thrombolytic agents, anticoagulants, and
      antibiotics. In two patients, splenic vein thrombus was visualized on initial
      postoperative imaging studies and the thrombus subsequently extended into the
      portal vein. Portal vein thrombosis should be considered in patients with fever
      and abdominal complaints after splenectomy. Urgent treatment with thrombolysis
      and anticoagulants may preserve bowel integrity and be lifesaving.

PMID- 8489391
TI  - The epidemiology of traumatic death. A population-based analysis.
AB  - Despite the proliferation of trauma systems, there are no population-based data
      describing the epidemiology of traumatic death. To provide these data, we
      reviewed all trauma deaths occurring in San Diego (California) County during 1
      year. There were 625 traumatic deaths during the study (27.3 deaths per 100,000
      population per year). Motor vehicle trauma was the most common cause of injury
      leading to death (N = 344 [55.2%]; 15.0 annual deaths per 100,000 population).
      Central nervous system injuries were the most common cause of death (48.5%, or
      13.2 deaths per 100,000 population per year). Sepsis was responsible for only
      2.5% of the overall mortality. Based on life-table data, traumatic death resulted
      in an annual loss of 1091 years of life per 100,000 and an annual loss of 492
      years of productivity per 100,000. Injury continues to account for an enormous
      loss of life despite improvements in survival wrought by trauma systems.

PMID- 8489392
TI  - Improved quality of diabetic foot care, 1984 vs 1990. Reduced length of stay and
      costs, insufficient reimbursement.
AB  - Ischemic foot ulceration in the diabetic patient is a source of great physical
      and emotional strain for the patient and represents a significant financial
      burden for the health care system responsible for the cost of such care. Limb
      salvage remains the primary therapeutic goal; yet, fiscal constraints imposed by
      diagnosis related group-based reimbursement systems require maximal cost
      efficiency in the care process. Between 1984 and 1990, the changes in our team
      management approach to this problem, emphasizing aggressive surgical
      revascularization of threatened limbs, have improved the quality of care and
      dramatically reduced the major and minor amputation rate. In the process, we have
      reduced the length of hospital stay and the overall cost of care. Despite this
      improvement in outcome and efficiency, Medicare reimbursement remains
      insufficient, with an average loss of $7480 per admission.

PMID- 8489393
TI  - Evaluation of right ventricular function during aortic operations.
AB  - The simultaneous measurements of mixed venous oxygen saturation (SvO2) and right
      ventricular ejection fraction (RVEF) have now made it possible to precisely
      define and correlate the various hemodynamic changes that occur during abdominal
      aortic operations. Twenty-five patients undergoing infrarenal abdominal aortic
      aneurysm repair were examined with a pulmonary artery catheter capable of
      continuously measuring SvO2 and RVEF. With aortic clamping, significant
      reductions in cardiac index, stroke volume index, and right ventricular end
      diastolic volume index (RVEDVI) were noted, while RVEF remained unchanged.
      Following unclamping of the aorta, a significant reduction in SvO2 occurred,
      accompanied by an increase in mean pulmonary artery pressure and in pulmonary
      vascular resistance. Despite the increase in afterload, RVEDVI and RVEF did not
      change after unclamping. These preliminary data suggest that right ventricular
      function is preserved during abdominal aortic aneurysm repair.

PMID- 8489394
TI  - A clinically based classification system for acute pancreatitis. Summary of the
      International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through
      13, 1992.
AB  - Acute pancreatitis is a protean disease capable of wide clinical variation,
      ranging from mild discomfort to apocalyptic prostration. Moreover, the
      inflammatory process may remain localized in the pancreas, spread to regional
      tissues, or even involve remote organ systems. This variability in presentation
      and clinical course has plagued the study and management of acute pancreatitis
      since its original clinical description. In the absence of accepted definitions
      for acute pancreatitis and its complications, it has not been possible to devise
      a clinical classification system useful for case management. Following 3 days of
      group meetings and open discussions, unanimous consensus on a series of
      definitions and a clinically based classification system for acute pancreatitis
      was achieved by a diverse group of 40 international authorities from six medical
      disciplines and 15 countries. The proposed classification system will be of value
      to practicing clinicians in the care of individual patients and to academicians
      seeking to compare interinstitutional data.

PMID- 8489395
TI  - Incidence, characteristics, and outcome of spinal cord injury at trauma centers
      in North America.
AB  - Acute spinal cord injury occurred in 2.6% of the 114,510 patients entered into
      the Major Trauma Outcome Study from 1982 to 1989. The most common causes of
      spinal cord injury were motor vehicle accidents (40%), falls (20%), and gunshot
      wounds (13.6%). Almost 80% of patients with spinal cord injury had multiple
      injuries. Cervical cord injury was seen in 65% of patients with isolated spinal
      cord injury, but in only 52% of patients with multiple injuries. The hospital
      mortality rate was 17%, with patients with multiple injuries having a
      significantly higher mortality rate than patients with isolated spinal cord
      injury (19.8% vs 6.9%). The TRISS method overpredicted the mortality rate among
      patients with multiple injuries (450 vs 379), but not among those with isolated
      injury. A program for better national surveillance and prevention of spinal cord
      injury is warranted.

PMID- 8489396
TI  - Autoamputation of appendix and the 'absent' appendix.

PMID- 8489397
TI  - Cost-effective hernia repair.

PMID- 8489398
TI  - On the late effects of surgery.

PMID- 8489399
TI  - Hypothesis: calcitriol mediates pregnancy's protective effect on multiple
      sclerosis.

PMID- 8489400
TI  - The planum temporale.

PMID- 8489401
TI  - Anomalous cerebral structure in dyslexia revealed with magnetic resonance
      imaging.
AB  - OBJECTIVE: To develop quantitative methods for identifying cerebral anomalies on
      magnetic resonance images of subjects with language disorders and other learning
      disabilities. DESIGN: Partially blinded comparison of subjects with dyslexia,
      unaffected relatives, and a control group balanced for age and socioeconomic
      status. Criterion standard: clinical diagnosis of dyslexia by physician or
      learning disabilities specialist on the basis of clinical assessment and family
      history. SETTINGS: Hospital pediatric neurology clinic and private reading
      clinic. PATIENTS AND OTHER PARTICIPANTS:  VOLUNTEERS: individuals with dyslexia
      (seven male and two female, aged 15 to 65 years) from professional families;
      unaffected first- and second-degree relatives (four male and six female, aged 6
      to 63 years) available in the geographical area; and controls (five male and
      seven female, aged 14 to 52 years). INTERVENTIONS: Gradient echo three
      dimensional scan in Seimens 1-Tesla Magnetom; 128 1.25-mm consecutive sagittal
      images. MAIN OUTCOME MEASURES: (1) Average length of the temporal (T) and
      parietal (P) banks of the planum temporale; (2) interhemispheric coefficients of
      asymmetry for T and P banks: Left-Right interhemispheric coefficients of
      asymmetry = (L-R)/[(L+R)/2]; (3) intrahemispheric coefficients of asymmetry = (T
      P)/[(T+P)/2]; and (4) qualitative assessment of gyral variants in the
      parietotemporal operculum. RESULTS: All groups had left-sided asymmetry for the
      temporal bank and right-sided asymmetry for the parietal bank. The group with
      dyslexia had exaggerated asymmetries, owing to a significant shift of right
      planar tissue from the temporal to parietal bank. They also had a higher
      incidence of cerebral anomalies bilaterally (subjects with dyslexia, six of nine;
      relatives, two of 10; and controls, zero of 12). CONCLUSIONS: Quantitative
      assessment of high-resolution magnetic resonance images can reveal functionally
      relevant variations and anomalies in cerebral structure. Further refinement of
      these measurement techniques should improve the diagnosis, classification, and
      treatment of language disorders and other learning disabilities.

PMID- 8489402
TI  - Atypical Leber's hereditary optic neuropathy with molecular confirmation.
AB  - OBJECTIVE: Leber's hereditary optic neuropathy (LHON) is typically a familial
      disease of primarily young, male adults. Analysis of mitochondrial DNA has
      identified point mutations associated with LHON and allowed us to identify cases
      of LHON not consistent with traditional descriptions of the disease. DATA
      SOURCES: The collective experience of three tertiary referral centers contributed
      to this report. STUDY SELECTION: Patients with bilateral optic neuropathies who
      were positive for the 11778 LHON mutation were included in this study if they
      were female and there was no family history of visual loss. DATA EXTRACTION: Six
      case histories are presented. DATA SYNTHESIS: The diagnosis of LHON remained
      unknown in six female patients with bilateral optic neuropathies until molecular
      analysis revealed the 11778 mitochondrial DNA mutation. None of the patients had
      a family history of visual loss, and five were initially diagnosed as having
      factitious visual loss. Other individual features atypical for LHON included lack
      of the characteristic LHON funduscopic appearance, bitemporal hemianopia, optic
      disc cupping, and premonitory episodes of transient visual loss. In one patient
      the correct diagnosis was delayed 17 years. CONCLUSIONS: The diagnosis of LHON
      should be considered in all cases of unexplained optic neuropathy, including
      those with negative family history, late or early age at onset, female gender, or
      normal funduscopic appearance.

PMID- 8489403
TI  - Effect of age on D2 dopamine receptors in normal human brain measured by positron
      emission tomography and 11C-raclopride.
AB  - Human postmortem and animal experimental results suggest a decline of the
      cerebral dopaminergic neuronal system with age. In this study, the radiotracer
      carbon 11-labeled-raclopride and positron emission tomography were applied to
      determine the effect of age on striatal D2 dopamine receptors in 32 healthy
      volunteer subjects (age range, 21 to 68 years; median, 31 years). An index of
      specific 11C-raclopride binding was calculated for putamen, caudate nucleus, and
      other brain regions in each subject. A significant decrease with age of the index
      for specific tracer uptake was found in putamen and caudate nucleus. The decrease
      was steep until 30 years, but slower afterward. After approximately 30 years of
      age, the decline of specific 11C-raclopride binding in putamen was found to be
      0.6% per year. Our results suggest that D2 dopamine receptor binding sites
      (mainly postsynaptically located) decrease as a consequence of normal aging in
      parallel with the decline of the presynaptic nigrostriatal dopaminergic neuronal
      system.

PMID- 8489404
TI  - Spinal fluid cells and protein in amyotrophic lateral sclerosis.
AB  - The cerebrospinal fluid total protein in 385 cases of sporadic amyotrophic
      lateral sclerosis showed no relationship to survival, but it was related to
      survival time in 34 cases of familial amyotrophic lateral sclerosis. Infrequent
      and mild pleocytosis, and oligoclonal bands seemed to have no clinical
      significance in well established cases of amyotrophic lateral sclerosis.

PMID- 8489405
TI  - Pathologic correlates of increased signals of the centrum ovale on magnetic
      resonance imaging.
AB  - The pathologic correlates of increased signal in the white matter of the centrum
      ovale in postmortem magnetic resonance imaging were investigated in an unselected
      series of 15 autopsies. Two types of magnetic resonance imaging hyperintensities
      could be separated on the basis of size (10-mm cutoff): extensive and punctate.
      The pathologic basis of extensive hyperintensities was large areas of pallor with
      ill-defined margins, located in the central white matter and sparing the
      subcortical U fibers on both myelin and axonal stains. Microscopically, these
      areas showed diffuse vacuolation and significant reduction in the areal densities
      of glial cells. This change was never seen in areas that did not show extensive
      white matter hyperdensities on magnetic resonance imaging. The correlates of
      punctate magnetic resonance imaging hyperintensities were less well defined;
      dilated Virchow-Robin spaces probably represent a common cause of this
      phenomenon.

PMID- 8489406
TI  - Thalamic stimulation and proximal tremor. A specific target in the nucleus
      ventrointermedius thalami.
AB  - The severe proximal cerebellar postural tremor (also called action or intention
      or hyperkinetic tremor) is barely influenced by thalamotomy or stimulation of the
      thalamus at the classic target in the lower part of the nucleus ventrointermedius
      thalami (VIM). In four patients with a severe postural distal and proximal
      tremor, an electrode fitted with four points of contact was introduced within the
      entire height of the VIM. In each patient, stimulation of the lower part of the
      VIM was most effective in the distal component of the tremor, whereas its
      proximal component was specifically reduced by stimulation of its upper part.
      These results indicate that (1) proximal postural tremors can be as much affected
      by stimulation of the VIM as distal tremors, (2) there is a somatotopy in the VIM
      that is similar to that in the nucleus ventralis posterolateralis thalami, and
      (3) it is possible with this technique to adjust the VIM stimulation site so as
      to obtain the maximum efficacy according to the locale of the tremor.

PMID- 8489407
TI  - Hemispheric differences in layer III pyramidal neurons of the anterior language
      area.
AB  - OBJECTIVE: The major objective of this study was to determine if the
      lateralization of motor speech functions may be associated with hemispheric
      differences in the size of layer III pyramidal neurons in Brodmann's area 45.
      DESIGN: A case series design involving postmortem human specimens was used to
      compare the cross-sectional area of NissI-stained layer III pyramidal neurons of
      Brodmann's area 45 from the left and right hemispheres. SUBJECTS: A convenience
      sample consisting of seven cases with no known neurological or psychiatric
      disorders was obtained at autopsy. MAIN OUTCOME MEASURES: The cross-sectional
      area of layer III pyramidal neurons in both left and right hemispheres was
      measured in four fields per hemisphere per brain using a computerized image
      analysis system. Measurements of both the largest layer III pyramids and of all
      layer III pyramids were done. RESULTS: The largest layer III pyramidal neurons of
      area 45 were significantly larger in the left than in the right hemisphere in
      both an unblinded and a blinded series of measurements. However, this hemispheric
      difference appeared to be restricted to the largest neurons, since the mean size
      of all layer III pyramids in this area was not significantly different in the
      left and right hemispheres. CONCLUSIONS: The presence of a unique population of
      large pyramidal neurons in left Brodmann's area 45 may be related to the
      involvement of this region in the circuitry that mediates motor speech functions.

PMID- 8489408
TI  - Imaging of D2 dopamine receptors of patients with Parkinson's disease using
      single photon emission computed tomography and iodobenzamide I 123.
AB  - OBJECTIVE: To test the usefulness of single photon emission computed tomography
      (SPECT) with iodobenzamide in imaging basal ganglia and to elucidate the
      postulated upward regulation of the striatal D2 dopamine receptors in patients
      with early Parkinson's disease. DESIGN: Fourteen patients with Parkinson's
      disease and eight control subjects were investigated with SPECT using
      iodobenzamide labeled with iodine 123 as dopamine receptor ligand. SETTING:
      Neurological outpatient service at a university hospital in Kuopio, Finland.
      PATIENTS: Fourteen patients with recently diagnosed unilateral, unmedicated
      Parkinson's disease and eight healthy control subjects. RESULTS: The SPECT images
      revealed high uptake of iodobenzamide in the basal ganglia. In the patient group,
      the accumulation was more intense and the iodobenzamide affinity rate was
      significantly higher in the striatum contralateral to the parkinsonian symptoms.
      Also, the basal ganglia-cerebellum ratio was higher in the contralateral
      hemisphere. In the control group, no significant side-to-side differences were
      observed. CONCLUSION: Iodobenzamide with SPECT imaging is useful in evaluating
      patients with Parkinson's disease. The results also suggest compensatory D2
      dopamine receptor upward regulation in the striatum of patients with early
      unmedicated Parkinson's disease.

PMID- 8489409
TI  - Multiple system atrophy and progressive supranuclear palsy. Diminished striatal
      D2 dopamine receptor activity demonstrated by 123I-IBZM single photon emission
      computed tomography.
AB  - OBJECTIVE: To measure D2 dopamine receptors in the striatum in patients with
      multiple system atrophy and progressive supranuclear palsy by I 3-iodo-6
      methoxybenzamide labeled with iodine I 123 (123I-IBZM) single photon emission
      computed tomography and differentiate them from control subjects. DESIGN: Survey
      with the following as retrospective criterion standards: (1) parkinsonism, (2)
      negative apomorphine test, and (3) no or only slight reaction to dopaminergic
      medication. SETTING: Ambulatory or hospitalized care in an academic referral
      center. PATIENTS AND CONTROL SUBJECTS: Twenty-one patients with parkinsonism not
      responding to dopaminergic medication (17 with multiple system atrophy and four
      with progressive supranuclear palsy) and 21 control subjects without
      parkinsonism. INTERVENTION: In vivo imaging by single photon emission computed
      tomography using the D2 dopamine receptor specific radioligand 123I-IBZM. MAIN
      OUTCOME MEASURE: Striatum/occipital cortex ratio of count rate density as
      semiquantitative measurement for striatal D2 dopamine receptor density. RESULTS:
      A highly significant loss of striatal uptake of 123I-IBZM was observed in the
      patients in comparison to the control subjects with little or no overlap between
      values. CONCLUSIONS: The hypothesized loss of D2 receptors in multiple system
      atrophy has been confirmed. Use of 123I-IBZM single photon emission computed
      tomography may be a cost-effective alternative to positron emission tomography in
      the differential diagnosis of parkinsonism and in the selection of patients for
      dopaminergic therapy.

PMID- 8489410
TI  - Transverse myelitis. Retrospective analysis of 33 cases, with differentiation of
      cases associated with multiple sclerosis and parainfectious events.
AB  - OBJECTIVE: A study was undertaken to determine whether cases of parainfectious
      associated transverse myelitis (TM) and multiple sclerosis-associated TM could be
      distinguished on the basis of clinical criteria, radiologic features, or
      cerebrospinal fluid examination. A secondary objective was to determine the
      incidence of TM in a US population. DESIGN: A retrospective analysis of 33 cases
      was conducted. Cases were classified as being related to parainfectious multiple
      sclerosis, or spinal cord ischemia, or idiopathic. SETTING: All cases occurring
      in the Albuquerque, NM, area from 1960 through 1990 were reviewed. The population
      base was 500,000. OUTCOME MEASURES: Clinical presentation, radiologic features,
      cerebrospinal fluid, recovery of ambulation and bladder function, and recurrence
      rates were compared. RESULTS: Thirty-three patients satisfied study criteria,
      corresponding to an incidence of 4.6 per million per year. Forty-five percent of
      these cases were categorized as parainfectious, 21% as associated with multiple
      sclerosis, 12% as associated with spinal cord ischemia, and 21% as idiopathic.
      Patients with parainfectious TM suffered from spinal shock more frequently than
      did those with multiple sclerosis-associated TM. Patients with parainfectious TM
      showed evidence of spinal cord swelling, whereas patients with multiple sclerosis
      associated TM had spinal cord plaques on magnetic resonance images but none
      showed swelling. Oligoclonal bands were absent in patients with parainfectious TM
      and present in three of five patients with multiple sclerosis-associated TM.
      CONCLUSIONS: Parainfectious TM may be distinguishable from that associated with
      multiple sclerosis on the basis of presentation, findings on imaging, and the
      presence of cerebrospinal fluid oligoclonal bands.

PMID- 8489411
TI  - Leber's hereditary optic neuropathy. New genetic considerations.
AB  - OBJECTIVE: Leber's hereditary optic neuropathy (LHON) is a maternally inherited
      disease that causes bilateral central visual loss, predominantly in young men.
      Recently, this disorder has been associated with point mutations in the
      mitochondrial genome. The clinical characteristics of LHON are reviewed with
      special attention to recent advances in mitochondrial genetics. DATA SOURCES:
      Literature from the mid-19th century to the present is reviewed. STUDY SELECTION:
      Major review articles that include multiple large pedigrees in their analysis are
      featured. Special emphasis is placed on the recent reports on mitochondrial DNA
      abnormalities associated with this disease. DATA EXTRACTION: The older literature
      is reviewed critically with an understanding that some of the patients included
      as examples of LHON may have had a different disease. The more current references
      are assessed in regard to their inclusion of appropriate and complete
      mitochondrial DNA analysis. DATA SYNTHESIS: Leber's hereditary optic neuropathy,
      a maternally inherited disease primarily of young men, results in bilateral,
      acute or subacute, central visual loss and, ultimately, optic atrophy. Point
      mutations in the mitochondrial genes encoding proteins essential to oxidative
      phosphorylation have been associated with this disorder. Primary mutations
      include those found at positions 11778, 3460, and, possibly, 15257 and 14484.
      Mitochondrial, nuclear, and environmental factors may modify phenotypic
      expression. CONCLUSION: Genetic analysis has allowed for a broader view of what
      constitutes the clinical phenotype of LHON.

PMID- 8489412
TI  - Dental arch asymmetry in young healthy human subjects evaluated by Euclidean
      distance matrix analysis.
AB  - Form differences between biological structures can be evaluated using several
      approaches. A recently proposed method (Euclidean distance matrix analysis; EDMA)
      seems to be able to differentiate between size and shape differences. Here it has
      been applied to study the asymmetry of mandibular and maxillary arches in 50 men
      and 45 women with sound dentitions. The centres of gravity (centroids) of the
      occlusal surfaces of all permanent teeth (right second molar to left second
      molar) were individualized on the dental casts of subjects. The form of the right
      and left maxillary and mandibular hemi-arches was separately assessed by
      calculating all the possible linear distances between pairs of teeth within arch
      and side. Side differences were tested by EDMA. In men, the maxillary and the
      mandibular arches were both symmetrical (i.e. there were no significant
      differences in size or shape between the left and right hemi-arches). In women,
      the mandibular arch was symmetrical, but in the maxillary arch the two antimeres
      had a significantly different shape. No size differences were found between the
      left and right female hemi-arches.

PMID- 8489413
TI  - Human jaw-elevator muscle activity and food comminution in the dentate and
      edentulous state.
AB  - Masseter and temporal surface electromyograms were obtained from seven dentate
      subjects and six complete-denture wearers during mastication, maximal voluntary
      clenching and measurements of bite force. The participants chewed two artificial
      test foods with different textures. The dentate subjects comminuted both foods
      much better than the denture wearers. In both groups, the softer food was
      comminuted better than the firmer food. The differences in particle-size
      reduction originated largely from differences in the numbers of particles
      fragmented per chewing stroke. The rhythm of mandibular movement was unaffected
      by food texture and dental state. No significant differences in the duration of
      bursts of electric muscle activity were found between either group. Peak
      amplitudes of activity during mastication and maximal voluntary clenching were
      more than twice as large in the dentate subjects as in the denture wearers. In
      both groups, chewing the softer food was associated with lower peaks of activity
      than with the firmer food. The peak amplitudes were weakly related to the
      reduction in particle size. In both groups, the peak forces determined from
      electromyographic activity were larger than the estimated forces required for
      fragmenting the particles between the teeth.

PMID- 8489414
TI  - A bromodeoxyuridine immunocytochemical and morphometric study of the influence of
      growth hormone on cell proliferation in odontogenic mesenchyme of the Lewis dwarf
      rat.
AB  - Cell proliferation was studied in pre-odontoblasts, and in cells of the dental
      papilla and lingual dental follicle using bromodeoxyuridine immunocytochemistry
      and morphometry in Bouin's perfused and paraffin-embedded, undemineralized
      maxillary incisors. Cells in DNA synthesis, as shown by this technique, or in
      mitosis, were counted. Significantly fewer labelled nuclei, unlabelled nuclei and
      total nuclei were found in the tissues of growth hormone-deficient dwarf rats
      than in normal tissues. However, in dwarf rats treated for 6 days with bovine
      growth hormone, their numbers were equivalent to, or in some instances greater
      than those in normal tissues. The bromodeoxyuridine labelling index, the ratio of
      positive to negative nuclei and the mitotic index of pre-odontoblasts in dwarf
      rats were consistently lower than in normal rats, and were reversible by growth
      hormone. Growth hormone thus plays a part in odontogenic mesenchymal
      proliferation.

PMID- 8489415
TI  - Measurement of mandibular bone density ex vivo and in vivo by dual-energy X-ray
      absorptiometry.
AB  - Severe bone resorption is a vexing clinical problem, especially in patients
      without teeth. To study resorption in vivo, measurements of bone mineral density
      (BMD) of the mandible of both patients with and without teeth are needed. Using a
      Hologic QDR-1000 bone densitometer designed to measure lumbar spine and hips, ex
      vivo and in vivo measurements were made in selected areas of the mandible. The
      mandible was positioned such that the X-ray beam was perpendicular to its
      sagittal plane. In this way the beam hits first one half of the mandible and then
      the other. The reproducibility--expressed as coefficient of variation--of the ex
      vivo measurements was 0.5%. For in vivo measurements this coefficient was 3%. The
      method used for mandibular BMD would make it possible to define an average BMD in
      several categories of the normal population and of patients, and to compare bone
      density in the mandible with that in the axial and perpendicular skeleton.
      Improvement may be obtained by repeating the measurement. The entrance dose per
      scan is low, equalling that of one bitewing/radiograph.

PMID- 8489416
TI  - Simple reaction-time responses to mechanical and electrical stimuli in human
      masseter muscle.
AB  - The latencies of the simple reaction-time responses for opening and closing of
      the jaws in response to taps and pushes on teeth and lip shocks were measured in
      human adults. The reaction times were scored from both the integrated
      electromyographic (EMG) signal in individual trials, and from the cumulative sum
      (CUSUM) of the averaged EMG response to 50 stimuli. The mean reaction times for
      both closing and opening were about 80-90 ms for taps and electrical lip shocks,
      and about 140 ms for push, measured from the CUSUMs. The reaction times in
      individual trials were difficult to measure from the EMG signal because of the
      unsteady baseline. In contrast, the reaction times measured from the CUSUMs were
      clearly defined by the point at which the record began to move sharply above or
      below the baseline. However, because of the delays inherent in the CUSUM
      procedure, they were systematically longer than the means of the trial-by-trial
      measurements.

PMID- 8489417
TI  - Modelling relative masseter force from surface electromyograms during mastication
      in non-human primates.
AB  - The purpose was to analyse the relation between masseter electromyograms (EMGs)
      and relative masseter force during the power stroke of mastication. The
      electromyographic activity of the masseter was characterized by recording from
      bipolar surface electrodes placed over the superficial portion of the muscle;
      relative masseter force was estimated by characterizing surface bone strain along
      the lateral aspect of the zygomatic arch. The subjects were six adult macaques
      and one adult baboon. Masseter EMGs were quantified by r.m.s. analysis of the raw
      digitized EMG. The length of the time interval (the time constant) during which
      the r.m.s. values were calculated was repeatedly altered so as to determine which
      time constant was optimal for producing an EMG-derived waveform that best
      mimicked relative masseter force during the near-isometric phase of muscle
      contraction. The data indicate that between subjects this time constant varied
      from 35 to 72 ms, with an overall median of 42 ms and a grand mean of 49 ms. The
      use of a 42-ms time constant for all of the subjects resulted in an average
      latency between the masseter EMG waveform and relative masseter force of about 30
      ms during the latter portion of the power stroke of mastication. This analysis
      provides, as a first approximation, an empirical basis for modelling relative jaw
      muscle force using surface EMGs recorded during that portion of the power stroke
      of mastication when the jaw-closing muscles are contracting under near isometric
      conditions.

PMID- 8489418
TI  - Bone sialoprotein in developing porcine dental tissues: cellular expression and
      comparison of tissue localization with osteopontin and osteonectin.
AB  - Bone sialoprotein (BSP) is a highly sulphated and glycosylated phosphoprotein
      that is a major constituent of bone and other mineralized connective tissues.
      Although BSP can mediate cell attachment through an RGD sequence and binds
      selectively to hydroxyapatite, its precise function in mineralized tissues is
      unknown. To provide insights into its possible function, affinity-purified
      polyclonal antibodies directed against porcine BSP were used to demonstrate the
      histological distribution of this protein in developing porcine mandibular
      alveolar bone and the associated tooth tissues from 35- and 50-day fetuses. In
      addition, a porcine cRNA probe was used to determine the cellular expression of
      BSP in the same tissues by in situ hybridization. Immunoreactivity to BSP protein
      was restricted to the cells and matrix of the mineralized tissues of alveolar
      bone and dentine. In dentine, BSP was localized to the odontoblasts and their
      processes and to the peritubular dentine. In the alveolar bone, immunoreactivity
      for BSP was evident in osteoblastic cells and osteocytes and in the bone matrix;
      the older bone stained more strongly than newly formed bone. In addition, BSP
      appeared to be concentrated in the reversal lines of the rapidly remodelling
      bone. The distribution of BSP in these tissues revealed distinct differences when
      compared to osteopontin and SPARC/osteonectin, which are also prominent non
      collagenous proteins of mineralized tissues. Most notable was the localization of
      osteopontin and especially osteonectin in non-mineralizing tissues. The
      immunoreactivity of osteoblasts and osteocytes for BSP in bone was consistent
      with the high levels of BSP mRNA revealed by in situ hybridization. However, much
      lower levels of hybridization were evident in the odontoblasts of developing
      mandibular molars. These studies demonstrate that BSP is expressed during the
      early formation of dentine and alveolar bone and that the protein accumulates in
      the peritubular dentine and bone matrix.

PMID- 8489419
TI  - Effect of the bathing fluid on measurements of diffusion in dental plaque.
AB  - The suggestion that loss of labile components from dental plaque into contacting
      aqueous buffer during some diffusion measurements might change the plaque's
      diffusion behaviour, and therefore invalidate the results, has been tested using
      tracer clearance. (a) Diffusion of [14C]-acetate and 3H2O was determined before
      and after a 3-4 h equilibration with neutral buffer. No differences or trends
      were found. (b) Mean normalized [14C]-acetate clearance curves from live plaque
      for measurements before and after such equilibration were identical in shape and
      showed no change in diffusion coefficient during clearance, as evidenced by their
      fits to the theoretical clearance curve. No significant difference was found
      between coefficients for the two periods (paired sample test). In addition, [14C]
      lactate and 3H2O were found to permeate plaque in a miniature diaphragm diffusion
      cell at rates independent of whether the plaque was bathed either in saliva
      supernatant, plaque fluid or neutral buffer. This lent some further support to
      the main findings. It is concluded that diffusion through dental plaque is little
      affected by the bathing fluid.

PMID- 8489420
TI  - The effect of four jaw relations on electromyographic activity in human
      masticatory muscles.
AB  - Significant differences were found in the electromyographic (EMG) activation
      between the masseter and temporalis muscles for the leaf gauge (LG), manually
      manipulated (CR) and neuromuscular (NM) bite positions during maximal static
      clench. The LG position consistently demonstrated the lowest EMG activity, while
      the NM position displayed the highest degree of muscle activity. Similarly, the
      ratio of the masseter/temporalis EMG activity during maximal clench was lower for
      the LG and CR positions and highest for the NM position. These data indicate that
      the NM position produced the greatest total muscle recruitment, with more
      masseter involvement during maximal clench, and enabled the subjects to generate
      greater clenching forces in the NM position as compared to the LG and CR
      positions.

PMID- 8489421
TI  - The microscopic structure and function of the vascular retrodiscal pad of the
      human temporomandibular joint.
AB  - The highly vascular retrodiscal pad attaches the articular disc of the
      temporomandibular joint to osseous structures posterior to it. There is debate as
      to whether or not the pad includes erectile tissue. Histological examination of
      11 retrodiscal pads revealed thick-walled muscular arteries, thin-walled veins
      and numerous vascular sinuses, which is different from the erectile tissue of the
      corpora cavernosa. Its histological features and position within the joint
      suggest that the retrodiscal pad may function differently from other human joints
      due to: (1) the large amount of distraction it undergoes relative to its size and
      (2) its location anterior to the ear.

PMID- 8489422
TI  - Evidence for endothelial junctions acting as a fluid flux pathway in tensioned
      periodontal ligament.
AB  - A continuous tension load of 1.0 N applied to the rat maxillary first molar for
      30 min led to a significant increase (p < 0.05) in the mean number of
      junctions/microns of endothelial perimeter. The mean number of junctions/microns
      was compared with the mean number of tissue channels/microns 2 as previously
      reported by fitting linear and quadratic equations. An increase in the mean
      number of junctions/microns was associated with an increase in mean number of
      tissue channels/microns 2 (p < 0.01) in control and experimental periodontal
      ligament. Significant increases in the mean number of junctions/microns occurred
      in the middle-third zone for venous capillaries (p < 0.01) and in the tooth-third
      zone for postcapillary-sized venules (p < 0.001). It is concluded that the
      endothelial junctions of venous capillaries and postcapillary-sized venules
      provide significant pathways for fluid transport across the tensioned walls of
      the microvascular bed of the periodontal ligament.

PMID- 8489423
TI  - Can cataract surgery be marketed like hamburgers in developing countries?

PMID- 8489424
TI  - Effect of continuous circular capsulorhexis and intraocular lens fixation on the
      blood-aqueous barrier.

PMID- 8489425
TI  - Corneal bifocal effects by laser photorefractive keratectomy.

PMID- 8489426
TI  - Statistical analysis for method comparison data.

PMID- 8489427
TI  - An unexpected problem with an inexpensive air pump for vitreous surgery.

PMID- 8489428
TI  - Diabetes-like preproliferative retinal changes in galactose-fed dogs.

PMID- 8489429
TI  - Intracameral tissue plasminogen activator in neovascular glaucoma.

PMID- 8489430
TI  - Aneurysmal bone cyst of the orbit and ethmoid sinus.

PMID- 8489432
TI  - DHHS cataract guidelines released.

PMID- 8489431
TI  - Sweet's syndrome presenting as conjunctivitis.

PMID- 8489433
TI  - Guidelines. Cataract surgery and beyond.

PMID- 8489434
TI  - The treatment of pediatric retinal detachment.

PMID- 8489435
TI  - The 25th anniversary of the National Eye Institute.

PMID- 8489436
TI  - Standard for clinical electro-oculography. International Society for Clinical
      Electrophysiology of Vision.
AB  - The electro-oculogram is a widely used electrophysiological test, but recording
      techniques vary among different laboratories. This standard, approved by the
      International Society for Clinical Electrophysiology of Vision (ISCEV), describes
      simple technical procedures that will allow reproducible and comparable electro
      oculograms to be recorded under a few defined conditions. The document is
      intended to improve the comparability of electro-oculographic data obtained
      throughout the world by guiding both clinicians and manufacturers, and the ISCEV
      recommends that future published reports indicate whether the recording technique
      meets the international standard.

PMID- 8489437
TI  - Accuracy of coding in Medicare part B claims. Cataract as a case study.
AB  - We studied the accuracy of Medicare part B coding for cataract extraction to
      provide validation for research involving Medicare data. Hospital and physician
      office records associated with a sample of 802 paid claims for cataract surgery
      were reviewed. The sample was randomly selected from 118,420 Medicare part B
      claims for cataract surgery submitted by physicians in an 11-state sample during
      the first quarter of 1988. Medical records were successfully obtained for 796
      cataract surgery episodes (99.2%), of which 794 (99.7%) indicated that cataract
      extraction had been performed. In the remaining two cases, cataract surgery was
      attempted but aborted. In 24 (3%) of the 794 cases, the surgical approach
      (intracapsular or extracapsular) indicated in the operative note differed from
      the coded on the physician's bill. In all cases in which the operative note
      indicated a secondary procedure performed at the time of surgery, the billing
      information was in agreement. We conclude that, at least in the case of cataract
      surgery, the Medicare part B database is 99% accurate (95% confidence interval,
      +/- 0.6%) for cataract surgery having occurred and 96% accurate (95% confidence
      interval, +/- 1.4%) in terms of surgical approach.

PMID- 8489438
TI  - Sub-pigment epithelial membranes after photocoagulation for diabetic macular
      edema.
AB  - OBJECTIVE: The chronic histopathologic effects of focal and grid argon laser
      photocoagulation were examined in eyes obtained at autopsy that had previously
      been treated for diabetic macular edema. The focus was on further characterizing
      fibrous sub-pigment epithelial membranes that previously had been shown to extend
      beyond burn edges. DESIGN: A total of 131 argon laser burns were evaluated in
      five eyes. Tissue was embedded in paraffin or glycol methacrylate, serially
      sectioned, and examined by light microscopy. MAIN OUTCOME MEASURE: Outer and
      inner nuclear layer defects were measured, and the frequency and extent of sub
      pigment epithelial membranes was estimated. The presence of Muller cell processes
      among membranes was evaluated by immunostaining for glial fibrillary acidic
      protein and enzyme histochemical staining for carbonic anhydrase. RESULTS: Burns
      consistently produced defects in the outer nuclear layer that were larger than
      the spot size of the laser beam. Inner nuclear layer defects were present in only
      seven of 131 burns. Glycol methacrylate--embedded tissue sections from 73 burns
      showed sub-pigment epithelial membranes in all five eyes. In one eye, membranes
      were confluent between burns. In the remaining four eyes, 37 individual membranes
      were found among 53 burns, and 47% of membranes contained Muller cell processes.
      The membranes in paraffin-embedded tissue could not be adequately evaluated.
      CONCLUSIONS: After focal laser treatment for diabetic macular edema, the inner
      retina was usually spared. Fibrous sub-pigment epithelial membranes were frequent
      among burns in all five eyes, and they showed a conspicuous contribution by
      Muller cell processes. We speculate that by impairing the overlying pigment
      epithelium, these membranes may contribute to a progressive enlargement of laser
      scars.

PMID- 8489439
TI  - Retinal detachments in incontinentia pigmenti.
AB  - We report on retinal detachments in six eyes of four patients with incontinentia
      pigmenti. These nonrhegmatogenous traction retinal detachments are characterized
      by extensive preretinal and vitreous fibrous organization that pull the retina
      anteriorly behind the lens. The clinical course and fundus appearance of the
      retinal detachments, beginning with the avascular peripheral retina and leading
      to traction retinal detachment, are similar to those of cicatricial retinopathy
      of prematurity. Vitreous surgery was performed on three eyes (two patients), with
      partial reattachment of a total retinal detachment in one eye and complete
      reattachment of a partial retinal detachment in a second eye. These cases
      represent the first successful surgical interventions reported for retinal
      detachment in incontinentia pigmenti.

PMID- 8489440
TI  - Surfactant prophylaxis and retinopathy of prematurity.
AB  - OBJECTIVE: The use of exogenous surfactant has led to a decrease in mortality of
      low-birth-weight infants. In some instances, use of this drug has also led to a
      reduction in neonatal morbidity, such as respiratory distress syndrome. This
      study was undertaken to determine whether prophylactic surfactant therapy has an
      effect on the incidence and severity of retinopathy of prematurity. DESIGN: The
      authors reviewed the findings of sequential prospective ophthalmologic
      examinations performed in two neonatal intensive care units that participated in
      randomized trials of prophylactic exogenous mammalian surfactant. PATIENTS: There
      were 43 patients in the control group (no prophylactic surfactant) and 43
      patients in the prophylactic surfactant group. These groups did not differ on the
      basis of birth weight, gestational age, race, or gender. RESULTS: The incidence
      and severity of retinopathy of prematurity did not vary between the control and
      surfactant-treated infants. Only birth weight appeared to be significantly
      related to the incidence and severity of retinopathy of prematurity. CONCLUSIONS:
      These results suggest that the widespread use of prophylactic surfactant therapy
      will not change the incidence of retinopathy of prematurity in extremely low
      birth-weight infants. However, the absolute number of affected patients will
      likely increase because of the decrease in mortality of extremely low-birth
      weight patients, the patients most at risk for retinopathy of prematurity.

PMID- 8489441
TI  - Posterior retinal folds following vitreoretinal surgery.
AB  - The authors conducted a retrospective review of 32 patients with posterior
      retinal folds following retinal reattachment surgery. Twenty-eight of these
      patients underwent combined pars plana vitrectomy, fluid-air exchange with either
      internal drainage through a preexisting retinal break or external drainage of
      subretinal fluid, and scleral buckle. We believe these drainage techniques
      resulted in incomplete elimination of subretinal fluid, with resultant
      sequestration of fluid at the dependent border between attached and detached
      retina. Metamorphopsia and decreased visual acuity were noted in patients with
      folds involving the macula. The likelihood of fold formation may be greatly
      reduced by internal drainage through a posterior retinotomy combined with more
      complete removal of slowly gravitating fluid as it flows dependently to the
      drainage site.

PMID- 8489442
TI  - Atypical presentations of macular holes.
AB  - OBJECTIVE: To describe nine cases of macular holes with atypical presentations
      and propose possible mechanistic explanations. SETTING: The steps leading to
      typical idiopathic macular hole formation have recently been defined. PATIENTS:
      Patients included seven with previous retinal detachment and subsequent macular
      hole formation and two with macular hole formation after vitrectomy for
      epiretinal membrane removal. CONCLUSIONS: The occurrence of these cases may seem
      to contradict reported pathogenesis schemes, but they are explainable within
      reported grading schemes.

PMID- 8489443
TI  - Long-term effectiveness of optic nerve sheath decompression for pseudotumor
      cerebri.
AB  - OBJECTIVE: To determine the long-term success of optic nerve sheath decompression
      in preserving visual function in patients with pseudotumor cerebri (PTC). DESIGN:
      To define stability of visual fields, we reviewed 32 series of postoperative
      visual fields in patients who were undergoing optic nerve sheath decompression
      for PTC who had stable visual acuity and four or more fields during 6 to 60
      months of follow-up. The SD of these series was 0.80 dB (+/- 0.39 dB) of mean
      deviation. Fluctuations within 2 SDs of the 1-month postoperative field were +/- 
      1.60 dB. We therefore defined stability as a mean deviation within 2 dB of the
      preoperative visual field; improvement, greater than 2-dB mean deviation, and
      worsening, less than 2-dB mean deviation. We then extended our review to include
      all patients (54 patients, 75 eyes) who underwent optic nerve sheath
      decompression for PTC, who were followed up with serial automated perimetry
      (Humphrey 30-2). RESULTS: Fifty-one eyes (68%) showed improvement (36%) or
      stabilization (32%) of visual function. Twenty-four eyes (32%) experienced
      deterioration of visual function after an initially successful optic nerve sheath
      decompression. The probability of failure from 3 to 5 years was .35 by life-table
      analysis. CONCLUSION: Optic nerve sheath decompression effectively stabilizes or
      improves visual function in the majority of patients with PTC and visual loss.
      However, it may fail at any time after surgery. Patients with PTC need to be
      followed up routinely with automated perimetry to detect deterioration of visual
      function.

PMID- 8489444
TI  - Effect of repetitive imaging on topographic measurements of the optic nerve head.
AB  - OBJECTIVE: A confocal scanning diode laser ophthalmoscope was used to determine
      the number of examinations needed to obtain highly reproducible topographic
      measurements of the optic nerve head and peripapillary retina. DESIGN:
      Topographic images of the optic nerve head and peripapillary retina were obtained
      in one randomly selected eye on five separate visits. On each occasion the
      selected eye had five examinations. For each examination, one image was acquired
      (a total of 25 images per eye). Reproducibility was calculated as the average SD
      of all image elements (65,536 pixels). SETTING: Glaucoma referral center.
      SUBJECTS: Five normal subjects and five patients with glaucoma. INTERVENTION:
      Topographic imaging of the optic nerve head and peripapillary retina. MAIN
      OUTCOME MEASURE: Number of examinations needed to obtain highly reproducible
      topographic measurements. RESULTS: In healthy subjects, reproducibility with one
      examination per visit was 35.5 microns; this improved to 25.7 microns with three
      examinations and 22.5 microns with five examinations. In older patients with
      glaucoma, the reproducibility improved from 40.2 microns with one examination per
      visit to 28.5 and 24.1 microns with three and five examinations, respectively.
      CONCLUSION: We recommend a series of three examinations to provide high
      reproducibility with optimal efficiency in terms of time and materials used.

PMID- 8489445
TI  - Comparison of the Farnsworth-Munsell 100-Hue, the Farnsworth D-15, and the
      L'Anthony D-15 desaturated color tests.
AB  - OBJECTIVE: The Farnsworth-Munsell 100-Hue, the Farnsworth D-15, and the L'Anthony
      D-15 desaturated color tests were administered to patients with glaucoma to
      determine whether the D-15 or D-15 desaturated color tests could be used to
      predict performance on the 100-Hue test in clinical populations. METHODS: The
      three color tests were administered to 35 patients with glaucoma. The results
      were analyzed using the method of Vingrys and King-Smith that calculates an angle
      (type of color loss) score, S-index (measure of the randomness of cap
      arrangement), and a C-index (a measure of the severity of color loss) based on
      the cap arrangement. RESULTS: The 100-Hue error score was significantly related
      to the D-15 and D-15 desaturated C-indexes. Furthermore, the 100-Hue S-index
      could be predicted from the D-15 or D-15 desaturated S-indexes. The 100-Hue angle
      could not be predicted from the D-15 or D-15 desaturated color tests.
      CONCLUSIONS: The D-15 desaturated color test (which requires significantly less
      time to administer) may be used to assess the severity of color vision deficit in
      some patient populations.

PMID- 8489446
TI  - Transbronchial lung biopsy in the diagnosis of suspected ocular sarcoidosis.
AB  - We conducted clinical research using transbronchial lung biopsy in 60 patients
      with suspected ocular sarcoidosis who showed no bilateral hilar lymphadenopathy
      and sparse contributory evidence for sarcoidosis. The patients had a combination
      of granulomatous iritis with mutton-fat keratic precipitates or iris nodules,
      trabecular nodules, tent-like peripheral anterior synechiae, snowball or string
      of-pearls vitreous opacities, retinal perivasculitis, and spotty retinochoroidal
      exudates. The transbronchial lung biopsy specimen showed noncaseating epithelioid
      granuloma in 37 patients (61.7%); these patients were diagnosed as having
      sarcoidosis. Bronchoalveolar lavage showed a high percentage of patients with an
      increased lymphocyte fraction among those with positive transbronchial lung
      biopsy results. The present results may serve as a basis for a clinical diagnosis
      of sarcoidosis in patients with suspected sarcoidosis without apparent
      extraocular manifestations.

PMID- 8489447
TI  - Blue-on-yellow perimetry can predict the development of glaucomatous visual field
      loss.
AB  - OBJECTIVE: The purpose of this investigation was to determine whether blue-on
      yellow (B/Y) perimetry is capable of predicting the onset and location of
      impending glaucomatous visual field loss in patients with ocular hypertension.
      DESIGN: A Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif) was
      modified to perform B/Y perimetry to isolate and measure the sensitivity of short
      wavelength-sensitive mechanisms. Participants were tested annually with standard
      white-on-white (W/W) and B/Y automated perimetry for a period of 5 years.
      PATIENTS: The study population consisted of 38 patients with ocular hypertension
      and 62 age-matched normal control subjects. RESULTS: Initially, all 76 ocular
      hypertensive eyes had normal W/W automated perimetry results, with 67 eyes having
      normal and nine eyes having abnormal B/Y test results. Five years later, five of
      the nine ocular hypertensive eyes with initial B/Y abnormal results developed
      glaucomatous visual field loss measured by standard W/W automated perimetry,
      while none of the 67 ocular hypertensive eyes with initially normal B/Y results
      developed abnormal W/W perimetry results. CONCLUSIONS: Blue-on-yellow perimetry
      deficits are an early indicator of glaucomatous damage and are predictive of
      impending glaucomatous visual field loss for standard W/W automated perimetry. To
      our knowledge, this is the first prospective, long-term longitudinal study that
      demonstrates the ability to predict the onset of glaucomatous visual field loss
      in patients with ocular hypertension on the basis of psychophysical testing.

PMID- 8489448
TI  - Progression of early glaucomatous visual field loss as detected by blue-on-yellow
      and standard white-on-white automated perimetry.
AB  - OBJECTIVE: To determine whether blue-on-yellow perimetry reveals progression of
      glaucomatous damage before it is evident with standard white-on-white perimetry.
      DESIGN: A Humphrey field analyzer (Humphrey Instruments, San Leandro, Calif) was
      modified to perform blue-on-yellow perimetry to isolate and measure the
      sensitivity of short wavelength-sensitive mechanisms. Participants were tested
      annually with standard white-on-white automated perimetry and blue-on-yellow
      automated perimetry for 5 years. PATIENTS: Sixteen patients with early
      glaucomatous visual field loss in one or both eyes and 62 age-matched normal
      control subjects. RESULTS: At baseline, 25 (78.1%) of the 32 eyes exhibited
      larger deficits with blue-on-yellow perimetry, five (15.6%) had equivalent loss
      with both tests, and two (6.3%) had larger deficits with standard white-on-white
      perimetry. Seven (21.9%) of the 32 eyes demonstrated evidence of progressive
      visual field loss with standard white-on-white perimetry in 5 years, while the
      other 25 eyes (78.1%) were relatively stable. Deficits with blue-on-yellow
      perimetry were twice as large as deficits with white-on-white perimetry in the
      stable group and were three to four times as large in the group with progressive
      field loss. CONCLUSIONS: Blue-on-yellow perimetry is effective in predicting
      which patients with early glaucomatous visual field loss are most likely to have
      progressive loss. The rate of progressive loss is greater with blue-on-yellow
      perimetry than with standard white-on-white perimetry.

PMID- 8489449
TI  - Maintained intraocular pressure reduction with once-a-day application of a new
      prostaglandin F2 alpha analogue (PhXA41). An in-hospital, placebo-controlled
      study.
AB  - To eliminate uncertainties about compliance, 15 patients with glaucoma
      (intraocular pressure [IOP] > 22 mm Hg and < 40 mm Hg) were hospitalized to
      participate in a clinical trial of the ocular hypotensive effectiveness of the
      new prostaglandin F2 alpha analogue prodrug, PhXA41 (13,14-dihydro-17-phenyl-18,
      19, 20-trinor-PGF2a-isopropyl ester; latanoprost [World Health Organization
      generic name]). At 9 PM on each of five consecutive days, one of the
      investigators applied one drop of a 0.006% solution of PhXA41 (representing
      approximately 2 micrograms of PhXA41 per treatment) to one eye of nine patients
      and one drop of placebo to one eye of six patients. This was followed by an
      evaluation of potential local side effects at 9:30 PM. Complete examinations,
      including tonometry (Goldmann), were also performed at 8 AM and 8 PM on days 1 to
      6, as well as at noon and 4 PM on days 1, 2, and 6. Except for mild conjunctival
      hyperemia in two PhXA41-treated eyes (once each at 8 AM), no side effects were
      observed or reported by any patient. Starting with the first IOP measurement
      after the first treatment (8 AM on day 2), IOP was reduced by 20% to 30% in the
      eyes treated with PhXA41. This reduction was highly significant (P < .01 at 12
      time points and P < .05 at the remaining two measurements) throughout the study.
      The IOP reduction did not become attenuated during the 23 hours after treatments.
      At 11 hours after the last treatment, the mean (+/- SD) IOP difference between
      PhXA41-treated and contralateral control eyes was -5.5 +/- 2.8 mm Hg, as compared
      with -6.1 +/- 1.8 mm Hg 12 hours later. PhXA41 must, therefore, be regarded as an
      excellent candidate for use as a once-a-day glaucoma medication.

PMID- 8489450
TI  - Interaction of PhXA41, a new prostaglandin analogue, with pilocarpine. A study on
      patients with elevated intraocular pressure.
AB  - OBJECTIVE: To evaluate the effects of PhXA41, a new prostaglandin analogue, on
      the intraocular pressure (IOP) in patients receiving pilocarpine treatment and
      the effects of pilocarpine in patients receiving PhXA41 treatment. DESIGN: Twenty
      patients with ocular hypertension were randomized into two parallel groups. The
      treatment period was 2 weeks. Ten patients in group 1 were given PhXA41 twice
      daily during week 1 and, in addition, pilocarpine three times daily during week
      2. Ten patients in group 2 received pilocarpine three times daily during week 1
      and PhXA41 twice daily in addition during week 2. PhXA41 was used in a
      concentration of 0.006%, and pilocarpine was given in a concentration of 2%. MAIN
      OUTCOME MEASURES: In group 1, the mean IOP on day 0 was 25.1 mm Hg; on day 7,
      19.1 mm Hg; and on day 14, 17.6 mm Hg. In group 2, the mean IOP on day 0 was 23.8
      mm Hg; on day 7, 20.4 mm Hg; and on day 14, 17.7 mm Hg. RESULTS: PhXA41 had a
      clinically significant IOP-lowering effect (23.4% reduction on day 7 as compared
      with baseline day (P < .001). The corresponding value with pilocarpine was 14.3%
      (P < .001). When pilocarpine was added to PhXA41, the additional IOP reduction
      was 7.4% (P < .01) compared with 14.2% (P < .01) when PhXA41 was added to
      pilocarpine. The two groups were found to have an almost equal reduction in IOP
      on day 14 (group 1, 29.4%; group 2, 26.6%). No serious adverse reactions were
      seen. Some conjunctival hyperemia in the PhXA41-treated eyes was noted on day 7,
      as compared with the pilocarpine-treated eyes, but there were few complaints of
      discomfort. CONCLUSIONS: This study indicated that PhXA41 could be useful in the
      treatment of glaucoma, as monotherapy, or in certain cases in combination with
      pilocarpine.

PMID- 8489451
TI  - Corneal endothelial involvement in pseudoexfoliation syndrome.
AB  - Information on corneal manifestation in pseudoexfoliation syndrome is restricted
      to specular microscopic studies. We investigated morphologic changes of the
      posterior cornea of two corneal buttons with Fuchs' endothelial dystrophy
      obtained at penetrating keratoplasty and of one enucleated glaucomatous eye from
      three patients with ocular pseudoexfoliation syndrome. By transmission electron
      microscopy, large clumps of typical pseudoexfoliation material were found
      adhering to the corneal endothelium and masses of pseudoexfoliation material were
      incorporated into the posterior Descemet's membrane. In the affected areas, the
      endothelial layer appeared irregular and discontinuous, with loosely adherent,
      degenerating cells producing pseudoexfoliation fibers and fibroblastic cells
      spreading to cover denuded Descemet's membrane. The present findings indicate
      that the pseudoexfoliation material is initially formed by degenerative
      endothelial cells and that it becomes subsequently buried by overgrowing cells.
      The corneal endothelial involvement may potentiate complications of cataract
      surgery and open angle glaucoma in patients with pseudoexfoliation syndrome.

PMID- 8489452
TI  - Cataract and survival in an elderly nondiabetic population.
AB  - Follow-up ranging between 6 and 8 years of the survival of a cohort of 473
      elderly nondiabetic subjects randomly selected from a small English town showed
      an age- and sex-adjusted association between nuclear cataract at the time of
      baseline examination and decreased survival (P = .002). Comparing those with and
      without nuclear cataract, the adjusted relative hazard for death was 1.52 (95%
      confidence interval, 1.15 to 1.99). This effect remained virtually unchanged when
      also adjusted for whether the subject reported ever having been a smoker.

PMID- 8489453
TI  - Vision change and quality of life in the elderly. Response to cataract surgery
      and treatment of other chronic ocular conditions.
AB  - OBJECTIVE: Evaluation of health care in older populations has increasingly
      focused on quality of life as a critical outcome of treatment. Vision is assumed
      to be central to functioning. Data suggest that aging, in itself, is associated
      with a decline in visual functioning, which, in turn, is related to a decline in
      physical and mental functioning. Other studies indicate that cataract surgery is
      followed by significant improvement in vision and visual function. Our objective
      was to test these assumptions. DESIGN: Prospective study of 1021 patients,
      consecutively drawn from 76 randomly selected ophthalmologists' offices in three
      cities. Structured interviews were completed at baseline, 2 months, and 1 year
      after entry. PATIENTS: Six hundred thirteen patients with cataracts and 408 other
      ophthalmic patients drawn from the same offices but treated for other chronic
      ocular disorders. All received refractive services as needed. SETTING: Patients
      from three cities (Baltimore, Md, St Louis, Mo, and San Diego, Calif) were
      interviewed once in their homes and twice by telephone. INTERVENTIONS: The study
      involved the measurement of the effects of usual treatment for cataracts and
      other degenerative eye diseases. MAJOR OUTCOME MEASURES: Visual, social, and
      psychological functioning. RESULTS: Within 1 year of treatment, change in visual
      function was accompanied by significant changes, in the same direction, in
      quality of life functions: night-time driving, daytime driving, community
      activities, home activities, mental health, and life satisfaction. In addition,
      the patients with cataracts showed significantly greater improvement in measures
      of vision than did the noncataract group. CONCLUSIONS: Regardless of treatment,
      improvement across quality of life functions occurred when visual function
      improved. Thus, many types of functional degeneration observed in older
      populations, attributed to a decline in vision, can be slowed, or even reversed,
      when visual function is improved. Cataract surgery was effective in improving
      vision and quality of life functions.

PMID- 8489454
TI  - Outcomes of cataract surgery. Improvement in visual acuity and subjective visual
      function after surgery in the first, second, and both eyes.
AB  - OBJECTIVE: No previous study documents improvement in visual acuity and
      subjective visual function associated with cataract surgery in the first eye,
      second eye, and both eyes. Measurement of subjective aspects of visual function
      and quality of life provides information that cannot be obtained with simple
      measurement of Snellen visual acuity. METHODS: From 76 ophthalmology practices in
      three cities, patients undergoing cataract extraction with intraocular lens
      implantation (n = 613) and comparison patients (n = 408) were enrolled in a
      prospective study. Questionnaires elicited visual function information before and
      after surgery, and visual acuity was obtained from the ophthalmologic record.
      RESULTS: Among patients with cataract and no other eye disease, baseline
      subjective visual function before surgery in the second eye was better than that
      before surgery in the first eye. Improvement in subjective visual function was
      approximately equal postoperatively in first and second eyes. Improvement in
      subjective function in both eyes postoperatively was significantly greater than
      that after surgery in the first eye or second eye alone. No statistically
      significant difference across surgical groups in the proportion of patients
      demonstrating improvement in visual acuity was observed. CONCLUSION: Patients who
      underwent surgery in both eyes reported greater improvement in subjective visual
      function than did those who underwent surgery in one eye. Thus, there seems to be
      a benefit associated with restoring binocular vision in this population. These
      findings support the policy recommendation that cataract surgery in both eyes
      remains the appropriate treatment for patients with bilateral, cataract-induced
      visual impairment.

PMID- 8489455
TI  - Comparison of laser phacovaporization using the Er-YAG and the Er-YSGG laser.
AB  - OBJECTIVE: To study the interaction of the erbium (Er)-YAG (2.94 microns) and the
      Er-YSGG (2.79 microns) lasers with the human crystalline lens tissue. METHODS:
      Fresh human crystalline lens sections were used to measure the photovaporization
      threshold, rate, and damage zone of the two lasers. RESULTS: We found the
      photovaporization threshold for the Er-YAG and the Er-YSGG lasers to be 1.4 J/cm2
      and 5.5 J/cm2, respectively. At 10 J/cm2, the photovaporization rate is 67.9
      microns per pulse for the Er-YAG laser and 18.4 microns per pulse for the Er-YSGG
      laser. The increased rate of photovaporization as a function of radiant energy
      for the Er-YAG laser is almost twice that for the Er-YSGG. Damage zones for the
      Er-YAG laser ranged from 4 to 9 microns compared with 10 to 22 microns for the Er
      YSGG. CONCLUSIONS: It is apparent that both lasers can adequately photovaporize
      human crystalline lens tissue and should be further studied for this purpose.

PMID- 8489456
TI  - Orbital varix.

PMID- 8489457
TI  - Ischemic hypertensive choroidopathy. Fluorescein angiography, indocyanine green
      videoangiography, and measurement of pulsatile blood flow.

PMID- 8489458
TI  - Posterior capsule tears during extracapsular cataract surgery in India.
AB  - We determined the incidence in a developing nation of posterior capsule rupture
      during planned extracapsular cataract surgery and insertion of a posterior
      chamber intraocular lens. The results, in part, determine whether this
      complication limits the widespread utility of this procedure in developing
      nations. We retrospectively reviewed charts of all patients undergoing planned
      extracapsular cataract surgery during a 6-month period; all patients received
      surgery as inpatients at the Aravind Eye Hospital, Madurai, India, and all were
      southern Indians. We tried to exclude most patients with prior ocular diseases
      associated with loss of zonular or posterior capsule integrity. One eye of all
      eligible patients was included. Extra-capsular cataract surgery was performed
      using manual irrigation and aspiration with the insertion of a posterior chamber
      intraocular lens. In this study, we evaluated the ability to maintain an intact
      posterior capsule with the insertion of a posterior chamber intraocular lens
      during surgery. Of 898 eyes operated on, 15 (1.7%) developed rents in the
      posterior capsule, and seven of these had vitreous in the anterior chamber. Nine
      of the 15 rents were in eyes with either traumatic or hypermature lenses. We
      conclude that even in a developing nation where many cataracts are mature,
      hypermature, or traumatic, extracapsular cataract surgery with the insertion of a
      posterior chamber intraocular lens is technically feasible if surgeons are
      skilled and experienced.

PMID- 8489459
TI  - Analysis of 20,119 deliveries in Dhaka Medical College Hospital.
AB  - Data of 20,119 deliveries in Dhaka Medical College Hospital are presented. Dhaka
      Medical College Hospital is the chief referral hospital in Dhaka city. The 15% of
      patient were 18 years of age or below and 18% were above 35 years of age or
      above. The 48.22% were primaegravida and 51.78% were multigravida, of these 28%
      were grandmultigravida. The 89% had no previous antenatal checkup. The 92.72% had
      cephalic presentation, 65.52% had normal vaginal delivery, 21.07% had caesarean
      section, 11.18% had forceps delivery. Perinatal mortality during hospital stay
      was 143/1,000 deliveries, maternal mortality 2,510/100,000, mainly due to
      eclampsia. Complications during delivery were mainly in the form of ruptured
      uterus (1.10%), P.P.H. (1.06%), and retained placenta (3.88%).

PMID- 8489460
TI  - Synchronous secretion of LH and prolactin during the normal menstrual cycle.
AB  - Integrated hourly concentrations of day-time prolactin and LH showed significant
      positive correlations (p < 0.05-0.001) on the day of the pre-ovulatory mid cycle
      LH surge (n = 3) and during the mid luteal phase (n = 6) in a group of regularly
      cyclic women. No correlations between these two hormones were seen during any
      other stage of the cycle. Consistent significant correlations were not evident
      between prolactin and oestradiol, prolactin and progesterone, LH and oestradiol
      or LH and progesterone during any other stage of the cycle.

PMID- 8489461
TI  - Changes of hemorheologic properties during normal human pregnancy.
AB  - To investigate alterations of hemorheologic properties during pregnancy, we
      measured the hematocrit (Hct) and fibrinogen levels, blood viscosity, and
      erythrocyte deformability in 10 healthy nonpregnant women and in 10 women with
      uncomplicated pregnancies. The Hct decreased during pregnancy, while the plasma
      fibrinogen concentration was elevated. No significant changes in blood viscosity
      were observed throughout pregnancy. Erythrocyte deformability was significantly
      decreased in pregnancy when compared to the nonpregnant state, but returned to
      the nonpregnant level by the 7th postpartum day. These findings suggest that
      adequate microcirculation is maintained in the uteroplacental unit during
      gestation by hemodilution, which prevents an elevation of blood viscosity despite
      the increase in fibrinogen and the decrease of erythrocyte deformability. These
      changes are thus thought to be among the physiological maternal adaptations to
      fetal growth and development.

PMID- 8489462
TI  - Combined examination of middle cerebral artery and umbilical artery flow velocity
      waveforms in growth-retarded fetuses.
AB  - The resistance index (RI) of middle cerebral artery (MCA) and umbilical artery
      (UA) flow velocity waveforms (FVWs) were characterized retrospectively in 60
      growth-retarded fetuses in the third trimester of gestation. Reference ranges of
      MCA-RI, UA-RI, and the UA-RI/MCA-RI ratio to gestational age were obtained from a
      cross-sectional study of 150 healthy fetuses. Growth-retarded fetuses that
      developed fetal distress had lower MCA-RIs, higher UA-RIs, and higher UA-RI/MCA
      RI ratios than growth-retarded fetuses that had good outcomes. The highest
      sensitivity for fetal distress was observed in the UA-RI/MCA-RI ratio (UA-RI/MCA
      RI 94.1%, MCA-RI 79.4%, UA-RI 61.8%), and the highest specificity was in MCA-RI
      (MCA-RI 92.3%, UA-RI 84.6%, UA-RI/MCA-RI 76.9%). In growth-retarded fetuses, the
      combined examination of MCA FVWs and UA FVWs was more useful in assessing fetal
      well-being than examination of UA FVWs alone.

PMID- 8489463
TI  - Outcome of pregnancy in patients with organic heart disease in Taiwan.
AB  - A total of 122 pregnancies in 101 women with organic heart disease were reviewed.
      The incidence of organic heart disease in pregnant women was 0.25%. The ratio of
      rheumatic to congenital heart disease was 1.0 to 1.5. In the congenital heart
      disease group, IUGR was more frequent in the cyanotic group as were preterm
      births. Patients with cyanotic lesions had a significantly higher maternal
      mortality rate than those with acyanotic lesions. The cyanotic group without
      surgical correction had a significantly higher maternal mortality rate and more
      IUGR than those with correction. Congestive heart failure was the most common
      maternal complication, with a rate of 38.1%. The patients with good cardiac
      status control during pregnancy developed less IUGR, had fewer preterm births,
      less maternal morbidity and less maternal mortality than those in poor condition.
      Patients in functional classes I and II before pregnancy carried less risk of
      maternal morbidity than those in classes III and IV.

PMID- 8489464
TI  - A case of successful pregnancy and delivery after brain metastasis of
      choriocarcinoma.
AB  - This is report regarding a 28-year-old woman who conceived and delivered a
      healthy child following treatment for brain metastasis of choriocarcinoma in 1980
      and a prolonged postoperative disease-free period. The patient had delivered a
      hydatidiform mole. Eight months afterwards she was admitted to our hospital with
      occipital pain, vomiting and stupor, and upon CT examination was found to have a
      brain tumor. The surgically removed tumor was pathologically diagnosed as
      choriocarcinoma. Postoperative methotrexate chemotherapy rapidly lowered the
      preoperative urinary human chorionic gonadotrophin (19 IU/ml), and allowed
      restoration of the preoperative LH level, consciousness, ambulation, and manifest
      ovulation. Occasional mild cramps were received by continuous use of
      anticonvulsants which did not affect her daily life. Four and one-half years
      postoperatively she conceived, and had a healthy boy weighing 2,294 g at the 39th
      week of gestation in June 1985. Both mother and baby have been doing well for 7
      postpartum years.

PMID- 8489465
TI  - A case report: cervical pregnancy with placenta percreta an ultrasonic assisted
      diagnosis.
AB  - A rare cervical pregnancy is reported, discussing the difficulty differentiating
      this condition from the cervical phase of an incomplete abortion. Placenta
      percreta further complicates this case. Ultrasound will give a firm diagnosis of
      cervical pregnancy and associated placenta percreta. Conservative and radical
      surgical care determined by vital signs are discussed.

PMID- 8489466
TI  - Sonographic prenatal diagnosis of congenital heart defects in thoraco
      omphalopagus.
AB  - Thoraco-omphalopagus is the most common variety of conjoined twins. About 90% of
      the conjoined thoraco-omphalopagus twins have a common pericardium, and 75% have
      conjoined hearts. Options for the treatment of thoraco-omphalopagus are largely
      dependent on the anatomy of the cardiovascular system. The extent of the
      conjunction of the heart and the severity of the associated cardiac defects
      primarily determine the feasibility of successful separation of the infants. Two
      dimensional echocardiography and color Doppler examination has become the method
      used to investigate cardiovascular system of conjoined twins with a high degree
      of confidence. A case of thoraco-omphalopagus conjoined twins prenatally
      determined of the extent of cardiac conjunction and diagnosis of associated
      defects by these methods is presented.

PMID- 8489467
TI  - Lupus anticoagulant (LAC) and its relation to pregnancy outcome: a report of five
      cases.
AB  - We examined the relation between the spontaneous remission and prednisolone
      induced suppression of lupus anticoagulant (LAC) or anticardiolipin antibody
      (ACA) and pregnancy outcome in 5 LAC-positive women. Two women showed a
      spontaneous remission of LAC and ACA during the observation period. One of these
      2 women became pregnant and delivered healthy twin infants at 36 weeks of
      pregnancy without any therapy. The other woman became LAC positive again after 1
      year of remission, and experienced 2 more fetal losses. Two of the remaining LAC
      positive women received prednisolone and aspirin. Only 1 woman, whose ACA was
      suppressed by medication, delivered a healthy newborn. The pregnancy of the other
      woman, whose LAC and ACA remained positive in spite of medication, terminated in
      an IUFD. These results suggest that the administration of prednisolone and
      aspirin is the first choice of therapy for LAC-positive women, and that
      encouraging such women to become pregnant while LAC is negative might be an
      alternative therapy.

PMID- 8489468
TI  - A case report on surgically managed elephantoid vulva due to donovanosis.

PMID- 8489469
TI  - Pregnancy in association with mitral valve prolapse.
AB  - Mitral valve prolapse (MVP) is considered to be the most common valvular heart
      lesion in adult females of reproductive age. Our report reviews the obstetrical
      performance and outcome of 34 pregnancies in 15 women with MVP. In 12 (80%)
      patients cardiac lesion was suspected due to enigmatic dyspnoea and palpitation
      during antenatal period. Four mothers required propranolol for cardiac
      arrhythmias. However, all of them tolerated pregnancy and labour well. Four
      pregnancies (11.8%) ended in spontaneous abortion and 1 mother had intrauterine
      fetal death due to severe pregnancy-induced hypertension. There were 25 (73.5%)
      term and 3 (8.8%) preterm neonates without congenital abnormality. One preterm
      neonate had tracheo-oesophageal fistula and died 6 hours after corrective
      surgery. The mean birth weight of 2.8 kg was appropriate for mean gestation of
      38.5 weeks when compared to the Institute's reference neonatal weight curve.
      Infective endocarditis prophylaxis was recommended in cases having mitral
      regurgitation and complicated delivery. Awareness of this common cardiac lesion,
      thorough cardiovascular examination during pregnancy, early detection and
      treatment of cardiac arrhythmias if any, are the essential steps to prevent rare
      but dreaded maternal complications.

PMID- 8489470
TI  - Clinical observation of personality characteristics of perimenopausal women with
      undefined complaints.
AB  - Personality tests, including the Self-Rating Questionnaire for Depression (SRQ
      D), the Minnesota Multiphasic Personality Inventory Alexithymia Scale (MMPI-AS),
      and the Egogram Check List (ECL) were completed by 202 perimenopausal women with
      undefined complaints. Patients diagnosed as having mental disorders showed SRQ-D
      scores of over 16 points. Patients diagnosed as having mental disorders showed
      MMPI-AS scores of over 13 points, which can be estimated as alexithymia. Patients
      experiencing climacteric disorders and the ovarian deficiency syndrome showed
      slightly higher MMPI-AS scores than healthy middle-aged women. The average ECL
      scores of patients diagnosed as having mental disorders tended to show an N-shape
      pattern. The findings suggest that personality tests would be helpful for
      screening perimenopausal women with mental disorders who are seen at outpatient
      gynecology clinics.

PMID- 8489471
TI  - Predictive value of 1 hour 50 g oral glucose load screening test for gestational
      diabetes mellitus compared to 3 hour oral glucose tolerance test in high risk
      pregnant women.
AB  - A prospective study for detecting gestational diabetes mellitus was undertaken to
      evaluate the use of one hour plasma glucose level after 50 g glucose loading test
      (1-hr GLT) as compared to the traditional 3-hours 100 g oral glucose tolerance
      test (3-hr OGTT) in 396 high risk cases. Each patient, had 1-hr GLT and 3-hr OGTT
      performed in a separate week. Forty-two cases (10.6%) who had abnormal 3-hr OGTT
      were classified as gestational diabetes (GDM). One hundred and sixty cases
      (40.4%) had an abnormal 1-hr GLT (plasma glucose level > or = 140 mg/dl). Thirty
      six of these 160 cases (22.5%) had an abnormal 3-hr OGTT. In 236 women (59.6%)
      that had normal 1-hr GLT (plasma glucose level < 140 mg/dl) only 6 cases (2.5%)
      had an abnormal 3-hr OGTT. If 1-hr plasma glucose level > or = 150 mg/dl was used
      as the cutoff point, 110 cases (27.8%) were found to have abnormal 1-hr GLT, and
      35 of these 110 cases (31.8%) had an abnormal 3-hr OGTT. Seven of 286 women
      (2.4%) that had normal 1-hr GLT (plasma glucose level < 150 mg/dl) had an
      abnormal 3-hr OGTT. The sensitivity and specificity of the 1-hr GLT when abnormal
      3-hr OGTT was used as gold standard for detecting GDM were 85.7% and 65%
      respectively (BS > or = 140 mg/dl). Whereas the sensitivity and specificity were
      83.3% and 78.8% respectively when plasma glucose level > 150 mg/dl was used as
      the cut point.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489472
TI  - Internal iliac artery ligation in obstetrics and gynecology. Ten years
      experience.
AB  - Twenty-two cases of bilateral internal iliac artery ligation done in the
      Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate
      Medical Education and Research (JIPMER), Pondicherry, India over a period of 10
      years (1981-1990) were studied. Various indications and complications were
      analysed. Internal iliac artery ligation is a life-saving procedure in pelvic
      hemorrhage. Complications are infrequents.

PMID- 8489473
TI  - Return of fertility after the removal of intrauterine devices: a comparison of
      inert and copper bearing devices.
AB  - The use of intrauterine device (IUD) has been suspected to be linked to
      involuntary infertility due to increased risk of pelvic inflammatory diseases.
      Nevertheless, it remains unclear whether the overall risk of infertility after
      discontinuing use of IUD increases with the duration of IUD use. Thus, the
      present study was designed to evaluate the return of fertility after
      discontinuing use of copper containing IUDs compared to inert IUD and to
      determine a possible relationship between the length of IUD use and return of
      fertility. Ninety women with Lippes Loop type D (LL), 88 women with Copper-T200
      (TCu-200) and 83 women with Multiload Copper-250 (MLCu-250) were included in the
      analysis. The life table analysis and log rank-test showed that TCu-200 and MLCu
      250 acceptors had a more rapid return of fertility compared to LL acceptors,
      although there was no significant difference in the return of fertility between
      TCu-200 and MLCu-250 acceptors. Compared to LL acceptors, the net cumulative
      probability of pregnancy after discontinuing use of IUD was 3 times higher in
      copper containing IUD acceptors in the first 3 months and somewhat higher in the
      first 4 to 11 months after removal of IUD. The length of use in copper containing
      IUDs (TCu-200 and MLCu-250) acceptors did not influence the return of fertility,
      whereas the return of fertility after removal of inert IUD (LL) was significantly
      higher in case of the use for shorter than 48 months compared to the use for
      longer than 48 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489474
TI  - The impact of autologous bone marrow transplantation on hematopoietic recovery
      after high-dose cyclophosphamide, doxorubicin and cisplatin chemotherapy for
      patients with gynecological malignancies.
AB  - Twenty-six patients with gynecological malignancies (21 ovarian and 5 uterine
      malignant tumors) who were treated 42 times with high-dose cyclophosphamide,
      doxorubicin and cisplatin (CAP) chemotherapy with autologous bone marrow
      transplantation (ABMT) were assessed for the impact of predictive parameters on
      hematopoietic recovery. An inverse correlation was observed between the number of
      infused nucleated marrow cells (NMC)/kg or colony-forming units of granulocyte
      macrophage (CFU-GM)/kg and the leukopenic duration < 1 x 10(3)/microliters; the
      correlation coefficients were r = -0.54 and -0.49, respectively (p < 0.001). The
      recovery time of platelet count to achieve more than 5 x 10(4)/microliters
      without transfusion was inversely correlated with CFU-GM/kg (r = -0.33, p < 0.05)
      but not with NMC/kg. Neither the episodes of fever nor the number of chemotherapy
      courses performed on the patients influenced the hematopoietic recovery. The
      numbers of infused CFU-GM and NMC were useful parameters of leukopoietic recovery
      after ABMT and high-dose CAP chemotherapy.

PMID- 8489475
TI  - Y chromosome analysis and laparoscopic surgery in XY pure gonadal dysgenesis: a
      case report and a review of literature.
AB  - DNA analysis and laparoscopic surgery were performed on a patient with 46, XY
      pure gonadal dysgenesis. Southern-blot and polymerase chain-reaction analyses
      revealed that she had no apparent deletion of the Y chromosome, including the SRY
      gene (sex-determining region Y), suggesting that the patient might have some
      other abnormality. Since the risk of gonadal neoplasia in XY gonadal dysplasia is
      high, operative laparoscopy was performed to ensure that there was no malignancy
      in the patient. Laparoscopic surgery is recommended because of the amount of the
      surgery and the rapid postoperative recovery of the patient.

PMID- 8489476
TI  - The masked threshold to noise ratio in brainstem electric response audiometry:
      assessment of the conductive loss component by bone-conducted masking.
AB  - The aim of this study was to assess the conductive loss component (CLC) by
      brainstem electric response audiometry. A bone-conducted noise was used to mask
      out the response to a conventional air-conducted click stimulus. The difference
      between the levels of the click and the noise is defined as the masked threshold
      to noise ratio (MTNR). This MTNR was determined for 21 normal ears (MTNR = -13 +/
      5 dB). The increase in MTNR compared to this normative value is a measure of the
      CLC. For 10 ears with an artificially induced purely conductive loss, the
      increase in MTNR is in good agreement with the results of conventional pure-tone
      and brainstem electric response audiometry.

PMID- 8489477
TI  - Prevalence of tympanogram asymmetries and fluctuations in otitis media with
      effusion: implications for binaural hearing.
AB  - It has been suggested that asymmetric or fluctuating hearing in otitis media with
      effusion (OME) could lead to abnormal binaural hearing. In a cohort of children
      with tympanogram data obtained at 3-monthly intervals from 2 to 4 years, 6.4% had
      asymmetric or unilateral B tympanograms on more than half the test occasions, or
      had 5 or more fluctuations between symmetric and asymmetric tympanograms. Hence
      there are sufficient cases for studies of sequelae or treatment in unilateral and
      fluctuating OME. Few of these cases would have received medical attention under a
      bilateral referral criterion.

PMID- 8489478
TI  - Relative effective frequency response of bone versus air conduction stimulation
      examined via masking.
AB  - An adaptation of the sensorineural acuity level procedure was employed to obtain
      thresholds under bone- (BC) vs. air-conducted (AC) white noise masking. For the
      BC masking condition, a Radioear B71 was placed on one mastoid. An Etymotic ER3
      with a foam tip placed in the ear on the same side was used to deliver the pure
      tone probe stimulus. This transducer was chosen to approximate the Telephonics
      TDH-39 earphone response characteristic while reducing occlusion effect. For the
      AC masking condition, the masker and probe were mixed electrically and delivered
      to the earphone. Masked threshold data, transformed into frequency response
      curves, demonstrated greater variance of BC vs. AC response across frequency but
      less high-frequency roll-off than expected from coupler measurements obtained
      using an artificial mastoid and 6-cm3 cavity, respectively.

PMID- 8489479
TI  - Spectral composition of infant auditory brainstem responses: implications for
      filtering.
AB  - Auditory brainstem responses (ABRs) were recorded from 20 normal neonates and 10
      normal-hearing adults. The spectral compositions of ABRs from both groups were
      compared. Results indicated that significant amounts of low-frequency information
      are concentrated below 150 Hz in both the neonate and the adult ABRs although the
      neonate ABR has a slightly greater percentage of low-frequency information than
      that of the adults. This has implications for filtering during ABR recording. A
      low high-pass setting which preserves more of the low-frequency information will
      allow enhanced detectability of wave V in neonate ABRs recorded at low stimulus
      intensities. Furthermore, our experience indicates that the use of a 30- to 3,000
      Hz bandpass is feasible in the neonatal intensive care unit as well as in the
      regular newborn nursery. Therefore the use of a 30- to 3,000-Hz bandpass is
      recommended for neonate ABR recordings.

PMID- 8489480
TI  - Influence of age on noise-induced permanent threshold shifts in CBA/Ca and
      C57BL/6J mice.
AB  - Two inbred strains of mice, CBA/Ca (showing a moderate hearing loss with onset
      late in life) and C57BL/6J (undergoing spontaneous auditory degeneration with
      onset during young adulthood), were exposed to a broad-band noise of 120 dB SPL
      (2-7 kHz) for 5 min at 1,2,3,6 or 12 (only for CBA) months of age. Permanent
      threshold shifts (PTS) were determined by recording auditory brainstem response
      (ABR) 1 month after exposure. C57 mice were more severely affected by acoustic
      trauma than age-matched CBA mice. With increasing age, susceptibility to PTS
      decreased in CBA mice but remained constant in C57 mice. Results indicate that
      the auditory system of CBA mice undergoes a progressive resistance to noise
      damage, whereas the persistent high susceptibility to acoustic trauma in C57 mice
      may be related to their genetic predisposition to rapid auditory degeneration.

PMID- 8489481
TI  - Comparison between self-hypnosis, masking and attentiveness for alleviation of
      chronic tinnitus.
AB  - The efficacy of self-hypnosis (SH), masking (MA) and attentiveness to the
      patient's complaints (AT) in the alleviation of tinnitus was evaluated. Forty
      five male patients close in age with chronic tinnitus related to acoustic trauma
      were assigned to three matched subgroups: SH, AT or MA. The therapeutic stimuli
      in the SH and MA sessions, recorded on audio cassettes, were given to the
      patients for use when needed. SH significantly reduced the tinnitus severity; AT
      partially relieved the tinnitus; MA did not have any significant effect.

PMID- 8489482
TI  - Pharmacology and molecular biology of adrenergic receptors.
AB  - The recent cloning of multiple adrenergic receptors has moved our understanding
      of these receptors from a conceptual one (Alquist, 1948) to one based on well
      defined unique cellular proteins. The biochemical and pharmacological properties
      of these receptors can now be studied in detail by expression of a single subtype
      in cells normally devoid of adrenergic receptors. By site-directed mutagenesis,
      the relationship between the structures of these receptors and their function is
      now being elucidated for each adrenergic receptor subtype. These functions
      include the binding of catecholamines and other ligands, G protein coupling and
      functional regulation.

PMID- 8489483
TI  - Plasma catecholamines--analytical challenges and physiological limitations.
AB  - Catecholamines in plasma may be measured to assess sympathoadrenal activity.
      Numerous assay methodologies have been published, illustrating the fact that
      there are many analytical problems. Different methodologies are discussed
      briefly. A plea for better validation, especially with regard to specificity
      (which should not be confused with sensitivity or reproducibility), is made.
      Plasma NA is a frequently used marker for sympathetic nerve activity in humans,
      but the data obtained are often misinterpreted due to lack of appreciation of the
      physiological determinants of the NA concentration measured. NA overflow from an
      organ gives a good reflection of nerve activity in that organ. However,
      sympathetic nerve activity is highly differentiated, particularly during stress,
      and conventional plasma NA levels (usually forearm venous samples) cannot be
      taken as an indication of 'sympathetic tone' in the whole individual. NA is
      rapidly removed from plasma, resulting in meaningless net veno-arterial
      concentration differences over organs unless its removal from arterial plasma is
      taken into account. In the forearm, for example, 40-50% of catecholamines are
      removed during one passage; about half of the NA in a venous sample is derived
      from the arm and half from the rest of the body. Therefore, conventional venous
      sampling overemphasizes local (mainly skeletal muscle) nerve activity. Whole-body
      sympathetic nerve activity may be monitored in arterial or mixed venous (i.e.
      pulmonary arterial) samples, which reflect NA overflow from all organs in the
      body. NA levels are determined both by overflow to plasma and clearance from
      plasma. NA turnover studies with 3H-NA infusions may be needed to assess
      clearance, but the simpler concentration measurements usually yield adequate
      information if the sampling site is relevant. NA overflow from an organ can be
      assessed (using 3H-NA or ADR as a marker for NA extraction in the organ) and
      provides valuable information on local sympathetic activity. Mental stress
      elicits marked circulatory responses, with mainly cardiorenal sympathetic
      activation and minor elevations of conventional venous plasma NA levels, thus
      illustrating the differentiated firing pattern of the sympathetic nerves.
      Circulating ADR is less important than neurogenic mechanisms in the responses to
      stress. Concentration-effect studies for infused catecholamines may be used for
      receptor sensitivity studies in vivo, but reflexogenic contributions to responses
      need to be determined. However, prejunctional mechanisms cannot be assessed
      without knowledge of the nerve activity present; for example, ADR infusion leads
      to increased nerve activity. When correctly sampled, measured and interpreted,
      plasma catecholamines can yield very valuable information on sympathoadrenal
      activity.

PMID- 8489484
TI  - Metabolic actions of catecholamines in man.

PMID- 8489485
TI  - Catecholamines and essential hypertension.
AB  - Given the ubiquitous distribution of catecholamines in mammals, and their
      importance in a range of physiological processes pivotal to blood pressure
      regulation, the subject of catecholamines and essential hypertension has a
      broader context than simply consideration of sympathetic nervous system and
      adrenal medullary dysfunction. These further matters are the likely involvement
      in hypertension pathogenesis of the CNS catecholaminergic neurones influencing
      peripheral sympathetic outflow, the possible pathogenetic significance of
      adrenaline released as a cotransmitter in sympathetic nerves, and the natriuretic
      renal tubular dopamine mechanisms for regulating body sodium balance which appear
      to be impaired in patients with essential hypertension. The central
      consideration, however, remains the important issue of the causes and
      consequences of the now well-documented sympathetic nervous overactivity which
      characterizes the early developmental phases of essential hypertension.

PMID- 8489486
TI  - Sympathetic dysfunction in heart failure.
AB  - CHF is a common, complex and life-threatening clinical syndrome. It is widely
      accepted that enhanced peripheral vascular tone plays a major role in the
      pathophysiology of CHF. Increased activity of the sympathetic nervous system is
      one of the most important factors responsible for the increased afterload in CHF.
      This increase in sympathetic activity occurs early in the course of development
      of CHF. Efferent sympathetic activity is distributed in a non-uniform way in CHF,
      with significant increases to the heart and kidney but normal activity to some
      other organs such as the lung. Increased renal sympathetic activity contributes
      significantly to altered neural haemodynamics, sodium and water retention, and
      modulation of the actions of other vasoactive hormones. The regional alteration
      in sympathetic activity may be largely responsible for the changes in resting
      regional blood flow to different organs in CHF and the maldistribution of blood
      flow that occurs during the stress of exercise. Disordered function of
      cardiovascular reflexes is observed in CHF and may contribute to disordered
      sympathetic function. In CHF there are significant interactions between the
      sympathetic nervous system and other humoral systems such as the renin
      angiotensin system, AVP, ANP, endothelin and renal DA. The various drugs used in
      the treatment of CHF have different effects on sympathetic activity: digitalis
      and ACE inhibitors tend to suppress activity while diuretics may have the
      opposite effect. Following cardiac transplantation, there is a prompt return of
      sympathetic function towards normal, although the heart may remain significantly
      denervated for a long time, with gradual reinnervation. Cyclosporin therapy tends
      to increase sympathetic activity and this may contribute to post-transplant
      hypertension.

PMID- 8489487
TI  - Sympathetic nervous system disorders in man.
AB  - The sympathetic nervous system innervates most organs in the body and controls
      their function. A variety of disease processes, surgery or drugs can result in
      disordered sympathetic nerve function, which can be either localized or more
      generalized. Malfunction can result in either sympathetic underactivity (causing
      postural hypotension, impotence or anhidrosis) or overactivity (causing
      paroxysmal hypertension or hyperhidrosis). The investigation of sympathetic
      disorders depends upon the system and organs involved and should include, where
      relevant, investigation of the possible aetiological processes. The clinical
      features and management of some of the major disorders affecting the sympathetic
      nervous system, including the recently described syndrome of DBH deficiency, are
      described.

PMID- 8489488
TI  - Imaging of catecholamine-secreting tumours: uses of MIBG in diagnosis and
      treatment.
AB  - MIBG radiolabelled with 131I or 123I is a radiopharmaceutical which is
      concentrated in neuroendocrine tumours, particularly phaeochromocytomas and
      neuroblastomas. This permits non-invasive whole-body scintigraphic screening for
      benign and malignant, familial and sporadic, intra-adrenal and extra-adrenal
      phaeochromocytomas and primary and metastatic neuroblastomas, with high
      sensitivity (85-90%) and specificity (> 95%). MIBG is also concentrated in
      presynaptic terminals of adrenergic, autonomically innervated organs such as the
      heart, and may be used as a non-invasive in vivo probe to study this system.
      Large doses of 131I-MIBG and 125I-MIBG have been used experimentally to
      selectively deliver therapeutic doses of radiotherapy to malignant
      phaeochromocytomas and refractory advanced neuroblastomas.

PMID- 8489489
TI  - Phaeochromocytoma and paraganglioma.
AB  - Use of current analytical techniques should lead to the successful diagnosis of
      most catecholamine-secreting tumours, and the experience and confidence which has
      evolved with the use of HPLC-ECD for plasma and urinary catecholamine estimation,
      as well as their greater diagnostic sensitivity and specificity, should soon
      render the older urinary assays based on catecholamine metabolites obsolete.
      Until then urinary metanephrine estimation will remain the diagnostic metabolite
      of choice. The diagnosis of small lesions and early recurrences will, however,
      continue to pose a great analytical challenge, and may call for the use of
      suppressive tests such as the pentolinium suppression test, venous
      catheterization, and MIBG scanning. The flow chart used for phaeochromocytoma
      diagnosis in our department is illustrated in Figure 12; and provides a strategy
      for the effective diagnosis of all but the most difficult lesions.

PMID- 8489490
TI  - [Homeopathy in veterinary medicine and its pharmacologic/toxicologic and drug
      regulatory evaluation].
AB  - This review gives a summary of the definitions, delimitations and principles of
      homeopathy and its potential mechanisms of action, which is followed by an
      overview and critical evaluation of the most important homeopathic drugs
      registered for treatment of animals. It is shown that several of the marketed
      homeopathic drugs for treatment of animals violate current drug laws and
      represent a risk for both the animals and the consumer of food produced from
      animals. Based on these potential risks of homeopathic treatments, new EC
      regulations were recently published, which will markedly affect (and hopefully
      improve) the current situation of veterinary homeopathic drugs.

PMID- 8489491
TI  - [Causes of kyphotic and lordotic curvature of the spine with cuneiform vertebral
      deformation in swine].
AB  - Clinical, radiographic and pathological findings demonstrate that kyphosis in 11
      weaned pigs with formation of wedge shaped vertebrae can be caused by congenital
      malformation, traumatic lesion (fracture), inflammation (osteomyelitis),
      metabolic bone disease or abnormal body posture following chronically painful
      diseases. Lordosis in 2 weaned pigs with cuneiform deformations of the dorsal
      part of vertebrae was also caused by developmental malformations or abnormal body
      posture (polyarthritis). No evidence of heredity in the group of congenital
      vertebral malformations was found.

PMID- 8489493
TI  - Is complex II involved in the inhibition of mitochondrial respiration by N-methyl
      4-phenylpyridinium cation (MMP+) and N-methyl-beta-carbolines?
AB  - It has been reported that N-methyl-beta-carbolinium analogues of the neurotoxic N
      methyl-4-phenylpyridinium cation (MPP+) inhibit NADH-linked mitochondrial
      oxidations, as well as mitochondrial respiration on succinate nearly to the same
      extent [Fields, Albores, Neafsey and Collins (1992) Arch. Biochem. Biophys. 294,
      539-544]. Those authors further claimed that MPP+ itself also blocks respiration
      through succinate dehydrogenase, in addition to its well-known effect on NADH
      dehydrogenase (Complex I), and concluded that both effects may contribute to the
      development of Parkinsonian symptoms. Since N-methyl-beta-carboliniums are
      thought to be endogenous metabolites, these findings, if verified, would have
      important implications on the etiology of idiopathic Parkinsonism. We have re
      examined these observations, using mitochondria after full activation of
      succinate dehydrogenase, as well as submitochondrial particles, in which
      complexities due to membrane transport are not present. We report the following
      observations. (1) N-Methyl-beta-carboliniums inhibit mitochondrial respiration on
      NAD(+)-linked substrates in a time-dependent manner, and the inhibition is
      potentiated by the presence of tetraphenylboron anion (TPB-), as expected for
      positively charged compounds. (2) Unlike MPP+ itself, however, these compounds
      are uncouplers at higher concentrations, so that the effects seen in State 3
      cannot be assigned exclusively to inhibition of NADH oxidation. (3) The effects
      on succinate oxidation in mitochondria, in which the full activity of the enzyme
      is expressed, are 1-1.5 orders of magnitude lower than on respiration via Complex
      I and are thus unlikely to contribute significantly to the neurotoxicity. (4) The
      effect of MPP+ on mitochondrial respiration via succinate dehydrogenase is
      trivial, in accord with previous reports from several laboratories, but
      contradicting the findings of Fields et al. (cited above). (5) In
      submitochondrial particles the inhibition of NADH oxidation (via the complete
      respiratory chain) has been confirmed, but it differs markedly from the action of
      MPP+ in two respects. First, the enhancement by TPB- is very small; secondly, the
      inhibition of NADH oxidation measured using ubiquinone (Q) analogues is far
      lower, suggesting that Complex I is not the only target. (6) In submitochondrial
      particles the inhibition of succinate oxidation by either O2 or Q analogues is
      incomplete, trivial or absent. (7) We thus conclude that we find no basis for
      assigning any potential biological effect of N-methyl-beta-carboliniums to the
      blockade of succinate oxidation.

PMID- 8489492
TI  - Molecular genetics of actin function.

PMID- 8489494
TI  - The bioactive phospholipid lysophosphatidic acid is released from activated
      platelets.
AB  - Lysophosphatidic acid (LPA) is a water-soluble phospholipid with hormone-like and
      growth-factor-like activities. LPA activates a putative G-protein-coupled
      receptor in responsive cells, but the natural source of exogenous LPA is unknown.
      Here we show that LPA is present in mammalian serum in an active form (bound to
      albumin) at concentrations of 1-5 microM, but is not detectable in platelet-poor
      plasma, suggesting that LPA is produced during blood clotting. We find that
      thrombin activation of platelets prelabelled with [32P]Pi results in the rapid
      release of newly formed [32P]LPA into the extracellular environment. We conclude
      that LPA is a novel platelet-derived lipid mediator that may play a role in
      inflammatory and proliferative responses to injury.

PMID- 8489495
TI  - Absence of phosphocreatine resynthesis in human calf muscle during ischaemic
      recovery.
AB  - Changes in the metabolites phosphocreatine (PCr), Pi and ATP were quantified by
      31P n.m.r. spectroscopy in the human calf muscle during isometric contraction and
      recovery under ischaemic conditions. Time resolution of the measurements was 10
      s. During a 30-60 s ischaemic isometric contraction, PCr decreased linearly at a
      rate of 1.17%/s (relative to the resting value) at a contraction strength
      equivalent to 70% of the maximal voluntary contraction (MVC) and at a rate of
      2.43%/s at 90% MVC. There was a corresponding increase in Pi but the
      concentration of ATP did not change. pH decreased linearly during contraction by
      4.22 and 8.23 milli-pH units/s at 70 and 90% MVC respectively. During a
      subsequent 5 min interval of ischaemic recovery, PCr, Pi, ATP, phosphomonoesters
      and calculated free ADP, free AMP and pH retained the value they had attained by
      the end of contraction with no significant recovery. Thus it is concluded that
      anaerobic glycolysis and glycogenolysis is halted momentarily on termination of
      contraction and that PCr is not resynthesized during ischaemic recovery. This
      paradoxical arrest of glycolytic flow in spite of the very significantly elevated
      concentration of potent activators such as Pi and free AMP clearly indicates that
      parameters other than PCr, ATP, Pi, calculated pH, free ADP and free AMP regulate
      glycolysis and glycogenolysis of human skeletal muscle very efficiently under
      ischaemic conditions.

PMID- 8489496
TI  - Purification and reactivation of recombinant Synechococcus phytoene desaturase
      from an overexpressing strain of Escherichia coli.
AB  - The Synechococcus phytoene desaturase has been isolated from an overexpressing
      strain of Escherichia coli. The plasma pPDSde135 mediated the overexpression of
      the full-length polypeptide directly. The recombinant protein comprised 5% of the
      total cellular protein and was found predominantly in the inclusion body
      fraction. Urea was used to solubilize the recombinant protein from the inclusion
      fraction and the protein was subsequently purified to homogeneity on a DEAE
      cellulose column. The purification scheme yielded 4.0 mg of homogeneous
      desaturase protein after a 20-fold purification, recovering 40% of the original
      protein from a 100 ml suspension culture of E. coli. The recombinant desaturase
      had an apparent molecular mass of 53 kDa on SDS/PAGE and crossreacted with an
      antiserum raised against the expressed protein. Desaturase activity was restored
      upon the removal of urea. The enzyme catalysed the conversion of phytoene to zeta
      carotene via phytofluene. These products of the desaturase reaction existed
      predominantly in a cis configuration. Lipid replenishment enhanced activity. NAD+
      and NADP+ were observed to be involved, whilst FAD was an ineffective electron
      acceptor.

PMID- 8489497
TI  - Retinol esterification in bovine retinal pigment epithelium: reversibility of
      lecithin:retinol acyltransferase.
AB  - Esterification of all-trans-retinol is a key reaction of the vertebrate visual
      cycle, since it produces an insoluble, relatively non-toxic, form of the vitamin
      for storage and supplies substrate for the isomerization reaction. CoA-dependent
      and -independent pathways have been described for retinol esterification in
      retinal pigment epithelium (RPE). The CoA-independent reaction, catalysed by
      lecithin:retinol acyltransferase (LRAT) was examined in more detail in this
      study. Addition of retinol to RPE microsomes results in a burst of retinyl ester
      synthesis, followed by a rapid apparent cessation of the reaction. However,
      [3H]retinol, added when retinyl ester synthesis has apparently ceased, is rapidly
      incorporated into retinyl ester without a net increase in the amount of ester.
      The specific radioactivities of [3H]retinol and [3H]retinyl ester reach the same
      value. [14C]Palmitate from palmitoyl-CoA is incorporated into preexisting retinyl
      ester in the absence of net ester synthesis, too. These exchange reactions
      suggest that the reaction has reached equilibrium at the plateau of the progress
      curve and that only the accumulation of retinyl ester, and not its synthesis, has
      stopped during this phase of the reaction. Studies with geometrical isomers of
      retinol revealed that the rate of exchange of all-trans-retinol with all-trans
      retinyl esters was about 6 times more rapid than exchange of 11-cis-retinol with
      11-cis-retinyl ester. This is the first demonstration of the reversibility of
      LRAT and the first example of stereospecificity of retinyl ester synthesis in the
      visual system. Reversal of the LRAT reaction could contribute to the mobilization
      of 11-cis-retinol from 11-cis-retinyl ester pools.

PMID- 8489498
TI  - Energy transduction by nitrogenase: binding of MgADP to the MoFe protein is
      dependent on the oxidation state of the iron-sulphur 'P' clusters.
AB  - Hydrolysis of MgATP to MgADP is essential for nitrogenase action. There is good
      evidence for binding of both nucleotides to the Fe protein of nitrogenase, but
      data indicating their binding to the MoFe protein have been controversial [see
      Miller and Eady (1989) Biochem. J. 263, 725-729]. The binding of MgADP to the
      MoFe protein of nitrogenase of Klebsiella pneumoniae was investigated by non
      equilibrium gel-filtration column methods. No binding of MgADP to the dithionite
      reduced protein could be detected. Treatment of the MoFe protein with
      phenosafranine [midpoint potential (Em) -270 mV] did not affect the activity, and
      oxidized the 'P' clusters but not the iron-molybdenum cofactor (FeMoco) centres.
      This oxidized species bound 3.9 mol of MgADP with a binding pattern
      characteristic of low rates of ligand dissociation. These observations suggest
      that the variability in published data on nucleotide binding to the MoFe protein
      is related to poor control of the protein oxidation level. Our data, coupled with
      the observation that 'P' clusters become oxidized during reduction of N2 [Lowe,
      Fisher and Thorneley (1993) Biochem. J., in the press], led us to propose that
      the ADP binding sites are transiently filled during enzyme turnover by hydrolysis
      of ATP originally bound to the Fe protein, and that hydrolysis occurs on a
      bridging site on the MoFe-Fe-protein complex.

PMID- 8489499
TI  - Evidence for N-linked glycosylation in Toxoplasma gondii.
AB  - In this paper we report experiments demonstrating the presence of N-linked
      oligosaccharide structures in Toxoplasma gondii tachyzoites, providing the first
      direct biochemical evidence that this sporozoan parasite is capable of
      synthesizing N-linked glycans. The tachyzoite surface glycoprotein gp23 was
      metabolically labelled with [3H]glucosamine and [3H]mannose. Gel-filtration
      chromatography on Bio-Gel P4 columns produced four radiolabelled N-linked
      glycopeptides which were sensitive to peptidase-N-glycanase F, but resistant to
      endoglycosidases H and F. Using chemical analysis and exoglycosidase digestions
      followed by Dionex-high-pH anion-exchange chromatography and size fractionation
      on Bio-Gel P4 we show that gp23 has N-linked glycans in the hybrid- or complex
      type structure composed of N-acetylgalactosamine, N-acetylglucosamine and mannose
      and devoid of sialic acid and fucose residues. In addition, the sensitivity of
      glycopeptides from glycoprotein extracts to endoglycosidases H and F revealed the
      in vivo synthesis of oligomannose-type structures by T. gondii tachyzoites. We
      have extended these findings by demonstrating the ability of T. gondii microsomes
      to synthesize in vitro a glucosylated lipid-bound high-mannose structure
      (Glc3Man9GlcNAc2) that is assumed to be identical with the common precursor for N
      glycosylation in eukaryotes.

PMID- 8489500
TI  - Intracellular maturation of the gamma-carboxyglutamic acid (Gla) region in
      prothrombin coincides with release of the propeptide.
AB  - Vitamin K-dependent coagulation factors undergo several post-translational
      modifications before the proteins are secreted into the blood as functional
      zymogens of the coagulation system. The modifications include Asn-linked
      glycosylation, Asn/Asp hydroxylation, removal of a signal peptide for
      translocation of the polypeptide into the endoplasmic reticulum and removal of a
      propeptide which, when attached to the intracellular coagulation factor
      precursor, directs the protein for vitamin K-dependent gamma-carboxylation. gamma
      Carboxylation of targeted Glu residues results in formation of Ca(2+)-binding
      gamma-carboxyglutamic acid (Gla) residues. Ca2+ binding by these residues induces
      a conformational change in the protein which is a necessary event for optimal
      activation or activity of the clotting factor in blood. In the present study we
      have monitored the intracellular prothrombin precursor in the secretory pathway
      of liver cells to determine the effect that the propeptide has on Ca(2+)
      dependent folding of the protein. The data provide evidence that the Ca(2+)
      induced conformational change required for activation of prothrombin coincides
      with release of the propeptide in the trans-Golgi apparatus of the liver cell and
      elucidates an important function for the endoproteinase furin in biosynthesis of
      vitamin K-dependent clotting factors.

PMID- 8489501
TI  - Biogenic-amine acetylation: an additional function of the N-acetyltransferase
      from Fasciola hepatica.
AB  - The previously described polyamine N-acetyltransferase from Fasciola hepatica has
      been observed to have an additional function, the acetylation of biogenic amines.
      The activities for biogenic amines, diamines and polyamines were in a constant
      ratio throughout the purification process. Biogenic amines found to be substrates
      for the enzyme included tyramine, tryptamine, beta-phenylethylamine and
      histamine, with Km values of 0.12 mM, 0.26 mM, 0.30 mM and 0.76 mM respectively.
      Octopamine, 5-hydroxytryptamine and alpha-phenylethylamine were also acceptable
      as substrates, though to a lesser degree. The optimum pH for biogenic-amine
      acetylation was 7.5, and CoA was inhibitory to the process, with a Ki of 5.5
      microM. N-Acetylation appears to play a major role in the amine metabolism of
      this trematode. We presume that acetylation represents the process by which the
      parasite inactivates excess amines.

PMID- 8489502
TI  - Control of the effective P/O ratio of oxidative phosphorylation in liver
      mitochondria and hepatocytes.
AB  - The control exerted by substrate oxidation reactions, by ATP turnover and by the
      proton leak over the oxygen consumption rate, the phosphorylation rate, the
      proton leak rate and the protonmotive force (delta p) in isolated rat liver
      mitochondria under a range of conditions between non-phosphorylating (State 4)
      and maximum phosphorylation (State 3) was investigated by using the top-down
      approach of metabolic control analysis. The experiments were carried out with
      saturating concentrations of the substrates succinate, glutamate with malate, or
      pyruvate with malate. The distribution of control was very similar with each of
      the three substrates. The effective P/O ratio (i.e. not corrected for leak
      reactions) was also measured; it varied from zero in State 4 to 80-90% of the
      maximum theoretical P/O ratio in State 3. Under most conditions control over the
      effective P/O ratio was shared between proton leak (which had negative control)
      and the phosphorylating subsystem (which had roughly equal positive control);
      near State 4, substrate oxidation reactions also acquired some control over this
      ratio. In resting hepatocytes the effective P/O ratio was only 50% of its maximum
      theoretical value, corresponding to an effective P/O ratio of only 1.3 for
      complete oxidation of glucose. The effective P/O ratio for intracellular
      mitochondrial oxygen consumption was 64% of the maximum value. The control
      coefficient of the mitochondrial proton leak over the effective P/O ratio in
      cells was -0.34; the control coefficient of phosphorylation reactions over this
      ratio was 0.31 and the control coefficient of substrate oxidation reactions over
      the ratio was 0.03, showing how the coupling efficiency in cells can respond
      sensitively to agents that change the proton leak or the ATP demand, but not to
      those that change substrate oxidation.

PMID- 8489503
TI  - Endocytosis of ricin by rat liver cells in vivo and in vitro is mainly mediated
      by mannose receptors on sinusoidal endothelial cells.
AB  - Upon intravenous injection into rats, the plant toxin ricin was rapidly cleared
      from the circulation by the liver. Among the different liver cell populations,
      most of the injected ricin associated with the sinusoidal endothelial cells (EC),
      whereas the liver parenchymal cells (PC) and Kupffer cells (KC) yielded minor
      contributions to the total liver uptake in vivo. Co-injection of mannan strongly
      inhibited ricin uptake by the EC, showing that it was mediated by mannose
      receptors. On the other hand, co-injection of lactose, which inhibits the
      galactose-specific association of ricin with cells, enhanced ricin uptake by the
      EC. The carbohydrate-dependency of the EC contribution to the uptake of ricin in
      vivo was reflected in the carbohydrate-dependency of the uptake in vivo by whole
      liver. In vitro, the EC also endocytosed ricin more efficiently than did the PC
      or KC. Whereas uptake in vitro in the EC was mainly mannose-specific, uptake in
      the two other cell types was mainly galactose-specific. Western blotting showed
      that the mannose receptors of liver non-parenchymal cells are identical with the
      mannose receptor previously isolated from alveolar macrophages. The mannose
      receptors are expressed at a higher level in EC than in KC. Ligand blotting
      showed that, in the presence of lactose, the mannose receptor is the only protein
      in the EC that binds ricin, and the binding is mannose-specific and Ca(2+)
      dependent.

PMID- 8489504
TI  - Role of maltase in the utilization of sucrose by Candida albicans.
AB  - Two isoenzymes of maltase (EC 3.2.1.20) were purified to homogeneity from Candida
      albicans. Isoenzymes I and II were found to have apparent molecular masses of 63
      and 66 kDa on SDS/PAGE with isoelectric points of 5.0 and 4.6 respectively. Both
      isoenzymes resembled each other in similar N-terminal sequence, specificity for
      the alpha(1-->4) glycosidic linkage and immune cross-reactivity on Western blots
      using a maltase II antigen-purified rabbit antibody. Maltase was induced by
      growth on sucrose whereas beta-fructofuranosidase activity could not be detected
      under similar conditions. Maltase I and II were shown to be unglycosylated
      enzymes by neutral sugar assay, and more than 90% of alpha-glucosidase activity
      was recoverable from spheroplasts. These data, in combination with other results
      from this laboratory [Geber, Williamson, Rex, Sweeney and Bennett (1992) J.
      Bacteriol. 174, 6992-6996] showing lack of a plausible leader sequence in genomic
      or mRNA transcripts, suggest an intracellular localization of the enzyme. To
      establish further the mechanism of sucrose assimilation by maltase, the existence
      of a sucrose-inducible H+/sucrose syn-transporter was demonstrated by (1) the
      kinetics of sucrose-induced [14C]sucrose uptake, (2) recovery of intact
      [14C]sucrose from ground cells by t.l.c. and (3) transport of 0.83 mol of H+/mol
      of [14C]sucrose. In total, the above is consistent with a mechanism whereby
      sucrose is transported into C. albicans to be hydrolysed by an intracellular
      maltase.

PMID- 8489505
TI  - Characterization of neutral endopeptidase 24.11 in dog glomeruli.
AB  - Neutral endopeptidase (NEP; also known as neprilysin and enkephalinase; EC
      3.4.24.11) is a cell-surface metallopeptidase that is present in many mammalian
      tissues. It is particularly abundant on the brush-border membranes of the kidney
      proximal tubule. In this paper, the presence of NEP in purified glomeruli from
      dog kidney was assessed by measuring phosphoramidon- and thiorphan-sensitive [D
      Ala2,Leu5]enkephalin-degrading activity. Using this assay, the Km and kcat. of
      the glomerular enzyme were found to be identical to those of the tubular enzyme.
      By Western blotting the apparent M(r) of the glomerular enzyme was found to be
      104,000, compared with 94,000 for the tubular enzyme. This might be due to a
      different glycosylation pattern, since endoglycosidase F treatment of NEP
      obtained from both tissues yielded deglycosylated enzymes with similar
      electrophoretic mobilities. The glomerular enzyme also appears to be membrane
      bound, since it was retained in the detergent-rich phase after phase separation
      with Triton X-114. Autoradiography experiments performed with RB104, a new highly
      selective and potent NEP inhibitor, showed that NEP was expressed in both
      glomeruli and proximal tubules. The presence in glomeruli of NEP and some other
      brush-border peptidases (dipeptidyl-dipeptidase IV, aminopeptidase N and
      angiotensin I-converting enzyme) suggests that cell-surface peptidases might play
      an important role as regulators of plasma-derived peptides in this part of the
      nephron.

PMID- 8489506
TI  - Cloning and sequence analysis of cDNAs encoding the alpha 1, alpha 2 and alpha 3
      chains of mouse collagen VI.
AB  - cDNA clones encoding the alpha 1, alpha 2 and alpha 3 chains of mouse collagen VI
      have been isolated by screening cDNA libraries with the corresponding human
      probes. The composite cDNAs for the alpha 1, alpha 2, and alpha 3 chains are 2.5,
      1.6 and 2.9 kb in size respectively. The alpha 1 and alpha 2 cDNAs encode the C
      terminal portions of the chains as well as the entire 3'-untranslated regions,
      while the alpha 3 cDNAs encode a central segment of 959 amino acids flanking the
      triple-helical domain. The deduced amino acid sequences share 86-88% identity
      with the human counterparts and 67-73% identity with the chicken equivalents.
      Alignment of the deduced amino acid sequences of mouse, human and chicken
      collagens reveal that the key features of the protein, including the cysteine
      residues, imperfections in the Gly-Xaa-Xaa regions, Arg-Gly-Asp sequences and
      potential N-glycosylation sites, are mostly conserved.

PMID- 8489507
TI  - Effect of temperature on bradykinin-induced arachidonate release and calcium
      mobilization in vascular endothelial cells.
AB  - The effect of decreased temperature on Ca(2+)-dependent arachidonic acid release
      was studied in vascular endothelial cells by investigating bradykinin (BK)
      stimulated Ca2+ mobilization, inositol phosphate formation and arachidonic acid
      release. At both 37 degrees C and 22 degrees C, BK efficiently increased
      cytosolic Ca2+ concn. ([Ca2+]i). At 22 degrees C, peak [Ca2+]i was higher and
      returned to basal levels more slowly. Although this response was preceded by
      rapid formation of Ins(1,4,5)P3, the activity of phospholipase C was
      significantly impaired at 22 degrees C. To determine if Ins(1,4,5)P3 effectively
      mobilized intracellular Ca2+, we used saponin-permeabilized cells. Ins(1,4,5)P3,
      mobilized sequestered Ca2+ to a similar degree at 37 degrees C and 22 degrees C,
      although Ca2+ release was prolonged at 22 degrees C. In intact cells, BK
      mobilized intracellular Ca2+ stores and activated Ca2+ entry. The rate of 45Ca2+
      entry was approx. 2-fold slower at 22 degrees C, even though the peak and
      duration of the rise in [Ca2+]i were higher and sustained at the lower
      temperature. TG mobilized intracellular Ca2+, activated Ca2+ entry and elevated
      [Ca2+]i at both temperatures. As with BK, the peak [Ca2+]i reached after
      thapsigargin treatment was higher at 22 degrees C. This effect of lower
      temperature on [Ca2+]i was most probably due to decreased Ca2+ efflux after a
      decrease in activity of the Ca(2+)-ATPase on the plasma membrane. Both A23187 and
      BK were shown to stimulate phospholipase A2 and arachidonic acid release at 22
      degrees C. In each case, the rate and extent of release were decreased compared
      with that at 37 degrees C. Among several effects, lowering the temperature
      decreases the activity of phospholipase C, Ca(2+)-ATPase(s), Ca(2+)-entry
      mechanisms and phospholipase A2. Together, these effects lead to a higher and
      more prolonged elevation of [Ca2+]i, but a decrease in arachidonate release in
      response to BK.

PMID- 8489508
TI  - Isoenzymes of protein kinase C in rat mammary tissue: changes in properties and
      relative amounts during pregnancy and lactation.
AB  - Protein kinase isoenzymes belonging to the protein kinase C (PK-C) family present
      in rat mammary tissue have been resolved from one another by chromatography on
      hydroxyapatite, and characterized. PK-C alpha is the predominant isoenzyme and is
      present at a constant level of activity throughout mammary-gland development and
      differentiation. In contrast, marked changes in the relative abundance of other
      mammary PK-C isoenzymes accompany the transition from pregnancy to lactation. The
      sensitivity of mammary PK-C alpha to Ca2+ is greater in tissue from pregnant than
      from lactating rats. This isoenzyme has other atypical properties consistent with
      its being more highly phosphorylated than PK-C alpha in rat brain and spleen. One
      of the protein kinase isoenzymes resolved from mammary tissue recognizes the
      peptide substrate used to assay AMP-activated kinase and may thus interfere in
      the determination of this activity. Another is fully active in the absence of
      Ca2+ and is more than 80% active in the absence of added lipid effectors. A
      'housekeeping' role is proposed for PK-C alpha in mammary tissue, whereas the
      less abundant PK-C isoenzymes may be involved in mammary cell proliferation and
      differentiation.

PMID- 8489509
TI  - Effect of 5'-deoxy-5'-isobutylthioadenosine on formation and release of adenosine
      from neonatal and adult rat ventricular myocytes.
AB  - 1. Studies in rat polymorphonuclear leucocytes have suggested that 5'-deoxy-5'
      isobutylthioadenosine (IBTA), an inhibitor of the IMP-selective cytosolic 5'
      nucleotidase, may be used to test its role in adenosine formation in intact
      cells. We investigated adenosine formation in neonatal and adult rat
      cardiomyocytes. 2. 2-Deoxyglucose (30 mM) with oligomycin (2 micrograms/ml)
      induced a 90-100% fall in ATP concentration in 10 min in neonatal and 60 min in
      adult heart cells. Adenosine accumulation was substantially increased, accounting
      for 13% of the fall in ATP concentration in neonatal cells and 56% in adult
      cells. 3. Anti-(rat liver ecto-5'-nucleotidase) serum did not inhibit adenosine
      accumulation. Furthermore, dipyridamole (10 microM), a nucleoside-transport
      blocker, inhibited by 80% the appearance of the newly formed adenosine in the
      medium, showing that adenosine is produced intracellularly by both adult and
      neonatal-rat myocytes in response to inhibition of oxidative metabolism. 4. IBTA
      (3 mM) inhibited by 80% the appearance of adenosine in the medium, but did not
      inhibit total adenosine accumulation by neonatal-rat myocytes and only modestly
      inhibited total adenosine accumulation by adult myocytes. 5. IBTA, like
      dipyridamole, inhibited incorporation of extracellular adenosine (10 microM) into
      neonatal and adult ventricular myocyte nucleotides by 60-70%. Transport of IBTA
      (100 microM) into the cells did not appear to be inhibited by dipyridamole (30
      microM). 6. We conclude that IBTA acted primarily to inhibit adenosine release
      from myocytes. The small effect on adenosine formation rates implies that the IMP
      selective cytosolic 5'-nucleotidase plays a minor role in this tissue.

PMID- 8489510
TI  - Alternative route for the biosynthesis of polyunsaturated fatty acids in K562
      cells.
AB  - K562 human leukaemia cells lack a significant delta 6-desaturase activity.
      However, they synthesize long-chain polyunsaturated fatty acids (PUFA) from
      linoleic (C18:2(9,12)) and linolenic (C18:3(9,12,15)) acids, by reactions
      involving a C2 chain elongation followed by a delta 5-desaturation step and, to
      some extent, a further elongation. The main products formed were separated by
      argentation t.l.c. and identified by g.l.c. as the uncommon fatty acids
      C20:3(5,11,14) and C20:4(5,11,14,17) respectively. These acids were also produced
      when cells were supplemented with C20:2(11,14) or C20:3(11,14,17) respectively.
      The presence of a delta 5-desaturase was further confirmed by using its
      corresponding normal substrates, C20:3(8,11,14) and C20:4(8,11,14,17), which led
      to C20:4(5,8,11,14) and C20:5(5,8,11,14,17) respectively. On the other hand, a
      high delta 9-desaturase activity, but no significant delta 4-desaturase activity,
      were detected in K562 cells. These results indicate the existence of an
      alternative pathway, involving delta 5-desaturase, which is the only route for
      PUFA biosynthesis in K562 cells. This pathway may be relevant for the
      biosynthesis of PUFA in cells lacking delta 6-desaturase activity.

PMID- 8489512
TI  - Role of tryptophan-388 of GLUT1 glucose transporter in glucose-transport activity
      and photoaffinity-labelling with forskolin.
AB  - GLUT1 glucose-transporter cDNA was modified to substitute leucine for Trp-388 and
      transfected into Chinese hamster ovary cells using the expression vector termed
      pMTHneo. This tryptophan residue is conserved among most of the facilitative
      glucose-transporter isoforms and has been proposed to be the photolabelling site
      of forskolin, a competitive inhibitor of glucose transport. In addition, this
      residue is located on membrane-spanning helix 10 which is suggested to contain
      the dynamic segment of the transporter. The mutated glucose transporter was
      expressed and inserted into the plasma membrane in a fashion similar to the wild
      type. Unexpectedly, this mutation did not abolish photolabelling with forskolin.
      However, the mutation induced a marked decrease in 2-deoxyglucose uptake with a 4
      fold decrease in turnover number and a 1.25-fold increase in Km compared with the
      wild-type GLUT1. A similar decrease in zero-trans influx activity was also
      observed for 3-O-methylglucose. In contrast, no apparent decrease was observed in
      zero trans efflux activity for 3-O-methylglucose. The mutation decreased the
      turnover number of the glucose transporter in equilibrium exchange influx for 3-O
      methylglucose by 33% without any change in Km. These results indicate that (1)
      Trp-388 is not the photolabelling site for forskolin, if we assume that the
      labelling occurs at a single site and (2) Trp-388 is more likely to be involved
      in interconversion between the inward-facing and outward-facing conformers of
      GLUT1 than binding of glucose, and thus, substitution of leucine for Trp-388 in
      this dynamic segment would decrease the rate of alternating conformation, which
      would preferentially affect the influx activity.

PMID- 8489511
TI  - Fragmentation of human polymorphonuclear-leucocyte collagenase.
AB  - Human polymorphonuclear-leucocyte collagenase (M(r) 64,000) shows autoproteolytic
      degradation to two major fragments of M(r) 40,000 and M(r) 27,000. N-terminal
      sequence data and investigation of the substrate specificity of the fragments
      demonstrate that the M(r)-40,000 fragment corresponds to the catalytic domain,
      whereas the M(r0-27,000 fragment shows no enzymic activity. The activity profile
      of the M(r)-40,000 fragment is comparable with the specificity of the intact
      active collagenase (M(r) 64,000), but the ability to cleave collagen was lost.
      The enzymic activity of this fragment can be inhibited by either tissue inhibitor
      of metalloproteinase (TIMP)-1 or recombinant TIMP-2 in a 1:1 molar ratio. The C
      terminal part of the enzyme (M(r) 27,000), important for the binding reaction
      with collagen substrates, is involved in collagenolysis.

PMID- 8489513
TI  - Sensitive, hydrosoluble, macromolecular fluorogenic substrates for human
      immunodeficiency virus 1 proteinase.
AB  - Hydrosoluble macromolecular fluorogenic substrates specific for the human
      immunodeficiency virus 1 (HIV-1) proteinase have been prepared. The fluoresceinyl
      peptide Ftc-epsilon-Ahx-Ser-Phe-Asn-Phe-Pro-Gln-Ile-Thr-(Gly)n, corresponding to
      the first cleavage site of HIV-1 gag-pol native precursor was linked to a water
      soluble neutral (Lys)n derivative. The epsilon-aminohexanoyl residue (epsilon
      Ahx) and the glycyl sequence were added in order to improve the stability of the
      substrate and the accessibility of the cleavage site to the HIV-1 proteinase
      respectively. This macro-molecular peptidic-substrate conjugate is significantly
      more water-soluble than the free peptide itself on a substrate molar
      concentration basis. The assay is based on the quantitative precipitation of the
      polymeric material by adding propan-2-ol whereas the fluorescent peptide moiety
      released upon proteolysis remains soluble in the supernatant. The proteinase
      activity is assessed by measuring the fluorescence of the supernatant. This assay
      allows the detection of a few fmol of HIV-1 proteinase, even in the presence of
      cell culture media, plasma or cell lysate and it gives accurate results within a
      large proteinase concentration range. The hydrosoluble macromolecular substrate
      is also suitable for determining the HIV-1 proteinase activity using 96-well
      microplates, allowing us to test accurately and rapidly numerous enzyme samples
      and/or the potency of new proteinase inhibitors.

PMID- 8489514
TI  - Hydrolyses of alpha- and beta-cellobiosyl fluorides by cellobiohydrolases of
      Trichoderma reesei.
AB  - Cellobiohydrolase II hydrolyses alpha- and beta-D-cellobiosyl fluorides to alpha
      cellobiose at comparable rates, according to Michaelis-Menten kinetics. The
      stereochemistry, absence of transfer products and strict hyperbolic kinetics of
      the hydrolysis of alpha-cellobiosyl fluoride suggest that the mechanism for the
      alpha-fluoride may be the enzymic counterpart of the SNi reaction observed in the
      trifluoroethanolysis of alpha-glucopyranosyl fluoride [Sinnott and Jencks (1980)
      J. Am. Chem. Soc. 102, 2026-2032]. The absolute factors by which this enzyme
      accelerates fluoride ion release are small and greater for the alpha-fluoride
      than for the beta, suggesting that its biological function may not be just
      glycoside hydrolysis. Cellobiohydrolase I hydrolyses only beta-cellobiosyl
      fluoride, which is, however, an approx. 1-3% contaminant in alpha-cellobiosyl
      fluoride as prepared and purified by conventional methods. Instrumental assays
      for the various components of the cellulase complex are discussed.

PMID- 8489515
TI  - N.m.r. spectroscopic studies of fucose-containing oligosaccharides derived from
      keratanase digestion of articular cartilage keratan sulphates. Influence of
      fucose residues on keratanase cleavage.
AB  - Keratan sulphate chains from bovine articular cartilage were fully digested with
      keratanase from Pseudomonas sp. and the products were reduced with alkaline
      borohydride. The resultant fragments were fractionated on a Nucleosil 5SB column
      and the earliest eluting fucose-containing oligosaccharides were isolated.
      Structural analysis using 1H n.m.r. spectroscopy (600 MHz) showed the two least
      charged species to have the following structure: GlcNAc(6S) beta 1-3Gal beta 1
      4(Fuc alpha 1-3)GlcNAc(6S) beta 1- 3Gal beta 1-4GlcNAc(6S) beta 1-3Gal-ol and
      GlcNAc(6S) beta 1-3Gal beta 1- 4(Fuc alpha 1-3)GlcNAc(6S) beta 1-3Gal beta 1
      4GlcNAc(6S) beta 1-6(Gal beta 1- 3)GalNAc-ol. Both galactoses adjacent to the
      fucosylated N-acetylglucosamine residue are unsulphated. Therefore, it can be
      deduced from these structures that the presence of fucose on N-acetylglucosamine
      residues in keratan sulphates protects both of the adjacent unsulphated galactose
      residues from keratanase cleavage. This result has implications for the
      interpretation of keratanase fingerprints, because in articular cartilage keratan
      sulphates the keratanase-resistant blocks are not solely those with fully
      sulphated galactose residues, but also include the fucosylated sequences, which
      have unsulphated galactoses. It is, therefore, not possible to estimate their
      galactose sulphation or the size of the fully sulphated disaccharide-repeat
      sequences from keratan sulphates that contain fucose.

PMID- 8489516
TI  - Formylmethionyl-leucylphenylalanine and the SOS operon in Escherichia coli: a
      model of host-bacterial interactions.
AB  - To determine the biological significance of the existence of highly specific
      receptors for the bacterial chemotactic peptide formylmethionyl
      leucylphenylalanine (fMet-Leu-Phe) on neutrophil leucocytes, we investigated the
      role of this peptide in bacterial metabolism. The UmuD protein of the Escherichia
      coli SOS operon was identified as having an N-terminal fMet-Leu-Phe sequence and
      a recombinant E. coli with the umuD gene on plasmid pSB13 was shown to be an over
      producer of both UmuD and fMet-Leu-Phe. Activation of SOS genes in conventional
      wild-type E. coli (K12) by u.v. light or hydrogen peroxide increased fMet-Leu-Phe
      production up to 4-fold. A RecA- strain, incapable of SOS activation, was a low
      basal producer of fMet-Leu-Phe and showed no increased production with u.v. light
      or oxidant stress. We propose that host phagocytes respond to fMet-Leu-Phe and
      closely related peptides because they are generated by bacteria under oxidant
      stress. Increased fMet-Leu-Phe production may signal to the host a change in the
      organism's biological status from commensal to pathogen because of the invasion
      into tissues exposing bacteria to high pO2 levels and oxidant stress.

PMID- 8489517
TI  - Inactivation of penicillin acylase from Kluyvera citrophila by N-ethoxycarbonyl-2
      ethoxy-1,2-dihydroquinoline: a case of time-dependent non-covalent enzyme
      inhibition.
AB  - Penicillin acylase (PA) from Kluyvera citrophila was inhibited by N
      ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ), a specific carboxy-group
      reactive reagent. Enzyme activity progressively decreased to a residual value
      depending on EEDQ concentration. Neither enzymic nor non-enzymic decomposition of
      EEDQ is concomitant with PA inactivation. Moreover, enzyme re-activation is
      achieved by chromatographic removal of EEDQ, pH increase or displacement of the
      reagent with penicillin G. It was then concluded that PA inactivation is due to
      an equilibrium reaction. The kinetics of enzyme inactivation was analysed by
      fitting data to theoretical equations derived in accordance with this mechanism.
      Corrections for re-activation during the enzyme assay were a necessary
      introduction. The pH-dependence of the rate constant for EEDQ hydrolysis either
      alone or in the presence of enzyme was studied by u.v. spectroscopy. It turned
      out to be coincident with the pH-dependence of the forward and reverse rate
      constants for the inactivation process. It is suggested that previous protonation
      of the EEDQ molecule is required for these reactions to occur. The thermodynamic
      values associated with the overall reaction showed little change. Finally it is
      proposed that the inactivation of PA by EEDQ proceeds through a two-step
      reaction. The initial and rapid reversible binding is followed by a slow, time
      dependent, non-covalent, reversible inactivating step. The expected behaviour in
      the case of enzyme modification by covalent activation of carboxy residues is
      also reviewed.

PMID- 8489518
TI  - The interaction of phospholipid bilayers with pig heart AMP deaminase: Fourier
      transform infrared spectroscopic and kinetic studies.
AB  - The interaction of pig heart AMP deaminase with different chemical species of
      phosphatidylcholine and with natural plasma membranes has been investigated.
      Phospholipids added to the system either as natural biological membranes (plasma
      membrane vesicles) or in the form of liposomes containing unsaturated
      phosphatidylcholine considerably enhanced AMP deaminase activity. The secondary
      structure of pig heart AMP deaminase in the absence and in the presence of
      dioleoyl phosphatidylcholine and dipalmitoyl phosphatidylcholine liposomes was
      investigated by Fourier-transform infrared spectroscopy. Quantitative analysis of
      the amide I band showed that the enzyme contains 45% beta-sheets, 28% alpha
      helix, 16% turns and 11% non-ordered structure. In the presence of dioleoyl
      phosphatidylcholine liposomes, the beta/alpha content ratio decreased; this
      decrease was dependent on the amount of lipid added. This phenomenon was not
      observed in the case of dipalmitoyl phosphatidylcholine liposomes. These data
      suggest a possible role for membrane phospholipids in the regulation of AMP
      deaminase activity.

PMID- 8489519
TI  - 8-vinyl reduction and chlorophyll a biosynthesis in higher plants.
AB  - A technique involving solid-phase extractions and polyethylene h.p.l.c. suitable
      for the routine compositional analysis of the total protochlorophyllide pool of
      plants is described. The resynthesis kinetics of the individual components of the
      pool have been studied in briefly illuminated etiolated tissue of wheat (Triticum
      aestivum) and cucumber (Cucumis sativus) during subsequent redarkening. The data
      are interpreted in terms of a precursor-product relationship between the di- and
      mono-vinyl analogues of protochlorophyllide during their reaccumulation in
      darkness. The interconversion is assumed to be catalysed by an 8-vinyl reductase,
      which shows greater activity in wheat than in cucumber. Analyses of the redox
      state of the nicotinamide nucleotide of the pool during the process are
      compatible with NADPH as the cofactor of the putative reductase.

PMID- 8489521
TI  - Hyaluronan-binding region of aggrecan from pig laryngeal cartilage. Amino acid
      sequence, analysis of N-linked oligosaccharides and location of the keratan
      sulphate.

PMID- 8489520
TI  - The role of Gi and the membrane-fluidizing agent benzyl alcohol in modulating the
      hysteretic activation of human platelet adenylate cyclase by guanylyl 5'
      imidodiphosphate.
AB  - The non-hydrolysable GTP analogue guanylyl 5'-imidodiphosphate (p[NH]ppG)
      elicited a profound increase in the adenylate cyclase activity of human
      platelets. This occurred after a well-defined lag period of around 6 min,
      whereupon an enhanced steady-state rate was evident. The duration of the lag
      period was unchanged over a range of concentrations of p[NH]ppG which gave very
      different steady-state rates of adenylate cyclase activity. Prior activation of
      the stimulatory G-protein Gs by cholera-toxin pre-treatment abolished the lag
      period and elicited a small increase in the steady-state rate. Manipulating
      function of the inhibitory G-protein Gi also led to profound changes in the lag
      periods. Thus marked decreases in the lag were seen (approximately 70-81%) when
      Gi function was ablated through pre-treatment of platelet membranes with
      pertussis toxin, or by using elevated (25 mM) Mg2+ levels in the assay, or when
      Mg2+ was replaced by 5 mM Mn2+ in the assay. In contrast with this, potentiation
      of Gi function led to an increase in the lag period, as seen under conditions of
      agonist occupancy of inhibitory alpha 2-adrenoceptors (increase approximately
      74%) or with the addition of 100 mM NaCl to the assays (increase approximately
      44%). The local anaesthetic and membrane-fluidizing agent benzyl alcohol elicited
      both a profound decrease (around 70% at 80 mM) in the p[NH]ppG-induced lag period
      and a marked augmentation (around 5-fold) in the steady-state adenylate cyclase
      activity. When adenylate cyclase assays were done at 35 degrees C instead of 25
      degrees C, then the lag period for activation by p[NH]ppG was decreased by around
      33% and the steady-state rate increased by around 3-fold. At 35 degrees C, the
      addition of benzyl alcohol led to the apparent abolition of the lag period for
      p[NH]ppG activation of adenylate cyclase and amplified the steady-state rate by
      only around 2.2-fold. It is shown that Gi plays a fundamental role in determining
      the rate of activation of Gs. The proposal is formulated that such an action may
      be mediated through the release of beta gamma-subunits. Thus beta gamma-subunit
      dissociation is proposed as providing the rate-limiting step in Gi activation.

PMID- 8489522
TI  - Cyclin synthesis: who needs it?
AB  - Studies of the G2 to M transition in amphibian oocytes, in combination with in
      vitro mitotic systems and yeast genetic analysis, have significantly contributed
      to our understanding of the mechanisms by which M-phase is regulated.
      Historically, oocyte maturation has provided a number of valuable initial
      observations, but the biochemical elucidation of cell cycle control mechanisms
      has proved more tractable in cell-free extracts of frog eggs which reproduce
      aspects of early embryogenic mitosis. Recent experiments examining the importance
      of protein synthesis in the maturing oocyte have highlighted some important
      differences between mitosis and meiosis. Additional controls found in meiosis but
      not embryonic mitosis, are similar to controls found in somatic cells. This
      suggests that understanding the differences, as well as the similarities, between
      meiosis in the oocyte and mitosis in the early embryo will help us to learn more
      about the way in which cells enter and leave mitosis.

PMID- 8489523
TI  - Pre-mRNA secondary structure and the regulation of splicing.
AB  - Nuclear pre-mRNAs must be precisely processed to give rise to mature cytoplasmic
      mRNAs. This maturation process, known as splicing, involves excision of intron
      sequences and ligation of the exon sequences. One of the major problems in
      understanding this process is how splice sites, the sequences which form the
      boundaries between introns and exons, can be accurately selected. A number of
      studies have defined conserved sequences within introns which were later shown to
      interact with small nuclear ribonucleoproteins (snRNPs). However, due to the
      simplicity of these conserved sequences it has become clear that other elements
      must be involved and a number of studies have indicated the importance of
      secondary structures within pre-mRNAs. Using various examples, we shall show that
      such structures can help to specify splice sites by modifying physical distances
      within introns or by being involved in the definition of exons and lastly, that
      they can be part of the regulation of alternative splicing.

PMID- 8489524
TI  - Vav: a potential link between tyrosine kinases and ras-like GTPases in
      hematopoietic cell signaling.
AB  - The vav proto-oncogene encodes a 95 kDa protein which is expressed exclusively in
      hematopoietic cells. Analysis of the deduced amino acid sequence has revealed the
      presence of a src-homology 2 (SH2) domain, 2 SH3 domains, a cysteine-rich region
      with similarity to protein kinase C, and a region highly similar to proteins with
      guanine nucleotide exchange activity on ras-like GTPases. Recent work has shown
      that vav is tyrosine phosphorylated in response to stimulation of surface
      membrane receptors in a variety of hematopoietic cell lines. Vav may play a role
      in hematopoietic cell signaling by coupling tyrosine kinase pathways to ras-like
      GTPases through the regulation of guanine nucleotide exchange.

PMID- 8489525
TI  - Cell commitment in the ectoderm of Drosophila melanogaster.

PMID- 8489526
TI  - The telophase disc: its possible role in mammalian cell cleavage.
AB  - The molecular signals that determine the position and timing of the furrow that
      forms during mammalian cell cytokinesis are presently unknown. It is apparent,
      however, that these signals are generated by the mitotic spindle after the onset
      of anaphase. Recently we have described a structure that bisects the cell during
      telophase at the position of the cytokinetic furrow. This structure, the
      telophase disc, appears to be templated by the mitotic spindle during anaphase,
      and precedes the formation of the cytokinetic furrow. The relationship of the
      telophase disc to the myosin and actin based furrowing mechanism is discussed
      here. We propose that the telophase disc may determine the position and timing of
      cleavage by recruitment and alignment of myosin.

PMID- 8489527
TI  - Fine tuning of DNA repair in transcribed genes: mechanisms, prevalence and
      consequences.
AB  - Cells fine-tune their DNA repair, selecting some regions of the genome in
      preference to others. In the paradigm case, excision of UV-induced pyrimidine
      dimers in mammalian cells, repair is concentrated in transcribed genes,
      especially in the transcribed strand. This is due both to chromatin structure
      being looser in transcribing domains, allowing more rapid repair, and to repair
      enzymes being coupled to RNA polymerases stalled at damage sites; possibly other
      factors are also involved. Some repair-defective diseases may involve repair
      transcription coupling: three candidate genes have been suggested. However,
      preferential excision of pyrimidine dimers is not uniformly linked to
      transcription. In mammals it varies with species, and with cell differentiation.
      In Drosophila embryo cells it is absent, and in yeast, the determining factor is
      nucleosome stability rather than transcription. Repair of other damage departs
      further from the paradigm, even in some UV-mimetic lesions. No selectivity is
      known for repair of the very frequent minor forms of base damage. And the most
      interesting consequence of selective repair, selective mutagenesis, normally
      occurs for UV-induced, but not for spontaneous mutations. The temptation to
      extrapolate from mammalian UV repair should be resisted.

PMID- 8489528
TI  - [Localization of an immunodominant site in the hepatitis delta viral antigen
      using synthetic peptides].
AB  - A set of 8 peptides from the immunodominant region (65-80 aa) of delta-antigen
      was prepared by solid-phase synthesis. Peptide 71-80 was synthesized in two
      variants--with different amino acid residues in positions 73, 74 and 76. Free
      peptides and their conjugates with bovine serum albumin were tested for
      antigenicity in ELISA. The correlation between the peptide chain's length and its
      antigenic activity was noted. Peptides 65-80 and 69-80 displayed a positive
      reaction with all individual sera and pools of sera from HDV chronic patients.
      Both variants of the peptide 71-80 reacted with 100% of sera pools but only with
      83% of individual sera. Smaller peptides from the same 65-80 region (73-80, 69
      78, 71-78, 71-76) did not bind to any anti-delta positive serum. All synthesized
      peptides reacted strongly with rabbit antisera raised to the conjugate of peptide
      65-80 with bovine albumin. These findings suggest that delta-antigen contains
      multiple highly immunogenic epitopes associated with the single immunodominant
      site between 69 and 80 amino acid residues.

PMID- 8489529
TI  - [Preparation, isolation, and study of mutant forms of ribosomal protein L7/L12].
AB  - Three mutant forms of the ribosomal protein L7/L12 with Ser1, Met14 and Met26
      substituted by the Tyr residue were constructed for studying the protein's N
      terminal domain. Three point mutations were introduced into the L7/L12 gene by
      means of the phage M13mp18 system, the mutant genes were expressed in Escherichia
      coli cells, and methods of the proteins' purification were developed. The mutant
      proteins L7/L12 are very close, in structure and properties to the wild type
      protein and represent suitable objects for the 1H-NMR study of the N-terminal
      domain.

PMID- 8489530
TI  - [Structure of molecules of crystalline (Phe1, Ala9)antamanide].
AB  - The molecular structure of a [Phe1, Ala9]antamanide complex with four water
      molecules has been determined by X-ray analysis. The antamanide's analogue,
      C64H74N10O10.4H2O, crystallizes in the space group P2(1)2(1)2(1) with a = 15.909,
      b = 28.071 and c = 14.367 A, Z = 4. The molecule contains a pseudo two-fold
      rotation axis and two intra-molecular NH...O = C bonds of the 5-->1 type, its
      conformation being similar to that of antamanide. There are inter-molecular H
      bonds over the water molecules in the structure.

PMID- 8489531
TI  - [Affinity modification of 40S ribosomal subparticles from human placenta with
      mRNA analogs--AUGUnC oligoribonucleotide analogs with an alkylating group at the
      3'-end].
AB  - Using 2',3'-O-[4-N-(2-chloroethyl)-N-methylamino]benzylidene derivatives of
      AUGUn[32P]pC (mRNA analogues), affinity labelling of human placenta 40S ribosomal
      subunits has been investigated in model initiation complexes obtained in the
      presence of the ternary complex eIF-2.GTP.Met-tRNA(fMet). The regions of 18S rRNA
      labelled with these mRNA analogues were identified. The main targets of 18S rRNA
      alkylation by the derivative of AUG[32P]pC were located within positions 1610
      1747 and 1748-1869. The site of covalent attachment of AUGU3[32P]pC derivative to
      18S rRNA was found within positions 593-673. Taking into account the data on
      labelling of human placenta ribosomes with the same derivatives of
      oligourydilates obtained previously, the conclusion was made that the arrangement
      of the codon U3 in the mRNA-binding centre of the initiation complex
      40S.AUGU3[32P]pC derivative.eIF-2.GTP.Met-TPHK(fMet) differs from the arrangement
      of the same codon at the A-site of the complex imitating the pretranslocation
      state of ribosomes.

PMID- 8489532
TI  - [Use of hydrazine for rapid deblocking of synthetic oligonucleotides].
AB  - A rapid method for the removal of protecting groups from synthetic
      oligodeoxyribonucleotides, obtained by the phosphoroamidite and H-phosphonate
      methods, including the use of hydrazine solutions has been developed. The
      combination of this procedure with the application of isopropoxyacetyl N
      protecting group and oxalyl ester linkage for the first nucleoside attachment to
      the polymer support allows to reduce to several minutes the time needed for the
      full oligonucleotide deprotection.

PMID- 8489533
TI  - [Structure of the repeating link of the acid polysaccharide of Alteromonas
      haloplanktis KMM 156].
AB  - An acidic capsular and an O-specific polysaccharide were isolated from the marine
      microorganism Alteromonas haloplanktis KMM 156. Both polysaccharides have the
      identical structure and are built up of tetrasaccharide repeating units,
      containing two residues of L-rhamnose as well as a 2-acetamido-2-deoxy-D-glucose
      and a 3-O-[(R)-1-carboxyethyl]-D-glucose (Glc3Lac) residue. On the basis of
      methylation studies, 1H- and 13C-NMR-spectroscopy including nuclear Overhauser
      effect and two-dimensional heteronuclear 13C/1H correlation spectroscopy, the
      following structure was suggested for the polysaccharide repeating unit:
      [formula: see text]

PMID- 8489534
TI  - [Synthesis of platelet activation factor analogs].
AB  - Novel structural analogues of the platelet activating factor (PAF), rac-1
      octadecyl-2-allyl-glycerol-3-phosphocholine and rac-1-octadecyl-2-allyl-1
      thioglycerol-3-phosphocholine , have been synthesized. The phospholipids obtained
      showed neither PAF-agonistic nor PAF-antagonistic activity at the concentration
      of 10(-5) to 10(-7) M.

PMID- 8489535
TI  - [Use of arylsulfenylchlorides for cleaving fibrinogen at methionine residues].
AB  - Conditions for the fibrinogen fragmentation with 2-pyridyl-or o
      nitrophenylsulfenylchloride were proposed. Resulting mixture of fragments is
      identical to the mixture prepared by the cyanogen bromide treatment and is
      suitable as supplementary analytical reagent in the determination of the tissue
      plasminogen activator (TPA) activity with a chromogenic substrate.

PMID- 8489536
TI  - AI/LEARN/Rheumatology. A comparative study of computer-assisted instruction for
      rheumatology.
AB  - OBJECTIVE: To assess the effectiveness of AI/LEARN/Rheumatology, a computer
      controlled interactive videodisc system for teaching. METHODS: We assessed
      improvement in knowledge about rheumatic diseases, using a pretest and posttest
      in a control year and a treatment year. The subjects were medical students and
      postgraduate trainees taking the rheumatology elective. The control year used
      traditional lectures and the standard rheumatology curriculum. The treatment year
      used AI/LEARN/Rheumatology in place of lectures on rheumatoid arthritis,
      ankylosing spondylitis, and osteoarthritis. RESULTS: The trainees showed
      significant improvement in knowledge in both the control year and the treatment
      year (P < 0.0001 for both). The average time spent using AI/LEARN/Rheumatology
      was similar to the time spent in lectures (3 hours). The number of patient
      consultations in which trainees participated was lower in the treatment year than
      in the control year; however, the adjusted posttest scores using the pretest as a
      covariate tended to be higher in the treatment year (P = 0.10). Analysis of
      covariance of the adjusted posttest scores for the treatment year only showed
      that the trainees who spent more time using AI/LEARN/Rheumatology learned more (r
      = 0.57). Trainees felt that AI/LEARN/Rheumatology was the most helpful
      educational experience of the elective. CONCLUSION: AI/LEARN/Rheumatology is an
      effective means of teaching about the rheumatic diseases. It has many advantages:
      availability for independent study, effective use of trainee's time, and
      liberation of faculty time from lectures. Trainees enjoyed using
      AI/LEARN/Rheumatology.

PMID- 8489537
TI  - Marital status and the progression of functional disability in patients with
      rheumatoid arthritis.
AB  - OBJECTIVE: To determine if marital status is associated with differences in rates
      of progression of functional disability in patients with rheumatoid arthritis
      (RA). METHODS: A community cohort of 282 persons with RA was followed
      prospectively for up to 9.5 years. The progression of functional disability over
      time was determined using the Health Assessment Questionnaire Disability Index,
      which was completed by study participants every 6 months. RESULTS: At study
      entry, the Disability Index was 1.1 +/- 0.8 (mean +/- 1 SD) (possible range 0-3)
      among the 188 married participants and 1.3 +/- 0.9 among the 94 unmarried
      participants. Over time, the rate of progression of functional disability was
      generally higher among unmarried participants. However, the extent of this
      difference varied somewhat over the disease course, with rates of progression
      higher among unmarried than among married participants during years 5-7 and years
      17-29 of RA. Overall estimated rates of progression, adjusted for the effects of
      other sociodemographic factors, were 0.03 Disability Index units per year in
      unmarried participants and 0.01 Disability Index units per year in married
      participants (P < 0.0001). CONCLUSION: Marriage, possibly reflecting the
      influence of social support, is associated with a lower rate of progression of
      functional disability in persons with RA.

PMID- 8489538
TI  - Marital status and social support in rheumatoid arthritis.

PMID- 8489539
TI  - The effects of drug therapy on radiographic progression of rheumatoid arthritis.
      Results of a 36-week randomized trial comparing methotrexate and auranofin.
AB  - OBJECTIVE: To determine the effects of drug therapy (methotrexate [MTX] versus
      auranofin [AUR]) on radiographic progression in patients with active rheumatoid
      arthritis (RA). METHODS: We conducted a 9-month randomized, multicenter, double
      blind trial comparing MTX and AUR. Standardized radiographs of the hands and
      wrists were obtained at baseline and at completion of the study. Four experienced
      bone radiologists graded the radiographs for erosions, joint space narrowing,
      erosion healing, and reparative bone formation. RESULTS: Two hundred eighty-one
      patients were enrolled in the study. Radiographs were available on 167 of the 183
      who completed the trial. After 9 months of therapy, there was a significantly
      greater worsening of the erosion score in the AUR group (mean +/- SEM change of
      1.67 +/- 0.4) compared with the change in the MTX group (0.60 +/- 0.3) (P =
      0.040). There was also a significantly greater worsening of the joint space
      narrowing score in the AUR group compared with the MTX group (1.36 +/- 0.3 versus
      0.42 +/- 0.2) (P = 0.007). There was no difference demonstrated between groups in
      healing of erosions or in reparative bone formation. CONCLUSION: The rate of
      radiographic progression in patients with RA, as measured by erosion score and
      joint space narrowing score, was demonstrated to be lower in those treated with
      MTX, as compared with AUR, over a 36-week period.

PMID- 8489540
TI  - Analysis of immunoglobulin gamma heavy chain expression in synovial tissue of a
      patient with rheumatoid arthritis.
AB  - OBJECTIVE: To gain insight into mechanisms underlying local immune responses in
      rheumatoid arthritis (RA), we analyzed the utilization of variable-region heavy
      chain (VH), diversity (DH), and joining (JH) gene segments expressed in synovial
      tissue of a patient with RA. METHODS: An unrestricted complementary DNA (cDNA)
      library was generated from unselected cells extracted from synovial tissue
      obtained at the time of joint replacement. Southern blot analysis for VH, JH, and
      C gamma subclass utilization was performed on the first 50 C gamma- and JH
      positive recombinants for which phage DNA was isolated. Eighteen of the clones
      were selected at random for sequence analysis. The VH gene segments were compared
      with an extensive database of germline and cDNA sequences. RESULTS: All
      transcripts utilized gene segments from the VH1 (28%), VH3 (56%), and VH4 (15%)
      families. There was a predominance of JH4, JH5, and JH6 gene segment utilization.
      Fourteen of 18 randomly sequenced clones contained sufficient VH-region
      information for analysis. Eight (57%) were most closely related to VH gene
      segments that are preferentially expressed in human fetal liver or that encode
      antibodies with self-reactivity. The variable domains were heavily mutated, and
      replacement-to-silent substitution ratios (R:S ratios) in the antigen-binding
      domains (complementarity-determining regions [CDRs]) were disproportionately
      high. CDR3 lengths were quite variable, due to extensive N-region addition and 5'
      exonuclease activity in the VH-DH-JH joins. CONCLUSION: Plasma cells in this
      synovial tissue sample appear to express VH gene segments that are preferentially
      utilized during fetal development or in autoantibodies. The JH repertoire is
      similar to that seen in adult peripheral blood lymphocytes, but much different
      from that found during fetal development. The large number of somatic mutations
      and the high R:S ratios in the CDRs suggest an antigen-driven response.

PMID- 8489541
TI  - Pressure pain threshold in pain-free subjects, in patients with chronic regional
      pain syndromes, and in patients with fibromyalgia syndrome.
AB  - OBJECTIVE: We hypothesized that change in pain threshold to pressure reflects a
      generalized change in the pain system affecting both tender and control points.
      METHODS: We assessed 18 tender points and 4 control points using an algometer in
      60 patients with generalized fibromyalgia/fibrositis syndrome, 60 patients with
      localized chronic pain syndromes, and in 60 pain-free subjects. RESULTS: A
      significant correlation was found between myalgia scores at tender points and
      control points in these subjects. CONCLUSION: These results suggest that there is
      a diffuse change in pain modulation in fibromyalgia, as hypothesized, but the
      tender point is still clinically useful.

PMID- 8489542
TI  - The spectrum of fibromyalgia disorders.

PMID- 8489543
TI  - Characteristics of anti-type II collagen antibody binding to articular cartilage.
AB  - OBJECTIVE: Previous studies suggested that it was possible to characterize the
      intact surface of articular cartilage by probing it with antibodies against
      matrix macromolecules. The present studies were undertaken to investigate type II
      collagen (CII) epitope availability on the intact surface of articular cartilage.
      METHODS: Normal bovine, rabbit, and human cartilage specimens were used to
      measure binding of anti-CII antibodies to the articular and cut surfaces of
      cartilage. Antisera were raised against the material obtained after brief
      extraction of the cartilage surface with 4M guanidine solution. RESULTS: Anti-CII
      did not bind to the intact surface of rabbit articular cartilage when compared
      with control rat sera, but did bind significantly to the cut surface. With normal
      human articular cartilage, the cut surfaces bound approximately 4 times as much
      anti-CII antibody as the intact articular surfaces. These findings suggested that
      the CII epitopes are normally protected by the superficial cartilage layer. In
      experiments carried out to characterize this layer, binding of anti-CII
      antibodies was unchanged after exhaustive washing of bovine or rabbit cartilage
      with phosphate buffered saline or 1M NaCl solution, whereas it was significantly
      increased after brief exposure to 4M guanidine solution or after incubation with
      neutrophil elastase. No restoration of the protection of CII epitopes in
      guanidine-treated cartilage could be achieved by incubation with undiluted normal
      bovine synovial fluid; however, 8-day culture of elastase-treated cartilage
      explants resulted in partial restoration of protection of the CII epitopes. Rat
      and rabbit antisera raised against the cartilage surface material extracted with
      4M guanidine contained antibodies that bound to the cartilage surface. By Western
      blotting, rat antibodies identified 50-65-kd protein bands present in the
      guanidine extract, but not present either in the material obtained from brief
      digestion of cartilage with neutrophil elastase or in synovial fluid. The rabbit
      antisera identified a broad 70-95-kd band. Exposure of elastase-treated cartilage
      to the guanidine-extracted material resulted in a partial decrease of anti-CII
      antibody binding. CONCLUSION: These results suggest that CII on intact cartilage
      is protected from antibody binding, and that the protective material is at least
      partly proteinaceous in nature, is unlikely to be derived from synovial fluid, is
      noncovalently bound to the underlying intercellular matrix, and is synthesized by
      resident chondrocytes. Further characterization of the protective material may
      provide important information on the mechanisms of early cartilage damage in
      inflammatory arthritis.

PMID- 8489544
TI  - Susceptibility to relapsing polychondritis is associated with HLA-DR4.
AB  - OBJECTIVE: To determine the frequency of HLA class II antigens in Caucasian
      central European patients with relapsing polychondritis (RP). METHODS: HLA class
      I, DR, and DQ specificities were identified in 41 patients with RP, and the
      frequencies were compared with those in 204 healthy, unrelated control subjects.
      HLA typing was performed using the standard complement-dependent
      microcytotoxicity assay. HLA-DR genotyping of 12 DR4-positive RP patients and 57
      controls was performed by allele-specific oligonucleotide probing after
      amplification of genomic DNA by polymerase chain reaction. RESULTS: A significant
      increase in DR4 antigen frequency was found in the patients (56.1%) as compared
      with that in healthy controls (25.5%) (Pcorr < 0.001). Genotyping of DR4-positive
      patients and controls revealed no predominance of any DR4 subtype. CONCLUSION:
      There are important clinical similarities and overlaps between RP and rheumatoid
      arthritis (RA). In RA, the association with DR4 has been well established. Our
      findings show that although there is a DR4 association with RP, the situation is
      sufficiently distinct from that of RA to imply considerable differences in
      pathogenesis of the two conditions.

PMID- 8489545
TI  - The polymerase chain reaction for the detection of Borrelia burgdorferi in human
      body fluids.
AB  - OBJECTIVE: To analyze clinical fluids for the presence of Borrelia burgdorferi
      DNA using the polymerase chain reaction (PCR). METHODS: We utilized a modified,
      nested PCR to detect the presence of Borrelia DNA in 99 samples of serum, urine,
      cerebrospinal fluid (CSF), or synovial fluid obtained from 44 patients with
      various stages of Lyme disease and 47 control subjects. Primer specificity was
      corroborated by examining 2 DNA data banks, testing against DNA from other
      organisms, and confirming results with a second set of nested primers. RESULTS:
      Nested PCR was capable of detecting DNA from fewer than 10 organisms in 1 ml of
      fluid. The specificity of this technique was 96.4%, with a sensitivity of 76.7%.
      Although the specificity was uniformly high, the sensitivity was dependent upon
      the body fluid being tested: CSF 100%, urine 100%, synovial fluid 80%, and serum
      59%. The rate of false-positive results was 3.6%. CONCLUSION: These data
      demonstrate the potential utility of PCR in confirming the clinical diagnosis of
      Lyme disease as well as providing insight into the pathogenesis of various stages
      of this disorder.

PMID- 8489546
TI  - Familial versus sporadic ankylosing spondylitis. Two different diseases?
AB  - OBJECTIVE: To define potential differences and the possible contribution of
      susceptibility or severity genes in familial versus sporadic ankylosing
      spondylitis (AS). METHODS: Three hundred twenty patients with AS were studied:
      160 who had first-degree relatives with AS (familial) and 160 age- and sex
      matched controls who had no first-degree relative with the disease (sporadic).
      Disease expression in the two groups was evaluated using an index of physical,
      psychological, and social functioning (the Arthritis Impact Measurement Scales
      [AIMS]) and an assessment of spinal mobility. RESULTS: Familial disease was
      significantly milder than sporadic disease as assessed by all measures, e.g.,
      spinal mobility score (mean 4.08 versus 4.65, P < 0.038), AIMS overall impact
      score (mean 2.63 versus 3.59, P = 0.002), AIMS physical activity score (4.19
      versus 5.10 [P = 0.004]), AIMS social function score (4.02 versus 4.60, P =
      0.023), and AIMS pain score (4.15 versus 5.33, P = 0.002). CONCLUSION: The
      greater prevalence of AS in at-risk families may be explained by the occurrence
      of more AS "susceptibility" genes in those families, whereas the more severe
      disease, seen in patients with sporadic AS, is conferred by the presence of more
      "severity" genes than "susceptibility" genes.

PMID- 8489547
TI  - Treatment of refractory, systemic lupus erythematosus-associated thrombocytopenia
      with intermittent low-dose intravenous cyclophosphamide.
AB  - We describe a patient with systemic lupus erythematosus and severe, treatment
      resistant thrombocytopenia. Prolonged treatment with high-dose steroids
      eventually led to reversal of the thrombocytopenia, but the dosage could not be
      tapered without relapse. Low-dose intravenous bolus cyclophosphamide was given,
      producing a response within 1 week. The steroid dosage was tapered, without
      relapse. Other than reversible alopecia, no toxicity was seen. The use of this
      treatment should be considered in patients in whom more conventional therapies
      are not effective or cannot be tolerated.

PMID- 8489548
TI  - Gastrointestinal regulatory peptides in systemic sclerosis.
AB  - OBJECTIVE: Gastrointestinal involvement commonly occurs in systemic sclerosis
      (SSc), but its pathogenesis is not well understood. Since there is evidence of a
      defect in neurotransmitter release, we were interested in examining the
      relationship between gastrointestinal dysfunction and plasma concentrations of
      gastrointestinal regulatory peptides in patients with SSc. We studied 43
      consecutive patients, 18 with diffuse and 25 with limited cutaneous disease.
      METHODS: Levels of corticotropin-releasing hormone (CRH), gastrin, motilin,
      neuropeptide Y (NPY), and peptide YY (PYY) were determined by radioimmunoassay
      and high-performance liquid chromatography (HPLC). RESULTS: Plasma concentrations
      of CRH, motilin, NPY, and PYY were significantly increased among SSc patients
      compared with healthy control subjects, and HPLC-characterization of motilin,
      NPY, and PYY showed a different pattern of fragments. No correlation was found
      between esophageal hypomotility and the concentration of peptide. Acid output did
      not correlate with gastrin levels, but was more often increased in patients with
      increased CRH and NPY values. Fat malabsorption, assessed by the triolein breath
      test, was more common among patients with increased motilin and PYY. CONCLUSION:
      This study shows that elevated peptide concentrations commonly occur in patients
      with SSc. Since regulatory peptides are involved in gastrointestinal motility,
      secretion, and absorption, further characterization of this neuroendocrine system
      may help in understanding the complex regulation of gastrointestinal dysfunction
      in SSc.

PMID- 8489549
TI  - Calcium pyrophosphate dihydrate crystal deposition in synovium. Relationship to
      collagen fibers and chondrometaplasia.
AB  - OBJECTIVE: Reasons for apparent primary deposition of calcium pyrophosphate
      dihydrate (CPPD) crystals in some synovial membranes have not been systematically
      examined. We undertook the present study to investigate for and compare possible
      cellular and matrix factors related to the presence of these crystals in synovium
      and cartilage. METHODS: Ten synovial membrane specimens and 6 cartilage specimens
      were obtained at the time of joint surgery from 10 patients with CPPD crystal
      deposition disease, for light microscopic (LM) and electron microscopic (EM)
      studies. RESULTS: In all synovial and cartilage specimens, we found many of the
      small CPPD crystals aligned on or in parallel to collagen fibers, as seen by EM.
      In 9 of the 10 crystal-containing synovia, we found foci of chondrometaplasia
      adjacent to CPPD, by LM. In 7 of the synovia, including the one without LM
      evidence of chondrometaplasia, we observed the presence of chondrocyte-like cells
      by EM. We did not note any predictable relationship between the crystals and
      matrix vesicles, either in synovium or in cartilage. CONCLUSION: Our EM findings
      provide evidence of the relationship of small CPPD-like crystals, presumably
      early forms, to collagen fibers both in synovium and in cartilage. By LM and EM,
      we also demonstrate evidence of a close association between chondrometaplasia and
      CPPD deposits in synovium. We suggest that chondrometaplasia might be responsible
      for synovial CPPD formation in predisposed patients. Both the collagen fibers and
      chondrocyte-like cells seem to be involved in the primary formation of CPPD
      deposits in the synovium as well as in the cartilage.

PMID- 8489550
TI  - Sarcoidosis accompanied by pulmonary tuberculosis and complicated by
      sacroiliitis.
AB  - We report the unique occurrence of a unilateral sacroiliitis in a patient with
      active sarcoidosis accompanied by pulmonary tuberculosis. Convincing (clinical)
      evidence of sarcoidosis as the extremely rare cause of this articular involvement
      is presented. Discussion is focused on comparison of sarcoidosis and
      tuberculosis, particularly with respect to their articular involvement, and the
      literature of previously reported cases of sarcoid sacroiliitis is briefly
      reviewed.

PMID- 8489551
TI  - Colchicine and mixed cryoglobulinemia.

PMID- 8489552
TI  - Treatment with anti-CD4 monoclonal antibody and acute interstitial nephritis.

PMID- 8489553
TI  - The watermelon stomach in scleroderma.

PMID- 8489554
TI  - Dopamine agonist activities of pergolide, its metabolites, and bromocriptine as
      measured by prolactin inhibition, compulsive turning, and stereotypic behavior.
AB  - Four pergolide metabolites and bromocriptine (CAS 25614-03-3) were compared to
      pergolide (8 beta-[(methylthio) methyl]-6-propyl-ergoline, CAS 66104-22-1) using
      three in vivo animal models of activity at dopamine receptors. The results
      obtained from these studies of prolactin inhibition, induction of compulsive
      turning, and stimulation of stereotypic behavior, were very consistent. Two of
      the metabolites, despropyl pergolide and despropyl pergolide sulfoxide, were
      devoid of dopamine-like effects in any of the models. Pergolide sulfone and
      pergolide sulfoxide, however, were found to be potent dopamine agonists, similar
      in activity to pergolide itself. Dopamine D2 receptors (and probably D1 receptors
      also) appear to be involved in the activities of these compounds. The compounds
      were active by both oral and i.p. routes of administration. Bromocriptine, while
      possessing some dopamine agonist activity at higher doses in some of these animal
      models, was much less potent (1/200 to 1/20) than either pergolide or its two
      dopaminergic metabolites.

PMID- 8489555
TI  - Disposition of remoxipride in different species. Species differences in
      metabolism.
AB  - The pharmacokinetics and metabolism of the new antipsychotic agent remoxipride
      ((S)-(-)-3-bromo-N(-)[(1-ethyl-2-pyrrolidinyl)methyl]-2, 6-dimethoxybenzamide,
      FLA731(-), Roxiam, CAS 80125-14-0) was studied in rodents (mice, rats, hamsters),
      dogs and human subjects using the unlabelled or the labelled (3H or 14C) drug.
      Oral administration of 20-40 mumol/kg to animals and approximately 3 mumol/kg to
      human volunteers showed that the absorption of remoxipride through the intestinal
      wall was rapid and almost complete in all species. However, the bioavailability
      was low in the rodents (< 10% in mice and hamsters and < 1% in rats) due to an
      extensive first-pass elimination in the hepato-portal system. Blood clearance
      estimated after the same intravenous doses was high in rodents and similar to or
      exceeding normal liver blood flow. In dogs and humans, clearance values were low
      and the bioavailability high (> 90%). In mice and rats the contribution of renal
      clearance to the total clearance was approximately 10%, while it was higher in
      dogs (approximately 15%) and humans (approximately 30%). Species differences were
      also observed in the degree of protein binding which was low in rodent plasma (20
      30%) but fairly high in canine and human plasma (approximately 80%). In dogs and
      humans, remoxipride was shown to bind primarily to the plasma alpha 1-acid
      glycoprotein fraction. In accordance with the binding data, the volume of
      distribution (Vss) was higher in rodents (3-6 l/kg) than in dogs (1.6 l/kg) and
      man (0.7 l/kg). Studies in dogs with 14C-remoxipride showed that the compound was
      rapidly distributed to tissues and eliminated at rates similar to that in plasma
      (t1/2 3-4 h). Retention of radioactivity was only observed in melanin-rich
      tissues. However, studies in pigmented mice showed that the affinity of
      remoxipride to melanin was lower than that of the other neuroleptics haloperidol
      and chlorpromazine. The excretion of radioactivity following oral administration
      of the labelled drug mainly occurred in the urine in all species. However,
      species differences were observed in the identification and analysis of the
      various metabolites present in plasma and excreted in urine. In rodents,
      metabolic reactions occurred mainly at the aromatic moiety, i.e. O-demethylation
      and aromatic hydroxylation. The resulting phenols were excreted mainly in
      conjugated forms. In dogs and humans, the predominant metabolic reactions were
      oxidations at the alpha-carbons of the pyrrolidine moiety leading to N
      demethylated and/or pyrrolidone and hydroxypyrrolidone products.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8489556
TI  - Pharmacokinetics of and monoamine oxidase B inhibition by (E)-4-fluoro-beta
      fluoromethylene benzene butanamine in man.
AB  - MDL 72974A ((E)-4-fluoro-beta-fluoromethylene benzene butanamine HCl salt, CAS
      120635-25-8) is a new irreversible inhibitor of the B form of monoamine oxidase
      (MAO-B). MDL 72974A's pharmacokinetic parameters were evaluated after
      administration of a single oral dose and after multiple oral doses. The
      concentration of parent drug was determined in plasma using a solid-liquid
      extraction method and gas chromatographic-mass spectrometric analysis. MDL 72974A
      produced significant inhibition of platelet MAO-B activity at all of the doses >
      or = 0.5 mg (> 95% after 1 h). The pharmacokinetic parameters showed a short
      plasma half-life (1 h) and a high total body clearance (Cltot) both probably due
      to extensive and rapid metabolism as suggested by the low urinary excretion of
      unchanged drug (< 1% of the administered dose). After the administration of
      multiple doses of MDL 72974A, a decrease in Cltot and a concomitant increase in
      the AUC and t1/2, was observed, probably due to a change in the elimination rate
      of MDL 72974A. Due to the once-a-day dosing schedule and the short plasma t1/2,
      no drug accumulation occurred.

PMID- 8489557
TI  - Electrophysiological characterization of class III activity of a verapamil
      derivative in guinea-pig cardiac tissues.
AB  - In isolated guinea-pig papillary muscle ([K+]o: 4.7 mmol/l, stimulation rate: 1
      Hz) the verapamil derivative NN-bis-(3,4-dimethoxyphenethyl)-N-methylamine)-HCl
      (YS035; 0.3-100 mumol/l) increased the action potential duration measured at 90%
      repolarization level (APD90) up to 132% of control and enhanced the force of
      contraction (Fc) up to 125% of control while resting potential (RP) and the
      maximum upstroke velocity (Vmax) remained nearly unchanged. At 300 mumol/l YS
      035, the membrane became depolarised and action potentials could no longer be
      elicited. These effects were reversed during wash-out. The increase of ADP90 was
      largest at 0.05 Hz, and the drug-induced effect continuously declined with an
      increase in stimulation frequency to 2 Hz. Control ADP90 was correlated to the
      absolute increase of ADP90 (r = 0.84). In atrial muscle the effect of YS 035 on
      APD90 was more pronounced than in papillary muscle. The Vmax of slow responses
      ([K+]o: 27 mmol/l, [Ba2+]o: 0.5 mmol/l) was not affected by concentrations as
      high as 30 mumol/l YS 035, whereas APD90 was enhanced. An increase in the
      stimulation rate (0.05 to 0.33 Hz) induced only a small decrease of Vmax at 100
      mumol/l YS 035. According to this electrophysiological characterisation YS 035
      shows Class III antiarrhythmic properties.

PMID- 8489559
TI  - In vitro and in vivo studies on slow release propranolol hydrochloride
      suppositories. Pharmacokinetic and pharmacodynamic evaluation.
AB  - Matrix-based slow release (SR) compressed propranolol HCl (25 mg) suppositories
      were formulated using PEG 4000 and either stearic acid or bees wax at different
      concentrations (5, 7.5 and 10%). In vitro studies revealed good slow release
      characteristics from the suppositories. Their in vivo performances-
      pharmacokinetics and pharmacodynamics--were evaluated in rabbits. Different
      pharmacokinetic parameters were determined from the plasma concentration-time
      profiles using a model-independent computer programme, RAMKIN. The relative
      bioavailability of propranolol (CAS 525-66-6) from three SR suppositories
      containing stearic acid, 7.5 and 10% and bees wax, 5%, was 86.4, 87.8, and 83.6%
      respectively. Pharmacodynamic response (beta-blockade) was assessed by
      determining the degree of reduction of isoprenaline-induced tachycardia at
      different time intervals. A minimum concentration of 40-60 ng/ml drug in plasma
      was maintained during 1-10 h, and there has been a minimum of about 40-50% of
      beta-blockade during 1-9 h post administration. A good correlation between
      pharmacokinetic and pharmacodynamic profiles was observed.

PMID- 8489558
TI  - Cardiotonic activity of the water soluble forskolin derivative 8,13-epoxy-6 beta
      (piperidinoacetoxy)- 1 alpha, 7 beta, 9 alpha-trihydroxy-labd- 14en-11-one.
AB  - 8,13-Epoxy-6 beta-(piperidinoacetoxy)-1 alpha,7 beta, 9 alpha-trihydroxy-labd 
      14en-11-one (HL 706, CAS 114376-11-3) is a water soluble derivative of forskolin
      with positive inotropic and vasodilating properties. In both in vitro and in vivo
      preparations, it exhibited significant positive inotropic activity with
      concomitant increase in heart rate and decrease in mean blood pressure. Though
      its potency is lower than that of forskolin, its duration of action is more
      prolonged. In conscious dog experiments, HL 706, administered orally, also showed
      a dose related increase in LV dP/dtmax. A significant reversal of cardiac failure
      was attained in anaesthetised dogs subjected to propranolol induced cardiac
      insufficiency. HL 706, like forskolin increased cAMP by virtue of its adenylate
      cyclase stimulant activity. Through increase in cAMP it also exhibited non
      specific smooth muscle relaxant activity in isolated vascular and ileal
      preparations. Its therapeutic ratio is quite favourable.

PMID- 8489560
TI  - Pharmacokinetics of 14C-N-N'-dicyclopropyl-methyl-piperazine-dichlorhydrate. 1st
      Communication: balance of elimination, plasma and blood kinetics, metabolism in
      rats.
AB  - N-N'-Dicyclopropyl-methyl-piperazine-dichlorhydrate (Ino 2628-CZ) is a novel
      inotropic compound. The absorption, distribution, excretion and metabolism of
      radiochemically labelled 14C-Ino 2628-CZ has been studied in male and female rats
      after intravenous and oral administration. The compound was mainly excreted
      during the first 24 h after both administrations, although traces of
      radioactivity were still measured at 7 days post-dose. About 20% of the drug is
      excreted in the urine unchanged. Nine metabolites were separated, four of them
      being characterized.

PMID- 8489561
TI  - Stability of amiodarone in serum samples under various storage conditions.
AB  - The present study was intended to examine the stability of amiodarone (Cordarex,
      CAS 1951-25-3) and its metabolite desethylamiodarone. For this purpose 20 ml of
      blood were taken from each of 12 patients treated with amiodarone and were
      stored, after centrifuging, at room temperature, +5 degrees C, -18 degrees C and 
      38 degrees C. The amiodarone and desethylamiodarone concentrations were
      determined by the HPLC method 30 min, 24 h, 48 h, 72 h, one and two weeks after
      blood-taking. It turned out that the serum levels decreased continuously as of
      the first day regardless of the storage temperature. Correction factors were
      therefore calculated for the amiodarone concentration: if the blood level
      determination takes place after 24 h one should add 8% to the obtained value,
      after 48 h 16%, after 72 h 19%, after one week 23% and after two weeks 32%.

PMID- 8489562
TI  - Effect of naftidrofuryl on platelet-induced vasospasm in vitro. Role of
      antiserotonergic actions.
AB  - This study was designed to analyse the spasmolytic actions of naftidrofuryl
      (Dusodril, CAS 31329-57-4) more in detail, using isolated vessel segments of
      bovine coronary arteries (BCA). In this preparation, naftidrofuryl caused a dose
      dependent inhibition of 5-HT, U 46.619 ((5Z, 9a, 11a, 13E, 15S)-11,9
      (epoxymethano) prosta-5,13-dienoic acid), PGF2 alpha and KCl-induced
      contractions. Additionally, the actions of naftidrofuryl on platelet-induced
      vasospasm were investigated using arachidonic acid (AA)-stimulated platelets and
      BCA. Naftidrofuryl antagonized the vasocontractile effects of secreted 5-HT, but
      was only slightly active in reducing the TXA2-dependent vessel contraction. The
      suppression of ADP-induced platelet aggregation and secretion required more than
      300 mumol/l naftidrofuryl. These data support the concept of a spasmolytic
      activity of naftidrofuryl which also involves the antagonism of platelet-derived
      vasocontractile mediators.

PMID- 8489563
TI  - Time course of the anti-oedematous effect of different dose regimens of O-(beta
      hydroxyethyl) rutosides in healthy volunteers.
AB  - The aim of this study was to compare the efficacy of two posologies of
      hydroxyethylrutosides (HR) as maintenance dose for the reduction of leg oedema.
      The increase in leg volume induced by standing motionless for one hour was
      measured in 12 healthy young male volunteers by a highly sensitive water
      displacement method. The volume increase (approx. 87.8 units) was found to be
      very reproducible after a one-week placebo run-in period. The mean value after 3
      weeks treatment at 1000 mg/day HR was reduced to 85.2 +/- 8.7 units. The subjects
      were then randomised to 3 groups and further measurements were made after
      additional 3, 5, 6 and 7 weeks. On placebo, the values returned to baseline
      within 5-6 weeks. On 500 mg/day, the values continued to oscillate around the
      values at randomisation (i.e., the effect was maintained). On continuing the dose
      unchanged at 1000 mg/day, the volume increases continued to fall progressively to
      79.1 +/- 7.7 at the end of the further 7 weeks. After analysis of all mean volume
      changes relative to the values at time of randomisation, it was found that the
      1000 mg/day dose showed a significant greater antioedematous effect than placebo
      (p = 0.0001) or 500 mg/day (p = 0.0028). Also the 500 mg/day dose was superior to
      placebo (p = 0.0328). We conclude that, after initial treatment for 3 weeks with
      1000 mg/day, a dose of 500 mg/day is adequate to maintain the resultant anti
      oedematous effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489564
TI  - Effect of acetyl-L-carnitine treatment on the levels of levocarnitine and its
      derivatives in streptozotocin-diabetic rats.
AB  - The effect of diabetes induced by streptozotocin and that of acetyl-L-carnitine
      (ALC) hydrochloride (CAS 5080-50-2) treatment on the homeostasis of the
      levocarnitine (L-carnitine) moiety was investigated in Sprague-Dawley rats. The
      diabetic status was ascertained by measuring blood glucose. L-carnitine (LC),
      total acid soluble L-carnitine (TC) and ALC were measured in serum, tissues and
      urine by radioenzymatic methods. Short-chain L-carnitine esters (SCLCE) were
      obtained by subtracting LC from TC. Serum concentration of L-carnitine moiety was
      decreased in diabetic when compared to normal rats; whereas ALC oral treatment
      (50 and 150 mg/kg p.o. for 4 weeks) in diabetic rats increased, dose-dependently,
      all the components of L-carnitine moiety, SCLCE and ALC being completely
      restored. In the liver of diabetic rats all the analytes proved to be higher than
      in normal rats, mainly LC and TC. A similar trend was observed in skeletal
      muscle, at least with LC and TC, whereas SCLCE and ALC were not affected. The
      treatment with ALC increased the liver concentration of all the analytes in a
      dose-related way whereas in skeletal muscle only LC and TC showed an increase
      with the highest dose of ALC. Myocardium and kidneys showed a decrease of all the
      analytes in diabetes; the treatment with ALC normalized the situation in kidneys,
      in a dose-related way, but not in the myocardium. Urinary excretion and renal
      clearance of L-carnitine moiety increased in diabetes; an additional dose-related
      increase was observed with the ALC treatment.

PMID- 8489565
TI  - Acetyl-L-carnitine effect on nerve conduction velocity in streptozotocin-diabetic
      rats.
AB  - Measurement of nerve conduction velocity (NCV) is a useful and sensitive tool for
      evaluating diabetes related neurological dysfunctions. The method used allows to
      monitor the parameter at different times in the same group of rats, so that it is
      possible to observe simultaneously the development of the damage in time, and to
      evaluate the improvement related to the treatment. The repeated oral treatment
      with acetyl-L-carnitine (ALC, CAS 5080-50-2) 250 mg/kg caused an improvement in
      NCV of the diabetic rats; the effect was higher when the treatment started early
      with respect to the diabetes induction. The improvement in NCV was constant in
      time and comparable from 2 to 6 weeks of the treatment. In conclusion, oral
      treatment with ALC was able to normalize the impairment of NCV in streptozotocin
      rats, the effect being constant in time from 2 to 6 weeks of treatment and up to
      8 weeks after induction when administration started in early stage of diabetes (2
      3 weeks after induction); however, at this time the NCV is already significantly
      decreased.

PMID- 8489566
TI  - [Comparison of the pharmacokinetics of a quick-release bezafibrate formulation
      with a sustained-release formulation. 1. Single-dose administration].
AB  - Comparison of the Pharmacokinetic Profiles of a Quick and a Sustained Release
      Bezafibrate Formulation/1st Communication: Single-dose application The
      hypolipaemic agent bezafibrate (CAS 41859-67-0) is available as immediate and
      sustained release formulation. The pharmacokinetic profile of an immediate
      release 300 mg dragee (A) was compared in a two-way cross-over design to that of
      a 400 mg sustained release dragee (B). Neglecting the dose difference, the AUEC
      of A (28.8 micrograms/ml.h) was equal to that of B (27.6 micrograms/ml.h),
      whereas the bioavailability of A appeared to be higher than that of B when AUEC
      was corrected for dose (AUEC ratio = 137%). Regarding Cmax and tmax, both
      formulations exhibited the expected differences.

PMID- 8489567
TI  - [Comparison of the pharmacokinetics of a quick-release bezafibrate formulation
      with a sustained-release formulation. 2. Multiple-dose administration and
      chronopharmacokinetics].
AB  - The pharmacokinetic profile of a 300 mg immediate release formulation (A) was
      compared to a 400 mg sustained release formulation (B) of the lipid lowering drug
      bezafibrate (CAS 41859-67-0). Preparation A was applied twice a day whereas B was
      applied once a day in the evening. The means of Cmax (12.5 micrograms/ml) and AUC
      (66.8 micrograms/ml.h) for preparation A were considerably higher than for B
      (Cmax: 6.6 micrograms/ml, AUC: 39.8 micrograms/ml.h), whereas no differences were
      found regarding Tcav (A: 8.9 h, B: 8.3 h) and PTF (A: 4.6, B; 4.1). An AUC ratio
      for A/B of 119% (CI90%: 108-132%) was determined after dose correction. For A an
      AUC/AUEC ratio of 110% was found when comparing multiple versus single-dose
      application, whereas this ratio with 136% appeared to be considerably higher for
      B. Slight chronopharmacological effects were found for preparation A, which was
      applied twice a day in the evening and in the morning. During night-time the AUC
      was (insignificantly) 12% higher than during day-time, whereas the apparent
      elimination halflife time was 40% longer at night (p < 0.025), which corresponded
      to an extended tmax of median 3 h during night-time as compared to 1.75 h at day
      time.

PMID- 8489568
TI  - Structural characterization of terflavoxate.
AB  - Data are reported on the structural characterization of 3-methyl-4-oxo-2-phenyl
      4H-1-benzopyran-8-carboxylic acid 1,1-dimethyl-2-(N-piperidinyl)ethyl ester
      hydrochloride (terflavoxate-HCl, Rec 15/2053, CAS 86433-39-8), a new
      antispasmodic for the lower urinary tract. UV, IR, NMR and MS spectra fully
      confirmed the structure. The X-ray crystal structure determination revealed that
      the molecular structure consists of a rigid platform, formed by the chromone
      system, with two arms, the phenyl group at C(2) and the ester chain at C(8). The
      ester chain conformation generates a small hollow where two oxygen atoms face.

PMID- 8489569
TI  - Pharmacokinetic studies in healthy volunteers on a new gastroprotective
      pharmaceutic form of diclofenac.
AB  - The pharmacokinetic properties of a new gastroprotective pharmaceutical
      formulation of diclofenac (CAS 15307-79-6) were investigated in twelve healthy
      volunteers. In this new form the diclofenac is the nucleus of sequential
      sucralfate-covered tablets. The experimental design was an open, random, two
      period balanced cross-over study. All the subjects received a single oral dose of
      50 mg diclofenac contained in the new formulation or in the reference enteric
      coated tablets. Plasma concentrations of diclofenac were determined at 0.5, 1, 2,
      4, 6, and 8 h after drug administration using HPLC method. After administration
      of a diclofenac-sucralfate association diclofenac was quickly absorbed and the
      peak plasma concentration (0.773 +/- 0.08 microgram/ml) was achieved in about 1
      h. AUC(0-infinity) value was about 1.8 micrograms/ml/h and the mean elimination
      half-life was 1.20 +/- 0.12 h. The pharmacokinetic profile of diclofenac
      sucralfate association is similar to the values reported in previous papers for
      enteric-coated forms; anyway an early occurrence of the peak plasma concentration
      was observed for the new formulation. The new diclofenac-sucralfate association
      shows a different rate of absorption (namely an early and greater peak plasma
      concentration of diclofenac) and a similar extent of absorption (AUC(0-infinity)
      being not statistically different) as compared to the reference enteric-coated
      tablets of 50 mg diclofenac. These results could be related to the delaying and
      protective effect of sucralfate whose action is different from the one carried by
      the coat of the enteric-coated tablets.

PMID- 8489570
TI  - Intracellular changes of HeLa cells after single or repeated treatment with
      cytostatics.
AB  - HeLa cells were treated once or repeatedly using the cytostatics doxorubicin
      (adriamycin, Ad, CAS 23214-92-8), cisplatin (Pt, CAS 15663-27-1) and fluorouracil
      (FU, CAS 51-21-8). Intracellular GSH (reduced glutathione) contents, activities
      of protein kinase C, cytotoxicity and membrane fluidity were investigated. During
      single treatment protein kinase C activities as well as membrane fluidity
      increased, whereas intracellular GSH decreased. With repeated treatments protein
      kinase C activities increased further. Membrane fluidity as well as intracellular
      GSH contents increased. The investigated parameters may be correlated with
      sensitivity of cells against cytostatics.

PMID- 8489571
TI  - In vitro cytotoxic activity of an N-hydroxypyridine-2-thione derivative.
AB  - The in vitro antitumor activity of N-(1-adamantoyloxy)pyridine-2-thione (APT), an
      N-hydroxypyridine-2-thione derivative, was investigated against a panel of both
      murine and human tumor cell lines growing in vitro. To evaluate the cytotoxic
      activity of APT the MTT ((4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium
      bromide) in vitro assay was used, which is considered to have predictive value
      for drug chemosensitivity evaluation. The results demonstrate that APT has
      antitumor activity, thus confirming theoretical suppositions about its
      cytoreductive potential.

PMID- 8489572
TI  - Pharmacokinetics and tolerance of fluconazole suppositories in healthy
      volunteers.
AB  - Fluconazole (Diflucan, CAS 86386-73-4) suppositories offer a novel way to
      administer this systemically active antimycotic. The pharmacokinetics and
      toleration of this new formulation have now been examined in healthy adult
      volunteers. In crossover experiments the bioequivalence was demonstrated for 200
      mg suppositories and 200 mg capsules, and for 25 mg suppositories and 25 mg
      fluconazole in an oral suspension. The mean bioavailability of the 200 mg
      suppository relative to the capsule was about 93%. The mean bioavailability of
      the 25 mg suppository relative to the oral suspension was 107%. Absorption of
      fluconazole after administration of the suppositories was, however, somewhat
      slower than after oral ingestion of the capsule or suspension. The
      pharmacokinetic parameters of the 200 mg and 25 mg suppositories suggest that the
      kinetics of rectally administered fluconazole are linear with dosage. Daily
      administration of the 200 mg suppository gives a continuous increase in the mean
      fluconazole plasma concentration, until steady-state is reached on about the 5th
      day. The systemic and local toleration of the fluconazole suppositories was good.

PMID- 8489573
TI  - Effects of D-penicillamine on human cell lines.
AB  - The effect of penicillamine on the proliferation and viability of human T, B and
      premacrophage/promyelocytic cell lines was evaluated. Whereas Raji cells and U937
      cells were not negatively influenced by the addition of 0.03-0.97 mmol/l D
      penicillamine (D-Pen, Trolovol, CAS 52-67-5), other cell lines such as H9, NC37
      and HL60 were clearly impaired by concentrations between 0.12 and 0.49 mmol/l.
      Similar effects on the uptake of 3H-thymidine, 3H-uridine and 3H-leucine were
      observed with the addition of other stereoisomeric forms of penicillamine, D,L-
      and L-penicillamine to H9 cell cultures. The evaluation of cell number and
      viability by light microscopy revealed similar actions of penicillamine on cell
      cultures. By these means its repressing effect on Jurkat, NC37 and even on U937
      became more transparent.

PMID- 8489574
TI  - Pen-based remote data entry system. A pilot clinical trial.
AB  - This study assesses the feasibility of pen-based remote data entry and measures
      the acceptance of such systems by patients and physicians. Three clinical
      investigators participated in a phase-I/II clinical trial of escalated doses of
      chemotherapy followed by Granulocyte-Macrophage Colony-Stimulating Factor (GM
      CSF). The study included 20 patients with testicular cancer who were treated at
      three university hospitals. The patients' data obtained in this trial were
      recorded and stored on a pen-based computer system. A total of 798 data points
      were recorded for each patient using 33 electronic forms resembling the paper
      forms used during an earlier phase of the study. The data recorded include the
      past medical history, inclusion/exclusion criteria, disease staging, therapy
      documentation, laboratory values and side effects. Both physicians and patients
      were interviewed directly after using the pen-based remote data entry system.
      Patients accepted that their physician was taking notes on an electronic form
      rather than on paper. All patients noted that a pen-based system is superior to a
      desktop computer when used during an interview. For the investigators electronic
      data entry takes additional effort, but time savings are realized later with less
      data clearing and increased data quality. These benefits are important for the
      study sponsor as well. In conclusion, pen-based remote data entry is a feasible
      new mode of recording clinical data with concrete benefits to both investigators
      and sponsors.

PMID- 8489575
TI  - Mifepristone (RU 486)--an abortifacient to prevent abortion?

PMID- 8489576
TI  - How to diagnose and treat Lyme disease in children.

PMID- 8489577
TI  - Do medical journals suppress information?

PMID- 8489578
TI  - Oxygen content, blood viscosity, and cerebral blood flow.

PMID- 8489579
TI  - Relation of site of acute myocardial infarction to the site of maximal coronary
      narrowing.

PMID- 8489580
TI  - Statistical problems with small sample size.

PMID- 8489581
TI  - Temperature monitoring during radiofrequency catheter ablation.

PMID- 8489582
TI  - Obstruction in chronic pancreatitis.

PMID- 8489583
TI  - The MD thesis in the training of a consultant physician.

PMID- 8489584
TI  - Quality of care in rural hospitals.

PMID- 8489585
TI  - Heterosexual transmission of HIV.

PMID- 8489586
TI  - Radiotherapy plus chemotherapy for head and neck cancer.

PMID- 8489587
TI  - More on disclosure of AIDS in celebrities.

PMID- 8489588
TI  - Aseptic meningitis and intravenous gammaglobulin treatment.

PMID- 8489589
TI  - A more specific definition of pathology practice.

PMID- 8489590
TI  - Renal failure after eating "magic" mushrooms.

PMID- 8489591
TI  - Normal concentration of uranium in urine.

PMID- 8489592
TI  - Medical waste.

PMID- 8489593
TI  - Pulmonary embolism caused by venous compression ultrasound examination.

PMID- 8489594
TI  - Sensitivity of ocular pulse amplitude.

PMID- 8489595
TI  - Response to editorial on obstetric anesthesia.

PMID- 8489596
TI  - Using music therapy as distraction during lumbar punctures.

PMID- 8489597
TI  - Doppler ultrasound and the silent ductus arteriosus.

PMID- 8489598
TI  - Blood loss during total hip replacement.

PMID- 8489599
TI  - Face masks and spinal anaesthesia.

PMID- 8489600
TI  - Misuse of anabolic drugs.

PMID- 8489601
TI  - Misuse of anabolic drugs.

PMID- 8489602
TI  - Asking patients about their treatment.

PMID- 8489603
TI  - Medical education.

PMID- 8489604
TI  - Practice reports.

PMID- 8489605
TI  - Consultant episodes.

PMID- 8489606
TI  - . . . and the value of membership for all.

PMID- 8489607
TI  - Combination treatment of depression.

PMID- 8489608
TI  - Conversion mnemonic.

PMID- 8489609
TI  - 'Mabi bark tea' consumption and psychosis?

PMID- 8489610
TI  - Endocrine findings in Cushing's disease.

PMID- 8489611
TI  - The cranial base in subjects with dental and skeletal Class II.

PMID- 8489612
TI  - Leiomyosarcoma with osteoclast-like giant cells.

PMID- 8489613
TI  - Subcutaneous T-cell lymphoma with florid granulomatous panniculitis.

PMID- 8489614
TI  - Hospitals without walls.

PMID- 8489615
TI  - The radiobiology of radiosurgery.

PMID- 8489616
TI  - "Does Kentucky need a primary medical school?".

PMID- 8489617
TI  - Cholesterol and mortality.

PMID- 8489618
TI  - In-house trauma surgeon--paradigm or paradox.

PMID- 8489619
TI  - 98.6 degrees F.

PMID- 8489620
TI  - 98.6 degrees F.

PMID- 8489621
TI  - Evaluation of a breast mass.

PMID- 8489622
TI  - Early single-stage repair of complex craniofacial trauma.

PMID- 8489623
TI  - Pontine hemorrhage.

PMID- 8489624
TI  - MS and Sjogren's syndrome.

PMID- 8489625
TI  - Natural oocyte retrieval with intravaginal fertilization: a simplified approach
      to in vitro fertilization.

PMID- 8489626
TI  - Hemolytic disease of the fetus: a plea for restraint.

PMID- 8489627
TI  - HMG CoA reductase inhibitors and diet in familial hypercholesterolaemia.

PMID- 8489628
TI  - Intravenous drips.

PMID- 8489629
TI  - Casualty slaughter prosecution.

PMID- 8489630
TI  - Is a casualty slaughter service necessary?

PMID- 8489631
TI  - Perilous times in pathology education.

PMID- 8489632
TI  - Methadone maintenance and recovery.

PMID- 8489633
TI  - Incidental appendectomy and pathologic conditions of the appendix vermiformis.

PMID- 8489634
TI  - The bigger slice of the pie?

PMID- 8489635
TI  - Measles and low serum vitamin A values.

PMID- 8489636
TI  - Treatment of lymphoid interstitial pneumonia with chloroquine.

PMID- 8489637
TI  - Ankylosing spondylitis with exuberant sclerosis or SAPHO syndrome?

PMID- 8489638
TI  - Variability in bone mass measurement.

PMID- 8489639
TI  - Pectus excavatum.

PMID- 8489641
TI  - Bovine caesarean section.

PMID- 8489640
TI  - Saddened not amused.

PMID- 8489642
TI  - Effects of thiazide diuretic therapy on bone mass, fractures, and falls. The
      Study of Osteoporotic Fractures Research Group.
AB  - OBJECTIVE: To determine the relation between the use of thiazide diuretics and
      bone mass, fractures, and falls in older women. DESIGN: Cross-sectional study of
      thiazide diuretics, bone mass, and prevalent vertebral deformities; cohort
      analysis of thiazide diuretics and nonspinal fractures and falls. SETTING: Four
      clinical centers located in Baltimore, Maryland; Minneapolis, Minnesota;
      Portland, Oregon; and the Monongahela Valley, Pennsylvania. PARTICIPANTS: A total
      of 9704 ambulatory, nonblack women who were 65 years or older. MEASUREMENTS:
      Information on thiazide use, demographic data, medical history, and
      anthropometric measurements were obtained by questionnaire, interview, and
      examination. Appendicular bone mass was measured by single-photon absorptiometry.
      Incident falls and fractures were ascertained every 4 months. RESULTS: Women
      using thiazide diuretics for more than 10 years had significantly higher bone
      mass than women who had never used thiazide diuretics (for example, 0.381 g/cm2
      compared with 0.355 g/cm2 for the distal radius [P < 0.001]). Current users of
      thiazide diuretics had an incidence of falls (relative risk, 1.06; 95% CI, 0.90
      to 1.25) that was similar to that of those who had never used these drugs. After
      adjusting for age, body weight, functional status, total calcium intake, duration
      of estrogen replacement therapy, and self-reported health status, we found that
      current users of thiazide diuretics who had taken these drugs for more than 10
      years had a risk for nonspinal (relative risk, 0.99; CI, 0.81 to 1.20) and
      osteoporotic (relative risk, 0.98; CI, 0.79 to 1.22) fractures that was similar
      to that of women who had never used thiazides; however, thiazide users did have a
      lower risk for fractures of the hip (relative risk, 0.63; CI, 0.34 to 1.16) and
      wrist (relative risk, 0.66; CI, 0.40 to 1.08), neither of which was significant.
      CONCLUSIONS: Thiazide diuretics have no effect on a women's risk for falling or
      for experiencing nonspinal fractures. The trend toward a lower risk for hip and
      wrist fractures is consistent with findings in previous cohort studies but may
      reflect selection factors for the use of thiazide diuretics. A randomized trial
      is needed to determine the effect ot thiazide diuretics on the incidence of
      fractures.

PMID- 8489643
TI  - Increased human erythrocyte sodium-lithium countertransport in hyperlipidaemic
      patients may indicate increased membrane lipid fluidity.
AB  - Erythrocyte sodium-lithium countertransport (SLC) activity, membrane fluidity,
      plasma triglyceride and cholesterol were measured in hyperlipidaemic patients and
      normal subjects. Fluidity was assessed by the fluorescence anisotropy (inversely
      related to fluidity) of the probes 1,6-diphenyl-1,3,5-hexatriene (DPH) and 1,4
      trimethylammonium-3,5-hexatriene (TMA-DPH). In a second group of patients the
      maximum velocity (Vmax) and external sodium affinity constant (km) of SLC was
      also measured. In the first group of patients, SLC activity was increased
      compared with the controls (0.279 +/- 0.019 vs. 0.213 +/- 0.013, P = 0.006) as
      was membrane fluidity in the deep hydrophobic regions (DPH anisotropy 0.211 +/-
      0.0007 vs. 0.215 +/- 0.0011, P = 0.007). There was a strong correlation between
      SLC and DPH anisotropy (Rs = -0.72, P = < 0.001) which was due to the correlation
      between Vmax and DPH anisotropy (Rs = -0.90, P = < 0.001). Increases in Vmax of
      SLC in hyperlipidaemic patients may be due to differences in lipid organisation
      in the deep hydrophobic regions of the membrane which may affect the turnover
      rate of the transporter.

PMID- 8489644
TI  - Lyme disease. A Canadian perspective.
AB  - Lyme disease is an expanding community health issue in the United States. This
      has led to greater public awareness in Canada, although the disease remains rare
      here. We review the biology of ticks and show how feeding patterns are relevant
      to disease transmission. Diagnosing Lyme disease is sometimes problematic, but
      treatment can be effective, particularly in the early stages. Preventive measures
      are aimed at avoiding tick contact and early tick removal.

PMID- 8489645
TI  - [Gastric adenocarcinoma with an endocrine component. Report of nine cases].
AB  - Nine gastric adenocarcinomas containing endocrine cells were retrospectively
      studied to evaluate anatomo-clinical and immunohistochemical features, and the
      out-come of the patients. These gastric tumors were bulky with frequently lymph
      node metastasis. The immunohistochemical analysis had shown that all tumors
      contain EC cells, two tumors D cells, one tumor PP cells, but neither G cells nor
      A cells were detected. Five-years survival rate of these gastric tumors was
      slightly but not significantly increased as compared to usual adenocarcinomas
      (45.5% vs 36.5%). However, one can raise the question of possible control of
      local hormonal secretions on tumoral growth, particularly the anti-trophic part
      of the somatostatin.

PMID- 8489646
TI  - [Hepatic epithelioid hemangioendothelioma. A case with liver transplantation.
      Review of the literature].
AB  - Epithelioid hemangioendothelioma (HEE) is an unusual malignant neoplasm of
      vasculo-endothelial origin, arising in soft tissues, lung and liver. One case of
      hepatic HEE is reported in a 32 year-old man wit an isolated multinodular
      hepatomegaly. The diagnosis was made by the histologic examination of biopsy
      specimens. At the time of diagnosis, there was evidence of pulmonary metastasis.
      However, an orthotopic liver transplantation was performed. The tumor cells were
      immunoreactive with factor VIII-related antigen, BNH9 and vimentin. There was no
      expression of cytokeratin and epithelial membrane antigen. The patient is alive
      and well 24 months after. The thoracic X-ray are unchanged. This case is compared
      with the 84 others cases of the literature. Fourteen experienced a favorable
      outcome after transplantation. Extra-hepatic dissemination doesn't contra
      indicate the graft. But hilar vascular involvement may be correlated with worse
      prognosis.

PMID- 8489647
TI  - [Follicular mucinosis. A dermatologic disorder frequently associated with T-cell
      lymphoma].
AB  - The case of a 40-year-old man with follicular mucinosis and simultaneous
      cutaneous T-cell lymphoma is reported. This observation emphasizes 1) the
      difficulties to interpret the lymphoid infiltration which accompanies a
      follicular mucinosis, 2) the necessity of immunochemistry and multiple biopsies
      in order not to ignore an associated lymphoma.

PMID- 8489648
TI  - [Inflammatory pseudo-tumor of the lung. Clinico-pathologic report of a case].
AB  - One case of a solitary pulmonary nodule occurring in a 54-year-old woman with
      history of breast carcinoma is presented. Histological examination of the
      surgical specimen excluded breast carcinoma metastasis and revealed an
      inflammatory pseudotumor. Principal clinico-pathological findings in previously
      reported cases are described. Inflammatory pseudotumors may exhibit, as in our
      case, some nuclear atypia making the diagnosis sometimes difficult with
      malignancy.

PMID- 8489649
TI  - [Botryoid rhabdomyosarcoma of the cervix. Clinico-pathologic study of a case].
AB  - The botryoid rhabdomyosarcoma of the cervix is a rare tumour occurring in young
      woman or during genital activity. It mainly causes vaginal bleeding or appears as
      a polypoid grape-like mass with a gelatinous cut-surface. The diagnosis is based
      on the presence of a submucosal cambium layer and a rhabdomyoblastic
      differentiation, corresponding to an intracytoplasmic double cross-striation.
      Metaplastic cartilaginous islands are sometimes observed. The immunostaining
      ensures the muscular origin of the tumour, characterized by the expression of
      actin and desmin. Apart from mullerian adenosarcomas, the main differential
      diagnosis is represented by the benign polypoid formations of the cervix: the
      genital rhabdomyoma and the fibroblastic lesion, called fibro-epithelial polyp
      with atypical stroma. The treatment actually includes both chemotherapy and
      surgery which is often limited to a conization.

PMID- 8489650
TI  - [Specimen fixation in seminoma].

PMID- 8489651
TI  - [Vaginal polyp. Case for diagnosis].

PMID- 8489653
TI  - [VIIth Meeting on Research in Cellular Pathology. Paris, 9 December 1992.
      Abstracts].

PMID- 8489652
TI  - [Invisible dermatoses].

PMID- 8489654
TI  - ["Bronchiolitis obliterans"].

PMID- 8489655
TI  - [Lung rejection in pulmonary and cardiopulmonary transplantation].

PMID- 8489656
TI  - The use of intravenous ketorolac for the treatment of renal colic in the
      emergency department.
AB  - The objective of this study was to report the authors' experience using
      intravenous ketorolac (Syntex Laboratories, Palo Alto, CA) as an analgesic in the
      treatment of renal colic in a convenience sample at three suburban community
      hospital emergency departments. Twenty-five patients with renal colic were
      participants. Pregnant women, patients with a history of renal or hepatic
      impairment, bleeding diathesis, active peptic ulcer disease, or hypersensitivity
      to aspirin or nonsteroidal antiinflammatory drugs (NSAID) were excluded.
      Ketorolac 30 mg administered intravenously during a 1-minute period, and the
      following parameters were monitored at times 0, 5, 10, 20, 30, and 60 minutes:
      pain on a scale of 0 to 10, pulse rate, blood pressure, and adverse side effects.
      A total of 25 patients were included in our series. Initially, they had a median
      pain score of 9 with an interquartile range of 1. Thereafter, the median pain
      scores and (interquartile ranges) were 8 (three) at 5 minutes, 5 (four) at 10
      minutes, 2 (four) at 20 minutes, 1 (three) at 30 minutes, and 0 (one) at 60
      minutes. There were no adverse side effects observed in any patients. Therefore,
      it can be concluded that intravenous ketorolac is an effective analgesic agent
      for the control of pain in patients with renal colic.

PMID- 8489657
TI  - Survival from out-of-hospital cardiac arrest: effects of patient age and presence
      of 911 Emergency Medical Services phone access.
AB  - The purpose of this investigation was to determine factors associated with
      survival from out-of-hospital cardiac arrest, including effects of 911 Emergency
      Medical Services telephone access and the age of patient. Subjects included 1,753
      prehospital cardiac arrest patients in Iowa. Patient survival status and other
      variables were compared for patients with access to a 911 service with those who
      did not, and for different age categories, using univariate associations and
      multivariate logistic regression analysis. The presence of 911 telephone access
      was significantly associated with survival from out-of-hospital cardiac arrest
      (9.18% versus 5.35% survival for 911 versus no 911 groups, respectively). This
      association was partially the result of the significant association of 911 with
      decreased time from collapse to call for help, decreased time to cardiopulmonary
      resuscitation (CPR), and decreased time to first shock (if in ventricular
      fibrillation [VF]). Younger age was significantly associated with survival in
      univariate analyses (8.94% versus 6.26% survival for younger versus older age
      groups, respectively), but this was not an independent association, which is
      indicated by the lack of significance of age in the multivariate model.

PMID- 8489658
TI  - Cricothyrotomy performed by prehospital personnel: a comparison of two techniques
      in a human cadaver model.
AB  - Little is known about the proficiency of prehospital personnel when performing
      cricothyrotomies. The authors compared two techniques for establishing an airway
      through the cricothyroid membrane used by paramedic students. One technique used
      a prepackaged kit that consisted of a dilator that is passed percutaneously
      through a breakaway needle. This percutaneous device (PD) was compared with a
      standard surgical approach (SA) using a scalpel and endotracheal tube. Data was
      collected on a total of 44 paramedic students who were allowed to attempt each of
      the procedures. No significant difference in the success rate on the first
      attempt was found between the two procedures (86% for the SA and 73% for the PD;
      P = .186). The surgical approach was significantly faster (46 +/- 17 seconds v
      103 +/- 62 seconds; P < .01). It was also judged to be significantly easier to
      perform when evaluated on a linear analog scale (SA, 2.6 +/- 2.0 v PD, 5.1 +/-
      2.8; P < .001). Because some procedures were performed on cadavers whose
      cricothyroid membranes had already been violated, the procedures performed on
      intact membranes only were also analyzed. Similar, statistically significant
      differences for insertion time and ease of insertion were again found.
      Prehospital personnel can be trained to perform cricothyrotomies with a
      reasonable degree of proficiency. A traditional surgical approach, however, may
      be faster and less difficult to perform than a comparable procedure using a
      commercially available percutaneous device.

PMID- 8489659
TI  - Prehospital seizure management: triage criteria for the advanced life support
      rescue team.
AB  - The present study was completed to establish advanced life support (ALS) versus
      non-ALS triage criteria for use by ALS prehospital personnel when faced with the
      seizure patient, in the hope of more efficient use of ALS rescue teams.
      Preselected triage criteria for acuity of care based on neurological condition,
      vital signs, and concomitant illness/injury were tested against retrospective
      data (paramedic run reports) collected on 230 patients. Triage criteria
      sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), and
      negative predictive value (NPV) were determined with a 95% confidence interval
      (CI). Point estimate of use/need of care was noted. ALS interventions were
      instituted in 58 patients (25%). In 57 of these cases, indication for and ALS
      intervention, were established on initial patient assessment (SENS, 98.28; 95%
      CI, 90.76 to 99.96). Of 173 patients requiring no ALS intervention on initial
      assessment, only 1 (0.58%) developed complications warranting ALS therapy during
      the course of prehospital care (SPEC, 100.00; 95% CI, 100.00 to 99.99; PPV,
      100.00; 95% CI, 100.00 to 94.63; NPV, 99.42; 95% CI, 96.82 to 99.99). No
      inappropriate use, point estimate (PE) [(0)/(172) (0.00% to 0.01%)] or unmet
      need, PE [(0)/(58) (0.00% to 5.16%)] of care was noted. The data presented in
      this study suggest that given similar field times, after initial patient
      assessment by ALS personnel, it is reasonable and safe to triage seizure patients
      who do not require ALS intervention to non-ALS rescue teams for continuation of
      care and transportation.

PMID- 8489661
TI  - Incidence of urethral disruption in females with traumatic pelvic fractures.
AB  - According to the National Center for Health Statistics, in 1986 1.4 million
      female patients in the United States were admitted to inpatient and short-stay
      nonfederal hospitals as a result of injuries acquired secondary to trauma. Of
      these, 45,000 had traumatic pelvic fractures. Rupture of the urethra is the most
      important lower urinary tract injury associated with traumatic pelvic fracture
      because of the high incidence of serious complications, such as urethral
      stricture and incontinence. To our knowledge, there are no satisfactory studies
      in the English literature documenting the incidence of urethral disruption in
      females with traumatic pelvic fractures. The records of all women patients with
      pelvic fractures registered in the Latter Day Saints Hospital trauma registry
      between July 1, 1981 and August 31, 1987 were reviewed. Of 146 female patients
      with traumatic pelvic fractures who were hospitalized during this period, none
      was found to have an urethral injury. Two patients (1.4%) had bladder contusions,
      and one (.7%) had a bladder rupture. This was the first large series attempting
      to identify the true incidence of urethral disruption in females with traumatic
      pelvic fracture, and it was found to be a rare occurrence.

PMID- 8489660
TI  - Changes in the parameters of oxygen metabolism in a clinical course recovering
      from potassium cyanide.
AB  - Poisoning with potassium cyanide is usually fatal because of the inhibition of
      cytochrome oxidase. The parameters of oxygen metabolism in a patient with cyanide
      poisoning who was admitted in a coma with seizures was monitored. The
      administration of amyl nitrite and sodium thiosulfate led to a rapid improvement:
      the parameters reflecting oxygen metabolism improved and the plasma level of
      cyanide decreased. The patient revived 1 1/2 hours after treatment. The arterial
      ketone body ratio (AKBR), which is the ratio of acetoacetate to beta
      hydroxybutyrate in arterial blood and which reflects the redox state in liver
      mitochondria, improved dramatically following treatment. Because the AKBR changes
      in relation to electron transport in liver mitochondria, it seems to be a logical
      parameter for evaluating the effect of potassium cyanide poisoning on electron
      transport. The AKBR also reflects the efficacy of treatment for cyanide
      poisoning.

PMID- 8489662
TI  - Out-of-hospital resuscitation preferences of emergency health care workers.
AB  - The objective of this study was to assess the personal preferences of emergency
      physicians, nurses, and medical technicians regarding their own potential out-of
      hospital resuscitation. An anonymous multiitem survey instrument was used at a
      statewide emergency medicine educational conference. Emergency personnel who
      regularly treat out-of-hospital cardiac arrest patients were enlisted to
      participate. Subjects picked the last intervention that they would wish for
      themselves in an optimally managed advanced cardiac life support (ACLS)-based
      resuscitation for ventricular fibrillation. One hundred millimeter visual analog
      scales were used to measure individual preferences for severe neurological
      disability or death. Hypothesis testing was by analysis of variance with Newman
      Keuls, multiple regression with stepwise variable selection, and the chi 2 and
      binomial distributions. Of 185 survey instruments, 105 were returned completed by
      eligible subjects. There was little difference among the three occupational
      groups (P > .5), although older respondents favored shorter resuscitations (r = 
      .38; P = .002). Ten subjects did not want cardiopulmonary resuscitation started,
      and 65% wanted resuscitation stopped before the second dose of epinephrine. Only
      three subjects chose to undergo the entire ACLS sequence. Eighty-two percent of
      respondents preferred death to severe neurological disability. Emergency health
      care professionals have a unique personal awareness of issues surrounding out-of
      hospital resuscitation. That a large majority would prefer death to severe
      disability and few would willingly undergo full resuscitation as currently
      practiced suggests that prevailing guidelines should be reevaluated.

PMID- 8489663
TI  - Counseling parents of a child dead on arrival: a survey of emergency departments.
AB  - The purposes of this study were to (1) document whether or not responding
      emergency departments (EDs) have a process and/or team to interact with parents
      of children dead on arrival (DOA); (2) conduct a needs assessment to determine
      what information is essential to convey to a family of a child DOA; and (3)
      determine what EDs are doing to their residents/fellows in crisis counseling. A
      survey instrument was developed using input from key health care professionals at
      Children's Hospital who are involved in the acute care of children and their
      families. This survey was sent to directors of EDs in all children's hospitals
      and those general hospitals with more than 400 beds. Respondents identified
      themselves as ED directors at children's hospitals or general hospitals
      throughout the United States. The survey documented the lack of a process or team
      approach to counseling the family of a child who presents DOA. Often, the most
      inexperienced physicians are expected to provide this information and to counsel
      parents. Few EDs reported offering communication skills training in this area.
      Many respondents expressed dissatisfaction about the lack of a process or team
      regarding patients who present DOA and recognize the need for improvement.

PMID- 8489664
TI  - Acute pancreatitis related to anticardiolipin antibodies in lupus patients
      visiting an emergency department.
AB  - Four patients with systemic lupus erythematosus visiting an emergency department
      were reported with clinical presentation of acute pancreatitis. All had high
      levels of anticardiolipin antibodies (aCL); at autopsy, one had multiple thrombi
      within the blood vessels of the pancreas. The aCL antibody might play an
      important role in the pathogenesis of acute pancreatitis. Three patients had
      multiple organ involvement, especially the central nervous system, concomitant
      with an acute attack of pancreatitis; all died from these complications. Thus it
      was suggested that initial acute pancreatitis is an omnious prognostic factor in
      lupus patients visiting an emergency department. When evaluating lupus patients
      visiting an emergency department, clinicians should be alert to the status of aCL
      and the possibility of pancreatitis in these patients.

PMID- 8489665
TI  - Atypical ectopic pregnancy.
AB  - Most emergency physicians will agree that bleeding and abdominal pain in women of
      child-bearing age is considered an ectopic pregnancy until proven otherwise.
      Ectopic pregnancy remains the leading cause of maternal mortality in the United
      States. A high index of suspicion is necessary for early intervention and
      reduction in morbidity and mortality. Risk factors for ectopic pregnancy include
      previous salpingo-oophoritis, ectopic pregnancy, tubal surgery or ligation, use
      of an intrauterine device, hormonal therapy, and, more recently, in vitro
      fertilization. In addition, this case emphasizes the possibility of ectopic
      pregnancy in women with a history of hysterectomy without bilateral oophorectomy.

PMID- 8489666
TI  - Isolated sphenoid sinusitis.
AB  - Isolated sphenoid sinusitis is an uncommon but potentially catastrophic
      infectious disease. The authors present 12 patients with acute, isolated sphenoid
      sinusitis and describe their presenting features and clinical courses. All
      patients experienced headache, facial pain, or both. Fever and leukocytosis were
      uncommon. Plain sinus radiographs and cranial computerized tomography scan were
      diagnostic. All patients were treated with antibiotics and recovered without
      infectious or neurological complications.

PMID- 8489667
TI  - Streptococcal toxic shock-like syndrome presenting with hypoglycemia and
      reversible paralysis.
AB  - A patient with pharyngitis progressive to Toxic Shock-Like Syndrome presented to
      the emergency department with a chief complaint of lower extremity paralysis.
      This paraplegia was completely reversed with the administration of intravenous
      glucose. Hypoglycemia-induced paraplegia has not previously been reported in the
      medical literature, and this report emphasizes the importance of considering low
      blood glucose as a potential etiology for patients who present with these
      neurological symptoms.

PMID- 8489668
TI  - Lidocaine in refractory status epilepticus: a forgotten drug in the emergency
      department.
AB  - Generalized tonic-clonic status epilepticus is usually treated with intravenous
      benzodiazepines and phenytoin. Patients who do not respond to this treatment are
      generally treated with phenobarbital or general anesthetics both of which may
      require intubation to maintain respiration. Our experience of four cases with
      status epilepticus treated with intravenous lidocaine who had failed to respond
      to diazepam and phenytoin therapy is presented. Two cases responded to a single
      dose of lidocaine, one required a second dose of lidocaine to control seizures,
      and the fourth patient failed to respond and died as a result of associated
      severe head injury. Therefore, there is a need to conduct further studies to
      establish the efficacy of intravenous lidocaine in the treatment of refractory
      status epilepticus.

PMID- 8489669
TI  - Acceleration of the ventricular response in paroxysmal lone atrial fibrillation
      following the injection of adenosine.
AB  - Treatment of a patient with new onset atrial fibrillation with intravenous
      adenosine was followed by transient but significant acceleration of the
      ventricular rate. This unexpected response to adenosine can be explained by a
      predominating increase in sympathetic discharge relative to the drug's direct
      atrial ventricular nodal-blocking action.

PMID- 8489670
TI  - Pediatric acepromazine poisoning: the importance of child-resistant packaging for
      veterinary drugs.
AB  - The first reported case of acepromazine ingestion in a pediatric patient is
      presented. It is an aliphatic phenothiazine that is structurally similar to
      chlorpromazine (thorazine). In our case, a 2 1/2-year-old male ingested 3 to 4 of
      his 80-pound Doberman's 25-mg tablets. The pills were stored in a vial without a
      child-resistant closure. The child displayed signs and symptoms of phenothiazine
      toxicity. There is no federal law which requires veterinary medicines to be
      dispensed in special packaging. All prescription medications should require child
      resistant packaging.

PMID- 8489671
TI  - Respiratory failure following adenosine administration.
AB  - Adenosine is frequently administered to convert the rhythm of patients with
      paroxysmal supraventricular tachycardia to sinus rhythm. Adverse reactions are
      common after its administration, but these have been short-lived because
      adenosine has a half-life of less than 10 seconds. This report describes a 54
      year-old male patient with chronic obstructive pulmonary disease who presented
      with paroxysmal supraventricular tachycardia at 200 beats/min. A 12-mg bolus
      injection of adenosine aggravated mild bronchospasm and produced respiratory
      failure. The patient subsequently required ventilatory support for 9 days. The
      presence of bronchoconstriction should be considered as a possible
      contraindication to the administration of intravenous adenosine.

PMID- 8489672
TI  - Increases in serum prolactin levels associated with syncopal attacks.
AB  - Numerous investigators have found that serum prolactin levels increase after
      tonic-clonic and partial complex seizures, but the effect of syncope on prolactin
      levels has been studied little. Serum prolactin levels were measured following
      unexpected syncopal attacks in patients seeking emergency treatment in a
      community hospital. Levels sampled 18 to 60 minutes after syncopal episodes were
      increased in 8 of 11 cases. Follow-up prolactin levels, measured 17 to 222 days
      later, were normal in all eight cases in which they were initially increased.
      Most subjects had concurrent illness. Although the current study does not clarify
      whether it was the syncope, the concurrent illness, or both that caused the
      prolactin elevations, it implies that measurement of this hormone will not help
      the clinician in distinguishing between seizures and syncopal attacks.

PMID- 8489673
TI  - Symptomatic bradycardia following the administration of sublingual nitroglycerin.
AB  - A case of severe bradycardia with junctional escape immediately following
      sublingual nitroglycerin is described. Bradycardia is a rare, but well
      documented, complication of nitroglycerin and is often reported in the setting of
      myocardial ischemia or infarction. This particular case reported was complicated
      by the presence of an angiographically documented congenital coronary anomaly,
      but did not have either electrocardiographic or enzymatic evidence of ischemia or
      infarction during this event. Previously reported cases were reviewed, as well as
      potential mechanisms for this phenomenon. All cases reported to date were easily
      corrected with passive leg elevation or atropine.

PMID- 8489674
TI  - Cervical spine trauma in children: Part II. Mechanisms and manifestations of
      injury, therapeutic considerations.

PMID- 8489675
TI  - Human rabies: a review.
AB  - Human rabies is a rarely observed but frequently prophylaxed disease in North
      America. Presented in this review is a typical emergency department case and a
      summary of the epidemiology of the rabies virus, its clinical appearances,
      diagnosis, and management. Emphasis is placed on issues pertinent to the
      emergency physician practicing in the United States. Current recommendations for
      the administration of both active and passive immunotherapy for preexposure and
      postexposure prophylaxis are discussed. A treatment algorithm to aid in the
      decisions faced by a practicing physician regarding proper animal management and
      patient therapy and future prospects for the control of rabies in wild animal
      populations are also included.

PMID- 8489676
TI  - Cases in electrocardiography.

PMID- 8489677
TI  - Discrepancy in resuscitation beliefs among physicians at various levels of
      training.
AB  - Having previously described some of the attitudes of health care providers toward
      resuscitation for themselves, based on an individual's beliefs about the
      likelihood of success of cardiopulmonary resuscitation (CPR), the differences
      among attitudes of physicians at different levels of training have now been
      assessed. A multi-question survey was sent to medical students, house officers,
      and attending physicians at two university medical centers. Sociodemographic
      information, questions regarding beliefs about outcome after CPR, and personal
      desires were included. Respondents were asked to identify the clinical condition
      carrying the worst prognosis during cardiac arrest from among: metastatic cancer
      (MC), end-stage renal disease (ESRD), acquired immunodeficiency syndrome (AIDS),
      sepsis, and myocardial infarction (MI), and to specify their resuscitation
      desires should they be affected by these conditions. The preferences of each
      group regarding resuscitation given their least favored diagnosis were assessed
      using chi 2 analysis of trends for binomial proportions. Approximately 186
      questionnaires were evaluated and consisted of 90 by medical students (MS), 67 by
      house officers (HOs), and 29 by attending physicians (APs). Resuscitation desires
      for each diagnosis were MC, 7 of 40; ESRD, 8 of 34; AIDS, 10 of 74; sepsis, 10 of
      15; and MI, 20 of 23. chi 2 test for trend of desire to be resuscitated from the
      self-selected worst prognostic category by level of training demonstrated no
      significant decrease in desire to be resuscitated with increasing level of
      training. Physician's beliefs about CPR may be influenced by their experiences
      with particular patients and events.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489678
TI  - Pediatric emergency care: an annotated bibliography of the recent literature.

PMID- 8489679
TI  - Cricothyrotomy performed by prehospital personnel.

PMID- 8489680
TI  - Emergency medicine and health care reform.

PMID- 8489681
TI  - Atropine use in electromechanical dissociation.

PMID- 8489682
TI  - Side effects of clozipine (Clozaril) requiring emergency treatment.

PMID- 8489683
TI  - Ethyl chloride intoxication.

PMID- 8489684
TI  - Fracture of titanium-rigid fixation plate not clearly discernable on panoramic
      radiograph.

PMID- 8489685
TI  - Intestinal obstruction: the marble effect.

PMID- 8489686
TI  - Diarrhea in acquired immune deficiency syndrome (AIDS).
AB  - Diarrhea is a common manifestation of HIV disease which most nurses will find
      themselves confronting at some point. It can be extremely debilitating, as well
      as causing psychological distress to patients. Treatment depends on etiology; it
      may be successful if the diarrhea is caused by a specific enteric pathogen or a
      specific medication the patient is taking. However, often the diarrhea cannot be
      resolved and treatment must be by supportive measures. Management has three
      components: diet, anti-diarrheal agents, and skin care. A multidisciplinary team
      provides the most effective approach for managing these complex, difficult cases.

PMID- 8489687
TI  - Case study: carbuncle of the neck with extensive tunnelling.
AB  - A 40 year old female developed a carbuncle at the base of the neck on the right
      side near the hairline. Despite her attempts to treat the carbuncle at home "it
      continued to enlarge and fester" (became inflamed and suppurated). She was
      admitted to the hospital and, following surgical incision and drainage, ET nurse
      consultation was requested to establish a wound treatment regimen.

PMID- 8489688
TI  - A patient teaching protocol for pressure ulcer prevention and management.

PMID- 8489689
TI  - The wound care puzzle.

PMID- 8489690
TI  - Pocket wound care cards: helpful hints for wound care.

PMID- 8489691
TI  - ICWM consensus statement: wound management. International Committee onWound
      Management.

PMID- 8489692
TI  - Confirmation of the airborne occurrence of micron-size airborne pollen antigen
      carrying particles by immunoblotting.
AB  - We confirmed the existence of micron-size airborne particles carrying major
      pollen antigen of Cryptomeria japonica (Cry j l) and Lolium perenne (Lol p l) by
      means of an immunoblotting technique and examination by light microscopy. The
      size of the spots on a nitrocellulose membrane, marking the presence of antigen
      on the sampler's tape, varied considerably under light microscopic examination.
      Spots smaller than pollen grains and micron-size spots were observed together
      with large spots which seem to have been derived from intact pollen grains. The
      number of micron-size spots counted under a light microscope did not correspond
      with the number of spots from pollen grain observable with the naked eyes. This
      suggests other sources of airborne Cry j l particles than intact pollen grains
      alone.

PMID- 8489693
TI  - Optimising the extraction of allergens in Betula pollen as determined by
      isoelectric focusing in polyacrylamide gels.
AB  - Water soluble proteins extracted from birch pollen are responsible for most of
      the allergic symptoms in central and northern Europe as well as in parts of
      northern U.S.A. and Canada. Previous immunological studies of pollen allergens by
      isoelectric focusing (IEF) in polyacrylamide gels (PAGs) used a variety of
      extraction methods with little regard to standardisation or optimisation. In the
      present study a variety of buffers with various pH, charged buffering ions and
      ionic strengths were evaluated against different extraction times and
      temperatures in order to determine the optimum conditions for protein extraction.
      The largest number of proteins, determined by IEF, were found when extractions
      were performed at 10 degrees C and for 1 hour. Coomassie Blue and silver staining
      methods were compared.

PMID- 8489694
TI  - A forecast model for hazel (Corylus) and chestnut (Castanea) pollen emission.
AB  - In this paper a simple conceptual model is introduced in order to predict the
      atmospheric pollen concentration threshold above which pollinotics show allergic
      symptoms. In addition, the range of the pollen sampler with respect to the local
      and remote emission of pollen grains, produced by the vegetation in its flowering
      phase, is highlighted. Two different pollen types have been considered; their
      emission in the atmosphere takes place in two periods of the year, which greatly
      differ both in climatological respect and concerning the atmospheric of mixing
      particles. The data analysis is carried using a methodological approach, taking
      into account phenological, aerobiological and meteorological parameters.

PMID- 8489695
TI  - Temperature influence on differentiation and release of hazel pollen.
AB  - The aim of the present work was to identify the classic phenological stages, and
      to understand its relation to catkin differentiation and growth, and its
      consequences for the start of pollination. Phenological observations and an
      aeropalynological survey on Corylus avellana, which is an example of an
      economically and allergologically interesting arboreal plant, were carried out
      during 1991-1992. The comparison between the different phenological phases and
      the aeropalynological data, showed that the pollen trap recorded hazel-pollen
      presence in the atmosphere immediately after the pollen release from the orchard.
      The start of catkin elongation in late winter, after the chilling requirement has
      been fulfilled, could be used to indicate the beginning of heat accumulation
      necessary for pollination.

PMID- 8489696
TI  - Change in the northward movement of the pollen front of Cryptomeria japonica in
      Japan, during 1986-1991.
AB  - A map of pollen fronts of Cryptomeria japonica was compiled from pollen counts
      taken at 28 airborne sampling sites in Japan in 1986. Thereafter, the number of
      sites was increased, reaching 80 in 1991. In this way an accurate and complete
      map of the C. japonica pollen fronts was compiled annually. We used the results
      obtained from mapping the pollen fronts to draw up a map of the average locations
      of the front, from which the beginning of the pollen season can be predicted. A
      close correlation was found between the latitude of the airborne sampling sites
      and the mean interval between January 1 and the day pollen release began during
      these 6 years.

PMID- 8489697
TI  - Comparison of gramineae and ragweed pollen counts measured by Hirst's and Cour's
      traps.
AB  - The aim of this study is to appreciate what conclusions may be drawn from the
      comparison between two different methods for pollen count determination in
      clinical allergology. In Lyon (France), two pollen collectors are set up in two
      places separated by ten kilometers, as the crow flies. The Hirst-type trap is on
      the roof of the Pasteur Institute in the town; the Cour's trap (French
      Association for Ragweed Study), is located at the meteorological station in the
      country at the east of the town. In the Rhone-Alpes region, pollinosis is
      essentially due to Poacae and Ambrosia elatior. The weekly data have been
      recorded during three years. The results of the two categories of herbaceous
      plants are not comparable, except as regards the date at which the pollen season
      commenced. Graminae pollination (GP) commences between 20th April and 6th of May.
      Ragweed pollination (RP) accurately commences 5th and 6th of August! Differences
      in the fluctuations of peak concentrations of GP from one trap to the other can
      be imputed to the collectors, the site where these are located, the method used
      to process the data, the herbaceous weeds themselves. RPC (the dates of the
      peaks) are closer and more coherent. Lastly, in allergological practice, the
      Jacques Dechamp's rule, to only emply with the A.F.E.D.A. trap, is a hardy aid
      used to predict the week of the all-important peak pollen concentrations of G and
      R.

PMID- 8489698
TI  - A statistic study of atmospheric pollen in Japan.
AB  - By using a volumetric method, the authors made an investigation on airborne
      pollen grains in connection with the incidence of pollinosis since 1969, in Toho
      University, Funabashi, Chiba, Japan. The airborne pollen grains in each sample
      were counted under the microscope to identify the pollen types, and the pollen
      grains were classified into seven types according to the classification of pollen
      grains in Japan reported by Ikuse. In this report, the accumulated number of each
      species was analyzed statistically by circular plot, semi-logarithmic plot and
      test of skewness (g1) and kurtosis (g2) of frequency distribution by G. W.
      Snedecor. From the investigation in the years of 1969, 1970, 1990, 1991, the most
      frequent airborne pollen grains belonged to the 1-aperturate 3C(ab) type pollen
      in 1969 and 1970, and to the 1-aperturate 3B type pollen in 1990 and 1991,
      reflecting the change of environment during twenty years. By the g1 and g2
      statistics for almost all species, the mode of distribution curve was
      significantly smaller than the mean, indicating that the whole distribution
      significantly skewed from a normal distribution, and the peak was flat for the
      herbs, while sharp for the trees.

PMID- 8489699
TI  - A simplified method for the purification of human red blood cell glyoxalase. I.
      Characteristics, immunoblotting, and inhibitor studies.
AB  - Glyoxalase I (EC 4.4.1.5) was purified from human red blood cells by a simplified
      method using S-hexylglutathione affinity chromatography with a modified
      concentration gradient of S-hexylglutathione for elution. The pure protein had a
      specific activity of 1830 U/mg of protein, where the overall yield was 9%. The
      pure protein had a molecular mass of 46,000 D, comprised of two subunits of
      23,000 D each, and an isoelectric point value of 5.1. The KM value for
      methylglyoxal-glutathione hemithioacetal was 192 +/- 8 microM and the kcat value
      was 10.9 +/- 0.2 x 10(4) min-1 (N = 15). The glyoxalase I inhibitor S-p
      bromobenzylglutathione had a Ki value of 0.16 +/- 0.04 microM and S-p
      nitrobenzoxycarbonylglutathione, previously thought to inhibit only glyoxalase
      II, also inhibited glyoxalase I with a Ki value of 3.12 +/- 0.88 microM. Reduced
      glutathione was a weak competitive inhibitor of glyoxalase I with a Ki value of
      18 +/- 8 mM. The polyclonal antibodies were raised to the purified enzyme and
      were found to react specifically with glyoxalase I antigen by immunoblotting.
      This procedure gave a protein of high purity with simple low pressure
      chromatographic techniques with a moderate but adequate yield for small-scale
      preparations.

PMID- 8489700
TI  - Refolding of cytochrome b562 and its structural stabilization by introducing a
      disulfide bond.
AB  - The packing mechanism of the secondary structures (4-alpha-helices and 3(10)
      helix) of cytochrome b562 is simulated by the "island model," where the formation
      of protein structure is accomplished by the growth-type mechanism with the
      driving force of packing of the long-range and specific hydrophobic interactions.
      Packing proceeds through the formation of the structure at the nonhelical part,
      where a lot of hydrophobic pairs are distributed. Consequently, conformation,
      nearly similar to the native one, is successfully obtained. With the help of this
      result, the theoretical prediction of the possibility of forming this disulfide
      mutant (N22C/G82C) of b562 can be performed prior to the experiments by our
      geometrical criterion ("lampshade"). This criterion is expected to be a
      significant principle for introducing possible disulfide bonds into a protein to
      be engineered.

PMID- 8489701
TI  - Conformational analysis and proteolytic processing of synthetic pre-pro-GnRH/GAP
      protein.
AB  - Homogeneous pre-pro-GnRH/GAP protein was recently synthesized in 100 mg
      quantities by solid-phase methods and surprisingly, the synthetic pre-pro
      protein, which normally does not escape the endoplasmic reticulum, was found to
      inhibit the release of prolactin from cultured pituitary cells. This is the first
      demonstration of significant biological activity associated with a precursor
      protein and provides the rationale for its further study. We now report the
      results of our initial examination of the conformational properties of pre-pro
      GnRH/GAP protein as a prelude to solving its solution phase conformation by
      homonuclear 1H-NMR protocols. Thermal and pH titration fluorescence and circular
      dichroism spectroscopies reveal that the protein is resistant to thermal-induced
      conformational changes but is particularly sensitive to pH-induced conformational
      changes; while Asp/Glu and Arg residues may contribute to structural stability,
      His and Lys residues predominate. Pre-pro-GnRH/GAP is about 30% helix in the
      range of 2-40 degrees C; however, even at 90 degrees C, the peptide retains
      nearly 50% of its helix character. There is no evidence for a cooperative
      transition; for this reason, differential scanning calorimetry failed to yield a
      defined transition thermogram. Pre-pro-GnRH/GAP apparently does not pass through
      a transition state as a function of temperature but appears to flex and retain a
      high percentage of helix structure, resulting in subtle changes in secondary
      structure. There is no discernible isodichroic point. On either side of the
      neutral pH range, however, there are dramatic changes in structure that result in
      nonreversible denaturation of the protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489702
TI  - Conformation and activity of Phaseolus coccineus var. rubronanus lectin.
AB  - The conformation of native and denatured Phaseolus coccineus var. rubronanus
      lectin was studied by circular dichroism (CD) and correlated to the
      hemagglutinating activity. The far-UV CD spectrum at 25 degrees C showed a broad,
      negative band around 223 nm and a positive one at 196 nm. CD data analysis of the
      lectin indicated a beta-sheet-rich protein. At high temperatures, the spectrum
      was blue-shifted with increasing magnitude; these changes correlated well with
      the loss of the activity. The conformation of lectin between pH 2 and 10 remained
      essentially unchanged. At pH 13 the CD spectrum resembled that of unordered form
      with a negative band near 200 nm and the activity was completely lost. The
      denatured lectin in 6 M guanidine hydrochloride would be renatured upon diluting
      the denaturant to 0.75 M; the changes in CD spectrum again correlated well with
      the loss of the activity. The effect of sodium dodecyl sulfate on the lectin was
      drastic; it sharply increased the alpha-helix at the expense of the beta-sheet
      and reduced the activity; the changes reached a plateau above 20 mM surfactant.

PMID- 8489703
TI  - A new approach to predicting protein folding types.
AB  - A new method is proposed for predicting the folding type of a protein according
      to its amino acid composition based on the following physical picture: (1) a
      protein is characterized as a vector of 20-dimensional space, in which its 20
      components are defined by the compositions of its 20 amino acids; and (2) the
      similarity of two proteins is proportional to the mutual projection of their
      characterized vectors, and hence inversely proportional to the size of their
      correlation angle. Thus, the prediction is performed by calculating the
      correlation angles of the vector for the predicted protein with a set of standard
      vectors representing the norms of four protein folding types (i.e., all alpha,
      all beta, alpha + beta, and alpha/beta). In comparison with the existing methods,
      the new method has the merits of yielding a higher rate of correct prediction,
      displaying a more intuitive physical picture, and being convenient in
      application. For instance, in predicting the 64 proteins in the development set
      based on which the standard vectors are derived, the average accuracy rate is
      83.6%, which is higher than that obtained for the same set of proteins by any of
      the existing methods. The average accuracy predicted for an independent set of 35
      proteins of known X-ray structure is 91.4%, which is significantly higher than
      any of the reported accuracies so far, implying that the new method is of great
      value in practical application. All of these have demonstrated that the new
      method as proposed in this paper is characterized by an improved feature in both
      self-consistency and extrapolating-effectiveness.

PMID- 8489704
TI  - Fluorescence quenching in riboflavin-binding protein and its complex with
      riboflavin.
AB  - Fluorescence quenching of tryptophan residues in egg-white riboflavin-binding
      protein by two typical quenchers (charged iodide and uncharged acrylamide)
      reveals acid-induced changes of protein conformation. At neutral pH, acrylamide
      flow in macromolecule, (i.e., the quenching effect) is decisive; tryptophan
      residue accessibility for iodide is small. At low pH, some tryptophan residues
      are exposed to the protein surface and become more accessible to iodide. In
      contrast, acrylamide is less able to permeate this conformational state of RBP.
      Fluorescence of tryptophan residues in riboflavin-RBP complex and chemically N
      bromosucinimide-modified RBP was quenched by iodide and acrylamide.

PMID- 8489705
TI  - An examination of structural interactions presumed to be of importance in the
      stabilization of phospholipase A2 dimers based upon comparative protein sequence
      analysis of a monomeric and dimeric enzyme from the venom of Agkistrodon p.
      piscivorus.
AB  - Phospholipases A2 may exist in solution both as monomers and dimers, but enzymes
      that form strong dimers (KD approximately 10(-9) M) have been found, thus far,
      only in venoms of the snake family Crotilidae. The complete amino acid sequences
      of a basic monomeric and an acidic dimeric phospholipase A2 from Agkistrodon
      piscivorus piscivorus (American cottonmouth water moccasin) venom have been
      determined by protein sequencing methods as part of a search for aspects of
      structure contributing to formation of stable dimers. Both the monomeric and
      dimeric phospholipases A2 are highly homologous to the dimeric phospholipases A2
      from Crotalus atrox and Crotalus adamanteus venoms, and both have the seven
      residue carboxy-terminal extension characteristic of the crotalid and viperid
      enzymes. Thus, it is clear that the extension is not a prerequisite for
      dimerization. Studies to date have revealed two characteristic features of
      phospholipases A2 that exist in solution as strong dimers. One is the presence in
      the dimers of a Pro-Pro sequence at position 112 and 113 which just precedes the
      seven residue carboxy-terminal extension (residues 116-122). The other is a low
      isoelectric point; only the acidic phospholipases A2 have been observed, thus
      far, to form stable dimers. These, alone or together, may be necessary, though
      not sufficient conditions for phospholipase A2 dimer formation. Ideas regarding
      subunit interactions based upon crystallographic data are evaluated relative to
      the new sequence information on the monomeric and dimeric phospholipases A2 from
      A.p. piscivorus venom.

PMID- 8489706
TI  - Studies in C-terminal sequencing: new reagents for the synthesis of
      peptidylthiohydantoins.
AB  - In previous studies aimed at the sequencing of peptides and proteins from the
      carboxy terminus, we have derivatized the C-terminus to a thiohydantoin using
      acetic anhydride and trimethylsilylisothiocyanate (TMS-ITC) and subsequently
      hydrolyzed it to form a shortened peptide capable of further degradation and an
      amino acid thiohydantoin which can be identified by reverse-phase HPLC. Current
      limitations to this chemistry include an inability to derivatize proline and low
      yields with asparagine and aspartic acid residues (Bailey et al., 1992). In an
      attempt to solve some of these problems, we have investigated the use of reagents
      other than acetic anhydride for the activation of the C-terminal carboxylic acid.
      These include 2-fluoro-1-methylpyridinium tosylate, 2-chloro-1-methylpyridinium
      iodide, and acetyl chloride. Addition of TMS-ITC to peptides activated by the 2
      halo-pyridinium salts formed the expected peptidylthiohydantoin, but in addition
      formed a peptide chemically modified at the C-terminus which was blocked to C
      terminal sequence analysis. This derivative was not obtained when either acetic
      anhydride or acetyl chloride was used for activation. Formation of this
      derivative was found to require the presence of an isothiocyanate reagent in
      addition to the halo-pyridinium salt. Sodium thiocyanate, TMS-ITC, and a new
      reagent for thiohydantoin synthesis, tributyltinisothiocyanate (TBSn-ITC), were
      all found to be capable of forming this analogue. Structural elucidation of the C
      terminally modified amino acid revealed it to be a 2-imino-pyridinium analogue.
      Formation of this C-terminally blocked peptide could be minimized by the use of
      the 2-chloro-pyridinium reagent, rather than the 2-fluoro reagent, and by
      performing the reaction at a temperature of 50 degrees C or lower. The 2-halo
      pyridinium reagents offer potential advantages over the use of acetic anhydride
      for activation of the C-terminal carboxylic acid. These include: milder reaction
      conditions, faster reaction times, and the ability to sequence through C-terminal
      aspartic acid. The TBSn-ITC reagent was found to be comparable to TMS-ITC for
      formation of peptidylthiohydantoins.

PMID- 8489708
TI  - Secondary structural changes of large and small fragments of bovine serum albumin
      in thermal denaturation and in sodium dodecyl sulfate denaturation.
AB  - The helicities in various fragments of bovine serum albumin (BSA) were examined
      in the thermal denaturation and in sodium dodecyl sulfate (SDS) denaturation. The
      thermal denaturation was examined in a temperature range between 2 and 65 degrees
      C. The helicity decreased with a rise of temperature and it recovered to some
      degree upon cooling temperature. A rather high reversibility was observed in the
      BSA fragments, which were located in the N-terminal of the parent protein and
      then contained the first large loop with no disulfide bridge. The high
      reversibility was available also for the helicity in the first large loop of the
      fragment, disulfide bridges of which were reduced. The fragments, which were
      smaller than one domain, became unstable in the SDS denaturation. The helicities
      of such fragments decreased in lower SDS concentrations compared with those of
      the intact BSA and the large fragments, which contained one or more domains. A
      resistance to the SDS denaturation appeared in the helices of every large loop
      even after the fragmentation. On the other hand, helicities of the fragments
      decreased to 20-25% upon the reduction of disulfide bridges. However, the
      helicities of these fragments increased to 35-40% in the SDS denaturation.

PMID- 8489707
TI  - Tryptophan207 is involved in the GTP-dependent conformational switch in the alpha
      subunit of the G protein transducin: chymotryptic digestion patterns of the GTP
      gamma S and GDP-bound forms.
AB  - The limited proteolytic pattern of transducin, Gt, and its purified subunits with
      chymotrypsin were analyzed and the cleavage sites on the alpha t subunit were
      identified. The alpha t subunit in the GTP gamma S bound form was cleaved into a
      major 38 kD fragment, whereas alpha t-GDP was progressively digested into 38, 23,
      21, and 15 kD fragments. The beta gamma t subunit was not very sensitive to
      proteolytic digestion with chymotrypsin. The gamma t subunit was not cleaved and
      only a small portion of beta t was digested into several fragments. In order to
      determine which proteolytic fragment of alpha t still contained the carboxyl
      terminal region, chymotrypsinization was carried out using Gt previously 32P
      labeled at Cys347 by pertussis toxin-catalyzed ADP-ribosylation. The 32P-label
      was mainly associated with the alpha t subunit and a 15 kD fragment. The 23 and
      21 kD fragments were not 32P-labeled. Analysis of amino terminal sequences of 38,
      21, and 15 kD proteolytic bands allowed the identification of the major cleavage
      sites. Chymotrypsin had two cleavage sites in the amino terminal region of alpha
      t, at Leu15 and Leu19. Chymotrypsin removed 15-19 amino acid residues from the
      amino terminus of alpha t, generating two peptides (38 kD) which comigrates in
      gel electrophoresis. Chymotrypsin also cleaved at Trp207 in a conformation
      dependent manner. Trp207 of alpha t-GTP gamma S was resistant to proteolysis but
      alpha t-GDP and the 38 kD fragments of alpha t-GDP produced the 23 and 21 kD
      fragments, respectively, and a 15 kD fragment containing the carboxyl
      terminus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489709
TI  - Structural characterization of the two refold dimers of recombinant bovine
      somatotropin (bST).
AB  - Two major dimers are generated during the folding/oxidation of inclusion bodies
      of recombinant bovine somatotropin (bST). These dimers represent the major part
      of the inactive high molecular weight species that are formed in this process.
      The structures of the two dimers are unambiguously determined by peptide mapping
      using trypsin, thrombin cleavage, and selective DTT reduction experiments.
      Results indicate that the formation of both dimers involves the large disulfide
      loop cysteines. The latter-eluting dimer from RP-HPLC, previously reported as a
      large loop concatenated dimer, was revised to be an antiparallel disulfide-linked
      dimer. On the other hand, the first eluting dimer is a concatenane in which two
      monomers are held together by the interlocking of the two large disulfide loops.

PMID- 8489710
TI  - Cell proliferation and chemical carcinogenesis: a symposium overview.

PMID- 8489711
TI  - How many mutations are required for tumorigenesis? Implications from human cancer
      data.

PMID- 8489712
TI  - Genetic predisposition and mesenchymal-epithelial interactions in ras+myc-induced
      carcinogenesis in reconstituted mouse prostate.
AB  - Using a mouse prostate reconstitution (MPR) model system, strain-specific
      responses to the ras and myc oncogenes were investigated. When ras + myc were
      introduced into both the mesenchymal and epithelial compartments of the
      urogenital sinus, poorly differentiated prostate cancer was produced at a high
      frequency (> 90%) in inbred C57BL/6 mice. In contrast, under similar conditions,
      inbred BALB/c MPRs formed benign prostatic hyperplasia that converted to cancer
      at a low frequency (< 10%). Restricting the oncogenes to the mesenchymal or
      epithelial compartments revealed that oncogene activities were more pronounced in
      the mesenchyme of C57BL/6 mice and resulted in elevated transforming growth
      factor-beta 1 expression along with a severe desmoplastic reaction. Heterologous
      MPRs composed of BALB/c mesenchyme and C57BL/6 epithelium or vice versa
      demonstrated that intrinsic properties of BALB/c mesenchyme can arrest the
      progression of ras + myc-initiated C57BL/6 epithelium from benign hyperplasia to
      malignant carcinoma.

PMID- 8489713
TI  - Carcinogen-induced diploid hepatocytes: sensitive target cells for transformation
      by mutated c-Ha-ras oncogene.
AB  - Sequential treatment of partially (two-thirds) hepatectomized rats with
      diethylnitrosamine and 2-acetylaminofluorene induces the emergence of diploid
      hepatocytes in rat liver. These carcinogen-induced diploid cell populations are
      thought to contain the progenitors of hepatocellular carcinoma (HCC), i.e.,
      initiated, cells. In the study presented here, we addressed the question of
      whether putative mutations in carcinogen-induced diploid hepatocytes can
      cooperate with activated oncogenes in the process of transformation in vitro.
      Both carcinogenesis in vivo and transformation in vitro have been shown to be
      multistep processes requiring at least two independent transforming events.
      Diploid and polyploid rat hepatocytes were isolated by centrifugal elutriation.
      The purity of the elutriated fractions was 88 +/- 3% in the diploid fraction and
      84 +/- 3% in the polyploid fraction. Hepatocytes from both the elutriated cell
      fractions and, for comparison, hepatocytes from untreated rats were transfected
      by electroporation with oncogene expression vectors containing the mutated human
      T24 c-Ha-ras gene and of the N-myc gene. Transient expression of transfected DNA
      was similar in both hepatocyte populations. No cell lines could be established by
      using the N-myc vector. In contrast, the carcinogen-induced diploid hepatocytes,
      but not polyploid hepatocytes, could be converted by transfection with the ras
      vector into permanent anchorage-independent growing cell lines with hepatocyte
      like morphology and differentiation. These cell lines expressed the myc proto
      oncogene and transforming growth factor-alpha constitutively. Thus, carcinogen
      induced diploid hepatocytes are sensitive to transformation by the ras oncogene,
      suggesting cooperation between putative preexisting mutations in the diploid
      cells and the ras oncogene product in hepatocellular transformation.

PMID- 8489714
TI  - Application of denaturing gradient gel blots to detect p53 mutations in X-ray
      transformed mouse C3H 10T1/2 clones.
AB  - The denaturing-gradient gel electrophoresis (DGGE) blot technique is a highly
      sensitive method developed to detect sequence differences (e.g., single base
      changes and small deletions) in genomic DNA. We used this method to screen for
      mutations within the p53 locus of independent X-ray-transformed C3H 10T1/2 cell
      clones. Genomic DNA from 29 transformed clones was digested with Haell and Hinfl
      endonucleases, electrophoresed on denaturing gradient gels, electroblotted onto
      nylon membranes, and hybridized to a radioactive p53 cDNA probe. Changes in the
      melting pattern of p53 were observed in DNAs from 9 of 29 X-ray-transformed
      clones examined. No changes were found in untransformed, wild-type 10T1/2 cell
      clones. These results indicate that X-ray-induced p53 mutations may contribute to
      cell transformation.

PMID- 8489715
TI  - Assessing satiation in the bottle-fed baby.

PMID- 8489716
TI  - Milk bank screening procedures.

PMID- 8489717
TI  - Inactivation of human immunodeficiency virus type I in human milk: effects of
      intrinsic factors in human milk and of pasteurization.
AB  - Human milk was inoculated with human immunodeficiency virus type I (HIV-1) or
      with HIV-1-infected cells in volumes and containers typically used in human milk
      banks. The inoculated milk was pasteurized at 62.5 degrees C for 30 minutes in a
      water bath, i.e., conditions currently in use or proposed for human milk
      pasteurization. The process of HIV-1 inoculation and pasteurization effectively
      inactivated the infectivity of both cell-free HIV-1 and HIV-1-infected cells. No
      virus was recovered after the process, even after repeated subculturing in
      attempts to rescue the virus. Pasteurization reduced the infectious titer of cell
      free HIV-1 and HIV-1-infected cells by more than 5 logs and 6 logs respectively.
      Human milk contains one or more components that inactive HIV-1 but that are not
      toxic for the cells used to replicate virus. These components have not been
      identified, but physical and solubility properties are consistent with
      characteristics of lipids.

PMID- 8489718
TI  - Breast pads: their effectiveness and use by lactating women.
AB  - The diversity of breast pads available and absence of data on their effectiveness
      led the Breastfeeding Association of South Africa to design laboratory simulation
      experiments measuring fluid retention and evaporative properties as indicators of
      pad surface dryness. Questionnaires distributed at four breastfeeding clinics
      were used to obtain data on mothers' use of pads and incidence of breast
      problems. The majority of mothers surveyed used a new disposable breast pad made
      by Johnson & Johnson. The experimental studies showed that this pad allowed no
      leaking and kept the breast markedly drier than other disposables. Exclusive use
      of these pads or cotton towelling pads did not produce a detectable increase in
      nipple problems. A home-made disposable breast pad using a nappy (diaper) liner
      encasing toilet paper was most effective at keeping the breast dry and offered
      good protection against leaking. Since it is economical and easy to use, it is
      recommended as a good alternative to expensive disposables. Clinging materials,
      e.g. gauze, cottonwool or paper, and panty liners, maintain excessive surface
      dampness and are not recommended. If used, two layers of nappy liner on the inner
      surface may enhance nipple dryness.

PMID- 8489719
TI  - Treatment of inverted nipples using a disposable syringe.
AB  - Seven mothers who had inverted nipples were helped to breastfeed their infants
      with the assistance of a simple device made from a 10 ml disposable syringe.
      These women were able to successfully breastfeed within one week. On follow-up,
      these mothers were able to sustain adequate breastfeeding.

PMID- 8489720
TI  - AIDS and breastfeeding: the ultimate paradox.

PMID- 8489721
TI  - Supporting the father when an infant is breastfed.
AB  - Breastfeeding is the best form of infant nutrition for mother and infant, but
      because it perpetuates the exclusive mother-infant relationship that existed
      during pregnancy, the father may feel excluded, jealous, and resentful to the
      detriment of breastfeeding success and the adult couple relationship. Supporting
      the father during breastfeeding may help improve the mother's satisfaction with
      breastfeeding, duration of breastfeeding, and adaptation of both parents to
      parenting. This paper provides recommendations for education and support related
      to breastfeeding based on recent research findings on the male experience of
      expectant and new parenthood. Recommendations based on these findings focus on
      anticipatory guidance about breastfeeding, anticipatory guidance to support the
      adult couple relationship during the transition to parenthood, and ways to
      enhance the father-infant relationship.

PMID- 8489722
TI  - Breastfeeding after pituitary resection: support for a theory of autocrine
      control of milk supply?
AB  - A 20-year-old woman with a history of pituitary resection complicated by diabetes
      insipidus was able to fully breastfeed for three months despite apparent
      hyposecretion of pituitary hormones. This case report adds to the growing body of
      evidence that control of milk production shifts from endocrine to autocrine
      control shortly after delivery. Autocrine control allows efficient regulation of
      milk supply to match the needs of the infant. A recently discovered factor in
      human milk that inhibits lactose and casein synthesis in vitro is believed to be
      responsible for local, short term control of milk production. This study suggests
      that practices which result in infrequent or incomplete removal of milk from the
      breast lead to decreased milk production and should be abandoned.

PMID- 8489723
TI  - Applying for provider status with insurance companies.

PMID- 8489724
TI  - Antiinfectives in breastmilk. Part III: Antituberculars, quinolones and urinary
      germicides.

PMID- 8489725
TI  - HIV and breastmilk: what it means for milk banks.

PMID- 8489726
TI  - On the wasting diseases of infants and children. 1885.

PMID- 8489727
TI  - We know where we have come from, but where are we going?

PMID- 8489729
TI  - A digest of the statistical report of the 1992 examination.

PMID- 8489728
TI  - 1-800 numbers of breastfeeding information.

PMID- 8489730
TI  - Is gentian violet safe?

PMID- 8489732
TI  - Folk wisdom, snakes, and mother's milk.

PMID- 8489731
TI  - Contemporary parents' needs and advice on sleep patterns.

PMID- 8489733
TI  - Dietitian/lactation consultant seeks others working in a children's hospital.

PMID- 8489734
TI  - Oversupply and retained placental fragment.

PMID- 8489735
TI  - The usefulness of cell surface markers in predicting the prognosis of non
      Hodgkin's lymphomas.
AB  - The Working Formulation for classification of non-Hodgkin's lymphomas provides
      useful prognostic information. Since this scheme was published in 1982, many
      studies have investigated the prognostic significance of various cell surface
      markers in lymphoma cases. This article reviews the value of distinguishing T
      cells from B cells, CD5+ B cells, immunoglobulin light chain types, proliferation
      antigens such as Ki 67, other markers of B-cell differentiation, and chromosomal
      anomalies. Each of these contributes some further prognostic significance to that
      already determined by the Working Formulation.

PMID- 8489736
TI  - [Risk of low birth weight in the Plaza de la Habana region].
AB  - The objective of this study was to confirm the risk factors (RF) for low birth
      weight (LBW) and suggest new risk factors, which were analyzed separately and
      together, in order to define a program to be coordinated by family doctors to
      reduce the frequency of this problem. For this purpose, a retrospective cross
      sectional survey was carried out with 57 cases (mothers who had had LBW babies)
      and 58 controls (mothers who had not had LBW babies). In addition, data were
      obtained from the prenatal records of mothers who received care at family
      doctors' offices and at the clinica in the Plaza de la Habana Area. Estimates
      were made of the relative risk and the percentage attributable risk of 107
      hypothetical RF for LBW from a clinical-epidemiological and social standpoint.
      One-way analysis of variance, the chi-square test, multiple linear regression,
      and logistic regression were used to analyze the results, which suggested the
      following RF for LBW: family dysfunction, family crisis, lack of spousal support,
      extended family, failure to attend prenatal group sessions for pregnant women,
      and failure to receive education on how to prevent LBW. The multifactorial risk
      profile was the following: risk of [corrected] intrauterine growth retardation,
      family dysfunction, threat of preterm delivery, coffee-drinking, attendance at
      fewer than 11 prenatal checkups, and failure to attend prenatal group sessions
      for pregnant women. The variables excluded from the model were: low weight-for
      height, lack of spousal support, smoking more than 10 cigarettes a day, and
      family history of LBW. The findings confirmed 10 of the suspected risk factors
      for LBW in Cuba and nine of those described in the international literature.
      Maternal age, spontaneous abortion, and alcohol consumption were not confirmed.
      Six RF for LBW preventable by the family doctor through his/her actions at the
      family and community level are identified, as is a multifactorial profile of six
      RF for LBW. On the basis of these results, proposals are made in regard to
      programming priorities and the implementation of strategies aimed at preventing
      LBW, and it is recommended that the study be continued with a larger sample.

PMID- 8489737
TI  - [Inter-episode continuity of primary health care: proposal for an indicator].
AB  - The objective of this study was to assess the quality of the data included in
      patients' personal histories and to prepare an indicator of the continuity of
      health care between episodes of illness based on the information contained in
      these records. The study was descriptive. Public health specialists from the
      Department of Preventive Medicine of the University of Granada, Spain,
      participated in the design and analysis, and the field work was carried out by
      specialists from family and community medicine from the Zaidin-Sur Health Center
      of Granada, where the research was conducted in April to December 1989. For the
      study, 1581 personal histories were analyzed. The most complete records were
      those having to do with personal background (37% of the personal histories
      evaluated) and the most complete histories were those of pediatric patients,
      women, and persons who participated in programs organized by the health center.
      The degree of completeness of the records was low. Based on the indicator
      developed, only 16% of the histories at the Center contained sufficient
      information to allow continuity of care. It is recommended that simple records
      systems be created and that primary care physicians be educated in the collection
      of essential data.

PMID- 8489738
TI  - Microbial metabolism of quinoline and related compounds. XVII. Degradation of 3
      methylquinoline by Comamonas testosteroni 63.
AB  - A bacterial strain which utilizes 3-methylquinoline as sole source of carbon,
      nitrogen and energy was isolated from activated sludge. On the basis of its
      morphological and physiological characteristics, this isolate was classified as
      Comamonas testosteroni. Four metabolites of 3-methylquinoline degradation were
      isolated from the culture supernatant and identified as 3-methyl-2-oxo-1,2
      dihydroquinoline, 6-hydroxy-3-methyl-2-oxo-1,2-dihydroquinoline, 5,6-dihydroxy-3
      methyl-2-oxo-1,2-dihydroquinoline and 2,5,6-trihydroxy-3-methylpyridine. Based on
      these results, a degradation pathway for 3-methylquinoline is proposed.

PMID- 8489739
TI  - Evidence that the presumptive second nucleotide interacting site on actin is of
      low specificity and affinity.
AB  - The contractile protein actin contains one mole of firmly bound nucleotide and a
      number of divalent cations bound with different affinities. During recent years
      evidence for a second nucleotide interacting site on actin has been reported.
      Therefore, a specific search for the presence of a second nucleotide-interacting
      site on actin was undertaken. For this purpose G- and F-actin or actin in complex
      with deoxyribonuclease I (DNase I) was passed over ADP-agarose which was found to
      retain all three forms of actin. Nucleotide bound to the high affinity site of
      actin did not exchange during passage and retention to agarose-immobilized ADP,
      thus indicating the presence of a second nucleotide interacting site. This site
      was found to be equally accessible in G- and F-actin and in the actin-DNase I
      complex, whereas DNase I alone passed unretained through this column. A number of
      nucleotides and phosphorylated compounds were tested for their ability to compete
      with immobilized ADP for actin interaction. It was found that all forms of actin
      are liberated only by high concentrations (5mM) of ADP, ATP and NADH, by 1mM CTP
      and ITP, and by high salt concentrations (150mM NaCl). Since it was found that
      EDTA- and heat-treated actin were also retained on ADP-agarose, we conclude that
      this second nucleotide interacting site is of limited specificity, low affinity,
      and not dependent on the native configuration of actin. It exhibits
      characteristics of an unspecific, polyanionic site, but may represent the low
      affinity phosphate binding site.

PMID- 8489740
TI  - Endogenous heterogeneity of relaxin and sequence of the major form in pregnant
      sow ovaries.
AB  - Using an extraction procedure that minimized proteolysis, followed by gel
      filtration, cation-exchange FPLC, and reverse-phase HPLC, the present study
      unambiguously showed the presence of multiple isoforms of relaxin in the ovaries
      of pregnant sows. Four relaxin isoforms were isolated (designated as R-I1, R-I2,
      R-II1 and R-III1). They had a similar migration pattern on SDS/urea PAGE, and
      showed no significant difference in biological activity. HPLC separation of the
      reduced and S-pyridylethylated relaxin variants indicated that R-I1, R-I2 and R
      III1 each contained multiple relaxin molecules which showed variability of the B
      chain, whereas R-II1 contained mostly a single relaxin molecule with only slight
      B-chain variability. R-II1 was thus considered likely to be the major form of
      relaxin stored in the ovary. Sequence analysis revealed that R-II1 contained 22
      amino-acid residues in the A-chain and 29 residues in the B-chain, with a total
      molecular mass of 5814.8 Da. It was thus equivalent to CM-a' relaxin designated
      by Sherwood and O'Byrne (1974).

PMID- 8489741
TI  - Assisted suicide.

PMID- 8489742
TI  - The Roy Adaptation Model used as a guide for the nursing care of an 8-year-old
      child with leukemia.
AB  - Roy's Adaptation Model provides a framework for holistic oncology nursing
      practice. In this article, an overview of Roy's model is provided. It is used to
      assess the behaviors and stimuli influencing the behaviors of an 8-year-old boy
      with acute lymphocytic leukemia. Planning and evaluating the nursing care of this
      child is based on the model. A comprehensive list of nursing diagnoses is
      categorized according to Roy's four adaptive modes, and a nursing care plan for
      two of these diagnoses is presented.

PMID- 8489743
TI  - Designing a conceptual or theoretical framework for research.

PMID- 8489744
TI  - Practical application of an algorithm for the thrombolytic treatment of occluded
      vascular access devices.

PMID- 8489745
TI  - Health-related quality of life.

PMID- 8489746
TI  - Development of a preclinical model for hormonal therapy of human endometrial
      carcinomas.
AB  - Endometrial carcinoma is the most common gynaecological malignancy. Progestins
      are widely used in the treatment of advanced and metastatic disease with about 20
      40% response rate. Attempts to develop a predictive test for progestin
      sensitivity of endometrial cancers are plagued by the problems of steroid
      receptor instability and the heterogeneous distribution of progesterone receptor.
      Successful development of a nude mouse model for human endometrial carcinoma has
      permitted a detailed investigation of the biological behaviour, hormonal
      modulation and resistance to progestin therapy. Use of this preclinical model
      should enhance our understanding of the hormonal mechanisms and lead to improved
      rational treatment strategies for this malignancy.

PMID- 8489747
TI  - The role of laparoscopic lymphadenectomy in staging and treatment of urological
      tumours.
AB  - Laparoscopic lymphadenectomy for managing a variety of urological malignancies is
      likely to continue to increase in popularity. It is essential that the role of
      these procedures be critically evaluated to ensure that they offer significant
      benefit without added morbidity as compared with standard techniques. The
      challenge for the future is to better define selection criteria for laparoscopic
      surgery, particularly in men with clinically localized prostate cancer, so that
      both staging methods and therapy can be tailored to the individual patient.

PMID- 8489748
TI  - Exploring pathogenetic mechanisms using transgenic animals.
AB  - Molecular technologies for the permanent germ-line transformation of animals are
      now well established and routine. These new strains of animals, called
      transgenic, offer an unprecedented opportunity to gain a basic understanding of
      human genetic disorders. In this brief review we discuss the role of transgenic
      animals in the creation of new models of human disease and their experimental use
      in biomedical research. Models are now available for the study of the genetic
      processes involved in the pathogenesis of neoplasia, diabetes, atherosclerosis,
      and developmental abnormalities. Many others are available and new ones are being
      produced at a great rate. Principles of gene replacement therapy are amenable to
      analysis with transgenic animals and the information gained will be important for
      the development of rational therapy.

PMID- 8489749
TI  - Female contraception: changing priorities.

PMID- 8489750
TI  - Medical consequences of 2 years' postponement of childbirth in Sweden.

PMID- 8489751
TI  - Hormonal intrauterine devices.
AB  - Intrauterine administration of progestogens from an IUD was introduced more than
      15 years ago in order to improve the contraceptive efficacy and to reduce side
      effects. A device releasing 20 micrograms levonorgestrel daily (Levonova) with a
      life span of at least 5 years is now available and has been subjected to an
      extensive study including 1821 women followed during 5 years. The safety and
      efficacy were evaluated in comparison to Cu-T IUDs. The pregnancy rate (Pearl
      index) was 0.09. During the first two cycles after insertion intermenstrual
      bleeding was common, otherwise the frequency of side-effects was low. The results
      seem to justify the conclusion that intrauterine administration of progestogens
      represents a further development of IUDs and hormonal contraception. Furthermore,
      these devices have proven to be effective in treatment of heavy menstrual blood
      losses. In many menorrhagic women, use of these IUDs can replace more invasive
      surgical methods such as hysterectomy or endometrial resection. Intrauterine
      administration of progestogens is also effective in opposing the proliferative
      effect of oestrogen on the endometrium in women on hormonal replacement therapy.

PMID- 8489752
TI  - A Latin American experience with levonorgestrel IUD.
AB  - The intrauterine contraceptive device is an effective, safe and convenient
      contraceptive method. Its use in less developed countries has been limited by the
      increase in menstrual blood loss, an important issue in populations with a high
      prevalence of anaemia. The levonorgestrel releasing IUD (LNg IUD) is the first
      device which is at the same time highly effective, long-lasting and reduces the
      blood loss during menstruation. This device was tested in 200 volunteers in Santo
      Domingo, Dominican Republic and in 381 in Campinas, Brazil. The cumulative
      pregnancy rate was 0 up to 7 years of use. The reduced bleeding was confirmed,
      and ferritin concentration among long-term users of the LNg IUD was significantly
      higher than among copper IUD users and controls using no contraception. Mean
      levonorgestrel plasma levels remained above 100 pg/ml until the seventh year of
      use. Endometrial histology showed mainly a marked reduction in epithelial growth,
      with variable signs of decidualization of the stroma. The most important reason
      for discontinuation in the two centres was amenorrhea, with cumulative rates of
      10 and 15, respectively. This device should be very well accepted and will have a
      clear niche among reversible contraceptives, when available.

PMID- 8489753
TI  - NORPLANT: levonorgestrel-releasing contraceptive implant.
AB  - NORPLANT is the newest contraceptive system to be introduced world-wide, with
      nearly a million current users. It consists of six Silastic capsules containing
      levonorgestrel (LNg), which are inserted under the skin in the arm. Release of
      the steroid commences immediately so that, after several weeks, circulating
      levels of LNg stabilize between 0.3 and 0.4 ng/ml of plasma, and they persist
      elevated with a minor decline for over 5 years. The gross cumulative pregnancy
      rate at 5 years is 2.6 per 100 woman-years. In the majority of women it produces
      no abnormalities in a variety of clinical chemistry, metabolic, haematological
      and coagulation parameters. The most common side-effect is disruption of the
      menstrual bleeding pattern; this is reported by two-thirds of the users in the
      first months and by one-third by the fifth year. Because it is the most
      disturbing side-effect for many users, counselling prior to insertion is of
      paramount importance. NORPLANT exerts varying degrees of gonadotrophin and
      ovarian inhibition, including anovulation and luteal insufficiency. Endometrial
      development is irregular and, irrespective of oestrogen levels, cervical mucus is
      thick and scanty at all times due to the strong antioestrogenic effect of LNg.
      Inhibition of sperm penetration fully accounts for the antifertility effect of
      NORPLANT in ovulatory cycles. The high contraceptive efficacy, lack of serious
      side-effects, reversibility and the convenience of long-term unattended use
      explain the high acceptability of NORPLANT.

PMID- 8489754
TI  - NORPLANT and the levonorgestrel IUD in Chinese family planning programmes.
AB  - NORPLANT was introduced into the Chinese family planning programmes in 1984 by
      the Population Council. After a pilot study of 1200 cases in four centres in
      China, the study was expanded to 12 centres with 10,718 cases of NORPLANT and
      1208 cases of NORPLANT-2 followed up for more than 6 years. The 5 years net
      cumulative pregnancy rates were 0.5-1.2 and the net cumulative continuation rates
      were around 65-72 per 100 users. There were significant differences in pregnancy
      rates between different groups of body weight and age, i.e. the pregnancy rates
      were higher in groups with body weight over 70 kg and those aged below 25 years.
      The age, body weight and dependence on contraceptive effectiveness of NORPLANT
      should be taken into account in the selection of users. Nationwide large-scale
      studies in provincial and country rural areas and postmarketing surveillance are
      being carried out. Changes in ovarian function and endometrium have been studied.
      Levonorgestrel IUD (LNg-IUD) was introduced into China in 1985. Comparative
      clinical studies on NORPLANT and LNg-IUD, pharmacokinetic and pharmacodynamic
      studies and endometrial studies of LNg-IUD were performed. The higher percentage
      (55.1%) of ovarian suppression in Chinese users of LNg-IUD may be attributed to
      ethnic differences among Caucasian women in their susceptibility to steroid
      hormones. Results showed favourable acceptance of both devices among Chinese
      women. The studies promoted the incorporation of new long-acting contraceptive
      methods into the Chinese family planning programmes.

PMID- 8489755
TI  - Experience with NORPLANT in Egypt.
AB  - Experience with the contraceptive NORPLANT in Egypt dates back to early 1980 when
      the first multicentre trial was initiated. To date, more than 3000 women have
      received this contraceptive at the Assiut University Family Clinic alone.
      Analysis of the overall experience in this clinic has indicated a 5-year
      cumulative continuation rate of 51 and a pregnancy rate of 1.8 per 100 women.
      Clinical pharmacology studies pertaining to the safety of NORPLANT in our
      community have indicated no deleterious effect on the lipid profile, liver
      functions and blood coagulation system. Two studies conducted in Egypt have
      indicated that the initiation of NORPLANT use shortly after delivery does not
      have any unfavourable effect on lactational performance, or on physical or
      psychomotor development of the breast-fed infants. This is particularly important
      in Arab and Moslem cultures where prolonged breast-feeding is emphasized. A study
      utilizing focus-group discussion to assess users' attitudes to NORPLANT has
      indicated the need to improve the informational/educational package given in the
      service by emphasizing certain cultural considerations. On the whole, this first
      implant method has proven to be safe and acceptable in Egypt, where there is a
      special need for long-term methods for contraception, particularly as
      sterilization is not socially acceptable.

PMID- 8489756
TI  - Intrauterine contraceptive device and pelvic inflammatory disease.
AB  - Comprehensive, mainly epidemiological data has helped us to recognize the
      strongest risk factors of pelvic inflammatory disease during intrauterine
      contraceptive device use. These are user's exposure to sexually transmitted
      diseases, young age and insertion of the device. Moreover, parity of the user and
      type of device may affect the risk of pelvic infection.

PMID- 8489757
TI  - Lactational infertility in family planning.
AB  - The contraceptive effect of breast-feeding is the single most important
      determinant of human population growth rates in traditional societies without
      access to modern forms of contraception; lactational amenorrhoea is Nature's
      contraceptive. Even today, breast-feeding still prevents more pregnancies than
      all modern forms of contraception in many developing countries. Afferent neural
      inputs from the nipple pass via the spinal cord to the hypothalamus, where they
      cause a local release of beta endorphin. This acts to depress GnRH secretion,
      thereby inhibiting pituitary gonadotrophin secretion, ovarian follicular
      development, ovulation and menstruation. The hypothalamic beta endorphin release
      also inhibits dopamine production, resulting in increased pituitary prolactin
      secretion. The higher the suckling frequency, the more beta endorphin that is
      released and hence the longer the duration of lactational amenorrhoea.
      Lactational amenorrhoea can be relied up to give over 98% contraceptive
      protection to breast-feeding women in the first 6 months postpartum, regardless
      of their nutritional status or the time of first supplement introduction to the
      baby. This is because the first postpartum menstruation usually precedes the
      first ovulation during these early months. Once menstruation has resumed,
      lactation's contraceptive effect can no longer be relied upon, even though the
      woman continues to breast-feed. In breast-feeding women whose amenorrhoea extends
      beyond 6 months, there is an increasing tendency for the first ovulation to
      precede the first menstruation, thereby decreasing the reliability of lactational
      amenorrhoea as a contraceptive. Nevertheless, many women who continue to breast
      feed may still have up to 1-2 years of good contraceptive protection from
      prolonged lactational amenorrhoea.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489758
TI  - Contraception during lactation.
AB  - The probability of pregnancy is very small during the first 2 months after
      delivery if the mother breast-feeds. The risk remains small for 6 months if the
      mother is fully breast-feeding her infant, is still amenorrhoeic and the child
      does not receive additional food. Under these conditions there is only about a 2%
      chance of pregnancy. Even full breast-feeding does not inhibit ovarian function
      after 6 months. Breast-feeding is a very important and efficient contraceptive
      method in the developing countries, but it is also a useful method in developed
      countries during the early puerperium. Barrier methods and progestogen-only
      hormonal methods (pills, implants and injectables) are the primary contraceptive
      alternatives during breast-feeding. They have no adverse effects on lactation,
      the condition of the infant or on maternal ovarian function. Sterilization is
      only a good alternative if the family wants a permanent method of contraception.
      Careful insertion of an IUD is possible even before the first menstrual period.
      Puerperal insertion of an IUD needs expertise and training because of the
      vulnerability of the very soft puerperal uterine wall. Combined oral
      contraceptives diminish milk production and therefore combined oral
      contraceptives are not recommended during lactation.

PMID- 8489759
TI  - Postabortal contraception.
AB  - The return of fertility is rapid after first trimester abortion. The first
      ovulation may take place as soon as 2 weeks after abortion, and half of the women
      have ovulated by 3 weeks. Hence, commencement of effective contraception is
      necessary even before the first postabortal menstrual period. Women are highly
      motivated as regards contraception at this time. Several studies, both in
      developed and developing countries, have shown that the insertion of a modern
      copper intrauterine device (IUD) at the end of the abortion procedure is a safe
      and well-accepted way to start the method. Hormonal methods, such as NORPLANT,
      levonorgestrel-releasing IUD, injectables and oral combination pills do not
      affect the recovery of the pituitary-ovarian system, even though introduced
      immediately after abortion. The combination of preceding pregnancy, abortion
      procedure and immediate start of low dose oral contraceptives containing 30
      micrograms of ethinyloestradiol results in a slight tendency towards
      hypercoagulability. This may be clinically insignificant, but it can be avoided
      by postponing oral contraceptives until 1 week after abortion, without losing the
      contraceptive efficacy of the method.

PMID- 8489760
TI  - Vaginal contraceptive rings.
AB  - Steroids diffuse through polysiloxone at a constant rate, and steroids placed in
      the vagina rapidly pass through the vaginal epithelium into the circulation.
      Combining these principles led to the development of contraceptive vaginal rings
      (CVR) consisting of various progestins, with and without oestrogen, placed in
      flexible polysiloxone, doughnut-shaped devices. As occurs with oral
      contraceptives, the CVRs containing progestin plus oestrogen are left in the
      vagina for 3 weeks and removed for 1 week to allow withdrawal bleeding, while
      CVRs releasing a small dose of progestins without oestrogen are left in the
      vagina continuously for several months. Large-scale, clinical trials were
      performed with a low dose levonorgestrel-releasing-only CVR by the WHO. At 1
      year, continuation rates were about 50 per 100 women with 17.2 per 100
      discontinuing for menstrual problems and 4.5 for pregnancy. Two sizes of a CVR
      containing levonorgestrel and oestradiol were studied in a multinational trial
      organized by the Population Council. At the end of 1 year, about half the women
      were continuing with the method, one-quarter had discontinued because of bleeding
      problems, and pregnancy rates were between 1 and 2 per 100 women. The CVR was
      well accepted by women and their partners, but because of lowered HDL-cholesterol
      levels and accelerated atherosclerosis in female monkeys, further development of
      this formulation was discontinued. Recently, phase II clinical trials with CVRs
      containing combinations of NET-acetate plus ethinyloestradiol and 3
      ketodesogestrel plus ethinyloestradiol have been undertaken. These CVRs provide
      good bleeding control, inhibit ovulation consistently and do not have an adverse
      effect on serum lipids. Phase III trials with these two types of CVRs will be
      initiated shortly.

PMID- 8489761
TI  - 7 alpha-methyl-nortestosterone (MENT): the optimal androgen for male
      contraception.
AB  - Many methods of contraception involve the use of drugs that affect the secretion
      of hormones essential for reproduction. Oestrogens and progestins have been used
      for contraction in women as inhibitors of gonadotrophin secretion and ovulation.
      Similarly, androgens must be used in methods of fertility control for men that
      block gonadotrophin secretion. Androgen supplementation currently involves large,
      frequent doses of testosterone esters that are associated with wide fluctuations
      of plasma testosterone levels. Hence, there is a need for an androgen preparation
      that provides appropriate, continuous replacement doses over long periods. To
      achieve this goal, 7 alpha-methyl-19-nortestosterone (MENT), a synthetic androgen
      that is considerably more potent than testosterone, is suitable. As a
      consequence, it is feasible to administer this androgen as a substitute for
      testosterone for 1 year by subdermal implants. Another important feature of MENT
      is that it does not undergo 5 alpha- reduction in prostate as does testosterone.
      As a consequence, a dose of MENT sufficient to maintain normal muscle mass and
      gonadotrophin secretion will not hyperstimulate the prostate because its action
      in this organ is not amplified as is that of testosterone. Thus, MENT can be
      administered to men with the assurance that it will be less prone to cause
      diseases of the prostate than testosterone. CONCLUSIONS: (i) MENT is the first
      androgen that has a health benefit compared to testosterone; (ii) MENT will be
      promoted as one component of a two-implant system for male contraception, the
      other component being an implant that will release an LHRH analogue; (iii) MENT
      has potential uses in patients with a variety of disorders, including
      hypogonadism, prostatic hyperplasia and muscle wasting.

PMID- 8489762
TI  - Air & Waste Management Association's Government Agencies Directory.

PMID- 8489763
TI  - Cleavage of tumor necrosis factor-alpha by Legionella exoprotease.
AB  - The role of the major secretory protein of Legionella pneumophila, a zinc
      protease, in Legionella infection is not known. Since an important step of the
      host reaction in Legionnaires' disease is the production of tumor necrosis factor
      alpha (TNF-alpha) by alveolar macrophages, we studied the interaction of
      Legionella protease and U-937 cells with respect to TNF-alpha. The Legionella
      protease was purified by fractionated precipitation, gel filtration and
      hydrophobic interaction chromatography. The purified enzyme was added to U-937
      cells, a promyelocytic cell line. In the supernatants of PMA-treated U-937 cells
      we found low concentrations of TNF-alpha after incubation with protease.
      Therefore we pursued the hypothesis of direct enzymatic degradation of TNF-alpha
      by Legionella protease. Enzymatic cleavage of TNF-alpha was proven by SDS-PAGE,
      ELISA and TNF-alpha bioassay with L-929 cells. The degradation of TNF-alpha by
      the Legionella protease was shown in all three systems. Enzymatic degradation of
      TNF-alpha might be important for the pathogenesis of Legionnaires' disease.

PMID- 8489764
TI  - Stereologic studies on collagen in bovine articular cartilage.
AB  - In an ultrastructural stereologic study on bovine articular cartilage we found
      that collagen volume density increased with increasing distance from the joint
      surface and from the chondrocyte. These results not only corroborate previous
      biomechanical data of a vertical stiffness gradient, but they also suggest that
      the mechanical forces are unevenly distributed horizontally. On the other hand,
      although mean collagen fibril diameter showed large differences between the
      interterritorial compartments of the three zones, there was a population of
      slender fibrils in all zones and compartments. Since the coarser fibrils provide
      the high tensile strength (Nimni 1988), the role of the slender fibrils may be to
      enhance the deformability of the tissue. Moreover, in spite of substantial
      differences in mean fibril diameter, collagen surface densities were in the same
      order of magnitude in the territorial and interterritorial compartments, and only
      slightly lower in the pericellular compartments. The surface parameter may be
      important for specific molecular interactions. The collagen fibrils have
      different polarity, i.e. the direction of the fibrils appears to be parallel and
      antiparallel, about 50% running in each direction. This, together with the very
      high length/diameter ratio (Clark 1985), may indicate that each fibril is
      assembled by the concerted action of many cells. The characteristic properties of
      articular cartilage depend on interactions between its macromolecular components,
      and the present quantitative data form a basis for discussions on the specificity
      and regulation of such interactions.

PMID- 8489765
TI  - Adherence and surface properties of buoyant density subpopulations of group B
      streptococci, type III.
AB  - From clinical isolates of group B streptococci, buoyant density subpopulations
      with variable amounts of type-specific polysaccharide can be derived. The ability
      of these subpopulations to adhere to vaginal epithelial cells and to glass was
      assessed by using [3H]-labeled bacteria. Subpopulations with no or minute amounts
      of capsule showed good adherence capacity and a hydrophobic cell surface. In
      contrast, a large capsule made the bacteria less adherent and rendered their
      surface hydrophilic. A negative cell surface charge, judged by determination of
      the z-potential, was directly related to the amount of capsule. Proteinase K
      treatment of less encapsulated variants significantly decreased the cell
      hydrophobicity. The ability of a GBS strain to express different surface
      characteristics may be a mechanism for adaptation to environmental changes, and
      may thereby contribute to the pathogenicity of GBS.

PMID- 8489766
TI  - Comparison of growth and susceptibility testing of pyrazinamide in different
      Bactec media using strains of the M. tuberculosis complex.
AB  - The aim of this study was to evaluate and compare growth and susceptibility
      testing of pyrazinamide (pza) in different Bactec media using 85 strains of the
      M. tuberculosis complex. Fifty-four were clinical isolates of M. tuberculosis, of
      which 34 strains were selected as they failed to grow in primary pza
      susceptibility testing. Fourteen were strains of M. bovis, 10 were different
      strains of M. bovis BCG, five were strains of M. africanum, and two were strains
      of M. microti. The following Bactec media were evaluated: (1) Bactec PZA test
      medium, (2) acidified Bactec 12B medium with pH reduced to 5.6, (3) acidified 12B
      medium supplemented with fresh egg yolk, (4) acidified 12B medium supplemented
      with a commercial egg yolk enrichment. Demonstration of pyrazinamidase activity
      was included for comparison. All strains of M. tuberculosis, M. microti and M.
      africanum were inhibited by pza at 100 micrograms/ml, and all strains of M. bovis
      and M. bovis BCG were found to be resistant to pza at 100 micrograms/ml. Bactec
      PZA test medium supported growth for all 85 strains tested. The two egg yolk
      supplemented media supported growth in all strains except one strain of M.
      microti, and acidified but otherwise unsupplemented Bactec 12B medium supported
      growth in 64 strains (75%). A pza sensitivity test result could be obtained
      within one week in > 79% of strains. An overall correlation of 89% between
      susceptibility to pza and demonstration of pyrazinamidase activity was
      demonstrated.

PMID- 8489767
TI  - A new Danish Listeria monocytogenes phage typing system.
AB  - A phage typing system was developed for Listeria monocytogenes. Phages were
      released from clinical and from food strains of L. monocytogenes by mitomycin C
      induction. The system consists of two subsystems, one of which is used to type L.
      monocytogenes serotype 1 strains, containing 12 phages, and a second which is
      used to type serotype 4 strains, containing 14 other phages. For the serotype 1
      subsystem, the reproducibility was > or = 90%, the typability 92%, and the
      discriminatory power, as judged by the discriminatory index, 80%. The
      corresponding figures for the serotype 4 subsystem were: reproducibility > or =
      94%, typability 87%, and discriminatory index 87%. The performance of the whole
      typing system is sufficient for it to be used for screening purposes.

PMID- 8489768
TI  - Mortality rate and bacteremia, endotoxin, and endothelin-1 levels in antibiotic
      therapy for E. coli septic peritonitis.
AB  - In order to study the mortality rate and bacteremia, plasma endotoxin, and plasma
      endothelin-1 levels in antibiotic therapy for E. coli peritonitis, blood samples
      were obtained from rats given intraperitoneal injections of latamoxef or placebo.
      Intraperitoneal injections of latamoxef improved the prognosis of peritonitis
      rats. Two h after treatment, bacteremia levels were noticeably higher in rats
      treated with placebo than in rats treated with latamoxef, but the latamoxef
      treated group manifested a significant elevation of plasma endotoxin and
      endothelin-1 levels compared to the placebo-treated group. The results of this
      study demonstrate that treating E. coli septic peritonitis with selected
      antibiotics induces increased plasma endotoxin levels, which are associated with
      elevation of plasma endothelin-1 levels.

PMID- 8489769
TI  - Effects of retinoic acid on interleukin-1 alpha and -1 beta expression by normal
      human keratinocytes cultured in defined medium.
AB  - In human epidermis, basal keratinocytes are the main source of interleukin-1 (IL
      1), and IL-1 alpha is the predominant form, whereas IL-1 beta appears to exist
      predominantly in cultured keratinocytes. We investigated the effects of retinoic
      acid (RA) treatments on IL-1 alpha and -beta protein and mRNA expression of
      normal human keratinocytes cultured in low-calcium defined medium with or without
      hydrocortisone. Radioimmunoassay showed that after stimulation by RA, the IL-1
      beta intracellular level is predominantly increased, with no significant
      modification of IL-1 alpha expression. The addition of hydrocortisone in the
      culture medium resulted in a decrease in RA-induced IL-1 beta overexpression,
      without notable modifications in untreated cultures. Release of both IL-1 alpha
      and -beta in culture supernatants was detectable only after RA treatment and in
      the absence of hydrocortisone. The overexpression of IL-1 beta in control and RA
      treated cultures mainly concerned the 52- and 31- to 36-kD biologically inactive
      precursor forms. Northern blot using specific IL-1 alpha and -beta
      oligonucleotide probes showed that IL-1 beta mRNA predominate over IL-1 alpha
      mRNA and reach a maximal level 6 h before the IL-1 beta protein peak. These
      findings indicate that in cultured keratinocytes intracellular IL-1 beta is
      preferentially increased by RA but in its immature forms. The significance of
      this overexpression remains to be elucidated.

PMID- 8489770
TI  - Porphyrin synthesis by murine epidermal cells.
AB  - Incubation of murine epidermal cells with delta-aminolevulinic acid (ALA)
      resulted in a dose- and time-dependent accumulation of porphyrins, predominantly
      of protoporphyrin. Porphyrin accumulation decreased in the presence of iron, and
      the iron-mediated decrease was partially reversed by CaMg EDTA (1.25-10.0 mM),
      suggesting that there is functionally active ferrochelatase in these cells. This
      study suggests that these cells may be a useful model for the study of cutaneous
      porphyrin metabolism involving ferrochelatase activity.

PMID- 8489771
TI  - Morphometric computerized analysis as a method to assess skin atrophy caused by
      corticosteroids.
AB  - We have employed morphometric computerized analysis to quantify changes in
      atrophic skin. Atrophy was induced on volunteers by means of the Duhring chamber
      assay, using two commercial corticosteroids with a steroid-free base as control.
      After 20 days, atrophy was assessed by subjective examination and rated on a five
      point scale. After 10 and 20 days, positive replicas of the areas under test were
      obtained. Photographic reproductions of these replicas were stored in the image
      memory of an interactive automatic computerized image analysis system, Kontron
      Zeiss Ibas 2, and processed with a suitable program. After selection of the
      measurement area by means of a circular measurement window, the 'continuous tone'
      image was converted to a 'binary' one by means of a dynamic discrimination
      function, in order to perform an automatic evaluation of the percentage area
      corresponding to the shadows cast by the surface markings. Morphometric
      computerized analysis proved to be a sensitive method for quantifying skin
      atrophy. A high degree of correspondence with subjective examination was shown.
      The method allows an objective differentiation between a mid-potency and a high
      potency topical corticosteroid.

PMID- 8489772
TI  - Transcutaneous CO2 and O2 diffusion.
AB  - Transcutaneous gas measurements offer a useful tool for non-invasive monitoring
      of skin function, but are affected by several variables that restrict their use
      in clinical and investigative dermatology. Skin thickness, stratum corneum and
      barrier function damage, blood vessel reactivity, arterial-gas concentration,
      skin and environmental temperature are important factors influencing
      transcutaneous gas flux. Improvement of techniques and standardization of methods
      with guidelines for operators should improve this interesting research approach.

PMID- 8489773
TI  - A method for the determination of viscoelastic parameters of human hair in
      relation to its structure.
AB  - An analytical model and the corresponding experimental procedure are presented,
      which make it possible to separately analyze the viscous and elastic components
      of human hair. Moreover, a computerized experimental system is described with
      which a standardized quantitative determination of the most important mechanical
      parameters of human hair can be performed. Comparative investigations of the
      mechanical behavior of hair specimens obtained from the frontoparietal and
      occipital scalp regions of 10 healthy human subjects showed no statistically
      significant differences with regard to their mechanical parameters. Nevertheless,
      the paired analysis of the mechanical parameters of thin and thick hair specimens
      revealed that the values of two of these parameters are significantly higher in
      thin than in thick hair specimens. These findings suggest that there are
      mechanical parameters of human hair related to gross hair morphology, whereas
      others depend on hair microstructure.

PMID- 8489774
TI  - Kinetics of sebum excretion evaluated by the Sebutape--Chromameter technique.
AB  - We present a novel method for studying the changing characteristics of sebum
      excretion of facial skin over a 3-hour period. Sebum production can be quantified
      by analysis of the pore patterns formed on a sebum-sensitive tape (Sebutape). We
      applied the CIE principles of reflectance colorimetry by measuring L*, a* and b*
      of Sebutapes every 15 min during 3 h of sebum collection. This combined technique
      yielded valuable new informations on the kinetics of sebum excretion, allowing
      the distinction between the follicular reservoir effect and the sebum flow.

PMID- 8489775
TI  - Lack of antiandrogenic effects of topical bifonazole on sebaceous glands and
      hairs in the hamster flank organ.
AB  - The activity of topically applied bifonazole was evaluated in vivo in the three
      androgen-dependent structures of the hamster flank organ, i.e. the pigmented
      spot, sebaceous glands and hairs. Topical bifonazole in our experience did not
      demonstrate any morphological effect on sebaceous gland and hair even when
      applied in the dosage of 3 mg/cm2/day. On the basis of our morphometric results
      we can conclude that topically applied bifonazole does not interfere with
      cutaneous androgen metabolic transformations in the pilosebaceous unit of the
      flank organ.

PMID- 8489776
TI  - Effect of some alkaloids, flavonoids and triterpenoids, contents of Japanese
      Chinese traditional herbal medicines, on the lipogenesis of sebaceous glands.
AB  - The effects of some alkaloids and flavonoids, which are major ingredients in some
      of the Japanese Kampoh drugs (Japanese-Chinese traditional herbal medicines)
      experientially known to be efficacious for the treatment of acne vulgaris, on the
      lipogenesis in the sebaceous glands of the hamster ear, an excellent animal model
      for the human sebaceous gland, were studied. Lipogenesis was assayed by
      determining 14C incorporation into sebaceous lipids extracted from the sebaceous
      glands which were preincubated with 14C-acetate. We found that the lipogenesis in
      the hamster sebaceous glands was suppressed 63 and 54% by 10(-4) M berberine (an
      alkaloid) and wogonin (a flavonoid), respectively. We suggest that the
      therapeutic effects of some Japanese Kampoh drugs experimentally used for acne
      vulgaris could be due to inhibition of lipogenesis by their active ingredients
      such as berberine and wogonin.

PMID- 8489777
TI  - Concentration of temarotene (Ro 15-0778) and its metabolite Ro 14-6113 in plasma
      and skin of hairless rat.
AB  - The aim of this preliminary report was to measure plasma and skin concentrations
      of Ro 15-0778 and its phenolic metabolite Ro 14-6113 in hairless rats receiving
      orally 10 mg/kg of Temarotene once daily during 10 days. Blood (2-3 ml) and skin
      (200-300 mg) samples were taken at different time points between 0.5 and 240 h
      after the last dose. We used a highly sensitive HPLC method for simultaneous
      determination of the two compounds with a quantification limit of 2 ng/ml in
      plasma and 10 ng/g in total skin (epidermis and dermis). After 10 h, plasma
      concentrations of Ro 14-6113 were 5-13 times higher than for Ro 15-0778. Ro 14
      6113 concentrations in the skin were 4-10 times higher than for Ro 15-0778 within
      the initial 48 h. The concentrations of both compounds in the skin were higher
      than concentrations in plasma.

PMID- 8489778
TI  - Regulation of collagen synthesis in human dermal fibroblasts by the sodium and
      magnesium salts of ascorbyl-2-phosphate.
AB  - Ascorbic acid has been shown to stimulate collagen synthesis in dermal
      fibroblasts by increasing the rate of transcription of collagen genes.
      Experiments involving the use of ascorbic acid require daily supplementation due
      to the instability of the molecule in aqueous solutions. In order to provide a
      more stable alternative to ascorbic acid, two salts of ascorbyl-2-phosphate,
      having a greater chemical stability than ascorbic acid, were tested for their
      ability to stimulate collagen synthesis in monolayer fibroblast cultures. The
      concentration and time dependence of their activities were compared with ascorbic
      acid. The magnesium salt of ascorbyl-2-phosphate was found to be equivalent to
      ascorbic acid in stimulating collagen synthesis in these assays, while the sodium
      salt required at least a tenfold greater concentration to produce the same effect
      as ascorbic acid. Solutions of either ascorbic acid or the ascorbyl-2-phosphate
      analogs (at 10 mM) in phosphate-buffered saline (PBS) were relatively stable as
      shown by their decay rates and their ability to stimulate collagen synthesis even
      after nine days in solution prior to testing their effects on cultured cells.
      Ascorbic acid was unstable at neutral pH compared to solutions of either sodium
      or magnesium ascorbyl-2-phosphate. These data support the use of magnesium
      ascorbyl-2-phosphate in experiments where stability of ascorbic acid is a
      concern, e.g. in long-term cultures or in in vivo studies.

PMID- 8489779
TI  - Principles and criteria in the development and optimization of topical
      therapeutic products.
AB  - The report differentiates between dermatological and transdermal products,
      identifies and discusses the principles involved in the development and
      optimization of topical drug products. The regulatory concerns in the evaluation
      of topical dermatological products with respect to bioequivalence and quality
      control are also discussed.

PMID- 8489780
TI  - Transesophageal echocardiography in the diagnosis of aortic disease.
AB  - Transesophageal echocardiography (TEE) has recently become a major diagnostic
      tool in aortic disease. By far the most important role of TEE is in the rapid
      diagnosis of acute aortic dissection. In this disease the sensitivity and
      specificity of TEE are both well more than 90%, patient risk is minimal, and the
      test can (and should) be done in the emergency department. Limitations of TEE
      include, in some cases, difficulty delineating involvement of the proximal arch,
      major branch vessels, and abdominal aorta. Another emergency department
      application of TEE is the assessment of patients suspected of traumatic aortic
      rupture. TEE also is being applied to the diagnosis of aortic protruding
      atheromas, thought to have significant embolic potential.

PMID- 8489781
TI  - Utility of ultrafast computed tomography in the detection of thoracic aortic
      aneurysms and dissections.
AB  - The millisecond image acquisition time characteristic of the ultrafast computed
      tomography (UFCT) scanner makes it an ideal modality for evaluating patients with
      suspected vascular lesions of the thoracic aorta. Unlike conventional CT, the
      UFCT electron beam technology produces images with excellent resolution, minimal
      respiratory artifact, and superior vascular enhancement. This report discusses
      the (1) basic characteristics of the UFCT scanner as they relate to the imaging
      of the thoracic aorta, (2) UFCT appearances of uncomplicated and complicated
      aneurysms and dissections, (3) appropriate CT protocols used in the work-up of
      suspected thoracic aortic disease, and (4) strengths and weaknesses of other
      imaging modalities compared with UFCT.

PMID- 8489782
TI  - Magnetic resonance imaging of the pediatric thoracic aorta.
AB  - Magnetic resonance imaging (MRI) is an ideal imaging modality for investigating
      anomalies of the pediatric thoracic aorta. Its multiplanar capabilities allow
      imaging along anatomic or perpendicular planes, and clearly show the relationship
      between the great vessels and the airway structures. The most common pediatric
      aortic lesions investigated by MRI include vascular rings and coarctation of the
      descending aorta and its surgical complications. Other obstructive, aneurysmal,
      and positional anomalies of the aorta are readily demonstrated and quantified.
      However, precise image prescription is necessary to obtain optimal information.
      This review discusses and illustrates the common pediatric anomalies and current
      appropriate choices of imaging techniques.

PMID- 8489783
TI  - The thoracic aorta.

PMID- 8489784
TI  - Traumatic aortic injuries: current concepts.
AB  - This article summarizes current concepts of traumatic injuries of the aorta. The
      "osseous pinch" mechanism of injury is presented and discussed. The role of each
      imaging modality in patient evaluation is considered and a rational approach to
      their use suggested based on current technology and practices.

PMID- 8489785
TI  - The role of intravascular ultrasound in acute traumatic aortic rupture.
AB  - Acute traumatic aortic rupture is a lethal injury and requires immediate
      diagnosis and surgical repair. The standard of diagnosis for aortic rupture is
      aortography. In patients in whom the angiographic findings of rupture are subtle
      or uncertain, intravascular ultrasound (IVUS) imaging of the descending aorta has
      been useful in confirming or excluding mural injury. However, because IVUS is
      unable to provide a complete and expeditious survey of the aorta and
      brachiocephalic arteries, the diagnosis of rupture will continue to rely on
      aortography or current generation computed tomography.

PMID- 8489786
TI  - Magnetic resonance imaging of the thoracic aorta.
AB  - Magnetic resonance imaging (MRI) is steadily becoming recognized as a premier
      imaging modality for evaluating the thoracic aorta. Its noninvasive, nonimaging
      approach and refined resolution capabilities effectively combine the advantages
      of echocardiography, angiography, and computed tomography (CT) under the auspices
      of a single imaging device. On static spin-echo MRI, blood flow appears dark,
      allowing superb depiction of both intra- and extra vascular anatomy. With dynamic
      MR studies, gradient echo (cine) and phase velocity mapping techniques have
      proven effective in assessing the physiological consequences of anatomic vascular
      abnormalities in a qualitative and quantitative manner, respectively. Magnetic
      resonance angiography (MRA) is fast becoming a prominent vascular imaging method.
      Although still evolving, MRA bolsters the vascular imaging capabilities of MRI by
      enhancing the imaging resolution of the major branch vessels and collateral
      vessels. With continued advances in this area, MRI may adopt the role as the
      primary imaging method for assessing the thoracic aorta.

PMID- 8489787
TI  - Management of acute asthma. Respiratory paediatricians of Australia and New
      Zealand.

PMID- 8489788
TI  - Is prescribing paracetamol 'pro re nata' acceptable?
AB  - The aim of this study was to assess the prescribing pattern of paracetamol in a
      children's department of a general hospital. A retrospective audit of the case
      record prescriptions revealed that 190 of a sample of 299 children had received
      paracetamol during their inpatient stay. The major indications for paracetamol
      use were fever associated with infection in medical patients and pain following
      minor surgical procedures. The most common regimen was 4 hourly p.r.n. and this
      had the greatest potential to lead to a dose in excess of 90 mg/kg per 24 h,
      other than the actual prescribing of high doses on a fixed basis. This dose was
      actually administered to 13.6% of the children, and was prescribed for 74% of the
      group. We conclude that a p.r.n. regimen can lead to overdose and this may be
      potentially hazardous for children.

PMID- 8489789
TI  - Prediction of outcome of preterm infants with severe bronchopulmonary dysplasia.
AB  - Forty-four preterm infants of less than 30 weeks gestation and birthweight < or =
      1250 g, with severe bronchopulmonary dysplasia requiring mechanical ventilation
      for at least 28 days, were reviewed. Twenty-seven infants (61%) survived; 17
      died. There were no significant differences between survivors and non-survivors
      with respect to birthweight, gestational age, sex, Apgar score at 5 min or
      pulmonary diagnosis. Non-survivors displayed more severe changes on chest X-ray
      than the survivors. Peak inspiratory pressure (PIP), ventilator rate (VR),
      ventilator index and mean airways pressure were significantly higher in the non
      surviving infants on days 2, 3, 4, 7, 14, 21 and 28, with non-survivors also
      having significantly higher alveolar-arterial oxygen gradients and lower arterial
      alveolar oxygen ratios than the survivors. Discriminant analysis with cross
      validation by pairing PIP and VR on day 28 produced a positive predictive value
      for non-survival of 88% and a negative predictive value of 89%. This result was
      better than was obtained for any other pair of ventilator parameter or
      oxygenation index. Discriminant analysis by combining X-ray appearances with
      ventilator settings did not improve the prediction. Having established a
      statistical model based on the PIP and VR of ventilator-dependent preterm infants
      on day 28, the outcome can be predicted with a high degree of confidence. This
      has the immediate potential application of indicating to staff in the neonatal
      unit a realistic approach to take when counselling parents of these infants.

PMID- 8489790
TI  - Individualizing aminophylline doses in premature infants using bioelectrical
      impedance: a non-invasive approach.
AB  - The role of bioelectrical impedance (BI) in estimating the pharmacokinetics and,
      therefore, individualized doses, of aminophylline in preterm infants (gestational
      age 26-35 weeks) was assessed in a two-phase study. Multiple regression analysis
      in the first group of neonates (phase I, n = 19) identified resistance,
      reactance, weight and length as optimal predictors of distribution volume
      (adjusted R2 = 0.84, coefficient of variation (CV) = 10.17%), and
      length2/impedance and postconceptual age as predictors of clearance (adjusted R2
      = 0.74, CV = 26.73%). Application of these models to an independent group (phase
      II, n = 20) generated doses which satisfactorily achieved target theophylline
      loading and steady-state (SS) 'peaks' of 10 micrograms/mL and SS 'troughs' of 7.7
      +/- 0.6 micrograms/mL. A better understanding of specific criteria and
      limitations of the impedance technique in neonates is necessary in order to
      refine BI measurements.

PMID- 8489791
TI  - Childhood emotional and behavioural problems: a comparison of children's reports
      with reports from parents and teachers.
AB  - Paediatricians are often asked to assess children with emotional and behavioural
      problems and are faced with the dilemma that reports about the children's
      behaviour obtained from the children, and from their parents and teachers, may
      differ. This study compares the number of childhood emotional and behavioural
      problems reported by children living in the community, with the number of
      problems reported by their parents and teachers. When describing both
      internalizing and externalizing problems, the children consistently reported that
      they had more problems than were reported by either their parents or teachers.
      This pattern was particularly evident with reports from older female children who
      reported many more internalizing problems than were reported by their parents and
      teachers. Possible reasons for the differences between reports from children and
      the other informants are discussed.

PMID- 8489792
TI  - Kawasaki disease in Adelaide: a review.
AB  - The role of Kawasaki disease (KD) as a contributor to early childhood cardiac
      morbidity in Adelaide was investigated by a review of hospital admission and case
      note data from January 1979 to June 1990. There were 57 episodes in 55 patients.
      The epidemiological data in this South Australian series are similar to that seen
      in other Australian and New Zealand centres and correlate better with the
      clinical data from North America than from Japan. The average age of admission
      was 3.2 years (median 2.7 years) with 38 and 85% of cases being less than 2 and 5
      years respectively. The male to female ratio was 1.5. The incidence of KD in the
      0-5 year age group was 3.9 cases per 100,000 children. This series represents a
      minimum number of cases for this period and illustrates an association of
      aneurysm-risk with prolonged fever; improved defervescence with the combination
      of intravenous gamma-globulin (IVGG) and aspirin compared with aspirin alone; and
      a more severe disease process in the very young. The series supports the efficacy
      of single dose IVGG therapy. Antibiotics were given prior to diagnosis of KD in
      79% of patients, often causing diagnostic confusion with possible drug reactions.
      The pathogenic mechanisms of KD are reviewed and a new hypothesis is proposed
      that incorporate mechanisms of vessel pathology resulting from release of
      endothelin and recognized mediators of endothelial damage including tumour
      necrosis factor-alpha and interleukin-1 beta.

PMID- 8489793
TI  - Ophthalmic assessment of physically disabled children attending a rehabilitation
      centre.
AB  - A retrospective analysis was conducted of 397 children, ranging in age from 2 to
      19 years, attending the Regency Park Centre for Young Disabled in Adelaide. The
      disorders represented included cerebral palsy, head injury, spina bifida, severe
      speech and/or language disorders, muscular dystrophy and a number of less common
      conditions. The incidence of significant ophthalmic abnormalities in this
      population was 51%, with the highest incidence being 69 and 62% among children
      with head injury and cerebral palsy, respectively. Children with severe speech
      and language disorders had an incidence of 24%. Overall, routine examinations
      revealed previously unsuspected significant eye abnormalities in 31% of the
      children. A complete ophthalmic examination should be part of the evaluation of
      all physically disabled children to ensure early identification and treatment of
      abnormalities, and to optimize rehabilitation.

PMID- 8489794
TI  - Childhood injury mortality in New South Wales: geographical and socio-economic
      variations.
AB  - This paper reports a retrospective study of deaths due to unintentional injury in
      children aged between 0 and 14 years of age in New South Wales between 1985 and
      1987. The aims were to determine whether the pattern of child injury mortality
      differed between rural and metropolitan New South Wales and to establish the
      relationship between socio-economic status, based on a geographical indicator of
      socio-economic status and child injury mortality. The child injury mortality rate
      for New South Wales in 1985-87 was 12.3 deaths per 100,000 population per year.
      The rate in the country area of 15.3 deaths per 100,000 was significantly higher
      than that for the metropolitan area of 11.3 per 100,000 (P < 0.05). Deaths of
      passengers in motor vehicle traffic accidents (P < 0.01) and deaths due to fires
      (P < 0.01) were greater in the country area. A negative linear association
      between socio-economic status and child injury mortality was found in the Sydney
      metropolitan area (P < 0.01). This trend was most apparent for deaths of child
      pedestrians (P < 0.01).

PMID- 8489795
TI  - Perianal group A streptococcal infection.
AB  - Four cases of perianal group A streptococcal infection presented with typical
      features of this condition; but because of lack of recognition appropriate
      therapy was delayed. Once group A streptococcal infection was diagnosed there was
      a high frequency of relapses. The need for prolonged treatment is illustrated.

PMID- 8489796
TI  - Adverse effects of neonatal transport between level III centres.
AB  - The effect of neonatal transport between level III intensive care nurseries was
      studied by comparing the outcome of 40 infants inborn at a regional level III
      centre but transported to other level III nurseries for intensive care, with 80
      matched inborn controls. Transport appeared to affect respiratory status
      adversely but transiently. However, transported infants grew less well than
      control infants (32% were below 3rd centile for weight at 36 weeks vs 15% of
      controls), were more likely to suffer periventricular haemorrhage (40 vs 21% of
      controls) and had a worse neurodevelopmental outcome (70% normal at follow up vs
      83% of controls). It can be concluded that for infants inborn at the National
      Women's Hospital, Auckland, transport to another level III centre for intensive
      care is associated with an increased risk of adverse outcome.

PMID- 8489797
TI  - Parental perception of the use and usefulness of a parent-held child health
      record.
AB  - This study surveyed 313 parents to investigate how frequently parents used a
      parent-held child health record, and whether they saw the record as useful. Since
      1981, The Child, Adolescent and Family Health Service has distributed a Personal
      Health Record (PHR) to the parents of all children in South Australia. The PHR
      has provided each family with an ongoing record that has been consistently used
      for immunization, child health checks and child health screening. However, little
      is known about how parents view the PHR, its usefulness, and how frequently the
      record is used. Previous studies, generally conducted prior to, or shortly after,
      a parent-held child health record was introduced, have shown a poor understanding
      of the uses of the PHR on the part of parents and a low level of use by health
      professionals such as general practitioners. In contrast, the results of this
      study show high levels of understanding of the health record on the part of
      parents, and an increase in the use of the health record by general practitioners
      over the 10 years since the record was introduced. Although moderated by the age
      of the child, the sections of the PHR seen as most useful (and the most
      frequently used) by parents were immunization, growth charts, progress notes and
      health checks.

PMID- 8489798
TI  - Episodic central neurogenic hyperventilation in an awake child with systemic
      histiocytosis.
AB  - A 3 year old boy with systemic histiocytosis, diabetes insipidus and a lytic
      parietal bone lesion experienced episodes of central neurogenic hyperventilation
      3 weeks after radiation to the head but was conscious and alert at presentation.
      At admission, the PaO2 was 133 mmHg, PaCO2 was 8 mmHg and pH 7.65. Magnetic
      resonance imaging revealed a pontomedullary lesion that resolved during the
      ensuring year. Central neurogenic hyperventilation has not been described
      previously as a complication of systemic histiocytosis.

PMID- 8489799
TI  - Mental retardation, macrostomia and hyperpnoea syndrome.
AB  - A syndrome with the triad of abnormalities of mental retardation, wide mouth and
      intermittent overbreathing is described, which has all the features of the
      syndrome previously described by Pitt and Hopkins. Pitt and Hopkins published two
      cases that bear close resemblance to each other, each having an abnormal
      respiratory rhythm. Both had an unusually wide mouth and palate, thick fleshy
      lips, broad-beaked nose, finger clubbing and abnormal electroencephalograms. This
      paper discusses a client living in a hostel for intellectually handicapped people
      who has all these features.

PMID- 8489800
TI  - Attitudes towards molecular genetic testing for neurofibromatosis type 1 in
      Western Australia.

PMID- 8489801
TI  - Using a computer database to record and evaluate a school screening service.

PMID- 8489802
TI  - Munchausen syndrome by proxy: repetitive infantile apnoea and homicide.

PMID- 8489803
TI  - Aluminium and infants.

PMID- 8489804
TI  - Paracetamol: when, why and how much.

PMID- 8489805
TI  - Bronchopulmonary dysplasia.

PMID- 8489806
TI  - Paediatrics in the Asia-Pacific region.

PMID- 8489807
TI  - Growth and congenital heart disease.

PMID- 8489808
TI  - The Australian College of Paediatrics and The Australasian College for Emergency
      Medicine. Policy statement. Hospital emergency department services for children.

PMID- 8489809
TI  - [Morgagni hernia in childhood].
AB  - We report six cases of Morgagni hernia diagnosed and operated on in our pediatric
      surgical unit during a 14-year period. Four children were younger than 1 year and
      two between 1 and 2 years. Predominance in males was found. Associated congenital
      pathology was present in 3 children (Down's syndrome, diaphragmatic relaxation,
      criptorquidia and pyelo-ureteral stenosis). Predominant clinical features were
      respiratory infections and vomiting. In only one patient clinical onset was with
      respiratory distress. Plain chest x-ray was the most used diagnostic procedure.
      In all cases barium enema was performed to confirm the clinical diagnosis. Most
      frequent surgical approach was a midline supra-umbilical laparotomy.
      Diaphragmatic defect was left sided in 3 children and right-sided in the other 3.
      Transverse colon and liver were the most frequent herniated viscera.
      Postoperative follow-up showed no complications or recidives.

PMID- 8489810
TI  - [Protection by zinc acexamate against gastric lesions induced by non-steroid anti
      inflammatory agents].
AB  - The ability of different non-steroidal anti-inflammatory drugs (diclofenac,
      indomethacin, ketoprofen, naproxen and piroxicam) to inhibit gastric
      prostaglandin E2 production in the rat was compared with their damaging potential
      on gastric mucosa. The influence of treatment with zinc acexamate (ZAC) on these
      two parameters was also determined. ZAC treatment significantly decreased the
      degree of gastric damage elicited by all the antiinflammatories tested. The
      experimental data confirm the complexity of the gastrolesive effect exerted by
      anti-inflammatory drugs and that only part of such effect would be related with
      their inhibition of prostaglandin synthesis. These results indicate that the
      gastroprotection of ZAC does not exclusively depend on the effect on the
      synthesis of prostaglandins by the gastric mucosa, yet it can additionally be
      exerted through alternative mechanisms.

PMID- 8489811
TI  - [Collagenous colitis: clinicopathologic study of 6 new cases].
AB  - Collagenous colitis (CC) is a newly recognized entity characterized clinically by
      chronic watery diarrhoea and pathologically by epithelial inflammatory injury and
      the presence of a thickened collagen band beneath the surface epithelium of the
      colon. Clinical and pathological data of six patients (5 women and 1 man, mean
      age 54 years) with this diagnosis have been reviewed. Chronic watery diarrhoea
      was the main symptom in all cases, ranging from 2 to 12 bowel movements a day
      (mean +/- SD, 5.5 +/- 2.3) lasting from 8 months to 19 years (mean +/- SD, 6.6 +/
      5.9 years). Laboratory, barium and endoscopic studies showed unspecific
      findings. Rheumatic and thyroid diseases as well as drug allergies were found in
      five cases. The cause of collagenous colitis and the mechanism of diarrhoea
      remains undefined, being the inflammatory and autoimmune hypothesis the most
      likely. Diagnosis was made by multiple rectal and colonic biopsies. Pathologic
      findings characteristic of CC were more prominent in proximal than in distal
      colonic specimens. Different treatments were applied and diverse clinic responses
      were obtained. A review of the literature is made.

PMID- 8489812
TI  - [Resection of hepatic metastases of colo-rectal carcinoma. Indications and
      initial results].
AB  - We report our initial experience in the resection of metastases from colo-rectal
      cancer confined to the liver. Seventeen hepatic resections were performed in
      sixteen patients over a thirty-eight months period. Median age was 58 years (45
      75). The extent of liver involvement was assessed by computerized tomographic
      portography and magnetic resonance. In fourteen cases there was a solitary
      lesion. Mean interval time between colo-rectal resection and hepatic resection
      was 18 months (0-69). Twelve major hepatic resections and five wedge resections
      were performed. There was not operative mortality. Seven patients received
      complementary chemotherapy. Mean follow-up was 14.8 months (2-34). One patient
      died from carcinoma of the lung, five patients (31.25%) are alive with recurrence
      of some sort (three recurrences being in the liver) and ten patients (62.5%) are
      free of disease. Indications for resection, methods used for identification of
      candidates, prognostic determinants and indications for complementary
      chemotherapy are discussed.

PMID- 8489813
TI  - Esophageal chest pain: an unsolved problem.

PMID- 8489814
TI  - New provocative tests in the diagnosis of esophageal chest pain.
AB  - In the present experience, two new provocative tests are proposed in the
      diagnosis of chest pain. Exertional pHmetry, consisting in a standard ergometric
      test during esophago-gastric pHmetry, is employed in the diagnosis of chest pain
      by gastroesophageal reflux. 67 patients with non-cardiac chest pain were
      submitted to the test: 46 (group A) presenting pain only at rest, and 21 (group
      B) with exertional or mixed type of pain. Out of group A, 12 (25%) patients
      presented a positive response (both gastroesophageal reflux and typical pain
      during exercise). Out of group B, 6 (28.5%) patients responded positively, too.
      The diagnostic advantage of exertional pHmetry, compared to prolonged pHmetry,
      amounts to 21.7%. Exertional pHmetry, repeated on the following day, showed that
      occurrence of gastroesophageal reflux and pain are reproducible in all patients,
      with occurrence at the same threshold of the first test in 11 (61.1%) out of 18
      patients. Endo-esophageal electrical stimulation is employed in the diagnosis of
      chest pain by motility disturbances: the technique is the same one of
      cardiological transesophageal atrial pacing. 6 healthy subjects and 21 patients
      with non-cardiac chest pain negative to other esophageal investigations (7 with
      and 14 without gastroesophageal reflux disease) were submitted to the test. 9
      (43%) out of 21 patients showed a positive response, while in 2 patients (9%) we
      observed manometric changes without pain, and 10 (48%) showed a negative
      response. All the control subjects submitted to the test showed a completely
      negative response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489815
TI  - [Hepatotoxicity induced by Droxicam: presentation of 4 cases].
AB  - Hepatotoxicity has been reported with most of the nonsteroidal antiinflammatory
      drugs (NSAID). We describe four patients who presented hepatic injury after of
      treatment with Droxicam, a new NSAID prodrug of piroxicam. Hepatitis was
      attributed to Droxicam because of the absence of other etiological factors,
      temporal relation with drug administration, clinical, laboratory and histological
      picture and evolution favorable after the drug suppression. The hepatic injury
      was manifested as cholestasis and withdrawal of the drug was followed by
      biochemical and clinical improvement until the complete normalization in three of
      the four patients. Postmarketing surveillance is necessary in new drugs with
      unknown hepatotoxicity.

PMID- 8489816
TI  - [False pancreatic pseudocyst during endoscopic retrograde
      cholangiopancreatography (ERCP) in a gastrectomized patient].
AB  - Endoscopic retrograde cholangiopancreatography (ERCP) is a very useful procedure
      for the diagnosis of biliopancreatic disorders. As a mixed endoscopic and
      radiologic procedure, its diagnostic yield depends heavily on the quality and
      skillful interpretation of radiological images. Diagnostic pitfalls must be kept
      in mind and avoided. We report on the case of a gastrectomized patient (Billroth
      II), in whom the observation during ERCP of two contrast-filled cavities,
      suggested the diagnosis of pancreatic pseudocysts. Other imaging procedures fully
      ruled out this diagnosis. The cause of this diagnostic pitfall was the
      accumulation of contrast in the blind end of the afferent loop. Additionally, we
      comment on other false cystic images in the ERCP.

PMID- 8489817
TI  - [Sclerosing cholangitis in a patient with acquired immunodeficiency syndrome].
AB  - The case of a man with the acquired immunodeficiency syndrome who had been
      intravenous drug abuser is reported. He was investigated because of the presence
      of both severe upper abdominal pain and raised levels of serum alkaline
      phosphatase and gamma-glutamyltransferase. The endoscopic retrograde
      cholangiopancreatography show stenosis of the major duodenal papilla associated
      with thickening and dilatation of intrahepatic bile ducts. The sclerosing
      cholangitis (SC) diagnostic was made with histological confirmation.
      Cryptosporidium oocysts were identified in sputum and bronchial lavage. We
      discuss his SC implication and we review the literature. We highlight the need to
      suspect this pathology in both positive serology human immunodeficiency patients
      or AIDS with abdominal pain and biochemical cholestasis.

PMID- 8489818
TI  - [Hepatic actinomycosis].
AB  - We present a case of primary liver actinomycosis in a patient who was operated on
      for a duodenal ulcus seven years before. A gastrectomy was performed. His
      gallbladder was also removed two years before. After the surgical treatment,
      followed by antibiotic and chemotherapeutic treatment, with the result of a
      pretended success, the patient developed a liver pyogenic abscess and portal
      hypertension. Authors emphasise the seriousness of the illness as well as its
      rarity even with an accurate treatment.

PMID- 8489819
TI  - [Hematoma of the sheath of the anterior rectus muscle of the abdomen].

PMID- 8489820
TI  - [Inflammatory fibroid polyp: an infrequent cause of intestinal obstruction].

PMID- 8489821
TI  - [Intestinal subocclusion caused by gigantic mesenteric cyst].

PMID- 8489822
TI  - [Intramural duodenal hematoma: report of a new case].

PMID- 8489823
TI  - The Shuler nurse practitioner practice model: a theoretical framework for nurse
      practitioner clinicians, educators, and researchers, Part 1.
AB  - Because nurse practitioners (NPs) have expanded their nursing knowledge and
      skills into medicine they need a model that reflects this expanded role. This
      article presents the Shuler Nurse Practitioner Practice Model, which is wellness
      oriented and suggests how patient interaction, assessment, intervention, and
      evaluation should occur.

PMID- 8489824
TI  - Utilizing nurse practitioners to provide health care for elderly patients in
      Massachusetts nursing homes.
AB  - This study evaluates the nursing contribution to the process of care utilizing
      nurse practitioners (NPs) to provide health care for nursing home patients in
      Massachusetts. Using magnetic tapes of data collected through retrospective chart
      reviews of 2,651 patient records in 110 Massachusetts nursing homes, comparisons
      were made of the process of care variables of NP/physician team and physician
      only models of care. Results from discriminant function analysis revealed process
      of care variables did discriminate between the two models. The conclusion that
      NPs provide not only a substitutive role to that of medical care but also a
      complementary one should be instrumental in enabling policy decisions that
      encourage the full utilization of NPs.

PMID- 8489825
TI  - Teaching strategies used by expert nurse practitioner preceptors: a qualitative
      study.
AB  - Nurse practitioner (NP) programs utilize expert clinicians as preceptors for
      their students. Little is written regarding this important role. This study
      explored teaching strategies used by expert preceptors. Fifteen preceptors in a
      master's level NP program participated in this qualitative study. The study
      identified (a) orientation strategies, (b) strategies used with all students, and
      (c) strategies used differentially according to level of learner. Two distinct
      preceptor styles emerged from the data ("incremental structure" and "sink or
      swim"). Preceptors also identified characteristics of student readiness for
      increased responsibility. Results of this qualitative study can be helpful in
      preceptor orientation and continued education.

PMID- 8489826
TI  - Battered women: intervention and prevention. A psychosociocultural perspective,
      Part 2.
AB  - Building on the foundation of understanding and comprehensive assessment of
      battered women, this article addresses service planning and intervention.
      Strategies are approached within the framework of a Crisis Paradigm developed
      from field research with battered women and their families. They include
      mechanisms such as support groups which link crisis service to the long-term
      needs of battered women, and systematic approaches to removing the obstacles
      which keep women victimized. An Assessment and Service Planning Guide (ASPG) is
      proposed for inclusion in routine health care of abused women. The article
      concludes with strategies for preventing violence at interpersonal and societal
      levels.

PMID- 8489827
TI  - Lyme disease.

PMID- 8489828
TI  - A new president: renewed prospects for major health care reform.

PMID- 8489829
TI  - The structure, content, and quality of family nurse practice.
AB  - Relatively little data has been collected documenting the scope of family nurse
      practitioner (FNP) clinical practice, and virtually no research definitively
      describes the quality of that practice. Physicians have led the way in
      quantitative collection of practice content information. The resulting analyses
      have determined not only the most common diagnoses in primary care but also the
      content of teaching and research in family practice. Nurse clinicians, educators,
      and researchers have assumed this content to be pertinent to FNP practice as
      well. This article describes the major studies of family physician practice and
      the few studies of nurse practitioner/FNP practice, and advocates intensified
      review of FNP clinical content as an empirical basis for practice, education, and
      research.

PMID- 8489830
TI  - High-osmolar and low-osmolar contrast media. An update on frequency of adverse
      drug reactions.
AB  - During the past 3 years a great number of papers about adverse drug reactions to
      intravascular injection of high-osmolar and low-osmolar iodinated contrast media
      (CM) have been published. They include observational studies, randomized trials,
      meta-analyses and committee reports. Thorough analysis of this material
      substantiates an improvement in safety of at least 6-fold using nonionic low
      osmolar CM compared with ionic high-osmolar CM. The point where only a small
      minority is continuing to argue effectively that low-osmolar CM are not better
      than conventional high-osmolar CM has now been reached. High-osmolar CM are used
      less and less for intravascular purposes, and, in fact, have been totally
      replaced by low-osmolar CM in 4 countries.

PMID- 8489831
TI  - Incidence of roentgen contrast medium reactions after intravenous injection in
      pre-registration trials and post-marketing surveillances.
AB  - The relative risk of adverse drug reactions of ionic versus non-ionic contrast
      media injected i.v. were compared for different types of trials using odds-ratio.
      The absolute and relative risk found in large post-marketing trials were compared
      with that found in the iohexol pre-registration trials. The absolute risks were 2
      to 10 times higher in the pre-registration trials compared to the post-marketing
      surveillances. The relative risk for all adverse drug reactions was 3 to 6 times
      higher for ionic vs. non-ionic media and independent of pre- or post-registration
      studies. The odds-ratio seems to be a feasible method of comparing the relative
      risk of adverse reactions in various trials.

PMID- 8489832
TI  - Effect of low-osmolality contrast media on red cell filterability.
AB  - The effects of low-osmolality contrast media (CM) on red blood cell (RBC)
      filterability were investigated using a recently developed nickel mesh filtration
      method. The conventional hypertonic CM iothalamate, low-osmolality iohexol, and
      the recently synthesized iomeprol were studied. Among them, the osmolality of
      iomeprol was the lowest. The impact of CM osmolality, viscosity, and iodine
      content on the RBC filterability was analyzed. Under equal iodine content or
      viscosity condition, the filterability order of RBCs suspended in CM was iomeprol
      > iohexol >> iothalamate, because of the osmolality of CM. Iomeprol caused small
      echinocytic changes but these had a negligible influence on RBC filterability. In
      conclusion, the osmotic effect of CM on RBC filterability is more predominant
      than the other CM effects, and iomeprol is the preferred CM for RBC
      filterability.

PMID- 8489833
TI  - Contrast media-induced renal morphologic lesions in diabetic rats.
AB  - Diabetes mellitus was induced in rats with streptozotocin and after 3 months the
      animals (n = 48) received an i.v. injection of 1 or 3 g I/kg in the form of high
      osmolar diatrizoate, low-osmolar iopromide or iohexol, or of 0.6 g I/kg of high
      osmolar Gd-DTPA. The controls were given an i.v. injection of physiologic saline.
      After 2 hours the kidneys were fixed by perfusion and the renal morphologic
      changes were semiquantitatively analyzed by two independent observers unaware of
      the agent administered. The contrast media (CM) induced pronounced cytoplasmic
      vacuolization in the proximal convoluted tubular cells. Such a lysosomal
      alteration may indicate CM uptake into the cell, and the ultrastructural
      evaluation revealed intracellular injuries related to the process. The
      alterations were most marked following administration of iohexol, but diatrizoate
      also induced a statistically highly significant vacuolization (p < 0.001). The
      lysosomal alterations following iopromide administration were not as striking,
      and Gd-DTPA induced only minor changes.

PMID- 8489834
TI  - Acute electrolyte disturbances in coronary sinus during left coronary
      arteriography in man.
AB  - Electrolyte disturbances, particularly reduction of ionized calcium, induced by
      iodinated contrast media (CM) are important considerations in coronary
      arteriography. A study was conducted in 24 patients to evaluate the acute
      electrolyte alterations in the coronary sinus during left coronary arteriography.
      During left coronary arteriography, coronary sinus blood was withdrawn for
      measurement of electrolytes. The CM used were diatrizoate, ioxaglate, iohexol,
      and iopamidol. The hematocrit was decreased moderately by all 4 CM used at 5 s
      and returned to the control level at 15 s. The level of ionized calcium was
      decreased by all CM at 5 s. Prolonged reduction of ionic calcium was observed
      with diatrizoate and ioxaglate at 15 s. The level of potassium was almost
      unchanged by diatrizoate and ioxaglate in spite of hemodilution, which may lead
      us to a hypothesis that potassium can be released from the intracellular spaces
      such as red blood cells and vascular endothelial cells. Thus the depression of
      left ventricular function might be caused not only by reduction of ionized
      calcium, but also by a relative increase in the level of serum potassium.

PMID- 8489835
TI  - Increased urinary excretion of iohexol after enteral administration in patients
      with ileal Crohn's disease. A new test for disease activity.
AB  - Iohexol is a water-soluble contrast medium that is partly absorbed/permeated
      through mucosa of the small bowel and excreted unchanged in the urine. Iohexol
      was administered orally to 12 patients with Crohn's disease of the ileum and to
      10 healthy controls to measure its excretion in the urine. The location and
      activity of Crohn's disease were determined by barium double-contrast radiography
      in all patients and by ileoscopy and biopsy in 9 patients. Iohexol concentrations
      in serum and 24-hour urine were measured using reversed phase high-performance
      liquid chromatography. Urinary excretion of iohexol was significantly greater in
      patients with active Crohn's disease than in controls. We suggest this method as
      a new way of measuring Crohn's disease activity and mucosal damage in the small
      bowel. Bowel inflammation and mucosal cell damage are strongly indicated if the
      iohexol excreted in the urine is over 1% of the oral intake.

PMID- 8489836
TI  - Iodixanol in abdominal digital subtraction angiography. A randomized, double
      blind, parallel trial with iodixanol and iohexol.
AB  - The safety, tolerability and efficacy of iodixanol 270 mg I/ml were compared to
      those of iohexol 300 mg I/ml in a double-blind, randomized, parallel abdominal
      intra-arterial DSA phase III trial. Fifty-nine patients were included in the
      trial; 39 patients received iodixanol and 20 received iohexol. The mean volume of
      iodixanol administered was 235.8 ml (0.93 g I/kg b.w.) while the mean volume of
      iohexol was 254.7 ml (1.10 g I/kg b.w.). No differences in diagnostic information
      and radiographic density were apparent in spite of the difference in the
      concentration of iodine. No serious adverse events occurred. Four patients (10%)
      in the iodixanol group and 2 (10%) in the iohexol group experienced adverse
      events. Eight percent of the injections of iodixanol promoted discomfort,
      compared to 12% of the injections of iohexol. An increase in S-urea and S
      creatinine was seen with both agents the first day after injection, but appeared
      to be less pronounced with iodixanol than with iohexol. Other serum tests
      revealed no changes of clinical importance. Both iodixanol and iohexol were found
      to be effective, safe and well tolerated contrast media for abdominal intra
      arterial DSA.

PMID- 8489837
TI  - Reduced risk of ventricular fibrillation by balancing sodium, calcium, potassium
      and magnesium added to nonionic contrast media. An investigation in the isolated
      rabbit heart.
AB  - The effect of addition of calcium, potassium and magnesium to iohexol (350 mg
      I/ml) enriched with 30 mM sodium was investigated with regard to ventricular
      fibrillation (VF) in isolated rabbit hearts. Enriching iohexol containing 30 mM
      sodium with increasing amounts of calcium (0-1.2 mM) caused an increase in the
      frequency of VF. Increasing amounts of potassium (0-3.8 mM) to iohexol with 30 mM
      Na + 0.15 mM Ca + 0.1 mM Mg reduced the risk of VF. However, this protective
      effect of potassium on VF was reduced if magnesium was removed from the test
      solution. Furthermore, increasing amounts of magnesium (0-1.2 mM) to iohexol with
      30 mM Na + 0.15 mM Ca + 0.4 mM K led to an increased frequency of VF. Iohexol
      with 30 mM Na + 0.3 mM Ca + 0.9 mM K + 0.3 mM Mg caused no VF. It is of interest
      to add multiple cations to sodium-containing nonionic media to improve cardiac
      contractility following coronary perfusion. The present study indicates that it
      is possible to enrich iohexol 350 mg I/ml + 30 mM Na with calcium, potassium and
      magnesium in small amounts, and balanced with respect to each ion, without
      changing the risk of VF.

PMID- 8489838
TI  - Expandable metallic endoprostheses for biliary obstruction.
AB  - Expandable metal stents (20 Gianturco Z-stents and 1 Strecker stent deployed
      through 8.5 F sheaths) were used with initial success for palliating bile duct
      obstruction in 10 patients, 8 with malignant and 2 with benign strictures. Short
      term failure occurred in one patient after 2 weeks, one died of unrelated causes
      after 10 days, and one remained jaundiced due to fulminant liver metastases. In
      the remaining 7 patients the obstruction was markedly palliated, with
      normalization of the serum bilirubin. Four have died without recurrent bile duct
      obstruction after a mean of 5.9 months, the 2 with benign strictures are well
      after 4 and 7 months, and one patient is presently palliated with a plastic
      endoprosthesis following reocclusion after 4 months. Expandable stents were
      easier to insert than conventional percutaneous endoprostheses of plastic
      polymers, and had longer patency in several patients, but reocclusion by tumor
      growth remains a constant threat in malignant disease. Metallic stents may be the
      therapy of choice in recurrent benign strictures, although the definitive
      conclusion needs longer observation and larger materials.

PMID- 8489839
TI  - Electrolytic stents to inhibit tumor growth. An experimental study in vitro and
      in rats.
AB  - Obstruction of metallic stents used in the management of malignant biliary
      strictures is common and in several cases due to tumor growth through the stent
      wall. In an experimental animal model in rats, a tumor was implanted
      subcutaneously adjacent to different metallic stents. Ingrowth of tumor through
      the wall of these stents was frequent. A stent generating direct electric current
      on the basis of electrolysis was developed and tested in vitro and in the
      experimental model. The study confirms that an "electrolytic" stent can inhibit
      ingrowth of tumor.

PMID- 8489840
TI  - Treatment of tuberculous bronchial stenosis with expandable metallic stents.
AB  - Gianturco expandable metallic stents were placed in 5 patients with dyspnea on
      exercise due to tuberculous bronchial stenosis. The stents were placed after
      dilatation with a 10-mm diameter high pressure balloon catheter. In all 5
      patients, obstructive changes disappeared following the procedure, and dyspnea on
      exercise improved markedly. No complications related to the procedure were
      encountered. At follow-up during a period of up to 38 months, 2 patients showed
      bronchial restenosis at 11 and 17 months, respectively, after stent placement.
      Restenosis by granulomatous tissue was successfully treated by laser ablation.
      One patient showed slight one-day hemoptysis 26 months after stent placement.

PMID- 8489841
TI  - Percutaneous rotational lithotripsy of urinary bladder stones. Clinical results
      with the Rotolith lithotriptor.
AB  - Mechanical rotational lithotripsy of urinary bladder stones, up to 20 mm in
      diameter, was performed in 6 male patients with the Rotolith lithotriptor. The
      lithotriptor was introduced through a 10 F (OD 3.3 mm) suprapubically inserted
      sheath, and the procedure was performed under intermittent fluoroscopy and
      inspection through a transurethral cystoscope. In 3 patients, the bladder stones
      were fragmented to pieces small enough to be evacuated through the cystoscope.
      The instrument, which is designed for lithotripsy of gallbladder stones, was less
      efficient for fragmentation of urinary bladder calculi, primarily due to the
      large volume of the human urinary bladder, and possibly because of the higher
      gravity of bladder stones. There was no substantial damage to the mucosa of the
      urinary bladder.

PMID- 8489842
TI  - Percutaneous rotational lithotripsy of gallbladder stones. Clinical results with
      the Rotolith lithotriptor.
AB  - Ten patients (aged 39-94 years) with cholecystolithiasis were selected for
      percutaneous rotational lithotripsy with the Rotolith lithotriptor either because
      they were considered high-risk patients for cholecystectomy or because they had
      refused surgery. The procedure was completed in 7 patients. Five of these were
      stone-free at cholangiography 1 to 2 days after lithotripsy. Conclusive
      cholangiograms were not obtained in 2 patients due to gallbladder leakage, which
      in itself did not cause any serious sequelae. At ultrasonography after one month,
      one of these 2 patients had no visible gallbladder, the other one had small
      residual gallbladder stones. Rotational lithotripsy is an alternative to
      cholecystectomy in patients at high surgical risk, especially elderly patients
      who have undergone cholecystostomy as an emergency treatment for acute
      cholecystitis.

PMID- 8489843
TI  - Changes in intracranial morphology, regional cerebral water content and vital
      physiological variables during epidural bleeding. An experimental MR study in
      dogs.
AB  - Epidural bleeding was produced in 8 anaesthetised and heparinised dogs by an
      artificial system. Changes in vital physiological variables were related to
      intracranial shifts and tissue water content assessed with MR imaging. Six
      animals survived while 2 succumbed. In the surviving animals intracranial shifts
      and compressions remained unchanged from an early stage. The cerebral perfusion
      pressure was reduced from between 80 and 110 mm Hg to between 40 and 60 mm Hg.
      Some increase in supratentorial white matter tissue water was observed. In the
      lethal experiments cerebral perfusion pressure fell to less than 40 mm Hg.
      Moreover, secondary delayed anatomical changes were seen including hydrocephalus.
      Increase in cerebral tissue water was more intense and widespread than in the
      survivors. These findings indicate that the outcome of epidural bleeding is
      related to cerebral perfusion pressure with secondary deterioration resulting
      from additional volume loading from increased tissue water and hydrocephalus.

PMID- 8489844
TI  - Progressive brain compression. Changes in vital physiological variables,
      correlated with brain tissue water content and brain tissue displacement.
      Experimental MR imaging in dogs.
AB  - Continuous recording of vital physiological variables and sequential MR imaging
      were performed simultaneously during continuous expansion of an epidural rubber
      balloon over the left hemisphere in anaesthetised dogs. Balloon expansion led to
      a progressive and slightly nonlinear rise in intracranial CSF pressures and a
      fall in local perfusion pressures. Changes in systemic arterial pressure, pulse
      rate, and respiration rate usually appeared at a balloon volume of 4% to 5% of
      the intracranial volume (reaction volume), together with a marked transtentorial
      pressure gradient and MR imaging changes consistent with tentorial herniation.
      Respiratory arrest occurred at a balloon volume of approximately 10% of the
      intracranial volume (apnoea volume), which was associated with occlusion of the
      cisterna magna, consistent with some degree of foramen magnum herniation.
      Increase in tissue water was observed beginning at approximately the reaction
      volume, presumably due to ischaemic oedema, due to the fall in perfusion
      pressures.

PMID- 8489845
TI  - Brain atrophy in neurodegenerative diseases. Quantitative and qualitative CT
      analysis.
AB  - A quantitative and qualitative analysis was done of 187 CT examinations in 59
      healthy subjects and 128 patients with various neurodegenerative diseases. The
      rates of agreement between quantitative measurements and the qualitative grading
      by two observers were 76.7% for the evaluation of lateral ventricular size and
      66.3% for the assessment of sulcal size. Increase in the width of the 3rd
      ventricle, in the bi-caudate span, and in the area of the lateral ventricles
      reflected a pathologic enlargement of the ventricles. The profile of ventricular
      dilatation in dementia patients was different from that of other patients with
      brain atrophy. However, the quantitative measurement of brain atrophy by a
      computer-based method did not increase the differential diagnostic accuracy among
      dementia patients. The results stress the importance of the selection of valid
      measures in the evaluation of structural changes of the brain. We suggest the use
      of reference scans for improving the reliability of the visual evaluation.

PMID- 8489846
TI  - Gallbladder necrosis following hepatic artery embolization. A new indication for
      percutaneous US-guided cholecystostomy?

PMID- 8489847
TI  - Ultrasound-guided tumor biopsy in the anterior mediastinum. An alternative to
      thoracotomy and mediastinoscopy.

PMID- 8489849
TI  - The art of value--added interviewing.

PMID- 8489848
TI  - Ten tips for telling people what they don't want to hear.

PMID- 8489850
TI  - Nurse executives share their first-class ideas: Kathy McDonagh on value-added
      interviewing.

PMID- 8489851
TI  - Action audits: a communication strategy.

PMID- 8489852
TI  - Power talk in health care organizations.

PMID- 8489853
TI  - The Electromation decision: yesterday notions for a tomorrow world.

PMID- 8489854
TI  - Separate contributions of large- and small-scale dynamics to the heat capacity of
      proteins. A new viscosity approach.
AB  - We present here a theoretical description and experimental verification of a
      novel method of separating large-scale (LS) and small-scale (SS) dynamics
      contributions to the heat capacities of proteins in solution by using viscosity
      dependences. It was assumed that the LS dynamics, related to the thermal
      fluctuations of domains and subunits, is dependent on solvent viscosity within a
      sucrose concentration of 0-15% w/v, in contrast with the SS dynamics, which are
      related to fluctuations of atoms and amino acid residues. The results obtained
      with immunoglobulin G, hemoglobin and cytochrome c were in reasonable accordance
      with the previous data achieved by a spin-label method: the LS dynamics decrease,
      whereas the SS dynamics increase within the temperature elevation. The changes
      are dependent on the stage of the active sites of the proteins. The internal
      compensation of molecular dynamics between the LS and SS fluctuations may be an
      important factor in the design of thermostable enzymes and proteins. A new
      phenomenon concerning the ability of macromolecules to increase free volume in
      water as a result of ice-like clusters stabilization is revealed.

PMID- 8489855
TI  - Coronary flow reserve.

PMID- 8489856
TI  - Starting treatment with angiotensin converting enzyme inhibitors in heart
      failure: how, where, and how much?

PMID- 8489857
TI  - How sound is the evidence that thrombolysis increases the risk of cardiac
      rupture?

PMID- 8489858
TI  - Impaired coronary flow reserve immediately after coronary angioplasty in patients
      with acute myocardial infarction.
AB  - OBJECTIVE: To examine coronary flow reserve immediately after emergency coronary
      angioplasty in patients with acute myocardial infarction. DESIGN: A 3 F coronary
      Doppler catheter was used to measure coronary blood flow velocity in the infarct
      artery and in the non-infarct artery. Maximal hyperaemia was produced by 10 mg of
      intracoronary papaverine and coronary flow reserve was calculated. PATIENTS: 11
      patients with acute myocardial infarction undergoing both emergency coronary
      angioplasty (4.7 (3.6) h after the onset of chest pain (mean (SD))) and at follow
      up catheterisation 16 (4) days after angioplasty. SETTING: Hiroshima City
      Hospital. RESULTS: There was no stenosis of > or = 50% in the coronary artery of
      interest. Immediately after coronary angioplasty the mean (1 SD) coronary flow
      reserve of the infarct artery was significantly less than that of the non-infarct
      artery (1.4 (0.4) v 2.8 (0.8), p < 0.001). At follow up catheterisation the
      coronary flow reserve of the infarct artery increased almost to the value of the
      non-infarct artery (2.8 (1.2) v 3.1 (0.8) p = NS). CONCLUSION: The coronary flow
      reserve in the infarct region was severely impaired immediately after
      reperfusion, even with a widely patent infarct artery. This could restrict the
      beneficial effects of reperfusion therapy, especially when there is a severe
      residual stenosis.

PMID- 8489859
TI  - In vivo detection of endothelium dependent and independent pulmonary artery
      relaxation in children.
AB  - BACKGROUND: In vitro studies have suggested an important role for the endothelium
      in the control of pulmonary vascular tone, but endothelium dependent and
      independent relaxation of pulmonary arteries have not been studied in children in
      vivo. METHODS: The response of the pulmonary circulation to graded infusions of
      acetylcholine (an endothelial dependent vasodilator) and to nitroprusside (a
      dilator not dependent on endothelium) was studied in 10 children aged four to 16
      years who had normal pulmonary haemodynamics. Arterial diameter was measured by
      quantitative angiography, and pulmonary blood flow velocity was measured with a
      3F intra-arterial Doppler catheter placed in a lower lobe segmental artery.
      RESULTS: There was a dose dependent increase in flow velocity in response to
      acetylcholine (maximum response 93%) (SEM 7%), and an increase of 51% (8%) in
      response to nitroprusside. By contrast, segmental artery diameter was unchanged
      during acetylcholine infusion in all patients, and increased only modestly in
      response to nitroprusside (5% (1%)). CONCLUSIONS: The most important site of
      action of endothelium dependent and independent pulmonary vasodilators is distal
      to the segmental pulmonary arteries. Despite low resting tone in the pulmonary
      circulation, endothelium dependent vasodilatation can be shown in vivo. This may
      allow study of the role of endothelial dysfunction in children with abnormal
      pulmonary haemodynamic secondary to congenital heart disease.

PMID- 8489860
TI  - Transient myocardial ischaemia after acute myocardial infarction does not induce
      ventricular arrhythmias.
AB  - OBJECTIVE: To see whether transient myocardial ischaemia on ambulatory monitoring
      after myocardial infarction is associated with ventricular arrhythmias. DESIGN: A
      prospective study. SETTING: The coronary care unit, general medical wards, and
      cardiorespiratory department of a major teaching hospital. PATIENTS: 203
      consecutive patients without specific exclusion criteria admitted with acute
      myocardial infarction. INTERVENTIONS: 24 hour ambulatory electrocardiographic
      monitoring for ventricular arrhythmias and ST depression both early (mean 6.3
      days after infarction, n = 201) and late (mean 38 days, n = 177). MAIN OUTCOME
      MEASURES: Episodes of myocardial ischaemia were identified during ambulatory
      monitoring by transient ST depression of > or = 1.0 mm lasting for > or = 30 s.
      Ventricular arrhythmias were single extrasystoles, couplets, or ventricular
      tachycardia. RESULTS: All ventricular arrhythmias were significantly more
      frequent in late than early monitoring. The arrhythmias included couplets (in
      83/174 (48%) v 49/200 (25%) of patients, p = 0.0000028) and ventricular
      tachycardia (29/174 (17%) v 15/199 (8%), p = 0.0064). Patients with ST depression
      (29 early; 56 late), compared with those without ischaemia, did not experience a
      significant increase in single extrasystoles, couplets (31% v 23% early; 47% v
      48% late), or ventricular tachycardia (3% v 8% early; 18% v 16% late). Even
      patients with frequent (> or = 3 episodes), and deep (> or = 1.5 mm) or prolonged
      (> or = 20 min) ST depression had no increase in arrhythmias. CONCLUSIONS:
      Ventricular arrhythmias after myocardial infarction are not associated with
      transient myocardial ischaemia during daily activities. This study does not
      support the belief that to abolish silent ischaemia would reduce the incidence of
      sudden death due to uncontrollable ventricular arrhythmias after myocardial
      infarction.

PMID- 8489861
TI  - Benefits of fludrocortisone in the treatment of symptomatic vasodepressor carotid
      sinus syndrome.
AB  - OBJECTIVE: To assess treatment with fludrocortisone in vasodepressor carotid
      sinus syndrome. PATIENTS AND METHODS: Eleven patients, mean (SD) age 83 (5)
      years, with daily dizzy episodes and a median of five (range two to 20) syncopal
      episodes over a median of one year were studied. All had vasodepressor carotid
      sinus syndrome (> 50 mm Hg fall in systolic blood pressure during carotid sinus
      massage independent of bradycardia). Carotid sinus massage was carried out while
      the patient was supine and upright (tilt table) before and after 600 micrograms
      intravenous atropine. Phasic heart rate and blood pressure recordings were
      monitored throughout. The study was repeated after 100 micrograms of
      fludrocortisone daily by mouth for two weeks. Patients continued to take
      fludrocortisone for a six month follow up period. RESULTS: Baseline systolic
      blood pressure was (mean (SD)) 169 (31) mm Hg and the RR interval was 770 (150)
      ms. After carotid sinus massage, systolic blood pressure fell to 113 (27) mm Hg
      (p < 0.01) and RR was 1060 (210) ms (NS). The vasodepressor response was 56 (12)
      mm Hg. Baseline systolic blood pressure after two weeks of fludrocortisone
      treatment was 171 (37) mm Hg (NS); but the fall in systolic blood pressure during
      carotid sinus massage was significantly reduced (32 (14) mm Hg; p < 0.01). At six
      months follow up, two patients complained of intermittent dizziness and no
      patients had syncope. CONCLUSION: Fludrocortisone effectively reduces the
      vasodepressor response and relieves the symptoms of vasodepressor carotid sinus
      syndrome.

PMID- 8489862
TI  - Abnormal autonomic modulation of QT interval in patients with idiopathic
      ventricular tachycardia associated with clinically normal hearts.
AB  - BACKGROUND: Idiopathic ventricular tachycardia (VT) occurs in a small but
      important subset of patients without clinically overt heart disease. The
      mechanism of the arrhythmogenesis remains unclear in these patients. This study
      examines modulation of the QT interval by the autonomic nervous system in a group
      of patients with idiopathic ventricular tachycardia. METHODS: Cardiac autonomic
      activity and ventricular repolarisation were studied in 27 patients with VT
      associated with a clinically normal heart (NHVT) and in 20 normal subjects. All
      the patients were in sinus rhythm, had normal atrioventricular conduction, and
      were in a drug free state. Cardiac efferent autonomic activity was measured by
      spectral analysis of heart rate variability from 24 hour ambulatory
      electrocardiograms on a Holter analysis system (Marquette). Ventricular
      repolarisation was evaluated by measuring the QT intervals from the same 24 hour
      Holter tapes at one hour intervals. RESULTS: There was no difference in any of
      the QT interval variables including the maximum, minimum, and mean of both the QT
      interval and its corrected value (Bazett's formula) between patients with NHVT
      and normal subjects. The high frequency component (0.04-0.15 Hz) of heart rate
      variability was significantly decreased in patients with NHVT compared with
      normal subjects (16 (8) v 21 (12) ms, p < 0.05). There was a significant
      correlation between the spectral variables of heart rate variability and the
      mean, maximal, and minimal QT intervals in normal subjects, whereas the relation
      was lost in patients with NHVT. No difference was found in mean heart rate
      between normal subjects and patients with NHVT (70 (9) v 72 (13) beats/min, NS).
      CONCLUSIONS: The high frequency component of heart rate variability is
      significantly decreased and the relation of QT interval to heart rate variability
      is significantly altered in patients with NHVT as compared with normal subjects.
      These findings suggest that abnormal modulation of the QT interval by the
      autonomic nervous system may play an important part in the arrhythmogenesis of
      NHVT. This might result from impaired vagal efferent cardiac activity in these
      patients.

PMID- 8489863
TI  - Radiofrequency ablation of accessory atrioventricular pathways: predictive value
      of local electrogram characteristics for the identification of successful target
      sites.
AB  - BACKGROUND: Radiofrequency catheter ablation of accessory arterioventricular
      pathways has been shown to be a highly effective treatment in patients with
      paroxysmal superventricular tachycardia. There is, however, considerable
      variability in the number of attempted ablation sites, contributing to lengthy
      operations in some cases. The purpose of this study was to investigate the
      predictive value of local electrogram characteristics for the identification of
      successful target sites. METHODS AND RESULTS: Local bipolar electrograms from 60
      patients recorded at 568 sites of attempted ablation were analysed. There were
      511 sites at which ablation was guided by antegrade mapping, with 49 successful
      sites and 462 failed sites including 61 at which accessory pathway conduction was
      blocked temporarily. In multivariate analysis, the time of local ventricular
      activation relative to onset of the QRS complex (QRS-V interval) (p < 0.001) and
      the presence of a possible accessory pathway potential (p < 0.05) were found to
      be independent predictors of successful outcome, whereas the atrioventricular
      interval, atrioventricular amplitude ratio, stability of local electrogram, and
      presence of continuous electrical activity were not. A QRS-V interval of < or =
      +10 ms identified successful sites with a sensitivity of 98%, but the positive
      predictive accuracy was only 11%. Even a QRS-V interval of < or = 20 ms resulted
      in only a 24% probability of success with a sensitivity of just 18%. Combining
      the QRS-V interval with the presence of a possible accessory pathway potential
      greatly reduced the sensitivity at all cut off values, but failed to increase
      positive predictive accuracy above 25%. There were no significant differences in
      electrogram characteristics between the successful sites and the sites at which
      conduction of the accessory pathway was interrupted transiently. There were 57
      sites (nine successful, 48 failed) at which ablation was guided by retrograde
      mapping, but none of the local electrogram characteristics analysed emerged as
      independent predictors of successful pathway ablation. CONCLUSION: Local
      electrogram characteristics used to guide radiofrequency catheter ablation are
      all associated with a low positive predictive accuracy, which significantly
      contributes to duration of the operation. It is unlikely that this problem will
      be resolved solely by modification of the mapping techniques. It could require
      advances in catheter technology and power sources to enable larger tissue lesions
      to be delivered more reliably than is possible with the equipment in current use.

PMID- 8489864
TI  - Rapid increase in plasma endothelin concentrations during percutaneous balloon
      dilatation of the mitral valve in patients with mitral stenosis.
AB  - OBJECTIVE: To investigate the relation between plasma concentrations of
      immunoreactive endothelin and haemodynamic variables before and after
      percutaneous transvenous balloon dilatation of the mitral valve. DESIGN:
      Prospective study. SETTING: National cardiovascular centre. PATIENTS: 25 patients
      with mitral stenosis and 26 healthy volunteers. MAIN OUTCOME MEASURES: Plasma
      concentrations of immunoreactive endothelin were measured in the pulmonary
      artery, left atrium, ascending aorta, and femoral vein before and after balloon
      dilatation of the mitral valve. RESULTS: Peripheral venous concentrations (mean
      (SD)) of endothelin were higher in the patients with mitral stenosis than in the
      healthy volunteers (1.76 (0.51) v 1.37 (0.45) pg/ml, p < 0.05) and they
      correlated with the mean left atrial pressure (r = 0.74, p < 0.01). Balloon
      dilatation of the mitral valve reduced the mean left atrial pressure without
      changing the mean right atrial pressure, systemic arterial pressure, heart rate,
      or cardiac index. Concentrations of plasma endothelin in the femoral vein
      increased from 1.76 (0.51) to 3.39 (2.46) (p < 0.01), 4.82 (2.34) (p < 0.001),
      and 2.43 (0.52) pg/ml (p < 0.05) at 15 and 30 minutes and 24 hours after the
      procedure. The concentration of endothelin in the pulmonary artery also increased
      from 1.85 (0.85) to 4.32 (1.58) pg/ml (p < 0.01) 30 minutes after the dilatation,
      whereas there were no appreciable changes in endothelin concentration in the left
      atrium or ascending aorta. CONCLUSIONS: Plasma endothelin concentrations were
      higher in patients with mitral stenosis than in healthy volunteers and the
      increase was proportional to left atrial pressure. After balloon dilatation of
      the mitral valve there was an abrupt rise in endothelin in the femoral vein and
      pulmonary artery but no change in left atrial or aortic blood samples. These
      findings suggest that endothelin may be another vasoactive substance involved in
      congestive heart failure.

PMID- 8489865
TI  - Shortened left ventricular filling time in dilated cardiomyopathy: additional
      effects on heart rate variability?
AB  - OBJECTIVE: To assess possible mechanical influences underlying the reduced heart
      rate variability in patients with dilated cardiomyopathy. DESIGN: Comparison of
      standard non-spectral indices of heart rate variability with echocardiographic
      Doppler measures of left ventricular function in patients and normal controls.
      PATIENTS: 20 patients with dilated cardiomyopathy and 15 normal subjects of
      similar ages were studied. METHODS: Standard non-spectral indices of heart rate
      variability were measured over 24 hours. These were correlated with left
      ventricular cavity size, shortening fraction, and isovolumic relaxation time
      measured by M mode echocardiography, and the duration of functional mitral
      regurgitation and left ventricular filling time assessed by continuous wave
      Doppler. RESULTS: Mean RR interval and estimates of short term variability (root
      mean square difference of successive RR intervals, proportion of adjacent RR
      intervals > 50 ms different, and SD indices) were not different from normal. The
      overall mean (SD) of the RR interval (65 (35)), and SD of five minute mean RR
      intervals (55 (30)), however, were reduced compared with normal values (115 (40)
      and 105 (45); p < 0.01 for both). Neither correlated with left ventricular cavity
      size or shortening fraction, but both were strongly related to left ventricular
      filling time (coefficient of variation, r = 0.82 and r = 0.81 respectively).
      Correlation persisted when the SD was corrected for RR interval (r = 0.69)
      although this correlation was not found in the controls. In individual patients,
      the difference between RR interval at the time of echo and minimum value during
      the 24 hours, a measure of ability to increase heart rate, also correlated
      closely with filling time (r = 0.92). CONCLUSION: As the duration of functional
      mitral regurgitation is effectively fixed, its presence can limit the time
      available for left ventricular filling in dilated cardiomyopathy when heart rate
      is high. This may become the mechanism by which maximum heart rate is set,
      becoming fixed to optimise cardiac output. This manifestation of dilated
      cardiomyopathy may be an important factor in reduction of heart rate variability
      in these patients.

PMID- 8489866
TI  - Fibrinogen in relation to personal history of prevalent hypertension, diabetes,
      stroke, intermittent claudication, coronary heart disease, and family history:
      the Scottish Heart Health Study.
AB  - OBJECTIVE: To determine the relations of plasma fibrinogen to family history of
      premature heart disease, personal history of hypertension, diabetes, stroke,
      coronary heart disease, and to presence of intermittent claudication. DESIGN:
      Random population survey across 22 local government districts in Scotland.
      PARTICIPANTS: 10,359 men and women aged 40 to 59 years. Plasma fibrinogen was
      measured in 8824. MAIN OUTCOME MEASURE: Plasma fibrinogen concentration. RESULTS:
      Persons with a family history of heart disease or a personal history of high
      blood pressure, diabetes, stroke, or presence of intermittent claudication all
      had higher plasma fibrinogen concentrations than those without. When compared
      with participants without cardiovascular or related disease (men: 2.27 (SE =
      0.01) g/l, n = 3367; women 2.34 (0.01) g/l, n = 3096), predefined cases of either
      myocardial infarction (men: 2.51 (0.02) g/l, n = 248; women: 2.63 (0.04) g/l, n =
      72) or angina (men: 2.45 (0.02) g/l, n = 394; women: 2.50 (0.02) g/l, n = 398)
      had significantly higher plasma fibrinogen concentrations (p < 0.001). After
      adjustment for 10 other coronary risk factors, there was a noticeable linear
      trend in the odds ratios for myocardial infarction across all quartiles
      (quarters) of plasma fibrinogen concentrations in both sexes. Similarly, the risk
      of angina increased linearly with increasing fibrinogen concentrations, although
      the test for a linear trend was NS among women. CONCLUSIONS: This large
      population study confirms that plasma fibrinogen is not only a risk factor for
      coronary heart disease and stroke, but it is also raised with family history of
      premature heart disease and with personal history of hypertension, diabetes, and
      presence of intermittent claudication.

PMID- 8489867
TI  - Radiofrequency-assisted "reconstruction" of the right ventricular outflow tract
      in muscular pulmonary atresia with ventricular septal defect.
AB  - A case of pulmonary atresia with ventricular septal defect is reported in which a
      communication was established between the right ventricle and the hypoplastic
      pulmonary artery by intervention, despite muscular atresia of the right
      ventricular outflow tract. The atresia was perforated with a special designed
      radiofrequency catheter (Osypka). After the creation of a canal within the
      muscular atresia, balloon dilatation (diameters 2, 3.5, and 7.2 mm) was
      performed. Arterial oxygen saturation increased from 64% to 78%. Lateral
      deviation of the radiofrequency catheter resulting in a lateral perforation of
      the atretic muscular infundibulum was well tolerated without later sequelae.
      Early restenosis within two weeks necessitated the implantation of a stent within
      the "recanalised" atresia resulting in an increased anterograde flow to the
      pulmonary artery. This case shows that "recanalisation" of muscular atresia of
      the pulmonary artery by radiofrequency is a promising technique. Additionally,
      stent implantation into the infundibulum to prevent restenosis is a first step to
      interventional right ventricular outflow tract reconstruction.

PMID- 8489868
TI  - Radiofrequency-assisted balloon dilatation in patients with pulmonary valve
      atresia and an intact ventricular septum.
AB  - OBJECTIVE: To investigate the efficacy and safety of transcatheter radiofrequency
      assisted valve dilatation for infants with pulmonary valve atresia and intact
      ventricular septum as an alternative to the use of laser heated wires. DESIGN:
      Prospective clinical study. SETTING: Three paediatric cardiology centres.
      PATIENTS: Four children (aged 5-101 days, weight 2.8 kg) with pulmonary valve
      atresia and intact ventricular septum underwent percutaneous radiofrequency
      assisted valve dilatation. METHODS: After delineating the atretic valve by
      angiography, 0.020 inch or 0.018 inch radiofrequency wires were used to perforate
      the atretic valve. The valve was then dilated with conventional balloon
      dilatation catheters up to the valve annulus diameter. RESULTS: In all four cases
      the radiofrequency wire perforated the atretic pulmonary valve and balloon
      dilatation was successful. In one patient the radiofrequency wire also passed
      through the anterior wall of the pulmonary artery causing tamponade which
      required surgical repair shortly afterwards. This patient died from sepsis six
      days later. One patient died three weeks after the procedure from septicaemia and
      a paradoxical coronary embolus. Two patients were discharged after 4 and 14 days
      respectively. CONCLUSIONS: Radiofrequency-assisted valve dilatation is a
      promising alternative to the recently developed laser wire technique. The major
      advantages are a reduction in cost and improved safety for the staff performing
      the procedure.

PMID- 8489869
TI  - Evaluation of anatomical obstruction by Doppler echocardiography and magnetic
      resonance imaging in patients with coarctation of the aorta.
AB  - OBJECTIVE: To evaluate a new Doppler echocardiographic index of obstruction in
      patients with native coarctation or recoarctation. PATIENTS: 32 patients (mean
      age 20, range 3 months--50 years). METHODS: Magnetic resonance imaging (MRI) was
      used to investigate the descending aorta. The cross sectional area of the
      obstruction was compared with the area of the abdominal aorta as an index of
      obstruction (CoA index). Doppler echocardiography was used to record the
      velocities in the coarctation jet and in the abdominal aorta. According to the
      continuity equation the ratio of these velocities should equal the ratios of the
      cross sectional areas. The gradients and diastolic half time of the Doppler curve
      were calculated. RESULTS: There was a close correlation between the MRI index of
      obstruction and the Doppler velocity ratio (r = 0.92). The sensitivity and
      specificity of this ratio in detecting a CoA index equal to or less than 0.25
      were better than those obtained with gradients only or the combination of
      gradients and diastolic half time. CONCLUSION: The new Doppler velocity ratio
      correlated closely with an anatomical index of obstruction. It was easy to record
      in most patients and it avoided difficulties about the choice of instantaneous or
      peak to peak gradients and whether or not to subtract proximal velocities for the
      calculation of gradients.

PMID- 8489870
TI  - Monophasic action potentials in a patient with multiform ventricular tachycardia
      without QT prolongation.
AB  - A 41 year old woman had multiform ventricular tachycardia without QT
      prolongation. Monophasic action potentials were recorded from the right ventricle
      during the attacks of multiform ventricular tachycardia and effective refractory
      periods were examined at the same sites. There was no abnormal hump to suggest
      early afterdepolarisation in the monophasic action potentials, but there was
      dispersion of the effective refractory period in the right ventricle (80 ms).
      Stimulation from the right ventricular apex, where the effective refractory
      period was shortest, reproducibly induced multiform ventricular tachycardia. Two
      weeks after admission, when her condition was stable, multiform ventricular
      tachycardia could not be induced and the dispersion of the effective refractory
      period in the right ventricle was 20 ms.

PMID- 8489871
TI  - Post-exertion dizziness as the sole presenting symptom of autonomic failure.
AB  - An otherwise fit young man, leading an active life, whose only complaint at
      presentation was dizziness after extreme exertion is described. He was found
      later to have postural and exercise induced hypotension. Subsequently, he
      developed typical symptoms of autonomic failure, with postural dizziness, urinary
      abnormalities, and erectile failure. Progression of autonomic failure was
      documented on testing. A fall in blood pressure during or after exercise has been
      reported previously in pure autonomic failure, but a presentation with exercise
      induced symptoms alone is unusual.

PMID- 8489872
TI  - Occlusion of coronary vein grafts secondary to non-penetrating chest injury.
AB  - Eighteen months after graft surgery to the posterior descending, circumflex, and
      left anterior descending coronary arteries, it seems that blunt chest trauma
      caused by a car accident resulted in occlusion of the grafts.

PMID- 8489873
TI  - Vasospastic angina induced by prostaglandin F2 alpha.
AB  - A 56 year old woman underwent cholecystectomy. Postoperative paralytic ileus was
      treated with an intravenous infusion of prostaglandin F2 alpha. During infusion
      she complained of oppressive chest pain. This was accompanied by ST segment
      depression, and was relieved by sublingual glyceryl trinitrate. Coronary
      arteriography did not show significant stenosis, but subsequent intravenous
      infusion of prostaglandin F2 alpha provoked multiple segmental spasm of both the
      right and left coronary arteries.

PMID- 8489874
TI  - Rupture of left ventricle after mitral valve repair: case report and new
      technique of repair.
AB  - Type 1 rupture of the left ventricle occurred during mitral valve repair. A
      repair operation, in which the posterior leaflet of the mitral valve was used as
      a buttress, was successful.

PMID- 8489875
TI  - Current perspectives on prosthetic heart valves and valve repair.
AB  - The quest for the ideal cardiac valve substitute represents a highly categorized
      goal for the cardiac surgical community. Ongoing research has resulted in the
      development and creation of multiple newer heart valves and techniques for valve
      repair. Each of the many valves commercially available possesses a wide array of
      features. With the expansion of research investigations, improvement in long-term
      management can be translated and incorporated directly into patient care. As
      valvular replacement and repair/reconstruction surgery become more commonplace,
      it is paramount for nurses to be knowledgeable regarding the critical components
      of care.

PMID- 8489876
TI  - Hypothermia and rewarming after cardiac surgery.
AB  - Ensuring adequate oxygen delivery to the tissues with respect to oxygen demand is
      an important operative challenge during cardiac surgery. The state of the art in
      myocardial preservation in the 1990s has evolved to include pretreatment of the
      myocardium; intraoperative use of systemic hypothermia with cardiopulmonary
      bypass (CPB), topical cooling of the myocardium, cold cardioplegia, and
      myocardial reperfusion; and postoperative oxygen transport support. These
      techniques optimize myocardial preservation while providing adequate cardiac
      surgery operative times by decreasing the myocardial ischemic period, decreasing
      cellular metabolic requirements, and preserving energy stores. Awareness of the
      physiologic consequences of hypothermia in the postoperative cardiac patient
      improves nursing assessment of the hypothermic patient. Appropriate temperature
      monitoring and reporting support timely medical and nursing interventions for
      hypothermia, such as internal and external rewarming techniques or drug
      administration to facilitate the rewarming process and suppress or treat
      shivering. This article addresses the physiologic condition of hypothermia, the
      elective hypothermia techniques used during cardiac surgery, and the medical or
      nursing rewarming and management techniques for the postoperative cardiac surgery
      patient.

PMID- 8489877
TI  - Myocardial depression after cardiac surgery: pharmacologic and mechanical
      support.
AB  - Cardiovascular surgery patients may experience a low cardiac output state as a
      result of anesthesia, cardiopulmonary bypass, and myocardial stunning. Prompt
      assessment and early intervention are critical to patient survival. A variety of
      pharmacologic agents are available to support the failing circulation, including
      several promising new experimental inotropic agents. Intraaortic balloon pumps
      (IABP) and ventricular assist devices (VAD) are additional therapies reserved for
      advanced cardiac decompensation that is unresponsive to pharmacologic treatment.
      A review of etiologic factors precipitating postcardiotomy failure is presented,
      and traditional and experimental inotropic agents are discussed. An overview of
      mechanical cardiac support with the IABP, centrifugal and pneumatic VAD, and the
      Hemopump (Johnson & Johnson Interventional Systems, New Brunswick, NJ) device is
      presented, all of which addresses information critical to optimal patient
      outcomes.

PMID- 8489878
TI  - Managing low cardiac output states: maintaining volume after cardiac surgery.
AB  - Low cardiac output after cardiac surgery may be caused by hypovolemia, myocardial
      depression, vasoconstriction, and dysrhythmias. Postoperative hypovolemia occurs
      because of blood volume loss and decreased diastolic filling. Diuresis,
      intravascular fluid shift into the interstitium, hormonal influences, and
      bleeding deplete blood volume. Diastolic filling may be compromised by positive
      end-expiratory pressure, vasodilation, dysrhythmias, and venous return
      obstruction. The primary indicator of intravascular volume is ventricular
      preload, which may be measured indirectly with central venous pressure, left
      atrial pressure, or pulmonary capillary wedge pressure. Recognition of
      hypovolemia is aided through the use of cardiac pressure trend monitoring and
      evaluation of noninvasive indicators of hypovolemia. Nursing goals, in response
      to hypovolemia, are to increase the circulating volume, optimize oxygen delivery,
      stabilize hemodynamics, improve tissue perfusion, and prevent shock.

PMID- 8489879
TI  - Quality of life after cardiac surgery.
AB  - Tremendous strides have been made in the surgical treatment of cardiac disease.
      Research has documented many physical and psychologic benefits for the patient,
      but many questions remain unanswered. The change in quality of life may be the
      single most important outcome of cardiac surgery. This issue has received
      considerable attention in professional literature in recent years, particularly
      in the midst of rapidly expanding technology and soaring health care costs. This
      article reviews the literature related to the quality of life of cardiac surgical
      patients. Specific topics, such as physiologic and psychologic outcomes, return
      to work, family responses, and issues related to transplant patients, are
      discussed. The article includes a discussion of nursing implications.

PMID- 8489880
TI  - Care of infants with hypoplastic left heart syndrome.
AB  - Hypoplastic left heart syndrome (HLHS) is a common congenital heart defect that
      is universally fatal without surgical intervention. Two distinctly different
      surgical options, heart transplantation and reconstruction surgery, have been
      successful in treating infants with HLHS. This article reviews the anatomy and
      pathophysiology of HLHS. Preoperative care of infants with HLHS is discussed. The
      care required by infants with HLHS after heart transplantation is the same as
      that required by other infants who need heart transplant and has been reported.
      The primary focus of this report is postoperative care after staged
      reconstructive surgery for infants with HLHS.

PMID- 8489881
TI  - The economics of cardiac surgery.
AB  - The coronary artery bypass graft (CABG) is the most costly single surgical
      procedure in the United States, making bypass surgery a key target for cost
      containment in the current health care reform environment. This article
      highlights the relationship between risk factors and costs and describes some of
      the current initiatives aimed at cost containment and quality enhancement.

PMID- 8489882
TI  - Management of acute burns and burn shock resuscitation.
AB  - Initial management of minor and moderate, uncomplicated burn injury focuses on
      wound management and patient comfort. Initial management of patients with major
      burn injury requires airway support, fluid resuscitation for burn shock,
      treatment for associated trauma and preexisting medical conditions, management of
      adynamic ileus, and initial wound treatment. Fluid resuscitation, based on
      assessment of the extent and depth of burn injury, requires administration of
      intravenous fluids using resuscitation formula guidelines for the initial 24
      hours after injury. Inhalation injury complicates flame burns and increases
      morbidity and mortality. Electrical injury places patients at risk for cardiac
      arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness
      burns to extremities compromise circulation and require escharotomy or
      fasciotomy. Circumferential torso burns compromise air exchange and cardiac
      return. Loss of skin function places patients at risk for hypothermia, fluid and
      electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury
      require aggressive medical management to assure survival and minimize
      complications.

PMID- 8489883
TI  - Inhalation injury.
AB  - Inhalation injury remains a primary determinant of patient survival, with 60% to
      70% of burn center fatalities attributed to the pulmonary complications of
      inhalation injury. Substantial airway damage and pulmonary complications can
      result from the inhalation of toxic fumes and gases found in smoke. Partial to
      complete airway obstruction, pulmonary edema, pneumonia, and progressive
      pulmonary failure may occur. Early diagnosis of inhalation injury and vigorous
      pulmonary care and support are vitally important to patient survival.
      Bronchoscopy and xenon 133 ventilation-perfusion scans are two of the newer
      diagnostic tools used to identify burn patients with inhalation injury. Treatment
      measures for patients with inhalation injury and recommendations for nursing
      practice are discussed.

PMID- 8489884
TI  - Burn wound management.
AB  - Management of a burn wound is interrelated with many patient care protocols.
      After the patient has received initial care, is in stable condition, and has been
      transported to the appropriate medical facility, the selection of burn wound
      treatment protocols is based on patient population. Hydrotherapy, debridement,
      topical antimicrobial agents, and dressings reduce bacterial colonization until
      the wound closes. Supportive care is essential to the preservation of viable
      tissue. Excision and autografting are the primary method of wound management. The
      practical application of cultured autograft and growth factors is under study.

PMID- 8489885
TI  - Burn care. Metabolic alterations and nutritional management.
AB  - Major burn trauma is one of the greatest insults the body can sustain. Complex
      responses to this injury greatly increase the body's energy and nutritional
      requirements. This article presents the metabolic responses and associated
      nutritional requirements that occur with a thermal injury. Nursing standards of
      care for the nutritional management of the patient with thermal injury are
      presented, since nurses have a primary role in managing the patient's care in a
      manner that will provide adequate nutrients, reduce energy demands, and prevent
      potential complications associated with the injury, healing process, and
      therapeutic interventions.

PMID- 8489886
TI  - Immune consequences of burn injury.
AB  - The purpose of the immune system is to protect cells from invasion by
      microorganisms. The body has three equally important interactive immune defense
      systems, all of which are profoundly disrupted with major burn injury. The immune
      response to burn injury is immediate, prolonged, and severe. The end result in
      individuals surviving burn shock is immunosuppression, with increased
      susceptibility to potentially fatal systemic burn wound or pulmonary sepsis.
      Nursing actions to support the humoral and cell-mediated immune system of the
      burned patient include providing nutritional support to maintain serum protein
      levels at optimal levels; measures to decrease edema and promote angiogenesis in
      areas of partial-thickness injury; meticulous treatment of the wound to prevent
      infection and promote healing; monitoring of antibiotic use; conservative use of
      invasive techniques, including intubation and vascular access devices;
      maintenance of fluid and electrolyte balance and body temperature; and energy
      conservation measures.

PMID- 8489887
TI  - Improving survival: infection control and burns.
AB  - In the past, survival of the thermally injured patient was greatly hindered by
      invasive infection that originated in the burn wound. Current treatment
      modalities, including early excision of the burn wound and prompt wound closure,
      administration of systemic antibiotics and topical antimicrobial agents, and
      mechanical isolation, have improved survival. However, infection and the sequelae
      of infection continue to be the leading causes of morbidity and mortality for the
      thermally injured patient. In addition, the burn patient remains highly
      susceptible to other infectious processes. A thorough understanding of infection
      control and burns are essential to the successful treatment of burn injuries.

PMID- 8489888
TI  - When is the burn injury healed?: psychosocial implications of care.
AB  - The psychosocial and economic effects of burn trauma are profound, not only for
      the patients, their families, and the burn unit staff members, but also for
      society as a whole. Understanding the perception of stresses experienced by
      patients, families, and staff is discussed, and related strategies to assist in
      reducing the stress are presented. A comprehensive psychosocial support system
      can assist the nurse in reducing the psychosocial morbidity of severe burn
      trauma.

PMID- 8489889
TI  - Pediatric burn injuries.
AB  - Care of the pediatric burn patient requires knowledge of physiologic differences
      between adults and children for estimation of burn size, calculation of fluid
      needs, and assessment of response. Dressing techniques, pain management, and
      nutritional and psychologic support of this population require special
      considerations.

PMID- 8489890
TI  - [Emergency or elective surgery in the treatment of acute cholecystitis].
AB  - The authors report their experience in the surgical management of acute
      cholecystitis. From 1979 to 1991, 308 patients underwent early cholecystectomy.
      Results obtained, accuracy of pre- and intraoperative diagnostic investigations,
      and surgical strategy are discussed in relation to prognostic indexes. Personal
      experience and literature review indicate early cholecystectomy as the treatment
      of choice in acute cholecystitis.

PMID- 8489891
TI  - [Posttraumatic pseudoaneurysms of the anterior tibial artery: a review of the
      literature and a clinical case report].
AB  - The authors after a review of the literature report a case of anterior tibial
      artery false aneurysm in a seventeen year old male, due to traumatic sprained
      ankle during a basketball match. Surgical techniques used in repairing the lesion
      as well as microsurgical technique for the direct suture of the artery, which
      allowed to resolve the problem, are discussed.

PMID- 8489892
TI  - [Echinococcal cysts with primary muscle localization: comments on a clinical
      case].
AB  - Primary muscular localization of echinococcosis is rare and unknown are the
      causes that determine it. The authors report a case recently observed and
      illustrate the etiopathogenetic hypothesis more accredited in the literature. It
      is concluded that surgical treatment is the best choice, although relapses are
      possible. Therefore, a long term follow up of the patients including clinical and
      serological investigations is advisable.

PMID- 8489893
TI  - [Primary sarcoidosis of the breast: a clinical case].
AB  - Sarcoidosis of the breast is rare and only few cases are reported in the
      literature. A case of sarcoidosis presenting as a breast mass with no other
      evidence of disease is herein reported. Ultrasound and fine needle aspiration
      biopsy were performed, but only excisional biopsy with microscopic examination
      confirmed the diagnosis. Differential diagnosis with other granulomatous lesions
      is important to select the proper treatment.

PMID- 8489894
TI  - [The pilonidal sinus: its surgical treatment, our experience and a review of the
      literature].
AB  - The authors report their experience in the surgical management of pilonidal
      sinus. During a 3-year period (1989-1991) 106 patients underwent primary closure.
      Average postoperative stay was 5.5 days, while mean healing time was 14.6 days.
      During the follow up, 3 patients developed a true recurrence (3.26%). After a
      critical review of the literature, the authors emphasize the importance of
      primary closure in the surgical treatment of pilonidal disease.

PMID- 8489895
TI  - [Quandrantectomy in the conservative treatment of breast carcinoma].
AB  - Two years after the first evaluation, the authors review the results of
      quadrantectomy in the conservative treatment of breast carcinoma. Local control
      of the disease by quadrantectomy with axillary lymphadenectomy and radiotherapy
      has been more difficult in the T2 patients (4 local relapses out of 41 patients)
      compared T1 patients (3 local relapses out of 52 patients). Nodal involvement
      appears to be not crucial for the prognosis (7 patients out of 10 with remote
      metastases were N- at the time of surgery).

PMID- 8489896
TI  - [A proposed clinico-instrumental protocol for diagnostic guidance in breast
      lumps].
AB  - Women who practice self-examination of the breast often believe to identify lumps
      which produce much concern; in many cases differential diagnosis with cancer is
      therefore necessary. The authors propose a clinical-instrumental protocol as a
      guide to the right diagnosis in these patients.

PMID- 8489897
TI  - [Peritonectomy in the treatment of ovarian carcinoma at an advanced stage].

PMID- 8489898
TI  - [The changes in the sexual behavior of patients undergoing aorto-iliac
      revascularization].
AB  - A correct approach to sexual disorders in vascular patients presupposes an
      accurate investigation before and after operation. The authors evaluate the
      reliability of the diagnostic methods used, pre- and postoperatively, to
      ascertain sexual disorders, and analyse the influence of surgery on sexual
      function.

PMID- 8489899
TI  - [Trauma: when the liver "ruptures".... Our experience of 125 cases].
AB  - Liver and spleen are the organs most frequently involved in the blunt abdominal
      trauma. Prognosis is severe in those cases classified as IV or V according to the
      More score. The imaging techniques, particularly CT scan, offer today a
      possibility in the nonoperative management of a selected group of
      haemodynamically stable patients, therefore reducing the need of surgery. The
      authors' experience in 125 patients observed from 1983 to 1991 is reported.

PMID- 8489900
TI  - [Ischemic colitis localized in the right colon. A clinical case report].
AB  - Ischemic colitis shock-associated still is a not well-defined clinical entity.
      The authors describe symptoms, clinical course and treatment in a case recently
      observed. They outline the difficulties of preoperative diagnosis and the need of
      a not postponable surgical treatment due to shock and peritonitis.

PMID- 8489901
TI  - [Anterior approaches to the spinal column: considerations of the surgical
      technic].
AB  - The anterior approach to the vertebral column is indicated in the tumors or
      traumas of the vertebral body with prevalent anterior expression. This method
      allows to control easily all the structures in front of the rachis. Furthermore,
      the current reconstructive techniques require the exposure of a long tract of the
      vertebral column. The Authors report their experience with the anterior approach
      in 22 patients (9 males, 13 females) affected by different pathologies: 10
      primary tumors divided as follows: 4 sacral chordomas, 1 L1 chordoma, 2 sacral
      neurinomas, 1 L5 malignant melanotic schwannoma, 1 D9 osteoblastoma, 1 D6
      intraspinal cavernoma, and 1 D3 myeloma; 4 metastatic tumors (2 D10, 1 L4 and 1
      L5); 5 fractures of the vertebral body (1 L1, 1 L1-L2, 2 L4 and 1 L5); 2
      echinococcal cysts respectively arising from the D11 body, the sacrum and ilium.
      The Authors overall performed 8 thoracotomies, 6 for dorsal location; in 1 case
      of L1-L2 fracture a thoracophrenolaparotomy was performed; in 7 cases involving
      the L3-L5 segment an abdominal anterolateral extraperitoneal approach was
      followed; finally in 6 cases a transperitoneal laparotomy to approach the sacrum
      and ilium was performed.

PMID- 8489902
TI  - Dracunculiasis. Global surveillance summary, 1992.

PMID- 8489903
TI  - The programme of undergraduate cancer education of the Lodz School of Medicine
      (Poland).

PMID- 8489904
TI  - The tumor cell biology doctoral training program at Northwestern University.

PMID- 8489905
TI  - The influence of undergraduate medical cancer education on students' sensitivity
      towards cancer.
AB  - Cancer is a disease that doctors will have to face for many years to come. Our
      Department of Surgical Oncology is particularly interested in altering
      undergraduate students' and junior doctors' performance with respect to cancer
      and cancer patients' care. We believe that a solid base of knowledge gained
      during the undergraduate period with appropriate guidance will equip doctors with
      the necessary discipline towards cancer and its prevention. Cancer education must
      be ongoing and supported by all specialists, since cancer is a disease requiring
      multidisciplinary attention. This survey was conducted to evaluate the oncologic
      aspects of the undergraduate curriculum of our medical school.

PMID- 8489906
TI  - Undergraduate medical teaching in departments of oncology in the United Kingdom:
      a questionnaire survey.
AB  - A questionnaire survey has been conducted to assess the nature and extent of
      teaching given to undergraduate medical students in departments of Oncology
      within the United Kingdom. Postal questionnaires were sent to 58 departments of
      Radiotherapy/Oncology and 30 departments of Medical Oncology. This included both
      teaching and nonteaching departments. Response rates were 84.5% (49 replies) and
      90% (27 replies), respectively. Of the responders, 26 Radiotherapy/Oncology
      departments (53%) and 21 Medical Oncology departments (78%) have a regular
      commitment to undergraduate medical teaching, the majority being units affiliated
      to teaching hospitals. The time spent in teaching, methods of teaching, the
      teaching curriculum, and other details have been documented and are summarised.
      The information obtained leads us to conclude that there is a considerable
      variation between departments with regard to teaching commitments and the
      curriculum. Such variations appear to be primarily centre oriented rather than
      specialty biased. The survey also raises a number of issues regarding
      undergraduate medical teaching with reference to oncology, which are discussed.

PMID- 8489907
TI  - Elective introduction to oncology.
AB  - Since 1974, the St. George Medical Society, a component of the American Cancer
      Society's Philadelphia Division's Professional Education Program, has sponsored
      paid summer clinical and research fellowships for Philadelphia medical students
      completing their first year. Six lectures at the student level are presented
      throughout the year. Students run a single society, elect officers, and select
      site and speakers under the guidance of the St. George Medical Society
      Subcommittee. Faculty from six medical schools and individual faculty preceptors
      donate time to provide a one-on-one summer experience in medical oncology,
      surgical oncology, gynecologic oncology, radiation oncology, pathology, and
      cancer-related research in university hospitals, community hospitals, and private
      offices. Financial support is provided by directed donations. Currently 50
      clinical fellowships are offered. Since its inception, over 750 "fellowships"
      have been awarded, and over 3,000 students have attended the lectures. The
      program successfully provides a voluntary one-on-one introduction to clinical
      oncology in a reproducible format.

PMID- 8489908
TI  - Cancer control knowledge and priorities among primary care physicians.
AB  - Primary care physicians can play a key role in prevention and early detection of
      cancer. To assess cancer control knowledge and priorities among primary care
      physicians in Missouri, we conducted a random survey of 207 physicians. Although
      reported knowledge of the role tobacco plays in cancer causation was high,
      activity in tobacco cessation counselling and referral was low. Respondents
      considered diet to be a relatively unimportant factor in cancer causation,
      whereas they viewed sun exposure, genetics/family history, and radiation exposure
      as large contributors to the cancer burden. Among cancer early detection tests,
      high activity was shown for the Pap test and breast examination. Conversely, low
      activity was reported for colon sigmoidoscopy. Inverse correlations were shown
      between age group of the physician and several cancer prevention and early
      detection practices. For each cancer prevention and screening practice, reported
      activity was higher for medical doctors than for doctors of osteopathic medicine.
      Possible barriers or controversies in cancer control included disagreement with
      the current recommendation for Pap testing, the cost of mammography, and patient
      fear of sigmoidoscopy. These findings suggest that primary care physicians are
      not achieving their full potential in cancer control and indicate areas where
      increased emphasis is warranted.

PMID- 8489909
TI  - Health-care professionals' use of cancer-related patient education materials: a
      pilot study.
AB  - While the American Cancer Society and National Cancer Institute expend much
      effort designing patient education materials, little is known about how health
      care professionals use such materials in everyday practice. We piloted a
      descriptive study of primary care providers in San Francisco. Using a
      standardized questionnaire, we conducted face-to-face interviews with 71 health
      care professionals who responded to a mailed offer of a free set of American
      Cancer Society (ACS) materials. Most (72%) said their patients rarely or never
      requested cancer information, yet most (87%) distributed some type of health
      education material. However, 35 (49%) did not currently use ACS materials, citing
      as reasons: not having access to them (97%), incorrect language for patient
      population served (9%), and patient illiteracy (6%). Only 6% of providers
      believed these materials ineffective. The 33 practitioners using ACS materials
      most commonly distributed breast self-examination, colorectal cancer screening,
      smoking cessation, and mammography information. All 71 respondents were given a
      display rack containing ACS materials. Most (70%) planned to place the display
      rack in their office waiting room; few planned to place it in their examination
      room (13%) or adjacent hallway (10%). One-third (32%) of providers planned simply
      to let their patients browse through the materials, and only 7% planned to hand
      materials to patients directly. Future studies should focus on how such materials
      can be more efficiently distributed and more effectively used.

PMID- 8489910
TI  - Psychological distress in cancer patients and their spouses.
AB  - The degree of psychosocial distress experienced by 15 cancer patients with newly
      diagnosed metastatic disease and their spouses was investigated. Of interest were
      mean changes over the six-month interval following diagnosis, and correlations
      between partners at 0, 3, and 6-7 months. The Psychosocial Adjustment to Illness
      Scale (PAIS) and the Family Environment Scale (FES) were used to quantify
      adjustment. Several PAIS subscales exhibited increasing distress over time for
      patients: Social Environment (p = 0.004), Vocational Environment (p = 0.028), and
      Psychological Distress (p = 0.029). FES Conflict increased over time (p < 0.005),
      while Intellectual Cultural Orientation declined (p = 0.02), both for spouses
      only. Of 24 patient-spouse PAIS correlations (7 subscales plus a global scale, at
      three times), 7 (29%) were 0.70 or greater (ps < 0.01). Of 30 FES correlations,
      17 (57%) were 0.7 or higher (ps < 0.01). These results suggest that some stresses
      increase over time, and that spouses and patients share a similar perceived level
      of distress. Health professionals must address the psychological distress of the
      spouse as well as the patient.

PMID- 8489911
TI  - Gender differences in perceptions of cancer.
AB  - The purpose of this study was to consider gender differences in laypeople's
      beliefs about and explanations of cancer. Over 700 adults answered a
      questionnaire about their perceptions and explanations of the disease. The
      majority of respondents identified cancer as the most fearful disease. Women were
      more frightened of cancer than were men, whereas men were more frightened of
      heart disease than were women. The greatest fear of cancer was its perceived
      incurability and the associated suffering, whereas the greatest fear of heart
      disease was perceived susceptibility. Men were more likely than women to hold a
      more negative attitude toward cancer information. Factor analysis of the
      perceived causes of cancer identified four causal factors, which were labelled
      Stress, Environmental, Health-related, and Behavioural. Men were more likely to
      identify behavioural items as important whereas women were more likely to rate
      heredity as important. Fear of cancer was highly correlated with the health
      beliefs but not with the perceived causes of cancer. However, a regression
      analysis found that these health beliefs explained only a small proportion of the
      variance in cancer fear. The findings are discussed with reference to cancer
      education.

PMID- 8489912
TI  - Nutritional concerns of women with breast cancer.
AB  - Health professionals should assess the nutrition information needs of women with
      breast cancer in order to provide appropriate services. Questionnaires were
      mailed to 143 Reach to Recovery volunteers who had had surgery for breast cancer,
      and 72% responded. The subjects were mostly concerned about and wanted
      information on diets for cancer prevention, low-fat diets, weight reduction, and
      vitamin supplements. Findings also showed the potential for excessive
      vitamin/mineral use among one-third of respondents and a tendency toward weight
      gain regardless of whether or not chemotherapy was received. The results provide
      direction for development of nutrition educational materials and programs for
      women with breast cancer.

PMID- 8489913
TI  - The training of a member of the multidisciplinary cancer teaching team.

PMID- 8489914
TI  - A strategy for evaluating a novel smoking intervention device.
AB  - The Victorian Smoking and Health Program (VSHP) was established in 1985 to (1)
      determine the views of smokers making a quit attempt regarding the acceptability
      and usefulness of a novel self-help smoking cessation device (the QUITZ pack),
      (2) define a potential market by determining the correlates of use of the QUITZ
      pack, and to (3) determine how the QUITZ pack compared to existing resources with
      proven acceptability and usefulness. Telephone interviews were conducted of 120
      smokers who rang the QUITZ office for resources to help in a quit attempt. The
      results showed that most people found the QUITZ pack to be acceptable, both on
      first receiving it (68% acceptable) and after they had had the resource for at
      least a week (61% acceptable). The QUITZ pack was used in some way by 58% of the
      people to whom it was sent. No significant associations were found between the
      use of the pack and any of the demographic, smoking history, or motivational
      factors examined. Around a third of smokers to whom it was sent rated the QUITZ
      pack as being either quite or very useful in their cessation attempt. Of those
      who reported using the QUITZ pack, 61% rated it as being quite or very useful.
      For those who used the pack and made a quit attempt, more respondents rated a
      self-help guide (the CanQuit book) (87%) and any other personally chosen strategy
      (87%) as being quite or very useful, than rated any components of the QUITZ pack
      in this way.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8489915
TI  - Evaluation of an electronic message strip to recruit smokers to a smoking
      cessation program.
AB  - Knowledge of outcome is essential when analyzing effectiveness of educational
      programs. Although quantitative data can be analyzed more rigorously than other
      forms of data, quantitation of behavioral processes is often difficult. To
      promote our smoking-cessation program we designed a method that relies on
      electronic message strips and a dedicated telephone line capable of providing
      quantitative outcome information. This approach appears quite versatile and shows
      that the electronic message strip is a surprisingly ineffective method of
      enlisting subjects into a smoking-cessation program in our hospital.

PMID- 8489916
TI  - Education in radiotherapy in Poland.

PMID- 8489917
TI  - Staff support: a family loss. Interview by Charlotte Alderman.

PMID- 8489918
TI  - Expedition medicine: a trip into the unknown.

PMID- 8489919
TI  - Nurses work. Nursing in continents.

PMID- 8489920
TI  - Nurses work. Katie's quest continues.

PMID- 8489921
TI  - Lifting patients: the challenge for nursing.
AB  - This article examines how nursing will need to respond to the guidelines included
      in the new Health and Safety Regulations on the minimum requirements for the
      handling of loads. Many lifts that nurses undertake are called into question and
      the author outlines where nurses may be at risk and suggests alternative methods
      to lifting. The article also looks at what can go wrong when decisions about
      lifting miss out key points related to lifting stance and sequence.

PMID- 8489922
TI  - Patients' views of their A&E experience.
AB  - The concluding article in this series will explore the patients' perspective of
      their A&E experience through the use of evaluative questionnaires. Developments
      in quality assurance and the impetus from the Patient's Charter have led to staff
      being more concerned with patients' evaluation of their experiences, and A&E is
      no exception. The study revealed that patients are poor predictors of their
      treatment but the majority are satisfied with their experience. A smaller study
      of patients who walked out before treatment showed that a third did not seek
      subsequent help. The author argues that the study supports the need for nurse
      triage and nurse practitioners.

PMID- 8489923
TI  - Nutritional problems in nursing homes (continuing education credit).
AB  - This article examines the incidence of clinical malnutrition among nursing home
      residents and comments on the relevance of the COMA report on dietary reference
      values (1) to elderly people. The author discusses the medical, social and
      economic causes of malnutrition and postulates that the gap between rich and
      poor, which has widened in the last decade, has increased the proportion of
      elderly people nutritionally at risk. She highlights the vulnerability of nursing
      home residents, calls for further research and makes key recommendations to
      improve current practice.

PMID- 8489924
TI  - Cardiac pacing: a clinical update.
AB  - The aim of this article is to review the current technology, clinical indications
      and implantation methods of cardiac pacemakers. The author describes the
      implantation procedure, and outlines appropriate pre and post-procedural care.
      Despite the complexity of the subject, cardiac pacing is a life-preserving
      procedure for many patients, and is one that nurses should understand.

PMID- 8489925
TI  - Media coverage about health care workers with AIDS.

PMID- 8489926
TI  - Purely academic?

PMID- 8489927
TI  - Enrolled over and died.

PMID- 8489928
TI  - Don't tell the patient.

PMID- 8489929
TI  - Private's progress.

PMID- 8489930
TI  - EuroQuan. Finnish first.

PMID- 8489931
TI  - EuroQuan. Quality questions.

PMID- 8489932
TI  - EuroQuan. The RCN ODySSSy project.

PMID- 8489933
TI  - EuroQuan. Setting up a network.

PMID- 8489934
TI  - EuroQuan. Quality in Europe.

PMID- 8489935
TI  - [Childhood anemias].

PMID- 8489936
TI  - [Hematopoietic growth factors].

PMID- 8489937
TI  - [Prenatal diagnosis and therapy of Rh-erythroblastosis].

PMID- 8489938
TI  - [Blood transfusions].

PMID- 8489939
TI  - [Thrombocytopenias and granulocytopenias].

PMID- 8489940
TI  - [Acute leukemia in children].

PMID- 8489941
TI  - [Handling cytostatic drugs].

PMID- 8489942
TI  - [Everyday life at the oncological pediatric department at the Freiburg
      Oncological Pediatric University Hospital].

PMID- 8489943
TI  - [Why do we need therapy studies?].

PMID- 8489944
TI  - [Special nursing measures in oncology departments].

PMID- 8489945
TI  - [Bone tumors in children].

PMID- 8489946
TI  - [Prosthetic measures in bone tumors].

PMID- 8489947
TI  - [Radiotherapy in pediatric oncology].

PMID- 8489948
TI  - [Preparation for radiotherapy, a task for the psychosocial team].

PMID- 8489949
TI  - [Bone marrow transplantation in children].

PMID- 8489950
TI  - [Role of the nursing personnel in the pediatric-oncologic team].

PMID- 8489951
TI  - [Dealing with relapsed patients--from the physician's point of view].

PMID- 8489952
TI  - [Dealing with relapsed patients--from the psychiatric therapist's viewpoint].

PMID- 8489953
TI  - [Dealing with relapsed patients--from the viewpoint of the nursing personnel].

PMID- 8489954
TI  - [First Aid for children by the Emergency Service. Possibilities and limitations].

PMID- 8489955
TI  - [Phimosis and balanitis--guidelines for care].

PMID- 8489956
TI  - [Short-term patient education for type I diabetics in the hospital--experiences
      in a pediatric department].

PMID- 8489957
TI  - ["Mischka-Russia-Childrens Aid Association"--an initiative helping disabled and
      sick children in Moscow].

PMID- 8489958
TI  - [New earthlings--and their parents].

PMID- 8489959
TI  - [Microwave heating of baby milk bottles].

PMID- 8489960
TI  - [Henri-Louis Roger (1809-1891)].

PMID- 8489961
TI  - [Obligation to inform prior to blood transfusions--this obligation includes
      information on the risk of hepatitis and AIDS infection due to homologous
      transfusion].

PMID- 8489962
TI  - [Vitamin K--preventive administration in the newborn].

PMID- 8489963
TI  - [Blood counts and their dependency on the patient's age].

PMID- 8489964
TI  - The role of hormonal and dietary factors in pancreatic carcinogenesis.
AB  - The pancreatic cancer continues to represent an important problem, as a cancer
      with extremely poor prognosis. To date more than 16 chemicals have been shown to
      induce pancreatic tumors, in animal models. The tumors developed in rats are
      essentially of acinar type and those in hamsters mostly of ductal type. Many
      studies proved the direct or indirect role of hormonal and dietary factors in
      pancreatic cancer. The development of alternative treatments according to
      biological and biochemical steps of carcinogenesis is available as adjuvant
      treatment. We present herein an overview of current experimental and clinical
      results in order to understand the evolution, histogenesis and biological
      behaviour of pancreatic cancer.

PMID- 8489965
TI  - Reticuloendothelial system function following acute liver failure induced by 90%
      hepatectomy in the rat.
AB  - Sepsis and bacterial infections are frequent complications of acute liver failure
      and following major liver resection. The mechanisms underlying this phenomenon
      are unclear. In this study, RES function and blood clearance of radiolabelled E.
      coli was immediately impaired following 90% hepatectomy, although the reduction
      in liver volume resulted in an increase in splenic (temporary) and pulmonary
      (persisting) uptake. A significant correlation between liver function and host
      RES function was observed. The uptake capacity of the RES in the liver remnant
      and spleen did not correlate with subserosal blood flow. The uptake in the brain
      gradually increased with time, paralleling an increased leakage across the blood
      brain barrier. Thus, a significantly impaired RES function resulted from
      experimental 90% hepatectomy-induced acute liver failure, which might explain the
      high incidence of septic events in the clinical situation.

PMID- 8489966
TI  - Injuries of the portal vein in patients with blunt abdominal trauma.
AB  - Between January 1987 and September 1991, 68 severely traumatized patients
      underwent emergency laparotomy because of blunt abdominal trauma.
      Intraoperatively, 54.4% of the patients had a major injury to one organ, 23.5%
      had injuries to two organs, 16.2% had injuries to three organs and 5.9% to four
      or more organs. Additionally, in 11.8% of these cases (n = 8) a major vascular
      injury (portal vein n = 5, vena cava n = 2, mesenteric root n = 1) was found.
      Injuries to the portal vein were always associated with complete rupture of the
      pancreas, requiring distal pancreatic resection in four cases and a duodenum
      preserving resection of the head of the pancreas in one. In two of these patients
      the portal vein had to be reconstructed with a Goretex prosthetic graft.
      Mortality was 14.7% for the whole group (n = 68) and 0% for patients with
      additional portal venous injuries.

PMID- 8489967
TI  - Ultrasonic mucosectomy of the gallbladder. A histological analysis.
AB  - The Cavitron Ultrasonic Surgical Aspirator (CUSA) may be used to remove mucosa of
      organs of the gastro-intestinal tract. A histological analysis was performed on
      gallbladders treated with a CUSA-mucosectomy to assess the extent and degree of
      mucosectomy and to evaluate parietal damage. The histological studies performed
      on three specimens of chronic cholecystitis revealed a complete mucosectomy
      except in areas where Rokitansky-Aschof sinuses were present. There was no
      evidence of parietal damage. The CUSA may be used to remove the mucosa of
      gallbladders without injury to other layers, and may have a potential application
      in procedures such as mucosal cholecystectomy.

PMID- 8489968
TI  - "Clip-stone" filiation within the biliary tract.
AB  - A case of cholangitis due to the migration of a metal clip used for surgical
      cholecystectomy 4 years earlier, is reported. The diagnostic approach and
      therapeutic options, either endoscopic or surgical are discussed. The use of
      resorbable clips during the performance of laparoscopic cholecystectomy should
      avoid this type of complication.

PMID- 8489969
TI  - Papillo-choledochectomy in the operative management of mucosal neoplasms of the
      periampullary region.
AB  - Two patients with mucosal cancer of the periampullary region were treated with
      papillo-choledochectomy, which entails removal of the papilla of Vater and the
      whole length of the common bile duct. The neoplasm is dissected out through the
      plane between the duodenal circular and longitudinal muscles, deep to the
      sphincter of Oddi and the fibromuscular layer of the bile duct. Pathological
      examination showed that cancer was confined to the mucosal layer without stromal
      invasion, and that the operation achieved radical cure. For mucosal cancer,
      papillo-choledochectomy is an alternative to pancreatoduodenectomy, provided that
      repeated frozen-section studies confirm the completeness of excision.

PMID- 8489970
TI  - Extrahepatic biliary papillomatosis occurring after removal of a dysplastic gall
      bladder.
AB  - A case is presented of a woman who developed obstructive jaundice secondary to
      dysplastic mucinous papillomatosis two years after she had undergone
      cholecystectomy and exploration of the common bile duct. The gall bladder was
      dysplastic. It is suggested that the dysplastic glands removed from the common
      bile duct at the second operation either represented seedlings from dysplastic
      areas of the gall bladder or were a manifestation of dysplastic field change.

PMID- 8489971
TI  - Cholangitis and Budd Chiari syndrome as complications of simple cystic liver
      disease.
AB  - We report the case of a 63 year old woman who developed the complications of
      cholangitis and Budd Chiari syndrome secondary to polycystic disease of the
      liver. The two complications were not present simultaneously, and both resolved
      after decompression of the liver cysts.

PMID- 8489972
TI  - Splenic vein obstruction due to a solitary echinococcal splenic cyst, resulting
      in gastric fundus varices: an unusual cause of variceal bleeding.
AB  - A 27-year old female patient, born and living in Morocco, suffered from severe
      variceal bleeding and weight loss. Eventually a diagnosis of gastric fundus
      varices was made supposedly resulting from partial obstruction of the splenic
      vein and collateral blood flow via the short gastric veins. Splenectomy was
      proposed. Peroperatively it became apparent that a solitary ecchinococcal cyst in
      the hilus of the spleen obstructed the blood flow in the splenic vein. The cyst,
      the spleen, and part of the pancreatic tail were removed. After splenectomy
      bleeding did not recur.

PMID- 8489973
TI  - Large foreign body as a nidus for a common duct stone in a patient without
      spontaneous biliary enteric fistula or previous abdominal surgery.
AB  - We report a case of a brown pigment gallstone, which formed around a phytobezoar
      in the common bile duct, in a patient without spontaneous biliary enteric fistula
      or previous abdominal surgery. A brief comment on the possible origin of the
      phytobezoar in this case and on the pattern of deposition of brown material over
      a pre-existent nidus is also presented.

PMID- 8489974
TI  - Effect of speed of injection on the maximum sensory level for spinal anesthesia
      using plain bupivacaine 0.5% at room temperature.
AB  - BACKGROUND AND OBJECTIVES: The aim of this study was to investigate if a ten-fold
      difference in speed of injection of a plain solution of bupivacaine 0.5% at room
      temperature into the subarachnoid space would result in a temperature-dependent
      change in baricity large enough to be reflected in a significant difference
      between the maximum levels of sensory blockade. METHODS: In this prospective
      study, 40 male patients were randomly assigned to one of two groups. Group 1
      patients received 3 ml plain bupivacaine 0.5% (20-22 degrees C) with the speed of
      injection as fast as possible. Group 2 patients received 3 ml plain bupivacaine
      0.5% (20-22 degrees C) at a rate of 0.05 ml/sec. Thirty minutes after
      subarachnoid injection the maximum level of sensory blockade was determined by
      pinprick in the anterior axillary line by a blinded observer. RESULTS: The mean
      maximum level of sensory blockade in patients of group 1 was T7.5 (median, T7;
      range, T3-12) and in group 2 patients T6.4 (median, 5.5; range, T3-11), the
      difference not being statistically significant (p > 0.05). CONCLUSIONS: There is
      no clinically relevant influence on the maximum level of sensory blockade when
      bupivacaine 0.5% at room temperature is injected with a ten-fold difference in
      speed.

PMID- 8489975
TI  - Pulse oximeter waveforms from the finger and toe during lumbar epidural
      anesthesia.
AB  - BACKGROUND AND OBJECTIVES: To determine whether lumbar epidural anesthesia
      affects pulse oximeter signals in the upper or lower extremity, 13 ASA I patients
      were studied. METHODS: Temperature and pulse oximeter probes were placed on the
      finger and the toe. RESULTS: After epidural injection, the amplitude of the pulse
      oximeter waveform on the toe increased eight-fold but declined by 50% in the
      finger. The increase in amplitude of the pulse oximeter waveform in the foot
      preceded the temperature rise. CONCLUSIONS: More reliable pulse oximeter signals
      may be obtained from the toe than the finger during lumbar epidural anesthesia.
      Furthermore, the increase in the pulse amplitude from the toe may aid in the
      early detection of successful epidural block.

PMID- 8489976
TI  - Prolonged placement of spinal catheters does not prevent postdural puncture
      headache.
AB  - OBJECTIVE: To determine whether leaving an intrathecal catheter in place in the
      postoperative period prevents postdural puncture headache (PDPH). METHODS: Lumbar
      puncture was performed with an 18-gauge Tuohy needle. 0.5% bupivacaine spinal
      anesthesia was given through a 20-gauge catheter in 87 patients having orthopedic
      surgery. Postoperatively, patients were allocated randomly to have the catheter
      immediately withdrawn (group 1, N = 47) or kept in place for 12 to 24 hours
      (group 2, N = 40). Patients were questioned by a blinded observer, about PDPH
      twice a day on postoperative days 1, 2, 3, and 8. RESULTS: The incidence of PDPH
      was 9.2%, and this was comparable in the two groups (5 patients in group 1 and 3
      patients in group 2). CONCLUSION: Leaving the intrathecal catheter in place in
      the postoperative period for 12 to 24 hours does not prevent PDPH.

PMID- 8489977
TI  - The characteristics of analgesic requirements following subarachnoid diamorphine
      in patients undergoing total hip replacement.
AB  - BACKGROUND AND OBJECTIVES: The postoperative pain scores and analgesic
      requirements were assessed in 60 patients who had undergone total hip replacement
      under bupivacaine spinal anesthesia. METHODS: Thirty of the patients had
      intrathecal diamorphine injected after the bupivacaine, and the remaining 30
      received saline. RESULTS: Superior postoperative pain relief was obtained in the
      diamorphine group, whose average postoperative morphine requirements were 12 +/-
      11.4 mg compared to 31 +/- 18.7 mg (mean +/- SD) in the control group. Despite
      the lower doses of morphine, their pain scores over the first 24 hours
      postoperatively were consistently lower. No differences were seen between the
      groups with respect to respiratory depression, nausea, pruritus, postoperative
      sedation, headache, or urinary retention. CONCLUSION: Pain control after
      intrathecal diamorphine supplemented by intravenous morphine from a patient
      controlled analgesia system is superior to intravenous morphine alone.

PMID- 8489978
TI  - Inhibition of epidural morphine-induced pruritus by intravenous droperidol.
AB  - BACKGROUND AND OBJECTIVES: Our objective was to study in more detail our previous
      finding that intravenous droperidol inhibits pruritus induced by epidural
      morphine. METHODS: In a double blind study, 107 ASA I or II patients undergoing
      cesarean section received epidural anesthesia with 150 mg (30 ml) of 0.5%
      bupivacaine with 1:200,000 epinephrine and 2 mg of morphine hydrochloride in a
      single injection. They were randomly allocated to either receive (treated group,
      n = 54) or not receive (control group, n = 53) an intravenous injection of 2.5 mg
      of droperidol just after delivery. During the postoperative period, the patients
      were assessed for the occurrence and severity of pruritus or other possible
      untoward symptoms. Pruritus was classified as absent, mild, moderate, or severe.
      RESULTS: The incidence of pruritus in control group was absent, 26.4%; mild,
      39.6%; moderate, 28.3%; severe, 5.7%; for the treated group, the incidences were,
      respectively: 59.2; 27.8; 13.0; and 0.0% (p = 0.0003; Mann-Whitney test). As for
      other side effects of morphine, nausea and vomiting had a similar incidence in
      the two groups; urinary retention could not be analyzed because of bladder
      catheterization, and constipation, herpes labialis and clinical evidence of
      respiratory depression were never observed. Droperidol produced a greater
      incidence of somnolence (2% in control and 17% in treated group--p < 0.02;
      Fisher's exact test), but it was never incapacitating. The incidence of
      hypotension was similar in the two groups. CONCLUSION: Intravenous droperidol
      reduces the incidence and severity of pruritus caused by epidural injection of
      morphine without inducing important side effects.

PMID- 8489979
TI  - Phantom limb pain.

PMID- 8489980
TI  - Complications during spinal anesthesia for cesarean delivery: a clinical report
      of one year's experience.
AB  - BACKGROUND AND OBJECTIVES: To evaluate the incidence and causes of complications
      associated with spinal anesthesia for cesarean delivery. METHODS: Prospective
      study, case series. SETTING: Tampere University Hospital, 284 patients scheduled
      for elective or nonelective cesarean delivery with spinal anesthesia.
      Complications occurring during spinal anesthesia with hyperbaric 0.5% bupivacaine
      during a 1-year period were analyzed. RESULTS: Hyperbaric 0.5% bupivacaine for
      cesarean delivery proved to be a reliable anesthetic with a failure rate of 2.8%.
      The most common complications were hypotension (42%) and nausea (14%). In 81% of
      patients, hypotensive periods occurred before delivery. Hypotension before
      delivery had no correlation with low Apgar scores or with low pH in the umbilical
      artery of the infant. Risk factors for hypotension were elective procedures and
      operations without prophylactic ephedrine infusion. Nausea occurred significantly
      more often if a lower interspace was used for administering the subarachnoid
      block. CONCLUSIONS: Spinal anesthesia proved to be a safe, reliable, and rapid
      method of anesthesia for cesarean delivery, but, in view of a high incidence of
      minor complications, careful patient monitoring during spinal anesthesia is
      necessary to make the outcome optimal for mother and fetus.

PMID- 8489981
TI  - Regional anesthesia in a patient with epidermolysis bullosa.

PMID- 8489982
TI  - Anesthetic management of a patient with Franklin's disease.

PMID- 8489983
TI  - A reliable method of testing regional block.

PMID- 8489984
TI  - Sphenopalatine ganglion block under vision using rigid nasal sinuscope.

PMID- 8489985
TI  - Transdermal clonidine: treating reflex sympathetic dystrophy.

PMID- 8489986
TI  - Management of postoperative pain by anesthesiologists: a time for optimism.

PMID- 8489987
TI  - Are anesthesia residency programs failing regional anesthesia? The past, present,
      and future.
AB  - BACKGROUND: A survey of anesthesia training programs in 1980 reported the use of
      a regional anesthetic technique in 21.3% of cases. Since that time, numerous
      changes have occurred in anesthesia residency programs. This survey was conducted
      to assess the impact these changes have had on the use and teaching of regional
      anesthetic techniques in residency training programs. METHODS: All anesthesia
      residency program directors were requested to send blinded copies of their
      residents' 1989-1990 American Board of Anesthesiology Annual Training Report
      Forms. Data from responding programs were compared to similar data from 1980, and
      analyzed for factors expected to influence the use of regional anesthesia during
      training. RESULTS: The use of regional anesthesia in residency training programs
      has increased from 21.3% in 1980 to 29.8% in 1990, primarily because of a two
      fold rise in the use of epidural anesthesia. The use of regional anesthesia is
      strongly correlated with a resident's exposure to obstetric anesthesia and pain
      consultations. Wide variability between residency programs remains. CONCLUSION:
      Some training programs continue to fail to provide adequate regional anesthesia
      exposure to train residents fully in these techniques, despite the overall
      increased use of regional anesthesia.

PMID- 8489988
TI  - Combined inguinal paravascular (3-in-1) and sciatic nerve blocks for lower limb
      surgery.
AB  - BACKGROUND AND OBJECTIVES: The effects of increasing the maximum recommended dose
      of lidocaine 1% plus epinephrine from 500-650 mg in combined 3-in-1/sciatic nerve
      block were investigated in 45 adult patients scheduled for surgery on the lower
      limb. The goal of the study was to show primarily, whether pneumatic tourniquet
      pain could be reduced, whether toxic plasma levels of local anesthetic were
      reached, and whether any other clinical side effects occurred. RESULTS: The
      results indicated that the incidence of tourniquet pain was significantly reduced
      and, most important, that there were no noteworthy differences in venous
      lidocaine plasma levels between the two groups investigated. CONCLUSIONS: There
      was a significant decrease in time required for complete neural blockade after
      administration of the 650 mg lidocaine dose, and little or no difference in the
      duration of postoperative analgesia.

PMID- 8489989
TI  - The effect of continuous interscalene brachial plexus block with 0.125%
      bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function.
AB  - BACKGROUND AND OBJECTIVES: Continuous interscalene brachial plexus block with
      0.25% bupivacaine decreases diaphragmatic motility and ventilatory function. The
      author studied the effects of 0.125% bupivacaine with and without fentanyl.
      METHODS: Forty patients who were to undergo shoulder surgery were given an
      interscalene brachial plexus block using 20-28 ml 0.75% bupivacaine plus
      epinephrine. In random order, 10 patients then had a 24-hour continuous block
      with 0.125% bupivacaine (BUPI) (5-9 ml/h). Nine patients had an additional s.c.
      infusion of fentanyl (F-SC) (15-27 micrograms/h) and 10 the same dose of fentanyl
      with the bupivacaine infusion (F-PLX). Ten patients had a single block (PLX) for
      minor surgery. Spirometry, double-exposure chest radiography, pulse oximetric
      hemoglobin saturation and maximal airway pressures were measured. RESULTS:
      Postoperatively, BUPI patients were given, on average, 1.2, F-SC patients 0.7,
      and F-PLX patients 0.4 doses of oxycodone in 24 hours (not significant). Average
      ipsilateral diaphragmatic motility was reduced to 8% in F-PLX group (p < 0.01)
      and to 19-30% in the other groups (p < 0.05). At 24 hours, average motility in
      BUPI, F-SC, F-PLX and PLX groups was 54, 48, 31 and 91%, respectively. In all
      groups FVC, FEV1 and PEF were reduced by 20-40% at 3 hours (p < 0.001). At 8 and
      24 hours, FVC and FEV1 were in F-SC and F-PLX groups significantly lower (p <
      0.05) than in PLX group. CONCLUSIONS: Use of 0.125% bupivacaine for continuous
      interscalene block did not prevent a deterioration of diaphragmatic motility and
      ventilatory function. Co-infusion of fentanyl did not significantly potentiate
      the block.

PMID- 8489990
TI  - Regional anesthesia for microvascular surgery: a combination of brachial plexus,
      spinal, and epidural blocks.
AB  - BACKGROUND AND OBJECTIVES: To evaluate the usefulness, safety, and efficacy of
      the combined plexus brachial, spinal, and epidural blocks in free toe to hand
      transplantations. METHODS:  DESIGN: Prospective, case series. SETTING: Tampere
      University Hospital, Finland. PATIENTS: Fifteen adult patients for toe to hand
      microvascular transplantation under combined regional anesthesia with
      bupivacaine. INTERVENTIONS: The efficacy of the blocks, complications, and
      patient satisfaction were recorded in the study form. MEASUREMENTS AND MAIN
      RESULTS: The duration of operations varied between 8 and 18 hours. No major
      complications occurred. Vasodilatation in the operated hand was maintained during
      the entire operation as well as in the postoperative period, and the surgical
      results were satisfactory. The mean skin temperature was 5 degrees C higher in
      the blocked extremity compared to the opposite hand. In every patient the skin
      temperature of the transplant was over 32.4 degrees C after the operation. Blood
      pressure, heart rate, temperature and oxygen saturation were well maintained
      during the entire procedure. All patients were satisfied with their anesthesia.
      Back pain occurred in 11 patients and in two it was considered severe. One
      patient may have had a systemic toxic reaction (shivering) due to high plasma
      levels of bupivacaine, but the symptom was transient. CONCLUSION: Combined
      regional anesthesia is an alternative to general anesthesia in prolonged
      microsurgical operations and it appears to improve perfusion of the transplanted
      extremity.

PMID- 8489991
TI  - Nutrient intake by duration of ex-smoking in the Scottish Heart Health Study.
AB  - Information on current-, never- and ex-smokers (including duration of cessation)
      was obtained in a cross-sectional survey of risk factors for coronary heart
      disease (CHD), the Scottish Heart Health Study. Diet was also assessed by food
      frequency questionnaire in a total of 4265 men and 4770 women. Nutrient intakes
      were computed by sex and smoking group and, according to their diet, the ex
      smokers were categorized as current- or never-smokers using discriminant analysis
      techniques. The current- and five ex-smoking groups differed negligibly in past
      smoking characteristics. Energy-adjusted intake of polyunsaturated fat, fibre and
      the antioxidant vitamins were lowest in current-smokers, and for men, intakes
      increased progressively with duration of ex-smoking to reach the level of never
      smokers. In a similar manner, energy, sugar and alcohol decreased with duration
      of ex-smoking. Fewer trends were observable for women, and the diets of ex
      smokers more immediately resembled that of never-smokers. Discriminant analysis
      for the combined nutrients correctly categorized 72 and 69% of male, and 66 and
      65% of female current- and never-smokers respectively. By 4 years of smoking
      cessation the general dietary pattern of ex-smokers was similar to never-smokers
      for both sexes. Whether this represents a change in diet over time or a cohort
      effect is unclear, but the results do suggest that the apparent healthier diet of
      ex-smokers may contribute to their reduction in CHD risk compared with life-long
      current-smokers.

PMID- 8489992
TI  - The respiratory quotient in relation to fat deposition in fattening-growing pigs.
AB  - The relationship between non-protein respiratory quotient (RQnp) and total fat
      retention (RFAT) or fat retained from synthesized carbohydrates (RFAT(CHO)) was
      evaluated from experiments with fattening--growing pigs in the live weight (LW)
      range from 45 to 120 kg. A commercial feed compound (31 g fat/kg) was fed at low
      (LI) or high (HI) feed intake in Expt 1, while a semi-purified diet (9.5 g
      fat/kg) was given without (LO) or with (HO) supplement of 90 g soya-bean oil/kg
      in Expt 2. RQnp was calculated from 24 h measurements of the gas exchange, RFAT
      from 7 d N and C balances and RFAT(CHO) from differences between RFAT and
      digested fat. The measurements showed that about 85% of the total gas exchange
      was caused by oxidation of non-protein nutrients and the RQnp varied from 1.00 to
      1.34. In Expt 1 RFAT increased with LW from 46 to 141 and from 199 to 335 g/d on
      LI and HI respectively, whilst in Expt 2 RFAT increased from 191 to 377 and from
      267 to 511 g/d on LO and HO respectively. A pronounced linearity was found
      between RQnp and RFAT for all diets, but the curve for Expt 2 on HO had a lower
      position than the common curve for the other diets. By relating RQnp to RFAT(CHO)
      a common linear curve and regression equation could be established in spite of
      the great variation in dietary composition, intake of fat and fat deposition.

PMID- 8489993
TI  - Hindlimb protein turnover and muscle protein synthesis in lambs: a comparison of
      techniques.
AB  - A combination of arterio-venous difference, kinetic isotope transfer and blood
      flow rate techniques were used to measure tyrosine metabolism across hindlimb
      tissues of nine growing lambs (average live weight 36.5 kg) fed on a range of dry
      matter intakes. Muscle protein synthesis was measured using a continuous infusion
      technique and compared with simultaneous estimates of hindlimb protein turnover
      calculated from the values for tyrosine metabolism. When the specific
      radioactivity (SRA) of tyrosine in the arterial plasma free pool was assumed to
      be the same as the SRA of tyrosine in the direct precursor pool of protein
      synthesis, hindlimb protein synthesis (ksav; 3.66 (SEM 0.50) %/d) was
      significantly (P < 0.001) higher (68%) than muscle protein synthesis (ksp; 2.18
      (SEM 0.31) %/d) but was similar to the value for muscle protein synthesis
      calculated using the homogenate free tyrosine SRA (ksh; 3.35 (SEM 0.42) %/d).
      Hindlimb and muscle protein synthesis (y) were both significantly related to dry
      matter intake (chi) (ksav, r2 0.667, P = 0.007; ksh, r2 0.968, P < 0.001) and
      there was no significant difference between the slopes (P = 0.532) and intercepts
      (P = 0.945) of the two regression lines. The results demonstrate that hindlimb
      protein turnover cannot be quantitatively compared with muscle protein synthesis,
      probably due to high protein metabolic activity in non-muscular tissues within
      the hindlimb, although similar responses in protein synthetic rate to the level
      of feed intake were observed between hindlimb and muscle tissues.

PMID- 8489994
TI  - Impact of exocrine pancreatic adaptation on in vitro protein digestibility.
AB  - An in vitro enzymic method was used to study the kinetics of digestion of casein
      and rapeseed proteins. After a predigestion step with pepsin (EC 3.4.23.1), the
      protein substrates were submitted to a 24 h hydrolysis either with pancreatin or
      pancreatic juices of pigs adapted either to casein or rapeseed diets and whose
      enzyme activities were different. After 3, 6 and 24 h of in vitro digestion,
      dialysates were collected and analysed for content of nitrogen, amino acids and
      low-molecular-weight peptides. For a long-term hydrolysis (24 h), overall
      digestibility of both substrates was not affected by the composition of
      pancreatic enzyme mixtures. However, at the beginning of hydrolysis a significant
      effect of pancreatic juices was observed, i.e. individual amino acid
      digestibility was generally higher when casein pancreatic juice was used for
      hydrolysis and their relative pattern of release was modified. For both
      substrates the proportion of amino acids released as low-molecular-weight
      peptides was not affected by the enzyme mixture used and made up about two-thirds
      of the total digested material. It is concluded that exocrine pancreatic
      adaptation to protein sources does not affect the total capacity of protein
      digestion. However, the changes in initial kinetics of release of amino acids are
      more dependent on the nature of the protein tested than on the composition of
      pancreatic enzyme mixtures.

PMID- 8489995
TI  - Effect of some gastrointestinal hormones on motor and electrical activity of the
      digestive tract in the conscious cat.
AB  - Three peptides structurally related to gastrin and known to be full agonists of
      antral motility in the conscious cat, pentagastrin (PG), cholecystokinin (CCK)
      and synthetic octapeptide of cholecystokinin (OP-CCK), were compared in relation
      to antral and duodenal electrical activity. They induced the same antral effect
      in eliciting an increase in the basal electrical rhythm (BER) and a short-lasting
      decrease in the frequency of the bursts of spikes. The electrical changes were
      correlated with lumen pressure changes measured in parallel, consisting of a
      decrease in the frequency of high-amplitude peaks and an increase in low
      amplitude peaks. The additive effect of PG and CCK shows that the peptides are
      full agonists for antral electrical activity, as they are for antral motility and
      acid secretion. In contrast to the antrum, the three peptides increased the
      frequency of the duodenal spike bursts, CCK and OP-CCK decreased the BER
      frequency, while PG increased BER slightly. The increase in antral and duodenal
      BER obtained after a beef-liver meal, which produced a large endogenous gastrin
      release, suggests a major role for gastrin in antral motility induced by feeding,
      at least in the cat.

PMID- 8489996
TI  - Absorption of volatile fatty acids from the rumen of lactating dairy cows as
      influenced by volatile fatty acid concentration, pH and rumen liquid volume.
AB  - The effect of rumen liquid volume, pH and concentration of volatile fatty acids
      (VFA) on the rates of absorption of acetic, propionic and butyric acids from the
      rumen was examined in lactating dairy cows. Experimental solutions introduced
      into the emptied, washed rumen comprised two different volumes (10 or 30 l), four
      levels of pH (4.5, 5.4, 6.3, 7.2) and three levels of individual VFA
      concentrations (20, 50 or 100 mM-acetic, propionic or butyric acid). All
      solutions contained a total of 170 mM-VFA and an osmotic value of 400 mOsmol/l.
      Absorption rates were calculated from the disappearance of VFA from the rumen
      corrected for passage with liquid phase to the omasum. An increase in initial
      fluid pH caused a reduction in fractional absorption rates of propionic and
      butyric acids. Increasing the initial pH from 4.5 to 7.2 reduced fractional
      absorption rates of acetic, propionic and butyric acids from 0.35, 0.67 and 0.85
      to 0.21, 0.35 and 0.28/h respectively. The fractional absorption rates of all VFA
      were reduced (P < 0.05) by an increase in initial rumen volume. The fractional
      absorption rate of acetic acid was lower (P < 0.05) at an initial concentration
      of 20 mM than of 50 mM. The fractional absorption rate of propionic acid tended
      (P < 0.10) to decrease as the level of concentration increased while fractional
      absorption rate of butyric acid was not affected by butyric acid concentration.
      These results indicate that relative concentrations of VFA in rumen fluid might
      not represent relative production rates and that attempts to estimate individual
      VFA production from substrate digestion must take account of pH and VFA
      concentration.

PMID- 8489997
TI  - Comparative effects of four legume species on plasma lipids and faecal steroid
      excretion in hypercholesterolaemic pigs.
AB  - The effect of four species of legume seeds on plasma cholesterol levels and
      faecal steroid excretion was studied in pigs. Thirty-six growing boars were
      randomly allocated in groups of six to six diets which they ate continuously for
      42 d. The diets fed were: 1, a semi-purified (SP; control group 1) diet; 2, SP +
      10 g cholesterol/kg (control group 2); 3, 4, 5, 6, SP + cooked legumes (70:30,
      w/w; respectively baked beans (Phaseolus vulgaris), peas (Pisum sativum), lentils
      (Lens culinaris Medik.), butter beans (Phaseolus lunatus)) + 10 g cholesterol/kg.
      Fasting blood samples were taken on days 0, 14, 28, and 42 for the determination
      of total plasma cholesterol, high-density-lipoprotein (HDL)-cholesterol and
      triacylglycerols. Between days 7 and 11 and days 28 and 32 complete 5 d faecal
      collections were made for the measurement of neutral, acidic and conjugated
      steroids. After 42 d total cholesterol and HDL-cholesterol levels were raised
      significantly in all groups, but to different extents. In comparison with control
      group 2, diet-induced hypercholesterolaemia was significantly inhibited in the
      groups consuming baked beans, peas and butter beans, although HDL-cholesterol
      levels were maintained. Faecal steroid excretion by the legume groups was not
      significantly different from that of control group 2. The results suggest that
      the mechanism for the hypocholesterolaemic effect does not involve increased
      hepatic bile acid synthesis and thereby increased cholesterol clearance via the
      intestinal route.

PMID- 8489998
TI  - The effect of increasing levels of dietary fish oil rich in eicosapentaenoic and
      docosahexaenoic acids on lymphocyte phospholipid fatty acid composition and cell
      mediated immunity in the mouse.
AB  - The influence of increasing intakes of fish oil on spleen leucocyte phospholipid
      fatty acid composition and cell-mediated immunity was studied in the mouse using
      a popliteal lymph node assay technique. The immune response was suppressed by 160
      g fish oil/kg diet, but not by lower doses. The proportion of 20:5n-3 in spleen
      leucocyte phospholipid increased from 0.14 in the controls to 3.8, 7.2, 8.5 and
      9.4% in the animals fed on 25, 50, 100 and 160 g fish oil/kg diet; the proportion
      of 22:6n-3 increased from 5.1 in the controls to 12.1, 12.2, 12.8 and 12.9%
      respectively. It is concluded that moderate intakes of fish oil are not
      immunosuppressive.

PMID- 8489999
TI  - Intestinal absorption and liver uptake of medium-chain fatty acids in non
      anaesthetized pigs.
AB  - In order to study the rate of intestinal absorption and hepatic uptake of medium
      chain fatty acids (MCFA), six growing pigs, mean body weight 65 kg, were fitted
      with a permanent fistula in the duodenum and with three catheters in the portal
      vein, carotid artery and hepatic vein respectively. Two electromagnetic flow
      probes were also set up, one around the portal vein and one around the hepatic
      artery. A mixture of octanoic and decanoic acids, esterified as medium-chain
      triacylglycerols, together with maltose dextrine and a nitrogenous fraction was
      continuously infused for 1 h into the duodenum. Samples of blood were withdrawn
      from the three vessels at regular intervals for 12 h and further analysed for
      their non-esterified octanoic and decanoic acid contents. The concentration of
      non-esterified octanoic and decanoic acids in the portal blood rose sharply after
      the beginning of each infusion and showed a biphasic time-course with two maximum
      values, one after 15 min and a later one between 75 and 90 min. Only 65% of
      octanoic acid infused into the duodenum and 54% of decanoic acid were recovered
      in the portal flow throughout each experiment. The amounts of non-esterified MCFA
      taken up per h by the liver were close to those absorbed from the gut via the
      portal vein within the same periods of time, showing that the liver is the main
      site of utilization of MCFA in pigs. These results have been discussed with a
      special emphasis laid on the possible mechanisms of the biphasic time-course of
      MCFA absorption and the incomplete recovery in the portal blood of the infused
      fatty acids.

PMID- 8490000
TI  - The digestion process of the sugar alcohol isomalt in the intestinal tract of the
      pig. 1. Studies with administration of isomalt in the feed.
AB  - In a study with twelve pigs of 60-70 kg live weight provided with a re-entrant
      cannula at the end of the ileum, and twelve intact, non-cannulated pigs, the fate
      of dietary doses of 100 and 200 g isomalt/kg during gastrointestinal passage was
      examined. From sugar analyses in ileal chyme it was calculated that 0.43 and 0.30
      of the isomalt consumed was digested in the small intestine with the 100 and 200
      g/kg doses of isomalt respectively. From findings on ileal energy digestibility
      it was calculated that, because of a secondary effect of isomalt on the digestion
      of the basal diet, isomalt digestibility in the small intestine was distinctly
      lower. In faeces no sugars were found, so faecal digestibility of isomalt was
      1.00 for both doses. The bacterial fermentation in the large intestine of the
      isomalt not digested in the small intestine caused an increase in the faecal
      excretion of nitrogen and energy. This increased faecal excretion was hardly
      (nitrogen) or not (energy) compensated by a decreased urinary excretion.

PMID- 8490001
TI  - The digestion process of the sugar alcohol isomalt in the intestinal tract of the
      pig. 2. Studies with administration of isomalt as a sweet.
AB  - In a study with ten pigs of 60-70 kg live weight, provided with a re-entrant
      cannula at the end of the ileum, and sixteen intact, non-cannulated pigs, the
      digestion and absorption of a dietary dose of 100 g isomalt/kg, and isomalt given
      between the meals as a 'sweet' on the basis of 50 and 100 g/kg feed consumption,
      were examined. In all three isomalt treatments slightly less than 0.40 of the
      isomalt consumed was digested in the small intestine when the calculations were
      based on ileal sugar passage. However, when basing the calculations on energy
      contents of ileal chyme, only approximately 0.10 was digested in the small
      intestine. The bacterial fermentation of the isomalt flowing into the large
      intestine was indicated by a decreased faecal energy digestibility and a slight
      reduction in faecal dry matter and nitrogen digestibility. The retention of the
      minerals sodium, potassium, magnesium, calcium and phosphorus was not influenced
      to any measurable extent when isomalt was fed.

PMID- 8490002
TI  - Gastrointestinal responses of rats fed on white and wholemeal breads: complex
      carbohydrate digestibility and the influence of dietary fat content.
AB  - To obtain quantitative information on the digestibility of the non-starch
      polysaccharides (NSP) fraction of white and wholemeal breads, rats were fed on
      diets in which freeze-dried bread (white, wholemeal or mixtures of the two)
      provided all the complex carbohydrates. In a second experiment the possibility
      that dietary fat concentration might influence NSP digestibility was tested by
      feeding diets containing 30 or 170 g maize oil/kg and either white or wholemeal
      bread. Multiple linear regression analysis provided little evidence of
      associative effects of dietary components on NSP digestibility and in the two
      experiments digestibilities of NSP for white and wholemeal breads were 0.77-0.82
      and 0.47-0.52 respectively. Xylose- and arabinose-containing polymers were better
      digested than was cellulose for both breads. Replacing white by wholemeal bread
      markedly increased the molar proportion of butyrate in caecal volatile fatty
      acids at the expense of acetate. This was associated with greater flows of
      organic matter to the large bowel (LB) and a reduction in caecal transit time
      (Expt 2). There was little detectable effect of dietary maize oil concentration
      on NSP digestibility or on LB fermentation. All breads contained some starch
      resistant to pancreatic alpha-amylase (EC 3.2.1.1) without previous treatment
      with dimethyl sulphoxide. The digestibility of this starch fraction was not
      significantly different from 1.0 for all diets except that containing wholemeal
      bread and the higher maize oil concentration where the apparent digestibility was
      0.89.

PMID- 8490003
TI  - Complex carbohydrate digestion and large bowel fermentation in rats given
      wholemeal bread and cooked haricot beans (Phaseolus vulgaris) fed in mixed diets.
AB  - The digestion of non-starch polysaccharides (NSP) and of resistant starch (RS) by
      rats fed on wholemeal-bread-based diets containing 0-450 g cooked, freeze-dried
      haricot beans (Phaseolus vulgaris)/kg diet was measured over the final 14 d of a
      21 d feeding experiment. The bread and beans provided all the dietary
      polysaccharide. RS could not be detected consistently in faeces and it was
      assumed that this fraction was entirely fermented in the large bowel (LB). NSP
      digestibilities were 0.56 and 0.86 for wholemeal bread and beans respectively
      with no evidence that the dietary presence of beans affected digestibility of
      bread NSP. Bean non-cellulosic polysaccharides were highly digestible with values
      of 0.98, 0.88 and 0.99 for arabinose, xylose and uronic acids components
      respectively. There were large increases in organic matter flow to the LB when
      beans were fed which was associated with marked caecal hypertrophy and
      alterations in caecal volatile fatty acids (VFA) pattern. Calculated VFA
      absorption from the LB was 5-fold higher with the highest level of beans and this
      was reflected in higher concentrations of VFA in portal and heart blood.

PMID- 8490004
TI  - Assessment of fermentation in growing pigs given unmolassed sugar-beet pulp: a
      stoichiometric approach.
AB  - In four experiments growing pigs were given a cereal-based diet alone or
      supplemented with unmolassed sugar-beet pulp (SBP), used as a model substrate for
      fermentation. The rates of production of methane and gaseous hydrogen were
      measured and, together with the molar proportions of volatile fatty acids (VFA)
      in the digesta, used in stoichiometric calculations of fermentation. The
      resulting estimates were only one-sixth of the observed extent of digestion of
      SBP. Bacteriostatic levels of antibiotics reduced fermentation by more than half,
      as judged from the digestion of non-starch polysaccharides: allowing for the
      incomplete suppression of fermentation it was estimated that the production of
      methane and VFA could account completely for the digested SBP. The potential
      contribution of various routes of hydrogen disposal to the error of the
      stoichiometric calculations is discussed.

PMID- 8490005
TI  - The effect of dietary calcium intake in weanling rats on the efficiency of
      calcium absorption.
AB  - Rats were weaned onto high (HCa, 14.6 g/kg)- or low (LCa, 3.88 g/kg)-Ca diets for
      12 d and the efficiency of absorption of Ca measured from 20 mg Ca (as CaCl2,
      labelled with 47Ca) by means of whole-body counting. The LCa group absorbed 74%
      of the test dose and the HCa group 60% of the test dose (P < 0.001). All animals
      were then given the LCa diet for 6 weeks and the absorption test repeated. This
      time there was no difference in efficiency of absorption (HCa 54%, LCa 57%). The
      femur dry weight was significantly lower in the group initially fed on the LCa
      diet, but the Ca concentration was similar to that of the HCa group. The results
      do not lend support to the suggestion that early dietary exposure to Ca manifests
      itself as a difference in Ca metabolism in later life. They do, however,
      highlight the importance of adequate Ca intake during critical periods of growth.

PMID- 8490006
TI  - Inhibition of haem-iron absorption in man by calcium.
AB  - The inhibiting effect of Ca on non-haem-Fe absorption is well established.
      Present studies showed that Ca inhibited haem-Fe absorption to the same extent
      when the same amount of Ca (165 mg Ca as CaCl2) was added to a meal. Attempts
      were made to examine the mechanism for this inhibition in the present studies.
      Meat is the only known dietary factor influencing haem-Fe absorption. The present
      studies were designed to examine whether Ca interfered with the enhancing effect
      of meat on haem-Fe absorption. We found that the inhibition was the same whether
      biosynthetically radio-Fe-labelled haemoglobin was given in meals with or without
      meat. The haem-Fe absorption ratio with:without added Ca was 0.59 (SE 0.07) when
      Ca was added to a hamburger meal, and 0.52 (SE 0.03) when added to a wheat roll.
      These values were not significantly different (t 0.95; P = 0.35). The inhibition
      of haem-Fe absorption by Ca is, thus, a direct effect on the absorption of haem
      Fe and not an indirect counteracting effect of the well-known enhancing effect of
      meat on haem-Fe absorption. Control studies were conducted to ensure that haem-Fe
      had not been degraded to non-haem-Fe during preparation of the foods. Since Ca
      inhibits the absorption of haem- and non-haem-Fe to the same extent, the present
      results strongly suggest that Ca interferes with the transport of Fe through the
      mucosal cell, and at a late stage, is common for haem- and non-haem-Fe
      transport.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490007
TI  - The effect of exercise on the riboflavin status of adult men.
AB  - Six sedentary to moderately active men with biochemical signs of riboflavin
      deficiency were studied under metabolic ward conditions to examine the effects of
      physical activity on riboflavin status. All participants were subjected to
      additional exercise (EXER) for an 18 d period between two maintenance (M1 and M2)
      periods (16 and 13 d respectively) of habitual physical activity. Energy balance
      and riboflavin intake were maintained throughout the study. Riboflavin status, as
      judged by a significant reduction in erythrocyte glutathione reductase (EC
      1.6.4.2) activation coefficient (EGR-AC), improved on changing from home (1.53
      (SD 0.14)) to period M1 (1.36 (SD 0.21)) diets. The exercise period, however,
      resulted in a significant deterioration in riboflavin status (1.57 (SD 0.31))
      which persisted in the subsequent period M2 (1.54 (SD 0.15)). There was a
      concomitant fall in the urinary excretion of riboflavin only in the EXER period,
      when results were expressed as a percentage of the dietary intake of riboflavin.
      These results suggest an increased demand for the vitamin for selective
      biochemical functions during exercise. However, the energy cost of walking
      (treadmill 4 km/h), 50 W and 100 W work-loads (bicycle ergometer) as well as
      delta mechanical efficiency (DME) did not change during the three metabolic
      periods. The urinary excretion of riboflavin was inversely related to DME (r 
      0.49; P < 0.05) and directly correlated with haemoglobin levels (r 0.63; P <
      0.005). The present study suggests that riboflavin status further deteriorates
      during a short period of increased physical activity in individuals whose
      riboflavin status is marginal.

PMID- 8490008
TI  - A proposed intestinal mechanism for the effect of riboflavin deficiency on iron
      loss in the rat.
AB  - The effect of riboflavin deficiency on gastrointestinal Fe distribution and loss
      was studied in weanling rats. Riboflavin deficiency was associated with a
      significant increase in crypt depth in the upper and mid small intestine and a
      twofold increase in the rate of crypt cell production compared with weight
      matched and ad lib.-fed control rats. The rate of loss of endogenous Fe, measured
      as faecal 59Fe after intraperitoneally administered 59Fe, was twice that from
      riboflavin-deficient rats compared with weight-matched controls. We suggest that
      while there may be a contribution from turnover of enterocytes with an enhanced
      Fe content, enhanced Fe loss associated with riboflavin deficiency is due
      predominantly to an accelerated rate of small-intestinal epithelial turnover.

PMID- 8490009
TI  - Vitamin C intake and plasma ascorbic acid concentration in adolescents.
AB  - The relationship between vitamin C intake and status was investigated in a group
      of adolescents (13-14 years old). Dietary intakes were assessed using a 7 d
      weighted dietary record method, coupled with the collection of duplicate diets.
      Vitamin C intakes calculated using food composition tables were compared with
      values obtained by direct analysis of duplicate diets. Vitamin C status was
      judged via measurement of plasma ascorbic acid (AA) concentration in blood
      samples taken after a 12-15 h fast. The relationship between calculated and
      analysed vitamin C intake and plasma AA concentration was examined. Average daily
      calculated vitamin C intakes, for the group (n 54) as a whole over a 7 d period,
      gave a good estimate of intake, as judged by prompt analysis of duplicate diets.
      However, analysed v. calculated intakes were significantly different for
      approximately one-third of subjects when data were examined on an individual
      basis. Large discrepancies between analysed and calculated values could not be
      accounted for on a food group basis. In all but two individuals, calculated
      vitamin C intake was in excess of the new reference nutrient intake (RNI, part of
      the new daily reference values (Department of Health and Social Security, 1991))
      of 40 mg and all plasma AA concentrations were well above those used to indicate
      even a moderate risk of deficiency. A relationship between vitamin C intake and
      plasma AA was observed for both males (n 19) and females (n 35). However, the
      relationship was much stronger for males who showed a wider range of both intake
      and plasma AA values.

PMID- 8490010
TI  - Long-term supplementation with selenate and selenomethionine: selenium and
      glutathione peroxidase (EC 1.11.1.9) in blood components of New Zealand women.
AB  - Thirty-three New Zealand women aged 18-23 years received daily for 32 weeks, 200
      micrograms Se as Se-enriched yeast (selenomethionine), or brewer's yeast mixed
      with selenate, or no added Se (placebo) in a double-blind trial. Se
      supplementation raised (P = 0.001) platelet glutathione peroxidase (EC 1.11.1.9;
      GSHPx) activity, and also Se and GSHPx in whole blood, erythrocytes and plasma.
      Selenomethionine was more effective in raising blood Se concentrations than
      selenate, but both were equally effective in raising GSHPx activities in whole
      blood, erythrocytes and plasma, indicating a similar bioavailability for the two
      forms. These observations and those of gel filtration studies of erythrocytes and
      plasma proteins reported elsewhere (Butler et al. 1991) are consistent with the
      incorporation of Se from selenomethionine into a general tissue protein pool
      while selenate is directly available for GSHPx synthesis, and explain the poorer
      correlation between Se and GSHPx in individuals with higher Se status. However,
      selenate raised platelet GSHPx activities to a greater extent than did
      selenomethionine suggesting some other effect of selenate on platelets which
      needs further investigation. A response of GSHPx activity in these New Zealand
      subjects indicates that their dietary Se intake is insufficient to meet
      recommended intakes based on the criterion of saturation of GSHPx activity, and
      could reflect a marginal Se status. The level of blood Se necessary for
      saturation of GSHPx of about 100 ng Se/ml whole blood confirms observations in
      earlier studies.

PMID- 8490011
TI  - Glutathione content of the small intestine: regulation and function.
AB  - In ad lib.-fed rats the epithelium of the small intestine, like the liver,
      contains large quantities of glutathione, 17.0 and 32.4 nmol/mg protein
      respectively. Following 24 h food restriction the glutathione content in both
      tissues fell 53 and 69% respectively. Unlike the liver, however, the glutathione
      content of the intestinal mucosa is not regulated to a diurnal rhythm, suggesting
      that the liver may provide glutathione or glutathione precursors to maintain
      intestinal glutathione levels. Intestinal epithelial cell preparations obtained
      from 24 h food-deprived rats had depleted glutathione stores (50%) and as a
      consequence were more susceptible to the oxidizing effects of cumene
      hydroperoxide. These results suggest that if glutathione plays a major role in
      the defence of the intestinal mucosa from ingested toxins then depletion of this
      defence during periods of food restriction could significantly increase the
      susceptibility of the individual to toxins present in the diet.

PMID- 8490012
TI  - Prophylactic nutritional modification of the incidence of diabetes in autoimmune
      non-obese diabetic (NOD) mice.
AB  - Experiments in rodent models of insulin-dependent diabetes mellitus (IDDM)
      suggest that destruction of pancreatic beta cells can be both initiated and
      inhibited by certain environmental factors such as dietary constituents. We
      studied nutritional impact of certain protein sources of natural-ingredient, non
      purified (NP) rodent diet on diabetes incidence and insulitis severity in the
      spontaneous diabetic, non-obese diabetic (NOD) mouse. Long-term ad lib. feeding
      of diets containing wheat flour (800 g/kg), and to a lesser extent soya-bean meal
      (400 g/kg), were associated with relatively high diabetes incidence (65 and 45%
      respectively), whereas a diet based on hydrolysed casein (HC; 200 g/kg) as the
      only source of protein significantly (compared with the wheat-flour diet)
      inhibited expression of diabetes (22%). Feeding a hypo-allergenic soya-bean
      protein hydrolysate resulted in diabetes incidence and insulitis severity similar
      to that of the soya-bean-meal-fed group. This may indicate that protein
      hydrolysis per se may not be necessary for dietary modification of diabetes in
      the NOD mouse. The window of vulnerability to diabetogenic diets was found to be
      between weaning and about 70 d of age. In the diabetic mice insulitis was less
      frequent in the HC-fed group when compared with those fed NP (P = 0.04), soybean
      meal (P = 0.03), soya-bean-protein hydrolysate (P = 0.012) or wheat flour (P =
      0.0002). In the non-diabetic mice the wheat-flour diet was associated with a high
      insulitis severity in comparison with the HC group (P = 0.004). Early avoidance
      of NP diet was associated with lower degree of insulitis in both diabetic (P =
      0.00003) and non-diabetic mice (P = 0.001) when compared with the mice fed on the
      HC diet later in life. These findings are contributing to further clarification
      of diabetes-promoting dietary constituents, which may have some nutritional
      implications for IDDM-susceptible children.

PMID- 8490013
TI  - Ileal digestibility and availability of lysine in protein concentrates for pigs.

PMID- 8490014
TI  - The carboxy terminus of the beta amyloid protein is critical for the seeding of
      amyloid formation: implications for the pathogenesis of Alzheimer's disease.
AB  - Several variants of the beta amyloid protein, differing only at their carboxy
      terminus (beta 1-39, beta 1-40, beta 1-42, and beta 1-43), have been identified
      as the major components of the cerebral amyloid deposits which are characteristic
      of Alzheimer's disease. Kinetic studies of aggregation by three naturally
      occurring beta protein variants (beta 1-39, beta 1-40, beta 1-42) and four model
      peptides (beta 26-39, beta 26-40, beta 26-42, beta 26-43) demonstrate that
      amyloid formation, like crystallization, is a nucleation-dependent phenomenon.
      This discovery has practical consequences for studies of the beta amyloid
      protein. The length of the C-terminus is a critical determinant of the rate of
      amyloid formation ("kinetic solubility") but has only a minor effect on the
      thermodynamic solubility. Amyloid formation by the kinetically soluble peptides
      (e.g., beta 1-39, beta 1-40, beta 26-39, beta 26-40) can be nucleated, or
      "seeded", by peptides which include the critical C-terminal residues (beta 1-42,
      beta 26-42, beta 26-43, beta 34-42). These results suggest that nucleation may be
      the rate-determining step of in vivo amyloidogenesis and that beta 1-42 and/or
      beta 1-43, rather than beta 1-40, may be the pathogenic protein(s) in AD.

PMID- 8490015
TI  - Sequence-specific cleavage of DNA via nucleophilic attack of hydrogen peroxide,
      assisted by Flp recombinase.
AB  - Hydrogen peroxide is capable of effecting the cleavage of a specific
      phosphodiester bond in DNA, when used in concert with the recombinase enzyme Flp
      from Saccharomyces cerevisiae. This cleavage is not caused by oxidative damage of
      the DNA backbone but instead is the result of nucleophilic attack by peroxide. A
      single phosphorus-oxygen bond is broken in the reaction. Cleavage of DNA by
      peroxide also occurs with an inactive mutant of Flp in which the active site
      nucleophile tyrosine has been replaced by phenylalanine. Besides providing
      information on the mechanism of strand cleavage by Flp, these results may
      contribute to the development of new synthetic DNA cleavage reagents that act by
      hydrolytic and not radical chemistry.

PMID- 8490016
TI  - A structural domain (the lid) found in pancreatic lipases is absent in the guinea
      pig (phospho)lipase.
AB  - Typically pancreatic lipases are characterized by the following properties: (1)
      they are activated by lipid/water interfaces (interfacial activation), (2) they
      are inhibited by bile salts but reactivated by colipase (a small activator
      protein), and (3) they do not hydrolyze significantly phospholipids. A cDNA clone
      encoding a guinea pig pancreatic (phospho)lipase (GPL) has been sequenced and
      expressed. The enzyme (recombinant as well as native) differs from other
      pancreatic lipases in that (1) it is not interfacially activated, (2) its
      activity is unaffected by the presence of bile salts and/or colipase using
      tributyrin as substrate, and (3) it exhibits equally phospholipase A1 and lipase
      activities. The amino acid sequence of GPL is highly homologous to that of other
      known pancreatic lipases, with the exception of a deletion in the so-called lid
      domain that regulates access to the active centers of other lipases. We propose
      that this deletion is directly responsible for the anomalous behavior of this
      enzyme. Thus GPL challenges the classical distinction between lipases, esterases,
      and phospholipases.

PMID- 8490017
TI  - Effect of site-specifically located mitomycin C-DNA monoadducts on in vitro DNA
      synthesis by DNA polymerases.
AB  - A series of site-specifically modified oligodeoxynucleotides were synthesized
      that contained either of the two known mitomycin C-DNA monoadducts. In vitro DNA
      synthesis was carried out on some of these templates using a modified
      bacteriophage T7 DNA polymerase (Sequenase), AMV reverse transcriptase, and two
      different varieties of Escherichia coli DNA polymerase I (Klenow fragment)--one
      that carries the normal 3'-->5' exonuclease activity and a mutant protein that
      lacks this enzymatic function. Regardless of the type of DNA polymerase being
      used, DNA synthesis was terminated nearly quantitatively at the nucleotide 3' to
      each of these two monoadduct sites, although primer extension to full length of
      the template was noted with the unmodified control template. Substitution of Mn2+
      for Mg2+ at a high concentration of the deoxynucleotide triphosphates resulted in
      incorporation of nucleotides opposite the adduct in the incubations with
      Sequenase or the 3'-->5' exonuclease-free Klenow fragment; however, primer
      extension beyond the adduct site did not take place. These studies demonstrated
      that the mitomycin monoadducts are strong blocks of replication and are likely to
      be toxic lesions in vivo. Since previous molecular modeling studies and molecular
      mechanical calculations indicated that the mitomycin adduction does not induce
      severe distortions at the site of adduction, a lack of base-pairing ability of
      the modified base in the extended product is unlikely to be the reason for the
      inhibitory effect. Instead, energy-minimized structural models indicated that
      additional hydrogen-bonding interactions have been introduced by the mitomycin
      moiety, and perhaps this increased thermodynamic stabilization of a distorted
      structure of the replication fork, in turn, may block the replication bypass.
      Experimental evidence of increased thermodynamic stability was provided by
      thermal melting of a template/primer complex that presumably a polymerase
      encounters in a typical replication fork. Consistently higher Tm of the adducted
      "replication fork" was noted when compared to its unmodified counterpart.

PMID- 8490018
TI  - Posttranscriptional regulation of chimeric human transferrin genes by iron.
AB  - Transferrin, the transferrin receptor, and ferritin are integral to the body's
      management of iron, an element required for life but highly toxic when present in
      excess. The transferrin receptor and ferritin are regulated posttranscriptionally
      by iron: the transferrin receptor by mRNA stability and ferritin by mRNA
      translation. Results described here indicate that transferrin, like ferritin, is
      regulated by iron at the level of translation. Chimeric genes introduced into the
      mouse genome were composed of the human transferrin 5' regulatory region fused to
      the chloramphenicol acetyl transferase (CAT) reporter gene. Iron administration
      to transgenic mice resulted in a significant decrease of transferrin-directed CAT
      enzyme activity and CAT protein in liver, but no significant decrease in human
      transferrin-CAT mRNA levels. Binding of specific RNA iron regulatory elements by
      proteins in cytoplasmic extracts have been shown to regulate ferritin and
      transferrin receptor synthesis. Similar results have been obtained with
      transferrin mRNA. A decreased binding of human transferrin 5'-untranslated region
      RNA by factors in cytoplasmic extracts of livers from mice receiving iron was
      found when compared to extracts from control mice. A human transferrin RNA
      protein complex migrated electrophoretically with the same mobility as a ferritin
      iron responsive element RNA-iron responsive element binding protein complex. The
      ferritin iron responsive element RNA also competed with the human transferrin 5'
      untranslated region RNA-protein complexes formed and vice versa. Therefore, iron
      modulation of human transferrin may share a factor common or similar to that
      observed in ferritin and transferrin receptor iron modulation.

PMID- 8490019
TI  - Specificity in the interactions of extracellular matrix proteins with
      subpopulations of the glycosaminoglycan heparin.
AB  - Many extracellular matrix glycoproteins--including laminin, fibronectin,
      thrombospondin, type I collagen, and other collagens--bind the glycosaminoglycan
      heparin, yet little is known about the functional significance of these
      interactions. It is also not known if heparin-binding extracellular matrix
      proteins recognize distinct structural elements in heparin, nor whether all
      extracellular matrix proteins recognize the same or different aspects of heparin
      structure. If extracellular matrix proteins each recognize distinct features of
      heparin, such specificity could be of importance in vivo, where structurally
      distinct heparan sulfate species occur. To investigate specificity in the binding
      between extracellular matrix proteins and heparin, the method of affinity
      coelectrophoresis (ACE) was used [Lee, M. K., & Lander, A. D. (1991) Proc. Natl.
      Acad. Sci. U.S.A. 88, 2768-2772]. Low M(r) (approximately 6 kDa) 125I-heparin was
      fractionated by electrophoresis through agarose gel lanes containing
      extracellular matrix proteins at various concentrations; from heparin migration
      patterns, binding affinities were calculated. The results indicate that
      fibronectin, type I collagen, and laminin--but not thrombospondin--each
      fractionate heparin into subpopulations that differ substantially in binding
      affinity. From ACE gels containing either fibronectin, type I collagen, or
      laminin, fractions of heparin were isolated that represent the 25% of molecules
      most strongly bound and the 25% least strongly bound by each of these proteins.
      Subsequent ACE analysis of these six fractions showed that (1) for each of
      fibronectin, type I collagen, and laminin, strongly- and weakly-binding heparin
      subfractions differ approximately 5-30-fold in Kd; (2) heparin that binds
      strongly to any one of fibronectin, type I collagen, or laminin also binds
      strongly to the other two; (3) heparin that binds weakly to any one of
      fibronectin, type I collagen, or laminin, also binds weakly to the other two; (4)
      heparin subfractions that differ greatly in affinity for fibronectin, type I
      collagen, and laminin show little difference in Kd for thrombospondin or for the
      heparin-binding growth factor basic fibroblast growth factor (bFGF); (5) neither
      heterogeneity in molecular charge [as measured by diethylaminoethyl (DEAE)
      chromatography] nor size nor the presence or absence of antithrombin III
      recognition sequences can account for the selective binding of heparin
      subpopulations to fibronectin, type I collagen, and laminin. These results
      suggest that structural elements within heparin can confer preferential binding
      to extracellular matrix proteins. Sensitivity of some, but not all, extracellular
      matrix proteins to these structural features suggests that similar features, if
      present in heparan sulfates or other glycosaminoglycans, may be physiologically
      relevant in vivo.

PMID- 8490020
TI  - Specific binding of human dihydrofolate reductase protein to dihydrofolate
      reductase messenger RNA in vitro.
AB  - Dihydrofolate reductase (DHFR) is a critical enzyme in de novo purine and
      thymidylate biosynthesis. An RNA gel mobility shift assay was used to demonstrate
      a specific interaction between human recombinant DHFR protein and its
      corresponding DHFR mRNA. Incubation of DHFR protein with either its substrates,
      dihydrofolate or NADPH, or with an inhibitor, methotrexate, repressed its ability
      to interact with DHFR mRNA. An in vitro rabbit reticulocyte lysate translation
      system was used to show that the addition of exogenous human recombinant DHFR
      protein to in vitro translation reactions specifically inhibited DHFR mRNA
      translation. These studies suggest that the direct interaction between DHFR
      protein and its mRNA may be a mechanism for regulation of DHFR synthesis.

PMID- 8490021
TI  - Mutagenesis of ribosomal protein S8 from Escherichia coli: expression, stability,
      and RNA-binding properties of S8 mutants.
AB  - Protein S8, a 129 amino acid component of the Escherichia coli ribosome, plays an
      essential role in the assembly of the 30S ribosomal subunit and in the
      translational regulation of the spc operon by virtue of its capacity to bind
      specifically to rRNA and mRNA. To study structure-function relationships within
      the protein, we have constructed a vector for its high-level expression in vivo
      and developed efficient methods for its purification. Under our conditions, S8
      accumulates to a level of 35% of the cellular protein and can be prepared at a
      purity of over 98% using either HPLC or a combination of ion-exchange and gel
      filtration chromatography. The unique cysteine residue at position 126 was
      replaced by alanine or serine by oligonucleotide-directed mutagenesis, and the
      two mutant proteins, CA126 and CS126, were expressed and isolated. The effects of
      the mutations on the RNA-binding ability, secondary structure, and stability of
      S8 were assessed. CD spectra indicated that wild-type S8 and the two mutant
      proteins have very similar secondary structures at 25 degrees C. In addition,
      both mutants are metabolically stable in vivo as inferred from pulse-chase
      labeling and immunoprecipitation experiments. However, while CA126 exhibits the
      same affinity for RNA and the same susceptibility to urea and thermal
      denaturation as wild-type S8, CS126 is severely impaired in its ability to
      interact with RNA and displays a dramatic reduction in conformational stability.
      Our results suggest that Cys126 is unlikely to play a specific role in RNA
      recognition but that it is an integral part of the RNA-binding domain of protein
      S8.

PMID- 8490022
TI  - Influence of QA site redox cofactor structure on equilibrium binding, in situ
      electrochemistry, and electron-transfer performance in the photosynthetic
      reaction center protein.
AB  - The native ubiquinone-10 redox cofactor has been removed from the QA site of the
      isolated reaction center protein from Rhodobacter sphaeroides and reconstitution
      attempted with 28 non-quinone molecules in order to identify factors governing
      cofactor function and the selectivity displayed by the site in the electron
      transfers that it catalyzes. Equilibrium binding, in situ electrochemistry, and
      the kinetics of electron transfer to and from the QA site occupant were examined.
      Four classes of non-quinone molecules are distinguished according to their
      ability to occupy the QA site and conduct intraprotein electron transfers. The
      minimal requirements for occupancy of the QA site are at least one ring and a
      heteroatom hydrogen bond acceptor. Thus, binding at the site is not highly
      selective. The rates of electron transfers to and from the class of non-quinone
      molecules (four) that satisfy the criteria for cofactor function at the QA site
      compare well with rates previously determined from 14 to 295 K for 14 quinone
      replacements with comparable values of the reaction free energy. This indicates
      that the rates are relatively insensitive to variations in exotic and quinone
      cofactor reorganization energy and the vibrational frequencies coupled to the
      electron transfers, and that the exotic and quinone cofactors are bound in the QA
      site in comparable positions. It appears that any variation in rate is determined
      predominantly by the value of the reaction free energy. The QA site protein
      cofactor solvation contribution to the in situ electrochemical potential is
      roughly constant for 12 rigid quinone and 2 exotic cofactors (average value-61 +/
      2 kcal/mol). Favorable electrostatic contributions governing the reaction free
      energy are therefore also relatively insensitive to cofactor structure. However,
      flexible molecules appear to encounter in situ steric constraints that lower the
      electron affinity by destabilizing the reduced cofactor species. This is a strong
      determinant of whether a molecule, once in the QA site, will function. These
      findings compare well with those from studies of electron transfers in synthetic
      systems.

PMID- 8490023
TI  - Picosecond fluorescence decay in photolyzed lens protein alpha-crystallin.
AB  - Photolysis of calf lens protein alpha-crystallin in aqueous solutions has been
      monitored by observing changes in fluorescence decay following UV irradiation at
      308 nm. The fluorescence decay was biexponential in dark controls and in
      photolyzed solutions. The recovered lifetime components in pH 7.4 phosphate
      buffer at 23 degrees C were 3.5 and 0.5 ns before irradiation and 2.7 and 0.5 ns
      after irradiation. As the UV dose increased, the relative weighting coefficient
      of the 2.7-ns decay component decreased, and that of the 0.5-ns component
      increased, resulting in an overall lifetime shortening. Similar results were
      obtained in 5 M guanidine hydrochloride solutions where lifetime components of
      2.7 and 0.5 ns were observed. These observations were in contrast to the behavior
      of tryptophan monomer solutions which did not show any change in fluorescence
      decay kinetics upon UV photolysis but only a reduced fluorescence intensity.
      Steady-state fluorescence spectra and fluorescence quantum yields were also
      measured at 23 degrees C for unirradiated bovine alpha-crystallin and gave phi F
      = 0.11 +/- 0.01 in pH 7.4 buffer and phi F = 0.10 +/- 0.01 in 5 M guanidine
      hydrochloride solutions. The combined steady-state and fluorescence decay data
      were consistent with assignment of the long-lived fluorescence decay component in
      alpha-crystallin to emission from Trp-9, which is known to photolyze relatively
      rapidly. The short decay component was assigned to Trp-60, which photolyzed much
      more slowly. We thus provide an example of using steady-state photochemical data
      to assign fluorescence decay components in a multi-tryptophan protein.

PMID- 8490024
TI  - Regioselectivity of cytochrome P-450 catalyzed hydroxylation of fluorobenzenes
      predicted by calculated frontier orbital substrate characteristics.
AB  - In the present study, a hypothesis is presented for the prediction of the
      regioselectivity of cytochrome P-450 catalyzed hydroxylation of fluorobenzenes.
      The regioselectivity of the in vivo hydroxylation of fluorobenzene, 1,2
      difluorobenzene, 1,3-difluorobenzene, 1,2,3-triluorobenzene, and 1,2,4
      triflurobenzene could be predicted within 6% accuracy on the basis of the
      substrate's frontier orbital characteristics for electrophilic attack. The in
      vivo regioselectivity of the hydroxylation of fluorobenzene was not significantly
      influenced by changes in the cytochrome P-450 enzyme pattern. This implies that
      the regioselectivity is not predominantly determined by the juxtaposition of the
      relatively small substrates in the active sites of the cytochrome P-450s
      catalyzing the reaction. Additional in vitro experiments using 1,2
      difluorobenzene as the model substrate demonstrated that minor factors
      influencing the regioselectivity and possibly responsible for the 6% deviation
      from the calculated values in in vivo experiments might be (i) the influence of
      biotransformation routes occurring in vivo but not of importance in in vitro
      microsomal incubations and (ii) a small variation due to influences of the
      contribution of various cytochrome P-450 enzymes. On the basis of the results
      obtained, it is concluded that the aromatic hydroxylation of fluorobenzenes
      proceeds through an initial electrophilic attack of (FeO)3+ on the aromatic
      substrate, and not through initial electron abstraction followed by attack of the
      (FeO)2+ species on the substrate radical cation. The fact that the
      regioselectivity observed could be predicted and/or explained by the site of
      initial (FeO)3+ attack also argues against epoxides as important intermediates in
      the formation of phenol metabolites from fluorobenzenes.

PMID- 8490025
TI  - Resonance Raman studies of iron-only hydrogenases.
AB  - The nature of the iron-sulfur clusters in oxidized and reduced forms of Fe-only
      hydrogenases from Desulfovibrio vulgaris, Thermotoga maritima, and Clostridium
      pasteurianum has been investigated by resonance Raman spectroscopy. The results
      indicate the presence of ferredoxin-like [4Fe-4S]2+,+ and [2Fe-2S]2+,+ clusters
      in both T. maritima hydrogenase and C. pasteurianum hydrogenase I, but only [4Fe
      4S]2+,+ clusters in D. vulgaris hydrogenase. This necessitates a reevaluation of
      the iron-sulfur cluster composition of C. pasteurianum hydrogenase I and
      indicates that the resonance Raman bands in the oxidized hydrogenase that were
      previously attributed to the hydrogen activating center [Macor, K. A.,
      Czernuszewicz, R. S., Adams, M. W. W., & Spiro, T. G. (1987) J. Biol. Chem. 262,
      9945-9947] arise from an indigenous [2Fe-2S]2+ cluster. No resonance Raman bands
      that could be uniquely attributed to the oxidized or reduced hydrogen activating
      center were observed. This suggests that the hydrogen activating center is a
      novel Fe center that is unrelated to any known type of Fe-S cluster.

PMID- 8490026
TI  - Dynamics of the internalization of phosphodiester oligodeoxynucleotides in HL60
      cells.
AB  - We have examined the cellular association and internalization of phosphodiester
      (PO) oligodeoxynucleotides (oligos) with HL60 cells. At 4 degrees C, a 15-mer PO
      homopolymer of thymidine (FOdT15) exhibits apparent saturation binding (Km = 22
      +/- 1 nM) that is competitive with the binding of phosphorothioate (PS) oligos.
      The value of Kc for SdC28, a PS 28-mer homopolymer of cytidine, is 5 +/- 2 nM.
      SdC28 was used to strip cell surface fluorescence: Internalized fluorescence
      accumulated in a (concentration)(time)-dependent fashion, consistent with a
      pinocytotic mechanism. PS, and to a lesser extent, PO oligos inhibited the rate
      of internalization of fluorescent albumin, also a marker of pinocytosis. This was
      correlated with direct in vitro inhibition of protein kinase C (PKC) beta 1 by
      the PS and PO oligos. Furthermore, other PKC inhibitors (H7, staurosporine, DMSO,
      PKC pseudosubstrate polypeptide) also inhibited intracellular accumulation of
      pinocytosed materials, perhaps by stimulating the exocytosis rate. In HL60 cells,
      the pinocytotic internalization of charged oligos appears to be dependent on
      intact PKC kinase activity, which is inhibited in vitro by PS and PO oligos.

PMID- 8490027
TI  - Estimation of the intracellular free ADP concentration by 19F NMR studies of
      fluorine-labeled yeast phosphoglycerate kinase in vivo.
AB  - Yeast phosphoglycerate kinase was selectively fluorine-labeled in vivo by
      inducing enzyme synthesis in stationary phase cells in the presence of 5
      fluorotryptophan. Inducible expression was obtained using a galactose-inducible
      expression vector containing the yeast phosphoglycerate kinase coding sequence.
      19F NMR measurements on intact cells showed two resolved resonances, from the two
      tryptophan residues in the protein, which underwent reversible changes in
      chemical shift under different metabolic conditions. Measurements in vitro showed
      that the difference in the chemical shifts of these two resonances was dependent
      on the adenine nucleotide concentration, in particular the MgADP concentration. A
      comparison of the spectra obtained in vitro with those obtained from the intact
      cell indicated that in glucose-fed cells the cytosolic free MgADP concentration
      was less than 50 microM, which is significantly lower than the concentrations
      measured in whole-cell extracts.

PMID- 8490028
TI  - Role of beta-turn in proteolytic processing of peptide hormone precursors at
      dibasic sites.
AB  - Proteolytic activation of prohormones and proproteins occurs most frequently at
      the level of basic amino acids arranged in doublets. Previous predictions by
      Rholam et al. [Rholam, M., Nicolas, P., & Cohen, P. (1986) FEBS Lett. 207. 1-6]
      have indicated, on the basis of 20 prohormone sequences containing 53 dibasic
      potential processing sites, that dibasic sites situated in, or next to, beta
      turns were cleaved in vivo, whereas sites included in ordered structures like
      beta-sheets or alpha-helices were not. We have used peptide analogs of the
      proocytocin/neurophysin processing domain and a purified preparation of the
      putative proocytocin convertase from bovine tissues as a model to demonstrate
      that (1) processing at dibasic sites is associated with a prohormone sequence
      organized in a beta-turn structure; (2) the beta-turn is an interchangeable motif
      since the original sequence could be replaced by an heterologous one possessing
      the ability to organize as a beta-turn; and (3) this particular secondary
      structure participates in the catalytic reaction, most likely by favoring the
      interactions of the substrate with the processing endoprotease. It is concluded
      that, in addition to the dibasic and other amino acids around the cleavage loci,
      the beta-turn constitutes a key feature in the proteolytic processing reaction in
      participating as the favorable conformation for optimal substrate-enzyme active
      site recognition.

PMID- 8490029
TI  - Biosynthesis and processing of endogenous parathyroid hormone related peptide
      (PTHRP) by rat Leydig cell tumor H-500.
AB  - We have examined in vitro the biosynthesis and processing of endogenous PTHRP in
      cultured rat H-500 Leydig tumor cells. Cells were grown to confluence and pulse
      labeled with [3H]Ile, 50 microCi/mL, in Ile free culture medium for 2 min to 6 h.
      In some experiments incubations were carried out in culture medium alone in the
      presence of 0.3 mM cycloheximide or 20 micrograms/mL unlabeled Ile. Cell extracts
      and culture media were analyzed by affinity chromatography employing an antibody
      directed against the bioactive NH2-terminal region, PTHRP(1-34), followed by gel
      permeation or reversed-phase high-performance liquid chromatography.
      Incorporation of [3H]Ile into PTHRP in cell extracts increased over 20 min during
      pulse labeling and then remained constant throughout the incubation period up to
      6 h. In contrast, the release of [3H]PTHRP into culture medium increased
      progressively over 6 h. Addition of cycloheximide or unlabeled Ile almost
      completely blocked incorporation of [3H]Ile into newly synthesised PTHRP. Three
      molecular forms of PTHRP were seen which comigrated with PTHRP(1-36), PTHRP(1
      86), and PTHRP(1-141) standards in both chromatographic systems employed. After
      20 min these species comprised approximately 63%, 30%, and 7% of newly
      synthesized PTHRP, respectively. These three molecular forms of PTHRP were
      observed both intra- and extracellularly, and no further metabolism of these
      species was seen after release into conditioned medium. Pulse-chase studies
      demonstrated a rapid decrease of newly synthesized PTHRP forms within cells after
      20 min; there was, however, a progressive increase in [3H]PTHRP in conditioned
      culture medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490030
TI  - Site-directed alteration of three active-site residues of a pyruvoyl-dependent
      histidine decarboxylase.
AB  - The active site of histidine decarboxylase (HDC) from Lactobacillus 30a contains
      a pyruvoyl cofactor sitting at the interface of two molecules in a trimer.
      Although exhibiting hyperbolic kinetics at pH 4.8, near its optimum, HDC is
      cooperative at pH 7.6, indicating that the units of the trimer communicate. A
      Hill plot analysis shows that HDC, at pH 7.6, can be described by a two-state
      model. The tense (T) state has an apparent Km for histidine of 50 mM, while the
      relaxed (R) state has a Km of 5 mM. To explore the catalytic mechanism, three of
      the cross-boundary active-site residues were altered by site-directed mutagenesis
      and their effects observed. Ile-59 is known to act as lid on the substrate
      binding pocket; it was converted to Ala (I59A) and to Val (I59V). The former was
      inactive, attesting to the importance of this residue in the mechanism. The I59V
      mutant showed a decrease in Km and in kcat at pHs 4.8 and 7.6. Ile-59 appears to
      help orient substrate properly for catalysis; decreasing its size expands the
      binding site. This may allow the substrate to bind more readily, but in a number
      of conformations which are not optimal for catalysis. Conversion of Tyr-62 to Phe
      (Y62F) had no effect on catalysis but raised the Km 7-fold at pH 4.8. Asp-63
      appears to form an ion pair to the substrate imidazolium. Conversion to the
      neutral amide (D63N) had no effect on the kcat, but raised the Km 240-fold at pH
      4.8. This is consistent with the notion that the ion pair is up to 3 kcal/mol
      stronger than a simple hydrogen bond with the substrate. The mutant had no
      detectable activity at pH 7.6.

PMID- 8490031
TI  - G protein binding and G protein activation by nucleotide transfer involve
      distinct domains on tubulin: regulation of signal transduction by cytoskeletal
      elements.
AB  - Cytoskeletal proteins have been demonstrated to interact with elements which
      mediate neuronal signal transduction. This laboratory has shown that tubulin
      forms complexes with certain G proteins and transfers GTP to them, and such
      nucleotide transfer correlates well with the inhibition of adenylyl cyclase. A
      previous study showed that tubulin-G protein complex formation occurred at
      regions of tubulin which were likely to be involved in binding to other tubulin
      dimers during the process of microtubule polymerization [Wang, N., & Rasenick, M.
      M. (1991) Biochemistry 30, 10957-10965]. This study represents an attempt to
      investigate the regions of tubulin which orchestrate the transfer of GTP from
      tubulin to G protein. It is demonstrated that two monoclonal antibodies, with
      determinants in similar regions of alpha (DM1a) or beta (DM1b) tubulin, blocked
      (by 70-80%) the ability of tubulin dimers (with GppNHp bound) to promote a stable
      inhibition of adenylyl cyclase. Under the same conditions, a polyclonal
      antitubulin antibody caused only a slight reduction in adenylyl cyclase
      inhibition. None of the antibodies altered the inhibition of adenylyl cyclase
      induced by GppNHp in the absence of tubulin. Under conditions where tubulin
      GppNHp inhibited synaptic membrane adenylyl cyclase, tubulin dimers with the
      photoaffinity GTP analog azidoanilido-GTP (32P-AAGTP) bound transferred that
      nucleotide to G alpha i1 on the membrane. DM1a and DM1b blocked this nucleotide
      transfer. Similarly, tubulin-AAGTP transferred AAGTP to purified G proteins in
      solution and DM1a and DM1b blocked this process as well. Despite their ability to
      block the activation of Gi1 by tubulin, neither antibody altered the ability of
      tubulin to bind to native Gi alpha affixed to nitrocellulose.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8490032
TI  - Conformational changes in oxidized phospholipids and their preferential
      hydrolysis by phospholipase A2: a monolayer study.
AB  - Cleavage of oxidized fatty acids by phospholipase A2 has been implicated as the
      first step in the repair mechanism for oxidative damage to membrane
      phospholipids. However, the mechanism by which this enzyme preferentially
      hydrolyzes oxidized fatty acyl chains is poorly understood. Using a lipid
      monolayer technique, we found that the molecular surface areas of 1-palmitoyl-2
      (9/13-hydroperoxylinoleoyl)-phosphatidylcholine (PLPC-OOH) and 1-palmitoyl-2
      (9/13-hydroxylinoleoyl)phosphatidylcholine (PLPC-OH) were increased by as much as
      50% relative to the parent nonoxidized 1-palmitoyl-2-linoleoylphosphatidylcholine
      (PLPC). These experimental data directly indicate a drastically changed molecular
      conformation of oxidized phospholipids in which the hydroperoxy or hydroxy group
      in the sn-2 fatty acid is close to the lipid-water interface. Phospholipases A2
      from porcine pancreas and from bee venom were shown to break down PLPC-OOH and
      PLPC-OH monolayers much faster than PLPC monolayers. In all cases, the presence
      of serum albumin in the subphase enhanced monolayer breakdown by extracting
      hydrolysis products from the monolayer, but monolayer breakdown was always much
      faster for oxidized than for nonoxidized PLPC. This did not appear to be due to
      change in the extent of monolayer penetration by phospholipase A2, since enzyme
      monolayer interaction studies revealed essentially identical penetration behavior
      of bee venom phospholipase A2 with PLPC, PLPC-OOH, and PLPC-OH monolayers. We
      propose that the altered molecular conformation of oxidized phospholipids
      facilitates access to the sn-2 ester bond, thereby ensuring their preferential
      hydrolysis in the presence of a phospholipase A2.

PMID- 8490033
TI  - Phosphorylation sites in bovine rhodopsin.
AB  - Bovine rhodopsin has been phosphorylated in rod outer segments by ATP and
      endogenous rhodopsin kinase. Mono-, di-, and triphosphorylated rhodopsins have
      been prepared by chromatofocusing. Nearly all of the phosphate is found in
      peptide 330-348, formed by digestion of phosphorhodopsins with endoproteinase Asp
      N. Sequence analysis of the phosphopeptides shows that monophosphorylated
      rhodopsin consists of a mixture containing rhodopsins phosphorylated at 338Ser
      and 343Ser. Diphosphorylated rhodopsin is phosphorylated at both 338Ser and
      343Ser. When rhodopsin becomes triphosphorylated it does not become
      phosphorylated on 334Ser but appears to become phosphorylated on one or more of
      the four threonine residues: 335Thr, 336Thr, 340Thr, and 342Thr.

PMID- 8490034
TI  - Novice and expert head nurses: a comparative study of work activities and
      behaviours.
AB  - The head nurse represents a key management position in hospital organizations.
      This descriptive study examines the role of the head nurse and identifies
      differences that exist between newly appointed head nurses and experts in the
      position. Questionnaire, interview and nonparticipant observation methods were
      used to collect and analyze data. Recommendations for educational preparation,
      selection criteria and recruitment and retention strategies are made based upon
      the study results.

PMID- 8490035
TI  - Planning: a cyclical and participative approach.
AB  - In today's turbulent environment, nurse administrators are challenged to plan and
      deliver change on several fronts at once. Most of us lack the resources to employ
      full time planners, or special project personnel. At KitchenerWaterloo Hospital
      the Nursing Division has developed and used a cost-effective approach to planning
      which allows for active involvement of all key stakeholders and assures that
      people are working on the plans that matter most to them. In less than three
      years, using this approach, the Division has implemented a broad range of
      progressive professional initiatives despite significant energies being required
      for rationalization of services with a neighbouring hospital, computerization,
      attempted unionization, three rounds of bed closures and the stress of severe
      budgetary deficit. Through it all, we have been able to maintain not only our
      commitment to patients, families, and each other, but also an enthusiasm and
      optimism for nursing's present and future.

PMID- 8490036
TI  - Work sampling revisited: a technique for understanding nursing work.
AB  - This article describes the work sampling methodology as a technique to provide
      direct observational data for the analysis of nursing job design. Work sampling
      has previously been used to examine the actual work of hospital nurses under the
      broad categories of direct and indirect care. We assert that work sampling can
      also be used to examine a specific type of nursing care, and use the example of
      intrapartum support to illustrate this. The purpose is to discuss the potential
      for using work sampling as a technique to examine the actual work nurses do and
      provide data for analysis of nurse job design.

PMID- 8490037
TI  - Changing realities: an analysis of the British Health Care system and the
      implications for nursing.
AB  - The British health care system is undergoing dramatic change as it moves from a
      management system based on scientific management principles towards a management
      system based on internal market principles. This restructuring, outlined in the
      British Government's White Paper, "Working for Patients" (1989), will have a
      significant impact on the practice of nursing. The changes will seriously affect,
      not only the nurse at the bedside, but also nursing management roles, practices
      and responsibilities. Ultimately these changes will require the radical
      restructuring of nursing education as British nurses know it today. This
      restructuring is essential if nurses are to meet and surpass the difficulties
      they face as their present role in the health care system is challenged, and in
      some areas seriously undermined. Similar problems are already being faced by
      Canadian nurses as they struggle to redefine the goals of their profession in
      light of new government strategies and policies on health care. An objective
      analysis of the problems faced by our British counterparts may offer insight into
      our own difficulties, and generate some solutions.

PMID- 8490038
TI  - Overcoming resistance to change.
AB  - The pace of change in health care organizations challenges nursing administrators
      at all levels of management to be effective change agents. As resistance is an
      inevitable element in the process of planned change, inclusion of interventions
      to overcome resistance is critical to the change agent role. The author presents
      five theoretically-based strategies for reducing the levels of resistance to
      planned change.

PMID- 8490039
TI  - Childhood asthma: beyond the myths (continuing education credit).

PMID- 8490040
TI  - The other foot: who is an agency nurse?

PMID- 8490041
TI  - This is leadership. Interview by Matt Little.

PMID- 8490043
TI  - 'If I had a hammer': the trials & tribulations of a nurse researcher.

PMID- 8490042
TI  - Nursing license #000001. Profile in courage: Lena Angevine Warner--Tennessee's
      Nightingale.

PMID- 8490044
TI  - Estimation of the secondary structure and conformation of bovine lens crystallins
      by infrared spectroscopy: quantitative analysis and resolution by Fourier self
      deconvolution and curve fit.
AB  - The secondary structure of six bovine lens protein fractions (two alpha, three
      beta and one gamma-crystallin) are examined in solution and in solid forms for
      the first time using FTIR spectroscopy. Films of the nuclear and cortical regions
      of the bovine lens are also examined. The structure is quantitatively estimated
      from the vibrational analysis of the resolution-enhanced amide-I profile achieved
      by Fourier self-deconvolution and linear least-squares curve-fit algorithm. All
      the protein fractions fold predominantly in a beta-pleated sheet structure with
      little or no alpha-helical domains in solution or in lyophilized solid form.
      These proteins also retain their predominant beta-sheet conformation in the
      cellular phospholipid environment of the lens, in conformity with the structure
      obtained for all the mammalian species examined to date. Despite structural
      homology, vibrational data indicate subtle structural differences within each
      class of the crystallins probably due to presence of several minor
      substructures/subconformations. Substantial high amounts of turns (approx. 40%)
      observed in the beta-fractions may have a fundamental implication in stabilizing
      the tertiary structure of the uniquely folded-proteins vital for the transparency
      of the lens. These proteins in solid KBr-matrix undergo a major structural
      change, induced primarily by ionic interactions which refold them in a helical
      conformation. IR spectroscopy together with band-narrowing procedures has proven
      to be an effective tool to obtain structural information of proteins in solution,
      as solid substrates or in a complex biological tissue, such as ocular lens.

PMID- 8490045
TI  - Quasi-irreversible inactivation of the sarcoplasmic reticulum Ca(2+)-ATPase by
      simultaneous tight binding of magnesium and fluoride to the catalytic site.
AB  - The sarcoplasmic reticulum Ca(2+)-ATPase was inactivated quasi-irreversibly by
      the treatment with KF in the presence of Mg2+ and absence of Ca2+. This
      inactivation was Mg(2+)-dependent, and prevented by high-affinity Ca2+ binding.
      The enzyme was completely protected by ATP against the inactivation with an
      affinity consistent with that of the catalytic site for ATP. The affinity for
      Mg2+ in this inactivation was in agreement with that for Mg2+ in phosphorylation
      of the enzyme with Pi. Mg.ATP did not bind to the inactivated enzyme, whereas
      metal-free ATP did bind to it with a high affinity. These findings suggest that
      the Mg2+ binding sub-site in the catalytic site of the inactivated enzyme is
      occupied by tightly-bound Mg2+. The enzyme was completely protected by Pi against
      the inactivation with an affinity consistent with that of the catalytic site for
      Pi. The inactivated enzyme showed neither phosphorylation with Pi nor high
      affinity vanadate binding. These findings suggest that the phosphorylation site
      of the inactivated enzyme is occupied by tightly-bound F-. The contents of
      tightly-bound Mg2+ and F- in the inactivated enzyme were determined after unbound
      Mg2+ and F- were removed by gel filtration. 2.3 mol of Mg2+ and 3.7 mol of F- per
      mol of phosphorylation sites were tightly bound to the enzyme. The tight binding
      of these ligands depended on the presence of each other, and was completely
      prevented by high-affinity Ca2+ binding. Linear relationships were found between
      the contents of the tightly-bound ligands and the extent of the enzyme
      inactivation. The tightly-bound Mg2+ and F- were entirely released by low
      affinity Ca2+ binding, and correspondingly the ATPase activity was restored. It
      is concluded that the observed enzyme inactivation is caused by simultaneous
      tight binding of Mg2+ and F- to the catalytic site.

PMID- 8490046
TI  - Activation of enzymes in organic media at low water activity by polyols and
      saccharides.
AB  - Horse liver alcohol dehydrogenase and alpha-chymotrypsin were deposited on a
      porous support material, Celite. After equilibration at a well-defined water
      activity, the catalytic activity was measured with diisopropyl ether as reaction
      medium. The effects of the presence of polyols and simple saccharides in the
      preparations were investigated. The additives caused a considerable increase in
      the amount of water bound to the preparation at a fixed water activity. At low
      water activities the catalytic activity was increased and at high water activity
      it was decreased by the additives. The presence of additives increased the ratio
      of alcoholysis-to-hydrolysis activity of chymotrypsin.

PMID- 8490047
TI  - Purification, characterization and molecular cloning of an acidic amino acid
      specific proteinase from Streptomyces fradiae ATCC 14544.
AB  - We have isolated a novel acidic amino-acid-specific proteinase from Streptomyces
      fradiae ATCC 14544, using benzyloxycarbonyl-L-Phe-L-Leu-L-Glu-p-nitroanilide (Z
      Phe-Leu-Glu-pNA) as a substrate. A proteinase, which we propose to call SFase,
      was purified from the culture filtrate by salting out, repeated S-Sepharose
      chromatography, and affinity chromatography (CH-Sepharose-Phe-Leu-D-Glu-OMe). The
      purified enzyme showed a single band having an apparent molecular weight of
      19,000 on sodium dodecyl sulfate polyacrylamide gel electrophoresis. When
      synthetic peptides were used as substrates, SFase showed high specificity for Z
      Phe-Leu-Glu-pNA. Comparison with nitroanilides of glutamic acid and aspartic acid
      as substrates revealed that the reactivity was about 10-fold higher for a
      glutamyl bond than an aspartyl bond. SFase selectively hydrolyzed the -Glu-Ala
      bond of two glutamyl bonds in the oxidized insulin B-chain within the initial
      reaction time until the starting material was completely digested.
      Diisopropylfluorophosphate and benzyloxycarbonyl-Phe-Leu-Glu chloromethylketone
      completely inhibited SFase, while metalloproteinase inhibitors, such as EDTA and
      o-phenanthrolin, did not inhibit the enzyme. The findings indicate that SFase can
      be classified as a serine proteinase, and is highly specific for a glutamyl bond
      in comparison with an aspartyl bond. To elucidate the complete primary structure
      and precursor of SFase, its gene was cloned from genomic DNA of the producing
      strain, and the nucleotide sequence was determined. Consideration of the N- and C
      terminal amino-acid sequences of the mature protein of SFase indicates that it
      consists of 187 amino acids, which follows a prepropeptide of 170 residues. In
      comparison with the acidic amino-acid-specific proteinase from Streptomyces
      griseus (Svendsen, I., Jensen, M.R. and Breddam, K. (1991) FEBS Lett. 292, 165
      167), SFase had 82% homology in the amino acid sequence. The processing site for
      maturation of SFase was a unique sequence (-Glu-Val-), so that the propeptide
      could be released by cleavage of the peptide bond between Glu and Val.

PMID- 8490048
TI  - Characterization of the covalent chromatography of thymidylate synthase on
      thiopropyl-Sepharose 6B.
AB  - We have examined the covalent chromatography of Lactobacillus casei thymidylate
      synthase on thiopropyl-Sepharose 6B resin. This enzyme is a dimer of identical
      subunits, each of which contains one active site that features a catalytic
      sulfhydryl group (Cys-198). Reversible coupling was achieved via the attack of
      one of the enzyme's two catalytic cysteine residues, causing displacement of 2
      thiopyridone, the reactive moiety of the resin. To establish the usefulness of
      this matrix for immobilization and the conditions required for chromatography,
      model studies were conducted with 2,2'-dithiodipyridine. The chemical
      modification of thymidylate synthase with 2,2'-dithiodipyridine was shown to be
      specific for the catalytic sulfhydryl groups of the native dimer, titrating 1.51
      sulfhydryl groups, while 2.93 cysteines were modified in the GnHCl-denatured
      protein. The former reaction, which resulted in total loss of enzyme activity,
      was reversible with complete recovery of control activity within 30 min after
      addition of 100 mM 2-mercaptoethanol. Characterization of the protein pools
      generated in the covalent chromatography procedure indicated that the enzyme
      fraction washing through the column without attachment had substantially lower
      catalytic and ligand binding activities than the original protein stock;
      conversely, the enzyme fraction eluted from the column by 2-mercaptoethanol
      exhibited higher levels of these activities. Gel electrophoresis studies further
      illustrated that the unique application of the covalent chromatography technique
      described herein fractionated homogeneous thymidylate synthase protein into
      enzyme pools exhibiting distinct biochemical properties. As immobilization
      reaction times were increased beyond 6 h, the coupling of thymidylate synthase
      was demonstrated to occur through more than one enzymic sulfhydryl group.
      Interestingly, no covalent coupling was detected in attempts using activated
      thiol-Sepharose 4B, a result underlining the importance of the structure of the
      resin linker arm in enzyme immobilization.

PMID- 8490049
TI  - A comparison of the effects of dietary selenium on selenoprotein expression in
      rat brain and liver.
AB  - In studies with rodents, when dietary supplies of the essential nutrient Se are
      restricted, in most tissues there are parallel substantial losses of the element
      and the important antioxidant selenoenzyme glutathione peroxidase (GPx) for which
      it is a cofactor. In brain, however, there appears to be both a sequestration of
      Se and a conservation of GPx activity when dietary Se is limited. To further
      explore the relation between these phenomena, we have undertaken a comparison of
      the effects of diets low, normal and high in Se on GPx activity, and labeling of
      selenoproteins following short-term (72 h) in vivo exposure to 75Se, in
      subcellular fractions from rat brain and liver, the latter serving as a
      representative tissue which does not retain Se and is depleted of most GPx
      activity following dietary restriction. Brains and livers from animals on the
      three diets showed different patterns of response with respect to both GPx
      activity and retention of the 75Se dose. The low-Se diet (0.006 ppm)
      substantially reduced GPx activity in liver but not brain, while high levels (1
      ppm) did not increase GPx in either tissue relative to a normal (0.1 ppm) intake.
      The 75Se was retained in brain homogenates and subcellular fractions to the
      greatest extent by rats on the restricted diet, while in liver, retention was
      greater in rats fed the normal supplement than in animals on either the low- or
      high-Se diets. Levels of non-protein-bound 75Se were higher in brain than liver
      and increased with dietary Se in both tissues. When proteins in brain and liver
      homogenates and subcellular fractions where separated by one-dimensional SDS-PAGE
      and exposed to X-ray film, the resulting autoradiograms revealed the existence of
      seven distinct selenoprotein bands in brain and eight in liver. Different
      patterns of selenoprotein expression were observed in subcellular fractions
      isolated from both tissues. Dependence of levels of individual selenoproteins on
      diet paralleled the effects on 75Se retention. Dietary influences on expression
      of protein bands tentatively identified as GPx were more pronounced in liver than
      brain. All of these observations provide further evidence of the unique nature of
      Se metabolism in brain.

PMID- 8490050
TI  - Catalytic properties of cytochrome P-450scc purified from the human placenta:
      comparison to bovine cytochrome P-450scc.
AB  - Cytochrome P-450scc was purified from the human placenta by extraction of
      mitochondria with cholate and Emulgen 911, chromatography on phenyl-Sepharose and
      DEAE-Sephacel, and ammonium sulphate fractionation. The catalytic properties of
      the purified human cytochrome P-450scc were analysed in Tween-20 micelles and
      compared to those of bovine adrenal cytochrome P-450scc analysed in the same
      system. Both enzymes had the same Km for cholesterol and were stimulated by
      cardiolipin when the cholesterol concentration was subsaturating. Examination of
      the rates of pregnenolone synthesis from 20 alpha-hydroxycholesterol, 22R
      hydroxycholesterol and 20 alpha, 22R-dihydroxycholesterol by human and bovine
      cytochromes P-450scc revealed that the first hydroxylation (22R position) was
      rate-limiting for both in Tween-20 micelles. The rate of the 22R-hydroxylation
      was further decreased when a 20 alpha-hydroxyl group was already present on the
      cholesterol side-chain. The second hydroxylation occurred at about the same rate
      as the third hydroxylation for both enzymes. The rate of side-chain cleavage of
      25-hydroxycholesterol by human cytochrome P-450scc in Tween-20 micelles was low,
      the highest rate being about 1% of the Vmax for cholesterol. Substrate inhibition
      was seen with high concentrations of 25-hydroxycholesterol. Conversion of 25
      hydroxycholesterol to pregnenolone was accompanied by a build-up of products with
      intact side-chains, which were probably intermediates of the reaction. Side-chain
      cleavage of 25-hydroxycholesterol by bovine cytochrome P-450scc showed similar
      characteristics to the human enzyme, except that the highest velocity observed
      was approx. 25% of the Vmax for cholesterol. Rates of cleavage of 25
      hydroxycholesterol by both enzymes were higher in dioleoylphosphatidylcholine
      vesicles than in Tween-20, but were still well below the Vmax for cholesterol and
      showed substrate inhibition. This study shows that there is close similarity in
      catalytic properties between human and bovine cytochromes P-450scc which suggests
      that the active site of the cytochrome is highly conserved.

PMID- 8490051
TI  - Catalytic efficiency of expressed aromatase following site-directed mutagenesis.
AB  - Mutant aromatase cytochrome P-450s, expressed in CHO cells after transfection
      with cDNAs, have been characterized in terms of their catalytic efficiencies.
      After solubilization from microsomes, specific aromatase P-450 content of wild
      type and mutants Pro308Phe, Asp309Asn, Asp309Ala and Phe406Arg was quantitated by
      a sandwich enzyme-linked immunosorbent assay (ELISA). Microsomal aromatase
      activity was determined by the 3H-water method using [1 beta-3H]androstenedione
      as substrate. Estimations of the actual turnover rate (catalytic efficiency) were
      derived from the combined data. The P-450 content in the mutants varied but was
      always less than that in the wild type. Hence, the decreases in the Vmax observed
      in the mutant enzymes did not correlate completely with reductions in catalytic
      effectiveness. In recent studies on the structure-function relationship of
      aromatase cytochrome P-450, the observed reduction of enzyme activity in terms of
      Vmax following site-directed mutagenesis led to the assumption that there was a
      corresponding loss of catalytic effectiveness. The present study reveals that a
      lower P-450 content can contribute significantly to decreasing catalytic activity
      in the mutants. In fact, in mutant Phe406Arg which exhibited virtually no
      catalytically active aromatase, the specific P-450 content was below the
      detectable level. Because of its location, the result of this latter mutation
      could be a major structural perturbation of the heme-binding property. Thus,
      interpretation of losses and reductions in aromatase activity resulting from
      single amino-acid replacement should take into account changes in the specific
      content of aromatase cytochrome P-450.

PMID- 8490052
TI  - Identification and immunohistochemistry of retinol dehydrogenase from bovine
      retinal pigment epithelium.
AB  - We studied the properties of retinol dehydrogenase (11-cis-specific) from bovine
      retinal pigment epithelium. Detergents caused a loss of retinol dehydrogenase
      activity; therefore, we added 3 mM NADH as a stabilizer to solubilize this enzyme
      and partially purified this enzyme using Sepharose CL-6B and hydroxyapatite
      column chromatography. The partially-purified sample, which contained two major
      proteins (66 kDa, 33 kDa), had substrate preference to 11-cis and 13-cis-retinal
      but not to all-trans and 9-cis isomers. Monoclonal anti-33 kDa protein of retinal
      pigment epithelial crude extract by Western blotting. In addition, we found that
      monoclonal anti-retinol dehydrogenase antibody bound specifically to retinal
      pigment epithelium and not to Muller cells or to rod outer segments by
      immunohistochemical methods.

PMID- 8490053
TI  - A comparative study of the solution structures of tachyplesin I and a novel anti
      HIV synthetic peptide, T22 ([Tyr5,12, Lys7]-polyphemusin II), determined by
      nuclear magnetic resonance.
AB  - The solution structure of tachyplesin I, which was isolated from membrane acid
      extracts of the hemocytes from the Japanese horseshoe crab (Tachypleus
      tridentatus), was determined by nuclear magnetic resonance (NMR) and distance
      geometry calculation. Tachyplesin I takes an antiparallel beta-sheet structure
      with a type-II beta-turn. Recently, among more than 20 synthetic peptides
      associated with tachyplesin and its isopeptide (polyphemusin), we found that a
      novel compound, which we designated as T22 ([Tyr5,12, Lys7]-polyphemusin II),
      strongly inhibited the human immunodeficiency virus (HIV)-1-induced cytopathic
      effect and viral antigen expression. The solution structure of T22 was
      investigated using NMR, and its secondary structure was confirmed to be similar
      to that of tachyplesin I. The anti-parallel beta-sheet structure and the several
      amino-acid side chains on the plane of the beta-sheet of T22 are thought to be
      associated with the expression of anti-HIV activity.

PMID- 8490054
TI  - Aryl sulfotransferase-IV-catalyzed sulfation of aryl oximes: steric and
      substituent effects.
AB  - The aryl sulfotransferases (EC 2.8.2.1) catalyze the sulfation of a wide variety
      of hydroxyl-containing molecules. The enzyme reaction requires 3'
      phosphoadenosine-5'-phosphosulfate as the sulfate donor and several isozymes with
      broad, overlapping substrate specificities have been identified. One of the
      isozymes in rat hepatic cytosol, isozyme IV, is a major contributor to enzymatic
      sulfation. It exhibits the broadest substrate specificity of the three isozymes
      which have been characterized to date. Its substrates include a wide variety of
      phenols, certain aromatic hydroxylamines and benzylic alcohols. The latter two
      substrate types have implicated this isozyme in the bioactivation of several
      toxic compounds. Relatively little information is available, however, on
      substrate molecular features which account for the ability of isozyme IV to
      sulfate compounds not utilized by isozymes I and II. A recent investigation of
      isozymes I and II with a series of model aryl-oxime substrates suggested that
      catalysis is influenced primarily by steric factors and in particular substrate
      planarity and hydroxyl group orientation (Mangold et al. (1989) Biochim. Biophys.
      Acta 991, 453-458). In the present study, isozyme IV was investigated to
      characterize its substrate requirements with a more extensive series of aryl
      oxime substrates. The results indicated that isozyme IV has a much less stringent
      requirement for planarity and hydroxyl-group orientation than isozymes I or II.
      Isozyme IV accepted a greater variety of aryl-oxime substrates, including several
      classes which were not substrates for isozymes I and II. A comparison of kinetic
      constants and catalytic efficiencies suggested that substituent effects play a
      role in the sulfation of aryl oximes by isozyme IV.

PMID- 8490055
TI  - Stimulated cellular immune system in patients with congestive heart failure.
AB  - In this cross-sectional study, we analysed serum concentrations of soluble
      markers of cellular immune activation, namely, interferon-gamma, neopterin (a
      product of activated macrophages), soluble interleukin-2 receptor, and soluble
      CD8, in 25 patients with congestive heart failure. Ten (40%) patients showed
      increased concentrations (i.e. above the reference ranges of healthy controls) of
      neopterin, 14 (56%) showed increased soluble interleukin-2 receptor, and 6 (24%)
      showed increased soluble CD8. Endogenous interferon-gamma was detectable in 10
      patients (40%). In addition, we found significant correlations between neopterin
      and interferon-gamma (rs = 0.417, p < 0.05), and between neopterin and soluble
      CD8 concentrations (rs = 0.430, p < 0.05). All patients with increased soluble
      CD8 also had increased soluble interleukin-2 receptor. However, no significant
      correlations of soluble interleukin-2 receptor with soluble CD8 or any of the
      other quantities were observed. Increased concentrations of soluble interleukin-2
      receptors, soluble CD8 and neopterin indicate that cellular immunity is
      stimulated in patients with congestive heart failure. Activated CD8-positive T
      lymphocytes may represent the source of increased soluble CD8. Endogenous
      interferon-gamma, which is derived from activated T-cells, may induce neopterin
      release by monocytes/macrophages.

PMID- 8490056
TI  - Abnormal bilirubin binding to human serum albumin in a patient with unusual
      myeloma immunoglobulin G.
AB  - The binding of bilirubin was analysed in the serum of a patient with unusual
      myeloma. This patient presented an acquired Von Willebrand's disease due to the
      presence of a ternary complex formed by one molecule of myeloma immunoglobulin G
      and two molecules of albumin (Harle et al. La Presse Medicale 19, 1661-1664
      (1990)). The binding characteristics of bilirubin--number of sites (n) and
      association constants (k)--were estimated in the serum of the proband, and
      compared with those of purified human serum albumin and pooled normal human
      serum. The data suggest that complex formation between albumin and immunoglobulin
      induces abnormal bilirubin binding in the patient's serum, which becomes apparent
      when the bilirubin/albumin ratio exceeds 1.3. This abnormal binding may be due to
      conformational changes of the albumin molecule in the complex. The greatly
      increased number of lower affinity binding sites for bilirubin is certainly due
      to the abnormally high concentration of myeloma immunoglobulin G in the serum of
      the patient.

PMID- 8490057
TI  - Biochemical diagnosis of a fatal case of Gunther's disease in a newborn with
      hydrops foetalis.
AB  - The birth of a male baby was induced at 32 weeks. In utero, the child presented,
      inter alia, signs of hydrops, hepatosplenomegaly and anaemia. Two in utero
      transfusions for correction of the anaemia were performed at 28 and 29 weeks,
      respectively. The baby rapidly presented respiratory distress with mixed
      acidosis. Three hours after birth, pink urine was excreted. Signs of icterus
      necessitated phototherapy, after which photosensitivity occurred. Erythrocytes
      were fluorescent under long-wavelength UV light. The baby died 24 hours after
      birth, displaying severe acidosis, a diffuse haemorrhagic syndrome, and repeated
      brady-cardia which did not respond to isoprenaline. The analysis of porphyrins in
      urine, blood and faeces of the baby gave the following results: 1) uroporphyrin
      (I and III isomeric series) was increased in urine and faeces, with traces in
      erythrocytes and plasma; 2) heptacarboxyporphyrin I was found mainly in urine and
      much less in erythrocytes, plasma and faeces; 3) coproporphyrin I was increased
      in urine, erythrocytes, plasma and faeces, and 4) 5-aminolaevulinic acid and
      porphobilinogen in urine and plasma were within the reference ranges.
      Determination of the enzymes of haem biosynthesis in erythrocytes and lymphocytes
      showed that both parents possessed only 50% of the normal activity of cosynthase.
      A previously described point mutation in codon 73 was observed in one parent.
      Fatal cases of neonatal Gunther's disease are extremely rare and such an
      observation, according to our knowledge, is probably one of the first described.

PMID- 8490058
TI  - A comparative study of urinary xanthopterin and neopterin in liver diseases.
AB  - By adsorption to activated charcoal, various pteridine derivatives in human urine
      are oxidized to xanthopterin. Following this oxidation, xanthopterin in urine
      from healthy subjects and from patients with liver diseases was assayed by high
      performance liquid chromatography. The mean values for xanthopterin in healthy
      subjects were 532 +/- 116 mumol/mol creatinine (mean +/- SD) in males and 585 +/-
      153 mumol/mol creatinine in females; the difference was statistically significant
      (p < 0.01). Xanthopterin concentrations in patients with liver disease were
      significantly higher than those in normal subjects. When compared with urinary
      neopterin, which is a marker of activated cell immunity, xanthopterin was
      significantly increased even in fatty liver disease. These findings suggest that
      increased concentrations of urinary xanthopterin in liver diseases reflect not
      only the status of activated cell-mediated immunity, but also injury to liver
      cells.

PMID- 8490059
TI  - Lipoprotein(a) concentrations are increased in patients with myocardial
      infarction and angiographically normal coronary arteries.
AB  - It is generally accepted that Lp(a) is an independent risk factor of
      cardiovascular diseases. Since the apolipoprotein component of Lp(a) shows some
      homologies to plasminogen, it is, however, unclear as to whether the pathological
      effect is due to the role played by the lipoprotein in lipid metabolism or in the
      fibrinolytic system. We compared two groups of patients with myocardial
      infarction, with and without angiographically documented coronary artery disease.
      In the latter group, imbalances in the clotting system are very likely, while
      members of the former group may also display disturbances of lipid metabolism.
      The results show that the two groups display differences in lipid metabolism,
      whereas they have similar patterns of thrombogenicity indices and Lp(a) values.
      This study seems to support the hypothesis that Lp(a) does play a role in the
      fibrinolytic system, since even those myocardial infarctions without obstructive
      coronary artery disease have a high frequency of Lp(a) concentrations above 300
      mg/l, i.e. similar to the situation found in the myocardial infarctions with
      angiographically documented coronary artery disease. Whether the high Lp(a)
      concentrations in the two groups are related to an impaired fibrinolysis will be
      the subject of further investigation.

PMID- 8490060
TI  - Serum creatinine and the DuPont dimension: possible improvements.
AB  - A study is reported on the determination of creatinine with the DuPont Dimension,
      paying special attention to interference by bilirubin. Various methods for
      dealing with bilirubin interference are described, including modification of the
      Jaffe reaction, enzymatic assay of creatinine, enzymatic destruction of
      bilirubin, and ultrafiltration of the serum sample. None of these modifications
      gave completely satisfactory results, although the Jaffe method with a
      ferricyanide oxidation step, and the enzymatic assay with ferrocyanide gave
      reasonable results with icteric specimens from adult patients, while only the
      latter method could be used for neonatal serum samples.

PMID- 8490061
TI  - Semiquantitative assay of human chorionic gonadotropin by a simple and fast
      immunofiltration technique.
AB  - An immunofiltration technique for the semiquantitative assay of human chorionic
      gonadotropin (hCG) was applied in two versions, using different antibodies. One
      anti-beta hCG subunit was immobilized on a glass microfibre disc in the form of
      six radially located bars, and the dry disc was placed on a water-absorbing
      material in a plastic device. A second antibody labelled with horse radish
      peroxidase conjugate was used in solution. For the colour reaction a solution
      with tetramethylbenzidine and hydrogen peroxide was used. The number of blue bars
      appearing on the test disc depended on concentration range of human chorionic
      gonadotropin. The technique with the monoclonal antibodies, anti-beta hCG and
      anti-alpha hCG-horse radish peroxidase conjugate, was specific for intact human
      chorionic gonadotropin, while the technique with the rabbit antibodies, raised
      against synthetic fragment 122-145-beta hCG and beta hCG-horse radish peroxidase,
      was useful for both intact human chorionic gonadotropin and its beta-chain. Cross
      reactions with human lutropin and thyrotropin were negligible. Haemoglobin, urea
      and various tested drugs did not affect the assay. In the assay of human
      chorionic gonadotropin in the urine of pregnant women and in sera of patients
      with trophoblastic diseases, the results from the immunofiltration technique were
      in accordance with data obtained by classical ELISA and by two commercial kits.

PMID- 8490062
TI  - Ektachem slides overestimate serum albumin in patients with nephrotic syndrome.
AB  - In a non-selected patient population (n = 140), serum albumin concentrations
      obtained with Ektachem slides were very significantly correlated with results
      determined with serum protein electrophoresis on Olympus Hite 200. In 7 patients
      with nephrotic syndrome, however, no such correlation existed, concentrations on
      Ektachem being 20 to 200% higher (up to 16 g/l difference). In other samples,
      albumin concentrations on Ektachem were 10 g/l lower. Between-method differences
      appeared most closely correlated with the sum of alpha 1- and alpha 2-globulins
      as determined by serum protein electrophoresis. Immunonephelometric determination
      of various serum proteins demonstrated that haptoglobin concentrations most
      closely paralleled the observed between-method differences.

PMID- 8490063
TI  - Evaluation of a fully mechanised immunoassay--Enzymun-Test System ES 300--and
      comparison with in-house methods for 8 analytes.
AB  - The following analytes were determined with the automated enzyme immunoassay
      unit, Enzymun-Test System ES 300, and by routine in-house tests, and the results
      were compared: thyrotropin, free thyroxine, cortisol, immunoglobulin E, digoxin,
      digitoxin, insulin and carcinoembryonic antigen. The methods used for comparison
      included two radioimmunoassays, one with enzyme labelling, two with fluorescence
      enhanced enzyme reactions and 3 luminescence immunoassays. In most cases, the
      precision of the ES 300 lay between 2 and 5% in all assays in the concentration
      ranges of clinical interest. The inter-assay variation was almost identical to
      the intra-assay precision, which reflects the constancy of reagent quality and
      machine performance. The correlation between in-house and Enzymun-Test was
      excellent, even though the slope of the regression line was sometimes far from
      unity, due to the calibration materials used. ES 300 can be used as a stand alone
      unit and connected to a host computer. As a "walk-away" machine, it is suitable
      for laboratories with medium length series. It is a multi-batch analyser capable
      of taking 12 analytes and a maximal series length of 136 tubes excluding
      standards and controls.

PMID- 8490064
TI  - A multi-centre evaluation of the measurement of high density lipoprotein
      cholesterol by the Reflotron assay.
AB  - A multi-centre study was undertaken to evaluate the performance of the Reflotron
      high density lipoprotein cholesterol method in twelve different clinical
      chemistry hospital laboratories. Results were compared with phosphotungistic
      acid/Mg2+ and polyethylene glycol/dextran sulphate/Mg2+ precipitation methods,
      routinely performed in these laboratories. Precision was found to be excellent,
      for both the day-to-day results (SD = 0.03 mmol/l) and for the overall between
      laboratory precision (SD = 0.02 mmol/l), measured with control sera. HDL
      cholesterol concentrations measured with the Reflotron system were about 10%
      lower than those obtained with the two routine precipitation methods, using
      different instruments with different cholesterol standardization procedures.

PMID- 8490065
TI  - Evaluation and performance of the Coulter STKS.
AB  - The Coulter STKS is a fully automated haematology analyser which quantitatively
      measures and computes haematological quantities including a full "five-part"
      differential. The aim of this study was to evaluate whether the Coulter STKS can
      be used for screening purposes in a non-academic clinic. Results from the
      haemocytometry part of the apparatus correlated very well with those from the
      Coulter S Plus IV. Reasonable to good correlations were obtained with the
      standard manual 100-cell differential for neutrophils, lymphocytes, monocytes and
      eosinophils. Significantly higher percentages of monocytes were found by
      microscopic observation than by the STKS. Samples from 1080 patients were
      analysed on the STKS, and manual differentials were also performed. After
      revision of discrepancies and with the exclusion of neonatal samples, a good
      numerical agreement for the "five-part" differential was obtained. The STKS gave
      1.8% false negatives, and both diagnostic sensitivity (96.3%) and specificity
      (83.3%) were high. A false negative rate of 1.9% was found for the indication
      left-shift, with a predictive value of a negative test of 97.4%. The predictive
      value of a positive test, however, was only 40.3%. An authorization procedure was
      implemented to reduce false negative samples. The routine laboratory work load
      for our differentials can be reduced by up to 70%. The Coulter STKS gave a high
      number of suspect flags for neonatal samples (75%) and is therefore not suitable
      for screening neonates.

PMID- 8490066
TI  - James Joseph Walsh (1865-1942), a forgotten psychiatrist.

PMID- 8490067
TI  - Thyroid function in bulimia nervosa.
AB  - Bulimia nervosa is characterized by episodes of binge eating. Bulimic patients
      have diminished caloric requirements and reduced metabolic rate. Because thyroid
      function is an important modulator of metabolic rate, we sought to clarify
      conflicting reports concerning this parameter in bulimic patients. Thyroid
      indices were examined in 18 bulimics at admission and after 3 weeks of
      abstinence. Patients had thyroid indices in the normal range at admission but
      slightly diminished triiodothyronine (T3) compared with control subjects (n =
      28). Significant declines in T3 and thyroxine and increases in thyrotropin were
      noted after 3 weeks of abstinence. At abstinence, T3 was positively correlated
      with caloric intake, protein, fat, and carbohydrate consumption and inversely
      correlated with percent ideal body weight. We hypothesize that binge-purge
      behavior may transiently increase thyroid indices and, consequently, metabolic
      rate in patients with bulimia nervosa. Furthermore, decreases in T3 following
      abstinence may be related to diminished caloric consumption or may reflect
      hypothalamic-pituitary dysregulation in these patients.

PMID- 8490068
TI  - Color vision deficiencies in the course of acute alcohol withdrawal.
AB  - Thirty-six male patients with a diagnosis of chronic alcoholism were detoxified
      and color vision tests were performed on day 4, 11, and 32 of their abstinence on
      an inpatient basis (Ishihara color plates, Nagel anomaloscope, three color
      matching tests according to Farnsworth). Of the 36 patients, 47.2% manifested
      color vision deficiencies. The frequency of congenital red/green defects (11.1%)
      and a ratio of 3:1 deutan/protan defects showed no significant difference from
      the incidence in the normal population. In 36.1%, manifest acquired color vision
      deficiencies were diagnosed. Within the course of withdrawal, a marked
      improvement of these disturbances could be proved. The degree of the disturbance
      seems to correlate with the severity of withdrawal symptoms, but seems to be
      unrelated to acute toxic effects of alcohol, nicotine, or medication.

PMID- 8490069
TI  - Quantitative EEG in obsessive-compulsive disorder.
AB  - Electroencephalograms (EEGs) were recorded from 13 unmedicated and nondepressed
      patients with DSM-III-R obsessive-compulsive disorder (OCD) and from 10 age
      matched controls. All subjects were also administered the Wechsler Memory Scale
      Delayed Logical Memory and Delayed Visual Reproduction tests. Quantitative
      analysis of the EEG revealed lower log absolute power in the delta, beta 1, and
      beta 2 bandwidths for OCD patients at frontal and right-hemisphere locations. OCD
      patients displayed greater hemispheric asymmetries in EEG activity based on
      difference measures of EEG power from homologous electrode pairs, indicative of
      severe right hemisphere EEG hypoactivity. Standardized measures of hemispheric
      asymmetry for the beta 2 bandwidth accurately predicted group membership and were
      correlated both with poorer patient performance on the visual-spatial memory task
      and better performance on the verbal memory task. OCD patients were significantly
      impaired on the visual-spatial task, but not on the verbal memory test, relative
      to controls.

PMID- 8490070
TI  - Depersonalization after marijuana smoking.
AB  - Depersonalization and other behavioral and physiological indices were monitored
      before and after the administration of high- and low-potency marijuana cigarettes
      and a placebo cigarette in 35 physically and mentally healthy normal volunteers.
      The cigarettes were administered under double-blind conditions during three
      visits to the laboratory separated by a minimum of 1 week. Marijuana smoking, but
      not placebo smoking, was associated with significant depersonalization that was
      maximal 30 min after smoking the high-potency cigarettes. Other behavioral
      changes induced by marijuana included disintegration of time sense, sensation of
      "high," increased state anxiety, tension, anger, and confusion. Respiration,
      pulse rate, and systolic blood pressure also increased after marijuana smoking.
      Multiple regression identified temporal disintegration as the most significant
      predictor of depersonalization.

PMID- 8490071
TI  - The dexamethasone suppression test and quantitative cerebral anatomy in
      depression.
AB  - To determine whether structural brain abnormalities in patients with depression
      are related to cortisol state, we examined the relationship between the
      dexamethasone suppression test (DST) and brain magnetic resonance imaging (MRI)
      in 40 inpatients with severe depression referred for electroconvulsive therapy
      (ECT). Prior to ECT, 27 (68%) of the patients exhibited nonsuppression on the
      DST. Frontal lobe volume was negatively correlated with peak post-dexamethasone
      cortisone (r = -0.37) and was 13% smaller in DST nonsuppressors than suppressors;
      these findings were no longer significant after adjustments for age, gender, and
      cranial size. Lateral and third ventricular volumes were also correlated with
      peak postdexamethasone cortisol (r = 0.34 and 0.33, respectively), but not after
      adjustments for age, gender, and cranial size. Subcortical hyperintensity was
      associated with peak postdexamethasone cortisol and was more common in DST
      nonsuppressors than suppressors. Again these findings were no longer significant
      after adjustments for age. Finally, longitudinal DST and brain MRI studies in 11
      of these patients revealed no changes in regional brain volumes nor in
      postdexamethasone cortisol up to six months after ECT. However, within individual
      patients, postdexamethasone cortisol was positively (and significantly)
      correlated with frontal lobe volume.

PMID- 8490072
TI  - Autoantibodies to DNA in multicase families with schizophrenia.
AB  - In an attempt to define the autoimmune status of members of multicase families
      with schizophrenia, sera of both patients and healthy relatives from 28 such
      cases were tested for antinuclear antibodies, anti-double-stranded DNA, and anti
      single-stranded DNA autoantibodies. These autoantibodies were significantly more
      frequent in both schizophrenic patients and healthy relatives than in normal
      subjects. Immunoglobulin (Ig) M anti-DNA antibodies were more common in patients,
      whereas in healthy relatives, IgG anti-DNA antibodies were more common. No
      significant differences were found between schizophrenic patients and their
      healthy relatives. The data indicate that an autoimmune process may be involved
      in the etiology of a subset of patients with schizophrenia.

PMID- 8490073
TI  - Effect of morning and afternoon naps on mood after total sleep deprivation in
      patients with major depression.
AB  - In 30 depressed patients who had responded to total sleep deprivation therapy,
      morning naps led more frequently to relapses into depression than did afternoon
      naps. Longer naps were less detrimental than shorter ones, and there was no
      significant relationship between the effect of a nap on mood and its content of
      slow-wave-sleep. The amount of the rapid eye-movement sleep, too, was unrelated
      to clinical nap effects. Thus, some of the current theories on the relationship
      between sleep and depressive symptomatology are not supported by the data. Our
      results demonstrate the importance of nap timing, suggesting a circadian
      variation of propensity to relapse into depression.

PMID- 8490074
TI  - Comparison of manic switch onset during fluoxetine and trazodone treatment.

PMID- 8490075
TI  - Is there any acid peptic disease that is refractory to proton pump inhibitors?
AB  - Non-healing and delayed healing during acid inhibition treatment depend on the
      extent to which acid and 'non-acid' factors are causative in the particular acid
      peptic disease, and on the effectiveness and duration of acid suppression.
      Refractoriness (defined arbitrarily) occurs less often with proton pump
      inhibitors than with H2-receptor antagonists as the former decrease acid more
      effectively; H2-receptor antagonist-refractory disease usually responds to
      treatment with proton pump inhibitors. In Rotherham, 5-10% of duodenal ulcer and
      gastric ulcer patients are refractory (not healed after > or = 3 months of
      standard-dose H2-receptor antagonist). In patients with oesophagitis 15% are
      refractory to high-dose H2-receptor antagonist (for example, 3.2 g cimetidine
      daily) and 5% to standard-dose proton pump inhibitors (for example, 20 mg
      omeprazole daily). In controlled clinical trials of patients with refractory
      duodenal ulcer, healing at 8 weeks with 40 mg omeprazole o.m. vs. continued
      standard-dose H2-receptor antagonist was 98% vs. 60%; and with 40 mg omeprazole
      vs. continued high-dose H2-receptor antagonist (2 g + 3 g cimetidine, that is,
      ultra-refractory disease) was 92% vs. 67%. After healing, in open studies,
      relapse with maintenance 400-800 mg cimetidine nocte was 45-69% at one year, but
      0% with 40 mg omeprazole administered for up to 6.5 years. For 53 patients with
      refractory gastric ulcer, in an open study, healing with omeprazole 40 mg o.m.
      occurred in 94% at 8 weeks, and none relapsed on long-term maintenance treatment
      at this dose. In controlled trials of patients with refractory oesophagitis,
      healing at 12 weeks with 40 mg omeprazole o.m. vs. high-dose ranitidine (300 mg
      b.d.) was 90% vs. 47%, and with maintenance 20 mg omeprazole o.m. vs. 150 mg
      ranitidine b.d., relapse at 1 year was 32% vs. 88%. In conclusion, acid peptic
      disease refractory to H2-receptor antagonists is uncommon and treatment with
      proton pump inhibitors is effective. Refractoriness to proton pump inhibitors is
      rare.

PMID- 8490076
TI  - Proton pump inhibitors, enterochromaffin-like cell growth and Helicobacter pylori
      gastritis.
AB  - In both rodents and humans the development of gastrin-promoted gastric argyrophil
      enterochromaffin-like cell carcinoids requires the involvement of a genetic
      factor inherent to multiple endocrine neoplasia syndrome or of type A autoimmune
      chronic atrophic gastritis. Prolonged severe hypergastrinaemia acting on non
      gastritic mucosa, as in Zollinger-Ellison syndrome patients, results in diffuse
      argyrophil enterochromaffin-like cell hyperplasia but, as a rule, does not
      produce tumours. Combination of chronic atrophic gastritis (mostly related to
      Helicobacter pylori infection) with hypergastrinaemia frequently causes linear
      and micronodular hyperplasia of argyrophil cells, whereas carcinoids are
      exceptional. No tumours or pre-neoplastic lesions have been observed in patients
      treated long-term with proton pump inhibitors, apart from rare cases in patients
      with combined Zollinger-Ellison and multiple endocrine neoplasia syndromes. A
      moderate increase in the incidence of argyrophil cell clustering, with or without
      hyperplasia, probably results from the parallel evolution of ulcer-associated
      Helicobacter gastritis into chronic atrophic gastritis. Eradication of H. pylori
      with a combination of proton pump inhibitors and antibiotics suppresses gastritis
      and prevents ulcer recurrence.

PMID- 8490077
TI  - Lansoprazole in the treatment of reflux oesophagitis: a survey of clinical
      studies.
AB  - The newly developed proton pump inhibitor lansoprazole has been compared to
      placebo, ranitidine and with omeprazole in a number of clinical studies in
      patients with reflux oesophagitis. In three comparative studies against
      ranitidine, lansoprazole was found to be superior in terms of healing rates and
      symptom relief. In two studies against omeprazole, no significant difference was
      found in healing rates, while a Scandinavian study demonstrated more prompt
      relief from heartburn. Further studies are presently being conducted to evaluate
      the potential of lansoprazole in long-term treatment of reflux oesophagitis. It
      is concluded that lansoprazole is a safe, effective therapy for reflux
      oesophagitis, superior to ranitidine and comparable with omeprazole.

PMID- 8490078
TI  - Acute treatment of duodenal ulcer: experience with lansoprazole.
AB  - Clinical experience with lansoprazole in the acute treatment of duodenal ulcer
      patients has been compared with treatment using placebo, H2-antagonists or
      omeprazole. Among the various lansoprazole dosage regimens that have been tested,
      30 mg daily for 4 weeks appears to be the optimal regimen to relieve pain rapidly
      and to heal ulceration in up to 90-95% of patients. Lansoprazole tolerability in
      the short term appears excellent, most adverse effects are trivial and not dose
      related. Duodenal ulcer relapse after ulcer healing with lansoprazole appears to
      occur at a rate similar to that observed after treatment with omeprazole or
      histamine H2-antagonists.

PMID- 8490079
TI  - Prospective study of the long-term efficacy and safety of lansoprazole in
      patients with the Zollinger-Ellison syndrome.
AB  - The long-term safety and efficacy of lansoprazole were studied in 21 patients
      with Zollinger-Ellison syndrome. The initial maintenance dose was determined by
      acid inhibition studies. In all patients lansoprazole controlled gastric acid
      hypersecretion and peptic symptoms in both the short and long term. Patients were
      treated for a mean of 31 months (range 1-43 months) with all but 4 patients
      followed for > 18 months. The mean initial dose was 60 mg/day, with 2 patients
      requiring a twice daily dose and the others a single daily dose. During long-term
      treatment 6 patients required an increased dosage, 5 within the first year. Long
      term maintenance doses were reduced in 5 of the 6 patients in whom this was
      attempted. No changes in serum gastrin concentration, haematological parameters,
      liver function studies or other biochemical parameters occurred due to
      lansoprazole. No patient developed a gastric carcinoid tumour while being treated
      with lansoprazole. These results demonstrate that long-term treatment with
      lansoprazole is both safe and effective in patients with Zollinger-Ellison
      syndrome, and suggest that this drug will be useful in such patients.
      Furthermore, maintenance doses of lansoprazole, determined by the currently
      recommended method of acute acid titration studies in patients with Zollinger
      Ellison syndrome, are too high.

PMID- 8490080
TI  - An open trial of long-term therapy with lansoprazole in patients with peptic
      ulceration resistant to extended high-dose ranitidine treatment.
AB  - Forty-two patients with peptic ulceration of the duodenum, stomach or oesophagus,
      who had not responded to 3 or more months of high-dose treatment with ranitidine
      (450 or 600 mg/day), were treated with oral lansoprazole at 30-60 mg daily. In 40
      patients (95.2%) the ulcers healed within 2-12 weeks. In the remaining 2 patients
      healing took several months but eventually all ulcers healed. After healing, 40
      patients underwent long-term maintenance treatment with 30-60 mg lansoprazole
      daily for 1-3 years (continuing). During maintenance therapy with lansoprazole,
      no endoscopically verified relapses occurred when the drug was taken regularly.
      In 1 patient treatment had to be discontinued because of a drug-related colitis
      that disappeared soon after treatment had been stopped. There were no significant
      changes in routine laboratory tests in any patient. Basal serum gastrin
      concentrations, which were already elevated by the previous high-dose ranitidine
      treatment (125 +/- 25 pg/ml), rose to four times the normal values after 4 weeks
      of treatment with lansoprazole (255 +/- 65 pg/ml). Thereafter no further
      increases in basal serum gastrin concentrations were observed, even after 3 years
      of administration. The volume density of argyrophilic cells in the oxyntic mucosa
      increased slightly during lansoprazole treatment; until now no dysplasia of the
      enterochromaffin-like cells has been observed. In conclusion, 30-60 mg
      lansoprazole daily healed ranitidine-resistant peptic ulcers, and subsequent
      maintenance therapy with 30-60 mg lansoprazole daily was found to be highly
      effective and safe over the time observed.

PMID- 8490081
TI  - Safety of lansoprazole.
AB  - The care with which patients are monitored during clinical trials provides an
      excellent database to assess the tolerability and safety of drugs. Additional
      information can be obtained from knowledge of the compound itself, its metabolism
      and its pharmacological action. Other compounds from the same class can highlight
      areas that need particular study. All these factors have been used to assess the
      safety of lansoprazole. Lansoprazole has been administered to 4749 subjects and
      has been well tolerated. Only 1.2% of patients have been withdrawn from trials
      because of suspected drug-related events but there was no pattern and no
      relationship to drug dosage. Diarrhoea (3.2%) and headache (4.7%) were the most
      commonly reported adverse events.

PMID- 8490082
TI  - Future prospects for proton pump inhibitors.
AB  - Future prospects for proton pump inhibitors depend on their efficacy and safety
      relative to H2-receptor antagonists, the therapeutic standard for acid peptic
      disorders. As safety concerns diminish, efficacy considerations become more
      important as these may pertain to cost effectiveness. Comparative, controlled
      trials show that omeprazole and lansoprazole are somewhat more effective than H2
      blockers in healing duodenal and gastric ulcers, providing faster relief of
      symptoms. Relapse after cessation of therapy is similar between the two classes.
      The proton pump inhibitors are substantially more effective in healing lesions
      and relieving symptoms in patients with reflux oesophagitis, and are particularly
      effective in cases that have failed to heal after 12 weeks of treatment with H2
      blockers. Relapse rates of oesophagitis are significantly less with prolonged
      treatment with omeprazole than ranitidine. A proton pump inhibitor combined with
      amoxicillin is less effective than triple therapy with antibiotics and bismuth in
      eradicating Helicobacter pylori infections, but is more convenient and associated
      with fewer side-effects. Efficacy might be improved by more optimal dosing
      regimens. Prospects for reversible proton pump inhibitors depend on the balance
      between their theoretical advantages and their acid inhibition profile which, at
      present, closely resembles that of H2-blockers.

PMID- 8490083
TI  - [A simple test procedure for detection of micro-bubbles in extracorporeal blood
      circulation].
AB  - A new contrast medium for the ultrasonic examination of the human heart was
      recently approved by the German medical authorities. It has proved useful for
      investigating the sensitivity of air detectors in detecting microbubbles
      measuring only a few microns in the extracorporeal line. Although the contrast
      medium, originally intended to be injected undiluted into the human blood
      circulation, was considerably diluted, microbubbles were detected by the
      ultrasonic air detector far below the danger limit.

PMID- 8490084
TI  - [ISFET-pH recording probe for vaginal pH monitoring].
AB  - The measurement of pH is increasingly being used as an additional or prophylactic
      diagnostic method in gynecology. In this paper a new measuring set-up for this
      purpose is described. The special rod-shaped probe contains an ISFET pH sensor
      and a miniaturized reference electrode. Initial experimental results of in vivo
      applications are discussed.

PMID- 8490085
TI  - [A program for control of competitive stimulation for inducing evoked
      potentials].
AB  - The Standard method of eliciting event-related potentials, the "oddball"
      paradigm, is insufficient as the sole technique for more differentiated problems.
      We therefore developed a more complex yet, in terms of variation of the stimuli,
      more flexible, method-competitive stimulation. This method also employs a two
      stimuli paradigm, but uses independently delivered identical target and non
      target stimuli with spatial separation. Since this technique requires special
      control mechanisms for the delivery of the stimuli, in particular with respect to
      the observance of time intervals between consecutive stimuli, we designed a
      software control program for the stimulation. This program can be run on any PC
      and permits great flexibility in the choice of the stimulus parameters and
      peripheral stimulating systems.

PMID- 8490086
TI  - [Fretting in modular design implant systems].
AB  - Fretting is a problem of load-bearing implants (hip, knee) especially when
      modular in design and employing different materials. In contrast, fretting has
      not yet been observed in dental implants. In the case of ceramic femoral heads
      and cups (e.g. BIOLOX) no problems with fretting have so far been reported. The
      state-of-the-art is discussed and assessed.

PMID- 8490087
TI  - The emerging genetic theories of unstable DNA, uniparental disomy, and
      imprinting.
AB  - Usually, genetic diseases segregate in a stable, predictable fashion throughout a
      family. For many inherited disorders, a mutation at the DNA level has been
      characterized, and prenatal diagnosis is available. Recently, however, the dogma
      of traditional mendelian inheritance has been challenged by the discovery of new
      patterns of gene segregation and expression. Unstable DNA segments varying in
      size have been associated with both fragile X syndrome and myotonic dystrophy and
      can now be diagnosed by direct DNA analysis. Uniparental disomy, the inheritance
      of both members of a chromosome pair from one parent, has been documented in
      autosomal and X-linked recessive diseases. Imprinted genes, the expression of
      which is dependent on the parent of origin, are being increasingly identified,
      especially in syndromes with abnormalities of growth. In the near future, the
      number of prenatally diagnosed disorders will expand as tests for unstable DNA,
      uniparental disomy, and imprinting become widely available.

PMID- 8490088
TI  - Fetal size and growth.
AB  - Prior to the introduction of ultrasound, Nagele's rule was the primary method for
      determining gestational age. Ultrasound has enabled a more accurate estimation of
      gestational age, allowing for improved detection of the fetus who is small for
      gestational age and reducing the number of women who are diagnosed as being
      overdue. The latest biometry charts that can be used for assessment of growth and
      dating are reviewed. It has long been recognized that a small or growth-retarded
      fetus has much greater short-term morbidity and mortality compared with its
      normal counterpart. More recently, the long-term sequelae of this condition are
      being recognized, illuminating the importance of the prevention and prediction of
      pregnancies with fetal growth problems. By focusing on better education and
      nutrition to prevent pregnancies at risk of becoming growth retarded and by using
      ultrasound to predict and manage these cases, we can improve the outcome for this
      group of patients.

PMID- 8490089
TI  - Doppler studies of deteriorating growth-retarded fetuses.
AB  - Intrauterine growth retardation continues to be one of the major problems in
      obstetrics and still greatly contributes to perinatal mortality and morbidity.
      This paper reviews the role of Doppler ultrasonography in the antenatal
      assessment of fetuses with intrauterine growth retardation. Recent developments
      in this field are described with particular emphasis on the pathophysiologic
      background of the hemodynamic modification of fetuses with intrauterine growth
      retardation. Doppler ultrasonography allows the prediction of the development of
      intrauterine growth retardation in selected populations and the identification
      among a population of small-for-gestational-age fetuses, those really at risk of
      unfavorable outcome. Finally, the modifications occurring after the establishment
      of the growth retardation with the progression of fetal deterioration are
      described in an attempt to clarify the natural history of this condition. To this
      end, the longitudinal changes of Doppler indices of placental vessels, fetal
      arterial vessels, fetal heart, and venous circulation are described, and their
      complex interrelationship is analyzed. The knowledge of these mechanisms may be
      useful in deciding the timing of delivery.

PMID- 8490090
TI  - Ultrasound screening for fetal structural anomalies.
AB  - Ultrasound prenatal diagnosis of structural anomalies has become almost a
      separate branch of obstetrics. The advantages of performing ultrasound in
      pregnancies at high risk for fetal structural anomalies are clear. Patients and
      the news media have placed ever-increasing expectations on persons performing
      diagnostic ultrasound of the fetus. However, the benefits and cost-effectiveness
      of routine ultrasound screening during pregnancy remain unclear. This review
      focuses on three controversial topics related to the use of screening ultrasound
      for fetal structural anomalies: routine ultrasound screening, the four-chamber
      view, and amniocentesis versus ultrasound for detection of neural tube defects.

PMID- 8490091
TI  - Amniocentesis and chorionic villus sampling.
AB  - Amniocentesis performed at 16 to 18 weeks' gestation has been the gold standard
      approach for prenatal cytogenetic diagnosis. Over the past few years, large
      collaborative studies on chorionic villus sampling have confirmed the safety and
      efficacy of chorionic villus sampling as a viable alternative for women seeking
      prenatal diagnosis. While the expanding experience with chorionic villus sampling
      has answered questions regarding the safety of the transabdominal approach, it
      has also raised questions concerning possible associations with limb
      abnormalities, its usefulness in multiple gestations, and the clinical
      significance of confined placental mosaicism. These issues, as well as the
      technical and gestational age limitations of chorionic villus sampling, have led
      many investigators to study the technical feasibility, safety, and accuracy of
      amniocentesis performed in the first trimester or early second trimester. While
      this approach appears both safe and efficacious, there are concerns regarding
      orthopedic abnormalities and the reliability of first-trimester amniotic fluid
      acetylcholinesterase and alpha-fetoprotein levels in the diagnosis of neural tube
      defects.

PMID- 8490092
TI  - Cordocentesis.
AB  - Access to the fetal circulation via cordocentesis has resulted in many advances
      in both prenatal diagnosis and fetal therapy over the past decade. In this
      review, current research in the assessment and treatment of erythrocyte
      isoimmunization and fetal infection by fetal blood sampling, as well as the role
      of cordocentesis in the evaluation of fetal platelet abnormalities, intrauterine
      growth retardation, fetal thyroid function, and genetic investigation, are
      discussed. Finally, a brief review of complications and loss rates relating to
      this procedure is given.

PMID- 8490093
TI  - Current management of unexplained infertility.
AB  - During the last decade, numerous studies have evaluated the effectiveness of
      various treatments for unexplained infertility. Few studies employ a design that
      allows for appropriate comparison with an untreated control group. This article
      reviews the efficacy of clomiphene citrate, human menopausal gonadotropin,
      intrauterine insemination, superovulation with intrauterine insemination, and
      gamete intrafallopian transfer in the treatment of unexplained infertility.
      Treatment for patients with unexplained infertility with superovulation or gamete
      intrafallopian transfer is promising, but the incremental contributions of
      intrauterine insemination, superovulation, or gamete intrafallopian transfer
      beyond untreated controls await appropriately designed trials. When counseling
      patients regarding treatment options, both the expected increase in cycle
      fecundity and treatment expense should be considered.

PMID- 8490094
TI  - The use of growth hormone treatment for ovulation induction.
AB  - The use of growth hormone in enhancing the ovarian response to gonadotropins is
      reviewed. The data support the utility of growth hormone in reducing the
      effective gonadotropin dosage and in most cases, increasing the ovulatory quota.

PMID- 8490095
TI  - Transcervical tubal cannulation and salpingoscopy in the treatment of tubal
      infertility.
AB  - Transcervical tubal cannulation and salpingoscopy are two recent techniques used
      for the evaluation of tubal patency and pathology. Selective tubal cannulation
      cannot determine the nature of the obstructive process, although it does allow
      for the demonstration of potential tubal patency. This may be important in
      deciding whether therapies requiring tubal patency may be used in specific
      clinical situations. Because currently there are no controlled studies in the
      literature evaluating this technique, the therapeutic value of the procedure must
      be considered unproven at this time. Salpingoscopy gives more detailed
      information concerning the tubal mucosa. The identification of specific tubal
      lesions has been described with this modality. The predictive value of
      salpingoscopy in cases of severe anatomic distortion, ie, fibrous obliteration,
      seems obvious. However, its predictive value in the presence of more subtle
      lesions needs to be studied further because its role as a therapeutic modality is
      as yet undefined.

PMID- 8490096
TI  - Reassessment of male-factor infertility, including the varicocele, sperm
      penetration assay, semen analysis, and in vitro fertilization.
AB  - Evaluation of the male factor in infertility is becoming increasingly important
      as new diagnostic techniques and therapeutic options become available.
      Varicoceles are among the most common treatable cause of male infertility.
      Varicoceles are present in 10% to 20% of all males but are found in as many as
      30% to 40% of men who present to an infertility clinic. Of men who have treatment
      for varicoceles, 50% to 75% will show some improvement in semen quality, and 30%
      to 40% will initiate a pregnancy. We review some controversial issues related to
      the diagnosis and treatment of varicoceles. In vitro fertilization, originally
      developed for the female with irreversible tubal damage, is now being evaluated
      as a possible therapy for severe male-factor infertility that has failed to
      respond to routine surgical or medical treatment. In vitro fertilization for the
      oligospermic male, however, is further complicated by the fact that men with poor
      sperm production frequently have poorly functioning sperm as well. Consequently,
      we discuss the value of the sperm penetration assay, with and without enhancement
      techniques to prospectively evaluate couples entering in vitro fertilization
      programs. We also discuss the role of strict criteria for determination of sperm
      morphology and quantitation of leukocytospermia in the evaluation of the
      infertile male. Finally, evaluation of the predictive value of "failure to
      fertilize" at in vitro fertilization for future in vitro fertilization success is
      discussed.

PMID- 8490097
TI  - Current status of immunologic recurrent pregnancy loss.
AB  - Normal mammalian pregnancy is confronted with a great number of self (autoimmune)
      and foreign (alloimmune) antigens that modulate the immune system of the mother.
      When maternal immune response is affected, recurrent pregnancy loss can result.
      Recurrent pregnancy loss affects 2% to 5% of reproducing couples. Half of these
      failures can be explained by genetic, hormonal, infectious, and anatomic factors.
      Eighty percent of the unexplained failures are proposed to have an immunologic
      cause. HLA typing, mixed lymphocytotoxic antibody tests, mixed lymphocyte culture
      reactions, lupus anticoagulant tests, and antiphospholipid antibody determination
      are methods used to study and differentiate between auto- and alloimmune
      response. Experimental therapies, including leukocyte immunization, seminal
      plasma suppositories, intravenous immunoglobulin, aspirin and prednisone, and
      heparin, have been tried to manage this condition. Results of randomized placebo
      controlled clinical trials will aid in the choice of treatment for recurrent
      pregnancy loss. New assays to diagnose auto- and alloimmune factors in recurrent
      pregnancy loss are being investigated.

PMID- 8490099
TI  - Prenatal diagnosis.

PMID- 8490098
TI  - Endoscopic treatment of ectopic pregnancies.
AB  - Laparoscopic management is now the gold standard treatment of ectopic pregnancy.
      It can be performed using different procedures such as salpingotomy and
      salpingectomy, or it can be combined with methotrexate injection. On the other
      hand, nonsurgical treatment is available. The authors discuss technique results
      and indications of these various therapeutic techniques.

PMID- 8490100
TI  - Fertility and infertility.

PMID- 8490101
TI  - Cell surface glycoproteins expressed on activated human T cells induce production
      of interleukin-1 beta by monocytic cells: a possible role of CD69.
AB  - In many immunoinflammatory diseases, macrophages, by producing interleukin-1 (IL
      1) and tumor necrosis factor alpha (TNF alpha), stimulate protease secretion in
      fibroblasts, thus contributing to tissue destruction. Monocyte/macrophage
      activation is prompted by soluble factors released by activated T cells as well
      as by cell-cell contact. Indeed, previous studies have shown that monocytes
      exposed to paraformaldehyde (PFA)-fixed, activated T cells produced high amounts
      of IL-1 beta. In this report, we used the T cell line HUT-78 to further
      characterize the T cell factor(s) responsible for monocyte activation by cell
      cell contact. After subcellular fractionation, most of the activity was found in
      the cellular membrane fraction of PHA/PMA-stimulated HUT-78 cells, and proved to
      be due to glycoproteins, following trypsin digestion and tunicamycin treatment.
      HUT-78 cells acquired the capacity to stimulate monocytic cells after as little
      as 1h of stimulation. De novo protein synthesis was required for the expression
      of the IL-1 beta inducing factor, as shown by cycloheximide treatment. When
      membrane proteins of PHA/PMA-stimulated HUT-78 cells were separated on SDS
      polyacrylamide gel, a peak of stimulatory activity was observed at Mr--25-35 x
      10(3). By using specific cytokine inhibitors or blocking mAbs, we ascertained
      that cell-associated cytokines (IL-1, IL-2, IFN gamma and GM-CSF) were not
      involved in monocyte activation by cell contact. Anti-CD2 and -CD11a (LFA-1) mAbs
      partially blocked IL-1 beta production by -25% and -35%, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8490102
TI  - One and two-level regulation patterns affecting NF-kappa B mRNA and nuclear NF
      kappa B activity after treatment with TNF-alpha, IFN-gamma and IL-4.
AB  - The transactivating nuclear factor NF-kappa B is believed to be important in the
      pathophysiology of many cellular systems and mainly during HIV infection. kappa B
      activation has also been implicated in the process of differentiation as a cell
      progresses to a more mature and functional stage. As induction of differentiation
      equals growth retardation we undertook this study in order to establish the role
      of NF-kappa B in cell growth and maturity. Thus we employed the well described HL
      60 cellular system that expresses constitutively basal amounts of NF-kappa B and
      is susceptible to NF-kappa B induction by various biological or chemical agents.
      We also used known inducers of differentiation like TNF-alpha, IFN-gamma and IL-4
      that interact via their corresponding surface receptors found on HL-60 cells. We
      first studied by Northern analysis the possible correlation between c-myc and NF
      kappa B precursor (p105) mRNA. We witnessed that all three cytokines were able to
      confer proliferative senescence and down-regulate concomitantly c-myc and NF
      kappa B mRNA levels, events chronologically in accord with induction of
      differentiation as assessed by the induction of HLA-DR surface antigens. It is
      known that TNF-alpha is capable of inducing nuclear kappa B activity in HL-60 as
      the cells progress to a more mature stage. Therefore we examined whether the
      other two cytokines could do the same during the time they lead the cells to a
      differentiated phenotype. If this was the case, nuclear activation of NF-kappa B
      should be obtained by the same factors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490103
TI  - Protein kinase C regulates TNF-alpha production by human monocytes.
AB  - Tumor Necrosis Factor alpha (TNF alpha) is a cytokine mediator that is produced
      primarily by activated monocytes/macrophages in response to
      endotoxin/lipopolysaccharide (LPS) as well as other stimuli. The second messenger
      systems that regulate the synthesis and release of TNF alpha are not clearly
      defined. In the present study, the role of protein kinase C (PKC) in the
      production of TNF alpha was investigated in human peripheral blood monocytes
      stimulated with either LPS or zymosan. Two broad spectrum protein kinase
      inhibitors (staurosporine and K252a) and two PKC specific inhibitors (calphostin
      C and chelerythrine), were used as probes to delineate the involvement of PKC in
      the production of TNF alpha. The results indicate that inhibition of PKC
      diminished LPS- or zymosan- induced TNF alpha production in a concentration
      dependent manner. The IC50 values for the inhibition of TNF alpha production were
      0.2 nM for staurosporine, and 20 nM for K252a, Calphostin C and chelerythrine.
      Furthermore, long term PMA treatment of these cells (to abrogate PKC-mediated
      responses) resulted in a significant reduction of stimuli-induced TNF alpha
      production. LPS and zymosan also induced an increase in membrane associated PKC
      activity in human monocytes, which could be inhibited by pretreatment of the
      cells with calphostin C. Finally, western blot analysis with PKC isoform-specific
      antibodies demonstrates that the alpha and xi are the predominent isoforms
      expressed in human monocytes. These data strongly suggest that an initial step in
      TNF alpha production by human monocytes challenged with physiological stimulants,
      such as LPS and zymosan, involves a PKC-dependent mechanism.

PMID- 8490104
TI  - Interleukin-2 and soluble interleukin-2 receptor levels in children with active
      pulmonary tuberculosis and atypical mycobacterial adenitis.
AB  - Interleukin-2 (IL-2) level was measured in sera and in supernatants of Purified
      Protein Derivatives of Tuberculin (PPD) stimulated peripheral blood mononuclear
      cells (PBMC) cultures from children with active primary pulmonary tuberculosis
      (TB), or adenitis caused by mycobacteria of the group Mycobacterium avium,
      intracellulare, scrofulaceum (MAIS). The control groups included BCG vaccinated
      children (BCG) and children with negative skin test to PPD (NST). High mean IL-2
      level was exclusively found in sera of mild TB patients (MTB), and not in sera of
      MAIS infected or BCG vaccinated children. The IL-2 level increased even more in
      MTB during treatment. In severe TB (STB) the IL-2 level was not elevated before
      treatment, but increased also during treatment. IL-2 production in supernatants
      of PPD stimulated PBMC cultures was increased in MTB as well as in MAIS and BCG
      subjects. Further, soluble IL-2 receptor (sIL-2R) levels were measured in the
      different groups of children. With the exception of the STB group, there was
      otherwise no significant increase of the receptor in the sera levels between
      groups. During treatment the sIL-2R levels decreased in MTB as well as in STB. A
      slight but non significant augmentation was found in the supernatants of PBMC
      cultures stimulated with PPD. This work suggests, along with other referable
      studies, that IL-2 and sIL-2R levels are inversely modulated by the disease.
      Indeed, the IL-2 seems to increase in MTB comparatively to NST children, and in
      treated TB comparatively to non treated TB children. On the other hand, the sIL
      2R level was found to decrease in TB under treatment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8490105
TI  - Human interleukin-6: detection of 10 attomoles by colorimetric sandwich ELISA
      using immunopurified polyclonal anti-IL-6 antibodies.
AB  - A convenient and sensitive sequential sandwich colorimetric ELISA test was
      established for quantitating IL-6 in culture supernatants or in serum.
      Immunopurified HRP-labelled rabbit Fab' fragment was used as the tracer and IgG
      coated microtiter plate as the capture antibody. The limit of detection was as
      low as 10 attomoles of analyte (2.5 pg/ml). Unglycosylated recombinant IL-6 and
      the natural glycosylated cytokine were recognized equally. In addition, IL-6
      measurements were unaffected by the presence of various cytokines and assay
      sensitivity was only slightly reduced in the presence of undiluted serum samples.
      The technique was applied to the study of in vitro IL-6 production from activated
      monocytes and to the in vivo determination of IL-6 in various pathological
      states.

PMID- 8490106
TI  - CD3-stimulated Jurkat T cells mediate IL-1 beta production in monocytic THP-1
      cells. Role of LFA-1 molecule and participation of CD69 T cell antigen.
AB  - In this study we investigated the T cell signals required for monocyte
      activation. We used an in vitro co-culture system involving two human cell lines:
      Jurkat T cells and THP-1 monocytes. Monocyte activation was monitored by
      measuring IL-1 beta production, whereas IL-2 secretion reflected Jurkat
      activation. We showed that CD-3 -stimulated Jurkat cells delivered an IL-1
      inductive signal to THP-1 cells through a cellular contact which was independent
      of THP-1 Fc receptors cross-linking. Stimulation of IL-1 beta production did not
      appear to require lymphokine secretion by T cell since a lymphokine defective
      mutant of Jurkat cell was able to deliver the stimulatory signal. The LFA-1
      molecule was clearly shown to participate in the cooperation process, but its
      role was likely to be restricted to mediating initial adhesive interaction rather
      than to transducing the IL-1 -inductive signal. Interestingly, the co-culture
      stimulated by (Fab')2 fragments of CD3 mAb displayed an enhanced IL-1 beta
      production without any increase of IL-2 secretion. This result indicated that
      Jurkat cells could stimulate THP-1 cells even when they were only partially
      activated. The kinetics and conditions of IL-1 beta production called our
      attention to the early T cell activation antigen CD69. We then showed that CD69
      mAb interfered with transmission of the IL-1 inductive signal (40-50% inhibition
      of IL-1 production). Our results are suggestive of a new role for CD69 molecule
      intervening in the T lymphocyte-dependent monocyte activation process.

PMID- 8490107
TI  - Immunomodulator polysaccharides: chemistry, disposition and metabolism.

PMID- 8490108
TI  - Pharmacokinetic study of a tripeptide HIV-1 protease inhibitor, KNI-174, in rats
      after intravenous and intraduodenal administrations.
AB  - Recently, as a new type of anti-AIDS drug, an HIV-1 protease inhibitor, KNI-174,
      has been synthesized; it shows a potent and selective HIV-1 protease inhibitory
      activity in vitro. In this study, we developed an HPLC assay system for KNI-174
      in rat plasma and examined the pharmacokinetics of KNI-174 in rats using this
      assay method after both intravenous (i.v.) and intraduodenal (i.d.)
      administrations to obtain the disposition characteristics and bioavailability of
      this new anti-AIDS drug. This HPLC assay method is specific to KNI-174 and the
      standard curve was linear from 0.02 to 30 micrograms ml-1 plasma. After i.v.
      administration, 10.0 mg kg-1, KNI-174 disappeared from the rats' plasma in a
      three-exponential decay. The mean terminal elimination half-life, t1/2 lambda z,
      was 3.97 +/- 0.19 (S.E.) h, the total body clearance, CLtot, was 9.53 +/- 1.08 ml
      min-1 and the distribution volume at steady state, Vd,ss, was 7070 +/- 960 ml kg
      1. In the case of the i.d. administration, 10.0 mg kg-1, the mean peak plasma
      concentration, Cmax, and the peak time, tmax, were 0.196 +/- 0.076 micrograms ml
      1 and 0.444 +/- 0.193 h, respectively. The bioavailability of KNI-174 till
      infinity, BA(0-infinity), was 5.37 per cent. Because the IC50 of KNI-174 against
      HIV-1 in PHA-PBM was 138 ng ml-1, the time needed for maintaining the
      concentrations above IC50 after a single i.d. administration of KNI-174 is
      estimated to be 0.350 +/- 0.184 h.

PMID- 8490109
TI  - Influence of food on the disposition of the monoamine oxidase-A inhibitor
      brofaromine in healthy volunteers.
AB  - The effect of food on the bioavailability of brofaromine hydrochloride was
      investigated in a randomized cross-over study. Eight healthy male volunteers were
      given single peroral doses of 75 mg brofaromine hydrochloride after overnight
      fasting or a fat- and protein-rich breakfast. Mean (+/- SD) areas under the
      plasma concentration-time curves (AUC) were 9.66 (2.35) mumol l-1 h when given to
      the fasted volunteers and 11.82 (3.78) mumol l-1 h (p = 0.0413) when given after
      a substantial breakfast. Mean (+/- SD) maximum plasma concentrations (Cmax) were
      0.71 (0.13) mumol l-1 when given to the fasted volunteers and 0.85 (0.22) mumol l
      1 (p > 0.05) when given after breakfast. Thus, both the average AUC and Cmax were
      increased by approximately 20 per cent when brofaromine hydrochloride was given
      with food. The times when Cmax was reached (tmax) as well as the elimination half
      lives were not influenced by concomitant intake of food. The tolerability was the
      same whether brofaromine was given before or after food in healthy volunteers.
      The slight effect of food on the bioavailability of brofaromine should be of
      little therapeutic consequence because of the observed wide inter-subject
      variability of the plasma levels.

PMID- 8490110
TI  - Pharmacokinetics of D-propranolol following oral, intra-arterial and intraportal
      administration: contrasting effects of oral glucose pretreatment.
AB  - Several research groups have reported that in man the oral administration of
      propranolol with food leads to a marked increase (about 50 per cent) in the area
      under the plasma concentration-time curve (AUCpo) of this well absorbed and
      highly metabolized drug. An acute change in hepatic metabolic enzyme activity has
      been postulated as one of the mechanisms which could be responsible for this
      observed 'food effect'. The administration of simple carbohydrates such as
      glucose and fructose has been documented to influence hepatic drug metabolism.
      Therefore, in the present study, the effect of oral glucose (4 g kg-1 as a 50 per
      cent aqueous solution) on the disposition kinetics of d-propranolol was examined
      in male Sprague-Dawley rats (8 to 9 per group). Oral glucose treatment caused a
      statistically significant decrease (50.4 +/- 12.3 vs 36.6 +/- 15.2 min micrograms
      ml-1; p < 0.05) in the AUCpo of propranolol when this drug was given by oral
      intubation (10 mg kg-1). This glucose treatment also caused the apparent mean
      residence time of propranolol after an oral dose to increase from 0.70 +/- 0.08 h
      to 1.79 +/- 0.29 h (p < 0.05), but did not change its rate of elimination
      (suggesting collectively a decreased apparent intrinsic clearance and prolonged
      drug absorption). In a second study, the same oral glucose treatment was
      demonstrated to have little impact on the steady state concentrations of
      propranolol when this drug was infused intraarterially at a constant rate. This
      confirms that the systemic clearance of propranolol is influenced minimally by
      the glucose treatment. In a third study, propranolol was infused at a constant
      rate into the portal vein (pyloric vein infusion) bypassing the processes of
      intestinal metabolism and absorption (i.e. to remove these sources of variability
      associated with oral administration). Under these conditions, no significant
      changes in AUC or apparent mean residence time were observed for the two
      propranolol doses studied (10 mg kg-1 and 5 mg kg-1). We conclude that the oral
      glucose and oral propranolol interaction appears to be due to an alteration in
      the input process before drug enters the liver. Furthermore, this experimental
      series suggests that studies combining accurate assessments of systemic clearance
      (constant rate intra-arterial infusion studies), intrinsic hepatic clearance
      (pyloric vein infusion studies), and oral administration supplemented with
      necessary protein binding studies may be used together to characterize the
      mechanism responsible for drug-nutrient and drug-drug interactions.

PMID- 8490111
TI  - Effect of intravenous infusion time on the pharmacokinetics and pharmacodynamics
      of the same total dose of bumetanide.
AB  - The pharmacokinetics and pharmacodynamics of bumetanide were evaluated after
      intravenous (i.v.) administration of the same total dose of bumetanide in
      different lengths of infusion times, 10 s (treatment I), 1 h (treatment II), and
      4 h (treatment III) to rabbits. The fluid loss in urine was immediately replaced
      volume for volume with i.v. infusion of lactated Ringer's solution. Some
      pharmacokinetic parameters of bumetanide were infusion time-dependent and it
      might be due to the saturable metabolism of bumetanide. For example, the mean
      values of CL (13.6, 25.3 vs 18.2 ml min-1 kg-1), MRT (9.70, 10.6 vs 21.8 min),
      Vss (128, 217 vs 378 ml kg-1), and CLNR (2.71, 9.24 vs 6.44 ml min-1 kg-1)
      increased when the same dose of bumetanide was infused in 1 h or 4 h. However,
      the mean values of t1/2, and CLR were not significantly different among three
      treatments. The diuretic effects (urine outputs and urinary excretions of sodium
      and chloride) increased significantly in 1 and 4 h of infusion although the total
      amounts of urinary excretion of unchanged bumetanide were 21.8 and 20.5 per cent
      lower in treatments II and III, respectively, when compared with the value in
      treatment I; the mean values of 8-h urine outputs were 373, 922, and 1030 ml for
      10s, 1 h, and 4 h of infusion, respectively, and the corresponding values for 24
      h sodium excretions were 49.0, 82.8, and 121 mmol, and for chloride were 47.5,
      71.1, and 114 mmol. It could be due to the higher diuretic efficiencies in
      treatments II and III. Plasma concentrations of bumetanide, and hourly urine
      outputs and hourly urinary excretion rates of bumetanide, sodium, potassium, and
      chloride during the apparent steady state (between 1 and 4 h) in the 4 h infusion
      study were fairly constant.

PMID- 8490112
TI  - Bioavailability of metformin in tablet form using a new high pressure liquid
      chromatography assay method.
AB  - Twenty-four young healthy volunteers received a single dose of metformin 500 mg
      (Glucophage, Nordic Laboratories, Canada) in tablet form. Plasma concentrations
      were determined by HPLC in samples collected prior to and 0.33, 0.66, 1, 1.33,
      1.66, 2, 2.5, 3, 4, 5, 6, 7, 8, 10, 12, 15, 18, 24, and 30 h after dosing. Mean
      (+/- SD) Cmax was 682.1 (160.6) ng ml-1 at a mean (+/- SD) tmax of 2.4 (0.93) h.
      Overall elimination was monoexponential with a mean (+/- SD) half-life of 3.16
      (0.47) h. We conclude that metformin is rapidly absorbed from this formulation
      and is also rapidly eliminated. Extrapolation to steady state predicts that
      equilibrium will be reached within 24 h.

PMID- 8490113
TI  - Kinetic modeling of liposome degradation in blood circulation.
AB  - The aim of this study is to develop a kinetic model for the quantitative
      evaluation of, and to examine dose dependency in liposome degradation in blood
      circulation in vivo. Multilamellar liposomes labeled with 3H-inulin were
      administered intravenously into rats and the time courses of blood concentration
      and urinary excretion of 3H-inulin were measured. The dosages of liposomes were
      fixed at 1, 5, and 100 mumolPCkg-1. Remarkable saturation was found in the time
      courses of both blood concentration and urinary excretion. Then a kinetic model
      for the degradation of liposomes in blood was developed, assuming that the
      degradation follows the first order rate process for each dose. The model fitted
      the observed time courses of excreted 3H-inulin well, and dose dependency could
      be observed in the rate constants for liposome degradation, which are more
      sensitive than urinary excretion of 3H-inulin. The degradation rate constant
      correlated well with the uptake rate constant, which suggests the same underlying
      mechanism for both uptake and degradation. These results indicate the usefulness
      of kinetic modeling in the quantitative evaluation of liposome degradation in
      blood circulation in vivo.

PMID- 8490114
TI  - Effect of pirenzepine on the N-demethylation of D(-)ephedrine and ethylmorphine
      by rabbit liver microsomes.
AB  - The possible interaction of pirenzepine with the mixed-function oxidases obtained
      from phenobarbital-pretreated rabbit microsomes was examined in vitro. Under
      experimental conditions that did not lead to its own N-demethylation, the drug
      inhibited the microsomal oxidase systems responsible for the N-demethylation of
      D(-)ephedrine and ethylmorphine. Kinetic studies showed that pirenzepine
      inhibited the metabolism of both drugs in a competitive manner. The results
      indicated that the observed pirenzepine stability to the hepatic N-demethylating
      system is not a result of low affinity of the drug to the system.

PMID- 8490115
TI  - Autosomal dominant polycystic kidney disease.
AB  - Autosomal dominant polycystic kidney disease (ADPKD) is an important cause of
      medical morbidity in the United States that affects one-half million persons and
      accounts for ESRD in about 10% of the chronic dialysis population. In addition to
      its effects on the kidney, the disease has important manifestations in the
      cardiovascular system (aneurysms, hypertension) and the gastrointestinal tract
      (hepatic cysts). Clinically important renal complications can develop as the
      disease progresses that require specialized attention, such as urinary tract
      infection, pain, and nephrolithiasis. The underlying cellular defect that causes
      ADPKD has eluded investigators thus far, but abnormalities in cellular
      proliferation, the tubular basement membrane, and cell fluid secretion appear
      important in pathogenesis. Factors that mediate progressive interstitial fibrosis
      and failure of renal function are undefined, although rigorous control of blood
      pressure appears to be an important therapeutic measure. Recent advances in
      molecular biology have localized the abnormal gene to chromosome 16 in 90% of
      families, making early genetic screening of asymptomatic family members possible
      in many cases. A positive diagnosis may have important effects on employment
      status, as well as health insurance, so that family members sometimes refuse to
      be assessed for the presence of the disease. Because of such complex social
      factors, counseling of an asymptomatic individual by his or her physician is
      required when considering the use of screening tests for ADPKD. Inadequate
      patient education may still represent an impediment to early detection, genetic
      counseling, and timely treatment of disease complications.

PMID- 8490116
TI  - Elevated blood pressure profile and left ventricular mass in children and young
      adults with autosomal dominant polycystic kidney disease.
AB  - Twelve children (< 15 yr) and 12 young adults with autosomal dominant polycystic
      kidney disease (ADPKD) confirmed by ultrasonography and 24 nonaffected
      individuals matched for age, sex, and body surface area were examined with
      ambulatory blood pressure monitoring and echocardiography. All patients and
      controls had normal renal function (median serum creatinine, 0.85 mg/dL; range,
      0.5 to 1.1). In children, daytime and nighttime blood pressures were not
      significantly different from those of controls; the median left ventricular mass
      index (in grams per square meter) was higher in patients (66.6 g/m2) than in
      controls (61.3 g/m2; P < 0.002), although all values remained within the normal
      range. In young adults with ADPKD, mean arterial blood pressure was significantly
      higher than that in controls both during daytime (98.3 mm Hg; range, 74 to 126
      versus 90.6 mm Hg; range, 73 to 116; P < 0.006) and during nighttime (83.2 mm Hg;
      range, 66.5 to 125 versus 79.0 mm Hg; range, 63 to 91; P < 0.05). In parallel,
      the median left ventricular mass index was significantly higher in young adults
      (81.8 g/m2; range, 62 to 174 versus 64.3 g/m2; range, 52 to 102; P < 0.02). The
      results document that ambulatory daytime and nighttime blood pressures and left
      ventricular mass indices are higher in asymptomatic carriers of the ADPKD trait
      compared with controls, although most values are still within the normal range.

PMID- 8490117
TI  - Heterogeneous nature of renal lesions in type II diabetes.
AB  - The nature of renal damage in patients with type II diabetes remains unclear.
      This study was directed to evaluate pathologic changes in 52 patients affected by
      type II diabetes with overt clinical nephropathy by conventional and morphometric
      techniques. The duration of diabetes ranged from 6 to 384 months, urinary protein
      excretion ranged from 0.9 to 9.2 g/24 h, and serum creatinine ranged from 0.9 to
      9 mg/dL. Specimens were examined semiquantitatively by light microscopy,
      immunofluorescence, and electron microscopy. Glomerular tuft cross-sectional area
      was measured by a versatile computer system. Pathologic examination revealed
      three distinct patterns arbitrarily defined as Classes 1, 2, and 3. Class 1
      included 19 patients with typical changes of diabetic nephropathy characterized
      by a high score of glomerulosclerosis (mean score, 2.1), marked glomerular
      hypertrophy (23,632 microns2), and arteriolar hyalinosis (mean score, 2). There
      was a positive correlation between glomerulosclerosis and arteriolar hyalinosis
      scores (P < 0.05). Class 2 included 16 patients showing chronic and aspecific
      changes. As compared with Class 1 patients, these patients had less
      glomerulosclerosis (mean score, 1.3) and less arteriolar hyalinosis (mean score,
      0.8) but more severe ischemic glomerular lesions (mean score, 1.4) and
      arteriosclerosis (mean score, 2). Class 3 included 17 patients showing glomerular
      disease superimposed on diabetic glomerulosclerosis. There were no differences in
      age, mean duration of diabetes, renal function, urinary protein excretion, and
      mean arterial pressure among the three classes of patients. This study indicates
      that renal lesions in patients with type II diabetes manifest in a quite
      heterogeneous fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490118
TI  - Racial variation in human leukocyte antigen frequency in insulin-dependent
      diabetic nephropathy. The South-Eastern Organ Procurement Foundation.
AB  - Black patients with insulin-dependent diabetes mellitus are at increased risk for
      the development of diabetic nephropathy compared with white patients. To
      determine if genetic differences associated with the HLA system account for
      racial variation in insulin-dependent diabetes mellitus-induced nephropathy,
      serologically defined HLA phenotypes from renal transplant recipients and donors
      in the South-Eastern Organ Procurement Foundation database from 1982 to 1986 were
      analyzed. Renal transplant recipients (N = 1,531) with insulin-dependent diabetes
      mellitus-induced renal failure as the cause of ESRD (patients) were compared with
      4,506 race-matched, nondiabetic cadaveric kidney donors (controls). Log-linear
      models were used to assess the relationship between insulin-dependent diabetes
      mellitus-induced renal failure and prevalence of each HLA phenotype. Bonferroni
      adjustments of P values were used to correct for multiple comparisons. A
      comparison of HLA frequencies in patients with insulin-dependent diabetes
      mellitus-induced renal failure demonstrated the presence of racial differences
      beyond those normally present between the black and white populations. Blacks,
      compared with whites, had increased frequencies of HLA-B62 (odds ratio [OR]
      black:white, 6.13:1.97; P < 0.02) and HLA-DR9 (OR black:white, 4.82:1.57; P <
      0.008) and decreased frequencies of HLA-A1 (OR white:black, 1.56:0.8; P < 0.008)
      and HLA-DR3 (OR white:black, 4.9:2.82; P < 0.004). These results suggest that
      differences in HLA frequency may account, in part, for the observed racial
      variation in incidence of diabetic nephropathy. In addition, several antigens in
      positive and negative association with diabetic nephropathy were identified
      within each race.

PMID- 8490119
TI  - Tissue concentration and urinary excretion pattern of sulfofluorescein by the rat
      kidney.
AB  - In order to find a fluorescein analog that is excreted in a way similar to p
      aminohippurate (PAH) and is suitable to register excretion into the urine and
      also to monitor continuously the concentration within cortical tissue, the
      interference of fluorescein, sulfofluorescein (SF), and fluorescein-5(6)
      sulfonate with the contraluminal transport systems of PAH, succinate, and sulfate
      and with the luminal transport system of sulfate and lactate was evaluated. All
      three substances exerted a strong inhibitory potency against contraluminal PAH
      uptake (apparent Ki, 0.06 to 0.1 mmol/L) and also showed a moderate to small
      inhibitory potency against contraluminal sulfate transport (apparent Ki, 0.7 to
      5.3 mmol/L). None of the three substrates interacted with the contraluminal
      dicarboxylate transport. Luminally, fluorescein and SF interacted with the
      lactate transporter (apparent Ki, approximately 3.0 mmol/L), whereas SF and
      fluorescein-5(6)-sulfonate had a very weak inhibitory potency against luminal
      sulfate transport (apparent Ki, 30 to 40 mmol/L). Because of its relatively low
      interference with the contraluminal sulfate transport, we preferred SF in the
      following study (protein binding, 88%) over fluorescein-5(6)-sulfonate (protein
      binding, 43.3%) and fluorescein (protein binding, 77.3%). A bolus injection of SF
      was given together with [14C]inulin into the jugular vein to rats in mannitol
      diuresis. Excretion of both substances in the urine was measured in 5-min
      samples. Fluorescence of the kidney surface was monitored at the exposed kidney
      with a photocell (excitation light, 470 nm; emission light, 530 nm). The effect
      of interfering substances was evaluated by their application 1 min before,
      simultaneously, or 1 min after SF bolus injection. PAH < probenecid < apalcillin
      inhibited SF excretion in the urine and, to a similar degree, SF fluorescence in
      cortical tissue. Inhibition was strongest when the substances were given
      simultaneously with SF. With the injection of alpha-ketoglutarate, glutarate, and
      succinate, an increase of SF excretion in the urine and, partially also, of SF
      content in tissue was seen. Tetrafluorosuccinate and mercaptosuccinate inhibited
      urinary SF excretion and tissue fluorescence strongly. Therefore, SF secretion is
      completely inhibited whereas filtration remained unaffected. The injection of
      acetate, lactate, and pyruvate as well as of 2-chloropropionate and thiosulfate
      did not change urinary excretion and tissue fluorescence of SF significantly. In
      SF-preloaded animals, the injection of probenecid, apalcillin,
      tetrafluorosuccinate, and mercaptosuccinate caused an immediate decrease of
      cellular SF content, whereas the injection of glutarate caused an increase. SF
      fluorescence in tissue was linearly related to urinary excretion of SF, whereas
      urinary excretion of inulin was barely affected.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8490120
TI  - Serum albumin in patients on continuous ambulatory peritoneal dialysis-
      predictors and correlations with outcomes.
AB  - Serum albumin (SA) is a powerful predictor of patient morbidity and mortality in
      hemodialysis, but data are limited for continuous ambulatory peritoneal dialysis
      (CAPD). SA was monitored in 76 new CAPD patients over 222 6-month periods and
      mean SA was correlated with morbidity and mortality during those periods. The
      influence of initial SA on duration of technique survival was also investigated.
      To determine which factors best predict SA, correlations with patient
      demographics and with 6-month measurements of dialytic dose, protein intake, and
      peritoneal transport were sought. Mean SA overall was 34.1 +/- 3.3 g/L, and mean
      initial SA was 33.4 +/- 3.1 g/L. Mean SA was lower in diabetics and in those aged
      65 or over. Mean SA tended to increase during the first year on CAPD, and this
      increase was maintained, except in patients aged 65 or over, where it tended to
      revert to initial values. SA correlated with hospital days (r = -0.20; P <
      0.005), fatigue index (r = -0.20; P < 0.005), nerve conduction (P < 0.001), and a
      variety of laboratory values, and lower SA was associated with technique failure
      (P < 0.03) and death (P < 0.07). Initial, as well as ongoing, SA was predictive
      of technique failure (P < 0.05) and Cox proportional hazards regression showed
      that this predictive power was independent of age, sex, diabetes, and other
      factors (P = 0.05). The strongest predictors of low SA by stepwise multiple
      regression were diabetes, a higher dialysate-to-plasma creatinine equilibration
      ratio, older age, lower body weight, and shorter time on CAPD.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8490121
TI  - Protein catabolic rate in patients with acute renal failure on continuous
      arteriovenous hemofiltration and total parenteral nutrition.
AB  - Continuous arteriovenous hemofiltration (CAVH) has been used to provide nutrition
      support to critically ill patients in acute renal failure (ARF). Limited
      information exists regarding protein needs of these patients. Nineteen
      postoperative patients in ARF and on CAVH and total parenteral nutrition (TPN)
      were studied (10 men; 9 women; mean age, 65 yr) to determine protein needs
      (protein catabolic rate; PCR), urea nitrogen appearance (UNA), and total nitrogen
      appearance (TNA). TPN was adjusted to meet the needs estimated by the Harris
      Benedict and Long equations. A total of 38 24-h studies were conducted on the 19
      subjects. TNA, UNA, and PCR were determined by direct measurement of body losses
      and calculation of body pool nitrogen changes. Patients received an average of
      93.9 +/- 30.5 g of protein (1.4 g/kg) and 2,600 +/- 534 kcal/day in TPN. Mean PCR
      was 117.5 +/- 42.8 g/day; UNA was 18.3 +/- 6.9 g/day. TNA and UNA were strongly
      correlated (r = 0.99; P < 0.001). PCR was less strongly correlated with estimated
      protein needs (r = 0.35; P = 0.03). A regression equation was developed
      describing the relationship between TNA and UNA as follows: TNA = 1.895 + 0.9444
      (UNA) or UNA = 0.1602 (PCR) - 0.916. On the basis of this study, CAVH permits the
      provision of adequate nutrition support to critically ill, unstable patients. It
      appears that the protein needs of patients in ARF on CAVH can be accurately
      estimated by determining UNA through the measurement of urea losses and urea body
      pool changes and by regression equations to calculate PCR.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8490122
TI  - Angiotensin or thromboxane receptor antagonism in rats with congenital
      hydronephrosis.
AB  - A technique for the measurement of GFR without collection of urine in rats was
      experimentally validated and applied to experiments designed to: (1) evaluate the
      degree of reduction of GFR in rats with congenital, unilateral hydronephrosis;
      and (2) to determine if the reduction in renal function is mediated by
      angiotensin II and/or thromboxane A2 mechanisms. Simultaneous measurements of GFR
      by a constant-infusion technique and the traditional inulin clearance technique
      in rats with either one or two normal kidneys were highly correlated (r = 0.934;
      P < 0.001; N = 17). GFR was approximately 24% lower (P < 0.001) in rats with
      congenital unilateral hydronephrosis than in rats with a normal kidney. The GFR
      in rats with hydronephrosis infused with a receptor blocker for either
      angiotensin II or thromboxane A2 was greater than the GFR in hydronephrotic
      kidneys without blockade and was not significantly different (P > 0.05) from that
      in rats with normal kidneys. These results indicate that a constant inulin
      infusion technique without urine collections can be used to accurately measure
      GFR in congenitally hydronephrotic kidneys, rendering values free from possible
      residual pelvic volume artifact. In addition, these results also indicate that a
      significant 24% reduction in GFR occurs in congenital unilateral hydronephrosis
      and is mediated by angiotensin II and thromboxane A2 mechanisms.

PMID- 8490123
TI  - Prospects for reverse genetics in plants using recombination.

PMID- 8490124
TI  - Levels and location of expression of the Agrobacterium tumefaciens pTiA6 ipt gene
      promoter in transgenic tobacco.
AB  - The location of gene expression of the Agrobacterium tumefaciens ipt gene
      promoter in transgenic tobacco plants was examined using the beta-glucuronidase
      (GUS) reporter gene. Expression of GUS was detected in every organ and most cell
      types examined. The highest levels of GUS activity were found in roots. To
      further examine the transcriptional basis of this broad expression pattern,
      deletions in the 5' non-coding region of the gene were translationally fused to
      two promoterless reporter genes, encoding the enzymes chloramphenicol acetyl
      transferase (CAT) and beta-glucuronidase (GUS). Reporter enzyme assays revealed
      the existence of an upstream segment required for maximal promoter function, the
      5' end of which is between -442 and -408 of the Pipt ATG codon. This upstream
      segment is required for maximal levels of GUS expression in roots, but not in
      other organs, and a tobacco suspension-cultured cell line. The implications of
      broad ipt expression on the process of crown gall tumorigenesis are discussed.

PMID- 8490125
TI  - Sequence analysis of pre-ferredoxin-NADP(+)-reductase cDNA from Cyanophora
      paradoxa specifying a precursor for a nucleus-encoded cyanelle polypeptide.
AB  - A cDNA clone for pre-ferredoxin-NADP+ reductase (FNR) was obtained by screening a
      Cyanophora paradoxa expression library with antibodies specific for cyanelle FNR.
      The 1.4 kb transcript was derived from a single-copy gene. The precursor (41 kDa)
      and mature forms (34 kDa) of FNR were identified by western blotting of in vitro
      translation products and cyanelle extracts, respectively. The derived amino acid
      sequence of the mature form was corroborated by data from N-terminal protein
      sequencing and yielded identity scores from 58% to 62% upon comparison with
      cyanobacterial FNRs. Sequence conservation seemed to be even more pronounced in
      comparison with enzymes from higher plants, but using the neighbor joining method
      the C. paradoxa sequence was clearly positioned between the prokaryotic and
      eukaryotic sequences. The transit peptide of 65 or 66 amino acids appeared to be
      totally unrelated to those from spinach, pea and ice plant but showed overall
      characteristics of stroma-targeting peptides.

PMID- 8490126
TI  - cDNA cloning of ECP40, an embryogenic-cell protein in carrot, and its expression
      during somatic and zygotic embryogenesis.
AB  - A cDNA of 1.2 kb was isolated from a cDNA library of embryogenic cells of carrot
      (Daucus carota L.) by use of nucleotide sequences that encode two internal amino
      acid sequences of ECP40 (an embryogenic-cell protein with a relative molecular
      mass of 40,000). A genomic Southern blot using the cDNA as probe suggested that
      there are at least two genes for ECP40 in the carrot genome. The cDNA encoded an
      open reading frame of 306 amino acids, and the deduced amino-acid sequence was
      found to share two motifs, namely SSSSSSEDDGXGGRRKKGXXXKIKEKLXGG and
      EKKXXXDKIKXKLPG, with rab16 protein from rice and dehydrins from barley and
      maize. The level of expression of these proteins has been reported to be high
      during late embryogenesis and to be induced by a plant hormone, ABA. Accumulation
      of ECP40-specific transcripts started 18 days after flowering and continued until
      maturation of seeds, but the levels decreased within 24 h after imbibition. ECP40
      and its mRNAs were detected in the endosperm and zygotic embryos of mature seeds
      by immunohistochemistry and in situ hybridization. Exogenous application of 0.1
      mM ABA to carrot seedlings did not induce expression of the gene for ECP40, while
      drought treatment induced the accumulation of low levels of the mRNAs. During
      somatic embryogenesis, the mRNAs were found at high levels in embryogenic cells
      and at low levels in somatic embryos at the torpedo stage. Immunohistochemical
      analysis and in situ hybridization showed that both ECP40 and its transcripts
      were preferentially localized in the peripheral cells of the clusters of
      embryogenic cells. In somatic embryos, application of ABA resulted in increases
      in levels of mRNAs for ECP40 up to the levels in embryogenic cells, but no such
      increases were observed in ABA-treated embryogenic cells. The pattern of
      expression of the gene for ECP40 during somatic embryogenesis was basically the
      same as that of ECP31, another ABA-regulable embryogenic-cell protein of carrot,
      the presence of which has been correlated with the embryogenic competence of
      cultured cells (T. Kiyosue, S. Satoh, H. Kamada and H. Harada, Plant Physiol 95
      (1991) 1077-1083). The various results together imply that a group of ABA
      inducible genes is expressed in these embryogenic cells.

PMID- 8490127
TI  - Co-transcription pattern of an introgressed operon in the maize chloroplast
      genome comprising four ATP synthase subunit genes and the ribosomal rps2.
AB  - Several examples of the introduction of a gene from one gene complex into another
      (introgression) are found when chloroplast RP gene clusters are compared to those
      in Escherichia coli or cyanobacteria. Here we describe the transcript pattern of
      one such cluster from maize (Zea mays) that includes the genes for 4 subunits of
      the thylakoid ATP synthase (atpI, H, F, A) and the rps2 gene. Twelve transcript
      species covering the size range from 7,000 to 800 nt were identified in RNA
      isolated from dark-grown and greening maize seedlings, and several of them were
      characterized by reverse transcription analysis. A major species of 6,200 nt,
      with its 5' end at 181 nt upstream of the initiating ATG of rps2, contained the
      transcripts of all the 5 genes. Two further sets of transcripts having their 5'
      ends ca. 120 and 50 nt upstream of the initiation codons of the atpI and atpH
      genes were also identified. Thus, this plastid gene cluster in maize is
      functionally organized as an operon with additional regulatory features to allow
      for increased accumulation of mRNAs for the thylakoid components.

PMID- 8490128
TI  - PCR-dependent amplification and sequence characterization of partial cDNAs
      encoding myosin-like proteins in Anemia phyllitidis (L.) Sw. and Arabidopsis
      thaliana (L.) Heynh.
AB  - Partial cDNAs encoding for myosin-like proteins from Anemia phyllitidis and
      Arabidopsis thaliana have been isolated using PCR technology. The deduced amino
      acid sequences show an average similarity up to 62% with known myosin heavy chain
      genes. From northern blot analysis we were able to estimate that transcripts of
      ca. 6.1 kb size are expressed in A. phyllitidis.

PMID- 8490129
TI  - Molecular cloning and expression of a Eucalyptus gunnii cDNA clone encoding
      cinnamyl alcohol dehydrogenase.
AB  - Cinnamyl alcohol dehydrogenase (CAD) catalyses the reduction of hydroxycinnamyl
      aldehydes (sinapyl, paracoumaryl, coniferyl aldehydes) to the corresponding
      alcohols which are the direct monomeric precursors of lignins. Recently, we have
      purified from Eucalyptus gunnii two isoforms of CAD (CAD1 and CAD2), distinct in
      their biochemical and functional properties. In this paper, we report the cloning
      of a CAD cDNA (pEuCAD2) isolated by screening a lambda gt11 library generated
      from cell suspension culture of Eucalyptus gunnii, using a tobacco CAD cDNA as a
      probe. This full-length clone (1392 bp) encodes a protein of 356 amino acids
      which corresponds to the subunit molecular weight of the CAD2 isoform. Sequence
      analysis revealed that CAD2 is very well conserved among species (78% homology
      with CAD from tobacco, a herbaceous angiosperm, and 81% with the partial sequence
      from a gymnosperm, loblolly pine). The identity of this clone was unambiguously
      demonstrated (1) by comparison with peptide sequence data from purified CAD2 and
      (2) by functional expression of the recombinant enzyme in Escherichia coli.
      Recombinant CAD showed the same properties as the natural isoform CAD2, in terms
      of electrophoretic mobility, polypeptide structure, substrate specificity and
      antigenicity. The CAD2 transcript is equally abundant in stems and leaves and at
      the limit of detection in roots. At the tissue level the CAD2 gene is highly
      expressed in xylem and virtually undetectable in phloem.

PMID- 8490130
TI  - A pathogen-induced gene of barley encodes a HSP90 homologue showing striking
      similarity to vertebrate forms resident in the endoplasmic reticulum.
AB  - The full-length nucleotide sequence of a barley (Hordeum vulgare L.) leaf mRNA,
      found to increase rapidly in amount during infection attempts by the powdery
      mildew fungus (Erysiphe graminis DC. ex Merat), is reported. The mRNA encodes a
      polypeptide of 809 amino acid residues which, by sequence comparison, was
      identified as a member of the 90 kDa heat shock protein (HSP90) family. The
      encoded protein most resembles the endoplasmic reticulum (ER) resident HSP90
      protein, the 94 kDa glucose-regulated protein (GRP94) of vertebrates, as it
      possesses both the characteristic N-terminal domain including a signal peptide
      sequence and the C-terminal ER retention signal (Lys-Asp-Glu-Leu). A transcript
      cross-hybridizing at high stringency accumulated rapidly in leaves upon heat
      shock treatment. Genomic DNA blot analysis indicated the presence of a family of
      related genes in the barley genome.

PMID- 8490131
TI  - Enigmatic double-stranded RNA in Japonica rice.
AB  - We have found a linear, 16 kb, double-stranded RNA (dsRNA) in symptomless
      Japonica rice (Oryza sativa L.) that is not found in Indica rice (Oryza sativa
      L.). The dsRNA was detected in every tissue and at every developmental stage, and
      its copy number was approximately constant (about 20 copies/cell). Double
      stranded RNA was also detected in two strains of Oryza rufipogon (an ancestor of
      O. sativa). Hybridization experiments indicated that the dsRNA of O. rufipogon
      was homologous but not identical to that of O. sativa. The sequence of about 13.2
      kb of the dsRNA was determined and two open reading frames (ORFs) were found. The
      larger ORF (ORF B) was more than 12,351 nucleotides long and encoded more than
      4,117 amino acid residues.

PMID- 8490132
TI  - The reconstruction and expression of a Bacillus thuringiensis cryIIIA gene in
      protoplasts and potato plants.
AB  - A Bacillus thuringiensis (B.t.) cryIIIA delta-endotoxin gene was designed for
      optimal expression in plants. The modified cry gene has the codon usage pattern
      of an average dicot gene and does not contain AT-rich nucleotide sequences
      typical of native B.t. cry genes. We assembled the 1.8 kb cryIIIA gene in nine
      blocks of three oligonucleotide pairs. For two DNA blocks, the polymerase chain
      reaction was used to enrich for correctly ligated pairs. We compared modified
      cryIIIA gene with native gene expression by electroporation of dicot (carrot) and
      monocot (corn) protoplasts. CryIIIA-specific RNA and protein was detected in
      carrot and corn protoplasts only after electroporation with the rebuilt gene.
      Transgenic potato lines were generated containing the redesigned cryIIIA gene
      under the transcriptional control of a chimeric CaMV 35S/mannopine synthetase
      (Mac) promoter. Out of 63 transgenic potato lines, 58 controlled first-instar
      Colorado potato beetle (CPB) larvae in bioassays. Egg masses which produced ca.
      250,000 CPB larvae were placed on replicate clones of 56 transgenic potatoes. No
      CPB larvae developed past the second instar on any of these plants. Plants
      expressing high levels of delta-endotoxin were identified by their toxicity to
      more resistant third-instar larvae. We show there was good correlation between
      insect control and the levels of delta-endotoxin RNA and protein.

PMID- 8490133
TI  - Identification of protein-binding DNA sequences in an auxin-regulated gene of
      soybean.
AB  - The promoter region of a soybean auxin-responsive gene, GmAux28, was analyzed to
      identify protein-binding DNA sequences that may be involved in regulation of
      expression. Using DNase I footprinting and gel mobility shift assays, multiple
      regions of interaction, including eight major protein-binding sites, were
      observed in the GmAux28 gene. Two sequence motifs, TGACGACA and TCCACGTGTC,
      related to as-1/Hex and G-box elements, respectively, found in several plant
      promoters, were identified. Four distinct A/T-rich domains were identified; such
      A/T-rich domains appear to modulate, but not to specify, the expression of many
      genes. Two new sequence motifs, delta-1 (D1) and delta-4 (D4) were also
      identified. D1 and D4 share a very similar core sequence, TAGTxxCTGT and
      TAGTxCTGT, respectively. In gel mobility shift analyses, D1 and D4 elements
      exhibit a complex interaction of binding proteins. The GmAux22 promoter also
      contains D1-related elements which compete with the GmAux28 elements. Sequence
      comparisons have identified D1/D4-like sequences in several other auxin
      responsive genes suggesting the possible importance of D1/D4 and the respective
      binding proteins in the regulation of expression of these genes.

PMID- 8490134
TI  - RNA editing gives a new meaning to the genetic information in mitochondria and
      chloroplasts.
AB  - RNA editing in plant mitochondria and chloroplasts alters mRNA sequences to code
      for different proteins than the DNA. Most of these C-to-U transitions occur in
      open reading frames, but a few are observed in intron sequences. Influences of
      the nuclear genome on editing patterns suggest that cytoplasmic factors
      participate in this process.

PMID- 8490135
TI  - Structure and expression of the S locus-related genes of maize.
AB  - The extracellular of the putative receptor-like protein kinase, ZmPK1, is related
      to the self-incompatibility locus (S-locus) genes of Brassica. We have isolated
      and characterized a genomic DNA clone of ZmPK1 and three additional genes from
      maize that are highly related to ZmPK1. These three S-locus related genes do not
      appear to have the protein kinase catalytic domain that is found in ZmPK1. One or
      more of these genes are expressed specifically in the silks. This initial
      description of S-locus related genes in monocotyledonous plants suggests that the
      S-locus domain may be involved in several different cellular functions in a wide
      variety of plants.

PMID- 8490136
TI  - Kinetic induction of oat shoot pulvinus invertase mRNA by gravistimulation and
      partial cDNA cloning by the polymerase chain reaction.
AB  - An asymmetric (top vs. bottom halves of pulvini) induction of invertase mRNA by
      gravistimulation was analyzed in oat shoot pulvini. Total RNA and poly(A)+ RNA,
      isolated from oat pulvini, and two oligonucleotide primers, corresponding to two
      conserved amino acid sequences (NDPNG and WECPD) found in invertase from other
      species, were used for the polymerase chain reaction (PCR). A partial length cDNA
      (550 bp) was obtained and characterized. A 62% nucleotide sequence homology and
      58% deduced amino acid sequence homology, as compared to beta-fructosidase of
      carrot cell wall, was found. Northern blot analysis showed that there was an
      obviously transient induction of invertase mRNA by gravistimulation in the oat
      pulvinus system. The mRNA was rapidly induced to a maximum level at 1 h after
      gravistimulation treatment and gradually decreased afterwards. The mRNA level in
      the bottom half of the oat pulvinus was significantly higher than that in the top
      half of the pulvinus tissue. The kinetic induction of invertase mRNA was
      consistent with the transient accumulation of invertase activity during the
      graviresponse of the pulvinus. This indicates that the expression of the
      invertase gene(s) could be regulated by gravistimulation at the transcriptional
      level. Southern blot analysis showed that there were two to three genomic DNA
      fragments which hybridized with the partial-length invertase cDNA.

PMID- 8490137
TI  - Stabilisation of a yeast artificial chromosome containing plant DNA using a
      recombination-deficient host.
AB  - The large genomes of many plant species contain numerous dispersed repeat
      sequences. The problem of large-scale structural instability due to the presence
      of such repeats in yeast artificial chromosome (YAC) clones was assessed. The
      feasibility of stabilising plant sequences prone to rearrangement in YACs was
      demonstrated using a host yeast strain deficient in recombination.

PMID- 8490138
TI  - In vivo suppression of phytochrome aggregation by the GroE chaperonins in
      Escherichia coli.
AB  - When expressed in Escherichia coli, a truncated form of phytochrome (oat PHYA AP3
      residues 464-1129) self associates to form a series of products ranging in size
      from monomers to aggregates of greater than 20 subunits. When these same
      phytochrome sequences are coexpressed with the chaperonins GroEL and GroES, the
      truncated phytochrome migrates as a native-like dimer in size exclusion
      chromatography and no higher-order aggregates were detected. GroEL and GroES
      inhibition of phytochrome aggregation in E. coli presumably occurs via the
      suppression of folding pathways leading to incorrectly folded phytochrome.

PMID- 8490139
TI  - Sequence of a novel plant ras-related cDNA from Pisum sativum.
AB  - A clone isolated from a purple podded pea (Pisum sativum L.) cDNA library was
      shown to contain the complete coding sequence of a polypeptide with considerable
      homology to various members of the ras superfamily. The ras superfamily are a
      group of monomeric GTP-binding proteins of 21-25 kDa found in eukaryotic cells.
      Conserved sequences in the isolated clone include the GTP-binding site, GDP/GTP
      hydrolysis domain and C-terminal Cys residues involved in membrane attachment.
      Comparisons of the predicted amino acid sequence with those of other ras proteins
      show significantly higher homologies (ca. 70%) to two mammalian gene products,
      those of the BRL-ras oncogene, and the canine rab7 gene, than to any of the plant
      ras gene products so far identified (< 40% homology). The high percentage of
      amino acid identity suggests that this cDNA may be the product of a gene,
      designated Psa-rab, which is the plant counterpart of rab7. Rab/ypt proteins are
      a subfamily of the ras superfamily thought to be involved in intracellular
      transport from the endoplasmic reticulum to the Golgi apparatus and in vesicular
      transport. Northern blot hybridisation analysis of total RNA from green and
      purple podded pea revealed a mRNA species of approximately the same size as the
      isolated cDNAs.

PMID- 8490140
TI  - Nitrite reductase gene from Synechococcus sp. PCC 7942: homology between
      cyanobacterial and higher-plant nitrite reductases.
AB  - The gene encoding nitrite reductase (nir) from the cyanobacterium Synechococcus
      sp. PCC 7942 has been identified and sequenced. This gene comprises 1536
      nucleotides and would encode a polypeptide of 56,506 Da that shows similarity to
      nitrite reductase from higher plants and to the sulfite reductase hemoprotein
      from enteric bacteria. Identities found at positions corresponding to those amino
      acids which in the above-mentioned proteins hold the Fe4S4-siroheme active center
      suggest that nitrite reductase from Synechococcus bears an active site much alike
      that present in those reductases. The fact that the Synechococcus and higher
      plant nitrite reductases are homologous proteins gives support to the
      endosymbiont theory for the origin of chloroplasts.

PMID- 8490141
TI  - Identification and characterization of a second plasma membrane H(+)-ATPase gene
      subfamily in Nicotiana plumbaginifolia.
AB  - A cDNA clone was isolated for a fourth pma gene encoding a putative plasma
      membrane H(+)-ATPase of Nicotiana plumbaginifolia. The sequence of the predicted
      952 residue PMA4 polypeptide was compared with those of other known plant PMAs,
      revealing a higher identity with the Arabidopsis thaliana proteins (86-89%) than
      with the other three N. plumbaginifolia PMA proteins (80-82%). This supports the
      view that there are two pma subfamilies which probably arose from a gene
      duplication predating the separation of the Dilleniidae and Asteridae plant
      subclasses. Measured pma4 transcript levels indicate that pma4 is similarly
      expressed in root, stem, leaf, and flower tissues, contrary to the pmal-3
      subfamily whose members displayed differential expression according to the organ.

PMID- 8490142
TI  - Proteins encoded by an auxin-regulated gene family of tobacco share limited but
      significant homology with glutathione S-transferases and one member indeed shows
      in vitro GST activity.
AB  - A number of cDNAs corresponding to auxin-regulated mRNAs have been isolated from
      tobacco and found to be encoded by a multigene family consisting of three
      subfamilies. Homologous proteins have been isolated independently from soybean
      and potato. Here we report that the encoded proteins show a limited but
      significant homology to both plant and animal glutathione S-transferases (GST, EC
      2.5.1.18). For the protein NT103, encoded by a member of the Nt103 subfamily, we
      demonstrate an in vitro GST activity. This is the first time a function is
      attributed to a member of this group of auxin-induced proteins or any of its
      homologues. The implications of this finding and the possible relationships
      between auxins and GSTs are discussed.

PMID- 8490143
TI  - cis-acting regulatory regions of the soybean seed storage 11S globulin gene and
      their interactions with seed embryo factors.
AB  - A 2.2 kb fragment containing the 5'-flanking region of the soybean glycinin A2B1a
      gene and its successive deletions with a shorter 5'-flanking sequence were fused,
      in frame, to the beta-glucuronidase (GUS) reporter gene. The resultant fusions
      were introduced into tobacco plants via Agrobacterium tumefaciens. Assays of the
      GUS activity in seeds of transgenic tobacco showed that the upstream region, -657
      to -327 (relative to the transcription initiation site [+1]), of the glycinin
      gene is required for optimal expression of the transformed gene. Interactions
      between embryo nuclear factors and DNA fragments covering the downstream region
      of -326, in which are included the TATA box and legumin boxes, were not apparent.
      The embryo factors capable of binding specifically to three subregions, -653 to 
      527, -526 to -422, and -427 to -321, of the upstream regulatory region were
      detected. Such factors appeared to be organ-specific and could be found solely in
      developing seeds at the early middle stage of embryogenesis (around 24 days after
      flowering). Evidence obtained by characterizing the nature of the binding
      proteins and by gel mobility shift assays established that the same factor does
      interact with a consensus motif 5'-ATA/TATTTCN-/CTA-3' which occurs four times in
      the cis-acting regulatory region between -657 and -327. Moreover, this conserved
      motif could also be found in the 5' regulatory region of another glycinin A1aB1b
      gene. Thus it is likely that the observed interaction between the nuclear factor
      and the conserved motifs would lead to activation of transcription from the
      glycinin genes in maturing soybean seeds.

PMID- 8490145
TI  - [Outpatient peripheral angioplasty--safety and limits].

PMID- 8490144
TI  - Tobacco proteinase inhibitor I genes are locally, but not systemically induced by
      stress.
AB  - A cDNA library of tobacco mosaic virus (TMV)-infected tobacco was screened with
      polymerase chain reaction products obtained using a degenerate primer
      corresponding to proteinase inhibitor I (PI-I) of tomato and potato. The
      resulting clones encoded two highly similar, putative tobacco PI-I proteins,
      indicating that both genes identified in tobacco are probably expressed. The
      tobacco PI-I's were approximately 50% identical to wound-inducible potato and
      tomato PI-I and 80% identical to an ethylene-regulated tomato PI-I. Northern blot
      analyses indicated that healthy tobacco leaf contains only minor amounts of PI-I
      mRNA, and that the inhibitor genes are induced by TMV infection, salicylate
      treatment, ethephon spraying, UV light irradiation and wounding. The results
      indicate that the tobacco PI-I genes are coordinately expressed with the genes
      for the basic pathogenesis-related proteins. Contrary to PI-I genes of tomato and
      potato, wound induction of the tobacco genes occurs only locally; the upper,
      unwounded leaves do not show any wound-induced PI-I gene expression.

PMID- 8490146
TI  - [Spiral CT in aortic aneurysms. 2D and 3D reconstructions and CT angiography].
AB  - Spiral CT was performed in 8 normals and 40 patients with alterations of the
      large thoracic and abdominal vessels. It proved to be the ideal basis for 2D and
      3D reconstructions. In 2D reconstruction the topographic aspects of aortic
      aneurysms were displayed better compared to the axial scans. In 3D reconstruction
      the segmentation of small vessels, and vessels running parallel to the scan plane
      showed problems. Stenoses were displayed unsatisfactory. In patients with aortic
      aneurysms 3D reconstruction showed well the location and dimension of the
      aneurysm as well as its position to branching arteries and the intraarterial
      thrombus. In case of dissecting aneurysms the true and the false lumen could
      clearly be distinguished. Colour-coded 3D reconstruction proved to be valuable to
      illustrate topographic information that could be detected only with difficulty on
      examining the original axial scan.

PMID- 8490147
TI  - [A comparison of color duplex sonography with selective penile DSA in assessing
      erectile dysfunction].
AB  - 42 patients with suspected vasculogenic impotence were examined via colour duplex
      sonography. Penile vascular anatomy was mapped and peak velocity was determined
      in both cavernous arteries before and after intracorporeal injection of 15 mg
      papaverine and 0.5 mg regitine. In all patients the results could be compared
      with selective penile pharmacoangiography as the gold standard. In 34/42 patients
      colour Duplex sonography and angiography led to an identical evaluation of penile
      blood supply. 4 patients were classified false-negative and 4 patients false
      positive. Sensitivity and specificity were calculated for each side separately.
      Sensitivity was 82.4% for left side angiogram and 83.3% for right side angiogram.
      Specificity was 88% for left side angiogram and 87.5% for right side angiogram.
      Peak flow velocity was significantly diminished in pathological angiograms.

PMID- 8490148
TI  - [CT arterioportography in the spiral technic for the demonstration of liver
      metastases].
AB  - CT arterioportography using indirect portal venous application of contrast media
      is the most sensitive preoperative diagnostic technique for detection of liver
      metastases. Spiral CT allows continuous examination of the liver (no gap) during
      a single breathhold. Due to short measurement times an optimized vessel and
      tissue contrast can be achieved during the portal venous phase. Compared with
      intraoperative ultrasonography CTAP using spiral CT offers similar sensitivity
      (96%) in the detection of liver metastases and thus emerges as an important
      technique for diagnosis and follow-up of liver metastases.

PMID- 8490149
TI  - [The MRT criteria for the differentiation of "pseudotumorous" lesions from bone
      sarcomas of the extremities].
AB  - The MRT scans of 57 patients with Ewing or osteosarcomas and 34 patients with
      haematogenous osteomyelitis or periostitis/stress fractures were examined in
      order to determine whether a distinction between benign or malignant lesions is
      possible. Four criteria were evaluated: the margin of the bone marrow component;
      intensity and homogeneity of the T1 weighted signal in the bone marrow; presence
      of an extraosseous structured soft tissue mass and/or soft tissue edema. It was
      found that central osteosarcomas and Ewing's sarcomas reduced signal intensity of
      the marrow to become muscle-isointense with a well-defined margin. In acute
      haematogenous osteomyelitis and periostitis/stress fracture the marrow lesion was
      not sharply demarcated. In contrast to patients with bone sarcomas, only one case
      of osteomyelitis showed an extraosseous structured soft tissue mass. On the basis
      of these findings we believe that acute haematogenous osteomyelitis can be
      distinguished with high degree of accuracy from Ewing's sarcoma and central
      osteosarcomas.

PMID- 8490150
TI  - [The MRT of the breast with 2D-spin-echo and gradient-echo sequences in
      diagnostically problematic cases].
AB  - One or both breasts of 296 patients with equivocal clinical or mammographic
      findings were examined with MRI. T1-weighted spin-echo (SE) and gradient-echo
      (FFE) sequences were acquired before and after i.v. application of Gadolinium
      DTPA. 50 lesions with enhancement after Gd-DTPA were biopsied--26 carcinomas, 17
      proliferating mastopathic tissues, 5 fibroadenomas and 1 abscess were found.
      Contrast enhanced MRI with 2D-SE and FFE sequences is an effective technique for
      evaluating suspicious breast lesions with high diagnostic accuracy.

PMID- 8490151
TI  - [The value of computed tomography in the diagnosis of the local and lymph node
      recurrences of head and neck tumors].
AB  - 544 CT studies of 231 patients were evaluated retrospectively to assess the role
      of CT in posttherapeutic monitoring of patients with head and neck tumours. CT
      (80%) was inferior to clinical evaluation (87%) in diagnosing recurrent
      malignancy due to a lack of specificity (76 vs. 92%). With CT small recurrencies
      were missed. Occasionally evaluation of the oral cavity was impaired by metal
      artifacts (dental fillings). However with larger recurrent tumours, CT offered
      important additional information regarding extent, infiltration of deeper
      compartments and bony destruction in 51% of the cases. CT (95%) was superior to
      clinical evaluation (80%) in diagnosing recurrent lymph node metastases. A
      baseline CT study at about 6-8 weeks after the end of therapy is of great
      importance for follow-up studies.

PMID- 8490152
TI  - [The value of magnetic resonance tomography and computed tomography in the tumor
      staging of laryngeal and hypopharyngeal carcinomas].
AB  - 43 patients with malignant tumours of the larynx or hypopharynx were examined by
      MRT and CT to compare their accuracy for T-staging. There was histological
      confirmation in all cases. Histological studies showed an accuracy in T-staging
      of 90% for MRT and 82% for CT. Differentiation between stages T2/T3 and T3/T4 is
      possible in most cases by either method. A source of error is the difficulty of
      differentiating oedema or inflammatory changes from tumour. This led to
      occasional overinterpretation of the T4 stage. Demonstration of cartilage
      involvement was easier with MRT (88%) than with CT (84%). The use of Gd-DTPA with
      T1 weighted and proton weighted sequences allows earlier diagnosis of cartilage
      invasion. Early cartilage involvement may be missed by CT when it is seen on MRT.
      In addition, the ability to produce coronal and sagittal images by MRT makes this
      superior to CT in judging tumour extension.

PMID- 8490153
TI  - [Magnetic resonance tomography with fast spin-echo sequences--the results in the
      ENT area].
AB  - The use of T2-weighted spin-echo sequences is mandatory for identifying tumours
      in the ENT region and for differential diagnosis of pathological findings. A
      highly promising alternative to time-consuming conventional SE sequences is now
      available in the fast-spin-echo sequences (FSE). FSE was compared with the
      conventional SE (CSE) basing on 100 assessments of examinations of 20 patients.
      RESULTS: Conventional SE = TR/TE = 1800/90 ms with one average (NEX), FSE = TR/TE
      = 3200/120 ms with 4 averages (NEX). Measurement time CSE 6:59 min, FSE 3:12 min.
      Analysis was performed in analogy to on ROC analysis by 5 radiologists as a blind
      study. The anatomic differentiation and contrast performance were compared as
      well as the differentiation and definition of lesion and lymphatic node and a
      subjective overall assessment. Differentiation of pathological findings was the
      same with both sequences. FSE was superior to CSE in the visualisation of normal
      tissue, lymph nodes and also in the subjective overall assessment. The following
      criteria were employed in the subjective overall valuation: sum total of
      impressions gathered from contrast behaviour or performance, susceptibility to
      artifacts, and signal-to-noise ratio. Due to the definitely improved parameters
      of image quality and the markedly reduced scanning time--which is reduced to 50%-
      FSE will replace the conventional spin-echo sequence in routine diagnostics.

PMID- 8490154
TI  - [The initial clinical experiences with a dynamic FLASH-2D sequence in tumors of
      the head and neck area].
AB  - 28 patients with clinically confirmed head and neck tumours were examined by MRI.
      The results of a dynamic FLASH-2D sequence and a Gd-DTPA enhanced T1-weighted
      sequence were analysed and retrospectively compared with surgery and pathological
      findings. The extent of tumours was clearly defined by the dynamic technique in
      21 cases. Furthermore, it was found to be superior for the purpose of
      demonstrating contrast behaviour and concerning T-classification. Here the
      dynamic FLASH-2D sequence proved to be an important supplement for preoperative
      diagnosis.

PMID- 8490155
TI  - [Liver regeneration in man. A prospective CT-volumetric study].
AB  - To get reliable data on human liver regeneration we performed CT volumetry in 25
      patients who underwent partial hepatectomy for benign and malignant liver tumours
      preoperatively and at least one year postoperatively in regular intervals in a
      prospective study. All patients received standardised CT-scans preoperatively and
      two weeks, 3, 6 and 12 months post-operatively. The resected specimen size was
      determined by water displacement. We were able to demonstrate human liver
      regeneration. Contrary to the well-known animal model the amount of regeneration
      in humans is less and regeneration takes a longer time. We did not find any
      statistical correlation to extent of resection, age of patients and other
      parameters. On the contrary, the human liver seems to regenerate until a certain
      relationship of liver volume and body-surface area is reached: 0.8 l/m2.

PMID- 8490156
TI  - [Measurement data of the lateral lumbosacral region in healthy subjects during
      the growth period].
AB  - The following measurement data were obtained to characterise the healthy
      lumbosacral profile, via lateral x-rays taken of 90 female and 90 male patients
      between 8 and 17 years of age: Degree of slip 0%, slip angle -21.3 degrees,
      sacral inclination 45.5 degrees, posterior lumbosacral angle 140.5 degrees. These
      measurement data are independent of age and sex. If an adolescent suffers from
      lumbosacral spondylolisthesis, they will quantify the process of slip that has
      taken place, more accurately than the conventional method after Meyerding. If the
      shape of the sacral vertebra is considered at the same time, these parameters
      will also enable to assess the risk of progression of spondylolisthesis to a
      degree that is satisfactorily accurate in clinical practice.

PMID- 8490157
TI  - [The initial results of lumbar dual-energy x-ray absorptiometry (DEXA) compared
      to double-energy quantitative computed tomography (DE-QCT)].
AB  - Bone density measurements were performed on 51 patients with suspected
      osteoporosis. We used DE-QCT and DEXA. The methods were compared with regard to
      deviation from normal. In 29 of the 51 patients there was more than half standard
      deviation and in 12 of the 51 cases there was more than a full standard
      deviation.

PMID- 8490158
TI  - [Osteoporosis diagnosis by broad-band ultrasound attenuation (BUA): its
      correlation with established measurement procedures of bone densitometry].
AB  - Broadband ultrasound attenuation (BUA) measurements of the os calcis of 54 women
      were correlated to single-energy x-ray absorptiometry (SXA) of the os calcis,
      dual-energy x-ray absorptiometry (DXA) of the lumbar spine, age and weight. The
      reproducibility of the BUA measurements was 2.1%. BUA was significantly
      correlated with SXA (r = 0.7), DXA (r = 0.5) and age (r = 0.6). BUA values ranged
      from 42 to 117 dB/MHz. Our results confirm BUA's potential as a simple,
      inexpensive, radiation free, and precise alternative technique for osteoporosis
      diagnostics of the os calcis. However, the correlation observed with bone mineral
      density of the spine is too weak to use BUA for predicting the lumbar density
      status. The ability of BUA to predict the risk of osteoporotic fractures has to
      be determined directly by assessing the association of BUA and the prevalence or
      preferably the incidence of fractures.

PMID- 8490159
TI  - [The determination of the surface and organ doses in the AMBER system. Advanced
      Multiple Beam Equalization Radiography].
AB  - Surface and organ doses were determined by means of thermoluminescence dosimetry
      with the Alderson-Rando phantom and the patient, for the AMBER thoracic imaging
      system, sensitivity class 400, and the conventional grid screen stand,
      sensitivity class 200. The dose on entering the body, which varied according to
      object-dependent modulation of x-ray intensity, was 140 microGy for the
      mediastinum and 96 microGy for the lung in p.a. AMBER takes, and hence was
      comparable with the entrance dose of 132 microGy with the conventional grid
      screen stand. In lateral takes the entrance doses were lower with the AMBER
      system (302 microGy) than with conventional takes (593 microGy). Exposure of the
      gonads at the AMBER system for p.a. thoracic takes was lower than at the screen
      grid stand in females (4-6 microGy). More unfavourable values were measured for
      the gonad exposure in males (2-0.8 micrograms).

PMID- 8490160
TI  - [Percutaneous sonographic gastrostomy].

PMID- 8490161
TI  - [An atraumatic Sprotte needle for double-contrast CT arthrography of the shoulder
      joint].

PMID- 8490162
TI  - [A giant, predominantly cystic local recurrence of prostatic carcinoma. Its
      imaging in sonography and computed tomography].

PMID- 8490163
TI  - Autoantibodies in chronic lymphocytic leukemia and related systemic autoimmune
      diseases.

PMID- 8490164
TI  - Expression of the ABL-BCR fusion gene in Philadelphia-positive acute
      lymphoblastic leukemia.
AB  - We have previously shown that the chimeric gene ABL-BCR, formed on the derivative
      chromosome 9q+ as a result of the t(9;22) translocation, is transcriptionally
      active in 65% of chronic myeloid leukemia patients. We have now used the same
      technique, reverse transcription/polymerase chain reaction amplification of ABL
      BCR transcripts, to study nine patients with Philadelphia (Ph) chromosome
      positive acute lymphoblastic leukemia (ALL); seven expressed the P190 and two the
      P210 type of BCR-ABL fusion protein. All seven patients with P190 had ABL-BCR
      transcripts containing a junction between ABL exon Ib and BCR exon 2 (Ib-e2); in
      two cases, ABL-BCR transcripts with the Ia-e2 junction type were also present. Of
      the two P210 ALL patients, one had a Ib-b4 ABL-BCR transcript and the other
      showed no detectable ABL-BCR expression. Although the BCR-ABL gene is probably
      fundamental in the pathogenesis of the Ph+ leukemias, differential expression of
      the ABL-BCR gene could contribute to the biologic heterogeneity of the disease.

PMID- 8490165
TI  - Activated platelets induce endothelial secretion of interleukin-8 in vitro via an
      interleukin-1-mediated event.
AB  - Migration of neutrophils through endothelial cells (EC) and induction of cytokine
      secretion are two well-documented events during the inflammatory reaction. The
      inflammatory, chemotactic cytokine interleukin-8 (IL-8) is secreted by EC in
      response to IL-1 stimulation. In this study, we show that platelets activated
      with either adenosine-5'-diphosphate or epinephrine induce IL-8 secretion by EC.
      This stimulatory activity was found to be associated with sedimented platelets
      after activation. Blockade of IL-1 receptors on EC with IL-1 receptor antagonist
      (IL-1Ra) decreased the stimulatory effect of whole activated platelet
      preparations by 59% (P < .05). Similarly, IL-1Ra pretreatment of EC reduced the
      stimulatory effect of sedimented activated platelets by 60% (P < .01). In
      addition, we treated human blood donors with 750 mg of oral aspirin, and
      evaluated the stimulatory effect of epinephrine-activated platelets on IL-8
      secretion by EC. IL-8 synthesis after aspirin ingestion was inhibited by 90% (P <
      .01) as compared with the preaspirin stimulation. These observations show that
      activated platelets induce IL-8 secretion via membrane-associated IL-1 activity,
      and provide a novel relationship between coagulation and inflammation that could
      be relevant to several diseases.

PMID- 8490166
TI  - A randomized controlled phase III trial of recombinant human granulocyte colony
      stimulating factor (filgrastim) for treatment of severe chronic neutropenia.
AB  - Patients with idiopathic, cyclic, and congenital neutropenia have recurrent
      severe bacterial infections. One hundred twenty-three patients with recurrent
      infections and severe chronic neutropenia (absolute neutrophil count < 0.5 x
      10(9)/L) due to these diseases were enrolled in this multicenter phase III trial.
      They were randomized to either immediately beginning recombinant human
      granulocyte colony-stimulating factor (filgrastim) (3.45 to 11.50
      micrograms/kg/d, subcutaneously) or entering a 4-month observation period
      followed by filgrastim administration. Blood neutrophil counts, bone marrow (BM)
      cell histology, and incidence and duration of infection-related events were
      monitored. Of the 123 patients enrolled, 120 received filgrastim. On therapy, 108
      patients had a median absolute neutrophil count of > or = 1.5 x 10(9)/L.
      Examination of BM aspirates showed increased proportions of maturing neutrophils.
      Infection-related events were significantly decreased (P < .05) with
      approximately 50% reduction in the incidence and duration of infection-related
      events and almost 70% reduction in duration of antibiotic use. Asymptomatic
      splenic enlargement occurred frequently; adverse events frequently reported were
      bone pain, headache, and rash, which were generally mild and easily manageable.
      These data indicate that treatment of patients with severe chronic neutropenia
      with filgrastim results in a stimulation of BM production and maturation of
      neutrophils, an increase in circulating neutrophils, and a reduction in infection
      related events.

PMID- 8490167
TI  - Effect of tunicamycin treatment on ligand binding to the erythropoietin receptor:
      conversion from two classes of binding sites to a single class.
AB  - Scatchard analyses of erythropoietin (EPO) binding to its receptor (EPO-R) have
      shown that some erythroid cells display a biphasic nature of the ligand
      saturation curve, indicating the presence of two classes of binding sites with
      different affinities. The biochemical basis accounting for this observation is
      unknown. We found that the culture of a human erythroleukemia cell line with
      tunicamycin, an inhibitor of N-glycosylation, converted the biphasic Scatchard
      plot to a single phase with high-affinity sites. Scatchard plots of baby hamster
      kidney (BHK) cells that had been engineered to express cloned mouse EPO-R were
      also biphasic and the plots of cells cultured with tunicamycin became a single
      phase with high-affinity sites. Mouse EPO-R is glycosylated at one asparagine
      residue in the extracellular region. The mutant EPO-R, in which asparagine
      residue responsible for N-glycosylation was replaced with glutamine residue, was
      expressed on BHK cells. Unexpectedly, mutant EPO-R was similar in ligand binding
      to wild-type EPO-R. BHK cells that expressed mutant EPO-R showed biphasic
      Scatchard plots that were converted to single-phase plots with only high-affinity
      sites by tunicamycin treatment. These results indicate that the N-linked sugar of
      EPO-R is not involved in the manifestation of two classes of binding sites, and
      that there is a yet unidentified glycoprotein crucial for the ligand-saturation
      characteristics of EPO-R.

PMID- 8490168
TI  - Mechanism of differential inhibition of factor-dependent cell proliferation by
      transforming growth factor-beta 1: selective uncoupling of FMS from MYC.
AB  - Transforming growth factor-beta 1 (TGF-beta 1) selectively modulates
      hematopoietic cell proliferation. The proliferation of FDC-P1 clone MAC-11, a
      factor-dependent murine myeloid progenitor cell line, was inhibited
      differentially by TGF-beta 1: strongly in macrophage colony-stimulating factor (M
      CSF), mildly in interleukin-3, and not at all in granulocyte-macrophage-CSF (GM
      CSF). Flow cytometry and Western blots showed an unexpected increase in
      expression of FMS, the receptor for M-CSF, in response to TGF-beta 1. Metabolic
      labeling with 35S-methionine showed that synthesis of FMS protein accelerated in
      response to TGF-beta 1, whereas its degradation was unaffected. Northern analyses
      showed a rapid increase in c-fms RNA after the addition of TGF-beta 1. TGF-beta 1
      did not affect kinase activity, cellular phosphotyrosine response, or
      internalization of FMS. However, TGF-beta 1 inhibited the induction by M-CSF of c
      myc RNA analyzed on Northern blots and protein detected by radioimmuno
      precipitation. TGF-beta 1 did not affect induction of c-myc expression by GM-CSF
      or induction of c-fos or c-jun by M-CSF. Therefore, FMS and the GM-CSF receptor
      induce c-myc via signal transduction pathways that differ in that only the former
      is inhibited by TGF-beta 1. This inhibition may account for the selective growth
      regulation by TGF-beta 1.

PMID- 8490169
TI  - Annexin V as a probe of aminophospholipid exposure and platelet membrane
      vesiculation: a flow cytometry study showing a role for free sulfhydryl groups.
AB  - Annexin V, a protein with a high affinity and a strict specificity for
      aminophospholipids at physiologic calcium concentrations, was used to probe
      platelet activation and the development of procoagulant activity. Platelet
      secretion was studied in parallel using VH10, a murine monoclonal antibody
      specific for GMP-140, an alpha-granule membrane glycoprotein. Both proteins were
      labeled with fluorescein isothiocyanate and platelet activation was assessed by
      flow cytometry. Microparticles, which are shed from the platelet surface and also
      support procoagulant activity, were distinguished from platelets according to
      their associated light scattering signal. The relative ability of different
      inducers to trigger exposure of the procoagulant surface and microparticle
      formation was: ionophore A23187 > thrombin plus collagen > collagen > thrombin.
      The density of aminophospholipid on microparticles was higher than on remnant
      platelets. Platelet activation by these agonists was accompanied by GMP-140
      exposure, both on platelets and microparticles. Here, thrombin was the most
      efficient agonist. The mechanisms responsible for the above processes were
      investigated using E-64-d, a specific membrane-permeable inhibitor of Ca(2+)
      activated protease (calpain); tetracaine, an activator of calpain; and N
      ethylmaleimide and diamide, two sulfhydryl-reactive agents. These agents were
      added to platelets alone or before stimulation by agonists. Calpain activity was
      assessed by the hydrolysis of cytoskeletal proteins as determined by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. Results showed that calpain
      activity is not essential for aminophospholipid translocation or for secretion.
      In contrast, although sulfhydryl-reactive agents alone can trigger procoagulant
      activity, they inhibit microvesicle formation and platelet secretion induced by
      the above agonists, suggesting that different mechanisms account for these
      phenomena. The use of annexin V in flow cytometry is a rapid method to assess
      procoagulant activity in platelets and the loss of phospholipid asymmetry in cell
      membranes.

PMID- 8490170
TI  - Binding of factor VIIa to tissue factor permits rapid antithrombin III/heparin
      inhibition of factor VIIa.
AB  - Because free factor VIIa is inactivated only very slowly by a plasma
      concentration of antithrombin III (AT III) even in the presence of heparin, it
      has been assumed that AT III plays no significant role in regulating the
      initiation of tissue factor-dependent blood coagulation. However, in the present
      study, we present evidence that factor VIIa bound to tissue factor, unlike free
      factor VIIa, is readily inactivated by AT III in the presence of heparin. In a
      reaction mixture containing calcium ions and approximately equimolar
      concentrations of relipidated tissue factor (8.9 nmol/L) and factor VIIa (10
      nmol/L), AT III (100 micrograms/mL) plus heparin (1 U/mL) inhibited 50% of the
      factor VIIa coagulant activity of the reaction mixture within 5 minutes. AT
      III/heparin was also shown to inhibit the catalytic activity towards factor X of
      factor VIIa/tissue factor complexes formed on monolayers of an ovarian carcinoma
      cell line (OC-2008) that constitutively expresses surface membrane tissue factor.
      AT III, even in the absence of exogenously added heparin, substantially inhibited
      the functional activity of factor VIIa/cell surface tissue factor complexes on
      intact monolayers. AT III alone and AT III/heparin, to a greater extent, also
      inhibited factor VIIa on "nonfunctional" factor VIIa/tissue factor complexes on
      intact monolayers, with resultant inhibition of their expression of factor
      VIIa/tissue factor catalytic activity toward factor X after cell lysis. The
      potential physiologic significance of these findings is discussed.

PMID- 8490171
TI  - Inherited abnormalities in platelet organelles and platelet formation and
      associated altered expression of low molecular weight guanosine triphosphate
      binding proteins in the mouse pigment mutant gunmetal.
AB  - Gunmetal (gm/gm) is a recessively inherited mouse pigment dilution mutant that
      has high mortality and poor reproductive rates. In these studies, several
      hematologic defects were found associated with the mutation, including prolonged
      bleeding times, together with thrombocytopenia and increased platelet size. A
      unique feature is the presence of simultaneous abnormalities in two platelet
      organelles, dense granules and alpha-granules. The dense granule component
      serotonin is present at about half the normal concentration, as are visible dense
      granules. Three alpha-granule components (fibrinogen, platelet factor 4, and von
      Willebrand factor) are also significantly reduced. Thus, in several respects the
      gunmetal mutant resembles the human gray platelet syndrome. A novel abnormality
      in expression of low molecular weight guanosine triphosphate (GTP)-binding
      proteins occurs in platelets of gunmetal. In Western blot assays, two additional
      GTP-binding proteins of 28.5 and 25 Kd were detected. The abnormal expression of
      GTP-binding proteins is, like the hematologic defects, genetically recessive and
      is tissue specific. Liver, kidney, brain, spleen, macrophages, and neutrophils
      have normal GTP-binding protein expression. The additional GTP-binding proteins
      are soluble. The data indicate that platelet formation and platelet organelle
      biogenesis are under common genetic control and that abnormal regulation of GTP
      binding proteins may affect one or both processes.

PMID- 8490172
TI  - Characterization of ultrasound-potentiated fibrinolysis in vitro.
AB  - We have characterized the effects of ultrasound on fibrinolysis in vitro to
      investigate the mechanism of ultrasonic potentiation of fibrinolysis and to
      identify potentially useful ultrasound parameters for therapeutic application.
      Radiolabeled clots in thin walled tubes were exposed to ultrasound fields in a
      water bath at 37 degrees C, and lysis was measured by solubilization of
      radiolabel. Ultrasound accelerated lysis of plasma, whole blood, and purified
      fibrin clots mediated by recombinant tissue-type plasminogen activator (rt-PA),
      urokinase, or streptokinase, but ultrasound by itself caused no clot
      solubilization. The degree of ultrasonic potentiation was dependent on
      plasminogen activator concentration, increasing from 2.2-fold at a streptokinase
      concentration of 75 U/mL to 5.5-fold at 250 U/mL in a 1 MHz ultrasound field at 4
      W/cm2. Ultrasound exposure resulted in heating due to absorption by the plastic
      tube, but the temperature increase was insufficient to account for the increase
      in clot lysis rate, indicating that the primary effect was nonthermal. Ultrasound
      did not accelerate hydrolysis of a peptide substrate by rt-PA and did not alter
      the rate of plasmic degradation of fibrinogen, indicating that the augmentation
      of enzymatic fibrinolysis required the presence of a fibrin gel. The acceleration
      of fibrinolysis by ultrasound was greater at higher intensities and duty cycles
      and was maximum at frequencies between 1 and 2.2 MHz, but decreased at 3.4 MHz.
      These findings suggest that ultrasound accelerates enzymatic fibrinolysis by
      increasing transport of reactants through a cavitation-related mechanism.

PMID- 8490173
TI  - The roles of von Willebrand factor and factor VIII in arterial thrombosis:
      studies in canine von Willebrand disease and hemophilia A.
AB  - We have studied the roles of von Willebrand factor (vWF) and factor VIII in
      arterial thrombosis in four canine phenotypes: normal (n = 6), hemophilia A (n =
      11), von Willebrand disease (vWD) (n = 9), and hemophilia A/vWD (n = 1). vWF
      activity was determined by botrocetin-induced agglutination of fixed human
      platelets and vWF antigen (vWF:Ag) by Laurell electroimmunoassay and crossed
      immunoelectrophoresis. Plasma from normal dogs and those with hemophilia A had
      vWF activity, vWF:Ag, and a full range of vWF:Ag multimers on gel electrophoresis
      equivalent to normal canine plasma pool. Platelet cytosol contents were isolated
      by freezing and thawing, triton X-100 solubilization, or sonication of washed
      platelets with and without protease inhibitors and inhibitors of platelet
      activation. Washed platelets were also stimulated with calcium ionophore and
      MgCl2. There was no measurable vWF activity or vWF:Ag in platelet lysates or
      releasates in any dog regardless of phenotype. All dogs were studied using a
      standard arterial stenosis and injury procedure to induce arterial thrombosis.
      Thromboses were detected by cyclic reductions in Doppler blood flow velocity.
      Vessels were examined by light and scanning electron microscopy. Thrombosis
      developed in the arteries of normal (9 of 10) and hemophilia A dogs (16 of 16)
      but in none of the vWD dogs (0 of 10). Infusion of canine vWF cryoprecipitate
      into vWD dogs markedly shortened bleeding time but did not support thrombosis as
      seen in dogs with vWF in the plasma and subendothelium. Thrombosis, then, fails
      to occur when vWF is absent from the plasma and subendothelial compartments or
      present only in the plasma compartment. These data are consistent with the
      hypothesis that vWF in the plasma and subendothelium supports thrombosis. Neither
      plasma FVIII nor platelet vWF is essential for thrombosis in this model.

PMID- 8490174
TI  - Adenosine diphosphate stimulation of cultured hematopoietic cell lines.
AB  - Adenosine diphosphate (ADP) plays a critical role in platelet activation both by
      exogenous stimulation and the release of endogenous intracellular stores. As the
      platelet ADP receptor is not well defined, we have chosen to identify and
      characterize several cell lines that possess functional receptors for this
      nucleotide. Rat promegakaryoblasts (RPM), human erythroleukemia cells (HEL),
      U937, and K562 leukemia cells responded to ADP, as measured by a rapid increase
      in intracellular calcium. In the case of RPM cells, ADP was the only naturally
      occurring platelet agonist capable of eliciting this response. Binding studies
      with [3H]ADP and fixed cells showed 3.99 +/- 1.77 x 10(5) binding sites/cell for
      RPM cells (apparent dissociation constant [kd] = 7.75 +/- 2.3 x 10(-8) mol/L),
      8.19 +/- 3.25 x 10(5) sites/cell for HEL cells (kd = 2.15 +/- 0.84 x 10(-7)
      mol/L, 1.15 +/- 0.23 x 10(6) sites/cell for U937 cells (kd = 2.20 +/- 0.53 x 10(
      7) mol/L) and 5.39 +/- 2.80 x 10(5) sites/cell for K562 cells (kd = 1.37 +/- 0.39
      x 10(-7) mol/L), Inhibition studies with unlabeled nucleotides and analogues
      showed that binding was approximately 85% specific and the inhibitory pattern was
      similar to that seen with mature platelets. The purine base adenosine resulted in
      little or no inhibition. These studies indicate that both human and rat
      hematopoietic cell lines possess intact ADP receptors and may be useful tools in
      future studies of the structure and function of this important platelet
      activation system.

PMID- 8490175
TI  - Phenotypic difference of normal plasma cells from mature myeloma cells.
AB  - We have recently shown that two-color analysis with fluorescein isothiocyanate
      (FITC)-anti-CD38 antibody could clearly distinguish myeloma cells (plasma cells)
      from other hematopoietic cells in the bone marrow. Myeloma cells (plasma cells)
      alone were located at CD38strong positive (++) fractions. To further distinguish
      normal plasma cells from mature myeloma cells phenotypically, we examined
      immunophenotypes of normal plasma cells and myeloma cells by two-color flow
      cytometry with FITC-anti-CD38 antibody and phycoerythrin staining with antibody
      to VLA-4, MPC-1, CD44, CD56, CD19, CD20, CD24, or CD10. Normal plasma cells were
      all VLA-4+VLA-5+MPC-1+CD44+ CD19+CD56- in the bone marrows from seven healthy
      donors, tonsils from four patients with chronic tonsillitis, a spleen from one
      patient with idiopathic thrombocytopenic purpura, and lymph nodes from two
      patients with chronic lymphadenitis, respectively. On the other hand, mature
      myeloma cells (12 of 20 cases), VLA-4+VLA-5+MPC-1+, were all CD19- and most of
      them CD56+, and there were no myeloma cells with the CD19+CD56- phenotype in the
      20 cases of myelomas we tested. Thus, as for the expression of CD19 and CD56,
      normal plasma cells from various tissues are all CD19+CD56-, whereas no myeloma
      cells have the CD19+CD56- phenotype. According to this finding, we investigated
      the expression of CD19 and CD56 on plasma cells (CD38++ fractions) in monoclonal
      gammopathy of undetermined significance (MGUS). Both CD19+CD56- and CD19-DC56+
      plasma cells were found in all five cases of MGUS we tested, suggesting that MGUS
      consists of phenotypically normal plasma cells and myeloma cells. Therefore, it
      is reasoned that phenotypic analysis of plasma cells with anti-CD19 and anti-CD56
      antibodies can distinguish normal plasma cells from malignant plasma cells
      (myeloma cells), and can detect malignant plasma cells even in MGUS or premyeloma
      states.

PMID- 8490176
TI  - Human megakaryocytes have a CD4 molecule capable of binding human
      immunodeficiency virus-1.
AB  - Most human megakaryocytes (MGKs) express the CD4 antigen on their surface.
      Approximately 25% have a CD4 receptor density comparable to that of CD4+ T cells
      (Basch et al, Proc Natl Acad Sci USA 87:8085, 1990). In these studies, we show:
      (1) the presence of mRNA for CD4 in human MGKs; (2) the binding of human
      immunodeficiency virus-1 (HIV-1) to human MGKs; (3) the inhibition of binding by
      anti-CD4 (Leu3a) antibody or rCD4; (4) the infection of a human MGK line, CHRF
      288 with HIV-1; and (5) inhibition of infection with anti-CD4. Human MGKs have
      mRNA for CD4 as shown by in situ hybridization with an RNA probe synthesized from
      a 3-kb cDNA sequence of plasmid pSP65.T4.8 containing the full-length CD4
      sequence. MGKs (23% +/- 17%) bound HIV-1, as determined by anti-gp120 and anti
      CD41 staining. Binding to human MGKs could be inhibited 55% to 75% with anti-CD4
      or rCD4, respectively. Infection of a CD4+ MGK line (CHRF-288) could be
      accomplished with HIV-1, as determined by proviral DNA polymerase chain reaction
      and p24 production. Preincubation with anti-CD4 inhibited apparent proviral DNA
      infection by 100% and p24 production by 65% to 70%. Thus, human MGKs have a CD4
      receptor capable of binding HIV-1. Using this receptor, HIV-1 can infect cells
      representative of the MGK lineage.

PMID- 8490177
TI  - Effect of granulocyte-macrophage colony-stimulating factor on lymphokine
      activated killer cell induction.
AB  - The treatment of cancer with lymphokine-activated killer (LAK) cells in
      conjunction with high-dose interleukin-2 (IL-2) has been limited by the toxicity
      of IL-2 and the narrow range of tumors that respond to therapy. Cytokines that
      are capable of augmenting lower doses of IL-2 are, therefore, a major focus of
      research. We report here that granulocyte-macrophage colony-stimulating factor
      (GM-CSF) can augment low-dose IL-2 LAK induction from murine splenocytes. Anti
      tumor necrosis factor alpha (anti-TNF alpha) or anti-interferon gamma (anti-IFN
      gamma) monoclonal antibodies did not inhibit (IL-2 + GM-CSF)-induced LAK
      generation, indicating that GM-CSF augmentation does not require TNF alpha or IFN
      gamma activity. Depletion of natural killer cells before culture did not inhibit
      low-dose IL-2-induced LAK generation or the ability of GM-CSF to augment LAK
      generation. In contrast, depletion of both CD4+ and CD8+ T cells before culture
      inhibited the generation of LAK activity. However, depletion of only CD4+ T
      cells, or only CD8+ T cells, did not inhibit the generation of IL-2 or (IL-2 + GM
      CSF) LAK activity. These results suggest that LAK precursors are present in both
      the CD4+ and CD8+ T-cell populations and suggest that the addition of GM-CSF to
      low-dose IL-2 may result in the generation of T-derived LAK cells.

PMID- 8490178
TI  - DCC tumor suppressor gene is inactivated in hematologic malignancies showing
      monosomy 18.
AB  - DCC (deleted in colorectal cancer) is a candidate tumor suppressor gene recently
      identified on chromosome band 18q21. Loss of one DCC allele or decreased DCC
      expression occurs in more than 70% of colorectal cancers, suggesting that DCC
      inactivation constitutes a critical event in the development of these tumors.
      Using polymerase chain reaction amplification of cDNA, we have studied DCC
      expression in bone marrow from 4 patients with leukemia (1 chronic myeloid
      leukemia-blastic crisis, case 1; 1 acute myeloid leukemia, case 2; 1 T-cell acute
      lymphoblastic leukemia [ALL], case 3; 1 B-cell ALL, case 4) showing loss of one
      DCC allele due to monosomy 18. We also studied DCC expression in multiple control
      samples, including normal lymphocytes, normal tonsillar tissue, and leukemias
      without 18q abnormalities. Four primer pairs consistently amplified the predicted
      DCC sequences from cDNA prepared from all control samples. However, in samples
      with monosomy 18, DCC transcripts were either not detected (case 1) or detected
      at a very low level (cases 2, 3, and 4). Southern analysis showed no structural
      rearrangement of the remaining DCC locus in all leukemia samples. Thus, loss of
      DCC expression was demonstrated in association with loss of one DCC allele in all
      cases tested. These results suggest that, as for colorectal tumors, the
      inactivation of DCC can have a role in the development of hematologic
      malignancies.

PMID- 8490179
TI  - Mutational activation of N- and K-ras oncogenes in plasma cell dyscrasias.
AB  - The frequency of N- and K-ras oncogene mutations was investigated in plasma cell
      dyscrasias. Genomic DNAs from 128 patients were selected for this study: 30
      monoclonal gammopathies of undetermined significance, 8 solitary plasmacytomas,
      77 multiple myelomas (MM), and 13 plasma cell leukemias (PCL). A two-step
      experimental approach was devised. All samples were screened for mutations by
      single-strand conformation polymorphism analysis. DNA fragments displaying an
      altered electrophoretic mobility were further studied by direct sequencing to
      confirm and characterize the nature of the mutations. Ras mutations are not
      randomly distributed because they are detectable only in MM (9%) and PCL (30.7%).
      N-ras codons 12, 13, and 61 and K-ras codon 12 were found to be mutated, but N
      ras codon 61 mutation was the most frequent finding (63.6%). In conclusion, ras
      mutations were found in PCL, and in a subset of MM characterized by advanced
      stage disease and adverse prognostic parameters. Furthermore, based on our
      findings, it is possible to speculate that ras mutations represent a late
      molecular lesion in the process of multistep carcinogenesis.

PMID- 8490180
TI  - Establishment of a karyotypically normal cytotoxic leukemic T-cell line from a T
      ALL sample engrafted in SCID mice.
AB  - Bone marrow (BM) cells from a child with an immature (CD3-) acute T lymphoblastic
      leukemia (T-ALL) bearing no chromosomal abnormalities failed to grow in long-term
      culture in the presence or absence of recombinant human (rh) growth factors but
      could be engrafted in severe combined immunodeficient (SCID) mice and induced
      leukemia. The leukemic cells recovered from the animal tissues could be adapted
      to grow in vitro in the presence of rh interleukin-2 (IL-2) and give rise to a
      growth factor-dependent cell line designated TALL-107. This cell line expresses T
      cell-specific mature markers (CD2, CD3/T-cell receptor [TCR] alpha beta, CD8,
      CD56), and its growth can be inhibited by IL-4 of all the cytokines tested.
      Similar to the original leukemic blasts, TALL-107 cells are clonal, have
      rearranged TCR-beta, gamma, and delta loci, and a normal 46 XY karyotype.
      However, unlike the patient's BM cells, the TALL-107 cell line displays potent
      tumoricidal activity that is not major histocompatibility complex restricted. The
      magnitude of mRNA expression of perforin and serine esterases and of lytic
      activity depends on the doses of IL-2 added. TALL-107 cells can also be triggered
      by CD3- and CD2-specific monoclonal antibodies (MoAbs) to mediate reverse tumor
      cell lysis. In addition, this cell line produces high levels of interferon gamma
      and tumor necrosis factor alpha on stimulation with anti-CD3 and/or anti-CD2 MoAb
      both in the presence or absence of IL-2. The overall data indicate that the SCID
      mouse is able to support the functional maturation and expansion of a cytotoxic T
      cell subset from some types of T-ALL.

PMID- 8490181
TI  - Involvement of the AML1 gene in the t(3;21) in therapy-related leukemia and in
      chronic myeloid leukemia in blast crisis.
AB  - A nonrandom translocation between chromosomes 3 and 21, t(3;21)(q26.2;q22) has
      been detected in patients with a myelodysplastic syndrome or acute myeloid
      leukemia after treatment (t-MDS/t-AML) for a primary malignant disease and in
      chronic myelogenous leukemia in blast crisis (CML-BC). In these patients, the
      breakpoint on chromosome 21 is at band 21q22. This band is also involved in the
      t(8;21)(q22;q22) detected in 40% of the patients with acute myeloid leukemia
      subtype M2 (AML-M2) de novo who have an abnormal karyotype. In the t(8;21), the
      AML1 gene is the site of the breakpoint on chromosome 21. The AML1 gene is
      transcribed from telomere to centromere, and in the t(8;21) the 5' part of AML1
      is fused to the ETO gene on chromosome 8 to produce the chimeric AML1/ETO on the
      der(8) chromosome. We found that AML1 is also rearranged in two t-AML patients
      and in one CML-BC patient with the t(3;21), but the breakpoints are approximately
      40 to 60 kb downstream to those of AML-M2 patients. This region contains at least
      one additional exon of AML1, as determined by using an AML1 cDNA as a probe in
      Southern blot analysis. The t(3;21) breakpoints for the remaining patients could
      not be determined because, by fluorescence in situ hybridization analysis, the
      breaks are outside of the region covered by the available probes.

PMID- 8490182
TI  - Mechanisms for actin reorganization in chemotactic factor-activated
      polymorphonuclear leukocytes.
AB  - Cytoskeletal structure in polymorphonuclear leukocytes (PMNs) is thought to
      reflect a simple equilibrium between two actin pools (globular [G]- and
      filamentous [F] actin). Recent description of two distinct F-actin pools in PMNs
      (Triton-insoluble [stable] and Triton-soluble [labile] F-actin pools) (Watts and
      Howard, Cell Motil Cytoskeleton, 21:25, 1992) suggest a tripartite equilibrium
      between these F-actin pools and G-actin and multiple possible mechanisms for
      polymerization. To study the contribution of each actin pool to actin dynamics in
      PMNs, changes in actin content of the Triton-soluble and -insoluble F-actin pools
      and G-actin in chemotactic factor (CTF)-activated PMNs were measured by
      NBDphallacidin binding and by gel scans of Triton-lysed PMNs. From 0 to 30
      seconds after CTF activation, PMNs rapidly increase total (Triton-soluble +
      Triton-insoluble) F-actin content (maximum = 1.7- +/- 0.10-fold basal at 30
      seconds). Concurrent measures of the actin content of individual actin pools
      (Triton-soluble and -insoluble F-actin and G-actin) show that at all times (0 to
      30 seconds) only the Triton-insoluble F-actin pool grows (maximum = 2.81- +/-
      0.73-fold basal at 30 seconds), whereas both the Triton-soluble and G-actin pools
      simultaneously decrease (50% decrease at 30 seconds). Concurrent growth of one F
      actin pool (Triton-insoluble) and loss of another F-actin pool (Triton-soluble)
      emphasize the functional uniqueness of the F-actin pools and can occur only if
      the Triton-soluble F-actin anneals or cross-links filament-to-filament with the
      Triton-insoluble fraction or if the Triton-insoluble F-actin pool first
      depolymerizes to monomer, which is then added to the Triton-insoluble pool.
      Because from 0 to 30 seconds after FMLP activation G-actin never increases, but,
      like the Triton-soluble F-actin progressively decreases, the results suggest that
      F-actin growth results from simultaneous new filament growth by monomer addition
      to the Triton-insoluble F-actin and cytoskeletal remodelling by Triton-soluble F
      actin annealing or cross-linking to Triton-insoluble F-actin. These findings
      offer important new insights into the mechanism(s) of actin polymerization in CTF
      activated human PMNs.

PMID- 8490183
TI  - Characterization of vascular permeability factor/vascular endothelial growth
      factor receptors on mononuclear phagocytes.
AB  - Vascular permeability factor/vascular endothelial growth factor (VPF/VEGF) is a
      polypeptide mediator, elaborated by certain tumors and other cell types, that
      exerts multiple effects on endothelium via interaction with a class of high
      affinity binding sites. In this report, the interaction of VPF/VEGF with human
      mononuclear phagocytes (MPs) is characterized. Radioligand binding studies at 4
      degrees C showed the presence of a single class of binding sites, kd
      approximately 300 to 500 pmol/L (approximately 20 times lower affinity than the
      high-affinity binding site on endothelial cells [ECs]), the occupancy of which
      correlated with VPF/VEGF-induced MP migration and expression of tissue factor.
      These binding results were paralleled by functional experiments which indicated
      that the same VPF/VEGF preparations were about an order of magnitude less
      effective in stimulating MP chemotaxis than in inducing EC proliferation. When
      MPs with surface-bound 125I-VPF/VEGF were warmed to 37 degrees C, endocytosis and
      degradation occurred. Occupancy of VPF/VEGF binding site resulted in subsequent
      activation of intracellular signal transduction mechanisms, as shown by an
      increase in MP intracellular calcium concentration. Cross-linking studies with
      125I-VPF/VEGF showed a new high-molecular weight band (corresponding to putative
      125I-VPF/VEGF-receptor complex), the appearance of which was blocked by excess
      unlabeled VPF/VEGF. Consistent with these results, immunoprecipitation of 32PO4
      labeled MPs exposed to VPF/VEGF showed a single band of similar mobility, not
      seen in untreated controls. These results demonstrate that the interaction of
      VPF/VEGF with MPs, though of lower affinity than that observed with ECs, also
      results from interaction of the polypeptide with a specific cell-surface protein
      and leads to activation of intracellular transduction mechanisms.

PMID- 8490184
TI  - Volume and osmotic properties of human neutrophils.
AB  - Quantitative models describing the dynamics of human neutrophils in the
      microcirculation require accurate morphometric parameters such as volume and
      surface membrane area. Using both a micropipette technique and video light
      microscopy (LM) to measure the diameters of the spherical cells, we have
      accurately determined the volume of the human neutrophil. Our value, 299 +/- 32
      microns 3, is in good agreement with our earlier results, but 55% larger than
      that reported by Schmid-Schonbein et al (Blood 56:866, 1980). However, the
      measurements of Schmid-Schonbein et al were based on the actual mass of the cells
      derived from transmission electron microscopic (TEM) images. The membrane surface
      area, at lysis, was calculated to be 2.6 times its initial projected area. After
      lysis, the cells do not reduce their size, indicative of the possibility of a F
      actin network formation that would stiffen the structure. Further, we show that
      neutrophils behave as ideal osmometers when exposed to anisotonic solutions at 21
      degrees C, as predicted by the Boyle-Van't Hoff relationship. The calculated
      Ponder's value, R, is 0.77, which corresponds to 77% of the cell volume being
      osmotically active under isotonic conditions. However, at 37 degrees C, the cells
      are able to regulate their volumes toward the original volumes after an osmotic
      stress.

PMID- 8490185
TI  - Characterization of the DNase I hypersensitive site 3' of the human beta globin
      gene domain.
AB  - The members of the human beta globin gene family are flanked by strong DNase I
      hypersensitive sites. The collection of sites 5' to the epsilon globin gene is
      able to confer high levels of expression of linked globin genes, but a function
      has not been assigned to the site 3' to the beta globin gene (3'HS1). Our
      analysis of this DNase I super hypersensitive site shows that the region is
      composed of multiple DNase I sites. By examination of the DNA sequence, we have
      determined that the region is very A/T-rich and contains topoisomerase II
      recognition sequences, as well as several consensus binding motifs for GATA-1 and
      AP-1/NF-E2. Gel mobility shift assays indicate that the region can interact in
      vitro with GATA-1 and AP-1/NF-E2, and functional studies show that the region
      serves as a scaffold attachment region in both erythroid and nonerythroid cell
      lines. Whereas many of the physical features of 3'HS1 are shared by 5'HS2 (a
      component of the 5' locus control region), transient expression studies show that
      3' HS1 does not share the erythroid-specific enhancer activity exhibited by
      5'HS2.

PMID- 8490186
TI  - A splice site mutation of alpha-spectrin gene causing skipping of exon 18 in
      hereditary elliptocytosis.
AB  - Spectrin Oran (alpha II/21) has been reported previously as a variant of the
      alpha II domain. Its expression level is low (10% of total spectrin) in
      heterozygotes denoting a major disadvantage of the mutated alpha-chain dimer or
      tetramer with respect to their normal counterparts. Spectrin Oran is associated
      with symptomatic elliptocytosis in the homozygous state. A 1-minute digestion
      time allowed to perceive a fast trypsin cleavage (not existing normally) after
      Arg 890 (helix 3 of repeating segment alpha 9). The responsible change was the
      lack of amino acids 822 to 862 (helix 2 of repeating segment alpha 8). Such a
      situation fits with the phasing of spectrin according to which mutated helix 2
      and distorted helix 3 are adjacent to one another. The internal position of the
      structural change accounts for the slight self-association defect. The ultimate
      genetic lesion was a G to A substitution (intronic position-1) in the acceptor
      splice site of intron 17 resulting in skipping of exon 18. The substitution also
      created an acceptor splice site 1 base downstream, but the latter was used at a
      low grade.

PMID- 8490187
TI  - Infusional cyclophosphamide, doxorubicin, and etoposide in human immunodeficiency
      virus- and human T-cell leukemia virus type I-related non-Hodgkin's lymphoma: a
      highly active regimen.
AB  - Fourteen patients with poor-prognosis intermediate- to high-grade non-Hodgkin's
      lymphoma (NHL) associated with human immunodeficiency virus (HIV) infection (12
      patients) or human T-cell leukemia virus type I (HTLV-I) infection (two patients)
      received cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and etoposide 240
      mg/m2 administered as a continuous intravenous (IV) infusion over 4 days
      (infusional CDE); treatment was repeated every 28 or more days for up to six
      cycles. All HIV-positive patients had at least one poor prognostic feature, which
      included either extranodal disease (10 patients), Karnofsky performance status
      less than 70% (six patients), a CD4 count less than 100/microL (six patients), or
      a prior history of acquired immunodeficiency syndrome (AIDS; one patient). Both
      HTLV-I-positive patients had an elevated serum lactate dehydrogenase (LDH) level,
      a poor prognostic feature in that setting. Complete response (CR) occurred in 10
      patients (71%; 95% confidence interval, 48% to 95%) and partial response (PR)
      occurred in three patients (21%), yielding an overall objective response rate of
      approximately 93%. The estimated Kaplan-Meier median survival was 17.4 months;
      seven of 12 HIV-positive patients are alive and disease-free with a median follow
      up of 15 months (range, 7 to 24 months). Hospitalization was required after 19%
      of treatment cycles due to fever associated with granulocytopenia. Documented or
      suspected opportunistic infection occurred in five patients (36%), bacteremia
      occurred in three patients (21%), and candidemia occurred in one patient (7%).
      There was one treatment-related death attributable to disseminated aspergillosis.
      This pilot study suggests that infusional CDE may be a highly active regimen
      capable of producing durable remissions in a high proportion of patients with HIV
      related NHL. Further study is required to confirm this observation.

PMID- 8490188
TI  - Autoreactive T-cell-dependent polyclonal B-cell differentiation in mantle zone
      lymphoma.

PMID- 8490189
TI  - Macrophage colony-stimulating factor: serum levels and cDNA structure in
      malignant osteopetrosis.

PMID- 8490190
TI  - A new, striking morphologic feature for the human erythrocyte in hereditary
      spherocytosis: the blebbing pattern.

PMID- 8490191
TI  - Cancer cachexia.
AB  - Cachexia is a common problem in the clinical management of cancer patients,
      particularly those with solid tumors. Cachexia is most obviously manifested as
      weight loss with massive depletion of both adipose tissue and muscle mass, and
      death is probably due to loss of lean body tissue. Not only is the survival time
      shorter in patients with cachexia, but the frequency of response to chemotherapy
      is also significantly reduced. Although anorexia frequently accompanies cachexia,
      attempts to halt or reverse cachexia by nutritional repletion have not been
      successful. This suggests that cachexia is due to metabolic abnormalities
      produced by the tumor in addition to the underlying anorexia. In some patients
      weight loss is associated with an increased relative energy expenditure possibly
      through an elevated adrenergic state. Several factors have been postulated as
      mediators of cancer cachexia and can be divided into two groups. (i) Materials
      with hormone-like characteristics which result in direct catabolism of host
      tissues. (ii) Cytokines which cause alterations in host metabolism indirectly.
      Included in group (i) are the conventional catabolic hormones and a lipid
      mobilizing factor (LMF) produced by tumors, which causes direct breakdown of
      adipose tissue. Included in group (ii) are tumor necrosis factor-alpha,
      interleukin-6, interferon-gamma and leukaemia inhibitory factor. The materials
      appear to influence adipose tissue indirectly through an inhibition of
      lipoprotein lipase. Reversal of cachexia has been achieved by two groups of
      agents. (i) Those stimulating food intake, e.g. megestrol acetate. (ii) Those
      directly inhibiting the LMF, e.g. eicosapentaenoic acid. While agents in group
      (i) can cause tumor growth stimulation, those in group (ii) act as tumor growth
      inhibitors. This latter results suggests that the products of catabolism of host
      tissues may be important for tumor growth and provides a new avenue for
      chemotherapeutic intervention.

PMID- 8490192
TI  - Can hematopoietic growth factors be used to improve the success of cytotoxic
      chemotherapy?
AB  - Hematopoietic growth factors (HGFs) have provided oncologists with powerful tools
      to investigate questions of chemotherapy dose and treatment outcome in cancer
      patients. Agents such as recombinant granulocyte colony-stimulating factor (e.g.
      G-CSF; filgrastim) significantly accelerate neutrophil recovery after
      chemotherapy and therefore allow the delivery of a planned dose on time.
      Moreover, it is possible to investigate the effects of escalated dose
      chemotherapy with HGF support. This can be done using the HGF alone or in
      conjunction with stem cell rescue. HGFs significantly reduce morbidity following
      bone marrow transplantation (BMT) and may also be used to mobilize peripheral
      blood progenitor cells (PBPC) to support high-dose chemotherapy. Growth factor
      mobilized PBPC have practical and clinical advantages over BMT and may be a more
      effective method of allowing the delivery of high-dose therapy, but for some
      patients (who for reasons not yet clear, display a poor mobilization response) a
      combination of autologous bone marrow and PBPC might be more effective at
      reconstituting hematopoiesis. Whether more intensive treatment approaches will
      significantly improve survival remains to be determined.

PMID- 8490193
TI  - Cisplatin and carboplatin induced changes in the neurohypophysis and parathyroid,
      and their role in nephrotoxicity.
AB  - Cytochemical and ultrastructural studies in Wistar rats [Crl: (WI)BR] show that
      cisplatin treatment (5-9 mg/kg) induces a release of neurosecretory granules from
      the neurohypophysis with a corresponding decrease in the urine output in a time
      and dose dependent fashion. Cisplatin induces low blood calcium and phosphate
      levels with a corresponding increase in the dark cells of the parathyroid gland.
      Injections of calcium before and during the treatment of cisplatin are effective
      in combating hypocalcemia, nephrotoxicity and gastrointestinal toxicity due to
      cisplatin. Carboplatin, a less nephrotoxic agent, does not demonstrate any of
      these changes.

PMID- 8490194
TI  - A phase I trial of trimetrexate (NSC352122) on a daily x 5 schedule in patients
      with refractory adult leukemia.
AB  - Seven adult patients with refractory acute leukemia were administered
      trimetrexate (TMTX), a non-classical folate antagonist, in a phase I trial. TMTX
      was administered as an intravenous bolus for five consecutive days at doses of 9
      12 mg/m2 based on marrow response. The maximum tolerated dose was 12 mg/m2.
      Hepatotoxicity was the dose-limiting toxicity. Initial dosage reductions in
      patients with liver disease and/or low protein concentrations may be necessary
      since TMTX is significantly protein bound and cleared primarily by hepatic
      metabolism. The recommended phase II dose on this dosing schedule is 9 mg/m2.

PMID- 8490195
TI  - Antitumor activity of a new series of platinum complexes: trans(+/-)-1,2
      cyclohexanediammineplatinum(II) conjugated to acid polysaccharides.
AB  - Complexes with trans(+/-)-1,2-cyclohexanediammineplatinum(II) conjugated to acid
      polysaccharides were synthesized and their antitumor activities were tested in
      female CDF1 mice with intraperitoneal leukemia L1210 cells. Platinum was released
      from the polymers under physiological conditions, with half-lives from 3.3 to
      19.3 h. A hyaluronic acid-supported complex was the most effective against the
      tumors (all six mice survived for 60 days). The group given a chondroitin
      polysulfate-supported complex had five survivors, the chondroitin sulfate A group
      also had five, the chondroitin sulfate C group had three and the heparan sulfate
      group had two. Part of the antitumor activity was due to increased efficacy of
      the polymers. The bioavailability of these complexes is high. Therefore, acid
      polysaccharides should be a good system for delivering antitumor platinum
      complexes.

PMID- 8490196
TI  - Reduced bone marrow toxicity of KW-2149, a mitomycin C derivative, in mice.
AB  - The bone marrow toxicity of KW-2149, a newly synthesized mitomycin C (MMC)
      derivative, was compared with MMC in different aged ddY mice. Both MMC and KW
      2149 exhibited a similar type of leukopenia in young adult mice. However, in
      mature adult mice, the recovery from leukopenia was rapid in KW-2149-treated
      mice, whereas in the MMC-treated mice, it was delayed. The difference between KW
      2149 and MMC was more significant in thrombocytopenia in mature mice, and that
      induced by KW-2149 was mild, whereas that by MMC was severe and delayed. This
      reduced bone marrow toxicity of KW-2149 in mature mice was confirmed by the assay
      of colony-forming units in culture, progenitors of granulocytes or macrophages,
      and megakaryocytic colony-forming units, progenitors of platelets, in the bone
      marrow cells. The bone marrow toxicity and lethal toxicity of MMC was augmented
      by weekly intermittent treatment; in contrast, that of KW-2149 was not,
      suggesting that bone marrow toxicity may have a critical role in the lethal
      toxicity of MMC. The non-cumulative bone marrow toxicity of KW-2149 enabled the
      weekly intermittent treatment of human lung adenocarcinoma L-27 inoculated into
      nude mice. Thus its antitumor activity was greater than with single treatment.

PMID- 8490197
TI  - A preliminary report of a pilot randomized trial comparing cyclophosphamide,
      methotrexate and 5-fluorouracil with cyclophosphamide, mitoxantrone and 5
      fluorouracil in the adjuvant therapy of stage II breast cancer with four or more
      positive axillary nodes.
AB  - Thirty-eight patients with stage II breast cancer with four or more positive
      axillary lymph nodes were randomized to receive CMF (cyclophosphamide,
      methotrexate and 5-fluorouracil, every 3 weeks) or CXF (cyclophosphamide,
      mitoxantrone and 5-fluorouracil, every 3 weeks). Pretreatment characteristics
      were similar for both groups. The actuarial 5 year disease-free survival (DFS)
      was 36% for the CMF group and 23% for the CXF group. The actuarial 5 year
      survival was 60% for the CMF arm and 66% for the CXF arm. These differences were
      not statistically significant. Partial alopecia was observed in 42% of patients
      in the CMF arm and in 100% of those receiving CXF (p = 0.0002). No episodes of
      leucopenic fever were observed in patients receiving CMF, while they were present
      in 53% of patients treated with CXF (p = 0.0006). No stomatitis occurred in the
      CMF group, but it was observed in 90% of patients who received CXF (p < 0.0001).
      Treatment with CXF had to be discontinued in two patients because of toxicity. In
      this small group of patients with poor prognosis, it seems that CXF at the doses
      given here is more toxic but not more effective than CMF, as represented by a
      similar DFS and survival.

PMID- 8490198
TI  - Intratunical injection of methotrexate for the treatment of seminoma of the
      testicle.
AB  - A bilateral testicular seminoma in a 32 year old man is reported. The patient was
      unmarried and refused bilateral orchidectomy for its sterile result. He was
      treated with four courses of methotrexate (MXT) injected in the tunica vaginalis
      sac. Each course comprised the administration of 50 mg MXT in each tunical sac
      every 5 days for five consecutive doses followed by 3 weeks rest. No toxicity was
      encountered. Testicular biopsy 6 months after the start of treatment was negative
      for malignant cells. A temporary drop of sperm count occurred during treatment.
      Treatment was performed 6 years ago, and the patient has had no recurrence and is
      fertile. The treatment was done on an outpatient basis.

PMID- 8490199
TI  - Oligonucleotide degradation contributes to resistance to antisense compounds.
AB  - A subline of the human B cell lymphoma DHL-4, grown in the artificial serum-free
      medium HB101, displayed a resistant phenotype to the activity of an antisense
      oligodeoxynucleotide (aODN) effective on the parental DHL-4 line. It was found
      that the cellular uptake of the 18mer aODN in the two cell lines was almost the
      same. In contrast, the unresponsive subline DHL-4r degraded the aODN very
      efficiently, in contrast to the stability of aODN inside cells of the parental
      DHL-4 line. Activation of the degrading 'machinery' combined with selective
      properties of the artificial medium may be responsible for the loss of
      responsiveness to aODN.

PMID- 8490200
TI  - Inhibition of c-myc in breast and ovarian carcinoma cells by 1,25
      dihydroxyvitamin D3, retinoic acid and dexamethasone.
AB  - The role and regulation of the c-myc protooncogene in breast and ovarian
      neoplasms is receiving increased attention. The downregulation of the c-myc
      protooncogene by 1,25-dihydroxyvitamin D3 (calcitriol), retinoic acid (RA) and
      dexamethasone (Dex) is closely associated with growth inhibition in leukemic
      cells. Calcitriol, RA and Dex have anti-proliferative activity in breast and
      gynecologic carcinoma cells; however, the regulation of c-myc by these agents in
      breast and ovarian cancers is mostly unknown. We have addressed the regulation of
      c-myc in these cancers using an adaptation of a novel method which employs an
      immunohistochemical procedure to detect c-myc protein followed by quantification
      of c-myc staining with computerized image analysis. This system represents an
      alternative to protein product assay by Western blotting and is straightforward,
      rapid (1 day), can be carried out on a small scale and provides a sample size
      that readily facilitates statistical analysis of assay data. In MCF-7 human
      breast cancer cells, c-myc was suppressed 29% by 0.5 nM Dex, 45% by 0.01 nM RA
      and 54% by 100 nM calcitriol after 24 h of drug treatment. At the same hormone
      concentrations, growth was inhibited 18% by Dex, 18% by RA and 39% by calcitriol
      after 3 days of treatment (p < 0.05 for all hormones). Similar patterns of growth
      and c-myc inhibition were seen in T47D human breast cancer cells and NIH:OVCAR3
      human ovarian cancer cells, with the exception of Dex in T47D cells, which caused
      no inhibition of c-myc or growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490201
TI  - Immunomodulatory effects of a polysaccharide from Tamarindus indica.
AB  - A polysaccharide isolated and purified from Tamarindus indica shows
      immunomodulatory activities such as phagocytic enhancement, leukocyte migration
      inhibition and inhibition of cell proliferation. These properties suggest that
      this polysaccharide from T. indica may have some biological applications.

PMID- 8490202
TI  - The cytotoxicity of heterocyclic thiosemicarbazones and their metal complexes on
      human and murine tissue culture cells.
AB  - Heterocyclic thiosemicarbazones, thioureas and 2-substituted pyridine N-oxides as
      well as representative nickel, cobalt and copper complexes were shown to be
      potent antineoplastic/cytotoxic agents. The cytotoxicity was demonstrated against
      single cell leukemia as well as cell lines derived from solid tissue (colon
      adenocarcinoma, HeLa, KB, skin, bronchogenic lung, bone osteosarcoma and glioma).
      In L1210 cells, DNA synthesis and subsequently RNA synthesis were particularly
      inhibited by the agents. IMP dehydrogenase activity and thus purine de novo
      synthesis was reduced significantly by the agents. Dihydrofolate reductase,
      ribonucleoside reductase, nucleoside kinase and DNA polymerase alpha activities
      were inhibited by the agents. d(NTP) pool levels were reduced by most of the
      agents. DNA strand scission was present with all of the derivatives; however,
      there was no evidence of intercalation, cross linking or alkylation/binding to
      bases of DNA. This new group of compounds may offer novel exploratory derivatives
      for future investigations in the treatment of cancer.

PMID- 8490203
TI  - Differential cytotoxicity, uptake and DNA binding of tetraplatin and analogous
      isomers in sensitive and resistant cancer cell lines.
AB  - Some platinum complexes contain 1,2-diaminocyclohexane (DACH) as a stable carrier
      ligand, which can exist as the R,R-, S,S- and cis-isomers. Tetraplatin, for
      instance, is a mixture of R,R- and S,S-DACH-Cl4-Pt(IV). We have examined each of
      the three individual isomers of DACH-Cl4-Pt(IV) with respect to cytotoxicity,
      uptake of platinum and total DNA-platinum in three murine leukemia L1210
      (cisplatin-sensitive L1210/0, 50-fold cisplatin-resistant L1210/DDP and 36-fold
      tetraplatin-resistant L1210/DACH) and human ovarian carcinoma A2780 (cisplatin
      sensitive) and A2780cp (8-fold cisplatin-resistant) cell lines. Against A2780,
      A2780cp and L1210/DDP cell lines, the R,R-isomer was the most potent followed by
      the S,S-isomer and then the cis-isomer. However, the three isomers demonstrated
      similar IC50 values against the L1210/0 and L1210/DACH cell lines. The cis-isomer
      demonstrated cross-resistance (9- to 20-fold) to cisplatin in L1210/DDP and
      A2780cp cell lines. On the other hand, R,R- and S,S-isomers demonstrated minimal
      (2- to 4-fold) cross-resistance against these tumor models. Intracellular
      platinum accumulation over a 2 h period at 40 microM drug concentration was
      significantly (p < 0.05) greater for the R,R-isomer than the cis-isomer in
      L1210/0 (122 versus 101 ng Pt/mg protein) and L1210/DDP (73 versus 50) cell
      lines, while no difference was observed in L1210/DACH cells (55 versus 56). In
      L1210/DDP cells, total DNA-bound platinum was significantly (p < 0.05) greater
      for the R,R-isomer compared with the cis-isomer (10.3 versus 7.5 ng Pt/mg
      DNA).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490204
TI  - Sodium butyrate inhibits rat insulinoma cell proliferation without affecting the
      cellular insulin content or insulin release.
AB  - The short-chain carboxylic acid sodium butyrate is known to induce
      differentiation in several cell systems. In this paper we have investigated the
      effect of sodium butyrate on the growth rate and hormone content and secretion in
      clonal rat insulinoma cells (RINm5F). Special attention was paid to the role of
      polyamines for these processes, since these compounds have been implicated in the
      regulation of growth and function of insulin-producing cells. For this purpose
      RINm5F cells were maintained in culture for 4 days in the presence or absence of
      1-2 mM sodium butyrate. It was found that sodium butyrate dose-dependently
      inhibited the proliferative activity of the RINm5F cells along with a decreased
      cellular polyamine content. The cellular content of insulin and secretion of the
      hormone into the culture medium were, however, not altered by sodium butyrate
      treatment, and neither did this treatment impose a glucose-sensitive insulin
      release. The decreased polyamine content was restored by the concomitant addition
      of exogenous putrescine; however, despite this, the reduced cell proliferation
      persisted. From these findings we conclude that the decreased growth rate evoked
      by sodium butyrate results from other events than specific polyamine synthesis
      inhibition. It is furthermore demonstrated that the processes of cell
      proliferation and regulation of cellular insulin content and secretion can be
      dissociated in the RINm5F cell line.

PMID- 8490205
TI  - Antiproliferative and chemomodulatory effects of interferon-gamma on doxorubicin
      sensitive and -resistant tumor cell lines.
AB  - Biological agents might offer various therapeutic opportunities in the treatment
      of cancer, including a direct and/or host-mediated antiproliferative effect and
      also the possibility to favorably modulate tumor resistance to antineoplastic
      drugs. We studied the in vitro antiproliferative effects of interferon (IFN)
      gamma on the mouse B16 melanoma and Friend erythroleukemia, and the human K562
      erythroleukemia, as doxorubicin (DXR)-sensitive and -resistant (multidrug
      resistant) variants. These effects were marked in B16 melanoma and rather slight
      in K562 erythroleukemia, without any difference between the DXR-sensitive and 
      resistant lines. The chemosensitive variant of Friend erythroleukemia showed an
      intermediate response, which was greater than that seen in its resistant
      counterpart. There was no apparent relationship between the antiproliferative
      activity of IFN-gamma and the glutathione content of the cell lines. On the other
      hand, this activity was enhanced by co-treatment with glutathione-depleting
      concentrations of buthionine sulfoximine, but only in the cell lines which had
      responded better to IFN-gamma alone. This result probably confirms that a free
      radical mechanism plays a part in the antitumor effect of the cytokine. Finally,
      a range of concentrations of IFN-gamma, including slightly cytotoxic ones, did
      not substantially improve the antiproliferative effects of doxorubicin on the
      various cell lines, except in the DXR-sensitive variant of Friend erythroleukemia
      where a synergistic effect of the combination was observed. Thus, our results are
      not very promising with regard to a possible favorable modulatory activity by IFN
      gamma of DXR (multidrug)-resistance.

PMID- 8490206
TI  - Isothiocyanates inhibit cell cycle progression of HeLa cells at G2/M phase.
AB  - To analyze the inhibitory effects of isothiocyanates on the growth of human
      cancer cells, the effects of these compounds on the cell cycle progression of
      HeLa cells were studied by flow cytometry. The accumulation of cells at G2/M
      phase was observed at 16 h after treatment with 10 microM allyl isothiocyanate,
      2.5 microM benzyl or phenethyl isothiocyanate, at which concentrations the cell
      growth was inhibited to 41-79% of control. These results suggest that
      isothiocyanates delay the cell cycle progression of HeLa cells, leading to
      inhibition of cell growth.

PMID- 8490207
TI  - Serotonin and the mammalian circadian system: I. In vitro phase shifts by
      serotonergic agonists and antagonists.
AB  - The primary mammalian circadian clock, located in the suprachiasmatic nuclei
      (SCN), receives a major input from the raphe nuclei. The role of this input is
      largely unknown, and is the focus of this research. The SCN clock survives in
      vitro, where it produces a 24-hr rhythm in spontaneous neuronal activity that is
      sustained for at least three cycles. The sensitivity of the SCN clock to drugs
      can therefore be tested in vitro by determining whether various compounds alter
      the phase of this rhythm. We have previously shown that the nonspecific serotonin
      (5-HT) agonist quipazine resets the SCN clock in vitro, inducing phase advances
      in the daytime and phase delays at night. These results suggest that the 5-HT
      ergic input from the raphe nuclei can modulate the phase of the SCN circadian
      clock. In this study we began by using autoradiography to determine that the SCN
      contain abundant 5-HT1A and 5-HT1B receptors, very few 5-HT1C and 5-HT2
      receptors, and no 5-HT3 receptors. Next we investigated the ability of 5-HT-ergic
      agonists and antagonists to reset the clock in vitro, in order to determine what
      type or types of 5-HT receptor(s) are functionally linked to the SCN clock. We
      began by providing further evidence of 5-HT-ergic effects in the SCN. We found
      that 5-HT mimicked the effects of quipazine, whereas the nonspecific 5-HT
      antagonist metergoline blocked these effects, in both the day and night. Next we
      found that the 5-HT1A agonist 8-OH-DPAT, and to a lesser extent the 5-HT1A-1B
      agonist RU 24969, mimicked the effects of quipazine during the subjective
      daytime, whereas the 5-HT1A antagonist NAN-190 blocked quipazine's effects. None
      of the other specific agonists or antagonists we tried induced similar effects.
      This suggests that quipazine acts on 5-HT1A receptors in the daytime to advance
      the SCN clock. None of the specific agents we tried were able either to mimic or
      to block the actions of 5-HT or quipazine at circadian time 15. Thus, we were
      unable to determine the type of 5-HT receptor involved in nighttime phase delays
      by quipazine or 5-HT. However, since the dose-response curves for quipazine
      during the day and night are virtually identical, we hypothesize that the
      nighttime 5-HT receptor is a 5-HT1-like receptor.

PMID- 8490208
TI  - Serotonin and the mammalian circadian system: II. Phase-shifting rat behavioral
      rhythms with serotonergic agonists.
AB  - The suprachiasmatic nuclei (SCN) receive primary afferents from the median and
      dorsal raphe, but the role of these projections in circadian timekeeping is
      poorly understood. Studies of the SCN in vitro suggest that quipazine, a general
      serotonin (5-HT) receptor agonist, can produce circadian time-dependent phase
      advances and phase delays in circadian rhythms of neuronal activity. The present
      study addresses whether quipazine and the selective 5-HT1A receptor agonist 8-OH
      DPAT are similarly effective in vivo. Drinking and wheel-running patterns of male
      Wistar rats individually housed in constant darkness were monitored before and
      after subcutaneous administration of quipazine (5-10 mg/kg) at either circadian
      time (CT) 6 or CT 18, with and without running wheels available. Dose-dependent
      phase advances (20-180 min) were produced at CT 6. Significant phase shifts were
      not observed at CT 18. CT 6 quipazine-treated animals also showed a sustained and
      significant shortening of rhythm period (tau) following treatment (-0.28 hr; p <
      0.002). tau shortening was inconsistently observed in CT 18 quipazine-treated
      rats. Neither quipazine-induced phase shifts nor tau effects were dependent on
      wheel-running activity per se. 8-OH-DPAT delivered via intracerebral ventricular
      treatment into the third ventricle (5 microliters at 100 microM in saline)
      produced slightly smaller phase advances (20-90 min) at CT 6, but did not produce
      phase delays at CT 18 or changes in tau. These findings support in vitro evidence
      that 5-HT-ergic agonists can phase-shift the circadian pacemaker.

PMID- 8490209
TI  - On the relationship between motor activity and the sleep-wake cycle in humans
      during temporal isolation.
AB  - In the free-running circadian rhythms of 14 human subjects (4 females, 10 males)
      who lived singly in an isolation unit without temporal clues, locomotor activity
      was recorded by means of contact plates installed below the carpet in the main
      room. During sleep, movements in bed were picked up by spring contacts attached
      to the mattress. In all subjects, the hourly means of locomotion during
      wakefulness (alpha) were negatively correlated with the duration of alpha to such
      an extent that the total amount of locomotion per cycle remained constant when
      alpha varied from 14 to 23 hr. The hourly values of movements in bed were
      independent of the duration of sleep (rho), so that the total number of movements
      was almost proportional to rho. The "homeostatic control" of locomotion during
      wake time is considered as a means to conserve energy when the duration of
      wakefulness increases.

PMID- 8490210
TI  - Photoperiodic time measurement and a graded response in a cockroach.
AB  - Almost exclusively, photoperiodic insects respond to a given photoperiod in one
      of two ways: a "long-day" response or a "short-day" response. Intermediate
      responses occur only at a very restricted range of photoperiods (often less than
      30 min) and are generally population phenomena rather than intermediate responses
      of individuals. In contrast, individuals of the wood roach, Parcoblatta
      pennsylvanica, show intermediate responses over a broad range of photoperiods. We
      examined the effect of constant light, constant darkness, and photoperiods
      ranging from 10 to 18 hr of light per 24 hr on growth rate as measured by weight
      gain, and found a robust photoperiodic response. Nymphs raised in photoperiods
      with light periods (photophases) from 0 to 12 hr gained little weight, whereas
      those in LD 18:6 were almost 15 times heavier. This is the first report of a
      photoperiodic response curve for a cockroach. Interestingly, there was a linear
      relationship between the duration of the photophase and weight gain over a broad
      range of photoperiods (LD 12:12 to LD 18:6; r2 = 0.99). Statistical analysis
      showed that the intermediate responses were attributable to individuals' growing
      at an intermediate rate. Another interesting observation was that all larval
      stages appeared to be capable of perceiving and responding to photoperiodic
      signals. The results of further experiments using non-24-hr photoperiods were
      consistent with the existence of a circadian component in the photoperiodic time
      measurement in this species.

PMID- 8490211
TI  - Behavioral decoupling of circadian rhythms.
AB  - Golden hamsters (Mesocricetus auratus) were kept in a light-dark cycle (LD
      14:10). For 2 weeks, almost every day they were placed in a novel running wheel
      for 3 hr, starting 7 hr before dark onset. Most of the animals made several
      thousand wheel revolutions during this 3 hr. When these animals were subsequently
      transferred to a dark room, their activity was split into two components, one
      close to the time of the previous exposure to the novel wheel and the other close
      to the time when they had been active in the dark phase of the previous LD cycle.
      The two components fused after a few days in darkness. These observations show
      that nonphotic events are capable of causing major reorganizations of circadian
      activity patterns, despite the presence of an LD cycle.

PMID- 8490212
TI  - Behavior in light-dark cycles of Drosophila mutants that are arrhythmic, blind,
      or both.
AB  - Certain of the rhythm mutations in Drosophila melanogaster lead to arrhythmic
      locomotor activity (and aperiodic eclosion) in constant conditions. In light-dark
      (LD) cycles, however, such mutants exhibit clear fluctuations between high levels
      of activity when the lights are on and much lower ones when they are off. Our
      data, in contrast to some previous conclusions, strongly suggest that period0
      (per0) adults are, in LD conditions, merely being "forced" into exhibiting
      periodic behavior. These experiments involved application of 8-, 12-, 16-, and 24
      hr LD cycles, in which the arrhythmic mutant could have any of these
      periodicities imposed upon it, whereas wild-type flies tended to exhibit periods
      of about 24 hr in cycling conditions whose T values were > 8 hr different from
      24. In phase-shift experiments, it was found that Drosophila expressing genotypes
      associated with rhythmicity achieved a 5-hr advance over a 2-day period following
      an advanced lights-on; per0 adults altered the phase of their locomotor peaks
      more rapidly. Against a background of the fact that eyeless or blind flies
      exhibit normal entrainment, it was hypothesized that double-mutant flies-
      carrying such visual mutations and per0 as well--should not synchronize to LD
      cycles, if the forced rhythms seen in the latter single-mutant type are mediated
      solely by light input through the external photoreceptors. Since an appreciable
      proportion of the double mutants did synchronize (to LD 12:12), it is thus
      suggested that the visual cues involved in forcing rhythmicity could be input
      through the same extraocular photoreceptors that, in general, subserve the fly's
      rhythm system.

PMID- 8490213
TI  - Being a burden on others.

PMID- 8490215
TI  - Do physicians' own preferences for life-sustaining treatment influence their
      perceptions of patients' preferences?

PMID- 8490214
TI  - The problem of proxies with interests of their own: toward a better theory of
      proxy decisions.

PMID- 8490216
TI  - The vagaries of patients' and families' discussing advance directives.

PMID- 8490217
TI  - Insights pertaining to patient assessments of states worse than death.

PMID- 8490218
TI  - Analyzing the values history: an evaluation of patient medical values and advance
      directives.

PMID- 8490219
TI  - Is the Patient Self-Determination Act appropriate for elderly persons
      hospitalized for depression?

PMID- 8490220
TI  - Establishing advance medical directives with demented patients: a pilot study.

PMID- 8490221
TI  - Decision making in an incapacitated patient.

PMID- 8490222
TI  - Authenticity, autonomy, and mental disorders.

PMID- 8490223
TI  - Meaning what you say.

PMID- 8490224
TI  - Patients should not always come first in treatment decisions.

PMID- 8490225
TI  - Hardwig on proxy decision making.

PMID- 8490226
TI  - Justice within intimate spheres.

PMID- 8490227
TI  - From PSDA to PTSD: the Patient Self-Determination Act and post-traumatic stress
      disorder.

PMID- 8490228
TI  - The PSDA and the depressed elderly: "intermittent competency" revisited.

PMID- 8490229
TI  - Advance directives: what have we learned so far?
AB  - As a result of the recent intense focus on advance directives, it is now possible
      to resolve several questions. It is clear that instructional directives are best
      able to represent a patient's wishes in the clinical context if they make use of
      scenario- and treatment-specific statements, perhaps combined with other types of
      value statements. Instructional directives are a type of advisory document that
      can provide clear and convincing evidence regarding a patient's wishes and, as
      such, the patient's wishes can thereby be constitutionally protected. It is clear
      that proxy judgments that are not specifically informed are not a good match with
      patients' wishes. Proxy decisions should, therefore, be guided by instructional
      directives--verbal or documented. It is now possible to construct a good clinical
      process for advance planning that is practical, maximizes benefits and minimizes
      risks, and includes both instructional planning and proxy empowerment. However,
      we have a long way to go before advance planning is widely and appropriately
      practiced.

PMID- 8490230
TI  - The PSDA and geriatric psychiatry: a cautionary tale.

PMID- 8490231
TI  - Application of cryotechniques in cartilage tissue preservation and immunoelectron
      microscopy: potentials and problems.
AB  - Cryotechnical processing of cartilage has the potential to solve many of the
      tissue-specific problems associated with various routine chemical fixation
      protocols. This is particularly the case with respect to extracellular matrix
      architecture, the distortion or destruction of which (caused by extraction and/or
      precipitation of proteoglycan molecules) may be prevented. Adoption of such
      techniques also permits high-sensitivity immunoelectron-microscopy of the
      extracellular matrix space (carbohydrate epitopes). However, a number of
      difficulties still remain to be resolved, particularly that of matrix-cell
      interface separation occurring during freeze substitution and low temperature
      embedding. These problems are briefly addressed and possible solutions outlined.

PMID- 8490232
TI  - Improved preservation of ultrastructure in difficult-to-fix organisms by high
      pressure freezing and freeze substitution: I. Drosophila melanogaster and
      Strongylocentrotus purpuratus embryos.
AB  - In this study, we have applied the techniques of high pressure freezing and
      freeze substitution to embryonic cell types which are usually difficult to fix
      properly for electron microscopy. In both Drosophila and Strongylocentrotus
      purpuratus, we see improved preservation of both membrane systems and
      cytoskeleton when compared to published results on the same cells using
      conventional electron microscope (EM) fixation methods. Finally, we have seen
      that postembedding labelling of sections is possible even after light osmium
      fixation during freeze substitution.

PMID- 8490233
TI  - Freeze substitution after fast-freeze fixation in preparation for
      immunocytochemistry.
AB  - As compared to classical chemical fixation, the physical immobilization of
      ultrastructures by fast-freeze fixation (FFF) and the subsequent exchange of
      water in its solid state by freeze substitution (FS) improve the preparation
      procedure for immunogold labeling (IGL). FFF-FS results in a morphological
      preservation of unchallenged quality, as well as in a better preservation of
      antigenic reactivity, thus allowing remarkable precision of labeling on sections.
      However, FFF, particularly over a cooled metal plate, requires a heavy and
      expensive machine. It is not suitable for all biological specimens and in the
      best conditions, which remain difficult to standardize, the thickness of the well
      preserved portion of the specimen does not exceed a few microns for compact
      tissues, and exceptionally 30-40 microns for isolated cells. The FS procedure is
      long and must be adjusted empirically for every new specimen and antigenic
      detection. The preservation of a given antigen's reactivity in the presence of
      fixative agents and embedding resins remains unpredictable. The action of
      fixative agents is different and milder in FS than when they are used classically
      in chemical fixation. By chance, one of the best FS procedures for the
      preservation of both ultrastructure and antigenicity appears to be by using
      acetone alone, together with a molecular sieve to improve the water exchange
      process. A large choice of embedding resins usually allows us to find a
      compromise between ultrastructural and antigenic preservation.

PMID- 8490234
TI  - Freeze-substitution for morphological and immunocytochemical studies in insects.
AB  - Methods of plunge freezing and freeze-substitution (FS) for insect antennae and
      similar body appendages are described. In these more or less cylindrical
      specimens, usually a layer below the cuticular surface of 10-15 microns thickness
      is well preserved without freezing damage, further inwards ice-crystal ghosts of
      increasing size are encountered, but in the very centre of antennal branches
      (diameter approximately 80 microns) of the silkmoth, Bombyx mori, freezing damage
      is usually reduced again. The frost-hardy species, Poecilocampa populi and Boreus
      hiemalis, exhibit regions free from freezing damage up to 40 microns below the
      cuticular surface. Secondary freezing damage in silkmoth sensory hairs is
      observed only after deliberately warming the specimens to -43 degrees C for >> 10
      min before FS. Secondary artefacts due to the substitution process are
      investigated by comparison with freeze-etching and by comparing different FS
      media and protocols. Methanol is not recommended as a substitution medium for
      insect specimens. Structures particularly liable to substitution damage are the
      stimulus-conducting pore tubules of olfactory sensilla and the receptor cell
      membrane. Extraction of soluble components is more likely with pure organic
      solvents without added chemical fixing agents and with prolonged substitution at
      elevated temperatures. Such extraction may also be a possible artefact with
      soluble antigens in immunocytochemical studies. A review is given of the major
      achievements attained with these techniques is insect functional morphology and
      immunocytochemistry.

PMID- 8490236
TI  - Discrepancies in kinematic calculations of HOLZ lines.
AB  - We have found significant differences between the results of computer simulations
      of HOLZ line patterns. The computations in question are made in the kinematical
      approximation. After trivial errors are eliminated the programs fall into two
      groups. There is a discrepancy between the two that increases with distance from
      the zone axis. The difference is small but not negligible at the level of
      precision used in determining lattice parameters or strain. We show which of the
      two is correct in the kinematic approximation and that the discrepancy between
      the two groups is of the order of the error introduced by dynamical interaction.

PMID- 8490235
TI  - Cross-sectional AEM preparation technique for ceramic-coated WC-Co cutting tools.
AB  - The preparation of cross-sectional specimens for AEM studies of materials such as
      ceramic coated tungsten carbide presents some unique problems. Pieces joined by
      the use of epoxides often separate at the interface between the WC and ceramic
      coating during the initial mechanical grinding and subsequent thinning process as
      a result of the vibration and physical strain placed on the sample. These
      problems have been overcome through the use of a preparation process which
      essentially encapsulates the sample within the confines of an epoxy filled quartz
      tube. This preparation process has allowed for facile AEM cross-sectional
      analysis of TiN/TiCN coatings on WC-Co substrates, and has revealed two distinct
      grain morphologies within the TiCN coating.

PMID- 8490237
TI  - Rapid fixation and embedding method for immunocytochemical studies of tomato
      spotted wilt tospovirus (TSWV) in plant and insect tissues.
AB  - A new rapid fixation and embedding technique using microwave energy was evaluated
      for immunolabelling and examination of ultrastructure of plant and insect cells.
      Tissues in gluteraldehyde-paraformaldehyde were fixed for fifteen seconds in a
      microwave at 100% power, and dehydrated. Microwave energy was then used to
      polymerize the London Resin White (LR White) acrylic resin during the embedding
      process. Embedded specimens were then thin sectioned (90 nm) and treated with
      anti-tomato spotted wilt tospovirus (TSWV) antiserum followed by protein A-gold
      label, or antisera against a TSWV encoded nonstructural protein followed by goat
      anti-rabbit gold label. Using this technique, structural and nonstructural
      proteins of TSWV were readily detected and specifically labelled in cells of the
      insect vector, the western flower thrips, Frankliniella occidentalis (Pergande),
      and in infected cells of the plant species, Emilia sonchifolia L.

PMID- 8490238
TI  - Rapid freezing replica studies of membrane specializations in the proximal
      tubules of mouse kidney.
AB  - The membrane specializations of the fresh unfixed kidney cortex of adult and
      neonatal ICR mice were examined by using rapid freezing replica methods. In
      proximal tubular cells, numerous apical intracellular tubules exhibited helical
      patterns on the E face with a pitch of about 12 nm. This regular pattern was
      often continuous with similar striped indentations on the edge of the vacuoles
      connecting with the tubules. On the luminal surface (ES) of these vacuoles,
      membrane surface particles were arranged regularly in striped patterns with a
      center-to-center spacing of about 12 nm. We could not identify differentiations
      on the PF or PS of the same membrane systems. Another membrane specialization was
      a plaque or patch of clear pits in tilted lattice alignments on the P face of the
      large vacuoles with a center-to-center spacing of about 20 nm. This type of
      specialization was often observed in the neonatal mice proximal tubular cells.
      These membrane specializations may indicate the active membrane functions in the
      proximal tubules and suggest the functional continuity and structural
      relationship of these apical endocytic membrane systems.

PMID- 8490239
TI  - Quantitative analysis and cartography in scanning electron microscopy:
      application to the study of bacterial adhesion to respiratory epithelium.
AB  - This paper describes the coupling between a scanning electron microscope (SEM)
      and an image analysis workstation. The system was designed in order to drive the
      SEM and to analyse any sample. It allows automatic (edge detection) or
      semiautomatic (pointing, marking, drawing) object detection. Two types of data
      can be obtained: (1) topographical information, such as the location of the
      object within a region of interest drawn at any magnification of the microscope,
      or (2) quantitative data, such as morphometric characteristics of objects. In
      addition, high resolution maps of the section, regions of interest, and objects
      can be obtained with a laser printer. This software was first applied to
      quantitate the adhesion of the bacteria Pseudomonas aeruginosa to human
      respiratory epithelial cells in culture. P. aeruginosa was shown associated with
      ciliated cells. The second application concerned the study of the distribution of
      specific carbohydrate residues at the surface of the respiratory cells. The gal
      residues were revealed using the lectin Ricinus communis agglutinin II, adsorbed
      to colloidal gold particles. A relationship between the presence of adherent
      bacteria and labelling was shown.

PMID- 8490240
TI  - Differential distribution of major gangliosides in rat central nervous system
      detected by specific monoclonal antibodies.
AB  - We investigated the localization of major gangliosides in adult rat brain by an
      immunofluorescence technique with mouse monoclonal antibodies (MAbs). Five MAbs
      (GMB16, GMR17, GGR12, GMR5 and GMR13) that specifically recognize gangliosides
      GM1, GD1a, GD1b, GT1b and GQ1b, respectively, were used. We have found that there
      is a cell type-specific expression of the ganglioside in the rat central nervous
      system. In cerebellar cortex, GM1 was expressed in myelin and some glial cells.
      GD1a was detected exclusively in the molecular layer. GD1b and GQ1b were present
      restrictedly on the granular layer; GD1b was detected on the surface of the
      granular cell bodies, whereas GQ1b was present in the cerebellar glomerulus. GT1b
      was distributed intensely in both the molecular layer and the granular layer. In
      cerebral cortex, GM1 was detected in some glial cells. Dense staining was limited
      to the white matter. GD1a was distributed in layers I, II/III and Va, and the
      upper part of layer VI, whereas GQ1b was localized in layers IV and Vb, and the
      lower part of layer VI. GD1b was detected beneath layer III. GT1b appeared to be
      distributed throughout all layers. In other regions, such as hippocampal
      formation and spinal cord, the expression of the ganglioside was also highly
      localized to a specific cell type and layer.

PMID- 8490241
TI  - Purification and characterization of bovine mannan-binding protein.
AB  - Bovine mannan-binding protein (bMBP) was observed in serum by its Ca(2+)
      dependent binding to mannan and by an M(r) of 28 kDa under reducing conditions on
      sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The lectin
      was isolated by precipitation with polyethyleneglycol (PEG), affinity
      chromatography on mannan-Sepharose eluted with EDTA, and absorption on Sepharose
      4B rabbit anti-bovine Ig to remove anti-mannan antibodies. Fractions containing
      the lectin were reapplied to mannan-Sepharose and eluted first with N-acetyl-D
      glucosamine (GlcNAc) to remove conglutinin, and then with mannose to elute the 28
      kDa lectin. Further purification was achieved by ion-exchange chromatography on
      Mono-Q and by mannose-gradient elution from a mannan-Sepharose column. SDS-PAGE
      of the purified lectin showed three high molecular weight bands under non
      reducing conditions. The reduced protein gave a single band of 28 kDa. On gel
      permeation chromatography under non-dissociating conditions, the protein emerged
      at a volume corresponding to M(r) approximately 750 kDa. Amino acid analysis
      showed the presence of hydroxyproline and hydroxylysine, and a high glycine
      content (17.7%), suggesting the presence of a collagen-like structure. This was
      supported by the susceptibility of the protein to collagenase digestion. The N
      terminal 26 amino acids showed 62% identity with human MBP, when three gaps were
      allowed in the alignment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490242
TI  - Effects of overexpression of beta 1,4-galactosyltransferase on glycoprotein
      biosynthesis in F9 embryonal carcinoma cells.
AB  - beta 1,4-Galactosyltransferase (GalTase) plays a central role in the biosynthesis
      of N-acetyllactosamine-containing oligosaccharides. However, despite this
      seemingly important function, little is known about how changes in the levels of
      GalTase affect oligosaccharide biosynthesis. We have examined the effects of
      overexpressing GalTase on the glycosylation of endogenous glycoproteins in F9
      mouse embryonal carcinoma cells. Cells transfected with either the short form of
      the GalTase cDNA (encoding a protein of 386 amino acids) or the long form of the
      GalTase cDNA (encoding a protein of 399 amino acids) had a 3-fold increase in
      total GalTase activity, relative to control F9 cells. Analysis of pronase
      digested glycopeptides obtained from control and transfected cells after
      metabolic labelling with [6-3H]galactose revealed no significant qualitative or
      quantitative differences, as assessed by Bio-Gel P-6 gel filtration
      chromatography and Tomato lectin affinity chromatography. Furthermore, SDS-PAGE
      analysis of immunoprecipitated [3H]galactose-labelled lysosomal-associated
      membrane protein-1 (LAMP-1) glycoprotein showed no difference in amounts or
      mobility. Pronase digestion and subsequent analysis of the gel-fractionated LAMP
      1 glycoproteins also indicated no differences between the various cell lines. The
      inability of elevated GalTase activity to affect glycosylation was not due to
      limiting levels of GalTase substrates, since an excess of substrates was
      detectable in lysed cells using either endogenous or exogenous GalTase and UDP
      [3H]galactose. Finally, the subcellular distribution of GalTase, as assessed by
      sucrose gradient fractionation, was similar between all cell types, thus
      suggesting that GalTase was appropriately compartmentalized in the transfected
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490243
TI  - Cell differentiation in Dictyostelium discoideum controls assembly of protein
      linked glycans.
AB  - The prestalk and prespore cells from the Dictyostelium discoideum multicellular
      slug stage of development differ in assembly of glycoconjugates. Prespore cells
      are 2- to 3-fold more active than prestalk cells in the assembly of N-linked
      glycans and 20-fold more active in their fucosylation. Only prespore cells
      synthesize an O-linked glycan consisting in part of Fuc alpha-linked to N
      acetylglucosamine. Incorporation of fucose, glucosamine, mannose and galactose
      into large pronase-resistant glycoconjugates was almost exclusively into prespore
      cells. Such glucosamine-labelled glycoconjugates resist fragmentation by beta
      elimination and include a glycoantigen dependent on the modB genetic locus. In
      contrast, large fucose-labelled glycoconjugates consisted of multiple, small, O
      linked oligosaccharides on carrier peptides. The spore coat protein SP96 has
      several fucosylated O-linked oligosaccharides, one of which correlates with a
      fucose epitope previously shown to localize in prespore vesicles and the outer
      layer of the spore coat.

PMID- 8490244
TI  - Expression and characterization of a carbohydrate-binding fragment of rat
      aggrecan.
AB  - The COOH-terminal portion of cartilage proteoglycan core protein, aggrecan,
      expressed by in vitro translation, binds carbohydrate-containing affinity
      columns. The in vitro expression approach has been used to define the sugar
      binding portion of the core protein. The active fragment, which corresponds
      closely to the carbohydrate-recognition domains in the family of Ca(2+)-dependent
      (C-type) animal lectins, has been expressed in bacteria and characterized. The CD
      spectrum of the domain is very similar to the spectrum of the binding domain of
      serum mannose-binding protein, suggesting that its overall structure probably
      resembles the known three-dimensional structure of the mannose-binding domain.
      The binding specificity of the core protein fragment has been characterized using
      a solid-phase assay. The results suggest that the monosaccharide-binding site is
      also similar to that in other C-type carbohydrate-recognition domains.

PMID- 8490245
TI  - Core 2 GlcNAc-transferase and polylactosamine expression in O-glycans.

PMID- 8490246
TI  - Biological roles of oligosaccharides: all of the theories are correct.
AB  - Many different theories have been advanced concerning the biological roles of the
      oligosaccharide units of individual classes of glycoconjugates. Analysis of the
      evidence indicates that while all of these theories are correct, exceptions to
      each can also be found. The biological roles of oligosaccharides appear to span
      the spectrum from those that are trivial, to those that are crucial for the
      development, growth, function or survival of an organism. Some general principles
      emerge. First, it is difficult to predict a priori the functions a given
      oligosaccharide on a given glycoconjugate might be mediating, or their relative
      importance to the organism. Second, the same oligosaccharide sequence may mediate
      different functions at different locations within the same organism, or at
      different times in its ontogeny or life cycle. Third, the more specific and
      crucial biological roles of oligosaccharides are often mediated by unusual
      oligosaccharide sequences, unusual presentations of common terminal sequences, or
      by further modifications of the sugars themselves. However, such oligosaccharide
      sequences are also more likely to be targets for recognition by pathogenic toxins
      and microorganisms. As such, they are subject to more intra- and inter-species
      variation because of ongoing host-pathogen interactions during evolution. In the
      final analysis, the only common features of the varied functions of
      oligosaccharides are that they either mediate 'specific recognition' events or
      that they provide 'modulation' of biological processes. In so doing, they
      generate much of the functional diversity required for the development and
      differentiation of complex organisms, and for their interactions with other
      organisms in the environment.

PMID- 8490247
TI  - Combined TEM and SEM analysis of the rostral wall of the human III ventricle.
AB  - A combined morphological study using transmission and scanning electron
      microscopy was carried out on the central zone of the rostral wall of the III
      ventricle from a sample taken during the operation of a patient with a
      retrochiasmatic craniopharyngioma. Under the scanning electron microscope, the
      apical cell wall of the ependymocytes generally appeared folded and lack in
      cilia, but with numerous microvilli developed to different extents. The flat
      surface cells were scarce and were polygonal in shape and limited by 3-7
      prominent edges. Ultrastructural analysis revealed the existence of several types
      of ependymocytes and subependymal epithelial cells arranged in different layers;
      in both layers the presence of abundant neurofilaments and intercellular
      junctions was striking.

PMID- 8490248
TI  - Pinocytotic vacuoles in human dental pulp capillaries.
AB  - Dental pulp capillaries were studied in human. They were of the continuous type,
      with the exception of a small number which were of the fenestrated type, located
      in the vicinity of the odontoblasts. A characteristic morphological peculiarity
      was found in the endothelial cells. In places there was a large quantity of multi
      sized vacuoles. The vacuoles were evidently of pinocytotic origin, and their
      content was emptied into the extracapillary space. The initiation of their
      formation was indicated by the creation of cytoplasmic flaps, which could not be
      characterised as typical pseudopodia, and which in cross sections resembled
      microvilli. The flaps engulfed a quantity of plasma and then, after bending over,
      their edge fused with the cell, creating a vacuole. The vacuole, after being
      moved abluminally, was emptied into the pericapillary area by exocytosis. There
      was indication that flaps created at the borders of the endothelial cells
      (flanges) acted likewise, transporting vacuoles through the intercellular spaces.
      Micropinocytosis, was a distinctly different phenomenon, contributing, to a very
      small degree, to the intracellular enlargement of the vacuoles. It seems that
      this vacuolar mechanism of transportation serves an augmented metabolic need of
      the surrounding tissue.

PMID- 8490249
TI  - A quantitative description of the insulin-induced ultrastructural changes in
      newborn rat hepatocytes.
AB  - The effects of insulin on the ultrastructure of newborn rat hepatocytes were
      systematically quantified at satisfactory statistical significance. Insulin
      prevented the normal postnatal increase in the total volume of lysosomes and the
      breakdown of glycogen inside these organelles. The lysosomal glycogen-hydrolysing
      enzyme, acid alpha 1,4 glucosidase was inhibited by the hormone. Insulin also
      prevented the normal postnatal increase in the total volume of peroxisomes,
      especially of the crystalloid core-devoid type. The hormone produced an increase
      in the area of cell membrane, due to the formation of many irregular folds of the
      cell surface. These results constitute good evidence for participation of
      lysosomes and peroxisomes in the overall glycogen degradation and or
      gluconeogenesis in the newborn rat hepatocytes.

PMID- 8490250
TI  - Gastric intestinal metaplasia eleven years after randomized selective proximal
      vagotomy for peptic ulcer.
AB  - The presence of intestinal metaplasia (IM) 11 years after selective proximal
      vagotomy (SPV), selective proximal vagotomy with pyloroplasty (SPV + PP) and
      selective vagotomy with pyloroplasty (SV + PP) was investigated in 38 consecutive
      patients. IM was significantly more frequent in SPV than in SV + PP, SPV + PP or
      in unoperated controls of matching ages. IM occurred more frequently both at an
      older age (> or = 60 years) in SPV and in a larger number of gastric areas than
      in the other group of patients. Reports in the literature indicate that vagotomy
      may increase the risk of gastric carcinoma and that IM may antedate malignant
      transformation. It would thus appear that patients previously operated with SPV
      (without pyloroplasty) having IM, should be the group of patients to be enrolled
      in endoscopical surveillance programs for detection of possible cancer
      development.

PMID- 8490251
TI  - Pathological changes in organs of rats chronically exposed to hypoxia.
      Development of pulmonary lipidosis.
AB  - Rats were exposed to chronic normobaric hypoxia of progressively increasing
      severity; down to 8% or 7% oxygen concentrations. In addition to loss of weight,
      pathology revealed congestion, haemorrhages, hypertrophy of the heart involving
      mainly the right ventricle, thickening of arteries, ischaemic changes in the
      myocardium and extramedullary haematopoiesis in the spleen. Changes not described
      up until now were: 1) sheets of foam cells in the pulmonary alveoli; 2) foamy and
      solid storing cells in the spleen; 3) mucoid changes in the atrioventricular
      valve leaflets; 4) hyperplasia of the juxtaglomerular apparatus; 5) atrophy of
      the adrenal glomerulosa and hyperplasia of medulla; 6) atrophy of the
      perifollicular B-cell zone in the spleen; and 7) lipid pigment deposition in
      various organs. The findings indicate that severe chronic hypoxia induces a
      significant pulmonary lipidosis similar to that caused by amphiphilic cationic
      drugs, presumably by inhibiting hydrolytic enzyme activities. The observations
      are of importance in human hypoxic conditions and open the possibility of their
      rational treatment.

PMID- 8490252
TI  - Fine structure of the retinal epithelium of the tiger salamander (Ambystoma
      tigrinum).
AB  - The retinal pigment epithelium (RPE) of the tiger salamander (Ambystoma tigrinum)
      consists of a single layer of large squamous-shaped cells. These RPE cells are
      but minimally infolded basally (sclerally) but show numerous apical (vitreal)
      processes that interdigitate with the photoreceptor cells. A series of apically
      located tight junctions joins the RPE cells to form part of the blood-ocular
      barrier. Internally the RPE nucleus is large, vesicular and flattened. Smooth
      endoplasmic reticulum predominates in these cells with only occasional small
      profiles of rough endoplasmic reticulum present. Polysomes and basally-located
      mitochondria are plentiful. Golgi zones, lipid droplets, lysosome-like bodies and
      phagosomes of outer segment material are also present. Myeloid bodies which may
      show ribosomes on their surface are also numerous. The round to oval melanosomes
      undergo retinomotor movements and in the light-adapted state reach almost to the
      external limiting membrane. Bruch's membrane or complexus basalis shows a
      pentalaminate structure with the central elastic lamina poorly represented. The
      choriocapillaris is a single layer of large anastomosing capillaries which are
      but minimally fenestrated.

PMID- 8490253
TI  - Fine structure of the retinal photoreceptors of the tiger salamander (Ambystoma
      tigrinum).
AB  - The retinal photoreceptors of the tiger salamander (Ambystoma tigrinum) have been
      studied by light and electron microscopy in both light- and dark-adaptation. Rods
      and cones are present in this duplex retina in a ratio of about 20:1. As in other
      urodele species these photoreceptors are very large cells. The rod outer segment
      is composed of bi-membranous discs of uniform diameter displaying several very
      deep incisures. The rod inner segment displays an ellipsoid of mitochondria and a
      myoid region which changes in diameter during the lighting cycle indicating that
      rods undergo photomechanical movements. Rod nuclei are located at all levels of
      the outer nuclear layer and rod spherules are large and display several
      invaginated and superficial synaptic sites. Cone photoreceptors while large cells
      are smaller than the rods. They show a smaller tapering outer segment, a large
      distal ellipsoid of mitochondria and a prominent paraboloid of glycogen but no
      oil droplet within the inner segment. Judging by the width of the myoid region
      which remains similar throughout the lighting cycle, cones in this species show
      no retino-motor responses. Cone nuclei are less electron dense than rods and are
      also located at all levels of the outer nuclear layer. The cone synaptic pedicle
      is larger than that of the rods and also shows several invaginated and
      superficial synaptic sites.

PMID- 8490254
TI  - Lectin histochemical study on the kidney of normal and streptozotocin-induced
      diabetic hamsters.
AB  - Lectin histochemical characteristics of the kidney of normal and streptozotocin
      (SZ)-induced diabetic APA hamsters were investigated. Paraffin sections of the
      kidney of animals killed at 1 and 3 months after SZ-injection were stained with
      the following 10 lectins: PNA, BPA, DBA, SBA, GSA-I, GSA-II, MPA, WGA, UEA-1 and
      Con A. Renal lectin binding characteristics of normal APA hamsters differed in
      some aspects from those in other species reported previously. In the kidney of SZ
      induced diabetic APA hamsters, binding activities of some lectins increased in
      the affected Bowman's capsules and glomeruli as well as in degenerated epithelial
      cells of uriniferous tubules. Among them, GSA-II in particular exhibited strong
      binding activity to the degenerated epithelial cells of Bowman's capsules, distal
      convoluted tubules and collecting ducts.

PMID- 8490255
TI  - Histochemical localization of glycosaminoglycans in the omasal papillae of sheep.
AB  - Histochemical localization of the glycosaminoglycans in the omasal laminae were
      examined at light and electron microscopic levels. The core region of the omasal
      papillae was stained strongly with alcian blue at pH 2.5 and 1.0. The staining
      was degraded moderately and completely when tissue sections were pretreated with
      mild and active methylation, respectively. Alcianophilia was moderately decreased
      with saponification. Furthermore, enzymatic digestion procedures showed that
      these alcianophilic substances contained a large amount of hyaluronic acid and
      chondroitin sulphate. Ultrastructurally, a spider web-like structure was widely
      distributed among the spindle-shaped fibroblast-like cells and fibrous networks
      of collagen and elastin. These results suggest that the core region of the omasal
      papillae not only acts as a physical buffer resisting the local pressure from the
      lumen, but may also influence material transport through the omasal mucosa.

PMID- 8490256
TI  - Effects of chronic ethanol administration on the serotonin-producing cells in rat
      gastric antral and duodenal mucosa.
AB  - The present study describes our observations on optical and ultrastructural
      features of serotonin-containing cells in the rat antral and upper duodenal
      mucosa, utilizing optic morphometric measurements in a model of experimental
      chronic alcoholism of rat in which nutrition was well controlled. Male Wistar
      rats were given ethanol to provide 23 per cent of the total calories, while
      starch replaced ethanol isocalorically in controls. Twenty-five per cent of the
      calories were provided by protein in both groups. Blood levels of serotonin were
      significantly raised after chronic ethanol feeding (0.059 +/- 0.06 vs. 0.159 +/-
      0.012 micrograms/ml, p < 0.01). Decrease in the number of immunohistochemically
      detectable serotonin-containing cells was found in the pyloric gland mucosal area
      specimens of the chronically ethanol-treated rats (68.9 +/- 5.2 vs 43.3 +/- 3.0;
      p < 0.001). The immunohistologically-evaluated number of the same cells in the
      duodenal mucosa specimens was significantly decreased by alcohol feeding.
      Although total villi and crypt count per whole circular section, and the number
      of crypts per villus were not significantly changed either in control animals or
      in chronically ethanol-fed rats, decreased number of these cells per whole
      circular section (289 +/- 21.6 vs. 183 +/- 10.5; p < 0.001) per villus (2.52 +/-
      0.14 vs. 1.21 +/- 0.10; p < 0.001) and per crypts (0.97 +/- 0.08 vs. 0.79 +/-
      0.04; p < 0.05) were reported after alcohol consumption. In both control and
      experimental rats the cells were predominantly found in the basal half of the
      antropyloric mucosa. Alcohol did not lead to any changes in normal distribution
      of the duodenal serotonin-producing cells. The above quantitative changes in
      serotonin-producing cells were not accompanied by changes in their subcellular
      appearance in stomach and duodenal mucosa of alcohol-treated rat.

PMID- 8490257
TI  - Morphological changes induced by colchicine in the chick optic cup in early
      stages of development. A stereological study.
AB  - In this study chick embryo optic cups at HH stage 13 of development were analyzed
      under normal conditions and after inoculation with colchicine for 1, 2, 4, and 8
      h. Several changes were seen after these periods of treatment: 1) modifications
      of the structure, with thicker regions in the cup and a general decrease in the
      total volume according to the duration of exposure to the drug (about 4 times
      less than normal, 5,035 x 10(3) microns 3 vs 1,334 x 10(3) microns 3 after 8 h of
      treatment); 2) enlargement of the ventricular cavity and its closure, due to
      failure of approximation of retinal and pigmentary layers; 3) failure of lens
      development, with delay and impairment of pit formation and deformation of all
      structures; lens volume was less than normal (about 4 times less, 2,148 x 10(3)
      microns 3 vs 658 x 10(3) microns 3 after 8 h of treatment); 4) a general
      segregation of the cells making up the structure, principally in the more active
      proliferating zones. The local alterations found are described.

PMID- 8490258
TI  - Lectin histochemistry of salivary glands in the giant ant-eater (Myrmecophaga
      tridactyla).
AB  - The submandibular and buccal glands of the Giant Ant-eater (Myrmecophaga
      tridactyla) have been studied by means of a series of carbohydrate histochemical
      methods, including a broad spectrum of PO-lectin procedures. The seromucous cells
      (Gl. submandibularis) and mucous cells (Gl. buccalis) of the glandular acini, as
      well as the secretion in the excretory duct system exhibited very strong to
      strong reactions for neutral and acidic glycoconjugates. The serous cells of the
      buccal glands and the excretory duct cells reacted rather weakly. The different
      controls applied particularly emphasized that sialoglycoconjugates are the
      predominant ingredients of the saliva secreted. Lectin histochemical
      differentiation demonstrated a varying pattern of saccharide residues in these
      substances. In the submandibular glands the glycoconjugates (mostly
      proteoglycans) of the seromucous cells and the luminal secretion normally
      contained terminal beta-galactose and minor contents of terminal alpha-N
      acetylglucosamine. After sialidase digestion this cell type exhibited distinct
      amounts of sialic acid-beta-galactose and sialic acid-alpha-N
      acetylgalactosamine. Sialic acid was also clearly present in the tough
      interlobular connective tissue. The buccal glands showed a similar distribution
      of saccharide residues in the mucous cells. In the serous cells, however, acidic
      glycoproteins with sialyl residues were observed, also containing terminal alpha
      D-mannosyl, alpha-N-acetylgalactosaminyl, and beta-D-galactosyl residues. The
      cells of the excretory duct system of both gland types reacted weakly to
      moderately for terminal sugar residues (N-acetyl-D-glucosamine, N-acetyl-D
      galactosamine, beta-D-galactose). The results obtained are discussed in view of
      the specific feeding mode of the Giant Ant-eater, whereby high contents of
      sialoglycoconjugates (proteoglycans, glycoproteins) produced by the salivary
      glands warrant for the main function of the non-sticky saliva; i.e., to act as an
      effective lubricant during tongue movement.

PMID- 8490259
TI  - Cellular proliferation and/or differentiation can condition modifications in the
      expression of AgNORs in rat anterior pituitary cells during growth.
AB  - The expression of argyrophilic nucleolar organizer regions (AgNORs) was studied
      in the anterior lobe of the hypophysis of 1-, 7-, 14-, 28- and 80-day-old rats.
      Mean area and numbers of AgNORs per nucleus decreased during this period with a
      simultaneous increase of both nuclear area and mean AgNOR-particle area.
      Comparison of our data on AgNOR expression with previously reported data on the
      proliferative activity and cell maturation and differentiation of anterior
      pituitary cells during a similar period led us to conclude that, at least in our
      experimental model, variations in the expression of AgNORs are more related to
      phenomena of cellular maturation than to proliferative activity.

PMID- 8490260
TI  - Selective immunolabeling of early gestational cytotrophoblast and its neoplastic
      counterpart by the monoclonal antibody Ber-EP4.
AB  - This report presents preliminary observations on the distribution of an
      epithelial surface antigen in human trophoblastic cells studied with the
      monoclonal antibody Ber-EP4 by means of an immunoperoxidase technique. Three
      cases of gestational choriocarcinoma and 20 cases of both villous and
      extravillous trophoblast, including one complete hydatidiform mole and one
      exaggerated placental site, were examined with a panel of monoclonal antibodies
      against epithelial antigen (Ber-EP4), cytokeratin (AE1 and AE3), vimentin (VIM),
      carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA), as well as
      with polyclonal antibodies against the beta subunit of human chorionic
      gonadotropin (hCG), human placental lactogen (hPL) and placental alkaline
      phosphatase (P1AP). While, as anticipated, all currently defined trophoblastic
      cell lines expressed low molecular weight cytokeratin only first trimester
      cytotrophoblastic cells and their neoplastic counterpart were found to possess
      the epithelial antigen detected by Ber-EP4. This distinctive property of the
      cytotrophoblast declined rapidly after eight weeks of gestational age but
      persisted in second trimester molar tissue and was prominently displayed in
      choriocarcinoma. By identifying the presence of cytotrophoblastic cell lines in
      malignancy more reliably than can be achieved with conventional panels of hCG,
      hPL and P1AP, Ber-EP4 has potential diagnostic utility in gestational
      trophoblastic disease. Our findings also suggest that the monoclonal anti-CEA
      antibody may be helpful in distinguishing between syncytiotrophoblastic cells and
      non-reactive multinucleate cells of the intermediate trophoblast.

PMID- 8490261
TI  - Morphological properties of human thyroid tumor cells in collagen gel culture and
      metastatic or invasive ability.
AB  - Using normal human thyroid cells and tumor cells, the reconstruction of various
      diseased cells in collagen gel as well as the relationship between the morphology
      of colonies in collagen-embedded culture and the biological behavior (benignity,
      malignancy, metastasis, and invasion) of the original tumors were studied. In
      collagen gel culture, normal thyroid cells reorganized follicle-like
      constructions, and follicular adenoma cells showed in vivo-like constructions.
      However, two different types of colonies were observed in cultures of cells from
      papillary carcinomas. One was the branching type with many outgrowths projecting
      to three dimensions and the other was the spherical type without any outgrowths.
      These spherical colonies were observed in all cases of papillary carcinoma, but
      varied from one case to another. Metastasis and invasion were detected during
      pathological examination in cases with a high ratio of spherical colonies. Our
      results indicate that cells from highly metastatic and invasive thyroid cancer
      form spherical colonies in the collagen gel culture, and that this collagen
      culture is a useful method for studying the heterogeneity of tumor cells as well
      as the metastasis and invasive ability of tumor cells in vitro.

PMID- 8490262
TI  - Tumor-infiltrating lymphocytes expressing IOT-10 marker. An immunohistochemical
      study of a series of 185 brain tumors.
AB  - The presence of IOT-10-positive lymphocytes among the tumor-infiltrating
      lymphocyte (TIL) population was studied in a series of 185 brain tumors. In most
      of the tumors, IOT-10-positive lymphocytes were identified, but generally they
      were scarce and masked among the tumor cells, suggesting that NK-cells exercise a
      poor participation in the tissular response against brain tumors. Isolated tumor
      cells showing IOT-10-positivity were found in low-grade astrocytomas, neurinomas
      and medulloblastomas. IOT-10-positivity on both tumor neuropil and tumor cells
      was considered a characteristic finding in oligodendrogliomas. The number of IOT
      10-positive NK-cells in brain metastases and in cerebellar hemangioblastomas was
      comparatively greater than in other types of brain tumor. Since in brain
      metastases, the presence of IOT-10-positive NK-cells can be related to the
      tissular response to an extracerebral malignancy, their considerable presence in
      cerebellar hemangioblastomas is an enigmatic finding that deserves further
      attention.

PMID- 8490263
TI  - Characterization of the glycoconjugate sugar residues in developing chick
      esophageal epithelium.
AB  - The development of the esophagus in the chick embryo is characterized by
      remarkable morphological changes especially at the level of the epithelium. Using
      horseradish peroxidase-conjugated lectins (DBA, PNA, SBA, WGA, ConA, LTA, UEAI)
      we have studied, at the level of the esophagus of chick embryos from the 8th to
      the 21st day of incubation and of 1- and 2-day-old chicken, the evolution of the
      saccharidic moieties of glycoconjugates, which precedes and/or is concomitant
      with the epithelial morphological transformations. We have found differences in
      content and cellular distribution of oligosaccharides during the histogenetic
      processes which characterize the lining and glandular epithelium. Before the
      appearance of cilia and mucus secretion at the bathyprismatic epithelial cells,
      the sugar residues D-galactose-(beta 1-->3)-N-acetyl-D-galactosamine, beta-N
      acetyl-D-galactosamine and alpha-L-fucose were detected only at the luminal cell
      surface. These oligosaccharides were probably involved in giving rise to the
      polarization of the esophageal epithelial cells. The esophageal gland mucus was
      first characterized by the presence of alpha-L-fucose and afterwards also by the
      presence of D-galactose-(beta 1-->3)-N-acetyl-D-galactosamine, D-glucosamine and
      sialic acid.

PMID- 8490264
TI  - Effects of bombesin and neuromedin-B on the proliferative activity of the rat
      adrenal cortex.
AB  - Bombesin (BM) and neuromedin-B (NMB) exert similar biological effects, acting via
      two functionally distinct BM-receptor subtypes. The present study aimed to
      investigate whether BM and NMB stimulate the proliferation of rat adrenocortical
      cells and to compare their mode of action. Adult female rats were treated with a
      single subcutaneous dose of 3 micrograms BM or NMB. Adrenocortical proliferative
      activity was assessed by the metaphase-arrest technique. BM administration
      resulted in a marked increase in the number of metaphases in zona glomerulosa
      (ZG) and zona fasciculata (ZF), and in the entire cortex. This increase appeared
      24 h after injection in the ZG, and after 48 h in the ZF. NMB administration, on
      the other hand, caused a prompt increase in the number of metaphases in the ZG
      and entire cortex at 12 h, followed by a subsequent drop below the control level
      at 24 and 48 h of experiment. These findings indicate that BM and NMB enhance the
      proliferative activity of rat adrenocortical cells acting via different receptors
      or different mediators.

PMID- 8490265
TI  - In vitro antigen trapping by gill cells of the rainbow trout: an
      immunohistochemical study.
AB  - An in vitro assay was used to study the involvement of gill cells in the trapping
      and processing of particulate antigens. Gills were routinely processed for light
      microscopy after being placed in medium containing either Yersinia ruckeri O
      antigen-labelled fluorescent beads, unlabelled fluorescent beads, Y, ruckeri O
      antigen or formalin-killed Y. ruckeri, for 0, 30 s, 1, 5 and 30 min. Y. ruckeri
      formalin-killed cells, Y. ruckeri O-antigen and fluorescent beads labelled with
      Y. ruckeri O-antigen were taken in by gill epithelial cells as soon as 30 s after
      administration. In contrast, unlabelled fluorescent beads adhered to the
      epithelial cell membranes, but did not occur inside the gill cells. These results
      are discussed principally in relationship with the specificity of antigen
      trapping.

PMID- 8490266
TI  - Reverse lectin histochemistry: design and application of glycoligands for
      detection of cell and tissue lectins.
AB  - Plant and invertebrate lectins are valuable cyto- and histological tools for the
      localization of defined carbohydrate determinants. The well-documented ubiquitous
      occurrence of sugar receptors encourages functional considerations. Undoubtedly,
      analysis of the presence of vertebrate lectins in tissues and cells is required
      to answer the pertinent and tempting question on the physiological relevance of
      protein (lectin)-carbohydrate recognition in situ. Carrier-immobilized
      glycoligands, derived from custom-made chemical synthesis, enable the
      visualization of respective binding sites. Histochemically inert proteins or
      synthetic polymers with appropriate functional groups are suitable carrier
      molecules for essential incorporation of ligand and label. The resulting
      neoglycoconjugates can track down tissue receptors that are neither impaired by
      fixation procedures nor blocked by endogenous high-affinity ligands. Lectins,
      especially the receptors of the tissue under investigation (endogenous lectins),
      and appropriately tailored immobilized glycoligands or lectin-specific antibodies
      (when available) are complementary tools to test the attractive hypothesis that
      diverse, functionally relevant glycobiological processes within or between cells
      are operative. Concomitant evaluation of both sides of lectin histochemistry,
      namely lectins as tools and lectins as functionally important molecules in situ,
      will indubitably render desired progress amenable in our often still fragmentary
      understanding of the importance of tissue lectin and glycoconjugate expression
      and its regulation.

PMID- 8490267
TI  - Epithelial stem cells and their possible role in the development of the normal
      and diseased human breast.
AB  - The developing breasts of peripubescent girls consist of ducts and budded
      structures, which can subdivide to alveolar buds/lobules with advancing maturity
      and finally to secretory alveoli during pregnancy and lactation. Immunochemical
      reagents have been used to visualize the three major cell types in histological
      sections of mature/pregnant breasts, the epithelial cells which line
      ducts/ductules, the smooth muscle-like myoepithelial cells and the casein
      secretory alveolar cells. Ductal budded structures contain basal cells
      intermediate in immunocytochemical staining characteristics between epithelial
      and myoepithelial cells. Immortalization of primary epithelial cultures of normal
      breasts by simian virus 40 yields epithelial cell lines that can differentiate to
      myoepithelial-like and to secretory alveolar-like cells; similar cell types are
      identifiable in primary cultures. Immunocytochemical staining shows that both
      hyperplastic and neoplastic benign lesions contain myoepithelial-like cells, and,
      under suitable hormonal conditions, alveolar-like cells, but invasive carcinomas
      contain neither differentiated cell type. Primary cell cultures of benign
      hyperplastic and neoplastic lesions contain epithelial, myoepithelial-like and
      presumptive alveolar-like cells whilst malignant cell fractions of invasive
      carcinomas contain only epithelial cells. Spontaneously-immortalized epithelial
      cell lines from hyperplastic benign breast disease can generate myoepithelial
      like and alveolar-like cells, whilst standard epithelial cell lines from pleural
      effusions and novel epithelial cell lines from primaries of invasive carcinomas
      fail to differentiate to either cell type. It is suggested that
      epithelial/intermediate stem cells exist in a basal position predominantly in
      terminal structures of growing breasts, and that they are the major cell type
      involved in benign hyperplastic, benign neoplastic and malignant breast diseases.
      The acquisition of the malignant phenotype is associated with the carcinoma cells
      having a greatly impaired ability to differentiate to myoepithelial and to
      alveolar cells.

PMID- 8490268
TI  - Effects of chromium, copper, nickel, and zinc on longevity and reproduction of
      the cladoceran Moina macrocopa.

PMID- 8490269
TI  - Toxicity testing with coastal species of southeastern Brazil. Echinoderm sperm
      and embryos.

PMID- 8490270
TI  - Uptake of pentachlorophenol in fish of acidified and nonacidified lakes.

PMID- 8490271
TI  - Recovery of Nostoc muscorum previously exposed to some triazine and phenylurea
      herbicides.

PMID- 8490272
TI  - Preliminary laboratory investigation of the bioconcentration of zinc and iron in
      selected tissues of the banded tilapia, Tilapia sparrmanii (Cichlidae).

PMID- 8490273
TI  - Electron microscopic study of the liver of Tilapia nilotica exposed to
      neopybuthrin.

PMID- 8490274
TI  - Accumulation and transfer of copper by Oocystis pusilla.

PMID- 8490275
TI  - Heavy metals in oysters from a subtropical coastal lagoon associated with an
      agricultural drainage basin.

PMID- 8490276
TI  - Rapid respirometric toxicity test: sensitivity to metals.

PMID- 8490277
TI  - Cadmium uptake and distribution in three cultivars of Lactuca sp.

PMID- 8490278
TI  - Actin filaments disassembly: a novel step in the genesis of paraquat toxicity?

PMID- 8490279
TI  - Carious teeth as indicators to lead exposure.

PMID- 8490280
TI  - Validity of hair cadmium in detecting chronic cadmium exposure in general
      populations.

PMID- 8490281
TI  - Effects of sublethal concentrations of aflatoxins on the reproductive performance
      of mink.

PMID- 8490282
TI  - Assessment of indoor exposure to polycyclic aromatic hydrocarbons for urban poor
      using various types of cooking fuels.

PMID- 8490283
TI  - Membrane disordering effect of thiram as assessed by brain synaptosomal and
      erythrocyte membrane constituents.

PMID- 8490284
TI  - Trihalomethane induced alterations in the content of metallothionein and in the
      activities of heme metabolizing enzymes in rats.

PMID- 8490285
TI  - AIDS: impact on the health care system.

PMID- 8490286
TI  - The high cost of hospital trauma care: an analysis of hospital length of stay,
      injury severity score, case mix index, and reimbursement-to-cost ratio.
AB  - We conducted a study to evaluate reimbursement characteristics for an urban
      hospital providing a high volume of trauma care. Complete clinical and financial
      data for 209 trauma patients admitted to the Bronx Municipal Hospital Center
      during September 1990 were entered into a trauma registry. Patients were
      categorized into three groups. Group 1 fulfilled criteria for reimbursement using
      the New York State Major Diagnostic Category 25 (NYSMDC 25) for trauma. Group 2
      patients fulfilled New York City Emergency Medical Service 911 criteria for
      transport to a level 1 trauma center. Group 3 patients did not fit either
      category. Analysis included age, race, sex, length of stay, injury severity
      score, case mix index, payer source, and reimbursement-to-cost ratio. Of the
      patients studied, 77.5% were men. Hispanic, African-American, and white patients
      constituted 40.2%, 26.3%, and 17.2%, respectively, of the study population. The
      payer mix was 36.6% Medicaid; 20.8% self-pay; 19.1% no fault; 9.6% Blue Cross;
      5.5% Medicare; 5% commercial; and 3.3% other. The study demonstrated that
      criteria for group 1 and group 2 define patients who constitute a distinct
      clinical group by injury severity score. As expected, the length of stay and case
      mix index were significantly higher for group 1, but they did not differ between
      group 2 and group 3. Group 1 was a small proportion (7.7%) of trauma patients
      admitted to the Bronx Municipal Hospital Center level 1 trauma center. Trauma
      admissions were treated at a net loss, with a projected high annual deficit of
      $5.3 million.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490287
TI  - Effect of cholecystokinin on food intake at different stages of the estrous cycle
      in female rats.
AB  - Effects of cholecystokinin octapeptide (CCK-8) on feeding behavior were examined
      in male and female rats. After an 18-hour fast, ad lib food intake for 30 minutes
      was measured for each rat. In male rats, food intake measured for 30 minutes was
      significantly decreased by intraperitoneal injection of 0.25 to 1 microgram/kg of
      CCK-8 in a dose-dependent manner. The satiety effect of CCK-8 was blocked by L
      364,718 (20 nmol/kg), a specific cholecystokinin receptor antagonist. In female
      rats, food intake at proestrus and estrus was significantly less than that at
      diestrus. Food intake of female rats at diestrus and metestrus was significantly
      decreased by an intraperitoneal injection of CCK-8 prior to feeding, but it was
      not affected at proestrus and estrus. The effect of CCK-8 on food intake at
      diestrus and metestrus was dose dependent and was nearly abolished when 20
      nmol/kg of L-364,718 was administered simultaneously. The results of this study
      suggest that stages of the estrous cycle affect feeding behavior of rats.
      Further, cholecystokinin's regulatory action on feeding behavior appears to be
      effective at diestrus and metestrus, but not at proestrus and estrus.

PMID- 8490288
TI  - Spirochetal antibodies in tropical spastic paraparesis: their significance.
AB  - The prevalence of antibodies to Treponema pallidum and Borrelia burgdorferi was
      investigated in Jamaicans with tropical spastic paraparesis (TSP). A
      significantly higher prevalence of reactive serologic tests for syphilis (STS)
      was found in TSP patients (35.0%) when compared with controls (14.5%; P < .001).
      Venereal Disease Research Laboratory (VDRL) test titers less than 1:8 were
      obtained in 88.4% of reactive sera from patients and in all reactive sera of
      controls. The biologic false-positive rate was also significantly higher in TSP
      patients (P < .05). A higher frequency of a reactive STS was observed in TSP
      patients (P < .01) and controls (P < .001) more than 40 years of age. The
      prevalence of reactive serologic tests for syphilis in TSP patients younger than
      40 years was also higher than in controls in this age group (P < .1). The
      prevalence of positive immunofluorescent antibody tests and enzyme immunoassay
      for antibodies to B burgdorferi was similar in sera of TSP patients (12.5%) and
      healthy controls (10%). However, none of the sera was positive by Western
      immunoblot. Leptospiral antibodies were not present in any serum tested. This
      study's data do not support an etiologic role for treponemal disease in tropical
      spastic paraparesis, but rather suggest that the high prevalence of reactive STS
      in Jamaicans is multifactorial.

PMID- 8490289
TI  - Effect of cold stress on coronary sinus blood flow in patients with scleroderma.
AB  - The mechanism of cardiac involvement in scleroderma is not known. Histologic
      studies of the myocardium in patients who died of scleroderma revealed that half
      had myocardial damage. Characteristic involvement ranges from focal contraction
      band necrosis to diffuse fibrosis despite the absence of obstructive coronary
      artery disease of the major epicardial vessels. These findings suggest that
      scleroderma heart disease might result from episodic reduction of coronary blood
      flow due to abnormalities of coronary vasomotor tone. Studies using cold pressor
      thallium 201 myocardial perfusion scans support this hypothesis. Our study
      measured coronary blood flow during hand immersion in ice water at cardiac
      catheterization to determine whether patients with scleroderma had an abnormal
      coronary blood flow response. Coronary sinus blood flow was measured using a
      thermodilution method. Five patients with scleroderma were compared with 5
      control subjects. All patients and controls had normal coronary angiograms. The
      coronary blood flow at baseline in the scleroderma and the control group (130 +/-
      33 mL/min and 86 +/- 27 mL/min, respectively) was not significantly different.
      During the cold pressor test, both groups had a small, insignificant increase in
      coronary blood flow from baseline to 60 seconds (130 to 144 mL/min, scleroderma
      patients; 86 to 89 mL/min, control subjects). Our findings suggest that the cold
      pressor test does not cause an abnormal increase in coronary vasomotor tone or an
      absolute reduction in coronary blood flow in patients with scleroderma, as
      previously suggested by thallium 201 cold pressor studies.

PMID- 8490290
TI  - [Differential diagnostic strategies in uncertain vision disorders].
AB  - The differential diagnosis of visual disturbances of unclear origin can cause
      major problems in ophthalmology, especially if there are no functional defects or
      if functional defects cannot be explained by morphological findings after an
      extensive regular ophthalmological investigation. The aim of this paper is to
      present strategies that allow subtle visual disturbances to be related to certain
      groups of functional defects. Especially simple investigations are emphasized
      that lead quickly to a well-founded possible diagnosis that helps both the
      ophthalmologist and patient save time and cost-consuming deviations. The key
      investigations are: (1) a symptom-oriented case history; (2) exclusion of
      refractive problems by pin-hole test, retinoscopy and ophthalmometry; (3) the
      swinging flashlight test; (4) ophthalmoscopy of the macula and optic disc; (5)
      visual field. A flow chart is presented that explains the strategy of additional
      special investigations based on the results of the key findings in order to
      approach quickly the cause of a visual disturbance. Some of the more common
      causes of visual disturbances of unclear origin are discussed, including some
      major therapeutic principles.

PMID- 8490291
TI  - [New diagnostic aids in automatic perimetry].
AB  - The Conformity Analysis is a new procedure for objective recognition of specific
      defect patterns in automated perimetry. The "Conformity Index," the measure of
      conformity between the distribution of defect values and several standard defect
      patterns, is calculated from the ratio of global variance and mean variance in
      particular regions. Using 68 visual fields from 68 normal persons, we determined
      normal values and limits of the Conformity Index for seven standard defect
      patterns: hemifields right-left, hemifields upper-lower, quadrants, sectors,
      rings with 5 degrees and 10 degrees radius interval and the perimetric nerve
      fiber bundles of Weber and Ulrich. The evaluation of 148 visual fields (68 normal
      eyes, 80 eyes with chronic glaucoma and all stages of damage) by both the
      Conformity Index and two experienced clinicians revealed an identical result in
      89%. Using the Conformity Analysis in 37 cases of pituitary adenoma, we could
      objectively identify quadrants, sectors and hemifields right-left to be the most
      common defect patterns in this disease. In glaucoma fields with marked damage (n
      = 46), the most frequent pathological Conformity Index was the index for
      perimetric nerve fiber bundles.

PMID- 8490292
TI  - [In incipient glaucoma the pattern electroretinogram displays diffuse, retinal
      damage].
AB  - The pattern electroretinogram (PERG), a noninvasive tool to measure the activity
      of retinal ganglion cells, shows changes in early glaucoma. We wanted to
      investigate whether or not the PERG is preferentially affected when the Bjerrum
      area is stimulated. We recorded the PERG from 17 eyes in 17 patients with initial
      stages of visual field defects due to open-angle glaucoma and from 10 eyes in 10
      normal subjects. Counter-phasing checkerboard patterns were used as visual
      stimuli with a check size of 0.8 degrees at 16 reversals/s and 98% contrast.
      Three visual field extents were stimulated: (1) full screen (31 degrees x 27
      degrees), (2) central stimulation with a diameter of 14 degrees, (3) peripheral
      stimulation = full screen with central mask of 14 degrees in diameter. The latter
      stimulus covers the regions where traditionally glaucomatous defects are expected
      early. In glaucoma patients, there was a significant decrease in the PERG
      amplitude compared to normals. This reduction was very similar for all three
      stimuli (42%, 52% and 47%, respectively). Thus, the PERG amplitude is reduced to
      a similar degree both in regions of the visual field where early damage is found
      (Bjerrum area) and in the central area. This result suggests that in early
      glaucoma there is focal as well as diffuse retinal damage.

PMID- 8490293
TI  - [The Freiburg Vision Test. A computer-assisted procedure with sequential
      strategy].
AB  - Single Landolt Cs were presented in one of four positions on a monitor. Subjects
      responded by pressing one of four buttons (forced choice). A computer selected
      the size of the Landolt Cs on a logarithmic scale using the "Best PEST" algorithm
      (Best Parameter Estimation by Sequential Testing), a modern procedure to measure
      psychophysical thresholds. For comparison, conventional measurements according to
      DIN 58220 (Deutsche Industrie Norm) were performed with Landolt Cs projected in
      eight positions, using three out of five correct responses as the threshold
      criterion. Examination of 23 patients (most of them with senile cataract) did not
      show any significant difference between the two tests in either visual acuity or
      reproducibility on two consecutive days. The coefficients of variation between
      sessions were 22% for the Freiburg test and 26% for the DIN test and 18% between
      the two tests, pooled over two sessions. The Freiburg acuity test thus appears to
      be numerically equivalent to the DIN 58220 procedure. In addition, it has a
      number of advantages: (1) examiner-dependent variability is reduced; therefore,
      the test can be used by inexperienced examiners; (2) the forced choice technique
      is used rigorously; (3) mistakes in confounding oblique directions are largely
      avoided; (4) the procedure is about twice as fast.

PMID- 8490294
TI  - [The effect of triamterene on the ERG of Long-Evans rats].
AB  - Dopamine is an important mediator of the neuronal adaptation mechanism of the
      retina. Tetrahydrobiopterin (BH4) is cofactor of the rate-limiting enzymatic
      tyrosine-hydroxylase step in the biosynthetic pathway of dopamine. This enzymatic
      step causes an oxidation of BH4 to dihydrobiopterin (BH2), which is reduced again
      to BH4 by action of dihydropterin-reductase (DHPR) and dihydrofolate-reductase
      (DHFR). Triamterene, a pterin derivate, is known to induce DHFR after initial
      inhibition. Concomitant elevation of retinal BH4 will result in a higher dopamine
      concentration. ERG changes of Long-Evans rats mediated by this triamterene effect
      on dopamine concentration were examined after the rats received triamterene with
      tap water in two experimental series for 5 and 11 days. After 5 days of
      triamterene administration a significant decrease of scotopic a- and b-wave ERG
      amplitudes were registered. After 11 days of triamterene application the decrease
      could be shown to be even more substantial. This effect was completely
      reversible: 10 weeks after cessation of triamterene supply ERG amplitudes
      increased to previous levels. The observed transient ERG changes support the
      concept of biopterin as an mediator of neuronal adaptation mechanisms of the
      retina.

PMID- 8490295
TI  - [Right shift in the EOG].
AB  - The evaluation of 1000 consecutively recorded EOGs showed in 10% of all cases a
      phenomenon which we called right shifting of the EOG: Dark trough and/or light
      peak were delayed. In cases of macular disease, atypical pigment degeneration and
      in control records during Chloroquine therapy we found right shifting more
      frequent.

PMID- 8490296
TI  - [Blue-sensitive mechanisms in pattern ERG and VEP].
AB  - Pattern onset-offset ERGs and VEPs in response to square-wave stripe patterns of
      different wavelengths and spatial frequencies under chromatic yellow adaptation
      (two-channel Maxwellian view) were studied in three subjects. One channel
      provided a steady homogeneous adapting field of 570 nm, while the other channel,
      containing the patterns, was superimposed on the adapting field (33 degrees). The
      spectral sensitivity curve of the ERG had a prominent peak in the blue (460 nm)
      and a shoulder in the red and green (above 500 nm). For wavelengths below 500 nm
      the shape of the psychophysically determined sensitivity curve to the onset and
      offset of the pattern was in close agreement with the electroretinal sensitivity
      curves determined for a low-amplitude criterion. With almost all wavelengths
      there were two components in the same VEP response at the same time: a slow
      negative wave with maximum sensitivity at 460 nm and an earlier fast positive
      component with maximum sensitivity in the red-green region. When the spatial
      frequency of a 460 nm test pattern was varied under yellow adaptation the onset
      response in the ERG showed only very slight spatial tuning. In the onset response
      of the VEP, however, the slow component showed prominent spatial tuning (around 2
      c/deg) under the same conditions.

PMID- 8490297
TI  - [Pattern-induced flicker colors. An ophthalmologic examination method].
AB  - The pattern-induced flicker colours (PIFC), which belong to the subjective
      colours, are presented here as a method of investigating diseases of the eye and
      the visual track. Starting with Benham's top, new methods are elaborated for
      producing PIFC by means of rotating black and white discs and a computer
      controlled black and white monitor. The investigations were performed in 40
      normal and 111 pathological cases. A differentiation is made concerning the
      neuronal X-Y system. Different deficiencies result from different diseases. The
      PIFC are particularly suitable for the differential diagnosis of the neuritis
      nervi optici.

PMID- 8490298
TI  - [Reference to the Abney effect within the scope of linear opponent-color theory].
AB  - The Abney effect states that desaturation of spectral colours does not only
      change their chromatic saturation but also their hue. By means of Hering's
      perceptual criteria "neither blue nor yellow" and "neither green nor red" and
      heterochromatic brightness matching, chromaticity loci were measured in a visual
      tri-stimulus colorimeter; the loci served for construction of an opponent-colour
      triangle and the associated opponent-colour space. The chromaticity line
      resulting from the perceptual criterion "neither green nor red" deviated markedly
      -as an expression of the Abney effect--from a straight line. This phenomenon was
      captured by piecewise linearizing. The transformation of the (known) fundamental
      colour space, which may be interpreted as a cone excitation space, onto the
      opponent colour space thus gained yielded an explicit opponent-colour theory that
      reproduces some aspects of the Abney effect.

PMID- 8490299
TI  - [Surgical correction of high degree corneal astigmatism].
AB  - Many patients with high-grade corneal astigmatism cannot tolerate correction with
      spectacles or contact lenses. In contrast to myopic patients, in these cases
      visual rehabilitation can only be achieved surgically. In 1990 we started to
      perform modified corneal T-incisions in cases with high-grade astigmatism and
      intolerance to glasses or contact lenses. According to the eligibility criteria
      for selection of patients only 12 eyes were operated on in 1990: 9 eyes were
      affected by congenital high-grade astigmatism (mean 5.25 D); 1 had 8.5 D
      astigmatism after perforating injury, keratoplasty and cataract operation; 1 had
      2.5 D astigmatism after perforating injury; and 1 eye showed 5.0 D astigmatism
      following cataract surgery. Without exception, the astigmatism was significantly
      reduced, from a preoperative mean of 5.25 D to a mean of 2.0 D postoperatively.
      The most impressive change was the improvement of uncorrected visual acuity. No
      complications were observed and none of the patients complained of postoperative
      glare. These results have encouraged us to continue with surgical correction of
      high-grade corneal astigmatism.

PMID- 8490300
TI  - [Endothelial cell transplantation in a model].
AB  - Human donor corneas that were unsuitable for transplantation were denuded of
      their endothelium and then used as substrates for seeding in vitro cultured human
      or porcine corneal endothelial cells. Only cells that expressed an endothelial
      like morphology in vitro formed a monolayer on the denuded matrix whereas
      fibroblast-like cells showed no redifferentiation. The maximal achieved cell
      density was 3,500 cells/mm2 if porcine cells were used and 1,800 cells/mm2 for
      human cells. Adhesion of the cells was best if the subendothelial matrix was
      carefully prepared mechanically. Moreover, cell seeding was improved by slight
      centrifugation. Fibroblast growth factor (FGF), which enhanced endothelial cell
      proliferation in vitro, did not influence proliferation after cell
      transplantation, but seemed to allow better regeneration of the newly formed
      monolayer on the corneas.

PMID- 8490301
TI  - [Duration of fluorescein diacetate in corneal endothelium].
AB  - Fluorescein diacetate (FDA) is a suitable substance for vital staining of corneal
      endothelium. Uptake and metabolism is an active process. This means that a
      fluorescing cell must be functionally intact. The duration of endothelial
      fluorescence is limited and should be tested in an experimental study. Cultured
      endothelial cells (calf aorta endothelial cells) were stained by FDA and the loss
      of fluorescence time registered. We tested corneal buttons in the same way. The
      cultured endothelial cells showed no fluorescence after 2 h and the corneal
      buttons after 40-50 min. The fluorescence of FDA-stained endothelial cells
      decreases both in cultured cells and in whole corneal buttons, but this is not a
      sign of loss of endothelial viability. This fact must be taken into consideration
      when interpreting the results of FDA staining.

PMID- 8490302
TI  - [HLA typing in high risk keratoplasty].
AB  - Improved microsurgical techniques and better immunosuppressive treatment have led
      to an increase in the number of corneal transplantations. However, graft
      rejection due to a disparity between donor and recipient major histocompatibility
      antigens remains the major complication. The risk of graft rejection is further
      increased in patients with vascularized graft beds and in presensitized persons.
      Well-designed experimental studies and clinical experience have clearly shown the
      importance of class-I-antigens. However, class-II antigens have not yet been
      studied to the same extent. METHODS: Multiorgan donors and corneal graft
      recipients were HLA typed using the lymphocytotoxicity test previously described
      by Terasaki. The recipients were typed retrospectively. Cadaver corneal graft
      donors were typed using a novel HLA typing technique on retinal pigment
      epithelial cells, as previously described by us. Postoperatively, all recipients
      were routinely examined for rejection over a period of 2 years. RESULTS: Graft
      rejection was observed in 25% of the 133 high-risk patients. Of the 13 class-I
      typed patients who showed a rejection 9 persons had two or more major
      histocompatibility mismatches. Of the 12 patients without rejection problems only
      5 had two or more HLA class-I-mismatches. Of the patients with one or two matches
      at the HLA-DR locus there were only 4 out of 9 patients with at least one graft
      rejection; 5 out of 6 patients showed no signs of rejection. CONCLUSIONS:
      Mismatches at either class-I- or class-II- gene loci lead to a higher frequency
      in corneal graft rejection. Apart from the major histocompatibility mismatches,
      other factors also influence graft rejection, such as the distance between the
      corneal transplant and corneal vessels, presensitization, and the indication for
      corneal grafting. If we are to define the factors influencing graft rejection
      better and further increase our knowledge on the role the major
      histocompatibility antigens play in corneal graft rejection in a larger patient
      group, then cooperation with other transplantation centers will be required.

PMID- 8490303
TI  - [Silicone impression procedure. Principles for determining ablation and healing
      parameters in vitro and in vivo].
AB  - Topometry and measurement of photoablation patterns are key questions for
      keratorefractive photoablation. So far, ablation rates have been determined
      either by tissue perforation or histological micrometry. A cast of irradiated
      cornea was made by using a 2-component silicon that polymerizes within minutes,
      thus preserving the corneal topography immediately after photoablation. The
      silicon surface is extremely smooth and the accuracy of the cast better than 1
      micron. Reproducibility and long-term stability were proven for casts of
      photoablated PMMA. Thus ablation rates and profile, volumetry and topometry can
      be determined at any time. The method was applied for 193 nm excimer and 2.94
      microns Er:YAG laser in vitro irradiation of the human cornea. Ablation rates in
      Bowman's layer and stroma were observed for various radiant energies and distinct
      pulse numbers. The average ablation rates are in agreement with published data.
      It could be demonstrated that there was an incubation effect for the first
      pulses. The method feasibility for in vivo measurement was also proven in an
      animal model. After excimer photoablation in rabbit eyes (beam diameter 3.5 mm,
      radiant energy 185 mJ/cm3, ablation rate 0.3 micron/pulse), wound healing was
      recorded: for the right eye silicon casts were molded at three different moments.
      For the left eye only photographs were taken. There was no difference in the time
      course of wound healing, so the silicon does not seem to interfere with repair
      mechanisms of the corneal epithelium. No side effects were observed.

PMID- 8490304
TI  - [Photoablation of the cornea with pulsed 2790 nm ErCr:YSGG laser irradiation.
      Basic studies].
AB  - The potential of 3 microns solid-state lasers as an alternative to excimer lasers
      for photoablative corneal surgery was investigated. A Q-switched ErCr:YSGG laser
      (2790 nm, 200 ns) was used for irradiation of porcine corneas and agar-agar
      samples. Mechanical tissue effects (stroma, endothelium) were documented by
      micromorphology. Laser-induced shock-waves were analyzed by piezo-electric
      transducers. No sharp ablation threshold, as in excimer laser photoablation,
      could be determined. Energy fluences < 2 J/cm2 led to dehydration of the
      irradiated samples. Higher fluences are necessary for the evaporation of tissue
      water to be so vigorous that the tissue matrix is expelled along with the organic
      matrix. At high fluences, the ablation rate exceeds the absorption depth of the
      laser radiation (up to 25 microns/pulse). At fluences between 2.5 and 28 J/cm2
      the thermal necrosis zone adjacent to the crater was 7 +/- 3 microns. The
      intensity of the laser-induced acoustic shock waves can peak to some hundred bar.
      Small gas bubbles up to 1 mm were found in the surrounding area of the ablation
      crater. Apparently, they were pressed between the collagen lamellas by the
      explosive force of the ablative process. In deep excisions (> 75%) endothelial
      defects underneath the beam axis could be documented. Large-area tissue ablation,
      with a resolution in the range of 1 micron, as necessary in myopia correction,
      will not be possible with the present generation of ErCr:YSGG lasers. Its high
      ablation rate makes this laser suitable as a cutting (astigmatism, keratoplasty,
      vitreous surgery) and drilling (glaucoma) device.

PMID- 8490305
TI  - ["To educate myself, quite as I am". On Education in Germany].

PMID- 8490306
TI  - [Diabetic retinopathy. Epidemiology, risk factors and staging].

PMID- 8490307
TI  - Effects of etomidate and hypothermia on cerebral metabolism and blood flow in a
      canine model of hypoperfusion.
AB  - Etomidate is a nonbarbiturate hypnotic agent which, like the barbiturates,
      decreases the cerebral metabolic rate of oxygen consumption (CMRO2) 35-50%. The
      present studies assessed whether etomidate decreased CMRO2 through temperature
      dependent mechanisms and whether the combination of etomidate and moderate
      hypothermia (28 degrees C) decreased CMRO2 more than hypothermia alone. Nineteen
      anesthetized dogs were treated with saline, etomidate (burst-suppressive doses),
      etomidate with hypothermia, or hypothermia alone. Etomidate did not affect (p >
      0.05) the mean arterial pressure (MAP, mm Hg) but modestly lowered the heart rate
      [HR; 124 +/- 6 to 105 +/- 14, (mean +/- SEM); p < 0.05] whereas hypothermia
      (without or with etomidate) lowered (p < 0.05) both MAP (141 +/- 4 to 116 +/- 5
      and 135 +/- 6 to 81 +/- 7) and HR (135 +/- 14 to 84 +/- 3 and 135 +/- 10 to 69 +/
      5, respectively). Etomidate administration did not result in a change (p > 0.05)
      in the esophageal, brain parenchymal, or subdural temperature. CMRO2 (ml/100
      g/min) decreased (p < 0.05) during etomidate administration (3.2 +/- 0.4 to 1.7
      +/- 0.2) and hypothermia (3.5 +/- 0.2 to 1.1 +/- 0.2), but the addition of
      etomidate to hypothermia did not further reduce CMRO2 in the animals (3.1 +/- 0.5
      to 1.3 +/- 0.2) despite decreasing their brain hemispheric electrical activity
      from 9 +/- 1 Hz to a burst-suppressive state.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8490308
TI  - Neuron-specific enolase as a marker of in vitro neuronal damage. Part I:
      Assessment of neuron-specific enolase as a quantitative and specific marker of
      neuronal damage.
AB  - Enolase in cerebrospinal fluid is a sensitive marker for many types of
      neurological injuries including head injury and ischemia. We assessed neuron
      specific enolase (NSE) as a quantitative and specific biochemical marker of
      neuronal damage in an experimental model of kainate neurotoxicity. Rat
      hippocampal cultures were treated with various concentrations of kainate. NSE
      release into the culture medium was compared with neuronal death estimated either
      by direct cell counting or by lactate dehydrogenase (LDH) release, largely used
      to quantify neuronal injury. A dose-response relationship was observed between
      kainate concentration and the amount of NSE released (r = -0.69; p < 0.05) as
      well as a significant correlation between NSE release and neuronal death (r =
      0.64; p < 0.05). Likewise, a significant correlation was found between LDH and
      NSE release (r = 0.85; p < 0.05). The specificity of NSE as an indicator of
      neuronal death was demonstrated using immunocyto-chemistry labeling and
      measurement of NSE release by pure astrocyte cultures. We concluded that NSE is a
      reliable, quantitative, and specific marker of neuronal injury.

PMID- 8490309
TI  - Neuron-specific enolase as a marker of in vitro neuronal damage. Part II:
      Investigation of the astrocyte protective effect against kainate-induced
      neurotoxicity.
AB  - The protective effect of astrocytes on hippocampal neurons against kainate
      induced toxicity was investigated using neuron-specific enolase as an indicator
      of neuronal death. Astrocyte-rich and astrocyte-poor mixed rat hippocampal
      cultures were submitted to various concentrations of kainate. At each kainate
      concentration, the amount of NSE released by neurons was significantly greater in
      astrocyte-poor than in astrocyte-rich cultures (p < 0.05). This protective effect
      was not observed when neuronal survival was tested on astrocyte-poor cultures in
      astrocyte-conditioned culture medium with or without 10(-4) M kainate. In
      conclusion, astrocytes significantly attenuate kainate toxicity on hippocampal
      neurons, and this effect is not mediated by a diffusible factor.

PMID- 8490310
TI  - Effect of cerebral venous congestion on the pressure-volume index in the
      evaluation of intracranial pressure dynamics.
AB  - Translocation of cerebrospinal fluid (CSF) between the intracranial and spinal
      subarachnoid space was blocked by ligating the cervical spinal core in eight cats
      under pentobarbital and nitrous oxide anesthesia, and the effects of cerebral
      venous congestion on the pressure-volume index (PVI), a measure relating the
      change in intracranial volume, and the logarithm of intracranial pressure (ICP)
      were evaluated. The changes in the volume-pressure response (VPR), a measure of
      intracranial elastance, were calculated simultaneously. Cerebral venous
      congestion was induced by lowering the head relative to the level of the heart by
      tilting the trunk of the animals to 20 degrees below horizontal. The presence of
      venous congestion was confirmed by an increase in the sagittal sinus pressure
      (SSP). The body position was shifted from horizontal prone (H1 group) to head
      down tilt (D1 group) in four animals (group 1) and from head-down tilt (D2 group)
      to horizontal prone (H2 group) in the other four animals (group 2), and PVI and
      VPR were determined in each group. The changes in ICP and SSP with change of body
      position in group 1 were not significantly different from those in group 2, with
      both pressures changing by 7-8 mm Hg. PVI showed no significant differences
      between the H1 group and H2 group or between the D1 group and D2 group. The mean
      (+/- SEM) PVI for all measurements in the head-down tilt position (D1 and D2
      groups) was significantly higher (0.50 +/- 0.02 ml; p < 0.01) than in the
      horizontal position (H1 and H2 groups; 0.35 +/- 0.02 ml).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8490312
TI  - Capnography in younger patients.

PMID- 8490311
TI  - An unexpected complication of encephalocele repair.

PMID- 8490313
TI  - On Rock & Roll and Index Medicus.

PMID- 8490314
TI  - Neurosurgical intensive care unit organization and function: an American
      experience.
AB  - This article describes the organization and function of a university-based
      neurosurgical intensive care unit. The unit's success has been based in part on
      its physical structure and in larger part on its organization. Patients are
      comanaged by a team of neurosurgeons and anesthesiologist intensive care
      specialists, who receive twice-weekly input from all other participating patient
      care specialists, including nurses, physical therapists, social workers, and
      others. This type of approach promotes teamwork and fosters mutual respect among
      the team. It also improves patient care and, frequently, outcome.

PMID- 8490315
TI  - Local versus general anesthesia for lumbar percutaneous discectomy.
AB  - Ninety-two adult patients scheduled for automated percutaneous discectomy (PERC)
      were assigned to receive either local anesthesia supplemented with monitored i.v.
      analgesia (MIVA) or general endotracheal anesthesia (GA-LITE). Patients were
      examined 1 week post-PERC for the presence of new paresthesias, and they
      completed a questionnaire 6-18 weeks after PERC about changes in their pain.
      Sixty-four percent of MIVA patients and 83% of GA-LITE patients had diminished
      pain following PERC. Results did not show any difference between the two groups
      for new paresthesias after PERC. There were no differences in postoperative pain
      medication requirements, but the GA-LITE group reported more postoperative
      nausea, vomiting, and sore throat. GA-LITE patients averaged 1.06 +/- 0.3 h in
      the recovery room compared with 0.70 +/- 0.3 h for MIVA patients. Although the
      use of general anesthesia for PERC has been contraindicated because of fear of
      damaging the nerve root in the sleeping patient, we conclude that general
      anesthesia does not increase nerve injuries attributable to instrumentation.
      However, general anesthesia did cause a higher incidence of minor complications
      such as nausea, vomiting, and sore throat in the immediate postoperative period
      than did MIVA.

PMID- 8490316
TI  - Transcranial Doppler monitoring during induction of anesthesia: effects of
      propofol, thiopental, and hyperventilation in patients with large malignant brain
      tumors.
AB  - Disturbed autoregulation and CO2 reactivity have been reported in patients with
      brain tumors. Therefore, we decided to monitor the cerebrovascular effects of
      anesthetic drugs and hyperventilation. Transcranial Doppler sonography (TCD) can
      measure noninvasively alterations of flow velocities (v) and cross-sectional
      vessel area (VA) in large brain arteries. Twenty-eight patients with large
      malignant brain tumors in the territory of the middle cerebral artery (MCA)
      randomly received propofol or thiopental for induction and maintenance of
      anesthesia. Mean arterial pressure (MAP), heart rate (HR), and TCD parameters
      (vMCA and VA of the tumor or nontumor side) were determined at six data points
      (DP). The first measurements (MAP, HR, and TCD of the nontumor side) were
      performed before (DP I) and 60 s after (DP II) induction of anesthesia with
      either 2 mg/kg propofol or 4 mg/kg thiopental. After intubation and
      normoventilation (50% O2 in air), 0.05-0.1 mg/kg midazolam and an alfentanil
      infusion (100 micrograms/kg x h) were initiated. Then MAP, HR, vMCA, and VA of
      the tumor side were analyzed before (DP III) and 60 s after (DP IV) either
      propofol (1 mg/kg) or thiopental (2 mg/kg) were given. Finally, the effects of
      hyperventilation on HR, MAP, vMCA, and VA (tumor side) were determined (DP V and
      VI). Mean +/- SD, thiopental or propofol reactivity (non-tumor and tumor side)
      and CO2 reactivity (tumor side) were calculated; statistical comparison between
      DP I and II, III and IV, and V and VI was performed by paired t tests (p < 0.05).
      Unpaired t tests were used to evaluate differences between groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8490317
TI  - Lactate and postischemic recovery of energy metabolism and electrical activity in
      the isolated perfused rat brain.
AB  - The aim of the present study was to evaluate whether lactate can maintain the
      energy metabolism and electrical activity of isolated perfused rat brain in the
      absence of glucose. To exhaust cerebral glucose stores and simultaneously raise
      endogenous lactate, complete ischemia was induced. After ischemia, when a glucose
      free perfusate was supplied, restoration of interstitial potassium (Ke+),
      cortical discontinuous current (DC) potential, electroencephalogram (EEG)
      activity, and ATP and phosphocreatine (PCr) was not significantly different from
      postischemic recovery findings when a glucose-containing perfusate was used. In
      the group receiving glucose-free perfusate, postischemic application of 1 mM
      iodoacetic acid did not inhibit the recovery of electrical activity, Ke+, or DC
      potential. After recovery of Ke+ in glucose-free reperfusion, a 20-30-Hz EEG
      pattern appeared and was maintained for about 20 min followed by disappearance of
      spontaneous electrical activity. An abrupt increase of Ke+, a steep negative DC
      shift, and a substantial decrease of ATP and PCr occurred after about 22 min of
      reperfusion. During the first 5 min of glucose-free reperfusion, consumption of
      lactate was significantly higher (0.89 mumol/g wet weight/min) than during
      reperfusion with medium containing glucose (0.41 mumol/g ww/min). Increasing
      amounts of tissue lactate prolonged maintenance of electrical function in glucose
      free reperfusion. This correlation could not be found for free fatty acids. In
      conclusion, after a few minutes of ischemia, the brain is able to recover
      cellular ion transport and electrical activity without a supply of glucose,
      preferentially by combustion of lactate accumulated in brain tissue. This
      mechanism is only useful during a limited time period until the lactate
      accumulated during ischemia is combusted.

PMID- 8490318
TI  - Spatial and temporal factors in the role of prefrontal and parietal cortex in
      visuomotor integration.
AB  - The effects of reversible lesion--by cooling--of dorsolateral prefrontal and
      posterior parietal cortex were studied in rhesus monkeys performing a cognitive
      visuomotor integration task. Correct performance required the use of a learned
      set of cue-response contingencies, some spatial and some nonspatial; in some
      cases, the task required the short-term retention, through a delay, of the color
      of the cue or its implicit response direction. Prefrontal cooling impaired
      performance of the task regardless of its spatial demands, an effect that
      increased with delay. Parietal cooling, on the other hand, only impaired
      performance if the task demanded the processing and retention of spatial
      information (i.e., if spatial active memory was required). Parietal effects were
      not related to delay. Both prefrontal and, even more, parietal cooling increased
      response time in all task contingencies. Thus, the results dissociate the
      respective contributions of the prefrontal and the posterior parietal cortex to
      the temporal and spatial aspects of information processing in visuomotor
      performance. They indicate that posterior parietal areas participate in spatial
      processing and in active memory of spatial information, whereas prefrontal areas
      subserve a broader role of visuomotor processing and cross-temporal integration
      of both spatial and nonspatial information.

PMID- 8490319
TI  - Low-affinity nerve growth factor receptor (p75NGFR)- and choline
      acetyltransferase (ChAT)-immunoreactive axons in the cerebral cortex and
      hippocampus of adult macaque monkeys and humans.
AB  - Low-affinity nerve growth factor receptor (p75NGFR) was analyzed in the adult
      monkey and human cerebral cortex and hippocampus by light and electron
      microscopic immunohistochemistry using a mouse monoclonal antibody raised against
      human p75NGFR. In the monkey only, the morphology and laminar and areal
      distribution of the p75NGFR-immunoreactive fibers were further compared with
      distribution of the ACh-synthesizing enzyme ChAT. We found that the p75NGFR fiber
      distribution is remarkably dense throughout the cerebral neocortex and highly
      similar in homologous cortical areas of monkey and human. In both species,
      p75NGFR-immunoreactive fibers are contracted in layers I, II, and the superficial
      portions of layer III in all frontal, parietal, temporal, and occipital areas
      examined. In the primary visual and somatosensory cortices, dense p75NGFR fiber
      plexuses are additionally found in layer IV. In the hippocampal formation, this
      fiber system is most dense in the CA2 and CA3 subfields as well as in the
      molecular and polymorphic layers of the dentate gyrus. The distribution and
      characteristics of the p75NGFR-positive fibers in the primates correspond almost
      exactly to those of the cholinergic fiber system as revealed by ChAT
      immunohistochemistry in the present study as well as in the literature (Lewis,
      1991; Mesulam et al., 1992; Voytko et al., 1992). Electron microscopy revealed
      that p75NGFR is associated mainly with axonal membranes and portions of the
      axoplasm in labeled fibers. Although the function of p75NGFR is still a matter of
      debate, its widespread distribution opens up new questions regarding its
      physiological role in the large and functionally differentiated cerebral cortex
      and hippocampus of monkey and human.

PMID- 8490320
TI  - Comparison of intrinsic connectivity in different areas of macaque monkey
      cerebral cortex.
AB  - We have used small injections of biocytin to label and compare patterns of
      intraareal, laterally spreading projections of pyramidal neurons in a number of
      areas of macaque monkey cerebral cortex. In visual areas (V1, V2, and V4),
      somatosensory areas (3b, 1, and 2), and motor area 4, a punctate discontinuous
      pattern of connections is made from 200-microns-diameter biocytin injections in
      the superficial layers. In prefrontal cortex (areas 9 and 46), stripe-like
      connectivity patterns are observed. In all areas of cortex examined, the width of
      the terminal-free gaps is closely scaled to the average diameter of terminal
      patches, or width of terminal stripes. In addition, both patch and gap dimensions
      match the average lateral spread of the dendritic field of single pyramidal
      neurons in the superficial layers of the same cortical region. These
      architectural features of the connectional mosaics are constant despite a twofold
      difference in scale across cortical areas and different species. They therefore
      appear to be fundamental features of cortical organization. A model is offered in
      which local circuit inhibitory "basket" interneurons, activated at the same time
      as excitatory pyramidal neurons, could veto pyramidal neuron connections within
      either circular or stripe-like domains; this could lead to the formation of the
      pattern of lateral connections observed in this study, and provides a framework
      for further theoretical studies of cerebral cortex function.

PMID- 8490321
TI  - Magnetoencephalography reveals two distinct sources associated with late positive
      evoked potentials during visual oddball task.
AB  - The present investigation was undertaken in order to utilize
      magnetoencephalography to locate generator sources, modeled as equivalent current
      point dipoles, that account for the well-established late positive electrical
      potentials commonly measured along the midline (Cz, Pz, Fz, and Oz) in response
      to rare or task-relevant stimuli and their simultaneously recorded magnetic field
      components. Two simultaneous but spatially distinct sources were present in all
      six subjects. One source in which the magnetic flux exited and reentered the
      brain over the right hemisphere was localized in deep structures under the
      temporal cortex in the vicinity of the right hippocampal formation. The other
      occurred in the vicinity of the primary visual cortex in the occipital area with
      magnetic flux entering and exiting over the posterior aspects of the subjects'
      heads. These data correspond to depth and surface electrode studies that have
      demonstrated multiple generator sources.

PMID- 8490322
TI  - Area V5 of the human brain: evidence from a combined study using positron
      emission tomography and magnetic resonance imaging.
AB  - In pursuing our work on the organization of human visual cortex, we wanted to
      specify more accurately the position of the visual motion area (area V5) in
      relation to the sulcal and gyral pattern of the cerebral cortex. We also wanted
      to determine the intersubject variation of area V5 in terms of position and
      extent of blood flow change in it, in response to the same task. We therefore
      used positron emission tomography (PET) to determine the foci of relative
      cerebral blood flow increases produced when subjects viewed a moving checkerboard
      pattern, compared to viewing the same pattern when it was stationary. We
      coregistered the PET images from each subject with images of the same brain
      obtained by magnetic resonance imaging, thus relating the position of V5 in all
      24 hemispheres examined to the individual gyral configuration of the same brains.
      This approach also enabled us to examine the extent to which results obtained by
      pooling the PET data from a small group of individuals (e.g., six), chosen at
      random, would be representative of a much larger sample in determining the mean
      location of V5 after transformation into Talairach coordinates. After stereotaxic
      transformation of each individual brain, we found that the position of area V5
      can vary by as much as 27 mm in the left hemisphere and 18 mm in the right for
      the pixel with the highest significance for blood flow change. There is also an
      intersubject variability in blood flow change within it in response to the same
      visual task. V5 nevertheless bears a consistent relationship, within each brain,
      to the sulcal pattern of the occipital lobe. It is situated ventrolaterally, just
      posterior to the meeting point of the ascending limb of the inferior temporal
      sulcus and the lateral occipital sulcus. In position it corresponds almost
      precisely with Flechsig's Feld 16, one of the areas that he found to be
      myelinated at birth.

PMID- 8490324
TI  - Influence of isotonic, isometric and isokinetic muscle strength on bone mineral
      density of the spine and femur in young women.
AB  - Bone mineral density (BMD) is dependent on multiple influences including
      genetics, mechanical forces, hormonal changes and nutritional mechanisms. The
      mechanical forces are, in part, influenced by muscle strength. This study
      examined the relationships between BMD of the spine and femur with muscle
      strength. Eighty-one healthy, non-athletic women aged 20-30 years were the
      subjects in the study. BMD was measured by dual energy x-ray absorptiometry.
      Trunk strength was measured by a Wagner Dynamometer or a Cable Tensiometer and
      leg strength was measured with a Cybex II isokinetic dynamometer. Trunk, leg and
      hip strength was also measured using 1 RM (one repetition maximum). There were
      significant correlations between spine density and trunk extension (r = 0.40, P =
      0.0001) and spine density and trunk flexion (r = 0.30, P = 0.0037). There were
      significant correlations between femoral neck density and knee extension (r =
      0.40, P = 0.003) and femoral neck density and knee flexion (r = 0.24, P =
      0.0240). Multiple regression analysis showed that amongst young adult females
      weight and trunk extensor muscle strength contributed about equally to spine
      density. Flexor muscle strength did not influence bone density.

PMID- 8490323
TI  - Dye-coupling in human neocortical tissue resected from children with intractable
      epilepsy.
AB  - Interneuronal communication mediated by gap junctions has been proposed to have
      an important role in brain development and in the genesis of epilepsy. Indirect
      evidence for the existence and function of gap junctions has been obtained by
      studying dye-coupling, the transfer of the low-molecular-weight fluorescent dye
      Lucifer yellow (LY), among neurons. In the present study, the incidence of dye
      coupling was assessed at different stages of human postnatal brain development.
      Pathological neocortical tissue was obtained from children from 3 to 172 months
      of age suffering from pediatric epilepsy and undergoing surgery to alleviate
      intractable seizures. Tissue samples were classified into least and most abnormal
      according to a number of diagnostic measures to ascertain if the incidence of dye
      coupling could be related to the degree of epileptogenicity of the sample.
      Regardless of the degree of abnormality, a significant developmental decrease in
      the incidence of dye-coupling was observed. In children 3-16 months, dye-coupling
      occurred in 38% of single intracellular injections of LY. From 32 to 83 months,
      the frequency of dye-coupling decreased to 13%. Finally, from 93 to 172 months,
      dye-coupling was observed in only 4% of injections. The frequency of dye-coupling
      between the least and most abnormal samples was not significantly different,
      although the frequency of dye-coupling was higher in the least abnormal samples
      from the youngest group (3-16 months). These findings underscore the role of gap
      junctions during brain development. However, they do not provide support, at
      least in vitro, for the hypothesis that gap junctions have an important role
      underlying epilepsy.

PMID- 8490325
TI  - Long-term cultivation of human osteoblasts.
AB  - Primary cultures of osteoblastic cells were obtained from human bone tissue after
      corrective surgery. Osteoblasts were isolated with a combined enzymatic and cell
      migration method and characterized by a high expression of alkaline phosphatase
      (AP), the marker enzyme for osteoblasts. For quantification of AP a new sensitive
      method has been developed. Also the secretion of osteocalcin measured by
      radioimmunoassay (RIA) which was stimulated by calcitriol, characterized isolated
      cells as osteoblasts. Osteoblasts isolated by the enzymatic and migration method
      formed 3-dimensional structures during cultivation in a mixed basal medium
      containing serum substitute, vitamin C and glycerophosphate. They maintained
      their specific cell characteristics over a period of 50 generations and did not
      dedifferentiate in contrast to their cultivation in medium containing fetal calf
      serum. Therefore a great amount of differentiated human osteoblasts could be
      obtained after cultivation of the primary cultures from different donors and this
      allows the examination of the influence of age and sex on cellular activity.

PMID- 8490326
TI  - The ultra long-term treatment of senile osteoporosis with 1 alpha-hydroxyvitamin
      D3.
AB  - We have attempted to examine the effects of long-term treatment with 1 alpha
      hydroxyvitamin D3 (1 alpha-OHD3; 0.5-1.0 microgram/day) on bone and chemical
      parameters in osteoporosis, retrospectively. Twenty-six pairs of age-, period of
      observation- and initial bone mineral density-matched patients with or without
      treatment were selected from 86 patients with osteoporosis. An 11% decrease (
      2.2%/year) and a 6% increase in radial mineral density at the peripheral cortical
      bone site was observed in the control and the treated group after 5 years,
      respectively (P < 0.05-0.01). There were no patients who showed hypercalcemia nor
      an abnormally high blood urea nitrogen (BUN) level in both groups. These results
      indicate that 1 alpha-OHD3 treatment in osteoporosis is effective and has no
      serious adverse effects. Although the facts were obtained from observations only
      at the peripheral cortical bone site, 1 alpha-OHD3 treatment may be considered as
      a potential mode of therapy for osteoporosis.

PMID- 8490327
TI  - Precision of dual energy x-ray absorptiometry in the upper extremities.
AB  - Dual energy x-ray absorptiometry (DEXA) has been shown to be a precise method for
      measuring bone mineral density (BMD) and content (BMC) in lumbar spine and
      proximal femur, but it has not been widely used in other skeletal sites. The in
      vivo day-to-day precision of DEXA (Norland XR-26) for seven anatomic sites in the
      upper extremities was evaluated by twice measuring both the right and left sides
      in ten subjects. For consistently defined regions-of-interest, the following
      precision values (coefficient of variation) were obtained for BMD and BMC: 0.8%
      and 1.0% (proximal humerus); 0.5% and 0.5% (humeral shaft); 0.7% and 0.5% (radial
      shaft); 1.3% and 1.1% (ulnar shaft); 0.7% and 1.0% (distal radius); 0.7% and 1.2%
      (distal ulna); 0.4% and 0.6% (hand). The initially observed relative side-to-side
      differences did not change significantly in the repeated measurements. Our
      results indicate that DEXA is a precise method for assessment of BMD and BMC also
      in the upper extremities.

PMID- 8490328
TI  - Lack of effect of nasal salmon calcitonin on cell-mediated immunity.
AB  - The calcium lowering hormone, calcitonin, also affects the immune system. The
      effect of nasal salmon calcitonin on lymphocyte transformation tests and on serum
      ionised calcium was investigated in a randomised, double-blind and placebo
      controlled study including 24 healthy adult volunteers. The participants received
      a single dose of either 200 IU of nasal salmon calcitonin or nasal placebo in the
      morning and measurements were done before and 3 h after administration of the
      spray. Nasal salmon calcitonin exerted a significant hypocalcemic effect, but did
      not interfere with antigen- or mitogen-induced expansion of T-lymphocytes. It is
      unlikely that nasal salmon calcitonin affects cell-mediated immunity in healthy
      subjects.

PMID- 8490329
TI  - Evidence for reduced cancellous bone mass in the spontaneously hypertensive rat.
AB  - The histomorphometric changes in the proximal tibial metaphysis and epiphyseal
      growth plate and midtibial shaft of 26-week-old spontaneously hypertensive rats
      (SHR) compared with those of the corresponding normotensive Wistar-Kyoto (WKY)
      rats were studied. A decrease in body weight, growth plate thickness, and
      longitudinal growth rate of the proximal tibial epiphysis, trabecular bone
      volume, trabecular thickness and number, the number of osteoblasts and
      osteoprogenitor cells per millimeter square surface of the proximal tibial
      metaphysis, periosteal and endocortical apposition rate and bone formation rate
      of the tibial diaphysis were observed in the SHR. Additionally, systolic blood
      pressure, the number of osteoclasts per millimeter square surface and average
      number of nuclei per osteoclast of the proximal tibial metaphysis were
      significantly increased. Thus, osteoclastic activity is dominant over
      osteoblastic and chondroblastic activity in the SHR that results in a cancellous
      bone deficit in the skeleton. It will require additional work to ascertain the
      underlying cause for this condition as several factors in the SHR with a
      potential for causing this change are present, including elevated parathyroid
      hormone (PTH), depressed 1,25-(OH)2D3, low calcium absorption, reduced body
      weight (reduced loading) elevated blood pressure and possibly other direct cell
      differences in the mutant strain. At present elevated PTH and adaptation to
      underloading from reduced weight are postulated to be a likely cause, but
      additional studies are required to test this interpretation.

PMID- 8490330
TI  - Protective effects of disodium etidronate and pamidronate against the
      biomechanical repercussion of betamethasone-induced osteopenia in growing rat
      femurs.
AB  - To assess the protective effect of bisphosphonates on the biomechanical
      repercussion of glucocorticoid-induced osteopenia, intraperitoneal doses of 1 or
      10 mg/kg/d of disodium etidronate or 1 or 50 mg/kg/day of pamidronate were given
      to groups of 6 growing rats simultaneously receiving subcutaneous doses of 4.8
      mg/kg/day of betamethasone for 20 days. Betamethasone impaired strength and
      stiffness of femur diaphyses through a reduction of geometric properties,
      abnormally enhancing bone ability to absorb energy. Both bisphosphonates
      partially prevented betamethasone effects on diaphyseal stiffness (but not
      strength) through positive, dose-related effects on material modulus of
      elasticity and slighter improvements in diaphyseal geometry, avoiding the
      enhancement of energy-absorbing ability and the subsequent tendency to production
      of comminute fractures. These results and others obtained treating normal rats
      with (pamidronate) APD suggest that the sign of bisphosphonate effects on bone
      biomechanics may depend not only on the type of compound but also on eventual
      interactions with concomitant treatments.

PMID- 8490331
TI  - Cardiac rehabilitation.

PMID- 8490332
TI  - Designer hips.

PMID- 8490333
TI  - Does Crohn's disease have a mycobacterial basis?

PMID- 8490334
TI  - Night visits in general practice.

PMID- 8490335
TI  - Role models and patronage.

PMID- 8490336
TI  - Career grade posts in NHS trusts.

PMID- 8490337
TI  - Rural population mixing and childhood leukaemia: effects of the North Sea oil
      industry in Scotland, including the area near Dounreay nuclear site.
AB  - OBJECTIVE: To determine if any excess of childhood leukaemia and non-Hodgkin's
      lymphoma was associated with certain striking examples of population mixing in
      rural Scotland produced by the North Sea oil industry. DESIGN: Details were
      traced for over 30,000 workers involved in the construction of the large oil
      terminals in the Shetland and Orkney islands in northern Scotland or employed
      offshore. Home addresses of the 17,160 Scottish residents were postcoded,
      integrated with census data, and then classified as urban or rural. Rural
      postcode sectors, ranked by proportion of oil workers, were grouped into three
      categories with similar numbers of children but contrasting densities of oil
      workers. The incidence of leukaemia and non-Hodgkin's lymphoma was examined in
      these rural (and also in urban) categories in the periods 1974-8, 1979-83 and
      1984-8. SETTING: Scotland. SUBJECTS: Young people below age 25. RESULTS: A
      significant excess of leukaemia and non-Hodgkin's lymphoma was found in 1979-83
      in the group of rural home areas with the largest proportion of oil workers,
      following closely on large increases in the workforce. The area near the Dounreay
      nuclear installation, where an excess of leukaemia is already well known, was
      within the rural high oil category. CONCLUSION: The findings support the
      infection hypothesis that population mixing can increase the incidence of
      childhood leukaemia in rural areas. They also suggest that the recent excess in
      the Dounreay-Thurso area is due to population mixing linked to the oil industry,
      promoted by certain unusual local demographic factors.

PMID- 8490338
TI  - Spontaneous resolution of severe chronic glue ear in children and the effect of
      adenoidectomy, tonsillectomy, and insertion of ventilation tubes (grommets).
AB  - OBJECTIVE: To measure the time to spontaneous resolution of severe chronic otitis
      media with effusion (glue ear) in children and study the effects of
      adenoidectomy, adenotonsillectomy, and ventilation tubes (grommets). DESIGN:
      Randomised controlled study over 12 years. SETTING: Paediatric
      otorhinolaryngology clinics and in-patient unit. SUBJECTS: 228 children aged 2-9
      years with pronounced hearing loss from glue ear and persistent bilateral middle
      ear effusions confirmed on three occasions over three months. INTERVENTIONS:
      Children were randomly allocated to adenotonsillectomy, adenoidectomy, or neither
      procedure. In all groups a Shepard type ventilation tube was inserted in one
      randomly chosen ear. Follow up was annually for five years and then less often
      for up to seven years four months. For analysis the two operated groups were
      combined. MAIN OUTCOME MEASURES: Otoscopic clearance of fluid, change in
      tympanogram, and improvement in mean audiometric hearing threshold. RESULTS:
      Survival analysis showed appreciable otoscopic and tympanometric resolution of
      fluid with ventilation tubes alone and adenoidectomy alone compared with no
      surgery. Further improvement was seen after combination of both treatments. Mean
      audiometric hearing thresholds improved with fluid resolution. Resolution was
      delayed in younger children and in those whose parents smoked, irrespective of
      treatment. Whereas a single insertion of a Shepard tube resolved the glue for a
      mean (SD) period of 9.5 (5.2) months, the effect of adenoidectomy was sustained
      throughout follow up. CONCLUSIONS: Treatment of glue ear considerably shortened
      the time to fluid resolution, combined adenoidectomy and tube insertion being
      better than either procedure alone. Resolution was longer in younger children and
      those whose parent(s) smoked, irrespective of treatment.

PMID- 8490339
TI  - Effect of influenza B virus infection on human performance.

PMID- 8490340
TI  - Visiting through the night.
AB  - OBJECTIVE: To describe the time distribution of visits at night and to evaluate
      trends in night visits from 1982 to 1992. DESIGN: Analysis of a sample of one in
      12 claim forms for night visits submitted over one year beginning 1 July 1991,
      and estimation of the number of night visits in previous years from data on
      payment. Further information was obtained from performance indicators from the
      Department of Health. SETTING: General practices responsible to Berkshire family
      health services authority. MAIN OUTCOME MEASURES: Times of night visits,
      proportion performed by deputies, and trend in number of night visits after
      adjusting for the increased hours during which visits are claimed. RESULTS: The
      change in the hours for which payment may be claimed accounted for 33.8%
      (536/1584) of all night visits in the sample. After visits during these extra two
      hours were excluded, claims increased by 38.7% from 1989 to 1992 and more than
      doubled in the past 10 years. Use of deputies both in Berkshire and in England
      and Wales dropped by more than half since 1989. General practitioners in
      Berkshire claimed 31.5 night visits per 1000 population in 1992. CONCLUSIONS: The
      increase in the number of night visits is only partly due to the change in hours
      during which visits may be claimed. It is also due to a long term and possibly
      accelerating rise in demand. This is despite a major reduction in the proportion
      of calls performed by deputising services, the use of which had been said to be
      the main factor increasing the numbers of night visits.

PMID- 8490342
TI  - ABC of sleep disorders. Daytime sleepiness.

PMID- 8490341
TI  - Care management and mental health.
AB  - The community care reforms will produce a new kind of key worker who will
      organise and budget for packages of care: the care manager. Care management goes
      live in April 1993 but is still poorly rehearsed and its performance may yet
      disappoint. This overview sets out the origins of case management, its
      transformation into care management, and the principles guiding its practice. To
      spell out how the concept works, plans for care management in Southwark's mental
      health services are described.

PMID- 8490343
TI  - Acute bacterial meningitis in young adults mistaken for substance abuse.

PMID- 8490344
TI  - Guidelines for the management of asthma: a summary. British Thoracic Society and
      others.

PMID- 8490345
TI  - Tackling inequalities in health: the Australian experience.
AB  - Federal and state governments in Australia have embarked on a series of national
      initiatives which show a firm commitment to tackling social inequalities in
      health. The development of national goals and targets for health, for example,
      covers social and environmental conditions and sets differential targets for
      specific social groups with very poor health status. In a complementary
      initiative, a wide ranging analysis of the health care system--the National
      Health Strategy--has as one of its main objectives to improve the equitable
      impact of the health system. Where problems of access to and quality of services
      have been exposed, policies have been devised to deal with them. The
      exceptionally poor health of the Aboriginal community has elicited cross party
      support for action. Resources have been allocated to implement the National
      Aboriginal Health Strategy: to improve living and working conditions, education,
      and employment opportunities. Britain can glean much from the Australian
      experience.

PMID- 8490346
TI  - Ethical issues in randomised prevention trials.

PMID- 8490347
TI  - Ethical issues in randomised preventive trials.

PMID- 8490348
TI  - Microphthalmos and anophthalmos and environmental pollutants.

PMID- 8490349
TI  - Harvard's "new pathway".

PMID- 8490350
TI  - Sexually transmitted diseases and HIV infection among homosexual men.

PMID- 8490351
TI  - Sexually transmitted diseases and HIV infection among homosexual men.

PMID- 8490352
TI  - Sexually transmitted diseases and HIV infection among homosexual men.

PMID- 8490353
TI  - Paradoxical pain.

PMID- 8490354
TI  - Paradoxical pain.

PMID- 8490355
TI  - Paradoxical pain.

PMID- 8490356
TI  - Paradoxical pain.

PMID- 8490357
TI  - Neonatal group B streptococcal infections.

PMID- 8490358
TI  - Treating hypertension in elderly patients.

PMID- 8490359
TI  - Inherited prion disease.

PMID- 8490360
TI  - Inherited prion disease.

PMID- 8490361
TI  - Interpreting fluoroscein angiograms.

PMID- 8490362
TI  - The language of health.

PMID- 8490363
TI  - The language of health.

PMID- 8490364
TI  - The new deal in Trent.

PMID- 8490365
TI  - Costs of screening are important.

PMID- 8490366
TI  - Health services research.

PMID- 8490368
TI  - Juniors' new deal meets its first deadline.

PMID- 8490367
TI  - Institutional care and elderly people.

PMID- 8490369
TI  - Enhancing the educational content of SHO posts.

PMID- 8490370
TI  - Urinary incontinence in the community.

PMID- 8490371
TI  - Filtering white cells from blood for transfusion.

PMID- 8490372
TI  - Effects of prematurity and intrauterine growth on respiratory health and lung
      function in childhood.
AB  - OBJECTIVE: To determine whether birth weight and gestational age are associated
      with respiratory illness and lung function in children aged 5-11 years. DESIGN:
      Cross sectional analysis of parent reported birth weight, gestational age, and
      respiratory symptoms; parental smoking and social conditions; forced vital
      capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory
      rates between 25% and 75% and 75% and 85% (FEF25-75 and FEF75-85), and height.
      SETTING: Primary schools in England and Scotland in 1990. SUBJECTS: 5573 children
      aged 5-11 (63.3% of eligible children) had respiratory symptoms analysed and 2036
      children (67.1% of eligible children) had lung function measured. MAIN OUTCOME
      MEASURES: Symptoms of asthma, bronchitis, occasional and frequent wheeze, cough
      first thing in the morning, and cough at any other time and lung function.
      RESULTS: Birth weight adjusted for gestational age was significantly associated
      with all lung function measurements, except FEF25-75. The association remained
      for FVC (b = 0.475, 95% confidence interval 0.181 to 0.769) and FEV1 (b = 0.502,
      0.204 to 0.800) after adjustment for gestational age, parental smoking, and
      social factors. FEF75-85 was the only lung function related to gestational age.
      Respiratory symptoms, especially wheeze most days (adjusted odds ratio 0.9, 0.84
      to 0.97) were significantly associated with prematurity. Every extra week of
      gestation reduced the risk of severe wheeze by about 10%. CONCLUSIONS: Lung
      function is affected mainly by intrauterine environment while respiratory
      illness, especially wheezing, in childhood is related to prematurity.

PMID- 8490373
TI  - An evaluation of the multidisciplinary approach to psychiatric diagnosis in
      elderly people.
AB  - OBJECTIVE: To determine the accuracy of psychiatric diagnoses made by two
      community psychogeriatric teams operating a multidisciplinary assessment
      procedure. DESIGN: Comparison of team diagnosis with independent formal
      assessment and consensus diagnosis by research psychiatrists. SETTING: Two
      community psychogeriatric teams with similar operational policies in an inner
      London health district. SUBJECTS: 100 people aged 65-90 (70 women) newly referred
      to the teams. MAIN OUTCOME MEASURES: Concordance between team and research
      diagnoses. RESULTS: Agreement between team and research diagnoses ranged from 90%
      to 99% for the specific psychiatric disorders studied. There was no significant
      difference between medical and non-medical team members in their diagnostic
      performance compared with the research psychiatrists. Increased diagnostic
      accuracy by team members was associated with longer experience of team working,
      regardless of the team members' professional background. CONCLUSIONS: The
      multidisciplinary approach to the assessment of referrals to these community
      teams for the elderly is not associated with misdiagnosis of psychiatric
      disorder.

PMID- 8490374
TI  - Evaluating perinatal mortality rates: effects of referral and case mix.
AB  - OBJECTIVE: To evaluate perinatal mortality rates as a method of auditing
      obstetric and neonatal care after account had been taken of transfer between
      hospitals during pregnancy and case mix. DESIGN: Case-control study of perinatal
      deaths. SETTING: Leicestershire health district. SUBJECTS: 1179 singleton
      perinatal deaths and their selected live born controls among 114,362 singleton
      births to women whose place of residence was Leicestershire during 1978-87. MAIN
      OUTCOME MEASURE: Crude perinatal mortality rates and rates adjusted for case mix.
      RESULTS: An estimated 11,701 of the 28,750 women booked for delivery in general
      practitioner maternity units were transferred to consultant units during their
      pregnancy. These 11,701 women had a high perinatal mortality rate (16.8/1000
      deliveries). Perinatal mortality rates by place of booking showed little
      difference between general practitioner units (8.8/1000) and consultant units
      (9.3-11.7/1000). Perinatal mortality rates by place of delivery, however, showed
      substantial differences between general practitioner units (3.3/1000) and
      consultant units (9.4-12.6/1000) because of the selective referral of high risk
      women from general practitioner units to consultant units. Adjustment for risk
      factors made little difference to the rates except when the subset of deaths due
      to immaturity was adjusted for birth weight. CONCLUSION: Perinatal mortality
      rates should be adjusted for case mix and referral patterns to get a meaningful
      result. Even when this is done it is difficult to compare the effectiveness of
      hospital units with perinatal mortality rates because of the increasingly small
      subset of perinatal deaths that are amenable to medical intervention.

PMID- 8490375
TI  - Residential care for elderly people: a decade of change.
AB  - OBJECTIVE: To determine the changes between 1979 and 1990 in demography and
      dependency levels in elderly people in residential care. DESIGN: Censuses of
      those aged 65 years and over in any type of residential care at midnight on 11
      December 1979 and 27 November 1990. SETTING: Leicestershire District Health
      Authority (population 865,133, 1991 census), coterminous with county and social
      services boundaries. MAIN OUTCOME MEASURES: Age, sex, length of stay, and
      dependency levels (measured by activities of daily living). RESULTS: In 1990
      (1979), 6079 (4678) elderly people were enumerated in 241 (133) establishments, a
      30% increase in the numbers of elderly people in residential care and an 82%
      increase in the number of establishments between 1979 and 1990. Dependency levels
      rose between 1979 and 1990 in all but the geriatric sector, the greatest
      increases being found in private residential homes where the largest percentage
      increase in the number of residents had occurred. CONCLUSIONS: Dependency levels
      in residential care have risen substantially, particularly in the private sector,
      even beyond levels expected from the greater numbers of elderly people. With the
      impending move to community care, dependency levels are likely to rise further,
      and more appropriate staff training and medical input to homes will become
      necessary.

PMID- 8490376
TI  - Leukaemia linked to eating disorders.

PMID- 8490377
TI  - Urinary incontinence in the community--analysis of a MORI poll.
AB  - OBJECTIVES: To investigate the prevalence of urinary incontinence among people
      living at home, their responses to it, and its emotional and social effects.
      DESIGN: Random sample of 4007 adults interviewed in their own homes. SETTING:
      Random sample of 178 constituency sampling points throughout Great Britain.
      SUBJECTS: 1883 men, 2124 women aged 30 and over. MAIN OUTCOME MEASURES: Responses
      to questionnaire. RESULTS: 6.6% (125) men and 14.0% (297) women had been
      incontinent of urine at some time--2.8% (52) men and 7.5% (159) women in the
      previous two months and 61% (124) of these for more than four years. 52% (108)
      had consulted their general practitioner at the onset of incontinence and a
      further 31% (65) later. Doctors commonly took a urine sample (163, 54%), referred
      the patient to a specialist (127, 42%), and prescribed tablets (109, 36%); only
      22% (66) carried out an abdominal, rectal, or vaginal examination. Patients were
      not embarrassed in seeing their doctor and most thought they were treated
      sympathetically. 60% (265) of all those affected were concerned or worried about
      their incontinence, and in almost half incontinence limited their daily social
      activities. CONCLUSION: More people with incontinence seem to be consulting their
      doctors about it than has been found in previous studies, but the procedures
      carried out by general practitioners still seem to be suboptimal. Urinary
      incontinence has a profound effect on the day to day lives of most of those who
      suffer from it.

PMID- 8490378
TI  - Is routine induction of labour at term ever justified?
AB  - Balancing the risks of prolonged gestation against those of induced labour is
      difficult. Risks to the fetus increase slightly after 42 weeks' gestation but
      women having labour induced are more likely to have instrumental deliveries or
      babies with low Apgar scores. Since many women are now expressing a preference
      for minimal interference in childbirth the most acceptable management of post
      term pregnancy seems to be increased fetal surveillance. Each case needs to be
      considered individually and it is important that the woman is involved in the
      decision to induce.

PMID- 8490379
TI  - Acute haemolysis induced by high dose ascorbic acid in glucose-6-phosphate
      dehydrogenase deficiency.

PMID- 8490380
TI  - ABC of sleep disorders. "I don't get enough sleep, doctor".

PMID- 8490381
TI  - Long term care on the NHS: a vanishing prospect.

PMID- 8490382
TI  - Mental health services--the user's view.
AB  - The needs of people with serious mental illnesses have dominated much of the
      debate on reforming community care. In this article Peter Campbell, who has used
      mental health services many times in the past, explains how the reforms could
      affect people like him. He welcomes the thinking behind the changes, particularly
      the idea that people who use community care should take part in planning
      services, but he warns that implementing the new philosophy might prove very
      difficult. Mr Campbell is secretary of a voluntary organisation for users of
      mental health services called Survivors Speak Out. The views he expresses here
      are his own, and do not necessarily reflect those of Survivors Speak Out.

PMID- 8490383
TI  - Racial discrimination against doctors.

PMID- 8490384
TI  - Racial discrimination against doctors.

PMID- 8490385
TI  - Death rate from asthma.

PMID- 8490386
TI  - Death rate from asthma.

PMID- 8490387
TI  - Screening for prostatic cancer.

PMID- 8490388
TI  - Screening for prostatic cancer.

PMID- 8490389
TI  - Dangers of long waiting times.

PMID- 8490390
TI  - Screening for prostatic cancer.

PMID- 8490391
TI  - Reducing waiting lists requires more staff.

PMID- 8490392
TI  - Waiting time for first outpatient appointment.

PMID- 8490393
TI  - Preventing congenital abnormalities.

PMID- 8490394
TI  - Publicity and infants' sleeping position.

PMID- 8490395
TI  - Screening for diabetes during pregnancy.

PMID- 8490396
TI  - Mothers' consent to screening newborn babies for disease.

PMID- 8490397
TI  - Medical management of Duchenne muscular dystrophy.

PMID- 8490398
TI  - Working with adult survivors of child sexual abuse.

PMID- 8490399
TI  - Screening for hypertrophic cardiomyopathy.

PMID- 8490400
TI  - Community dermatology.

PMID- 8490401
TI  - Screening for hypertrophic cardiomyopathy.

PMID- 8490402
TI  - Community dermatology.

PMID- 8490403
TI  - Academic obstetrics and gynecology.

PMID- 8490404
TI  - Continuing education needed for forensic medical examiners.

PMID- 8490405
TI  - Male obstetricians and their patients.

PMID- 8490406
TI  - Commissioning specialist services.

PMID- 8490407
TI  - An old problem solved in child care.

PMID- 8490408
TI  - Dural puncture and headache.

PMID- 8490409
TI  - Managing miscarriage medically.

PMID- 8490410
TI  - Accidental dural puncture in obstetric patients and long term symptoms.
AB  - OBJECTIVE: To examine the association between accidental dural puncture and long
      term headache and related symptoms. DESIGN: Postal questionnaire survey to
      elucidate new symptoms occurring after childbirth, and linking of these to data
      in obstetric and anaesthetic case notes. Women were surveyed between 13 months
      and nine years after delivery. SETTING: Birmingham Maternity Hospital. SUBJECTS:
      4700 women who had delivered their most recent baby under epidural anaesthesia,
      74 of whom had suffered an accidental dural puncture. MAIN OUTCOME MEASURES:
      Frequencies of new headache or migraine or neck ache starting within three months
      after childbirth and lasting over six weeks. RESULTS: Among the 74 women who had
      had an accidental dural puncture there were 17 (23%) who reported one or more of
      the above symptoms. By comparison, among those who had had an epidural
      anaesthetic but no recorded puncture, only 329 (7.1%) reported these symptoms.
      The duration of the headache or migraine or neck ache in the dural tap group
      ranged from nine weeks to over eight years. Ten of these women reported still
      unresolved symptoms. CONCLUSIONS: Conclusions on causality were tentative. Most
      women would remember a dural tap, and this might influence their reporting of
      subsequent symptoms attributable to the event. In addition, detailed
      characterisation of the symptoms was not available. Nevertheless, the findings
      provide a clear indication of the need for further study of the possible long
      term sequelae of accidental dural puncture.

PMID- 8490411
TI  - Factors affecting quality of informed consent.
AB  - OBJECTIVE: To examine the factors influencing quality of informed consent.
      DESIGN: Prospective study comprising interviews with patients and patients'
      completing standard questionnaires. SETTING: Academic surgical unit of large
      teaching hospital. PATIENTS: 265 patients undergoing intrathoracic,
      intraperitoneal, and vascular surgical procedures. Of these patients, 192 have
      been followed up for six months. MAIN OUTCOME MEASURES: Patients' recall of
      information at various points in the study; this score was compared by age,
      provision of written information, cognitive function, intelligence quotient (IQ),
      mood state and personality traits, and health locus of control. RESULTS: The
      patients were best informed immediately after signing the consent form and from
      then on recall of information deteriorated. A total of 172/250 (69%) patients
      admitted to not reading the consent form before signing it. Old age adversely
      affected recall of information at all assessment points. Impaired cognitive
      function reduced information recall only during the stay in hospital. Patients
      with above average IQs handled information better than those with a lower IQ
      except immediately after the signing of consent forms. Patients with an internal
      locus of health control (that is, those who believed their health to be in their
      own control) were better informed than those with an external locus of health
      control. Operation information cards improved recall only on the day of
      discharge. CONCLUSION: Elderly patients and patients with below average IQ,
      impaired cognitive functions, and an external locus of control have poor
      information recall. Written information may be more useful if given before
      admission to hospital.

PMID- 8490412
TI  - Prolonged infection with hepatitis B virus and association between low blood
      cholesterol concentration and liver cancer.
AB  - OBJECTIVE: To determine whether prolonged infection with hepatitis B virus is
      associated with a lower blood cholesterol concentration. DESIGN: Cross sectional
      study. SETTING: 81 villages in rural China with a high prevalence of chronic
      infection with hepatitis B virus. SUBJECTS: 1556 apparently healthy men aged 35
      64 years, randomly selected. MAIN OUTCOME MEASURES: Hepatitis B virus carrier
      state; plasma concentrations of cholesterol, apolipoprotein B, and apolipoprotein
      A I. RESULTS: 238 (15%) of the men were positive for hepatitis B surface antigen,
      indicating that they were chronic carriers. Plasma concentration of cholesterol
      was 4.2% (0.11 mmol/l) lower among carriers (that is, positive for hepatitis B
      surface antigen) than among non-carriers (95% confidence interval 0.6% to 8.0%
      (0.01 to 0.21 mmol/l), p < 0.05), and apolipoprotein B concentration was 7.0%
      (0.036 g/l) lower (2.8% to 11.2% (0.014 to 0.058 g/l), p < 0.001). In contrast,
      no association was observed between plasma concentrations of cholesterol or
      apolipoprotein and hepatitis B that had been eradicated (that is, patient
      positive for hepatitis B core antibody but negative for hepatitis B surface
      antigen). CONCLUSIONS: Chronic hepatitis B virus infection, which usually starts
      in early childhood in China, seems to lead not only to a greatly increased risk
      of death from liver disease but also to a somewhat lower cholesterol
      concentration in adulthood. This common cause produces an inverse association
      between cholesterol concentration and risk of death from liver cancer or from
      other chronic liver diseases.

PMID- 8490413
TI  - Medical management of miscarriage: non-surgical uterine evacuation of incomplete
      and inevitable spontaneous abortion.

PMID- 8490414
TI  - Severity of inflammation of tympanic membrane as predictor of clinical course of
      recurrent acute otitis media.

PMID- 8490415
TI  - Benylin (dextromethorphan) abuse and mania.

PMID- 8490416
TI  - Hypercalcaemia associated with calcipotriol (Dovonex) treatment.

PMID- 8490417
TI  - Interstitial pneumonitis and interferon-alfa.

PMID- 8490418
TI  - Low back pain associated with anistreplase.

PMID- 8490419
TI  - Developing a register of randomised controlled trials in primary care.
AB  - OBJECTIVE: To determine the number, nature, site of publication, and feasibility
      of identifying randomised controlled trials relevant to primary care. DESIGN:
      Review of literature using three strategies: approaching journal editors, Medline
      search, and manual search of individual journals. SETTING: Journals containing
      publications of studies based in primary care. MAIN OUTCOME MEASURES: The number,
      site of publication, and subject of trials identified. RESULTS: No journal had a
      system which enabled identification of all the randomised controlled trials it
      published. 266 trials relevant to primary care were identified from 110 different
      journals during 1987-91 by Medline. Of these, only 62 trials were published in
      primary care journals. Hand searching of seven major primary care research
      journals showed that between 13% and 38% of the trials had been missed by the
      Medline search. Of the trials identified, 47 (18%) were concerned with mental
      disease (including neuroses, tobacco misuse and alcohol misuse) and 43 (16%) were
      concerned with hypertension. CONCLUSION: Given the diversity of publication
      sources and topics, this supports the need for a centrally based register of
      randomised controlled trials that may be relevant to primary care overviews in
      the future.

PMID- 8490420
TI  - Personalia and the current health crisis.
AB  - Recent changes in the Russian government introduced by Boris Yeltsin include the
      appointment of Eduard Nechaev as health minister at the beginning of this year.
      The appointment received little publicity in the West, although his predecessor
      was sacked after only one year for failing to make any effort to improve health
      care. The challenges facing the new minister are enormous. Not only does he have
      to introduce a new medical insurance system but he has to tackle the problems of
      falling population, rising childhood illness linked to poor diet, and the spread
      of polio and diphtheria. It remains to be seen whether his experience in the
      military medical service has equipped him for the job.

PMID- 8490421
TI  - Lessons from Lithuania: rethinking public health training.
AB  - Lithuania faces stark problems that are familiar to most countries in the former
      Soviet Union: high morbidity and mortality rates, pollution, an unstable economy,
      and rapid changes in the financing and organisation of health care. In this
      environment Moore and Dixon visited Kaunas Medical Academy to help identify how
      training in public health medicine could contribute towards improving the health
      of the population. Although over 200 hours are devoted to public health training
      for medical undergraduates, teaching is unfocused, fragmented, and includes
      little epidemiology--the core subject for public health physicians. Teaching is
      mainly through long lectures with few group discussions. Student participation
      and motivation are low. As well as recommending redesign of the curriculum, Moore
      and Dixon suggested training in teaching methods for teachers. They also
      suggested that postgraduate training in public health should begin and should be
      targeted at hospital managers, teaching staff, and existing public health
      physicians.

PMID- 8490422
TI  - Advice to a Moscow children's hospital.
AB  - At the request of the largest children's hospital in Moscow, McKenzie and
      colleagues made recommendations for improving the service. Restrictions on
      visiting and fears of contracting illness from non-disposable needles have
      discouraged the local population from using the hospital. Consequently the
      hospital is underused and overstaffed. Serious shortages of drugs and surgical
      supplies compromise care. Fundamental changes are needed in nursing and
      postgraduate education. The authors encouraged their Russian colleagues to
      address the health care needs of their local population and to develop family
      centred care, and they offered training in London.

PMID- 8490423
TI  - Headache after dural puncture.

PMID- 8490424
TI  - Old people's homes: the relatives' view.
AB  - On 1 April new arrangements came into force for arranging and funding residential
      care for elderly people in Britain. From now on those who seem to need full time
      care will be assessed first by care managers employed by local authority social
      services departments. This may lead to admission to an old people's home or a
      nursing home. Local authorities have been told to consult both users and carers
      about such decisions. But what about relatives who have not actually been giving
      care directly? The Relatives Association was set up last year as a voluntary
      organisation for the relatives and friends of older people living in residential
      homes. Below, its vice president, Mavis Nicholson, a journalist and broadcaster
      whose mother died of Alzheimer's disease in a residential home last year, gives
      her personal view of being such a relative. And Dorothy White, the association's
      founder, explains what the future may hold for elderly residents and their
      relatives.

PMID- 8490425
TI  - ABC of sleep disorders. Parasomnias.

PMID- 8490426
TI  - ACE inhibitors after myocardial infarction.

PMID- 8490427
TI  - ACE inhibitors after myocardial infarction.

PMID- 8490428
TI  - Cardiovascular disease in developing countries.

PMID- 8490429
TI  - Informed consent.

PMID- 8490430
TI  - Informed consent.

PMID- 8490431
TI  - Informed consent.

PMID- 8490432
TI  - Informed consent.

PMID- 8490433
TI  - Informed consent.

PMID- 8490434
TI  - Informed consent.

PMID- 8490435
TI  - Consent for surgery for psychiatric patients.

PMID- 8490436
TI  - Population mixing and excess of childhood leukemia.

PMID- 8490437
TI  - Epidemiology of endometriosis.

PMID- 8490438
TI  - Epidemiology of endometriosis.

PMID- 8490439
TI  - Increasing patients' knowledge of secondary contraception.

PMID- 8490440
TI  - Re-emergence of tuberculosis.

PMID- 8490441
TI  - Re-emergence of tuberculosis.

PMID- 8490442
TI  - Re-emergence of tuberculosis.

PMID- 8490443
TI  - HIV and AIDS in health care workers.

PMID- 8490444
TI  - HIV and AIDS in health care workers.

PMID- 8490445
TI  - The thrifty genotype and non-insulin dependent diabetes.

PMID- 8490446
TI  - The thrifty genotype and non-insulin dependent diabetes.

PMID- 8490447
TI  - Persistent vegetative state.

PMID- 8490448
TI  - The thrifty genotype and non-insulin dependent diabetes.

PMID- 8490449
TI  - Waiting for plastic surgery.

PMID- 8490450
TI  - Waiting for plastic surgery.

PMID- 8490451
TI  - Tomlinson and the BMA.

PMID- 8490452
TI  - Diabetic patients' eyes must be examined.

PMID- 8490453
TI  - Listening to patients.

PMID- 8490454
TI  - Listening to patients.

PMID- 8490455
TI  - Drug smuggler's delirium.

PMID- 8490456
TI  - Drug smuggler's delirium.

PMID- 8490457
TI  - Measuring the outcome of perinatal care.

PMID- 8490458
TI  - Fundholding.

PMID- 8490459
TI  - Treating bed wetting.

PMID- 8490460
TI  - NHS rationing.

PMID- 8490461
TI  - Use of Indian ethnic remedies.

PMID- 8490462
TI  - Productivity in clinical medicine.

PMID- 8490463
TI  - Mitral valve prolapse.

PMID- 8490464
TI  - What social workers need.

PMID- 8490465
TI  - 1966 revisited: bright new contract or brave old world?

PMID- 8490466
TI  - Where are we now with vaccines against AIDS?

PMID- 8490467
TI  - HIV is active even in latency, say scientists.

PMID- 8490468
TI  - Doubt cast on zidovudine's use in delaying AIDS.

PMID- 8490469
TI  - Cerebral herniation during bacterial meningitis in children.
AB  - OBJECTIVE: To see whether the incidence of cerebral herniation is increased
      immediately after lumbar puncture in children with bacterial meningitis and
      whether any children with herniation have normal results on cranial computed
      tomography. DESIGN: Retrospective review of case notes; computed tomograms were
      read again. SETTING: Large paediatric teaching hospital. SUBJECTS: 445 children
      over 30 days old admitted to hospital with bacterial meningitis. MAIN OUTCOME
      MEASURES: Timing of herniation in relation to lumbar puncture; findings on
      computed tomography in children with herniation. RESULTS: Cerebral herniation was
      detected in 19 (4.3%) of the 445 children (21 episodes; herniation occurred twice
      in two children). Herniation occurred in 14 (45%) of the 31 children who died.
      Nineteen episodes of herniation occurred in the 17 children who had a lumbar
      puncture; 12 of the episodes occurred in the first 12 hours after the lumbar
      puncture and seven over six other 12 hour periods (odds ratio 32.6 (95%
      confidence interval 8.5 to 117.3); p < 0.001). The results of cranial computed
      tomography were normal in five (36%) of the 14 episodes of herniation in which
      scanning was performed at about the time of herniation. CONCLUSIONS: The temporal
      relation between lumbar puncture and herniation strongly suggests that a lumbar
      puncture may cause herniation in some patients, and normal results on computed
      tomography do not mean that it is safe to do a lumbar puncture in a child with
      bacterial meningitis.

PMID- 8490470
TI  - Oral contraception and risk of a cerebral thromboembolic attack: results of a
      case-control study.
AB  - OBJECTIVE: To assess the risk of cerebral thromboembolism in women using low dose
      oral contraceptives. DESIGN: A retrospective case-control study. SETTING: All
      Danish medical, neurological, neurosurgical, and gynaecological departments.
      SUBJECTS: All 794 women in Denmark aged 15-44 who had suffered a cerebral
      thromboembolic attack during 1985-9 and 1588 age matched randomly selected
      controls. RESULTS: Of 692/1584 case/control questionnaires sent out, 590/1396
      (85.3%/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a
      revised or unreliable diagnosis, 40 had had thromboembolic disease previously, 13
      were pregnant, and 152 had a disease predisposing to a cerebral thromboembolic
      attack. Of the 323 cases without a known predisposition, 320 reported use or non
      use of oral contraception. Among the 1396 controls, eight refused to participate,
      were mentally retarded, or lived abroad; 18 returned an uncompleted
      questionnaire; 17 had had thromboembolic disease previously; 31 were pregnant;
      and 130 had a disease predisposing to a cerebral thromboembolic attack. Thus 1198
      non-predisposed controls were available, among whom 1197 reported use or non-use
      of oral contraception. Among the 320 cases, 116 (36.3%) were oral contraceptive
      users at the time of the cerebral thromboembolic attack. By comparison there were
      191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0.
      After multivariate analysis, including confounder control for age, smoking, years
      of schooling, and trend in use of different types of oral contraceptives during
      1985-90, pills containing 50 micrograms oestrogen were associated with an odds
      ratio for cerebral thromboembolic attack of 2.9 (95% confidence interval 1.6 to
      5.4), those containing 30-40 micrograms oestrogen an odds ratio of 1.8 (1.1 to
      2.9), those containing progestogen only an odds ratio of 0.9 (0.4 to 2.4). The
      odds ratio did not change with increasing age or with duration of oral
      contraceptive use. A 50% increased risk of a cerebral thromboembolic attacks
      among cigarette smokers (after confounder control) was independent of oral
      contraception status and age. CONCLUSION: Low dose oral contraceptives are
      associated with an increased risk of cerebral thromboembolic attack. Combined or
      sequential pills containing 30-40 micrograms oestrogen are associated with a one
      third reduced risk compared with preparations containing 50 micrograms oestrogen.
      Progestogen only pills did not increase the risk of a cerebral thromboembolic
      attack.

PMID- 8490471
TI  - Effect of stress management on blood pressure in mild primary hypertension.
AB  - OBJECTIVE: To establish whether stress management had a larger effect than a
      control treatment on resting blood pressure, ambulatory blood pressure, and left
      ventricular mass. DESIGN: A 12 week baseline period of habituation to measurement
      of blood pressure was followed by randomisation to either stress management or
      mild exercise for six months and follow up six months later. SETTING: General
      practice, district general hospital, and medical school. PATIENTS: Of the 184
      patients aged under 60 with mild primary hypertension who entered the baseline
      habituation period, 88 were excluded because they failed to meet the entry
      criteria or they withdrew from the study. The remaining 46 men and 50 women
      underwent treatment. INTERVENTIONS: 10 clinical sessions and daily practice at
      home of either stress management based on relaxation or non-aerobic stretching
      exercises. Mildly stressful 15 minute interviews before and after treatment. MAIN
      OUTCOME MEASURES: Diastolic and systolic blood pressure in the clinic and during
      12 hours of ambulatory recording, and left ventricular mass measured by
      echocardiography. RESULTS: The patients' blood pressure fell during habituation
      (systolic pressure from 152 mmHg to 140 mmHg, diastolic pressure from 98 to 93 mm
      Hg), but neither resting nor ambulatory blood pressure was changed by the
      treatments. Left ventricular mass was also unchanged. Blood pressure rose during
      the stressful interview, but this rise was reduced by stress management (systolic
      pressure rose by 7.4 mmHg before treatment and by 3.7 mmHg after treatment).
      CONCLUSION: Stress management of a type advocated for treating mild primary
      hypertension is ineffective in lowering blood pressure in patients who are well
      habituated to measuring blood pressure.

PMID- 8490472
TI  - Rationale for stopping cervical screening in women over 50.
AB  - OBJECTIVE: To investigate whether the currently recommended age at which to stop
      cervical screening (64) can be lowered and what criteria should be used for
      safely doing so. DESIGN: Retrospective case analysis study. SETTING: Dundee and
      Angus districts of Scotland. SUBJECTS: Women diagnosed as having cervical
      intraepithelial neoplasia and microinvasive or invasive cancer of the cervix in
      1989 and 1990 (798 cases). MAIN OUTCOME MEASURE: History of cervical cytology
      results according to age (age groups of five years) and screening interval (three
      years and five years). RESULTS: Cervical intraepithelial neoplasia was most
      common in women under 45 (711 cases in women of 45 and under v 38 cases in those
      of 46 and over). Cervical intraepithelial neoplasia occurring de novo was not
      seen in women over 50 who had been screened every three years. Microinvasive or
      invasive cancer of the cervix was diagnosed in 26 women over 50. None of these
      women had participated adequately in the cervical screening programme.
      CONCLUSION: Cervical intraepithelial neoplasia typically occurs in younger women.
      All women over 50 with an adequate history of negative results on smear testing
      every three years may be safely discharged from further screening if these
      findings are confirmed in other populations.

PMID- 8490473
TI  - Antibody persistence after accelerated immunisation against Haemophilus
      influenzae type b.

PMID- 8490474
TI  - Clinical coding: completeness and accuracy when doctors take it on.

PMID- 8490475
TI  - A new skin lesion associated with intravenous streptokinase.

PMID- 8490476
TI  - Acute renal failure during interferon treatment.

PMID- 8490477
TI  - Hypersensitivity vasculitis related to nicoumalone.

PMID- 8490478
TI  - Immunisation against influenza among people aged over 65 living at home in
      Leicestershire during winter 1991-2.
AB  - OBJECTIVES: To assess the size of the elderly population for whom influenza
      vaccine is indicated and how many are vaccinated. DESIGN: Cohort questionnaire
      study. SETTING: Leicestershire general practices. SUBJECTS: 800 elderly subjects
      selected a random from the Leicestershire family health services authority list
      who were not living in residential care, 565 of whom returned a questionnaire.
      MAIN OUTCOME MEASURES: Patient profile, vaccine offers, vaccination status, and
      reasons for not accepting vaccine. RESULTS: 170 of 334 (51%) people aged 65-74
      years and 106 of 205 (52%) aged > or = 75 years had one or more medical
      indications for influenza vaccine. 195 people were offered vaccine, 49 of whom
      had no risk factor. 152 offers were made opportunistically during visits to the
      practice and only six were made in writing or by telephone. Overall 113 of 266
      patients with known medical indications were immunised. Vaccine was accepted by
      148 of 189 (78%) offered it, and, as judged by acceptance in sequential years,
      influenza vaccine was well tolerated. The main reasons for not being vaccinated
      were misconception about risk status and inadequate advice from doctors.
      CONCLUSIONS: The prevalence of medical indications for vaccine is not large
      enough to justify a policy of universal immunisation. Most patients offered
      vaccine accept it and tolerate it well. Improved targeting and education is
      needed to increase immunisation of people at risk.

PMID- 8490479
TI  - The Royal College of General Practitioners revisited.

PMID- 8490480
TI  - Is London overbedded?
AB  - OBJECTIVE: To examine whether there are too many hospital beds in London. DESIGN:
      Analysis of data from the Hospital In-Patient Enquiry, Mental Health Enquiry,
      health service indicators, and Emergency Bed Service. SETTING: England, London,
      and inner London. RESULTS: Hospital admission rates for acute plus geriatric
      services for London residents were very similar to the national values in all age
      groups. In the special case considered in the Tomlinson report--acute services in
      inner London--the admission rate was 22% above the value for England. However,
      the admission rate of inner deprived Londoners was 9% below that of comparable
      areas outside London. For psychiatry, admission rates in London roughly equalled
      those in comparable areas. When special health authorities were excluded, in 1990
      1 there were 4% more acute plus geriatric beds available per resident in London
      than in England. Bed provision has been reduced more rapidly in London than
      nationally. Extrapolating the trend of bed closures forward indicates that beds
      (all and acute) per resident in London are now at about the national average.
      Data from the Emergency Bed Service indicate that the pressure on available
      hospital beds in London has been increasing since 1985. CONCLUSIONS: Data
      regarding bed provision and utilisation for all specialties by London residents
      do not provide a case for reducing the total hospital bed stock in London at a
      rate faster than elsewhere. Bed closures should take account of London's
      relatively poorer social and primary health care circumstances, longer hospital
      waiting lists, poorer provision of residential homes, and evidence from the
      Emergency Bed Service of increasing pressure on beds. Higher average costs in
      London, some unavoidable, are forcing hospital beds to be closed at a faster rate
      in London than nationally.

PMID- 8490481
TI  - Management guidelines in essential hypertension: report of the second working
      party of the British Hypertension Society.
AB  - Several important new issues have arisen in the management of patients with
      hypertension. A working party of the British Hypertension Society has therefore
      reviewed available intervention studies on anti-hypertensive treatment and made
      recommendations on blood pressure thresholds for intervention, on non
      pharmacological and pharmacological treatments, and on treatment goals. This
      report also provides guidelines on blood pressure measurement, essential
      investigations, referrals for specialist advice, follow up, and stopping
      treatment.

PMID- 8490482
TI  - Is the money following the clients with learning disabilities?
AB  - For the past decade patients with learning disabilities living in long stay
      mental handicap hospitals have been resettled in the community. Local authorities
      have also taken on the care of new patients who would once have been long stay
      residents. The imperfect data that are available suggest that in England about
      half the residents in mental handicap hospitals in 1981 are now the
      responsibility of local authorities; the figures for Wales and Northern Ireland
      are 38% and 33%. Data on revenue suggest that the savings to the health service
      are much less--perhaps 9% in Northern Ireland and 3.6% in England, although there
      have also been capital gains through the sale of hospitals. Existing methods of
      transferring money from health to local authorities--joint finance and "dowries"
      for individual patients--do not seem adequately to have compensated local
      authorities. Moreover, as patients still to be transferred are more severely
      disabled local authorities will require larger sums--about 26 000 pounds per
      patient per year plus 39 200 pounds in capital. If the government chooses not to
      transfer these resources from health authorities it will be switching funds away
      from learning disabled people to other care groups.

PMID- 8490483
TI  - Helping disabled people--the user's view.
AB  - The main needs for most people with physical disabilities are housing and help
      with daily living. Thus, many of them will find the new emphasis on social
      aspects of community care particularly relevant. Peter Swain is a disabled man
      who leads a project in east Devon which ensures that disabled people have a voice
      in helping to shape the services they need. In this article he explains how the
      project, Living Options East Devon, works and how the new legislation for
      community care might affect disabled people.

PMID- 8490484
TI  - ABC of sleep disorder. Dreams and medical illness.

PMID- 8490485
TI  - Contamination of urine and faecal specimens.

PMID- 8490486
TI  - Treating hypoglycaemia in general practice.

PMID- 8490487
TI  - Treating hypoglycaemia in general practice.

PMID- 8490488
TI  - Tobacco and health education.

PMID- 8490489
TI  - Sudden infant death syndrome.

PMID- 8490490
TI  - Revised guidelines for HIV infected health care workers.

PMID- 8490491
TI  - Improving the management of superficial bladder cancer.

PMID- 8490492
TI  - What's happening to health care in Germany?

PMID- 8490493
TI  - Reporting deaths to coroners.

PMID- 8490495
TI  - Eastern Europe hopes to prevent AIDS epidemic.

PMID- 8490494
TI  - Revised guidelines for HIV infected health workers.

PMID- 8490496
TI  - Screening for early familial ovarian cancer with transvaginal ultrasonography and
      colour blood flow imaging.
AB  - OBJECTIVE: To assess the value of transvaginal ultrasonography with colour blood
      flow imaging in detecting early ovarian cancer in women with a family history of
      the disease. DESIGN: Study of self referred symptomless women with a close
      relative who had developed the disease. Each woman was screened to detect
      persistent lesions and defined changes in ovarian volume. Morphological score and
      pulsatility index were recorded. SETTING: Ovarian screening clinic. SUBJECTS:
      1601 self referred women. INTERVENTIONS: Women with a positive screening result
      were recommended to have further investigations. MAIN OUTCOME MEASURES: Findings
      at surgery and histology of abnormal ovaries. Morphological score > or = 5 and
      pulsatility index < 1.0 at last scan. RESULTS: Women were aged 17 to 79 (mean 47)
      years; 959 (60%) were premenopausal, 469 (29%) were naturally postmenopausal, and
      173 (11%) had had a hysterectomy. 157 women had a pedigree suggestive of the site
      specific ovarian cancer syndrome and 288 of multiple site cancers. 61 women had a
      positive screening result (3.8%, 95% confidence interval 2.9 to 4.9%), six of
      whom had primary ovarian cancer detected at surgery (five stage Ia, one stage
      III). Use of a high morphological score or a low pulsatility index increased the
      odds of finding ovarian cancer from 1:9 to about 2:5 (1:1 in the highest risk
      groups). Five interval cancers were reported (three ovarian and two peritoneal).
      Eight of the 11 cancers developed in women with pedigrees suggestive of inherited
      cancer. CONCLUSIONS: Transvaginal ultrasonography with colour flow imaging can
      effectively detect early ovarian cancer in women with a family history of the
      disease. The screening interval should be less than two years.

PMID- 8490498
TI  - Clinicians and the coronial system: ability of clinicians to recognise reportable
      deaths.
AB  - OBJECTIVE: To assess the ability of clinicians to recognise deaths which require
      referral to the coroner. DESIGN: Postal questionnaire consisting of 16 fictitious
      case histories, 14 of which contained a clear indication for referral to the
      coroner. SETTING: Large teaching hospital. Coroner's office. SUBJECTS: 200
      clinicians from general medical and surgical firms and senior staff of the local
      coroner's office (two coroner's officers and the two deputy coroners). MAIN
      OUTCOME MEASURES: Number of correct assessments on questionnaire. RESULTS: The
      mean recognition score for the clinicians was 9.11 (range 3-14) with no
      difference between the clinical grades. All of the coroner's senior staff
      recorded maximum recognition scores of 16. CONCLUSIONS: The study highlights
      several features of the coronial system which are poorly understood by clinicians
      and provides the basis for an initiative to improve the medicolegal education of
      all clinicians.

PMID- 8490497
TI  - Prevalence screening for ovarian cancer in postmenopausal women by CA 125
      measurement and ultrasonography.
AB  - OBJECTIVE: To assess the performance of the sequential combination of serum CA
      125 measurement and ultrasonography in screening for ovarian cancer. DESIGN: The
      serum CA 125 concentration of each subject was determined and those with a
      concentration > or = 30 U/ml were recalled for abdominal ultrasonography. If
      ultrasonography gave abnormal results surgical investigation was arranged.
      Volunteers were followed up by annual postal questionnaire. SETTING: General
      practice, occupational health departments, ovarian cancer screening clinic.
      SUBJECTS: 22,000 women volunteers who were postmenopausal and aged over 45 years.
      MAIN OUTCOME MEASURES: Apparent sensitivity, specificity, positive predictive
      value, years of cancer detected. RESULTS: 41 women had a positive screening
      result and were investigated surgically. 11 had ovarian cancer (true positive
      result) and 30 had other disorders or no abnormality (false positive result). Of
      the 21,959 volunteers with a negative screening result, eight subsequently
      presented clinically with ovarian cancer (false negative result) and 21,951 had
      not developed ovarian cancer during follow up (apparent true negative result).
      The screening protocol achieved a specificity of 99.9%, a positive predictive
      value of 26.8%, and an apparent sensitivity of 78.6% and 57.9% at one year and
      two year follow up respectively. The estimated number of years of cancer detected
      by the prevalence screen was 1.4 years. CONCLUSIONS: This screening protocol is
      highly specific for ovarian cancer and can detect a substantial proportion of
      cases at a preclinical stage. Further investigation is required to determine the
      effect of the screening protocol on the ratio of early to late stage disease
      detected and on mortality from ovarian cancer.

PMID- 8490499
TI  - Pre-employment chest radiography for health service staff: who needs it?

PMID- 8490500
TI  - Litter and medical waste on bathing beaches in England and Wales.

PMID- 8490501
TI  - An instrument for assessment of videotapes of general practitioners' performance.
AB  - OBJECTIVES: To identify those important characteristics of doctors' and patients'
      behaviour that distinguish between "good" and "bad" consultations when viewed on
      videotape; to use these characteristics to develop a reliable instrument for
      assessing general practitioners' performance in their own consultations. DESIGN:
      Questionnaires completed by patients, general practitioner trainers, and general
      practitioner trainees. Reliability of draft instrument tested by general
      practitioner trainers. SETTING: All vocational training schemes for general
      practice in the Northern region of England. SUBJECTS: First stage: 76 patients in
      seven groups, 108 general practice trainers in 12 groups, and 122 general
      practice trainees in 10 groups. Second stage: 85 general practice trainers in 12
      groups. MAIN OUTCOME MEASURES: Trainers' ratings of importance; alpha
      coefficients of draft instrument by trainee, group, and consultation. RESULTS:
      6890 characteristics of good and bad consultations were consolidated into a draft
      assessment instrument consisting of 46 pairs of definitions separated by six
      point bipolar scales. Nine statement pairs given low importance ratings by
      trainers were eliminated, reducing the instrument to 37 statement pairs. To test
      reliability, general practitioner trainers used the instrument to assess three
      consultations. With the exception of one group of trainers, all alpha
      coefficients exceeded the acceptable level of 0.80. CONCLUSION: The instrument
      produced is reliable for assessing general practitioners' performance in their
      own consultations.

PMID- 8490502
TI  - Refusing to treat smokers is unethical and a dangerous precedent.

PMID- 8490503
TI  - Should smokers be offered coronary bypass surgery? Human frailty should not be
      penalised.

PMID- 8490504
TI  - Should smokers be offered coronary bypass surgery? Let the health authority take
      the responsibility.

PMID- 8490505
TI  - British National Formulary: its birth, death, and rebirth.
AB  - The British National Formulary is a direct descendant of the National War
      Formulary, in which the titles of the preparations were in Latin and the doses in
      minims and grains. The British National Formulary was born in 1948, did a good
      job for about 20 years, but sickened and died in 1976. It was reborn in 1981.
      Parturition was painful with a very hostile reception from the media and the drug
      industry, but it survived and has grown in stature. The 25th edition was
      published in February. Wish it well for the next 25 issues!

PMID- 8490506
TI  - Chronic liver disease due to hepatitis C.
AB  - The low concentration of hepatitis C virus in the blood of infected patients has
      made it difficult to detect. Infected patients can now be identified by using
      more sensitive immunoassays and amplification of viral RNA by the polymerase
      chain reaction. Nevertheless, the virus remains difficult to eliminate. We
      present the case of a woman with a history of autoimmune haemolytic anaemia,
      thrombocytopenia, and common variable immunodeficiency who developed chronic
      hepatitis.

PMID- 8490507
TI  - ABC of sleep disorders. The sleep apnoea/hypopnoea syndrome and snoring.

PMID- 8490508
TI  - Intraocular foreign body missed by radiography.

PMID- 8490509
TI  - Selective decontamination of the gut.

PMID- 8490510
TI  - Selective decontamination of the gut.

PMID- 8490511
TI  - Infertility linked to breast cancer.

PMID- 8490512
TI  - Prenatal diagnosis of late onset diseases.

PMID- 8490513
TI  - Clinical diagnosis of pyloric stenosis.

PMID- 8490514
TI  - Dose equivalence of drugs for asthma.

PMID- 8490515
TI  - Dose equivalence of drugs for asthma.

PMID- 8490516
TI  - Toxic shock syndrome after minor dermatological surgery.

PMID- 8490517
TI  - Night visiting in general practice.

PMID- 8490518
TI  - Methodology in health services research.

PMID- 8490519
TI  - Rate of asthmatic attacks.

PMID- 8490520
TI  - Communication between GPs and psychiatrists.

PMID- 8490521
TI  - Communication between GPs and psychiatrists.

PMID- 8490522
TI  - Search for primary cancer.

PMID- 8490523
TI  - Gulf war casualties revised.

PMID- 8490524
TI  - Interventional genetics and cancer treatment.

PMID- 8490525
TI  - Traumatic rupture of the diaphragm.

PMID- 8490526
TI  - Protecting the population in occupied areas of Croatia.

PMID- 8490527
TI  - Cost effectiveness league tables.

PMID- 8490528
TI  - National Blood Authority.

PMID- 8490529
TI  - Rational care needed, not rationing.

PMID- 8490530
TI  - The development of a physiological hip prosthesis: evaluation of the strains
      after implantation of a prototype of hip implant: experiment in a dry femur.
AB  - Based upon previous research on the relation between hip prosthesis designs and
      strain distributions in a proximal femur model, a prototype of a "physiological"
      hip prosthesis was designed and manufactured. Strain gauge measurements on a dry
      femur before and after implantation of this prosthesis were made in different
      loading conditions simulating one-legged stance with and without torsional
      loading and two-legged stance. The strains in the outer cortex were within 10% of
      the physiological values along the whole medial side in all measurement
      conditions.

PMID- 8490531
TI  - Energy absorption characteristics of football helmets under low and high rates of
      loading.
AB  - The purpose of this study was to examine the force-deformation characteristics of
      football helmets subjected to compressive loading on the crown surface. Tests
      were conducted at quasi-static and dynamic rates of loading. Energies were
      computed from the force-deformation data. The padding systems represented by the
      helmets differed in their ability to absorb energy under varying loading rates.
      Helmets using pneumatic or combination pneumatic-foam padding systems were the
      most successful while suspension helmets were able to absorb the least amount of
      energy. The evaluation of energy absorption characteristics is an alternative
      method of describing the effectiveness of football helmets in preventing head
      injury.

PMID- 8490532
TI  - Effect of exercise on strength and chemical composition of rat femur bone.
AB  - The effect of exercise on strength and chemical composition of rat femur bone was
      examined. Ten 5-week-old rats were forced to exercise on a treadmill with a
      running speed of 20 m/min at set time intervals for a 4-week period. Another 10
      rats were kept idle as controls. After exercising, bending tests of the rat femur
      bones were carried out, and the content ratios of Sr to Ca, Sr/Ca, were measured
      by energy-dispersive fluorescent X-ray analysis and EPMA line analysis. The
      strength of the exercise group was greater than that of the control group. The
      ratio, Sr/Ca, of the exercise group showed a tendency to increase compared to
      that of the control group. It is clear that the chemical composition of bone
      varies with the degree of exercise, and that the bone becomes strengthened at the
      same time.